ObjectiveTo evaluate the effectiveness and safety of Sufei Pingchuan Formula （肃肺平喘方） in the treatment of bronchiectasis with airflow limitation， phlegm-heat obstructing the lung， and lung-spleen qi deficiency syndrome. MethodsA randomized， double-blind， placebo-controlled trial was conducted. A total of 72 patients with stable bronchiectasis with airflow limitation of phlegm-heat obstructing the lung and lung-spleen qi deficiency syndrome were randomly divided into treatment group and control group， with 36 cases in each group. On the basis of regular inhalation of tiotropium bromide inhalation spray， the treatment group was given Sufei Pingchuan Formula granules， and the control group was given Sufei Pingchuan Formula granule simulant. The course of treatment in both groups was 12 weeks. The pulmonary function of both groups before and after treatment was observed， specifically focusing on forced expiratory volume in one second （FEV1）； the modified British Medical Research Council （mMRC） dyspnea scale， 24-hour sputum volume， COPD assessment test （CAT）， and traditional Chinese medicine （TCM） syndrome scores were assessed before treatment and after 4， 8， and 12 weeks of treatment； acute exacerbations were recorded at weeks 4， 8， and 12； additionally， changes in routine blood tests， urinalysis， liver and kidney function， and adverse events were monitored before and after treatment. ResultsAfter treatment， 4 patients in the treatment group and 6 in the control group dropped out. After 12 weeks of treatment， FEV1 increased in both groups compared to pre-treatment levels （P＜0.05）， but the difference between groups was not statistically significant （P＞0.05）. Compared to before treatment， the treatment group showed a reduction in mMRC scores after 12 weeks （P＜0.05） and a decrease in 24-hour sputum volume， CAT scores， and TCM syndrome scores at weeks 4， 8， and 12 （P＜0.05）. In the control group， 24-hour sputum volume decreased after 12 weeks （P＜0.05）， and TCM syndrome scores decreased at weeks 8 and 12 （P＜0.05）. Compared to the control group， the treatment group showed a greater reduction in mMRC scores at week 12 （P＜0.05）， a decrease in 24-hour sputum volume and TCM syndrome scores at weeks 4， 8， and 12 （P＜0.05）， and lower CAT scores at weeks 8 and 12 （P＜0.05）. The frequency and number of acute exacerbations in the treatment group were significantly lower than those in the control group at week 12 （P＜0.05）. No severe adverse events occurred in either group. ConclusionSufei Pingchuan Formula can improve the pulmonary function FEV1， the severity of dyspnea， reduce 24-hour sputum volume and frequent acute exacerbations， and improve the quality of life in patients with bronchiectasis and airflow limitation， with good safety.

Shengma Gegentang is one of the classic formulas in the Catalogue of Ancient Classic Prescriptions （Second Batch）. This study reviewed ancient and modern literature and used literature tracing and bibliometric methods to analyze the historical evolution， efficacy， indications， dosage decoctions， and modern clinical disease spectrum of Shengma Gegentang. The results indicated that the earliest record of Shengma Gegentang can be found in the Taiping Huimin Heji Jufang of the Song dynasty， but its origin can be traced back to the Shaoyao Siwu Jiejitang in the Beiji Qianjin Yaofang of the Tang dynasty. The composition dosage of Shengma Gegentang is 413 g of Cimicifugae Rhizoma， 619.5 g of Puerariae Lobatae Radix， 413 g of Paeoniae Radix Alba， and 413 g of Glycyrrhizae Radix et Rhizoma， which are ground into coarse powder. Each dose is 12.39 g， and the amount of water added is 300 mL. 100 mL of solution is decocted and taken at the right time. The four drugs in the formula play the role of relieving exterior syndrome， penetrating pathogenic factors， and detoxicating together. Its indications are widely involved in internal medicine， pediatrics， surgery， ophthalmology and otorhinolaryngology， obstetrics and gynecology， sexually transmitted diseases， and other diseases， such as measles， sores， acne， spots， surgical gangrene， red eyes， toothache， chancre， and fetal poison. The epidemic diseases treated by Shengma Gegentang are complicated， including rash， pox， macula， numbness， summer diarrhea， dysentery， sha disease， febrile symptoms， spring warmth， winter warmth， and cold pestilence. At the same time， it is a plague prevention formula. Although Shengma Gegentang has a wide range of indications， it cannot be separated from the pathogenic mechanism of evil Qi blocking the muscle surface and heat in the lungs and stomach. The modern clinical disease spectrum of Shengma Gegentang involves the ophthalmology and otorhinolaryngology system， nervous system， pediatric-related diseases and syndromes， skin system， hepatobiliary system， and digestive system. It plays a key role in the treatment of epidemic diseases such as measles， chronic hepatitis B， dysentery， and tetanus.

