BACKGROUND: Huaier granule is an important medicinal fungus extract widely used in cancer treatment. Previous retrospective studies have reported its effectiveness in breast cancer patients, but the imbalanced baseline characteristics of participants could have biased the results. Therefore, this retrospective study aimed to examine the efficacy of Huaier granule on the prognosis of breast cancer patients. METHODS: In this single-center cohort study, breast cancer patients diagnosed and treated at the Guangdong Provincial Hospital of Chinese Medicine between 2009 and 2017 were selected. The data were retrospectively analyzed and divided into two groups according to whether the patients received Huaier granules. The propensity score matching (PSM) method was used to eliminate selection bias. The disease-free survival (DFS) and overall survival (OS) for these groups were compared using the Kaplan-Meier method and the Cox regression. RESULTS: This study included 214 early invasive breast cancer patients, 107 in the Huaier group and 107 in the control group. In the Kaplan-Meier analysis, the 2-year and 5-year DFS rates were significantly different in the Huaier group and control group (hazard ratio [HR], 0.495; 95% confidence interval [CI], 0.257-0.953; P = 0.023). The 2-year and 5-year OS rates were also significantly different (HR, 0.308; 95% CI, 0.148-0.644; P = 0.001). On multivariable Cox regression, Huaier granule was associated with improved DFS (HR, 0.440; 95% CI, 0.223-0.868; P = 0.018) and OS (HR, 0.236; 95% CI, 0.103-0.540; P = 0.001). CONCLUSION In this retrospective study, Huaier granules improved the DFS and OS of early invasive breast cancer patients, providing real-world evidence for further prospective studies on treating breast cancer with Huaier granules.
Humans ; Breast Neoplasms/mortality* ; Retrospective Studies ; Female ; Propensity Score ; Middle Aged ; Adult ; Prognosis ; Disease-Free Survival ; Kaplan-Meier Estimate ; Aged ; Proportional Hazards Models ; Complex Mixtures/therapeutic use* ; Drugs, Chinese Herbal/therapeutic use* ; Trametes

[Objective]Using data mining technology to explore the medication rule and clinical experience of QIU Shengliang,Chief TCM physician(referred as Chief QIU),in treating chronic atrophic gastritis(CAG)with liver and stomach Qi stagnation syndrome.[Methods]By collecting data,setting up admission and discharge standards,establishing a database,standardizing data processing,conducting frequency analysis,constructing a Chinese medicine matrix and performing clustering analysis,combined with the clinical experience of Chief QIU,it conducted analysis and induction of his medication rules for CAG of liver and stomach Qi stagnation syndrome.[Results]This study involved 162 prescriptions,171 herbs.The high-frequency drugs were:Magnolia officinalis,Fructus aurantii,ginger pinellia;Among them,the medicinal properties were mainly warm,the medicinal tastes were mainly spicy,bitter and sweet,and the channels were mainly stomach,spleen,lung and liver.The core drug group was pinellia,Magnolia officinalis and Fructus aurantii.Cluster analysis showed that the core ingredients were:ginger pinellia,Magnolia officinalis,Fructus aurantii,dandelion,galangal,knife bean,spiral flower,cuttlebone,water red flower seed,corrugated seed,hedgehog skin,bamboo shavings and wood butterfly.[Conclusion]Chief QIU is skilled in treating CAG liver and stomach Qi stagnation syndrome.He often uses warm-tonifying herbs and prescribes treatments to regulate Qi and promote Yang,with a focus on resolving stagnation,harmonizing the stomach,dispersing phlegm and eliminating lumps.He emphasizes achieving balance between Yin and Yang,promoting the interaction between rising and descending Qi,harmonizing dryness and dampness,and nurturing the body's vital energy.His prescriptions are tailored to the specific method,and the method is based on the patient's symptoms.

