OBJECTIVE To establish a interview outline design process and quality control evaluation method based on grounded theory， providing ideas for qualitative research interview outline design in medical fields. METHODS A literature review was conducted to understand the current research status； a preliminary interview outline was developed around the research content. The triangulation method， group evaluation， expert review and pre-interview were adopted to execute the interview outline and conduct quality control. The evaluation indicators and target values were formulated （an average score for the overall quality evaluation of all indicators ≥4.5， and an average score for individual indicators ≥4.00） to evaluate the effect of the interview outline. Taking the research on the mechanism of physicians’ prescribing behavior under the background of Diagnosis Related Groups （DRGs） payment as an example， the methodological contents of above interview outline were applied in practical research. RESULTS The interview outline included basic information and interview questions. The interview questions were divided into three parts：influencing factors survey， promoting and hindering factors of standardizing physician prescription behavior， and communication， with a total of 12 questions. After being reviewed by members of the research group， experts review and pre- interview， a total of 9 people participated in the quality control evaluation of the interview outline. The overall evaluation score was 4.94 （＞4.50）， and the average score of each indicator was greater than 4.00， indicating that the quality of the outline met the requirements for the interview and could be used for the formal interview. CONCLUSIONS The established interview outline design and quality control method based on grounded theory provides ideas for the qualitative research interview outline design in the medical field， and lays the foundation for further using grounded theory to study the influencing factors and mechanisms of physician prescription behavior under the DRG background.

Objective: To explore the impacts of coal mine dust on lung function in rats, so as to provide the basis for the early prevention and treatment of coal worker's pneumoconiosis. Methods: Seventy-two SPF-grade 8-week-old male Sprague-Dawley rats were randomly divided into the coal dust group, the coal-silica dust group, the silica dust group and the control group. The rats in the first three groups of rats were administered 1 mL corresponding dust suspension into the lungs using non-exposure tracheal instillation, while the rats in the control group were administered 1 mL normal saline. Respiratory rate (f), forced vital capacity (FVC), peak expiratory flow (PEF) and dynamic pulmonary compliance (Cdyn) were measured at 1, 3 and 6 months after dust exposure. Lung tissues were collected to measure reactive oxygen species (ROS) and adenosine triphosphate (ATP) levels using corresponding ELISA kits and ATP assay kits, respectively. The relative mRNA expressions of peroxisome proliferators-activated receptor gamma coactivator 1-alpha (PGC-1α) and mitochondrial transcription factor A (TFAM) were detected using real-time fluorescent quantitative polymerase chain reaction assay. The relative protein expressions of PGC-1α and TFAM were detected using Western blotting. Results: There was no interaction between dust type and exposure duration on f (P>0.05), but there were interactions on FVC, PEF and Cdyn (all P<0.05). Compared with the control group at 6 months after dust exposure, the f of the rats in the silica dust group were increased, while the FVC and PEF of the rats in the coal-silica dust and silica dust groups were decreased, and Cdyn of the rats in the coal dust, coal-silica dust and silica dust groups were decreased (all P<0.05). There were interactions between dust type and exposure duration on ROS and ATP levels, the relative mRNA and protein expressions of PGC-1α and TFAM (all P<0.05). Compared with the control group at 3 and 6 months after dust exposure, the ROS levels in the rats in the coal dust, coal-silica dust and silica dust groups were increased, while the ATP levels, the relative mRNA and protein expressions of PGC-1α and TFAM were decreased (all P<0.05). Conclusion The lung function impairment in rats caused by different types of coal mine dust is related to PGC-1α-mediated mitochondrial biogenesis dysfunction, which leads to increased ROS levels, decreased ATP and TFAM levels.

This paper summarizes Professor ZHAI Shuangqing's clinical experience in using metal and mineral medicines to treat mental disorders. Based on xiang thinking， the symptoms of mental disorders are classified into five categories， depression-xiang， wind-xiang， fire-xiang， phlegm-xiang， and deficiency-xiang， and the mechanisms of disease development are discussed accordingly. Metal and mineral medicines are key treatments for mental disorders， not only having the function of calming the mind but also promoting qi， stabilizing wind， expelling evil， and tonifying. In clinical practice， the emphasis is placed on harmonizing the disease and its symptoms. Based on self-developed prescription formulas， the appropriate metal and mineral medicines are selected according to the properties， flavors， meridian tropism， and actions of the medicines， as well as the xiang patterns of the mental disorder. For example， Attention Deficit Hyperactivity Disorder （ADHD） is treated by Modified Xiehuang Powder （泻黄散） with Sijunzi Decoction （四君子汤） and adding Fulonggan （Testudinis Carapax） and Longgu （Os Draconis）. Persistent insomnia is treated by combining a self-developed insomnia formula with Longgu （Os Draconis）， Hupo （Succinum）， and Cishi （Magnetitum）. Obsessive-compulsive disorder （OCD） is treated by combining a self-developed OCD formula with Longchi （Dens Draconis）， Qingmengshi （Fluoritum）， and Zheshi （Haematitum）. Epilepsy is treated by combining an anti-epilepsy decoction with Qingmengshi （Fluoritum）， Longchi （Dens Draconis）， and Shengtieluo （Ferrum Rudis）.

