ObjectiveTo explore the mechanism of Yishen Huashi granules in alleviating renal tubular epithelial cell injury and relieving diabetic kidney disease by regulating the mitogen-activated protein kinase （MAPK） signaling pathway. MethodsThe db/db mice of 12 weeks old were randomly assigned into model ， dapagliflozin （1.6 mg·kg^-1）， and Yishen Huashi granules （4.7 g·kg^-1）， and db/m mice were used as the control group. The general conditions of mice were observed， and fasting blood glucose and 24-h urinary protein and albumin-to-creatinine ratio （ACR） were measured at weeks 0 and 12 of administration. After 12 weeks of treatment， the levels of serum creatinine （SCr）， blood urea （UREA）， triglycerides （TG）， total cholesterol （TC）， and low density lipoprotein （LDL） were measured. The pathological changes in the renal tissue were observed by hematoxylin-eosin （HE） staining， Periodic acid-Schiff （PAS） staining， Mallory staining， and transmission electron microscopy. Real-time PCR was employed to determine the mRNA levels of monocyte chemotactic protein-1 （MCP-1） and CC chemokine receptor-2 （CCR2） in the renal tissue of mice. The immunohistochemical assay was employed to examine the expression of p38， phospho-p38 （p-p38）， MCP-1， and CCR2 in the renal tissue of mice. Western blotting was employed to measure the protein levels of p-p38， p38， MCP-1， and CCR2 in the renal tissue of mice.HK-2 cells cultured in vitro were grouped as follows： negative control， high glucose（30 mmol·L^-1）， Yishen Huashi granule-containing serum， and SB203580. After 48 h of cell culture in each group， RNA were extracted and the levels of MCP-1， and CCR2 mRNA were determined by Real-time PCR，proteins were extracted and the levels of p38， p-p38， MCP-1， and CCR2 were determined by Western blot. ResultsThe in vivo experiments showed that before treatment， other groups had higher body weight， blood glucose level， 24 h urinary protein， and ACR than the control group （P<0.05，P<0.01）. After 12 weeks of treatment， compared with the model group， the Yishen Huashi granules group showed improved general conditions， a decreasing trend in body weight， lowered levels of blood glucose， 24-h urinary protein， and ACR （P<0.01）， reduced SCr and UREA （P<0.01）， and declined levels of TC， TG， and LDL （P<0.05，P<0.01）. Compared with the model group， the Yishen Huashi granules group showed alleviated damage and interstitial fibrosis in the renal tissue as well as reductions in glomerular foot process fusion and basement membrane thickening. Moreover， the Yishen Huashi granules group showed down-regulated mRNA levels of MCP-1 and CCR2 （P<0.01）， reduced positive expression of p-p38， MCP-1， and CCR2 （P<0.01）， and down-regulated protein levels of p-p38/p38， MCP-1， and CCR2 （P<0.05） in the renal tissue. The cell experiment showed that compared with the high glucose group， the Yishen Huashi granule-containing serum group showcased down-regulated mRNA levels of MCP-1 and CCR2 （P<0.01） and down-regulated protein levels of p-p38/p38， MCP-1， and CCR2（P<0.05，P<0.01）. ConclusionYishen Huashi granules can regulate glucose-lipid metabolism， reduce 24 h urinary protein and ACR， improve the renal function， alleviate the renal tubule injury caused by high glucose， and protect renal tubule epithelial cells in db/db mice by reducing MCP-1/CCR2 activation via the p38 MAPK signaling pathway.

