Objective: To explore the distribution of traditional Chinese medicine (TCM) syndromes in patients with interstitial lung disease (ILD) and its influencing factors. Methods: This cross-sectional study included 385 patients with ILD admitted to the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine) from January 2018 to June 2022. Data on sex, age, body mass index, smoking history, respiratory rate, hospitalization time, treatment cost, whether velcro rales can be heard, comorbidities with rheumatic immune diseases, TCM four examination information, and clinical examination results, including CT imaging, D-dimer level, and lung function-related indicators, were collected. The distribution pattern of TCM syndromes in patients with ILD and the association between TCM syndromes and clinical indicators were analyzed using the cluster analysis and binary Logistic regression analysis. Results: Among the 385 patients with ILD, sticky phlegm (59.74%) and shortness of breath (56.10%) were common symptoms, while greasy tongue coating (55.32%), red tongue (52.73%), and slippery and rapid pulse (25.71%) were common tongue and pulse manifestations. The patients were divided into five syndromes using cluster analysis: syndrome of phlegm-heat stagnation in the lung (36.62%), syndrome of turbid phlegm obstructing lung (29.35%), syndrome of deficiency of both qi and yin (12.99%), syndrome of qi deficiency of lung and kidney (11.95%), and syndrome of phlegm and blood stasis obstructing lung (9.09%). The D-dimer level was lower in patients with syndrome of phlegm-heat stagnation in the lung, syndrome of turbid phlegm obstructing lung, syndrome of deficiency of both qi and yin, and syndrome of qi deficiency of lung and kidney than in those with syndrome of phlegm and blood stasis obstructing lung (P<0.05). The percentage of predicted forced vital capacity (FVC%pred) of patients with syndrome of phlegm-heat stagnation in the lung, syndrome of turbid phlegm obstructing lung, syndrome of deficiency of both qi and yin, and syndrome of phlegm and blood stasis obstructing lung was higher than in those with syndrome of qi deficiency of lung and kidney (P<0.05). Among patients aged 60 and above, those with syndrome of phlegm-heat stagnation in the lung, syndrome of phlegm and blood stasis obstructing lung, and syndrome of deficiency of both qi and yin containing dual pathogenic syndrome elements were more likely to experience moderate to severe pulmonary diffusion impairment than those with syndrome of turbid phlegm obstructing lung and syndrome of qi deficiency of lung and kidney containing single pathogenic syndrome elements (P<0.05). The Logistic regression showed that the FVC%pred was an influential factor for syndrome of qi deficiency of lung and kidney, and the area under the receiver operating characteristic (ROC) curve (AUC) between FVC%pred and the formation of syndrome of qi deficiency of lung and kidney was 0.676 (95%CI: 0.598-0.755), P=0.002. The sensitivity was 0.431, the specificity was 0.966, and the best threshold on the ROC curve of 0.397 was 79.1%. The D-dimer level was an influential factor in the formation of syndrome of phlegm and blood stasis obstructing lung. The AUC between D-dimer level and the formation of syndrome of phlegm and blood stasis obstructing lung was 0.729 (95%CI: 0.655-0.802), P<0.001. The sensitivity was 0.914, the specificity was 0.523, and the best threshold on the ROC curve of 0.437 was 0.675 mg/L. Conclusion syndrome of phlegm-heat stagnation in the lung and syndrome of turbid phlegm obstructing lung are common among patients with ILD. Complex pathological syndromes are more likely to exacerbate pulmonary diffusion dysfunction. The FVC%pred can assist in differentiating syndrome of qi deficiency of lung and kidney, whereas the D-dimer level can assist in differentiating syndrome of phlegm and blood stasis obstructing lung.

