This article combined the pathogenic characteristics of "latent wind" with the theory of collateral diseases to clarify the pathological features of tumor blood vessels， including their active proliferation， high permeabi-lity， and promotion of metastasis. The theory framework of "latent wind in collaterals" as the tumor mechanism was proposed， which suggests that at the site of tumor lesions， the collaterals inherit the nature of latent wind to grow excessively， adopt an open and discharge nature to leak essence， and tumor toxins， characterized by their rapid movement and frequent changes， spread and metastasize， driving the progression of malignant tumors. Focusing on the fundamental pathogenesis of "latent wind in collaterals"， specific clinical treatment principles and methods centered on treating wind are proposed， including regulating qi and dispelling wind， clearing heat and extinguishing wind， unblocking collaterals and expelling wind， and reinforcing healthy qi to calm wind， so as to provide references for enhancing the precision of traditional Chinese medicine in treating malignant tumors.

Objective:To compare the efficacy of internal fixation using cannulated screw combined with fibular allograft and internal fixation using cannulated screw alone in the treatment of femoral neck fracture in young and middle-aged patients.Methods:A retrospective cohort study was conducted to analyze the clinical data of 75 young and middle-aged patients with femoral neck fracture admitted to the Third Hospital of Hebei Medical University from January 2020 to December 2022, including 44 males and 31 females, aged 34-56 years [(46.1±12.7)years]. According to Garden classification, 26 patients were classified as type II, 35 type III and 14 type IV. According to the Pauwels classification, 9 patients were classified as type I, 31 type II and 35 type III. Forty-nine patients were treated with internal fixation using three cannulated screws alone (cannulated screw group) and 26 with internal fixation using three cannulated screws combined with double-barrel fibular allograft (cannulated screw combined with bone grafting group). The operation time, intraoperative blood loss, length of hospital stay, and quality of fracture reduction were compared between the two groups. At 4, 8 months after operation and at the last follow-up, grading of femoral neck shortening, number of patients walking with crutches, Barthel index, and Harris hip function score were evaluated. The incidence of complications was measured at the last follow-up.Results:All the patients were followed up for 16-37 months [(23.2±4.5)months]. The operation time of the cannulated screw combined with bone grafting group was (86.3±16.1)minutes, longer than (76.9±20.8)minutes of the cannulated screw group ( P<0.05). The intraoperative blood loss was 100.0(50.0, 200.0)ml in the cannulated screw combined with bone grafting group, more than 50.0(50.0, 100.0)ml in the cannulated screw group ( P<0.01). There were no significant differences in the length of hospital stay or the quality of fracture reduction between the two groups ( P>0.05). At 4 months after operation, grading of the femoral neck shortening in the cannulated screw combined with bone grafting group [24 patients (92.3%) with grade 1, 2(7.7%) with grade 2, and 0(0.0%) with grade 3] was better than that in the cannulated screw group [18 patients (36.7%) with grade 1, 28(57.1%) with grade 2, and 3(6.2%) with grade 3] ( P<0.01). At 8 months after operation, grading of femoral neck shortening in the cannulated screw combined with bone grafting group [22 patients (84.6%) with grade 1, 3(11.5%) with grade 2, and 1(3.8%) with grade 3] was better than that in the cannulated screw group [13 patients (26.5%) with grade 1, 27(55.1%) with grade 2, and 9(18.4%) with grade 3] ( P<0.01). At the last follow-up, grading of femoral neck shortening in the cannulated screw combined with bone grafting group [19 patients (73.0%) with grade 1, 5(19.2%) with grade 2, and 2(7.6%) with grade 3] was better than that in the cannulated screw group [8 patients (16.3%) with grade 1, 31(63.2%) with grade 2, and 10(20.4%) with grade 3] ( P<0.01). At 4, 8 months after operation and at the last follow-up, 12(46.2%), 8(30.8%) and 5(19.2%) patients in the cannulated screw combined with bone grafting group and 38(77.6%), 27(55.1%) and 20(40.8%) patients in the cannulated screw group had to walk with crutches, respectively, showing significant difference between the two groups at the other two time points ( P<0.05 or 0.01) except for at the last follow-up ( P>0.05). The Barthel index values were 85.3±3.2, 90.3±4.3, and 95.3±3.9 in the cannulated screw combined with bone grafting group at 4, 8 months after operation and at the last follow-up, significantly higher than 80.8±7.3, 85.4±7.4, and 90.9±7.8 in the cannulated screw group ( P<0.05 or 0.01). The Harris hip scores were (87.0±2.9)points, (92.0±2.9)points and (91.3±2.4)points in the cannulated screw combined with bone grafting group at 4, 8 months after operation and at the last follow-up, significantly higher than (81.0±6.1)points, (85.7±5.8)points, and (89.6±2.0)points in the cannulated screw group ( P<0.01). At the last follow-up, the complication rate was 3.8%(1/26) in the cannulated screw combined with bone grafting group, significantly lower than 22.4%(11/49) in the cannulated screw group ( P<0.05). Conclusion:For femoral neck fractures in young and middle-aged patients, compared with internal fixation using cannulated screw alone, internal fixation using cannulated screw combined with fibular allograft has more advantages in correcting femoral neck shortening, restoring independent living activities and hip joint function, and reducing the incidence of complications despite its longer operation time and more intraoperative blood loss.