A wealth of prior studies has confirmed that intratumoral microbiota can survive within tumor tissue, thereby promoting or inhibiting tumor growth. With the development of high-throughput sequencing and metabolomics, increasing attention has been paid to the correlation between intratumoral microbiota and host metabolism, and their effect on tumorigenesis and progression. This review focuses on the interaction between intratumoral microbiota and tumor metabolism. It emphasizes the effects of intratumoral microbiota on tumor sugar, lipid, and amino acid metabolism and explores emerging therapeutic strategies for guiding tumor prevention and treatment by modulating tumor metabolism. Although the specific role of intratumoral microbiota in tumor metabolism remains to be further studied, a deepened understanding of the interaction between tumor-specific microbiota and tumor metabolism may provide new directions and application prospects for tumor prevention and treatment.

Objective To explore the potential causality between visceral adipose tissue (VAT) and inflammatory bowel disease, peptic ulcer disease, irritable bowel syndrome and gastroesophageal reflux disease. Methods Two-sample Mendelian randomization (MR) investigations were carried out, employing genetic variants closely linked with VAT as instrumental variables. The summary data for aforementioned gastrointestinal disorders were obtained from the genome-wide association study (GWAS) in UK biobank and Finn Gen databases, respectively. The inverse variance-weighted method (IVW) was employed as the primary analytical method, bolstered by a sequence of sensitivity analyses to verify the robustness of MR. Subsequently, a meta-analysis was conducted to amalgamate the findings derived from both databases. Results This study included a total of 42 single nucleotide polymorphisms that were strongly associated with visceral adipose tissue as instrumental variables. Statistically significant correlations were found between VAT and peptic ulcer (OR=1.17, 95% CI: 1.08-1.27, P < 0.01), gastroesophageal reflux disease (OR=1.10, 95% CI: 1.03-1.18, P = 0.02), and irritable bowel syndrome (OR=1.12, 95% CI: 1.04-1.12, P = 0.03). There was no statistical significance between VAT and inflammatory bowel disease (OR=0.94, 95% CI: 0.79-1.12, P = 0.65). Conclusion VAT exhibits a causal linkage with peptic ulcer, gastroesophageal reflux disease, and irritable bowel syndrome. Accurately assessing VAT levels via imaging methods, screening individuals at high-risk, and actively controlling abdominal obesity bear important clinical significance.

