Objective:To estimate the clinical effect of integrated Xinjia Shashen Maidong Decoction and radiotherapy on advanced non-small-cell lung cancer (NSCLC) patients.Methods:30 NSCLC patients were treated with Xinjia Shashen Maidong Decoction after radiotherapy for more than two months,then the clinical effect were evaluated by tumor-mass stable rate,symptoms,Karnofsky score and survival period.Results:Response Evaluation Criteria in Solid Tumor (RECIST) evaluation results showed that the effective rate on relieving tumor mass was 53.3%,stable rate was 86.7%.The symptom of cough was much relieved,with 56.7% effective rate and 93.3% stable rate.And effect on Karnofsky score was good,that effective rate was 56.7% and stable rate was 86.7%. Fortunately,the patients had a median survival period of 11 months.Conclusion:Xinjia Shashen Maidong Decoction enhanced the efficacy of radiotherapy and reduced its side-effects in the treatment of advanced NSCLC patients.

Objective: To discuss the effect of group counseling on the self-control of male adolescents drug addicts. Methods: 90 male adolescents drug addicts who accepted group counseling were identified as test group, while another 97 male adolescents drug addicts who accepted no intervention as control group. Self Control Scale developed by Grasmick in 1993 was used to assess the outcome. Results: The total scores in the test group decreased from 52.06?6.67 to 47.68? 8.67, and all dimension scores were at significant level (P

Objective To evaluate the safety and efficacy of combining radiofrequency ablation(RFA) with arsenious acid(AA) locally to treat liver VX2 tumor in rabbits,and to explore its mechanism.Methods Twenty-eight New Zealand White rabbits with implanted liver VX2 tumors were randomly divided into four groups: control group(n= 7),AA group(n=7),RFA group(n=7),and combination(RFA+AA) group(n=7).ALT was measured before treatment and on the day 0,day 3,day 7 and day 14 after treatment,meanwhile ultrasonic(US) examination was performed.All rabbits were killed 14 days after treatment.Vascular endothelial growth factor(VEGF) was examined by immunohistochemistry,and the relationship of VEGF and gross tumor volume was analyzed.Results Combination(RAF+AA) therapy caused little damage to hepatic function but had better inhibited tumor growth.The level of VEGF in AA,RFA and RAF+AA group was lower than that of the control group(P

Objective:To explore the role of WeChat platform combined with flipped classroom in improving the working ability of resident doctors in the fever clinic.Methods:A total of 118 resident doctors who rotated in the fever clinic of department of emergency medicine were selected as the study subjects, and they were randomized into experimental group and control group, with 59 people in each group. The experimental group used WeChat platform and flipped classroom teaching, and the control group used traditional teaching. The results of theory assessment, operation performance and questionnaire survey were compared between the two groups. SPSS 26.0 statistical software was used for t test and chi-square test. Results:There was no significant difference in theoretical test scores between the experimental group and the control group ( P>0.05). The experimental group scored (91.61±3.01) points and the control group scored (84.52±4.02) points in operational assessment, with significant differences ( t=-10.85, P<0.05). The results of the satisfaction survey showed that there was no significant difference in teaching time distribution between the two groups, and the experimental group was better than the control group in any other aspects. Conclusion:The use of WeChat platform combined with flipped classroom during the COVID-19 epidemic can improve the level of operational skills of the resident doctors to wear or take off the protective clothing and collect nasopharyngeal swabs, help residents to avoid the infections, and improve the level of daily diagnosis and treatment of fever clinic.

Objective To study the present situation and influence factors of pulmonary rehabilitation among COPD patients in community.Methods The present situation of pulmonary rehabilitation was investigated using questionnaire in 201 COPD patients,including one community in Guangzhou and three communities in Qingyuan,and the influencing factors were analyzed by Logistic regression.Results Total of 201 COPD patients,20.4％ COPD patients could insist on oxygen therapy,just one patient's oxygen time more than 15 hours;40.8％ COPD patients would increase the oxygen flow if exacerbation;17.9％ COPD patients could insist on respiratory exercising,and 75.5％ COPD patients took exercise in wrong way.50.7％ COPD patients took exercise in their life.3-4 times in hospital with a high rate of home oxygen therapy.Farmers and the course more than ten years with a high rate of exercising.Conclusions The cognition of COPD patients about pulmonary rehabilitation is poor,and also the compliance of pulmonary rehabilitation exercise is bad.The medical staff should strengthen the education of pulmonary rehabilitation of COPI patients in community,and pay attention to patients' hospitalization,occupation,and course of disease.

