Objective To evaluate the efficacy and safety of CT-guided percutaneous radiofrequency ablation (RFA) as an alternative for video-assisted thoracoscopic surgery (VATS) in treating multiple pulmonary nodules. Methods A retrospective analysis was conducted on the clinical data of 113 patients with multiple pulmonary nodules admitted to Jiangsu Provincial Hospital of Traditional Chinese Medicine from October 2020 to October 2022. The patients were divided into the RFA group (n＝50) and the VATS group (n＝63) based on the treatment method. Perioperative indicators (operation time, intraoperative blood loss, postoperative length of hospital stay), oncological outcomes (recurrence-free survival [RFS], overall survival [OS]), and postoperative complication rates were compared between the two groups. Univariate and multivariate Cox regression analysis was performed to identify independent prognostic factors. Results The operation time in the RFA group was significantly shorter than that in the VATS group ([75.2±20.1] min vs [102.3±28.7]) min, P＜0.001). No statistically significant differences were observed in intraoperative blood loss and postoperative length of hospital stay. After follow-up of 24 (12, 30) months, no statistically significant differences were found in RFS (HR＝1.25, P＝0.445) or OS (HR＝1.42, P＝0.402) between the two groups. Mixed ground-glass nodules with high solid component and solid nodule were identified as independent risk factors for RFS (HR＝2.44, P＝0.023; HR＝2.97, P＝0.007) and OS (HR＝2.87, P＝0.022; HR＝3.43, P＝0.005) in patients with multiple pulmonary nodules. The total complication rate in the RFA group was lower than that in the VATS group (12.0% vs 34.9%, P＝0.009). Conclusions The efficacy of CT-guided RFA in treating multiple pulmonary nodules is comparable to that of VATS, with good safety, and it shows promise as an alternative to surgical treatment for multiple pulmonary nodules.

OBJECTIVE To explore the effect and mechanism of Zexie tang （ZXT） on reducing lipid accumulation through network pharmacology， and compare the difference of traditional decoction versus formula granules. METHODS The active components and targets of ZXT were identified using TCMSP and SwissTargetPrediction databases. GeneCards， OMIM， DisGeNET and TTD databases were used to analyze the related targets of non-alcoholic fatty liver disease （NAFLD）； protein-protein interaction network model was constructed by String database；“ ZXT-NAFLD target-pathway” network diagram was constructed by using CytoScape software； target enrichment analysis was performed by using Metascape platform. Fat accumulation model of human hepatocellular carcinoma HepG2 cells was established to observe the effects of traditional decoction and formula granules of ZXT on lipid accumulation of cells. RESULTS Alisol B， alisol C， 1-monolinolein and alisol B monoacetate were the key active components of ZXT in the treatment of NAFLD. The core targets included MDM2， MAPK1， PIK3CB， PRKCQ and MAPK14， etc. The core signaling pathways included endocrine resistance， insulin resistance and Th17 cell differentiation. Compared with model group， except for the Zexie formula granules group and Baizhu formula granules group， the absorbance values in all other administration groups were significantly decreased （P＜0.01）； the absorbance value of Baizhu traditional decoction group was significantly higher than that of ZXT traditional decoction group （P＜0.01）； the absorbance values of Zexie formula granule group and Baizhu formula granule group were significantly higher than that of ZXT formula granule group （P＜0.01）； the absorbance value of Zexie formula granule group was significantly higher than that of Zexie traditional decoction group （P＜0.01）； the absorbance value of Baizhu formula granule group was significantly higher than that of Baizhu traditional decoction group （P＜0.01）. CONCLUSIONS ZXT reduces lipid accumulation of human hepatocellular carcinoma cells through multiple components， multiple target and multiple pathways， and its traditional decoction and formula granules exhibit slightly different lipid-lowering effects.

