It is believed that wind pathogen is one of the core pathogenic factors of small cell lung cancer （SCLC）. The nature and pathogenic characteristics of wind pathogen are closely related to the occurrence and metastasis of SCLC. Mainly manifested as deficiency of both qi and yin， healthy qi deficiency of SCLC makes it susceptible to invasion of external wind. Simultaneously， there are internal wind pathogenesis such as yin deficiency causing wind， blood deficiency causing wind， phlegm， stasis and toxin causing wind， liver yang transforming into wind. The internal and external winds together lead to the disease. Therefore， it is proposed to treat SCLC from wind theory， that is， boosting qi and nourishing yin to extinguish wind with taizishen （Radix Pseudostellariae）， wuweizi （Fructus Schisandrae Chinensis） and others； resolving phlegm and moving stasis to dispel wind with wind-dispelling and phlegm-resolving medicinals such as jiangcan （Bombyx Batryticatus）， muhudie （Semen Oroxyli）， fangfeng （Radix Saposhnikoviae）， tianma （Rhizoma Gastrodiae）， quanxie （Scorpio） and blood-invigorating and wind-dispelling medi-cinals such as danggui （Radix Angelicae Sinensis）， chuanxiong （Rhizoma Chuanxiong） and danshen （Radix et Rhizoma Salviae Miltiorrhizae）； attacking toxin and dissipating masses to dispel wind with shuizhi （Hirudo）， dilong （Pheretima）， fengfang （Nidus Vespae）， quanxie， baihuashe （Agkistrodon）， jiuxiangchong （Aspongopus） and other drastic medicinals； calming liver and extinguishing wind to prevent brain metastasis of SCLC with Tianma Gouteng Beverage （天麻钩藤饮） modification.

Objective To analyze the predictive value of cone beam computed tomography(CBCT)in styloid process syndrome(SPS)via logistic regression combined with receiver operating characteristic(ROC)curve.Methods A retrospective analysis was conducted on imaging data of 186 patients who underwent styloid CBCT.Among them,65 patients were clinically diagnosed with SPS(patient group),while 121 constituted the healthy controls(control group).The styloid length,inclination angle,and anteversion angle were measured,respectively.Logistic regression analysis was employed,and ROC curves were plotted to calculate sensitivity,specificity,and Youden index,the diagnostic cut-off values for SPS was obtained.Results In the control group,the styloid length was(29.66±7.22)mm,inclination angle was(22.34±3.05)°,and anteversion angle was(31.01±4.13)°.In the patient group,the styloid length was(40.30±8.65)mm,inclination angle was(21.86±3.74)°,and anteversion angle was(35.88±6.37)°.Logistic regression analysis revealed that styloid length and anteversion angle were risk factors for diagnosing SPS(P＜0.05),while inclination angle was not a risk factor for diagno-sing SPS(P＞0.05).ROC curve analysis demonstrated that diagnosing SPS,the area under the curve(AUC),sensitivity,specificity,and optimal cut-off value for styloid length were 0.868,92.3％,69.7％,and 31.23 mm,respectively;and for anteversion angle were 0.765,63.1％,89.3％,and 35.15°,respectively.Conclusion CBCT measurements of styloid length,inclination angle,and antever-sion angle suggest that a styloid length exceeding 31.23 mm and an styloid anteversion angle greater than 35.15° may indicate a higher likelihood of SPS.CBCT is a convenient,cost-effective,and safe diagnostic tool with positive clinical implications.

Tumor immune checkpoint inhibitors (ICIs) present a dual nature, offering therapeutic benefits alongside possible toxic side effects. Despite their significant clinical advantages, immune-related adverse events (irAEs) are major concern. In particular, the multi-organ irAEs (MO-irAEs) caused by ICIs present complex clinical manifestations, affecting a high proportion of critically ill patients. There is a lack of clinical awareness and attention towards these adverse events, making management relatively difficult, thus potentially threatening the life of patients. Reasonable application of hormones and immune modulators, along with symptomatic and supportive treatment, as well as careful monitoring and long-term follow-up are crucial measures to control MO-irAEs. Clinical characteristics, peripheral blood indicators, and genetic predisposition can serve as predictive markers for MO-irAEs occurrence and progression to some extent. A comprehensive understanding of clinical features, intervention measures, prognosis, potential molecular mechanisms and predictive factors of MO-irAEs can help to effectively control MO-irAEs, ultimately improving patient outcomes.

