Taking chronic atrophic gastritis （CAG） as an example， the frontier technologies in data science have been introduced into the inheritance， innovation and development of traditional Chinese medicine （TCM）， providing reference for conducting real-world clinical research on specialized diseases of TCM. This paper put forward the construction of CAG data science system by elaborating the connotation of data science and its application value in TCM， and discussed the path to build CAG data science system， namely through "data acquisition-knowledge expression-knowledge reasoning" to establish CAG database， knowledge base and develop diagnosis platform differentiating diseases and syndromes. Besides， this paper analyzed the prospects of CAG data science in improving data governance ability and knowledge discovery efficiency， deepening the level of knowledge sharing， promoting interdisciplinary integration， and strengthening the integration process of industry， academia and research.

Objective To investigate the effects of different concentrations of morphine in combination with ropivacaine on proliferation,migration,invasion and cell cycle in MDA-MB-231 breast cancer cells.Methods MDA-MB-231 breast cancer cells were inoculated on the culture plate for 24h and randomly divided into 8 groups:Control group(C),ropivacaine 400μg/ml group(R),morphine 3μg/ml group(LM),morphine 30μg/ml group(MM),morphine 300μg/ml group(HM),ropivacaine 400μg/ml group+ morphine 3μg/ml group(R+LM),ropivacaine 400μg/ml+ morphine 30μg/ml group(R+MM),and ropivacaine 400μg/ml+ morphine 300μg/ml group(R+HM).After treaments of MDA-MB-231 breast cancer cells for 24h,these proliferation,migration,invasion and cell cycle were evaluated.Results When using morphine alone,the proliferation inhibitive effect was positively correlated with the concentration of morphine.The proliferation was significantly inhibited by morphine of LM,MM,HM group(P<0.05).When using ropivacaine alone,the proliferation was significantly inhibited(P<0.05).When using morphine combined with ropivacaine,the high concentration morphine group has a synergistic effect with ropivacaine group on proliferation inhibition(P<0.05).When using morphine alone,the migration rate decreases sequentially with the increase of morphine concentration.The migration rate was significantly inhibited by morphine of LM,MM,HM group(P<0.05).When using ropivacaine alone,the migration rate was inhibited(P<0.05).When using morphine combined with ropivacaine,the low and medium concentration morphine group have a synergistic effect with ropivacaine group on migration rate(P<0.05).When using morphine alone,the number of cell invasion was decreased with the concentration of morphine increasing(P<0.05).The MM and HM groups inhibited cell invasion ability.When using ropivacaine alone,the invasiveness of cells was also inhibited(P<0.05).When using morphine combined with ropivacaine,the medium and high concentration morphine groups have a synergistic effect with ropivacaine group on inhibiting cell invasion ability(P<0.05).When using morphine alone,the cell cycle progression was inhibited into G2/M Phase(P<0.05).When using ropivacaine alone,the cell cycle progression was inhibited into G2/M phase(P<0.05).The combination of low concentration morphine and ropivacaine has synergistic effect on arresting at G0/G1 and S phase(P<0.05).Conclusion Morphine combined with ropivacaine inhibits the Proliferation,migration and invasion of MDA-MB-231 breast cancer cells in a dose-dependent manner.

Objective Preliminary exploration of the effects of modified electroconvulsive therapy(MECT)on cognitive function and gender differences in middle-aged and young patients with depressive episodes.Methods A group of middle-aged and young patients with depressive episodes,who were admitted to Beijing Anding Hospital affiliated to Capital Medical University,completed 6 rounds of MECT.The 17-item Hamilton depression scale(HAMD-17),Hamilton anxiety scale(HAMA),and repetitive battery for the assessment of neuropsychological status(RBANS)were used to score depressive symptoms,anxiety symptoms,and cognitive function at baseline,after the 3rd MECT,and after the 6th MECT,respectively.Gender differences were compared between the young and middle-aged groups.Results A total of 122 patients with depressive episodes were included,with 83 cases in the youth group and 39 cases in the middle-aged group.There was no gender difference in baseline HAMD and HAMA scores,as well as the HAMD reduction rates after MECT between the two groups(P>0.05).Repeated measures ANOVA showed that in the youth group,the time effects of RBANS total score,visual breadth factor score,and attention factor score were significant(P<0.05),and increased after treatment compared to baseline.There was no significance in gender group effects or interaction effects(P>0.05).In the middle-aged group,the time and gender interaction effect of RBANS total score and visual breadth factor score was significant(P<0.05).Female patients showed an increase in RBANS total score,visual breadth factor score,and attention factor score after the 6th MECT compared to baseline(P<0.05),while there was no significance in time effect and gender group effect(P>0.05).Conclusion Middle-aged and young depressed patients showed overall improvement in cognitive function after MECT,while there were gender differences in cognitive function changes among middle-aged patients.It is necessary to optimize the MECT program based on the patient's gender and age characteristics to reduce cognitive impairment.

