Humans ; Kounis Syndrome/complications* ; Takotsubo Cardiomyopathy/complications*

The present study investigated the chemical constituents from the leaves of Craibiodendron yunnanense. The compounds were isolated and purified from the leaves of C. yunnanense by a combination of various chromatographic techniques including column chromatography over polyamide, silica gel, Sephadex LH-20, and reversed-phase HPLC. Their structures were identified by extensive spectroscopic analyses including MS and NMR data. As a result, 10 compounds, including melionoside F(1), meliosmaionol D(2), naringenin(3), quercetin-3-O-α-L-arabinopyranoside(4), epicatechin(5), quercetin-3'-glucoside(6), corbulain Ib(7), loliolide(8), asiatic acid(9), and ursolic acid(10), were isolated. Compounds 1 and 2 were two new compounds, and compound 7 was isolated from this genus for the first time. All compounds showed no significant cytotoxic activity by MTT assay.
Quercetin ; Ericaceae ; Plant Leaves ; Catechin ; Chromatography, High Pressure Liquid

Episodic syndromes that may be associated with migraine Episodic syndromes that may be associated with migraine are commonly seen in children and are likely to evolve into migraine in the subsequent course of the disease， including several subtypes such as benign paroxysmal torticollis， benign paroxysmal vertigo， and recurrent gastrointestinal disturbance. Understanding the above syndromes has an important clinical significance in the diagnosis of migraine in children.
Migraine Disorders

Traditional Chinese medicine （TCM） and western medicine have their respective advantages and limitations in the diagnosis and treatment of common otorhinolaryngology head and neck diseases. Although the integrated TCM and western medicine exhibits definite curative effects， there is no consensus on the otorhinolaryngology head and neck diseases responding specifically to TCM or integrated TCM and western medicine， as well as the diagnosis and treatment schemes. The China Association of Chinese Medicine （CACM） thus organized the otorhinolaryngology head and neck specialists of both TCM and western medicine to discuss the etiology， pathogenesis， and clinical diagnosis and treatment methods of common otorhinolaryngology head and neck diseases with the results of multiple clinical trials taken into account. The acute pharyngitis， chronic pharyngolaryngitis， paraesthesia pharyngis， hysterical aphasia， allergic rhinitis， subjective tinnitus， and otogenic vertigo were confirmed to respond specifically to TCM or integrated TCM and western medicine. Then a mutually agreed diagnosis and treatment scheme and recommendation with integrated TCM and western medicine was formulated as a reference for clinical practice， thus benefiting more patients.

OBJECTIVE: To determine the environmental contamination degree of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in corona virus disease 2019 (COVID-19) wards, to offer gui-dance for the infection control and to improve safety practices for medical staff, by sampling and detecting SARS-CoV-2 nucleic acid from the air of hospital wards, the high-frequency contact surfaces in the contaminated area and the surfaces of medical staff's protective equipment in a COVID-19 designated hospital in Wuhan, China. METHODS: From March 11 to March 19, 2020, we collected air samples from the clean area, the buffer room and the contaminated area respectively in the COVID-19 wards using a portable bioaerosol concentrator WA-15. And sterile premoistened swabs were used to sample the high-frequency contacted surfaces in the contaminated area and the surfaces of medical staff's protective equipment including outermost gloves, tracheotomy operator's positive pressure respiratory protective hood and isolation clothing. The SARS-CoV-2 nucleic acid of the samples were detected by real-time fluorescence quantitative PCR. During the isolation medical observation period, those medical staff who worked in the COVID-19 wards were detected for SARS-CoV-2 nucleic acid with oropharyngeal swabs, IgM and IgG antibody in the sera, and chest CT scans to confirm the infection status of COVID-19. RESULTS: No SARS-CoV-2 nucleic acid was detected in the tested samples, including the 90 air samples from the COVID-19 wards including clean area, buffer room and contaminated area, the 38 high-frequency contact surfaces samples of the contaminated area and 16 surface samples of medical staff's protective equipment including outermost gloves and isolation clothing. Moreover, detection of SARS-CoV-2 nucleic acid by oropharyngeal swabs and IgM, IgG antibodies in the sera of all the health-care workers who participated in the treatment for COVID-19 were all negative. Besides, no chest CT scan images of medical staff exhibited COVID-19 lung presentations. CONCLUSION Good ventilation conditions, strict disinfection of environmental facilities in hospital wards, guidance for correct habits in patients, and strict hand hygiene during medical staff are important to reduce the formation of viral aerosols, cut down the aerosol load, and avoid cross-infection in isolation wards. In the face of infectious diseases that were not fully mastered but ma-naged as class A, it is safe for medical personnel to be equipped at a high level.
Betacoronavirus ; COVID-19 ; China ; Coronavirus Infections ; Humans ; Medical Staff ; Pandemics ; Pneumonia, Viral ; Protective Devices ; SARS-CoV-2 ; Severe Acute Respiratory Syndrome/prevention & control*

