Objective: To observe the clinical efficacy and safety of Yiqi Tongluo Decoction in the intervention of early traditional Chinese medicine (TCM) syndromes after ischemic cerebrovascular disease (ICVD) intervention. Methods: From October 2020 to July 2023, a randomized, double-blind, placebo-controlled study was conducted to include 60 patients with qi deficiency, blood stasis, and phlegm obstruction syndrome after ICVD interventional therapy. They were assigned to the Yiqi Tongluo Decoction treatment group (30 cases) and the TCM placebo routine treatment control group (30 cases) according to the randomized block design. Both groups received routine standardized treatment of Western medicine, including dual antiplatelet, lipid regulation, and control of risk factors for cerebrovascular disease. The treatment group was treated with Yiqi Tongluo Decoction based on the control group. The course of treatment was 60 days and follow-up was carried out 2 and 6 months after the operation. The improvement of qi deficiency syndrome, blood stasis syndrome, phlegm syndrome score and TCM syndrome score, modified Rankin score (mRS), Barthel index (BI) score, Fatty acid-binding protein 4 (FABP4) level, incidence of transient ischemic attack (TIA) and ischemic stroke (IS) and incidence of adverse reactions, Head and neck CT angiography (CTA) or digital subtraction angiography (DSA) examination were collected. The clinical efficacy of the patients 2 months after the operation was taken as the main outcome index to preliminarily evaluate the early and long-term efficacy of Yiqi Tongluo Decoction after the ICVD intervention. The early and long-term clinical efficacy and safety of Western medicine standardized treatment combined with TCM Yiqi Tongluo Decoction on patients with qi deficiency, blood stasis and phlegm obstruction syndrome after ICVD intervention were evaluated. The safety of Yiqi Tongluo Decoction in the treatment of patients after ICVD intervention with white blood cell (WBC), C-reactive protein (CRP), fibrinogen (FIB), plasminogen time (PT), recurrence of cerebral ischaemia and restenosis in patients at 2 and 6 months after treatment were evaluated. Results: Compared to the control group, the TCM syndrome scores for qi deficiency, blood stasis and phlegm syndrome in the treatment group reduced significantly, the clinical efficacy improved significantly, the mRS score and FABP4 were reduced, and the BI score was increased. Adverse events such as cerebral ischaemia were fewer in the treatment group than in the control group, but the difference was not statistically significant; levels of CRP, WBC and PT were reduced, and levels of FIB were reduced at 6 months post-treatment, all P<0.01, and images were intuitively compared. The treatment group was superior to the control group. Conclusion Yiqi Tongluo Decoction combined with Western medicine standard treatment can improve the early clinical efficacy of ICVD patients with qi deficiency, blood stasis and phlegm obstruction syndrome after interventional surgery, improve neurological impairment and daily living ability, reduce the state of qi deficiency syndrome, blood stasis syndrome and phlegm syndrome after interventional surgery, and improve the clinical efficacy of TCM. At the same time, it can reduce the level of FABP4, the target of atherosclerosis and restenosis after interventional surgery, reduce the level of inflammation after interventional surgery in patients with ICVD, regulate coagulation function, and reduce the incidence of long-term recurrence of cerebral ischemia after interventional surgery, with good safety.

