Objective The study aimed to elucidate the evolution of the syndromes in Traditional Chinese Medicine(TCM)and TCM syndrome elements in different chronic stages of psoriasis vulgaris.Methods A database was constructed using electronic medical records collected from July 2019 to March 2024 from 1,049 patients with psoriasis vulgaris.The study used Sankey diagrams and network association graphs to analyze the evolution of TCM syndromes and their elements in patients at the different stages:initial diagnosis,progressive stage(Week 2-3),progressive stage(Week 4-5),skin lesion improvement stage(Week 6-7),and remission stage.The syndrome elements network was constructed using community detection algorithms,and the association rules between local skin lesion syndrome differentiation and overall syndrome differentiation were displayed using heatmaps.Results(ⅰ)Initial diagnosis.In the syndrome differentiation of local skin lesions,blood heat syndrome was the most common(79.79％);among the disease location of TCM syndrome elements(called"disease location"),liver was the most prevalent(35.62％);and among the pathological factors of TCM syndrome elements(called"pathological factors"),fire(heat)was the most common(75.48％).(ⅱ)Active stage(Week 2-3).In the syndrome differentiation of local skin lesions,blood heat syndrome remained the most prevalent(73.13％);among the disease location,liver was still the most prevalent(31.71％);and among the pathological factors,fire(heat)continued to be the most common(82.11％),while dampness(22.26％)and qi stagnation(8.39％)began to increase.(ⅲ)Active stage(Week 4-5).The syndrome differentiation of local skin lesions was dominated by blood heat syndrome(45.91％)and blood dryness syndrome(37.19％);among disease location,the interior was the most prevalent(15.25％);and among the pathological factors,fire(heat)remained the most common(50.66％),with an increase in yin deficiency(34.26％).(ⅳ)Skin lesion improvement stage(Week 6-7).In the syndrome differentiation of local skin lesions,both blood dryness syndrome(49.44％)and blood stasis syndrome(33.33％)increased;among the disease location,meridians increased most significantly and became the most prevalent(13.44％);and among the pathological factors,blood stasis increased most significantly and became the most prevalent(28.20％).(ⅴ)Remission stage.In the syndrome differentiation of local skin lesions,blood stasis syndrome became the primary(55.69％),while the percentage of blood dryness syndrome decreased(21.16％);meridians(25.71％)and blood stasis(62.34％)remained the most predominant syndrome elements related to disease location or pathological factors.Conclusion The overall pattern of TCM syndromes in psoriasis vulgaris evolved from excess to deficiency.From the initial diagnosis to the active phase(Week 2-3),heat syndrome dominated;during the active phase(Week 4-5),heat syndrome coexisted with damp syndrome or yin deficiency syndrome;changes in the syndrome element network were the most significant during the lesion improvement phase,with blood stasis gradually increasing and peaking during the remission phase.Blood stasis,dampness,and qi stagnation were pervasive throughout psoriasis vulgaris;qi stagnation and blood stasis may be the main elements causing further deterioration and prolonged course of the disease during the active phase in patients.

Objective:To explore the nutritional status and quality of life of gastric cancer patients one month after operation in the context of enhanced recovery, and analyze the correlation between them.Methods:From August 2020 to August 2021, 168 patients discharged from the Gastrointestinal Surgery of Ningbo First Hospital after radical resection of gastric cancer were selected as the study subject by convenience sampling. The Nutritional Risking Screening 2002 (NRS2002) and the Global Leadership Initiative on Malnutrition (GLIM) step 2 (excluding muscle mass measurement index) were used to assess the postoperative nutritional status of patients. The quality of life of patients with gastric cancer after operation was investigated with the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) . Logistic regression analysis was used to explore the influencing factors of nutritional status of postoperative patients with gastric cancer. A total of 168 questionnaires were distributed, and 168 valid questionnaires were recovered, with a valid recovery rate of 100.0%.Results:A total of 104 patients (61.9%) had nutritional risk and 46 patients (27.4%) had malnutrition. There were statistical differences in age, education level, tumor stage, body mass index, physical function, role function, emotional function, cognitive function, general health, fatigue, nausea and vomiting, and loss of appetite among gastric cancer patients with different nutritional status after operation ( P<0.05) . Logistic regression analysis showed that body mass index, physical function, role function, emotional function and fatigue were the influencing factors of the nutritional status of patients one month after operation ( P<0.05) . Conclusions:In the context of enhanced recovery, the nutritional risk and malnutrition rate of gastric cancer patients one month after operation are high, and are closely related to the quality of life. When implementing enhanced recovery after surgery, medical and nursing staff should strengthen and optimize the nutrition management of gastric cancer patients before hospital, during perioperative period and after discharge, improve the nutritional status after operation and the quality of life of patients.