[Objective]To summarize and analyze the educational quality and problems of Traditional Chinese Medicine students in Zhejiang Chinese Medical University,and provide reference for improving the teaching quality and students'clinical knowledge and skills.[Methods]Taking the students of Traditional Chinese Medicine who participated in the step-1 medical licensing examination empirical research in Zhejiang Chinese Medical University from 2018 to 2020 as the research objects,the data was analyzed by variance analysis and χ2 test.[Results]Staged examination scores could reflect students'academic performance,the average passing rate of theoretical examination was 68.64%,and the average passing rate of skill assessment was 95.27%.The average total mastery rate of theoretical examination was 65.06%,including basic medicine(55.57%)and clinical medicine(52.12%),whose comparison with the total mastery rate of theoretical examination was statistically significant(P<0.05).The total mastery rate of skill assessment was 76.57%,and the average mastery rates of stations 3～4(physical examination)were 71.24%and 72.24%,whose comparison with the total mastery rate of skill assessment was statistically significant(P<0.05).It proposed improvement measures and strategies such as establishing exam incentive mechanisms to enhance students'internal motivation in exams,strengthening clinical medicine course training to improve staged examination pass rates of theoretical part,and repeatedly training clinical skills to fill the gaps in skill assessment.[Conclusion]Traditional Chinese medicine universities can improve the clinical knowledge and skills of students by establishing examination incentive mechanisms,strengthening clinical medicine course training and repeating clinical skill training,so as to improve the quality of training for students majoring in Traditional Chinese Medicine.

Objective To explore the impact of IL-10 gene polymorphisms on the outcome in HLA matched sibling hematopoietic stem cell transplantation (HSCT).Methods PCR-sequencespecific primer (PCR-SSP) assay was used to analyze the SNP of IL-10 in 77 recipient and donor pairs:-1082 A/G,-819 T/C,-592 C/A.Results IL-10 ATA/ATA (1082,-819,-592) genotype in recipients significantly decreased the incidence of grade Ⅱ-Ⅳ acute graft vursus-host disease (aGVHD) (6.1％ vs.25.0 ％,P＜0.05),reduced 5-year transplant-related mortality (TRM) (10.7 ％± 5.9％ vs.29.7％ ± 5.2％,P＜0.05) and increased disease free survival (DFS) (81.8％ ± 6.7％ vs.56.8％ ± 7.5％,P＜0.05).With regard to the donor genotype,the incidence of grade Ⅱ-Ⅳ aGVHD,extensive chronic GVHD,5-year TRM and DFS had no signicant difference between IL-10 ATA/ATA and non ATA/ATA subgroup.Multivariable analysis also revealed that IL-10 non-ATA/ATA genotype in recipients and high-risk status of disease were two independent risk factors for DFS (HR =2.911,P =0.029; HR =2.686,P =0.027).Conclusion In HLA-matched sibling HSCT,the presence of recipient IL-10 ATA/ATA significantly decreased the incidence of grade Ⅱ-Ⅳ aGVHD and TRM,and increased DFS.

