Objective:Chronic obstructive pulmonary disease(COPD)is a significant global public health issue.Modern medical treatments have both benefits and limitations,prompting increasing attention from scholars worldwide on traditional ethnic medicine,and the Zangsiwei Qingfei Mixture is a newly developed formula derived from the effective components of classical Tibetan medicine to treat chronic respiratory diseases.This study aims to investigate the clinical efficacy and safety of the Zangsiwei Qingfei Mixture combined with conventional treatment in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods:Sixty AECOPD patients admitted to the Second Xiangya Hospital of Central South University from May 2021 to May 2023 were enrolled and randomly divided into 2 groups,with 30 patients in each group.The control group received conventional treatment,including bronchodilators,anti-infection agents,expectorants,and oxygen therapy.The experimental group received the Zangsiwei Qingfei Mixture in addition to conventional treatment.The treatment duration was 7 d for both groups.Baseline data such as gender,age,body mass index(BMI),smoking status,Global Initiative for Chronic Obstructive Lung Disease(GOLD)classification,COPD course,and the number of COPD exacerbations in the past year were collected.The primary efficacy indicators were assessed using the modified Medical Research Council(mMRC)dyspnea scale and the modified Borg scale.Secondary indicators included arterial lactic acid(LAC)and serum tumor necrosis factor alpha(TNF-α)levels.Safety indicators included liver and kidney function[alanine transaminase(ALT),aspartate transaminase(AST),serum creatinine(SCr),serum uric acid(SUA)],coagulation function[activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(FIB),and D-dimer].The generalized linear mixed model(GLMM)was used to evaluate the clinical efficacy and safety of the Zangsiwei Qingfei Mixture. Results:Before treatment,there were no statistically significant differences in general baseline data,grading of mMRC dyspnea scale,score of modified Borg scale,arterial LAC,ALT,AST,SCr,SUA,APTT,FIB,and D-dimer between the 2 groups(all P＞0.05).However,serum TNF-α and PT levels in the experimental group were significantly lower than those in the control group(both P＜0.05).GLMM analysis showed that after adjusting for pre-and post-treatment,gender,age,BMI,smoking status,GOLD classification,COPD course,and the number of COPD exacerbations in the past year,the experimental group demonstrated significantly lower grading of mMRC dyspnea scale(coefficient=-0.329,P=0.036),score of modified Borg scale(coefficient=-1.077,P=0.001),serum TNF-α level(coefficient=-14.378,P＜0.001),and arterial LAC level(coefficient=-0.409,P=0.012)compared to the control group.The Zangsiwei Qingfei Mixture had no significant effect on liver,kidney,or coagulation function indicators(all P＞0.05). Conclusion:The Zangsiwei Qingfei Mixture combined with conventional treatment can improve clinical symptoms and promote homeostasis in AECOPD patients,demonstrating safety and reliability.Combining modem medicine with traditional ethnic medicine offers a feasible approach to treating chronic respiratory diseases in the future.

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care

Objective To study the current situation of chronic diseases among island residents who have drunken desalinated water for a long time， and to reveal the relationship between drinking desalinated water and water from other sources and the prevalence of chronic diseases among the population. Methods According to the different drinking water sources of island residents， the research subjects were divided into seawater desalination group （residents of Gouqi Township， Shengsi County）， mixed water source group （residents of Shengshan Town， Shengsi County） and freshwater group （residents of Huanglong Township， Shengsi County）. Through the chronic disease network report and resident health file system， the current situation of chronic diseases in different water groups was investigated and analyzed. Results There were significant differences in the prevalence of malignant tumor among drinking water sources （ χ ²=23.867， P <0.001）， with the prevalence of mixed water group >desalination group >fresh water group. There were significant differences in the prevalence of coronary heart disease （ χ ²=194.883， P <0.001）， with the prevalence of mixed water group >desalination group >fresh water group. There were significant differences in the prevalence of stroke （ χ ²=35.637， P <0.001）， with the prevalence of fresh water group > mixed water group > desalination group. There was no significant difference in the prevalence of diabetes mellitus （ χ ²=2.808， P =0.246）， but there was significant difference in the age of onset of diabetes mellitus （ χ ²=7.368， P =0.001）， and significant difference in the prevalence of diabetes mellitus in the age group ≥55 （ χ ²=17.144， P <0.001）， and the onset age and prevalence were all in the order of fresh water group > desalination group > mixed water source group. There was no significant difference in the prevalence of hypertension （ χ ²=3.962， P =0.138）， but there was significant difference in the prevalence of hypertension in the age group ≥55 （ χ ²=20.734， P <0.001）， with the prevalence of fresh water group > desalination group > mixed water source group. Conclusion Long-term consumption of desalinated water by residents is correlated with malignant tumors， coronary heart disease and stroke， and has no correlation with diabetes and hypertension.

