Objective:To investigate the application value of 72-hour three-lead electrocardiogram(ECG)monitoring with adhesive patch(AP)in patients with palpitation.Methods:A retrospective analysis was performed for the medical history and ECG data of the patients who underwent 72-hour three-lead ECG monitoring with AP due to palpitation in The First Affiliated Hospital of Chongqing Medical University.The incidence rates of arrhythmia and transient ST-T changes were compared at 24 and 72 hours,as well as the rate difference between the detection rate of arrhythmia and transient ST-T changes at 72 hours and the detection rate at 24 hours in the context of various risk factors such as age,hypertension,hyperlipidemia,and coronary heart disease.Results:Among the 216 pa-tients with palpitation,the detection rates of various types of arrhythmia and transient ST-T changes at 72 hours were significantly higher than those at 24 hours(P<0.05).The rate difference of atrial premature beats in patients aged<60 years was significantly higher than that in patients aged≥60 years(P<0.01).The rate difference of atrial premature beats in hypertensive patients was lower than that in non-hypertensive patients(P<0.05).The rate difference of T-wave changes in patients without hypertension or coronary heart dis-ease was greater than that in patients with hypertension or coronary heart disease(P<0.01).Compared with 24-hour three-lead ECG monitoring,72-hour three-lead ECG monitoring with AP can significantly improve the detection rate of arrhythmia and transient ST-T changes.In patients with palpitation aged<60 years or without hypertension,72-hour three-lead ECG monitoring with AP is more sen-sitive to atrial premature beats which are consistent with self-perceived symptoms,and in patients with palpitation without hyperten-sion or coronary heart disease,72-hour three-lead ECG monitoring with AP is more sensitive to transient T-wave changes associated with symptoms.Conclusion:The technique of 72-hour three-lead ECG monitoring with AP greatly promotes the accuracy and timeli-ness of diagnosis,reduces the economic burden of patients with pal-pitations,and optimizes the allocation of medical resources.

Objective:To investigate the value of electrical cardiometry(EC),a noninvasive hemodynamic testing technique,in the di-agnosis of heart failure(HF)in adults.Methods:A prospective study was conducted among the adult patients who were hospitalized in Department of Cardiology,The First Affiliated Hospital of Chongqing Medical University,from September 2022 to May 2024,and the patients who were diagnosed with HF were enrolled as HF group,while those who were excluded from the clinical diagnosis of HF were enrolled as control group.The two groups were compared in terms of general clinical data and related parameters measured by EC,in-cluding stroke volume variation(SVV),systolic time ratio(STR),pre-ejection period(PEP),index of contractility(ICON),ICON varia-tion(VIC),left ventricular ejection time(LVET),and left ventricular ejection fraction(LVEF).A multivariate logistic regression model established by the forward method was used to investigate the factors associated with HF.The receiver operating characteristic(ROC)curve was plotted for the hemodynamic parameters measured by EC in the diagnosis of HF,and the area under the ROC curve(AUC)was calculated.Results:A total of 239 patients were enrolled,with 126 in the HF group and 113 in the control group.Compared with the control group,the HF group had significantly higher SVV,STR,PEP,VIC,and age and significantly lower ICON,LVET,and LVEF(all P<0.001).The multivariate logistic regression model estab-lished by the forward method showed that STR(odds ratio[OR]=1.199,95%CI=1.110-1.294,P<0.001),VIC(OR=1.176,95%CI=1.090-1.269,P<0.001),and age(OR=1.068,95%CI=1.010-1.128,P<0.05)were positively correlated with HF,and ICON(OR=0.968,95%CI=0.941-0.996,P<0.05)and LVEF(OR=0.854,95%CI=0.798-0.913,P<0.001)were negatively correlated with HF.The ROC curve analysis showed that STR,VIC,and ICON had an AUC of 0.887(95%CI=0.848-0.927),0.891(95%CI=0.851-0.932),and 0.718(95%CI=0.654-0.782),respectively,in the diagnosis of HF,with an optimal cut-off value of 37.5%,19.5%,and 49.3,respec-tively,a sensitivity of 91.3%,73.8%,and 50.0%,respectively,and a specificity of 61.4%,93.8%,and 86.7%,respectively.Among these indicators,STR combined with VIC had an AUC of 0.940(95%CI=0.912-0.967)in the diagnosis of HF,with a sensitivity of 83.3%and a specificity of 91.2%.Conclusion:The EC method can effectively assess the cardiac functional status of adult patients,and STR combined with VIC has some clinical value for the diagnosis of heart failure.

