ObjectiveTo investigate the influencing factors for traditional Chinese medicine （TCM） syndromes of primary liver cancer， and to provide a theoretical basis for the TCM syndrome differentiation and standardized treatment of liver cancer. MethodsTCM syndrome differentiation was performed for 415 patients who were admitted to Shanxi Institute of Traditional Chinese Medicine and were diagnosed with primary liver cancer based on pathological or clinical examinations from January 2019 to December 2023. The chi-square test was used for comparison of categorical data between groups， and the unordered polytomous logistic regression model was used to investigate the influencing factors for TCM syndromes of liver cancer. ResultsThe common initial symptoms of the 415 patients with primary liver cancer included pain in the liver area （31.81%）， abdominal distension （25.30%）， abdominal pain （15.18%）， and weakness （13.98%）， and the main clinical symptoms included poor appetite （70.84%）， fatigue （69.16%）， pain in the liver area （67.47%）， poor sleep （59.04%）， abdominal distension （53.01%）， and constipation （52.53%）. There were significant differences in TCM syndromes between patients with different sexes， courses of the disease， clinical stages， Child-Pugh classes， presence or absence of intrahepatic and extrahepatic metastasis， and presence or absence of transcatheter arterial chemoembolization （TACE） and radiofrequency ablation （all P<0.05）. The logistic regression analysis showed that male sex was a risk factor for damp-heat accumulation （odds ratio ［OR］=2.036， P=0.048） and the syndrome of spleen-kidney Yang deficiency （OR=5.240， P<0.001）； a course of disease of<1 year was a risk factor for damp-heat accumulation （OR=2.837， P=0.004） and syndrome of Qi stagnation and blood stasis （OR=2.317， P=0.021）， but it was a protective factor against syndrome of spleen-kidney Yang deficiency （OR=0.385， P=0.005）； Child-Pugh class A/B was a protective factor against liver-kidney Yin deficiency （OR=0.079， P<0.001）； intrahepatic metastasis was a risk factor for liver-kidney Yin deficiency （OR=5.117， P=0.003） and syndrome of spleen-kidney Yang deficiency （OR=3.303， P=0.010）； TACE was a protective factor against liver-kidney Yin deficiency （OR=0.171， P<0.001） and syndrome of spleen-kidney Yang deficiency （OR=0.138， P<0.001）； radiofrequency ablation was a risk factor for damp-heat accumulation （OR=4.408， P<0.001） and liver-kidney Yin deficiency （OR=32.036， P<0.001）. ConclusionSex， course of disease， Child-Pugh class， intrahepatic metastasis， TACE， and radiofrequency ablation are the main influencing factors for TCM syndromes of liver cancer.