Objective:To evaluate the fitness of bilateral free-end dentition defect removable partial denture framework fabricated by selective laser melting (SLM) technique with different support angles.Methods:After the control group has been set to eliminate the system error, and according to the standard model of bilateral mandibular posterior teeth loss, eighteen titanium alloy removable partial denture frameworks fabricated by SLM technology were divided into 3 groups with support angles of 0° (horizontal group), 45°(45° group) and 90° (vertical group). Plaster cast with duplicated structure of tissue surface of the removable partial denture (RPD) framework was obtained. A three-dimensional scanner was used to scan original and duplicated plaster casts. The gaps between framework and the model in different parts were analyzed using Geomagic Qualify software to evaluate the fitness of the framework with visual method.Results:The framework fits on the plaster model completely, and its tissue surface fitted on the plaster model well. The deviation between frameworks and plaster casts was calculated as follow: the total deviations of the horizontal, 45°, and vertical group were (0.146±0.017), (0.182±0.015) and (0.185±0.022) mm respectively. The mean deviation of the horizontal group was significantly less than those of the 45° group and the vertical group ( P<0.05). Moreover, there was no significant difference in the total deviation between the 45° group and the vertical group. The total deviation of occlusal rest of the horizontal group was significantly less than that of the 45° group ( P<0.05). However, no significant difference was detected in the deviation of occlusal rest among the vertical group, the horizontal group, and the 45° group ( P>0.05). There was no significant difference in the deviation of occlusal rest among the vertical group, the horizontal group, and the 45° group. The deviation of clasp of the horizontal group was significantly smaller than those of the 45° group and the vertical group ( P<0.05). Whereas, there was no significant difference in the deviation of clasp between the 45° group and the 90° group ( P>0.05). No significant difference was found in the deviation of lingual bar among the three groups ( P>0.05). Conclusions:Among the three kinds of bilateral free-end dentition defect RPD framework fabricated by SLM in different support angles, horizontal printing was proved to reach the minimal deviation, even though the fitness of all three kinds of frameworks can fullfil clinical requirements according to previous studies.

Objective: To understand the concentrations and source of SO42-,NO3-,Cl- and NH4+ in atmospheric PM2.5 in Zhoushan,and to provide reference for controlling PM2.5 and formulating effective environmental protection measures. Methods: Monitoring sites in new districts of Zhoushan were set up to continuously collect PM2.5 from 10th to 16th of each month and under the hazy weather during 2015-2016（AQI > 200）. The mass concentration of PM2.5 was measured by weighing method,and the concentrations of SO42-,NO3-,Cl- and NH4+ in PM2.5 components was detected by ion chromatography. Results: The average daily concentration of PM2.5 in Zhoushan from 2015 to 2016 was（40.91±27.39）μg/m3. The concentration of the four water-soluble non-metal ions in PM2.5 components was 3.56-103.03 μg/m3,with an average of（23.06±20.00）μg/m3,accounting for about 56.64% of PM2.5 contents. The average monthly concentration of SO42- was the highest[（10.35±6.48）μg/m3],while the average monthly concentration of Cl- was the lowest [（0.49±0.73）μg/m3]. The concentration of the four ions was the highest in winter[（37.56±27.74）μg/m3]and the lowest in summer[（12.32±5.88）μg/m3]. The differences between different seasons was statistically significant（P<0.05）. The highest concentration of NO3- occurred in winter,which was（14.48±13.28）μg/m3. The concentration ratio of NO3- to SO42- ranged from 0 to 2.58,with an average of 0.55. There were 28 days（14.74%）with the ratio greater than one,22 days of which was in winter. Conclusion The concentration of SO42- was the highest and Cl- was the lowest in atmospheric PM2.5 in Zhoushan. The highest concentration of the four ions occurred in winter. The concentration of NO3- in winter was higher than that of SO42-,suggesting that motor vehicle exhaust might be the main source of PM2.5 in winter.

