Chronic rhinosinusitis(CRS)is a common chronic inflammation of nasal cavity and sinus mucosa,involving multiple pathogenesis mechanisms such as infection,allergic reactions,and immune abnormalities.Its main symptoms include nasal obstruction,rhinorrhea,and hyposmia,sig-nificantly affecting patients' quality of life.Seeking safe and effective long-term treatment methods is crucial for managing CRS.Traditional Chinese medicine(TCM)has a long history of treating CRS and has gained attention due to its profound theoretical basis,high safety,and low recurrence rate.According to TCM,CRS is mostly caused by the invasion of wind-cold-damp pathogens,heat accumu-lation in the Lung meridian,or spleen-stomach weakness.Various therapies such as oral administra-tion of Chinese herbal medicines,nasal drops,acupuncture,and moxibustion are employed to adjust the body's balance and achieve therapeutic goals.This article comprehensively analyzed recent do-mestic and international literature and reviewed the research progress on pathogenesis of CRS and its treatment with TCM,with particular emphasis on roles and mechanisms of active ingredients in Chi-nese herbal medicines.The aim of the study is to provide scientific evidence and technical support for prevention and treatment of CRS.

[Objective]To sort out Chinese drugs and its active ingredients for improving sleep,analysis functions and similarities and differences in mechanisms,explore new approaches to the treatment of insomnia with TCM.[Methods]By using keywords such as"insomnia""Chinese drugs""ingredients",research reports on insomnia treatment with Chinese medicine in China National Knowledge Infrastructure(CNKI),Wanfang Databases,ScienceDirect,Web of Science,and PubMed in the past 15 years were retrieved.The effects and potential mechanisms of Chinese drugs in regulating sleep were analyzed and summarized deeply in a layered approach,focusing on formulas,couplet drugs,single drugs and active ingredients.Based on this,feasible directions for research on Chinese medicine treatment of insomnia were proposed.[Results]Totally 115 relevant literatures are acquired.Insomnia is often related to dysfunction of organs such as the liver,gallbladder and stomach.Heart and spleen deficiency,heart and kidney dysfunction,phlegm-heat disturbing the heart and imbalance of Yin and Yang are important causes of sleep disorders;Chinese drugs,formulas and active ingredients each exert therapeutic effects on insomnia by regulating the overall balance of Qi and blood,Yin and Yang,improving the functions of important organs such as the heart,kidney and gallbladder,and intervening in specific targets.Commonly used drugs are mainly tonifying,calming and heat-clearing ones.The mechanism of Chinese drugs in treating insomnia is mainly related to improving the structure of intestinal microbiota,reducing the expression level of inflammatory cytokines and regulating neurotransmitters and the balance of hormone levels.There are differences in the effects of different Chinese medicine and their formulas,but their characteristics and advantages are not obvious;the correlation among the drugs in formulas,different ingredients of single medicine and the interaction among active ingredients still need to be further studied.[Conclusion]Chinese drugs formulas,drug pairs,single medicine and its active ingredients,although are used in different forms,all aim to regulate the balance of Qi and blood,Yin and Yang in the body and the functions of organs,and further restore the normal secretion of neurotransmitters,hormones and so on,and improve sleep quality.Alternative therapies based on intestinal function regulation may be a new strategy for treating insomnia.

