Objective:To explore the application and nursing of chest radiograph combined with body surface measurement in measuring the length of PICC intubation in tumor patients.Methods:Totally 60 cases of malignant tumor patients in our hospital from March 2019 to January 2020 were selected and randomly divided into two groups by the method of random number table. 30 cases in the control group were given PICC catheterization by conventional body surface measurement; 30 cases in the observation group were given PICC catheterization combined with chest imaging data. After the intervention, the precise position of PICC catheter, indwelling time, complications, nursing satisfaction rate and quality of life were compared between the two groups.Results:After the intervention, the accurate placement rate, adjustment ratio and indwelling time of the observation group were 100.00% (30/30), 0, (146.35±21.74) d, which were significantly better than 83.33% (25/30), 16.67% (5/30) and (118.44±17.36) d of the control group, the difference was statistically significant ( tvalue was 5.495, χ 2values were 4.286, 5.455, all P<0.05); after intervention the complication rate, nursing satisfaction rate, and quality of life score in the observation group were 3.33% (1/30), 99.67% (29/30), (91.35±8.58) points, which were significantly better than the control group's 26.67% (8/30), 80.00% (24/30), (83.57±7.36) points, the difference was statistically significant ( χ 2values were 6.405, 4.043, tvalue was 3.775, P<0.05 or 0.01). Conclusion:Chest imaging data combined with body surface measurement methods combined with comprehensive care can significantly improve the accuracy of PICC catheter placement in cancer patients, reduce catheter adjustment and the deviation of actual length from the ideal length, extend the indwelling time, reduce complications, and improve patients Care satisfaction rate and quality of life.

Objective To establish an universal primer-multiplex PCR system for diagnosis of Y chromosome AZF region microdeletions in 262 patients with non-obstructive azoospermic and severe oligozoospermic male infertility. Methods In each panel of multiplex PCR, YUP and YCP containing a fragment of non-human DNA sequence at their 5' ends were designed. The universal primers and chimiric primers were employed for the amplification at the same multiplex PCR system to screen for the Y chromosome AZF region ( a, b and c) microdeletions in 262 non-obstructive azoospermic and severe oligozoospermic male infertility patients. Results Thirty-three out of 262 patients (12. 60% ) were detected with Y chromosome AZF microdeletions. Among them, 27 cases were AZF c microdeletions and 6 ones were AZF b + c microdeletions. These results were in agreement with the results from EMQN method. There was no false-positivity. The gel electrophoresis for detection of multiple STS from both methods showed that the sY84,sY86, sY127, sY134, sY254, sY255, SRY bands were homogeneous and clear with similar brightness. Conclusion The modified multiplex PCR is suitable for screening of Y chromosome AZF microdeletions in non-obstructive azoospermic and severe digozoospermic male infertility patients.

Purpose To study the levels and subcellular localization of β-catenin in 5 different molecular subtypes of breast carcino-mas. Methods An immunohistochemical study was undertaken for measuring the levels and subcellular localization ofβ-catenin in 58 breast carcinomas. Results ( 1 ) The cytoplasmic expression of β-catenin was 21. 1%, 50%, 60%, 100% and 60% ( TNBC 84. 6%) in Lumina A, Lumina B, HER-2-OE, basal-like breast carcinoma ( BLBC) and uncl phenotype respectively. High cytoplas-mic expression was associated with the BLBC and TNBC subtypes ( P<0. 05 ) . ( 2 ) An association was identified between high cyto-plasmic expression of β-catenin, and high tumor grade (P<0. 01), abnormal E-cadherin, positive Ki-67 and CK5/6 (P<0. 05), negative ER and PR (P<0. 01), but no association was observed for lymph node metastasis, tumor size and patients’age. Conclu-sion An association is identified between high cytoplasmic expression, and high tumor grade, positive Ki-67 and CK5/6, negative ER and PR, that means a high cytoplasmic expression ofβ-catenin is associated with an adverse outcome in breast cancer. High cytoplas-mic expression are associated with the BLBC and TNBC subtypes whcih recognizing Wnt signaling as a rational target in TNBC and BLBC. The results of the study have implications for therapeutic target identification and the design of future clinical trials for TNBC and BLBC.

