Objective To investigate the clinical efficacy of purging fu-organs traditional Chinese medicine (TCM)therapy for treatment of patients with severe pneumonia and sthenia-heat. Methods According to random number table method,71 patients with sthenia-heat of severe pneumonia were divided into a treatment group (35 cases)and a control group(36 cases). Conventional basic treatment was given to both groups,and additionally, small chengqi decoction was applied nasogastrically for the therapy in treatment group for 2 weeks. The clinical pulmonary infection score(CPIS),Marshall score,integration score of TCM syndromes and the mortalities in 28 days and 60 days were used to compare the clinical efficacy of the two groups. Results With the prolongation of treatment,the CPIS,Marshall score and integration score of syndromes in the two groups were gradually decreased. In treatment group,CPIS and Marshall scores were lower than those of control group on the 4th day ,and there were statistically significant differences(CPIS score:5.8±1.7 vs. 6.8±1.9,Marshall score:5.3±2.3 vs. 6.6±2.7,both P<0.05);the above 2 scores in treatment group were also lower than those of control group on the 7th and 14th day after treatment(7th day CPIS score:5.3±1.5 vs. 5.6±1.4,Marshall score:5.1±1.9 vs. 5.7±1.8;14th day CPIS score:3.9±1.7 vs. 4.4±2.3,Marshall score:4.2±1.9 vs. 4.9±2.5),but there were no statistically significant differences(all P>0.05). In addition,the integration scores of syndromes were significantly decreased on the 4th, 7th and 14th day in the treatment group significantly lower than those in the control group(4th day:7.6±2.3 vs. 10.6±2.7,7th day:7.4±2.5 vs. 9.2±2.1,14th day:6.1±1.9 vs. 8.3±2.4,all P<0.05). However,there were no statistically significant differences in mortality rates in 28 days and 60 days respectively between control group and treatment group(28 days:16.7% vs. 11.4%,60 days:25.0% vs. 20.3%,both P>0.05). Conclusion Purging fu-organs therapy not only can decrease the CPIS and Marshall scores of patients with sthenia-heat of severe pneumonia,but also can improve their syndromes.

Angioplasty, Balloon, Coronary ; Humans ; Percutaneous Coronary Intervention ; instrumentation

OBJECTIVE:To investigate characteristics and regularity of ADR induced by antineoplastic drugs and provide ref-erence for the safe drug use. METHODS:7 417 ADR reports induced by antineoplastic drugs from 91 hospitals from 2009 to 2013 were collected in the ADR monitoring center of PLA. According to the classification in national ADR monitoring cencer,Excel soft-ware was performed to statistically analyze the data. RESULTS:Among 7 417 ADR reports,1 475 were severe ADR(19.89%), 196 were the new and general ADR(2.64%),and 44 were new and severe ADR(0.59%);the elderly patients aged from 45-59 years accounted for the highest proportion (41.01%);intravenous administration was the main administration route causing ADR (88.96%);the incidence of antineoplastic drugs was higher in plant-derived drugs(26.55%),platinum drugs(24.86%)and an-ti-metabolism drugs (19.46%);ADR mostly manifested as lesions of digestive system (38.80%),blood system (16.53%) and general system(12.79%);43.60%ADR occurred within 12 hours after administration. CONCLUSIONS:Highly poisonous,nar-row-range security antineoplastic drugs could easily induce ADR. Risk prevention of antineoplastic drugs should be strengthened to undertake monitoring for high-risk patients and antineoplastic drugs,and severe ADR. More attention should be attached to the reac-tions after 12 h administration to reduce ADR incidence as much as possible.

Objective: To explore the risk factors for ventricular aneurysm formation in patients after acute myocardial infarction (AMI).
Methods: Our research included 2 groups of AMI patients who received percutaneous coronary intervention (PCI)
in our hospital from 2012-04 to 2014-07 as Ventricular aneurysm group,n=146 and Control group,n=142, in which the AMI patients without ventricular aneurysm formation. The baseline condition with aneurysm related risk factors were analyzed and compared between 2 groups including age, gender, hypertension, hyperlipidaemia, diabetes, smoking, family history, MI history, anterior myocardial wall infarction, angina pectoris, left main (LM) disease, the lesion at proximal left anterior descending (LAD) artery, NYHA classiifcation III/IV, chest pain time ≥ 24 hours and ST-segment elevation ≥ 4 adjacent leads in ECG.
Results: Compared with Control group, the patients in Ventricular aneurysm group had the elder age (OR=1.023, 95% CI 1.000-1.046), higher incidence rates of smoking (OR=1.819, 95% CI 1.130-2.928) and anterior MI (OR=9.162, 95% CI 4.657-18.028), more patients with ≥ 4 adjacent ST-segment elevation (OR=6.571, 95% CI 2.426-17.798), while less patients with angina pectoris (OR=0.557, 95% CI 0.335-0.927, allP<0.05. With adjusted relating factors of age, gender, hypertension, diabetes and angina pectoris, the multivariate Logistic regression analysis indicated that smoking (regression coefifcient: 0.833, OR=2.301, 95% CI 1.283-4.125), anterior MI (regression coefifcient: 1.799, OR=6.041, 95% CI 2.831-12.894) were positively related to ventricular aneurysm formation.
Conclusion: Smoking and anterior MI were strongly related to ventricular aneurysm formation in patients after AMI.

