Objective:To evaluate the clinical efficacy of intermediate frequency pulse electrical stimulation combined with TCM directional drug penetration therapy in the treatment of patients with lumbar spinal stenosis.Methods:Randomized controlled trial. Totally 90 patients with lumbar spinal stenosis who were treated between July 2018 and December 2021 in the hospital were selected according to randomized controlled trial design, and they were divided into the two groups through the random number table method, with 45 cases in each group. The control group was given non-steroidal anti-inflammatory drugs+conventional intermittent traction + intermediate frequency pulse electrical stimulation, and the combined group was treated with TCM directional drug penetration therapy on the basis of the control group. Both groups were continuously treated for 1 month. The TCM syndromes were scored before and after treatment, and Visual Analogue Scale (VAS) was used to evaluate the pain degree. Japanese Orthopedic Association (JOA) and Oswestry Disability Index (ODI) were applied to assess the dysfunction degree and quality of life, and the clinical efficacy was assessed.Results:The total effective rate was 95.56% (43/45) in combined group and was 82.22% (37/45) in control group, with statistical significance ( χ2=4.05, P=0.044). The scores of lumbago pain, articular soreness, knee soreness and weakness and impaired activity and total score in combined group after treatment were lower than those in the control group ( t=18.40, 15.81, 15.40, 26.50, 59.575, P<0.01), and the JOA score was higher than that of the control group ( t=5.62, P<0.01), while the ODI score was lower than that of the control group ( t=9.43, P<0.01). The time-point effect and between-group effect of VAS score in combined group were lower than those in the control group with the extension of time ( F=240.00, 17.19, P<0.01), and there was an interaction effect between decrease and treatment method ( F=6.66, P<0.01). Conclusion:Intermediate frequency pulse electrical stimulation combined with TCM directional drug penetration therapy is helpful to relieve the pain, improve the lumbar dysfunction degree and enhance the quality of life and clinical efficacy in patients with lumbar spinal stenosis.

Objective: To describe the current reporting of pneumonia of unknown etiology (PUE) and factors that affect reporting by clinicians in China using the PUE surveillance system in order to provide a reference for improving PUE reporting rates in the future. Methods: Clinicians were recruited via the Sojump platform and requested to complete an anonymous self-administered questionnaire. Multivariate logistic regression analysis was used to assess factors influencing clinicians' reporting activities. Results: This study showed a low PUE case reporting rate and a poor understanding of PUE reporting among the investigated clinicians. Of the 136 clinicians who had diagnosed PUE cases, multivariate logistic regression analysis results showed that clinicians who had attended in-hospital training were more likely to report PUE than those who had not (OR 4.48, 95% CI 1.49-13.46). Clinicians with an expert panel on PUE in their hospital were more likely to report PUE cases than those without (OR 5.46, 95% CI 1.85-16.11). Conclusions: There is a need to promote and reinforce PUE surveillance system training among medical staff. In addition, PUE testing technologies in hospital laboratories should be upgraded, especially in primary and unclassified hospitals, to increase surveillance efficiency and improve PUE reporting rates.

Objective:To observe the application effect of skillful communication combined with pathway pain management on patients with hemorrhoids undergoing endoscopic sclerotherapy.Methods:Using the convenient sampling method, a total of 85 patients who received endoscopic sclerotherapy of internal hemorrhoids in the People's Hospital of Anyang City from September 2020 to August 2021 were selected as the research objects. They were divided into the intervention group (44 cases) and the control group (41 cases) . The control group was given routine nursing intervention, while the observation group was given skillful communication combined with pathway pain management on the basis of the control group. The pain level (VAS) before and 12, 24, 48, and 72 hours after the operation, as well as the negative emotions [anxiety (SAS) , depression (SDS) ], resilience (CD-RISC) and quality of life (WHOQOL-BREF) score of patients before and after the intervention were compared between the two groups.Results:Compared with before operation, the VAS scores of the intervention group at 12, 24, 48 and 72 h after operation were lower, and the VAS scores of the intervention group at each time point after operation were lower than those of the control group, and the differences were statistically significant ( P<0.05) . After the intervention, SAS and SDS scores of patients of the two groups were lower than those before the intervention, and SAS and SDS scores of the intervention group after the intervention were lower than those of the control group, and the differences were statistically significant ( P<0.05) . The scores of each dimension of CD-RISC after intervention in the two groups were higher than those before intervention, and the scores of each dimension of CD-RISC in the intervention group after intervention were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The scores of each dimension of WHOQOL-BREF in the two groups after intervention were higher than those before intervention, and the scores of each dimension of WHOQOL-BREF in the intervention group after intervention were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Skillful communication combined with pathway pain management can reduce the pain level of patients undergoing endoscopic sclerotherapy of internal hemorrhoids, relieve the negative emotions of patients and improve their psychological resilience and quality of life, which is worthy of clinical promotion.

