OBJECTIVE To investigate the improvement mechanism of Huatan tongmai decoction on rats with polycystic ovary syndrome （PCOS） by regulating autophagy through phosphatidylinositol-3-kinase（PI3K）/protein kinase B（AKT）/mammalian target of rapamycin （mTOR） pathway. METHODS A total of 40 rats were randomly divided into blank group （purified water）， model group （purified water）， traditional Chinese medicine group [Huatan tongmai decoction， 24 g/（kg·d）] and chemical drug group [metformin， 0.16 g/（kg·d）]， with 10 rats in each group. Except for blank group， other groups were given a combination of high-fat diet and intragastric administration of 1 mg/kg letrozole suspension to establish PCOS rat model. After modeling， they were given relevant medicine or water intragastrically， once a day， for 42 consecutive days. After the last administration， the pathological and ultrastructural changes of ovarian tissue were observed. The levels of follicle stimulating hormone （FSH）， testosterone （T）， estradiol （E2） ，luteinizing hormone （LH） in serum were detected，and the LH/FSH ratio was calculated. mRNA expressions of Beclin-1， p62 and microtubule-associated protein 1 light chain 3 （LC3） in ovarian tissue were detected. The expressions of related proteins of PI3K/AKT/mTOR pathway and autophagy in rat ovarian tissues were also detected. RESULTS Compared with blank group， the pathological damage and ultrastructural changes of the ovarian tissue in the model group rats were obvious， and a large number of autophagosomes could be seen in cells. The levels of T and LH and the LH/FSH ratio in serum， as well as mRNA and protein expressions of Beclin-1 and LC3， were increased significantly （P＜0.05）， while the levels of E2 and FSH in serum， as well as mRNA and protein expressions of p62 and the phosphorylation levels of PI3K， AKT and mTOR proteins in ovarian tissue， were significantly decreased （P＜0.05）. Compared with model group， the pathological damage of ovarian tissue in the administration groups was significantly reduced， the number of autophagosomes was smaller， and the expression levels of the above indicators were significantly reversed （P＜0.05）. CONCLUSIONS Huatan tongmai decoction can inhibit autophagy in ovarian granular cells by activating the PI3K/AKT/mTOR pathway， regulate the secretion of sex hormones， alleviate pathological damage in ovarian tissues， and promote normal follicular development， thereby exerting an ameliorative effect on PCOS rats.

Objective:To analyze the detection strategy and basic detection situation of markers of infectious diseases transmitted by transfusion in blood testing laboratories of blood stations in China.Methods:Based on the data of practice comparison working party of Blood Stations in Mainland of China from 2017 to 2021, the data on the testing strategies and the basic detection information of the markers for the transmission of infectious diseases through transfusion in the member laboratories of the practice comparison working party of Blood Stations in Mainland of China from 2017 to 2021 were collected, and the situation of the selection for testing markers, testing strategy and the testing method and other relevant aspects were sorted out and analyzed by charts.Results:The selection of the testing markers was consistent, but HTLV testing item was added in some member laboratories. The detection strategy of using two ELISA reagents and one nucleic acid testing (NAT) reagent simultaneously was adopted in 47 member blood stations; 3) NAT method was dominated by mini pool-NAT in member laboratories. The number of members adopting mini-pools of 8 (MP8)-NAT decreased from 17 in 2017 to 14 in 2021, while the number of members adopting mini-pools of 6 (MP6)-NAT increased from 13 in 2017 to 22 in 2021; Roche NAT system accounted for the largest proportion.Conclusions:In order to ensure blood safety and avoid missing detection, the blood stations still adopt the detection strategy of using two ELISA reagents and one nucleic acid testing (NAT) reagent simultaneously; Meanwhile, in order to increase the NAT positive rate, the proportion of mini pool-NAT mainly decreased year by year despite its dominating role, while the proportion of individual donation-NAT increased year by year; NAT method is transiting from mini-pools of 8 (MP8) to mini-pools of 6 (MP6); The proportion of imported NAT system used in NAT laboratory is relatively large.