ObjectiveTo investigate the satisfaction of both service providers and users in community health service centers through questionnaires， and to analyze the reasons， so as to put forward suggestions for improving satisfaction. MethodsSampling was conducted in 247 community health service centers in 16 districts of Shanghai， and data were collected from employees and patients through on-site questionnaires. ResultsA total of 10 334 eligible questionnaires were collected from community health service centers， of which 7 712 were from patients and 2 622 were from employees. In 2021， the public's satisfaction with community health service centers was 96.51 points， and the satisfaction of employees was 94.08 points. The public expressed lower satisfaction with the availability of essential drugs for outpatient services， while the staff were less satisfied with their salary and benefits， work recognition， and career development. Regarding family doctor services， 73.38% of the public had signed up for family doctor services， while 23.57% of the public did not know about the family doctor services， and 16.18% believed it was necessary to improve the publicity of basic public health services. ConclusionThe public's overall satisfaction with the service of community health services is gradually increased. The basic medical services of community health are recognized by residents. Drug allocation needs to be improved urgently， and publicity and promotion need to be further strengthened. The overall satisfaction of employees is high， but further improvement is needed in terms of salary and benefits， work recognition， and career development.

The National Medical Products Administration has authorized sodium oligomannate for treating mild-to-moderate Alzheimer's disease.In this study,an LC-MS/MS method was developed and validated to quantitate sodium oligomannate in different biomatrices.The plasma pharmacokinetics,tissue distri-bution,and excretion of sodium oligomannate in Sprague-Dawley rats and beagle dogs were system-atically investigated.Despite its complicated structural composition,the absorption,distribution,metabolism,and excretion profiles of the oligosaccharides in sodium oligomannate of different sizes and terminal derivatives were indiscriminate.Sodium oligomannate mainly crossed the gastrointestinal epithelium through paracellular transport following oral administration,with very low oral bioavail-ability in rats(0.6％-1.6％)and dogs(4.5％-9.3％).Absorbed sodium oligomannate mainly resided in circulating body fluids in free form with minimal distribution into erythrocytes and major tissues.So-dium oligomannate could penetrate the blood-cerebrospinal fluid(CSF)barrier of rats,showing a con-stant area under the concentration-time curve ratio(CSF/plasma)of approximately 5％.The cumulative urinary excretion of sodium oligomannate was commensurate with its oral bioavailability,supporting that excretion was predominantly renal,whereas no obvious biliary secretion was observed following a single oral dose to bile duct-cannulated rats.Moreover,only 33.7％(male)and 26.3％(female)of the oral dose were recovered in the rat excreta within 96 h following a single oral administration,suggesting that the intestinal flora may have ingested a portion of unabsorbed sodium oligomannate as a nutrient.

