BACKGROUND:Traditional scoliosis orthosis has some disadvantages,such as complex manufacturing process,long processing cycle,poor fit and so on.Three-dimensional printed scoliosis orthosis has the advantages of high manufacturing precision and personalization. OBJECTIVE:To evaluate the efficacy of three-dimensional printed scoliosis orthosis for scoliosis based on multi-criteria decision model. METHODS:Clinical data of 72 patients with scoliosis admitted to Chen Xinghai Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to October 2022 were retrospectively collected and divided into two groups according to the treatment of orthosis.Study group(n=23)received three-dimensional printed scoliosis orthosis.Traditional group(n=49)received the traditional polypropylene spine brace treatment.The clinical efficacy and complications were compared between the two groups.A multi-criteria decision model for the treatment of scoliosis with three-dimensional printed scoliosis orthosis was established,and the stability of the benefit value,risk value and decision model of the two groups were evaluated. RESULTS AND CONCLUSION:(1)Compared with the traditional group,there were significant differences in the top vertebral offset distance,Cobb angle,top vertebral rotation,Functional Movement Screen score,visual analog scale score and total effective rate in the study group at 6 months after surgery(P<0.05).(2)Among the benefit indexes,Cobb angle had the greatest impact on the condition of patients,while the risk indexes had the greatest impact on dyspnea.(3)The benefit values of the study group and the traditional group for scoliosis were 79 and 64,and the risk values were 74 and 57,respectively.The combined benefit and risk values found that the benefit-risk value of the study group was 16 higher than that of the traditional group.(4)In the range of 0-100%relative risk weight,the benefit-risk value of the study group was always higher than that of the traditional group,which proved that the multi-criteria decision-making model had good stability.(5)It is indicated that three-dimensional printed scoliosis orthosis can better restore the physiological curvature of scoliosis and improve the efficiency of treatment.

【Objective】 To study the correlation between platelet transfusion efficacy and KIR receptor-HLA ligand. 【Methods】 Thirty-three leukemia patients with positive HLA antibody were tested for cross-matching with donor platelets. Platelets from suitable donors were selected for transfusion, and the 24-hour platelet corrected count increment (CCI) was used to determine the transfusion effect. KIR and ligand genotyping were performed on blood samples from patients and donors by PCR-SSP method, and the relationship between platelet transfusion effects and KIR receptor-HLA ligand was analyzed. 【Results】 In 74 occasions of platelet transfusion, 42 were ineffective and 32 were effective. When the donor had C2 gene and HLA-B Bw4-80T gene, the frequency of ineffective platelet transfusion in the recipient was 69.0% (29/42) and 52.4% (22/35), respectively, which was significantly higher than that in the effective group [25.0% (8/32) and 25.0% (8/32)]. When the donor had C1 gene, and the frequency of effective platelet transfusion in the recipient was 100.0%(32/32), which was higher than that in the ineffective group [83.3%(35/42)]. When the recipient-donor matching mode was KIR2DL1-C2 and KIR3DL1-(HLA-B Bw4-80T), the frequency of ineffective platelet transfusion was 69.0%(29/42) and 40.5%(22/42),higher than that of the effective group [25% (8/32) and 18.8% (6/32)]. When the recipient-donor matching model was KIR2DL3-C1, the rate of effective platelet transfusion in 32 patients (100.0%), which was higher than that (35 patients 83. 3%) in the ineffective group. When the mismatch mode of recipient iKIR+donor HLA ligand receptor was KIR2DL1-C2, the frequency of effective platelet transfusion in the recipient was 78.1% (25/32), which was much higher than that in the ineffective group [31.0% (13/42)]. When the mismatch mode was KIR3DL1-(HLA-B Bw4-80T), the rate of effective platelet transfusion in the recipient was 68.8% (22/32), which was higher than that in the ineffective group (42.9%, 18/42). The difference between the above groups was statistically significant(P<0.05). 【Conclusion】 HLA-C1 and HLA-C2 genes are the key factors affecting the efficacy of platelet transfusion.For platelet refractorines, HLA-C1 is the protective gene, while HLA-C2 and HLA-B Bw4-80T are the susceptible genes. The recipient iKIR+donor HLA ligand receptor model may play an important role in platelet refractoriness.

