Objective To explore the clinical effect of the application of modified Chaihuguizhi dried ginger soup in the treatment of liver stagnation and spleen deficiency migraine.Methods 102 cases of liver stagnation and spleen deficiency migraine patients treated in our hospital from June 2014 to February 2016 were selected and randomly divided into two groups.The control group were given conventional western medicine; the observation group were given modified Chaihuguizhi dried ginger soup.The clinical curative effect, accompanied symptoms before and after the treatment, duration, degree of pain, the symptom scores of episode, and plasma specific viscosity, whole blood viscosity, hematocrit of red blood cell (HCT), serum 5-hydroxytryptamine(5-HT) level, medication safety during the treatment of the groups were recorded and compared.Results The total effective rate of the observation group (92.16%) was significantly higher than the control group (76.47%) (P<0.05); accompanied symptoms, duration, degree of pain and the number of attacks of the two groups after the treatment, compared with those before the treatment, improved significantly( P<0.01), and the decrease degree of the observation group was more significant(P<0.01);compared with those before the treatment, the plasma specific viscosity, blood viscosity, HCT and 5-HT levels improved significantly in the two groups after the treatment(P<0.01), and the observation group was better(P<0.01).Conclusion The application of Chaihuguizhi dried ginger soup in the treatment of migraine of liver stagnation and spleen deficiency is more conducive to ease the clinical symptoms, with more remarkable curative effect, safely and reliably, which has high clinical reference value.

Objective To establish fingerprint and mutual mode of aqueous extracts of Eucommia ulmoides Oliv.from different regions by high performance liquid chromatography ( HPLC). Methods The column of SinoChrom ODS￣BP (250 mm×4.6 mm, 5 μm) was used.The mobile phase consisted of acetonitrile￣0.1% phosphoric acid with gradient elution.The flow rate was 1.0 mL.min-1 , the detective wavelength was 230 nm, and the column temperature was 25 ℃ . Results The fingerprint consisted of 14 common peaks.The overall similarity for ten batches of Eucommia ulmoides Oliv.from different regions was 0.592-0.986.The standard fingerprint of Eucommia ulmoides Oliv.was established by HPLC. Conclusion This fingerprint method is simple and repeatable, and it provides a scientific basis for the quality control of Eucommia ulmoides Oliv.

Objective To explore the effect of total saponins from Medicago polymorpha (TSMP) on glucose metabolism in type 2 diabetes mellitus (T2DM) rats and its possible mechanism.Methods T2DM rats were established by feeding with fat diets and intraperitoneally injecting with STZ 30 mg/kg.The rats were divided into control group,model group,metformin group (0.2 g/kg),TSMP high dose group (1.4 g/kg) and TSMP low dose group (0.7 g/kg),which were administrated for four weeks.At the end of administration,blood samples were collected to determine insulin resistance index (IRI),levels of fasting blood glucose (FBG),glycosylated hemoglobin (HbAlc),hepatic glycogen,interleukin (IL)-1 β,tumor necrosis factor (TNF)-α,free fatty acids (FFA) and Leptin,and activities of pyruvate kinase (PK),hexokinase (HK),glucose-6-phosphatase (G-6-Pase),fructose-1,6-bisphosphatase and glucokinase (GK).Western blot was used to detect the expression levels of G-6-Pase and phosphoenolpyruvate carboxykinase (PEPCK) proteins.Results Compared withthe model group,high dose (1.4 g/kg) TSMP decreased IRI,levels of FBG,HbA1 c,IL-1β,TNF-α,FFA and Leptin,and activities of G-6-Pase and fructose-1,6-bisphosphatase in T2DM rats (P＜ 0.05),while increased level of hepatic glycogen,and activities of PK,HK and GK (P＜0.05).Moreover,high dose (1.4 g/kg) TSMP down-regulated expression levels of G-6-Pase and PEPCK protein in liver tissues.Conclusion Chronic administration of TSMP can improved glucose homeostasis in T2DM rats,which might be related to promoting utilization of glucose,and alleviating inflammatory and insulin resistance.

