Objective To evaluate the effect of gastric compound on patients with middle-late gastric cancer of spleen deficiency and stasis toxin. Methods Ninety patients with middle-late gastric cancer of spleen deficiency and stasis toxin were randomly divided into combined group, chemotherapy group, and gastric compound group, 30 cases in each group. Patients in the combined group were treated with gastric compound and chemotherapy;patients in the chemotherapy group were treated with placebo;patients in the gastric compound group were treated with gastric compound. The changes of QLQ-C30 scale integral, fatigue scale intergral, TCM symptom intergral, Karnofsky integral, and toxic and side effects of digestive tract and myelosuppression were observed to evaluate the effect of gastric compound on quality of life in patients. Results The changes of QLQ-C30 scale integral, fatigue scale intergral, TCM symptom intergral, Karnofsky intergal in combined group were better than those in chemotherapy group and gastric compound group, with statistical significance (P<0.05). The changes of fatigue scale intergral and TCM symptom intergral in gastric compound group were better than those in chemotherapy group, with statistical significance (P<0.05). The myelosuppression and toxic and side effects of digestive tract of combined group was lighter than those of chemotherapy group, with statistical significance (P<0.01). Conclusion Gastric compound combined with chemotherapy can improve quality of life in patients with middle-late gastric cancer of spleen deficiency and stasis toxin, and reduce myelosuppression and toxic and side effects of digestive tract.

Objective:To investigate the inhibitory effects of rosmarinic acid (RA) on high glucose-induced angiogenesis of human retinal microvascular endothelial cells (HRMEC) and nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome pathway-related proteins.Methods:The HRMEC were divided into control group, high glucose group, high glucose+ low concentration RA group, high glucose+ medium concentration RA group, and high glucose+ high concentration RA group, and were cultured in vitro with conventional medium, 30 mmol/L D-glucose medium, 30 mmol/L D-glucose+ 25 μmol/L RA medium, 30 mmol/L D-glucose+ 50 μmol/L RA medium and 30 mmol/L D-glucose+ 100 μmol/L RA medium accordingly.The 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2H-tetrazolium bromide (MTT) assay was used to detect the cell proliferation.Transwell assay was performed to detect the cell migration.Matrigel assay was employed to determine the tube formation ability of cells.Western blot was utilized to detect the expression levels of NLRP3, apoptosis-associated speck like protein (ASC) and cysteinyl aspartate-specific protease-1 (Caspase-1). Enzyme-linked immunosorbent assay (ELISA) kit was used to detect the concentrations of interleukin (IL)-1β and IL-18 in supernatant of cell culture. Results:The cell proliferation rate, the number of migrated cells and the number of formed tubes were (100.00±0.92)%, 37.67±9.02 and 45.00±4.58 in the control group, (163.56±1.46)%, 117.33±7.23 and 95.00±9.54 in the high glucose group, (152.29±2.90)%, 78.67±4.04 and 84.67±1.53 in the high glucose+ low concentration RA group, (147.72±2.22)%, 65.33±4.16 and 71.00±3.61 in the high glucose+ medium concentration RA group, (132.47±0.74)%, 52.67±6.81 and 60.00±1.00 in the high glucose+ high concentration RA group, respectively.There were statistically significant differences in cell proliferation rate, the number of migrated cells and formed tubes among all groups ( F=537.07, 64.63, 45.58; all at P<0.001). Compared with the control group, the cell proliferation rate, the number of migrated cells and formed tubes were significantly increased in the high glucose group, high glucose+ low concentration RA group, high glucose+ medium concentration RA group and high glucose+ high concentration RA group, showing statistical significances (all at P<0.05). Compared with the high glucose group, the cell proliferation rate, the number of migrated cells and formed tubes were significantly decreased in the different concentrations RA groups (all at P<0.05). With the increase of RA concentration, the cell proliferation rate, the number of migrated cells and formed tubes were decreased, and there were statistical differences among high glucose+ low/medium/high concentrations RA groups (all at P<0.05). There were significantly differences in the relative expression levels of NLRP3, ASC and Caspase-1 proteins in cells and the concentrations of IL-1β and IL-18 in cell culture supernatant among all the five groups ( F=145.12, 422.82, 463.79, 2 019.96, 33 406.97; all at P<0.001). Compared with the control group, the relative expression levels of NLRP3, ASC and Caspase-1 proteins as well as the concentrations of IL-1β and IL-18 in cell culture supernatant were significantly increased in the high glucose group, high glucose+ low concentration RA group, high glucose+ medium concentration RA group and high glucose+ high concentration RA group (all at P<0.05). Compared with the high glucose group, the expression levels of NLRP3, ASC and Caspase-1 proteins as well as the concentrations of IL-1β and IL-18 were decreased in the different concentrations RA groups, and the differences were statistically significant (all at P<0.05). With the increase of RA concentration, the expression levels of NLRP3, ASC and Caspase-1 proteins as well as the concentrations of IL-1β and IL-18 were decreased, and there were statistically significant differences among high glucose+ low/medium/high concentrations RA groups (all at P<0.05). Conclusions:RA can inhibit proliferation, migration and tube formation of HRMEC induced by high glucose, and inhibit high glucose-induced activation of NLRP3 inflammasome signaling pathway.

