Objective To investigate the prevalence of perimenopausal syndrome and relative risk factors in perimenopausal and postmenopausal women in Chongqing city .Methods Totally 1 680 questionnaires from women with perimenopausal syndrome , all the objects were patients who visited gynecology clinic from January 2013 to June 2014 in Chongqing .Results The average men‐arche age was (14 .71 ± 1 .95) years old ;average menopause age was (47 .22 ± 3 .13) years old in 1 680 perimenopausal women . 93 .51% (1 571/1 680) objects were diagnosed perimenopausal syndrome ,mainly presented to be forgetfulness ,sleep disorder ,irrita‐bility ,palpitation ,headache ,hot flashes ,sweating ,loss of libido ,orgasmic dysfunction ,dyspareunia ,colpoxerosis ,bone ,joint and muscle pain ,paraesthesia of skin ,depression .The risk factors were analyzed ,forgetfulness(P < 0 .01) ,sleep disorder(P < 0 .01) , menopause(P< 0 .01) ,normal sex or not(P< 0 .05) ,the attitude of sex(P< 0 .05) ,and the attitude of menopause(P< 0 .05) .Con‐clusion Most women in the period of perimenopausal have the problem with perimenopausal syndrome .The special service should be provided to perimenopausal women ,such as knowledge about perimenopausal and rational hormone replacement therapy .

Objective To explore the clinical and pathological features, treatment, and prognosis of capillary proliferative purpura nephritis (DEP-HSPN) in children.MethodsThe clinical data of 19 children diagnosed with DEP-HSPN were retrospectively analysis. Fifty-five children diagnosed with HSPN by renal biopsy were randomly selected as control group. ResultsThe average age was 10.6±2.6 years old, and the average course of disease were 19.4±7.4 days before renal biopsy in 19 children with DEP-HSPN (14 males and 5 females) who make up 3.92% of anaphylactic purpura nephritis children conifrmed by renal biopsy in the same period. In these 19 children, there were 10 cases having nephrotic syndrome and 9 case having hematuria and proteinuria type, all of whom were received immunosuppressive therapy. Finally, 14 cases achieved completely remission and 5 cases had partly remission. All of their classiifcations of renal pathology wereⅢb levels, accompanied with 6.38% to 36.36% of crescents. Compared with 55 age and sex matched children with renal pathology classiifcation ofⅢb, the DEP-HSPN children had shorter disease course, higher level of proteinuria, and lower pathological score of chronic renal injury (P all?

Objective To explore the medication law of Professor Ding Ying in the treatment of Henoch-Sch?nlein purpura;To analyze Professor Ding Ying's academic thought and clinical experience in the treatment of Henoch-Sch?nlein purpura.Methods Professor Ding Ying's prescriptions for the treatment of Henoch-Sch?nlein purpura in The First Affiliated Hospital of Henan University of Chinese Medicine from January 2013 to January 2020 were selected.Through the analysis of the Integrated Platform for Inheriting Famous Doctors,drug-drug and drug-symptom networks were constructed,and in-depth analysis of its core drug groups and their associated patterns was conducted.Results Totally 195 cases were included in the study,involving 585 times of diagnosis and 585 prescriptions.153 kinds of Chinese materia medica were involved in the prescriptions,with a total frequency of 8 017 times.The medicinal properties were mainly cold,warm and neutral,the medicinal taste was mainly bitter,and the meridians are mainly liver meridian and heart meridian.The analysis of drug weight grade showed that Rehmanniae Radix,Angelicae Sinensis Radix,Forsythiae Fructus,Lonicerae Japonicae Caulis,Moutan Cortex,Arnebiae Radix,Chuanxiong Rhizoma,Kochia Fructus,Piperis Kadsurae Caulis,Trachelospermi Caulis et Folium,Cynanchi Paniculati Radix et Rhizoma,Tripterygium wilfordii,Coicis Semen,Scutellariae Radix,Bubali Cornu,Amomi Fructus,Paeoniae Radix Alba,Spirodelae Herba and Glycyrrhizae Radix et Rhizoma were the core prescriptions for the treatment of Henoch-Sch?nlein purpura.Drug-drug co-occurrence analysis showed that Rehmanniae Radix-Angelicae Sinensis Radix,Rehmanniae Radix-Moutan Cortex,Forsythiae Fructus-Moutan Cortex,Kochia Fructus-Lonicera Japonicae Caulis,Chuanxiong Rhizoma-Lonicera Japonicae Caulis,Lonicerae Japonicae Caulis-Angelicae Sinensis Radix,Kochia Fructus-Forsythiae Fructus,Moutan Cortex-Arnebiae Radix,Angelicae Sinensis Radix-Moutan Cortex,Rehmanniae Radix-Forsythiae Fructus,Forsythiae Fructus,Rehmanniae Radix-Lonicera Japonicae Caulis were commonly used in the treatment of Henoch-Sch?nlein purpura.Clustering analysis showed 10 potential drug groups.Conclusion Professor Ding Ying emphasizes the combination of disease,syndrome,and symptoms in the treatment of Henoch-Sch?nlein purpura,as well as the application of couplet medicines.Clinical treatment follows the concept of"dispelling pathogens and calming the collaterals",making good use of heat clearing and detoxifying drugs,heat clearing and wind dispelling drugs,and heat clearing and dampness dispelling drugs to"dispel pathogens",and making good use of blood activating and cooling drugs,as well as blood nourishing and unblocking drugs to"calm the collaterals".

