BACKGROUND:Intestinal acute graft-versus-host disease is one of the most aggressive complications after allogeneic hematopoietic stem cell transplantation with high lethality.How to improve intestinal inflammation and regulate autophagy by applying traditional Chinese medicine in order to treat intestinal acute graft-versus-host disease is a worthwhile research issue nowadays. OBJECTIVE:To investigate the mechanism of Huangqintang modulating intestinal flora for the treatment of intestinal acute graft-versus-host disease. METHODS:CB6F1 mice were irradiated with 60Co X radiation at a total dose of 8 Gy,and then single nucleated cell suspensions(bone marrow cells+splenocytes)from Balb/c H-2d mice were injected into the tail vein in order to prepare a model of intestinal acute graft-versus-host disease.These samples were randomly divided into the model group and the high-,moderate-,and low-dose Huangqintang groups.After modeling,the model,high-,moderate-,and low-dose groups received different doses of Huangqintang or an equal volume of saline by continuous gavage for 14 days.Clinical acute graft-versus-host disease grading,and survival time was recorded.Small intestinal tissues from each group were stained with hematoxylin and eosin for small intestinal mucosal pathology scoring.The intestinal flora of mice in each group was detected using 16S rDNA sequencing.Autophagy-related markers were detected using immunofluorescence,immunohistochemistry,and PCR. RESULTS AND CONCLUSION:(1)Compared with the model group,the survival time of mice was significantly prolonged(P<0.01);the clinical acute graft-versus-host disease scores were significantly reduced(P<0.01);the pathological grading scores of the small intestinal mucosa were significantly diminished(P<0.01);the levels of the small intestinal tissue inflammatory factors tumor necrosis factor-α,interleukin-1β,and interleukin-6,were significantly decreased(P<0.01);the structural integrity of the small intestinal mucosal epithelium was partially restored in mice after the intervention of moderate and high-dose Huangqintang.(2)The study of intestinal flora found that compared with the model group,the pro-inflammatory strain Enterococcus was significantly reduced(P<0.05),while beneficial bacteria such as Clostridium_innocuum and Rhodococcus,a pro-autophagy bacterium,were significantly elevated(P<0.05)in the moderate-dose Huangqintang group.(3)Compared with the model group,the autophagy markers were significantly elevated in the moderate-dose Huangqintang group(P<0.05);under transmission electron microscopy,the number of autophagic vacuoles of moderate-dose Huangqintang group increased significantly.(4)The results showed that Huangqintang significantly reduced the abundance of conditionally pathogenic bacteria and the level of inflammatory factors in small intestinal tissues,and increased the relative abundance of beneficial bacteria and promoted the expression of autophagy in the small intestinal mucosa,which resulted in a significant improvement of intestinal symptoms in mice with acute graft-versus-host disease.

