OBJECTIVE To provide reference for rational clinical use of immune checkpoint inhibitor （ICI）. METHODS Electronic medical record information of patients who received ICI treatment from January 1st 2020 to December 31st 2023 at a certain hospital was collected. Patients were divided into thyroid immune-related adverse event （irAE） group （subdivided into clinical hypothyroidism， clinical hyperthyroidism， subclinical hypothyroidism， and subclinical hyperthyroidism subgroups） and non- thyroid irAE group based on whether they experienced immune-induced thyroid irAE. Univariate and multivariate Logistic regression analyses were employed to analyze the influencing factors of ICI-related thyroid adverse events. RESULTS A total of 382 patients who received ICI treatment were included， with 137 cases in the thyroid irAE group （accounting for 35.9%） and 245 cases in the non-thyroid irAE group （accounting for 64.1%）. Multivariate Logistic regression analysis， following univariate screening， revealed that ICI combined with radiotherapy was positively associated with the occurrence of thyroid irAE [odds ratio （OR）＝2.157， 95% confidence interval （CI） （1.144， 4.066）， P＜0.05]， while lung squamous cell carcinoma was negatively associated with the occurrence of thyroid irAE [OR＝0.600， 95%CI （0.369， 0.975）， P＜0.05]. Among various thyroid irAE， nasopharyngeal malignancy was positively associated with the occurrence of immune-related clinical hyperthyroidism [OR＝4.678， 95%CI （1.149， 19.042）， P＜0.05]； ICI combined with radiotherapy [OR＝2.622， 95%CI （1.227， 5.603）， P＜0.05] and lung adenocarcinoma [OR＝2.013， 95%CI （1.078， 3.759）， P＜0.05] were positively associated with the occurrence of immune-related subclinical hyperthyroidism. Age was negatively associated with the occurrence of immune-related clinical hypothyroidism [OR＝0.944， 95%CI （0.896， 0.995）， P＜0.05]； age [OR＝0.963， 95%CI （0.932， 0.994）， P＜0.05] and ICI combined with chemotherapy [OR＝0.332， 95%CI （0.137， 0.802）， P＜0.05] were negatively associated with the occurrence of immune-related subclinical hypothyroidism. CONCLUSIONS Among patients receiving ICI treatment， younger patients are more prone to thyroid irAE. Patients receiving ICI combined with chemotherapy are less likely to experience subclinical hypothyroidism， while ICI combined with radiotherapy significantly increases the risk of thyroid adverse events.

Objective This study aims to construct a network of post-traumatic stress disorder(PTSD)symptoms in first stroke patients,to explore the network characteristics and identify core symptom through network analysis,and provide a basis for precise intervention of symptoms.Methods From October 2022 to April 2023,we recruited 232 first stroke patients by using convenience sampling from a tertiary hospital in Qingdao.PTSD checklist for DSM-5 was used to investigate 20 symptoms,construct a symptom network,and analyze the accuracy and stability of core symptom and network structure.Statistical analysis of the network and data visualization were achieved by R software.The test shows that the accuracy and stability of the network are good,and the network model is reliable.Results The PTSD network shows symptoms of"hypervigilance"and"hyperactive startle response","avoidance of memories,thoughts,or feelings related to the traumatic event"and"avoidance of extemal cues related to the traumatic event","negative beliefs"and"blaming oneself or others"had the strongest association between these 2 symptoms of all.Their regularized partial correlation coefficients were 0.650,0.635,0.381.The symptom"trauma-related forgetting"had the highest predictability.The expected influence results indicated that the symptom"restriction of positive emotion"had the highest centrality.This symptom was more closely related to other symptoms.Conclusion In this study,symptom network analysis was used to explore the symptom network of PTSD in first stroke patients.According to the symptoms with the strongest relationship and the high predictability value in the results,it is suggested that the strong connection between these symptoms should be cut off preventatively during the intervention process to improve the intervention efficiency.The results of PTSD symptom network show that"restriction of positive emotion"is the most core symptom of PTSD.This suggests that clinical health care personnel should take this symptom as the target point of intervention and use it as a breakthrough point to formulate scientific psychological interventions to effectively improve patients'mental health,enhance the control effect of PTSD and promote psychological recovery.

