The theory of medicinal properties of traditional Chinese medicine (TCM) is one of the core theories of TCM, which is an important basis for guiding the clinical application of TCM and the key supporting point for the modernization of TCM. How to study the modernization of TCM under the guidance of traditional Chinese medicine theory has become a great challenge for modern researchers. Currently, the researches in TCM mainly focus on chemical studies such as on active ingredients and effective components, lacking the guidance of traditional Chinese medicine theory, and losing the inherent characteristics of TCM. Therefore, the combination of the theory of TCM and the modernization of TCM and the establishment of research mode that is in line with the characteristics of modernization of traditional Chinese medicine under guidance by the theory of medicinal properties of TCM shall be the top priority in modern Chinese medicine research. The property and flavor of TCM are closely related to its chemical compositions, and also have certain regularity. The researches on the chemical components of TCM, systematic design of property and flavor, as well as the separation and combination of TCM property and flavor are beneficial to the overall analysis of the characteristics of TCM, showing great significance to inherit and carry forward TCM. The pharmacological effects about separation and combination methods based on TCM property and flavor were reviewed in this study, providing theoretical reference for the development of new drugs and the application of TCM.

Objective:To explore effects of clinical learning environment on occupational values of nursing students in higher vocational colleges under the background of industry-education integration so as to provide the basis for improving the clinical learning environment and improving the quality of nursing personnel training.Methods:From May to June 2019, 3 colleges were selected from the higher vocational colleges in Jiangsu Province that carried out medical and educational cooperative nursing personnel training and 200 nursing students in the second grade (2017 grade) of nursing majors from each of 3 colleges were selected as research objects by the convenient sampling method.Results:The total score of the nursing occupational value scale for 85 nursing students was (90.70±10.88) , and the total score of the clinical learning environment assessment scale was (152.72±14.84) . The results of multiple linear regression analysis showed that interpersonal relationship, working atmosphere and team spirit, task positioning in the clinical learning environment assessment scale were the influencing factors of occupational values of nursing students ( P<0.05) . Conclusions:Under the medical and educational cooperation talent training model, occupational values of nursing students are at a medium level, and clinical learning environment has positive effects on occupational values. It is necessary for schools and teaching hospitals to further improve the clinical learning environment so as to improve occupational values of nursing students.

Ovarian cancer has become the most lethal gynecological tumor due to the difficulty in early diagnosis,the late stage when diagnosed and the high recurrence rate.Resistance to platinum-based anti-tumor chemotherapy drugs is an important reason for the poor prognosis of ovarian cancer.circular RNA(circRNA)is more stable than mRNA in cells due to its special structure,and it is involved in the regulation of the occurrence,development and chemotherapy resistance of a variety of tumors.circRNA can be used as a competing endogenous RNA(ceRNA)of miRNA to bind to proteins,and regulates the phenotypic polarization of macrophages,it can also be used as an exosomal circRNA to regulate the sensitivity of platinum resistance in ovarian cancer.circRNA is expected to be a new marker of platinum resistance and a new target for the treatment of platinum resistance.In order to further explore the relationship between circRNA and platinum resistance in ovarian cancer,this article summarizes the recent literature related to circRNA and platinum resistance in ovarian cancer.

Trichinosis is a global food-borne zoonotic parasitic disease caused by Trichinella spiralis(T.spiralis),which causes serious harm to animal production,and the public health safety of humans and animals.T.spiralis has a complex devel-opment history,and its entire life cycle is completed in the same host.To coexist with the host,it has evolved various immune escape mechanisms for avoiding immune clearance by the host,thus establishing long-term chronic infection.In this study,to aid in understanding the pathogenic mechanism of T.spiralis,the immune escape mechanism of Trichinella is discussed from three aspects:the molecular role of antigens in various stages,the immune regulatory effect on the host,and the formation of cysts to generate immune isolation.

Objective: To analyze the hints role of surveillance cultures of Carbapenem-resistant Enterobacteriaceae (CRE) by perianal swabs in patients with hematological diseases, and seek risk factors of CRE bloodstream infection. Methods: The resistance of CRE from 2 914 patients with hematological diseases who cultured perianal swabs, CRE bloodstream infection and risk factors were analyzed during January 2016 to December 2017. Results: In this study, perianal swabs from 2 914 patients with hematological diseases were cultured, 74 patients were CRE positive, and bloodstream infection with CRE was found in 13 of these patients. A total of 87 CRE strains were isolated (The same patient only keep the first one for the same location), including 31 Klebsiella pheuminiae, 43 Escherichia coli, 8 Enterobacter cloacae and 6 other Enterobacteriaceae. The resistance rates to piperacillin / tazobactam, imipenem, meropenam, amikacin, levofloxacin, tigecycline were 91.9%, 74.4%, 98.8%, 17.6%, 74.4% and 8.0%, respectively. Resistance to carbapenem, aminoglycoside, quinolones and tegacycline were highly consistent between two sites from 13 patients, whose both perianal swabs and blood were positive in CRE cultures. Febrile neutropenic time, digestive tract symptoms and perianal infection were independent risk factors for bloodstream infection in patients with perianal swabs positive results, the odds ratios (OR) were 1.10 (P=0.029), 1.13 (P=0.005) and 1.23 (P=0.016), respectively. Conclusion: Perianal swabs surveillance cultures of CRE can be hints for CRE bloodstream infection in patients with hematological diseases, and also can provide suggestions for antibiotics. Long time of febrile neutropenic, digestive tract symptoms and perianal infection can be the early warning for CRE bloodstream infections.
Anti-Bacterial Agents ; Bacteremia ; Carbapenem-Resistant Enterobacteriaceae ; Carbapenems ; Enterobacteriaceae Infections ; Hematologic Diseases ; Humans

