Objective:To explore the therapeutic effect of Bupiqiangli compound on experimental myasthenia gravis with sub-clinical hypothyroidism in rats and the influence of hypothalamus-pituitary-thyroid-thymus(HPTT)axis.Methods:SPF Lewis rats were randomly divided into normal group,model group,Bupiqiangli compound low-dose,medium-dose and high-dose groups.Model rats were immunized with AchR-α subunit 97-116 peptide sequence to construct an experimental myasthenia gravis model,and then methimazole was used to prepare an experimental myasthenia gravis with subclinical hypothyroidism model.Bupiqiangli compound low-dose,medium-dose and high-dose groups were given 4.57 g/kg,7.12 g/kg and 9.49 g/kg of Bupiqiangli compound by gavage,nor-mal group and model group were given an equal volume of normal saline by gavage,once a day,for 4 weeks.After the last gavage,Lennon scores of rats in each group were recorded;HE staining was used to detect pathological changes of thymus and thyroid;ELISA was used to detect expression levels of acetylcholine receptor antibody(AchRab),thyroid stimulating hormone(TSH),thyrotropin releasing hormone(TRH),free thyroxine(FT4)and thyroxine(T4)in serum;mRNA level of TRH in hypothalamus and TSH in pituitary tissue were detected by qPCR;Western blot detected changes of protein expressions of Cleaved Caspase3,Bcl2 associated X protein(Bax)and B-cell lymphoma-2(Bcl2)in thymus.Results:Compared with normal group,model group showed obvious symp-toms of muscle weakness,Lennon score increased significantly(P<0.05),obvious pathological changes in thymus and thyroid tissues,while no significant changes in expressions of FT4 and T4 in serum(P>0.05),expressions of AchRab,TSH and TRH in serum were significantly increased(P<0.05),expressions of TRH in hypothalamus and TSH in pituitary were significantly increased(P<0.05),protein expressions of Cleaved Caspase3 and Bax in thymus were significantly decreased(P<0.05),while expression of Bcl2 protein in thymus increased significantly(P<0.05).Compared with model group,myasthenia symptoms of compound high-dose group were im-proved,Lennon score was significantly decreased(P<0.05),pathological changes of thymus and thyroid tissues were improved,ex-pressions of FT4 and T4 in serum had no significant changes(P>0.05),expressions of AchRab,TSH and TRH in serum were signifi-cantly decreased(P<0.05),expressions of TRH in hypothalamus and TSH in pituitary were significantly decreased(P<0.05),expres-sions of Cleaved Caspase3 and Bax in thymus were significantly increased(P<0.05),while expression of Bcl2 in thymus was signifi-cantly decreased(P<0.05).Conclusion:Bupiqiang compound can improve clinical symptoms of experimental myasthenia gravis with subclinical hypothyroidism in rats,and its mechanism may be related to the regulation of HPTT axis.

