ObjectiveTo explore the syndrome elements and evolving patterns of patients with hepatitis B virus-related acute on chronic liver failure （HBV-ACLF） at different stages. MethodsClinical information of 1,058 hospitalized HBV-ACLF patients， including 618 in the early stage， 355 in the middle stage， and 85 in the late stage， were collected from 18 clinical centers across 12 regions nationwide from January 1， 2012 to February 28， 2015. The “Hepatitis B-related Chronic and Acute Liver Failure Chinese Medicine Clinical Questionnaire” were designed to investigate the basic information of the patients， like the four diagnostic information （including symptoms， tongue， pulse） of traditional Chinese medicine （TCM）， and to count the frequency of the appearance of the four diagnostic information. Factor analysis and cluster analysis were employed to determine and statistically analyze the syndrome elements and patterns of HBV-ACLF patients at different stages. ResultsThere were 76 four diagnostic information from 1058 HBV-ACLF patients， and 53 four diagnostic information with a frequency of occurrence ≥ 5% were used as factor analysis entries， including 36 symptom information， 12 tongue information， and 5 pulse information. Four types of TCM patterns were identified in HBV-ACLF， which were liver-gallbladder damp-heat pattern， qi deficiency and blood stasis pattern， liver-kidney yin deficiency pattern， and spleen-kidney yang-deficiency pattern. In the early stage， heat （39.4%， 359/912） and dampness （27.5%， 251/912） were most common， and the pattern of the disease was dominated by liver-gallbladder damp-heat pattern （74.6%， 461/618）； in the middle stage， dampness （30.2%， 187/619） and blood stasis （20.7%， 128/619） were most common， and the patterns of the disease were dominated by liver-gallbladder damp-heat pattern （53.2%， 189/355）， and qi deficiency and blood stasis pattern （27.6%， 98/355）； and in the late stage， the pattern of the disease was dominated by qi deficiency （26.3%， 40/152） and yin deficiency （20.4%， 31/152）， and the patterns were dominated by qi deficiency and blood stasis pattern （36.5%， 31/85）， and liver-gallbladder damp-heat pattern （25.9%， 22/85）. ConclusionThere are significant differences in the distribution of syndrome elements and patterns at different stages of HBV-ACLF， presenting an overall trend of evolving patterns as "from excess to deficiency， transforming from excess to deficiency"， which is damp-heat → blood stasis → qi-blood yin-yang deficiency.

Consumptive thirst is widely discussed in Huangdi Neijing and it is classified as a"strange disease"in Suwen·Strange Diseases Treatise,which reflects the intractable nature of consumptive thirst.This paper explores and analyzes consumptive thirst based on the core concept in Huangdi Neijing.First,this paper approaches the subject through the use of image thinking method from Huangdi Neijing,recognizing that consumptive thirst can lead to changes in the internal climate of the human body.Then,guided by the theories of essence and qi,yin and yang,and the five elements in Huangdi Neijing,it deconstructs and analyzes the causes of these changes and the laws of qi transformation.It points out that the changing climate of consumptive thirst is characterized by"heat symptoms".The main cause of"heat symptoms"is spleen deficiency and excessive dampness,and its qi transformation law is the heat transformation of Shaoyin.The intractable nature of consumptive thirst is mainly reflected in the uncontrolled"heat symptoms"caused by the imbalance of the five elements.Based on the understanding of the heat symptoms of consumptive thirst,this paper proposes a treatment strategy for preventing the disease by resolving dampness and regulating the spleen,harmonizing kidney qi to prevent progression,and balancing yin and yang to treat chronic and recalcitrant conditions.The aim is to provide a reference for optimizing the treatment of consumptive thirst.

Objective: To investigate the relationship between childhood abuse and recent negative life events with suicidal ideation and attempt, and to provide reference for prevention and control of suicidal behaviors in middle school students. Methods: Stratified cluster sampling method was used to select 7 986 middle school students from Shenzhen, Nanchang and Shenyang as participants. Questionnaire survey was conducted to collect information on demographic indicators, childhood abuse, negative life events, suicidal ideation and suicide attempt, etc. Logistic regression was used to analyze the relationship between childhood abuse experience and negative life events with suicidal ideation and suicide attempt. Results: The prevalence of suicidal ideation and suicide attempt was 22.9% and 4.7%. After adjusted for confounding variables, with the increase of childhood abuse and negative life events, suicidal ideation and attempt in middle school students showed an increasing trend(P<0.05). Compared those with low level of childhood abuse and negative life events, students with high childhood abuse and high negative life events had a higher suicidal ideation and suicide attempt risk, the multiple adjusted odds ratio was 10.43 and 19.75(P<0.05). Conclusion Childhood abuse and negative life events are important risk factors affecting suicidal ideation and attempt in middle school students. Strategies to reduce childhood abuse and negative life events should be an integral component of targeted mental health interventions.

