Objective:To explore the risk factors for postoperative lower extremity lymphedema in patients with cervical cancer and construct a nomogram prediction model.Methods:A retrospective case-control study was conducted. Using convenience sampling method, 750 cervical cancer patients in Ziyang People's Hospital from May 2014 to May 2022 were selected. The included patients were divided into a modeling group (525 cases) and a validation group (225 cases) according to a ratio of 7∶3. In the modeling group, patients were divided into a developing group and a non-developing group according to the incidence of postoperative lower extremity lymphedema. Self-designed baseline data questionnaire was used to collect clinical data of patients. Logistic stepwise regression analysis was used to analyze the influencing factor for the incidence of postoperative lower extremity lymphedema in cervical cancer patients. R 4.0.2 software was used to construct a nomogram model for predicting the incidence risk of postoperative lower extremity lymphedema in cervical cancer patients based on the independent risk factors. Receiver operating characteristic (ROC) curve was used to evaluate the differentiation of the nomogram prediction model. Calibration curves were drawn to evaluate the consistency of the nomogram prediction model.Results:Among 525 cervical cancer patients in the modeling group, 109 (20.76%) had postoperative lower extremity lymphedema. There were statistically significant differences in the proportions of patients with different ages, tumor stages, surgical methods, postoperative drainage time, continuous standing time, number of lymph node dissection, and with or without diabetes mellitus, postoperative chemotherapy, postoperative radiotherapy, strenuous exercise or physical labor between the developing group and the non-developing group (all P < 0.05). Multivariate logistic regression analysis showed that age ≥ 60 years old( OR = 2.548, 95% CI: 1.253-5.181), postoperative radiotherapy ( OR = 8.048, 95% CI: 3.867-16.749), postoperative drainage time ≥5 d ( OR = 2.664, 95% CI: 1.043-6.803), continuous standing time ≥ 1 h ( OR = 3.024, 95% CI: 1.252-7.305), number of lymph node dissection > 20 ( OR = 7.063, 95% CI: 1.595-31.281), comorbid diabetes mellitus ( OR = 2.617, 95% CI: 1.200-5.711), and strenuous exercise or physical labor ( OR = 3.518, 95% CI: 1.841-6.721) were all independent risk factors affecting the incidence of postoperative lower extremity lymphedema in cervical cancer patients (all P < 0.05). Based on the above risk factors, a nomogram model was established to predict the incidence risk of postoperative lower extremity lymphedema in cervical cancer patients, and internal and external validation was performed. The results showed that the calibration curves of the modeling group and the validation group showed a good fit to the ideal curves (modeling group: χ2 = 7.87, P = 0.446; validation group: χ2 = 7.92, P = 0.441); the area under the ROC curve was 0.839 (95% CI: 0.795-0.883) and 0.834 (95% CI: 0.783-0.885), respectively, indicating that the prediction model had good predictive efficacy. Conclusions:Age, postoperative radiotherapy, postoperative drainage time, continuous standing time, number of lymph node dissection, whether combined with diabetes mellitus and strenuous exercise or physical labor may be the influencing factors for the incidence of postoperative lower extremity lymphedema in cervical cancer patients. The constructed nomogram model has high clinical value in evaluating the incidence risk of postoperative lower extremity lymphedema in cervical cancer patients.

