Objective To evaluate the impact of optimizing the stroke green channel on the efficiency of acute ischemic stroke management in a county hospital. Methods A retrospective analysis of the emergency stroke green channel treatment data from Sixian People’s Hospital from May 2020 to April 2021 (before optimization of the green channel) and from May 2021 to April 2022 (after optimization of the green channel) was conducted. The rates of intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) patients, as well as door-to-needle time (DNT), door-to-puncture time (DPT), and the modified Rankin scale (mRS) scores of patients three months post-treatment before and after the optimization of the stroke green channel were compared. Results Within one year before and after optimization of the green channel, the number of acute visits for ischemic stroke was 3 143 and 2 623, respectively. Before optimization, 84 and 51 underwent IVT and MT, respectively. After optimization of the green channel, the ratios of patients underwent IVT (n＝215) and MT (n＝103) significantly increased, and both DNT and DPT were significantly shortened (P＜0.000 1); the proportion of MT patients with an mRS score of 0-2 at 3 months post-discharge significantly increased (46/99 vs 13/46, P＝0.038). Conclusion After optimizing the green channel at Sixian People’s Hospital, the efficiency of stroke treatment has significantly improved, and the patients’ prognosis improved.

Objective    To compare the clinical efficacy between right visual double lumen tube (VDLT) intubation and right common double lumen tube (DLT) intubation in lung isolation technique. Methods    A total of 57 patients undergoing thoracoscopic surgery with right DLT lung isolation technique in the First People's Hospital of Chenzhou City and West China Hospital from June 2020 to June 2021 were randomly divided into two groups: a DLT group (n=29, 16 males and 13 females, with a mean age of 54.3±13.2 years) and a VDLT group (n=28, 18 males and 10 females, with a mean age of 55.1±13.7 years) at 1 : 1 with random number table generated by the computer. The clinical data of the two groups were compared. Results    Compared with the DLT group, the catheter positioning time in the VDLT group was statistically shorter (74.9±47.5 s vs. 151.6±88.9 s, P<0.001), the right upper lung occlusion rate (21.4% vs. 51.7%) and the intraoperative re-adjustment catheterization rate (14.3% vs. 48.3%) were lower (P<0.05). The quality of lung collapses immediately after thoracotomy (67.9% vs. 24.1%) and 20 minutes after thoracotomy (100.0% vs. 75.9%) were improved (P<0.05). There was no significant difference in the rate of fiberoptic bronchoscope assistance for positioning, or the incidence of pharynx pain and hoarseness between the two groups (P>0.05). Conclusion    Compared  with common DLT, VDLT is more efficient, accurate and intuitive in the location of right bronchial intubation.

Objective:To observe the interventative effect of Ziyin-Huatan Decoction by regulating exosomes on subcutaneous tumor of mice with gastric cancer. Methods:MGC-803 cells were randomly divided into exosome control group, low-dose group and high-dose group. The low-dose group and high-dose group were intervened with Ziyin-Huatan Decoction of 25 μg/ml and 100 μg/ml respectively. After 48 hours, the exosomes secreted by MGC-803 cells in each group were extracted. Twenty BALB/c male mice were randomly divided into exosome control group, low-dose Ziyin-Huatan Decoction group, high-dose Ziyin-Huatan Decoction group and blank control group, with 5 mice in each group. Except for the blank control group, the mice in the other groups were injected with exosomes extracted from the cells of the corresponding group through the orbit, 10 μg/time for each mouse, once every other day, a total of 15 times; the blank control group was injected with the same amount of PBS. Then SGC-7901 cells were inoculated into mice to establish a tumor model. The tumorigenic rate and body weight of mice were observed. The levels of CD31, VEGF and bFGF in tumor tissues were detected by immunohistochemistry. Results:Compared with the blank control group, the tumor weight [(170.00 ± 10.00) mg vs. (343.33 ± 20.82) mg] and the expression of CD31 (37.43 ± 0.55 vs. 63.30 ± 0.85), VEGF (11.37 ± 1.19 vs. 70.30 ± 0.72) and bFGF (43.77 ± 1.53 vs. 84.97 ± 1.86) in the high-dose Ziyin-Huatan Decoction group significantly decreased ( P<0.05). Compared with exosome control group, the expressions of CD31, VEGF and bFGF in low and high dose Ziyin-Huatan Decoction groups were decreased ( P<0.05). Conclusion:Ziyin-Huatan Decoction can significantly inhibit the growth of subcutaneous tumor of gastric cancer in mice by regulating exudation, which may be related to the inhibition of tumor angiogenesis.