OBJECTIVE：To study the h ypoglycemic effect of Hordeum vulgare polysaccharide（HVP）on diabetes mellitus model mice and its mechanism. METHODS ：The mice were given intraperitoneal injection of streptozotocin （120 mg/kg）to induce diabetes mellitus model. After modeling ，the mice were randomly divided into model group ，metformin group （positive control ， 200 mg/kg），HVP high-dose ，medium-dose and low-dose groups （300，150 and 75 mg/kg），with 10 mice in each group. Blank control group was established additionally. Administration groups were given relevant medicine intragastrically ；blank control group and model group were given constant volume of water intragastrically ，once a day ，for consecutive 30 days. The levels of fasting blood glucose （FBG）were determined after 10，20，30 days of administration. After last FBG test ，mice were intraperitoneally injected with 10％ glucose solution （2 g/kg），then the area under the glucose tolerance （GTT）curve was measured at 30 and 120 min after injection. The serum levels of insulin ，the content of superoxide dismutase （SOD），glutathione peroxidase （GSH-Px）， malondialdehyde（MDA）in liver tissue were detected. Pancreatic morphology of mice were detected by HE staining. RESULTS ： Compared with blank control group ，the FBG ，area under GTT curve and MDA contnet in liver tissue were increased significantly in model group （P＜0.01），while serum levels of insulin ，SOD and GSH-Px contents in liver tissue were decreased significantly （P＜0.01）；the pancreatic tissue was seriously damaged with incomplete morphology and obvious vacuoles. Compared with model group，FBG，area under GTT curve ，MDA content in liver Δ 基金项目：国家自然科学基金资助项目（No.81473179） tissue were decreased significantly in HVP high-dose group ＊主管药师 。研究方向 ：临床药学 。电话：0510-85351490。E- mail：Wangshengya_helen@126.com （P＜0.05 or P＜0.01），serum content of insulin ，the content # 通信作者 ：副主任药师 。研究方向 ：医院药学 。电话：0510- of SOD and GSH-Px in liver tissue were increased 85351490。E-mail：3103221944@qq.com significantly（P＜0.05 or P＜0.01）；above indexes of HVP 中国药房 2021年第32卷第7期 China Pharmacy 2021Vol. 32 No. 7 ·807· low-dose and medium-dose groups were improved partially ，with statistical significance （P＜0.05 or P＜0.01）；the pancreatic tissue damage was alleviated ，the morphology was relatively complete ，the islet cells were closely arranged ，and the vacuoles were reduced. CONLUSIONS ：HVP can reduce the level of blood glucose in diabetic model mice ，increase insulin level and relieve pancreatic injury. The mechanism may be related to its antioxidation.

ObjectiveTo investigate the efficacy and safety of sertraline combined with low-dose aripiprazole in the treatment of obsessive-compulsive disorder in children and adolescents. MethodsA total of 62 cases pediatric patients aged 9~16 years who attended the outpatient clinic of a psychiatric hospital in Xiamen from June 2018 to May 2020 and met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） for obsessive-compulsive disorder were enrolled in the study. The selected children were randomly classified into two groups for different treatments. Control group （n=30） received sertraline monotherapy， and study group （n=32） received sertraline combined with low-dose aripiprazole treatment. At the baseline and the end of the 2^nd， 4^th， 8^th and 12^th weeks of treatment， children were assessed using Children's Yale-Brown Obsessive Compulsive Scale （CY-BOCS） and Treatment Emergent Symptoms Scale （TESS）. Thereafter， the clinical efficacy and adverse reactions were compared between two groups. ResultsThe compulsive behavior dimensional score of CY-BOCS of study group was lower than that of control group at end of the 2^nd and 4^th weeks of treatment （t=-2.083， -2.176， P<0.05）. At the end of the 2^nd week of treatment， the effective rate was 40.63% in study group， which was significantly higher than 3.33% in control group （χ²=12.317， P<0.01）. By the end of the 12^th weeks of treatment， the incidence rate of side effects yielded no statistical difference between two groups （χ²=1.608， P=0.205）. ConclusionCompared with sertraline monotherapy， its combination with low-dose aripiprazole treatment can effectively accelerate the improvement of clinical symptoms in childrenand adolescents with obsessive-compulsive disorder， while the combination therapy and sertraline monotherapy have equivalent safety.

Objective:To analyze the expression level of malignant biological marker gene in locally advanced low rectal cancer tissues after neoadjuvant chemotherapy with XELOX, so as to provide guidance for clinical treatment.Methods:Based on the established inclusion and exclusion criteria, 104 patients with locally advanced low rectal cancer treated in the Surgery Department of the Affiliate Hospital of Qingdao University from January 2017 to January 2018 were included in the study. Based on the random number table method, they were divided into observation group and control group, with 52 patients in each group. Radical resection was performed in both groups, while radical resection was performed directly in the control group, and neoadjuvant chemotherapy with XELOX plus radical resection was performed in the observation group. The effect of tumor resection in the two groups was compared and analyzed, and the expression levels of tumor markers and malignant biological marker genes in the tumor tissues after surgery were determined. The 3-year postoperative survival rate of the two groups was followed up.Results:The R0 resection rate was 96.15% in the observation group and 80.77% in the control group, with statistically significant difference ( P<0.05). There were no significant differences in the serum levels of cancer antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA) and carbohydrate antigen 50 (CA50) before the operation in the two groups ( P>0.05). One week after the operation, the serum levels of CA19-9, CEA and CA50 in the observation group were significantly lower than those in the control group ( P<0.05). Through detection, the relative mRNA expression levels of PPTG and Smad4 in the postoperative observation group were higher than those in the control group, while the relative mRNA expression levels of Runx3 and APC were lower than those in the control group, with statistically significant difference ( P<0.05). The 3-year follow-up survival rate in the observation group was 90.38%, significantly higher than 78.85% in the control group ( P<0.05). Conclusions:The application of XELOX neoadjuvant chemotherapy in radical resection of locally advanced low rectal cancer has important clinical value in reducing tumor malignancy, improving tumor resection effect and improving survival.

