Objective To observe the clinical efficacy of combining Yuan-Primary and Luo-Connecting points in treating insomnia due to imbalance between heart and kidney, for providing novel method and evidence for the treatment of insomnia with acupuncture-moxibustion.Method Totally 100 insomnia patients due to imbalance between heart and kidney were randomized into a treatment group and a control group, 50 in each. The treatment group was intervened by acupuncture at Yuan-Primary and Luo-Connecting points, while the control group was by conventional acupuncture. The Pittsburgh Sleep Quality Index (PSQI), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) were observed before and after intervention for efficacy evaluation.Result The PSQI item scores were significantly changed after intervention in both groups (P<0.05). The SAS and SDS scores were significantly different from that before treatment in both groups (P<0.05). After treatment, the SAS and SDS scores of the treatment group were significantly different from that of the control group (P<0.05). The recovery rate and total effective rate were 26.0% and 92.0% in the treatment group versus 12.0% and 86.0% in the control group, and there was a significant difference in comparing the recovery rate (P<0.05).Conclusion Combining use of Yuan-Primary and Luo-Connecting points is an effective approach in treating insomnia due to imbalance between heart and kidney.

Objective To observe the effect of Huoxue Jiedu Recipe(Herbal recipe for activating blood and removing toxins)on proliferation and cell cycle status of keratinocytes cultured in vitro in psoriasis.Methods Using the serum pharmacologic technique,the clean SD rats were adopted to make the Huoxue Jiedu Recipe medicated serum(high,moderate,low dose),Dexamethasone medicated serum,and blank serum,which were added into the keratinocytes culture system respectively.After incubated for 48 hours,the cell proliferation of keratinocytes was measured by MTT assay,and the cell cycle distribution estimated with flow cytometer(FCM).Results The different density of Huoxue Jiedu Recipe could all inhibit significantly the generation of COLO-16 keratinocyte line and change the distribution proportion of each phase in the cell division cycle.Conclusion Huoxue Jiedu Recipe treats psoriasis through inhibiting the proliferation of keratinocytes.

Objective : To investigate the status of occupational stress, burnout, and coping styles, and to explore the moderating effects of coping styles on the relationship between occupational stress and burnout among medical staff from one tertiary first-class hospital in Hubei Province, in order to provide the basis for mental health promotion of medical staff. Methods: From June to October in 2020, using stratified cluster sampling, doctors, nurses, and medical or pharmaceutical technicians on the ratio of 2∶2∶1 were selected from the tertiary first-class hospital. Chinese version of Burnout Questionnaire, Core Occupational Stress Scale (COSS) and Trait Coping Style Questionnaire were used to investigate the levels of burnout, occupational stress and coping styles. A linear stratified regression model was used to analyze the moderating effect of coping styles on the relationship between occupational stress and burnout. Results: Among 735 questionnaires issued, 679 valid ones were collected, with the response rate of 92.38%. The age of the respondents was ( 34.29±8.20 ) years old. There were 165 ( 24.30% ) males and 514 ( 75.70% ) females, including 241 ( 35.49% ) doctors, 358 ( 52.72% ) nurses and 80 (11.78%) medical or pharmaceutical technicians. The burnout score was 2.29±1.11 , and the positive rate of burnout was 44.33%; the COSS score was 47.32±8.31; the positive and negative coping style scores were 30.64±6.06 and 26.81±6.26, respectively. The linear stratified regression analysis suggested that the interactions between social support ( β=0.590, P<0.05 ), organization and reward ( β=0.523, P<0.05 ), and positive coping style were positively associated with burnout, and the interaction between organization and reward (β=-0.666, P<0.05) and negative coping style was negatively associated with burnout. Conclusions About 44.33% of medical staff investigated have burnout. Coping styles have a moderating effect on the relationship between occupational stress and burnout. Positive coping style helps to perceive social support and organizational support, to alleviate the adverse effects of occupational stress, and to reduce the risk of burnout.