[摘 要] 目的：探讨甲状腺滤泡癌（FTC）组织中程序性死亡蛋白1（PD-1）和NOD样受体蛋白3（NLRP3）的表达及其与患者临床病理特征和预后的关系。方法：收集2015年1月至2020年6月福建医科大学附属第二医院手术切除的60例FTC患者的癌和配对癌旁组织标本，采用免疫组织化学染色法检测癌及癌旁组织中PD-1和NLRP3的阳性表达率，χ²检验或者Fisher精确检验法分析PD-1和NLRP3表达与FTC患者临床病理特征的关系，Pearson相关性分析PD-1与NLRP3表达的关系，Kaplan-Meier生存和Logistic回归分析PD-1和NLRP3表达与患者预后的关系。结果：在60例FTC组织中，PD-1和NLRP3均有较高的阳性表达率（46.67%与63.33%）。PD-1表达与FTC患者肿瘤分期、肿瘤大小、血管侵犯、复发与否具有显著相关性（均P<0.05），NLRP3表达与患者肿瘤大小、血管侵犯、甲状腺外浸润以及复发具有显著相关性（均P<0.05）。PD-1与NLRP3的表达成负相关，前者与患者更好的预后相关，后者是FTC复发的独立风险因素。结论：PD-1和NLRP3在FTC组织中有较高的阳性表达率，前者与患者更好的预后相关，后者是FTC复发的独立风险因素，且两者的表达呈负相关。

Objective:This study aimed to explore variables associated with remission rate and survival in patients with acute myeloid leukemia (AML) after induction failure and relapse.Methods:Data of 373 consecutive patients with AML were analyzed after induction failure and relapse. Binary logistics and the Cox model regression were used to identify variables associated with remission rate and outcomes.Results:In patients with AML after induction failure and relapse, the total CR+CRi rates were 50.6% and 40.3%, respectively; among those who achieved CR/CRi, the 3-year RFS rates were 34.4% and 30.4%, respectively, and the 3-year overall survival rates were 40.1% and 31.6%, respectively. In the multivariate analyses, using CLAG or FLAG regimen as a re-induction chemotherapy regimen, age <39 years and SWOG low-risk were significantly associated with higher remission rates in patients with induction failure. Male, secondary AML, SWOG high-risk, the interval from the first remission to relapse within 12 months, and bone marrow blasts ≥20% at the time of relapse were significantly associated with lower remission rates in relapsed patients. Transplantation was significantly associated with prolonged relapse-free survival and overall survival in patients achieving hematologic remission; the SWOG low-risk group was significantly associated with longer overall survival in those with induction failure; and achieving CR (not CRi) or having female gender was associated with longer RFS or overall survival in relapsed patients.Conclusion:Reinduction chemotherapy regimen, age, gender, SWOG risk, secondary AML, the interval from the first remission to relapse, and bone marrow blast percentage at the time of relapse were significantly associated with remission rates in the patients with AML after induction failure and relapse. Transplantation, SWOG low-risk, achieving CR, or female gender were associated with longer survivals in those achieving remission.