Objective To explore the clinical therapeutic effect of thoracoscopy and laparoscopy combined radical operation for esophageal carcinoma and provide reference for clinical treatment.Methods The clinical data of five hundred and twenty-one patients with esophageal cancer in Kunming General Hospital of PLA from June 2010 to May 2017 were analyzed retrospectively.The patients were divided into experimental group (n =276) and control group (n =245) according to the type of procedure.The experimental group was treated with thoracoscopy and laparoscopy,and the control group was treated with open esophagectomy.The intra-operative condition (surgery time,intraoperative blood loss),postoperative condition (postoperative drainage volume,postoperative catheterization time,postoperative hospital stay),postoperative complications (pulmonary infection,anastomotic fistula,recurrent nerve paralysis,chylothorax,gastric emptying delayed,pleural effusion,incisal infection) and life quality [quality of life questionnaire C30 (QLQ-C30) version 3.0 core,quality of life questionnaire-OES18 (QLQ-OES18)] were compared between the two groups.The measurement data were expressed by ((x) ±s) and the two group were compared with the t test.The count data were expressed by percentage (％) and inter-group comparisons were performed by chi-square test between the two groups.Results The operation time [(238.7± 32.4) min vs (245.1 ± 34.6) min],period of catheter indwelling [(5.7 ± 1.2) d vs (8.7 ± 2.6) d] and hospital stay [(9.6 ± 2.7) d vs (1 1.4 ±4.6) d] were shorter,the amount of intraoperative bleeding [(198.6 ±41.2) ml vs (231.9 ±43.5) ml] and post-operation drainage [(221.7 ±32.1) ml vs (257.8 ±38.6) ml] were less,and the morbidity of lung infection,anastomotic fistula and incision infection were lower in the experimental group than in the control group.The scores of emotional function,physical function and overall health status which belong to QLQ-C30 scale were higher and the scores of difficulty in feeding,reflux,pain,loss of appetite and cough which belong to QLQ-OES18 were lower in the experimental group than in the control group.The differences between the two groups had statistical significance (P ＜ O.05).Conclusion Compared with open esophagectomy,thoracoscopy and laparoscopy combined radical operation for esophageal carcinoma has an advantage in improving the intra-operative and postoperative condition,reducing the postoperative complication rate and enhancing the postoperative life quality.

Surgical treatment is an important treatment for spontaneous pneumothorax, which can remove the gas in the pleural cavity, relieve symptoms, promote lung recruitment, moreover, prevent future recurrence. The surgical modalities included video-assisted thoracoscopic surgery (VATS) and non VATS treatment. Nowadays, the treatment of spontaneous pneumothorax has entered a minimally invasive era. With the development of minimally invasive techniques in recent years, as the representative of minimally invasive surgery, the surgeon techniques of VATS has developed to diversity, including three-port VATS, two-port VATS, uniportal VATS, subxiphoid uniportal VATS, 3D VATS, robotic-assisted VAT and cervical uniportal VATS. Each technique has its own advantages and limitations, and individual choices should be made.

Objective To investigate the differentially expressed serum proteins in patients with liver cirrhosis complicated by portal vein thrombosis (PVT) . Methods Serum samples were collected from 45 patients with liver cirrhosis who were hospitalized in Infectious Disease Center, The First Affiliated Hospital of Xinjiang Medical University, from November 2015 to November 2016, and among these patients, 22 had PVT and 23 had no PVT. Isobaric tags for relative and absolute quantitation (i TRAQ) combined with chromatography and mass spectrometry were used to screen out the differentially expressed serum proteins, and a bioinformatics analysis was performed for the differentially expressed proteins. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. The Fisher's exact test was used to compare the distribution of GO terms or KEGG pathways in the target protein set or total protein set, in order to evaluate the significance level of protein enrichment of a GO term or KEGG pathway. Results A total of 800 proteins were screened out, among which 86 were differentially expressed, including 32 upregulated proteins (ratio ≥1. 2, P ＜ 0. 05) and 54 downregulated proteins (ratio ≤0. 83, P ＜ 0. 05) . Among these proteins, 14 were associated with cellular component, 22 were involved in biochemical processes, and 10 were associated with molecular function. The KEGG analysis showed that there were significant differences in 18 proteins in 5 metabolic and signaling pathways between the liver cirrhosis-PVT group and liver cirrhosis group. These 5 metabolic and signaling pathways were associated with fat digestion and absorption, platelet activation, metabolism of glyoxylic acid and dicarboxylic acid, osteoclast differentiation, and axon guidance. Conclusion i TRAQ combined with chromatography and mass spectrometry can effectively screen out the differentially expressed serum proteins, among which GP5, FGA, and FGG may be potential biological markers for PVT in patients with liver cirrhosis and are worthy of further research.

