Objectives:To explore the clinical characteristics of children with adenoid hypertrophy (AH) and laryngopharyngeal reflux (LPR) by detecting the expression of pepsin in adenoids as a standard for AH with LPR.Methods:A total of 190 children who were admitted for surgical treatment due to AH were included in the study. The main clinical symptoms of the patients were recorded, and the degree of adenoid hypertrophy was evaluated. Before the surgery, Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) were used to evaluate the reflux symptoms. After the surgery, pepsin immunohistochemical staining was performed on the adenoid tissue, and according to the staining results, the patients were divided into study group (pepsin staining positive) and control group (pepsin staining negative). SPSS 19.0 software was used for statistical analysis. Quantitative data conforming to normal distribution between the two groups were tested by two-independent sample t test, and quantitative data with skewed distribution were tested by Mann-Whitney U test. Results:The positive rate of pepsin staining in the 190 AH patients was 78.4% (149/190). The study group had higher levels of preoperative symptoms such as erythema and/or congestion of the pharynx(2.1±0.7 vs. 1.8±0.6, t=2.23), vocal cord edema[1.0(0, 1.0) vs. 1.0(0, 1.0), Z=2.00], diffuse laryngeal edema[0(0, 1.0) vs. 0(0, 0), Z=2.48], posterior commissure hypertrophy[(1.4±0.6 vs. 1.1±0.5), t=2.63], and a higher total score on the RFS scale than the control group(6.2±2.7 vs. 5.0±2.6, t=2.47), with statistical differences ( P<0.05). The sensitivity and specificity of RFS score in diagnosing AH with LPR were 24.8% and 80.5%, respectively. When RFS>5 was used as the positive threshold, the sensitivity and specificity of RFS score in diagnosing AH with LPR were 61.1% and 58.5%, respectively. There was a statistical difference in the number of positive cases of RFS score between the study group and the control group(91 vs. 17, χ2=5.04, P=0.032). Conclusions:LPR is common in AH children. Children with AH and LPR have specific performance in electronic laryngoscopy, such as erythema with edema in the pharynx, posterior commissure hypertrophy, and vocal cord edema.

ObjectiveTo explore the intervention mechanism of Xiangsha Liujunzi Tang in rats with functional dyspepsia （FD） based on the Ras homolog gene family member A （RhoA）/Rho-associated coiled-coil containing protein kinase 2 （ROCK2）/Myosin phosphatase target Subunit 1 （MYPT1） pathway. MethodSixty male SD suckling rats in SPF grades were randomly divided into blank group （n=10） and model group （n=50）. The comprehensive modeling method （gavage administration of iodoacetamide+exhaustion of swimming+disturbance of hunger and satiety） was used to replicate the rat model of FD. After successful replication of the model， the rats in the model group were randomly divided into model group， mosapride group， and high， middle， and low-dose Xiangsha Liujunzi Tang groups， with 10 rats in each group. Rats in the blank group and model group were given 10 mL kg^-1·d^-1 normal saline， those in the mosapride group were given 1.35 mg·kg^-1·d^-1 mosapride， and those in the high， middle， and low-dose Xiangsha Liujunzi Tang groups were given 12， 6， and 3 g·kg^-1·d^-1 Xiangsha Liujunzi Tang， respectively. The intervention lasted 14 days. The general living conditions of rats were observed before and after modeling and administration， and the 3-hour food intake and body mass of rats were measured. After intervention， the intestinal propulsion rate of rats was measured， and the pathological changes in the gastric tissue were observed by hematoxylin-eosin （HE） staining. The content of choline acetyl transferase （ChAT） and vasoactive intestinal peptide （VIP） in the medulla oblongata and gastric tissue homogenate was determined by enzyme-linked immunosorbent assay （ELISA）， the distribution of adenosine triphosphate （ATP） enzyme in gastric antrum smooth muscle was observed by frozen section staining， and the protein expression levels of RhoA， ROCK2， and phosphorylated-myosin phosphatase target subunit 1 （p-MYPT1） in the gastric tissue were detected by Western blot. ResultCompared with the blank group， the model group had withered hair， lazy movement， slow action， poor general living condition， lower 3-hour food intake， body mass， and lower intestinal propulsion rate （P<0.05）， whereas no obvious abnormality in gastric histopathology. In the model group， the content of ChAT in the medulla oblongata and gastric tissue decreased， the content of VIP in gastric tissue increased， the distribution of ATP enzyme in gastric antrum smooth muscle decreased significantly， and the protein expression levels of RhoA， ROCK2， and p-MYPT1 in the gastric tissue decreased significantly （P<0.05）. As compared with the model group， the general living condition of rats in each intervention group was significantly improved， and the 3-hour food intake， body mass， and intestinal propulsion rate were significantly increased （P<0.05）. There was no significant difference in gastric pathology in the intervention groups. The content of ChAT in the medulla oblongata and gastric tissue increased significantly， the content of VIP in the gastric tissue decreased， the distribution of ATP enzyme in gastric antrum smooth muscle increased significantly， and the protein expression levels of RhoA， ROCK2， and p-MYPT1 in the gastric tissue increased significantly （P<0.05）. The intervention effect of Xiangsha Liujunzi Tang group on the above indexes was dose-dependent. ConclusionXiangsha Liujunzi Tang can effectively improve the general living condition and gastric motility of rats with FD， and its specific mechanism may be related to the activation of the RhoA/ROCK2/MYPT1 pathway in the gastric tissue to regulate smooth muscle relaxation and contraction and promote gastric motility.