Objective ToinvestigatethefeasibilityofpredictingtheKi-67expressionusing MRandclinicalfeaturesofbreast cancer.Methods 52patientswith56invasivebreastcarcinomawereretrospectivelyinvestigated.Eachsubjectunderwentpresurgical breastMRI,whichincludeddynamiccontrastenhancementandDWI(b=0s/mm2,1000s/mm2).Clinicalcharacteristicsand MR findingswerecollected,includingage,ER ,PR ,HER2,tumorsize,location,number,spiculesign,lobulationsign,margin,TICandADCvalues. Ki-67expressionwasrecordedbyimmunohistochemicalstaining,whichwasdividedintohighexpression(≥20%)andlowexpression (<20%).Leastabsoluteshrinkageandselectionoperator(Lasso)wereperformedtoselectthefeaturesmostassociatedwithKi-67 expression.ThenomogramwasconstructedtopredictKi-67expression,aswellasAUCand95%confidenceinterval(CI)werecalculated.Results TICtypesandADCvaluesassociatedwithKi-67expressionwereidentifiedbyLassoregression.Thenomogram predictedthehigh andlow Ki-67expressionwithanAUCof0.827 (95% CI:0.713-0.940).TheKi-67expressionwasnegativelycorrelatedwiththe ADCvalues(r=-0.430,P=0.003).Ki-67expressionwassignificantlycorrelatedwithTICtype,andTICⅢwasmorelikelytohavehigher expressionofKi-67.Conclusion ThereisindividualandrespectivecorrelationbetweentheexpressionlevelofKi-67andTICtype, ADCvalue.TheexpressionlevelofKi-67canbepredictedtosomeextentbyADCvaluesandTICtypes.

Objective To evaluate the application of Burnet Institute-made prototype IgA rapid test,a kind of point-of-care (POC) testing,in the diagnosis of early syphilis.Methods Totally,455 stored serum samples in the Reference Laboratory of Sexually Transmitted Disease,the Institute of Dermatology were used to evaluate the application of the prototype IgA rapid test (IgA-POC) in the diagnosis of early syphilis.According to resluts of Treponema pallidum hemagglutination assay (TPHA),rapid plasma reagin card test (RPR),and enzyme-linked immunosorbent assay for IgM antibodies (IgM-ELISA),these stored samples were divided into 3 groups:uninfected group,previously infected group and early active syphilis group.IgA-POC test was performed in the 3 groups to evaluate its diagnostic performance for active syphilis,and researchers were blind to the group information.Results The prototype IgA-POC test had a sensitivity of 92.6％ (147/163) for the early active syphilis group,a specificity of 72.22％ (104/144) for the previously infected group,and a specificity of 97.97％ (145/148) for the uninfected group.The total specificity of the prototype IgA-POC test was 85.27％,which met the minimum requirement of WHO for the POC test.The prototype IgA-POC test showed a significantly higher sensitivity for the diagnosis of early active syphilis compared with the IgM-ELISA (59.51％,Z =6.88,P ＜ 0.05),but a significantly lower specificity for the diagnosis of previous syphilis infection compared with the IgM-ELISA (98.61％,Z =6.18,P ＜ 0.05).Moreover,no significant difference in the specificity for the diagnosis of non-infection was observed between the prototype IgA-POC test and IgM-ELISA (Z =1.16,P =0.25).Conclusion The prototype IgA-POC test has better capacity for the diagnosis of early active syphilis compared with the IgM-ELISA,so it can be applied to the screening of early active syphilis.

