ObjectiveTo investigate the potential mechanism of action of the Qufeng Tongqiao Cough-relieving Decoction （祛风通窍止咳方， QTCD） in the treatment of upper airway cough syndrome （UACS）. MethodsTwenty-four guinea pigs were randomly divided into blank group， model group， traditional Chinese medicine （TCM） group， and inhibitor group， with six guinea pigs in each group. Except for the blank group， guinea pigs were sensitized with ovalbumin and aluminum hydroxide via intraperitoneal injection， followed by ovalbumin nasal drops combined with smoke exposure to establish the UACS model. After modeling， the TCM group was administered QTCD 0.9 g/（100 g·d） by gavage， the inhibitor group received the transient receptor potential vanilloid receptor 4 （TRPV4） inhibitor GSK2193874 1 mmol/L， 5 min by nebulisation， and the blank group and model group were given 2 ml/（100 g·d） normal saline by gavage once daily. After 7 days of treatment， a cough provocation test was performed using 0.4 mol/L citric acid. The levels of IgE in serum and inflammatory cytokines， including interleukin-6 （IL-6）， interleukin-8 （IL-8） in serum， bronchoalveolar lavage fluid （BALF）， and nasal lavage fluid （NLF） were detected by enzyme-linked immunosorbent assay （ELISA）. Histopathological changes in lung and nasal mucosal tissues were observed by hematoxylin-eosin （HE） staining. Immunohistochemistry was used to detect the protein levels of TRPV4， substance P （SP）， and calcitonin gene-related peptide （CGRP） in lung and nasal mucosal tissues. Real-time polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of TRPV4， SP， and CGRP in lung tissues. ResultsHE staining showed significant structural damage and infiltration of inflammatory cells in the lung and nasal mucosal tissues in the model group， while the TCM group and inhibitor group showed improved pathological changes. Compared with the blank group， the model group showed increased cough frequency， serum IgE level， and IL-6 and IL-8 levels in serum， BALF， and NLF. The protein levels of TRPV4， SP， and CGRP in lung and nasal mucosal tissues and their mRNA expression were elevated （P＜0.05 or P＜0.01）. Compared with the model group， the TCM group and inhibitor group showed reduced cough frequency， serum IgE level， and TRPV4 and SP mRNA expression in lung tissues. The TCM group showed reduced IL-6 and IL-8 levels in serum， BALF， and NLF， and reduced TRPV4 and CGRP protein levels in lung and nasal mucosal tissues. The inhibitor group showed reduced IL-6 and IL-8 levels in serum， BALF， and NLF， reduced IL-6 in BALF， reduced IL-8 in NLF， and decreased TRPV4， SP， and CGRP protein levels in lung tissues and SP and CGRP protein levels in nasal mucosal tissues （P＜0.05 or P＜0.01）. Compared with the TCM group， the inhibitor group had increased serum IgE， IL-6， and IL-8 levels， increased IL-6 level in BALF， and increased IL-8 levle in NLF， but decreased SP protein level in lung tissues and increased TRPV4 and SP mRNA expression in lung tissues （P＜0.01）. ConclusionQTCD effectively reduces cough frequency in the UACS guinea pig model. Its mechanism may involve inhibiting the activation of the TRPV4 pathway， improving airway neurogenic inflammation， alleviating inflammatory responses， and reducing cough hypersensitivity.

Objective To explore the value of automated functional imaging(AFI)in predicting coronary artery stenosis in patients without ventricular wall motion abnormalities.Methods A total of 40 patients without ventricular wall motion abnormalities under two-dimensional echocardiography and confirmed coronary artery heart diseases(CHD)(coronary stenosis≥70％)by coronary angiography(CAG)at the Xinxiang Central Hospital from July 2018 to September 2019 were selected as the research subjects.The detection rates of coronary artery stenosis ≥70％by AFI and CAG were compared.With reference to CAG as the gold standard,the predictive value of AFI for coronary artery stenosis ≥70％was evaluated.Results There was no significant difference in the detection rates of coronary artery stenosis ≥70％by AFI and CAG(x2=1.667,P＞0.05).The predictive efficacy of AFI for coronary artery stenosis ≥70％was as follows:a sensitivity of 100％,a specificity of 63.6％,the positive predictive value of 69.2％,the negative predictive value of 100％,and an accuracy of 80％for predicting stenosis ≥70％in the left anterior descending artery;a sensitivity of 56.2％,a specificity of 91.6％,the positive predictive value of 81.8％,the negative predictive value of 75.8％,and an accuracy of 77.5％for predicting stenosis ≥70％in the left circumflex artery;a sensitivity of 95.6％,a specificity of 47.0％,the positive predictive value of 70.9％,the negative predictive value of 88.0％,and an accuracy of 75.0％for predicting stenosis ≥70％in the right coronary artery;the overall sensitivity of 85.9％,the overall specificity of 69.8％,the overall positive predictive value of 72.0％,the overall negative predictive value of 84.6％,and the overall accuracy of 77.5％.Conclusion AFI can provide a sensitive,objective,non-invasive,and inexpensive examination method for the early clinical forecast of coronary artery stenosis.

