Internal jugular venous flow disorder can affect intracranial hemodynamics extensively，and studies have shown that internal jugular venous flow disorder has an impact on various nervous system diseases. This article reviews the association of internal jugular venous flow disorder with related diseases and non-specific symptoms，such as transient global amnesia，transient monocular blindness，white matter lesions，cognitive impairment，Parkinson disease，idiopathic intracranial hypertension，and multiple sclerosis，in order to expand the clinical thinking of the nervous system diseases associated with internal jugular venous flow disorder.
Parkinson Disease

Qingyan Dropping Pills have the effects of relieving wind and heat, detoxifying, and promoting the pharynx. It is commonly used in traditional Chinese medicines to treat acute and chronic pharyngitis, as well as sore throats and dry throats caused by surgery. Recently, many studies have shown that Qingyan Dropping Pills have certain effects on bacteriostasis, anti-inflammatory, antioxidant, and antiviral activities. As the coronavirus disease 2019 (COVID-19) pandemic enters the post-epidemic era, the regular use of drugs for COVID-19 pandemic symptoms has become a new trend. Therefore, there is a good market prospect to explore and develop Chinese patent medicines with antiviral effects. A preliminary study on the herbal formula and material basis of Qingyan Dropping Pills revealed that they have potential for antiviral applications. In this paper, the research on the quality study and antiviral effect of Qingyan Dropping Pills was reviewed, and the research direction of its secondary development was discussed to provide ideas and references for the new use of old traditional Chinese medicines.

Objective:To establish donor liver quality related risk factors for the loss of function of transplanted liver.Methods:The data of donors and recipients of liver transplantation at the Organ Donation and Transplantation Center of the First Affiliated Hospital of Sun Yat-sen University from Nov 2011 to Dec 2018 were analyzed retrospectively. Propensity score matching (PSM) was performed to evaluate and screen the data of donors and recipients, in order to balance the covariates.Results:Of the organ donation, there were 70 males and 20 females , aging (40.6±16.3) years. Of the liver transplantation recipients, there were 70 males and 20 females , aging (41.8±20.3) years. Liver dysfunction after transplantation was significantly correlated with the following variables: the donor's CPR time( t=0.429, P=0.000), 15-minute retention rate of indocyanine green ( χ2=67.151, P=0.000), liver function grading ( χ2=54.154, P=0.000), bullae fatty liver grading ( χ2=8.120, P=0.017), vesicular fatty liver grading ( χ2=16.000, P=0.001), ICU stay time ( χ2=14.900, P=0.001)and serum creatinine level ( χ2=44.685, P=0.000). The donor scoring system was established in our studying. For the 90 organ donation cases, the donated liver quality were classified into four levels,which were of good correspondence to the prognosis of the recipients. Conclusion:This donor scoring system and grading standards established by analyzing the high-risk factors of liver dysfunction after transplantation helps evaluate the quality of donor liver in China.

Objective:To introduce some rare clinical features of the variant Guillain-barre syndrome (GBS) and to explore its possible pathogenesis for the early diagnosis.Methods:The clinical data, laboratory data and treatment outcomes of four patients, who admitted to Shenzhen People′s Hospital from October 2017 to June 2018 and diagnosed with variant GBS were analyzed and summarized.Results:All the four patients presented limb weakness as a first manifestation. However, they all had clinical features that were inconsistent with typical GBS, and the clinical features were shown differently in each patient. One patient showed asymmetrical limb paralysis. The first manifestation of one patient was severe and persistent back pain accompanied by paraplegia. One patient was accompanied by obvious headache and positive meningeal irritation. One patients had the plane of sensory obstacles, paraplegia, and positive pathological sign. Cerebrospinal fluid examination showed protein cell dissociation in four patients. Electromyogram was consistent with peripheral neurogenic damage. Magnetic resonance imaging (MRI) of the brain and the spinal cord showed no obvious abnormalities. The four patients with obvious improvement in symptoms were treated with gamma globulin and glucocorticoid.Conclusions:Variant GBS is rare and clinical symptoms are various. Patients with atypical clinical symptoms should still be diagnosed by relevant auxiliary examinations to avoid delayed illness.

