ObjectiveTo observe the clinical efficacy of modified Jinwei Guben Decoction （金卫固本汤， MJGD） combined with Bailing Capsule （百令胶囊， BC） in the treatment of chronic obstructive pulmonary disease （COPD） patients in the stable stage with qi deficiency， blood stasis and phlegm obstruction syndrome， in addition to conventional western medicine treatment. MethodsA total of 102 patients with stable COPD and qi deficiency， blood stasis， and phlegm obstruction syndrome were included in the study. According to the patients'preferences， they were divided into treatment group （49 cases） and control group （53 cases）. The control group received conventional western medicine treatment， while the treatment group was given MJGD （1 dose daily） combined with BC （2.0 g each time， three times a day） additionally. The treatment period was 3 months， and the patients were followed up for 1 year after the treatment. The acute exacerbation frequency （mild， moderate， severe） before treatment， during treatment， at 6-month follow-up， and at 1-year follow-up was compared between groups. Additionally， the lung function indicators such as FEV₁， FEV₁%pred， FVC， and FEV₁/FVC ratio， traditional Chinese medicine （TCM） syndrome scores， modified British Medical Research Council （mMRC） dyspnea scale， and the COPD Assessment Test （CAT） scores before and after treatment were compared. A logistic regression model was constructed to analyze the impact of MJGD combined with BC on clinical efficacy. ResultsFour patients dropped out from the treatment group and eight from the control group， leaving 45 patients of each group for statistical analysis. The number of mild and moderate acute exacerbations in the treatment group was lower than that in the control group during the treatment period， at 6-month follow-up and within 1 year of follow-up （P＜0.05） .The number of severe acute exacerbations was only lower in the treatment group than in the control group at 6-month follow-up （P＜0.05）. Compared with that before treatment， the number of acute exacerbations of all degrees in the treatment group was significantly reduced within 1 year of follow-up （P＜0.05），while only the number of mild acute exacerbations in the control group was significantly reduced within 1 year of follow-up （P＜0.05）. The treatment group showed significant improvement in FEV₁ and FEV₁%pred and FEV₁/FEV， while the control group showed a significant decline in FEV₁ and FVC （P＜0.05）. After treatment， both groups showed significant reductions in TCM syndrome scores， including coughing， sputum， wheezing， chest tightness， shortness of breath， and fatigue， as well as mMRC and CAT scores （P＜0.05）， with the treatment group having significantly lower scores than the control group （P＜0.05）. The overall clinical effective rate of in the treatment group was 93.33% （42/45）， significantly higher than that of the control group， 75.56% （34/45， P＜0.05）. Multivariate logistic regression analysis showed that the use of MJGD combined with BC （OR = 4.68， 95%CI： 1.15 - 19.09， P = 0.03） was positively correlated with clinical efficacy. ConclusionsIn addition to conventional western medicine treatment， the combination of MJGD and BC can reduce the frequency of acute exacerbations， delay the decline of lung function， improve clinical symptoms， and significantly enhance the clinical efficacy in patients with stable COPD and qi deficiency， blood stasis， and phlegm obstruction syndrome.