Objective To explore the TCM syndrome characteristics,inherent patterns,and the relationships between TCM syndrome elements and related factors in patients with asthma-chronic obstructive pulmonary disease(COPD)overlap(ACO).Methods A retrospective analysis was conducted on the medical records of 72 ACO patients to determine the distribution of TCM syndrome elements and to analyze their correlations with underlying diseases and laboratory indicators.Results(1)Among the 72 ACO patients,the involved diseases-location syndrome elements included lung,heart,exterior,kidney,liver,small intestine,spleen,and meridians,while disease-nature syndrome elements included phlegm,yin deficiency,heat,qi deficiency,fluid retention,blood deficiency,dampness,yang deficiency,cold,blood stasis,external wind,qi stagnation,parasitic infestation,dryness,food stagnation,and instability.(2)The study identified 17 combinations of diseases-location syndrome elements,and the two-element combinations were the most common forms(40.28％,29/72),including"lung+exterior"(18.06％),"lung+heart"(16.67％),and"lung+heart+exterior"(9.72％).A total of 55 combinations of disease-nature syndrome elements were observed,with mixed deficiency-excess patterns(58.57％,41/70)being predominant.Common combinations included"phlegm+heat+yin deficiency"(5.71％),"phlegm+yin deficiency"(4.29％),"phlegm+heat"(4.29％),and"phlegm+heat+dampness+yin deficiency"(4.29％).(3)Logistic regression analysis revealed that in ACO patients,pulmonary hypertension was positively correlated with qi deficiency(OR=1.169,P＜0.05),serving as an independent risk factor for qi deficiency.Smoking was positively correlated with qi deficiency(OR=7.108,P＜0.05)and heart involvement(OR=29.189,P＜0.01),acting as their independent risk factors.Diabetes was positively correlated with exterior syndrome(OR=7.091,P＜0.05)and acted its independent risk factor,while hemoglobin levels were negatively correlated with exterior syndrome(OR=0.969,P＜0.05),acting as a protective factor.Conclusion ACO mainly involves the lung,with associations to the heart and exterior.Its nature is characterized by deficiency in the origin and excess in the superficiality,with yin deficiency and qi deficiency as predominant deficiencies and phlegm as the primary excess,often accompanied by heat,fluid retention,and dampness.Patients with pulmonary hypertension are more prone to qi deficiency,those with a smoking history exhibit higher risks of qi deficiency and heart involvement,diabetic patients are more likely to present exterior syndrome,and the increase of hemoglobin levels may reduce the occurrence of exterior syndrome.

Objective:To explore the risk factors for postoperative lower extremity lymphedema in patients with cervical cancer and construct a nomogram prediction model.Methods:A retrospective case-control study was conducted. Using convenience sampling method, 750 cervical cancer patients in Ziyang People's Hospital from May 2014 to May 2022 were selected. The included patients were divided into a modeling group (525 cases) and a validation group (225 cases) according to a ratio of 7∶3. In the modeling group, patients were divided into a developing group and a non-developing group according to the incidence of postoperative lower extremity lymphedema. Self-designed baseline data questionnaire was used to collect clinical data of patients. Logistic stepwise regression analysis was used to analyze the influencing factor for the incidence of postoperative lower extremity lymphedema in cervical cancer patients. R 4.0.2 software was used to construct a nomogram model for predicting the incidence risk of postoperative lower extremity lymphedema in cervical cancer patients based on the independent risk factors. Receiver operating characteristic (ROC) curve was used to evaluate the differentiation of the nomogram prediction model. Calibration curves were drawn to evaluate the consistency of the nomogram prediction model.Results:Among 525 cervical cancer patients in the modeling group, 109 (20.76%) had postoperative lower extremity lymphedema. There were statistically significant differences in the proportions of patients with different ages, tumor stages, surgical methods, postoperative drainage time, continuous standing time, number of lymph node dissection, and with or without diabetes mellitus, postoperative chemotherapy, postoperative radiotherapy, strenuous exercise or physical labor between the developing group and the non-developing group (all P < 0.05). Multivariate logistic regression analysis showed that age ≥ 60 years old( OR = 2.548, 95% CI: 1.253-5.181), postoperative radiotherapy ( OR = 8.048, 95% CI: 3.867-16.749), postoperative drainage time ≥5 d ( OR = 2.664, 95% CI: 1.043-6.803), continuous standing time ≥ 1 h ( OR = 3.024, 95% CI: 1.252-7.305), number of lymph node dissection > 20 ( OR = 7.063, 95% CI: 1.595-31.281), comorbid diabetes mellitus ( OR = 2.617, 95% CI: 1.200-5.711), and strenuous exercise or physical labor ( OR = 3.518, 95% CI: 1.841-6.721) were all independent risk factors affecting the incidence of postoperative lower extremity lymphedema in cervical cancer patients (all P < 0.05). Based on the above risk factors, a nomogram model was established to predict the incidence risk of postoperative lower extremity lymphedema in cervical cancer patients, and internal and external validation was performed. The results showed that the calibration curves of the modeling group and the validation group showed a good fit to the ideal curves (modeling group: χ2 = 7.87, P = 0.446; validation group: χ2 = 7.92, P = 0.441); the area under the ROC curve was 0.839 (95% CI: 0.795-0.883) and 0.834 (95% CI: 0.783-0.885), respectively, indicating that the prediction model had good predictive efficacy. Conclusions:Age, postoperative radiotherapy, postoperative drainage time, continuous standing time, number of lymph node dissection, whether combined with diabetes mellitus and strenuous exercise or physical labor may be the influencing factors for the incidence of postoperative lower extremity lymphedema in cervical cancer patients. The constructed nomogram model has high clinical value in evaluating the incidence risk of postoperative lower extremity lymphedema in cervical cancer patients.

