This article compares and analyzes the content and theoretical structure of the concept of pathogenesis from the national textbooks of Basic Theory of Chinese Medicine and Diagnostics in Chinese Medicine from the first to the ninth version.The authors consider the mechanism as the main content of pathogenesis concept in contemporary Chinese medicine.During the construction of this concept,the concept of pathology has a profound influence,wh ich differs a lot from the emphasis on key in ancient pathogenesis content,mainly reflected in clinical diagnosis and treatment ideas transferring from dealing with key issues to dealing with abstract concept.This change is associated with the impact of western medicine on modern Chinese medicine,emphasizing the mechanism and so on,so that the ancient Xiang (象) concept is marginalized.

BACKGROUNDS: At present, there is no consensus on the induction methods in term pregnancy with borderline oligohydramnios. This study aimed to compare the effectiveness and pregnancy outcomes of labor induction with dinoprostone or single-balloon catheter (SBC) in term nulliparous women with borderline oligohydramnios. METHODS: We conducted a retrospective cohort study from January 2016 to November 2018. During the study period, a total of 244 cases were enrolled. Of these, 103 cases were selected for induction using dinoprostone and 141 cases were selected for induction with SBC. The pregnancy outcomes between the two groups were compared. Primary outcomes were successful vaginal delivery rates. Secondary outcomes were maternal and neonatal adverse events. Multivariate logistic regression was used to assess the risk factors for vaginal delivery failure in the two groups. RESULTS: The successful vaginal delivery rates were similar between the dinoprostone group and the SBC group (64.1% [66/103] vs. 59.6%, [84/141] P = 0.475), even after adjustment for potential confounding factors (adjusted odds ratio [aOR]: 1.07, 95% confidence interval [CI]: 0.57-2.00, P = 0.835). The incidence of intra-amniotic infection was lower in the dinoprostone group than in the SBC group (1.9% [2/103] vs. 7.8%, [11/141] P < 0.001), but the presence of non-reassuring fetal heart rate was higher in the dinoprostone group than in the SBC group (12.6% [13/103] vs. 0.7%, [1/141] P < 0.001). Multivariate logistic regression showed that nuchal cord was a risk factor for vaginal delivery failure after induction with dinoprostone (aOR: 6.71, 95% CI: 1.96-22.95). There were three factors related to vaginal delivery failure after induction with SBC, namely gestational age (aOR: 1.51, 95% CI: 1.07-2.14), body mass index (BMI) >30 kg/m2 (aOR: 2.98, 95% CI: 1.10-8.02), and fetal weight >3500 g (aOR: 2.49, 95% CI: 1.12-5.50). CONCLUSIONS Term nulliparous women with borderline oligohydramnios have similar successful vaginal delivery rates after induction with dinoprostone or SBC, with their advantages and disadvantages. In women with nuchal cord, the risk of vaginal delivery failure is increased if dinoprostone is used in the induction of labor. BMI >30 kg/m2, large gestational age, and estimated fetal weight >3500 g are risk factors for vaginal delivery failure after induction with SBC.
Administration, Intravaginal ; Catheters ; Dinoprostone/therapeutic use* ; Female ; Fetal Weight ; Humans ; Infant, Newborn ; Labor, Induced/methods* ; Nuchal Cord ; Oligohydramnios ; Oxytocics ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies

This study examined the impact of astragalus polysaccharide synbiotics on fecal scores and blood indices in calves suffering from E.coli-induced diarrhea.Twenty Holstein calves,aged 6-9 days and weighing approximately(44.56±5)kg,were randomly divided into a control group and an experimental group.The experiment lasted 10 days.Both control and experimental group calves received daily intramuscular injections of borlococci(1 mg/kg)and enrofloxacin(20 mg/kg)dur-ing experimental period.In addition to the standard treatment regimen,calves in the experimental group were given 20 g of Astragali polysaccharide synbiotics in their milk each day.Fecal scoring was conducted daily at 9:00 a.m.,and jugular blood was collected at the end of experiment to eval-uate relevant blood parameters.Results indicated a 17％reduction in diarrhea rates in the experi-mental group compared to the control group,although there was no statistically significant differ-ence in fecal scores.Compared to the control group,the experimental group showed a significant in-crease in the levels of immunoglobulin A(IgA)and immunoglobulin M(IgM)by 54.81％and 60.40％,respectively(P＜0.01).Immunoglobulin G(IgG)and interleukin-10(IL-10)levels increased by 50.89％and 46.80％,respectively(P＜0.05).while interleukin-6(IL-6),interleukin-1β(IL-1 β),and tumor necrosis factor-α(TNF-α)decreased by 28.99％,20.88％,and 37.10％,re-spectively(P＜0.01).The experimental group showed a significant reduction in the level of D-lac-tic acid(D-LA)and endotoxin(LPS)by 47.46％and 65.31％compared to the control group,re-spectively(P＜0.01),and diamine oxidase(DAO)activity was 30％lower(P＜0.01).Total su-peroxide dismutase(T-SOD)content increased by 12.78％(P＜0.05),and catalase(CAT)and glutathione peroxidase(GSH-Px)contents increased by 53.09％,and 60.57％,respectively(P＜0.01).Furthermore,malondialdehyde(MDA)content decreased by 33.29％(P＜0.01)in the ex-perimental group.In conclusion,administering astragalus polysaccharide synbiotics could reduce in-testinal mucosal damage in calves with E.coli diarrhea,enhance their immunity and antioxidative stress response,and mitigate the impact of pathogenic bacteria and oxidative stress on intestinal mucosal permeability.