Objective:To systematically evaluate the risk factors for oral mucositis (OM) in patients receiving hematopoietic stem cell transplantation (HSCT) , and provide a reference for the prevention and treatment of OM.Methods:Articles published up to June 2020 were systematically retrieved from PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Embase, SinoMed, China National Knowledge Infrastructure (CNKI) , VIP, and Wanfang databases, and screened independently by two reviewers according to the inclusion and exclusion criteria. The research design, patient characteristics, follow-up time point, evaluation tools, statistical analysis results and other information of the included articles were extracted. After evaluating the risk of bias, RevMan 5.3 was used for statistical analysis.Results:A total of 17 studies and 3 659 HSCT patients were included. Meta-analysis was conducted on 9 factors related to OM, 2 factors related to moderate to severe OM, and 6 factors related to severe OM, and the results showed that the risk factors related to OM were female ( OR=1.40, 95% CI: 1.10-1.79, P=0.007) , bone marrow transplantation ( OR=1.86, 95% CI: 1.00-3.47, P=0.05) , oral busulfan ( OR=38.61, 95% CI: 11.04-134.97, P<0.001) , use of methotrexate ( OR=2.34, 95% CI: 1.38-3.98, P=0.002) , and allografting ( OR=2.21, 95% CI: 1.18-4.15, P=0.01) , and the risk factors associated with severe OM were a pretreatment program containing high-dose melphalan ( OR=2.00, 95% CI: 1.24-3.22, P=0.004) . Conclusions:Female, bone marrow transplantation, oral busulfan, use of methotrexate, and allografting are correlated with OM, and the pretreatment program containing high-dose melphalan is correlated with severe OM. The correlation between other factors and OM still needs further verification. Medical staff should pay attention to these risk factors and take targeted prevention and treatment strategies to further improve the quality of nursing work.

Objective To understand the status of type 2 diabetes mellitus (T2DM) patients′ trust in their family physicians, and to explore the role of the trust on patients′ medication adherence. Methods A total of 1078 patients with T2DM were recruited by cluster and systematic sampling method, from ten rural communities in Sanlong township in Yancheng city and five rural communities of Pingchao township in Nantong city, during February to April in 2018. The survey covered their trust behavior and attitude scale (PTBAS), and an 8-item Morisky medication adherence scale ( MMAS-8). Both measurement data and enumeration data were subject to descriptive analysis by mean ± SD and proportion respectively. Multiple linear regression was employed to explore the determinants of trust in physicians. Ordered logistic regression analysis was used to explore the relationship between patient-physician trust and medication adherence. Results The mean scoring of patients′ trust and medication adherence was 20. 16 ± 2. 13, 7. 07 ± 1. 54 respectively. 55. 40 percent of the patients had high medication compliance, 28. 53 percent of them had medium compliance and 16. 07 percent had poor compliance. Multiple linear regression analysis showed that the patient′s occupation, course of disease, self-reported health status and mental health status influenced their trust behavior (P < 0. 05). Ordered logistic regression analysis showed that each 1 point increase in patient′s trust in physicians, the medication compliance increased by 11. 0％ (OR = 1. 110, P < 0. 001). Medication adherence is also affected by age, employment status, course of illness, and mental health status. Conclusions Diabetes patients′ trust in their family physicians improves their medication adherence.

Objective To study the expression of CD62P and carbohydrate antigen 153 (CA153) in peripheral blood of patients with breast cancer, and to explore the value of CD62P and CA153 in the di-agnosis of breast cancer. Methods The CD62P ratio in peripheral blood of 60 patients with breast cancer ( breast cancer group) , 52 patients with breast fibroma ( fibroma group) and 25 healthy volunteers ( control group) was detected by flow cytometry ( FCM) . The serum CA153 level was detected by electro chemilumi-nescence ( ECLIA) , and the relationship between their expression levels and clinicopathological factors of breast cancer patients was analyzed. The sensitivity and specificity of serum CD62P, CA153 and their com-bination in the diagnosis of breast cancer were analyzed by receiver operating characteristic ( ROC) curve. Results ⑴ The expression levels of CD62P and CA153 in breast cancer group were significantly higher than those in fibroma group and control group (P<0. 05), but with no significant difference between fibro-ma group and control group (P>0. 05). ⑵The expression levels of CA153 and CD62P in peripheral blood of breast cancer group were correlated with clinical stage and lymphatic metastasis (all P<0. 05), and the expression levels of CA153 and CD62P were positively correlated (r=0. 514, P<0. 05). ⑶The sensitivity and specificity of combined detection of CD62P and CA153 for breast cancer were higher than those of single detection. Conclusions CD62P is highly expressed in peripheral blood of patients with breast cancer, which may be a new marker for the diagnosis of breast cancer.

