Objective To construct a risk prediction model for atherosclerosis(AS)in patients with rheumatoid arthritis(RA)based on Lasso-Logistic regression analysis and provide a scientific basis for individualized clinical intervention.Methods The retrospective clinical data were collected from 344 RA patients,including 86 patients with AS(RA+AS group)and 258 patients with without AS(RA group).The clinical characteristics and initial laboratory test results were compared between the two groups.Lasso regression was used to screen the key predictive variables,and Logistic regression was combined to construct the prediction mode.The discrimination of the model was evaluated through the receiver operating characteristic(ROC)curve and the area under the curve(AUC).The Hosmer-Lemeshow test was used to assess the calibration,and decision curve analysis was used to verify the clinical applicability of the model.Results Seven predictive variables were identified including RA disease duration,DAS28 score,C-reactive protein(CRP),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG)and hypertension.The risk prediction model for AS in RA patients was:Logit(P)=-2.674+0.605×RA disease duration+0.393×DAS28 score+0.310×CRP+1.346×TG-2.289×HDL-C+0.679×FBG+0.711×hypertension.The AUC of the model was 0.965(95%CI:0.943-0.987),and the Hosmer-Lemeshow test showed χ2=0.547,P=1.000,indicating good discrimination and calibration.Clinical decision curve analysis showed that the probability threshold ranged from 7%to 92%,demonstrating high clinical applicability.Conclusion The AS risk prediction model constructed in this study for RA patients can effectively identify high-risk individuals,supporting the development of personalized prevention and treatment strategies.

Objective To investigate the distribution of traditional Chinese medicine(TCM)syndrome types in patients with rheumatoid arthritis(RA)and to explore their correlation with serum homocysteine(Hcy)and C-reactive protein(CRP)levels.Methods From December 2021 to December 2023,a total of 186 RA patients admitted to Dezhou Hospital of Qilu Hospital of Shandong University were selected as the study group,and the patients were classified into four TCM syndrome types according to the criteria of TCM syndrome differentiation,namely cold-damp blockage syndrome,qi and blood deficiency syndrome,phlegm-stasis blockage syndrome,deficiency of liver and kidney syndrome.Moreover,100 healthy volunteers who had physical examination at the same hospital during the same period were included as the healthy control group.The distribution of TCM syndrome types in RA patients was investigated,the serum Hcy and CRP levels in the two groups and in RA patients with various TCM syndrome types were observed,and then Pearson's correlation was used for explorating the correlation of serum Hcy and CRP levels with severity of illness of RA patients with different TCM syndrome types.Results(1)Among the 186 RA patients in the study group,there were 41 cases(22.04％)of cold-damp blockage syndrome,40 cases(21.51％)of phlegm-stasis blockage syndrome,50 cases(26.88％)of qi and blood deficiency syndrome,and 55 cases(29.57％)of deficiency of liver and kidney syndrome.(2)The serum Hcy and CRP levels in the study group were(7.61±2.07)μmol/L and(27.93±5.92)mg/L,respectively,which were higher than those of the healthy control group[(5.33±0.91)μmol/L and(1.85±0.67)mg/L,respectively],and the differences were statistically significant(P<0.01).Statistically significant differences of serum Hcy and CRP levels were shown among the patients with various TCM syndrome types(F=7.637,P<0.01;F=5.639,P<0.01).The serum levels of Hcy and CRP in patients with cold-damp blockage syndrome were the highest,and the levels in patients with phlegm-stasis blockage syndrome,qi and blood deficiency syndrome,and deficiency of liver and kidney syndrome were in decreasing sequence.The pairwise comparison between groups showed that the differences were statistically significant(P<0.05).(3)Pearson's correlation analysis showed that Disease Activity Score in 28 joints(DAS28)scores were positively correlated with serum Hcy and CRP levels(r=0.396,P<0.01;r=0.407,P<0.01),and the serum Hcy and CRP levels were positively correlated with the severity of illness in RA patients with different TCM syndrome types(P<0.05 or P<0.01).Conclusion The expression of serum Hcy and CRP in patients with RA is abnormally increased,and the expression levels of serum Hcy and CRP are correlated with TCM syndrome types.RA patients with cold-damp blockage syndrome have the highest expression levels of serum Hcy and CRP.

