Objective To study the effect of Ditan Decoction combined with aripiprazole and olanzapine in the treatment of schizophrenia and its influence on serum inflammatory factors chnage.Methods Seventy-seven patients with schizophrenia meeting the requirements visiting the outpatient department and hospitalized in Dazu District Hospital of Traditional Chinese Medicine and Dazu District Mental Health Center from July 2021 to March 2023 were selected as the study subjects and divided into the observation group(n=38)and control group(n=39).The control group was treated with aripiprazole and olanzapine,and the observation group was combined with Ditan Decoction on the basis of the control group.After 8 weeks of treatment,the TCM syndrome scores,Positive and Negative Syndrome Scale(PANSS)score,serum inflammatory factors(IL-6,IL-1β,IL-17)levels were compared between the two groups.Results The total effective rate was 97.37％in the observation group and 84.65％in the control group,and the difference was statistically signifi-cant(P＜0.05).The TCM syndrome score of each item and total scores after treatment in the observation group were lower than those in the control group(P＜0.05),the PANSS positive symptoms,negative symp-toms,general psychopathology and total scores in the observation group were lower than those in the control group(P＜0.05).The IL-17,IL-6 and IL-1β levels after treatment in observation group were lower than those in the control group(P＜0.05).Conclusion Ditan Decoction combined with aripiprazole and olanzapine has significant clinical efficacy in the treatment of schizophrenia,which could further reduce the symptom score of the patients and improve the serum inflammatory factors levels.The treatment is highly safe and worthy of clinical recommendation.

Objective:To explore the effect of music therapy in patients with post-stroke cognitive impairment (PSCI) based on Meta-analysis.Methods:The randomized controlled trial (RCT) on the effect of music therapy in PSCI patients was searched through computer on China National Knowledge Infrastructure, WanFang, VIP, PubMed, Embase, Web of Science, and Cochrane Library. Researchers screened articles according to inclusion and exclusion criteria, evaluated quality, and extracted data. Meta-analysis of the data was conducted using RevMan 5.4 software. The search period was from the establishment of the database to April 6, 2022.Results:A total of 19 RCTs were included, including 1 496 study subjects. The results showed that music therapy could improve cognitive function [ SMD=1.31, 95% CI (1.00, 1.62), P<0.01], increase ability of daily living [ SMD=1.19, 95% CI (0.41, 1.96), P<0.05], relieve anxiety [ SMD=-1.38, 95% CI (-1.88, -0.88), P<0.01], and depression [ SMD=-2.40, 95% CI (-3.73, -1.07), P<0.01]in PSCI patients. Conclusions:Existing evidence suggests that music therapy has a certain improvement effect on the cognitive function of PSCI patients, and can enhance their ability of daily living, reduce negative emotions such as anxiety and depression.

Objective: To explore the costs and other information of two different treatment plans for pediatric acute promyelocytic leukemia (APL): one is the traditional intravenous drip arsenic (arsenic trioxide) combined with chemotherapy treatment, and the other is a medication family treatment program based on oral arsenic (Realgar-Indigo naturalis formula), in order to provide a reference for the promotion of pediatric APL family treatment mode and the formulation of medical insurance policies. Methods: The medical record homepage data and drug using of pediatric APL from 2010 to 2018 in Institute of Hematology & Blood Diseases Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College were retrospectively analyzed, and the newly diagnosed pediatric patients (≤14 years old) with APL were included. The hospitalization expenses and hospitalization time of two treatment options were compared. One treatment option was Chinese children APL treatment plan 2010 (CCAPL 2010), which was based on intravenous drip arsenic trioxide. The other was Chinese Children Cancer Group APL treatment plan 2017 (CCCG-APL 2017), which was based on oral Realgar-Indigo naturalis formula. Results: A total of 79 pediatric APL patients were included and grouped according to the treatment plans, 56 patients were treated with CCAPL 2010 plan, and 23 patients were treated with CCCG-APL 2017 plan. The median costs of one single pediatric APL patient in CCAPL 2010 plan was 167 700 yuan (95 800-386 600 yuan), and the median hospital stay time of one single pediatric APL patient was 102 days (14-157 days). The median costs of one single pediatric APL patient in CCCG-APL 2017 plan group was 118 700 yuan(50 800-270 600 yuan), and the median hospital stay time of one single pediatric APL patient was 37 days(5-96 days). The costs and hospital stay time of one single pediatric APL patient with CCCG-APL 2017 plan were remarkably less than those of one single pediatric APL patient with CCAPL 2010 plan (U = 178, P < 0.01; U = 66, P < 0.01). Conclusions The CCCG-APL 2017 plan simplifies the treatment plan compared with the CCAPL 2010 plan and significantly reduces the patient's medical expenses and shortens the hospitalization days. The CCCG-APL 2017 plan is suitable for family therapy and has good social and economic benefits, which is worthy of clinical promotion.

This paper introduces the related concepts and research status at home and abroad of caregiver burden in elderly patients with hip fracture, and reviews the influencing factors of caregiver burden from four aspects of patients, caregivers, family economic and social support, so as to provide reference for exploring more targeted nursing measures and reducing caregiver burden.

