This paper summarizes clinical insights on treating the syndrome of coexisting dryness and dampness in Sjögren's syndrome （SS） based on the "three methods for liver diseases". It is proposed that the core pathogenesis of this subtype lies in the liver's failure to regulate and disperse， leading to fluid retention and transformation into dryness； disharmony between wood （liver） and earth （spleen）， resulting in internal generation of dryness and dampness； and liver impairment affecting the kidney， eventually causing extreme dryness to transform into dampness. This syndrome is thus characterized by disharmony between the liver and spleen， as well as dysfunction between ti （character， 体） and yong （function， 用）. Drawing from the Guide to Clinical Case （《临证指南医案》）， the "three methods for liver diseases" are applied as follows，i.e. using pungent and dispersing herbs to regulate the liver and resolve qi stagnation； using sweet and gentle herbs to soothe the liver and address the root of concurrent dryness and dampness； and using sour and purgative herbs to soften the liver and restore fluid balance. The coordinated use of these three methods， treating both ti and yong， facilitates the separation of dryness and dampness， providing a novel approach to syndrome differentiation and treatment for this subtype of SS.

The pathogenesis of Sjögren's syndrome （SS） was considered to involve external dryness， internal injured essence and blood， yin-deficiency endowment， and abnormal emotion and spirit， and it was believed that SS has the characteristics of dryness and impassability， and the pathogenesis of deficiency-excess in complexity. According to the theory “upper dryness treats qi， and lower dryness treats blood” in YE Gui's monograph “Medical Records for Clinical Guidance”， the dryness was divided into upper dryness and lower dryness syndromes to be differentiated and treated. When treating dryness syndrome， the patient should follow the characteristics of the five zang organs， using soft and cool medicines， avoiding warm and dry medicines， and valuing the animal products. The upper dryness could be treated with Sangxiang Decoction （桑杏汤） to clear the qi and moisten the dryness， Qiaohe Decoction （翘荷汤） to clear the upper with pungent-cool， and Shashen Maidong Decoction （沙参麦冬汤） to nourish yin and promote the production of body fluid. The lower dryness could be treated with Fumai Decoction （复脉汤） to enrich and nourish the five kinds of fluid. Liuwei Dihuang Pill （六味地黄丸） to nourish the kidneys and supplement essence， and Wuren Pill （五仁丸） to moisten the dryness and nourish the blood， which provided a new way of thinking for differentiation of the dryness syndrome.

【Objective:】 To explore the network structure characteristics and core items of meaning in life and coping styles among college students, and provide a basis for understanding their relationships and related interventions. 【Methods:】 A survey was conducted among college students using the Simplified Coping Style Questionnaire and Meaning in Life Questionnaire . The network analysis method was used to construct a network of college students’ meaning in life and coping styles, and R software was used for statistical analysis and visualization. 【Results:】 In the network of college students’ meaning in life and coping styles, "believing that time will change the status quo, and the only thing to do is to wait" and "trying to forget the whole thing" had the closest connection. "Learning from others to handle similar difficult situations" had the highest expected impact. "Seeking the meaning in life" and "pursuing hobbies and actively participating in cultural and sports activities" had the highest bridge expected influence. The average predictability value of all nodes was 0.775. 【Conclusions:】 Interventions aimed at "learning from others to handle similar difficult situations", "changing one’s own ideas and rediscovering what is important in life" and "changing some of the original practices or problems" may maximize the coping effect of college students. "Seeking the meaning in life" can furthest influence the coping styles, and "pursuing hobbies and actively participating in cultural and sports activities" can maximize the improvement of meaning in life.

【Objective】 To report the early clinical effects and surgical complications of endoscopic spinal fusion technology （Endo-LIF） in the treatment of degenerative lumbar disease. 【Methods】 The clinical data of 31 patients with degenerative lumbar spine disease treated with Endo-LIF from June 2019 to May 2021 were retrospectively analyzed. All the 31 patients underwent endoscopic spinal fusion therapy. We recorded the operation time， hospital stay duration， postoperative complications， visual analogue scale for pain （VAS）， oswestry dysfunction Index （ODI） and low back pain in the Chinese Orthopaedic Association Spine Group Surgery scoring standards before operation， immediately after operation， and the last follow-up to evaluate clinical efficacy. 【Results】 The operation time of the 31 patients was （134.80±34.98） min， the intraoperative blood loss was （100.13±18.49） mL， the hospital stay was （6.65±0.17） days， and the follow-up time was 6 to 18 （14±2.3） months. One patient had hematoma compression after surgery； he had incision made immediately to clear the hematoma and healed after bed rest. Two patients developed spinal hypertension and healed after bed rest. All the patients had no symptoms of nerve injury after operation， and the clinical symptoms were significantly relieved. We compared the perioperative VAS score and ODI index of all the patients， which were lower immediately after operation and at the last follow-up than those before the operation （P<0.05）， and the difference was statistically significant. 【Conclusion】 Endo-LIF technology has good short-term clinical effects and the advantages of milder trauma， less blood loss， and quick recovery after surgery. It is a safe and minimally invasive lumbar fusion surgery.

