Objective To exploring the drug rules for treating children's night cough based on the theory of"Shaoyang as the pivot".Methods 189 cases of children with night cough were included,and 224 prescriptions.Used the Traditional Chinese Medicine Inheritance Assistance Platform to analyze the time distribution,syndrome types,and four nature,five flavors,and channel tropism of diseases.Used frequency statistics,association rule analysis,and cluster analysis to extract drug patterns for pediatric night cough.Results Coughing occured most frequently during the Yin period.The syndrome type was mainly Shaoyang syndrome.The high-frequency core drugs were Chaihu,Huangqin,and Banxia,etc..The prescription characteristics were Xiaochaihu decoction without Renshen,Shengjiang,and Dazao,and added Wuweizi,Danggui and Xingren.The drugs were used flexibly according to the syndromes:Maxing Er San decoction was added to the phlegm and drink syndrome,Qumai Er Chen decoction was added to the food stagnation syndrome,Sijunzi decoction was added to the qi deficiency syndrome,Maiwei Dihuang decoction was added to the yin deficiency syndrome,and Weijing decoction was added to the phlegm and heat syndrome.Conclusion Based on the basic principle of harmonizing Shaoyang,and according to the disease mechanism,the classical prescription is flexibly used,forming a night cough treatment system based on the"Shaoyang as the pivot"theory,with distinct clinical characteristics.

Objective To identify the factors influencing postoperative recurrence in endometriosis patients after laparoscopic surgery and to evaluate their clinical predictive performance for postoperative recurrence.Methods The clinical data of 190 endometriosis patients who underwent laparoscopic surgery at our hospital between January 2019 and January 2024 were retrospectively collected.Patients were divided into a non-recurrence group(109 cases)and a recurrence group(81 cases)based on their status of postoperative recurrence.Univariate analysis was performed with the clinical data.Multivariate logistic regression analysis was performed to identify the influencing factors of recurrence after laparoscopic surgery.Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of the relevant indicators.Results According to the results of the univariate analysis,the prevalence of preoperative history of dysmenorrhea,number of preoperative pregnancies,history of previous uterine cavity procedures,smoking,and drinking in the non-recurrence group was lower than that in the recurrence group(P<0.05).The non-recurrence group also had lower preoperative serum levels of transforming growth factor-β1(TGF-β1),interleukin(IL)-1β,IL-17,and IL-22 compared with those of the recurrence group(P<0.05).Except for the history of previous uterine cavity procedures,drinking,and the level of IL-17,all other factors were independent risk factors for recurrence after laparoscopic surgery(P<0.05).The area under the curve(AUC)for preoperative serum TGF-β1+IL-1β and TGF-β1+IL-1β+IL-22 was 0.980(95%CI,0.965-0.994)and 0.982(95%CI,0.968-0.996),respectively,indicating a high predictive value for recurrence in patients after laparoscopic surgery.Conclusion The history of preoperative dysmenorrhea,number of preoperative pregnancies,smoking,and preoperative levels of serum TGF-β1,IL-1β,and IL-22 are risk factors for the recurrence of endometriosis after laparoscopic surgery.The combination of TGF-β1 and IL-1β,as well as the combination of TGF-β1,IL-1β,and IL-22,both demonstrated good performance for predicting the recurrence of endometriosis after laparoscopic surgery.

