Objective]The article summarizes the H-hypertension's clinical experience by professor He Jia. [Methods]From following professor He Jia clinical studies, summarize professor He Jia from different ages, the treatment by applying the method of tonifying qi by stasis H-hypertension qi deficiency blood stasis syndrome differentiation thinking and clinical experience, and for proven cases.[Result]The professor He Jia considers the method of Buqi Zhuyu as the basic therapeutic principle, with pathogenesis of qi deficiency and blood stasis in the collaterals. And also to make up for points and syndromes differentiation from youthes and older, in the young and middle-aged people and see blood stasis into collaterals, the treatment of blood stasis by the main,the old people see more Qi deficiency into the network, to make up for the deficiency of Qi.Her clinical medicine is characterized in paying equal attention to the Qi and blood, Buqi Zhuyu, using opportunely insect medicine,Soufeng Tongluo,using the mineral medicine, Ziyin Qianyang along with the disease change, with good effect.[Conclusion]Professor He Jia for H-hypertension treatment of qi deficiency blood stasis unique insights, obtains good effect, often with fellow mutual information.

Objective To observe the changes of the peripheral blood T helper (Th)17 cells/regulatory T cells (Treg) ratio in patients with anti‐tuberculosis drug‐induced liver injury ,and to explore the relationship between Th17/Treg ratio and liver function . Methods Ninety inpatients with the diagnosis of secondary pulmonary tuberculosis (TB) from Affiliated Hospital of Zunyi Medical College from Feb .2013 to Mar .2015 were included in this study .All these patients had normal base line liver function .After 2 weeks of anti‐TB chemotherapy ,21 patients with alanine transaminase (ALT) and/or aspartate aminotransferase (AST) ≥2 × upper limit of normal (ULN) were defined as TB with liver injure group ,the other 69 patients with ALT and/or AST<2 × ULN were defined as TB with non‐liver injured group .Before treatment and two weeks after anti‐TB therapy ,the peripheral blood Th17/Treg ratios and liver functions of all patients in both groups were detected in order to compare the changes of Th17/Treg ratios pre and post anti‐TB chemotherapy and to explore the relationship between Th17/Treg ratio and ALT/AST levels .Student′s t test was used for statistical analysis ,and Pearson correlation analysis was used for correlation test .Results Before treatment ,there was no statistical significance of Th17 ,Treg and Th17/Treg ratio between groups (P> 0 .05) .The Th17 levels in TB with liver injured group ([2 .522 ± 0 .388]/mL vs [2 .075 ± 0 .369]/mL ,t=3 .633 ,P<0 .01) and TB with non‐liver injured group ([2 .326 ± 0 .348]/mL vs [1 .929 ± 0 .402]/mL ,t= 6 .468 , P< 0 .01) ,and Th17/Treg ratios in both groups(0.618±0.104vs0.489±0.107,t=3.553,P<0.01 ;0.554±0.108vs0.450±0.098,t=6 .353 ,P<0 .01) were all increased after anti‐TB chemotherapy ,with statistically significant differences . However ,there was no statistical significance of Treg levels pre and post anti‐treatment in both groups (both P>0 .05) .The Th17 level and Th17/Treg ratio in TB with liver injured group were significantly higher than those in TB with non‐liver injured group (t= 2 .203 , P< 0 .05 and t= 2 .345 , P< 0 .05 , respectively) .In liver injured group ,the Th17/Treg ratio was positively correlated with ALT level (r=0 .849 ,P=0 .044) ,but not with AST level (P>0 .05) .Conclusion The changes of Th17/Treg ratio are related with anti‐TB drug‐induced liver injury in patients with secondary pulmonary tuberculosis .

