This paper systematically reviews the current status of integrated traditional Chinese and western medicine in the treatment of Helicobacter pylori （Hp） infection， as well as recent progress in clinical and basic research both in China and internationally. It summarizes the advantages of traditional Chinese medicine （TCM） in Hp infection management， including improving Hp eradication rates， enhancing antibiotic sensitivity， reducing antimicrobial resistance， decreasing drug-related adverse effects， and ameliorating gastric mucosal lesions. These advantages are particularly evident in patients who are intolerant to bismuth-containing regimens， those with refractory Hp infection， and individuals with precancerous gastric lesions. An integrated， whole-process management approach and individualized， staged comprehensive treatment strategies combining TCM and western medicine are proposed for Hp infection. Future prevention and control of Hp infection should adopt an integrative Chinese-western medical strategy， emphasizing prevention， strengthening primary care， implementing proactive long-term monitoring， optimizing screening strategies， and advancing the development of novel technologies and mechanistic studies of Chinese herbal interventions. These efforts aim to provide a theoretical basis and practical pathways for the establishment and improvement of Hp infection prevention and control systems.

Objective This study focuses on the construction and cultivation of young administrative management per-sonnel in Shanghai's public hospitals,aiming to provide scientific support for the development of high-quality young administra-tive management professionals in public hospitals.Methods Utilizing an anonymous online survey,this research collected data on the current state of subjective well-being and its influencing factors among the targeted groups from hospitals.Analysis of vari-ance and multivariate analysis were conducted to analyze potential factors affecting their sense of well-being.Results A total of 171 cases were included in the survey,with an average score of 80.37.This group of respondents exhibited a higher level of sub-jective well-being compared to the national norm.Notably,young administrative staff who had obtained Shanghai residency,had a surplus income,spent time with family after work,had career advancement opportunities,felt a strong connection to their work's value,and received affirmation from family members,demonstrated higher subjective well-being scores,with significant statisti-cal differences(P＜0.05).Conversely,those with an income ranging from 0 to 100 000,and those who felt overwhelmed by their current roles,scored lower on well-being,with significant statistical differences(P＜0.05).Conclusion This study sug-gests that by bolstering professional security and job stability,fostering a set of correct values and a sense of work identity,and improving job satisfaction and competence,the subjective well-being of this group can be further elevated.This,in turn,can in-ject new momentum into the high-quality development of public hospitals.

Objective This study aimed to assess the clinical efficacy of Shenling Baizhu Granules in treating low anterior resection syndrome(LARS)in rectal cancer.Methods The study employed a randomized,double-blind,placebo-parallel controlled,single-center,validity-tested clinical trial design.December 2019 to June 2022,the Department of Gastrointestinal Surgery and Integrated Traditional Chinese and Western Medicine of Peking University First Hospital recruited 110 patients who had undergone low anterior resection(LAR)for rectal cancer and subsequently developed LARS.These patients,meeting the enrollment criteria,were randomly assigned into the treatment group(55)and the control group(55)using the double-blind method principle.The randomization table was generated by SAS 9.2 software employing the double-blind method.The treatment group received oral Shenling Baizhu Granules,while the control group received oral placebo granules.Both groups commenced treatment on the 10th day after-surgery for 30 consecutive days.Patients were evaluated using LARS score,traditional Chinese medicine(TCM)symptom grading,and XU Zhongfa score before treatment,on the 15th day of treatment,and on the 1st day after treatment cessation.Results Out of 110 patients,107 were included in the full analysis set for efficacy analysis:55 patients in the treatment group and 55 patients in the control group.One case in the treatment group was excluded(against protocol),and two cases in the control group were excluded(one lost to follow-up,one against protocol).Baseline data between the two groups were consistent,with no statistically significant difference.Before treatment,LARS scores for the treatment and control groups were 33.0(31.0,36.0)and 34.0(32.0,37.0)respectively.Patients with TCM symptom scores of grades 2 to 3 accounted for 92.73％and 90.57％in the treatment and control groups,respectively,with no statistically significant difference.After 30 days of treatment,LARS scores for the treatment and control groups were 21.0(19.8,23.0)and 26.0(22.0,28.0)respectively.The percentage of patients with TCM symptom scores of grades 2 to 3 decreased to 33.33％in the treatment group and 66.04％in the control group,with a statistically significant difference.Shenling Baizhu Granules showed rapid improvement in watery or loose stools in post-operative rectal cancer patients.After 30 days of treatment,Shenling Baizhu Granules significantly improved appetite,stool consistency,abdominal distension,abdominal pain,and eructation symptoms in postoperative rectal cancer patients.Before treatment,the XU Zhongfa scores for the treatment and control groups were 3.0(2.0,4.3)and 4.0(2.0,4.0)respectively,with no statistically significant difference.After 30 days of treatment,the XU Zhongfa scores for the treatment and control groups were 7.0(6.0,8.0)and 6.0(5.0,7.0)respectively,with the treatment group significantly higher than the control group(P＜0.01).Conclusion Shenling Baizhu Granules can effectively improve LARS symptoms in patients following LAR of rectal cancer within a short period of time.