Objective:To examine the impact of Developmental Human Resource Management Practices(D-HRMPs)on innova-tive performance of health professionals from the public hospitals.Methods:A questionnaire survey was conducted to collect data from health professionals in the public hospitals in Beijing,including D-HRMPs scale,innovation performance scale,inclusive lead-ership scale and team innovation atmosphere scale.Descriptive statistics and structural equation model were used for the analysis.Results:D-HRMPs had a direct effect on the innovation performance of public hospital health professionals.Inclusive leadership can positive-ly affect the implementation of D-HRMPs and the formation of team innovation atmosphere.Meanwhile,team innovation atmo-sphere plays a mediating effect,that is,D-HRMPs can actively promote the formation of team innovation climate,and further indi-rectly affect the innovation performance of employees.Conclusion:The directors of public hospitals can further explore the im-plementation of D-HRMPs,and pay attention to adopting inclusive leadership to deepen the reform of personnel management system,and promote high-quality development of public hospitals.

Objective:To explore the influence of simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) on tumor markers and quality of life after breast-conserving surgery for breast cancer.Methods:Patients after breast-conserving surgery for breast cancer in the Third People' s Hospital of Chengdu were selected from June 2015 to June 2018 as the study subjects. Fifty-five cases with conventional radiotherapy (CRT) were selected and included in control group, and 49 cases with SIB-IMRT were enrolled as observation group. The radiotherapy time and radiotherapy-related adverse reactions, serum tumor markers (β2-microglobulin (β2-MG), carbohydrate antigen 125 (CA125), tissue polypeptide specific antigen (TPS), carbohydrate antigen 153 (CA153)) before radiotherapy and at 6 months after radiotherapy, short-term solid tumor treatment effect at 6 months after radiotherapy and quality of life (progression-free survival (PFS), overall survival (OS)) after 5 years of follow-up were collected in both groups of patients. Measurement data were presented as xˉ± s by t test. Enumeration data were analyzed by χ2 test or Fisher test. Nonparametric rank sum test was used to compare the distribution of ranked data between groups. Results:The radiotherapy time in observation group was shorter than that in control group ((37.46±6.74) d vs (43.63±7.26) d), and the incidence of radiotherapy-related adverse reactions was lower than that in control group (14.29% (7/49) vs 32.73% (18/55))(Statistical values were 4.47 and 4.83, P values were <0.001 and 0.028). At 6 months after radiotherapy, the levels of β2-MG, CA125, TPS and CA153 in observation group were lower compared to control group ((1.25±0.21) mg/L vs (1.86±0.37) mg/L, (15.17±2.56) kU/L vs (18.81±3.13) kU/L, (9.43±1.58) μg/L vs (13.49±2.51) μg/L, (11.75±1.63) kU/L vs (15.46±3.07) kU/L) ( t=10.17, 6.44, 9.73, 7.56; all P<0.01), but there was no statistical significance in disease control rate between the two groups ( P>0.05). The observation group had higher objective remission rate (53.06%(26/49) vs 32.73%(18/55)), and the difference was statistically significant( χ2=4.39, P=0.036). After a 5-year follow-up, 44 patients in the observation group survived (89.80%, 44/49), with an OS of (57.92±11.21) months; 42 patients in the control group survived (76.36%, 42/55), with an OS of (54.05±10.14) months. There was no statistically significant difference between the two groups (both P>0.05). The PFS of the observation group patients was higher than that of the control group ((54.93±10.07) months compared to (50.76±9.95) months), and the difference was statistically significant ( t=2.12, P=0.036). Conclusion:Simultaneous integrated boost intensity-modulated radiation therapy for breast cancer patients undergoing breast-conserving surgery can reduce the levels of serum tumor markers, improve the breast aesthetics, and enhance the short-term and long-term quality of life of patients.