Objective:To explore the risk factors of coronary slow flow(CSF)and the role of inflammatory response on its pathogenesis.Methods:The CSF was evaluated by corrected thrombolysis in myocardial infarction(TIMI)frame count (CTFC).Totally 96 cases with CSF(CSF group)and 106 cases with normal flow(NCSF group)were selected from patients undergoing coronary angiography(CAG)in our hospital from January 2016 to December 2016.Single and multi-variable logistic regression analysis was used to assess the relationship between CSF and clinical characteristics,baseline biochemistry and related inflammation factors(both in peripheral venous blood and in coronary arterial blood)including interleukin-6(IL-6), hypersensitive C reactive protein(hsCRP)and matrix metalloproteinase-9(MMP-9).Results:The CTFC values of three branches of coronary arteria in CSF group were all significantly higher than those in control group(left anterior descending:32.3 ± 3.7 vs 17.8 ± 2.1,left circumflex branch:34.5 ± 3.9 vs 23.1 ± 2.8,right coronary artery:34.9 ± 4.3 vs 21.4 ± 3.2, all P<0.01).The most common coronary artery involved by CSF was right coronary artery(83.3%).Single factor analysis found that the body mass index,diabetes ratio,uric acid,IL-6,hsCRP in coronary arterial blood,MMP-9 in both peripheral venous and coronary arterial blood in CSF group were significantly higher than those in NCSF group(P< 0.05 or 0.01). Logistic regression analysis found that body mass index(OR= 1.313,95% CI 1.026-1.654,P= 0.034),diabetes(OR=1.604,95% CI 1.198-2.466,P=0.006),uric acid(OR=1.036,95% CI 1.006-1.102,P= 0.027),M M P-9 in peripheral venous blood(OR=2.279,95% CI 1.478-4.022,P=0.004),M M P-9 in involved coronary arterial blood(OR=3.145,95%CI 2.011-5.023,P=0.000)were independent risk factors of CSF.Conclusions:Body mass index,diabetes,and uric acid are independent risk factors of CSF.Compared with the systemic inflammatory response,local inflammatory response of the involved coronary arteries is more relevant to CSF.MMP-9 plays an important role in the pathogenesis of CSF.

BACKGROUNDSacroiliac (SI) screw fixation is a demanding technique, with a high rate of screw malposition due to the complex pelvic anatomy. TiRobot™ is an orthopedic surgery robot which can be used for SI screw fixation. This study aimed to evaluate the accuracy of robot-assisted placement of SI screws compared with a freehand technique.

METHODSThirty patients requiring posterior pelvic ring stabilization were randomized to receive freehand or robot-assisted SI screw fixation, between January 2016 and June 2016 at Beijing Jishuitan Hospital. Forty-five screws were placed at levels S1 and S2. In both methods, the primary end point screw position was assessed and classified using postoperative computed tomography. Fisher's exact probability test was used to analyze the screws' positions. Secondary end points, such as duration of trajectory planning, surgical time after reduction of the pelvis, insertion time for guide wire, number of guide wire attempts, and radiation exposure without pelvic reduction, were also assessed.

RESULTSTwenty-three screws were placed in the robot-assisted group and 22 screws in the freehand group; no postoperative complications or revisions were reported. The excellent and good rate of screw placement was 100% in the robot-assisted group and 95% in the freehand group. The P value (0.009) showed the same superiority in screw distribution. The fluoroscopy time after pelvic reduction in the robot-assisted group was significantly shorter than that in the freehand group (median [Q1, Q3]: 6.0 [6.0, 9.0] s vs. median [Q1, Q3]: 36.0 [21.5, 48.0] s; χ2 = 13.590, respectively, P < 0.001); no difference in operation time after reduction of the pelvis was noted (χ2 = 1.990, P = 0.158). Time for guide wire insertion was significantly shorter for the robot-assisted group than that for the freehand group (median [Q1, Q3]: 2.0 [2.0, 2.7] min vs. median [Q1, Q3]: 19.0 [15.5, 45.0] min; χ2 = 20.952, respectively, P < 0.001). The number of guide wire attempts in the robot-assisted group was significantly less than that in the freehand group (median [Q1, Q3]: 1.0 [1.0,1.0] time vs. median [Q1, Q3]: 7.0 [1.0, 9.0] times; χ2 = 15.771, respectively, P < 0.001). The instrumented SI levels did not differ between both groups (from S1 to S2, χ2 = 4.760, P = 0.093).

