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2021 Vol. 18, No. 6 Published: 2021-02-25

	4	Expert consensus of integrated traditional Chinese and Western medicine for depression disorder
		Expert Consensus Group of Integrated Diagnosis and Treatment of Traditional Chinese and Western Medicine for Depression Disorder Chinese Ethnic Medicine Society Mental Illness Branch
		Depressive disorder is a kind of mental illness that seriously affects public health. In the past 20 years, great achievements have been made in the clinical and basic research of integrated traditional Chinese and Western medicine in the treatment of depression disorder. This expert consensus organizes experts from different disciplines to sort out the pathological mechanism, diagnostic classification and treatment principles of Western medicine, treatment methods, integrated traditional Chinese and Western medicine treatment, clinical treatment suggestions for special populations of depression disorder, suggestions on prevention and recurrence prevention of depression disorder, treatment of adverse reactions of antidepressant drugs and chemicals and summary and prospect, so as to provide guidance and suggestions for clinicians in the diagnosis and treatment of depression disorder with integrated traditional Chinese and Western medicine.
		2021 Vol. 18 (6): 4-12 [Abstract] ( 369 ) HTML (1 KB) PDF (564 KB) ( 254 )

	13	Effect of titanium elastic nail in treatment of displaced midshaft clavicle fractures in older children
		REN Jinke JIA Zhaofeng HU Xinjia
		Objective To investigate the effect of titanium elastic nail (TEN) in the treatment of displaced midshaft clavicle fractures in older children. Methods The clinical data of 47 children with displaced midshaft clavicle fractures who were treated and followed up in Department of Osteoarthropathy, Shenzhen People’s Hospital, Guangdong Province from March 2016 to July 2019 were retrospectively analyzed. According to the different treatment methods, the children were divided into two groups: the conservative group (26 cases), which received conservative treatment with transverse “8” bandage fixation; and the surgery group (21 cases), which received small incision assisted reduction and TEN fixation treatment. The children was followed up regularly in the outpatient department, and X-ray films was reexamined to evaluate fracture displacement and healing. Visual analogue scale (VAS) and Constant-Murley shoulder function score were used to evaluate the pain degree and shoulder function of the children. Results No fracture complications occurred in both groups, and regular reexamination of X-ray films showed that fractures in both groups had achieved bone healing. There were significant differences in VAS between groups, time point comparison and interaction between the two groups (all P ＜ 0.05). Comparison within the two groups: the VAS after treatment were lower in both groups than before, and the VAS at each time point after treatment were lower than before, and the differences were statistically significant (all P ＜ 0.05). Comparison between groups: VAS in the surgery group were lower than those in the conservative group one and two months after treatment, and the differences were statistically significant (all P ＜ 0.05). There were statistically significant differences in Constant-Murley shoulder function assessment between groups, time point comparison and interaction between the two groups (all P ＜ 0.05). Comparison within the two groups: Constant-Murley shoulder function score after treatment was higher in both groups than before treatment, and the differences were statistically significant (all P ＜ 0.05). Comparison between groups: one, two and three months after treatment, Constant-Murley shoulder function scores in the surgery group were higher than those in the conservative group, and the differences were statistically significant (all P ＜ 0.05). Conclusion TEN is a safe, reliable and satisfactory treatment for displaced midshaft clavicle fractures in older children. Compared with conservative treatment, TEN can relieve pain and recover function faster.
		2021 Vol. 18 (6): 13-17 [Abstract] ( 485 ) HTML (1 KB) PDF (794 KB) ( 61 )

	18	Study on preparation technology and quality control of Jiawei Wuzi Yanzong Concentration Pills
		OU YANG Ruoshui1，2 ZHONG Lanying1 WEN Guiqing1 ZHONG Nijun1 ZHUO Jinsheng3 XING Yitao4 WANG Lisheng1
		Objective To establish a preparation method for Jiawei Wuzi Yanzong Concentration Pills and to test the quality of the concentration pills. Methods The concentration pills were prepared by plastic molded method. The formulation molding process was determined based on the soft material properties, moldability, moisture content and dissolution time limit, and the quality standard was tested according to the relevant requirements of Pharmacopoeia of the People’s Republic of China (2015 edition). Results The optimum forming process of Jiawei Wuzi Yanzong Concentration Pills was as follows: the relative density of thick paste was 1.40, the dosage ratio of medicine to honey was 1∶0.4, the powder fineness was 100 mesh, the drying temperature was 60℃ and the drying time was 10 h. The moisture content, dissolution time limit, weight difference and content of concentration pills were all in line with the regulations of Pharmacopoeia of the People’s Republic of China. Conclusion The molding process of concentration pills by this process is stable, reliable, simple and easy to operate, which provides a basis for industrial production.
		2021 Vol. 18 (6): 18-22 [Abstract] ( 127 ) HTML (1 KB) PDF (745 KB) ( 76 )

	23	Effect of interferon-α on chemosensitivity in osteosarcoma U2OS cells
		HUANG Xiufang1 YUAN Xiangwei2▲ QIN Ying2 CHEN Zhongxian2
		Objective To study the effect of interferon-α (IFN-α) on chemosensitivity in osteosarcoma U2OS cells. Methods Cells were divided into control group, IFN-α group, Cisplatin group and IFN-α+Cisplatin group. After treatment for 72 hours, cell growth inhibition rate was determined by Trypan Blue exclude test. Apoptosis was evaluated with Hoechst 33258 staining and DNA ladder. Expressions of caspase-3, 8 and 9 were detected through Western blot. After pre-treatment with Z-VAD-FMK, cell was treated with Cisplatin or combination. Growth inhibition was determined with Trypan Blue exclude test. Results Cells growth inhibition rates in IFN-α group, Cisplatin group and IFN-α+Cisplatin group were higher than those in control group, cells growth inhibition rate in IFN-α+Cisplatin group was higher than that in Cisplatin group (P < 0.01). DNA ladder appeared in IFN-α+Cisplatin group. Compared with Cisplatin group, the expression of caspase-3, 8 and 9 in IFN-α+Cisplatin group was significantly increased (P < 0.01). Cells growth inhibition rate of IFN-α+Cisplatin+Z-VAD-FMK group was lower than that of IFN-α+Cisplatin group (P < 0.01). Conclusion IFN-α enhances chemosensitivity to Cisplatin in U2OS cells through caspase-dependent apoptosis.
		2021 Vol. 18 (6): 23-26 [Abstract] ( 365 ) HTML (1 KB) PDF (874 KB) ( 46 )

	27	Study on the repairing effect of BM-MSCs derived neuron-like cells on sciatic nerve injury in rats
		HU Anquan FENG Qijun WANG Zheng’an QIN Li LI Zhe
		Objective To investigate the repairing effect of bone marrow mesenchymal stem cells (BM-MSCs) derived neuron-like cells on sciatic nerve injury rats. Methods BM-MSCs from 12 SD rats were isolated and purified, and they were divided into control group, β-mercaptoethanol group, all-trans retinoic acid group and Transwell cell co-culture group for seven days respectively. The cells with the highest induced differentiation rate were selected for animal experiments. A total of 90 rats were divided into sham-operation group, model group, general cell group and directional induction group according to the random number table method. The sciatic nerve crush injury model was established by clamping method, and 20 rats in each group were selected. The rats of general cell group and directional induction group were injected with BM-MSCs or neuron-like BM-MSCs respectively at the site of injury sciatic nerve. The rats in sham-operation group and model group were injected with the same amount of normal saline. The sciatic nerve function index (SFI), Bsso Beattie Bresnahan (BBB) scores and the recovery rate of muscle wet weight were compared among four groups. The expression of brain-derived neurotrophic factor (BDNF), myelin basic protein (MBP) and growth associated protein 43 (GAP-43) of nerve tissue were detected by Western blot. Results β-mercaptoethanol was used in subsequent animal experiments. SFI of model group at 2, 4, 8 and 12 weeks after operation were lower than those of the sham-operation group, and the differences were statistically significant (all P < 0.05). SFI of directional induction group at 2, 4, 8 and 12 weeks after operation were higher than those of model group and general cell group; SFI of general cell group at 2, 4, 8 and 12 weeks after operation were higher than those of model group, and the differences were statistically significant (all P < 0.05). BBB scores in model group at 2, 4, 8 and 12 weeks after operation were lower than those in sham-operation group, and the differences were statistically significant (all P < 0.05). BBB scores in directional induction group were higher than those in model group and general cell group at 8 and 12 weeks after operation; BBB scores of general cell group at 8 and 12 weeks after operation were higher than those of model group, and the differences were statistically significant (all P < 0.05). The recovery rate of muscle wet weight in model group was lower than that in sham-operation group, and the difference was statistically significant (P < 0.05). The recovery rate of muscle wet weight in directional induction group was higher than that in general cell group and model group; the recovery rate of muscle wet weight in general cell group was higher than that in model group, and the differences were statistically significant (all P < 0.05). The protein expression levels of BDNF, MBP and GAP-43 in model group were lower than those in sham-operation group, and the differences were statistically significant (all P < 0.05). The protein expression of BDNF, MBP and GAP-43 in directional induction group were higher than those in model group and normal cell group; and the protein expressions of BDNF, MBP and GAP-43 in general cell group were higher than those in model group, and the differences were statistically significant (all P < 0.05). Conclusion β-mercaptoethanol can induce BM-MSCs to differentiate into neuron-like cells to obtain the stable neurons. In addition, neuron-like cells directed by mesenchymal stem cells has obvious repair effect on sciatic nerve injury.
		2021 Vol. 18 (6): 27-33 [Abstract] ( 274 ) HTML (1 KB) PDF (1092 KB) ( 93 )