OBJECTIVE: To explore the correlation between albumin (Alb) combined with diuretic treatment and the mortality risk of septic patients with pre-existing congestive heart failure based on the United States Critical Care Medical Information Database-IV (MIMIC-IV), and to conduct the external validation. METHODS: A retrospective cohort study was conducted. The clinical data of septic patients with pre-existing congestive heart failure admitted to the intensive care unit (ICU) from 2008 to 2019 in the MIMIC-IV 2.0 were extracted, including demographic characteristics, comorbidities, laboratory indicators on the first day of ICU admission, severity of illness, treatment measures, etc. For external validation, clinical data were collected from septic patients with pre-existing congestive heart failure admitted to the ICU of the Second People's Hospital of Shenzhen from October 2022 to December 2023. The patients were divided into Alb alone group and Alb combined with diuretic group. The ICU mortality was defined as the primary outcome event, and the 30-day and 60-day mortality were defined as the secondary outcomes. Multivariate Cox proportional hazard regression analysis was conducted to investigate the relationship between Alb combined with diuretic treatment and the mortality risk of ICU and 30 days in septic patients with pre-existing congestive heart failure, and subgroup analysis was performed. Kaplan-Meier survival curve was plotted to compared the 60-day cumulative survival rate between the Alb alone group and Alb combined with diuretic group. RESULTS: (1) Analysis results of data from MIMIC-IV: a total 1 754 patients were enrolled, of which 378 in the Alb alone group, and 1 376 in the Alb combined with diuretic group. Compared with the Alb alone group, the patients in the Alb combined with diuretic group had significantly lower ICU, 30-day, and 60-day mortality [ICU mortality: 19.11% (263/1 376) vs. 30.42% (115/378), 30-day mortality: 18.90% (260/1 376) vs. 32.54% (123/378), 60-day mortality: 24.49% (337/1 376) vs. 39.15% (148/378), all P < 0.05]. Based on the multivariate Cox proportional hazard regression adjusted models considering demographic characteristics, comorbidities, laboratory indicators, severity of illness, and treatment measures, it was shown that the use of Alb combined with diuretic was significantly associated with a reduced risk death of ICU and 30 days [ICU mortality risk: hazard ratio (HR) = 0.597, 95% confidence interval (95%CI) was 0.460-0.774, P < 0.001; 30-day mortality risk: HR = 0.557, 95%CI was 0.433-0.716, P < 0.001]. Subgroup analysis revealed that after adjusting for variables, regardless of gender, age, and whether or not patients had comorbidities such as hypertension, diabetes, severe liver disease, acute renal insufficiency, and sequential organ failure assessment (SOFA) score, the ICU mortality risk was significantly reduced in patients treated with Alb combined with diuretic (all HR < 1, P < 0.05), with no interaction observed (all P > 0.05). Kaplan-Meier survival curve showed the 60-day cumulative survival rate of patients in the Alb combined with diuretic group was significantly higher than that in the Alb alone group (Log-rank test: χ ² = 49.62, P < 0.05). (2) External validation: a total of 385 patients were enrolled, of which 144 in the Alb alone group, and 241 in the Alb combined with diuretic group. Compared with the Alb alone group, the patients of the Alb combined with diuretic group had significantly lower ICU, 30-day, and 60-day mortality [ICU mortality: 19.92% (48/241) vs. 31.25% (45/144), 30-day mortality: 19.09% (46/241) vs. 28.47% (41/144), 60-day mortality: 24.07% (58/241) vs. 34.03% (49/144), all P < 0.05]. The results of multivariate Cox proportional hazard regression analysis, subgroup analysis, and Kaplan-Meier survival curve analysis were consistent with the data analysis of the MIMIC-IV database. CONCLUSIONS Combination therapy of Alb and diuretic was associated with reduced mortality risk in septic patients with pre-existing congestive heart failure.
Humans ; Heart Failure/mortality* ; Retrospective Studies ; Sepsis/drug therapy* ; Intensive Care Units ; Diuretics/therapeutic use* ; Male ; Female ; Aged ; Middle Aged ; Proportional Hazards Models ; Hospital Mortality