Objective:This study aimed to evaluate the performance of breast magnetic resonance imaging (MRI) abbreviated protocol (AP) in diagnosing breast neoplasms.Methods:We retrospectively analyzed the data of 86 patients who had undergone breast MRI examinations and compared the images using an AP and full diagnostic protocol (FDP). The AP consisted of axial T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and four-phase dynamic enhancement sequences. The FDP consisted of sagittal T2WI, axial T2WI, T1-weighted imaging, DWI, and seven-phase dynamic enhancement sequences. All the images were analyzed using the Breast Imaging Reporting and Data System (BI-RADS). The consistencies between the different protocols were then calculated. With the pathological diagnosis as the gold standard, the diagnostic capabilities of the two protocols were compared.Result:Two radiologists analyzed the AP and FDP images. The consistencies in the BI-RADS between the different protocols were 0.856 and 0.900, and those in time-signal intensity curves (TICs) were 0.822 and 0.922. Within the same protocol, the consistencies in the BI-RADS between different radiologists were 0.744 and 0.822, and those in TICs were 0.889 and 0.878. No significant differences were found ( P>0.05). In terms of diagnosing malignant neoplasms using the BI-RADS, the sensitivities of the AP and FDP were 89.8% (95 %CI: 0.785-0.958) and 91.5% (95 %CI: 0.806-0.968), respectively; their specificities were 71.0% (95 %CI: 0.518-0.851) and 77.4% (95 %CI: 0.585-0.897), respectively; and the areas under the curves (AUCs) were 0.804 (95 %CI: 0.698-0.910) and 0.845 (95 %CI: 0.748-0.941), respectively. Diagnosing malignant neoplasms using TICs, the sensitivities of the AP and FDP were 86.4% (95 %CI: 0.745-0.936) and 89.8% (95 %CI: 0.785-0.958), respectively; their specificities were 61.3% (95 %CI: 0.423-0.776) and 67.7% (95 %CI: 0.485-0.827), respectively, and the AUCs were 0.739 (95 %CI: 0.623-0.855) and 0.788 (95 %CI: 0.679-0.897), respectively. There was no significant difference between the AP and FDP ( P>0.05). The MRI acquisition times of the AP and FDP were 11.97±0.94 min and 21.25±1.12 min, respectively, with a significant difference ( P<0.001). The average reading time was reduced by 13.5% using the AP compared with that using the FDP. Conclusion:Compared with the FDP, the AP reduced the acquisition time and maintained the diagnostic accuracy, which can be used as an improved pattern for MRI screening in high-risk populations of breast neoplasms.

