Objective:To study the clinical effect and safety of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of liver cirrhosis with esophageal variceal bleeding.Methods:86 cases of cirrhotic patients with esophageal and gastric varices bleeding admitted in our hospital from August 2013 to April 2015 were selected and randomly divided into the control group and the observation group with 43 cases in each group.The control group underwent percutaneous transhepatic coronary vein embolization (PTVE) treatment,while the observation group were treated with TIPS.The success rate of surgery,the incidence of various complications,the long-term survival rate and the symptoms and the changes of liver function after operation were compared between the two groups of patients.Results:The portal vein pressure after operation in the observation group was significantly lower than that of the control group (P=0.00),at 3 months,6 months and 12 months after operation,the rebleeding rate in the observation group were significantly lower than that of the control group (P＜0.05),but the incidence of hepatic encephalopathy showed no significant difference between the two groups (P＞0.05);before operation and at 6 months and 12 months after operation,the Child-Pugh score,serum TBIL,DBIL levels showed no significant difference between the two groups (P＞0.05),at 3 months after operation,the Child-Pugh score,serum TBIL,DBIL levels in the observation group were significantly higher than those of the control group (P＜0.01);the 1 year survival rate showed no significant difference between two groups (P=0.72).Conclusion:TIPS could effectively improve the symptoms of varicose veins,better on liver function damage,and enhance the long-term survival high rate with high safely in the treatment of esophageal variceal bleeding in patients with cirrhosis.

Objective To investigate the changes in endothelial progenitor cells (EPCs) number in peripheral blood of patients with acute cerebral infarction and after Naoxintong treatment.Methods Sixty patients were selected as subject and randomly divided into aspirin group and aspirin (30 patients) + Naoxintong group (30 patients).Meanwhile 30 patients without cerebral infarction were served as control group The number of peripheral blood EPCs were detected by flow cytometry at different time point.NIH-NINDS stroke score was used to elevate the neurological function.Results Compared with the control group,number of peripheral blood EPCs significantly decreased in the early stage of acute cerebral infarction (P ＜ 0.05),and then gradually increased until 7th day,which was back to the normal level.There was a positive correlation between improvement of NIHSS and number of peripheral blood EPCs in acute cerebral infarction.Compared with aspirin group,the number of peripheral blood EPCs in Naoxintong group increased sigrificanfly [41.40 ±0.18/million cells vs 41.40 ±0.18/million cells] at 14th day in patients treated with aspirin and Naoxintong.Conclusion The number of peripheral blood EPCs showed a U shape dynamic change in acute cerebral infarctior.Increase the number of peripheral blood EPCs might improve prognosis in patients with acute cerebral infarction.On the basis of routine treatment of aspirin,Naoxintong plus aspirin treatment might improve the number of peripheral blood EPCs in acute cerebral infarction.

Objective:To investigate the status and influencing factors of activities of daily living (ADL), anxiety and depression of the community-dwelling elderly, and to explore the mediating effect of social support and social participation on ADL, anxiety and depression.Methods:A questionnaire survey was conducted from July to October 2022, among 637 residents over 60 years old registered in the Community Health Service Center of Taiyuan Economic and Technological Development Zone selected by simple random sampling method. The general information questionnaire, Activities of Daily Living (ADL) scale, Anxiety Self-assessment Scale, Depression Self-assessment Scale, Social Support Scale, and Social Participation Scale were used in the survey. The dichotomous logistic regression model was used to analyze the influencing factors of disability, anxiety, and depression of the elderly. Structural equation modeling was used to verify the mediating effects of social participation and social support on the ADL and mental health status in the elderly.Results:The disability rate of the elderly in the community was 42.9%(258/602). Age( OR=2.87-4.91), acute disease attack in the last three months( OR=2.03),poor economic status( OR=2.39), impaired social participation ability( OR=4.07, 11.75) and low level of social support( OR=2.37) were risk factors for disability of the elderly in the community. The incidence of anxiety symptoms was 22.7%(137/602). The risk factors of anxiety were having more than one chronic disease ( OR=2.24), poor economic status ( OR=2.27), mild and intermediate impairment of social participation ability( OR=6.97, 180.43)and low level of social support( OR=2.04). The incidence of depressive symptoms was 19.4%(117/602). The risk factors of depression were acute disease attack in the past three months ( OR=1.90), loneliness in the past three months ( OR=2.17), impaired social participation ( OR=4.17) and low level of social support ( OR=3.90). The direct effect of ADL on mental health was 0.204 (Bootstrap 95% CI:0.081-0.330), accounting for 34.58% of the total effect. The mediating effects of social participation and social support on ADL and mental health were 0.343 (Bootstrap 95% CI:0.274-0.418) and 0.042 (Bootstrap 95% CI:0.015-0.075) respectively, accounting for 58.13% and 7.12% of the total effect. Conclusions:Social support and social participation are not only the common influencing factors of ADL, anxiety and depression of the community-dwelling elderly, but also have a mediating effect on ADL and mental health. Promoting the social participation of the community-dwelling elderly and increasing social support can improve both ADL and mental health for them.

[Objective]To do textual research on the meaning of"Fanteng"(烦疼)and"Tengfan"(疼烦)in Treatise on Febrile Diseases and Synopsis of the Golden Chamber.[Methods]By reviewing the annotations and commentaries from different scholars throughout history,the paper summarizes and analyzes their different viewpoints.Additionally,through philological research and references to medical and non-medical literature from the Qin and Han Dynasties,the paper seeks to ascertain the semantic meaning of the word"Fan"(烦).Furthermore,by analyzing ZHANG Zhongjing's original text,the paper explores the intended meanings of these two symptoms.[Results]Scholars throughout history have interpreted these two symptoms as intense pain,pain accompanied by restlessness and inappropriate pain caused by heat.In addition to expressing the uncomfortable feeling of mind,"fan"(烦)also means numerous and frequent.In ZHANG Zhongjing's original texts,these two symptoms are used in conjunction with specific body parts,in dampness disease,malaria and Shaoyang disease,etc.,indicating frequent and recurring pain.[Conclusion]In ZHANG Zhongjing's original texts,"Fanteng"(烦疼)and"Tengfan"(疼烦)actually refer to the concept of"frequent pain".