Many species of the genus Asarum plants are used as Chinese traditional or folk medicines, in Chinese which are known as "Xixin" (Asari Radix et Rhizoma) , "Bei-Xixin" , "Hua-Xixin" and "Nan-Xixin" , etc. In order to get a clear picture of resources distribution and varieties on Chinese markets of the crude drug Xixin and provide scientific basis for their resource conservation and sustainable use, during recent years we conducted field investigations and market researches many times. The results showed that the resources of both official Xixins and non-official Xixins were decreased because of the ecological environment damage and over-digging, especially species whose population size was small. Bei-Xixin derived from A. heterotropoides var. mandshuricum was the most species on the Chinese markets except for a few areas of China. Hua-Xixin derived from A. sieboldii and non-official Xixins were mainly used in their producing areas. Cultivation of Hua-Xixin should be greatly developed, and wild resources of non-official species must be preserved strictly.
China ; Conservation of Natural Resources ; Data Collection ; Drugs, Chinese Herbal ; classification ; standards ; supply & distribution ; Quality Control

OBJECTIVETo explore the effects of the method of soothing the liver and regulating qi on expression of gastrin and somatostatin in hypothalamus and gastric antrum of functional dyspepsia model rats.

METHODThe 32 rats were randomly divided into normal group, model group, Chaihu Shugansan group and domperidone group (n = 8). The functional dyspepsia model was established by constantly squeezing their tails and mean while saline, Chaihu Shugansan decoction and domperidone suspension were administered respectively to 4 groups by gavage. The expression of gastrin and somatostatin in hypothalamus and gastric antrum of rats by immunohistochemical were detected 3 weeks later.

RESULTThe expression of GAS in the hypothalamus and gastric antrum of model group were less than those of normal group (P < 0.05, P < 0.01), while the expression of SS in the hypothalamus and gastric antrum in Model group were significantly increased than those of normal group (P < 0.01). The expression of GAS and SS in gastric antrum of Chaihu Shugansan group and domperidone group were increased and decreased respectively, and the differences were significant (P < 0.05, P < 0.01). There were no obvious difference about expression of GAS, SS in the hypothalamus between domperidone group and model group. GAS expression in hypothalamus of Chaihu Shugansan group were increased than those of normal group but there was no obvious difference in SS expression in hypothalamus between Chaihu Shugansan group and model group.

CONCLUSIONThe method of soothing the liver and regulating qi can increase GAS expression in central and peripheral and decrease SS expression in peripheral gastric antrum, which may be one of its therapeutic mechanisms on functional dyspepsia.

Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; therapeutic use ; Dyspepsia ; drug therapy ; genetics ; metabolism ; Female ; Gastrins ; genetics ; metabolism ; Gene Expression Regulation ; drug effects ; Humans ; Hypothalamus ; drug effects ; metabolism ; Liver ; drug effects ; physiopathology ; Pyloric Antrum ; drug effects ; metabolism ; Qi ; Random Allocation ; Rats ; Rats, Wistar ; Somatostatin ; genetics ; metabolism

Objective To investigate the association of proton pump inhibitors(PPIs)use with short-term and long-term mortality risk in patients with severe ischemic stroke.Methods This retrospective study based on the U.S.Medical Information Mark for Intensive Care Ⅲ(MIMIC-Ⅲ)database,ICU patients aged ≥18 years with the first ICU admission and a diagnosis of ischemic stroke were finally included in the study.All enrolled subjects were divided into PPIs group and non-PPIs group according to whether they had used PPIs(pantoprazole,lansoprazole and omeprazole)during hospitalization.Kaplan-Meier survival analyses and Cox regression models were used to analyze the association between the use of PPIs and the risk of ICU death,30 d risk of death,90 d risk of death in patients with severe ischemic stroke.Results A total of 1 015 patients were included,402 cases in the PPIs group and 613 in the non-PPIs group.The ICU-mortality,30 d and 90 d mortality were 15.37％,13.60％and 20.10％,respectively.Kaplan-Meier survival analyses illustrated that the PPIs group survived better than non-PPIs group in ICU mortality analysis(P=0.002).In Cox regression analysis,after adjustment for potential confounders,the hazard ratio(HR)for ICU mortality in the PPIs group relative to the non-PPIs group was 0.671 9(95％CI 0.478 8 to 0.942 8,P=0.021),but there was no significant difference between 30 d and 90 d mortality(P＞0.05).Conclusion In patients with severe ischemic stroke,the use of PPIs may be effective in reducing the risk of ICU death,but does not improve 30 d and 90 d risk of death in patients.

Needle-embedding therapy is characterized by shallow puncture and long retention of needle, which can reduce the pain during acupuncture and prolong the time of acupuncture effect to improve the effect, especially suitable for perioperative patients. The study shows that the clinical application of needle-embedding therapy has the effects of sedation, analgesia, reducing stress response, protecting gastrointestinal function and promoting postoperative recovery. The paper shows the advantages of traditional Chinese medicine (TCM) treatment in the field of rapid recovery during perioperative period and provides a new method for perioperative patients.

