Objective We aimed to evaluate the efficacy and safety of Shengxuebao Mixture in the treatment of cancer-related anemia(CRA)presenting with syndrome of deficiency of liver and kidney combined with syndrome of deficiency of both qi and blood.Methods A randomized,double-blind,placebo-controlled,multicenter clinical trial was conducted.Eligible patients with malignant tumors meeting the inclusion and exclusion criteria were enrolled from 26 hospitals,including Dongzhimen Hospital,Beijing University of Chinese Medicine,Xiaogan Central Hospital,and Yangzhou Hospital of Traditional Chinese Medicine,from June 1,2022,to September 30,2024.Patients were allocated 1:1 to either the experimental group receiving Shengxuebao Mixture or the control group receiving its simulator(placebo)using a block randomization method under double-blind conditions.Both groups received 15 mL orally three times daily for 28 consecutive days.The primary efficacy indicators included the hemoglobin(Hb)improvement rate(RHb)and the traditional Chinese medicine(TCM)syndrome improvement rate(RTCM)at week 4 of treatment.The secondary efficacy indicators encompassed Hb and red blood cell(RBC)count,Karnofsky Performance Status(KPS)score,TCM syndrome score,individual TCM symptom scores,and changes in each of these indicators compared to the baseline period at weeks 2,4,and 6 of treatment.Safety evaluations were conducted at week 4 of treatment.Results A total of 239 patients were enrolled,with 225 cases included in the Full Analysis Set(FAS)(109 in the experimental group vs.116 control group),163 in the Per Protocol Set(PPS)(77 vs.86),and 225 in the Safety Set(SS)(109 vs.116).Baseline characteristics between groups showed no significant differences.Significant differences were observed between the experimental and control groups in RHb at week 4(FAS:49.51%vs.35.24%,P<0.05;PPS:53.25%vs.36.05%,P<0.05)and RTCM at week 4(FAS:61.54%vs.39.62%,P<0.01;PPS:64.94%vs.40.70%,P<0.01).At weeks 2,4,and 6,the experimental group showed greater improvements in Hb and RBC counts than the control group.Additionally,the TCM syndrome scores were lower in the experimental group than in the control group at these time points.Except for week 2 in PPS,the KPS improvement was better in the experimental group than in the control group(P<0.05).The experimental group also demonstrated a greater reduction in scores for individual TCM symptoms such as spiritlessness and weakness,poor appetite and reduced food intake at weeks 4 and 6 compared to the control group(P<0.05,P<0.01).Furthermore,the reduction in vertigo score was more pronounced in the experimental group at week 6(P<0.01).For the score of pale and lusterless complexion,only in the PPS was the reduction from baseline more significant in the experimental group than in the control group at weeks 4 and 6(P<0.05).No significant differences were observed between the experimental and control groups in the incidence of all adverse events or drug-related adverse reactions.Conclusion Shengxuebao Mixture demonstrates significant efficacy in patients with CRA presenting syndrome of deficiency of liver and kidney combined with syndrome of deficiency of both qi and blood,effectively increasing Hb levels,ameliorating TCM syndromes,alleviating clinical symptoms,and enhancing functional status,with no significant difference in adverse drug reactions compared to the placebo.