Tumor-associated macrophages(TAMs)are the predominant cell group in the tumor microenvironment(TME)and are the most important regulatory cells of immune system suppression and tumor cell proliferation in TIME.Src homology-2 domain-containing protein tyrosine phosphatase 2(SHP-2)is a non-receptor protein tyrosine phosphatase that plays an important role in the transmission of signals from the cell surface to the nucleus.SHP-2 is a key intracellular regulatory factor mediating cell proliferation and differentiation and is involved in a variety of growth factor and cytokine signaling pathways linking the cell surface to the nucleus.Recent studies have shown that SHP-2 is a key enzyme in determining the function of TAMs,but because of its variable function,it plays different or even opposite roles in different solid TMEs.This paper reviews the function of SHP-2 in TAMs and related solid tumors to provide a comprehensive reference for tumor immunity and targeted therapy research.

To define the concept of digital-intelligent pharmacy from three aspects:digital technology,digital intelligence,and data intelligence.By sorting out the development process of hospital pharmacy from informatization to digitalization and then to intelligence in recent years,and combining with the practical experience of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology in the field of digital pharmacy,this paper discussed the meaning of digital pharmacy and provided new ideas and new assistance for the transformation of hospital pharmacy.Digital pharmacy refers to pharmacists with digital intelligence,who apply digital technology to hospital pharmacy scenarios,combining their own pharmaceutical knowledge,to obtain and produce data intelligence,and realize the digital transformation of hospital pharmacy.Digital pharmacy has become an emerging interdisciplinary subject in hospital pharmacy,which can promote the high-quality development of hospital pharmacy in the future and is a new productive force in hospital pharmacy.

Objective:To investigate the diagnostic value of 99mTc-methylenediphosphonate(MDP) whole body bone scintigraphy in early brucellosis patients with bone and joint injuries. Methods:According to the Diagnosis for Brucellosis (WS 269-2019), combined with epidemiological history, clinical manifestations and serological tests, from November 2020 to April 2021, 15 early brucellosis patients (the course of disease was within 6 months) who had not received any drug treatment diagnosed at the Department for Brucellosis Prevention and Control, Qinghai Institute for Endemic Disease Prevention and Control were selected as the research subjects, and 99mTc-MDP whole body bone scintigraphy was performed on the patients to evaluate the images and analyze the pathological changes. Results:The 99mTc-MDP whole body bone scintigraphy of 15 patients with early brucellosis showed abnormalities, and the abnormal concentration of radionuclides mainly occurred in the 8th to 12th thoracic vertebrae (T8-12), the 1st to 2nd lumbar vertebrae (L1-2) and L4-5. Among them, the thoracic vertebrae abnormalities were T8, T9, T10, T11 and T12 in 1 case each; lumbar vertebrae abnormalities were 1 case of L1, 1 case of L2, 4 cases of L4, and 5 cases of L5. Conclusions:The 99mTc-MDP whole body bone scintigraphy is abnormal in patients with early brucellosis. Bone scintigraphy has certain value in the diagnosis of bone and joint injuries in patients with early brucellosis.