Objective:To explore the correlation between serum nitric oxide synthase (NOS) levels and readmission due to acute exacerbation within 30 days in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:A prospective cohort study was conducted. The AECOPD patients admitted to the First Affiliated Hospital of Hebei North University from January 2020 to December 2022 were enrolled as the research subjects. The general data such as gender, age, body mass index (BMI), chronic obstructive pulmonary disease (COPD) course, smoking history, and basic diseases were collected. The laboratory indicators, serum NOS level [inducible nitric oxide synthase (iNOS), endothelial nitric oxide synthase (eNOS), neuronal nitric oxide synthase (nNOS)] and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score within 24 hours after admission and total length of hospital stay were also collected, and whether patients were readmitted due to acute exacerbation within 30 days after discharge were recorded. The differences in the above clinical indexes between the readmitted and non-readmitted patients within 30 days were compared. Multivariate Logistic regression analysis was used to screen the influencing factors of readmission within 30 days after discharge in AECOPD patients. Receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of various influencing factors on readmission.Results:A total of 168 patients were enrolled, 38 patients were readmitted due to acute aggravation within 30 days after discharge, and 130 were not readmitted. Compared with the non-readmission group, the levels of white blood cell count (WBC), C-reactive protein (CRP), APACHEⅡ score, and serum iNOS and eNOS levels within 24 hours after admission in the readmission group were significantly increased [WBC (×10 9/L): 14.19 (12.88, 16.12) vs. 11.81 (10.63, 14.11), CRP (mg/L): 51.41±12.35 vs. 40.12±7.79, APACHEⅡ score: 22.0 (19.0, 25.0) vs. 18.0 (14.0,20.5), iNOS (μg/L): 5.87±1.36 vs. 4.52±0.89, eNOS (μg/L): 4.40±1.00 vs. 3.51±1.08, all P < 0.01], and the levels of hemoglobin (Hb) and albumin (Alb) were significantly decreased [Hb (g/L): 108.82±22.06 vs. 123.98±24.26, Alb (g/L): 30.28±3.27 vs. 33.68±2.76, both P < 0.01]. There were no significant differences in gender, age, BMI, COPD course, smoking history, basic diseases, total length of hospital stay and serum nNOS level between the two groups. Multivariate Logistic regression analysis showed that CRP [odds ratio ( OR) = 1.201, 95% confidence interval (95% CI) was 1.075-1.341], APACHEⅡ score ( OR = 1.335, 95% CI was 1.120-1.590), and serum iNOS ( OR = 5.496, 95% CI was 2.143-14.095) and eNOS ( OR = 3.366, 95% CI was 1.272-8.090) were the independent risk factors for readmission within 30 days after discharge in AECOPD patients (all P < 0.05), and Hb ( OR = 0.965, 95% CI was 0.933-0.997) and Alb ( OR = 0.551, 95% CI was 0.380-0.799) were protective factors (both P < 0.05). ROC curve analysis showed that serum iNOS and eNOS levels had predictive value for readmission within 30 days after discharge in AECOPD patients, and the area under the ROC curve (AUC) was 0.791 (95% CI was 0.694-0.887) and 0.742 (95% CI was 0.660-0.823), respectively. When the optimal cut-off value was 5.22 μg/L and 3.82 μg/L, the sensitivity was 81.54% and 69.23%, and the specificity was 71.05% and 81.58%, respectively. The AUC of serum iNOS and eNOS levels combined with Hb, Alb, CRP and APACHEⅡ score for predicting the readmission was 0.979 (95% CI was 0.958-1.000), the sensitivity was 91.54%, and the specificity was 97.37%. Conclusions:The increased serum iNOS and eNOS levels of AECOPD patients correlate with the readmission due to acute exacerbation within 30 days after discharge. Combined detection of Hb, Alb, CRP, serum iNOS and eNOS levels, and evaluation of APACHEⅡ score within 24 hours after admission can effectively predict readmission.

Objective:To comprehensively collect the clinical research evidence of Wuqinxi, and provide reference for the future clinical research.Methods:China National Knowledge Infrastructure (CNKI), WanFang Database, VIP, China Biology Medicine disc (CBM), PubMed, Embase, Cochrane Library, and Web of Science were searched. The retrieval time limit was from the establishment of each database to March 31, 2021. After screening and extracting, SPSS 22.0 was used to analyze the basic characteristics, sample size, control and intervention measures, outcomes.Results:Totally 230 studies were included, of which 58.26% (134/230) were randomized controlled trial. The top 6 diseases were chronic obstructive pulmonary disease, osteoporosis, cervical pain, low back pain, diabetes and knee osteoarthritis. Common outcome included four items of blood lipid tests, blood glucose, immunological indicators and the evaluation of disease-related symptoms, such as pain, sleep and range of motion. The median frequency of Wuqinxi was once a day, 45 minutes each time, 5 days a week and lasted for 3 months. 94.78% (218/230) of the studies reported positive results. The safety and compliance of Wuqinxi intervention were good.Conclusions:The number of clinical studies on Wuqinxi is significantly less than Baduanjin and Taijiquan. It is necessary to formulate the report specification of intervention measures for Wuqinxi, so as to report the intervention plan of Wuqinxi more clearly and transparently.

Objective:To research the clinical effect of early comprehensive intervention for physical and intelligence development of premature infant (test-tube baby).Methods:One hundred and eleven premature infant in Dalian Municipal Women and Children′s Medical Center from June 2016 to June 2018 were enrolled. Study group (57 cases) received comprehensive intervention including health education, exercise training, nutrition guidance and rehabilitation therapy, and control group (54 cases) received health education. The weight, height, head circumference and CDCC score of two groups were analyzed in 3, 6 and 12 month.Results:Physical development: the weight [3 month: (4.72 ± 0.19) kg vs. (4.34 ± 0.29) kg; 6 month: (6.49 ± 0.37) kg vs. (6.25 ± 0.41) kg; 12 month: (9.58 ± 1.15) kg vs. (8.76 ± 0.92) kg] and height [3 month: (59.63 ± 5.51) cm vs. (56.29 ± 5.86) cm; 6 month: (65.09 ± 5.94) cm vs. (62.36 ± 6.20) cm] in 3, 6 and 12 month, and head circumference in 3 and 6 month [3 month: (37.71 ± 1.77) cm vs. (35.90 ± 1.48) cm; 6 month: (43.18 ± 1.96) cm vs. (41.82 ± 2.61) cm] of study group were higher than those in control group, and all difference had statistical significant ( P<0.05). Intelligence development: the MDI [3 month: (84.49 ± 9.78) scores vs. (80.58 ± 10.40) scores; 6 month: (89.65 ± 13.21) scores vs. (83.24 ± 17.66) scores; 12 month: (96.03 ± 15.43) scores vs. (89.71 ± 17.85) scores] and PDI score of study group was higher than that in control group in 3, 6 and 12 month [3 month: (82.68 ± 5.35) scores vs. (79.43 ± 7.21) scores; 6 month: (86.34 ± 8.33) scores vs. (82.51 ± 9.67) scores; 12 month: (94.86 ± 10.27) scores vs. (90.32 ± 11.65) scores] ( P<0.05). Conclusions:Early comprehensive intervention has a good clinical efficacy for physical and intelligence development of premature infant (test-tube baby) and is worthy of popularizing and applying.