Objective We aimed to evaluate the efficacy and safety of Shengxuebao Mixture in the treatment of cancer-related anemia(CRA)presenting with syndrome of deficiency of liver and kidney combined with syndrome of deficiency of both qi and blood.Methods A randomized,double-blind,placebo-controlled,multicenter clinical trial was conducted.Eligible patients with malignant tumors meeting the inclusion and exclusion criteria were enrolled from 26 hospitals,including Dongzhimen Hospital,Beijing University of Chinese Medicine,Xiaogan Central Hospital,and Yangzhou Hospital of Traditional Chinese Medicine,from June 1,2022,to September 30,2024.Patients were allocated 1:1 to either the experimental group receiving Shengxuebao Mixture or the control group receiving its simulator(placebo)using a block randomization method under double-blind conditions.Both groups received 15 mL orally three times daily for 28 consecutive days.The primary efficacy indicators included the hemoglobin(Hb)improvement rate(RHb)and the traditional Chinese medicine(TCM)syndrome improvement rate(RTCM)at week 4 of treatment.The secondary efficacy indicators encompassed Hb and red blood cell(RBC)count,Karnofsky Performance Status(KPS)score,TCM syndrome score,individual TCM symptom scores,and changes in each of these indicators compared to the baseline period at weeks 2,4,and 6 of treatment.Safety evaluations were conducted at week 4 of treatment.Results A total of 239 patients were enrolled,with 225 cases included in the Full Analysis Set(FAS)(109 in the experimental group vs.116 control group),163 in the Per Protocol Set(PPS)(77 vs.86),and 225 in the Safety Set(SS)(109 vs.116).Baseline characteristics between groups showed no significant differences.Significant differences were observed between the experimental and control groups in RHb at week 4(FAS:49.51%vs.35.24%,P<0.05;PPS:53.25%vs.36.05%,P<0.05)and RTCM at week 4(FAS:61.54%vs.39.62%,P<0.01;PPS:64.94%vs.40.70%,P<0.01).At weeks 2,4,and 6,the experimental group showed greater improvements in Hb and RBC counts than the control group.Additionally,the TCM syndrome scores were lower in the experimental group than in the control group at these time points.Except for week 2 in PPS,the KPS improvement was better in the experimental group than in the control group(P<0.05).The experimental group also demonstrated a greater reduction in scores for individual TCM symptoms such as spiritlessness and weakness,poor appetite and reduced food intake at weeks 4 and 6 compared to the control group(P<0.05,P<0.01).Furthermore,the reduction in vertigo score was more pronounced in the experimental group at week 6(P<0.01).For the score of pale and lusterless complexion,only in the PPS was the reduction from baseline more significant in the experimental group than in the control group at weeks 4 and 6(P<0.05).No significant differences were observed between the experimental and control groups in the incidence of all adverse events or drug-related adverse reactions.Conclusion Shengxuebao Mixture demonstrates significant efficacy in patients with CRA presenting syndrome of deficiency of liver and kidney combined with syndrome of deficiency of both qi and blood,effectively increasing Hb levels,ameliorating TCM syndromes,alleviating clinical symptoms,and enhancing functional status,with no significant difference in adverse drug reactions compared to the placebo.

Objective To explore the antioxidant capacity of the volatile oil components of the Mongolian medicine Zhenbaowan and the mechanism of action in the treatment of rheumatoid arthritis(RA)by using bioinformatics technology,GC-MS technology,and antioxidant activity experiment.Methods The volatile oil in Zhenbaowan was extracted using water vapor distillation and the volatile oil components were qualitatively analyzed by GC-MS.Based on the results of GC-MS analysis,bioinfor-matics analysis was used to investigate the main components,key targets,and pathways of the volatile oil of Zhenbaowan in pre-venting and treating RA.Meanwhile,the antioxidant activity of the volatile oil was determined and analyzed using the 2,2-Diphen-yl-1-picrylhydrazyl(DPPH)method.Results A total of 115 volatile oil components were identified in Zhenbaowan,of which the top 48 components accounted for 97.66%of the total volatile oil content.Bioinformatics analysis revealed that Zhenbaowan can regulate signal transduction,inflammation,and protein phosphorylation through 147 RA-related targets,and intervene in signaling pathways such as PI3K-Akt,MAPK,and RAS.Molecular docking results showed that the seven main components of Zhenbaowan volatile oil can spontaneously bind to the five core targets.Antioxidant activity tests have proved that the volatile oil of Zhenbaowan has a more significant antioxidant capacity.Conclusion Using GC-MS high-throughput analysis technology combined with bioinformatic analysis and antioxidant activity test,the pharmacodynamic substances and mechanism of action of the volatile oil components of Zhenbaowan,a Mongolian medicine,in the treatment of RA are hypothesized.It provides a theoretical basis for the further study of the volatile oil components of Zhenbaowan.