Objective: To explore the effect of comprehensive rehabilitation treatment of individualized exercise program on lung function, exercise ability, quality of life and biochemical indexes of coal workers’ pneumoconiosis patients, and to provide scientific and effective methods for rehabilitation treatment of coal workers' pneumoconiosis. Methods: In Huaibei Coal Mine Occupational Disease Prevention and Control Hospital, the data of pneumoconiosis patients treated by pneumoconiosis department in the hospital were collected and sorted out. 80 patients were selected according to the inclusion and exclusion criteria. Using a random number table, they were randomly divided into two groups with 40 cases in each group. The data investigated in this study include the results before and after treatment. Pulmonary function index, BMI index, six-minute walking distance (6MWD) , quality of life questionnaire (SF-36) , hospital anxiety and depression scale (HADS) , st George's breathing questionnaire (sgrq) , c-reactive protein (CRP) and blood oxygen saturation (SpO₂) were used to evaluate and compare the efficacy of the two groups. Results: The lung function indexes of the test group were significantly higher than those of the control group after treatment (P<0.05) , including forced vital capacity, forced vital capacity in the first second, maximum expiratory flow, expiratory flow when vital capacity was 75% and expiratory flow when vital capacity was 25%. The forced vital capacity, the first-second forced vital capacity and the maximum expiratory flow of the patients in the test group were higher after treatment than before (P<0.05) . The six-minute walking distance of the test group was greater than that of the control group after treatment (P<0.05) . After treatment, the scores of st George’s breathing questionnaire in the test group were lower than those in the control group (P<0.05) . The scores of quality of life questionnaire in the test group were higher than those in the control group after treatment (P<0.05) . Conclusion The comprehensive rehabilitation treatment of individualized exercise program improved the endurance and exercise ability of pneumoconiosis patients, improved the respiratory status and quality of life of pneumoconiosis patients in Huaibei Coal Mine, improved the lung function of pneumoconiosis patients, and improved the forced vital capacity of patients, but the small airway function has not been significantly improved.

Objective To assess the characteristics of brain glucose metabolism in patients with early Parkinson's disease (PD) accompanied by visuospatial working memory impairment using 18F-fluorodeoxyglucose (FDG) PET imaging.Methods Between January 2015 and March 2017,early PD patients with visuospatial working memory impairment (14 males,6 females,age:(55.7±6.7) years),early PD patients without visuospatial working memory impairment (13 males,7 females,age:(55.7±8.5) years) and healthy controls (14 males,6 females,age:(54.6±6.4) years) were included.Resting-state 18F-FDG PET was performed to obtain the brain glucose metabolism,Subsequently,statistical parametric mapping (SPM) was used to compare the brain glucose metabolic changes among different groups.Results Compared with the control group,hypermetabolism was observed in putamen,globus pallidus,thalamus,pons,cerebellum and primary motor cortex and hypometabolism was found in part of the occipital and temporal lobe in the groups ofearly PD (Zmax values:3.19-6.86,t values:2.11-9.96,all P＜0.001).The PD group with visuospatial working memory impairment had hypometabolism regions in bilateral lateral prefrontal cortex and posterior parietal cortex compared with the group without visuospatial working memory impairment.Conclusion Abnormal metabolism of glucose in visual processing channels of brain in early PD patients may be one of the causes of visuospatial working memory impairment.

Objective To construct the male and female rat model of fluorosis and to explore the gender difference in fluorosis. Methods A total of 48 clean-grade SD rats with the body weight of about 150 g (male∶female=1∶1) were equally divided into the control group and fluorosis model group. Rats in the fluorosis model group were fed with fluorine-containing (100 mg/kg) feedstuff. The general condition, changes in body weight and dental fluorosis of the rats were observed every three days. A batch of female and male rats were sacrificed by femoral artery bleeding on the 70th and 110th day of experiment, respectively, when all rats showed dental fluorosis. The levels of urinary fluoride and bone fluoride of the rats were measured by a fluoride ion-selective electrode. Results All the male and female rats in the control group did not show dental fluorosis during the entire experiment. The female and male rats in the fluorosis group showed dental fluorosis visible to naked eye began approximately on the 60th and 80th day, respectively, indicating that the appearance of dental fluorosis of the male rats was about 20 days later than the female rats. After 30 days or so, the male and female rats went into a rapid growth period, and there were significant differences between the body weights of the male and female rats (P＜ 0. 01). The body weight of the male and female rats in the fluorosis group was higher than that of the control group on the 110th day. With the progression of fluorosis, the levels of urinary fluoride and bone fluoride of the rats were gradually increased, and finally significantly higher than those of the control group (P＜ 0. 01). There was a positive correlation between the levels of urinary and bone fluoride and the time of fluorosis. The levels of urinary and bone fluoride of the male rats were significantly higher than those of the female rats (P＜ 0. 01), indicating that they are affected by gender. Conclusions The body weight of the rat model of fluorosis, the starting time when dental fluorosis occurs and the levels of urinary and bone fluorine are all different between male and female rats.

