Objective To investigate the effect of shenfu injection on immune function in severe trauma patients.Methods 60 severe trauma patients were divided into the control group (n =30)and shefu group (n =30) by random number table.Other 30 cases were chosen as the health control group at the same phase.All patients were received conventional treatments,however,patients of the shenfu group were additionally received the shenfu injection treatment in the early stage.The CD +3 ,CD +4 ,CD +8 cell,human leukocyte antigen (HLA -DR),interleukin -1(IL -1),interleukin -6(IL -6)were detected on 3rd and 7th day by double -antibody sandwich enzyme -linked immu-nosorbent assay (ELISA).Results Compared to the health control group,the IL -1,IL -6 in the control and shenfu group were significantly higher than the health control group(f=7.128,q =9.212,10.112,all P <0.05).The IL -1and IL -6 in the control and shenfu group were significantly increased on 3rd day (t =11.126,10.013,all P <0.05)and decreased on 7th day(t =17.121,14.213,all P <0.05).The IL -1 and IL -6 in shenfu group were sig-nificantly lower than that of the control group(χ2 =4.113,10.117,all P <0.05).The CD +3 ,CD +4 ,CD +8 ,HLA -DR and CD +3 /CD +8 rate in the control and shenfu group were significantly lower than the health control group(f=11.071, q =10.229,12.032,all P <0.05).On 3rd day,the CD +3 ,CD +4 ,CD +8 ,HLA -DR and CD +3 /CD +8 rate in shenfu group were significantly increased(t =10.013,P <0.05).On 7th day,CD +3 ,CD +4 ,CD +8 ,HLA -DR and CD +3 /CD +8 rate in the control and shenfu group were both increased(t =11.126,15.932,all P <0.05).And the CD +3 ,CD +4 ,CD +8 ,HLA -DR and CD +3 /CD +8 rate in shenfu group were significantly higher than the control group(χ2 =3.771,P <0.05).Conclusion Shenfu injection can regulate immune function in severe trauma and improve clinical treatment.

Objective To explore the prognosis and risk factors for cervical cancer in elderly patients. Methods Clinical data of 337 elderly patients (≥ 65 years old )admitted into Zhejiang Cancer Hospital from June 2008 to June 2013 were retrospectively analyzed.Clinical data and the follow-up information were collected. The correlation of prognosis with age ,performance status score , International Federation of Gynecology and Obstetrics (FIGO )staging ,tumor size ,pathological type , treatment and comorbidities were analyzed. Results Among 337 elderly patients ,the 5-year overall survival(OS )rates for patients with stage Ⅰ,Ⅱ,Ⅲ,Ⅳ were 81.8% ,62.3% ,53.5% and 0.0% , respectively (χ2=63.414 ,P=0.000) ;local recurrence rate was 33.5% ;the 5-year OS rate of patients with and without comorbidities were 54.0% and 70.0% ,respectively(χ2=8.907 ,P=0.003).Among 119 cervical cancer patients with stage ⅠA-ⅡA ,5-year OS for surgery group and radiotherapy group were 83.5% and 55.0% ,respectively(χ2=13.161 ,P=0.000).Among 218 advanced cervical cancer patients ,the 5 year OS for chemoradiotherapy and radiotherapy groups were 69.7% and 51.9% , respectively(χ2=4.030 ,P=0.045). The acute toxicity reactions of radiotherapy and chemoradiotherapy groups were as follows. The incidences of acute grades 3-4 hematological toxicity were 9.7% and 42.4% in radiotherapy group and chemoradiotherapy groups respectively (χ2=21.362 ,P=0.000) ,and the incidences of acute grade 3 gastrointestinal toxicity were 5.9% and 9.1% (χ2=0.086 ,P=0.769)in radiotherapy group and chemoradiotherapy group ,respectively.No grade 4 gastrointestinal toxicity was found.Multivariate Cox regression analysis showed that age ,PS score , FIGO staging ,pathological type ,treatment and comorbidities were influencing factors for prognosis in elderly patients with cervical cancer (P＜0.05). Conclusions Elderly cervical cancer patients have a good tolerance to treatment. The comorbidity is one of negatively influencing factors for prognosis. The efficacy of definitive radiotherapy is inferior to surgery in elderly patients with early stage cervical cancer due to the high proportion of comorbidities.Concurrent chemoradiotherapy can improve the prognosis of middle and advanced cervical cancer in elderly patients.

