As a patented characteristic medicine of Yi ethnic minority， Pingxuan capsules have the effects of nourishing the liver and kidney， pacifying the liver， and subduing Yang. With the main indications of dizziness， headache， palpitations， tinnitus， insomnia， dreaminess， waist and knee soreness caused by liver-kidney deficiency and liver Yang upward disturbance， Pingxuan capsules are widely used in the treatment of posterior circulation ischemic vertigo， vestibular migraine， benign paroxysmal positional vertigo. However， the current knowledge is limited regarding the efficacy， syndrome differentiation， and safety of this medicine. On the basis of summarizing the experience of clinicians and the existing evidence， this study invites clinical experts of traditional Chinese and Western medicine， pharmaceutical experts， and methodological experts from relevant fields across China to conduct evidence-based evaluation of Pingxuan capsules. The evaluation follows the Specifications for the Development of Clinical Expert Consensus on Chinese Patent Medicines issued by the Standardization Office of the China Association of Chinese Medicine， and reaches 5 recommendations and 16 consensus suggestions. The consensus clarifies the clinical applications， efficacy， dose， course of treatment， combination of medicines， precautions， and contraindications of Pingxuan capsules in the treatment of vertigo and explains the safety of clinical application. This consensus is applicable to clinicians （traditional Chinese medicine， Western medicine， and integrated traditional Chinese and Western medicine） and pharmacists in tertiary hospitals， secondary hospitals， and community-level medical and health institutions across China， providing a reference for the rational use of Pingxuan capsules in the treatment of vertigo. It is hoped that the promotion of this consensus can facilitate the rational use of drugs in clinical practice， reduce the risk of drug use， and give full play to the advantages of Pingxuan capsules in the treatment of vertigo diseases. This consensus has been reviewed and published by the China Association of Chinese Medicine， with the number GS/CACM330-2023.

Among tumor microenvironment (TME), the entire metabolic characteristics of tumor-resident cells are reprogrammed to benefit the expansion of tumor cells, which count on glutamine in large part to fuel the tricarboxylic acid cycle for energy generation and anabolic metabolism support. Endothelial cells that are abducted by tumor cells to form a pathological tumor vascular network for constructing the hypoxic immunosuppressive TME, also rely on glutaminolysis as the "engine" of angiogenesis. Additionally, the glutamine metabolic preference benefits the polarization of TAMs towards pro-tumoral M2 phenotype as well. Herein, we developed a type of siRNA micelleplexes (MH@siGLS1) to reverse immunosuppressive TME by targeting glutaminolysis within tumor-resident cells for tumor vasculature normalization- and TAMs repolarization-enhanced photo-immunotherapy. Tumor cell starvation and antioxidant system destruction achieved by MH@siGLS1-mediated glutaminolysis inhibition could promote photodynamic therapy efficacy, which was available to trigger immunogenic cell death for adaptive antitumor immune responses. Meanwhile, glutaminolysis inhibition of tumor endothelial cells and TAMs could realize tumor vascular normalization and TAMs repolarization for antitumor immunity amplification. This study provides a unique perspective on cancer treatments by focusing on the interrelations of metabolic characteristics and the biofunctions of various cell types within TME.

