ObjectiveTo evaluate the reliability and validity of the Dampness Syndrome Scale of Chinese Medicine （DSSCM） among patients with persistent asthma， and to explore the correlation between dampness syndrome and clinical characteristics of persistent asthma. MethodsA cross-sectional survey was conducted. Basic information， examination results， DSSCM， Asthma Control Test （ACT）， Generalized Anxiety Disorder-7 （GAD-7）， and Patient Health Questionnaire-9 （PHQ-9） scores were collected from 206 patients with persistent asthma to evaluate the reliability and validity of DSSCM and to explore the correlation between dampness syndrome and clinical characteristics. ResultsThe mean score of DSSCM among 206 patients was 14.59 ± 10.53. The overall Cronbach α coefficient and Spearman-Brown split-half reliability coefficient of the scale were both greater than 0.8， and the success rate of scale convergent and discriminant validity calibration were greater than 80%. The confirmatory factor analysis showed that the χ²/df was 2.309， and the root mean square error of approximation （RMSEA） was 0.08； the root mean square residual （RMR） was 0.049， whereas the comparative fit index （CFI）， the goodness of fit index （GFI）， the adjusted goodness of fit index （AGFI）， the normed fit index （NFI） and the incremental fit index （IFI） were less than 0.9. Correlation analysis showed that DSSCM scores were positively correlated with disease duration， GAD-7 scores， and PHQ-9 scores （P＜0.05）， and negatively correlated with ACT scores （P＜0.01）. The DSSCM scores were significantly different between patients with different disease severity （H = 10.92， P = 0.01）， and the DSSCM scores of allergic patients were higher than those of non-allergic patients （Z = -4.19， P＜0.001）. ConclusionDSSCM has acceptable reliability and validity for patients with persistent asthma. The scores of DSSCM correlated with the disease duration， ACT score， GAD-7 score， PHQ-9 score， disease severity and allergic status of persistent asthmatics.

ObjectiveTo evaluate the clinical efficacy and safety of Xianqi Qinglong Formula （仙芪青龙方， XQF） in the treatment of cough variant asthma （CVS） patients with lung and kidney deficiency and exuberant wind-induced spasm and tension syndrome. MethodsA randomized， positive-controlled， non-inferiority clinical trial was designed. Totally， 102 CVS patients with lung and kidney deficiency and exuberant wind-induced spasm and tension syndrome were randomly divided into a treatment group （52 cases） and a control group （50 cases）. The treatment group was given XQF granules orally， 1 dose per day， 2 bags each time （9.25 g/bag）， twice a day， after breakfast and dinner； the control group was given XQF granules placebo orally combined with inhaled fluticasone propionate inhalation aerosol （125 μg each time， twice a day）. Both groups were treated for 12 weeks and followed up for 12 weeks， with a total of 24 weeks. The primary outcome was the cough symptom score （including daytime， nighttime and total score）， evaluated before treatment （at enrollment）， during treatment （after the 6th week of enrollment）， at the end of treatment （after the 12th week of enrollment）， and at the end of follow-up （after the 24th week of enrollment）. The non-inferiority was determined by the lower limit （LCL） of the unilateral 95% confidence interval. The secondary outcomes included cough relief and disappearance， total score of TCM syndrome， cough visual analogue （VAS） score， Leicester Cough Questionnaire （LCQ） score， and lung function indicators including forced expiratory volume in 1 second （FEV1）， percentage of predicted forced expiratory volume in 1 second （FEV1%pred）， forced vital capacity （FVC）， and peak expiratory flow （PEF）. Blood routine and liver and kidney function were tested before and after treatment， and the adverse events were recorded. ResultsA total of 101 patients were included in the full analysis set （FAS）， including 52 cases in the treatment group and 49 cases in the control group. After treatment， the daytime， nighttime and total cough symptom scores during treatment， at the end of treatment and at the end of follow-up all decreased in both two groups （P＜0.01）. The unilateral 95% LCL of the total cough symptom scores during treatment， at the end of treatment and at the end of follow-up of the two groups were -0.14， -0.47 and -0.27 （95% LCL all＞-0.6）. There were no significant differences in the cough relief rate， cough disappearance rate， cough relief days and cough disappearance days between the two groups at each time point （P＞0.05）. Compared to those before treatment， the TCM syndrome scores and cough VAS scores during treatment， at the end of treatment and at the end of follow-up decreased in both groups， while the LCQ scores increased （P＜0.01）， but there were no significant differences in FEV1， FEV1%， FVC and PEF before and after treatment （P＞0.05）. There were no significant differences in TCM syndrome scores， cough VAS scores， LCQ scores， FEV1， FEV1%， FVC， and PEF between the two groups at each time point （P＞0.05）. No clinically significant abnormal liver and kidney function were found in the two groups before and after treatment. ConclusionXQF is not inferior to fluticasone propionate inhalation aerosol in relieving cough symptoms， reducing cough scores， decreasing the number of cough attack days， and improving the quality of life when treating CVS patients with lung and kidney deficiency and exuberant wind-induced spasms and tension syndrome， and relatively safe.

