OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is a major chronic respiratory condition with high morbidity and mortality, imposing a serious economic and public health burden. The World Health Organization ranks COPD among the top 4 chronic diseases worldwide. Zangsiwei Qingfei Mixture (ZSWQF), a novel Tibetan herbal formulation independently developed by our research team, has shown therapeutic potential for chronic respiratory diseases. This study aims to evaluate the effects of aerosolized ZSWQF on cigarette smoke-induced COPD in mice and explore its underlying mechanisms. METHODS: Thirty C57 mice were randomly divided into a Control group, a COPD group, and a ZSWQF group. The Control group received saline aerosol inhalation without cigarette smoke exposure; both the COPD group and the ZSWQF group were exposed to cigarette smoke, with the former receiving saline inhalation and the latter treated with ZSWQF aerosol. White blood cell (WBC) count was performed using a fully automatic blood cell analyzer. Serum, alanine transaminase (ALT), and serum creatinine (SCr), as well as interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF)-α levels in serum and bronchoalveolar lavage fluid (BALF) were measured by enzyme-linked immunosorbent assay (ELISA). BALF cell classification was determined using a hematology analyzer. Lung function was assessed with a small animal pulmonary function system, including airway resistance (RI) and cyclic dynamic compliance (CyDN). Lung tissues were stained with hematoxylin and eosin (HE), and mean linear intercept (MLI) and destruction index (DI) were calculated to evaluate morphological changes. Network pharmacology was applied to identify disease-related and ZSWQF-related targets, followed by intersection and protein-protein interaction (PPI) network analysis, and enrichment analysis of biological functions and pathways. Primary type II alveolar epithelial cell (AEC II) from SD rats were isolated and divided into a Control group, a lipopolysaccharide (LPS) group, a normal serum group, a water extract of ZSWQF (W-ZSWQF) group, a ZSWQF containing serum group, and a MLN-4760 [angiotensin-converting enzyme (ACE) 2 inhibitor]. Western blotting was performed to assess protein expression of ACE, p38 [a mitogen-activated protein kinase (MAPK)], phospho (p)-p38, extracellular signal-regulated kinases 1 and 2 (ERK1/2), p-ERK1/2, c-Jun N-terminal kinase (JNK), p-JNK, inhibitor of nuclear factor-kappa B alpha (IκBα), p-IκBα, and p-p65 subunit of nuclear factor-kappa B (NF-κBp65). RESULTS: WBC counts were significantly higher in the COPD group than in controls (P<0.01) and decreased following ZSWQF treatment (P<0.05). No significant intergroup differences were found in organ weights, ALT, or SCr (all P>0.05). Serum and BALF levels of IL-6, IL-8, and TNF-α, as well as total BALF cells, neutrophils, and macrophages, were elevated in the COPD group compared with controls and reduced by ZSWQF treatment (P<0.05). COPD mice exhibited increased RI, decreased CyDN, marked alveolar congestion, inflammatory infiltration, thickened septa, and higher MLI and DI values versus controls (P<0.05); ZSWQF treatment significantly reduced MLI and DI (P<0.05). Network pharmacology identified 151 potential therapeutic targets for ZSWQF against COPD, with key nodes including TNF, IL-6, protein kinase B (Akt) 1, albumin (ALB), tumor protein p53 (TP53), non-receptor tyrosine kinase (SRC), epidermal growth factor receptor (EGFR), signal transducer and activator of transcription 3 (STAT) 3, matrix metalloproteinase (MMP)-9, and beta-catenin (CTNNB1). Enrichment analysis indicates involvement of cancer-related, phosphatidylinositol 3-kinase (PI3K)/Akt, hypoxia-inducible factor (HIF)-1, calcium, and MAPK signaling pathways. Western blotting results showed that compared with the LPS group, AEC II treated with ZSWQF-containing serum exhibited decreased expression of ACE, p-p38/p38, p-ERK1/2/ERK1/2, p-JNK/JNK, p-IκBα/IκBα, and p-NF-κBp65, while ACE2 expression was upregulated, consistent with the MAPK/nuclear factor-kappa B (NF-κB) pathway regulation predicted by network pharmacology. CONCLUSIONS Aerosolized ZSWQF provides protective effects in COPD mice by reducing airway inflammation and remodeling.
Animals ; Pulmonary Disease, Chronic Obstructive/etiology* ; Drugs, Chinese Herbal/therapeutic use* ; Mice ; Mice, Inbred C57BL ; Male ; Network Pharmacology ; Smoke/adverse effects* ; Bronchoalveolar Lavage Fluid ; Administration, Inhalation ; Inflammation/drug therapy* ; Tumor Necrosis Factor-alpha ; Lung/drug effects* ; Interleukin-6/blood*

