ObjectiveTo observe the effect of Yifei Jianpi prescription on the of signal transducer and activator of transcription protein 1 （STAT1）/interferon regulatory factor 3 （IRF3） signaling pathway in a pneumonia model induced by lipopolysaccharide （LPS） and to explore the mechanism of Yifei Jianpi prescription in improving lung immune and inflammatory responses. MethodsSixty male SPF SD rats were used in this study. Ten rats were randomly assigned to the normal control group， and the remaining 50 were instilled with LPS in the trachea to establish a pneumonia model. After successful modeling， the rats were randomly divided into the model group， dexamethasone group （0.5 mg·kg^-1）， and Yifei Jianpi prescription high-dose （12 mg·kg^-1）， medium-dose （6 mg·kg^-1）， and low-dose （3 mg·kg^-1） groups， with 10 rats in each group. Treatment was administered once daily， and the normal control and model groups received the same volume of normal saline. After 14 days， flow cytometry was used to detect the classification of whole blood lymphocytes. Enzyme-linked immunosorbent assay （ELISA） was used to measure serum levels of immunoglobulin G （IgG）， immunoglobulin A （IgA）， immunoglobulin M （IgM）， and the content of tumor necrosis factor-α （TNF-α）， interleukin-8 （IL-8）， interleukin-6 （IL-6）， and interleukin-10 （IL-10） in alveolar lavage fluid （BALF）. Hematoxylin-eosin （HE） staining was used to observe lung tissue pathology and score the damage. Thymus weight， spleen weight， and wet-to-dry weight ratio （W/D） were recorded. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of STAT1， IRF3， IL-6， and interferon-alpha （IFN-α） in lung tissues， while Western blot was performed to assess the protein expression of STAT1， IRF3， IL-6， and IFN-α. ResultsCompared with the normal control group， the model group showed significantly increased proportion of B lymphocytes in peripheral blood， decreased proportions of NK cells and CD4⁺/CD8⁺ （P<0.05， P<0.01）， decreased serum levels of IgG and IgA， significantly increased IgM levels （P<0.01）， significantly elevated content of TNF-α， IL-6， and IL-8 in BALF， and significantly decreased IL-10 levels （P<0.01）. Lung tissue damage was evident， with significant increases in thymus and spleen weights and a higher W/D ratio （P<0.01）. The mRNA and protein expression of STAT1， IRF3， IFN-α， and IL-6 in lung tissues was significantly upregulated （P<0.05，P<0.01）. Compared with the model group， the Yifei Jianpi prescription groups showed significantly reduced proportions of B lymphocytes in peripheral blood， increased proportions of NK cells and CD4⁺/CD8⁺ ratios （P<0.05， P<0.01）， significantly increased serum levels of IgG and IgA， significantly decreased IgM levels （P<0.05， P<0.01）， significantly reduced levels of TNF-α， IL-6， and IL-8 in BALF， and significantly increased IL-10 levels （P<0.01）. Lung tissue damage was alleviated， thymus and spleen weights were significantly reduced， and the W/D ratio was markedly decreased （P<0.01）. The mRNA and protein expression of STAT1， IRF3， IFN-α， and IL-6 in lung tissues was significantly downregulated （P<0.05， P<0.01）. ConclusionYifei Jianpi prescription can alleviate lung tissue damage and improve immune and inflammatory responses in LPS-induced pneumonia rats. The mechanism may be related to the inhibition of STAT1/IRF3 signaling pathway activation.

Objective:To explore the medication rules of Professor Wang Pei in the treatment of colon cancer.Methods:The medical records of Professor Wang Pei's outpatient treatment for colon cancer were collected, entered into the Traditional Chinese Medicine Inheritance Computing Platform V3.0, and the laws of the prescription's nature, flavor, meridian, drug frequency, drug combination, association rules, and cluster analysis were explored.Results:A total of 65 prescriptions were collected, including 150 Chinese materia medica. The medicinal properties of these Chinese materia medica are mainly warm, cold and flat, the tastes were mainly sweet, bitter and pungent, and the meridians were mainly liver, spleen and kidney meridians. Dampness category and blood circulation promoting and blood stasis category were mainly used, and the most frequently used drugs include Poria, Polyporus, Scutellariae Barbatae Herba, Astragali Radix, Curcumae Rhizoma, and the pairs of Polyporus- Poria, Astragali Radix- Astragali Radix Praeparata cum Melle, Scutellariae Barbatae Herba- Curcumae Rhizoma. Twenty nine high-related drug pairs were obtained from association rules, including Polyporus- Astragali Radix Praeparata cum Melle- Astragali Radix, Poria- Scutellariae Barbatae Herba- Polyporus, Scutellariae Barbatae Herba- Curcumae Rhizoma- Polyporus. The cluster analysis showed the combination of 6 types of medicines mainly focuses on strengthening the spleen and removing dampness, nourishing qi and promoting blood, clearing heat and detoxifying, and astringing the intestines to stop bleeding. Conclusion:Professor Wang Pei mostly discusses the treatment of colon cancer from "spleen dampness, rectification deficiency, heat toxin, blood stasis, bleeding", and the treatment is "invigorating the spleen and removing dampness, invigorating Qi and strengthening the body, clearing away heat and detoxifying, promoting blood circulation and removing blood stasis, and astringent intestines to stop bleeding", which is in line with the thought of Traditional Chinese Medicine treatment of tumors, strengthening the righteousness and eliminating pathogenic factors, and and can be used for clinical reference.

