Objective The purpose is to discuss the characteristics of the TCM syndromes of the patients with advanced gastric cancer, in order to reveal the pathological characteristics of Chinese medicine. Methods By observing the symptoms and signs of 126 patients with advanced gastric cancer, the TCM syndromes was used to analyze the distribution of TCM syndromes' frequency and the scores of symptoms. Results The resut showed that the common TCM syndromes for the disease location were stomach, spleen, liver, kidney, gallbladder, large intestine, small intestine, lung, utreus, heart, brain and bladder, where the frequency of stomach, spleen were higher than other. And the common TCM syndromes for the disease pathology were Qi deficiency, blood deficiency, Qi stagnation, blood stasis, toxin, phlegm, dampness, Yin deficiency, Qi revresion, heat, food stagnation, water stagnation and Yang deficiency.Conclusions The common TCM syndromes for the disease location of advanced gastric cancer were stomach, spleen, liver, kidney; And the common TCM syndromesfor the disease pathology were Qi deficiency and blood deficiency, Qi stagnation, blood stasis, toxin, phlegm, dampness, Yin deficiency, Qi revresion, heat, food stagnation, water stagnation and Yang deficiency.

Objective To analyze the hot spots and frontiers in domestic and foreign precision medicine with CiteSpace. Methods The CNKI and WOS-covered papers on precision medicine were analyzed by bibliometrics combined with CiteSpace. Results Domestic precision medicine got off in 1992 and scholars became interested in it from 2010 . Foreign precision medicine started in 1985 and studies on it increased rapidly from 2006 . The node of precision medicine was the largest in China with a rather high value of gene mutation, US president Barack Obama ( precision medicine program) , personalized medicine, gene chip, genomics and pharmacogenomics whereas the node of personalized medicine, cancer and breast cancer was the largest with a rather high value of precision medi-cine, pharmacogenomics and pharmacogenetics. Conclusion The number of domestic and foreign papers on US president Barack Obama ( precision medicine program) is rapidly increased and pharmacogenomics is their common frontier. However, cancer is highly concerned in foreign countries.

Objective To study the effects of living environment conditions and animal-animal interaction on the blood hormone levels and psychological behavior in Chinese tree shrews .Methods Chinese tree shrews were raised in ca-ges of different space sizes or were administered reserpine for 15, 30, 60, 120, 180 days, respectively.Then the animals were anesthetized by ether inhalation , and blood samples were taken from the heart to detect the levels of blood testosterone (T), estradiol (E2), endothelin (ET), adrenaline (A) and noradrenaline (NA) by radioimmunoassay (RIA).Results 1.Chinese tree shrews were bred in large cage (D1group) or small cage (X1 group) for 15, 30, 60, 120, 180 days, re-spectively.Compared with the animals bred in the large cage (D1 group), the level of blood testosterone (T) was signifi-cantly reduced (P<0.01), and the levels of adrenaline , noradrenaline and endothelin were significantly increased in the small cage group (P<0.01 for all).2.The animals raised in small cages in close neighborhood with large cages for 15, 30, 60, 120, 180 days, respectively.The levels of testosterone, adrenaline and noradrenaline in the large cage group (X2 group) were significantly higher than those of the small cage group (X1 group) (P<0.01 for all).3.The adrenaline and noradrenaline levels were significantly lower in all the reserpine groups (P<0.01 for all).4.The animals bred in small cages (X1 group) and in small cages in close neighborhood with large cages showed sudden loss , reduced appetite, testicu-lar atrophy , penile prolapse and stress symptoms .The animals of the reserpine groups appeared gentle temperament , signif-icantly reduced activity and reduced appetite .However , after stopping the reserpine administration and feeding them in large cages , the animals gradually returned to normal behavior .Conclusion Both animals living environment conditions and animal-animal interaction may cause changes of blood hormone levels and psychological behavior in Chinese tree shrews.

