Objective To analyze the quality of 22 batches of Fritillariae thunbergii bulbus Formula Granules from 12 different manufacturers by using water-extraction reference substance of Fritillariae thunbergii bulbus(ZBM ERS ST)and water-extraction reference substance of Fritillariae hupehensis bulbus(HBBM ERS ST)as references.Methods Ethyl acetate-methanol-triethylamine-water(17∶1∶1∶0.5)was used as the developing solvent for high-performance thin-layer chromatography(HPTLC)fingerprint analysis.The high-performance liquid chromatography(HPLC)fingerprint analysis was performed on a Agilent Eclipse XDB-C18 column(4.6 mm×250 mm,5 μm)with the gradient mobile phase consisted of acetonitrile-0.03%diethylamine solution.The column temperature was set at 25℃and evaporative light-scattering detector was used.The determination was conducted according to standard test method for measurement of Fritillariae thunbergii bulbus Formula Granules(Guangdong PFKL00117).Results The results of HPTLC and HPLC analysis showed that there are significant differences among the 22 batches of Fritillariae thunbergii bulbus Formula Granules.There were 4 batches of Fritillariae thunbergii bulbus Formula Granules from 3 manufacturers among them showed fingerprint characteristics of Fritillariae hupehensis bulbus.The total amount of peimine and peiminine in the remaining 18 batches of Fritillariae thunbergii bulbus Formula Granules was 0.291-3.179 mg·g-1,which were quite different.Conclusion Currently,the quality of Fritillariae thunbergii bulbus Formula Granules on the market varies greatly.Standardized water-extract reference substance has better applicability for the analysis of the quality of Fritillariae thunbergii bulbus Formula Granules than the control medicinal materials.

At present,precise radiotherapy has been widely used through the development with many years,but the existing technique still is limited by the limitation of tolerance dose of normal tissues,which cannot achieve the optimal goal of treating tumor.Flash radiotherapy(Flash-RT)is one kind of radiotherapy technique that uses the beam with ultra-high dose rate(UHDR)to conduct irradiation,which can furthest treat tumors while significantly reduce radiation injury of normal tissues.But until now,the biological mechanism,key physical parameters and triggering mechanism of Flash-RT are still unclear,and its principle and clinical translational application are still in the stage of research.This review clarified the technological advance and clinical translational application of Flash-RT research through summarized the relevant research of Flash-RT.

Objective To explore the effect of the physician-nurse-social worker linkage rehabilitation model on the psychological status in patients receiving methadone maintenance treatment(MMT).Methods Ninety-four patients who received MMT were enrolled and randomly divided into experimental group(n = 48)and control group(n = 46).The experimental group received physician-nurse-social worker linkage rehabilitation model intervention,while the control group received conventional methadone treatment service.The anxiety,depression and quality of life of the two groups were evaluated before the intervention,3 months and 6 months after the intervention.Results After 6 months of physician-nurse-social worker linkage rehabilitation mode intervention,the depression status and the anxiety status of the experimental group subjects were significantly improved compared with those before intervention,and both BDI and BAI scores were significantly lower than those of the control group subjects(P＜0.05).Moreover,the proportion of"had depression"and"had anxiety"in the experimental group were significantly lower than those in the control group(P＜0.05).After 6 months of intervention,the QOL-DA score of the experimental group subjects(183.77±8.90)was significantly higher than that of the control group sub-jects(174.76±11.14)(P＜0.01).Conclusion The physician-nurse-social worker linkage rehabilitation model had certain advantages in improving the psychological state of MMT patients,which is worthy of promotion.

Objective:A dose verification system of two-dimensional semiconductor matrix(SRS MapCHECK)was used to verify the dose of the clinical treatment plan of patients who underwent CyberKnife(CK),which realized rapid verification for individualization of radiotherapy plans of patients through analyzed the γ-passing rates of them.Methods:A total of 253 patients with tumor who received CK clinical treatment in the First Medical Center of Chinese PLA General Hospital from March 2021 to May 2023 were selected.Among of them,121 cases received CK treatment on head,and 30 cases received that on lung,and 102 cases received CK treatment on abdomen and other metastatic tumor.In the MultiPlan treatment plan system,the plan of patient was mapped to the integrated model composed of StereoPHAN model and SRS MapCHECK matrix dose verification system by the means of the plan image center overlap.The dose verification was conducted on the plan of each patient on the basis of ensuring the consistency of the number of beam,direction of beam and the monitor unit.The different γ analysis standards(1%/1 mm,2%/1 mm,3%/1 mm,1%/2 mm,2%/2 mm,3%/2 mm,1%/3 mm,2%/3 mm and 3%/3 mm)were adopted to conduct global analysis of absolute dose for each verification plan,and the threshold(TH)of low dose was set as 10%.Results:The γ passing rates of phantom verification plans of 253 patients were respectively(88.64±5.91)%,(95.43±3.40)%,(97.90±2.06)%,(96.51±2.35)%,(98.15±1.68)%,(99.06±1.12)%,(98.30±1.39)%,(99.09±0.97)%and(99.52±0.63)%under different analysis standards.The γ passing rates of other standards of patients with tumor on different parts were larger than 95%except the analysis result of 1%1 mm standard.The overall analysis result of the deviation of central point dose was(-1.30±2.17)%,among of which the tumor of head,abdominal tumors and other metastatic tumor were about approximately-2%,while that of lung tumors were approximately-3%.The deviation of abdominal and other metastatic tumor was the minimum.The correlation analysis showed that the target volume and the size of the minimum collimator were respectively correlated to the dose deviation of the center.Conclusion:SRS MapCHECK dose verification system can conveniently and quickly realize the individualized verification for the plan of patients who receive CK treatment.

