Objective:To observe the multi-modal fundus imaging features of subretinal drusenoid deposit (SDD) in age-related macular degeneration (AMD), and observe image features.Methods:A prospective clinical study. From December 2019 to December 2023, 65 patients (104 eyes) with a diagnosis of AMD-SDD by spectral domain optical coherence tomography (SD-OCT) examination in Shandong Eye Hospital were included. All eyes were examined by best corrected visual acuity (BCVA), traditional color fundus photography (CFP), ultra-wide-angle scanning laser fundus imaging (UWF), multicolor scanning laser fundus imaging (MC) and SD-OCT. The standard MC images were obtained by using Spectralis HRA+OCT for MC examination. The multi-mode image characteristics of SDD were analyzed retrospectively. Area under curve (AUC) was used to evaluate the sensitivity and specificity of CFP, MC and UWF in detecting SDD.Results:Among 65 patients with SDD, 29 cases of males (52 eyes) and 36 cases of females (52 eyes) was included. There were 26 patients with unilateral SDD and 39 patients with bilateral SDD. The average age was (71.74±10.97) years. The early, middle and late stages of AMD were 31 (29.8%, 31/104), 24 (23.1%, 24/104), 49 (47.1%, 49/104) eyes, respectively. The SDD detected by CFP, MC and UWF was 76 (73.1%, 76/104), 94 (90.4%, 94/104), 96 (92.3%, 96/104) eyes. CFP showed that the edge of SDD in the macular area was blurred. UWF showed that the dot and the ribbon SDD were light yellow pale discrete deposits and light yellow interlaced network deposits respectively. MC showed the dot SDD had a strong yellow-green circular reflection, while the edge of the ribbon SDD was surrounded by a weak reflection, and the boundary was clear. SD-OCT showed that SDD had strong reflection signal, which was located between the retinal pigment epithelium layer and the photoreceptor cell layer. The dot SDD could break through the ellipsoid zone and caused slight uplift or interruption of the external membrane, showing a cone-like strong reflection signal. While the ribbon SDD showed a continuous "hill-like" protrusion, which hardly broke through ellipsoid zone. The sensitivity and specificity of CFP, MC and UWF for SDD were 73.1%, 90.4%, 92.3% and 61.1%, 94.4% and 83.3%, respectively.Conclusions:MC and UWF show high sensitivity and specificity in diagnosing AMD-SDD, which is superior to CFP. SD-OCT can effectively reveal the location and morphoLogical characteristics of SDD under retina.

Objective:To construct a theoretical model of medical quality and safety management based on the current situation of medical quality and safety management mode in China, providing reference for continuous improvement of medical quality and safety management.Methods:The CNKI database was used as the data source to search literature, with a high citation index H=38 as the judgment standard, the core literature related to the quality and safety management in China was selected. Based on the structure-process-outcome (SPO) model, Nvivo qualitative analysis software was used to code and analyze the included literature, sort out the relevant elements of China′s medical quality and safety management, and clarify the logical relationship between the elements, forming a generalized SPO model of China′s medical quality and safety management.Results:Through a systematic summary and review of relevant literature, a generalized SPO model for medical quality and safety management was proposed, including 5 structural elements (organizational structure, personnel management, resource management, informatization, management standards), 2 process elements (management methods, service processes), and 3 outcome elements (patient outcomes, employee outcomes, organizational results). The logical relationships between and within the three major elements were constructed.Conclusions:To improve the level of medical quality and safety management in China, the structural dimension should be focused on clarifying the responsibilities of the main body of quality management, establishing an independent and perfect quality control department, strengthening the investment and construction of information technology, and promoting the implementation of the medical quality management standard; the process dimension should be focused on promoting the rational application of quality management tools; and the outcome dimension should be focused on strengthening the management of patient safety and improving the individual satisfaction.

