Objective:To explore the application effect of a self-made new spinal nerve assessment form in the nursing of patients with spinal cord injury, and to evaluate the observation ability of clinical nurses on the changes in the condition of spinal cord injury patients.Methods:This study adopted a randomized controlled trial and designed and developed a novel spinal nerve assessment form based on the "International Classification of Spinal Cord Injury Neurology (2019 edition)". The 32 nursing staff from the Department of Spine and Orthopedics of the First Affiliated Hospital of Guangzhou University of Chinese Medicine were selected and randomly divided into an observation group and a control group, with 16 nurses in each group. A total of 600 spinal cord injury patients admitted to the Department of Spine and Orthopedics of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from April 2022 to April 2023 were grouped for evaluation. The observation group implemented a new spinal nerve assessment record form to evaluate patients. The control group nurses evaluated patients using routine functional assessment methods. The rates of incorrect evaluation, missed evaluation, evaluation time and other factors were compared between the two groups.Results:Both groups of nurses were female, with the control group aged (30.98 ± 2.38) years and the observation group aged (31.28 ± 1.68) years. There were 200 male and 100 female patients in the control group, aged (55.18 ± 15.28) years; there were 189 male and 111 female patients in the observation group, aged (54.48 ± 16.48) years. The error rate and omission rate of the observation group after using the new spinal nerve assessment tool were 2.31% (245/10 584) and 1.82% (196/10 780), respectively, while the control group was 3.51% (368/10 486) and 2.73% (294/10 780). The differences between the two groups were statistically significant ( χ2=25.40, 20.06, both P<0.05); the evaluation time for cervical and lumbar spine injuries in the observation group were (238.79 ± 10.41) and (118.99 ± 11.12) h, respectively, while in the control group were (366.88 ± 11.89) and (197.22 ± 12.21) h. The differences between the two groups were statistically significant ( t=102.70, 82.51, both P<0.05). Conclusions:The self-made new spinal nerve assessment form can reduce error rate and omission rate in the spinal nerve assessment of spinal cord injury patients by nurses, save assessment time, standardize nurse operations, improve the quality of specialized nursing work, and ensure nursing safety.

OBJECTIVE To deeply explore the in vivo pharmacodynamic substance basis of Zhigancao Decoction,a classic tradi-tional Chinese medicine formula,and provide scientific evidence for its rational application and development in modern clinical practice.METHODS Wistar rats were treated with 12.15 g·kg-1 Zhigancao Decoction by gavage.Rat plasma samples were collect-ed at 10 time points(5,15,30,60,120,240,360,480,600 and 720 min after administration)and rat heart(atrial and ventricu-lar)tissue samples were collected at 12 h after administration.Components in the plasma and heart samples were qualitatively identi-fied by ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF/MS),and the distri-bution characteristics of Zhigancao Decoction in vivo were analyzed.At the same time,the time-concentration curve of the prototype components and metabolites in Zhigancao Decoction was drawn to observe the changes of blood drug concentration.RESULTS A total of 11 prototype components(Ajugol,Nicotiflorin,Isoschaftoside,4-Hydroxycinnamic acid,Rehmapicrogenin,4-Hydroxybenzoic acid,4′,7-Dihydroxyflavone,Calycosin,3′,4′,7-Trihydroxyflavone,Pinellic acid,Truxillic acid)and 7 metabolites were identified from the plasma samples of Zhigancao Decoction,mainly including flavonoids(flavonoids glycosides),organic acids,and iridoid glyco-sides,etc.Additionally,6 prototype components(Ajugol,Isoschaftoside,Rehmapicrogenin,4′,7-Dihydroxyflavone,Liquiritigenin,3′,4′,7-Trihydroxyflavone)and 3 metabolites were identified from the cardiac samples(the atrium and the ventricle showed the same results).The metabolic pathways mainly involved Phase Ⅰ metabolism and glucuronidation.CONCLUSION The prototype compo-nents and metabolites in plasma and heart tissue of Zhigancao Decoction is preliminarily determined,providing a reference for analyzing the active components of Zhigancao Decoction in heart tissue.

