Objective To elucidate the molecular mechanism of shugan formula in regulating intestinal flora in liver cancer using network pharmacology.Methods The active components and targets of shugan formula were screened using the TCMSP and BATMAN-TCM databases.Targets associated with liver cancer and intestinal flora were extracted from the GeneCards and OMIM databases.The in-tersection targets between the drug and disease were identified using a Venn diagram.Kyoto Encyclopedia of Genes and Genomes(KEGG)and Gene Ontology(GO)enrichment analysis were performed on the intersection targets.Molecular docking technology was em-ployed to validate the binding activities of key components,such as quercetin,kaempferol,with core targets,including TP53 and STAT3.The correlation between targets and the prognosis of liver cancer was assessed through survival analysis.Results KEGG enrichment anal-ysis indicated that shugan formula was primarily enriched in pathways such as cancer pathways.GO enrichment analysis suggested its in-volvement in regulating processes like apoptosis.Molecular docking demonstrated stable binding between key components and core targets.Survival analysis revealed that high expression of tumor protein p53gene(TP53)shortened the overall survival of liver cancer patients,whereas high expression of signal transducer and activator of transcription 3(STAT3)prolonged survival.Conclusion Shugan formula may upregulate STAT3 expression,inhibit TP53 expression,modulate relevant signaling pathways,improve the structure of intestinal flora in liver cancer,and thereby inhibit the proliferation and metastasis of liver cancer cells.

Objective To elucidate the molecular mechanism of shugan formula in regulating intestinal flora in liver cancer using network pharmacology.Methods The active components and targets of shugan formula were screened using the TCMSP and BATMAN-TCM databases.Targets associated with liver cancer and intestinal flora were extracted from the GeneCards and OMIM databases.The in-tersection targets between the drug and disease were identified using a Venn diagram.Kyoto Encyclopedia of Genes and Genomes(KEGG)and Gene Ontology(GO)enrichment analysis were performed on the intersection targets.Molecular docking technology was em-ployed to validate the binding activities of key components,such as quercetin,kaempferol,with core targets,including TP53 and STAT3.The correlation between targets and the prognosis of liver cancer was assessed through survival analysis.Results KEGG enrichment anal-ysis indicated that shugan formula was primarily enriched in pathways such as cancer pathways.GO enrichment analysis suggested its in-volvement in regulating processes like apoptosis.Molecular docking demonstrated stable binding between key components and core targets.Survival analysis revealed that high expression of tumor protein p53gene(TP53)shortened the overall survival of liver cancer patients,whereas high expression of signal transducer and activator of transcription 3(STAT3)prolonged survival.Conclusion Shugan formula may upregulate STAT3 expression,inhibit TP53 expression,modulate relevant signaling pathways,improve the structure of intestinal flora in liver cancer,and thereby inhibit the proliferation and metastasis of liver cancer cells.

Objective:To compare the clinical outcomes and correction effects of kyphosis between Zero-profile device (Zero-p) and plate/cage structures (PCC) in treating cervical spondylotic myelopathy (CSM) patients with cervical kyphosis.Methods:From August 2016 to July 2018, a total of 54 cases of cervical spondylotic myelopathy patients with cervical kyphosis were analyzed retrospectively, including 26 cases treated with Zero-p and 28 cases treated with PCC system. There was no significant difference between the two groups in gender, age, body mass index (BMI) and operative segment. The operation duration and the blood loss were recorded. The clinical outcomes of the patients were measured by visual analogue score (VAS) for neck pain and Japanese Orthopedic Association (JOA) score for neurological function. Moreover, JOA recovery rate was obtained to assess the surgical results. The cervical lordosis (C 2-C 7 Cobb angle), the Cobb angle of the operation segment, the C 2-C 7 vertical axis (C 2 SVA) and the cervical range of motion (ROM) were measured on the lateral and dynamic radiographs of the cervical spine, respectively. Results:In the Zero-p group, the operation duration was 83.0±14.9 (range 60-120) min, intraoperative blood loss was 70.5±27.3 (range 30-150) ml. In PCC group, the operation duration was 100.0±23.9 (range 65-145) min, intraoperative blood loss was 104.2±38.8 (range 30-250) ml. There were significant difference in above parameters between two groups ( t=3.40, 2.06; P=0.00, 0.04). The follow-up duration in Zero-p group was 30.4±5.8 (range 24-36) months and 31.2±4.9 (range 24-36) months in PCC group without significant difference ( t=1.061, P=0.291). The VAS/JOA score of the Zero-p group was improved from (5.9±1.0)/(9.2±1.7) preoperatively to (2.1±0.8)/(14.9±1.0) at 1 month postoperatively, and to (3.4±1.0)/(15.1±0.9) at the last follow-up. The difference between them was statistically significant ( F=130.96, 221.40, P=0.00). The VAS/JOA score of the PCC group was improved from (5.9±1.1)/(8.7±1.6) preoperatively to (2.3±0.9)/(14.9±1.0) at 1 month after surgery, and to (2.6±0.9)/(15.6±1.1) at the last follow-up. The difference between them was statistically significant ( F=303.35, 126.64, P=0.00). However, the VAS score of neck pain in the Zero-p group at the last follow-up was significantly deteriorated, which was significantly higher than that in PCC group ( P<0.05). The cervical lordosis/operative segment Cobb angle in the Zero-p group was improved from preoperative (-6.7°±2.7°)/(-6.5°±3.2°) preoperatively to (14.2°±4.9°)/(12.9°±4.9°) at 1 month postoperatively, and to (5.9°±4.7°)/(5.0°±4.0°) at the last follow-up with statistical significance ( F=196.98, 179.97, P=0.00). The cervical lordosis/operative segment Cobb angle in the PCC group was improved from (-5.7°±3.5°)/(-6.1°±4.0°) preoperatively to (13.9°±6.9°)/(13.0°±6.4°) 1 month after surgery, and to (11.0°±5.5°)/(10.4°±5.6°) at the last follow-up with statistical significance ( F=127.27, 119.98, P=0.00). However, the cervical lordosis and operative segment Cobb angle at the last follow-up in the Zero-p group were significantly lost compared with those at 1 month after surgery, which were significantly smaller than those in the PCC group ( P<0.05). The incidence of dysphagia after operation was 7.7% (2/26) in the Zero-p group and 28.6% (8/28) in the PCC group (χ 2=5.11, P=0.02). Conclusion:For CSM patients with cervical kyphosis, PCC could achieve much better mid-term kyphotic correction and clinical outcomes. However, Zero-p should be avoided as much as possible.

