Objective To compare the efficacy of Si Wu particles to treat young women with chronic attachment inflammation.Methods70 young women with chronic attachment inflammation in department of gynecology from January 2015-July 2016 were grouped by Lottery method.Two groups were treated with levofloxacin and metronidazole, observation group was another given Si Wu particles.To analyze treatment efficacy between two groups.ResultsAfter treatment, total effective rate of observation group was higher than control group(P<0.05).After treatment, whole blood high-viscosity, whole blood low-viscosity and plasma viscosity of observation group were lower than control group(P<0.05).After the third week of treatment, TCM syndrome points of observation group was lower than control group (P<0.05).Adverse reactions and recurrence rate of observation group were lower than control group, but no statistical significance.ConclusionSi Wu particles can improve efficacy to young women with chronic attachment inflammation.

Objective To approach the clinical features of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children and provide evidence for clinical treatment.Methods A retrospective analysis was conducted.Two hundreds and twenty children with Mycoplasma pneumoniae pneumonia (MPP) admitted to the Integrated Chinese and Western Medicine Hospital of Zhejiang Province were enrolled from January 2013 to June 2016.According to the criteria of diagnosis of MPP and RMPP,the patients were divided into a general group (172 cases) and a refractory group (48 cases).Their general information,incidence of pulmonary positive sign,laboratory data,radiological findings,complications,therapeutic situations and prognoses,etc.between the two groups were observated.Results There were no significant difference in gender distribution between the two groups,but the age of the refractory group was much older than that of the general group (years:7.15 ± 1.89 vs.4.86±2.16),and the fever duration in the refractory group was obviously longer than that in the general group (days:11.17±2.82 vs.6.27±2.29,P ＜ 0.01).the levels of C-reactive protein [CRP (mg/L):46.8 ± 18.6 vs.13.5 ± 8.4],erythrocyte sedimentation rate [ESR (mm/1 h):56.9 ± 14.8 vs.28.7 ± 10.2],incidence of positive pulmonary sign [100.0％ (48/48) vs.33.7％ (58/172)],the incidence of pulmonary segmental consolidation [81.3％ (39/48) vs.27.9％ (48/172)] and incidence of extra-pulmonary complications [83.3％ (40/48) vs.16.3％ (28/172)] were all higher in refractory group than those in general group (all P ＜ 0.01).All the patients were treated with macrolide antibiotics and traditional Chinese medicine,the patients in the refractory group was additionally treated with glucocorticoids,and a few of them were treated with gamma immunoglobulin and bronchoalveolar lavage;all of them recovered well,high temperature had returned to normal and the imageology findings recovered well,then they all discharged without any sequela such as bronchiectasis and pulmonary atelectasis.Conclusions Physicians should pay more attention to the MPP patients with longer fever duration (especially longer than 10 days),serious signs and symptoms,more complications,higher CRP and ESR and severe radiological findings.Besides early application of macrolide antibiotics,rational use of glucocorticoids,gamma immunoglobulin and bronchoalveolar lavage can be considered.

AIM: To investigate the effect of compound rhubarb preparation (Kintop) in preventing obesity in rats and its probable mechanism involved. METHODS: Twenty-six newborn SD rats were randomly grouped as rhubarb preparation plus high-energy forage group( n= 8), high-energy forage control group( n= 8) and ordinary forage control group( n= 10). The rats in rhubarb preparation plus high-energy forage group and high-energy forage control group were fed with high-energy forage and those in ordinary forage control group were fed with ordinary forage. The rats in rhubarb preparation plus high-energy forage group were administered by compound rhubarb preparation (40 mg?100 g -1 body weight?d -1 ) from 9th to 17th week. The dynamic changes in body weight, celiac fat weight and adipocytes size were measured. Immunohistochemical analysis of leptin in celiac adipocytes (ABC method) and measurement of serum leptin level (RID method) were performed. RESULTS: The body weight and the wet weights of celiac fat were lower, their adipocytes were smaller and immunohistochemical stainings of leptin were weaker in rhubarb preparation plus high-energy forage group than those in high-energy forage control group. There was an obvious positive correlation between the expression of leptin and celiac fat tissue weight( r= 0.8663, P

