OBJECTIVE To compare the phar macokinetics o f ligustrazine hydrochlori de，salvianic acid and rosemarinic acid from Shenxiong glucose injection （SGI）in normal and acute myocardial ischemia （AMI）rats. METHODS Male SD rats were randomly divided into normal group and model group ，with 9 rats in each group. AMI model was established by isoproterenol hydrochloride modeling method. Three rats in each group were selected for model verification. The remaining 6 rats in each group were given SGI （1.2 mL/kg）or equal volum of normal saline via tail vein ；0.3 mL blood was collected through orbital venous bush 0.083，0.167，0.333，0.5，0.75，1，1.5，2，3，5 h after administration. Using luteoloside as internal standard ，the plasma concentrations of ligustrazine hydrochloride ，salvianic acid and rosemarinic acid were determined by ultra performance liquid chromatography-tandem mass spectrometry. Pharmacokinetic parameters were fitted by WinNonlin 8.1 software，and statistical analysis was performed by SPSS 18.0 software. RESULTS The linear ranges of ligustrazine hydrochloride ，salvianic acid and rosmarinic acid were 0.06-29.96，0.01-5.15 and 0.006-3.09 μ g/mL（all r＞0.99），respectively. The results of methodological investigation were all in line with the requirements of Chinese Pharmacopoeia （2020 edition）. Compared with normal rats ，CLz of ligustrazine hydrochloride in AMI model rats was significantly increased （P＜0.05）；t1/2 and Vz of salvianic acid were significantly prolonged or increased （P＜0.05）；but the cmax and AUC 0－5 h were significantly decreased （P＜0.05）；AUC0－5 h of rosmarinic acid was significantly decreased （P＜0.05）. CONCLUSIONS The exposure levels of salvianic acid and rosmarinic acid in SGI are lower in AMI model rats than in normal rats ，and the elimination of ligustrazine hydrochloride in AMI model rats is stronger than that in normal rats.

Objective:To observe the clinical effect of four-point fixation in patients with posterior chamber intraocular lens dislocation.Methods:A retrospective case series study was adopted.Sixteen patients (16 eyes) with posterior chamber intraocular lens dislocation who underwent suture suspension techniques with four-point fixation in Changzhou No.2 people's Hospital from January 2015 to January 2018 were enrolled.Postoperative effects were observed during follow-up, ranging from 6 to 13 months.The preoperative and 6-month postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), corneal endothelium cell count and astigmatism were measured and the differences were compared, and the relationships between total astigmatism and corneal astigmatism or intraocular lens induced astigmatism were analyzed, and the postoperative position of intraocular lens and complications were observed.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Changzhou No.2 People's Hospital (No.2015-C-012-01).Written informed consent was obtained from each patient before surgery.Results:The mean preoperative UCVA (LogMAR) and BCVA (LogMAR) were 1.09±0.24 and 0.48±0.20, respectively, which were significantly improved to 0.30±0.12 and 0.26±0.13 at 6 months after operation, respectively.And the differences were statistically significant ( t=11.782, 3.795; both at P<0.01).The preoperative and 6-month postoperative corneal endothelium cell count were (2 270±360)/mm 2 and (2 032±327)/mm 2, respectively, and the difference was not significant ( t=1.921, P=0.074).The 6-month postoperative mean total astigmatism, corneal astigmatism and intraocular lens induced astigmatism were (-1.47±0.82)D, (-1.34±0.61)D and (-0.22±0.35)D, respectively.There was a highly positive correlation between total astigmatism and corneal astigmatism ( r=0.885, P<0.05), but there was no significant correlation between total astigmatism and intraocular lens induced astigmatism ( r=-0.432, P=0.095).No dislocation, deviation or torsion of intraocular lens were observed during the follow-up.Varying degree of symptoms of iridocyclitis were observed during early stage after operation, which disappeared after treatment.There were two cases of high intraocular pressure, which were normal after treatment.No retinal detachment, choroidal detachment, expulsive suprachoroidal hemorrhage, endophthalmitis, corneal endothelial decompensation or other complications occurred during and after operation. Conclusions:There is a stable position of intraocular lens, good visual acuity and few complications after four-point fixation with suture and suspension, which is a feasible method to treat dislocated intraocular lens.

