Objective To systematically evaluate the impact of cough enhancement techniques on weaning outcomes in adult patients under mechanical ventilation(MV).Methods Databases from the inception to 15th November,2024 were searched for randomised controlled trials(RCTs)on cough enhancement technique in MV patients.The searched databases were CNKI,Wanfang Data base,SinoMed,Vip,PubMed,Web of Science,Cochrane Library,Embase,and CINAHL.Literature and evidence quality were evaluated using Cochrane's evaluation tool for intervention research and the GRADE system,and data were extracted and analysed via Meta-analysis with Review Manager 5.3.Results A total of 27 studies were included,involving 2,322 patients(1,169 in the trial group and 1,153 in the control group).Compared with the control group,the trial group had shorter time of mechanical ventilation[MD=-1.40,95%CI(-1.83,-0.97),P<0.001],lower weaning failure rate[OR=0.48,95%CI(0.27,0.85),P=0.01],higher oxygenation index[MD=35.48,95%CI(21.53,49.43),P<0.001],lower pulmonary atelectasis incidence[OR=0.30,95%CI(0.18,0.49),P<0.001],greater sputum volume[MD=1.88,95%CI(0.76,3.01),P=0.001],shorter ICU stay[MD=-1.90,95%CI(-2.95,-0.85),P<0.001]and lower serum procalcitonin(PCT)[MD=-0.89,95%CI(-1.64,-0.14),P=0.02],all with statistically significant differences.However,there was no significant difference in the ventilator-associated pneumonia(VAP)between the two groups[OR=0.54,95%CI(0.21,1.35),P=0.19].Conclusion Cough enhancement techniques promote sputum discharge,improve infection and oxygenation,shorten mechanical ventilation and ICU stay,reduce weaning failure and atelectasis rates in MV patients.Further studies are required to reduce the incidence of VAP.

Objective To systematically evaluate the impact of cough enhancement techniques on weaning outcomes in adult patients under mechanical ventilation(MV).Methods Databases from the inception to 15th November,2024 were searched for randomised controlled trials(RCTs)on cough enhancement technique in MV patients.The searched databases were CNKI,Wanfang Data base,SinoMed,Vip,PubMed,Web of Science,Cochrane Library,Embase,and CINAHL.Literature and evidence quality were evaluated using Cochrane's evaluation tool for intervention research and the GRADE system,and data were extracted and analysed via Meta-analysis with Review Manager 5.3.Results A total of 27 studies were included,involving 2,322 patients(1,169 in the trial group and 1,153 in the control group).Compared with the control group,the trial group had shorter time of mechanical ventilation[MD=-1.40,95%CI(-1.83,-0.97),P<0.001],lower weaning failure rate[OR=0.48,95%CI(0.27,0.85),P=0.01],higher oxygenation index[MD=35.48,95%CI(21.53,49.43),P<0.001],lower pulmonary atelectasis incidence[OR=0.30,95%CI(0.18,0.49),P<0.001],greater sputum volume[MD=1.88,95%CI(0.76,3.01),P=0.001],shorter ICU stay[MD=-1.90,95%CI(-2.95,-0.85),P<0.001]and lower serum procalcitonin(PCT)[MD=-0.89,95%CI(-1.64,-0.14),P=0.02],all with statistically significant differences.However,there was no significant difference in the ventilator-associated pneumonia(VAP)between the two groups[OR=0.54,95%CI(0.21,1.35),P=0.19].Conclusion Cough enhancement techniques promote sputum discharge,improve infection and oxygenation,shorten mechanical ventilation and ICU stay,reduce weaning failure and atelectasis rates in MV patients.Further studies are required to reduce the incidence of VAP.