Objective:To construct future-oriented theoretical management model for medical quality and patient safety.Methods:Procedure grounded theory was applied to code data including 30 expert interview records from July 2021 to June 2022 and the qualitative analysis results of 71 core literatures in Chinese and English, and then the theoretical model was constructed.Results:After three-level coding, 555 reference points, 249 initial concepts, 41 categories, 27 main categories and 7 core categories related to medical quality and safety management were sorted out, and the theoretical model of SQ (I-SPORT) matrix for medical quality and safety management was constructed. This model extended the traditional dimension in quality and safety management.Conclusions:Regarding medical quality and safety management, on one hand, should focus on the systematic improvement of structure, process, results, reengineering, education and training in terms of management functions; on the other hand, it is necessary to improve the organization, employees, resources, technology and tools, and patient experience in terms of management elements.

Objective:To establish the normal reference value of lumbar bone mineral density (BMD) under quantitative CT (QCT) in Chinese healthy adult females and to explore the regional differences.Methods:Total of 35 431 healthy women who met the inclusion criteria of Chinese health quantitative CT big data program were selected in this study. The BMD of the central plane of L 1 and L 2 vertebrae was measured by Mindways′s QCT system, and the mean value was taken. One-way analysis of variance was used to compare the BMD differences of lumbar vertebrae in women of different ages and regions. The subjects were grouped by an age interval of 10 years, and the level of BMD in different regions of the same age group were compaired. Results:The peak BMD of Chinese healthy adult women appeared in the age group of 20-29 years (Northeast China(183.01±24.58) mg/cm 3, North China (188.93±24.80) mg/cm 3, East China (187.54±27.71) mg/cm 3, South China (186.22±33.72) mg/cm 3, Central China (176.33±24.91) mg/cm 3, Southwest China(182.25±28.00) mg/cm 3), and then it decreased with age. The level of BMD in different regions decreased with the age. Before the age of 70 years, BMD in Central and Southwest China was always at a low level((176.23±24.91) to (90.38±28.12) mg/cm 3, 182.25±28.00 to (88.55±25.68) mg/cm 3), lower than those in Northeast China ((183.01±24.58) to (99.69±27.85) mg/cm 3), North China ((188.93±24.80) to (95.89±26.12) mg/cm 3), East China ((187.54±27.71) to (95.65±27.86) mg/cm 3). After 70 years of age, BMD tended to be the same in different regions ( P>0.05). The BMD values in Central China and Southwest China were similar in the age group of 40-60 years ( P>0.05). The BMD values in the health adult femles in the age group of 60 years in different regions of Chinawere all lower than those of bone mass abnormality (all P<0.05). The detection rate of osteoporosis in females over 50 years was the highest in Southwest China (25.65%) and it was the lowest in North China (17.30%). Conclusions:This study establishes reference values of BMD under QCT in healthy Chinese women, which can be used as a reference basis for identifying women with low BMD who are at risk of osteoporosis. The BMD value is the lowest in Southwest China and the highest in South China.

The aim of this paper was to compare the influence of freeze-drying and sun-drying on six main nucleosides and nucleobases of Cordyceps sinensis by HPLC. Hypoxanthine,xanthine,uridine,inosine,guanosine and adenosine were reference substances. HPLC analysis was performed on a GL Inertsustain AQ-C_(18) column( 4. 6 mm×250 mm,5 μm),with mobile phase consisting of water( A)-acetonitrile( B) at the flow rate of 1. 0 mL·min~(-1)( 0-10 min,0-1% B; 10-65 min,1%-3% B). The detection wavelength was 260 nm,the column temperature was controlled at 30 ℃,and the injection volume was 5 μL. The linear ranges of hypoxanthine,xanthine,uridine,inosine,guanosine and adenosine were 1. 025-20. 50( r = 0. 999 8),0. 545-10. 90( r = 0. 999 9),4. 051-81. 02( r = 0. 999 8),4. 044-80. 88( r= 0. 999 9),2. 075-41. 50( r= 0. 999 9),4. 032-80. 64( r = 0. 999 9) mg·L~(-1),respectively. The average recoveries of them( n = 6)were as follows: 102. 3%( RSD 2. 1%),101. 1%( RSD 2. 4%),97. 80%( RSD 1. 7%),101. 8%( RSD 1. 8%),98. 90%( RSD2. 0%) and 98. 10%( RSD 1. 4%),respectively. Each sample was processed by freeze-drying and sun-drying so as to compare the difference between the two drying methods. The contents of six index ingredients were significantly different between freeze-drying and sun-drying sample of C. sinensis. The total contents of six index ingredients in sun-drying sample were higher than that in the corresponding freeze-drying sample. This research results provide the scientific basis for the drying methods and quality evaluation of C. sinensis.
Chromatography, High Pressure Liquid ; Cordyceps ; chemistry ; Desiccation ; Freeze Drying ; Nucleosides ; analysis

