Integrated elderly care and medical services with characteristics of traditional Chinese medicine （TCM） has unique advantages in improving the sub-health status of the elderly， managing chronic disease， and promoting medical rehabilitation. However， there is currently a lack of research on the actual needs of the elderly for community- and home-based integrated elderly care and medical services with characteristics of TCM. This paper analyzed and measured the demand for community- and home-based integrated elderly care and medical services with characteristics of TCM， constructed an evaluation index system through grounded theory for the community- and home-based integrated elderly care and medical services with characteristics of TCM， consisting of 4 first-level indicators， 11 second-level indicators， and 38 third-level indicators. The analysis network process method was used to obtain the weight of each indicator. This study showed that the demand for service projects of TCM was diverse， with a strong demand for highly professional and specialized technologies； there was a growing demand for popularizing knowledge of integrated elderly care and medical services with characteristics of TCM， with the effectiveness of popularization being the top priority； there was an urgent need to establish and improve a political supervision system， with resources and management being the underlying support needs. Combined with the results of demand analysis， targeted recommendations were proposed， including developing and promoting the projects of integrated elderly care and medical services with TCM， strengthening talent training and discipline integration； optimizing the knowledge popularization process of integrated elderly care and medical services with TCM； as well as establishing and improving the political supervision system and optimizing resource allocation and management.

Coronavirus-related diseases pose a significant challenge to the global health system. Given the diversity of coronaviruses and the unpredictable nature of disease outbreaks, the traditional "one bug, one drug" paradigm struggles to address the growing number of emerging crises. Therefore, there is an urgent need for therapeutic agents with broad-spectrum anti-coronavirus activity. Here, we provide evidence that ATV006, an anti-SARS-CoV-2 nucleoside analog targeting RNA-dependent RNA polymerase (RdRp), has broad antiviral activity against human and animal coronaviruses. Using mouse hepatitis virus (MHV) and human coronavirus NL63 (HCoV-NL63) as a model, we show that ATV006 has potent prophylactic and therapeutic activity against murine coronavirus infection in vivo. Remarkably, ATV006 successfully inhibits viral replication in mice even when administered 96 h after infection. Due to its oral bioavailability and potency against multiple coronaviruses, ATV006 has the potential to become a useful antiviral agent against SARS-CoV-2 and other circulating and emerging coronaviruses in humans and animals.

Objective To investigate the expression and signaling pathway of TAGLN2 gene in low-grade glioma (LGG),and the relation of its expression with prognoses of patients.Methods The expression of TAGLN2 gene in Oncomine and TCGA databases was analyzed by bioinformatics analysis.The TAGLN2-related protein-protein interaction network was mapped using STRING database,and the interacting protein coding genes involved in the network were enriched.According to the expression level of TAGLN2 gene in glioma,the patients were divided into high expression group and low expression group;the differences of overall survival (OS) and disease free survival (DFS) were compared between the two groups.Results The expression level of TAGLN2 gene was up-regulated in most of the tumors.The expression level of TAGLN2 gene in the tumors of LGG patients was obviously higher than that in the corresponding normal brain tissues.The missense mutation of TA GLN2 gene was analyzed in TCGA database,and 1.5％ of TAGLN2 gene missense mutation occurred in glioma tissues.There were 51 nodes in TAGLN2-related protein-protein interaction network and 254 interaction relations,and the regional clustering index was 0.69.The network protein enrichment was obvious (P=1.0E-16).The proteins encoding and interacting with TAGLN2 gene were mainly concentrated in vesicles,extracellular matrix and cell membrane.Their molecular functions were mainly protein binding,iron binding and accounting binding;their biological processes were mainly concentrated in the regulation of biological functions,cell development and multicellular tissue processes.OS and DFS of TAGLN2 high expression group were significantly lower than those of low expression group (HR=2.7,HR=1.8,P＜0.05).Analysis of LGG cell subtypes showed that OS and DFS of astrocytoma in TA GLN2 high expression group were lower than those in low expression group (P＜0.05).The OS of oligodendroglioma in the TA GLN2 high expression group was significantly lower than that in the low expression group (P＜0.05).There were no significant differences in OS and DFS of oligodendrocytoma and DFS of oligodendroglioma between the TAGLN2 high and low expression groups (P＞0.05).Conclusion TAGLN2 is highly expressed in LGG tissues and is associated with poor prognosis.

