【Objective】 To observe the promoting action of spleen-strengthening and Qi-promoting herbs on enteral nutrition(EN) for patients after abdominal surgery.【Methods】 Sixty patients after abdominal surgery were equally randomized into groups A and B.The two groups received oral use or tube feeding of enteral nutrition(Fresubin).Group A received oral use or tube feeding of the decoction with spleen-strengthening and Qi-promoting actions(composed of Radix Pseudostellariae,Rhizoma Dioscoreae,Fructus Hordei Germinatus,Pericarpium Citrus Reticulata,Radix Notoginseng) additionally.The treatment lasted one week.Before and after EN treatment,the contents of hemoglobin(Hb),total lymphocyte count(TLC),albumin(Alb),serum total protein(TP) and the ratio of albumin and globumin(A/G) were observed.【Results】After EN treatment,the above laboratory parameters were increased in the two groups as compared with those before treatment(P

Objective To study the expression and significance of Th17 and Tc17 cells in the peripheral blood,skin and lung in a murine model of bleomycin (BLM)-induced systemic sclerosis (SSc).Methods Thirty female BALB/c mouse were randomly divided into 3 groups,including a control group ( A group),a injected with BLM 4 week without pulmonary fibrosis(PF) group( B group) and with obviously PF group(C group).Pathological changes of skin and lung were detected.The proportion of CD4+,CD8+,CD4+IL-17+(Th17),CD8+IL-17+(Tc17) cells in the peripheral blood,skin and lung of mouse was determined by flow cytometry.The mRNA expressions of RORγt,IL-17A in skin and lung of mouse were evaluated by real-time PCR.Enzyme linked immunosorbent assay(ELISA) was used to measure the levels of IL-17 in serum.Results Dermal hydroxyproline(HYP) contents and the score of PF were significantly increased in C group [ (3.07±1.26) μg/mg,4.0±1.41 ]and B group [ (2.43±0.61) μμg/mg,1.50±0.76]as compared with A group [ (1.45±0.40) μg/mg,0.60±0.70 ],and pulmonary HYP contents was obviously increased in C group than in A and B groups,all P＜0.05.Compared with the A group,the percentage of CD4+ and Th17 cells in the peripheral blood,skin and lung of B and C groups,Tc17 cells of C group was significantly increased,and CD8+ cells was significantly decreased(all P＜0.05).The ratio of Th17/CD4+CD8+ in the peripheral blood,skin and lung of B and C groups [ ( 1.41 ±0.36)％,( 1.79±0.77)％ ],[ (2.58±1.07)％,(5.23±2.34)％ ]and [ (3.50±1.20)％,(4.02±1.32) ％ ]was significantly increased compared with A group (0.71±0.25)％,(1.15±0.59)％,(0.99±0.46)％.The ratio of Tc17/CD4+CD8+ in the lung of C groups( 1.62±0.53) ％ and in the skin of B and C groups [ (1.70±0.70) ％,( 1.63±0.63 ) ％ ]was significantly increased compared with A group [ ( 1.00±0.47 ) ％,( 1.1 1 ±0.34 ) ％ ],all P＜0.05.Compared with the A group,the mRNA levels of IL-17A,RORγt in skin of B and C groups,and in lung of C group were higher and the levels of IL-17 in serum was significantly increased,all P＜0.05.Th17 cells and the levels of IL-17 in blood were positive correlation with dermal and pulmonary inflammation,fibrosis and H YP contents,all P＜0.01.The frequency of Th17 and Tc17 cells in skin and lung respectively had a positive correlation with dermal and pulmonary inflammation,the score of fibrosis,and HYP contents of skin and lung,all P＜0.01.Conclusion Th17 and Tc17 cells were significantly increased in the peripheral blood,skin and lung of a murine model of SSc,and Th17 cells is dominated.They correlated with the inflammation and fibrosis of skin and lung,and may participate in the pathogenesis of SSc through secrete IL-17.