Objective? To explore the effect of rehabilitation nursing based on 5E concept in patients after SuperPath minimally invasive total hip replacemen(t THR). Methods? From February 2016 to February 2018, 194 patients who underwent THR through SuperPath approach in Huzhou Central Hospital of Zhejiang Province were selected as the study subjects. The patients were randomly divided into observation group (n=97) and control group by coin flipping method. The control group was given routine nursing care while the observation group was given the rehabilitation nursing based on 5E concept on the basis of that in the control group. The degree of pain, hip function score, incidence of complications and compliance of functional exercise were compared between the two groups. Results? The Harris score of the patients in the observation group was (65.25±5.29) at 1 month, (87.69±6.47) at 3 months and (93.85±8.66) at 6 months after operation, while that of the control group was (55.84±4.14), (77.48±5.89), (82.45±7.69). There were significant differences between the two groups (t=13.767, 11.511, 9.465;P＜ 0.05). The incidence of postoperative complications was 4.12% (4/97) in the observation group and 27.84% (27/97) in the control group (χ2=20.310, P＜ 0.05). The total compliance rate of functional exercise was 95.88% (93/97) in the observation group and 87.63% (85/97) in the control group, the difference was statistically significant (χ2=4.359,P＜ 0.05). The nursing satisfaction of patients in the observation group was 96.91% (94/97) and 81.44% (79/97) in the control group. The difference was statistically significant (χ2=12.015,P＜0.05). Conclusions? The application of comprehensive rehabilitation nursing based on 5E concept in SuperPath minimally invasive THR can effectively promote the recovery of hip function, reduce the occurrence of complications after operation, enhance the compliance of patients with functional exercise, and significantly improve the satisfaction of patients with nursing.

The TLC method was established for identification of Holotricha diomphalia larvae and the HPLC method was used to determine the content of inosine and guanosine in H. diomphalia larvae. The HPLC analysis was performed on a Waters HSS T3（4.6 mm×250 mm, 5 μm） column of with mobile phase consisting of acetonitrile (A) and 0.08% trifluoroacetic acid (B) in gradient elution. The detection wavelength was 260 nm. The flow rate was 1.0 mL·min⁻¹. The column temperature was 30 °C. As a result, TLC identification method had a good reproducibility and highly specificity. The linear equations of inosine and guanosine were in good linear range (r>0.999 8). The average recovery of inosine and guanosine was 96.53% (RSD=1.6%), 99.71% (RSD=2.7%). The method is simple, accurate and reproducible, which can provide a basis for quality standard improvement H. diomphalia larvae.

Objective: To elucidate the association between large conductance calcium-activated potassium channels (BK_Ca) in the paraventricular hypothalamic nucleus (PVN) and sympathetic outflow in rats with chronic heart failure (CHF) . Methods: Male Wistar rats (6-7 weeks old) were randomized to sham operated group and CHF group (coronary artery ligation) . Two weeks after operation, BK_Ca inhibitor Iberiotoxin (IBTX) was infused into PVN by osmotic minipumps, rats were divided into following groups: sham+aCSF, CHF+aCSF, sham+low dose IBTX (0.125 nmol/nl) , CHF+low dose IBTX, sham+moderate dose IBTX (1.25 nmol/nl) , CHF+moderate dose IBTX, sham+ high dose IBTX (12.5 nmol/nl) , and CHF+high dose IBTX (n=6 each) . Additional rats were grouped as follows: sham+vehicle, sham+KCNMB4 knockdown (by rAAV2-KCNMB4 shRNA virus injection in PVN) , CHF+vehicle, CHF+ KCNMB4 knockdown group (n=6 each) . The cardiac function was determined by echocardiography, left ventricular hemodynamics were measured invasively, renal sympathetic nerve activity (RSNA) was recorded at 6 weeks after coronary artery ligation or sham operation. The contents of norepinephrine (NE) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in plasma were determined by enzyme-linked immunosorbent assay. The protein and mRNA expression of KCNMB4 in PVN were measured by immunofluorescence staining, Western blot, and real-time PCR, mRNA expression of BK_Ca in PVN was detected by real-time PCR. Results: Compared with the sham operation group, the cardiac function of the heart failure group was significantly reduced (P<0.05) , and the plasma NE and the serum NT-proBNP were significantly elevated (P<0.05) . The protein and mRNA expression of KCNMB4 in PVN were obviously down-regulated in CHF rats (P<0.05) . After perfusion of IBTX or KCNMB4 knockdown by microinjection of rAAV2-KCNMB4 shRNA virus,right ventricular weight/body weight and lung weight/body weight ratio as well as left ventricular end-diastolic diameter were increased and left ventricular ejection fraction was decreased (all P<0.05) , the sympathetic driving indexes was increased in sham rats, changes of these parameters further aggravated in CHF rats (P<0.05) . KCNMB4 knockdown further downregulated protein expression in PVN of CHF rats. Conclusion Downregulation and blunted function of BK_Ca in PVN may contribute to sympathoexcitation and deterioration of cardiac function in rats with chronic heart failure.

