BACKGROUND: Qiangji jianli liquid plays a key role in prevention and cure of myasthenia gravis; however, whether changes of nucleic acid and protein are related to its mechanism or not should be studied further.OBJECTIVE: To observe the effect of qiangji jianli liquid on synthesis of nucleic acid and protein in mice with experimental spleen deficiency syndrome, and investigate the effect on myasthenia gravis and the molecular biological basis.DESIGN: Randomized controlled animal study.SETTING: Testing Center and Basic Medical College of Guangzhou University of Traditional Chinese Medicine.MATERIALS: Healthy male NIH mice, aged 4 weeks, of clean grade, weighing 17-21 g, were provided by Medical Experimental Animal Center of Guangdong Province. Qiangji jianli liquid (Guangdong Dongfang Shencao Pharmaceutical Factory); serpate solution (Guangdong Bangmin Pharmaceutical Factory); [5-methyl-3H] TdR, [5-3H] uridine and L-[4,5-3H]leucine (Atom High-nuclear Technology Application Limited Company).METHODS: The experiment was carried out in the Laboratory of Nuclear Medicine of Guangzhou University of Traditional Chinese Medicine from June to November 2005. A total of 180 healthy male NIH mice were randomly divided into normal control group, model group, 26 g/kg qiangji jianli liquid group, 13 g/kg qiangjijianli liquid group and sijunzi decoction group with 36 in each group. Except normal control group, serpate was used to establish animal models of spleen deficiency syndrome. 0.2 mg/(kg ·d) serpate was intraperitoneally injected into mice. ① 0.1 mL/(mouse·d) saline was intraperitoneally injected into mice in normal control group. ② 26 g/kg and 13 g/kg were perfused into mice in 26 g/kg and 13 g/kg qiangji jianli liquid groups, respectively, once a day. Qiangji jianli liquid consisted of beiqi, dangshen, shengma,baizhu, gaicao, etc., with 1.204 g raw drugs a milliliter. ③ 26 g/kg sijunzi decoction, which consisted of dangshen,baizhu, fuling, jiugancao, etc., was perfused into mice with the dosage of 0.5 mL/mouse in si junzi decoction group once a day. After 16 successive days, contents of DNA, RNA and protein were measured in spleen and kidney tissue; meanwhile, body mass, ratio between spleen mass and body mass, and ratio between kidney mass and body mass were also measured before modeling and after administration.MAIN OUTCOME MEASURES: ① Changes of body mass before modeling and at 16 days after administration; ② changes of mass of spleen and kidney tissues; ③ Comparisons of DNA, RNA and protein in spleen and kidney tissues at 16 days after administration.RESULTS: All 180 mice were involved in the final analysis without any loss. ① There was no significant difference of body mass (17.4-21 g) among groups before experiment (P =0.993); however, after experiment, body mass in model group was lower than that in normal control group (Q =22.84, P ＜ 0.01); 16 days after administration, body mass was higher in qiangji jianli liquid groups (26 g/kg, 13 g/kg) and sijunzi decoction group than that in model group (Q =8.66-10.24, P ＜ 0.01). ② Values of spleen mass/body mass and kidney mass/body mass were decreased in model group as compared with those in normal control group (Q =4.02-12.93, P ＜ 0.01); masses of spleen and kidney tissues were increased in qiangji jianli liquid groups (26 g/kg, 13 g/kg) and sijunzi decoction group as compared with those in model group (Q =3.21-9.69, P ＜ 0.05-0.01); ratios in 13 g/kg qiangji jianli liquid group were higher than those in model group (Q =4.07, 5.92; P ＜ 0.05, 0.01). ③ Contents of DNA, RNA and protein in spleen tissue and contents of RNA and protein in kidney tissue were lower in model group than those in normal control group (Q =7.15-19.2, P＜ 0.01); however, content of DNA in kidney tissue was higher in model group than that in normal control group (Q =4.19, P ＜ 0.05). Contents of DNA, RNA and protein in spleen tissue and contents of RNA and protein in kidney tissue were higher in 26 g/kg qiangji jianli liquid group and sijunzi decoction group than those in model group (Q =2.91-14.12, P ＜ 0.05-0.01 ).CONCLUSION: Qiangji jianli liquid can accelerate synthesis of nucleic acid and protein; additionally, onset of spleen deficiency syndrome may be related to decreasing synthesis of nucleic acid and protein.

