Objective To investigate the clinical efficacy of Bushen Tiaojing Recipe Extract(an extract preparation of Chinese herbal medicine with the actions of tonifying kidney and regulating menstruation) for the treatment of kidney deficiency type of premature ovarian failure (POF),and to observe the effect of the extract formula on sexual hormone levels of POF patients.Methods A total of 75 POF patients were randomly divided into Chinese medicine (CM) decoction group,CM extract group and western medicine (WM) group,25 cases in each group.CM decoction group was treated with the decoction of Bushen Tiaojing Recipe (a decoction recipe for tonifying kidney and regulating menstruation),CM extract group was treated with Bushen Tiaojing Recipe Extract,and WM group was treated with hormone replacement therapy(HRT).Twenty-eight days constituted one treatment course,and the treatment for the 3 groups lasted 3 continuous courses.After treatment,the patients were followed up for 3 months.Clinical efficacy of the 3 groups was evaluated,and clinical symptom scores,the improvement of menstruation and the changes ofsexual hormones ofestrogen(E2),follicle-stimulatinghormone(FSH) and luteinizing hormone (LH) were observed before and after treatment.Results (1) Two cases of each group dropped out,and a total of 69 patients completed the study.(2) The total effective rate of CM decoction group and CM extract group was 73.91％,78.26％ respectively,higher than 52.17％ of WM group (P ＜ 0.05).(3)After treatment,clinical symptoms of CM decoction group and CM extract group were obviously improved (P ＜ 0.05 or P ＜ 0.01 compared with those before treatment),while WM group only had an effect on improving the abnormal menstruation (P ＜ 0.01 compared with that before treatment).CM decoction group and CM extract group had better effect on improving the clinical symptoms than WM group (P ＜ 0.05 or P ＜ 0.01).(4) CM decoction group and CM extract group had higher menstrual improvement rate,shorter menstrual-improvement time and lower recurrence rate than WM group (P ＜0.05).(5) CM decoction group and CM extract group had better effect on increasing serum E2 level and decreasing FSH and LH levels than WM group (P ＜ 0.05 or P ＜ 0.01).(6) The adverse reaction incidence of CM decoction group and CM extract group was all 4.35％,lower than 13.04％ of WM group (P ＜ 0.05).Conclusion Bushen Tiaojing Recipe Extract has high drug concentration,and its effect is stable,mild and lasting,having the advantages of convenience for carrying and medication.The extract exerts certain clinical efficacy for the treatment of POF,and is effective on alleviating clinical symptoms,recovering normal menstruation,regulating serum sexual hormone levels,with lower abnormal menstruation relapse rate and less adverse reaction.

Objective To investigate the expression of MMP-9 genes in primary hepatocellular carcinoma(HCC).Methods RT-PCR was used to detect MMP-9 mRNA in surgically extracted specimens from 28 patients with HCC.Results The expression of MMP-9 mRNA was significantly higher in tumor than in corresponding nontumoral tissue(P0.05).Meanwhile,the expression of MMP-9 mRNA in HCC was significantly correlated to the existence of portal vein tumor thrombus(P

Objective To observe the clinical efficacy of TCM periodic therapy combined with estradiol progesterone tablets (Diane-35) in the treatment for polycystic ovary syndrome (PCOS), and its effects on serum sex hormone, glucose and lipid metabolism.Methods Totally 74 patients with PCOS were randomly divided into Western medicine (WM) group and Chinese and Western medicine (CWM) group, 37 cases in each group. WM group was given Diane-35, while CWM group was treated with TCM periodic therapy additionally, for three courses, 28 d of one course. Clinical symptoms, sex hormones and glucose and lipid metabolism of two groups were observed before and after treatment and withdrawal treatment for 3 months.Results Two patients in each group were lost to follow-up. Markedly effective rate and total efficiency rate of CWM group were better than WM group (P<0.05). After treatment, symptom integrals of CWM group decreased significantly (P<0.01). Serum E2 increased (P<0.01), while LH, T and LH/FSH decreased in two groups (P<0.01). After treatment and withdrawal treatment for 3 months, improvement of clinical symptoms and sex hormone levels in CWM group was superior to CM group (P<0.01), FPG, FINS, TG, TC and BMI of CWM group decreased in CWM group (P<0.05), and lower than that of CM group (P<0.05,P<0.01). Adverse reaction rates of WM group and CWM group were 17.1% and 5.71% (P<0.05).Conclusion Efficacy of TCM periodic therapy combined with Diane-35 in treatment of PCOS is significant, which can obviously improve patients’ clinical symptoms, and regulate hormone and lipid metabolism disorders, with fewer adverse reactions.

