[Objective] To observe the therapeutic effect of spleen-invigorating and lung-nourishing therapy and its influence on nutritive index and quality of life (QOL) in patients with chronic obstructive pulmonary disease (COPD) at stationary phase. [ Methods ] Ninety cases of COPD were randomized into three groups. Group A was given routine symptomatic treatment; groups B and C were given oral use of Jianpi yifei Granules and routine symptomatic treatment and group C was additionally treated with garlic-partition moxibustion and acupoint injection of Shenmai Injection on bilateral Zusanli (ST 36) point alternatively. The treatment lasted 2 months. [Results] The effective rate was 93.33% in group C, 86.67% in group B and 56.67% in group A (P 0.05) compared with those before treatment. Scores of activity of daily life (ADL) , depression and anxiety and the total score of QOL were obviously decreased in groups B and C (P

Objective To explore the application value of ultrasound-guided fine needle aspiration biopsy(FNAB) in diagnosing thyroid nodules of TI-RADS 4-6 categories.Methods A retrospective analysis was made on the pathologic data of 494 patients (totally 501 nodules) who underwent TI-RADS ultrasonographic stratification and ultrasound-guided FNAB.168 thyroid nodules of TI-RADS 4-6 categories were selected from 163 patients and classified into three groups:group T,TI-RADS 4A categories;group Ⅱ,TI-RADS 4B category; group Ⅲ,TI-RADS 5-6 category(the pathologically confirmed cases in category 6 had been removed).The ultimate pathologic findings were taken as golden standards to calculate the accuracy,sensitivity,specificity,positive predictive value of ultrasound-guided FNAB in the three groups.ROC curve was drawn to evaluate the diagnostic value of FNAB.Results The accuracy,sensitivity,specificity,positive predictive value of the ultrasound-guided FNAB in the three groups were listed as follows:group Ⅰ 74.4％,73.3％,75.0％,64.7％;group Ⅱ 83.9％,87.5％,71.4％,91.3％;group Ⅲ 89.3％,91.7 ％,75.0％,95.7 ％ respectively.The positive predictive values of the ultrasound-guided FNAB for group Ⅰ and group Ⅱ was higher than that of conventional TI-RADS classification criteria,so the difference was statistically significant; while the positive predictive values for group Ⅲ was close to the conventional ultrasound TI-RADS classification criteria,the difference was not statistically significant.Conclusions The combination application of TI-RADS classification criteria and FNAB can improve the accuracy of ultrasound diagnosis in group Ⅰ and group Ⅱ,and reduce the puncture rate of group Ⅲ.

Objective To study if IRF1 could regulate the polarization by IRF 1 and M1 status and affect M1 media-ted antitumor function .Methods U937 derived M1 macrophage ( U937-M1 ) model was established .The cells were devided into 4 groups:the PMA pretreated unpolarized macrophage (M0), the PMA, IFN-γand LPS induced M1 macrophage (M1), the siRNA of IRF1 knocked down M1 macrophage (siIRF1) and the negative control siR-NA treated M1 macrophage (siC).Furthermore, the expression of CD86 and CD206 was detected by flow cytome-try, the M1/M2 associated markers (IL-12p35,IL-12p40,IL-23p19,IL-6,TNF-α/IL-10) and IFNB1 were ana-lyzed by qPCR,the expression of IL-12p70 and IL-10 was examined by ELISA, the expression of IRF1 and IRF5 was detected by Western blot , the proliferration and apoptosis of HCC were analyzed by CCK 8 and flow cytometry , respectively.Results Compared with the U937-M1, the IRF1 knocked down group showed impaired CD 86 expres-sion, but enhanced CD206 expreesion ( P<0.05 ); the expression of M1 related cytokines including IL-12p35, IL-12p40,IL-23p19,IL-6,TNF-αand IFNB1 was decreased, but M2 related cytokine IL-10 level was increased (P<0.01);the expression of IFN-β, IL-12p70 and IRF5 was impaired, but IL-10 was enhanced (P<0.05).In IRF1 knocked down U937-M1, the CCK8 analysis indicated that the M1 mediated anti-proliferation effects on hepatoma carcinoma cell were turned to pro-proliferation ( P<0.05);the flow cytometry showed that the M 1 mediated pro-ap-optosis effects were reversed to anti-apoptosis ( P<0.01 ) .Interestingly , IRF5 and IFN-βwere decreased at both mRNA and protein levels in IRF1 knocked down U937-M1 compared with the U937-M1 (P<0.01).Conclusions IRF1 may partly modulate IRF5 and IFN-β, and further regulate M1 polarization and its antitumor effects .