OBJECTIVE To deeply explore the in vivo pharmacodynamic substance basis of Zhigancao Decoction,a classic tradi-tional Chinese medicine formula,and provide scientific evidence for its rational application and development in modern clinical practice.METHODS Wistar rats were treated with 12.15 g·kg-1 Zhigancao Decoction by gavage.Rat plasma samples were collect-ed at 10 time points(5,15,30,60,120,240,360,480,600 and 720 min after administration)and rat heart(atrial and ventricu-lar)tissue samples were collected at 12 h after administration.Components in the plasma and heart samples were qualitatively identi-fied by ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF/MS),and the distri-bution characteristics of Zhigancao Decoction in vivo were analyzed.At the same time,the time-concentration curve of the prototype components and metabolites in Zhigancao Decoction was drawn to observe the changes of blood drug concentration.RESULTS A total of 11 prototype components(Ajugol,Nicotiflorin,Isoschaftoside,4-Hydroxycinnamic acid,Rehmapicrogenin,4-Hydroxybenzoic acid,4′,7-Dihydroxyflavone,Calycosin,3′,4′,7-Trihydroxyflavone,Pinellic acid,Truxillic acid)and 7 metabolites were identified from the plasma samples of Zhigancao Decoction,mainly including flavonoids(flavonoids glycosides),organic acids,and iridoid glyco-sides,etc.Additionally,6 prototype components(Ajugol,Isoschaftoside,Rehmapicrogenin,4′,7-Dihydroxyflavone,Liquiritigenin,3′,4′,7-Trihydroxyflavone)and 3 metabolites were identified from the cardiac samples(the atrium and the ventricle showed the same results).The metabolic pathways mainly involved Phase Ⅰ metabolism and glucuronidation.CONCLUSION The prototype compo-nents and metabolites in plasma and heart tissue of Zhigancao Decoction is preliminarily determined,providing a reference for analyzing the active components of Zhigancao Decoction in heart tissue.

Objective:To explore the application effect of a self-made new spinal nerve assessment form in the nursing of patients with spinal cord injury, and to evaluate the observation ability of clinical nurses on the changes in the condition of spinal cord injury patients.Methods:This study adopted a randomized controlled trial and designed and developed a novel spinal nerve assessment form based on the "International Classification of Spinal Cord Injury Neurology (2019 edition)". The 32 nursing staff from the Department of Spine and Orthopedics of the First Affiliated Hospital of Guangzhou University of Chinese Medicine were selected and randomly divided into an observation group and a control group, with 16 nurses in each group. A total of 600 spinal cord injury patients admitted to the Department of Spine and Orthopedics of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from April 2022 to April 2023 were grouped for evaluation. The observation group implemented a new spinal nerve assessment record form to evaluate patients. The control group nurses evaluated patients using routine functional assessment methods. The rates of incorrect evaluation, missed evaluation, evaluation time and other factors were compared between the two groups.Results:Both groups of nurses were female, with the control group aged (30.98 ± 2.38) years and the observation group aged (31.28 ± 1.68) years. There were 200 male and 100 female patients in the control group, aged (55.18 ± 15.28) years; there were 189 male and 111 female patients in the observation group, aged (54.48 ± 16.48) years. The error rate and omission rate of the observation group after using the new spinal nerve assessment tool were 2.31% (245/10 584) and 1.82% (196/10 780), respectively, while the control group was 3.51% (368/10 486) and 2.73% (294/10 780). The differences between the two groups were statistically significant ( χ2=25.40, 20.06, both P<0.05); the evaluation time for cervical and lumbar spine injuries in the observation group were (238.79 ± 10.41) and (118.99 ± 11.12) h, respectively, while in the control group were (366.88 ± 11.89) and (197.22 ± 12.21) h. The differences between the two groups were statistically significant ( t=102.70, 82.51, both P<0.05). Conclusions:The self-made new spinal nerve assessment form can reduce error rate and omission rate in the spinal nerve assessment of spinal cord injury patients by nurses, save assessment time, standardize nurse operations, improve the quality of specialized nursing work, and ensure nursing safety.

