OBJECTIVE To investigate the effect of pharyngeal cavity and genoglossus muscle exercises in patients with mild obstructive sleep apnea syndrome(OSAHS)left over after palatopharyngoplasty with diastolic cardiac dysfunction.METHODS A total of 75 patients with mild OSAHS left after palatopharyngoplasty with diastolic cardiac dysfunction from January 2021 to August 2023 were selected for retrospective study.Among them,37 patients underwent pharyngeal cavity and mentoglossum muscle exercise(observation group),while 38 patients did not(control group).Using postoperative data as baseline value.mean blood oxygen saturation(MSpO2),lowest oxygen saturation(LSpO2),sleep efficiency,apnea index(AI),sleep latency,apnea hypopnea index(AHI),hypopnea index(HI),microarousal index(MAI),rapid eye movement latency,arterial blood pressure of carbon dioxide(PaCO2),pH,arterial partial oxygen pressure(PaO2),left ventricular end-systolic diameter(LVDs),blood lactic acid,left ventricular ejection fraction(LVEF),Tei index,left ventricular end-diastolic diameter(LVDd),daytime Epworth sleepiness scale(ESS)score,Pittsburgh sleep quality index(PSQI)score and incidence of adverse cardiovascular events(MACE)were compared at baseline and 3 months later.RESULTS After 3 months,AHI,HI and AI in observation group were lower than those in control group,and MSpO2 and LSpO2 were higher than those in control group(P<0.05);Sleep efficiency of observation group was higher than control group,daytime ESS score,PSQI score and MAI were lower than control group(P<0.05).There were no significant differences in PaCO2,LVDd,PaO2,blood lactic acid,sleep latency,pH,LVEF,rapid eye movement latency,LVDd,Tei index between the observation group and the control group(P>0.05).The incidence of MACE in the observation group was 5.41%(2/37),compared with 13.16%(5/38)in the control group,there was no significant difference(P>0.05).CONCLUSION In patients with mild OSAHS left after palatopharyngoplasty with diastolic cardiac dysfunction,the exercise of pharyngeal cavity and genoglossus can improve hypopnea,alleviate clinical symptoms and improve sleep quality,but it has limited effect on the improvement of cardiac function.

Digestive tract diseases， especially digestive tract tumors， including liver cancer， pancreatic cancer， and colorectal cancer， have high incidence in China. Digestive tract tumor is one of the top 10 cancers in terms of the number of new cases and deaths in the world， and the incidence and mortality of tumor diseases have been increasing year by year. Therefore， the prevention and treatment of tumors is particularly important. With the application and promotion of traditional Chinese medicine in the medical field and the rapid development of molecular biology and pharmacology， more and more potential active components of Chinese medicinal materials have been extracted and studied. These active components can inhibit tumor cells in a multi-target and multi-pathway manner. Cinobufotalin is an effective component extracted from the skin of Bufo bufo gargarizans. It has been prepared into a variety of agents with anti-tumor， immunomodulatory， cardiac boosting， pain-easing， anti-inflammatory， and swelling-relieving activities. In clinical practice， cinobufotalin is mainly used to assist the treatment of liver cancer， lung cancer， colorectal cancer， gastric cancer and other malignant tumors， which can reduce the adverse reactions of patients in the middle and late stages and improve the quality of life and five-year survival rate of patients. The available studies of molecular mechanism have demonstrated that cinobufotalin can play a therapeutic role by inducing cell apoptosis， regulating cell cycle， inhibiting cell proliferation and angiogenesis， modulating immune response， reversing multidrug resistance， enhancing radiochemotherapy sensitivity， inhibiting tumor inflammation， invasion， and metastasis， etc. This review focuses on the clinical application and mechanism of cinobufotalin against digestive tract tumors in recent years， aiming to provide a theoretical basis for the anti-tumor research of cinobufotalin， promote the application of cinobufotalin in tumor treatment， and facilitate the further research and development of this compound.

TAM(tumor-associated macrophage)is a kind of immune cell in tumor microenvironment,which mainly exists in tumor matrix to mediate inflammatory reaction.Generally,TAM can be stimulated by different cytokines to polarize into M1 macrophage or M2 macrophage with different phenotypes.In the early stage of tumor,M1 macrophages in TAM exhibit pro-inflammatory and anti-tumor activities,while as tumor progresses,TAMs tend to polarize into M2 macrophages to play anti-inflammatory and tumor-promoting roles.A large number of studies have shown that TAM is closely related to tumor growth,invasion,metastasis and poor prognosis.Therefore,targeting TAM has become the focus of anti-tumor immunotherapy.This paper has summarized the origin of TAM,and introduced the specific roles of TAM in promoting tumor proliferation,angiogenesis,migration and invasion and the formation of immunosuppressive environment.At the same time,the research progress of TAM-targeted anti-tumor immu-notherapy in recent years was discussed from 3 aspects:inhibiting monocyte recruitment,promoting TAM apoptosis and reshaping TAM phenotype.