Objective:To carry out content analysis of clinical practice guideline recommendations related to physical activity in survivors of colorectal cancer at home and abroad so as to provide a reference for formulating a standardized and personalized physical activity plan for survivors of colorectal cancer.Methods:Clinical practice guidelines related to physical activity in survivors of colorectal cancer were retrieved in Chinese-English databases, guideline websites and professional society websites by computer from 1st, January 2009 to 1st, July 2019. Guideline recommendations were extracted, translated, classified and analyzed on content with the method of content analysis.Results:A total of 7 clinical practice guidelines were included and 26 recommendations on physical activity of survivors of colorectal cancer were extracted. A total of 8-item content on physical activity were analyzed including the safety and benefits of physical activity, assessment before physical activity, amount of physical activity, way of physical activity, intensity, frequency and duration of physical activity, attention of physical activity, contraindications of physical activity and incremental strategy of physical activity.Conclusions:There are many recommendations on the way, amount, frequency, intensity and attention of physical activity. There are inconsistencies between recommendation mentioned frequency and clinical importance, and consistencies between partial recommendations and domestic practice content, and the recom mendations are more diversified than domestic practice content. We should carry out localization for the high level of foreign guideline to explore the evidences suitable for physical activity in survivors of colorectal cancer in China.

Objective To investigate the application value of single detection and combined detection of 4 kinds of inflammatory indicators of procalcitonin (PCT ) ,high sensitivity C-reactive protein(hs-CRP) ,interleu-kin-6(IL-6) and white blood cell(WBC) in diagnosing type 2 diabetes mellitus(T2DM) bloodstream by analy-zing the levels of peripheral blood PCT ,hs-CRP ,IL-6 and WBC in the T2DM bloodstream infection group and T2DM non-bloodstream infection group .Methods The clinical data in 85 patients with T2DM bloodstream in-fection (T2DM bloodstream infection group ) and contemporaneous 80 cases of T2DM non-bloodstream infec-tion(T2DM non-bloodstream infection group) in this hospital from January 2013 to July 2016 were retrospec-tively analyzed .The levels of various inflammatory indicators in peripheral blood were analyzed .The receiver operating characteristic(ROC) curve of various inflammatory indicators was drawn ,the area under the curve (AUC) and the best cut-off value were calculated .The detection schemes included 24 kinds of schemes such as the single indicator ,2-indicator ,3-indicator and 4-indicator .Results The levels of PCT ,hs-CRP ,IL-6 and WBC in the T2DM bloodstream infection group were significantly higher than those in the T 2DM non-blood-stream infection group ,the difference was statistically significant (P<0 .05) .AUC of PCT ,hs-CRP ,IL-6 and WBC were 0 .909 ,0 .818 ,0 .838 and 0 .760 respectively ,with best cut-off values of 0 .493 ng/mL ,11 .19 ng/mL ,40 .95 pg/mL and 11 .87 × 109/L respectively .The Youden index of PCT was highest (0 .65) and the ac-curacy of IL-6 was highest (83 .33％ ) in the single indicator detection scheme .The Youden index and accuracy of the scheme of PCT/hs-CRP and PCT+hs-CRP+IL-6 were highest in the combined detection scheme .Con-clusion PCT detection has the prominent value in the assisted diagnosis of T 2DM bloodstream infection .Inthe combined detection scheme ,PCT/hs-CRP and PCT+hs-CRP+IL-6 have the highest value in the assisted diagnosis in T2DM bloodstream infection .

