Objective To explore the lipid-lowering effect of Qige Decoction before and after compatibility through the combination of pharmacodynamics and liver metabolomics,and to provide new research strategies for exploring the scientific notation of traditional Chinese medicine compatibility.Methods According to the pharmacodynamic strategy,three groups of drug administration were set up as Qige Decoction group,Astragali Radix-Puerariae Radix group,and Pericarpium Citri Tangerinae group.Four indices of blood lipids,serum biochemical indicators,and liver morphology and pathology were used to evaluate the intervention effect of Qige Decoction on hyperlipidemic rats.Liver metabolomics technology was used to analyze the effects of Qige Decoction on metabolites before and after compatibility,and multivariate statistical analysis was used to evaluate the differences between groups in terms of differential metabolites and metabolic pathways.Results Compared with the model group,the callback abilities of four indices of blood lipid in the Qige Decoction group were higher than those in Astragali Radix-Puerariae Radix group and Pericarpium Citri Tangerinae group,among which the total cholesterol(TC)and triglyceride(TG)levels in the Qige Decoction group decreased(P＜0.05).A total of 86 potential biomarkers were identified by liver metabolomics,with 23,13,and 7 metabolites being significantly different in the Qige Decoction group,Astragali Radix-Puerariae Radix group,and Pericarpium Citri Tangerinae group,respectively(P＜0.05).Metabolic pathway analysis of 29 specific biomarkers with significant callback effects showed that they were related to glycerophospholipid metabolism,linoleic acid metabolism,α-linolenic acid metabolism,sphingolipid metabolism,arachidonic acid metabolism,and unsaturated fatty acid biosynthesis.Qige Decoction mainly regulates glycerophospholipid and linoleic acid metabolism,and uniquely acts on sphingolipid metabolism.Conclusion Qige Decoction has more lipid-lowering targets after compatibility,with better lipid-lowering effects than the Astragali Radix-Puerariae Radix group and Pericarpium Citri Tangerinae group.This study provides experimental evidence and research strategies for further revealing the scientific notation of traditional Chinese medicine compatibility.

Objective:To explore the value of the classifier model based on CT radiomic characteristics in predicting the activity of pulmonary cystic echinococcosis (CE).Methods:The study was designed as cross-sectional. A retrospective analysis was performed on 81 patients diagnosed with pulmonary CE in the First Affiliated Hospital of Xinjiang Medical University from January 2010 to October 2020. The Python function divided 17 cases into an internal verification group and 64 cases into a training group with a ratio of 2∶8. In addition, 16 patients diagnosed with pulmonary CE from the Fourth Affiliated Hospital of Xinjiang Medical University from October 2020 to 2024 were included in the external validation group. All patients underwent CT examination, and radiomics features were extracted using Radcloud platform of Huimedi Huiying. The intraclass correlation coefficient was performed on the features, then feature screening was performed using the SelectKBest method, variance thresholding method, and least absolute shrinkage and selection operator. Finally, three classifiers (including support vector machine (SVM), K-neighborhood (KNN), and logistic regression (LR)) were used to build the models. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the model′s efficiency.Results:Among 81 patients with lung CE, 58 were male, and 23 were female. twenty-eight lesions were active and 53 were inactive. A total of 11 optimal features were selected. Based on the selected features, the SVM classifier model, KNN classifier model, and LR classifier model were established. The KNN classifier model in the training group had the highest AUC value (0.93) and the highest specificity (0.98) in predicting lung CE activity. In the internal validation group, the SVM classifier model had the highest AUC value (0.92) and the highest specificity (0.91) in predicting lung CE activity. The LR classifier model performed best with the highest AUC of 0.85 for predicting lung CE activity in the external validation group, and the specificity of the three models was 0.92.Conclusion:The classifier model established based on CT radiomic features has a certain value in predicting lung CE activity, and may be helpful in clinical decision-making.

