Objective To analyze risk factors of acute respiratory failure(ARF)in patients with hypertriglyceridemia acute pancreatitis(HTG-AP)and construct a risk prediction model.Methods A total of 222 HTG-AP patients were included in this study and divided into the non-ARF group(176 cases)and the ARF group(46 cases)according to diagnostic guidelines for ARF.Clinical data of the two groups were compared and the predictive factors were screened.These selected factors were then utilized in a multivariate Logistic regression analysis to construct a Logistic regression model.Subsequent evaluation of the model′s predictive ability,accuracy and clinical utility was conducted through ROC,curve analysis,calibration plot examination and decision curve analysis(DCA),respectively.Results Compared with the non-ARF group,the levels of high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL)-C and albumin(ALB)were decreased in the ARF group(P＜0.05),while the levels of creatinine(Cr),urea nitrogen(BUN),aspartate aminotransferase(AST)and C-reactive protein(CRP)were increased,and the incidence of pleural fluid and ascites was also increased(P＜0.05).Multivariate Logistic regression analysis showed that higher levels of Cr and AST,lower levels of ALB,HDL-C and ascites were independent risk factors for HTG-AP complicated ARF(P＜0.05).Based on these results,a column-line prediction model for HTG-AP complicated ARF was established.After internal verification,the area under curve(AUC)of receiver operating characteristic(ROC)curve of the nomogram model was 0.952(95%CI:0.923-0.981),the Youden index was 0.808 and the sensitivity and specificity were 93.33%and 87.43%,respectively.The calibration curve showed that the probability of HTG-AP concurrent ARF predicted by the model was in good agreement with the actual probability.The DCA curve showed that the model had certain clinical value.Conclusion The nomogram prediction model combined could provide a scheme for the clinical prevention of HTG-AP complicated with ARF.

Objective:To observe the effect of pecking moxibustion on the pattern characteristics of redness,swelling,heat,and pain in the affected joints,also the synovial cell ultrastructure in rats with rheumatoid arthritis(RA)due to damp heat affecting bones/joints,and to explore the anti-inflammatory mechanism of pecking moxibustion in treating the early stage of RA. Methods:Eighteen rats were randomly selected from 78 female ones as the blank group,and all the other rats were subjected to preparing the"differentiation of disease and pattern"RA model due to damp heat affecting bones/joints by using the method of"collagen-induced arthritis plus windy,damp,and hot environment stimulation".Fifty-four rats with successful modeling were randomly divided into a model group,a drug group,and a pecking moxibustion group,with 18 rats in each group.Rats in the drug group were given methotrexate at a dose of 1 mg/(kg·bw)on the 1st,8th,and 15th days.Rats in the pecking moxibustion group were treated with pecking moxibustion at Quchi(LI11),Dazhui(GV14),and Ashi points,and each point was treated with moxibustion for 15 min every day and a total of 3 courses of treatment,with 6 d as a course of treatment.After treatment,the capillary permeability,joint swelling,joint surface temperature,and plantar thermal pain threshold of the diseased joints in rats were observed,and the ultrastructural changes of synovial cells were observed by transmission electron microscopy. Results:The local swelling,surface temperature,and Evans blue(EB)leakage volume were significantly higher(P<0.05),the thermal pain threshold was significantly lower(P<0.05),and the synovial cell ultrastructure was obviously damaged in the affected joints in the model group compared with the blank group.The swelling degree,surface temperature,and EB leakage volume were significantly reduced(P<0.05),the thermal pain threshold was significantly increased(P<0.05),and the ultrastructural abnormalities of synovial cells were significantly improved in the diseased joints in the drug group and the pecking moxibustion group compared with the model group.The thermal pain threshold of rats in the pecking moxibustion group was significantly improved compared with the drug group(P<0.05). Conclusion:Pecking moxibustion obviously improves the pattern characteristics of local redness,swelling,heat,and pain in the diseased joints of rats with RA due to damp heat affecting bones/joints and effectively repairs the ultrastructure of the damaged synovium.It suggests that the pecking moxibustion intervention has a significant anti-inflammatory effect on early RA.