Objective:To explore the feasibility of fast and accurate osteotomy using a new angle adjustable osteotomy guide (AAOG) in closing wedge distal femoral osteotomy(CWDFO).Methods:The clinical data of 14 patients (17 knees) with valgus knee treated with CWDFO at Department of Integrated Chinese and Western Medicine Orthopedics, Honghui Hospital, Xi′an Jiaotong University from January 2018 to July 2019 were analyzed retrospectively. There were 3 males and 11 females, aging (41.4±16.4) years (range: 18 to 56 years). The body mass index was (23.5±3.5) kg/m 2 (range: 18.1 to 28.9 kg/m 2). The guide pins were placed with the assistance of the self-designed AAOG. Before the surgery, Solidworks software was used to calculate the correction angle and the osteotomy radius accurately. The osteotomy guide was adjusted according to these two parameters. During the surgery, the adjusted osteotomy guide was placed to the surface of bone closely and the guide pins were drilled into the bone through the guide holes. The position of the guide pins was confirmed under fluoroscopy. The osteotomy was finished under guide of pins and fixed with Tomofix plate (Synthes). The times and duration of placement of the guide pins, the times of X-ray examination, the planned and actual thickness of the osteotomy wedge, the top and bottom area of the osteotomy wedge, the posterior distal femoral angle(PDFA), the correction of the weight line, and the American Knee Society Score(AKSS) and Tegner scores were collected and compared by paired t test or Kruskal-Wallis non-parametric test. Healing time after osteotomy and complications were recorded. Results:The guide pins were successfully placed once in 10 knees, adjusted once in 5 knees and twice in 2 knees. The time spent in placing all the 6 pins was 82.4 seconds (range: 51 to 125 seconds), and the times of X-ray examination was 1.5 times (range: 1 to 5 times). The top and bottom areas of the osteotomy wedge were (5.52±0.52)cm 2 and (5.36±0.49)cm 2. PDFA was (85.2±2.6)° preoperatively and (85.5±1.4)° postoperatively ( t=-0.401, P>0.05). The thickness of the osteotomy was (11.3±1.9)mm according to the preoperative plan, and the actual thickness was (8.1±1.7)mm. All the patients were followed up for 6 months after surgery and AKSS and Tegner scores improved significantly (all P<0.05). The correction of the weight lines was within the ideal range. Fractures of the hinge point occurred in 3 knees. All of the osseous healing without complications. Conclusion:The new osteotomy guide helps to place the guide pins rapidly and precisely according to the preoperative planning, which should be widely used in clinical applications with promising outcomes.

