Objective:To investigate the efficacy of modified fire dragon moxibustion in patients with phlegm-dampness obesity and prediabetes.Methods:From April 2024 to March 2025, 62 patients with phlegm-dampness obesity and prediabetes who visited the Department of Endocrinology of Ningbo Hospital of Traditional Chinese Medicine were selected as study subjects using convenience sampling. The study subjects were divided into an intervention group and a control group using a random number table method, with 31 cases in each group. Control group received conventional medication, dietary and exercise management, while intervention group received modified fire dragon moxibustion in addition to conventional medication, dietary and exercise management. Both groups underwent the intervention for 60 days. Fasting blood glucose (FBG) , glycated hemoglobin (HbA1c) , triglycerides (TG) , body mass index, fasting insulin (FINS) , and homeostatic model assessment of insulin resistance (HOMA-IR) were compared between the two groups before and after intervention.Results:After intervention, the body mass index, FBG, HbA1c, FINS, and HOMA-IR of intervention group were lower than those of control group, and the differences were statistically significant ( P<0.05) . Conclusions:The modified fire dragon moxibustion can reduce the body mass index, improve glucose metabolism indicators, and FINS and HOMA-IR levels in patients with phlegm-dampness obesity and prediabetes.

Objective:To investigate the efficacy of modified fire dragon moxibustion in patients with phlegm-dampness obesity and prediabetes.Methods:From April 2024 to March 2025, 62 patients with phlegm-dampness obesity and prediabetes who visited the Department of Endocrinology of Ningbo Hospital of Traditional Chinese Medicine were selected as study subjects using convenience sampling. The study subjects were divided into an intervention group and a control group using a random number table method, with 31 cases in each group. Control group received conventional medication, dietary and exercise management, while intervention group received modified fire dragon moxibustion in addition to conventional medication, dietary and exercise management. Both groups underwent the intervention for 60 days. Fasting blood glucose (FBG) , glycated hemoglobin (HbA1c) , triglycerides (TG) , body mass index, fasting insulin (FINS) , and homeostatic model assessment of insulin resistance (HOMA-IR) were compared between the two groups before and after intervention.Results:After intervention, the body mass index, FBG, HbA1c, FINS, and HOMA-IR of intervention group were lower than those of control group, and the differences were statistically significant ( P<0.05) . Conclusions:The modified fire dragon moxibustion can reduce the body mass index, improve glucose metabolism indicators, and FINS and HOMA-IR levels in patients with phlegm-dampness obesity and prediabetes.

Objective To explore the correlation between the diseases-location and disease-nature elements of phlegm and blood stasis syndrome in diabetic kidney disease(DKD)and single nucleotide polymorphism(SNP)of glucose transporter 1(Glut1)and vascular endothelial growth factor(VEGF)genes.Methods The SNP genotyping for Glut1 rs710218 and VEGF rs833061 of 224 patients with DKD were performed firstly by the resequencing of target region with multiplex polymerase chain reaction(PCR)and high-throughput sequencing technology,and then by revealing the mutation information of the targeted site with biological information methods.Moreover,the syndrome elements of traditional Chinese medicine(TCM)in 224 patients with DKD who received inpatient treatment at the Department of Endocrinology of Ningbo Municipal Hospital of Traditional Chinese Medicine between August 2017 and April 2021 were extracted after analyzing the information obtained by four diagnostic methods.Of the 224 patients,78 cases had phlegm syndrome(serving as phlegm syndrome group),and 82 cases had blood stasis syndrome(serving as the blood stasis syndrome group).For the requirement of comparative analysis,79 cases were sampled from the left 146 cases of non-phlegm syndrome at random and served as the non-phlegm syndrome group,and 89 cases were sampled from the left 142 cases of non-blood stasis syndrome at random and served as the non-blood stasis syndrome group.The correlation between them was analyzed by using statistical methods.Results(1)In the rs710218 site of Glut1 gene,the AT genotype frequency in the phlegm syndrome group was significantly higher than that in the non-phlegm syndrome group,and the comparison between the two groups showed that the difference was statistically significant(P<0.05).In the phlegm syndrome group,the patients with disease-location element of kidney had a higher AT genotype frequency in the rs710218 site of Glut1 gene than those with other disease-location elements,and the difference was statistically significant(P<0.05).(2)The TT genotype frequency in the rs833061 site of VEGF gene in the blood stasis syndrome group was significantly higher than that in the non-blood stasis syndrome group,and the difference was statistically significant between the two groups(P<0.05).In the blood stasis syndrome group,the patients with disease-location element of liver or kidney had a higher TT genotype frequency in the rs833061 site of VEGF gene than those with other disease-location elements,and the difference was statistically significant(P<0.05 or P<0.01).Conclusion The AT genotype on the rs710218 site of Glut1 gene is correlated with phlegm syndrome in DKD,which may contribute to the genetic evidences for the affection of kidney in the phlegm syndrome in DKD patients;the TT genotype on the rs833061 site of VEGF gene is correlated with DKD of blood stasis syndrome,and the TT genotype are usually expressed in the DKD patients of blood stasis syndrome with disease-location element of liver or kidney.

