Objective To explore the clinical effect of balanced cupping intervention in treatment of patients with primary dysmenorrhea differentiated as type of qi stagnation and blood stasis Methods A total of 64 patients with primary dysmenorrhea differentiated as type of qi stagnation and blood stasis in the First Affiliated Hospital of Henan University of Chinese Medicine from January 2020 to December 2021 were selected as the research objects, and they were divided into observation group and control group according to the order of consultation and patients' wishes, with 32 cases in each group. The control group received routine health guidance for dysmenorrhea, while the observation group received balanced cupping intervention on the basis of the control group. The Visual Analogue Scale (VAS) score, dysmenorrhea symptom score, serum prostaglandin E₂ (PGE₂), estradiol (E₂), menstrual onset time, menstrual cycle, menstrual volume, and efficacy were compared between the two groups before and after treatment. Results There were significant differences in VAS scores during the 1st, 2nd and 3rd menstruation compared with those before intervention between the two groups (P<0.05); the VAS scores of the observation group during the 1st, 2nd and 3rd menstruation were significantly lower than those of the control group (P<0.05). There were significant differences in dysmenorrhea symptom scores during the 1st, 2nd and 3rd menstruation with those before intervention between the two groups (P<0.05); the dysmenorrhea symptom score of the observation group during the 1st, 2nd and 3rd menstruation was significantly lower than those of the control group (P<0.05). The total effective rate of the observation group was significantly higher than that of the control group (P<0.05). There were significant differences in PGE₂ and E₂ levels during the 1st, 2nd and 3rd menstruation with those before intervention between the two groups (P<0.05). There were significant differences in PGE₂ and E₂ levels between the two groups during the 1st, 2nd and 3rd menstruation (P<0.05). There were no significant differences in menstrual cycle, menstrual duration and menstrual volume between the two groups (P>0.05). Conclusion Balanced cupping intervention has a good effect and high safety in the treatment of patients with primary dysmenorrhea differentiated as type of qi stagnation and blood stasis.

Objectives:To explore the early clinical efficacies of unilateral decompression and bilateral decompression by one-hole split endoscope(OSE)technique for moderate-severe lumbar spinal stenosis(LSS)with unilateral symptoms amongst middle aged and elderly people.Methods:A retrospective analysis was performed on the patients with moderate-severe LSS who underwent unilateral decompression and bilateral decompression using OSE technique between January 2021 and December 2021.According to the inclusion and exclusion criteria,a total of 120 patients were enrolled in this study,with 60 patients in the unilateral decompression group(group A)and 60 patients in the bilateral decompression group(group B).The length of hospitalization,operative time,incision length and intraoperative blood loss were counted and compared between group A and group B.Moreover,range of motion(ROM)and sagittal translation(ST)on lumbar dynamic X-ray,facet preservation rate on the approach side,and cross-sectional area of the canal(CAC)of the surgical segment before and after operation were recorded and compared.The visual analogue scale(VAS)of back and leg pain was used before surgery,and at 7 days,3 months and 18 months after surgery,the Oswestry disability index(ODI)was used to evaluate the functional improvement,and the clinical efficacy was evaluated by modified Macnab criteria at the last follow-up.All the clinical scores of both groups were analyzed and compared between before and after surgery.Results:All the patients underwent surgical inter-vention successfully.There was no statistical significance in the length of hospitalization between groups A and B(P＞0.05),but group B was longer in operative time,bigger in incision,and more in blood loss than group A,with statistical significance(P＜0.05).The VAS for back and leg pain and the ODI after operation in both groups were all significantly lower than those before surgery,respectively(P＜0.05),and the values at each postoperative time point within group were significantly different when compared pairwise(P＜0.05);There was no significant difference between the two groups before surgery(P＞0.05),but group B had more significant improvement than group A at 7 days,3 months and 18 months after surgery(P＜0.05).There was no statistical significance in ST and ROM of surgical segment before and after surgery between the two groups(P＞0.05).The postoperative facet preservation rate was higher in group B than in group A(P＜0.05).There was no sig-nificant difference in the CAC of the surgery segment before operation between the two groups(P＞0.05),how-ever,the CAC of the surgical segment in group B was larger than that in group A(P＜0.05).The rate of im-provement in CAC was higher in group B than in group A(P＜0.05).The CAC of the surgical segment postop-eratively in both groups were significantly larger than before surgery,with statistical significance(P＜0.05).Ex-cellent-good rate at 18 months after surgery was 86.7％in group A and 91.7％in group B.There was no significant difference in the number of excellent and good cases between the two groups at 18 months after operation(P＞0.05).One patient in group A had numbness and discomfort in the lower limb on the healthy side after surgery,and one case with mild dural tear in group B.Conclusions:Both unilateral decompression and bilateral decompression under OSE are safe and effective in the treatment of moderate and severe central canal and bilateral lateral recess stenosis with unilateral symptoms in the middle-aged and elderly people,with definite early clinical efficacy.Bilateral decompression is more complete and better in clinical efficacy than unilateral decompression,but further follow-up is required in the long term.

