ObjectiveTo investigate the antitumor effect and mechanism of Guiqi Yiyuan ointment on Lewis lung cancer mice based on the extracellular regulatory protein kinase （ERK） signaling pathway. MethodsA Lewis lung cancer mouse model was established. Except for the blank group， the model mice were randomly divided into the model group， Guiqi Yiyuan ointment low， medium， and high dose groups， and the extracellular ERK1/2 inhibitor group， with 10 mice per group. The Guiqi Yiyuan ointment was administered by gavage at doses of 1.75， 3.5， 7.0 g·kg^-1·d^-1 for the low， medium， and high dose groups， respectively. The ERK1/2 inhibitor group was given the ERK1/2 inhibitor LY3214996 （100 mg·kg^-1·d^-1） by gavage. The treatment was administered for 14 consecutive days， after which samples were collected. Tumor histopathological changes were observed using hematoxylin-eosin （HE） staining. Transmission electron microscopy was used to observe ultrastructural changes in tumor cells. Immunofluorescence was performed to measure the phosphorylation of ERK1/2 （p-ERK1/2） and the expression of programmed cell death ligand-1 （PD-L1） in tumor tissues. Western blot and real-time quantitative polymerase chain reaction （Real-time PCR） were used to detect the expression of p-ERK1/2， PD-L1， the autophagy marker Beclin-1， the autophagic protein p62， and the microtubule-associated protein light chains LC3Ⅰ and LC3Ⅱ at both the protein and gene levels. ResultsCompared with the model group， the average tumor weight was significantly reduced in the low and medium dose groups of Guiqi Yiyuan ointment （P<0.05）， and markedly reduced in the high dose and inhibitor groups （P<0.01）. Tumor cells in all treatment groups became progressively irregular， with ruptured nuclei and expanded areas of cell disintegration and necrosis. The number of organellar ablations in tumor tissues increased， and the number of autophagic vesicles also increased in all groups. The mean fluorescence intensity of p-ERK1/2 and PD-L1 was reduced in the low and medium dose groups of Guiqi Yiyuan ointment （P<0.05）， and significantly reduced in the high dose and inhibitor groups （P<0.01）. The mRNA expression of ERK1/2， PD-L1， Beclin-1， and p62 was reduced in the medium dose group （P<0.05）， while LC3Ⅰ/Ⅱ mRNA expression was elevated （P<0.05）. In the high dose and inhibitor groups， mRNA expression of ERK1/2， PD-L1， Beclin-1， and p62 was significantly reduced （P<0.01）， while LC3Ⅰ/Ⅱ mRNA expression was significantly increased （P<0.01）. Protein expression of p-ERK1/2， PD-L1， Beclin-1， and p62 was reduced in the medium dose group （P<0.05）， and LC3Ⅰ/Ⅱ protein expression was elevated （P<0.05）. In the high dose and inhibitor groups， protein expression of p-ERK1/2， PD-L1， Beclin-1， and p62 was significantly reduced （P<0.01）， while LC3Ⅰ/Ⅱ protein expression was significantly elevated （P<0.01）. ConclusionGuiqi Yiyuan ointment may inhibit the activation of the ERK signaling pathway， downregulate the expression of p-ERK1/2， promote autophagic flux in tumor cells， and regulate the expression of PD-L1， thereby exerting an inhibitory effect on tumor growth in Lewis lung cancer mice.