[Objective]To sort out Chinese drugs and its active ingredients for improving sleep,analysis functions and similarities and differences in mechanisms,explore new approaches to the treatment of insomnia with TCM.[Methods]By using keywords such as"insomnia""Chinese drugs""ingredients",research reports on insomnia treatment with Chinese medicine in China National Knowledge Infrastructure(CNKI),Wanfang Databases,ScienceDirect,Web of Science,and PubMed in the past 15 years were retrieved.The effects and potential mechanisms of Chinese drugs in regulating sleep were analyzed and summarized deeply in a layered approach,focusing on formulas,couplet drugs,single drugs and active ingredients.Based on this,feasible directions for research on Chinese medicine treatment of insomnia were proposed.[Results]Totally 115 relevant literatures are acquired.Insomnia is often related to dysfunction of organs such as the liver,gallbladder and stomach.Heart and spleen deficiency,heart and kidney dysfunction,phlegm-heat disturbing the heart and imbalance of Yin and Yang are important causes of sleep disorders;Chinese drugs,formulas and active ingredients each exert therapeutic effects on insomnia by regulating the overall balance of Qi and blood,Yin and Yang,improving the functions of important organs such as the heart,kidney and gallbladder,and intervening in specific targets.Commonly used drugs are mainly tonifying,calming and heat-clearing ones.The mechanism of Chinese drugs in treating insomnia is mainly related to improving the structure of intestinal microbiota,reducing the expression level of inflammatory cytokines and regulating neurotransmitters and the balance of hormone levels.There are differences in the effects of different Chinese medicine and their formulas,but their characteristics and advantages are not obvious;the correlation among the drugs in formulas,different ingredients of single medicine and the interaction among active ingredients still need to be further studied.[Conclusion]Chinese drugs formulas,drug pairs,single medicine and its active ingredients,although are used in different forms,all aim to regulate the balance of Qi and blood,Yin and Yang in the body and the functions of organs,and further restore the normal secretion of neurotransmitters,hormones and so on,and improve sleep quality.Alternative therapies based on intestinal function regulation may be a new strategy for treating insomnia.

Objective:To observe the effect of ubiquilin 2 gene (UBQLN2) on the radiosensitivity of human esophageal squamous cell carcinoma cells (ESCC) of EC109 and KYSE30, and explore underlying molecular mechanism.Methods:siRNA and lentivirus transfection techniques were used to establish UBQLN2-knockdown and UBQLN2-overexpression cell lines. The cells were irradiated with a dose of 4 Gy X-rays. UPLC-Q-TOF-MS technique was used for metabolite difference analysis and KEGG pathway analysis. The results of metabonomics analyses were verified by qRT-PCR assay. The influence of UBQLN2 level on the radiosensitivity of ESCC was confirmed by CCK-8 cell proliferation assay and clone formation assay and further verified by treating the cells with metabolic enzyme inhibitors and exogenous metabolites.Results:Compared with irradiation alone, down-regulating UBQLN2 in EC109 and KYSE30 cell lines reduced the cell survival by 32.29% and 16.42% ( t=5.35, 4.88, P<0.05), and reduced the clone formation rate by 11.07% and 7.47% after 4 Gy irradiation, respectively ( t=4.18, 5.09, P<0.05). On the contrary, up-regulating UBQLN2 in EC109 and KYSE30 cell lines increased the survival rate by 14.07% and 10.64% ( t=5.88, 4.21, P<0.05), and increased the clone formation rate by 6.53% and 7.87% after 4 Gy irradiation, respectively ( t=8.60, 8.26, P<0.05). Metabonomics study showed that the purine metabolic pathway was significantly enriched after down-regulating UBQLN2 in EC109 cell. The qRT-PCR experiment showed a positive correlation between the expression level of UBQLN2 and the mRNA level of five purine metabolism enzymes. The viability of irradiated UBQLN2-overexpression cells decreased by 18.28% and 25.58%, respectively ( t=7.76, 10.95, P<0.05), and the clone formation rate decreased by 9.33% and 9.93%, respectively ( t=5.97, 8.02, P<0.05) after adding mycophenolic acid(MPA). However, the survival rate of cells increased by by 8.28% and 10.74% ( t=2.83, 6.20, P<0.05), and the clone formation rate increased by 7.33% and 5.80%, respectively ( t=7.16, 5.49, P<0.05), when exogenous supplementation of nucleotides (ATP + GTP) were added. Conclusion:The expression level of UBQLN2 was negatively related to the radiosensitivity of ESCC by up-regulating purine metabolism.