Objective To evaluate the efficacy of precision therapy with direct-acting antiviral drugs (DAAs) for patients with chronic HCV gene type 1b infection.Methods One hundred and thirteen patients with chronic HCV genotype 1b infection admitted in the Department of Infectious Diseases of First Hospital of Shanxi Medical University from January 2018 to July 2019 were enrolled,including 89 patients with chronic hepatitis and 24 patients with cirrhosis.Different DAAs therapeutic schedule were taken based on liver function, kidney function, complication and treatment costs.Seventy-two patients were treated with pan-genotype drugs, including 43 patients treated with Sofosbuvir and Velpatasvir (SOF+VEL), 13 treated with Sofosbuvir and Ribavirin ( SOF +RBV), and 16 treated with Sofosbuvir and Daclatasvir ( SOF +DCV).Forty one patients were treated with specific genotype DAAs , including 15 treated with Ombitasvir and Dasabuvir (OBV+DSV), and 26 treated with Elbasvir and Grazoprevir tablets (EBR+GZR).Pair t test and Chi-square test were used to compare virological response rate , the liver function and the adverse reactions were observed.Results The super-rapid virological response (SRVR) rate with DAAs treatment at 1 week was 88.5%(100／113),and the rapid virological response ( RVR) at 4 weeks of treatment was 98.2%(111／113).There was no significant differences in SRVR and RVR among the patients treated with five treatment regimens (χ2 ＝5.95 and 1.04,P＞0.05), all the patients obtained complete early virological response (CEVR) at 12 weeks and sustained virological response ( SVR12) at 12 weeks after treatment. Besides, there were no significant differences in SRVR and RVR between pan-genotype and gene-specific drugs (χ2 ＝0.03 and 0.17, P＞0.05),both CEVR and SVR12 reached 100% in all patients.The liver transaminase levels were improved in patients undergoing pan-genotype or gene-specific drugs treatment. Mild adverse reactions were observed in 5 cases, hemolysis occurred in 1 patient and it was cured after replacement of drugs.Conclusion Both pan-genotype and specific genotypes of DAAs can achieve high virological response rates.Genotypic testing should be performed before antiviral therapy , in order to accurately select treatment options and to save costs.

Objective To explore how to optimize management process of pressure injury for surgery patients by applying information system.Methods We built an integrated surgery patients pressure injury management information system based on chain-type process along with controlling key links and realizing monitoring in a whole process and many links for surgery patients from be hospitalized to leave hospital.This research took the surgery patients pressure injury chain-type process as a breakthrough and selected 1240 patients as subjects in experimental operating room.A total of 578 patients were in control group in May 2016 before implementing information system and 662 patients were in observation group in May 2017 after implementing information system.We compared the qualified rate of pressure injury assessment,accuracy rate of screen for patients with high-risk pressure injury and being with pressure injury,accordance rate of description in skin condition during transportation and handover,the incidence of pressure injury in hospital and surgery patients in the first stage,the second stage and above.Results The qualified rate of pressure injury assessment,accuracy rate of screen for patients with high-risk pressure injury,accordance rate of description in skin condition during transportation and handover of observation group was 99.24％,100％and 100.00％significantly higher than those of control group(P< 0.05).The incidence of pressure injury in hospital and in the first stage of surgery patients was 2.95％and 2.65％in observation group with significant differences compared with those in control group(6.51％,5.82％)(P< 0.05).Conclusions The integrated surgery patients pressure injury management information system based on chain-type process realizes a full,continuous,accurate,dynamic evaluation and monitoring for patients' skin.It can effectively improve the nursing quality of pressure injury and is convenientfor managers to carry out a continuous improvement.