ObjectiveTo observe the clinical effectiveness of midnight-noon ebb-low acupuncture by hour-prescription of points combined with western medicine for patients of Parkinson's disease with restless legs syndrome. MethodsSixty cases of Parkinson's disease with restless legs syndrome were divided into a control group and a treatment group randomly， with 30 cases in each group. The control group was given conventional western medicine treatment， and the treatment group was given the treatment of the control group with midnight-noon ebb-low acupuncture by hour-prescription of points based on Daling （PC 7）， Zhongzhu （TE 3）， Yanglingquan （GB 34）， Zusanli （ST 36）， and Sanyinjiao （SP 6） with perpendicular insertion， and Baihui （GV 20） with oblique insertion to the back，all of them used the manipulation of neutral reinforcement and reduction； Dudu （SP 2） and Taibai （SP 3） acupoints were inserted in accordance with the direction of the meridian travelling when the patients inhaled， and the needle was removed when exhaled； the time of acupuncture manipulation selected as Si time （9 AM-11 AM）， the needle stay for 30 mins each time， once a day， 5 times a week， a total of 4 weeks of treatment. The international restless legs severity scale （IRLSS）， Pittsburgh sleep quality index （PSQI）， Parkinson's disease quality of life questionnaire （PDQ-39）， and the International Movement Disorder Society unified Parkinson's disease rating scale part Ⅰ （MDS-UPDRS Ⅰ） were compared before and after the treatment， and the clinical effectiveness of the two groups were compared after the treatment. ResultsIRLSS scores， PSQI scores， PDQ-39 scores and MDS-UPDRS Ⅰ scores decreased in both groups after treatment compared to those before treatment （P＜0.05 or P＜0.01）. After treatment， the total effective rate in the treatment group （83.3%， 25/30） was higher than that in the control group （60%， 18/30） （P＜0.05）. ConclusionAdding midnight-noon ebb-low acupuncture with hour-prescription of points on conventional western medicine treatment for Parkinson's disease with restless legs syndrome can significantly improve patients' clinical symptoms， sleep quality， quality of life， and enhance clinical effectiveness.

Objective:To analyze the effect of percutaneous transluminal angioplasty (PTA) in the treatment of autogenous arteriovenous fistula (AVF) stenosis and influcing factors of restenosis/loss of function after PTA.Methods:The medical records of 104 patients with AVF stenosis treated by PTA in People′s Hospital of Huadu District from March 2019 to July 2020 and the 1-year follow-up were retrospectively analyzed. Kaplan-meier curves were used to analyze the primary patency rates at 3 months, 6 months and 1 year. COX regression was used to analyze the influencing factors of restenosis/loss of function after PTA.Results:The primary patency rates of AVF at 3, 6 and 12 months after PTA were 86.2%, 83.2% and 64.7%, respectively. Guide wire entry into the distal end of radial artery, the use of two balloons in stepwise mode, postoperative dilatation diameter, and dialysis blood flow after PTA were independent risk factors for restenosis/loss of fuction after PTA for AVF stenosis (all P<0.05). Conclusions:The guide wire into the distal end of the artery and passive use of more than two balloons are important factors affecting AVF restenosis/loss of function after PTA .