[Objective]To summarize the clinical experience of Dr.QIU Shengliang in treating gastro-esophageal reflux disease(GERD)through regulating Qi dynamics,providing reference for traditional Chinese medicine(TCM)syndrome differentiation and treatment of this condition.[Methods]Through clinical apprenticeships and case analysis combined with classical text research,this paper elucidates the core pathogenesis of"Qi movement disorders"in GERD.It systematically presents Dr.QIU's diagnostic framework centering on regulating Qi dynamics,focusing on spleen-stomach-liver coordination while addressing phlegm-stasis complications.The treatment protocol features flexible herbal applications tailored to syndrome patterns,supported with a representative case study.[Results]Guided by the principle of harmonizing the flow of Qi,Dr.QIU's approach integrates three therapeutic strategies:strengthening the spleen and stomach,soothing liver Qi,and resolving phlegm and blood stasis.The subsequent follow-up revealed that the patient's symptoms were effectively relieved,with no recurrence,thereby validating this method.[Conclusion]Dr.QIU's treatment system emphasizes Qi dynamics regulation as the core principle for GERD management,focusing on visceral functional balance through multi-dimensional interventions encompassing herbal therapy,dietary regulation,emotional management and exercise guidance.This holistic approach demonstrates significant clinical efficacy while embodying TCM's characteristic holistic philosophy and syndrome differentiation principles,offering valuable insights for TCM management of GERD.

Objective:To construct and evaluate a training program for cardiovascular nurse specialists based on a core competency framework.Methods:Among 61 trainees participating in the first training class for cardiovascular nurse specialists organized by a provincial nursing society, a training program focusing on the nine core competencies for cardiovascular nurse specialists was implemented, which consisted of 4-week theoretical and 4-week practical training. The effectiveness of the training program was evaluated using the Kirkpatrick model. Data analyses were performed by using SPSS 26.0. Categorical data were presented as the number of cases; continuous variables in normal distribution were expressed as mean±standard deviation; and continuous variables in non-normal distribution were presented as median (interquartile range) and compared using non-parametric tests.Results:At the reaction level, the satisfaction rates of trainees with the theoretical and practical sections of the training program were 98.36% (60/61) and 95.08% (58/61), respectively. At the learning level, the comprehensive assessment score of the trainees was (83.01±3.39) points, and all of them successfully obtained their completion certificates, with a pass rate of 100.00% (61/61). At the behavior level, the core competencies for cardiovascular nurse specialists were significantly improved after training [the total score increased from 291.00 (254.00, 334.25) to 410.50 (354.50, 433.00), P<0.001]. At the results level, at six months after training, there were significant increases in the number of participants engaging in cardiovascular care practices, clinical nursing education and guidance, leadership roles, and research projects within their units as well as the number of individuals achieving career advancement (all P<0.05). Conclusions:The trainees are highly satisfied with the core competency-focused cardiovascular nurse training program, which can improve core competencies and cardiovascular nursing capabilities, expand the scope of cardiovascular nursing services, and foster the sustained advancement of the participants.

BACKGROUND:Postoperative fever is one of the common clinical symptoms after posterior lumbar interbody fusion. There is no clear etiology or pathogenesis. The postoperative body temperature of patients is easy to repeat,the course of the disease is long,and the therapeutic effect of western medicine is poor,which affects the postoperative recovery of patients. OBJECTIVE:To review the relationship between inflammatory signaling pathways and postoperative fever and the mechanism of Chinese medicine inpreventing and treating fever after posterior lumbar interbody fusion,and to explore new therapeutic drugs for postoperative fever.METHODS:The CNKI Chinese Journal full-text database,WanFang database,and PubMed database were searched for articles published from June 2006 to December 2023. Chinese search terms were "Chinese medicine,postoperative fever,inflammation,interleukin-1,interleukin-6,interleukin-8,interferon gamma,tumor necrosis factor,prostaglandin E2,p38 mitogen-activated protein kinase,nuclear