Objective:To investigate the imaging characteristics of chest CT angiography in patients with active pulmonary tuberculosis complicated with pulmonary embolism, so as to improve the detection rate of active pulmonary tuberculosis complicated with pulmonary embolism.Methods:The clinical data of 103 patients with active pulmonary tuberculosis treated in Tianjin Haihe Hospital from January 2013 to January 2020 were retrospectively analyzed, including general conditions, symptoms and complications. According to the occurrence of pulmonary embolism, the patients were divided into active pulmonary tuberculosis complicated with pulmonary embolism group (study group, n=43) and active pulmonary tuberculosis without pulmonary embolism group (control group, n=60). The time between the onset of pulmonary embolism and the onset of tuberculosis of the patients in the study group was collected. The chest CT imaging characteristics of the patients of two groups were analyzed. The imaging characteristics, embolism distribution and secondary changes of the patients in the study group were summarized. Results:Time from onset of tuberculosis to pulmonary embolism of the patients in the study group was about 60 days (14 days to 75 days). The incidence of chest tightness and dyspnea of the patients in the study group was significantly higher than that in the control group (all P<0.05). The number of lung lobes involved in lung lesions of the patients in the study group was significantly higher than that in the control group ( P<0.05). The incidence of lesions in the middle lobe of the right lung, the tongue lobe of the left lung and the lower lobes of both lungs of the patients in the study group was higher than that in the control group (all P<0.05). The incidence of peripheral pulmonary embolism was significantly higher than that of central pulmonary embolism ( P<0.05). However, the incidence of atelectasis, pulmonary artery widening, and right heart enlargement in the patients with central pulmonary embolism was significantly higher than that in the patients with central pulmonary embolism (all P<0.05). Conclusions:Multi-slice spiral CT chest angiography can show some important imaging manifestations of patients with active pulmonary tuberculosis and pulmonary embolism, which is helpful for the early detection of the disease and the improvement of its prognosis. Multi slice spiral CT chest angiography can show some important imaging manifestations of patients with active pulmonary tuberculosis complicated with pulmonary embolism, and timely detection is helpful to improve the prognosis of patients with active pulmonary tuberculosis complicated with pulmonary embolism.

Objective To investigate the clinical manifestations,imaging and pathological features and treatment prognosis of primary renal sarcoma in adults.Methods A retrospective analysis was performed on the clinical data of 48 patients with primary renal sarcoma from January 2009 to December 2018 in the first affiliated hospital and cancer center of Sun Yat-Sen university.There were 30 males and 18 females.Their aged ranged from 27 to 76 yrs with an average age of 50 yrs.A total of 24 patients presented with lumbar and abdominal pain.Abdominal mass was found in 2 cases.Gross hematuria was noticed in 4 cases.Febrile was recorded in 2 cases and 21 cases were diagnosed by physical examination.31 tumors located in the left kidney and 17 tumors located in the right kidney.The tumor diameter ranged from 3 to 16 cm with an average diameter of 8 cm.All patients underwent ultrasound or CT/MRI examination of the urinary system before surgery.The ultrasound showed the undistributed echo inside the tumor with the undistinguished border.The image of necrosis and liquefaction could be seen in some cases.The CT/MRI examination showed the lesion site with the necrosis,liquefaction or cystic changing.The mass exhibited the unregular enhancement with undistinguished border line.The mean diameter of liposcarcoma was 10.2 cm.CT scan demonstrated the relative low density of tumor,which was hard to be identified with AML.The average diameter of leiomyosarcoma was 6.5 cm.The enhanced CT scan showed the low density of tumor,compared with renal parenchyma.46 patients underwent radical nephrectomy,2 patients underwent renal tumor biopsy.And postoperative follow-up was performed.Results Pathological diagnosis revealed that 19 cases with liposarcoma,9 cases with leiomyosarcoma and 4 cases with synovial sarcoma,especially 4 cases with Ewing' s sarcoma and 12 cases with other sarcoma.36 cases were followed up and survived for 4 to 64 months.The average survival time was 28 months.The longest mean survival time was seen in patients with liposarcoma,which was 32 months (ranging 11 to 64 months).The mean survival time of synovial sarcoma group was 25 months (ranging 5-58 months).The mean survival time of Ewing's sarcoma group was 22 months(ranging 12-46 months).and the survival time of leiomyosarcoma group was the shortest 20 months (ranging 4-36 months).Conclusion Renal sarcoma is rare and highly malignant.It needs to be diagnosed with clinical manifestations,imaging and pathological data together.