BACKGROUND:A large number of studies have confirmed that both amniotic extracellular matrix materials and bladder extracellular matrix materials can be used as stem cell carriers for the treatment of endometrial injury,but the difference in effect between the two materials is relatively rare.OBJECTIVE:To compare the difference of amniotic extracellular matrix materials and bladder extracellular matrix materials as stem cell carrier in the treatment of endometrial injury.METHODS:Whole bone marrow adhesion method was used to isolate and purify bone marrow mesenchymal stem cells from SD rats.SD-rat amniotic extracellular matrix materials and bladder extracellular matrix materials were prepared respectively,and then bone marrow mesenchymal stem cells were inoculated on the surface of the two materials to detect cell proliferation and adhesion.Forty SD rats were randomly divided into four groups(n=10 per group).Except the sham operation group,the endometrial injury group,the amniotic extracellular matrix group,and the bladder extracellular matrix group were all established by mechanical intervention.The amniotic extracellular matrix/bone marrow mesenchymal stem cell complex and bladder stromal extracellular matrix/bone marrow mesenchymal stem cell complex were transplanted into the injured endometrial site in the amniotic extracellular matrix group and the bladder extracellular matrix group.Samples were collected and detected 14 and 28 days after transplantation.The morphology of rat endometrial tissue was observed by hematoxylin-eosin staining.The levels of basic fibroblast growth factor,insulin-like growth factor 1,and vascular endothelial growth factor in endometrial tissues were analyzed by enzyme-linked immunosorbent assay.The expression levels of vimentin and CD34 in endometrial tissues were analyzed by immunohistochemical staining.RESULTS AND CONCLUSION:(1)Both kinds of extracellular matrix materials were beneficial to the proliferation of bone marrow mesenchymal stem cells.Compared with bladder extracellular matrix materials,amniotic extracellular matrix materials could promote the adhesion of bone marrow mesenchymal stem cells.(2)Compared with the sham operation group,the levels of basic fibroblast growth factor,insulin-like growth factor 1,and vascular endothelial growth factor were significantly decreased(P<0.01),endometrial tissue was dysplastic,endometrial thickness and number of glands were significantly decreased,and vimentin and CD34 positive expression levels were significantly decreased(P<0.01)in the endometrial injury group.Compared with the endometrial injury group,the levels of basic fibroblast growth factor,insulin-like growth factor 1,and vascular endothelial growth factor were increased(P<0.05 or P<0.01),the endometrial tissue morphology was significantly improved,and the endometrial thickness and the number of glands were significantly increased;the positive expressions of vimentin and CD34 were significantly increased(P<0.05 or P<0.01)in the amniotic extracellular matrix group and the bladder extracellular matrix group,and the improvement of amniotic extracellular matrix group was better than that of bladder extracellular matrix group(P<0.05).(3)The results show that compared with bladder extracellular matrix materials,amniotic extracellular matrix material as a carrier of bone marrow mesenchymal stem cells can further promote the repair of damaged endometrium.

Objective To describe the clinical features of patients with primary sclerosing cholangitis(PSC)in China based on a nationwide multicenter patient cohort,and to investigate the risk factors for prognosis.Methods A retrospective cohort study was conducted among the patients with a confirmed diagnosis of PSC based on the electronic medical record system of seven grade A tertiary hospitals across the country,and related data were extracted.The Mann-Whitney U test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups.The Kaplan-Meier method was used to estimate liver transplant-free survival,and the log-rank test was used for comparison of survival rate between PSC patients with different features.The Cox regression model was used to identify independent risk factors for the prognosis of PSC patients and the interactions between key factors.Results A total of 107 patients were enrolled,among whom 55.6%(55/99)had large-duct PSC and 29.0%(31/107)had comorbidity with inflammatory bowel disease(IBD).The positivity rate of anti-neutrophil cytoplasmic antibody(ANCA)was 32.9%(24/73),and 50.0%(40/80)of the patients had an increase in IgG/IgM.The median symptom-to-diagnosis interval was 1 year(<1-4.0),and 38.3%(41/107)of the patients had progressed to decompensated cirrhosis at the time of diagnosis.The median liver transplant-free survival time was 114 months(95%confidence interval[CI]:62-166),with a 5-year survival rate of 65.7%.The multivariate analysis showed that an increase in total bile acid(TBA)(hazard