[摘 要] 目的： 探讨程序性死亡蛋白-配体1（programmed death ligand-1，PD-L1）和肿瘤浸润淋巴细胞（tumor-infiltrating lymphocyte, TIL）在三阴性乳腺癌（triple-negative breast cancer，TNBC）组织中的水平及其临床意义。方法：收集2015年1月至2019年1月福建医科大学附属第二医院手术切除的61例TNBC患者的癌及癌旁组织石蜡标本，用免疫组化法检测癌组织中PD-L1表达和CD8+ TIL的水平，用卡方检测方法分析TNBC组织中PD-L1和CD8+ TIL水平与患者临床病理特征及预后的关系。结果： PD-L1和CD8+ TIL在TNBC组织中的阳性率分别为63.9%（39/61）和32.8%（20/61）。PD-L1表达与TNBC患者的肿瘤大小、淋巴结转移、病理分期、复发与否有明显关联（均P<0.05），与患者的年龄、肿瘤分化程度、脉管侵犯以及Ki67表达水平无明显关联（均P>0.05）；CD8+ TIL水平与TNBC患者的肿瘤大小、肿瘤分化程度、淋巴结转移、病理分期、复发与否有明显关联（均P<0.05），与患者的年龄、脉管侵犯以及Ki67表达水平无明显关联（均P>0.05）。PD-L1和CD8+ TIL水平与患者的无进展生存期（PFS）及总生存期（OS）具有显著相关性（均P<0.05），PD-L1+或者缺乏CD8+ TIL与患者更差的PFS及OS相关（均P<0.05）。结论：TNBC组织中存在较高水平的PD-L1和CD8+ TIL，PD-L1阳性表达或缺乏CD8+ TIL与肿瘤侵袭性增加相关，也与患者更差的PFS及OS相关。

Objective:To explore the effect of different head elevation angle on intracranial pressure and cerebral blood flow of patients with hypertensive cerebral hemorrhage in a resting state, to provide scientific basis for nursing development.Methods:A total of 72 hypertensive cerebral hemorrhage patients were selected as research subject, at the resting state, head elevation was raised up with 0°, 5°, 10°, 15°, 20°, 25°, 30° in the supine position with 5 minutes interval between different positions. The levels of intracranial pressure, cerebral perfusion pressure, regional oxygen saturation, blood pressure, heart rate, pulse oxygen saturation were recorded.Results:With head elevation from 0° to 5°, 10°, 15°, 20°, 25°, 30°, the levels of intracranial pressure were (12.39±3.32), (10.64±3.19), (9.84±2.58), (9.09±1.76), (8.33±2.51), (7.13±1.81), (6.81±1.67) mmHg(1 mmHg=0.133 kPa); mean arterial pressure were (106.06±10.17), (104.45±10.77), (105.87±6.73), (106.82±10.36), (105.78±10.27), (106.77±6.15), (100.30±10.92) mmHg; cerebral perfusion pressure were (93.67±10.36), (93.82±10.81), (96.03±7.26), (97.73±10.63), (97.45±10.38), (99.65±6.62), (93.49±10.99) mmHg; regional oxygen saturation were (65.91±6.70)%, (66.89±6.52)%, (67.12±8.04)%, (69.33±13.26)%, (69.31±8.47)%, (68.94±9.82)%, (66.12±6.78)%. Intracranial pressure was increased gradually with head elevation from 0° to 5°, 10°, 15°, 20°, 25°, 30°, the difference was statistically significant ( F value was 45.380, P<0.01). Mean arterial pressure was significantly decreased at 30° head elevation compared to the 0°, 5°, 10°, 15°, 20°, 25° head elevation ( t values were 2.331-2.997, P<0.05). Cerebral perfusion pressure and regional oxygen saturation showed an increased trend, however, those index was decreased at 30° head elevation, the levels of cerebral perfusion pressure and regional oxygen saturation was significantly increased at 15°, 20°, 25° head elevation compared to the 0° and 30° head elevation ( t values were 2.554-3.331 and 2.378-3.091, P<0.05). However, there was no significant difference between 0°, 5°, 10°, 15°, 20°, 25°, 30° head elevation in systolic pressure, diastolic pressure, heart rate, pulse oxygen saturation ( P>0.05). Conclusions:15°-25° head elevation is a relatively appropriate position in patients with hypertensive cerebral hemorrhage.

