Objective To establish a HPLC method for determining thimerosal compounds in eye drops. Methods A gradient HPLC system was used in the quantitative analysis of thimerosal compounds on Shiseido MGII C₁₈ column （4.6 mm×250 mm，5 μm）, using 1% triethylamine solution （pH adjusted to 3.0 with phosphate） as mobile phase A, the methanol as mobile phase B, gradient elution, The column temperature was 40 ℃, the detection wavelength was 222 nm, the flow rate was 1 ml/min and the injection volume was 20 µl. Results The established method had good linearity within the concentration range of 4.3-216.7 μg/ml （r>0.999） for thimerosal, with average recoveries was 102.1%, RSD2.7%. Conclusion This method was simple, accurate and highly specific, and could be used for determination of thimerosal compound in eye drops.

Objective To explore the clinical efficacy of edaravone dexborneol combined with intravenous thrombolysis with alteplase,in the treatment of patients with acute ischemic stroke(AIS).Methods The patients with AIS undergoing intravenous thrombolysis with alteplase between January 7,2021 and December 31,2022 were enrolled and randomly divided into observation group and control group.The control group was treated with standard treatment according to the AIS guidelines,and the observation group was treated with edaravone dexborneol injection within 48 hours from thrombolysis to the onset of the disease on the basis of the treatment in the control group.7-day post-thrombolysis National Institutes of Health stroke scale(NIHSS),discharged NIHSS,difference between 7-day post-thrombolysis NIHSS and pre-thrombolysis NIHSS,and 3-month all-cause mortality and 3-month poor prognosis ratio were compared between the two groups.Results A total of 232 patients with AIS were randomly allocated to the observation group(n=1 16)and the control group(n=1 16).The differences between the two groups were not statistically significant for 7-day post-thrombolysis NIHSS and difference between 7-day post-thrombolysis NIHSS and pre-thrombolysis NIHSS(P＞0.05),and there were statistical differences in distribution of the discharged NIHSS score between the observation group and control group[2.0(0,3.0)vs.2.0(1.0,5.0),P＜0.05].The 3-month poor prognosis ratio was significantly lower in the observation group than in the control group(12.1％vs.28.4％;OR=0.252,95％CI 0.105 to 0.602,P=0.002).Conclusion Edaravone dexborneol enhances the efficacy of AIS undergoing intravenous thrombolysis with alteplase and improves the 3-month outcome of patients.

【Objective】 To reduce the incidence of postoperative intestinal obstruction, we tried to improve surgical techniques by closing the cavity formed during radical cystectomy + ileal passage (Bricker) via laparoscopy to prevent the formation of abdominal hernia. 【Methods】 During Oct.2018 and Feb.2022, 41 patients were involved (conventional group). After standard laparoscopic radical cystectomy + pelvic lymphadenectomy, the ileum channel was established. The right medial retroperitoneum was sutured to cover the mesothelium and end of the ileum channel under open operation or endoscope. The space between the ureter and mesothelium of the ileum channel was sealed, and the end of the ileum channel and both ureters were externalized. During Feb.2022 and Dec.2022, 15 patients were involved (modified group). The right inner and outer lateral peritoneums below the ileal conduit were sutured to "bottom out" the gap between the ileal conduit and the right abdominal wall in addition to standard procedures. The recovery of intestinal function and incidence of bowel obstruction were compared between the two groups. 【Results】 In the conventional group, the intestinal function recovered within 2 to 6 days after surgery, with a median ventilation time of 3 days. Intestinal obstruction occurred in 3 patients, 2 of whom improved after conservative treatment while 1 underwent surgical exploration after ineffective conservative therapy. There were no significant differences in the time of discharge and ventilation between the two groups, but no intestinal obstruction occurred in the modified group. 【Conclusion】 Peritoneal externalization at the end of ileal passage can reduce the incidence of intra-abdominal hernia and postoperative intestinal obstruction, which is worthy of clinical application.