The reuse of high-cost single-use medical devices (SUD) is permitted in many countries, such as the United States, Germany and the United Kingdom, but strict regulatory requirements must be met. In addition to regulatory policies and regulations, such as market access mode and special requirements on Good Manufacture Practice (GMP), there are strict technical requirements on the potential risk control and quality assurance system. Therefore, effective risk assessment and risk control technology are the keys to ensure effective quality control and safe use of SUDs. In this article, based on analyzing the technological requirements of the national regulatory on SUDs in the United States, Germany and Britain, and combined with the review from latest relevant literature, to discuss the strategies of how to carry out scientific risk assessment. Some risk control technologies on the reuse of SUDs are introduced, which will provide support for the further study on risk control strategies and regulatory decisions for the reuse of SUDs in China.

Some single-use medical devices are reprocessed and reused in some countries in the world, but the regulatory approach is different, and in some countries it isn't regulated yet. In this article, the regulatory status quo of single-use medical devices is reviewed. The regulatory development, important regulatory documents and regulatory approaches of single-use medical device reprocessing in the United States, Germany and the UK are introduced. And how to perform scientific risk assessment and effective risk control is discussed. The information is useful to establish China-specific regulations, and to develop relevant standards, guidelines or specifications and the risk control strategies.
China ; Equipment Reuse ; Equipment Safety ; Equipment and Supplies ; Risk Assessment ; United States

Purpose To evaluate the value ofintravoxel incoherent motion (IVIM) imaging in diagnosis of liver fibrosis staging in rats.Materials and Methods Rabbit models of liver fibrosis at different stages were established.All rabbits were divided into four groups based on the pathological results of fibrosis grading as S1-S4.The 1VIM imagings with 8 b-values (0,50,100,200,300,800,1000,1200 s/mm2) were performed.The diffusion coefficient (D),perfusion-related coefficient (D*),and perfusion fraction (f) were calculated and compared between control (only injection of saline) and S 1 group,S2 and S3 group.Results The D value was significantly lower in S1 group compared with control group (P＜0.05),but the D* and f values showed no significant difference between the two groups (both P＞0.05).With the progression of liver fibrosis,the D,D* and f value decreased gradually;the D* value showed significant difference between S2 and S3 group (P＜0.05),but the D and f values showed no significant differences between the two groups (both P＞0.05).Conclusion The D value is useful for differentiation of normal liver and hepatic fibrosis of S1 stage,while the D* is valuable for differentiation of hepatic fibrosis of S2 and S3 stage.However,the f value neither could detect early fibrosis,nor could differentiate hepatic fibrosis staging.IVIM imaging provides a noninvasive method for early and accurate staging of liver fibrosis,which may be of great help in clinical diagnosis and treatment.

Objective To investigate color Doppler flow imaging (CDFI)and transcranial color-coded sonography (TCCS)for detection and evaluation of severe stenosis of intracranial vertebral artery (IVA) before and after stenting,as well as the hemodynamic changes of restenosis and their clinical value. Methods A total of 102 patients with severe stenosis of IVA confirmed by CDFI plus TCCS and DSA from November 2011 to November 2013 were analyzed retrospectively. Extra- and intracranial segments peak systolic velocity (PSV),end-diastolic velocity (EDV),IVA pulsatility index (PI),extracranial resistance index (RI),tube diameter,spectrum morphology,and hemodynamic parameters before stenting and 1 week, 3,6 and 12 months after stenting were compared. According to the results of TCCS,they were further divided into either a restnosis group (n=16 )or a non-restnosis group (n=86 ). Results (1 )The results of TCCS detection showed:PSV,EDV,and PI of the stenotic segments were improved significantly at 1 week after stenting,they were 109 ± 40 cm/s vs. 258 ± 63 cm/s,47 ± 18 cm/s vs. 132 ± 45 cm/s,0. 91 ± 0. 15 vs. 0.75 ± 0. 18,respectively. There were significant differences (all P<0. 01). PSV and EDV of the restenosis group were increased gradually from 3 to 12 months after procedure. There were significant differences between 12 months after procedure and one week after procedure (all P<0. 01). There were no significant differences in PSV,EDV,and PI of the non-restenosis group between the 12-month observation period after procedure and one week after procedure (P>0. 05). (2)The results of CDFI showed:PSV and EDV of the ipsilateral extracranial segment were improved significantly after procedure compare with those before procedure, they were 64 ± 15 cm/s vs. 51 ± 15 cm/s and 24 ± 6 cm/s vs. 19 ± 7 cm/s (all P<0. 05). The RI value and vertebral artery diameter of the extracranial segment were improved gradually,and they reached the peak at 12 months after procedure (0. 61 ± 0. 07 vs. 0. 63 ± 0. 12,P=0. 038;3. 6 ± 0. 4 mm vs. 3. 4 ± 0.5 mm,P=0. 009). Conclusion CDFI in combination with TCCS can objectively evaluate the extra-and intracranial hemodynamic changes before and after IVA stenting,and provide reference information for the effectiveness of stenting and the imaging evaluation of restenosis.