Objective: To compare the prevalence of dental caries and periodontal disease in patients with end-stage renal disease treated with maintenance hemodialysis with that in healthy controls and to investigate the relationship between end-stage renal disease, dental caries and periodontal disease. Methods : A total of 82 maintenance hemodialysis patients who met the inclusion criteria were selected as the case group, and 86 healthy persons who underwent oral examination in the physical examination center were selected as the control group. Dental caries and periodontal conditions were examined in the two groups. The dental caries examination was conducted by determining the number of decayed-missing-filled teeth, which was recorded as recommended by the World Health Organization. The periodontal condition parameters included the plaque index, calculus index, bleeding on probing, periodontal pocket depth and clinical attachment loss. Results: The prevalence of dental caries in the case group and healthy control group was 87.8% and 81.4%, respectively, and there was no statistically significant difference between the two groups (P > 0.05). The periodontal indexes, including the plaque index, calculus index, probe bleeding index, periodontal pocket depth and clinical attachment level, in the case group were significantly higher than those in the control group (P < 0.05), and the prevalence of periodontitis in the case group was significantly higher than that in the control group (97.6% vs 88.4%, P < 0.05). Conclusion The dental caries conditions were comparable between the case group and the control group, but the prevalence and severity of periodontitis were significantly higher in the case group than in the control group.

Objective:To investigate the current status of intensive care unit-acquired weakness (ICU-AW) assessment, analyze the assessment barriers, and to provide reference to improve ICU-AW assessment.Methods:A convenient sampling cross-sectional survey was conducted. First, an interview outline which based on related domestic and international literatures and combining with the research purpose of this study were designed. Thirteen medical personnel (8 ICU nurses, 3 ICU doctors, 1 respiratory therapist and 1 physiotherapist) who worked in the intensive care unit (ICU) of the First Hospital of Lanzhou University were enrolled with convenience sampling method to interview. Second, the topics were comprehensively analyzed and extracted, and then a questionnaire was constructed, and the reliability and validity was assessed. Finally, the questionnaire survey including the general situation of ICU medical staffs, the current practices of ICU-AW and influencing factors was implemented in China.Results:The retest reliability was 0.92 and expert validity was 0.96 of the questionnaire. There were 3 563 respondents in 31 provinces, municipalities and autonomous regions which eliminated 357 unqualified questionnaires, including 173 respondents from neonatal or pediatric ICU, 89 respondents whose working time was less than 6 months, and 95 invalid respondents, and then there were finally 3 206 valid questionnaires and the response rate were 90.0%. Those 3 206 respondents included 616 doctors (19.2%), 2 371 nurses (74.0%), 129 respiratory therapists (4.0%), 51 physiotherapist (1.6%) and 39 dietitians (1.2%). The mean age was (30.7±6.3) years old. Most of them had bachelor's degree (65.9%), master and above was 14.1%. Associate senior physician and above was 8.0%; ICU working time was (5.94±4.50) years. In clinical practice, only 26.5% of the ICU medical staffs confirmed that they had treated or taken care for ICU-AW patients; 52.9% of medical staffs evaluated ICU-AW only based on clinical experience, and only 12.3% used ICU-AW assessment tools. The majority of respondents believed that ICU-AW knowledge training should be performed (81.8%), ICU-AW assessment should be as important as other complications (pressure sore, infected ventilator associated pneumonia, etc., 75.1%), and ICU-AW assessment should be part of daily treatment and care activities (61.2%). However, only 10.2% of respondents had received ICU-AW related knowledge training, and 42.7% respondents believed that their ICU-AW related knowledge could not meet clinical needs. Only 18.7% respondents would actively assess whether patients suffered from ICU-AW or not, and 42.3% respondents thought that ICU-AW should be assessed every day, and the assessment tools were also inconsistent. There were 44.0% respondents considered the Medical Research Council Muscle score (MRC-score) scale was the optimal tool for diagnosing ICU-AW, the following were neuro-electrophysiological examination (17.2%) and manual muscle strength (MMT, 11.1%). The main cause of the ICU-AW assessment barriers was the lack of ICU-AW related knowledge (88.1%), and the following were lack of ICU-AW assessment guidelines (76.5%), patients' cognitive impairment or limited understanding ability (84.6%), unable to cooperate with the assessment due to critical illness (83.0%), and inadequate attention to ICU-AW assessment by the department (77.5%).Conclusion:The current status of ICU-AW assessment were unsatisfying in China, and the main barriers were lack of skills and knowledge.