ObjectiveTo investigate the efficacy and safety of Shengxiantang in the treatment of early Parkinson's disease with autonomic dysfunction of Qi deficiency pattern. MethodA total of 82 eligible patients were randomized into control group （41 cases） and traditional Chinese medicine （TCM） group （41 cases）. On the basis of standardized treatment of western medicine， TCM group was prescribed Shengxiantang while control group were treated with placebo for 12 consecutive weeks additionally. Scale for Outcomes in Parkinson's Disease-Autonomic （SCOPA-AUT） questionnaire， Unified Parkinson's Disease Rating Scale （UPDRS）， Traditional Chinese Medicine Qi Deficiency Symptom Score of Parkinson's Disease （TCMQDSSPD）， serum levels of glutathione peroxidase （GPx） and superoxide dismutase （SOD）， daily dosage of pramipexole and levodopa and benserazide hydrochloride， and safety index were evaluated both before and after treatment. ResultAfter treatment， the total score of SCOPA-AUT， gastrointestinal score， urinary score， and thermoregulatory score in the control group were higher than those before treatment （P<0.01）， while the above sores in the TCM group were lower than those before treatment （P<0.05， P<0.01）. In addition， the cardiovascular score， pupillomotor score， and sexual score in two groups showed no significant difference from those before treatment. After treatment， the total score of SCOPA-AUT， gastrointestinal score， urinary score， and thermoregulatory score in the TCM group were lower than those in the control group （P<0.05， P<0.01）， and cardiovascular score， pupillomotor score， and sexual score showed no significant difference between two groups. After treatment， the total score of TCMQDSSPD， main symptom scores， and minor symptom scores in the control group had no significant difference from those before treatment. The total score of TCMQDSSPD and minor symptom scores of TCM group were lower than those before treatment （P<0.01）， while the main symptom scores of the TCM group showed no significant difference from those before treatment. After treatment， the UPDRS score， serum GPx and SOD levels， and daily dosage of pramipexole and levodopa and benserazide hydrochloride demonstrated no significant difference from those before treatment in the two groups and between the two groups. No abnormality was found in the safety indexes. ConclusionBased on the standardized treatment of western medicine， Shengxiantang can effectively and safely improve the autonomic symptoms of gastrointestinal system， urinary system， and thermoregulation， as well as the symptoms of Qi deficiency syndrome in early Parkinson's disease with autonomic dysfunction.

Objective:To analyze the supervision mode and problems of intensive countywide medical communities and explore the methods and strategies to improve their supervision system.Methods:From March 2022 to May 2022, a stratified random sampling method was used and the intensive countywide medical communities in the province were selected for field study. In-depth interviews were made with the staff of the healthcare administration departments and health insurance agencies affiliated with intensive countywide medical communities, directors of general hospitals, directors of township hospitals, and heads of functional departments. These interviews mainly covered the principal entities of countywide medical community supervision, supervision measures and contents, supervision effects, supervision weaknesses, and how to improve internal and external supervision mechanisms. The interviews results were analyzed using thematic framework analysis and the data were subject to a descriptive analysis.Results:23 persons of five intensive countywide medical communities were selected for key person interview. The finalized framework of regulatory elements of intensive countywide medical communities consists of such five general themes as regulatory subjects, regulatory content, regulatory measures, regulatory effectiveness and existing problems, comprising 14 level-1 indicators and 52 level-2 indicators. The main regulatory bodies were mainly government departments (15 times), the regulatory content was focused on medical resources (10 times), the regulatory measures cover specific regulations (4 times), specific activities (4 times) and assessment and evaluation (4 times). And the regulatory effectiveness demonstrated a currently strong regulation strength of medical communities (5 times), and the existing problems were insufficient government supervision (12 times), difficulties encountered by social forces in their supervision (11 times) and internal governance (5 times).Conclusions:The supervision system of intensive countywide medical communities should be optimized by improving the governmental supervision mechanism, inviting supervision of social forces and building an effective internal governance.

Objective:To observe the efficacy of gentle moxibustion combined with Western medicine in treating rheumatoid arthritis(RA)due to damp heat affecting bones/joints to further certificate the scientific nature of the theory that"heat pattern can be treated by moxibustion therapy". Methods:A total of 78 patients with RA due to damp heat affecting bones/joints were divided into an observation group and a control group using the random number table method,with 39 cases in each group.The control group was treated with regular Western medicine,on the basic of which the observation group was treated with additional gentle moxibustion.Patients in the observation group received gentle moxibustion therapy once a day for 8 weeks with a one-day rest every 2 weeks.The wrist circumference,wrist pain degree,skin color and temperature of the wrist,and range of dorsiflexion motion of the wrist in the two groups of patients were compared before and after treatment under the condition of safety observed. Results:The total effective rate in the observation group was 94.9%,which was higher than the result of 79.5%in the control group(P<0.05).Among the quantitative indicators of syndrome differentiation,the wrist circumference,pain degree,skin temperature,and range of dorsiflexion motion in both groups were significantly improved(P<0.01),and the improvements were more significant in the observation group than in the control group(P<0.05).The skin color of the wrist joint was improved in both groups after treatment(P<0.05),and there was no statistical significance in comparing the improvement of skin color and the occurrence of adverse reactions between the two groups(P>0.05). Conclusion:Compared with Western medicine treatment alone,the combination of gentle moxibustion and Western medicine treatment has significantly better treatment efficacy and shares high safety,which helps to prove the scientific nature of the theory that"heat pattern can be treated by moxibustion therapy".

