Objective To explore the medication pattern of Chinese medicine practitioner LYU Guoxiong in treating vertigo from the phlegm theory,and to provide diagnostic and therapeutic solutions and scientific basis for the treatment of vertigo by traditional Chinese medicine.Methods To collect the diagnosis and treatment information of patients who attended the outpatient clinic of the Department of Neurology,Affiliated Hospital of Jiangxi University of Chinese Medicine and diagnosed with vertigo from October 2023 to March 2024,to construct a database of the inclusion criteria,and to analyse the frequency of use of traditional Chinese medicines,the four Qi,the flavour of a drug,the attribution of the meridians,the rules of association,and the clustering.Results A total of 150 patients with vertigo who met the criteria were included,and 150 prescriptions were recorded.Involving 114 flavours of traditional Chinese medicine,the total frequency of traditional Chinese medicines using was 1846 times.Among them,16 Chinese medicines were used>30 times,in the order of Huanglian,Fuling,Gancao,Baizhu,Chenpi,Banxia,Zhuru,Yanhusuo,Xiangfu,Niuxi,Gouteng,Zhenzhumu,Huangqin,Chaihu,Shouwuteng etc.The efficacy of high-frequency drugs was based on clearing heat and drying dampness to resolve phlegm,inducing dampness to strengthen the spleen,lowering Qi to resolve phlegm and remove lumps,relieving Qi stagnancy in stomach,activating blood circulation and removing blood stasis,etc.The tastes of the drugs were mostly to be hard and warm,sweet and flat,and bitter and cold,and the attributing meridians were mainly the spleen and liver meridians.The most commonly used drug pairs were Fuling-Zhuru,Huanglian-Fabanxia,Chenpi-Zhuru,Fuling-Gancao,etc.The drug pairs with high association support and confidence level were Huanglian-Chenpi,Fabanxia-Chenpi,Zhishi-Zhuru,Zhuru-Fabanxia,Fuling-Chenpi,Gancao-Chenpi.Conclusion Treating dizziness from the perspective of phlegm,the method of treating dizziness is to clear heat and phlegm,clear the gallbladder and stomach.Commonly used formulas such as Huanglian Wendan decoction are modified and adjusted according to the syndrome.

Objective:To investigate the protective effects of Huoxue Rongluo Decoction on hypoxic-ischemic brain damage (HIBD) rats; To clarify the expression of AMPK signaling pathway during HIBD injury and repair.Methods:On the basis of the hypoxia ischemia reperfusion model, an improved hypoxia bottle was used to establish a full-term HIBD rat model. Totally 60 successfully modeled mice were divided into model group and TCM group using a random number table method, with 30 mice in each group and 30 mice in a control group. Two hours before surgery, TCM group was orally administered with Huoxue Rongluo Decoction 1.17 g/100 g (equivalent dose). The control group and model group were orally administered with equal volume of physiological saline. Two hours after surgery, it was orally administered again, twice a day, for consecutive 5 d. Behavioral tests (convulsion assessment, Longa score, suspension test, water maze test) were used to evaluate the motor nerve function and long-term learning ability of young rats in different groups. HE staining and electron microscopy were used to observe the pathological changes of brain tissue and mitochondrial damage. Evans blue (EB) staining and brain water content measurement were used to detect blood-brain barrier permeability and brain edema. The expression of AMPK signaling pathway related genes in brain tissues of different groups of young rats was detected by PCR array technique.Results:Compared with the model group, the convulsions of the rats in the TCM group were improved, the Longa score was significantly reduced, the grip strength test score and suspension time were significantly improved, the escape latency was significantly shortened, and the number of crossing platforms significantly increased ( P<0.05); the degree of neuronal and mitochondrial damage in the TCM group was reduced, and cerebral vascular permeability and brain water content were significantly reduced ( P<0.01). The results of PCR array showed that compared with the control group, 2 genes were significantly up-regulated and 12 genes were significantly down-regulated in the brain tissue of the model group; compared with TCM group, 15 genes were relatively down-regulated in the model group. Conclusion:Huoxue Rongluo Decoction can significantly reduce the degree of brain injury after HIBD, improve the motor nerve function and long-term learning and cognitive ability of model rats, and its damage repair mechanism is related to the expression regulation of AMPK signaling pathway related genes.

