[Objective]To investigate the effect of Qifu Qiangxin Decoction on heart failure(HF)and explore its mechanism.[Methods]Forty male C57BL/6N mice were randomly divided into sham surgery(Sham)group,model(HF)group,low-dose Qifu Qiangxin Formula(HF+QL)group,high-dose Qifu Qiangxin Formula(HF+QH)group and angiotensin-converting enzyme inhibitor(HF+ACEI)group according to the random number table method.The mouse HF model was established by ligating the left anterior descending(LAD)artery.Cell model in cardiac fibroblasts(CFs)was stimulated by Angiotensin Ⅱ(Ang Ⅱ).Ang Ⅱ-stimulated CFs were treated with drug-containing serum or blank serum,then incubated with gamma-secretase inhibitor(DAPT)and transmembrane receptor Notch1 siRNA.Enzyme-linked immunosorbent assay(ELISA)was used to assess serum B-syndrome natriuretic peptide(BNP)levels in mice.Left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),ejection fraction(EF)and fraction shorting(FS)were measured by ultrasound cardiogram(UCG).The histological structure was observed after hematoxylin-eosin(HE)staining,while the collagen protein expression in heart muscle tissues was measured by using Picro sirius red(PSR)and Masson staining.Quantitative reverse transcription-polymerase chain reaction(qRT-PCR),western blot and immunofluorescence(IF)was used to determine the expression levels of collagenⅠ,collagen Ⅲ,α-smooth muscle actin(α-SMA),Notch1,Notch intracellular domain-1(NICD1),transforming growth factor-β1(TGF-β1),Smad protein 2(Smad2),phosphorylated-Smad2(p-Smad2),Smad protein 3(Smad3),phosphorylated-Smad3(p-Smad3),Smad protein 7(Smad7)in CFs and heart tissues,and the migration of CFs was determined by examining wound healing.[Results]Compared with HF group,Qifu Qiangxin Decoction reduced histopathological changes,serum BNP levels,LVESD and LVEDD,and collagen deposition,while increasing EF and FS(P<0.01,P<0.001).Qifu Qiangxin Decoction also notably inhibited the cell viability,migration,collagen Ⅰ,collagen Ⅲ mRNA and α-SMA protein expression in Ang Ⅱ stimulated CFs(P<0.05,P<0.01,P<0.001);promoted Notch1,NICD1 and Smad7 protein expression and hindered TGF-β1,p-Smad2,p-Smad3 protein expression in HF mice and Ang Ⅱ-stimulated CFs(P<0.001).siNotch1 abolished the impact of Qifu Qiangxin Decoction on Notch1,NICD1,TGF-β1,p-Smad2 and p-Smad3 protein expression,and cell viability,migration,as well as collagen Ⅰ,collagen Ⅲ mRNA and α-SMA protein expression in Ang Ⅱ-stimulated CFs(P<0.05,P<0.01,P<0.001).[Conclusion]To some extent,Qifu Qiangxin Decoction showed protective properties against HF,and its mechanism may be through the regulation of the TGF-β1/Smad pathway by Notch1.