Objective:To analyze the survival time, prognostic factors and the value of postoperative thoracic radiotherapy in resected small cell lung cancer (SCLC) patients.Methods:Clinic opathological data of SCLC patients who received surgical treatment in Cancer Hospital & General Hospital of Ningxia Medical University from April 2014 to September 2021 were enrolled in this retrospective study. All patients were subject to follow-up. The survival time of SCLC patients was evaluated by Kaplan-Meier method. Univariate and multivariate analyses of prognostic factors were performed by Cox proportional hazard model.Results:A total of 64 patients with SCLC were enrolled in the study. The 5-year overall survival (OS) rate was 43.5%. Univariate analysis showed that TNM staging ( P=0.027), postoperative neutrophil-lymphocyte ratio (NLR) ( P=0.039) and adjuvant thoracic radiotherapy ( P=0.041) were the prognostic factors. Multivariate analysis showed that TNM staging ( P=0.038) and adjuvant thoracic radiotherapy ( P=0.022) were the prognostic factors in patients with SCLC. The 5-year OS rates of patients with and without adjuvant thoracic radiotherapy were 71.6% and 35.4% ( P=0.028), respectively. There was a statistically significant difference in the 5-year OS rates between pathological stage N 2 SCLC patients with or without adjuvant thoracic radiotherapy (75.0% vs. 0%, P=0.030). Conclusions:TNM staging and postoperative adjuvant thoracic radiotherapy are prognostic factors in patients with SCLC undergoing surgical treatment. Pathological stage N 2 SCLC patients can benefit from adjuvant thoracic radiotherapy.

Objective:To investigate the clinical efficacy and safety of domestic bortezomib in the treatment of patients with multiple myeloma (MM).Methods:The data of 60 MM patients treated with domestic bortezomib as the basic chemotherapy regimen in 5 medical centers of Qilu Hospital of Shandong University, Heze Municipal Hospital, Weifang People's Hospital, Binzhou Medical University Hospital, Zibo Central Hospital in Shandong Province from January 2018 to June 2019 were retrospectively analyzed, 52 of which were newly treated patients and 8 were relapsed and refractory patients. The patients received at least 2 courses of combined chemotherapy based on domestic bortezomib, and the efficacy was assessed and evaluated every 2 courses.Results:Follow-up until June 30, 2019 showed that some patients were unable to return to the hospital for regular treatment. All patients completed at least 2 courses of treatment, with an overall effective rate (ORR) of 76.7% (46/60); 42 patients completed 4 courses of treatment, with an ORR of 78.6% (33/42); 30 patients completed 6 courses of treatment, with an ORR of 86.7% (26/30); there was no significant difference in ORR of 2, 4 and 6 courses ( P > 0.05). The complete remission+very good partial remission rates of 2, 4 and 6 courses were 16.7% (10/60), 47.6% (20/42) and 66.7% (20/30), respectively, and the difference was statistically significant ( P < 0.01). During the treatment, the adverse events mainly included infection, peripheral neuropathy, herpes, digestive tract symptoms, hematologic toxicities and so on, which were light and moderate mostly, and most of them can be reversed. The total incidence of adverse events in patients who completed 2, 4 and 6 courses of treatment were 91.7% (55/60), 66.7% (28/42) and 36.7% (11/30), respectively. Conclusions:The domestic bortezomib-based chemotherapy regimens have good efficacy in the treatment of MM. The incidence of adverse events is similar to that of the original drug, and patients can tolerate the adverse events.

Objective:To evaluate the clinical efficacy and safety of endoscopic submucosal dissection (ESD) for treatment of duodenal lesions.Methods:A retrospective analysis was performed on the data of 45 patients with 46 duodenal lesions who underwent ESD at the Second Xiangya Hospital of Central South University from January 2011 to May 2019. The lesion features, en bloc resection rate, complete resection rate, complications, postoperative pathology and recurrence were assessed.Results:Among the 45 patients, 20 were males and 25 were females, with age of 52.0±11.8 years. Of the 46 lesions, 31 (67.4%) were located in the duodenal bulb, 12 (26.1%) in the descending part, and 3 (6.5%) at the junction of bulb and descending part. The diameter of the lesions was 2.4±1.9 cm. There were 14 (30.4%) lesions originated from mucosal layer, 29 (63.1%) from submucosal layer, and 3 (6.5%) from muscularis propria.Postoperative pathology showed 11 (23.9%) cases of Brunner gland tumors, 9 (19.6%) neuroendocrine tumors, 5 (10.9%) ectopic pancreas, 5 (10.9%) lipomas, and 16 (34.8%) other pathological patterns. All 45 patients with 46 lesions underwent ESD successfully, and the en bloc resection rate was 100.0% (46/46), complete resection rate was 91.3% (42/46). Intraoperative bleeding occurred in 1 case (2.2%), which was successfully treated by endoscopy. One (2.2%) delayed perforation occurred and was treated by surgical intervention. Electrocoagulation syndrome occurred in 1 case (2.2%), which was relieved after conservative medical therapy. Two cases received further surgery after ESD. The mean hospital stay was 6.2 days (ranged 2-21 days) and no death occurred. Forty-one cases were followed up for 1-78 months, with mean time of 30 months. During the follow-up period, local recurrence occurred in 1 patient (2.4%).Conclusion:ESD is an effective and safe treatment for duodenal lesions and has a good clinical practical value.

