Objective To analyze the correlation between the multiple evaluation indicators in the early stage and the cure time(needed time from treatment to cure)of the patients with facial neuritis treated by ac-upuncture combined with medication,and to optimize the subjective and objective indicators enable predicting the cure time of facial neuritis in early stage.Methods All patients were treated by acupuncture and medica-tion combination.The research subjects were 64 patients with facial neuritis from the outpatient of cupuncture and moxibustion department of this hospital.The correlation between the grade of facial nerve paralysis,sur-face electromyography related data,scores of self-made symptom scoring scale,Sunnybrook Facial Grading System(SFGS)score,Facial Disability Index-Physical(FDIP)score,Facial Disability Index-Social(FDIS)score on 7 d of onset with the cure time was analyzed.Results The cure time was positively correlated with the grade of facial nerve paralysis and FDIS score on 7 d of onset(P＜0.01),amd negatively correlated with the scores of self-made symptom scoring scale,FDIP score,SFGS score and the affected side to healthy ratio of CMAP amplitude of buccal temporal branch of facial nerve(P＜0.01 or P＜0.05);the cure time had no sig-nificant correlation with the ratio of affected side and healthy side of CMAP amplitude in zygomatic branch of facial nerve,the ratio of affected side and healthy side of CMAP latent period of temporal branch,buccal branch and zygomatic branch of facial nerve and F wave output rate(P＞0.05).Conclusion In the early stage subjective indicators of the acupuncture combined with medication for treating facial neuritis,grade of facial nerve paralysis,self-made symptom scoring scale,scores of self-made symptom scoring scale,FDIP and FDIS scores and the ratio of affected side to healthy side of CMAP amplitude of the buccal branch,temporal branch of the facial nerve in sEMG in the objective indicators could be used to predict the cure time,better guide the treatment and have more effective and accurate comunication with the patients.

Objective:To analyze the clinical manifestations, risk factors and risk of recurrence in patients with primary antiphospholipid syndrome (PAPS) complicated with cerebral infarction.Methods:Inpatients diagnosed with PAPS was recruited between 2010 and 2020. Clinical characteristics,laboratory results and adjusted global antiphospholipid syndrome score (aGAPSS) were compared between patients with cerebral infarction and without cerebral infarction by χ2 test, t test or Mann-Whitney U test. Univariate and multivariate Logistic analysis were performed to identify the risk factors associated with cerebral infarction. Results:In 145 PAPS patients [median age 44.0 (34.0, 51.5) years, 66.2% female], 46 (31.7%) patients had cerebral infarction. Patients with cerebral infarction had higher rates of transient ischemic attack (TIA) (50.0% and 20.2%, χ2=13.37, P<0.001), cardiac valvular anomalies (32.6% and 11.1%, χ2=9.86, P=0.002), lupus anticoagulant (LA) (87.0% and 42.4%, χ2=25.35, P<0.001) and triple antiphospholipid antibodies (aPL) positivity (50.0% and 11.1%, χ2=26.64, P<0.001). The aGAPSS value was significantly higher in patients with cerebral infarction compared to those without [13(11, 14) and 9(7, 13), U=934.50, P<0.001]. The independent risk factors for PAPS-associated cerebral infarction were TIA [ OR (95% CI)= 3.612 (1.387, 9.403), P=0.009]、triple aPL positivity[ OR(95% CI)=8.904 (3.169, 25.019), P<0.001], higher aGAPSS[ OR(95% CI)=1.421(1.209, 1.670), P<0.001]. Conclusion:Patients with cerebral infarction may have a higher risk of thrombus recurrence. TIA, triple aPL positivity and higher aGAPSS are independent risk factors for PAPS patients with cerebral infarction.

