Objective To observe the clinical effect of three antisyphilic drugs in the treatment of early syphilis.Methods From January 2007 to March 2013, 90 cases early syphilis in department of dermatology of our hospital were selected and randomly devided into three groups: benzathine penicillin group, clarithromycin group and azithromycin group.The efficacy including the onset time of improvement, recovery time of skin lesions and TRUST negative conversion rate were compared in three groups.Results The onset time of skin lesions improvement in patients with primary syphilis result showed that there was significant difference between benzathine penicillin and clarithromycin (t =14.603, P<0.05), clarithromycin and azithromycin (t=12.682, P<0.05).While in the treatment of primary syphilis and secondary syphilis, there were no significant differences among recovery time of skin lesions.And there were no significant differences the onset time of skin lesions improvement in treatment of secondary syphilis among three groups.The TRUST negative conversion rates of benzathine penicillin and clarithromycin both were 100%, and azithromycin was 96.7%, with no significant difference.Conclusion The antisyphilic efficacy of three drugs are similar.The patients allergic to penicillin may be treated with clarithromycin or azithromycin, who would aquaire a satisfied result.

Objective To establish a test method for determining the vitamin B4 tablets dissolution.Methods Paddle method was used to 900 mL pH6.8 phosphate buffer solution as the dissolution medium, the temperature of 37℃, the speed of 50 r/min, take time for 45 min.Taking the filtrate through the 0.45μm microporous membrane filtration, vitamin B4 tablets dissolution quantity determined by ultraviolet spectrophotometry, determined the wavelength of 262 nm, dissolution limit for 80% of the labeled amount.Results Vitamin B4 concentration had a good linear relationship with the absorbance in 4~16μg/mL, r=0.9999 (n =5), the average recovery was 100.1%, RSD =1.0% (n=9).Conclusion The method is simple, sensitive and accurate, has certain effect on prescription and study of the process of different production enterprises, can be used for the dissolution determination of vitamin B4 tablets.

Objective To observe the effect of extract of Coprinus comatus on small intestinal propulsion and gastric emptying function in mice.Methods Effect of extract of Coprinus comatus at different doses on small intestinal propulsion and gastric emptying function was observed in normal mice,neostigmine-load mice and epinephrine-load mice by charcoal powder method and by modified phenol red method respectively.Results The small intestinal propulsion of normal mice was promoted by the extract of Coprinus comatus at the doses of 3.0,6.0,9.0 and 12.0 g/kg,and the gastric emptying function of normal mice was promoted by the extract of Coprinus comatus at the doses of 1.5,3.0,6.0,9.0 and 12.0 g/kg,the difference being significant as compared with the normal group (P

Objective:To explore the effects of kangaroo nursing after cesarean section on the paternal role adaptation and subjective well-being of first-time fathers.Methods:In this randomized controlled trial, a total of 160 first-time fathers of newborns delivered by cesarean section from May 2021 to May 2022 in the First Affiliated Hospital of Wenzhou Medical University were continuously selected as research objects and randomly divided into experimental group (80 cases) and control group (80 cases) by random number table method. In the control group, the nursing staff carried out routine obstetric care after the birth of the newborns, the newborns were swaddled to keep warm and transferred to the ward, the fathers took care of them by the side; and the fathers were given postnatal routine education and guidance once a day, including newborn bathing, touching and umbilical buttock care, maternal breast care, breastfeeding, diet, medication and discharge precautions etc. The experimental group were given kangaroo nursing on care basis of control group: the father took a comfortable position that half leaned on the recliner with his shirt unbuttoned, the naked newborn was placed on the father′s chest at an angle of approximately 60 degree on the head up and feet down for maximum skin to skin contact with the help of researchers. The newborn′s back was covered with a blanket and wrapped in the father′s clothes, soft music was playing throughout the whole process, meanwhile, researchers encouraged interactions through verbal communications and touching between the father and the newborn. After newborns returned to the ward, they were given kangaroo nursing immediately by the fathers for the first time, and then twice a day in the same way, lasting for 30-40 min every time, and a total of 6 times of kangaroo nursing were completed during in first 3 days after birth. The average hospitalization period of both groups was 5 days. The father-role adjustment scale and subjective well-being scale were asseessed in the fathers, the independent sample t test was used to compare differences of father-role adjustment level and subjective well-being at the time of discharge between the two groups, the Pearson correlation analysis was used to evaluate the correlation between the two variables. Results:The total score of paternal role adaptation, and the three dimensions scores including role identity, parent-child attachment establishment and nursing behavior implementation in the experimental group were all significantly higher than those in the control group (83.91±7.90 vs 78.79±9.44, 28.94±2.64 vs 27.85±3.36, 28.39±3.15 vs 26.46±3.52, 26.59±4.26 vs 24.48±3.81) ( t=3.725, 2.276, 3.647, 3.309, all P<0.05). The total score of subjective well-being, and the three dimensions scores including health worry, energy, melancholy or pleasant mood in the experimental were all significantly higher than those in the control group (88.34±6.38 vs 83.43±7.26, 7.70±1.77 vs 6.95±1.46, 20.03±3.15 vs 18.76±2.94, 19.41±2.01 vs 17.99±2.68) ( t=4.546, 2.928, 2.625, 3.805, all P<0.05), and were all significantly higher than those before the intervention (74.83±5.84, 6.11±2.22, 16.98±2.68, 15.18±2.13) ( t=13.069, 5.207, 6.261, 13.332, all P<0.05). There was a positive correlation between fathers′ subjective well-being and paternal role adaptation ( r=0.614, P<0.001). Conclusions:The father-centered kangaroo nursing after cesarean section can improve postpartum paternal role adaptation and subjective well-being of first-time fathers. There is a positive correlation between the subjective well-being and the paternal role adaptation level.

