Based on the previous publications， it is believed that damp-heat syndrome is the core syndrome of rheumatoid arthritis （RA）， and Qingre Huoxue Formula （清热活血方） is an effective formula for the treatment of damp-heat syndrome of RA. “Inflammation-bone destruction” is a key pathological link of RA， and it is also the advantage of the effectiveness of Qingre Huoxue Formula. Leucine rich α-2-glycoprotein 1 （LRG1） can mediate the transforming growth factor-β （TGF-β） signalling pathway to participate in the pathogenic process of “inflammation-bone destruction” of RA， and it can be used as a target protein in the treatment of damp-heat syndrome of RA by Qingre Huoxue Formula. Accordingly， a scientific hypothesis was proposed that Qingre Huoxue Formula may regulate TGF-β signalling pathway mediated by LRG1 to improve “inflammation-bone destruction” of RA， and it was envisioned that the clinical effect of Qingre Huoxue Formula on LRG1 could be confirmed through clinical studies， and the mechanism of action of Qingre Huoxue Formula on the LRG1/TGF-β signalling axis as well as the influence of the expression or non-expression of the LRG1/TGF-β signalling axis on the therapeutic effectiveness of Qingre Huoxue Formula could be clarified through animal experiments.

Objective To analyze the hot spots,rules and distribution on safety research of inhalation preparations at home and abroad in the past 20 years,and to summarize the current status of safety and risk control research on inhalation preparations.Methods This reaserch is based on the literature related to the safety and risk control of inhalation preparations in the core collection database of the Web of Science.With the help of Excel 2021 and CiteSpace6.1.R3,visualized processing and analysis were carried out on the annual number of publications,countries,institutions,authors,co-occurrence of keywords,clustering and prominence.Results A total of 365 articles were included,the annual publication number in the field of the safety and risk control of inhalation preparations was less than 30 per year from 2002 to 2018.But since 2019,the number of articles published this year has exceeded 30.Through the analysis of the cooperation network of countries and institutions,the top four countries in terms of publication volume are the United States,the United Kingdom,Germany,and China,and the top three institutions are AstraZeneca,GlaxoSmithKline and Pfizer.Through the analysis of the author cooperation network,the cooperation network between European and American authors was formed earlier,and a certain research group has appeared in 2002.In contrast,a more concentrated cooperation network has been formed in China in 2020.Conclusions In the past 20 years,the research on inhalation preparations has mainly focused on their safety and efficacy,while there are few studies on their risk control.There is a disconnect between safety assessment and risk assessment,and the future focus maybe focused on the adverse reaction assessment and risk management research of inhalation preparations.

Existing traditional Chinese medicine (TCM)-related databases are still insufficient in data standardization, integrity and precision, and need to be updated urgently. Herein, an Encyclopedia of Traditional Chinese Medicine version 2.0 (ETCM v2.0, http://www.tcmip.cn/ETCM2/front/#/) was constructed as the latest curated database hosting 48,442 TCM formulas recorded by ancient Chinese medical books, 9872 Chinese patent drugs, 2079 Chinese medicinal materials and 38,298 ingredients. To facilitate the mechanistic research and new drug discovery, we improved the target identification method based on a two-dimensional ligand similarity search module, which provides the confirmed and/or potential targets of each ingredient, as well as their binding activities. Importantly, five TCM formulas/Chinese patent drugs/herbs/ingredients with the highest Jaccard similarity scores to the submitted drugs are offered in ETCM v2.0, which may be of significance to identify prescriptions/herbs/ingredients with similar clinical efficacy, to summarize the rules of prescription use, and to find alternative drugs for endangered Chinese medicinal materials. Moreover, ETCM v2.0 provides an enhanced JavaScript-based network visualization tool for creating, modifying and exploring multi-scale biological networks. ETCM v2.0 may be a major data warehouse for the quality marker identification of TCMs, the TCM-derived drug discovery and repurposing, and the pharmacological mechanism investigation of TCMs against various human diseases.

