Fibromyalgia syndrome （FMS） is a refractory， chronic non-articular rheumatic disease characterized by widespread pain throughout the body， for which there are no satisfactory therapeutic drugs or options. There are rich Chinese medical therapies， and some non-drug therapies， such as acupuncture， Tai Chi， and Ba-Duan-Jin， have shown satisfactory efficacy and safety and definite advantages of simultaneously adjusting mind and body. FMS is taken as a disease responding specifically to traditional Chinese medicine （TCM） by the National Administration of Traditional Chinese Medicine in 2018. In order to clarify the research progress in FMS and the clinical advantages of TCM/integrated Chinese and Western medicine， the China Academy of Chinese Medicine organized a seminar for nearly 20 experts in Chinese and Western medicine， including rheumatology， psychology， acupuncture and moxibustion， and encephalopathy， with the topic of difficulties in clinical diagnosis and treatment of FMS and advantages of TCM and Western medicine. The recommendations were reached on the difficulties in early diagnosis and solutions of FMS， mitigation of common non-specific symptoms， preferential analgesic therapy， TCM pathogenesis and treatment advantages， and direction of treatment with integrated Chinese and Western medicine. FMS is currently facing the triple dilemma of low early correct diagnosis， poor patient participation， and unsatisfactory benefit from pure Western medicine treatment. To solve the above problems， this paper suggests that rheumatologists should serve as the main diagnostic force of this disease， and they should improve patient participation in treatment decision-making， implement exercise therapy， and fully utilize the holistic and multidimensional features of TCM， which is effective in alleviating pain， improving mood， and decreasing adverse events. In addition， it is suggested that FMS treatment should rely on both TCM and Western medicine and adopt multidisciplinary joint treatment， which is expected to improve the standard of diagnosis and treatment of FMS in China.

Objective:To investigate the correlation between fluid-attenuated inversion recovery vascular hyperintensities(FVH) and prognosis and cognitive dysfunction in patients with internal watershed cerebral infarction(IWI).Methods:Totally106 patients with IWI were selected.According to FVH diagnostic criteria, there were 59 cases in FVH (+ ) group and 47 cases in FVH (-) group.Demographic data and risk factors of cerebrovascular disease were collected to assess the clinical neurological function of the patients at admission and discharge, and the short-term outcome was assessed by modified RANKIN scale (mRS) score at 90 days after discharge.The cognitive function of patients was assessed by MMSE scale.Results:There was no significant difference in NIHSS score between the two groups on admission ( P>0.05). The NIHSS score of FVH (+ ) group((3.37±2.33))at discharge was significantly lower than that of the FVH (-) group ((4.43±2.72))( P<0.05). The rate of neural function improvement and mRS score after discharge 90 days in FVH (+ ) group((42.16±12.20)%, (1.75±1.12)) was significantly higher than that in FVH (-) group((37.58±13.64)%, (2.19±1.38))(both P<0.05). The scores of orientation, recall and language ability of MMSE in FVH (+ ) group ((9.26±0.21), (1.66±0.27), (7.69±0.44) respectively)were significantly lower than those of FVH (-) group((9.43±0.36), (1.83±0.34), (7.85±0.28) respectively)(all P<0.05). There was no significant difference in memory, attention and calculation between the two groups ( P>0.05). Conclusion:FVH has no correlation with the severity of IWI patients when they are admitted to hospital.FVH may be used as an imaging sign for prognosis evaluation of patients with IWI .However, IWI patients with FVH may have more severe cognitive impairment.