ObjectiveTo explore the clinical efficacy of compound Wufengcao liquid （CWL） on tuberculous ulcer and the influence on macrophage polarization. Method① Clinical experiment： A total of 145 patients with tuberculous ulcer who were treated in Nanjing Integrated Traditional Chinese and Western Medicine Hospital were randomized into observation group， control group Ⅰ， and control group Ⅱ according to the random number table method. In addition to the basic anti-tuberculosis chemotherapy， CWL， Kangfuxin liquid， and isoniazid solution （local external application） were respectively used in the observation group， control group Ⅰ， and control group Ⅱ. The treatment lasted 4 weeks for each group. The total effective rate in wound healing， traditional Chinese medicine（TCM） syndrome score， and histopathological morphology of wound were observed and the expression of inducible nitric oxide synthase （iNOS） and arginase-1 （Arg-1） in wound tissue was measured. ② Cell experiment： RAW264.7 cells were cultured in DMEM （10% fetal bovine serum， 1% double-antibody solution） in a cell incubator （37 °C， 5% CO₂）. Phorbol 12-myristate 13-acetate （PMA） was used to induce the differentiation of RAW264.7 cells into macrophages. Lipopolysaccharide （LPS） was employed to stimulate polarization of macrophages into M1 type and interleukin-4 （IL-4） to induce the polarization into M2 type. Kangfuxin solution， isoniazid solution， and CWL were respectively applied to the above cell model for 36 h. The cell supernatant was collected and centrifuged. Western blot was used to detect the protein expression of tumor necrosis factor-α （TNF-α）， transforming growth factor-β （TGF-β）， iNOS， and Arg-1， and flow cytometry （FCM） to detect the expression of CD86 and CD206. Result①Clinical experiment： The total effective rate in the CWL group ［98.0% （48/49）］ was higher than that in the control group Ⅰ ［87.5% （42/48）， χ²=3.962， P<0.05］ and control group Ⅱ ［83.3% （40/48）， χ²=6.162， P<0.05］. After 28 days of treatment， compared with control group Ⅰ and control group Ⅱ， CWL decreased the TCM syndrome score （P<0.05） and obviously improved the histopathological morphology of the wound. Immunohistochemistry results showed that the iNOS expression in local focus tissue was lower （P<0.05） and the expression of Arg-1 was higher （P<0.05， P<0.01） in the CWL group than in the control group Ⅰ and control group Ⅱ after 28 days of treatment. ② Cell experiment： Western blot assay showed that the expression of iNOS and TNF-α in LPS group increased compared with that in the M0 group （P<0.01） and the expression in the LPS+ isoniazid group， LPS+ Kangfuxin group， and LPS+CWL group was lower than that in the LPS group （P<0.05）. The expression of iNOS in LPS+Kangfuxin group and LPS+ CWL group was lower than that in the LPS+isoniazid group （P<0.05， P<0.01）， and the expression of TNF-α in LPS+ CWL group was lower than that in LPS+isoniazid group （P<0.01）. The expression of TNF-α in LPS+ CWL group decreased compared with that in the LPS+ Kangfuxin group （P<0.05）. The expression of Arg-1 and TGF-β in IL-4 group was higher than that in the M0 group （P<0.01）， and the expression in the IL-4+isoniazid group， IL-4+Kangfuxin group， and IL-4+ CWL group was higher than that in the IL-4 group （P<0.05）. The expression of Arg-1 and TGF-β in the IL-4+ Kangfuxin group and IL-4+CWL group was higher than that in the IL-4+isoniazid group （P<0.05， P<0.01）， and the expression was higher in the IL-4+CWL group than in the IL-4+Kangfuxin group （P<0.05， P<0.01）. The FCM result showed that the expression of CD86 and CD206 in LPS group and IL-4 group was higher than that in M0 group （P<0.01）. CD86 expression in LPS+isoniazid group， LPS+ Kangfuxin group， and LPS+CWL group was lower than that in the LPS group （P<0.01）. The expression of CD86 in LPS+Kangfuxin group and LPS+ CWL group increased compared with that in the LPS+isoniazid group （P<0.01）， and the expression was higher in the LPS+ CWL group than in the LPS+Kangfuxin group （P<0.01）. CD206 expression in IL-4+ isoniazid group， IL-4+Kangfuxin liquor group， and IL-4+ CWL group was increased compared with that in the IL-4 group （P<0.01）. CD206 expression in IL-4+Kangfuxin liquid group and IL-4+ CWL group was decreased compared with that in the IL-4+isoniazid group （P<0.01）. CD206 expression in IL-4+CWL group was lower than that in the IL-4+ Kangfuxin group （P<0.05）. ConclusionCWL can promote the healing of tuberculous ulcers， and the mechanism is that it inhibits the expression of iNOS， TNF-α， and CD86 and promotes the expression of Arg-1， TGF-β， and CD206， thereby regulating M1/M2 polarization balance.

