By reviewing the historical materia medica， medical books and modern literature， this paper has systematically sorted out and verified the name， origin， quality and other aspects of Ophicalcitum. After herbal textual research， it is shown that before the Qing dynasty， the mineral medicine was mostly recorded in the name of Huarushi， but now it is called Huaruishi， and there is another mixed name Baiyunshi. The light white spots described in the historical materia medica are consistent with the characteristics of marble with sparkling star-like luster， combined with the color like sulfur， color are green， black spots and other serpentine features， it is deduced that it is serpentine marble， consistent with the present-day Ophicalcitum， and Ophicalcitum in the Song dynasty has a high content of serpentine. The main producing areas are Henan， Shaanxi， Shanxi and Sichuan， Jiangsu， Zhejiang， Hebei and other places are also available. Successive generations of materia medica on the quality evaluation of Ophicalcitum is less， the modern to neat and firm in the texture， sandwiched with yellow-green mottled for the best. Ophicalcitum is acidic， astringent and neutral in nature， belonging to the liver meridian， with the efficacy of treatment of gold sores and blood flow， internal leakage of cataracts， dropping afterbirth， now describing its efficacy as removing blood stasis and stopping bleeding. In ancient times， the earliest processing method was burning， followed by calcination by sulphur， calcination， quenching with vinegar and other methods. In modern times， it has been simplified to open calcination， processing with vinegar and the addition of water quenching. The gravimetric method and ethylenediaminetetraacetic acid titration were used to detect the contents of CO₃^2- and CaCO₃ in Ophicalcitum， respectively， and it was found that the gap in CaCO₃ content among commercially available products was wide， and the content of CaCO₃ in sample S13 and sample S18 was the same， but their compositions were different， and according to the contents of CO₃^2- and CaCO₃， the dolomite and calcite contents could be calculated， of which the higher the calcite content the more obvious the sparkling star-like luster. Raman spectroscopy and X-ray diffraction（XRD） were used to detect the physical phase composition of the powder of the samples， and Raman spectroscopy was used for the rapid non-destructive testing of the striped part， which showed that Ophicalcitum was mainly composed of dolomite， calcite， serpentine， olivine and pyroxene， with serpentine dominanting the striped part. In summary， the 2020 edition of Chinese Pharmacopoeia stipulates that the content of CaCO₃ in Ophicalcitum is not less than 40%， which is difficult to control its quality， and it is suggested to increase the detection of CO₃^2- content. This study can provide a scientific basis for the traceability of Ophicalcitum and better guide the clinical medication and rational utilization of resources.

Objective:To investigate the application status of emergency radiology in China, and to provide data support for the standardized development, scientific management and big data research of emergency radiology.Methods:From August 12th to October 19th, 2022, a questionnaire survey was conducted through WeChat"Questionnaire Star"to send targeted questionnaires to investigate the relevant data of the current status of emergency radiology in China, mainly including digital radiography (DR) and computed tomography (CT). This study was initiated by the Chinese Emergency Radiology Database Collaboration Group, and comprehensively investigated emergency imaging personnel, equipment, workload, critical value reporting process, and artificial intelligence (AI) application status.Results:There were 123 hospitals in the study. The survey showed that emergency DR/CT reports were mainly completed by residents and above (69.1%). There were 21 DR brands, 10 CT brands and 8 MR brands used for emergency imaging examinations. The median number of DR examinations in tertiary hospitals and secondary hospitals investigated from January to June 2022 was 4 642 and 2 015 cases respectively, and the median number of CT examinations was 16 512 and 3 762 cases respectively. The average single-shift workload of DR in the emergency radiology department during the day and night shift in tertiary hospitals was mainly ≤20 copies and 21-50 copies, and the average single-shift workload of CT in the emergency radiology department during the day and night shift was mainly 21-50 copies and 51-100 copies, while the average single-shift workload of DR/CT in the emergency radiology department during the day/night shift in secondary hospitals was mainly ≤20 copies. In terms of critical value reporting process, 74.8% of emergency imaging doctors and 84.6% of emergency imaging technicians took the way of phone/text message to notify the clinical doctor or the patients′ family. The overall deployment rate of AI in emergency imaging was about 60.2%. 75% of the respondents believed that in the future, AI can improve emergency radiology work from aspects such as emergency screening, aided diagnosis and process optimization.Conclusions:The emergency medical imaging mainly based on DR and CT has the current situations such as generally low seniority of doctors, diverse brands of imaging equipments, large volume of examinations and intense workload per doctor, especially in tertiary hospitals, and dependence on traditional means for critical value reporting. At present, AI is emerging in the field of emergency imaging, and there is still a long way to go to play the huge potential of AI in the intelligent whole process of emergency imaging in the future.