Objective:To investigate the status of innovative behavioral ability of undergraduate nursing students, analyze the relationship between nursing students′ sense of benefit, self-transcendence and innovative behavioral ability, and explore the mediating effect of occupational benefit in self-transcendence and innovative behavioral ability.Methods:A convenient sampling method was used to select 223 undergraduate nursing students in the First Affiliated Hospital of Guangxi University of Chinese Medicine as the research object from October 2017 to April 2019. The cross-sectional survey was conducted using the occupational benefit, self-transcendment scale and nurses′ innovative behavior scale. Apply SPSS21.0 to analyze the correlation between self-transcendence, occupational benefit and innovative behavior of undergraduate nursing students, apply AMOS 22.0 for mediating effect test, and use the bias-corrected percentile Bootstrap method to estimate the median effect of occupational benefit 95% confidence interval.Results:The path coefficient of undergraduate nursing students′ self-transcendence to innovative behavioral ability was significant ( r value was 0.31, P<0.01). Self-transcendence had a significant positive effect on positive occupational sense ( r value was 0.36, P<0.05). The 95% confidence interval for the Bootstrap test of the indirect effect of positive occupationality was 0.02-0.07; the positive sense of occupation had a partial mediating effect between self-transcendence and innovative behavioral ability, with an effect value of 0.14 and a total effect value of 0.42. That was, the mediation effect value accounted for 33.3% of the total effect value. The path coefficient of the team's ability to feel innovative behavior was significant ( r value was 0.39, P<0.05), and self-transcendence had a positive impact on team belonging ( r value was 0.28, P<0.01). The 95% confidence interval for the Bootstrap test for the indirect effects of team belonging was distributed in 0.10-0.42. The sense of belonging of the team had a partial mediating effect between self-transcendence and innovative behavioral ability. The mediating effect value was 0.07, and the total effect value was 0.42, that was, the mediating effect value accounts for 16.7% of the total effect value. Conclusions:Self-transcendence of undergraduate nursing students can directly predict the ability of innovative behavior, and can also indirectly predict the ability of innovative behavior through the mediating role of positive career perception and team belonging in the sense of professional benefit. Improving the professional benefit and self-transcendence of nursing students in clinical teaching may be an effective way to improve the ability of innovative behavior.

Objective To investigate the clinical characteristics of 40 patients with ocular toxocariasis (OT) on the first attendance.Methods A total of 40 consecutive patients who were clinically and serologically diagnosed with OT were retrospectively reviewed.Results The mean age of patients was (12.12±10.42) years.There were 29 males and 11 females.29 cases presented with decreased vision,4 children with leukocoria,2 cases with strabismus and 5 cases was found abnormal during regular eye examination.Initially 8 eyes (20％) were misdiagnosed as retinoblastoma (1 eye),Coat' s disease (1 eye),cataract (2 eyes),iridocyclitis (2 eyes) and retinal detachment (2 eyes).23 eyes had retinal detachment,19 eyes had cataract.OT was the initial diagnosis for 15 patients (37.5％).The best corrected visual acuity (BCVA) were NLP to 0.7.Ultrasound biomicroscopy (UBM) were performed in 29 eyes,and identified peripheral granulomas in 23 eyes and adjacent tractional retinal detachment in 12 eyes.We also identified 17 cases (68.0％) with elevated IgE level among 25 patients with positive serological antibody test.Conclusions Tractional retinal detachment,vitreous opacities and cataract are the common clinical findings at the first attendance of OT patients.The adjunctive test of serum total IgE level may be helpful for the diagnosis.The application of UBM and specific IgG detection in serum and intraocular fluid,can also improve the diagnosis.