Bupleuri radix is the dried root of Bupleuri radix or narrow-leaved Bupleuri radix of the umbelliferae family,and it is the most commonly used traditional Chinese medicine,which was first published in Shennong's Classic of Materia Medica.It has a variety of pharmacological effects such as anti-inflammatory,antioxidant,hepatoprotective,antitumor,antidepressant,et al.In the modern study,the extract of Bupleuri radix mainly includes a variety of chemical components such as Bupleuri radix saponin,flavonoids and volatile oil.By reviewing the relevant literature at home and abroad,this paper summarizes the research progress on the chemical composition and pharmacological effects of Bupleuri radix,and points out the future research direction to provide a certain reference basis for the subsequent research.

Objective To investigate the electrophysiological characteristics of hamster primary cortical neurons by using the whole-cell patch-clamp recordings in a Mg2+-free cell model of epilepsy.Methods The cerebral cortex were isolated for primary neuron culture from neonatal Syrian hamsters 1-2 days after birth.After 12 days,primary neurons were exposed to normal external(Mg2+group)or Mg2+-free external(Mg2+-free group)respectively for 3 hours,followed by a 24-hour incubation in normal culture medium.Excitatory postsynaptic currents(EPSC)and excitatory postsynaptic potentials(EPSP)were recorded in voltage clamp mode and current clamp mode using whole-cell patch-clamp recordings,respectively.Results Compared to Mg2+group,the frequency of EPSC[(124.38±75.15)Hz vs.(33.93±22.32)Hz,P<0.001](P<0.001)and EPSP[(37.05±38.37)Hz vs.(5.63±9.52)Hz,P<0.01]in primary cortical neurons from the Mg2+-free group increased significantly.Meanwhile,there were no statistically significant differences in the amplitude,area under the curve and half-width of EPSC and EPSP between the two groups(P>0.05).Conclusion The present study demonstrates an increase in excitability of primary hamsters cortical neurons after Mg2+depletion,suggesting that these neurons can be utilized to use to create cell models of epilepsy.

Objective     To investigate the current status of constipation during postoperative hospitalization and the factors associated with moderate to severe constipation at discharge in lung cancer patients. Methods     Lung cancer patients who underwent surgery in 6 tertiary hospitals in Sichuan Province from November 2017 to January 2020 were enrolled. The MD Anderson Symptom Scale-Lung Cancer Module was used to collect postoperative constipation scores. Unconditional logistic stepwise regression was used to analyze the related influencing factors for moderate to severe constipation on the day of discharge. Results     Finally 337 patients were collected. There were 171 males and 166 females, with an average age of 55.0±10.3 years. Constipation scores of lung cancer patients increased from postoperative day 1 to day 3, and showed a decreasing trend from day 3 to day 7. Moderate to severe constipation was present in 68 (20.2%) patients at discharge. The postoperative hospital stay (OR=0.743, P<0.001) and the dose of morphine used during postoperative hospitalization (OR=1.002, P=0.015) were influencing factors for moderate to severe constipation at discharge in lung cancer patients. Conclusion    Lung cancer patients have the most severe constipation on postoperative day 3. Moderate to severe constipation at discharge is associated with the postoperative hospital stay and the dose of morphine used during postoperative hospitalization.

Objective:We aimed to estimate the incidence of anxiety or depression in asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) patients and explore its related factors.Methods:Stable patients who were treated or followed up in the outpatient department of respiratory medicine in the First Hospital of China Medical University from March 2018 to March 2019 were enrolled, including 53 ACO patients, 74 asthma patients, and 138 patients with COPD. Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to evaluating the anxiety and depression status of the three groups of patients, and the risk factors of anxiety and/or depression in ACO patients were analyzed.Results:There were 33 cases (62.3%), 35 cases (47.3%) and 69 cases (50.0%) combined with anxiety in ACO, asthma and COPD group; there were 29 cases (54.7%), 25 cases (33.8%) and 58 cases (42.0%) combined with depression in ACO, asthma and COPD group, respectively. The patients with depression in ACO were significantly higher than those in asthma group ( P<0.05). There were 28 patients (52.8%), 24 patients (32.4%) and 52 patients (37.7%) combined with anxiety and depression in ACO, asthma and COPD group, respectively, with significant difference in ACO group and asthma group ( P<0.05). Multivariate logistic regression analysis showed that chronic obstructive pulmonary disease assessment test (CAT) score≥10 was associated with anxiety ( OR=15.00, P<0.01) or depression ( OR=8.667, P<0.01) in patients with ACO. Conclusions:Anxiety/depression is common in chronic airway disease. Compared with asthma, anxiety and/or depression is more frequent in the patients with ACO. ACO patients with high CAT scores should pay attention to screening for anxiety/depression.