Objective To explore the current status,hotspots and trends of research on the TCM regulation of cellular autophagy;To provide reference for related research.Methods The literature related to the TCM regulation of cellular autophagy was retrieved from CNKI,Wanfang Data,VIP and CBM from the establishment of the databases to December 31,2022.Authors and institutional collaboration networks were drawn using CiteSpace 5.7.R5.keywords emergence analysis and timeline view were drawn.VOSviewer 1.6.18 software was used to draw keyword co-occurrence mapping.Results A total of 2 001 articles were included,with a general upward trend in the number of publications.The cooperation teams were mainly represented by Jia Lianqun,Yang Guanlin,Song Nan and others.Research institutions with more publications included Hunan University of Chinese Medicine,Liaoning University of Chinese Medicine,and Guangzhou University of Chinese Medicine.The keywords of the literature formed 9 meaningful clusters,showing that the research hotspots in this field mainly focused on apoptosis,mitochondrial autophagy,experimental studies,signaling pathways,and herbal monomers,etc.TCM interventions that attracted much attention included electroacupuncture,moxibustion,resveratrol,curcumin,etc,mainly involving PI3K/Akt,AMPK/mTOR and other signaling pathways.Conclusion The research on cellular autophagy in the field of TCM has been highly popular in recent years.Experimental studies,molecular mechanisms,related diseases,and TCM intervention are the research hotspots in this field.The research trend is dominated by TCM monomer,TCM theory research and other directions,mainly focusing on apoptosis,oxidative stress and other pathways to carry out extensive research.

Objective To evaluate the feasibility of confirming syphilis reactive blood donors.Methods The serum of donors with anti-TP reaction by ELISA were confirmed by treponema pallidum particle agglutination(TPPA)and Western blotting(WB).The results of two confirmation methods that were negative,suspicious or inconsistent were followed up and compared.At the same time,the analytical index values of the screening reagent A,B and C and their combinations were e-valuated and compared using the the receiver operating characteristic curve(ROC curve)based on the results of the two confirmation methods.Results The positive rate of 223 ELISA anti-TP reactive samples(including 124 double-reagent ELISA reactive samples and 99 single-reagent ELISA reactive samples)was 57.40%confirmed by TPPA and 38.57%con-firmed by WB(89.52%vs 17.17%by TPPA and 52.42%vs 21.21%by WB for double-reagent and single-reagent ELISA reactive samples).The confirmed negative rate of TPPA was 35.43%and that of WB was 42.60%(6.45%vs 71.72%of TP-PA and 29.84%vs 58.59%of WB for double-reagent and single-reagent ELISA reactive samples).According to Kappa test,the confirmed results between the two methods were not consistent,especially for those single-regent ELISA reactive sam-ples.Thirty six cases were followed up successfully,of which 17(47.22%)confirmed changes in the test results but the changes were irregular.Based on the confirmed results of TPPA and WB,the ROC curve analysis was performed on the anti-TP screening S/CO values of double-reagent ELISA reactive samples.When combining ELISA screening reagents as A/B and A/C,the optimal S/CO values of reagent A were 1.815,5.73 and 10.205,16.165,respectively.Conclusion TPPA and WB have poor consistency in the confirmation of ELISA anti-TP reactive blood samples,and the outcome of follow-up confirmation is unclear.The S/CO threshold of ROC curve is affected by the combination of confirmatory screening reagents,and it is difficult to confirm the results of ELISA anti-TP reactive blood donors.

Objective:To investigate the effect and influencing factors of anti-retroviral therapy (ART) in human immunodeficiency virus (HIV)-positive female commercial sex workers (CSW) in Guangxi Zhuang Autonomous Region.Methods:A retrospective cohort study was used in this study. A total of 661 HIV-positive CSW receiving ART from the Guangxi Zhuang Autonomous Region′s municipal and county-level Centers for Disease Control and Prevention (CDC) reported to Guangxi Zhuang Autonomous Region CDC from January 1, 2009 to December 31, 2018 were included.The demographic information of the patients, marital status, past medical history, acquired immunodeficiency syndrome (AIDS)-related diseases after six to 12 months of ART, medications, CD4 + T lymphocytes, virological and immunological effects after receiving ART for six to 12 months were collected. Logistic regression model was used to analyze the influencing factors of virological failure and immunological failure of HIV-positive CSW after six to 12 months of ART. Results:Among 661 HIV-positive CSW, 50(7.6%) cases experienced virological failure, 80(12.1%) cases experienced immunological failure, and 13(2.0%) had both virological failure and immunological failure.There were 85 cases (12.9%) who had a history of sexually transmitted diseases. Multivariate logistic regression analysis showed that unmarried (adjusted odds ratio (a OR)=3.298, 95% confidence interval ( CI) 1.285 to 8.461), AIDS-related diseases after six to 12 months of ART (a OR=4.391, 95% CI 1.555 to 12.402) and missed medications in the last seven days (a OR=3.731, 95% CI 1.942 to 7.166) were risk factors for virological failure. Compared with CD4 + T lymphocytes<200.00/μL at baseline, 350.00≤CD4 + T lymphocytes <500.00/μL (a OR=3.543, 95% CI 1.631 to 7.701) and CD4 + T lymphocytes≥500.00/μL (a OR=2.358, 95% CI 1.002 to 5.547) were risk factors for immunological failure. Conclusions:HIV-positive CSW in Guangxi Zhuang Autonomous Region have a better treatment effect, with low rates of virological failure and immunological failure. Marital status, baseline CD4 + T lymphocyte counts, AIDS-related diseases after six to 12 months of ART, and missed medication in the last seven days are factors influencing the effect of six to 12 months of ART.

