Objective To observe the clinical curative effect of stomach dampness decoction combined with quadruple therapy in the treatment of Hp related peptic ulcer.Methods 80 cases of Hp related peptic ulcer were randomly divided into control group and treatment group,40 cases in each group.The control group was treated with quadruple therapy(oral amoxicillin capsule,left ofloxacin tablets,pantoprazole enteric coated tablets,citric acid bis-muth potassium granule),the treatment group was given stomach dampness soup on the basis of the control group.The treatment course was 14 days,1 month after anti Hp therapy,assessed HP eradication rate of the two groups.Results The Hp eradication rate of the treatment group was 95% which was higher than 80% of the control group,the differ-ence was statistically significant(χ2 =4.114,P <0.05).Conclusion Hewei huashi decoction combined with quad-ruple therapy in treating Hp -related petic ulcer has better Hp eradication rate and drug safety than the quadruple therapy.

OBJECTIVE: To investigate the mechanism of Chinese herbal recipe Weichang'an (WCA) in inducing cell apoptosis of human gastric cancer grafted onto nude mice. METHODS: The high performance liquid chromatography was used for monitoring the stability of WCA. A human gastric cancer cell line SGC-7901 grafted in nude mouse was used as the animal model. The mice were divided into untreated group and two experimental groups. Animals in the two experimental groups received either WCA over a 34-day period or 5-fluorouracil (5-FU) over a 6-day period starting at the 8th day after grafting. Animals in the untreated group received normal saline on an identical schedule. Animals were killed 41 days after being grafted. To assess the effect of the treatment on tumor, the tumor weight was determined by the electron balance immediately after the animals were killed. SP immunohistochemical method was used to detect the expression of proliferating cell nuclear antigen (PCNA) in grafts. Apoptotic indices (AI) of the tumor cells were examined by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate fluorescence nick end labeling (TUNEL) method. SP method was also used to detect the expressions of cleaved caspase-3, caspase-8 and caspase-9. SYBR green dye I real-time quantitative polymerase chain reaction (real-time quantitative [corrected] PCR) was used to assess the related gene alterations in mRNA level. The expressions of phospho-Stat3 (Tyr705) and bcl-2 proteins were detected by using SP method. RESULTS: Compared with the untreated group, tumor growth was significantly inhibited by treatment of WCA or 5-FU (P<0.01, respectively). The tumor inhibition rate in the WCA-treated group was 48.70% and that in the 5-FU-treated group was 60.10%. The average labeling index (LI) for PCNA in the WCA-treated group and 5-FU-treated group was significantly decreased as compared with that in the untreated group, respectively. The AI of human gastric cancer grafted in the nude mice detected by using TUNEL method was significantly increased to (9.72+/-4.51)% in the WCA-treated group, while it was (2.45+/-1.37)% in the untreated group. 5-FU-treated group was also found a significantly increased AI compared with the untreated group. The expressions of cleaved caspase-3 and caspase-9 in the WCA-treated group and 5-FU-treated group were significantly increased as compared with those in the untreated group. But caspase-8 showed no significant alteration either in the WCA-treated group or in the 5-FU-treated group. The expression levels of Stat3 (2(-)delta delta C(T))=0.16) and bcl-2 (2(-)delta delta C(T))=0.10) detected by using real-time quantitative [corrected] PCR were lower in the WCA-treated group than those in the untreated group. The expressions of phospho-Stat3 (Tyr705) and bcl-2 in the WCA-treated group were significantly decreased as compared with those in the untreated group. CONCLUSIONS: Chinese herbal recipe WCA can inhibit gastric cancer cell SGC-7901 growth in vivo, induce gastric cancer cell apoptosis and suppress the cell proliferation. WCA induces apoptosis through the caspase-9 and caspase-3 pathway in vivo. Its mechanism might be involved in the down-regulation of Stat3 and bcl-2 genes.

