Gei Herba is a traditional folk herbal medicine with a variety of functions such as replenishing Qi and invigorating spleen， tonifying blood and nourishing Yin， moistening lung and resolving phlegm， activating blood and alleviating edema， moving Qi， and activating blood. The reports about the pharmacological effects of this herbal medicine have been increasing in recent years. By reviewing the ancient and modern literature about Gei Herba， we systematically organized the name， original plants， nature， taste， and functions of this herbal medicine， and summarized the modern pharmacological studies and clinical applications of Gei Herba in cardiovascular and cerebrovascular diseases. Gei Herba was first recorded in the name of "Dijiao" in the Geng Xin Yu Ce（《庚辛玉册》） written in the Ming Dynasty. It is derived from Geum japonicum var. chinense （Rosaceae） and sometimes confused with Adina rubella （Rubiaceae）. This medicine had numerous synonyms in the local materia medica books. Gei Herba is widely distributed and harvested in summer and autumn， with the dried whole grass used as medicine. The historical records of the nature， taste， meridian tropism， main functions， and indications of Gei Herba are not consistent. It is generally believed that Gei Herba is pungent， bitter， sweet， cool， and has tropism to the liver， spleen， and lung meridians. Based on the effects of tonifying Qi， activating blood， and nourishing Yin， modern pharmacological studies have reported that the extracts of Gei Herba and the tannin phenolic acid compounds and triterpenoids isolated from Gei Herba have therapeutic effects on cardiovascular and cerebrovascular diseases such as hypertension， myocardial ischemia， cerebral ischemia， and vascular dementia. This study provides a reference for discovering the clinical advantages of Gei Herba and developing new drugs.

Objective:To systematically evaluate the dose-response relationships of resistance exercise intensity in frail elderly.Methods:A comprehensive search of randomized controlled trials on the dose-response relationships of resistance exercise for frail elderly in PubMed, Embase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Database. The documents that met the conditions were screened out, and after the data were extracted and the quality of the documents were evaluated, the RevMan 5.3 software was used for Meta analysis.Results:A total of 10 eligible randomized controlled trials were included in this study. The subjects of the study were 454 cases of frail and pre-frail elderly. After Meta analysis, there was a dose-response relationships between the training intensity of resistance exercise and the muscle strength, muscle endurance, and physical function of frail elderly. Both low-intensity and high-intensity resistance exercises can significantly increase the leg muscle strength of frail elderly people ( MD=4.58, 95% CI 3.34-5.82, P<0.05) and muscle endurance ( MD=12.27, 95% CI 6.54-17.99, P<0.05). Compared with low-intensity resistance exercise, high-intensity resistance exercise increased leg muscle strength of frail elderly people ( MD=7.97, 95% CI 0.85-15.09, P<0.05) and muscle endurance ( MD=6.94, 95% CI 5.21-8.66, P<0.05) showed more obvious advantages. The analysis of the results of the chair sitting test and the stairs climbing test shows that low-intensity resistance exercise has no obvious advantage in improving the physical function of frail elderly people, while high-intensity resistance exercise can significantly improve the physical function of frail elderly people ( MD=-5.8, 95% CI -7.3--4.29, P<0.05; MD=-1.20, 95% CI-2.17--0.23, P<0.05). Conclusions:Resistance exercise can significantly improve the muscle strength, muscle endurance and physical function of the frail elderly. High-intensity resistance exercise is more effective than low-intensity resistance exercise.