Objective To study the clinical application of intercalated combination of osimertinib and docetaxel in T790M mutation-positive lung adenocarcinoma patients with bone metastasis in the southern Hainan Province. Methods T790M mutation-positive lung adenocarcinoma patients with bone metastasis in the sou-thern Hainan Province treated at the Third People's Hospital of Hainan Province from January 2018 to October 2018 were enrolled,and they were divided into intercalated combination of osimertinib and docetaxel group (n = 32)and osimertinib group (n = 28)according to the treatment. The patients in intercalated combination of osimertinib and docetaxel group received oral osimertinib (80 mg,qd),and received docetaxel (75 mg/ m2 , repeated in three-week intervals)when taking to tumor progression,and oral osimertinib treatment (80 mg, qd)was maintained until tumor partial response or stable disease after chemotherapy. The patients in osimer-tinib group received oral osimertinib (80 mg,qd). The patients in both groups received zoledronic acid. The response rate,disease control rate,overall survival (OS)and the incidence of adverse reactions of both groups were contrastively analyzed. Results The response rate of intercalated combination of osimertinib and doceta-xel group (62. 5％,20 / 32)was higher than that of osimertinib group (35. 7％,10 / 28),and disease control rate (93. 8％,30 / 32)was also higher than that of osimertinib group (67. 9％,19 / 28),with statistically sig-nificant differences (χ2 = 4. 286,P = 0. 038;χ2 = 6. 687,P = 0. 010). The median OS of intercalated combi-nation of osimertinib and docetaxel group was 10. 0 months,which was longer than that of osimertinib group (9. 0 months),with statistically significant difference (χ2 = 5. 917,P = 0. 015). Moreover,the adverse reac-tions in both groups were all grade Ⅰ or Ⅱ,which could be relieved or improved through symptomatic treat-ment. Conclusion Intercalated treatment of osimertinib with docetaxel is safe and effective in T790M muta-tion-positive lung adenocarcinoma patients with bone metastasis in the southern Hainan Province. It can prolong the survival time of patients.

OBJECTIVETo analyze the pattern and prevalence of partial copy deletion of deleted-in-azoospermia (DAZ) gene in the azoospermia factor C(AZFc) region of patients with idiopathic azoospermia or severe oligozoospermia.

METHODSsY581 and sY587 in DAZ gene region were analyzed by polymerase chain reaction-restriction length polymorphism(PCR-RFLP) for its deletion in 197 patients with azoospermia, 166 patients with severe oligozoospermia, and 210 fertile men as controls.

RESULTSDeletion of both DAZ1 and DAZ2 was detected in 18 patients with azoospermia and 10 with severe oligozoospermia, and the prevalence was 9.1% and 6.0% respectively. There was significant difference in deletion rate between the cases and controls.

CONCLUSIONThe frequency of partial copy deletion of DAZ gene in Chinese idiopathic azoospermia or severe oligozoospermia patients is much higher than that of fertile controls, suggesting that the deletion of DAZ1/DAZ2 may be one of the important genetic etiological factors of spermatogenesis damage. The pattern and prevalence of DAZ partial copy deletion are similar to those of Caucasians populations, and detection of DAZ gene partial copy deletion by PCR-RFLP may be adopted as an additional clinical gene diagnostic measure after AZF microdeletion detection.