Objective To observe the effects and mechanism of Guiqi Yiyuan Ointment on immune function in 12C6+ beam bystander-effect rats.Methods Totally 60 Wistar rats were randomly divided into blank group,model group,positive control group,and TCM low-,medium-,and high-dosage groups,with 10 rats in each group.TCM low-,medium-,and high-dosage groups were given 1.2,2.4,and 4.8 g/kg Guiqi Yiyuan Ointment for gavage,and the blank group,model group and positive control group were given equal dose of sodium chloride solution for gavage for 14 days.Positive control group received intraperitoneal injection of amifostine 30 minutes before modeling.On the 15th day,except the blank group,the other groups were given 4 Gy 12C6+ beam of single irradiation on the right lung.After irradiation,each group was given gavage for 3 days.The general condition of rats was observed,peripheral blood leukocyte(WBC),red blood cell(RBC),hemoglobin(Hb),platelet(PLT)levels were detected,ELISA was used to detect the contents of serum interleukin(IL)-4 and interferon-γ(IFN-γ),lung and spleen organ indices were calculated,HE staining was used to observe the pathological morphology of left lung and spleen tissues,and flow cytometry was used to detect the proportion of CD4+ and CD8+ T lymphocytes in the spleen,qPCR was used to detect the expressions of T-bet and GATA-3 mRNA in right lung and spleen tissues.Results Compared with the blank group,the model group rats showed a decrease in peripheral blood WBC,an increase in RBC,Hb,PLT,and an decrease in serum IL-4 and IFN-γ contents;the organ indices of left lung and spleen was significantly reduced,the alveoli were deformed,the alveolar walls became thicker,the alveolar cavities shrank,the lung tissue was significantly bleeding,the spleen tissue structure was severely damaged,the splenic sinus cavity became narrower,and the splenic cord showed fibrous hyperplasia;the proportion of CD4+ T lymphocytes and CD4+/CD8+ ratio in spleen tissue of the model group decreased,while the proportion of CD8+ T lymphocytes increased,the expression of T-bet mRNA in the left lung and spleen tissues decreased,while the expression of GATA-3 mRNA increased,with statistical significance(P<0.05).Compared with the model group,the positive control group and TCM medium-and high-dosage groups showed an increase in peripheral blood WBC,an decrease in RBC,Hb,PLT,an increase in serum IL-4 and IFN-γ contents;the index of left lung and spleen organs increased in TCM high-dosage group;the pathological damage of left lung and spleen tissues in each treatment group alleviated to varying degrees,while the proportion of CD4+ T lymphocytes and CD4+/CD8+ ratio in spleen tissue of the positive control group and TCM high-dosage group increased,the proportion of CD8+ T lymphocytes decreased,the expression of T-bet mRNA in left lung and spleen tissues increased,and the expression of GATA-3 mRNA decreased,with statistical significance(P<0.05).Conclusion Guiqi Yiyuan Ointment can alleviate the lung and spleen injury of rats induced by 12C6+ beam radiation.Its mechanism is related to regulating the proportion of CD4+,CD8+ T lymphocytes and the expression of T-bet and GATA-3,and recovering cellular immune function.

Electrocardiogram (ECG) monitoring owns important clinical value in diagnosis, prevention and rehabilitation of cardiovascular disease (CVD). With the rapid development of Internet of Things (IoT), big data, cloud computing, artificial intelligence (AI) and other advanced technologies, wearable ECG is playing an increasingly important role. With the aging process of the population, it is more and more urgent to upgrade the diagnostic mode of CVD. Using AI technology to assist the clinical analysis of long-term ECGs, and thus to improve the ability of early detection and prediction of CVD has become an important direction. Intelligent wearable ECG monitoring needs the collaboration between edge and cloud computing. Meanwhile, the clarity of medical scene is conducive for the precise implementation of wearable ECG monitoring. This paper first summarized the progress of AI-related ECG studies and the current technical orientation. Then three cases were depicted to illustrate how the AI in wearable ECG cooperate with the clinic. Finally, we demonstrated the two core issues-the reliability and worth of AI-related ECG technology and prospected the future opportunities and challenges.
Humans ; Artificial Intelligence ; Reproducibility of Results ; Electrocardiography ; Cardiovascular Diseases ; Wearable Electronic Devices

