OBJECTIVE To evaluate the efficacy and safety of high-dose ilaprazole combined with amoxicillin for newly diagnosed elderly patients with Helicobacter pylori （Hp） infection， and analyze independent risk factors for failure of Hp infection eradication treatment. METHODS Totally 200 cases of newly diagnosed elderly patients with Hp infection in Xinxiang Central Hospital from August 1， 2021 to December 1， 2024 were selected and randomly divided into control group and study group， with 100 cases in each group. The control group was treated with classic quadruple therapy regimen （Amoxicillin capsules+ Clarithromycin tablets+Bismuth potassium citrate tablets+Ilaprazole enteric-coated tablets）. The study group was treated with high- dose Ilaprazole enteric-coated tablets+Amoxicillin capsules. All patients were administered medication for 2 weeks. Hp eradication rates in the two groups were compared using intention-to-treat （ITT） and per-protocol （PP） analyses. The incidence of adverse reactions in both groups was also recorded. The multiple-factor Logistic regression analysis was used to identify independent risk factors for failure of Hp infection eradication treatment. RESULTS In ITT and PP analyses， there was no significant difference of Hp eradication rates between the two groups （P＞0.05）. There was no significant difference in incidence of mild to moderate adverse reactions between the two groups （P＞0.05）. BMI ≤18.5 kg/m2， BMI ＞23.9 kg/m2， rural residence， concomitant diabetes and concomitant heart disease were identified as independent risk factors influencing the failure of Hp infection eradication treatment （P＜0.05）. CONCLUSIONS The efficacy and safety of high-dose ilaprazole combined with amoxicillin are comparable to classic quadruple therapy regimen in treating newly diagnosed elderly patients with Hp infection. Independent risk factors influencing the failure of Hp infection eradication treatment include BMI ≤18.5 kg/m2， BMI ＞23.9 kg/m2， rural residence， concomitant diabetes and concomitant heart disease.

As a Chinese saying goes， "good Chinese medicinal material makes good medicine"， the quality of Chinese herbal medicines is related to the development prospect of Chinese medicine industry in China. With the rapid development of new technologies such as traceability methods and monitoring instruments， it is imperative to integrate and innovate traditional Chinese herbal medicines with new-generation information technology in view of the quality problems existing in the current production and circulation of Chinese herbal medicines， and it is of great significance for the construction of traceability system to ensure the quality and safety of Chinese herbal medicines and to promote the industry of Chinese herbal medicines to move towards high-quality development. This paper reviews the development history of the traceability system of Chinese herbal medicines in China， takes the influencing factors of the quality of Chinese herbal medicines as the entry point， and proposes that the construction of the traceability system should satisfy the traceability requirements of the characteristics of Chinese herbal medicines and their traditional medication experience. By analyzing the influencing factors of the quality of Chinese herbal medicines， it is pointed out that focusing on the influencing factors to build a traceability system is of great significance for targeting the problematic links at a later stage and exploring the interrelationship between environmental factors and the quality of Chinese herbal medicines. Based on the previous explorations， the author summarizes the system framework， functional modules and practical applications of the traceability system of Chinese herbal medicines， and looks forward to the development of a traceability system with risk early warning function and expert decision-making function in its functional development. Finally， based on the factors affecting the quality of Chinese herbal medicines， the author puts forward several thoughts on construction of the traceability system， and makes an in-depth analysis and puts forward a solution for the current situation that a unified， standardized and universal traceability system has not yet been built， with a view to providing ideas and references for the construction of traceability system of Chinese herbal medicines.