Objective To investigate the effect of Shuxuetong Injection,which is a Chinese patent drug with the blood-breaking and stasis-resolving actions and is administered within 24 hours after revascularization,on hemorrhagic transformation(HT)in patients with acute ischemic stroke(AIS).Methods The retrospective study was carried out in 204 AIS patients who received revascularization treatment such as intravenous thrombolysis,mechanical thrombectomy,or bridging therapy at the Encephalopathy Center of Guangdong Provincial Hospital of Chinese Medicine between January 1,2018,and April 30,2021.The patients were divided into Shuxuetong group(57 cases,receiving Shuxuetong injection within 24 hours after revascularization)and the non-Shuxuetong group(147 cases,having no Shuxuetong injection within 24 hours revascularization).With HT incidence as the primary outcome,Logistic regression analysis was performed to explore the correlation between Shuxuetong use and HT,and the results were expressed as odds ratios(OR)and 95%confidence intervals(CIs).Results(1)There were 6 cases of HT(10.53%)in the Shuxuetong group and 33 cases of HT(22.45%)in the non-Shuxuetong group.The Shuxuetong group tended to have a lower HT incidence,though the difference was not statistically significant(P=0.052).(2)The Shuxuetong group had a younger age,lower baseline National Institutes of Health Stroke Scale(NIHSS)scores,white blood cell count(WBC)and international normalized ratio(INR),longer onset-to-needle time(ONT)and onset-to-puncture time(OPT),higher percentage of using intravenous thrombolysis,and lower percentage of prior anticoagulant use than the non-Shuxuetong group when admitted to the hospital(all P＜0.05).(3)Patients were divided into HT group(39 cases,19.12%)and non-HT group(165 cases,80.88%)according to the occurrence of HT.Shuxuetong use was less frequent in the HT group(6 cases,15.38%)than that in the non-HT group(51 cases,30.91%),but the difference was not significant(P=0.052).Intravenous thrombolysis was less common in the HT group(4 cases,10.26%)than that in the non-HT group(53 cases,32.12%),and the difference was significant(P＜0.05).(4)Univariate analysis(Model 1)showed that non-users of Shuxuetong within 24 hours had 2.46-fold higher HT risk than the users[95%CI(0.970-6.239),P=0.058].In the multivariate logistic regression analysis(Model 2),adjustment was conducted for HT-related confounders of age,sex,intravenous thrombolysis,baseline NIHSS score,atrial fibrillation,prior antiplatelet/anticoagulant use,admission systolic/diastolic blood pressure,diabetes,24-hour antiplatelet/anticoagulation treatment.Model 2 analysis revealed that non-users of Shuxuetong within 24 hours had 3.17-fold higher HT risk than the users[95%CI(1.061-9.456),P=0.039].Conclusion Among AIS patients receiving revascularization treatment such as intravenous thrombolysis,mechanical thrombectomy,or bridging therapy therapies,administration of Shuxuetong Injection within 24 hours does not increase HT risk.

Purpose: This study aims to explore whether neoadjuvant chemotherapy with immunotherapy (NACI) leads to different tumor shrinkage patterns, based on magnetic resonance imaging (MRI), compared to neoadjuvant chemotherapy (NAC) alone in patients with triple-negative breast cancer (TNBC). Additionally, the study investigates the relationship between tumor shrinkage patterns and treatment efficacy was investigated. Methods: This retrospective study included patients with TNBC patients receiving NAC or NACI from January 2019 until July 2021 at our center. Pre- and post-treatment MRI results were obtained for each patient, and tumor shrinkage patterns were classified into three categories as follows: 1) concentric shrinkage (CS); 2) diffuse decrease; and 3) no change.Tumor shrinkage patterns were compared between the NAC and NACI groups, and the relevance of the patterns to treatment efficacy was assessed. Results: Of the 99 patients, 65 received NAC and 34 received NACI. The CS pattern was observed in 53% and 20% of patients in the NAC and NACI groups, respectively. Diffuse decrease pattern was observed in 36% and 68% of patients in the NAC and NACI groups. The association between the treatment regimens (NAC and NACI) and tumor shrinkage patterns was statistically significant (p = 0.004). The postoperative pathological complete response (pCR) rate was 45% and 82% in the NAC and NACI groups (p < 0.001), respectively. In the NACI group, 17% of patients with the CS pattern and 56% of those with the diffuse decrease pattern achieved pCR (p = 0.903). All tumor shrinkage patterns were associated with achieved a high pCR rate in the NACI group. Conclusion Our study demonstrates that the diffuse decrease pattern of tumor shrinkage is more common following NACI than that following NAC. Furthermore, our findings suggest that all tumor shrinkage patterns are associated with a high pCR rate in patients with TNBC treated with NACI.