	34	The diagnostic value of neutrophil CD64 and monocyte HLA-DR in bacterial and viral infections
		YU Jianhua1 ZHANG Yanhong1 ZOU Xiaofeng1 ZHU Wenting1 LI Xin2 CHEN Meiqi3
		Objective To explore the diagnostic value of neutrophil CD64 index (nCD64 index) and monocyte human leukocyte antigen DR (mHLA-DR) in distinguishing bacterial and viral infections. Methods A total of 74 fever patients diagnosed and treated by Dongguan Kanghua Hospital (hereinafter referred to as “our hospital”) were selected from January to November 2019. According to the cause, they were divided into bacterial infection group (40 cases) and viral infection group (34 cases), while 40 healthy people who received physical examination in the hospital during the same period were served as healthy controls. The levels of CD64 and HLA-DR in each group were detected and compared, and receiver operating curve (ROC) was used to analyze the diagnostic value of each index in identifying infections. Results The nCD64 and nCD64 index of the bacterial infection group were significantly higher than those of the healthy control group and the virus infection group, and the differences were statistically significant (P < 0.05); the virus infection group was positive for mHLA-DR and the percentage of monocyte HLA-DR [mHLA-DR+(%)] were significantly higher than those of the healthy control group and the bacterial infection group, and the differences were statistically significant (P < 0.05). The best cut-off values of nCD64, nCD64 index, mHLA-DR and mHLA-DR+ (%) in identifying infections were 30.8, 0.53, 325 and 93.9%, respectively, while the area under the ROC were 0.929, 0.969, 0.778 and 0.782, respectively. The combined detection of nCD64 index and mHLA-DR had an area under the differential infection curve of 0.971, with high sensitivity (95.00%) and specificity (94.12%). Conclusion The combined detection of nCD64 index and mHLA-DR by flow cytometry can be used for the differential diagnosis of bacterial and viral infections.
		2021 Vol. 18 (6): 34-37,53 [Abstract] ( 191 ) HTML (1 KB) PDF (1222 KB) ( 84 )

	38	Practical research on internal control mechanism of emergency procurement of medical materials in emergency state
		ZHOU Jianjun1,2 JI Zhiyong3
		Medical materials such as medical equipment and protective materials are important guarantees for medical diagnosis and treatment activities. In an emergency situation, hospitals need to respond quickly, mobilize various resources in the shortest possible time for emergency procurement of urgent medical supplies, to meet the needs of epidemic prevention and control while meeting the management requirements of internal control. This paper analyzes the characteristics of emergency procurement, dissects the possible risks and problems in it, and proposes to establish an emergency procurement system suitable for hospitals by studying the internal control mechanism of hospital emergency procurement under the premise of orderly and controllable. To guide the emergency procurement of emergency medical supplies during the epidemic prevention and control period in an orderly, effective, fast and good manner, strengthen internal control and supervision, and achieve risk control and legal compliance in the entire emergency procurement, which can serve the entire epidemic prevention and control work.
		2021 Vol. 18 (6): 38-41,66 [Abstract] ( 180 ) HTML (1 KB) PDF (1213 KB) ( 113 )

	42	Research progress on the relationship between mitochondrial dysfunction and insulin resistance in polycystic ovary syndrome
		WANG Jing1 MA Shuting2 ZHANG Yuehui2
		Polycystic ovary syndrome (PCOS) is a common and difficult disease in clinical gynecology, with low cure rate and hereditary. The characteristics of endocrine disorders seriously affects women’s life, and its pathogenesis is complex and diverse. Insulin resistance (IR) is a common endocrine manifestation associated with PCOS, which is closely related to long-term complications of PCOS and adverse pregnancy outcomes, and may aggravate another endocrine characteristic of this disease -- hyperandrogenemia. In recent years, the pathogenesis of mitochondrial dysfunction and this disease has attracted much attention. It has been found that it also has direct effects on PCOS-IR in many aspects. Mitochondrial DNA damage, mitochondrial transport RNA gene mutation, oxidative stress and so on affect the normal function of mitochondria, leading to or aggravating PCOS-IR. In this paper, the interaction effect between impaired mitochondrial function and PCOS-IR is reviewed.
		2021 Vol. 18 (6): 42-45 [Abstract] ( 373 ) HTML (1 KB) PDF (578 KB) ( 36 )

	46	Research progress on signaling pathways related to healing of diabetic foot ulcer
		WANG Gengxin1 ZHANG Chunling2 TANG Lisha1 LUO Kaizhong1 LI Tao1 ZHANG Yun1
		Diabetic foot ulcer (DFU) is one of the most common complications of diabetes, which is difficult to treat and leads to irreversible amputation. In recent years, there have been many studies on the causes of delayed healing of DFU, mainly including decreased angiogenesis, grows slowly of granulation tissue, insufficient collagen synthesis, increased apoptosis, etc. But there have been few studies on the specific mechanism of healing promotion. In this paper, domestic and foreign literatures were analyzed and summarized in recent years, and the mechanism of action of traditional Chinese medicine monomer, compound and dressing on DFU was discussed based on DFU cell signaling pathway, so as to provide relevant reference for the research and treatment of DFU.
		2021 Vol. 18 (6): 46-49 [Abstract] ( 592 ) HTML (1 KB) PDF (578 KB) ( 142 )

	50	Research progress of the correlation between TGF-β1 and CTGF and tubal fibrosis in inflammatory obstructive infertility
		ZHANG Yu1 XUE Qinmei2
		Salpingitis obstructive infertility (SOI) is a common cause of infertility in women of childbearing age, and tubal fibrosis is the pathological basis of this disease. The loss of the normal anatomical structure of the fibrotic fallopian tube leads to the impact of its functions such as egg picking, fertilization, and transportation of fertilized eggs, which leads to infertility. Inflammatory factors are involved in all stages of organ fibrosis. Transforming growth factor-β1 (TGF-β1) and connective tissue growth factor (CTGF) are involved in tubal inflammation and tubal fibrosis. Both play an important role and are the key link of this disease. Taking TGF-β1 and CTGF as effective targets for preventing and improving fallopian tube fibrosis will be of great significance for the treatment of SOI.
		2021 Vol. 18 (6): 50-53 [Abstract] ( 269 ) HTML (1 KB) PDF (580 KB) ( 66 )

	54	Research progress of the application of artery-first approach in laparotomy and minimally invasive pancreaticoduodenectomy
		DONG Ye1 ZHANG Xinning1 ZHOU Yi1 ZHANG Zizhao1 HUANG Hao1 WEI Zhigang2▲
		Pancreaticoduodenectomy (PD) is currently the only effective operation for patients with pancreatic head cancer to have a chance of cure, and the key of operation is whether R0 resection can be achieved. The improvement of R0 resection rate is directly related to the reasonable choice of operative approach, the technique of the operator and the individual condition of the patient. The latter two factors vary from person to person and are not conducive to generalization as experience. Therefore, it is particularly important to continuously optimize the operative approach. Artery-first approach is based on this appeal, which advocates that the operation should start from peripancreatic artery, and the tumor should be identified as early as possible to the invasion of the artery and be dealt with. In this paper, the research status of the application of artery-first approach in laparotomy and minimally invasive PD in recent years is reviewed, in order to provide reference for clinical practice.
		2021 Vol. 18 (6): 54-58 [Abstract] ( 241 ) HTML (1 KB) PDF (588 KB) ( 150 )

	59	Research progress of Janus kinase inhibitors in the treatment of atopic dermatitis
		YANG Liting WU Liming
		Atopic dermatitis is a chronic inflammatory skin disease related to impaired epidermal barrier function and immune function imbalance. Its pathogenesis is closely related to the Janus kinase (JAK)-signal transduction and activator of transcription (STAT) signaling pathway. According to blocking the JAK-STAT signaling pathway mediated by interleukin (IL)-4, IL-13, IL-31 and other related cytokines, it affects the expression of downstream genes, thereby treating atopic dermatitis. This article reviews recent studies on the involvement of JAK-STAT signaling pathway in the pathogenesis of atopic dermatitis and the application of JAK inhibitors in atopic dermatitis.
		2021 Vol. 18 (6): 59-62 [Abstract] ( 291 ) HTML (1 KB) PDF (613 KB) ( 13 )

