Objective:To investigate the molecular mechanism by which 2',4'-dihydroxychalcone(D2)inhibits proliferation,migration,and epithelial-mesenchymal transition(EMT)in colorectal cancer cells through miR-7-5p-mediated autophagy.Methods:Human colorectal cancer cell lines HCT-15 and SW620 were treated with D2 at concentrations of 0,12.5,25,and 50 μmol/L.Cell proliferation and clonogenic capacity were evaluated using MTT and colony formation assays.Cell migration was assessed by wound healing and Transwell assays.WB assay was used to detect the expression of EMT-related proteins,autophagy-related proteins,and key components of the PI3K/AKT/mTOR pathway.Autophagosome formation was visualized by immunofluorescence staining.TCGA database and KEGG pathway analyses were performed to evaluate miR-7-5p expression and its association with colorectal cancer.RT-qPCR was used to quantify miR-7-5p expression,and lentiviral transduction was employed to establish stable miR-7-5p knockdown or overexpression cell lines.Results:D2 significantly inhibited colorectal cancer cell proliferation,migration,and EMT(P<0.05 or P<0.01).TCGA and KEGG analyses revealed that miR-7-5p expression was downregulated in colorectal cancer and closely associated with disease progression.D2 treatment(12.5,25,and 50 μmol/L)significantly upregulated miR-7-5p expression in HCT-15 and SW620 cells(P<0.01).At 25 μmol/L,D2 increased the expression of autophagy-related proteins(LC3 and p-ULK1)and inhibited the PI3K/AKT/mTOR signaling pathway(P<0.05),accompanied by increased autophagosome formation(P<0.01).In miR-7-5p-knockdown cells treated with D2,the levels of LC3 and p-ULK1 were significantly reduced compared to D2-only treated cells(P<0.05 or P<0.01).Conclusion:D2 upregulates miR-7-5p to induce autophagy,thereby inhibiting colorectal cancer cell proliferation,migration,and EMT,possibly through suppression of the PI3K/AKT/mTOR signaling pathway.

Cinnamomi Ramulus and Alismatis Rhizoma are commonly used in the treatment of external-contraction diseases. Cinnamomi Ramulus is pungent， sweet， and warm， with the effects of ventilating lung and dispersing cold， warming Yang and transforming Qi， and promoting water and liquid flow from Taiyang meridian to remove dampness. Alismatis Rhizoma is sweet and cold， with the effects of draining dampness and promoting urination， regulating the waterway， removing water retention in lung， and promoting urination to remove dampness and heat. Herbal pairs are extracted from the accumulated experience of medical practitioners over the ages in the use of medicines and have been proved by clinical application to be composed of simple and effective combinations for specific diseases. The herb pair Cinnamomi Ramulus-Alismatis Rhizoma is an important part in ancient classic formulas such as Wulingsan. Both herbs play a role in draining dampness and promoting urination， warming Yang and transforming Qi， being a representative herb pair used for treating external-contraction exterior syndrome and water retention inside. The review of ancient medical publications revealed that there were a large number of compound formulas containing Cinnamomi Ramulus-Alismatis Rhizoma for dispersing cold and removing dampness， which were widely used for thousands of years in clinical practice. Modern pharmacological studies have shown that the active pharmacological components of Cinnamomi Ramulus （cinnamaldehyde and cinnamic acid） and Alismatis Rhizoma （alisol A and 23-acetate alisol B） have anti-inflammatory， antiviral， and immunoregulatory effects and high safety. Qingfei Paidu decoction containing this herbal pair played an important role in fighting against COVID-19. Despite the extensive pharmacological studies on Cinnamomi Ramulus and Alismatis Rhizoma， few studies have been carried out regarding this herb pair. This paper summarizes the traditional Chinese medicine knowledge about Cinnamomi Ramulus and Alismatis Rhizoma in the treatment of external-contraction diseases and summarizes the chemical composition， pharmacological effects， toxicology and other aspects of the two herbs before and after compatibility， aiming to provide a reference for further research and clinical application.