Objective:To evaluate the effect of mixed reality (MR) in the standardized resident training on oral and maxillofacial-head and neck tumor surgery.Methods:Twenty resident doctors, who received standardized training in the department of maxillofacial oncology of our hospital, were randomly divided into experimental group and control group. The MR teaching method was used in the experimental group, while the traditional teaching method was used in the control group. The teaching effect was evaluated by theoretical and operational tests and a questionnaire survey. Statistical analysis was performed with the SPSS 24.0 software. Statistical comparisons were performed by the Students' t-test or the Wilcoxon rank correlation test. Results:The theoretical test results showed that the scores of the experimental group were significantly higher than those of the control group (85.30±3.59 vs. 80.20±5.63, t = 2.41, P = 0.027). The operational test results showed that the scores of the experimental group were significantly higher than those of the control group (89.20±5.07 vs. 82.30±6.36, t = 2.68, P = 0.015). The questionnaire survey results showed that the MR teaching helped to easily acquire the knowledge of head and neck anatomy and operation skills. Besides, the doctors in the experimental group were more active and glad to communicate with others than those in the control group. In addition, the MR teaching method improved the learning interest of doctors. The doctors in the experimental group were more satisfied with the teaching effect than those in the control group, and they recommended that the MR teaching method be used in clinical training and teaching on oral and maxillofacial-head and neck tumor surgery. Conclusion:MR teaching can help doctors understand and master the knowledge of head and neck anatomy and operation skills and improve their learning interest, achieving a good teaching effect, so it has important application value in the standardized resident training on oral and maxillofacial-head and neck tumor surgery.

Objective To develop a nurse-patient interaction integrated APP"NET Home"to provide detailed care and follow-up management for patients with neuroendocrine tumors(NENs)trea-ted with long-acting octreotide.Methods"NET Home"APP included three ports:patient side,medical side and management side.After discharge,NENs patients timely and comprehensive fed back on adverse reactions and discomfort symptoms through APP,and medical staff timely guided patients to deal with them online.Results At 1 year after"NET Home"APP application,45 patients registered(injected with long-acting octreotide once every 28 days).A total of 145 copies of Micro-nutrition Evaluation Scales,147 Tumor Patients'Quality of Life Rating scales,102 Pain Digital Evaluation Scales,103 Adverse Reactions Questionnaire of Long-acting Octreotide Injection,102 Self-care Ability Scales,111 Self-rating Scales for depression and 102 Self-rating Scales for anxiety were collected.The medical staff treated 5 cases of adverse reactions by APP,and gave timely handling to 1 case of severe adverse reactions(the patient eventually stopped long-acting octreotide therapy).Compared with NENs patients who did not use APP,anxiety scores of NENs patients who used APP decreased(P＜0.05);their satisfaction scores and quality of life scores were improved,and the number of unplanned admissions decreased,but the differences showed no statistically significant(P＞0.05).Conclusion"NET Home"APP can realize refined and personalized nursing intervention through multiple module functions,which can realize continuous home care for NENs patients,relieve their anxiety and improve their self-management ability,quality of life and treatment compliance.

Objective To develop a nurse-patient interaction integrated APP"NET Home"to provide detailed care and follow-up management for patients with neuroendocrine tumors(NENs)trea-ted with long-acting octreotide.Methods"NET Home"APP included three ports:patient side,medical side and management side.After discharge,NENs patients timely and comprehensive fed back on adverse reactions and discomfort symptoms through APP,and medical staff timely guided patients to deal with them online.Results At 1 year after"NET Home"APP application,45 patients registered(injected with long-acting octreotide once every 28 days).A total of 145 copies of Micro-nutrition Evaluation Scales,147 Tumor Patients'Quality of Life Rating scales,102 Pain Digital Evaluation Scales,103 Adverse Reactions Questionnaire of Long-acting Octreotide Injection,102 Self-care Ability Scales,111 Self-rating Scales for depression and 102 Self-rating Scales for anxiety were collected.The medical staff treated 5 cases of adverse reactions by APP,and gave timely handling to 1 case of severe adverse reactions(the patient eventually stopped long-acting octreotide therapy).Compared with NENs patients who did not use APP,anxiety scores of NENs patients who used APP decreased(P＜0.05);their satisfaction scores and quality of life scores were improved,and the number of unplanned admissions decreased,but the differences showed no statistically significant(P＞0.05).Conclusion"NET Home"APP can realize refined and personalized nursing intervention through multiple module functions,which can realize continuous home care for NENs patients,relieve their anxiety and improve their self-management ability,quality of life and treatment compliance.