	63	Research progress of Linc-RoR and pancreatic cancer
		WANG Qianqian1 WANG Huizhi2 XU Min2
		Pancreatic cancer is currently one of the cancers with a poor prognosis. Long non-coding RNA (LncRNA) plays an important role in the diagnosis, treatment and prognosis of pancreatic cancer. As an important member of the lncRNA family, intergenic long non-coding RNA-recoding regulatory factor (Linc-RoR) also plays an important role in pancreatic cancer. Linc-RoR is highly expressed in pancreatic cancer and promotes the proliferation, migration, invasion and drug resistance of pancreatic cancer cells. Linc-RoR is also involved in the stemness maintenance of pancreatic cancer stem cells, and is closely related to the prognosis of pancreatic cancer. Linc-RoR is expected to become a new biomarker and gene therapy target for pancreatic cancer, bringing new hope to the clinical treatment of pancreatic cancer.
		2021 Vol. 18 (6): 63-66 [Abstract] ( 308 ) HTML (1 KB) PDF (577 KB) ( 54 )

	67	Current status of dementia-related knowledge of caregivers for the Alzheimer’s disease patients in Urumqi
		WANG Yanru YU Mingkai DENG Jinglan YAO Licong Parida·Maimaiti
		Objective To understand the current status of caregivers’ dementia-related knowledge of the Alzheimer’s disease (AD) patients in Urumqi, to analyze the influencing factors, and to provide a basis for improving the scores of caregivers’ dementia-related knowledge. Methods From May to October 2019, a two-stage random sampling method was used to select three districts and 12 community health service centers in Urumqi, and a total of 136 dementia elderly caregivers were investigated for dementia knowledge status and influencing factors analysis. Results The caregiver’s dementia-related knowledge score were (13.83±3.57) points. There was a statistically significant difference in the caregivers’s dementia-related knowledge scores of different genders, ages, and educational levels (P ＜ 0.05). Nursing time and access to knowledge were influencing factors of caregivers’ dementia-related knowledge scores (P ＜ 0.05). Conclusion The knowledge scores of AD patients caregivers are generally low, and the care time are long, the community health education approach to obtain care knowledge is helpful to improve the dementia knowledge scores of caregivers.
		2021 Vol. 18 (6): 67-70 [Abstract] ( 434 ) HTML (1 KB) PDF (580 KB) ( 77 )

	71	Analysis of current status and influencing factors of health literacy of nursing staff in nursing homes
		WEI Yuqi1 YANG Xia1 WANG Ruirui1 YANG Ting1 CHU Haiyan2 LIU Yanhui1
		Objective To investigate the current health literacy status of nursing staff in Tianjin nursing homes, to analyze its influencing factors, and to provide a theoretical basis for improving the health literacy level of nursing staff. Methods From November 2019 to January 2020, facilitate the selection of caregivers from four nursing homes in Tianjin, the 2015 National Resident Health Literacy Monitoring Questionnaire was used. According to the survey results, the caregivers who scored 80% of the total score were included in the health literacy group (82 cases), and the others were included in the health literacy group (147 cases). Results The overall health literacy possession rate of nursing home nurses was 35.8%; basic knowledge and concepts, healthy lifestyle and behavior, and basic skills literacy were 48.0%, 34.5%, and 31.4%, respectively. Univariate analysis showed that there was a statistically significant difference between the two groups of caregivers in terms of age, ethnicity, education level, marital status and the presence or absence of chronic diseases (P ＜ 0.05). The logistic regression results showed that age (OR = 0.246), educational level (OR = 2.221), ethnicity (OR = 0.067), marital status (OR = 0.102) and the presence or absence of chronic diseases (OR = 4.635) were influencing factors of health literacy of nurses (P ＜ 0.05). Conclusion The overall level of health literacy of nursing staff in nursing homes is low, and managers should take targeted intervention measures to improve their health literacy levels, thereby improving the quality of elderly care services.
		2021 Vol. 18 (6): 71-74 [Abstract] ( 409 ) HTML (1 KB) PDF (584 KB) ( 30 )

	75	Development and reliability and validity test of breastfeeding knowledge-belief-practice survey scale for obstetric medical staff
		HUANG Dongdi1 GAO Yulin1 YU Shuyi2 MURONG Shaowen3 MAI Daiying3
		Objective To compile a survey scale suitable for breastfeeding knowledge-attitude-practice of obstetric medical staff, and to conduct reliability and validity tests. Methods Through literature review, qualitative interviews, expert consultation and pre-investigation, a preliminary scale was formed on the basis of the theory of knowledge-attitude-practice. From May to August 2019, a total of 430 obstetric medical staff from five third-level first-class and two second-level first-class obstetrics in Guangdong Province were selected for investigation, and the reliability and validity of the scale were tested. Results The constructed obstetric medical staff breastfeeding knowledge, attitude and behavior survey scale contains three dimensions of knowledge, attitude and behavior, 35 items, and uses the Likert five-level scoring method. Exploratory factor analysis extracts three common factors, and the cumulative variance contribution rate was 70.574%; the confirmatory factor analysis showed that all the fitting indexes of the scale reached the fitting standard value, and had good structural validity; the total scale and the reduction coefficient of each dimension were 0.915, 0.954, 0.884, 0.906 respectively; the content validity index S-CVI was 0.95, and I-CVI was 0.80-1.00; the Cronbach’s α coefficient of the total scale was 0.978, and the Cronbach’s α coefficient of each dimension was 0.972, 0.946 and 0.944. Conclusion The scale has good reliability and validity, and can be used to investigate breastfeeding knowledge-attitude-practice of obstetric medical staff.
		2021 Vol. 18 (6): 75-78,90 [Abstract] ( 195 ) HTML (1 KB) PDF (877 KB) ( 103 )

	80	Investigation on the prevalence of chronic insomnia and analysis of related factors in community of Chaoyang District, Beijing
		SUN Xumin YIN Lu LI Zuchang
		Objective To understand the prevalence of chronic insomnia and related influencing factors in the surrounding communities, to provide scientific basis for disease prevention control and treatment. Methods The whole group were stratified and randomly selected permanent residents in three communities around the Xiangheryuan Street, Beijing as the research samples, and 4300 valid samples were collected from April 2014 to May 2016 by means of questionnaire surveys. The Pittsburgh Sleep Quality Index to objectively evaluate sleep quality was used and the factors affecting sleep were analyzed. Results The prevalence of chronic insomnia in the community was 23.26%. There was a statistically significant difference in the incidence of insomnia among people with different ages, ethnicities, marital status, education level, occupation, smoking and poor life stimulation (P ＜ 0.05). Logistic regression analysis showed that over 60 years old (OR = 3.275), widowed (OR = 2.104), master’s degree or above (OR = 3.008), retirement (OR = 4.673), average monthly household income less than 5000 yuan (OR = 1.702), smoking (OR = 1.397), people who were exposed to adverse life stimuli (OR = 5.550) may have a higher risk of chronic insomnia (P ＜ 0.05). Conclusion The prevalence of chronic insomnia in the surrounding communities is relatively high, which may be affected by many factors, and corresponding measures should be taken for vulnerable populations to reduce the number of patients.
		2021 Vol. 18 (6): 80-83 [Abstract] ( 196 ) HTML (1 KB) PDF (584 KB) ( 36 )

	84	Analysis of the current situation and influencing factors of scanning performance execution ability of nurses’ personal digital assistants in operating room
		DAI Chao LIU Xiaoxin▲
		Objective To observe the current status of scanning performance of nurses’ personal digital assistants (PDA) in operating room, and to analyze the influencing factors of PDA scanning performance execution ability of operating room nurses. Methods From November 2018 to November 2019, 60 operating room nurses in Shanghai Chest Hospital who used PDA on a daily basis were selected as the research subjects. The nurses were divided into categories by referring to the self-made scale of the Registered Nurses’ Core Competence Scale and the execution ability of PDA scanning codes execution ability were eualuated. The nurses were divded into the poor group and the better execution group. The single factor and multi-factor analysis were used to analyze the influencing factors of scanning performance execution ability of nurses in the operating room. Results This study included 60 operating room nurses, 8 persons were poor in execution, 52 persons were good in execution. The poor execution group had shorter working years than the good execution group, while the proportion of self-efficacy, low social support, and severe job burnout of the poor execution group were higher than those of the good execution group, and the differences were statistically significant (P ＜ 0.05). Short working years, low self-efficacy, low social support, and severe job burnout were all influencing factors of PDA scanning performance execution ability of operating room nurses (P ＜ 0.05). Conclusion Some operating room nurses have poor PDA scanning performance execution ability, which may be related to nurses’ short working experience, low self-efficacy, low social support, and severe job burnout.
		2021 Vol. 18 (6): 84-86,94 [Abstract] ( 369 ) HTML (1 KB) PDF (861 KB) ( 64 )