Objective: To explore the serological and genotypic characteristics of a pedigree with B(A).06 subtype. Methods: Serological methods was used to identify the ABO phenotypes. Exons 6 and 7 of the ABO gene and flanking regions were subjected to direct sequencing and TA clonal sequencing in order to determine the genotype of individuals with inconsistent results for forward and reverse serological typing. Results: Among 12 individuals from 4 generations, 5 were identified with a AwB phenotype, along with a c. 803C>G mutation in exon 7 of the B allele, which was named as B(A).06. The B(A).06/O.01.01 phenotype may be easily missed due to its weak anti-A antibody in the serum upon initial serological test. Conclusion A B(A).06 subtype family was identified. The serological phenotype of individuals carrying the B(A).06 allele may be affected by the opposite DNA strand.

Objective: To analyze the risk factors of adverse neurodevelopmental prognostic in very /extremely low birth weight infants (VLBWI/ELBWI). Methods: The 24 hours VLBWI/ELBWI admitted to the neonatal intensive care unit between January 2016 and October 2016 were enrolled.These infants were followed up and neurodevelopmental evaluation was performed at a corrected age of 12 months by using the Bayley Scales of Infant Development Ⅱ (BSID-Ⅱ). According to the neurodevelopmental outcomes, they were divided into normal and abnormal neurodeve-lopment groups.The data of prenatal, intrapartum and postpartum periods in the two groups were compared.Potential risk factors of neurodevelopmental impairment were analyzed with Logistic stepwise regression. Results: A total of 167 VLBWI/ELBWI were enrolled, among which 14 cases died during hospitalization or after giving up treatment.At the corrected age of 12 months, 140(91.5%) infants completed follow-up and 13(8.5%) were lost to follow-up.Among 140 infants who completed neurodevelopmental evaluation at the corrected age of 12 months, there were 86 males, 54 females, and in which 28 cases had extremely low birth weight, 112 cases with very low birth weight, with gestational age of (30.4±2.2) weeks (25.3-36.0 weeks). There were one hundred and twenty-five cases with normal neurodevelopmental outcomes and 15 cases with abnormal neurodevelopmental outcomes.The results of univariate analysis showed that birth weight<1 000 g, exposure to antenatal steroids, N -terminal brain natriuretic peptide (NT-proBNP) ≥35 000 ng/L and bronchopulmonary dysplasia (BPD) in the two groups were statistically significant(P<0.05). Logistic stepwise regression showed that NT-proBNP level≥35 000 ng/L may independently predict neurodevelopmental impairment among VLBWI/ELBWI (OR=22.774, 95%CI: 3.079-168.425, P=0.002). Exposure to antenatal steroids may be a protective factor for neurodevelopmental impairment (OR=0.125, 95%CI: 0.020-0.782, P=0.026). Conclusions Plasma NT-proBNP level ≥35 000 ng/L may independently predict neurodevelopmental impairment among VLBWI/ELBWI.Antenatal corticosteroids may be the protective factor of poor neurodevelopmental outcomes.

OBJECTIVE: To study the expression of PSMA7 and its effect on proliferation, invasion and migration of gastric cancer and subcutaneous tumorigenesis in nude mice. >and subcutaneous tumorigenesis in nude mice. METHODS: Specimens of tumor tissues and paired adjacent tissues were collected from 60 patients with gastric cancer for detecting the expression levels of PSMA7 using immunohistochemical method. Gastric cancer cell line SGC7901 was transfected with a lentiviral vector to inhibit PSMA7 expression, and the changes in cell proliferation and invasion were observed using cell counting kit-8 (CCK-8), clone formation assay and Transwell assay. A BALB/c mouse model bearing subcutaneous gastric cancer xenograft was established using SGC7901 cells with stable PSMA7 knockdown to assess the effect of low expression of PSMA7 on xenograft growth. RESULTS: Gastric cancer tissues expressed significantly higher levels of PSMA7 than the paired adjacent tissues ( < 0.05). In SGC7901 cells, interference of PSMA7 expression significantly inhibited the cell proliferation and invasion ( < 0.05). In the tumor-bearing BALB/c mice, the xenografts derived from SGC7901 cells with PSMA7 expression interference showed significant growth suppression as compared with the control xenografts ( < 0.05). CONCLUSIONS PPSMA 7 is overexpressed in gastric cancer tissues, and PSMA7 knockdown inhibits the proliferation, invasion, migration and subcutaneous tumorigenesis of gastric cancer cells in nude mice.
Animals ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Invasiveness ; Proteasome Endopeptidase Complex ; metabolism ; Stomach Neoplasms