ObjectiveTo investigate the mechanism of Shenkang injection in delaying diabetic kidney disease by regulating endoplasmic reticulum stress and attenuating podocyte apoptosis through the Glucose regulated protein 78 （ GRP78 ） / transcription factor C / EBP homologous protein （ CHOP ） signaling pathway （GRP78/CHOP） signaling pathway. MethodsFor the animal experiment， 10 12-week-old db/m mice were selected as a normal group， and 30 12-week-old db/db mice were randomly divided into a model group， a Shenkang injection group （15.6 mL·kg^-1）， and a dapagliflozin group （1.6 mg·kg^-1）. To observe the general condition of mice， fasting blood glucose， urinary albumin/urine creatinine （ACR）， and 24 h urine protein quantification were detected in each group before drug administration. After 12 weeks of drug treatment， mice were tested for fasting blood glucose， total cholesterol （TC）， triglyceride （TG）， low-density cholesterol （LDL）， ACR， 24 h urine protein quantification， blood creatinine （SCr）， and blood urea （UREA）. Hematoxylin-eosin （HE） staining， periodic acid-Schiff （PAS） staining， and transmission electron microscopy were used to observe the pathologic morphology in renal tissue. Immunohistochemistry was used to detect the expressions of nephroprotective marker protein （Nephrin）， glucose-regulated protein 78 （GRP78）， CCAAT/enhancer-binding protein homologous protein （CHOP）， B-cell lymphoma-2 （Bcl-2）， and Bcl-2-associated X protein （Bax） in renal tissue. Western blot was used to detect the expressions of GRP78， CHOP， Bcl-2， Bax， and Nephrin proteins， and Real-time polymerase chain reaction （Real-time PCR） was employed to detect the expressions of Nephrin， GRP78， CHOP， Bcl-2， and Bax mRNAs in renal tissue. ResultsBefore drug administration， compared with those in the normal group， the body mass of db/db mice was significantly increased， and blood glucose， 24 h urine protein quantification， and ACR were significantly elevated in the Shenkang injection group and Dapagliflozin group （P<0.01）. After 12 weeks of administration， compared with those in the model group， the general state of mice in the Shenkang injection group was significantly improved， and the body mass was decreased. The blood glucose was significantly reduced （P<0.01）， and blood lipids TC， TG， and LDL were significantly decreased （P<0.05， P<0.01）. The 24 h urine protein quantification and ACR were significantly decreased （P<0.05）， and SCr and UREA were significantly reduced （P<0.01）. Compared with those of the model group， the pathologic results of the Shenkang injection group showed that proliferation of mesangial cells， reduction of inflammatory cell infiltration， and alleviation of renal tubular vacuolization and podocyte damage were observed in renal tissue of mice. Electron microscopy showed that fusion of the pedicle protruding and thickening of the basement membrane were reduced. Immunohistochemistry results showed that the expressions of GRP78， CHOP， and Bax proteins were significantly reduced （P<0.01）， and the expressions of Nephrin and Bcl-2 proteins were significantly increased （P<0.01） in renal tissue of the Shenkang injection group. Western blot results showed that the expressions of Nephrin and Bcl-2 in the Shenkang injection group were significantly increased （P<0.05， P<0.01）， and the expressions of GRP78， CHOP， and Bax proteins were significantly decreased （P<0.05， P<0.01）. Real-time PCR results showed that the expressions of GRP78， CHOP， and Bax mRNAs were down regulated in the Shenkang injection group （P<0.01）， and the expressions of Nephrin and Bcl-2 mRNAs were up regulated （P<0.01）. ConclusionShenkang injection inhibits endoplasmic reticulum stress response and podocyte apoptosis by regulating the GRP78/CHOP signaling pathway， which in turn ensures the integrity of glomerular filtration barrier， reduces the occurrence of proteinuria， improves renal function， and thus delays the progression of diabetic kidney disease.

ObjectiveTo investigate the mechanism of Shenkang injection in delaying diabetic kidney disease by regulating endoplasmic reticulum stress and attenuating podocyte apoptosis through the Glucose regulated protein 78 （ GRP78 ） / transcription factor C / EBP homologous protein （ CHOP ） signaling pathway （GRP78/CHOP） signaling pathway. MethodsFor the animal experiment， 10 12-week-old db/m mice were selected as a normal group， and 30 12-week-old db/db mice were randomly divided into a model group， a Shenkang injection group （15.6 mL·kg^-1）， and a dapagliflozin group （1.6 mg·kg^-1）. To observe the general condition of mice， fasting blood glucose， urinary albumin/urine creatinine （ACR）， and 24 h urine protein quantification were detected in each group before drug administration. After 12 weeks of drug treatment， mice were tested for fasting blood glucose， total cholesterol （TC）， triglyceride （TG）， low-density cholesterol （LDL）， ACR， 24 h urine protein quantification， blood creatinine （SCr）， and blood urea （UREA）. Hematoxylin-eosin （HE） staining， periodic acid-Schiff （PAS） staining， and transmission electron microscopy were used to observe the pathologic morphology in renal tissue. Immunohistochemistry was used to detect the expressions of nephroprotective marker protein （Nephrin）， glucose-regulated