Objective:To explore the related factors of postoperative adjuvant therapy for cervical cancer stagedⅠB1-ⅡA2 [according to 2018 International Federation of Gynecology and Obstetrics (FIGO) staging standard], and to establish a nomogram model to predict the risk of postoperative adjuvant therapy for locally advanced cervical cancer.Methods:A total of 714 patients with cervical squamous cell cancer staged FIGO ⅠB1-ⅡA2 treated by surgery in Anhui Provincial Hospital were selected as the research objects from January 2009 to December 2019, and their clinicopathological data were analyzed. Multiple logistic regression analysis was used to determine the influencing factors, and a nomogram model was established to predict the risk of postoperative adjuvant treatment of cervical cancer. The predictive performance of the model was evaluated with the consistency index (C-index), and the compliance of the model was evaluated with the calibration curve.Results:Univariate analysis suggested that postoperative adjuvant therapy for cervical cancer was associated with gravidity ( χ2=11.506, P=0.001), underlying disease (hypertension or diabetes) ( χ2=7.668, P=0.006), squamous cell cancer antigen (SCC-AG) level ( χ2=19.392, P<0.001), imaging risk factors ( χ2=16.392, P<0.001), FIGO stage ( χ2=25.686, P<0.001), tumor size ( χ2=9.392, P=0.025) and surgical path ( χ2=16.590, P<0.001). Multivariate logistic regression analysis suggested that the number of pregnancy >2 times ( OR=1.951, 95% CI: 1.355-2.808, P<0.001), SCC-Ag ≥1.5 μg/L ( OR=2.021, 95% CI: 1.444-2.829, P<0.001), FIGO stage ⅠB3-ⅡA2 [ⅠB3 ( OR=1.933, 95% CI: 1.139-3.282, P=0.015); ⅡA1 ( OR=2.723, 95% CI: 1.556-4.765, P<0.001); ⅡA2 ( OR=3.159, 95% CI: 1.502-6.646, P=0.002)], with underlying disease (hypertension or diabetes) ( OR=1.867, 95% CI: 1.051-3.318, P=0.033), imaging risk factors ( OR=1.997, 95% CI: 1.127-3.537, P=0.018), without neoadjuvant therapy [preoperative neoadjuvant therapy for 1 cycle ( OR=0.402, 95% CI: 0.207-0.783, P=0.007)] and laparoscopic surgery ( OR=2.177, 95% CI: 1.524-3.112, P<0.001) were independent influencing factors for postoperative adjuvant treatment of cervical cancer. Based on the screened variables, the nomogram model to predict the risk of postoperative adjuvant treatment for cervical cancer has good predictive performance (C-index was 0.702) and compliance. Conclusion:The number of pregnancy >2 times, SCC-Ag ≥1.5 μg/L, FIGO stage ⅠB3-ⅡA2, with underlying disease (hypertension or diabetes), imaging risk factors, without neoadjuvant therapy, and laparoscopic surgery are independent influencing factors for postoperative adjuvant treatment of cervical cancer. A nomogram model has been constructed to predict the risk of postoperative adjuvant therapy for locally advanced cerrical cancer, and it can provide evidence for clinical treatment selection.