In designated hospitals for critical patients with COVID-19 in Wuhan, time-efficient pharmaceutical emergency protection system was of great significance for epidemic prevention. Described in the paper are measures taken by the pharmaceutical department of the hospital as follows. These measures include launching an emergency response mechanism, formulating a catalogue of COVID-19 key therapeutic drugs, urgently purchasing therapeutic drugs, transforming the processes of emergency pharmacy, establishing a drug donation management system, building a COVID-19 pharmaceutical care team, and setting up a " cloud pharmacy" to meet the drug needs of patients with non-COVID-19 chronic diseases, in addition to strengthening personnel protection of pharmacists. During such an epidemic, the pharmacy administration works in a professional, comprehensive, complex and systematic emergency program, which guaranteed the safety of drug supply, medication and enabled the treatment to be carried out in an orderly manner.

After the outbreak of COVID-19, due to environmental pollution in the isolated ward and operational constraints caused by protective clothing and other factors, intravenous drugs in the designated hospitals should be centralized. Combined with the existing process mode, the process of pharmacy intravenous admixture services was optimized, the operation mode of the operation platform was adjusted, the scheduling mechanism was optimized, and the node control process of " first verify and five checks" was explored and developed, so as to meet the 24 h needs of COVID-19 patients. According to the characteristics of COVID-19 drug treatment, the focus of prescription review was adjusted to ensure the drug safety of patients. Other measures included implementing paperless prescription to reduce unnecessary media; implementing segmented infusion distribution management to ensure no cross infection; hierarchical control and configuration environment, strengthening the protection and management of pharmacists, to avoid the risk of personnel infection; optimizing human resource allocation and improving work efficiency. This process reengineering and optimization established the emergency management mode of centralized intravenous drug deployment under the background of COVID-19, which ensured the intravenous drug demand and safety of COVID-19 patients. The treatment work was carried out orderly, and could provide reference for the pharmaceutical department in medical institutions to deal with major public health emergencies in the future.

Objective:To evaluate the effectiveness of Simplified Airway Risk Index (SARI) score in predicting difficult airway in Chinese patients.Methods:One thousand and three hundred patients of both sexes, aged 18-90 yr, with American Society of Anesthesiologists physical status Ⅰ-Ⅲ, undergoing tracheal intubation with the laryngoscope under general anaesthesia, were enrolled in this study.SARI scores (including 7 evaluation items: mouth opening, thyromental distance, Mallampati classification, neck mobility, mandibular protrusion, body weight, and history of difficulty in tracheal intubation) were determined before anesthesia induction.The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the effectiveness of SARI scores in predicting difficult tracheal intubation and difficult laryngoscopy.Results:The AUC and 95% confidence interval of the SARI score, mouth opening, modified Mallampati classification and thyromental distance in predicting difficult tracheal intubation were 0.91 (0.89-0.93), 0.84 (0.82-0.86), 0.81 (0.79-0.83) and 0.83 (0.80-0.85), respectively.The AUC and 95% confidence interval of the SARI score, mouth opening, modified Mallampati classification and thyromental distance in predicting difficult laryngoscopy were 0.90 (0.88-0.91), 0.79 (0.76-0.81), 0.76 (0.74-0.78) and 0.73 (0.70-0.75), respectively.The AUC of SARI scores in predicting difficult tracheal intubation and difficult laryngoscopy was significantly larger than that of the mouth opening, modified Mallampati classification and thyromental distance ( P<0.05). Conclusion:The SARI score produces better efficacy in predicting tracheal intubation and difficult laryngoscopy in Chinese patients.