Diarrhea-predominant irritable bowel syndrome(IBS-D)is a clinically common functional gastrointestinal disease,the"SCFAs-intestinal barrier"pathway plays an important role in the pathogenesis of IBS-D.Traditional Chinese medicine monomers/compounds or Chinese medicine compound can treat IBS-D by regulating the"SCFAs-intestinal barrier"through multiple pathways and multiple targets.This article takes the relationship between SCFAs and the four major intestinal barriers,as well as the mediating effect of IBS-D,as the starting point to systematically review and sort out the relevant literature on the targeted regulation of"SCFAs-intestinal barrier"in the treatment of IBS-D by Traditional Chinese medicine monomers/compounds and Chinese medicine compound;explores the theoretical basis of IBS-D caused by"SCFAs-intestinal barrier"from the perspective of"Large intes-tine dominating fluid",in order to provid ideas for Traditional Chinese medicine to establish a precision treatment system with Chinese medicine characteristics.

OBJECTIVE To study the differences in toxicity between intravenous(iv)administration and aqueous solution exposure of Dichroa alkali salt(DAS)in zebrafish.METHODS ① Well-devel-oped zebrafish larvae of 2 d post fertilization(2 dpf)were randomly divided into the normal control(no treatment),solvent control(saline,iv),and DAS groups(0.125,0.25,0.50,1.00 and 2.00 mg·kg-1,iv)before being observed for 3 consecutive days after administration.A heart rate of 0 was determined as death of zebrafish,and the mortality rate,maximum non-lethal dose(MNLD),and 10 percent lethal dose(LD10)were calculated.The incidence of venous sinus congestion,pericardial edema,slowing heart rate and blood flow of zebrafish in the 0.50 and 2.00 mg·kg-1 groups were observed and calculated by somatoscopic microscopy at 4 h after drug administration.Zebrafish larvae were iv given DAS at doses of 0.041,0.136,0.412,and 0.452 mg·kg-1 while the malformation phenotypes of zebrafish larvae development were observed under a stereomicroscope for 3 consecutive days,including pericardial edema,abnormal heart rate,slow blood flow,loss of circulation,eye abnormalities,brain malforma-tions,jaw abnormalities,loss/degeneration of the liver,delayed yolk sac absorption,intestinal abnormal-ities,abnormal body coloration,body edema,curvature of the trunk/tail/nodal cord and muscle degener-ation before the incidence was calculated.②Zebrafish larvae were randomly divided into a normal control group and DAS aqueous solution exposure groups at concentrations of 2.5,5.0,10.0,25.0,50.0,75.0,and 100.0 mg·L-1,observed for 3 d until the mortality rate,LD10,and MNLD were calculated.Zebrafish were exposed to DAS aqueous solutions at concentrations of 0.32,1.06,3.20,and 11.00 mg·L-1,and the malformation phenotypes of zebrafish larvae development were observed under a stereomicro-scope for 3 consecutive days to calculate the incidence.RESULTS ① The MNLD and LD10 of DAS iv administered to zebrafish larvae were 0.412 and 0.452 mg·kg-1,respectively.Compared with the solvent control group,4 h after DAS iv administration,the incidence of sinus congestion,slow heart rate and pericardial edema in the 0.50 and 2.00 mg·kg-1 groups significantly increased(P<0.05,P<0.01),so was the incidence of slow blood flow in the 2.00 mg·kg-1 group(P<0.01).The rate of delayed yolk sac absorption was significantly increased in the 0.041,0.136,0.412,and 0.452 mg·kg-1 groups(P<0.05,P<0.01),so was the mortality rate in the 0.452 mg·kg-1 group(P<0.05),with pericardial edema observed in the dead zebrafish.② The MNLD and LD10 of DAS aqueous solution exposure for zebrafish larvae were 3.20 and 11.00 mg·L-1,respectively.Compared with the normal control group,the incidence of decreased heart rate and slow blood flow was significantly increased in the 3.20 and 11.00 mg·L-1 groups(P<0.01),so was the incidence of significantly darkened intestines in the 1.06,3.20,and 11.00 mg·L-1 groups(P<0.01).The incidence of delayed yolk sac absorption was significantly increased in the 0.32,1.06,3.20,and 11.00 mg·L-1 groups(P<0.05,P<0.01),so was the incidence of trunk curvature and lower jaw malformation in the 11.00 mg·L-1 group(P<0.01).CONCLUSION The toxic phenotypes of DAS are different between iv administration and aqueous solution exposure in zebrafish larvae.DAS aqueous solution exposure can not only lead to slow heart rate,slow blood rheology,delayed yolk sac absorption and intestinal blackening,but also induce neurodevelopmental toxicity.However,iv adminis-tration can effectively ward off significant gastrointestinal damage and neurodevelopmental toxicity.