Objective To observe the incidence of pericardial tamponade(PT)after left atrial appendage closure(LAAC)in patients with non-valvular atrial fibrillation(NVAF),and to explore its related factors and outcomes.Methods NVAF patients who were hospitalized and treated with LAAC in Department of Cardiology of our hospital from August 2014 to March 2023 were selected for the study.The general clinical data,preoperative transthoracic echocardiography and transesophageal echocardiography data,results of routine preoperative laboratory tests,intraoperative data and follow-up data of the patients were collected through the hospital medical record management system.The enrolled patients were classified into the non-PT group(n=8)and the PT group(n =1184)according to whether PT occurred after LAAC or not.The incidence of PT,related risk factors and outcomes were statistically analyzed.Results This study included 639 males(53.6%)and 553 females(46.4%),with an average age of 68.1±9.65 years.The CHA2 DS2-VASc score was 4.51±1.72,and the HAS-BLED score was 3.36±1.09.PT occurred in 8 cases(0.67%),among them,6 cases occurred 1 to 33 h after LAAC,and 2 cases occurred on day 19 and day 27 after LAAC.As for the results of transesophageal echocardiography(TEE)and LAA angiography,compared with the non-PT group,the PT group had the significantly larger maximum caliber of the LAA(P=0.025,P=0.015),smaller maximum depth of the LAA(P=0.028,P=0.031),and lower success rate of one-time placement of the occluder(P=0.031);The occluder compression rate of the PT group was significantly greater than that of the non-PT group(P=0.046).Multivariate analysis showed that larger maximum diameter of LAA,smaller average effective depth of LAA and larger compression rate of occluder were the main risk factors for PT.All the 8 PT patients were cured by stopping antithrombotic drugs,pericardiocentesis or surgical drainage.During a mean follow-up of 39±27 months,there were no device-related thrombosis(DRT),ischemic stroke,systemic embolism and other complications in the PT group.Conclusion The incidence of PT after LAAC is low,which is related to the large diameter of LAA,the relatively insufficient depth of the LAA and the large compression rate of the occlude.PT can be cured by stopping antithrombotic drugs and pericardiocentesis/surgical drainage.

TCM functional exercises are the important means of TCM to prevent and cure diseases. By adjusting the bones and muscles externally, adjusting the heart and organs internally, promoting blood circulation, improving sleep disorders, enhancing metabolism and immune capacity, the aim of preventing and treating diseases, prolonging life span, and strengthening the body is achieved. TCM exercises have a significant effect on the treatment of various types of fatigue such as chronic fatigue syndrome, Exercise-induced fatigue, post-stroke fatigue, and cancer-related fatigue.

Objective: To investigate the prevalence and influencing factors of work-related musculoskeletal disorders (WMSDs) in neck and shoulder among workers in pharmaceutical and chemical enterprises, so as to provide the basis for prevention of WMSDs. Methods: Workers in 8 pharmaceutical and chemical enterprises in Jinhua City, Zhejiang Province from July to October 2023 were sampled using a stratified random sampling method, and demography, work conditions and WMSDs prevalence were collected using questionnaire surveys. Factors affecting WMSDs in neck and shoulder were analyzed using a multivariable logistic regression model. Results: A total of 1 343 workers were surveyed, including 496 males (36.93%) and 847 females (63.07%). The mean age of workers was 38 (15) years, and the length of service in current posts was 6 (8) years. There were 356 workers with WMSDs (26.51%), with 206 workers with neck WMSDs (15.34%) and 167 workers with shoulder WMSDs (12.43%). Multivariable logistic regression analysis showed that gender (female, OR=1.692, 95%CI: 1.203-2.381), sufficient rest time (OR=0.660, 95%CI: 0.471-0.926) and maintaining same neck posture for a long time (OR=1.690, 95%CI: 1.148-2.510) were factors affecting neck WMSDs; gender (female, OR=1.572, 95%CI: 1.060-2.311), sufficient rest time (OR=0.619, 95%CI: 0.422-0.906), repetitive daily work (OR=1.678, 95%CI: 1.064-2.647), uncomfortable work posture (OR=3.791, 95%CI: 1.330-10.803), multiple repetitive movements per minute (OR: 1.988-2.413, 95%CI: 1.060-4.161) and maintaining same neck posture for a long time (OR=1.926, 95%CI: 1.218-3.043) were factors affecting shoulder WMSDs. Conclusion The prevalence of WMSDs in neck and shoulder are high among workers in pharmaceutical and chemical enterprises in Jinhua City, and mainly affected by gender, rest time and adverse ergonomics.