Objective:To investigate the application value of CT and MRI imageomics based on machine learning method in the diagnosis of pancreatic cancer.Methods:The clinical data of 62 patients with surgically resected and pathologically confirmed pancreatic cancer, who underwent enhanced CT scan, MRI plain or enhanced scan in Shanghai General Hospital between January 2014 and December 2021 were collected. According to the chronological order of surgery, 49 patients from January 2014 to December 2020 were enrolled in the training set and 13 patients from January 2021 to December 2021 were enrolled in the validation set. 3D-slicer 4.8.1 software was used to draw the region of interest in each layer of CT and MRI images for cancerous and paracancerous tissue segment. Image features were extracted by Python and the optimal feature set from the training set data was obtained by using Lasso regression model. The machine learning decision tree model was constructed. The receiver operating characteristic curve(ROC) curve was drawn, and the area under the curve (AUC) was calculated to evaluate the value of these three kinds of imageomics models in the diagnosis of pancreatic cancer.Results:The 1 767 CT features and 1 674 MRI features were obtained from enhanced CT scan, MRI plain scan and enhanced MRI scan, respectively. For the differential diagnosis model of cancerous tissue and paracancerous tissue, the enhanced CT scan data model obtained the optimal feature set involving 6 features, the MRI plain scan model obtained the optimal feature set involving 16 features, and the enhanced MRI scan model obtained the optimal feature set involving 15 features. The diagnostic model based on enhanced CT scan had an AUC of 0.98 in the training set and 1 in the verification group. The AUC of the MRI plain scan and enhanced MRI scan models in both the training set and the validation set was 1. The specificity and sensitivity of machine learning decision tree model based on the three kinds of imageomics models in the diagnosis of cancerous tissue and paracancerous tissue were 100%. For the differential diagnosis model of splenic artery wrapping, the enhanced CT scan model didn′t obtain the optimal features and had no diagnostic efficacy. The MRI plain scan model and enhanced MRI scan model obtained the optimal feature set involving 5 and 4 features, respectively. The AUC of the MRI plain scan model in the training set and the validation set were 0.862 and 0.750, respectively, with diagnostic sensitivity of 93.8% and 50.0%, and specificity of 78.6% and 100%, respectively. The AUC of the enhanced MRI scan model in the training set and the validation set were 0.950 and 0.861, respectively, with diagnostic sensitivity of 90.0% and 93.6%, and specificity of 100% and 78.6%, respectively.Conclusions:Based on the radiomics of CT enhanced, MRI plain scan and enhanced MRI scan, the machine learning diagnostic model has an accuracy of more than 90% in differentiating pancreatic cancer from paracancerous tissue. For the differentiation of splenic artery wrapping in pancreatic cancer, the diagnostic model based on enhanced MRI scan haS the best diagnostic efficiency.

Objective:To compare the efficacy and safety of pegylated liposomal Doxorubicin(PLD)and Epirubicin(EPI)as first-line chemotherapy for diffuse large B-cell lymphoma(DLBCL).Methods:Clinical data of DLBCL patients treated at Zhejiang Cancer Hospital from March 2013 to April 2018 were retrospectively collected.A total of 411 patients who had received first-line chemotherapy were included.Based on age, sex, Ann Arbor staging and other parameters and using the PSM method for 1∶1 matching, 151 patients were assigned into each of the PLD group and the EPI group.Efficacy and adverse events were compared between the PLD group and the EPI group.All patients were followed up for 3 years after treatment to monitor survival.Results:The complete response(CR)rate in the PLD group was 81.5%, and the CR rate in the EPI group was 72.2%.The objective response rate(ORR)of the PLD group was 98%, and the ORR of the EPI group was 96.7%.There was no significant difference in CR rate( χ2=0.478, P=0.489)or ORR between the two groups( χ2=0.007, P=0.934). In the PLD group, myelosuppression occurred in 25 cases(16.6%)and cardiotoxicity-related events in 21 cases(13.9%); in the EPI group, there were 24 cases(15.9%)of myelosuppression and the same number of cases of cardiotoxicity-related events, and there were no significant differences in myelosuppression( χ2=0.018, P=0.895)or cardiotoxicity( χ2=0.174, P=0.677)between the two groups.During the 3-year follow-up, the progression free survival(PFS)rates of the PLD group and the EPI group were 79.1% and 69.6%, respectively, with a statistically significant difference between the two groups( χ2=3.930, P=0.047). Both the PLD group and the EPI group had a 3-year OS rate of 85.2%, with no statistically significant difference between the two groups( χ2=0.402, P=0.538). Conclusions:The 3-year progression-free survival of DLBCL patients with PLD as first-line chemotherapy is significantly better than with EPI, and the 3-year overall survival, short-term efficacy and myelosuppression are comparable to those with EPI.