Objective:To study the effect of Qingyi Lidan Granule on the serum levels of high mobility group box 1 (HMGB 1),heat shock protein 70 (HSP70),heat shock protein 27 (HSP27) and interleukin-8 (IL-8) of patients with severe acute pancreatitis.Methods:From August 2015 to July 2016,84 patients with severe acute pancreatitis in our hospital were selected and randomly divided into the observation group and the control group according to random number,42 cases in each group.The control group was given routine treatment,and the observation group was treated by Qingyi Lidan Granule on the basis of control group.The recovery of blood amylase to normal time,white blood cell recovery to normal time,recovery of gastrointestinal function to normal time and relieving time of abdominal pain,serum levels of HMGB1,HSP70,HSP72 and IL-8 in both groups were observed and compared before and after treatment.Results:After treatment,the total clinical effective rate of observation group was significantly higher than that of the control group[92.86％ (39/42) vs 71.43％ (30/42)] (P＜0.05).The recovery of blood amylase to normal time,white blood cell recovery to normal time,recovery of gastrointestinal function to normal time and relieving time of abdominal pain in the observation group were significantly shorter than those of the control group (P ＜0.05).Before treatment,no significant difference was found in the serum levels of HMGB 1,HSP70,HSP72,IL-8 between groups (P＞0.05).After treatment,the serum levels ofHMGB1,HSP70,HSP72 and IL-8 in both groups were significantly lower than those before treatment (P＜0.05).The levels ofHMGB1,HSP70,HSP72 and IL-8 in the observation group were lower than those in the control group (P＜0.05).Conclusion:Qingyi Lidan Granule could effectively reduce the levels of serum HMGB 1,H SP70,HSP27 and IL-8 and enhance the clinical curative effect of patients with severe acute pancreatitis.

Objective: To investigate the effect of polycyclic aromatic hydrocarbons (PAHs) exposure on the level of histone H3Ser10 phosphorylation (p-H3S10) and DNA damage degree in peripheral blood lymphocyte (PBLCs). Method: 75 coke oven workers from Benxi steel plant in Liaoning Province of China (PAHs-exposed group) and local 50 hot rolling workers (control group) were recruited in this study with age, working years, labor intensity and high temperature for matching factors using cluster sampling method in 2014. HPLC-fluorescence was performed to determine the level of urinary 1-hydroxypyrene (1-OHP), DNA damage and specific histone modification were measured in PBLCs of the subjects through comet assay and ELISA assay, respectively. Linear regression model analysis was used to analyze the differences among PAHs exposure, DNA damage and p-H3S10 level in two groups. The Mediation analysis was used to analyze the regulated relationships between urinary 1-OHP, DNA damage and histone modification through the bootstrap method. Results: Age of the control and the exposed group were (45.32±8.32) and (43.87±5.67) years old (P=0.284). The concentration of urinary 1-OHP, OTM value, Tail DNA% and p-H3S10 level in exposure group were higher than that in control group, while the M (P₅-P₉₅) of p-H3S10 levels in control and exposed group were 2.21 (0.68-4.71), 4.54 (1.85-23.91) (P<0.001). The degree p-H3S10 level was increased after the subgroups which were (2.59±1.19)%, (3.24±2.81)%, (5.55±3.25)%, (8.77±7.84)%, respectively, divided by quantitated 1-OHP concentration as P₀-P₂₅, P₂₆-P₅₀, P₅₁-P₇₅ and P₇₆-P₁₀₀ (P<0.001). We also found the correlations between urinary 1-OHP and p-H3S10 level or OTM value or Tail DNA%, β (95%CI) were 0.264 (0.167-0.360), 0.500 (0.299-0.702), and 0.510 (0.384-0.671), respectively (P<0.001). Similar result was also observed between p-H3S10 level and OTM value or Tail DNA%, β (95%CI) were 0.149 (0.073-0.226) and 0.220 (0.132-0.308) (P<0.001). Moreover, the mediation effect value of DNA damage on PAHs induced p-H3S10 alteration was 0.054(P=0.040). Conclusion The results suggested that PAHs exposure could induce DNA damage and an increase in histone H3Ser10 phosphorylation in PBLCs. Particularly, the alteration of H3S10 phosphorylation may play an important role in regulating cell DNA damage repair.

Objective To investigate the effect of polycyclic aromatic hydrocarbons (PAHs) exposure on the level of histone H3Ser10 phosphorylation (p-H3S10) and DNA damage degree in peripheral blood lymphocyte (PBLCs). Method 75 coke oven workers from Benxi steel plant in Liaoning Province of China (PAHs-exposed group) and local 50 hot rolling workers (control group) were recruited in this study with age, working years, labor intensity and high temperature for matching factors using cluster sampling method in 2014. HPLC-fluorescence was performed to determine the level of urinary 1-hydroxypyrene (1-OHP), DNA damage and specific histone modification were measured in PBLCs of the subjects through comet assay and ELISA assay, respectively. Linear regression model analysis was used to analyze the differences among PAHs exposure, DNA damage and p-H3S10 level in two groups. The Mediation analysis was used to analyze the regulated relationships between urinary 1-OHP, DNA damage and histone modification through the bootstrap method. Results Age of the control and the exposed group were (45.32± 8.32) and (43.87 ± 5.67) years old (P=0.284). The concentration of urinary 1-OHP, OTM value, Tail DNA%and p-H3S10 level in exposure group were higher than that in control group,while the M (P5-P95) of p-H3S10 levels in control and exposed group were 2.21 (0.68-4.71), 4.54 (1.85-23.91) (P<0.001). The degree p-H3S10 level was increased after the subgroups which were (2.59 ± 1.19)%, (3.24 ± 2.81)%, (5.55 ± 3.25)%, (8.77 ± 7.84)%, respectively, divided by quantitated 1-OHP concentration as P0-P25, P26-P50, P51-P75 and P76-P100 (P<0.001). We also found the correlations between urinary 1-OHP and p-H3S10 level or OTM value or Tail DNA%, β (95%CI) were 0.264 (0.167-0.360), 0.500 (0.299-0.702), and 0.510 (0.384-0.671), respectively (P<0.001). Similar result was also observed between p-H3S10 level and OTM value or Tail DNA%, β (95%CI) were 0.149 (0.073-0.226) and 0.220 (0.132-0.308) (P<0.001). Moreover, the mediation effect value of DNA damage on PAHs induced p-H3S10 alteration was 0.054(P=0.040). Conclusion The results suggested that PAHs exposure could induce DNA damage and an increase in histone H3Ser10 phosphorylation in PBLCs. Particularly, the alteration of H3S10 phosphorylation may play an important role in regulating cell DNA damage repair.