Objective:To analyze the risk factors of radiation-based sarcopenia in patients with multiple myeloma (MM).Methods:A total of 185 clinical and imaging data of patients with MM admitted to Beijing Chaoyang Hospital from September 2009 to October 2019 were retrospectively analyzed. The area of the erector spinae muscle and the area of fatty infiltration (FI) in the fascial compartment were measured by Image-pro Ρlus software, and the area of the fat-free erector spinae muscle and the fat infiltration rate (FI%) were calculated. Sarcopenia was defined as an erector spinae area of less than 3 197 mm 2 in males and 2 895 mm 2 in females. The differences in gender, age, body mass index, disease duration, hemoglobin, leukocytes, platelets, albumin, serum calcium, lactate dehydrogenase, serum creatinine, alkaline phosphatase, M-protein, serum β 2-microglobulin, bortezomib chemotherapy, receipt of stem cell transplantation, osteopathy, stage, recurrence and progression of MM between the sarcopenia group and the normal muscle group were compared. Binary logistic regression was used to analyze the independent risk factors of sarcopenia in MM patients. Kaplan-Meier curves were drawn to compare the survival rates between the two groups. Results:53.0% (98/185) of MM patients were complicated with sarcopenia: there were 30 males, whose fat-free erector spinae area was 25.0±6.0 cm 2, the FI of erector spinae was 12.0±4.8 cm 2, and the FI% was 31.5%±12.0%, while there were 68 females, whose fat-free erector spinae area was 22.7±4.2 cm 2, the FI of erector spinae was 10.7±4.1 cm 2, and the FI% was 30.2%±9.8%. 47.0% (87/185) of MM patients had normal muscle mass: there were 62 males, whose fat-free erector spinae area was 40.6±6.5 cm 2, the FI of erector spinae was 9.3±4.8 cm 2, and the FI% was 17.9%±7.4%, while there were 25 females, whose fat-free erector spinae area was 33.6±5.1 cm 2, the FI of erector spinae was 9.9±3.0 cm 2, and the FI% was 21.9%±5.7%. There were statistically significant differences in the gender composition ratio (χ 2=30.47, P<0.001), hemoglobin ( t=-2.73, P=0.007), serum creatinine ( Z=-2.26, P=0.024), receipt of stem cell transplantation (χ 2=4.32, P=0.038), and MM recurrence and progression (χ 2=3.85, P=0.050) between the two groups. However, there were no significant differences in age, body mass index, course of disease, leukocytes, platelets, albumin, alkaline phosphatase, lactate dehydrogenase, serum calcium, M-protein, serum β 2-microglobulin, bortezomib chemotherapy, osteopathy or MM stage ( P>0.05). Binary logistic regression analysis showed that female was an independent risk factor for sarcopenia in MM patients. The survival rates at 2, 3, 4, and 5 years were 87.9%, 71.8%, 64.4%, and 53.7% in the sarcopenia group, and 92.1%, 75.8%, 66.8%, and 66.8% in the normal muscle group, respectively, with no statistically significant differences ( HR=0.71, P=0.364). Conclusion:The incidence of radiation-based sarcopenia in MM patients is 53.0%. Low hemoglobin and blood creatinine levels, not receiving stem cell transplantation, and recurrence or progression of MM are associated with sarcopenia in MM patients, and female is an independent risk factor for sarcopenia in MM patients.