Objective:To evaluate the residual risk (RR) of transfusion transmitted HIV (TT-HIV) after the implementation of nucleic acid amplification test (NAT) in blood screening test among blood centers in China.Methods:The data of blood donors and HIV infection markers from 2017 to 2020 were collected from 28 blood centers via the Platform of Comparison of blood establishments Practice in Chinese Mainland. The new infection rate/window period mathematical model was used for two types of blood screening strategies, namely, two rounds ELISA plus individual NAT take turn with pooling NAT (2ELISA+ ID-NAT/MP-NAT) and two ELISA plus one round pooling NAT (2ELISA+ MP-NAT), and the RR of HIV infection was estimated also based on first donors (FDs) and repeated donors (RDs) in different blood donation years. T-test analyses were conducted for comparing TT HIV RR among FDs and RDs in different blood donation years with two blood screening strategies, and the variation trend of RR in HIV test was observed.Results:From 2017 to 2020, the RR of FDs in 2ELISA+ ID-NAT/MP-NAT blood screening strategy was 2.869/10 6 person-year, 3.795/10 6 persons-year, 3.879/10 6 person-year, and 2.890/10 6 person-year respectively. The RR of RDs was 1.797/10 6 person-year, 1.502/10 6 person-year, 1.857/10 6 person-year, and 1.483/10 6 person-year respectively. Significant difference exists between RR of FDs and RDs, with F=9.898 and p<0.05. In 2ELISA+ MP-NAT strategy, the RR of FDs was 3.508/10 6 person-year, 1.868/10 6 person-year, 2.204/10 6 person-year, and 1.765/10 6 person-year respectively. The RR of RDs was 0.948/10 6 person-year, 0.926/10 6 person-year, 0.748/10 6 person-year, and 0.682/10 6 person-year respectively. Statistical difference existed between RR of FDs and RDs, with F=17.126 and P<0.05. There was no significant difference between the RR of FDs in these two strategies with F=3.493 and P>0.05, while there was a difference between the RR of RDs in these two strategies with F=24.516 and P<0.05, and a difference between the RR of total donors (TDs) in these two strategies F=20.216 and P<0.05. Conclusions:The RR of TT HIV significantly decreased after the introduction of NAT into blood test among blood centers in China. There were some differences in the RR of HIV testing among different blood screening strategies. There could be significant differences in the RR of HIV testing among different groups of blood donors. Compared with FDs, RDs is the low risk group for HIV.

Objective:To evaluate the effect of goal-directed fluid therapy (GDFT) based on permissive high stroke volume variation (SVV) guidance on residual liver function in elderly patients undergoing laparoscopic hepatectomy.Methods:A total of 100 elderly patients of either sex, aged 65-80 yr, with body mass index of 18.5-24.9 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with Child-Pugh grade A or B, scheduled for elective laparoscopic hepatectomy, were divided into 2 groups ( n=50 each) by the random number table method: SVV-guided GDFT group (group SG) and CVP-guided fluid replacement group (group C). Intraoperative fluid management was divided into 2 stages.The first stage was from the start of surgery to the completion of liver resection, the SVV was maintained at 13%-20% in group SG, and the low CVP was maintained at 0-5 cmH 2O in group C. The second stage was from completion of liver resection to the end of the operation, SVV was maintained at 9%-13%, additional hydroxyethyl starch 3 ml/kg was given or repeatedly administered when SVV>13% (for 5 min) or when the response to previous fluid replacement was positive (SVV increased by more than 10%), and the infusion rate was slowed down when the SVV was 9%-13% in group SG, and CVP was maintained at 5-12 cmH 2O in group C. Mean arterial pressure and heart rate were recorded on admission to the operating room, at skin incision (T 1), at the start of liver resection (T 2), at completion of liver resection (T 3) and at the end of operation (T 4). The operation time, intraoperative blood loss, transfusion volume, urine volume and levels of serum lactic acid before operation and at the end of operation were recorded.Blood samples from the median cubital vein were collected at T 0-4 to measure blood glucose and cortisol concentrations.The concentrations of serum aspartate aminotransferase, alanine aminotransferase, total bilirubin and albumin were measured before operation, at 1, 3 and 5 days after operation, and prothrombin time, activated partial thromboplastin time, thrombin time and Fib were recorded.The concentrations of serum interleukin-6, tumor necrosis factor-alpha and C-reactive protein were measured by enzyme-linked immunosorbent assay before operation and at the end of operation, and the postoperative complications and length of hospital stay were recorded. Results:Compared with group C, mean arterial pressure and heart rate were significantly decreased at T 2, 3, blood loss was reduced, transfusion volume and urine volume were increased, prothrombin time and activated partial thromboplastin time were shortened at the end of operation, serum concentrations of interleukin-6 and lactic acid and concentrations of aspartate aminotransferase and alanine aminotransferase in serum at 5 days after operation were decreased, and the length of hospital stay was shortened in group SG ( P<0.05). Conclusions:GDFT based on permissive high SVV guidance can improve residual liver function in elderly patients undergoing laparoscopic hepatectomy.