Objective:To analyze the expression level of minichromosome maintenance protein 6 (MCM6) in colon cancer tissues, the correlation between the expression level of MCM6 and the clinicopathological characteristics of colon cancer patients, and the correlation between MCM6 and PCNA expression.Methods:The expression levels of MCM6 in different tumor tissues were analyzed based on the Human Protein Atlas (HPA) database. The expression levels and correlations of MCM6 and PCNA in colon cancer tissues were analyzed based on The Cancer Genome Atlas (TCGA) database and immunohistochemical experiments. The correlation between MCM6 expression level and clinical characteristics of colon cancer patients was analyzed. The correlation between MCM6 and PCNA expression in colon cancer was analyzed based on TCGA database and Gene Expression Profile Interaction Analysis (GEPIA) database.Results:Bioinformatics analysis and immunohistochemical results confirmed that MCM6 was highly expressed in colon cancer tissues, and its expression level was correlated with the tumor stage of patients ( P=0.01). In colon cancer, the expression of MCM6 and PCNA was correlated with statistical significance ( P<0.05). Conclusions:MCM6 is highly expressed in colon cancer tissue and is related to the clinical characteristics of patients, suggesting that MCM6 can be used as a potential marker of colon cancer.

Numerous studies of relationship between epigenomic features have focused on their strong correlation across the genome, likely because such relationship can be easily identified by many established methods for correlation analysis. However, two features with little correlation may still colocalize at many genomic sites to implement important functions. There is no bioinfor-matic tool for researchers to specifically identify such feature pairs. Here, we develop a method to identify feature pairs in which two features have maximal colocalization minimal correlation (MACMIC) across the genome. By MACMIC analysis of 3306 feature pairs in 16 human cell types, we reveal a dual role of CCCTC-binding factor (CTCF) in epigenetic regulation of cell identity genes. Although super-enhancers are associated with activation of target genes, only a subset of super-enhancers colocalized with CTCF regulate cell identity genes. At super-enhancers colocalized with CTCF, CTCF is required for the active marker H3K27ac in cell types requiring the activation, and also required for the repressive marker H3K27me3 in other cell types requiring repression. Our work demonstrates the biological utility of the MACMIC analysis and reveals a key role for CTCF in epigenetic regulation of cell identity. The code for MACMIC is available at https://github.com/bxia888/MACMIC.

To examine the efficacy and safety for metformin in treating antipsychotic-induced dyslipidemia.
 Methods: Two randomized placebo-controlled trials were included in the analysis. A total of 201 schizophrenia patients with dyslipidemia after treatment with an antipsychotic were collected, and the patients were divided into two groups: a 1 000 mg/d metformin group (n=103) and a placebo group (n=98). The clinical symptoms and metabolic indicators such as body weight, blood glucose, and blood lipids were assessed at baseline, the 12th week and the 24th week after treatment respectively.
 Results: After metformin treatment, the mean difference in the low-density lipoprotein cholesterol (LDL-C) value between the metformin group and the placebo group was from 0.16 mmol/L at baseline to -0.86 mmol/L at the end of the 24th week, which was decreased by 1.02 mmol/L 
(P<0.01). At the 24th week, the LDL-C was more than 3.37 mmol/L in 25.3% patients in the metformin group, which was significantly lower than that in the placebo group (64.8%) (P<0.01). Compared with the placebo group, there were significant changes in the weight, body mass index (BMI), insulin, insulin resistance index, total cholesterol and triglyceride, and high-density lipoprotein cholesterol (HDL-C) in the metformin group (all P<0.05). The treatment effects on weight and insulin resistance appeared at the 12th week and further improved at the 24th week, but the effects on improving dyslipidemia only significantly occurred at the end of the 24th week.
 Conclusion: The metformin treatment is effective in improving antipsychotic-induced dyslipidemia and insulin resistance, and the effect to reduce the antipsychotic-induced insulin resistance appears earlier than the effect to improve dyslipidemia.
Antipsychotic Agents ; adverse effects ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Double-Blind Method ; Dyslipidemias ; chemically induced ; drug therapy ; Humans ; Hypoglycemic Agents ; Metformin ; therapeutic use