Objective:To explore the clinical utility of liquid chromatography tandem mass spectrometry forprimary aldosteronism screening.Methods:From January to October 2019, 413 inpatients diagnosed hypertension from Fuwai Hospital of Chinese Academy of Medical Sciences were enrolled, including 60 Primary aldosteronism(PA)patients and 353 primary hypertension patients. The plasma aldosterone concentration (PAC) and renin concentration (DRC) were measured after 2 h of standing. The 24 h urine samples were collected for measurement of aldosterone using LC-MS/MS. The performance of urine aldosterone and urine aldosterone/renin ratio (UADRR) in PA screening was evaluated by ROC, and compared with PAC/DRC ratio (ADRR). Meanwhile, the efficiency of urine aldosterone in elderly patients or patients with low blood potassium or 24 h urine sodium over 200 mmol was investigated.Results:Area under the curve (AUC)of urine aldosterone was 0.725 (95 %CI 0.679-0.767), and the best cut-off was 7.13 μg/24 h, which was lower than AUC of ADRR (0.958, 95 %CI 0.934-0.975). The AUC of UADRR was 0.947 (95 %CI 0.920-0.966), the best cut-off was 1.11 (μg/24 h)/(μIU/ml), the sensitivity and specificity were 91.7% and 89.0%, respectively. There is no significant differences found with ADRR. In patients with 24 h urine sodium over 200 mmol, AUC of aldosterone was 0.834 (95 %CI 0.730-0.910) and the best cut-off was 9.31 μg/24 h. The sensitivity and specificity were 90.9% and 68.7%, respectively. For the elderly patients over 60 years old, the AUC of urinary aldosterone was 0.860 (95 %CI 0.770-0.925), and the best cut-off was 6.91 μg/24 h. The sensitivity and specificity were 84.6% and 81.3%, respectively. When admission blood potassium was less than 3.50 mmol/L, AUC of urinary aldosterone was 0.822 (95 %CI 0.684-0.917), and the best cut-off was 10.63 μg/24 h. The sensitivity and specificity were 85.7% and 66.7%, respectively. Conclusion:The detection of aldosterone in urine by LC-MS/MS can provide clinical information for PA screening, and the screening performance is better in patients with 24-hour urine sodium over 200 mmol, elderly patients or patients with low blood potassium. If combined with renin, screening efficiency was the same as that in ADRR.

Objective To investigate the value of early?phase enhancement ratio combined with peripheral vascular diameter in the differential diagnosis of benign and malignant breast lesions using 3.0 T dynamic contrast?enhanced magnetic resonance imaging (DCE?MRI). Methods Sixty seven cases of patients (35 with malignant lesions and 32 with benign lesions in the breasts) were retrospectively analyzed. Their diagnoses were confirmed by surgery and pathology and all the patients underwent breast MRI plain scan and DCE?MRI in the two weeks before surgery. Lesion ROIs were drawn and time?signal intensity curves in the DCE?MRI were generated. Early?phase enhancement rate, time to peak, early?phase enhancement ratio, numbers of tumor vessel within 3 cm of the lesion and diameter of the largest vessel were recorded. Mann?Whitney U test was used to compare the difference of DCE?MRI between benign and malignant lesions, and the ROC curve was used to evaluate the efficiency of early?phase enhancement rate, early?phase enhancement ratio and vascular diameter in differentiating benign and malignant lesions. Results With breast malignant lesions, the medians of time to peak, early?phase enhancement rate, early?phase enhancement ratio, numbers of tumor vessel and vascular diameter were 2.2 s, 176.0%, 100.0%, 4 and 2.96 mm respectively, while with benign lesions of these parameters were 4.7 s, 113.3%, 81.9%, 0 and 0.00 mm respectively, and the differences were statistically significant (all P<0.05).When early?phase enhancement rate was used for differential diagnosis of breast benign and malignant lesions, the area under the ROC curve was 0.702 and the sensitivity and specificity were 82.86%and 56.25%with a threshold of 120.0%. When early?phase enhancement ratio was used, the area under the ROC curve was 0.854 and the sensitivity and specificity were 94.29% and 68.75% with a threshold of 86.0%. When peripheral vascular diameter was used, the area under the ROC curve was 0.896 and the sensitivity and specificity were 74.29%and 84.38% with a threshold of 2.78 mm. When early?phase enhancement ratio was combined with peripheral vascular diameter, the area was 0.925 and the sensitivity and specificity were 97.14% and 62.50%. Conclusion In the differential diagnosis of benign and malignant breast lesions under DCE?MRI, early?phase enhancement ratio combining with peripheral vascular diameter has improved sensitivity.

Three new glucosylated caffeoylquinic acid isomers (1-3), along with six known compounds, have been isolated from an aqueous extract of the flower buds of Lonicera japonica. Structures of the new compounds were determined by spectroscopic and chemical methods as (-)-4-O-(4-O-β-d-glucopyranosylcaffeoyl)quinic acid (1), (-)-3-O-(4-O-β-d-glucopyranosylcaffeoyl)quinic acid (2), and (-)-5-O-(4-O-β-d-glucopyranosylcaffeoyl)quinic acid (3), respectively. In the preliminary in vitro assays, two known compounds methyl caffeate and 2'-O-methyladenosine showed inhibitory activity against Coxsackie virus B3 with IC50 values of 3.70 μmol/L and 6.41 μmol/L and SI values of 7.8 and 12.1, respectively.