Objective:To explore the feasibility of fast and accurate osteotomy using a new angle adjustable osteotomy guide (AAOG) in closing wedge distal femoral osteotomy(CWDFO).Methods:The clinical data of 14 patients (17 knees) with valgus knee treated with CWDFO at Department of Integrated Chinese and Western Medicine Orthopedics, Honghui Hospital, Xi′an Jiaotong University from January 2018 to July 2019 were analyzed retrospectively. There were 3 males and 11 females, aging (41.4±16.4) years (range: 18 to 56 years). The body mass index was (23.5±3.5) kg/m 2 (range: 18.1 to 28.9 kg/m 2). The guide pins were placed with the assistance of the self-designed AAOG. Before the surgery, Solidworks software was used to calculate the correction angle and the osteotomy radius accurately. The osteotomy guide was adjusted according to these two parameters. During the surgery, the adjusted osteotomy guide was placed to the surface of bone closely and the guide pins were drilled into the bone through the guide holes. The position of the guide pins was confirmed under fluoroscopy. The osteotomy was finished under guide of pins and fixed with Tomofix plate (Synthes). The times and duration of placement of the guide pins, the times of X-ray examination, the planned and actual thickness of the osteotomy wedge, the top and bottom area of the osteotomy wedge, the posterior distal femoral angle(PDFA), the correction of the weight line, and the American Knee Society Score(AKSS) and Tegner scores were collected and compared by paired t test or Kruskal-Wallis non-parametric test. Healing time after osteotomy and complications were recorded. Results:The guide pins were successfully placed once in 10 knees, adjusted once in 5 knees and twice in 2 knees. The time spent in placing all the 6 pins was 82.4 seconds (range: 51 to 125 seconds), and the times of X-ray examination was 1.5 times (range: 1 to 5 times). The top and bottom areas of the osteotomy wedge were (5.52±0.52)cm 2 and (5.36±0.49)cm 2. PDFA was (85.2±2.6)° preoperatively and (85.5±1.4)° postoperatively ( t=-0.401, P>0.05). The thickness of the osteotomy was (11.3±1.9)mm according to the preoperative plan, and the actual thickness was (8.1±1.7)mm. All the patients were followed up for 6 months after surgery and AKSS and Tegner scores improved significantly (all P<0.05). The correction of the weight lines was within the ideal range. Fractures of the hinge point occurred in 3 knees. All of the osseous healing without complications. Conclusion:The new osteotomy guide helps to place the guide pins rapidly and precisely according to the preoperative planning, which should be widely used in clinical applications with promising outcomes.

Objective To investigate the effect of flipped classroom based on WeChat and mi-crolecture in medical chemistry experiment course in the context of "internet". Methods The classes were randomly divided into 2 groups, experimental group (flipped classroom teaching, n=97) and the control group (traditional teaching, n=98). Comparison of the chemistry experiment test results were performed with the use of t test between the two teaching groups at the end of the semester to evaluate the experimental teaching method. All statistical processing and analyses were performed with SPSS software (version 12.0). Results The chemistry experiment test score of the experimental group was higher than that of the control group [(77.84±8.22) vs. (73.43±10.14), t=3.341, P=0.008), and the difference was statistically significant. The results of the questionnaire showed that the students in the experimental group generally consider that flipped classroom teaching is better than the traditional teaching in terms of the cultivation of comprehen-sive quality and the teaching effect. Conclusion In the context of "internet", flipped classroom teaching with WeChat microlecture can better mobilize the enthusiasm of students to learn and participate in medical chemistry experiment course, which has been welcomed by students and further suggest good application prospects.

Objective To explore the medical care and evacuation equipment at sea in China.Methods The present situation of the medical care and evacuation equipment at sea in China was discussed from the aspects of equipment system,medical service support,mechanism for utilization,management and maintenance as well as informatization.The problems were analyzed in equipment system,support ability,equipment integration and update as well as equipment performances.Results Some measures were put forward from the aspects of equipment system,support ability,equipment integration and update as well as equipment performances.Conclusion The development of medical care and evacuation equipment at sea has to take considerations on medical service requirements at sea,integrated civilian and military uses,personnel,innovation and etc.

