Objective To investigate the therapeutic effects and mechanisms of Yishen Shengyang formula in allergic rhinitis(AR)by regulating the transcription factor BTB and CNC homology 2(Bach2)to promote regulatory T cell(Treg cell)differentiation.Methods AR mouse models were established via ovalbumin(OVA)sensitization and randomly divided into control group,AR model group(AR group),Yishen Shengyang formula group and dexamethasone group.Nasal symptoms were evaluated using behavioral scores;Histopathological changes in nasal mucosa were observed via hematoxylin-eosin and periodic acid Schiff stain;Serum levels of OVA-specific immunoglobulin E(sIgE),interleukin-4(IL-4),and transforming growth factor-β(TGF-β)were measured by enzyme linked immunosorbent assay;Splenic Treg proportions were analyzed via flow cytometry;Bach2 protein expression was assessed by Western blot.Results Compared with control group,AR group mice showed significantly increased behavioral scores(P<0.05),goblet cell hyperplasia,inflammatory infiltration,elevated OVA-sIgE and IL-4 levels(P<0.05),reduced TGF-β(P<0.05),and decreased splenic Treg proportions and Bach2 expression(P<0.05).Yishen Shengyang formula treatment alleviated nasal symptoms(P<0.05),mitigated mucosal damage,decreased OVA-sIgE and IL-4,increased TGF-β(P<0.05),and upregulated Treg proportions and Bach2 expression(P<0.05),with efficacy comparable to dexamethasone.Conclusion Yishen Shengyang formula demonstrates potential therapeutic effects on allergic rhinitis by upregulating Bach2 expression and promoting Treg cell differentiation.This study provides a novel strategy and experimental basis for the traditional Chinese medicine treatment of AR.

Objective To investigate the therapeutic effects and mechanisms of Yishen Shengyang formula in allergic rhinitis(AR)by regulating the transcription factor BTB and CNC homology 2(Bach2)to promote regulatory T cell(Treg cell)differentiation.Methods AR mouse models were established via ovalbumin(OVA)sensitization and randomly divided into control group,AR model group(AR group),Yishen Shengyang formula group and dexamethasone group.Nasal symptoms were evaluated using behavioral scores;Histopathological changes in nasal mucosa were observed via hematoxylin-eosin and periodic acid Schiff stain;Serum levels of OVA-specific immunoglobulin E(sIgE),interleukin-4(IL-4),and transforming growth factor-β(TGF-β)were measured by enzyme linked immunosorbent assay;Splenic Treg proportions were analyzed via flow cytometry;Bach2 protein expression was assessed by Western blot.Results Compared with control group,AR group mice showed significantly increased behavioral scores(P<0.05),goblet cell hyperplasia,inflammatory infiltration,elevated OVA-sIgE and IL-4 levels(P<0.05),reduced TGF-β(P<0.05),and decreased splenic Treg proportions and Bach2 expression(P<0.05).Yishen Shengyang formula treatment alleviated nasal symptoms(P<0.05),mitigated mucosal damage,decreased OVA-sIgE and IL-4,increased TGF-β(P<0.05),and upregulated Treg proportions and Bach2 expression(P<0.05),with efficacy comparable to dexamethasone.Conclusion Yishen Shengyang formula demonstrates potential therapeutic effects on allergic rhinitis by upregulating Bach2 expression and promoting Treg cell differentiation.This study provides a novel strategy and experimental basis for the traditional Chinese medicine treatment of AR.

This study searched the clinical researches on traditional Chinese medicine （TCM） for cardiovascular diseases registered in Chinese Clinical Trial Registry and the US Clinical Trial Registry， the cardiovascular disease-related studies funded by the National Natural Science Foundation of China， as well as those published in China National Knowledge Infrastructure （CNKI）， Wanfang database， VIP.com， China Biology Medicine disc （CBMdisc）， Embase， Medline， Cochrane Library， and other databases published cardiovascular disease-related studies from 1 January 2021 to 30 June 2023. In order to analyse and evaluate the research progress of TCM treatment for coronary heart disease， hypertension， heart failure， and arrhythmia， this study aimed at recent research hotspots and research direction. It is found that the research on TCM for cardiovascular diseases was gradually deepening and the high-quality evidence continued to emerge. It is believed that studies related to the prevention and treatment of common cardiovascular diseases by TCM reflected the multi-angle integration of modern technology and pattern differentiation and treatment， closer integration of clinical and basic research， and further optimisation of pattern identification and interventions. On this basis， the research programme and implementation process should be further standardized， and the translation of research results should be emphasized to promote the standardized application and promotion of TCM diagnosis and treatment of cardiovascular diseases.

