ObjectiveThis paper aims to investigate and evaluate the staged efficacy and safety of the representative empirical prescription of the “Zhu Ke Jiao” theory， Qijia Rougan prescription， combined with entecavir in the treatment of hepatic fibrosis in chronic hepatitis B. MethodsA multicenter randomized controlled clinical study was conducted， and 101 patients diagnosed with chronic hepatitis B-related hepatic fibrosis （CHB-HF） who met the diagnosis and inclusion criteria were randomly assigned to an observation group （Qijia Rougan prescription + entecavir） and a control group （entecavir）. The treatment duration was 24 weeks. Liver stiffness measurement （LSM）， fibrosis-4 index （FIB-4）， portal vein diameter， hepatitis B serology， biochemical indicators， hepatic fibrosis markers in serum ［hyaluronic acid （HA）， laminin （LN）， procollagen Ⅲ peptide （PⅢP）， and type Ⅳ collagen （Ⅳ-C）］， and traditional Chinese medicine syndrome scores were used as efficacy evaluation indicators. Efficacy assessments and explorations of different staged subgroups of Qijia Rougan prescription were conducted according to LSM values based on the Metavir pathological staging standard. ResultsA total of 98 cases were included for statistical analysis， with 49 cases in the observation group and 49 in the control group. The general data of the patients in both groups were comparable. Compared with the same group before treatment， the observation group showed a significant reduction in LSM and FIB-4 （P<0.01）， as well as notable improvements in LN， Ⅳ-C， and various TCM syndrome scores （P<0.05， P<0.01）. When compared to the control group after treatment， the observation group demonstrated significant improvements in LSM， FIB-4， and various TCM syndrome score indicators （P<0.05， P<0.01）， indicating that the observation group performed better than the control group. Subgroup analysis of the regression of hepatic fibrosis stages showed that compared to the same group before treatment， the observation group had better improvement in regression of stages F2 and F3 （P<0.05）. When compared to the control group after treatment， the observation group exhibited superior improvement in regression of stage F3 （P<0.05）. No adverse events occurred in either group during the treatment period. ConclusionCompared with entecavir alone， the combination of Qijia Rougan prescription and entecavir significantly improves the degree of hepatic fibrosis and clinical TCM symptoms in patients. The optimal intervention period is primarily during stage F3， which is a potential “interception” point of the “Zhu Ke Jiao” theory.

ObjectiveTo evaluate the efficacy and safety of early intradermal needle therapy in preventing retained products of conception （RPOC） following induced abortion. MethodsA randomized， single-blind， placebo-controlled trial design was applied. Eighty-eight patients scheduled for early induced abortion were randomly assigned to either an intradermal needle group （44 cases） or a sham control group （44 cases）. Both groups underwent ultrasound-guided vacuum aspiration under general anesthesia and received standard postoperative pharmacological care. Immediately following the operation， the intradermal needle group received active intradermal needle therapy at bilateral Sanyinjiao （SP 6）， Hegu （LI 4） and Zhiyin （BL 67）， with needles retaining for 3 days， acupoint pressing three times daily for 5 minutes per acupoint， followed by 5 minutes of walking after each pressing session； while the sham control group received a visually identical， blunt-tipped sham needle intervention. The primary outcome was endometrial thickness measured by Doppler ultrasound at week 2 post-procedure. Secondary outcomes included the incidence of RPOC， visual analog scale （VAS） score and PTSD Checklist-Civilian Version （PCL-C） score at 2 hours post-procedure， volume and duration of vaginal bleeding， uterine volume， Pictorial Blood Loss Assessment Chart （PBAC） scores at weeks 5 and 12， menstrual cycle characteristics， and adverse events should be recorded. ResultsAt week 2 post-procedure， endometrial thickness was significantly lower in the intradermal needle group compared to the sham control group （P＜0.05）. Transvaginal ultrasonography at postoperative week 2 showed thinner endometrium in the intradermal needle group than in the sham group （P＜0.05）. RPOC occurred 1 case （2.27%） in the intradermal needle group versus 9 cases （20.45%） in the sham control group， yielding a significantly higher RPOC incidence in the sham control group （P＜0.05）. Patients in the intradermal needle group had less postoperative vaginal bleeding volume and shorter bleeding duration than those in the sham control group （P＜0.05）. No statistically significant difference was found in 2-hour postoperative VAS pain score， uterine volume at postoperative week 2 and week 5， PBAC score at postoperative week 5 and week 12， or menstrual cycle at postoperative week 12 between groups（all P＞0.05）. No obvious adverse reactions were observed in either group. ConclusionImmediate intradermal needle intervention after early induced abortion can significantly reduce the incidence of postoperative RPOC， exert beneficial effects on reducing the volume and duration of postoperative vaginal bleeding as well as alleviating post-traumatic stress symptoms， with good safety.

