Objective To explore the effect of cellular inhibitor of apoptosis protein1 (cIAP-1) gene on the radiosensitivity of SMMC-7721 cells.Methods We silenced cIAP-1 expressions by the shRNA technology,and then we detected the changes of cell proliferation,cell cycle and cell apoptosis by CCK8 as-say,Western blot,qRT-PCR and flow cytometry after the radiotherapy.Results The cell proliferation rate of liver cancer SMMC-7721 cells at different radiation doses of 1 Gy,4 Gy,7 Gy and 10 Gy was detected.Comparing with control group (pGCsi-H1-control),the cell proliferation in cIAP-1 silencing group (pGCsiH1-shRNA) was significantly reduced at various radiation doses,and the effect was dose-dependent (P ＜ 0.05).G1/G0 phase arrest was observed after radiation (P ＜0.01),and the proportion of cells in S phase was significantly reduced compared with control (P ＜ 0.01).Compared with control group,G1/G0 phase arrest was detected (P ＜ 0.05),and the percentage of cell apoptosis was increased significantly in cIAP-1 silencing group (P ＜ 0.05).Conclusion cIAP-1 silencing can enhance the radiosensitivity of liver cancer cells,and inhibit cell proliferation by promoting the anti-tumor effect of radiation.

Objective To study the cause,prevention and treatment of postpancreaticoduodenectomy hemorrhage.Method The clinical data of 422 patients who underwent PD in our hospital between January 2000 and January 2012 were retrospective analyzed.Results The incidence of postoperative hemorrhage was 8.1％ (34/422),and the mortality was 20.6％ (7/34).Early and delayed hemorrhage occurred in 19 and 15 patients,respectively.Intra-abdominal and gastrointestinal hemorrhage occurred in 20 and 14 patients,respectively.For the 19 patients who underwent reoperation,the mortality was 20.6％ (7/34).When compared with the delayed hemorrhage group,the mortality of the early hemorrhage group was significantly lower (P＜0.05).Conclusions Meticulous operation and reliable hemostasis during operation and prevention of pancreatic fistula,biliary fistula and peritoneal fluid collection after operation are the key points in reducing postoperative hemorrhage.A timely and decisive reoperation is important to manage postoperative hemorrhage.

Objective To apply Nutritional Risk Screening-2002(NRS-2002) to perform primary screening for nutritional risk in patients with esophageal cancer who undergo radiotherapy, and assess their nutritional status, and to investigate the value of NRS-2002 in such patients.Methods A total of 97 patients who were diagnosed with esophageal cancer and underwent radiotherapy in Zhejiang Cancer Hospital from January 2010 to April 2014 were analyzed retrospectively.The Kaplan-Meier method was applied to analyze the difference in survival, and the chi-square test and the Pearson correlation analysis were applied to analyze the correlation between NRS-2002 score and blood parameters.Results Of all patients, 26.8%had nutritional risk before radiotherapy, which gradually increased with the progress of radiotherapy.The 1-year overall survival rates of the patients with NRS-2002scores of ≤3 and ≥4 on admission were 91.1%and 61.9%, respectively (P=0.010).As for the patients with the highest NRS-2002 scores of ≤2 and ≥3 during treatment, the 1-year overall survival rates were 94.2% and 77.5%, respectively (P=0.012).As for the patients with the lowest NRS-2002 scores of ≤3 and ≥4 during treatment, the 1-year overall survival rates were 91.3% and 54.5%, respectively ( P=0.018).The NRS-2002 score was correlated with prealbumin on admission and at week 1 of radiotherapy (P=0.000 and 0.002), and the NRS-2002 score was correlated with albumin at week 3 of radiotherapy (P=0.036).The multivariate analysis showed that the TNM stage of esophageal cancer and the highest NRS-2002 score during treatment were the independent prognostic factors in esophageal cancer (P=0.001 and 0.005).Conclusions The patients with esophageal cancer undergoing radiotherapy have high nutritional risk, and NRS-2002 score is the independent prognostic factor in these patients and can be used as a tool for primary screening for nutritional risk.