Objective:To evaluate the diagnostic value of refined transthoracic lung ultrasound(TLUS) scoring method in interstitial lung diseases(ILD).Methods:The TLUS was performed in 39 ILD patients in respiratory department and immunology department of the Second Affiliated Hospital of Fujian Medical University from March 2019 to February 2020. The ultrasonic recordings were evaluated by Buda ultrasound scoring method and refined ultrasound scoring method. The diagnostic efficacies of the refined ultrasound scoring method, Buda ultrasound scoring method and high resolution computed tomography(HRCT) scoring method for ILD were analyzed. The correlations between refined ultrasound score and Buda ultrasound score/HRCT score were evaluated. The difference of diagnostic efficacy between refined ultrasound scoring method and Buda ultrasound scoring method were analyzed in different severity of ILD. Then, the HRCT Warrick scoring method was used as the criterion to judge the severity of ILD, and the receiver operator characteristic (ROC) curve was plotted to predict the cutoff values of the fefined ultrasound score for different degrees of ILD.Results:①The sensitivity of the refined ultrasound scoring method in diagnosing ILD was 92.3%, specificity was 92.3%, area under ROC curve(AUC)=0.978, 95% CI=0.941-1.000. The sensitivity of Buda ultrasound scoring method in diagnosing ILD was 87.2%, specificity was 87.2%, AUC=0.950, 95% CI=0.892-1.000. The sensitivity of HRCT scoring method in diagnosing ILD was 97.4%, specificity was 97.4%, AUC=0.999, 95% CI=0.994-1.000. ②The correlations between the refined ultrasound score, the HRCT Warrick score and the Buda ultrasound score were high ( r=0.929, 0.920, 0.862 respectively, P<0.001). ③The values of refined ultrasound scoring method and Buda ultrasound scoring method consistently and significantly increased with the increasing severity of ILD. With regards to the former one, there were significant differences among mild group, moderate group and severe group ( P<0.05). ④The ROC curve confirmed that refined ultrasound score cut-off points for predicting mild and severe interstitial lung diseases, were 34 [sensitivity of 100%, specificity of 87.5% respectively, AUC=0.891, 95% CI=0.686-1.000] and 64.5 [sensitivity of 91.3%, specificity of 87.5% respectively, AUC=0.954, 95% CI=0.877-1.000]. Conclusions:The severity of the interstitial lung diseases could be evaluated by the refined ultrasound scoring method, which is useful in the semi-quantitative evaluation of ILD.

Objective:To investigate the expression and cellular provenance of interleukin 17A (IL-17A) in non-eosinophilic chronic rhinosinusitis with nasal polyps (nECRSwNP), and to analyze the possible reasons for its different expression.Methods:Samples were collected from 14 patients with eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) and 28 patients with nECRSwNP, who underwent functional endoscopic sinus surgery in the Third Affiliated Hospital of Sun Yat-sen University from January 2017 to May 2018, including 33 males and 9 females, with the age ranging from 18 to 65 years old. Enzyme linked immune sorbent assay (ELISA) and flow cytometry were used to investigate the expression and cellular origins of IL-17A in the nasal tissue of ECRSwNP and nECRSwNP groups. Then the difference of quantity and differentiation ability of the major cells producing IL-17A between ECRSwNP and nECRSwNP groups were analyzed by flow cytometry. Finally, the expressions of IL-6, transforming growth factor-β(TGF-β), and IL-23, which were considered as the important factors in promoting Th17/Tc17 differentiation in CRSwNP and their correlation with IL-17A, were analyzed by ELISA. Statistical analysis was performed using IBM SPSS 20.Results:The IL-17A protein levels and IL-17A +lymphocyte percentages were higher in nECRSwNP group compared with that of the ECRSwNP group (158.56 (167.76) pg/ml ( M( QR)) vs. 9.42 (11.33) pg/ml, 10.21%±1.54% ( ± s) vs. 3.93%±0.80%, Z=2.95, t=3.62, all P<0.01). Tc17 cells (CD8 +T cells producing IL-17A) and Th17 cells (CD4 +T cells producing IL-17A) were major IL-17A producers in both ECRSwNP and nECRSwNP group. Further analysis revealed that there was no significant difference in quantity of CD8 +and CD4 +T cells between ECRSwNP and nECRSwNP group, but the differentiation ability about CD8 +and CD4 +T cells differentiating into Tc17 and Th17 in nECRSwNP group was stronger than that in ECRSwNP. The high expressions of IL-6 and TGF-β, which were considered as the important factors in promoting Th17/Tc17 differentiation were also found in nECRSwNP group compared with ECRSwNP (56.07 (234.25) pg/ml vs. 8.27 (12.51) pg/ml, (5.44±0.34) pg/ml vs. (4.17±0.22) pg/ml, Z=2.426, t=2.29, all P<0.05). But the difference in expression of IL-23 was not significant difference between the two groups. Moreover, the expression of IL-17A showed significantly positive correlation with IL-6 ( r=0.615, P=0.009). No positive correlation between IL-17A and TGF-β or IL-23 was observed. Conclusions:The expression of IL-17A in nasal mucosa of nECRSwNP patients is significantly higher than that of ECRSwNP, which is due to the increase of expression and differentiation of Tc17/Th17 cells. IL-17A shows positive correlation with IL-6 in CRSwNP, which is the important factor in promoting Th17/Tc17 differentiation.