Objective:To observe the effect of personalized nutritional support on postoperative rehabilitation and nutritional status in patients undergoing radical mastectomy and reconstruction of oral malignant tumor.Methods:Eighty-eight patients with oral malignant tumor admitted from January 2018 to December 2018 in Hospital of Stomatology, Sun Yat-sen University were divided into two groups according to the time of admission. 40 patients were selected as the study group and 48 patients were selected as the routine group. The routine group was given traditional health education and dietary guidance. In addition to dietary guidance, the study group was given personalized nutritional support according to the patients' body mass index and nutritional status before and after operation, including oral nutritional supplement before operation, personalized nutritional prescription after operation, and increased protein intake according to the nutritional indicators of the patients. The nutritional status, enteral nutrition complications and postoperative rehabilitation were compared between the two groups two weeks after operation.Results:Two weeks after operation, the hemoglobin, total protein, prealbumin were (107.93±16.19) g/L, (68.40±4.87) g/L, (189.02±55.19) mg/L in the study group, and (101.23±14.62) g/L, (63.11±6.42) g/L, (165.75±40.60) mg/L in the routine group, there were significant differences ( t values were -2.037, -4.271, -2.276, all P<0.05). The incidence of malnutrition, wound infection and gastrointestinal complications were 42.50%(17/40), 0, 5.00%(2/40) in the study group and 64.58%(31/48), 16.67%(8/48), 20.83%(10/48) in the control group, there were significant differences( χ2 values were 4.292, 7.333, 4.644, P<0.05). Conclusions:Perioperative personalized nutritional support can effectively improve the nutritional status, reduce enteral nutrition-related complications, improve immunity and reduce the risk of incision infection in patients undergoing radical mastectomy and simultaneous reconstruction of oral malignant tumors, which is helpful to improve the quality of life of patients and is worthy of clinical reference.