Objective To analyze the quality of 19 batches of Ginseng Formula Granules from 11 different manufacturers by using Ginseng water Extract reference substance(GWERS)as references.Methods Thin layer chromatography(TLC)identification and feature map detection were carried out according to the identification items and characteristic maps of Ginseng Formula Granules standard(YBZ-PFKL-2021186)issued by the National Medical Products Administration.Results The results of TLC analysis showed that the 19 batches of Ginseng Formula Granules-labeled samples could be divided into three categories.The overall pattern of the first type of samples was consistent with that of GWERS,and the similarity was high.Pseudoginsenoside F11,a unique component of American ginseng,was detected in the second type of samples.Four blue fluorescent spots were observed in the third type of samples compared to GWERS.HPLC results indicated that all 19 batches of Ginseng Formula Granules showed eight characteristic peaks at the same retention time as that of GWERS chromatogram.Two more chromatographic peaks were found in the chromatogram of three batches of samples from one manufacturer compared to the chromatogram of other samples,whose similarity to the GWERS chromatogram was less than 0.65.The similarity between the chromatogram of the remaining 16 sample and GWERS chromatogram was higher than 0.94.Conclusion At present,the quality of Ginseng Formula Granules on the market varies greatly.It was suspected that American ginseng might appear among them.The application of GWERS for quality analysis of Ginseng Formula Granules has better applicability to the control medicinal materials.

Objective To explore the effect of improving clinical practice ability of nursing undergraduates via double evaluation.Methods From September 2015 to May 2016, 61 nursing undergraduates enrolled in 2012 to Guangzhou University of Chinese Medicine were selected by convenience sampling method and divided randomly according to their student number into experimental group (30 cases) and control group (31 cases). According to the double evaluation method adopted in the experimental group, clinical teaching scheme was modified dynamically. In the control group, clinical teaching was conducted according to clinical teaching scheme made by the university, with OSCE and evaluation form of clinical practice ability as tools for observer and self evaluation.Results Within the experimental group, both scores of observer evaluation in OSCE and scores of self evaluation in clinical practice behavior showed a trend of going up in phases (P<0.05). In comparison of observer evaluation in OSCE at the 9th month, scores of the experimental group were all higher than those in the control group in all dimensions except writing of nursing documents (P<0.05). In comparison of self evaluation in clinical practice behavior at the 9th month, scores of the experimental group were all higher than those in the control group in all dimensions except communication ability, slightly lower (P<0.05).Conclusions With the double evaluation method adopted, dynamically modified clinical teaching scheme according to phases can obviously improve clinical practice ability of nursing students.

Objective To evaluate the teaching activity on public health courses from clinical medical students in our university in order to provide a scientific basis for improving the curriculum design and teaching reform. Methods The “Questionnaire on Teaching Evaluation in Public Health Courses”, including teaching attitude, teaching content, teaching methods and teaching effectiveness was designed, and a general investigation was conducted among the clinical medical students of five-year program (840 students) and eight-year program (278 students) in these three aspects to under-stand students' evaluation to the course, who had finished the public health courses, including Preven-tive Medicine, Medical Statistics and Epidemiology (hereinafter referred to as: statistics, epidemiology, prevention) in Sun Yat-sen University. Statistical analysis was made using SPSS 13.0 software. Data analysis methods contain descriptive analysis, T-test, ANOVA, LSD, SNK, hierarchical logistic regres-sion analysis, etc. Results The overall score of teaching evaluation is (4.04±0.60). Differences exist between the evaluation in the five-year medical students and the eight-year medical students. The P values were 0.000 (Medical Statistics), 0.269 (Epidemiology), 0.047 (Preventive Medicine). The com-parison of scores among the four dimensions shows: Teaching effectiveness < Teaching methods β' effectiveness. Conclusions Clinical Medical students' overall evaluation on the public health courses offered by this university was good. Teaching effectiveness and teaching methods still need improvement. Teaching contents are the most influential factor of overall teaching satisfaction, followed by teaching effectiveness.

