Objective To quantitatively assess the association of short-term exposure to polycyclic aromatic hydrocarbons (PAHs) in ambient fine particulate matter (PM2.5) with residents mortality. Methods A time-stratified case-crossover study was conducted from 2020 to 2022 among 10606 non-accidental residents by using the Guangzhou Cause of Death Surveillance System in Conghua District, Guangzhou. Exposure levels of PAHs in PM_2.5 and meteorological data during the study period were obtained from the Center for Disease Control and Prevention in Conghua District and the China Meteorological Administration Land Data Assimilation System (CLDAS-V2.0), respectively. Conditional Poisson regression model was used to estimate the exposure-response association between PAHs and the mortality risk. Results Fluoranthene, chrysene, benzo[k]fluoranthene, benzo[a]pyrene, and indeno[1,2,3-cd]pyrene were significantly associated with an increased risk of mortality. For every one interquartile range increase in exposure levels, the non-accidental mortality risks increased by 8.33% (95% CI: 1.80%, 15.27%), 4.67% (95% CI: 1.86%, 7.57%), 6.07% (95% CI: 2.08%, 10.21%), 4.62% (95% CI: 1.85%, 7.47%), and 4.70% (95% CI: 0.53%, 9.03%), respectively. The estimated non accidental deaths attributable to exposure to fluoranthene, chrysene, benzo[k]fluorine, benzo[a]pyrene and indine[1,2,3-cd]pyrene were 5.91%, 6.08%, 6.51%, 6.46%, and 4.21%, respectively. Conclusions Short-term exposure to PAHs in PM_2.5, including fluoranthene, chrysene, benzo[k]fluoranthene, benzo[a]pyrene and indine[1,2,3-cd]pyrene, was significantly associated with an increased risk of mortality among residents.

Objective:To investigate the feasibility of stapled closure of the internal fistula orifice in anal fistula (SCIA) combined with catheter drainage in the extra-sphincteric space in the treatment of high complex anal fistula.Methods:Methods Surgical procedure: Under combined spinal-epidural anesthesia, a submucosal purse-string suture was placed above the dentate line, and the stapler was inserted to close the internal opening. The fistulous tract was dissected from the external opening toward the cranial side and excised along its path to the level of the levator ani muscle, followed by placement of catheter drainage in the extra-sphincteric space.Results:A retrospective analysis was conducted on the clinical data of a 40-year-old male patient with a high-position complex anal fistula, who underwent SCIA combined with catheter drainage in the extra-sphincteric space at the Department of Colorectal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine in December 2024. The surgery was successful with minimal intraoperative bleeding, a complete anastomosis, and thorough fistula tract dissection. There was no sphincter injury occurred, and the catheter drainage was unobstructed. The patient was discharged on postoperative day 8. Postoperative follow-up visits were conducted at 2 months and 6 months after surgery. The patient had no symptoms such as pain, purulent discharge, or pruritus. MRI scans of the anal canal (both plain and contrast-enhanced) at 2 months and 6 months showed no recurrence of the fistula. The Wexner fecal incontinence score was 0, indicating normal bowel control, and the Garg score was less than 8, suggesting fistula healing and low probability of recurrence.Conclusion:SCIA combined with catheter drainage in the extra-sphincteric space is a safe and feasible procedure for the treatment of high complex anal fistula.

Objective:To investigate the feasibility of stapled closure of the internal fistula orifice in anal fistula (SCIA) combined with catheter drainage in the extra-sphincteric space in the treatment of high complex anal fistula.Methods:Methods Surgical procedure: Under combined spinal-epidural anesthesia, a submucosal purse-string suture was placed above the dentate line, and the stapler was inserted to close the internal opening. The fistulous tract was dissected from the external opening toward the cranial side and excised along its path to the level of the levator ani muscle, followed by placement of catheter drainage in the extra-sphincteric space.Results:A retrospective analysis was conducted on the clinical data of a 40-year-old male patient with a high-position complex anal fistula, who underwent SCIA combined with catheter drainage in the extra-sphincteric space at the Department of Colorectal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine in December 2024. The surgery was successful with minimal intraoperative bleeding, a complete anastomosis, and thorough fistula tract dissection. There was no sphincter injury occurred, and the catheter drainage was unobstructed. The patient was discharged on postoperative day 8. Postoperative follow-up visits were conducted at 2 months and 6 months after surgery. The patient had no symptoms such as pain, purulent discharge, or pruritus. MRI scans of the anal canal (both plain and contrast-enhanced) at 2 months and 6 months showed no recurrence of the fistula. The Wexner fecal incontinence score was 0, indicating normal bowel control, and the Garg score was less than 8, suggesting fistula healing and low probability of recurrence.Conclusion:SCIA combined with catheter drainage in the extra-sphincteric space is a safe and feasible procedure for the treatment of high complex anal fistula.