Objective To investigate the role and mechanism of the DNA helicase PIF1 in the proliferation of ovarian cancer cells and its response to DNA damage.Methods The relative expression of the PIF1 gene in normal ovarian tissue compared to ovarian cancer tissue,as well as the relationship between PIF1 expression and overall survival in ovarian cancer patients,was analyzed using the Gene Expression Profiling Interactive Analysis(GEPIA)and Kaplan-Meier Plotter public databases.PIF1 knockout ovarian cancer cells were established using CRISPR/Cas9 gene-editing technology.A retroviral vector overexpressing Rad51 recombinase was constructed,and then transfected into PIF1 knockout ES-2 ovarian cancer cells.Western blot analysis was used to determine the effects of PIF1 knockout and Rad51 overexpression in the transfected cells.Cell proliferation was assessed with cell counting,colony formation assay and CCK-8 assay.A total of 32 female BALB/c nude mice(6～8 weeks old,weighing 20～25 g)were randomly divided into ES-2 control group,ES-2 knockout group,OVCAR-3 control group,and OVCAR-3 knockout group,with 8 mice in each group.A mouse xenograft model was established to assess the in vivo proliferative capacity of ovarian cancer cells.Apoptotic rate and cell cycle were assessed using flow cytometry.The senescence of ovarian cancer cells was evaluated through a β-galactosidase activity assay.Western blotting and immunofluorescence assay were applied to determine the changes in phosphorylated histone H2AX(γ-H2AX)protein were measured with to evaluate the effects of PIF1 knockout and Rad51 overexpression on DNA damage and to observe the localization of PIF1 and Rad51 in ovarian cancer cells.Results The analysis of public databases revealed that PIF1 overexpression was negatively correlated with the overall survival of patients(P＜0.001),and PIF1 was found to be overexpressed in the ovarian cancer tissues than the normal ovarian tissues(P＜0.05).CRISPR/Cas9-mediated knockout of PIF1 significantly inhibited the proliferation(P＜0.01)and clonogenic ability(P＜0.001)of ovarian cancer cells,which was also validated in mouse model(P＜0.05).Flow cytometry indicated that PIF1 knockout promoted apoptosis(P＜0.01)and induced cell cycle arrest(P＜0.01)in ovarian cancer cells.In addition,β-galactosidase activity assay demonstrated that PIF1 knockout enhanced cellular senescence(P＜0.001).Western blot and CCK-8 assays further revealed that PIF1 knockout increased the expression of γ-H2AX protein(P＜0.05)and suppressed the proliferative capacity of ovarian cancer cells following cisplatin treatment(P＜0.05).In PIF1 knockout ovarian cancer cells,Rad51 expression was diminished.However,overexpression of Rad51 in PIF1-deficient cells restored PIF1 expression,decreased γ-H2AX protein level(P＜0.05),and rescued cell proliferation(P＜0.01).Immunofluorescence assay demonstrated that EGFP-PIF1 and Rad51 were co-localized in the nucleus.Conclusion PIF1 and Rad51 collaboratively regulate DNA damage and cell proliferation in ovarian cancer cells.

