Objective To investigate the effect of Qufu Shengji ointment combined with ulinastatin in the treatment of wound healing after perianal surgery and its effect on the level of inflammatory factors.Methods Patients who underwent perianal surgery in Guilin Hospital of Integrated Traditional Chinese and Western Medicine from July 2020 to January 2022 were randomly divided into control group and test group.The patients in both groups were treated with conventional debridement therapy and ulinastatin,and the test group was treated with Qufu Shengji ointment.The wound healing efficacy,TCM symptom score,inflammatory factor level,growth factor level and treatment safety of the two groups were compared.Results A total of 116 patients were included in the study,including 58 patients in the test group and 58 in the control group.The total effective rate of the test group(91.38％)was higher than that of the control group(75.86％),and the difference was statistically significant(P＜0.05).After treatment,the TCM syndrome score levels of interleukin-17A(IL-17A),C-reactive protein(CRP)and serum amyloid A(SAA)in the test group were lower than those in the control group(P＜0.05).The levels of vascular endothelial growth factor receptor 1(VEGFR1),fibroblast growth factor receptor(FGFR)and transforming growth factor-β1(TGF-β1)were higher than those in the control group(P＜0.05).The anal function index was higher than that of the control group(P＜0.05).The incidence of adverse reactions between the two groups was 13.79％and 8.62％,respectively,and the difference was not statistically significant(P＞0.05).Conclusion The effect of Qufu Shengji ointment combined with ulinastatin in the treatment of wound healing after perianal surgery is significant,which can improve the TCM syndrome,reduce inflammatory factors,and upregulate growth factors,and has good safety.

Objective To investigate the effects of total flavonoids from Vine tea on the intestinal flora of high-fat diet(HFD)induced non-alcoholic fatty liver disease(NAFLD)mice.Methods Twenty-eight mice were randomly divided into four groups:blank control group,model control group(HFD group),low-dose TF group(TF-L group),and high-dose TF group(TF-H group),with 7 mice in each group.Mice in the HFD group,TF-L group,and TF-H group were fed with high-fat diet(HFD)for 12 weeks,while those in the blank control group were fed a normal diet.After 12 weeks of high-fat diet feeding,mice in the TF-L group and TF-H group were orally administered TF solution at doses of 125 and 250 mg·kg-1·d-1 by gavage administration for 6 weeks of intervention.Pathological changes in the liver and intestine of mice were observed using hematoxylin-eosin(H&E)staining,and the expression levels of tight junction proteins between the epithelial cells of the colonic mucosa was analyzed by immunohistochemistry.ELISA kit was used to detect the level of serum inflammatory factors in mice.Changes of intestinal flora in mice were analyzed by 16S rRNA sequencing technology.Results Total flavonoids from Vine tea could effectively improve the pathological changes of liver and intestinal tract in mice,reduce the levels of serum inflammatory factors IL-6 and TNF-α,and promote the expression of tight junction proteins Occludin,ZO-1 and Claudin 1 in the colon.There were significant differences in the intestinal flora of the three groups of mice.Total flavonoids from Vine tea significantly decreased the ratio of Firmicutes to Bacteroidota(P＜0.05),increased the abundance of Faecalibaculum,Ligilactobacillus and Lactobacillus,which resulted in the improvement of intestinal flora disorders.Conclusion Total flavonoids from Vine tea have certain ameliorative effects on high-fat diet-induced NAFLD,and the mechanism may be related to the promotion of intestinal barrier repair and the improvement of intestinal flora disorders.