Objective:To probe the effect of intermittent aerobic exercise on adrenomedullin secretion of kidney in hypertensive nephropathy rat (HNR),and investigate the renal mechanism for exercise in the prevention and treatment of hypertension.Method:Thirty-two HNRs were divided into two groups:intermittent exercise group (Group IAE) and control group (Group C).The IAE group performed intermittent treadmill exercise for 8 weeks and their blood pressure was measured before and after exercise by tail pressure of HNR,and serum ADM was detected by enzyme linked immunosorbent assay.Adrenomedullin (ADM) was expressed in kidney by immunohistochemistry.Quantification of specific receptor RAMP2 and CRLR in kidney ADM was detected by immunoblotting.Result:The blood pressure in the Group IAE was significantly lower than that in the Group C(P＜ 0.05).The expression of ADM of kidney and serum in the Group IAE was obviously higher than that in the Group C.The quantity of RAMP2 and CRLR in kidney was obviously increased(P ＜ 0.05).Conclusion:Intermittent aerobic exercise increases serum ADM of HNR with the up-regulated expression of ADM in kidney and their specific receptor CRLR and RAMP2.The increase of serum ADM induced by intermittent aerobic exercise may be related to the change of ADM and the regulation of its specific receptor which may be one of the mechanisms for intermittent aerobic exercise in the prevention and treatment of hypertension.

Objective To explore the effect of finger exercises and cognitive training on cognitive function, ability of daily living and quality of life of elderly patients with mild cognitive impairment. Methods About 90 elderly patients with mild cognitive impairment were randomly divided into experimental group and control group. In the experimental group finger exercises and cognitive training were implemented, and the control group was given routine care and health education. 3 months and 6 months after the intervention, the two groups were compared in respect of the cognitive function, ability of daily living and quality of life. Results The difference of cognitive function, daily living ability and quality of life in the elderly were statistically significant between the two groups 3 month and 6 month after the intervention (P<0.05). Pairwise comparison done at three time points (before intervention, 3 months and 6 months after intervention) in the experimental group showed that the difference of cognitive function, daily living ability and quality of life in the elderly were statistically significant between before intervention and 3 months after intervention, before intervention and 6 months after intervention. Conclusion The finger exercises and cognitive training in elderly patients with mild cognitive impairment can effectively strengthen the cognitive function and ability of daily living, and improve the quality of life.