Objective To investigate the occurrence and influencing factors of perimenopausal syndrome (MPS) and natural menopause women age 40-60 years in Guiyang city, with the purpose of providing information for planning care for menopausal women. Methods A convenient sampling was conducted among 40-60 years old healthy women visiting the three Medical Examination Centers of affiliated hospital of Guizhou Medical University, 1594 subjects were interviewed using a self-designed questionnaire. Improved Kupperman Scale was used to evaluate the MPS. Results The percentage of MPS in the 40-60 years old women is 61.60%, of them, the proportion of mild, moderate and severe cases were 38.96%, 21.52% and 1.13% respectively. Mild and moderate account for the most cases. The top 5 symptoms of MPS were:mood agitation (60.85%), wakefulness (58.22%), muscle or joint ache (57.40%) , fatigue (57.09%) and dizziness (48.68%). The incidence of MPS was related to the following factors: age, marital status, degree of education, family monthly income, current menstrual conditions, age of first sexual life and the frequency of pregnancies and deliveries. The occurrence of MPS were associated with age, educational status,family income,current menstruation condition, age of first sexual intercourse and number of pregnancies. As age increases, the severity of MPS arise. With menstrual changes from normal to irregular and menopause, the rate and severity of MPS increased. With the frequency of pregnancies increases, the possibility of moderate and severe degree of PMS increase. The natural menopause age of healthy women in Guiyang was 49.17 ± 3.12. Conclusion The occurrence of perimenopausal syndrome was related to age,current menstruation condition and frequency of pregnancies. Care for perimenopausal period should start as early as possible.

To observe the hypoglycemic effect of Qizhi Jiangtang capsule in rats with type 2 diabetes, and investigate the preliminary mechanism of its hypoglycemic effect, type 2 diabetes rat models were established by high glucose and high fat combined with small dose of streptozotocin (STZ). After continuous administration for 6 weeks, blood glucose, and glycosylated serum protein (GSP) levels were detected in all of the animals; immunohistochemistry assay was used to detect the number of islet β cells; Western blot assay was used to detect the protein expression levels of insulin receptor (InsR), phosphoinositide-3 kinases (PI3K), glucose transporter-2 (GLUT2) and phosphorylated Jun N-terminal kinases (p-JNK)in hepatic tissues. The results showed that Qizhi Jiangtang capsule could reduce the blood sugar and GSP levels in serum in animals with type 2 diabetes mellitus, increase the level of insulin in serum and number of islet β cells, increase the protein expression levels of InsR, PI3K and GLUT2, and reduce the level of p-JNK protein expression. In conclusion, Qizhi Jiangtang capsule has relatively stable hypoglycemic effect, and the mechanism may be associated with increasing the number of islet β cells and level of insulin in serum, up-regulating the protein expression levels of InsR, PI3K and GLUT2, down-regulating the level of p-JNK protein expression in hepatic tissues, and reducing the level of insulin in hepatic tissues.