Objective To compare the efficacy of monochromatic excimer light and narrow-band ultraviolet in the treatment of facial vitiligo patients.Methods Seventy-nine patients with facial vitiligo were randomly divided into MEL group and NB-UVB group.The MEL and 311-nm NB-UVB were applied respectively.Both groups were treated twice a week,total 30 times.Results After ten times treatment,the effective rate of MEL group and NB-UVB group was 39.02％ and 15.79％,respectively.There was significant difference between the two groups (P＜0.05).After twenty times treatment,the effective rate of MEL group and NB-UVB group was 70.73％ and 44.74％,respective ly,with significant difference between the two groups (P＜0.05).After thirty times treatment,the efficacy of MEL group and NB-UVB group was 87.80％ and 84.21 ％,respectively.No statistical significance was found between the two groups (P ＞ 0.05).The efficacy of both groups showed that disease duration was a negative factor.It seemed that shorter duration of facial vitiligo would obtain better clinical effect.MEL and NB-UVB were safe and effective for the progressive vitiligo.In both groups,few adverse effets in some patients were observed.Conclusions The clinical effect of MEL in treating facial vitiligo is more rapidly than NB-UVB,but as the treatment times increase,the efficacy becomes similar.Both methods are safe in treating facial vitiligo of different stages.

Objective To explore the risk factors of postoperative pulmonary infection in patients with craniocerebral injury and establish a nomogram model to predict the risk of postoperative pulmonary infection after craniocerebral injury.Methods The clinical data of 169 patients with craniocerebral injury,admitted to and underwent craniotomy in our hospital from January 2013 to December 2018,were retrospectively analyzed.The clinical data of patients with postoperative pulmonary infection and without postoperative pulmonary infection were compared.The risk factors of postoperative pulmonary infection were analyzed by multivariate Logistic regression.R language was used to establish a nomogram model to predict the risk of postoperative pulmonary infection after craniocerebral injury.Receiver operating characteristic (ROC) curve was used to explore the prediction efficiency of the nomogram model for pulmonary infection after craniocerebral injury.Results Among the 169 patients,74 (43.8％) were complicated with pulmonary infection and 95 (56.2％) were not complicated with pulmonary infection.As compared with non-pulmonary infection group,pulmonary infection group had significantly higher percentages of patients with open craniocerebral injury and Glasgow coma scale (GCS) scores＜7,significantly higher American Society of Anesthesiologists (ASA) grading,lower albumin level one week after surgery,statistically longer operation time,and significantly higher percentages of patients with conscious disorder,patients accepted intraoperative blood transfusion,patients used breathing machine,and patients stayed in bed for 4 weeks or more (P＜0.05).Multivariate Logistic regression analysis showed that GCS scores (OR=0.243,95％CI:0.122-0.497,P=0.000),ASA grading (OR=3.349,95％CI:2.233-5.021,P=0.000),disturbance of consciousness (OR=3.185,95％CI:1.217-8.334,P=0.018),and useofventilator (OR=3.376,95％CI:1.590-7.167,P=0.002) were independent risk factors for postoperative pulmonary infection in patients with craniocerebral injury.The scores of the nomograrn model were 13.7,100.0,38.0 and 27.5 in GCS scores,ASA grading,disturbance of consciousness and use of ventilator,respectively.The consistency index of the nomogram model for predicting postoperative pulmonary infection in patients with craniocerebral injury was 0.835.ROC curve showed that the area under the curve predicted by nomogram model for postoperative pulmonary infection in patients with craniocranial injury was 0.840 (95％CI:0.778-0.901).Conclusion Based on the risk factors for pulmonary infection after craniocerebral injury,a nomogram model for predicting the risk of pulmonary infection is established,which has a good differentiation degree and prediction effect,and can provide a reference for medical staffto identify high-risk patients at an early stage,so as to take more targeted intervention measures.

