This article mainly introduces Professor Xu Zhenye's experience in treating advanced colorectal cancer.According to Professor Xu,the pathogenesis of advanced colorectal cancer is mainly based on deficiency,supplemented by evils and realities,and most of the patients are suffering from deficiency of essence and Qi.The treatment should focus on replenishing the deficiency,followed by removing the evils and poisons.Professor Xu innovatively put forward the theory of"spleen deficiency and essence deficiency,supporting the positive to fight against cancer",treating intestinal cancer by strengthening the spleen,tonifying the kidney and nourishing the essence,supplemented by clearing heat and removing toxins to fight against tumour.

Objective To observe the clinical efficacy and safety of Kangyan Jingfang in the treatment of post-operative cancer-related fatigue in Stage ⅡB-Ⅲ colorectal cancer.Methods A total of 66 patients with stage ⅡB-Ⅲ colorectal cancer who were diagnosed as cancer-related fatigue(CRF)based on TCM syndrome differentiation as spleen vacuity and essence depletion were divided into treatment group and control group randomly,with 33 cases in each group.The treatment group was treated with conventional symptomatic treatment combined with Kangyan Jingfang,and the control group was treated with conventional symptomatic treatment,the course of treatment was 60 days.The scores of cancer-related Fatigue(CFS),TCM syndrome accumulation scale,the revised Piper fatigue scale,Karnofsky performance status,hospital anxiety and depression scale(HAD),tumor markers(CEA,CA19-9,CA72-4,CA12-5,CA15-3,CA242,CA50,Septin9 gene methylation,etc.),immune function(CD3+T lymphocyte level,CD4+T lymphocyte level,CD8+T lymphocyte level and CD4+/CD8+ratio)and safety indexes(blood routine,liver and kidney function)were compared between the two groups in order to evaluate the clinical efficacy of Kangyan Jingfang on CRF.Results 60 cases were included in the observation finally,including 30 cases in each group.After treatment,the scores CFS,TCM syndrome accumulation scale,the revised Piper fatigue scale and HAD of two groups were decreased,but the treatment group before treatment showed a significant decrease in all indicators compared to the control group(P<0.05).The KPS score in the treatment group improved after treatment compared to the control group significantly(P<0.05).CEA,CA19-9 and the methylation of Septin9 gene were significantly decreased in the treatment group after treatment(P<0.05).CD3 and CD4 in treatment groups were higher than control group after treatment significantly(P<0.05).There were no significant abnormal changes in safety indexes before and after treatment(P>0.05).Conclusion Kangyan Jingfang can effectively improve the clinical symptoms of cancer-related fatigue in patients with stage ⅡB-Ⅲ colorectal cancer after surgery,reduce the physical and emotional suffering of patients,improve the quality of life,and enhance the immune function of the body.The efficacy is safe and reliable,and it has certain clinical application value.

This article mainly introduces Professor Xu Zhenye's experience in treating advanced colorectal cancer.According to Professor Xu,the pathogenesis of advanced colorectal cancer is mainly based on deficiency,supplemented by evils and realities,and most of the patients are suffering from deficiency of essence and Qi.The treatment should focus on replenishing the deficiency,followed by removing the evils and poisons.Professor Xu innovatively put forward the theory of"spleen deficiency and essence deficiency,supporting the positive to fight against cancer",treating intestinal cancer by strengthening the spleen,tonifying the kidney and nourishing the essence,supplemented by clearing heat and removing toxins to fight against tumour.

Objective To observe the clinical efficacy and safety of Kangyan Jingfang in the treatment of post-operative cancer-related fatigue in Stage ⅡB-Ⅲ colorectal cancer.Methods A total of 66 patients with stage ⅡB-Ⅲ colorectal cancer who were diagnosed as cancer-related fatigue(CRF)based on TCM syndrome differentiation as spleen vacuity and essence depletion were divided into treatment group and control group randomly,with 33 cases in each group.The treatment group was treated with conventional symptomatic treatment combined with Kangyan Jingfang,and the control group was treated with conventional symptomatic treatment,the course of treatment was 60 days.The scores of cancer-related Fatigue(CFS),TCM syndrome accumulation scale,the revised Piper fatigue scale,Karnofsky performance status,hospital anxiety and depression scale(HAD),tumor markers(CEA,CA19-9,CA72-4,CA12-5,CA15-3,CA242,CA50,Septin9 gene methylation,etc.),immune function(CD3+T lymphocyte level,CD4+T lymphocyte level,CD8+T lymphocyte level and CD4+/CD8+ratio)and safety indexes(blood routine,liver and kidney function)were compared between the two groups in order to evaluate the clinical efficacy of Kangyan Jingfang on CRF.Results 60 cases were included in the observation finally,including 30 cases in each group.After treatment,the scores CFS,TCM syndrome accumulation scale,the revised Piper fatigue scale and HAD of two groups were decreased,but the treatment group before treatment showed a significant decrease in all indicators compared to the control group(P<0.05).The KPS score in the treatment group improved after treatment compared to the control group significantly(P<0.05).CEA,CA19-9 and the methylation of Septin9 gene were significantly decreased in the treatment group after treatment(P<0.05).CD3 and CD4 in treatment groups were higher than control group after treatment significantly(P<0.05).There were no significant abnormal changes in safety indexes before and after treatment(P>0.05).Conclusion Kangyan Jingfang can effectively improve the clinical symptoms of cancer-related fatigue in patients with stage ⅡB-Ⅲ colorectal cancer after surgery,reduce the physical and emotional suffering of patients,improve the quality of life,and enhance the immune function of the body.The efficacy is safe and reliable,and it has certain clinical application value.