protein 78 （GRP78）， CCAAT/enhancer-binding protein homologous protein （CHOP）， B-cell lymphoma-2 （Bcl-2）， and Bcl-2-associated X protein （Bax） in renal tissue. Western blot was used to detect the expressions of GRP78， CHOP， Bcl-2， Bax， and Nephrin proteins， and Real-time polymerase chain reaction （Real-time PCR） was employed to detect the expressions of Nephrin， GRP78， CHOP， Bcl-2， and Bax mRNAs in renal tissue. ResultsBefore drug administration， compared with those in the normal group， the body mass of db/db mice was significantly increased， and blood glucose， 24 h urine protein quantification， and ACR were significantly elevated in the Shenkang injection group and Dapagliflozin group （P<0.01）. After 12 weeks of administration， compared with those in the model group， the general state of mice in the Shenkang injection group was significantly improved， and the body mass was decreased. The blood glucose was significantly reduced （P<0.01）， and blood lipids TC， TG， and LDL were significantly decreased （P<0.05， P<0.01）. The 24 h urine protein quantification and ACR were significantly decreased （P<0.05）， and SCr and UREA were significantly reduced （P<0.01）. Compared with those of the model group， the pathologic results of the Shenkang injection group showed that proliferation of mesangial cells， reduction of inflammatory cell infiltration， and alleviation of renal tubular vacuolization and podocyte damage were observed in renal tissue of mice. Electron microscopy showed that fusion of the pedicle protruding and thickening of the basement membrane were reduced. Immunohistochemistry results showed that the expressions of GRP78， CHOP， and Bax proteins were significantly reduced （P<0.01）， and the expressions of Nephrin and Bcl-2 proteins were significantly increased （P<0.01） in renal tissue of the Shenkang injection group. Western blot results showed that the expressions of Nephrin and Bcl-2 in the Shenkang injection group were significantly increased （P<0.05， P<0.01）， and the expressions of GRP78， CHOP， and Bax proteins were significantly decreased （P<0.05， P<0.01）. Real-time PCR results showed that the expressions of GRP78， CHOP， and Bax mRNAs were down regulated in the Shenkang injection group （P<0.01）， and the expressions of Nephrin and Bcl-2 mRNAs were up regulated （P<0.01）. ConclusionShenkang injection inhibits endoplasmic reticulum stress response and podocyte apoptosis by regulating the GRP78/CHOP signaling pathway， which in turn ensures the integrity of glomerular filtration barrier， reduces the occurrence of proteinuria， improves renal function， and thus delays the progression of diabetic kidney disease.

Objective To investigate the predictive value of serum procalcitonin(PCT),interleukin-6(IL-6),C-reactive protein/albumin(CRP/ALB)and microRNA-335-5p(miR-335-5p)for bowel obstruction after colorectal cancer(CRC)surgery.Methods A total of 100 CRC patients admitted to the hospital and under-went surgical treatment from July 2022 to July 2023 were selected to observe whether intestinal obstruction occurred in patients 1 week after surgery,and they were divided into the intestinal obstruction group(13 ca-ses)and the non-intestinal obstruction group(87 cases)according to the occurrence of intestinal obstruction.The clinical data and serum PCT,IL-6,CRP/ALB,miR-335-5p levels of the two groups were compared,and Multivariate Logistic regression was used to analyze the risk factors for the occurrence of intestinal obstruc-tion after CRC surgery.The predictive value of serum PCT,IL-6,CRP/ALB,miR-335-5p for the occurrence of intestinal obstruction after CRC surgery was analyzed.Results Postoperative serum PCT,IL-6,CRP/ALB and miR-335-5p levels were higher than the preoperative levels in CRC patients(P＜0.05).Among 100 pa-tients for CRC surgery,a total of 13(13.00％)d eveloped intestinal obstruction within 2 weeks after surgery.The proportions of rectal tumor and clinical stage Ⅲ、miR-335-5p were higher in the intestinal obstruction group than those in the non-intestinal obstruction group,and the proportion of laparoscopic surgery was lower than that in the non-intestinal obstruction group(P＜0.05).Serum PCT,IL-6,and CRP/ALB levels were higher in the intestinal obstruction group than those in the non-intestinal obstruction group,miR-335-5p level was lower than that in the non-intestinal obstruction group(P＜0.05).Serum PCT,IL-6 and CRP/ALB were independent risk factors for the occurrence of intestinal obstruction after CRC surgery(P＜0.05),and miR-335-5p was a protective factor(P＜0.05).The area under the curve(AUC)of serum PCT,IL-6,CRP/ALB,miR-335-5p and the combined detection for predicting the occurrence of intestinal obstruction after CRC sur-gery was 0.818,0.805,0.862,0.938,and 0.980,and AUC of the combined detection was higher than that of single detection(ZPCT-combined detection-2.193,ZIL-6 combined detection-2.210,Z CRP/ALB combined detection=2.188,ZmiR-335-5p combined detection=2.437,P＜0.05).Conclusion Postoperative serum PCT,IL-6,CRP/ALB and miR-335-5p of CRC patients have a certain predictive value for the occurrence of intestinal obstruction in patients,and the combined detection could largely improve the accuracy of predicting the occurrence of postoperative intes-tinal obstruction.

