Objective To investigate the clinical efficacy of Tongfu Xiefei Formula in treating patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)based on the theory of simultaneous treatment of lung and intestine,and to observe its effects on serum inflammatory cytokines.Methods A retrospective study was conducted on 134 AECOPD patients treated at the Department of Pulmonary Diseases of Traditional Chinese Medicine,Tangshan Hospital of Traditional Chinese Medicine from December 2020 to December 2022.The patients were divided into an observation group and a western medicine group based on the treatment plans,with 67 cases in each group.The western medicine group received conventional western medical treatment,while the observation group was given Tongfu Xiefei Formula orally in addition to the western medical treatment.The course of treatment covered 2 weeks.Before and after treatment,the two groups were observed in the changes of the modified Medical Research Council(mMRC)dyspnea scale scores,COPD Assessment Test(CAT)scores,lung function indicators,arterial blood gas analysis indicators,and serum inflammatory cytokine levels.The clinical efficacy,total incidence of adverse reactions,and hospitalization time were compared between the two groups.Results(1)After 2 weeks of treatment,the total effective rate in the observation group was 95.52%(64/67),compared to 79.10%(53/67)in the western medicine group.The intergroup comparison(tested by the chi-square test)showed that the efficacy of the observation group was significantly superior to that of the western medicine group(P＜0.01).(2)After treatment,the mMRC scores and CAT scores in both groups were significantly decreased(P＜0.05),and the decrease in the observation group was significantly superior to that in the western medicine group(P＜0.01).(3)After treatment,lung function indicators of the forced expiratory volume in one second(FEV1),forced vital capacity(FVC),and their ratio(FEV1/FVC)in both groups were significantly increased(P＜0.05),and the increase in the observation group was significantly superior to that in the western medicine group(P＜0.01).(4)After treatment,the oxygen saturation(SaO2)and arterial oxygen partial pressure(PaO2)levels in both groups significantly increased(P＜0.05),while the arterial carbon dioxide partial pressure(PaCO2)level was significantly decreased(P＜0.05).The increase in SaO2 and PaO2 levels and the decrease in PaCO2 level in the observation group were significantly superior to those in the western medicine group(P＜0.01).(5)After treatment,the levels of serum inflammatory cytokines of tumor necrosis factor α(TNF-α),C-reactive protein(CRP),and interleukin-6(IL-6)in both groups were significantly decreased(P＜0.05),and the decrease in the observation group was significantly superior to that in the western medicine group(P＜0.01).(6)The total incidence of adverse reactions in the observation group was 2.99%(2/67),compared to 5.97%(4/67)in the western medicine group,with no statistically significant difference between the two groups(P＞0.05).(7)The observation group had a significantly shorter hospitalization time than the western medicine group,and the difference was statistically significant(P＜0.05).Conclusion Tongfu Xiefei Formula,formulated based on theory of simultaneous treatment of lung and intestine,is effective and safe on relieving symptoms such as dyspnea in AECOPD patients,improving lung function,correcting arterial blood gas disorders,inhibiting the release of inflammatory factors,shortening treatment time,while causing no serious adverse reactions.

Background::Atopic dermatitis (AD) affects approximately 10% of adults worldwide. CM310 is a humanized monoclonal antibody targeting interleukin-4 receptor alpha that blocks interleukin-4 and interleukin-13 signaling. This trial aimed to evaluate the efficacy and safety of CM310 in Chinese adults with moderate-to-severe AD.Methods::This multicenter, randomized, double-blind, placebo-controlled, phase 2b trial was conducted in 21 medical institutions in China from February to November 2021. Totally 120 eligible patients were enrolled and randomized (1:1:1) to receive subcutaneous injections of 300 mg CM310, 150 mg CM310, or placebo every 2 weeks for 16 weeks, followed by an 8-week follow-up period. The primary endpoint was the proportion of patients achieving ≥75% improvement in the Eczema Area and Severity Index (EASI-75) score from baseline at week 16. Safety and pharmacodynamics were also studied.Results::At week 16, the proportion of EASI-75 responders from baseline was significantly higher in the CM310 groups (70% [28/40] for high-dose and 65% [26/40] for low-dose) than that in the placebo group (20%[8/40]). The differences in EASI-75 response rate were 50% (high vs. placebo, 95% CI 31%–69%) and 45% (low vs. placebo, 95% CI 26%–64%), with both P values <0.0001. CM310 at both doses also significantly improved the EASI score, Investigator’s Global Assessment score, daily peak pruritus Numerical Rating Scale, AD-affected body surface area, and Dermatology Life Quality Index compared with placebo. CM310 treatment reduced levels of thymus and activation-regulated chemokine, total immunoglobulin E, lactate dehydrogenase, and blood eosinophils. The incidence of treatment-emergent adverse events (TEAEs) was similar among all three groups, with the most common TEAEs reported being upper respiratory tract infection, atopic dermatitis, hyperlipidemia, and hyperuricemia. No severe adverse events were deemed to be attributed to CM310. Conclusion::CM310 at 150 mg and 300 mg every 2 weeks demonstrated significant efficacy and was well-tolerated in adults with moderate-to-severe AD.Trial Registration::ClinicalTrials.gov, NCT04805411.