Objective To predict clinical chemotherapy sensitivity of primary ovarian cancer by jointing adenosine triphosphate(ATP) - tumor chemo-sensitivity assay(TCA) method in vitro and detection of drug resistance genes, provide reference for clinical treatment. Methods Forty-seven primary epithelial ovarian tumor samples were collected from the patients who received cytoreductive surgery. Viable ovarian cancer cells obtained from malignant tissue were tested for their sensitivity to carboplatin (CBP), cisplatin (DDP), paclitaxel(PTX) and CBP + PTX using ATP-TCA method in vitro; at same time, real-time quantitative PCR was used to analysis BRCA1 and ERCC1 mRNA relative expression in forty-six specimens (1 frozen tumor samples mRNA were not detected due to serious degradation). The relationship between ATP-TCA test results, clinical indicators, and the effectiveness of the joint prediction on clinical chemosensitivity by combining these two methods were statistically analyzed using chi-square test. Results (1)The results showns that three programs of DDP,CBP and PTX + CBP were significantly related with clinical results(P<0.05) in vitro, in which the compliance rate in PTX + CBP program was the highest 83%(39/47) ,and the predictive sensitivity, predictive specificity, positive predictive value, negative predictive value and predictive accurate rate were 90%,71%,84% and 80% ,respectively.PTX + CBP combined in vitro test results was also related with residual tumor size and neoadjuvant chemotherapy, which was more prone to drug resistance with residual tumor larger than 2 cm (P = 0. 023) and with neoadjuvant chemotherapy (P = 0.011). (2) BRCA1 mRNA expression levels in the clinical-resistant group and the clinical-sensitive group was 0.673 ± 2.143 and - 1.436 ± 2.594 (P=0.008), ERCC1 mRNA expression levels in the clinical-resistant group and the clinical-sensitive group was -0.529 ± 1.982 and - 3.188 ±2.601 (P =0.001). There were also significant correlation among the expression levels of BRCA1 ,ERCC1 mRNA and clinical efficacy (P<0.01). (3)ATP-TCA and detection of drug resistance genes combined to predict the clinical application of PTX + CBP resistance may occur in 8/9 cases. Conclusions ATP-TCA may be an ideal method of in vitro drug sensitivity testing method, which could effectively predict clinical chemotherapy sensitivity. Combination of the drug-resistant associated genes detection method and the ATP-TCA method can increase the predictive effectiveness of ovarian cancer chemosensitivity and guide individual chemotherapy of ovarian cancer.

Objective To investigate the impact of overweight on the prognosis of patients with acute mild ischemic stroke or moderate-high risk transient ischemic attack(TIA).Methods A total of 366 patients with acute mild ischemic stroke or moderate-high risk TIA who carried CYP2C19 loss-of-function alleles were included in the study.Baseline data were collected at admission,and clinical outcomes were collected within 3 months post-onset(primary outcomes:stroke recurrences within 3 months post-onset;secondary outcomes:composite outcome of stroke recurrence or death within 3 months post-onset,vascular events,and quality of life within 3 months).Kaplan-Meier method was used to plot the cumulative incidence curve of outcomes.Multivariate Cox proportional hazards mod-el and multivariate Logistic regression model were used to evaluate the relationship between over-weight and clinical outcomes within 3 months post-onset in patientswith ischemic stroke or TIA.The integrated discrimination improvement index(IDI)and net reclassification improvement index(NRI)were calculated to assess the predictive value of adding body mass index(BMI,whether o-verweight or not)based on traditional models for predicting the prognosis of acute ischemic stroke or TIA.Results After 3 months of follow-up,28 patients had stroke recurrence,1 patient died,and 31 patients had vascular events.The Kaplan-Meier cumulative incidence curve showed that the cu-mulative incidences of stroke recurrence,stroke recurrence or death,and vascular events after 3 months of onset were lower in overweight patients compared with non-overweight patients(Log-rank P＜0.05).Multivariate analysis showed that compared with non-overweight patients,overweight pa-tients had significantly reduced risks of stroke recurrence within 3 months(HR=0.24;95％CI,0.08 to 0.71),composite outcome of stroke recurrence or death(HR=0.24;95％CI,0.08 to 0.69),and vascular events(HR=0.22;95％CI,0.07 to 0.63),and significantly improved qual-ity of life within 3 months(OR=0.39;95％CI,0.20 to 0.76).The IDI and NRI calculations showed that compared with traditional models,the new model adding BMI(whether overweight)had significantly improved predictive ability for the prognosis of acute ischemic stroke or TIA.Conclu-sion Overweight may be a protective factor for the prognosis of TIA patients with acute mild ische-mic stroke or moderate-high risk who carry CYP2C19 loss-of-function alleles.Compared with non-o-verweight patients,overweight patients have reduced risks of stroke recurrence,composite outcome of stroke recurrence or death,and vascular events within 3 months post-onset,and improved quality of life within 3 months post-onset.

