Houpo Qiwutang originated from the Synopsis of the Golden Chamber， and it consists of seven medicines： Magnoliae Officinalis Cortex， Rhei Radix et Rhizoma， Aurantii Fructus Immaturus， Cinnamomi Ramulus， Zingiberis Rhizoma Recens， Glycyrrhizae Radix et Rhizoma， and Jujubae Fructus. It is a basic formula for the treatment of abdominal fullness. Through the bibliometric method， the historical history， drug base， preparation and dosage， decoction method， and ancient and modern applications of Houpu Qiwu Tang were analyzed by means of textual research. The research finds that Houpu Qiwu Tang has been passed down through the generations in an orderly manner with fewer changes. The drug base of this formula is basically clear， and the base of Magnoliae Officinalis Cortex， Rhei Radix et Rhizoma， Cinnamomi Ramulus， Zingiberis Rhizoma Recens， and Jujubae Fructus is consistent with the 2020 edition of Chinese Pharmacopoeia. The mainstream base of Aurantii Fructus Immaturus is the dried young fruit of Citrus aurantium of Rutaceae family， and the historical mainstream base of Glycyrrhizae Radix et Rhizoma is the dried root of Glycyrrhiza uralensis of Leguminosae family. The modern dosage of this formula is 110.40 g of Magnoliae Officinalis Cortex， 41.40 g of Rhei Radix et Rhizoma， 69 g of Aurantii Fructus Immaturus， 27.60 g of Cinnamomi Ramulus， 69 g of Zingiberis Rhizoma Recens， 41.40 g of Glycyrrhizae Radix et Rhizoma， and 30 g of Jujubae Fructus. In addition， the decoction method is to add 2 000 mL of water with the above seven flavors of the medicine， boil it to 800 mL， and then take 160 mL in a warm state each time. The amount of the medicine taken for each time is 22.08 g of Magnoliae Officinalis Cortex， 8.28 g of Rhei Radix et Rhizoma， 13.80 g of Aurantii Fructus Immaturus， 5.52 g of Cinnamomi Ramulus， 13.80 g of Zingiberis Rhizoma Recens， 8.28 g of Glycyrrhizae Radix et Rhizoma， and 6 g of Jujubae Fructus. The modern application of this formula involves the digestive system， respiratory system， and urinary system. It is more advantageous in digestive system diseases such as early postoperative inflammatory bowel obstruction， functional dyspepsia， gastric pain， functional abdominal distension， and gastric reflux esophagitis. By comprehensively examining the key information of Houpu Qiwu Tang， this paper aims to provide literature support for the development and clinical application of this formula.

In January 2023,the American Heart Association(AHA)released A Scientific Statement:Cancer Therapy Related Hypertension,provided an overview of the mechanisms and clinical management of anticancer therapy related hypertension.Contemporary anticancer drugs are mostly at the expense of cardiovascular toxicities,one of the most common side effects is hypertension,especially vascular endothelial growth factor inhibitors,as well as tyrosine kinase inhibitors and proteasome inhibitors.Cancer therapy related hypertension is often dose limiting,and is usually reversible after interruption or discontinuation of treatment.The exact molecular mechanisms underlying hypertension are unclear,recent discoveries indicate an important role for decreased nitric oxide,increased endothelin-1,endothelial dysfunction,increased sympathetic outflow,and microvascular rarefaction.Based on the International Cardio Oncology Society(IC-OS),this article provides an interpretation of the diagnosis and management of hypertension related to cancer treatment.Insufficient evidence exists supporting an antihypertensive medication strategy specific to patients with anticancer therapy induced hypertension,therefore,antihypertensive management should follow current guidelines for the general population..Multidisciplinary cooperation is needed to optimize management to ensure the optimal therapeutic effect from cancer treatment while minimizing competing cardiovascular toxicities.

Acute ST-segment elevation myocardial infarction with multivessel disease is one of the high-risk types of coronary heart disease.Early opening of infarct-related artery and reperfusion of myocardium could significantly reduce the mortality in acute phase.However,the presence of non-culprit lesions in non-infarct-related arteries is still at risk and has an important impact on the long-term prognosis of patients.It remains controversial on how to precisely evaluate the clinical significance and revascularization value of non-culprit lesions.This article aims to review the research status and progress of guidance strategies of non-culprit lesion revascularization in patients with ST-segment elevation myocardial infarction and multivessel disease.