BACKGROUND:Increasing studies have shown that autophagy plays an important role in the treatment of osteoarthritis,and moderate autophagy can preserve the normal physiological function of osteoarticular chondrocytes.Traditional Chinese medicine(TCM)monomers can target and modulate autophagy to treat osteoarthritis,and their characteristics such as single components,clear efficacy,low price,and easy availability have obvious benefits in the treatment of osteoarthritis.OBJECTIVE:To review the effects of TCM monomers on the targeted regulation of autophagy in the treatment of osteoarthritis and the research progress,with a view to laying a foundation for the treatment of osteoarthritis and even other bone metabolic diseases.METHODS:Relevant literature published from January 2012 to October 2022 was retrieved in PubMed,Web of Science,CNKI,and WanFang using the keywords of"traditional Chinese medicine,Chinese herbal monomer,autophagy,osteoarthritis"in English and Chinese.Inclusion and exclusion criteria were developed,and 63 relevant articles were finally included by screening through reading the title,abstract,and full-text content.RESULTS AND CONCLUSION:TCM monomers can treat osteoarthritis by targeting autophagy to inhibit chondrocyte apoptosis,protect cartilage extracellular matrix,reduce inflammation and antagonize oxidative stress injury.Different TCM monomers can regulate autophagy in the same way,and the same TCM monomers can affect autophagy in different ways.The combination of multiple monomers and the multi-target and multi-pathway regulation of autophagy by TCM monomers remain to be explored.The regulation of autophagy by TCM monomers can provide new ideas and strategies for the prevention and treatment of osteoarthritis.Moderate regulation of autophagy by TCM monomers to keep the autophagic flux unimpeded may be the key to treating osteoarthritis.

BACKGROUND:More and more studies have shown that oxidative stress should play an important role in the treatment of osteoporosis.Oxidative stress should cause the accumulation of oxidation activity,which will damage bone-related cells.Finally,it causes the imbalance of bone resorption and bone formation,resulting in a decrease in bone volume and the destruction of the slight structure.Research in recent years has found that some natural products can regulate oxidative stress to treat osteoporosis.The characteristics of extensive sources and small side effects have obvious advantages in the treatment of osteoporosis,and the efficacy is objective. OBJECTIVE:To discuss the mechanism of natural product regulation of oxidation stress in treatment of osteoporosis,conduct a review based on the latest related research progress,provide reference and ideas for more natural products to treat osteoporosis in the future,and provide data support for the clinical application of natural compounds in the treatment of osteoporosis. METHODS:"oxidative stress,free radical,antioxidant,phytotherapy,plant extracts,medicinal plants,herbal medicine,osteoporosis,bone density,bone loss"were used as the keywords in PubMed,Web of Science,Embase,Cochrane,VIP,CBM,WanFang,and CNKI databases to search relevant articles published from January 2010 to February 2023.Inclusion and exclusion criteria were developed,and 64 relevant articles were selected by reading titles,abstracts,and full texts. RESULTS AND CONCLUSION:(1)Some natural products have antioxidant effects and can regulate osteogenic differentiation,osteoblast bone matrix mineralization,osteoclast-mediated bone resorption,proliferation,differentiation,activity,and apoptosis of bone-related cells by improving oxidative stress,thus affecting bone metabolism.(2)These natural products with antioxidant effects play a role in treating osteoporosis by improving bone remodeling balance.(3)The research on the combination of a variety of natural products to improve osteoporosis remains to be explored.(4)The use of natural products to regulate oxidative stress may become a powerful weapon for the clinical treatment of osteoporosis in the future.