OBJECTIVE：To ex plore the protective effects of Longbie capsule contained serum （called“LBJN”for short ）on the apoptosis of chondrocytes induced by YAP inhibitor verteporfin and its mechanism. METHODS ：Primary human knee osteoarthritis（OA）chondrocytes were extracted by two-step enzymatic digestion ，and then identif ied by toluidine blue staining and type Ⅱ collagen immunofluorescence staining. The effects of 2，5 μmol/L verteporfin alone or combined with 5％LBJN on cell apoptosis were detected by flow cytometry. Solvent control （0.1％ DMSO）and 5％ LBJN were set. Western blot assay was adopted to detect the expression of apoptosis related proteins （YAP，Bcl-2，cleaved-caspase-3） after treated with 0.1％DMSO（solvent control ），2 μmol/L verteporfin，2 μmol/L verteporfin+5％LBJN 和 0（blank control ），2.5％ LBJN and 5％ LBJN for 48 h. The expression of autophagy related proteins （mTOR，Beclin-1，LC3A/B） after treated with 0 （blank control ），2.5％，5％ LBJN for 48 h were det ected by Western blot assay. RESULTS ：The isolated cells accorded with the characteristics of chondrocytes. Compared with 0.1％DMSO， the apoptosis rates of cells were increased significantly after treated with 2，5 μmol/L verteporfin（P＜0.05），and the effects of the two concentrations were similar （P＞0.05）. Compared with verteporfin alone ，2，5 μmol/L verteporfin combined with 5％LBJN could significantly decrease the apoptotic rate of cells （P＜0.05）. Compared with 0.1％DMSO，the protein expression of YAP and Bcl-2 were decreased significantly after treated with 2 μ mol/L verteporfin （P＜0.05）， while the protein expression of cleaved-caspase-3 were increased significantly （P＜0.05）. Compared with 2 μmol/L verteporfin，protein expression of YAP and Bcl-2 were increased significantly after treated with 2 μmol/L verteporfin+5％LBJN（P＜0.05），while the protein expression of cleaved-caspase-3 were decreased significantly （P＜0.05）. Compared with blank control ，the protein expression of YAP ，Bcl-2 and Beclin-1 were increased significantly after treated with 2.5％，5％LBJN（P＜0.05），while protein expression of cleaved-caspase- 3 and mTOR were decreased significantly （P＜0.05）. CONCLUSIONS ：LBJN can block the apoptosis of chondrocytes induced by YAP inhibitor verteporfin ，and its mechanism may be related to regulating the expression of apoptosis related proteins and enhancing autophagy of chondrocytes.

Objective:To explore the efficacy of doctor-nurse co-led care involving education and engagement of patients on improving compliance of patients, and a treat-to-target urate-lowering rate for gout.Methods:Nurses were trained in practice management of gout. Patients diagnosed with gout in the departments of rheumatology and immunology of Anqing Municipal Hospital in Anhui Province were prospectively enrolled from January 1 to June 30, 2019. The patients were divided into the continuous-care group and the conventional management group by random number table method. The patients of continuous-care group received telephone follow-up, WeChat tracking and regular face-to-face communication. The patients of conventional management group were told to follow up regularly in the outpatient department, and the nurses did not follow up. Patients were evaluated before intervention and 12 months after intervention. The treat-to-target rate of blood uric acid and the frequency of gout flares were observed.Results:After 12 months of intervention, the patients of serum uric acid concentrations below 360 μmol/L were 92.39% (85/92) in the continuous-care group, and 26.74% (23/86) in the conventional management group. There was significant difference ( χ2 value was 80.282, P<0.001). After 12 months of intervention, the average serum uric acid concentration of patients in the continuous-care group was (301.6±61.4) μmol/L, and that in the conventional management group was (419.0±98.0) μmol/L, both of which were significantly lower than before intervention, continuous-care group (466.1±119.7) μmol/L, conventional management group (477.8±113.1) μmol/L. But the average serum uric acid concentration of patients in the continuous-care group was significantly lower than that in the conventional management group. There was significant difference between them ( t value was 96.678, P<0.001). At the end of 12 months, the patients of uric-acid-lowering therapy increased in both groups. The proportion of patients was 94.56% (87/92) in the continuous-care group, which was significantly higher than that in the conventional management group (58.14%, 50/86), there was significant difference ( χ2 value was 33.260, P<0.001). Conclusions:The mode of continuing nursing combined with specialized physician-led treatment can significantly improve the compliance and the control rate of treat-to-target for gout, and this management method is simple and feasible which provides a new management concept for clinical treatment of gout.

Objectives:To investigate the common risk factors for excess daytime sleepiness (EDS) and hypertension in obstructive sleep apnea-hypopnea syndrome(OSAHS) patients.Methods:Between January 2020 and February 2021, a total of 103 OSAHS patients diagnosed in the Department of Sleep Medicine Center, the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University were enrolled as the study population. During polysomnography (PSG) monitoring, noninvasive continuous blood pressure (BP) and heart rate variability (HRV) were monitored simultaneously. Low/high frequency components (LF/HF) were used to reflect sympathetic-vagal balance in frequency domain analysis. According to Epworth Sleepiness Scale (ESS) and BP levels, patients were divided into four groups: simple OSAHS group (ESS<10 scores and BP<140/90 mmHg, n=30)(1 mmHg=0.133 kPa), OSAHS+hypertension group (ESS<10 scores and BP≥140/90 mmHg, n=23), OSAHS+EDS group (ESS≥10 scores and BP<140/90 mmHg, n=26) and OSAHS+hypertension+EDS group (ESS≥10scores and BP≥140/90 mmHg, n=24). The clinical and PSG parameters were analyzed and compared among the four groups. Regression analyses were used to explore the common causative factors for EDS and hypertension. Results:The LF/HF in OSAHS+hypertension+EDS group was significantly higher than the other three groups [3.2% (2.6%, 4.2%) vs 1.4% (1.2%, 1.6%), 2.2% (1.8%, 2.9%), 2.5% (1.6%, 3.1%), all P<0.05]. No difference was observed between OSAHS+hypertension group and OSAHS+EDS group ( P=0.779), but both higher than simple OSAHS group. The linear regression equation showed that LF/HF was most correlated with the percentage of sleep time with oxygen saturation<90% (T90) as compared to the other parameters of sleep disordered breathing (β=0.201, P=0.006). In addition, Pearson correlation analysis showed that LF/HF was significantly correlated with ESS scores and asleep BP levels ( r=0.536, r=0.456, all P<0.05). The logical regression equation showed that LF/HF was a causative risk factor for both EDS and hypertension in OSAHS (β=0.164, 95% CI: 1.018-1.364, P=0.028). Conclusion:The sympathetic-vagal imbalance is a common risk factor for EDS and hypertension in OSAHS patients