Objective To study the cellular changes of colonic smooth muscle cells in rats with spleen-deficiency functional diarrhea treated with Pixu Sihao Fang (PXSHF, No.4 Formula for Spleen Deficiency) dosed serum.Methods Colonic smooth muscle cells from functional diarrhea spleen-deficiency rats were extracted for primary culture and then divided into the following six groups: normal control group, model group, PXSHF low-dose, medium-dose, and high-dose groups, and montmorillonite powder (Mnt) group.All the dosed serum groups were treated with 5% drug serum for 48 h.CCK-8 test for detecting the cell proliferation activity and QRT-PCR test for checking the expression of brain-gut petide mRNA were performed.Results OD value of the model group was significantly lower than that of the control group (P<0.01) in CCK-8 test while the OD value of the drug serum groups were significantly higher than that of the model group (P<0.01).QRT-PCR test showed that the CCK/VIP/SS mRNA expression of the model group was significant lower than that of the control group (P<0.05).Compared with the model group, the CCK/VIP/SS mRNA expression in each drug serum group presented with an increase tendency.CCK mRNA expression of the group treated with low-dose PXSHF dosed serum was higher than of the model group (P<0.05).VIP mRNA expression of the groups treated with PXSHF dosed serum were significantly higher than that of the model group (P<0.01).Conclusion PXSHF dosed serum can effectively promote the proliferation activity of the colonic smooth muscle cells.Changes in the expression of CCK, VIP and SS mRNA might be indicative of the role of brain-gut peptide in the development of functional diarrhea with spleen deficiency pattern.

Objective:To compare and analyze the predictive value of different inflammatory factors and tumor markers in intrahepatic cholangiocarcinoma and to develop a new and effective preoperative prognostic scoring system.Methods:102 and 72 cases with intrahepatic cholangiocarcinoma who underwent radical surgery in Tianjin Medical University Cancer Institute and Hospital and the Affiliated Hospital of Weifang Medical University were selected as the experimental group and the validation group, respectively. Clinicopathological and follow-up data were collected. Cox proportional-hazards model was used to analyze the predictive value of different prognostic markers. The relationship between prognostic markers and clinicopathological data was analyzed by rank sum test, χ2 or Fisher's exact test. Results:Among the direct inflammatory factors, tumor markers and combined inflammatory factors, prognostic inflammatory index (PII), carbohydrate antigen (CA) 19-9 and systemic inflammation score (SIS) were the most significant predictive factors for postoperative survival outcomes in patients with intrahepatic cholangiocarcinoma. The prognostic inflammatory and tumor score (PITS) was proposed as a new prognostic scoring system for intrahepatic cholangiocarcinoma. PII and CA19-9 were included into the scoring criteria for prognostic stratification of patients. PITS was an independent predictor of tumor-free survival and overall survival in patients with intrahepatic cholangiocarcinoma. Patients with high-grade PITS had later tumor grade and higher frequency of vascular invasion.Conclusion:PITS is highly effective prognostic scoring system for patients with intrahepatic cholangiocarcinoma. In addition, PITS is recommended for preoperative prognostic stratification in patients with intrahepatic cholangiocarcinoma.

