ObjectiveTo explore the clinical efficacy of Gandou decoction in treating Wilson's disease （WD） with dampness heat accumulation accompanied by rapid eye movement （REM） sleep behavior disorder （RBD）. MethodFrom April 2019 to August 2023，62 patients with dampness heat accumulation type WD accompanied by RBD who met the inclusion criteria were selected from the Department of Encephalopathy at the First Affiliated Hospital of Anhui University of Chinese Medicine. They were randomly divided into a control group and an observation group with 31 cases each using a computer distributor. The control group received routine copper removal treatment，while the observation group received additional treatment with Gandou decoction on the basis of the control group. Eight days was one course of treatment，totaling three courses. The scores of traditional Chinese medicine syndromes，RBD screening questionnaire （RBDSQ） scores，RBD questionnaire-Hong Kong （RBDQ-HK） scores，polysomnography （PSG） parameters，24-hour urine copper （24 h U-Cu） levels，and non-ceruloplasmin-bound copper （NCC） levels between the two groups before and after treatment were compared，and adverse reactions were observed. ResultSixty trial cases were ultimately completed，with 30 cases in each group. Before treatment，there was no statistically significant difference in various indicators between the two groups， and thus they were comparable. Compared with those before treatment，the traditional Chinese medicine syndrome scores，RBDSQ scores and RBDQ-HK scores of the two groups were significantly reduced，the 24 h U-Cu levels were significantly increased，and the NCC levels were significantly reduced （P<0.05，P<0.01）. Compared with the control group， the observation group showed better improvement in traditional Chinese medicine syndrome scores， RBDSQ scores， RBDQ-HK scores， and NCC levels （P<0.05，P<0.01）. Compared with those before treatment，the total sleep time （TST），sleep efficiency （SE），sleep/REM latency，the proportion of N1/N2/REM stages，arousal index （ARI），and proportion of phasic electromyographic activity （P-EMG-A） were significantly improved in both groups （P<0.05）. Compared with the control group after treatment，the observation group showed more significant improvements in the proportion of TST，SE，REM stages，ARI，and P-EMG-A proportion （P<0.05）. ConclusionGandou decoction can not only improve the traditional Chinese medicine syndrome of WD patients with dampness heat accumulation accompanied by RBD but also alleviate their RBD symptoms.

Humans ; Aged ; Lung Diseases ; Pneumonia/drug therapy* ; Adrenal Cortex Hormones/therapeutic use* ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Administration, Inhalation ; Community-Acquired Infections/drug therapy*

Objective To obtain the metabolomics characteristics of patients in the active stage of ulcerative colitis(UC)with syndrome of dampness-heat in large intestine through non-target metabolomics technology,and to provide a basis for promoting the theoretical system of traditional Chinese medicine(TCM)syndrome differentiation of disease syndrome combination and micro-macro combinations.Methods Non-target metabolomics technology was used to detect the serum samples from 159 patients in the active stage of UC(81 cases with syndrome of dampness-heat in large intestine and 78 cases with syndrome of non-dampness-heat in large intestine)and 30 healthy volunteers.The orthogonal partial sample least squares discriminant analysis model was constructed to screen metabolites with significant changes among groups.The variable importance in projection≥1,P<0.05,and fold change(FC)>1.20 or FC<0.83 were used as the criteria for the screening of differential metabolites.The Kyoto Encyclopedia of Genes and Genomes(KEGG)was used to annotate differential metabolites,and MetaboAnalyst software was used for pathway analysis.Results Between patients in active stage of UC with syndrome of dampness-heat in large intestine and syndrome of non-dampness-heat in large intestine,a total of 99 differential metabolites were screened in the positive ion mode,of which 48 were upregulated and 51 were downregulated.In the negative ion mode,a total of 38 differential metabolites were screened,of which 19 were upregulated and 19 were downregulated.The KEGG enrichment analysis showed that there were 21 metabolic pathways,and the pathway analysis showed that there were mainly four metabolic pathways involved in tryptophan metabolism,sphingolipid metabolism,glycerophospholipid metabolism,and pyrimidine metabolism.Conclusion Patients in the active stage of UC with syndrome of dampness-heat in large intestine have abnormal metabolic pathways,which can provide a basis for TCM syndrome differentiation and treatment for UC with syndrome of dampness-heat in large intestine.

