Jiegengtang is a basic formula for treating sore throat and cough. By means of bibliometrics， this study conducted a textual research and analysis on the key information such as formula origin， decocting methods， and clinical application of Jiegengtang. After the research， it can be seen that Jiegengtang is firstly contained in Treatise on Febrile and Miscellaneous Disease， which is also known as Ganjietang， and it has been inherited and innovated by medical practitioners of various dynasties in later times. The origins of Chinese medicines in this formula is basically clear， Jiegeng is the dried roots of Platycodon grandiflorum， Gancao is the dried roots and rhizomes of Glycyrrhiza uralensis， the two medicines are selected raw products. The dosage is 27.60 g of Glycyrrhizae Radix et Rhizoma and 13.80 g of Platycodonis Radix， decocted with 600 mL of water to 200 mL， taken warmly after meals， twice a day， 100 mL for each time. In ancient times， Jiegengtang was mainly used for treating Shaoyin-heat invasion syndrome， with cough and sore throat as its core symptoms. In modern clinical practice， Jiegengtang is mainly used for respiratory diseases such as pharyngitis， esophagitis， tonsillitis and lung abscess， especially for pharyngitis and lung abscess with remarkable efficacy. This paper can provide literature reference basis for the modern clinical application and new drug development of Jiegengtang.

Jiegengtang is a basic formula for treating sore throat and cough. By means of bibliometrics， this study conducted a textual research and analysis on the key information such as formula origin， decocting methods， and clinical application of Jiegengtang. After the research， it can be seen that Jiegengtang is firstly contained in Treatise on Febrile and Miscellaneous Disease， which is also known as Ganjietang， and it has been inherited and innovated by medical practitioners of various dynasties in later times. The origins of Chinese medicines in this formula is basically clear， Jiegeng is the dried roots of Platycodon grandiflorum， Gancao is the dried roots and rhizomes of Glycyrrhiza uralensis， the two medicines are selected raw products. The dosage is 27.60 g of Glycyrrhizae Radix et Rhizoma and 13.80 g of Platycodonis Radix， decocted with 600 mL of water to 200 mL， taken warmly after meals， twice a day， 100 mL for each time. In ancient times， Jiegengtang was mainly used for treating Shaoyin-heat invasion syndrome， with cough and sore throat as its core symptoms. In modern clinical practice， Jiegengtang is mainly used for respiratory diseases such as pharyngitis， esophagitis， tonsillitis and lung abscess， especially for pharyngitis and lung abscess with remarkable efficacy. This paper can provide literature reference basis for the modern clinical application and new drug development of Jiegengtang.

Objective To analyze the diagnostic value of systemic immune inflammation index(SII)and systemic inflammation response index(SIRI)in rheumatoid arthritis(RA).Methods A total of 470 RA pa-tients diagnosed in the hospital from January to December 2023 were selected.According to the results of anti-cyclic citrullinated peptide(anti-CCP)antibody and rheumatoid factor(RF),RA was divided into four groups:anti-CCP antibody and RF negative group(52 cases),anti-CCP antibody positive RF negative group(70 cases),anti-CCP antibody negative RF positive group(18 cases),anti-CCP antibody and RF positive group(330 cases),and 300 healthy subjects were selected as control group.After calculating SII and SIRI in each group,Kruskal-Wallis was used to examine the difference between SII and SIRI in the anti-CCP antibody and RF negative group,anti-CCP antibody positive RF negative group,anti-CCP antibody negative RF positive group,anti-CCP antibody and RF positive group of RA patients and the control group,and the receiver operat-ing characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of SII and SIRI in the anti-CCP antibody and RF negative group,anti-CCP antibody positive RF negative group,anti-CCP antibody negative RF positive group,anti-CCP antibody and RF positive group of RA patients.Results SII and SIRI in four groups of RA patients were significantly higher than those in control group(P＜0.05).The area under the curve(AUC)of SII in evaluating the four groups of RA patients were 0.689,0.724,0.709,and 0.774,respec-tively.SIRI had an AUC of 0.679,0.729,0.679,and 0.772 in the evaluation of the four groups of RA pa-tients,respectively.Conclusion SII and SIRI are both elevated in patients with RA,and have certain predictive value for RA.

This report described one patient of giant polycystic liver and polycystic kidney involving iliac fossa. Preoperative computed tomography (CT) revealed a large polycystic kidney occupying partially iliac fossa space. A decompression of lower pole of original kidney was planned for placing transplanted kidney. During total liver resection plus orthotopic liver transplantation, right polycystic kidney could move up on its own and iliac fossa space was released for placing transplanted kidney smoothly. Polycystic kidney shrunk markedly post-operation. It provided references for surgical planning of combined liver-kidney transplantation for this type of disease.

