Objective To evaluate the efficacy and safety of Shenbao tablet in the treatment of kidney-yang deficiency syndrome.Methods Patients with kidney-yang deficiency syndrome,will were treated with Shenbao Tablets orally,3 tablets once,3 times a day,and the course of treatment was 56 days or 84 days,depending on the condition.By comparing the clinical efficacy,the changes of symptom scores and syndrome scores before and after treatment,and symptoms remission time,the effectiveness of Shenbao tablet in the treatment of kidney-yang deficiency syndrome was evaluated.The safety was evaluated by adverse reactions.Results There were 339 patients in the 56-day group and 345 patients in the 84-day group.After treatment,the clinical effective rates of the 56-day group and the 84-day group were 91.74％and 97.97％,respectively,and the difference was statistically significant(P＜0.05).In the 56-day group and the 84-day group,the excellent rate were 58.41％and 59.13％,clinical control rates were 18.58％and 27.54％,and the progress rates were 14.75％and 11.30％,respectively.After treatment,the symptom scores of kidney-yang deficiency syndrome were significantly reduced respectively within both groups(P＜0.05).In the 56-day group and the 84-day group,the nocturia scores of were 0.89±1.27 and 0.60±1.03,the soreness of waist scores were 1.31±1.19 and 0.72±1.00,the morning diarrhea scores were 0.28±0.74 and 0.19±0.61,the anaphrodisia scores were 0.65±1.13 and 0.53±0.98,the low spirits scores were 0.29±0.81 and 0.08±0.40,the cold limbs score were 1.09±1.20 and 0.55±0.93,the edema scores were 0.14±0.55 and 0.05±0.30,the bright pale complexion scores were 0.20±0.59 and 0.24±0.65,respectively.There were significant differences in the reduction of each symptom score between the two groups(P＜0.05);the 56-day group had a more significant decrease in the score of cold limbs than the 84-day group.The remaining symptom scores decreased more significantly in the 84-day group.After treatment,the syndrome scores of kidney-yang deficiency syndrome in the two groups were significantly lower than those before treatment(all P＜0.05);the change rates of score in the 56-day group and the 84-day group were(-72.33±24.57)％and(-78.77±19.53)％,respectively,and the difference was statistically significant(P＜0.05).The self-reported time to first symptom relief was(14.85±7.18)days in the 56-day group and(14.10±7.78)days in the 84-day group,with no significant difference(P＞0.05).The incidence of adverse reactions of Shenbao tablets was 5.37％,mainly reflected in hepatobiliary system diseases,gastrointestinal system diseases and various examination abnormalities.Conclusions After taking Shenbao tablets for 2 to 3 months,the clinical symptoms of kidney-yang deficiency were better improved,and the improvement was more significant after 3 months of treatment.The security of Shenbao Tablets was good.

Objective To observe the efficacy of postauricular injection of compound betamethasone injection in the treatment of sudden deafness and its influence on transcranial doppler(TCD)parameters and fibrinolysis-coagulation indicators.Methods Patients with sudden deafness were divided into control group and treatment group according to cohort methed.The control group was given intravenous injection of dexamethasone sodium phosphate for 10 days on the basis of conventional treatment,and the treatment group was given postauricular injection of compound betamethasone injection 0.8 g for once every other day for 5 times in addition to conventional treatment.The clinical efficacy,hearing level,haemodynamics and laboratory indicators[homocysteine(Hcy),platelet(PLT)count]were compared between the two groups of patients,and the adverse drug reactions or complications were counted.Results There were 50 cases in treatment group and 50 cases in control group.After treatment,the total effective rates in treatment group and control group were 94.00％(47 cases/50 cases)and 80.00％(40 cases/50 cases),with significant difference(P＜0.05).After treatment,the acoustic thresholds under 0.5 kHz,1 kHz,2 kHz and 4 kHz in treatment group were(42.48±5.65),(45.35±6.44),(48.67±5.58)and(50.25±6.06)dB,which in control group were(50.64±6.92),(57.66±7.41),(60.24±8.31)and(63.15±8.25)dB,all with significant difference(all P＜0.05).After treatment,the whole blood high-shear viscosities in treatment group and control group were(4.18±0.58)and(4.99±0.76)mpa·s;the whole blood low-shear viscosities were(9.18±1.15)and(10.31±1.28)mpa·s;the plasma viscosities were(1.44±0.32)and(1.76±0.25)mpa·s;the Hcy levels in treatment group and control group were(15.57±4.25)and(21.75±4.93)μmol·L-1;PLT levels were(198.72±21.41)×109·L-1and(212.67±18.46)×109·L-1 respectively,all with significant difference(all P＜0.05).There were no obvious adverse drug reactions in treatment group and control group.Conclusion Postauricular injection of compound betamethasone injection can improve the hearing level and enhance the clinical efficacy in patients with sudden deafness,and it is helpful to improve haemodynamics and reduce serum Hcy level,with good safety.

