Chronic atrophic gastritis is a common and frequent disease in clinical practice. The symptoms of this disease can be attributed to the categories of " gastric pain" and " plumpness" in traditional Chinese medicine,and its pathogenesis is closely related to the dysfunction of xuanfu,qi-fluids,and stomach collaterals. In this study,we systematically rationalize the historical origin of the xuanfu,qi-fluids,and stomach collaterals and the relationship between them. According to the structure,physiological function and pathological characteristics of " xuanfu-qi-fluids-stomach collaterals",combined with the evolution of the chronic atrophic gastritis disease process,xuanfu depression and closure is believed to be the direct cause of chronic atrophic gastritis occurrence. The disharmony between qi and fluids is the core of the progression of chronic atrophic gastritis. Collateral deficiency and toxin damage are the root causes of the progression of chronic atrophic gastritis. Based on the mechanism of "xuanfu depression and closure-the disharmony between qi and fluids-collateral deficiency and toxin damage",it is proposed to open the xuanfu,restore the pivotal mechanism,activate blood circulation and diuresis,propagate qi and fluids,and supplement deficiency to unblock collaterals. From the perspective of "xuanfu-qi-fluids-stomach collaterals ",a more systematic and comprehensive understanding of the dynamic development process of chronic atrophic gastritis can be achieved,which will provide new ideas for the treatment of this disease in traditional Chinese medicine.

To study the clinical correlation between fasting plasma glucose, lipid metabolism, prostate-specific antigen and prostate volume in patients with benign prostatic hyperplasia, and to explore the combined effect as diagnostic indicators. A total of 108 patients with benign prostatic hyperplasia treated in Beijing University of Chinese Medicine Third Affiliated Hospital from June 2021 to March 2023 were retrospectively analyzed as the hyperplasia group, and 98 healthy physical examination personnel were selected as the control group during the same period. Compare the differences in levels of fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), small and dense low-density lipoprotein cholesterol (sdLDL-C), homocysteine, lipoprotein a (LPa), prostate specific antigen (PSA), and free prostate specific antigen (fPSA) between two groups of patients. Using Pearson analysis method to analyze the correlation between the above indicators and the size of prostate volume in patients with benign prostatic hyperplasia; using multiple linear regression to analyze the influencing factors of prostate volume enlargement; draw receiver operating characteristic (ROC) curves and analyze the application value of individual and combined detection of HDL, FPG, PSA, and fPSA. The results showed that there were significant differences in HDL, FPG, PSA, and fPSA levels between the control group and the proliferative group( P<0.05). The size of prostate volume is negatively correlated with HDL( r=-0.183, P<0.05) and positively correlated with FPG ( r=0.202, P<0.05), PSA( r=0.412, P<0.05), and fPSA( r=0.425, P<0.05). The results of multiple linear regression analysis showed that HDL( P=0.000), FPG( P=0.048), PSA( P=0.044), and fPSA ( P=0.012) were risk factors for increased volume of benign prostatic hyperplasia; ROC curve analysis shows that the AUC of HDL, FPG, PSA, and fPSA combined detection is 0.823, which is better than individual detection. In conclusion,HDL, FPG, PSA, fPSA has close correlation with hyperplasia of prostate, the joint detection may has better prediction for benign prostatic hyperplasia.

To study the clinical correlation between fasting plasma glucose, lipid metabolism, prostate-specific antigen and prostate volume in patients with benign prostatic hyperplasia, and to explore the combined effect as diagnostic indicators. A total of 108 patients with benign prostatic hyperplasia treated in Beijing University of Chinese Medicine Third Affiliated Hospital from June 2021 to March 2023 were retrospectively analyzed as the hyperplasia group, and 98 healthy physical examination personnel were selected as the control group during the same period. Compare the differences in levels of fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), small and dense low-density lipoprotein cholesterol (sdLDL-C), homocysteine, lipoprotein a (LPa), prostate specific antigen (PSA), and free prostate specific antigen (fPSA) between two groups of patients. Using Pearson analysis method to analyze the correlation between the above indicators and the size of prostate volume in patients with benign prostatic hyperplasia; using multiple linear regression to analyze the influencing factors of prostate volume enlargement; draw receiver operating characteristic (ROC) curves and analyze the application value of individual and combined detection of HDL, FPG, PSA, and fPSA. The results showed that there were significant differences in HDL, FPG, PSA, and fPSA levels between the control group and the proliferative group( P<0.05). The size of prostate volume is negatively correlated with HDL( r=-0.183, P<0.05) and positively correlated with FPG ( r=0.202, P<0.05), PSA( r=0.412, P<0.05), and fPSA( r=0.425, P<0.05). The results of multiple linear regression analysis showed that HDL( P=0.000), FPG( P=0.048), PSA( P=0.044), and fPSA ( P=0.012) were risk factors for increased volume of benign prostatic hyperplasia; ROC curve analysis shows that the AUC of HDL, FPG, PSA, and fPSA combined detection is 0.823, which is better than individual detection. In conclusion,HDL, FPG, PSA, fPSA has close correlation with hyperplasia of prostate, the joint detection may has better prediction for benign prostatic hyperplasia.