Objective: To assess the risk factors associated with nosocomial infection in patients with non-surgical basal ganglia intracranial hemorrhage (ICH) in the acute phase to provide evidence for prevention and intervention of nosocomial infections. Methods: Clinical data of 224 patients with non-surgical basal ganglia ICH from January 2014 to December 2018 in the Shenzhen People′s Hospital were analyzed. Patients were divided into 2 groups based on the presence or absence of infection. Clinical data between the two groups were compared including gender, age, past medical history, bleeding volume, hematoma growth rate, systolic blood pressure, diastolic blood pressure, GCS, NIHSS, WBC, RBC, FBI, PLT, CR, BUN, GLU, CRP, UA, CHOL, TG, LDL, HCY. Multivariate Logistic regression analysis and the area under the ROC curve were performed on meaningful variables (P<0.05) to determine the early independent predictors of risk factors for nosocomial infections. ResuIts: Nosocomial infection occurred in 47 of 224 patients, with an infection rate of 20.98%. Compared with infected group, non-infected group had a higher value of age [(63.91 ± 12.37) years vs. (58.66 ± 12.37) years, P=0.010], bleeding volume [(10.33 ± 7.94) ml vs. (7.61 ± 6.58) ml, P=0.034], hematoma growth rate [(7.34 ± 9.17) ml/h vs. (4.33 ± 6.77) ml/h, P=0.040], systolic blood pressure [(177.94 ± 25.28) mmHg (1 mmHg=0.133 kPa) vs. (164.85 ± 22.34) mmHg, P=0.001], NIHSS score [(7.89 ± 4.92) scores vs. (4.84 ± 4.59) scores, P<0.01], WBC [(9.50 ± 3.23) × 10⁹/L vs. (8.25 ± 2.28) × 10⁹/L, P=0.015], FBI [(3.44 ± 0.95) g/L vs. (3.03 ± 0.63) g/L, P=0.007], BUN [(7.01 ± 5.84) mmol/L vs. (4.95 ± 1.93) mmol/L, P=0.021], GLU [(7.27 ± 2.84) mmol/L vs. (5.96 ± 1.75), P=0.004] and CRP [(11.94 ± 21.4) mg/L vs. (4.39 ± 6.41) mg/L, P=0.021]. Multivariate Logistic regression analysis showed that systolic blood pressure (OR=1.021, 95% CI 1.005 -1.037, P=0.012), NIHSS score (OR=1.143, 95% CI 1.056 - 1.237, P=0.001), BUN (OR=1.174, 95% CI 1.025 - 1.344, P=0.020), CRP (OR=1.063, 95% CI 1.016 - 1.112, P=0.008) and age (OR=1.053, 95%CI 1.019 -1.089, P=0.002) was an independent risk factor for nosocomial infection in non-surgical basal ganglia ICH patients in the acute phase. The Area Under Curve (AUC) of the above independent risk factors was calculated, and the results showed that systolic blood pressure (AUC=0.653, 95% CI 0.564 -0.741, P=0.001), NIHSS score (AUC=0.679, 95% CI 0.592 - 0.767, P=0.000), BUN (AUC=0.617, 95% CI 0.526 - 0.708, P=0.014), CRP (AUC=0.691, 95% CI 0.614 - 0.768, P=0.000) and age (AUC=0.643, 95% CI 0.557 - 0.728, P=0.003) had an early predictive value for the occurrence of nosocomial infection in non-operative basal ganglia ICH patients in the acute stage. Conclusions The occurrence of nosocomial infections has identifiable and early predictive risk factors in patients with non-surgical basal ganglia ICH during acute phase. Therefore, controllable risk factors need to be controlled to reduce the incidence of nosocomial infections.

Objective To analyze the incidence of BK virus (BKV) infection after kidney transplantation in our center and to evaluate the efficacy and safety of conversion treatment with Mizoribine (MZR) on BKV infection after kidney transplantation.Methods The information of recipients who received BK virus screening in hospital or outpatient during 2015-02 to 2016-12 in our center was retrospectively analyzed.The recipients positive for BKV were divided into experiment group (given conversion treatment with MZR) and control group (not given MZR conversion) according to the inclusion criteria.The negative rate of BKV,AR,hyperuricemia and the function of renal allograft during the conversion treatment with MZR were observed.Results 182 recipients accepted BKV screening during 2015-02 to 2016-12 and 68 cases were positive.The positive rate of BKV was 38.5 ％.The positive rate of peripheral blood specimens and midstream urine specimens was 7.1％ and 36.8％ respectively.Twelve recipients were positive for BKV in both peripheral blood specimens and midstream urine specimens.There were 27 recipients in experiment group and 36 cases in control group.Fourteen recipients positive for BKV became negative after MZR conversion in experiment group and the negative rate was up to 51.9％.The mean time of negative rate was 3.2 ± 2.7 (1-10) months after MZR conversion.During the conversion treatment with MZR,AR occurred in 1 case and was reversed by the impact therapy with Thymoglobulin in experiment group.The value of serum uric acid was maintained stable before and after MZR conversion under the action of uric-acidlowering drug.The renal function was kept stable in both experiment group and control group after renal transplantation.No deaths and renal allograft failure cases occurred in both groups during the research period.The 2-year survival rate for patients and kidneys was both 100％.Conclusion The incidence of BKV infection after kidney transplantation was high and the treatment scheme of MZR conversion was safe and effective.