Objective:To investigate the clinical effects of chidamide combined with linperlisib in treatment of recurrent angioimmunoblastic T-cell lymphoma (AITL) after autologous stem cell transplantation (ASCT).Methods:The clinical data of 1 patient with recurrent AITL receiving treatment of chidamide combined with linperlisib after ASCT in Sun Yat-Sen University Cancer Center in March, 2021 were retrospectively analyzed, and the related literatures were reviewed.Results:The 55- year-old male patient was presented with fatigue, night sweats and emaciation. According to the results of pathology, immunohistochemistry and imaging after admission, this patient was diagnosed as AITL. After treatment with venbutuximab + CDP (cyclophosphamide + doxorubicin + prednisone) regimen, the patient achieved complete remission, and then ASCT was performed. After the transplatation, programmed death receptor 1 inhibitor was maintained for 4 courses of treatment. It recurred 16 months after ASCT, and the patient achieved partial remission after 1 course of chidamide combined with linperlisib, and achieved complete remission after 2 courses of treatment. Later, recheck of hepatitis B virus showed a quantitative increase after the self withdrawal of anti hepatitis B drugs, and then the primary treatment was suspended. The last follow-up time was March, 2024, and recheck results of whole body enhanced magnetic resonance imaging indicated recurrence.Conclusions:The combination of chidamide and linperlisib is effective and safe in treatment of recurrent ATIL after ASCT.

ObjectiveTo evaluate the efficacy and safety of topical Bisaitong （鼻塞通） in treating moderate-to-severe allergic rhinitis （AR）. MethodsA randomized， positive-controlled， non-inferiority clinical trial design was adopted. Totally， 108 cases of moderate-to-severe AR were randomly divided into Bisaitong group and mometasone furoate group，with 54 cases in each group. The Bisaitong group was treated with Bisaitong smeared at the nasal cavity twice a day， and the mometasone furoate group received inhalation of mometasone furoate nasal spray 100 μg in each nostril， once a day. Both groups were treated for 4 weeks and followed up after additional 4 weeks. Both groups were compared on the rhinoconjunctivitis quality of life questionnaire （RQLQ）， rhinoconjunctivitis total symptom score （RTSS）， visual analogue score （VAS） of sneezing， runny nose， nasal itching， nasal congestion degree， days of AR episodes at enrollment， after 2- and 4-week， and at follow-up. The peripheral blood eosinophil （EOS） count and percentage （EOS%）， serum eosinophil cationic protein （ECP）， serum dust mite， dermatophagoides farinae， and cockroach allergen-specific IgE （sIgE） levels were compared between groups at enrollment and after 4-week treatment. Drug overuse rate was calculated， and the safety was evaluated. The analysis of all efficacy outcomes was based on both full analysis set （FAS） and per-protocol set （PPS）. ResultsThe lower limit of the 95% confidence interval for the differences in RQLQ scores were greater than -0.6 measured after 2- and 4-week treatment and at follow-up compared to that measured at the enrollment in both groups， indicating of the Bisaitong group being non-inferior to the mometasone furoate group. There was no statistically significant difference between groups on RTSS score， VAS scores of sneezing， runny nose， nasal itching， nasal congestion degree and days of episodes at all timepoints （P＞0.05）， but each outcome changed significantly over time in both groups （P＜0.01）. The differences between groups in EOS count， EOS%， ECP levels， serum dust mite， dermatophagoides farinae， cockroach sIgE levels， and drug overuse rate were not statistically significant at enrollment and after 4-week treatment （P＞0.05）. Adverse events occurred in eight cases （15.10%） in the Bisaitong group and five cases （9.30%） in the mometasone furoate group， showing no significant difference between groups （P＞0.05）. ConclusionTopical Bisaitong is non-inferior to mometasone furoate nasal spray in the treatment of moderate to severe AR in terms of clinical symptom relief，reduction in the episodes， improvement of quality of life， and sound safety.