Azoospermia ; complications ; genetics ; Chromosomes, Human, Y ; genetics ; Deleted in Azoospermia 1 Protein ; Gene Deletion ; Humans ; Infertility, Male ; etiology ; genetics ; Male ; Models, Genetic ; Polymerase Chain Reaction ; RNA-Binding Proteins ; genetics

Objective:To evaluate the efficacy of cerebral-placental-uterine ratio(CPUR)in predicting late-on-set fetal growth restriction(FGR).Methods:From May 2020 to May 2021,1255 women with singleton pregnancy who underwent prenatal examinations at the University of Hong Kong Shenzhen Hospital were selected for fetal growth and Doppler measurements at 35-37 +6 weeks of gestation.Pregnant women with birth weight of newbo-rns＜the 10th percentile were the FGR group.The pulsatility index(PI)of uterine artery(UtA),umbilical artery(UA)and fetal middle cerebral artery(MCA)were analyzed separately and in combination.ROC curve was used to analyze the cerebral-placental-uterine ratio(CPUR),cerebral-placental ratio(CPR),cerebral-uterine ratio(C-UtA)for predicting late-onset FGR;and to evaluate the sensitivity,positive and negative predictive value and of CPUR in the prediction of late-onset FGR.Results:The area under the curve(AUC)of CPUR,CPR,C-UtA and mean UtA-PI for FGR grope were 0.88,0.86,0.84 and 0.72.Under certain cut-off values and 87% specificity,the specificity of CPUR,CPR,C-UtA and mean UtA-Pifor predicting FGR group was 43.2%,46.6%,39.8% and 23.9%,respectively.The positive predictive values of CPUR,CPR,C-UtA and mean UtA-PI,UA-PI for predicting FGR group were 90.5%,71.9%,83.3%,63.6%and 5.2%,respectively.Conclusions:CPUR is more effective in predicting late onset FGR than CPR,C-UtA and mean UtA-PI.It can effectively increase the detection rate of fetal growth restrictionand reduce the FGR risk.

