Objective To investigate the characteristics of traditional Chinese medicine(TCM)syndrome elements and the distribution patterns of TCM syndromes in senile osteoporosis(SOP),providing a reference for TCM treatment of SOP.Methods A cross-sectional study was conducted on 200 SOP patients aged over 70 years treated at Wuxi Huishan Chinese Medicine Hospital from January 2022 to June 2023.General information and TCM diagnostic data were collected.The syndrome element differentiation scoring method was employed for analysis.Results(1)Among the 200 SOP patients,the most prevalent disease-location syndrome element was kidney(61.50％),followed by liver(48.50％),bones and tendons(45.50％),spleen(37.00％),meridians(25.50％),heart(12.50％),and lung(10.50％).Statistical analysis showed significantly higher syndrome element scores for kidney,liver,bones and tendons,spleen,and meridians compared to heart and lung(P＜0.01).(2)Regarding disease-nature syndrome elements,deficiency-type elements predominated,with yang deficiency(52.50％)being most common,followed by blood deficiency(46.00％),essence depletion(45.50％),qi deficiency(45.50％),yin deficiency(37.00％),unconsolidation(25.50％),and qi sinking(15.50％).Yang deficiency,blood deficiency,essence depletion,qi deficiency,and yin deficiency scores were significantly higher than those of insecurity and qi sinking,the difference being statistically significant(P＜0.01).Among excess-type elements,cold(47.00％)was most prevalent,followed by blood stasis(45.00％),qi stagnation(43.50％),dampness(34.50％),phlegm(27.50％),and heat(25.00％).Cold and blood stasis scores were significantly higher than phlegm,while cold,blood stasis,qi stagnation,dampness,and phlegm scores were significantly higher than heat,the difference being statistically significant(P＜0.05).(3)Eighteen TCM syndrome patterns were identified.Spleen-kidney yang deficiency(40.00％)was most frequent,followed by liver blood deficiency(37.50％),kidney essence insufficiency(35.00％),qi stagnation and blood stasis(31.00％),cold congelation and obstruction(25.50％),phlegm-damp obstruction(27.50％),and qi-yin deficiency with qi insecurity(11.00％).Based on syndrome element scores,the primary syndromes were defiined as spleen-kidney yang deficiency(35.60％),liver blood deficiency(25.13％),kidney essence insufficiency(18.32％),and qi stagnation and blood stasis(13.09％),etc.Conclusion The characteristic TCM syndrome elements of SOP patients involve qi-blood-yin-yang deficiency of kidney,spleen,and liver,combined with cold congelation,blood stasis,and qi stagnation.The main TCM syndromes are spleen-kidney yang deficiency,liver blood deficiency,kidney essence insufficiency,and qi stagnation with blood stasis.

【Objective】 To establish a risk model for predicting spontaneous rupture bleeding of renal angiomyolipoma (RAML) in order to better assess and deal with the risk. 【Methods】 The information of 436 RAML patients diagnosed during Jan.2018 and Dec.2022 was retrospectively analyzed.According to the inclusion and exclusion criteria, 216 patients were included and divided into the rupture bleeding group (n=35) and non-rupture bleeding group (n=181).The factors influencing spontaneous rupture bleeding were identified using univariate and multivariate analysis, and a nomogram was constructed accordingly with R language.The nomogram was evaluated using Calibration curve and area under the receiver operator characteristic curve (AUC). 【Results】 It was found that clinical manifestations, tumor diameter, tumor convexity, tumor blood supply, and tuberous sclerosis complex (TSC) were significantly correlated with rupture bleeding.The Calibration curve fitted well with the nomogram.The AUC was 0.956 (95%CI: 0.856-0.943), indicating that the nomogram had good statistical performance. 【Conclusion】 The model can effectively predict the risk of spontaneous rupture bleeding of renal angiomyolipoma.

The STAR tool was used to evaluate and analyze the science, transparency, and applicability of Chinese pathology guidelines and consensus published in medical journals in 2022. There were a total of 18 pathology guidelines and consensuses published in 2022, including 1 guideline and 17 consensuses. The results showed that the guideline score was 21.83 points, lower than the overall guideline average (43.4 points). Consensus ratings scored an average of 27.87 points, on par with the overall consensus level (28.3 points). Areas that scored above the overall level were "conflict of interest" and "working groups", while areas that scored below the overall level were "proposals", "funding", "evidence", "consensus approaches" and "accessibility". To sum up, the formulation of pathology guidelines and consensuses in 2022 is not standardized, and the evidence retrieval process, evidence evaluation methods and grading criteria for recommendations on clinical issues are not provided in the formulation process; the process and method for reaching consensus are not provided, the plan is lacking, and registration is not carried out. It is therefore suggested that guidelines/consensus makers in the field of pathology should attach importance to evidence-based medical evidence, strictly follow guideline formulation methods and processes, further improve the scientific, applicable and transparent guidelines/consensuses in the field, and better provide support for clinicians and patients.