Objective:To design a modified S1PR3 specific agonist, GPS-725.017, and investigate its protective effect on acute lung injury by promoting macrophage clearance of bacteria.Methods:A short peptide derived from the intracellular region of S1PR3 receptor was named GPS725.017, which was modified with norleucine (Nle) and myristicacid (myr) at its N terminus. Mice were divided into the sham operation group, solvent group and GPS-725.017 treatment group. The acute lung injury model was induced by endotracheal injection of E. coli (5×10 6 CFU), and the experimental group was treated with GPS-725.017 (10 mg/kg). The 48-h survival rate of mice was recorded. After 5 h of modeling, the bacterial load and inflammatory cytokines in peripheral blood and lung were detected, and Vps34 protein content in alveolar macrophages was determined by Western blot. After 12-h of modeling, lung tissues were collected for H&E staining and pathological scores. Results:Compared with the solvent group, the survival rate of mice in the GPS-725.017 treatment group was significantly improved ( P<0.01), the bacterial CFU in blood and alveolar lavage fluid was significantly lower than that in the solvent group ( P<0.001), and the levels of TNF-α and IL-1β in blood and alveolar lavage fluid were significantly lower than those in the solvent group ( P<0.001). Western blot showed that the expression level of Vps34 protein in alveolar macrophages was significantly higher than that in the solvent group ( P<0.01). Histopathology result showed that the pathological damage of lung in the treatment group was significantly less than that in the solvent group ( P<0.001). Conclusions:The modified synthetic S1PR3 specific agonist GPS-725.017 could specifically activate the S1PR3 receptor on the membrane of alveolar macrophages and up-regulate the expression level of intracellular Vps34 protein, which can promote the removal of bacteria in alveolar macrophages, significantly reduce the degree of lung injury and improve the survival rate in ALI mice.

Background In recent years, the incidence of metabolic syndrome (MS) is increasing significantly in China. Some studies have found that temperature is related to single metabolic index, but there is a lack of research on associated mechanism and identifying path of the influence of temperature on MS. Objective Based on the data of Guangdong Province, to investigate the effect of temperature on MS and its pathway. Methods A total of 8524 residents were enrolled by multi-stage random sampling from October 2015 to January 2016 in Guangdong. Basic characteristics, behavioral characteristics, health status, and physical activity level were obtained through questionnaires and physical examinations, and meteorological data were obtained from meteorological monitoring sites. We matched individual data both with the temperature data of the physical examination day and of a lag of 14 d. A generalized additive model was used to explore the exposure-effect relationship between temperature and MS and its indexes, calculate effect values, and explore the effects of single-day lag temperature. Based on the literature and the results of generalized additive model analysis, a path analysis was conducted to explore the pathways of temperature influencing MS. Results The association between daily average temperature on the current day or lag 14 day and MS risk was not statistically significant. When daily average temperature increased by 1 ℃, the change values of fasting blood-glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and high density lipoprotein cholesterol (HDL-C) were −0.033 (95%CI: −0.040-−0.026) mmol·L⁻¹, −0.662 (95%CI: −0.741-−0.583) mmHg, −0.277 (95%CI: −0.323-−0.230) mmHg, and −0.005 (95%CI: −0.007-−0.004) mmol·L⁻¹ respectively. The effects of average daily temperature on FBG, blood pressure, HDL-C, and waist circumference lasted until lag 14 day. The effects of daily average temperature on SBP and DBP were the largest on the current day. Daily average temperature of current day had direct and indirect effects on FBG and SBP. Temperature had an indirect effect on TG, and the intermediate variables were waist circumference and FBG, with an indirect effect value of −0.011 (95%CI: −0.020-−0.002). The indirect effects of daily average temperature on SBP, FBG, and TG were weak. Conclusion There is no significant correlation between temperature and risk of MS, and daily average temperature of current day could significantly affected blood pressure and FBG with a lag effect. Daily average temperature of current day has indirect effects on FBG and TG.

Objective:To explore the effect of the application of mixed reality (MR) technology in clinical teaching of fibular flap preparation.Methods:Twenty residents from the Department of Oral and Maxillofacial Surgery in School of Stomatology, the Fourth Military Medical University in 2018 and 2019 participated in the present study. They were randomly divided into two groups according to the method of random drawing. The teaching content of the two groups was fibular flap preparation. The MR group was taught by using the new teaching mode which was mainly based on MR, while the conventional teaching group was educated by conventional teaching method. At the end of the training, the theoretical knowledge and operational skills of the residents were statistically analyzed to evaluate the learning effect. Questionnaire survey was also conducted. Each item in the questionnaire was scored between 0 and 5, representing poor to excellent.Results:The theoretical scores of MR group (91.4±4.4) were higher than that of the conventional teaching group (83.3±3.2) ( P<0.01). The durations of preoperative marking and simulated osteotomy in MR group [(5.7±1.2) and (20.9±2.28) min, respectively] were shorter than those in the conventional teaching group [(7.2±1.7) and (26.1±3.6) min, respectively] ( P<0.05). The results of the questionnaire showed that MR group had a significant improvement in the scores of classroom atmosphere, satisfaction, three-dimensional construction, theoretical knowledge and problem-solving ability ( P<0.01). However, there was no statistically significant difference in scores of learning concentration between the two groups ( P>0.05). Conclusions:The application of MR technology achieved a better teaching effect, which could help residents to deeply understand the methods of fibular flap preparation, and showed a broad application prospect.