Objective To expore the effects of international resident assessment instruments (InterRAI) comprehensive evaluation and intervention on nutritional status of aged inpatients.Methods Totally 235 aged inpatients of a tertiary hospital from February to December 2015 were selected,and 126 cases of them had nutritional risk after the test of NRS 2002. Patients with nutritional risk were randomly divided into the intervention group and the control group,with 63 cases in each group. Patients in two groups were all given dietary estimation,nutritional education,and enteral or parenteral nutrition;besides,patients in the intervention group also received InterRAI comprehensive evaluation and intervention. At the first day and three months after intervention,Inbody 720 body composition analyzer was used to test the protein,body fat, skeletal muscle and BMI,and the second nutritional evaluation was conducted through blood nutrition indicators (plasma total protein concentration,serum albumin,prealbumin and transferrin). SPSS 17.0 software was used to analyze the data,and measurement data adopted two independent samples to design thet test.Results At the first day after admission,there were no differences in body composition index and blood nutrition indicators between two groups (P>0.05). Reexamination after three months showed that,the protein (8.5±0.7) kg,body fat (16.5± 4.8) kg,skeletal muscle (24.2±4.0) kg and BMI (17.2±5.6) kg/m2 in the intervention group,were all higher than the protein (6.6±0.9) kg,body fat (20.2±5.6) kg,skeletal muscle (18.5±3.1) kg and BMI (16.5±6.1) kg/m2 in the control group (t=9.595,8.055,11.331,2.015;P<0.05). and blood nutrition indicators in the intervention group, were better than that in the control group (P<0.05). The plasma total protein concentration (67.1±6.9) g/L, serum albumin (44.3±7.4) g/L, prealbumin (245.1±15.4) mg/L and transferrin (2 530.3±190.5) mg/L in the intervention group,were all higher than the plasma total protein concentration (55.6±7.2) g/L,serum albumin (32.5±6.3)g/L, prealbumin (210.1±16.8) mg/L and transferrin (2 001.1±169.8) mg/L in the control group (t=12.805,7.890, 9.421,14.427;P<0.05).Conclusions The InterRAI comprehensive evaluation and intervention can effectively improve the nutritional status and the quality of life in the elderly,and reduce the nutritional risk.

Objective To provide valid data and useful genetic counseling in the clinical application of non‐invasive prenatal test (NIPT) ,fetal chromosomal disorder were screened by massive parallel sequencing and made a follow‐up study .Methods Preg‐nant women with Down screening in high‐risk were screened by NIPT ;NIPT verified high‐risk individuals were suggested for kary‐otyping ;and we follow up on whoever showed low risk by NIPT before and after their deliveries .Results (1)Totally 1 676 cases of pregnant women were tested by NIPT ,25 cases prompted to be abnormal ,with an abnormal rate of 1 .49% ,karyotype analysis re‐sults in 12 cases of abnormalit ,the accuracies of NIPT for T21 ,T18 ,XO ,XXY ,and XYY were 99 .93% ,100 .00% ,99 .66% , 100 .00% ,100 .00% respectively ;the accuracy of NIPT for women with advanced paternal age and twins were both 100 .00% ;kary‐otyping positive individuals underwent abortion ,which gives a prenatal intervention rate of 100 .00% .(2)Out of 1 651 cases of NIPT low risk testers ,1 468 cases were successfully followed up ,with a 88 .91% success rate .We found chromosome abnormality with one case of inversion of chromosome 9 (maternal) .(3)Ultrasound‐detection possessed 98 .17% accuracy and 7 .69% in detec‐tion rate;in high‐risk pregnant woman ,Down screening had an accuracy of 0 .88% and false positive rate of 99 .12% ;98 .71%women were avoided prenatal diagnosis via NIPT .Conclusion Compare to ultrasound and maternal plasma screening ,NIPT is a far more accurate prenatal screening approach .To build effective follow‐up and service systems of NIPT is necessary to reduce birth de‐fects in medical institutions .

Objective To implement comprehensive nutrition management based on the advanced concept of health quotient in elderly patients with femoral neck fracture,and explore the effect in improving nutriture of patients after operation.Methods The concept of health quotient was introduced to comprehensive nutrition management,and a systematic assessment and screening system of three-level nutrition was built.Besides,we carried out hierarchical and thinning nutritional intervention based on health quotient score and health education system with continual improvement.The index of health quotient and relevant index of nutrition were evaluated among 71 patients after being hospitalized and 14 days after operation.Results There were statistically significant differences in the score of health quotient and McDonald nutrition index among 71 elderly patients with femoral neck fracture after being hospitalized and 14 days after operation (P ＜ 0.05).Conclusions Nutrition management based on health quotient can solve the problem related to nutrition and health after operation among elderly patients with femoral neck fracture,improve the nutritional support and nutrition-related indicators,it is conducive to the recovery.