Objective The efficacy and safety of rectal instillation with formula for clearing heat, eliminating phlegm and relaxing bowel on treating encephalopathy complicated with pulmonary infection were evaluated by randomized controlled clinical trials. Methods Eighty eligible cases of encephalopathy complicated with pulmonary infection were randomly divided into treatment group and control group. Control group was given conventional treatment and treatment group was given rectal instillation treatment with formula for clearing heat , eliminating phlegm and relaxing bowel. The changes of index were observed before and after treatment in two groups including temperature,antifebrile time,white blood cell count,neutrophils ratio,C-reactive protein,procalcitonin, pneumonia severity index,and the efficacy score of TCM syndrome. Results Rectal instillation with formula for clearing heat and eliminating phlegm to relax bowel can be better improved encephalopathy complicated with pulmonary infection with syndrome of phlegm-heat obstructing in which the patients have yellow sputum, constipation,yellow urinary and other symptoms. It can reduce TCM syndrome score and level of serum calcitonin, relieve inflammation,enhanc antibacterial effect,and improve the clinical curative effect. Conclusions The curative effects of rectal instillation with formula for clearing heat and eliminating phlegm to relax bowel on treating encephalopathy complicated with pulmonary is definite which has no adverse reaction and safety use. It is worthy of further popularizing in clinic.

Objective To observe the effect of infliximab combination therapy on the expression of CD147 on the peripheral CD14+ monocytes of active rheumatoid arthritis (RA) patients. Methods Thirty active RA patients who were refractory to MTX treatment were randomized into three groups (group A, B, C) with the proportion of 3:1:1. Group A and B received four or three infusions of infliximab (3 mg/kg), group C received four infusions of placebo. All three groups were added to a stable background of MTX. The mean fluorescence intensity (MFI) of CD147 expression on the peripheral CD14+ monocytes of RA patients and normal healthy controls were detected by flow cytometry analysis. Clinical and laboratory parameters were assessed before each infusion. One-way ANOVA, Kruskal-Wallis the MFI of CD147 expression at week 18 (P<0.05). Marked differences were observed between the infliximab + MTX group and the placebo + MTX group on the change of the MFI of CD147 expression from baseline to week 18 (P<0.05).Conclusion CD147 expression on the peripheral CD14+ monocytes of active RA patients is increased, and combination therapy of infliximab and MTX can inhibit the expression.

Objective To systematically evaluate the risk factors for pulmonary infection in patients with lung cancer after chemotherapy.Methods CNKI,Wanfang Data,VIP,PubMed,Embase,and the Cochrane Library were searched from inception to October 2022 to collect case-control studies and cohort studies about risk factors for pulmonary infection in patients with lung cancer after chemotherapy.Two researchers independently conducted literature screening,data extraction,and quality assessment.Rev Man 5.3 software was used for Meta-analysis.Results A total of 15 literatures were included,including 3960 patients with lung cancer after chemotherapy.Meta analysis results showed that age≥60 years,smoking history,drinking history,hypertension,diabetes mellitus,atelectasis,hypoproteinaemia,TNM staging of stage Ⅲ-Ⅳ,central lung cancer,small cell lung cancer,invasive operation,Karnofsky performance status score＜80 points before chemotherapy,combined chemotherapy drugs,duration of chemotherapeutic ?2 weeks,white blood cell count≤3.0×109/L after chemotherapy,albumin＜30g/L after chemotherapy,and hospital stay>20 days were risk factors for pulmonary infection in patients with lung cancer after chemotherapy(P＜0.05).Conclusion There were many risk factors for pulmonary infection in patients with lung cancer after chemotherapy.Prevention and control measures should be taken based on the related risk factors to reduce the incidence rate of pulmonary infection.

In recent years, the clinical guidelines for the diagnosis and treatment of rheumatoid arthritis (RA) have been constantly updated. Among the general principles, it is particularly emphasized that, in order to improve the ratio of treat to target(T2T) of RA, doctors and patients should work together to negotiate the details of the guidelines. Therefore, it is important for patients to further understand the disease and clinical guidelines of RA, and to better cooperate with doctors. This study was based on the most concerned issues of RA patients and international standard procedure of guideline study, we organized the working group and introduce the following 16 recommendations constituting the RA patients′ practice guidelines.

In recent years, osteoporosis (OP) has become one of the main diseases affecting the health of middle-aged and elderly people in China, and the prevalence of OP has increased significantly. The clinical diagnosis and treatment guidelines for this disease are also constantly updated. The overall principles speciallyemphasise that doctors and patients need to work together to negotiate the details of the diagnosis and treatment guidelines, in order to improve the OP clinical diagnosis and treatment rate. Therefore, patients′ knowledge of the disease, understanding of clinical guidelines, and cooperation with doctors to implement diagnosis and treatment plans are very important. In this study, from the most concerned issues of the patients, we established the OP patient practice guideline working group. 14 recommendations, as the OP patient practice guidelines, are proposed in accordance with the relevant principles of the "World Health Organization guidelines development manual" and the international normative process.