Objective To investigate the expression of T helper type 17 cells (Th17) and cell‐related cytokines ,including interleukin (IL)‐21 ,IL‐22 ,IL‐23 in the peripheral blood of different clinical stages of patients with acute hepatitis B (AHB) .Methods Ten cases of AHB patients were enrolled .The frequency of Th17 cells in the three clinical stages (i .e .acute phase ,convalescent phase and resolved phase) were detected by flow cytometry . IL‐21 , IL‐22 and IL‐23 were measured by enzyme‐linked immunosorbent assay (ELISA) .Control group was composed of ten healthy subjects .The comparison between the two groups was done by t test and the differences among multiple groups were compared by one way ANOVA .Pearson correlation analysis was used for correlation analysis .Results The frequency of Th17 in healthy controls was (0 .68 ± 0 .29)% ,while those in acute phase ,convalescent phase and resolved phase of AHB patients were (18 .22 ± 4 .13)% , (3 .14 ± 1 .90 )% and (3 .31 ± 0 .95 )% , The differences between the two groups were significant (t= 13 .405 ,4 .047 and 8 .342 , respectively ;all P< 0 .01) .The levels of IL‐21 ,IL‐22 and IL‐23 in healthy controls were (42 .00 ± 6 .95) ,(315 .89 ± 96 .16) and (11 .95 ± 6 .95) ng/L ,respectively .Those in acute phase of AHB patients were (575 .39 ± 47 .01) ,(648 .44 ± 47 .12) and (38 .29 ± 4 .68) ng/L ,respectively ,those in convalescent phase were (366 .50 ± 33 .74) ,(405 .04 ± 47 .12) and (25 .10 ± 4 .69) ng/L ,respectively ,while those in resolved phase of AHB patients were (46 .62 ± 8 .28) ,(365 .94 ± 45 .62) and (15 .29 ± 4 .69) ng/L , respectively .Compared with healthy controls ,t values of the levels of IL‐21 in three different phases of AHB patients were 35 .497 ,29 .792 and 1 .354 with P value of <0 .01 ,<0 .01 and 0 .193 ,respectively ;those of IL‐22 were 9 .820 ,2 .632 and 1 .487 with P value of < 0 .01 ,0 .021 and 0 .161 ,respectively ;those of IL‐23 were 9 .944 ,4 .961 and 1 .260 with P values of <0 .01 ,<0 .01 and 0 .226 ,respectively . After comparison of IL‐21 ,IL‐22 and IL‐23 among three different phase of AHB ,F values were 622 .784 , 107 .772 and 60 .743 with all P values less than 0 .01 ,respectively .The levels of IL‐21 ,IL‐22 and IL‐23 were all positively correlated with the serum ALT level in acute phase (r= 0 .655 ,0 .666 and 0 .673 , respectively ;all P<0 .05) .Correlation analysis demonstrated that the frequency of Th17 was positively correlated with the levels of IL‐21 , IL‐22 and IL‐23 in acute phase ( r= 0 .879 ,0 .866 and 0 .879 , respectively ;all P<0 .01) .The frequency of Th17 was positively correlated with the level of IL‐21 in the resolved phase . No correlations between the remaining groups were confirmed . Conclusion The expressions of Th17 and cell‐related cytokines ,including IL‐21 ,IL‐22 and IL‐23 decline with the recovery of A HB .