Objective:This study aimed to reveal the distribution and course of the branches of the infraorbital nerve(IN),its communication relationship between the branches of the infraorbital nerve and facial nerve,so as to provide morphological basis for clinical implementation of accurate infraorbital nerve trunk in the infraorbital canal,regional facial anesthesia and facial surgery,so as to improve the success rate of maxillofacial surgery.Methods:25 adult cada-vers with formalin immobilized semi-face were selected.Exclude facial defect samples caused by tumor,trauma,deformity,surgery,etc.The length and diameter of the trunk of the infraorbital nerve and the length of the infraorbital canal were measured.The total number of infraorbital nerve and the number of branches were counted,and the course,distribution and communication relationship between infraorbital nerve and facial nerve were investigated.Results:The length of infraorbital nerve trunk ranged from 19.61 to 44.47 mm,with an average length of(23.33±4.95)mm.The length of infraorbital canal ranged from 9.49 to 31.21 mm,with an average length of(12.87±3.99)mm.The number of infraorbital nerve branches ranged from 5 to 12,and the average number was(7.29±2.29).The number of upper labial branches was the widest,ranging from 1 to 5,while the distribution area of eyelid branches was the narrowest.There are(were)a large number of intersections and anastomoses between the infraorbital nerve and the facial nerve,forming a complex multi-layer network structure.Conclusion:The infraorbital nerve trunk and the infraorbital canal va-ry in length.The number and distribution range of infraorbital nerve branches are not constant,and the communication relationship between infraorbital nerve and facial nerve is complicated.

Pancreatic cancer, notorious for its late diagnosis and aggressive progression, poses a substantial challenge owing to scarce treatment alternatives. This review endeavors to furnish a holistic insight into pancreatic cancer, encompassing its epidemiology, genomic characterization, risk factors, diagnosis, therapeutic strategies, and treatment resistance mechanisms. We delve into identifying risk factors, including genetic predisposition and environmental exposures, and explore recent research advancements in precursor lesions and molecular subtypes of pancreatic cancer. Additionally, we highlight the development and application of multi-omics approaches in pancreatic cancer research and discuss the latest combinations of pancreatic cancer biomarkers and their efficacy. We also dissect the primary mechanisms underlying treatment resistance in this malignancy, illustrating the latest therapeutic options and advancements in the field. Conclusively, we accentuate the urgent demand for more extensive research to enhance the prognosis for pancreatic cancer patients.
Humans ; Pancreatic Neoplasms/therapy* ; Prognosis ; Pancreas/pathology* ; Genetic Predisposition to Disease ; Genomics