Objective To explore the nursing measures in blue laser endoscopy. Methods Endoscopy was performed in 102 patients. The nursing was done including preoperative preparation, nurse's coordination for different mode of endoscpy, postoperative nursing and so on. Result The endoscopy for the 102 patients was successfully done,the time ranging between 10~25 min,averaged 13.85 min.No complications were found. Conclusion The nursing measures including careful preoperative preparation,intraoperative cooperation and postoperative nursing are key to the successful detection and diagnosis of diseases by blue laser endoscopy.

Objective To investigate the protective effects of Bcl-2 associated with athanogene-1 (BAG-1) gene on human neuroblastoma cells (SH-SY5Y) injury induced by hypoxia/reoxygenation,and its influence on heat shock protein 70 (HSP70) expression.Methods The SH-SYSY cells at logarithmic growth phase were collected.Lenti virus mediated RNA interference (RNAi) technology was used to suppress the BAG-1 expression.The cells screened out can be divided into four groups:the cell control group with no lentivirus infection,lentivirus control group (containing only fluorescein protein lentivirus infection),BAG-1 siRNA group (BAG-1 siRNA silencing group),including BAG-1 siRNA-α group and BAG-1 siRNA-β group with lentivirus containing fluorescein protein (GFP) but at different BAG-1 siRNA target sites of silencing.Western Blot was used to detect the protein expression of BAG-1 and HSP70 in target cells after infectious recombination lentivirus for 72 hours;the Cell Counting Kit-8 (CCK-8) was used to detect the activity of four different group cells after hypoxia;the flow cytometry was used to detect the cell apoptosis;the HSP70 mRNA transcription level were detected by real-time fluorescent quantitative reverse transcription-polymerase chain reaction (RT-qPCR) respectively in each group.Results After lentiviral infection for 72 hours,the Western Blot results showed that in the two BAG-1 siRNA silencing groups,the interference effect of BAG-1 siRNA-β group was superior to that of BAG-1 siRNA-α group.The cell viability of each group showed an increase followed by a decrease with the prolongation of hypoxia time,and reaching the peak at 8 hours.After hypoxia for 8 hours being given,the cell viability in BAG-1 siRNA-β group was significantly lower than that of the cell control group,lentivirus control group and BAG-1 siRNA-α group (A value:0.59 ±0.09 vs.0.94±0.12,0.90± 0.11,0.91± 0.14,P ＜ 0.01);the cell apoptosis rate was obviously higher in BAG-1 siRNA-β than that in the above three groups [(34.63 ± 3.46)％ vs.(14.83 ± 3.75)％,(19.93 ± 6.49)％,(16.40± 1.18)％,all P ＜ 0.01].There were no statistically significant differences in the HSP70 protein level and mRNA transcription level between BAG-1 siRNA-3 grroup,and the cell control group,lentivirus control group and BAG-1 siRNA-α group respectively (all P ＞ 0.05).Conclusion BAG-1 gene can play a role in protection of hypoxia nerve cells,reduce the apoptosis,and its protective effect can be independent of HSP70 gene.

[Objective] The objective of this study was to evaluate the diagnostic accuracy of the 2013 edition of Breast Imaging Reporting and Data System (BI-RADS) ultrasound lexicon in diagnosing breast categories 3-5 lesions.[Methods] Using our breast ultrasound database from June 2014 to June 2016,we identified 4428 BI-RADS category 3 to 5 lesions with a known pathological diagnosis in 4 428 adult women.The positive predictive value (PPV) of each BI-RADS category was calculated based on the pathological diagnoses and compared with the reference range provided by the American College of Radiology (ACR).[Results] 4 428 lesions from 4428 patients were included in this study.The PPV of each BI-RADS category waswithin the reference range provided by the ACR in 2013.1198 (27.1％) pathological malignant/borderline results were found in the 4 428 lesions,the other 3 230 (72.9％)lesions were diagnosed with benign results.Among the malignant/borderline lesions,the rate of lymph node metastasis gradually increased as the BI-RADS categories were upgraded.Malignant lesions with a diagnosis ofinvasive ductal carcinoma or invasive lobular carcinoma showed an increasing distribution trend from category 3 to 5.[Conclusion] The 2013 editionof BI-RADS ultrasound lexiconhas good diagnostic accuracy and efficiencyin clinical practice.