ObjectiveTo investigate the influencing factors for traditional Chinese medicine （TCM） syndromes in pancreatic cancer by analyzing 608 cases， and to provide a theoretical reference for TCM syndrome differentiation and standardized treatment of pancreatic cancer. MethodsA total of 608 patients with a pathological or clinical diagnosis of pancreatic cancer who were admitted to Shanxi Institute of Traditional Chinese Medicine， The Affiliated Hospital of Shanxi University of Chinese Medicine， and Shanxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to December 2023 were enrolled， and TCM syndrome differentiation was performed. The chi-square test was used for comparison of categorical data between groups. The clinical data with statistical significance between groups were included in the regression analysis， and the unordered polytomous logistic regression model was used to investigate the influencing factors for the TCM syndrome of pancreatic cancer. ResultsFor the 608 patients with pancreatic cancer， common initial symptoms included abdominal pain （32.40%）， abdominal distension （23.85%）， fatigue （16.12%）， and emaciation （10.03%）， and the main clinical symptoms included poor appetite （75.97%）， abdominal pain （67.27%）， fatigue （61.84%）， abdominal distension （57.40%）， and emaciation （53.62%）. There were significant differences between the patients with different TCM syndromes of pancreatic cancer in sex （χ²=62.823， P<0.001）， disease duration （χ²=14.868， P=0.011）， clinical stage （χ²=21.006， P<0.001）， lymph node metastasis （χ²=2.205， P=0.032）， surgery （χ²=38.008， P<0.001）， chemotherapy （χ²=21.384， P<0.001）， radiotherapy （χ²=17.510， P=0.004）， and immunotherapy （χ²=18.573， P=0.002）. The logistic regression analysis showed that male sex was a protective factor against Qi and blood deficiency syndrome （odds ratio ［OR］=0.081， 95% confidence interval ［CI］： 0.031‍ ‍—‍ ‍0.213， P<0.001）， Qi stagnation and blood stasis syndrome （OR=0.100， 95%CI： 0.041‍ ‍—‍ ‍0.247， P<0.001）， and syndrome of Yin deficiency with internal heat （OR=0.158， 95%CI： 0.057‍ ‍—‍ ‍0.444， P<0.001）， while it was a risk factor for the syndrome of damp-heat accumulation （OR=2.378， 95%CI： 1.074‍ ‍—‍ ‍5.266， P=0.033）； the course of the disease of<1 year was a protective factor against Qi and blood deficiency syndrome （OR=0.167， 95%CI： 0.073‍ ‍—‍ ‍0.383， P<0.001）， syndrome of spleen-kidney Yang deficiency （OR=0.183， 95%CI： 0.089‍ ‍—‍ ‍0.378， P<0.001）， and syndrome of Yin deficiency and internal heat （OR=0.164， 95%CI： 0.070‍ ‍—‍ ‍0.385， P<0.001）； clinical stage Ⅰ/Ⅱ/Ⅲ was a risk factor for damp-heat accumulation （OR=2.793， 95%CI： 1.259‍ ‍—‍ ‍6.196， P=0.012） and Qi stagnation and blood stasis syndrome （OR=7.863， 95%CI： 2.808‍ ‍—‍ ‍22.020， P<0.001）； lymph node metastasis was a risk factor for Qi and blood deficiency syndrome （OR=4.005， 95%CI： 1.477‍ ‍—‍ ‍10.861， P=0.006）； surgical treatment was a risk factor for Qi and blood deficiency syndrome （OR=4.151， 95%CI： 1.916‍ ‍—‍ ‍8.995， P<0.001）， syndrome of spleen-kidney yang deficiency （OR=5.352， 95%CI： 2.436‍ ‍—‍ ‍11.759， P<0.001）， Qi stagnation and blood stasis syndrome （OR=2.334， 95%CI： 1.071‍ ‍—‍ ‍5.088， P=0.033）， and syndrome of Yin deficiency and internal heat （OR=4.167， 95%CI： 1.789‍ ‍—‍ ‍9.707， P<0.001）； chemotherapy was a protective factor against damp-heat accumulation （OR=0.188， 95%CI： 0.082‍ ‍—‍ ‍0.428， P<0.001）； radiotherapy was a risk factor for damp-heat accumulation （OR=2.571， 95%CI： 1.151‍ ‍—‍ ‍5.746， P=0.021） and syndrome of Yin deficiency with internal heat （OR=8.384， 95%CI： 3.348‍ ‍—‍ ‍20.997， P<0.001）； immunotherapy was a risk factor for Qi and blood deficiency syndrome （OR=2.114， 95%CI： 1.021‍ ‍—‍ ‍4.379， P=0.044）. ConclusionSex， course of the disease， clinical stage， presence or absence of lymph node metastasis， surgery， chemotherapy， radiotherapy， and immunotherapy are the main influencing factors for the TCM syndrome of pancreatic cancer.