Objective To explore the effect of Jintiange capsule on treatment of postmenopausal osteoporosis (PMOP) and its mechanism.Method 133 patients diagnosed as PMOP and meeting the standard were collected from Oct.2011 to Aug.2015 in our hospital.They were randomly divided into two groups:treatment group and the control group.The control group received calcium and alendronate,while the treatment group received 3 Jintiange capsules 3 times daily on the basis of the control group.The lumbar bone densit (BMD),greater trochanter BMD,femoral neck BMD,Ward triangle BMD,visual analogue score (VAS) of knee and back,the serum levels of bone glaprotein (BGP),alkaline phosphatase (ALP),β-C-terminal telopeptide of type Ⅰ collagen (β-CTX),N-terminal propeptide of type Ⅰ procollagen (PINP) and adverse reactions were recorded before and after treatment.Results The lumbar BMD,greater trochanter BMD,femoral neck BMD,ward triangle BMD of treatment group after treatment were higher than those before treatment and those of the control group (P＜0.05).VAS score of knee and back of treatment group were lower than those of the control group (P＜0.05).The serum levels of BGP,ALP,β-CTX,PINP of treatment group were lower than those of the control group (P＜0.05).The adverse reactions rate of two groups had no significant difference (P＞0.05).Conclusion Jintiange capsule can significantly reduce bone metabolism level,increasing BMD,reducing bone loss,relieving knee and back pain of PMOP,without increasing complication rates,which is worthy to be promoted due to high safety and efficacy.

BACKGROUND: Multiwaled carbon nanotubes can accelerate the proliferation and differentiation of osteoblasts, and exert a therapeutic effect on steroid-induced necrosis of femoral head (SNFH). OBJECTIVE:To investigate the function of multiwaled carbon nanotubes in the establishment of a rabbit model of SNFH. METHODS:Thirty-six New Zealand white rabbits were divided randomly into three groups. In treatment group, 16 rabbits were given intraglutealy injection of dexamethasone (2.5 mg/kg) every day and injection of 1 mL liquor of multiwaled carbon nanotubes (0.1 g/L) into the bilateral femur medulary space every week. In model group, 16 rabbits were given intraglutealy injection of dexamethasone (2.5 mg/kg) every day and injection of 1 mL normal saline into the bilateral femur medulary space every week. In control group, four rabbits were given intraglutealy injection of 2 mL normal saline every day and injection of 1 mL normal saline into the bilateral femur medulary space every week. RESULTS AND CONCLUSION: Four weeks after hormone injection, the trabeculae began to exhibit a smal amount of thinner fractures, an accumulation of fatty tissue in the bone marrow were obvious, bone marrow fat cels became bigger and microvascular thrombosis appeared in the model group, while there was no positive histopathological manifestation in the treatment group. This indicates that the multiwaled carbon nanotubes can extenuate pathological damage to the femoral head to a certain extent.

BACKGROUND:Polyvinyl alcohol is a biocompatible and biodegradable polymer. It is widely used in clinical areas because of its water-soluble, film forming, emulsification, adhesiveness, tasteless, and nontoxic.
OBJECTIVE:To review the applications of polyvinyl alcohol and its composite materials in bone, cartilage, skin, vessels and other tissue engineering scaffolds.
METHODS:A computer-based online search of CNKI database from January 2000 to December 2011, PubMed database and Elsevier (ScienceDirect) database from January 1980 to December 2012, was performed by the first author with key words of“poly(vinyl alcohol), composite material, tissue engineering scaffold”both in Chinese and English. Literatures concerning polyvinyl alcohol and its composite materials in bone, cartilage, skin, vessels and other tissue engineering scaffolds were included, and repetitive research was excluded.
RESULTS AND CONCLUSION:Although there are not enough strength, complications and other shortcomings in vivo, due to its good biocompatibility and biodegradable properties, polyvinyl alcohol and its composite
materials have made great progress in tissue engineering applications from the laboratory to the pre-clinical
research. But its long-term effects need further research. It wil be a main research aim of scaffold materials in the future to improve the interaction of cel s with the scaffold materials by surface modification, to prepare biomimetic materials by cel microenvironment simulation, to improve the hydrophilicity, the adhesion of cel s, and cel
differentiation and proliferation, to bionic the structure and function of the natural extracel ular matrix by building three-dimensional porous structure and control ing the release of cel growth factors, to meet the need of tissue regeneration by congruity or harmony of degradation and mechanical strength.