Objective:To investigate the clinical features of chronic spontaneous urticaria (CSU) patients with angioedema (AE) .Methods:Clinical data were collected from adult outpatients with active CSU diagnosed and treated at the First Hospital of China Medical University from January 2019 to December 2021, and analyzed retrospectively. The data included gender, age, disease duration, the presence or absence of angioedema, urticaria activity score for one day, prior treatments, previous history, family history, laboratory test results, therapeutic effect, and adverse reactions. Their treatment regimens were based on the Chinese guidelines for the diagnosis and treatment of urticaria (2018) and the American guidelines for the diagnosis and management of urticaria (2014). Statistical analysis was carried out by using Mann-Whitney U test, two-independent-sample t test, Chi-square test, corrected Chi-square test, and Fisher's exact test. Results:A total of 131 CSU patients were collected, including 78 females and 53 males. Their age at the first visit was 44.6 ± 13.3 years, and the disease duration ( M[ Q1, Q3]) was 4.0 (2.0, 10.0) months. Among these CSU patients, there were 58 with AE and 73 without AE. The disease duration was significantly longer in the CSU patients with AE (6.0 [3.0, 24.0] months) than in those without AE (3.5 [2.0, 6.0] months; Z = -2.78, P = 0.005). The urticaria activity score for one day was also significantly higher in the CSU patients with AE (5.0 [3.0, 5.3] points) than in those without AE (4.0 [3.0, 5.0] points; Z = -2.63, P = 0.008). The CSU patients with AE showed a decreased proportion of patients completely controlled by licensed-dose second-generation H1-antihistamines (sgAHs) (8.6%, 5/58) compared with those without AE (24.7%, 18/73), but an increased proportion of patients uncontrolled by licensed-dose sgAHs (91.4%, 53/58) compared with those without AE (74.0%, 54/73; Z = -2.53, P = 0.011) ; there were no significant differences in the proportions of patients completely controlled or uncontrolled by updosed sgAHs alone or combinations of 2- to 4-fold equivalent-dose sgAHs, or in the proportions of patients completely controlled or uncontrolled by combination therapy with 4-fold equivalent-dose sgAHs and non-H1-antihistamines between the CSU patients with AE and those without AE ( P > 0.05) . Conclusion:Compared with the CSU patients without AE, the CSU patients with AE had a longer disease duration, higher disease activity, a lower proportion of patients completely controlled by licensed-dose sgAHs, and a higher proportion of patients uncontrolled by licensed-dose sgAHs.

Objective To analyze and study the prescriptions of Chief Physician Chang Yalin for treating breast hyperplasia patients in the outpatient department,explores and summarizes the medication patterns for treating breast hyperplasia,and provides reference and dialectical medication ideas for clinical treatment of breast hyperplasia by using data mining technology.Methods Collect the prescriptions of Dr.Chang Yalin for treating breast hyperplasia patients at the Outpatient Department of Jiuquan Traditional Chinese Medicine Hospital from January 1,2017 to December 31,2022.After induction and organization,establish a data table,use Excel 2019 to statistically analyze the drug frequency and gender,taste,and meridian.Use SPSS Modoler 18.0 software April algorithm to analyze the association rules of the drugs,and use SPSS Statistics for cluster analysis.Results A total of 184 prescriptions were included,covering 140 types of traditional Chinese medicine,with a total frequency of use of 4059 times.Among them,Cornus officinalis,dried ginger,roasted licorice,Poria cocos,and jujube are commonly used drugs for the treatment of breast hyperplasia.The top three types of Chinese medicine that are commonly used are tonifying deficiency,warming internal medicine,and relieving external symptoms.The medicinal properties are mainly warm and mild;The medicinal taste is characterized by sweetness,bitterness,and bitterness;The main meridians of drugs are spleen,lung,and heart meridians.Association rule analysis shows that roasted licorice white peony,poria cocos,licorice,and cornus flesh white peony,jujube,and ginger are equivalent.Classify commonly used drugs into 4 categories using Euclidean distance clustering and segmentation with 5.Conclusion Dr.Chang Yalin has always implemented the core idea of treating breast hyperplasia through the coordination of liver and spleen,the simultaneous application of attack and tonifying,and the simultaneous treatment of phlegm and blood stasis.In terms of the combination of latent drugs,the main focus is on tonifying qi and spleen,tonifying yin/blood and regulating liver,and resolving stasis/resolving phlegm and dispersing stagnation.In terms of the combination of"cold phlegm"and"blood stasis and toxin",as well as the combination of"eighteen contraindications"and"nineteen contraindications",his principles and methods are more distinctive and worthy of further research and promotion.

