ObjectiveTo observe the effects of Guben Fangxiao decoction-containing serum on the expression of transcription factors and cytokines associated with calcitonin gene-related peptide （CGRP）， γ-aminobutyric acid （GABA）， and type Ⅱ innate lymphoid cells （ILC2） in human bronchial epithelial cells （BEAS-2B） stimulated with interleukin-4 （IL-4） combined with interleukin-13 （IL-13）， and explore the possible mechanism of Guben Fangxiao decoction-containing serum in alleviating type Ⅱ inflammation of bronchial epithelial cells. MethodsBEAS-2B cells stimulated with IL-4 combined with IL-13 were treated with the sera containing high （20%）， medium （15%）， and low （10%） doses of Guben Fangxiao decoction and the montelukast-containing serum （10%）. Real-time PCR was used to measure the mRNA levels of CGRP， GABA， mucin 5AC （MUC5AC）， thymic stromal lymphopoietin （TSLP）， interleukin （IL）-25， IL-33， IL-5， GATA-binding protein 3 （GATA3）， and B cell lymphoma/leukemia 11B （Bcl-11B） in each group. Western blot was employed to determine the relative protein levels of CGRP and MUC5AC. The immunofluorescence assay was employed to observe the relative expression of CGRP and GABA in the cells. Enzyme-linked immunosorbent assay was used to quantify the protein levels of IL-33， MUC5AC， and IL-5 in the culture and cell supernatants. Periodic acid-Schiff staining was performed to assess mucin secretion. ResultsCompared with the control group， the model group showed up-regulated mRNA levels of CGRP， GABA， MUC5AC， TSLP， IL-25， and IL-33 （P<0.05， P<0.01）. Compared with the normal group， the Guben Fangxiao decoction-containing serum down-regulated the mRNA levels of CGRP， GABA， MUC5AC， IL-5， GATA3， and Bcl-11B （P<0.05， P<0.01） in a dose-dependent manner. Compared with the normal group， the model group showed up-regulated protein levels of CGRP， GABA， MUC5AC， IL-33， and IL-5 （P<0.05， P<0.01）， which were down-regulated by the Guben Fangxiao decoction-containing serum （P<0.05， P<0.01）. Compared with the normal group， the model group showed enhanced average fluorescence intensity of CGRP and GABA （P<0.01）， which was weakened by the Guben Fangxiao decoction-containing serum （P<0.01）. Compared with the normal group， the model group showed increased secretion of mucin， which was reduced by the Guben Fangxiao decoction-containing serum. ConclusionGuben Fangxiao decoction can treat bronchial asthma by alleviating type Ⅱ immune airway inflammation and reducing airway mucus secretion， which is achieved by regulating the expression of CGRP， GABA， MUC5AC， and ILC2-related transcription factors.

Objective:To investigate the urodynamic characteristics in Parkinson's disease(PD)versus multiple system atrophy(MSA)patients with lower urinary tract symptoms(LUTS).Methods:We performed a retrospective study in PD and MSA patients admitted to the First Affiliated Hospital of Zhengzhou University and undergone urodynamic examinations from January 2016 to June 2019.A total of 178 patients, mean age(59.2±9.7)years were enrolled, with 64 PD patients, 74 MSA patients and 40 normal controls.Urodynamic parameters included maximum flow rate(Qmax), post-voided residual urine volume(PVR), bladder compliance(BC), overactive bladder(OAB), maximum cystometric capacity(MCC)and detrusor pressure at maximum flow rate(PdetQmax). Bladder function was assessed.Results:Frequent urination(68.8%)was the most common LUTS in PD patients, as opposed to urinary retention(91.9%)in MSA patients.The Qmax, PdetQmax and incidence of OAB were higher and the PVR were lower in PD patients than in MSA patients [free-flow(FF)-Qmax: (13.5±7.1)ml/s vs.(10.1±5.2)ml/s, U=26.98, P<0.01]; pressure-flow study(PFS)-Qmax: [(13.6±5.7)ml/s vs.(10.5±3.3)ml/s, U=34.90, P<0.01]; PFS-PdetQmax: [(23.9±11.3)cm H 2O vs.(16.3±8.6)cmH 2O, U=35.04, P<0.01]; OAB: (46.9% vs.27.0%, χ2=5.85, P<0.01); FF-PVR: [(30.4±20.0)ml vs.(161.7±79.8)ml, U=-71.81, P<0.01]; PFS-PVR: [(65.9±30.7)ml vs.