Objective To establish and evaluate a method for determination of total arsenic in urine by test-tube rapid digestion hydride generation atomic fluorescence spectrometry.Methods After digestion of urine samples using graduated test-tube and graphite digestion apparatus,arsenic content in urine was determined with atomic fluorescence spectrometer.Then the test results were evaluated by using quality control measures,such as precision and accuracy experiments,and the results between different laboratories were reviewed and compared.Results The urinary arsenic was in a linear range of 0-0.300 mg/L,correlation coefficient (r) ＞ 0.999 3,detection limit was 0.000 21 mg/L,relative standard deviation (RSD) ≤4.62％ and the recoveries of standard addition were 93.9％-104.3％.The value of standard reference material measured was within the allowable range.The blind sample of the national urinary arsenic was qualified.Conclusions This method is suitable for large scale determination of urinary arsenic for its micro sample amount needed,less interference and strong practicability.The error results are in a controlled range.

Objective To investigate the status on children of 3-14 years old who suffered from cerebral palsy in Liaoning province. Methods One thousand three hundred and twenty-three cases of children with cerebral palsy of 3-14 years old who received rehabilitation in city hospital, county hospital and community hospital were investigated from January 2013 to October 2016 in 14 cities in Liaoning Province. The proportion of cerebral palsy children in 3-4 years old, 4-5 years old, 8-9 years old, 5-6 years old , 6-7 years old and 7-8 years old was about 10%, and in the other age the proportion was about 7%. The proportion of men and women generally was 4:1;neonatal convulsion (252 cases, 19%), premature delivery (230 cases , 17.3%) and low birth weight infant (187 cases, 14.1%) were main risk factors and accounted for more than 10%. Spastic type cerebral palsy accounted for the highest proportion (54.35%, 719 cases)and ataxia cerebral palsy accounted for the lowest proportion (2.95%). In complications , lower intelligence accounted for the highest proportion (50.34%, 666 cases), followed by the language barrier (43.99% , 582 cases), and the other complications accounted for less than 10%.;gross motor function classification in most studied children was stageⅡ(35%) and stageⅢ(32.50%); 6.95% patients could go to school, and 84.96% patients had health insurance. Patients coming from city accounted for 69.01%, and patients coming from rural area accounted for 30.99%. Mothers′ education below primary school was 4.16% . 36.05% children received rehabilitation in comprehensive hospital, 60.09%in children′s hospital and 3.85%in maternal and child health hospital. Conclusions Spastic cerebral palsy is the main type of children with cerebral palsy in Liaoning.High risk factors include neonatal convulsions, premature birth and low birth weight infants. Most patients complicate with low intelligence and language barriers.This paper can be used as the basis of further research on prevention and treatment

OBJECTIVETo compare the efficacy differences between manual acupuncture (MA) and electroacupuncture (EA) in the treatment of hemiplegia after acute ischemic stroke.

METHODSSixty-eight patients of hemiplegia after acute ischemic stroke were randomized into a MA group (34 cases) and an EA group (34 cases). The routine western medication and bilateral Dingnieqianxiexian (MS 6) were adopted in the two groups. The needles were retained for 30 min. In the MA group, the even-needling technique was used for 3 times during the needle retaining, 1 min each time. In the EA group, on the basis of manual stimulation, EA therapy was added, with disperse-dense wave, 5 Hz/20 Hz. The treatment was given once every day, 6 treatments a week, totally for 2 weeks. US National Institutes of Health stroke scale (NIHSS) score, the simplified Fugl-Meyer motor function (FMA) score and Barthel index (BI) were observed before and after treatment in the two groups. The clinical efficacy was compared between the two groups.

RESULTSNIHSS score was reduced apparently after treatment in the two groups (both<0.01). The score in the EA group was lower than that in the MA group (<0.05). After treatment, FMA score and BI score were all increased apparently in the two groups (all<0.01) and the scores in the EA group were higher than those in the MA group (both<0.01). The total effective rate was 94.1% (32/34) in the EA group and was 85.3% (29/34) in the MA group. The efficacy in the EA group was better than that in the MA group (<0.05).

CONCLUSIONSEA acts on the rehabilitative effect on nerve defect function in the patients of hemiplegia after acute ischemic stroke. It improves limb motor function and the ability ofdaily life activity. The efficacy is better than that of MA.

Objective To observe the effect of partial body weight support training (PBWST) on walking ability of cerebral palsy (CP) children with spasticity diplegia.Methods 60 CP children with spasticity dilegia were randomly divided into the PBWST group and control group with 30 cases in each group. All cases were treated by traditional physical treatment, but those of the PBWST group were added with PBWST. The changes of walking ability and endurance of all cases before and after treatment were observed.Results After treatment, the walking ability and endurance of the cases in two groups improved significantly, but the effect of the PBWST group was obviously superior to the control group ( P<0.05), especially in walking endurance ( P<0.001).Conclusion PBWST can improve the walking ability of CP children with spasticity diplegia and already having walking ability.