Objective To investigate the effect of curcumin on the expression of heat shock protein 70 (HSP70) in the hippocampus and spatial learning ability in APPswe/PS1△9 transgenic mice,and provide a new theoretical basis for the treatment of Alzheimer' s disease (AD).Methods Mice were divided into wild-type (WT) group,APP/PS1 transgenic group,curcumin-treated group,quercetin combined with curcumin-treated group.The 5-month-old mice in curcumin-treated group received 150 mg · kg-1 · d-1 curcumin by intraperitoneal injection for four consecutive weeks.In addition to curcumin,the mice in quercetin combined with curcumin-treated group also received quercetin 50 mg· kg-1 · d-1 intraperitoneally for four consecutive weeks.The expression of HSP70 in the hippocampus of APP/PS1 mice was detected by Western blot.Learning and memory ability of APP/ PS1 mice were measured by Morris water maze test.The latency of finding the platforms and the number of crossing the platforms were observed.Results The results of Western blot analyses showed that the expression of HSP70 in the hippocampus of APP/PS1 transgenic mice decreased significantly compared with that of WT mice (OD:APPswe/PS1△9:0.31±0.14;WT:1.14±0.51;P＜0.01).The expression of HSP70 in curcumin-treated group significantly increased compared with that of APP/PS1 transgenic group (OD:0.91±0.20 in curcumin-treated group;P＜0.05).The results of water maze test showed that compared with WT group,in APP/PS1 group,the latency of finding the platforms was significantly longer (APPswe/PS 1 △9:(82.3 ± 6.8) s;WT:(19.5±4.4) s),and the number of crossing tbe platforms were significantly decreased (APPswe/PS1 △9:(2.7± 1.1);WT:(5.2± 2.1)).In curcumin-treated group,the latency of finding the platform ((47.7±7.6) s) was significantly shorter and the number of crossing platform ((4.5±1.9) s) was more than those in APP/ PS1 group.However,in quercetin combined with curcumin-treated group,the latency of finding the platform was significantly longer ((69.7±9.1) s) and the number of crossing platform (3.2±1.6) was decreased compared with those in curcumin-treated group.Conclusion Curcumin can promote the expression of HSP70 in the hippocampus of APP/PS1 transgenic mice,thus improve spatial learning ability of APP/PS1 transgenic mice.These results provide evidences that curcumin may have potential therapeutic value for the treatment of AD.

Objective: To investigate the clinical effect of entecavir combined with pegylated interferons in the patients with hepatitis B.Methods: Totally 72 patients with hepatitis B were randomly divided into the experimental group and the control group with 36 ones in each.The patients in the experimental group were treated with entecavir combined with pegylated interferons, and those in the control group were treated with entecavir.The clinical indicators in the two groups were detected and compared after the 24-week, 48-week and 6-month treatment.The adverse drug reactions in the two groups were recorded and compared.Results: After the 24-week treatment, the differences in the clinical indicators between the groups were not statistically significant (P >0.05).After the 48-week and 6-month treatment, the clinical indicators in the experimental group were obviously higher than those in the control group, and the differences were statistically significant (P <0.05).The difference in the adverse drug reactions in the two groups was not statistically significant (P >0.05).Conclusion: Compared with entecavir, pegylated interferon combined with entecavir in the treatment of hepatitis B shows better clinical effect and security, which is more worthy of clinical promotion.

Objective:To investigate the differences in efficacy, survival outcomes, and acute and late toxicities for patients with local/regional advanced nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT) in combination with che-motherapy (CT) and by IMRT alone. Methods:A total of 72 newly diagnosed local/regional advanced NPC patients were randomly subjected to IMRT/RT+adjuvant CT (after radiotherapy, RT) (n=42) or IMRT+adjuvant CT (after RT) (n=30). The Kaplan-Meier meth-od was used to analyze the two-year local/regional control rates, distant metastasis-free survivals, and overall survivals. The acute and late radiation toxicities were evaluated based on the toxicity criteria of the Radiation Therapy Oncology Group and European Organiza-tion for Research and Treatment of Cancer. Results:A median follow up period of 13.5 months was included in the study. The one-year and two-year local/regional control rates, distant metastasis-free survivals, and overall survival in the IMRT group were 95.0%, 80.0%, and 95.0%, and 80%, 60.0%, and 75.0%, respectively. For the IMRT+CT group, such rates were 100%, 96.4%, and 96.4%, and 100%, 92.9%, and 92.9%, respectively. The two-year local/regional control rate and distant metastasis-free survivals in the IMRT+CT group were higher than those in the IMRT group (P<0.05). Most patients had grade 1 to grade 2 acute radiation toxicities and grade 0 to grade 1 late radiation toxicities (P>0.05). No patient showed a grade 4 acute or late toxicity. The blood and gastrointestinal toxicity rates were high in the IMRT+CT group (P<0.05). Conclusion:The IMRT+CT treatment has potential advantages over the IMRT in the treatment of local/regional advanced NPC patients in terms of local/regional control and overall survival. The blood and gastrointestinal toxicity rates in the IMRT+CT group were higher than in the IMRT group but still within a tolerable range.