Objective:To discover the epidemiological characteristics and clinical manifestations of Nontyphoidal Salmonella(NTS) infection in children suffering from diarrhea in Guangzhou, and to provide references for the prevention and treatment of salmonella infection. Methods:A total of 570 diarrhea children and 296 non-diarrhea controls were collected with stratified sampling from three districts of Guangzhou Women and Children′s Medical Center from January 2019 to December 2019. Through bacterial culture, corresponding colonies were selected and Salmonella diagnostic serum was applied for preliminary serum diagnosis, and then systemic biochemical method was adopted for diagnosis. A structured questionnaire was conducted to record the demographic information and clinical symptoms from each subject. Results:The detection rate of NTS was 6.67% (38/570 cases, 95% CI: 4.90%-9.02%) in children with diarrhea, and 1.01% (3/296 cases, 95% CI: 0.34%-2.93%) in children without diarrhea. There were statistically differences in NTS detection rate between children with diarrhea and the control ( χ2=13.805, P<0.05, OR=6.976, 95% CI: 2.135-22.796). There were no significant differences in NTS detection rate between male and female children with diarrhea ( χ2=0.395, P>0.05, OR=1.254, 95% CI: 0.619-2.541). The detection rate of NTS was 5.30% (22/416 cases, 95% CI: 3.52%-7.88%) in children younger than 2 years old, and was 10.40% (16/154 cases, 95% CI: 6.50%-15.21%) in children over 2 years old. There were statistically differences ( χ2=4.700, P<0.05, OR=2.076, 95% CI: 1.060-4.068) between the younger and the older groups.The detection rate of NTS was 5.40% (25/460 cases, 95% CI: 3.70%-7.89%) for children with diarrhea in outpatient department and 11.80% (13/110 cases, 95% CI: 7.04 %-19.18%) for children with diarrhea in inpatient department, with statistically significant differences ( χ2=5.813, P<0.05, OR=2.332, 95% CI: 1.152-4.721). The detection rate of NTS diarrhea in children was 4.60% (10/217 cases, 95% CI: 2.52%-8.28%) in spring, 8.50% (12/141 cases, 95% CI: 4.93%-14.29%) in summer, 9.60% (15/144 cases, 95% CI: 6.41%-16.48%) in autumn and 1.50% (1/168 cases, 95% CI: 0.11%-3.30%) in winter, respectively, with statistically differences among the four seasons( χ2=9.404, P<0.05). There were significant differences in most common clinical symptoms of fever, vomiting, abdominal pain, bloody stool and pasty stool between NTS positive and negative children(all P<0.05). Salmonella enteritis is the main type, and Salmonella typhimurium is the second type. Conclusions:NTS is one of the most important bacterial pathogens and leads to diarrhea in children in Guangzhou city, without differences in gender.Children over 2 years old are more likely to suffer from NTS infection.High incidence is in autumn.The most common clinical symptoms include fever, vomiting, abdominal pain, bloody stool and pasty stool. Salmonella enteritis is the main type, and Salmonella typhimurium is the second type.Laboratory tests can provide references for the diagnosis and treatment of NTS-related diarrhea.

Objective To investigate the inhibitory effect of apigenin-7-o-glucoside (AGL) on the viability of Huh7 cells and tumor growth in Huh7-xenograft tumor nude mice. Methods CCK-8 was used to detect the proliferation inhibitory effect and the half inhibitory concentration of AGL on Huh7 cells. The mitochondrial membrane potential measurement was used to analyze the early apoptosis of Huh7 cells after AGL treatment. Flow cytometry was used to analyze the effect of AGL on Huh7 cell apoptosis, and Western blot was used to explore the expression level of the proteins associated with apoptosis and inflammation, as well as the possible related mechanism. In Huh7-xenograft tumor nude mice, vernier caliper was used to measure tumor volume to analyze the effect of AGL on tumor growth rate. HE staining was used to observe the pathological state of mouse organs, and the inflammation-related factors in serum were detected with ELISA. Results After Huh7 cells were treated with AGL, the mitochondrial membrane potential reduced, the content of ROS increased and the apoptosis rate was increased to 25.23% by 50 μmol/L AGL treatment; while the expression levels of Bax, Bad, Cleaved Caspase-3 and Cleaved Caspase-9 increased, and the expression levels of Bcl2 and Bcl-x^L decreased, the phosphorylation level of NF-κB, IKKα/β and IκBα decreased; the tumor growth rate decreased, the serum IL-6 and TNF-α levels significantly decreased, while the IL-2 and IL-10 levels increased. Conclusion AGL could promote the apoptosis of Huh7 cells and relieve the tumor development in Huh7-xenograft tumor nude mice, which may be related to the NF-κB pathway.