Objective:To investigate the risk factors of cardiovascular and cerebrovascular diseases in young patients with hyperhomocysteinemia.Methods:A total of 260 patients younger than 45 years old who received treatment at the Department of Emergency, Seventh Medical Center, Chinese PLA General Hospital from January 2018 to January 2019 were included in this study. Among these patients, 126 patients with serum homocysteine levels ≥ 15.0 μmol/L were included in the hyperhomocysteinemia group, and 134 patients with serum homocysteine levels < 15.0 μmol/L were included in the control group. Height, body weight, body mass index, blood pressure, homocysteine, fasting blood glucose, blood uric acid, total cholesterol, triacylglycerol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and N-terminal B-type natriuretic peptide were determined in each group. Changes in risk factors of cardiovascular and cerebrovascular diseases were compared between the hyperhomocysteinemia and control groups.Results:There were significant differences in body mass index [(26.42 ± 3.54) kg/m 2vs. (22.14 ± 3.22) kg/m 2, t = 10.21, P = 0.016], blood uric acid [(308.71 ± 78.44) μmol/L vs. (285.05 ± 92.09) μmol/L, t = 2.22, P = 0.027], the incidence of coronary heart disease (73/126 vs. 61/134, χ2 = 4.00, P = 0.045) and the incidence of stroke (19/126 vs. 6/134, χ2 = 8.39, P = 0.004) between the hyperhomocysteinemia and control groups. There were no significant differences in fasting blood glucose, blood lipid level, N-terminal B-type natriuretic peptide, and the incidences of diabetes mellitus and hypertension between the two groups (all P > 0.05). Conclusion:The related risk factors of cardiovascular and cerebrovascular diseases increase in young patients with hyperhomocysteinemia. The incidences of coronary heart disease and stroke are very high, and therefore timely intervention should be carried out.

Objective:To compare the impact of different portal exposure techniques in the Kasai surgery on children with type Ⅲ. biliary atresia during their different perioperative periods.Methods:A retrospective study was performed on the data of children with type Ⅲ. biliary atresia who underwent Kasai surgery at Fujian Children's Hospital from January 2017 to October 2020. Of 45 children enrolled in this study, there were 24 males and 21 females, aged (71.3±21.0) days. Patients who had left and right branches of the portal vein and the left and right hepatic arteries in the portal area being completely freed and elastically stretched during the Kasai operation were included into the free group ( n=22) and the remaining patients were included in the control group ( n=23). Postoperative hospital stay, postoperative direct bilirubin levels, postoperative complications and transplant-free survival after the Kasai operation were compared between the 2 groups. Results:Postoperative hospital stay of (17.1±4.4) d in the free group was significantly lower than that in the control group (20.1±5.4) d, ( t=2.07, P=0.044). The direct bilirubin level at 3 months after surgery for the control group was 30.0 (109, 108.0)μmol/L, which was significantly higher than that of 14.5 (4.0, 37.5) μmol/L in the free group ( Z=-2.16, P=0.031). Twenty-one patients (91.3%) in the control group had frequent attacks of postoperative cholangitis, compared with 13 patients (59.1%) in the free group. The difference was statistically significant (χ 2=4.69, P=0.030). Eleven surviving patients (47.8%) in the control group did not undergo liver transplantation at one year after surgery, compared with 15 patients (68.2%) in the free group. At two years after surgery, 7 surviving patients (30.4%) in the control group did not undergo liver transplantation compared with 10 patients (45.5%) in the free group. Conclusion:For children with type Ⅲ. biliary atresia, completely freeing the left and right branches of portal vein, and left and right hepatic arteries in the liver portal area, and elastically stretching these vessels to expose the portal area of the liver during Kasai surgery increased surgical safety and reduced hospital stay.

