OBJECTIVE To predict the amount of colorants used in the preparation of placebo of Chinese medicine by construc-ting particle swarm optimization-back propagation neural network PSO-BPNN compound granules,and to provide a new idea for the simulation of placebo color of Chinese medicine compound granules.METHODS The BP neural network was used to establish the model of sample color parameters L,a?,b?and pigment mass fraction.The global search ability of particle swarm optimization algo-rithm was used to optimize the weight and bias of BP neural network to prevent the local minimum value of the model.The linear reduc-tion weight coefficient method and the introduction of mutation operator were used to improve the global optimization ability of particle swarm optimization algorithm.The color comprehensive evaluation index(ΔE)was used as the objective evaluation standard to verify the test results.RESULTS The training results show that the fitting accuracy of the improved PSO-BP neural network was up to 98.31%.The prediction results show that the prediction error of the improved PSO-BP neural network was the smallest,and the mean absolute percentage error(MAPE),root mean square error(RMSE)and mean color difference(ΔE)were 0.411 5,2.164 6 and 2.56,respectively.The verification samples of three kinds of particles were prepared for verification.The ΔE of the verification sample and the model drug were 1.73,2.63 and 4.11,respectively.The color difference between the two groups and the model drug was small by visual evaluation.CONCLUSION The BP neural network based on the improved particle swarm optimization algorithm can simulate the prediction of the amount of colorants used in the preparation of Chinese medicine compound granules,and can be used as a recommended optimization model for placebo color matching research.

Objective To observe the effect of Qixian Tongluo Formula on contralateral corticospinal tract(CST)remodeling and motor functional recovery in rats with cerebral infarction,and to explore its potential molecular mechanism from the perspective of regulating factors related to never remodeling.Methods The rat middle cerebral artery occlusion(MCAO)model was established by silk thread ligation.Fifty model rats were randomly divided into model group,citicoline group(0.054 g·kg-1),Qixian Tongluo Formula low-,medium-and high-dose(7.83,15.66,31.32 g·kg-1)groups,and sham operation group,with 10 rats in each group.The intervention administration was started on the 3rd day after operation once a day for 26 consecutive days.On the 3rd,14th and 28th day after operation,the gross motor function was evaluated by Longa score,and the fine motor function was evaluated by beam-walking test(BWT)score.The contralateral motor cortex was injected with the nerve tracer biotin dextran amine(BDA)on the 14 th day after operation to anterogradely trace the CST.On the 28th day after operation,the expression of axonal growth associated protein-43(GAP-43)and BDA positive fibers in the contralateral motor cortex and cervical spinal cord were detected by immunohistochemistry.The co-localization areas of BDA positive fibers and presynaptic marker protein vesicular glutamate transporter 1(VGLUT1)in the cervical spinal cord gray matter were detected by immunofluorescence.The expressions of brain-derived neurotrophic factor(BDNF),glial cell-derived neurotrophic factor(GDNF),nerve growth factor(NGF)and nerve remodeling-associated inhibitory factor[Nogo-A,oligodendrocyte myelin glycoprotein(OMgp)and myelin-associated glycoprotein(MAG)]in the contralateral motor cortex were detected by Western Blot.Pearson correlation analysis was used to analyze the correlation between Longa score or BWT score and BDA/VGLUT1 co-localization area,respectively.Results Compared with the sham operation group,rats in the model group had obvious symptoms of motor function deficits,and the Longa scores were significantly increased(P＜0.01)and the BWT scores were significantly decreased(P＜0.05,P＜0.01)at each time point.The expression of GAP-43 in the contralateral motor cortex and cervical spinal cord was up-regulated(P＜0.05),the number of edge-crossing fibers from the posterior funiculus in cervical cord was increased(P＜0.05),the co-localization area of BDA/VGLUT1 in the gray matter of the cervical spinal cord was increased(P＜0.05),the expressions of BDNF,GDNF and NGF in the contralateral motor cortex were up-regulated(P＜0.05),while the expressions of Nogo-A,OMgp and MAG were down-regulated(P＜0.05).Compared with the model group,the Longa scores in each administration group on the 14th and 28th day after MCAO operation were significantly decreased(P＜0.01),the BWT scores were significantly increased(P＜0.01),the expression of GAP-43 in the contralateral motor cortex and cervical spinal cord was significantly up-regulated(P＜0.01).The number of edge-crossing fibers from the posterior funiculus in cervical cord was significantly increased(P＜0.01),the co-localization area of BDA/VGLUT1 in the gray matter of the cervical spinal cord was significantly increased(P＜0.01).The expressions of BDNF,GDNF and NGF in the contralateral motor cortex were significantly up-regulated(P＜0.01,P＜0.05),while the expressions of Nogo-A,OMgp and MAG were significantly down-regulated(P＜0.05),and the most significant effect was observed in the high dose group.The Longa score was negatively correlated with the co-localization area of BDA/VGLUT1(r=-0.89,P＜0.01),and the BWT score was positively correlated with the co-localization area of BDA/VGLUT1(r=0.84,P＜0.01).Conclusion Qixian Tongluo Formula can improve motor function through promoting contralateral CST remodeling in MCAO rats after cerebral infarction,and the molecular mechanism may be related to the regulation of the expression of nerve remodeling-associated factor in the contralateral motor cortex.