Objective To compare the effects of different oral motor interventions,including non-nutritive sucking (NNS) and acupuncture point stimulation of oral and cheek combined with NNS,on oral feeding of prematures.Methods A total of 164 prematures were randomly divided into three groups. Group A (n=53) received routine feeding nursing care;Group B (n=54) were given non-nutritive sucking for 3 minutes before and after feeding,with 8 times per day;Group C (n=57) were given acupuncture point stimulation of oral and cheek for 17 minutes and non-nutritive sucking for 3 minutes before feeding,with twice per day.Results There was no significant difference between group B and C on the transitional time from the initiation of oral feeding to full oral feeding (P>0.05). Transitional time of both groups were significant shorter than that of group A (P<0.05). Feeding performance of prematures from the initiation of oral feeding to full oral feeding in group C was significant better than group A and B (P<0.05). There was significant difference in the feeding performance of prematures at the initiation of oral feeding between A and B group (P<0.05),but no significant differences between two groups after full oral feeding (P>0.05).Conclusions Different oral motor interventions including NNS and acupuncture point stimulation of oral and cheek combined with NNS can reduce the time of achieving full oral feeding in prematures. Acupuncture point stimulation of oral and cheek combined with NNS performs better than only NNS on feeding in prematures.

Objective To explore effect of 5 -aminolevulinic acid -photodynamic therapy combined with thymopentin -5 on IL -17,IL -23 expression of recurrent condylomata acuminata patients.Methods 140 patients with recurrent condylomata acuminata were randomly divided into 3 groups.53 cases in observation group were treated by 5 -aminolevulinic acid -photodynamic therapy combined with thymopentin -5,42 cases in control group 1 were treated by 5 -aminolevulinic acid -photodynamic therapy,and 45 cases in control group 2 were treated by thymopen-tin -5.24 healthy subjects were served as normal controls.IL -17,IL -23 levels were determined by enzyme linked immunosorbent assay before and after the clinical therapy.Results IL -17,IL -23 levels in the patients with recur-rent condylomata acuminata were significantly lower than those in healthy subjects(t =28.10,P <0.01;t =11.10, P <0.01).There were significant differences in IL -17,IL -23 between recurrent condylomata acuminata patients and healthy persons before treatment.There was significant difference after treatment(t =61.17,P <0.01;t =28.02, P <0.01).Conclusion 5 -aminolevulinic acid -photodynamic therapy combined with thymopentin -5 in the treat-ment of recurrent condylomata acuminata inhibited IL -17,IL -23 expression,so as to achieve therapeutic effect.

BACKGROUND:There is a great dispute on the choice of repair materials for ossicular chain damage.
OBJECTIVE:To explore the effects of new hydroxyapatite-bone morphogenetic protein ossicular prosthesis versus al ogeneic cartilage ossicular prosthesis in patients with ossicular chain damage.
METHODS:Sixty patients with chronic otitis media were equal y assigned into a control group and a test group. Two groups of patients underwent tympanoplasty and ossicular chain reconstruction with al ogeneic cartilage ossicular prosthesis or hydroxyapatite-bone morphogenetic protein ossicular prosthesis, respectively. Twelve months after surgery, fol ow-up results were compared between two groups.
RESULTS AND CONCLUSION:Air conduction value and air-bone gap value were both improved significantly in the two groups after surgery (P<0.05), and especial y, the postoperative air conduction value was better in the test group than the control group (P<0.05). Implant detachment was found in three cases of the control group, whereas did not occur in the test group. Improved hearing was found in 28 cases in the test group with an improvement rate of 93%and 25 cases in the control group with an improvement rate of 83%. There was a significant difference in the hearing improvement between the two groups (P<0.05). Overal , two kinds of prostheses can share similar effects on the ossicular chain repair.
Subject headings:Tympanoplasty;Otitis Media;Bone Morphogenetic Proteins;Tissue Engineering