Objective lo analyze the difference of peri-coronary tat attenuation index(pr Al)on different grades of hypertension(HT),and to explore the value of pFAI in evaluating the risk of HT patients.Methods Retrospective data on hospitalized patients who underwent coronary computed tomography angiography(CCTA)examination for chest pain were collected.A total of 415 clini-cally confirmed HT patients were selected as observation group(including 132 patients in grade 1 HT group,137 patients in grade 2 HT group,146 patients in grade 3 HT group),and 187 non-hypertension patients during the same period as control group.The differ-ence of fat attenuation index(FAI)in three main coronary arteries[left anterior descending artery(LAD),left circumflex artery(LCX),right coronary artery(RCA)]was compared,and the correlation between pF AI and HT patients was analyzed.Results RCA-FAI(-78.86 HU±7.66 HU)and LAD-FAI(-80.62 HU±7.50 HU)were higher in HT group than those in control group(-84.46 HU± 8.00 HU,-83.43 HU±7.51 HU,P＜0.05).pFAI value was higher in grade 3 HT group than that in grade 1 HT group and grade 2 HT group(P＜0.05),while there were no differences between grade 1 HT group and grade 2 HT group(P＞0.05).After adjusting the influence of traditional risk factors and coronaryartery disease,RCA-FAI had relatively closer relationship with HT grades(r=0.47,P＜0.001).Conclusion LAD-FAI,RCA-FAI in the HT group are higher than those in control group and RCA-FAI has relatively closer relationship with HT grades,suggesting that RCA-FAI may be an imaging indicator to evaluate the pro-gression of HT and predict the risk of HT.

Objective:To establish the fingerprints of Microctis Folium by ultra high performance liquid chromatography (UPLC); To determine the contents of three flavonoids in the Microctis Folium; To evaluate the quality difference of Microctis Folium from different producing areas. Methods:The fingerprints were performed on Agilent ZORBAX SB C18 column (2.1 mm×150 mm,1.8 μm). The mobile phase was acetonitrile - 0.1 % acetic acid solution with gradient elution at a flow rate of 0.30 ml/min. The column temperature was 30 ℃ and the detection wavelength was 315 nm. The common fingerprint peaks were identified by UPLC-mass spectrometry, and the identification results were confirmed by comparison of reference materials. Waters Cortecs T3 C18 chromatographic column (2.1 mm × 100 mm,1.6 μm) was used for content determination. The mobile phase was methanol-0.1 % formic acid solution with gradient elution at a flow rate of 0.35 ml/min. The column temperature was 30 ℃ and the detection wavelength was 339 nm. The contents of vitexin, isovitexin and narcissoside in 15 batches of Microctis Folium from different habitats were determine. Results:There were 11 common peaks in the fingerprint of Microctis Folium. Identified by mass spectrometry and confirmed by reference substance,10 chemical components were identified, including caffeic acid, p-hydroxycinnamic acid, ferulic acid, vitexin, isovitexin, kaempferol-3-O-rutoside, astragaloside, narcissoside, isorhamnetin-3-O-glucoside and linden glycoside. The similarity between the fingerprints of 15 batches of Microctis Folium and the control fingerprint was greater than 0.95, indicating that the overall similarity of the fingerprints of Microctis Folium from different producing areas was high. The total contents of three active components were 3.23-5.64 mg/g in Yangjiang City, Guangdong, 3.60-5.78 mg/g in Zhanjiang City, Guangdong, 4.68-5.73 mg/g in Yulin City, Guangxi and 3.87-5.21 mg/g in Wuzhishan City, Hainan . There was no significant difference in the content of three active components in different producing areas. Conclusion:The fingerprints and the determination method established in the study are stable and feasible, which can be used for the quality evaluation of Microctis Folium.