Objective This study examined the prevalence of underweight and its related risk factors of community-dwelling patients with schizophrenia. Methods Five hundred and three community-dwelling patients with schizophrenia and 323 healthy controls were recruited in a cross-sectional study. Body mass index less than 18.5 was defined as underweight. Their demographic and clinical data including anthropometric data, plasma glucose and lipid parameters were collected. The Positive and Negative Syndrome Scale (PANSS) was used to assess patients' psychopathology. Results The prevalence of underweight was 9.9% (50/503) in schizophrenia patients versus 1.5% (5/323) in the control group ( P<0.01). Further logistic regression analysis showed that male ( OR=2.43, 95%CI:1.74~3.39), smoking behavior (OR=1.50, 95%CI: 1.21~1.86), hospitalization times (OR=1.18, 95% CI: 1.06~1.31), PANSS negative score (OR=1.09, 95% CI: 1.04~1.14) were significant predictors for underweight (all P<0.05). Conclusion The prevalence of underweight is higher in Chinese patients with schizophrenia than in the general population. Some demographic and clinical variables are risk factors for underweight in schizophrenia.

Objective To observe the effects of Kuijiening Plaster point application on the levels of pro-inflammatory cytokines IFN-γ, IL-12 and anti-inflammatory cytokines IL-4, IL-10 in serum and colonic tissue of ulcerative colitis (UC) rats with spleen-kidney yang deficiency; To investigate the possible mechanism of Kuijiening for the treatment of UC with spleen-kidney yang deficiency. Methods Sennae Folium solution gavage, ice water stimulation and trinitrobenzene-sulfonic acid ethanol combinative methods were applied to establish the models of UC rats with spleen-kidney yang deficiency. Rat models were randomly divided into control group, model group, application group and SASP group, 10 in each group. The control group and model group were given medicine-free cataplasm matrix point application and perfused with NS. The application group was given Kuijiening Plaster point application and perfused with NS. SASP group was given medicine-free cataplasm matrix point application and perfused with SASP. The courses were 28 days. General conditions of rats in each group were observed during treatment. The general morphology and pathological form of colonic tissue were observed with naked eye and light microscopy through HE staining respectively in each group post-treatment. Pathological features were observed and scored by HE dyeing. Levels of IFN-γ, IL-12, IL-4 and IL-10 in serum and colonic tissue of rats in each group were detected with ELISA. Results The general conditions, gross morphology and optical microscope pathological morphology of colonic tissue improved and scores decreased in application group and SASP group. Compared with the model group, levels of IL-4 and IL-10 significantly increased, while the levels of IFN-γ and IL-12 decreased in serum and colonic tissue in application group and SASP group, with statistical significance (P<0.01). Moreover, levels of IL-4 and IL-10 in application group decreased not as much as those in SASP group, while IFN-γ and IL-12 concentration increased higher than SASP group, without statistical significance (P>0.05). Conclusion Kuijiening Plaster point application can play a role in treating UC with spleen-kidney yang deficiency through partially restoring the balance between pro- and anti-inflammatory cytokines in serum and colon tissue of rats.

Objective To compare cognitive function and alexithymia between the schizophrenic patients treated with chlorpromazine and those treated with clozapine. Methods The patients with schizophrenia in stable condition that received maintenance treatment either with chlorpromazine or clozapine and normal control subjects were recruited (n=24 per group). Neuropsychological tests, including Digit Vigilance Test, Controlled Oral Word Association Test, Trail Making Test-A&B (TMT-A&B), Animal Naming Test, Stroop Color-Word Test, Block Design and Spatial Span Test were used to assess the participant’s cognitive function. The twenty-item Toronto Alexithymia Scale (TAS-20) were used to evaluate the participant’s alexithymia. Results The significant differences were found between the patients and the controls in all items of cognitive function and all factor scores of TAS-20 (P<0.05). There were no significant differences in all items of cognitive function and all factor scores of TAS-20 between chlorpromazine group and clozapine group (P>0.05). Multivari? ate linear regression analysis showed that in the clozapine group, attention function associated with the total score of TAS (β=-0.20, P<0.05), executive function associated with TAS factor 1 (β=-0.26, P=0.03), spatial function associated with TAS factor 2 (β=-0.24, P<0.01). In the chlorpromazine group, attention function associated with TAS factor 2 (β=-1.24, P<0.01), executive function associated with TAS factor 2 (β=-0.33, P=0.02). Conclusions Patients with schizophrenia in maintenance period have widely cognitive impairment and alexithymia, both of which are related to each other.