Objective:To evaluate the efficacy of dupilumab in the treatment of moderate to severe atopic dermatitis (AD) in children, and to analyze its influencing factors.Methods:A retrospective analysis was carried out on the demographic and clinical data collected from children with moderate to severe AD, who were treated with dupilumab in the Department of Dermatology, Xiangya Hospital, Central South University from October 2020 to October 2022. The initial dose (200 - 600 mg) of dupilumab was administered based on children's age and weight, followed by 200 - 300 mg every 2 - 3 weeks. The curative efficacy and quality of life were evaluated using the Investigator's Global Assessment (IGA), Eczema Area and Severity Index (EASI), SCORing Atopic Dermatitis (SCORAD), Peak Pruritus Numerical Rating Scale (PP-NRS), Patient-Oriented Eczema Measure (POEM), and the Children's Dermatology Life Quality Index (CDLQI) /Infants' Dermatitis Quality of Life Index (IDQoL) before treatment, and at weeks 4, 12, and 16 after treatment. Adverse events during the treatment period were also recorded. The main outcome indicators were the proportion of patients achieving IGA0/1 and EASI75 (≥ 75% improvement from baseline in EASI score) at week 16. Changes in the clinical scores and laboratory parameters at different time points after the treatment with dupilumab were analyzed using generalized estimating equations, and a logistic regression model was used to identify the influencing factors for EASI75 response at week 16.Results:A total of 136 children aged 2 - 11 years met the diagnosis of moderate to severe AD and received at least one dose of dupilumab, among whom 123 children met the inclusion criteria for this analysis. IGA, EASI, SCORAD, POEM, CDLQI/IDQoL, and PP-NRS scores were significantly improved at weeks 4, 12, and 16 after dupilumab therapy compared with baseline scores (all P < 0.01). At week 16, the proportions of patients achieving IGA0/1, EASI50, EASI75, EASI90, CDLQI/IDQoL improvement ≥ 4 points, and PP-NRS improvement ≥ 4 points were 44.6% (33/74), 86.5% (64/74), 70.3% (52/74), 48.7% (36/74), 56.8% (42/74), and 77.0% (57/74), respectively; the eosinophil counts significantly decreased compared with the baseline level ( P = 0.001). The total IgE levels at different time points after treatment did not differ from the baseline level ( P > 0.01). At week 16, the related factors for the response to dupilumab were relatively low ages (compared with the children aged 6 - 11 years, those aged 2 - 5 years showed lower EASI75 response rates: OR = 0.148, 95% CI: 0.027 - 0.823, P = 0.029) and having a family history of urticaria ( OR = 0.033, 95% CI: 0.002 - 0.601, P = 0.021), while gender, AD duration, subtypes and main clinical phenotypes of AD, allergic history, family history of atopic diseases, presence of serum allergen-specific IgE antibodies, serum total IgE levels, or eosinophil counts did not affect the efficacy of dupilumab (all P > 0.05). During the 16-week treatment, 3 children discontinued the dupilumab treatment due to disease exacerbation, and 1 child developed conjunctivitis. Conclusions:Dupilumab could effectively improve the symptoms and signs of children with moderate to severe AD whose condition was poorly controlled by conventional treatments, with a low incidence rate of adverse reactions. Relatively low ages and having a family history of urticaria may be negative factors influencing the efficacy of dupilumab in children with moderate to severe AD at week 16.