Objective To investigate the relationship between interleukin-1β (IL-1β) and miR-185-5p in the process of joint injury in acute gouty arthritis (AGA). Methods The serum miR-185-5p levels of 89 AGA patients and 91 healthy volunteers were detected by real-time quantitative PCR. The correlation between miR-185-5p expression level and VAS score or IL-1β expression level was evaluated by Pearson correlation coefficient method. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of miR-185-5p in AGA. THP-1 cells were induced by sodium urate (MSU) to construct an in vitro acute gouty inflammatory cell model. After the expression level of miR-185-5p in THP-1 cells was upregulated or downregulated by transfection of miR-185-5p mimics or inhibitors in vitro, inflammatory cytokines of THP-1 cells, such as IL-1β, IL-8 and tumor necrosis factor α (TNF-α), were detected by ELISA. The luciferase reporter gene assay was used to determine the interaction between miR-185-5p and the 3'-UTR of IL-1β. Results Compared with the healthy control group, the expression level of serum miR-185-5p in AGA patients was significantly reduced. The level of serum miR-185-5p was negatively correlated with VAS score and IL-1β expression level. The area under the curve (AUC) was 0.905, the sensitivity was 80.17% and the specificity was 83.52%. Down-regulation of miR-185-5p significantly promoted the expression of IL-1β, IL-8 and tumor necrosis factor (TNF-α), while overexpression of miR-185-5p showed the opposite results. Luciferase reporter gene assay showed that IL-1β was the target gene of miR-185-5p, and miR-185-5p negatively regulated the expression of IL-1β. Conclusion miR-185-5p alleviates the inflammatory response in AGA by inhibiting IL-1β.
Humans ; 3' Untranslated Regions ; Arthritis, Gouty/genetics* ; Interleukin-1beta/genetics* ; Interleukin-8 ; Luciferases ; MicroRNAs/genetics* ; Tumor Necrosis Factor-alpha

Objective To explore the imaging features, clinical outcome, and prognosis of indeterminate pulmonary nodules (IPN) in patients with high-grade soft tissue sarcoma. Methods A retrospective study of 82 patients with high-grade soft tissue sarcoma who have IPNs. The clinical characteristics, imaging features of IPN, and survival of patients were analyzed with statistical software. Results The IPN size of 82 patients was 6.453±0.864 mm. IPN diameter, shape, density, and nodule discovery interval may be CT imaging features related to malignancy tendency. Age (HR=1.047, 95%CI: 1.007-1.088) and interval between each nodule discovery (HR=3.194, 95%CI: 1.052-9.694) are independent factors that affect the survival of patients with malignant IPN. Conclusion The imaging features of chest CT may provide important guidance for determining the nature and survival prognosis of benign and malignant nodules.

