Objective To discovery the difference about TCM constitution between urban and rural area from the survey results performed in 2 communities of Beijing. Methods 9 standard survey scales of Chinese Medicine Constitution and four diagnostic methods of TCM were performed to identify body constitution of 161 people whose age are almost 64 years; The distribution of total constitution and the constitution distribution of same sex were further analyzed. Results The distribution of 9 TCM body constitution were different between town and country, the gentleness type distribution in country was lower than city (24.68%, 51.19%) ; Qi-depression type distribution was significant higher in country than city (44.16%,5.95%) . Conclusion Most of people in the country were yang-deficiency type and qi-depression type body constitution, the distribution of which affected by gender and age, etc.

Objective To investigate the relationship between the expression of MIF mRNA and TNF-α in the lung tissue of rats with acute necrotizing pancreatitis (ANP) and explore their mechanism of action in acute lung injury during the course of ANP. Methods A total of 40 Sprague-Dawley rats were randomly divided into four groups (n = 10 in each group) : the sham operation (SO) group, ANP 3h group, 6h group, 12h group. The model of ANP was induced by retrograde injection of 5% sodium tanrocholate (0. 1 ml/100 g) into the biliary and pancreatic duct. The level of serum amylase was determined;pancreatic and lung tissues were harvested for pathological examination, and wet/dry weight ratios were estimated. Intrapulmonary expression of MIF mRNA was assayed by semi-quantitative RT-PCR. TNF-α in pulmonary homogenate was measured by immunoradiometric assay. Results Serum amylase, wet/dry weight ratios of pancreatic and lung tissues all significantly increased, and pathological injuries aggravated with time in ANP groups. Levels of TNF-α in ANP 3h, 6h, 12h group were (0.69 ± 0. 107) ng/ml, (1.64 ± 0. 10) ng/ml and (0.92 ± 0.11) ng/ml, and expression of MIF mRNA were 1.97±0.09, 2.55±0.23, 3.29±0.26, which were significantly higher than those in control group [(0. 19±0.06)ng/ml, 1.21±0.34, P<0.01]. lntrapulmonary expression of MIF mRNA was positively associated with lung pathological injuries, wet/dry weight ratio, and TNF-α(r = 0. 637, r = 0.684, r = 0.858, P < 0.01). Intrapulmonary levels of TNF-α was positively associated with lung pathological injuries, wet/dry weight ratio (r=0.540, r=0.421, P<0.01). Conclusions MIF mRNA was over- expressed and level of TNF-α was significantly increased in pulmonary tissue in rats with ANP, and this may be one of the mechanisms in the pathogenesis of lung injury in ANP.

Infants suffering from angiostrongylus eosinophilic meningitis (AEM) is rare, while AEM can cause severe consequences.The diagnostic value of high-throughput sequencing for AEM was studied by analyzing 2 AEM children (< 2 years old) in the Department of Neurology, Shenzhen Children′s Hospital in 2019.Case 1 mainly pre-sented intermittent fever, vomiting, mental fatigue and bregma bulge.Case 2 mainly manifested intermittent fever, cough, vomiting and convulsion.Due to hypereosinophils in patients′ peripheral blood and cerebrospinal fluid (CSF), and abundant DNA sequences from a cantonensis in CSF and positive antibody test, the patients were diagnosed with AEM.The patients were treated with albendazole to deworm, and small doses of methylprednisolone to reduce inflammation.The clinical characteristics of AEM infant are not typical, and high-throughput sequencing technology can assist the diagnosis of AEM.

In recent years, more and more attention has been paid to the occurrence and harm of delirium, and intensive care unit (ICU) delirium has become a hot issue. The incidence of delirium in ICU patients is much higher than that of general wards, all kinds of complications caused by delirium and increased mortality should win enough attention of the clinicians. There is no uniform standard for the diagnosis and evaluation of ICU delirium, which is a major problem that affects clinicians in the early diagnosis and assessment of prognosis. By reviewing the domestic and international researches of ICU delirium, the latest progress of diagnostic and assessment instruments for delirium in ICU is stated, which provides an important basis for the early identification and diagnosis of delirium in ICU.

Objective:To explore the pathogenic characteristics of incision wound infections after breast cancer surgery and related influencing factors.Methods:Clinical files of 200 middle-aged and elderly patients who underwent breast-conserving surgery for breast cancer in the Affiliated Three Gorges Hospital from May 2016 to April 2021 were retrospectively analyzed.The results of pathogenic bacteria and drug sensitivity tests were examined, and the influencing factors of postoperative incision infections after breast cancer surgery were analyzed.Results:Among 200 middle-aged and elderly patients aged 55-75 years who underwent breast-conserving surgery for breast cancer, 13 patients(4.64%)developed postoperative incision infections, with 40 strains of pathogenic bacteria isolated, including 14 strains of gram-positive bacteria, 25 strains of gram-negative bacteria and 1 fungal strain.Univariate and multivariate logistic regression analysis showed that age( OR=3.40), duration of surgery( OR=2.50), albumin level( OR=2.83), underlying diseases( OR=4.23), preventive use of antibiotics( OR=3.14)and length of hospital stay( OR=2.33)were independent risk factors for postoperative incision infections in breast cancer patients(all P<0.05). Conclusions:Common pathogens of incision infections after breast-conserving surgery are Gram-negative bacteria.There are many factors affecting postoperative incision infections.Clinical measures need to be taken to reduce or prevent postoperative incision infections.

