Intercourse between heart and kidney and harmonization of fire and water are important concepts in TCM.At present,discussions about them are not clear,but confused.This paper concludes the concepts and meanings about intercourse between heart and kidney and harmonization of water and fire,based on opinions of ancient theories of yin and yang,and five elements.It also expounds the differences and relations about harmonization of yin and yang,harmonization of water and fire,and intercourse between heart and kidney,and puts forward that the concept of intercourse between heart and kidney should be divided into aspect in two parts which are in broad sense and in narrow sense.In broad sense,it indicates kidney qi and heart qi interacts in all aspects;in narrow sense,it indicates the intercourse between heart fire and kidney water.The pathway,the time and other meanings about intercourse between heart and kidney are also reviewed in this article.

Objective To investigate the surgical approach of Siewert Ⅱ and Ⅲ gastroesophageal junction adenocarcinoma.Methods A total of 148 cases with Siewert Ⅱ,Ⅲ type patients were prospectively studied.The patients were divided into two groups,including transthoracic approach group (58 cases) and transabdominal approach group(90 cases).The results of surgery were compared.Patients were followed up for 2 years and survival rate were compared.Results In transthoracic approach group and transabdominal approach group,operative time ((329.5 ± 84.3) min vs.(202.4± 84.5) min,t =15.431,P ＜ 0.001),the positive rate margin stump (8.62％ vs.1.11％,x2 =5.763,P =0.012),pleural effusion (13.79％ vs.2.22％,x2 =10.462,P ＜0.001) and pulmonary infection rate (15.52％ vs 1.11％,x2 =12.574,P＜ 0.001) were significantly higher than transabdominal approach group,and number of lymph node dissection ((16.7 ± 4.3) vs.(22.6± 5.5),t =6.321,P =0.004) was significantly less than transabdominal approach group.In incidence of blood loss,tumor diameter,anastomotic leakage (or bleeding) and discharge time,there was no significant difference (P ＞0.05).One-year survival rate of transthoracic approach group was 73.24％,and 2-year survival rate was 53.43％.Oneyear survival rate of transabdominal approach group was 78.42％,and 2-year survival rate was 57.51％.Survival rate of two groups showed no significant difference (P =0.453,0.311).Conclusion Transabdominal surgical approach in Siewert Ⅱ,Ⅲ patients is better than transthoracic approach,can better carry out abdominal lymph node dissection,does not destroy the integrity of the chest,and avoid the occurrence of related complications.

Objective To explore the influence of different testing methods on detecting value of to-tal cell volume. Methods 60 reusable dialyzers(low-flux dialyzer and high-flux dialyzer were 30 respec-tively) were enrolled. They were divided into the traditional testing group, the modified testing group and the automatic dialyzer reuse group with 20 dialyzers in each group according to different detecting methods, the results underwent analysis. Results The basic total cell volume of the traditional testing group, the modified testing group and the automatic dialyzer reuse group were (100.10±0.25) ml, (100.13±0.50) ml and (102.00±1.41) ml in 6LR dialyzer, while in 17R dialyzer, they were (113.67±1.30) ml, (118.67±1.30) ml and (119.93±1.77)ml respectively. The total cell volume of the dialyzer reuse in the traditional testing group, the modified testing group and the automatic dialyzer reuse group were (95.20±7.76) ml, (96.20± 7.22) ml and (102.80±4.26) ml in 6LR dialyzer, while in 17R dialyzer, they were (100.00±11.48) ml, (114.35±3.31 ) ml and (117.07±2.96) ml respectively. There was significant difference between the tradi-tional and the modified testing groups in high-flux dialyzers reuse. Conclusions The modified testing method can improve the accuracy of the testing of total cell volume in high-flux dialyzer reuse.