Objective:To analyze and summarize the imaging characteristics and clinical follow-up results of Ewing sarcoma of bone.Methods:The imaging data of 23 patients with Ewing sarcoma confirmed by pathology who treatment in Drum Tower Hospital Affiliated to Nanjing University School of Medicine from May 2010 to October 2021 were retrospectively analyzed, and clinical follow-up was performed.Results:Of the 23 patients with Ewing sarcoma of the bone in this group, a total of 18 patients had follow-up results and 5 cases were lost to follow-up. Of the 18 cases, 6 cases died and 12 cases survived. The main cause of death was lung metastasis. There were 27 lesions in total, femoral diaphysis was the most common site of the disease; bone structure destruction and soft tissue mass shadows could be seen in the images of each lesion. Periosteal reaction could be seen in most of the lesions (92.59%, 25/27). There were certain differences in signs of bone destruction and periosteal reaction between different bone types.Conclusions:The imaging of Ewing sarcoma of bone mainly manifests various types of bone destruction, soft tissue masses and periosteal reactions. Ewing sarcoma of bone is mainly bone marrow metastasis and lung metastasis, and lung metastasis is the main cause of death.

Objective:To investigate the efficacy of metagenomic next generation sequencing (mNGS) in the etiological diagnosis of patients with spinal infection, so as to provide reference for timely diagnosis and treatment.Methods:A total of 40 patients with suspected spinal infection admitted to the Department of Infectious Diseases in Henan Provincial People′s Hospital from January 2020 to July 2022 were included. The results of tissue culture, histopathological examination and tissue mNGS detection were analyzed retrospectively. According to the clinical diagnose, the patients were divided into the spinal infection group (28 cases) and the non-spinal infection group (12 cases). The positive rate, sensitivity and specificity of mNGS and tissue culture in the pathogen detection of patients with spinal infection were compared. McNemar test was used for statistical analysis.Results:There were 23 males and 17 females in 40 patients. The positive rate of mNGS was higher than that of tissue culture (75.0%(30/40) vs 12.5%(5/40)), and the difference was statistically significant ( χ2=0.08, P<0.001). Based on clinical diagnostic criteria, the sensitivity of mNGS in the diagnosis of spinal infection was higher than that of tissue culture (82.1% vs 17.9%), with a statistically significant difference ( χ2=0.02, P<0.001), while the specificity compared to the tissue culture (33.3% vs 100.0%), the difference was not statistically significant ( P>0.05). Conclusions:mNGS has a high pathogen detection rate and sensitivity in the etiological diagnosis of patients with spinal infection, which could provide clinical guidance for the diagnosis and treatment of patients with spinal infection.

Objective:To compare the depth of cure, surface hardness and microleakage applied to primary teeth of three types of bulk-fill resins, so as to provide reference for clinical application.Methods:Composite resin Filtek TM Z350 XT (group A) and giomer Beautifil Ⅱ (group B) were used as controls, high-viscosity bulk-fill resin Filtek TM Bulk Fill (group C), sonic-activated bulk-fill resin SonicFill 2 (group D) and flowable bulk-fill resin SDR ? flow+(group E) were studied. The microstructure of each group was observed by scanning electron microscope (SEM). Specimens of each group were prepared (6 pieces per group), and the Vickers microhardness of the surface layer and different depths of each group were measured, and then the depths of cure were calculated. Twenty-five primary molars dentin were filled by resins of each group (5 teeth per group), sliced, then aged, slices of each group were developed by silver ion staining. SEM was used to observed the distribution of silver ions. Microleakage of each group were analyzed by Jonckheere-Terpstra rank sum test. Results:SEM showed that the filler particles in groups A and C were spherical and evenly distributed. The shape of the fillers in groups B, D and E were polygonal and unevenly distributed. The surface hardness of groups A, B, C, D and E were (84.97±6.30), (65.04±5.95), (57.80±1.18), (60.77±2.34), (33.32±1.83) MPa respectively. Group A had the highest hardness, while group E was the lowest, and the differences between the two groups and other groups was statistically significant ( P<0.05). There were no statistically significant differences among groups B, C, and D ( P>0.05). The curing depths of groups A, B, C, D and E were 2.6, 3.4, 5.8, 3.8 and 7.8 mm respectively. The largest microleakage was found in group E [2% (1/50) for grade 0, 22% (11/50) for grade 1, 30% (15/50) for grade 2, 24% (12/50) for grade 3, and 22% (11/50) for grade 4], which was statistically different from other groups ( P<0.05). No statistically significant differences were found among other 3 groups ( P>0.05). Conclusions:Both high-viscosity and sonic-activated bulk-fill resins have the greater depth of cure, the same hardness and microleakage as giomer, which might be an option for restoration in primary teeth.