(212.6±83.0)ml, U=-65.29, P<0.01]. Compared with the control group, the incidences of OAB and PFS-PVR were increased and the MCC and PdetQmax were decreased in the PD group(OAB: 46.9% vs.7.5%, χ2=6.15, P<0.018); PFS-PVR: [(65.9±30.7)ml vs.(22.2±10.4)ml, U=47.25, P<0.01]; MCC: [(305.1±79.7)ml vs.(389.6±65.2)ml, U=-52.13, P<0.01]; PdetQmax: [(23.9±11.3)cmH 2O vs.(37.3±10.3)cmH 2O, U=-49.88, P<0.01]. Compared also with the control group, the MSA group had a lower Qmax, PdetQmax and MCC, FF-Qmax: [(10.1±5.2)ml/s vs.(16.3±4.7)ml/s, U=-50.11, P<0.01]; PFS-Qmax: [(10.5±3.3)ml/s vs.(13.1±5.0)ml/s, U=-27.54, P<0.05]; PdetQmax: [(16.3±8.6)cmH 2O vs.(37.3±10.3)cmH 2O, U=-84.92, P<0.01]; MCC: [(284.3±71.8)ml vs.(389.6±65.2)ml, U=-39.31, P<0.01], a higher PVR, lower bladder compliance(BC)and a higher incidence of OAB(FF-PVR: [(161.7±79.8)ml vs.(22.0±13.0)ml, U=84.82, P<0.01]; PFS-PVR: [(212.6±83.0)ml vs.(22.2±10.4)ml, U=112.54, P<0.01]; BC: (28.4% vs.7.5%, χ2=6.81, P<0.01); OAB: (27.0% vs.7.5%, χ2=17.62, P<0.01). Conclusions:PD and MSA patients with LUTS have bladder dysfunction.MSA patients have more serious bladder dysfunction than PD patients.

Objective:To develop a prediction model based on imaging features by contrast-enhanced MRI radiomics combined with clinical features for early recurrence of hepatocellular carcinoma (HCC) after radical resection.Methods:A retrospective study was carried out on 109 HCC patients who underwent radical resection at the Fifth Affiliated Hospital of Wenzhou Medical University from January 2015 to December 2020. Of 109 patients enrolled in this study, there were 96 males and 13 females, aged (58.3±10.7) years. Based on whether there was recurrence within 12 months after operation, the patients were divided into the early recurrence group ( n=31) and the control group ( n=78). These 109 patients were then randomly divided into the validation set ( n=23) and the training set ( n=86) at a ratio of 1∶4. Based on preoperative multi-phase contrast-enhanced MRI scanning, the tumor lesions were delineated on the Radcloud platform, and 1 409 quantitative radiomic features were extracted. Dimension reduction and screening of these features were carried out using variance threshold, SelectKBest and LASSO. Combined with clinical features (alpha fetoprotein, tumor size), several prediction model were established through machine learning. The predictive efficiencies of these models were evaluated using the area under the receiver operating characteristic (ROC) curve, accuracy rate, recall rate and balanced F score. Results:The proportions of irregular tumor shape and unclear tumor boundary, as well as maximum tumor diameter in the early recurrence group were significantly higher than that in the control group, but the proportion of pseudocapsule was significantly lower than that in the control group (all P<0.05). A total of 465 features were screened from the 1 409 features using the variance threshold method, followed by 38 features were screened using the method of SelectKBest. Finally 7 optimal radiomic features were screened based on the LASSO method. When combined with clinical features, 5 prediction models were established through machine learning. These models were support vector machine, Gaussian naive bayes, logistic regression, Multinomial naive bayes and K-nearest neighbor (KNN), respectively. Among these 5 models, the prediction efficiency of the KNN model was relatively highest, with the area under the ROC curve, accuracy rate, recall rate and balanced F score being 0.90, 0.98, 0.74 and 0.84 in the training set, and 0.76, 0.92, 0.75 and 0.83 in the verification set, respectively. Thus, the KNN model was selected as the best prediction model in this study. Conclusion:The prediction model of KNN was developed for early recurrence of HCC after radical resection based on preoperative contrast-enhanced MRI radiomics combined with clinical features.