Objective:The nasal swell body（NSB） consists of the nasal septal cartilage, nasal bone, and swollen soft tissue, all of which are visible during endoscopic and imaging examinations. Although the function of the NSB remains uncertain, there is evidence to suggest that it plays a vital role in regulating nasal airflow and filtering inhaled air. Based on anatomical and histological evidence, it is hypothesized that the NSB is indispensable in these processes. This study aims to investigate the impact of NSB on nasal aerodynamics and the deposition of allergen particles under physiological conditions. Methods:The three-dimensional （3D） nasal models were reconstructed from computed tomography （CT） scans of the paranasal sinus and nasal cavity in 30 healthy adult volunteers from Northwest China, providing basis for the construction of models without NSB following virtual NSB-removal surgery. To analyze the distribution of airflow in the nasal cavity, nasal resistance, heating and humidification efficiency, and pollen particle deposition rate at various anatomical sites, we employed the computed fluid dynamics（CFD） method for numerical simulation and quantitative analysis. In addition, we created fully transparent segmented nasal cavity models through 3D printing, which were used to conduct bionic experiments to measure nasal resistance and allergen particle deposition. Results:①The average width and length of the NSB in healthy adults in Northwest China were （12.85±1.74） mm and （28.30±1.92） mm, respectively. ②After NSB removal, there was no significant change in total nasal resistance, and cross-sectional airflow velocity remained essentially unaltered except for a decrease in topical airflow velocity in the NSB plane. ③There was no discernible difference in the nasal heating and humidification function following the removal of the NSB; ④After NSB removal, the deposition fraction（DF） of Artemisia pollen in the nasal septum decreased, and the DFs post-and pre-NSB removal were（22.79±6.61）% vs （30.70±12.27）%, respectively; the DF in the lower airway increased, and the DFs post-and pre-NSB removal were（24.12±6.59）% vs （17.00±5.57）%, respectively. Conclusion:This study is the first to explore the effects of NSB on nasal airflow, heating and humidification, and allergen particle deposition in a healthy population. After NSB removal from the healthy nasal cavities: ①nasal airflow distribution was mildly altered while nasal resistance showed no significantly changed; ②nasal heating and humidification were not significantly changed; ③the nasal septum's ability to filter out Artemisia pollen was diminished, which could lead to increased deposition of Artemisia pollen in the lower airway.
Adult ; Humans ; Cross-Sectional Studies ; Nasal Cavity/surgery* ; Allergens ; Pollen ; Artemisia ; Hydrodynamics

Objective:To investigate the role of miR-144-3p in cisplatin resistance of bladder cancer.Methods:Bladder cancer T24 cells were cultured in vitro and divided into blank group (untreated), mimetic control group, miR-144-3p mimetic transfection group, inhibitor control group, and miR-144-3p inhibitor transfection group. Real time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to verify the transfection effect, methyl thiazolyl tetrazolium (MTT) method was used to detect the survival rate of cells treated with cisplatin in each group, and Western blot was used to detect the expression of the target protein. The targeting relationship between miR-144-3p and nuclear factor E2 related factor 2 (Nrf2) was validated using dual fluorescence reporter gene experiments. Furthermore, Nrf2 was knocked out in each group of cells, and the mRNA and protein expression levels of HO-1, Bcl-2, and Caspase-3 were detected by qRT-PCR and Western blot in each group of cells.Results:Compared with the control group, bladder cancer cells in the miR-144-3p mimetic transfection group were more sensitive to cisplatin, while the miR-144-3p inhibitor transfection group had the opposite effect; The miR-144-3p simulant transfection group can effectively inhibit the mRNA and protein expression level of Nrf2 in bladder cancer cells (all P<0.05), while the miR-144-3p inhibitor transfection group can up regulate the mRNA and protein level of Nrf2 (all P<0.05). The miR-144-3p mimetic transfection group showed significant downregulation of mRNA and protein expression of HO-1 and Bcl-2, while the expression of Caspase-3 was upregulated (all P<0.05), while the miR-144-3p inhibitor transfection group showed the opposite results. The luciferase results confirmed that miR 144 3p can directly bind to the 3′- UTR region of Nrf2, reducing the mRNA level of Nrf2. When Nrf2 was knocked out, whether miR-144-3p mimetic transfection group or miR-144-3p inhibitor transfection group, the mRNA and protein expression levels of HO-1, Bcl-2 and Caspase-3 did not change significantly, and miR-144-3p lost the ability to regulate the cisplatin sensitivity of bladder cancer cells. Conclusions:miR-144-3p targets to regulate the sensitivity of Nrf2 to cisplatin in bladder cancer, and miR-144-3p is expected to become a new target for the treatment of cisplatin resistant or refractory bladder cancer.