ObjectiveTo study the effect of Jinwei Pingchuan decoction combined with conventional Western medicine on the number of acute exacerbations， lung function， and clinical symptoms in patients with acute exacerbation of chronic obstructive pulmonary disease （COPD） with phlegm-heat obstruction in lung syndrome. MethodsA non-randomized controlled trial was conducted to include 60 patients with acute exacerbation of COPD with phlegm-heat obstruction in lung syndrome. Patients were divided into a treatment group and a control group based on whether they received Jinwei Pingchuan decoction， with 30 patients in each group. The treatment group received Jinwei Pingchuan decoction combined with conventional Western medicine therapy， while the control group received conventional Western medicine therapy alone. Both groups received treatment for 7 days. The number of acute exacerbations and lung function indices were followed up and recorded before treatment and three months after treatment. The following outcomes were observed before and after treatment： the number of acute exacerbations， lung function indices （forced expiratory volume in one second ［FEV₁］， percentage of predicted value ［FEV₁%pred］， forced vital capacity ［FVC］， and FEV₁/FVC ratio）， the degree of acute exacerbation， TCM syndrome score， COPD assessment test （CAT） score， modified British Medical Research Council Dyspnea Questionnaire （mMRC） score， C-reactive protein （CRP）， and white blood cell （WBC） count. ResultsAfter 3 months of follow-up， the treatment group showed a significant reduction in the number of acute exacerbations compared with the pre-treatment values （P<0.05）. After treatment， the treatment group had fewer acute exacerbations than the control group （P<0.05）. The degree of acute exacerbation in the treatment group improved significantly compared with the pre-treatment values （P<0.05）. After treatment， the degree of acute exacerbation in the treatment group was improved compared to the control group （P<0.05）. Regarding lung function， FEV₁， FEV₁%pred， FVC， and FEV₁/FVC ratio increased significantly in the treatment group compared with the pre-treatment values （P<0.05）， and similar improvements were observed in the control group （P<0.05）. After treatment， FEV₁ and FVC were higher in the treatment group than the control group （P<0.05）. Regarding TCM syndrome scores， the scores for individual symptoms such as wheezing， cough， expectoration， chest tightness， shortness of breath， and fatigue， as well as the total score， decreased significantly in the treatment group compared with the pre-treatment values （P<0.05）. In the control group， the scores for cough， expectoration， chest tightness， fatigue， and palpitation， as well as the total score， also decreased （P<0.05）. After treatment， the treatment group showed significantly lower scores for wheezing， cough， chest tightness， shortness of breath， and the total score than the control group （P<0.05）. Regarding the CAT score， the scores for cough， expectoration， chest tightness， climbing stairs， going out， activity， and energy， as well as the total score， decreased significantly in the treatment group compared with the pre-treatment values （P<0.05）. In the control group， the scores for cough， expectoration， chest tightness， sleep， energy， and the total score decreased （P<0.05）. After treatment， the treatment group showed significantly lower scores for cough， expectoration， chest tightness， activity， and going out than the control group （P<0.05）. Regarding the mMRC score， CRP level， and WBC count， all these parameters decreased significantly in the treatment group compared with the pre-treatment values （P<0.05）， and similar reductions were observed in the control group （P<0.05）. ConclusionJinwei Pingchuan decoction can reduce the number of acute exacerbations and the degree of acute exacerbation in patients with acute exacerbation of COPD with phlegm-heat obstruction in lung syndrome. It also improves lung function and symptoms such as cough and chest tightness， thereby enhancing the quality of life of patients.

ObjectiveTo study the effect of Jinwei Pingchuan decoction combined with conventional Western medicine on the number of acute exacerbations， lung function， and clinical symptoms in patients with acute exacerbation of chronic obstructive pulmonary disease （COPD） with phlegm-heat obstruction in lung syndrome. MethodsA non-randomized controlled trial was conducted to include 60 patients with acute exacerbation of COPD with phlegm-heat obstruction in lung syndrome. Patients were divided into a treatment group and a control group based on whether they received Jinwei Pingchuan decoction， with 30 patients in each group. The treatment group received Jinwei Pingchuan decoction combined with conventional Western medicine therapy， while the control group received conventional Western medicine therapy alone. Both groups received treatment for 7 days. The number of acute exacerbations