Background A number of studies have shown that heavy metals in atmospheric PM_2.5 have impacts on human health, while studies on the impact of long-term and low-concentration exposure to lead in PM_2.5 on human health are limited. Objective To investigate the pollution characteristics of lead in ambient PM_2.5 and assess its chronic health risks. Methods Daily PM_2.5 concentration data in Jinan from 2014 to 2019 were collected, and the year-by-year trend of PM_2.5 concentration was analyzed. Licheng District (an industrial area) and Shizhong District (a residential area) were elected to install an ambient PM_2.5 monitoring stationrespectively. The sampling instrument was a 100 L·min⁻¹ high-flow PM_2.5 sampler, with a cumulative sampling time of 20-24 h per day, using a quartz fiber filter membrane for lead detection and a glass fiber filter membrane for PM_2.5 determination. The sampling frequency was 7 consecutive days per month from the 10^th to the 16^th (A total of 493 d were sampled and some were missing; 172 d during the heating period and 321 d during the non-heating period). Two PM_2.5 samples were collected in one monitoring site each day. A total of 986 samples were collected in one monitoring site. The lead content in PM_2.5 samples was detected by inductively coupled plasma mass spectrometry. The concentration of PM_2.5 was measured by weighing method. The annual average concentration and enrichment factor of lead in PM_2.5, the change trend of lead content per unit mass of PM_2.5, and the difference between heating period and non-heating period from 2014 to 2019 were estimated. Technical guide for environment health risk assessment of chemical exposure (WS/T 777-2021) was used to assess the health risks of exposure to lead in PM_2.5. Results The average annual concentration of lead in PM_2.5 ranged from 23.2 ng·m⁻³ to 154.7 ng·m⁻³. The average concentration in heating period from 2015 to 2019 was higher than that in non-heating period, and the differences in 2015, 2017, and 2019 were statistically significant (P < 0.01 or 0.001). The enrichment factors ranged from 200 to 1342 in 2014 to 2019. The average enrichment factors in heating period in 2015, 2017, and 2018 was higher than those in non-heating period, and the difference was statistically significant (P < 0.05 or 0.001). The lead contents per unit mass of PM_2.5 ranged from 493 ng·mg⁻¹ to 1944 ng·mg⁻¹, and the differences between heating period and non-heating period in 2014, 2017, and 2018 were statistically significant (P < 0.05 or 0.001). The average annual concentration and enrichment factor of lead in PM_2.5 showed a downward trend, and thus the lead content per unit mass of PM_2.5 also decreased. From 2014 to 2019, the carcinogenic risk of lead in PM_2.5 in Jinan ranged from 1.69×10⁻⁸ to 2.45×10⁻⁶, showing a significant downward trend year by year, and the 95^th percentile decreased by 3%-46% from the previous year. The carcinogenic risk level of lead was reduced to an acceptable level (<1×10⁻⁶) after 2017. Conclusion From 2015 to 2019, lead concentration and enrichment factor in PM_2.5 increase during heating period compared with non-heating period, but it is not completely consistent of lead content in PM_2.5 per unit mass. From 2014 to 2016, exposure to lead in PM_2.5 may elevate carcinogenic risk to human. After 2017, the carcinogenic risks of exposure to lead in PM_2.5 are at an acceptable level.

Objective:To explore the clinical effect of positive reinforcement theory nursing intervention in the rehabilitation treatment of patients with cervical spondylosis and its influence on cervical function and quality of life.Methods:From March 2017 to May 2020, 94 patients who received rehabilitation after anterior cervical decompression surgery were selected as the research samples. They were divided into the control group and the study group by random digits table method with 47 cases in each group. The control group was given routine nursing care, and the study group received positive reinforcement theoretical nursing intervention on the basis of the control group.The nursing effect,cervical vertebra function and quality of life before and after nursing were evaluated by Visual Analogue Scale(VAS), Japanese Orthopaedic Association assesses treatment(JOA) score, SF-36. The nursing satisfaction rate was evaluated by questionnaire.Results:The JOA score, quality of life score and VAS score of the study group before nursing were (7.57 ± 1.35), (56.78 ± 5.62), (6.53 ± 0.34) respectively, while those of the control group were (7.32 ± 1.27), (56.32 ± 5.31), (6.32 ± 0.31) respectively, and there was no significant difference between the two groups ( P > 0.05). The JOA score and quality of life score of the study group after nursing were (15.73 ± 0.33) and (91.67 ± 2.34) respectively, which were higher than those of the control group (12.18 ± 0.46) and (83.43 ± 3.33) respectively. The VAS score of the study group after nursing was (2.33 ± 0.11) and lower than that of the control group (4.53 ± 0.25). The differences were statistically significant ( t values were 3.47, 5.43, 4.67, P< 0.05). Compared with the control group, the nursing satisfaction rate of the study group was higher than that of the control group (85.11%, 40/47 vs. 97.87%,46/47, χ2 value was 4.92, P < 0.05). Conclusions:Positive reinforcement theory nursing intervention can effectively relieve the pain symptoms of patients, improve the cervical function, and effectively improve the quality of life.