Objective To investigate the role of MMPs expression in the invasion and metastasis of bladder cancer.Methods 50 patients with bladder cancer were selected as observation group .30 healthy people were selected as control group.ELISA method was used to detect the serum contents of MMP -2 and MMP -9.The distribution and expression of MMP -2 and MMP-9 were detected by immunohistochemical SP method .The results of the two groups were compared .Results The serum levels of MMP-2 and MMP-9 between bladder cancer with lymph node metastasis group and control group had statistically significant differences (t =7.532,6.358,all P <0.05 ) , and the differences between bladder cancer with lymph node metastasis group and bladder cancer without lymph node metastasis group were statistically significant (t =5.486,6.225,all P <0.05),and the differences between bladder cancer without lymph node metastasis group and normal control group were statistically significant (t=9.687,8.425,all P<0.05).The expression of MMP -2 and MMP-9 in bladder epithelial tissues of normal control group was negative , MMP-2 and MMP-9 expression in tumor cells and stromal cells of 50 patients with bladder cancer metastasis was positive ,mainly expressed in tumor cells ,MMP-2 positive expression in 37 patients, MMP-9 positive expression in 49 patients.With the increase of tumor grade and lymph node metastasis , the expression of MMP-2 and MMP-9 increased obviously,the differences were statistically significant (χ2 =9.268, 11.258,8.412,6.354,all P<0.05).MMP-2 and MMP-9 levels were associated with tumor histological grade and lymph node metastasis in bladder cancer cell metastasis (χ2 =11.742,P<0.05).Conclusion Serum contents and expression of MMP-2 and MMP-9 are closely related with invasion and metastasis of bladder cancer ,which can be used as objective indicators that estimate the prognosis of bladder transitional cell carcinoma .

A 48-year-old male was suffered from slowly progressive dysuria over twenty years. Although multiple urethral dilatation was treated, the effect was unsatisfactory. He was diagnosed with penile lichen sclerosus related to urethral stricture due to the lichenification of glans penis, the stenosis of urethral meatus, and the long anterior urethral stricture shown by urethrography. Finally, the patient underwent an enlarged urethroplasty with lingual mucosal graft (17 cm in length), and obtained a good outcome. During the two-year postoperative follow-up, the patient maintained a satisfactory urination without any complication.

Objective:To investigate the breakthrough points and methods of pharmaceutical care performed by clinical pharma-cists for chemotherapy-induced Ⅳ degree myelosuppression. Methods: One advanced lung adenocarcinoma patient suffering from IV degree myolosuppression after being treated with pemetrexed combined with nedaplatin was selected as the example, and the chemother-apy regimen, the cause and treatment of IV degree myolosuppression and the pharmaceutical service could be carried out were ana-lyzed. Results: With the help of clinical pharmacists, the patient conquered chemotherapy-induced myelosuppression, and clinical pharmacists enhanced the awareness of pharmaceutical care and played a positive role in the safe and effective drug use. Conclusion:The participation of clinical pharmacists in clinical pharmaceutical care through providing pharmaceutical service is beneficial to safer and more effective drug therapy.

asty without increasing morbidity, especially for slim patients or patients with a large renal pelvis.