Objective: To summarize the nursing experience of postoperative infection of hip joint replacement combined with gaucher′s disease. Methods: According to the characteristics of the disease, nursing intervention and symptomatic treatment were given, including infection control, nursing of complications, nursing of joint puncture, medical treatment and nursing, and strengthening psychological nursing and safety nursing. Results: Through targeted nursing, the patient′s infection was controlled, the condition was stable, the symptoms were relieved, and the patient was discharged. Conclusions In view of the patient′s condition, the development and implementation of comprehensive and integrated targeted nursing measures can effectively reduce the complications, alleviate the progress of the disease, improve the understanding of gaucher′s disease and the quality and effect of the disease nursing.

Objective To explore the correlation between depressive symptoms and frailty,in order to provide evidence for prevention and relief of depressive symptoms in elderly inpatients.Methods A cross-sectional survey and comprehensive geriatric assessment(CGA)were conducted with 248 eligible elderly inpatients from December 2015 to February 2017 in our hospital.Depressive symptoms were assessed by the 5-Item Geriatric Depression Scale(GDS-5),and frailty was identified by the frailty phenotype method.Results In all respondents,50 (20.2 ％)patients showed depressive symptoms,93(37.5 ％)patients had pre-frailty and 39 (15.7 ％)patients had frailty.Correlation analysis showed that frailty degree,low grip strength,slow gait speed,low physical activity,fatigue,and weakness were all positively correlated with depressive symptoms in elderly inpatients (r =0.441,0.315,0.426,0.316,0.395 and 0.151,respectively,P ＜ 0.05).Logistic regression analysis showed that patients who had more severe frailty faced a much higher risk of developing depressive symptoms (OR=2.608,P＜0.05).Of the 5 indicators of frailty,slow gait speed and frailty also increased the risk of having depressive symptoms (OR =2.801 and 3.484,P ＜ 0.05).Conclusions Frailty degree,gait speed and fatigue are associated with increased risk of depression in the elderly.Depressive symptoms can be reduced in elderly inpatients with prevention and intervention of pre-frailty and frailty.

Objective Observed the characteristics and influence factors of blood pressure circadian rhythm in continuous ambulatory peritoneal dialysis patients.To investigate the effect of residual renal function and cardiac function.Methods Prospectively collected 120 cases of continuous ambulatory peritoneal dialysis from June 2016 to March 2017 in Tangshan renal medicine dialysis centers,who combined with hypertension were treated with peritoneal dialysis for more than 3 months.According to the dynamic monitoring blood pressure circadian rhythm of blood pressure,120 cases were divided into the normal rhythm of blood pressure and the abnormal blood pressure rhythm group.Collected medical history;Tested related test index respectively;Cardiac ultrasound.According to the formula to calculate residual renal function,left ventricular mass index,Eingabe/Ausgabe,Ejection Fraction.Univariate and multivariate unconditional logistic regression analysis was used to analyze the risk factors of circadian rhythm of blood pressure.Stepwise multiple linear regression analysis was used to analyze the risk factors of residual renal function and cardiac function.Results CAPD patients with normal blood pressure rhythm in 14 cases(11.7％),abnormal blood pressure rhythm in 106 cases(88.3％),Among them,non dipper blood pressure accounted for 75 cases(62.5％).Single factor and multiple factors unconditioned logistic regression analysis revealed that after the comparison of gender and age,Risk factors for abnormal circadian rhythm of blood pressure were:UA(OR=1.197,95％CI:1.099-1.441),CRP(OR=1.170,95％CI:1.061-1.331),RRF(OR=1.389,95％CI:1.160-1.779).Using stepwise multiple linear regression analysis of dangerous factors affecting residual renal function and cardiac function,we found:Residual renal function negatively correlated with left ventricular myocardial mass index,systolic blood pressure drops at night rate,and ultrafiltration volume;LVMI (cardiac function) Positively correlated with 24 h average systolic blood pressure,and negatively correlated with systolic blood pressure drop ratio and residual renal function at night.Abnormal circadian rhythm of blood pressure may lead to the decline of residual renal function and cardiac function.Conclusions UA,CRP and RRF may affect the CAPD patients blood pressure circadian rhythm.At the same time,abnormal circadian rhythm of blood pressure may lead to the decline of residual renal function and cardiac function.Therefore,pay attention to the monitoring and control of ABPM,can better protect the residual renal function and improve cardiac function,so as to prolong and improve the survival time and quality of life of patients with CAPD.