Pulmonary hypertension is a progressive disease characterized by pulmonary vascular remodeling and eventually develops into right heart failure, which seriously affects the quality of life and safety of patients. Traditional drug therapy can alleviate disease progression, but the prognosis is poor.Mesenchymal stem cells have been shown to be effective in experimental pulmonary hypertension and right heart failure, which is an important research direction in the future.In this paper, the research progress of mesenchymal stem cells in pulmonary hypertension and right heart failure is reviewed.

Objective:To investigate the relationship between blood glucose fluctuation and carotid intima-media thickness (CIMT) in newly diagnosed patients with type 2 diabetes mellitus (T2DM) and the predictive value of betatrophin.Methods:A total of 180 newly diagnosed T2DM patients in Taiyuan Central Hospital from June 2018 to December 2019 were included for the study. And they were divided into normal intima-media group (81 cases), intima-media thickening group (60 cases) and plaque formation group (39 cases) according to the results of carotid ultrasound. The body test indexes, glucose and lipid metabolism indexes, blood glucose fluctuation and betatrophin level were compared among the three groups, and the correlation of these indexes with CIMT and risk factors of CIMT were analyzed.Results:The mean and maximal amplitude of glycemic excursions (AGE) in the plaque formation group and intima-media thickening group were significantly higher than those in the normal intima-media group [(5.08±0.62), (4.06±0.54) vs (3.17±0.41) mmol/L and (5.20±0.72), (4.26±0.54) vs (3.34±0.59) mmol/L] (all P<0.05), and these indexes in the plaque formation group were significantly higher than the intima-media thickening group (all P<0.05). Betatrophin levels in intima-media thickening group and plaque formation group were significantly higher than those in normal intima-media group [(423.35±76.24) and (490.68±97.84) vs (358.29±92.27) ng/L] (both P<0.05). Hip circumference and triglyceride (TG) in plaque formation group were obviously higher than those of the normal intima-media group and intima-media thickening group [(103.5±6.3) vs (97.6±7.0), (99.5±7.4) cm and 2.99 (1.32, 3.92) vs 1.70 (1.21, 2.39), 1.84(1.43, 2.93) mmol/L] (all P<0.05), and waist circumference, systolic blood pressure, fasting blood glucose (FBG), total cholesterol (TC), insulin resistance of homeostasis model assessment (HOMA-IR) levels in plaque formation group were significantly higher than those in normal intima-media group [(94.0 (86.0, 102.0) vs 88.0 (82.5, 94.0) cm, (136.2±18.0) vs (125.9±15.3) mmHg, 10.16 (8.43, 13.23) vs 8.49 (6.98, 9.97) mmol/L, (6.31±0.90) vs (4.99±0.99) mmol/L, 4.90 (3.50, 7.13) vs 2.77 (1.32, 5.07)] (all P<0.05). CIMT was positively correlated with waist circumference, hip circumference, systolic blood pressure (SBP), FBG, TC, TG, HOMA-IR, betatrophin, the mean and maximal AGE, blood glucose fluctuation coefficient (BGFC) (all P<0.05), and it was negatively correlated with time in range (TIR) ( P<0.05). The mean and maximal AGE, TC, TG and betatrophin were independent risk factors of CIMT (all P<0.05). Conclusion:Blood glucose fluctuation is closely related to CIMT in patients with T2DM, and betatrophin is expected to be an early predictor of diabetic macroangiopathy.