Objective To explore the effects of the Chinese medicine, modified Erchen decoction, on the serum lipid spectrum of ApoE-/-mice, and to explore its possible anti-atherosclerotic mechanism.Methods Forty-four male 7-8-week old ApoE-/-mice were used in this experiment.ApoE-/-mouse models of atherosclerosis were generated by high-cholesterol diet for 4 weeks.And then, they were given simvastatin or modified Erchen decoction by gavage.The body weight of mice was recorded every week, The mice were sacrificed after treated with the drugs for 8 weeks continuously, and the plasma lipid was determined by enzymatic method.The aortic valves and arches were stained with oil red O to depict atherosclerotic plaques and liver structural changes of the mice were examined by pathology.Results Modified Erchen decoction lowered plasma lipid ( including TCHOL and LDL-C ) significantly ( P<0.01 ) .The body weight was increased in the mice of all groups, but it was more pronounced in the mice of model group than in the blank and modified Erchen decoction groups.The serum CHOL and LDL-C levels were significantly lowered in the modified Erchen decoction group (P<0.01).The area of atherosclerotic plaques in the aortic wall was significantly reduced in the mice of modified Erchen decoction group as shown by oil red O staining.The pathological changes of hepatocytes were less severe and the structure of hepatic lobules was better preserved in the mice of modified Erchen decoction group.Conclusions The Chinese medicin modified Erchen decoction can effectively reduce serum lipids, regulate lipid metabolism, and ameliorate the process of atherosclerosis in ApoE-/-mice.

Objective:To investigate the epidemiological and clinical features of patients with hemorrhagic fever with renal syndrome (HFRS) from 2017 to 2019.Methods:Seventy-five patients with HFRS from the Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University during January 1, 2017 to December 31, 2019 were included. The data of epidemiology, clinical symptoms, blood routine, urine routine, serum creatinine, liver function and other laboratory examination indexes were retrospectively analyzed. The measurement data with skewness distribution were expressed by M( QR) and compared by nonparametric test. Multivariate logistic regression analysis was used to analyze disease-related risk factors. Results:The 75 patients were mainly located in the western and northern regions of Anhui Province. A total of 37 cases (49.3%) were infected during November, December and January next year. Fifty-four (72.0%) patients were farmers and 10(13.3%) patients had a clear history of rodent contact. Only 19(25.3%) patients had typical clinical manifestations of "three red and three pain" . Fifty-eight (77.3%) patients had elevated white blood cell count, 67(89.3%) patients had decreased platelet count, 55(73.3%) patients had urinary protein + + + , 65(86.7%) patients had abnormal urinary occult blood, and 67(89.3%) patients had elevated serum creatinine. The serum creatinine and potassium levels in 31 severe and critical patients were 495(301) μmol/L and 4.14(0.77) mmol/L, respectively, which were both higher than those in 44 mild and moderate patients (235(289) μmol/L and 3.65(1.02) mmol/L, respectively). The differences were both statistically significant ( Z=-3.187 and -2.796, respectively, both P<0.01). Multivariate logistic regression analysis showed that serum creatinine (odds ratio ( OR)=1.005, 95% confidence interval ( CI)1.002-1.008) and serum potassium ( OR=2.632, 95% CI 1.098-6.313) were independent risk factors for disease severity. All patients received comprehensive medical treatment, and 27 patients received renal replacement therapy. Sixty-eight patients had good prognosis and four patients died. Conclusions:HFRS is still common in the rural area in winter and spring. Patients with atypical clinical manifestations and severe and critical patients should be intensively monitored.

OBJECTIVE:To provide reference for promoting the inherirance and development of TCM powder decoction piec-es. METHODS:By retrieving literature,the inheritance,overview of modernization development,and key points in industrial de-velopment of TCM powder decoction pieces were analyzed,and development suggestion was put forward. RESULTS & CONCLU-SIONS:Aiming at inheritance of TCM powder decoction pieces,suggestions were put forward as explaining scientific connotation of TCM powder decoction pieces,mining the essence of preparation technology,and cultivating comprehensive decoction pieces talents with basic knowledge of powder science. According to the particle size of powder,TCM powder decoction pieces can be di-vided into TCM common powder,TCM ultrafine particle powder,and TCM nano powder. Aiming at the key points of TCM pow-der decoction pieces,such as application scope,particle size and its correlation with the performance of TCM,grinding technology and equipment and quality standards,the developing strategies were put forward as adjusting the suitable application scope,select-ing appropriate particle size,strengthening its performance research,standardizing and innovating the preparation,improving the packaging and sterilization technologies,establishing and implementing the quality standard with characteristics.