Objective:To investigate the safety and feasibility of the CHESS endoscpic ruler (CHESS ruler), and the consistency between the measured values and the interpretation values by endoscopic physician experience.Methods:From January 2021 to January 2022, a total of 105 liver cirrhosis patients with portal hypertension were prospectively enrolled from General Hospital, Xixia Branch Hospital, Ningnan Hospital of People′s Hospital of Ningxia Hui Autonomous Region (29 cases), and the First People′s Hospital of Yinchuan (25 cases), General Hospital of Ningxia Medical University (18 cases), Wuzhong People′s Hospital (10 cases), the Fifth People′s Hospital of Ningxia Hui Autonomous Region (10 cases), Shizuishan Second People′s Hospital (6 cases), Yinchuan Second People′s Hospital (5 cases), and Zhongwei People′s Hospital (2 cases) 8 hospitals. The clinical characteristics of all the patients, including gender, age, nationality, etiolog of liver cirrhosis, and Child-Pugh classification of liver function were recorded. A big gastroesophageal varices was defined as diameter of varices ≥5 mm. Endoscopist (associated chief physician) performed gastroscopy according to the routine gastroscopy procedures, and the diameter of the biggest esophageal varices was measured by experience and images were collected, and then objective measurement was with the CHESS ruler and images were collected. The diameter of esophageal varices of 10 randomly selected patients (random number table method) was determined by 6 endoscopists (attending physician or associated chief physician) with experience or measured by CHESS ruler. Kappa test was used to test the consistency in the diameter of esophageal varices between measured values by CHESS ruler and the interpretation values by endoscopic physician experience.Results:Among 105 liver cirrhosis patients with portal hypertension, male 65 cases and female 40 cases, aged (54.8±12.2) years old, Han nationality 82 cases, Hui nationality 21 cases and Mongolian nationality 2 cases. The etiology of liver cirrhosis included chronic hepatitis B (79 cases), alcoholic liver disease (7 cases), autoimmune hepatitis (7 cases), chronic hepatitis C (2 cases), and other etiology (10 cases). Liver function of 32 cases was Child-Pugh A, Child-Pugh B 57 cases, and Child-Pugh C 16 cases. All 105 liver cirrhosis patients with cirrhotic portal hypertension were successfully measured the diameter of gastroesophageal varices by CHESS ruler, and the success rate of application of CHESS ruler was 100.0% (105/105). The procedure time from the CHESS ruler into the body to the exit of the body after measurement was (3.50±2.55) min. No complications happened in all the patients during measurement. Among 105 liver cirrhosis patients with cirrhotic portal hypertension, 96 cases (91.4%) were recognized as big gastroesophageal varices by the endoscopists. Totally 93 cases (88.6%) were considered as big gastroesophageal varices by CHESS ruler. Eight cases were recognized as big gastroesophageal varices by the endoscopist, however not by the CHESS ruler; 5 cases were recognized as big gastroesophageal varices by the CHESS ruler, but not by the endoscopists; 4 cases were not recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler; 88 cases were recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler. The missed diagnostic rate of big gastroesophageal varices by the endoscopists experience was 5.4% (5/93), and the Kappa value of consistency coefficient between the measurement by the CHESS ruler and the interpretation by endoscopists experience was 0.31 (95% confidence interval 0.03 to 0.60). The overall Kappa value of consistency coefficient by 6 endoscopists measured by CHESS ruler in big gastroesophageal varices diagnosis was 0.77 (95% confidence interval 0.61 to 0.93).Conclusion:As an objective measurement tool, CHESS ruler can make up for the deficiency of subjective judgment by endoscopists, accurately measure the diameter of gastroesophageal varices, and is highly feasible and safe.