Objective To investigate changes in nutritional status in senile dementia patients with malnutrition treated with enteral nutrition combined with rehabilitation therapy evaluated by using the Mini Nutritional Assessment-Short Form(MNA-SF).Methods Fifty hospitalized patients with senile dementia and malnutrition at the internal medicine department of our hospital from July 2014 to July 2017 were enrolled and further divided into an enteral nutrition group(a control group,n =25)and an enteral nutrition combined with rehabilitation therapy group(an observation group,n=25).Anthropometric parameters including body mass index,biceps circumference,calf circumference,triceps skin-fold thickness,and blood biochemical parameters including hemoglobin,total cholesterol,triacylglycerol,albumin,lymphocyte count before and after treatment were compared between the groups.Results Anthropometric parameters such as body mass index,biceps circumference,calf circumference and triceps skin-fold thickness had no significant difference between the two groups before treatment (P ＞ 0.05),while after 30 days of treatment,anthropometric parameters saw improvement in both groups compared with those before treatment,and the improvement was greater in the observation group than in the control group(P ＜0.01).Blood biochemical parameters had no significant difference between the two groups before treatment(P＞0.05).After 30 days of treatment,levels of total cholesterol and triacylglycerol had no significant difference compared with those before treatment or between the two groups(P ＞0.05),while levels of hemoglobin,albumin and lymphocyte count improved compared with those before treatment (t =2.645,2.843,2.967,respectively,P ＜0.01),and had significant differences between the groups (t =2.548,2.864,2.976,respectively,P＜0.01).Conclusions Enteral nutrition combined with rehabilitation therapy has a measurable,positive influence on nutritional status in senile dementia patients with malnutrition.

Objective To investigate the potential prognostic factors in patients with hepatocellular carcinoma (HCC) complicate by portal vein tumor thrombosis (PVTT) who are treated with transcatheter arterial chemoembolization (TACE). Methods The complete clinical data of a total of 46 patients with HCC complicate by PVTT, who were treated with TACE during the period from January 2010 to March 2016, were retrospectively analyzed. Clinical material database was established. Kaplan-Meier test was adopted to analyze the survival rate and the COX risk ratio model was used to screen out the independent prognostic factors. Life table method was employed to calculate the survival time. Results The 6-, 12-, 18- and 24-month survival rates were 51. 2％, 28. 9％, 23. 4％ and 10. 2％, respectively. The median survival time was 6. 7 months. According to mRECIST standard, complete remission (CR) was obtained in one patient (2. 1％), partial remission (PR) in 11 patients (23. 9％), stable disease (SD) in 16 patients (34. 8％) and progress disease (PD) in 18 patients (39. 2％). Multivariate analysis indicated that local tumor response, ascites, cholinesterase, and arteriovenous fistula were the independent factors affecting the prognosis. Conclusion The independent prognostic factors that affect the survival time of HCC patient include local tumor response, ascites, cholinesterase and arteriovenous fistula. (J Intervent Radiol, 2018, 27: 266-271)

Objective To evaluate the effect of fluid resuscitation with early external jugular vein access on prognosis of sepsis patients.Methods One hundred and twenty patients with sepsis,admitted to emergency intensive care unit (EICU) and the general intensive care units (ICU) were randomly divided into two groups,external jugular vein group (n=60) and deep-vein group (e.g.internal jugular vein,subclavian vein,femoral vein,n=60).The time elapsed from admission to initial application of norepinephrine,the time required for getting the early goal directed therapy (EGDT) after standard procedure,the length of time needed for subsequent use of vasoactive agents during the entire course of resuscitation serum lactate level at3 h and 6 h after resuscitation,lactate clearance rate,SOFA scores were documented.The mortality rates of 14 days and 28 days were observed after treatment.Results Compared with deep vein access,the time elapsed from admission to the initial application of norepinephrine and the time required for getting EGDT were significantly shortened [(20.78±5.03) vs.(6.12±2.58),P＜0.01;(6.15±2.03)vs.(5.35±2.21),P＜0.05],and the serum level of lactate was significantly decreased[(6.88±1.71)vs.(6.28±1.51),P＜0.05] at 3 h after resuscitation,and lactate clearance rate in percentage was significantly increased at 3 h after resuscitation,and SOFA at 6 h was decreased[(25.8±9.2) vs.(31.2±13.3),P＜0.05],and SOFA at 6 h was distinctly reduced [(5.78±1.19) vs.(5.38±0.96),P＜0.05],and.the mortality rates of 14 days decreased significantly in the external jugular vein group(33.3％ vs.16.7％,P＜0.05).Conclusions Early external jugular vein access can more significantly save time,improve the effect of fluid resuscitation,promote recovery of important organ.It is helpful for improving prognosis in sepsis patients.