OBJECTIVE To study the improvement effect and mechanism of Shengmai powder on heart failure （HF） mice with qi-yin deficiency. METHODS The mice were randomly divided into blank group （water）， model group （water）， Shengmai powder low-， medium-， and high-dose groups [2.61， 5.22 and 10.44 g/kg （based on crude drug dosage）] and positive control group （metoprolol， 30 mg/kg）， with 10 mice in each group. Except for the blank group， all other groups were subcutaneously injected with D-galactose， and a qi-yin deficiency HF mice model was established by continuous food restriction and weight-bearing swimming. At the same time of modeling， the corresponding medicine/water was gavaged once a day for five weeks. The general state of mice was recorded and the traditional Chinese medicine （TCM） syndrome score was evaluated. Behavioral experiments were conducted to investigate the total distance of open field action， the percentage of immobility time， and the swimming exhaustion time of mice. The contents of aspartate transaminase （AST）， creatine kinase （CK） and lactate dehydrogenase （LDH） in the serum of mice were detected； cardiac function indexes [heart rate， left ventricular ejection fraction （LVEF）， left ventricular end systolic diameter （LVESD）， left ventricular end diastolic diameter （LVEDD）， left ventricular mass index and whole heart mass index] were all detected； the histopathological morphology of mice myocardium was observed； the level of cardiomyocyte apoptosis in mice was detected； mRNA expression levels of B-cell lymphoma 2 （Bcl-2）， Bcl-2 associated X protein （Bax）， and Cleaved-caspase-3 in myocardial tissue of mice were detected； the phosphorylation levels of sarcoplasmic reticulum calcium regulatory related proteins [ryanodine receptor 2 （RyR2） and phospholamban （PLB）] in myocardial tissue of mice were detected. RESULTS Compared with the blank group， the body weight， total distance of open field action， swimming exhaustion time， LVEF， LVEDD， Bcl-2 mRNA expression level in myocardial tissue and PLB protein phosphorylation level in the model group were significantly reduced/shortened （P＜0.05）； TCM syndrome score， the percentage of immobility time， heart rate， LVESD， left ventricular mass index， whole heart mass index， cardiomyocyte apoptosis rate， the contents of CK， LDH and AST in serum， mRNA expression levels of Cleaved-caspase-3 and Bax and the phosphorylation level of RyR2 protein in myocardial tissue were significantly increased （P＜0.05）； there were inflammatory cell infiltration， disordered cell arrangement and obvious myocardial interstitial fibrosis in myocardial tissue. After the intervention of Shengmai powder， most of the above quantitative indexes in mice were significantly reversed （P＜0.05）， the inflammatory cell infiltration in myocardial tissue was reduced， and the degree of fibrosis was significantly reduced. CONCLUSIONS Shengmai powder can improve cardiac function， reduce the level of cardiomyocyte apoptosis and myocardial fibrosis in HF mice with qi-yin deficiency. Its mechanism may be related to the regulation of the expression of sarcoplasmic reticulum calcium regulation related proteins.

ObjectiveTo observe the clinical effectiveness and safety of Xuandi Ziyin Mixture （玄地滋阴合剂） for central precocious puberty （CPP） in girls with syndrome of yin deficiency and fire exuberance， and to analyse the effect of body mass index （BMI） on the effectiveness. MethodsA total of 236 girls with CPP of yin deficiency and fire exuberance syndrome were included， and all of them were given Xuandi Ziyin Mixture， 30 ml each time， twice a day， for a total treatment period of 6 months. Before and after treatment， children's weight， height and bone age were measured， BMI and BMI Z-score （BMI Z） and the difference between bone age and actual age were calculated； ultrasound was used to detect uterine and ovarian sizes， and to calculate uterine volume （V_uterus）， bilateral ovarian volume （V_{left ovary}， V_{right ovary}）， and bilateral maximal follicle diameters （r_{left follicle} and r_{right follicle}）； and serum sex hormones were measured， including follicle-stimulating hormone （FSH）， luteinising hormone （LH）， prolactin （PRL）， estradiol （E₂）， and testosterone （T）， and were scored for traditional Chinese medicine （TCM） syndrome. Multiple linear regression was used to analyse the influence factors of the difference between bone age and actual age， and changes in uterine volume. The children were divided into the normal weight group and the overweight/obesity group according to baseline BMI， and the bone age， the difference between bone age and actual age， V_uterus and BMI Z scores before and after treatment were compared between the two groups. ResultsFinally， 199 children entered the statistical analysis. Compared with pre-treatment， the bone age， BMI and BMI Z scores of the children increased after treatment， and the difference between bone age and actual age， TCM syndrome scores， V_uterus， V_{left ovary}， V_{right ovary}， r_{left follicle} and r_{right follicle} decreased； and the levels of serum FSH， LH， E₂， and T significantly decreased （P＜0.05 or P＜0.01）. The difference between bone age and actual age was negatively correlated with LH and V_uterus （P＜0.05）， and changes in uterine volume were positively correlated with LH （P＜0.01）. Comparing between the groups before and after treatment， the bone age， difference between bone age and actual age， and BMI Z scores of children in the normal weight group （100 cases） were significantly smaller than those in the overweight/obesity group （99 cases） （P＜0.01）. Compared with pre-treatment， the bone age of the children in both groups increased， but the difference between bone age and actual age and V_uterus were significantly smaller （P＜0.01）. Further comparison of Δ bone age and actual age difference and ΔV_uterus （Δ = post-treatment value - pre-treatment value） between the two groups showed no statistically significant difference （P＞0.05）. ConclusionsXuandi Ziyin Mixture can reduce bone age， sex hormone level， ovary and uterus size， and improve clinical symptoms in girls with yin deficiency and fire exuberance syndrome of CPP. It is also effective in overweight/obese children， and the inhibitory effect on bone age in girls with CPP is not affected by BMI， with good safety.