Objective To evaluate the diagnostic efficacy of Kwak and ACR( 2017 ) thyroid imaging reporting and data systems ( T I‐RADS ) for thyroid nodules . Methods Cases of thyroid nodule who underwent surgery from January 2015 to M arch 2018 in 15 hospitals in Sichuan province were collected and the ultrasonographic features of thyroid nodules were retrospectively analyzed by trained senior ultrasound physicians using Kwak and ACR T I‐RADS classification methods . Totally ,12 712 thyroid nodules were observed ,7 023 thyroid nodules in 7 023 cases with complete ultrasound and surgical and pathological data were eventually enrolled in the study . T hyroid nodules with solid ,hypoechoic or very hypoechoic ,tall/wide ratio ≥ 1 , margin ill‐defined and microcalcification were classified as malignant signs of ultrasound . M alignant percentage was calculated and diagnostic tests were performed . Results ① T here was a statistical difference between the benign and malignant nodules in the two types of T I‐RADS classification ( P＜0 .01) . ② T he area under ROC curve of Kwak and ACR in the diagnosis of malignant nodules were 0 .89 and 0 .84 ,respectively . T he Youden index of Kwak and ACR were 0 .66 and 0 .57 ,respectively . ③Taking Kwak T I4B and ACR T R4 as critical points for malignancy ,the sensitivity ,specificity ,positive predictive value and negative predictive value of Kwak T I 4B were 75 .0% ,90 .9% ,83 .2% ,and 85 .9% , respectively . T he accuracy of Kwak T I4B was 84 .9% ; T he sensitivity ,specificity ,positive predictive value and negative predictive value of ACR T R4 were 88 .2% ,68 .9% ,62 .9% ,and 90 .8% ,respectively . T he accuracy of ACR T R4 was 76 .2% . T he Kappa value of Kwak TI4B and ACR T R4 was 0 .52 . T he χ2 value of Kwak T I4B and ACR T R4 was 2 174 .6 ( P ＜ 0 .01 ) . Conclusions T he diagnostic values of two T I‐RADS classification methods for thyroid malignant nodules are high . T he overall efficiency of Kwak T I‐RADS classification method is better than that of ACR TI‐RADS classification method .

ObjectiveTo elucidate the mechanism of Osteoking against fracture， femoral head necrosis， osteoarthritis， and lumbar disc herniation by integrating heterogeneous information network mining and experimental validation. MethodOn the basis of the disease-related database and transcriptome expression profiling dataset， as well as the ETCM database， the gene sets related to four target diseases and the candidate target spectrum of Osteoking were obtained through the integration and analysis of bioinformatics data， and a "disease-syndrome-formula-target-pathway-effect" heterogeneous information network was constructed. In addition， by functional enrichment analysis， the core targets of Osteoking in interfering with the imbalance network of four kinds of bone injury diseases， the biological pathways involved， and the corresponding clinical symptoms were screened， and they were verified in animal experiments. ResultHeterogeneous information network mining indicates that Osteoking may commonly reverse the imbalance networks of fracture， femoral head necrosis， osteoarthritis， and lumbar disc herniation via regulating cell function and activity， inhibiting inflammatory response， reducing bone destruction， and improving the immune function of the body by modulating relevant core candidate targets such as RAC-alpha serine/threonine-protein kinase （Akt1）， catenin beta-1 （CTNNB1）， epidermal growth factor receptor （EGFR）， heat shock protein 90-alpha （HSP90AA1）， and phosphatidylinositol 3-kinase catalytic subunit alpha isoform （PI3KCA）， as well as related biological pathways such as phosphatidylinositide 3-kinases/protein kinase B （PI3K/Akt）， janus kinase/signal transducer and activator of transcription （JAK/STAT）， tumor necrosis factor （TNF）， nuclear factor kappa-B （NF-κB）， and Toll-like receptors. In particular， Osteoking may improve the blood supply of the fracture end by regulating blood circulation at the target site of the disease， and it may maintain the balance of bone metabolism by regulating hormone-related pathways to promote fracture healing. In addition， Osteoking may relieve lipid metabolism disorders by targeting and regulating lipid-related pathways， accelerate bone formation and bone repair， and delay the progression of femoral head necrosis. Osteoking may relieve the symptoms of pain by acting on neurological pathways to reduce local nociceptive stimulation in patients with osteoarthritis and lumbar disc herniation. Further experimental validation demonstrates that the PI3K/Akt signaling pathway is the most significantly enriched pathway for the key network targets of Osteoking for the four diseases. The candidate target of Osteoking may have the strongest association with the network of fracture-related genes. Therefore， this study chooses fracture as the target disease to verify the efficacy of Osteoking. The results show that Osteoking can accelerate bone formation and promote fracture healing by inhibiting the activation of the PI3K/Akt signaling axis. ConclusionThe study shows that the main mechanism of "treating different diseases with an identical treatment" of four bone injury diseases with Osteoking involves cell function regulation and immune inflammation-related signaling pathways. Further experimental validation identifies that the PI3K/Akt signaling axis may be one of the key pathways of Osteoking to promote bone regeneration， bone reconstruction， and bone metabolism homeostasis.

