Objective:To analyze and summarize the characteristics and rules of upper airway computerized tomography (CT) in obstructive sleep apnea (OSA) patients with epiglottic collapse.Methods:As a cross-sectional study, OSA patients (all were male, aged 18 to 60) who received Han-uvulopalatopharyngoplasty (H-UPPP) surgery at Second Affiliated Hospital of Zhejiang University School of Medicine from April 2023 to February 2024 were continuously selected. All patients underwent physical examination, polysomnography (PSG) and three-dimensional CT plain scan of upper airway before surgery. Preoperative drug-induced sleep endoscopy (DISE) was performed on the day of surgery. According to the findings of DISE, all patients were divided into two groups: epiglottic collapse group and non-epiglottic collapse group. The relevant data were collected, and the measured data included epiglottic length, epiglottic width, epiglottic curvature, epiglottic angle, distance between epiglottis and posterior pharyngeal wall, distance between epiglottis and tongue base, angle between epiglottis and tongue base, the lymph tissue classification of the tongue base, airway length, mandibular - hyoid bone distance, soft palate length and soft palate - hard palate Angle. Statistical analysis was performed using SPSS 25.0.Results:There were a total of 104 patients with OSA, consisting of 27 patients with epiglottic collapse and 77 patients with non-epiglottic collapse. In this study, the incidence of epiglottic collapse was 25.96%. There were no significant differences in apnea hyponea index (AHI), minimum blood oxygen saturation and the time ratio of blood oxygen saturation below 90% (TS90) between the two groups (all P>0.05). Compared with the non-epiglottic collapse group, the epiglottic length [(19.77±2.42)mm vs. (18.54±2.62)mm, t=2.162, P=0.033] and the lymph tissue classification of the tongue base [4(1,4) vs.2(1,3), Z=-2.968, P=0.003] in the epiglottic collapse group increased. Distance between epiglottis and tongue base reduced [2.70(0,5.88) mm vs. 5.45(2.15,6.98)mm, Z=-2.385, P=0.017]. According to Logistic regression analysis, epiglottic collapse and epiglottic width ( OR: 1.201; 95% CI: 1.009-1.430, P=0.039) were positively correlated, epiglottic curvature ( OR: 0.979; 95% CI: 0.961-0.998, P=0.030) was negatively correlated, and with the grade of lymph tissue of tongue root ( OR: 1.936; 95% CI: 1.294-2.896, P=0.001) was positively correlated. Conclusion:CT examination in awake OSA patients with epiglottic collapse can reveal its characteristic indicators. The wider the epiglottic width, the smaller the epiglottic curvature, and the larger the lymph tissue grade of the base of tongue were effective predictors of epiglottic collapse.

Objective:To analyze and summarize the characteristics and rules of upper airway computerized tomography (CT) in obstructive sleep apnea (OSA) patients with epiglottic collapse.Methods:As a cross-sectional study, OSA patients (all were male, aged 18 to 60) who received Han-uvulopalatopharyngoplasty (H-UPPP) surgery at Second Affiliated Hospital of Zhejiang University School of Medicine from April 2023 to February 2024 were continuously selected. All patients underwent physical examination, polysomnography (PSG) and three-dimensional CT plain scan of upper airway before surgery. Preoperative drug-induced sleep endoscopy (DISE) was performed on the day of surgery. According to the findings of DISE, all patients were divided into two groups: epiglottic collapse group and non-epiglottic collapse group. The relevant data were collected, and the measured data included epiglottic length, epiglottic width, epiglottic curvature, epiglottic angle, distance between epiglottis and posterior pharyngeal wall, distance between epiglottis and tongue base, angle between epiglottis and tongue base, the lymph tissue classification of the tongue base, airway length, mandibular - hyoid bone distance, soft palate length and soft palate - hard palate Angle. Statistical analysis was performed using SPSS 25.0.Results:There were a total of 104 patients with OSA, consisting of 27 patients with epiglottic collapse and 77 patients with non-epiglottic collapse. In this study, the incidence of epiglottic collapse was 25.96%. There were no significant differences in apnea hyponea index (AHI), minimum blood oxygen saturation and the time ratio of blood oxygen saturation below 90% (TS90) between the two groups (all P>0.05). Compared with the non-epiglottic collapse group, the epiglottic length [(19.77±2.42)mm vs. (18.54±2.62)mm, t=2.162, P=0.033] and the lymph tissue classification of the tongue base [4(1,4) vs.2(1,3), Z=-2.968, P=0.003] in the epiglottic collapse group increased. Distance between epiglottis and tongue base reduced [2.70(0,5.88) mm vs. 5.45(2.15,6.98)mm, Z=-2.385, P=0.017]. According to Logistic regression analysis, epiglottic collapse and epiglottic width ( OR: 1.201; 95% CI: 1.009-1.430, P=0.039) were positively correlated, epiglottic curvature ( OR: 0.979; 95% CI: 0.961-0.998, P=0.030) was negatively correlated, and with the grade of lymph tissue of tongue root ( OR: 1.936; 95% CI: 1.294-2.896, P=0.001) was positively correlated. Conclusion:CT examination in awake OSA patients with epiglottic collapse can reveal its characteristic indicators. The wider the epiglottic width, the smaller the epiglottic curvature, and the larger the lymph tissue grade of the base of tongue were effective predictors of epiglottic collapse.