NK cells are important components of innate immune system and play a key role in immune responses.Activation of NK cells mainly depends on dynamic balance between activatory and inhibitory receptors expressed on surface.However,in many chronic diseases,balance between these receptors of NK cells is disorder,resulting in reduced cytolysis activity and cytokine produc-tion,which is in a state of immune inactivation.In recent years,many studies have shown that intracellular metabolism is crucial for immune cells such as NK cells,and changes of metabolism will regulate functions of immune cells by affecting cell development,pro-liferation and activity.In view of powerful anti-tumor and anti-viral effects of NK cells and their important clinical application value,it is important to study their metabolic characteristics and mechanisms.This review mainly introduces metabolic patterns of NK cell,related regulatory pathways,regulatory effects of metabolism on NK cell development,memory and functions,and metabolism-based NK cell therapy,also expounds important role of metabolism on NK cell biosynthesis,stability and effector function in vivo,as well as metabolism-related factors involved in NK cell inactivation in different chronic diseases,providing a solid research basis for clinical application of NK cell therapy.

Objective This study aims to analyze the application value of the Kirkpatrick Evaluation Model in the evalu-ation of hospital service training.Methods A total of 100 hospital front desk service personnel participating in service training from July 2021 to July 2023 at Qingyuan People's Hospital were selected as the research subjects.They were randomly divided into a study group and a control group,with 50 participants in each group.The study group implemented training based on the Kirkpatrick Evaluation Model,while the control group received conventional training.The learning level,behavior level,reaction level,and result level(including service satisfaction,complaint rate,and occurrence of service incidents)of the two groups were compared,as well as the evaluation effects.Results The study group showed significantly higher scores in theoretical knowl-edge,skill operations,thinking patterns,and humanistic care compared to the control group.The training satisfaction was signifi-cantly higher in the study group.The scores for interpersonal communication,question answering,and front desk material man-agement were significantly higher in the study group.The service satisfaction and training effectiveness were significantly higher,while the complaint rate and occurrence of service incidents were significantly lower in the study group compared to the control group(P<0.05).Conclusion Implementing training for hospital front desk service personnel based on the Kirkpatrick Evalua-tion Model can improve their theoretical knowledge and service level,enhance patient satisfaction,and reduce the complaint rate and occurrence of service incidents.