Objective To evaluate the clinical value of the upper extremital artery supply and vein running back in the patients after peripheral vascular surgery by Na99mTcO4 trace imaging(TTI).Methods SPECT static imaging was performed on 36 patients after peripheral vascular surgery in vein injecting Na99mTcO4 740 MBq 5min.The radioactivity uptake of operated limb(finger)/normal limb(finger) ratio(T/NT) was analyzed using region of interest analysis.0,Ⅰ,Ⅱand Ⅲ scales were classified according to their radionuclide distribution and T/NT,were divided into A,B,C and D group,respectively.Localy warming and anticontrctive therapy were only given in A and B group for 30min,routine therapy in C group,and raising operated limb (finger) and reductive pressure treatment in D group.Then,exploratory surgery was performed on 0 scales and Ⅲ scales of TTI again.Results A,B,C and D group were 11,7,13 and 5 patients,their T/NT was (0.142 ± 0.058),(0.384 ± 0.046),(0.794 ± 0.072) and (1.12 ±0.076),respectvely,and there were significant differences among the groups(t =2.33a,4.33b,6.90b,2.59a,5.73b,2.12a,aP ＜ 0.05,b P ＜ 0.O1) ;TTI again showed:there were 7 cases of 0 scales (arterial thrombosis was confirmed by exploratory surgery) and 4 cases of Ⅰ scales in A group,3 cases of Ⅰ scales and 4 cases of Ⅱ scales in B group,all 13 cases of Ⅱ scales in C group,4 cases of Ⅱ scales and 1 case of Ⅲ scales(vein thrombosis was confirmed by exploratory surgery) in D group.Conclusion TTI could play an important role in economical,simple and notraumatic diagnosing the extremital artery supply and vein running back in the patients after peripheral vascular surgery.

Objective To investigate the clinical value of the decfion of percentage of pulmonary perfusion defect score (PPDS％) in patients with pulmonary embolism (PE).Methods A retrospective study was carried out on PPDs％ data of patients(n =36) with clinical confirmed PE.The patients were divided into three levels:low (PPDS％ ＜30％),medial (30％ ≤PPDS％ ＜50％) and high (PPDS％ ≥50％) risk groups,according to the standard of PPDs％ diagnosis.the PPDS％ and the incidence rate of the clinical adverse events were compared in mild,moderate and severe risk PE.The therapeutic results were compared with the PPDS％ changes.Results The mild,moderate and severe risk patients with PE were 15 cases,13 cases and 8 cases respectively,according to the standard of PPDS％ diagnosis.16 cases,12 cases and 8 cases respectively,according to the standard of 2008 ESC APE diagnosis and treatment guidelines.The uniform rate was 94.4％ for two methods,the uniform rate was 100.0％ in which high risk of PE.The PPDS％ of PE was (46.2 ± 4.6) ％ before treatment.The data was significantly higher than that post treatment (31.6％ ± 1.8％) (t =17.38,P ＜ 0.01).The scores of low,medial and high risk patients were (25.9 ± 3.9) ％,(45.6 ± 4.3) ％ and (58.4 ± 4.9) ％ (t =6.18,P ＜ 0.01),respectively.The mild,moderate and severe risk PE according to the PPDS％ standard with clinical adverse events for were 1 cases (6.5％),3 cases (23.0％) and 5 cases (62.5 ％) respectively,with a significant difference (x2 =8.71,P ＜ 0.05).Conclusion PPDS％ could be used as an important reference index for risk stratification of diagnosis,evaluating therapeutic efficiency and predicting the prognosis in patients with PE.