Objective:To explore the therapeutic effect of Bupiqiangli compound on experimental myasthenia gravis with sub-clinical hypothyroidism in rats and the influence of hypothalamus-pituitary-thyroid-thymus(HPTT)axis.Methods:SPF Lewis rats were randomly divided into normal group,model group,Bupiqiangli compound low-dose,medium-dose and high-dose groups.Model rats were immunized with AchR-α subunit 97-116 peptide sequence to construct an experimental myasthenia gravis model,and then methimazole was used to prepare an experimental myasthenia gravis with subclinical hypothyroidism model.Bupiqiangli compound low-dose,medium-dose and high-dose groups were given 4.57 g/kg,7.12 g/kg and 9.49 g/kg of Bupiqiangli compound by gavage,nor-mal group and model group were given an equal volume of normal saline by gavage,once a day,for 4 weeks.After the last gavage,Lennon scores of rats in each group were recorded;HE staining was used to detect pathological changes of thymus and thyroid;ELISA was used to detect expression levels of acetylcholine receptor antibody(AchRab),thyroid stimulating hormone(TSH),thyrotropin releasing hormone(TRH),free thyroxine(FT4)and thyroxine(T4)in serum;mRNA level of TRH in hypothalamus and TSH in pituitary tissue were detected by qPCR;Western blot detected changes of protein expressions of Cleaved Caspase3,Bcl2 associated X protein(Bax)and B-cell lymphoma-2(Bcl2)in thymus.Results:Compared with normal group,model group showed obvious symp-toms of muscle weakness,Lennon score increased significantly(P<0.05),obvious pathological changes in thymus and thyroid tissues,while no significant changes in expressions of FT4 and T4 in serum(P>0.05),expressions of AchRab,TSH and TRH in serum were significantly increased(P<0.05),expressions of TRH in hypothalamus and TSH in pituitary were significantly increased(P<0.05),protein expressions of Cleaved Caspase3 and Bax in thymus were significantly decreased(P<0.05),while expression of Bcl2 protein in thymus increased significantly(P<0.05).Compared with model group,myasthenia symptoms of compound high-dose group were im-proved,Lennon score was significantly decreased(P<0.05),pathological changes of thymus and thyroid tissues were improved,ex-pressions of FT4 and T4 in serum had no significant changes(P>0.05),expressions of AchRab,TSH and TRH in serum were signifi-cantly decreased(P<0.05),expressions of TRH in hypothalamus and TSH in pituitary were significantly decreased(P<0.05),expres-sions of Cleaved Caspase3 and Bax in thymus were significantly increased(P<0.05),while expression of Bcl2 in thymus was signifi-cantly decreased(P<0.05).Conclusion:Bupiqiang compound can improve clinical symptoms of experimental myasthenia gravis with subclinical hypothyroidism in rats,and its mechanism may be related to the regulation of HPTT axis.

An early warning system of sudden cardiac death based on the Internet electrocardiograph and intelligent platform is designed to detect the signal of sudden cardiac death in time and save lives.The system is mainly composed of four parts:Internet electrocardiograph,mobile terminal,intelligent platform and 120 emergency center.It has been verified that the sudden cardiac death early warning system is reliable,suitable for remote electrocardiogram monitoring,and can provide diagnosis and early warning for people at risk of sudden cardiac death.The system realizes the miniaturization of ECG monitoring equipment,and has the advantages of intelligent diagnosis and rapid warning,and can be applied to the pre-hospital monitoring of high-risk groups of sudden cardiac death and has a good application value.

The design and development of electrocardiogram(ECG)monitoring cloud platform based on the Internet of Things(IoT)electrocardiograph is introduced.The platform is mainly composed of ECG acquisition module,algorithm module,diagnostic model comparison module,warning module,positioning module and medical aid system.The ECG acquisition module collects ECG signals of patients and displays them in real time on the mobile terminals.Then they are uploaded to the ECG monitoring cloud platform through the IoT.The algorithm module and the diagnostic model comparison module mark,process,analyze and diagnose the ECG.Meanwhile,the ECG diagnosis and warning results are pushed to patients and 120 emergency centers through the IoT.Furthermore,the cloud platform will guide patients to self-rescue and the emergency platform will open the green channel to save patients in time.The platform realizes from the onset to diagnosis and treatment in one step,and saves lives against time.