Objective:To analyze the clinical characteristics of patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR), and to explore the risk factors leading to poor prognosis.Methods:The clinical data of 95 patients with ECPR admitted to the First Affiliated Hospital of Zhengzhou University from January 2020 to May 2023 were retrospectively analyzed. According to the survival status at the time of discharge, the patients were divided into the survival group and death group. The difference of clinical data between the two groups was compared to explore the risk factors related to death and poor prognosis. Risk factors associated with death were identified by Binary Logistic regression analysis. Results:A total of 95 patients with ECPR were included in this study, 62 (65.3%) died and 33 (34.7%) survived at discharge. Patients in the death group had longer low blood flow time [40 (30, 52.5) min vs. 30 (24.5, 40) min ] and total cardiac arrest time[40 (30, 52.5) min vs. 30(24.5, 40) min], shorter total hospital stay [3 (2, 7.25) d vs. 19 (13.5, 31) d] and extracorporeal membrane oxygenation (ECMO) assisted time [26.5 (17, 50) h vs. 62 (44, 80.5) h], and more IHCA patients (56.5% vs. 33.3%) and less had spontaneous rhythm recovery before ECMO (37.1% vs. 84.8%). Initial lactate value [(14.008 ± 5.188) mmol/L vs.(11.23 ± 4.718) mmol/L], APACHEⅡ score [(30.10 ± 7.45) vs. (25.88 ± 7.68)] and SOFA score [12 (10.75, 16) vs. 10 (9.5, 13)] were higher ( P< 0.05). Conclusions:No spontaneous rhythm recovery before ECMO, high initial lactic acid and high SOFA score are independent risk factors for poor prognosis in ECPR patients.

Objective To observe the effect of a new cell delivery tool(MSC exo)on the proliferation of pancreatic cancer by transferring targeted genes.Methods Transmission Electron Microscope(TEM)and Nanoparticle Tracking Analysis(NTA)were used to identify human mesenchymal stem cell exosomes(MSC-exo)and transport miR-450a-5p into CFPAC-1,to explore the effect of miR-450a-5p targeting BZW2 on inhibiting the proliferation of pancreatic cancer cells.Results The expression of miR-450a-5p was low in pancreatic cancer tissue(P<0.05),and the expression of CD63 and TSG101 of MSC-exo-miR-450a-5p in CFPAC-1 cells was higher than that of MSC-exo by Western blot(P<0.05).CCK-8 and EdU results showed that MSC-exo-miR-450a-5p significantly inhibited the proliferation of CFPAC-1 cells(P<0.05).Cell scratch and Transwell experiments showed that MSC-exo-miR-450a-5p can inhibit the migration and invasion of CFPAC-1 cells(P<0.05).Through dual luciferase assay,it was confirmed that miR-450a-5p targets BZW2,and RT-qPCR and Western blotting showed a negative correlation(P<0.05)between miR-450a-5p and BZW2 expression.Overexpression of BZW2,CCK-8,EdU,cell scratch,and Transwell experiments confirmed that pc-BZW2 reversed the anti-cancer function of MSC-exo-miR-450a-5p on CFPAC-1.Western blot detected PCNA,Ki-67,MMP2,MMP9,and the results were consistent with the above experiments(P<0.05).Conclusion hMSC exo is a new delivery system,targeting BZW2 to transport miR-450a-5p to inhibit the biological malignancy of pancreatic cancer cells,which provides an important clue for the research of targeted treatment of pancreatic cancer.

Objective:Explore the application of Delphi method and analytic hierarchy process to explore the construction of scientific, objective and comprehensive evaluation index system for healthy enterprise construction and promote the construction of healthy enterprises.Methods:In October 2022, through Delphi expert consultation and analytic hierarchy process, the indexes were screened and the weights of the indexes were determined, and the evaluation index system of healthy enterprises was established.Results:The positive coefficients of experts in the two rounds were all 100.00%, the authority coefficient of experts was 0.82, the coefficients of variation of the indexes in the two rounds were all less than 0.30. The coordination coefficients of experts in the first and second rounds were 0.64 and 0.77, respectively ( P<0.001) . After two rounds of Delphi method expert consultation, a healthy enterprise evaluation index system including 4 first-level indexes, 14 second-level indexes, and 63 third-level indexes was constructed. Conclusion:The constructed health enterprise evaluation index system is highly scientific and reliable, covering the main factors of healthy enterprise construction, and providing a reliable and quantifiable basis and self-assessment basis for the establishment of healthy enterprises.