Transcatheter tricuspid valve intervention is the new frontier of interventional cardiology. The LuX-Valve is a radial force-independent orthotopic tricuspid valve replacement device developed in China. The LuX-Valve Plus transcatheter tricuspid valve replacement (TTVR) system is changed from the trans-atrial to the transjugular approach, which further reduces trauma and pulmonary complications compared with the first generation LuX-Valve. The first-in-human study has been completed at Zhongshan Hospital, Fudan University and an exploratory multicentre clinical study is underway. Echocardiography plays an important role in pre-TTVR screening, intraoperative guidance and postoperative evaluation and follow-up, especially two-dimensional transoesophageal echocardiography (2D-TEE) and three-dimensional transoesophageal echocardiography (3D-TEE). However, there is a lack of appropriate intraoperative guidance and assessment protocols. In this study, we briefly described the protocols and imaging considerations for intraoperative 2D-TEE and 3D-TEE to ensure the successful implantation of TTVR.

Objective:To investigate the association between time in target range and risk of vertebral fracture in patients with type 2 diabetes.Methods:The clinical data of 1 032 patients with type 2 diabetes who were hospitalized in endocrine department of Henan Provincial People′s Hospital from June 2017 to July 2021 were collected. Among which 632 patients were included into final analysis. The diabetes-specific risk score for vertebral fracture was used to assess the risk of vertebral fracture. Multivariate linear regression analysis was used to test the association between time in target range and risk score of vertebral fracture. Risk score≥9 was defined as increased risk of vertebral fracture. Multivariate logistic regression was used to estimate the association between time in target range and risk of vertebral fracture. Results:Among the included patients, mean age was(55.0±12.4) years and the percent of male was 72.5%. The mean course of diabetes was(9.4±8.0) years, and mean score of risk of vertebral fracture was 5.6±4.3. Time in target range was negatively correlated with risk score of vertebral fracture( P for trend <0.001), which was independent of potential confounders and continuous glucose monitoring parameters. The included patients were divided into four groups based on quartiles of time in target range. Multivariate logistic regression indicated that the risk of vertebral fracture in the first quartile of time in target range was 4.6 times higherthanthatinthe4thquartile, and the significance remained adjusted for potential confounders, s, CV, or meanamplitudeofglycemicexcursions(MAGE), respectively. Conclusion:Timein target rangewasnegativelycorrelatedwithriskscoreofvertebralfracturein patient with type 2 diabetes. Low time in range level was an independent risk factor for increased risk of vertebral fracture.