The comparison between traditional Chinese medicine Jinzhen oral liquid (JZOL) and Western medicine in treating children with acute bronchitis (AB) showed encouraging outcomes. This trial evaluated the efficacy and safety of the JZOL for improving cough and expectoration in children with AB. 480 children were randomly assigned to take JZOL or ambroxol hydrochloride and clenbuterol hydrochloride oral solution for 7 days. The primary outcome was time-to-cough resolution. The median time-to-cough resolution in both groups was 5.0 days and the antitussive onset median time was only 1 day. This randomized controlled trial showed that JZOL was not inferior to cough suppressant and phlegm resolving western medicine in treating cough and sputum and could comprehensively treat respiratory and systemic discomfort symptoms. Combined with clinical trials, the mechanism of JZOL against AB was uncovered by network target analysis, it was found that the pathways in TRP channels like IL-1β/IL1R/TRPV1/TRPA1, NGF/TrkA/TRPV1/TRPA1, and PGE2/EP/PKA/TRPV1/TRPA1 might play important roles. Animal experiments further confirmed that inflammation and the immune regulatory effect of JZOL in the treatment of AB were of vital importance and TRP channels were the key mechanism of action.

Objective To explore the status quo of medication belief in the patients with myasthenia gravis and analyze their influencing factors,so as to provide reference for health care professionals to develop targeted interventions.Methods A total of 145 patients with myasthenia gravis visiting the First Affiliated Hospital of Guangzhou University of Chinese Medicine from July 2021 to March 2022 were selected.The Be-liefs about Medicines Questionnaire(BMQ)was used to investigate.The multiple linear regression was used to analyze the relevant influencing factors.Results The scores of medication belief,necessity belief and con-cern belief in 145 patients were(4.17±1.23)points,(19.52±3.45)points and(18.29±4.26)points respec-tively.There was statistically significant difference between the scores of necessity belief and concern belief(P＜0.05).The education level,financial burden,duration of illness,length of medication,number of recur-rent hospitalizations,and inappropriate medication-induced exacerbations had influence on the medication be-lief scores of the patients with myasthenia gravis(P＜0.05).The duration of illness,length of medication and number of recurrent hospitalizations had the influence on the medication necessity scores of patients with my-asthenia gravis(P＜0.05).The financial burden had the influence on the medication concerns scores of the patients with myasthenia gravis(P＜0.05).Conclusion The medication belief in the patient swith myasthe-nia gravis is at a low level,and the number of recurrent hospitalizations and financial burden are the independ-ent risk factors affecting the medication belief scores in the patients with myasthenia gravis.The number of recurrent hospitalizations is an independent risk factor for the score of medication necessity dimension.

Myasthenia gravis crisis (MC) often involves respiratory muscles and requires mechanical ventilation urgently. As non-invasive mechanical ventilation (NIV) technology unceasing development, its use in acute respiratory failure caused by MC shows obvious advantages. However, how to identify the occurrence of MC at early stage, predict the relevant indicators of NIV for MC treatment, and apply different ventilation strategies to improve the effect of treatment are worthy of attention. In addition, the new development of NIV modes in recent years also provides new direction for the treatment of MC. Therefore, this article reviews recent advance in the clinical application of NIV in MC to provide clinical references.