Objective To study the expression of zinc finger and BTB domain containing 20 (ZBTB20) in peripheral blood B cells of the patients with systemic lupus erythematosus (SLE),and to investigate its clinical significance in SLE.Methods The ZBTB20 mRNA expression level in peripheral blood CD19+B cells of 36 cases of SLE (SLE group) and 30 healthy controls(control group) was detected by RT-PCR.The ZBTB20 protein level was detected by western blot;the proportion of B cell subset was measured by flow cytometry.Then the relationship between the ZBTB20 mRNA expression with B cells subset proportion change and its correlation with clinical indicators[anti-dsDNA antibody,immunoglobulin G (IgG),anti-nucleosome antibody (ANA) and anti-extractable nuclear antigen (ENA) antibody] in SLE patients were analyzed.Results The expression level of ZBTB20 mRNA in peripheral blood CD19+B cells of the SLE group was significantly higher than that of the control group (P＜0.05).The peripheral blood ZBTB20 protein level was higher than that of the control group (P＜0.05);the peripheral blood B cells subsets and CD19+ B cells proportion in the SLE patients were decreased,while the CD19-CD138+ plasmocytes/CD19+ B cells ratio and CD19-CD138+ plasmocytes proportion were significantly increased (P＜0.05).The expression level of ZBTB20 mRNA in B cells of SLE patients was positively correlated with the ratio of CD19-CD138+ plasmocytes/CD19+ B cells (P＜0.05).The expression of ZBTB20 mRNA was positively correlated with anti-ds-DNA antibody,ANA and anti-ENA antibody (P＜0.05).Conclusion ZBTB20 might participate in the pathogenesis of SLE possibly via promoting B cells differentiation.

Objective To explore the clinical features and surgical treatment of cervical tuberculous lymphadenopathy associated with abscess formation.Methods The clinical data of 95 cases of cervical tuberculous lymphadenopathy associated with abscess formation were reviewed and analyzed retrospectively.All the patients were treated in Shenzhen Third People's Hospital during the period from February 2012 to May 2014.Results The mean age of the 95 patients was (27.8±8.2) years.The average duration of the disease was 4.0 months.The tuberculous lymphadenopathy was most frequently found in Level Ⅳ cervical lymph nodes.Thirty-four patients were complicated with pulmonary tuberculosis.History of surgical treatment for tuberculous cervical lymphadenopathy was reported in 26 cases.Sixty-five patients were managed with incision and drainage plus dress changing.Twenty-two patients underwent abscess rinsing,excision and primary wound closure.And 8 patients received excision of ulcers and sinuses,and lymphadenopathy cleaning.The average healing time was (2.11± 1.76) months for incision and drainage.Abscess and ulcer reoccurred in 18 of the 65 patients after healing completely by incision and drainage.All the patients treated by the other two surgical modalities were cured as primary healing except 2 patients,who received local flap grafting after primary surgery.Conclusions Cervical tuberculous lymphadenopathy associated with abscess formation has special features in diagnosis and treatment.Surgical approach is usually effective if optimized for individual patients.

