Objective To explore the potential causal relationship between 91 inflammatory factors and the risk of lung cancer (LC). Methods By extracting related data of inflammatory factors and LC and its subtypes from public databases of Genome-wide Association Studies (GWAS), bidirectional, repeated, multivariable Mendelian randomization (MR) and subgroup MR methods were used for analysis. The inverse variance weighted method was mainly used for causal inference, and a series of sensitivity analyses were applied to verify the strength of the results. Results Higher levels of CD5, interleukin-18 (IL-18), and oncostatin-M (OSM) were causally associated with a lower risk of LC, while nerve growth factor-β (NGF-β) and S100 calcium-binding protein A12 (S100A12) were associated with an increased risk of LC. Subgroup MR analysis results showed that IL-18 had a causal relationship with a reduced risk of lung adenocarcinoma, while NGF-β and S100A12 had a causal relationship with an increased risk of lung adenocarcinoma; CD5 and OSM had a causal relationship with a reduced risk of lung squamous cell carcinoma; NGF-β had a causal relationship with an increased risk of small cell lung cancer. Conclusion Five inflammatory factors, including CD5, IL-18, OSM, NGF-β, and S100A12 have a causal correlation with the risk of LC, providing potential targets for early screening of LC patients and development of therapeutic drugs.

ObjectiveTo explore the therapeutic mechanism of Buchong Tiaojing prescription for rats with diminished ovarian reserve （DOR） from the perspectives of nucleotide-binding oligomerization domain （NOD）-like receptor protein 3 （NLRP3） inflammasome and ferroptosis. MethodsA total of 48 female SD rats were randomly divided into a normal group， a model group， low， medium， and high dose groups of Buchong Tiaojing prescription， and an MCC950 group， with eight rats in each group. Except the normal group， all the other groups were injected subcutaneously on the back of the neck with D-galactose to prepare the DOR rat model. From the 15th day of modeling， the rats in the low， medium， and high dose groups of Buchong Tiaojing prescription were subjected to gavage daily at doses of 14.4， 28.8， 57.6 g·kg^-1， respectively. Rats in the MCC950 group were injected intraperitoneally with MCC950 at a dose of 10 mg·kg^-1， once every other day. The interventions of all the groups lasted for 4 weeks. The estrous cycle of the rats was observed with vaginal exfoliated cell smear. Hematoxylin-eosin （HE） staining was performed to observe the development of follicles and corpus luteum in the ovary. Enzyme-linked immunosorbent assay （ELISA） was performed to detect the levels of serum sex hormones and interleukin-1β （IL-1β）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot assay were performed to detect the mRNA and protein expression of NLRP3 inflammasome， acyl-CoA synthetase long-chain family member 4 （ACSL4）， transferrin receptor 1 （TFR1）， and glutathione peroxidase 4 （GPX4）， and oxidative stress kits were used to detect ovarian superoxide dismutase （SOD） and malondialdehyde （MDA） levels. ResultsDuring the experiment， one rat died in the high dose group of Buchong Tiaojing prescription， and a total of 47 rats were finally included in the index tests and statistics. Compared with those in the normal group， rats in the model group had significantly disturbed estrous cycles， increased number of atretic follicles， and significant disorder of serum sex hormones. The mRNA and protein expression of NLRP3 inflammasome， ACSL4， and TFR1 in ovarian tissue was up-regulated （P<0.01）， while that of GPX4 was significantly down-regulated （P<0.01）. The SOD content in the ovary was decreased significantly， while the MDA level was increased （P<0.01）. After drug intervention， the estrous cycle of rats was basically resumed， and the follicles at all levels were more structurally intact and significantly increased in number. Additionally， the levels of serum sex hormones and IL-1β were significantly improved. The mRNA and protein expression of NLRP3 inflammasome， ACSL4， and TFR1 were down-regulated， while that of GPX4 was significantly up-regulated， and the ovarian oxidative stress was alleviated （P<0.05， P<0.01）， especially in the high dose group of Buchong Tiaojing prescription and the MCC950 group. ConclusionInflammatory injury and ferroptosis occur in the ovaries of DOR rats， and the Buchong Tiaojing prescription is able to inhibit ovarian NLRP3 inflammasome， alleviate the degree of ovarian ferroptosis， and improve ovarian reserve.