[Objective]To investigate the effect of Qifu Qiangxin Decoction on heart failure(HF)and explore its mechanism.[Methods]Forty male C57BL/6N mice were randomly divided into sham surgery(Sham)group,model(HF)group,low-dose Qifu Qiangxin Formula(HF+QL)group,high-dose Qifu Qiangxin Formula(HF+QH)group and angiotensin-converting enzyme inhibitor(HF+ACEI)group according to the random number table method.The mouse HF model was established by ligating the left anterior descending(LAD)artery.Cell model in cardiac fibroblasts(CFs)was stimulated by Angiotensin Ⅱ(Ang Ⅱ).Ang Ⅱ-stimulated CFs were treated with drug-containing serum or blank serum,then incubated with gamma-secretase inhibitor(DAPT)and transmembrane receptor Notch1 siRNA.Enzyme-linked immunosorbent assay(ELISA)was used to assess serum B-syndrome natriuretic peptide(BNP)levels in mice.Left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),ejection fraction(EF)and fraction shorting(FS)were measured by ultrasound cardiogram(UCG).The histological structure was observed after hematoxylin-eosin(HE)staining,while the collagen protein expression in heart muscle tissues was measured by using Picro sirius red(PSR)and Masson staining.Quantitative reverse transcription-polymerase chain reaction(qRT-PCR),western blot and immunofluorescence(IF)was used to determine the expression levels of collagenⅠ,collagen Ⅲ,α-smooth muscle actin(α-SMA),Notch1,Notch intracellular domain-1(NICD1),transforming growth factor-β1(TGF-β1),Smad protein 2(Smad2),phosphorylated-Smad2(p-Smad2),Smad protein 3(Smad3),phosphorylated-Smad3(p-Smad3),Smad protein 7(Smad7)in CFs and heart tissues,and the migration of CFs was determined by examining wound healing.[Results]Compared with HF group,Qifu Qiangxin Decoction reduced histopathological changes,serum BNP levels,LVESD and LVEDD,and collagen deposition,while increasing EF and FS(P<0.01,P<0.001).Qifu Qiangxin Decoction also notably inhibited the cell viability,migration,collagen Ⅰ,collagen Ⅲ mRNA and α-SMA protein expression in Ang Ⅱ stimulated CFs(P<0.05,P<0.01,P<0.001);promoted Notch1,NICD1 and Smad7 protein expression and hindered TGF-β1,p-Smad2,p-Smad3 protein expression in HF mice and Ang Ⅱ-stimulated CFs(P<0.001).siNotch1 abolished the impact of Qifu Qiangxin Decoction on Notch1,NICD1,TGF-β1,p-Smad2 and p-Smad3 protein expression,and cell viability,migration,as well as collagen Ⅰ,collagen Ⅲ mRNA and α-SMA protein expression in Ang Ⅱ-stimulated CFs(P<0.05,P<0.01,P<0.001).[Conclusion]To some extent,Qifu Qiangxin Decoction showed protective properties against HF,and its mechanism may be through the regulation of the TGF-β1/Smad pathway by Notch1.

Concurrent chemoradiotherapy (CCRT) refers to the simultaneous treatment of chemotherapy and radiotherapy, and the effect of radiotherapy is enhanced with low-dose chemotherapy, which can reduce tumor recurrence and metastasis and improve clinical prognosis of patients. At present, the main factors for the increase of radiosensitivity of concurrent chemotherapy is that concurrent chemotherapy prevents the repair of tumor cells, and chemotherapy and radiotherapy act on different cell cycles and have synergistic effects. However, even for patients with locally advanced cervical cancer (LACC) who have undergone CCRT, the 5-year survival rate is only 60%, which is still not ideal. In order to improve the efficacy, researchers have conducted a series of exploratory studies, which consist of the combination of targeted drugs and immunodrugs, and neoadjuvant regimens before CCRT, etc. Although targeted or immunologic drugs are effective treatment of LACC, in view of the lack of large-scale evidence-based medical evidence, multi-center prospective and randomized phase III clinical trials and high-level articles are needed to improve the level of evidence-based medicine. This consensus summarizes several key evidence-based medical studies published recently, especially the clinical research progress in targeted and immunological therapies, providing reference for domestic peers.