OBJECTIVE:To establish GC-MS fingerprints of liposoluble constituents from Danqi soft capsule. METHODS:GC-MS method was adopted. GC chromatogram column was DB-5 ms capillary column with high purity helium (99.999%)as carrier gas at the flow rate of 1.0 mL/min,with temperature programming. The injector temperature was 250 ℃. The sample size was 1 μL. The shunt ratio was 1:40,with distributary injection. Ionization mode was as follows as electron bombardment ion source,ion source temperature of 280 ℃,injector temperature of 300 ℃,electronic energy of 70 eV, solvent delay time of 3 min,mass charge ratio(m/z)of 50-550. Using ethyl palmitate as reference,MS spectrums of 11 batches of samples were determined. Similarity evaluation was conducted by using TCM Fingerprint Chromatogram Similarity Evaluation System(2004 A edition)to determine common peak. The common peaks were determined by LC Solution 2 workstation standard mass spectrometry Library(NIST05.LIB or NIST05s.LIB). RESULTS:The similarity of 11 batches of samples was higher than 0.90. After validation,GC-MS chromatograms of 11 batches of samples were in good agreement with control fingerprint. There were 49 common peaks in GC-MS chromatogram,and 38 chemical constituents were identified, accounting for 94.94% of total peak areas. CONCLUSIONS:Established fingerprint can provide evidence for quality evaluation of Danqi soft capsule.

Objective To evaluate the feasibility and validity of near infrared fluorescence imaging with indocyanine green in sentinel node biopsy for cN0 oral carcinoma.Methods Thirty cases of previously untreated oral carcinoma staged cT1-3 N0M0 were enrolled in this study.1 ml of indocyanine green (25 mg/ 5 ml) was injected both around the primary tumor in a 4 quadrant pattern and in the base of the tumor before skin incision.After elevation of the platysma flap and posterior retraction of the sternocleidomastoid muscle,fluorescence images were taken with a near infrared fluorescence detector until the hotspots were captured,then the hotspot lymph nodes were removed.Lymph nodes identified with fluorescent hotspots and verified in vivo were defined as sentinel nodes,and they were harvested and sent together with neck dissection specimen for pathologic study.Results Sentinel nodes were successfully harvested in all 30 cases.The number of sentinel nodes per case varied from 1 to 9,with an average number of 3.4.Routine pathology demonstrated that occult metastasis was exclusively found in the sentinel nodes in 5 cases (16.67％),and all the other lymph nodes were free from metastasis.No tracer associated adverse effects occurred in this series.Conclusion Near infrared fluorescence imaging with indocyanine green has a high detection rate in sentinel node biopsy for cN0 oral/oropharyngeal carcinoma and the sentinel nodes can evaluate the cervical metastatic status accurately.It is an easy,feasible and promising method,which is worthy of further investigation.

[ABSTRACT]OBJECTIVEThis study was designed to compare the quality of life between patients who
underwent a tongue reconstruction with radial forearm flap (RFF) and infrahyoid myocutaneous flap (IHMCF) after hemiglossectomy for their tongue cancers, and to figure out an optimal reconstructive method for the defects resulted from hemiglossectomy.METHODSA non-randomized case-control study was performed on 24 patients with tongue squamous cell carcinoma who underwent a standard hemiglossectomy combined with perfectly tongue reconstruction from June 2005 to June 2012. All of the cases were without tongue base invasion. Of the 24 cases, 19 had T2 disease, 5 had T3 disease, and they were divided into RFF group (n=10) and IHMCF group (n=14). The quality of life were evaluated one year after operation using EORTC-QLQ30 and FACT-H&N35 and compared between the two groups.RESULTSThe scores were comparable between the two group with regard to all domains of EORTC-QLQ30,with all P values>0.05.The scores of swallowing(P=0.005), speech (P=0.008), teeth (P=0.014), and cough (P=0.009) domains were significantly higher in IHMCF group than in RFF group, with P value of 0.005, 0.008, 0.014 and 0.009 respectively, while the other domains of FACT-H&N35 were comparable between the two groups, with allP values>0.05.CONCLUSIONOverall quality of life was similar in the two groups. Oral function domains were better in IHMCF group than in RFF group. When guarantee of flap survival is available, IHMCF could be used as a good alternative flap to RFF in tongue reconstruction after hemiglossectomy.

Objective To evaluate if Ⅵ region lymph nodes metastasis status can be a reliable indicator in prediction of lateral lymph nodes metastasis in papillary thyroid carcinoma (PTC) with negative cervical lymph nodes (cN0).Methods Retrospectively reviewed the medical records from January 2003 to October 2011 of 73 patients with PTC who underwent prophylactic lateral neck dissection (Ⅱ-Ⅴ region or Ⅱ-Ⅳ region).The relationship between cervical lymph nodes metastasis and lateral lymph nodes metastasis was assessed.Results The rate of lateral lymph nodes metastasis was 16.4％(12/73).The rate of Ⅵ region lymph nodes metastasis was 42.5％(31/73).Multivariate analysis showed that Ⅵ region lymph nodes metastasis was the risk factor of lateral lymph nodes metastasis in cN0 patients with PTC(OR =7.3,P=0.020).Conclusion Ⅵ region lymph nodes metastasis status can be a reliable indicator of lateral lymph nodes metastasis in cN0 patients with PTC.

