Objective To observe the clinical efficacy of Shiwei Longdanhua Capsule combined with western medicine on patients with mild acute exacerbation of chronic obstructive pulmonary disease (COPD) with phlegm-heat obstructing lung syndrome. Methods Totally 192 cases of COPD with mild acute exacerbation (phlegm-heat obstructing lung syndrome) were recruited. They were randomly divided into the treatment group (96 cases) and the control group (96 cases). Patients in the control group were treated in line with the regular Western treatment, while patients in the treatment group were additionally treated by Shiwei Longdanhua Capsule. After 10-day treatment, the changes of TCM syndrome score, symptom integral and the lung function before and after treatment were compared. Results After treatment, 14 patients withdrew from the treatment group and 15 patients withdrew from the control group. The total efficiency rate of TCM syndrome was 80.49% (66/82) in the treatment group, while it was 56.79% (46/81) in the control group, with statistical difference between the two groups (P<0.05). The severity and frequency of cough and expectoration of the treatment group were better than the control group (P<0.05). The breathing symptom and pulmonary function of patients in the two groups improved, with similar efficacy. Conclusion The efficiency of Shiwei Longdanhua Capsule combined with Western medicine in the treatment of acute exacerbation of COPD is superior to that of simple Western medicine treatment, especially in terms of relieving cough and expectoration.

Objective To observe the clinical efficacy of fire-needle acupuncture in treating chronic cough after a cold. Method Totally 120 eligible subjects with chronic cough after a cold were randomized into two groups: 60 cases in the treatment group were intervened by acupuncture with fire-needles, while the other 60 cases in the control group were by acupuncture with ordinary filiform needles plus cupping. Result The recovery rate was 85.0% in the treatment group versus 65.0% in the control group, and the difference was statistically significant (P<0.05). Conclusion Fire-needle acupuncture can produce a significant efficacy in treating chronic cough after a cold, and it has a rapid onset of action, lower cost, and it’s easy-to-operate.

Objective:To analyze the clinical value of indocyanine green (ICC) fluorescence imaging in Mirizzi syndrome type Ⅱ-Ⅲ laparoscopic cholecystectomy (LC).Methods:A retrospective analysis was performed on 80 patients diagnosed with Mirizzi syndrome types Ⅱ-Ⅲ who underdoing LC in Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from October 2018 to February 2022, including 32 males and 48 females, aged (63.5±6.9) years. Patients were divided into two groups based on whether ICG fluorescence imaging technology was used, the control group ( n=38) that patients were treated with conventional LC and the experimental group ( n=42) patients were treated with LC guided by ICG fluorescence imaging. In the experimental group, the extrahepatic bile duct was identified by ICG fluorescence imaging during LC, and ICG was injected intraoperally to determine the reserved blood flow of gallbladder flap for fluorescence imaging and determine the resection line. Operation time, intraoperative blood loss, conversion rate of laparotomy and postoperative complications (bile leakage, incision infection, etc.) were compared between the two groups. Intraoperative fluorescence imaging and determination of the modified resection line of reserved gallbladder were analyzed in the observation group. Results:There was no significant difference in age, male proportion, type of Mirizzi syndrome and conversion rate of laparotomy between the two groups (all P>0.05). In the observation group, the operative time was (208.7±32.0) min, the intraoperative blood loss was (50.5±23.8) ml, and the biliary leakage was 7.1% (3/42), which was lower than that in the control group (228.2±33.9) min, (73.8±31.0) ml, 26.3% (10/38). The differences were statistically significant (all P<0.05). Of 37 cases (88%) showed common hepatic duct and common bile duct successfully in the observation group. In the observation group, ICG fluorescence imaging was used to determine the gallbladder resection line in 8 cases (19.0%). The gallbladder flap without fluorescence imaging was removed. Conclusion:ICG fluorescence imaging in LC for Mirizzi syndrome patients can identify the common bile duct and hepatic duct to guide surgical resection, determine the gallbladder flap resection line, reduce postoperative bile leakage and bleeding, and accelerate the surgical progress.

Objective To analyze the expression of serum carbohydrate antigen 153(CA153) and human epididymis protein 4 (HE4) in the cervical cancer patients. Methods 72 cases of cervix neoplasms patients received from Jun 2010 to July 2013,were divided into the cervical cancer group(36 cases)and cervical benign lesions group(36 cases)according to different pathological results, 36 cases of healthy women undergoing physical examination at the same time were chosen as control group. The level of serum CA153 and HE4 of above research subjects were detected and analyzed. Results The level of serum CA153 of cervical cancer group(79.6±14.8)U/mL was higher than that of cervical benign lesions group (t=5.17, P<0.05) and control group (t=7.31, P<0.05), there was statistically significant differ-ence; the level of serum HE4 of cervical cancer grou (216.3±8.1) pmol/L was higher that of cervical benign lesions group(t=9.71,P<0.05) and control group (t=11.84, P<0.05), there was statistically significant difference; the posi-tive rate of combined detection was higher than that of single detection, there was statistically significant difference(χ2=4.527,P<0.05); The level of serum CA153 and HE4 in III/IV stage were higher than that in I/II stage, and the difference was statistically significant (P<0.05). Conclusion The level of serum CA153 and HE4 of cervical cancer patients increase significantly. The combined detection of CA153 and HE4 can improve the diagnostic sensitivity,specificity and accordance rate of cervical cancer prominently,so it has great reference value in the early diagnosis and treatment of cervical cancer.