Objective To observe the effect of stomach dampness decoction combed with quadruple therapy in the treatment of Hp related peptic ulcer .Methods 80 patients with Hp related peptic ulcer were randomly divided into two groups according to randomized block design , with 40 cases in each group .The control group received the quadruple therapy ,inculding orally pantoprazole enteric -coated tablets ,bismuth potassium citrate granules ,amoxicil-lin capsules,levofloxacin tablets.The study group was given Hewei Huashi decoction on the basis of the control group . The duration of treatment was 14 days and the effect was assessed after 1 month,the healing of ulcer and the improve-ment of clinical symptoms were observed .Results The ulcer healing rate in the study group ( 82 .5％) was higher than that in the control group (62.5％),the difference was statistically significant (χ2 =4.013,P=0.045).There was no statistically significant difference in total effective rate between the two groups ( 95.0％ vs.87.5％,χ2 =0.626,P=0.429).Before treatment,there were no statistically significant differences in the integral and the total integral of the imultaneous phenomenon between the two groups (all P>0.05).After treatment,the accompanying symptom scores and the total integral of the study group significantly reduced ,and the fullness[(0.28 ±1.03)points vs.(0.62 ±0.87)points,Z=-2.022],ructus[(0.40 ±0.67)points vs.(0.88 ±1.04)points,Z=-2.054],noisy [(0.25 ±0.49)points vs.(0.60 ±0.78)points,Z =-2.135],diarrhea[(0.25 ±0.49)points vs.(0.62 ± 0.71)points,Z=-2.642]and the total score[(2.52 ±1.71)points vs.(4.35 ±2.76)points,Z=-3.073]were better than those of the control group,and the differences were statistically significant (all P <0.05).The total effective rate of imultaneous phenomenon in the study group (97.5％) was higher than that of the control group (75.0％),and the difference was statistically significant (χ2 =6.746,P =0.009).Conclusion The stomach dampness decoction combined with quadruple therapy in the treatment of Hp related peptic ulcer has better curative effect,and it can more effectively improve the quality of healing and clinical symptoms .

Objective To research the effect of alkylation of glycerol phosphate synthase (AGPS) in isoproterenol (ISO) induced rat cardiac hypertrophy. Methods The pathological cardiac hypertrophy rat model was constructed by ISO intraperitoneal injection. Twelve healthy Sprague-Dawley rats (120～150 g) were divided into ISO group and control group randomly. In the ISO group, rats were injected with ISO (3 mg/kg) per day for two consecutive weeks. In the control group, rats were injected with normal saline (3 mg/kg) per day for two consecutive weeks. Changes of left ventricular diastolic diameter, left ventricular posterior wall thickness, left ventricular ejection fraction, left ventricular short-axis shortening rate and left ventricular mass were detected by echocardiography. The cross-sectional area of myocardial cells in rats was measured by hematoxylin-eosin staining. The expression of hypertrophic factors [atrial natriuretic peptide (ANP), myosin light chain-2V (MLC-2V), α-myosin heavy chain (α-MHC)] and AGPS were detected by Western Blot and real-time quantitative PCR (qPCR). Results The results of echocardiography showed that the cardiac hypertrophy rat model was successfully constructed. The results of hematoxylin-eosin staining showed that the myocardial cross-sectional area in the ISO group was significantly larger than that of the control group. The Western Blot and qPCR results indicated that the relative expression of protein and mRNA of hypertrophic factor and AGPS in the ISO group were both up-regulated comparing with that of the control group, and the differences were statistical significance (all P<0.05). Conclusions The rat model of pathological cardiac hypertrophy with up-regulated AGPS expression was successfully constructed providing a theoretical basis for further study on the role of AGPS in pathogenesis of pathological cardiac hypertrophy.

Objective:To build a medical service experience system based on role play of hospital staff, and explore its contribution to upgrading medical service, elevating medical service quality, and improving patients′ satisfaction.Methods:An indicator system for medical service experience was developed via literature review. 20 newly recruited hospital employees in 2019 were sampled randomly to form a service experience team, who were arranged to experience the full medical service process of outpatients and inpatients based on role play. The questionnaire for service quality based on patient perception and expectation was used to survey the expectation and perception values of those role players on their medical service experiences, and summarize the defects found on such six dimensions as hospital reliability, responsiveness, tangibility, assurance, empathy and cost-effectiveness. After due corrections of these defects, further experiences and patient satisfaction survey were made to assess the effects of such actions taken. Paired t test was used respectively in statistical analysis of service experience value and actual perception value, as well as the perception values before and after the actions taken, and χ2 test was used for a statistical analysis of patient satisfaction. Results:Role players experienced respectively at the emergency, outpatient and inpatient departments of the hospital for a week in August 2019. Statistics of their experiences indicated≥0.50 points difference between the mean expectation and perception values on doctor-patient communication, patient help responsiveness, outpatient process, examination report delivery duration, service attitude, patient trust on medical workers, medical environment and patient privacy protection.Following a 3-month reform, role players found improvements in such aspects as hospital reliability, responsiveness, tangibility, assurance, empathy and cost-effectiveness; patient satisfaction improved sizably in December 2019 over January of the same year( P<0.05). Conclusions:The construction and application of the medical service experience system based on role play of hospital staff prove highly useful in upgrading medical service actions, improving medical service quality, and improving patient satisfaction.

