Objective: To observe the effects of tendon-regulating and stretching manipulation plus JIN's three-needle therapy for the shoulder on pain and shoulder joint function in subacromial impingement syndrome (SIS). Methods: Eighty patients with SIS were recruited and divided into a control group and a treatment group by the random number table method, with 40 cases in each group. The control group was given JIN's three-needle therapy for the shoulder, and the treatment group received additional tendon-regulating and stretching manipulation. The visual analog scale (VAS) score and constant-Murley score (CMS) were observed before and after the intervention, and the total effective rate was also observed. Results: The total effective rate was 92.5％ in the treatment group versus 70.0％ in the control group, and the difference was statistically significant (P<0.05). The VAS score and CMS changed notably after treatment in both groups (P<0.05), and the improvements were markedly greater in the treatment group than in the control group (P<0.05). Conclusion: Tendon-regulating and stretching manipulation plus JIN's three-needle therapy for the shoulder can facilitate the relief of pain and the improvement of shoulder joint function in SIS patients.

Objective:To investigate the application value of laparoscopic duodenum-preserving pancreatic head resection (LDPPHR).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 25 patients undergoing LDPPHR in the Second Hospital of Hebei Medical University from November 2016 to November 2020 were collected. There were 7 males and 18 females, aged from 14 to 66 years, with a median age of 29 years. All the 25 patients underwent LDPPHR. Observation indicators: (1) surgical situations; (2) postoperative histopathological examination; (3) follow-up. Follow-up was conducted using outpatient examination or telephone interview to detect the recovery of patients up to March 2021. Measurement data with skewed distribution were represented as M (range) and count data were descripted as absolute numbers. Results:(1) Surgical situations: all the 25 patients underwent LDPPHR successfully, including 23 cases undergoing total pancreatic head resection and 2 cases undergoing subtotal pancreatic head resection. The operation time and volume of intraoperative blood loss of 25 patients were 310 minutes (range, 207 to 540 minutes) and 200 mL (range, 50 to 800 mL), respectively. Of the 25 patients, 1 case was infused with 4 U of red blood cells and 400 mL of plasma, 1 case was infused with 500 mL of plasma, 1 case was infused with 600 mL of plasma and the remaining 22 cases were not infused with red blood cells or plasma. Of the 25 patients, 3 cases with pancreatic fistula of class B were discharged after drainage, 4 cases had biliary fistula including 2 cases undergoing symptoms disappeared after implantation of common bile duct stent by endoscopic retrograde cholangiopancreatography, 1 case recovering well with drainage, 1 case with postoperative perihepatic effusion undergoing symptoms disappeared after the treatment of drainage and common bile duct stent implantation, and the remaining 18 cases had no complications. The duration of postoperative hospital stay was 17 days (range, 9 to 27 days) of the 25 patients. (2) Postoperative histopathological examination: the tumor volume of the 25 patients was 6.0 cm×5.0 cm×2.0 cm (range, 1.0 cm×2.0 cm×1.5 cm to 10.0 cm×9.0 cm×8.0 cm). Results of the postoperative histopathological examination showed that there were 12 cases with pancreatic solid pseudopaillary neoplasm, 4 cases with intraductal papillary mucinous neoplasm, 3 cases with serous cystadenoma, 2 cases with mucinous cystadenoma, 1 case with neuroendocrine neoplasm, 1 case with pancreatic true cyst, 1 case with cholesterol crystals combined with calcification in the center of pancreatic nodules and 1 case with cavernous hemangioma of pancreas. (3) Follow-up: all the 25 patients were followed up for 4 months to 48 months, with a median follow-up time of 27 months. During the follow-up, 1 case of the 25 patients with postoperative diabetes controlled blood glucose in the normal range after regular injection of insulin, 1 case with fatty diarrhea had symptoms improved after oral supplement of pancreatic enzyme preparation, 1 case with preoperative intermittent dizziness, weakness of both lower limbs and hypoglycemia had the level of blood glucose returned to normal without any special treatment after operation, and the remaining 23 cases had no metabolic complications. None of the 25 patients had tumor malignant transformation, recurrence or death. No long-term complications such as delayed gastric emptying, bile duct stones or stricture occurred to the 25 patients.Conclusion:LDPPHR is safe and feasible for the treatment of benign or low-grade malignant tumors of the pancreatic head, with the advantage of preserving the integrity of digestive tract.

Clostridioides difficile is a key pathogen of antibiotic related diarrhea and hospital associated infection, causing several outbreaks in Europe and North Americans and resulting in severe disease burden. However, the standardized diagnostic principle and detection specifications in C. difficile infection (CDI) survey are limited in China, and the infection rate and disease burden of CDI in China are unclear. Therefore, National Institute for Communicable Disease Control and Prevention,National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, together with another 11 institutions, draft the group standard entitled "Diagnosis of Clostridium difficile infection (T/CPMA 008-2020)" of Chinese Preventive Medicine Association. Based on the principle of "legality, scientificity, advancement, and feasibility", this standard clarifies risk factors, diagnosis principles, diagnoses and differential diagnoses in order to improve the accuracy of CDI diagnosis in clinical practice, guide the surveillance for CDI, and understand the infection rate and disease burden of CDI in China .

