This paper summarized the experience of Professor FANG Dingya in staged treatment of Sjögren's syndrome from the perspective of dryness toxin. It is believed that the cause of Sjögren's syndrome is externally-contracted dryness， consumption of essence and fluid， congenital and acquired essence deficiency， depleted essence and insufficient blood， and the core mechanism is internal accumulation of dryness toxin. The treatment can be divided into three stages， that is dryness toxin transforming into fire-heat， damp-heat and phlegm-stasis， from the perspective of dryness metal qi transformation. It is emphasized to dispel pathogen mainly， to clear and moisten with yin-nourishing medicinals in supplementation， and to treat by stages based on syndrome differentiation. For dryness toxin with fire-heat， it is suggested to moisten dryness， resolve toxins and subdue fire， with self-made Runzao Jiedu Decoction （润燥解毒汤） in modification. For dryness toxin with damp-heat， the method of nourishing yin， clearing heat and draining dampness should be used， and Chunze Decoction （春泽汤） in modification is suggested. For dryness toxin with phlegm-stasis， it is recommended to unblock collaterals， disperse phlegm and dissipate stasis， with self-made Sanyu Xiaotan Decoction （散瘀消痰汤） in modification.

Objective:To analyze the evaluation of the application effect and deficiency of nurses acting as standardized parents in the graduation examination of standardized residency training of pediatrics and further improve and promote the level of standardized parents.Methods:A questionnaire survey was used to collect the scores of nurse standardized parents by students and examiners who took part in the graduation examination of standardized residency training of pediatrics in 2021. And the self-evaluation scores of standardized parents were collected. Counting data were represented by the number of cases and composition ratio. A Chi-square test was used to compare the rates.Results:A total of 125 questionnaires from students and 37 questionnaires from nurse standardized parents were collected, and the overall satisfaction (very satisfied + satisfied) of standardized parents reached 121 (96.80%). In the three dimensions of simulation ability, compliance with question-and-answer rules, and simulated attitude, students believed that the consistency between standardized parents and actual parents in simulated altitude was lower than that in the simulation ability and compliance with question-and-answer rules ( P=0.007, P=0.001). The overall satisfaction of standardized parents (very satisfied + satisfied) reached 87.38% (388/444). There were 26 (70.27%) nurse standardized parents who had the lowest satisfaction with their own performance ability, followed by 28 (75.68%) cases of imitation ability and 30 (81.08%) cases of adaptability. Conclusions:It is feasible to adopt nurse standardized parents in the assessment of standardized residency training of pediatrics, and both students and examiners have higher satisfaction. The next step is to improve the training of nurses standardized parents in the attitude of simulation and, at the same time, enhance the training of imitation ability and adaptability, so as to further expand the construction of standardized parents.

Purpose To explore the influence of different spin-locking frequencies on T1ρ values based on a 3.0T MR system.Materials and Methods Thirty-eight healthy adult volunteers underwent cardiac magnetic resonance imaging at the First Affiliated Hospital of Anhui Medical University from July to September 2023.T1ρ mapping and short-axis cine imaging with steady-state free precession sequences were performed with 3.0T MR system.T1ρ mapping sequence in three short-axis slices with three spin-lock frequencies at the amplitude of 5 Hz,300 Hz,400 Hz,and 500 Hz was scanned,respectively.T1ρ relaxation times and myocardial fibrosis index were quantified for each slice and each myocardial segment,the difference in T1ρ of different spin-locking frequencies and myocardial fibrosis index was analyzed using one-way repeated-measures analysis of variance method.Results T1ρ of 5 Hz,300 Hz,400 Hz,and 500 Hz were(33.9±2.8)ms,(43.4±2.1)ms,(45.4±2.6)ms and(46.5±2.4)ms,respectively;and T1ρ values showed a significant progressive increase from the low spin-lock frequency to the high spin-lock frequency of the heart(300 Hz vs.400 Hz:P<0.001;300 Hz vs.500 Hz:P<0.001;400 Hz vs.500 Hz:P=0.043).In addition,the measured myocardial fibrosis index at 300 Hz,400 Hz and 500 Hz were(9.4±2.2)ms,(11.3±2.9)ms and(12.6±2.7)ms,respectively.Statistical analysis underscored significant variations among these measurements(300 Hz vs.400 Hz:P<0.001;300 Hz vs.500 Hz:P<0.001;400 Hz vs.500 Hz:P=0.033).Conclusion In this prospective study,myocardial T1ρ values for the specific cardiac magnetic resonance setting are provided,and we found that spin-lock frequency can affect the T1ρ values.