Objective:To investigate the relationship between micropapillary patten, cribriform pattern and retraction clefting of HPV associated endocervical adenocarcinoma and Silva classification and prognosis; and to validate the application and clinical significance of Silva system in endocervical adenocarcinoma.Methods:Cases of endocervical adenocarcinoma from January 2009 to November 2017 were selected from the Second Hospital of Jilin University and followed up. The morphologic characteristics of Silva classification, micropapillary patten, cribriform pattern and retraction clefting were observed and recorded. Inferential analysis was performed to compare clinicopathological variables data between pattern subgroups.Results:The study included 120 patients (ranging from 26 to 73 years) with an average age of (48.0±9.1)years. Silva A, B and C accounted for 9.2% (11/120), 18.3% (22/120) and 72.5% (87/120), respectively. Cases with micropapillary pattern accounted for 25.8%(31/120), of which six cases were Silva B and 25 cases were Silva C. Cases with cribriform pattern accounted for 53.3%(64/120), including three cases of Silva A, 17 cases of Silva B and 44 cases of Silva C. Retraction clefting occurred in 28.3%(34/120) cases, all were Silva C. The three morphologic features were associated with lymph node metastasis ( P<0.05). Univariate analysis showed that micropapillary pattern was related to prognosis of endocervical carcinoma ( P<0.05), while cribriform pattern, retraction clefting and Silva classification showed no correlation with overall survival and disease-free survival. Conclusions:The suggestion is revising the Silva C criteria by adding papillary patten and retraction clefting as factors and expanding the Silva pattern system to include more histologic variants. The Silva system is helpful to select appropriate operation before surgery, but its prognostic value requires further evaluation.

【Objective】 To explore the relationship between preoperative anemia and perioperative red blood cell (RBC) transfusion and postoperative outcomes in patients undergoing mitral valve surgery. 【Methods】 The clinical data, laboratory findings, blood transfused and outcomes data of 493 patients who underwent mitral valve surgery in Fuwai Hospital in 2017 were collected by blood transfusion management system and retrospectively analyzed by SPSS. The patients were divided into anemia group (n=34, male Hb<120 g/L and female Hb<110 g/L) and non-anemia group (n=459) .The measurement data were statistically analyzed with t test or rank sum test, and enumeration data by Fisher test and Chi-square test, and then all analyzed by binary logistics regression. 【Results】 The incidence of anemia before mitral valve surgery was 6.90% (34/493). Perioperative erythrocyte dosage (U) (median), erythrocyte transfusion rate, ICU stay time (d) (median) and hospital mortality rate(%) in anemia group and non-anemia group were 4.00 vs 0.00 (OR: 2.55, 95% CI: 1.70~3.40, P<0.05), 67.65% vs 21.35% (OR: 12.98, 95% Cl: 5.21~31.15, P<0.05), 2.50 vs 2.00 (B: 0.71, 95% Cl: 0.08~1.33, P<0.05) and 5.88 vs 0.22(P<0.05)respectively. 【Conclusion】 Preoperative anemic is independently associated with perioperative RBC transfusion in patients undergoing mitral valve surgery, and may increase ICU length of stay and hospital mortality.

Ischemic stroke is a severe disorder resulting from acute cerebral thrombosis. Here we demonstrated that post-ischemic treatment with ciclopirox olamine (CPX), a potent antifungal clinical drug, alleviated brain infarction, neurological deficits and brain edema in a classic rat model of ischemic stroke. Single dose post-ischemic administration of CPX provided a long-lasting neuroprotective effect, which can be further enhanced by multiple doses administration of CPX. CPX also effectively reversed ischemia-induced neuronal loss, glial activation as well as blood-brain barrier (BBB) damage. Employing quantitative phosphoproteomic analysis, 130 phosphosites in 122 proteins were identified to be significantly regulated by CPX treatment in oxygen glucose deprivation (OGD)-exposed SH-SY5Y cells, which revealed that phosphokinases and cell cycle-related phosphoproteins were largely influenced. Subsequently, we demonstrated that CPX markedly enhanced the AKT (protein kinase B, PKB/AKT) and GSK3 (glycogen synthase kinase 3) phosphorylation in OGD-exposed SH-SY5Y cells, and regulated the cell cycle progression and nitric oxide (NO) release in lipopolysaccharide (LPS)-induced BV-2 cells, which may contribute to its ameliorative effects against ischemia-associated neuronal death and microglial inflammation. Our study suggests that CPX could be a promising compound to reduce multiple ischemic injuries; however, further studies will be needed to clarify the molecular mechanisms involved.