ABSTRACT:Objective To explore the application value of psychological nursing in treatment of patients with malignant tumor chemotherapy.Methods A total of 105 patients with malignant tumor chemotherapy were randomly divided into intervention group (52 cases)and control group (53 cases).Control group was treated with routine nursing,on this basis intervention group was added with psychological nursing,including evaluation of psychological condition,establishment of favorable nurse-patient relationship,regular communication,optimization of patients’social sup-port network and relaxation training,etc.Results After nursing,self-rating anxiety scale (SAS) and self-rating depression scale (SDS)scores of both groups decreased significantly,which were significantly lower in intervention group than control group (P <0.01).After nursing,there were no significant differences in role function,emotional function and social function in intervention group when compared with nursing before (P >0.05),but the scores of rest programs of European Organization Research and Treatment of Cancer (EORTC)Quality of Life Questionnaire (QLQ)-30 decreased significantly than nursing before (P <0.01),and intervention group was significantly lower in each score of above programs than control group (P <0.05 or P <0.01).Conclusion Psychological nursing can effectively improve the psychological condition,reduce negative emotions and improve the quality of life in patients with malignant tumor chemotherapy.

ABSTRACT:Objective To explore the application value of psychological nursing in treatment of patients with malignant tumor chemotherapy.Methods A total of 105 patients with malignant tumor chemotherapy were randomly divided into intervention group (52 cases)and control group (53 cases).Control group was treated with routine nursing,on this basis intervention group was added with psychological nursing,including evaluation of psychological condition,establishment of favorable nurse-patient relationship,regular communication,optimization of patients’social sup-port network and relaxation training,etc.Results After nursing,self-rating anxiety scale (SAS) and self-rating depression scale (SDS)scores of both groups decreased significantly,which were significantly lower in intervention group than control group (P <0.01).After nursing,there were no significant differences in role function,emotional function and social function in intervention group when compared with nursing before (P >0.05),but the scores of rest programs of European Organization Research and Treatment of Cancer (EORTC)Quality of Life Questionnaire (QLQ)-30 decreased significantly than nursing before (P <0.01),and intervention group was significantly lower in each score of above programs than control group (P <0.05 or P <0.01).Conclusion Psychological nursing can effectively improve the psychological condition,reduce negative emotions and improve the quality of life in patients with malignant tumor chemotherapy.

Background Senescence marker protein 30 (SMP30) is a new calcium regulatory protein,which plays anti-oxidation,stable calcium and anti-apoptosis roles in vivo.Researches determined that the expression of SMP30 in human cells gradually decreased as ageing.However,the study on the relationship between SMP30 and age-related cataract is rarely.Objective The aim of this study was to investigate the expression of SMP30 in lens epithelial cells (LECs) of different ages of cataract patients.Methods This study was approved by Ethic Commission of the First Affiliated Hospital of Guangxi Medical University.A non-randomized controlled trail was designed.The samples of the anterior capsular membrane of lens were collected during the cataract surgery from the children group (1-18 years),youth group (19-45 years),mid adult group (46-60 years) and elder group (＞60 years) and 12 pieces of capsular membrane for each group.In addition,12 pieces of lens capsular membrane from normal donors aged 19-45 years were obtained as normal control group.The expression of SMP30 in the samples was detected by indirect immunofluorescence method.The average fluorescent values were calculated as absorbance (A) / area.Results SMP30 was expressed in LECs of different groups with the green fluorescence primarily in the cytoplasm.The mean fluorescence intensity was 0.185±0.020,0.181±0.034,0.207±0.018 and 0.126±0.027 in the children group,youth group,mid adult group and elder group,respectively,which were significantly enhanced than 0.087±0.007 of the normal control group(q=3.96,3.82,4.01,3.55,all at P＜0.01).No significant differences in the expression of SMP30 among the children group,youth group and mid adult group (all at P＞0.05).However,the expression of SMP30 in LECs in the elder group was significantly lower than that in the children group,youth group and mid adult group (q =3.42,3.21,3.80,all at P＜ 0.05).Conclusions Expression of SMP30 in LECs dramatically increases in cataract patients,suggesting that SMP30 may be a protective factor for LECs.But SMP30 contents are lower in age-related cataract patients,which may be one of causes of senior cataract.