As the need for antibody production rises, there is an urgent need to lower the costs and enhance the efficiency of the separation process. Currently, the chromatographic media used for antibody separation and purification often focus on individual properties of antibodies, such as affinity, hydrophobicity, and charge, leading to issues like low purification efficiency or inadequate adsorption capacity. To address this, an electrostatically coupled polypeptide affinity medium (FD7-3, 5-diaminobenzoic acid n-sepharose, FD7-DA-Sepharose) was developed for rapid purification of antibodies from cell culture supernatant. This medium utilized 3, 5-diaminobenzoic acid as a spacer to attach the heptapeptide-affinity ligand (FYEILHD, FD7) to agarose microspheres. Antibodies could be adsorbed through charge interactions with the carboxyl functional group of the FD7-DA-Sepharose spacer, while FD7 enhanced electrostatic coupling and affinity adsorption through synergistic effects, significantly increasing the adsorption capacity while maintaining the affinity and specificity. The influences of pH and ionic strength on adsorption capacity were investigated with human immunoglobulin as a model protein. The static adsorption capacity (Q_m) of FD7-DA-Sepharose in the solution of pH 6.0 reached 67.73 mg/mL, representing a 52.68% increase compared with that (44.36 mg/mL) of the commercial Protein A affinity medium. Furthermore, the elution conditions for FD7-DA- Sepharose were mild (20 mmol/L PB, 0.5 mol/L NaCl, pH 6.0), in contrast to the harsh acidic elution (pH 2.7-3.6) typically associated with Protein A, which can damage antibody integrity. The FD7-DA-Sepharose medium was then employed to purify antibodies from cell culture supernatant, achieving the yield of 94.8% and the purity of 98.4%. The secondary structure of the purified antibody was determined by circular dichroism spectroscopy. The results demonstrated that FD7-DA-Sepharose enabled efficient purification of antibodies from cell culture supernatant, which provided a cost-effective solution (approximately one-third the price of commercial Protein A affinity medium) with gentle elution conditions that preserve the natural conformation of antibodies. This approach paves a novel, economical, and efficient way for the separation and purification of antibodies from cell culture supernatant.
Chromatography, Affinity/methods* ; Static Electricity ; Humans ; Sepharose/analogs & derivatives* ; Peptides/chemistry* ; Adsorption ; Antibodies/isolation & purification*

Objective: To investigate the value of metagene next⁃generation sequencing ( mNGS) in the detection of pathogens in patients with pulmonary infection. Methods: A retrospective analysis was performed on clinical data from 434 patients with pulmonary infections admitted over the past four years. Based on the presence of underlying comorbidities , patients were divided into underlying disease group (n = 262) and non⁃underlying disease group (n = 172) . Pathogen detection was conducted using both mNGS and conventional tests. Clinical and laboratory parameters , radiographic findings , and pathogen detection results were systematically analyzed. The diagnostic performance of the two methods in identifying causative pathogens of pulmonary infections was compared. Results: The positive rate of mNGS in 434 patients was higher than that of conventional tests , and the difference was statisti⁃cally significant (P < 0. 05) . The efficacy of mNGS in detecting bacteria and viruses was significantly higher than that of conventional tests , and the difference was statistically significant (P < 0. 05) . Although the fungal detection rate of mNGS was higher than that of conventional tests , the difference was not statistically significant. Among them , the detection rates of Mycobacterium tuberculosis , Mycoplasma pneumoniae , Haemophilus influenzae , Strepto⁃ coccus pneumoniae , Streptococcus constellation , Staphylococcus aureus and Aspergillus fumigatus were significantly higher than those of conventional tests , and the difference was statistically significant (P < 0. 05) . Subgroup analy- sis showed that the proportion of males , hospital stay , smoking prevalence and average age in the underlying dis- ease group were higher than those in the non-underlying disease group , and the difference was statistically signifi- cant (P < 0. 05) , while there were no significant differences in antibiotic use and endotracheal intubation rate be- tween the two groups. The most common pathogens detected by mNGS in the underlying disease group were Myco⁃ bacterium tuberculosis , Haemophilus influenzae , Streptococcus pneumoniae , Pseudomonas aeruginosa , human herpes⁃ virus type 4 and Aspergillus fumigatus , while the most common pathogens in the non-underlying disease group were Mycobacterium tuberculosis , Haemophilus influenzae , Streptococcus pneumoniae , Mycoplasma pneumoniae and Kleb⁃ siella pneumoniae. The positive rate of mNGS in the two groups was significantly higher than that of conventional tests , and the difference was statistically significant (P < 0. 05) , while the difference in the positive rate of mNGS between the two groups was not statistically significant. Conclusion mNGS has significant advantages over con- ventional tests of pathogen in lung infection , and is less affected by underlying diseases , which can provide an etio- logical basis for lung infection.