Objective To assess the structure validity of application of sub-health measurement scale version 1.0(SHMS V1.0)in college students in Guangzhou City to lay a foundation for further analyzing the healthy status in this group and its influen-cing factors.Methods Nine hundreds college students were selected by adopting the stratified random sampling method for conduc-ting the questionnaire survey.The SPSS20.0 and AMOS21.0 were adopted to conduct the exploratory factor analysis(EFA)and confirmatory factor analysis(CFA)respectively.Results EFA obtained 7 factors with eigenvalue more than 1,the cumulative vari-ance contribution rate was 56.766%,moreover 7 factors were basically consistent with the theoretical structure of SHMS V 1.0. CFA conducted the model fitting for 3 total scales and 3 subscales,the results showed that the fitting of 3 subscales was good,the fitting result of total scale could be accepted,but did not reach the desired effect.Therefore,five times modification was applied in the total scale,and the fitting indexes after modification were CMIN/DF=2.723,GFI=0.907,IFI=0.917,TLI= 0.905,CFI=0.917,RMSEA=0.046,the fitting effect was comparatively excellent.Conclusion The dimension division of sub-health measure-ment scale is basically reasonable,and using this scale for measuring the sub-health status of college students in Guangzhou City has a better structure validity.

Objective To analyze the clinical manifestations of pulmonary fungal disease in patients with different pathogen infection and different immune states. Methods A retrospective analysis was carried out with the clinical data of 78 patients with pulmonary fungal disease who were treated in Fujian Provincial Hospital from June 2012 to June 2016. Results The identified pathogens included Cryptococcus (78.2％, 61/78), Aspergillus(17.9％, 14/78), Talaromyces marneffei, Mucor, and Trichosporon asahii (one each). Cryptococcus was mostly found in healthy individuals without underlying disease and Aspergillus largely infected those with underlying disease. Diabetes mellitus was the most common underlying disease. Pulmonary fungal infection was confirmed by pneumonectomy (41.0％, 32/78), CT-guided percutaneous transthoracic biopsy (43.6％, 34/78), transbronchial lung biopsy (14.1％, 11/78), or blood culture (1.3％, 1/78). Pulmonary cryptococcosis was often asymptomatic (47.5％, 29/61). Hemoptysis was only found in the patients with underlying disease. The patients with pulmonary aspergillosis showed higher prevalence of hemoptysis (57.1％, 8/14) than the patients with other pulmonary fungal diseases. Bronchoscopy usually gave negative finding in case of pulmonary cryptococcosis (77.8％, 14/18). Inflammatory exudation was the primary finding of pulmonary aspergillosis (6/10). Intraluminal necrosis and neoplasia were only found in the aspergillosis patients with underlying disease. The primary imaging findings in pulmonary cryptococcosis was nodule or mass (78.7％, 48/61). Halo sign and crescent sign were rarely found in pulmonary aspergillosis. Of the 78 patients, 45 (57.7％) patients received pharmacological therapy alone, 15 (19.2％) surgical treatment alone, and 18 (23.1％) received drugs in combination with surgery. Six patients died, 25 lost to follow-up, and 47 with stable disease. Conclusions The clinical characteristics of pulmonary fungal disease vary with the pathogen and the immune states of patients. Clinical symptoms and immune status of patients should be taken into account when making diagnosis of pulmonary fungal disease for the purpose to speculate the probable fungal pathogen and choose the most appropriate diagnostic tool.