Objective To explore the application value of different dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) models in pathological grading of breast invasive ductal carcinoma.Methods Forty-five cases of breast invasive ductal carcinoma confirmed by clinical pathology from June 2016 to October 2017 in Shanxi Provincial People's Hospital were enrolled in this study.Grade 1 and 2 invasive ductal carcinomas were classified into the low-grade group,grade 3 invasive ductal carcinomas was classified as the high-grade group.The whole patients underwent DCE-MRI scans.Volume transport constant (Ktrans) was obtained by using the Extended Tofts Linear model with population arterial input function (AIF).Then,the Reference Region model was used to obtain the reference region model volume transport constant(RRKtrans).The performances of histogram analysis of these two quantitative parameters in pathological grading of breast invasive ductal carcinoma were compared.Results The mean,25 ％,50 ％,75 ％,90 ％ percentiles,kurtosis and skewness of RRKtrans in high grade group were (0.793±0.258)/min,(0.484±0.209)/min,(0.773±0.277)/min,(1.066±0.351)/min,(1.322±0.406)/min,2.647 (1.426,3.679),0.398 (0.297,0.514) respectively,and the corresponding parameters in low grade group were (0.506±0.203)/min,(0.301 ±0.142)/min,(0.487 ±0.211)/min,(0.692±0.281)/min,(0.861±0.323)/min,1.725 (0.779,2.316),0.258 (0.133,0.302) respectively.There were significant differences between the two groups (all P ＜ 0.05).The mean,50 ％,75 ％,90 ％percentiles of Ktrans in high grade groups were (0.099±0.034)/min,(0.110±0.033)/min,(0.132±0.045)/min,(0.140±0.047)/min respectively,and the corresponding parameters in low grade group were (0.067±0.030)/min,(0.082 ±0.067)/min,(0.096 ±0.059)/min,(0.113 ±0.074)/min respectively.There were significant differences between the two groups (all P ＜ 0.05).RRKtrans was superior to Ktrans in distinguishing area under the curve (AUC) of receiver operating characteristic curve (ROC) of high and low grading of breast invasive ductal carcinoma.Conclusion RRKtrans obtained by Reference Region model and Ktrans obtained by Population AIF DCE-MRI have some values in pathological grading of breast invasive ductal carcinoma,but the performance of RRKtrans is superior to Kftrans.

Objective:To establish the HPLC fingerprint of Cassia leschenaultiana from different regions. Methods: The column was SinoChrom ODS-BP (250 mm × 4. 6 mm, 5 μm). The mobile phase consisted of acetonitrile-0. 1% phosphoric acid with gradient elution. The flow rate was 1. 0 ml·min-1 , the detection wavelength was 285 nm, the column temperature was 25℃, and the injection volume was 10 μl. Results: The fingerprint consisted of 13 common peaks. The range of similarity for ten batches of Cassia le-schenaultiana was 0. 839-0. 998. And the reference fingerprint of Cassia leschenaultiana was established by HPLC. Conclusion: The fingerprint method is simple and reproducible, which can provide basis for the quality control and the medicinal resources exploration.

Objective:To study the chemical constituents in the seed of Cassia leschenaultiana.Methods: The compounds were separated and purified by column chromatography , thin-layer chromatography and recrystallization .The structures were identified by the physicoche mical identification and spectral analysis .Results:Seven compounds were isolated from the seeds of Cassia leschenaultiana and identified as 1-desmethylchryso-obtusin (Ⅰ) , aurantio-obtusin (Ⅱ) , ale-emodin (Ⅲ) , obtusin (Ⅳ) , chryso-obtusin (Ⅴ) , ob-tusifoline(Ⅵ)and aurantio-obtusin(Ⅶ).Conclusion:All of the compounds are isolated from the seeds of Cassia leschenaultiana for the first time.

OBJECTIVE: To describe and analyze the clinical characteristics of nasopharyngeal teratoma in infants and improve the levels of diagnosis and treatment to reduce misdiagnosis. METHOD: The clinical data of 11 cases of nasopharyngeal teratoma in infants were reviewed retrospectively and summarized the clinical features. After the preoperative examination of nasopharyngeal endoscopy and imaging (CT or MRI), all patients were under general anesthesia of nasopharyngeal teratoma surgical resection. Of them, 8 cases were used radiofrequency ablation, 3 cases used conventional power systems. RESULT: Eleven cases with neoformation were completely removed, the operation time was 5-15 min, blood loss was 1-5 ml, patients had no significant nasal obstruction, bleeding, eating nasopharyngeal regurgitation, breathing difficulties or other complications. No recurrence was found after 10 months to 9 years followed up. CONCLUSION The nasopharyngeal mass must be kept in mind in the differential diagnosis of breathing difficulties in infants, especially when it exists together with upper airway obstruction symptoms; The low-temperature radiofrequency ablation with endoscopic had the advantages of short time, precise control, less bleeding, clear operative field, little injury and pain, low recurrence, providing a new clinical treatments.
Catheter Ablation ; Child ; Child, Preschool ; Endoscopy ; Humans ; Infant ; Nasal Obstruction ; Nasopharyngeal Neoplasms ; surgery ; Nasopharynx ; pathology ; Neoplasm Recurrence, Local ; Retrospective Studies ; Teratoma ; surgery