Objective:To retrieve the evidence of scraping operation in patients with neck, shoulder and low back pain, and evaluate and summarize the evidence.Methods:Identified evidence-based problems based on the population, intervention, professional, outcome, setting and type of evidence (PIPOST) model, and searched UpToDate, British Medical Journal (BMJ) Clinical Evidence, Guidelines International Network, Registered Nurses' Association of Ontario, Scottish Intercollegiate Guidelines Network, New Zealand Guidelines Group, World Health Organization, American College of Physicians Club, BMJ Best Practice, Agency for Healthcare Research and Quality, Joanna Briggs Institute Evidence-Based Health Care Center Database, Nursing Consult, China Guideline Clearinghouse, Cochrane Library, Embase, PubMed, CINAHL, Web of Science, Medlive, China National Knowledge Infrastructure and SinoMed. The retrieval time limit was from March 1, 2012 to April 30, 2022. Four researchers independently evaluated the quality of the article, and two researchers summarized the evidence of the included article.Results:A total of 9 articles were included, including 1 guideline, 2 systematic reviews, and 6 randomized controlled trials. A total of 20 pieces of scraping application evidence were extracted from patients with neck, shoulder and low back pain, including 6 aspects, involving preparation before scraping, scraping intervention methods, scraping degree, precautions, contraindications, and handling of abnormal conditions.Conclusions:The best evidence of scraping therapy to improve patients' neck, shoulder and low back pain summarized in this study can provide a reference for improving the operation practice of medical and nursing staffs and nursing outcomes.

Objective:To explore the value of Gestational Diabetes Mellitus Risk Score in monitoring hypoglycemia among neonates delivered by mothers with gestational diabetes mellitus (GDM) .Methods:From February 2018 to June 2020, 240 neonates delivered by mothers with GDM admitted to the Shanghai First Maternity and Infant Hospital affiliated to Tongji University were selected as the study subject. The patients were assessed and divided into groups by the Gestational Diabetes Mellitus Risk Score and the Supplementary Gestational Diabetes Mellitus Risk Score from 12 to 20 weeks. The low-risk group ( n=63) was defined as the score of Gestational Diabetes Mellitus Risk Score ≤ 20 and the score of Supplementary Gestational Diabetes Mellitus Risk Score<33 from 12 to 20 weeks. The group with the score of Gestational Diabetes Mellitus Risk Score>20 and the score of Supplementary Gestational Diabetes Mellitus Risk Score <33 from 12 to 20 weeks was classified as the medium-risk group ( n=49) . High-risk group ( n=128) was defined as the score of Gestational Diabetes Mellitus Risk Score >20 and the score of Supplementary Gestational Diabetes Mellitus Risk Score >33 from 12 to 20 weeks. Three groups of patients were tested for fasting blood glucose (FPG) . Within one hour after birth, neonates were tested for blood glucose using the glucose oxidase blood glucose meter and given early sucking. Within 72 hours after birth, continuous dynamic blood glucose monitoring methods were used to measure blood glucose in neonates. This study compared the blood glucose within one hour and at 6, 12, 24, 48, and 72 hours after birth and the incidence of hypoglycemia at 72 hours after birth among three groups. Results:Among the 240 neonates in the risk group, 197 experienced hypoglycemia, with an incidence rate of 82.08%. There were statistically significant differences in the incidence of hypoglycemia before treatment, one occurrence of hypoglycemia within 72 hours, and recurrent hypoglycemia among the three groups of neonates ( P<0.01) . There were statistically significant differences in blood glucose among the three groups of newborns within one hour, 6, 12, and 24 hours after birth ( P<0.05) . There was no statistically significant difference in blood glucose among the three groups at 48 hours and 72 hours after birth ( P>0.05) . Conclusions:Neonates with gestational diabetes will suffer from repeated hypoglycemia. The higher the risk level, the higher the incidence of hypoglycemia. It is important to assess the risk of neonates with GDM, monitor their blood glucose in real time and treat them accordingly.