CONCLUSIONSAccuracy of the robot-assisted technique was superior to that of the freehand technique. Robot-assisted navigation is safe for unstable posterior pelvic ring stabilization, especially in S1, but also in S2. SI screw insertion with robot-assisted navigation is clinically feasible.

AIM: To study the effect of torsional mode phacoemulsification on cornea in patient with age-related cataract.METHODS: Totally 161 age-related cataract patients (196 eyes) were assigned randomly to phacoemulsification by torsional mode(Group A) or conventional ultrasound mode (Group B) in our hospital from January 2012 to December 2014.The intraoperative data of effective ultrasound time(UST)and effective cumulative dissipated energy(CDE) were recorded.Postoperative outcomes and the change of the best corrected visual acuity(BCVA),corneal edema degree(CED),central corneal thickness(CCT) and endothelial cell count were also recorded and compared.RESULTS: For grade Ⅰ,Ⅱ,Ⅲ and Ⅳ nuclear density,the mean UST and mean CDE were significantly lower in Group A.The average BCVA of Group A was better than Group B at 1 and 7d after surgery.But at 30d postoperative,there was no statistical difference between these two groups(P>0.05).The corneal clarity and the mean change of central thickness showed significantly less corneal edema in Group A than Group B in 1 and 7d postoperatively.This difference was no longer found significantly at 30d after surgery(P>0.05).At 7 and 30d postoperative,the endothelial cells in Group B were lower than in Group A.CONCLUSION: By reducing the effective UST and CDE intraoperatively,the main effect of torsional mode phacoemulsification on cornea shows less damage to endothelium cells,and patients get better prognosis.But the damage to cornea by torsional mode phacoemulsification isn`t fundamentally solved.

Cultivation of clinical profession ability of integrated traditional Chinese and Western medicine graduates involves the policy, management, evaluation, training, and many other aspects of colleges and universities. This article put forward the organic convergence of cultivation education and clinical profession post competence. According to the real situation of graduates, sectional, individualized, and true practice of clinical cultivation education was conducted, which could make graduates get into the cultivation education mode of "early clinical practice, more clinical practice, true clinical practice". This could effectively enhance the cultivation effects and clinical profession post competence of integrated traditional Chinese and Western medicine graduates.

Background: Sacroiliac (SI) screw fixation is a demanding technique, with a high rate of screw malposition due to the complex pelvic anatomy. TiRobot? is an orthopedic surgery robot which can be used for SI screw fixation. This study aimed to evaluate the accuracy of robot?assisted placement of SI screws compared with a freehand technique. Methods:Thirty patients requiring posterior pelvic ring stabilization were randomized to receive freehand or robot?assisted SI screw fixation, between January 2016 and June 2016 at Beijing Jishuitan Hospital. Forty?five screws were placed at levels S1 and S2. In both methods, the primary end point screw position was assessed and classified using postoperative computed tomography. Fisher's exact probability test was used to analyze the screws'positions. Secondary end points, such as duration of trajectory planning, surgical time after reduction of the pelvis, insertion time for guide wire, number of guide wire attempts, and radiation exposure without pelvic reduction, were also assessed. Results: Twenty?three screws were placed in the robot?assisted group and 22 screws in the freehand group; no postoperative complications or revisions were reported. The excellent and good rate of screw placement was 100% in the robot?assisted group and 95% in the freehand group. The P value (0.009) showed the same superiority in screw distribution. The fluoroscopy time after pelvic reduction in the robot?assisted group was significantly shorter than that in the freehand group (median [Q1, Q3]: 6.0 [6.0, 9.0] s vs. median [Q1, Q3]: 36.0 [21.5, 48.0] s; χ2 = 13.590, respectively, P < 0.001); no difference in operation time after reduction of the pelvis was noted (χ2 = 1.990, P = 0.158). Time for guide wire insertion was significantly shorter for the robot?assisted group than that for the freehand group (median [Q1, Q3]: 2.0 [2.0, 2.7] min vs. median [Q1, Q3]: 19.0 [15.5, 45.0] min; χ2 = 20.952, respectively, P < 0.001). The number of guide wire attempts in the robot?assisted group was significantly less than that in the freehand group (median [Q1, Q3]: 1.0 [1.0,1.0] time vs. median [Q1, Q3]: 7.0 [1.0, 9.0] times; χ2 = 15.771, respectively, P < 0.001). The instrumented SI levels did not differ between both groups (from S1 to S2, χ2 = 4.760, P = 0.093). Conclusions: Accuracy of the robot?assisted technique was superior to that of the freehand technique. Robot?assisted navigation is safe for unstable posterior pelvic ring stabilization, especially in S1, but also in S2. SI screw insertion with robot?assisted navigation is clinically feasible.