OBJECTIVE To explore the efficacy of alfacalcidol combined with conventional antihypertensive and lipid- lowering drugs on liver and kidney function， serum inflammatory cytokines and renin-angiotensin system（RAS） in hypertensive patients with renal impairment. METHODS A total of 200 hypertensive patients with renal impairment who were treated in the department of nephrology in our hospital from December 2017 to December 2020 were selected and randomly divided into control group and observation group， with 100 cases in each group. Both groups of patients were treated with conventional antihypertensive and lipid-lowering drugs for a total of 14 weeks， patients in the observation group were additionally treated with oral alfacalcidol after 2 weeks of treatment （0.25 μg each time， once a day， for a total of 12 weeks）. The levels of liver function indexes [aspartate aminotransferase （AST）， alanine aminotransferase （ALT）]， renal function indexes [blood calcium， blood phosphorus， blood urea nitrogen （BUN）， cystatin C （Cys-C）， serum creatinine （Scr）， urine microalbumin （mAlb）， β2-microglobulin （β2-MG）， urinary N- acetyl β-D-glucosaminidase （NAG）， 24 h urinary protein]， inflammatory factors [serum interleukin 6 （IL-6）， tumor necrosis factor α （TNF-α）， hypersensitive C-reactive protein （hs-CRP）] and RAS activity indexes [renin， angiotensin Ⅰ（Ang Ⅰ）， Ang Ⅱ and aldosterone] were observed in 2 groups before and after treatment， and the occurrence of adverse drug reactions was recorded during treatment. RESULTS There was no statistical significance in the levels of detection indexes between 2 groups before treatment （P＞0.05）. After treatment， the level of blood calcium in the observation group was significantly higher than before treatment （P＜0.05）， but remained at clinically normal level. Compared with before treatment， the levels of Cys-C， Scr， BUN， urine mAlb， β2-MG， NAG and 24 h urinary protein， hs-CRP， IL-6， TNF-α， renin， Ang Ⅰ， Ang Ⅱ and aldosterone were significantly decreased in the observation group after treatment （P＜0.05）. After treatment， the level of blood calcium in observation group was significantly higher than control group （P＜0.05）. Additionally， the levels of Cys-C， Scr， BUN，urine mAlb， β2-MG， NAG， 24 h urinary protein， hs-CRP， IL-6， TNF-α， renin， Ang Ⅰ， Ang Ⅱ and aldosterone were significantly lower than control group （P＜0.05）. There was no statistical significance in the incidence of adverse drug reactions between 2 groups during treatment （P＞0.05）. CONCLUSIONS Alfacalcidol combined with routine therapy of antihypertensive and lipid-lowering drugs could effectively improve liver and renal functions， inhibit inflammation and RAS activity in hypertensive patients with renal impairment， with a favorable safety.

ObjectiveTo evaluate the clinical efficacy of Qingbu Weijing decoction in the treatment of patients suffering from stable bronchiectasis complicated with airway mucus hypersecretion （Qi and Yin deficiency， phlegm heat accumulation in lung）. MethodEighty patients with stable bronchiectasis and airway mucus hypersecretion were randomly divided into an observation group and a control group， 40 in each group. In the observation group， 38 cases were finally included for 1 case was lost and 1 withdrew， while in the control group， 35 cases were finally included for 1 case was lost and 4 withdrew. The observation group was po administered with Qingbu Weijing decoction granules， 1 dose twice a day. The control group was treated with oral Carbocysteine Oral Solutioncarboxymethylstein， 500 mg each time for three times a day. Both groups received health education and postural drainage. After 12 weeks of treatment and 12 months of follow-up， the changes in the number of acute exacerbations， Cough and Sputum Assessment Questionnaire （CASA-Q）， traditional Chinese medicine （TCM） syndrome score， lung function ［percentage of peak expiratory flow （PEF） to estimated value （PEF% pred）， percentage of forced expiratory volume in one second to estimated value （FEV₁%pred）， FEV₁/forced vital capacity （FVC）］ and serum inflammatory factors ［C-reactive protein （CRP）， tumor necrosis factor-α （TNF-α）， interleukin -8 （IL-8）， interleukin -10 （IL-10）， neutrophil elastase （NE）］ levels in the two groups after treatment were evaluated. ResultThe number of acute exacerbations in the observation group was lower than that in the control group after 12 weeks of treatment and 12 months of follow-up （P<0.01）. Compared with the condition before treatment， the cough symptom domain （COUS） score of CASA-Q in the observation group was increased after 4， 8， 12 weeks of treatment and 3， 6， 9， 12 months of follow-up， while the COUS score in the control group was increased during treatment but decreased during follow-up， with the observation group higher than the control group （P<0.05， P<0.01）. The cough influence domain （COUI） score in the observation group was higher than that before treatment at 4， 8， 12 weeks after treatment and 3， 6， 9， 12 months after follow-up， while the COUI score in the control group was lower than that before treatment， with the observation group superior to the control group （P<0.05， P<0.01）. In terms of sputum symptom domain （SPUS）， the two groups both had elevated SPUS score after 4， 8， 12 weeks of treatment and 3， 6， 9， 12 months of follow-up， but the observation group was better than the control group （P<0.05， P<0.01）. In terms of sputum influence domain （SPUI）， the observation group had elevated SPUI score after 4， 8， 12 weeks of treatment and 3， 6， 9， 12 months of follow-up， while the control group presented increased SPUI score during treatment but reduced score during follow-up， with the observation group higher than the control group at 3， 6， 9 months of follow-up （P<0.05）. The observation group outweighed the control group in the effective rate， while difference was only observed between the two groups after 8 weeks of treatment （χ²=3.868， P<0.05） and 3 months of follow-up （χ²=6.510， P<0.05）. Compared with the condition before treatment， the TCM symptom score was lowered in both groups after 4， 8， and 12 weeks of treatment and 3， 6， 9， 12 months of follow-up （P<0.01）， and except for 4 weeks of treatment， the observation group had more reduction than the control group （P<0.05）. The pulmonary function of patients in the observation group was improved compared with the condition before treatment， and there was difference in PEF% pred in intergroup and intragroup comparisons （P<0.05）. Both groups had reduced level of serum inflammatory factors， but difference was only observed in TNF-α， IL-8， IL-10 and NE in the observation group compared with those before treatment （P<0.05）， and in IL-8 between the two groups （P<0.05）. ConclusionQingbu Weijing decoction in the treatment of stable bronchiectasis patients with airway mucus hypersecretion （Qi and Yin deficiency， phlegm and heat accumulation in lung） can significantly alleviate their cough and expectoration and reduce the repeated acute exacerbation， and can down-regulate the level of serum inflammatory factors， thereby improving the lung function of patients to a certain extent.