Objective To establish the quality standard for Sanyuan Rupixiao Gel Paste. Methods Sparganii Rhizoma, Gleditsiae Sinensis Fructus, Cyperi Rhizoma and Impatientis Semen were identified by TLC method. The content of tetrahydropalmatine was determined by HPLC. Waters symmetry column was used with the mobile phase of acetonitrile-0.1% phosphatic acid in a gradient manner (pH was adjusted to 6.4 by triethylamine) (55:45) at the detection wavelength of 280 nm. The flow rate was 1.0 mL/min at the column temperature of 30 ℃. Results The spots in TLC were clear without any interference;tetrahydropalmatine showed a good linear relation in the range of 0.092–1.84 μg;the average recovery was 100.15%with RSD of 1.58%(n=6). Conclusion The method is simple and accurate with high reproducibility, which can be used for the quality control of Sanyuan Rupixiao Gel Paste.

Asthma and chronic obstructive pulmonary disease overlap (ACO) is a hot topic in recent years. Although the precise definition of ACO is still controversial, scholars have found that the patients with overlapping features of asthma and COPD have a worse prognosis and increased medical cost than those with asthma or COPD alone. Thus, there is a big challenge to have a better understanding and to manage these patients in clinical practice. To strengthen awareness of this type of patients, the Global initiative for Chronic Obstructive Lung Disease (GOLD) and Global initiative for asthma (GINA) in 2014 named them as " Asthma Chronic Obstructive Lung Overlap Syndrome" (ACOS), which was further revised to the Asthma Chronic Obstructive Lung Overlap (ACO) in the follow-up GINA guidelines (2017). In the updated version, it emphasized that ACO was not a separate disease. However, although the research on ACO has increased significantly in recent years, there are still many controversies, which includes the definition, diagnostic criteria and treatment therapies. In this review, we provide the recent advances in the diagnosis and an overview of available treatment for of ACO.

Objective:To characterize the digital language markers in Alzheimer′s disease (AD) and mild cognitive impairment (MCI) patients, and to explore the pathological effect and aging effect on these markers.Methods:AD ( n=14) and MCI ( n=16) patients from memory clinic in Peking Union Medical College Hospital, age-matched cognitively normal elderly adults ( n=18) and youthful adults ( n=19) as controls participated in the study. The digital speech data of animal fluency test were collected. Novel language markers such as response time, semantic similarity and word frequency were analyzed in addition to the traditional word production, clustering and switching indicators by trained professionals. Multiple linear regression analysis with multiple comparison was used to test the associations of language markers with the cognitive status, adjusting for education. Results:The results of multiple regression analysis showed that, after adjusting for the years of education, statistically significant differences existed in 11 language markers among the four groups ( P<0.001), except for the effective word production in the last 15 s, cluster size, the first word response time and the average semantic similarity. Compared to other three groups, AD group differed significantly in effective word production, effective rate, repetitive rate, effective word production in the first 15 s, the number of subcategories, single word production time and inter-subcategory switching interval ( P<0.001). In addition, compared to cognitively normal youthful group, AD group had less number of switching and shorter semantic maximum distance ( P=0.001, P<0.001); both AD and MCI groups had longer intra-subcategory switching interval ( P<0.001, P=0.001); AD, MCI and cognitively normal elderly groups had significantly higher word frequency ( P<0.001); MCI group had significantly less number of effective word production and subcategories ( P=0.002, P=0.003); both MCI and cognitively normal elderly groups had significantly longer single word production time ( P<0.001). Conclusions:The performance of AD patients on the semantic fluency test task was affected by both pathological effect and normal aging effect. Pathological indicators included effective word production, effective rate, repetition rate, effective word production in the first 15 s, the number of subcategories, inter-subcategory switching interval and single word production time. These results provide a new approach to identify the specific effects of AD dementia.