Objective:To observe the clinical efficacy of warm needling plus acupoint sticking therapy for primary dysmenorrhea.
Methods:A total of 60 eligible cases were randomly allocated into a treatment group (n=30) and a control group (n=30) according to their sequence of consultation. Patients in the treatment group were treated with warm needling combined with acupoint sticking therapy, whereas patients in the control group were treated with oral Ibuprofen (Fenbid) capsules. After two menstrual cycles, the visual analogue scale (VAS) score, COX menstrual symptom scale (CMSS) and clinical efficacy were compared between the two groups.
Results:After treatment, the VAS and CMSS scores were significantly reduced in both groups, indicating that both treatment protocols can remarkably alleviate pain. There was a between-group statistical difference in comparing the CMSS score (P<0.05), but no between-group statistical difference in the VAS score (P>0.05). However, the follow-up visit showed between-group statistical differences in comparing VOA and CMSS scores (bothP<0.01). The clinical effect, relapse rate and long-term efficacy in the treatment group were better than those in the control group.
Conclusion:Warm needling plus acupoint sticking therapy is a simple but effective therapy for primary dysmenorrhea. In addition, it causes fewer cases with relapse.

Objective To evaluate the different arteriographic manifestations of acute renal arterial hemorrhage,and the treatment effects of emergency interventional embolization.Methods 87 patients with renal arterial hemorrhage who were failed to conservative treatment underwent the renal arteriography to confirm the position and degree of lesion.According to the arteriographic manifesta-tions,appropriate embolic agents such as spring coil,acrylic acid microspheres and the like were used to embolize the targeted vessel. The arteriographic manifestations and embolization efficacy were retrospectively analyzed.Results Contrast medium leakage was showed by renal angiography in 43 patients,13 of whom had arterio-venous fistula (AVF)and 1 5 of whom had renal pseudoaneu-rysms (RAP).Among this 1 5 patients,there were 5 patients with arteriovenous fistula and one patiernt with artery-calyces fistula. Hemorrhage of tumor vessel was shown in 1 5 patients and renal arteriovenous malformation (RAVM)in 1.47 patients underwent renal artery CT arteriography before emergency interventional embolization.The hematuresis was completely stopped or significantly relieved in 82 of all patients.Only 3 patients with renal trauma and 2 patients with percutaneous nephroscope were still had haematu-ria.All patients were followed up for 2 years.The total effective rate of emergency interventional embolization treatment was 94.25%(82/87),and no serious complications were observed.Conclusion As a safe,effective and micro-invasive treatment,emergency in-terventional embolization therapy can be used to treat the acute renal hemorrhage effectively.It can keep the maximum renal func-tion.Though acute renal hemorrhage angiography may have different manifestations,the choice of embolic agents is the key to stop the symptom.Renal artery CTA before embolotherapy is important for the diagnosis and therapy of acute renal hemorrhage.

Objective To investigate the clinical significance of children bronchial asthma detection by using negative expiratory pressure (NEP) technique.Methods The children with bronchial asthma admitted to Department of Pediatrics of Zhejiang Provincial Integrated Traditional Chinese and Western Medicine Hospital from March 2016 to March 2018 were enrolled.They were divided into mild group (0-4 scores) and severe group (5-12 scores) according to asthma clinical scoring criteria.The children undergoing physical examination at the same period were served as healthy control group.NEP technique and tidal volume (VT) were detected by the pulmonary function instrument.Respiratory flow-volume curves (F-V curves) without NEP were compared with tidal F-V curves after NEP application to assess expiratory flow limitation (EFL).EFL index was calculated according to the percentage of expiratory VT after EFL and expiratory VT when NEP was not used.Pearson correlation method was used to analyze the relationship between EFL index and severity of bronchial asthma.Receiver operating characteristic (ROC) curve was plotted to analyze the value of EFL index in evaluating the severity of bronchial asthma in children.Results A total of 86 children with bronchial asthma were enrolled in the study,and 84 patients completed the test and 2 children withdrew due to other diseases.Finally,84 patients were included in the final analysis,including 41 mild and 43 severe children.Forty-two healthy children in the same period were served as healthy control group.There was no significant difference in gender or age among the groups,and no adverse reactions occurred during the test.The EFL index of children with bronchial asthma was significantly higher than that of the healthy control group,and it was increased with the severity of the disease [mild group compared with healthy control group:(30.60± 6.03)％ vs.(6.64 ± 2.37)％,severe group compared with healthy control group:(33.70 ± 5.41)％ vs.(6.64 ± 2.37)％,both P ＜ 0.05].There was no significant difference in respiratory rate (RR) or VT between mild group or severe group and healthy control group [RR (times/min):31.45 ± 4.18,32.81 ± 4.07 vs.31.97 ± 4.01,VT (mL/kg):6.29 ± 1.14,5.96 ± 0.90 vs.6.30 ± 1.20,all P ＞ 0.05].It was shown by the correlation analysis that EFL index was positively correlated with the severity of asthma (r =0.836,P =0.000).It was shown by ROC curve analysis that the area under ROC curve (AUC) of EFL index for predicting the severity of bronchial asthma in children was 0.801 [95％ confidence interval (95％C/) =0.725-0.878];when the best cut-off value of EFL index was 29.21％,the sensitivity was 85.7％,the specificity was 69.2％,the positive predictive value was 75.1％,and the negative predictive value was 60.2％.Conclusions The EFL index measured by NEP technology was closely related to the severity of bronchial asthma.The higher the EFL index,the more serious of the condition.The severity of bronchial asthma could be early judged by EFL index,which provided a basis for the evaluation and treatment of bronchial asthma.