Objective To evaluate the characteristics and the value of dual-source CT single-energy high pitch scanning technology in postoperative follow-up of endovascular graft exclusion to DeBakey Ⅲ aortic dissection.Methods All of 58 patients with endovas-cular graft exclusion to Debakey Ⅲ aortic dissection underwent dual-source CT checkup.30 patients (group A)were scanned with single-energy high pitch technology,voltage 120 kV,pitch 3.2;28 patients (group B)were scanned with dual-energy standard pitch technology,voltage 100 kV and 140 kV,pitch 1.0;both groups were used CareDose4D technology to automatically track the cur-rent.Image post-processing was completed at the workstation.The stent condition,endoleak and residual dissection were observed and analyzed.The differences of image quality and radiation dose between two scanning modes were compared.Results All of 58 cases,postoperative conditions to 9 cases were perfect,the proportion was 1 5.52%;43 cases were with distal residual dissection,the proportion is 74.14%;and 12 cases were accompanied with endoleaks,the proportion was 20.69%.The endoleaks manifestation in-cluded punctuate,band-like,and patchy high density around the stent in enhanced images.The difference of scan length between group A and group B was not statistically significant,the image quality of both groups met excellent standard .The acquisition time and effective radiation dose to group A were 1/4 and 56% of group B respectively.the differences of both groups were statistically significant.Conclusion Dual-source CT with single-energy high pitch scanning technology can ensure image quality and significantly reduce the effective radiation dose,it is a more advantageous scanning mode.

Objective To investigate the clinical effect of application of dezocine combined with sufentanil in patients under‐going thoracic surgery ,and discuss its security .Methods Selected 60 cases of patients undergoing thoracic surgery treatedn in the hospital from January to June 2013 ,then divided into two groups with 30 cases in each group randomly .ASA grade Ⅰ - Ⅱ ,the ob‐servation group took dezocine combined with sufentanil after the surgery ,the control group took sufentanil for analgesia ,then ob‐served the analgesia and sedative effect and the occurrence rate of adverse reaction between two groups of patients .Results The observation group′VAS pain score on postoperative 6 ,12 ,24 ,48 h were (3 .21 ± 0 .76)% ,(3 .01 ± 0 .77)% ,(2 .79 ± 0 .69)% , (2 .67 ± 0 .66)% and significantly better than the control group(P<0 .05);The observation group′Ramsay sedation score on post‐operative 6 ,12 ,24 ,48 h were (2 .12 ± 0 .23)% ,(2 .07 ± 0 .22)% ,(2 .02 ± 0 .24)% ,(2 .01 ± 0 .21)% ,the sedative effect was better than the control group(P<0 .05);48 h after the surgery the pressing times and effective analgesia pump frequency and adverse re‐action of the patients in the observation group were lower than that of the control group(P<0 .05) .Conclusion The effect for se‐dation and analgesia of dezocine combined with sufentanil in patients undergoing thoracic surgery is better and safe .

Objective To evaluate the feasibility of chest digital tomosynthesis(DTS)for lung lesion screening by comparing the effective dose of chest DTS with chest digital radiography(DR),low-dose MSCT and MSCT examinations.Methods The Fluke lung/chest phantom underwent posterior-anterior (PA),left lateral(LAT)chest DR and DTS with automatic exposure control technique.Using RTI DoseGuard and WinODS,the dose area product(DAP)and effective dose of PA,LAT and total DTS were calculated.CareDose technique was used for MSCT and low-dose MSCT scans,the dose length products (DLP)was acquired.According to the DLP to E(k)conversion coefficient in ICRP 103,the effective dose of low-dose MSCT and MSCT were calculated.Paired t test was used for comparison of the mean effective dose of DTS,DR and low-dose MSCT.Results The mean effective dose was 0.1 3 mSv for chest DR and 0.11 mSv for DTS examination.The mean effective dose of low-dose MSCT and MSCT scans were 1.13 mSv and 6.38 mSv.The effective dose of chest DTS was comparable to that of chest DR,and was approximately 1/10 and 1/60 times lower than that of low-dose MSCT and MSCT scans.There was no statistical difference between chest DTS and DR(t =3.514,P ＞0.01),and there was a significant difference between chest DTS and low-dose MSCT(t =178.769,P ＜0.01).Conclusion DTS is a new X-ray tomography which has the advantage of low radiation dosage in chest examination for lung lesion screening comparing with low-dose MSCT.