Objective:To explore the clinical utility of metagenomic next-generation sequencing (mNGS) for patients with critically ill atypical rickettsial infections in the early diagnosis and therapy.Methods:From Jan 2020 to Aug 2022, clinical features, blood biochemical results, imaging data and mNGS results in patients with unexplained critical illnesses were collected and analyzed retrospectively. Fisher's exact test was used to compare the positive rate of mNGS and weil felix reaction.Results:All 15 patients with rickettsial disease had fever, 12 cases had headache, but only 3 had a typical rash or scab of diagnostic significance, 6 had septic shock and all had multi-organ dysfunction; blood mNGS tests were positive in 15 cases, of which 10 had Orientia tsutsugamushi detected in their blood and the remaining five had Rickettsia moschata detected in their blood. The positive rate of mNGS was significantly higher than that of the weil felix reaction (15/15 vs 0, P<0.001). All patients were given doxycycline and other treatments after diagnosis, of which 14 improved and were discharged, and one died 1 week after discharge due to critical condition and abandonment of treatment. Conclusion:mNGS can improve the detection rate of atypical rickettsiae in patients with negative routine test results, which can provide valuable reference basis for early diagnosis and early anti-infection treatment of patients with critical rickettsial disease.

Objective To explore the curative effect of embolism of cavernous sinus with Onyx and coils on cavernous sinus dural arteriovenous fistulas (csDAVFs) and to sum up the experiences.Methods Retrospective analysis of clinical data and radiographic records of 25 patients with csDAVFs who had received embolisation of cavernous sinus using Onyx or in combination with coils through inferior petrosal sinus between August 2008 and February 2013 was performed;all patients were diagnosed by conventional cerebral angiography and received ophthalmological examination before operation.Twenty-two patients used coils and Onyx,three patients used Onyx only.Results Twenty-five embolization sessions were conducted.The mean number of coils was 2.55±0.91 and the mean volume was 32.15±16.03 mm3per patient;the mean volume of Onyx was 2.57±0.86 mL per patient.Three patients (12.0％) who used only Onyx achieved subtotal occlusion and other 22 patients (88.0％) were completely occluded in the immediate angiography.All patients (100％) achieved complete occlusion in the follow-up angiography.Seven patients (28.0％) demonstrated no symptoms at discharge time and 18 patients (72.0％) demonstrated symptoms improvement.All patients remained asymptomatic in the subsequent follow-up periods.Six patients (24.0％) occurred complications and all the complications were cured after proper treatment.Conclusion Effective use of Onyx and coils is the key to cure cavernous sinus dural arteriovenous fistulas and reduce the complications.

Objective: To screen the effective hemostasis fraction of Balanophora involucrata. Methods: Balanophora involucrata was extracted by 95% ethanol using reflux extraction, and the residue was extracted by water. The filtrate was combined and concen-trated, and then extracted by petroleum ether, ethylacetate and n-butylalcohol in turn to respectively obtain petroleum ether phase, eth-ylacetate phase, n-butylalcohol phase and H2O phase. The effective hemostasis fraction was determined by measuring the time of blood coagulation and hemorrhage combined with plasma recalcification time. Results: Compared with the blank group, ethylacetate extract from Balanophora involucrata could significantly shorten the time of blood coagulation and hemorrhage, and the plasma recalcification time (P<0. 01). n-Butylalcohol group at high dose could shorten the time of hemorrhage and the plasma recalcification time (P<0.05),while had no effect on the time of blood coagulation(P>0.05). Petroleum ether extract and H2O phase couldn't shorten the time of blood coagulation and hemorrhage, and the plasma recalcification time(P>0. 05). Conclusion: The effective hemostasis frac-tion of Balanophora involucrata mainly concentrates in ethylacetate extract.

Objective:To construct a psychological support training program for palliative care specialist nurses based on positive psychology theory and make a preliminary application.Methods:From August to September, 2020, 142 palliative nursing specialist nurses in Hunan Provincial Palliative Nursing Specialist Training Base were selected as the research objects. Based on positive psychology therapy, using literature review and analysis, semi-structured interviews, expert group meetings and other methods to construct the program, and the work stress, psychological resilience and subjective well-being scores of nurses before and after 8 weeks of psychological support training were compared.Results:The program included three dimensions: cognition, emotion and behavior. After the psychological support training for 8 weeks, the nursing staff′s work stress score 80.76 ± 20.43 was lower than that before the psychological support training 84.70 ± 19.88, the difference was statistically significant( t=6.59, P<0.05), and the psychological resilience score 64.40 ±14.26 was higher than that before the psychological support training 60.19 ±15.85, the difference was statistically significant ( t=-7.39, P<0.05), and the subjective well-being score 75.70 ± 7.70 was higher than that before the psychological support training 74.13 ± 5.98, the difference was statistically significant ( t=-3.52, P<0.05). Conclusions:The psychological support training program based on positive psychology theory can reduce the the work stress, improve psychological resilience and increase subjective well-being of palliative care specialist nurses.