and lung function indices were followed up and recorded before treatment and three months after treatment. The following outcomes were observed before and after treatment： the number of acute exacerbations， lung function indices （forced expiratory volume in one second ［FEV₁］， percentage of predicted value ［FEV₁%pred］， forced vital capacity ［FVC］， and FEV₁/FVC ratio）， the degree of acute exacerbation， TCM syndrome score， COPD assessment test （CAT） score， modified British Medical Research Council Dyspnea Questionnaire （mMRC） score， C-reactive protein （CRP）， and white blood cell （WBC） count. ResultsAfter 3 months of follow-up， the treatment group showed a significant reduction in the number of acute exacerbations compared with the pre-treatment values （P<0.05）. After treatment， the treatment group had fewer acute exacerbations than the control group （P<0.05）. The degree of acute exacerbation in the treatment group improved significantly compared with the pre-treatment values （P<0.05）. After treatment， the degree of acute exacerbation in the treatment group was improved compared to the control group （P<0.05）. Regarding lung function， FEV₁， FEV₁%pred， FVC， and FEV₁/FVC ratio increased significantly in the treatment group compared with the pre-treatment values （P<0.05）， and similar improvements were observed in the control group （P<0.05）. After treatment， FEV₁ and FVC were higher in the treatment group than the control group （P<0.05）. Regarding TCM syndrome scores， the scores for individual symptoms such as wheezing， cough， expectoration， chest tightness， shortness of breath， and fatigue， as well as the total score， decreased significantly in the treatment group compared with the pre-treatment values （P<0.05）. In the control group， the scores for cough， expectoration， chest tightness， fatigue， and palpitation， as well as the total score， also decreased （P<0.05）. After treatment， the treatment group showed significantly lower scores for wheezing， cough， chest tightness， shortness of breath， and the total score than the control group （P<0.05）. Regarding the CAT score， the scores for cough， expectoration， chest tightness， climbing stairs， going out， activity， and energy， as well as the total score， decreased significantly in the treatment group compared with the pre-treatment values （P<0.05）. In the control group， the scores for cough， expectoration， chest tightness， sleep， energy， and the total score decreased （P<0.05）. After treatment， the treatment group showed significantly lower scores for cough， expectoration， chest tightness， activity， and going out than the control group （P<0.05）. Regarding the mMRC score， CRP level， and WBC count， all these parameters decreased significantly in the treatment group compared with the pre-treatment values （P<0.05）， and similar reductions were observed in the control group （P<0.05）. ConclusionJinwei Pingchuan decoction can reduce the number of acute exacerbations and the degree of acute exacerbation in patients with acute exacerbation of COPD with phlegm-heat obstruction in lung syndrome. It also improves lung function and symptoms such as cough and chest tightness， thereby enhancing the quality of life of patients.

Objective To analyze the predictive value of cone beam computed tomography(CBCT)in styloid process syndrome(SPS)via logistic regression combined with receiver operating characteristic(ROC)curve.Methods A retrospective analysis was conducted on imaging data of 186 patients who underwent styloid CBCT.Among them,65 patients were clinically diagnosed with SPS(patient group),while 121 constituted the healthy controls(control group).The styloid length,inclination angle,and anteversion angle were measured,respectively.Logistic regression analysis was employed,and ROC curves were plotted to calculate sensitivity,specificity,and Youden index,the diagnostic cut-off values for SPS was obtained.Results In the control group,the styloid length was(29.66±7.22)mm,inclination angle was(22.34±3.05)°,and anteversion angle was(31.01±4.13)°.In the patient group,the styloid length was(40.30±8.65)mm,inclination angle was(21.86±3.74)°,and anteversion angle was(35.88±6.37)°.Logistic regression analysis revealed that styloid length and anteversion angle were risk factors for diagnosing SPS(P＜0.05),while inclination angle was not a risk factor for diagno-sing SPS(P＞0.05).ROC curve analysis demonstrated that diagnosing SPS,the area under the curve(AUC),sensitivity,specificity,and optimal cut-off value for styloid length were 0.868,92.3％,69.7％,and 31.23 mm,respectively;and for anteversion angle were 0.765,63.1％,89.3％,and 35.15°,respectively.Conclusion CBCT measurements of styloid length,inclination angle,and antever-sion angle suggest that a styloid length exceeding 31.23 mm and an styloid anteversion angle greater than 35.15° may indicate a higher likelihood of SPS.CBCT is a convenient,cost-effective,and safe diagnostic tool with positive clinical implications.