Objective To analyze the publication profile and research hotspots of studies at home and abroad on postoperative cognitive dysfunction by bibliometric methods. Methods Literatures related to postoperative cognitive dysfunction published in the China National Knowledge Infrastructure (CNKI) and Web of Science databases from 2013 to 2023 were included, and statistical analysis was conducted by CiteSpace software. Results A total of 2 705 Chinese literatures and 2 412 English core literatures were included. The number of literatures on postoperative cognitive dysfunction showed an annual increase from 2013 to 2023; China was the country with the highest number of publications internationally, with Capital Medical University ranking the top among Chinese institutions; domestically, postoperative cognitive dysfunction researches predominantly focused on clinical studies, while overseas researches emphasized pathological mechanisms and basic investigations. Research hotspot analysis revealed an enhanced interest in the inflammatory mechanisms and anesthetic aspects of postoperative cognitive dysfunction. Conclusion From 2013 to 2023, the overall research at home and abroad interest in postoperative cognitive dysfunction has shown an upward trend, yet its pathophysiological mechanisms need further exploration. The risk factors for postoperative cognitive impairment and their correlations with anesthesia and mortality are being actively explored, and new methods for prevention and treatment such as percutaneous electrical stimulation are gradually emerging.

Objective:To explore the application effect of problem-based learning (PBL) combined with WeChat assisted teaching pattern in teaching rounds of encephalopathy department.Methods:Undergraduate interns of Batch 2018 from the encephalopathy department were enrolled in the study. The observation group ( n=36) was taught by PBL combined with WeChat teaching mode. The control group ( n=36) was taught by the conventional teaching mode. At the end of rotation, the scores of theoretical and practical skills tests of the two groups were compared, and at the same time, the results of the survey were compared according to the questionnaire. SPSS 19.0 was used for statistical analysis of the data. Results:The test scores of the observation group were significantly higher than those of the control group ( P<0.05). The recognition in nine aspects of the observation group was also significantly higher than that of the control group, such as the interaction with the teaching teachers, the effect of improving clinical learning interest and the ability of inspiring thinking and innovation ( P<0.05). There was no significant difference in recognition about improving the efficiency of clinical teaching rounds between two groups ( P>0.05). Conclusion:PBL combined with WeChat teaching rounds model has certain advantages over traditional rounds in TCM clinical teaching, which are mainly manifested in the mastery of clinical knowledge, the communication ability of interns, the ability of interaction and cooperation, the ability of innovation and thinking, and the improvement of learning initiative.