Objective:To investigate the efficacy and adverse reactions of concurrent chemoradiotherapy (CRT) and radiotherapy (RT) alone in the treatment of cervical cancer patients with intermediate-risk factors after operation.Methods:The clinical data of 210 patients with cervical cancer patients after operation in Shanxi Province Cancer Hospital between August 2014 to March 2016 were retrospectively analyzed. The postoperative pathology met the Sedlis standard. All patients were divided into RT alone group (100 cases) and CRT group (110 cases) according to the different adjuvant treatment regimens; and the efficacy and adverse reactions of both groups were also analyzed.Results:The 3-year progression-free survival (PFS) rate was 82.8%, 81.5%, respectively in RT alone group and CRT group ; 5-year PFS rate was 80.6%, 77.4%, respectively in RT alone group and CRT group; and there were no statistically significant differences in the PFS of both groups ( χ2 = 0.29, P = 0.591). The 3-year overall survival (OS) rate was 88.5%, 86.7%, respectively in RT alone group and CRT group; 5-year OS rate was 86.4%,82.6%, respectively in RT alone group and CRT group; and there were no statistically significant differences in the OS of both groups ( χ2 = 0.59, P = 0.443). The local recurrence rate was 8.0% (8/100) and 9.1% (10/110), respectively in RT alone group and CRT group, and the difference was statistically significant ( χ2 = 0.08, P = 0.778); the distant metastasis rate was 11.0% (11/100) and 12.7% (14/110), respectively in RT alone group and CRT group, and the difference was statistically significant ( χ2 = 0.15, P = 0.699); the incidence of bone marrow suppression was 42.0% (42 /100) and 61.8% (68/110), respectively in RT alone group and CRT group, and the difference was statistically significant ( χ2 = 8.25, P < 0.01). The incidence of gastrointestinal reactions was 23.0% (23/100) and 77.3% (85/110), respectively in RT alone group and CRT group, and the difference was statistically significant ( χ2 = 49.94, P < 0.01);the incidence of radiation cystitis was 3.0% (3/100) and 3.6% (4/110), respectively in RT alone group and CRT group, and the difference was statistically significant ( χ2 = 0.06, P = 0.798). The incidence of radiation proctitis was 5.0 %(5/100) and 4.5% (5/110), respectively in RT alone group and CRT group, and the difference was statistically significant ( χ2 = 0.02, P = 0.877). Conclusions:For cervical cancer patients with intermediate-risk factors, CRT shows no survival benefit and increases the incidence of adverse reactions compared with RT alone.

Objective Through factor analysis of the quantified syndrome information of 558 cases of kidney yang deficiency syndrome,the constructing feature of kidney yang deficiency syndrome was revealed,which provides clinical data support for the objectification,standardization and normalization of kidney Yang deficiency syndrome.Methods Firstly,the frequency analysis of symptoms,tongue and pulse signs of 558 patients with kidney Yang deficiency syndrome was carried out,and then the main syndrome information of the patients with kidney Yang deficiency syndrome was quantified.Finally,the common factors and their representative variables of kidney Yang deficiency syndrome were screened out through factor analysis,and the constructing feature of kidney Yang deficiency syndrome was analyzed combined with TCM syndrome knowledge.Results Eight common factors with eigenvalues greater than 1 were extracted by principal component analysis,and the cumulative contribution rate was 60.483%.After the factor rotation,the representative variables with the absolute value of load coefficient greater than 0.45 in each common factor were selected.The representative variables of F1 are afraid of cold and fond of warmth(0.947)and intolerance to cold(0.932).The representative variables of F2 are waist pain(0.754),waist and knee weakness(0.720)and cold in waist and knees(0.466).The representative variables of F3 are depression(0.749),insomnia(0.711)and diarrhoea(0.470).The representative variables of F4 are thin fur(0.819)and white fur(0.768).The representative variable of F5 are tinnitus and deafness(0.687),frequent nocturnal urination(0.591)and decreased libido(0.587).The representative variables of F6 are pulse sinking(0.766)and pulse weakness(0.736).The representative variables of F7 is thready pulse(0.942).The representative variable of F8 is pale tongue(0.961).External syndrome of disease location involved in these common factors are waist,bone,brain,ear,anterior Yin,posterior Yin and reproductive function.The disease nature involved in these common factors is deficiency and cold.Conclusion The basic constituent units of kidney Yang deficiency syndrome include disease location syndrome elements and disease nature syndrome elements.The disease location is kidney,and the abnormal changes of kidney location are mainly external symptoms of waist,bone,brain,ear,anterior Yin,posterior Yin and reproductive function.Its disease nature is deficiency and cold.Yang deficiency leads to external cold.Yang Qi deficiency can not warm the body surface resulting in the appearance of external cold syndrome.