Objective To observe the effect of coronary reperfusion therapy on the differential ex-pression of plasma exosomal miRNAs in patients with acute myocardial infarction(AMI).Meth-ods Three elderly male AMI patients undergoing coronary reperfusion therapy in our hospital from October to November 2022 were recruited in this study.The venous blood samples were col-lected at admission and 2 and 24 h after recanalization.MiRNA-sequencing was used to screen the differentially expressed miRNAs which were commonly expressed in the plasma exosomes of the 3 patients.Bioinformatics analysis was performed on the target genes,and then the differentially expressed miR-499a-5p was verified by qPCR.Results Compared with the plasma exosomal miRNAs at admission,there were 418 up-regulated and 406 down-regulated miRNAs at 2 h after operation,and 320 up-regulated and 225 down-regulated miRNAs at 24 h after operation(P＜0.05);Compared with the miRNAs at 2 h after operation,there were 344 up-regulated and 350 down-regulated ones at 24 h after operation(P＜0.05).Kyoto Encyclopedia of Genes and Ge-nomes enrichment analysis showed that the differentially expressed miRNAs were enriched in phosphatidylinositol-3-kinase-protein kinase B,hypoxia-inducible factor 1,and vascular smooth muscle contraction pathways.Gene Ontology analysis indicated that the molecular functions of dif-ferentially expressed miRNA target genes were mainly enriched in protein binding and DNA bind-ing;cellular components were mainly enriched in cell membrane and cytoplasm;and biological processes were mainly enriched in signaling and transcription of DNA templates.The miR-499a-5p level was significantly lower at 2 h postoperatively than at admission[(0.577±0.020)vs(1.000± 0.023),P＜0.05],and at 24 h postoperatively than at 2 h postoperatively[(0.068±0.006)vs(0.577±0.020),P＜0.05].Conclusion Plasma exosomal miRNAs can be used as a biomarker for early diagnosis of elderly AMI patients and for predicting the efficacy of reperfusion therapy.

[摘 要] 目的：探讨内吞作用相关基因FCHO2在各亚型乳腺癌中的表达及其与乳腺癌患者的预后和免疫细胞浸润的相关性。方法：应用免疫组化法和bc-GenExMiner v5.0数据库数据分析FCHO2在各亚型乳腺癌组织中的表达，通过GEO和TIMER数据库数据分析FCHO2与各亚型乳腺癌患者预后和免疫细胞浸润的关系，利用STRING和GEPIA数据库数据分析与FCHO2的互作蛋白网络和其与互作蛋白的相关性，通过UALCAN和DAVID数据库数据对乳腺癌组织中FCHO2表达相关基因进行KEGG和GO分析。结果：免疫组化法结果显示，FCHO2在管腔型和HER2+乳腺癌组织中均呈高表达（均P<0.05），且与HER2和Ki67表达有关联（P=0.03和P=0.007）。FCHO2高表达的管腔型乳腺癌患者总生存期（OS）和无复发生存期（RFS）均明显缩短（均P<0.05）。FCHO2蛋白与EPS15等多种蛋白表达相关且构成蛋白-蛋白互作网络。KEGG和GO分析显示，乳腺癌组织中FCHO2相关表达基因主要与昼夜节律、自噬等生物学过程有关，涉及叉头框蛋白O（FoxO）和TGF-β等信号通路。FCHO2表达与各亚型乳腺癌组织中的免疫细胞浸润相关（均P<0.05）。结论：FCHO2在管腔型、HER2+乳腺癌组织中呈高表达，且与管腔型乳腺癌患者预后及免疫细胞浸润相关，其可能成为乳腺癌治疗的潜在靶点。