Objective:To investigate the application value of P-loop digestive tract recons-truction in pancreaticoduodenectomy (PD).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 21 ampullary disease patients undergoing PD in the Liuzhou People′s Hospital Affiliated to Guangxi Medical University from April to December 2020 were collected. There were 13 males and 8 females, aged from 35 to 76 years, with a median age of 60 years. All the 21 patients underwent PD and digestive tract reconstruction using P-loop method based on the Child reconstruction. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted using outpatient examination or telephone interview to detect survival and discomfort symptoms of patients up to December 2020. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers or persentages. Results:(1) Surgical situations: all the 21 patients underwent PD successfully. The operation time, time of P-loop anastomosis and volume of intraoperative blood loss of 21 patients were (317±74)minutes, (14±3)minutes and 375 mL(range, 100-800 mL), respectively. Of the 21 patients, 17 cases had pancreatic texture as soft, 4 cases had pancreatic texture as hard, 3 cases had diameter of pancreas ≤3 mm, 18 cases had diameter of pancreas >3 mm, 14 cases were placed pancreatic duct stent, 7 cases were not placed pancreatic duct stent. (2) Postoperative situations: 2 of the 21 patients had grade A pancreatic fistula, and none of patient had grade B or grade C pancreatic fistula. One case had hepaticojejunal anastomotic fistula, 2 cases without pancreatic fistula had delayed gastric emptying and none of patient had abdominal infection or bleeding. The duration of postoperative hospital stay of 21 patients was (16±5)days, and none of patient died during postoperative 30 days. Results of postoperative histopathological examination showed there were 10 cases with duodenal papillary carcinoma, 4 cases with lower bile duct carcinoma, 3 cases with pancreatic head ductal adenocarcinoma, 1 case with duodenum stromal tumors, 1 case with gastric antrum carcinoma, 1 case with mass in the head of the pancreas of IgG4 and 1 case with choledochal cyst of type 3. (3) Follow-up: all 21 patients were followed up for 1.0 to 7.0 months, with a median follow-up time of 4.3 months. None of patient died. There was no abdominal pain, distension or dyspepsia during follow-up. One case was diagnosed as tumor liver metastasis at postoperative 5 months.Conclusion:P-loop digestive tract reconstruction in PD is safe and effective, with good short-term effect.

Objective:To evaluate the effect of problem-based learning (PBL) combined with scene simulation in the cardiopulmonary resuscitation (CPR) teaching of standardized training of general practitioner, and explore a high-quality teaching method that will help students develop their clinical thinking and practical skills.Methods:Forty students of the Grade 2018 general practitioner training program in Yixing Hospital Affiliated to Jiangsu University were randomly divided into experimental group ( n=20) given PBL combined with scene simulation teaching method and control group ( n=20) given traditional teaching method. The pre-class preparation, classroom discussions, actual combat simulations, and analysis and summary were conducted in the experimental group (4-hour CPR training), while classroom teaching, teaching rounds, analysis and discussion, skills training were conducted in the control group (4-hour CPR training). Furthermore, both groups received the same theoretical test, skill assessment, and questionnaires. t-test or chis-quare test was performed for comparison between the two groups using SPSS 18.0. Results:The average score of theoretical test in the experimental group was significantly higher than that in the control group [(87.5±4.3) vs. (81.2±4.7), P<0.05]; the average score of the skill assessment in the experimental group was significantly higher than that in the control group [(91.0±1.5) vs. (83.1±1.8), P<0.05]. The questionnaire survey showed more students of the experimental group who reported greater improvement in their abilities than those of the control group ( P<0.05). Conclusion:PBL combined with scene simulation teaching method can effectively improve the quality of CPR teaching for standardized training of general practitioners, help students improve clinical thinking and comprehensive processing capabilities.