Objective:To study the effect of comprehensive nursing combined with cervical spine health care on postoperative psychological status and the prevention of various complications of patients with cervical spine surgery.Methods:A total of 102 patients who underwent cervical spine surgery in Dalian Third People′s Hospital from June 2018 to February 2020 were selected as the research objects. The patients were randomly divided into a control group and an experimental group. The control group was given routine care, and the experimental group was given comprehensive care combined with cervical spine for health care intervention, the main observation indicators included the mental state of the two groups of patients, the incidence of postoperative complications, and the patients' satisfaction with nursing work.Results:After comprehensive nursing combined with cervical health care intervention, the SAS score of the control group was 50.14±3.51 and the SAS score of the experimental group was 30.27±1.12. The SAS score of the control group was significantly higher than that of the experimentalgroup ( t value was 24.134, P< 0.05); the SDS score of the control group was 50.45±1.11, the SDS score of the experimental group was 39.45±2.21, the SDS score of the control group was significantly higher than that of the experimental group ( t value was 20.293, P<0.05), the difference was statistical significance: Compared with the control group (27.45%,14/51), the incidence of postoperative complications (9.80%,5/51) in the experimental group was significantly reduced ( χ2 value was 10.409, P<0.05); the nursing attitude of the patients to nursing staff (91.11± 5.32), nursing quality (90.41±2.30), nursing responsibility (92.82±4.69) in the experimental group were all significantly higher than those of the control group (80.67±3.51, 80.21±4.43, 80.78±4.82), the difference was statistically significant ( t value was 9.151, 14.671, 16.124, P<0.05). Conclusion:Rehabilitation nursing intervention of comprehensive nursing combined with cervical spine health care can improve mental state, reduce incidence of complication and increase satisfaction degree for patients undergoing cervical spondylopathy surgery, which is worthy of further clinical application and promotion.

Objective:To analyze the effect of Maixuekang Capsule on the treatment outcome of coronary heart disease (CHD) by propensity score.Methods:Based on the electronic medical record database of 22 large-scale tertiary hospitals nationwide, this study matched the coronary heart disease patients using and not using Maixuekang capsule according to a certain standard (1∶1). After matching, there were 2 464 cases in the patients group (group A) and the patients group (group B). In the database, the recombination of " recovery" and " improvement" is defined as effective treatment, and " invalid" , " death" and " other" are combined as ineffective treatment population. The effectiveness of the two groups after the re combination is compared by propensity score.Results:The results of χ 2 test showed that the difference between the two groups was statistically significant ( P<0.05) without controlling the confounding factors, and the treatment effect of group A was better than that of group B. In order to further observe the difference between the two groups, three logistic regression analysis methods were used to analyze, which showed that the regression coefficient was >0, and there was statistical significance ( P<0.01). Conclusions:The therapeutic effect of Maixuekang capsule on coronary heart disease is higher than that of patients without the drug.