Based on the characteristics of postoperative gynaecological diseases， Lingnan LUO's Gynaecology has summarized the idea of "eliminating abdominal mass to help pregnancy"， and applied the elimination method in the postoperative gynaecological treatment to promote rehabilitation， prevent recurrence， and regulate menstruation in a sequential manner， which is divided into three phases of diagnosis and treatment. The first stage of postoperative rehabilitation （2 weeks after surgery） is based on the pathogenesis of profuse deficiency， profuse stasis， and easy to retain pathogens， and the treatment should focus on tonifying the positive qi and eliminating abdominal mass at the same time， commonly used in modified Sijunzi Dcoction （四君子汤） and Shenghua Dcoction （生化汤）. In the second stage of postoperative rehabilitation （2 weeks to 2-3 months after surgery）， the pathogenesis is mainly kidney deficiency and blood stasis， which should be treated by tonifying kidney and supplement essence， eliminate blood stasis and eliminate abdominal mass， and commonly use the Guishen Pill （归肾丸） with herbs that invigorating blood， dissolving stasis， and clearing the collaterals. Postoperative sequential menstrual regulation and fertility promotion stage （after the end of the postoperative rehabilitation stage， the normal anatomy of the uterine cavity and pelvis is basically restored） adopts cyclic sequential therapy， according to the characteristics of the pathogenesis of the different periods of menstruation in phases， always tonifying kidney and regulating menstruation， eliminating abdominal mass， and attaches importance to the application of four methods of eliminating abdominal mass， including invigorating blood and dissolving stasis， moving qi to resolve constraint， dissolving phlegm and dispelling dampness， resolving accumulation and removing stagnation.

Threatened abortion is a common disease of obstetrics and gynecology and one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in TCM obstetrics and gynecology， Western medicine obstetrics and gynecology， and pharmacology to deeply discuss the advantages of TCM and integrated Chinese and Western medicine treatment as well as the medication plans for threatened abortion. After discussion， the experts concluded that chromosome， endocrine， and immune abnormalities were the key factors for the occurrence of threatened abortion， and the Qi and blood disorders in thoroughfare and conception vessels were the core pathogenesis. In the treatment of threatened abortion， TCM has advantages in preventing miscarriages， alleviating clinical symptoms and TCM syndromes， relieving anxiety， regulating reproductive endocrine and immune abnormalities， personalized and diversified treatment， enhancing efficiency and reducing toxicity， and preventing the disease before occurrence. The difficulty in diagnosis and treatment of threatened abortion with traditional Chinese and Western medicine lies in identifying the predictors of abortion caused by maternal factors and the treatment of thrombophilia. Recurrent abortion is the breakthrough point of treatment with integrated traditional Chinese and Western medicine. It is urgent to carry out high-quality evidence-based medicine research in the future to improve the modern diagnosis and treatment of threatened abortion with TCM.