Objective:To explore the clinical value of indocyanine green (ICG) fluorescence imaging technology in complex laparoscopic cholecystectomy (LC) for real-time imaging of extrahepatic bile ducts to avoid bile duct damage.Methods:The data of 90 patients with complicated gallbladder stones with cholecystitis who underwent LC from November 2018 to May 2019 at Liaoning University of Traditional Chinese Medicine Affiliated Hospital were studied. The patients were divided into the control group and the experimental group based on different imaging methods. The control group underwent conventional LC, and the experimental group underwent LC under guidance of ICG fluorescence imaging technology. ICG 5 mg were injected into a peripheral vein (elbow vein) 12 hours before operation. The pre-LC common bile duct, common hepatic duct and cystic duct recognition rates, time to establish gallbladder triangle, intraoperative blood loss, bile duct injuries and postoperative complications were determined.Results:Of the 45 patients in the experimental group, there were 18 males and 27 females. The age was (60.9±9.3) years. The body mass index (BMI) was (26.2±2.0) kg/m 2. Of the 45 patients in the control group, there were 23 males and 22 females. The age was (57.5±8.7) years. The BMI was (26.7±2.7) kg/m 2. There were no significant differences in the clinical data between the two groups ( P>0.05). In the experimental group, the common bile duct was successfully shown in 40 patients (88.9%) and the cystic duct in 34 patients (75.6%). In the control group, the common bile duct was shown in 13 patients (28.9%) and the cystic duct in 12 patients (26.7%). The time taken for the experimental group to establish the triangle of gallbladder was (33.4±9.0) min. The corresponding time for the control group was (52.7±15.0) min. The intraoperative blood loss was (15.5±5.4) ml in the experimental group and (23.0±15.6) ml in the control group. One patient in the control group, but no patients in the experimental group, had to be converted to laparotomy. The control group had 1 right hepatic duct injury and 1 common bile duct injury. Each group had 1 patient with a sub-xiphoid incision infection. No additional complications were detected after a follow-up of 3 months. The differences in pre-LC common bile duct, common hepatic duct, and cystic duct recognition rates, time to establish the gallbladder triangle, and intraoperative blood loss were significantly different between the two groups ( P<0.05). There were no significant differences in biliary tract injuries and postoperative complications rates ( P>0.05). Conclusion:Early observation of the cystic duct and common bile duct with ICG fluorescence imaging in complex LC can help prevent common bile duct damage and speed up the progress of surgery.

Objective:To investigate the etiological diagnostic value of metagenomic sequencing in central nervous system (CNS) infectious diseases.Methods:A total of 170 patients with central nervous system infection admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2020 were selected as the study subjects according to inclusion and exclusion criteria. General clinical data and pathogen test results were collected. All included patients underwent routine examination and mNGS test, and were divided into the conventional method test group and mNGS test group according to the test results. The measurement data conforming to normal distribution were represented by ± s; The measurement data that did not conform to normal distribution were represented by median and interquartile range. The classification data were expressed by the number of cases and percentage( n,%), and were compared by χ2 test or Fisher's exact test. Consistency test was represented by Kappa value. The detection of pathogenic microorganisms by the two methods and the rule of pathogen spectrum were compared and analyzed. Results:The overall positive rate of mNGS in CNS infectious diseases was higher than that of conventional methods (58.23% vs. 18.82%), and the difference was statistically significant ( P<0.01). Among the 20 samples which were both positive by the two methods, 10 cases were completely pathogenic, 5 cases were partially consistent and 5 cases were completely inconsistent. In the detection of tuberculous nervous system infection, the positive rates were 66.7%, 53.8%, 44.0%, 40.0%, 4.0% in blood T-SPOT, cerebrospinal fluid mNGS, ADA, Mycobacterium tuberculosis DNA and tuberculous specific antibody, respectively. The positive rate of acid-fast staining was 0. The positive rate of mNGS combined with conventional method was 80.8%. Conclusions:The detection rate of mNGS in CNS infection is better than that of conventional methods. However, it does not show obvious superiority in the detection rate of Mycobacterium tuberculosis associated nervous system infection. In general, mNGS detection of pathogenic bacteria is more extensive, which is conducive to a thorough and comprehensive understanding of the bacterial characteristics of central nervous system infection. The combination of the two methods can make up for the deficiency of clinical routine detection to a certain extent, and can maximize the detection rate.