OBJECTIVE:To provide reference for TCM in the treatment of coronary heart disease (CHD) unstable angina and new drug research and development.METHODS:TCM inheritance auxiliary platform software was adopted to build prescription database of TCM in the treatment of CHD unstable angina.The software function of clinical collection,platform management,information management,knowledge retrieval,statistics,data analysis were adopted to analyze prescription database in respects of four properties,five tastes,channel tropism distribution,frequency statistics,rules of prescriptions and potential new prescriptions,etc.RESULTS:Through analyzing 178 prescriptions of CHD unstable angina,152 ingredients were involved.Top 3 in the list of distribution frequency of four properties were warm (617),cold (474) and mild (288).Top 3 in the list of distribution frequency of five tastes were bitter (750),sweet (732) and pungent (497).Top 3 in the list of distribution frequency of channel tropism were liver (860),heart (573) and spleen (549).A total of 40 ingredients were used more than 10 times,and top 5 were Ligusticum chuanxiong,Salvia miltiorrhiza,Astragalus membranaceus,Angelica sinensis and Carthamus tinctorious.According to the frequency of the drug combination,top 5 in descending order were L.chuanxiong-S.miltiorrhiza,L.chuanxiong-A.sinensis,L.chuanxiong-A.membranaceus,C.tinctorious-L.chuanxiong and S.miltiorrhiza-A.membranaceus.A total of 8 new prescriptions were obtained after evolution.CONCLUSIONS:Main prescriptions for CHD unstable angina included in CNKI are mild drug property,sweetness and bitterness in taste.Main selected ingredients can promote blood circulation,remove blood stasis and relieve pain,relieve restlessness and tranquilize the mind.It embodies the CHD unstable angina treatment principles of "treat both the incidental and fundamental aspects,tonification and purgation in combination".

Objective To evaluate the correlation between serum uric acid with cognitive disorder after acute cere?bral infarction by prospective study. Methods Four hundred consecutively enrolled patients of acute cerebral infarction were divided into no cognitive impairment group and cognitive impairment group according to the assess of Montreal Cog?nitive Assessment (MoCA). Univariate analysises were conducted in the potential risk factors of cognitive impairment in?cluding age, sex, smoking, alcohol, hypertension, diabetes, dyslipidemia, level of education, infarction in key parts, atrial fibrillation, serum uric acid, blood homocysteine between two groups. The statistically significant indicators in univariate analysises were used as independent variables and the scores of MoCA were used as the dependent variable to conduct multiple linear regression analysis. The assessment on the risk of cognitive impairment after cerebral infarction were con?ducted according to serum uric acid, sex, age and TOAST classification further. Results Serum uric acid was indepen?dent risk factors of cognitive disorder after acute cerebral infarction. The risk of cognitive disorder after acute cerebral in?farction was significantly increased in patients with high level of serum uric acid than with normal level and the relative risk was 1.35,95%CI(1.098,1.660). Especially for the young, male or patients with cerebral infarction in classification of small artery occlusion, the risk increased further, and the relative risk was 1.513, 95%CI(1.092, 2.096)1.412, 95%CI (1.125, 1.771)and 1.464, 95%CI(1.128, 1.900)respectively. Conclusion Exaltation of Serum uric acid was indepen?dent risk factor of cognitive disorder after acute cerebral infarction. The risk of cognitive disorder after acute cerebral in?farction was significantly increased in patients with high level of serum uric acid than with normal level, and especially for the young, male and patients with cerebral infarction in classification of small artery occlusion, the risk increased fur?ther.

This article selected several typical clinical cases, analyzed many factors affect the doctor-patient relationship of ethical issues and new technology of differentiating the ethical dilemma for clinical application, and put forward some suggestions for the reference of medical staff , hospital ethics committees and health policy makers.