Objective:To explore the diagnostic accuracy of muscle ultrasound and plasma monocyte chemoattractant protein-1 (MCP-1) for ICU-acquired weakness (ICU-AW) in patients with sepsis.Methods:A prospective observational study was conducted. Patients with sepsis admitted to the intensive care unit (ICU) of Henan Provincial People's Hospital from April 2021 to October 2021 were enrolled. The demographic data were collected. The enrolled patients were evaluated with Medical Research Council (MRC) score every day until discharged from ICU. During this period, patients with total MRC score < 48 (for two consecutive times and a time interval of 24 hours) were divided into ICU-AW group, those with total MRC score ≥ 48 were served as non-ICU-AW group. On the 1st, 4th and 7th day following admission into ICU, ultrasound was used to measure the muscle linear thickness of the rectus femoris (RF-MLT), the cross sectional area of the rectus femoris (RF-CSA) and the muscle linear thickness of the vastus intermedius muscle (VI-MLT). And meanwhile, the plasmas samples of patients were collected to measure MCP-1 concentration by enzyme-linked immunosorbent assay (ELISA). The difference of each index was compared between the ICU-AW group and the non-ICU-AW group. The risk factors of ICU-AW in patients with sepsis were analyzed by binary Logistic regression. Besides, receiver operator characteristic curve (ROC curve) was plotted, the diagnostic value of ultrasound parameters and plasma MCP-1 level for ICU-AW in patients with sepsis was analyzed.Results:A total of 99 septic patients were enrolled, with 68 patients in the ICU-AW group and 31 patients in the non-ICU-AW group. Compared with the patients in the ICU-AW group, the patients in the non-ICU-AW group tended to be older, and had higher sequential organ failure assessment (SOFA) score, higher acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, higher rates of septic shock, higher blood lactic acid and lower Glasgow coma score (GCS). Binary Logistic regression analysis showed that APACHEⅡ score and septic shock were the risk factors of ICU-AW for septic patients [odds ratio ( OR) and 95% confidence interval (95% CI) were 1.310 (1.138-1.509) and 0.232 (0.072-0.746), respectively, both P < 0.05]. The RF-MLT, RF-CSA and VI-MLT on the 1st, 4th and 7th ICU day was falling over time. Compared with the patients in the ICU-AW group, the patients in the non-ICU-AW group had smaller RF-MLT on the 7th day [cm: 0.32 (0.22, 0.47) vs. 0.45 (0.34, 0.63), P < 0.05] and higher 7-day RF-CSA atrophy rate [25.85% (10.37%, 34.28%) vs. 11.65% (2.28%, 22.41%), P < 0.05]. According to ROC curve analysis, 7-day RF-MLT had diagnostic value for ICU-AW of septic patients. Area under ROC curve (AUC) was 0.688 (95% CI was 0.526-0.849); when the cut-off value was 0.41 cm, the sensitivity and the specificity were 66.7% and 68.4%. The levels of plasma MCP-1 in the ICU-AW group were significantly higher than those in the non-ICU-AW group on the 1st, 4th and 7th day. ROC curve analysis showed that the plasma MCP-1 levels on the 1st, 4th and 7th day played a significant role to diagnose ICU-AW for septic patients, the AUC and 95% CI were 0.732 (0.629-0.836), 0.865 (0.777-0.953), 0.891 (0.795-0.986), respectively. When the cut-off values were 206.3, 410.9, 239.5 ng/L, the sensitivity was 87.1%, 64.0%, 82.4%, and the specificity was 54.4%, 96.1%, 86.2%, respectively. Conclusion:The muscle mass parameters on the 7th day of bedside ultrasound and plasma MCP-1 levels had certain diagnostic values for ICU-AW in patients with sepsis.

ObjectiveTo observe the clinical efficacy and safety of modified Banxia Xiexintang in treating simple obesity in children with the syndrome of stomach hyperactivity and spleen stagnation. MethodA randomized， double-blind， placebo-controlled study was conducted， in which 78 children with simple obesity due to stomach hyperactivity and spleen stagnation were randomized into an observation group （39 cases） and a control group （39 cases）. On the basis of diet and exercise intervention， the observation group received modified Banxia Xiexintang and the control group received placebo. The two groups were compared in terms of the therapeutic effect regarding TCM symptoms， body mass index （BMI）， waist circumference， hip circumference， obesity， and visual analogue scale of appetite after 2 months of treatment， and the treatment safety was observed. ResultAfter treatment， the response rate in the observation group was 88.89% （32/36）， which was higher than that （77.14%， 27/35） in the control group （Z=-2.301， P<0.05）. After 2 months of treatment， the body weight， BMI， waist circumference， hip circumference， and obesity decreased in both groups （P<0.05，P<0.01）. The TCM symptom scores and visual analogue scale scores of appetite in the observation group declined （P<0.05）. The control group showed decreased scores of TCM symptoms except gluttony and overeating （P<0.05）， declined scores of desire to eat， hunger， and willingness to eat declined （P<0.05）， and no significant change in the score of fullness before and after treatment. Compared with the control group， the observation group showed decreased total score of TCM symptoms， scores of primary and secondary TCM symptoms， body weight， BMI， waist circumference， hip circumference， obesity， and scores of desire to eat， hunger， and willingness to eat （P<0.05） and no significant difference in the score of fullness after treatment. No adverse reaction related to the drug application was observed during the treatment period. ConclusionModified Banxia Xiexintang can reduce the body weight， BMI， waist circumference， hip circumference， and obesity， improve the body shape， alleviate the symptoms， and enhance the therapeutic effect and compliance of children with simple obesity， being safe in clinical application.

