Objective:To explore the correlation between the indexes of tongue coating exfoliated cells and the Traditional Chinese Medicine (TCM) syndromes of patients with chronic gastritis.Methods:One hundred and forty-eight patients with chronic gastritis in our hospital from March 2017 to May 2018 were selected and divided into 4 groups, including 36 patients with spleen and stomach weakness syndrome, 39 patients with liver-stomach discordance syndrome, 32 patients with stomach yin deficiency syndrome, and spleen and 41patients with stomach damp-heat syndrome according to the TCM classification. In addition, another 50 healthy people without cold and heat deficiency syndrome were selected as healthy control group. The maturity index (MI) and mature value (MV) of tongue coating exfoliated cells, chemical indicators and cell cycle of tongue coating exfoliated cells were detected. The spearman rank correlation method was used to analyze the indicators of tongue coating exfoliated cells and TCM syndromes.Results:Compared with the healthy control group, the subjects with spleen and stomach weakness syndrome, liver-stomach discord syndrome, stomach-yin deficiency syndrome, spleen-stomach damp-heat syndrome showed significantly higher percentage of intermediate cells [(14.85 ± 4.03) % vs. (26.47 ± 3.94) %, (22.32 ± 5.41) %, (31.47 ± 3.28) %, (35.62 ± 3.96) %, P<0.05], significantly lower percentage of surface cells [(85.15 ± 5.33) % vs. (73.53 ± 6.47) %, (77.68 ± 5.38) %, (68.53 ± 4.20) %, (64.38 ± 4.39) %, P<0.05], and significantly lower percentage of MV value [(92.61 ± 3.74) % vs. (83.52 ± 3.10) %, (87.64 ± 2.95) %, (79.38 ± 3.21) %, (75.63 ± 2.83) %, P<0.05]. Compared with the healthy control group, the ACP, LDH, SDH, and -SH in tongue coating exfoliated cells of subjects with spleen and stomach weakness syndrome, liver and stomach discordance syndrome, and stomach yin deficiency syndrome were all significantly decreased ( P<0.05), while ACP, LDH, SDH, and -SH in subjects with spleen and stomach damp-heat syndrome were all significantly increased ( P<0.05). the percentage of cells in G1 phase of subjects with gastric yin deficiency and spleen and stomach damp-heat syndrome were significantly decreased ( P<0.05), while the percentage of S phase cells were significantly increased ( P<0.05). Spearman rank correlation analysis showed that each syndrome type was correlated with ACP, LDH, SDH, -SH ( r values were 0.608, 0.712, 0.704, 0.631, respectively, all Ps<0.05). Conclusion:Patients with different TCM syndromes of chronic gastritis may have different morphological changes of tongue coating exfoliated cells, large differences in cell cycle, and different levels of cell biochemical indicators.

Objective To explore the value of tuberculosis infected T cells spot test(T-SPOT.TB),heated mycobacterium tuberculosis nucleic acid amplification testing(TB-SAT),and adenosine deaminase(ADA)in diagnosing tuberculous pleural effusion.Methods A total of 135 patients with pleural effusion treated at the First Affiliated Hospital of Xinxiang Medical University from January 2021 to December 2021 were selected as the research subjects,including 83 patients with tuberculous pleural effusion and 52 patients with non-tuberculous pleural effusion.All these patients received peripheral blood T-SPOT.TB,chest water TB-SAT and chest water ADA tests,and the sensitivity and specificity of the above three methods in detecting tuberculous pleural effusion alone and in combination were compared.Results In terms of sensitivity and specificity,there was no statistically significant difference among the T-SPOT.TB,TB-SAT and ADA tests in detecting tuberculous pleural effusion alone(P＞0.05).The sensitivity of the T-SPOT.TB+TB-SAT combined test in detecting tuberculous pleural effusion was significantly higher than that of the T-SPOT.TB,TB-SAT and ADA tests alone(x2=4.990,13.410,14.590;P＜0.05),while the specificity of the T-SPOT.TB+TB-SAT combined test in detecting tuberculous pleural effusion showed no significant difference with that of the T-SPOT.TB,TB-SAT and ADA tests alone(x2=0.000,2.420,0.060;P＞0.05).The sensitivity of the T-SPOT.TB+ADA combined test in detecting tuberculous pleural effusion was significantly higher than that of the ADA test alone(x2=4.069,P＜0.05),but showed no significant difference with that of the T-SPOT.TB and TB-SAT tests alone(x2=0.055,3.384;P＞0.05).The specificity of the T-SPOT.TB+ADA combined test in detecting tuberculous pleural effusion was significantly lower than that of the T-SPOT.TB,TB-SAT and ADA tests alone(x2=4.370,12.511,5.371;P＜0.05).The sensitivity of the TB-SAT+ADA combined test in detecting tuberculous pleural effusion showed no significant difference with that of the T-SPOT.TB,TB-SAT and ADA tests alone(x2=0.000,2.604,3.213;P＞0.05).The specificity of the TB-SAT+ADA combined test in detecting tuberculous pleural effusion was significantly lower than that of the TB-SAT test alone(x2=5.765,P＜0.05),but showed no significant difference with that of the T-SPOT.TB and ADA tests alone(x2=0.782,1.251;P＞0.05).The sensitivity of