Objective:To investigate the effect of sarcopenia on physical performance and nutritional status in elderly patients with gastrointestinal tumors.Methods:a total of 120 eligible in-patients were enrolled from gastrointestinal surgery department of a Grade A tertiary hospital in Ningbo city from September 2021 to January 2022. General clinical data were collected, nutritional risk was screened using Nutritional Risk Screening 2002 (NRS 2002), physical performance was assessed by Short Physical Performance Battery (SPPB), skeletal muscle index at the third lumbar vertebra level (L3 SMI) was calculated using abdominal CT scan, and grip strength/muscle strength, gait speed by 6 Meter Timed Walk Test and calf circumference were measured. Subjects were divided into sarcopenia and non-sarcopenia group according to the diagnostic criteria of the Asian Working Group for Sarcopenia (AWGS). Impacting factors of sarcopenia and the correlation between muscle mass and physical performance in elderly patients with gastrointestinal tumors were analyzed.Results:The overall prevalence rate of sarcopenia in elderly patients with gastrointestinal tumors was 28.3% (34/120) and it was 28.9% (22/76) and 27.3% (12/44) in males and females respectively. There were statistically significant differences in age, tumor stage, nutritional risk, body mass index, calf circumference, L3 SMI, grip strength/muscle strength, gait speed and SPPB score between patients with and without sarcopenia (P<0.05). Muscle strength/grip strength, L3 SMI and gait speed were closely correlated with the occurrence of sarcopenia in elderly patients with gastrointestinal tumors (P<0.05). The L3 SMI was positively correlated with physical performance as assessed with SPPB in both groups.Conclusions:Sarcopenia is a common complication in elderly patients with gastrointestinal tumors with multiple influencing factors. Timely nutritional intervention and exercise intervention should be incorporated into the treatment of elderly gastrointestinal tumor patients with sarcopenia in order to improve nutrition status.

Objective:To investigate the relationship between discharge readiness and nutritional status of patients undergoing gastric cancer surgery in the context of enhanced recovery after surgery (ERAS) , so as to provide individualized guidance for patients after discharge.Methods:Using the convenient sampling method, a total of 120 patients who underwent radical gastrectomy for gastric cancer from June 2020 to June 2021 in Ningbo First Hospital were selected as research objects, and they all received ERAS nursing care. One day before discharge, Nutritional Risk Screening Table and Discharge Readiness Scale were used for questionnaire analysis.Results:The total score of discharge readiness of 120 patients with gastric cancer after surgery was (81.42±6.87) . Among the three dimensions, personal status was (19.65±2.19) , adaptability was (29.67±3.10) and anticipatory support was (32.10±2.61) . 57.5% (69/120) of gastric cancer patients discharged from hospital had nutritional risk. The scores of hospital discharge readiness and the scores of each dimension in the nutritional risk group were lower than those in the non-nutritional risk group, and the differences were statistically significant ( P<0.05) . Multivariate analysis showed that nutritional status was an influencing factor for the total score of hospital discharge readiness in patients with gastric cancer surgery (standardized regression coefficient was 0.321, P<0.05) . Conclusions:Under the background of ERAS, the discharge readiness of patients after gastric cancer surgery is at a moderate level, postoperative patients are generally at nutritional risk and the discharge readiness of patients with nutritional risk is lower than that of patients without nutritional risk. Perioperative nutrition management by nursing staff can improve the discharge readiness of patients undergoing gastric cancer surgery, and continuous nutrition management should be carried out for discharged patients with nutritional risk, in order to promote home rehabilitation of patients with gastric cancer surgery.

