ObjectiveTo investigate the effects of Guizhi Jia Longgu Mulitang on the expression difference of interleukin-10 （IL-10） and tumor necrosis factor -α （TNF-α） in related organs of insomnia rats with sensory dysfunction dominated by lung and study the mechanism of Guizhi Jia Longgu Mulitang in improving insomnia. MethodSD rats were randomly divided into the blank group， model group， western medicine group， and traditional Chinese medicine （TCM） group， with 10 rats in each group. The rats were deprived of sleep by shallow water environment method in a long platform， and the modeling lasted for 42 d. The blank group and model group were given 0.05 mL·kg^-1 normal saline by gavage， and the western medicine group and TCM group were given drugs during modeling. To be specific， the western medicine group was given 0.105 mg·kg^-1 dexzopiclone tablet by gavage， while the TCM group was given 7 600 mg·kg^-1 Guizhi Jia Longgu Mulitang by gavage， both lasting for 28 days. After successful modeling， the Morris water maze experiment was performed on the 42nd day to detect the motion and spatial memory ability of rats. The levels of IL-10 and TNF-α in serum were detected by enzyme-linked immunosorbent assay （ELISA）. The protein expression of IL-10 and TNF-α in the lung and brain tissue of rats was detected by Western blot. The levels of IL-10 and TNF-α in the lung and brain tissue of rats were detected by immunohistochemistry. ResultCompared with the blank group， the sleep stages non-rapid eye movement ( NREM ) and rapid eye movement ( REM ) of the model group were significantly shortened （P<0.5， P<0.01）， and the wake stage was significantly increased （P<0.01）. The total time and distance of platform exploration were significantly increased （P<0.01）. In the target quadrant （the third quadrant）， the percentage of exploration time and the times of crossing the platform were significantly decreased （P<0.01）. ELISA results showed that the serum IL-10 level was significantly decreased （P<0.01）， and TNF-α level was significantly increased （P<0.01）. The results of Western blot showed that the protein expression of IL-10 in brain and lung tissue of rats was significantly decreased （P<0.01）， and the protein expression of TNF-α was significantly increased （P<0.01）. The results of immunohistochemistry showed that the expression of IL-10 in the brain and lung tissue of rats was significantly decreased （P<0.01）， and that of TNF-α was significantly increased （P<0.01）. Compared with the model group， the NREM stage and REM stage of the western medicine group and the TCM group were significantly increased （P<0.5， P<0.01）， and the wake stage was shortened （P<0.5）. The total time and distance of platform exploration were significantly decreased （P<0.01）. In the target quadrant （the third quadrant）， the percentage of exploration time and the times of crossing the platform were significantly increased （P<0.05， P<0.01）. The serum IL-10 level was significantly increased （P<0.01）， and the serum TNF-α level was significantly decreased according to the ELISA results （P<0.01）. The results of Western blot showed that the protein expression of IL-10 in brain tissue and lung tissue was significantly increased （P<0.01）， and the protein expression of TNF-α was significantly decreased （P<0.01）. The results of immunohistochemistry showed that the expression of IL-10 in brain tissue and lung tissue was significantly increased （P<0.05， P<0.01）， and the expression of TNF-α was significantly decreased （P<0.05， P<0.01）. ConclusionGuizhi Jia Longgu Mulitang can improve the expression of IL-10 and TNF-α in brain and lung tissue of insomnia rats with sensory dysfunction dominated by lung， prolong sleep time， and then improve insomnia. The mechanism may be related to improving the expression level of inflammatory factors.