Objective To analyze the MRI findings of invasive lesions originating from uterine smooth muscle,and to improve the preoperative accurate diagnosis ability.Methods A total of 29 patients with invasive tumors originating from uterine smooth muscle and confirmed by surgery and pathology were selected and divided into benign group and malignant group.The shape of the lesion and the signal characteristics of MRI sequences were analyzed retrospectively,the apparent diffusion coefficient(ADC)values of solid components of lesions were measured,and the ADC values of different tumors were compared.Independent sample t test was used for statistical analysis.Results A total of 26 cases were correctly diagnosed by MRI,and the diagnostic accuracy rate was 89.7%.Eighteen cases of intravenous leiomyomatosis(IVL)had a history of uterine fibroid,extrauterine lesions showed sausage or nodular-shaped with slightly higher signal on T2WI,equi signal on T1WI and diffusion weighted imaging(DWI),dynamic enhanced scanning sequence showed synchronous enhancement with myometrium of uterus;Two cases of leiomyomatosis peritonealis disseminate(LPD)had a history of uterine fibroid,solid cystic masses were found in the uterus,solid components showed equivalent or slightly higher signal on T2WI,equi signal on T1WI,equivalent or slightly higher signal on DWI,multiple solitary nodules were found in pelvic wall,uterus and rectum fossa,mesentery and omental sac,with uniform signal and clear boundary,equi signal on T2WI,T1WI and DWI,dynamic enhanced scanning sequence showed synchronous enhancement with myometrium of uterus,strengthening uniform;Of the 9 cases of leiomyosarcoma,8 cases showed solid cystic masses with T1WI high signal bleeding focus,solid components showed slightly higher signal on T2WI,equi signal on T1WI,obvious higher signal on DWI,the boundary of the mass was unclear,and the enhancement was uneven after enhancement;There were 20 cases in benign group,including 18 cases of IVL and 2 cases of LPD,the mean ADC values were(1 357.06±74.55)×10-3mm2/s,the malignant group was leiomyosarcoma,the mean ADC values were(849.56±22.80)×10-3mm2/s,there were statistical difference between the groups(P<0.05).Conclusion The MRI findings of invasive tumors originating from uterine smooth muscle are dif-ferent,the measurement of ADC value can be used as a quantitative diagnostic basis for benign and malignant determination.

Objective To explore the research dynamics and hotspots of project management in the field of hospital man-agement,and analyze the contents that still need to be improved,so as to provide references for the subsequent research,and provide hospital managers with practical experience in hospital management.Methods Based on the PubMed database,we used the citexs data analysis platform to analyze the literature and big data from January 2012 to December 2022 on the application of project management in the field of hospital management.Results The effective literature was retrieved from 4236 articles,and the analysis found thatthe annualnumberofpublicationsinthisfield hasbeenincreasing,2021 sawthe highestannualnumberof 573 articles,and the fastest growth rate was 20.36% in 2017.The country with the most publications is the United States(1 546 articles,36.5% ),the research institution with the most publications is Monash University,Australia,the journal with the most publications is BMJ Open(124 articles),and the key words with the highest frequency of occurrence in the retrieved literature are quality improvement,primary care improvement,covid-19,telemedicine.Conclusion The research in this field has been rapidly developed and is in a fast rising phase.In almost every organization and industry,the share of project management or"projectization"is increasing,and project management has become an important part of hospital management research and prac-tice.In the context of building a modern hospital management system,the application of project management to hospital manage-ment is an effective means of improving the level of fine hospital management.

Objective To sort out and summarize the research hotspots and trends of Chinese medicine nursing technolo-gy at the present stage.Methods We searched the research literature on TCM nursing technology included in China Knowledge,Wanfang,and Wipu build-up to November 30,2023,and used CiteSpace 6.1.R6 software to perform co-occurrence analysis of research institutions and keyword clustering,timeline,and emergence analysis.Results A total of 5 771 documents were in-cluded,with a general upward trend in the number of publications,peaking at 692 publications in 2021.5 206 documents from 673 journals were included in the research literature,of which 19 journals had ≥50 publications(35.47％).2 087 research or-ganizations were involved,of which 27 had ≥20 publications(13.24％).Involving 9 484 authors,there were a total of 8 au-thors ≥5 in the cluster,indicating the existence of stable teamwork in the cluster.The keyword co-occurrence analysis yielded the research hotspots of TCM nursing technology as TCM nursing,training,nursing management,clinical efficacy,complica-tions,and quality of life.Conclusion Based on the econometrics and visualization analysis of the literature on TCM nursing technology,we explored the research hotspots and trends in this field,and provided two theoretical paths for medical institution managers to construct and optimize the management system of TCM nursing technology:to standardize the TCM nursing technology in hospitals and establish a clinical access management system;and based on the multidimensional management method,to inno-vate the training system of TCM nursing technology.

