Wumei Pills is mostly used to treat ulcerative colitis, irritable bowel syndrome, intestinal polyps, chronic atrophic gastritis, gastroesophageal reflux disease, gastric cancer and other digestive system diseases with its modified formula or combination with Western medicine. Wumei Pills can play a role in treating digestive system diseases through antioxidant stress, Inhibiting inflammatory response, regulating intestinal flora, anti-tumor, promoting intestinal mucosal repair, etc. Most of the related research on the mechanism of Wumei Pills in the treatment of digestive system diseases were studied in a single pathway. The relationship between other mechanisms and pathways is worthy of further exploration. In addition, the current research mostly focuses on the lower digestive system diseases with diarrhea as the main manifestation, and there is still room for research and reporting in the treatment of upper digestive system diseases.

Objective:To evaluate the effectiveness of oral-nasal oxygen supply mouth guard in painless gastroscopy for snoring patients.Methods:The snoring patients who underwent painless gastroscopy at two Endoscopy Centers of Shanghai East Hospital, Tongji University in July 2022 were randomly divided into the observation group (using oral-nasal oxygen supply mouth guard) and the control group (using ordinary nasal oxygen tube and mouth guard). Parameters such as the wearing time and the removal time of the mouth guard, lowest pulse oxygen saturation (SpO 2), incidence of hypoxemia, and the satisfaction of medical staff were compared between the two groups. Results:The wearing time of mouth guard was 11.63±0.84 seconds and the removal time was 5.33±0.76 seconds in the observation group ( n=40), which were lower than those in the control group ( n=47) (14.91±1.21 seconds, t=-14.463, P<0.001; 10.38±0.80 seconds, t=-30.095, P<0.001). The wearing satisfaction score was 9.80±0.61, the lowest SpO 2 was (96.70±3.42)%, the removal satisfaction score was 9.75±0.67, and the anesthesiologists' satisfaction score was 9.20±1.42 in the observation group, which were higher than those in the control group [7.70±0.93, t=12.209, P<0.001; (94.06±3.72)%, t=3.417, P=0.001; 7.96±0.98, t=9.803, P<0.001; 8.13±1.35, t=3.615, P=0.001] with significant difference. There was no significant difference in the incidence of hypoxemia [10.00% (4/40) VS 14.89% (7/47), χ2=0.130, P=0.718] and endoscopic physician satisfaction score (9.30±0.97 VS 9.02±1.31, t=1.112, P=0.269) between the two groups. Conclusion:The oral-nasal oxygen supply mouth guard is easy to wear and remove, effectively reducing SpO 2 fluctuations during painless gastroscopy for snoring patients. It can enhance medical staff satisfaction with high clinical value.

Chronic fatigue syndrome （CFS） is a heterogeneous disease with dysfunction in multiple systems and multiple organs. Its etiology and pathogenesis have not been fully clarified， and its treatment also lacks specificity. The key to studying CFS is developing animal models that reflect the underlying mechanisms and etiology of CFS. The existing CFS modeling methods are complicated and not unified. By sorting out relevant literature，the present study evaluated the modeling methods，modeling standards，mechanisms， and clinical coincidence of the immune model，the stress model， and the disease-syndrome combination model in traditional Chinese medicine （TCM）. The immune model is mainly constructed from the perspective of pathophysiology， with easy operation and wide investigation， which can simulate the pathological characteristics of CFS to ensure pathogenesis research，but the experimental repeatability is general. Stress modeling is a common method for a variety of neuropsychiatric diseases，including CFS. Many different stressors can be employed to investigate the etiology of CFS， but their effects are unpredictable. Compared with the two western medicine models mentioned above，the TCM disease-syndrome combination model integrates modern medicine with TCM theory，with high clinical coincidence and great practical value. However，the TCM disease-syndrome combination model of CFS is still in the exploratory stage with a few types of models，which needs to be further improved， aiming to establish scientific，reasonable，simple， and efficient animal models to provide support for exploring the etiology，pathogenesis， and new treatment ideas of CFS.