Objective To explore the effect of traditional Chinese medicine enema combined with acupoint massage on postoperative intestinal function recovery.Methods A total of 80 patients with abdominal surgery admitted to First Affiliated Hospital of Huzhou University from January 2022 to June 2023 were selected and divided into study group and control group according to random number table method,with 40 cases in each group.The control group was treated with conventional Western medicine,while the study group was treated with traditional Chinese medicine enema combined with acupoint massage on the basis of conventional Western medicine treatment.The therapeutic effect,postoperative recovery time,gastrointestinal hormone level,abdominal distension pain and gastrointestinal reaction score were compared between two groups.Results Postoperative bowel sound recovery time,first anal defecation time and full-flow diet recovery time in study group were significantly shorter than those in control group(P<0.05).At 5 days after surgery,the levels of motilin(MTL),gastrin(GAS)and gastric inhibitory peptide(GIP)in two groups were significantly higher than those in this group at 1 day after surgery(P<0.05).The levels of MTL,GAS and GIP in study group were significantly higher than those in control group(P<0.05).At 5 days after surgery,abdominal distension score and gastrointestinal reaction score in two groups were significantly lower than those in this group 1 day after surgery(P<0.05),and abdominal distension score and gastrointestinal reaction score in study group were significantly lower than those in control group(P<0.05).The total effective rate of study group was significantly higher than that of control group(χ2=3.914,P=0.048).Conclusion Traditional Chinese medicine enema combined with acupoint massage can effectively shorten the recovery time of intestinal function,improve the level of gastrointestinal hormone,relieve abdominal distension pain and gastrointestinal reaction after abdominal operation,and the effect is significant,worthy of clinical application.

Objective:To investigate the seroepidemiological status of Toxoplasma gondii among humans, dogs and cats and its influencing factors in three counties of Yunnan Province, and to assess the risk of dogs and cats transmitting Toxoplasma gondii to humans and causing disease and epidemics. Methods:Three pestis foci of demestic rodent in Mile City, Mang City and Lianghe County in Yunnan Province were selected as the investigation areas, and blood samples of humans, dogs and cats from 16 natural villages were collected. Serum IgG antibodies against Toxoplasma gondii were detected by indirect enzyme-linked immunosorbent assay, and the influencing factors were analyzed by logistic regression. Results:A total of 368 human serum samples, 307 dog serum samples, and 12 cat serum samples were tested. The positive rates of serum IgG antibodies against Toxoplasma gondii in humans, dogs and cats were 54.62% (201/368), 90.88% (279/307), and 91.67% (11/12), respectively. Logistic regression analysis showed that the risk of Toxoplasma gondii infection (serum IgG antibodies positive) in humans of Mang City and Lianghe County were 8.20 times ( AOR = 8.20, 95% CI: 4.38 - 15.36) and 2.22 times ( AOR = 2.22, 95% CI: 1.24 - 3.97) higher than those in Mile City, respectively, and the risk of Toxoplasma gondii infection (serum IgG antibodies positive) in humans in the age group of 30 - < 40 years old decreased by 57% compared to the age group of 30 years old ( AOR = 0.43, 95% CI: 0.19 - 0.98, P < 0.10). The risk of Toxoplasma gondii infection (serum IgG antibodies positive) in dogs of Lianghe County was 89% lower than that in Mile City ( AOR = 0.11, 95% CI: 0.02 - 0.47). The risk of Toxoplasma gondii infection(serum IgG antibodies positive) in dogs aged 2 years old and older was 2.05 times higher than that in dogs aged younger than 2 years old ( AOR = 2.05, 95% CI: 0.91 - 4.64, P < 0.10). Conclusions:The positive rates of serum IgG antibodies against Toxoplasma gondii in humans, dogs and cats in the three counties where the three pestis foci of demestic rodent are located in Yunnan Province is relatively high. The risk of Toxoplasma gondii infection (serum IgG antibodies positive) in humans, dogs is related to the region and age. The risk of dogs and cats transmitting Toxoplasma gondii to humans and other animals is relatively high. It is necessary to strengthen monitoring in key regions, carry out health education, and take corresponding health measures.