Objective:To explore application of the mixed reality (MR) technique in the surgery for complex pilon fractures.Methods:A retrospective analysis was conducted of the 22 patients with pilon fracture of Rüedi-Allg?wer type Ⅲ who had been treated at the Department of Orthopedics, Nanjing Tongren Hospital from May 2018 to October 2020. They were divided into 2 groups according to their treatment procedures. In the MR group of 9 cases, there were 8 males and one female, with an age of (39.2 ± 15.1) years. In addition to calcaneal traction plus open reduction and internal fixation, the MR technique was used to assist doctor-patient communication, preoperative planning, surgical guidance and rehabilitation exercises. In the control group of 13 male cases with an age of (33.7 ± 9.6) years, only conventional calcaneal traction plus open reduction and internal fixation were carried out. The communication efficiency, operation time, intraoperative blood loss, fluoroscopy frequency, fracture reduction, post-operative complications and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score at one year postoperatively were recorded and compared between the 2 groups.Results:There was no significant difference in the general data between the MR group and the control group, showing they were comparable ( P > 0.05). The questionnaire score of patients' surgical awareness [(77.8 ± 19.2) points] in the MR group was significantly higher than that in the control group [(50.0 ± 30.6) points] ( P = 0.017). The fluoroscopy frequency [(7.3 ± 2.6) times] in the MR group was significantly lower than that in the control group [(9.5 ± 2.3) times] ( P = 0.043). No significant differences were observed between the 2 groups in either the operation time [(98.3 ± 14.4) min versus (110.4 ± 20.4) min] or the intraoperative blood loss [(118.9 ± 36.5) mL versus (128.8 ± 35.2) mL] ( P = 0.142, P = 0.527). In the MR group, 8 cases achieved anatomical reduction and one case good reduction; in the control group, 4 cases achieved anatomical reduction, 8 cases good reduction and one case poor reduction. The anatomical reduction in the MR group was significantly better than that in the control group ( P = 0.011). There were one case of delayed wound healing, one case of nonunion, and one case of traumatic osteoarthritis in the MR group while there were 2 cases of delayed wound healing, one case of superficial soft tissue infection, one case of nonunion, and 2 cases of traumatic osteoarthritis in the control group. The average AOFSA ankle-hindfoot score at one year postoperatively in the MR group [(83.8 ± 9.0) points] was significantly higher than that in the control group [(73.3 ± 11.8) points] ( P = 0.035). However, there was no significant difference between the MR group and the control group in the good to excellent rate by the AOFSA ankle-hindfoot score at one year postoperatively (6 excellent cases, one good case, and 2 fair cases in the former versus 6 excellent cases, 2 good cases, 4 fair cases, and one poor case in the latter) ( P = 0.648). Conclusions:In the surgery for complex pilon fractures, MR technique can increase the efficiency of doctor-patient communication, reduce intraoperative fluoroscopy frequency, and improve reduction quality and ankle function, but fails to significantly reduce operation time and intraoperative blood loss.

Since the Global Polio Eradication Initiative was launched by the World Health Assembly in 1988, significant progress has been made in global polio prevention and control. But the occurrence of vaccine-associated paralytic poliomyelitis cases and vaccine-derived poliovirus related cases have become a major challenge during the post-polio era. While coronavirus disease 2019(COVID-19) has brought serious disease burden and economic burden to all countries in the world, prevention and control of vaccine-preventable infectious diseases such as polio should not be neglected under the background of the global common fight against COVID-19. Taking the type Ⅲ VDPV cycle event in Shanghai as an example, the paper discussed how to do a good job of routine inoculation under the prevention and control of COVID-19 to strictly prevent the outbreak of vaccine-preventable infectious diseases.
COVID-19 ; China ; Humans ; Poliovirus ; Poliovirus Vaccine, Oral ; SARS-CoV-2 ; Vaccination

