Objective To study the application effect of quality control circle(QCC)in reducing the dissatisfaction rate of physical examination clients in health management center.Methods To establish QCC,selected the health check-up popula-tion in our hospital in September-2019 and March-2020,through the questionnaire investigation and analysis,compare the dis-satisfaction of the clients before and after the quality control circle.Results After carrying out QCC activities,the dissatisfaction of physical examination clients was significantly lower than that before QCC,and the difference was statistically significant(P＜0.05).Conclusion The activities of QCC in the health management center can effectively improve the quality of the physical examination work and reduce the dissatisfaction of the customers in the physical examination.It is of great significance to the health management.

Objective To investigate the prognostic value of alanine aminotransferase(ALT)/alkaline phosphatase(ALP)ratio,platelet(PLT)count/lymphocyte(LYM)ratio(PLR)in elderly patients with septic shock complicated with liver injury.Methods The clinical data of 116 patients with septic shock complicated with liver injury were retrospectively analyzed.According to the degree of liver injury,patients were divided into the mild group(39 cases),the moderate group(47 cases)and the severe group(30 cases).According to the survival of patients 28 days after admission,patients were divided into the death group(69 cases)and the survival group(47 cases).Acute physiological score,chronic healthⅡ(APACHE Ⅱ)score and sequential organ failure(SOFA)score were collected.PLT and LYM in peripheral blood were detected,and PLR was calculated.ALT and ALP were measured and ALT/ALP ratio was calculated.White blood cell count,blood lactic acid,C-reactive protein and other laboratory indicators were detected.Multivariate Logistic regression was used to analyze prognostic factors of patients with septic shock complicated with liver injury.The predictive values of ALT/ALP ratio and PLR on the prognosis of patients with septic shock complicated with liver injury were analyzed by receiver operating characteristic(ROC)curve.Results Serum ALT and ALP levels,ALT/ALP ratio,PLT and PLR were increased successively in the mild group,the moderate group and the severe group,while LYM was decreased successively in the three groups(P＜0.05).The age,APACHE Ⅱ score,SOFA score,PLR,ALT/ALP ratio and blood lactic acid level were higher in the death group than those in the survival group(P＜0.05).There was no significant difference in liver injury degree between the two groups(P＜0.05).Multivariate Logistic regression analysis showed that high SOFA score,high PLR,high ALT/ALP ratio and moderate to severe liver injury were risk factors for death in patients with septic shock complicated with liver injury.ROC curve analysis showed that the combined ALT/ALP ratio and PLR prediction efficiency[area under the curve 0.915(95%CI:0.849-0.959),sensitivity and specificity 94.20%and 89.36%,respectively]was superior to single prediction(P＜0.05).Conclusion Increased ALT/ALP ratio and PLR are associated with aggravation of liver injury and poor prognosis in patients with septic shock.ALT/ALP ratio and PLR can be used as prognostic markers.

Objective:To investigate the application value of fluorescence imaging in single-port thoracoscopic anatomic segmentectomy.Methods:The clinical data of 280 patients (145 patients with fluorescence method and 135 patients with modified inflation-deflation method) who underwent thoracoscopic anatomic segmentectomy were retrospectively studied in the Anhui Chest Hospital from June 2020 to June 2021. There were 113 patients in the simple segmentectomy group and 167 patients in the complex segmentectomy group. The baseline data of the fluorescence method and the modified inflation-deflation method in the complex segmentectomy group were corrected by propensity score matching, and the perioperative results were compared between the groups.Results:There were no significant differences in segmental resection time, intraoperative blood loss, postoperative drainage, postoperative pain, postoperative extubation time, length of hospital stay, incidence of complications and cost of hand-holding between the fluorescence method and the modified method of the simple segmentectomy group.In the complex segmentectomy group, the time of segmental resection with the fluorescence method was significantly shorter than that with the modified inflation-deflation method( P<0.05), and other indexes had no significant difference. Conclusion:Fluorescence method single-port thoracoscopic anatomic segmentectomy has the same perioperative safety and short-term efficacy as modified inflation-deflation method, which can significantly shorten the operative time and improve the operative efficiency in complex anatomic segmentectomy.