Objective To summarize the medication law of TCM in the treatment of chronic bronchitis;To provide reference for clinical medication.Methods Medical records of patients with chronic bronchitis who were hospitalized in the Respiratory Department of the First Affiliated Hospital of Henan University of Chinese Medicine from January 1,2016 to December 31,2021 were extracted based on HIS electronic medical record data.After screening,the TCM prescriptions used by patients with chronic bronchitis were input into Excel 2019 to establish a database.Based on the software Lantern 5.0,the latent structure model was learned,hidden variables and explicit variables were obtained,and the model was interpreted.SPSS Modeler 18.0 was used to establish model points with Apriori algorithm for Chinese materia medica with a frequency greater than 6%,to obtain the association rules between drugs,and to analyze the medication law of TCM in treating chronic bronchitis.Results A total of 3 410 cases were included,involving 423 kinds of Chinese materia medica,with a cumulative frequency of 82 766 times.Among them,109 kinds of Chinese materia medica with a frequency of>6 % had a cumulative frequency of 69 845 times.The top five commonly used medicines were Fritillariae Cirrhosae Bulbus,Poria,Atractyodis Macrocephalae Rhizoma,Asteris Radix et Rhizoma,Citri Reticulatae Pericarpium,mainly with medicines of reducing cough and phlegm,antiasthmatic medicine,tonifying deficiency,clearing heat,relieving superficies,promoting blood circulation and removing blood stasis.The medicinal properties were warming,cold and mild,and the main tastes were bitter,sweet and pungent,and the meridians were mainly lung,spleen,liver and stomach meridians.Through analysis of latent structure,49 hidden variables and 149 hidden classes were obtained.Combined with professional knowledge,10 comprehensive clustering models and 21 core formulas were deduced,such as Sangbaipi Decoction,Xuefu Zhuyu Decoction,Xiaoqinglong Decoction,Erchen Decoction,Shashen Maidong Decoction,Liuwei Dihuang Pills,Yinqiao Powder,Zhisou Powder,Yupingfeng Powder,Xuefu Zhuyu Decoction combined with Daotan Decoction,etc.It was concluded that the chronic bronchitis syndrome included phlegm-heat stagnation lung syndrome,qi stagnation blood stasis syndrome,cold fluid attacking lung syndrome,phlegm-dampness accumulation lung syndrome,lung qi and yin deficiency syndrome,kidney yin deficiency syndrome,wind heat attacking lung syndrome,wind cold attacking lung syndrome,lung qi and spleen deficiency syndrome,phlegm stasis interjunction syndrome.A total of 41 strong association rules were screened in the analysis of association rules,including 5 strong association rules for two and 36 strong association rules for three.The high confidence rules were Saposheikovize Radix + Angelicae Sinensis Radix →Atractyodis Macrocephalae Rhizoma,Saposheikovize Radix + Codonopsis Radix → Atractyodis Macrocephalae Rhizoma,Codonopsis Radix + Citri Reticulatae Pericarpium → Atractyodis Macrocephalae Rhizoma;the higher degree of improvement were Bupleuri Radix + Mori Cortex → Scutellariae Radix,Perillae Fructus + Belamcandae Rhizoma → Fritillariae Cirrhosae Bulbus,Armeniacae Semen Amarum + Pinelliae Rhizoma → Citri Reticulatae Pericarpium,etc.Conclusion In the treatment of chronic bronchitis,TCM is mainly used to reduce phlegm,relieve cough and asthma,and the method of promoting blood circulation and removing blood stasis is commonly used to help eliminate phlegm.In addition,TCM pays attention to the application of methods such as tonifying lung and securing the exterior,invigorating spleen and benefiting qi.