Objective To clarify the effects of Jisuikang on expression levels of BDNF and NGF protein in serum of rats with spinal cord injury;To explore its probable mechanism to improve the axon regeneration microenvironment and resistance spinal cord injury.Methods Ninety SD rats were chosen to establish acute spinal cord injury model through modified Allen's method. 15 rats were chosen randomly as sham-operation group, and the other 75 rats were randomly divided into model group, prednisone group and high-, medium-, and low-doseJisuikang groups. All administration groups were given relevant medicine for gavage, while rats in sham-operation group and model group were given normal saline with the same volume for gavage. The activity and death condition of rats were recorded. Rats were put to death on the 3rd, 7th and 14th d of intervention for carotid artery blood collection. The expressions of BDNF and NGF in serum were detected by ELISA.Results After modeling, the rats in model group showed a typical paraplegia syndrome. 3 day after operation, BDNF showed no statistical significance between model group and prednisone group, while each treatment group showed significant difference when compared with prednisone group (P<0.05,P<0.01). 7 d and 14 d after operation, compared with the model group, BDNF of prednisone group and medium-dose Jisuikang group showed statistical significance, and there was no significant difference between prednisone group and medium-dose Jisuikang group (P<0.05,P<0.01). The expression of NGF in each treatment group at each time point with the prednisone group showed statistical significance. 3 d and 7 d after operation, among prednisone group, high- and medium-doseJisuikang groups, the expression of NGF was significantly higher than model group. 14 d after operation, compared with the model group, the expression of NGF in medium- and low-dose Jisuikang groups and prednisone group still maintained at a relatively high level, with statistical significance (P<0.05,P<0.01).Conclusion Jisuikang can effectively promote the expressions of BDNF and NGF in serum after spinal cord injury and maintained at a relatively high level, so as to improve the microenvironment of axonal regeneration and promote nerve regeneration.

Objective To establish serum NGAL reference range of healthy populations in Xi'an Area.Methods 2 665 cases (aged 6 to 95 years old,male 1 370,female 1 295) of health-check people were collected from March 2014 to October 2016 in Medical Examination Center of Shaanxi Provincial People's Hospital,and 682 cases (aged 0 to 6 years old,male 356,female 326) were collected from preschool children of prevention.Serum NGAL concentration of them were analysed by immunoturbidimetry method with the Automatic Biochemical Analysis Assembly Line of Beckman-AU5800,and the detection data for statistical analysis.Then established the reference range of serum NGAL population of different age and different sex in Xi'an.Results The serum NGAL levels in healthy subjects showed a skewed distribution,which were preschool children under 6 years of age 37.66±23.12 ng/ml,6～15 years 39.25±25.34 ng/ml,16～49 years 46.68±27.06 ng/ml,and 50～ 69 years 57.82±29.13 ng/ml.Compared the first two with the latter,there was a significant difference (t=0.589,P＜ 0.05).The serum NGAL levels of over 70 years were 61.87 ± 32.64 ng/ml,and there was a significant difference between the ages of 15 and 49 and over 70 years (t=8.529,P＜0.01).At the same time,the serum NGAL was closely correlated with age (r=0.298,P＜0.01).But there was no significant difference in serum NGAL level between male and female (t=0.263～0.542,all P＞0.05).87ng/ml was the upper limit of the reference value for the age of 50 years.Conclusion The level of serum NGAL was related to age and increased with age,but not with gender.

Objective To explore the impact and protective mechanisms of head cooling on neural activity during passive hyperthermia.Methods Sixteen subjects were randomly exposed for 1 h to three different conditions: normal (25℃), hot (50℃) and head cooling (chamber:50℃,cold packs:5℃),after environment exposure, rs-fMRI were performed.Regional homogeneity(ReHo) datum at three different conditions were analyzed by REST2.0 to obtain brain areas with statistical difference.Brain voxel with statistical difference were selected as ROIs to ReHo values and were analyzed by One-Way ANOVA with SPSS18.0.Neural activity of brain areas with statistical difference were compared in any two groups by Post hoc.Results The brain regions showing differences among three groups included right orbital frontal cortex,left middle frontal gyrus,bilateral amygdala,left middle temporal gyrus,left hippocampus,bilateral parietal inferior, left precentral gyrus.Compared with normal group, ReHo increased in right orbital frontal cortex, and decreased in left precentral gyrus,left middle frontal gyrus,left parietal inferior,but no changed in bilateral amygdala,left middle temporal gyrus,left hippocampus,right parietal inferior in head cooling group.Compared with hot group,head cooling group showed increased ReHo in left middle temporal gyrus,left hippocampus,right parietal inferior,and decreased ReHo in bilateral amygdala,left parietal inferior,unchanged ReHo in right orbital frontal cortex, left precentral gyrus, left middle frontal gyrus.Conclusion The specified alterations of ReHo may reflect that the head cooling could partially eliminate the impact of passive hyperthermia, and is closely linked with emotional function.