Purpose To explore the changes in biventricular volume and mass in chronic kidney disease(CKD)patients with preserved ejection fraction using cardiac magnetic resonance(CMR),and evaluate cardiac function using tissue-tracking strain analysis.Materials and Methods The retrospective analysis of 40 CKD patients without symptoms of cardiovascular disease,diabetes and the estimated glomerular filtration rate<60 ml/(min·1.73 m2)who were treated at the First Affiliated Hospital of Anhui Medical University from October 2020 to June 2023 and 25 age-and gender-matched healthy volunteers.All participants underwent 1.5T CMR scans to calculate left and right ventricular function,myocardial strain and native T1 and T2 values,and differences in various imaging parameters between the two groups were compared.Results The native T1 value[(1 109.6±35.9)ms]and T2 value[(58.1±2.9)ms]of CKD patients were significantly higher than those in control group[(1 046.3±15.9)ms,(53.3±2.3)ms](t=8.296,6.916,both P<0.001).The left ventricular end-diastolic volume index,left ventricular end-systolic volume index,left ventricular mass index,right ventricular end-diastolic volume index,right ventricular end-systolic volume index and right ventricular mass index of CKD patients were significantly increased compared with the control group(t=3.233,3.350,5.751,7.746,5.937,2.363,all P<0.05),while the left and right ventricular strain parameters,left ventricular global longitudinal strain,left ventricular global circumferential strain,left ventricular global radial strain,right ventricular global longitudinal strain,right ventricular global circumferential strain and right ventricular global radial strain were significantly decreased(t=9.506,9.072,-10.603,10.496,11.574,-4.018,all P<0.001),and the estimated glomerular filtration rate exhibited significant correlations with left ventricular global longitudinal strain(r=-0.636),left ventricular global radial strain(r=0.688),right ventricular global longitudinal strain(r=-0.513),right ventricular global circumferential strain(r=-0.827)and right ventricular global radial strain(r=0.514)(all P<0.001).Conclusion CMR can quantitatively assess myocardial fibrosis and edema in patients with CKD,and tissue tracking strain analysis can detect myocardial motion abnormalities before changes in ventricular ejection fraction,offering value in the early detection of cardiac involvement in CKD patients..

Objective:To investigate the status quo of thriving at work, career resilience and voice behavior in organ transplantation nurses, and mediation effects of thriving at work between the latter two.Methods:From June to August 2018,180 nurses with organ transplant qualification departments in two Grade A hospitals in Fuzhou, Fujian Province were investigated by the general situation survey form, Thriving At Work Scale, Career Resilience Scale and Voice Behavior Scale.Results:The scores of thriving at work, career resilience and voice behavior were 3.68 ± 0.65, 3.56 ± 0.61 and 3.42 ± 0.62. There was a pairwise positive correlation among the three: thriving at work, career resilience and voice behavior( r values were 0.270-0.664, all P<0.05). Thriving at work played a partial mediating role between career resilience and voice behavior ( B values were 0.138-0.611, all P<0.05). Conclusions:Ii is necessary to improve thriving at work, career resilience and voice behavior in organ transplantation nurses. Thriving at work is the intermediary factor between the latter two. The improvement of thriving at work and career resilience will help to promote organ transplant specialist nurses to make positive voice behavior.

Hepatogenous diabetes (HD) is a common complication of end-stage liver disease, and many studies have confirmed its adverse effect on prognosis. In recent ten years, a great number of studies have been conducted on the pathogenesis of HD and some progress has been made. This article reviews the research advances in the pathogenesis of HD, in order to provide a reference for the diagnosis and treatment of HD by clinicians.

Both diabetes mellitus and liver cirrhosis have high incidence rate and mortality rate around the world, and in recent ten years, scholars in China and globally have conducted many studies on the association between diabetes mellitus and liver cirrhosis. This article systematically reviews the advances in the basic and clinical research on the influence of diabetes mellitus on liver cirrhosis and its complications and summarizes possible mechanisms. The results show that diabetes mellitus can accelerate the process of liver fibrosis, increase the risk of complications and progression to liver cancer in patients with liver cirrhosis, and reduce their survival rate.