Objective To investigate the clinical value of percentage of pulmonary perfusion defect score ( PPDs％ ) for risk stratification and prognosis evaluation in patients with acute pulmonary embolism (APE).Methods A retrospective study was carried out on PPDs％ data of patients( n =21 ) with confirmed APE from January 2001 to December 2008.The patients were divided into three levels,low( n =10),medial( n =7) and high risk groups( n =4),according to 2008 ESC APE diagnosis and treatment guidelines.The reference index in predicting risk stratification by PPDs％ was ascertained.34 patients with confirmed APE were divided into three levels ( mild,moderate and severe risk levels) according to the standard of PPDS％ diagnosis from January 2009 to June 2011.A prospective study on the incidence rate of the clinical adverse events was performed.Results The PPDs％ of low,medial and high risk levels according to 2008 ESC guidelines were (25.94 ± 3.95 ) ％,(45.63 ± 4.38 ) ％ and ( 58.42 ± 4.96 ) ％ respectively,with a significant difference ( t ≥4.755,P ＜ 0.01 ).The standard of PPDS％ diagnosis for risk stratification was confirmed in APE:low risk levels:PPDs％ ＜ 30％,moderate:30％ ≤ PPDs％ ＜50％,and high:PPDs％ ≥50％.The mild,moderate and severe risk patients with APE were 17cases,11cases and 6cases respectively,according to the standard of PPDs％ diagnosis,or 15cases,13cases and 6cases respectiveldy,according to the standard of 2008 ESC guidelines.The uniform rate was 94.11％ for two methods; the uniform rate was 100.00％ in which high risk of APE.The mild,moderate and severe risk patients with APE according to the standard of PPDs％ standard with clinical adverse events for were 1case (5.89％ ),3cases (27.27％ ) and 4cases (66.67％ ) respectively,with a significant difference ( x2 =9.23,P ＜0.01 ).Conclusions PPDs％ could be used as an important reference index for risk stratification of diagnosis,selecting therapeutic programs,evaluating therapeutic efficiency and predicting the prognosis in patients with APE.

Objective To study the application of a new magnetic beads made in China in DNA extraction of forensic biological samples with automation workstation.Methods DNA was extracted from common forensic biological samples by QIAGEN Bio-Robert Universal System and a new magnetic beads made in China,and then typed with Identifiler system in ABI3130XL Genetic Analyzer.210 of these samples were also quantitated by ABI7500 Real Time System.Results Total of 9100 genomic DNA was extracted from various forensic biological samples by the new magnetic beads made in China and automation workstation methods,and most of them were successfully typed for STR analysis.In these biological samples,oral swabs and muscles were of the highest Success rate of STR typing(100%),and the lowest was touched cell samples (50.0%).Conclusion The new magnetic beads made in China with automation workstation methods can be applied to DNA extraction of most forensic biological samples.

Objective To explore feasibility of monitoring the extremital arterial blood supply and venous blood circulation in rabbits with replanted limb by Na~(99m)TcO_4 trace imaging(TTI). Methods TTI was performed on 6 normal control rabbits and 30 rabbits with replanted limb at 24～36h after replantation. The radioactivity uptake ratio of replanted limb/normal limb(T/NT) was analyzed. Imaging was classified into ?,Ⅰ,Ⅱand Ⅲ scales according to the accumulation amount of extremital radionuclide. Then an exploratory operation was performed on each rabbit. Results Rabbits with ?,Ⅰ,Ⅱand Ⅳ scales had 8,6,15(including 6 normal control rabbits),and 7 animals, respectively, and their T/NT were 0.178?0.072, 0.461?0.046, 0.816?0.074, 1.14?0.086(P1.05) may serve as a qualitative and semiquantitative diagnostic standard for venous blood circulation block. Conclusion TTI was feasible in monitoring the extremital arterial blood supply and venous blood circulation in patients with replanted limb(finger).