Objective　To explore the predictive value of the ratio of C-reactive protein to high-density lipoprotein cholesterol (CHR) for carotid plaque vulnerability in patients with ischemic stroke.Methods　A retrospectively enrolled 349 patients with acute ischemic stroke in the Department of Neurology of Baoding First Central Hospital from January 2019 to January 2020.All subjects underwent ultrasound examination to evaluate the condition of carotid artery plaques,and based on the ultrasound results,they were divided into no plaque group,stable plaque group,unstable plaque group.The differences in risk factors,blood lipids,and inflammatory indicators in each group were compared.The receiver operating characteristic (ROC) curve was used to estimate the predictive value of each index on the vulnerability of carotid plaque.Results　C-reactive protein and CHR of the unstable plaque group were higher than those of the stable plaque group,and the difference was statistically significant (P<0.05).ROC curve shows that CHR can predict carotid plaque instability more reliably than a single C-reactive protein.Conclusion　CHR has high predictive value for carotid artery vulnerable plaque and can be used as a new circulating biomarker to identify carotid artery plaque vulnerability.

Background: In acute and chronic renal inflammatory diseases, the activation of inflammatory cells is involved in the defect of erythropoietin (EPO) production. Ras guanine nucleotide-releasing protein-4 (RasGRP4) promotes renal inflammatory injury in type 2 diabetes mellitus (T2DM). Our study aimed to investigate the role and mechanism of RasGRP4 in the production of renal EPO in diabetes. Methods: The degree of tissue injury was observed by pathological staining. Inflammatory cell infiltration was analyzed by immunohistochemical staining. Serum EPO levels were detected by enzyme-linked immunosorbent assay, and EPO production and renal interstitial fibrosis were analyzed by immunofluorescence. Quantitative real-time polymerase chain reaction and Western blotting were used to detect the expression of key inflammatory factors and the activation of signaling pathways. In vitro, the interaction between peripheral blood mononuclear cells (PBMCs) and C3H10T1/2 cells was investigated via cell coculture experiments. Results: RasGRP4 decreased the expression of hypoxia-inducible factor 2-alpha (HIF2A) via the ubiquitination–proteasome degradation pathway and promoted myofibroblastic transformation by activating critical inflammatory pathways, consequently reducing the production of EPO in T2DM mice. Conclusion RasGRP4 participates in the production of renal EPO in diabetic mice by affecting the secretion of proinflammatory cytokines in PBMCs, degrading HIF2A, and promoting the myofibroblastic transformation of C3H10T1/2 cells.

Background: In acute and chronic renal inflammatory diseases, the activation of inflammatory cells is involved in the defect of erythropoietin (EPO) production. Ras guanine nucleotide-releasing protein-4 (RasGRP4) promotes renal inflammatory injury in type 2 diabetes mellitus (T2DM). Our study aimed to investigate the role and mechanism of RasGRP4 in the production of renal EPO in diabetes. Methods: The degree of tissue injury was observed by pathological staining. Inflammatory cell infiltration was analyzed by immunohistochemical staining. Serum EPO levels were detected by enzyme-linked immunosorbent assay, and EPO production and renal interstitial fibrosis were analyzed by immunofluorescence. Quantitative real-time polymerase chain reaction and Western blotting were used to detect the expression of key inflammatory factors and the activation of signaling pathways. In vitro, the interaction between peripheral blood mononuclear cells (PBMCs) and C3H10T1/2 cells was investigated via cell coculture experiments. Results: RasGRP4 decreased the expression of hypoxia-inducible factor 2-alpha (HIF2A) via the ubiquitination–proteasome degradation pathway and promoted myofibroblastic transformation by activating critical inflammatory pathways, consequently reducing the production of EPO in T2DM mice. Conclusion RasGRP4 participates in the production of renal EPO in diabetic mice by affecting the secretion of proinflammatory cytokines in PBMCs, degrading HIF2A, and promoting the myofibroblastic transformation of C3H10T1/2 cells.