BackgroundNon-suicidal self-injury （NSSI） behavior poses a significant risk to the psychosomatic health of middle school students. However， the intrinsic mechanisms underlying the risk factors associated with NSSI behavior remain unclear. ObjectiveTo explore the relationship and underlying mechanism between depressive mood， impulsivity， and NSSI behavior in middle school students， and provide valuable insights for the prevention and intervention of NSSI behavior in this population. MethodsIn March 2021， 1 161 middle school students were recruited by cluster random sampling. They were assessed using Adolescent Non-Suicidal Self-Injury Assessment Questionnaire （ANSAQ）， Center for Epidemiologic Studies Depression Scale （CES-D）， and Barratt Impulsivity Scale （BIS-II）. Spearman's correlation analysis was used to examine the correlation between depressive mood， impulsivity and NSSI behavior in middle school students. Moreover， the Process mediation effect analysis was adopted to test the mediating role of impulsivity between depressive mood and NSSI behavior. ResultsTotal of 122 people（10.51%） with NSSI behavior were detected. CES-D score was positively correlated with the total score of BIS-II and scores of all dimensions （r=0.340~0.556， P<0.01）， and also were positively correlated with the total score of ANSAQ and scores of all dimensions （r=0.437~0.540， P<0.01）. Additionally， the total score and dimension scores of BIS-II were positively correlated with the total score and dimension scores of ANSAQ （r=0.157~0.437， P<0.01）. Impulsivity played a partial mediating role between depressive mood and NSSI behavior ［indirect effect=0.035 （95% CI： 0.004~0.067， P<0.01）， indirect effect accounted for 5.81% of the total effect］. ConclusionDepressive mood in middle school students has both a direct and indirect influence on NSSI behavior， partially mediated by impulsivity. Consequently， impulsivity plays a partial mediating role between depressive mood and NSSI behavior.［Funded by Humanities and Social Sciences Research Science Institute of Chongqing Municipal Education Commission （number， 23KSZ017）］

To investigate the clinical features of patients with PLA2G6 gene related early onset Parkinson syndrome (EOP) with cerebellar atrophy, the clinical data of 3 hospitalized EOP patients with PLA2G6 gene mutation were collected in Xuanwu Hospital, Capital Medical University, and the clinical characteristics, imaging features and genetic testing results were comparatively analyzed. Related literatures were also reviewed. Cerebellar atrophy was observed on cranial magnetic resonance imaging in all 3 patients with Parkinson syndrome except for extrapyramidal symptoms. All 3 patients had heterozygous mutations of PLA2G6 gene, and the common mutation site of c.991G>T (p. D331Y) was found in 2 patients by second-generation sequencing. This report enlarges the clinical phenotypic spectrum of the disease and helps to better understand the disease.

To investigate the freshness, high molecular weight substances, the determination of polypeptide, haemolysis and agglomeration, biological activity of Cervus and Cucumis polypeptide injection; to provide the direction for improving the quality of products for enterprises; furthermore, to provide reference for the revision of the quality standards of Cervus and Cucumis polypeptide injection. Firstly, we investigated the factors affecting the freshness of the injection, including biogenic amines, aflatoxins, the acid value and peroxide value of the melon seeds. The method of dansyl chloride pre-column derivatization-HPLC was used to determine the content of 8 biogenic amines in Cervus and Cucumis polypeptide injection. The method validation results showed good specificity, precision, linearity and recovery rates, which was suitable for the determination of biogenic amines in Cervus and Cucumis polypeptide injection. The results of sample determination showed that relatively higher concentrations of cadaverine were detected in the products from company B. The results of aflatoxins, acid value and peroxide value showed that the melon seeds from some companies had rancidity, mildew and other problems, indicating that the quality standards of multi-component biochemical drugs containing animal- and plant-derived components should be controlled in terms of freshness. Secondly, the methods for the determination of high molecular weight substances and polypeptides in the quality standard were improved. Tricine-SDS-PAGE electrophoresis was used instead of gel chromatography to determine the high molecular weight substances, which improved the accuracy of determination. The kits were used instead of folin-phenol for the determination of peptide content, which is easy to operate, specific and suitable for high-throughput sample determination. Finally, the haemolysis, agglomeration, and biological activity of Cervus and Cucumis polypeptide injection were studied. The results showed that no haemolysis and agglomeration were found in all samples, and the inhibitory effect of samples on THP-1 proliferation in vitro from different companies was different to some extent. In conclusion, the optimized quality standard is more suitable for the detection of Cervus and Cucumis polypeptide injection, and can lay the foundation for improving the safety of multi-component biochemical drugs.