Objective:To explore the effect of the lean management based on time-action in the nursing management of patients undergoing off-pump coronary artery bypass grafting (OPCABG) .Methods:From January 2019 to December 2020, convenience sampling was used to select 248 patients undergoing OPCABG who were admitted to the Cardiovascular Surgery of Linfen Central Hospital as the research object. The patients admitted from January to December 2019 were set as the control group ( n=120) , and the patients admitted from January to December 2020 were set as the observation group ( n=128) . The control group was given routine Operating Room nursing management, while the observation group was given time-action based lean management on the basis of the control group. The Operating Room nursing quality, operation-associated indicators, nursing risk events, transfer to cardiopulmonary bypass and early postoperative complications were compared between the two groups. Results:In the observation group, the score of equipment and instrument management was (27.65±1.73) , the score of nurse cooperation was (27.41±1.88) , the score of equipment preparation was (18.37±1.29) , and the total score of nursing quality was (92.08±3.92) , and the scores were higher than those of the control group [ (24.48±1.89) , (25.35±1.64) , (16.45±1.82) , and (84.86±4.79) ], with statistical differences ( P<0.01) . In the observation group, the preoperative preparation time was (27.08±6.64) min, the operation time was (174.12±42.55) min, and the pick-up time was (21.68±5.35) min, which were shorter than those of the control group [ (35.62±7.81) min and (192.55±43.06) min, (26.44±6.57) min], and the differences were statistically significant ( P<0.01) . The lowest intraoperative nasopharyngeal temperature in the observation group was (34.79±0.84) ℃, and the lowest hematocrit was (33.66±2.74) %, which were higher than those in the control group, and the differences were statistically significant ( P<0.01) . In the observation group, the total incidence of nursing risk events was 2.34% (3/128) , the rate of transfer to cardiopulmonary bypass was 1.56% (2/128) , and the total incidence of postoperative complications was 18.75% (24/128) , which were lower than those of the control group [8.33% (10/120) , 6.67% (8/120) , 31.67% (38/120) ], and the differences were statistically significant ( P<0.05) . Conclusions:The application of the lean management based on time-action in the nursing management of OPCABG patients in the Operating Room can improve the quality of nursing, efficiency and safety of surgery, and help reduce the incidence of cardiopulmonary bypass, nursing risk events and postoperative complications.

Objective:To understand the degree of professional autonomy of nurses in Pediatric Nursing Alliance and the status of pediatric nursing practice environment, which providing guidance for the development of a series of specialized training in the alliance.Methods:Stratified random sampling method was used to conduct a questionnaire survey on nursing staff of different professional levels in Pediatric Nursing Alliance, which through the questionnaire star by using the questionnaire general information and training demand questionnaire, nurses practice professional autonomy scale, pediatric nursing staff structural empowerment questionnaire and nursing practice influencing factors questionnaire through the questionnaire star.Results:The total score for professional autonomy of nurses in the pediatric alliance was 192.66±18.63, the structural empowerment ( OR=1.137, 95% CI=1.084-1.194), lack of caring team ( OR=2.763, 95% CI=1.443-5.292) and performance evaluation ( OR=0.498, 95% CI= 0.274-0.908), specialized education and professional experience ( OR=0.548, 95% CI= 0.334-0.871) were affecting the clinical nursing practice. Conclusion:The degree of professional autonomy of nurses in the Pediatric Nursing Alliance is in the middle and high level. Key factors affecting nursing practice including insufficient structural empowerment, lack of opportunities to continue learning, lack of nursing teams, lack of effectiveness evaluation and the lack of specialized education and work experience, which guiding the pediatric nursing alliance to continuously deepen the connotation of pediatric nursing professional and innovative team collaboration new model, utilize the advantages of resources to actively cultivate specialized nursing research personnel, carry out multi-disciplinary and cross-disciplinary cooperation, improve the nursing quality evaluation index system, so as to enhance the professional nursing service capacity and value.