Acidosis, regardless of hypoxia involvement, is recognized as a chronic and harsh tumor microenvironment (TME) that educates malignant cells to thrive and metastasize. Although overwhelming evidence supports an acidic environment as a driver or ubiquitous hallmark of cancer progression, the unrevealed core mechanisms underlying the direct effect of acidification on tumorigenesis have hindered the discovery of novel therapeutic targets and clinical therapy. Here, chemical-induced and transgenic mouse models for colon, liver and lung cancer were established, respectively. miR-7 and TGF-β2 expressions were examined in clinical tissues (n = 184). RNA-seq, miRNA-seq, proteomics, biosynthesis analyses and functional studies were performed to validate the mechanisms involved in the acidic TME-induced lung cancer metastasis. Our data show that lung cancer is sensitive to the increased acidification of TME, and acidic TME-induced lung cancer metastasis via inhibition of miR-7-5p. TGF-β2 is a direct target of miR-7-5p. The reduced expression of miR-7-5p subsequently increases the expression of TGF-β2 which enhances the metastatic potential of the lung cancer. Indeed, overexpression of miR-7-5p reduces the acidic pH-enhanced lung cancer metastasis. Furthermore, the human lung tumor samples also show a reduced miR-7-5p expression but an elevated level of activated TGF-β2; the expressions of both miR-7-5p and TGF-β2 are correlated with patients' survival. We are the first to identify the role of the miR-7/TGF-β2 axis in acidic pH-enhanced lung cancer metastasis. Our study not only delineates how acidification directly affects tumorigenesis, but also suggests miR-7 is a novel reliable biomarker for acidic TME and a novel therapeutic target for non-small cell lung cancer (NSCLC) treatment. Our study opens an avenue to explore the pH-sensitive subcellular components as novel therapeutic targets for cancer treatment.

Objective:This investigation aims to assess the impact of CSF3R mutations and the presence of measurable residual disease (MRD) on the prognosis of patients with CEBPA double mutations who have acute myeloid leukemia (AML) .Methods:The prognostic significance of these two factors was examined in the present study, which included 66 patients with complete genetic mutations and sequential MRD information.Results:Following the second course of chemotherapy, the MRD status and CSF3R mutations of these patients were linked to their long-term prognosis. CSF3R mutated patients showed inferior relapse-free survival (RFS) (5-year RFS: 15.2% vs 38.7% , P=0.006) and overall survival (OS) (5-year OS: 18.2% vs 60.6% , P=0.038) compared with those with wild-type CSF3R. After the second course of chemotherapy, patients with negative MRD had an RFS of 64 months and an OS of not reaching, which was significantly longer than that of patients with positive MRD (15 and 48 months, and the P value were 0.004 and 0.050, respectively) . CSF3R mutations ( HR=0.317, 95% CI 0.129-0.779, P=0.012) , WT1 mutations ( HR=0.304, 95% CI 0.115-0.804, P=0.016) , and NRAS mutations ( HR=0.153, 95% CI 0.061-0.385, P<0.001) were all independently associated with a poor prognosis for RFS, and CSF3R mutations and positive MRD tended to be independently associated with a poor prognosis for OS, according to the results of a Cox proportional-hazards model analysis ( P values were 0.071 and 0.088, respectively) . The patients were divided into three groups based on their CSF3R mutation status and MRD status following treatment: wide-type CSF3R and negative MRD, mutated CSF3R or positive MRD, and mutated CSF3R and positive MRD, which showed significantly different RFS ( P<0.001) and OS ( P=0.006) . Conclusion:Both CSF3R mutations and positive MRD were associated with poor outcome in AML patients with CEBPA double mutations. An integrity model based on these two factors may be beneficial for accurately evaluating the prognosis of these patients.

Incentive system is an indispensable means in the process of standardized residency training, which plays an important role in improving the work efficiency and service quality of residents, teachers and other participants. Based on the analysis of the problems existing in the holistic incentive system, we have implemented a set of personalized incentive measures for the training of residents in department rotation and achieved preliminary results, which provides ideas for exploring personalized incentive system for standardized residency training.