Objective To explore the prescription law of Professor Wang Yinglin for treating pediatric cough based on the Carma algorithm and complex network.Methods The prescriptions of children with cough as the chief complaint who were treated by Professor Wang in the outpatient department from November 2022 to May 2023 were taken as the research object.Carma algorithm and complex network were used to analyze the main prescriptions of Professor Wang for treating children's cough,and explore the prescription law of Professor Wang for treating children's cough.Results A total of 420 cases were included,with an average age of 6.5 years old.Among them,there were 158 males and 262 females,involving 420 prescriptions,97 kinds of Chinese materia medica,a total frequency of 4 665,and 37 drugs with a frequency of use>20.By analyzing the drug combination derived from Carma analysis of algorithms and clinical verification,it was found that Professor Wang commonly used two drug combinations to treat children's cough:Poria-Exocarpium Citri Rubrum,Scrophulariae Radix-Imperatae Rhizoma,Peucedani Radix-Cynanchi Stauntonii Rhizoma,Perillae Fructus-Asteris Radix,Saposhnikoviae Radix-Liquidambaris Fructus;three medicine combination:Perillae Fructus-Asteris Radix-Semen Lepidii,Poria-Cablin Potchouli Herb-Exocarpium Citri Rubrum,Magnoliae Flos-Saposhnikoviae Radix-Liquidambaris Fructus;the combination of four drugs included Poria-Scrophulariae Radix-Exocarpium Citri Rubrum-Imperatae Rhizoma,Poria-Adenophorae Radix-Exocarpium Citri Rubrum-Scrophulariae Radix;five medicine combinations:Poria-Scrophulariae Radix-Exocarpium Citri Rubrum-Imperatae Rhizoma-Adenophorae Radix,Poria-Scrophulariae Radix-Exocarpium Citri Rubrum-Imperatae Rhizoma-Cablin Potchouli Herb;six medicine combinations:Poria-Scrophulariae Radix-Exocarpium Citri Rubrum-Imperatae Rhizoma-Adenophorae Radix-Folium Eriobotryae,Poria-Scrophulariae Radix-Exocarpium Citri Rubrum-Imperatae Rhizoma-Adenophorae Radix-Isatidis Radix,Poria-Scrophulariae Radix-Exocarpium Citri Rubrum-Imperatae Rhizoma-Cablin Potchouli Herb-Saposhnikoviae Radix,Folium Eriobotryae-Perillae Fructus-Asteris Radix-Semen Lepidii-Peucedani Radix-Cynanchi Stauntonii Rhizoma,Glehniae Radix-Crataegi Fructus-Stemonae Radix-Bulbus Lilii-Bulbus Fritillariae Cirrhosae-Ophiopogonis Radix.Complex network analysis found that the core drugs were:Adenophorae Radix,Poria,Exocarpium Citri Rubrum,Scrophulariae Radix,Imperatae Rhizoma,Folium Eriobotryae,Bulbus Fritillariae Thunbergii,Isatidis Radix,Peucedani Radix,Cynanchi Stauntonii Rhizoma,Stemonae Radix,Bambusae Concretio Silicea,Cablin Potchouli Herb.Five core prescriptions were obtained by multi-scale backbone network analysis.Conclusion Professor Wang's treatment of pediatric cough varies depending on the medical history,symptoms,and location of the disease,with different prescriptions.New diseases are often considered based on pathogenic factors,with phlegm heat as the main treatment,and the efficacy is mostly achieved by purging the lungs and resolving phlegm;phlegm heat gradually subsides,and residual pathogens are not cleared.The main approach is to eliminate residual pathogens and replenish qi and yin;long term illness mainly focuses on supplementing qi and nourishing yin.

【Objective】 To study the level of occult hepatitis B virus methylation and replication related genes, and to explore the effect of the former on the latter. 【Methods】 The cases in control group (healthy control, n=3), occult hepatitis B group (occult HBV group, n=3) and hepatitis B group (HBV group, n=3) were detected by Illumina methylation 850k chip. The difference analysis, GO analysis and KEGG analysis were carried out. The methylation and virus replication related genes DNMT1, DNMT2, Dnmt3a and ZHX2 were screened for RT-PCR. 【Results】 The methylation level of occult HBV group and HBV group was significantly higher than that of the control group. Difference analysis showed that there were 1 050 differential methylation sites in occult HBV group with the methylation level greater than non-methylation level, and 1 340 differential methylation sites as the opposite compared with the control group. In HBV group, there were 1 008 differential methylation sites with methylation level greater than non-methylation level, and 1 242 differential methylation sites as the opposite. Go analysis showed that compared with the control group, the differential gene expression in occult HBV group and HBV group was significantly related to many anabolic processes in biological process (BP), cell composition (CC) and molecular function (MF). The enrichment analysis of KEGG pathway between the control group and the occult HBV group showed that the differential genes were mainly involved in adhesion junction, basal cell carcinoma, endometrial carcinoma, EB virus infection, hepatocellular carcinoma and other signal pathways. The enrichment analysis of KEGG pathway in occult HBV group and HBV group showed that the differential genes were mainly involved in AMPK signal pathway, cell cycle, endometrial cancer, hepatitis C, hepatocellular carcinoma and other signal pathways. DNMT1 and DNMT3a in occult HBV group and HBV group were significantly higher while ZHX2 was significantly lower than those in control group. 【Conclusion】 The methylation level of occult HBV group and HBV group increased significantly while ZHX2 decreased significantly. Hypermethylation inhibited the expression of ZHX2 and changed the replication of hepatitis B virus. Hepatitis B virus DNA methylation provides a theoretical basis for the replication mechanism of hepatitis B virus and a new method for the treatment of hepatitis B virus.