Objective:To investigate the preoperative evaluation and treatment methods of non-firearm penetrating brain injury (PBI) in children.Methods:A retrospective analysis was performed. The clinical data of 18 children with non-firearm PBI admitted to our hospital from January 2012 to December 2020 were collected.Results:CT angiography was performed in 10 patients and MRI in 8 patients before treatment. CT angiography indicated that the intracranial large vessels were not injured by the foreign bodies. The foreign bodies of 7 patients were removed by craniotomy and the foreign bodies of 3 patients were removed directly under general anesthesia; the foreign bodies of 8 patients were removed directly outside the hospital without anesthesia. Cerebrospinal fluid leakage was noted in 4 patients and intracranial infection in 7 patients after surgery; no foreign body residue or intracranial hemorrhage after surgery was noted. After 3-69 months of follow-up, 3 patients had visual decline, one had limited eye movement, and one had olfactory decline.Conclusion:CT angiography is a safe and effective evaluation method for children with non-firearm PBI, and direct extraction of foreign body under general anesthesia is a feasible surgical method when CT angiography shows that the blood vessels are not hurted by the foreign bodies.

Objective: To investigate the effects of exogenous interleukin (IL)-35 on the balance of helper T cell 17 (Th17) and regulatory T cell (Treg) in peripheral blood of patients with oral lichen planus (OLP). Methods: Totally 12 peripheral blood samples of OLP patients (OLP group, one male and 11 female, 26-68 years old; four cases of reticular OLP and eight cases of erosive OLP) were collected from patients of Department of Oral Mucosal Specialist of the Affiliated Hospital of Guizhou Medical University from October to December 2016. During the same period, thirteen normal peripheral blood samples were collected from the Physical Examination Center of the Affiliated Hospital of Guizhou Medical University (normal control group, one male and 12 female, 20-68 years old). The peripheral blood mononuclear cells (PBMC) were extracted in sterile condition and CD4+ T cells were sorted by flow cytometry (FCM). Quantitative real-time PCR (qPCR) technique was used to detect the mRNA expression levels of retinoid-related orphan nuclear γt (RORγt) and forkhead box3 (Foxp3). The CD4+ T cells were divided into experimental group and control group. The CD4+ T cells of experimental group were cultured in vitro by adding rhIL-35, and the CD4+ T cells of control group were cultured with the same volume of phosphate buffered saline (PBS). After the completion of the culture, the cells were collected. The expression levels of the same factors were detected by qPCR. Results: The expression [M(Q₂₅, Q₇₅)] of Foxp3 [0.15 (0.09, 0.30)] and RORγt mRNA [1.04 (0.45, 2.15)] in the CD4+ T cells of OLP were significantly higher than those in normal control group [0.04 (0.02, 0.06), 0.10 (0.05, 0.11)] (Z=-4.134, P<0.01; Z=-3.699, P<0.01). The ratio of ROR γt/Foxp3 mRNA in OLP group [6.22(3.67, 15.34)] was higher than that in normal control group [2.50 (1.24, 5.23)] (Z=-2.665, P=0.007). In the CD4+ T cells of OLP patients, the expression of Foxp3 mRNA in the experiment group [0.40 (0.21, 1.22)] was higher than that in the control group [0.15 (0.11, 0.26)](Z=-2.510, P=0.012), and the expression of ROR γt mRNA between two groups showed no significant difference (P>0.05). The ROR γt/Foxp3 mRNA ratio [3.44 (1.55, 8.16)] of the experiment group was lower than that in the control group [6.22 (4.43, 12.21)] (Z=-2.746, P=0.006). Conclusions There was a Th17/Treg imbalance with predominated by Th17 cells in the peripheral blood of patients with OLP. Exogenous rhIL-35 had an immunomodulatory effect on the balance of Th17/Treg.

In December 2019, COVID-19 broke out in Wuhan, China. The disease is highly contagious and quickly spreads at home and abroad, causing great concern. However, there are no definite effective antiviral drugs in clinic. Given the urgency of the COVID-19 outbreak, based on the diagnosis and treatment recommendation and previous researches, this review describes the optional antiviral drugs such as remdesivir, oseltamivir, Arbidol, lopinavir/ritonavir, ribavirin, and interferon-α to provide a reference for the infection therapy.

In December 2019, the endemic of COVID-19 broke out in Wuhan, China. The disease is highly contagious and quickly spreads at home and abroad, causing great concern. However, there are no definite effective antiviral drugs in clinical use. Given the urgency of the COVID-19 outbreak, based on the diagnosis and treatment recommendation and relavant researches, this article describes the optional antiviral drugs such as remdesivir, oseltamivir, arbidol, lopinavir/ritonavir, ribavirin, and interferon-α to provide a reference for treatment of COVID-19.