Objective To determine the amount of serum Vitamin D in premature infants,and to investigate its correlation with bone quantitative ultrasound measurement.Methods The serum of premature infants born between 2013 March and 2014 March in the Maternal and Children Health Hospital of Huadu District in Guangzhou were collected,and serum 25-hydroxyvitamin D [25-(OH) D] level was measured by using chemiluminescence immunoassay,while Omnisense quantitative ultrasound was used to measure bone speed of sound(SOS) in the middle area of the left tibia.According to gestational age,the participants were divided into A,B and C groups(28-32 weeks,32 +1-34 weeks,34 + 1-36 +6 weeks,respectively).The levels of 25-(OH)D and SOS were compared and the correlation between them was analyzed.Results The amount of 25-(OH) D of the 3 groups was (41.65 ± 21.15) nmoL/L,(47.15 ± 19.78) nmol/L,and (49.35 ± 19.93) nmol/L,respectively,and the differences among the 3 groups were statistically significant (F =4.441,P =0.012).The ratio of vitamin D abundant or not (insufficiency including deficiency and lack) in preterm among the 3 groups were compared,and the differences among the 3 groups were statistically significant(x2 =11.38,P =0.023).SOS of the 3 groups were (2 787.85 ± 123.01) m/s,(2 865.12 ± 129.44) m/s and (2 908.59 ± 124.01) m/s,respectively,and the differences among the 3 groups were statistically significant (F =28.716,P =0.000).There was a positive correlation between 25-(OH) D and SOS (r =0.084,P =0.024).Conclusions Level of Vitamin D in premature infants is generally inadequate.The smaller the gestational age,the higher the occurrence rate.Vitamin D levels and SOS are significantly positively correlated,and both of them increase with gestational age.

Objective To investigate the expression and clinicalsignificance of neutrophils heparin binding protein (HBP) and CD64 in the chronic obstructive pulmonary disease to explore the clinical value. Methods From March 2015 to December 2015 , 197 patients with chronic obstructive pulmonary disease (COPD), 223 patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and 265 healthy persons were recruited in this study. 223 patients with AECOPD were divided into two groups based on bacteria concentration in lower respiratory. Infection group was defined as patients with bacteria concentration exceeded 107 cfu/mL group. The rest of patients were in the non-bacterial infection group. Flow cytometry was used to analyzeexpression of CD64 and convert to index of CD64. Enzyme-linked immunosorbent assay (ELISA) was used to analyze expression of HBP. PCT, hs-CRP and WBC were measured at the same time. Results CD64 , HBP , CRP , WBC and PCT were highly expressed inthe acute exacerbation of chronic obstructive pulmonary patients than those in the chronic obstructive pulmonary patients and healthy group (P<0.01). CD64, HBP , CRP , WBC and PCT were highly expressed inthe acute exacerbation of chronic obstructive pulmonary bacterial infection group patients before treatment than thenon-bacterial infection group (P<0.01). HBP, CD64, CRP , WBC and PCT decline dramatically inthe AECOPDbacterial infection group patients after treatment , which were close to the levels in non-bacterial infection group.When the intercept value of CD64 index was defined as 4.0, the sensitivity to diagnose AECOPD bacterial infection was 92.2% with specificity of 86.2%. When the intercept value of HBP index was defined as 49 ng/mL , the sensitivity to diagnose AECOPD bacterial infection was 87.3% with specificity of 92.3%. Therefore, 4.0 of CD64 index and 49ng/ml of HBP index could be used as sensitive indicator of AECOPD detectedby bacterial infections. Conclusion HBP,CD64 were highly expressed in the acute exacerbation of chronic obstructive pulmonary patients than the those of chronic obstructive pulmonary patients and healthygroup, and decline dramatically after treatment. HBP and CD64 has high sensitivity and specificity to diagnose AECOPD bacterial infection. HBP and CD64 could be used as the indicators of auxiliary diagnosis of acute exacerbation of chronic obstructive pulmonary disease and to guide the clinical medication.

To investigate the related substances of tenofovir, 3 related substances were synthesized. RP-HPLC analytical method was developed using Agilent ZORBAX SB-C18 column. The mobile phase composed of methanol and 0. 02 mol/L potassium dihydrogen phosphate. Linear gradient elution was used and the detection wavelength was 260 nm. 3 impurities were found in tenofovir. The established method was accurate and reproducible, and it can be applied for the related substances test in tenofovir.

