To summarize the distribution characteristics of human papillomavirus(HPV) infection types in patients with cervical squamous intraepithelial lesion(SIL) and cervical cancer(CC), and to explore the impact of HPV vaccination, HPV infection types, and general clinical data on different grades of cervical lesions.

The "integrated time-space" perspective of life in traditional Chinese medicine holds that structure and function respectively belong to the realms of space and time. The orderly integration of time and space not only supports the existence and development of life， but also serves as the foundation for biological evolution. Based on this standpoint， this paper proposes the spatiotemporal structural theory of visceral manifestation， characterized by the fusion of time and space， the integration of internal and external dimensions， and the absence of primary or secondary distinctions. Using the individual human body as the boundary， it delineates the man and nature spatiotemporal structure， based on the theory of the "correspondence between man and nature"， and the internal spatiotemporal structure of the living body. The man and nature spatiotemporal structure， with yin-yang and the five phases as its core， reveals the correspondence and connectivity between the external environment and the internal zang-fu organs within the spatiotemporal dimension. The internal temporal structure of the body refers to the collective physiological rhythms related to the zang-fu organs， while the spatial structure refers to the tangible forms， spatial positions， and connective structures of the zang-fu organs. The proposal of the spatiotemporal structural theory of visceral manifestation represents a rational reconstruction and practical exploration of the essential connotations of visceral manifestation， aiming to provide new perspectives for subsequent theoretical research and clinical applications.

OBJECTIVE This study investigated the clinical implications of endothelial cell-specific molecule 1(ESM-1)in obstructive sleep apnea(OSA)patients,with particular focus on its dynamic correlation with adhesion molecules,aiming to elucidate the regulatory role of ESM-1 in OSA-associated vascular endothelial impairment.METHODS This cross-sectional study enrolled participants undergoing polysomnography(PSG)at the Sleep Medicine Center of Beijing Anzhen Hospital,Capital Medical University between March 2017 and January 2018.Based on the inclusion criteria,161 participants were ultimately included and divided into OSA group(n=118)and control group(n=43).Demographic data and polysomnography parameters were collected.We used a powerful high-throughput Multiplex Immunobead Assay technology to simultaneously test plasm cytokines levels of ESM-1,inter-cellular adhesion molecule 1(ICAM-1),vascular cell adhesion molecule 1(VCAM-1).Circulating C-reactive protein(CRP)and homocysteine(Hcy)were detected by routine blood chemistry panel.RESULTS Circulating ESM-1 levels were significantly elevated in patients with OSA compared with healthy controls[819.73(612.36-1393.47)pg/ml]vs.[286.17(114.48-513.81)pg/ml,P<0.001].After adjusting for confounding factors,we found that circulating ESM-1 levels were an independent risk factor for OSA(odds ratio=2.162,95%CI=1.522-3.072,P<0.001)and circulating ESM-1 levels were positively associated with ICAM-1 and VCAM-1 levels(β=1.977,95%CI=1.429-2.734,P<0.001).CONCLUSION Circulating ESM-1 levels were significantly increased in patients with OSA,which is closely related with adhesion molecules levels.ESM-1 may be a surrogate endothelial dysfunction marker and an independent risk factor for OSA.