OBJECTIVE：To provide reference for improving the quality standard of Rhizoma Bego niae from Guizhou . METHODS：Five batches of Rhizoma Begoniae from Guizhou were collected ，and the microscopic characteri stics of the Rhizoma Begoniae powder were observed. According to the corresponding methods in 2015 edition of Chinese Pharmacopoeia （part Ⅳ）， potent adenosine 50-triphosphate competitive phosphati - dylinositol-3-kinase/mammalian target of rapamycin inhibitors：discovery of compound 26（PKI-587），a highly effi cacious dual inhibitor Morpholine as a privileged structure ：a review on the me - dicinal chemistry and pharmacological activity of morpho - line containing bioactive molecules[J]. Med Res Rev ， qq.com 2019. DOI ：10.1002/med.21634. qualitative identification of Rhizoma Begoniae was conducted by TLC ，and the contents of moisture ，total ash and water-soluble extract in Rhizoma Begoniae were determined. The contents of rutin were determined by HPLC. RESULTS ：The powder of Rhizoma Begoniae medicinal materials was brown ，stone cells were square ，polygonal-like or irregular. There were many starch grains and few complex grains. The conduit ，calcium oxalate square crystal/cluster crystal were visible. The same fluorescence spots were found in the same location of TLC atlas of Rhizoma Begoniae control herb. The moisture ，total ash ，water-soluble extract contents were 10.15％-11.41％，8.70％-12.59％ and 16.91％-19.58％，respectively. The linear range of rutin were 18.47-147.8 μg/mL （r＝0.999 8）；RSDs of reproducibility ，intermediate precision and stability tests （8 h）were all lower than 3.0％；the average recoveries were 99.39％-100.29％（RSDs were 0.23％-2.59％，n＝3）；the contents of rutin in 5 batches of Rhizoma Begoniae were 0.102％-0.198％. CONCLUSIONS ：The contents of moisture and total ash shall not exceed 13.0％ and 14.0％ respectively， and the contents of water-soluble extract and rutin shall not be less than 15.0％ and 0.080％. The quality standard established in this study can be used for the quality control of Rhizoma Begoniae from Guizhou.

Objective? To define the difficulty coefficient of Operating Room nursing items which is suitable for difficulty evaluation and can represent the workload of Operating Room nursing. Methods? From January 2017 to March 2018, through literature review, questionnaire survey and expert demonstration meeting, the nursing work items and operational difficulty indicators suitable for difficulty evaluation in Operating Room were determined. The weight of difficulty indicators was determined by analytic hierarchy process. Fifteen experts were selected for three rounds of Delphi inquiry. The coefficients of difficulty were determined by weighted linear method. Results? Finally, the difficulty coefficients of 68 operating room nursing items were obtained. The top three difficulty coefficients were "position placement and observation of lateral traction bed (7.268 7)", "position placement and observation of fixed skull (7.254 0)" and "position and observation of skull-brain frame lateral decubitus position (7.243 3)"; the last three difficulty coefficients were "horizontal supine position placement and observation (2.178 2)" and "sterile sheet laying (2.046 0)" , "no-contact wearing of sterile gloves (1.000 0)". Conclusions? This study defines 68 difficulty coefficients of operating room nursing work items which are suitable for difficulty evaluation and can represent the workload of Operating Room nursing. It can quantify the difficulty of Operating Room nursing work items and enhance the rationality of Operating Room nursing workload counting.