Objective:To investigate the relationship between spread through air spaces(STAS) of peripheral stage ⅠA small adenocarcinoma of the lung(≤2 cm) and related factors such as clinical and CT morphological features, and to construct a nomogram model.Methods:Relevant clinical, pathological and imaging data of patients who underwent lung surgery and were diagnosed as peripheral stage ⅠA small lung adenocarcinoma by postoperative pathology in the Affiliated Hospital of Nantong University from 2017 to 2022 were collected, of which cases that met the inclusion criteria from 2017 to 2021 served as the training group, and those that met the inclusion criteria in 2022 served as the validation group. The independent risk factors for the occurrence of STAS in peripheral stage ⅠA lung small adenocarcinoma were investigated by using univariate analysis and multifactorial logistic regression analysis, based on which a nomogram prediction model was constructed, and the subjects were analyzed by using the receiver operating characteristic curve( ROC), correction model, etc. were used to evaluate the model. Results:A total of 430 patients who met the criteria were included, including 351 patients in the training group(109 STAS-positive and 242 STAS-negative) and 79 patients in the validation group(23 STAS-positive and 56 STAS-negative). Univariate analysis showed that the patients in the two groups showed a significant difference in age(>58 years old), gender, smoking history, tumor location(subpleural, non-subpleural), pleural pull, nodule type, nodule maximal diameter, solid component maximal diameter, consolidation tumor ratio(CTR), lobulation sign, burr sign, bronchial truncation sign, vascular sign(includes thickening and distortion of blood vessels in/around the nodes), satellite lesions, and ground-glass band sign were statistically significant( P<0.05). The results of multifactorial logistic regression analysis showed that CTR( OR=4.98, P<0.001), lobulation sign( OR=4.07, P=0.013), burr sign( OR=3.66, P<0.001), and satellite lesions( OR=3.56, P=0.009) were the independent risk factors for the occurrence of STAS. Applying the above factors to construct the nomogram model and validate the model, the results showed that the ROC curve was plotted by the nomogram prediction model, and the area under the ROC curve( AUC) of the training set was 0.840(sensitivity 0.835, specificity 0.734), and the validation set had an AUC value of 0.852(sensitivity 0.786, specificity 0.783), and the training set and validation set calibration curves have good overlap with the ideal curve. Conclusion:CTR, lobular sign, burr sign, and satellite lesions are independent risk factors for STAS, and the nomogram model constructed in this study has good predictive value.

Head and neck tumor is a common malignant tumor with increasing incidence and mortality worldwide. Traditional diagnostic methods for head and neck tumor are limited by the lack of specific biomarkers and the limitation of invasive detection methods, as well as high time cost and a high rate of misdiagnosis. Therefore, research on head and neck tumor diagnosis based on new technologies is needed. Hyperspectral imaging (HSI) is a non-contact optical imaging technique that captures a series of images in multiple spectral bands to generate a hyperspectral image cube. HSI has shown its corresponding potential in the early diagnosis, tumor margin identification and clinical research of head and neck cancer.

As a microbial therapy method, fecal microbiota transplantation (FMT) has attracted the attention of researchers in recent years. As one of the most direct and effective methods to improve gut microbiota, FMT achieves therapeutic benefits by transplanting functional gut microbiota from healthy human feces into the intestines of patients to reconstruct new gut microbiota. FMT has been proven to be an effective treatment for gastrointestinal diseases such as Clostridium difficile infection, irritable bowel syndrome, and inflammatory bowel disease. In addition, the clinical and basic research of FMT outside the gastrointestinal system is also emerging. It is worth noting that there is bidirectional communication between the gut microbial community and the central nervous system (CNS) through the gut-brain axis. Some gut bacteria can synthesize and release neurotransmitters such as glutamate, gamma-aminobutyric acid (GABA) and dopamine. Imbalanced gut microbiota may interfere with the normal levels of these neurotransmitters, thereby affecting brain function. Gut microbiota can also produce metabolites that may cross the blood-brain barrier and affect CNS function. FMT may affect the occurrence and development of CNS and its related diseases by reshaping the gut microbiota of patients through a variety of pathways such as nerves, immunity, and metabolites. This article introduces the development of FMT and the research status of FMT in China, and reviews the basic and clinical research of FMT in neurodegenerative diseases (Alzheimer’s disease, Parkinson’s disease), neurotraumatic diseases (spinal cord injury, traumatic brain injury) and stroke from the characteristics of three types of nervous system diseases, the characteristics of intestinal flora, and the therapeutic effect and mechanism of fecal microbiota transplantation, summarize the common mechanism of fecal microbiota transplantation in the treatment of CNS diseases and the therapeutic targets. We found that the common mechanisms of FMT in the treatment of nervous system diseases may include the following 3 categories through summary and analysis. (1) Gut microbiota metabolites, such as SCFAs, TMAO and LPS. (2) Inflammatory factors and immune inflammatory pathways such as TLR-MyD88 and NF-κB. (3) Neurotransmitter 5-HT. In the process of reviewing the studies, we found the following problems. (1) In basic researches on the relationship between FMT and CNS diseases, there are relatively few studies involving the autonomic nervous system pathway. (2) Clinical trial studies have shown that FMT improves the severity of patients’ symptoms and may be a promising treatment for a variety of neurological diseases. (3) The improvement of clinical efficacy is closely related to the choice of donor, especially emphasizing that FMT from healthy and young donors may be the key to the improvement of neurological diseases. However, there are common challenges in current research on FMT, such as the scientific and rigorous design of FMT clinical trials, including whether antibiotics are used before transplantation or different antibiotics are used, as well as different FMT processes, different donors, different functional analysis methods of gut microbiota, and the duration of FMT effect. Besides, the safety of FMT should be better elucidated, especially weighing the relationship between the therapeutic benefits and potential risks of FMT carefully. It is worth mentioning that the clinical development of FMT even exceeds its basic research. Science and TIME rated FMT as one of the top 10 breakthroughs in the field of biomedicine in 2013. FMT therapy has great potential in the treatment of nervous system diseases, is expected to open up a new situation in the medical field, and may become an innovative weapon in the medical field.

