Objective To explore the relationship between serum long non-coding RNA X-inactive specific transcript(LncRNA XIST)and microRNA-122-5p(miR-122-5p)expression and the severity of brain injury and prognosis in patients with sepsis-associated encephalopathy(SAE).Methods A total of 108 SAE patients(SAE group)and 52 patients with sepsis only(non-SAE group)admitted to the Ankang Hospital of Tradi-tional Chinese Medicine from January 2019 to December 2023 were selected as the study subjects.According to the degree of brain injury,the SAE patients were categorized into mild brain injury group[Glasgow Coma Scale(GCS)score 13-14,27 cases],moderate brain injury group(GCS score 9-12,36 cases),and severe brain injury group(GCS score 3-8,45 cases).Based on the 28-day prognosis,they were divided into death group(51 cases)and survival group(57 cases).Serum LncRNA XIST and miR-122-5p expression levels were measured using real-time quantitative PCR.The binding site of LncRNA XIST and miR-122-5p was predicted using the StarBase database,and Pearson correlation analysis was performed to evaluate the relationship be-tween serum LncRNA XIST and miR-122-5p expression in SAE patients.Multivariate unconditional Logistic regression was used to determine the association between serum LncRNA XIST,miR-122-5p expression,and prognosis in SAE patients.Receiver operating characteristic curves were used to assess the predictive efficacy of LncRNA XIST and miR-122-5p expression for SAE prognosis.Results Compared with non-SAE group,se-rum LncRNA XIST expression was increased and miR-122-5p expression was decreased in SAE group,with statistical significance(P＜0.05).There were binding sites between LncRNA XIST and miR-122-5p,and the expression of LncRNA XIST in serum of SAE patients was negatively correlated with that of miR-122-5p(P＜0.05).Serum LncRNA XIST expression in mild brain injury group,middle brain injury group and severe brain injury group was increased successively,while miR-122-5p expression was decreased successively,with statistical significance(P＜0.05).The 28-day mortality rate of SAE patients after admission was 47.22％(51/108).Compared with the survival group,the expression of serum LncRNA XIST was higher in the death group,and the expression of miR-122-5p was lower,with statistical significance(P＜0.05).High sequential organ failure assessment(SOFA)score and high expression of LncRNA XIST were independent risk factors for death in SAE patients,while high GCS scores and high miR-122-5p expression of were independent protec-tive factors(P＜0.05).The combined expression of serum LncRNA XIST and miR-122-5p predicted the death of SAE patients with greater area under the curve than that of serum LncRNA XIST and miR-122-5p a-lone(P＜0.05).Conclusion Elevated serum LncRNA XIST and decreased miR-122-5p expression levels are associated with the severity of brain injury and poor prognosis in SAE patients.The combined detection of Ln-cRNA XIST and miR-122-5p has a high predictive value for SAE prognosis.

Objective To compare the changes of the Chinese Materia Medica resources(CMMR)in Sichuan based on the data of the 3rd Chinese Materia Medica Resource Inventory(CMMRI,1983-1986)and the 4th CMMRI(2011-2022).Methods Using new techniques,after field investigation,collection and identification of the specimens of the animals,plants and minerals.The data of the CMMR in Sichuan found in the 4th CMMRI were analysed and compared with the data of 3rd CMMRI.Results ①9055 species of CMMR were found in Sichuan during the 4th CMMRI,including 8272 species of medicinal plants,745 species of medicinal animals and 38 species of medicinal minerals.Compared with the 3rd CMMRI,the number of CMMR found in Sichuan have greatly increased.The number of medicinal plants increased 5018 species,the number of medicinal animals increased 637 species and the number of medicinal minerals increased 5 species,too.②The medicinal plants is the main part of the CMMR,and the higher plants(7774 species)has the absolute advantage of the CMMR.The top 20 families which have plenty of plant species include Compositae,Rosaceae,Leguminosae,Ranunculaceae,etc.③ Based on the data of the CMMR of the 183 counties in Sichuan,the reserves of 235 species of wild CMMR in Sichuan is about 36.72 million ton.There were 49 CMMR which have reserves beyond 100 thousand tons,such as Arisaematis rhizoma,Epimedii folium,Cimicifugae rhizoma,Acori tatarinowii rhizoma,Gentianae macrophyllae radix,Polygoni multiflori radix etc.④In 2021,there were 215 species of CMMR cultivated in Sichuan,the main species were Aurantii fructus,Chuanxiong rhizoma,Polygonati rhizome,Salviae miltiorrhizae radix et rhizome.The planting area was 8.17 million and the production was 1.26 million ton.⑤All 183 countries were found CMMR,the number of the species of CMMR in 30 countries exceeded 800,including 16 countries which had more than 1000 kinds of CMMR,such as Emeishan,Hongya,Muli etc.The total types of the CMMR(up 118.31%),the reserves of the wild CMMR(up 119 times)and the number of the counties(up 3 times)which had plenty of CMMR,showed a marked increase over the 3rd CMMRI.8 new species were found in the the 4th CMMRI,such as Codonopsis atriplicifolia,Tongoloa tagongensis,Allium xinlongense,etc.Conclusion The species,the reserves of the CMMR and the resource rich countries in Sichuan are the top 3 in China and Sichuan is worthy of the title of"Hometown of Traditional Chinese Medicine".The compositions and types of the family,genus and species of the CMMR in Sichuan have significantly increased.The basic information of the CMR in Sichuan was clearly found out during the 4th CMMRI,and beneficial for the sustainable development and utilization of the CMMR in Sichuan.