ObjectiveTo analyze the characteristics of kidney Yang deficiency syndrome in different stages and time evolution of chronic kidney disease （CKD） to explore the evolution patterns of kidney Yang deficiency syndrome in CKD. MethodThe evidence information of 256 patients with CKD was collected from October 2020 to September 2022 according to relevant standards， and the "Kidney Yang Deficiency Syndrome Evaluation Scale for Chronic Kidney Disease" was developed. With SPSS Statistics 20.0， SPSS Modeler 18.0， Gephi 0.9.2， and R 4.2.1， the syndrome information of CKD patients at various stages and the syndrome changes after one year were statistically analyzed using complex network analysis， association rule analysis， probability transition matrix analysis， and chi-square test， and the kidney Yang deficiency syndrome of patients at various stages was comprehensively evaluated. ResultIn the CKD population， the proportion of females with kidney Yang deficiency syndrome was higher than that of males （P<0.01）， and the proportion of people over 65 years old was higher than in people under 65 years old. The proportion of people with kidney Yang deficiency syndrome increased with the progression of kidney disease， and the proportion of Ⅳ-Ⅴ CKD patients with kidney Yang deficiency syndrome was higher than that of Ⅰ-Ⅱ CKD patients （P<0.01）. From Ⅰ CKD to Ⅴ CKD， the frequency of dull tongue continued to increase， and the frequency of enlarged tongue and tooth-marked tongue continued to increase after Ⅲ CKD. The frequency of thick coating and greasy coating ranked in the top 3 of frequency distribution in Ⅴ CKD. After Ⅲ CKD， the top 3 tongue characteristics were weak pulse， deep pulse， and thready pulse， all of which were characteristics of kidney Yang deficiency syndrome. Complex network analysis of the tongue and pulse showed that the core tongue and pulse characteristics of patients with end-stage CKD were tooth-marked tongue with white coating and deep and thready pulse. The results of symptom frequency analysis and complex network analysis showed that aversion to cold and preference for warmth， weakness of the knees， and cold extremities were the top 3 symptoms in Ⅰ-Ⅲ CKD patients with kidney Yang deficiency syndrome， and in Ⅳ-Ⅴ CKD， the manifestations of the syndrome of Yang deficiency and water diffusion， such as drowsiness and fatigue， edema， and frequent urination at night became characteristic symptoms. The scores of edema， pale complexion， soreness and weakness of the waist and knees， loose stools， and mental depression symptoms， as well as the total score of kidney Yang deficiency syndrome gradually increased with disease progression， with statistical differences between different stages of CKD （P<0.05， P<0.01）. The frequency analysis of disease-related syndrome elements showed that the frequencies of Yang deficiency syndrome， phlegm-dampness syndrome， blood stasis syndrome， and turbidity-toxin syndrome gradually increased with disease progression， and there were statistically significant differences in the distribution between different stages of CKD （P<0.05， P<0.01）. The results of complex network analysis showed that Yang deficiency syndrome was the core syndrome element throughout all stages of CKD and was the main syndrome element type of CKD， while phlegm-dampness syndrome， blood stasis syndrome， and turbidity-toxin syndrome were gradually revealed in the middle and late stages of CKD. In the CKD population with kidney-Yang deficiency syndrome， the distribution of phlegm-dampness syndrome， blood