Objective To explore the mechanism of Yanggan Anhun Decoction in the treatment of insomnia with liver failing in storing soul type based on network pharmacological methods;To perform animal model validation.Methods The drug components and targets of Yanggan Anhun Decoction were retrieved from TCMSP and BATMAN-TCM databases,and the targets of insomnia with liver failure store soul type were retrieved from GeneCards,NCBI and DisGeNET databases.By constructing a protein-protein interaction(PPI)network and analyzing GO and KEGG pathway enrichment,the signaling pathway of Yanggan Anxin Decoction in treating insomnia with liver failing in storing soul type was determined,and molecular docking was performed between the main active components and core targets.24 SD rats were randomly divided into normal group,model group,TCM group and Western medicine group,with 6 rats in each group.The insomnia model rats with liver failing in storing soul type were constructed by compound multi factor stimulation method,and were given drugs for 14 days.The cognitive memory ability of rats were detected by Morris water maze test;Nissl staining was used to observe the morphology and number of Nissl bodies in the hypothalamus of rats;serum IL-6 and TNF-α contents were detected by ELISA;IL-6 and TNF-α in hypothalamus and Bcl-2,Bax protein expression levels of rats were detected by immunohistochemistry.The relative expressions of p38 MAPK,p-p38 MAPK,Bcl-2,Bax proteins in the hypothalamus of rats were detected by Western blot.Results A total of 301 active components,321 potential targets and 92 key targets were obtained.Key active components such as quercetin,kaempferol,luteolin,wogonin,sebiferic acid and β-sitosterol,as well as core targets such as MAPK,IL6 and TNF were obtained after screening.The key targets mainly focused on various signaling pathways such as TNF signaling pathway,MAPK signaling pathway,PI3K-Akt signaling pathway,dopaminergic synapse,and neuroactive ligand-receptor interaction,etc.Kaempferol,quercetin,digitonin and other flavonoids had good binding activity and stability with MAPK,TNF,IL6 and showed good affinity.The results of animal experiments showed that,compared with the normal group,the cognitive memory ability of the model group decreased(P<0.05),Nissl bodies were stained shallowly,the density was lower,the cell body was shrunk and deformed,the cell nucleus was broken and dissolved,and the serum and hypothalamic IL-6,TNF-α increased(P<0.05),the expressions of p-p38 MAPK/p38 MAPK and Bax in hypothalamus increased(P<0.05),while the expressions of Bcl-2 and Bcl-2/Bax decreased(P<0.05);compared with the model group,the cognitive memory ability of the TCM group and the Western medicine group were improved,the number of Nissl bodies significantly increased,the nucleus was clear,the cell body shrinkage and deformation were improved(P<0.05),the levels of IL-6 and TNF-α in serum and hypothalamus decreased(P<0.05),while the expressions of p-p38 MAPK/p38 MAPK and Bax decreased,and the expression of Bcl-2 and Bcl-2/Bax increased(P<0.05).Conclusion Yanggan Anhun Decoction may play its effects in treating insomnia with liver failing in storing soul type by regulating MAPK,TNF,IL6,Bcl-2,Bax and other core targets,and interfering with p38MAPK signaling pathway.