The treatment of inner ear disease is developing towards local drug delivery to avoid drawbacks of systemic approach.The cochlear implants with drug delivery functions,a newly developed method of drug delivery into inner ear for treatment,has become the focus of research in recent years.In this review,we will describe recent advances in characteristics,product developments and applications of different types of drug loaded cochlear implants for local therapy.

Objective:To explore the effect of the"internet+health education system"in nursing care after stapler circumci-sion.Methods:A total of 260 patients underwent stapler circumcision in the Outpatient Department of our hospital from January 2022 to July 2022,of whom 130 received routine nursing after operation(the control group),and the other 130 internet+medical nursing service based on the internet+health education system(the experimental group).We followed up the patients on the 1st,3rd,7th and 30th day after surgery,recorded their Visual Analogue Scale(VAS)scores within 24 hours postoperatively,their satisfac-tion scores with surgery and nursing,the incidence of complications and falloff of the stapler nails,and compared them between the two groups.Results:The postoperative VAS scores of the patients and the incidences of postoperative edema,bleeding,infection and other complications were significantly lower(P<0.05),the falloff of the stapler nails markedly sooner,and the patients'satisfaction scores with surgery and nursing service remarkably higher(P<0.05)in the experimental than in the control group(P<0.05).Conclusion:The application of the internet+health education system in nursing care after stapler circumcision can impart relevant knowledge to the patients,enhance their self-care ability,effectively reduce postoperative complications,and improve the patients'sat-isfaction with surgery and nursing service.

AIM To study the chemical constituents from the ethyl acetate fraction of Baccharis trimera(Less.)DC.METHODS The ethyl acetate fraction of B.trimera was isolated and purified by macroporous resin D101,Sephadex LH-20 gel,silica gel and other chromatographic techniques,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Twenty-three compounds were isolated and identified as 15,16-epoxy-15α-methoxy-ent-clerod-3-en-18-oic acid(1),13-epi-15,16-epoxy-15α-methoxy-ent-clerod-3-en-18-oic acid(2),methyltrineracetal(3),epimethyltrineracetal(4),trinerolide(5),15-epitrinerolide(6),18-methylmalonyl-7α-hydroxy-meth-yltrineracetal(7),18-methylmalonyl-7α-hydroxy-epimethyltriner-acetal(8),18-methylmalonyl-methyltrineracetal(9),18-methylmalonyl-epi-methyltrineracetal(10),methy 3,5-dicaffeoylquinate(11),8-dimetho-xyflavone(12),4',7-dihydroxy-5-methoxyflavanone(13),4-(3',4'-dihydroxycinna-moyl)-oxy-methy-lcinnamate(14),3',7-dihydroxy-4',6,8-trimethoxy-flavone(15),erigeroflavanone(16),nepetin(17),4,2',4',β-tetrahydroxy-6'-methoxy-α,β-dihydrochalcone(18),eugeniyl-O-β-D-glucoside(19),7-hydroxyl-5,6,3',4'-tetramethoxylflavone(20),phomoxanthone J(21),18-acetyl-7α-hydroxy-methyltrineracetal(22),18-acetyl-7α-hydroxy-epimethyltrineracetal(23).CONCLUSION Compounds 3-10 and 22-23 are epimers isolated from this plant for the first time.Compounds 11-16,18-21 are first isolated from genus Baccharis.