Objective To investigate the impact of overweight on the prognosis of patients with acute mild ischemic stroke or moderate-high risk transient ischemic attack(TIA).Methods A total of 366 patients with acute mild ischemic stroke or moderate-high risk TIA who carried CYP2C19 loss-of-function alleles were included in the study.Baseline data were collected at admission,and clinical outcomes were collected within 3 months post-onset(primary outcomes:stroke recurrences within 3 months post-onset;secondary outcomes:composite outcome of stroke recurrence or death within 3 months post-onset,vascular events,and quality of life within 3 months).Kaplan-Meier method was used to plot the cumulative incidence curve of outcomes.Multivariate Cox proportional hazards mod-el and multivariate Logistic regression model were used to evaluate the relationship between over-weight and clinical outcomes within 3 months post-onset in patientswith ischemic stroke or TIA.The integrated discrimination improvement index(IDI)and net reclassification improvement index(NRI)were calculated to assess the predictive value of adding body mass index(BMI,whether o-verweight or not)based on traditional models for predicting the prognosis of acute ischemic stroke or TIA.Results After 3 months of follow-up,28 patients had stroke recurrence,1 patient died,and 31 patients had vascular events.The Kaplan-Meier cumulative incidence curve showed that the cu-mulative incidences of stroke recurrence,stroke recurrence or death,and vascular events after 3 months of onset were lower in overweight patients compared with non-overweight patients(Log-rank P＜0.05).Multivariate analysis showed that compared with non-overweight patients,overweight pa-tients had significantly reduced risks of stroke recurrence within 3 months(HR=0.24;95％CI,0.08 to 0.71),composite outcome of stroke recurrence or death(HR=0.24;95％CI,0.08 to 0.69),and vascular events(HR=0.22;95％CI,0.07 to 0.63),and significantly improved qual-ity of life within 3 months(OR=0.39;95％CI,0.20 to 0.76).The IDI and NRI calculations showed that compared with traditional models,the new model adding BMI(whether overweight)had significantly improved predictive ability for the prognosis of acute ischemic stroke or TIA.Conclu-sion Overweight may be a protective factor for the prognosis of TIA patients with acute mild ische-mic stroke or moderate-high risk who carry CYP2C19 loss-of-function alleles.Compared with non-o-verweight patients,overweight patients have reduced risks of stroke recurrence,composite outcome of stroke recurrence or death,and vascular events within 3 months post-onset,and improved quality of life within 3 months post-onset.

Objective:To investigate the types, incidences, and clinical characteristics of shock in polytrauma patients at different stages after polytrauma.Methods:A retrospective study was conducted on polytrauma patients admitted to multiple trauma centers from June 2020 to December 2021. The inclusion criteria were patients >18 years old and treated due to polytrauma. Exclusion criteria included an admission time of more than 48 h after trauma, a history of malignancy, or metabolic, consumptive, and immunological diseases. The early stage was defined as the period of ≤48 h after polytrauma, and the middle stage was defined as the period between 48 h and 14 days. The patient’s medical history, clinical manifestations, laboratory tests, imaging examination, injury severity score (ISS), and Glasgow coma scale (GCS) were collected. The types, incidences, and clinical characteristics of shock in different stages after polytrauma were analyzed, according to the diagnostic criteria of each type of shock. The differences between the groups were compared by Student’s t test, χ2 test or Mann-Whitney U test. Results:The incidence of the early and middle stage shock after polytrauma were 73.1% and 36.4%, respectively, with statistically significant difference between stages ( P<0.01). There were significant differences in the incidence of hypovolemic shock (83.6% vs. 28.4%), distributed shock (13.7% vs. 80.9%) and cardiogenic shock (3.5% vs. 6.6%) between stages (all P<0.05). The incidence of obstructive shock (8.4% vs. 9.7%, P>0.05) was similar between stages. The incidence of undifferentiated shock was 1.6% and 1.2%, respectively. There were 9.5% patients with multifactorial shock in the early stage and 14.4% in the middle stage. Totally 7 combinations of multifactorial shock were found in different stages after polytrauma. In the early stage, the combination of HS and DS accounted the highest ratio (42.3%) and followed by HS and OS for 28.8%. In the middle stage, the combination of HS and DS was the most common (48.6%) and followed by DS and OS (24.3%). Conclusions:The incidence of shock in polytrauma patients is high. Different types of shock can occur simultaneously or sequentially. Therefore a comprehensive resuscitation strategy is significant to improve the success rate of treatment.