OBJECTIVE:To optimize extraction technology of protein from Cryptotympana pustulata and investigate its in vitro antioxidant activity,so as to provide reference for further research of protein from C. pustulata. METHODS:Using extraction amount of protein as response value,based on single factor test,Box-Behnken response surface methodology was used to optimize the ratio of liquid to material,ultraonic time and extraction times.Validation test was conducted. Using Vitamin C(VC)as positive control, in vitro antioxidant activity of protein from C. pustulata was evaluated by using scavenging rate of 1, 1-diphenyl-2-picrylhydrazyl(DPPH)and 2,2′-azino-bis(3-ethyl benzothiazoline-6-sulfonic acid)(ABTS)free radical as index. RESULTS:The optimal extraction condition of protein from C.pustulata was as follows as the ratio of liquid to material 28:1(mL/g), ultrasonic time of 65 min,extracting for twice. In validation test,average extraction amount of protein from C. pustulata was 65.45 mg/g(RSD=1.68%,n=3),relative error of which to predicted value was 5.48%. The protein from C. pustulata showed strong scavenging effect on ABTS and DPPH free radicals. When the concentration of protein from C. slough was 0.2 mg/mL,and the scavenging rate of it to ABTS free radicals was 97%,the effect of which was similar to VC.The protein from C. pustulata showed weak scavenging ability to DPPH free radical,IC50was 0.96 mg/mL,the effect of which was not as good as VC. CONCLUSIONS:The extraction technology of protein from C. pustulata optimized by Box-Behnken response surface methodology shows high accuracy and good reliability.The protein from C.pustulata shows certain antioxidant activity in vitro.

OBJECTIVE：To study the difference of dissolution performance of chemical component and anticonvulsant effect of Bombyx mori decoction and powder taken with water，and to provide reference for the selection of application forms of B. mori. METHODS：The yield of dry extract was determined for decoction and powder biomimetic gastric juice of B. mori. HPLC method was used to detect the content of ammonium oxalate in decoction and powder biomimetic gastric juice of B. mori. The content of protein in decoction and powder biomimetic gastric juice of B. mori was determined with bicinchoninic acid（BCA）method. Mice was divided into normal group（1％Sodium carboxymethylcellulose solution），model group（1％Sodium carboxymethylcellulose solution），positive group （phenytoin，2 mg/kg） and B. mori decoction and powder suspensions high-dose，medium-dose and low-dose groups（0.75，1.5，3 g/kg by crude drug）according to random number table，with 20 mice in each group. After 60 min of intragastric administration，electric stimulation was conducted，and the rate of convulsion in mice was recorded. RESULTS：The yields of dry extract were 22.08％ and 26.40％ in decoction and powder gastric juice of B. mori （P＜0.05）；the contents of ammonium oxalate were 11.22％ and 16.83％ （P＜0.05），and the contents of protein was 3.39％ and 4.92％ （P＜0.01）. Compared with normal group，convulsion rate of mice was increased significantly in model group （P＜0.01）；compared with model group，convulsion rates of mice were decreased significantly in administration groups （P＜0.05 or P＜0.01），and the convulsion rate of mice in B. mori powder suspensions group was lower than decoction group. CONCLUSIONS：The dissolution performance of the chemical component from gastric juice of B. mori powder is better than that of decoction， and the anticonvulsant effect of B. mori powder is better than decoction.

Objective To explore the ideal positions for venous indwelling needle among elderly patients. Methods A total of 135 elderly patients, who required transfusion aged from 70 to 90 years old, were randomly divided into observation group (n=66) and control group (n=69). Patients of the observation group underwent the pricking of forearm vein whiles patients of the control group received the pricking of dorsal hand vein. We compared the indwelling length of venous indwelling needle, incidences of related complications, success rate of pricking at first time and the pain level of pricking. Results The indwelling time of observation group was (4. 45 ± 0. 75) d higher than (4. 16 ± 0. 85) d of the control group; the complications such as phlebitis, fluid exudation in the observation was 12. 1% lower than 27. 5% in the control group (t/χ2 =2. 136, 5. 010;P<0. 05). There was no statistical significance for pain level of pricking and success rate of pricking at first time [(4. 12 ± 1. 99) vs (3. 61 ± 1. 58) score; 86. 4% vs 89. 9%; t/χ2 =1. 652, 0. 394;P>0. 05]. Conclusions The venous indwelling needle in forearm vein has some priority, decreases the complications incidences during needle indwelling, and postpones the length of indwelling, which can be the first choice.