To evaluate the clinical value of a new method of guide wire extraction and single reverse-α fixation with short nasobiliary duct for oronasal conversion and fixation, patients who underwent endoscopic nasobiliary drainage in Shanghai East Hospital, Tongji University from January to August 2022 were selected. They were randomly divided into guide wire extraction and single reverse-α fixation with short nasobiliary duct group (the observation group, n=145) and guide wire taking and reverse-α fixation group (the control group, n=71). The operation time, one-time operation success rate, adverse events, comfort and satisfaction between the two groups were compared. The operation time in the observation group was significantly shorter than that in the control group [102 ( 91, 117) s VS 136 (127, 145) s, Z=-9.639, P<0.001]. The one-time operation success rate in the observation group was significantly higher than that in the control group [88.28% (128/145) VS 67.61% (48/71), χ2=13.496], the nasopharynx stimulation score [1 (1, 2) VS 2 (1, 2), Z=-4.457] and adverse events incidence [4.14% (6/145) VS 15.49% (11/71), χ2=8.475] in the observation group were significantly lower than those in the control group ( P<0.05). During the indwelling of nasobiliary duct, the bile drainage volume (179.45±81.54 mL VS 142.89±55.69 mL, t=3.407) and nursing satisfaction score (7.72±0.99 VS 6.06±1.07, t=11.337) in the observation group were higher than those in the control group, and the comfort score (3.00±1.01 VS 4.83±0.99, t=-12.642) and incidence of adverse events [3.45% (5/145) VS 14.08% (10/71), χ2=8.344] in the observation group were lower than those in the control group ( P<0.05). The operation time of nasobiliary duct removal in the observation group was significantly shorter than that in the control group (9.00±1.14 s VS 11.93±1.36 s, t=-16.616, P<0.001). In conclusion, the guide wire extraction and single reverse-α fixation with short nasobiliary duct for nasobiliary oronasal conversion and fixation in endoscopic nasobiliary drainage has the advantages of simple operation, small irritation response and low complication incidence, which is worth of clinical promotion.

We report a neonate with transaldolase deficiency caused by compound heterozygous variation of the TALDO1 gene. A pregnant woman, who had an adverse pregnancy history, was found with multiple fetal abnormalities on prenatal ultrasound and the following whole exon sequencing indicated a likely pathogenic heterozygous variation of c.462-2A>G and c.574C>T(p.R192C) in TALDO1 gene in the fetus. A body was born at 38 +1 weeks and presented dysmorphic features (cutis laxa/wrinkled skin and low-set ears, etc.), splenomegaly, anemia, abnormal liver function and coagulation. In combination with the prenatal testing results, transaldolase deficiency was diagnosed. The patients still had cutis laxa/wrinkled skin on the back of both hands and neck at one year and three months old. Therefore, for babies with hepatosplenomegaly, anemia, thrombocytopenia, coagulation dysfunction, at the same time with dysmorphic features such as cutis laxa, low-set ears, attention should be paid to the investigation of transaldolase deficiency.

Objective:To investigate the effect of short single reverse-α fixation of nasobiliary tube after endoscopic nasobiliary drainage.Methods:From January 2019 to October 2019, the patients who performed with endoscopic nasolbiliary drainage in Tongji University Affiliated Shanghai East Hospital were randomly divided into experimental group (short single reverse-α fixation, 155 cases) and control group (routine reverse-α fixation, 137 cases). The incidences of the fixation time, prolapse rate, nursing time, scores of nasal comfort and bile flow rate of nasobiliary duct were evaluated between the two groups.Results:The average time of nasobiliary duct fixation was (18.31±1.67) s, the prolapse rate was 5.2% (8/155) and the time of nursing was (35.03±2.68) s, which were lower than those of the control group (46.50±5.50) s, 13.9% (19/137) and (72.07±7.63) s. The difference was statistically significant ( t or χ 2 values were 60.795, 6.570, 56.629, P<0.01 or 0.05). The comfort score of the experimental group was (4.61±1.06) points, the bile flow rate was (241.52±53.95) ml/days, which were higher than (5.76±0.76) points and (174.09±47.55) ml/days of the control group, the difference was statistically significant ( t values were 10.448, 11.265, P<0.01). Conclusions:Shortening the length of nasobiliary duct combined with single reaction "α" method has the advantages of simper operation and nursing, low prolapse rate, high comfort and good drainage effect. It is worthy of clinical application.

The role of Nod-like receptor pyrin domain 3 (NLRP3) inflammasome and pyroptosis in bronchial asthma (asthma) has attracted increasing attention in recent years.The activation of NLRP3 leads to the recruitment and activation of Cysteinyl aspartate specific proteinase-1 and the release of interleukin-1β(IL-1β) and interleukin-18(IL-18), which aggravates the airway inflammation in asthma.Meanwhile, NLRP3 further results in the clea-vage of Gasdermin D and pyroptosis.Finally, the cell damage stimulates the airway remodeling of asthma.This article focused on the mechanisms of NLRP3 inflammatory response and pyroptosis as well as its role in asthma.