Objectiveto investigate the differential expression of intestinal flora and serum metabolites and potential biomarkers in patients with pre-diabetic sputum syndrome. MethodA total of 34 patients with pre-diabetic sputum syndrome were included as the phlegm syndrome group，and 37 healthy people were selected as the normal group. Serum and fecal samples of the two groups were collected，and liquid chromatography-mass spectrometry （LC-MS） non-targeted metabolomics and 16S rRNA high-throughput sequencing technology were used to detect serum metabolites and different intestinal flora of the two groups and explore the relationship among pre-diabetic sputum syndrome，serum metabolites，and intestinal flora. ResultIn the distribution of disease syndrome elements in the phlegm syndrome group，the first five disease syndrome elements in terms of frequency and proportion were dampness （73.53%），Qi stagnation （58.82%），Yin deficiency （50.00%），blood stasis （41.18%），and heat （35.29%）. According to the frequency and proportion of disease location syndrome elements，the first three main disease location syndrome elements were spleen （100.00%），liver （41.18%），and kidney （23.53%）. The results of 16S rRNA high-throughput sequencing showed that there were 44 different intestinal flora between the two groups. In order genus，there were significant differences in Bifidobacterium，Veillonococcus，and Roseococcus between the two groups （P<0.05）. The diversity，abundance，and evenness of intestinal flora in the phlegm syndrome group were lower than those in the normal group，with the difference not statistically significant. There was no significant difference in the community structure between two groups. The results of serum metabolomics showed that there were 13 differential metabolites in the two groups，which were mainly concentrated in amino acid metabolism，bile secretion，bile acid biosynthesis，and lipid metabolism （P<0.05）. The correlation among differential metabolites，intestinal flora，and syndrome elements was analyzed，and the results showed that ① lysine was positively correlated with spleen，Yin deficiency，and blood stasis，while taurocholic acid was positively correlated with liver，kidney，blood stasis，and dampness，and there was a positive correlation between taurocholic acid and yin deficiency and heat. The taurochenodeoxycholic acid was positively correlated with liver and dampness，and there was a negative correlation between arachidonic acid and dampness，as well as a positive correlation between glucose and spleen and blood stasis. ② Clostridium was positively correlated with spleen，kidney，Yin deficiency，and Qi stagnation. Rosepiella was negatively correlated with spleen，and Sutterella was negatively correlated with dampness. Bacteroides was negatively correlated with the spleen and kidney，and Bifidobacterium was negatively correlated with the spleen and dampness. ③ Bifidobacterium was positively correlated with glycine，threonine，lysine，and deoxycholic acid significantly，negatively correlated with cholic acid significantly，and positively correlated with taurochenodeoxycholic acid and pyruvic acid. Clostridium was positively correlated with glycine significantly and positively correlated with threonine and lysine. Lachnospira was negatively correlated with glycine，threonine，and pyruvic acid. Lysine was also negatively correlated with Faecalibacterium and Eubacterium ventriosum and positively correlated with Megamonas. There was a positive correlation between taurocholic acid and glycine bile acid and Campylobacter，between taurochenodeoxycholic acid and Veillonococcus，and between glucose and Rosepiella and Eubacterium ventriosum. There was a negative correlation between pyruvic acid and Escheria-Shigella and between taurochenodeoxycholic acid and Prevotella. Conclusionthere are differences in intestinal flora and serum metabolites between patients with pre-diabetic sputum syndrome and healthy people. The intestinal flora and metabolites have been disturbed in the stage of pre-diabetes，Bifidobacterium，Clostridium，Lachnospira，glycine，threonine，and lysine may be the breakthrough to explore the development of pre-diabetic sputum syndrome.