Objective To investigate the impact of statistical uncertainty per control point(SUpCP)on dose calculation on volumetric modulated arc therapy(VMAT)for rectum cancer,and to analyze the accuracy and efficiency of calculation.Methods 19 patients with rectum cancer undergoing radiotherapy were selected.The initial VMAT plans were generated on Monaco TPS using SUpCP=3,then changed SUpCP in the dose calculation process as follow:10 SUpCPs(1～10)for each patient,and totally190 VMAT dose distributions were obtained.For plan evaluation,Dmax,Dmean,D95%,V50,homogeneity index(HI),conformity index(CI)of the planning target volume(PTV),dissymmetric variations of bladder,small intestine and femoral head,and time calculation(Time)were analyzed.Patient specific quality assurance(PSQA),dose deviation of isocenter(ΔDISO)and passing rate of three-dimensional dose distribution(γ33,γ32,γ22)between calculated and delivered radiation doses were measured.Results AsSUpC increased,Dmax and HI of PTV,Dmax of bladder were increased,but D95%and V50 of PTV,Time,γ32 and γ22 were decreased(P<0.05).Dmax and CI of PTV,Dmean of bladder,Dmax and Dmean of small intestine and femoral head,ΔDISO and γ33 showed no statistical significance(P>0.05).When ΔDISO<1%,gamma passing rate>90%for all VMAT plan.When SUpCP<6,Dmax of PTV<110%of the prescribed dose was obtained;while SUpCP>2,time for dose calculation was less than 5 min.Conclusion For VMAT plan of rectum cancer on Monaco TPS using XVMC algorithm,3%～5%of statistical uncertainty per control point for dose calculation,and 3%2 mm or 2%2 mm gamma criteria for three-dimensional dose verification is recommended.This study provides clinical application basis for precise dose calculation of VMAT plan of rectum cancer.

Objective To develop a rapid and accurate Monte Carlo program(simplified code for dosimetry of carbon ions,SPEEDO)for carbon ion therapy.Methods For electromagnetic process,type Ⅱ condensed history simulation scheme and continuous slowing down approximation were used to simulate energy straggling,range straggling,multiple scattering,and ionization processes.For nuclear interaction,5 types of target nuclei were considered,including hydrogen,carbon,nitrogen,oxygen,and calcium.The produced secondary charged particles followed the same condensed history framework.The study simulated the transport of carbon ions in 4 materials(water,soft tissues,lung,and bone),and the calculated doses were validated against TOPAS(a Monte Carlo simulation software for radiotherapy physics),followed by a comparison with dose measurements in a water phantom from the HIMM-WW(a medical heavy-ion accelerator facility in Wuwei).Results SPEEDO's simulation results showed good consistency with TOPAS.For each material,in the voxel region where the physical dose was greater than 10％of the maximum dose point,the relative maximum dose error of both was less than 2％.At treatment energy of 400 MeV/u,SPEEDO's computation time was significantly less than that of TOPAS(13.8 min vs 105.0 min).SPEEDO's calculation results also showed good agreement with HIMM-WW measurements in terms of lateral dose distribution and integrated dose depth curve.Conclusion SPEEDO program can accurately and rapidly perform Monte Carlo dose calculations for carbon-ion therapy.

Objective:To assess the effect of Bolus materials(a material has the same effect with tissue)on dose distribution of electron beam radiotherapy on chest wall after surgery for breast cancer.Methods:Radiotherapy model of chest wall after modified radical mastectomy for breast cancer was constructed in this study.Based on the 6 MeV electron beam phase space file(PSF),which came from the International Atomic Energy Agency(IAEA)official website,and the Geant4 Monte Carlo software package,the research calculated the dose distributions of the electron beam radiotherapy of 5 kinds of different materials included water,polystyrene,polylactic acid,glycerol and silica-gel in Bolus materials,and compared the differences of the dose distributions between chest wall and lung tissue.Results:The Bolus materials have a relatively minor effect on the depth of maximum dose(dmax)of electron beams on the chest wall.The dmax maximum difference that was caused by Bolus with 10mm thickness only was 2mm.The Bolus materials with 10mm thickness have a notable effect on dose distribution,particularly in the posterior edge of the chest wall and shallow lung tissue.The order of Bolus materials corresponding to the dose in the posterior edge of the chest wall,from large to small,was polystyrene,water,polylactic acid,silica-gel and glycerol.For Bolus materials with 5 mm thickness and 10 mm thickness,the dose differences were approximate 8%and 15%,respectively.In shallow lung tissue,the corresponding Bolus materials with doses from large to small were water,polystyrene,polylactic acid,silica-gel and glycerol.For Bolus materials with 5 mm thickness and 10 mm thickness,the maximum dose differences were approximate 50%and 70%,respectively.Conclusion:The effect of Bolus materials has larger effect on the dose distribution of electron beam radiotherapy on the chest wall.The reasonable selection of Bolus materials is contributed to ensure the dose of target region,and minimize dose deposition of lung tissue.