【Objective】 To investigate the clinicopathological characteristics and prognosis of solitary fibrous tumor (SFT) in the retroperitoneum. 【Methods】 We summarized the clinical and prognostic data of nine patients admitted to The First Affiliated Hospital of Xi’an Jiaotong University between January 2007 and December 2017 who were diagnosed with SFT by surgical resection and pathological examination. Nine cases of retroperitoneal SFT were detected by HE and immunohistochemical SP method. The expressions of Vimintin (Vim), CD34, CD99, Ki-67, Bcl-2 and S-100 in tumor cells were analyzed for their clinicopathological characteristics and prognosis. 【Results】 Among the nine patients, four were male and five were female, aged 37-69 years old. Five of them showed abdominal distension, while the other four had no obvious clinical symptoms. The tumor size was (1.0 cm×1.0 cm×2.0 cm)-(30.0 cm×25.0 cm×10.0 cm). There were seven single cases and two multiple cases. Histology showed bundle-shaped, braided spindle cells and collagen fibers of varying degrees, accompanied by mucinous degeneration and hemangiopericytoma-like morphology. Immunohistochemical results were as follows: The positive rate was 100% (9/9) for Vim, CD34 and CD99, 77% (7/9) for Ki-67, 67% (6/9) for Bcl-2, and 22% (2/9) for S-100. All the patients were followed up effectively. Two of them died (the cause of death was not related to the disease studied, and the survival time from postoperative to death was 6.5 years and 8.3 years, respectively). One surviving case relapsed 3 years after the operation, but did not recur after the second operation. No recurrence or metastasis was found in the remaining cases. 【Conclusion】 Retroperitoneal SFT is rare in the clinic, and there are no typical clinical symptoms in the early stage. Most of them are detected in physical check-ups. Ultrasound and CT examinations are the main preoperative examination methods, but they are not specific to SFT. Pathological examination is the only method for diagnosis. Radical resection is the first-choice of treatment. The preferred method for this disease is effective in early radical surgery and regular postoperative review.

Standardized residency training is the only way for medical students to grow into clin-icians. At present, the number of under training residents in China has reached 190000 (excluding special-ized degree graduate students). It is very important to manage each stage of this training well, which is an guarantee for improving the effect of standardized training. The residents who attend the training are com-posed of "unit personnel" and "intra-industry social personnel", and after standardized and homogenized training, the two types of students have officially become the new force in the medical industry after passing the final examination. In order to do a good job in the management of standardized residency training, to achieve fine management at all stages , this paper focuses on the differences between the two types of students, analyzes in detail the characteristics of these two types of students in the recruitment, training and welfare guarantee stages. "Unit personnel" are given the security, supervision and containment of the origi-nal unit, while due to the pressure of job-hunting and the uncertainty of future welfare, "intra-industry so-cial personnel" are equipped with more initiative. Based on advanced management experience in Beijing,Shanghai, Sichuan and Tianjin, this paper aims to summarize the key points in management of the two types of students in training, propose countermeasures to the difficulties in management, innovative management solutions, and provide reference for the optimization management of standardized residency training.

Objective:To explore the macroporous resin adsorption and the membrane separation technologies for the purification of saponins water extract of Anemarrhena asphodeloides. Methods:Ten-fold amount of water was used to extract twice for 120 min each time to extract saponins from Anemarrhena asphodeloides. The macroporous resin adsorption(HP-20,HPD-600,D101,AB-8) and the membrane separation technologies (ceramic microfiltration membranes 0.8 μm and 0.05 μm, and hollow fiber ultrafiltration mem-branes 50,10 and 6 kDa) were adopted to purify the saponins water extract liquid. The physicochemical parameters including electri-cal conductivity,viscosity and turbidity were measured,as well as the contents of total saponins,proteins and polysaccharides were de-termined. Results:The viscosity and turbidity decreased,the value of pH increased and the electrical conductivity of the saponins puri-fication liquid changed irregularly after the membrane filtration. The microfiltration membrane was more advantageous than the ultrafil-tration membrane in removing macromolecular substances. The smaller the pore diameter of microfiltration membrane, the smaller the intercepted molecular weigh,the higher the removal ratio of proteins and the higher the penetration rate of the total saponins,while the polysaccharides content was stable, which was consistent with the results of physicochemical parameters. The ceramic microfiltration membrane could obtain clearer extract,while the ultrafiltration membrane was more suitable for the enrichment of saponins when the in-tercepted molecular weight was 6 kDa. The macroporous resin HPD-600 was the best for the purification of timosaponin water extraction liquid.Conclusion:The selection of membrane for the separation and purification of different substances is particularly important. The change of physicochemical parameters and the content decrease of macromolecular substances have obvious corresponding relationship. Ultrafiltration membrane is better than microfiltration membrane for the purification of timosaponin water extract liquid.