Objective To compare the short-term clinical effects of unilateral dual-channel endoscopic discectomy(UBED)and percutaneous endoscopic intervertebral discectomy(PEID)in the treatment of L5S,Lumbar disc herniation,LDH.Methods From January 2019 to January 2021,a total of 57 cases of L5S,LDH treated by UBED or PEID were analyzed retrospectively,including 30 cases in UBED group and 27 cases in PEID group.The operation time,intraoperative fluoroscopy times,postoperative hospitalization days and surgical complications were compared between the two groups.The visual analogue scale(VAS)and oswestry disability index(ODI)were used to compare the postoperative quality of life of the two groups,and the modified MacNab criteria was used to evaluate the clinical efficacy in the last follow-up.Results The operation time of UBED group and PEID group was(75.30±8.44)minutes and(68.37±4.63)minutes,respectively,and the difference between the two groups was statistically significant(P＜0.05).VAS and ODI of 1 week,3 months,1 year and 1.5 years after surgery in 2 groups were significantly decreased compared with those before surgery,with statistical significance(P＜0.05).The VAS score of low back pain in UBED group was higher than that in PEID group[(3.87±1.14)points vs(2.70±0.67)points]at 1 week after surgery(P＜0.05),and there was no significant difference in VAS and ODI at the other time points(P＞0.05).There was no statistical difference in the results of modified MacNab criteria in the last follow-up(P＞0.05).There were 2 cases of dural tear in PEID group,1 case of dural tear in UBED group and 1 case of temporary nerve root injury in PEID group after operation,all of which were cured after symptomatic treatment.Conclusion Compared with PEID,UBED has a longer operation time,more trauma and more obvious low back pain in the short term after operation.The short-term curative effect of the two operations on L5S1 LDH is similar,the incidence of complications is low,and the times of fluoroscopy are few.Both operations are safe and effective.

The Ly-6 and uPAR (LU) domain-containing proteins represent a large family of cell-surface markers. In particular, mouse Ly-6A/Sca-1 is a widely used marker for various stem cells; however, its human ortholog is missing. In this study, based on a systematic survey and comparative genomic study of mouse and human LU domain-containing proteins, we identified a previously unannotated human gene encoding the candidate ortholog of mouse Ly-6A/Sca-1. This gene, hereby named LY6A, reversely overlaps with a lncRNA gene in the majority of exonic sequences. We found that LY6A is aberrantly expressed in pituitary tumors, but not in normal pituitary tissues, and may contribute to tumorigenesis. Similar to mouse Ly-6A/Sca-1, human LY6A is also upregulated by interferon, suggesting a conserved transcriptional regulatory mechanism between humans and mice. We cloned the full-length LY6A cDNA, whose encoded protein sequence, domain architecture, and exon-intron structures are all well conserved with mouse Ly-6A/Sca-1. Ectopic expression of the LY6A protein in cells demonstrates that it acts the same as mouse Ly-6A/Sca-1 in their processing and glycosylphosphatidylinositol anchoring to the cell membrane. Collectively, these studies unveil a novel human gene encoding a candidate biomarker and provide an interesting model gene for studying gene regulatory and evolutionary mechanisms.
Humans ; Membrane Proteins/genetics* ; Pituitary Neoplasms/genetics* ; Biomarkers

Objective: To investigate the imaging characteristics and the cause for the misdiagnosis and mistreatment of epidermoid cyst in intrapancreatic accessory spleen (ECIPAS) in order to improve the accuracy of preoperative diagnosis. Methods: The clinical and imaging data of 8 patients with ECIPAS confirmed by pathology in Zhejiang Provincial People′s Hospital between June 2008 and February 2018 were collected. The reason for doctor visit included CA19-9 elevation (n=1) and pancreatic occupying mass (n=9) during physical examination and no obvious symptoms were reported. CT and MRI imaging features, diagnosis and treatment were analyzed. Results: The lesions in 8 cases of ECIPAS were all located in the tail of the pancreas and were cystic and solid. The lesions in 3 cases were mainly cystic and the cystic wall was linear, whose CT density, MRI signal and enhancement pattern cannot be compared with those of the spleen. Solid components can be seen in 5 cases, and the CT density or MR signal of the solid part was similar to that of the spleen. After enhancement, the solid part at the artery stage was uniformly enhanced and the enhancement degree was higher than that of the pancreas. Similar to the spleen, it was uniformly enhanced at the portal vein stage and the enhancement degree of the spleen was consistent. All 8 patients were diagnosed with pancreatic neoplastic lesions before surgery, and 1 patient had pancreatic fistula and peripancreatic necrosis after surgery. Postoperative pathology confirmed the diagnosis of ECIPAS. Conclusions Improving the radiologists and clinicians′ cognition of the imaging manifestations of ECIPAS can improve the accuracy of preoperative diagnosis and avoid unnecessary surgery due to misdiagnosis.

