Post-stroke depression(PSD)is one of the commonly-seen complications after stroke,which seriously affects patients'quality of life and outcome of disease.Traditional Chinese medicine(TCM)classifies PSD as the co-morbidity of stroke and depression.This paper explored the pathogenesis and therapeutic principles of PSD from the view of"heart-blood-vessels"integration.It is proposed that PSD originates from the lesions of blood and vessels,and then the heart-body is involved;the lesions of heart,blood and vessels can cause the disorders of spirit.The core pathogenesis is due to the deficiency of heart qi,unsmoothed circulation of the vessels,and blood stasis causing depression of spirit.The principle of intervention of PSD should be focused on protecting vessels and regulating blood,nourishing heart and tranquilizing.Protecting vessels can be achieved by generating vessels,soothing vessels,and unblocking vessels through the application of Shengmai San,Zhi Gancao Decoction,and Tongmai Sini Decoction respectively.Regulating blood can be achieved by activating blood and generating blood.For activating blood,Danshen Decoction and Xuefu Zhuyu Decoction can be employed;for generating blood,Bazhen Decoction,Renshen Yangrong Decoction and Danggui Buxue Decoction can be employed.For nourishing heart and tranquilizing,the modified Gan Mai Dazao Decoction and Guipi Decoction can be employed.The view of"heart-blood-vessels"integration makes up for the disadvantages in separating the physique from the spirit,and in separating the structure from the function in the theory of the vessels and collaterals,and expands the approach of TCM treatment for PSD.

As the most distal branches of the meridian system,tertiary collaterals(sunluo)are morphologically similar to microvessels in western medicine,while Henoch-Sch?nlein purpura(HSP)is a manifestation of systemic vascular inflammation.The discussion in Huang Di Nei Jing(The Yellow Emperor's Inner Classic)regarding tertiary collaterals"draining pathogenic factors and regulating ying-wei"provides valuable theoretical guidance for the traditional Chinese medicine(TCM)treatment of HSP.This article thoroughly analyzes the physiological functions of tertiary collaterals and proposes that the formation of HSP is due to the invasion of pathogenic factors into the tertiary collaterals,leading to the imbalance of ying-wei,heat stasis obstructing the vessels,and blood extravasation,resulting in symptoms such as skin purpura,gastrointestinal bleeding,and joint pain.These symptoms further interfere with the convergence and biochemical processes of ying-wei,causing an imbalance of body fluids and blood.The overflow of body fluids from the tertiary collaterals,unable to return,leads to fluid stagnation.The accumulation of blood stasis and dampness in the kidney collaterals may cause kidney damage,manifesting as hematuria and proteinuria.The pathogenesis at different stages of the disease can be summarized as follows:in the early stage,pathogenic factors invade the tertiary collaterals,causing wei stagnation and ying obstruction;in the middle stage,fire toxin scorches the tertiary collaterals,affecting ying-wei,damaging yang and yin;or damp pathogens invade the lower regions through the tertiary collaterals,affecting the yin organs;in the late stage,deficiency of vital qi and collateral stasis lead to kidney dysfunction.Based on these pathological mechanisms,the treatment principle should focus on"harmonizing pathogenic wind and blood circulation,and unblocking the tertiary collaterals,"aiming to alleviate purpura symptoms,shorten the disease course,promote recovery,and achieve comprehensive prevention and treatment effects.

The implantation of a left ventricular assist device (LVAD) is an important therapeutic tool for patients with end-stage heart failure, which can either help patients transit to the heart transplantation stage or serve as destination therapy until the end of their lives. In recent years, the third generation of LVAD has evolved rapidly and several brands have been marketed both domestically and internationally. The number of LVAD implantations has been increasing and the long-term survival rate of implanted patients has improved, so this device has a broad development perspective. This article summarizes the current status, usage standards and precautions, and common complications after implantation of LVAD, as well as looks forward to the future development of LVAD, hoping to be helpful for researchers who are new to this field.