Objective:To investigate the clinical efficacy and mechanism of Ganoderma lucidum hypoglycemic formula in the treatment of insulin resistance in patients with type 2 diabetes mellitus (T2DM) with liver and kidney yin deficiency. Methods:A total of 86 patients with T2DM with liver and kidney yin deficiency who were diagnosed and treated at Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine from January 2021 to February 2022 were included in this study. These patients were divided into a control group and a treatment group, with 43 patients in each group using a 1:1 ratio using the sealed envelope method. Both groups were treated with standardized Western medicine. The treatment group was also treated with the Ganoderma lucidum hypoglycemic formula. All patients were followed up for 12 weeks. The clinical symptoms, curative effect, glucose and lipid metabolism, inflammatory factors, oxidative stress change, and safety were compared between the two groups. Results:The total response rate in the treatment group was 88.4% (38/43), which was significantly higher than 53.5% (23/43) in the control group ( χ2 = 12.69, P < 0.001). After treatment, the traditional Chinese medicine syndrome score, fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin, insulin resistance index, total cholesterol, triglyceride, tumor necrosis factor α, and interleukin-6 decreased in each group. The amplitudes of decrease of the above indexes were greater in the treatment group compared with the control group (all P < 0.05). C-peptide in the fasting state, C-peptide at 2 hours after a diet, and superoxide dismutase increased in each group. The amplitudes of increase of the three indexes were greater in the treatment group compared with the control group (all P < 0.05). Conclusion:Ganoderma lucidum hypoglycemic formula can greatly improve insulin resistance and glucose and lipid metabolism in T2DM patients with liver and kidney yin deficiency. The underlying mechanism may be to further reduce the inflammatory response and anti-oxidative stress by down-regulating tumor necrosis factor α and interleukin-6 levels and up-regulating superoxide dismutase level, thereby effectively alleviating insulin resistance in T2DM.

Diabetic kidney disease is a severe microvascular complication of diabetes characterized by complex etiology, diverse mechanisms, long course, and poor prognosis, posing a significant threat to patients′ quality of life. In recent years, research on gut microbiota has progressed deeper, and the concept of the gut-kidney axis emerges, introducing novel therapeutic concepts. This article provides an overview of the role of gut microbiota in the development of diabetic kidney disease and explores potential therapeutic strategies involving gut microbiota for the treatment of this condition.