Objective To investigate the effect and mechanism of dabrafenib （DAB） combined with tremelimumab （TREM） on melanoma. Methods The effects of DAB combined with TREM on cell viability, cytotoxicity and cell migration of A375 cells were evaluated by Cell Counting Kit-8 （CCK-8） method, lactate dehydrogenase （LDH） method and scratch assay. The levels of reactive oxygen species （ROS）, adenosine triphosphate （ATP）, malondialdehyde （MDA）, and superoxide dismutase （SOD） were detected to evaluate the effects of combined drugs on oxidative stress and energy metabolism. In addition, A375 tumor-bearing nude mice model was used to evaluate the inhibitory effect of the combined treatment on tumor growth in vivo, and the degree of cell apoptosis and cell proliferation in tumor tissues were analyzed by terminal deoxynucleotidyl transferase-mediated dutP Nick end labeling （TUNEL） and proliferating cell nuclear antigen （PCNA） immunohistochemical staining. Results The combined treatment significantly inhibited the survival rate and migration ability of A375 cells and enhanced the cytotoxicity. The combined intervention also significantly increased ROS level, decreased ATP, SOD and MDA levels. It effectively inhibited tumor growth in tumor-bearing nude mice, increased the apoptosis rate of tumor cells and inhibited cell proliferation. Conclusion DAB combined with TREM may improve the therapeutic effect of melanoma by enhancing oxidative stress, inhibiting energy metabolism, and promoting cell apoptosis. This combination therapy may provide a new therapeutic strategy to overcome the limitations of singledrug therapy.

AIM:To display the distribution of evi-dence in the field of Yiqifumai injection treatment for heart failure.METHODS:To retrieve relevant da-tabases such as CBM,CNKI,Wanfang,VIP,Co-chrane Library,PubMed,Embase,and Web of Sci-ence,and search for the China Clinical Trial Regis-try,ClinicalTrials.gov and collect clinical studies,sys-tematic evaluations,and guideline studies on the treatment of heart failure with Yiqifumai injection.The evidence map research method use a table to display the proportion of literature,sample size,co-morbidities,and quality evaluations of systematic evaluations.Use a pie chart to display the propor-tion distribution of research types,a line chart to describe publication trends,and a bubble chart to display the distribution of evidence.RESULTS:The overall number of articles on the treatment of heart failure with Yiqifumai injection is in a steady development stage.Clinical studies are mainly small sample,single center,short-term randomized controlled trials,with a sample size of 60-100 cases and an intervention duration of mostly 14 days.The underlying disease is mainly coronary heart dis-ease.Clinical research evidence tends to support the therapeutic effect of Yiqifumai injection com-bined with conventional Western medicine in im-proving heart failure patients'heart function and quality of life.However,there are also issues such as low overall quality of research,unreasonable clinical trial design,small sample size,incomplete selection of outcome indicators,low international recognition of certain outcome indicators,and lack of reporting on long-term outcomes The overall quality of randomized controlled trials andsystem-atic evaluation methodology is low.CONCLUSION:In the future,more large sample,multicenter clini-cal randomized controlled trials should be conduct-ed to obtain higher-level evidence-based medicine evidence to fully demonstrate the advantages of traditional Chinese medicine treatment,and pro-mote the common development of traditional Chi-nese medicine cardiology and evidence-based med-icine.