ObjectiveTo determine the prevalence of nutritional risk and application of nutrition support in hospitalized patients in the department of general surgey,and to evaluate the relationship between nutrition support and clinical outcome as well as between nutritional risk and clinical outcome.MethodsHospitalized patients in the department of general surgery were enrolled from September 2009 to April 2010.The patients were screened using Nutritional Risk Screening 2002 ( NRS 2002) on admission.Data were collected on the application of nutrition support within 2 weeks,complication rate,length of stay,and hospital charges.ResultsAltogether 3000 patients were included in the present study.The overall prevalence of nutritional risk was 18.5％,in which gastric cancer patients showed the highest prevalence (48.3％ ).The proportion of patients receiving nutrition support was 44.1％ in those with nutritional risk and 14.3％ in those without nutritional risk.The ratio of parenteral nutrition to enteral nutrition was 1.2:1.The patients with nutritional risk had higher complication rate,longer length of stay,and higher hospital charge [24.1％ vs.14.2％,(11.1 ±4.8) daysvs.(9.6±3.7) days,(12891.5±4831.2) yuan vs.(9982.7 ±3996.4) yuan,all P=0.0000].Among the gastric cancer,colorectal cancer,and hepato-biliopancreatic cancer patients with nutritional risk,the complication rate,length of stay,and hospital charge were significantly lower in the patients receiving nutrition support than those in the patients receiving no nutrition support ( all P ＜ 0.05 ).ConclusionsA number of inpatients in general surgery department are at nutritional risk.The prevalence of nutritional risk is considerably high in gastric cancer patients.Nutritional risk is correlated with the clinical outcome of the patients.Nutrition support may improve the clinical outcome of gastric cancer,colorectal cancer,and hepato-bilio-pancreatic cancer patients.

The Continuing Education Department of Chinese Medical Association has undertaken and participated in a number of tasks for the training of primary health care personnel in recent years. It has been recognized that the main measures to promote the development of primary continuing medical education including four aspects: national policies provide the direction of the development; medical progress is the output of the primary continuing medical education; the combination of multiple measures is a good way to carry out the primary continuing medical education; and technical means are the support of the development. Through understanding and grasping such factors as the national policies, medical development, education level, and technical conditions, and actively thinking about the relevant countermeasures, we can steadily and rapidly continue to promote the healthy development of continuing medical education at the grassroots level.

Objective:To investigate the current status of self-regulatory fatigue in patients after hematopoietic stem cell transplantation (HSCT) and analyze its influencing factors.Methods:From March 2022 to September 2023, convenience sampling was used to select 161 HSCT patients who were hospitalized and followed up in the Hematology Department of a Class Ⅲ Grade A hospital in Jinan City. A survey was conducted on patients using the General Information Questionnaire, Self-Regulatory Fatigue Scale (SRF-S), Perceived Social Support Scale, Connor and Davidson Resilience Scale, and Medical Coping Modes Questionnaire. Pearson correlation was used to analyze the correlation between self-regulatory fatigue and perceived social support, psychological resilience, and medical coping styles in patients after HSCT. Multiple linear regression was used to analyze the influencing factors of self-regulatory fatigue in patients after HSCT.Results:A total of 161 questionnaires were distributed, and 156 valid questionnaires were collected, with an effective response rate of 96.89% (156/161). The total SRF-S score of 156 patients after HSCT was (49.06±6.62). Multiple linear regression analysis showed that the current work or life status, perceived social support, psychological resilience, avoidance and surrender coping styles were the influencing factors of self-regulatory fatigue in patients after HSCT ( P<0.05) . Conclusions:After HSCT, patients generally experience self-regulatory fatigue, and psychological distress needs improvement. Medical and nursing staff should regularly evaluate the self-regulatory fatigue of patients and develop targeted intervention measures based on influencing factors to reduce the degree of self-regulatory fatigue of patients, improve their prognosis and psychological state.