【Objective】 To investigate and analyze the current situation of the human resources as well as blood collection and supply of blood banks of Zhejiang Province, so as to understand the problems existing in the development of human resources and put forward suggestions. 【Methods】 Questionnaires were issued to Blood Center of Zhejiang Province, municipal central blood stations, and county-level central blood banks to investigate the relevant data in 2015 and 2019. Meanwhile, some data were obtained through the Zhejiang Blood Management Information System (BIS3.0), symposiums, and querying medical service data. Statistical analysis was carried out. 【Results】 Among the 28 blood banks, filled the questionnaires, 927 personnel were in accordance with the authorized strength, accounting for 62.26% (927/1 489), and 1069 health technicians, accounting for 71.519% (1 060/1 489). From 2015 to 2019, the annual growth rate of human resources in blood banks was 2.02%, lower than the annual growth rate of whole blood collection volume 4.83% and the annual growth rate of clinical blood supply (red blood cell) 4.82%, lagging behind the annual growth rate of 6.55%, 8.71% and 12.36% in the number of diagnoses, inpatients and surgeries in the hospitals across the province. The average annual growth rate of doctors and nurses in blood banks was 0.17% and 1.67%, lower than that of licebsed doctors and registered nurses of the province, which was 6.78% and 8.27%, respectively. 【Conclusion】 With the development trend of blood collection and supply, the personnel allocation and the proportion of health technicians of blood banks across Zhejiang Province is insufficient. It is suggested to establish a manpower allocation standard suitable to the business volume, give priority to properly solvement of the current employment, strengthen training, and improve the efficiency of physical examination consultation, testing and phlebotomy positions.

BACKGROUND: Low dose computed tomography (LDCT) for lung cancer screening is widely employed in China as a result of increasing cancer screening awareness. Although some pulmonary lesions detected by LDCT are cancerous, most of the pulmonary nodules are benign. It is important to make effective preoperative differentiation of pulmonary lesions and to obviate the need for surgery in some patients with benign disease. METHODS: From January 1, 2017 to December 31, 2018, patients in our institution with surgical pathology confirmed benign pulmonary lesions in which malignancy could not be excluded in preoperative assessment were enrolled in this study. Retrospective analysis of clinical data was conducted. RESULTS: 297 cases were collected in this study. Prevalence of benign disease in patients underwent resection for focal pulmonary lesions is 9.8% in our institution. In 197 patients (66.3%), pulmonary lesions were detected by LDCT screening. A total of 323 assessable pulmonary lesions were detected by chest CT. The average diameter of pulmonary lesions was (17.9±12.1) mm, and 91.0% of which were greater than or equal to 8 mm. Solid nodules accounted for 65.6% of these lesions. Imaging characteristics suggesting malignancy were common, including spicule sign (71/323, 22.0%), lobulation (94/323, 29.1%), pleural indentation (81/323, 25.1%), vascular convergence sign (130/323, 40.2%) and vacuole sign (23/323, 7.1%). 292 patients (98.3%) underwent video-assisted thoracoscopic surgery (VATS). Pulmonary wedge resection was performed in 232 cases (78.1%), segmental resection in 13 cases (4.4%) and lobotomy in 51 cases (17.2%). Surgical complications occurred in 4 patients (1.3%). The most frequent findings on surgical pathology analysis were: infectious lesions in 98 cases (33.0%), inflammatory nodules in 96 cases (32.3%), and hamartoma in 64 cases (21.5%). CONCLUSIONS Solid nodules accounted for most of these benign pulmonary lesions in which malignancy could not be excluded preoperatively, and imaging characteristics suggesting malignancy were common. VATS is an important biopsy method to identify etiology and pathology for lesions. The most frequent benign pulmonary diseases that are suspected to be malignant and underwent surgical resection are: infectious lesions, inflammatory nodules and hamartoma.