	87	Analysis of self-image status of patients with hyperthyroidism and its influencing factors
		CHENG Chao GUO Feng REN Juan▲
		Objective To explore the influencing factors self-image status of patients with hyperthyroidism (hereinafter referred to as “hyperthyroidism”) and its influencing factors. Methods Data of 76 patients with hyperthyroidism admitted to Qingdao Municipal Hospital, Shandong Province from January 2018 to August 2019 were collected retrospectively. After six months of treatment, the self-image status of hyperthyroidism patients was evaluated by the self-image scale (BIS), and the patients were divided into the good group (36 cases) (BIS < 10 points) and the poor group (BIS≥10 points) according to the result of BIS score. The general data of the two groups were compared, and multivariate logistic regression analysis was used to evaluate the influencing factors of self-image status of patients with hyperthyroidism. Results There were no significant differences in gender, course of disease, marital status, educational level, monthly family income and working status between the two groups (P ＞ 0.05). The age and self-management ability of the poor group were lower than those of the good group, and the differences were statistically significant (all P ＜ 0.05). Multivariate logistic regression analysis showed that young age (OR = 1.096, 95%CI: 1.007-1.193) and low self-management ability (OR = 1.343, 95%CI: 1.181-1.527) were the influencing factors for poor self-image of hyperthyroidism patients (P ＜ 0.05). Conclusion More than half of patients with hyperthyroidism have poor self-image, which may be related to patients’ age and self-management ability, especially the influence of self-management ability is more significant. Patients with poor self-management ability have poor self-image. Clinically, intervention in self-management ability of patients with hyperthyroidism can be considered to improve the self-image status.
		2021 Vol. 18 (6): 87-90 [Abstract] ( 225 ) HTML (1 KB) PDF (453 KB) ( 47 )

	91	Therapeutic effect of Sitagliptin Phosphate combined with Metformin on blood glucose control and insulin resistance in patients with type 2 diabetes mellitus
		YUAN Ting
		Objective To investigate the effect of Sitagliptin Phosphate combined with Metformin on the improvement of blood glucose control and insulin resistance in patients with type 2 diabetes mellitus, and to provide evidence for the diagnosis and treatment of patients. Methods Eighty patients with type 2 diabetes mellitus who were admitted to Fuyang Women’s and Children’s Hospital, Anhui Province from April 2019 to April 2020 were selected as the research subjects. They were divided into observation group and control group by random number table method, with 40 cases in each group. The control group was treated with Metformin and the observation group was treated with Sitagliptin Phosphate combined with Metformin. Both groups were treated for 12 weeks. The effects of treatment were compared between the two groups. The changes of fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPBG), glycosylated hemoglobin (HbA1c) and fasting insulin (FINS) before and after treatment were recorded in the two groups, and the adverse reactions during treatment in the two groups were counted. Results The total effective rate of observation group was significantly higher than that of control group, the difference was statistically significant (P ＜ 0.05). After treatment, FBG, 2hPBG and HbA1c in the observation group were lower than those in the control group, with statistical significance (all P ＜ 0.05). FINS in observation group was higher than that in control group, and the difference was statistically significant (P ＜ 0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P ＞ 0.05). Conclusion Sitagliptin Phosphate combined with Metformin has a definite effect on the treatment of type 2 diabetes mellitus, which can effectively improve blood glucose, improve the secretion function of pancreatic β cells, reduce insulin resistance, and has a high safety.
		2021 Vol. 18 (6): 91-94 [Abstract] ( 518 ) HTML (1 KB) PDF (428 KB) ( 50 )

	95	Expression difference and clinical significance of chitinase protein-40 in patients with renal tuberculosis and renal tumor
		LI Xiujun AN Haixia YANG Jiaxin CHEN Huai’an
		Objective To analysis the levels and differences of chitinase protein-40 (YKL-40) in serum and urine of patients with renal tuberculosis and renal tumors. Methods From May 2016 to May 2019, 100 patients with renal tuberculosis admitted to the First Affiliated Hospital of Hebei North University (hereinafter referred to as “our hospital”) were selected as renal tuberculosis group and 50 patients with renal tumor as renal tumor group. Meanwhile, 100 examinees who came to our hospital for physical examination at the same time were selected as the reference group, and YKL-40 levels in serum and urine of three groups of patients were detected by enzyme-linked immunosorbent assay. At the same time, the normal tissues around the lesion were collected and made into paraffin samples. The expression of YKL-40 in the lesion was observed by immunohistochemistry. The clinical data of all study samples were retrospectively analyzed. Compared the difference of YKL-40 levels in urine and serum between patients with renal tuberculosis and renal tumor and normal persons, and observed the expression of YKL-40 in pathological tissues and surrounding normal tissues of patients with renal tuberculosis and renal tumor. Results The level of YKL-40 in serum and urine samples of reference group was lower than that of renal tuberculosis group and renal tumor group (P ＜ 0.05). There was no significant difference in serum and urine YKL-40 levels between renal tuberculosis group and renal tumor group (P ＞ 0.05). The level of YKL-40 in pathological tissues of patients with renal tuberculosis and renal tumor was significantly higher than that in surrounding normal tissues (P ＜ 0.05). Conclusion The level of YKL-40 in urine and serum of patients with renal tuberculosis and renal tumor is significantly increased, which can be used as the basis for the preliminary diagnosis of the disease. However, in order to improve the diagnostic accuracy, it should be combined with other laboratory diagnostic criteria.
		2021 Vol. 18 (6): 95-98 [Abstract] ( 180 ) HTML (1 KB) PDF (410 KB) ( 66 )

	99	Clinical effect of knee osteoarthritis treated by kneeling under the theory of “muscle and bone balance”
		WANG Jing1,2 ZHANG Min1 YANG Qi1 XU Zhangying2 PANG Jian1 DU Jiong1
		Objective To observe the effect of kneeling treatment on the biomechanics of lower limbs in patients with knee osteoarthritis (KOA) and evaluate its clinical effect. Methods Thirty patients with KOA in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from May 2018 to January 2019 were selected and divided into treatment group and control group according to random number table method, with 15 cases in each group. The treatment group received kneeling treatment, while the control group did not receive any form of intervention. The Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and BTE Primus Rs simulation test evaluation system were used to determine the clinical efficacy. Results After treatment, the WOMAC total score, WOMAC pain score, and the ratio of 60° peak flexion torque to peak extension torque in the treatment group decreased compared with before treatment, and the treatment group was lower than the control group, with statistical significances (all P < 0.05). After treatment, the range of motion of knee joint in the treatment group increased compared with before treatment, and the treatment group was higher than the control group, with statistical significances (all P ＜ 0.05). There was no significant difference in the peak strength of extensor muscle between the two groups (P ＞ 0.05). Conclusion Kneeling training therapy can improve the balance of joint mobility and muscle flexion and extension in patients with KOA, and then effectively relieve the symptoms of knee pain.
		2021 Vol. 18 (6): 99-102 [Abstract] ( 423 ) HTML (1 KB) PDF (634 KB) ( 104 )

	103	Effect of minimally invasive percutaneous bridge internal fixation in the treatment of unstable pelvic fractures
		LIU Guoqiang1 ZENG Lingguo1 XIE Long1 ZHONG Xueren1 ZHOU Longze1 ZHOU Bin1 SI Zebing1 PENG Xiaoming1,2
		Objective To investigate the clinical effect of minimally invasive percutaneous bridge internal fixation in the treatment of unstable pelvic fractures. Methods A total of 80 cases of unstable pelvic fracture in Yuebei People’s Hospital from January 2015 to January 2019 were collected as the research objects. According to the different surgical treatment methods, they were divided into observation group (43 cases) and control group (37 cases). The observation group was treated with minimally invasive percutaneous bridge internal fixation, and the control group was treated were traditional external fixation. The operation status, complication rate and operation effect of the two groups were statistically compared, and 12 months follow-up observation was conducted, the Harris hip joint score of the two groups was evaluated. Results The hospitalization time and fracture healing time of the observation group were lower than those of the control group, and the differences were statistically significant (P ＜ 0.05). The incidence of complications rate in the observation group was lower than that in the control group , and the difference was statistically significant (P ＜ 0.05). The excellent and good rate of fracture reduction in the observation group was higher than that in the control group, and the difference was statistically significant (P ＜ 0.05). There were highly statistically significant differences in the harris hip function score time between groups and interaction between the two groups (P ＜ 0.01). Further pair comparison and intra-group comparison: the Harris hip function score at 3, 6, 9 and 12 months after surgery in both groups were higher than those before surgery, and the differences at each time points after surgery were statistically significant (all P ＜ 0.05). Comparison between groups: the Harris hip function score in the observation group was higher than that in the control group at all time points, with all statistical significant differences (all P ＜ 0.05). Conclusion The clinical effect of minimally invasive percutaneous bridge internal fixation in the treatment of unstable pelvic fractures is significant, which can promote the fracture healing of patients, improve the reduction effect and postoperative hip joint activity function, and the incidence of complications is low, and the operation safety is better.
		2021 Vol. 18 (6): 103-106,114 [Abstract] ( 471 ) HTML (1 KB) PDF (571 KB) ( 62 )