Objective:To summarize the clinical characteristics, common images, pathogens, and gene mutation types of chronic granulomatosis disease (CGD) in 19 children.Methods:The clinical manifestations, laboratory findings, treatment, and prognosis of 19 patients diagnosed with CGD in Hong Kong University-Shenzhen Hospital from December 2012 to December 2018 were analyzed.Results:The 19 patients were all males and confirmed as CGD by the dihydrorhodamine test and gene sequencing.The age of the first infection was mostly 1 month after birth(13 cases), and the age of clinical diagnosis ranged from 2 months to 10 years.Sixteen mothers were carriers.The patients presented with pulmonary fungal infection (19/19 cases), Bacillus Calmette Guerin (BCG)-osis (14/19 cases), lymphadenitis (14/19 cases), perianal abscess (9/19 cases), skin abscess (5/19 cases) and ulcerative colitis (2/19 cases). There were 59 positive cultures.Pathogens included fungi (9 cases), Klebsiella pneumonia (8 cases), mycobacteria (7 cases), Streptococcus Viridans (5 cases), Escherichia coli (3 cases), gram-positive bacteria (3 cases), Staphylococcus aureus (3 cases), and Burkholderia cenocepacia (2 cases). Gene mutations were found in all 19 patients, including 17 cases of CYBB, 1 case of CYBA and 1 case of NCF2.The type of mutations included nonsense mutations (6 cases), deletion mutations (5 cases, including 2 large fragment deletions), splice mutations (3 cases) and missense mutations (5 cases). Five mutations were novel.Splice mutations in 3 cases often led to skin abscess, perianal abscess and lymphadenitis.Two patients with large deletion mutations had more serious infection than other patients. Conclusions:In China, CGD is characterized with pulmonary infection and disseminated BCG-osis.Mycobacteria are common pathogens of CGD, and fungi are dominant pathogens of CGD.The most common infection is respiratory infection. Klebsiella pneumonia and Escherichia coli often lead to perianal abscess.The relationship between gene mutation types and clinical phenotypes requires further verification by big data.

Colorectal cancer patients with potential resectable liver metastases may benefit from hepatectomy or other local treatment to achieve R 0 resection or no evidence disease after conversion treatment by chemotherapy with or without target therapy. FOLFOX or FOLFIRI combined with cetuximab is appropriate for RAS and BRAF wide type and primary tumor at left-side colon cancer and rectal cancer. It is complex for RAS and BRAF wide type and primary tumor at right-side colon cancer or RAS or BRAF mutated patients. FOLFOXIRI combined with bevacizumab may be the first choice for those patients with young age and good performance score to achieve best conversion chance, while FOLFOX/CapeOx/FOLFIRI combined with bevacizumab could be the second choice. A surgical re-evaluation should be planned every 2 months after initiation of conversion treatment in multi-disciplinary treatment assessment. Once it is demonstrated conversion treatment is successful, surgery should be performed as soon as possible.