Objective To observe the efficacy and safety of different doses of mizoribine to prevent rejection after renal transplantation. Methods Sorted by time of operation and odevity, 206 primary kidney transplant recipients were divided into 3 groups, including MMF group, MZR Ⅰ group and MZR Ⅱ group. All recipients in 3 groups were administrated CsA and Pred, combined with mycophenolate mofitile (MMF) in MMF group and mizoribine (MMF) in MZR Ⅰ and Ⅱ groups.The dosage of MMF was 1. 0 g/day, while dosage of MZR in MZR Ⅰ and Ⅱ groups was 100 and 200 mg/day, respectively. There was no difference in usage of cyclosporine (CsA) and prednisone (Pred) among 3 groups. 100, 60 and 30 recipients were followed up in MMF, MZR Ⅰ and MZR Ⅱ groups respectively in 5 years. During the follow-up period of 5 years, the incidence of acute rejection, patient/graft survival and adverse effects associated with drugs in three groups were observed. Results The patient/graft survival was 88. 3 % (53/60), 85 % (51/60) in MZR Ⅰ group, 90 % (27/30),86.7 % (26/30) in MZR Ⅱ group, and 88% (88/100), 86% (86/100) in MMF group, respectively (P>0. 05). There was no significant difference in incidence of acute rejection among MZR Ⅰ (10 %, 6/60), MZR Ⅱ (6. 7 %, 2/30) and MMF groups (9 %, 9/100). The incidence of severe pulmonary infection in MZR Ⅰ group was 3. 3 % (2/60), and 10 % (3/30) in MZR Ⅱ , and the former was lower than MMF group (15 %, 15/100) significantly. There was significant difference in mortality of severe pulmonary infection between MZR Ⅰ group (0, 0/2) and MMT group (73. 3 %, 11/15). The rate of ACR in MZR Ⅱ group (10 %, 3/30) was lower significantly than MMF group (30 %, 30/100) and MZR Ⅰ group (31.7 %, 19/60). There was significant difference in the incidence of hyperuricacidemia between two MZR groups (30 %, 56. 7 %) and MMF group (10 %)(P<0. 05), while the incidence of diarrhea and myelosuppression was lower significantly in MZR Ⅰ group than in MMF group. Conclusion MZR can prevent acute rejection after kidney transplantation effectively and safely. Immunosuppressive therapy including mizoribine is the best choice especially for high risk group because of susceptibility to infection and those who suffer from tenacious diarrhea owing to the side effect.

Objective To observe the expression of αA-and αB-crystallin in retina after blue-light exposure.Methods Forty female Wistar rats were divided randomly into 4 groups:control group,and blue-light exposure for 6,12,and 24 hours groups,with 10 rats in each group.The rats in the control group were not intervened.The other three groups of rats were exposed to blue fluorescent lights for 6,12,and 24 hours respcetively.Then the rats were kept in darkness for 12 hours.The globes were enucleated after anaesthesia.The immunohistochemistry and Western blot were performed to detect the expression of αA-and αB-crystallin in retina.Results The absorbance value(A value)of retina αA-crystallin was 1.40573±0.70748 in the control group,and were 4.317 51±0.412 97,7.397 08±1.947 90,9.634 32±2.377 61,respectively in the other 3 groups;the difference among the groups was significant(F=24.569,P<0.001).The A value of retina αB-crystallin is 0.129 36±0.033 93 in the control group,and were 0.507 17±0.117 55,7.345 43±2.292 97,4.042 26±3.890 23,respectively in the other 3 groups;the difference among the groups was significant(F=40.102,P<0.001).The results of Western blot showed that the expression of αA-and αB-crystallin in groups with blue-light exposure was obviously higher than that in the control group.Conclusions Blue light may up-regulate the expression of αA-and αB-crystallin in rats' retina.