OBJECTIVE：To systematically evaluate the effectiveness and safety of Shenfu qiangxin pills combined with chemical medicine conventional therapy in the treatment of chronic heart failure ，and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from CNKI ，Wanfang database ，VIP，Google Scholar ，PubMed，the Cochrane Library and Embase database ，RCTs about Shengfu qiangxin pills combined with chemical medicine conventional therapy （trial group ） versus chemical medicine conventional treatment （control group ）were collected during the inception to May 12th，2020. After literature screening and data extraction ，the quality of the literatures was evaluated with risk bias assessment tool recommended by Cochrane 5.1.0 system evaluator manual. Meta-analysis and sensitivity analysis were performed by using Stata 14.0 software. RESULTS：A total of 7 RCTs were included ，involving 596 patients. Meta-analysis results showed that the total response rate of trial group was significantly higher than that of control group [OR ＝4.14，95％CI（2.15，7.97），P＜0.000 01]；the results of sub-group analysis according to the different criteria for determining the efficacy showed that the total response rates of trial group determined by Lee integral method and cardiac function grading method were sig nificantly higher than that of the control group （P＜0.05）. After treatment ，N-terminal pro-B-type natriuretic peptide （NT-proBNP） level of trial group was significantly lower than that of control group [OR ＝－1.33，95％CI（－1.55， qq.com －1.11），P＜0.000 01]. Results of sub-group analysis accor- ding to cardiac failure type showed that NT-proBNP level of patients with chronic heart failure in trial group was lower than control group （P＜0.001）. The level of left ventricular ejection fraction （LVEF）in trial group after treatment [WMD ＝5.76，95％CI （5.05，6.47），P＜0.000 01] was significantly higher than control group ；after treatment ，the level of B-type natriuretic peptide [SMD＝－1.61，95％CI（－2.58，－0.54），P＜0.000 01]，left ventricular end-diastolic diameter （LVEDD）level [WMD ＝ －6.06，95％CI（－6.84，－5.27），P＜0.000 01]，left ventricular end-systolic diameter level [WMD ＝－0.52，95％CI（－5.70，－4.33）， P＜0.000 01] were significantly lower than control group. There was no statistically significant difference in the incidence of ADR between 2 groups（P＞0.05）. Results of sensitivity analysis showed that when NT-proBNP ，LVEF level ，LVEDD level after treatment were used as indicators ，there was no significant difference in the analysis results after eliminating heterogeneity source ， compared with before elimination. CONCLUSIONS ：Shenfu qiangxin pills combined with chemical medicine conventional treatment has good efficacy and safety.

OBJECTIVE： To explore potential mechanism of “Astragalus membranaceus-Draba nemorosa” couplet medicine for heart failure. METHODS： By network pharmacology， based on drug-like and oral bioavailability， the active components of “A. membranaceus-D. nemorosa” for chronic heart failure were screened and the targets of treating chronic heart failure were predicted by using TCMSP，GeneCards database， OMIM database and DRAR-CPI. The active component-chronic heart failure target network was established by Cytoscape 3.6.0 software. The protein-protein interaction network was constructed by utilizing STRING database. Then top 5 targets in the list of connectivity were screened and performed a molecular docking in molecular docking server. Finally， GO bioprocess analysis and KEGG pathway enrichment analysis were performed in DAVID database. RESULTS： The study predicted 28 active components in total， including 20 A. membranaceus and 12 D. nemorosa， such as kaempferol and quercetin， there were four components in common. Totally 92 target gene of active components were obtained， including heat shock protein 90α （HSP90AA1）， tyrosine protein kinase SRC gene， etc. Results of GO bioprocess analysis showed an association with mitochondrial electron transport， mitochondrial intima， cytoplasmic sol， extracellular body， mitochondrial matrix and drug response. KEGG pathway enrichment analysis showed a link with MAPK signal pathway， TGF signal pathway， PI3K signal pathway， cAMP signal pathway， protein kinase B signal pathway， EPK1 signal pathway and NF-κB signal pathway. CONCLUSIONS： “A. membranaceus-D. nemorosa” couplet medicine exerts therapeutic effects on heart failure from multiple targets as HSP90AA1， SRC and mitochondrial electron transport and MAPK signaling pathway. The study can provide reference for further researches on its material basis and mechanism.

Objective To explore the correlation between the self-management and self-efficacy of senile patients with chronic heart failure (CHF). Methods In this study, the conveninent sampling method was adopted. From June to December 2016, totally 416 senile CHF patients hospitalized in the Department of Cardiology of 5 general class Ⅲ grade A hospitals in Xi'an were investigated with the general demographic data questionnaire, self-management scale for CHF patients and chronic disease self-efficacy scale. Results The score of self-management in the senile CHF patients in Xi'an totaled (50.76±9.98), with a scoring rate of 63.5%; the scores of medication management, food and beverage management, psychological and social management and symptom management were (13.38±3.38), (7.89±2.14), (12.81±2.91) and (16.69±4.26), with the scoring rates of 66.9%, 65.8%, 64.1% and 59.6%, respectively, showing a medium level; and there was statistically significant difference in the total self-management score between patients with different marital status, per capita income and heart function grading (t=-2.443, 10.906, 16.229;P<0.05). The score of self-efficacy totaled (34.30±11.90), with a scoring rate of 57.17%, showing a medium level. The correlation analysis showed that there was a positive correlation between self-efficacy and self-management (r=0.161, P< 0.05). Conclusions The self-management and self-efficacy of the senile CHF patients in Xi'an remain at a medium level, which could be possibly improved, and the two are closely correlated. The results suggest that we should pay more attention to the patient's management confidence in the disease itself, attach importance to their psychological and social support and enhance their self-efficacy, thus improving their self-management. This is of great significance in controlling CHF and improving the patient's quality of life.