Objective:To analyze clinical characteristics of neurosyphilis patients with abnormal mental behaviors as the initial symptom, and to provide a reference for clinical classification of, as well as outcome prediction and efficacy monitoring in neurosyphilis.Methods:Clinical data were collected from 67 HIV-negative neurosyphilis patients with abnormal mental behaviors as the initial symptom in the Second Affiliated Hospital of Soochow University from November 2012 to November 2019, and retrospectively analyzed. Statistical analysis was carried out by using t test. Results:Among the 67 patients, 52 (77.6%) were males, and 15 (22.4%) were females; there were 63 (94.0%) middle-aged and elderly patients and 4 (6.0%) adolescent patients; 38 (56.7%) patients were diagnosed with progressive general paresis, 21 (31.3%) with meningovascular neurosyphilis, 1 (1.5%) with meningeal neurosyphilis, 3 (4.5%) with tabes dorsalis, and 4 (6.0%) with mixed-type neurosyphilis. As laboratory examination showed, 67 patients all presented with positive serum rapid plasma reagin (RPR) test, serum Treponema pallidum particle agglutination (TPPA) test, and cerebrospinal fluid TPPA test, 55 (82.1%) had positive cerebrospinal fluid RPR test, 47 (70.1%) had elevated cerebrospinal fluid protein levels of > 0.45 g/L, 50 (74.6%) had increased white blood cell counts of > 8 ×10 6/L in cerebrospinal fluids, and 28 (41.8%) had elevated IgG levels in cerebrospinal fluids. Magnetic resonance imaging of the brain revealed multiple ischemic foci in 21 (31.3%) cases, multiple leukodystrophy in 17 (25.4%) , cerebral atrophy in 15 (22.4%) , infarction in 8 (11.9%) , and encephalitis-like changes in 2 (3.0%) . Of the 67 patients, 48 were treated with penicillin in aqueous solutions, 15 with ceftriaxone, and 4 with doxycycline. Six months later, the follow-up showed that 46 (68.7%) patients responded to the treatment, and the early course of disease was significantly shorter in the highly responsive group than in the poorly responsive group ( P < 0.05) . Conclusion:The middle-aged and elderly males were predominant in the neurosyphilis patients with abnormal mental behaviors as the initial symptom, magnetic resonance imaging is helpful for clinical classification and prognosis prediction of neurosyphilis, and early and standardized antisyphilitic treatment can markedly improve the prognosis of patients.

Objective:To study the reliability and validity of the Chinese version of the Cancer Empowerment Questionnaire.Methods:In June 2020, the English version of the Cancer Empowerment Questionnaire was translated into Chinese and cross-culturally adapted according to the standard of World Health Organization-Quality of Life. The reliability and validity were tested in 150 hospitalized cancer patients in the Department of Oncology, Affiliated Hospital of Southwest Medical University. The Chinese version was tested in 150 patients for reliability and validity.Results:The Cronbach α coefficient of the total scale and 4 factors were 0.96, and 0.864-0.928. The Guttman Split-Half reliability was 0.884. The test-retest reliability was 0.83. The Chinese version had 40 items. Factor analysis extracted 4 factors, which could explain 56.450% of the total variance. The correlation coefficient between the factors were 0.665-0.837. The HTMT ranged from 0.691 to 0.895.Conclusion:The Chinese version of the Cancer Empowerment Questionnaire has better reliability and validity in the Chinese language environment, which meets the requirements of psychological survey.

Objective: To investigate the imaging characteristics and the cause for the misdiagnosis and mistreatment of epidermoid cyst in intrapancreatic accessory spleen (ECIPAS) in order to improve the accuracy of preoperative diagnosis. Methods: The clinical and imaging data of 8 patients with ECIPAS confirmed by pathology in Zhejiang Provincial People′s Hospital between June 2008 and February 2018 were collected. The reason for doctor visit included CA19-9 elevation (n=1) and pancreatic occupying mass (n=9) during physical examination and no obvious symptoms were reported. CT and MRI imaging features, diagnosis and treatment were analyzed. Results: The lesions in 8 cases of ECIPAS were all located in the tail of the pancreas and were cystic and solid. The lesions in 3 cases were mainly cystic and the cystic wall was linear, whose CT density, MRI signal and enhancement pattern cannot be compared with those of the spleen. Solid components can be seen in 5 cases, and the CT density or MR signal of the solid part was similar to that of the spleen. After enhancement, the solid part at the artery stage was uniformly enhanced and the enhancement degree was higher than that of the pancreas. Similar to the spleen, it was uniformly enhanced at the portal vein stage and the enhancement degree of the spleen was consistent. All 8 patients were diagnosed with pancreatic neoplastic lesions before surgery, and 1 patient had pancreatic fistula and peripancreatic necrosis after surgery. Postoperative pathology confirmed the diagnosis of ECIPAS. Conclusions Improving the radiologists and clinicians′ cognition of the imaging manifestations of ECIPAS can improve the accuracy of preoperative diagnosis and avoid unnecessary surgery due to misdiagnosis.