OBJECTIVE To explore the role of the establishment of the trans-regional review system on rational drug use in second-grade general hospital ，and to promote the rational drug use. METHODS With the administrative support of Jiuquan Health Commission，5 second-grade general hospitals in Jiuquan Medical Association jointly established Jiuquan Rational Drug Use Review Training Center . A trans-regional review system was established to carry out cross-review of prescriptions and medical orders among 5 second-grade general hospitals. Totally 1 500 prescriptions and 900 medical records were collected from 5 second-grade general hospitals before （April to June ，2020）and after （July to September ，2020）the implementation of the project. The changes of rational drug use indicators ，the results of prescriptions and medical order review were investigated before and after the implementation of the project. RESULTS After the implementation of the project ，except for one hospital ，the proportion of drugs in other hospitals decreased to varying degrees with the highest decline rate of 22.56％ . Compared with before the implementation of the project ，reasonable rate of outpatient and emergency prescription review increased by 5.72％ averagely and the reasonable rate of medical order review increased by 10.10％（P＜0.05）. The average utilization rate of antibiotics in outpatients decreased by 14.45％，the average utilization rate of antibiotics in inpatients decreased by 7.98％，and the average use intensity of antibiotics decreased by 25.19％. CONCLUSIONS Through the establishment of trans-regional review system ，medical institutions can be forced to pay more attention to prescription review ，effectively improve the prescription review of pharmacists in medical institutions，and promote the rational use of drugs in medical institutions in the region. However ，there are still some problems ， such as incomplete system coverage ，insufficient work experience ，lagging of informatization ，uneven pharmacist level ，and insufficient assessment and supervision of administrative functional departments.

Objective:To explore application value of dance movement therapy in the chemotherapy of young and middle-aged patients with breast cancer, so as to provide reference for rehabilitation nursing.Methods:By convenient sampling method, 90 young and middle-aged female breast cancer patients during chemotherapy from June 2020 to June 2021 in Renmin Hospital of Wuhan University were enrolled in the present study. They were assiged to experimental group and control group with 45 cases in each group according to the enrolled ward. The control group received routine nursing and the experimental group received 4 cycles of dance movement therapy. Before and after intervention, the effects were assessed by Cancer Fatigue Scale (CFS) and Patient-Generated Subjective Global Assessment (PG-SGA) as well as biochemical nutrition indexes.Results:After intervention, the physical fatigue score, emotional fatigue score, cognitive fatigue score and total CFS score were (8.29 ± 3.58), (7.74 ± 1.68), (5.57 ± 1.11), (21.59 ± 4.41) points in the experimental group, which were significantly lower than (9.86 ± 3.49), (8.95 ± 2.62), (6.27 ± 1.70), (25.09 ± 4.33) points in the control group ( t values were 2.07-3.71, all P<0.05). After intervention, the PG-SGA score was (2.81 ± 0.71) points in the experimental group, which was significantly lower than (3.29 ± 1.15) points in the control group ( t=2.37, P<0.05). Conclusions:Dance movement therapy can alleviate the cancer related fatigue and promote nutritional status of young and middle-aged female breast cancer patients with chemotherapy.