OBJECTIVE: To evaluate the efficacy of sublingual immunotherapy (SLIT) with standardized Dermatophagoides farina drops in monosensitized and polysensitized patients with allergic rhinitis. METHOD: The clinical data of 162 patients treated with standardized Dermatophagoides farina drops were analyzed retrospectively. These patients were divided into the monoallergen sensitized group and polyallergen sensitized group according to the results of skin prick tests. The total nasal symptoms score (TNSS), the total medication score (TMS) and adverse effects (AEs) were evaluated before treatment, 2 year after SLIT treatment and 3 year after drug discontinuance. Result:After SLIT treatment for 2 years and drug discontinuance for 3 years, the TNSS (3. 14[2. 47; 3. 65], 3. 45 [2. 76; 3. 92], respectively) and TMS (0. 42[0. 36; 0. 57],0. 35[0. 26; 0. 44], respectively) in the monoallergen sensitized group were lower than that before the treatment (TNSS: 9. 00 [8. 00; 10. 00], TMS: 2. 16 [1. 88; 2. 37]), which have showed a statistically significant difference(P<0. 05). Similarly, after SLIT treatment for 2 years and drug discontinuance for 3 years, the TNSS (3. 14[2. 46; 3. 63], 4. 23[3. 65; 4. 96], respectively) and TMS (0. 42[0. 36; 0. 58], 0. 50[0. 34; 0. 72], respectively) in the polyallergen sensitized group were lower than that before the treatment (TNSS: 9. 00[8. 00; 10. 00], TMS: 2. 18[1. 95; 2. 37]), which have showed a statistically significant difference(P<0. 05). No statistically significant finding could be observed in monoallergen and polyallergen sensitized group before the treatment and 2 years after treatment, respectively. However, a statistically significant finding could be observed between two groups in the drug discontinuance for 3 years (P<0. 05). Eleven patients suffered local adverse effects, and the incidence of adverse effects showed no significantly difference (P>0. 05). CONCLUSION SLIT with standardized Dermatophagoides farina drops has a long-term efficacy in monosensitized and polysensitized patients with allergic rhinitis. Moreover, a longer SLIT treatment (>2 years) may be necessary to consolidate its efficacy.
Administration, Sublingual ; Animals ; Antigens, Dermatophagoides ; therapeutic use ; Humans ; Pyroglyphidae ; Retrospective Studies ; Rhinitis, Allergic ; therapy ; Skin Tests ; Sublingual Immunotherapy ; Treatment Outcome

OBJECTIVE: To explore the clinical characteristics and treatment skills of children with respiratory special foreign body. METHOD: To retrospectively analyze the clinical characteristics of 49 cases of special airway foreign bodies in children during 2013. 5.1-2014. 5.1 in our hospital, and the treatment methods were summarized. RESULT: Fourty-seven cases with rigid bronchoscopy foreign body cured, 1 case turned Department of thoracic sur- gery chest to remove foreign body, 1 case of death. CONCLUSION The clinical characteristics of special airway foreign bodies in children is different from ordinary foreign body, treatment of preoperative, intraoperative and postoperative is not fully equivalent to the ordinary foreign body.
Bronchoscopy ; Child ; Foreign Bodies ; diagnosis ; surgery ; Humans ; Respiratory System ; pathology ; Retrospective Studies

Objective To study the causes and clinical features associated with hoarseness in children.Meth-ods The data of 4 668 children suffering from hoarseness were analyzed with electronic-nasopharyngolaryngosco-py retrospectively.ResuIts The top 6 common causes of hoarseness were chronic laryngitis (1 817 cases,38.9%), vocal cord nodules (1 494 cases,32.0%),vocal hypertrophy (560 cases,12.0%),the paralysis of vocal cord (373 cases,8.0%),congenital sulcus vocalis (149 cases,3.2%)and recurrent respiratory papilloma disease (140 cases,3. 0%).These six diseases were common in children with hoarseness with 4 533 out of 4668 (97.1%);of the chil-dren were 2 to 10 years old as the largest age group (65.8%,3 072/4 668)and the ratio of male and female was 2. 48:1.The top six diseases were statistically distributed in different age groups (P<0.01).ConcIusion The main causes of hoarseness were different in different age groups.The children aged 2 to 10 years old made up the largest group (3 072/4 668),showing the greatest incidence of hoarseness in children .The incidence for male patients was higher than female and the chronic laryngitis was the top disease.Hoarseness in children was different from that of adults so that to understand the characteristics of this disorder in children will be beneficial to the proper diagnosis and effective treatment.