OBJECTIVE To compare the efficacy of Eustachian tube pressure nebulization and insuffiation system and conventional drugs on acute otitis media of effusion in adults. METHODS Sixty ears of acute otitis media of effusion in our hospital were selected as the research objects. All patients were divided into two groups according to the treatment,which received drug therapy alone and received drug therapy and nebulizer therapy. The course lasted for 7 days. ETS,ETDQ-7,related hearing tests(acoustic immitance and pure tone threshold),and the therapeutic effect were compared among the three groups. RESULTS In drug therapy alone group,6 ears were cured,10 ears were improved,and the total effective rate was 53.3％. In drug therapy and nebulizer therapy group,17 ears were cured,9 ears were improved,and the total effective rate was 86.7％. There were no complications or adverse reactions in all patients. CONCLUSION The effective rate of the patients treated with Eustachian tube pressure nebulization and insuffiation system combined drug therapy was significantly higher than that of drug therapy alone. On the basis of conventional drug therapy combined with eustachian tube pressure nebulization and insuffiation system might can be a new effective choice for acute otitis media of effusion in adults.

Objective:To evaluate the quality of life (QoL) of Chinese chronic pancreatitis (CP) patients based on the Chinese version of the pancreatitis quality of life Instrument (PANQOLI) and explore its impact factors.Methods:404 patients with CP admitted to the Department of Gastroenterology of the First Affiliated Hospital of Naval Medical University between September 2021 and January 2022 were enrolled. The Chinese version of PANQOLI was used for questionnaire survey on QoL of CP patients. Univariate analysis and multiple linear regression analysis were used to explore the impact factors for QoL of CP patients.Results:The total score of QoL of 404 Chinese CP patients was 28-94(72.47±13.61), which declined by 29.64% compared to the highest total score (103) in the Chinese version of PANQOLI. Score of physical function, role function, emotional function, and self-worth domain was 25.63±4.84, 13.86±2.78, 16.98±6.21 and 16.00±4.65, respectively. Compared to the highest scores (30, 25, 24 and 24), the scores of aforementioned four domains declined by 14.57%, 44.56%, 29.25% and 33.33%, respectively. Univariate analysis showed that sex, age, employment status, smoking, alcohol consumption, and frequency of pancreatitis recurrence were significantly associated with QoL of CP patients. Multiple linear regression analysis indicated that older age (coefficient=-0.127), unemployment status (coefficient=-0.106), smoking (coefficient=-0.176), and high frequency of pancreatitis recurrence (coefficient=-0.123) were independent factors for QoL of CP patients (all P value <0.05). Conclusions:The Chinese version of PANQOLI could be effectively applied to Chinese CP patients. Older age, unemployment, smoking, and pancreatitis attacks were risk factors for QoL of CP patients, indicating that the formulation of personalized intervention measures may help to improve QoL of CP patients.

Objective: To investigate the healthcare expenditures and self-payment among patients with lung cancer in Wenling City before and after implementation of diagnosis-related groups (DRGs), so as to provide the evidence for controlling medical costs and relieving burdens of patients with lung cancer. Methods: The basic data and healthcare expenditures of lung cancer patients that were definitively diagnosed from 2015 to 2019 and covered by medical insurance were captured from the cancer registration database of Wenling Center for Disease Control and Prevention and the database of chronic and specific diseases in Wenling Bureau of Medical Insurance. The changes of outpatient expenditures, inpatient expenditures and self-payments were compared before (2015-2016) and after implementation of DRGs (2018-2019) among lung cancer patients. Results: Totally 4 947 lung cancer patients covered by medical insurance were enrolled in this study, including 3 052 males (61.69%) and 1 895 females (38.31%), with a mean age of (64.88±11.64) years. The annual mean healthcare expenditure was 56 675.85 Yuan per capita during the period between 2015 and 2016, in which 14.48% were outpatient expenditures and 85.52% were inpatient expenditures, and the annual mean healthcare expenditure was 38 702.94 Yuan per capita during the period between 2018 and 2019 (a 31.71% reduction as compared to that in 2015 and 2016), in which 24.49% were outpatient expenditures and 75.51% were inpatient expenditures. The proportions of outpatient expenditures, inpatient expenditures and total self-payments consisted of 25.38%, 32.49% and 29.67% of total healthcare expenditures in 2018 and 2019, which were significantly lower than those (50.84%, 50.96% and 50.95%, respectively) in 2015 and 2016 (χ2=13.741, P<0.001; χ2=7.015, P=0.008; χ2=9.340, P=0.002). Conclusions The annual mean healthcare expenditures per capita and the proportion of self-payment reduce among lung cancer patients covered by medical insurance following implementation of DRGs.