AIM:To display the distribution of evi-dence in the field of Yiqifumai injection treatment for heart failure.METHODS:To retrieve relevant da-tabases such as CBM,CNKI,Wanfang,VIP,Co-chrane Library,PubMed,Embase,and Web of Sci-ence,and search for the China Clinical Trial Regis-try,ClinicalTrials.gov and collect clinical studies,sys-tematic evaluations,and guideline studies on the treatment of heart failure with Yiqifumai injection.The evidence map research method use a table to display the proportion of literature,sample size,co-morbidities,and quality evaluations of systematic evaluations.Use a pie chart to display the propor-tion distribution of research types,a line chart to describe publication trends,and a bubble chart to display the distribution of evidence.RESULTS:The overall number of articles on the treatment of heart failure with Yiqifumai injection is in a steady development stage.Clinical studies are mainly small sample,single center,short-term randomized controlled trials,with a sample size of 60-100 cases and an intervention duration of mostly 14 days.The underlying disease is mainly coronary heart dis-ease.Clinical research evidence tends to support the therapeutic effect of Yiqifumai injection com-bined with conventional Western medicine in im-proving heart failure patients'heart function and quality of life.However,there are also issues such as low overall quality of research,unreasonable clinical trial design,small sample size,incomplete selection of outcome indicators,low international recognition of certain outcome indicators,and lack of reporting on long-term outcomes The overall quality of randomized controlled trials andsystem-atic evaluation methodology is low.CONCLUSION:In the future,more large sample,multicenter clini-cal randomized controlled trials should be conduct-ed to obtain higher-level evidence-based medicine evidence to fully demonstrate the advantages of traditional Chinese medicine treatment,and pro-mote the common development of traditional Chi-nese medicine cardiology and evidence-based med-icine.

Objective:To summarize the consultation data from the department of rheumatology and clinical immunology of Peking Union Medical College Hospital, and to describe the distribution of consultation needs of different rheumatic and immunologic diseases (RID) in each unit.Methods:To collect and analyze the data of patients who accepted the consultations of rheumatology and clinical immunology of Peking Union Medical College Hospital from January 1, 2021 to December 31, 2021.Results:A total of 1 640 consultations were executed. The ratio of male-to-female was 556∶1 084, with an average age of (44.5±16.0)years. The proportion of single consultation was 57.26% (939/1 640) while that of twice and multiple consultation was 42.74% (701/1 640). Among the consultations, 87.56% (1 436/1 640) were routine ones, especially from emergency 25.21% (362/1 436), department of infectious diseases 12.88% (185/1 436) and cardiology 12.47% (179/1 436). The other 12.44% (204/1 640) were multi-disciplinary treatment (MDT), mainly in department of general internal medicine, emergency and obstetrics. Main purposes of consultation included 52.66% (514/976) for RID condition assessment/medication adjustment and 47.34% (462/976) for etiological diagnosis in internal medicine unit; while 55.77% (58/104) for guidance for perioperative RID treatment in surgery. In Obstetrics and Gynecology, the majority purposes were RID condition assessment/medication adjustment 36.36% (12/33), perioperative treatment guidance 27.27% (9/33) and surgical risk/timing assessment 27.27% (9/33). Most consultations were focused on SLE, UCTD, SS, RA and TA.Conclusion:Requested as MDT and multiple repeat,consultation needs for department of rheumatology and clinical immunology are great, especially from emergency and infectious disease unit. It may improve the efficacy of consultation by popularizing the meaning of autoantibodies and enhancing the awarness of common RID and its complications, as well as the awareness of perioperative and prenatel periods.