Objective To summarize the experience of applying transradial sheathless technique in treat-ment of bifurcation coronary lesions. Methods The clinical data on 39 patients with bifurcation coronary lesions who received transradial PCI using sheathless guide catheter produced by ASAHI or self-made sheathless guide catheter were retrospectively analyzed. Passing ability of sheathless guide catheter, success rate and complications of PCI were observed.Results There were 10 patients with left main bifurcation lesions, 29 left anterior descend-ing branch and diagonal branch bifurcation lesions. 33 patients were treated using sheathless of 7.5 Fr and 6 were treated by self-made sheathless guide catheter.PCI achieved expected goal.No catheter placement related complica-tions, cardiovascular or cerebrovascular events were observed in 39 patients in their hospital stay. Conclusions Transradial sheathless technique can be applied in of coronary lesions. Sheathless of 7.5 Fr is easy to use and has perfect passing ability.Sheathless guide catheter is effective,safe and highly practicable.Both procedures are worth of clinical application.

Objective To discuss the clinical effects and the major adverse cardiac events of intracoronary prostaglandin E1 injection prior to percutaneous coronary intervention (PCI) in early(within 24h of symptom onset) interventional treatment for patients with acute non -ST segment elevation myocardial infarction ( NSTEMI ) . Methods 122 patients with NSTEMI who underwent early interventional treatment were divided into three groups according to the digital table:41 cases in prostaglandin E 1 group,41 cases in nitroglycerin group ,40 cases in control group.The TIMI blood flow was compared among the three groups after PCI .All patients were followed up during 6 months about major adverse cardiac events ( MACE) and the cardiac structure and function by echocardiography . Results After primary PCI,the corrected TIMI frame count(CTFC) was significantly better in the prostaglandin E 1 group[(20.22 ±6.82)] than in the nitroglycerin group[(26.35 ±8.71)] and the control group[(27.02 ±9.65), t=6.451,6.763,all P<0.05].The TIMI myocardial perfusion grade (TMP) was significantly better in the prosta-glandin E1 group(7.3％) than in the nitroglycerin group(26.8％) and the control group(30.0％)(P<0.05). There was no statistically significant difference between the nitroglycerin group and the control group (P>0.05).All patients were followed up for 6 months,the LVDd in the prostaglandin E1 group[(46.8 ±3.7)mm] was significantly lower than that in the nitroglycerin group[(49.5 ±5.8) mm] and the control group [(50.2 ±4.9) mm,t=6.312, 5.893,all P<0.05].The LVEF in the prostaglandin E1 group [(55.8 ±8.2)％] was significantly higher than that in the nitroglycerin group [(49.3 ±7.9)％] and the control group [(50.5 ±6.8)％,t=7.011,5.981,all P<0.05].The incidence rate of MACE in the prostaglandin E 1 group(4.9％) was significantly lower than that in the nitroglycerin group(12.2％) and control group(12.5％)(χ2 =5.834,5.719,all P<0.05).There was no statistically significant difference between the nitroglycerin group and the control group (P>0.05).Conclusion Intracoronary administration of prostaglandin E 1 injection prior to balloon dilation can significantly improve the myocardial microcir-culation perfusion,and can decrease MACE in patients with NSTEMI who underwent early interventional treatment .

Objective To study the effects of microemulsion/ethosomes on transdermal absorption properties and efficacy of Huoxue Zhitong Cataplasm. Methods The improved Franz diffusion cells were used for the in-vitro permeation experiment with rat skins as the barriers, which was used to evaluate the transdermal absorption properties. In the erxeriment, the contents of paeonol, eugenol and methyl salicylate were used as markers, and detected by ultra performance liquid chromatography to evaluate the transdermal absorption effects. The anti-inflammatory and analgesia activity were evaluated through the writhing plate experiments. Results The cumulative release rate of paeonol in Huoxue Zhitong Cataplasm, Microemulsion Huoxue Zhitong Cataplasm and Ethosomes Huoxue Zhitong Cataplasm were, in order, 65.30%, 61.30%and 60.20%in 24 h;eugenol were, in order, 51.08%, 54.71% and 55.66% in 24 h; methyl salicylate were, in order, 49.20%, 65.17% and 72.15% in 24 h. Furthermore, Microemulsion Huoxue Zhitong Cataplasm high-dose group and Ethosomes Huoxue Zhitong Cataplasm medium-dose group had good effects on reducing the inflammatory exudate of peritoneal capillary and capillary permeability (P<0.05) in animal models. Conclusion Huoxue Zhitong Cataplasm based on microemulsion/ethosomesnano-technology has good transdermal absorption properties and efficacy.