OBJECTIVE: To observe the efficacy and safety of Tiaowei Jiannao acupuncture (acupuncture for regulating defensive qi and nourishing brain) for post-ischemic stroke insomnia (PISI). METHODS: A total of 96 patients with PISI were randomized into an acupuncture group (32 cases, 1 case was excluded), a medication group (32 cases, 1 case dropped out, 1 case was excluded) and a sham-acupuncture group (32 cases, 1 case dropped out, 1 case was excluded). In the acupuncture group, Tiaowei Jiannao acupuncture was applied at bilateral Shenmai (BL62), Zhaohai (KI6), Hegu (LI4), Taichong (LR3), and Baihui (GV20), Sishencong (EX-HN1), Yintang (GV24⁺), Shenting (GV24), once a day, 1-day interval was taken after 6-day treatment, for 3 weeks totally. In the medication group, eszopiclone tablet was given orally, 1-3 mg a time, once a day for 3 weeks. In the sham-acupuncture group, non-invasive sham acupuncture was applied, the acupoint selection, frequency and course of treatment were the same as the acupuncture group. Before treatment, after 2,3 weeks of treatment, the scores of Pittsburgh sleep quality index (PSQI), self-rating sleep scale (SRSS), National Institutes of Health Stroke scale (NIHSS), Hamilton depression scale-17 (HAMD-17) were observed; before and after treatment, the sleep parameters were recorded using polysomnography (PSG); and the efficacy and safety were evaluated after treatment in the 3 groups. RESULTS: After 2,3 weeks of treatment, the scores of PSQI, HAMD-17 and SRSS in the acupuncture group and the medication group, as well as the SRSS scores in the sham-acupuncture group were decreased compared with those before treatment (P<0.05); after 2 weeks of treatment, the NIHSS score in the acupuncture group was decreased compared with that before treatment (P<0.05); after 3 weeks of treatment, the NIHSS scores in the acupuncture group, the medication group and the sham-acupuncture group were decreased compared with those before treatment (P<0.05). After 3 weeks of treatment, the scores of PSQI, SRSS, HAMD-17 and NIHSS in the acupuncture group and the medication group, as well as the NIHSS score in the sham-acupuncture group were decreased compared with those after 2 weeks of treatment (P<0.05). After 2,3 weeks of treatment, the scores of PSQI, SRSS and HAMD-17 in the acupuncture group and the medication group were lower than those in the sham-acupuncture group (P<0.05), the NIHSS scores in the acupuncture group were lower than those in the medication group and the sham-acupuncture group (P<0.05); after 3 weeks of treatment, HAMD-17 score in the acupuncture group was lower than that in the medication group (P<0.05), the NIHSS score in the medication group was lower than that in the sham-acupuncture group (P<0.05). Compared before treatment, after treatment, the total sleep time was prolonged (P<0.05), the wake after sleep onset, sleep latency, and non-rapid eye movement (NREM) sleep latency were shortened (P<0.05), the sleep efficiency was improved (P<0.05), the number of awakenings was reduced (P<0.05), the percentage of rapid eye movement (REM%) and the percentage of NREM stage 1 (N1%) were decreased (P<0.05), the percentage of NREM stage 2 (N2%) and the percentage of NREM stage 3 (N3%) were increased (P<0.05) in the acupuncture group and the medication group; the sleep latency was shortened in the sham-acupuncture group (P<0.05). After treatment, the PSG indexes in the acupuncture group and the medication group were superior to those in the sham-acupuncture group (P<0.05); in the acupuncture group, the number of awakenings was less than that in the medication group (P<0.05), the REM% and N1% were lower than those in the medication group (P<0.05), the N2% and N3% were higher than those in the medication group (P<0.05). The total effective rate were 93.5% (29/31) and 90.0% (27/30) in the acupuncture group and the medication group respectively, which were higher than 10.0% (3/30) in the sham-acupuncture group (P<0.05). There was no serious adverse events in any of the 3 groups. CONCLUSION Tiaowei Jiannao acupuncture improves the insomnia symptoms in patients with ischemic stroke, improves the quality of sleep, increases the deep sleep, promotes the recovery of neurological function, and relieves the depression. It is effective and safe for the treatment of PISI.
Humans ; Acupuncture Therapy ; Male ; Sleep Initiation and Maintenance Disorders/physiopathology* ; Female ; Middle Aged ; Aged ; Acupuncture Points ; Treatment Outcome ; Adult ; Ischemic Stroke/complications* ; Stroke/complications* ; Sleep

Clinical pharmacists participated in the antithrombotic diagnosis and treatment of a child with severe pneumonia complicated with intraventricular thrombosis,pulmonary embolism and high renal excretion rate.The child was admitted to the hospital due to"severe pneumonia".Based on the initial coagulation routine indicators,it was considered that the coagulation dysfunction was caused by severe pneumonia.Later,it progressed to right ventricular thrombus and multiple embolisms in both pulmonary arteries.The clinical pharmacist evaluated the risk of thrombus and bleeding by considering the child's age,weight,dynamic changes in disseminated intravascular coagulation and platelet count indicators,as well as liver and kidney function changes.They assisted the clinician in developing an individualized antithrombotic treatment plan.During hospitalization,the child's D-dimer level increased progressively,which was considered to be related to the child's high renal excretion rate.The clinical pharmacist promptly suggested adjusting the frequency and dosage of the antithrombotic medication.The clinician adopted the suggestion,and the child's thrombus masses reduced and dissipated.The child recovered well during hospitalization and was discharged smoothly,follow-up showed no recurrence of thrombus.Clinical pharmacists assisted physicians in developing individualized antithrombotic regimens for children through full pharmacological monitoring,which improved the prognosis of the children,ensured the effectiveness and safety of antithrombotic medication use,and could also provide a reference for antithrombotic therapy for similar children.