Objective: To investigate the regulatory role of microRNA-375 (miR-375) in the process of cytokine-induced killer (CIK) cells killing cervical cancer SiHa cells, and to determine the target genes of miR-375 and their molecular mechanisms. Methods: The peripheral blood mononuclear cells (PBMC) were isolated from the healthy people, and cultured in vitro with different cytokines for 14 d to induce into CIK cells. CIK cells were stimulated as the effector cells. The phenotype of CIK cells was analyzed by FCM, and the killing effect of CIK cells on cervical cancer SiHa cells was detected by CCK-8 method. Real-time fluorescent quantitative PCR was used to detect the change of miR-375 expression level in SiHa cells after co-culture with CIK cells. CCK-8 method was used to detect the proliferation of SiHa cells transfected with miR-375 mimic and the inhibitory effect of CIK cells on proliferation of SiHa cells transfected miR-375 inhibitor. The expression of Yes-associated protein (YAP) in SiHa cells transfected with miR-375 inhibitor and co-cultured with CIK cells was detected by immunofluorescence assay and Western blotting, respectively. Results: After co-culture with CIK cells for 24, 48 and 72 h, the growth inhibitory rates of SiHa cells were (22.97±3.54)%, (37.48±3.64)% and (54.32±4.25)%, respectively. The relative expression levels of miR-375 in SiHa cells after co-culture with CIK cells for 24, 48 and 72 h were about 1.39, 1.57 and 2.68 times higher than those before co-culture, respectively. The viability of SiHa cells transfected with miR-375 mimic was significantly decreased (P < 0.001). After co-culture with CIK cells, the suppression effect on the growth of SiHa cells transfected with miR-375 inhibitor was significantly decreased (P < 0.001). YAP protein was expressed abundantly in SiHa cells, and mainly concentrated in cell nucleus. After co-culture with CIK cells, the expression of YAP protein in SiHa cells transfected with miR-375 inhibitor was more significantly up-regulated (P < 0.01). Conclusion: CIK cells can effectively kill cervical cancer SiHa cells. As a tumor-suppressor factor, miR-375 may play an important role in the process of CIK cells killing SiHa cells through down-regulating the expression of YAP gene.

Objective To edit Chinese version of the Minnesota living with heart failure questionnaire (MLHFQ) and to estimate its reliability and validity.Metheds Translated and edited the Chinese version of MLHFQ according to the standard procedures,and tested 83 inpatients which were recruited from three polyclinics of Beijing district in China.Results Cronbach's alpha consistency was>0.80 for the three MLHFQ scores.Reproducibility ranged from 0.48 to 0.84 for items of weighted kappa coefficient and from 0.88 to 0.94 for three do-mains of Spearman's correlation coefficient.MLHFQ scores varied significantly with NYHA functional class(P<0.05),and there were intermediate-to-high correlations with the assumed corresponding SF-36 domains(-0.73 to -0.59).Factor analysis revealed three-factor structure explained 49.34% of the total variance.The MLHFQ scores before and after the treatment combined TCM and western medicine were significant (physical domain (26.15±7.15,17.63±8.50),emotional domain (8.96±5.73,6.8l±5.31),overall score(56.38±16.88,39.77±15.69) all P<0.01).Conclusions The Chinese version of MLHFQ is translated and edited according to the standard procedures.Its reliability and validity is good,and could be used as a clinical outcome measurement.

Objective To explore the effects of crisis-based interventions on breast cancer patients who received peripherally inserted central catheters (PICC). Methods A total of 104 breast cancer patients who were admitted in He'nan Cancer Hospital between May 2016 and May 2017 were selected by purposive sampling and divided into the control group (n=52) and the observation group (n=52) according to the random number table. Patients in the control group received routine nursing care for PICC, while patients in the observation group received crisis-based interventions. The Triages Assessment Form (TAF) and Hamilton Depression Scale (HAMD) were used to compare the effects of interventions. Results Patients in the observation group scored (4.11±1.65), (5.14±0.31) and (5.32±0.54) in the dimensions of emotion, cognition and behavior in TAF, lower than those of the control group (t=3.229, 8.933, 5.290; P＜ 0.01). Patients in the observation group scored (1.47±0.46), (1.02±0.89) and (1.13±0.21) in the dimensions of depression, somatic anxiety and mental anxiety, lower than those of the control group (t=4.890, 3.039, 11.264; P＜ 0.01). Conclusions Crisis-based interventions can improve the negative emotions of breast cancer patients receiving PICC, which is worth promoting in clinical practice.