	107	Efficacy of Guli Capsules combined with Salmon Calcitonin Injection in treatment of senile osteoporosis and its effects on bone metabolic index
		ZHANG Wei LIU Zhaoli TANG Bo GAO Feng LI En
		Objective To explore the efficacy of Guli Capsules combined with Salmon Calcitonin Injection in treatment of senile osteoporosis and its effects on bone metabolic index. Methods A total of 80 cases of elderly patients with osteoporosis in Xinyi People’s Hospital from January 2017 to January 2019 were selected, according to the random number table method, they were divided into control group and the observation group, 40 cases in each group. The control group was treated with Salmon Calcitonin Injection, while the observation group was treated with Guli Capsules combined with Salmon Calcitonin Injection, the two groups were treated for two months. Clinical curative effect was evaluated after treatment. The visual analogue scale (VAS) scores, Oswestry dability index (ODI) scores, serum osteocalcin (BGP), β-collagen carboxy-terminal peptide (β-CTX), 25-hydroxyvitamin D3 [25-(OH)D3], bone mineral density, bone mineral levels of the two groups before and after treatment were compared. The adverse reactions of the two groups during the treatment were recorded and compared. Results The total effective rate of observation group was significantly higher than that of the control group, the difference between the two groups was statistically significant (P ＜ 0.05). After treatment, the VAS, ODI scores and serum β-CTX of the two groups were significantly lower than before treatment (P ＜ 0.05), the BGP, 25-(OH)D3, bone mineral density and bone mineral levels were significantly higher than before treatment (P ＜ 0.05). After treatment, the VAS, ODI score and serum β-CTX level in the observation group were significantly lower than those in the control group (P ＜ 0.05), while the BGP, 25-(OH) D3 level, bone mineral density and bone mineral level in the observation group were significantly higher than those in the control group (P ＜ 0.05). During treatment, there was no serious adverse reaction of the two groups. Conclusion Guli Capsules combined with Salmon Calcitonin Injection has a significant clinical effect in treatment of senile osteoporosis, which can significantly reduce the pain, improve the bone metabolic index and bone strength, and has a good safety.
		2021 Vol. 18 (6): 107-110 [Abstract] ( 418 ) HTML (1 KB) PDF (551 KB) ( 75 )

	111	Clinical effect of medium frequency pulsed electrically combined semiconductor laser on sciatica of lumbar disc herniation
		ZHANG Jingzheng1 GUO Chuang2▲
		Objective To investigate the clinical effect of semiconductor laser and intermediate frequency pulse electrotherapy on patients with sciatica caused by lumbar disc herniation. Methods A total of 82 patients with lumbar disc herniation and sciatica who were hospitalized in the Department of Rehabilitation, the First People’s Hospital of Suzhou City in Anhui Province from April 2018 to December 2019 were selected as the research objects. According to the order of admission, they were randomly divided into 42 cases in the control group and 42 cases in the interventim group. The control group was given intermediate frequency pulse electric therapy, and the intervention group was added with semiconductor laser treatment on the basis of the control group. The pain, inflammatory factors and clinical efficacy of the two groups before and after intervention were compared. Results The total scores of pain rating index (PRI), visual analog scale (VAS), present pain index (PPI) and simple pain questionnaire (McGill) in the two groups after intervention were lower than those before intervention, and the total scores of PRI, VAS, PPI and McGill scores in the intervention group were lower than those in the control group, with statistical significant differences (all P ＜ 0.05). After intervention, serum levels of β-endorphin (β-EP) were significantly incresed and tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the two groups were significantly reduced after intervention, and β-EP in the intervention group was higher than that in the control group, while TNF-α and IL-6 in the intervention group were lower than those in the control group, with statistical significant differences (all P ＜ 0.05). The effective rate of the intervention group was higher than that of the control group, and the difference was statistically significant (P ＜ 0.05). Conclusion Intermediate frequency pulsed electricity combined with semiconductor laser has a significant clinical effect in treating lumbar disc herniation and sciatica, which is worthy of clinical application.
		2021 Vol. 18 (6): 111-114 [Abstract] ( 309 ) HTML (1 KB) PDF (580 KB) ( 24 )

	115	Clinical effect of pulmonary surfactant combined with Budesonide in the treatment of premature infants with severe respiratory distress syndrome
		CHEN Jing1 JIANG Xiaohua2 SHEN Weiqi1
		Objective To investigate the clinical effect of pulmonary surfactant (PS) combined with Budesonide in the treatment of premature infants with severe respiratory distress syndrome (RDS). Methods A total of 168 premature infants with severe RDS admitted in People’s Hospital of Hechuan District of Chongqing from July 2016 to December 2019 were selected. They were divided into control group and study group according to the random number table method, With 84 cases in each group. The control group was treated with PS, and the study group was treated with Budesonide on the basis of the control group. The clinical efficacy, inflammatory factors (Interleukin-6 [IL-6], tumor necrosis factor-α [TNF-α]), blood gas analysis (oxygenation index [OI], arterial partial pressure of carbon dioxide [PaCO2], arterial partial pressure of oxygen [PaO2]) and complications of two groups were compared. Results After 72 hours of treatment, PaO2 and OI in two groups were higher than those before treatment, and study group was higher than control group (all P < 0.05). PaCO2 in two groups were lower than those before treatment, and study group was lower than control group (all P < 0.05). The total effective rate of study group was higher than that of control group (P < 0.05). The levels of serum IL-6 and TNF-α in two groups were lower than those before treatment, and study group was lower than control group (all P < 0.05). There was no significant difference in the total incidence rate of complications between two groups (P > 0.05). Conclusion PS combined with Budesonide in the treatment of severe RDS premature infants can effectively reduce the level of inflammatery factors, improve the level of blood gas analysis, which is safe and effective.
		2021 Vol. 18 (6): 115-118 [Abstract] ( 465 ) HTML (1 KB) PDF (483 KB) ( 33 )

	119	Clinical study of mild hypothermia combined with cerebroprotein hydrolysate in the treatment of neonatal asphyxia brain injury and its influence on blood GFAP
		MU Yanshun LIU Weijuan GAO Jialing LIU Hongwei FAN Qingman
		Objective To observe the effect of mild hypothermia combined with cerebroprotein hydrolysate in the treatment of neonatal asphyxia brain injury and its influence on blood glial fibrillary acidic protein (GFAP). Methods Retrospective analysis was performed on 81 cases of neonatal asphyxia with moderate and severe brain injury admitted to Department of Neonatology, Huabei Petroleum Administration Bureau General Hospital from May 2018 to May 2020. According to the drug use, they were divided into cerebroprotein hydrolysate group (40 cases) and mild hypothermia combined with cerebroprotein hydrolysate group (41 cases). Two groups were given symptomatic support treatment, such as maintaining electrolyte balance, reducing intracranial pressure, anti infection, intravenous nutrition support, etc. Cerebroprotein hydrolysate group was treated with Trixerutin Brain Protein Hydrolysate Injection and mild hypothermia combined with cerebroprotein hydrolysate group was combined with head mild hypothermia treatment on the basis of cerebroprotein hydrolysate group. The consciousness recovery time, muscle tension recovery time, primary reflex recovery time and blood GFAP level were compared between two groups. Results The consciousness recovery time, muscle tension recovery time, primary reflex recovery time in mild hypothermia combined with cerebroprotein hydrolysate group were shorter than those in cerebroprotein hydrolysate group (all P < 0.05). Before treatment, there was no significant difference in blood GFAP level between the two groups (P ＞ 0.05). After seven days of treatment, the blood GFAP level in both groups were higher than those before treatment and after three days of treatment. After three days of treatment, the blood GFAP level in both groups were higher than those before treatment (all P < 0.05). After three, seven days of treatment, the blood GFAP level of the mild hypothermia combined with cerebroprotein hydrolysate group were lower than those of cerebroprotein hydrolysate group (all P < 0.05). Conclusion Mild hypothermia combined with cerebroprotein hydrolysate can significantly improve the clinical manifestations of neonatal asphyxia brain injury and the detection of blood GFAP is helpful for the prognosis of neonatal asphyxia brain injury.
		2021 Vol. 18 (6): 119-122 [Abstract] ( 154 ) HTML (1 KB) PDF (483 KB) ( 70 )