Objective To study the clinical efficiency and adverse reactions of simultaneous modulated accelerated radiotherapy (SMART)and intensity-modulated radiation therapy (IMRT)in advanced cervical cancer. Methods Sixty patients with advanced cervical cancer were collected from April 2011 to April 2017 in our hospital. The 60 patients were randomly divided into experimental group (30 cases)and control group (30 cases)by using stratified randomization method. The two groups were given intracavitary irradiation and concur-rent chemotherapy. The patients in experimental group were treated with SMART and the patients in control group were treated with IMRT. 95％ planned target volume was 50. 4 Gy/ 28 F in the two groups and the dose for IMRT with simultaneous integrated boost was 64. 4 Gy/ 28 F to the planning target volume. Disease progres-sion,survival time and adverse reactions of the two groups were compared. Results At the end of radiothe-rapy,the experimental group had 23 patients with complete response (CR),4 patients with partial response (PR),2 patients with unaltered stable disease (SD),1 patient with progressive disease (PD),and the control group had 22 patients with CR,3 patients with PR,3 patients with SD,2 patients with PD. The overall effi-ciency of the experimental group was slightly higher than that of the control group (90. 0％ vs. 83. 3％),but the difference was not statistically significant (χ2 = 0. 144,P = 0. 704). After 3 months of radiotherapy,the experimental group had 28 patients with CR,1 patient with PR,1 patient with PD,and the control group had 22 patients with CR,2 patients with PR,3 patients with SD,3 patients with PD. The overall efficiency of the experimental group (96. 7％)was higher than that of the control group (96. 7％ vs. 80. 0％),but the diffe-rence was not statistically significant (χ2 = 2. 588,P = 0. 108). The median overall survival time of the experi-mental group and control group were 43 months and 38 months,and the difference was statistically significant (χ2 = 7. 087,P = 0. 008). The 1-year survival rates of the two groups were 96. 6％ and 85. 7％,and the 3-year survival rates were 86. 2％ and 60. 7％,respectively. There were no significant differences in the inci-dences of gastrointestinal reaction (66. 7％ vs. 63. 3％,χ2 = 0. 073,P = 0. 787),urinary system reaction (33. 3％ vs. 30. 0％,χ2 = 0. 077,P = 0. 781)and bone marrow suppression (83. 3％ vs. 86. 7％,χ2 =0. 000,P = 1. 000)between the two groups. Conclusion The efficiency of advanced cervical cancer patient treated with SMART is better than IMRT,and the adverse reactions are tolerable,which is worthy of clinical promotion.

Objective To investigate effects of total flavonoids of litchi (TFL) on the proliferation of rat hepatic stellate cells (HSC-T6) in comparison with western medicine rosiglitazone, and to explore the mechanism of anti hepatic fibrosis of TFL. Methods Effect of TFL on proliferation of HSC-T6 was examined by MTT. The expression of peroxisome proliferator-activated receptor-γ (PPAR-γ) mRNA, connective tissue growth factor (CTGF) mRNA in HSC-T6 cells exposured were examined by real-time quantitative PCR. Effects on HSC-T6 CTGF protein from TFL and rosiglitazone were detected by Western bloting. Results The expression of PPAR-γ mRNA was upregulated and the expression of CTGF mRNA and protein was downregulated after exposure to TFL and rosiglitazone for 72 hours. And the effect of TFL increased with the increase of concentration. Conclusion TFL can inhibit the proliferation of HSC-T6 and antagonizing liver fibrosis. This mechanism may be associated with the upregulation of PPAR-γ expression and the downregulation of CTGF expression.

