Objective To elucidate the efficacy and possible mechanism of Qingchang mixture in ameliorating postoperative abdominal adhesions in rats.Methods Seventy-five Sprague-Dawley rats were randomly allocated into five experimental groups:the control group,the sham-operated group,the model group,the Qingchang mixture treatment group and the sodium hyaluronate treatment group.Except the control group and the sham-operated group,the other three groups were treated with cecal abrasion method to establish the rat model of abdominal adhesion.In the sodium hyaluronate group,2 mL sodium hyaluronate gel was meticulously applied to the injured abdominal wall and cecum prior to abdominal closure.Following successful establishment of adhesion model,the Qingchang mixture group received a daily oral gavage of 2 mL Qingchang mixture(14.58 g/kg),while the other four groups were given equal volume normal saline administration.In each group,five rats were euthanized on postoperative days 3,7 and 14 to assess abdominal adhesions using Nair's scoring system.Adhesive tissue or normal peritoneal tissue were harvested on postoperative day 7,and mRNA expression levels of interleukin-4(IL-4),signal transducer and activator of transcription 6(STAT-6)and interferon-γ(IFN-γ)were quantified via fluorescence-based real-time PCR.Concurrently,Western blot analysis was employed to evaluate protein expression levels of IL-4,interleukin-10(IL-10),STAT-6 and IFN-γ.Pathological alterations in adhesive tissue were visualized using hematoxylin-eosin(HE)staining under light microscopy,and inflammation and fibrotic changes were assessed accordingly.Results Compared with the blank and sham-operated groups,mRNA and protein expression levels of IL-4 and STAT-6 were significantly downregulated in the model group,protein expression level of IL-10 was also reduced.Conversely,the mRNA and protein expression levels of IFN-γ,as well as the inflammation and fibrosis scores were significantly elevated(P＜0.05).In comparison to the model group,IL-4 and STAT-6 mRNA and protein expression levels were increased in the Qingchang mixture group and the hyaluronic acid group,along with an increase in IL-10 protein expression.Conversely,these groups exhibited a significant reduction in Nair's scores,inflammation scores,fibrosis scores,and IFN-γ mRNA and protein expression levels were decreased(P＜0.05).Conclusion Qingchang mixture appears to suppress the development of postoperative peritoneal adhesions,likely through mechanism that involves modulating the expression of T-helper 1 and T-helper 2 cytokines,thereby attenuating inflammatory response.

Objective To investigate the pass rates of fit tests for various brands of medical protective masks and to explore methods for quickly matching these masks based on their head and face dimensions.Methods A total of 202 medical staff from designated hospitals in Tianjin were selected as subjects.Quantitative fit tests were conducted on 5 brands of masks(A,B,C,D,and E)using an aerosol condensation nucleus counter.Two-dimensional photographic measurement was used to obtain the face length and width of the subjects,categorizing them into face types#1 to#10.The pass rates of masks across different face zones,brands,and face types were compared.Results A total of 202 testers participated in this study.According to the guidelines,face type#1 was the most common[43.6%(88/202)],followed by face type#3[18.2%(37/202)].The majority of subjects were categorized as face types#1,#2,#3,and#4,totaling 176 subjects(87.1%).A total of 914 tests were conducted,with 678 passes,resulting in an overall mask pass rate of 74.18%.The pass rates of masks A,B,and C were significantly higher than those of masks D and E[87.03%(161/185),85.57%,(166/194),82.02%(146/178)vs.62.98%(114/181),51.70%(91/176),all P<0.05].The pass rate of adjustable head-mounted masks was significantly higher than that of non-adjustable masks[79.54%(587/738)vs.51.70%(91/176),P<0.05].The fit factor(FF)for mask B in face types#1 to#5 was significantly higher than that in face types#6 to#10[200(163,200)vs.132(86,200),P<0.05].Conclusions Two-dimensional photographic measurement can quickly obtain facial information of the subjects and match the corresponding masks.Hospitals can match masks with higher test pass rates according to the proportion of face types among medical staff.When selecting masks,preference should be given to adjustable head-mounted masks.