O bjective To understand the effects and clinical significance of the 2019 guidelines for the human epidermal growth factor receptor 2 (HER2) detection. Methods:According to the 2014 guidelines, 548 cases of invasive breast cancer with equivocal HER2 (2+) detected by immunohistochemistry (IHC) in Taizhou Enze Medical Center, Zhejiang Province, China from 2013 to 2019 were selected. The results of IHC and HER2/CEPl7 double-probe were reevaluated and divided into groups according to the 2019 guidelines for the comparative analysis.Results:Among the 548 IHC HER2 (2+) invasive breast cancers, the number of positive, equivocal and negative cases for HER2 were 96 (17.52%), 81 (14.78%) and 371 (67.70%), respectively, according to the 2014 guidelines. However, according to the 2019 guidelines, 10 cases (1.82%) were reclassified as IHC 1+, 2 cases in the group 2 were reclassified as negative, and all the originally equivocal cases in group 4 were reclassified as negative. Finally, the total number of positive and negative cases for HER2 were 94 (17.15%) and 454 (82.85%), respectively.Conclusions:After applying the 2019 guidelines, the number of IHC 2+ cases decreases, and the positive rate for HER2 also decreases slightly due to the reevaluation change in groups 2 and 4, leading to reclassification of the cases that were deemed equivocal according to the 2014 guidelines. In general, the new 2019 guidelines are more reasonable and easier to use.

To investigate the molecular mechanism of modified Yigong powder(MYG)in the treat-ment of spleen deficiency syndrome based on network pharmacology and analyzed the effect of MYG on gastrointestinal simulated intestinal flora of spleen deficiency dogs and mucosal barrier of Caco-2 cells,as well as the interaction between intestinal flora and mucosal barrier.The molecular mechanism of MYG in the treatment of spleen deficiency syndrome was predicted by network pharmacology.The fecal samples of three canines(12±1)years old with spleen deficiency were collected to establish an in vitro gastrointestinal simulation system,which was divided into the o-riginal fecal sample group,the gastrointestinal simulation group and the gastrointestinal simulation treated by MYG group.The structural changes of the flora in each group were detected by 16S rD-NA sequencing.The metabolites were extracted from the gastrointestinal simulation system trea-ted by MYG group to study its effect on LPS-induced Caco-2 cell mucosal barrier injury model.The cell experiments included the blank control group,LPS model group,modified Yigong metabolite group.The permeability of mucosal was determined by fluorescein sodium,and then relative ex-pression levels of Claudin-1,Occludin and ZO-1 mRNA were determined by qPCR.The correlation between intestinal flora and Caco-2 cell mucosal barrier index after MYG intervention was further analyzed.The results showed that MYG had 76 active ingredients and 45 potential targets for the treatment of spleen deficiency syndrome.Forty key targets were obtained through protein interac-tion analysis,34 items were obtained by GO enrichment analysis,and 16 pathways were obtained by KEGG enrichment analysis.In the gastrointestinal simulation system,compared with the gas-trointestinal simulation group,at the phylum level,the abundance of Firmicutes,Bacteroides and Actinobacteriota increased significantly(P＜0.05),and the abundance of Proteobacteria decreased significantly(P＜0.05).At the genus level,the abundance of Fusobacterium,[Ruminococcus]gna-vus group and Blautia increased significantly(P＜0.05),while the abundance of Escherichia-Shi-gella and Citrobacter decreased significantly(P＜0.05).The diversity index of intestinal flora in the gastrointestinal simulation treated by MYG group was significantly increased(P＜0.05).In cell experiments,compared with the LPS model group,the mucosal permeability of Caco-2 cells in the modified Yigong metabolite group was significantly reduced(P＜0.01),and the expression levels of Claudin-1,Occludin and ZO-1 mRNA were significantly increased(P＜0.01).Correlation analysis showed that there was a certain correlation between bacterial community structure and mucosal barrier indexes.In summary,MYG may act on 40 key targets such as TNF,IL6,IL18,CX-CL8 and AKT1 through 76 active ingredients such as quercetin,arachidonic acid and naringin,and treat spleen deficiency syndrome in dogs through 16 signaling pathways such as AGE-RAGE,FoxO and HIF-l.In addition,the gastrointestinal metabolites of MYG up-regulate tight junction protein mRNA expression,reduce mucosal permeability,and repair mucosal barrier,which may be related to MYG's regulation of flora structure.