Objective:To explore the effect of the hyperbaric oxygen therapy combined with percutaneous coronary intervention (PCI) on blood rheological properties in patients with unstable angina and its protective effect on myocardial injury.Methods:A total of 168 cases of patients with unstable angina admitted to Department of Cardiovascular Medicine of the First Affiliated Hospital of Henan University from June 2017 to December 2018 were selected as research subjects and divided into control group (84 cases) and observation group (84 cases). The control group was given conventional PCI, and symptomatic and supportive treatment, while the observation group were given hyperbaric oxygen therapy (1 time/day, 10 days constitute one treatment course, 2 courses in total) on the basis of the treatments in the control group. The clinical efficacy was compared between the two groups. The changes in blood rheological indexes and myocardial injury markers of the patients were detected before and after treatment.Results:In the observation group, there were 45 cases with markedly efficacy, and 34 cases showed some efficacy. The total effective rate was 94.05%, which was significantly higher than that of 84.52% in the control group. The difference was statistically significant ( P<0.05). After treatment, the PaO 2 of the patients in the observation group significantly increased, while the PaCO 2 significantly decreased. The improvement of the blood oxygen metabolism was more significant than that in the control group ( P<0.05). Meanwhile, the levels of blood rheological indexes, e. g. whole blood viscosity (ηb), erythrocyte sedimentation rate (ESR), hematocrit (HCT), erythrocyte electrophoresis time (EET), erythrocyte aggregation index (EAI), and platelet aggregation rate (PAgT), in the two groups all declined obviously, and those in the observation group had greater decline than those in the control group ( P<0.05). The lysophospholipids acid (LPA) and platelet-activating factor P-selectin (CD62P) in the two groups significantly decreased, and the levels of LPA and CD62P in the observation group had greater decreases than those in the control group ( P<0.05). Moreover, the levels of the markers of myocardial injury, e. g. cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) in both groups increased significantly, and the cTnI and CK-MB levels in the observation group were significantly lower than those in the control group. Conclusion:Through increasing blood oxygen content in body tissues, hyperbaric oxygen can effectively reduce blood viscosity, improve blood rheological properties, and therefore, reduce platelet activation, thus preventing thrombosis. It can also reduce myocardial injury and enhance the clinical efficacy for patients with unstable angina.

Objective:To explore the effect of the hyperbaric oxygen therapy combined with percutaneous coronary intervention (PCI) on blood rheological properties in patients with unstable angina and its protective effect on myocardial injury.Methods:A total of 168 cases of patients with unstable angina admitted to Department of Cardiovascular Medicine of the First Affiliated Hospital of Henan University from June 2017 to December 2018 were selected as research subjects and divided into control group (84 cases) and observation group (84 cases). The control group was given conventional PCI, and symptomatic and supportive treatment, while the observation group were given hyperbaric oxygen therapy (1 time/day, 10 days constitute one treatment course, 2 courses in total) on the basis of the treatments in the control group. The clinical efficacy was compared between the two groups. The changes in blood rheological indexes and myocardial injury markers of the patients were detected before and after treatment.Results:In the observation group, there were 45 cases with markedly efficacy, and 34 cases showed some efficacy. The total effective rate was 94.05%, which was significantly higher than that of 84.52% in the control group. The difference was statistically significant ( P<0.05). After treatment, the PaO 2 of the patients in the observation group significantly increased, while the PaCO 2 significantly decreased. The improvement of the blood oxygen metabolism was more significant than that in the control group ( P<0.05). Meanwhile, the levels of blood rheological indexes, e. g. whole blood viscosity (ηb), erythrocyte sedimentation rate (ESR), hematocrit (HCT), erythrocyte electrophoresis time (EET), erythrocyte aggregation index (EAI), and platelet aggregation rate (PAgT), in the two groups all declined obviously, and those in the observation group had greater decline than those in the control group ( P<0.05). The lysophospholipids acid (LPA) and platelet-activating factor P-selectin (CD62P) in the two groups significantly decreased, and the levels of LPA and CD62P in the observation group had greater decreases than those in the control group ( P<0.05). Moreover, the levels of the markers of myocardial injury, e. g. cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) in both groups increased significantly, and the cTnI and CK-MB levels in the observation group were significantly lower than those in the control group. Conclusion:Through increasing blood oxygen content in body tissues, hyperbaric oxygen can effectively reduce blood viscosity, improve blood rheological properties, and therefore, reduce platelet activation, thus preventing thrombosis. It can also reduce myocardial injury and enhance the clinical efficacy for patients with unstable angina.