Objective:To investigate the prevalence, clinical characteristics, risk factors, and prognosis of chronic drug-induced liver injury (DILI).Methods:A multicenter, open, retrospective, non-interventional epidemiological survey was conducted. According to the inclusion criteria, patients with DILI and hospitalized in 308 hospitals in China from January 1, 2012 to December 31, 2014 were enrolled, and medical records of the patients were collected. The patients with DILI were divided into chronic and acute DILI groups. The clinical characteristics, laboratory tests, and prognosis in patients of the 2 groups were compared, and the suspected drugs that induced the liver injury were analyzed. Univariate and multivariate logistic regression analyses were used to analyze the influencing factors of chronic DILI.Results:A total of 25 927 patients were enrolled in the study, including 22 556 (87%) with acute DILI (acute DILI group) and 3 371 (13%) with chronic DILI (chronic DILI group). In the chronic DILI group, there were high proportion of women and the patients were older in age; more patients were with a history of liver disease and the time from medication to DILI was longer; more patients had digestive system symptoms (including loss of appetite, abdominal distension, nausea, vomiting, etc.), fatigue, jaundice, pruritus, liver pain/discomfort, bleeding tendency; the alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubin, and international normalized ratio were higher, while the serum albumin and platelet counts were lower; the proportion of patients with model for end-stage liver disease score ≥ 15 was higher; the all-cause mortality rate and liver disease-related mortality rate were higher, compared with the acute DILI group. The differences above-mentioned were statistically significant (all P<0.05). Multivariate logistic regression analysis showed that male was protective factor [odds ratio ( OR)=0.76, 95% confidence interval ( CI): 0.69-0.83], while previous liver disease history ( OR=2.00, 95% CI: 1.82-2.19) and hypoalbuminemia ( OR=0.96, 95% CI: 0.95-0.96) were independent risk factors for chronic DILI. Conclusions:In the study period, the proportion of chronic DILI among DILI inpatients is 13.0% in the 308 hospitals. Compared with those with acute DILI, more chronic DILI patients were female, and patients with chronic DILI have higher ages, severer conditions, and poorer prognoses; female, previous liver disease history, and hypoalbuminemia are independent risk factors for chronic DILI.