Objective:To analyze the clinical course and targeted therapy of pyogenic sterile arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome.Methods:The clinical history of a 6-year-old boy with PAPA syndrome, who was admitted to Hong Kong University Shenzhen Hospital in September 2017, was reviewed. His genetic diagnosis was confirmed by whole exome sequencing. The response to targeted therapy was evaluated by comparing the inflammatory markers (erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) and serum cytokines (interleukin (IL)-1, IL-6 and tumor necrosis factor-α (TNF-α)) before and after biological agents treatment. For literature review, "PAPA syndrome" and"PSTPIP1 gene"were used as keywords to retrieve papers published from January 1997 to December 2019 from Pubmed, Wanfang and CNKI database.Results:The patient was a 6-year-old boy, admitted to the hospital due to recurrent joint swelling and pain for more than 4 years. Before treatment, the CRP (256 mg/L), ESR (105 mm/1 h) and cytokines including serum TNF-α (7.43 ng/L), IL-1 (<5 ng/L), IL-6 (301 ng/L) were significantly elevated. Culture of the joint effusion was negative, but the IL-6 level was above 1 000 ng/L. MRI showed osteomyelitis at the lower end of the right femur. Gene detection found a heterozygous variation of PSTPIP1 gene (c.748G>A, p.E250K). Arthralgia once alleviated after the initiation of tocilizumab and infliximab, but recurred after 1 year of treatment. Thereafter, the anti-IL-1 receptor antagonist (Anakinra) was commenced, followed by a significant improvement of the arthralgia, and a complete remission during the follow-up. Besides, the level of CRP, ESR, serum TNF-α, IL-1 and IL-6 were all decreased to normal on the last followed up in December 2019. Literature review found 29 articles and 87 patients in total. The initial symptoms included those of arthritis ( n=58), pyoderma gangrenosum ( n=33), and acne ( n=24). Among all the cases, 13 genotypes were confirmed, and 47 variations involved amino acid p.E250. Steroid and/or biological agents were used in most patients. Conclusions:PAPA syndrome should be suspected in children with recurrent pyogenic sterile arthritis, and an early diagnosis could be achieved by genetic test. Targeted treatment with biological agent may control the symptoms effectively. Biological agents can control symptoms of this disorder effectively.

OBJECTIVE To investigate the relationship between genetic polymorphim of X-ray repair cross complementing gene 1(XRCC1) and EBV infection in NPC cell.METHODS NPC CNE cell strain was divided into different groups depending on its XRCC1 genetic polymorphism,and EBV was transferred into different groups.Characteristics of cells and XRCC1 protein were detected among different groups before and after EBV transferring.RESULTS There was no difference in cell characteristics and XRCC1 protein level among different genotypes in NPC CNE cells strain.After EBV transferring,there was an increasing in cell malignancy in NPC cells,including control group,wild type group,and 194,280,399 mutant genotype groups,and the differences were statistically significant(P>0.05).There was no difference in XRCC1 protein level before and after EBV transferring.Compared with other groups,the increasing in cell malignancy was less in the 194 mutant genotype group before and after EBV transferring,especially in cell migration and proliferation.There were no difference in the increasing of cell malignancy and XRCC1 protein level among control group,wild type and 280,399 mutant genotypes of NPC CNE cells before and after EBV transferring.CONCLUSION The results suggest that EBV transferring can raise the carcinogenicity of NPC cell.After EBV transferring,the 194 mutant genotype is associated with a reduced carcinogenicity of NPC cells compared with other genotypes.

Objective To investigate the feasibility and clinical value of the road drainage after early mini-mally invasive treatment of severe acute pancreatitis (severe acute pancreatitis,SAP).Methods A retrospective analysis were used to investigate the clinical data of 37 patients with SAP in March 2011 to March 2011 after conven-tional treatment and early minimally invasive approach drainage treatment.Drainage of early after minimally invasive approach group were treated by laparoscopic retroperitoneal approach surgery in the early onset,and were removed of necrotic tissue and catheter drainage of the retroperitoneal clearance.Then postoperative double pipe for irrigation and the negative pressure drainage were applied.Two groups of postoperative complications,mortality,medical expenses, length of hospital stay,etc.were compared.Results Early minimally invasive drainage of into the road after acute physiology and chronic health evaluation (APACHE Ⅱ)was superior to the conventional treatment group (P =0.00).The overall incidence of complications and mortality of multiple organ dysfunction syndrome (multiple out-raged dysfunction syndrome,MODS),was superior to the conventional treatment group,and the differences were statis-tically significant (P =0.023,P =0.033,P =0.046).Early into the road drainage of hospitalization expenses after minimally invasive were reduced ((19.74 ±2.22)than (36.15 ±1.92)ten thousand yuan,t =23.989,P =0.000),hospitalization time were shorter (4.76 ±0.64)weeks than (6.03 ±0.73)weeks,t =5.635,P =0.000). Conclusion Early minimally invasive retroperitoneal approach of drainage treatment of SAP can reduce the incidence of complications and mortality,reduce hospitalization expenses,shorten hospitalization time,and has the clinical feasi-bility and application value.