Objective:To investigate the application value of nasolabial flaps in addressing tissue defects after resection of benign and malignant nasal vestibular lesions. Methods:The clinical data of patients with benign and malignant nasal vestibular lesions were analyzed retrospectively. There were 4 cases of squamous cell carcinoma, 2 cases of black hairy nevus and 1 case of chronic proliferative inflammatory lesions, all of which were repaired by adjacent nasolabial flap. Results:After 6 months of follow-up, none of the patients developed nasal vestibular contracture or nostril stenosis, and postoperative nasal ventilation function was good. Conclusion:The preoperative design of individual nasolabial flaps is very important for maintaining maxillofacial aesthetics, protectingthe nasolabial framework, and preserving postoperative nasal ventilation function.
Humans ; Retrospective Studies ; Middle Aged ; Nose Neoplasms/surgery* ; Surgical Flaps ; Male ; Female ; Adult ; Nose/surgery* ; Plastic Surgery Procedures/methods* ; Carcinoma, Squamous Cell/surgery* ; Aged ; Skin Transplantation

OBJECTIVE To provide standardized whole-process guidance on drug traceability codes for medical institutions in Sichuan province， ensuring medication safety and compliance with medical insurance supervision requirements. METHODS Based on evidence-based principles and expert consensus， Expert Consensus on Whole-process Management of Drug Traceability Codes in Medical Institutions of Sichuan Province （hereinafter referred to as the Consensus） was formulated through systematic literature review， field investigations， establishment of a multidisciplinary expert committee and multiple rounds of questionnare consultation via the modified Delphi method， and finalized through consensus meetings. RESULTS & CONCLUSIONS The Consensus clarifies key operating procedures for code verification， code assignment and code return， whole-process operational standards for drug warehouse acceptance and storage， drug warehouse outbound delivery and pharmacy acceptance check， drug distribution and dispensing in pharmacy and intravenous admixture center， medication administration in nursing units and examination departments， as well as drug return process. Key recommendations are proposed such as improving the core functions of the drug traceability system， unifying the hospital-wide traceability code database， strengthening the management of traceability codes for backup medications， establishing a management organization and institutional framework， and optimizing the architectural design and data governance requirements of the drug traceability system. The release of the Consensus will provide scientific， standardized and implementable practical guidelines for medical institutions of Sichuan province， helping to improve closed-loop management of the drug traceability system， strengthen medication safety and fulfil medical insurance fund supervision.

Objective To evaluate the efficacy of Broncho-Vaxom combined with physiological sea water nasal wash in the treatment of chronic rhinitis-rhinosinusitis in children. Methods A total of 179 children with chronic rhinitis-rhinosinusitis were randomly divided into observation group of 90 cases and control group of 89 cases. The observation group received treatment of oral administration of Broncho-Vaxom capsules at a dose of 3.5 mg once daily on an empty stomach in the morning for 10 consecutive days, with a 20-day drug-free period as one course of treatment, for a total of 3 courses. Additionally, they underwent nasal irrigation with physiological sea water twice daily in the morning and evening, for 10 consecutive days, with a 20-day break as one course of treatment, for a total of 3 courses. The control group underwent nasal irrigation with physiological sea water using the same method of the observation group. Both groups received symptomatic treatment such as anti-allergy therapy, and antibiotics were added when there presented obvious inflammatory changes. After treatment, the clinical total effective rate was compared between the two groups. Changes in the scores of Visual Analogue Scale (VAS) and Lund-Kenndy scale for nasal endoscopy, as well as changes in serum IgG, IgE, and T lymphocyte subsets were also compared. A six-month follow-up was conducted to assess the recurrence rate and average number of episodes of rhinosinusitis (times per person). Results The clinical total effective rate in the observation group was significantly higher compared to that in the control group(95.56% versus 86.52%). The scores of VAS and Lund-Kenndy scale in the observation group were significantly better than those in the control group. Serum IgG levels in the observation group were increased and higher than those in the control group, while serum IgE level in the observation group was decreased and lower than that in the control group. After 3 courses of treatment, the levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in the blood of the observation group were increased, while the level of CD8⁺ was decreased. The six-month follow-up after treatment showed that the recurrence rate of rhinitis-rhinosinusitis in the observation group was 17.05%, with an average of 0.28 episodes per person, which was lower than that in the control group (P < 0.05). Conclusion The combination of Broncho-Vaxom and physiological sea water nasal wash is effective in treating chronic rhinitis-rhinosinusitis in children, and can increase serum IgG level, decrease serum IgE level, optimize the structure of T lymphocyte subsets, enhance immune resistance, and improve allergic constitution. The six-month follow-up of the treatment reduces recurrence rate and average number of episodes of rhinitis-rhinosinusitis.