The prevention and control of chronic and non-communicable diseases is an important public health problem in China. The general environment in the northwestern China is unique, and the health and disease status of local population is distinctive. In order to meet the urgent need for in-depth research of the causes, mechanisms and prognosis of chronic and non-communicable diseases in this area, a general population cohort in Shaanxi Province, Gansu Province and Qinghai Province, Ningxia Hui Autonomous Region and Xinjiang Uygur Autonomous Region was established during 2017-2019. A total of 117 644 general individuals aged 35-74 years in the multi-ethnic groups (Han, Hui, Uygur, Kazak and Tibetan) were recruited according to the special ecological environment, population size and ethnic distribution. The baseline information about individual exposure, environment and society were collected. More than 900 000 biological samples, including whole blood, plasma, serum and buffy coat, were collected and stored at -80 ℃ in standardized biobank. The long-term observation has started in forms of routine monitoring and active follow-up. The average age of the cohort members was 52.43 years, and 70 391 cohort members were women (59.8%). There were some differences in socio-economic status and lifestyle among different ethnic groups. Although the cohort members in different ethnic groups had similar health status, different characteristics still existed. The cohort can serve as a platform for in-depth research of the relationship between major chronic and non-communicable diseases and environment, people's lifestyle and genetic factors, and the research results can be used as important epidemiological evidence for clarifying the causes of chronic and non-communicable diseases and long-term health hazards in different ethnic groups in this area and reference for the national chronic and non-communicable disease prevention and control. This paper briefly introduces the design and practice of general population cohort in northwestern China.

In 2016, a national one million general population cohort project was set up in China for the first time in "Precision Medicine Research" Key Project, National Key Research and Development Program of China, which consists of general population cohorts in seven areas in China. As one of the seven major areas in China, northeastern China has unique climate and specific dietary patterns, and population aging is serious in this area. And the burden of chronic and non-communicable diseases ranks tops in China. Therefore, it is of great significance to establish a large general population cohort in northeastern China to explore the area specific exposure factors related to pathogenesis and prognosis of chronic and non-communicable diseases, develop new prevention strategies to reduce the burden of the diseases and improve the population health in northeastern China. In July 2018, the general population cohort study in northeastern China was launched, the study includes questionnaire survey, health examination and blood, urine and stool sample collection and detection in recruited participants. By now, the cohort has covered all age groups, and the baseline data of 115 414 persons have been collected. This paper summarizes the design and practice of the general population cohort study in northeastern China to provide reference for related research in China.

