ObjectiveTo observe the effect of Yifei Jianpi prescription on the of signal transducer and activator of transcription protein 1 （STAT1）/interferon regulatory factor 3 （IRF3） signaling pathway in a pneumonia model induced by lipopolysaccharide （LPS） and to explore the mechanism of Yifei Jianpi prescription in improving lung immune and inflammatory responses. MethodsSixty male SPF SD rats were used in this study. Ten rats were randomly assigned to the normal control group， and the remaining 50 were instilled with LPS in the trachea to establish a pneumonia model. After successful modeling， the rats were randomly divided into the model group， dexamethasone group （0.5 mg·kg^-1）， and Yifei Jianpi prescription high-dose （12 mg·kg^-1）， medium-dose （6 mg·kg^-1）， and low-dose （3 mg·kg^-1） groups， with 10 rats in each group. Treatment was administered once daily， and the normal control and model groups received the same volume of normal saline. After 14 days， flow cytometry was used to detect the classification of whole blood lymphocytes. Enzyme-linked immunosorbent assay （ELISA） was used to measure serum levels of immunoglobulin G （IgG）， immunoglobulin A （IgA）， immunoglobulin M （IgM）， and the content of tumor necrosis factor-α （TNF-α）， interleukin-8 （IL-8）， interleukin-6 （IL-6）， and interleukin-10 （IL-10） in alveolar lavage fluid （BALF）. Hematoxylin-eosin （HE） staining was used to observe lung tissue pathology and score the damage. Thymus weight， spleen weight， and wet-to-dry weight ratio （W/D） were recorded. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of STAT1， IRF3， IL-6， and interferon-alpha （IFN-α） in lung tissues， while Western blot was performed to assess the protein expression of STAT1， IRF3， IL-6， and IFN-α. ResultsCompared with the normal control group， the model group showed significantly increased proportion of B lymphocytes in peripheral blood， decreased proportions of NK cells and CD4⁺/CD8⁺ （P<0.05， P<0.01）， decreased serum levels of IgG and IgA， significantly increased IgM levels （P<0.01）， significantly elevated content of TNF-α， IL-6， and IL-8 in BALF， and significantly decreased IL-10 levels （P<0.01）. Lung tissue damage was evident， with significant increases in thymus and spleen weights and a higher W/D ratio （P<0.01）. The mRNA and protein expression of STAT1， IRF3， IFN-α， and IL-6 in lung tissues was significantly upregulated （P<0.05，P<0.01）. Compared with the model group， the Yifei Jianpi prescription groups showed significantly reduced proportions of B lymphocytes in peripheral blood， increased proportions of NK cells and CD4⁺/CD8⁺ ratios （P<0.05， P<0.01）， significantly increased serum levels of IgG and IgA， significantly decreased IgM levels （P<0.05， P<0.01）， significantly reduced levels of TNF-α， IL-6， and IL-8 in BALF， and significantly increased IL-10 levels （P<0.01）. Lung tissue damage was alleviated， thymus and spleen weights were significantly reduced， and the W/D ratio was markedly decreased （P<0.01）. The mRNA and protein expression of STAT1， IRF3， IFN-α， and IL-6 in lung tissues was significantly downregulated （P<0.05， P<0.01）. ConclusionYifei Jianpi prescription can alleviate lung tissue damage and improve immune and inflammatory responses in LPS-induced pneumonia rats. The mechanism may be related to the inhibition of STAT1/IRF3 signaling pathway activation.