The peptides,proteins and other biological molecules in transudative pleural effusion correlate directly or indirectly with specific physiological and pathological state,reflecting the information regarding the lungs or other parts of the body.In the present study,the peptide fraction in transudative pleural effusion was isolated by uhrafiltration.After desalted and enriched by C18 tips,the peptide mixture was analyzed by nano LC-MS/MS.The results showed that 314 peptides,which were originated from 52 proteins,in pleural transudate were identified.More than half of the peptides were derived from fibrinogen.Many peptides were characterized as displaying ladder sequences.In addition,a large number of proline oxidation modifications were detected in the peptides derived from collagen and fibrinogen.Gene ontology enrichment analysis showed that the most of the proteins extracellular properties of pleural transudate polypeptide components were protein with exocytosis.The study provided a rapid and efficient separation and analysis methods for lung disease markers related peptide compounds in pleural fluid leakage.Also this research provided a rapid and effective method for screening peptide biomarkers related to lung diseases from transudative pleural effusion.

Objective: To investigate the clinicopathologic features, molecular characteristics and prognosis of spread through air space (STAS) in patients with adenocarcinoma of the lung. Methods: Two hundred and eighty-eight lung adenocarcinoma patients with complete clinicopathologic and follow-up data were included. The patients were divided into STAS positive (178 cases) and negative (110 cases) groups.EGFR and KRAS gene mutations were detected by amplification refractory mutation system (ARMS), and ALK and ROS1 gene fusion were detected by fluorescence in situ hybridization method. The relationship between STAS and clinicopathologic, molecular features, and patient outcome was analyzed. Results: STAS was present in 61.8%(178/288) of lung adenocarcinomas. The positive rate of STAS in tumors >3 cm was significantly higher than that in tumors ≤3 cm (P=0.009), and was significantly higher in tumors with pleural invasion (P<0.01), venous invasion (P<0.01), lymphatic invasion (P<0.01), perineural invasion (P=0.029) and tumors with necrosis (P<0.01). STAS was also correlated with tumor recurrence (P<0.01) and advanced pathologic TNM stage (P=0.002). There was no significant correlation with patients′ gender, age and smoking history. Histologically, STAS was present in 58.0%(91/157), 67.6%(50/74), 2/6, 64.3%(27/42) and 8/9 of acinar, papillary, lepidic, solid and micropapillary adenocarcinomas, respectively. In addition, the positive rates of STAS in tumor with micropapillary (>5%) and without micropapillary pattern were 80.9%(55/68) and 55.9%(123/220), respectively (P<0.01). STAS was significantly higher in EGFR negative group (P=0.034), ALK gene rearrangement group (P=0.003) and ROS1 gene rearrangement group (P=0.012), but there was no significant correlation with KRAS mutation. Univariate survival analysis showed that patients with STAS had a shorter progression-free survival (PFS, P<0.01) and overall survival (P=0.013). Multivariate analysis confirmed that STAS was an independent predictor of PFS in lung adenocarcinoma patients (HR: 2.749, 95%CI: 1.550-4.876, P=0.001). Conclusions The presence of STAS in lung adenocarcinoma suggests high risk of recurrence and invasion and is thus an important prognostic factor. In addition, STAS is associated with EGFR mutation, ALK and ROS1 gene rearrangement.

Objective To reduce the incidence of falls in elderly patients and improve the quality of nursing safety using tracing method. Methods The tracking methodology was used to formulate fall prevention system and implement tracking path. The tracking centered on patients with high risk of fall and included three aspects: mastery degree of nurses on fall prevention system, participation degree of patients and the implementation of first class quality control. The comparison of tracking result analysis of two quarters in 2016 helped to find out the main reason of the occurrence of falls in elderly patients, make targeted improvement measures and evaluate the effect. Results After the continuous improvement of using tracking methodology, the scores of inspection results and the mastery degree of all nurses on fall core competence in the second quarter were significantly improved when compared to the first quarter (t=23.18, 17.25;P< 0.01); the incidence of falls decreased from 13 cases (6.5%) in the first quarter to 4 cases (2.0%) in the second quarter, while patients' satisfaction degree increased from 85.5% in the first quarter to 98.5% in the second quarter with statistically significant differences between two quarters (χ2=6.38, 14.72; P< 0.01). Conclusions The application of tracing method can effectively reduce the incidence of falls in elderly patients. The method is beneficial to the long-term management of nursing quality, simple, feasible, easy to use, and worthy promoting.

Objective To explore the influence of continuing nursing care on sexual quality of patients after laparoscopic subtotal hysterectomy.Methods Seventy-eight patients with selective laparoscopic subtotal hysterectomy enrolled from March 2014 to April 2015 were numbered according to their enrollment date,and divided into control group and intervention group randomly.Both groups were conducted laparoscopic subtotal hysterectomy under general anesthesia.After the surgery,the control group was treated with standard nursing care and the intervention group received continuing nursing care beyond the standard nursing care.Participants' sexual quality of 3 months and 6 months after surgery were evaluated using the female sexual function index (FSFI) Results The scores of FSFI of intervention group were significantly higher than those of the control group.Conclusion The continuing nursing care of patients after laparoscopic subtotal hysterectomy can effectively improve patient's short-term sexual quality,which is worth of being applied in gynecology nursing care in the future.