Objective:To evaluate the efficacy of dupilumab in the treatment of moderate to severe atopic dermatitis (AD) in children, and to analyze its influencing factors.Methods:A retrospective analysis was carried out on the demographic and clinical data collected from children with moderate to severe AD, who were treated with dupilumab in the Department of Dermatology, Xiangya Hospital, Central South University from October 2020 to October 2022. The initial dose (200 - 600 mg) of dupilumab was administered based on children's age and weight, followed by 200 - 300 mg every 2 - 3 weeks. The curative efficacy and quality of life were evaluated using the Investigator's Global Assessment (IGA), Eczema Area and Severity Index (EASI), SCORing Atopic Dermatitis (SCORAD), Peak Pruritus Numerical Rating Scale (PP-NRS), Patient-Oriented Eczema Measure (POEM), and the Children's Dermatology Life Quality Index (CDLQI) /Infants' Dermatitis Quality of Life Index (IDQoL) before treatment, and at weeks 4, 12, and 16 after treatment. Adverse events during the treatment period were also recorded. The main outcome indicators were the proportion of patients achieving IGA0/1 and EASI75 (≥ 75% improvement from baseline in EASI score) at week 16. Changes in the clinical scores and laboratory parameters at different time points after the treatment with dupilumab were analyzed using generalized estimating equations, and a logistic regression model was used to identify the influencing factors for EASI75 response at week 16.Results:A total of 136 children aged 2 - 11 years met the diagnosis of moderate to severe AD and received at least one dose of dupilumab, among whom 123 children met the inclusion criteria for this analysis. IGA, EASI, SCORAD, POEM, CDLQI/IDQoL, and PP-NRS scores were significantly improved at weeks 4, 12, and 16 after dupilumab therapy compared with baseline scores (all P < 0.01). At week 16, the proportions of patients achieving IGA0/1, EASI50, EASI75, EASI90, CDLQI/IDQoL improvement ≥ 4 points, and PP-NRS improvement ≥ 4 points were 44.6% (33/74), 86.5% (64/74), 70.3% (52/74), 48.7% (36/74), 56.8% (42/74), and 77.0% (57/74), respectively; the eosinophil counts significantly decreased compared with the baseline level ( P = 0.001). The total IgE levels at different time points after treatment did not differ from the baseline level ( P > 0.01). At week 16, the related factors for the response to dupilumab were relatively low ages (compared with the children aged 6 - 11 years, those aged 2 - 5 years showed lower EASI75 response rates: OR = 0.148, 95% CI: 0.027 - 0.823, P = 0.029) and having a family history of urticaria ( OR = 0.033, 95% CI: 0.002 - 0.601, P = 0.021), while gender, AD duration, subtypes and main clinical phenotypes of AD, allergic history, family history of atopic diseases, presence of serum allergen-specific IgE antibodies, serum total IgE levels, or eosinophil counts did not affect the efficacy of dupilumab (all P > 0.05). During the 16-week treatment, 3 children discontinued the dupilumab treatment due to disease exacerbation, and 1 child developed conjunctivitis. Conclusions:Dupilumab could effectively improve the symptoms and signs of children with moderate to severe AD whose condition was poorly controlled by conventional treatments, with a low incidence rate of adverse reactions. Relatively low ages and having a family history of urticaria may be negative factors influencing the efficacy of dupilumab in children with moderate to severe AD at week 16.

Objective:To analyze the difference of clinical characteristics and outcomes of infants with moderate and severe pediatric acute respiratory distress syndrome(PARDS)diagnosed according to baseline oxygenation index(OI) in pediatric intensive care unit(PICU).Methods:Second analysis of the data collected from the "Efficacy of pulmonary surfactant (PS) in the treatment of children with moderate and severe ARDS" program.Retrospectively compare of the differences in clinical data such as general condition, underlying diseases, OI, mechanical ventilation, PS administration and outcomes among infants with moderate and severe PARDS divided by baseline OI who admitted to PICUs at 14 participating tertiary hospitals from 2016 to December 2021.Results:Among the 101 cases, 55 cases (54.5%) were moderate and 46 cases (45.5%) were severe PARDS.The proportion of male in the severe group (50.0% vs.72.7%, P=0.019) and the pediatric critical illness score(PCIS)[72 (68, 78) vs.76 (70, 80), P=0.019] were significantly lower than those in the moderate group, while there was no significant difference regarding age, body weight, etiology of PARDS and underlying diseases.The utilization rate of high-frequency ventilator in the severe group was significantly higher than that in the moderate group (34.8% vs.10.9%, P=0.004), but there was no significant difference in PS use, fluid load and pulmonary complications.The 24 h OI improvement (0.26±0.33 vs.0.04±0.34, P=0.001) and the 72 h OI improvement[0.34 (-0.04, 0.62) vs.0.15 (-0.14, 0.42), P=0.029)]in the severe group were significantly better than those in the moderate group, but there was no significant difference regarding mortality, length of hospital stay and intubation duration after diagnosis of PARDS between the two groups. Conclusion:In moderate and severe(divided by baseline OI) PARDS infants with invasive mechanical ventilation, children in severe group have better oxygenation improvement in the early stage after PARDS identified and are more likely to receive high frequency ventilation compared to those in moderate group.Baseline OI can not sensitively distinguish the outcomes and is not an ideal index for PARDS grading of this kind of patient.

The aim of this study was to investigate the preventive effect of pancreatic duct stent on acute pancreatitis after endoscopic retrograde cholangiopancreatography. A retrospective analysis of the case data of patients who first underwent endoscopic retrograde cholangiopancreatography for choledocholithiasis in the Beijing Friendship Hospital from January 2015 to December 2019 for 5 years. According to whether the pancreatic duct stent was indwelled during the operation, they were divided into pancreatic duct stent group (147 cases) and non-indwelling pancreatic duct stent group (192 cases). The incidence of acute pancreatitis after endoscopic retrograde cholangiopancreatography was compared between the two groups according to COTTON criteria. Independent sample t test, Pearson Chi-square test (χ 2) and Fisher′s exact test were used to compare groups′ differences. There were 2 cases of acute pancreatitis in the pancreatic duct stent group, all of which improved after 48 hours. There were 22 cases of acute pancreatitis in the non-indwelling pancreatic duct stent group, of which 20 cases improved within 48 hours, and the other 2 cases had severe pancreatitis, which improved and discharged after 30 days of treatment. There was significant difference in the incidence of acute pancreatitis between the pancreatic duct stenting group (1.4%) and the group without placement of pancreatic duct stents (11.5%) (χ2=12.905, P<0.001). In conclusion, Pancreatic duct stent may be an effective method to prevent PEP.