Objective:To study the efficacy and influencing factors of ursodeoxycholic acid (UDCA) in the treatment of cholesterol gallstone, so as to provide reference for the treatment of cholesterol gallstone by internal medicine.Methods:From March 1, 2017 to March 31, 2018, at outpatient department of gastroenterology of 9 Beijing medical centers including Peking University People′s Hospital, the Sixth Medical Center of PLA General Hospital, Beijing Huaxin Hospital, PLA Rocket Force Characteristic Medical Center, Peking University Aerospace Center Hospital, Beijing Youan Hospital of Capital Medical University and Beijing Tiantan Hospital of Capital Medical University, Beijing Tongren Hospital of Capital Medical University, and Beijing Shijitan Hospital of Capital Medical University, the data of patients with cholesterol gallstone treated by UDCA were collected. The inclusion criteria were that the largest diameter of stone was ≤10 mm and the stone was not detected under X-ray. The treatment plan was taking UDCA orally for 6 months at a dose of 10 mg·kg -1·d -1. The basic information of patients, the ultrasound examination results before treatment and 6 months after treatment, and scores of biliary abdominal pain and dyspepsia symptom were collected. Univariate and multivariate logistic regression were used to analyze the influencing factors of the efficacy in gallstrone dissolution by UDCA, and Wilcoxon signed rank test was used for statistical analysis. Results:A total of 215 patients were enrolled. The complete dissolution rate of gallstone was 19.5% (42/215) and partial dissolution rate was 50.7% (109/215), and the total effective rate was 70.2% (151/215). The complete dissolution rate of sandy stone was significantly higher than that of lumped stones (37.0%(17/46) vs. 14.8%(25/169); OR=3.377, 95% confidence interval (95% CI) 1.621 to 7.035, P=0.001). In lumped stones, the complete dissolution rate of the stones with diameter ≤5 mm was significantly higher than that of the stones with diameter >5 mm (37.5%(9/24) vs. 11.0%(16/145); OR=4.837, 95% CI 1.823 to 12.839, P=0.002). The complete dissolution rate of patients with higher body mass index ( OR=0.872, 95% CI 0.764 to 0.995, P=0.043) and longer disease course ( OR=0.942, 95% CI 0.912 to 0.973, P<0.001) was low. The results of multivariate logistic analysis indicated that long disease course of gallstone ( OR=0.940, 95% CI 0.908 to 0.974, P=0.001), rough gallbladder wall ( OR=0.438, 95% CI 0.200 to 0.962, P=0.040) and lumped stone ( OR=0.236, 95% CI 0.101 to 0.550, P=0.001) were independent risk factors of influencing the efficacy of stone dissolution by UDCA. As for lumped stones, the independent risk factors included long disease course of gallstone ( OR=0.926, 95% CI 0.877 to 0.978, P=0.006) and stone diameter >5 mm ( OR=0.142, 95% CI 0.043 to 0.470, P=0.001). After 6 months of UDCA treatment, score of biliary abdominal pain decreased from 0 (0 to 6) to 0 (0 to 0) and the score of dyspepsia symptom decreased from 1 (0 to 2) to 0 (0 to 0), and the differences between before treatment and after treatment were statistically significant ( Z=-8.50, and -9.13, both P<0.001). Conclusions:UDCA has a certain efficacy in cholesterol gallstone dissolution and can ease biliary abdominal pain and dyspepsia symptom. Long disease course of gallstone, rough gallbladder wall and stone diameter >5 mm are independent risk factors of poor efficacy in gallstone dissolution by UDCA.