the T-SPOT.TB+TB-SAT+ADA combined test in detecting tuberculous pleural effusion was significantly higher than that of the T-SPOT.TB,TB-SAT and ADA tests alone(x2=6.760,15.755,16.966;P＜0.05),while the specificity of the T-SPOT.TB+TB-SAT+ADA combined test in detecting tuberculous pleural effusion was significantly lower than that of the T-SPOT.TB,TB-SAT and ADA tests alone(x2=4.370,12.511,5.371;P＜0.05).The sensitivity of the T-SPOT.TB+TB-SAT combined test in detecting tuberculous pleural effusion was significantly higher than that of the T-SPOT.TB+ADA and TB-SAT+ADA combined tests(x2=4.090,4.990;P＜0.05);there was no statistically significant difference in the sensitivity in detecting tuberculous pleural effusion between the T-SPOT.TB+ADA combined test and the TB-SAT+ADA combined test(x2=0.060,P＞0.05).The specificity of the T-SPOT.TB+TB-SAT combined test in detecting tuberculous pleural effusion was significantly higher than that of the T-SPOT.TB+ADA combined test(x2=4.371,P＜0.05);the specificity of the TB-SAT+ADA combined test showed no significant difference with that of the T-SPOT.TB+TB-SAT and T-SPOT.TB+ADA combined tests(x2=0.780,1.490;P＞0.05).There was no statistically significant difference in the sensitivity in detecting tuberculous pleural effusion between the T-SPOT.TB+TB-SAT+ADA combined test and the T-SPOT.TB+TB-SAT combined test(x2=0.210,P＞0.05);the sensitivity of the T-SPOT.TB+TB-SAT+ADA combined test in detecting tuberculous pleural effusion was significantly higher than that of the T-SPOT.TB+ADA and TB-SAT+ADA combined tests(x2=5.750,6.760;P＜0.05).The specificity of the T-SPOT.TB+TB-SAT+ADA combined test in detecting tuberculous pleural effusion was significantly lower than that of the T-SPOT.TB+TB-SAT combined test(x2=4.370,P＜0.05);the specificity of the T-SPOT.TB+TB-SAT+ADA combined test in detecting tuberculous pleural effusion showed no significant difference with that of the T-SPOT.TB+ADA and TB-SAT+ADA combined tests(x2=0.000,1.490;P＞0.05).Conclusion The combined detection performs better than the single detection in diagnosing tuberculous pleural effusion,and the peripheral blood T-SPOT.TB combined with chest water TB-SAT performs the best in detecting tuberculous pleural effusion.The combined detection can effectively reduce the missed diagnosis rate and the misdiagnosis rate,and has high clinical application value for diagnosing tuberculous pleural effusion.

Objective:To explore the mechanism of Shuerjing Capsule in treating primary dysmenorrhea based on molecular docking of network pharmacology and in vivo experiment.Methods:By using TCMSP to screen the active components and targets of Shuerjing Capsule; by using GeneCards and DrungBank databases to retrieve targeted proteins of primary dysmenorrhea, and the intersection targets of drugs and diseases were obtained through Weishengxin online platform; by using Cytoscape 3.9.1 software to produce component-target network of Shuerjing Capsule for the treatment of primary dysmenorrhea; by STRING databases to construct drug-disease target PPI network; by DAVID database to perform GO and KEGG pathway enrichment analysis.The key active components of the drug and the core targets of the disease were obtained with molecular docking. The rats were randomly divided into control group, model group, the low-dose group, medium-dose group and high-dose group of Shujing Capsule (0.15, 0.21, 0.42 g/kg), and ibuprofen group (20 mg/kg), with 10 rats in each group. The animal model of primary dysmenorrhea was established by subcutaneous injection of estradiol benzoate and intervented by drugs. The number of writhing reaction, uterine contractile inhibition rate and uterine index of rats were observed. The expressions of TNF-α, IL-6 and IL-1 in serum and the levels of PTGS2 and VEGFA in uterine tissue were detected by ELISA.Results:A total of 188 active ingredients of Shuerjing Capsule were screened, and 51 targets of Shuerjing Capsule and primary dysmenorrhea were identified. TNF, IL-6, AKT1 and TP53 may be the key targets of Shuerjing Capsule in the treatment of primary dysmenorrhea. A total of 519 GO biological processes and 119 related signaling pathways were obtained, among which estrogen, IL-17, HIF-1 and other signaling pathways were closely related to the treatment of primary dysmenorrhea. The results of molecular docking were good, among which stigmasterol had the strongest binding ability to TP53. The experimental results showed that compared with the model group, the uterine index and the number of torsion were decreased in the low -, medium - and high-dose Shuojing Capsule groups ( P<0.05), the uterine contraction inhibition rate increased ( P<0.05); Serum levels of TNF-α, IL-6 and IL-1 of medium and high dose group decreased ( P<0.05), the levels of PTGS2 and VEGFA in uterine tissues decreased ( P<0.05). Conclusion:Shuerjing Capsule has the effect of anti-inflammatation and improveing hypoxia, which may be related to the inhibition of TNF-α, IL-6 and IL-1 inflammatory factors in serum and the expression of PTGS2 and VEGFA proteins in uterine tissues.

