Rhizome anemarrhena,sweet and bitter to taste,cold,in the lung,stomach and kidney meridian,has the function clearing away heat and purging pathogenic fire,nourishing Yin and moistening dryness.Zhang Zhong Jin in "Essential Prescriptions of the Golden Chamber "with a different combination of herbs and Rhizome anemarrhenae,reflects the multiple efficacies of TCM and compatibility.

Objective To summarize the MSCT signs and the key points of differential diagnosis of sclerosing mesenteritises (SM) which were misdiagnosed by clinical and CT,to reduce the misdiagnosis rate.Methods Clinical and MSCT data of 23 misdiagnosed SM patients were analyzed retrospectively.The misdiagnosed diseases,misdiagnosed causes,and differential diagnosis were analyzed.Results SM were mainly misdiagnosed as tumor and infective inflammation.The main causes of misdiagnosis and differential diagnostic features were listed as follows.(1)SM didn't have specific clinical manifestations.(2)The density of the adipose tissue in mesentery increasedmisty mesentery.A clear demarcation between the lesion and the surrounding normal fatty tissue could be differentiated from infective inflammation.(3)The mass-like false capsule had space-occupying effect of displacement of the surrounding structures.However, the blood vessels were encapsulated by the mass-like false capsule with fat ring around, which could be differentiated from fat-containing tumors.(4)The soft mass was formed at the root of the mesentery.The fat halo sign and mild enhancement of the mass can be differentiated from lymphoma and carcinoid.Conclusion SM is easily misdiagnosed both in clinical practice and medical imaging.Recognition of differential diagnostic features of MSCT can reduce the misdiagnosis rate.

Objective To investigate the inhibitory effect of aqueous extract of Taxus chinensis.vat (AETC) combining Cisplatin (DDP) on vitro cultured human lung carcinoma A549 cells,and the effects on resistance genes.Methods The A549 cells were divided into different concentrations of DDP groups,different concentrations of AETC groups,and blank group,and drug effect of 48 h with the method of cell counting kit-8 (CCK-8) and the effect on cell survival were detected.Based on the above results,then A549 cells were divided into DDP combining different concentrations of AETC groups,DDP group,blank control group,and drug effect of 48 h with the method of CCK-8 and the effect on cells survival were detected.The gene expressions of adenosine triphosphate (ATP)-binding cassette subfamily B member 1 trans-porter (ABCB1),ABCG2,and ABCC1 were examined by polymerase chain reaction (RT-PCR).Results Cisplatin 12 μg/ml (DDP),DDP + ATEC 400 μg/ml,DDP + ATEC 800 μg/ml,DDP + ATEC 1 200 μg/ml,DDP + ATEC 1 600 μg/ml,A549 cell inhibition rate of each group was 44.36％,69.61％,74.73％,80.10％,and 74.73％,respectively;Different concentrations of AETC combining DDP could decrease the resistance related gene ABCC1,ABCB1 expressions,and correlated to the dose.AETC combining DDP showed no effects on ABCG2 gene expression.Conclusions AETC combining DDP could inhibit the growth of A549 cells,and decrease the resistance-related gene ABCC1,ABCB1 expressions.

Objective: To explore the impact of five-flavor Sophora flavescens enteric-coated capsules (FSEC) on the intestinal flora of rats with ulcerative colitis (UC), so as to provide the reference for the mechanism of FSEC in treating UC. Methods: Forty SPF-grade Wistar rats were randomly divided into the control group, the model group, the mesalazine group and the FSEC group. Except the control group (0.9% sodium chloride solution), the other 3 groups used 3% dextran sulfate sodium (DSS) for 7 days to establish UC model. After successful modeling, the control group and the model group were given 2 mL/kgbw of 0.9% sodium chloride solution by gavage for 2 weeks, while the mesalazine group and the FSEC group were given 2 mL/kgbw of mesalazine suspension (0.2 g/kg) and FSEC granule suspension (2.16 g/kg), respectively. Pathological changes of colon tissue were observed after hematoxylin-eosin (HE) staining. Rat fecal samples were collected, and 16S rDNA high-throughput sequencing and bioinformatics analysis were performed on intestinal flora. The α and β diversity of intestinal flora among the four groups were compared, and the dominant flora was screened using LEfSe analysis. Results: Compared with the control group, the model group showed a significant loss of colonic crypts and a large infiltration of inflammatory cells. Compared with the model group, the mesalazine group and the FSEC group exhibited a slight loss of colonic crypts, a small amount or an absence inflammatory cell infiltration, and improved tissue damage. The α-diversity analysis showed that compared with the control group, the Chao1 and Shannon indices in the model group increased, while the Simpson index decreased; compared with the model group, the Chao1 and Shannon indices in the mesalazine group and the FSEC group decreased, and the Simpson index increased（all P<0.05）. The β-diversity analysis showed that the sample distance between the FSEC group and the control group were more closer than that between the model group and the control group. LEfSe analysis results showed that the dominant bacteria in the model group were mainly from the Alistipes and Oscillospira. In the FSEC group, the dominant bacteria were from the Ruminococcus and Prevotella. Conclusion FSEC can improve the structures of intestinal flora, increase the abundance of beneficial bacteria such as Ruminococcus and Prevotella, reduce the abundance of pathogenic bacteria such as Alistipes, and alleviate the inflammatory response in UC rats.