Objective:To explore the effect of manual prompts in the first detection of lung function and fractional exhaled nitric oxide (FeNO) in patients with airway inflammation of unknown origin.Methods:From May 2018 to December 2020, convenience sampling was used to select 810 patients with airway inflammation of unknown origin in the Department of Respiratory of the China-Japan Union Hospital of Jilin University as the subject. Subjects were divided into a observation group ( n=406) and a control group ( n=404) . This study compared the quality control parameters of lung function detection [forced expiratory time (PET) , backward extrapolated volume (VBE) , time from forced expiratory to peak flow rate (FET-PET) , percentage of backward extrapolated volume to forced vital capacity (VBE/FVC%) ] , reproducibility parameters [variation between optimal and suboptimal forced vital capacity (ΔFVC) , variation between optimal and suboptimal first second forced expiratory volume (ΔFEV 1) ] , and detection efficiency indicators (detection time for lung function and FeNO, one-time success rate of FeNO detection) between two groups. Results:The VBE/FVC%, ΔFVC, and ΔFEV 1 in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The lung function and FeNO detection time of the observation group were shorter than those of the control group, and the one-time success rate of FeNO detection was higher than that of the control group, with statistical differences ( P<0.05) . Conclusions:In lung function and FeNO detection for the first time among patients with airway inflammation of unknown origin, manual prompts can improve the quality control and reproducibility of the detection, shorten the detection time, and increase the one-time success rate of FeNO detection.

Objective:To evaluate the relationship between hippocampal miR-3065-5p and insulin-like growth factor-1/phosphatidylinositol 3-kinase/protein kinase B(IGF-1/PI3K/Akt)signaling pathway in a mouse model of perioperative neurocognitive disorder (PND).Methods:Eighty clean-grade healthy male C75BL/6 mice, aged 12-14 weeks, weighing 20-30 g, were divided them into 4 groups ( n=20 each) using the random number table method: control group (C group), PND group, miR-3065-5p agonist group (Ag group) and miR-3065-5p agonist negative control group (Ag-NC group). PND model was prepared by internal fixation of tibial fracture under anesthesia with 1.5% isoflurane. Two days before developing the model, miR-3065-5p agomir 2 μl was injected into the lateral ventricle in Ag group, miR-3065-5p agomir negative control 2 μl was injected into the lateral ventricle in Ag-NC group. Morris water maze test and open field test were performed at 7 days after surgery. The mice were sacrificed after the end of test, and hippocampal tissues were obtained for determination of the expression of miR-3065-5p, IGF-1 mRNA and Bcl-2 mRNA (by quantitative real-time polymerase chain reaction) and expression of IGF-1, phosphorylated Akt (p-Akt), phosphorylated glycogen synthase kinase-3β (p-GSK3β) and Bcl-2 (by Western blot). Results:There was no significant difference in each parameter in the open field test among the four groups ( P>0.05). Compared with group C, the postoperative escape latency was significantly prolonged, the percentage of time of stay at the target quadrant was decreased, the number of crossing the original platform was reduced, the expression of miR-3065-5p was up-regulated, and the expression of IGF-1 mRNA, Bcl-2 mRNA, IGF-1, p-Akt, p-GSK3β and Bcl-2 was down-regulated in the other three groups ( P<0.05). Compared with PND group and Ag-NC group, the postoperative escape latency was significantly prolonged, the percentage of time of stay at the target quadrant was decreased, the number of crossing the original platform was reduced, the expression of miR-3065-5p was up-regulated, and the expression of IGF-1 mRNA, Bcl-2 mRNA, IGF-1, p-Akt, p-GSK3β and Bcl-2 was down-regulated in Ag group ( P<0.05). Conclusions:Up-regulation of miR-3065-5p can inhibit the activation of IGF-1/PI3K/Akt signaling pathway, which might be one of the mechanisms of PND developed in mice.