Medical curriculum integration mode is the development trend of medical education re-form. The Institute of Basic Science of Guangzhou Medical University has given full consideration to the present situation at home and abroad and its own conditions, modularized the traditional basic medicine ex-periment course according to the similar content, and formed medical human morphology (human anatomy and tissue embryology, pathology), immune and pathogenic biology (microorganisms, parasites, immunology), biological science (cell biology, genetics, biological sciences) three modules, and then gradually established and perfected a scientific and effective comprehensive morphology experiment teaching material, teaching method, examination and evaluation system based on the teaching content of integration. The establishment of this new basic medical morphology course system, which is based on the organs and systems, shows the less content redundancy, good structural and overall coordination of the new curriculum, so as to play its comprehensive advantages and conform to the trend of the development of the medical education.

Objective To explore the efficacy and adverse reactions of diminishing scheme of cefaclor sustained re-lease tablets in the treatment of recurrent urinary tract infection(RUTI).Methods 60 RUTI patients in a hospital were divided into treatment group(n=30)and control group (n=30),patients in treatment group were treated with diminishing scheme of cefaclor sustained release tablets,patients in control group were treated with diminishing scheme of levofloxacin tablets,clinical therapeutic efficacy and adverse reactions of two groups were observed. Results The curative rate in treatment group was higher than control group ([80.00%,n =24]vs [53.33%,n =16])(χ2 =4.80,P =0.028).The incidence of RUTI in treatment group was lower than control group ([6.67%,n=2]vs [26.67%,n=8])(χ2 =4.32,P =0.038).Incidence of adverse reactions in treatment group was lower than control group (16.67% vs 50.00%)(χ2 =7.50,P =0.006).Conclusion The diminishing scheme of cefaclor sus-tained release tablets in the treatment of RUTI has good curative efficacy,low recurrence rate,fewer adverse reac-tions,and can be used for the treatment of recurrence of RUTI.

Objective To investigate the cellular immune function changes and the effect of thymosin alpha-1 on the changes in elderly patients with severe pneumonia. Methods T cell subset and natural killer (NK) cell were detected in 66 elderly patients with severe pneumonia and 34 elderly patients with common pneumonia. The severe pneumonia patients were randomly divided into 2 groups: the treatment groups (34 cases) and the control group (32 cases). All patients received conventional therapy of pneumonia. The treatment group received 1.6 mg of thymosin alpha-1 through subcutaneous injection once a day for a week and twice a week later. Results The levels of CD3, CD4, CD8 and NK cell were lower in elderly patients with severe pneumonia than in patients with common pneumonia [(43.54%±18.97%) vs. (45.46%±10.43%), (25.43%±12.72%) vs. (38.47%±8.20%), (16.68%±9.30%) vs. (22.36%±8.06%), (13.52%±4.66%) vs. (17.87%±7.11%), t=-6.779、-5.85、-3.161、-3.285 respectively all P＜0.05]. The levels of CD3, CD4, CD4/CD8 and NK cell increased significantly after treatment in treatment group [(64.22%±5.53%) vs. (61.53%±13.41%), (31.70%±4.38%) vs. (26.07%±4.31%), (1.27%±0.91%) vs. (0.97%±0.22%), (17.67%±4.56%) vs. (15.44%±3.82%), F=5.591,11.526,8.934,4.564 respectively, all P＜0.05]. The duration of antibiotic injection and length of stay were lower in treatment group than in control group [(14.17±2.51) d vs. (14.42±2.79) d, (12.69±2.80) d vs. (15.04±3.58) d, t=-3.152、-2.690 respectively, all P＜0.05]. Conclusions The immune function of the elderly patients with severe pneumonia is lower. Thymosin alpha-1 can improve the immune function of the elder patients with severe pneumonia and is helpful for controlling an infection.