OBJECTIVE To explore the characteristics of hot flushes and the effect of Erxian Decoction in rats after bilateral oo-phorectomy.METHODS Forty-eight female SD rats were randomly divided into 4 groups:sham operation group,bilateral ovariecto-my group,17β-estradiol treatment group and Erxian Decoction treatment group,with 12 rats in each group.After bilateral ovariecto-my,rats were gavaged with 17β-estradiol(0.1 mg·kg-1·d-1)and Erxian Decoction(8 g·kg-1·d-1)for 6 weeks.On the 21st and 42nd days of modeling,the body weight,rectal temperature,infrared thermography of the body surface and other characteristic informa-tion of the rats were detected.Serum E2 content was detected by ELISA.The pathological changes of the uterus and foot pad sweat glands of the rats were observed by HE staining.The hypothalamic estrogen receptor(ER)and thermoreceptor transient receptor poten-tial vanilloid 3(TRPV3)and transient receptor potential vanilloid 4(TRPV4)were detected by immunohistochemistry.The protein ex-pression of ERβ,PAC1R and PKA was detected by Western blot.RESULTS Compared with the sham operation group during the same period,the body weight of the rats in the bilateral ovariectomy group increased significantly(P<0.01),while the body weight of the rats in the 17β-estradiol group and Erxian Decoction group increased slowly.Compared with the sham operation group,the rectal temperature of the bilateral ovariectomy group and the 17β-estradiol group increased significantly on the 21st day after modeling(P<0.01),and decreased significantly on the 42nd day after modeling(P<0.05);on the 21st and 42nd days after modeling,the maxi-mum body surface temperature of the rats in the bilateral ovariectomy group,the 17β-estradiol group and the Erxian Decoction group decreased significantly(P<0.01),and on the 42nd day after modeling,the tail/body temperature ratio of the rats in the bilateral ovari-ectomy group increased significantly(P<0.05);the number of sweat points in the bilateral ovariectomy group increased significantly(P<0.01);the uterine index of the bilateral ovariectomy group,the 17β-estradiol group and the Erxian Decoction group decreased sig-nificantly(P<0.01);the serum E2 in the bilateral ovariectomy group decreased significantly(P<0.05);the number of ER-positive cells in the hypothalamus of the rats in the bilateral ovariectomy group decreased significantly(P<0.01),while the number of TRPV3 positive cells increased significantly(P<0.05);the number of ER and TRPV3 positive cells decreased in the 17β-estradiol group(P<0.05),and the number of TRPV4 positive cells increased(P<0.01);17β-estradiol inhibited the expression of PAC1R and PKA pro-teins(P<0.05),and Erxian Decoction significantly inhibited the expression of PAC1R,PKA and ERβ proteins(P<0.01).Compared with the bilateral ovariectomy group,the rectal temperature of the Erxian Decoction group decreased significantly on the 21st day(P<0.01);the number of sweat spots in the 17β-estradiol group and the Erxian Decoction group decreased significantly(P<0.01);the E2 level in the Erxian Decoction group increased significantly(P<0.05),the number of ER positive cells in the hypothalamus increased significantly(P<0.01),and the expression of ERβ and PAC1R proteins decreased significantly(P<0.01).CONCLUSION Bilater-al oophorectomy rat model is associated with hot flashes,and its symptom characteristics are yin deficiency and internal heat,as well as insufficient yang qi,resulting in a yin-yang imbalance;Erxian Decoction affects the sensitivity of temperature changes by promoting es-trogen secretion and its receptor expression.