Objective To investigate the long-term curative effect of the radiotherapy combined uterine arterial interventional chemoembolization for cervical cancer.Methods Records of 632 patients with cervical cancer stage Ⅱ-Ⅳa proved by pathology in Lanzhou Command General Hospital from January 1st,1999 to August 31st.2009 were retrospective analysed.One hundrand and twenty-six cases of them were treated with radical radiothempy combined uterine arterial interventional chemoembolization(arterial chemoembolization+radiotherapy group).506 cases of them were treated with radical radiotherapy only (radiotherapy group);the evaluation of the late radiation injury was done,according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer(RTOG/EORTC)advanced radiation injury criteria.Prognosis and complications were compared between two groups,relative risk factors of radiothempy complications were identified by method of logistic regression.Results (1)Survival:the total survival mtes of 1-year,2-year,5-year and 8-year were 94.4%,82.3%,48.8%,29.1%,respectively.The survival rates of arterial chemoembolization+radiotherapy group were 96.0%.82.1%,37.2%,25.7%,while the survival rates of radiotherapy group were 94.1%,80.8%,51.1%,31.5%,in which there were significant differences between two groups (x2 = 0.009, P= 0.993; x2 =0. 158, P =0.691;X2 =11. 197,P=0. 001;x2 =9. 649,P =0.002). During the follow-up period, the rate of recurrence and metastasis in arterial chemoembolization + radiotherapy group were 77. 0% (97/126), while 73. 3% (371/ 506) in radiotherapy group ( x2 = 0. 705,P = 0. 401). (2) Radiotherapy complications and relative risk factors; the total incidence of tardive bladder injury higher than RTOG/EORTC stage II was 5.5% (35/632), while it was 11. l%(14/126)in arterial chemoembolization + radiotherapy group, 4.2% (21/506) in the radiotherapy group(x2 =9.344,P =0.002). The results of logistic regression showed that the uterine arterial interventional chemoembolization was relative risk factors of the tardive bladder injury ( x2 =6. 440, OR = 2. 869,P=0. 011). Conclusions Compared with the simple radiotherapy, there are a similar short-term survival rate and significant poor 5-year, 8-year survival rate in the patients treated with the uterine arterial interventional chemoembolization combined with radiotherapy, which also may be strong dangerous factor for the occurrence of tardive bladder injury. The results shown that the uterine arterial interventional chemoem bolization do not recommend to be routine adjuvant therapy for the radical radiotherapy of cervical cancer.

With the rapid development of the Internet,e-health technology-based interventions provide high-quality supportive care to meet the care needs of family caregivers of cancer patients,thereby improving the physical and mental health of family caregivers.This article aims to summarize the concept of e-health technology,its current applications,intervention content,and effects among family caregivers of cancer patients.Additionally,it analyzes the shortcomings in the current stage of research and applications,with the goal of providing insights for promoting the utilization of e-health technology in the context of family caregivers of cancer patients.