Objective To explore the value of hydronephrosis volume measured by 64 slice CT scan, evaluating renal function in patients with obstructive hydronephrosis.Methods The patients performed with both single photon emission computed tomography(SPECT) renal dynamic imaging and 64 slice CT scan in three days were chosen, 176 cases included finally.The images of renal dynamic imaging were divided into normal renal function group, mild renal impairment group, moderate renal impairment group and severe renal impairment group according to glomerular filtration rate (GFR) measured by SPECT.At the same time, CT three-dimensional reconstruction technique has been used to measure the volume of hydronephrosis, compare the differences of hydronephrosis volume among these groups, and future analyze the correlation of hydronephrosis volume with renal GFR value.Results The hydronephrosis volume of the four groups were respectively (31.47±3.81) cm3,(83.43±7.81) cm3,(208.53±15.47) cm3 and (577.31±61.32) cm3.There was statistical significance among these groups (P<0.01),except between normal renal function group and mild renal impairment group.The volume of hydronephrosis showed positive correlations with renal GFR (r=-0.614).Conclusion The volume of hydronephrosis measured by 64 slice CT has positive correlation with GFR measured by SPECT, which could reflect renal function to some extent.

Objective To explore the clinical efficacy of prostaglandin E1 injected by coronary or peripheral venous in early stage (within 24 h of symptom onset) in treating patients with acute non-ST segment elevation myocardial infarction (NSTEMI) by percutaneous coronary intervention (PCI) and its influence on major adverse cardiac events (MACE).Methods A total of 136 patients with NSTEMI underwent PCI within 24 h were divided into intracoronary injection group,peripheral vein injection group and control group.All the patients were followed up for 9 months,no reflow or slow blood flow,the incidence of angina pectoris,heart failure,and target vessel revascularization,recurrent myocardial infarction and cardiac death and major cardiac adverse events during hospitalization were compared between three groups.The changes of left ventricular end diastolic diameter (LVDd),left ventricular ejection fraction (LVEF) and other indicators were compared.Results After PCI,the corrected TIMI frame count (CTFC) and TIMI myocardial perfusion grade (TMP) were significantly better in intracoronary injection group than peripheral vein injection group and control group (P ＜ 0.05).All patients were followed up for 9 months,LVDd in intracoronary injection group was significantly lower than those in peripheral vein injection group and control group (P ＜ 0.05).LVEF in intracoronary injection group was significantly higher than that in peripheral vein injection group and control group (P ＜ 0.05).The incidence rate of MACE in intracoronary injection group was significantly less than that in peripheral vein injection group and control group (P ＜ 0.05).There was no significantly difference between the peripheral vein injection group and control group (P ＞ 0.05).Conclusion For NSTEMI patients with early PCI,intracoronary injection and peripheral intravenous injection of prostaglandin E1 can get a better myocardial microcirculation reperfusion during operation,and intracoronary injection can significantly reduce the incidence of adverse cardiac events.

Objective To explore the clinical efficacy of prostaglandin E1 injected by coronary or peripheral venous in early stage (within 24 h of symptom onset) in treating patients with acute non-ST segment elevation myocardial infarction (NSTEMI) by percutaneous coronary intervention (PCI) and its influence on major adverse cardiac events (MACE).Methods A total of 136 patients with NSTEMI underwent PCI within 24 h were divided into intracoronary injection group,peripheral vein injection group and control group.All the patients were followed up for 9 months,no reflow or slow blood flow,the incidence of angina pectoris,heart failure,and target vessel revascularization,recurrent myocardial infarction and cardiac death and major cardiac adverse events during hospitalization were compared between three groups.The changes of left ventricular end diastolic diameter (LVDd),left ventricular ejection fraction (LVEF) and other indicators were compared.Results After PCI,the corrected TIMI frame count (CTFC) and TIMI myocardial perfusion grade (TMP) were significantly better in intracoronary injection group than peripheral vein injection group and control group (P ＜ 0.05).All patients were followed up for 9 months,LVDd in intracoronary injection group was significantly lower than those in peripheral vein injection group and control group (P ＜ 0.05).LVEF in intracoronary injection group was significantly higher than that in peripheral vein injection group and control group (P ＜ 0.05).The incidence rate of MACE in intracoronary injection group was significantly less than that in peripheral vein injection group and control group (P ＜ 0.05).There was no significantly difference between the peripheral vein injection group and control group (P ＞ 0.05).Conclusion For NSTEMI patients with early PCI,intracoronary injection and peripheral intravenous injection of prostaglandin E1 can get a better myocardial microcirculation reperfusion during operation,and intracoronary injection can significantly reduce the incidence of adverse cardiac events.