Objective:To explore the effects of the continuous nursing model on the prognosis, outcome and quality of life of patients with systemic lupus erythematosus (SLE) .Methods:Totally 175 SLE inpatients admitted in the Department of Rheumatology and Immunology in Guangdong Second Provincial General Hospital from January 2016 to September 2019 were selected by convenient sampling and divided into the experimental group ( n=84) and the control group ( n=91) . Patients in the experimental group received continuous nursing care, while patients in the control group received routine care for 3 months The Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) , Systemic Lupus Erythematosus Knowledge Questionnaire (SLEKQ) , MOS SF-36 Health Survey (SF-36) , readmission rate and nursing satisfaction rate were compared between the two groups. Results:After intervention, the patient knowledge and patient's perception of family knowledge scores in the SLEKQ of the experimental group were higher than those of the control group, whereas the SLEDAI-2K score was lower in the experimental group than in the control group, and the differences were statistically significant ( P< 0.05) . After intervention, the scores of all SF-36 dimensions in the experimental group were higher than those in the control group, and the differences were statistically significant ( P < 0.05) ; the readmission rate of the experimental group was lower than that of the control group, and the difference was statistically significant ( P<0.05) ; the nursing satisfaction of the experimental group was higher than that of the control group, and the difference was statistically significant ( P< 0.05) . Conclusions:The implementation of the continuous nursing model can more effectively improve the disease awareness of SLE patients, improve the health-related quality of life, and reduce the readmission rate.

BACKGROUNDThe SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery Score II (SS-II) can well predict 4-year mortality in patients with complex coronary artery disease (CAD), and guide decision-making between coronary artery bypass graft surgery and percutaneous coronary intervention (PCI). However, there is lack of data regarding the utility of the SS-II in patients with three-vessel CAD undergoing PCI treated with second-generation drug-eluting stents (DES). The purpose of the present study was to evaluate the ability of the SS-II to predict long-term mortality in patients with three-vessel CAD undergoing PCI with second-generation DES.

METHODSTotally, 573 consecutive patients with de novo three-vessel CAD who underwent PCI with second-generation DES were retrospectively studied. According to the tertiles of the SS-II, the patients were divided into three groups: The lowest SS-II tertile (SS-II ≤20), intermediate SS-II tertile (SS-II of 21-31), and the highest SS-II tertile (SS-II ≥32). The survival curves of the different groups were estimated by the Kaplan-Meier method. Univariate and multivariate Cox proportional hazard regression analyses were performed to evaluate the relationship between the SS-II and 5-year mortality. The performance of the SS-II with respect to predicting the rate of mortality was studied by calculating the area under the receiver operator characteristic (ROC) curve. The predictive ability of the SS-II for 5-year mortality was evaluated and compared with the SS alone.

RESULTSThe overall SS-II was 27.6 ± 9.0. Among patients in the lowest, intermediate and the highest SS-II tertiles, the 5-year rates of mortality were 1.6%, 3.2%, and 8.6%, respectively (P = 0.003); the cardiac mortality rates were 0.5%, 1.9%, and 5.2%, respectively (P = 0.014). By multivariable analysis, adjusting for the potential confounders, the SS-II was an independent predictor of 5-year mortality (hazard ratio: 2.45, 95% confidence interval: 1.38-4.36; P = 0.002). The SS-II demonstrated a higher predictive accuracy for 5-year mortality compared with the SS alone (the area under the ROC curve was 0.705 and 0.598, respectively).

CONCLUSIONThe SS-II is an independent predictor of 5-year mortality in patients with three-vessel CAD undergoing PCI treated with second-generation DES, and demonstrates a superior predictive ability over the SS alone.

Aged ; Coronary Disease ; mortality ; surgery ; Drug-Eluting Stents ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; mortality ; Retrospective Studies

BACKGROUNDThere are limited data on longer-term outcomes (>5 years) for patients with unprotected left main coronary artery (ULMCA) disease who underwent percutaneous coronary intervention (PCI) in the drug-eluting stents (DES) era. This study aimed at comparing the long-term (>5 years) outcomes of patients with ULMCA disease underwent PCI with DES and coronary artery bypass grafting (CABG) and the predictors of adverse events.

METHODSAll consecutive patients with ULMCA disease treated with DES implantation versus CABG in our center, between January 2003 and July 2009, were screened for analyzing. A propensity score analysis was carried out to adjust for potential confounding between the two groups.