OBJECTIVE:To investigate improvement effect of external administration of water extract from Eriocarpous Glochidion on chronic dermatitis-eczema model mice, and to provide reference for developing new dermatological drug. METHODS:A total of 60 mice were randomly divided into blank group (distilled water), model group (distilled water), compound triamcinolone acetonide acetate group (positive control group, original liquid) , high-concentration, medium-concentration and low-concentration groups of water extract from Eriocarpous Glochidion(2.0,1.0,0.5 g/mL,calculated by crude drug),10 mice in each group. Except for blank group,other groups were given 2,4-dinitrochlorobenzene to induce chronic dermatitis-eczema model. Since the third day of the experiment,two sides of right ears of the mice were given relevant medicine twice at 7:00 and 15:00,15 μL each time,for consecutive 12 d. In the tenth,thirteenth,sixteenth day of the experiment,the difference of thickness of right ears of the mice was calculated(the difference value before experiment),the times of scratching in ear of mice were recorded within 30 min. In sixteenth day of the experiment,ear swelling degree of mice was determined,and thymus index and spleen index in mice were calculated. Optical microscope was used to observe the pathological changes of ear tissues of mice. RESULTS:Compared with blank group,the difference of thickness of right ears,ear swelling degree,spleen index and scratching times were increased significantly in model group(P<0.05 or P<0.01). The epidermis of the ear tissue was thickened,the cell proliferation was obvious,and cavernous edema was found in the epidermis. Compared with model group,other indexes in were decreased significantly,except that the difference value of thickness of right ears in sixteenth day of the experiment,scratching times in ninth and fifteenth day of the experiment were decreased slightly in low-concentration group of water extract from Eriocarpous Glochidion and the thymus index and spleen index in medium-concentration, low-concentration groups of water extract from Eriocarpous Glochidion (P<0.05 or P<0.01). The pathological changes of ear tissue were improved in administration groups to certain extent. CONCLUSIONS:External administration of water extract of Eriocarpous Glochidion has good improvement effect against chronic dermatitis-eczema in mice, which is worthy of further development and investigation.

Objective To investigate the value of delayed 18F-FDG PET/CT with oral intake small dosage diuretics for diagnosing urogenital cancers.Methods Patients with suspected urogenital system cancers were divided into routine dosage diuretic group (n=12) and small dosage diuretics group (n=35).All patients underwent whole-body PET/CT followed by delayed scanning after oral 40 mg or 20 mg Furosemide respectively.The urine maximum standard uptake value (SUVmax) and T/U (the ratio of urine and lesion SUVmax) before and after diuresis were compared respectively.Diagnostic efficacy for malignant urogenital system cancers of small dosage group was calculated.Results The urine SUVmax and T/U were statistically different between routine whole body and delayed scans in both groups (P＜0.05).SUVmax and T/U of routine and delayed scans had no statistical differences between the two groups (P＞0.05).In small dosage group,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of delayed imaging and routine imaging was 96.77％ (30/31)and 61.29％ (19/31),75.00％ (3/4) and 50.00％ (2/4),96.77％ (30/31) and 90.48％ (19/21),75.00％ (3/4)and 14.29％ (2/14),94.29％ (33/35) and 60.00％ (21/35),respectively.The sensitivity and accuracy were statistically different between routine and delayed imaging (P＜0.001).Conclusion Delayed PET/CT imaging with oral small dosage Furosemide has the same efficacy as PET/CT using routine dosage diuretics,which is useful for diagnosing urogenital cancers.

Objective To establisha multiplex STR genotyping m ethod for autosom al STR and Y-STR loci in forensic biological practice. Methods W idely used autosom al STR loci and Y-STR loci w ere se-lected. A set of PC R prim ers w as designed, and a 5-dye fluorescent labeled STR multiplex PC R reagent kit w as developed. Results A kit w as developed w hich can sim ultaneously detect 15 autosom al STR loci, 10 Y-STR loci, and an Amelogenin. Conclusion The 15 autosom al STR plus 10 Y-STR kit in com bination w ith capillary electrophoresis m ethod w as used to STR genotyping w ith accurate and reli-able results. The new one-step testing kit can potentially be w idely used in forensic cases and D N A databank in the future.

Objective To explore the application effect of detailed nursing on ensuring nursing safety in operation room.Methods 200 patients were divided into control group (50 pa-tients)and observation group(150 patients)according to different nursing methods in operation room.The control group was received routine nursing while the observation group was given de-tailed nursing based on the control group,and nursing quality and satisfaction were compared be-tween the two groups.Results Instrument preparation,nurse coordination skills,equipment management and quality score of disinfection and isolation and safety score of nursing quality in the observation group were higher than that in the control group,the difference was statistical signifi-cant (P <0.05).The difference was not statistical significant in operation time between two groups (P >0.05).Score of image and occupation accomplishment of nursing staff,intraoperative nursing comprehensive score and nursing satisfaction in the observation group were higher than that in the control group,the result revealed that the difference was statistically significant(P <0.05). Conclusion Detailed nursing in operation room can ensure the operation safety and increase pa-tients’satisfaction.