Objective To explore the risk factors of orthostatic hypotension(OH)in patients with multiple system atrophy(MSA).Methods A total of 199 MSA patients were included,and they were divided into groups based on the severity of OH.The data differences between the groups were compared,and the risk factors for the occurrence of OH in MSA patients were analyzed from ordered Logistic regression.Results There were significant differences in gender,diabetes,disease grade,syncope,supine hypertension,fatigue and brain protective drugs among patients with different OH grades(all P＜0.05).Ordered Logistic regression analysis found that disease grade(probable MSA),syncope,supine hypertension,and fatigue were independent risk factors for the occurrence of OH in MSA patients(all P＜0.05).Conclusions OH is commonly present in MSA patients,and its severity is influenced by many factors.Disease grade(probable MSA),syncope,lying hypertension and fatigue are independent risk factors of OH in patients with MSA.

The establishment of a traceability system for the entire industry chain of Chinese medicinal materials can enhance regional brand building,raise the quality awareness of medicinal material producers,standardize the production processes of Chinese medicinal materials,and ensure the production of high-quality medicinal materials.Sichuan Province has successfully implemented a provincial-level Traditional Chinese Medicine(TCM)tracing system that is interconnected across provinces,cities,and counties.This system enables the complete tracking of the entire supply chain,starting from seed and seedling cultivation,through planting and breeding,harvesting and processing,and finally to the production and distribution of decoction pieces in trade and medical institutions.This research provides a comprehensive overview of the progress made in establishing the Chinese herbal medicine traceability system in Sichuan Province.It analyzes the existing challenges faced by participating enterprises,such as the hierarchy of involvement,information integrity,and the overall impact of the system.Moreover,the paper presents valuable insights and suggestions for the further development of the Chinese herbal medicine traceability system in Sichuan Province.These recommendations focus on enhancing the traceability scope,improving service capabilities,promoting data sharing,and establishing standardized norms and guidelines.

Purpose: Neoadjuvant chemotherapy is strongly recommended for advanced gastric cancer due to good local control and a high rate of R0 dissection with this strategy. Minimally invasive techniques such as laparoscopy-assisted or total laparoscopic approaches is becoming more and more acceptable in the treatment for gastric cancer. However, the safety and efficiency of total laparoscopic D2 gastrectomy (TLG) for advanced gastric cancer after neoadjuvant chemotherapy have not been well evaluated. Methods: A retrospective study in a single center from 2014 to 2016 was conducted. A total of 65 locally advanced gastric cancers were treated by laparoscopy-assisted gastrectomy (LAG) or TLG. Parameters which include operation time, blood loss, complications, hospital stay, 3-year overall survival, and 3-year disease-free survival were used for comparison. Results: The time of operation in the TLG group was shorter than in the LAG group (P = 0.013), blood loss was less (P = 0.002) and time to first flatus was shorter (P = 0.039) in the TLG group than that in the LLG group. Intraoperative and postoperative complications were comparable in both groups. No significant difference was found in 3-year overall and disease-free survival. Conclusion For patients with locally advanced gastric cancer after neoadjuvant chemotherapy, laparoscopic D2 gastrectomy can be considered as a safe and efficient alternative. A further multicenter prospective randomized controlled study is needed to elucidate the applicability of this technique for advanced gastric cancer.

Objective To investigate the expression levels and clinical significance of absolute counts of lymphocyte subsets and immunoglobulins (Ig) in peripheral blood of children with autism spectrum disorder (ASD). Methods Seventy-five children with ASD were selected as study group, and another 75 healthy children who underwent physical examination were selected as control group. Flow cytometry was used to detect the absolute counts of lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺, CD19⁺, CD56⁺CD16⁺) and IgA, IgG, IgM levels in peripheral blood of both groups of children. Pearson correlation analysis was used to explore the correlation between each detection index and the total score of the Childhood Autism Rating Scale (CARS). Results The number of absolute counts of CD3⁺ and CD4⁺ in the study group were (62.49±8.71) and (34.87±7.86) in one μL, respectively, which were separately lower than (67.73±5.11) and (39.56±4.60)]in one μL in the control group (P < 0.05). There were no significant differences in the absolute counts of CD8⁺, CD19⁺, CD56⁺CD16⁺ between the two groups (P>0.05). The levels of IgA, IgG, IgM in the study group were (0.79±0.33), (8.39±2.03), (0.95±0.27), respectively, which were lower than (0.94±0.29), (9.28±1.37), (1.16±0.39) in the control group (P < 0.05). Pearson correlation analysis showed that IgA level was significantly negatively correlated with CARS total score (r= -0.317, P=0.034), while the absolute counts of CD3⁺, CD4⁺, CD8⁺, CD19⁺, CD56⁺CD16⁺ and IgG, IgM levels had no correlation with CARS total score (P>0.05). Conclusion Abnormal expression levels of lymphocyte subsets and Ig-mediated immune dysfunction are closely related to the occurrence of ASD in children. CD3⁺, CD4⁺, IgA, IgG, and IgM can be used as potential biological indicators for screening the immunological etiology of ASD in children, and IgA can be used as an indicator for evaluating the efficacy of ASD children with immunological etiology.