Objective To discuss the clinical value of bidirectional quantitative detection of MSCT in the diagnosis of diabetic lung injury.Methods From May 2016 to July 2017,120 patients with diabetes in Wenzhou Hospital of Traditional Chinese Medicine were selected as diabetic group,and 50 healthy people were selected as control group.The two groups received the pulmonary function test ( PFT) and the MSCT bidirectional quantitative detection,the test results of the two groups were analyzed.And the correlation of indicators of MSCT bidirectional detection and PFT detection indicators was analyzed.Results After examination,the maximum inspiratory lung volume (Vin),maximum expiratory volume (Vex),respiratory volume (EVvin,EVvex)-emphysema,EIvin (%),EIvex (%) in the diabetic group were (3 627.64 ±867.43)mL,(3 785.34 ±835.64)mL,(476.95 ±326.25)mL,(236.53 ±86.18)mL,(9.26 ±4.85)%,(4.11 ±2.58)%,respectively,which were significantly lower than those in the control group (t＝11.151,13.809,21.317,21.623,24.76,26.708,all P＜0.05).The Vin,Vex,EVvin,EVvex,EIvin(%),EIvex(%) in the patients with ≤5 years of diabetes were (3 627.64 ±867.43)mL,(3 785.34 ± 835.64)mL,(326.25 ±56.95) mL,(236.53 ±86.18) mL,(9.26 ±4.85)%,(4.11 ±2.58)%,respectively,which were significantly higher than those in the patients with ＞5-10 years of diabetes mellitus (t＝129.09,36.01,21.03,12.38,22.17,19.48,all P＜0.05).Conclusion MSCT bidirectional quantitative detection is of great signif-icance for patients with diabetes lung injury,and plays a significant role in clinical treatment.

Objective To explore the correlation between serum homocysteine(Hcy) levels and behavioral and psychological symptoms dementia (BPSD) in patients with mild to moderate vascular dementia (VaD).Methods Two hundred and ninety-three patients with mild to moderate vascular dementia (aged 40 or over) admitted to the department of neurology of the First Affiliated Hospital of Liaoning Medical College from January 2012 to January 2015.Patients were diagnosed with dementia by NINDS-AIREN criteria,MMSE scores ≤26,Hachinski ischemic scale(≥4) and clinical dementia rating(1≤ C DR ≤ 2).VaD patients were divided into high Hcy(HHcy) group (Hcy≥ 15 μ,mol/L,n=188) and control group(Hcy＜15 μmol/L,n=105).The total scores and the scores of 12 functional domains of behavioral and psychological symptoms in NPI were analyzed by using comparative statistical methods.Results Prevalence of high homocysteine was 64.16％ (n=188) among mild to moderate VaD (n=293).The incidence of BPSD in HHcy group(80.9％) was significantly higher than that in the control group (57.1％),the difference was statistically significant (x2=18.932,P＜0.01).HHcy patients (27.95±5.04) had a significantly higher total score of NPI compared with control patients (16.87± 1.87),the difference was statistically significant (t=3.753,P＜0.01).In terms of scores in 12 functional domains in NPI,the scores in sleep disorders (2.99± 1.40),high (2.10±0.53),irritability/mood swings (2.64± 1.43),abnormal behavior (1.74±0.52),disinhibition (1.40±0.43),agitation (2.02±0.74) were higher than those in control groups (1.85±0.37,0.21±0.05,1.80 ±0.56,0.36±0.09,0.45±0.07,0.68±0.23),all the difference were significant(t=2.327,t=2.012,t=2.136,t=2.066,t=2.050,t=2.007,all P＜0.05).Binary logistic regression analysis showed that there were positive correlation between scores of NPI and plasma Hcy levels (OR=1.164,95％ CI:1.052-1.288,P=0.003).Compared with HHcy group and control group,there were no statistical significance in regard to infarcted brain focus including the frontal lobe,parietal lobe,temporal lobe,occipital lobe,basal ganglia,brain stem and cerebellum (x2=0.528,x2=0.043,x2=0.630,x2=0.166,x2=0.657,x2=1.010,x2=0.019,allP＞0.05).Conclusion High homocysteine levels are correlated with behavioral and psychological symptoms in patients with mild to moderate VaD,including performance of sleep disorders,high,irritability/mood swings,abnormal behavior,disinhibition and agitation.Moreover,the severity of BPSD is positively associated with homocysteine levels.The higher the homocysteine level,the more severe the BPSD.The serum homocysteine levels are no correlated with infarcted brain focus.