Objective To investigate the prevalence of tension-type headache(TTH)in children and adolescents aged 0-19 years globally in 1990-2021,and to provide a basis for the prevention and treatment of TTH.Methods Based on the Global Burden of Disease Study data,the age-standardized prevalence distribution of TTH and its changing trend were analyzed among the children and adolescents aged 0-19 years,with different sexes,age groups,sociodemographic index(SDI)regions and countries/territories.Results The age-standardized prevalence rate(ASPR)of TTH in children and adolescents aged 0-19 globally in 2021 was 17 339.89/100 000,which was increased by 1.73%since 1990.The ASPR in females was slightly higher than that in males(1990:17 707.65/100 000 vs 16 403.78/100 000;2021:17 946.29/100 000 vs 16 763.09/100 000).The ASPR in adolescence was significantly higher than that in school-aged and preschool periods(1990:27 672.04/100 000 vs 10 134.16/100 000;2021:28 239.04/100 000 vs 10 059.39/100 000).Regions with high SDI exhibited a higher ASPR than the other regions,with significant differences in prevalence rates across different countries.From 1990 to 2021,there was a slight increase in global ASPR,with an average annual percentage change(AAPC)of 0.06%.Females experienced a smaller increase than males based on AAPC(0.04%vs 0.07%).There was reduction in ASPR in preschool and school-aged groups,with an AAPC of-0.02%,while there was a significant increase in ASPR in adolescence,with an AAPC of 0.07%.ASPR decreased in regions with low-middle and low levels of SDI,with an AAPC of-0.02%and-0.04%,respectively,while it increased in regions with middle SDI,with an AAPC of 0.24%.Conclusions There is a consistent increase in the ASPR of TTH in children and adolescents aged 0-19 years globally,with significant differences across sexes,age groups,SDI regions and countries/territories.

Objective To propose a sperm classification model based on convolutional neural network to enhance the accuracy of sperm morphological classification.Methods A FT-EfficientNet model was constructed using EfficientNetB0 as the base model,which was fine-tuned by data preprocessing enhancement,transfer learning and cosine decay.Classification experi-ments were performed on the sperm public datasets SCIAN-Morpho and HuSHeM,and the datasets were segmented and vali-dated using 5-fold cross-validation.The classification results by the FT-EfficientNet model were compared with those by the cascade ensemble of support vector machines(CE-SVM)model,the adaptive patch-based dictionary learning(APDL)model,fine tuning of visual geometry group(FT-VGG)model,morphological classification of human sperm heads(MH-HSH)model and transfer learning(TL)model.Ablation experiments were performed in the SCIAN-Morpho dataset to verify the effect of different fine-tuning methods on the model.Results The FT-EfficientNet model proposed had the accuracy,precision and F1 score on the SCIAN-Morpho validation set being 64.1％,63.8％and 64.8％,respectively,which were better than CE-SVM,APDL,FT-VGG and MC-HSH models.The recall rate of the model proposed(65.2％)was slightly lower than that of MC-HSH model(68.0％).The accuracy,precision,F1 score and recall rate on the HuSHeM validation set was 95.4％,95.8％,95.4％and 96.0％,respectively,which were slightly lower than those of TL model while better than those of CE-SVM,APDL,FT-VGG and MC-HSH models.Ablation experiments showed the FT-EfficientNet model behaved the best in fine-tuning.Conclusion The sperm classification model based on convolutional neural network facilitates sperm morphology classification with high accuracy and performance.[Chinese Medical Equipment Journal,2024,45(10):7-13]

DRG payment reform is an important means to control the unreasonable growth of medical expenses, improve the quality of medical services and achieve a win-win situation among three sides of hospitals, medical insurance and patients. This study adopted the Smith policy implementation process model to analyze the difficulties in the DRG policy implementation process from four aspects(idealized policies, policy implementation institutions, target groups, and policy environment), including the deviation between policy connotations and actual needs; the interest objectives of all parties were not completely aligned, the target group lacked a sense of identity, and the social impact and technological support needed to be improved. It was suggested that optimization should be carried out from four dimensions: policy supply coordination and precision, performance evaluation and personnel literacy, target group cognitive level and participation willingness, and policy implementation environment and atmosphere, in order to synergistically promote the effective implementation of DRG policies.