Objective To investigate nutritional knowledge,attitude,and practice (K-A-P) of medical staff in the nerve-related departments in Hebei province,with the aim of determining a basis for the effective education of nutrition.Methods A multicenter,observational study was utilized to conduct a questionnaire survey.642 medical staff in nerve-related departments from 15 hospitals in 11 prefecture level cities was surveyed from September 2016 to March 2017 in Hebei Province.Results were statistically analyzed.Results The overall scores of nutrition knowledge,attitude,and practice were 34.88±22.90,69.14± 16.75 and 42.86± 18.22,respectively.There were positive correlations between nutrition knowledge and attitude (r=0.150,P＜ 0.001),knowledge and practice (r=0.152,P＜0.001),and attitude and practice (r =0.432,P＜0.001).The nutrition knowledge score of male medical staff was higher than that of female (t =3.546,P＜0.01) however,there was no significant difference between males and females in nutrition attitude and practice scores (t =0.685,P=0.494;t=1.649,P=0.091).In addition,the nutrition knowledge scores of physicians and medical technicians were significantly higher than that of nurses (F=46.89,P＜0.01) while the nutrition practice scores of physicians were significantly higher than both medical technicians and nurses (F=7.85,P＜0.01).It was also found that nutrition attitude scores of senior and secondary medical staff were higher than junior medical staff (F=5.116,P=0.002) and nutrition practice scores of senior and secondary senior medical staff were higher than that of junior medical staff (F=4.074,P=0.007).Furthermore,it was found that nutrition knoledge scores of undergraduate,master and doctoral degree staff were higher than that of junior college staff (F=15.617,P＜0.001) and nutrition attitude score of undergraduate and master degree staff were significantly higher than that of junior college staff (F =4.11,P =0.003).It was also found that the nutrition knowledge scores of medical staff with less than 5 years of work experience were significantly higher than those with more than 5 years of work experience (F=3.312,P =0.02).However,the scores of nutrition attitude of medical staff with more than 15 years of work experience were significantly higher than those with less than 15 years of work experience (F=6.356,P＜0.001) and the scores of nutrition practice of medical staff with 10-15 years of work experience were higher than that of less than 5 years and 5-10 years of work experience (F=2.959,P=0.032).It was also identified that the top three ways to obtain nutrition knowledge were learning at work (68.85％),learning at university (68.69％) and reading books and journals (57.79％).Conclusion The medical staff of nerve-related departments in Hebei province has positive attitudes towards nutrition treatments.However,their mastery of nutritional knowledge and practice could and should be improved further.Therefore,it is necessary to strengthen the nutrition education for medical staff of the nerve profession.

Objective To explore the value of controlling nutritional status(CONUT)score and related inflammatory indicators in predicting the prognosis of clear cell renal cell carcinoma(ccRCC)patients,to provide a reference for better clinical assessment and individualized treatment plan.Methods A retrospective study was conducted on 132 patients with ccRCC admitted to four comprehensive hospitals in Yibin during 2010 and 2018.Patients'medical and follow-up records were collected,and receiver operating characteristic(ROC)curve was drawn to analyze the area under the curve(AUC)and optimal cut-off value of CONUT score and related indicators.Survival curve was plotted with Kaplan-Meier method,and the influencing factors of prognosis were analyzed with Log-rank test and Cox regression.Results During the follow-up of 62(53,71)months,37(28.03％)deaths occurred.The disease-specific survival(DSS)and progression-free survival(PFS)were 51(41,58)and 46(35,56)months,respectively.The 3-year and 5-year DSS and PFS were 84.09％and 71.97％,and 75.00％and 71.97％,respectively.The AUC of CONUT score,neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and lymphocyte to monocyte ratio(LMR)were 0.980,0.905,0.899 and 0.884,respectively,with the optimal cut-off values of 3.50,3.19,89.07 and 3.56,respectively.Cox regression showed that CONUT score(HR=0.042,95％CI:0.013-0.140)and PLR(HR=0.182,95％CI:0.045-0.744)were associated with DSS;CONUT score(HR=0.029,95％CI:0.010-0.086)and LMR(HR=2.984,95％CI:1.227-7.258)were associated with PFS.Conclusion The prognosis of ccRCC patients is related to their nutritional,immune,and inflammatory status.CONUT score and inflammatory factors(PLR,LMR)may be important predictors of DSS and PFS.