Objective To analyze the genetic characteristics of VP1-VP4 genes carried by cox-sackievirus A6 (CVA6) strains isolated from severe cases of hand, foot, and mouth disease (HFMD) in Shenzhen during 2012 to 2015. -ethods The VP1-VP4 genes of CVA6 strains isolated from severe HFMD cases in Shenzhen during 2012 to 2015 were amplified and sequenced. Phylogenetic analysis was performed to analyze the VP1-VP4 genes of CVA6 isolates and sequences downloaded from GenBank by using DNASTAR6. 0 and MEGA6. 02 software packages. Results Four cases of severe HFMD were caused by CVA6 in Shenzhen during 2012 to 2015. All of the patients had the symptom of fever, skin rash and aseptic encephalitis. The CVA6 strain causing severe HFMD in 2013 shared 98. 8％-98. 9％ homology in nucleotide sequences and 99. 3％-99. 8％ in amino acid sequences with the strains isolated in 2012. Two amino acid mutations were found in the CVA6 strain isolated in 2013, which were G73E in VP2 region and S13G in VP1 region. However, the CVA6 strain isolated in 2015 only shared 95. 0％ homology in nucleotide sequences and 99. 3％ homology in amino acid sequences with the strain isolated in 2013. Six amino acid mutations were identified including E73G in VP2 region and T5A, S27N, A30V, N137S and V242I in VP1 region. The phylogenetic analysis revealed that the four CVA6 strains belong to D3 sub-genotype. The CVA6 strains causing severe cases in 2012 had the nearest genetic relationship with the strain isolated in Changsha in 2012 (KJ156349). The CVA6 strain isolated in Shenzhen in 2013 had the nearest genetic relationship with the strain isolated in Shanghai in 2013 (KJ612513). The Shenzhen CVA6 isolate in 2015 showed high similarity to Weifang CVA6 isolate in 2014 (KX752785). Conclusions All CVA6 strains causing severe HFMD ca-ses in Shenzhen during 2012 to 2015 belongs to D3 sub-genotype. Mutations of S27N and A30V in the VP1 region of the CVA6 isolate in 2015 are located in the B cell epitopes. In addition, the VP1-V242I mutation in the CVA6 strain isolated in 2015 is located in the binding site of PSGL-1 receptor. These mutations may affect the binding of CVA6 strains to the cellular receptors and their infectivity to people.

OBJECTIVEA Dengue outbreak was reported in Dongfen town Jianou county, Fujian province on September 19, 2014. The goal of this project was to explore the role of syndromic surveillance program in the practice of early detection on disease outbreak through the case mentioned above.

METHODSThe authors retrospectively collected data related to Outpatient log and Pharmacy drug use in Dongfen township hospital through the electronic information system of the hospital from August to November, 2014. All the abnormal events were recorded, according to related data on fever and drug use. Description of fever, syndromic characteristics, correlation and Linear regression analyses were conducted, using the surveillance data on fever syndrome and drug use from the pharmacy.

RESULTSA total of 1 102 cases with fever and 2 437 fever-related clinic visits were reported which showing an increased number of 19.6, 10.2 times respectively, when compared to the same period of the previous year in which men accounted for 45.3% (499/1 102) and female accounted for 54.7% (603/1 102). Age groups presented an atypical type " M" type. 5 and 10 year olds groups formed the largest proportion, accounted for 11.5% (127/1 102) of the total number os the patients. The correlation coefficient ranged from 0.85 to 0.97 (P<0.05). Data from the syndromic surveillance program showed an " outbreak" was occured in August 23, 2014.