Objective To evaluate the efficacy and safety of high intensity focused ultrasound(HFIU)combined with endometrial ablation in the treatment of adenomyosis(AM)patients with heavy menstrual bleeding(HMB).Method A total of 199 patients with AM combined with HMB who underwent HIFU treatment at the Obstetrics and Gynecology Center of Affiliated Hospital of Chengdu University of TCM from July 2020 to September 2022 were selected and divided into two groups according to the ablation range.The combined ablation group included 80 cases with lesion and endometrial ablation(endometrial ablation rate≥30%),while the lesion ablation group 119 cases with simple lesion ablation.A 1∶1 propensity score matching was performed on the two groups,resulting in 59 patients in each group.A 6-month follow-up was conducted.The clinical manifestations(menstrual volume,degree of dysmenorrhea,uterine and lesion volume),quality of life(MS-QOL,UFS-QOL),and postoperative adverse reactions between the two groups before and 6 months after surgery was compared.Results Menstrual volume,degree of dysmenorrhea,uterine and lesion volume,MS-QOL score,and UFS-QOL score of the both groups were improved 6 months after surgery,when compared to those before surgery(P<0.05).Significantly reduced menstrual volume,degree of dysmenorrhea,and lower MS-QOL score were observed in the combined ablation group when compared with the lesion ablation group(P<0.05),but there was no statistical significance in uterine and lesion volume and UFS-QOL score(P>0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05),but the combined ablation group had longer vaginal bleeding and fluid flow time(P<0.05).Conclusion The combined HIFU and endometrial ablation can effectively reduce menstrual flow,alleviate dysmenorrhea,and improve quality of life in patients with AM combined with HMB.Although it increases vaginal bleeding and fluid flow time,reasonable symptomatic management can effectively prevent the occurrence of adverse consequences such as infection.

Objective To investigate the effect of acupuncture combined with Shenfu injection on brain injury and hemodynamics after cardiopulmonary resuscitation in patients with cardiac arrest.Methods A total of 100 patients who underwent cardiopulmonary resuscitation after cardiac arrest admitted to 903rd Hospital of the Joint Support Force of PLA from May 2019 to May 2022 were selected as the research objects,and they were divided into acupuncture group and combined group,with 50 cases in each group according to the random number table method.The acupuncture group was given acupuncture therapy,and the combined group was injected Shenfu injection on the basis of acupuncture group.S100β,neuron specific enolase(NSE),National Institutes of Health stroke scale(NIHSS)score,mini mental status examination(MMSE)score,hemodynamic index,Glasgow coma scale(GCS)score,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score and incidence of adverse reactions were compared between two groups.Results After treatment,S100β,NSE,NIHSS score,APACHE Ⅱscore,and heart rate(HR)of two groups were significantly lower than those before treatment,MMSE score,GCS score,cardiac output(CO),central venous pressure(CVP),mean arterial pressure(MAP)were significantly higher than those before treatment(P<0.05).S100β,NSE,NIHSS score,APACHE Ⅱ score and HR in combined group were significantly lower than those in acupuncture group,and MMSE score,GCS score,CO,CVP,and MAP were significantly higher than those in acupuncture group(P<0.05).The incidence of adverse reactions in combined group was significantly lower than that in acupuncture group(χ2=6.453,P=0.011).Conclusion Acupuncture combined with Shenfu injection treatment can improve brain injury and hemodynamics after cardiopulmonary resuscitation in patients with cardiac arrest,and the effect is significant.

Objective:This study aims to analyze the efficacy and safety of anlotinib in the real world for patients with unresectable or metastatic bone and soft-tissue sarcomas(STSs). Methods:Clinical data of 124 patients with unresectable or metastatic bone and STSs treated with anlotinib in the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2020 were retrospectively analyzed.Information on age,sex,performance status,lines of anlotinib,surgical history,reduction of anlotinib,adverse reaction,metastatic site,tumor location,pathological subtypes and combination chemotherapy was collected and analyzed.The objective response rate(ORR)and disease control rate(DCR)was analyzed for short-term efficacy.Kaplan-Meier method was performed for survival analysis,and the evaluation indexes were median progression-free survival(mPFS)and median overall survival(mOS). Results:The main pathological subtypes of 124 patients were Synovial sarcoma(SS),Leiomyosarcoma(LMS),liposarcoma(LPS).The median age was 48.5 years(9-83 years).The ORR and DCR of anlotinib used in first-line therapy were 26.8％and 82.1％,but in second-line therapy and beyond,the ORR and DCR only were 5.9％and 64.7％.There were improvement in mPFS and mOS with anlotinib in first-line therapy compared to second-line therapy and beyond(mPFS:22.0 months vs 7.0 months,P=0.001;mOS:51.0 months vs 32.0 months,P=0.035).Adverse reactions of anlotinib were well tolerated,and the main grades of adverse reactions were grade Ⅰ and Ⅱ.No new anlotinib-related adverse reactions were identified. Conclusion:Anlotinib has shown a definite effect in the treatment of unresectable or metastatic bone and STSs.The adverse events of anlotinib are minor and well tolerated,and the efficacy of first-line treatment is better.