database until 2015-01, and all randomized controlled trials (RCT) upon (RVS) pacing and (RVA) pacing in Chinese population were enrolled. According to Cochrane Handbook 5.0.2 quality evaluation criteria, the publications were selected by 2 independent researchers and Meta-analysis was conducted with RevMan5.0 software.
Results: A total of 16 RCT articles including 1199 patients were enrolled in this study. The research was divided into 2 groups: RVS group,n=602 and RVA group,n=597. Meta-analysis indicated that the following indexes in RVS group were better than those in RVA group: the differences between post-and pre-operation for the combination value in LVEF (MD=1.90, 95% CI 0.75-3.05,P=0.001), stroke volume (MD=7.08, 95% CI 2.39-11.76,P=0.003), QRS wave width (MD=29.13, 95% CI 5.71-52.54,P=0.01), LVESV (MD=2.04, 95% CI -4.22 to 8.31,P<0.00001), LVEDV (MD=2.64, 95% CI 1.80-3.49, P<0.00001), BNP (MD=68.00, 95% CI 57.57-78.43,P<0.00001), inter ventricular septum and left ventricular posterior wall motion delay time (SPWMD) (MD=22.68, 95% CI 16.91-28.45,P<0.00001), E/A (MD=0.49, 95% CI 0.41-0.57, P<0.00001), LRVPEI (MD=14.06, 95% CI 12.36-15.75,P<0.00001), resistance of electrode (MD=-67.02, 95% CI -119.96 to -14.08,P=0.01) and pacing threshold (MD=0.09, 95% CI 0.00-0.18,P=0.04). The time of operation in RVS group was longer than that in RVA group, (MD=-11.76, 95% CI -14.69 to -8.82,P<0.00001). The differences between post- and pre-operation in LVEDD, Tei index and X-ray exposure time were similar between 2 groups,P>0.05.
Conclusion: RVS is a relatively feasible pacing method in Chinese population.

Objective To evaluate the effect of individualized food composition table on serum phosphorus management for patients undergoing peritoneal dialysis(PD). Methods A total of 83 patients who were treated with PD for over 3 months with serum phosphorus greater than 1.78 mmol/L were included from March to May 2016 in PD Center of the Second Hospital of Hebei Medical University by convenient sampling. They received dietary guidance with individualized food composition table and stable phosphorus binding agent. After 6 months, level of serum phosphorus, biochemical indicators and other PD indicators before and after the intervention were compared. Results After 6 months of diet intervention, the patients' serum phosphorus achieved rate was 71%. Serum phosphorus, potassium, parathyroid hormone decreased, and hemoglobin, serum albumin increased (P<0.05). For the PD indicators, blood pressure control was improved (P<0.05), and the rest of the indicators had no difference compared with those before intervention (P>0.05). Conclusions Dietary intervention based on individual food composition table can effectively reduce the serum phosphorus levels in patients with PD,and improve the nutritional status and simplify education working process of the PD center diet as well.

Objectives: . The necessity to develop a method for prognostication and to identify novel biomarkers for personalized medicine in patients with head and neck squamous cell carcinoma (HNSCC) cannot be overstated. Recently, pathomics, which relies on quantitative analysis of medical imaging, has come to the forefront. CXCL8, an essential inflammatory cytokine, has been shown to correlate with overall survival (OS). This study examined the relationship between CXCL8 mRNA expression and pathomics features and aimed to explore the biological underpinnings of CXCL8. Methods: . Clinical information and transcripts per million mRNA sequencing data were obtained from The Cancer Genome Atlas (TCGA)-HNSCC dataset. We identified correlations between CXCL8 mRNA expression and patient survival rates using a Kaplan-Meier survival curve. A retrospective analysis of 313 samples diagnosed with HNSCC in the TCGA database was conducted. Pathomics features were extracted from hematoxylin and eosin–stained images, and then the minimum redundancy maximum relevance, with recursive feature elimination (mRMR-RFE) method was applied, followed by screening with the logistic regression algorithm. Results: . Kaplan-Meier curves indicated that high expression of CXCL8 was significantly associated with decreased OS. The logistic regression pathomics model incorporated 16 radiomics features identified by the mRMR-RFE method in the training set and demonstrated strong performance in the testing set. Calibration plots showed that the probability of high gene expression predicted by the pathomics model was in good agreement with actual observations, suggesting the model’s high clinical applicability. Conclusion . The pathomics model of CXCL8 mRNA expression serves as an effective tool for predicting prognosis in patients with HNSCC and can aid in clinical decision-making. Elevated levels of CXCL8 expression may lead to reduced DNA damage and are associated with a pro-inflammatory tumor microenvironment, offering a potential therapeutic target.