Analgesia is an important link in the treatment of severe patients after neurosurgery and plays a vital role in improving the prognosis of the patients.Understanding the status quo and influencing fac-tors of pain in severe patients after neurosurgery helps to predict the occurrence of pain,which is crucial for determining the new pain assessment methods and auxiliary analgesic methods and developing novel analgesic drugs.This paper reviews the pain status,pain evaluation and analgesic methods of severe patients after neuro-surgery in recent years so as to understand the pain management current status of the patients with severe neurological conditions and provide reference for the medical staff to implement the analgesic programs.

The goal of gastrointestinal endoscopy anesthesia management is to effectively calm and re-lieve pain while minimizing related adverse reactions and ensuring patient safety.Hypoxemia is the most com-mon adverse event during painless gastrointestinalendoscopy,and severe hypoxemia can cause cardiac and brain accidents.Therefore,how to prevent and reduce the occurrence of hypoxemia isa hot topic in clinical re-search.This article reviews the methods of preventing and reducing hypoxemia in general painless gastrointes-tinal endoscopy,and provides a reference for the selection of appropriate sedation and ventilation strategies for general painless gastrointestinal endoscopy anesthesia.

Objective To explore the effects of flumatinib,decitabine,arsenic trioxide and venetoclax on the proliferation of K562 cell line in human chronic myeloid leukemia(CML),and provide laboratory basis for new treatment options for CML.Methods Differ-ent concentrations of flumatinib,decitabine,arsenic trioxide,and venetoclax were used to treat on K562 cells alone or in combination.The cell proliferation activity was determined by CCK8method,and the combined index of the two drugs was calculated by Compusyn soft-ware.Results Different concentrations of flumatinib,arsenic trioxide,decitabine and venetoclax alone could inhibit the proliferation of K562 cells,and the differences were statistically significant(P＜0.01);The combination of two drugs with flumatinib,decitabine and ar-senic trioxide could enhance the inhibition effect on K562 cells(P＜0.01),but the combination with venetoclax was not significantly en-hancement on the inhibition effect on K562 cells(P＞0.05).Conclusion Flumatinib,arsenic trioxide,decitabine,and venetoclax a-lone can inhibit the proliferation of K562 cells,and the combination of two drugs with flumatinib,decitabine,and arsenic trioxide has syn-ergistic effect.There was no obvious synergistic effect between the three drugs combined with venetoclax,respectively.

Background Sleep disturbances in children and adolescents have become a global public health concern,with pronounced issues in the Western China.Despite this,research on the prevalence of insomnia and its influencing factors among children and adolescents in Chongqing is still lacking.Objective To understand the prevalence of insomnia and analyze its influencing factors among children and adolescents in Chongqing,so as to provide references for clinical interventions and preventive strategies of insomnia.Methods A stratified random sampling method was used to select 9 969 children and adolescents in Chongqing from November to December 2021.Insomnia Severity Index(ISI)and a self-designed questionnaire on awareness of core mental health knowledge were administered.Binary Logistic regression analysis was used to identify the influencing factors of insomnia in this population.Results A total of 3 578 children and adolescents(35.89％)were found to have insomnia symptoms.There were statistically significant differences in the detection of insomnia symptoms among gender,ethnicity,education level,domicile,only-child status,parental education level,introversion/extroversion,parental relationship,average monthly per capita income,family history of mental illness,medical insurance coverage,living situation and understanding of mental health knowledge(P<0.05 or 0.01).Binary Logistic regression analysis identified several risk factors for insomnia,including female gender(OR=1.301,95％CI:1.192～1.419),ethnic minority status(OR=1.163,95％CI:1.015～1.333),junior high school for education level(OR=1.985,95％CI:1.774～2.220),senior high school for education level(OR=3.085,95％CI:2.749～3.462),non-only-child status(OR=1.127,95％CI:1.013～1.253),degree of harmony between parents is not high or not harmonious[(OR=1.846,95％CI:1.669～2.041 for relatively harmonious;OR=2.524,95％CI:2.214～2.877 for generally harmonious;OR=2.452,95％CI:1.999～3.007 for not very harmonious;OR=2.926,95％CI:2.307～3.710 for very discordant)]and incomplete medical insurance coverage(OR=1.218,95％CI:1.093～1.358).Protective factors included an extroverted personality(OR=0.838,95％CI:0.766～0.917),absence of family history of mental illness(OR=0.719,95％CI:0.549～0.941),junior high school for mother's education level(OR=0.822,95％CI:0.734～0.920),senior high school or secondary specialized school for mother's education level(OR=0.862,95％CI:0.752～0.988),college and above for mother's education level(OR=0.748,95％CI:0.633～0.884)and knowledge of mental health(OR=0.854,95％CI:0.778～0.937).Conclusion The problem of insomnia among children and adolescents in Chongqing is quite serious.Risk factors for insomnia include female gender,ethnic minority status,higher education levels,being a non-only child,poor family relationships and incomplete medical insurance.Conversely,an extroverted personality,absence of family history of mental illness,higher maternal education and knowledge of mental health serve as protective factors against insomnia.