Objective:To compare the short-term efficacy of hip arthroscopic surgery assisted by platelet-rich plasma (PRP) and hip arthroscopy alone in the treatment of femoroacetabular impingement (FAI).Methods:A retrospective cohort study was performed on the clinical data of 133 FAI patients admitted to Fourth Medical Center of PLA General Hospital from January 2019 to January 2021. The patients included 86 males and 47 females, aged 19-71 years [(39.1±12.6)years]. A total of 67 patients were treated with hip arthroscopy alone (hip arthroscopy group), and 66 patients were treated with PRP after hip arthroscopy under ultrasound guidance (hip arthroscopy+PRP group). The two groups were compared before, at 12 months after surgery and at the last follow-up regarding the following items: Visual Analogue Scale (VAS), Modified Harris Hip Score, International Hip Outcome Tool-12 (iHOT-12), and Hip Outcome Score Activities of Daily Living Scale (HOS-ADL). The incidence rate of complications after surgery was compared between the two groups.Results:A total of 108 patients were followed up for 24-36 months [(28.5±3.8)months], while 25 patients were lost to follow-up because of withdrawal of consent, wrong telephone number, etc, including 11 patients (16.4%) in the hip arthroscopy group and 14 patients (21.2%) in the hip arthroscopy+PRP group. The values of VAS in the hip arthroscopy group before, at 12 months after surgery and at the last follow-up were 5.00(5.00, 7.00)points, 3.00(2.00, 3.75)points, and 1.00(0.00, 2.00)points, respectively; the values of Modified Harris Hip Score were 49.00(39.00, 57.00)points, 76.00(69.25, 82.00)points, and 86.00(82.00, 88.00)points, respectively; the values of iHOT-12 were 0.45(0.28, 0.58)points, 0.69(0.58, 0.80)points, and 0.81(0.70, 0.92)points, respectively; the values of HOS-ADL were 0.52(0.42, 0.68)points, 0.87(0.75, 0.93)points, and 0.93(0.86, 0.99)points, respectively. The scores of VAS in the hip arthroscopy + PRP group before, at 12 months after surgery and at the last follow-up were 6.00(5.00, 7.00)points, 3.00(2.00, 3.75)points, and 1.00(0.00, 2.00)points, respectively; the values of Modified Harris Hip Score were 46.50(37.00, 56.75)points, 78.00(72.00, 84.00)points, and 84.50(82.00, 88.00)points, respectively; the values of iHOT-12 were 0.42(0.26, 0.51)points, 0.66(0.58, 0.74)points, and 0.81(0.68, 0.88)points, respectively; the values of HOS-ADL were 0.54(0.38, 0.65)points, 0.87(0.72, 0.96)points, and 0.94(0.86, 1.00)points, respectively. In both groups, VAS, Modified Harris Hip Score, iHOT-12, and HOS-ADL were significantly improved at 12 months after surgery and at the last follow-up compared with those before surgery, and were further improved at the last follow-up compared with those at 12 months after surgery (all P<0.01). There were no significant differences in VAS, Modified Harris Hip Score, iHOT-12 and HOS-ADL between the two groups before, at 12 months after surgery and at the last follow-up (all P>0.05). There was no significant difference in the incidence rates of postoperative hip pain and clicking between the two groups (both P>0.05). Conclusion:Hip arthroscopy can considerably improve short-term hip symptoms and function in FAI patients, but the use of PRP treatment after hip arthroscopy cannot further improve its short-term efficacy in FAI patients.