Objective To estimate the value of multi-modal guiding in transrectal ultrasound-guided prostate targeted biopsies (TB) in the biopsy naive patients.Methods From June 2016 to December 2017,178 patients with suspicious prostate cancer were retrospectively evaluated.The age of patients was 54-87 years(median 70 yesrs).Serum PSA level before biopsy was 1.5-95.0 ng/ml (median 13.2 ng/ml),in which 70 cases with PSA ＜ 10 ng/ml,58 cases 10-20 ng/ml,and 50 cases ＞ 20 ng/ml.All patients underwent transrectal ultrasound (TRUS),real-time tissue elastography (RTE) and contrast-enhanced ultrasonography(CEUS).All positive sites on imaging undergoing two-core TB and 10 core-systematic biopsy (SB).The detection rates and positive rates of biopsy for any cancer (PCa) and clinically significant prostate cancer (CsPCa) were compared between TB and SB.Pathological findings of each biopsy core was analyzed for Gleason grade and the single-core length of prostate cancer.Results The total detection rate for PCa was 48.8％ (87/178).The diagnostic accuracy of PCa did not significantly differ between TB 35.5％ (63/178) and SB 42.8％ (76/178) groups.There was no significant difference between the proportion of CsPCa in TB group and SB group [80％ (50/63) vs.66％ (50/76),P =0.21].TB had an obvious higher single-core positive rate for prostate cancer 60.6％ (449/740) and an obvious higher singlecore positive rate for high-risk prostate cancer [10.3％ (76/740)] than SB [29.7％ (530/1 780) and 5.5 ％ (98/1 780)],with statistically signficant difference (P ＜ 0.001,P =0.002).TB also had a higher single-core length of prostate cancer than SB [6.80 (0.20-15.00) mm vs.5.50 (0.06-18.00) mm,P ＜0.05].Conclusions This study revealed a similar rate of prostate cancer detection between multi-modal guiding in transrectal ultrasound-guided prostate targeted biopsies (TB) and 10 core-systematic biopsy (SB).TB maybe tend to detect higher proportion of high-risk PCa.

OBJECTIVE: To study the biological exposure limit of 1,3-butadiene occupational exposure. METHODS: A total of 139 workers who exposed to 1,3-butadiene in a rubber plant was chosen as exposure group,and 45 workers without 1,3-butadiene exposure were chosen as control group by judgment sampling method. Gas chromatography-flame ionization detection method was used to detect the level of 1,3-butadiene in workplace air,and ultra-high performance liquid chromatography-tandem mass spectrometric was used to determine the level of urinary dihydroxybutyl mercapturic acid( DHBMA) in end-of-shift workers. The correlation between 1,3-butadiene level and urinary DHBMA level was analyzed.The biological limit of 1,3-butadiene occupational exposure was assessed. RESULTS: The range of concentration-time weighted average( C_(TWA)) of 1,3-butadiene was from 0. 004 to 7. 609 mg/m~3,the medium was 0. 253 mg/m~3 in the exposure group,while the level of urinary DHBMA was from 0. 171 to 4. 235 mg/g Cr,and the medium was 1. 220 mg/g Cr. The range of C_(TWA)of 1,3-butadiene was below detection limit in the control group. The level of urinary DHBMA was from 0. 157 to 1. 808 mg/g Cr,and the medium was 0. 627 mg/g Cr in the control group. The level of urinary DHBMA in the exposure group was higher than that of the control group( P < 0. 01). The level of urinary DHBMA( y) of workers was related to the level of 1,3-butadiene( x) of the workplace air in the exposure group( y = 0. 349 x + 1. 082,P < 0. 01).CONCLUSION: DHBMA in urine could be used as a biomarker for 1,3-butadiene exposure in workers. The recommended biological exposure limit of DHBMA is 2. 900 mg/g Cr.

Background:Erythrocytosis,a rare paraneoplastic syndrome,generally occurs in patients with clear cell renal cell carcinoma and has never been reported in patients with chromophobe renal cell carcinoma.Case presentation:We report a case of a young man suffering from a giant (22-cm) mass on his left kidney.Because of a history of polycythemia vera,the patient had been treated for the condition for 9 years.Radical nephrectomy was successfully performed,and the postoperative pathologic examination confirmed a diagnosis ofchromophobe renal cell carcinoma.Unexpectedly,the symptom of erythrocytosis disappeared after the surgery.Further examination and analysis were performed,and we finally attributed his erythrocytosis to chromophobe renal cell carcinoma.Conclusions:Chromophobe renal cell carcinoma could cause erythrocytosis,but the clear-cut mechanism needs further research.Secondary erythrocytosis such as those related with renal tumors should be taken into consideration during the diagnosis of polycythemia vera.