Objective To observe the effects of Tongluo-Jiedu-Huazhuo decoction on hemorheological indexes and gastric juice components in patients with chronic atrophic gastritis.Methods According to the inclusion criteria,84 patients with chronic atrophic gastritis were randomly divided into the observation group and the control group,with 42 cases in each group.The control group received the routine clinical treatment,and the observation group was treated with Tongluo-Jiedu-Huazhuo decoction on the basis of the control group.The clinical symptoms were scored before and after treatment.The blood viscosity,plasma viscosity,hematocrit,fibrinogen and erythrocyte aggregation index were measured bY automatic hemorheology instrument,and gastric juice pH,free acid,pepsin and nitrite levels were measured by serial gastric juice detection method.The clinical efficacy was evaluted.Results The total effective rate of the observation group was 90.5％ (38/42),and the total effective rate of the control group was 76.2％ (32/42),with statistically significant difference (Z=-2.683,P＜0.05).After treatment,the scores of epigastric pain,stomach swelling,nausea and vomiting,acid reflux and dietary deficiency in the observation group were significantly lower than those in the control group (t were 4.865,4.632,4.716,4.582,4.433,respectively,all Ps＜0.05),and the whole blood viscosity,plasma viscosity,hematocrit,fibrinogen and erythrocyte aggregation index were significantly lower than those in the control group (t were 5.044,4.462,5.274,4.231 and 4.485,respectively,all Ps＜0.05).The gastric juice pH (2.28 ± 0.33 vs.2.75 ± 0.38,t=4.825),nitrite (33.27 ± 4.45 mg/L vs.38.80 ± 4.93 mg/L,t=5.136) in the observation group were significantly lower than the control group (P＜0.05).The free acid (22.13 ± 3.36 mmol/L vs.18.65 ± 2.54 mmol/L,t=5.382),pepsin (144.56 ± 15.86 U vs.137.16 ± 14.63 U,t=5.736) in the observation group were significantly higher than the control group (P＜0.05).Conclusions The application of Tongluo-Jiedu-Huazhuo decoction in patients with chronic atrophic gastritis can improve the hemorrheology index and regulate the function of gastric secretion,which is helpful to protect the gastric mucosa and relieve the clinical symptoms.

Objective To observe clinical effect of Huxiang-Yangwei powder combined with conventional western medicine on gastric motility and gastrointestinal hormones in patients with chronic atrophic gastritis. Methods A total of 100 patients with chronic atrophic gastritis according to the inclusion criteria were randomly divided into the observation group and the control group, with 50 cases in each group. The control group was given routine symptomatic treatment. Based on the treatment of control group, the observation group was given Huxiang-Yangwei powder therapy. After 1 month, the gastroscope score, pathological tissue score, gastric motility index (gastric motility rhythm, gastroelectric rhythm and gastric antrum motility), and the improvement of plasma gastrointestinal hormone (MTL, GAS, SS) were compared. Results The total effective rate of the observation group was 92.0% (42/50), and the total effective rate of the control group was 78.0% (39/50), with statistically significant (Z=-2.978, P=0.003). After treatment, the under gastroscope score (0.59 ± 0.06 vs. 1.23 ± 0.17, t=4.877) and the pathological organization score (0.65 ± 0.08 vs. 1.33 ± 0.19, t=5.096) of the observation group were significantly lower than those of the control group (P<0.05). After treatment, the gastric motility rhythm (76.15% ± 8.77% vs. 62.35% ± 7.31%, t=5.301), gastroelectric rhythm (81.02% ± 9.23% vs. 73.02% ± 8.43%, t=5.286), gastric antral motility (0.012 ± 0.002? vs. 0.008 ± 0.001 ?, t=4.160) of the observation group were significantly higher than those of the control group (P<0.05). After treatment, the plasma MTL (246.73 ± 31.82 pg/ml vs. 203.86 ± 27.91 pg/ml, t=5.832), GAS (49.55 ± 6.25 pg/ml vs. 35.81 ± 4.63 pg/ml, t=5.126), SS (17.35 ± 2.76 pg/ml vs. 15.01 ± 2.60 pg/ml, t=4.970) of the observation group were significantly higher than those of the control group (P<0.05). Conclusions The application of Huxiang-Yangwei powder in the treatment of chronic atrophic gastritis patients can repair gastric mucosa, regulate gastrointestinal hormone levels and increase gastric motility.