factor-κB,Toll-like receptor,Janus kinases/signal transduction and transcriptional activator,Notch signaling pathway." English search terms were "medicinal herb,postoperative fever,inflammation,interleukin-1,interleukin-6,interleukin-8,γ-interferon,tumor necrosis factor,prostaglandin E2,p38 mitogen-activated protein kinase,nuclear factor-κB,toll-like receptor,janus kinases/signal transducer and activator of transcription,notch signaling pathway." Articles with irrelevant research content and poor quality were excluded,and 100 articles were included and summarized.RESULTS AND CONCLUSION:(1) The operation induced the release of inflammatory factors,and the pro-inflammatory factors acted on the thermoregulatory center in the anterior hypothalamus to promote fever. (2) The absorption of bleeding and oozing fluid in the incision after surgery,and the phagocytosis of the egg white decomposition products of the necrotic cells,produce endogenous pyrogen (interleukin,tumor necrosis factor,interferon,etc.),leading to fever. (3) Cytokines pass through inflammatory signals,play an inflammatory role,and promote fever. (4) Chinese herbs or Chinese herbal compounds can regulate inflammatory signaling pathways and play an anti-inflammatory and antipyretic role in preventing and treating postoperative fever. Due to the lack of the mechanism of action of traditional Chinese medicine,it is necessary to further study and clarify the signaling pathways related to the prevention and treatment of postoperative fever by traditional Chinese medicine,and use modern technology to link cellular and molecular technology with the pharmacological mechanism of traditional Chinese medicine,so as to guide clinicians to use medicine and promote postoperative recovery of patients. (5) Chinese medicine combined with Western medicine in the treatment of postoperative fever is a future research hotspot. We should give full play to the advantages of Chinese medicine,and clarify the target mechanism of action of different syndrome types of Chinese medicine monomer or active ingredient extracts and Chinese medicine decoction.

Objective:To analyze the molecular mechanism of Huangqin Decoction in the treatment of acute lung injury (ALI) with network pharmacology; To conduct experimental validation.Methods:Active compounds and corresponding targets of Huangqin Decoction were retrieved from the TCMIP database. ALI-related targets were obtained from GeneCards, DisGeNet, TTD, and OMIM, and the intersection targets were obtained. The intersection targets were imported into the string database to build the PPI network, and the core targets were obtained through topology analysis by Cytoscape 3.10.1 software. GO and KEGG pathway enrichment analyses were conducted using clusterProfiler software. 16 SD rats were divided into two groups ( n = 8 per group) with random number table method: control and Huangqin Decoction. Rats in the Huangqin Decoction group received Huangqin Decoction by gavage at a dosage of 40 mg/kg, while the control group was administered an equal volume of distilled water. After seven consecutive treatments, drug-containing serum was collected. A549 cells were divided into four groups: control, model, Huangqin Decoction, and received relevant drugs as intervention for 24 h. Levels of SOD, MDA, GSH-Px, IL-1β, TNF-α, and IL-6 in the culture supernatant were measured by ELISA. Apoptosis was analyzed by flow cytometry. The expressions of PI3K, p-PI3K, Akt, p-Akt, mTOR, p-mTOR, LC3Ⅱ/Ⅰ, and Beclin-1 proteins were determined by Western blot. Results:A total of 137 active compounds and 178 common targets were identified in Huangqin Decoction, with TP53, AKT1, STAT3, TNF, IL6, and ESR1 as core nodes. GO enrichment indicated involvement in oxidative stress and responses to lipopolysaccharides, bacterial molecules, and hypoxia. KEGG analysis revealed enrichment in lipid and atherosclerosis, PI3K-Akt signaling pathway, hepatitis, MAPK signaling pathway, prostate cancer, small-cell lung cancer, and mTOR signaling pathway. In cell experiments, compared with the model group, Huangqin Decoction and inhibitor groups showed increased A549xibo ( P<0.05); levels of IL-1β, TNF-α, IL-6, and MDA in the supernatant were reduced ( P<0.05 or P<0.01), while SOD and GSH-Px levels were elevated ( P<0.05 or P<0.01); the apoptosis rate decreased ( P<0.05 or P<0.01); the expressions of LC3-Ⅱ/Ⅰ and Beclin-1 proteins decreased ( P<0.05 or P<0.01), whereas the expressions of p-mTOR/mTOR, p-Akt/Akt, and p-PI3K/PI3K increased ( P<0.05 or P<0.01). Conclusion:Huangqin Decoction exerts protective effects against ALI mainly by reducing cellular autophagy, and its mechanism may be related to the activation of the mTOR/Akt/PI3K signaling pathway.