ratio[HR]=1.006,95%CI:1.002-1.010,P=0.001)and a prolonged symptom-to-diagnosis interval(HR=1.252,95%CI:1.059-1.480,P=0.009)were independent risk factors for prognosis.The interaction analysis showed that compared with the female patients with TBA<50 μmol/L,both male and female patients with TBA≥50 μmol/L had a significant increase in the risk of liver transplantation or death(male:HR=16.563,95%CI:2.103-130.449,P<0.001;female:HR=17.009,95%CI:2.113-136.934,P<0.001),and compared with the patients with an age of<45 years and a TBA level of<50 μmol/L,the patients with an age of≥45 years and a TBA level of≥50 μmol/L had a significant increase in the risk of liver transplantation or death(HR=10.729,95%CI:1.325-86.859,P=0.026).Compared with the female patients with an symptom-to-diagnosis interval of≤2 years,the male patients with a symptom-to-diagnosis interval of>2 years had an increased risk of liver transplantation or death(HR=4.825,95%CI:1.725-13.644,P=0.003),and compared with the patients with an age of<45 years and a symptom-to-diagnosis interval of≤2 years,the patients with an age of<45 years and a symptom-to-diagnosis interval of>2 years had an increased risk of liver transplantation or death(HR=4.983,95%CI:1.366-18.173,P=0.015).Conclusion Compared with the reports from Western countries,large-duct PSC is also the main type of PSC in China,but with a relatively low proportion,and there is also a relatively low proportion of patients with IBD or positive ANCA.An increase in TBA and a prolonged symptom-to-diagnosis interval are independent risk factors for prognosis,with significant interactions with age and sex.This suggests that early screening and intervention should be enhanced to improve prognosis.

Objective To describe the clinical features of patients with primary sclerosing cholangitis(PSC)in China based on a nationwide multicenter patient cohort,and to investigate the risk factors for prognosis.Methods A retrospective cohort study was conducted among the patients with a confirmed diagnosis of PSC based on the electronic medical record system of seven grade A tertiary hospitals across the country,and related data were extracted.The Mann-Whitney U test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups.The Kaplan-Meier method was used to estimate liver transplant-free survival,and the log-rank test was used for comparison of survival rate between PSC patients with different features.The Cox regression model was used to identify independent risk factors for the prognosis of PSC patients and the interactions between key factors.Results A total of 107 patients were enrolled,among whom 55.6%(55/99)had large-duct PSC and 29.0%(31/107)had comorbidity with inflammatory bowel disease(IBD).The positivity rate of anti-neutrophil cytoplasmic antibody(ANCA)was 32.9%(24/73),and 50.0%(40/80)of the patients had an increase in IgG/IgM.The median symptom-to-diagnosis interval was 1 year(<1-4.0),and 38.3%(41/107)of the patients had progressed to decompensated cirrhosis at the time of diagnosis.The median liver transplant-free survival time was 114 months(95%confidence interval[CI]:62-166),with a 5-year survival rate of 65.7%.The multivariate analysis showed that an increase in total bile acid(TBA)(hazard ratio[HR]=1.006,95%CI:1.002-1.010,P=0.001)and a prolonged symptom-to-diagnosis interval(HR=1.252,95%CI:1.059-1.480,P=0.009)were independent risk factors for prognosis.The interaction analysis showed that compared with the female patients with TBA<50 μmol/L,both male and female patients with TBA≥50 μmol/L had a significant increase in the risk of liver transplantation or death(male:HR=16.563,95%CI:2.103-130.449,P<0.001;female:HR=17.009,95%CI:2.113-136.934,P<0.001),and compared with the patients with an age of<45 years and a TBA level of<50 μmol/L,the patients with an age of≥45 years and a TBA level of≥50 μmol/L had a significant increase in the risk of liver transplantation or death(HR=10.729,95%CI:1.325-86.859,P=0.026).Compared with the female patients with an symptom-to-diagnosis interval of≤2 years,the male patients with a symptom-to-diagnosis interval of>2 years had an increased risk of liver transplantation or death(HR=4.825,95%CI:1.725-13.644,P=0.003),and compared with the patients with an age of<45 years and a symptom-to-diagnosis interval of≤2 years,the patients with an age of<45 years and a symptom-to-diagnosis interval of>2 years had an increased risk of liver transplantation or death(HR=4.983,95%CI:1.366-18.173,P=0.015).Conclusion Compared with the reports from Western countries,large-duct PSC is also the main type of PSC in China,but with a relatively low proportion,and there is also a relatively low proportion of patients with IBD or positive ANCA.An increase in TBA and a prolonged symptom-to-diagnosis interval are independent risk factors for prognosis,with significant interactions with age and sex.This suggests that early screening and intervention should be enhanced to improve prognosis.