Objective:To explore the risk factors of intensive care unit acquired weakness (ICUAW) in patients with sepsis, and to evaluate the predictive value of each risk factor for ICUAW.Methods:A case control study was conducted, 60 septic patients admitted to the intensive care unit (ICU) of Henan Provincial People's Hospital from October 20, 2020 to February 20, 2021 were enrolled. The patients were divided into two groups: sepsis ICUAW group and sepsis non-ICUAW group. The data of gender, age, body mass index (BMI), acute physiology and chronic health evaluationⅡ(APACHEⅡ) score, complications, mechanical ventilation, duration of ICUAW, length of stay in ICU, fasting blood glucose, blood lactic acid (Lac), procalcitonin (PCT), C-reactive protein (CRP), sequential organ failure assessment (SOFA) score, outcome, antimicrobial agent, glucocorticoid, sedatives and analgesics drugs and vasoactive drugs were collected. Risk factors were screened by univariate Logistic regression analysis, and odds ratio ( OR) was adjusted by multivariate binary logistic regression, P < 0.05 was considered as independent risk factors. Finally, the receiver operating characteristic curve (ROC curve) was drawn to analyze the predictive value of independent risk factors. Results:The APACHEⅡ score of the sepsis ICUAW group was significantly higher than that of the sepsis non-ICUAW group (23.05±8.17 vs. 15.33±4.89, P < 0.05), the total length of stay in the ICU was significantly longer than that of the sepsis non-ICUAW group (days: 15.1±9.2 vs. 8.5±3.4, P < 0.05), the improvement rate of patients was significantly lower than that of the sepsis non-ICUAW group [45.0% (9/20) vs. 95.0% (38/40), P < 0.05]. After univariate Logistic regression and multicollinearity test analysis, 7 factors including APACHEⅡ score, average SOFA score, blood lactic acid, proportion of mechanical ventilation, sedatives and analgesics drugs, type of antibiotics and type of vasoactive drugs were included in the binary Logistic regression model [ OR: 1.21, 2.05, 2.26, 0.21, 1.54, 2.07, 1.38, 95% confidence interval (95% CI): 1.09-1.35, 1.42-2.94, 1.12-4.57, 0.05-0.66, 1.03-2.29, 1.27-3.37, 0.96-2.00, all P < 0.05]. Hosmer-Lemchaw test P = 0.901, and the correct percentage of prediction was 85%, indicating good model fit. Multivariate binary Logistic regression analysis showed that APACHEⅡ score and average SOFA score were independent risk factors for the occurrence of ICUAW in septic patients (APACHEⅡscore: OR = 1.17, 95% CI was 1.004-1.376, P = 0.044; average SOFA score: OR = 1.86, 95% CI was 1.157-2.981, P = 0.01). ROC curve analysis showed that the mean value of APACHEⅡ score, average SOFA score and their combined detection had a certain predictive value for the occurrence of ICUAW in sepsis patients, areas under ROC curve (AUC) were 0.787, 0.881, 0.905, 95% CI was 0.646-0.928, 0.791-0.972, 0.828-0.982, all P < 0.05. When the cut-off value was 19.500, 6.225, 0.375, the sensitivity was 75%, 90%, 90%, and the specificity were 80%, 80%, 85%, respectively. Conclusion:APACHEⅡ score and average SOFA score can be used as independent risk factors for the occurrence of ICUAW in sepsis, and their combined predictive value is better than that of individual index.