ObjectiveTo explore the evolution principles of symptoms including deficiency， phlegm and blood stasis， and of the functional near-infrared spectroscopy （fNIRS） cerebral hemodynamic characteristics at various stages in patients of Alzheimer's disease. MethodsA total of 497 patients with complaint of memory loss were included， and were divided into subjective cognitive decline （SCD） group （198 participants）， mild cognitive impairment （MCI） group （228 participants） and dementia （AD） group （71 participants）. Neuropsychological evaluation， traditional Chinese medicine （TCM） syndrome investigation， and fNIRS data collection of prefrontal cortex were performed in each group. Descriptive statistics were used to analyze the distribution of TCM syndromes and the difference of TCM syndrome scores in each group； logistic regression was used to analyze the influence of TCM syndromes on the incidence of the patients； association rules were used to analyze the TCM syndromes of the patients； the hemodynamic characteristics of fNIRS in the prefrontal cortex of each group were compared. ResultsKidney essence deficiency syndrome was the dominant syndrome in all stages of AD. There were statistically significant differences in the distribution frequency of kidney essence deficiency， phlegm turbidity obstructing orifices， blood stasis obstructing collaterals， qi and blood deficiency， heat toxin in the interior， and fu-organ stagnation and turbidity retention syndromes among the three groups （P＜0.01）， and the scores of kidney essence deficiency syndrome among the three groups were statistically significant （P＜0.01）. Logistic regression analysis showed that kidney essence deficiency， and qi and blood deficiency syndromes were the main risk factors for the SCD group （P＜0.05）， phlegm turbidity obstructing orifices syndrome was the main risk factor for the MCI group （P＜0.05）， and heat toxin in the interior， and fu-organ stagnation and turbidity retention syndromes were the main risk factors for the AD group （P＜0.05）. The association rule analysis showed that the combination of kidney essence deficiency plus phlegm turbidity obstructing orifices had the highest support （33.33%） in the SCD group， and the combination of kidney essence deficiency plus blood stasis obstructing collaterals had the highest support （32.90% and 52.13%） in both the MCI and AD group. The prefrontal fNIRS results showed that the mean ∆HbO₂ concentration in the left dorsolateral prefrontal cortex （LDLPFC） decreased sequentially among the three groups （P＜0.05）， and the mean ∆HbO₂ concentration in the LDLPFC was negatively correlated with the MoCA score among the three groups （r = -0.142， P＜0.05）. Further analysis showed that the mean ∆HbO₂ concentration in the LDLPFC of patients with kidney essence deficiency syndrome were statistically significant differences among the three groups （P＜0.05）. ConclusionKidney deficiency is the basis of the pathogenesis of AD， and the key brain area damaged is the LDLPFC. Turbid pathogens such as phlegm and blood stasis are the pathological factors that aggravate the disease， and the syndromes of AD show the evolution law of deficiency and excess as “kidney deficiency→phlegm turbidity→blood stasis→turbid toxin”. The changes in prefrontal hemodynamics based on fNIRS are consistent with the changes in the characteristics of symptoms， which can be used to assess the degree of cognitive impairment in AD patients.