ObjectiveBioinformatics methods were used to systematically identify the Salvia miltiorrhiza terpenoid synthase （SmTPS） gene family members and predict their functions from the perspective of the genome. MethodThe genome and transcriptome data of S. miltiorrhiza， Arabidopsis thaliana， and tomato were obtained from the national genomics data center （NGDC）， national center for biotechnology information （NCBI）， the Arabidopsis information resource （TAIR）， and tomato functional genomics database （TFGD）， and the whole genome identification and bioinformatics analysis of the SmTPS gene family member were carried out with the help of Perl language programming， Tbtools， and other bioinformatics tools. ResultA total of 52 TPS gene family members were identified， and they were distributed on eight chromosomes of S. miltiorrhiza. Their coding amino acid number was 207-822 aa. The isoelectric points were 4.76-9.16. The molecular mass was 24.11-94.81 kDa， and all members are hydrophilic proteins. Gene structure analysis showed that there were significant differences in the number of introns among different subfamilies. The number of introns in 72.6% of TPS-a， b， and g subfamilies was 6， and that in 88.9% of TPS-c and e/f subfamilies was more than 10. Protein motifs were conserved among TPS subfamilies. The analysis of promoter cis-acting elements showed that all promoters of the SmTPSs contained a large number of light-responsive elements， and most of them had hormone-responsive elements. Gene expression analysis showed that SmTPS gene family members exhibited tissue-specific expression， and 24 of them responded to exogenous methyl jasmonate. ConclusionBased on the published S. miltiorrhiza genome， 52 SmTPS gene family members were identified， and their functions were predicted based on the phylogenetic analysis and expression patterns. This paper provides reference information for the further biosynthesis pathway and regulatory mechanism analysis of terpenoids in S. miltiorrhiza.

OBJECTIVE To analyze the influential factors for rivaroxaban-induced bleeding events in patients with non- valvular atrial fibrillation （NVAF） and coronary heart disease. METHODS A total of 64 hospitalized patients with NVAF complicated with coronary heart disease who were treated with rivaroxaban and admitted to the Fuzhou University Affiliated Provincial Hospital from November 2021 to May 2023 were included in this retrospective study. The demographic data， laboratory test indexes and other general clinical data， and steady-state trough concentration of rivaroxaban were collected， and the dose- adjusted trough concentration was calculated. The occurrence of bleeding events within 6 months after discharge was recorded. The univariate analysis and binary Logistic regression analysis were adopted to determine the independent risk factors of rivaroxaban- related bleeding events. The binary Logistic regression equation was constructed to predict the probability of bleeding events. The area under the receiver operator characteristic （ROC） curve （AUC） was used to analyze the predictive value of the regression equation. RESULTS Among 64 patients， 19 patients had 24 case-times bleeding events， most of which were mild bleeding （19 case-times， 79.2%）， and mainly gastrointestinal bleeding （17 case-times， 70.8%）. After symptomatic treatment and adjustment of the anticoagulant regimen， most of them were improved or cured. In the univariate analysis， the proportion of patients with a history of anemia， platelet count， urea nitrogen content， steady-state trough concentration of rivaroxaban， dose-adjusted trough concentration and coagulation indexes [international normalized ratio， prothrombin time （PT）， activated partial thromboplastin time] in bleeding group were significantly more or higher than those in non-bleeding group， while the albumin level was significantly lower than that in non-bleeding group （P＜0.05）. In binary Logistics regression analysis， high PT level （odds ratio＝1.473， 95% confidence interval＝1.103-1.967， P＝ 0.009） and high rivaroxaban dose-adjusted trough concentration （odds ratio＝1.174， 95% confidence interval＝1.018-1.355， P＝ 0.027） were independent risk factors for rivaroxaban-related bleeding events. The binary Logistic regression equation of bleeding event prediction probability （P） was LogitP＝－6.975+0.387×PT level+0.161×dose-adjusted trough concentration， and the AUC of the ROC curve was 0.825 （95% confidence interval was 0.708-0.909， P＜0.001）. CONCLUSIONS The risk factors of rivaroxaban-related bleeding events in patients with NVAF and coronary heart disease include previous anemia history， high platelet count， high urea nitrogen content， high rivaroxaban steady-state trough concentration， high dose-adjusted trough concentration， high coagulation indexes and low albumin level. High PT level and high dose-adjusted trough concentration are independent risk factors that can be used to predict the risk of rivaroxaban-induced bleeding events. The regression equation has good predictive value.