Objective: To investigate reduction and fixation of complex acetabular fractures using three-dimensional (3D) printing technique and personalized acetabular wing-plate via lateral-rectus approach. Methods: From March to July 2016, 8 patients with complex acetabular fractures were surgically managed through 3D printing personalized acetabular wing-plate via lateral-rectus approach at Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University. There were 4 male patients and 4 female patients, with an average age of 57 years (ranging from 31 to 76 years). According to Letournel-Judet classification, there were 2 anterior+ posterior hemitransverse fractures and 6 both-column fractures, without posterior wall fracture or contralateral pelvic fracture. The CT data files of acetabular fracture were imported into the computer and 3D printing technique was used to print the fractures models after reduction by digital orthopedic technique. The acetabular wing-plate was designed and printed with titanium. All fractures were treated via the lateral-rectus approach in a horizontal position after general anesthesia. The anterior column and the quadrilateral surface fractures were fixed by 3D printing personalized acetabular wing-plate, and the posterior column fractures were reduction and fixed by antegrade lag screws under direct vision. Results: All the 8 cases underwent the operation successfully. Postoperative X-ray and CT examination showed excellent or good reduction of anterior and posterior column, without any operation complications. Only 1 case with 75 years old was found screw loosening in the pubic bone with osteoporosis after 1 month′s follow-up, who didn′t accept any treatment because the patient didn′t feel discomfort. According to the Matta radiological evaluation, the reduction of the acetabular fracture was rated as excellent in 3 cases, good in 4 cases and fair in 1 case. All patients were followed up for 3 to 6 months and all patients had achieved bone union. According to the modified Merle D′Aubigné and Postel scoring system, 5 cases were excellent, 2 cases were good, 1 case was fair. Conclusions Surgical management of complex acetabular fracture via lateral-rectus approach combine with 3D printing personalized acetabular wing-plate can effectively improve reduction quality and fixation effect. It will be truly accurate, personalized and minimally invasive.

Through introducing mutations into ribosomes by obtaining spontaneous drug resistance of microorganisms, ribosome engineering technology is an effective approach to develop mutant strains that overproduce secondary metabolites. In this study, ribosome engineering was used to improve the yield of butenyl-spinosyns produced by Saccharopolyspora pogona by screening streptomycin resistant mutants. The yields of butenyl-spinosyns were then analyzed and compared with the parent strain. Among the mutants, S13 displayed the greatest increase in the yield of butenyl-spinosyns, which was 1.79 fold higher than that in the parent strain. Further analysis of the metabolite profile of S13 by mass spectrometry lead to the discovery of Spinosyn α1, which was absent from the parent strain. DNA sequencing showed that there existed two point mutations in the conserved regions of rpsL gene which encodes ribosomal protein S12 in S13. The mutations occurred a C to A and a C to T transversion mutations occurred at nucleotide pair 314 and 320 respectively, which resulted in the mutations of Proline (105) to Gultamine and Alanine (107) to Valine. It also demonstrated that S13 exhibited genetic stability even after five passages.
Genetic Engineering ; Macrolides ; metabolism ; Point Mutation ; Ribosomal Proteins ; genetics ; Ribosomes ; metabolism ; Saccharopolyspora ; metabolism

Background and objectiveSmall cell lung cancer combined with squamous cell carcinoma are rare. hTe aim of this study was to analyze the clinicopathological characteristics and treatment, and explored the prognostic factors of this disease.MethodsBetween January 2004 and December 2012, 58 patients with cytopathologically conifrmed small cell lung cancers combined with squamous cell carcinoma were retrospectively analyzed.Kaplan-Meier methods were used to calculate the survival rate, andLog-rank test was used to examine differences between arms. hTeCox regression model was used to analyze the independent factors affecting the overall survival (OS).Results hTe OS of the 58 patients was 22.7 months with a range of 0.3 to 124.3 months. In univariate analysis, Karnofsky performance score before treatment, extensive disease, tumor stage were the considered prognostic factors affecting the OS rate (P<0.05).Cox multivariate analysis showed that only the tumor-node-metastasis (TNM) stage was the independent prognostic factor (P=0.019). hTe majority of the patients received multimodality therapy and chemotherapy was the main treatment. Distant metastasis was the main reasonfor the treatment failure.ConclusionCombined therapy with chemotherapy as the main treatment should be adopted in therapeutic regimen of the patients with small cell lung cancers combined with squamous cell carcinoma. TNM stage was the independent prognos-tic factor inlfuencing the OS.