Objective: To investigate the protective effect of glucose regulatory protein 78 (GRP78) on cardiomyocytes in atrial fibrillation and its mechanism. Methods: HL-1 cardiomyocyte cell line was cultured from June 2016 to March 2017 at Harbin Medical University Central Laboratory.The cells were randomly divided into 4 groups: control group, pacing group, pacing+ GRP78cDNA group, pacing+ GRP78siRNA group.The following indicators were detected: (1)oxidative stress: flow cytometry was used to detect the content of reactive oxygen species (ROS) in each group; (2)Ca²⁺ overload and cell electrophysiology: flow cytometry was used to detect Ca²⁺ content in each group; (3)cell structure reconstruction: cell apoptosis was detected by flow cytometry. Results: The ROS production in the pacing group was significantly higher than that in the control group [(28.8±0.5)% vs.(4.5±0.8)%, F=27.91, P<0.01]. The number of ROS in the GRP78siRNA group was significantly higher than that in the pacing group [(71.1±0.3%) vs.(28.8±0.5)%, F=34.12, P<0.01]. The ROS content of the GRP78cDNA group was lower than that of the pacing group [(26.1±2.7)% vs.(28.8±0.5)%, F=26.60, P<0.01]. Pacing significantly increased Ca²⁺ concentration in HL-1 cells; GRP concentration in HL-1 cells in the GRP78siRNA group was significantly higher than that in the pacing group [(72.53±2.5)AM vs.(39.23±1.9)AM, F=19.50, P<0.05]. The intracellular Ca²⁺ concentration in the GRP78cDNA group was significantly lower than that in the pacing group [(31.23±0.57)AM vs.(39.23±1.9)AM, F=28.17, P<0.01]. The survival rate of the GRP78cDNA group was significantly higher than that of the pacing group [(87.9±0.4)% vs.(80.1±0.5)%, F=19, P<0.05]. Conclusion GRP78 protein reduces intracellular calcium overload by reducing ROS production in myocardial cells during atrial fibrillation.It can alleviate the oxidative stress of cardiomyocytes and improve the survival rate of cardiomyocytes, and has protective effect on cardiomyocytes.

Objective To evaluate effects of 7 common hemoglobin variants on HbA 1c measurements using 4 ion exchange high performance liquid chromatography methods .Methods Ninety five samples with hemoglobin variants were collected from January 2017 to February 2018 during HbA1c measurements in laboratary medicine of peking university shenzhen hospital .Samples with 7 common hemoglobin variants were measured using Sebia Capillary 2 Flex Piercing, Bio-Rad D-10, Arkray HA8180V, Tosoh G8, and MQ6000 Plus, respectively.Effects of 7 common hemoglobin variants on HbA 1c measurements by the 4 methods were analyzed using Capillary 2 Flex Piercing as a comparative method .All statistical analyses were carried out using SPSS software version 19.0 .Mean bias were calculated for samples with hemoglobin variants , box plot was established to display bias distribution .Results Hb New York showed no interference on the 4 HPLC mechods although Hb New York could not be detected .D-10 could detect 6 Hb variants, and showed clinically significant interference for Hb J-Bangkok, Hb G-Coushatta, and Hb G-Taipei.HA-8180V fast mode yielded no HbA1c values for Hb J-Bangkok, Hb G-Coushatta, and Hb G-Taipei.Hb E, Hb Q-Thailand, and Hb G-Honolulu produced significant negative biases for HA-8180V.G8 standard mode could detect 1 Hb variant, and showed significant negative biases for six Hb variants .MQ6000 Plus could separate six Hb variants , only Hb G-Coushatta and Hb G-Taipei produced significant negative biases for the system . Conclusions Some common hemoglobin variants can interfere with HbA 1c determination by the most popular methods in South China , which may lead to erroneous HbA 1c values.