Objective To analyze the precision and stability of optical surface imaging system for patients who received radiotherapy with active breath control. Methods Eighteen radiotherapy patients with lung metastasis were managed by active breath control (ABC).The difference error detected by optical surface imaging system and CBCT were defined as the precision of optical surface imaging system. The variation among the error of optical surface imaging positioning the value of correction of treatment position and the error detected by optical surface imaging again were defined as the stability of optical surface imaging system. Intrafractional errors were analyzed by optical surface imaging system through whole treatment process (including breath hold and free breath). Results The optical surface imaging system had precision (systematic (Σ) and random errors (σ)) of 1.78/3.42 mm 2.54/6.57 mm and 2.79/3.22 mm respectively and stability of2.12/2.54 mm 3. 09/4.02 mm and 1.37/3.55 mm respectively in lateral-medial superior-inferior and anterior-posterior directions. The intrafractional errors (Σ and σ) were 0.42/0.85 mm 0.41/1.47 mm and 0.41/1.47 mm respectively for breath hold duration and 4.76/4.16 mm 6.54/7.78 mm and 3.13/5.92 mm for free breath duration in lateral-medial superior-inferior and anterior-posterior directions. Conclusions As an effective method for validate breath hold;Optical surface imaging system can improve the precision and safety of active breath control. However,the factors that affect the accuracy and stability of the optical surface imaging system in patients undergoing radiotherapy with ABC are not clear;it cannot replace the CBCT for positioning verification.

BACKGROUND:Medical polyethylene glycol berberine is a biomaterial against tissue adhesion, with anti-inflammatory effects, which can prevent scar formation and reduce local inflammation. OBJECTIVE:To observe the clinical efficacy of medical polyethylene glycol berberinevia shoulder joint injections on subacromial impingement syndrome. METHODS:Forty patients with subacromial impingement syndrome I, II were voluntarily divided into two groups: biomaterial group (n=20), single intra-articular injection of 3 mL medical polyethylene glycol berberine; conservative treatment group (n=20), single subacromial space closed treatment of betamethasone combined with lidocaine hydrochloride folowed by oral administration of celecoxib 200 mg once, twice a day, totaly for 1 week. Patients were folowed up clinicaly for visual analog scale scores, range of motion of the shoulder and the American Shoulder and Elbow Surgeons scores. RESULTS AND CONCLUSION:Both of two groups had a great improvement in visual analog scale scores, range of motion of the shoulder and the American Shoulder and Elbow Surgeons scores after treatment (P< 0.05), and these scores were improved more significantly in the biomaterial group than the conservative treatment group at 2 weeks, 4 weeks, 3 months, 6 months after treatment (P < 0.001). These findings indicate that the intra-articular injection of medical polyethylene glycol berberine for subacromial impingement syndrome can effectively aleviate shoulder pain, improve shoulder mobility, and promote functional recovery of the shoulder.

BACKGROUND:Hyaluronic acid or compound betamethasone for treatment of knee osteoarthritis can reduce inflammatory reactions in the joints, relieve pain, and protect the function of the knee joint. OBJECTIVE:To investigate the clinical efficacy of intra-articular injection of hyaluronic acid combined with compound betamethasone on middle-stage knee osteoarthritis as wel as protective effect on joint function. METHODS:A total of 100 patients with II, III knee osteoarthritis were randomly divided into two groups: intra-articular injection of hyaluronic acid (2 mL) as control group and intra-articular injection of hyaluronic acid (2 mL) combined with compound betamethasone (1 mL) as testing group. The intra-articular injection was carried out once a week, totaly for consecutive 5 weeks. Visual analog scale score, Lysholm knee joint score and erythrocyte sedimentation rate were compared between two groups before and after treatment. RESULTS AND CONCLUSION:After treatment, the visual analog scale score, Lysholm knee joint score and erythrocyte sedimentation rate were improved significantly in the two groups as compared with those before treatment (P < 0.05); in addition, these parameters were al better in the testing group than the control group (P < 0.05). No systemic adverse reactions occurred in the two groups. These findings indicate that the intra-articular injection of hyaluronic acid combined with compound betamethasone can reduce inflammatory reactions, relieve pain, and improve joint function.