With the recent ongoing autumn/winter 2022 COVID-19 wave and the adjustment of public health control measures, there have been widespread SARS-CoV-2 infections in Chinese mainland. Here we have analyzed 369 viral genomes from recently diagnosed COVID-19 patients in Shanghai, identifying a large number of sublineages of the SARS-CoV-2 Omicron family. Phylogenetic analysis, coupled with contact history tracing, revealed simultaneous community transmission of two Omicron sublineages dominating the infections in some areas of China (BA.5.2 mainly in Guangzhou and Shanghai, and BF.7 mainly in Beijing) and two highly infectious sublineages recently imported from abroad (XBB and BQ.1). Publicly available data from August 31 to November 29, 2022 indicated an overall severe/critical case rate of 0.035% nationwide, while analysis of 5706 symptomatic patients treated at the Shanghai Public Health Center between September 1 and December 26, 2022 showed that 20 cases (0.35%) without comorbidities progressed into severe/critical conditions and 153 cases (2.68%) with COVID-19-exacerbated comorbidities progressed into severe/critical conditions. These observations shall alert healthcare providers to place more resources for the treatment of severe/critical cases. Furthermore, mathematical modeling predicts this autumn/winter wave might pass through major cities in China by the end of the year, whereas some middle and western provinces and rural areas would be hit by the upcoming infection wave in mid-to-late January 2023, and the duration and magnitude of upcoming outbreak could be dramatically enhanced by the extensive travels during the Spring Festival (January 21, 2023). Altogether, these preliminary data highlight the needs to allocate resources to early diagnosis and effective treatment of severe cases and the protection of vulnerable population, especially in the rural areas, to ensure the country's smooth exit from the ongoing pandemic and accelerate socio-economic recovery.

Objective To delve into the causal relationship between 211 gut microbiota and sepsis employing bidirectional Mendelian randomization(MR).Methods The gut microbiota genome-wide association study(GWAS)data from the Microbiome Genetics Consortium(MiBioGen,n = 18 340)and sepsis GWAS data from the FinnGen(n = 286 146)were harnessed for this study.Initially,single nucleotide polymorphisms(SNP)significantly associated with the relative abundance of 211 gut microbiota taxa were identified as instrumental variables using predefined selection criteria.The primary analytical approach was characterized by the application of inverse variance weighting(IVW),with the effect measure represented by the odds ratio(OR)to assess the results of MR.To ensure precision and reliability,analyses were conducted,including leave-one-out analysis,heterogeneity testing,and tests for pleiotropy at both coherent and incoherent levels.Results The increased risk of sepsis was associated with the elevated abundance of Collinsella[OR = 1.28,95%confidence interval(95%CI)was 1.06-1.56,P = 0.01]and Ruminococcus(OR = 1.19,95%CI was 1.05-1.35,P = 0.005).Furthermore,a protective effect against the development of sepsis was observed in association with the increased abundance of Prevotella(OR = 0.88,95%CI was 0.79-0.97,P = 0.01)and Firmicutes(OR = 0.86,95%CI was 0.75-0.996,P = 0.04).No obvious heterogeneity and irrelevant level pleiotropy were detected.Conclusion Collinsella and Ruminococcus increase the risk of sepsis,while Prevotella and Firmicutes have protective effects against sepsis.