	123	Effect of simulation training on decision to delivery interval in high-risk pregnancy cesarean section
		ZHAO Xinzhao DUAN Yanli▲
		Objective To explore the effect of simulation training on decision to delivery interval (DDI) in high-risk pregnancy cesarean section, and to provide a basis for the promotion and improvement of obstetric simulation training. Methods A total of 50 cases with high-risk pregnancy cesarean section in Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January 2019 to January 2020 were selected as the observation group; 50 case with high-risk pregnancy cesarean section from November 2017 to October 2018 were selected as the control group. The observation group was received emergency cesarean section simulation training process, and the control group was received emergency cesarean section with routine procedures. The time from determining surgery to admission, the time from admission to surgery, the time from surgery to delivery and DDI were compared between the two groups; the neonatal Apgar scores at one and five minutes after birth were compared between the two groups; and the adverse pregnancy outcomes (postpartum hemorrhage, neonatal asphyxia, neonatal death) were compared between the two groups. Results The time from determining surgery to admission, the time from admission to surgery, the time from surgery to delivery and DDI of the observation group were all shorter than the control group, the differences were all highly statistically significant (all P < 0.01); neonatal Apgar scores at one and five minutes after birth in the observation group were higher than those in the control group, the differences were all highly statistically significant (all P < 0.01). There were no significant differencs in the incidence of postpartum hemorrhage and neonatal death between the two groups (P > 0.05); and the incidence of neonatal asphyxia in the observation group was lower than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion Simulation training can improve the work efficiency of obstetric medical staff, and thus shorten the time from determining surgery to admission, the time from admission to surgery, the time from surgery to delivery and DDI of high-risk pregnancy cesarean section maternal, and it is conducive to improving neonatal health and reducing the incidence of neonatal asphyxia.
		2021 Vol. 18 (6): 123-126 [Abstract] ( 335 ) HTML (1 KB) PDF (482 KB) ( 49 )

	127	Clinical effect of zirconia endocrown in repairing of low occlusal gingival distance molar
		CHEN Weiwei
		Objective To investigate the clinical effect of zirconia endocrown in repairing of low occlusal gingival distance molar. Methods From January 2017 to March 2018, 38 patients (40 affected teeth) admitted to the Department of Stomatology, Shunyi Hospital, Beijing Hospital Traditional Chinese Medicine were selected. All patients were treated with zirconia endocrown. At two weeks, six months, and twelve months after restoration, the edge closeness, restoration integrity, adjacency, abutment loosening or fracture, secondary caries, and gingival condition were assessed. Results After two weeks of reexamination, all the evaluation indexes of 40 low occlusal gingival distance molars after restoration reached the clinically acceptable level. After six months of reexamination, the gingival hyperemia of two affected teeth was mild, no bleeding was found by probe, and no problems of the prosthesis or abutment teeth were found in the rest. At twelve months of reexamination, one affected tooth had poor adjacency relationship; one affected tooth had mild gingival hyperemia and no bleeding was observed by probe; one affected tooth had gingival hyperemia and bleeding was observed by probe, and the rest had no problems with the prosthesis and abutment teeth. Conclusion Zirconia endocrown has a good clinical effect in repairing the defect of molar with low occlusal gingival distance, and it is safe, reliable, beautiful and practical.
		2021 Vol. 18 (6): 127-130 [Abstract] ( 409 ) HTML (1 KB) PDF (364 KB) ( 59 )

	131	Guiding ideology and fundamental adherence of health emergency management training in China
		ZHANG Wei1 WU Wei1 Nulanbieke·Hasenbieke1 JIA Xiaoting1 ZHU Qing1 ZHU Yu1 XU Peihai1 WANG Qinchi2
		The capability of emergency management of public health is an important part of the national governance capabilities. The prevention and control of the Covid-19 pandemic highlights the advantages of the socialism system with Chinese characteristics, but also exposes some problems and weaknesses of China’s capacity building of emergency management of public health. Urgent training of emergency management of public health is required to be strengthened. The training of emergency management of public health should be carried on in accordance with the party’s basic strategy of governing the country, the new situation and new tasks of health work, the scientific methods and basic laws of cadre capability building, under guidance of the holistic view of national security, and clearly clarify the target orientation, focal and important points of the training of emergency management of public health, and carry out the party’s cadre education theory and principles and policies, and implement the strategy of comprehensively governing the country according to law, and improve the cadre’s integrative capability and professional qualities of emergency management of public health comprehensively.
		2021 Vol. 18 (6): 131-134 [Abstract] ( 195 ) HTML (1 KB) PDF (493 KB) ( 55 )

	135	Analysis on the allocation and utilization efficiency of traditional Chinese medicine health resources in Hu’nan Province
		SHEN Weiwei SU Jie ZHAN Huan
		Objective To sort out the current situation of the allocation and utilization of traditional Chinese medicine health resources in Hu’nan Province, and evaluate the utilization efficiency of traditional Chinese medicine health resources. Methods Descriptive statistical methods was used to analyze the situation of the allocation and utilization of traditional Chinese medicine health resources in various medical and health institutions from January 2015 to December 2017, and the utilization efficiency of traditional Chinese medicine health resources was evaluated based on data envelopment analysis (DEA). Results From January 2015 to December 2017, the allocation and utilization of traditional Chinese medicine health resources in Hu’nan Province increased year by year. Among all kinds of health institutions, only traditional Chinese medicine hospitals and traditional Chinese medicine outpatient institutions had the same scale remuneration, and other types of institutions were in a state of increasing scale remuneration, with an average comprehensive efficiency value of 0.21. Conclusion The two-way proportion of traditional Chinese medicine health resources in Hu’nan Province should be increased to achieve the optimal allocation of resources; highlight the characteristics and advantages of traditional Chinese medicine health services, and improve the utilization rate of traditional Chinese medicine health resources; strengthen the construction of high-quality connotation of traditional Chinese medicine health institutions, and seek high efficiency of institutional services.
		2021 Vol. 18 (6): 135-139 [Abstract] ( 391 ) HTML (1 KB) PDF (560 KB) ( 83 )

	140	Discussion on the management of public hospital trusteeship risk based on the COSO-ERM (2017) framework
		MA Jie HONG Xuezhi PAN Jiaxin LI Xiuli WU Jiejie ZHOU Jincan JIN Jinhua
		The reform of public hospital trusteeship is one of the effective means to optimize the allocation of medical resources and improve the overall efficiency of the health system. At present, the trusteeship of public hospitals in China is still being explored and developed, and there are still many risks in practice. In order to reduce the risk and promote the effective operation of the reform of public hospital trusteeship system, this paper uses the COSO-ERM (2017) to analyze the public hospital trusteeship risk management system and finds that there is a weak awareness of the risk culture of the responsible subject, the goal issues such as mere formality, single risk assessment methods, and imperfect risk information communication mechanisms were established. Based on this, it suggestions to optimize the hospital trusteeship reform of governance structure, strengthen the subject consciousness of risk culture, establish the targets of fine management, perfect the risk information communication mechanism, effective risk assessment and response managed in the form of diversification, and dynamic adjustment trusteeship risk management system, improve the applicability and operability of risk management.
		2021 Vol. 18 (6): 140-143 [Abstract] ( 332 ) HTML (1 KB) PDF (543 KB) ( 15 )

	144	Clinical effect of Jin’s three needles combined with repetitive transcranial magnetism in the treatment of insomnia with syndrome of deficiency of both heart and spleen
		ZHANG Hanyuan1 LIU Yuhuan2 LI Tie2 DUAN Changwei2 LI Hai2
		Objective To investigate clinical effect of Jin’s three needles combined with repetitive transcranial magnetism in the treatment of insomnia with syndrome of deficiency of both heart and spleen. Methods One hundred and thirty-four patients with insomnia with syndrome of deficiency of both heart and spleen admitted to the 3rd Affiliated Hospital of Changchun University of Chinese Medicine from October 2017 to October 2018 were divided into two groups. The patients in control group (67 cases) received repetitive transcranial magnetism, and the patients in observation group (67 cases) received Jin’s three needles combined with repetitive transcranial magnetism. Patients in both groups were treated continuously for four courses. The clinical efficacy of the two groups was compared. Before and after treatment, the scores of Pittsburgh sleep quality index (PSQI), self-rating anxiety scale (SAS), self-rating depression scale (SDS), World Health Organization quality of life brief version (WHOQOL-BREF) and traditional Chinese medicine syndromes were evaluated. The improvement of symptoms in the two groups was compared. Results The total effective rate in observation group was higher than control group, and the difference was statistically significant (P ＜ 0.05). After treatment, scores of PSQI (sleep quality, time to fall asleep, sleep efficiency, daytime function, sleep disorder, sleep time, hypnotics, total score), SAS, SDS and TCM syndromes (sleep restlessness, palpitation restlessness, amnesia, spiritlessness and weakness, dizziness, total score) in the two groups were lower than those before treatment, while the scores and total scores of PSQI, scores of SAS, SDS and TCM syndromes in the observation group were lower than those in the control group, and all the differences were statistically significant (P ＜ 0.05). After treatment, the WHOQOL-BREF scores (physiological, psychological, social and environmental fields) in both groups were higher than those before treatment. After treatment, the scores of WHOQOL-BREF in the observation group were higher than those in the control group, and the differences were statistically significant (P ＜ 0.05). After treatment, the time to fall asleep in both groups was shorter than that before treatment, the sleep time was longer than that before treatment, and the number of night wakefulness was less than that before treatment. The time to fall asleep in the observation group was shorter than that in the control group, the sleep time was longer than that in the control group, and the number of night wakefulness was less than that in the control group, with statistically significant differences (P ＜ 0.05). Conclusion Jin’s three needles combined with repetitive transcranial magnetism have significant effect in treatment of insomnia with syndrome of deficiency of both heart and spleen, which can improve patients’ mood, alleviate symptoms, improve life quality and sleep quality.
		2021 Vol. 18 (6): 144-148 [Abstract] ( 269 ) HTML (1 KB) PDF (755 KB) ( 63 )

