Objective To evaluate the therapeutic effect of Xiaoqinglong decoction combined with standard treatment for acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods A total of 60 patients with acute exacerbation of COPD were enrolled and randomly divided into a standard treatment group and a combined treatment group, 30 in each group. The standard treatment group received standard therapy and the combined treatment group receivedXiao Qing Long decoction combined with standard treatment. The forced vital capacity (FVC), forced expiratory volume in first second (FEV1), FEV1/FVC were detected using a pulmonary function tester. The partial pressure of arterial oxygen (PaO2), carbon dioxide (PaCO2) were evaluated.Results After the treatment, the FVC (1.94 ± 0.26 Lvs. 1.55 ± 0.33 L;t=-2.201, P<0.05), FEV1 (1.34 ± 0.24 Lvs. 0.99 ± 0.25 L;t=-6.004,P<0.05), and PaO2 (86.12 ± 13.26 mmHgvs. 80.02 ± 12.75 mmHg;t=-14.158,P<0.05) in the combined treatment group were significantly higher than those in the standard treatment group. The total effective rate in the combined treatment group was significantly higher than that in the standard treatment group (86.7%vs.70.0%;χ2=2.095,P=0.036).Conclusions Xiaoqinglong decoction combined with standard treatment can improve symptom, sign, arterial blood gas and the pulmonary function in patients with acute exacerbation of COPD, and its efficiency is superior to standard therapy alone.

Objective To investigate the curative effect of modified Yanghe decoction on pulmonary interstitial fibrosis.Methods In this study,62 patients suffering fiom pulmonary interstitial fibrosis were randomly divided into 2 groups with the use of the Random Number Table method.31 cases in the treatment group were treated with modified Yanghe decoction,while 31 cases in the control group were treated with prednisone,40 mg/d (produced by Zhejiang Xianju Pharmaceutical Factory).The dosages of prednisone were gradually reduced a month later.The changes and improvement in symptoms,pulmonary function,chest CT,etc were observed and analyzed after three month.Results The study showed that the total?effective?rates of the treatment group and control group were 83.9％ (26/31) and 58.1％ (18/31) respectively,and the difference had statistical significance (P=0.031,P＜0.05).The integrals of gasping,breathlessness,cough and Velcros Rale of the treatment group before the treatment were (3.1 ± 2.61),(4.1 ± 1.53),(1.38 ± 1.02),(1.56 ±2.34)respectively while those of the control group were (2.83±2.34),(3.90±1.67),(1.28±1.24),(1.61±2.14) respectively.The after-treatment integrals of the treatment group were (1.1 ± 1.06),(1.52± 1.40),(0.36±0.71),(0.65±0.67)respectively while those of the control group were(1.2± 1.33),(2.15±1.31),(0.41±0.70),(0.78 ± 0.30)respectively.Compwered with their symptoms before the treatment,there was obviousimprovement in the symptoms of both groups after the treatment,(P＜0.05),but the difference in these aspects between the two groups had no statistical significance (P＞0.05).Before the treatment,the total lung capacity,vital capacity,diffusion function,arterial oxygen pressure of the treatment group were (69.80±21.7) ％,(73.16±16.38) ％,(51.46± 16.42) ％,(69.70± 10.74) mm Hg (1 mm Hg=0.133 kPa) respectively while those of the control group were(77.52 ± 15.96)％,(74.57 ± 20.73)％,(55.68 ± 17.27)％,(64.86 ± 11.40)mm Hg respectively.After the treatment,the total lung capacity,vital capacity,mass function,arterial oxygen pressure of the treatment group were (82.31±21.65)％,(83.66±17.32)％,(62.34±17.96)％,(83.51±9.37)mm Hg respectively while those of the control group were (85.06± 16.10) ％,(85.72± 20.40) ％,(68.32± 20.16) ％,(79.61 ±9.41)mm Hg respectively.Compwered with their symptoms before the treatment,there was obvious improvement in the symptoms of both groups after the treatment (P＜0.05),but the difference in these aspects between the two groups had no statistical significance (P＞0.05).Conclusion Modified Yanghe decoction can be effectively applied in the prevention and treatment of pulmonary interstitial fibrosis.

Objective To investigate the relationship between the plasma neutrophil gelatinase-associated lipocalin (NGAL)and endothelin-1 (ET-1) levels and cognitive dysfunction in chronic obstructive pulmonary disease (COPD) patients.Methods A case-control study was performed,consisting of 128 patients with COPD(68 patients without cognitive dysfunction and 60 patients with cognitive dysfunction) and 70 normal controls.All patients with COPD were diagnosed by pulmonary function tests and plasma levels of NGAL and ET-1 were determined by enzyme immunoassay.The cognitive function was evaluated by the MMSE and MoCA.Results ①Compared with normal control,the levels of plasma NGAL and ET-1 were increased(NGAL:(2.20±0.60) μg/L vs (1.69±0.73) μg/L,P＜0.05;ET-1:(26.19± 10.55)pg/ml vs (13.05±2.37) pg/ml,P＜0.05) in COPD patients without cognitive dysfunction and in COPD patients with cognitive dysfunction(NGAL:(3.80±2.75) μg/L vs (1.69±0.73) μg/L,P＜0.01;ET-1:(37.82±0.29) pg/ml vs (13.05±2.37) pg/ml,P＜0.01).Compared with the COPD patients without cognitive dysfunction,the levels of plasma NGAL and ET-1 were also increased in COPD patients with cognitive dysfunction (all P＜0.05).②The plasma NGAL levels were correlated negatively with MMSE scores(r=-0.524,P＜0.05),and negatively correlated with MoCA scores (r=-0.527,P＜0.05).The plasma ET-1 levels were negatively correlated with MMSE scores(r=-0.549,P＜0.05),and negatively correlated with MoCA scores(r=-0.558,P＜0.05).The levels of NGAL and ET-1 were positively correlated(r=0.564,P＜0.05).Conclusion NGAL and ET-1 may be involved in the pathophysiological process of cognitive dysfunction in patients with COPD,which provides a certain clinical value for the assessment of cognitive dysfunction in patients with COPD.