Objective:To study the expression and value of inflammatory factors and disease activity in dry eyes of rheumatoid arthritis patients.Methods:From March 2017 to November 2019, 78 patients with rheumatoid arthritis complicated with dry eye diagnosed by the rheumatology department of our hospital, 80 patients with simple dry eye treated in the ophthalmology clinic and 80 normal volunteers were collected. All subjects were examined for OSDI questionnaire scores, tear film rupture time (BUT), tear secretion test (SIT), and corneal fluorescein staining (FL) scores. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF) and other disease activity-related indicators were collected. The concentrations of interleukin-1b (il-1b), tumor necrosis factor-a (tnf-a), chemokine 3(CCL3), CCL4, CCL5, and vascular endothelial growth factor (VEGF) in the collected tears were detected by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA). One-way Anova was used to analyze the correlative indexes among the three groups, LSD- t method was used for multiple comparison. Pearson's method was used to analyze the correlation between Ra activity and dry eye. Results:The results of OSDI [(44±9) points vs (44±9) points vs (24±7) points], SIT [(3.3±2.2) mm/5 min vs (3.6±2.1) mm/5 min vs (11.7±1.6) mm/5 min], BUT [(4.3±1.8) s vs (5.9±1.9) s vs (10.4±2.0) s], FL [(7.3±3.1) points vs (5.7±2.8) points vs (1.6±1.6) points] were com-pared among the three groups. There were significant differences among the three groups( F=154.22, P<0.01; F=470.49, P<0.01; F=217.72, P<0.01; F=101.99, P<0.01). The concentrations of IL-1β [(1.92±0.14) ng/L vs (1.28±0.18) ng/L vs (0.64±0.15) ng/L], IL-6 [(38.24±0.69) ng/L vs (36.31±0.82) ng/L vs (30.43±0.87) ng/L]、TNF-α [(0.78±0.03) ng/L vs (0.67±0.03) ng/L vs (0.56±0.02) ng/L], CCL3 [(91±25) ng/L vs (83±21) ng/L vs (24±18) ng/L], CCL4 [(187±76) ng/L vs (137±64) ng/L vs (37±5) ng/L], CCL5[(259±70) ng/L vs (182±42) ng/L vs (135±34) ng/L] and VEGF [(172±25) ng/L vs (152±22) ng/L vs (41±21) ng/L] in the tears of the three groups were significantly different( F=1 300.15, P<0.01; F=2 036.37, P<0.01; F=1 305.89, P<0.01; F=764.01, P<0.01; F=225.47, P<0.01; F=138.48, P<0.01; F=121.04, P<0.01). The indexes of disease activity (ESR, CRP, RF) were compared among the three groups. The positive rate of RF[(100%) vs (5%) vs (4%)] was significantly higher in Ra dry eye group than in the other two groups ( χ2=127.38, P<0.01) There were significant differences in ESR[(51±23) mm/1 h vs (9±4) mm/1 h vs (8±5) mm/1 h] and CRP[(44±23) g/L vs (5±4) g/L vs (6±4) g/L] among the three groups ( F=253.18, P<0.01; F=222.36, P<0.01) . BUT was negatively correlated with the activity index (ESR, CRP, RF) in rheumatoid arthritis dry eye group ( r=-0.398, P=0.005; r=-0.353, P=0.010; r=-0.302, P=0.038) , FL was positively correlated with activity index (ESR, CRP, RF) ( r=0.345, P=0.014; r=0.385, P=0.007; r=0.412, P=0.003) . There was no correlation between SIT, OSDI and activity index (ESR, CRP, RF)( r=-0.265, P=0.060; r=-0.156, P=0.318; r=-0.275, P=0.070); ( r=-0.087, P=0.582、 r=-0.065, P=0.664; r=-0.045, P=0.768). Conclusion:Inflammatory factors and disease activity indexes are highly expressed in rheumatoid arthritis patients with dry eye of disease, and there is a correlation between disease activity of rheumatoid arthritis and dry eye, which has some clinical meaing.

Vaccination is the most effective way to prevent influenza and severe outcoming caused by influenza viruses.Health care workers(HCW) are exposed to patients with influenza and they are at high risk of occupationally acquired influenza and of causing nosocomial infection among patients,increasing the incidence rate,the risk of severe and death of patients.Improving the influenza immunization in HCW can not only reduce the prevalence of themselves and keep a weel-oiled of health care facilities during the influenza seasons,but also reduce the risk of severe and death among patients and increase the influenza vaccine uptake in whole population.At present,the influenza immunization coverage of HCW is low.The obstacles and myths of influenza vaccine are barriers for vaccine uptake among HCW.The various strategies are critical in order to improve the influenza coverage rates of HCW.