Objective:To study the role of special microbial communities in the development of periodontitis in type 2 diabetes melli-tus(T2DM)patients.Methods:40 subjects aged 20-70 years were included and divided into 3 groups:moderate to severe periodon-titis with T2DM(SP.T2DM,n=15),moderate to severe periodontitis group(SP,n=15)and normal healthy group(N,n=10).The basic information,periodontal clinical indicators and blood sugar of the subjects were recorded.Subgingival plaque samples were col-lected,DNA samples of the plaque were extracted,and sequenced by Illumina NovaSeq6000 platform.The microbial diversity,eco-logical characteristics and functions of the plaque were analyzed by Uparse,SPSS and other softwares.Results:481 species in 22 phyla,30 classes,73 orders,129 families and 265 genera were obtained from the samples.Beta polymorphism analysis showed that the species composition of CP.T2DM group and CP group was similar.Alpha polymorphism analysis showed that the species richness and evenness in CP.T2DM group and CP group were higher than those in N group(P＜0.01).Venn diagram analysis showed that the species richness of the plaque in CP.T2DM group was the highest,followed by CP group and the lowest in N group.At the genus lev-el,Klebsiella and Bifidobacterium in CP.T2DM group were larger than those in CP group and N group(P＜0.05),and between group CP and N,P＞0.05.At the species level,the Capnocytophaga leadbetteri in CP.T2DM group was higher than that in CP group and N group(P＜0.05),between group CP and N,P＞0.05;There were some differences in the microbial community structure of subgingival plaque among the 3 groups.The species richness of subgingival flora in patients with CP and T2DM was higher than that in patients with CP and healthy people.Conclusion:The increase of Klebsiella,Bifidobacterium and Capnocytophaga leadbetter in subgingival flora of patients with moderate and severe periodontitis may be related to the development of T2DM.

miR-135 is a highly conserved miRNA in mammals and includes miR-135a and miR-135b.Recent studies have shown that miR-135b is a key regulatory factor in cardio-cerebrovascular diseases.It is involved in regulating the pathological process of myocardial infarction,myocardial ischemia/reperfusion injury,cardiac hypertrophy,atrial fibrillation,diabetic cardiomyopathy,atherosclerosis,pulmonary hyperten-sion,cerebral ischemia/reperfusion injury,Parkinson's disease,and Alzheimer's disease.Obviously,miR-135b is an emerging player in cardio-cerebrovascular diseases and is expected to be an important target for the treatment of cardio-cerebrovascular diseases.However,the crucial role of miR-135b in cardio-cerebrovascular diseases and its underlying mechanism of action has not been reviewed.Therefore,in this review,we aimed to comprehensively summarize the role of miR-135b and the signaling pathway mediated by miR-135b in cardio-cerebrovascular diseases.Drugs targeting miR-135b for the treatment of diseases and related patents,highlighting the importance of this target and its utility as a therapeutic target for cardio-cerebrovascular diseases,have been discussed.

Objective:To develop an HPLC method with gradient elution for the simultaneous determination of 4 bacteriostatic agents in triamcinolone acetonide econazole cream from the different manufacturers.Methods:The test was performed on a Waters Symmetry C18 column(250 mm ×4.6 mm,5 μm)under gradient elution of metha-nol(A)and methanol-0.02 mol·L-1 sodium dihydrogen phosphate solution(B).The flow rate of 1.0 mL·min-1 and the column temperature was 35 ℃.The detection wavelengths were 228 nm and 254 nm.Results:The good separation of the bacteriostatic agents peaks were achieved.The linear ranges of benzoic acid,methyl hydroxybenzoate,ethylparaben and propylparaben fell into 0.010 348-0.155 22 mg·mL-1,0.009 876-0.148145 mg·mL-1,0.010 106-0.151 588 mg·mL-1 and 0.010 259-0.153 882 mg·mL-1 respectively.The av-erage recoveries were 99.68％(RSD=2.35％),100.21％(RSD=1.78％),100.47％(RSD=1.59％)and 100.06％(RSD=1.65％)respectively.The LODs were 3 × 10-5 mg·mL-1,1.67 × 10-5 mg·mL-1,1.67 × 10-5 mg·mL-1 and 1.67 × 10-5 mg·mL-1 respectively.Conclusion:The established method is sensitive and accurate,and has the good separation.It provides the reliable basis for the quality control of triamcinolone ace-tonide econazole cream.