Objective:To report the clinical efficacy of adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical procedures in patients with initially unresectable hepatocellular carcinoma.Methods:This is a retrospective case series study. Data from 100 patients who underwent adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical procedures with long-term survival were collected from December 2018 to December 2022 at the Faculty of Hepato-Pancreato-Biliary Surgery, First Medical Center, Chinese People′s Liberation Army General Hospital. According to inclusion and exclusion criteria, 47 cases were included, among which patients who met the discontinuation criteria and maintained a drug-free tumor-free status. Thirty-nine male and eight female patients were included, with an age of (54.2±18.8)years(range:38 to 73 years) at initial diagnosis. At the time of initial diagnosis, 43 cases (91.5%) were classified as Barcelona Clinic Liver Cancer stage C. Survival curves were made using Kaplan Meier method.Results:Forty-seven patients underwent R0 resection, all achieved a drug-free tumor-free state through postoperative adjuvant therapy based on pathological examination results. Thirty-six patients(76.6%) maintained a drug-free tumor-free survival status for more than 6 months,28 patients(59.6%) for more than 12 months,and 8 patients(17.0%) for more than 24 months. The longest drug-free tumor-free survival in this cohort reached 48 months. The median follow-up time in this study was 32 months. After diagnosis, the overall survival rates at 1- and 3- years were 97.7%(95% CI:93.4% to 100%) and 90.7%(95% CI:82.5% to 99.8%). The postoperative recurrence-free survival rates at 1- and 3- years were 91.0%(95% CI:83.0% to 99.8%) and 71.3%(95% CI:58.7% to 86.5%). Conclusions:The adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical approach provides long-term survival benefits for patients with initially unresectable hepatocellular carcinoma. Standardized adjuvant therapy maybe sustain long-term tumor-free status,and achieve drug-free tumor-free survival.

Objective:To report the clinical efficacy of adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical procedures in patients with initially unresectable hepatocellular carcinoma.Methods:This is a retrospective case series study. Data from 100 patients who underwent adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical procedures with long-term survival were collected from December 2018 to December 2022 at the Faculty of Hepato-Pancreato-Biliary Surgery, First Medical Center, Chinese People′s Liberation Army General Hospital. According to inclusion and exclusion criteria, 47 cases were included, among which patients who met the discontinuation criteria and maintained a drug-free tumor-free status. Thirty-nine male and eight female patients were included, with an age of (54.2±18.8)years(range:38 to 73 years) at initial diagnosis. At the time of initial diagnosis, 43 cases (91.5%) were classified as Barcelona Clinic Liver Cancer stage C. Survival curves were made using Kaplan Meier method.Results:Forty-seven patients underwent R0 resection, all achieved a drug-free tumor-free state through postoperative adjuvant therapy based on pathological examination results. Thirty-six patients(76.6%) maintained a drug-free tumor-free survival status for more than 6 months,28 patients(59.6%) for more than 12 months,and 8 patients(17.0%) for more than 24 months. The longest drug-free tumor-free survival in this cohort reached 48 months. The median follow-up time in this study was 32 months. After diagnosis, the overall survival rates at 1- and 3- years were 97.7%(95% CI:93.4% to 100%) and 90.7%(95% CI:82.5% to 99.8%). The postoperative recurrence-free survival rates at 1- and 3- years were 91.0%(95% CI:83.0% to 99.8%) and 71.3%(95% CI:58.7% to 86.5%). Conclusions:The adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical approach provides long-term survival benefits for patients with initially unresectable hepatocellular carcinoma. Standardized adjuvant therapy maybe sustain long-term tumor-free status,and achieve drug-free tumor-free survival.