Objective:To investigate the prevalence, clinical characteristics, risk factors, and prognosis of chronic drug-induced liver injury (DILI).Methods:A multicenter, open, retrospective, non-interventional epidemiological survey was conducted. According to the inclusion criteria, patients with DILI and hospitalized in 308 hospitals in China from January 1, 2012 to December 31, 2014 were enrolled, and medical records of the patients were collected. The patients with DILI were divided into chronic and acute DILI groups. The clinical characteristics, laboratory tests, and prognosis in patients of the 2 groups were compared, and the suspected drugs that induced the liver injury were analyzed. Univariate and multivariate logistic regression analyses were used to analyze the influencing factors of chronic DILI.Results:A total of 25 927 patients were enrolled in the study, including 22 556 (87%) with acute DILI (acute DILI group) and 3 371 (13%) with chronic DILI (chronic DILI group). In the chronic DILI group, there were high proportion of women and the patients were older in age; more patients were with a history of liver disease and the time from medication to DILI was longer; more patients had digestive system symptoms (including loss of appetite, abdominal distension, nausea, vomiting, etc.), fatigue, jaundice, pruritus, liver pain/discomfort, bleeding tendency; the alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubin, and international normalized ratio were higher, while the serum albumin and platelet counts were lower; the proportion of patients with model for end-stage liver disease score ≥ 15 was higher; the all-cause mortality rate and liver disease-related mortality rate were higher, compared with the acute DILI group. The differences above-mentioned were statistically significant (all P<0.05). Multivariate logistic regression analysis showed that male was protective factor [odds ratio ( OR)=0.76, 95% confidence interval ( CI): 0.69-0.83], while previous liver disease history ( OR=2.00, 95% CI: 1.82-2.19) and hypoalbuminemia ( OR=0.96, 95% CI: 0.95-0.96) were independent risk factors for chronic DILI. Conclusions:In the study period, the proportion of chronic DILI among DILI inpatients is 13.0% in the 308 hospitals. Compared with those with acute DILI, more chronic DILI patients were female, and patients with chronic DILI have higher ages, severer conditions, and poorer prognoses; female, previous liver disease history, and hypoalbuminemia are independent risk factors for chronic DILI.

Objective:To construct an evaluation index system for quality of use of insulin pumps in hospitals, in order to provide a reference for evaluating quality of use of insulin pumps in hospitals in clinical work.Methods:Based on the three-dimensional quality evaluation model of "structure-process-result", the first draft was determined through literature review and group discussion from January to February 2022. Using the Delphi expert correspondence method, 26 experts from 13 provinces/municipalities in China were consulted in two rounds to determine the quality evaluation index system for the use of insulin pumps in the hospital.Results:The recovery rate of the two rounds of expert questionnaire was 100%, and the expert authority coefficient was 0.971. The mean value of the second round of index importance assignment was 4.500-5.000 and the coefficient of variation was 0-0.22. The final construction of quality evaluation index system of insulin pump use in the hospital included 3 first-level indicators, 15 second-level indicators and 37 third-level indicators.Conclusions:The constructed quality evaluation index system of insulin pump use in the hospital is scientific, reasonable and practical, which has guiding significance for evaluating the quality of insulin pump use in the hospital.

In order to enable the teachers of professional basic courses to play a role adequately in teaching and educating students, the elements of humanistic quality education are excavated from Histology and Embryology chapters and integrated with professional basic knowledges. The effects of teaching are tested through students' writing experience, teachers' interview and national peer review. The results show that students have received the education of gratitude, dedication and responsibility, meanwhile their enthusiasm for learning has been significantly improved. Teachers believe that teaching and learning has achieved self-education at the same time. The national colleagues agree that it's feasible to integrate humanistic quality education into the teaching process of professional basic courses, and the better teaching effect is also be achieved.

Objective To investigate the prevalence of nutritional risk (NRS2002) and malnutrition inhospitalized stroke patient and their nutritional intervention. Methods The stroke patients admitted to three de-partments of vascular neurology ward including cerebral hemorrhage, cerebral infarction and subarachnoid hemor-rhage in Beijing Tiantan Hospital from January 2018 to January 2019 were recruited using cluster sampling. Nutri-tional risk screening 2002 ( NRS 2002) was used to screen the nutritional risk of inpatients Malnutrition was as-sessed by criteria:(1) body mass index (BMI) <18. 5 kg/m2 with poorer general condition from January 2018 to January 2019;(2) Global leadership initiative on malnutrition ( GLIM) criteria were used except whole body muscle mass measurement from October 2018 to January 2019. The nutritional intervention for patients were closely observed during hospitalization. Results A total of 1532 patients were registered and1036 patients were included in the final analysis considering the inclusion and exclusion criteria. The prevalence of nutritional risk was 33. 0％ ( 342/1036) . The prevalence of malnutrition based on BMI and GLIM criteria was 0. 9％( 9/1036) and 2. 5％ (10/393) respectively. Among the 342 patients with nutritional risk, 112 patients received nutritional support therapy by tube feeding, but only 29 patients received nutritional support that met guideline standards. 81 patients received not standard nutritional support, and 2 patients received highly unregulated nutritional sup-port. No patients received sugar and electrolyte infusion, oral nutritional supplements ( ONS) , oral nutritional a-gents and compound nutrition intervention. The other 230 patients took hospital diet. Conclusion The prevalence of nutritional risk in hospitalized patients with cerebral hemorrhage, cerebral infarction or subarachnoid hemorrhage was high, and the prevalence of malnutrition was extremely low. There was a low proportion of nutri-tional support. High quality of large sample cohort studies will be conducted to show whether reasonable applica-tion of nutritional support therapy in patients with nutritional risk can improve patient outcome.