Objective:To study the effects of hypoxia on the autophagy level in the spleen of mice with OSAHS.Methods:Mouse OSAHS hypoxia model was established in 24 C57BL/6 mice and the mice were divided into 3 groups:normoxic group,hypoxic group and resveratrol group(n=8).Real time PCR,Western blot and immunohistochemical staining(IHC)were used to detect the mRNA and protein expression of autophagy related proteins microtube associated protein 1 light chain 3 B(LC3B),myosin-like BCL2 inteacting protein(Beclin1)and autophagy related gene 5(ATG5)in mouse spleen respectively.Results:The mRNA expres-sion of LC3B,Beclin1,and ATG5 in the hypoxic group was lower than that in the normoxic group(P＜0.01,P＜0.01,P＜0.001),resveratrol upregulated the expression levels of LC3B and ATG5 mRNA in the hypoxic group(P＜0.05,P＜0.001),but did not up-regulate the expression of Beclin1(P＞0.05).The protein expression levels of LC3B,Beclin1 and ATG5 in the hypoxic group were lower than that in the normoxic group(P＜0.05,P＜0.05,P＜0.01).Resveratrol upregulated the expression levels of LC3B and ATG5 in the hypoxic group(P＜0.05,P＜0.01),but did not upregulated the expression of Beclin1(P＞0.05).IHC test showed that the expression level of LC3B,Beclin1 and ATG5 in the hypoxic group was lower than that in the normoxic group(P＜0.01,P＜0.01,P＜0.001).Resveratrol increased the expression level of LC3B and ATG5 in the hypoxic group(P＜0.05,P＜0.01),but did not upregulate the expression of Beclin1(P＞0.05).Conclusion:Hypoxia may inhibite the autophagy level of spleen in mice.Resvera-trol derivatives increases the autophagy level of mice under hypoxia condition,but has no significant effect on Beclin1 expression.

OBJECTIVE To explore the characteristics of hot flushes and the effect of Erxian Decoction in rats after bilateral oo-phorectomy.METHODS Forty-eight female SD rats were randomly divided into 4 groups:sham operation group,bilateral ovariecto-my group,17β-estradiol treatment group and Erxian Decoction treatment group,with 12 rats in each group.After bilateral ovariecto-my,rats were gavaged with 17β-estradiol(0.1 mg·kg-1·d-1)and Erxian Decoction(8 g·kg-1·d-1)for 6 weeks.On the 21st and 42nd days of modeling,the body weight,rectal temperature,infrared thermography of the body surface and other characteristic informa-tion of the rats were detected.Serum E2 content was detected by ELISA.The pathological changes of the uterus and foot pad sweat glands of the rats were observed by HE staining.The hypothalamic estrogen receptor(ER)and thermoreceptor transient receptor poten-tial vanilloid 3(TRPV3)and transient receptor potential vanilloid 4(TRPV4)were detected by immunohistochemistry.The protein ex-pression of ERβ,PAC1R and PKA was detected by Western blot.RESULTS Compared with the sham operation group during the same period,the body weight of the rats in the bilateral ovariectomy group increased significantly(P<0.01),while the body weight of the rats in the 17β-estradiol group and Erxian Decoction group increased slowly.Compared with the sham operation group,the rectal temperature of the bilateral ovariectomy group and the 17β-estradiol group increased significantly on the 21st day after modeling(P<0.01),and decreased significantly on the 42nd day after modeling(P<0.05);on the 21st and 42nd days after modeling,the maxi-mum body surface temperature of the rats in the bilateral ovariectomy group,the 17β-estradiol group and the Erxian Decoction group decreased significantly(P<0.01),and on the 42nd day after modeling,the tail/body temperature ratio of the rats in the bilateral ovari-ectomy group increased significantly(P<0.05);the number of sweat points in the bilateral ovariectomy group increased significantly(P<0.01);the uterine index of the bilateral ovariectomy group,the 17β-estradiol group and the Erxian Decoction group decreased sig-nificantly(P<0.01);the serum E2 in the bilateral ovariectomy group decreased significantly(P<0.05);the number of ER-positive cells in the hypothalamus of the rats in the bilateral ovariectomy group decreased significantly(P<0.01),while the number of TRPV3 positive cells increased significantly(P<0.05);the number of ER and TRPV3 positive cells decreased in the 17β-estradiol group(P<0.05),and the number of TRPV4 positive cells increased(P<0.01);17β-estradiol inhibited the expression of PAC1R and PKA pro-teins(P<0.05),and Erxian Decoction significantly inhibited the expression of PAC1R,PKA and ERβ proteins(P<0.01).Compared with the bilateral ovariectomy group,the rectal temperature of the Erxian Decoction group decreased significantly on the 21st day(P<0.01);the number of sweat spots in the 17β-estradiol group and the Erxian Decoction group decreased significantly(P<0.01);the E2 level in the Erxian Decoction group increased significantly(P<0.05),the number of ER positive cells in the hypothalamus increased significantly(P<0.01),and the expression of ERβ and PAC1R proteins decreased significantly(P<0.01).CONCLUSION Bilater-al oophorectomy rat model is associated with hot flashes,and its symptom characteristics are yin deficiency and internal heat,as well as insufficient yang qi,resulting in a yin-yang imbalance;Erxian Decoction affects the sensitivity of temperature changes by promoting es-trogen secretion and its receptor expression.