ObjectiveTo investigate the change in the activity of glucosylceramide synthase, the key enzyme in glycosphingolipid metabolism and synthesis, in Huh7 cells infected by hepatitis B virus (HBV) in vitro. MethodsBlood samples were collected from nine previously untreated patients with acute hepatitis B who attended Department of Infectious Diseases, The First Hospital of Lanzhou University, from June to August, 2019, and the blood samples collected from seven healthy individuals who underwent physical examination were established as control. Huh7 cells were inoculated with the high-copy HBV particles (＞9.9×107 IU/ml) in the serum of patients with HBV infection (infection group), and Huh7 cells co-cultured with the serum of healthy individuals were established as control group. The expression levels of HBsAg and HBV DNA in the cytoplasm of HBV-infected Huh7 cells were measured, and the correlation between GCS activity and virus was analyzed. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups, and a Pearson correlation analysis was performed. ResultsCompared with the control group, the infection group had a significant reduction in the number of cells, an increase in cell volume, and cell membrane fragmentation. The infection group had a significant increase in the expression of HBsAg in cytoplasm at 4 hours, 8 hours, 2 days, and 5 days after infection (P＜0.05); the expression level of HBV DNA tended to increase significantly from 4 hours after infection to 8 hours, 2 days, and 5 days after infection (16.67±11.55 IU/ml vs 112.01±25.94 IU/ml/328.01±10350 IU/ml/101.60±49.84 IU/ml, P＜0.001), with the highest level at 2 days after infection. During HBV infection, the activity of GCS gradually increased with the increase in viral replication from 4 hours after infection (126.21±9.59 IU/ml) and reached a peak at 2 days after infection (226.53±36.27 IU/ml), with a significant difference between the infection group and the control group at 2 days after infection (226.53±36.27 IU/ml vs 136.50±1544 IU/ml, t=3.956, P=0.016 7). The activity of GCS was positively correlated with HBV DNA level (r=0.576 8, P=0047 1). ConclusionHuh7 cells are successfully infected with the high-copy HBV particles in the serum of patients with HBV infection, which mimics the characteristics of HBV infection in vitro to a certain degree. The activity of GCS may be associated with HBV infection, suggesting that glycosphingolipid synthesis and metabolism may be closely associated with HBV.

Objective To explore the morphological mechanism of contrast-induced encephalopathy（CIE）by observing the effect of ioversol on blood-brain barrier（BBB）in rats. MethodsA total of 42 Sprague-Dawley rats were randomly divided into normal control group（n=6），ioversol group（n=24）and normal saline group（n=12）. The latter two groups were divided into four subgroups based on time points after treatment（0.5 h，3 h，6 h，and 24 h）. Carotid injection of ioversol was to prepare a rat model of brain damage. BBB permeability was examined by an Evans Blue（EB）assay. BBB ultrastructural changes were observed via transmission electron microscopy（TEM）. ResultsCompared with the normal group，there was no significant change in EB content in brain at 0.5 h after the administration of ioversol，while other groups were significantly higher（both P<0.05）. EB content increased at first and then decreased with time，and the highest level was found in 6 h group. The morphology of vascular endothelial cells changed and the structure of tight junctions（TJs）was incomplete in 3 h and 6 h groups，but the ultrastructure of BBB in 0.5 h and 24 h groups had no obvious change compared with the normal group. ConclusionBBB permeability and ultrastructure of rats at different time points after carotid injection of ioversol showed consistent reversible changes，and this dynamic change of BBB was related to the structural changes of TJs.

Objective To observe the clinical effect of traditional Chinese medicine (TCM) characteristic lung rehabilitation in treatment of patients with chronic obstructive pulmonary disease (COPD) and TCM syndrome of lung and kidney qi deficiency at stable period. Methods Sixty patients with stable COPD and lung and kidney qi deficiency syndrome admitted to the First Affiliated Hospital of Anhui University of Chinese Medicine from June to August 2017 were enrolled, and they were divided into routine treatment group and lung rehabilitation treatment group according to the random number table method, each group 30 cases. The routine treatment group was given Seretide (serevent/futicasone) dry powderi nhalation therapy; on the basis of therapy in the routine treatment group, the lung rehabilitation treatment group was treated with TCM characteristic lung rehabilitation technology (acupoint application + Chinese medicine ionic induction + oral administration of Chinese medicine Liuweibuqi granules, delivery at appropriate intervals); both groups were treated for 2 months. The changes of TCM syndrome score, western medicine symptom score, the times of acute exacerbation of COPD, COPD assessment test (CAT) score, lung function indexes: forced expiratory volume in one second (FEV1), FEV1/forced vital capacity (FVC) were observed before and after treatment in two groups. Results After treatment, TCM syndrome score, western medicine symptom score, CAT score, and after treatment the times of acute exacerbation of COPD in both groups were significantly lower than those before treatment, and the above indexes in the lung rehabilitation treatment group were markedly lower than those in routine treatment group [TCM syndrome score:11.93±1.80 vs. 14.27±2.88, western medicine symptom score: 14.20±2.75 vs. 11.93±4.23, CAT score: 14.87±2.60 vs. 16.23±4.39, the times of acute exacerbation of COPD (times): 0.63±0.49 vs. 0.95±0.83, all P < 0.05]. The improvement of FEV1 in the two groups was not significant; but FEV1/FVC in lung rehabilitation treatment group was obviously higher than that before treatment, FEV1/FVC in lung rehabilitation treatment group was significantly higher than that in the routine treatment group [(57.93±7.27)% vs. (52.49±6.61)%, P < 0.05]. Conclusion The application of TCM characteristic lung rehabilitation in the treatment of COPD patients with stable lung and kidney qi deficiency syndrome based on bronchodilators and glucocorticoids can reduce the number of acute exacerbation, improve the patients' clinical symptoms and living quality, but the improvement of lung function is not significant.