Objective:To investigate the effects of β-1,4-galactosyltransferase 2(B4GALT2)on the proliferation,migration and invasion of human breast cancer MCF-7 and MDA-MB-231 cells,and to explore its underlying mechanism.Methods:The mRNA and protein expression of B4GALT2 in breast cancer tissues was analyzed using data from TCGA database and the CPTAC proteomics database.Immunohistochemical staining was used to validate the expression of B4GALT2 protein in breast cancer tissues of Chinese population.The correlation between B4GALT2 mRNA expression in breast cancer tissues and patient prognosis was analyzed using data from the Kaplan-Meier Plotter database.MCF-7 and MDA-MB-231 cells were routinely cultured and transfected with siNC,siRNA#1,siRNA#2,empty vector,and B4GALT2 overexpression plasmids using transfection reagents.The transfected cells were classified as NC group,siRNA#1 group,siRNA#2 group,empty vector group,and OE-B4GALT2 group accordingly.CCK-8 assay and clone formation assay were used to detect the effects of B4GALT2 knockdown on proliferation of transfected cells.Scratch healing assay and Transwell chamber assay were applied to evaluate the effects of B4GALT2 knockdown on cell migration and invasion.WB assay was used to detect the phosphorylation levels of the PI3K/AKT signaling pathway in MCF-7,MDA-MB-231 cells after B4GALT2 knockdown or overexpression.Results:B4GALT2 was highly expressed in breast cancer tissues at both mRNA and protein levels(both P<0.01),and B4GALT2 protein was also highly expressed in Chinese breast cancer tissues(P<0.000 1),confirming the initial findings.High B4GALT2 expression was significantly associated with shorter overall prognosis(OS),recurrence-free survival(RFS),and post-progression survival(PPS)(P<0.01,P<0.05,P<0.001)in patients.After B4GALT2 knockdown,the proliferation,migration and invasion of MCF-7 and MDA-MB-231 cells were significantly suppressed(all P<0.01),and the PI3K/AKT signaling pathway was significantly inhibited(all P<0.01).The PI3K/AKT signaling pathway was significantly activated after B4GALT2 overexpression(all P<0.01).Conclusion:B4GALT2 is highly expressed in breast cancer tissues.It promotes the malignant biological behaviors of MCF-7 and MDA-MB-231 cells by regulating the PI3K/AKT signaling pathway.

Objective     To explore the association between the preoperative systemic immune-inflammation index (SII) and prognosis in non-small cell lung cancer (NSCLC) patients. Methods     A comprehensive literature survey was performed on PubMed, Web of Science, EMbase, The Cochrane Library, Wanfang, and CNKI databases to search the related studies from inception to December 2021. The hazard ratio (HR) and 95% confidence interval (CI) were combined to evaluate the correlation of the preoperative SII with overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) in NSCLC patients. Results     A total of 11 studies involving 9 180 patients were eventually included. The combined analysis showed that high SII levels were significantly associated with worse OS (HR=1.61, 95%CI 1.36-1.90, P<0.001), DFS (HR=1.50, 95%CI 1.34-1.68, P<0.001), and RFS (HR=1.17, 95%CI 1.04-1.33, P<0.001). Subgroup analyses also further verified the above results. Conclusion     Preoperative SII is a powerful prognostic biomarker for predicting outcome in patients with operable NSCLC and contribute to prognosis evaluation and treatment strategy formulation. However, more well-designed and prospective studies are warranted to verify our findings.