Objective:To study the effects of hypoxia on the autophagy level in the spleen of mice with OSAHS.Methods:Mouse OSAHS hypoxia model was established in 24 C57BL/6 mice and the mice were divided into 3 groups:normoxic group,hypoxic group and resveratrol group(n=8).Real time PCR,Western blot and immunohistochemical staining(IHC)were used to detect the mRNA and protein expression of autophagy related proteins microtube associated protein 1 light chain 3 B(LC3B),myosin-like BCL2 inteacting protein(Beclin1)and autophagy related gene 5(ATG5)in mouse spleen respectively.Results:The mRNA expres-sion of LC3B,Beclin1,and ATG5 in the hypoxic group was lower than that in the normoxic group(P＜0.01,P＜0.01,P＜0.001),resveratrol upregulated the expression levels of LC3B and ATG5 mRNA in the hypoxic group(P＜0.05,P＜0.001),but did not up-regulate the expression of Beclin1(P＞0.05).The protein expression levels of LC3B,Beclin1 and ATG5 in the hypoxic group were lower than that in the normoxic group(P＜0.05,P＜0.05,P＜0.01).Resveratrol upregulated the expression levels of LC3B and ATG5 in the hypoxic group(P＜0.05,P＜0.01),but did not upregulated the expression of Beclin1(P＞0.05).IHC test showed that the expression level of LC3B,Beclin1 and ATG5 in the hypoxic group was lower than that in the normoxic group(P＜0.01,P＜0.01,P＜0.001).Resveratrol increased the expression level of LC3B and ATG5 in the hypoxic group(P＜0.05,P＜0.01),but did not upregulate the expression of Beclin1(P＞0.05).Conclusion:Hypoxia may inhibite the autophagy level of spleen in mice.Resvera-trol derivatives increases the autophagy level of mice under hypoxia condition,but has no significant effect on Beclin1 expression.

Objective:To explore the efficacy and safety of domestic bortezomib in combination with lenalidomide and dexamethasone in the treatment of newly diagnosed multiple myeloma (NDMM) .Methods:This multicenter, prospective, single-arm clinical study included 126 patients with NDMM admitted to seven hospitals between December 2019 and January 2022. All patients received domestic bortezomib in combination with lenalidomide and dexamethasone (BLD regimen), and the efficacy, prognostic factors, and safety were analyzed.Results:Among the 126 patients with NDMM, 118 completed four cycles of treatment, with an overall response rate (ORR) of 93.22% (110/118) and a ≥very good partial response (VGPR) rate of 68.64% (81/118). Ultimately, 114 patients completed at least eight cycles of treatment, with an ORR of 92.98% (106/114) and a ≥VGPR rate of 77.19% (88/114). Eighteen patients underwent autologous hematopoietic stem cell transplantation after completing 6-8 cycles of the BLD regimen, with an ORR of 100% (18/18) and a ≥VGPR rate of 88.9% (16/18). The proportion of patients achieving ≥VGPR increased with the treatment duration, and factors such as staging and age did not significantly affect efficacy. Single-factor analysis showed that R2-ISS stage Ⅲ/Ⅳ, blood calcium >2.27 mmol/L, and failure to achieve VGPR after six cycles were adverse prognostic factors for progression-free survival (PFS) ( P<0.05), whereas failure to achieve VGPR after six cycles was an adverse prognostic factor for overall survival (OS) ( P<0.001). Multifactor analysis demonstrated that failure to achieve VGPR after six cycles is an independent adverse prognostic factor for PFS ( P=0.002). The incidence of hematologic adverse reactions was 16.7% (19/114), and nonhematologic adverse reactions were mainly mild to moderate, with no significant cardiac or renal adverse reactions observed. Conclusion:The BLD regimen is effective in treating NDMM, in which patients with high-risk genetic features are still achieving a high ≥VGPR rate, and the overall safety is good.