Objective:To evaluate the relationship between hippocampal macrophage polarization and perioperative neurocognitive disorders in mice with tibial fractures.Methods:Forty-five clean-grade healthy male C57/BL6 mice, aged 5-7 months, were divided into 3 groups ( n=15 each) using the random number table method: control group (group C), anesthesia group (group A) and anesthesia surgery group (group AS). Group C received no treatment. Group A was anesthetized with isoflurane inhaled for 15 min. In AS group, intramedullary nail fixation of tibial fracture was performed under anesthesia through inhalation of 2% isoflurane. Morris water maze test and open field test were performed before anesthesia/on 1 day before surgery and after anesthesia/on 1, 3 and 7 days after operation. Five mice were randomly selected after the behavioral experiments were completed at each time point, and hippocampal tissues were taken after the animals were sacrificed for determination of the expression of tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), IL-6, chemokine (c-c motif) ligand 12 (CCL2), CCL5, CCL8, iNOS and Arg-1 mRNA (by quantitative real-time polymerase chain reaction), expression of iNOS and Arg-1 proteins (by Western blot), and percentage of CD11b, CD45, CD86 and CD206 cells in hippcampal area (by immunofluorescence staining). Results:Compared with group C, the escape latency was significantly prolonged after operation, the number of crossing the platform was reduced after operation, the expression of TNF-ɑ, IL-6, CCL5 and CCL8 mRNA and iNOS protein and mRNA was up-regulated, the expression of Arg-1 protein and mRNA was down-regulated, the percentages of CD11b + CD45 + cells and CD11b + CD86 + cells in the hippocampus were increased, and the percentages of CD11b + CD206 + cells were decreased in AS group ( P<0.05), and no significant change was found in the parameters mentioned above in group A ( P>0.05). Compared with group A, the escape latency was significantly prolonged after surgery, the frequency of crossing the platform was reduced after surgery, the expression of iNOS mRNA was up-regulated, the percentages of CD11b + CD45 + cells and CD11b + CD86 + cells were increased, and the percentages of CD11b + CD206 + cells were decreased in AS group ( P<0.05). Conclusions:The occurrence of PND may be related to increased polarization to M1 macrophages in the hippocampus and decreased polarization to M2 macrophages in mice with tibial fracture, which further leads to central inflammatory responses.

【Objective】 To compare the clinical efficacy of minimally invasive percutaneous approach with Wiltse approach in the treatment of thoracolumbar fracture without neurological deficit in young and middle-aged patients. 【Methods】 A prospective study was conducted in 108 patients with thoracolumbar fracture without neurological symptoms treated in Department of Orthopedics， The First Affiliated Hospital of Xi’an Jiaotong University from March 2015 to March 2018. We randomly assigned 54 patients to minimally invasive percutaneous approach group （Group A） and 54 ones to Wiltse approach group （Group B）. We compared the operation time， intraoperative blood loss， incision length， the number of intraoperative fluoroscopy times， and postoperative hospital stay of Group A and Group B. We also compared the VAS scores of the two groups before and 3 days after surgery and at each review， the vertebral frontal height compression ratio and Cobb Angle before and immediately after surgery， 3 months 1 year and 3 years after surgery， and ODI index before surgery and 3 months， 1 year and 3 years after surgery. 【Results】 All the 108 patients were followed up. There were no significant differences in operation time， intraoperative blood loss or postoperative hospital stay between the two groups （P>0.05）. The number of intraoperative fluoroscopy times was significantly smaller in Group B than in Group A （P<0.05）， and the incision length was shorter than that in Group A （P<0.05）. The two groups did not significantly differ in VAS score or ODI index before operation （P>0.05）， after operation， or at follow-up， while the anterior vertebral body height ratio and Cobb angle were significantly lower in Group B than in Group A （P<0.0125）. 【Conclusion】 Minimally invasive percutaneous approach and Wiltse approach are both safe and effective in the treatment of thoracolumbar fracture without neurological deficit. However， the number of intraoperative fluoroscopy times of Wiltse approach was significantly reduced， the incision length was smaller than that of the percutaneous pedicle group， and the postoperative anterior vertebral compression rate and Cobb Angle were lower than those of the percutaneous group， indicating better clinical efficacy.

Objective To investigate the combined effect of berberine （BBR） and fluconazole （FLC） on FLC-tolerant Candida albicans in vitro. Methods The sensitivity of 8 strains of Candida albicans to FLC was assessed by determining their minimal inhibitory concentration （MIC） using broth microdilution method. FLC-tolerant strains were screened from FLC-sensitive strains by disk diffusion assay. The effect of BBR combined with FLC on FLC-tolerant Candida albicans was investigated by disk diffusion assay. Results All eight strains of Candida albicans exhibited sensitivity to FLC, with minimal inhibitory concentration （MIC₅₀） values below 0.5 μg/ml. Strains Y0109, 9821, 7879, 7654, and 9296 displayed colony growth in the inhibition zone after 48 h of constant temperature incubation, indicating FLC tolerance. When strains Y0109 and 9821 were subjected to a combination of BBR and FLC, the number of colonies within the inhibition zone decreased progressively with the increase of BBR concentration following a 48 h constant temperature culture. The inhibition zone became clear with the increasing of BBR concentration and increased with the increase of FLC loading, which showed a dose-dependent relationship. Conclusion The BBR combined with FLC demonstrated efficacy against FLC-tolerant strains.