Objective:To investigate the measurements of the ciliary body in patients with acute primary angle-closure (APAC).Methods:This was a case-control study.Subjects were admitted to Ningxia Eye Hospital from January to October 2016.Fifty-five consecutive patients diagnosed with APAC in one eye were presented as case groups, and their fellow eyes were presented as fellow groups.Fifty-five eyes from 55 age-matched normal controls were also recruited as control groups.A-scan ultrasonography and ultrasound biomicroscopy (UBM) were conducted to determine biometric measurements and ciliary body parameters.Biometric measurements included axial length (AL), lens thickness (LT), anterior chamber depth (ACD), pupil diameter (PD), anterior chamber width (ACW) and lens vault (LV). Ciliary body parameters included maximum ciliary body thickness (CBTmax), ciliary body thickness at the point of the scleral spur (CBT 0) and 1 000 μm from the scleral spur (CBT 1000), anterior placement of the ciliary body (APCB), and trabecular-ciliary process angle (TCA), respectively.Pearson correlation analysis was used to examine the correlation between the biometric measurements and the ciliary body parameters.Written informed consent was obtained from each subject before any medical examination.The study protocol was approved by the Ethics Committee of People's Hospital of Ningxia Hui Autonomous Region. Results:The ACD was smaller, while the PD and lens thickness were larger in eyes with APAC compared with their fellow eyes.The differences were statistically significant ( t=-6.805, 3.490, 2.624; all at P<0.05). Smaller AL and ACD measurements were found in the fellow eyes of APAC patients compared with normal eyes, and these differences were statistically significant ( t=-4.828, -6.947; both at P<0.001). For eyes with APAC, their fellow eyes and normal eyes, the average CBT max were (0.907±0.106), (0.960±0.098) and (1.020±0.108)mm; average TCA were (48.99±11.48)°, (51.32±10.87)° and (81.94±12.45)°, respectively.CBT max, CBT 0, CBT 1000, and TCA measukements were smaller, and APCB were larger in eyes with APAC compared with their fellow eyes, and these differences were statistically significant ( t=-5.354, -3.517, -3.407, -0.753; all at P<0.05). In addition, CBT max, CBT 0, CBT 1000, and TCA measurements were smaller, and APCB were larger in the fellow eyes compared with the normal eyes, these differences were also statistically significant ( t=-6.040, -3.132, -6.005, -13.509, 16.795; all at P<0.05). Positive correlations were found between AL and CBT 1000, and between AL and TCA ( r=0.335, P=0.012; r=0.380, P=0.004), while a negative correlation was found between intraocular pressure and CBTmax ( r=-0.289, P=0.032). Conclusions:In eyes with APAC, as well as their fellow eyes, ciliary bodies are thinner and anteriorly rotated, and this anatomical change is associated with shorter AL and high intraocular pressure.

Objective:To explore the influence of organizational management mode and regional medical resource allocation on thrombolysis rate of stroke.Methods:A cross-sectional study was carried out in 61 thrombolytic units distributed at 16 administrative districts of Shanghai to collect information including the number of imaging equipment, neurologists and nurses, hospital organization and management mode, thrombolytic rate, etc. Using SPSS 19.0 statistical software, simple linear regression analysis and chi square test were used to analyze the correlation between related indexes and thrombolysis rate.Results:There was no linear correlation between imaging equipment, human resources and regional thrombolysis rate. The key factor to improve thrombolysis rate was the organizational management of stroke( OR=1.488, 95% CI=1.357-1.631, P<0.001). Conclusions:An effective hospital organization and management model, including the establishment of multi department cooperation, stroke emergency team, stroke green channel, can significantly improve the thrombolysis rate of stroke.

Objective To explore the value of axis shift between the baseline normal sinus rhythm (NSR) and WCT in diagnosis of wide QRS-complex tachycardia (WCT). Methods 390 surface ECGs of 186 patients with WCT were obtained from April 2012 to April 2018 at Ningbo Medical Center Lihuili Hospital at which the arrhythmia diagnosis was proven by intracardiac electrophysiological study. The axis shift between the baseline NSR and WCT was calculated by table lookup method. Then we analyzed the role of axis shift in diagnosis of WCT. Results Among the 186 patients with WCT, 147 (79.03％) were ventricular tachycardia (VT) , and 39 (20.97％) were supraventricual tachycardia (SVT) with conduction abnormalities. In the 95％ confidence interval, the axis shift showed an outstanding discrimination performance. The area under the ROC curve is 0.708 (0.579-0.817, P =0.007). Compared with left axis deviation, right axis deviation, the right axis deviation of LBBB morphology, the axis shift> 68 degree is more sensitive (53.06％) , and the specificity (91.43％) is also more desirable. Moreover, if the axis shift set> 130 degree, the specificity can reach 100％, and the sensitivity (12.24％) is equivalent to northwestern axis. Conclusion A significant axis shift between the baseline NRS and WCT can distinguish WCT accurately. Given the ease of grasping, it can probably be feasible to popularize as a routine diagnosis method for WCT in primary hospitals.