AIM: To investigate the efficacy and safety of ZKY001 eye drops with different concentrations in the treatment of corneal epithelial defects(CED)after primary pterygium excision.METHODS: This was a multicenter, randomized, double-blinded, placebo-controlled phase II clinical trial. From March 15, 2022 to November 14, 2022, patients with primary pterygium who had undergone surgery were recruited from 12 tertiary hospitals across China. Using block randomization, 178 patients(178 eyes)were randomly assigned to 3 groups in a 1:1:1 ratio: 0.002% ZKY001 group(n=59), 0.004% ZKY001 group(n=59), and placebo group(n=60, receiving ZKY001 sham eye drops). Subjects in each group received 1 drop of the study drug 4 times per day for 4 d. The percentage of CED area recovery from baseline, the first complete healing time of CED area, the number of first complete healing cases of CED, and changes in visual analogue scale(VAS)scores for eye discomfort including eye pain, foreign body sensation, tearing and photophobia were observed.RESULTS: In terms of improvement in CED, there were no statistically significant differences among the three groups including the first healing time of CED, the percentage improvement in CED area compared to baseline, and the percentage of first healing cases at different follow-up visits(all P>0.05). Numerically, the first healing time of CED was shorter in the test groups compared to the placebo group(67.87±21.688 h for the 0.002% ZKY001 group, 61.48±22.091 h for the 0.004% ZKY001 group, and 68.85±20.851 h for the placebo group). On D1 morning, the percentage improvement in CED area compared to baseline was maximally different from the placebo group, and the numerical difference advantage was maintained at subsequent follow-up visits. The number of first healing cases in the CED area at different follow-up visits was higher in the test groups than the placebo group. In terms of improvement in ocular discomfort, the total VAS scores were lower in the test groups compared to the placebo group, mainly due to reductions in foreign body sensation and pain scores. At D3, the 0.004% ZKY001 group showed statistically significant improvement in foreign body sensation(P<0.017). In terms of safety, the overall incidence of adverse events was low(9.0%)and similar among groups.CONCLUSION: The use of ZKY001 eyedrops after primary pterygium surgery can safely improve the CED repair, and alleviate postoperative symptoms caused by CED.

Background::Bladder cancer, characterized by a high potential of tumor recurrence, has high lifelong monitoring and treatment costs. To date, tumor cells with intrinsic softness have been identified to function as cancer stem cells in several cancer types. Nonetheless, the existence of soft tumor cells in bladder tumors remains elusive. Thus, our study aimed to develop a microbarrier microfluidic chip to efficiently isolate deformable tumor cells from distinct types of bladder cancer cells.Methods::The stiffness of bladder cancer cells was determined by atomic force microscopy (AFM). The modified microfluidic chip was utilized to separate soft cells, and the 3D Matrigel culture system was to maintain the softness of tumor cells. Expression patterns of integrin β8 (ITGB8), protein kinase B (AKT), and mammalian target of rapamycin (mTOR) were determined by Western blotting. Double immunostaining was conducted to examine the interaction between F-actin and tripartite motif containing 59 (TRIM59). The stem-cell-like characteristics of soft cells were explored by colony formation assay and in vivo studies upon xenografted tumor models. Results::Using our newly designed microfluidic approach, we identified a small fraction of soft tumor cells in bladder cancer cells. More importantly, the existence of soft tumor cells was confirmed in clinical human bladder cancer specimens, in which the number of soft tumor cells was associated with tumor relapse. Furthermore, we demonstrated that the biomechanical stimuli arising from 3D Matrigel activated the F-actin/ITGB8/TRIM59/AKT/mTOR/glycolysis pathways to enhance the softness and tumorigenic capacity of tumor cells. Simultaneously, we detected a remarkable up-regulation in ITGB8, TRIM59, and phospho-AKT in clinical bladder recurrent tumors compared with their non-recurrent counterparts.Conclusions::The ITGB8/TRIM59/AKT/mTOR/glycolysis axis plays a crucial role in modulating tumor softness and stemness. Meanwhile, the soft tumor cells become more sensitive to chemotherapy after stiffening, that offers new insights for hampering tumor progression and recurrence.