Objective To investigate the effects of somatostatin (SST) on levels of IL-6,IL-8 and TNF-αduring CPB in pigs. Methods Twenty four healthy pigs were randomly divided into control group (SS00) and 3 experimental groups, SS05, SS10 and SS20. All pigs were performed by CPB for cardiac arrest in 45 min. the levels of IL-6, IL-10 and TNF-αwere tested and compared. Results The TNF-α, IL-6 and IL-10 levels were higher than T0 among all groups after CPB(P<0.05);The levels of TNF-αand IL-6 after CPB in SS10, SS20 groups were lower than SS00 group(P<0.05), and the IL-10 level was higher(P<0.05). Conclusion Infusing with a certain dose of SST before CPB could down-regulate acute inflammatory response;SST has no impact on the operative safety.

Objective To investigate the application value of two kinds of endometrial preparation in patients with thin endometrium of frozen thawed embryo transfer cycle.Methods A retrospective analysis of the clinical data of 82 cycle of 76 patients was carried out.According to the difference of the endometrial preparation,the two groups were divided into two groups.One group was progynova group (42 cycles),and the other group was femonston group (40 cycles).Baseline information,endometrial status and pregnancy outcome were compared between the two groups.Results There was no significant difference in baseline data (age,years of infertility,body mass index,basal hormone level) between the two groups.There was no significant difference in endometrial thickness[progynova group (5.52 ± 0.74) mm,femonston group (5.33 ± 0.66) mm,t =1.290,P =0.203],endometrial volume (progynova grouP ＜ 2mL and ≥ 2mL 38 patients and 4 patients,that of femonston group 36 cases and 4 cases,x2 =0.005,P =0.942),endometrial type (progynova group A,B,C type 35 cases,7 cases,0 case,those of emonston group 34 cases,6 cases,0 case,x2 =0.043,P =0.836) and blood flow (progynova group Ⅰ + Ⅱ and Ⅲ 34 cases and 8 cases,those of femonston group 35 cases and 5 cases,x2 =0.658,.P =0.417) between the two groups before treatment.After administration,endometrial thickness [progynova group (6.90 ± 0.62) mm,femonston group (7.60 ± 0.63) mm,t =5.04,P =0.000],neointimal growth [progynova group (1.67 ± 0.48) mm,femonston group (3.20 ± 0.61) mm,t =12.74,P =0.000],ratio of endometrial volume more than or equal to 2 mL [progynova group 52.38 ％ (22/42),femonston group 80.00％ (32/40),x2 =6.95,P =0.008],and ratio of endometrial blood flow type Ⅲ [progynova group 38.10％ (16/42),femonston group 70.00％ (28/40),x2 =8.387,P =0.004] of femonston group were higher than those of progynova group.The dosage[progynova group (112.43 ± 16.39)mg,femonston group (78.85 ± 10.17)mg,t =11.08,P =0.000] was lower than that of progynova group,and the difference was statistically significant.There was no significant difference in the two groups in endometrial type (progynova group A,B,C 30 cases,12 cases and 0 case,those of femonston group 28,12 and 0,x2 =0.020,P =0.887) after the treatment.There was no significant difference in the number of transplanted embryos (progynova group 1.78 ± 0.47,femonston group 1.77 ± 0.42,t =0.108,P =0.914),high quality embryo rate [progynova group 74.67 ％ (56/75),femonston group 73.24 ％ (52/71),x2 =0.039,P =0.844],implantation rate [progynova group 14.67 ％ (11/75),femonston group 16.90％ (12/71),x2 =0.137,P =0.711],biochemical pregnancy rate[progynova group 38.10％ (16/42),femonston group 40.00％ (16/40),x2 =0.031,P =0.860] and clinical pregnancy rate [progynova group 28.57 ％ (12/42),femonston group 32.50％ (13/40),x2 =0.149,P =0.699] between the two groups.Conclusion Femonston with less dosage,better improvement of the endometrial thickness,endometrial volume,endometrial blood flow of patients with thin endometrium of patients can obtain similar pregnancy outcomes compared with progynova.