Objective To explore the effectiveness of building block assembly games in the upper limb functional exercise of school-aged children with peripherally inserted central catheter catheterization.Methods Using convenience sampling,90 catheterized children who met the inclusion criteria in the pediatric ward of a tertiary hospital in Henan Province from November 2022 to April 2023 were selected as research subjects.They were randomly divided into an experimental group and a control group,with 45 cases in each group.The experimental group participated in building block assembly games in addition to conventional ball-gripping exercises,while the control group engaged solely in conventional ball-gripping exercises.The compliance rates of upper limb exercises,time average peak flow rate of axillary vein of the catheterization side,and the incidence of catheter-related complications were compared between the 2 groups.Results During the study,2 cases in the experimental group and 3 in the control group dropped out,resulting in 43 cases in the experimental group and 42 in the control group.The compliance rate of upper limb exercises in the experimental group during hospitalization was 93.03％,significantly higher than 64.29％in the control group(P＜0.001).On the third day after catheterization,the time average peak flow rate of axillary vein of the catheterization side was(5.58±1.24)cm/s and(5.37±1.24)cm/s on the seventh day in the experimental group,compared to(3.87±1.06)cm/s and(3.56±0.81)cm/s,respectively,in the control group.These differences were statistically significant(P＜0.001).The incidence of catheter-related thrombosis in the experimental group was 4.65％,significantly lower than 21.43％in the control group(P=0.021).The rates of bleeding at the puncture site and catheter displacement in the experimental group were both 4.65％,compared to 7.14％and 4.76％,respectively,in the control group.These differences were not statistically significant(both P＞0.05).Conclusion Incorporating building block assembly games into routine ball-gripping exercises can improve the compliance of upper limb exercises in children with PICC placement,improve the blood flow velocity in the axillary vein of the catheterization upper limb,and reduce the incidence of catheter-related thrombosis,without increasing the risk of bleeding at the puncture site or catheter displacement.

Objective To select a cheap, portable along with avoiding cross infection method of inhaled humidified gases according to the effect of three methods for inhaled humidified gases on degree of comfort in bilateral nasal catheter patients with nasal endoscopic surgery so as to improve the compliance of humidification for nasal cavity.Methods A total of 120 bilateral nasal catheter patients with nasal endoscopic surgery were randomly divided into four groups including wet gauze group (n=30), humidified gauze mask group (n=30), humidifier group (n=30) and control group (n=30). The assessment on the visual analogue scale (VAS) and SNOT-20 were carried out along with analysing the cost, convenience and acceptance in the first to the third day after surgery.Results The score of VAS in research groups was statistically higher than that in control group in the third day after surgery (P＜0.05) with no significant difference in that among research groups (P＞0.05). There were statistically significant differences in the score of SNOT-20 between wet gauze group and control group, between humidifier group and control group in the third day after surgery (P＜0.05). There was a statistically significant difference in the score of SNOT-20 between humidified gauze mask group and control group in the second and third day after surgery (P＜0.05). The score of the nasal symptom, other symptoms and sleep disorder and so on in research groups was lower than those in control group in the third day after surgery with significant differences (P＜0.05).Conclusions Three methods (wet gauze group, humidified gauze mask group, humidifier) for inhaled humidified gases can obviously improve the degree of comfort in bilateral nasal catheter patients with nasal endoscopic surgery. The clinical nursing practice should fully consider the objective condition of patients along with applying it neatly and synthetically so as to improve the quality of life of patients.