Objective To investigate the effect of polycyclic aromatic hydrocarbons (PAHs) exposure on the level of histone H3Ser10 phosphorylation (p-H3S10) and DNA damage degree in peripheral blood lymphocyte (PBLCs). Method 75 coke oven workers from Benxi steel plant in Liaoning Province of China (PAHs-exposed group) and local 50 hot rolling workers (control group) were recruited in this study with age, working years, labor intensity and high temperature for matching factors using cluster sampling method in 2014. HPLC-fluorescence was performed to determine the level of urinary 1-hydroxypyrene (1-OHP), DNA damage and specific histone modification were measured in PBLCs of the subjects through comet assay and ELISA assay, respectively. Linear regression model analysis was used to analyze the differences among PAHs exposure, DNA damage and p-H3S10 level in two groups. The Mediation analysis was used to analyze the regulated relationships between urinary 1-OHP, DNA damage and histone modification through the bootstrap method. Results Age of the control and the exposed group were (45.32± 8.32) and (43.87 ± 5.67) years old (P=0.284). The concentration of urinary 1-OHP, OTM value, Tail DNA%and p-H3S10 level in exposure group were higher than that in control group,while the M (P5-P95) of p-H3S10 levels in control and exposed group were 2.21 (0.68-4.71), 4.54 (1.85-23.91) (P<0.001). The degree p-H3S10 level was increased after the subgroups which were (2.59 ± 1.19)%, (3.24 ± 2.81)%, (5.55 ± 3.25)%, (8.77 ± 7.84)%, respectively, divided by quantitated 1-OHP concentration as P0-P25, P26-P50, P51-P75 and P76-P100 (P<0.001). We also found the correlations between urinary 1-OHP and p-H3S10 level or OTM value or Tail DNA%, β (95%CI) were 0.264 (0.167-0.360), 0.500 (0.299-0.702), and 0.510 (0.384-0.671), respectively (P<0.001). Similar result was also observed between p-H3S10 level and OTM value or Tail DNA%, β (95%CI) were 0.149 (0.073-0.226) and 0.220 (0.132-0.308) (P<0.001). Moreover, the mediation effect value of DNA damage on PAHs induced p-H3S10 alteration was 0.054(P=0.040). Conclusion The results suggested that PAHs exposure could induce DNA damage and an increase in histone H3Ser10 phosphorylation in PBLCs. Particularly, the alteration of H3S10 phosphorylation may play an important role in regulating cell DNA damage repair.

Objective To establish a diarrhea rat model using multiple-stimulating factors and choosing the best indexes to assess whether the model is consistent with the disease characteristics of liver -QI stagnation with spleen deficien-cy in traditional Chinese medicine .Methods Newborn SD rats were randomly divided into model group ( n=20 ) and control group (n=10).The rats of model group were stimulated by maternal separation , restraint stress and rectum acetic acid irritation, while the rats in control group were fed as normal .Weight changes, rectal sensitivity, Bristol scores and wa-ter content of feces and histology of the colon tissues were used as evaluation indexes to assess whether the model meets the demands for further studies .Results The rats in the model group showed loss of appetite , increase of water intake and u-rine reduction .Some rats showed increased activity , and even mania .Bristol scores and water content of feces were signifi-cantly higher than that of the control group , and the rectal sensitivity was significantly increased .The colon mucosa showed slightly thickened submucosal layer and mild inflammatory cell infiltration in the model rats .Conclusions The rat model established in this study is better to simulate the clinical manifestation of liver -QI stagnation with spleen deficiency in Chi-nese medicine , and may meet the demands of related researches of this disease .