Objective:To observe the effect of G protein alpha inhibitory subunit (Gαi) 1 and Gαi3 on signal transduction and angiogenesis induced by Netrin-1 (NTN1) and explore the possible mechanisms.Methods:Twenty male C57BL/6J mice aged 6 to 8 weeks were randomly assigned to a control group and a diabetic group, with 10 mice in each group. Diabete group mice were induced by streptozotocin to establish diabetes model. 12 weeks after modeling, quantitative real-time polymerase chain reaction and Western blot were performed to detect the expression of Ntn1, Gαi1 and Gαi3 in diabetic retinas. Additionally, 35 male C57BL/6J mice aged 2 weeks were randomly stratified into three groups: a control group, an intravitreal injection of NTN1 group (NTN1 group), and a retinal endothelial cell-specific Gαi1/Gαi3 knockdown coupled with intravitreal NTN1 injection group (Gαi1/Gαi3 eKD+NTN1 group), with 15 mice in each of the normal control and NTN1 groups, and 5 mice in the Gαi1/Gαi3 eKD+NTN1 group. Isolectin B4 staining was performed to observe retinal neovascularization. In vitro, human umbilical vein endothelial cells (HUVEC) were divided into four groups: negative control lentiviral transfection group (shC group), negative control lentiviral transfection+NTN1 treatment group (shC+NTN1 group), Gαi1/Gαi3 knockdown group (shGαi1/Gαi3 group), and Gαi1/Gαi3 knockdown+NTN1 treatment group (shGαi1/Gαi3+NTN1 group). The effects of NTN1, Gαi1, and Gαi3 on HUVEC proliferation were assessed using the EdU assay. Transwell assays were conducted to determine the effects on HUVEC migration, and Matrigel assays were used to evaluate the effects on HUVEC tube formation. Protein kinase B (Akt), phosphorylated Akt (p-Akt), ribosomal protein S6 kinase (S6K), phosphorylated S6K (p-S6K), extracellular regulatory protein kinase (Erk1/2), phosphorylated Erk1/2 (p-Erk1/2) protein expression on HUVEC were detected by Western blot.Results:Compared with the control group, the relative expression levels of Ntn1, Gαi1, and Gαi3 mRNA and protein in the diabetic group retina were significantly increased, with statistically significant differences ( t=11.800, 9.298, 10.620, 7.503, 3.432, 8.037; P<0.000 1). Compared with the shC group, the relative expression levels of Gαi1 and Gαi3 mRNA and protein in the shGαi1/Gαi3 group in HUVEC were significantly reduced, showing statistically significant differences ( t=16.310, 16.300, 13.600, 9.068; P<0.000 1). HUVEC proliferation rate, migration number and lumen formation number: compared with shC group, shC+NTN1 group significantly increased, while shGαi1/Gαi3 group and shGαi1/Gαi3+NTN1 group significantly decreased, and the differences were statistically significant ( F=62.750, 49.830, 54.900; P<0.000 1). Compared with the control group, the relative expression levels of Gαi1 and Gαi3 mRNA and protein in retina were significantly decreased in the Gαi1/Gαi3 eKD group, showing statistically significant differences ( t=10.920, 13.460, 9.219, 10.500; P<0.000 1). Retinal neovasculogenesis area: compared with the normal control group, the area of retinal neovasculogenesis increased significantly in the NTN1 group, but decreased significantly in the Gαi1/Gαi3 eKD+NTN1 group, with statistical significance ( F=24.010, P<0.000 1). The protein expression of p-Akt relative to Akt, p-S6K relative to S6K, and p-Erk1/2 relative to Erk1/2: compared with shC group, the protein expression of shC+NTN1 group was significantly increased, while that of shGαi1/Gαi3 group and shGαi1/Gαi3+NTN1 group was significantly decreased, with statistical significance ( F=78.610, 144.400, 77.010; P<0.000 1). Conclusions:NTN1 induces Gαi1/Gαi3 to mediate activation of downstream Akt-mammalian target proteins of rapamycin and Erk1/2, thereby promoting angiogenesis in vivo and in vitro environments. Knocking down Gαi1/Gαi3 significantly reduces the NTN1-induced angiogenesis effect.