CONCLUSIONSCompared to routine surveillance program, the syndromic surveillance program could detect the appearence of an outbreak, a month or even more earlier. The role of syndromic surveillance program needs to be further explored.

Data Collection ; Dengue ; diagnosis ; epidemiology ; prevention & control ; Disease Outbreaks ; prevention & control ; Drug Prescriptions ; statistics & numerical data ; Drug Utilization ; statistics & numerical data ; trends ; Early Diagnosis ; Female ; Fever ; etiology ; Health Information Systems ; Humans ; Male ; Pharmacy Service, Hospital ; Population Surveillance ; methods ; Retrospective Studies

BACKGROUND:Current research has shown that many cellgrowth factors can promote the proliferation and differentiation of epiphysis stem cells, and this regulation is closely related to Sox-9.
OBJECTIVE:To investigate the effects of smal interfering RNA-induced specific silence of Sox-9 gene on the proliferation and apoptosis of epiphysis stem cells.
METHODS:Epiphysis stem cells were isolated from the ring of La Croix with enzyme digestion and purified with magnetic activated cellsorting, identified by immunocytochemistry assay. The cells in good conditions were selected to be transfected by Sox-9 silenced by smal interfering RNA with fluorescent marker, and then were observed under the fluorescent microscope to check the transfection efficiency. Next step, epiphysis stem cells were divided into 2 groups:group one was cultured normal y as control group;group two was transfected by Sox-9 silenced by smal interfering RNA through LipofectamineTM 2000 as experimental group.
RESULTS AND CONCLUSION:The primary epiphysis stem cells were separated and purified, which were of stable growth and tightly attachment. The results of immunohistochemistry and immunofluorescence showed the epiphysis stem cells expressed cel-specific markers, fibroblast growth factor receptor 3. After transfection, reverse transcription-PCR results showed that Sox-9 gene expression in epiphysis stem cellwas inhibited specifical y;3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide results showed that cellproliferation in experimental group decreased significantly compared with the control group (P<0.05), and the cellapoptosis detected by flow cytometry showed that the experimental group increased as compared with the control group (P<0.05). Sox-9 gene plays an important role in regulating the proliferation and apoptosis of rat epiphysis stem cells.

Objective To evaluate the biomechanical characteristics of the long U-shaped hollow pedicle screw system for percutaneous fixation of thoracolumbar fractures.Methods Models of vertebral compression fracture were created by flexion in 8 fresh cadaveric samples of thoracolumbar spine.The models were divided into 2 equal groups according to the fixation system applied.In group A conventional pedicle screws were used while in group B long U-shaped hollow pedicle screws were used.The yield compressive strength,axial compression stiffness,bending stiffness,torque and torsional stiffness of all the fixated spines in the 2 groups were tested by the bio-mechanical electrical measurement and compared as well.Results The conventional pedicle screws and long U-shaped hollow pedicle screws showed no significant differences regarding yield compressive strength (3450.02 ± 110.03 MPa vs.3430.04 ± 102.12 MPa),axial compressionstiffness (407.52 ± 33.02 N/mm vs.395.04 ± 26.46 N/mm),bending stiffness (305.14 ± 26.53 N · cm/Degvs.295.12±23.80 N · cm/Deg),torque (6.45±0.25 N · m vs.6.25±0.21 N · m) or torsional stiffness (0.54±0.04N·cm/Degvs.0.52±0.03N·cm/Deg) (P＞ 0.05).Conclusion The long U-shaped hollow pedicle screw system can satisfy the biomechanical requirements for fixation of thoracolumbar fractures and can function as well as the conventional pedicle screw system.