Objective:Analyzed the funding data of the National Natural Science Foundation of China in the field of preventive medicine from 2009 to 2019 in Nanjing Medical University, to provide scientific basis for scientific research management and decision-making.Methods:Descriptive statistics was used to reveal the status of application and funding in the field of preventive medicine, the distribution and development trends of each secondary code, the research hotspots and key themes in this field.Results:From 2009 to 2019, Nanjing Medical University submitted 566 applications in total and 230 projects were funded with a total funding of 144.03 million in the field of preventive medicine. The top five codes in the funded projects were H2610, H2607, H2603, H2611 and H2601.The funding of H2610 was mainly concentrated in four major areas including cancer, cardiovascular and cerebrovascular diseases, diabetes and hematological system diseases.H2607 funded a large amount of projects for Non-coding RNA and related pathways in recent years. Funding in the H2603 were mainly focused on tumors, glucose metabolism disorders and vitamin A requirements. The funding rate in the H2605 was 9.26%, which was significantly lower than other secondary disciplines in preventive medicine.Conclusions:The National Natural Science Foundation of Preventive Medicine in the Nanjing Medical University has a good development trend, but it also faced challenges. In the future, evidence-based scientific management will be adopted to promote the development of preventive medicine according to the characteristics of different secondary disciplines.

This paper intends to summarize the disaster nursing in recent 10 years, including the content of clinical research, educational research information, theoretical research results, academic exchange organizations, periodicals and magazines,aiming to provide a reference for the development of disaster nursing in China. Compared with developed countries, China Disaster Nursing Research started relatively late and is still in its infancy, there are many projects to be studied and developed in disaster nursing.

OBJECTIVE: This paper used plantar pressure analysis equipment to discuss the plantar pressure distribution pattern and balance ability of patients with the knee joint injury under static standing. METHODS: Zebris FDM-S plantar pressure analysis equipment was used to collect plantar pressure data from subjects with the knee joint injury and healthy control subjects. We compared the pressure values in each region of pelma, and then assessing the balance ability of the subjects based on the trajectory of the overall pressure center movement. RESULTS: Compared with the healthy control group, patients with knee joint injury have a significantly lower pressure in the heel areas and a significantly higher pressure in the middle foot area. And the total pressure of the injured limb foot in the patient group is lower than that in the contralateral foot. In addition, there is a significant increase in the parameters of the balance ability index in the patient group. CONCLUSIONS The plantar pressure distribution pattern of patients with knee joint injury is different from that of normal people in static standing, and the balance ability is poor. Therefore, this method has a positive guiding significance in the evaluation and application of knee joint injury.
Biomechanical Phenomena ; Equipment Design ; Foot ; Gait ; Humans ; Knee Joint ; Pressure

ObjectiveTo explore the risk factors of VAP among multiple injury patients in comprehensive ICU so as to provide the basis for prevention and cure of VAP.MethodsThe retrospective analysis was made to the clinical data from 126 patients with mechanical ventilation for over 48 hours in ICU at the Third People's Hospital of Zhenjiang,the Affiliated Hospital of Jiangsu University,from January 2014 to December 2015. The Logistic regression analysis was performed to research related data in order to identify the risk factors of VAP.ResultsIn 126 patients,there were 37 (29.37％) patients with VAP. Single factor analysis showed that the risk factors were the time of mechanical ventilation,score of the injury severity scale (ISS), time of being admitted to ICU,coma,sedation and analgesia,hormone use,medical history of chronic lung disease,combined antibiotic (>2 kinds),craniocerebral trauma,thoracic injury,spinal injury with significant differences (t/χ2=3.382,20.241,4.212,29.837,7.616,5.322,4.384,8.246,5.677,15.394,4.864;P<0.05). Logistic regression analysis revealed that the risk factors of VAP in multiple injury patients were the time of mechanical ventilation,score of ISS,coma,combined antibiotic (>2 kinds),medical history of chronic lung disease,craniocerebral trauma,thoracic injury (OR=3.897,6.697,5.506,5.104,10.984,4.911,6.046;P<0.05). ConclusionsThe incidence of VAP is high among multiple injury patients in comprehensive ICU. The monitor of risk factors of VAP in multiple injury patients should be enhanced. Moreover,the effective intervention on prevention and cure of VAP should be taken for patients with long time of mechanical ventilation,high score of ISS,coma,combined antibiotic (>2 kinds),medical history of chronic lung disease,craniocerebral trauma, thoracic injury and so on so as to reduce the incidence of VAP.