Objective This study aims to explore the application value of tuberculosis T lymphocytes enzyme-linked immune SPOT test (T-SPOT.TB) on early diagnosis of tuberculosis.Methods The TB infection in 189 inpatients suspected tuberculosis in pneumology department of Shaanxi Provincial People's Hospital was detected with T-SPOT.TB,fluorescence RQPCR,tuberculosis (TB-Ab)protein chip and PPD methods.Results The sensitivity of four methods was 91.54％ (119/130),73.85％(96/130),63.08％(82/130) and 57.69％ (75/130) respectively and the specificity of those was 89.83％ (53/59),86.44％(51/59),67.79％(40/59) and 66.10％(39/59),respectively.The sensitivity of T-SPOT.TB method was statistically higher than those of other three tests,respectively (P＜0.05).The specificity of T-SPOT.TB was significantly higher than those of TB-AB and PPD (P＜0.05),but there was no statistical difference between RQ-PCR and T-SPOT.TB (P＞0.05).The positive predictive values of T-SPOT.TB,fluorescent quantitative PCR,TB-Ab and PPD assays were 95.2％ (119/1250),92.3％ (96/104),81.2％ (82/101) and 78.9％ (75/95) respectively while the negative predictive values of those were 82.8％ (53/64),60％ (51/85),45.5％ (40/88) and 41.5％ (39/94),respectively.The false-positive rates (misdiagnosis rate) of four assays were 10.2％ (6/59),13.6％ (8/59),32.2％ (19/59) and 33.9％ (20/59) respectively and the false-negative rates (rates of missed diagnosis) of those were 8.5％ (11/130),26.2％ (34/130),36.9％ (48/130)and 42.3 ％ (55/130),respectively.The negative likelihood ratios of T SPOT.TB,fluorescent quantitative PCR,TB-Ab and PPD assays were 0.11,0.16,0.48 and 0.51 respectively,meanwhile the positive likelihood ratios of T-SPOT.TB,fluorescent quantitative PCR,TB-Ab andPPD assays were 9.0,5.4,2.0 and 1.7,respectively.What' s more,the diagnostic accordance rates of the four assays were 91.0％ (172 189),77.8％ (147 189).64.6％ (122/189) and 60.3％ (114/189),respectively.Conclusion T-SPOT.TB test is a more sensitive and specific method and of great significance to the early diagnosis of TB,which has more clinical value in different stages of tuberculosis diagnosis.

Objective To evaluate the clinical effects of CT-guided 125I radioactive seed implantation in treatment of stage Ⅲ non-small cell lung cancer ( NSCLC ) and the influential factors of prognosis.Methods 247 patients of stage Ⅲa/Ⅲb NSCLC underwent CT-guided 125I radioactive seed implantation.The clinical effects and the factors affecting prognosis were analyzed by univariate and multivariate analyses.Results The 1-,3-,and 5- year overall survival rates were 82.8％,23.8％,and 11.5 ％,respectively.The median survival time was 24.8 months,and the local control rate was 92.2 ％,63.8％,and 25.7％,respectively.The 5- year overall survival rate was 14.7％,and the median survival time was 29.7 months of the stage Ⅲ,patients.And the 5- year overall survival rate was 11.2％,and the median survival time was 24.0 months at the stage Ⅲb.Univariate analysis showed that age,course of disease,hemoglobin before treatment,clinical stage,maximum diameter of tumor,prescribed dose (PD),post-operational mean dose,post-operational dose covering 100％ volume (D100),remedial model were the main prognostic factors; however,multivariate analysis revealed that hemoglobin ≥ 120 g/L before treatment,post-operational dose covering 100％ volume (D100) and maximum diameter of tumor were the independent risk factors for predicting the survival.Aerothorax was observed in 37 patients with an incidence rate of 14.9％,and hemothorax was observed in 22 patients with an incidence rate of 9％.Conclusions 125I radioactive seed implantation therapy is effective in the treatment of stage Ⅲ NSCLC.Hemoglobin level before treatment,post-operational dose covering 100％ volume (D100 ),and maximum diameter of tumor are the main prognostic factors for the NSCLC patients treated with radiotherapy for NSCLC.