Objective To investigate the changing trend and correlation of platelet count and spleen diameter in patients with digestive system malignancy receiving oxaliplatin-based chemotherapy. Methods We retrospectively analyzed clinical data of 72 patients with digestive system cancer, recorded and analyzed platelet count and spleen diameter during and after oxaliplatin-based chemotherapy. Results The incidence of thrombocytopenia in all patients was 65.3%. The median time of thrombocytopenia after the beginning of chemotherapy was 2.53±0.49 months, and the median cumulative dose of oxaliplatin was 520±35.81 mg/m²; the median time of lowest platelet count after the beginning of chemotherapy was 4.03±0.49 months, and the median cumulative dose of oxaliplatin was 780±36.32 mg/m². Splenomegaly occurred in 52(72.2%) patients during the follow-up. The median increase rate was (18.82±0.01)%. The median time of splenomegaly after the beginning of chemotherapy was 2.15±0.19 months, the median time for the largest spleen diameter was 4.68±2.89 months; after the end of chemotherapy, the median time for spleen contraction was 3.28±0.44 months, and the median time for spleen recovery was 8.80±1.05 months. Conclusion Oxaliplatin-based chemotherapy can cause thrombocytopenia and splenomegaly, and it is difficult to recover to baseline for a long time after the end of chemotherapy. The increase of spleen diameter was positively correlated with splenomegaly and thrombocytosis.

Objective:To explore the profile and gene functional changes of gut microbiota (GM) in women with postmenopausal osteoporosis (PMOP) in Northwest China, and the correlations between GM and bone mineral density (BMD).Methods:From November 2018 to October 2019, postmenopausal women were screened on their initial visits to our hospital, and 24 new osteoporosis (OP) patients, 30 new osteopenia patients and nine negative controls were recruited. Fecal samples were collected for GM DNA extraction, and Illumina platforms were used for high-throughput sequencing of 16S rRNA and metagenome. Species annotation, GM profile and gene functions were viewed and analyzed.Results:GM profiles were significatly different in different groups, and the LDA scores of Peptostreptococcaceae, Romboutsia, unidentified Clostridiales, Megamonas, Erysipelatoclostridium, Klebsiella and Erysipelatoclostridium ramosum were more than 3 in OP group. Metagenomic sequencing analysis indicated that gene numbers were positively correlated with BMD, and metabolism, carbohydrate metabolism, starch and sucrose metabolism and oxidative phosphorylation were negatively correlated with BMD. Receiver operating characteristic curve(ROC) showed that carbohydrate metabolism, starch and sucrose metabolism, amino sugar and nucleotide sugar metabolism, oxidative phosphorylation, respectively, could identify OP with preferable sensitivity and specificity (areas under curve were 0.70, 0.72, 0.73 and 0.75, respectively). Conclusions:High-throughput sequencing had great potential for GM analysis of postmenopausal women with OP, providing evidence of the correlations between GM and BMD.

OBJECTIVE：To establish a method for the content determination of to tal flavonoids from Amomum tsao-ko ，and to optimize the purification technology by macroporous resin. METHODS ：The content of total flavonoids was measured by HPLC. The determination was performed on Eclipse Plus C 18 column with mobile phase consisted of acetonitrile- 1％ acetic acid solution （15∶85，V/V）at the flow rate of 0.8 mL/min. The column temperature was 40 ℃，and the detection wavelength was set at 256 nm. The sample size was 10 μL. Taking the adsorption and desorption performance as indexes，6 kinds of macroporous resins were screened out by static adsorption and desorption tests ；adsorption and desorption time were investigated by static adsorption and desorption kinetics tests. Using the content of total flavonoids （calculated by rutin ）as index ，with sample concentration ，sample pH，ethanol volume fraction and elution amount as factors ，based on single factor test ，orthogonal design was used to optimize the purification technology of total flavonoids from A. tsao-ko ，and validation test was performed. RESULTS ：The linear range of rutin were 0.028-0.281 mg/mL（r＝0.999 9）. The limit of quantification was 437.5 ng/mL and the limit of detection was 109.4 ng/mL. RSDs of precision ，stability and reproducibility tests were all lower than 2％；the recoveries were 96.24％-99.75％（RSD＜2％，n＝ 6）. The comprehensive capacity of adsorption and desorption of HPD 450 macroporous resin was the most suitable ，and the best static adsorption and desorption time both were 12 h. The optimal purification technology was 1.854 4 mg/mL ； ethanol elution was 8 times of the column volume. Vertificationtests show that after optimized ，the content of total flavonoids from A. tsao-ko increased from 22.556 7 mg/g to 57.728 2 mg/g. The purity of was 2.56 and stable for the content determination. Optimal purification technology is stable and feasible ，which is suitable for purifieation of total flavonoids from A. tsao-ko .