Humans ; Aged ; Acute Kidney Injury ; Risk Factors ; Creatinine

Objective:To compare the application effectiveness of conventional rehabilitation combined with thoracic spine mobility exercises and conventional rehabilitation in postoperative rehabilitation of patients with rotator cuff injury.Methods:A retrospective cohort study was conducted to analyze the clinical data of 204 patients with rotator cuff injury admitted to First Affiliated Hospital of Jinan University from February 2019 to February 2022, including 88 males and 116 females; aged 18-87 years [(54.1±11.8)years]. Initial unilateral arthroscopic rotator cuff repair was performed on all the patients. A total of 98 patients received a conventional rehabilitation plan (conventional rehabilitation group), and 106 patients received additional thoracic spine mobility exercises as well as conventional rehabilitation (additional exercise rehabilitation group). The visual analog scale (VAS), Constant shoulder joint score, University of California at Los Angeles (UCLA) shoulder joint score, and shoulder range of motion (forward flexion, abduction, and external rotation) before surgery and at 1, 3, and 6 months after surgery were compared between the two groups. The occurrence of complications after rehabilitation was observed.Results:All the patients were followed up for 6-18 months [(8.4±3.5)months]. The VAS score, Constant shoulder joint score, UCLA shoulder joint score, and shoulder joint range of motion of both groups were improved significantly at 1, 3, and 6 months after surgery compared with those before surgery (all P<0.01). There was no statistically significant difference in VAS score between the two groups before surgery and at 1, 3, and 6 months after surgery respectively (all P>0.05). At 3 and 6 months after surgery, the values of the Constant shoulder joint score of the additional exercise rehabilitation group were (77.7±5.8)points and (88.4±7.7)points respectively, which were higher than those of the conventional rehabilitation group [(73.7±6.6)points and (85.5±4.9)points] (all P<0.01). There was no statistically significant difference in the Constant shoulder joint score between the two groups before and at 1 month after surgery (all P>0.05). At 3 months after surgery, the value of the UCLA shoulder joint score of the additional exercise rehabilitation group was (25.5±3.7)points, significantly higher than that of the conventional rehabilitation group [(21.8±5.6)points] ( P<0.01). There was no statistically significant difference in the UCLA shoulder joint score between the two groups before surgery and at 1 and 6 months after surgery (all P>0.05). At 3 and 6 months after surgery, the forward flexion angles of the additional exercise rehabilitation group were (135.5±12.8)° and (165.1±11.3)° respectively, which were higher than those of the conventional rehabilitation group [(129.3±12.3)° and (151.1±11.2)°]; the abduction angles of the additional exercise rehabilitation group were (102.3±12.9)° and (130.4±15.1)° respectively, which were higher than those of the conventional rehabilitation group [(93.2±11.0)° and (123.5±13.7)°]; the external rotation angles of the additional exercise rehabilitation group were (57.2±13.1)° and (72.3±12.3)°respectively, which were higher than those of the conventional rehabilitation group [(46.4±8.8)° and (67.4±14.1)°] (all P<0.01). There was no statistically significant difference in the forward flexion, abduction and external rotation angles between the two groups before surgery and at 1 month after surgery (all P>0.05). At 6 months after surgery, recurrent rotator cuff tear occurred in 1 patient (1.0%) in the conventional rehabilitation group and in 2 (1.9%) in the additional exercise rehabilitation group; shoulder joint adhesion deveplpoed in 5 patients (5.1%) in the conventional rehabilitation group and in 3 (2.8%) in the additional exercise rehabilitation group. No statistically significant difference was found in the incidence rate of postoperative complications between the two groups (all P>0.05). Conclusion:Compared with the conventional rehabilitation plan, addition of thoracic spine mobility exercise to the rehabilitation after arthroscopic repair surgery in patients with rotator cuff injury can achieve better joint function and range of motion, with no increase in the incidence of complications.