Objective: To analyze the processing situation of 124 batches of scorpions and optimize the salt-water processing.Methods: The character, extract, moisture, total ash, acid insoluble ash, amino acids content and heavy metals in the marketed scorpions were determined.Using extract and amino acids contents as the indices, the salt-water processing was optimized.Results: The results of the above determinations showed that the quality difference was very obvious for the marketed scorpion, and the extract and amino acids contents were the highest in scorpion boiled in 2% sodium chloride aqueous solution for 5 min.Conclusion: The item of extract test should be revised in the current standard, and the items such as moisture, total ash, acid insoluble ash, amino acids content and heavy metals should be taken into consideration in order to control the quality of scorpion more comprehensively.The best salt-water processing of scorpion is boiled in 2% sodium chloride aqueous solution for 5 min.

Objective To compare imaging quality and radiation dose of different anode filter combination for full-field digital mammography.MethodsThe image of FLUKE NA 18-220 phantom were taken at full-field digital mammography (FFDM),system with Mo/Mo,Mo/Rh,Rh/Rh anode/filter combination by automatic exposure control,record the exposure factors and doses.The images on monitor with the best window width and window level were read by 4 independent radiologists,the images of specks groups,nylon fibers and masses was assessed by the 4 experienced readers at the criterion of American College of Radiology 1999 mammography quality control manual.Statistical analysis was performed using analysis of variance.ResultsThe nylon fibers scores of Mo/Mo,Mo/Rh and Rh/Rh were 5.50 ± 2.12,4.50 ± 1.85 and 4.38 ± 1.38 ; the specks groups scores of Mo/Mo,Mo/Rh and Rh/Rh were 5.38 ± 1.98,4.25 ± 1.56 and 4.38 ± 1.38;the masses scores of Mo/Mo,Mo/Rh and Rh/Rh were 5.38 ± 1.98,4.38 ±1.68 and 4.25 ± 1.56,the detection of specks groups,nylon fibers was not statistically significant ( F =4.56 and 4.32,P ＞ 0.05 ),but the detection of masses was statistically significant ( F =36.65,P ＜ 0.05).The radiation doses were different,the entrance surface dose (ESD) and average glandular dose (AGD) of Rh/Rh were (5.11 ± 1.89) and ( 1.08 ± 0.13 ) mGy,the ESD and AGD of Mo/Mo were (6.66 ± 2.33 )and ( 1.29 ± 0.38 ) mGy,the ESD and AGD of Mo/Rh anode/filter combination were (5.67 ± 2.02) and ( 1.29 ± 0.38) mGy.ConclusionsThe radiation dose of Rh/Rh and Mo/Rh anode/filter combination of FFDM were lower,and the imaging was clear,so Rh/Rh and Mo/Rh anode/filter combination of FFDM prefer to mostly patients,especially when the thinkness is large,Rh/Rh anode/filter combination is preferred,because the kV values was higher,the penetration of X-ray was stronger.The Mo/Mo anode/filter combination was used when the needs of high-resolution,because the detection of masses of it was better.

Objective To compare imaging quality and radiation dose on full-field digital mammography (FFDM) system and dual-sided reading CR mammography (DSCRM) system.Methods The TRM of ALVIM statistics phantom was exposed by FFDM system and (DSCRM) with the same radiation dose.The exposure parameters and the entrance surface dose (ESD) were recorded.Then,the phantom was exposed by DSCRM system with different mAs and same kV,and the ESD was recorded.The images obtained above were read by three radiologists on the monitor of diagnosis work station with the same window width and window level.The evaluation of the images were given using a five-level confidence scale.ROC curves were drawn and probability Pdet were calculated.Results The ROC analysis of microcalcifications and masses showed A(z) values of 0.730-0.925 and 0.670-0.945 for FFDM,and 0.632-0.815 and 0.575-0.785 for DSCRM when the radiation dose is 1.36 mGy.The radiation dose with DR system could be reduced compared with dual-sided reading CR system at the same probabilities Pdet,the ESD reduced from 1.63 mGy to 1.36 mGy by 19.8％,the AGD reduced from 0.65 mGy to 0.56 mGy by 16.0％.Conclusions The observable details with FFDM system were proved to be superior to DSCRM system at the same radiation dose.With the similar image quality,the radiation dose of FFDM system was less than the DSCRM system.