BACKGROUND:Our previous studies found that decreased expression of connexin 43 and its Ser368 phosphorylation after myocardial hypothermic ischemia-reperfusion was closely associated with decreased cardiac conduction velocity and reperfusion arrhythmia.OBJECTIVE:To observe the effect of changes in membrane-type matrix metalloproteinase 2,matrix metalloproteinase 2 and collagen type Ⅳ on the expression of connexin 43 and its Ser368 phosphorylation and electrical conduction in the myocardial extracellular matrix after hypothermic ischemia-reperfusion.METHODS:Sixteen Langendorff extracorporeal cardiac perfusion models were successfully established from SD rats and randomly divided into a control group(n=8)and a hypothermic ischemia-reperfusion group(n=8).The control group was balanced perfused with 37 ℃ Krebs-Henseleit solution for 15 minutes and then continued to be perfused with 37 ℃ Krebs-Henseleit solution for 90 minutes.The hypothermic ischemia-reperfusion group was balanced perfused with 37 ℃ Krebs-Henseleit solution for 15 minutes,and then the heart was arrested for 60 minutes by injection of 4 ℃ Thomas solution.During the cardiac arrest,the periphery was protected by 4 ℃ Krebs-Henseleit solution.Half-volume 4 ℃ Thomas solution was reperfused 30 minutes after the arrest.After stopping the arrest,the heart was reperfused with 37 ℃ Krebs-Henseleit solution for 30 minutes.The occurrence of arrhythmias,rebeating time,and the duration of arrhythmias were recorded from the immediate time point to the end of the reperfusion period.Conduction velocity,absolute inhomogeneity,and inhomogeneity index were measured using the Mapping Lab multi-channel electrophysiological mapping system at the time of balanced perfusion for 15 minutes(T1),reperfusion for 15 minutes/continuous perfusion for 90 minutes(T2),and reperfusion for 30 minutes/continuous perfusion for 105 minutes(T3).The relative expression levels of membrane-type matrix metalloproteinase 2,matrix metalloproteinase 2,collagen type Ⅳ,connexin 43,and its Ser368 phosphorylation in ventricular tissue were detected by western blot assay.RESULTS AND CONCLUSION:(1)No arrhythmia occurred in the control group.There were six cases of arrhythmia in the hypothermic ischemia-reperfusion group during reperfusion.Rebeating time and duration of arrhythmias were(25.38+12.02)and(158.67±67.68)seconds,respectively.(2)The conduction sochronal diagrams at T1,T2,and T3 in the control group were uniform and regular in direction,and the conduction velocity at T2 and T3 was not different from that at T1(P＞0.05).The conduction isochronal diagrams at T2 and T3 in the hypothermic ischemia-reperfusion group were uneven and irregular in direction,and the conduction velocity was slower than that at T1(P＜0.01).The conduction velocity at T2 and T3 in the hypothermic ischemia-reperfusion group was slower than that in the control group(P＜0.01).Conduction dispersion was greater in the hypothermic ischemia-reperfusion group than that in the control group at T2 and T3(P＜0.05).(3)Compared with the control group,the protein expressions of membrane-type matrix metalloproteinase 2 and matrix metalloproteinase 2 in the hypothermic ischemia-reperfusion group were increased(P＜0.05 or P＜0.01),and the protein expression levels of type Ⅳ collagen,connexin 43 and its Ser368 phosphorylation were decreased(P＜0.05 or P＜0.01).(4)The results indicate that after hypothermic ischemia-reperfusion,myocardial extracellular matrix remodeling may mediate the downregulation of myocardial connexin 43 and its Ser368 phosphorylation,slowed conduction velocity and increased conduction dispersion,thereby increasing the risk of arrhythmia.