Objective To investigate the application effect of nursing risk management among severe burn patients in intensive care unit ( ICU). Methods To select patients who were treated by nursing risk management intervention before was as control group, and the patients after nursing risk management intervention were chosen as observation group. We comparatively analyzed the knowledge control of nursing risk management before and after the intervention, adverse events of the patients, BICU hospitalization time, and the nursing work quality. Results The knowledge related severe burn acquired the average score of (78. 3 ± 10. 8) before intervention and (87. 6 ±11. 3) after intervention (t =2. 524,P <0. 05). During the treatment in the observation group, there were 14 cases pressure ulcer, 2 cases nosocomial infection, and 22 cases wound sepsis, all which were lower than those of the control group (χ2 =5. 340,5. 273,9. 877,respectively;P <0. 05). Conclusions The implementation of the nursing risk management can effectively improve the nurses′ risk consciousness and coping capacity, and it has great significance in reducing the occurrence of nursing adverse events and nursing disputes, so it is worth of popularization and application.

Objective To study the relationship between the virus content of high risk HPV and cervical intraepithelial neoplasia(CIN).Methods 450 patients with cervical intraepithelial neoplasia (CIN) were selected as the observation group ,450 healthy women at the same time were the control group ,then the positive rate and content of the control group and observation group with different high risk HPV types were detected and compared ,then the detection results of observation group with different CIN classification were compared too ,and the relationship of the detection indexes between the CIN were analyzed by the Logistic analysis .Results The HPV DNA positive rate of observation group with different high risk types were 9.11%,6.67%,6.67%,6.67%and 6.00%,respectively,and they were all higher than those of control group (χ2 =6.871,6.240,6.240,6.240,5.871,all P<0.05),and the positive rate of patients with different CIN classification had obvious differences too ,the virus content and constitution of observation group were respectively (301.35 ±32.67) Copies/mL and 11.56%,10.22%,9.56%,and they were all obviously higher than those of control group (t=6.276,χ2 =7.132,6.915,5.878,all P<0.05),and the content of patients with different classification had obvious differences ,all P<0.05,there were all significant differences ,and the item had close relationship to CIN by the Logistic analysis .Conclusion The high risk HPV virus content of patients with cervical intraepithelial neoplasia shows abnormal state ,and which have close relationship to the disease .

Objective To investigate the correlation between serum tumor necrosis factor (TNF)-α,neuron-specific enolase (NSE)and the degree of hypoxic-ischemic encephalopathy (HIE).Methods Forty-six HIE patients in acute and convalescent stage and 30 full-term newborn infant were enrolled in this study.The level of serum of TNF-α and NSE were detected.The relationship between TNF-α,NSE level and severity of HIE was analyzed.Results The level of serum TNF-α and NSE in acute stage of HIE group were (156.3 ± 28.8) ng/L and (21.5 ± 3.6) μg/L,in convalescent stage of HIE group were (80.7 ± 26.1) ng/L and (10.6 ± 1.7) μ g/L,and in control group were (76.3 ± 24.4) ng/L and (9.4 ± 1.6) μ g/L.The level of serum TNF-α and NSE in acute stage of HIE group were significantly higher than those in convalescent stage of HIE group and control group (P ＜ 0.05).The level of serum TNF-α and NSE in convalescent stage of HIE group had no significant difference compared with those in control group (P ＞ 0.05).The level of serum TNF-α and NSE in mild HIE group were (88.5 ± 25.6) ng/L and (9.7 ± 2.4) μ g/L,in moderate HIE group were (150.1 ± 16.5) ng/L and (17.8 ± 3.6) μ g/L,and in severe HIE group were (197.3 ± 30.2) ng/L and (23.6 ±4.3) μg/L.The level of TNF-αand NSE were increased with the aggravation of HIE and there had significant difference among different degree of HIE(P ＜ 0.05).The level of serum TNF-α and NSE in mild HIE group and control group had no significant difference (P ＞ 0.05),and there had significant difference between moderate HIE group,severe HIE group and control group (P ＜ 0.05).Spearman rank correlation analysis showed that the level of TNF-α and NSE had positive correlation with the degree of HIE (r =0.54,0.57,P ＜ 0.01 or ＜ 0.05).Pearson correlation analysis showed that the level of TNF-α had positive correlation with the level of NSE (r =0.46,P ＜ 0.05).Conclusions The variation of TNF-α and NSE level in HIE newborn infant is parallel to the severity of the disease,which can sensitively reflect the severity of HIE.Therefore,TNF-α and NSE may be used as vital indexes for the evaluation of the severity of HIE.