Objective:To compare the application effects of upper arm autogenous arteriovenous fistula (AVF) and forearm arteriovenous graft (AVG) in maintenance hemodialysis (MHD) patients, and to analyze the factors influencing the long-term patency rate of arteriovenous fistulas in MHD patients.Methods:It was a retrospective cohort study. The data of MHD patients treated in the First Affiliated Hospital of Zhejiang University School of Medicine from January 2021 to May 2023 was collected. Participants were stratified into two groups: forearm AVG and upper arm AVF. The parameters including urea clearance index (Kt/V), serum C-reactive protein (CRP), albumin levels, access-related costs, complication rates, and long-term primary patency were compared. The end event was defined as arteriovenous fistula failure, that was, the arteriovenous fistula could not be used for dialysis puncture, or the arteriovenous fistula lost function after adequate blood flow was achieved. Kaplan-Meier survival curves with log-rank tests were employed to compare access survival, while multivariable Cox regression was used to analyze the independent associated factors of patency.Results:A total of 71 MHD patients were enrolled in this study, including 35 males, with age of (64.9±11.7) years and fistula establishment time of 30.0(17.0, 58.0) months. There were 32 cases (45.1%) in the forearm AVG group and 39 cases (54.9%) in the upper arm AVF group. Compared with the forearm AVG group, the upper arm AVF group had higher serum albumin levels [38.9 (37.0, 42.1) g/L vs. 38.0 (34.6, 40.0) g/L, Z=-2.364, P=0.018], higher pain scores [3.0(2.0, 5.0) points vs. 2.0(1.0, 3.0) points, Z=-3.012, P=0.003], and higher long-term patency rates of arteriovenous fistulas (at 3, 6, 12, and 24 months, all P<0.01), while the complication rate[61.5% (24/39) vs. 93.7% (30/32), χ2=10.015, P=0.002], the cost of the access [0 (0, 9,117.0) yuan·year -1·person -1vs. 10 380.5 (7 186.0, 30 228.5) yuan·year -1·person -1, Z=-4.094, P<0.001] were lower, and the length of the available puncture vessel segment was shorter [3.5(3.0, 5.0) cm vs. 6.5(6.0, 8.0) cm, Z=-6.477, P<0.001].The Kaplan-Meier survival analysis results showed that the primary patency rate of the upper arm AVF group was significantly higher than that of the forearm AVG group (Log-rank test, χ2=23.690, P<0.001). The multivariate Cox regression analysis results indicated that the type of fistula being forearm AVG (with upper arm AVF as reference, HR=4.907, 95% CI 1.740-13.840) and increased complications number ( HR=1.234, 95% CI 1.040-1.464) were the independent factors promoting the arteriovenous fistula failure in MHD patients. Conclusions:The type of internal fistula and the complications are the factors affecting the long-term patency rate of internal fistula in MHD patients.Upper arm AVF offers cost-effectiveness and sustained patency advantages over forearm AVG but requires careful consideration of puncture challenges and patient discomfort. Individualized access selection should balance anatomical constraints with clinical priorities.

Objective To investigate the current status of hypertension in the old adults living in urban city and rural areas in Qinghai Plateau and analyze the related influencing factors in order to provide data and evidence for targeted formulation of preventive and control measures for the pop-ulation.Methods Cluster-random sampling was used to subject 1372 elderly people(aged ≥60 years)from 8 urban areas and 25 natural villages in Xining City,Qinghai Province.Questionnaires were used to collect their demographic data,body mass index(BMI),history of chronic diseases,and lipid-related indicators.According to complicated with hypertension or not,they were divided into a hypertension group(615 cases)and a non-hypertension group(757 cases).SPSS 26.0 soft-ware was employed to perform statistical analyses with descriptive analysis and multivarlate un-conditional logistic regression analysis.Results Among the 1372 elderly persons,615 participants had hypertension,and the overall prevalence was 44.8％,and that in urban area and rural area was 50.1％and 38.5％,respectively,with significant difference(P＜0.01).Statistical differences were observed between those with and without hypertension in terms of age,BMI,and proportions of coronary heart disease(CHD),diabetes and stroke(P＜0.05,P＜0.01).In the urban populations,there were obvious differences in marital status,BMI,and proportions of CHD and diabetes be-tween those with and without hypertension(P＜0.01).For the rural populations,notable differ-ences were observed in age and proportions of CHD and diabetes between those with and without hypertension(P＜0.05,P＜0.01).Multivariate unconditional logistic regression analysis revealed that urban areas,obesity,CHD and diabetes were risk factors for hypertension in the elderly living in the urban and rural areas(OR=1.622,95％CI:1.299-2.026,P=0.000;OR=0.564,95％CI:0.315-1.006,P=0.042;OR=0.604,95％CI:0.417-0.874,P=0.008;OR=0.472,95％CI:0.328-0.678,P=0.000;OR=0.474,95％CI:0.334-0.673,P=0.000).Obesity,CHD and diabetes were risk factors for hypertension in those in the urban areas(OR=0.553,95％CI:0.317-0.963,P=0.036;OR=0.506,95％CI:0.320-0.800,P=0.004;OR=0.458,95％CI:0.303-0.692,P=0.000),and CHD and diabetes were risk factors in those in the rural areas(OR=0.382,95％CI:0.219-0.666,P=0.001;OR=0.452,95％CI:0.253-0.807,P=0.007).Conclusion There is sig-nificant difference in the prevalence of hypertension between the elderly living in the urban city and rural areas in Qinghai Plateau.The old adults with overweight,obesity,and complication of CHD and diabetes are prone to developing hypertension.