Background Kunming is a plateau city with sufficient sunshine, high ultraviolet intensity, and strong radiation. In recent years, ozone (O₃) pollution has gradually become the primary problem of air pollution in the city. Objective To evaluate the health effects of atmospheric O₃ exposure on non-accidental deaths in Kunming. Methods The data of meteorological variables (average temperature, average relative humidity, average air pressure, and average wind speed), air pollutants (PM_2.5, PM₁₀, SO₂, CO, and O₃) and non-accidental deaths (NAD) of residents were collected in Kunming from 2017 to 2019. A generalized additive model was adopted to conduct time-series analyses on the current-day (lag0), single-day (lag1-lag3), and cumulative lag (lag01-lag03) effects of O₃ on NAD; furthermore, hierarchical analyses by gender, age, and season (warm and cold) were conducted. Results The average concentration of O₃-8h from 2017 to 2019 was (84.3±32.3) μg·m⁻³. For every 10 μg·m⁻³ increase in O₃-8h concentration, the NAD risks of lag0, lag01, and lag02 of total population increased by 0.70% (95%CI: 0.11%-1.29%) 0.79% (95%CI: 0.14%-1.44%), and 0.75% (95%CI: 0.08%-1.43%), respectively; for women, the NAD risks of lag2 and lag02 increased by 0.80% (95%CI: 0.08%-1.53%) and 1.05% (95%CI: 0.09%-2.03%) respectively; for the residents over the age of 65, the associated NAD risks of lag0, lag01, and lag02 increased by 0.82% (95%CI: 0.16%-1.48%), 0.93% (95%CI: 0.20%-1.67%), and 0.96% (95%CI: 0.20%-1.73%), respectively; in the warm season, the NAD risks of lag0, lag01, and lag02 increased by 0.91% (95%CI: 0.12%-1.70%), 0.98% (95%CI: 0.12%-1.86%), and 1.00% (95%CI: 0.07%-1.93%), respectively; After introducing PM_2.5, PM₁₀, SO₂, NO₂, and CO to the model, the effects of O₃ exposure level on resident’s NAD was not statistically significant. Conclusion An increase of O₃ exposure level associates with an increase of NAD risk in residents, and there is a lag effect. Residents over the age of 65, women, and all residents in warm season may be more sensitive to O₃ exposure.

Objective To investigate the expressing patterns of serum inflammatory factors in patients with gastric cancer(GC)with different types of tongue fur.Methods GC patients with different types of longue fur(n=134)and non-GC subjects with different types of tongue fur(n=93)were chosen from clinic.The levels of serum inflammatory factors were detected by using electro-chemiluminescence immu-noassay(ECLIA),and correlation between types of tongue fur and serum inflammatory factors was ana-lyzed by using multi-factor association method.Results The levels of serum interleukin-17α(IL-17α) had significant difference in GC patients with different types of longue fur(P<0.05).The analysis on fur color showed that level of serum IL-17αwas 3.062 ng/L in GC patients with yellow fur and 3.982 ng/L in those with white fur(P<0.05).ROC analysis showed that the sensitivity was 72.7%,specific-ity was 91.3%and AUC(95% CI)was 0.639(0.539 -0.739)of serum IL-17αin distinguishing white fur and yellow fur,and cutoff value was 6.033 ng/L.The similar tendency was identified in non-GC subjects.The correlation analysis showed that there were 20 serum inflammatory factors with signifi-cant positive correlation in GC patients with the same types of tongue fur,and significant negative correla-tion in GC patients with different types of tongue fur.Conclusion The level of IL-17αcan significantly distinguish white tongue fur and yellow tongue fur.The white-yellow tongue fur and thin-thick tongue fur may reflect adverse inflammatory status in GC patients.

Objective To explore the value of MRI histogram analysis in the risk assessment of medulloblastoma recur rence.Methods The data of 28 patients pathologically confirmed of medulloblastoma was analyzed retrospectively.All patients were divided into recurrent group and the non recurrent group (each n=14).The ROIs were drawn on the maximum level of enhanced MR sagittal images,and the histogram analysis were performed using the software named Mazda.The statistical analysis was performed on the histogram parameters to find out the different characteristics between the two groups,and the ROC curve was drawn to evaluate its diagnostic efficacy for recurrence of medulloblastoma.Results In all of the 9 parameters which are extracted from histogram,kurtosis had statistical significance between the 2 groups (P=0.018).The area under the ROC curve was 0.776 (P=0.018),and the sensitivity and specificity of kurtosis in the risk assessment of medulloblastoma recurrence were 64.3％ and 71.4％,respectively.Conclusion MRI histogram analysis can be an important method to assess the risk of medulloblastoma recurrence.