Objective To investigate the clinical data of a family diagnosed with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy(CADASIL) with isolated vertigo as the initial symptom. Methods The clinical manifestations,imaging findings,pathology,genetic testing results,and CADASIL scale score of a patient with CADASIL were summarized,and a family investigation was conducted. Results The proband of this case experienced recurrent isolated vertigo and gradually developed emotional disorder. Cranial magnetic resonance imaging(MRI) FLAIR revealed extensive subcortical white matter degeneration in both hemispheres,characteristic abnormal hyperintensity in bilateral temporal poles and external capsules,abnormal hyperintensity in bilateral brainstems,and multiple lacunar infarctions in bilateral corona radiata and basal ganglia. The score of CADASIL scale was 16 points. Skin biopsy showed the deposition of electron-dense granular osmiophilic material around vascular smooth muscle. Genetic testing identified a heterozygous mutation of c. 1163G>A(p. C388Y) in the NOTCH3 gene. The elder sister of the proband also had isolated vertigo and was found to have the same mutation by genetic testing. The father and uncle of the proband died of cerebral infarction,while the aunt of the proband suffered from severe dementia,and all of them had experienced dizziness in the early stage. Conclusion CADASIL has clinical heterogeneity and can manifest as isolated vertigo. Abnormal signals in temporal poles and external capsules on cranial MRI have an important value in the diagnosis of this disease,while pathological examination is required to make a confirmed diagnosis,and genetic testing can further clarify the diagnosis and perform screening of other family members.

BACKGROUND: Teeth can be used as a raw material for preparing bone substitutes due to their similar chemical composition to bone. The objective of our study was to evaluate the effect of odontogenic biphasic calcium phosphate (BCP) incorporating dentin noncollagenous proteins (DNCPs) on osteogenesis and stability in maxillary sinus augmentation. METHODS: The composition, structure and morphology of the odontogenic BCP were tested by X-ray powder diffraction (XRD), Brunauer–Emmett–Teller, and scanning electron microscopy methods. The biocompatibility and osteoinduction of DNCPs and materials were examined in vitro and their bone regeneration capacity was verified in vivo. RESULTS: The results showed that the cells adhered and proliferated well on the DNCP-loaded BCP scaffold. The odontogenic BCP and DNCPs promoted osteogenic differentiation of cells, The new bone formation in the BCP groups and DNCP subgroups was significantly higher than the new bone formation in the control, and the new bone quality was better.The bone regeneration effect of odontogenic BCP was similar to the effect of deproteinized bovine bone mineral, but b-TCP did not maintain the height and volume of bone reconstruction. CONCLUSION In conclusion, the combined application of DNCPs and odontogenic BCP is an effective strategy for tissue engineering osteogenesis in the maxillary sinus region. The biomimetic strategy could provide a new approach for patients requiring maxillary sinus lifting.

Background The converter stations of high-voltage direct current (HVDC) transmission lines generate special total electric fields. At present, few investigations have been conducted on total electric fields in the workplace of converter stations from an perspective of occupational health. Objective To understand the current situation of total electric field strength in the workplace of converter stations. Methods Using purposive sampling, a calibrated HDEM-1 direct current (DC) total electric field strength measurement system was used to measure the total electric fields of 12 converter stations serving 6 DC lines in Southeast and Southwest China according to the Measurement method for total electric field strength and ion current density of the converter stations and DC transmission lines (DL/T 1089—2008). The results were evaluated according to occupational exposure limits recommended by The limits of electromagnetic environment at ±800 kV UHV DC converter station (DL/T 275—2012), the American Conference of Governmental Industrial Hygienists (ACGIH), and the International Commission on Non-Ionizing Radiation Protection (ICNIRP). Results A total of 615 check points were planned, the total electric field strength was 0.05-37.05 kV·m⁻¹, and the median was 10.45 kV·m⁻¹. The total electric field strength of 39 check points (6.3%) exceeded 25 kV·m⁻¹ (the limits of ACGIH and ICNIRP), and the total electric field strength of 12 check points (2.0%) exceeded 30 kV·m⁻¹ (the limit of DL/T 275—2012). There were statistically significant differences in the total electric field strength values and the proportions of exceeding 25 kV·m⁻¹ between the neutral regions and the positive regions and between the neutral regions and the negative regions (P < 0.01). The proportion of total electric field strength exceeding 30 kV·m⁻¹ in the negative regions was higher than that in the positive regions (P < 0.01). There were no significant differences in the total electric field strength of converter stations at different voltage levels and different altitudes (P > 0.05). There were no significant differences in the proportions of total electric field exceeding 25 kV·m⁻¹ and exceeding 30 kV·m⁻¹ in converter stations at different voltage levels and different altitudes (P > 0.05). Conclusion The total electric field in some workplace of converter stations exceeds selected limits. Converter station operators may be exposed to high-strength total electric field for a short time.