Objective:To explore the value of 5G-based robotic remote ultrasound diagnosis system in musculoskeletal joint injuries.Methods:From March to December 2020, 58 volunteers at a training base who felt musculoskeletal pain or paresthesia were selected and performed both robotic remote ultrasound (remote ultrasound group) and conventional ultrasound (portable ultrasound group). The two types of examinations were compared, the consistency of the two diagnosis results was analyzed by the Kappa test, and the the difference of the diagnosis results was compared by McNemar test.Results:Among the 58 volunteers, 40 cases were positive by both methods and 11 volunteers had 2-3 positive results. There were 59 positive results in the remote ultrasound group and 64 positive results in the portable ultrasound group. The positive rate of the examination sites from high to low was knee joint>foot and ankle joint >hand and wrist joint >shoulder joint>elbow joint, calf and hip. The diagnosis results of the two groups were in good consistency (Kappa=0.782, P<0.001), and there was no statistically significant difference in the diagnosis results between the two groups (χ 2=3.2, P=0.063). Five more diseases with positive results were detected in the portable ultrasound group: 1 meniscus injury, 1 medial collateral ligament injury, 1 soft tissue injury around the metatarsal, 1 biceps tendinitis with effusion and 1 cubital ulnar nerve subluxation. Conclusions:The 5G-based robotic remote ultrasound system has good consistency with conventional ultrasound in the diagnosis of musculoskeletal injures. It can be applied to the ultrasound diagnosis of musculoskeletal joint injuries in remote areas.

This paper　explored the disease mechanism of autism spectrum disorders （ASD） from the perspectives of “vital activity” and “qi configuration”， and it is believed that “vital activity” represents the internal regulatory mechanisms of the human body， while “qi configuration” represents the ability of the body to communicate and adapt to the external environment. Abnormal genetic factors lead to the extinction of vital activity in children with ASD， resulting in increased susceptibility to ASD. Environmental instability leads to the solitary qi configuration in ASD， triggering and exacerbating the manifestations of ASD on the basis of genetic susceptibility. In addition， epigenetic mechanisms also play an important role in the pathogenesis of ASD. Imbalances in vital activity and disruptions in qi configuration result in failure in qi transformation of zang-fu organs， with abnormal symptoms manifested through the five orifices. It is proposed that the treatment of ASD should aim to achieve a harmonious interaction between “vital activity” and “qi configuration” to accelerate the recovery of affected children.

Daochisan is a pediatric famous classical formula in traditional Chinese medicine（TCM） specializing in clearing the heart， disinhibiting water and enriching Yin， which has been inherited and developed by medical experts of successive generations. The formula can be traced back to Xiaoer Yaozheng Zhijue written by QIAN Yi from Song dynasty， and most of the later-developed Daochisan（Daochitang） is based on this formula with additions and subtractions. So as to promote the literature excavation of this formula， this paper conducts a thorough textual research and analysis of the composition， processing， preparation methods， clinical applications of Daochisan based on a systematic collation of relevant ancient and modern literature in the method of bibliometrics. A total of 127 pieces of data involving 86 antient TCM books were collected. Statistical analysis showed that the drug origin of Daochisan is basically clear， we suggest that Rehmanniae Radix is the root tuber of Rehmannia glutinosa of Scrophulariaceae， Akebiae Caulis is the dry stem of Akebia quinata of Lardizabalaceae， Glycyrrhizae Radix et Rhizoma is the dry root and stem of Glycyrrhiza uralensis of legume， bamboo leaf is the dry leaves of Phyllostachys nigra var. henonis of gramineous plants. Four herbs are recommended to use its raw products. The key information of the dosage and decocting method is supposed to be "4.13 g each of raw Rehmanniae Radix， raw Glycyrrhizae Radix et Rhizoma， Akebiae Caulis， adding 300 mL of water， and then adding 4.13 g of bamboo leaf， decocting together to 150 mL， taking warmly after meal". Daochisan has the effect of clearing the heart and enriching Yin， disinhibiting water and relieving stranguria， and is widely used in treating symptoms such as heart vexed hotness， hydrodipsia and reddish complexion. Modern studies have showed that Daochisan are frequently used in treating oral ulcer， herpetic stomatitis， urinary tract infection， herpes zoster and other diseases. The above research results can provide scientific reference for the future development and research of Daochisan.