Objective To explore stigma in patients after breast modified radical mastectomy, and analyze the correlation of stigma with coping style and self-esteem.Methods From January 2015 to February 2017, totally 186 patients after breast modified radical mastectomy were selected by convenience sampling method and investigated by self-designed general demographic questionnaire, Social Impact Scale, Medical Coping Modes Questionnaire and Self-Esteem Scale. Pearson correlation analysis was used to investigate the correlation of breast cancer patients' stigma with coping style and self-esteem, and multiple linear regression was adopted to analyze the influencing factors of stigma.Results Patients' stigma after surgery was (61.04±11.99), which was at a moderate level. The stigma was negatively correlated with confrontation and self-esteem (r= -0.421, -0.574;P<0.05), and positively correlated with resignation and avoidance (r=0.564, 0.414;P<0.05). The result of multiple linear regression showed that age and resigned coping style were the influencing factors of stigma (β'=0.291,0.263;P<0.05).Conclusions The stigma of patients after breast modified radical mastectomy is at a moderate level, and should be paid attention. Nurses should encourage patients to face difficulties and challenges, and communicate with others actively. Besides, young adult patients should be taken into consideration.

Objective:To study the gene regulatory network during the osteogenic differentiation process of dental follicle stem cells (DFSCs)with bioinformatic analysis.Methods:The differentially expressed genes during the osteogenic diffrentiation process of DF-SCs were selected from the GEO Datasets.Then the relationship among the genes were analysed using DAVID and GeneMANIA data-base.Results:Numerous differentially expressed genes during the osteogenic differentiation process of DFSCs were obtained,289 genes with significance of different expression(P <0.05)were enriched into “cell differentiation”,“cell proliferation”,“skeletal sys-tem development”and “calcium signaling pathway”subgroups.ALPL,CTSK,TUFT1 ,TGFBR2,FHL2,ROR2,STC1 ,POSTN, ZBTB1 6,FRZB,PRELP and IGFBP5 were enriched into the “skeletal system development”subgroup.The 1 2 genes exhibited interac-tions,including co-expression,co-localization,genetic interaction and signal pathways.Conclusion:There is a complex molecular regulatory network among the differentially expressed genes during the osteogenic differentiation process of DFSCs.It is necessary to an-alyse the osteogenic differentiation process of DFSCs as a whole from WNT,TGFbeta,MAPK siganal pathyways,Homeobox transcrip-tion factors and osteogenic differentiation marker genes.

This study was aimed to observe the clinical efficacy of Highly Active Antiretroviral Therapy (HAART) combined withPing-Ai(PA) Mixture in the treatment of Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) patients with non-infectious skin lesions, in order to study the advantages of integrative medicine in AIDS prevention and treatment. A total of 9 cases, who met the inclusion criteria of AIDS-associated non-infectious skin lesion with the pattern ofqi-yin deficiency and internal obstruction of phlegm-stasis, were selected. The combination of HAART and number 1 and 4 prescription of PA Mixture were used in the treatment for 3 months. The observations were made on changes of clinical symptoms, body signs, Karovsky integral and CD4+ T cells of patients before and after treatment. Stata 12.0 was used in the statistical analysis. The results showed that after integrative therapy, the single integral of clinical symptoms and body signs, such as skin spot papula, subcutaneous nodules, skin itching, fatigue was obviously reduced compared to that of the pretreatment. The total score decreased than that of the pretreatment. The patients’ quality of life (QOL) significantly increased. The Karovsky integral increased compared with that of pretreatment. The CD4+ T cells values were higher than that of the pretreatment. It was concluded that the integrative therapy had a certain effect in the treatment of AIDS-associated non-infectious skin lesions, which can improve the clinical symptoms, body signs, obviously increase the patients’ QOL and immune function.