Objective To evaluate the effect of the LEMON method in predicting difficult air-way.Methods A total of 1 528 patients scheduled for elective surgery requiring tracheal intubation under general anaesthesia,680 males and 848 females,aged 18-83 years,ASA physical status Ⅰ orⅡ,were enrolled in the study.We used the LEMON method to assess airway conditions before an-aesthesia and recorded the scores.The primary end point was difficult tracheal intubation.The sec-ondary end point was difficult laryngoscopy.Receiver operating characteristic (ROC)curve analysis and the area under the curve (AUC)were used to evaluate the clinical effect of the LEMON mothod. Results There were 37 cases with difficult tracheal intubation and 106 cases with difficult laryngosco-py.The incidence of difficult tracheal intubation and difficult laryngoscopy were 2.4% and 6.9%,re-spectively.The area under the curve of the LEMON method for predicting difficult laryngoscopy and difficult tracheal intubation were 0.884 (95% CI 0.867-0.899)and 0.934 (95% CI 0.921-0.946), respectively.Conclusion The LEMON method has good clinical effect in predicting difficult airway.

Objective: To investigate the determinants affecting the heart rate deceleration capacity (DC) in patients with dilated cardiomyopathy (DCM). Methods: One hundred patients with DCM (DCM group) and 202 healthy subjects (control group) were respectively enrolled. Echocardiography and 24 hours electrocardiogram were performed in all subjects. DC value was compared between the two groups. Multiple regression analysis was made to evaluate the related determinants of DC ((age, sex, echocardiographic parameters including the left atrial diameter (LAD) and left ventricular ejection fraction (LVEF)). Results: (1) DC value was significantly lower in DCM group than in control group( (4.40±2.03) ms vs. (7.30±1.81) ms, P<0.01), prevalence of DC value≤4.5 ms was significantly higher in DCM group than in control group (62% vs. 6%, P<0.01). (2) DC value in the DCM group decreased in proportion to increasing LAD dimension, DC value was (5.60±2.04) ms, (4.50±2.07) ms and (3.60±1.62) ms (P<0.05) in DCM patients with LAD≤40 mm, 40 mm50 mm, respectively. (3) DC value in the DCM group was negatively related to the LAD (r=-0.366, P<0.01), positively related to the LVEF (r= 0.241, P<0.01), but not related with age and sex. Multiple factors regression analysis showed that increased LAD was related to the reduced DC values independtly. Conclusion DC value of the patients in the DCM group is decreased, which indicate the decrease of the vagus nerve tension, and increased LAD is related to the reduced DC value independtly in DCM patients.

OBJECTIVETo explore the efficacy and prognostic factors of induction therapy combined with autogenetic peripheral blood stem cells transplantation (APBSCT)in patients with multiple myeloma (MM).

METHODSFrom January 1998 to May 2015, 201 patients with MM were enrolled. All patients received APBSCT after induction therapy. With the follow up to 20 June 2015, the overall survival (OS), progression free survival (PFS)and prognostic factor were analyzed.

RESULTS① With a media follow up of 36.67 months, the median PFS and OS were 22.87 (17.48- 28.26)and 69.63 (63.57- 75.69)months, 5-year PFS and OS were 17% and 49%, respectively. ②After APBSCT, when the subgroup (n= 112) achieved complete response (CR)compared with the subgroup (n=89) not achieved CR, the median PFS were 32.93 (21.03-44.83) and 18.13 (14.46-21.80) months (P<0.001), respectively; And the media OS were 96.77 (71.79- 121.75)and 54.70 (49.53- 59.87) months (P=0.004), respectively. The risks for disease progression and death declined in CR subgroup. ③ Two subgroups included or not included bortezomib/thalidomide at induction therapy (123 patientsvs 21 patients), the media PFS were 31.67 (24.36- 38.98)and 15.20 (10.11- 20.29) months (P=0.013), respectively; And the media OS were 76.30 (55.44- 97.15)and 52.03 (33.76- 70.30) months (P=0.014), respectively. ④According to the ISS stage, the media OS of stageⅠ, Ⅱ, Ⅲ were 99.47 (59.58-139.36), 66.77 (52.17-81.37), 53.97 (28.71-79.23) (P< 0.001), respectively. The risk for death of stage Ⅱ, Ⅲ were 2.16 and 3.04 times higher than stage Ⅰ, with no difference in terms of PFS. ⑤ The media PFS in IgD (n=22) and IgG (n=101) type MM were 11.17 (10.27- 13.13)and 35.43 (22.69- 48.17)months (P=0.007) , respectively; The media OS were 30.83 (0.24-61.42)and 70.70 (53.52-87.88) months (P=0.039), respectively. The risk for disease progression of IgD type was 2.47 times higher than IgG type. ⑥ Patients received 1 line induction therapy (n=132) compared with more than 1 line (n=69), the media PFS were 25.43 (16.09- 34.77)and 20.27 (15.04- 25.50) months (P=0.042). ⑦Cox analysis showed that CR after APBSCT and ISS stage were independent prognostic factors for OS. IgD type MM and CR after APBSCT were independent prognosis factor for PFS.