Objective To compare the effect of internal iliac artery block using balloon of different properties in cesarean section for delivery female patients with pernicious placenta previa(PPP).Methods The clinical data of 82 delivery female patients with PPP were retrospectively analyzed.The patients were divided into observation group(n=40)and control group(n=42).The patients of the observation group received compliant Fogarty balloon block of bilateral internal iliac arteries,while the patients of the control group received non-compliant balloon block of bilateral internal iliac arteries.The preoperative and postoperative systolic blood pressure and heart rate,X-ray fluoroscopy time,fetal body surface radiation dose,time spent for cesarean section,intraoperative blood loss amount and blood transfusion quantity,uterine artery embolization rate,hysterectomy rate,1-,5-,and 10-minute neonatal Apgar scores,postoperative hospital stay,and surgery-related complications were compared between the two groups.Results In all patients of both groups,the uterus was successfully preserved and the bilateral internal iliac artery balloon obstruction-assisted cesarean section was successfully accomplished.After the balloon catheter was withdrawn,uterine artery embolization was carried out in some patients,and no patient received ovarian artery embolization and hysterectomy.No statistically significant differences in preoperative,postoperative systolic blood pressure and heart rate existed between the two groups,but in both groups the postoperative systolic blood pressure and heart rate were lower than their preoperative values(all P＜0.05).No statistically significant differences in X-ray fluoroscopy time,fetal body surface radiation dose,uterine artery embolization rate,hysterectomy rate,1-,5-,and 10-minute neonatal Apgar scores,and postoperative hospital stay existed between the two groups.In the observation group the time spent for cesarean section,intraoperative blood loss amount and blood transfusion quantity were lower than those in the control group(all P＜0.05).The difference in the incidence of balloon obstruction-related complications between the two groups was not statistically significant.Conclusion In cesarean section for delivery female patients with PPP,balloon block of bilateral internal iliac,regardless of using compliant Fogarty balloon catheter or non-compliant balloon catheter,is clinically safe and effective.However,the use of compliant Fogarty balloon catheter is superior to the use of non-compliant balloon catheter in reducing the cesarean section operative time,intraoperative blood loss amount,and intraoperative blood transfusion quantity.

Objective To evaluate the postoperative analgesia efficacy and clinical safety of hydro-morphone patients-controlled intravenous analgesia(PCIA)in patients with scar pregnancy after auxiliary uterine artery embolization(UAE).Methods A total of 116 patients with scar pregnancy,who received auxiliary UAE at the Fuyang Municipal People's Hospital of China between January 2021 and September 2022,were enrolled in this study.According to the intravenous self-controlled analgesic drugs used after UAE,the patients were randomly and equally divided into observation group(n=58)and control group(n=58).Ten minutes before the procedure,intravenous injection of 2 mg hydromorphone(observation group)or 2 μg/kg sufentanyl(control group)was performed,and the PCIA pump was connected.In the observation group,the mixed solution of 10 mg hydromorphone+100 mg flurbiprofen axetil+100 mL saline was put in the analgesic pump,while in the control group,the mixed solution of 2 μg/kg sufentanyl+flurbiprofen axetil 100 mg+100 mL saline was put in the analgesic pump.The post-UAE 0.5-h,4-h,8-h,12-h,24-h and 48-h visual analogue scale(VAS)scores,the Bruggrmann comfort scale(BCS)scores,the number of pressing analgesic pump times within postoperative 48 hours,the used dosage of analgesic drugs,the adverse reactions,and the incidence of postoperative complications