Objective:To observe the changes of pelvic floor structure and function in female vaginal laxity after CO 2 fractional laser transvaginal treatment. Methods:This study reviewed the improvement of pelvic floor structure and function after CO 2 fractional laser transvaginal treatment in 28 female patients [aged 26-59 (37.5±8.3) years] with vaginal laxity syndrome seen at the Department of Dermatology, the First Affiliated Hospital of Air Force Medical University from March 2020 to November 2021. A total of 28 female patients with vaginal laxity syndrome underwent intravaginal treatment by CO 2 fractional laser instrument once/month for 3 times. The clinical efficacy and safety were evaluated according to the pre- and post-treatment transverse vaginal diameter, FSFI score of female sexual function, VHIS score of vaginal environment, vaginal tactile imaging system (VTI), pelvic ultrasound and MRI, tissue biopsy, patient satisfaction, pain score, and postoperative adverse effects. Results:Twenty-one of the twenty-eight female patients with vaginal laxity syndrome showed significant improvement in symptoms related to vaginal laxity syndrome after intravaginal treatment with CO 2 fractional laser therapy. All patients showed improvement in all indexes before and 1 month after treatments the mean vaginal transverse diameter decreased from (3.00±0.39) fingers to (2.71±0.40) fingers ( P<0.05), VHIS increased from (17.12±3.97) to (21.69±3.61) ( P<0.05), FSFI score improved from (23.11±3.70) to (27.43±5.33) ( P<0.05), and VTI examination showed that vaginal muscle strength and elasticity were improved to different degrees, and there was a statistical difference compared with that before treatment (total contractility of the anterior vaginal wall: t=26.23, P<0.001; total contractility of posterior vaginal wall: t=39.02, P<0.001; the mean contractility of the anterior vaginal wall: t=17.92, P<0.001; the mean contractility of the posterior vaginal wall: t=22.57, P<0.001). At the same time, questionnaire score of international consultation on incontinent questionnaire short form (ICI-Q-SF scale) of 13 patients with combined mild to moderate stress urinary incontinence showed a statistically significant decrease compared with those before treatment (8.97±2.99 before treatment and (7.18±1.79) one month after treatment; t=2.792, P<0.01). Pelvic ultrasound and magnetic resonance examination indicated a tightening of the vaginal wall structure, and pelvic ultrasound observed a significant decrease in bladder neck mobility and a significant decrease in vesicourethral rotation angle. Vaginal tissue biopsy indicated an increase in the thickness of the vaginal mucosa and an increase in the number and more regular arrangement of collagen fibers after treatment. All patients had high treatment satisfaction and there were no adverse effects such as infection and bleeding during the treatment. Conclusions:Transvaginal CO 2 fractional laser treatment can improve the pelvic floor structure and function around the vagina, treat female vaginal laxity syndrome, stress urinary incontinence and female sexual dysfunction, with significant clinical efficacy and good safety.

【Objective】 To evaluate the efficacy and safety of intravaginal fractional superpulse CO2 laser in the treatment of mild to moderate female stress urinary incontinence (SUI), so as to provide reference for the treatment options for female SUI. 【Methods】 A total of 41 female mild-to-moderate SUI patients confirmed at the Department of Urology, The First Affiliated Hospital, Air Force Medical University, during Aug.2019 and Nov.2020 were involved.All patients received 3 intravaginal fractional superpulse CO2 laser treatments (1/month).The improvement of urinary incontinence symptoms after treatment was evaluated with International Consultation on Incontinent Questionnaire Short Form (ICI-Q-SF).The motion of bladder neck and rotation angle of bladder and urethra were measured with pelvic ultrasound before and after treatment.The therapeutic effects, pain and patients’ satisfaction were evaluated, and adverse reactions such as bleeding, infection and scar were observed. 【Results】 Three months after treatment, urinary incontinence symptoms improved to varying degrees, the ICI-Q-SF score decreased, the motion of bladder neck [ (28.70±3.11) mm vs.(19.10±4.54) mm] and the vesicourethral rotation angle [(52.78°±15.79°) vs.(41.56°±13.24°)] significantly decreased (P<0.05).The total effective rate was 100.0%.No patients complained severe pain during treatment.All patients were satisfied with the treatment.No adverse reactions such as bleeding, infection or scar occurred. 【Conclusion】 Intravaginal fractional superpulse CO2 laser is effective and safe in the treatment of mild to moderate female SUI, but the long-term efficacy still needs further observation.