Objective:To explore the status and influencing factors of stigma in patients with pituitary adenoma.Methods:From January 2020 to May 2021, a total of 106 patients with pituitary adenoma in the Affiliated Huai'an No.1 People 's Hospital of Nanjing Medical University were selected using the convenience sampling method. Internalized Stigma of Mental Illness, Medical Coping Style Questionnaire and Connor-Davidson Resilience Scale were used to investigate them. Binary Logistic regression analysis was used to evaluate the influencing factors of stigma in patients with pituitary adenoma. Results:Among 106 patients with pituitary adenoma, 87 (82.08%) had stigma. The stigma score of patients with pituitary adenoma was (2.58±0.61) . Binary Logistic regression analysis results showed that family monthly income, coping style and mental elasticity were the influencing factors of stigma in patients with pituitary adenoma ( P<0.05) . Conclusions:Stigma is common in patients with pituitary adenoma. Medical staff should take targeted intervention measures according to the influencing factors of stigma in patients with pituitary adenoma, so as to help patients reduce stigma.

Background::Sepsis is a serious disease caused by infection. Aminophylline has anti-asthma and anti-inflammatory effects. We aimed to explore the safety and effect of aminophylline in sepsis.Methods::We conducted a clinical randomized controlled trial involving 100 patients diagnosed with sepsis within 48 h after intensive care unit (ICU) admission in two sites. All patients were randomized in a 1:1 ratio to receive standard therapy with or without aminophylline. The primary clinical outcome was all-cause mortality at 28 days.Results::From September 27, 2018 to February 12, 2020, we screened 277 septic patients and eventually enrolled 100 patients, with 50 assigned to the aminophylline group and 50 to the usual-care group. At 28 days, 7 of 50 patients (14.0%) in the aminophylline group had died, compared with 16 of 50 (32.0%) in the usual-care group ( P = 0.032). Cox regression showed that the aminophylline group had a lower hazard of death (hazard ratio = 0.312, 95% confidence interval: 0.129-0.753). Compared with the usual-care group, patients in the aminophylline group had a longer survival time ( P = 0.039 by the log-rank test). The effects of aminophylline on vasopressor dose, oxygenation index, and sequential organ failure assessment score were time-dependent with treatment. There were no significant differences in total hospitalization days, ICU hospitalization days, and rates of serious adverse events (all P > 0.05). No adverse events were observed in the trial. Conclusions::Aminophylline as an adjunct therapy could significantly reduce the risk of death and prolong the survival time of patients with sepsis.Trial registration::ChiCTR.org.cn, ChiCTR1800019173.

Objective:To investigate the clinical characteristics of patients with aspergillus spondylitis, and to provide reference for timely diagnosis and treatment.Methods:The clinical manifestations, imaging performance, laboratory examination results, diagnosis and treatment outcomes of six patients with confirmed aspergillus spondylitis in Department of Infectious Diseases, Henan Provincial People′s Hospital during April 30, 2015 and May 1, 2020 were retrospectively analyzed.Results:The main manifestations of six patients were fever and neck pain or low back pain. The time from the onset of clinical manifestations to diagnosis was more than two months to 14 months. Spine magnetic resonance imaging (MRI) showed long T1 and T2 signals on vertebral body, high pressure lipid signal, obvious enhanced scan enhancement, and paravertebral abscess formation might be presented. Among the six patients, C-reactive protein increased in four patients, erythrocyte sedimentation rate increased in five patients, β-D-glucan test (G test) increased in three patients, galactomannan antigen test (GM test) increased in four patients. Six patients with aspergillus spondylitis were all confirmed by biopsy of diseased tissue for fungal smear, tissue culture or metagenomics next generation sequencing. After treatment with voriconazole or itraconazole, five patients recovered and one patient was still under treatment.Conclusions:The clinical manifestations and imaging examination of patients with aspergillus spondylitis are nonspecific. Peripheral blood G test and GM test need to be combined for diagnosis. The diagnosis depends on tissue puncture pathology examination, and the metagenomics next generation sequencing is needed if necessary.

Objective:To establish a quality control system of enteral nutrition nursing for critically ill patients, and to apply this system in clinical practice and evaluate its effect.Methods:Delphi method was used to construct the quality control system. By training nurses in this system, through the training of the system for nurses and clinical quality control, enteral nutrition complications of patients before and after the training and nurses' knowledge of enteral nutrition were compared.Results:after the system applied in the nursing clinic, the incidence of enteral nutrition gastrointestinal complications, infectious complications, metabolic complications and mechanical complications in patients with critical illness decreased from 11.3% (18/160), 1.9% (3/160), 5.6% (9/160), 6.9% (11/160) to 3.9% (6/152), 0.7% (1/152), 1.3% (2/152), 1.9% (3/152) respectively, with statistically significant differences ( χ 2 values were 6.35-91.33, P <0.01). ICU nurses' awareness of enteral nutrition theory was significantly improved, and the questionnaire score increased from (70.22±8.78) points to (95.25±4.18) points, with statistically significant difference ( t value was 18.792, P<0.01). Conclusion:The enteral nutrition nursing quality control system developed in this study can effectively guide nursing staff to implement enteral nutrition during nursing behavior, reduce the occurrence of enteral nutrition complications in patients with critical illness, to ensure the safety of patients, and is worthy of clinical promotion and application.