Objective:To evaluate the efficacy of long-pulsed 1 064-nm Nd:YAG laser combined with a topical emulsion containing Camellia reticulata and Radix Notoginseng in the treatment of melasma. Methods:A total of 80 patients with melasma were enrolled from Department of Dermatology, People′s Hospital of Ningxia Hui Autonomous Region from June 2019 to June 2020, and randomly and equally divided into control group and observation group by using a random number table: 40 patients in the control group were treated with long-pulsed 1 064-nm Nd:YAG laser once every 2 weeks for 6 sessions as a course of treatment; another 40 in the observation group were treated with the same laser therapy as the control group and a topical emulsion containing Camellia reticulata and Radix Notoginseng twice a day for 3 months as a course of treatment. Melasma area and severity index (MASI), clinical efficacy, patient satisfaction rate and safety were compared between the 2 groups before and/or after treatment. Results:After 4- and 8-week treatment, there was no significant difference in the MASI score between the observation group (14.57 ± 3.22 points, 10.00 ± 2.94 points, respectively) and control group (14.74 ± 3.11 points, 11.31 ± 3.00 points, respectively; both P>0.05). After 12-week treatment, the MASI score was significantly lower in the observation group (4.80 ± 2.78 points) than in the control group (7.07 ± 3.22 points, t = -3.38, P<0.01). After 3-month treatment, the response rate was significantly higher in the observation group (36 cases, 90%) than in the control group (31 cases, 77.5%; χ2 = 4.58, P < 0.001) ; however, there was no significant difference in the patient satisfaction rate between the observation group (87.5%) and control group (72.5%, χ2 = 7.26, P = 0.06). In addition, no significant difference in the occurrence of adverse reactions was observed between the observation group (5 cases, 12.5%) and control group (7 cases, 17.5%; P > 0.05) . Conclusion:Compared with the long-pulsed 1 064-nm Nd:YAG laser alone, the topical emulsion containing Camellia reticulata and Radix Notoginseng in combination with the long-pulsed 1 064-nm Nd:YAG laser is more effective for the treatment of melasma, with higher patient satisfaction and less adverse reactions.

Glycyrrizae Radix et Rhizoma has high medicinal value and is widely used in compatibility. It is used most frequently in the compatibility of Chinese medicine prescriptions，and is known as ''Guolao''（national medicine） and "master of all medicines". The characteristic active ingredients are mainly liquitin，glycyrrizic acid，glycyrrizin，and licochalcone. In different compatibilities，based on traditional and modern pharmacological theories，the corresponding effect of Glycyrrizae Radix et Rhizoma are brought into play through different mechanisms. Based on the traditional pharmacology of Glycyrrizae Radix et Rhizoma for tonifying spleen，replenishing Qi，clearing heat，removing toxin，dispelling phlegm，relieving cough and pain，and harmonizing various medicines，this paper used herbal authentication to analyze its compatibility application and mechanism. It was found that Glycyrrizae Radix et Rhizoma played corresponding effect in compatibilities through "tonification"，"harmonization"，and "regulation". For example，Glycyrrizae Radix et Rhizoma was combined with tonics including Ginseng Radix et Rhizoma and Atractylodis Macrocephalae Rhizoma to tonify the five Zang-organs through its strong tonifying effect，combined with Paeoniae Radix Alba and Aconiti Lateralis Radix Praeparata to relieve emergencies and pains through harmonizing medicine power and properties，and combined with Rhei Radix et Rhizoma and Natrii Sulfas to reduce medicine intensity through regulating medicine properties and body characteristics. The application law and mechanism of the modern pharmacological compatibility of Glycyrrizae Radix et Rhizoma were analyzed by data mining and network pharmacology. It was found that the modern clinical formula was often compatible with Glycyrrizae Radix et Rhizoma for anti-inflammation，cardiovascular and cerebrovascular protection，anti-virus，and anti-tumor，Ephedrae Herba and Scutellariae Radix for anti-inflammation，Bambusae Caulis in Taenias，Salviae Miltiorrhizae Radix et Rhizoma，and Aurantii Fructus Immaturus for cardiovascular and cerebrovascular protection，and Ophiopogonis Radix and Chuanxiong Rhizoma for nerves protection. Meanwhile，the important targets of the characteristic ingredients were protein kinase B1 （Akt1），interleukin-6 （IL-6），tumor necrosis factor （TNF），and epidermal growth factor receptor （EGFR）. The important characteristic pathways such as tyrosine kinase inhibitor resistance pathway and cyclic guanosine monophosphate （cGMP）/protein kinase G （PKG） signal pathway played the role of cardiovascular and cerebrovascular protection，and proteoglycan pathway in cancer played a neuroprotective role. This study is expected to provide references for the rational compatibility and application of Glycyrrizae Radix et Rhizoma，as well as the compatibility application of Chinese medicine prescriptions.