ObjectiveTo explore the underlying mechanism of Tripterygium wilfordii polyglycoside tablets （TWPT） in the prevention and treatment of kidney injury in diabetic nephropathy （DN） through the nuclear factor of activated T-cells 2（NFAT2）/cyclooxygenase-2（COX-2） pathway. MethodForty-two male SD rats of SPF grade were selected and randomly divided into a normal group （n=8） and an experimental group （n=34） after one week of adaptive feeding. The rats in the normal group were fed conventionally. The DN model was established in rats of the experimental group by intraperitoneal injection of streptozotocin （STZ） following one week of feeding on a high-fat and high-glucose diet. After the death and failure cases during modeling were eliminated， the remaining 24 model rats were randomly divided into model group， valsartan （8.33 mg·kg^-1·d^-1） group， and TWPT （5 mg·kg^-1·d^-1） group. Rats in normal group and model group were given equal amounts of normal saline by gavage. After six weeks， body weight was measured and urine samples were collected. Blood samples were collected from the abdominal aorta， and then the rats were sacrificed for sampling. Biochemical indicators， such as serum blood urea nitrogen （BUN）， serum creatinine （SCr）， alanine aminotransferase （ALT）， blood lipid， blood glucose， and 24-hour urine total protein （24 h UTP）， were determined. Hematoxylin-eosin （HE） staining and Masson staining were used to observe the pathology of the kidney. Enzyme-linked immunosorbent assay （ELISA） was used to detect NFAT2 and COX-2 expression levels in the serum. Western blot and Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR）were adopted to detect NFAT2， COX-2 protein and mRNA expression in kidney tissues， respectively. ResultCompared with the normal group， the model group showed elevated 24 h UTP， BUN， SCr， CHO， TG， and FBG， increased serum NFAT2 and COX-2 production and expression （P<0.01）， and elevated protein and mRNA expression of NFAT2 and COX-2 in kidney tissues （P<0.01）. In addition， the pathology of the kidney showed enlarged glomeruli， mild proliferation of mesangial cells， and widened mesangial stroma. Compared with the model group， the TWPT group showed decreased 24 h UTP， BUN， SCr， CHO， TG， and FBG （P<0.05，P<0.01）， basically normal glomerular morphology， decreased expression of serum NFAT2 and COX-2 （P<0.01）， and down-regulated protein and mRNA expression of NFAT2 and COX-2 in kidney tissues （P<0.01）. ConclusionTWPT can alleviate 24 h UTP in DN model rats， protect renal function， and improve renal pathology， and its mechanism of action may be related to the down-regulation of NFAT2/COX-2 expression in the serum and kidney tissues.