Objective To exploring the drug rules for treating children's night cough based on the theory of"Shaoyang as the pivot".Methods 189 cases of children with night cough were included,and 224 prescriptions.Used the Traditional Chinese Medicine Inheritance Assistance Platform to analyze the time distribution,syndrome types,and four nature,five flavors,and channel tropism of diseases.Used frequency statistics,association rule analysis,and cluster analysis to extract drug patterns for pediatric night cough.Results Coughing occured most frequently during the Yin period.The syndrome type was mainly Shaoyang syndrome.The high-frequency core drugs were Chaihu,Huangqin,and Banxia,etc..The prescription characteristics were Xiaochaihu decoction without Renshen,Shengjiang,and Dazao,and added Wuweizi,Danggui and Xingren.The drugs were used flexibly according to the syndromes:Maxing Er San decoction was added to the phlegm and drink syndrome,Qumai Er Chen decoction was added to the food stagnation syndrome,Sijunzi decoction was added to the qi deficiency syndrome,Maiwei Dihuang decoction was added to the yin deficiency syndrome,and Weijing decoction was added to the phlegm and heat syndrome.Conclusion Based on the basic principle of harmonizing Shaoyang,and according to the disease mechanism,the classical prescription is flexibly used,forming a night cough treatment system based on the"Shaoyang as the pivot"theory,with distinct clinical characteristics.

BACKGROUND:A large number of studies have confirmed that both amniotic extracellular matrix materials and bladder extracellular matrix materials can be used as stem cell carriers for the treatment of endometrial injury,but the difference in effect between the two materials is relatively rare.OBJECTIVE:To compare the difference of amniotic extracellular matrix materials and bladder extracellular matrix materials as stem cell carrier in the treatment of endometrial injury.METHODS:Whole bone marrow adhesion method was used to isolate and purify bone marrow mesenchymal stem cells from SD rats.SD-rat amniotic extracellular matrix materials and bladder extracellular matrix materials were prepared respectively,and then bone marrow mesenchymal stem cells were inoculated on the surface of the two materials to detect cell proliferation and adhesion.Forty SD rats were randomly divided into four groups(n=10 per group).Except the sham operation group,the endometrial injury group,the amniotic extracellular matrix group,and the bladder extracellular matrix group were all established by mechanical intervention.The amniotic extracellular matrix/bone marrow mesenchymal stem cell complex and bladder stromal extracellular matrix/bone marrow mesenchymal stem cell complex were transplanted into the injured endometrial site in the amniotic extracellular matrix group and the bladder extracellular matrix group.Samples were collected and detected 14 and 28 days after transplantation.The morphology of rat endometrial tissue was observed by hematoxylin-eosin staining.The levels of basic fibroblast growth factor,insulin-like growth factor 1,and vascular endothelial growth factor in endometrial tissues were analyzed by enzyme-linked immunosorbent assay.The expression levels of vimentin and CD34 in endometrial tissues were analyzed by immunohistochemical staining.RESULTS AND CONCLUSION:(1)Both kinds of extracellular matrix materials were beneficial to the proliferation of bone marrow mesenchymal stem cells.Compared with bladder extracellular matrix materials,amniotic extracellular matrix materials could promote the adhesion of bone marrow mesenchymal stem cells.(2)Compared with the sham operation group,the levels of basic fibroblast growth factor,insulin-like growth factor 1,and vascular endothelial growth factor were significantly decreased(P<0.01),endometrial tissue was dysplastic,endometrial thickness and number of glands were significantly decreased,and vimentin and CD34 positive expression levels were significantly decreased(P<0.01)in the endometrial injury group.Compared with the endometrial injury group,the levels of basic fibroblast growth factor,insulin-like growth factor 1,and vascular endothelial growth factor were increased(P<0.05 or P<0.01),the endometrial tissue morphology was significantly improved,and the endometrial thickness and the number of glands were significantly increased;the positive expressions of vimentin and CD34 were significantly increased(P<0.05 or P<0.01)in the amniotic extracellular matrix group and the bladder extracellular matrix group,and the improvement of amniotic extracellular matrix group was better than that of bladder extracellular matrix group(P<0.05).(3)The results show that compared with bladder extracellular matrix materials,amniotic extracellular matrix material as a carrier of bone marrow mesenchymal stem cells can further promote the repair of damaged endometrium.

