Objective:to analyze the relationship between the changes of lymphocyte subsets and cardiac function classification in elderly patients with chronic heart failure and preserved ejection fraction.Methods:A total of 835 elderly patients with preserved ejection fraction treated in our hospital from August 2022 to June 2023 were retrospectively selected, and divided into grade Ⅰ(302 cases), grade Ⅱ(254 cases), grade Ⅲ(144 cases)and grade Ⅳ(135 cases)according to the cardiac function classification, and 211 cases in the same period were selected as the control group.The general data of patients were collected, and the expression of T lymphocyte subsets and serum levels of cardiac related factor in patients with different cardiac function classifications were compared and analyzed.Results:There were no statistically significant differences in age, gender, BMI, systolic blood pressure, diastolic blood pressure and heart rate between the two groups( P>0.05).The lower the cardiac function classification, the higher the levels of CD4 + [grade Ⅰ: (39.7±8.0)%, grade Ⅱ: (36.9±8.3)%, grade Ⅲ: (32.1±6.5)%, grade Ⅳ: (31.3±5.1)%], CD4 + /CD8 + [grade Ⅰ: (1.8±0.5), grade Ⅱ: (1.5±0.5), grade Ⅲ: (1.4±0.5), grade Ⅳ: (1.1±0.3)], and the lower the levels of CD8 + [grade Ⅰ: (23.9±5.1)%, grade Ⅱ: (25.5±8.4)%, grade Ⅲ: (26.3±10.0)%, grade Ⅳ: (30.7±9.0)%]in T lymphocyte subsets( F=56.846, 84.154, 23.965, P<0.05); the lower the levels of sST2, GAL-3 and GDF-15 in serum of patients with lower cardiac function classification( F=217.081, 141.741, 123.835, P<0.05); CD4 + and CD4 + /CD8 + were negatively correlated with cardiac function grading( r=-0.482 and r=-0.849, P<0.05), CD8 + was positively correlated with cardiac function grading( r=0.948, P<0.05); the effect of using T lymphocyte subsets to diagnose cardiac function grading was higher and the AUC was 0.984. Conclusions:The accuracy of lymphocyte subsets in the diagnosis of cardiac function grading in elderly patients with chronic heart failure and preserved ejection fraction is higher, which is worthy of promotion.

Hirsutine,an indole alkaloid extracted from the traditional Chinese herb Uncaria,has exhibits diverse pharmaco-logical activities,including antihypotensive,antiinfective,and cardioprotection.In cervical cancer,breast cancer,colon cancer,and oth-er malignant tumors,hirsutine has effects on anti-tumor by regulating cell apoptosis,immune regulation and other pathways,laying the foundation for the application of hirsutine in the field of cancer therapy.This article reviews relevant literature both domestically and internationally to elucidate the research progress of hirsutine in anti-tumor therapy,providing new ideas and strategies for cancer treat-ment.