Objective To understand the rationality and safety of oral antihypertensive drugs on chronic renal disease(CKD)combined with hypertension hospitalized patients. Methods It was a multi-center and retrospective investigation. The electronic medical records of CKD with hypertension patients who were hospitalized in 6 comprehensive hospitals in Beijing and used oral antihypertensive drugs on October 1st,2013 to March 31st,2015 were collected. The pharmacists who participated in the project from the 6 research centers filled out the investigation form. According to the drug instruction,the rationality of antihypertensive medication was evaluated by daily dose,frequency of drug delivery,the dosage for renal insufficiency,contraindications and adverse interactions. Results There were 2 833 valid cases in this study,1 730 males and 1 103 females. The ratio of male to female was 1:0.64. The range of age was 18~101 years. The average age was(61 ± 18)years. There were 1 630(57.54%)cases whose age was≥60;314(11.1%)cases were CKD level 1,526(18.6%)cases were CKD level 2,1 117(39.4%)cases were CKD level 3,423(14.9%)cases were CKD level 4,453(16.0%)cases were CKD level 5. 144 (5.1%)cases were hypertension level 1,592(20.9%)cases were hypertension level 2,1 398 cases (49.3%)were hypertension level 3,and 699(24.7%)cases were not graded. The oral hypotensive drugs applied during the hospitalization of 2 833 patients included calcium channel blockers(CCB),beta blockers,diuretics,angiotensin Ⅱ receptor blocker(ARB),angiotensin converting enzyme inhibitors (ACEI),alpha/beta blockers and alpha blockers. 1 022(36.1%)cases used 1 kind of antihypertensive drugs,1 032(36.4%)cases used 2 kinds of antihypertensive drugs,591(20.9%)cases used 3 kinds of antihyper-tensive drugs,157(5.5%)cases used 4 kinds of antihypertensive drugs and 31(1.1%)cases used 5 kinds of antihypertensive drugs. A total of 6038 cases of antihypertensive drugs were administered. The top priority was CCB(35.11%,2 120),the second was beta blockers(17.26%,1 042)and the third was diuretics(16.23%,980). The choice of a single drug for antihypertensive drugs was reasonable. The 2,3,4,5 combined drug users who were not recommended by the guidelines were 4.8%(50/1 032), 21.2%(125/591),28.0%(44/157)and 64.5%(20/31)respectively. The situation of blood pressure control was evaluated with blood pressure target values achieved rate. With blood pressure below 130/80 mmHg as the standard,the admission and discharge blood pressure target achieved rate was 31.2%(884/2 833)and 29.5%(799/2 705)respectively. With blood pressure below 140/90 mmHg as the standard, the admission and discharge blood pressure target achievement rate was 53.6%(1 519/2 833)and 64.4%(1 743/2 705)respectively. Among the 2 833 cases,903(31.9%)cases had 1 204 times of unreasonable use of the drug. The top three were excessive daily frequency of medication(1 029,85.5%),total daily dosage(114,9.5%),and use of drugs that were contraindicated(51,4.2%). Two cases had adverse drug reactions related to antihypertensive drugs. Conclusion The use of antihypertensive drugs in patients with CKD in the six hospitals involved in the investigation was reasonable,but there was still some problems in the combination of drugs. Some doctors are not familiar with the drug instructions,and there are some problems such as increasing the frequency of drug use,overdose medication,and use of drugs that are contraindicated. Clinical pharmacists should be more involved in clinical work in these areas.