	149	Analysis on clinical medication of Professor Zhou Yabin in the treatment of chronic pulmonary heart disease
		YUAN Ye1 FAN Zengguang1 WANG Yan2 YANG Jianfei2
		Objective To analyze the medication rules of Professor Zhou Yabin in the treatment of chronic pulmonary heart disease through the medication statistics of Professor Zhou Yabin in the treatment of patients with chronic pulmonary heart disease. Methods The complete and effective medical records of patients with chronic pulmonary heart disease diagnosed and treated by Professor Zhou Yabin in the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from September 2015 to August 2019 were collected. The database was established by using Excel software and SPSS 24.0 software, drug category, drug frequency and cluster analysis were carried out, and high frequency drug category, common Chinese medicine, drug pair and drug combination were obtained. Through statistical results, clinical medication characteristics of Professor Zhou Yabin in the treatment of chronic pulmonary heart disease were explored. Results In this study, a total of 97 compound prescriptions of Chinese materia medica of Professor Zhou Yabin for the diagnosis and treatment of chronic pulmonary heart disease were collected, involving 149 Chinese materia medica, of which, 27 were used more than 20 times, with a cumulative frequency of 68.29%. In the categories of drugies, the proportion of tonifying deficiency drugs, drugs for diuresis and diffusing dampness, warming interior medicine, drugs for dissipating phlegm and relieving cough and antiasthmatic, and blood activating and stasis removing drugs was larger, and the cumulative frequency was as high as 81.83%. Then the cluster analysis of the 27 traditional Chinese medicines was carried out, and three clustering formulas and six common drug pairs were obtained. Conclusion Professor Zhou Yabin’s internal prescriptions for treating chronic pulmonary heart disease are mainly benefiting qi and warming yang, ventilating lung qi and water circulation, promoting blood circulation and removing blood stasis, and the effect is significant.
		2021 Vol. 18 (6): 149-152 [Abstract] ( 201 ) HTML (1 KB) PDF (772 KB) ( 62 )

	153	Analysis on medication regularity of modern prescriptions of nourishing yin and clearing heat in treating diabetes mellitus
		BAI Wanjiao1 LU Bo2
		Objective To analyze medication regularity of modern prescriptions of nourishing yin and clearing heat in treating diabetes mellitus from Selected Chinese Diabetes Prescriptions. Methods The database of modern prescriptions of nourishing yin and clearing heat recorded in Selected Chinese Diabetes Prescriptions was constructed. The relevant function of the traditional Chinese medicine inheritance support system (V2.5) were used for statistical analysis. Results A total of 384 modern prescriptions were included, involving 256 drugs. Through the analysis of the frequency, patterns and association rules of modern prescriptions of nourishing yin and clearing heat in the treatment of diabetes mellitus, it was concluded that there were 28 drugs with medication frequency of more than 30 times. The results showed that there were 23 drug combinations with frequency of more than 80 times, including eight drugs. And there were 17 drug combination association rules with confidence＞0.800. Conclusion The traditional Chinese medicine inheritance support system (V2.5) is used to analyze the medication rules of modern prescriptions of nourishing yin and clearing heat in the treatment of diabetes mellitus, and give full play to the advantages of traditional Chinese medicine in the treatment of diabetes mellitus, in order to provide further reasonable and effective reference for clinical workers in the treatment of diabetes mellitus.
		2021 Vol. 18 (6): 153-156 [Abstract] ( 459 ) HTML (1 KB) PDF (767 KB) ( 79 )

	157	Professor Lü Peiwen’s experience in treating comedomastitis with three methods of “resolving, promoting and tonifying”
		FU Na LYU Peiwen HUANG Qiao ZHAO Wenjie DONG Hao ZHANG Dongxiao
		At present, comedomastitis is a kind of disease which is difficult to treat, especially the complicated lesion often has many kinds of symptoms such as redness and swelling, lump and ulcer, which brings great difficulty to the treatment. This disease is the preponderant illness for therapy in traditional Chinese medicine. According to the relationship between rising and falling of vital qi and pathogen, and the prosperity and deficiency of qi and blood, Professor Lü Peiwen divides the comedomastitis into three stages: the initial stage, the purulent stage and the ulcerative stage. She advocates the combination of internal and external treatment with the three methods of “resolving, promoting and tonifying”, and the combination of reinforcement and elimination, so as to achieve the goal of resolving with promoting, promoting with resolving, resolving and tonifying together, with remarkable clinical effect. In this paper, Professor Lü Peiwen’s experience in the treatment of comedomastitis is summarized. The purpose is to learn the academic experience of famous expert in traditional Chinese medicine and improve the level of clinical diagnosis and treatment.
		2021 Vol. 18 (6): 157-160 [Abstract] ( 163 ) HTML (1 KB) PDF (774 KB) ( 107 )

	161	Exploration on the theory of sore and ulcer with “half yin and half yang syndrome” in traditional Chinese medicine from the perspective of “yin-yang theory”
		JIAO Yuqi DANG Ying HAI Ri LAN Dandan LI Yuewei SHI Jianping
		Sore and ulcer are the surgical diseases that occur on the body surface. According to the etiology, pathogenesis, clinical manifestations, and characteristics of pulse manifestation, it can be distinguished as yang syndrome, half yin and half yang syndrome and yin syndrome. In clinics, sore and ulcer with pure yang syndrome or yin syndrome are rare. Most cases are yang in yin and yin in yang. Therefore, “half yin and half yang syndrome” is the key to the treatment of sore and ulcer. However, yin and yang changes in this syndrome often make it difficult for doctors to understand its true meaning. Thus, it is impossible to use drugs flexibly. Based on “yin-yang theory”, this article combines with the relativity, universality and particularity of yin and yang to analyze syndrome changes and clinical medication records of “half yin and half yang syndrome” of physicians in the past dynasties. It has been concluded that “half yin and half yang syndrome” is a key transitional stage of sore and ulcer from the yang syndrome to the yin syndrome and manifests two components of yin and yang. It is a temporary equilibrium of the disease, but it is also a danger. Incorrect treatment can easily cause pure yin syndrome and become difficult to treat. The treatment focuses on reconciling hot and cold, deficiency and excess, qi and blood with warm medicine, and transforming yin to yang to reconcile yin and yang. The outcome of syndromes lies in the ebb and flow of the opposite elements of the yin and yang attributes.
		2021 Vol. 18 (6): 161-164 [Abstract] ( 217 ) HTML (1 KB) PDF (738 KB) ( 94 )

	165	Textual research on the only existing traditional Chinese medicine ancient manuscripts in National Library of China
		WEN Jiayu WANG Yulin FU Peng
		In recent years, with the advancement of ancient books arrangement, the unique copied manuscripts which used to be the marginal material in ancient medical literatures have been paid more and more attention. National Library of China is based in Beijing and serves the whole country. It has a certain number of precious ancient Chinese medicine manuscripts. But at present, there is no special research and introduction, and the existing results are also flawed. According to General Catalogue of Chinese Ancient Books of Chinese Medicine (General Catalogue for short), there are 191 kinds of Chinese ancient manuscripts in National Library of China, including 13 kinds of manuscripts and 168 kinds of copied manuscripts. But after checking with the actual collection of National Library of China, nine of them have not found the collection information, and four copies of unrecorded manuscripts in the General Catalogue have been added. Through the literature materials provided by the General Catalogue, Chinese Medical Dictionary and other books, as well as the on-the-spot investigation of the original books, we can have a more specific grasp of Chinese medicine manuscripts in National Library of China. The research results can supplement some gaps in the current research of ancient books, supplement the lack of existing records, promote the research of manuscript and manuscript documents, and provide readers with more detailed information.
		2021 Vol. 18 (6): 165-168 [Abstract] ( 215 ) HTML (1 KB) PDF (772 KB) ( 25 )