Objective To investigate the current status of hypertension in the old adults living in urban city and rural areas in Qinghai Plateau and analyze the related influencing factors in order to provide data and evidence for targeted formulation of preventive and control measures for the pop-ulation.Methods Cluster-random sampling was used to subject 1372 elderly people(aged ≥60 years)from 8 urban areas and 25 natural villages in Xining City,Qinghai Province.Questionnaires were used to collect their demographic data,body mass index(BMI),history of chronic diseases,and lipid-related indicators.According to complicated with hypertension or not,they were divided into a hypertension group(615 cases)and a non-hypertension group(757 cases).SPSS 26.0 soft-ware was employed to perform statistical analyses with descriptive analysis and multivarlate un-conditional logistic regression analysis.Results Among the 1372 elderly persons,615 participants had hypertension,and the overall prevalence was 44.8％,and that in urban area and rural area was 50.1％and 38.5％,respectively,with significant difference(P＜0.01).Statistical differences were observed between those with and without hypertension in terms of age,BMI,and proportions of coronary heart disease(CHD),diabetes and stroke(P＜0.05,P＜0.01).In the urban populations,there were obvious differences in marital status,BMI,and proportions of CHD and diabetes be-tween those with and without hypertension(P＜0.01).For the rural populations,notable differ-ences were observed in age and proportions of CHD and diabetes between those with and without hypertension(P＜0.05,P＜0.01).Multivariate unconditional logistic regression analysis revealed that urban areas,obesity,CHD and diabetes were risk factors for hypertension in the elderly living in the urban and rural areas(OR=1.622,95％CI:1.299-2.026,P=0.000;OR=0.564,95％CI:0.315-1.006,P=0.042;OR=0.604,95％CI:0.417-0.874,P=0.008;OR=0.472,95％CI:0.328-0.678,P=0.000;OR=0.474,95％CI:0.334-0.673,P=0.000).Obesity,CHD and diabetes were risk factors for hypertension in those in the urban areas(OR=0.553,95％CI:0.317-0.963,P=0.036;OR=0.506,95％CI:0.320-0.800,P=0.004;OR=0.458,95％CI:0.303-0.692,P=0.000),and CHD and diabetes were risk factors in those in the rural areas(OR=0.382,95％CI:0.219-0.666,P=0.001;OR=0.452,95％CI:0.253-0.807,P=0.007).Conclusion There is sig-nificant difference in the prevalence of hypertension between the elderly living in the urban city and rural areas in Qinghai Plateau.The old adults with overweight,obesity,and complication of CHD and diabetes are prone to developing hypertension.

Objective:To compare the application effects of upper arm autogenous arteriovenous fistula (AVF) and forearm arteriovenous graft (AVG) in maintenance hemodialysis (MHD) patients, and to analyze the factors influencing the long-term patency rate of arteriovenous fistulas in MHD patients.Methods:It was a retrospective cohort study. The data of MHD patients treated in the First Affiliated Hospital of Zhejiang University School of Medicine from January 2021 to May 2023 was collected. Participants were stratified into two groups: forearm AVG and upper arm AVF. The parameters including urea clearance index (Kt/V), serum C-reactive protein (CRP), albumin levels, access-related costs, complication rates, and long-term primary patency were compared. The end event was defined as arteriovenous fistula failure, that was, the arteriovenous fistula could not be used for dialysis puncture, or the arteriovenous fistula lost function after adequate blood flow was achieved. Kaplan-Meier survival curves with log-rank tests were employed to compare access survival, while multivariable Cox regression was used to analyze the independent associated factors of patency.Results:A total of 71 MHD patients were enrolled in this study, including 35 males, with age of (64.9±11.7) years and fistula establishment time of 30.0(17.0, 58.0) months. There were 32 cases (45.1%) in the forearm AVG group and 39 cases (54.9%) in the upper arm AVF group. Compared with the forearm AVG group, the upper arm AVF group had higher serum albumin levels [38.9 (37.0, 42.1) g/L vs. 38.0 (34.6, 40.0) g/L, Z=-2.364, P=0.018], higher pain scores [3.0(2.0, 5.0) points vs. 2.0(1.0, 3.0) points, Z=-3.012, P=0.003], and higher long-term patency rates of arteriovenous fistulas (at 3, 6, 12, and 24 months, all P<0.01), while the complication rate[61.5% (24/39) vs. 93.7% (30/32), χ2=10.015, P=0.002], the cost of the access [0 (0, 9,117.0) yuan·year -1·person -1vs. 10 380.5 (7 186.0, 30 228.5) yuan·year -1·person -1, Z=-4.094, P<0.001] were lower, and the length of the available puncture vessel segment was shorter [3.5(3.0, 5.0) cm vs. 6.5(6.0, 8.0) cm, Z=-6.477, P<0.001].The Kaplan-Meier survival analysis results showed that the primary patency rate of the upper arm AVF group was significantly higher than that of the forearm AVG group (Log-rank test, χ2=23.690, P<0.001). The multivariate Cox regression analysis results indicated that the type of fistula being forearm AVG (with upper arm AVF as reference, HR=4.907, 95% CI 1.740-13.840) and increased complications number ( HR=1.234, 95% CI 1.040-1.464) were the independent factors promoting the arteriovenous fistula failure in MHD patients. Conclusions:The type of internal fistula and the complications are the factors affecting the long-term patency rate of internal fistula in MHD patients.Upper arm AVF offers cost-effectiveness and sustained patency advantages over forearm AVG but requires careful consideration of puncture challenges and patient discomfort. Individualized access selection should balance anatomical constraints with clinical priorities.