Objective To explore the implementation effect of PDCA(plan-do-check-action)style training of severe ultrasound and hemodynamics in standardized training(residential training)for residents majoring in internal medicine on improving their clinical decision-making ability.Methods A retrospective research method was conducted,60 residents in Xinyang Central Hospital from July 2017 to July 2023 were selected as the research objects,and patients were randomly divided into experimental group and control group,with 30 residents in each group.After the routine entrance education,the experimental group applied the PDCA mode training of severe ultrasound and hemodynamics.The control group was trained with the training objectives and requirements of the department of critical care medicine in the contents and standards of standardized training for internal medicine residents for 2 months.At the end of the training period,the residents of the two groups were assessed and investigated by questionnaire,and the differences of theoretical knowledge assessment,clinical practice skills assessment,case assessment scores and satisfaction between the two groups were compared.Results The results of theoretical knowledge examination,diagnosis and differential diagnosis,and clinical decision-making in the experimental group were significantly higher than those in the control group(theoretical knowledge examination score:90.5±2.7 vs.85.7±3.8,diagnosis and differential diagnosis score:92.0±2.4 vs.87.9±3.7,clinical decision-making score:90.3±3.1 vs.85.5±3.9,all P<0.05),satisfaction with teaching methods,stimulating learning interest,firmly mastering knowledge,enhancing problem-solving ability,improving learning enthusiasm,improving clinical thinking ability and enhancing team consciousness was also significantly higher than that of the control group[teaching methods:80.0%(24/30)vs.46.7%(14/30),stimulate learning interest:83.3%(25/30)vs.56.7%(17/30),firmly mastering knowledge:80.0%(24/30)vs.40.0%(12/30),enhance problem-solving ability:70.0%(21/30)vs.43.3%(13/30),improving learning enthusiasm:83.3%(25/30)vs.50.0%(15/30),improving clinical thinking ability:60.0%(18/30)vs.40.0%(12/30),enhancing team consciousness:73.3%(22/30)vs.46.7%(14/30),all P<0.05].Conclusion The application of PDCA-style training of severe ultrasound and hemodynamics can help internal medicine residents master the basic theory and skills of severe diseases faster and better in the rotation of critical medicine departments,which is more conducive to improving the clinical decision-making ability of internal medicine residents.

Objective:To compare the therapeutic effects of cannulated screws and Kirschner wires in the treatment of medial malleolar fractures of Salter-Harris types Ⅲ and Ⅳ in children.Methods:A retrospective study was conducted to analyze the data of 48 and 16 children who had been treated respectively at Department of Pediatric Orthopaedics, Fuzhou Second General Hospital, and Department of Pediatric Orthopaedics, Foshan Hospital of Traditional Chinese Medicine for medial malleolar fractures of Salter-Harris types Ⅲ and Ⅳ from June 2016 to June 2022. There were 32 males and 32 females with an age of 12 (10, 14) years; 31 left and 33 right sides were affected. By the Salter-Harris classification: type Ⅲ in 45 cases, and type Ⅳ in 19 cases. The patients were divided into 2 groups according to their internal fixation methods. Group A (44 cases) was subjected to internal fixation with cannulated screws and group B (20 cases) to internal fixation with Kirschner wires. At the last follow-up, anteroposterior and lateral X-ray films of their ankle joints were taken for imaging evaluation. Functional recovery of the affected limbs was evaluated based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scoring, and related complications were recorded.Results:The 2 groups were comparable because there were no significant differences in their preoperative general data except laterality ( P>0.05). All the patients were followed up for (37.3±21.5) months and achieved bony union. At the last follow-up, for groups A and B respectively, the distal lateral angle of the tibia was 89.0° (89.0°, 90.0°) and 89.0° (89.0°, 90.0°), the range of ankle motion was 73.5° (67.8°, 76.0°) and 70.0° (70.0°, 75.0°), and the good and excellent rate by the AOFAS ankle-hindfoot scoring was 97.7% (43/44) and 95.0% (19/20), showing no significant difference between the 2 groups ( P>0.05). There was a significant difference between the 2 groups in the incidence of premature physeal closure [36.4% (16/44) versus 65.0% (13/20)] ( P=0.033). Conclusions:In the treatment of medial malleolar fractures of Salter-Harris types Ⅲ and Ⅳ in children, internal fixation with both cannulated screws and Kirschner wires can lead to comparable efficacy in good functional recovery and imaging evaluation. However, fixation with cannulated screws may be more advantageous in reducing the risk of early closure of the epiphysis.

Objective To investigate the transcriptome differences of ovarian cancer cells after cisplatin(DDP)resistance,and to find potential antagonists based on this screening.Methods DDP-resistant cell line A2780-DDP was constructed with A2780 cells as the research object.Through transcriptome sequencing anal-ysis,the key factors of DDP resistance were found and verified by quantitative real-time PCR(qPCR)and Western blot experiments.Through the screening of small molecule inhibitors,CCK-8 cell viability assay was used to find potential antagonists.Results A2780-DDP were successfully constructed,and it was found that there was no difference in cell proliferation after drug resistance,but the ability of cell invasion and migration was enhanced.Through transcriptome sequencing analysis,it was found that ITGB7 and Akt may be the key genes of A2780-DDP,and qPCR and Western blot showed that they were highly expressed in A2780-DDP.CCK-8 results showed that triptolide(TPL)and Olaparib had good inhibitory effects in DDP-resistant cell lines.Conclusion The ITGB7/Akt pathway plays an important role in DDP resistance,and potential DDP re-sistance antagonists such as TPL can provide new ideas for the treatment of ovarian cancer.