Objective To observe the efficacy and acute inflammatory reactionof Qingjin Huazhuo Prescription combined with Western medicine therapy for treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Totally 60 hospitalized patients with AECOPD (Grade Ⅱ) and acute exacerbation course≤1 week were enrolled in this study. The patients were randomly divided into two groups, with 30 cases in each group. The control group was treated with conventional Western medicine. The observation group was treated with conventional Western medicine and oral administration of Qingjin Huazhuo Prescription for 10 days, once a day. TCM syndrome and dyspnea grading (mMRC score), white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT) and partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), were measured before and after the treatment. Results The total scores of TCM syndromes and cough, expectoration, wheezing, fever, and cyanosis in the two groups decreased significantly (P<0.05). The improving degrees of cough and expectoration were better in the observation group than in the control group (P<0.05). The scores of mMRC in the two groups were better than before treatment (P<0.05). The levels of WBC, CRP and PaCO2 in the two groups were lower than those before treatment (P<0.05). The decreased degrees of CRP and PaCO2 in the observation group were better than those in the control group (P<0.05, P<0.01). Conclusion Qingjin Huazhuo Prescription combined with Western medicine therapy can relieve clinical symptoms, reduce the acute inflammatory reaction of AECOPD patients and improve respiration.

Objective To analyze the medical service capacity of primary healthcare in Zhejiang province since the ongoing healthcare reform and put forward suggestions. Methods Key indicators of healthcare resources and medical service utilization from 2009 to 2015 reflecting the primary healthcare were identified,for a quantitative analysis in terms of the structure-process-outcome dimensions. Results In terms of structural service capacity,the average headcount growth rate of primary healthcare′s technical personnel was 5. 7% per year; the personnel competence structure kept improving; the hospital beds at primary institutions and their ratio among all were slightly decreased,with better devices and informatization. In terms of procedural service capacity,the proportion of primary institutions with contract-based services amounted to 89. 9%,with the standard contract signing rate up to 18. 8%. In terms of consequential service capacity,the average growth rate of the number of outpatient visits at primary institutions was 6. 3%. The amount and proportion of inpatients were slightly decreased,while the hospital bed utilization ratio was increased slightly. Conclusions It is necessary to further strengthen the training and introduction of primary healthcare professionals. The functional orientation of hospitals at various levels should be clarified, encouraging contract-signing of general practitioners, promote the medical insurance payment reform featuring the capitation payment at primary level,and improve the income distribution and incentive mechanism.

Objective To evaluate the consistency of psoriasis-involved body surface area (BSA) measurement among raters from different clinical centers after training in a new standard operating procedure (SOP) for involved BSA measurement,so as to provide a method for the evaluation of psoriasis with high accuracy and operability.Methods Firstly,two raters from Guangdong Provincial Hospital of Chinese Medicine (GPHCM) independently and alternately assessed the disease severity in 40 patients with psoriasis after systematic training in the BSA-SOP.Then,one of the raters from GPHCM and 11 raters from 11 subcenters separately assessed the disease severity in 209 patients with psoriasis by using the BSA-SOP,and the consistency was evaluated by using intraclass correlation coefficient (ICC).Results There was a very high degree of consistency in involved BSA values between the 2 raters from GPHCM (ICC =0.989,95％ confidence interval:0.979-0.994).The consistency of involved BSA values for the assessment of psoriasis severity was also high among the rater from GPHCM and the raters from 11 subcenters (ICC ranging from 0.849 to 0.998).Conclusion The raters from different centers showed high consistency of involved BSA measurement for the assessment of psoriasis severity after training in the new BSA-SOP,so the BSA-SOP can serve as a reliable reference for multicenter clinical studies.