[摘 要] 目的：探讨内吞作用相关基因FCHO2在各亚型乳腺癌中的表达及其与乳腺癌患者的预后和免疫细胞浸润的相关性。方法：应用免疫组化法和bc-GenExMiner v5.0数据库数据分析FCHO2在各亚型乳腺癌组织中的表达，通过GEO和TIMER数据库数据分析FCHO2与各亚型乳腺癌患者预后和免疫细胞浸润的关系，利用STRING和GEPIA数据库数据分析与FCHO2的互作蛋白网络和其与互作蛋白的相关性，通过UALCAN和DAVID数据库数据对乳腺癌组织中FCHO2表达相关基因进行KEGG和GO分析。结果：免疫组化法结果显示，FCHO2在管腔型和HER2+乳腺癌组织中均呈高表达（均P<0.05），且与HER2和Ki67表达有关联（P=0.03和P=0.007）。FCHO2高表达的管腔型乳腺癌患者总生存期（OS）和无复发生存期（RFS）均明显缩短（均P<0.05）。FCHO2蛋白与EPS15等多种蛋白表达相关且构成蛋白-蛋白互作网络。KEGG和GO分析显示，乳腺癌组织中FCHO2相关表达基因主要与昼夜节律、自噬等生物学过程有关，涉及叉头框蛋白O（FoxO）和TGF-β等信号通路。FCHO2表达与各亚型乳腺癌组织中的免疫细胞浸润相关（均P<0.05）。结论：FCHO2在管腔型、HER2+乳腺癌组织中呈高表达，且与管腔型乳腺癌患者预后及免疫细胞浸润相关，其可能成为乳腺癌治疗的潜在靶点。

Objective:To investigate the trend of radiological diagnostic examination frequency and the related influencing factors in a general hospital in recent four years.Methods:The hospital information system and the radiology information system were used to collect the information on the numbers of the outpatients, the emergency patients, and the inpatients and the radiology examination information from 2019 to 2022. The examination frequency and proportion of various imaging equipment were counted by using the perspective table of data, and the examination items and the proportion of the radiological diagnostic examinations were calculated. The positive rates of the radiological examinations were measured from 2019 to 2022. The gender and age distribution of the patients were analyzed. Spearman correlation analysis was used to analyze the relationships between the numbers of the patients undergoing radiological examinations and the numbers of the outpatients, emergency patients and the inpatients.Results:The annual frequency of radiological diagnostic examinations from 2019 to 2022 were 307 306, 245 418, 317 250 and 325 625, respectively, with a total of 1 195 599. Among them, the proportions of CT, X-rays, bedside X-rays, bone density, gastrointestinal imaging and mammography were 59.74%, 38.04%, 1.39%, 0.42%, 0.21% and 0.19%, respectively. In each year, the proportion of CT in all radiological diagnostic examinations was 49.58%, 63.40%, 60.40% and 65.20%, respectively. The frequency of emergency CT and emergency chest CT was correlated with the number of emergency patients( r =0.63, 0.61, P<0.05), and the frequency of non-emergency CT was correlated with the number of outpatients and inpatients ( r =0.61, 0.66, P<0.05). The positive rates of the CT examinations were higher than 80% except the lowest of 79.95% in 2021. Conclusions:Radiological examinations especially CT examinations have increased significantly, and played an important role in the diagnosis of diseases. However, attention should be paid to the Justification of the CT examinations. Timely statistical analysis of radiological examination information can provide data supports and references for scientific management of radiological examinations.

TCM believes that spleen deficiency is the root cause of emotional abnormalities in chronic fatigue syndrome (CFS), and clinical treatment often involves the heart, liver and kidney. TCM therapy has a significant efficacy in CFS emotional abnormalities. It is mostly treated with oral administration of TCM, acupuncture, moxibustion and massage therapy. It may play a therapeutic role by improving oxidative stress and immune inflammation, regulating nerve-endocrine, controlling energy metabolism and other ways. It is suggested to establish the syndrome differentiation standard of CFS emotional abnormality in the future, so as to improve the accuracy of syndrome differentiation and treatment; form a perfect treatment guide or expert consensus to guide the standardized application of various internal and external treatment methods; explore objective indicators based on the pathogenesis, and focus on the morphological and functional changes of disease target brain regions with the help of neuroimaging techniques, so as to improve the diagnosis and prognosis evaluation of CFS; based on the guidance of TCM theory, improve the CFS emotional abnormal animal modeling method.