Guided by the theory of "kidney generates marrow"， the study elaborates the viewpoint that the route of Yin Heel Channel （阴跷脉） is consistent with the "kidney-marrow-brain" axis from the perspective of the circulation of the meridians and the relationship between the zang-fu organs. Accordingly， it is believed that disease of Yin Heel Channel and dysfunction of the "kidney-marrow-brain" axis are the core pathogenesis of children enuresis， and it is elaborated from the following three major aspects， firstly， insufficient kidney essence， dysfunction of the "kidney-marrow-brain" axis， secondly， disease of Yin Heel Channel and deficiency and cold in lower jiao， and thirdly， disease of Yin Heel Channel and loss of nourishment of Chong Vessel. It is proposed to use the mode of "firstly needle， secondly moxibustion， and lastly consolidation" to treat children enuresis. Needle is to adjust yin and yang， warm yang and tonify kidney， and wake up the brain and open the orifices. The acupoints in Yin Heel Channel such as Zhaohai （KI 6）， Jiaoxin （KI 8） and confluence points of the eight extraordinary vessels such as Waiguan （TE 5）， Zulinqi （GB 41） are used， together with Baihui （GV 20）， Yintang （EX-HN 3）， Guanyuan （CV 4）， Qixue （KI 13）， Dazhong （KI 4）. Moxibustion is to reinforce healthy qi and warm yang， bank up the root and consolidate the original qi by moxibustion at Shenque （CV 8）， Mingmen （GV 4）， and Xuanshu （GV 5）. Consolidation is to use acupoints application to consolidate the therapeutic effect， and Guanyuan （CV 4） & Pangguangshu （BL 28）， Qihai （CV 6） & Zhishi （BL 52）， and Shenque （CV 8） & Ciliao （BL 32） are commonly used as the three groups of acupoints to warm the kidney and stop collapse， regulate and tonify the qi and blood.

ObjectiveTo explore the possible mechanism of Yiqi Yangyin Huoxue prescription in the prevention and treatment of kidney injury of diabetic kidney disease（DKD）rats based on NOD-like receptor protein 3（NLRP3）/cysteine protease-1（Caspase-1）/gasdermin D （GSDMD）pyroptosis pathway. MethodFifty male SD rats were randomly divided into normal group （n=8） and modeling group （n=42）. The modeling group was given a one-time intraperitoneal injection of streptozotocin （STZ） after high-sugar and high-fat diet for 6 weeks to induce the establishment of a DKD rat model. After successful modeling， the rats were randomly divided into model group， valsartan group （8.33 mg·kg^-1）， and Yiqi Yangyin Huoxue prescription low-dose and high-dose group （11，22 g·kg^-1）. After continuous gavage for 6 weeks， the fasting blood glucose （FBG）， total cholesterol （CHO）， triglyceride （TG）， blood urea nitrogen （BUN）， serum creatinine （SCr） and 24-hour urine protein quantification （24 h-UTP） were detected in each group of rats. Hematoxylin-eosin （HE） staining was used to observe the pathological changes of kidney tissue. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum interleukin-1β （IL-1β） and interleukin-18 （IL-18） levels. The protein and mRNA expression levels of NLRP3/Caspase-1/GSDMD in kidney tissue of rats in each group were determined by Western blot and real-time quantitative polymerase chain reaction （Real-time PCR）. ResultCompared with the conditions in normal group， the levels of FBG， CHO， TG， BUN， SCr， 24 h-UTP and serum IL-1β and IL-18 as well as the protein and mRNA expression levels of NLRP3/Caspase-1/GSDMD in kidney tissue in model group were increased （P<0.01）， and the kidney tissue lesions were severe. Compared with the conditions in model group， the levels of FBG， CHO， TG， BUN， SCr， 24 h-UTP and serum IL-1β and IL-18 as well as the protein and mRNA expression levels of NLRP3/Caspase-1/GSDMD in kidney tissue in each intervention group were decreased （P<0.05， P<0.01）， and the degree of kidney tissue lesions was improved， with Yiqi Yangyin Huoxue prescription high-dose group showing the optimal effect. ConclusionYiqi Yangyin Huoxue prescription could inhibit pyroptosis by regulating the NLRP3/Caspase-1/GSDMD pathway， and thus relieve the inflammatory response of DKD rats and alleviate the pathological damage of the kidneys.