Objective:To provide data support for the improvement of aeromedical support by summarizing the disease characteristics and analyzing the change pattern of disease spectrum for the temporarily grounded military flying personnel assessed in the annual physical examination.Methods:The clinical data of military flying personnel who were assessed as temporary grounding in the annual physical examination in Air Force Healthcare Center for Special Services Hangzhou from 2012 to 2021 were retrospectively analyzed. They were divided into 2012—2016 group and 2017—2021 group with a 5-year span. The distributions of disease, age and aircraft type were statistically compared between 2 groups of temporarily grounded military flying personnel.Results:A total of 522 flying personnel, aged from 23-55 years and flew 100-20 000 h, were enrolled. There were 242 cases in 2012—2016 group and 280 cases in 2017—2021 group. Compared with 2012—2016 group, 2017—2021 group was found 9 new diseases. Among the top 10 diseases in 2017—2021 group, the proportion of pulmonary nodules, hypertension, diabetes, abnormal tumor indicators, positive fecal occult blood was increased, and the proportion of thyroid nodules, abnormal liver function, arrhythmia was decreased. There was a significant difference in the age distribution between 2 groups of temporarily grounded military flying personnel ( χ2=20.97, P<0.001). The proportion of flying personnel aged ≥40 years old was increased in 2017—2021 group. The proportion of fighter-trainer pilots and bomb-transporter flying personnel increased in 2017—2021 group, and the difference was significant ( χ2=14.66, P=0.001). Conclusions:In recent years, more diseases, mostly occult diseases, are found in the disease spectrum of the temporarily grounded military flying personnel. Since some insidious diseases require more time to observe their convalescent effect and the influence to flight but the routine phone follow-up is called within 2 months of discharge, so a long-term and effective follow-up mechanism is suggested.

Objective:To provide data support for the improvement of aeromedical support by summarizing the disease characteristics and analyzing the change pattern of disease spectrum for the temporarily grounded military flying personnel assessed in the annual physical examination.Methods:The clinical data of military flying personnel who were assessed as temporary grounding in the annual physical examination in Air Force Healthcare Center for Special Services Hangzhou from 2012 to 2021 were retrospectively analyzed. They were divided into 2012—2016 group and 2017—2021 group with a 5-year span. The distributions of disease, age and aircraft type were statistically compared between 2 groups of temporarily grounded military flying personnel.Results:A total of 522 flying personnel, aged from 23-55 years and flew 100-20 000 h, were enrolled. There were 242 cases in 2012—2016 group and 280 cases in 2017—2021 group. Compared with 2012—2016 group, 2017—2021 group was found 9 new diseases. Among the top 10 diseases in 2017—2021 group, the proportion of pulmonary nodules, hypertension, diabetes, abnormal tumor indicators, positive fecal occult blood was increased, and the proportion of thyroid nodules, abnormal liver function, arrhythmia was decreased. There was a significant difference in the age distribution between 2 groups of temporarily grounded military flying personnel ( χ2=20.97, P<0.001). The proportion of flying personnel aged ≥40 years old was increased in 2017—2021 group. The proportion of fighter-trainer pilots and bomb-transporter flying personnel increased in 2017—2021 group, and the difference was significant ( χ2=14.66, P=0.001). Conclusions:In recent years, more diseases, mostly occult diseases, are found in the disease spectrum of the temporarily grounded military flying personnel. Since some insidious diseases require more time to observe their convalescent effect and the influence to flight but the routine phone follow-up is called within 2 months of discharge, so a long-term and effective follow-up mechanism is suggested.

Objective: To investigate the impact of bladder filling status on the movement of uterine and on the volume of organs at risk(OAR), so as to provide theoretical basis for individualized internal target volume (ITV) and planning target volume (PTV). Methods: Simulation CT images for a total of 27 patients with locally advanced cervical cancer were acquired with empty bladder, 1.0 h after bladder filling, 1.5 h after bladder filling, respectively. The volumes of uterine corpus, cervix, OARs, CTV and PTV 1.0 h after bladder filling were delineated. The impact of bladder filling status on the displacements of cervix and corpus, volumetric changes of rectum, small intestine, and the volumes of small intestine, bladder and rectum within PTV were analyzed. The correlation between bladder filling status and uterine displacement and volume of OAR was also investigated, as well as the volume of cervix and corpus in the PTV with empty bladder and 1.5 h after bladder filling. Results: Bladder filling status is different for individual cases. The maximum movement range of cervix and uterine body with bladder filling state was 0-3.04 cm and 0-4.31 cm respectively. The anterior displacements of corpus (F=7.818, P<0.05), the volumetric changes of blander, as well the volume of bladder and small intestine in the PTV (F=46.197, 44.609, 29.546, P<0.05) were significantly different between different bladder filling status. The bladder filling status was correlated with the displacements of the anterior of corpus, volumetric changes of small intestine, and the volumes of bladder and small intestine within the PTV (r=-0.232, -0.298, 0.915, -0.336, P<0.05). The volumes of cervix and corpus out of the PTV were significantly different between the empty bladder and 1.5 h after bladder filling (t=-1.326, -1.559, P<0.05). Conclusions Bladder filling status was different for individual patients. The displacements of the anterior of the corpus were significantly affected by the bladder filling status. Increasing the anterior margin of PTV was recommended. The consistency of bladder filling status was critical for the precise cervical cancer IMRT.