stasis syndrome， and turbidity-toxin syndrome as concurrent syndromes in different CKD stages had statistically significant differences （P<0.05， P<0.01）. The association rule analysis showed that as the disease progressed， associations between the concurrent syndromes， such as phlegm-dampness syndrome， blood stasis syndrome， turbidity-toxin syndrome， and fluid retention syndrome， and kidney-Yang deficiency syndrome were gradually enhanced. The comparison of the changes in CKD with kidney Yang deficiency syndrome within one year showed that the disease location was centered on the kidney and transmitted between the spleen， stomach， heart， and liver. There is a 23.81% probability of kidney-Yang deficiency syndrome transforming into Qi deficiency syndromes （Qi deficiency in the spleen and kidney， Qi deficiency in the liver， and Qi deficiency in the heart）， 23.79% into Yin deficiency syndromes （Yin deficiency in the liver and kidney， Qi and Yin deficiency， and Yin deficiency in the liver and stomach）， and 9.52% into dampness syndromes （phlegm-dampness internal obstruction and wind-dampness obstruction）. In contrast， 20% of spleen and kidney Qi deficiency syndrome transformed into kidney Yang deficiency syndrome， and 33.33% of Qi deficiency and blood stasis syndrome transformed into kidney Yang deficiency syndrome. ConclusionAs Ⅰ CKD progresses to Ⅴ CKD， the severity of kidney Yang deficiency syndrome gradually increases， and the syndrome characteristics of kidney Yang deficiency become pronounced. Furthermore， the pathogenic factors， such as phlegm-dampness， blood stasis， and turbidity-toxin， gradually increase. With the change of time， kidney Yang deficiency syndrome in CKD tends to evolve into syndromes related to Qi deficiency， Yin deficiency， and dampness. The discovery of these rules provides a theoretical basis and reference guidance for the treatment of CKD based on syndrome differentiation.

Objective:To compare the differences of chemical components between single decoction and mixed decoction with different compatibility ratio of Inulae Flos- Haematitum medicinal pair. Methods:UPLC method was used to determine the contents of 5-caffeoylquinic acid, chlorogenic acid, 4-dicaffeoylquinic acid, caffeic acid, isoquercitrin, isochlorogenic acid B, 1,5- dicaffeoyl quinic acid, isochlorogenic acid C and the fingerprints of the single decoctions and mixed decoctions of Inulae Flos- Haematitum medicinal pair in four groups of proportions. The "peak area/sample weight" value of each common peak in the fingerprints was calculated, and the SPSS 26.0 was used for independent-sample t-test analysis. Results:There are significant differences in the "peak area/weight" values of peak 1, peak 2, peak 4, peak 6 , peak 9, peak 10, peak 12, peak 13, peak 15 between mixed decoction and single decoction of Inulae Flos - Haematitum medicinal pair with different compatibility ratios ( P<0.05), with statistical significance; when the compatibility ratio of Inulae Flos- Haematitum medicinal pair was 3:1, the difference of fingerprints and index components content between single decoction and combined decoction was the largest. Except for peak 7 and peak 14, the difference of "peak area/sample weight" value of other characteristic peaks was statistically significant ( P<0.05), and the content difference of 8 index components was statistically significant ( P<0.05). Conclusion:There are differences in the chemical components of Inulae Flos - Haematitum medicinal pair for single decoction and mixed decoction.