Objective To explore the comorbidity patterns of chronic diseases and their associat-ed factors in the elderly population aged 60 and above in China.Methods Based on the data from the 2018 China Health and Retirement Longitudinal Study(CHARLS),the Apriori algorithm in R4.0.4 software was used to extract frequent itemsets and construct an association rule model between chronic diseases and their associated factors,targeting the information on 14 chronic diseases in people aged 60 and above in the database.Results Among the 13 206 participants,3 691 cases(27.90％)suffered from at least one chronic disease,while 6 217 cases(47.08％)suffered from two or more chronic diseases.Analysis of association rules showed that the most common comorbidity patterns in-cluded heart disease and hypertension,dyslipidemia and hypertension,diabetes and hypertension,as well as"heart disease,arthritis→high blood pressure""high blood pressure,stomach disease→arthri-tis""dyslipidemia,arthritis→hypertension",with support degrees of 8.93％,8.29％,5.44％,3.82％,3.71％and 3.22％,and confidence degrees of 55.15％,59.64％,60.13％,53.67％,51.58％and 60.11％respectively.Irregular sleep patterns,urban living backgrounds,and high so-cial participation were strongly associated with hypertension;while irregular sleep patterns,rural resi-dency,and female were highly associated with arthritis.Conclusion Given the universality of hyper-tension in multiple chronic disease comorbidity patterns,the prevention and screening of hypertension and its complications in the elderly population should be strengthened.For the comorbidity patterns of chronic diseases coexisting with hypertension,special attention should be paid to the daily disease screening and management of the elderly who participate in social activities in cities.At the same time,for elderly women,poor sleep qual ity,and rural residents,the screening and attention to the comorbidity patterns of chronic diseases with arthritis need to be strengthened.

Objective To explore the comorbidity patterns of chronic diseases and their associat-ed factors in the elderly population aged 60 and above in China.Methods Based on the data from the 2018 China Health and Retirement Longitudinal Study(CHARLS),the Apriori algorithm in R4.0.4 software was used to extract frequent itemsets and construct an association rule model between chronic diseases and their associated factors,targeting the information on 14 chronic diseases in people aged 60 and above in the database.Results Among the 13 206 participants,3 691 cases(27.90％)suffered from at least one chronic disease,while 6 217 cases(47.08％)suffered from two or more chronic diseases.Analysis of association rules showed that the most common comorbidity patterns in-cluded heart disease and hypertension,dyslipidemia and hypertension,diabetes and hypertension,as well as"heart disease,arthritis→high blood pressure""high blood pressure,stomach disease→arthri-tis""dyslipidemia,arthritis→hypertension",with support degrees of 8.93％,8.29％,5.44％,3.82％,3.71％and 3.22％,and confidence degrees of 55.15％,59.64％,60.13％,53.67％,51.58％and 60.11％respectively.Irregular sleep patterns,urban living backgrounds,and high so-cial participation were strongly associated with hypertension;while irregular sleep patterns,rural resi-dency,and female were highly associated with arthritis.Conclusion Given the universality of hyper-tension in multiple chronic disease comorbidity patterns,the prevention and screening of hypertension and its complications in the elderly population should be strengthened.For the comorbidity patterns of chronic diseases coexisting with hypertension,special attention should be paid to the daily disease screening and management of the elderly who participate in social activities in cities.At the same time,for elderly women,poor sleep qual ity,and rural residents,the screening and attention to the comorbidity patterns of chronic diseases with arthritis need to be strengthened.