ObjectiveTo investigate the clinical efficacy and mechanisms of Osteoking in the treatment of knee osteoarthritis （KOA） in real-world practice， so as to provide a basis for the rational clinical use of Osteoking. MethodFrom the Osteoking for knee osteoarthritis case registration system， 638 KOA cases treated with Osteoking were selected and analyzed in SPSS 26.0. The clinical data were collected from 20 hospitals in China from May 2020 to December 2021. Descriptive analyses of patient age， gender， body mass index， course of treatment and other parameters were performed. The Mann-Whitney U test was performed to compare the visual analogue scale （VAS） and Western Ontario and McMaster universities arthritis index （WOMAC） scores before and after treatment. The integrative pharmacology-based research platform of traditional Chinese medicine （TCMIP） v2.0 was used for network analysis of the core targets of Osteoking in treating knee osteoarthritis. Furthermore， 20 KOA patients treated with Osteoking in the Third Affiliated Hospital of Beijing University of Chinese Medicine from October to December in 2022 were enrolled in the treatment group， and 20 healthy volunteers in the control group. The enzyme-linked immunosorbent assay was employed to measure the serum levels of related indicators to verify the prediction results. ResultA total of 638 KOA patients were treated with Osteoking， including 429 （67.24%） receiving Osteoking alone and 209 （32.76%） receiving Osteoking combined with other therapies. The female patients （415， 65.05%） were more than the male patients （223， 34.95%）. The patients showed the mean age of （63.48±13.51） years， mean body mass index of （24.09±2.98） kg·m^-2， and mean course of treatment of （15.78±9.66） days. Most of the patients were rated as grades Ⅱ （46.24%） and Ⅲ （34.64%） in Kellgren-Lawrence （K-L） grading and in the relief stage （82.45%） in clinical staging. There was no significant correlation between clinical staging and K-L grading results. The cluster analysis identified three TCM syndromes： Qi stagnation and blood stasis， cold-dampness obstruction， and liver-kidney deficiency. The overall clinical efficacy evaluation showed that VAS score decreased from （6.01±0.85） scores before treatment to （2.54±1.73） scores after treatment （P<0.05）， and the WOMAC score decreased from （93.25±25.91） scores before treatment to （50.73±25.14） scores after treatment （P<0.05）. The network analysis predicted that Osteoking might regulate the transforming growth factor-beta （TGF-β）， tumor necrosis factor-alpha （TNF-α）， and nuclear factor-kappa B （NF-κB） signaling pathways to exert the therapeutic effect. The clinical trial showed elevated TGF-β₁ level （P<0.01） and lowered NF-κB subunit RELA and tumor necrosis factor receptor superfamily， member 1A （TNFRSF1A） levels （P<0.05） after treatment. The synergistic effects of these changes provide a multidimensional and comprehensive therapeutic efficacy for KOA， alleviating the joint pain and limited mobility in patients. ConclusionOsteoking showed significant therapeutic efficacy in treating KOA. Osteoking may act on multiple pathways involved in cartilage metabolism and inflammation. The findings provide experimental evidence and theoretical support for elucidating the multi-target mechanism of Osteoking in treating KOA.