Objective:To analyze the related factors affecting the use of autogenous arteriovenous fistula (AVF), and provide a theoretical basis for prolonging the service life of AVF in hemodialysis patients.Methods:This was a retrospective study. The patients undergoing AVF and using it to maintain hemodialysis (MHD) in the First Affiliated Hospital of Nanchang University from October 2004 to June 2017 were selected as study subjects to discuss the relevant factors affecting the service life of AVF. The data of general information, dialysis and laboratory examinations were collected through questionnaire surveys, hospital case system and hemodialysis record sheets. The patients were divided into the patency group and the dysfunction group according to the status of AVF, and the related factors were compared. Multivariate Cox proportional hazard model was used to analyze the influencing factors, and Kaplan-Meier survival curve was used to determine the service life of AVF, respectively.Results:A total of 187 subjects were included in the study. The patency group had 140 cases and the dysfunction group had 47 cases. There were statistically significant differences in the proportion of diabetes, the level of serum albumin, uric acid and parathyroid hormone (PTH) between the two groups (all P<0.05). Multivariate Cox proportional hazard regression analysis showed that diabetes ( HR=9.348, 95% CI 3.507-24.918, P<0.001) and hypoalbuminemia ( HR=12.650, 95% CI 2.925-54.714, P=0.001) were risk factors for the short service life of AVF. The results of Kaplan-Meier analysis showed that the service life of AVF in patients with diabetes was significantly shorter than that in MHD patients without diabetes (Log-rank χ2=13.191, P<0.001); the service life of AVF in patients with hypoalbuminemia was significantly shorter than that without hypoalbuminemia (Log-rank χ2=13.591, P<0.001). Conclusions:Diabetes mellitus and hypoalbuminemia are risk factors for the short service life of AVF. Therefore, intervention programs should be formulated to extend the service life of AVF.

Trace amines(TAs)are metabolically related to catecholamine and associated with cancer and neuro-logical disorders.Comprehensive measurement of TAs is essential for understanding pathological pro-cesses and providing proper drug intervention.However,the trace amounts and chemical instability of TAs challenge quantification.Here,diisopropyl phosphite coupled with chip two-dimensional(2D)liquid chromatography tandem triple-quadrupole mass spectrometry(LC-QQQ/MS)was developed to simul-taneously determine TAs and associated metabolites.The results showed that the sensitivities of TAs increased up to 5520 times compared with those using nonderivatized LC-QQQ/MS.This sensitive method was utilized to investigate their alterations in hepatoma cells after treatment with sorafenib.The significantly altered TAs and associated metabolites suggested that phenylalanine and tyrosine metabolic pathways were related to sorafenib treatment in Hep3B cells.This sensitive method has great potential to elucidate the mechanism and diagnose diseases considering that an increasing number of physiological functions of TAs have been discovered in recent decades.

In our country, there are a large number of carbon monoxide poisoning patients every winter. 10% to 30% of patients with acute carbon monoxide poisoning develop acute carbon monoxide poisoning delayed encephalopathy after a "false recovery period" of about 2 to 60 days. The morbidity and mortality rates of the disease are extremely high, but there is still no effective treatment for this condition. The pathogenesis of the disease is complex, and there is no clear conclusion yet. After consulting a large number of recent relevant literatures, this article reviews the main research results of the pathogenesis of the disease so far, with an aim to facilitate its early clinical diagnosis and correct treatment.