Objective To establish the analytical performance specifications(APS)for routine items of biochemical inspection based on the external quality assessment(EQA)and internal quality control(IQC)data.Methods The EQA data and IQC data of routine items of biochemistry inspection in clinical laboratory center of national health commission from 2021 to 2023 were collected from the Department Clinical Laboratory of Traditional Chinese Medicine Hospital of Chengdu Pidu District.Comparing the percentage difference of the EQA data and the IQC in control imprecision[expressed as the coefficient of variation(CV)]data with the 3-level evaluation criteria derived based on biological variation(BV),the percentage pass rate of EQA data and the pass rate of CV under control were calculated,so as to achieve the quality target of APS with 80％or more as the quality control product of this level as the routine biochemical test items of the laboratory.For the inspection items that did not reach BV standard APS or were not applicable to meet the standard,the APS would be set to the WS/T 403-2012 industry standard or based on current technical level.Results TEa/allowable CV of biochemical inspection items were as follows:Potassium(K)2.4％/1.9％,Sodium(Na)4.0％/0.9％,Chloride(Cl)4.0％/0.9％,Calcium(Ca)3.4％/1.8％,Phosphate(P)9.6％/1.9％,Magnesium(Mg)3.8％/2.0％,Glucose(Glu)6.1％/2.3％,Creatinine(Crea)3.9％/2.2％,Urea(Urea)8.6％/3.3％,Total protein(TP)4.9％/2.0％,Albumin(Alb)3.3％/1.9％,Total bilirubin(TBil)6.3％/2.4％,Alanine transaminase(ALT)9.3％/2.9％,Asparpartate transaminase(AST)6.2％/2.1％,γ-glutamyl transferase activity(GGT)9.2％/2.1％,Lactate dehydrogenase(LDH)6.8％/2.2％,Alkaline phosphatase(ALP)7.2％/3.3％,Total cholesterol(TC)of 8.3％/2.6％,Triglyceride(TG)12.9％/4.9％,Amylase(AMY)5.9％/1.6％,Creatine kinase(CK)4.3％/1.6％and Uric acid(UA)2.9％/1.0％.Conclusion The APS set based on BV or current technical level can be used as a quality target for routine laboratory clinical biochemistry testing programs,and the laboratory can select the suitable APS according to the actual situation.

In the past 20 years,near infrared spectrum technology has been widely used in human body monitoring due to its non-invasive and real-time characteristics.Oxygen,as the main metabolic substance of the human body,is consumed the most in brain tissue.In order to prevent complications caused by a decrease in brain tissue oxygen during treatment,the patient's brain tissue blood oxygen saturation needs to be monitored in real time.Currently,most of the clinically used non-invasive cerebral blood oxygen detection equipments use dual wavelengths.Other substances on the detection path will cause errors in the measurement results.Therefore,this article proposes a three-wavelength method based on the basic principle of non-invasive monitoring of cerebral blood oxygen using near-infrared spectrum.The brain tissue oxygen saturation monitoring method of detecting light sources was initially verified through the built system,laying the foundation for subsequent system engineering.

OBJECTIVE To observe the clinical efficacy of Yangyin Jiedu Decoction in the prevention and treatment of acute ra-diation-induced oral mucositis(RTOM).METHODS A total of 80 inpatients who were diagnosed with head and neck tumors by pathological examination and received radiotherapy in the Department of Radiotherapy,Affiliated Hospital of Nanjing University of Chi-nese Medicine from November 2021 to September 2023 were selected and randomly divided into an observation group and a control group with 40 cases in each group.The control group was given mouthwash treatment from the onset of RTOM symptoms until the symp-toms disappeared;the observation group was given Yangyin Jiedu Decoction from the first day of radiotherapy on the basis of the treat-ment of the control group until the end of radiotherapy.During the treatment,the onset time,duration and incidence of grade Ⅱ-ⅣRTOM in the two groups were observed;the pain numerical rating scale(NRS)score,Karnofsky performance status(KPS)score,body mass index(BMI)changes were evaluated;and the levels of serum inflammatory factors[C-reactive protein(CRP),interleukin 6(IL-6),interleukin 1β(IL-1β),tumor necrosis factor α(TNF-α)]were detected.RESULTS After radiotherapy,RTOM ap-peared in both groups to varying degrees.The incidence of grade Ⅱ-Ⅳ RTOM,the onset time,duration and NRS score of RTOM in the observation group were significantly better than those in the control group(P<0.05,P<0.01).After radiotherapy,the levels of se-rum CRP,IL-6,IL-1β and TNF-α in the observation group were lower than those in the control group(P<0.05,P<0.01).After radiotherapy and 1 month of follow-up,the KPS score and BMI in the observation group were higher than those in the control group(P<0.05,P<0.01).CONCLUSION Yangyin Jiedu Decoction can decrease the incidence and severity of RTOM in patients with head and neck tumors,shorten its duration,improve the quality of life of patients,downregulate the level of inflammatory cytokines,and has a preventive effect on RTOM caused by radiotherapy in patients with head and neck tumors.