Objective:To analyze the main effect of improving the image quality of digital radiography (DR) high kilovoltage chest radiography in Tianjin, and to provide reference for the implementation of quality control work.Methods:In November 2023, the image quality evaluation results of DR high kilovoltage chest radiographs submitted for approval by Tianjin Occupational Health Inspection Institutions from 2022 to 2023 were analyzed. According to the results of the image quality review in 2022, the outstanding problems, causes and improvement plans were summarized, and the contents of the image quality improvement projects in 2023 were determined. χ 2 test was used to compare the evaluation results of DR high kilovoltage chest radiograph image quality and the differences among various specific evaluation indicators before and after the improvement, and to compare the differences of image quality evaluation results among groups participating in different quality control improvement projects after the improvement. Results:Compared with 2022, after the implementation of the quality control improvement projects in 2023, the rate of level 1 film (excellent film) and level 2 film (good film) of DR high kilovoltage chest radiographs increased by 3.7% and 20.0%, respectively, and the rate of level 4 film (waste film) decreased by 30.0%. After the implementation of the improvement projects, the non-conformity rate and the serious non-conformity rate of 7 indicators were significantly reduced ( P<0.05). The medical institutions participating in the two quality control improvement projects of related training and on-site guidance increased the rate of level 2 film (good film) and decreased the rate of level 4 film (waste film) compared with the medical institutions participating in the one improvement project of related training (χ 2=14.78, P<0.05) . Conclusion:The quality control improvement projects can improve the image quality of Tianjin DR high kilovoltage chest radiography, and the combination of relevant training and on-site guidance may have better improvement effect.

Objective:To analyze the main effect of improving the image quality of digital radiography (DR) high kilovoltage chest radiography in Tianjin, and to provide reference for the implementation of quality control work.Methods:In November 2023, the image quality evaluation results of DR high kilovoltage chest radiographs submitted for approval by Tianjin Occupational Health Inspection Institutions from 2022 to 2023 were analyzed. According to the results of the image quality review in 2022, the outstanding problems, causes and improvement plans were summarized, and the contents of the image quality improvement projects in 2023 were determined. χ 2 test was used to compare the evaluation results of DR high kilovoltage chest radiograph image quality and the differences among various specific evaluation indicators before and after the improvement, and to compare the differences of image quality evaluation results among groups participating in different quality control improvement projects after the improvement. Results:Compared with 2022, after the implementation of the quality control improvement projects in 2023, the rate of level 1 film (excellent film) and level 2 film (good film) of DR high kilovoltage chest radiographs increased by 3.7% and 20.0%, respectively, and the rate of level 4 film (waste film) decreased by 30.0%. After the implementation of the improvement projects, the non-conformity rate and the serious non-conformity rate of 7 indicators were significantly reduced ( P<0.05). The medical institutions participating in the two quality control improvement projects of related training and on-site guidance increased the rate of level 2 film (good film) and decreased the rate of level 4 film (waste film) compared with the medical institutions participating in the one improvement project of related training (χ 2=14.78, P<0.05) . Conclusion:The quality control improvement projects can improve the image quality of Tianjin DR high kilovoltage chest radiography, and the combination of relevant training and on-site guidance may have better improvement effect.