Objective:To explore the learning curve of primary urologists mastering Holmium laser enucleation of the prostate for the treatment of large volume benign prostatic hyperplasia (BPH).Methods:The clinical data of 92 patients with larger volume BPH who received HoLEP performed by a urologist in Beijing Friendship Hospital Pinggu Campus, Capital Medical University were retrospectively reviewed. 92 patients were divided into group A (1-23 cases, n=23), group B (24-46 cases, n=23), group C (47-69 cases, n=23), and group D (70-92 cases, n=23) based on the sequence of surgery. The clinical characteristics, including prostate volume, operation time, enucleation efficiency, indwelling catheter time, decrease value of hemoglobin, intraoperative blood transfusion, perioperative complications, and international prostate symptom score (IPSS), quality of life (QOL) score, Qmax, and postvoid residual urine (PVR) at 3 months postoperatively were compared between the four groups. Measurement data were expressed as mean ± standard deviation ( ± s), one-way analysis of variance was used for comparisons among multiple groups, and t-test was used for comparisons between two groups. Count data were expressed as the cases and percentage, and the Chi-square test was used for comparison between groups. Results:There were significant differences among the four groups in terms of operation time [(94.43±8.26) min, (86.39±5.89) min, (70.70±5.64) min, (64.70±4.23) min, P=0.001], enucleation efficiency [(0.90±0.08) mL/min, (1.01±0.07) mL/min, (1.23±0.12) mL/min, (1.34±0.12) mL/min, P=0.001], decrease value of hemoglobin [(25.98±1.39) g/L, (23.27±1.49) g/L, (20.03±1.07) g/L, (18.49±0.96) g/L, P=0.001] and indwelling catheter time [(5.91±1.54) d, (5.35±1.27) d, (3.39±0.72) d, (3.04±0.64) d, P=0.001]. Compared with group C and group D, the operation time was longer, the enucleation efficiency was lower, the decrease value of hemoglobin before and after the operation was higher, and the indwelling catheter time was longer, the above differences were all statistically significant ( P<0.05). However, there was no statistically significant difference between group A and group B, or group C and group D ( P>0.05). Among the 92 patients, only 3 patients received blood transfusion during operation, including 2 patients in group A and 1 patient in group B. 2 patients underwent surgical complications during the perioperative period. Among them, 1 patient suffered bladder wall injury due to improper operation of the tissue pulverizer in group A, and 1 patient developed prostatic capsule perforation in group B. Furthermore, after 56 cases of operation, a primary urologist can perform HoLEP surgery quickly and safely. Conclusion:The learning curve of a primary urologist mastering HoLEP for larger volume (≥ 80 mL) BPH was 56 procedures, and the operation efficiency and safety were significantly improved.

Objective To investigate the clinical efficacy of Xiaqi Decoction(mainly composed of Poria,Pinelliae Rhizoma Praeparatum,Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,Armeniacae Semen Amarum,Citri Grandis Exocarpium,Paeoniae Radix Alba,Polygoni Multiflori Radix,and Moutan Cortex)on patients with stage Ⅲ-Ⅳ colorectal cancer accompanied by cancer-related fatigue(CRF)after chemotherapy.Methods Sixty patients with stage Ⅲ-Ⅳ colorectal cancer accompanied by CRF after chemotherapy who admitted to Guangdong Second Traditional Chinese Medicine Hospital from January 2023 to March 2024 were randomly divided into chemotherapy group and Xiaqi Decoction group according to the random number table method,with 30 patients in each group.The chemotherapy group was given chemotherapy regimen of Avastin+mFOLFOX6/FOLFIRI,and Xiaqi Decoction group was given Xiaqi Decoction orally on the basis of treatment for the chemotherapy group.Two weeks constituted a course of treatment,and two consecutive courses of treatment were performed.Before and after treatment,the two groups were observed in the changes of Revised Piper Fatigue Scale(PFS-R)scores,EORTC Quality of Life Questionnaire-Core 30(QLQ-C30)scores,Patient-Generated Subjective Global Assessment(PG-SGA)scores,Karnofsky Performance Status(KPS)scores,poor appetite scores,and serum levels of interleukin 6(IL-6),tumor necrosis factor α(TNF-α),and interleukin 1β(IL-1β)were observed.After treatment,the clinical efficacy and safety between the two groups of patients were evaluated.Results(1)After two courses of treatment,the total effective rate of the Xiaqi Decoction group was 86.21%(25/29)and that of the chemotherapy group was 62.07%(18/29),and the intergroup comparison(tested by chi-square test)showed that the efficacy of Xiaqi Decoction group was significantly superior to that of chemotherapy group(P<0.05).(2)In the second and fourth weeks of chemotherapy,the PFS-R scores for evaluating the degree of fatigue of patients in the two groups were increased when compared with those in the day before chemotherapy(P<0.05),but the PFS-R scores in Xiaqi Decoction group were significantly lower than those in the chemotherapy group after chemotherapy(P<0.01).(3)In the second and fourth weeks of chemotherapy,the QLQ-C30 scores for evaluating the quality of life in the chemotherapy group was decreased when compared with that one day before chemotherapy(P<0.05),whereas the QLQ-C30 scores in the Xiaqi Decoction group showed no obvious changes when compared with that one day before chemotherapy(P>0.05).The intergroup comparison showed that the QLQ-C30 scores of the Xiaqi Decoction group were all significantly higher than those of the chemotherapy group after chemotherapy(P<0.01).(4)The evaluation of nutritional status showed that in the fourth week of chemotherapy,PG-SGA score and poor appetite score in the two groups as well as KPS score in Xiaqi Decoction group were increased when compared with those one day before chemotherapy(P<0.05),while the KPS score in the chemotherapy group was decreased when compared with that one day before chemotherapy(P<0.05).The intergroup comparison showed that PG-SGA score and poor appetite score of Xiaqi Decoction after chemotherapy were lower than those of the chemotherapy group,and the KPS score was higher than that of the chemotherapy group,the differences being statistically significant(P<0.05 or P<0.01).(5)In the chemotherapy group,the serum inflammatory factor levels of TNF-α and IL-6 in the second week of chemotherapy and the serum TNF-α,IL-1β and IL-6 levels in the fourth week of chemotherapy were all increased when compared with those one day before chemotherapy(P<0.05).In the Xiaqi Decoction group,the serum TNF-α,IL-1β,and IL-6 levels were all decreased when compared with those one day before chemotherapy,and significant differences were shown in the serum IL-6 level in the second week of chemotherapy and in the serum levels of IL-1β and IL-6 in the fourth week of chemotherapy when compared with those one day before chemotherapy(P<0.05).The intergroup comparison showed that serum TNF-α,IL-1β,and IL-6 levels in the Xiaqi Decoction group after chemotherapy were significantly lower than those in the chemotherapy group(P<0.05 or P<0.01).Conclusion Xiaqi Decoction is effective on relieving the clinical symptoms and enhancing the efficacy of patients receiving chemotherapy for stage Ⅲ-Ⅳ colorectal cancer.It can inhibit the expression of inflammatory factors,relieve the CRF and improve the nutritional status and the quality of life of the patients,with higher safety.