CONCLUSIONCR after APBSCT and ISS stage were independent prognostic factors for OS in MM. CR after APBSCT was independent prognostic factor for PFS in MM. However, disease progression more likely occurred in IgD type MM, which was independent negative prognostic factor for PFS in MM.

Antineoplastic Combined Chemotherapy Protocols ; Bortezomib ; therapeutic use ; Disease-Free Survival ; Humans ; Multiple Myeloma ; diagnosis ; therapy ; Neoadjuvant Therapy ; Peripheral Blood Stem Cell Transplantation ; Prognosis ; Remission Induction ; Survival Rate ; Thalidomide ; therapeutic use ; Transplantation, Autologous ; Treatment Outcome

OBJECTIVE:To systematically review the effectiveness and safety of Yinzhihuang oral liquid in the adjuvant treat-ment of neonatal jaundice,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from CJFD,VIP Da-tabase,Wanfang Database,Medline and EMBase,randomized controlled trials(RCT)about the effectiveness of Yinzhihuang oral liquid(test group)based on the canventional treatment(control group)in the adjuvant treatment of neonatal jaundice were collect-ed,and Meta-analysis was performed by using Rev Man 5.2 software after data extracting and quality evaluating by modified Jadad. RESULTS:Totally 12 RCTs were enrolled,involving 1585 patients. Results of Meta-analysis showed total effective rate [OR=0.19,95%CI(0.12,0.30),P<0.001],serum total bilirubin levels [MD=-40.78,95%CI(-42.68,-38.89),P<0.001] and time of bilirubin decreased to normal [MD=-2.56,95%CI(-2.72,-2.40),P<0.001] in test group were significantly better than control group,the differences were statistically significant between 2 groups;3 reports of adverse reactions showed scme children had vomiting and mild diarrhea,they were improved after symptomatic treatment,and it did not affect the treatment. CONCLU-SIONS:The effectiveness of Yinzhihuang oral liquid is good in the adjuvant treatment of neonatal jaundice,with mild adverse reac-tions.

OBJECTIVE:Tosystematically evaluate the efficacy of Yixinshu capsule in the adjuvant treatmentof angina pecto-ris,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from CJFD,VIP Database,Wanfang Data-base,Medline and EMBase,randomized controlled trials(RCT)about the efficacyof Yixinshu capsule(test group)versus other drugs (control group) in the adjuvant treatment of angina pectoris were collected. Meta-analysis was performed bu using Rev Man 5.2 software after data extraction and quality evaluation by modified Jadad. RESULTS:Totally 11 RCTs were enrolled,involving 1 827 pa-tients. Results of Meta-analysis showed the total effective rate of angina pectoris improvement [OR=0.30,95%CI(0.23,0.40),P<0.001] and electrocardiogram improvement [OR=0.52,95%CI(0.41,0.66),P<0.001] in test group were significantly higher than control group,there was significant difference between 2 groups. CONCLUSIONS:Yixinshu is effective for the adjuvant treatment of angina pectoris.