Pulmonary fibrosis is a respiratory system disorder characterized by damage to alveolar epithelial cells,pathological proliferation and transformation of fibroblasts,excessive deposition of extracellular matrix,leading to structural damage and loss of function in lung tissues,with a high mortality rate and limited effective treatment methods.This article was based on the TCM understanding of"lung connecting to large intestine",namely the theory of"lung and the large intestine being interior-exterior related",and set the modern medical understanding of"lung connecting to large intestine",namely the theory of"gut-lung axis"as the key.Combining the TCM pathogenesis of pulmonary fibrosis and the related mechanisms of"gut-lung axis"in pulmonary fibrosis,it preliminarily expounded the connotation of TCM regulating the"gut-lung axis"to treat pulmonary fibrosis,aiming to provide new ideas for clinical treatment of pulmonary fibrosis through the"gut-lung axis".

Objective:The surveillance results of brucellosis in Lushan County, Pingdingshan City, Henan Province are analyzed to provide basis for formulating prevention and control strategies.Methods:Retrospective analysis method was used to collect the surveillance data from Lushan County Center for Disease Control and Prevention and Animal Husbandry Department from 2011 to 2019. Descriptive statistical analysis was made on the serological, pathogenic of brucellosis.Results:From 2011 to 2019, 15 943 high-risk people were investigated, and 10 834 were serologically tested, with a positive detection rate of 23.11% (2 504/10 834). Among them, the positive detection rate of brucellosis serum increased rapidly in 2013 and decreased after 2016. The positive detection rate was 25.87% (1 593/6 157) in men and 19.48% (911/4 677) in women. The age of positive detection was mainly 40-< 70 years old, accounting for 70.45% (1 764/2 504). The positive detection rate of farmers in all occupations was the highest, which was 25.97% (2 242/8 634). There were significant differences in the positive detection rates among different gender, age and occupation (χ 2=61.163, 27.855, 257.412, P < 0.01). A total of 578 blood samples from patients with acute brucellosis were isolated and cultured, 215 strains of Brucella were detected, and the positive detection rate was 37.20%. Conclusions:The high-risk group of human brucellosis in Lushan County, Pingdingshan City is middle-aged and elderly male farmers engaged in aquaculture. It is suggested that the joint prevention and control measures should be strengthened, the health education of high-risk groups should be strengthened, and comprehensive prevention and control measures should be taken to control the occurrence and prevalence of brucellosis.