AIM To investigate the ameliorative effects of Schisandrol A(Sol A)in Suhuang antitussive capsule on post-infectious cough(PIC).METHODS The in vivo mouse PIC model was established by intratracheal instillation of lipopolysaccharide(LPS)combined with cigarette smoke exposure.The mice were randomly divided into the control group,the model group,the Suhuang antitussive capsule group(14 g/kg),the montelukast sodium positive control group(3 mg/kg),and low and high dose Sol A groups(10,30 mg/kg).The in vitro PIC model was established by stimulating human bronchial epithelial cells(BEAS-2B)with LPS.The cells were divided into the control group,the model group,the Suhuang antitussive capsule group(10 μg/mL)and low and high dose Sol A groups(3,10 μmol/L).HE and Masson staining were used to detect the pathological changes of the lung and bronchial tissues.ELISA was used to detect the levels of IL-1β,IL-6,TNF-α,ROS,MDA,SOD and GSH in the lung tissues.RT-qPCR was used to detect the IL-1β,IL-6 and TNF-α mRNA expressions in BEAS-2B cells.And Western blot was applied to detect the protein expressions of p-PI3K,p-Akt,NOX4,SIRT1,p-ERK,Fibronectin,E-cadherin,Vimentin and α-SMA in mouse lung tissue and BEAS-2B cells.RESULTS Compared with the model group,the groups intervened with Sol A or Suhuang antitussive capsule displayed prolonged cough latency(P＜0.01);reduced cough frequency(P＜0.01);relieved pulmonary inflammatory cell infiltration and collagen deposition in PIC mice;decreased pulmonary levels of IL-1β,IL-6,TNF-α,ROS,MDA and protein expressions of Fibronectin,Vimentin,α-SMA,p-ERK,p-PI3K,p-Akt,and NOX4(P＜0.05,P＜0.01);increased pulmonary levels of SOD and GSH and protein expressions of E-cadherin and SIRT1(P＜0.05,P＜0.01);decreased ROS level,IL-1β,IL-6,TNF-α mRNA expressions and p-ERK,p-PI3K,p-Akt,NOX4 protein expressions in vitro(P＜0.05,P＜0.01);and increased SIRT1 protein expression in vitro as well(P＜0.01).CONCLUSION Being the main antitussive component of Suhuang antitussive capsule upon the PIC model,Sol A inhibits the inflammation via SIRT1/ERK signaling pathway and relieve the oxidative stress via PI3K/Akt/NOX4 signaling pathway.

Cancer-associated thromboembolism(CAT)is one of the most common complications and the second direct cause of mortality in patients with malignant tumors,which seriously affect patients'life quality and prognosis.In recent years,with the deepening of mechanism researches of cancer and thrombosis,treatment strategies of CAT were also improved.The current status and progresses of clinical treatment of CAT were reviewed in this article.