Objective:The study aimed to quantify the contents of peimine and peiminine in huangshi xiangsheng pills using a nano quantity analyte detector(NQAD)and compare the results with the evaporative light scattering detector(ELSD).Methods:Analytical separation was conducted utilizing a CAPCELL PAK MG Ⅲ C18 column(4.6 mm ×250 mm,5 μmi)as the stationary phase.The mobile phase consisted of a mixture of acetonitrile-water-diethylamine(65∶35∶0.03),with a flow rate set at 1.0 mL·min-1 and the column maintained at a temperature of 25℃.Results:NQAD analysis revealed a robust linear correlation between the concentration and the peak area for peimine within a concentration range of 2.450 to 1.470 μg·mL-1,achieving a correlation coefficient of 0.999 3.The limit of detection(LOD)and recovery rate for peimine were determined to be 14.70 ng and 99.50％(n=9),respectively.Similarly,a linear relationship was observed for peiminine between the concentration and the peak area,spanning a range of 3.657 to 1.170 μg·mL-1,with a correlation coefficient of 0.999 1.The LOD and recovery rate for peiminine were 21.94 ng and 100.5％(n=9),respectively.In contrast,ELSD yielded LOD of 24.50 ng for peimine and 36.57 ng for peiminine,with linear range of double logarithmic fitting was 4.900 to 490.0 μg·mL-1 and 7.314 to 585.1 μg·mL-1,respectively.Conclusion:NQAD outperforms ELSD in the quantification of peimine and peiminine,offering superior accuracy,precision,and sensitivity,along with an extended dynamic linear range.By enabling direct content calculation via linear regression,it streamlines the process,bypassing the complex double logarithmic calculations.This approach not only boosts the efficiency of data handling but also substantially simplifies the computational steps,addressing the detection and analysis needs for peimine and peiminine in huangshi xiangsheng pills.

Objective:The study aimed to quantify the contents of peimine and peiminine in huangshi xiangsheng pills using a nano quantity analyte detector(NQAD)and compare the results with the evaporative light scattering detector(ELSD).Methods:Analytical separation was conducted utilizing a CAPCELL PAK MG Ⅲ C18 column(4.6 mm ×250 mm,5 μmi)as the stationary phase.The mobile phase consisted of a mixture of acetonitrile-water-diethylamine(65∶35∶0.03),with a flow rate set at 1.0 mL·min-1 and the column maintained at a temperature of 25℃.Results:NQAD analysis revealed a robust linear correlation between the concentration and the peak area for peimine within a concentration range of 2.450 to 1.470 μg·mL-1,achieving a correlation coefficient of 0.999 3.The limit of detection(LOD)and recovery rate for peimine were determined to be 14.70 ng and 99.50％(n=9),respectively.Similarly,a linear relationship was observed for peiminine between the concentration and the peak area,spanning a range of 3.657 to 1.170 μg·mL-1,with a correlation coefficient of 0.999 1.The LOD and recovery rate for peiminine were 21.94 ng and 100.5％(n=9),respectively.In contrast,ELSD yielded LOD of 24.50 ng for peimine and 36.57 ng for peiminine,with linear range of double logarithmic fitting was 4.900 to 490.0 μg·mL-1 and 7.314 to 585.1 μg·mL-1,respectively.Conclusion:NQAD outperforms ELSD in the quantification of peimine and peiminine,offering superior accuracy,precision,and sensitivity,along with an extended dynamic linear range.By enabling direct content calculation via linear regression,it streamlines the process,bypassing the complex double logarithmic calculations.This approach not only boosts the efficiency of data handling but also substantially simplifies the computational steps,addressing the detection and analysis needs for peimine and peiminine in huangshi xiangsheng pills.

【Objective:】 The co-word analysis method was used to analyze narrative medical literature studied in China in the past 10 years to explore the research status in this field and lay a foundation for further research. 【Methods:】 Using "narrative medicine" as the theme term, with the limited time interval of 2013—2022 to retrieve for relevant literature in CNKI, Wanfang, and VIP databases, and include literature that meets the research standards. Bicomb2 was used to perform keyword statistics and analysis on the downloaded literature. Ucinet6.0 and Netdraw were used to draw co-occurrence analysis graphs to visualize the co-occurrence relationship between high-frequency keywords. 【Results:】 A total of 565 papers were included and 31 high-frequency keywords were extracted. The co-occurrence relationship diagrams showed that the current research hotspots of narrative medicine in China include traditional Chinese medicine, nursing, general practice, evidence-based medicine, medical ethics, hospice care, chronic diseases, cancer and other popular disciplines and diseases. Most of them were about enhancing the empathy and humanistic caring ability of medical personnel and improving doctor-patient communication to improve the doctor-patient relationship, as well as doing well in medical humanities education and cultivating narrative ability through parallel medical records and reflective writing. The research on gerontology, improving the professional identity of medical staff, integrating literature and medicine, and the impact on patients were relatively few. 【Conclusion:】 At present, narrative medicine in China has achieved many achievements in fields such as nursing, traditional Chinese medicine, general practice medicine, chronic diseases, cancer, medical humanities education, and improving doctor-patient relationships. In the future, in-depth exploration can be conducted from the use of narrative medicine in multi-disciplinary and disease fields, trying different training methods, and synchronous cultivation of teachers and students, so as to build a more comprehensive narrative medicine system.