Objective:To understand the characteristics of the HIV-1 molecular networks in injected drug users (IDUs) in Guangzhou from 2008 to 2017, and provide reference for the prevention and control of AIDS in this population.Methods:The serum samples of newly diagnosed HIV-1 positive IDUs in Guangzhou from 2008 to 2017 were collected, HIV-1 RNA was extracted for pol gene amplification and sequencing. The molecular cluster in the phylogenetic tree was identified by Cluster Picker 1.2.3 for cluster analysis. TN93 model in HyPhy2.2.4 was used to calculate the gene distance between the cluster sequences. Software Cytoscape3.8.2 was used to visualize the molecular network, and χ2 test or exact probability method was used for cluster analysis and centrality analysis. Results:A total of 586 sequences were successfully amplified (73.9%, 586/793), and 80 molecular clusters were produced, with a clustering rate of 46.6% (273/586). In molecular clusters, the proportions of the strains from IDUs in Han ethnic group (48.4%, 260/537), IDUs who were local residents in Guangdong (52.7%, 146/277) and IDUs whose strain sequence subtype was CRF55_01B (93.3%, 14/15) were higher. In the molecular network, the degree range was 1-7, and nodes with degree ≥3 accounted for 12.8% (24/187), which was associated with another 81 nodes in the molecular network (43.3%, 81/187). The centrality analysis showed that the proportions of housework/unemployed with high degree centrality (19.0%, 19/100), high intermediary (22.0%, 22/100), and high proximity centrality (32.0%, 32/100) were higher in IDUs infected with HIV-1.Conclusion:The risk of HIV-1 clustering in IDUs in Guangzhou was high, suggesting that IDUs who were from both Guangdong and Guangxi and were house workers or unemployed should be viewed as the key targets, and precise intervention should be implemented to reduce the HIV-1 infection rate in this population.

With the development of the times, the comprehensive treatment technology of breast conserving or modified radical mastectomy plus radiotherapy for breast cancer has become more mature and perfect. As the first station of lymphatic drainage of breast, internal mammary lymph nodes have been paid much attention. At present, there is a controversy about whether the internal mammary lymph nodes are irradiated or not. Previous studies have shown that local lymph nodes irradiation containing internal mammary lymph nodes has survival benefit value. However, as a part of regional lymph nodse irradiation, internal mammary lymph nodes irradiation has also been proved to increase the toxicity of heart and lung, which leads to some research institutions and scholars to remain skeptical about internal mammary lymph nodes irradiation. In recent years, with the improvement of radiotherapy technology and equipment and the accumulation of clinical experience, more and more scholars tend to accept internal mammary lymph nodes radiotherapy. But we should pay attention to the indications of internal mammary lymph nodes irradiation, in order to select appropriate treatment options to achieve real benefits.

Background Clinical work found that triamcinolone acetonide (TA)bleeding during vitrectomy in proliferative diabetic retinopathy (PDR),but its mechanism is not clear.Objective This study was to explore the anastalsis of TA in vitrectomy for PDR.Methods A prospective study was performed.Twelve eyes of 12 patients who received vitrectomy combined with the intraocular use of TA for PDR were in cluded in Tianjin Medical University General Hospital from 2011 to 2014 and served as TA group.Thirty-two eyes of 32 patients who underwent vitrectomy for epimacular membrane or macular hole were enrolled as control group.The vitreous specimens of 0.6 ～0.8 ml was collected during the surgery.The concentrations of urokinase plasminogen activator (u-PA),tissue plasminogen activator (t-PA) and plasminogen activator inhibitors 1 (PAI-1) in vatreous were measured by ELISA.Results The mean contents u-PA,t-PA and PAI-1 in the vatreous were 25.45,127.44 and 0.42 ng/ml respectively in the TA group,and those the mean contents in the control group were 22.94,142.37 and 0.27 ng/ml respectively,shouwing a significant difference between the TA group and the control group (Z=-2.268,P＜0.05).NO significant difference was found in vitreous t-PA and PAI-1 between TA and control groups (Z =-0.092,-1.847,both at P＞0.05).Conclusions Vitreous u-PA content is increased in PDR eyes,which is more likely to lead bleeding.Anastalsis of TA during vitrectomy for PDR may be relatived to decreasing vitreous t-PA and u-PA contents as well as increasing PAI-1 contents.