This article applied the five-viscera correlation theory proposed by Professor DENG Tietao to the field of gynecology， and combined with Professor LUO Yuankai's theory of female reproductive regulation axis of traditional Chinese medicine （TCM）， to identify from the perspective of the overall transmission of diseases between the five-viscera correlation theory， which affects the female reproductive regulation axis of TCM and leads to reproductive disorders. It advocates breaking away from specialized barriers， forming a new medical concept of holism， combining multiple specialties， and using the concept of treating diseases before they occur to prevent and treat reproductive disorders caused by chronic diseases in various departments； in the meanwhile， paying attention to female patients with chronic diseases in various specialties who have been using medication for a long period of time； making sure that they understand menstruation in adolescent and childbearing females， checking the function of the ovaries in a timely manner， and protecting their fertility； so as to propose new ideas of research on TCM theories， as well as providing a new concept for clinical research on integration of TCM with Western medicine.

Objective:To explore the switch time of noninvasive-invasive mechanical ventilation sequential treatment for acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and effectively reduce the rate of tracheal intubation.Methods:A retrospective study was performed on patients with AECOPD, who underwent mechanical ventilation in emergency resuscitation room and admitted to department of respiration of Kaifeng Central Hospital Emergency Center from July 2014 to March 2019. The patients who used noninvasive mechanical ventilation (NIV) were included in NIV group (118 cases), and those who used invasive positive pressure ventilation (IPPV) were included in IPPV group (52 cases). The usage of breathing machine time, hospital days and hospital mortality were compared between the two groups. Clinical indicators such as age, gender, body temperature, respiratory rate, body mass index (BMI), mean arterial pressure (MAP), oxygenation index (PaO 2/FiO 2), respiratory index (RI), pH value, D-dimer, hemoglobin (HB), albumin, blood lactate (Lac), brain natriuretic peptide (BNP), C-reactive protein (CRP), procalcitonin (PCT), serum creatinine (SCr), white blood cell count (WBC), Glasgow coma scale (GCS), sputum excretion drainage were collected. The factors influencing the failure of NIV were analyzed by Logistic stepwise regression analysis. The receiver operating characteristic (ROC) curve was used to test the value of the NIV failure risk prediction model. Results:There was no significant difference in total mechanical ventilation time and hospital mortality between NIV group and IPPV group (hours: 65.6±11.11 vs. 66.9±12.1, 6.8% vs. 9.6%, both P > 0.05), but the hospital time in group NIV was significantly shorter than that in IPPV group (days: 12.3±2.1 vs. 14.2±2.5, P < 0.05). In NIV group, 101 cases completed NIV continuously, 17 cases of NIV failure turned to IPPV, and the failure rate of NIV was 14.4%. There were statistically significant differences in gender, PaO 2/FiO 2, RI, pH value, D-dimer, PCT, WBC, Lac, sputum excretion drainage and GCS score between NIV failure patients and NIV success patients. Logistic regression analysis showed that RI, pH value, WBC and sputum excretion drainage were independent risk factors for NIV failure [RI: odds ratio ( OR) = 3.879, 95% confidence interval (95% CI) was 1.258-11.963, P = 0.018; pH value: OR = 3.316, 95% CI was 1.270-8.660, P = 0.014; WBC: OR = 3.684, 95% CI was 1.172-11.581, P = 0.026; sputum excretion drainage: OR = 0.125, 95% CI was 0.042-0.366, P = 0.000]. The NIV failure risk prediction model based on the above independent risk factors had a good goodness of fit ( χ2 = 9.02, P = 0.34). ROC curve analysis showed that the NIV failure risk prediction model had a high predictive value for the patients with AECOPD [the area under ROC curve (AUC) was 0.818±0.051, 95% CI was 0.718-0.918, P = 0.000]. Conclusions:If patients with AECOPD have relative contraindications of NIV but still insist on using NIV, further risk stratification of NIV failure is needed. For those with RI, pH value, WBC abnormalities and sputum excretion drainage, the risk of choosing NIV is significantly increased. We need to pay more attention to the change of the condition and switch to IPPV in time to avoid exacerbation of the condition.