Objective: To explore the relationship between weight change and the changes in blood pressure, blood glucose and blood lipid profiles in middle-aged and elderly Chinese people. Methods: All participants were from the Dongfeng-Tongji cohort study. The study included 16 606 middle-aged and elderly Chinese people with complete information in the baseline survey in 2008 and the first follow-up survey in 2013. We collected the data on demographic characteristics, lifestyle, history of diseases and medication, and the results of medical health examinations, including height, weight, blood pressure, fasting blood glucose and lipid profiles. We divided the weight change into five groups, moderate or above weight loss (<-8.0%), slight weight loss (-8.0%, -3.1%), weight maintenance (-3.0%, 3.0%), slight weight increased (3.1%, 8.0%), and moderate or above weight increased (>8.0%). Generalized linear regression model was used to analyze the relationship between weight change and the changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglyceride (TG). Subgroup analyses were used to explore the influences of gender, age and baseline BMI level on the relationship between weight change and the above-mentioned metabolic indicators. Results: The average age of participants in baseline survey was (62.19±7.28) years with a range of 45 to 89 years. During the five-year period, there were 18.86% (2 633), 28.03% (4 655), 35.87% (5 956), 13.96% (2 319), 6.28% (1 043) people with moderate or above weight loss, slight weight loss, weight maintenance, slight weight increased, and moderate or above weight increased, respectively. Regression analyses showed that body weight change were positively correlated with changes in SBP, DBP, FBG, TC, LDL-C and TG, and negatively correlated with change in HDL-C (all linear trend P values were<0.05); As every 10% of weight changed, the β (95%CI) of changes in SBP (mmHg) (1 mmHg=0.133 kPa), DBP (mmHg), FBG (mmol/L), TC (mmol/L), LDL-C (mmol/L), HDL-C (mmol/L) and TG (mmol/L) were 4.94 (4.32, 5.55), 2.50 (2.11, 2.88), 0.05 (0.02, 0.08), 0.13 (0.11, 0.16), 0.14 (0.12, 0.16), -0.05 (-0.07, -0.04) and 0.16 (0.14, 0.18), respectively. Furthermore, subgroup analyses showed that weight change can lead to greater changes in blood pressure in older and overweight or obesity elderly people (all P for interaction<0.05). Conclusion Weight loss was beneficial for middle-aged and elderly people to improve the blood pressure, blood glucose and blood lipid profiles, regardless of the weight at the baseline, while weight gain was not.

OBJECTIVETo observe the clinical efficacy of auricular point sticking on prevention and treatment of gastrointestinal complications after gynecological laparoscopic operation of general anesthesia, and to explore whether it is achieved by regulating the secretion of plasma motilin (MTL).

METHODSSixty patients who received selective gynecological laparoscopy under general anesthesia were randomly assigned into an observation group and a control group, 30 patients in each one. The patients in the observation group were treated with auricular point sticking at each morning and night, 30 min before anesthesia, revival after surgery and 24 h after surgery. The adhesive fabric with vaccaria seeds was pressed at shenmen (TF), wei (CO), benmen (CO), jiaogan (AH) and pizhixia (AT) for 3 to 5 min until the sensation of sourness, distension and numb appeared. The treatment was given for one week. The patients in the control group were treated only with similar adhesive fabric at auricular points at identical time points; each auricular point was pressed for 3 to 5 min. The anus exhaust time, defecating time and borborygmus were recorded; the level of plasma MTL was tested 30 min before anesthesia, 24 h after o-peration and 48 h after operation; the occurrence of nausea and vomiting from the end of operation to the end of treatment were also recorded.

RESULTSCompared with the control group, the occurrence of nausea after operation was reduced in the observation group (<0.05), and the anus exhaust time and defecating time were shortened (both<0.05), and the recovery of borborygmus was improved (<0.05). The levels of MTL 24 h and 48 h after surgery were higher than those before operation in the two groups (all<0.05); The levels of MTL 24 h and 48 h after surgery in the observation group were significantly lower than those in the control group (both<0.05).

CONCLUSIONSThe assist of auricular point sticking could reduce the occurrence of nausea-vomiting and accelerate the recovery of gastrointestinal function in gynecological laparoscopic operation under general anesthesia, which is likely to be related with the inhibition on excess secretion of MTL.

Objective To summarize nursing care of 6 critically ill patients with human infections of avian influenza A H7N9 virus. Methods Totally 6 cases of human infection with H7N9 avian influenza in our hospital during December 2016 to February 2017 were treated, with nursing care including:careful nursing of medication, nutrition management, oxygen therapy, analgesic sedative care, delirium prevention, humane care and protective isolation. Results About 5 cases were discharged from the hospital and 1 case died. Conclusion The key nursing points include observation of anti-avian influenza virus efficacy and side effects, nutrition management, oxygen therapy and mechanical ventilation care, analgesic sedative care, delirium prevention, humane care, and preventive isolation, which are key to the successful treatment of critically ill patients with human infections of avian influenza A H7N9 virus.