Objective:To evaluate the health benefits and intervention efficiency of different strategies of initiating antihypertensive therapy for the primary prevention of cardiovascular diseases in a community-based Chinese population from the Chinese electronic health records research in Yinzhou(CHERRY)study.Methods:A decision-analytic Markov model was used to simulate and compare different antihy-pertensive initiation strategies,including:Strategy 1,initiation of antihypertensive therapy for Chinese adults with systolic blood pressure(SBP)≥140 mmHg(2020 Chinese guideline on the primary preven-tion of cardiovascular diseases);Strategy 2,initiation of antihypertensive therapy for Chinese adults with SBP≥130 mmHg;Strategy 3,initiation of antihypertensive therapy for Chinese adults with SBP ≥140 mmHg,or with SBP between 130 and 140 mmHg and at high risk of cardiovascular diseases(2017 American College of Cardiology/American Heart Association guideline for the prevention,detection,evaluation,and management of high blood pressure in adults);Strategy 4,initiation of antihypertensive therapy for Chinese adults with SBP≥ 160 mmHg,or with SBP between 140 and 160 mmHg and at high risk of car-diovascular diseases(2019 United Kingdom National Institute for Health and Care Excellence guideline for the hypertension in adults:Diagnosis and management).The high 10-year cardiovascular risk was de-fined as the predicted risk over 10％based on the 2019 World Health Organization cardiovascular disease risk charts.Different strategies were simulated by the Markov model for ten years(cycles),with parame-ters mainly from the CHERRY study or published literature.After ten cycles of simulation,the numbers of quality-adjusted life years(QALY),cardiovascular events and all-cause deaths were calculated to evaluate the health benefits of each strategy,and the numbers needed to treat(NNT)for each cardiovas-cular event or all-cause death could be prevented were calculated to assess the intervention efficiency.One-way sensitivity analysis on the uncertainty of incidence rates of cardiovascular disease and probabilis-tic sensitivity analysis on the uncertainty of hazard ratios of interventions were conducted.Results:A to-tal of 213 987 Chinese adults aged 35-79 years without cardiovascular diseases were included.Com-pared with strategy 1,the number of cardiovascular events that could be prevented in strategy 2 increased by 666(95％UI:334-975),while the NNT per cardiovascular event prevented increased by 10(95％UI:7-20).In contrast to strategy 1,the number of cardiovascular events that could be prevented in strategy 3 increased by 388(95％UI:194-569),and the NNT per cardiovascular event prevented decreased by 6(95％UI:4-12),suggesting that strategy 3 had better health benefits and intervention efficiency.Compared to strategy 1,although the number of cardiovascular events that could be prevented decreased by 193(95％UI:98-281)in strategy 4,the NNT per cardiovascular event prevented decreased by 18(95％UI:13-37)with better efficiency.The results were consistent in the sensitivity analyses.Conclusion:When initiating antihypertensive therapy in an economically developed area of China,the strategy combined with cardiovascular risk assessment is more efficient than those purely based on the SBP threshold.The cardiovascular risk assessment strategy with different SBP thresholds is suggested to balance health benefits and intervention efficiency in diverse populations.

Objective To investigate the clinical value of 99Tcm-methoxyisobutylisonitrile (MIBI) double-phase imaging in differential diagnosis of bone lesions in tumor patients,which was indefinite in 99Tcm-methylene diphosphonate (MDP) bone imaging,and evaluate the correlation between 99Tcm-MIBI imaging and chemotherapy efficacy.Methods Fifty-two tumor patients (23 males,29 females,mean age 58 years) with bone isolated lesions(≤3) found by 99Tcm-MDP bone scintigraphy was enrolled from June 2014 to November 2015.Since the results of 99Tcm-MDP imaging were indefinite,99Tcm-MIBI double-phase (10 min and 30 min after injection of 99Tcm-MIBI) SPECT/CT imaging was then performed within 1 week.The final diagnosis was made according to results of more than two imaging modalities (CT,MRI,PET/CT) and/or follow-up (≥6 months).The diagnostic efficacy of 99Tcm-MIBI SPECT/CT imaging was calculated.The clinical dataof chemotherapy were also collected.Patients with bone metastasis were grouped as the treatment response.Retention index (RI) of metastatic lesions was calculated and compared between different groups using two-sample t test.The relationship between RI and chemotherapy efficacy was investigated by Spearman correlation analysis.Results A total of 12 benign lesions and 84 malignant lesions were eventually diagnosed.The sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV) and Youden index of 99Tcm-MIBI imaging were 96.43％(81/84),83.33％(10/12),97.59％(81/83),76.92％(10/13),and 0.80,respectively.The RI was statistically different between complete remission (CR)+partial remission (PR) group and stable disease (SD) + progressive disease (PD) group:-0.142± 0.036 vs-0.384± 0.067 (t =2.367,P＜0.05).The RI of 99Tcm-MIBI in bone metastases was positively correlated with the chemotherapy efficacy (rs =0.78,P＜0.01).Conclusions 99Tcm-MIBI imaging is helpful in differential diagnosis of bone lesions with indefinite diagnosis by 99Tcm-MDP bone imaging in tumor patients.99Tcm-MIBI RI of bone metastasis may predict the therapeutic response of chemotherapy efficacy.