This study investigated the drug delivery performance of oral co-loaded puerarin(PUE) and daidzein(DAZ) mixed micelles(PUE/DAZ-FS/PMMs) from the perspectives of pharmacokinetics, pharmacodynamics, and tissue distribution. The changes in PUE plasma concentration in rats were evaluated based on PUE suspension, single drug-loaded micelles(PUE-FS/PMMs), and co-loaded micelles(PUE/DAZ-FS/PMMs). Spontaneously hypertensive rats(SHR) were used to monitor systolic blood pressure, diastolic blood pressure, and mean arterial pressure for 10 weeks after administration by tail volume manometry. The content of PUE in the heart, liver, spleen, lung, kidney, brain, and testes was determined using LC-MS/MS. The results showed that compared with PUE suspension and PUE-FS/PMMs, PUE/DAZ-FS/PMMs significantly increased C_(max) in rats(P<0.01) and had a relative bioavailability of 122%. The C_(max), AUC_(0-t), AUC_(0-∞), t_(1/2), and MRT of PUE/DAZ-FS/PMMs were 1.77, 1.22, 1.22, 1.17, and 1.13 times higher than those of PUE suspension, and 1.76, 1.16, 1.08, 0.84, and 0.78 times higher than those of PUE-FS/PMMs, respectively. Compared with the model control group, PUE/DAZ-FS/PMMs significantly reduced systolic blood pressure, diastolic blood pressure, and mean arterial pressure in SHR rats(P<0.05). The antihypertensive effect of PUE/DAZ-FS/PMMs was greater than that of PUE suspension, and even greater than that of PUE-FS/PMMs at high doses. Additionally, the distribution of PMMs in various tissues showed dose dependency. The distribution of PMMs in the kidney and liver, which are metabolically related tissues, was lower than that in the suspension group, while the distribution in the brain was higher than that in the conventional dose group. In conclusion, PUE/DAZ-FS/PMMs not only improved the bioavailability of PUE and synergistically enhanced its therapeutic effect but also prolonged the elimination of the drug to some extent. Furthermore, the micelles facilitated drug penetration through the blood-brain barrier. This study provides a foundation for the development of co-loaded mixed micelles containing homologous components.
Rats ; Animals ; Micelles ; Tissue Distribution ; Chromatography, Liquid ; Tandem Mass Spectrometry ; Rats, Inbred SHR ; Isoflavones/pharmacology*

Objective:To study the clinical manifestations and treatment of neonatal testicular torsion (NTT) and to summarize the experience of diagnosis and treatment.Methods:The clinical data of the patients with NTT admitted to the Department of Pediatric Urology in Guangzhou Women and Children's Medical Center from January 2015 to January 2021 were analyzed retrospectively. The data included demographic information, testicular torsion duration, clinical presentation, ultrasonography findings, surgical procedures, pathological results, follow-ups, and prognosis.Results:A total of 17 cases were enrolled in this study, and the median age was 5.2 d, ranging from 1 d to 17 d; the weight ranging from 2 800 g to 4 000 g. 11 cases of left testicular torsion and 6 cases of right testicular torsion. The median time from onset to medical attention was 3.8 d, ranging from 10 h to 15 d. The first manifestations being reported were scrotal swelling, color change, or painless mass. Emergency ultrasound revealed that the blood flow signal in the testis was significantly reduced or disappeared, and heterogeneous mass echoes were detected in the scrotum. Surgical exploration was performed in all 17 cases and confirmed to be testicular torsion. There were 15 cases of extravaginal torsion and 2 cases of intravaginal torsion. There were 6 cases of clockwise torsion and 11 cases of anticlockwise torsion. The average degree of twisted testis was 450.8°, ranging from 270° to 720°. The rate of orchiectomy was 88.2% (15/17). All patients were followed up for a minimum of 1 year postoperatively. None of the patients experienced postoperative bleeding or infection at the scrotal incision site. There were no instances of recurrent testicular torsion, and the contralateral testicles showed no abnormalities. In 2 cases where the affected testicle was preserved, ultrasound reevaluation at 6 months postoperatively revealed atrophy of the affected testicle.Conclusions:NTT is rare in clinics and lacks specificity, with a high rate of testis loss. When the newborns exhibit scrotal swelling, color change, or other abnormalities, testicular torsion cannot be ruled out, and early surgical exploration is required.