Objective:To evaluate the effect of permissive high stroke volume variability (SVV) on postoperative delirium (POD) in elderly patients undergoing laparoscopic hepatectomy.Methods:A total of 100 elderly patients of either sex, with body mass index of 18.5-24.9 kg/m 2, aged 65-80 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with Child-Pugh grade A or B, scheduled for elective laparoscopic hepatectomy, were divided into 2 groups ( n=50 each) using a random number table method: permissive high SVV group (group S) and control group (group C). Group S was given goal-directed fluid infusion with a target of high SVV (13%-20%), and fluid replacement was performed according to the intraoperative CVP in group C. Oxygen extraction ratio was calculated on admission to the operating room (T 0), at skin incision (T 1), at the beginning of liver resection (T 2), completion of liver resection (T 3) and at the end of operation (T 4). Intraoperative blood loss, volume of fluid infused and urine volume were recorded.Lactic acid concentrations were measured at T 0 and T 4.Regional cerebral oxygen saturation (rSO 2) was continuously recorded, and the maximum percentage of decrease in rSO 2 from baseline (rSO 2max%) was calculated.Peripheral venous blood samples were collected at 1 day before operation, at the end of operation, and at 1 and 3 days after operation to determine the concentrations of serum S100β and neuron-specific enolase.POD was evaluated at 1, 3 and 7 days after operation, and the hospitalization time was recorded. Results:Compared with group C, the intraoperative blood loss was significantly decreased, the volume of fluid infused and urine volume were increased, the lactic acid concentration at T 4, rSO 2max%, oxygen extraction ratio at T 2-4, serum S100β and neuron-specific enolase concentrations and incidence of POD at 1 and 3 days after operation were decreased, and the hospitalization time was shortened in group S ( P<0.05). Conclusion:Permissive high SVV can decrease the development of POD in elderly patients undergoing laparoscopic hepatectomy, which is related to reduction of cerebral oxygen metabolism.

Objective:Establishment of a new model of human primary colon cancer transplantation tumor in normal immune mice and to provide a reliable experimental animal model for studying the pathogenesis of colon cancer under normal immunity.Methods:Human colon cancer cells come from colon cancer patients who underwent surgery in the Affiliated Hospital of Jining Medical College in 2017. The mice in the cell control group were inoculated with phosphate buffered solution (PBS) containing colon cancer cells, the microcarrier control group was inoculated with PBS containing microcarrier 6, and the cell-microcarrier complex group was inoculated with the PBS containing colon cancer cell-microcarrier complex. The cells of each group were inoculated under the skin of the right axilla of mice by subcutaneous injection, and the time, size, tumor formation rate and pathological changes under microscope were recorded. The transplanted tumor tissue was immunohistochemically stained with the EnVisiion two-step method, and the tumor formation rate of the transplanted tumor was judged according to the proportion of positive cells in the visual field. The polymerase chain reaction (PCR) method was used to detect the expression of human-specific Alu sequence in mice tumor tissue.Results:After inoculation with tumor cells, the mice in the cell control group and the microcarrier control group did not die and did not form tumors; the mice in the cell-microcarrier complex group had palpable subcutaneous tumors in the right axillary subcutaneously on the 5th to 7th days after inoculation, and tumor formation rate is 67% (10/15), and the tumor volume can reach about 500 mm 3 2 to 3 weeks after vaccination. The immunohistochemistry results showed that CK20, CDX-2 and carcinoembryonic antigen were all positively expressed. The PCR results showed that the expression of human-specific Alu sequence can be detected in the transplanted tumor tissue of tumor-bearing mice. Conclusion:Human primary colon cancer cells used microcarrier 6 as a carrier to form tumors in normal immunized mice, and successfully established a new model of human colon cancer transplantation tumor in normal immune mice.

Objective:To explore the application effect of residual urine measurement combined with intermittent catheterization in patients after tension-free vaginal tape-obturator technique (TVT-O) .Methods:Using the convenient sampling method, a total of 80 inpatients who underwent TVT-O in Department of Gynecology in the Second Hospital of Hebei Medical University from April 2018 to December 2019 as the research objects. According to the random number table method, they were divided into the control group and the observation group, with 40 cases in each group. In the control group, the indwelling catheter was kept open for 48 hours and then removed according to the nursing routine, and indwelling catheter in the observation group was removed after 24 hours of indwelling catheter. Patients were encouraged to urinate on their own, and patients with dysuria underwent intermittent catheterization as needed after passing residual urine measurement. The rate of postoperative urinary system infection and recovery time of voluntary urination were compared between the two groups.Results:The rate of urinary system infection of the observation group was lower than that of the control group and recovery time of voluntary urination was shorter than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Application of residual urine measurement combined with intermittent catheterization in tension-free vaginal tape-obturator technique can reduce the rate of urinary system infection and help patients restore bladder function.