Objective To construct a risk prediction model for atherosclerosis(AS)in patients with rheumatoid arthritis(RA)based on Lasso-Logistic regression analysis and provide a scientific basis for individualized clinical intervention.Methods The retrospective clinical data were collected from 344 RA patients,including 86 patients with AS(RA+AS group)and 258 patients with without AS(RA group).The clinical characteristics and initial laboratory test results were compared between the two groups.Lasso regression was used to screen the key predictive variables,and Logistic regression was combined to construct the prediction mode.The discrimination of the model was evaluated through the receiver operating characteristic(ROC)curve and the area under the curve(AUC).The Hosmer-Lemeshow test was used to assess the calibration,and decision curve analysis was used to verify the clinical applicability of the model.Results Seven predictive variables were identified including RA disease duration,DAS28 score,C-reactive protein(CRP),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG)and hypertension.The risk prediction model for AS in RA patients was:Logit(P)=-2.674+0.605×RA disease duration+0.393×DAS28 score+0.310×CRP+1.346×TG-2.289×HDL-C+0.679×FBG+0.711×hypertension.The AUC of the model was 0.965(95%CI:0.943-0.987),and the Hosmer-Lemeshow test showed χ2=0.547,P=1.000,indicating good discrimination and calibration.Clinical decision curve analysis showed that the probability threshold ranged from 7%to 92%,demonstrating high clinical applicability.Conclusion The AS risk prediction model constructed in this study for RA patients can effectively identify high-risk individuals,supporting the development of personalized prevention and treatment strategies.

"Tendency of disease" is an important concept in the theory of traditional Chinese medicine （TCM）. It was born out of and rooted in the thinking of "conducting by tendency" of ancient Chinese philosophy， meaning that the development and change of humans and nature have their own inevitable laws and dynamic tendencies. Based on the concept of holism and constant motion， the basic definition of "tendency"， the origin of the idea， the influence factors and related concepts were analysed， to grasp the overall connection in the dynamic changes in space and time， and to find a scientific and comprehensive objective law of development. The "tendency" was regarded as dynamic forces in the complex system， when yin and yang harmonized， called normal tendency； when fail to keep normal， called disease tendency； the season have sequential tendency， the earth has geographical tendency， people have body tendency， medications have medical tendency， and pulse has pulse tendency. Then the "eight methods of treating tendency" were summed up as observing tendency， evaluating tendency， waiting for tendency， accumulating tendency， favoring tendency， counteracting tendency， preventing tendency， and borrowing tendency， and condenses the methodo-logical thinking of "treatment according to disease tendency"， with a view to re-understanding the internal logic of TCM diagnosis and treatment， and providing metaphysical contemplation and exploration for the construction of a new paradigm of TCM syndrome differentiation and treatment.

OBJECTIVES: To observe the efficacy and adverse reactions of the combination of endostar with chemotherapy in the treatment of advanced (IVb) and recurrent metastatic cervical cancer. METHODS: Forty-four patients with recurrent and metastatic cervical cancer, who were admitted to the Second Xiangya Hospital, Central South University from December 2016 to December 2018 were randomly divided into an experimental group and a control group (22 cases in each group). The control group was given gemcitabine plus cisplatin (GP) or docetaxel plus cisplatin (DP) treatment, the experimental group was treated with endostar on the basis of the control group. RESULTS: The objective response rate (ORR) was 42.9% in the experimental group and 22.7% in the control group. There was no significant difference between the 2 groups ( CONCLUSIONS Compared with chemotherapy alone, endostar combined with chemotherapy can prolong the median progression-free survival, with higher ORR and similar adverse reactions.
Antineoplastic Combined Chemotherapy Protocols/adverse effects* ; Cisplatin/therapeutic use* ; Endostatins ; Female ; Humans ; Lung Neoplasms/pathology* ; Neoplasm Recurrence, Local/pathology* ; Neoplasm Staging ; Recombinant Proteins ; Uterine Cervical Neoplasms

Objective:To explore the clinical characteristics of one living-related kidney transplant recipient infected with 2019 coronavirus disease(COVID-19).Methods:The clinical diagnosis and treatment of one living-related kidney transplant recipient after the occurrence of COVID-19 were analyzed retrospectively. Course of onset, clinical manifestations, laboratory and image enamination, outpatient and inpatient therapies and outcomes.Results:The renal transplant recipient was diagnosed as COVID-19(severe) with influenza A virus infection based upon epidemiological survey, clinical manifestations, laboratory examinations, imaging findings and etiological tests. The clinical symptoms were gradually relieved and lung lesions became absorbed after tapering and withdrawing immunosuppressants, antiviral therapy of abidol/oseltamivir, antibiotic therapy, hormonal anti-inflammation, oxygen inhalation, nutritional supports and adequate rest.Conclusions:Living-related kidney transplant recipients have specific immunosuppressive states.The long-term effect of covid-19 on recipients should be determined through long-term follow-ups.