Objective: To investigate the urodynamic characteristics and clinical significance of bladder function in patients with parkinsonism dominant multiple system atrophy (MSA-P) with abnormal urination. Methods: The clinical data of 58 patients with multiple system atrophy (MSA) and urinary dysfunction who were hospitalized in the First Affiliated Hospital of Zhengzhou University from January 2015 to June 2018 were analyzed. The bladder function status of MSA-P patients was evaluated, and the characteristics of urinary motility examination results were analyzed. Results: According to the diagnostic criteria, 51 patients were MSA, and seven patients were suspicious, all diagnosed as MSA-P. All MSA-P patients had abnormal urination with different symptoms, including dysuria (77.6%), frequent urination (62.1%), urgency (62.1%), urinary incontinence (65.5%), urinary retention (12.1%). Of the MSA-P patients with abnormal urination, the maximum flow rate (Q_max) was (12.46±2.85) ml/s, the average flow rate (Q_ave) was (5.19±2.06) ml/s, the voided volume was (171.73±11.47) ml, postvoid residual urine was (136.15±10.47) ml, maximal detrusor pressure was (20.78±3.55) cmH₂O, bladder compliance was (16.59±2.91) ml/cmH₂O, normal desire to void was (223.64±11.02) ml, and maximal capacity was (287.57±12.51) ml. The Q_max, Q_ave, voided volume, maximal detrusor pressure, bladder compliance, normal desire to void, and maximal capacity of patients with MSA-P with abnormal urination were significantly decreased, while the bladder residual urine volume was significantly increased, with statistically significant differences compared to normal reference values (P<0.05). Conclusion The urinary motility of bladder function in patients with MSA-P and urinary abnormalities is mainly characterized by decreased bladder compliance and detrusor dysfunction, while urodynamic testing is helpful for early diagnosis.

This paper summarized professor WANG Shouchuan's experience in differentiating and treating children epistaxis from the perspective of "four excess and three deficiency". It is believed that the pathogenesis of children epistaxis is concluded as "four excess and three deficiency"， of which the four excess syndromes are exuberant heat in the lung channel， intense stomach fire， heart fire hyperactivity， and liver fire flaming upward， while the three deficiency syndromes include qi， yin and yang deficiency. Seven methods for treating children epistaxis are summarized. For exuberant heat in the lung channel syndrome， it is recommended to clear lung and direct qi downward， using self-made Xiebai Zhiniu Decoction （泻白止衄汤）. For intense stomach fire syndrome， the method of clearing stomach and draining fire can be used with self-made Qingwei Zhiniu Decoction （清胃止衄汤）. In terms of heart fire hyperactivity syndrome， it is better to clear heart and drain fire， using self-made Daochi Zhiniu Decoction （导赤止衄汤）. For liver fire flaming upward syndrome， it is advised to clear liver and drain fire， using self-made Yimu Zhiniu Decoction （抑木止衄汤）. In terms of qi deficiency syndrome， the method of fortifying spleen and boosting qi and containing blood should be used with self-made Futu Zhiniu Decoction （扶土止衄汤）. If there is yin deficiency syndrome， it is advised to supplement kidney， enrich yin and clear heat， using self-made Zishui Zhiniu Decoction （滋水止衄汤）. If there is yang deficiency syndrome， the method of boosting qi， warming yang and nourishing blood can be used， using self-made Wenpi Zhiniu Decoction （温脾止衄汤）.