Objective:To explore the effect of comprehensive moxibustion with Huolong cupping in patients with lung-spleen qi deficiency type allergic rhinitis.Methods:This study was a randomized controlled trial. From October 2022 to April 2023, convenience sampling was used to select 66 patients with lung-spleen qi deficiency type allergic rhinitis who visited the Otolaryngology Head and Neck Clinic of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine as the research subject. The patients were randomly divided into an experimental group ( n=33) and a control group ( n=33). Both groups received routine oral Chinese medicine treatment. On the basis of routine treatment, the experimental group performed comprehensive moxibustion with Huolong cupping on the meridians of the Du meridian and bladder meridian. This study compared the scores of Nasal Airway Resistance (NAR), Total Nasal Symptom Score (TNSS), Visual Analogue Scale (VAS), and Chinese version of Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) between two groups of patients before and after intervention. Results:Eventually 30 patients in each of the experimental group and control group completed the study. After intervention, the NAR score of the experimental group was lower than that of the control group, and the difference was statistically significant ( P<0.05). Repeated measures analysis of variance showed that with the increase of treatment time, the TNSS, VAS, and RQLQ scores of the experimental group were lower than those of the control group with statistical differences ( P<0.05), and the time effect, inter group effect, and interaction effect were statistically significant ( P<0.05) . Conclusions:Huolong cupping comprehensive moxibustion can reduce nasal resistance, meliorate nasal symptoms and accompanying nasal symptoms, and improve the quality of life of patients.

The clinical application of immune checkpoint inhibitors (ICIs) has significantly improved the prognosis of hepatocellular carcinoma (HCC) patients. With the widespread applica-tion of ICIs in HCC, the management of immune-related adverse events (irAE) gained more and more attention. However, the complicated disease characteristics and various combination therapies in HCC throw out challenges to irAE management. Therefore, the editorial board of the 'Chinese expert consensus on the management of immune-related adverse events of hepatocellular carcinoma treated with immune checkpoint inhibitors (2021 edition)' organizes multidisciplinary experts to discuss and formulate this consensus. The consensus focuses on issues related to HCC irAE manage-ment, and puts forward suggestions, in order to improve standardized and safety clinical medication, so as to maximize the benefits of immunotherapy for patients.

BACKGROUND: Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE). METHODS: This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE. RESULTS: This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively. CONCLUSIONS Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.

Objective:To investigate the nutritional status of elderly inpatients in China, and to assess its relationship with clinical outcomes.Methods:A prospective, multicenter, parallel investigation was organized and conducted by the Chinese Medical Association's Group of Geriatric Nutrition Support.Patients aged ≥65 years from 30 major hospitals of 14 cities in China were evaluated by the Nutritional Risk Screening 2002(NRS2002)and the Mini-Nutritional Assessment-Short Form(MNA-SF), in order to understand the nutritional status and nutritional risk of elderly inpatients in China.The indicators of clinical outcomes were summarized, and the correlation between nutritional status and clinical outcomes was analyzed.Results:A total of 10 184 elderly patients who met the inclusion criteria were enrolled in this study, aged 65-112(74.81±7.01)years, with a body mass index(BMI)of 17.80-35.50(23.32±3.83)kg/m 2.Grip strength of the dominant hand was(16.95±18.42)kg, upper arm circumference was(25.68±3.70)cm, and calf circumference was(32.07±3.89)cm.BMI, grip strength, upper arm circumference and calf circumference decreased significantly with age( F=13.74, 97.47, 28.31 and 88.68, all P<0.001). NRS2002 was conducted on 10 182 patients.Of them, 10.14%(895/10 182)suffered malnutrition(BMI≤18.5 kg/m 2), and 46.42%(4 726/10 182)were at nutritional risk(NRS2002 score≥3). Nutrition deficiency and nutritional risk showed upward trends with age( F=43.41 and 177.05, both P<0.001). A total of 9 755 patients(95.79%, 9 755/10 182)completed the MNA-SF.Of them, 14.67%(1 431/9 755)had malnutrition, 35.04%(3 418/9 755)were at risk of malnutrition, and 50.29%(4 906/9 755)had normal nutritional status.The incidence of malnutrition and the risk of malnutrition significantly increased with age( F=172.79, 12.10 and 152.42, all P<0.05). Nutritional risk(NRS2002 score≥3)was related to age, BMI, mortality, infectious complications, length of hospital stay and total hospital cost(all P<0.05). Conclusions:The incidence of malnutrition and the risk of malnutrition are high in elderly inpatients in China.Nutritional risk is an influencing factor for adverse clinical outcomes.