Since December 2019, the corona virus disease 2019 (COVID-19) caused by the 2019 novel coronavirus (2019-nCoV) has been reported in Wuhan, Hubei Province. Almost 70% of patients susceptible to 2019-nCoV are over age of 50 years, with extremely large proportion of critical illness and death of the elderly patients. Meanwhile, the elderly patients are at high risk of osteoporotic fractures especially osteoporotic vertebral compression fractures (OVCF). During the prevention and control of COVID-19 epidemic, orthopedists are confronted with the following difficulties including how to screen and protect OVCF patients, how to accurately diagnose and assess the condition of OVCF patients with suspected or confirmed COVID-19, and how to develop reasonable treatment plans and comprehensive protective measures in emergency and outpatient clinics. In order to standardize the diagnosis and treatment of patients with OVCF diagnosed with COVID-19, the authors jointly develop this expert consensus. The consensus systematically recommends the standardized emergency and outpatient screening and confirmation procedures for OVCF patients with suspected or confirmed COVID-19 and protective measures for emergency and outpatient clinics. Moreover, the consensus describes the grading and classification of OVCF patients diagnosed with COVID-19 according to the severity of illness and recommends different treatment plans and corresponding protective measures based on the different types and epidemic prevention and control requirements.

Objective: To explore how to select osteotomy line and its significance in mandibular distraction osteogenesis in infants and young children. Methods: From May 2013 to July 2018, 208 infants and young children with mandibular deformity were admitted to the Department of Oral and Maxillofacial Surgery, Guangzhou Women and Children Medical Center, including 131 males and 77 females, with the age range of 8 days to 4 years, mean age of 6 months. Their clinical records were retrospectively analyzed. There were 162 cases of Robin sequence, 37 cases of the first and branchial arch anomalies, 2 cases of Treacher-Collins syndrome, and 7 cases of other congenital malformations. During the distraction osteogenesis, different osteotomy lines were selected according to the characteristics of the mandibular deformity: (1) For short mandibular body, the straight osteotomy line was used to extend the mandibular body. (2) For short mandibular ramus, a polygonal osteotomy line was used to extend the ramus. (3) For the increased mandibular angle, a curved osteotomy line was used to change the angulation. Results: Linear osteotomy was used in 38 patients, polygonal line osteotomy were used in 129 patients, and curved osteotomy was performed in 41 patients. Among them, 4 patients with linear osteotomy had deciduous embryo injury, 6 patients with linear osteotomy and 2 patients with polygonal osteotomy had open occlusion, and patients with curved osteotomy did not have tooth and mandible damage, or malocclusion. All patients were followed up for 3 months to 5 years. The average follow-up time was 6.2 months. All osteotomy healed well, without osteonecrosis or nonunion. Conclusions For the mandibular distraction osteogenesis, osteotomy line could be individualized, according to the characteristics of mandibular deformity of infants and young children, which can reduce complications such as dental damage and open occlusion.

Purpose To evaluate the quality assessed by iconographic diagnostic test system using ROBIS. Materials and Methods"Diagnostic tests, system evaluation, Meta analysis, diagnoses*test, diagnoses*trial, systematic review, meta-analysis" were used as search term to retrieve relevant literatures recorded in CBM, CNKI, Wanfang Data, PubMed, Embase, and Cochrane Library from January. 1, 2014 to December. 31, 2016. After two independent researchers screened the literature and extracted the information, the quality of included literatures was evaluated using ROBIS. Results Totally 219 articles were included in the study, including 93 Chinese literatures and 126 English literatures. The results of subgroup analysis showed that the quality difference between Chinese and English documents was statistically significant (P=0.018); the quality difference between the Chinese literatures and those of other regions was statistically significant (P<0.001); there was no statistical significance in quality difference regarding the year of publication (P=0.34). The ROBIS evaluation results showed that there were only 15 literatures (6.85%) with low-risk, including 2 Chinese literatures and 13 English literatures. Conclusion The quality evaluated by Chinese and English diagnostic test system, which is publicly published in iconographic diagnostic test from 2014 to 2016, is generally low, and the quality of literatures published by domestic scholars and in Chinese is still behind international levels. The maker of system evaluation in this field should prepare their research plans in advance and fully report them in future research, adequately obtain evidence, minimize bias in respects of document screening, information extraction, and evaluation of original research bias, and take into account of results stability, based on which the quality of system evaluation in this field should be further improved.