Background::Data on the glycemic profile of pregnant women with gestational diabetes mellitus (GDM) during the perinatal period are sparse. This study described the intrapartum and early postpartum glucose profiles among pregnant women with GDM, and analyzed factors potentially affecting glycemic parameters during the period.Methods::This was a prospective observational study conducted from March 2020 to November 2021. Pregnant women with GDM receiving lifestyle interventions alone during pregnancy and matched women with non-diabetic pregnancies (NDPs) were enrolled from among patients admitted to the obstetrics department for childbirth. Glucose monitoring was performed via a flash glucose monitoring (FGM) system on admission, and glucose readings during labor and early postpartum were analyzed. The clinical characteristics and FGM-based parameters of participants in the two groups were compared.Results::A total of 124 participants (mean age: 29.5 ± 3.5 years, 92 [74.2%] primipara) were included in the final analysis. A total of 17,571 glucose readings were retrieved. There were no significant differences in clinical characteristics between the GDM ( n = 60) and NDP ( n = 64) groups. The average glucose level was 92.2 mg/dL, and the level was higher in the GDM group (95.5 ± 12.1 mg/dL vs. 89.1 ± 13.4 mg/dL, P = 0.008) during the intrapartum and early postpartum periods. The data were split into the intrapartum period (from the start of labor to delivery of the placenta) and the early postpartum period (within 24 h after placental delivery) for analysis. During intrapartum, women with GDM exhibited glycemic profiles and fluctuations similar to those in the NDP group. However, women with GDM had higher postpartum glucose levels (97.7 ± 13.4 mg/dL vs. 90.8 ± 15.3 mg/dL, P = 0.009), a longer time spent >140 mg/dL (8.7 ± 9.3% vs. 5.9 ± 10.3%, P = 0.011), and greater glycemic fluctuations than those with NDP. Postpartum hyperglycemia in GDM might be associated with high parity and postprandial glucose abnormalities in GDM screening tests. Conclusion::Compared to those with normoglycemia, pregnant women with GDM receiving lifestyle interventions alone had similar intrapartum glucose profiles but higher early postpartum glucose levels and greater glucose variability, providing evidence for modification of the current perinatal glucose monitoring strategy for GDM.Trial Registration::ChiCTR.org.cn, ChiCTR2000030972

Objective:To explore the contents and methods of clinical comprehensive evaluation of microecologics, with the example of Bifidobacterium quadruple viable tablet, in order to provide evidence for clinical rational use of microecologics, and microecologics research, development and related decision-making, and to promote rational use of medications. Methods:Based on the research data collected from systematic literature search, health technology assessment methods such as evidence-based medicine and pharmacoeconomics evaluation were used to estimate the safety, efficacy, economics, suitability, accessibility and innovation of Bifidobacterium quadruple viable tablet. Results:In terms of efficacy, Bifidobacterium quadruple viable tablet showed significant therapeutic effects in the treatment of pediatric diarrhea, antibiotic-related diarrhea, diarrhea-predominant irritable bowel syndrome, and secondary diarrhea caused by diseases such as ulcerative colitis, as well as constipation and functional dyspepsia. It can also be used in the treatment of various diseases such as Helicobacter pylori related gastritis, liver cirrhosis, non-alcoholic fatty liver disease. In terms of safety, the incidence of adverse effects of this medication was low, and most were mild to moderate and transient symptoms. In terms of economics, compared with mesalazine alone in the treatment of ulcerative colitis, the incremental cost-effectiveness ratio of combination of Bifidobacterium quadruple viable tablet and mesalazine was 1 743.2. Besides, the daily treatment cost of Bifidobacterium quadruple viable tablet was lower than that of combination of Bifidobacterium triple viable and Bacillus licheniformis (1.87 to 2.80 yuan vs. 2.08 to 5.78 yuan). In terms of innovation, this medication had multiple patents and had been identified as a high-tech product in Zhejiang Province. In terms of suitability, the overall suitability of use and technical characteristics of medication were good. It could be further improved in the aspects of dosage form and system. In terms of accessibility, the price of the medication was stable, affordable and accessible to the general public. Conclusions:Based on the existing evidence, Bifidobacterium quadruple viable tablet presented effective with supported evidences, good safety, accessibility and innovation. The suitability can be further optimized. However, more in-depth and targeted research is needed in terms of economics and innovation in different clinical applications, and there is space for optimization in medication suitability.