were recorded.Results The difference in the post-UAE 0.5-h VAS scores between the observation group and the control group was not statistically significant(P＞0.05),while the post-UAE 4-h,8-h,12-h,24-h and 48-h VAS scores in the observation group were significantly lower than those in the control group,and the differences were statistically significant(all P＜0.05).The post-UAE 0.5-h,4-h,8-h,12-h,24-h and 48-h BCS scores in the observation group were significantly higher than those in the control group,and the differences were statistically significant(all P＜0.05).The number of pressing analgesic pump times and the used dosage of analgesic drugs within postoperative 48 hours in the observation group were lower than those in the control group,and the differences were statistically significant(all P＜0.05).No statistically significant differences in the complications such as drowsiness,skin itching,hypoxia,or respiratory depression,etc.existed between the two groups,while the difference in the incidence of adverse reactions between the two groups was statistically significant(P＜0.05).Conclusion Hydromorphone and sufentanil PCIA can relieve the pain in scar pregnancy patients after UAE.Hydromorphone is superior to sufentanil in reducing the number of pressing analgesic pump times within postoperative 48 hours,reducing the used dosage of analgesic drugs,and decreasing the incidence of adverse reactions,therefore,hydromorphone PCIA has a certain promotion value.(J Intervent Radiol,2024,33:240-244)

ObjectiveTo explore the effect of Tanreqing injection combined with Ceftazide on the clinical efficacy， lung function， and laboratory inflammatory index of patients suffering from phlegm heat obstructing lung syndrome in acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. MethodFrom June 2021 to June 2023， 76 patients diagnosed with phlegm heat obstructing lung syndrome in AECOPD were enrolled in the respiratory and critical medical department of Jieshou Hospital of Traditional Chinese Medicine. They were randomly divided into a control group and an observation group with 38 cases each. The control group used Ceftazidime intravenous drip and other conventional oxygen inhalation and antispasmodic treatment measures of western medicine. The observation group received Tanreqing injection intravenous drip based on the treatment of the control group， with a course of 10 days. The changes of laboratory indicators such as hs-CRP， calcitonin （PCT）， and interleukin-6 （IL-6） before and after treatment were analyzed， and the improvement of forced expiratory volume in the first second （FEV₁）， forced vital capacity （FVC）， one second rate （FEV₁/FVC）， assessment and improvement of the British Medical Research Society’s dyspnea index （mMRC）， self-evaluation test of chronic obstructive pulmonary disease patients （CAT）， and traditional Chinese medicine syndrome score was compared. In addition， the total effective rate between the two groups after treatment was compared. ResultAfter treatment， the hs-CRP， PCT， IL-6， FEV₁， FVC， FEV₁/FVC， mMRC， CAT scores， and traditional Chinese medicine syndrome evaluation of both groups improved （P<0.01）. After treatment， compared with the control group， the observation group showed more significant improvements in hs-CRP， PCT， IL-6， FEV₁， FVC， FEV₁/FVC， mMRC， CAT scores， and traditional Chinese medicine syndrome evaluation， and the difference was statistically significant （P<0.05，P<0.01）. The total clinical effective rate of the control group was 86.84% （33/38）， while that of the observation group was 94.74% （36/38）. The therapeutic effect of the observation group was better than that of the control group （χ²=8.471， P<0.05）. ConclusionTanreqing injection combined with Ceftazidime has obvious efficacy in the treatment of phlegm heat obstructing lung syndrome in AECOPD， which is better than the treatment of Ceftazidime antibiotics alone. It can reduce the risk of acute exacerbation， alleviate clinical symptoms， and delay the decline of lung function.