Objective: To investigate the first family cluster of COVID-19 in Lanzhou, so as to provide basis for improving the COVID-19 outbreak prevention capacity. Methods : On January 23, the First Hospital of Lanzhou University reported two suspected cases of COVID-19.According to the COVID-19 Epidemiological Investigation Plan ( second edition ) , general information, disease diagnosis and treatment, clinical symptoms, laboratory test results, household environment, exposure history and close contacts were collected to figure out the source of infection and routes of transmission. Results: This family cluster lasted 29 days, from January 23 to February 21, reporting nine confirmed cases ( one death ) and one asymptomatic case. There were three imported cases from Wuhan, who were the source of the cluster; and seven secondary cases, who all had close contact with the imported cases during daily life or through having dinners. The secondary attack rate was 41.18% ( 7/17 ) . Among 9 confirmed cases, the incubation period ranged from four to ten days, with a median of nine days. Except for seven secondary cases, 24 close contacts were found and detected negative in the nucleic acid tests. Conclusions The first family cluster of COVID-19 in Lanzhou is caused by the imported cases from Wuhan. All the secondary cases have had dinners and/or had contact with the imported cases, thus they are infected through respiratory droplets and close contact.

Immune checkpoint inhibitors are able to reactivate the immune system therefore enhance the anti-tumor effects. However, over-activated T cells may induce immune related adverse events (irAEs). Hematological irAEs are rarely reported, which mainly represent as mono-lineage cytopenia or pancytopenia, including autoimmune hemolytic anemia (AIHA), immune thrombocytopenia (ITP), neutropenia and aplastic anemia, sometimes even lethal, such as hemophagocytic lymphohistiocytosis. The clinical manifestations of hematological irAEs will be summarized and recommendations of diagnosis and treatment are proposed.

Immune checkpoint inhibitors (ICIs) have been used more and more Increasingly in clinical oncology treatment, which has significantly improved the prognosis of cancer patients. Over-activation of T cells and related signaling pathways may cause immune-related adverse effects. Renal immune side-effects are relatively rare, but some of them are serious and fatal. This review analyses of the Incidence, clinical and pathological manifestations of ICIs-induced renal injury, and focuses on the differential diagnosis and treatment. Because there are many secondary factors that need to be differentiated from immune mechanism, renal biopsy should be performed if necessary to determine the important decision.

Objective: To explore the effects of temperature on the daily cases of varicella. Methods: The data of daily cases of varicella was collected during 2008 to 2016 in Lanzhou from National Notifiable Disease Report System, and the meteorological data at the same period was integrated from Gansu Meteorological Administration. Distributed lag nonlinear model was fitted to reveal the relationship between the daily mean temperature and the daily cases of varicella and susceptible population. The minimum morbidity temperature was defined as the reference for the estimation of RRs in different temperature level (-5.2 ℃, 1.7 ℃, 20.1 ℃ and 25.4 ℃). Results: The total of 21 254 cases were reported from 2008 to 2016, of which the ratio of male to female was 1.28 (11 951/9 303) and people aged 6-14 years accounted for 52.87%. The relationship between the daily mean temperature and the daily cases of varicella was M type. For all subjects, the accumulative effects of temperature had statistical significance from lag 0-14 d when temperatures was at -5.2 ℃, 1.7 ℃ and 20.1 ℃,while the RRs (95%CI) were 1.87 (1.64-2.12) , 1.33 (1.10-1.62) ,1.60 (1.38-1.86) ,while from lag 0-7 d when temperatures was at 25.4 ℃,and the RR (95%CI) was 2.51 (1.93-3.27) . The RR value of accumulative effects was 6.23(95%CI: 4.38-8.86) on lag 7 d when temperatures was at -5.2 ℃, which was the highest value at different temperature during lag days. The cumulative effects trends of different temperatures were similar for different gender population or different age subjects. However, the cumulative effects of was highest for children aged 6-14 years among all subjects, and the value of RR was 6.12 (95%CI:3.71-10.10) on lag 5d when temperatures was at -5.2 ℃. Conclusion We conclude that the increasing risk of varicella is associative with low and high temperature in Lanzhou. The effects of low temperature are stronger than those of high temperature. The children aged 6-14 years belong to the high-risk population of varicella.