Objective To understand the rationality and safety of oral antihypertensive drugs on chronic renal disease(CKD)combined with hypertension hospitalized patients. Methods It was a multi-center and retrospective investigation. The electronic medical records of CKD with hypertension patients who were hospitalized in 6 comprehensive hospitals in Beijing and used oral antihypertensive drugs on October 1st,2013 to March 31st,2015 were collected. The pharmacists who participated in the project from the 6 research centers filled out the investigation form. According to the drug instruction,the rationality of antihypertensive medication was evaluated by daily dose,frequency of drug delivery,the dosage for renal insufficiency,contraindications and adverse interactions. Results There were 2 833 valid cases in this study,1 730 males and 1 103 females. The ratio of male to female was 1:0.64. The range of age was 18~101 years. The average age was(61 ± 18)years. There were 1 630(57.54%)cases whose age was≥60;314(11.1%)cases were CKD level 1,526(18.6%)cases were CKD level 2,1 117(39.4%)cases were CKD level 3,423(14.9%)cases were CKD level 4,453(16.0%)cases were CKD level 5. 144 (5.1%)cases were hypertension level 1,592(20.9%)cases were hypertension level 2,1 398 cases (49.3%)were hypertension level 3,and 699(24.7%)cases were not graded. The oral hypotensive drugs applied during the hospitalization of 2 833 patients included calcium channel blockers(CCB),beta blockers,diuretics,angiotensin Ⅱ receptor blocker(ARB),angiotensin converting enzyme inhibitors (ACEI),alpha/beta blockers and alpha blockers. 1 022(36.1%)cases used 1 kind of antihypertensive drugs,1 032(36.4%)cases used 2 kinds of antihypertensive drugs,591(20.9%)cases used 3 kinds of antihyper-tensive drugs,157(5.5%)cases used 4 kinds of antihypertensive drugs and 31(1.1%)cases used 5 kinds of antihypertensive drugs. A total of 6038 cases of antihypertensive drugs were administered. The top priority was CCB(35.11%,2 120),the second was beta blockers(17.26%,1 042)and the third was diuretics(16.23%,980). The choice of a single drug for antihypertensive drugs was reasonable. The 2,3,4,5 combined drug users who were not recommended by the guidelines were 4.8%(50/1 032), 21.2%(125/591),28.0%(44/157)and 64.5%(20/31)respectively. The situation of blood pressure control was evaluated with blood pressure target values achieved rate. With blood pressure below 130/80 mmHg as the standard,the admission and discharge blood pressure target achieved rate was 31.2%(884/2 833)and 29.5%(799/2 705)respectively. With blood pressure below 140/90 mmHg as the standard, the admission and discharge blood pressure target achievement rate was 53.6%(1 519/2 833)and 64.4%(1 743/2 705)respectively. Among the 2 833 cases,903(31.9%)cases had 1 204 times of unreasonable use of the drug. The top three were excessive daily frequency of medication(1 029,85.5%),total daily dosage(114,9.5%),and use of drugs that were contraindicated(51,4.2%). Two cases had adverse drug reactions related to antihypertensive drugs. Conclusion The use of antihypertensive drugs in patients with CKD in the six hospitals involved in the investigation was reasonable,but there was still some problems in the combination of drugs. Some doctors are not familiar with the drug instructions,and there are some problems such as increasing the frequency of drug use,overdose medication,and use of drugs that are contraindicated. Clinical pharmacists should be more involved in clinical work in these areas.

Objective To establish a method of quick three-dimensional (3D) reconstruction of pubic symphysis based on magnetic resonance imaging. Methods The pelvis images of adult male were generated on a 3.0 T scanner using a T1 Gradient Echo FLASH-3D (T1- FL3D) sequence and imported the images into medical image control system. Segmentation of binaryzation threshold was conducted and pelvic soft tissue image was extracted by regional growth, 3D structure model of pubic symphysis was obtained by Boolean operation. The 3D structure model of pubic symphysis was established by the noise reduction of reverse engineering software. And compared with the 3D reconstruction model pubic bone CT scan. Results The morphological characters of the MRI pubic symphysis 3D model, such as the ridges and furrows on the symphysial surface, lower extremity, dorsal margin (beveling), margin (beveling) and pubic tubercle, were highly consistent with the morphological characters of the 3D model established by CT scan. Conclusion MRI scan can be used to reconstruct the 3D structure of pubic symphysis quickly and effectively, and it can provide a safe radiation-free 3D visualization imaging technique for forensic age estimation for the living.