Purpose/Significance To explore the feasibility of applying blockchain technology to the current healthcare system of hos-pitals,and to achieve the purpose of protecting patients'privacy to the greatest extent possible at a lower cost.Method/Process 505 questionnaires are randomly distributed and collected from people of different age groups in Beijing,Tianjin,Shanghai and Shenzhen who have a certain degree of understanding of blockchain technology,and the results are analyzed.Result/Conclusion Different age groups are highly concerned about personal privacy and privacy protection,and are willing to accept blockchain as an emerging technology.There is a greater demand and acceptance for the application of blockchain technology in the primary health care systems.

Objective:To evaluate the practical value of the up-converting phosphor technology (UPT) in the field fast detection of plague, and to provide scientific basis for its promotion and application in the field work of plague monitoring.Methods:In September 2020, a total of 116 samples (including 4 samples for epidemic determination) were collected at the plague epidemic site in Menghai County, Yunnan Province, including 24 human blood and lymphatic fluid samples, 83 rat liver and muscle samples, and 9 rat blood samples. In March 2023, a total of 12 rat liver and muscle samples were collected from Lijiang City for on-site monitoring of plague outbreak (all of them were outbreak determination samples). All of the above samples were tested for Yersinia pestis antibody and antigen using the up-converting phosphor technology. At the same time, haemagglutination test, real-time fluorescence quantitative PCR and bacterial culture were conducted to compare the detection process and results of different experimental methods, the advantages and disadvantages of the up-converting phosphor technology for detecting Yersinia pestis were analyzed, and the feasibility of using this detection method in the field of plague epidemic monitoring was judged. Results:The plague epidemic samples site in Menghai County, Yunnan Province were tested by up-converting phosphor technology, and 19 samples were found to be positive for Yersinia pestis (1 antibody-positive and 18 antigen-positive). Among the samples determined, 4 samples with positive results of Yersinia pestis were detected by up-converting phosphor technology, and the results of their haemagglutination test, real-time fluorescence quantitative PCR and bacterial culture were all positive. All samples from Lijiang City were tested by up-converting luminescence technology, two samples were positive for Yersinia pestis(antigen-positive). The results of haemagglutination test and real-time fluorescence quantitative PCR were positive, and one sample was positive for bacterial culture. The time required for up-converting phosphor technology, haemagglutination test, real-time fluorescence quantitative PCR, and bacterial culture were 0.5, 4.0, 2.5 and 72.0 h, respectively. Conclusions:The results of Yersinia pestis detection by up-converting phosphor technology are basically consistent with the results of haemagglutination test, real-time fluorescence quantitative PCR and bacterial culture, but the time used is relatively short. When the number of samples is large, this method can be used preferentially in the field work of plague outbreak monitoring, which can quickly complete the preliminary judgement of plague outbreak, and save a lot of time and economic resources for the next step of plague prevention and control work.

Objective To compare the contents of alkaloid in Aconiti Kusnezoffii Radix with different degrees of processing and their effects on electrocardiogram and vagus nerve action potential in SD rats;To establish a toxicity evaluation method for Aconiti Kusnezoffii Radix and its processed products.Methods HPLC was used to determine the contents of six alkaloid components,including benzoyl neoaconitine,benzoyl aconitine,benzoyl subeaconitine,neoaconitine,subeaconitine and aconitine in Aconiti Kusnezoffii Radix and Aconiti Kusnezoffii Radix Cocta of soaking and boiled for 30 minutes,boiled for 4 h without soaking,soaking and boiled for 4 h,and soaking and boiled for 8 h.SD rats were subjected to sublingual drainage with Aconiti Kusnezoffii Radix and four types of processed products.The vagus nerve action potential and electrocardiogram of rats before and after administration were recorded,and the correlation analysis between alkaloid content and vagus nerve action potential and heart rate was conducted.Results The contents of alkaloid of the four processed products showed that the content of diester alkaloids was soaking and boiled for 30 min>boiled for 4 h without soaking>soaking and boiled for 4 h>soaking and boiled for 8 h;monoester alkaloid content:boiled for 4 h without soaking>soaking and boiled for 30 min>soaking and boiled for 4 h>soaking and boiled for 8 h.After the administration of each sample,compared with the basal discharge,the vagus nerve discharge of rats with different processed products was changed by sublingual administration,heart rate increased,the degree of arrhythmia increased,and it varied with the degree of processing;the results of correlation analysis showed that there was a significant correlation between the nerve discharge area and the contents of diester alkaloids and total alkaloids.Conclusion The action potential of the vagus nerve and electrocardiogram of rats after sublingual drainage administration can reflect the degree of numbness in the tongue,which can provide reference for the study of tongue sensation of Aconiti Kusnezoffii Radix.