Objective To investigate the correlation between blood pressure variability (BPV) and early neurological deterioration (END) in patients with acute anterior circulation large artery atherosclerotic (LAA)stroke. Methods From January 2015 to June 2018, consecutive patients with anterior circulation acute ischemic stroke admitted to the Department of Neurology, the Affiliated Hospital of Yangzhou University were enrolled prospectively. According to the etiological classification, they were divided into LAA group and non-LAA group. By monitoring the blood pressure within 72 h of hospitalization, the mean, maximum (max)and minimum (min) values, and the difference between max and min (max-min), standard deviation (SD),and coefficient of variation (CV; CV = SD × 100/mean) were calculated. END was defined as the highest score of the National Institutes of Health Stroke Scale (NIHSS) within 72 h of admission increased by ≥2than the baseline. Multivariate logistic regression analysis was used to determine the correlation between BPV parameters and END. Results A total of 271 patients with anterior circulation acute ischemic stroke were enrolled, including 101 females (37. 3％) and 170 males (62. 7％), with an average age of 64. 99 ± 11. 51 years. There were 95 patients (35. 1％) with LAA and 176 (64. 9％) with non-LAA. In the LAA group and non-LAA group, 36 patients (37.9％) and 50 patients (28.4％) developed END respectively. The comparison between END patients and non-END patients in the LAA group showed that there were significant differences in age, sex, diabetes mellitus, baseline NIHSS score and C-reactive protein, as well as SBPmax , SBPmax-min , SBPSD , SBPCV, DBPmax , DBPmax-min , DBPSD , and DBPCV in BPV indices (all P < 0. 05).Multivariate logistic regression analysis showed that many BPV indices were the independent risk factors for END, including SBPmax (odds ratio [OR] 1. 027, 95％ confidence interval [CI] 1. 003-1. 052; P = 0. 027),SBPmax-min (OR 1. 041, 95％CI 1. 015-1. 068; P = 0. 002), SBPSD (OR 1. 177, 95％ CI 1. 048-1. 322; P =0. 006), SBPCV (OR 1. 226, 95％ CI 1. 036-1.451; P = 0. 018), DBPmax (OR 1. 073, 95％ CI 1. 017-1. 133;P = 0. 010), DBPmax-min (OR 1. 107, 95％CI 1. 044-1. 174; P = 0. 001), DBPSD (OR 1. 693, 95％CI 1. 268- 2. 260; P < 0. 001), and DBPCV(OR 1. 726, 95％CI 1. 311-2. 271; P < 0. 001). In the non-LAA group, there were no significant association between all BPV parameters and the occurrence of END. Conclusion BPV was significantly correlated with END in patients with anterior circulation LAA.

Objective To investigate the relationship of angiotensin converting enzyme (ACE I/D) gene I/D polymorphism with vitiligo.Methods PubMed,the Cochrane Library,China academic journal full-text database and VIP database and Wan fang database were searched according to the inclusion and exclusion criteria,and the quality of included studies was assessed.The data were quantitatively analyzed by Stata 12.0 software.Results Nine articles were included.Meta analysis results showed that the susceptibility of vitiligo difference was statistically significant in the total population of ACE I/D genotype (DD + II)vs.DI (OR=0.759,95％ CI:0.643 ～0.896,P=0.001),the (DD+DI) vs.II (OR=1.523,95％ CI:1.153 ～2.011,P =0.003).The genotype subgroup analysis showed the D vs.I (OR =1.381,95％ CI:1.054 ～1.810,P=0.019),DDvs.II (OR=1.830,95％ CI:1.110～3.017,P=0.018),(DD+ II) vs.DI (OR=0.814,95％ CI:0.667 ～0.994,P=0.043),and the (DD+ID) vs.II (OR=1.690,95％ CI:1.147 ～2.489,P =0.008) in Asian.The difference was statistically significantly related to vitiligo.Arab genotype (DD + II) vs.DI (OR =0.545,95％ CI:0.354 ～ 0.840,P =0.006) was associated with vitiligo occurrence.Begg's inspection publication bias analysis showed all genetic types did not exist any publication bias.Conclusions The ACE gene I/D polymorphism may be associated with vitiligo susceptibility.