In our country, there are a large number of carbon monoxide poisoning patients every winter. 10% to 30% of patients with acute carbon monoxide poisoning develop acute carbon monoxide poisoning delayed encephalopathy after a "false recovery period" of about 2 to 60 days. The morbidity and mortality rates of the disease are extremely high, but there is still no effective treatment for this condition. The pathogenesis of the disease is complex, and there is no clear conclusion yet. After consulting a large number of recent relevant literatures, this article reviews the main research results of the pathogenesis of the disease so far, with an aim to facilitate its early clinical diagnosis and correct treatment.

Objective To train influenza clinical syndrome data using machine learning methods;To obtain an influenza syndrome differentiation model.Methods The medical records of influenza patients who visited the fever clinic of China-Japan Friendship Hospital from December 2019 to March 2022 were collected.The data set system was used for data processing,and the data generated by different data processing processes were stored separately for training.The study selected logistic regression,decision tree,naive Bayes,support vector machine,multi-layer perceptron,lightGBM and random forest as alternative models,and optimized the hyperparameters through Optuna.Models were trained separately in each data set,and the model prediction performance was evaluated,with the macro-F1 score as the core.Results Totally 1 011 training samples were collected,including 453 cases of wind-heat syndrome,152 cases of superficial wind-cold syndrome,and 406 cases of superficial cold and internal heat syndrome;8 data sets were obtained for training,containing 80 copies of data.After training,the macro-F1 scores of logistic regression,decision tree,naive Bayes,support vector machine,multi-layer perceptron lightGBM and random forest model were 0.783 0,0.774 2,0.731 5,0.782 4,0.716 7,0.793 8 and 0.815 3,respectively.Weighted samples could significantly improve the average model performance,while PCA would reduce the average model performance.The prediction performance of the logistic regression model was the best in the single method models,and the random forest model was the best in the integrated method models.Conclusion In the case of a small sample size,it is more appropriate to use logistic regression,decision tree,support vector machine and lightGBM for the TCM influenza syndrome differentiation model.As the sample size increases,logistic regression,support vector machine,lightGBM and random forest may be more suitable.Different data processing methods will affect model performance.Collecting information on the typical degree of syndrome types is beneficial to improving model performance.

OBJECTIVE：To evaluate the efficacy and safety of atomization inhalation of polymyxin combined in the adjunctive treatment for ventilator-associated pneumonia ，and to provide evidence-based reference for clinical treatment. METHODS ： Retrieved from Cochrane Library ，Embase，PubMed，Web of Science ，CNKI，CBM，VIP and Wanfang database （from their inception to March 2021），randomized controlled trials （RCTs）about efficacy and safety of atomization inhalation of polymyxin combined with conventional treatment （trial group ） versus conventional treatment （control group ） for ventilator- associated pneumonia were collected. After data extraction and quality evaluation of included literatures met inclusion and exclusion criteria ， Meta-analysis was performed by using Rev Man 5.4 software. RESULTS ：A total of 13 clinical studies were included ，involving 2 RCTs and 11 cohort studies with a total of 1 066 patients. The results of Meta-analysis showed that clinical response rate [OR ＝ 1.53，95％CI（1.17，2.00），P＝0.002]，microbial clearance rate [OR ＝1.46，95％CI（1.11，1.91），P＝0.007] of trial group were significantly higher than those of control group ，with statistical significance. There was no statistical significance in the mortality rate [OR ＝0.88，95％CI（0.68，1.14），P＝0.32] and the incidence of renal impairment [OR ＝1.04，95％CI（0.72，1.49），P＝0.85] between 2 groups. CONCLUSIONS ：Based on current evidence ，atomization inhalation of polymyxin combined with conventional treatment can significantly improve clinical response rate and microbial clearance rate of patients with ventilator- associated pneumonia. However ， more strictly-designed ， long-term follow-up and large-scale RCTs are needed.

Gestational diabetes mellitus (GDM) is common during pregnancy, with the prevalence reaching as high as 31.0% in some European regions (McIntyre et al., 2019). Dysfunction of the glucose metabolism in pregnancy can influence fetal growth via alteration of the intrauterine environment, resulting in an increased risk of abnormal offspring birth weight (McIntyre et al., 2019). Infants with abnormal birth weight will be faced with increased risks of neonatal complications in the perinatal period and chronic non-communicable diseases in childhood and adulthood (Mitanchez et al., 2015; McIntyre et al., 2019). Therefore, accurate estimation of birth weight for neonates from women with GDM is crucial for more sensible perinatal decision-making and improvement of perinatal outcomes. Timely antenatal intervention, with reference to accurately estimated fetal weight, may also decrease the risks of adverse long-term diseases.
Adult ; Birth Weight ; Diabetes, Gestational ; Female ; Fetal Development ; Humans ; Infant ; Infant, Newborn ; Neural Networks, Computer ; Pregnancy