Objective Aiming at the characteristics of the course of acupuncture and massage,to discuss the application of Situational heuristic teaching.Methods 60 undergraduate students in Grade Four of Jiangxi University of Traditional Chinese Medicine (clinical practice) were even divided into 2 groups,that was situational teaching group (the experimental group) and the traditional teaching group (control group).The students in the experimental group received basic theory course of 30 hours,60 hours in the course of situational teaching.The clinical cases of teaching were carefully designed according to the simulated hospital scene in each chapter,including large cases,acupuncture and massage therapy program,which were conducted between teachers and students through interactive and positive research and other forms.In the control group the teachers taught the content to students in class for full 90 hours in accordance with the requirements of the teaching syllabus.Taking objective theoretical examination,subjective questionnaire survey,and subjective clinical return visit questionnaire scores as indicators the difference of the two kinds of teaching methods were compared and statistical analysis was carried out by SPSS 19.0 software,chi square test and t test.Results By comparison of objective theoretical examination results of two groups of subjects,the number of good students in the experimental group was 10,and the number of outstanding students was 7,with an average of (80.63 ± 1.35) points.In the control group,the number of good students was 9,the number of outstanding students was 6,with the average score of (80.54 ± 1.32),and the average score of the objective theory test scores were not statistically significant (P＞0.05).The learning satisfaction of the students in the experimental group was (3.91 ± 0.29).Students in the experimental group thought situation heuristic teaching was conducive to professional development (3.23 ± 0.39),to improving the learning quality (3.68 ± 0.72),clinical thinking culture (4.11 ± 0.24),clinical ability (3.72 ± 0.27),clinical physician-patient communication skills (3.28 ± 0.79),basic clinical skills (3.48 ± 0.42) points,with teaching satisfaction (4.19 ± 0.25),which were all higher than the control group,and the difference was statistically significant (P＜0.05).Conclusion Situational heuristic teaching method is better than the traditional teaching method in stimulating students' learning enthusiasm,innovation ability,cultivating professional interest and cultivating students' clinical practice ability.The teaching practice of teachers should give full play to the advantages of the method and improve the teaching effect,which is worthy of further research and promotion.

Objective To study the clinical significance of monitoring the urine iodine level in pregnant women.Methods The urine iodine levels were detected in 391 cases of pregnant women.The relativity was analyzed among the pregnancy gestation,pregnancy complications and the urine iodine levels.The corresponding health educa-tion of iodine nutritional knowledge was conducted according to the results of the determination.Results (1 )The urine iodine value was (124.73 ±70.61)μg/L in 391 pregnant women.The severe deficiency iodine rate,deficiency iodine rate and appropriate iodine rate of pregnant women were 37.85%,64.70% and 25.06%,respectively.(2) There was no significant difference in values of urine iodine among the pregnant women during the first,second and third trimester of pregnancy[(121.76 ±71.81)μg/L,(125.52 ±69.28)μg/L,(129.30 ±75.19)μg/L](t≤0.59, all P >0.05).The mean values were all lower than the appropriate values of WHO(150 ~249 μg/L).The low iodine rates were 67.20%,63.23% and 65.12%,respectively.There was no significant difference among them(χ2 =0.56, P >0.05 ).(3 )The urine iodine value of the pregnant women complicated with hyperthyroidism [(85.76 ± 53.09)μg/L]was significantly lower than that of primary hypothyroidism combined with pregnancy [(133.65 ± 73.41)μg/L],pregnancy combined with subclinical hypothyroidism[(136.50 ±79.19)μg/L]and no pregnancy complication[(119.34 ±66.43)μg/L](t≥2.76,P <0.01).The rate of iodine deficiency(87.88%)was highest (χ2 =8.72,P <0.05).(4)The urine iodine value after iodine nutrition intervention was significantly higher than those before in 77 pregnant women[(129.74 ±68.04)μg/L vs.(107.01 ±74.36)μg/L,t =1.98,P <0.05].The iodine deficiency rate dropped from 79.22% to 63.64%(χ2 =4.58,P <0.05).Conclusion In order to improve the appropriate iodine rate of pregnant women,it should be very important significance on monitoring the urine iodine level of pregnant women in particular with a complication of pregnancy and conducting iodine nutrition intervention in whole pregnancy gestation.