Objective:To determine whether postoperative concurrent chemoradiotherapy (CCRT) improves the survival outcomes of cervical cancer patients with pelvic and/or para-aortic lymph node metastasis after radical surgery.Methods:Clinical data of 188 cervical cancer patients presenting with pelvic and/or para-aortic lymph node metastasis after radical surgery between February 2008 and November 2011 were retrospectively analyzed. The incidence of pelvic and/or para-aortic lymph node metastasis was confirmed by postoperative pathology. The clinical efficacy of CCRT was evaluated.Results:Recurrence/metastasis occurred in 46 patients. In the radiotherapy alone group, 4(57.1%) patients had recurrence/metastasis in the posterior peritoneum subgroup, 5(55.6%) in the iliac subgroup and 11(28.2%) in the pelvic non-iliac subgroup, respectively. In the CCRT group, there were 5(62.5%) cases of recurrence/metastasis in the posterior peritoneum subgroup, 5(25%) in the iliac subgroup and 16(15.2%) in the pelvic non-iliac subgroup, respectively. Compared with the radiotherapy alone, CCRT could significantly improve the 5-year overall survival (OS) rate of patients with pelvic without iliac lymph node metastasis or iliac lymph node metastasis (pelvic without iliac: 88.6% vs.76.9%, P=0.003; iliac: 80.0% vs.44.4%, P=0.041), whereas failed to improve the 5-year OS of patients with para-aortic lymph node metastasis (50.0% vs.42.9%, P=0.973). The location of lymph node metastasis and CCRT were the independent prognostic factors for OS (para-aortic vs. pelvic without iliac: hazard ratio[HR]=4.259, 95% CI=1.700-10.671, P=0.002; iliac vs. pelvic without iliac: HR=2.985, 95% CI=1.290-6.907, P=0.011; concurrent chemotherapy vs. radiotherapy alone: HR=0.439, 95% CI=0.218-0.885, P=0.021). Conclusions:CCRT can improve the survival of patients with pelvic lymph node metastasis, but it fails to enhance the survival rate of patients with para-aortic lymph node metastasis.

Objective:To understand the use of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD) in the real world and analyze its compliance with the guidelines.Methods:This study is a multicenter, cross-sectional study. 1 051 COPD patients who were treated in the Second Xiangya Hospital of Central South University, the First Affiliated Hospital of Shaoyang College and Zhuzhou Central Hospital from January 2020 to March 2022 were collected. The general information, drug use, types of exposure risk factors, acute exacerbation (AE) in the past year, the scores of the modified British Medical Research Council Dyspnea Questionnaire (mMRC), COPD Assessment Test (CAT), pulmonary function, blood routine of patients were collected. The status of ICS use in COPD patients, the clinical characteristics and guideline compliance of non-ICS users and ICS users were analyzed.Results:Among 1 051 patients with COPD, ICS was used in 490 cases (46.6%) and was not used in 561 cases (53.4%). ICS use was associated with relapse, frequent AE, severe AE, Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) grade 2 or above, GOLD D group, mMRC score, bronchial asthma, and blood eosinophils (EOS) (all P<0.05). Among 1 051 patients, 583(55.5%) were newly treated, 222(38.1%) were newly treated with ICS, and 361(61.9%) were not treated with ICS. ICS use in newly treated patients was associated with frequent AE, severe AE in the past year, GOLD grade 2 to 3, GOLD B and D group, mMRC score, bronchial asthma, and blood EOS (all P<0.05). Conclusions:Nearly half of patients with COPD are treated with ICS, and patients with ICS use had a higher risk of AE, more severe symptoms, higher blood EOS, and higher rates of asthma. However, there still exists the phenomenon of overuse of ICS.

Objective: To compare the curative effect of postoperative concurrent chemoradiotherapy (CCRT) and radiation therapy (RT) alone on early-stage cervical cancer patients with intermediate-risk factors. Methods: Clinical data of patients with early stage (ⅠB-ⅡA) cervical cancer who underwent radical hysterectomy and pelvic lymphadenectomy in Zhejiang Cancer Hospital between January 2008 and December 2011 were retrospectively analyzed. Cervical squamous cell carcinoma patients with more than two intermediate-risk factors, including lymphatic vascular infiltration, depth of cervical stromal infiltration >1/2 cm or tumor size >4 cm, were screened. Among them, 80 patients were divided into the RT group, 137 patients were divided into the CCRT group. The survivals of these patients were analyzed. Results: At the end of the follow-up period, a total of 22 patients were dead, one patient was alive with neoplasm. There were 23 patients who occurred recurrence/ metastasis, 14 of them were in the RT group and 9 were in the CCRT group. The 5-year progression free survival (PFS) and 5-year overall survival (OS) rate of the entire cohort were 89.9% and 89.8%, respectively. The 5-year PFS rate of RT group was 82.4%, the 5-year PFS rate of CCRT group was 94.1%, and the difference between the two groups was statistically significant (P=0.013). The 5-year OS rate of RT group was 85.1%, the 5-year OS rate of CCRT group was 92.7%, and the difference between the two groups was statistically significant (P=0.049). Univariate analysis showed that therapeutic modality was associated with the 5-year DFS and OS of early-stage cervical cancer patients with intermediate-risk factors (P<0.05). The results of multivariate analysis showed that therapeutic modality was an independent prognostic factor of favorable PFS (RR=3.741, 95% CI: 1.506-9.289, P=0.004) and OS (RR=2.754, 95%CI=1.143-6.637, P=0.024). Neither of the two groups occurred severe anemia. However, the incidence of mild and moderate anemia in the CCRT group was higher than that of RT group (P<0.001). The incidence of leukocytopenia severer than grade Ⅲ in the CCRT group was significantly higher than that of RT group (P<0.001). However, the patients could recover quickly with the treatment of granulocyte colony-stimulating factor. Conclusion Postoperative CCRT improves the survival of early stage cervical cancer patients with two or more intermediate-risk factors.