Objective To provide a reference for the selection of frailty assessment tools for stroke patients by conducting a literature review of existing frailty assessment tools for stroke patients.Methods Systematic searches were conducted in PubMed,Web of Science,EMbase,SinoMed,Wanfang,VIP,and China National Knowledge Infrastructure(CNKI)databases from their inception to May 2023.The literature that met the research purpose and question were screened,and the basic in-formation of each article,including the first author,publication year,country of publication,type of research design,name of the assessment tool,dimensions of scale,the number of items,and assess-ment time,was extracted.Results A total of 1,729 articles were retrieved in this study.After multi-ple screenings,22 articles(including 8 frailty assessment tools)were ultimately included.The analy-sis results showed that the evaluation indicators,evaluation time,and evaluation methods of the 8 frail-ty assessment tools were different and had their own advantages and disadvantages.Among them,the frailty index was the most commonly used frailty assessment tool for stroke patients.The selection of ef-fective frailty assessment tools for stroke patients is essential for strengthening prestroke risk stratifica-tion and improving poststroke outcomes.Conclusion There are significant differences among different frailty assessment tools,and existing assessment tools have limitations in measuring frailty in stroke pa-tients.Comprehensive assessments should be conducted in combination with clinicians'experience and judgment.New frailty assessment tools are needed in future research to better guide the rehabilitation treatment and management of stroke patients.

Objective To provide a reference for the selection of frailty assessment tools for stroke patients by conducting a literature review of existing frailty assessment tools for stroke patients.Methods Systematic searches were conducted in PubMed,Web of Science,EMbase,SinoMed,Wanfang,VIP,and China National Knowledge Infrastructure(CNKI)databases from their inception to May 2023.The literature that met the research purpose and question were screened,and the basic in-formation of each article,including the first author,publication year,country of publication,type of research design,name of the assessment tool,dimensions of scale,the number of items,and assess-ment time,was extracted.Results A total of 1,729 articles were retrieved in this study.After multi-ple screenings,22 articles(including 8 frailty assessment tools)were ultimately included.The analy-sis results showed that the evaluation indicators,evaluation time,and evaluation methods of the 8 frail-ty assessment tools were different and had their own advantages and disadvantages.Among them,the frailty index was the most commonly used frailty assessment tool for stroke patients.The selection of ef-fective frailty assessment tools for stroke patients is essential for strengthening prestroke risk stratifica-tion and improving poststroke outcomes.Conclusion There are significant differences among different frailty assessment tools,and existing assessment tools have limitations in measuring frailty in stroke pa-tients.Comprehensive assessments should be conducted in combination with clinicians'experience and judgment.New frailty assessment tools are needed in future research to better guide the rehabilitation treatment and management of stroke patients.