ObjectiveTo explore the therapeutic effect and mechanism of dexamethasone combined with puerarin for treatment of paraquat (PQ) poisoned rats.Methods Thirty Sprague Dawley (SD) rats were divided by random number table into 5 groups: control, model, dexamethasone, puerarin and combined groups, 6 rats in each group. The PQ poisoned rat model was established by intraperitoneal injection of PQ 25 mg/kg (1 mL), while in the rat of the control group, the same volume of normal saline was injected intraperitoneally. After 2 hours, in the rat of dexamethasone group, 20 mg/kg dexamethasone in 1.5 mL was injected intraperitoneally, and in the rat of puerarin group, 100 mg/kg puerarin in 1.5 mL was injected intraperitoneally. In the rat of combined group, 20 mg/kg dexamethasone combined with 100 mg/kg puerarin in a total amount of 1.5 mL was injected intraperitoneally. In the control group and model group, 1.5 mL of normal saline was injected intraperitoneally. The above mentioned treatments were repeated once more 26 hours later. In 26-50 hours after modeling, urine was collected, and urine N-acetyl-beta-D-amino glycosidase enzymes (NAG) was tested; at the 50th, abdominal aortic blood was collected to test oxygen partial pressure (PaO2). The lung index, kidney index, and the levels of malonaldehyde (MDA), superoxide dismutase (SOD) and myeloperoxidase (MPO) were measured in the left lung and kidney tissue homogenates separately; the right lung and kidney were
harvested to observe pathological changes under light microscope. Another 30 SD rats were treated the same as above measures but no sacrifice to observe 30-day survival rate in each group.Results The lung index, kidney index, NAG in urine, MDA and MPO levels in lung and kidney tissue homogenates in model group were significantly higher than those in the control group [lung index: 9.80±1.83 vs. 4.97±1.14, kidney index: 9.40±1.32 vs. 7.01±0.32, NAG (U·kg-1·day-1): 1.93±0.18 vs. 0.41±0.03, MDA of lung (nmol/mg): 1.04±0.15 vs. 0.28±0.10, MDA of kidney (nmol/mg): 1.39±0.16 vs. 0.66±0.13, MPO of lung (U/g): 1.14±0.08 vs. 0.81±0.06, MPO of kidney (U/g): 0.88±0.08 vs. 0.52±0.12]; while PaO2 [mmHg (1 mmHg = 0.133 kPa): 59.83±4.40 vs. 97.00±2.83] and SOD (U/mg): lung was 27.38±3.48 vs. 86.88±5.88; kidney was 24.18±3.74 vs. 57.86±6.14) were obviously lower than those in control group (allP < 0.05). After drug treatment was given, lung index (7.21±1.87), urine NAG (1.01±0.21) and MDA (lung was 0.49±0.09, kidney was 0.85±0.08), MPO (lung was 0.97±0.07, kidney was 0.68±0.10) in the puerarin group were significantly lower than those in model group, while PaO2 (82.17±5.38), SOD (lung was 68.99±6.51, kidney was 37.90±3.62) were remarkably higher than those in model group (allP < 0.05). The improvement in the indexes related to the kidney injury was not obvious in dexamethasone group and in the dexamethasone combined with puerarin group, while the lung and kidney pathological changes were lesser in extent in each of the above two treatment groups than those in model group. The 30-day survival rate in model group was significantly lower than that in control group (0% vs. 100.0%);the 30-day survival rates in control group, dexamethasone group, puerarin group and combined group were remarkably higher than those in model group (100.0%, 16.7%, 50.0% and 33.3% vs. 0%, allP < 0.05). But there were no statistical significant differences in the survival rates among those treatment groups (P > 0.05).Conclusions Dexamethasone can improve the prognosis of rats with acute paraquat intoxication, it can provide lung protection markedly, but cannot provide significant protective effect on kidney; puerarin has therapeutic effect on rats with acute PQ poisoning, it can provide not only lung protection but also kidney protection. The effect of treatment with dexamethasone combined with puerarin is not superior to that by using dexamethasone or puerarin alone.

