The concept of "qi deficiency with stagnation" refers to a pathological state characterized by the depletion of primordial qi， impaired qi transformation， and the development of internal stagnation. Under the cyclic chemotherapy regimen in oncology， chemotherapy-induced myelosuppression follows a progressive pathological course from qi deficiency to increasing stagnation. This sequential evolution from mild to severe myelosuppression closely aligns with the dynamic syndrome differentiation and treatment framework of "qi deficiency with stagnation". "Qi deficiency" reflects the gradual depletion of qi， blood， and essence， while "stagnation" refers to the accumulation of phlegm， turbid dampness， and blood stasis. These two components interact reciprocally， forming a vicious cycle where deficiency leads to stagnation， and stagnation further damages the healthy qi. In the early stage of mild myelosuppression， chemotoxicity begins to accumulate in the bone marrow， leading to qi consumption， blood deficiency， yin injury， and the gradual formation of turbid phlegm and damp stagnation. In the advanced stage of severe myelosuppression， the accumulation of toxicity causes qi sinking， exhaustion of essence， and marrow depletion， along with blood stasis obstructing the collaterals. Treatment strategies should be based on syndrome differentiation， with an emphasis on assessing the severity of the condition， balancing deficiency and excess， and achieving both symptomatic relief and root cause resolution.

Objective To investigate the serum levels of Sestrin2 and Survivin in patients with acute myo-cardial infarction(AMI)and their correlation with the degree of coronary artery stenosis.Methods A total of 120 AMI patients admitted to Hanzhong 3201 Hospital from October 2020 to December 2022 were selected as the observation subjects,and there were 67 cases of ST-segment elevation myocardial infarction(STEMI)and 53 cases of non-ST-segment elevation myocardial infarction(NSTEMI).According to the Gensini score,pa-tients were grouped into mild stenosis group and severe stenosis group,60 patients who underwent coronary angiography(stenosis degree＜50％)at the same time and did not meet the diagnosis standard of AMI were regarded as the control group.The levels of serum Sestrin2 and Survivin were detected by enzyme linked im-munosorbent assay,Spearman method was used for correlation analysis,and receiver operating characteristic curve was applied to analyze the diagnostic value of serum Sestrin2 and Survivin in severe stenotic AMI.Results There were statistically significant differences in brain natriuretic peptide,troponin,creatine kinase isoenzyme,left ventricular ejection fraction,fasting plasma glucose among the control group,NSTEMI group and STEMI group(P＜0.05).Compared with the control group,the levels of serum Sestrin2 and Survivin in NSTEMI group and STEMI group were obviously higher(P＜0.05).Serum Sestrin2 and Survivin levels in-creased with the increase of coronary artery lesion number and stenosis degree in AMI patients(P＜0.05).Serum Sestrin2 and Survivin levels were positively correlated with the number of coronary lesions,SYNTAX score and Gensini score in AMI patients(P＜0.05).The area under the curve(AUC)of serum Sestrin2 and Survivin in diagnosis of severe stenotic AMI alone and in combination were 0.840,0.823 and 0.920,respec-tively,and AUC of the combined detection was larger than those of singe detection(P＜0.05).Conclusion The serum levels of Sestrin2 and Survivin in patients with AMI are increased,they are related to the degree of coronary artery stenosis,and they may become marker to evaluate the degree of coronary artery disease.

Objective: To compare the adverse events, immune status, and short-term efficacy between chronomodulated chemotherapy (CCR) and routine chemotherapy (RCR) combined with intensity modulated radiotherapy (IMRT)in the treatment of patients with locally advanced nasopharyngeal carcinoma. Methods: A total of 159 patients with newly diagnosed locally advanced nasopharyngeal carcinoma were randomized into the CCR group and the RCR group to evaluate the short-term efficacy and adverse events. Results: No significant difference was found in CR, PR, SD, and PD between the CCR group and the RCR group (P>0.05), and no significant difference was observed in the response rate (CR+ PR) between the two groups (P>0.05). The incidence of leukopenia(Z=-2.222, P<0.05), neutropenia(Z=-1.999, P<0.05), vomiting(Z=-2.298, P<0.05), and oral mucositis(Z=-3.571, P<0.05)of the CCR group was lower than those of the RCR group with statistical significance. The CD16+ 56+ lymphocyte cell count was higher in the CCR group than that in the RCR group(Z=-2.332, P<0.05). Conclusions As a novel invention, CCR combined with IMRT can reduce the incidence and severity of treatment-related adverse events and improve immune status without diminishing clinical efficacy, therefore deserving clinical application.

Objective To investigate serum complement 1q (C1q) levels in the patients with coronary artery disease (CAD),and evaluate its clinical values in predicting and discriminating acute coronary syndrome (ACS) and stable coronary artery disease (SCAD).Methods A total of 52 ACS patients,66 SCAD patients and 54 healthy controls were enrolled in this study.Their serum C1q and oxidized low-density lipoprotein (ox-LDL) levels were detected by an immune turbidimetric method and an enzyme linked immunosorbent assay,respectively.Their serum total cholesterol,triglyceride,high-density lipoprotein cholesterol and low-density lipoprotein cholesterol levels were also determined.Then,the Gensini scores in CAD patients were calculated,and the clinical values of Clq in predicting and discriminating ACS and SCAD were evaluated by stepwise multiple linear regression analysis and Logistic regression analysis.Results Serum C1q and ox-LDL levels in ACS (C1q:t =4.405,P＜0.001;ox-LDL:Z=5.941,P＜0.001) and SCAD (C1q:t =2.320,P=0.022;ox-LDL:Z =4.119,P ＜0.001) patients were significantly higher than those in healthy controls.Moreover,serum C1q (t =2.344,P =0.021) and ox-LDL (Z =2.166,P =0.030) levels in ACS patients were significantly higher than that in SCAD patients.Serum C1 q levels were positively correlated with serum ox-LDL (r =0.246,P =0.028) and TG (r =0.232,P =0.002) levels and Gensini scores (r =0.341,P =0.020) in ACS patients.The stepwise multiple regression analysis showed that serum ox-LDL levels were still independently correlated with serum C1 q levels in ACS patients (β =0.676,P =0.045,adjusted R2 =0.380) after adjusting for age,gender and other biochemical markers.The Logistic regression analysis showed that the increased serum C1q and ox-LDL levels were closely related to the occurrence of ACS (C1q:OR =1.05,95％ CI =1.03-1.08,P ＜ 0.001;ox-LDL:OR =1.18,95％ CI =1.08-1.29,P ＜0.001) and SCAD (C1q:OR =1.04,95％CI=1.01-1.06,P=0.003;ox-LDL:OR=I.11,95％CI=1.03-1.18,P=0.004),and that they could discriminate ACS and SCAD (C 1 q:OR =1.01,95 ％ CI =1.00-1.03,P =0.022;ox-LDL:OR =1.06,95 ％ CI =1.01-1.12,P =0.023).Conclusion Serum C1q levels increase significantly in CAD patients,and that of ACS patients is significantly higher than SCAD patients.In ACS patients,serum C1q levels are independently correlated with ox-LDL levels.Serum C1q levels may be served as a novel biomarker for the prediction and discrimination of ACS and SCAD.