Objective To investigate the application value of mini-nutritional assessment short-form(MNA-SF) in screening and evaluating nutritional status in elderly hospitalized patients with malignant tumor.Methods 1472 elderly hospitalized patients(≥65 years old)with malignant tumor were enrolled and prospectively studied for evaluating the nutritional status by nutritional risk screening 2002 (NRS 2002)assessment.Indicators of clinical outcomes were summarized.The consistencies of MNA-SF with body mass index(BMI),grip and results of NRS 2002 assessment,and the relationship between the different nutritional status and clinical outcomes were analyzed.Results The patients meeting the inclusion/exclusion criteria were aged(72.1±5.9)years,with BMI of(22.3 ±3.7)kg/m2 and grip of(21.7± 19.0)kg.Among 16.7％ of the malnourished patients with malignant tumors,pancreatic cancer (30.9 ％),bile duct cancer (24.1％) and esophageal cancer (21.2 ％) occupied the top three incidence of malnutrition,with the lowest (5.4％)incidence in breast cancer.Among 59.2％ of patients being malnourished (16.7％)or at risk(42.5％)of malnutrition,the highest incidence was in bile duct cancer(82.8％),and lowest one was in breast cancer(28.6 ％).MNA-SF-discriminated malnutrition(0～ 7 points)showed a great agreement with malnutrition evaluation by BMI(＜18.5),but had a poor agreement with grip in screening malnutrition.MNA-SF-discriminated nutrition problem(malnourishment plus at risk of malnutrition)showed a great agreement with NRS 2002-discovered nutrition problem (score≥3).Under-nourished patients had a higher infection complication(9.29％ vs.5.14％,P =0.006)and longer hospital stays(15.4 d vs.12.8 d,P＜0.01)as compared with patients with normal nutrition status.Conclusions The prevalence and risk factors for malnutrition are higher in elderly patients with malignant tumor.Poor nutritional status is correlated with poor clinical outcomes.MNA-SF can be used as a tool for evaluating the nutritional status of elderly patients with malignant tumor.

Objective To observe the therapeutic efficacy of electroacupuncture at the acupoints on extremities or abdominal acupoints and orally taking Mosapride in treating functional dyspepsia (FD) and the different effects on life style, for guiding the points selection in acupuncture-moxibustion treatment for FD.Method Sixty FD patients were randomized into an extremity-electroacupuncture group, an abdomen-electroacupuncture group, and a Western medication group by their visiting sequence, 20 cases in each group. In theextremity-electroacupuncture group, Zusanli (ST36), Sanyinjiao (SP6), Neiguan (PC6) and Gongsun (SP4) were selected. Bilateral Zusanli and Sanyinjiao were respectively connected to G6805-2 electroacupuncture apparatus, 30 min for each session, once everyother day, 10 sessions in total. In the abdomen-electroacpuncture group, Zhongwan (CV12), Tianshu (ST25), and Qihai (CV6) were selected. Bilateral Tianshu were connected to electroacupuncture apparatus, with same treatment time, frequency and sessions. The Western medication group was intervened by oral administration of Mosapride, 1 tablet each time, 3 times a day, for 20 d in total. The three groups were evaluated by using Nepean Dyspepsia Index (NDI) prior to the treatment, after the treatment and 1 month after the treatment (follow-up study), and the therapeutic efficacies were estimated after the treatment.Result The effective rate of the extremity-electroacupuncture group was higher than that of the abdomen-electroacupuncture group and Western medication group, while there was no significant difference between the abdomen-electroacupuncture group and Western medication group in comparing the effective rate. After the treatment, the improvement of Nepean Dyspepsia Symptom Index (NDSI) in the extremity-electroacupuncture group was more significant than that in the abdomen-electroacupuncture group and Western medication group (P<0.05), while there was no significant difference between the abdomen-electroacupuncture group and Western medication group (P>0.05). The 1-month follow-up showed that the improvement of symptoms in the extremity-electroacupuncture group was more significant than that in the abdomen-electroacupuncture group (P<0.05), and the improvement in the abdomen-electroacupuncture group wasmore significant than that in the Western medication group (P<0.05). After the treatment, the improvements of Nepean Dyspepsia Life Quality Index (NDLQI) in the extremity-electroacupuncture group and abdomen-electroacupuncture group were superior to the improvement in the Western medication group (P<0.05), while there was no significant difference between the two electroacupuncture groups (P>0.05). The 1-month follow-up study showed that the quality of life in the extremity-electroacupuncture group was still significantly improved compared to that before the treatment, while the improvement in the Western medication group was insignificant.Conclusion Electroacupuncture at the acupoints on extremities and abdominal acupoints both can more effectively and consistently improve the symptoms and quality of life of FD patients compared to orally taking Mosapride. Compared to electroacupuncture at the abdominal acupoints, electroacupuncture at the extremity points works better in improving the symptoms of FD butdoesn't show advantage in improving the quality of life.