ObjectiveTo study the correlations of the characteristics of kidney Yang deficiency syndrome in patients with chronic kidney disease （CKD） with clinical indicators and to explore the risk factors of kidney Yang deficiency in CKD. MethodThe differentiation of traditional Chinese medicine （TCM） syndrome classified the 225 CKD patients who met the inclusion criteria into two groups： one group of kidney Yang deficiency syndrome （99 patients） and one group of non-kidney Yang deficiency syndrome （126 patients）. The symptoms， tongue manifestation， pulse manifestation， and accompanied symptoms of the kidney Yang deficiency syndrome group were recorded. The syndrome characteristics were summarized by factor analysis and clustering analysis. The levels of hemoglobin, red blood cell count, urinary protein, urinary glucose, creatinine, urea nitrogen and glomerular filtration rate were compared between the kidney Yang deficiency syndrome group, the non-kidney Yang deficiency syndrome group and the normal control group by ANOVA and non-parametric test. The binary logistic regression model was employed to analyze the correlations of lifestyle， body mass index （BMI） with syndrome. ResultThe high-frequency symptoms of CKD patients with kidney Yang deficiency syndrome were waist pain， fear of cold， favor of warm， lethargy， fear of cold at waist and knees， etc. The patients mainly presented deep pulse， thready pulse， or weak pulse， and the tongue with white coating， greasy coating， or thin coating. A total of 13 common factors were obtained， which can be classified into 5 categories. The patients with kidney Yang deficiency syndrome mainly had symptoms in limbs （especially lower limbs）， chest， bladder， fleshy exterior， and stomach， with the main manifestations of deficiency-cold， Qi deficiency， fluid retention， and blood stasis. The clustering analysis classified the patients into 11 categories， which reflected that kidney Yang deficiency syndrome mainly presented the symptoms of Qi deficiency， blood stasis， and fluid retention， with fleshy exterior， limbs， spleen， stomach， ears， mind， and bladder involved. The results of clustering analysis and factor analysis were consistent， both of which indicated that the patients were weak with deficiency-cold， accompanied by fluid retention and blood stasis. Frequency analysis also showed that common symptoms mainly included Qi deficiency， fluid retention， cold-dampness， and blood stasis. Compared with the non-kidney Yang deficiency group， the kidney Yang deficiency group showed a large proportion of patients in stage 3-5 CKD， elevated urea nitrogen （P<0.05）， decreased glomerular filtration rate， hemoglobin， and red blood cell count （P<0.05）， and increased qualitative grade of urine protein. In addition， the results of regression analysis showed that female， little or no exercise， and diet preference were the risk factors for kidney Yang deficiency syndrome in CKD （P<0.05）. ConclusionThe disease location and manifestations have correspondence in the CKD patients with kidney Yang deficiency syndrome. The TCM symptoms are correlated with clinical indicators. Hemoglobin， red blood cell count， glomerular filtration rate， urea nitrogen， and urine protein can reflect the connotation of kidney Yang deficiency syndrome in CKD to a certain extent. Additionally， related risk factors in life can affect the occurrence of kidney Yang deficiency syndrome in CKD.

Objective:To investigate the relationship between tumor volume changes, squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125) and the prognosis of cervical cancer patients with concurrent radiotherapy and chemotherapy and their combined prediction of prognosis.Methods:One hundred and twenty-eight patients in Shanxi Cancer Hospital from February 2018 to February 2020, with cervical cancer undergoing radical concurrent radiotherapy and chemotherapy were selected for a prospective study. According to different prognostic effects, the patients were divided into poor prognosis group (44 cases) and good prognosis group (84 cases). The general data, tumor reduction rate (TVRR), SCC-Ag, CEA, and CA125 levels were compared between the two groups, and the Logistic regression equation was used to analyze the prognostic factors of patients with concurrent radiotherapy and chemotherapy for cervical cancer. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to analyze the performance of each index and the joint prediction of prognosis. Kaplan-Meier survival curve analysis and log-rank (Mantel-Cox) were used to test the survival curves of TVRR, SCC-Ag, CEA, CA125 high-risk individuals and low-risk individuals.Results:The TVRR in the poor prognosis group was significantly lower than that in the good prognosis group: (76.63 ± 7.52)% vs. (85.54 ± 6.71)%, the SCC-Ag, CEA, CA125 were significantly higher than those in the good prognosis group: (6.98 ± 2.15) μg/L vs. (4.61 ± 1.37) μg/L, (9.34 ± 2.23) μg/L vs. (5.76 ± 1.87) μg/L, (68.79 ± 12.01) kU/L vs. (49.97 ± 15.22) kU/L, and there were statistical differences ( P<0.05). Logistic regression showed that TVRR, SCC-Ag, CEA and CA125 were significant factors influencing the prognosis of patients with concurrent chemoradiotherapy for cervical cancer ( P<0.05). Among the single indicators, TVRR predicted the highest prognosis AUC, and the combined prognostic AUC of all indicators (0.837, 95% CI 0.761 to 0.920) was higher than any single indicator, with a sensitivity of 81.82% and specificity of 84.52%. The survival curves of TVRR, SCC-Ag, CEA, CA125 between high-risk and low-risk patients showed statistically significant differences ( P<0.05). Conclusions:The changes in tumor volume, SCC-Ag, CEA, CA125 and the prognosis of patients with concurrent radiotherapy and chemotherapy for cervical cancer have a certain correlation. The combined examination of the four in the early stage is expected to become a new approach to clinically predict the prognosis of cervical cancer and make appropriate treatment plans.