Objective: The spatial distribution model of particulate matter based on time change in a specific place was established to analyze the spatial and temporal distribution characteristics and movement of particulate matter. Methods: A convenience store was selected as the research subject. The micro-climate and particle number concentration (PNC) of the site were detected, and numerical simulation was carried out by computational fluid dynamics (CFD) simulation method. Based on the discrete phase model, the temporal and spatial distribution characteristics and movement rules of simulated particles were analyzed. Results: The wind speed at the entrance of the convenience store was low and almost unchanged during the detection, while the wind speeds outside and inside outlets were high and changed sharply. The PNC of particle size of 0.02-1.00 μm was higher than that of particle size >1.00 μm (all P<0.05). The PNC with particle size of 0.02-1.00 μm from high to low were checkout counter, entrance, outer outlet and inner outlet (all P<0.05). The PNC of the checkout counter and entrance varies greatly, while the PNC of the outer outlet and inner outlet was relatively steady. The CFD simulation results showed that particles exhaled by individuals near the entrance of the checkout counter of the convenience store could be expelled outdoors more quickly with the influence of airflow. However, particles exhaled by individuals in the middle of the shelves remained suspended indoors for a longer period of time compared to those near the checkout counter. Particles emitted from the air conditioning outlet diffuse throughout the entire store and reach a steady state in 300 seconds. Conclusion: The particulate matter in the convenience store was mainly small particle with the size less than 1.00 μm. The residence time, downward trend and number of suspended particulates of human exhaled particles were related to air flow. The particulates escaped from the air conditioner could quickly spread to almost the entire convenience store.

Renal tubular secretion mediated by organic anion transporters(OATs)and the multidrug resistance-associated protein 4(MRP4)is an important means of drug and toxin excretion.Unfortunately,there are no biomarkers to evaluate their function.The aim of this study was to identify and characterize an endogenous biomarker of the renal tubular OATs-MRP4 channel.Twenty-six uremic toxins were selected as candidate compounds,of which kynurenic acid was identified as a potential biomarker by assessing the protein-binding ratio and the uptake in OAT1-,OAT3-,and MRP4-overexpressing cell lines.OAT1/3 and MRP4 mediated the transcellular vectorial transport of kynurenic acid in vitro.Serum kynurenic acid concentration was dramatically increased in rats treated with a rat OAT1/3(rOAT1/3)inhibitor and in rOAT1/3 double knockout(rOAT1/3-/-)rats,and the renal concentrations were markedly elevated by the rat MRP4(rMRP4)inhibitor.Kynurenic acid was not filtered at the glomerulus(99％of albumin binding),and was specifically secreted in renal tubules through the OAT1/3-MRP4 channel with an appropriate affinity(Km)(496.7 μM and 382.2 μM for OAT1 and OAT3,respectively)and renal clearance half-life(ti/2)in vivo(3.7±0.7 h).There is a strong correlation in area under the plasma drug concentration-time curve(AUC0-t)between cefmetazole and kynurenic acid,but not with creatinine,after inhibition of rOATs.In addition,the phase of increased kynurenic acid level is earlier than that of creatinine in acute kidney injury process.These results suggest that albumin-bound kynurenic acid is an appropriate endogenous biomarker for adjusting the dosage of drugs secreted by this channel or predicting kidney injury.

Reduning nasal sprays were prepared from Reduning injection to explore the pharmacokinetics of its nasal administration in rabbits. Healthy rabbits were divided into three groups: blank group, nasal administration group, and intravenous injection group. Plasma samples were pretreated using acetonitrite to precipitate proteins. High-performance liquid chromatography(HPLC)was performed for the detection of chlorogenic acid. The results showed that chlorogenic acid was detected in the plasma samples of nasal administration group with the highest concentration occurring in 2-5 min after administration, which indicated that Reduning nasal sprays could be successfully absorbed from nasal mucosa and could rapidly metabolize in blood. Compared with intravenous injection group, nasal administration group had lower concentration of active ingredients, revealing that the transdermal absorption rate of Reduning nasal sprays requires further improvement.