Excessive N-acetyl-p-benzoquinone imine(NAPQI)formation is a starting event that triggers oxidative stress and subsequent hepatocyte necrosis in acetaminophen(APAP)overdose caused acute liver failure(ALF).S-glutathionylation is a reversible redox post-translational modification and a prospective mechanism of APAP hepatotoxicity.Glutaredoxin-1(Glrx1),a glutathione-specific thioltransferase,is a primary enzyme to catalyze deglutathionylation.The objective of this study was to explored whether and how Glrx1 is associated with the development of ALF induced by APAP.The Glrx1 knockout mice(Glrx1-/-)and liver-specific overexpression of Glrx1(AAV8-Glrx1)mice were produced and underwent APAP-induced ALF.Pirfenidone(PFD),a potential inducer of Glrx1,was administrated preceding APAP to assess its protective effects.Our results revealed that the hepatic total protein S-glutathionylation(PSSG)increased and the Glrx1 level reduced in mice after APAP toxicity.Glrx1-/- mice were more sensitive to APAP overdose,with higher oxidative stress and more toxic metabolites of APAP.This was attributed to Glrx1 deficiency increasing the total hepatic PSSG and the S-glutathionylation of cytochrome p450 3a 11(Cyp3a11),which likely increased the activity of Cyp3a11.Conversely,AAV8-Glrx1 mice were defended against liver damage caused by APAP overdose by inhibiting the S-glutathionylation and activity of Cyp3a11,which reduced the toxic metabolites of APAP and oxidative stress.PFD precede administration upregulated Glrx1 expression and alleviated APAP-induced ALF by decreasing oxidative stress.We have identified the function of Glrx1 mediated PSSG in liver injury caused by APAP overdose.Increasing Glrx1 expression may be investigated for the medical treatment of APAP-caused hepatic injury.

OBJECTIVE To investigate the related factors of central lymph node metastasis(CLNM)in papillary thyroid carcinoma(PTC)with capsular invasion,and to construct a clinical nomogram prediction model.Its purpose is to provide theoretical basis for clinical diagnosis and treatment.METHODS The clinical data of PTC patients with capsule invasion admitted to the Department of General Surgery,Baoding First Central Hospital from October,2020 to October,2023 were retrospectively analyzed.The data included gender,age,body mass index(BMI),aspect ratio,tumor location,multifocality,microcalcification,Hashimoto thyroiditis(HT)and tumor diameter.According to the presence or absence of CLNM,the patients were divided into the normal group(107 cases)and the metastasis group(108 cases).Univariate and multivariate analysis of the data were performed to construct a visual nomogram prediction model,and the receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of the model.The nomogram model was internally verified using a Bootstrap test with 1000 repeated samples.Consistency index(C-index)and calibration curve were used to describe the prediction performance and prediction accuracy of the model.Finally,the clinical decision curve(DCA)was drawn to determine the clinical application ability of the model.RESULTS A total of 215 PTC patients with capsular invasion were included,of whom 108(50.23%)had CLNM.Univariate analysis showed that the occurrence of CLNM was associated with tumor diameter,aspect ratio>1,tumor located in the lower pole,multifocality,and HT(P<0.05).Multivariate regression analysis showed that tumor diameter,aspect ratio>1,tumor located in the lower pole and multifocus were independent risk factors for CLNM(OR=1.401,1.875,2.291,2.303,P<0.05),and HT was a protective factor for CLNM(OR=0.501,P<0.05).Based on the above risk factors,a nomogram prediction model for CLNM in patients with PTC with capsule invasion was constructed.The ROC curves showed that the area under the curve(AUC)was 0.859(95%CI:0.792-0.925,Yoden Index was 0.734,the sensitivity was 0.878,a specificity was 0.856),and the model had higher predictive value.Internal validation consistency index(C-index)was 0.83(95%CI,0.748 to 0.959).The calibration curve showed that the predictive value was close to the ideal curve,and it had good consistency.The DCA curve showed that the model had good clinical efficacy.CONCLUSION Larger tumor size,aspect ratio>1,tumor located in the lower pole and multifocality suggest higher risk of CLNM in PTC with capsular invasion,while HT is a protective factor for CLNM.The nomogram model based on the above risk factors has high discrimination and calibration,which is helpful for clinicians in preoperative evaluation and intraoperative exploration,so that high-risk patients can be prevented and treated as soon as possible.

Female ; Humans ; Ovarian Neoplasms/surgery* ; Peritoneal Neoplasms ; Teratoma/surgery*