Objective To analyze the clinical characteristics of 310 patients with anti-tuberculosis drug-induced liver injury(ATB-DILI),to explore prognostic influencing factors,and to provide reference for its prevention and treatment.Methods Primary tuberculosis patients hospitalized in the Department of Tuberculosis of the Third People's Hospital of Kunming from November 2020 to November 2022 who met the diagnosis of ATB-DILI were enrolled.Statistics by gender,age,history,type of tuberculosis,co-morbidities,frequency of anti-tuberculosis regimens leading to liver injury,use of hepatoprotective drugs,and management and regression were performed to analyze the clinical characteristics of the patients and the factors influencing their prognosis.Results 310 patients were included,male,148(47.74%)and female,162(52.26%).The mean age was 44.33±17.47 years.Thirty-four patients had a history of allergy.The combination of isoniazid,rifampicin,pyrazinamide,and ethambutol(244 patients,78.71%)was the anti-tuberculosis regimen that resulted in the highest number of cases of hepatic injury.The median time between initiation of the tuberculosis regimen and the development of hepatic injury in patients with ATB-DILI was 30 d,and the mean duration of hospitalization was 16.39±7.01 d.The most used hepatoprotective drug was reduced glutathione(154 patients,49.68%),and most patients used a combination of 2 hepatoprotective drugs(128 patients,41.29%).Liver injury improved in 257 cases(82.90%)and failed in 53 cases(17.10%).The differences in alcohol consumption,severity,clinical staging,TT,ALP,TBIL,DBIL,IBIL,and GGT were statistically significant compared to those who did not recover(P<0.05),and severity and high ALP were independent risk factors for poor prognosis.Conclusions Patients should be carefully asked if they have a history of basic liver disease and alcoholism before using anti-tuberculosis drugs.In the course of anti-tuberculosis treatment,the combined use of anti-tuberculosis drugs is more serious than the use of single drugs to cause liver damage.Drugs that may cause liver damage should be used with caution and improved anti-tuberculosis programs should be explored.At the same time,liver function should be monitored regularly during anti-tuberculosis treatment,especially 30 days after medication,in order to reduce the occurrence of adverse reactions.

Objective To investigate the effect and application value of HC visual laryngoscope used for the emergency tracheal intubation on obese patients in the Emergency Department. Methods Totally 80 obese patients enrolled from January 2014 to December 2016 from Emergency Department, Second affiliated hospital of Xi'an Jiaotong University who needed the emergency tracheal intubation were randomly (random number) divided into two groups. Patients in group T were operated with traditional laryngoscope, and patients in group HC with HC visual laryngoscope. Then the success rate of glottis exposure, the trial times, operative time, success rate and complication rate of tracheal intubation were compared between the two groups. Results The success rate of glottis exposure in group HC was significantly higher than that in group T (95％ vs 77.5％, P<0.05). The one-time success rate of tracheal intubation and the total success rate of tracheal intubation in group HC were significantly higher than those in group T (72.5％ vs 37.5％, and 95％ vs 62.5％, respectively, P<0.05). However, the trial times of successful intubation cases and the operative time of successful intubation cases were significantly less than those in group T (1.26±0.40) vs (1.64±0.82), and (30.74±6.17) s vs (44.2±7.68) s, respectively, P<0.05. The complication rate of tracheal intubation in group HC was significantly less than that in group T (12.5％ vs 35％, P<0.05). Conclusions HC visual laryngoscope used for the obese patients in Emergency Department can not only increase the success rate of glottis exposure, decrease trial times and shorten operative time of intubation, but also improve the success rate and decrease the complication rate of emergency tracheal intubation, thus having a certain application value.

Objective To discuss the ethical necessity and feasibility of implementing multiple comprehensive psychological intervention measures in intensive care unit (ICU), and to investigate the effect of the measures on treatment compliance. Methods The conscious adult patients hospitalized in emergency ICU (EICU) of the Second Affiliated Hospital of Xi'an Jiaotong University from 2015 to 2017 were enrolled, and divided into control group and intervention group according to random number table, with 40 patients in each group. Patients in control group were treated with routine care and routine diagnosis and treatment, and patients in intervention group were treated with the help of psychologists and with multiple comprehensive psychological intervention measures (including nursing care, medical treatment, family and management) based on routine care and routine diagnosis and treatment. After 5 days of intervention, the treatment compliance, the medical coping attitude and the mental health were assessed respectively using the Treatment Compliance Scale, the Medical Coping Modes Questionnaire (MCMQ) and the Symptom Checklist Scale (SCL-90), and then comparation were done between the two groups. Results After 5 days of intervention, 3 patients in the control group and 4 patients in the intervention group withdraw the study because of the change of illness, and at last 37 patients in the control group and 36 in the intervention group were enrolled. There was no significant difference in basic data such as gender, age, education level, disease, course of disease, the length of EICU stay, and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score between the two groups. The scores of treatment compliance in intervention group was significantly higher than that in control group (2.89±0.67 vs. 2.32±0.91, P < 0.01). Compared with the control group, the "confrontation" dimension score of the MCMQ questionnaire in intervention group was significantly increased (19.75±2.08 vs. 18.62±2.65, P < 0.05), while the "avoidance" and"surrender" dimensions scores were significantly decreased (14.22±1.91 vs. 15.14±1.92, 8.83±1.54 vs. 9.73±2.10, both P < 0.05). In the SCL-90 scale, the scores of the 5 factors such as "somatization", "interpersonal sensitivity","depression", "anxiety" and "photic anxiety" in intervention group were significantly less than those in control group (1.59±0.38 vs. 1.81±0.37, 1.72±0.40 vs. 1.93±0.42, 1.76±0.32 vs. 1.92±0.29, 1.82±0.40 vs. 2.14±0.40, 1.44±0.30 vs. 1.60±0.38, all P < 0.05), while there was no significantly difference in the scores of the other 4 factors as "obsessive-compulsive symptoms", "hostile", "bigotry" and "psychoticism" between the two groups (all P > 0.05). Conclusion The multiple comprehensive psychological intervention measures used for ICU conscious patients could improve the treatment compliance, make the patients' medical coping attitude more active and improve the mental health of the patients, so it has ethical necessity and certain feasibility.