Objective:To develop a nomogram to predict the probability of prostate cancer after transeperineal prostate biopsy, and verify the diagnostic efficacy and clinical applicable value of the model.Methods:The clinicopathologic data of 475 patients who underwent prostate biopsy at Yijishan Hospital of Wannan Medical College between January 2019 to August 2021 were retrospectively reviewed. Of all the patients, 367 patients from January 2019 to December 2020 were in the development cohort and 108 patients from January 2021 to August 2021 were in the validation cohort. Patients in the development cohort were (68.86±9.00) years old. The tPSA level was 13.6(8.6, 23.3)ng/ml, and Prostate Imaging Reporting and Data System (PI-RADS) score was 4(3, 4) points. Patients in the validation cohort were (68.89±8.67) years old. The tPSA was 13.1(8.7, 25.6)ng/ml, and PI-RADS score was 4 (3, 5) points. Univariate and multivariate logistic regression were used to analyze prostate cancer risk factors in the development cohort. Then the nomogram prediction model was established by the risk factors. The prediction model's performance was evaluated using receiver operating characteristic (ROC) curves, calibration maps, and decision curve (DCA) analysis in the development cohort. The performance of the model was verified in the validation cohort.Results:The pathological results showed 180 patients with prostate cancer and 187 patients without prostate cancer in the development cohort. The validation cohort included 53 patients with and 55 without prostate cancer. Based on the results of the univariate and multivariate logistic regression analysis, this model incorporates factors including age ( OR=1.059, P=0.003), platelet-to-monocyte ratio (PMR) ( OR=0.002, P=0.011), f/tPSA ( OR=0.009, P=0.020), and PI-RADS score ( OR= 3.076, P<0.001). The calibration curve revealed a great agreement. Internal validation of the nomogram showed that the area under the ROC curve was 0.845 (95% CI 0.794-0.895). The Hosmer-Lemeshow test was also performed( χ2=1.476, P=0.224). The validation group with an area under the ROC curve was 0.869 (95% CI 0.797-0.941). The results of the decision curve analysis indicated that the decision curve was located above the positive and negative lines in the threshold range of 10% to 90%, within which the model has clinical application. Conclusions:The nomogram, which combines patient age, PMR, f/t PSA, and PI-RADS scores, has high predictive efficacy for prostate cancer and has clinical application value.

Bladder clear cell carcinoma is a rare variant of epithelial carcinoma of the lower urinary tract. This manuscript reported a case of 71-year-old female patient with the main complaint of gross hematuria. Transurethral resection of baldder tumor(TURBT) was performed after Gynecological consultation, and postoperative pathology results revealed clear cell carcinoma in bladder. Four months after surgery, the pelvic CT showed tumor recurrence in bladder. Another TURBT was performed followed with gemcitabine infusion chemotherapy. At 5 months after the second surgery, the tumor recurred again, and also resected by TURBT. No relapse or metastasis occurred during the 5-month follow-up after the third operation.

OBJECTIVE: To analyze the current status of diagnosis and management of acute appendicitis (AA) in China. METHODS: Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary. RESULTS: A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001). CONCLUSIONS The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.
Acute Disease ; Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Appendectomy ; Appendicitis ; diagnosis ; therapy ; China ; Female ; Health Care Surveys ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective To detect the expression of tumor necrosis factor-α-induced protein-8 like-3 (TIPE3) in colonic mucosa of patients with colon cancer,and to analyze the correlation between its abnormal expression and clinicopathological features of patients with colon cancer.Methods The expression of TIPE3 mRNA in 58 cases of colon cancer and tumor adjacent tissues was detected by realtime polymerase chain reaction (RT-PCR).The expression of TIPE3 at protein level in 83 cases of colon cancer and tumor-adjacent tissues was determined by SP immunohistochemistry.Nonparametric rank-sum test and chi-square test were performed for statistical analysis.Results The relative expression of TIPE3 mRNA in the colon cancer tissues was 0.719 (0.104 to 0.887),which was lower than that of tumor-adjacent tissues (4.770,1.732 to 6.800),and the difference was statistically significant (Z=-6.345,P＜0.05).There was no statistically significant difference in the expression of TIPE3 mRNA in colon cancer tissues between different gender,age and TNM stage (all P＞0.05).The expression of TIPE3 mRNA in group of patients with lymph node metastasis (0.113,0.061 to 