OBJECTIVE： To investigate the effects of Dendrobium officinale polysaccharides on gene expression profile of HUVEC. METHODS： HUVEC was selected as objects. MTS method was used to detect the effects of different doses of D. officinale polysaccharides （50， 100， 200， 400， 800 μg/mL） on the proliferation activity of HUVEC. The growth inhibitory concentration of 30％ cells （IC30） was calculated to screen the dose of follow-up tests. cDNA microarray assay was used to detect the changes of gene expression profile for HUVEC after treated with D. officinale polysaccharides for 24 h， so as to screen differentially expressed genes. GO enrichment analysis and KEGG pathway enrichment analysis were performed for top 5 differentially expressed genes by using DAVID bioinformatics resource database. Real-time fluorescence quantitative polymerase chain reaction （qRT-PCR） was used to validate the results of microarray detection with immunity-related differentially expressed genes as objects. RESULTS： After treated with 100， 200， 400， 800 μg/mL D. officinale polysaccharides， survival rate of HUVEC  were decreased significantly （P＜0.05 or P＜0.01）. IC30 value was 408 μg/mL. After treated with 400 μg/mL （by IC30） D. officinale polysaccharides， there were 91 differentially expressed genes in HUVEC cells， of which 84 were up-regulated and 7 were down-regulated. Top 5 genes of up-regulated and down- regulated expression were SELE， CCL2， CXCL6， IL8， ICAM1 as well as VWCE， CPT1A， CLU， CCL14， CINS4， which may be mainly associated with immune conditions and inflammatory responses. The differentially expressed genes mainly distributed in extracellular domain， and were enriched in biological processes such as production and response of cytokines and stimulus response， and played molecular functions such as chemokine and its receptor activity. The up-regulated genes as SELE， ICAM1 and CXCL2 were mainly enriched in TNF signaling pathway， influenza A （H1N1）， herpes simplex virus infection and other pathways. The down-regulated gene CCL14 was mainly enriched in chemokine signaling pathway. Results of qRT-PCR validation tests showed that relative expression of ICAM1 was increased significantly， while that of CCL14 was decreased significantly （P＜0.05）， which was in agreement with microarray detection results. CONCLUSIONS： After treated with D. officinale polysaccharides， the expression of 91 genes in HUVEC cells are different significantly， mainly being up-regulated. The differentially expressed genes may participate in immune regulation through TNF signaling pathway， influenza A （H1N1） and herpes simplex virus infection.

Objective To investigate the expression of miR-30d in breast cancer tissues and demonstrate the regula-tive effects of miR-30d ASO on the invasion and migration of breast cancer cells in vitro. Methods The expression levels of miR-30d in 108 breast cancer tissues and their adjacent tissues were detected by real-time quantitative PCR method. Af-ter transfection with miR-30d ASO, the biological effects of miR-30d on in breast cancer cells was measured by transwell as-say and wound healing assay. The expressions of matrix metalloproteinase (MMP)-2 and MMP-9 were analyzed by Western blot assay. Results The expression level of miR-30d was found to be over-expressed in breast cancer tissues(P<0.05). Compared with control group and nonsense interference group, the miR-30d expression was significantly decreased in breast cancer cells(transfection with miR-30d ASO). Results of transwell and wound healing assay showed that the invasion and mi-gration ability decreased significantly after transfection with miR-30d ASO, and expressions of MMP-2 and MMP-9 were down-regulated (P<0.05). Conclusion miR-30d was over-expressed in human breast cancer. The invasion and migration of breast cancer cells can be effectively inhibited by decreasing the expression of miR-30d. miR-30d may become a new tar-get for the regulation of invasion and migration in breast cancer.

Objective To study the impact of the thymosin alpha 1 on the toxicity and celluar immune function during neoadjuvant chemotherapy of breast cancer.Methods 83 patients of Ⅱ b-Ⅲ a stage breast cancer were randomly divided into two groups:study group(40 patients,neoadjuvant chemotherapy of CEF combined with thymosin α 11.6mg HQD) and control group(43 cases,neoadjuvant chemotherapy of CEF alone).Results Rates of gastrointestinal reaction and bone marrow depression in study group were significantly lower than those in control group.The levels of CD3,CD4,CD4/CD8 and NK in study group were significantly higher than those in control group after chemotherapy.Conclusion The combination of thymosin alpha 1 and neoadjuvant chemotherapy for breast cancer can reduce the toxicity,improve the tolerance,enhance cellular immune function and improve the quality of breast cancer patient's life.

Objective: To establish a female SPF BALB/c mouse model of antibiotic-associated intestinal microflora disturbance and analyze the effect of lactobacillus acidophilus.Methods: Female SPF BALB/c mice were treated with ceftriaxone in drinking water for five days,and followed by oral gavage of sodium chloride as natural recovery group or lactobacillus acidophilus(108CFU/mL) as therapeutic group.After seven days the intestinal microflora of the cecum content was abstracted and computed by plate counts and 16S rDNA-based PCR-DGGE method.Results: Plate counts indicated that the number of original bacterium lacticum and bacillus bifidus decreased significantly and enterococci proliferated abnormally after antibiotic treatment.After lactobacillus acidophilus treatment,the number of physiological bacteria and enterococci go back to normal levels.DGGE profile clearly indicated that the dominant bacteria changed and the bacterial diversity of intestinal microbiota was obviously decreased in the antibiotics treated group. Conclusion: Oral gavage of lactobacillus acidophilus has adjustment effect on Ceftriaxone induced intestinal microbiota disturbance.PCR-DGGE is a rapid、effective molecule method to reveal the whole microbiota status.