OBJECTIVE：To estab lish the quality standard of Tetrastigma hemsleyanum stem and leaves dispensing granules ， and to determine the contents of 5 active ingredients simultaneously. METHODS ： Chlorogenic acid ， isoorientin and isoorientin-2′-O-rhamnoside in T. hemsleyanum stem and leaves dispensing granules were identified by TLC. The total flavonoids of the 3 batches granules were determined by UV spectrophotometry （by isoorientin ）. The granule sizes ，moisture contents ， dissolvability，and content uniformity were determined. Using isoorientin as internal reference ，relative correction factors of other components were established. QAMS method was adopted to determine the contents of neochlorogenic acid ，chlorogenic acid ， orientin，isoorientin and isoorientin- 2′-O-rhamnoside，which were compared with the results of ESM method. RESULTS ：TLC spots of chlorogenic acid ，isoorientin and isoorientin- 2′-O-rhamnoside were clear and well-separated ，without interference from negative control. The linear range of isoorientin were 7.73-61.82 μ g/mL（r＝0.999 9）. RSDs of precision ，stability and reproducibility tests were all lower than 2％. The recoveries were 93.75％-97.85％（RSD＝1.41％，n＝6）. The average percentages that the 3 batches granules could not pass through sieve No. 1 - moisture contents were 4.63％，5.18％ and 4.03％（n＝3）. were dissolved within 5 min ，and content uniformity were 4.8％-5.0％. Which were all in line with the relevant provi-sions of granules in 2015 edition of Chinese Pharmacopoeia . The linear range of 5 ingredients were 2.325-93 μg/mL（r＝0.999 9），5.125-205 μg/mL（r＝0.999 9），1.150- 46 μg/mL（r＝0.999 3），2.625-105 μg/mL（r＝0.999 9），4.725-189 μg/mL（r＝0.999 9），respectively. RSD of precision ，stability and reproducibility tests were all lower than 3％. The recoveries were 99.78％-106.13％（RSD＝2.33％，n＝6），95.07％-103.32％ （RSD＝2.72％，n＝6），97.17％-105.43％（RSD＝2.98％，n＝6），95.52％-101.33％（RSD＝2.46％，n＝6），99.42％-105.56％ （RSD＝2.34％，n＝6）. Using isoorientin as internal reference ，relative correction factors of neochlorogenic acid ，chlorogenic acid ， isoorientin and isoorientin- 2′-O-rhamnoside were 0.731，0.805，0.821，0.590，respectively. The contents were 0.828-1.123， 2.379-3.118，0.281-0.880，1.039-1.393，2.121-3.209 mg/g by QAMS method ，while the contents were 0.803-1.099，2.345-3.085， 0.269-0.872，1.309-1.393，2.113-3.201 mg/g by ESM method ，there was no significant difference in the content determination results between QAMS and ESM method （P＞0.05）. CONCLUSIONS ：Established quality standard is simple and rapid ，and can be used for quality control of T. hemsleyanum stem and leaves dispensing granules. Established QAMS method is accurate and efficient，and it can be used for simultaneous determination of 5 active ingredients of T. hemsleyanum stem and levels dispensing granules.

Objective:To explore the clinical characteristics of cryptococcus neoformans patients who suspected as lung cancer and treated with surgery, and to improve the diagnosis of the disease.Methods:A retrospective analysis on clinical data(including preoperative laboratory examination, chest CT imaging and postoperative pathology) of 21 cryptococcosis neoformans patients misdiagnosed as lung cancer in our hospital from February 2016 to July 2019.Results:Among the 21 patients, 17 cases were single nodules and 4 cases were multiple nodules, among which 15 cases were highly suspected malignancy. The postoperative pathological diagnosis was cryptococcal pulmonary granulomatosis. 14 patients were treated with antifungal therapy after surgery. No recurrence was found after postoperative follow-up.Conclusion:The clinical manifestations and imaging examination of pulmonary cryptococcus neoformans patients have no obvious specificity, and it is easy to be misdiagnosed as early lung cancer. The diagnosis can only be confirmed by the combination of various means such as regular follow-up, laboratory examination, percutaneous lung puncture or surgical biopsy.