Objective To evaluate the antitumor effect of dacarbazine (DTIC) on B16-F1 melanoma after CDK2 gene silencing.Methods Cultured B16-F1 melanoma cells were divided into 4 groups:control group receiving no treatment,CDK2-shRNA group infected with a recombinant lentivirus pUL-CDK2-shRNA,DTIC group cultured in 96-well plates followed 12 hours later by the treatment with 250 μmol/L DTIC,CDK2-shRNA + DTIC group infected with pUL-CDK2-shRNA followed 12 hours later by the treatment with 250 μmol/L DTIC.MTT assay was performed to evaluate the growth inhibition of B16-F1 melanoma cells,and coefficient of drug interaction (CDI) was calculated.AnnexinV-FITC/PI double staining was conducted to detect cell apoptosis.C57BL/6 mice were subcutaneously injected with B16-F1 cells at exponential growth phase into the right groin to establish melanoma-bearing mouse models.Twenty mouse models were randomly and equally divided into 4 groups:control mouse group injected with phosphate-buffered solution (PBS) into tumors,CDK2-shRNA mouse group injected with pUL-CDK2-shRNA into tumors,DTIC mouse group injected with DTIC into the abdominal cavity,and CDK2-shRNA + DTIC mouse group treated with pUL-CDK2-shRNA and DTIC.The animal experiment lasted 18 days,and the tumor growth curve was drawn.After 18-day treatment,all the mice were sacrificed,and tumors were isolated and weighed.The tumor growth inhibition rate was calculated,and the tumor cell apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end-labeling (TUNEL).Results After 72-hour culture,compared with the control group,the CDK2-shRNA group,DTIC group,and CDK2-shRNA + DTIC group showed significantly decreased relative cell survival rates (40.6％ ± 2.8％,45.2％ ± 3.7％,28.7％ ± 2.1％,respectively;F =458.04,P ＜ 0.05),but significantly increased cell apoptosis rates (25.1％ ± 3.3％,15.6％ ± 2.2％,45.6％ ± 3.5％,respectively;F =115.46,P ＜ 0.05).Additionally,CDK2-shRNA + DTIC group showed significantly lower relative cell survival rates (P ＜ 0.01),but higher cell apoptosis rates (P ＜ 0.01) compared with the DTIC group.The CDI value was less than 0.7.On the sixth day after the in vivo treatment,the tumor volumes in the control mouse group,CDK2-shRNA mouse group,DTIC mouse group,and CDK2-shRNA + DTIC mouse group were (185.44 ± 68.97) mm3,(83.91 ± 14.33) mm3,(123.70 ± 20.85) mm3,and (34.54 ± 10.72) mm3 respectively.From then on,the CDK2-shRNA mouse group,DTIC mouse group,and CDK2-shRNA + DTIC mouse group showed significantly decreased tumor growth rates compared with the control mouse group (F =11.819,P ＜ 0.05),and the tumor growth rate was significantly lower in the CDK2-shRNA + DTIC mouse group than in the DTIC mouse group (P =0.04).The calculated tumor growth inhibition rates in the CDK2-shRNA mouse group,DTIC mouse group and CDK2-shRNA + DTIC mouse group were 52.2％,41.2％ and 86.4％ respectively.Compared with the control mouse group,the CDK2-shRNA mouse group,DTIC mouse group,and CDK2-shRNA + DTIC mouse group showed significantly increased tumor cell apoptosis indice (32.93％ ± 3.72％,21.62％ ± 3.54％,63.29％ ± 4.74％ respectively;F =222.25,P ＜ 0.05).Moreover,the tumor cell apoptosis index was significantly higher in the CDK2-shRNA + DTIC mouse group than in the DTIC mouse group (P ＜ 0.01).Conclusion CDK2 gene silencing can enhance the inhibitory effect of DTIC on the growth of melanoma,and show a synergistic effect with DTIC,likely by increasing the apoptosis of tumor cells.

Objective: Leukocyte mediated IL-6 (IL-6) plays an important role in chronic viral hepatitis pathogenesis and related liver diseases, We did a large sample-size case-control study and clinical data analysis to find association between IL-6 single nucleotide polymorphism and HBV susceptibility, and to achieve the detection of the body on the expression of IL-6 for the prevention and treatment of HBV infection. Methods: Totally 848 HBV patients and 894 healthy controls in Shenzhen were selected and rs1800796 genotypes were determined by TaqMan assays. Results: The result showed that rs1800796 polymorphism was associated with susceptibility to HBV infection (P=0.0003, odds ratio (OR)=1.43, the difference was statistically significant. Conclusions The single nucleotide polymorphism of IL-6rs1800796 locus was associated with the susceptibility of HBV infection in Chinese population, and the rs1800796 G allele is a protective gene for HBV infection.

Objective To investigate the different effect among ropivacaine,bupivacaine,lidocaine on analgesia after harvesting grafts from the scalp in burn patients. Methods 84 patients who need harvesting grafts from the scalp after burn were divided in 4 groups random-ly(n=21). Patients in group C hypodermically injected with saline 200 mL were control,while patients in group R injected with 0. 05% ropi-vacaine 200 mL,group B with 0. 188% bupivacaine,and group L with 0. 1% lidocaine. Motor activity assessment scale( MAAS) and visual analogue scale(VAS) were made before anesthesia(T0) and 20 min,5 h,10 h after awake of patients. VAS were made focus on head and body in part. Vital signs were also monitored and recorded for assessment of security. Results All patients in 4 groups had passed the period of operation safely. Patients in group R have better VAS than other groups. Conclusion Low concentration ropivacaine hypodermically injec-tion of head is helpful to relieve the pain after harvesting grafts from the scalp.