Objective To evaluate an effective and feasible quantitative evaluation table of traditional Chinese medicine (TCM) syndrome differentiation, and to observe the effect of combination of TCM syndrome differentiation and standard bundle therapy in patients with septic shock. Methods A prospective randomized controlled trial was conducted. The septic shock patients with acute deficiency syndrome admitted to department of critical care medicine of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 1st, 2016 to December 31st, 2017 were enrolled. The patients were randomly divided into control group and Shenfu group. The patients in both groups received early application of standardized bundle therapy; those in Shenfu group received 60 mL Shenfu injection infusion in addition for 7 days. The TCM syndrome score was evaluated by classification and scoring method of TCM symptoms. The circulation and tissue perfusion, severity of disease, organ function, inflammation response, adjuvant treatment and 28-day mortality were compared between the two groups. Results A total of 50 patients with septic shock were enrolled in the analysis, 25 in control group and 25 in Shenfu group. The markedly effective rate of TCM symptoms score in Shenfu group was significantly higher than that in control group [60.0% (15/25) vs. 16.0% (4/25), P < 0.01]. There was no significant difference in all parameters before treatment between the two groups. After treatment, the observation indexes of both groups were improved. Compared with control group, the mean arterial pressure (MAP) in Shenfu group increased more significantly [mmHg (1 mmHg = 0.133 kPa): 13.0 (2.5, 28.5) vs. 6.0 (0, 13.5)], the lactate (Lac) and procalcitonin (PCT) decreased more significantly [Lac (mmol/L): 0.8 (0.1, 3.7) vs. 0.5 (-0.6, 1.7), PCT (μg/L): 2.0 (0.7, 32.3) vs. 0 (-1.8, 3.8)], activated partial thromboplastin time (APTT) was shortened more significantly [s: 8.5 (0, 12.9) vs. 0 (-7.2, 10.0)], and interleukins (IL-2 receptor and IL-6) levels decreased more significantly [IL-2 receptor (ng/L):1 031.0 (533.0, 1 840.0) vs. 525.5 (186.0, 1 166.8), IL-6 (ng/L): 153.1 (21.4, 406.8) vs. 35.1 (16.3, 110.1)] with significant differences (all P < 0.05). There was no significant difference in the use time of vasoactive drugs, duration of mechanical ventilation, severity of the disease or 28-day mortality between the two groups. However, the use time of vasoactive drugs in Shenfu group was shorter than that in control group (days: 5.48±4.81 vs. 8.28±7.83), and the 28-day mortality was decreased [8.0% (2/25) vs. 20.0% (5/25)]. Conclusions TCM syndrome score is helpful to evaluate the effect of TCM syndrome differentiation and treatment, and it is effective and feasible in clinical application. Septic shock patients treated with TCM syndrome differentiation and treatment combined with standard bundle therapy were significantly improved in circulation, tissue perfusion, coagulation function and inflammation reaction.

This paper expatiates on the effective application of domestic and foreign daily living ability assessment scale in the elderly's daily living ability assessment, subsidy, care policy assessment and insurance compensation. It analyzes and discusses the problems in the application of the daily living activity ability scale, and provide suggestions for Chinese pension service institutions.