Objective: To explore the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection who received entecavir alone or in combination with anluohuaxianwan for 78 weeks. Methods: Patients with chronic HBV infection were randomly treated with entecavir alone or in combination with anluohuaxian for 78 weeks. Ishak fibrosis score was used for blind interpretation of liver biopsy specimens. The improvement in liver fibrosis condition before and after the treatment was compared. Student's t test and non-parametric test (Mann-Whitney U-Test and Kruskal-Wallis test) were used to analyze the measurement data. The categorical variables were analyzed by Chi-square test method and Spearman’s rank correlation coefficient was used to test bivariate associations. Results: Liver fibrosis improvement rate after 78 weeks of treatment was 36.53% (80/219) and the progression rate was 23.29% (51/219). The improvement of liver fibrosis was associated to the degree of baseline fibrosis and treatment methods (P < 0.05). The improvement rate of hepatic fibrosis in patients treated with anluohuaxianwan combined with entecavir at baseline F < 3 (54.74%, 52/95) was significantly higher than that in patients treated only with entecavir (33.33%, 16/48), P = 0.016 and the progression rate of hepatic fibrosis (13.68%, 13/95) was lower than that in patients treated alone (18.75%, 9/48), P = 0.466. In patients with baseline F < 3, the proportion of patients with improved and stable liver fibrosis in the combined treatment group (68.1%, 32/47) was higher than that in the treatment group alone (51.7%, 15/29). Conclusion Combined anluohuaxianwan and entecavir treatment can significantly improve the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection. Furthermore, it has the tendency to improve the stability rate and reduce the rate of progression of liver fibrosis.

Radiation-induced pulmonary injury(RPI)refers to intrathoracic neoplasm after radiotherapy, radiation wild area normal lung tissue injury complicated by damage to the reaction. Traditional Chinese medicine was used for nourishing yin and clearing lung, heat-clearing and detoxifying, promoting blood circulation to remove blood stasis in reducing the adverse reaction of radiotherapy. TCM showed the advantage for radioactive lung injury. Based on the different mechanism of action and from the perspective of TCM treatment, the article reviewed the latest experiment research of TCM on radiation-induced pulmonary injury were summarized, and we discussed and pointed out the existing problems and prospect solution

Objective: To investigate the expression levels and clinical significance of serum suppressor of cytokine signaling-3 (SOCS3) and associated cytokines in HIV/TB co-infected patients. Methods: The serum levels of SOCS3, IFN-γ, IL-2, IL-4, IL-6, IL-10, IL-17 and IL-22 were quantified by using enzyme-linked immunosorbent assays (ELISA) in 50 HIV-infected patients, 48 HIV/TB co-infected patients and 50 healthy donors. Pearson correlation analysis was used to analyze the correlation between SOCS3 and other seven cytokines. Results: Serum levels of SOCS3 expression in HIV/TB co-infection group were significantly higher than those in HIV-infection alone and the control group. There was also significant correlation between SOCS3 and IFN-γ, IL-4, IL-6, IL-10, IL-2 in HIV/TB co-infection group. Conclusions These findings indicated that SOCS3 may play an important role in the immune response of patients with HIV/TB co-infection and it may be helpful in the diagnosis of HIV/TB co-infection.