OBJECTIVE To analyze the medication rules of Professor Shen Hong's TCM treatment of Crohn's disease(CD)and form the core prescription using data mining technology,and to retrospectively analyze the clinical efficacy of the core prescription com-bined with ustekinumab in the treatment of CD with dampness-stasis interjunction syndrome.METHODS CD patient outpatient re-cords treated by Professor Shen Hong were collected,and the property,taste and meridian tropism,drug frequency,association rules and complex network analysis of drugs were summarized,in order to sort out the core prescription.62 cases of active ileocolic CD with TCM syndrome of dampness-stasis interjunction were retrospectively included,with 32 patients in the control group and 30 patients in the observation group.The control group was only given ustekinumab,and the observation group was given the core prescription oral treatment on the basis of the treatment in the control group.The observation course was 8 weeks.The improvement of clinical symptoms and changes of inflammatory indicators[erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),fecal calprotectin(FC)]before and after treatment were analyzed.RESULTS The core prescription was obtained by combining drug frequency,association rules and cluster analysis,which included scutellaria baicalensis,radix sophorae flavescentis,smilax glabr,angelicae sinensis,angeli-ca dahurica,atractylodes,tangerine peel,paeoniae alba,saposhnikovia,coicis semen,yam,nidus vespae,cynanchum paniculatum,radix aucklandiae,massa medicata fermentata,glycyrrhiza uralensis,and was named Qingchang Tongluo Formula by Professor Shen Hong.Retrospective clinical research showed that after treatment,the TCM syndrome scores of the 2 groups of patients were significant-ly reduced(P<0.05,P<0.01),the total TCM syndrome score of the observation group was better than that of the control group(P<0.01),and the TCM clinical significant recovery rate of the observation group was better than the control group(P<0.05);the ESR,CRP,and FC levels of patients in both groups were significantly reduced(P<0.01),and the improvement in the observation group was better than that in the control group(P<0.05).No obvious drug-related adverse reactions were found in the 2 groups of patients during treatment.CONCLUSION Professor Shen Hong distinguishes the treatment of CD by clearing heat and removing blood stasis,strengthening spleen and healing lesions.The core prescription Qingchang Tongluo prescription,combined with ustekinumab can im-prove clinical symptoms and inflammation levels.It can be used clinically as an effective treatment for ileocolonic Crohn's disease with dampness-stasis interjunction syndrome.

The esophagus is referred to as the conduit for food and drink.It can be categorized into three distinct phases:an era characterized by written descriptions,a phase marked by anatomical illustrations,and a period of integration between Chinese and Western medical practices.In the initial phase of written descriptions,seminal texts such as The Yellow Emperor's Inner Classic and The Classic of Difficult Issues documented aspects regarding both length and function of the esophagus;however,these accounts were relatively succinct.The subsequent phase saw advancements in anatomical illustrations that refined our comprehension of esophageal structure and functionality.During the period of the integration of Chinese and Western medicine,insights from Western anatomy prompted a reevaluation within Chinese medicine concerning both anatomy and physiology related to the esophagus;concurrently,clini-cal cases involving esophageal disorders emerged prominently.Consequently,Chinese medicine's grasp on esophageal physiology,pa-thology,anatomy,and function became increasingly comprehensive over time.Choosing the esophagus as the starting point for observ-ing the theory of viscera in Chinese medicine is intended to illustrate that Chinese medicine's understanding of life,health and disease is based on the observation and continuous improvement of the anatomical functions of the viscera,integrating the physiological func-tions to form a highly integrated system with functional states,so as to facilitate the use of natural medicines for regulation and treatment.This is a distinctive feature different from Western medicine,and it can keep pace with the times and absorb modern re-search results,and continuously improve the theory and treatment system,so as to obtain strong vitality and benefit mankind.