ObjectiveTo systematically evaluate the safety of Chinese medicines combined with Tripterygium wilfordii polyglycoside tablets/Tripterygium wilfordii tablets （TWPT/TWT） in the treatment of rheumatoid arthritis （RA）， and to explore the network regulatory mechanisms of enhancing efficacy and reducing toxicity of commonly used combination regimes. MethodThe literature involving the adverse reactions of TWPT/TWT in treating RA was searched and collected from three Chinese databases （CNKI， Wanfang Data， VIP） and three English databases （PubMed， Cochrane Library， Embase） from the inception of the databases to July 2021. All studies were assessed by the Cochrane risk of bias tool， and the data were extracted and analyzed by Stata 15.0. Furthermore， Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine 2.0 （TCMIP v2.0，http：//www.tcmip.cn/） was used to construct a "drug target-symptom gene of efficacy and toxicity" interaction network， to explore the underlying network regulatory mechanisms of enhancing efficacy and reducing toxicity of common T. wilfordii preparation combinations. ResultA total of 2 132 articles on Chinese medicines combined with TWPT/TWT in the treatment of RA were retrieved， and 18 of them were finally included. The systematic review showed that the adverse reactions of TWPT/TWT against RA mainly occurred in the digestive system， blood system， and reproductive system， of which digestive system had the highest incidence of damages. However， the combination with Chinese medicines effectively alleviated the adverse reactions caused by TWPT/TWT ［RR （95% CI）=0.45 （0.30， 0.66）， P<0.01］. In addition， the subgroup analysis indicated that the age of RA patients， course of disease， combination regimen， medication dosage and duration of treatment all affected the occurrence of adverse reactions of TWPT/TWT. It was found in clinical studies that total glucosides of paeony （TGP） and TWPT/TWT was most widely combined， and the effect of TGP in reducing TWPT/TWT-induced hepatotoxicity was also more significant than that of other Chinese medicines. Moreover， taking this combination regime as an example， this paper explored the "efficacy-toxicity" association mechanisms of TGP-TWPT/TWT against RA. The "drug target-symptom gene of efficacy and toxicity" interaction network revealed that the core network targets of TGP-TWPT/TWT enhanced efficacy and reduced toxicity mainly through regulating immunity-inflammation-related pathways， metabolic pathways and cell signal transduction. Especially， interleukin-4 （IL-4） and interleukin-13 （IL-13）， which were involved in the "immunity-inflammation" module， were the common targets of TGP-TWPT/TWT to enhance efficacy and reduce toxicity. The endogenous sterols， bile acids and bile salts， insulin secretion and other metabolic pathways in the "body metabolism" module were closely associated with the mechanisms of TWPT/TWT inducing hepatotoxicity and TGP reducing hepatotoxicity. While cell function regulation pathways， such as stem cell factor （SCF）/tyrosine kinase receptor （KIT） signaling pathway and phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）signaling pathway were involved in both anti-RA effects and hepatotoxicity of TWPT/TWT. ConclusionClinical application of suitable Chinese medicines combined with TWPT/TWT in the treatment of RA can effectively improve the rheumatism and reduce the adverse reactions of TWPT/TWT， and TGP-TWPT/TWT has the most significant toxicity-reducing effect. Further biological network-based investigation indicates that the toxicity-reducing mechanism of TGP-TWPT/TWT may be related to the regulation of interleukin signaling pathway and bile acid metabolism pathway， and the synergistic efficacy-enhancing effect of the combination may be achieved by acting on interleukin signaling pathway and cell function regulation pathway.

ObjectiveTo explore the "efficacy-toxicity" association mechanisms of Tripterygium wilfordii polyglycoside tablets （TWPT） by establishing and analyzing an interaction network associated with the clinical efficacy of TWPT in the treatment of rheumatoid arthritis （RA） and TWPT-induced liver injury. MethodOn the basis of the TWPT efficacy-related gene expression profile and TWPT-induced liver injury-related protein expression profile which were both obtained from our clinical cohorts， the "efficacy-toxicity" association network of TWPT was constructed， and the key network targets were identified by calculating the topological values of the nodes， including the degree， closeness and betweenness. After that， the biological functions and pathways of the key network targets were investigated by enrichment analysis. ResultA total of 119 differentially expressed genes （58 up-regulated and 61 down-regulated） between RA patients with TWPT well and weak response were identified as TWPT efficacy-related genes by clinical transcriptomics， and 49 differentially expressed proteins （36 up-regulated and 13 down-regulated） were demonstrated to be TWPT-induced liver injury-related proteins by clinical proteomics. In addition， the clinical symptom enrichment analysis indicated that the TWPT efficacy-related genes were significantly associated with various clinical symptoms of arthralgia in traditional Chinese medicine and clinical phenotypes of modern medicine， and most of the TWPT-induced liver injury-related proteins were involved in digestive system abnormalities. Therefore， the aforementioned multi-omics data represented the main clinical symptoms of TWPT treating RA and inducing liver injury. Mechanically， the "efficacy-toxicity" association network revealed that both TWPT efficacy-related genes and TWPT-induced liver injury-related core proteins were involved in the "immune-inflammatory" imbalance， especially playing an important role in neutrophil degranulation， complement cascade reaction， and immune-inflammatory response mediated by protein post-translational modification. Notably， the above genes and proteins were also enriched in various signaling pathways related to cell proliferation and cell cycle regulation， such as RAS and mitogen-activated protein kinase （MAPK） signaling pathway， and in several liver functional processes， such as glycogen metabolism and redox reaction. ConclusionThis study systematically explained the "efficacy-toxicity" association characteristics and molecular mechanisms of TWPT by applying a research strategy integrating clinical phenomics， transcriptomics and proteomics， laying a good data foundation for exploring the "efficacy enhancing and toxicity-reducing" mechanisms of TWPT.