OBJECTIVE:To reflect the representative problems existing in the medication safety of public from the side,and provide reference for conducting the following public survey in a large area. METHODS:Questionnaires were used to investigate the knowledge of drug and medication habits of teachers in a senior high school in Beijing,and the received data was statistically analyzed. RESULTS:Totally 88 questionnaires were issued in this investigation,84 effective questionnaires were acquired,with ef-fective recovery of 95.45%. A few teachers had blind faith in intravenous infusion and preferred using antibiotics without doctor's di-agnosis when they caught a cold and fever;48.81%of the respondents barely understood or only partly understood the drug instruc-tions;34.52% didn't know that more serious adverse reactions induce by intravenous infusion were more serious than by oral treat-ment;46.43% rarely checked the period of validity of reserved drugs at home;38.10% didn’t following directions when taking drugs;80.95% had never received the education of medication safety,and 21.43% of them had no intention to accept this educa-tion;when taking drugs for a long time,79.76% of them didn’t do regular examinations of blood routine,renal and liver function tests. CONCLUSIONS:The knowledge of drug use of the respondents in the school is poor,there are many misunderstandings ex-isted in the medication habit,which prompts hidden trouble also exists in medication safety,and reflects hidden trouble commonly exists in medication safety for public from the side.

Objective To observe the bacteriostasis of herba houttuyniae liquid in bladder irrigation for treatment of rabbit bladder infection model, and to offer a new way for prevention and treatment of urinary tract infection.Methods Twenty male New Zealand long-eared white rabbits were divided into gentamicin control group and three different concentrations herba houttuyniae groups according to random number table method, each group 5 rabbits. The rabbit bladder infection model was replicated by injecting coli liquid 1 mL (105 cfu/mL) into the urinary bladder through a urethral catheter, and clipping the catheter for 1 hour. After model establishment for 3 days, in the three herba houttuyniae groups, 0.25, 0.50, 1.00 g/mL herba houttuyniae liquid 50 mL were injected into the bladder respectively, and in the gentamicin control group, 160 kU gentamicin was injected into the bladder. Before molding and after molding for 3, 5, 7, 9 days, ear blood in rabbit was taken, and white blood cell (WBC) count and neutrophil percentage (N%) were tested; at the same time, the middle segment morning urine was taken to detect bacteriuria and urine WBC positive rates; after the experiment, the animals were sacrificed, the urinary bladder tissues were taken, and the pathological changes in urinary bladder tissue were observed by a light microscope.Results Before molding, the bacteriuria in animals of each group was negative and the results of urine WBC, blood WBC and N% were within normal range. After molding for 3 days, bacteriuria and urine WBC positive rates reached 100%; with the prolongation of treatment after molding, the above two rates in each group were gradually decreased, and herba houttuyniae 0.50 g/mL and 1.00 g/mL groups appeared statistical significance on the 5th day (bacteriuria positive rate was 60% and 40%, urine WBC positive rate was 60% and 40% respectively, while the gentamicin control group and herba houttuyniae 0.25 g/mL group was still 100% positive, allP < 0.01); on the 9th day, the bacteriuria positive rate in both higher dosage herba houttuyniae groups was 0, in 0.25 g/mL group, it still had the positive rate 20%, showing herba houttuyniae 0.50 g/mL and 1.00 g/mL had stronger inhibitory effect than herba houttuyniae 0.25 g/mL. WBC and N% were increased in each group after molding, and on the 3rd day, WBC and N were significantly higher in each group than those before molding [WBC (×109/L): gentamicin control group 13.00±5.23 vs. 8.95±2.69, herba houttuyniae 0.25 g/mL group 14.52±10.28 vs. 8.73±3.16, herba houttuyniae 0.50 g/mL group 12.97±11.33 vs. 7.83±4.51, herba houttuyniae 1.00 g/mL group 13.03±9.17 vs. 6.45±3.85. N%: gentamicin control group 80.99±14.93 vs. 63.41±7.96, herba houttuyniae 0.25 g/mL group 89.62±9.41 vs. 70.01±9.13, herba houttuyniae 0.50 g/mL group 87.69±11.34 vs. 67.75±8.91, herba houttuyniae 1.00 g/mL group 85.67±12.81 vs. 65.12±4.63]. On the 7th day, WBC and N% fell, and on the 9th day, the WBC and N% were restored to normal range in herba houttuyniae 0.50 g/mL and 1.00 g/mL groups [WBC (×109/L): herba houttuyniae 0.50 g/mL group 8.56±5.38, herba houttuyniae 1.00 g/mL group 7.93±4.82. N%: herba houttuyniae 0.50 g/mL group 65.97±8.35, herba houttuyniae 1.00 g/mL group 65.57±9.12]. Under light microscopy, it was shown that the morphological appearances of tissue cells in various layers of bladder mucosa were normal in herba houttuyniae group, demonstrating that herba houttuyniae fluid in bladder did not cause allergic inflammatory reaction, etc.Conclusion The bacteriostatic action of herba houttuyniae liquid for bladder irrigation in treatment of rabbits with urinary tract infection is better than that of gentamicin.