Background: The mitogen-activated extracellular signal-regulated kinase 1/2 (MEK1/2) inhibitor trametinib has shown promising therapeutic effects on melanoma, but its efficacy on colorectal cancer (CRC) is limited. Synthetic lethality arises with a combination of two or more separate gene mutations that causes cell death, whereas individual mutations keep cells alive. This study aimed to identify the genes responsible for resistance to trametinib in CRC cells, using a synthetic lethal short hairpin RNA (shRNA) screening approach. Methods: We infected HT29 cells with a pooled lentiviral shRNA library and applied next-generation sequencing to identify shRNAs with reduced abundance after 8-day treatment of 20 nmol/L trametinib. HCT116 and HT29 cells were used in validation studies. Stable ring finger protein 183 (RNF183)-overexpressing cell lines were generated by pcDNA4-myc/his-RNF183 transfection. Stable RNF183-knockdown cell lines were generated by infection of lentivi-ruses that express RNF183 shRNA, and small interference RNA (siRNA) was used to knock down RNF183 transiently. Quantitative real-time PCR was used to determine the mRNA expression. Western blotting, immunohistochemical analysis, and enzyme-linked immunosorbent assay (ELISA) were used to evaluate the protein abundance. MTT assay, colony formation assay, and subcutaneous xenograft tumor growth model were used to evaluate cell proliferation. Results: In the primary screening, we found that the abundance of RNF183 shRNA was markedly reduced after treatment with trametinib. Trametinib induced the expression of RNF183, which conferred resistance to drug-induced cell growth repression and apoptotic and non-apoptotic cell deaths. Moreover, interleukin-8 (IL-8) was a downstream gene of RNF183 and was required for the function of RNF183 in facilitating cell growth. Additionally, elevated RNF183 expression partly reduced the inhibitory effect of trametinib on IL-8 expression. Finally, xenograft tumor model showed the synergism of RNF183 knockdown and trametinib in repressing the growth of CRC cells in vivo. Conclusion: The RNF183-IL-8 axis is responsible for the resistance of CRC cells to the MEK1/2 inhibitor trametinib and may serve as a candidate target for combined therapy for CRC.

Objective:To explore the application of PDCA (plan, do, check, act) cycle theory in the teaching of eight-year clinical medical students for the course of Laboratory Diagnostics.Methods:From September 2021 to November 2022, the students majoring in clinical medicine of eight-year system who were studying the course of Laboratory Diagnostics at Peking Union Medical College were selected as the research objects. The teaching reform of the course of Laboratory Diagnostics was carried out according to the four stages of PDCA cycle theory, and the teaching effect was evaluated by the final examination results and questionnaire survey scores of the students.Results:The score of theoretical examination of eight-year students in 2018 was (86.7±4.68) points, which was higher than that of students in 2017 [(83.3±3.89) points], and the difference was statistically significant ( P<0.05). The questionnaire survey results of the two groups of students showed that the rating of experimental course was higher than that of theoretical course ( P<0.05). After the teaching reform based on PDCA cycle theory, the questionnaire survey scores of theoretical course [(3.83±0.25) points vs (2.94±0.28) points] and experimental course [(4.13±0.09) points vs (3.32±0.12) points] in students of 2018 were higher than those of 2017 (all P<0.001). Conclusion:PDCA cycle theory provides new methods and ideas for teaching management, which helps to improve the performance of clinical medical students of eight-year system and their recognition of the course.

Objective:To evaluate consistency between 2-fold serial and 4-fold serial diluted neutralization tests against Enterovirus A71 (EV-A71) in estimating titer, Geometric mean titer (GMT), seroprevalence, and seroincidence.Methods:Based on a prospective cohort of 1-9 years old children, mothers and infants established in Anhua County, Hunan Province, during 2013-2018, from which 92 participants with a total of 386 blood specimens were sampled and tested with a 2-fold serial dilution and a 4-fold serial dilution neutralization tests against EV-A71 at the same time. Agreement was estimated using the Bland-Altman method. Stratified analysis was conducted to estimate effect dilution approach on GMT, seroprevalence and seroincidence.Results:The mean difference (0.04, 95% CI:-0.02-0.10) between the two dilution approaches was not significant. However, the limits of agreement (LOA) (-1.12-1.21), with the 95% confidence interval of upper LOA (1.10-1.31) and of lower LOA (-1.22--1.02), significantly exceeded the Clinic accept interval (-1, 1) indicating insufficient agreement between the two approaches in practice. While the dilution approaches did not affect estimates of GMT of the total population and the positive population, and seroincidence with seroconversion only, the differences were 2, 6 and 2%, respectively ( P>0.05). Estimates of seroincidence with at least 4-fold increase and seroconversion/4-fold increase were significantly higher using a 4-fold dilution neutralization test compared to the 2-fold dilution neutralization test with 8% (95% CI: 1%-12%) and 9% (95% CI: 1%-17%), respectively. Conclusion:The 2-dilution and 4-dilution neutralization tests yielded comparable results when estimating the population′s GMT; however, the difference between the two is not negligible when assessing the seroincidence.