Objective To investigate the effect of PKM2 on the invasive ability of bladder urothelial carcinoma cells by regulating the reactive oxygen species(ROS)-dependent PI3K/Akt signaling pathway.Methods Human bladder cancer T24 cells were divided into the control,si-NC,si-PKM2,and si-PKM2+IGF-1 groups.PKM2mRNA expression,proliferation,invasion and migration,and apoptosis of T24 cells were detected using real-time PCR,CCK-8 assay,Transwell assay,and Hoechst 33342 fluorescence staining and flow cyto-metry,respectively.The ROS level in the cells was measured using ROS fluorescence probe staining.Western blotting was used to detect the expression of PI3K,Akt,mTOR,caspase-3,Bax,and Bcl-2 proteins.Results The expression of PKM2 mRNA in human bladder cancer T24 cells was significantly higher than in normal bladder SV-HUC-1 cells(P<0.05).Compared to the control group,the expres-sion of PKM2mRNA,cell proliferation ability,number of invading cells,p-PI3K/PI3K ratio,p-Akt/Akt ratio,p-mTOR/mTOR ratio,and Bcl-2 protein expression in T24 cells in the si-PKM2 group were significantly decreased(P<0.05),whereas the apoptosis rate,relative ROS level,and expression of Bax and caspase-3 proteins were significantly increased(P<0.05).Compared to the si-PKM2 group,the expression of PKM2mRNA,cell proliferation ability,number of invading cells,p-PI3K/PI3K ratio,p-Akt/Akt ratio,p-mTOR/mTOR ratio,and Bcl-2 protein expression in T24 cells in the si-PKM2+IGF-1 group were significantly increased(P<0.05),whereas the apoptosis rate,relative ROS level,and expression of Bax and caspase-3 proteins were significantly decreased(P<0.05).Conclusion Knockdown of PKM2can increase the level of ROS in bladder urothelial carcinoma cells and inhibit the activation of the PI3K/Akt/mTOR signaling pathway,thus inhibiting cell invasion and promoting cell apoptosis.

Purpose To explore the cardioprotective effect of cang-ai volatile oil(CAVO)on rats with cardiac function impairment model under low-pressure and low-oxygen environment in Tibet Plateau based on 7.0T cardiovascular magnetic resonance(CMR)imaging.Materials and Methods Forty SD rats were randomly divided into the normal group,the high altitude model group,the CAVO-treated group and the rhodiola rosea-treated group,with 10 rats in each group.Except for the normal group,the rats in other groups were transferred from the plain(500 m above sea level)to the Tibet Plateau(4 250 m above sea level)for two months,and then administered with the corresponding drugs by gavage for 14 d.The left ventricle function was measured by using a 7.0T high-field strength CMR and myocardial strain was analysed by using tissue tracing technique.HE staining was used to observe the morphology of cardiomyocytes,Masson staining to observe interstitial fibrosis,wheat germ agglutinin staining to observe cardiomyocyte hypertrophy,and transmission electron microscopy to observe the morphological changes of mitochondria in each group.Serum levels of creatine kinase,creatine kinase isoenzyme,lactate dehydrogenase,cardiac troponin T,superoxide dismutase,malondialdehyde and glutathione peroxidase were detected.Intracellular reactive oxygen species levels were detected using flow cytometry.Results The left ventricular ejection fraction of rats in the CAVO-treated group was higher than that of the high altitude model group[(66.61±1.38)％vs.(60.94±3.21)％;t=3.969,P=0.032];meanwhile,the global circumferential strain of the left ventricle in the CAVO-treated group was higher than that of the high altitude model group(-25.68±1.30 vs.-22.84±1.17;t=3.967,P=0.003).HE,Masson and wheat germ agglutinin staining showed hypertrophy and necrosis as well as interstitial fibrosis and ultrastructural disruption of cardiomyocytes in the high altitude model group,which improved after CAVO treatment.The level of cardiac troponin T in the serum of rats with CAVO treatment group was significantly decreased compared with that of the high altitude model group[(314.03±20.05)pg/ml vs.(518.30±18.13)pg/ml;1=13.090,P=0.001].Conclusion CAVO treatment can reduce cardiac injury caused by low-pressure hypoxia in high altitude,and its effect can be detected dynamically and non-invasively by 7.0T high-field strength CMR.