Objective To investigate the quality of life, sexual quality of life and its influencing factors in cervical cancer patients undergoing radiotherapy. Methods Pre-menopausal patients of 87 cases were diagnosed with cervical cancer treated with radiotherapy at Peking Union Medical College Hospital from December 2013 to December 2018 were recruited in this study. The functional assessment of cancer therapy-cervix ( FACT-Cx V4. 0) and the female sexual function index ( FSFI) were evaluated. Demographic and treatment data were collected. The influencing factors were analyzed by multiple linear regression analysis. Results The total score of quality of life was 114( 100-126) , 19( 16-21) for physiology, 21( 18-24) for social/family, 19( 17-21 ) for emotion, 19 ( 14-22 ) for function and 39 ( 34-43 ) for additional attention, respectively. The end time of radiotherapy was the influencing factor of the total score ( P= 0.034 ) , physiology ( P=0) and function ( P=0.008) . Family was the influencing factor of social family dimension ( P=0.010) . The total score of FSFI was 8.0( 5.0-20.5) , 1.8( 1.2-3.0) for sexual desire, 1.5( 0-2.7) for sexual arousal, 0.3( 0-3.6) for vaginal lubrication, 0( 0-3.6) for orgasm, 3.2( 2-4) for satisfaction and 0( 0-3.6) for sexual pain, respectively. The total score was less than 27 in 97%( 84/87) of the patients and had sexual dysfunction. Age was the influencing factor of sexual arousal ( P=0.005) and vaginal lubrication ( P=0.039) . Occupation was the influencing factor of sexual pain ( P=0.004) . Conclusions The quality of life of premenopausal patients with cervical cancer is affected by multiple factors. Radiotherapy-related complications should be actively treated to improve the quality of life and sexual life of patients.

Objective To explore the clinical effect of enhanced recovery after surgery and pain management during the perioperative period in rectal cancer patients.Methods 100 rectal cancer patients after radical resection were divided into ERAS group (50 cases) and routine care group (50 cases).Results Compare with the routine group,the time of ERAS group was shorter in postoperative bowel function recovery [(1.8 ± 0.6) d vs.(3.4 ± 0.6) d,t =-8.1,P ＜ 0.001],oral feeding [(1.3 ± 0.6) d vs.(3.2 ± 0.6) d,t =-10.1,P ＜ 0.001],intraperitoneal catheter drain [(3.6 ± 0.7) d vs.(5.3 ±0.8) d,t=-6.7,P＜0.001] and mobilization[(1.1 ±0.3)d vs.(2.7 ±0.5) d,t=-12.7,P＜0.001].ERAS group was associated with shorter hospital stay [(4.6 ± 0.6) d vs.(6.1 ± 0.6) d,t =-7.7,P ＜ 0.001],lower costs (P =0.014),lower pain score at the time of 6 h,12 h,24 h and 48 h after surgery (P ＜0.001).There was no significant statistical difference in postoperative complication rate 8％ and 10％ (P =1.000).Conclusions ERAS management in rectal cancer patients after radical operation enhanced postoperative recovery.

Objective:To investigate the anxiety and depression of cancer patients undergoing radiotherapy during the epidemic of COVID-19.Methods:By using self-rating anxiety scale and self-rating depression scale, a cross-sectional survey was conducted during the COVID-19 epidemic period.Results:During the COVID-19 epidemic period, the incidence of anxiety and depression in cancer patients undergoing radiotherapy was 15.8% and 27.7% respectively, of which 12.9% suffered from both anxiety and depression. The average scores of anxiety and depression were 49.4(25/76) and 46.4(25/83), respectively, which were higher than those of the domestic norm. Age is a contributing factor for anxiety, and patients living in urban are more likely to experience depression.Conclusions:The prevalence of anxiety and depression of cancer patients undergoing radiotherapy are higher than healthy people during the COVID-19 outbreak. We should pay more attention to the psychological states of the cancer patients.