Objective: To analyze the clinical characteristics of one living-related kidney transplant recipient infected with 2019 coronavirus disease (COVID-19) . Method: The clinical diagnosis and treatment of one relative renal transplant recipient after the occurrence of COVID-19 were analyzed retrospectively, including the course of onset, clinical manifestations, blood routine test, renal function, lung CT scan, nucleic acid detection, outpatient and inpatient therapies and outcomes. Result: The case was diagnosed as COVID-19 (severe type) with influenza A virus infection. The clinical symptoms were gradually relieved and the lung lesions were absorbed through the treatment of reduce and stop taking immunosuppressant, antiviral therapy of abidol/oseltamivir, prevention of bacterial infection, hormone anti-inflammatory, oxygen inhalation, nutritional support and adequate rest. Conclusion This case present typical characteristics of COVID-19 in epidemiological investigation, clinical manifestation, examination, pulmonary imaging and etiology. After comprehensive treatment including reduce and stop immunosuppressive therapy, clinical cure was achieved. The long-term effect of COVID-19 on this immunosuppressive patient remains follow-up.

Objective To optimize the process of ultrasonic extraction of polysaccharide in Anoectochilus roxburghii and to investigate the method of protein removal. Methods The extraction rate of polysaccharide was used as the detection index. On the basis of single factor investigation, Box-Behnken experimental design and response surface method were used to optimize the three factors of material-liquid ratio, ultrasonic time and ultrasonic extraction temperature. The five deproteinization methods including Sevage reagent method, TCA method, salt method (NaOH-CaCl₂ and NaOH-NaCl) and hydrochloric acid method were investigated with the retention rate of polysaccharide and protein removal rate. Results The optimal extraction conditions of polysaccharide from Anoectochilus roxburghii were as follows: liquid-to-solid ratio was 10∶1, extraction temperature was 48 ℃ and extraction time was 36 min with extraction 2 times, ultrasonic power was 300 W, the extraction rate was 13.13%. NaOH-CaCl₂ deproteinized methods∶ the loss rate of polysaccharide was 18.74%, and the removal rate of protein was 95.62%. Conclusion Ultrasonic extraction is easy to operate, and the optimized extraction method can achieve a high extraction rate. NaOH-CaCl₂ deproteinization methods can get high protein removal rate and polysaccharide retention rate. This method is suitable for the research and development of the active components of the polysaccharides from Anoectochilus roxburghii.

Transcriptome sequencing was performed for the first time on Anoectochilus roxburghii(AR)in different harvesting periods using RNA-seq high-throughput sequencing technique, and the results were verified and analyzed by Q-PCR and HPLC. A total of 51, 370 genes were obtained by transcriptome sequencing and annotated to the database of Nr, GO, Swiss-Prot, KEGG and KOG. The species that were sequenced according to the homology sequence were the same as AR monocotyledon plants. Through comparison of AR transcriptome in different periods, it was found that the differences were mainly in flavonoid biosynthesis-related genes. The expression levels of flavonoid biosynthesis-related genes(trans-cinnamate 4-monooxygenase, caffeoyl-CoA O-methyltransferase, chalcone synthase, flavonol synthase, shikimate O-hydroxycinnamoyltransferase and flavonoid 3′, 5′-hydroxylase)were verified by Q-PCR, and the results were consistent with those of transcriptome sequencing. The contents of 6 flavonoids(rutin, isoquercitrin, narcissin, quercetin, kaempferol and isorhamnrtin)were determined by HPLC. The results showed that the expression of flavonoid synthetic gene in AR increased with the growth time, and the variation trend of flavonoid compound content and gene expression were basically consistent. Combined with transcriptome data, the biosynthetic pathway of flavonoid content in AR was plotted. This study provides important genetic resources for the key genes of flavonoid synthesis in AR and the biosynthesis of flavonoids, as well as the basis for the development of its medicinal value.

The forecast of health human resources demand is the most important and one of the most complex aspects of health manpower planning projections. There are many methods in forecasting human resources demand,and each method has its own advantages and disadvantages. Five kinds of commonly used basic methods are comparatively analysised in this paper.