Objective To explore the feasibility of differential diagnosis of Gleason score (GS)(3+4)and (4+3)in prostate cancer (PCa) based on texture parameters of T2 WI and ADC maps.Methods A total of 77 patients with GS 7 points in PCa confirmed by pathology were enrolled in this retrospective study,including 45 GS(3+4)cases and 32 GS(4+3)cases.ROI was manually drew on the largest section of tumor on the axial T2 WI and ADC maps,and five texture parameters were extracted,namely,angular second moment (ASM),contrast, correlation,inverse difference moment and entropy,and the texture parameters between groups were analyzed statistically,then ROC curve was used to evaluate the diagnostic efficiency of texture parameters with statistical differences.Results There was no significant difference in age and prostate specific antigen (PSA)between GS (3 + 4)and GS (4 + 3)groups (P＞0.05).There were significant differences in ASM and entropy between T2 WI and ADC (P＜0.05),but there was no statistical difference in contrast,correlation and inverse difference moment (P＞0.05).Except for the AUC of T2 WIASM,there were statistical differences among T2 WIentropy ,ADCASM and ADCentropy.The AUC of ADCASM and ADCentropy were larger than that of T2 WIASM and T2 WIentropy.The AUC of ADCentropy had the largest AUC (0.732),the cut off value was 5.71 ,with the sensitivity was 97.6% and specificity was 5 9.5%.Conclusion MRI texture analysis can be used to differentiate GS (3 + 4)from GS (4 + 3)in PCa,and the ADCentropy have the best diagnostic efficacy.

Objective To investigate the effect of the Qingjin-Huazhuo prescription on the fractional exhaled nitric oxide (FeNO) in the patients with phlegm heat accumulation of lung syndrome in acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods A total of 72 patients with phlegm heat accumulation of lung syndrome in AECOPD who met the criteria were included were randomly divided into two groups,36 in each group.The control group received the conventional western medicine treatment,and the observation group received the additional Qingjin-Huazhuo prescription on the basis of the western medicine treatment.The duration of treatment was 10 days.The changes of TCM syndromes,FeNO and pulmonary function (FEV 1％,FVC％,FEV 1/FVC) on both two groups before and after treatment were recorded and compared.Results The improvement of cough,phlegm,wheeze and total score of TCM syndrome in the observation group were significantly better than the control group (t=3.091,2.303,3.063,2.412,P＜0.05).The improvement of FeNO in the observation group was significantly better than the control group (9.81 ± 12.10 ppb vs.3.42 ± 14.78 ppb,t=2.007) (P＜0.05).As for the pulmonary function,the improvement of FEV1％,FVC％,FEV1/FVC in the observation group were better than the control group (t=1.295,1.187,0.829,P=-0.200,0.240,0.411),but the differences were not significantly.Conclusions The Qingjin-Huazhuo prescription on the basis of conventional western medicine treatment for patientswith phlegm heat accumulation of lung syndrome in AECOPD,showed the improvement of symptoms,inhibit the inflammation in the respiratory tract and improve the ventilation function.

Anti neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) is a systemic disease characterized by small vessel wall inflammation and cellulose necrosis mediated by ANCA. Renal injury caused by AAV is called ANCA-associated glomerulonephritis (AAGN). The paper reported a case of AAV with renal damage combined with human immunodeficiency virus (HIV) infection. The patient was an elderly male with clinical manifestations of hematuria and uremia. Renal pathological examination showed AAV and renal injury. This case is the first report in China while reviewing the relevant literature, and it is still inconclusive whether this is an overlap of the two diseases or a specific pathological type of HIV-associated nephritis. We believe that AAV has the potential to occur in HIV-infected patients, so clinicians should not ignore the phenomenon of ANCA positivity in HIV-infected patients, and the follow-up of such patients needs to be enhanced. Clinical and renal pathological examinations are the main methods to diagnose HIV infection with AAV. At the same time, there are no clear guideline guidelines on how to administer immunosuppressive therapy for such patients who have immunodeficiency and are at higher risk of opportunistic infections, and in whom to make the best possible outcomes.