Objective:To establish the quality evaluation method of Prunellae spica dispensing granules based on three quality indexes of standard decoction. Methods:Fourteen batches of Prunellae spica were collected from different habitats. According to technical requirements, fourteen batches of Prunellae spica standard decoction and three batches of formula granules were prepared and the paste-forming rates were calculated. The fingerprints of Prunellae spica standard decoction and formula granules were established by Ultra High Performance Liquid Chromatography (UPLC). The similarity values of fingerprints between dispensing granules and standard decoction were calculated. The content and transferring rate of Rosmarinic acid were determined and calculated. Results:The average paste-forming rate of Prunellae spica was (12.59±2.32)%. The paste-forming rates of the three batches were 11.14%, 10.78% and 10.39% respectively. The average content of Rosmarinic acid in standard decoction was (18.99±9.74)mg/g. The average transferring rate was (60.58±7.87)%. The contents of three batches were 7.40 mg/g, 7.49 mg/g and 7.09 mg/g. The transferring rates were 52.06%, 50.10% and 50.40% respectively. Nine common fingerprint peaks were identified in the fingerprints of standard decoction and formula granules, two of which were identified as Rosmarinic acid and Caffeic acid by comparison of reference substance. The fingerprints similarity of Prunellae spica dispensing granules and standard decoction were 0.954, 0.973 and 0.952, respectively. Conclusions:The quality indexes of three batches of formulation granules are consistent with standard decoction. This method could provide reference for the establishment of quality standard of Prunellae spica dispensing granules.

Purpose: Our study aimed to make a propensity score matching (PSM) analysis on the clinical application of gastricjejunum pouch anastomosis (GJPA) and Billroth-II anastomosis after distal gastrectomy. Methods: We collected clinical data from 249 patients who received distal gastrectomy from January 2016 to July 2020. According to the reconstruction method used, all patients were divided into the Billroth-II group and the GJPA group. Clinical data and operation complications were analyzed. Results: The clinical characteristics of the 2 groups were comparable after PSM. In the Billroth-II group, the incidence rate of delayed gastric emptying was higher than that in the GJPA group. Fewer patients suffered reflux gastritis in the GJPA group. The RGB (residue, gastritis, and bile) scores related to the severity of bile reflux into the remnant stomach, gastritis, and residue were higher in the Billroth-II group. Postoperative nutritional status and Visick classification demonstrated that postoperative subjective feelings in the GJPA group were improved significantly. Conclusion The application of GJPA in reconstruction after distal gastrectomy is safe, economical, and reliable. This reconstruction improved the quality of life of patients. It is worth popularizing widely in clinical settings.

Objective: To analyze the differentially expressed genes of patients with oral squamous cell carcinoma (OSCC) from paracarcinoma through biological information analysis to preliminarily identify OSCC-associated genes. Methods: GSE23558, GSE37991 and GSE30784 were downloaded from the Gene Expression Omnibus (GEO), which is the mRNA expression profile dataset. The differentially expressed genes (DEGs) were identified based on the gene ontology and the Kyoto Encyclopedia of Genes and Genomes. Then, the protein-protein interaction (PPI) network was constructed using the STRING online tool, and Cytoscape was used to filter the critical genes. Furthermore, key genes involved in the survival of patients with OSCC were analyzed using Kaplan-Meier analysis. The expression of hub genes was validated based on GEPIA（http://gepia.cancer-pku.cn/）. Results : A total of 212 DEGs were screened, and further analysis revealed 16 core genes, among which the core genes associated with prognosis included aurora kinase A (AURKA), aurora kinase B (AURKB), apoptosis inhibiting factor 5 (BIRC5), cell division cycle 6 (CDC6), E2F transcription factor 7 (E2F7), ubiquitin-like with PHD and ring finger domains 1 (UHRF1). These key genes were highly expressed in patients with oral squamous cell carcinoma, and the survival time of patients was short; the difference was statistically significant (P < 0.05). Conclusion AURKA, AURKB, BIRC5, CDC6, E2F7 and UHRF1 may be useful as potential biomarkers for OSCC prognosis prediction.