Objective: To investigate the short-term outcome of patients with acute myocardial infarction complicating cardiogenic shock due to left main disease. Methods: A total of 24 patients with acute myocardial infarction complicating cardiogenic shock due to left main artery disease hospitalized in Fuwai hospital from June 2012 to May 2018 were included. The clinical data were analyzed,and the patients were divided into survivor group (11 cases) and death group (13 cases) according to survival status at 28 days post the diagnosis of shock. The patients were further divided into thrombolysis in myocardial infarction(TIMI) flow grade 0-2 group (11 cases) and TIMI flow grade 3 group (13 cases) according to TIMI flow grade after the procedure. The patients were then divided into non-three-vessel lesions group (14 cases) and three-vessel lesions group (10 cases) according to coronary angiography results. Results: Compared with survivor group, patients in death group presented with lower worst systolic blood pressure within 24 hours after admission (50(48, 70) mmHg (1 mmHg=0.133 kPa) vs. 73(70, 80) mmHg, P<0.01), lower worst diastolic blood pressure with in 24 hours after admission ((33.5±12.4) mmHg vs. (48.9±9.4) mmHg, P<0.01), higher respiratory rates ((27.3±2.5) times/min vs. (21.5±4.0) times/min, P<0.01), less 24 hours urine output ((422±266) ml vs. (1 680±863) ml, P<0.01), lower platelet counts ((161.9±81.9)×10⁹/L vs. (241.6±94.0)×10⁹/L, P=0.03), higher serum creatinine ((250.0±36.8) μmol/L vs. (132.7±34.2) μmol/L, P<0.01), higher alanine aminotransferase (288(76,846) IU/ml vs. 81(42, 109) IU/ml, P=0.04), lower artery pH (7.11±0.17 vs. 7.39±0.09, P<0.01), higher lactic acid ((10.29±3.62) mmol/L vs. (4.21±2.85) mmol/L, P<0.01), higher incidence of invasive ventilation (7/13 vs. 2/11, P=0.02), higher scores of acute physiology and chronic health evaluation (APACHE) Ⅱ (35.4±6.8 vs. 18.7±1.7, P<0.01) and simplified acute physiology score (SAPS) Ⅱ (73.5±17.4 vs. 47.0±4.3, P<0.01), and higher incidence of target vessel TIMI flow grade 0-2 (10/13 vs. 1/11, P<0.01). Kaplan-Meier survival curve analysis showed that survival rate at 28 days post the diagnosis of shock in TIMI flow grade 3 group was higher than that in TIMI flow grade 0-2 group (76.9% vs. 9.1%, log-rank test, P<0.01), and mortality rate was similar at 28 days post the diagnosis of shock between non-three-vessel lesions group and three-vessel lesions group (35.7% vs. 60.0%, log-rank test, P=0.14). Multivariate logistic regression analysis showed that compared with TIMI flow grade 0-2 group, the OR value of death at 28 days post the diagnosis of shock in TIMI flow grade 3 patients with acute myocardial infarction complicating cardiogenic shock due to left main disease was 0.030(95%CI 0.003-0.340, P<0.01). Conclusion Short-term outcomeof patients with acute myocardial infarction complicating cardiogenic shock due to left main disease remains poor, and final flow of TIMI grade 3 is confirmed as independent protective factor of death at 28 days post the diagnosis of shock in these patients.

Brain ; pathology ; China ; Humans ; Organ Preservation ; standards ; Tissue Banks ; ethics ; standards

Objective The quality evaluation of the Shuwei mixture was determined by the content of the six components of sinapine cyanide sulfonate, magnolol, honokiol, hesperidin, naringin and neohesperidin. Methods RP-HPLC method was used.The separation was performed on a Agilent ZORBAX Eclispse SB-C18column (4.6 mm×250 mm,5 mm),the mobile phase consisted of acetonitrile(A)-0.1% phosphoric acid with gradient elution at the flow rate of 1.0 mL·min-1.The detection wavelength was 326 nm ( sinapine cyanide sulfonate ), 294 nm ( magnolol, honokiol ) and 283 nm ( naringin, neohesperidin).The column temperature was kept at 30 ℃. Results The sinapine cyanide sulfonate, magnolol, honokiol, hesperidin,naringin and neohesperidin all had good linear relationship in the ranges of 0.049 6-1.24,0.048 2-1.205,0.060 5-1.512 5,0.187 2-4.68,0.131 6-3.29,0.197-4.925 μg.The average recoveries were 100.66%, 99.86%, 101.37%, 102.41%, 99.01%, 102.05%, respectively, RSD were 0.82%, 1.89%, 2.56 %, 0.74%, 1.54%, 0.99%, respectively. Conclusion The method is simple,accurate,reproducible and nice to the separation,and can be used for the quality evaluation of Shuwei mixture.

OBJECTIVE:To optimize the extraction technology of garlic oil. METHODS:Using extraction rate of garlic oil as index,based on single factor test,Box-Behnken response surface method was used to optimize conditions of steam distillation method for the extraction of garlic as fermentation time,solid to liquid ratio,fermentation temperature and the verification test were made for the optimized technology. RESULTS:The optimal extraction technology was as follows as fermentation time of 4.5 h,solid to liquid ratio of 1:7,fermentation temperature of 55 ℃. The average extraction rate of garlic oil in verification test was 0.32%(RSD=1.43%,n=3);the relative error between the measured value and predicted value was 0.06%. CONCLUSIONS:Box-Behnken response surface method is simple,reasonable and feasible to optimize the extraction technology of garlic oil,which can provide a scientific basis for industrial production.