Objective:To evaluate the effect of early mobilization on mortality in intensive care unit (ICU) patients with mechanical ventilation after discharge by Meta-analysis.Methods:Databases including SinoMed, China National Knowledge Infrastructure (CNKI), Wanfang data, PubMed, the Cochrane Library, Web of Science, and Embase were searched from inception to September 17th, 2020, to collect randomized controlled trials (RCT) about early mobilization on mortality of patients with mechanical ventilation in ICU after discharge, the references included in the literature were traced. The control group was given routine care, the experimental group was given early mobilization on the basis of the control group, including passive or active mobilization on the bed, sitting on the bed, standing by the bed, transferring to the bedside chair and assisting walking. The literature screening, data extracting, and the bias risk assessment of included studies were conducted independently by two reviewers. Stata 12.0 software was then used to perform Meta-analysis. Funnel plot was used to test publication bias.Results:A total of 10 RCT studies involving 1 323 patients were included, with 660 patients in the control group and 663 patients in the experimental group. The results of literature quality evaluation showed that 7 studies were grade A and 3 studies were grade B, indicating that the overall quality of included literatures was high. The Meta-analysis results showed that early mobilization did not increase the mortality of patients with mechanical ventilation in ICU after discharge [odds ratio ( OR) = 0.92, 95% confidence interval (95% CI) was 0.75-1.13, P = 0.449]. Subgroup analysis results showed that early mobilization had a tendency to reduce the mortality of ICU patients with mechanical ventilation at 3, 6 and 12 months after discharge, but the difference was not statistically significant (3-month mortality: OR = 1.02, 95% CI was 0.74-1.40, P = 0.927; 6-month mortality: OR = 0.95, 95% CI was 0.70-1.27, P = 0.712; 12-month mortality: OR = 0.60, 95% CI was 0.33-1.10, P = 0.101). Funnel plot showed that the distribution of included literatures was not completely symmetrical, suggesting that publication bias might exist. Conclusions:Early mobilization does not increase the mortality of ICU patients with mechanical ventilation after discharge. Although it tends to have a favorable outcome in reducing mortality, and has a trend to reduce the mortality. However, due to the small number of included literatures, small sample size and differences in the specific implementation of early mobilization among various studies, a large number of high-quality RCT studies are still needed for further verification.

Objective:To evaluate the effect of preventing and treatment of pharmaceuticals on intensive care unit-acquired weakness (ICU-AW) by systematic review.Methods:The randomized controlled trials (RCTs) concerning pharmaceutical prevention and treatment about ICU-AW in SinoMed, CNKI, Wanfang data, PubMed, Cochrane Library, Web of Science, EMbase, and other sources were searched from their foundation to May 30th, 2019. The patients in the intervention group were treated with drugs to prevent or treat ICU-AW; and those in control group were treated with other rehabilitation methods. Data searching, extracting and quality evaluation were assessed by two reviewers independently. Stata 12.0 software was then used for Meta-analysis. Only descriptive analysis was conducted when only one study was enrolled.Results:A total of 11 RCTs were enrolled with 1 865 patients in the intervention group and 1 894 in the control group. The results of quality evaluation showed that 4 studies were A-level and 7 studies were B-level, indicating that the overall quality of the enrolled literature was high. Meta-analysis showed that intensive insulin therapy could prevent ICU-AW [relative risk ( RR) = 0.761, 95% confidence interval (95% CI) was 0.662-0.876, P = 0.000], but reduced phenylalanine loss (nmol·100 mL -1·min -1: -3±3 vs. -11±3, P < 0.05) and glutamine intake (nmol·100 mL -1·min -1: -97±22 vs. -51±13, P < 0.05). There was no significant difference in the prevention and treatment of ICU-AW between other drugs (including growth hormone, glutamine, dexmedetomidine, neostigmine, oxandrolone, and intravenous immunoglobulin) and control group. Conclusions:Intensive insulin therapy can prevent ICU-AW, but the risk of hypoglycemia will increase. Other drugs including growth hormone, glutamine, dexmedetomidine, neostigmine, oxandrolone, and intravenous immunoglobulin have no obvious advantages in the prevention and treatment of ICU-AW, so no drug has been recommended to prevent and treat ICU-AW.

Objective: To compare the prevalence of dental caries and periodontal disease in patients with end-stage renal disease treated with maintenance hemodialysis with that in healthy controls and to investigate the relationship between end-stage renal disease, dental caries and periodontal disease. Methods : A total of 82 maintenance hemodialysis patients who met the inclusion criteria were selected as the case group, and 86 healthy persons who underwent oral examination in the physical examination center were selected as the control group. Dental caries and periodontal conditions were examined in the two groups. The dental caries examination was conducted by determining the number of decayed-missing-filled teeth, which was recorded as recommended by the World Health Organization. The periodontal condition parameters included the plaque index, calculus index, bleeding on probing, periodontal pocket depth and clinical attachment loss. Results: The prevalence of dental caries in the case group and healthy control group was 87.8% and 81.4%, respectively, and there was no statistically significant difference between the two groups (P > 0.05). The periodontal indexes, including the plaque index, calculus index, probe bleeding index, periodontal pocket depth and clinical attachment level, in the case group were significantly higher than those in the control group (P < 0.05), and the prevalence of periodontitis in the case group was significantly higher than that in the control group (97.6% vs 88.4%, P < 0.05). Conclusion The dental caries conditions were comparable between the case group and the control group, but the prevalence and severity of periodontitis were significantly higher in the case group than in the control group.