Objective:To evaluate the feasibility of 8E5 cells and CD19-CAR-Jurkat cells used as reference cells in the detection of lentiviral vector integration sites with different methods.Methods:Single clones of 8E5 cells and CD19-CAR-Jurkat cells were selected using limiting dilution method. Digital PCR was established to detect the copy number of HIV-1 in 8E5 cells and the copy number of CAR in CD19-CAR-Jurkat cells. High-throughput sequencing techniques (whole-genome resequencing, modified genome sequencing and probe hybridization capture) were used to detect integration sites in 8E5 cells and CD19-CAR-Jurkat cells, and optical genome mapping (OGM) technology was used for further confirmation.Results:Three clones of 8E5-D8 cells and six clones of CD19-CAR-Jurkat 2-6 cells were selected using the limiting dilution method. 8E5-D8 and CD19-CAR-Jurkat 2-6 were chosen as candidate cells based on their gene copy numbers detected by digital PCR and flow cytometry. These cells were then expanded and cryopreserved. Digital PCR showed that 8E5-D8 cells contained approximately 1 copy per cell, while CD19-CAR-Jurkat 2-6 cells contained approximately 13 copies per cell. High-throughput sequencing revealed one integration site in 8E5 cells and 13 integration sites in CD19-CAR-Jurkat cells, which matched the copy number detection results. All these integration sites were further confirmed at the submicroscopic level of chromosomes using OGM.Conclusions:Based on the insertion copy numbers and integration sites, 8E5-D8 cells and CD19-CAR-Jurkat 2-6 cells could be used as reference cells in further development of methods for detecting integration sites in CAR-T cell lentiviral vectors.

Objective:To investigate the value of nomogram predictive model established by the risk factors of upper extremity venous thrombosis risk associated with peripherally venous inserted central catheter (PICC) in cancer patients.Methods:A total of 1 032 patients who underwent PICC insertion between January 2016 and March 2017 in Zhejiang Cancer Hospital were selected by using prospective cohort study and convenience sampling. Risk factors of upper extremity venous thrombosis risk associated with PICC in cancer patients were evaluated by using Cox regression model. The nomogram predictive model of upper extremity venous thrombosis risk associated with PICC insertion was constructed. Bootstrap method was used to complete the inside check, and figure calibration was used to verify the nomogram.Results:A multivariate Cox regression analysis showed that trombosis history ( HR = 27.82, 95% CI 8.17-94.88, P < 0.01) and hyperlipidemia ( HR = 3.01, 95% CI 1.31-6.93, P = 0.009) were independent risk factors for upper extremity venous thrombosis associated with PICC. The nomogram model C-index was 0.71 (95% CI 0.63-0.80) based on the above risk factors, which indicated that the nomogram had a good differentiation. The calibration curve for predicting the probability of upper extremity venous thrombosis risk associated with PICC within one week, two weeks and one month deviated slightly from the standard curve, suggesting that the model might overestimate the risk of upper extremity venous thrombosis associated with PICC in cancer patients. Conclusions:The nomogram model has a good predictive value and strong operability, which can be used to predict the probability of upper extremity venous thrombosis associated with PICC in cancer patients after PICC insertion. It can provide a reference for identifying the high-risk cancer patients and formulating proper therapeutic strategies.

Objective:To explore the incidence and risk factors of peripherally inserted central catheter (PICC) related upper extremity venous thrombosis (UEVT) in patients with head and neck neoplasm so as to provide a basis for preventing thrombosis.Methods:This study used the design of prospective cohort study. From January 2016 to March 2018, UEVT follow-up examination by B ultrasound was carried out for 1 137 head and neck neoplasm patients with PICC selected by convenience sampling. Single factor and multivariate Cox regression were used to determine the risk factors of PICC related UEVT.Results:There were 3.6% (41/1 137) of patients with PICC related UEVT. Multivariate Cox regression showed that the independent risk factors of PICC related UEVT included the older patients ( RR=1.04, 95% CI: 1.01-1.07, P=0.013) , being with a history of PICC catheterization ( RR=3.22, 95% CI: 1.53-6.77, P=0.002) and high frequency of catheter delivery ( RR=1.98, 95% CI: 1.30-3.00, P=0.001) . Conclusions:Patients with head and neck neoplasm have the low incidence of PICC related UEVT. The independent risk factors of PICC related UEVT in patients with head and neck neoplasm include the older ages, history of PICC catheterization and high frequency of catheter delivery. Positive intervention should be carried out for those patients which may reduce the incidence of PICC related thrombosis.