	169	She Jilin’s clinical experience in treating various diseases with Feng’s spinal pinding treatment
		WANG Jiaqi1 SHE Jilin2
		In the past 40 years of clinical work, She Jilin, a famous traditional Chinese medical doctor in the capital, has carried out in-depth and meticulous excavation, arrangement, innovation and promotion of Feng’s spinal pinding treatment. These in-depth and orderly work have greatly improved the academic status of this therapy in theory and practice, making it one of the seven schools of pediatric massage in China. In addition, She Jilin innovates this treatment in a targeted way, so that it can be widely and effectively used in the clinical treatment of various children’s diseases. Through the examples of medical records, this paper introduces in detail how Feng’s spinal pinding treatment is used to other diseases outside the digestive system, and analyzes and summarizes the treatment ideas.
		2021 Vol. 18 (6): 169-171,184 [Abstract] ( 168 ) HTML (1 KB) PDF (1017 KB) ( 33 )

	172	Prediction and analysis of Oenanthe javanica in the treatment of coronavirus disease 2019 based on network pharmacology
		LIU Qingchuan CAO Wenbin YANG Xinbo WANG Renjie WANG Mengmeng HUANG Zhengming
		Objective To predict and analyze the possibility and the mechanism of Oenanthe javanica in the treatment of coronavirus disease 2019 (COVID-19) by the method of network pharmacology. Methods The potential targets of Oenanthe javanica in therapy of COVID-19 were obtained through literatures, TCMSP and Swiss Target Prediction database. The relative targets of COVID-19 were acquired by the databases, such as GeneCards, TTD, OMIM and Drugbank. The “active components-targets-disease network” was established by Cytoscape. The network graph of protein-protein interaction (PPI) was set up by STRING database and Cytoscape. The gene ontology (GO) and the Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis were performed by DAVID database and R language. Results Sixty active components-disease targets were obtained from seven constituents of Oenanthe javanica. The key targets included TNF, IL-6, TPS3, MARK-1, CASP3, etc. KEGG pathway enrichment analysis revealed several signaling pathways, such as TNF, Toll-like receptor, PI3K-Akt signaling pathway, etc. GO function indicated that biological process mainly involved inflammatory response, apoptosis and immune response. Molecular function mainly involved protein binding, enzyme binding and cytokine activity. Cell compositions involved cytoplasm, plasma membrane, nucleus and mitochondrion. Conclusion Active components of Oenanthe javanica may affect expression of key proteins in virus through TNF, Toll-like receptor signaling pathway, and play an anti-infection, immunomodulatory, antiviral and other roles. This study provides theoretic evidence for further research of Oenanthe javanica in COVID-19 treatment.
		2021 Vol. 18 (6): 172-176 [Abstract] ( 474 ) HTML (1 KB) PDF (1284 KB) ( 9 )

	177	A case of emergency endovascular treatment of CTA negative large vessel occlusion acute cerebral infarction
		LIU Shudong LI Wenyan▲
		Emergency endovascular treatment is the preferred treatment for severe acute cerebral infarction with large vessel occlusion due to ultra venous thrombolytic time window. The preconditions for emergency endovascular treatment are preoperative confirmation of the presence of pathogenic large vessel occlusion and salvage ischemic penumbra. CT angiography (CTA) and magnetic resonance angiography (MRA) are commonly used preoperative vascular examination methods, which can show occlusion or stenosis at the proximal end of the large intracranial vessels, but have some limitations in the distal segment or branch. This paper report a case of CTA negative acute cerebral infarction with large vessel occlusion who received emergency endovascular treatment in the Department of Neurology, Yongchuan Hospital of Chongqing Medical University in 2019. Through the diagnosis and treatment process, probes into the definition of lange vascular occlusive cerebral infarction, CTA and conventional two-dimensional digital subtraction angiography (2D-DSA) in the diagnosis of the limitation of the middle cerebral artery occlusion of the M2, clinical manifestation and CT perfusion imaging (CTPI) to identify the significance of the arge vessels occlusion and three-dimensional digital subtraction angiography (3D-DSA) application in the diagnosis and treatment of middle cerebral artery occlusion of the M2 value, to improve the diagnosis and treatment of M2 segment occlusive acute cerebral infarction.
		2021 Vol. 18 (6): 177-180 [Abstract] ( 332 ) HTML (1 KB) PDF (759 KB) ( 80 )

	181	A case report of long term aortic esophageal fistula after endovascular isolation of thoracic aortic aneurysm and literature review
		TANG Shengjie1,2 ZHOU Haining1,2
		Aortoesophageal fistula (AEF) is a rare disease with high misdiagnosis rate and fatality rate, which can be caused by thoracic aortic aneurysm, foreign body intake, and thoracic endovascular aortic repair (TEVAR). This case was admitted to Suining Central Hospital (hereinafter referred to as “our hospital”) in February 2016 due to chest and back pain. The descending aortic aneurysm was diagnosed by chest enhanced CT examination, and endoluminal isolation was performed with thoracic aortic stent placement. The reexamination half a year after the operation revealed type Ⅰ leakage. The patient refused surgical intervention and was admitted to our hospital again four years later due to heart fatigue and palpitation. Chest enhanced CT suggested AEF, and reTEVAR + esophageal reconstruction hybrid surgery was planned. The patient refused the surgery and died due to bleeding and infection one month later. Long-term AEF of aortic aneurysm stent placement is rare. In this paper, a case of long-term AEF after TEVAR was reported. Combined with the existing reports, the clinical manifestations, diagnosis and treatment of this disease were reviewed in order to improve the understanding of this disease.
		2021 Vol. 18 (6): 181-184 [Abstract] ( 365 ) HTML (1 KB) PDF (493 KB) ( 74 )

	185	Exploring the scientific communication path of traditional Chinese medicine culture in the new era from the perspective of “inheritance and integrity”
		CHANG Xing YAO Shunyu LIU Zhiming LIU Ruxiu
		On October 25, 2019, General Secretary Xi Jinping gave important instructions on the deployment and implementation of traditional Chinese medicine work in the new era: to inherit the essence, maintain integrity and innovation, and promote traditional Chinese medicine to the world. To promote the inheritance and development of traditional Chinese medicine requires active and reasonable scientific communication. Based on the perspective of “inheritance and integrity”, this article made an in-depth discussion and explanation on how to take the path of scientific communication of traditional Chinese medicine culture in the new era. A rational analysis of the core connotation, historical changes and achievements of the scientific communication of traditional Chinese medicine culture in recent years were carried out, and the two major foundations of traditional Chinese medicine cultural communication, namely “inheritance” and “integrity” were put forward. From the perspectives of the equal development of traditional Chinese medicine and Western medicine and the overseas communication of traditional Chinese medicine culture, this paper discussed the development of the scientific communication of traditional Chinese medicine in the future. This not only had far-reaching significance for the interpretation of the connotation of traditional Chinese medicine science communication, but also had a certain role in promoting the implementation of the important instructions of General Secretary Jinping “Inherit the essence, uphold the innovation”.
		2021 Vol. 18 (6): 185-189 [Abstract] ( 454 ) HTML (1 KB) PDF (517 KB) ( 65 )

	189	Analysis and Countermeasures of the party building work of the postgraduates of master of traditional Chinese medicine
		ZHANG Chao1 LI Xin’an2 BAI Juan1
		At present, the Party building work of the postgraduates with master’s degree of traditional Chinese medicine (hereinafter referred to as “master of traditional Chinese medicine”) is facing new situation and requirements. This is because since 2015, after the integration of clinical practice teaching in the later stage of master of traditional Chinese medicine and the standardized training system for resident doctors of traditional Chinese medicine (hereinafter referred to as the “standardized training of traditional Chinese Medicine”), master of traditional Chinese medicine need to leave the school as a whole and enter the hospitals of various training bases for clinical rotation training. So how to optimize the construction of Party branches, how to carry out organizational activities, how to strengthen the ideological guidance are the outstanding problems that colleges and universities are facing. This article analyzes and synthesizes the questions faced by the Party building work of the master of traditional Chinese medicine, explores the effective scheme of the Party construction work, and puts forward countermeasures and views, so as to promote the high-quality development of the Party building work of the master of traditional Chinese medicine, and then to realize the purpose of improving the comprehensive quality of graduate students.
		2021 Vol. 18 (6): 189-192,196 [Abstract] ( 265 ) HTML (1 KB) PDF (537 KB) ( 66 )

	193	Thinking of medical complaint management from the perspective of stakeholder
		XIAO Longhua ZHANG Yong SONG Zhen WANG Jinyu
		Based on the stakeholder theory, this study analyzes the basic positions, main interest appeals and problems of the major stakeholders in medical complaint management, such as patients, complaint managers, medical personnel and public security departments. On this basis, the complaint management should give full consideration to the interests of all stakeholders, and formulate standardized systems and procedures to eliminate conflicts of interest. Medical institutions should correctly understand and value the complaints from patients, public security departments should strengthen the punishment for any excessive behavior, and other issues that should be paid attention to in the management of complaints.
		2021 Vol. 18 (6): 193-196 [Abstract] ( 100 ) HTML (1 KB) PDF (512 KB) ( 57 )

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