Objective: To investigate the efficacy, safety, and traditional Chinese medicine (TCM) medication patterns of rituximab (RTX) combined with TCM on treating children with steroid-dependent nephrotic syndrome (SDNS). Methods: One hundred and forty-three children with SDNS who visited the Pediatric Nephrology Department of the First Affiliated Hospital of Henan University of Chinese Medicine from January 2018 to December 2022 were enrolled. A cohort study design was adopted, with " RTX treatment" as the exposure factor. Children who met this exposure factor were assigned to the RTX cohort (RTX, glucocorticoid, immunosuppressive agent, combined with traditional Chinese medicine syndrome differentiation treatment), whereas those who did not were assigned to the basic treatment cohort (glucocorticoid, immunosuppressive agent, combined with traditional Chinese medicine syndrome differentiation treatment ), and followed up for 6 months. The frequency of urinary protein recurrences, urinary protein remission duration, proportion and duration of steroid reduction and cessation, cumulative usage of steroids, proportion of recurrence, recurrence amount of steroid used, efficacy of TCM syndrome, and laboratory and safety indicators after treatment, and height and CD19+ B cell count before and after treatment were compared between the two cohorts. The medication patterns of TCM in the two cohorts were analyzed using frequency statistics, association rule analysis, and systematic clustering analysis. Results: Compared with the basic treatment cohort, the RTX cohort showed a decrease in the frequency of urinary protein recurrence, extended sustained remission of urinary protein, an increase in the proportion of steroid reduction and cessation, a shorter duration of steroid reduction and cessation, a decrease in cumulative steroid dosage, a lower recurrence rate, a decrease in CD19+ B cell count, and a decrease in 24-h urinary total protein quantification and the level of cholesterol (P<0.05). No significant difference in the recurrence amount of steroid used, height, TCM syndrome efficacy, albumin, aspartate transaminase, blood urea nitrogen, platelet count, and safety indicators between the two cohorts. Children with SDNS were mostly characterized by qi and yin deficiency syndrome, followed by spleen and kidney yang deficiency syndrome. A total of 175 TCMs were included, including 28 high-frequency drugs such as Huangqi, Fuling, Gancao, Baizhu, Dangshen, and Jiuyurou. The primary use of medication is to nourish the qi and spleen, nourish the kidney, and warm yang. The analysis of association rules yielded eight binary associations and ten three-phase associations, with Huangqi, Baizhu, Fuling, and Dangshen, being the most closely related. Cluster analysis identified four TCM combinations, primarily focusing on tonifying kidney and replenishing essence, benefiting qi and nourishing yin, and removing blood stasis. Conclusion RTX combined with TCM syndrome differentiation treatment can reduce the recurrence frequency of SDNS, prolong the remission period, reduce the glucocorticoid dosage, and have no marked effect on height growth. No apparent adverse reactions were observed. TCM should focus on nourishing qi and yin while removing blood stasis.

OBJECTIVE To explore the renal protective mechanism of Shenbining granules on IgA nephropathy （IgAN） rats based on mitochondrial quality control system. METHODS IgAN rat model was established by the method of “bovine serum albumin+carbon tetrachloride+lipopolysaccharide”. The model rats were randomly divided into model group， prednisone acetate group （6.25 mg/kg）， Shenbining equal-dose group （4.1 g/kg） and Shenbining high-dose group （20.5 g/kg）. The normal rats were taken as the normal control group， with 12 rats in each group. Rats were given corresponding drugs or distilled water intragastrically in each group， once a day， for 4 consecutive weeks. After the last medication， the 24 h total urinary protein （24 h- UTP） and erythrocyte count in urine were determined， and the levels of serum creatinine （Scr）， blood urea nitrogen （BUN）， albumin （ALB） and alanine transaminase （ALT） were also detected. The histopathological changes in the kidneys and changes in IgA deposition in the mesangial area of the kidney were observed. mRNA and protein expression levels of PTEN-induced putative kinase 1 （PINK1）， E3 ubiquitin ligase（Parkin）， microtubule-associated protein 1 light chain-3 （LC3）， dynamin-related protein 1 （Drp1） and mitofusin 2 （Mfn2） were detected in the kidney tissues of rats. RESULTS Compared with model group， 24 h-UTP， urinary erythrocyte count， ALT， BUN and Scr levels， LC3-Ⅱ/LC3-Ⅰ mRNA ratio， mRNA and protein expressions of Drp1 were reduced significantly in prednisone acetate group， Shenbining equal-dose group and Shenbining high-dose group （P＜0.05）； ALB level， LC3-Ⅱ/LC3-Ⅰ protein ratio， mRNA and protein expressions of PINK1， Parkin and Mfn2 were increased significantly （P＜0.05）； the pathological morphology of kidney tissue in rats was significantly improved， and IgA deposition was significantly reduced. CONCLUSIONS Shenbining granule may reduce renal pathological injury in IgAN rats and protect renal function by activating the PINK1/Parkin pathway， enhancing mitochondrial autophagy， and correcting mitochondrial kinetic disorders.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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