Objective To describe the change of symptoms and quality of life among nasopharyngeal carcinoma patients who undergo radiotherapy, and analyze the correlation between them.Methods A total of 218 nasopharyngeal carcinoma patients who received radiotherapy were included by convenient sampling method and they were asked to finish the questionnaire of general information, Chinese Version of the M.D. Anderson Symptom Inventory(MDASI-C) and Quality of Life Instruments for Cancer Patients-Head and Neck (QLICP-HN) at five time points, which were beginning, intermediate (the volume of radiotherapy at 36-40 Gy), end of radiotherapy, three months and six months after radiotherapy.Results The severity of symptoms at five time points were (1.86±1.75),(3.20±1.75),(3.59±1.81),(0.65±0.59) and (0.52±0.50), presenting decreased gradually first, and then alleviated. The score of symptom severity at five time points were significantly different (F=182.86,P<0.05). Fatigue, appetite loss and dry mouth were the most sever and high-incidence symptoms during and within six months after radiotherapy. The quality scores of life were (65.39±10.90),(58.78±8.77),(57.82±9.20),(79.76±5.75) and( 76.79±4.78) at five time points, representing the same trend as the scores of symptom, and the difference were statistically significan(t F=129.75,P< 0.05). Spearman correlation analysissuggested that there were negative correlation between severity of symptoms and total score of quality of life (P < 0.05). Conclusions The symptoms of nasopharyngeal carcinoma patients exacerbates with dose of radiotherapy increase, and the quality of life is also decreased. Although most of symptoms disappear within six months after radiotherapy, fatigue, appetite loss and dry mouth persisted and influence patients' quality of life.Nurses should pay attention to patients' symptoms when they stay at hospital as well as discharged, and intervention is necessary to improve their quality of life.

Objective To investigate the dynamic changes of symptom clusters among nasopharyngeal carcinoma patients receiving radiotherapy and provide evidence for intervention clinically.Methods The data were collected at three time points that were before radiotherapy,during the radiotherapy and after radiotherapy, by surveying 273 first visit of nasopharyngeal carcinoma patients from May 201 4 to January 201 5 with a self-designed general information questionnaire and the Chinese version of the M.D.Anderson symptom inventory and observing the changes of symptom clusters in our hospital.One-way analysis of variance and the exploratory factor analysis were applied to observe the incidence of symptoms and the changes of symptom clusters during radiotherapy.Results The statistics revealed that the incidence and intensity of all the symptoms at 3 time points were significantly increased(P <0.05),except the symptom of amnesia.There were 3 symptom clusters among 3 time points,named as gastrointestinal symptom cluster,sickness symptom cluster and somatic symptom cluster,but the composition and the variance were different at different time point.Gastrointestinal symptom cluster was made of nausea and vomiting,adding poor appetite only before radiotherapy.The gastrointestinal symptom cluster was most prominent before radiotherapy.Sickness symptom cluster consisted of drowsiness, numbness symptom before radiotherapy, while it consisted of shortness of breath, numbness, difficulty remembering symptoms in other time.Somatic symptom cluster mainly consisted of pain and fatigue,dry mouth symptom joining it during and after radiotherapy.Conclusions With the treatment of radiotherapy,the incidence and intensity of symptoms are significantly enhanced,and the constitution of symptom clusters is different at different stage.Therefore,it is important for clinical nurses to strengthen dynamic assessment of all symptoms,monitor the changes and composition of symptom clusters,thus establish corresponding management measures to improve patients′quality of life.