Objective:To construct and validate a prediction model for the risk of intermediate cesarean delivery for primiparous women with failed vaginal trial of labor.Methods:Clinical data of 6 128 pregnant women who gave birth in the Affiliated Hospital of Jining Medical College from January 2019 to December 2020 were collected. The puerpera was randomly divided into train set ( n=4 290) and validation set ( n=1 838). The factors influencing the conversion to cesarean section in primiparous women with failed vaginal trial of labor were analyzed with univariate and binary multivariate logistic regression, and a risk prediction model was established based on the influencing factors. The predictive power of the model was assessed by receiver operating characteristic (ROC) curve and the Hosmer-Lemeshow goodness-of-fit test in train set and validation set. Results:Among 6 128 pregnant women 1 042 cases failed in vaginal trial of labor and were transferred to cesarean section. Univariate analysis showed age, occupation, gestational weight gain, days of gestation, body temperature before delivery, fetal heart condition at delivery, fetal abdominal circumference, Bishop score, premature rupture of membranes, gestational illness, mode of induction of labor, labor analgesia, and fetal orientation were significantly associated with converting to cesarean delivery (all P<0.05). The multivariate binary logistic regression analysis showed that the age, gestational weight gain, body temperature, gestational co-morbidities, days of gestation, premature rupture of membranes, amniotic fluid contamination, induction of labor, and abnormal occipital position were independent risk factors for intermediate cesarean delivery ( OR=1.03-8.06, all P<0.05); while height, occupation, Bishop score, and labor analgesia were protective factors for intermediate cesarean delivery ( OR=0.17-0.96, all P<0.05). A risk prediction model was constructed based on the risk factors and protective factors. In train set, the area under the ROC curve(AUC) of the model was 0.902 (95% CI: 0.89-0.92, P<0.001), with the best cutoff value of 0.138, the sensitivity and specificity were 0.837 and 0.825, respectively; and the Hosmer-Lemeshow goodness-of-fit test showed P=0.192. In validation set the AUC of the model was 0.917 (95% CI: 0.90-0.93, P<0.001), and the sensitivity and specificity were 0.826 and 0.851, respectively; the total correct rate of the model was 87.21% (1 603/1 838). Conclusion:The risk prediction model of failed vaginal trial of labor in primiparous women for intermediate cesarean delivery constructed in this study has good clinical prediction efficacy and high correctness rate.

Objective To explore the characteristic of early evaluation of patients with amplitude-integrated electroencephalogram (aEEG) on brain function prognosis after cardiopulmonary cerebral resuscitation (CPCR). Methods A retrospective analysis of the clinical data of patients with adult CPCR in intensive care unit (ICU) of Henan Provincial People's Hospital from March 2016 to March 2017 was performed. The length of stay, recovery time, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, aEEG and Glasgow coma scale (GCS) within 72 hours were recorded. The main clinical outcome was the prognosis of brain function (Glasgow-Pittsburgh cerebral performance category, CPC) in patients with CPCR after 3 months. Relationship between aEEG and GCS and their correlation with brain function prognosis was analyzed by Spearman rank correlation analysis. The effects of aEEG and GCS on prognosis of brain function were evaluated by Logistic regression analysis. The predictive ability of aEEG and GCS for brain function prognosis was evaluated by receiver operating characteristic (ROC) curve.Results A total of 31 patients with CPCR were enrolled, with 18 males and 13 females; mean age was (41.84±16.96) years old; recovery time average was (19.42±10.79) minutes; the length of stay was (14.84±10.86) days; APACHE Ⅱ score 19.29±6.42; aEEG grade Ⅰ(normal amplitude) in 7 cases, grade Ⅱ (mild to moderate abnormal amplitude) in 13 cases, grade Ⅲ (severe abnormal amplitude) in 11 cases; GCS grade Ⅰ (9-14 scores) in 7 cases, grade Ⅱ (4-8 scores) in 14 cases, grade Ⅲ (3 scores) in 10 cases; 19 survivals, 12 deaths; the prognosis of brain function was good (CPC 1-2) in 8 cases, and the prognosis of brain function was poor (CPC 3-5) in 23 cases. There was no significant difference in age, gender, recovery time, length of stay and APACHE Ⅱ score between two groups with different brain function prognosis, while aEEG grade and GCS grade were significantly different. Cochran-Armitage trend test showed that the higher the grade of aEEG and GCS, the worse the prognosis of CPCR patients (bothP-trend < 0.01). With the increase in GCS classification, the classification of aEEG was also increasing (r = 0.6206,P = 0.0003). Both aEEG and GCS were positively correlated with the prognosis of brain function (r1 = 0.7796,P1 < 0.0001;r2 = 0.7021,P2 < 0.0001). Univariate Logistic regression analysis showed that aEEG and GCS had significant effect on early brain function prognosis [aEEG: odds ratio (OR) = 37.234, 95％confidence interval (95％CI) = 3.168-437.652,P = 0.004, GCS:OR = 12.333, 95％CI = 1.992-76.352,P = 0.007]; after adjusting for aEEG and GCS, only aEEG had significant effect on the early prognosis of brain function (OR = 26.932, 95％CI = 1.729-419.471,P = 0.019). The ROC curve analysis showed that in the evaluation of the prognosis of CPCR patients with brain function, the area under ROC curve (AUC) of aEEG was 0.913, when the cut-off value of aEEG was 1.5, the sensitivity was 95.7％ and the specificity was 75.0％. The AUC of GCS was 0.851, the best cut-off value was 1.5, the sensitivity was 91.3％ and the specificity was 62.5％.Conclusion aEEG and GCS scores have a good correlation in the evaluation of brain function prognosis in patients with CPCR, the accuracy of aEEG in the early evaluation of the prognosis of patients with CPCR is higher than the GCS score.