Objective To observe the therapeutic effect and mechanism of Xiaqi Decoction for mice with chemotherapy-induced cancer-related fatigue(CRF)in colon cancer.Methods The successfully constructed chemotherapy-induced CRF mouse model of colon cancer was randomly divided into the model control group and the Xiaqi Decoction group,with 10 mice in each group,and a blank control group was also set up.After each group was given the corresponding intervention,the mice exhaustive swimming time was determined,the tumor size was measured,the tumor inhibition rate was calculated,and the serum levels of inflammatory factors such as tumor necrosis factor(TNF)-α,interleukin(IL)-1β,IL-6 and other safety indicators such as alanine aminotransferase(ALT),aspartate aminotransferase(AST)and blood ureanitrogen(BUN)were detected by enzyme-linked immunosorbent assay(ELISA),the protein expression levels of Toll-like receptor 4(TLR4)and nuclear factor κB(NF-κB)p65 in the epithelial cells of tumor lumps(or axillary tissues)were detected by Western Blot.Results(1)Before treatment,the exhaustive swimming time of mice in the model control group was significantly less than that of the blank control group(P<0.01);after 28 days of treatment,the exhaustive swimming time of mice in the Xiaqi Decoction group was significantly longer than that of the model control group(P<0.01),and it was time-dependent.(2)The tumor size of mice in the Xiaqi Decoction group was gradually decreased from 4-28 days of treatment,and the tumor inhibition rate was 68.96%after 28 days of treatment.(3)The serum levels of TNF-α,IL-1β and IL-6 in the model control group were significantly higher than those in the blank control group(P<0.01);and the serum levels of TNF-α,IL-1β and IL-6 in the Xiaqi Decoction group were significantly lower than those in the model control group(P<0.05).(4)The serum levels of ALT,AST and BUN in the model control group were higher than those in the blank control group(P<0.05 or P<0.01);the serum levels of ALT,AST and BUN in the Xiaqi Decoction group were lower than those in the model control group(P<0.05).(5)The protein expression levels of TLR4 and NF-κB p65 in tumor epithelial cells of the model control group were higher than those of the blank control group(P<0.01);the protein expression levels of TLR4 and NF-κB p65 in tumor epithelial cells of the Xiaqi Decoction group were lower than those of the model control group(P<0.01).Conclusion Xiaqi Decoction can effectively promote physical recovery,and inhibit tumor growth in mice with chemotherapy-induced CRF of colon cancer,and its mechanism may be related to the inhibition of TLR4 and NF-κB p65 expression,thus to reduce the inflammatory response,with certain degree of safety.