Objective To analyze the risk factors of failure of emergency treatment with invasive mechanical ventilation (IPPV) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods The clinical data of 122 patients with AECOPD to undergo IPPV admitted to the Emergency Center of Kaifeng Central Hospital from July 2015 to March 2018 were retrospectively analyzed. The patient's general information [gender, age, body mass index (BMI)] and the patient's body temperature (T) at initial IPPV, respiratory rate (RR), mean arterial pressure (MAP), heart rate (HR), white blood cell count (WBC), hemoglobin (Hb), electrolyte (K+, Na+ and Cl-), pH value, D-dimer, albumin, C-reactive protein (CRP), blood lactic acid (Lac), B-type brain natriuretic peptide (BNP), procalcitonin (PCT), serum creatinine (SCr), oxygenation index, respiratory index (RI), the occurrence of serious arrhythmia or not, Glasgow coma score (GCS) were statistically analyzed. The indicators with statistical significance in the univariate analysis were introduced into the multivariate Logistic regression analysis to screen out the risk factors affecting the failure of IPPV in the patients; receiver operating characteristic (ROC) curve was drawn to analyze the test effectiveness of the risk factors. Results There were totally 98 cases underwent emergency IPPV, failure in 17 cases and success in 81 cases. The levels of oxygenation index, pH value, WBC and GCS scores of the IPPV success group were significantly higher than those of the IPPV failure group [oxygenation index (mmHg, 1 mmHg =0.133 kPa): 304.10±115.35 vs. 285.93±184.64, pH value: 7.34±0.17 vs. 7.18±0.24, WBC (×109/L): 40.90±8.72 vs. 26.61±6.86, GCS score: 12.42±1.35 vs. 9.89±2.13, all P < 0.05]; the levels of RI, D-dimer, PCT, Lac and incidence of serious arrhythmia in the IPPV success group were significantly lower than those in the IPPV failure group [RI: 2.53±2.39 vs. 3.69±3.64, D-dimer (mg/L): 1.80±0.06 vs. 3.16±2.60, PCT (μg/L): 1.36±0.65 vs. 2.23±2.07, Lac (mmol/L): 3.98±0.63 vs. 7.06±3.44, incidence of serious arrhythmia: 23.46% (19/81) vs. 47.06% (8/17), all P < 0.05]. Logistic regression analysis showed that RI [odds ratio (OR) = 3.479, 95% confidence interval (95%CI)= 1.248-11.996], pH value (OR = 3.153, 95%CI = 1.256-8.656), WBC (OR = 3.364, 95%CI = 1.171-11.561), and the occurrence of severe arrhythmia (OR = 4.125, 95%CI = 0.042-0.342) were risk factors affecting the prognosis of AECOPD patients treated with IPPV (all P < 0.05). ROC curve analysis showed that the area under the ROC curve (AUC) of RI, pH value, WBC and occurrence of severe arrhthmia was 0.718 (P = 0.012), 0.832 (P = 0.008), 0.645 (P = 0.004), 0.617 (P = 0.003), and the sensitivity were 37.0%, 55.6%, 81.5%, 60.4%, the specificity were 19.1%, 26.8%, 60.3%, 83.0% respectively, that had certain value to predict the failure of using IPPV to treat patients with AECOPD. Conclusion Multiple factors may result in failure in emergency patients with AECOPD to apply invasive mechanical ventilator for treatment, that may lead to death, and RI, pH value, WBC, the occurrence of severe arrhythmia are the independent risk factors of failure in such patients using IPPV; emergency physicians should pay attention to AECOPD patients' risk factors at initial period of using IPPV in order to give early warning after assessment.

The National Excellent Course of Gynecology of Chinese Medicine is a main clinical subject of TCM,which puts emphasis on clinical application.The non-medical doctoral students are lack of the knowledge of traditional Chinese medicine and clinical experience,and the existing classroom teaching has the problem of the basic theory of traditional Chinese medicine being out of line with the clinical application,which has become the hindering factors of TCM gynecology teaching.By designing and perfecting the process of preparation before class-classroom teaching-discussion teaching-clinical probation-after class feedback,the related teaching teachers better improve the non medical doctoral students' ability to put the traditional Chinese medicine gynecology basic knowledge into clinical practice,which is well received by the students.