Objective To investigate the effect of gefitinib on mucus hypersecretion by inhibiting epidermal growth factor receptor (EGFR) activity in chronic obstructive pulmonary disease (COPD).Methods Human airway epithelail cell lines 16HBE cells were exposed to cigarette smoke extraction (CSE) to establish the COPD model.EGFR activity was inhibited by tyrosine kinase inhibitor gefitinib.The mRNA expressions of EGFR and MUC5AC were detected by real-time PCR.EGFR,p-EGFR and MUC5AC protein levels were determined by Western blot and ELISA.Results EGFR mRNA level was increased by 12.7％ in CSE and 8.6％ in gefitinib group,but had no significant differences among CSE,gefitinib group and control group (all P＞ 0.05).MUC5AC mRNA levels were enhanced by 141.7％,26.4％ in CSE group and gefitinib group respectively,and there were significant differences among CSE,gefitinib group and control group (all P＜0.05).EGFR protein levels were (600.34±64.58) μg/mg,(632.58±72.94) μg/mg,(584.57±67.39) μg/mg,in control,CSE and gefitinib groups,respectively,and there were no significant differences between groups (all P＞0.05).p-EGFR protein levels were (338.62±45.28) μg/mg,(679.43±78.23) μg/mg,(292.74±59.17) μg/mg in control,CSE and gefitinib groups,respectively.MUC5AC protein levels were(72.80±6.25)μg/mg,(187.00±±10.26)μg/mg,(92.57±8.32)μg/mg in control,CSE and gefitinib groups respectively.Compared with control group,p-EGFR and MUC5AC protein levels were increased significantly in CSE group (both P＜0.05),and had no significant differences in p EGFR and MUC5AC protein levels between control group and gefitinib group.Conclusions CSE may lead to mucus hypersecretion through activating the EGFR-mediated signaling pathways.Gefitinib may inhibit mucus hypersecretion by inhibiting EGFR tyrosine kinanse activity.EGFR may serve as a potential target for COPD.

ObjectiveTo observe the effects of salmeterol fluticasone on the glucose metabolism and bone density of the elderly patients with chronic obstructive pulmonary disease (COPD) combined with type 2 diabetes mellitus (T2DM).MethodsThirty-one patients with COPD combined with T2DM were divided into 2 groups by random digits table,14 cases in control group were given conventional therapy,17 cases in experimental group were given conventional therapy and fluticasone propionate 50/500 μg,twice a day,for 3 months.The fasting blood glucose,postprandial 2 hours glucose,glycosylated hemoglobin,plasma cortisol and bone density respectively before and after treatment were detected.ResultsIn experimental group,the fasting blood glucose,postprandial 2 hours glucose,glycosylated hemoglobin and bone density before treatment was (5.25 ± 0.21 ) mmol/L,(7.14 ± 0.33 ) mmol/L,(5.58 ± 0.26 )％,( 1.96 ± 0.11 ) g/cm2,and after treatment was(5.31 ± 0.27 ) mmol/L,(7.22 ± 0.29 ) mmol/L,(5.67 ± 0.23 )％,(2.03 ± 0.15 ) g/cm2,there was no significant difference (P ＞ 0.05).In control groups,the fasting blood glucose,postprandial 2 hours glucose,glycosylated hemoglobin and bone density before treatment was (5.33 ± 0.35) mmol/L,( 7.26 ± 0.29 ) mmol/L,( 5.62 ± 0.19 )％,( 1.88 ± 0.20 ) g/cm2,and after treatment was ( 5.36 ± 0.31 ) mmol/L,(7.30 ± 0.35 ) mmol/L,( 5.69 ± 0.26 )％,( 1.98 ± 0.17 ) g/cm2,there was no significant difference (P ＞ 0.05 ).There was no significant difference in plasma cortisol before and after treatment in two groups (P ＞0.05).ConclusionInhaling salmeterol fluticasone for elderly patients with COPD combined with T2DM is safe.