Objective To predict the tolerance range of set-up errors in clinical practice by predicting the virtual set-up errors of postoperative radiotherapy patients for breast cancer. Methods A retrospective analysis was made of the patients who underwent radiotherapy after breast cancer surgery in recent 3 years. According to different treatment method, 10 cases of breast cancer after modified radical mastectomy and 10 cases after breast conserving radical mastectomy were selected. The target area was delineated, the volume modulated radiation therapy plan was made, the virtual moving error of the center point of the plan was moved, and the maximum moving error was 5 mm by 1 mm step. After recalculating the dose, the corresponding data including the clinical target areas ( CT ) , CTV ( V50 ) , average heart volume, V20 of the affected lung and CTV volume were recorded. SPSS 19. 0 software was used for statistical analysis, and repeated measurement of variance analysis was used to analyze the changes of the actual dose in the target area after moving the center point. Linear regression analysis method was used to analyze the correlation between the CTV volume and the dose change after the CTV moving midline. Results The virtual set-up error had little influence on the axis direction of the approximate mammary tangent direction, while the vertical direction of the approximate mammary tangent direction had greater influence. After moving more than 3 mm on the vertical axis, the CTV ( V50 ) decreased to below 90％, which was lower than the general requirement for the target area of CTV. Statistical analysis of set-up errors in all directions showed that there was significant difference in dosimetric changes ( F=34. 182, 12. 877, 16. 443, 9. 846, 46. 829, 10. 122, 57. 931, P <0. 05) in all directions except the B direction of left breast set-up errors (P>0. 05). Between breast conserving surgery and modified radical mastectomy, there was little effect on target movement. Through correlation analysis, it was found that the volume of CTV in the target area of breast cancer patients was linearly related to the errors caused by the movement of B, C and B directions of left breast and right breast(F=5. 733, 18. 496, 6. 630, P<0. 05). Conclusions In postoperative radiotherapy for breast cancer, the errors perpendicular to the section of breast should be paid special attention to whether left or right breast. When the error of this direction exceeds 3 mm, CTV is obviously less than V50 below 83. 85％. The effect of set-up error on the dose of CTV was not related to the operation mode of breast cancer and there was no obvious correlation with the volume of the target area.

Objective: To observe the clinical efficacy of application in canicular days plus enteral nutrition in treating cough variant asthma (CVA) in kids, and to explore its action mechanism. Methods:Following a randomized controlled single-blind parallel-group design, 138 eligible kids with CVA were randomized into an observation group, a canicular-day application group, and an enteral nutrition group, 46 kids in each group. The canicular-day application group was intervened by application in canicular days, the enteral nutrition group was by enteral feeding, and the observation group was by both canicular-day application and enteral feeding. The therapeutic efficacies were evaluated after a treatment course. Results: The recovery rate and total effective rate were respectively 50.0% and 98.0% in the observation group, versus 23.9% and 91.3% in the canicular-day application group, and 13.0% and 78.6% in the enteral nutrition group. The observation group was significantly superior to the other two groups (bothP<0.05). In comparing the global symptom score, peak expiratory flow (PEF), forced expiratory volume in one second (FEV1), CD3+, CD4+, CD4+/CD8+, CD8+, hemoglobin (Hb), total protein (TP), albumin (ALB), eosinophil cationic protein (ECP), lipid peroxide (LPO), leukotriene (LT), body weight (BW), triceps skin-fold (TSF), and arm muscle circumference (AMC), the observation group was significantly better than the other two groups (bothP<0.05). Conclusion:Application in canicular days plus enteral nutrition can significantly improve the pulmonary function and symptoms in children’s CVA, and the effect is possibly produced by regulating cellular immune system, enhancing Hb, TP, ALB, BW, TSF, AMC, and inhibiting the production of ECP, LPO, and LT.