Objective : To analyze the oral adverse drug reactions induced by omeprazole and provide a reference for rational clinical drug use. Methods: From January 2019 to June 2020, the clinical data of patients with burning mouth syndrome caused by omeprazole were collected and analyzed. Additionally, the related literature was reviewed. Results: Among the six patients, omeprazole was taken orally for as little as 6 months and as long as more than 5 years. The symptoms of burning mouth syndrome were mainly burning sensation in the mouth and paresthesia on the tongue that might be accompanied by extremity numbness. Vitamin and trace element supplementation was administered. The patient discontinued omeprazole, and symptoms disappeared after symptomatic treatment for 1 month to half a year. Literature review suggests that the reason may be associated with peripheral or central nervous system injury, altered saliva composition, and impaired vitamin and micronutrient intake caused by omeprazole. Conclusion The cause of burning mouth syndrome-like symptoms may be related to peripheral nerve injury caused by omeprazole and saliva changes. The main treatment is withdrawal and symptomatic treatment.

Objective:To investigate the influencing factors for orthostatic hypotension(OH)in elderly patients with hypertension.Methods:This was a case-control study.A total of 224 patients with hypertension aged over 65 years were included.After resting for more than 5 minutes, subjects had their blood pressures measured in the supine and standing position at 0 min, 1 min, 2 min and 3 min.OH was defined as a fall in systolic BP of more 20 mmHg(1 mmHg=0.133 kPa)and/or diastolic BP below 10 mmHg of baseline within 3 min in the upright position.Subjects were divided into the OH group( n=34)and the non-OH group( n=190). Baseline data, comorbidities and differences in medications were compare between the OH group and the non-OH group, and the influencing factors for OH were analyzed. Results:The proportion of drinkers was higher in the OH group than in the non-OH group(29.4% or 10/34 vs.7.4% or 14/190, χ2=14.649, P<0.01). Both systolic pressure(139.0±22.1 mmHg vs.124.5±16.3 mmHg, t=-3.661, P<0.01)and diastolic pressure(77.6±6.3 mmHg vs.69.2±9.0 mmHg, t=-6.696, P<0.01)in the supine position were higher in the OH group than in the non-OH group.The proportions of patients with diabetes(47.1% or 16/34 vs.25.3% or 48/190, χ2=6.731, P<0.05)and stroke(41.2% or 14/34 vs.24.2% or 46/190, χ2=4.233, P<0.05)were higher in the OH group than in the non-OH group.The proportion of patients receiving α receptor blockers was higher in the OH group than in the non-OH group(23.5% or 8/34 vs.4.2% or 8/190, χ2=16.228, P<0.01). After adjusting for factors such as alcohol consumption, diabetes, stroke and other differences between the OH and non-OH group, logistic regression found patients with alcohol intake( OR=5.274, 95% CI: 1.990~13.982, P<0.01), diabetes( OR=2.744, 95% CI: 1.213~6.208, P<0.05)and using α receptor blockers( OR=8.812, 95% CI: 2.835~27.383, P<0.01)had a higher risk of OH. Conclusions:OH is very common in elderly patients with hypertension.Alcohol consumption, diabetes mellitus and the application of α receptor blockers can increase the risk of OH.