Objective To investigate the age distribution and types of human papillomavirus (HPV) cervical infection in patients in Wuhan region, so as to provide scientific basis for the prevention and treatment of HPV infection and cervical cancer.Methods 9 915 exfoliated cervical cell specimens from patients in Wuhan Medical and Health Center for Women and Children between January 2015 and March 2016 were performed HPV genotyping (21 subtypes), clinical data of 1 732 HPV positive cases were statistically analyzed.Results HPV-positive rates in ≤25, 26~, 36~, 46~, and ≥56 age groups were 22.15%, 15.90%, 17.04%, 19.97%, and 17.57%,respectively (χ2=36.587,P<0.01),HPV-positive rates in ≤25 and 46~ age groups were both higher than other age groups.There were significant differences in single infection and multiple infection rates among different age groups respectively(χ2=14.39, 36.51,respectively, both P<0.05),single infection rate was highest in 46~ and ≤25 age groups (15.41% and 15.24% respectively);multiple infection rates was highest in ≤25 and ≥56 age groups (6.90% and 5.86% respectively).The percentage of single infection and multiple infection were 75.58% and 24.42% respectively, the major single infection type was HPV high-risk subtype (84.34%),the major multiple infection types were high-risk and high-risk compound subtype as well as high-risk and low-risk compound subtype, accounting for 60.52% and 38.77% respectively.The main single infection types were HPV high-risk subtypes 33, 68, 31 and 16, as well as and low-risk subtype 11, the ratios of single infection to multiple infection were 3.13, 2.03, 1.71, 1.67 and 2.00 respectively.Conclusion Cervical infection rates in women in Wuhan region is high in ≤25 and 46~ age groups, there are differences in the distribution of different HPV subtypes of single infection and multiple infection.

Objective To observe the role of clinical pathway method of teaching in the new nurses pre-job standardization training, and provide evidence for the exploration of scientific teaching methods. Methods Make training manual for new nurses on the basis of clinical path model. New nurses were assigned randomly to clinical pathway group (29 cases) and control group (28 cases). The clinical pathway and effective quality supervision were adopted in clinical pathway group, and the traditional teaching method were adopted in control group. The level of theory, basic skills, professional skills were evaluated, and satisfaction of teaching method and self-assessment were collected and analyzed. Results The results of theory, basic skills, and professional skills in clinical pathway group were (89.41 ± 5.07), (95.28 ± 2.96), (93.10 ± 2.86) points, and those in control group were (80.92 ± 7.64), (89.82 ± 3.77), (85.57 ± 5.33) points, the differences were significant (t=4.792, 6.083, 6.682, P=0.000).The number of satisfaction of teaching method was 28 cases in clinical pathway group and 22 cases in control group, the difference was significant (Z=38.316, P=0.000). Learning motivation, the ability of autonomous learning, communication, problem analyzing and solving, critical thinking, and the nursing behavior standardization in the self-assessment part in clinical pathway group were all better than those in the control group, the differences were significant (Z=-3.938~-2.143, P<0.01 or 0.05). Conclusions The application of clinical pathway method in new nurses pre-job training could effectively improve the level of theory, basic skills and professional skills, increase their satisfaction of teaching method and self-assessment.

Objective To study the correlation between the levels of IP-10 mRNA in peripheral blood mononuclear cells (PBMCs) and prognosis of acute-on-chronic hepatitis B virus related liver failure (HBV-ACLF).Methods Fifty patients diagnosed with HBV-ACLF were administered a combined modality therapy and followed up until death or for 3 months.In addition,20 patients with chronic hepatitis B(CHB),20 patients with hepatitis B related cirrhosis and 20 healthy volunteers were matched for use as control.The levels of IP-10 mRNA in PBMCs were detected at baseline and last follow-up visit and compared between groups by statistical analysis.Results At baseline,the CHB group had a significantly higher level of IP-10 mRNA in PBNCs than the healthy control group(t =-6.972,P ＜0.01).However,the level of IP-10 mRNA in PBMCs of the liver failure group was significantly higher than that of boththe CHB group(t =2.510,P ＜ 0.05) and the healthy control group (t =8.648,P ＜ 0.01).When patients within the liver failure group were divided by survival and death occurring during the 3-month follow-up period,the patients who died were found to have a significantly higher level of IP-10 mRNA in PBMCs than the surviving patients(P ＜ 0.01).The area under the curve of ROC curve is 0.81,and cut off value is 0.9255.Conclusion The level of IP-10 mRNA in PBMCs is positively correlated with risk of death in patients with HBV-ACLF,and its detecting might predict the prognosis of HBV-ACLF.