Atherosclerosis (As) is an important pathological basis of cardiovascular and cerebrovascular diseases. The pathogenesis studies of As have been a hot topic in the field of vascular biology research. The inflammation is known as a major participant in the development process of As. And monocyte-macrophage plays a central role in inflam-mation. In recent years, with the deepening research on inflammatory mechanisms, the As macrophage polarization is attracting researchers' attention. Under different environmental inductions, macrophages develop into M1 and M2 phenotypes. M1 macrophages (classical type), which can stimulate the secretion of pro-inflammatory cytokines, is generally considered as pro-inflammatory subtypes and can facilitate the progress of As. Whereas, M2 macrophages (alternative type), which can inhibit pro-inflammatory factor production, function as anti-inflammatory subtypes and likely to inhibit the progression of As. The mechanisms of As, macrophage polarization in As, and opportunities for herbal medicines will be summarized in this review.

Objective To explore the effect of exercise preconditioning on inflammatory response in ischemic stroke brain tissue which mediated by miR-146a in extracellular vesicles in rats with middle cerebral artery oc-clusion(MCAO),and its mechanism.Methods Sixty 6-week-old male Sprague-Dawley rats were randomly divid-ed into a non-exercise group and an exercise group.The non-exercise group was further divided into a sham-operation control group(C,n=15)and an MCAO model group(M,n=15),while the exercise group was further di-vided into an exercise only group(E,n=15)and an exercise plus MCAO model group(EM,n=15).Rats in the E and EM groups underwent 8 weeks of treadmill exercise,6 days per week,30 minutes per day.Then rats in the M and EM groups received MCAO to induce ischemic stroke,while the C and E groups underwent a sham surgery.Twenty-four hours after the surgery,neurobehavioral tests were performed.Plasma was collected to ex-tract extracellular vesicles,and brain tissue was collected to measure the volume of cerebral infarction by using the triphenyl tetrazolium chloride(TTC)staining.Moreover,the Nissl staining was conducted to observe neuronal and Nissl body.Mean while,the content of miR-146a in plasma extracellular vesicles and brain tissue was mea-sured by using the quantitative polymerase chain reaction(qPCR),and the expression of TNF receptor associat-ed factor 6(TRAF6),nuclear factor kappa-B(NF-κB)and tumor necrosis factor-α(TNF-α)in brain tissues were determined using Western blotting.The targeting relationship between miR-146a and TRAF6 was detected by using the dual luciferase reporter gene assay.Results(1)The neurological behavioral scores of the EM and M groups were higher than those of the C group(P<0.01 and P<0.01),with that of the EM group lower than the M group(P<0.01).(2)TTC staining showed that the infarct volume of the EM and M groups was larger than that of the other two groups(P<0.01 and P<0.01),with that of the EM group smaller than the M group(P<0.01).(3)Nissl staining results showed that the neuronal arrangement was loose,the number of neurons re-duced,and the Nissl bodies were lightly stained and decreased in the M group compared with the C and E groups.Moreover,compared with the M group,the number of neurons and Nissl bodies increased in the EM group.(4)The qPCR analysis showed that the expression of miR-146a in the plasma-derived exosomes and brain tissues of the EM and M groups decreased compared with the C group(P<0.05 and P<0.01),with that of the EM group higher than the M group(P<0.05).(5)According to Western blotting,compared with the C group,the expression levels of TRAF6,NF-κB,and TNF-α proteins increased significantly(P<0.05 and P<0.01),with that of group EM signfiicantly lower than group M(P<0.05 and P<0.05).(6)Dual-luciferase report-er gene assay showed that miR-146a had a specific binding site with TRAF6.Conclusion Eight weeks of exer-cise preconditioning reduces the infarct area and the extent of brain damage,which may be mediated by miR-146a via exosomes,increasing the expression of miR-146a in brain tissue,targeting TRAF6,negatively regulat-ing TRAF6/NF-κB,and reducing the expression of TNF-α,thus alleviating the inflammatory response in brain tissue and exerting a protective effect on ischemic brain injury.