[Objective] To observe the effect of Chai Qin Pingwei Capsule (CQPC) on gastric mucosal cell apoptosis and regulatory genes in rats with bile reflux gastritis. [ Methods ] Wistar rats were randomized into 6 groups: sham-operation group (A), model group (B) , CQPC groups in the dosages of 16.66 (high) ,8.33 (moderate), and 4.17 (low) g/kg respectively (C, D and E respectively), Xiao Chaihu Granules group in the dosage of 10g/kg (F). Except the sham-operation group, the rats in other groups received B- II gastrojejunostomy to induce bile reflux gastritis and were treated with gastric gavage of corresponding drugs according to the experimental design for 4 weeks. Effects of CQPC on gastric mucosal cell apoptosis and the expression of p53 mRNA, Bax and Bcl-2 were observed by enzyme-linked immunosorbent assay (ELISA), hybridization in situ and immunohistochemistry method. [Results] Bile reflux in the model group caused the increase of gastric mucosal cell apoptosis, the up-regulation of wild-type p53 mRNA and Bax protein expression, and the down-regulation of Bcl-2 protein expression, the difference being significant as compared with the sham-operation group (P

OBJECTIVE:To study the effects on gastric secretion and anti-gastr ic ulcer action of sea buckthorn pulp oil(SBPO)in rats METHODS:The effects of SB PO on gastric secretion in rats were studied with pylorus ligation The anti-ga stric ulcer actions of SBPO was observed on the gastric ulcer models induced by water immersion stress,reserpine,pylorus ligation or acetic acid The analgesi c effect was tested by the hot-plate method and writhing method RESULTS:SBPO significantly inhibited the secretion of gastric acid and pepsin and promoted th e secretion of gastric mucus SBPO markedly protected the formation of gastric u lcer induced by water immersion stress,reserpine or pylorus ligation and promot ed the healing of acetic acid induced gastric ulcer SBPO significantly decrease d the number of twisting body in mice CONCLUSION:SBPO has anti-gastric ulcer effect The mechanisms of anti-gastric ulcer action might be its effects of inh ibition of the secretion of gastric juice,promotion of the secretion of gastric mucus and analgesic effect

AIM: To study the action of Shugan Pills (SHGP) (Fructus Toosendan, Rhizoma corydalis, Radix Paloniae Albe, Radix Aucklandiae, Cortex Magnoliae Officinalis, Fructus Aurantii, etc.) on treatment of epigastralgia. METHODS: The analgesic effect was tested by the hot plate test and writhing method. The anti gastric ulcer action of SHGP was observed on the gastric ulcer induced by water immersion stress, reserpine and absolute ethyl alcohol. The effect on gastric secretion in rats was studied with pylorus ligation. The effect on gastrointestinal motility was observed by determination of gastric emptying and small intestinal propulsion ability in mouse. RESULTS: SHGP enhanced hot pain threhshold and decreased the number of twisting body in mouse. SHGP markedly inhibited gastric ulcer induced by water immersion stress, reserpine and absolute ethyl alcohol. SHGP significantly inhibited the secretion of gastric acid and pepsin and promoted the secretion of gastric mucus. SHGP markedly delayed gastric emptying in normal mouse and when gastric emptying and small intestinal propulsion was stimulated by neostigmine. SHGP faintly strengthed the effect of atropine on inhibition of gastrointestinal motility. CONCLUSION: Shugan Pills could have analgesic effect, anti gastric ulcer action, it inhibited the secrection of gastric juice and the activity of gastric smooth muscle. These effects might be the pharmacological mechanisms of SHGP on treatment of epigastralgia.

AIM:To investigate the effects of Zhouluotong (Radix Astragali, Ramulus Cinnamomi, Radix Angelicae Sinensis, Radix Rchmannia, Herba Asari, etc.) on nerve function and polyol pathway in streptozotocin diabetic rats. METHODS: Streptozotocin diabetic rats were administrated with Zhouluotong for 8 weeks. Effects of drugs on sciatic never morphological alterations, sciatic never conduction velocity, aldose reductase activity, Na +,K + ATPase activity and sciatic nerve polyol contents were determined. RESULTS: Compared with diabetic group, sciatic never morphological alterations was improved, sciatic never conduction velocity was increased, aldose reductase activity was depressed and Na +,K + ATPase activity was increased in each administrated group. Sorbitol and gloucose contents were decreased in Zhouluotong groups. CONCLUSION: Zhouluotong could improve metabolism and function of peripheral nerve issue in streptozotocin diabetic rats. As a result of that, it could prevent diabetic peripheral neuropathy in streptozotocin diabetic rats.