Objective To observe the clinical efficacy of cerebral palsy children with liver strong spleen weak syndrome treated with integrated traditional Chinese medicine therapy. Methods Eighty cerebral palsy children with liver strong spleen weak syndrome were divided into treatment group (40 cases) and control group (40 cases). Patients in control group were treated with conventional therapy (including exercise therapy, occupational therapy, guidance education, physical factors, and psychological therapy), and patients in treatment group were treated with integrated traditional Chinese medicine therapy (acupuncture and traditional Chinese medicine medicated bath) additionally. Three months were set for a course of treatment, and the whole treatment lasted for a total of four courses. TCM clinical symptoms were scored every six months, muscle tone (MAS), gross motor function (GMFM), and daily life activity ability (MBI) were evaluated every three months for both groups. Results There were significant differences in the total scores of TCM clinical symptom, MAS, GMFM, and MBI at different treatment time points in the two groups, compared with that before treatment (P<0.01). There were significant differences in the total scores of clinical symptom for Chinese medicine, MAS, GMFM, and MBI at different treatment time points for treatment group, compared with that of control group (P<0.05). Conclusion Integrated traditional Chinese medicine therapy (acupuncture and traditional Chinese medicine medicated bath) for cerebral palsy children on the basis of western medicine therapy can more effectively improve function and life quality of children patients.

Objective To observe the effect of spleen-warming and kidney-tonifying therapy on Toll-like receptor 4 (TLR4) signaling pathway of cerebral infarction sequelae patients. Methods A total of 60 cerebral infarction sequelae patients with spleen and kidney(yang) deficiency were divided into control group and treatment group, 30 cases in each group. The two groups were given function rehabilitation training following by the theory of modern rehabilitation medicine, and additionally the treatment group was treated with spleen-warming and kidney-tonifying herbs orally. The treatment period for the two groups averaged 3 months. Before and after treatment, the scores of traditional Chinese medicine (TCM) symptoms and signs, peripheral blood TLR4 mRNA expression level, and the inflammation-related factors in the two groups were observed, and the observation parameters were compared with 30 healthy volunteers. Meanwhile, the changes of modern rehabilitation evaluation indexes were also evaluated before and after treatment. Results (1) After treatment, the Fugl-Meyer scores for motor function and Modified Barthel Index(MBI) scores for activities of daily living in the treatment group were obviously increased(P < 0.05 or P < 0.01 compared with those before treatment); the MBI scores in the control group was much increased(P < 0.05 compared with those before treatment), but the Fugl -Meyer scores only showed an increasing trend(P > 0.05). (2) After treatment, the predominant symptoms and signs of hemiplegia, facial distortion and dysphasia in the two groups were much improved(P < 0.01 compared with those before treatment), and the improvement in the treatment group was superior to that in the control group(P < 0.05). The control group had no significant effect on relieving the symptoms and signs of dizziness and blurred vision, numbness of limbs, spontaneous sweating, shortness of breath and weakness, and darkish tongue(P > 0.05 compared with those before treatment); the treatment group had obvious effect on the above symptoms and signs, and the effect was superior to that in the control group(P < 0.05 or P < 0.01).(3) For the inflammation-related factors, tumor necrosis factor alpha(TNF-α) level in the treatment group was much decreased and even arrived to the normal level(P > 0.05), and TNF-α level in the control group was decreased but did not arrive to the normal level(P < 0.05); levels of interleukin(IL)-1β, IL-6 and TLR4 mRNA in the two groups were decreased but did not arrive to the normal(P < 0.01), and the decrease in the treatment group was superior to that in the control group(P < 0.05 or P < 0.01). (4) During the treatment period, no obvious adverse effect was found in the two groups. Conclusion Oral use of spleen -warming and kidney –tonifying Chinese medicine combined with modern rehabilitation therapy is effective for the treatment of the sequelae of cerebral infarction patients by relieving the clinical TCM symptoms, and one of the therapeutic mechanisms is probably related with the TLR4 signaling pathway through regulating the expression of inflammatory factors.