Objective To explore the mechanism of Zishen Jianpi Huayu Tablets(Corni Fructus,Notoginseng Radix et Rhizoma,Astragali Radix,Puerariae Lobatae Radix,Spatholobi Caulis,Rehmanniae Radix)in the treatment of diabetic retinopathy(DR)by means of network pharmacology and molecular docking technique,and verified by in vitro experiments.Methods The active components of Zishen Jianpi Huayu Tablets and their corresponding target proteins were screened using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)and the BATMAN-TCM database.Drug target proteins were converted to their corresponding gene names through the UniProt database.DR-related targets were searched using"diabetic retinopathy"as a keyword in GeneCards,DrugBank,OMIM,and TTD databases.Common targets between the disease and the drug were identified using the Venny tool.These common targets were analyzed using the String database,a protein-protein interaction(PPI)network was constructed.Topological heterogeneity analysis was performed using Cytoscape 3.9.1 to select core targets and create a PPI network diagram.These common targets were entered into the Metascape database for Gene Ontology(GO)function analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis to identify potential action pathways.Molecular docking of the main active components and core targets was performed using Auto Dock tools software,followed by further experimental validation.The CCK-8 assay was used to assess the effect of Zishen Jianpi Huayu Tablet medicated serum on the cell viability of Human Retinal Microvascular Endothelial Cells(HRmECs)under high glucose conditions,and RT-qPCR was used to measure the expression of IL-1β,AKT1,VEGFA,and TP53 mRNA in HRmECs.Results(1)The effective components and corresponding target proteins of Zishen Jianpi Huayu Tablets were screened by Traditional Chinese Medicine System Pharmacology Database and Analysis Platform(TCMSP)and BATMAN-TCM database.The disease-related targets of DR were searched by GeneCards,OMIM and TTD databases.The use of VENNY platform for drug active components target and DR disease-related target to take intersection(common target),that is,Zishen Jianpi Huayu Tablets in the treatment of DR potential target.The network of"drugs-active components-common targets"was constructed to screen out the key active components of Zishen Jianpi Huayu Tablets in the treatment of DR.Import the common target into STRING database,obtain the PPI network relationship,and screen out the core target.Metascape platform was used to analyze the GO function and KEGG pathway enrichment of the common targets.The key active components and core targets were verified by Autodock 4 software for molecular docking.(2)The drug-containing serum and blank serum of Zishen Jianpi Huayu Tablets was prepared.Human retinal microvascular endothelial cells(HRmECs)were randomly divided into 5 groups:the control group(low-sugar DMEM medium+10%blank serum),high-glucose group(high-sugar DMEM medium+10%blank serum)and Zishen Jianpi Huayu Tablets containing low-,medium-and high-dose serum(high-sugar DMEM medium+10%low-,medium-and high-dose drug containing serum)were detected after 48 hours of culture.The proliferative activity of HRmECs cells was detected by CCK-8 method,and the mRNA expressions of IL-1β,AKT1,VEGFA and TP53 in HRmECs cells were detected by RT-qPCR method.Conclusion Zishen Jianpi Huayu Tablets may act on core targets such as IL-1β,IL-6 and VEGFA,as well as key pathways such as NF-κB signaling pathway,AGE-RAGE signaling pathway and PI3K-AKT pathway through various active components such as quercetin,kaempferol and rehmannia flavonoids,so as to play a therapeutic role in DR.