Objectives:This study aimed to assess the efficacy and safety of bendamustine in combination with rituximab (BR regimen) for the treatment of newly diagnosed indolent B-cell non-Hodgkin's lymphoma (B-iNHL) and elderly mantle cell lymphoma (eMCL) .Methods:From December 1, 2020 to September 10, 2022, a multi-center prospective study was conducted across ten Grade A tertiary hospitals in Shandong Province, China. The BR regimen was administered to evaluate its efficacy and safety in newly diagnosed B-iNHL and eMCL patients, and all completed at least four cycles of induction therapy.Results:The 72 enrolled patients with B-iNHL or MCL were aged 24-74 years, with a median age of 55 years. Eastern Cooperative Oncology Group (ECOG) performance status scores of 0-1 were observed in 76.4% of patients, while 23.6% had scores of 2. Disease distribution included follicular lymphoma (FL) (51.4% ), marginal zone lymphoma (MZL) (33.3% ), eMCL (11.1% ), and the unknown subtype (4.2% ). According to the Ann Arbor staging system, 16.7% and 65.3% of patients were diagnosed with stage Ⅲ and stage Ⅳ lymphomas, respectively. Following four cycles of BR induction therapy, the overall response rate was 98.6%, with a complete response (CR) rate of 83.3% and a partial response (PR) rate of 15.3%. Only one eMCL patient experienced disease progression during treatment, and only one FL patient experienced a relapse. Even when evaluated using CT alone, the CR rate was 63.9%, considering the differences between PET/CT and CT assessments. The median follow-up duration was 11 months (range: 4-22), with a PFS rate of 96.8% and an OS rate of 100.0%. The main hematologic adverse reactions included grade 3-4 leukopenia (27.8%, with febrile neutropenia observed in 8.3% of patients), grade 3-4 lymphopenia (23.6% ), grade 3-4 anemia (5.6% ), and grade 3-4 thrombocytopenia (4.2% ). The main non-hematologic adverse reactions such as fatigue, nausea/vomiting, rash, and infections occurred in less than 20.0% of patients.Conclusion:Within the scope of this clinical trial conducted in China, the BR regimen demonstrated efficacy and safety in treating newly diagnosed B-iNHL and eMCL patients.

Objective To explore the animal model of syndrome used in the study of hot flash phenomenon in women.Methods Twenty-four female SD rats were divided randomly into three groups:Con group,Ovx group,and tamoxifen group(n = 8 rats per group).Hot flashes were induced by bilateral oophorectomy and intragastric tamoxifen 10 mg/(kg·d),respectively.Open-field activity,anal temperature,and body surface infrared thermograms were detected on model days 14 and 28.The rats were then killed on day 29 and their uteruses were removed,weighed,and sectioned.Blood estradiol and catecholamine levels were determined by enzyme-linked immunosorbent assay.Gene expression levels of adrenal sex hormone synthetases(Star,Cyp11a1,Cyp17a1,Cyp19a1,Por,Hsd3b2,Hsd17b1)and catecholamine synthetases(Th,Ddc,Dbh,Pnmt)in the adrenal medulla were detected by reverse transcription-polymerase chain reaction.Results Rat body weight was significantly higher in the Ovx group compared with Con group(P<0.01),while body weight increased slowly in the tamoxifen group.The maximum body surface temperature was significantly decreased on day 28 in the Ovx group(P<0.01),the difference between the maximum and minimum abdominal temperatures was significantly increased on day 14(P<0.05),the difference between the maximum and minimum temperatures on the back was significantly increased on day 28(P<0.01),and the open-field activity was decreased(P<0.01).Compared with the sham operation group,the maximum body surface temperature in the tamoxifen group was significantly decreased(P<0.01)but the open-field activity was increased(P<0.01).The uterine index was significantly decreased in both models(P<0.01).Estradiol levels were significantly decreased(P<0.01)and NE and epinephrine were also significantly decreased in the Ovx group compared with Con group(P<0.05),and β-EP was also significantly decreased in Ovx group(P<0.05).Adrenal Cyp11a1 gene expression was significantly increased(P<0.05)while Cyp17a1 and Hsd17b1 gene expression levels were significantly decreased(P<0.05)in bilateral ovariectomized rats compared with Con group.Compared with Con group,gene expression levels of Star and Por were significantly increased(P<0.01)while Cyp17a1 gene expression was significantly decreased(P<0.01)in the tamoxifen group,and Pnmt gene expression was significantly down-regulated in Ovx group(P<0.01).Conclusions Bilateral ovariectomized rats can be used for the study of perimenopausal hot flashes,which resemble kidney Yang and Yin deficiency in traditional Chinese medicine.