Objective To study the effect of evidence-based nursing intervention in preventing postoperative concurrent infection in patients with acute cholecystitis.Methods A total of 120 patients with acute cholecystitis who underwent surgical treatment in our hospital were divided into control group and study group according to random number table method,with 60 cases per grop.Patients in the control group were given routine care,and the study group was given evidence-based nursing intervention based on routine nursing.The exhaust,hospitalization time,postoperative 24,72 h pain score and postoperative complications were compared between the two groups.Results After operation,the exhaust time and hospitalization time of the study group were lower,the pain scores at 24,72 h were lower than that in the control group,and the differences were statistically significant (P ＜ 0.05).The total postoperative infection rate in the study group was lower than that in the control group (5.0％ vs.18.3％,P ＜0.05).Conclusion Evidence-based care intervention can reduce the risk of postoperative concurrent infection in patients with acute cholecystitis,reduce postoperative pain,and promote patients'rehabilitation.

Objective To study the effect of evidence-based nursing intervention in preventing postoperative concurrent infection in patients with acute cholecystitis.Methods A total of 120 patients with acute cholecystitis who underwent surgical treatment in our hospital were divided into control group and study group according to random number table method,with 60 cases per grop.Patients in the control group were given routine care,and the study group was given evidence-based nursing intervention based on routine nursing.The exhaust,hospitalization time,postoperative 24,72 h pain score and postoperative complications were compared between the two groups.Results After operation,the exhaust time and hospitalization time of the study group were lower,the pain scores at 24,72 h were lower than that in the control group,and the differences were statistically significant (P ＜ 0.05).The total postoperative infection rate in the study group was lower than that in the control group (5.0％ vs.18.3％,P ＜0.05).Conclusion Evidence-based care intervention can reduce the risk of postoperative concurrent infection in patients with acute cholecystitis,reduce postoperative pain,and promote patients'rehabilitation.

Objective To investigate the relationship between the level of serum triglyceride and early pain after posterior lumbar interbody fusion.Methods A total of 79 patients who were admitted into our hospital from March 2016 to December 2016 were selected into the study,and these patients were divided into two groups according to the degree of pain which means 32 cases in the minor pain group and 47 cases in the intermediate pain group.The difference of serum triglyceride level 3 days after operation were compared between the two groups.Pearson correlation analysis was performed to test the correlation between the level of serum triglyceride and early post-surgical pain.Logistic regression analysis was performed to test the risk factors for early post-surgical pain.Results The data indicated the level of pain was significant higher in the intermediate pain group than that of the minor pain group.Level of serum triglyceride had a significantly positive correlation with the level of post-surgical pain and it was the risk factor of pain after posterior lumbar interbody fusion.Conclusion The level of serum triglyceride is the risk factor of early post-surgical pain of lumbar single level interbody infusion,and it should be adjusted in the perioperative treatment.

Objective The study aimed to identify risk factors of lumbar disc herniation in patients after decompression,and provide theoretical basis for postoperaive rehabilitation.Methods A told of 169 patients with lumbar spinal stenosis underwent bilateral partial laminectomy were included in the study,24 patients in herniation group,and 145 patients without develop postoperative acute sciatica as a control group.The radiographic variables were measured.The threshold of risk factors was evaluated by multiple logistics analysis and receiver operating characteristic curve(ROC) analysis.Results The results revealed that preoperative retrolisthesis during extension was the independent risk factor for lumbar disc herniation(1.24,95％CI[1.07～1.43];P<0.01).The area under the curve(AUC) was 0.801,and the cutoff value was 6.89％.Conclusion The preoperative retrolisthesis was the risk factor of lumbar disc herniation.