Bronchial asthma （referred to as “asthma”） is a heterogeneous airway disease characterized by chronic airway inflammation and airway remodeling. Its pathogenesis is complex， the incidence is high and the disease is easy to repeat. Autophagy plays an important regulatory role in improving asthma symptoms. By regulating autophagy-related proteins and signaling pathways， the active components of traditional Chinese medicine （such as flavonoids， anthraquinones， terpenoids） and traditional Chinese medicine compounds （such as Wuhu decoction， Pingchuan granule， Sanzi yangqin decoction） can inhibit airway inflammatory response，reduce airway hyperresponsiveness，and alleviate airway remodeling，thus playing a role in the treatment of asthma. However， most of the current studies are basic studies，and the quality of evidence is not high．In the future，high-quality clinical and basic studies should be further carried out to fully demonstrate the scientific nature of traditional Chinese medicine in the treatment of asthma by regulating autophagy．

Objective: To analyze the interactions between different structural types of volatile oil components (VOCs) and skin lipid molecules, and investigate the mechanism of volatile oil in Chinese materia medica (VOCMM) as penetration enhancers. Methods: In this study, 210 different structural types of VOCs were selected from the VOCMM penetration enhancer database, and the molecular docking experiments were conducted with three main lipid molecules of skin: ceramide 2 (CER2), cholesterol (CHL), and free fatty acid (FFA). Each VOC was docked individually with each lipid molecule. Cluster analysis was used to explore the relationship between the binding energy of VOCs and their molecular structures. Nine specific pathogen-free (SPF) Sprague Dawley (SD) rats were randomly divided into Control, Nootkatone, and 3-Butylidenephthalide groups for in vitro percutaneous experiments, with three rats in each group. The donor pool solutions were 3% gastrodin, 3% gastrodin + 3% nootkatone, and 3% gastrodin + 3% 3-butylidenephthalide, respectively. The penetration enhancing effects of VOCs with higher binding energy were evaluated by comparing the 12-hour cumulative percutaneous absorption of gastrodin (Q12, µg/cm²). Result: (i) Most of the VOCs were non-hydrogen bonded to the hydrophobic parts of CHL and FFA, and hydrogen bonded to the head group of CER2. Among them, sesquiterpene oxides showed the most pronounced binding affinity to CER2. The VOCs with 2 − 4 rings (including carbon rings, benzene rings, and heterocycles) demonstrated stronger binding affinity for three skin lipid molecules compared with the VOCs without intramolecular rings (P < 0.01). (ii) According to the cluster analysis, most of the VOCs that bond well to CER2 had 2 − 3 intramolecular rings. The non-oxygenated VOCs were bonded to CER2 in a hydrophobic manner. The oxygenated VOCs were mostly bonded to CER2 by hydrogen bonding. (iii) The results of Franz diffusion cell experiment showed that the Q12 of Control group was 260.60 ± 25.09 µg/cm2, and the transdermal absorption of gastrodin was significantly increased in Nootkatone group (Q12 = 5 503.00 ± 1 080.00 µg/cm², P < 0.01).  The transdermal absorption of gastrodin was also increased in 3-Butylidenephthalide  group (Q12 = 495.40 ± 56.98 µg/cm², P > 0.05). (iv) The type of oxygen-containing functional groups in VOCs was also an influencing factor of binding affinity to CER2. Conclusion The interactions between different types of VOCs with different structures in the VOCMM and three skin lipid molecules in the stratum corneum were investigated at the molecular level in this paper. This research provided theoretical guidance and data support for the screening of volatile oil-based penetration enhancers,  and a simple and rapid method for studying the penetration-enhancing mechanism of volatile oils.