Background PM_2.5 pollution has become a widely concerned environmental health problem. Polycyclic aromatic hydrocarbons(PAHs) are the main harmful components of PM_2.5, and their sources and carcinogenic risk deserve attention. Objective To analyze the source apportionment of PAHs in ambient PM_2.5 in Fuzhou, and to evaluate the potential carcinogenic risk through inhalation due to exposure to PAHs. Methods In this study, two sampling sites were set up in Cangshan (industrial area) and Taijiang (commercial and residential area) districts in Fuzhou City. PM_2.5 was collected from 10th to 16th of each month from 2017 to 2020 by membrane filtration method. The concentrations of ambient PM_2.5 were measured by weighing, and the concentrations of 16 PAHs, including naphthalene(NAP), acenaphthylene(ACY), acenaphthene(ACE), fluorene(FLU), phenanthrene(PHE), anthracene(ANT), fluoranthene(FLT), pyrene(PYR), benzo[a]anthracene(BaA), chrysene(CHR), benzo[b]fluoranthene(BbF), benzo[k]fluoranthene(BkF), benzo[a]pyrene(BaP), indeno[1,2,3-cd]pyrene(IcdP), dibenzo[a,h]anthracene(DahA), and benzo[g,h,i]perylene(BghiP), were determined by ultra-high performance liquid chromatography coupled with diode array detector and fluorescence detector. The concentrations of PM_2.5 and PAHs were compared in the two districts and the concentrations of PAHs were also compared in different seasons. The diagnostic ratio [FLT/(FLT+PYR), IcdP/(IcdP+BghiP), BaA/(BaA+CHR), and BaP/BghiP] method and positive matrix factorization (PMF) analysis were used to determine the sources of PAHs in PM_2.5 in Fuzhou. The excess carcinogenic risk (ECR) model was used to assess the potential health risk of inhalation exposure to PAHs. Results During 2017–2020, the M (P₂₅, P₇₅) concentration of ambient PM_2.5 in Cangshan and Taijiang districts of Fuzhou were 35.0 (25.0, 47.5) and 34.0 (25.5, 46.0) μg·m⁻³ respectively, and the percentages of PM_2.5 exceeding the national standard in Cangshan and Taijiang were 2.68% and 4.17%, respectively, without significant differences (P＞0.05). The M (P₂₅, P₇₅) concentrations of ΣPAHs in Cangshan was 5.03 (3.07, 7.67) ng·m⁻³, higher than that in Taijiang, 3.20 (2.05, 5.59) ng·m⁻³ (P＜0.05). The M (P₂₅, P₇₅) concentrations of PAHs monomers except ACY, FLU, and ACE in Cangshan were higher than those in Taijiang (P＜0.05). The concentrations of ΣPAHs in PM_2.5 in four seasons in Cangshan were higher than those in Taijiang (P＜0.05). In both districts, the concentration of ΣPAHs in winter was higher than those in spring, summer, and autumn (P＜0.05). According to the diagnostic ratio method, the median ratios of FLT/(FLT+PYR) in the two districts ranged from 0.4 to 0.5, and those of IcdP/(IcdP+BghiP), BaA/(BaA+CHR), and BaP/BghiP were from 0.2 to 0.5, from 0.2 to 0.35, and less than 0.6, respectively. The results of PMF analysis showed the proportions of four factors in Cangshan were 37.9%, 13.2%, 24.0%, and 24.9%, respectively. The major load contributors to factor 1 included FLT, PHE, and PYR; to factor 2, FLU, ACY, and ACE; to factor 3, DahA; to factor 4, BghiP, IcdP, and BaP. The proportions of four factors in Taijiang were 23.6%, 19.3%, 22.0%, and 35.1%, respectively. The main load contributor to factor 1 was DahA; to factor 2, BghiP; to factor 3, FLT, PHE, and PYR; to factor 4, IcdP, BaP, BbF, BkF, CHR, and BaA. The benzo[a]pyrene equivalences (BEQ) in Cangshan and Taijiang districts were 1.87 ng·m⁻³ and 1.61 ng·m⁻³, respectively. The excess carcinogenic risks of PAHs through inhalation exposure was 3.83×10⁻⁶ and 3.30×10⁻⁶, respectively. Conclusion The complex sources of PAHs in ambient PM_2.5 include dust, vehicle emissions, industrial emissions in Fuzhou, and are different in selected two districts. The level of PAHs in ambient PM_2.5 may pose a potential carcinogenic risk to local population.

Trib. Lorantheae used as traditional Chinese materia medica has a long history. There are 41 genera of Trib. Lorantheae， of which 6 belong to China， all have medicinal value， mainly distributed in Southwest， Southern， and Central and Southern China， with abundant resources. Twenty-two species of Trib. Lorantheae are used as medicinal materials or herbs in China. It mainly includes Taxillus. chinensis， T. sutchuenensis， Scurrula parasitica， Loranthus tanakae， Dendrophthoe pentandra， S. ferruginea， etc.， of which T. chinensis is the most widely used. The main chemical components of Trib. Lorantheae include flavonoids， terpenoids， sterols， phenylpropanoids， curcumins， phenolic acids， violate oils， sugars， and other compounds. Modern studies show that the extracts and monomer compounds of Trib. Lorantheae have various pharmacological effects such as anti-inflammation， anti-tumor， anti-oxidation， anti-osteoporosis， bacteriostasis， anti-virus， and lowering blood sugar， blood pressure， and lipid. It is believe that most active components related to their pharmacological effects are flavonoids， most of which are the main pharmacodynamic substances of the parasitic plants of Trib. Lorantheae， playing an important role in anti-inflammation， anti-tumor， anti-oxidation， anti-osteoporosis， and other pharmacological effect. This paper systematically summarized the literature and data on plants of Trib. Lorantheae and reviewed their chemical components and pharmacological effects， which provided references for the research， development， and utilization of Trib. Lorantheae.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.