Objective To explore the effects of mitogen-activated protein kinase (MAPK) pathway by estradiol induced vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in endometrial cancer Ishikawa cells.Methods The experiments were divided into 4 groups:E2 group (Ishikawa cells treated with 1 p mol/L estradiol for 30 minutes); inhibitor group:including Ishikawa cells treated with 10 μmol/L Bibf1 120 (Bibf1 120 group),or treated with 2.5 μmol/L Ponatinib (Ponatinib group),or treated with 10 p mol/L U0126 (U0126 group) for 60 minutes; inhibitor + E2 group:including Ishikawa cells treated with 10 μmol/L Bibf1120 (Bibf1120 + E2 group),or treated with 2.5 μmol/L Ponatinib (Ponatinib + E2 group),or treated with 10 μmol/L U0126 (U0126+ E2 group) for 60 minutes following incubation with 1 μmol/L estradiol for 30 minutes; control group:only adding the culture medium without serum DMEM.(1) Western blot analysis was used to detect phosphorylation extracellular signal-regulated kinase 1/2(p-ERK 1/2) protein expression with stimulation in different concentrations of estradiol (0.01,0.1,1,10,100 μmol/L).(2) Quantitative fluorescent reverse transcription (qRT)-PCR and western blot analysis was used to test the level of mRNA and protein of VEGF,bFGF,MAPK kinase 1/2 (MEK1/2),extracellular signal-regulated kinase 1/2 (ERK1/2),p-ERK1/2 and phosphorylation MEK1/2 (p-MEK1/2).Flow cytometry were used to examine the cell cycle,and transwell chamber assay were used to detect the cell migration in different groups.Results The expression of the p-ERK1/2 protein at 0.01,0.1,1,10,100 μ mol/L were 0.16±0.03,0.10±0.03,0.41 ±0.04,0.19±0.03,0.19±0.03,there were significantly higher than that in control group(0.05±0.00,P＜0.05),and which was more obvious at the concentration of 1 μmol/L estradiol.The expression level of VEGF,bFGF mRNA and protein in E2 group were higher than those in the control group (P＜O.05).VEGF mRNA and protein in Bibf1120+E2 group were higher than those in E2 group.The expression of MEK1/2,ERK1/2 mRNA protein in E2 group were higher than those in control group (P＜0.05).The expression of MEK1/2,ERK1/2 mRNA or p-MEK1/2,p-ERK1/2 protein in Bibf1120 + E2 group,Ponatinib+E2 group or U0126+E2 group were lower than those in E2 group(all P＜0.05).Percentage of G1 phase [(53.6±3.2)％] and S phase[(29.2±4.2)％] in E2 group was significantly different with those in control group respectively(P＜0.05).Percentage of G1 phase[(66.8±2.6)％,(63.1±2.6)％ and (63.3±0.4)％] and S phase [(25.4±1.9)％,(25.0±3.8)％ and(23.8±0.5)％] in U0126+E2 group,Bibf1120+E2 group or Ponatinib +E2 group was also significantly different with those in control group (all P＜0.05); percentage of G1 phase and S phase in U0126+E2 group was significant difference with those in Bibf1120+E2 group or ponatinib+E2 group (P＜0.05).The number of cell colony in E2 group (110± 17) was more than those in control group (65±8) ;the number of cell colony in U0126+E2 group(28±4),Bibf1120+E2 group(38±5) or Ponatinib+E2group(42±6) were significant different with those in E2 group (P＜0.05),the number of cell colony in U0126+E2 group was significant difference with those in Bibf1 120+E2 group or Ponatinib+E2 group (all P＜0.05).The results shown that the abilities of proliferation and cell migration were significantly increased in cells after estradiol stimulation.Conclusion Estradiol inducing the production of VEGF and bFGF could activate MAPK pathway through ER-independent manner,further promote development.

Teaching hospital plays a central role in training excellent doctor.Clinical teaching secretaries act as the advisor,coordinator,logistics people and supervisor in hospital clinical teaching management.Their duties include helping leader form and fulfill teaching plan,collect and arrange teaching records.To better accomplish the teaching secretarial job,a clinical teaching secretary should keep improving professional quality and personal comprehensive ability,ameliorating working methods and enhancing innovative thinking in a sound managing and evaluating system.