Objective : To evaluate the effect of platelet-rich fibrin (PRF) on alveolar ridge preservation after tooth extraction. Methods: Randomized controlled trials (RCTs) published before August 25, 2020 about the use of PRF after tooth extraction were searched through the PubMed, Embase, Cochrane Library, HowNet, Wanfang, CBM databases and clinical trial registration centers in China and the United States. Outcome indicators included in the studies included dry socket occurrence, alveolar bone resorption in the horizontal and vertical directions, and the percentage of new bone. Meta-analysis was conducted with Review Manager Version 5.3 software. Results: A total of 706 studies were retrieved. After screening, 8 studies were analyzed quantitatively. Meta-analysis results showed that PRF could reduce the absorption of alveolar bone after tooth extraction, which reduced the horizontal bone mass (WMD=-0.71, 95% CI=-1.11 to -0.32, P < 0.05) and buccal (WMD=-1.38, 95% CI =-1.87 to -0.88, P < 0.05) and lingual sides (WMD=-0.49, 95% CI=-0.92 to -0.06, P < 0.05) and increased the percentage of new bone (SMD=1.24, 95% CI =0.25 to 2.23, P < 0.05). However, there was no significant difference in preventing the occurrence of dry socket (RD < 0.01, 95% CI=-0.05 to 0.04, P=0.95) and reducing bone absorption in the vertical direction of mesial (WMD=-0.11, 95% CI=-1.17 to 0.95, P=0.84) and distal (WMD=-0.66, 95% CI=-1.93 to 0.60, P=0.30) alveolar ridge after tooth extraction. Conclusion Using PRF alone after tooth extraction can effectively preserve bone mass in the horizontal direction of the alveolar ridge and the vertical direction of the buccal and lingual sides.

Objective: To observe the effectiveness of mini-clinical evaluation exercise (Mini-CEX) on the standardized training of residents in the department of nephrology. Methods: Mini-CEX was used to evaluate the 80 residents who received clinical standardized training in the department of nephrology from March 2017 to March 2018 in our hospital. The assessment mainly contained seven aspects: medical history taking, physical examination, clinical diagnosis, therapeutic regimen, doctor-patient communication, humanistic care, and overall clinical ability. Meanwhile, a Mini-CEX questionnaire was conducted among 9 teachers and 80 residents, including their viewpiont and satisfaction degree on Mini-CEX. The SPSS 21.0 was used for statistical analysis and the independent sample t-test was used for comparison between the two groups. Results: Through the Mini-CEX assessment, every aspect of clinical competence of residents at the end of this program was significantly higher than that at the early period, and the difference was statistically significant (P<0.05). The most obvious improvement in residents was their treatment plan, overall clinical ability and physical examination. About the assessment of therapeutic regimen, the average score at the end of the training was (7.525±1.062), which was better than before (5.175±1.035), and the difference was statistically significant (P=0.000). Besides, clinical diagnosis and humanistic care were significantly better than those at the beginning (P<0.05). About the assessment of clinical diagnosis, the average score after the training was (6.925±1.071), which was better than before (5.425±1.238), and the difference was statistically significant (P=0.000). According to results of Mini-CEX questionnaire, teachers thought that Mini-CEX was a better way of assessment (88.9%) and could promote self-learning (77.8%), while residents believed that Mini-CEX was close to clinical practice and the ward-or-practice-based assessment was relatively comprehensive, which could significantly improve clinical skills (85.0%) and comprehensive quality (87.5%), with a satisfaction degree of 92.5%. Conclusion Mini-CEX is applied in the standardized training of residents in the department of nephrology, which can effectively improve clinical comprehensive ability of residents and improve Self-learning of teachers.