Objective:To investigate the construction and application value of a predictive model for prolonged surgical duration in Da Vinci robotic radical gastrectomy for gastric cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 534 patients who underwent Da Vinci robotic radical gastrectomy for gastric cancer in the Fujian Medical University Union Hospital from August 2016 to August 2021 were collected. There were 389 males and 145 females, aged (60±11)years. All 534 patients were randomly divided into the training dataset of 374 cases and the validation dataset of 160 cases with a ratio of 7∶3 based on random number method in the SPSS 25.0 software. Observation indicators: (1) incidence of prolonged surgical duration; (2) intraoperative and postoperative conditions in patients with prolonged surgical duration and without prolonged surgical duration; (3) complications in patients with prolonged surgical duration and without prolonged surgical duration; (4) analysis of risk factors influencing prolonged surgical duration; (5) construction and evaluation of an artificial neural network predictive model for pro-longed surgical duration. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or per-centages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the nonparametric test. Univariate and multivariate analyses were conducted using the Logistic regression model. Based on the results of univariate analysis, a multilayer perceptron was employed to train an artificial neural network pre-dictive model for prolonged surgical duration. The receiver operating characteristic (ROC) curve was drawn, and the area under curve (AUC), the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were used to assess the model′s performance. Results:(1) Incidence of prolonged surgical duration. Of 534 patients, 284 cases underwent total gastrectomy, and 250 cases underwent distal gastrectomy, with operation time of (206±42)minutes and (187±36)minutes, res-pectively. Cases with prolonged surgical duration and without prolonged surgical duration who under-went total gastrectomy were 41 and 243, and cases with prolonged surgical duration and without prolonged surgical duration who underwent distal gastrectomy were 40 and 210. The gender (male, female), age, body mass index (BMI), tumor diameter, tumor location (upper stomach, middle stomach, lower stomach, mixed type), cases with neoadjuvant therapy, cases with preoperative American Society of Anesthesiologists (ASA) score as 1, 2, 3, cases with clinical T staging as stage T1, stage T2, stage T3, stage T4a, cases with clinical N staging as stage N0, stage N1, stage N2, stage N3, cases with clinical TNM staging as stage Ⅰ, stage Ⅱ, stage Ⅲ, cases with surgical resection scope as total gastrec-tomy or distal gastrectomy, cases with digestive tract reconstruction method as Billroth-Ⅰ anasto-mosis, Billroth-Ⅱ anastomosis, Roux-en-Y anastomosis, cases with surgeon experiences as ≤20 cases or >20 cases were 61,20, (61±9)years, (24±3)kg/m2, 4.0(2.5, 5.0)cm, 34, 10, 33, 4, 1, 3, 73, 5, 3, 6, 26, 46, 14, 41, 19, 7, 5, 13, 63, 41, 40, 1, 33, 47, 5, 76 in the 81 patients with prolonged surgical duration, versus 328, 125, (60±11)years, (23±3)kg/m2, 3.5(2.0, 5.0)cm, 129, 71, 227, 26, 6, 45, 382, 26, 73, 100, 118, 162, 211, 180, 52, 10, 138, 108,207, 243, 210, 13,200, 240, 15, 438 in the 453 patients without prolonged surgical duration, showing significant differences in the BMI, clinical T staging, clinical N staging, clinical TNM staging ( t=-3.68, Z=-4.63, -5.53, -5.56, P<0.05), and no significant difference in the gender, age, tumor diameter, tumor location, preoperative ASA score, surgical resec-tion scope, digestive tract reconstruction method, and surgeon experiences ( χ2=0.29, t=-0.95, Z=-1.27, χ2=5.92, Z=-1.46, χ2=0.25, 1.35, 0.87, P>0.05). There was no significant difference in cases with neoadjuvant therapy between them ( P>0.05). (2) Intraoperative and postoperative conditions in patients with prolonged surgical duration and without prolonged surgical duration. The operation time, volume of intraoperative blood loss, the number of lymph nodes dissected, time to postopera-tive first