Objective To detect the expression level and procoagulant activity of tissue factor (TF)in the blood and urine in patients with type 2 diabetic nephropathy (DN),and investigate its related clinical significance.Methods A total of 120 DN patients were collected and divided into 3 groups according to urinary albumin and creatinine ratio:normal albuminuria group (＜3.4 mg/mmol) with 64 cases,microalbuminuria group ( ≥3.4 mg/nunol,and ＜ 34.1 mg/mmol) with 35 cases and macroalbuminuria group (≥34.1 mg/mnol) with 21 cases.Twenty healthy persons were enrolled as control group.The expression of monocytes TF in peripheral blood was detected by flow cytometric analyzer.The expression ofTF in the blood and urine was detected by ELLSA.The prcoagulant activity of TF was detected by one-stage coagulation.Results The expressions of monocytes TF in normal albuminuria group,microalbuminuria group and macroalbuminuria group [ (4.32 ± 1.25 )％,(5.01 ± 1.73)％,( 1 1.83 ± 2.14)％ ] were significantly higher than that in control group [(0.84 ± 0.36)％ ](P ＜0.01).TF procoagulant activity in normal albuminuria group,microalbuminuria group and macroalbuminuria group [ ( 64.3 ± 21.2),( 67.1 ± 17.3 ),( 113.8 ± 44.4)mU/L] were obviously higher than that in control grouP [ (23.8 ± 16.4) mU/L](P＜ 0.01 ).The expression of monocytes TF in normal albuminuria group and microalbuminuria group had no statistical significance (P＞0.05),while the expression in macroalbuminuria group had significant difference compared with that in normal albuminuria group and microalbuminuria group (P ＜ 0.01 ).The expression of TF in the blood and urine of DN patients was obviously higher than that of control group (P ＜ 0.01 ).The expression of TF in the blood was positively correlated with that in urine (r =0.684,P ＜ 0.01 ).Conclusions The expressions of TF in the blood and urine in DN patients increase and its procoagulant activity enhances.The expression level of TF has a closed relationship with the increase of albuminuria.

Objective To evaluate the pattern of lateral cervical metastases and to investigate the risk factors for lateral cervical lymph node metastases in paoiuary thyroid carcinoma patients with clinical negative lateral neck lymph node.Methods 73 patients with paoiuary thyroid carcinoma who underwent prophylactic lateral neck dissections(level Ⅱ-Ⅵ or level Ⅱ-ⅣandⅥ) were reviewed retrospectively on their medical records paoiuary thyroid carcinoma.None of patients in this study had a clinically positive lymph node.Neck dissection specimens were obtained for histological analysis for node metastasis with respect to the individual neck levels.Results Occult metastases in lateral neck were observed in 12(16.4 ％)patients.9.6 ％,0,13.6 ％,9.6 ％,0,4.8 ％ and 42.4 ％ patients had histologically positive lymph nodes in levels Ⅱa,Ⅱb,Ⅲ,Ⅳ,Va,Vband Ⅵ respectively.In multivariate analysis,lymphatic metastases in level Ⅵ was associated with lateral neck metastasis(OR=7.3,P=0.020)in cN0 patients with paoiuary thyroid carcinoma.Conclusion Levels Ⅲ,Ⅱa and Ⅳwere the most common stages showing occult lymph node metastases.Prophylactic lateral neck dissections may be omitted in the treatment of cN0 PTC patients ff level Ⅵ lymphatic metastases are not found on histological exam.

Objective To compare the treatment outcome of underwent surgery plus radiotherapy and radiotherapy/chemoradiotherapy plus salvage surgery for stage Ⅲ/Ⅳ laryngeal carcinoma,to investigate an optimized treatment for the patients of stage Ⅲ/Ⅳ laryngeal carcinoma.Methods Clinical data from 103 patients with stage Ⅲ (39 cases) or stage Ⅳ (64 cases) laryngeal carcinoma were retrospectively analyzed.The patients were divided into surgery plus radiotherapy group (S±R,46 cases) and radiotherapy/chemoradiotherapy plus salvage surgery group (R±S,57 cases).Overall survival,relapse free survival,and laryngeal preservation rate were used to compare the treatment outcome between two groups.Multivariate regression models were used to analyze the independent factors for survival and laryngeal preservation rate.Results Survival rate was higher in S±R group than in R±S group [2 year overall survival/relapse free survival 74.7 ％ (34/46) / 72.4 ％ (33/46) vs 46.4 ％ (26/57) / 40.9 ％ (23/57),P ＜ 0.05].Laryngeal preservation rate was higher in R±S group than in S±R group [93.0 ％ (15/46) vs 32.6 ％ (53/57),P ＜ 0.05].Multivariate analysis demonstrated that treatment modality and T stage were independent factors for long-term survival,while treatment modality was the only an independent factor for laryngeal preservation rate.Conclusions Surgery plus radiotherapy result in better survival and lower laryngeal preservation rate than radiotherapy/chemoradiotherapy plus salvage surgery in treatment of stage Ⅲ/Ⅳ laryngeal carcinoma.Surgery plus radiotherapy should be the first choice for treatment of locally advanced laryngeal carcinoma.Improvement of the quality of life could be achieved by laryngeal preservation surgery and phonation reconstruction procedures.