Objective:To explore the application value of dual contrast-enhanced ultrasound in the differential diagnosis of renal cystic lesions.Methods:Eighty-four cases with renal cysts who were diagnosed by routine ultrasound in Zhejiang Cancer Hospital and Zhejiang Xiaoshan Hospital from January 2019 to October 2020 were included in the study. Intravenous contrast-enhanced ultrasound and enhanced MRI were performed to differentiate benign and malignant cysts. Patients with benign cysts underuent intravenous pyelography and intracapsular contrast-enhanced ultrasound. Before sclerotheraphy to exclude renal pelvic cysts. The diagnostic results of dual radiography were compared with MRI and intravenous pyelography.Results:Among 84 patients with suspected renal cysts, the diagnostic accuracy of enhanced MRI for cystic renal cancer was 97.62%, and the sensitivity was 97.62%. The diagnostic accuracy of intravenous contrast-enhanced ultrasound was 98.81, the sensitivity was 100%, and the specificity was 98.73%. There was no statistically significant difference between the two groups (all P>0.05). 77 cases were diagnosed as benign renal cysts, the detection rate of intravenous pyelography was 9.1% (7/77), the detection rate of renal pelvic cysts by intracystic ultrasonography was 6.5% (5/77). With intravenous pyelography as the gold standard, the diagnostic accuracy of intracapsular contrast-enhanced ultrasound was 97.4% (75/77), the sensitivity was 71.4% (5/7), and the specificity was 100% (70/70). Conclusions:Compared with enhanced magnetic resonance and intravenous pyelography before renal cyst sclerosing therapy, there is no difference in diagnostic efficiency of double contrast ultrasound for benign and malignant cysts. The diagnostic efficiency of renal pelvic cysts is high, and the operation is convenient. It can identify cystic renal cancer and cysts from the renal pelvis and improve the safety of sclerotherapy.

OBJECTIVE To study the changes in medical-insuran ce payme nt limitations of anti tumor drugs in national medical- insurance negotiation （hereinafter referred to as “national negotiation ”）and recommendations of diagnosis and treatment guidelines corresponding to tumor issued by Chinese Society of Clinical Oncology （CSCO），so as to provide reference for the performance of national negotiation. METHODS The annual list of anti tumor drugs in national negotiation were summarized ；CSCO diagnosis and treatment guidelines were searched according to the tumor types restricted by the medical- insurance payment limitations of antitumor drugs in national negotiation ；the evidence evolution of the payment limitations of medical insurance for anti tumor drugs and CSCO diagnosis and treatment guidelines were analyzed quantitatively. RESULTS & CONCLUSIONS Finally，46 antitumor drugs in the agreement period were included ；seven of their payment limitations of medical insurance had changed ；and there were differences among the payment limitation of medical insurance ，drug labels and recommendations of CSCO diagnosis and treatment guidelines for 13 varieties；the recommendations ，strength of evidence ，recommendation level of CSCO diagnosis and treatment guidelines were changing for 28 varieties anti tumor drugs in different years ；the number of anti tumor drugs recommended by CSCO diagnosis and treatment guidelines differed significantly among different cancer varieties. The medical insurance payment limitations of anti tumor drugs in national negotiation have been gradually expanded ，and the corresponding recommendations ，strength of evidence， recommendation level in guidelines have been constantly improved. However ， the payment limitation of B-19-H-20200622） medical insurance for most drugs are limited to the indicationsof drug labels and drugs for some cancers are scarce ，such as 85420393。E-mail：oushunlong@sohu.com esophageal cancer and nasopharyngeal carcinoma.

The clinical randomized controlled trial(RCT) of Chinese patent medicine in the treatment of influenza were reviewed and analyzed to provide basic information for clinical decision and related research. On the basis of the collection in the Traditional Chinese Medicine(TCM) Clinical Evidence Database System(EVDS), CNKI, Wanfang, VIP, SinoMed, EMbase, PubMed, and Cochrane Library were searched for RCTs of Chinese patent medicine for influenza published from database inception to July 25, 2021. The publication time, sample size, intervention and control measures, course of treatment, outcome indicators, and methodological quality of the trials were analyzed and evaluated. Ninety-two RCTs of Chinese patent medicine for influenza published between 2005 and 2021, were included, among which 17 RCTs(18.48%) had a sample size higher than 200 and the average sample size was about 145. Twenty-seven Chinese patent medicines were involved, including twenty-one oral medicines and six injections. The Chinese patent medicines in trials reported in more than five papers included Lianhua Qingwen Capsules/Gra-nules, Tanreqing Injection, and Reduning Injection. Fourteen intervention protocols were reported, of which Chinese patent medicine+western medicine+conventional treatment vs western medicine+conventional treatment(20.65%) was the most frequently employed. Additionally, 85.87% of the RCTs reported the course of treatment, and 80.43% of the RCTs determined 3-7 d as the intervention course. Forty-five outcome indicators were extracted, which were used 434 times, including symptoms/signs, physicochemical detection, safety events, TCM symptoms/syndromes, quality of life, long-term prognosis, and economic evaluation. Symptoms/signs(61.52%) exhibited the highest frequency. Methodological problems were prevalent in the included trials. The findings reveal that there are few clinical trials on influenza treatment by Chinese patent medicine, and the methodological problems are prominent, affec-ting the reliability and practicability of the trials. In the future research, the value characteristics of Chinese patent medicine should be highlighted and the quality control in the whole process should be strengthened based on the scientific and rigorous design.
China ; Clinical Trials as Topic ; Drugs, Chinese Herbal/therapeutic use* ; Humans ; Influenza, Human/drug therapy* ; Medicine, Chinese Traditional ; Nonprescription Drugs/therapeutic use* ; Quality of Life ; Reproducibility of Results