Objective To observe the application effect of the H2H model in rehabilitation nurs-ing for patients undergoing radical mastectomy.Methods A total of 294 patients who underwent rad-ical mastectomy were enrolled as study subjects and randomly divided into conventional group and H2H group using a simple randomization method(coin toss),with 147 patients in each group.The conventional group received routine nursing interventions,while the H2H group received nursing in-terventions based on the H2H model.At 1 week and 3 months post-intervention,shoulder joint func-tion[assessed using the Constant-Murley Shoulder Function Score(CMS)],nutritional indicators(serum albumin,hemoglobin)levels,self-management efficacy[assessed using the Self-care Self-ef-ficacy Scale(SUPPH)],and quality of life[assessed using the Functional Assessment of Cancer Therapy-Breast(FACT-B)]were observed and compared between the two groups.Results At 3 months post-intervention,the pain,daily living activities,range of motion,and muscle strength scores in the CMS were higher than those at 1 week post-intervention in both groups,with the H2H group showing higher scores than the conventional group,and the differences were statistically signifi-cant(P＜0.05).At 3 months post-intervention,the albumin and hemoglobin levels were lower than those at 1 week post-intervention in both groups,but the H2H group had higher levels than the con-ventional group,and the differences were statistically significant(P＜0.05).At 3 months post-inter-vention,the positive attitude,self-decision-making,and self-stress reduction scores in the SUPPH were higher than those at 1 week post-intervention in both groups,with the H2H group showing higher scores than the conventional group,and the differences were statistically significant(P＜0.05).At 3 months post-intervention,the scores for physical well-being,social/family well-being,emotional well-being,functional well-being,and the breast cancer-specific module in the FACT-B were higher than those at 1 week post-intervention in both groups,with the H2H group showing higher scores than the conventional group,and the differences were statistically significant(P＜0.05).Conclu-sion The application of the H2H model in rehabilitation nursing for patients after radical mastecto-my can promote the recovery of shoulder joint function,improve nutritional status,and enhance self-management efficacy and quality of life.

The irrational use of Chinese patent medicines （CPM） is becoming more and more prominent， which makes the demand for clinical practice guidelines of CPM gradually increase. In order to make domestic scholars understand the latest developments and existing problems of the CPM guidelines， and promote its development， this paper introduced the concept of CPM guidelines， summarized the characteristics of the two development modes， namely “taking CPM as the key” and “taking disease/syndrome as the key”， and analyzed the current methodological status of developing and reporting CPM guidelines. Based on the existed problems， three suggestions have been put forward to optimize the quality of CPM guidelines， which were clarifying the target users and scope of CPM guidelines， establishing an open and transparent mechanism of the personnel involvement and process steps， and formulating implementable and operable recommendations for the use of CPM.

This paper summarized the key points and methods in terms of the establishment of the guideline working group and the management of conflict of interests， trying to provide reference for the development of clinical practice guidelines for Chinese patent medicine （CPM）. The establishment of the working group is the first important step for developing CPM guidelines. Considering the characteristics of the clinical practice guidelines for CPM， this study suggests that the three key elements of ‘multidisciplinarity’， ‘clinical relevance’ and ‘geographical representativeness’ should be put focus on when forming the working group. The guideline advisory committee， clinical expert group， evidence systematic evaluation group， secretary group and the external review group should be established. All group members should clarify the conflict of interest， and the process and management method of the conflict of interest should be clearly reported.

The systematic and comprehensive introduction and interpretation of the Reporting Checklist of Clinical Practice Guidelines for Chinese Patent Medicines V1.0 is conducive to the presentation of high-quality clinical practice guidelines for Chinese patent medicines （CPMs）， thus improving their dissemination and use. The Reporting Checklist of Clinical Practice Guidelines for Chinese Patent Medicines V1.0 specifies the requirements for clear， complete and transparent reporting of the whole process of developing CPMs guidelines， containing 4 domains， 17 topics and 43 items， and involving the basic information， recommendations and methods of guideline development. Especially， it details the items related to the rules and regulations of the use of CPMs in the recommendations， which is helpful for improving the completeness， scientificity and practicality of the reporting of CPMs guideline.