ObjectiveTo investigate the clinical effect of Fuhe Beihua prescription combined with transcatheter arterial chemoembolization (TACE) in the treatment of primary liver cancer patients with liver depression and spleen deficiency and its effect on T lymphocyte subsets. MethodsA retrospective analysis was performed for the clinical data of stage Ⅲ primary liver cancer patients with liver depression and spleen deficiency who were treated in Department of Hepatology and Department of Oncology in The First Affiliated Hospital of Guangxi University of Chinese Medicine from January 2018 to January 2020. According to whether the traditional Chinese medicine Fuhe Beihua prescription was used, the patients were divided into treatment group (treated with routine TACE and oral administration of Fuhe Beihua prescription) and control group (treated with routine TACE alone), and the course of treatment was 16 weeks for both groups. The two groups were compared in terms of short-term response rate, quality-of-life score, serum alpha-fetoprotein (AFP) level, four indicators of liver fibrosis, coagulation function parameters, peripheral blood T lymphocyte subsets, and liver function parameters. The independent samples t-test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. A repeated-measures analysis of variance was used for comparison of continuous data between different groups at different time points. ResultsA total of 218 patients were selected, with 118 in the control group and 100 in the treatment group. The treatment group had an objective response rate of 33% and a disease control rate of 66% at week 8 of treatment and an objective response rate of 34% and a disease control rate of 69% at week 16 of treatment, and the control group had an objective response rate of 26.27% and a disease control rate of 68.64% at week 8 of treatment and an objective response rate of 30.51% and a disease control rate of 68.64% at week 16 of treatment; there was a significant difference in objective response rate between the two groups at weeks 8 and 16 of treatment (P＜0.05). Both groups had significant increases in Karnofsky Performance Scale (KPS) score, fibrinogen, and albumin (Alb) from before treatment to weeks 8 and 16 of treatment (all P＜0.05), and there were significant differences in KPS score, fibrinogen, and Alb between the two groups at weeks 8 and 16 of treatment (all P＜0.05). Both groups had significant reductions in AFP, the four indicators of liver fibrosis, alanine aminotransferase (ALT), aspartate aminotransferase (AST), prothrombin time (PT), and traditional Chinese medicine (TCM) syndrome score after treatment (all P＜0.05), and at weeks 8 and 16 of treatment, there were significant differences between the two groups in AFP, the four indicators of liver fibrosis, ALT, AST, PT, and TCM syndrome score (all P＜0.05). At weeks 8 and 16 of treatment, the treatment group had significant increases in the levels of CD3+, CD4+, and CD4+/CD8+ (all P＜0.05) and a significant reduction in the level of CD8+ (P＜0.05), and there were significant differences in the levels of T lymphocyte subsets between the two groups at weeks 8 and 16 of treatment (all P＜0.05). ConclusionFuhe Beihua prescription combined with routine TACE has a better clinical effect than TACE alone in the treatment of primary liver cancer patients with liver depression and spleen deficiency, possibly by regulating the levels of T lymphocyte subsets.

Objective: To investigate the relationship between after-school schedule and bone mineral density in middle-school students in Shanghai, to provide a reference for taking targeted measures. Methods: From November 2017 to April 2018，eighteen classes of six middle schools in Shanghai (from urban districts, urban-suburb combined districts and suburban districts, respectively) were selected based on cluster random sampling. In each school, 2-4 classes were further randomly chosen in the 6th grade. Questionnaires were completed by 518 students and their parents, as well as physical examination and bone mineral density assessment. Results: The average time spent on after-school academic learning during weekends was 4.0 (IQR: 2.0, 6.0) h. The Z-score of bone density was 0.3 (IQR: -0.7, 1.0). The smooth curve fit model showed a non-linear relationship between after-school academic learning time during weekends and the Z-scores of bone mineral densities. A two-stage multiple linear regression analysis was further applied according to the fit results, and the results showed that when total afterschool academic learning time <4.5 hours during weekends, the learning time was inversely correlated with the bone density Z-scores (β=-0.11,P=0.01), and when the learning time ≥4.5 hours, there was no significant correlation between the learning time and bone density Z-scores (β=0.02, P=0.65). Parent and student questionnaires showed that there was a non-linear relationship between students’ daily time spent on outdoor sports-related activities and bone density Z-scores. When time spent on the outdoor activities ≥45 minutes per day, outdoor activities were positively correlated with bone density Z-scores (P<0.05). However, when the time spent on outdoor activities <45 minutes per day, there was no significant relationship between outdoor activities and bone density Z-scores (P>0.05). Conclusion Too much time on after-school academic learning during weekends or limited time on outdoor activities are both related to impaired bone mineral densities. Therefore, a reasonable after-school schedule for middle-school students is important for physical development, especially during weekends.