Objective:To compare the clinical efficacy of ultrasound-guided spinal nerve block (SNB) and paraverteral nerve block (PVB) in treating postherpetic neuralgia.Methods:A total of 52 patients with postherpetic neuralgia who visited the Pain Clinic of the Xiangya Hospital, Central South University from February 2020 to December 2022 were selected and randomly divided into an ultrasound-guided SNB group and a PVB group using a random number table method, with 26 patients in each group. Patients in the SNB group received ultrasound-guided spinal nerve block therapy; The PVB group received ultrasound-guided paraverteral nerve block treatment. Visual Analog Scale (VAS) scores, 36-Item Short Form Survey (SF-36) scores, and total effective rate were observed in two groups of patients before treatment, 2 weeks after treatment, 1 month after treatment, 3 months after treatment, and 6 months after treatment. Complications during treatment were also observed.Results:The total effective rates of SNB group patients at 1, 3, and 6 months after treatment were significantly higher than those of PVB group (all P<0.05). After treatment, the VAS scores of both groups of patients at each time point were significantly reduced compared to before treatment (all P<0.05); The VAS scores of patients in the SNB group were lower than those in the PVB group at 1, 3, and 6 months after treatment, but the difference was not statistically significant (all P>0.05). There was no statistically significant difference in Physical Component Summary (PCS) and Mental Component Summary (MCS) scores between SNB and PVB groups before nerve block treatment (all P>0.05). The MCS and PCS scores of the two groups of patients were significantly higher than before treatment at 2 weeks, 1 month, 3 months, and 6 months after treatment (all P<0.05). The MCS scores of the SNB group were significantly higher than those of the PVB group at 2 weeks, 1 month, 3 months, and 6 months after treatment (all P<0.05), but there was no statistically significant difference in PCS scores between the two groups (all P>0.05). Both groups of patients did not experience any serious complications related to the treatment in this study during the follow-up period. Conclusions:Both ultrasound-guided spinal nerve block and paraverteral nerve block can safely and effectively treat postherpetic neuralgia. The clinical effect of ultrasound-guided spinal nerve block in treating postherpetic neuralgia is better than that of paraverteral nerve block.

Objective To investigate the predictive value of C-reactive protein/albumin(CRP/Alb)ratio on early small or medi-um-sized coronary artery aneurysm(CAA)of children with Kawasaki disease(KD).Methods The clinical data of 116 children with KD admitted to the First Affiliated Hospital of Xinxiang Medical University from September 2018 to December 2021 were retrospectively analyzed,and they were divided into CAA group(n=34)and non-CAA group(n=82).The general conditions,clinical characteris-tics and laboratory indicators were compared between the two groups.Univariate analysis was used to screen the related factors of early small or medium-sized CAA of children with KD,and multivariate Logistic regression analysis was used to estimate the independent risk factors of early small or medium-sized CAA of children with KD.Then the receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of CRP/Alb ratio on early small or medium-sized CAA of children with KD.Results Univariate analysis showed that compared with the non-CAA group,the proportion of males in CAA group was higher,the incidence of pleomorphic rash was higher,CRP,fibrinogen and CRP/Alb ratio were significantly increased,and the differences were statistically significant(P＜0.05).The multivariate logistic regression analysis showed that male,fibrinogen and CRP/Alb ratio were the independent risk factors for early small or medium-sized CAA of children with KD.The ROC curve analysis showed that CRP/Alb ratio had a good predictive value for early small or medium-sized CAA of children with KD,with the best cut-off value of 1.4,with sensitivity of 82％,specificity of 66％,and the area under the ROC curve of 0.811.Conclusion CRP/Alb ratio can be used as a marker of predict the early small or medium-sized CAA of children with KD.

Objective: To explore the network structure characteristics and core items of rural middle school students suffering from campus bullying and anxiety symptoms, so as to provide a reference basis for the precise prevention and intervention of the comorbidity of campus bullying and anxiety symptoms. Methods: From September 2021 to March 2022, a multi stage random cluster sampling method was used to select 1 920 rural middle school students from Xuzhou. The Chinese version of the Olweus Bully/Victim Questionnaire was used to investigate the situation of campus bullying, and the Chinese version of the Generalized Anxiety Disorder (GAD-7) was used to assess anxiety symptoms. The network analysis method was used to construct the network between suffering from campus bullying and anxiety symptoms of rural middle school students to evaluate the centrality, bridge strength, stability and accuracy of each item. Results: The total score of suffering from campus bullying symptoms of rural middle school students was (10.42±3.26) points, and the total score of anxiety symptoms was (11.47±4.93) points. The symptom with the highest strength and expected influence was "unable to stop or control one s worry emotions", and the node strength and expected influence value was 1.041 7. The nodes "feel nervous, anxious or irritable" and "unable to stop or control one s worry emotions" were most closely related. The symptoms with the highest bridge strength were "others give me ugly nicknames to scold me or make fun of and satirize me" and "unable to stop or control one s worry emotions". Conclusions Rural middle school students suffering from campus bullying is related to anxiety symptoms. Accurate intervention according to the intervention targets may minimize the negative impact of suffering from campus bullying and anxiety symptoms on rural middle school students.