RESULTSNine hundred and twenty-two patients with ULMCA disease were enrolled for the analyses (DES = 465 vs. CABG = 457). During the median follow-up of 7.1 years (interquartile range 5.3-8.2 years), no difference was found between PCI and CABG in the occurrence of death (P = 0.282) and the composite endpoint of cardiac death, myocardial infarction (MI) and stroke (P = 0.294). Rates of major adverse cardiac and cerebrovascular events were significantly higher in the PCI group (P = 0.014) in large part because of the significantly higher rate of repeat revascularization (P < 0.001). PCI was correlated with the lower occurrence of stroke (P = 0.004). Multivariate analysis showed ejection fraction (EF) (P = 0.012), creatinine (P = 0.016), and prior stroke (P = 0.031) were independent predictors of the composite endpoint of cardiac death, MI, and stroke in the DES group, while age (P = 0.026) and EF (P = 0.002) were independent predictors in the CABG group.

CONCLUSIONSDuring a median follow-up of 7.1 years, there was no difference in the rate of death between PCI with DES implantation and CABG in ULMCA lesions in the patient cohort. CABG group was observed to have significantly lower rates of repeat revascularization but higher stroke rates compared with PCI. EF, creatinine, and prior stroke were independent predictors of the composite endpoint of cardiac death, MI, and stroke in the DES group, while age and EF were independent predictors in the CABG group.

Aged ; Coronary Artery Bypass ; Coronary Artery Disease ; physiopathology ; therapy ; Drug-Eluting Stents ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Stroke Volume

Objective:To observe the clinical efficacy as well as anti-inflammatory and anti-fibrosis mechanism of Yishen Tongluo decoction in the treatment of chronic glomerulonephritis （CGN） with spleen and kidney Qi deficiency and blood stasis syndrome. Method:According to the random number table method， one hundred and twenty patients were divided into control group （60 cases） and observation group （60 cases）. The two groups were given oral valsartan capsules， 160 mg/time， 1 time/day， and dipyridamole tablets orally， 50 mg/time， 3 times/day. Patients in control group additionally took Wubi Shanyao pills orally， 9 g/time， 2 times/day， while patients in observation group additionally took Yishen Tongluo decoction orally， 1 dose/day. Both groups were treated continuously for four months. Before and after treatment， 24 h urine total protein （24 h UTP）， creatinine （SCr）， urea nitrogen （BUN）， serum cystatin C （CysC）， tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， IL-17， interferon-γ （IFN-γ）， transforming growth factor-β₁ （TGF-β₁）， connective tissue growth factor （CTGF）， matrix metalloproteinase-9 （MMP-9）， tissue inhibitor of metalloproteinases （TMP-1） and hypoxia inducible factor-1α （HIF-1α） levels were detected in both groups. The scores of spleen and kidney Qi deficiency and blood stasis syndrome were graded. Urine protein， and urine red blood cells （urinary RBC） were monitored. Result:The 24 h UTP， SCr， BUN and CysC levels of the observation group were lower than those of the control group （P<0.01）. The score of spleen and kidney Qi deficiency and blood stasis syndrome in the observation group was lower than that in the control group （P<0.01）. The levels of TNF-α， IL-6， IL-17 and IFN-γ in the observation group were lower than those in the control group （P<0.01）. The levels of TGF-β₁， CTGF， TMP-1 and HIF-1α in the observation group were lower than those in the control group （P<0.01）. While MMP-9 level was higher than that in control group （P<0.01）. The clinical effective rate was 88.33% （53/60） in the observation group， higher than 73.33% （44/60） in the control group （χ2=4.356， P<0.05）. Conclusion:On the basis of conventional Western medicine treatment， Yishen Tongluo decoction in the treatment of CGN patients with spleen and kidney Qi deficiency and blood stasis syndrome can reduce proteinuria， and improve traditional Chinese medicine （TCM） syndromes， with anti-inflammatory and anti-kidney fibrosis effects. Thereby， it plays a role in protecting renal function and delaying the malignant progression of renal function， with high clinical efficacy and value of clinical use.

In 2004, it was the first time that Wollensak and Spoerl had applied physical and chemical cross-linking methods to scleral tissue. They found that the biomechanical strength of cross-linked sclera, induced by riboflavin/ultraviolet A, glyceraldehyde and glutaraldehyde, could be improved and proposed that scleral collagen cross-linking is expected to be a new method for the treatment of pathologic myopia. In recent years, a series of explorations have been made on the effectiveness and adverse reactions of physical and chemical cross-linking in the prevention and treatment of pathologic myopia, including the establishment of various animal models and different myopia modeling methods, the improvement of cross-linking methods, the amelioration of the measurement of biomechanical strength of scleral tissue and the attention of biological parameters such as the thickness of retinal nerve fiber layer and the amplitude of electroretinogram in vivo. Genipin-crosslinking of the scleral collagen combined with posterior scleral contraction/reinforcement has been applied to clinical research. This review summarizes physical cross-linking and the genipin-crosslinking of scleral collagen to explore the effectiveness and safety of the methods in the prevention and treatment of the pathologic myopia.