ambulation, time to postoperative anal exhaust, time to postoperative first intake of liquid diet, time to postoperative first intake of semi-liquid diet, duration of postoperative hospital stay were (261±34)minutes, 50(30, 50)mL, 39±15, (2.3±0.6)days, (3.4±0.9)days, (4.1±1.2)days, (5.7±1.2)days, 8.0(7.0, 9.0)days in the 81 patients with prolonged surgical duration, versus (186±29)minutes, 30(20,50)mL, 42±14, (2.2±0.6)days, (3.4±0.8)days, (4.1±1.1)days, (5.7±1.4)days, 8.0(7.0, 9.0)days in the 453 patients without prolonged surgical duration, showing significant differences in operation time, volume of intraoperative blood loss ( t=-20.46, Z=-3.32, P<0.05), and no significant difference in the number of lymph nodes dissected, time to postoperative first ambulation, time to postopera-tive anal exhaust, time to postoperative first intake of liquid diet, time to first intake of semi-liquid diet, duration of postoperative hospital stay ( t=1.87, -0.87, -0.16, 0.28, 0.03, Z=-1.45, P>0.05). (3) Complications in patients with prolonged surgical duration and without prolonged surgical duration. The overall incidence of complications, incidence of surgical complications (abdominal infection, anastomotic fistula, abdominal bleeding, incision-related complications, intestinal obstruction, lymphatic fistula), incidence of medical complications (pulmonary infection, liver-related complications) were 22.22%(18/81), 0, 0, 2.47%(2/81), 0, 8.64%(7/81), 1.23%(1/81), 12.35%(10/81), 1.23%(1/81) in the 81 patients with prolonged surgical duration, versus 13.47%(61/453), 2.65%(12/453), 0.44%(2/453), 1.77%(8/453), 0.44%(2/453), 3.31%(15/453), 0, 7.28%(33/453), 1.55%(7/453) in the 453 patients without prolonged surgical duration, showing a significant difference in the overall incidence of complications ( χ2=4.18, P<0.05), and no significant difference in the incidence of abdo-minal infection, anastomotic fistula, abdominal bleeding, incision-related complications, intestinal obstruction, lymphatic fistula, liver-related complications ( P>0.05). There was no significant difference in the incidence of pulmonary infection between them ( χ2=2.38, P>0.05). (4) Analysis of risk factors influencing prolonged surgical duration. Results of univariate analysis showed that BMI ≥25 kg/m2, tumor located in the lower stomach, clinical T3-T4a stage, clinical N1-N3 stage were correlated factors influencing prolonged surgical duration in Da Vinci robotic radical gastrectomy for gastric cancer ( odds ratio=1.88, 0.40, 6.24, 6.51, 3.08, 3.39, 17.15, 95% confidence interval as 1.03-3.42, 0.21-0.76, 1.40-27.76, 1.50-28.30, 1.43-6.60, 1.29-8.92, 4.84-60.74, P<0.05). Results of multivariate analysis showed that BMI ≥25 kg/m2, clinical T3 stage, clinical N3 stage were independent risk factors influencing prolonged surgical duration in Da Vinci robotic radical gastrectomy for gastric cancer ( odds ratio=2.31, 4.97, 11.08, 95% confidence interval as 1.19-4.46, 1.05-23.55, 2.72-45.13, P<0.05). (5) Construction and evaluation of an artificial neural network predictive model for pro-longed surgical duration. The BMI, tumor location, clinical T staging, and clinical N staging were incorporated into a multilayer perceptron to construct an artificial neural network predictive model for prolonged surgical duration. Results of ROC curve showed that the AUC, accuracy, sensitivity, specificity, positive predictive value, negative predictive value of the predictive model in the training dataset were 0.73 (95% confidence interval as 0.68-0.78), 91.4%, 68.1%, 94.8%, 65.3%, 95.4%. The above indicators of the predictive model in the validation dataset 0.72 (95% confidence interval as 0.65-0.79), 88.1%, 67.6%, 93.7%, 74.2%, 91.5%. Conclusions:BMI ≥25 kg/m2, clinical T3 stage, clinical N3 stage are independent risk factors influencing prolonged surgical duration in Da Vinci robotic radical gastrectomy for gastric cancer. The artificial neural network predictive model con-structed based on BMI, tumor location, clinical T staging, and clinical N staging can effectively predict patients at high risk of prolonged surgical duration in Da Vinci robotic radical gastrectomy for gastric cancer.