Objective:To explore the mediating effect of self-management efficacy between social support and self-management behavior in cancer patients treated with proton-heavy ions.Methods:From April 2020 to April 2021, convenience sampling was used to select 674 cancer patients in Shanghai Proton and Heavy Ion Center as the research subject. The patients were investigated with the General Information Questionnaire, Chronic Disease Self-Management Study Measures (CDSMS) , Chinese-version Strategies Used by People to Promote Health (C-SUPPH) , and Medical Outcome Study Social Support Survey (MOS-SSS) . Statistical analysis was performed using SPSS 24.0 and AMOS 24.0 software. Pearson correlation was used to calculate the correlation between variables, and a structural equation model was constructed to test the relationship between variables. A total of 674 questionnaires were distributed, 610 valid questionnaires were recovered, and the valid recovery rate was 90.5% (610/674) .Results:The total scores of self-management behavior, self-management efficacy, and social support in 610 cancer patients treated with proton heavy ions were (18.38±7.64) , (94.30±22.72) and (73.97±13.94) , respectively. Pearson correlation analysis showed that except for the dimension of life support with dimension of exercise, all the other dimension scores and the total score of patients' social support were positively correlated with all the dimension scores and the total score of self-management behaviors ( P<0.05) ; the dimension scores and the total score of patients' social support were positively correlated with the dimension scores and the total score of self-management efficacy ( P<0.05) ; the dimension scores and the total score of patients' self-management efficacy were positively correlated with the dimension scores and the total score of self-management behavior ( P<0.05) . Self-management efficacy had a partial mediating effect between social support and medical staff communication behavior, with an effect value of 23.4% ( P<0.05) . Conclusions:Cancer patients treated with proton-heavy ions have poor levels of self-management behavior. Nurses can improve the patients' self-efficacy and enhance the impact of social support on the patients' self-management behavior, so as to promote the precise realization and timely completion of proton heavy ion therapy.

Colorectal cancer is a significant public health issue all over the world. Screening has been shown effective in improving the survival rate and decreasing the deaths of colorectal cancer. Several organizations have released guidelines for colorectal cancer screening. However, detailed recommendations like the age to begin remain controversial. This paper summarizes the recommended different age groups in initiating the colorectal cancer screening program from a few guidelines and analyzes the reasons for the inconsistency, thus facilitating the drafting of colorectal cancer screening guidelines in China.

Objective:To analyze the results of liver cancer screening for urban residents in Zhejiang Province from 2013 to 2018 and explore the influencing factors of the detection rate.Methods:From September 2013 to August 2019, six urban communities in Hangzhou (Jianggan District and Gongshu District), Ningbo (Haishu District, Yinzhou District and Jiangbei District), and Quzhou (Kecheng District) were selected as study sites. All permanent residents aged 40-74 (with local household registration and living in the local area for more than 3 years) were selected as the research subjects by using cluster sampling method. Patients with confirmed cancers and other serious medical and surgical diseases were excluded. A total of 166 293 research subjects were included. Basic demographic characteristics and risk factors of subjects were obtained through questionnaire surveys. The cancer risk assessment system was used to evaluate the liver cancer risk of subjects. Clinical screening participation and screening results for subjects at high risk of liver cancer were obtained from participating hospitals. The high-risk rate of liver cancer, clinical screening rate, detection rate of positive lesions, and detection rate of suspected liver cancer were analyzed. Poisson regression was used to analyze the influencing factors of detection rate.Results:The age of 166 293 subjects was (56.01±8.40) years, of which 41.36% (68 777) were males. A total of 23 765 high-risk subjects for liver cancer were screened (the high-risk rate was 14.29%). Among them, a total of 12 375 subjects participated in clinical screening for liver cancer, with a screening rate of 52.07% (12 375/23 765). A total of 297 cases of positive lesions were detected and the detection rate was 2.40% (297/12 375). A total of 8 cases of suspected liver cancer were detected, with a detection rate of 0.06% (8/12 375). The results of multivariate Poisson regression model analysis showed that compared with men, people who never smoked, never ate pickled food, had low oil content, and had no history of hepatobiliary disease, female, people who were smoking or had smoked, sometimes ate pickled food, ate higher oil content, and had a history of hepatobiliary disease had a higher detection rate of positive lesions. The incidence rate ratio (IRR) ( 95%CI) values were 1.98 (1.45-2.70), 2.23 (1.61-3.09)/2.08 (1.31-3.28), 1.82 (1.22-2.70), 1.44 (1.08-1.91), and 1.45 (1.05-2.00), respectively. Compared with those aged from 40 to 49 years old and without HBsAg test, the IRR (95% CI) of suspected liver cancer in people aged 70 to 74 years old and HBsAg positive were 16.30 (1.32-200.74) and 6.43 (1.24-33.22), respectively. Conclusion:The urban cancer early diagnosis and early treatment project in Zhejiang Province has good compliance in clinical screening of liver cancer. Abdominal ultrasound examination and serum alpha-fetoprotein detection are helpful to detect liver cancer and its precancerous lesions in the high-risk population of liver cancer.