Objective: To investigate the efficacy and toxicity of apatinib combined with S1 as a third-line therapy for advanced colorectal cancer. Methods: Forty-four patients with adavanced colorectal cancer from Tongji Hospital Cancer Center were enrolled from April 2016 to August 2018. The median follow-up period was 8 months. Data related to efficacy and adverse effects were recorded. Results: The median progression-free survival (PFS) time was 3.93 months (95%CI: 2.72-5.15 months), and the median overall survival (OS) time was 7.77 months (95%CI: 5.36-10.18 months). Patients with left hemicolon cancer and rectal cancer group had a longer PFS than patients with right hemicolon cancer group (4.94 months vs . 3.89 months, P=0.024); the OS for left hemicolon cancer and rectal cancer was 12.5 months, the OS for right hemicolon cancer was 7.4 months, P=0.080; gender, previous bevacizumab use and liver metastasis had no statistically significant effect on PFS and OS; the PFS was 4.48 months and 1.10 month, in the patients with ECOG 0-1 and ECOG 2; the OS was 9.67 months and 2.90 month, in these two groups respectively. The major adverse effects of the combination therapy were fatigue (52.3%), hypertension (45%), hand-foot syndrome (22.7%), leukopenia (15.9%), and neutropenia (15.9%), thrombocytopenia (22.7%), elevated transaminase levels (13.6%), diarrhea (15.9%). Conclusions: The results suggest that the combination of apatinib and S-1 is safe and effective as a third-line treatment for advanced colorectal cancer.

The role of malate dehydrogenase 2 (MDH2) in tumors is double-sided,it has a cancerpromoting effect in some tumors and an inhibitory effect in other tumors.The function of MDH2 is related to energy metabolism,tumor resistance and its pseudo hypoxia.MDH2 plays an important role in the occurrence,development,invasion and metastasis of tumors.An in-depth understanding of the functional mechanism of MDH2 in tumors can provide new molecular targets for tumor intervention in the clinic.

Malignant acute abdomen is a emergency with abrupt onset, rapid progress and often a complex etiology, presenting difficulties for treatment and high mortality. Therefore, multidisciplinary team (MDT) treatment modality is required. Compared with single-discipline diagnosis and treatment modality, diagnosis made from MDT discussion is more accurate, where specialists can improve efficiency and quality of the treatment through better communication. A good MDT can cover all stages from the diagnosis to the assessment and treatment of the disease, and combine them into a more coherent process. This article discusses the development of radiotherapy-related malignant acute abdomen and the role of radiotherapy in the treatment of malignant acute abdomen from the perspective of oncologic radiotherapy. Common causes of radiotherapy-related acute abdomen from gastric cancer include gastric hemorrhage, upper gastrointestinal obstruction and gastric perforation, while those of radiotherapy-related acute abdomen from colorectal cancer include lower gastrointestinal hemorrhage, intestinal obstruction, intestinal perforation and intestinal fistula. For patients with acute bleeding from gastric cancer that can not be treated by surgery, endoscopic hemostasis or embolization, palliative radiotherapy should be considered. Palliative hypofractionated radiotherapy has the advantage of reducing tumor burden in addition to relieving symptoms of gastric cancer. In patients with acute lower gastrointestinal hemorrhage, as relatively few studies have been established, short course of hypofractionated radiotherapy can be selectively applied. For patients with obstruction, palliative radiotherapy may be considered when surgical assessment is not feasible or tolerable. As malignant acute abdomen has rapid onset and progress, complex etiology and high rate of comorbidity MDT should be fully carried out. For patients with mild symptoms and slow development, radiotherapy can be applied with caution. Emergency treatment such as surgery and intervention should be given when necessary. Passive observation can result in missing the treatment opportunity and should be avoided.
Abdomen, Acute ; radiotherapy ; Abdominal Neoplasms ; radiotherapy ; Humans ; Patient Care Team