Objective To explore the safety and efficacy of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in treating hepatic alveolar echinococcosis. Methods Clinical data of 2 patients with hepatic alveolar echinococcosis undergoing ALPPS in the First Affiliated Hospital of Xi'an Jiaotong University between June 2015 and January 2016 were analyzed retrospectively. The informed consents of both patients were obtained and the local ethical committee approval was received. Case 1 was male, 47 years old. Case 2 was female, 24 years old. Both were diagnosed as hepatic echinococcosis. For case 1, ligation of the right portal vein and division of the left medial lobe and left lateral lobe were performed in the first stage, and resection of 3 right lobes was performed in the second stage. For case 2, right hemihepatectomy and division of the left medial lobe and left lateral lobe were performed in the first stage, and hepatic left lateral lobectomy was performed in the second stage. Results For case 1 in the first stage, the operation duration was 540 min, blood loss was 2 000 ml, intraoperative RBC infusion was 8 U, and plasma infusion was 800 ml; in the second stage, the operation duration was 660 min, blood loss was 4 500 ml, RBC infusion was 32 U, and plasma infusion was 2 000 ml. Case 1 recovered well after the first stage operation, but suffered from bile leakage after the second stage operation, then received percutaneous transhepatic biliary drainage and recovered afterward. For case 2 in the first stage, the operation duration was 405 min, blood loss was 2 000 ml, intraoperative RBC infusion was 10 U, and plasma infusion was 2 000 ml;in the second stage, the operation duration was 190 min, blood loss was 1 000 ml, RBC infusion was 4 U, and plasma infusion was 800 ml. The patient recovered well after operation. Both 2 patients were followed up for 24 months after operation and lived in a good condition, no complication or recurrence of hydatid disease was observed. Conclusion ALPPS has provided a new option for the operative treatment of complex hepatic alveolar echinococcosis with insufficient remnant liver volume.

Objective: To establish a high performance liquid chromatography-tandem mass spectrometric method ( HPLC-MS/MS) method for the determination of PA-824 in the plasma of Beagle dogs, and study the pharmacokinetics of PA-824 in Beagle dogs. Methods:Carbamazepine was used as the internal standard, and the plasma samples were pretreated with ethyl acetate for the liquid-liquid extraction of PA-824. An Eclipse Plus C18 column (100 mm × 2. 1 mm, 3. 5 μm) was used with the mobile phase consisting of methanol-water (90 :10). The flow rate was 0. 6 ml·min-1 and the column temperature was 30 ℃. The injection volume was 5 μl and the sample analysis time was 5 min. The determination was performed with an electrospray ionization ( ESI) source in the positive multiple reaction monitoring (MRM) mode. The ion pairs were m/z 360. 1→m/z 175. 0 (collision energy of 35, solution cluster volt-age of 65) for PA-824 and m/z 237. 2→m/z 194. 0 (collision energy of 28, solution cluster voltage of 83) for carbamazepine. After the oral administration, PA-824 in plasma was measured at different time points, and then the pharmacokinetic parameters were calcu-lated by DAS 2. 0 software. Results: PA-824 showed a good linear relationship within the range of 50-10000 ng · ml-1 ( r =0. 9991). The recovery was 97. 7%-105. 1%, and the RSDs of intra-day and inter-day were less than 5. 0%. At three different dosa-ges (100, 200 and 500 mg) of PA-824, AUC0-twere (5735. 18 ± 1918. 76),(11548. 47 ± 1838. 04) and (21987. 88 ± 4587. 58) ng·min·ml-1,t1/2 were(14.17 ±5.97),(11.11 ±4.39) and (13.13 ±5.46)h,and Cmaxwere(626.66 ±188.48),(2399.13 ± 516.51) and (4861.33 ±2253.61)ng·ml-1, respectively. Conclusion:The method is simple, accurate, rapid and reproducible, and suitable for the pharmacokinetic study of PA-824 in the plasma of Beagle dogs.