Objective To investigate the current situation and influencing factors of latent tuberculosis infection(LTBI)among close contacts of positive etiology pulmonary tuberculosis(PTB)patients,provide basis for formula-ting intervention measures for LTBI.Methods A multi-stage stratified cluster random sampling method was used to select close contacts of positive etiology PTB patients from 39 districts and counties in Chongqing City as the study objects.Demographic information was collected by questionnaire survey and the infection of Mycobacterium tuberculosis was detected by interferon gamma release assay(IGRA).The influencing factors of LTBI were analyzed by x2 test and binary logistic regression model.Results A total of 2 591 close contacts were included,the male to female ratio was 0.69∶1,with the mean age of(35.72±16.64)years.1 058 cases of LTBI were detected,Myco-bacterium tuberculosis latent infection rate was 40.83％.Univariate analysis showed that the infection rate was dif-ferent among peoples of different age,body mass index(BMI),occupation,education level,marital status,wheth-er they had chronic disease or major surgery history,whether they lived together with the indicator case,and whether the cumulative contact time with the indicator case ≥250 hours,difference were all statistically significant(all P＜0.05);infection rate presented increased trend with the increase of age and BMI(both P＜0.001),and decreased trend with the increase of education(P＜0.05).Logistic regression analysis showed that age 45-54 years old(OR=1.951,95％CI:1.031-3.693),age 55-64 years old(OR=2.473,95％CI:1.279-4.781),other occupations(OR=0.530,95％CI:0.292-0.964),teachers(OR=0.439,95％CI:0.242-0.794),students(OR=0.445,95％CI:0.233-0.851),junior high school education or below(OR=1.412,95％CI:1.025-1.944),BMI＜18.5 kg/m2(OR=0.762,95％CI:0.586-0.991),co-living with indicator cases(OR=1.621,95％CI1.316-1.997)and cumu-lative contact time with indicator cases ≥250 hours(OR=1.292,95％CI:1.083-1.540)were the influential fac-tors for LTBI(all P＜0.05).Conclusion The close contacts with positive etiology PTB have a high latent infection rate of Mycobacterium tuberculosis,and it is necessary to pay attention to close contacts of high age,farmers,and frequent contact with patients,and take timely targeted interventions to reduce the risk of occurrence of disease.

ObjectiveTo investigate the levels of neutralizing antibodies against the novel coronavirus in the serum of elderly individuals aged 60 years and above in Shanghai’s Changning District， following natural infection and mixed immunity， in order to provide a basis for strengthening immunity in the elderly. MethodsElderly people who participated in free health check-ups at 10 community health service centers in Changning District from May to June 2023 were selected as the subjects. Information such as gender， age， COVID-19 infection history， COVID-19 vaccine immunization history， and chronic disease history were collected. Serum samples of the subjects were collected and quantitative detection of SARS-CoV-2 neutralizing antibodies was performed by magnetic particle chemiluminescence method. The antibody levels of different populations were analyzed. ResultsA total of 620 subjects were included， 586 of whom （241 males and 345 females） met the study conditions. There were 90 people in the full vaccination + infection group， 224 people in the intensive vaccination + infection group， and 272 people in the unvaccinated + infection group. The positive rates of COVID-19 antibody in the three groups were 94.44% （95%CI： 87.51%‒98.17%）， 95.98% （95%CI：92.51%‒98.15%） and 22.06% （95%CI： 17.28%‒27.46%）， respectively. The positive rates in full vaccination + infection group and intensive vaccination + infection group was significantly higher than that in unvaccinated + infection group （χ²=147.561，P<0.01；χ²=271.729，P<0.01）. The antibody level in full vaccination + infection group （640.74 AU·mL^-1） and intensive vaccination + infection group （1 200.88 AU·mL^-1） was significantly higher than that in unvaccinated + infection group （4.51 AU·mL^-1） （all P<0.01）.The antibody level in the intensive vaccination + infection group was also significantly higher than that in the whole vaccination + infection group （P < 0.05）. ConclusionAfter 5‒6 months of infection， the neutralizing antibody positive rate and antibody level were significantly higher in the elderly who received the full vaccination and infection or intensive vaccination and infection. It is recommended that elderly individuals， who have been infected for more than 5‒6 months but have not been vaccinated， should consider getting vaccinated to enhance their levels of neutralizing antibodies.