BACKGROUND:Postoperative fever is one of the common clinical symptoms after posterior lumbar interbody fusion. There is no clear etiology or pathogenesis. The postoperative body temperature of patients is easy to repeat,the course of the disease is long,and the therapeutic effect of western medicine is poor,which affects the postoperative recovery of patients. OBJECTIVE:To review the relationship between inflammatory signaling pathways and postoperative fever and the mechanism of Chinese medicine inpreventing and treating fever after posterior lumbar interbody fusion,and to explore new therapeutic drugs for postoperative fever.METHODS:The CNKI Chinese Journal full-text database,WanFang database,and PubMed database were searched for articles published from June 2006 to December 2023. Chinese search terms were "Chinese medicine,postoperative fever,inflammation,interleukin-1,interleukin-6,interleukin-8,interferon gamma,tumor necrosis factor,prostaglandin E2,p38 mitogen-activated protein kinase,nuclear factor-κB,Toll-like receptor,Janus kinases/signal transduction and transcriptional activator,Notch signaling pathway." English search terms were "medicinal herb,postoperative fever,inflammation,interleukin-1,interleukin-6,interleukin-8,γ-interferon,tumor necrosis factor,prostaglandin E2,p38 mitogen-activated protein kinase,nuclear factor-κB,toll-like receptor,janus kinases/signal transducer and activator of transcription,notch signaling pathway." Articles with irrelevant research content and poor quality were excluded,and 100 articles were included and summarized.RESULTS AND CONCLUSION:(1) The operation induced the release of inflammatory factors,and the pro-inflammatory factors acted on the thermoregulatory center in the anterior hypothalamus to promote fever. (2) The absorption of bleeding and oozing fluid in the incision after surgery,and the phagocytosis of the egg white decomposition products of the necrotic cells,produce endogenous pyrogen (interleukin,tumor necrosis factor,interferon,etc.),leading to fever. (3) Cytokines pass through inflammatory signals,play an inflammatory role,and promote fever. (4) Chinese herbs or Chinese herbal compounds can regulate inflammatory signaling pathways and play an anti-inflammatory and antipyretic role in preventing and treating postoperative fever. Due to the lack of the mechanism of action of traditional Chinese medicine,it is necessary to further study and clarify the signaling pathways related to the prevention and treatment of postoperative fever by traditional Chinese medicine,and use modern technology to link cellular and molecular technology with the pharmacological mechanism of traditional Chinese medicine,so as to guide clinicians to use medicine and promote postoperative recovery of patients. (5) Chinese medicine combined with Western medicine in the treatment of postoperative fever is a future research hotspot. We should give full play to the advantages of Chinese medicine,and clarify the target mechanism of action of different syndrome types of Chinese medicine monomer or active ingredient extracts and Chinese medicine decoction.

Objective:To construct and evaluate a training program for cardiovascular nurse specialists based on a core competency framework.Methods:Among 61 trainees participating in the first training class for cardiovascular nurse specialists organized by a provincial nursing society, a training program focusing on the nine core competencies for cardiovascular nurse specialists was implemented, which consisted of 4-week theoretical and 4-week practical training. The effectiveness of the training program was evaluated using the Kirkpatrick model. Data analyses were performed by using SPSS 26.0. Categorical data were presented as the number of cases; continuous variables in normal distribution were expressed as mean±standard deviation; and continuous variables in non-normal distribution were presented as median (interquartile range) and compared using non-parametric tests.Results:At the reaction level, the satisfaction rates of trainees with the theoretical and practical sections of the training program were 98.36% (60/61) and 95.08% (58/61), respectively. At the learning level, the comprehensive assessment score of the trainees was (83.01±3.39) points, and all of them successfully obtained their completion certificates, with a pass rate of 100.00% (61/61). At the behavior level, the core competencies for cardiovascular nurse specialists were significantly improved after training [the total score increased from 291.00 (254.00, 334.25) to 410.50 (354.50, 433.00), P<0.001]. At the results level, at six months after training, there were significant increases in the number of participants engaging in cardiovascular care practices, clinical nursing education and guidance, leadership roles, and research projects within their units as well as the number of individuals achieving career advancement (all P<0.05). Conclusions:The trainees are highly satisfied with the core competency-focused cardiovascular nurse training program, which can improve core competencies and cardiovascular nursing capabilities, expand the scope of cardiovascular nursing services, and foster the sustained advancement of the participants.