Objective To investigate the effect of palmitoleic acid(POA)on pyroptosis of cardiomyocytes after hy-poxia/reoxygenation-induced injury in the human myocardium.Methods The experiment comprised a control group(Control,normal culture),a hypoxia/reoxygenation group(HR),a palmitoleic acid-treated group(HR+POA),and an anhydrous ethanol control group(HR+ET).Cardiomyocytes viability was assessed using CCK-8 assay,and the level of pyroptosis of cardiomyocytes was measured through the double staining with Hoechst33342/PI and LDH assay.ELISA was employed to detect the release of inflammatory factors IL-1 β and IL-18 in the cell culture supernatant.qRT-PCR and Western blot were utilized to determine the relative expression levels of mRNA and protein of pyroptosis-related genes,namely NLRP3,ASC,Caspase-1,GSDMD,IL-1 β and IL-18,respective-ly.Results CCK-8 assay showed that the survival of hypoxic/reoxygenated cardiomyocytes increased with the ad-dition of POA at concentrations ranging from 25 to 100 μmol/L,as compared to the HR group;a hypoxia/reoxy-genation model of cardiomyocyte was established.The expression of protein and mRNA increased in NLRP3,ASC,Cleaved caspase-1,GSDMD-N,IL-Iβ and IL-18 vs the control group(P＜0.05),the positive percentage of Ho-echst33342/PI staining in cardiomyocytes increased significantly(P＜0.05),the release of LDH,IL-Iβ,and IL-18 increased(P＜0.05).After intervention with 100 μmol/L POA,the protein and mRNA expression levels of NLRP3,ASC,Cleaved caspase-1,GSDMD-N,IL-Iβ,and IL-18 were significantly reduced in the HR+POA group vs HR+ET group(P＜0.05).The positive percentage of Hoechst33342/PI staining in cardiomyocytes de-creased significantly,and the levels of LDH,IL-Iβ and IL-18 significantly decreased(P＜0.05).Conclusion Palmitoleic acid may alleviate hypoxia/reoxygenation-induced injury of cardiomyocytes by inhibiting pyroptosis and inflammatory response after hypoxia/reoxygenation in human myocardium.

Objective:The result of influenza etiology surveillance in Chuxiong prefecture were analyzed to master the epidemic characteristics of influenza virus and provide scientific basis for influenza prevention and control.Methods:Real-time PCR assay and MDCK cell culture method were used to detect and separate influenza virus nucleic acids from influenza-like cases (ILI) and suspected influenza cases from 2017 to 2022 come from the sentinel hospitals.Results:From 2017 to 2022, a total of 7 302 cases of ILI and 1 079 cases were detected positive, with a positive rate of 14.78%. The positive rate in the six years was 14.71%、15.44%、20.11%、5.04%、10.90% and 21.08%, and the positive rate in 2020 was the lowest. Among them, the positive rate of influenza A was higher than that of influenza B, and higher in spring and winter than in summer and autumn., One H9N2 human infected with avian influenza virus was detected positive.The outbreak cases were mainly influenza B, followed by influenza A H3N2, and students were susceptible to it. The proportion of influenza-like cases in the 0~5 year old group was the highest (64.16%), and the protortion in 60~year old group was the lowest (0.05%).Conclusions:From 2017 to 2022, influenza A was predominant in Chuxiong prefecture, with high prevalence in winter and spring. The influenza strains presented diversity and each strain circulated alternately. The implementation of COVID-19 prevention and control measures can effectively reduce the infection rate of influenza virus .In addition, there are human cases of avian influenza infection in Chuxiong prefecture. So the surveillance of influenza-like cases should be strengthened an improved, and to expand the monitoring of human and avian influenza.

Objective To analyze the blood gas analysis before extubation related to early withdraw venti-lator in infants with congenital heart disease.Methods Collecting the blood gas analysis datas before extubation of infants with congenital heart disease who were treated with CICU in our hospital from 2014. 01.01 to 2017.01.01, To analyze the relationship between early withdraw ventialtor and the blood gas analysis before extubation. Re-sults 1.Univariate analysis showed that infants with congenital heart disease early postoperative rate of weaning were related to blood gas analysis before extubation with PH,HCO3-,Lac-,SaO2,A-aDO2,respiratory index and oxygenation index(P<0.05).2.The results of non conditional logisitic regression analysis showed that PH,HCO3-and Lac- were independent factors,the value of OR(95%CI) were 50.1(80-311),1.51(1.12-2.02) and 0.18 (0.05-0.65). Conclusion In infants with congenital heart disease before extubation SaO2high,A-aDO2≤ 100 mmHg,respiratory index low and oxygenation index high were the important factors of postoperative early weaning;The PH,HCO3-and Lac-were independent factors,even though early withdrawal unit blood gas analysis before ex-tubation the index is inferior to late withdrawal unit's,it can also achieve early weaning in the basic normal value range.