0.375) was lower than group of patients without lymph node metastasis (0.489,0.327 to 0.956;Z=3.815,P＜0.01).The expression of TIPE3 mRNA of patients survived less than five years after operation (0.104,0.049 to 0.220) was lower than that of patients survived over five years (0.482,0.266 to 0.908;Z=-3.653,P＜0.01).The expression of TIPE3 mRNA of patients with recurrence after operation (0.188,0.091 to 0.493) was lower than that of patients without recurrence (0.409,0.233 to 1.010;Z=-2.431,P=0.015).The recurrence rate of TIPE3 mRNA high expression group in five years after operation was lower than that of TIPE3 mRNA low expression group (23.1％,6/26 vs 56.2％,18/32);and the difference was statistically significant (x2 =6.508,P＜0.05).The expression of TIPE3 at protein level of colon cancer tissues (44.6 ％,37/83) was lower than that of tumor-adjacent tissues (68.7 ％,57/83;x2 =8.004,P＜0.05).The expression of TIPE3 at protein level was not correlated with age and gender (both P＞0.05).The positive expression rate of patients at stage Ⅱ was higher than that of patients at stage Ⅲ (60.5％,23/38 vs 29.7％,1/37);and the difference was statistically significant (x2 =7.174,P＜ 0.05).The positive expression rate of TIPE3 in group of patients with lymph node metastasis was lower than that of groups of patients without lymph node metastasis (28.2％,11/39 vs 59.1％,26/44),and the difference was statistically significant (x2=7.983,P =0.005).Conclusions The expression of TIPE3 in colon cancer tissues is lower than that in tumor-adjacent tissues.Furthermore,it is correlated with lymph node metastasis,recurrence rate and survival rate.TIPE3 may be involved in the genesis,development,invasion and metastasis of colon cancer.

A new microfluidic system with four different microchambers (a circle and three equilateral concave polygons) was designed and fabricated using poly(dimethylsiloxane) (PDMS) and the soft lithography method.Using this microfluidic device at six flow rates (5,10,20,30,40,and 50 μL/h),the effects of microenvironmental geometry and aqueous flow on bacterial adhesion behaviors were investigated.Escherichia coli HB101 pGLO,which could produce a green fluorescent protein induced by L-arabinose,was utilized as the model bacteria.The results demonstrated that bacterial adhesion was significantly related to culture time,microenvironment geometry,and aqueous flow rates.Adhered bacterial density increased with the culture time.Initially,the adhesion occurred at the microchamber sides,and then the entire chamber was gradually covered with increased culture time.Adhesion densities in the side zones were larger than those in the center zones because of the lower shearing force in the side zone.Also,the adhesion densities in the complex chambers were larger than those in the simple chambers.At low flow rates,the orientation of adhered bacteria was random and disorderly.At high flow rates,bacterial orientation became close to the streamline and oriented toward the flow direction.All these results implied that bacterial adhesion tended to occur in complicated aqueous flow areas.The present study provided an on-chip flow system for physiological behavior of biological cells,as well as provided a strategic cue for the prevention of bacterial infection and biofilm formation.

Abstract A new microfluidic system with four different microchambers （a circle and three equilateral concave polygons） was designed and fabricated using poly（dimethylsiloxane） （PDMS） and the soft lithography method. Using this microfluidic device at six flow rates （5, 10, 20, 30, 40, and 50 μL/h）, the effects of microenvironmental geometry and aqueous flow on bacterial adhesion behaviors were investigated. Escherichia coli HB101 pGLO, which could produce a green fluorescent protein induced by L-arabinose, was utilized as the model bacteria. The results demonstrated that bacterial adhesion was significantly related to culture time, microenvironment geometry, and aqueous flow rates. Adhered bacterial density increased with the culture time. Initially, the adhesion occurred at the microchamber sides, and then the entire chamber was gradually covered with increased culture time. Adhesion densities in the side zones were larger than those in the center zones because of the lower shearing force in the side zone. Also, the adhesion densities in the complex chambers were larger than those in the simple chambers. At low flow rates, the orientation of adhered bacteria was random and disorderly. At high flow rates, bacterial orientation became close to the streamline and oriented toward the flow direction; All these results implied that bacterial adhesion tended to occur in complicated aqueous flow areas.The present study provided an on-chip flow system for physiological behavior of biological cells, as well as provided a strategic cue for the prevention of bacterial infection and biofilm formation.