Objective To investigate the factors related with home rehabilitation in disabled older people. Methods 350 disabled older persons in line with Maoming home rehabilitation were investigated face to face or with telephone, with self-designed questionnaire. Results and Conclusion The factors affected home rehabilitation included economic capacity, ratio of pension in expense, income, social security system, efficacy of rehabilitation, diffusion of policy. The most significant factors were the economic factors.

Closed-loop hospital management can effectivly cope with the COVID-19 pandemic. In order to ensure the continuity of treatments for hemodialysis patients under closed-loop management and minimize possible medical and infection risks, Huashan Hospital affiliated to Fudan University and 9 hospitals in Shanghai established a hemodialysis alliance in January 2021.The alliance optimized hemodialysis resources within the region through overall planning by preparing sites, materials and personnel shifts in advance, and establishing management systems and work processes to ensure that patients could be quickly and orderly diverted to other blood dialysis centers for uninterrupted high-quality hemodialysis services, in case that some hemodialysis centers in the alliance under closed-loop management.From November 2021 to April 2022, 317 of 1 459 hemodialysis patients in the alliance were diverted to other centers for treatment, accumulating 1 215 times/cases of treatments without obvious adverse reactions. The practice could provide a reference for medical institutions to quickly establish mutual support mode under major public health events.

Objective : To investigate the protective effect of melatonin (MT) on formaldehyde (FA) inhalation-in- duced acute lung injury (ALI) in rats and its mechanism through the regulation of nuclear factor E2-related factor 2 (Nrf2) signaling pathway． Methods : Fifty female Wistar rats were randomly divided into Control group ，FA group，FA + MT 5 mg / kg group，FA + MT 10 mg / kg group and FA + MT 20 mg / kg group，with 10 rats in each group．Except for the Control group，all other groups inhaled 3 mg / m3 FA daily for 21 d consecutively to construct the tainted model，and then treated with different MT doses for 14 d．The tainting was continued during the MT treatment．Hematoxylin-eosin (HE) staining was used to observe the histopathological changes in lung tissue，lung water content and lung coefficient were weighed and measured，glutathione ( GSH) ，superoxide dismutase (SOD) and 8-hydroxydeoxyguanosine ( 8-OHdG) levels were measured by absorbance photometric method ，and enzyme linked immunosorbent assay(ELISA) was used to measure the levels of tumor necrosis factor-alpha (TNF-α) ，in- terleukin (IL) -6，and IL-1 β concentrations，Western blot to detect the protein expression levels of Nrf2，heme ox- ygenase-1 (HO-1) ，nuclear factor-κB ( NF-κB) ，and phosphorylated nuclear factor-κB ( p-NF-κB) in lung tis- sues，and quantitative polymerase chain reaction(qPCR) to detect the Nrf2，HO-1，and Kelch-like ECH-associated protein 1 (Keap1) mRNA expression levels. Results : Compared with the control group，lung injury was obvious in rats in the FA group ; lung tissue GSH and SOD levels were reduced ，and 8-OHdG levels were elevated ( P < 0. 05) ; alveolar lavage fluid TNF-α , IL-6，and IL-1 β levels were elevated (P＜0. 05) ; Nrf 2 and HO-1 protein expression levels were reduced in the lung tissue (P＜0. 05) ，and p-NF-κB protein expression levels were was ele- vated (P＜0. 05) ; the relative mRNA expression of Nrf2 and HO-1 in lung tissue was decreased，and the relative mRNA expression of Keap1 was elevated (P＜0. 05) ．Compared with the FA group，the lung injury of rats in the MT group was improved ; the levels of GSH and SOD in the lung tissue were increased (P＜0. 05) ，and the level of 8-OHdG was decreased (P＜0. 05) ; the levels of TNF-α , IL-6，and IL-1 β in the alveolar lavage fluid were de- creased (P＜0. 05) ; and the expression levels of the Nrf2 and HO-1 proteins in the lung tissue were increased (P ＜0. 05) ．p-NF-κB protein expression level was decreased (P ＜0. 05) ; the relative mRNA expression levels of Nrf2 and HO-1 in lung tissues were increased (P＜0. 05) ，and the relative mRNA expression level of Keap1 was decreased (P＜0. 05) in lung tissues，and all of them were in a dose-dependent manner． Conclusion MT can al- leviate oxidative stress and inflammatory responses and mitigate FA exposure-induced acute lung injury by regula- ting the Nrf2 / Keap1 / HO-1 signaling pathway.