Objective:The purpose of the study was to explore the association between red blood cell volume distribution width(RDW)and in-hospital mortality in elderly patients with acute ST segment elevation myocardial infarction(STEMI).Methods:A total of 429 elderly patients aged ≥65 years diagnosed with acute STEMI were recruited for this study.These patients were divided into 2 groups according to the median RDW: the low RDW group(RDW<13.33%, n=213)and the high RDW group(RDW≥13.33%, n=216). The in-hospital mortality was compared between the groups, and the relationship between RDW and in-hospital mortality in elderly STEMI patients was analyzed.Results:The in-hospital mortality of the high RDW group was significantly higher than that of the low RDW group(12.0% or 26 cases vs.3.3% or 7 cases, P<0.01). After adjusting for differences in age, sex, mean erythrocyte volume, RDW grouping and Killip grade between the two groups, the risk of in-hospital death for patients in the high RDW group was 3.258 times that in the low RDW group( OR=3.258, 95% CI: 1.291-8.222, P<0.05). In addition, aging( OR=1.079, 95% CI: 1.003-1.161, P<0.05)and Killip grade ≥Ⅲ( OR=13.987, 95% CI: 6.136-1.879, P<0.01)were also associated with increased risk of in-hospital death in elderly STEMI patients. Conclusions:RDW is associated with in-hospital mortality in elderly STEMI patients and can predict in-hospital mortality of STMEI in elderly patients.

Objective To evaluate the clinical efficacy and safety of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) to the tumor center in the treatment of bulky cervical cancer with massive bleeding in the first course radiotherapy.Methods Twenty-one cases with bulky cervical cancer complicated with massive vaginal bleeding were enrolled.At the first three times of external irradiation,a high dose radiotherapy (15 Gy/3 fractions) was delivered to the tumor center (the region retracted 2 cm from the periphery of cervical mass),followed by conventional irradiation (2 Gy/fraction) in the posterior course.Conventional dose irradiation (46 Gy/23 fractions) was given to the tumor periphery and pelvic lymphatic drainage area throughout the whole course.Concurrent chemotherapy by cisplatin at a dose of 25 mg/m2 was delivered weekly.After the external irradiation,intracavitary radiotherapy was given (20 Gy/4 fractions).Results Within 24 h after the first course radiotherapy,the volume of vaginal bleeding was significantly decreased by 50％ and the bleeding was almost stopped within one week.The hemostasis rate was 100％.Conclusions SIB-IMRT into the center of bulky cervical cancer is an efficacious treatment of massive vaginal bleeding.

Objective To investigate the value of urodynamic in treating those patients with benign prostatic hyperplasia complicated with bladder dysfunction.Methods 130 patients with benign prostatic hyperplasia were retrospectively reviewed between December 2015 and December 2016.The exclusive criteria included nervous system diseases,moderate to severe diabetes,moderate to severe hypertension,urethral stricture,bladder stones,prostate cancer,etc.The patient's age is ranged 51 to 92,mean 72 years old.The previous history of disease ranged from 3 months to 15 years,mean 4 years.All patients accepted the urodynamic examination.Different treatments were considered according to urodynamic studies.Results According to the classification of bladder outlet obstruction,130 cases were classified as bladder outlet obstruction in 109 cases,bladder suspicious obstruction in 15 cases,no bladder obstruction in 6 cases.According to the classification of bladder function,130 cases were divided into unstable bladder in 6 cases,low compliance bladder in 7 cases,bladder atony in 15 cases,bladder without tension in 3 cases,normal bladder function in 99 cases.3 cases without bladder tension,including BOO in 2 cases,suspected BOO in 1 case,were accepted the cystostomy.15 cases with less detrusor contraction,including BOO in 4 cases,suspected BOO in 9 cases,were accepted the cystostomy and TURP.Conservative treatment was performed in other 2 cases without obstruction.In 6 cases with unstable bladder,2 cases without obstruction accepted the conservative treatment,4 cases with suspected BOO accepted the TURP.In 7 patients with low compliance bladder,2 cases without obstruction accepted the conservative treatment,5 cases with suspected BOO accepted the TURP.The duration of following up was 3-6 months.The symptoms of the patients in this group improved significantly during following up.Conclusion For patients with benign prostatic hyperplasia complicated with bladder dysfunction,the results of urodynamics can help to choose the right treatment and improve effect of treatment.