Huang-Qin Decoction (HQD) is a classic prescription for diarrhea in Chinese medicine treatment. Recent studies have demonstrated that HQD and its modified formulation PHY906 could ameliorate irinotecan (CPT-11) induced gastrointestinal (GI) toxicity and enhance its anticancer therapeutic efficacy. Nevertheless, which constituents in HQD are effective is still unclear so far. The study aims to screen out the key bioactive components combination from HQD that could enhance the anticancer effect of CPT-11. First, the potential bioactive constituents were obtained through system pharmacology strategy. Then the bioactivity of each constituent was investigated synthetically from the aspects of NCM460 cell migration, TNF-α release of THP-1-derived macrophage and MTT assay in HCT116 cell. The contribution of each constituent in HQD was evaluated using the bioactive index E

Objective:To analyze the main factors affecting the Ziziphus jujuba distribution and expand the understanding of its distribution and the corresponding influencing factors by comparing the distribution sites of Z. jujuba predicted by models with those recorded in the literature. Method:More than 200 distribution sites of Z. jujuba accompanied by 55 environmental factors were obtained from literature and specimen review. The environmental factors that affect the distribution of Z. jujuba were explored by maximum entropy （MaxEnt） model， and the potential distribution areas of Z. jujuba in China were analyzed by ArcGIS， followed by the verification of the main environmental factors using receiver-operating characteristic （ROC） curve and Jackknife method. Result:The area under the curve （AUC） values for the test data and training data were both greater than 0.9， which perfectly satisfied the standard， indicating that the research results were accurate and reliable. Conclusion:The annual average temperature， the average temperature in May， the average temperature in the warmest season， vegetation type， soil type， average temperature in June， average temperature in September， and average temperature in August are proved to be the main environmental factors affecting the distribution of Z. jujuba， which can be found almost all over China， except for Heilongjiang and Tibet. Z. jujuba is most suitable to be planted in southeastern Sichuan， Chongqing， southern Gansu， Ningxia， most areas of central Shaanxi， eastern and southwestern Shanxi， Henan， eastern and northern Hubei， northern and eastern Anhui， Shandong， Hebei， Beijing， Tianjin， western Liaoning， and Zhejiang. As revealed by literature review， the most suitable growing areas of Z. jujuba are southeastern Sichuan， central Shaanxi， southwestern Shanxi， western and northern Henan， Shandong， and southwestern and eastern Hebei.

Objective: To evaluate anemia and related nutritional status of 6-17 years old boarding school students in rural areas of central and western China, and to reveal the difference of nutrition problems in different regions. Methods: In the central and western regions, Henan, Anhui, Jiangxi, Guangxi and Sichuan provinces, as well as Tibet Autonomous Region were selected for this survey considering similar per capita GDP levels. One secondary school and one primary school which participated in the National Nutrition Improvement Program for Rural Compulsory Education Students were selected from each province. One class was selected from each grade of every school by using cluster sampling method. A total of 2 180 students were selected in this survey. Venous blood was collected and the level of hemoglobin, ferritin, soluble transferrin receptor, folic acid and vitamin B12 was analyzed to evaluate anemia and nutrient deficiencies. Results: As for western region, prevalence of anemia among students aged 6-8 and 9-11 years was 3.2% and 2.9%, respectively; iron deficiency prevalence among students aged 6-8, 9-11 and 12-14 years was 10.8%, 13.8% and 24.3%, respectively; and folic deficiency prevalence among students aged 12-14 and 15-17 years was 32.7 % and 49.4%, respectively. Prevalence of anemia, iron and folic deficiency in those areas was significantly higher than those of central regions (all P <0.05). As for the central regions, vitamin B12 deficiency prevalence of students aged 6-8, 9-11, 12-14 and 15-17 years was 7.3%, 19.4%, 29.2% and 45.5% respectively, which was significantly higher than of those of the western regions at the same age group. Conclusion Anemia, iron deficiency and folic acid deficiency are more common among students in western region, while the vitamin B12 deficiency problem is more common in central region. There are regional differences in the nutritional problems of students in the rural areas of central and western part of China. Nutrition improvement of student needs to be adapted to local conditions.