Objective: This study aimed to find out the myopia rate and related ocular biological parameters of grade 1-3 students in Peixian, Xuzhou City, and to establish a cohort observation population, so as to provide baseline reference for control strategies for myopia and reduce the myopia rate. Methods: A total of 1 952 students from two nine year schools in Peixian were selected by stratified cluster sampling in June 2020. Visual examination was administered by trained personnel using uniformly equipped instruments, including uncorrected visual acuity, diopter, intraocular pressure, axial length. Results: The overall myopia rate of students from grade one to grade three in two schools in Peixian was 21.77%, and the myopia rate of girls (23.81%) was significantly higher than that of boys (20.16%). With the growth of age and grade, the myopia rate increased continuously, and the difference was statistically significant ( χ 2=134.10, 144.30, P <0.05). The myopia rate of 6-year-old group was 8.87 %. The axial length of the left and right eyes of the myopic group was significantly higher than that of the non myopic group ( t = 411.95, 366.85, P <0.01), the intraocular pressure and mean corneal curvature of the left eye of the myopic group were higher than those of the nonmyopic group ( t =5.91, 10.22 , P <0.05). Conclusion The baseline survey results show that the myopia rate of grade 1-3 in Peixian of Xuzhou City is low, but myopia has occurred in the 6-year-old group. With the growth of age and grade, the myopia rate continues to rise. So it is urgent to explore effective and feasible myopia prevention and control measures.

Objective:To identify the pathogenic gene mutations in a family with early onset severe retinal dystrophy (EOSRD).Methods:A retrospective clinical study. One patient and three family members from a Han of EOSRD who were diagnosed at Henan Eye Hospital in August 2018 were included in the study. After the detailed history of the patients was collected, all participants underwent best corrected visual acuity (BCVA), slit-lamp, fundus biomicroscopy with the slit lamp, untra-widefield fundus color photography, spectral-domain optical coherence tomography (SD-OCT) and full-field electroretinography (ff-ERG). The subject’s peripheral venous blood of 5 ml was collected and the whole genome DNA was extracted. A genetic eye disease capture chip containing 441 disease-causing genes was used for targeted capture and enrichment of high-throughput sequencing, and Sanger sequencing was performed for the clear pathogenic mutation sites; the analysis software was used for bioinformatics analysis of the mutation sites.Results:A 6-year-old female proband developed poor night vision in both eyes after 1 year old. The BCVA of both eyes were 0.1. The color of the optic disc was slightly lighter; the diameter of the retinal vessels was slightly reduced, and extensive pigment changes can be seen in the retina outside the vascular arch. SD-OCT examination showed that the outer membrane, ellipsoid zone and chimera zone in the central fovea of both eyes were unclear and intermittent. The visual area outside the fovea was neuroepithelial outer plexiform layer, outer nuclear layer, outer membrane, ellipsoid zone. The chimera zone gradually disappeared, and the thickness of the pigment epithelial layer was not uniform. In ff-ERG examination, the functions of the binocular cone and rod system were severely decreased. The results of genetic testing showed that there were c.921C>A homozygous mutations in the Tubby-like protein (TULP1) gene of the proband, and c.3121C>T and c.3488G>A compound heterozygous mutations in the cyclic nucleotide gated channel beta 1 (CNGB1) gene. Amino acid conservation analysis results showed that the above three mutation sites were highly conserved in multiple species; bioinformatics analysis results showed that TULP1 gene c.921C>A (p.Cys307*) had translation termination in the protein conserved region, CNGB1 gene c.3121C>T (p.Arg1041Trp) and c.3488G>A (p.Gly1163Glu) had amino acid polarity changes in the protein conserved region, which led to major changes in the protein spatial structure.Conclusion:TULP1 gene c.921C>A homozygous mutation, CNGB1 gene c.3121C>T and c.3488G>A compound heterozygous mutation are the mutation sites of this EOSRD family.