Objective:To evaluate the role of autophagy in ischemia postconditioning (IPO)-induced attenuation of intestinal ischemia-reperfusion (I/R) injury in mice.Methods:Thirty-two SPF healthy adult male C57BL/6J mice, aged 9-12 weeks, weighing 25-29 g, were divided into 4 groups ( n=8 each) using a random number table method: sham operation group (group S), intestinal I/R group (group IIR), group IPO and IPO plus 3-methyladenine (3-MA) group (group IPO+ 3-MA). The model of intestinal I/R was established by occlusion of superior mesenteric artery for 45 min followed by 2-h reperfusion in anesthetized animals.The mice underwent 3 cycles of 30-s reperfusion followed by 30-s ischemia before restoration of reperfusion in group IPO.Blood samples from the femoral artery were collected at 2 h of reperfusion for determination of concentrations of serum diamine oxidase (DAO), D-lactate (D-LA) and intestinal fatty acid binding protein (I-FABP). The animals were then sacrificed and intestinal tissues were removed for microscopic examination of the pathologic changes which were scored according to Chiu and for determination of the expression of autophagy-related proteins Beclin-1 and p62 (by Western blot). The water content of intestinal tissues was calculated. Results:Compared with group S, the Chiu′s score, concentrations of serum DAO, D-LA and I-FABP, water content of intestinal tissues, and LC3Ⅱ/LC3Ⅰ ratio were significantly increased, Beclin-1 expression was up-regulated, and p62 expression was down-regulated in IIR, IPO and IPO+ 3-MA groups ( P<0.05). Compared with group IIR, the Chiu′s score, concentrations of serum DAO, D-LA and I-FABP, water content of intestinal tissues, and LC3Ⅱ/LC3Ⅰ ratio were significantly decreased, Beclin-1 expression was up-regulated, and p62 expression was down-regulated in group IPO ( P<0.05). Compared with group IPO, the Chiu′s score, concentrations of serum DAO, D-LA and I-FABP, and water content of intestinal tissues were significantly increased, LC3Ⅱ/LC3Ⅰratio was decreased, Beclin-1 expression was down-regulated, and p62 expression was up-regulated in group IPO+ 3-MA ( P<0.05). Conclusion:Autophagy is involved in ischemia postconditioning-induced attenuation of intestinal I/R injury in mice.

OBJECTIVE： To provide reference for the clinical use and dosage form development of Strychnos nuxvomica. METHODS： The prescriptions containing S. nuxvomica were collected and sorted from the Dictionary of Traditional Chinese Medicine Prescription， and then formula name， prescription source， name of treatment disease， composition， usage and dosage， medication route were input into Access 2010 and database was established. According to the usage， these prescriptions were divided into internal use and external use， and the frequencies of diseases treated by internal/external use prescriptions were counted respectively. Apriori algorithm of SPSS Modeler 18.0 software was used to analyze the drug combination rule of compound prescription containing S. nuxvomica. RESULTS： A total of 78 prescriptions were included， of which 42 were oral prescriptions， 33 were external prescriptions and 3 were both oral and external prescriptions. Internal prescriptions were used to treat diseases such as atrophy-flaccidity disease， arthralgia， hemorrhoids， anal fistula， bones and muscles pain. The external prescriptions were mainly used to treat skin diseases， tumors， lump. Internal and external prescriptions could treat sore， injuries and fractures. In internal prescriptions， S. nuxvomica was often compatible with Boswellia carterii， myrrha， Daemonorops draco， Manis pentadactyla， pyritum， Angelica sinensis， Ephedra sinica， Aconitum kusnezoffii. In external prescriptions， S. nuxvomica was often compatible with Radix Paeoniae， Rehmannia glutinosa， Phellodendron chinense， Coptis chinensis， Scutellaria baicalensis， Angelica sinensis， Angelica dahurica， Buthus martensii. Most of S. nuxvomica were used after processing， and mainly took sesame oil as an auxiliary material （77.97％）. CONCLUSIONS： Diseases treated with the prescriptions containing S. nuxvomica can be classified into three types of diseases， i.e. polymyalgia rheumatica and paralysis， bruise and bone fracture， carbuncle and stubbornness tinea. In external prescriptions， S. nuxvomica is often compatible with drug for clearing heat and drying dampness， cooling blood and activating blood， and relieving pain. In internal prescriptions， S. nuxvomica is often compatible with the agents for blood-activating and stasis-resolving medicinal. In addition， the processing of S. nuxvomica with sesame oil is an important measure to ensure its safety.