Objective To establish an early prediction model for the diagnosis of severe acute pancreatitis based on the improved machine learning models,and to analyze its clinical value.Methods A case-control study was conducted on 352 patients with acute pancreatitis admitted to the Gastroenterology and Hepatobiliary Surgery Departments of the Army Medical Center of PLA and Emergency and Critical Care Medicine Department of No.945 Hospital of Joint Logistics Support Force of PLA from January 2014 to August 2023.According to the severity of the disease,the patients were divided into the severe group(n=88)and the non-severe group(n=264).The RUSBoost model and improved Archimead optimization algorithm was used to analyze 39 routine laboratory biochemical indicators within 48 h after admission to construct an early diagnosis and prediction model for severe acute pancreatitis.The task of feature screening and hyperparameter optimization was completed simultaneously.The ReliefF algorithm feature importance rank and multivariate logistic analysis were used to analyze the value of the selected features.Results In the training set,the area under curve(AUC)of the improved machine learning model was 0.922.In the testing set,the AUC of the improved machine learning model reached 0.888.The 4 key features of predicting severe acute pancreatitis based on the improved Archimedes optimization algorithm were C-reactive protein,blood chlorine,blood magnesium and fibrinogen level,which were consistent with the results of ReliefF algorithm feature importance ranking and multivariate logistic analysis.Conclusion The application of improved machine learning model analyzing the laboratory examination results can help to early predict the occurrence of severe acute pancreatitis.

OBJECTIVETo explore the effect of Biejiajian Oral Liquid (, BOL) on CCl-induced hepatic fibrosis in rats by detecting the changes in the levels of angiotensin II (Ang II), angiotensin-(1-7) [Ang-(1-7)], angiotensin-converting enzyme (ACE), ACE2, angiotensin II type 1 receptor (AT1R), Mas, etc. METHODS: A total of 180 Wistar rats were randomly divided into two groups by random digital table method: prevention experiment and treatment experiment. Each group was further subdivided into the following 6 subgroups: normal control group, model group, vitamin E [100 mg/(kg·d), VE] group, enalapril [10 mg/(kg·g), Ena] group, high-dosage [20 g/(kg·d)] BOL group, and low-dosage [10 g/(kg·d)] BOL group. The hepatic fibrosis rat model was established by subcutaneous injection of CCl for 6 weeks. Prevention experiment and treatment experiment were administered with specific drugs at different times. At the end of treatment experiment, the pathological changes of liver were observed after hematoxylin-eosin staining. The expressions of ingredients in renin-angiotensin-aldosterone system (RAAS) such as AngII, Ang-(1-7), ACE, ACE2, AT1R, Mas, renin, CYP11B2 and angen in liver were detected by enzyme linked immunosorbent assay, immunohistochemistry method or reverse transcription-polymerase chain reaction, respectively.

RESULTSThe levels of AngII and Ang-(1-7) at the 6th week increased by 496.10% and 73.64%, respectively, compared with those at the 2nd week in the model group (P<0.01). With prevention or treatment with high-dosage BOL, there was an evident reduction of AngII level but an improvement of Ang-(1-7) level. Specifically, AngII level of high-dosage group decreased by 77.50% in prevention experiment (P=0.000) and by 76.93% in treatment experiment (P=0.002) compared with that in the model group. Ang-(1-7) level increased by 91.69% in prevention experiment (P=0.006) and by 70.77% in the treatment experiment (P=0.010) compared with that in the model group. The expression levels of mRNA of renin, ACE, CYP11B2, angen and AT1R decreased by 58.15%, 99.90%, 99.84%, 99.99% and 99.99% (all P<0.01), respectively.

CONCLUSIONSBOL could help resist liver fibrosis in rats by enhancing the level of each ingredient in ACE2-Ang-(1-7)-Mas axis, while decreasing the level of each ingredient in ACE-AngII-AT1R axis. To some extent, BOL could enhance the regulation of RAAS in rats with CCl-induced hepatic fibrosis.

Blast injury of the chest injury is the most common wound in modern war trauma and terrorist attacks, and is also the most fatal type of whole body explosion injury. Most patients with severe blast injury of the chest die in the early stage before hospitalization or during transportation, so first aid is critically important. At present, there exist widespread problems such as non-standard treatment and large difference in curative effect, while there lacks clinical treatment standards for blast injury of the chest. According to the principles of scientificity, practicality and advancement, the Trauma Society of Chinese Medical Association has formulated the guidance of classification, pre-hospital first aid, in-hospital treatment and major injury management strategies for blast injury of the chest, aiming to provide reference for clinical diagnosis and treatment.