This paper reviews the Traditional Chinese Medicine (TCM) diagnosis and treatments for Coronavirus Disease 2019 (COVID-19) and the theories of different experts in TCM. The pathogenesis of COVID-19 involves dampness, toxin, heat, cold, blood stasis and deficiency. Dampness and poison were the core pathological factors. The treatment is based on the situation of patients in different regions and different stages of the disease, and focuses on dampness and toxin, with the purpose of eliminating evil and consolidating the foundation. Oral TCM prescriptions such as Qingfei-Paidu Decoction, Qingfei-Touxie-Fuzheng Decoction, Lianhua-Qingwen capsule (granule) show good curative effect. TCM non drug therapies, such as acupuncture, moxibustion, acupoint application, ear acupuncture, traditional exercises, etc., are mostly aimed at light, ordinary and convalescent patients, which can improve symptoms. However, high-quality TCM research is still needed.

0bjective To analyze the clinical characteristics, pathological types, treatment and prognosis in children with steroid resistant nephrotic syndrome (SRNS) in Northwest China, in order to provide reference for the treatment of SRNS. Methods:The clinical data, renal pathological results, treatment plan and efficacy of 102 children diagnosed with SRNS in the Department of Nephrology, Xi'an Children's Hospital of Shaanxi Province from January 1st, 2018 to December thirty-first, 2020 were analyzed retrospectively. All children were divided into groups according to age, clinical classification, pathological type, treatment scheme and treatment outcome, and the risk factors affecting the prognosis of children with SRNS were discussed. The measurement datas conforming to normal distribution were expressed as xˉ± s, and t test was used for comparison between groups. Measurement datas that did not conform to normal distribution were represented by M ( Q1, Q3), and Kruskall-Wallis test was used for comparison between groups.Enumeration datas were compared by χ 2 test. Risk factors were analyzed by multiple factor Logistic regression analysis. Results:The median age of onset of 102 children with SRNS was 3.0 years. Focal segmental glomerulosclerosis (FSGS) accounted for 36.3% (37/102), minimal lesions accounted for 33.3% (34/102), and mesangial proliferative glomerulonephritis accounted for 23.5% (24/102). The prevalence rates of hypertension (35.1% (13/37)), 24-h urine protein quantification (130.5 (91.5, 159.6) mg/(kg·24 h) and renal insufficiency (21.6% (8/37)) in FSGS group were higher than those in non-FSGS group (13.8% (9/65), 65.8 (51.2,85.5) mg/(kg·24 h), 4.6% (3/65)). The differences between the two groups were statistically significant (statistical values were χ 2=6.32, Z=5.90, χ 2=7.09; P values were 0.012, <0.001, 0.008). Logistic multivariate regression analysis showed that the hypertension ( OR=4.055, 95% CI 1.178-3.962) and 24 hour urinary protein ( OR=1.036, 95% CI 1.020-1.053) were associated with the increased risk of FSGS ( P values were 0.026 and <0.001). ROC curve ananlysis showed that the optimal critical value of 24 hour urinary protein was 85.65 mg/(kg·24 h) in FSGS. After treatment, complete remission was 61.8%(63/102), partial remission was 14.7%(15/102), and no remission was 23.5%(24/102). By the end of follow-up the treatment effective rate in the small lesion group (94.1%(32/34)) was higher than that in the FSGS Group (51.3%(19/37)), and the difference between the two groups was statistically significant (χ 2=16.02, P<0.001). In the initial immunosuppressive treatment, the complete remission rate of hormone combined with calcineurin inhibitor group (77.1%(37/48)) was higher than that of hormone combined with cyclophosphamide Group (11.1%(3/27)). There was significant difference between the two groups ( Z=32.28, P<0.001). Conclusion:The most common pathological type in children with SRNS was FSGS, and the age of onset was generally small. The prognosis of patients with pathological type FSGS was the worst, and the prognosis of small lesions was better. Hypertension and 24-hour urinary protein quantification were the risk factors of FSGS. Calcineurin inhibitors were the first choice for the second-line immunosuppressants of SRNS in children.