Objective: To preliminarily evaluate the safety of the coplanar template-assisted ¹⁹²Ir hypofractionated stereotactic ablative brachytherapy (SABT) in patients with locally advanced non-small cell lung cancer (LA-NSCLC), and assess the effect of template-assisted technology upon the accuracy of SABT by comparing the consistency of dosimetric parameters between preoperative and operative plans. Methods: Fifteen patients histologically confirmed with LA-NSCLC (stage Ⅱ_B-Ⅲ_A) were recruited and received the template-assisted SABT delivered in a risk-adapted fractionation (30 Gy/1F). Preoperative planning, template-assisted needle implantation, operative planning and implementation were performed in all patients. Dosimetric results of preoperative and operative plans were statistically compared by assessing the dosimetric parameters of gross tumor volume (HI, CI, D₉₀, V₁₀₀ and V₁₅₀) and organ at risk(V₅, V₂₀ and mean dose of bilateral lung, D_2cc of spinal cord. The incidence of perioperative complications of SABT was recorded. The safety and feasibility of SABT were evaluated. Results: Slight changes were noted in terms of target dose and irradiated dose to the lung between preoperative and operative plans without statistical significance (both P>0.05). No severe adverse events, such as severe pneumothorax, hemothorax and hemoptysis were observed. Conclusions Application of the template-assisted SABT can enhance the accuracy of implantation, maintain the consistency of the dosimetric parameters between the preoperative and operative plans and guarantee the clinical efficacy.

Objective To investigate the effectiveness of treatment of primary orbital varix via venous embolization therapy approach. Methods From January 2007 to January 2015,the clinical data of 12 patients with primary orbital varix were analyzed retrospectively. All the micro-catheters were implanted via the inferior petrosal sinus approach. The microcoils and Onyx18 were used to embolize the primary orbital varix. Four patients were embolized with micro-coils only, three were embolized with Onyx, and five were embolized with microcoil + Onyx. Results After successful catheterization, the lesions were totally embolized in 12 patients. The symptoms of postural exophthalmos disappeared and the pain was relieved,the depressed symptom of eyeball disappeared in 10 cases, and two patients were relieved partially ( single material embolization) . Nine patients were followed up for 6 to 24 months. The orbital DSA,MRI or CT re-examination was performed. The thrombosis of orbital varices within the lesions was observed and no cavity was found. One of the patients suffered from limited lateral eyeball abduction. Another three were lost to follow up. Conclusion The embolization treatment of primary orbital varix is safe, effective, and convenient via inferior petrosal sinus approach.

Objective To analyze the effect of needle arrangement on the lung dose in interstitial brachytherapy for lung cancer. Methods For 15 patients undergoing interstitial brachytherapy for lung cancer, a virtual radiotherapy plan in which needle arrangement was not restricted by the ribs was designed and compared with the original plan. For the two plans, V5, V20, V30, and mean lung dose(MLD)of the whole lung were determined when the prescribed doses were 10,30, 60, and 120 Gy, respectively. The data were analyzed by Wilcoxon signed-rank test. Results The lung V5,V20, V30, and MLD were significantly smaller in the virtual plan than in the actual plan(all P<0.05). Conclusions Irregular needle arrangement prevents a further reduction in the lung dose in interstitial brachytherapy for lung cancer. In the implantation surgery, therefore, the needles should be arranged as regularly as possible.

Objective:To investigate the effect of different postoperative nutritional support on the gastrointestinal function and nutritional status in acute colon peforation patients.Methods:60 cases of acute emergency operation patients with perforation of the colon,according to the given nutritional support treatment of the different ways,were divided into enteral parenteral joint nutrition (EN + PN) group and total parenteral nutrition (TPN) group.Clinical therapeutic effects of two groups were compared.Results:The results of EN + PN group were significantly better than the those in TPN group (P ＜ 0.05).Conclusion:EN + PN model can improve the postoperative nutritional status and accelerate the recovery of patients with acute colonic perforation.