Objective To establish the norms of Self-rated Health Measurement Scale Version 1. 0 ( SRHMS V1.0) for urban residents in Guangdong. Methods We used regional stratified random sampling method to select 6000 urban residents of 5 cities in Guangdong ( including Guangzhou, Maoming, Shantou, Shaoguan and Shenzhen) for a questionnaire investigation with SRHMS V1. 0, and establish the norms of mean,percentile and threshold based on characteristics of SRHMS V1.0 scores. Results The residents can be divided into 8 groups on the basis of gender and cut-off point of age 40,50 and 60. The mean norms of SRHMS V1.0 total scores were:(78.57±10.10),(76.93±9.90),(75.33±10.66),(69.45±13.90)for males under age40,40-50,50-60 and above 60 respectively;(77.03±10.00),(74.55±10.27),(72.24±11.76), (66.48±14.37)for females under age40,40-50,50-60 and above 60 respectively. The percentile norms of SRHMS V1.0 from 5 percent to 95 percent were established with 5% as interval. The norms of cutting off scores were established as five states according to the scores of TS,namely severe poor health,poor health,gen-eral health,good health and fairly good health,with( x-s),( x-0.5s),( x+0.5s),( x+s) as cutting off scores. Conclusion The study established the SRHMS V1.0 norms for urban residents of Guangdong preliminarily,which provides reference for further research of the population''s health status and its impacting factors.

Objective To explore epidemiology, clinical features and prevention strategy for pulmonary tuberculosis in the military units of the Southern Theatre of Operations.Methods Analyses were made on the epidemiological and clinical data of 146 confirmed cases of pulmonary tuberculosis ( TB) from 2008 to 2012 in the Southern Theatre of Operations.Then, short-term chemother-apy and preventive anti-TB chemotherapy were given to the patients and those having close contact with the patients.Results Morbidity of pulmonary tuberculosis in the military units of the Southern Theatre of Operations tended to decrease year by year.Incidence was higher in summer and autumn seasons and most victims were military personnel with 1-3 years of service.Main clinical symptoms were cough, sputum, chest pain, and tightness in the chest.Positive rates of serum TB antibody, tuberculin (PPD) test and sputum TB bac-teria test were usually not high ( about 30%) .Lung imaging foci were mostly in the upper lobe of the lung, accounting for 63%.Re-sults of the 2-month treatment indicated that effectual rate was 91.1%(133 cases), effective rate 7.5%(11 cases) and non-effective rate 1.4%(2 cases), with total effective rate being 98.6%and recurrent rate being 1.5%(2/133).Outbreak of pulmonary tubercu-losis infection was seen neither among those in close contact with TB patients nor in their units.Conclusion The strategy for the pre-vention and control of pulmonary TB in the Southern Theatre of Operations was early diagnosis and treatment of the disease.Routine health check and health check before deployment, close monitoring of main risk population and preventive treatment of those in close contact with open pulmonary TB patients with anti-TB chemotherapy were important measures, so that the outbreak of TB infection could be effectively curbed in the military units.

OBJECTIVE To explore the relationship between the point mutations of gene CYP51 and the azole-resistance mechanism in clinical Candida albicans isolates.METHODS The paper diffusion test and NCCLS M-27 protocols were used to screen the fluconazole-resistant and itraconazole-resistant C.albicans clinical isolates.Gene CYP51 of two azole-resistant C.albicans clinical strains(2007H and 2007T strains) was amplified by three pairs of primers,respectively.The PCR products purified were sequenced,and compared with the nucleotide sequences of C.albicans(accession No.:X13296) to find out the mutation sites.RESULTS The nucleotide sequence analysis showed that there were both significant point mutations and silent mutations in gene CYP51 from two azole-resistant isolates of C.albicans.Seven mutations previously described,F105L,K128T,Y132H,T199I,R267H,G464S,and R467K,were identified in the two strains.The animo acid substitutions of Y132H and R467K,known to contribution to azole resistance,were detected in both 2007H strain and 2007T strain.Four novel mutations,including F71L,W244R,T311N and T352I,were simultanously identified.Nine silent mutations appeared in two isolates.CONCLUSIONS In this survey,the two azole-resistant C.albicans clinical isolates contained more than one mutation in gene CYP51 that is associated with azole resistance.Four novel mutations of CYP51 may be associated with the resistance of C.albicans to azoles.And the mechanisms need to be further studied in detail.