Objective To monitor the antifungal resistance of clinical isolates of Candida spp.in the East China region.Methods MALDI-TOF MS or molecular methods were used to re-identify the strains collected from January 2018 to December 2022.Antifungal susceptibility testing was performed using the broth microdilution method.The susceptibility test results were interpreted according to the breakpoints of 2022 Clinical and Laboratory Standards Institute(CLSI)documents M27 M44s-Ed3 and M57s-Ed4.Results A total of 3 026 strains of Candida were collected,65.33％of which were isolated from sterile body sites,mainly from blood(38.86％)and pleural effusion/ascites(10.21％).The predominant species of Candida were Candida albicans(44.51％),followed by Candida parapsilosis complex(19.46％),Candida tropicalis(13.98％),Candida glabrata(10.34％),and other Candida species(0.79％).Candida albicans showed overall high susceptibility rates to the 10 antifungal drugs tested(the lowest rate being 93.62％).Only 2.97％of the strains showed dose-dependent susceptibility(SDD)to fluconazole.Candida parapsilosis complex had a SDD rate of 2.61％and a resistance rate of 9.42％to fluconazole,and susceptibility rates above 90％to other drugs.Candida glabrata had a SDD rate of 92.01％and a resistance rate of 7.99％to fluconazole,resistance rates of 32.27％and 48.24％to posaconazole and voriconazole non-wild-type strains(NWT),respectively,and susceptibility rates above 90％to other drugs.Candida tropicalis had resistance rates of 29.55％and 26.24％to fluconazole and voriconazole,respectively,resistance rates of 76.60％and 21.99％to posaconazole and echinocandins non-wild-type strains(NWT),and a resistance rate of 2.36％to echinocandins.Conclusions The prevalence and species distribution of Candida spp.in the East China region are consistent with previous domestic and international reports.Candida glabrata exhibits certain degree of resistance to fluconazole,while Candida tropicalis demonstrates higher resistance to triazole drugs.Additionally,echinocandins resistance has emerged in Candida albicans,Candida glabrata,Candida tropicalis,and Candida parapsilosis.

Objective To investigate the value of polar residual network(PResNet)model for assisting evaluation on rat myocardial infarction(MI)segment in myocardial contrast echocardiography(MCE).Methods Twenty-five male SD rats were randomly divided into MI group(n=15)and sham operation group(n=10).MI models were established in MI group through ligation of the left anterior descending coronary artery using atraumatic suture,while no intervention was given to those in sham operation group after thoracotomy.MCE images of both basal and papillary muscle levels on the short axis section of left ventricles were acquired after 1 week,which were assessed independently by 2 junior and 2 senior ultrasound physicians.The evaluating efficacy of MI segment,the mean interpretation time and the consistency were compared whether under the assistance of PResNet model or not.Results No significant difference of efficacy of evaluation on MI segment was found for senior physicians with or without assistance of PResNet model(both P＞0.05).Under the assistance of PResNet model,the efficacy of junior physicians for diagnosing MI segment was significantly improved compared with that without the assistance of PResNet model(both P＜0.01),and was comparable to that of senior physicians.Under the assistance of PResNet model,the mean interpretation time of each physician was significantly shorter than that without assistance(all P＜0.001),and the consistency between junior physicians and among junior and senior physicians were both moderate(Kappa=0.692,0.542),which became better under the assistance(Kappa=0.763,0.749).Conclusion PResNet could improve the efficacy of junior physicians for evaluation on rat MI segment in MCE images,shorten interpretation time with different aptitudes,also improve the consistency to some extent.