Objective To evaluate the short-term and long-term effects in patients of carotid artery subtotal or complete occlusion after carotid endarterectomy ( CEA) using vascular ultrasound. Methods A total of 107 consecutive patients were diagnosed as carotid artery occlusive disease with DSA and treated with CEA at Beijing Xuanwu Hospital,Capital Medical University from January 2005 to January 2014 were enrolled retrospectively. Sixty-three of them had subtotal occlusion ( the carotid artery stenosis rate 95% to 99%) and 44 had complete occlusion. The occurrence of perioperative complications of all patients was documented. The follow-up study used outpatient follow-up and telephone tracking. The patients of surgical recanalization were followed up with ultrasound at 1 week, 3, 6, 12, and 24 months after procedure. The clinical prognosis, restenosis, vascular structure and hemodynamic changes of the patients after CEA were documented. Results (1) Of the 107 patients,86 (80. 4%) achieved recanalization after procedure and 21 (19. 6%) did not. The incidence of stroke and death was 4. 7% (5 cases) within 30 days after procedure,among them the incidence of subtotal occlusion group was 4. 8% ( n=3 cases) and the complete occlusion group was 4. 5% (2 cases). (2) Within one week after procedure,the peak systolic velocity ( PSV) ,end diastolic velocity ( EDV) ,and pulsatility index ( PI) of the ipsilateral middle cerebral artery in the recanalization patients increased significantly (120 ± 39 cm/s vs 60 ± 17 cm/s,50 ± 18 cm/s vs 33±11cm/s,and0.96±0.20vs0.67±0.14,respectively).Thereweresignificantdifferences(allP<0. 01). Carotid artery ultrasound showed that the local vessel diameters of the original lesions in the recanalization patients were widened as compared with preoperation (4. 4 ± 1. 1 and 3. 6 ± 1. 0 mm). There was significant difference (P<0. 01). (3) Sixty-nine patients with recanalization were followed up for 1 to 60 months( the median time was 12 months) . One to six months after procedure,the patency rate of the patients was 95. 6%(n=66),>6 to 12 months was 94. 2%(n=65),>12 to 24 months was 94. 2%(n=65),and more than 2 years was 91. 3%(n=63). Conclusion Vascular ultrasound can conduct short-term and long-term follow-up for carotid artery occlusive disease after CEA. The degree of blood flow improvement should be identified and restenosis should be found in time after procedure.

Objective To investigate diagnostic approaches of cervical glandular intraepithelial neoplasia (CGIN) for improving the diagnostic levels of CGIN.Methods Clinical data of 106 cases with CGIN admitted in hospital from Jan.2008 to Dec.2010 were analyzed retrospectively.All data from preoperative thin-prep cytologic test (TCT),cervical biopsies and postoperative pathological examination of the excised cervical tissues were reviewed.Results Among 106 patients,62 cases (58.5％,62/106) were low grade CGIN (L-CGIN),44 cases (41.5％,44/106) were high grade CGIN (H-CGIN) ; 25 cases (23.6％,25/106) were pure CGIN and 81 cases (76.4％,81/106) were CGIN mixed with cervical intraepithelial neoplasia (CIN).Fifteen cases (14.2％,15/106) were found atypical glandular cell (AGC)by TCT..In the 15 cases,there were 4 cases (6.5％,4/62) L-CGIN,and 11 cases (25.0％,11/44)H-CGIN,there was significant difference between the two groups (P ＜ 0.05) ; among 15 cases with AGC,11 cases of them (44.0％,11/25) were pure CGIN,4 cases (4.9％,4/81) mixed with CIN,in which there were significant difference (P ＜0.01).Seven cases (25.0％,7/28) were detected glandular lesions in 28 cases by endocervical curettage (ECC).Totally 23 cases (22.8％,23/101) were detected CGIN by colposcopy-directed biopsy,11 cases (19.0％,11/58) were with L-CGIN,12 cases (27.9％,12/43)H-CGIN,there was no significant difference between them (P ＞ 0.05).Among the 23 cases,13 eases(52.0％,13/25) were pure CGIN,10 cases (12.3％,10/81) CGIN mixed with CIN,which showed significant difference (P ＜ 0.01).All 106 patients were treated,101 cases treated with cervical conization and 5 cases performed hysterectomy; 23 cases were diagnosed CGIN preoperation,the ratio of preoperative diagnosis was 21.7％ (23/106),83 cases (80.3％,83/106) diagnosed postoperatively.Conclusions Routine diagnostic methods of CGIN were not satisfaction,most CGIN were diagnosed after cervical resection.Cervical conization may play a very important role in diagnosis of CGIN.The positivity of TCT in H-CGIN was higher than L-CGIN.There was no different in diagnosing different CGIN grades by colposcopy-directed biopsy.The ratio of preoperative diagnosis of pure CGIN was higher than those with CGIN mixed with CIN.