Objective: To explore the clinical significance of serum squamous cell carcinoma antigen (SCC-Ag) in early cervical squamous cell carcinoma. Methods: The clinicopathological data and follow-up information of 1435 patients with stage ⅠA2-ⅡA cervical squamous cell carcinoma were collected. The correlation between serum SCC-Ag level and clinicopathological feature and prognosis were analyzed. The best cut-off of serum SCC-Ag for predicting pelvic lymph node metastasis and survival of cervical squamous cell carcinoma patients were also identified. Results: The result of univariate analysis showed that The International Federation of Gynecology and Obstetrics (FIGO) staging, tumor size, depth of cervical stromal invasion, lymphovascular space involvement, pelvic lymph node metastasis, common iliac lymph node metastasis and para-aortic lymph node metastasis were significantly related with serum SCC-Ag level (all P<0.05). The result of multivariate logistic regression analysis showed that tumor size, depth of cervical stromal invasion, pelvic lymph node metastasis and common iliac lymph node metastasis were the independent risk factors of preoperative serum SCC-Ag>2.65 ng/ml (all P<0.001). Multivariate Cox regression analysis showed that lymphovascular space involvement, SCC-Ag>3.15 ng/ml, common iliac lymph node metastasis and tumor size >4 cm were the independent prognostic risk factors (all P<0.05). The univariate analysis showed that, the tumor size, FIGO stage, depth of cervical stromal invasion and SCC-Ag level were significantly related with the recurrence of 1 096 patients without postoperative high risk factors (all P<0.05). Multivariate logistic regression analysis showed that FIGO stage (OR=1.671) and SCC-Ag>2.65 ng/ml (OR=4.490) were the independent risk factors for recurrence (both P<0.05). The best cut off of SCC-Ag for predicting early postoperative cervical lymph node metastasis of cervical squamous cell carcinoma was 2.65 ng/ml, the sensitivity was 60.8%, the specificity was 71.8%. The best cut off of SCC-Ag for predicting prognosis of cervical squamous cell carcinoma was 3.15 ng/ml, the sensitivity was 53.5%, the specificity was 71.1%. Conclusions Preoperative serum squamous cell carcinoma antigen is an independent prognostic risk factor of survival of patients with early cervical squamous cell carcinoma, and is significantly related with recurrence of patients without postoperative high-risk factors. It can be used as a reference factor for postoperative adjuvant radiotherapy.

Objective:To establish an accurate C57BL6/J mouse model of acute radiation-induced enteritis based on small animal radiation research platform (SARRP).Methods:Forty-eight female mice were randomly divided into the following four groups: blank control group, 6 Gy irradiation group, 9 Gy irradiation group and 12 Gy irradiation group. Based on the SARRP, the mice in the irradiation groups were exposed to a single fraction dose of 6 Gy, 9 Gy and 12 Gy at a dose rate of 4Gy/min, respectively. The general condition, body weight and pathological changes of the small intestine of mice were observed.Results:After CT scanning, the target area and normal tissues were delineated. According to the dose distribution of the target area and the protection of spinal cord, the AP-PA field irradiation scheme at the isocentric level was adopted. The average irradiation time in the 6, 9 and 12 Gy groups was 163, 252 and 328 seconds, respectively. The survival rates of mice in the 6, 9 and 12 Gy groups were 100%, 100% and 50% 15 days after irradiation.The body weight of mice in the 6 Gy ( P=0.035), 9 Gy ( P=0.002) and 12 Gy groups ( P<0.001) was decreased significantly on the 5 th day after irradiation, and gradually increased on the 10 th day. With the increase of irradiation dose, the villus and gland injury was aggravated. Compared with the blank control group, the villus length in the 9 and 12 Gy groups was significantly shorter (both P<0.001), and the intestinal wall thickness in the irradiation groups was significantly thinner (all P<0.001). Conclusion:SARRP can provide accurate target location, planned screening and accurate dose delivery in the establishment of C57BL6/J mouse model of acute radiation-induced enteritis. The C57BL6/J mouse model of acute radiation-induced enteritis can be successfully established by a single fraction total-abdominal irradiation of 6-9 Gy.