Objective:To explore the application effect of case-based learning (CBL), teaching mode combined with 3D printing in clinical teaching of sacral tumors.Methods:A total of 108 undergraduate interns and standardized residency training students who studied in our hospital from 2017 to 2018 were divided into the CBL teaching group ( n = 53) and the CBL combined with 3D printing teaching group ( n = 55) according to their study time. The combined teaching group used computer tomography (CT) data to reconstruct and print out a 3D model of sacral tumors based on CBL, and performed preoperative teaching on the invasion of the surrounding tissues of the tumor. The scores of the students in the two groups were evaluated respectively, and the students were surveyed by self-identification questionnaire (learning interest, self-learning ability, teamwork ability, comprehensive analysis ability and clinical thinking ability). The t-test (one-sided) was used for comparison between groups using stata 14.0. Results:The score of CBL teaching group (75.90±6.70) was lower than that of CBL combined with 3D printing teaching group (83.60±7.40). In terms of critical thinking ability evaluation, self-learning ability, learning interest, comprehensive analysis ability and clinical thinking ability, the CBL combined 3D printing teaching group was superior to the CBL teaching group, and the difference was statistically significant ( P<0.001). In terms of teamwork ability, there was no statistical difference between the two groups. Conclusion:The CBL teaching mode combined with 3D printing can improve academic performance, students' learning interest and clinical thinking ability of sacral tumors in the teaching of undergraduate interns and standardized residency training students.

Objective To investigate the diagnostic value of cervical vagus nerve cross-sectional area(CAS)for Parkinson's disease(PD).Methods Thirty patients with PD admitted to the People's Hospital of Zhengzhou University from October 2019 to October 2022 were selected as PD group,25 patients with multiple system atrophy(MSA)admitted to the People's Hospital of Zhengzhou University during the same period were selected as the MSA group,and 30 healthy individuals who underwent physical examination in the People's Hospital of Zhengzhou University during the same period were selected as healthy control group.Cervical vagus CAS of subjects in the three groups were measured by high-resolution ultrasound,and the difference of CAS of cervical vagus nerve was compared among the three groups.The degree of impairment of autonomic nervous function of subjects in the three groups was evaluated by PD autonomic symptom scale(SCOPA-AUT).The diagnostic value of cervical vagus nerve CAS for PD was analyzed by receiver operating characteristic(ROC)curve.Results The CAS of the right cervical vagus nerve of subjects was significantly larger than that of the left in the healthy control group and PD group(P＜0.05);there was no significant difference in CAS of bilateral cervical vagus nerve of subjects in the MSA group(P＞0.05).The CAS and average CAS of bilateral cervical vagus nerve of subjects in the PD group and MSA group were significantly lower than those in the healthy control group(P＜0.01).The CAS of the right vagus nerve of subjects in the MSA group was significantly lower than that in the PD group(P＜0.05);there was no significant difference in CAS and the average CAS of the left vagus nerve between the MSA group and the PD group(P＞0.05).The total score of SCOPA-AUT and gastrointestinal(GI),cardiovascular(CV),urinary(UR)and sexual(SX)scores of subjects in the PD group and MSA group were significantly higher than those in the healthy control group(P＜0.01).The total score of SCOPA-AUT and UR,SX scores of subjects in the MSA group were significantly higher than those in the PD group(P＜0.05).There was no significant difference in temperature(TH)and pupil(PU)of subjects among the three groups(P＞0.05).Pearson correlation analysis showed that the CAS of cervical vagus nerve of PD patients was not correlated with the total score of SCOPA-AUT and the UR,TH,PU,SX scores(r=-0.143,0.281,0.297,0.265,0.312;P＞0.05).The CAS of cervical vagus nerve of PD patients was negatively correlated with GI and CV scores(r=-0.683,-0.373;P＜0.05).ROC curve analysis showed that the area under the curve of cervical vagus nerve for diagnosing PD was 0.870(95％confidence interval:0.773-0.966,P＜0.05);the critical value was 3.064 mm2,the sensitivity was 96％,and the specificity was 67％.The area under the curve of CAS of cervical vagus nerve in differential diagnosis of PD,MSA was 0.680(95％confidence interval:0.537-0.823,P＜0.05).The sensitivity and specificity for the diagnosis of MSA were 68％and 70％when the CAS of the cervical vagus nerve＜2.709 mm2.Conclusion The CAS of cervical vagal nerve has high clinical diagnostic value for PD,and it provides a new way to improve the diagnosis rate of PD.