Objective:To summarize the consultation data from the department of rheumatology and clinical immunology of Peking Union Medical College Hospital, and to describe the distribution of consultation needs of different rheumatic and immunologic diseases (RID) in each unit.Methods:To collect and analyze the data of patients who accepted the consultations of rheumatology and clinical immunology of Peking Union Medical College Hospital from January 1, 2021 to December 31, 2021.Results:A total of 1 640 consultations were executed. The ratio of male-to-female was 556∶1 084, with an average age of (44.5±16.0)years. The proportion of single consultation was 57.26% (939/1 640) while that of twice and multiple consultation was 42.74% (701/1 640). Among the consultations, 87.56% (1 436/1 640) were routine ones, especially from emergency 25.21% (362/1 436), department of infectious diseases 12.88% (185/1 436) and cardiology 12.47% (179/1 436). The other 12.44% (204/1 640) were multi-disciplinary treatment (MDT), mainly in department of general internal medicine, emergency and obstetrics. Main purposes of consultation included 52.66% (514/976) for RID condition assessment/medication adjustment and 47.34% (462/976) for etiological diagnosis in internal medicine unit; while 55.77% (58/104) for guidance for perioperative RID treatment in surgery. In Obstetrics and Gynecology, the majority purposes were RID condition assessment/medication adjustment 36.36% (12/33), perioperative treatment guidance 27.27% (9/33) and surgical risk/timing assessment 27.27% (9/33). Most consultations were focused on SLE, UCTD, SS, RA and TA.Conclusion:Requested as MDT and multiple repeat,consultation needs for department of rheumatology and clinical immunology are great, especially from emergency and infectious disease unit. It may improve the efficacy of consultation by popularizing the meaning of autoantibodies and enhancing the awarness of common RID and its complications, as well as the awareness of perioperative and prenatel periods.

Objective: To investigate the association of sleep quality, depressive symptoms and their interaction with non suicidal self injury (NSSI) among rural middle school students, so as to provide a reference for early prevention and control of NSSI among rural middle school students. Methods: A multi stage cluster sampling method was used to randomly select four rural middle schools in Xuzhou, Jiangsu Province. A total of 1 723 middle school students were investigated according to the principle of grade stratification and class random selection. Paper questionnaires (including demographic factors, Non Suicidal Self Injury Short Scale, Pittsburgh Sleep Quality Index, Patient Health Questionnare-9) were used to conduct the questionnaire survey. Logistic regression model was used to analyze the association of sleep quality, depressive symptoms and their interaction with NSSI among rural middle school students. Results: Totally 30.5% of middle school students had NSSI. Univariate results showed that girls (33.0%) had a higher incidence of NSSI than boys(27.3%), and those with sleep disorders and depressive symptoms had a higher incidence of NSSI, which was 46.8%, 43.6%. The results of multivariate Logistic regression showed that the risk of NSSI in students with sleep disorder was 1.80 times that in those without sleep disorder( OR 95%CI=1.42-2.28, P <0.01). The risk of NSSI in students with depressive symptoms was 3.32 times higher than that in those without depressive symptoms( OR 95%CI=2.60-4.24, P <0.01). The interaction results showed that there was additive interaction between sleep disturbance and depressive symptoms on the occurrence of NSSI behavior in rural middle school students, and the relative excess risk, attributable proportion and synergy index were 1.80, 0.30 and 1.57, respectively. Conclusion Sleep disorder and depressive symptoms are risk factors for NSSI among rural middle school students, and there is additive interaction between them.