Objective:To understand the current situation of the demand for humanistic care of schizophrenics in convalescence and analyze the influencing factors, so as to provide the basis for clinical nurses to carry out targeted humanistic care for patients.Methods:A self-produced scale with a total score of 49-245 was used to investigate 516 convalescent period schizophrenic patients in 18 tertiary mental health institutions in 13 provinces of China, single factor analysis and multiple regression analysis were performed on their influencing factors.Results:The Likert 5-point scoring method was used. The overall score of the nursing care needs of hospitalized schizophrenic patients was (202.85±35.06) points, and the average score of total items were (4.14±0.16) points. Multiple linear regression results showed female ( B=0.100, P=0.024), stable marriage ( B=-0.098, P=0.026),high school (including secondary school) Education ( B=-0.107, P=0.018), family per capita monthly income of 2 000 yuan or above ( B=0.093, P=0.043),central region ( B=-0.110, P=0.014) were the main factors that affect the demand for humanistic care of inpatients with schizophrenia in convalescence. Conclusion:The hospitalized schizophrenic patients have higher and diversified needs for humanistic care. Patients with different genders, marital status, education level, monthly family income and living area have different needs for humanistic care. Individualized and standardized nursing should be given according to the actual situation of patients' needs to provide a more supportive environment for their rehabilitation.

Objective: To investigate the entry points of traditional Chinese clinical pharmacists participating in multidisciplinary team (MDT) to provide reference for more peers and subject development. Methods: According to the daily work of traditional Chi-nese clinical pharmacists in joint multidisciplinary clinic and combining with patients' medication characteristics, traditional Chinese clinical pharmacists carried out works from three aspects including doctors, patients and peers. Results: After the medication was guided by traditional Chinese clinical pharmacists, the effect of medicinal treatment was improved, the patients' medication compliance increased and the incidence of adverse reactions was reduced. Moreover, it brought more ideas to the peers within the discipline in our hospital. Conclusion: Traditional Chinese clinical pharmacists can exploit their advantages to the full to find clinical demands and more entry points in works. At the same time, traditional Chinese clinical pharmacists should enhance related knowledge, professional qualities, and cooperation and communication ability comprehensively.

Objective To introduce the working experience of clinical pharmacists who provide pharmaceutical service in participating integrated diabetes out-patient.Methods Review and analyze the patients' clinical features and the clinical pharmacists' working model and effect in integrated diabetes out-patient of the Sixth People's Hospital Affiliated to Shanghai Jiaotong University.Results Among these patients who got pharmaceutical service in integrated diabetes out-patient, 81.7% were 40 to 70 years old, 51.7% had diabetes for 5 to 10 years, 50.0% were taking oral antidiabetic drugs to control blood glucose, and 90.0% were having complications.After the medication guide by clinical pharmacists,patients' medication compliance was increased from the percentage of 30.0% to 80.0%, the good control rate of blood glucose was increased from the percentage of 8.3% to 41.7%, and the incidence rate of adverse reaction was reduced from 10.0% to 3.3%.Conclusion Clinical pharmacists who actively participate in integrated diabetes out-patient could ensure the effective and safe treatment to diabetic patients.Therefore, this model is worth to be popularized due to professional value of clinical pharmacists.

Objective To compare the value of transrectal ultrasonography(TRUS) and magnetic resonance(MR) in preoperative estimation of circumferential resection margin (CRM) of mid-low rectal cancer.Methods Both TRUS and MR were performed prior to surgery in 111 patients with mid-low rectal cancer.The CRM was evaluated and compared with the postoperative pathologic findings.Results The accuracy of TRUS and MR for CRM was 91.9％(102/111) and 85.6％(95/111),respectively,there was no statistical difference between them (P =0.137).Their specificities were 94.0％ (79/84)and 84.5％ (71/84),there was statistical difference between them(P =0.046).The consistency of the results between TRUS and pathology was better than that between MR and pathology(Kappa1 =0.783,Kappas =0.652).Conclusions TRUS is proved to have an important diagnostic value for CRM of mid-low rectal cancer.