Background/Aims: Existing hepatocellular carcinoma (HCC) prediction models are derived mainly from pretreatment or early on-treatment parameters. We reassessed the dynamic changes in the performance of 17 HCC models in patients with chronic hepatitis B (CHB) during long-term antiviral therapy (AVT). Methods: Among 987 CHB patients administered long-term entecavir therapy, 660 patients had 8 years of follow-up data. Model scores were calculated using on-treatment values at 2.5, 3, 3.5, 4, 4.5, and 5 years of AVT to predict threeyear HCC occurrence. Model performance was assessed with the area under the receiver operating curve (AUROC). The original model cutoffs to distinguish different levels of HCC risk were evaluated by the log-rank test. Results: The AUROCs of the 17 HCC models varied from 0.51 to 0.78 when using on-treatment scores from years 2.5 to 5. Models with a cirrhosis variable showed numerically higher AUROCs (pooled at 0.65–0.73 for treated, untreated, or mixed treatment models) than models without (treated or mixed models: 0.61–0.68; untreated models: 0.51–0.59). Stratification into low, intermediate, and high-risk levels using the original cutoff values could no longer reflect the true HCC incidence using scores after 3.5 years of AVT for models without cirrhosis and after 4 years of AVT for models with cirrhosis. Conclusions The performance of existing HCC prediction models, especially models without the cirrhosis variable, decreased in CHB patients on long-term AVT. The optimization of existing models or the development of novel models for better HCC prediction during long-term AVT is warranted.

Objective:Our study aims to determine histological regression and clinical improvement after long-term antiviral therapy in hepatitis B virus-related cirrhosis patients.Methods:Treatment-na?ve chronic hepatitis B patients with histologically or clinically diagnosed liver cirrhosis were enrolled. Liver biopsies were performed after 5 years entecavir-based antiviral treatment. Patients were followed up every 6 months. Cirrhosis regression was evaluated based on Metavir system and P-I-R score. Clinical improvement was evaluated before and after the long-term treatment. Kruskal Wallis test and Wilcoxon signed-rank test were used for continuous variables, Fisher's exact test was used for categorical variables and multivariate analysis was performed using logistic regression analysis.Results:Totals of 73 patients with HBV-related liver cirrhosis were enrolled. Among them, 30 (41.1%) patients were biopsy proved liver cirrhosis and the remaining 43 (58.9%) cirrhotic patients were diagnosed by clinical features. Based on Metavir system and P-I-R score, 72.6% (53/73) patients attained histological regression. Furthermore, 30.1% (22/73) were defined as significant regression (Metavir decrease ≥2 stage), 42.5% (31/73) were mild regression (Metavir decrease 1 stage or predominantly regressive by P-I-R system if still cirrhosis after treatment) and 27.4% (20/73) were the non-regression. Compared to levels of clinical characteristics at baseline, HBV DNA, ALT, AST, liver stiffness(decreased from 12.7 to 6.4 kPa in significant regression, from 18.1 to 7.3 kPa in mild regression and from 21.4 to 11.2 kPa in non-regression)and Ishak-HAI score significantly decreased after 5 years of anti-HBV treatment, while serum levels of platelets and albumin improved remarkably ( P<0.05). In multivariate analysis, only the pre-treatment liver stiffness level was associated with significant regression ( OR=0.887, 95% CI: 0.802-0.981, P=0.020). Conclusions:After long-term antiviral therapy, patients with HBV-related cirrhosis are easily to attain improvements in clinical parameters, while a certain percentage of these patients still cannot achieve histological reversal.