Objective The relationship between toll like receptor 4 (TLR4) the single nucleotide polymor-phisms of gene (SNP) and ischemic stroke reperfusion injury was evaluated by meta-analysis ,which was de-signed to provide evidence-based medicine for the prevention of ischemic stroke reperfusion injury . Methods In Medline ,PubMed ,EMBASE ,Cochrane ,CBM ,Chinese Journal Net ,academic conference materials and dissertations ,we searched for comprehensive information on the relationship between TLR4 gene SNP (rs10759932 ,rs11536891 ,rs11536879) in ischemic stroke Cohort study and case-control literature to determine whether the gene SNP (rs10759932 ,rs11536891 ,rs11536879) was associated with ischemic stroke reperfusion injury by genotype comparison .The heterogeneity test was performed by Stata11 .0 .The heterogeneity test was used to calculate the OR value .The heterogeneity between different studies was analyzed quantitatively . The fixed effect model was used and the percentage I2 was calculated .Results Meta analysis showed that 1943 cases of ischemia-reperfusion injury and 5043 cases of control group were analyzed ,TLR4 gene SNP (rs10759932 ,rs11536891 ,rs11536879) was associated with the risk of ischemic stroke reperfusion injury ,the dominant fixed effect models were (OR=1 .653 ,95％ CI:1 .416 -1 .930 ;OR=1 .653 ,95％ CI:1 .416 -1 .930 ;OR=1 .653 ,95％ CI:1 .416-1 .930 ;);a co-dominant fixed effect model (OR=1 .525 ,95％ CI:1 .350 -1 .723 ;OR= 1 .653 ,95％ CI:1 .416 -1 .930 ;OR= 1 .653 ,95％ CI:1 .416 -1 .930) .Conclusion TLR4 gene SNP (rs10759932 ,rs11536891 ,rs11536879) was associated with the occurrence of ischemic stroke reperfusion inju-ry by Meta-analysis .

Objective To analyze the preoperative related factors of early weaning of infants with congenital heart disease after operation. Methods From January ,2014 to January ,2017 in Pediatric Cardiology CICU , infants with congenital heart disease were selected as research objects. The clinical data were retrospectively collect ed and the relationship between preoperative influencing factors and postoperative early weaning were analyzed. Early weaning meant mechanical ventilation time was shorter than 24 h and late weaning meant longer than 24 h. Results Single factor analysis showed that early weaning success rate was related to preoperative cardiac function grade 1,NNIS grade 0~1,ASA grade 1,no lung infection and no or mild pulmonary hypertension(average P<0.05). Non conditional logistic regression analysis showed that preoperative heart function grade 1 was an indepen-dent influencing factor,with OR value(95%CI)of 3.9(1.9~7.7). Conclusions In infants with congenital heart disease,preoperative heart function grade 1,NNIS grade 0 ~ 1 ,ASA grade 1,no lung infection and no or mild pulmonary hypertension benefit early withdrawing of ventilator and preoperative cardiac function grade 1 is an inde-pendent factor for early weaning.

Research on disease-syndrome combination is the main approach and method of research on integrative traditional Chinese and Western medicine. Disease-syndrome combination embodies the complementary advantages of traditional Chinese medicine and Western medicine. It discusses the relationship between diseases and syndromes through an interdisciplinary approach, and explores rules of disease diagnosis and treatment based on differential diagnosis. Thanks to the development of modern life science techniques, research on disease-syndrome combination has made great achievements. This article mainly introduced the application and the development prospects of new techniques, such as data mining, system biology, epigenetics, biological network and network pharmacology in the research on disease-syndrome combination in recent years, with a purpose to provide the ideas and the methods for further research and clinical application.