OBJECTIVE: To explore the genetic basis for an infant with neonatal diabetes (NDM) and multiple malformations. METHODS: Genetic variants were detected by next generation sequencing (NGS). Suspected variant was verified by Sanger sequencing. RESULTS: A de novo heterozygous variant, c.1454_1455del(p.K485Rfs), was detected in exon 5 of the GATA6 gene. The variant was undetected in his parents and unreported previously. Bioinformatic analysis predicted the variant to be pathogenic. CONCLUSION The heterozygous variant of c.1454_1455del(p.K485Rfs) of the GATA6 gene probably underlies the disease in this child. Genetic testing can facilitate diagnosis and genetic counseling for NDM.
Abnormalities, Multiple ; Adult ; Diabetes Mellitus/genetics* ; Female ; Genetic Testing ; Heterozygote ; High-Throughput Nucleotide Sequencing ; Humans ; Infant, Newborn ; Male ; Sequence Deletion/genetics*

The medical-industrial fusion training model combines the knowledge and technology of medical and engineering disciplines in the training of oncology graduate students, which can help accurate diagnosis and treatment of tumors, promote cooperation and innovation in oncology research, as well as promote the cultivation and exchanges of composite and innovative medical talents in oncology, promote the innovation and development of oncology diagnostic and treatment technology, and improve the survival rate and quality of life of oncology patients. This paper discusses the application of medical-industrial fusion training model in the training of o ncology professionals, and explores the new teaching mode of medical-industrial fusion thinking in the cultivation of complex and innovative medical talents in oncology under the background of "new medical science".

With the deepening of China's medical reform, people's demand for health is growing, which promotes the construction of "new medicine" and puts forward higher requirements for the cultivation and education of medical students. Undergraduate medical education is a crucial period for the growth of medical students, and how to do a good job in undergraduate teaching under the background of "new medicine" is currently a research hotspot. The clinical teaching stage is an important period for medical students to fully understand clinical disciplines and cultivate their understanding of specialties. Therefore, we should explore new teaching methods and means to adapt to the needs of the new era. In the context of "new medicine", the medical-engineering fusion diagnosis and treatment technology has become an important trend in the clinical diagnosis and treatment of oncology. In order to adapt to this change, clinical teaching and teaching management in oncology also need new exploration and research. Taking the clinical teaching of oncology as an example, this article discusses how to cultivate medical students' thinking of medical-engineering fusion.

OBJECTIVE To explore the safety， effectiveness， and cost-effectiveness of elderly patients with sarcopenia receiving Shenling baizhu powder combined with nutrition and exercise intervention， providing a reference for rational clinical drug use. METHODS A total of 237 elderly sarcopenia patients were randomly assigned to an observation group （118 cases） and a control group （119 cases）. Both groups of patients received nutrition and exercise intervention； the observation group added Shenling baizhu powder （6 g each time， three times daily） on this basis. The safety， effectiveness， and cost-effectiveness of the two plans were compared after 3 months. RESULTS Both groups of patients completed the follow-up. Before intervention， no significant difference was observed in skeletal muscle index （SMI）， grip strength， and 6-minute walk test （6MWT） speed between the two groups （P＞0.05）. After intervention， the grip strength of the patients in the observation group was significantly greater than that of the control group （25.05 kg vs. 23.18 kg， P＜0.01）； the treatment response rate of sarcopenia， SMI， and 6MWT speed were higher than those of the control group， butthe differences were not statistically significant （P＞0.05）. The adverse reaction/event rate of the patients in the observation group was lower than that of the control group （14.41% vs. 16.81%， P＝0.611）， but the difference was not statistically significant. Compared with the control group’s plan， the cost of the observation group’s plan was higher （981.25 yuan vs. 913.94 yuan）， and the effect was better （effectiveness rate： 0.618 6 vs. 0.563 0）， with an incremental cost-effectiveness ratio of 1 210.61 yuan. The results of the sensitivity analysis were consistent with the cost-effectiveness analysis results. CONCLUSION Elderly patients with sarcopenia who receive Shenling baizhu powder combined with nutrition and exercise intervention can significantly strengthen grip strength without increasing the incidence of adverse reactions/events. Compared with the control group plan， the observation group needs to spend an additional 1 210.61 yuan for each additional effective patient with sarcopenia.