Chaihu Guizhi Ganjiangtang with a definite clinical effect has been widely used and recorded since the Han Dynasty. As a classic prescription of Chaihu classic formula praised by doctors ofsuccessive generations， it has been included in the Ancient Classic Prescription Catalogue （Second Batch）： Han Medicine published by the National Administration of Traditional Chinese Medicine in August 2023. We carried out a bibliometric study involved 34 ancient books of traditional Chinese medicine， with 37 records including the name and composition of the prescription. This paper summarizes the source name， composition， original medicinal plant， dose， preparation method， usage， ancient and modern indications， and clinical application of Chaihu Guizhi Ganjiangtang. The results of textual research show that Chaihu Guizhi Ganjiangtang is derived from the Treatise on Febrile Diseases （Shanghanlun） written by ZHANG Zhongjing in the Han dynasty， and the original plants of medicines in this prescription are basically the same in ancient and modern times. Most records about the doses in ancient books are consistent with those in the Treatise on Febrile Diseases （Shanghanlun）. The efficacy of Chaihu Guizhi Ganjiangtang is to harmonize lesser yang and resolve water retention by warming. This prescription was used to treat a variety of diseases， especially those caused by disturbance of Qi movement in the greater Yang and lesser Yang. It is now mainly used to treat the diseases in the digestive system， respiratory system， dermatology， nervous system， etc.， being effective for difficult and complicated diseases. Through the excavation and combing of the ancient records of Chaihu Guizhi Ganjiangtang， this paper clarifies the key information， providing a reference for the clinical application of classical prescriptions and the development of new drugs.

The classical prescription Yangweitang， derived from Zhengzhi Zhunsheng， is specialized in treating syndromes of chill and fever due to exogenous pathogens， inner-cooling， and malaria， and it has been included in the Catalogue of Ancient Classical Formulas （the First Batch） published by the National Administration of Traditional Chinese Medicine （TCM） in 2018. Through bibliographical research， the relevant ancient books and modern documents were systematically sorted out， and it was found that there were many prescriptions related to the Yangweitang from Zhengzhi Zhunsheng. They were interwoven with Yangweitang from Zhengzhi Zhunsheng and widely used in clinical practice. In order to clarify their history and evolution， this paper combed the historical origin of Yangweitang and its related prescriptions and conducted textual analysis on key information such as semantic composition， herb origin， processing method， and efficacy. A total of 896 pieces of data on Yangweitang from Zhengzhi Zhunsheng were collected. 26 pieces of effective data were included after the screening， involving 17 ancient TCM books. Then， a total of 28 pieces of data on prescriptions related to the Yangweitang from Zhengzhi Zhunsheng were included， involving 23 ancient TCM books for reference. The textual analysis showed that Yangweitang originated from the Renshen Yangweitang recorded in Taiping Huimin Heji Jufang in the Song dynasty. Based on the original formula， medical experts from later generations have modified it into many different versions. A comparative analysis showed that Yangweitang from different generations had similar compositions， and the herb origin and processing method were basically clear. The recommended prescriptions are as follows： 37.3 g of Pinelliae Rhizoma Praeparatum Cum Alumine， Magnoliae Officinalis Cortex（fried with ginger juice）， and frying with rice water Atractlodis Rhizoma， 27.98 g of Citri Exocarpium Rubrum， 18.65 g of Pogostemon cablin leaf， Tsaoko Fructus， Poria， and Ginseng Radix et Rhizoma， and 9.33 g of Glycyrrhizae Radix et Rhizoma. They could be ground into a coarse powder， with 14.92 g for every dose， and they could be orally taken after being decocted with 450 mL of water， 7 g of fresh ginger， and 2 g of Mume Fructus to 270 mL in warm conditions. Yangweitang from Zhengzhi Zhunsheng has the effect of warming the middle and releasing the external， and it can treat many syndromes including spleen and stomach disharmony caused by chill and fever due to exogenous pathogens and inner-cooling， as well as all kinds of malaria. Modern clinical applications mainly focus on chronic atrophic gastritis and other digestive system diseases.