The aim of this study was to investigate the preventive effect of pancreatic duct stent on acute pancreatitis after endoscopic retrograde cholangiopancreatography. A retrospective analysis of the case data of patients who first underwent endoscopic retrograde cholangiopancreatography for choledocholithiasis in the Beijing Friendship Hospital from January 2015 to December 2019 for 5 years. According to whether the pancreatic duct stent was indwelled during the operation, they were divided into pancreatic duct stent group (147 cases) and non-indwelling pancreatic duct stent group (192 cases). The incidence of acute pancreatitis after endoscopic retrograde cholangiopancreatography was compared between the two groups according to COTTON criteria. Independent sample t test, Pearson Chi-square test (χ 2) and Fisher′s exact test were used to compare groups′ differences. There were 2 cases of acute pancreatitis in the pancreatic duct stent group, all of which improved after 48 hours. There were 22 cases of acute pancreatitis in the non-indwelling pancreatic duct stent group, of which 20 cases improved within 48 hours, and the other 2 cases had severe pancreatitis, which improved and discharged after 30 days of treatment. There was significant difference in the incidence of acute pancreatitis between the pancreatic duct stenting group (1.4%) and the group without placement of pancreatic duct stents (11.5%) (χ2=12.905, P<0.001). In conclusion, Pancreatic duct stent may be an effective method to prevent PEP.

Objective: To investigate the recurrence of pulmonary tuberculosis patients 5 years after successful treatment in Hengyang City, Hunan Province, and to analyze its influencing factors. Methods: The data of pulmonary tuberculosis patients who were successfully treated in Hengyang City in 2014 were collected through the tuberculosis management information system. The recurrence of pulmonary tuberculosis was defined as the endpoint, and all patients were observed for five consecutive years. Factors affecting recurrence of pulmonary tuberculosis were identified using Kaplan-Meier estimates, log-rank test and multivariable Cox proportional hazards regression analysis. Results: A total of 6 626 patients with successfully treated pulmonary tuberculosis were included, including 4 961 males and 1 665 females, with a median age of 54 years. There were 536 cases with recurrence of pulmonary tuberculosis within five years, with a 8.09% cumulative proportion of recurrence and annual recurrence rate of 1.75 per 100 person-years. Multivariable Cox proportional hazards regression analysis showed that men ( HR=1.592, 95%CI: 1.256-2.019 ), age of 40 years and greater ( age of 40 to 59 years, HR=7.025, 95%CI: 1.739-28.377; age of 60 years and greater, HR=8.175, 95%CI: 2.024-33.023), farmers ( HR=1.379, 95%CI: 1.070-1.778 ), retreatment ( HR=6.398, 95%CI: 5.163-7.929 ) and positive etiology ( HR=1.255, 95%CI: 1.042-1.511 ) were risk factors for five-year recurrence of pulmonary tuberculosis among successfully-treated patients. Conclusions High recurrence rate is found among pulmonary tuberculosis patients within five years after successful treatment in Hengyang City. There is a high risk of pulmonary tuberculosis recurrence among male, etiologically positive, retreated farmers at ages of 40 years and older, and targeted interventions are recommended.

Objective:To construct a standardized training program for full-time nursing postgraduate students, and to provide a basis for the training the high-quality nursing talents in hospitals.Methods:Through literature review and demi structured interview, preliminarily develop the training program was established from January to March 2021. Through two rounds of expert consultations of 16 experts, the standardized training program for nursing postgraduates was formulated.Results:The recovery rate of the two rounds were both 16/16. The expert authority coefficients of the two rounds of consultation were 0.819, respectively. The Kendall′s coordination coefficients of the two rounds of consultation were 0.329 and 0.334, respectively, and the difference was statistically significant ( P< 0.01). Finally, a standardized training program for entry-level nursing postgraduates was formed, which included five parts: training objects and quality requirements, training methods, training objectives, training contents and evaluation, with a total of 225 items. Conclusions:The standardized training program for nursing postgraduates formed is reliable, scientific and practical, which provides guidance and reference for the training and use of highly educated clinical nursing talents in hospitals.