Objective To investigate the status quo of cancer pain level and cancer pain self-efficacy in the patients with cancer pain and to analyze the influencing factors of cancer pain self-efficacy.Methods The cross sectional investigation was adopted.A total of 200 inpatients with cancer pain in the Affiliated Hospital and Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University from February to September 2016 were recruited as the respondents by using the convenience sampling method.The questionnaire investigation was performed by adopting the general data questionnaire from,pain degree scale and chro nic pain self-efficacy scale.Results The total score of cancer pain self-efficacy was (45.82±15.47) points,and the score of pain management self-efficacy,symptom coping self-efficacy and somatic function self-efficacy were (10.32 ± 2.93),(17.34 ± 6.22) and (18.16 ± 8.38) points respectively.The five factors of maximal influence degree on cancer pain self-efficacy were the physical exercise situation after illness(| b| =9.96),family economic status(| b| =6.89),maximal pain degree at nearest 24 h(| b | =5.44),average pain degree at nearest 24 h(| b| =4.31) and age(|b| =0.27).Conclusion The cancer pain self-efficacy in the respondents was in the middle-to-low level.The patients with smaller age,good family economic status,usual physical exercise after illness and milder degree in maximal pain within 24 h had higher cancer pain self-efficacy.

Objective To investigate the clinical efficacy of Changqin No. 1 combined with Western therapy for severe traumatic brain injury and its effects on prognosis. Methods Totally 65 cases of severe traumatic brain injury were randomly divided into the treatment group (n=32) and the control group (n=33). The control group was treated with basic Western therapy (dehydration reduction of intracranial pressure, nutrition nerve, scavenging oxygen free radicals, improve cerebral circulation, nutritional support and maintain the internal environment stability, anti-infection, prevention and treatment of complications, hyperbaric oxygen). The treatment group was treated with Changqin No. 1 plus the basis of routine treatment, 1 dosage per day, 2 times stomach tube nasal feeding or blunt, for 14 d. One month after treatment, awake rate, awake time, the incidence of complications and MMSE in both groups were compared. Three months after treatment, the prognosis of two groups were compared by GOS. Results One month after treatment, the awake rate in treatment group was 77.4% (24/31) and 53.1% (17/32) in the control group, with statistical significance (χ2=4.089, P=0.043), and the death rate was 0. The awake time in the treatment group was significantly shorter than that of the control group (t=2.458, P=0.017). The incidence of pulmonary infection in the treatment group was lower than the control group (P=0.001). There was no statistical significance in urinary tract infection, epilepsy, liver and kidney dysfunction rate of the two groups (P>0.05). The number of awake case was 24 in the treatment group and 17 in the control group. The number of normal MMSE cognitive function was 3 in the treatment group and 2 in the control group, and the treatment group was better than the control group (Z=-2.205, P=0.027). Three months after treatment, the good prognosis was 58.08% (18/31) in the treatment group and 28.12%(9/32) in the control group, with statistical significance (χ2=5.763, P=0.016). Conclusion Changqin No. 1 combined with Western basic treatment can help patients with severe traumatic head injury awake early, reduce pulmonary infection complications, and improve the cognitive function of sober patients and improve the prognosis.

Chemotherapy is one of the main treatment methods in malignant tumor.Tumor multidrug resistance (MDR) is one of the important reasons for the failure of chemotherapy.It makes some progress in reversing tumor MDR,such as chemical drug,traditional Chinese medicine,immunotherapy,gene therapy,nanoparticles drug system and so on.But it takes more effort to develop medicine of less adverse reactions,better pharmacodynamic and application to clinic widely.