Objective To explore the effects of acupoint application combined with modified Xiaoqinglong decoction on airway remodeling and serum C-reactive protein (CRP), interleukin-8 (IL-8) and eosinophil chemotactic factor (eotaxin) levels in patients with bronchial asthma. Methods A total of 78 patients with bronchial asthma were randomly divided into two groups, 39 cases each group. The control group was treated with conventional western medicine therapy, and the study group was treated with acupoints plus Xiaoqinglong decoction on the basis of the control group.The treatment effect,adverse reaction were observed, and airway remodeling associated indicators like Transforming growth factor-β1 (TGF-β1), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and serum CRP, IL-8, Eotaxin levels were detected as well. Results After treatment, the clinical asthma control rate was 87.18% (34/39) in the study group and 58.97% (23/39) in the control group, and the difference was statistically significant (χ2=7.885,P<0.05).After treatment,the TGF-β1(6.74 ± 2.21 μmol/L vs.10.90 ± 2.24 μmol/L,t=8.256),VEGF(27.63 ± 5.14 ng/ml vs.35.76 ± 5.82 ng/ml,t=6.539),bFGF(7.15 ± 1.54 μmol/L vs.12.62 ± 2.23μmol/L,t=12.605)in the study group were significantly lower than those of the control group (P<0.05). After treatment, the CRP (9.16 ± 1.85 mg/L vs.16.74 ± 2.20 mg/L,t=16.468),IL-8(51.26 ± 17.25 pg/L vs.114.32 ± 20.15 pg/L,t=14.847),IL-8 (98.59 ± 34.12 pg/ml vs.159.62 ± 52.74 pg/ml,t=6.068)in the study group were significantly lower than those of the control group (P<0.05). There was no significant difference in the incidence of adverse reaction between the study group 20.5%(8/39) and the control group12.8%(5/39) during treatment (χ2=0.831, P>0.05). Conclusions The acupoint application combined with modified Xiaoqinglong decoction can significantly improve the clinical effect, inhibit airway remodeling, decrease the level of serum CRP, IL-8 and Eotaxin in patients with bronchial asthma, and its safety is high.

The formative assessment system has been applied to the internship education for the clinical anesthesia with the aim to improve students' initiative and to evaluate their outcomes more compre-hensively. The students' performance in the shift exchange, case discussion, raising question, solving question at the time points of after the preclinical train, one month and 3 months into the anesthesia internship, and after the completion of internship, and their capability in preoperative patient assessment, condition report, clinical practice, review writing have been evaluated to determine the educational quality and to instruct the improvement of educational approach. Assess process takes into account both the individuality and the gen-eral character of the students and feedbacks the evaluation result to improve the practice teaching The im-plementation of the evaluation can promote students' autonomous learning and comprehensively evaluate students' practice process.

Objective To explore the long-term outcomes and complications of patients with hematological malignancies (HM) after haploidentical donor transplantation (HDT) or siblingidentical donor transplantation (SDT).Methods From June,2011 to July,2016,89 patients with HM receiving allo-HSCT were retrospectively analyzed,including 57 patients undergoing HDT and 32 cases undergoing SDT.Results The median time to achieve neutrophil engraftment was 2 days shorter after HDT than SDT,whereas that of platelet engraftment was 3 days longer after HDT than SDT.The cumulative incidence for 3 to 4 grade acute graft-versus-host disease (GVHD) was not obviously different between HDT and SDT (8.77％ versus 12.5％ respectively;x2 =0.313,P =0.576).The cumulative incidence for chronic GVHD was not significantly different between HDT and SDT (45.6％ versus 37.5％;~ =0.551,P =0.458).Cytomegalovirus (CMV) reactivity was significantly higher in patients after HDT (77.19％) than those after SDT (21.88％) (x2 =25.633,P＜0.001).The occurrence of hemorrhagic cystitis was also obviously higher in patients after HDT (26.32％)than those after SDT (3.85％) (x2 =5.340,P =0.021).The 1-,2-,and 3-year relapse-free survival rate of patients receiving HDT and SDT was 63.9％,55.4％,44.3％ and 71.2％,58.3％,51.8％,respectively (P =0.541).The 1-,2-,and 3-year overall survival rate of patients receiving HDT and SDT was 75.3％,65.3％,52.3％ and 76.9％,62.9％,62.9％,respectively (P =0.777).Conclusion Considering similar incidence of severe GVHD and long-term outcomes,haploidentical donors should be recommended as a potential alternative donor source when an identical donor is lacking for patients with HM.