OBJECTIVE:To develop a method for rapid determination of moisture and salidroside in Rhodiolae crenulatae.METHODS:The content of moisture was determined by the methods of oven drying (as reference value);the content of salidroside was determined by HPLC (as reference value).Near infrared spectroscopy (NIR) combined with partial least squares (PLS) algorithm were adopted to establish quantitative model for the contents of moisture and salidroside.According to reference value,83 samples were collected for preprocessing spectra by Savitsky Golay with second derivative and Norris Derivative with first derivative.The optimal spectrum range of moisture and salidroside were 7 343.60-6 865.34,5 183.72-4 890.59 cm-1 and 7 050.47-4 327.48 cm-1,respectively.RESULTS:The content determination methodology of salidroside was in line with the requirement.The correlation coefficients of calibration for moisture and salidroside were 0.968 9 and 0.920 3,and the root mean square errors of calibration were 0.273 0 and 0.085 0,respectively.The correlation coefficients of predication were 0.977 1 and 0.930 0,and the root mean square errors of prediction were 0.222 0 and 0.075 5,respectively.CONCLUSIONS:The method is proved to be simple,rapid,non-destructive and accurate,which can be used for the rapid determination of moisture and salidroside in R.crenulatae.

To study the potential molecular mechanism of tumor angiogenesis in its microenvironment, we investigated the effects of HepG2 conditioned medium on the proliferation of vascular endothelial cell and vascular angiogenesis in our laboratory. Human umbilical vein endothelial EA. hy926 cells were co-cultured with HepG2 conditioned medium in vitro. The proliferation and the tubulogenesis of EA. hy926 cells were detected by teramethylazo salt azole (MTT) and tube formation assay, respectively. The results showed that the survival rate of the EA. hy926 cells was significantly increased under the co-culture condition. HepG2 conditioned medium also enhanced the angiogenesis ability of EA. hy926 cells. In addition, the expressions of intracellular VEGF and extracellular VEGFR (Flk-1) were regulated upward in a time-dependent manner. In conclusion, the proliferation of vascular endothelial cells and Vascula angiogenesis were improved under the condition of indirect co-culture.
Carcinoma, Hepatocellular ; pathology ; Cell Proliferation ; Coculture Techniques ; Culture Media, Conditioned ; Endothelial Cells ; cytology ; Hep G2 Cells ; Human Umbilical Vein Endothelial Cells ; Humans ; Liver Neoplasms ; pathology ; Neovascularization, Pathologic ; Tumor Microenvironment ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism

Objective To assess the relationship between fat metabolic parameters and androgen concentration in the cord blood of newborns of mothers with polycystic ovary syndrome (PCOS). Methods This cross-sectional study included PCOS women (n=55) and neonatal, and 40 cases with matched body mass index (BMI) were used as control. The clinical data including height, body mass, waist circumference, hip circumference of PCOS group, and length and head circumference in newborns after delivery were measured and compared. Blood lipid level, serum insulin and testosterone level were detected using umbilical artery-vein mixed cord blood after delivery. Regression analysis was used to analyze the influence factors of neonatal cholesterol and testosterone levels. Results The neonatal birth weight, head circumference, cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and triglyceride level were significantly lower, birth height and testosterone level were significantly higher, in PCOS group than those of control group (P＜0.05). Values of waist to hip ratio, BMI, cholesterol, high density lipoprotein cholesterol and testosterone levels were significantly higher in PCOS group than those of control group (P＜0.05). The insulin, cholesterol and triglyceride levels of PCOS mother were risk factors for neonatal cholesterol level(P ＜ 0.05). The cholesterol, triglyceride and free testosterone levels of PCOS mother were risk factors for increased neonatal free testosterone (P ＜ 0.05). Conclusion Mother with PCOS may affect fetal birth weight, head circumference and cord blood lipid metabolism, which may be related with the elevated level of testosterone during the fetal period.