Objective:To determine the derivative chromosome 9 by the method of detecting the ASS gene,and to explore the relationship between the deletion of derivative chromosome 9 and the efficacy and prognosis of the chronic myeloid leukemia (CML)patients. Methods:The materials of 34 CML patients with positive BCR-ABL fusion gene whose ASS genes were detected were retrospectively analyzed. All patients were treated with Extra-signal (ES)probe to detect the derivative chromosome 9.All patients were divided into two groups according to whether they carried the derivative chromosome 9.The blastic phase or the accelerated phase rates in two groups were compared by using Fisher exact probability. Results:All patients were detected by FISH (BCR-ABL ES probe),and all the BCR-ABL fusion signals were positive.6 of 34 patients were found the deletion of ASS gene, among them 1 case blonged to chronic phase,and 5 cases developed into blastic phase or accelerated phase. In the patients without ASS gene deletion,there were 22 cases in chronic phase,and 6 cases in plastic phase or accelerate phase,there was significant difference of blastic phase rate/accelated phase rate between them (P<0.05).A total of 26 patients were treated with tyrosine kinase inhibitors (TKI).5 of 26 patients belonged to the ASS gene deletion group,1 of 5 patients treated with TKI got molecular remission,4 of 5 patients developed into blastic phase or accelerated phase.21 of 26 patients belonged to the group without ASS gene deletion,and among them,19 cases got molecular remission,2 cases developed into plastic phase or accelerated phase after treatment of TKI,there was significant difference between them (P < 0.05 ). 6 patients were treated with traditional chemotherapy (hydroxyurea,interferon);1 of 6 patients belonged to the ASS gene deletion group,finally developed into the blastic phase or accelerated phase;5 of 6 patients belonged to the group without ASS gene deletion,2 cases got the hematological remission,and 3 patients developed into blastic phase or accelerated phase after treatment,and there was no significant difference of blastic phase rate/ accelerated phase rate between them (P > 0.05 ). Conclusion:The CML patients with derivative chromosome 9 (ASS gene deletion)prone to get disease progression, and have a higher proportion in the blastic phase or accelerated phase patients.Derivative chromosome 9 is related to the bad treatment efficacy of TKI and the poor prognosis of CML.

Objective To investigate the factor that affecting the prevalence of osteoarthritis in rural areas of Shanxi, China. Methods All the residents above 16-year-old from the villages chosen by multi-stage stratified cluster sampling in Yangcheng County and Pianguan County in Shanxi Province were investigated by COPCORD procedure of WHO. All respondents signed the informed consent forms. Chi-square test and multivariable logistic regression analysis were used for the risk factor analysis. Results Seven thousand one hundred and twenty-six permanent residents in the two counties were investigated, of which 1734 cases of patients with osteoarthritis were identified. Take with or without osteoarthritis as response variables, statistically significant variables in the univariate analysis were substituted into the logistic regression model. Forward method was used for the variable selection. The inclusion criteria set as 0.10. The results showed that, age, room heating and ventilation, marital status, occupation, education, engaged in coal mine work, accompanied cardiovascular disease were the risk factors for osteoarthritis disease. Conclusion There were many factors that affect the prevalence of osteoarthritis in Shanxi rural communities, in which lifestyle may play an important role. Early intervention on risk factors may have a significant effect on reducing the prevalence.

Objective To evaluate the diagnostic value of endoscopic ultrasonography(EUS) in the eminence lesions of gastrointestinal tract.Methods The clinical data of 420 patients with gastrointestinal eminence lesions subsequently received EUS were analyzed.Results In 420 cases,235 cases lesions were located in the stomach,129 cases in the esophagus,29 cases in the duodenum and 27 cases in the colon.Occurred in the wall itself of the digestive tract lesions was 85.00％ (357/420),and 73.10 ％(307/420) of submucosal neoplasm,and gastrointestinal stromal tumor,leiomyoma or leiomyosarcoma was seen [60.24％ (253/420)].Lesions was not found in the digestive tract wall external oppression and lesions accounted for 14.52％(61/420),external lesions and infiltrated digestive tract was 0.48％(2/420).Conclusions EUS is an ideal diagnostic modality in distinguishing different layers of the wall of the gastrointestinal tract,and thus of important value in precise localization of lesions beneath the mucosa.And be able to hint the nature of the lesion.Meanwhile,this may be associated with colonic mucous membrane structure.