BACKGROUND:Our previous studies found that decreased expression of connexin 43 and its Ser368 phosphorylation after myocardial hypothermic ischemia-reperfusion was closely associated with decreased cardiac conduction velocity and reperfusion arrhythmia.OBJECTIVE:To observe the effect of changes in membrane-type matrix metalloproteinase 2,matrix metalloproteinase 2 and collagen type Ⅳ on the expression of connexin 43 and its Ser368 phosphorylation and electrical conduction in the myocardial extracellular matrix after hypothermic ischemia-reperfusion.METHODS:Sixteen Langendorff extracorporeal cardiac perfusion models were successfully established from SD rats and randomly divided into a control group(n=8)and a hypothermic ischemia-reperfusion group(n=8).The control group was balanced perfused with 37 ℃ Krebs-Henseleit solution for 15 minutes and then continued to be perfused with 37 ℃ Krebs-Henseleit solution for 90 minutes.The hypothermic ischemia-reperfusion group was balanced perfused with 37 ℃ Krebs-Henseleit solution for 15 minutes,and then the heart was arrested for 60 minutes by injection of 4 ℃ Thomas solution.During the cardiac arrest,the periphery was protected by 4 ℃ Krebs-Henseleit solution.Half-volume 4 ℃ Thomas solution was reperfused 30 minutes after the arrest.After stopping the arrest,the heart was reperfused with 37 ℃ Krebs-Henseleit solution for 30 minutes.The occurrence of arrhythmias,rebeating time,and the duration of arrhythmias were recorded from the immediate time point to the end of the reperfusion period.Conduction velocity,absolute inhomogeneity,and inhomogeneity index were measured using the Mapping Lab multi-channel electrophysiological mapping system at the time of balanced perfusion for 15 minutes(T1),reperfusion for 15 minutes/continuous perfusion for 90 minutes(T2),and reperfusion for 30 minutes/continuous perfusion for 105 minutes(T3).The relative expression levels of membrane-type matrix metalloproteinase 2,matrix metalloproteinase 2,collagen type Ⅳ,connexin 43,and its Ser368 phosphorylation in ventricular tissue were detected by western blot assay.RESULTS AND CONCLUSION:(1)No arrhythmia occurred in the control group.There were six cases of arrhythmia in the hypothermic ischemia-reperfusion group during reperfusion.Rebeating time and duration of arrhythmias were(25.38+12.02)and(158.67±67.68)seconds,respectively.(2)The conduction sochronal diagrams at T1,T2,and T3 in the control group were uniform and regular in direction,and the conduction velocity at T2 and T3 was not different from that at T1(P＞0.05).The conduction isochronal diagrams at T2 and T3 in the hypothermic ischemia-reperfusion group were uneven and irregular in direction,and the conduction velocity was slower than that at T1(P＜0.01).The conduction velocity at T2 and T3 in the hypothermic ischemia-reperfusion group was slower than that in the control group(P＜0.01).Conduction dispersion was greater in the hypothermic ischemia-reperfusion group than that in the control group at T2 and T3(P＜0.05).(3)Compared with the control group,the protein expressions of membrane-type matrix metalloproteinase 2 and matrix metalloproteinase 2 in the hypothermic ischemia-reperfusion group were increased(P＜0.05 or P＜0.01),and the protein expression levels of type Ⅳ collagen,connexin 43 and its Ser368 phosphorylation were decreased(P＜0.05 or P＜0.01).(4)The results indicate that after hypothermic ischemia-reperfusion,myocardial extracellular matrix remodeling may mediate the downregulation of myocardial connexin 43 and its Ser368 phosphorylation,slowed conduction velocity and increased conduction dispersion,thereby increasing the risk of arrhythmia.