Objective: To clarify the specific mechanisms of action of raw Phellodendron chinense Schneid. (RPC) and saltwater-processed PC (SPC) in the treatment of rats with a kidney-yin deficiency pattern (KYDP). Methods: Healthy rats were administered hydrocortisone to establish a KYDP model. The rats were divided into seven groups: blank control, model, positive control (Liuwei Dihuang pills), high-dose RPC, low-dose RPC, high-dose SPC, and low-dose SPC. Enzyme-linked immunosorbent assay was used to measure the levels of cAMP, cGMP, TRH, TSH, T3, T4, IFN-γ, TNF-α, and testosterone in the serum and the levels of Na+-K+-ATPase and Ca2+-Mg2+-ATPase in the liver. TRH mRNA expression in the rat hypothalamus was measured using RT-PCR. THRα1+2 protein expression in the hypothalamus of rats was measured using Western blot. Immunohistochemistry was performed to determine the expression levels of FAS, FasL, and TSHR. Flow cytometry was used to determine CD4+ and CD8+ T lymphocyte levels. Illumina MiSeq sequencing technology was used to evaluate the diversity of intestinal flora in KYDP rats. Results: The cAMP/cGMP ratio was significantly higher in the model group than in the blank control group (P = .048). Compared with the model group, after administration, the levels of the above-mentioned serum and liver indexes decreased, except that of testosterone. The CD4+/CD8+ ratio also decreased. Compared with the RPC group, the levels of T3, IFN-γ, FAS, FasL, and TSHR in the SPC group decreased whereas that of testosterone increased. Additionally, immune function and intestinal flora diversity improved in the SPC group. SPC proved to be more effective in improving liver energy metabolism in KYDP rats than RPC. Conclusion SPC had a better therapeutic effect on KYDP than RPC. The underlying mechanism of action may be related to improvements in liver energy metabolism, immune function, and intestinal flora diversity.

Yi He Rehabilitation,which is based on traditional Chinese rehabilitation treatments and rehabilitation principles from modern medicine,is effective in staging treatment of post-stroke hemiplegia.This paper systematically discusses the origin and annotation of Yi and He from the perspectives of traditional Chinese medicine and modern medicine.The medicinal connection between Yi and the body and its function is related to unobstructed attunement.Based on the connotation of Yi and He,we believe that the pathogenesis of post-stroke hemiplegia is the comprehensive result of abnormal effects of Yi on the organism at the microscopic level and abnormal effects of He on function at the macroscopic level,featured as tense muscle movement and a pathological process of abnormal motion,including the disturbance of yang qi with body dysfunction,the disorder of spirit with sinews and vessels with diversion,and the variation of brain collateral with physical and mental inconsistency.By inducing relaxation and calmness,Yi He rehabilitation takes effect in staging treatment of post-stroke hemiplegia with characteristic mechanisms.First,by calming ascending yang and relaxing the disordered body in periods of relaxation,it can achieve the maintenance function of the kinematic chain peripherally with passive rehabilitation.Second,by calming the disordered spirit and relaxing the inhibited meridian sinews in spasmodic periods,it can reconstruct the neural plasticity of motor function centrally with assistive rehabilitation.Third,by calming damaged brain collateral and relaxing the impassable zang organs in the recovery period,it can close the central-peripheral-central loop of rehabilitation with active rehabilitation.

Objective To evaluate the effectiveness of the central government-funded echinococcosis control programme in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, so as to provide insights into echinococcosis control. Methods Administrative villages were sampled using a multi-stage cluster random sampling method from Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, and all residents at ages of 12 years and older in the sampled villages were screened for echinococcosis, and schools were sampled using a cluster sampling method, and all children at ages of 12 years and older in the sampled schools were screened for echinococcosis. Domestic dogs were sampled using a systematic random sampling method, and one domestic dog stool sample was collected from each household. Stray dog stool samples were collected outside the villages, and Echinococcus coproantigens were detected using enzyme-linked immunosorbent assay in domestic and stray dogs. In addition, echinococcosis was screened in sheep and cattle in designated slaughterhouses in Tianzhu Tibetan Autonomous County. The trends in the prevalence of echinococcosis in humans and livestock and the positive rate of Echinococcus coproantigens in dogs were examined with the Cochran-Armitage trend test. In addition, individuals screened for echinococcosis were randomly sampled from 2007 to 2022 for survey on the awareness of echinococcosis control knowledge. Results A total of 290 356 person-times were screened for echinococcosis among residents at ages of 12 years and older in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, with 1 094 residents detected with cystic echinococcosis, and the detection of echinococcosis appeared a tendency towards a gradual decline over years (χ² = 358.602, P < 0.001). A total of 32 931 person-times were screened for echinococcosis among children at ages of 12 years and older in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, with 296 children detected with echinococcosis, and the detection of echinococcosis appeared a tendency towards a gradual decline over years (χ² = 267.673, P < 0.001). A total of 33 230 domestic dog stool samples were tested for Echinococcus coproantigens in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, with 1 777 Echinococcus coproantigens-positive samples tested, and the positive rate of Echinococcus coproantigens appeared a tendency towards a decline in domestic dogs over years (χ² = 2 210.428, P < 0.001), while the positive rate of Echinococcus coproantigens showed a tendency towards a rise in domestic animals from 2016 to 2022 (χ² = 37.745, P < 0.001). The positive rate of Echinococcus coproantigens remained relatively stable in stray dogs in Tianzhu Tibetan Autonomous County, Gansu Province from 2019 to 2022 (χ² = 0.315, P = 0.575). A total of 10 973 sheep were screened for echinococcosis in Tianzhu Tibetan Autonomous County from 2007 to 2022, with 334 sheep detected with echinococcosis, and the detection of echinococcosis appeared a tendency towards a decline in sheep over years (χ² = 53.579, P < 0.001); however, there was no significant change in the detection of echinococcosis during the period from 2015 through 2022 (χ² = 1.520, P = 0.218). A total of 2 400 cattle were screened for echinococcosis in Tianzhu Tibetan Autonomous County from 2017 to 2022, with 231 cattle detected with echinococcosis, and the detection of echinococcosis showed a tendency towards a decline over years (χ² = 5.579, P < 0.05). The awareness of echinococcosis control knowledge increased from 44.37% in 2007 to 94.00% in 2022 among residents at ages of 12 years and older and from 52.50% in 2007 to 92.50% in 2022 among children at ages of 12 years and older in Tianzhu Tibetan Autonomous County, respectively. Conclusions There has been a reduction in the detection of echinococcosis in humans and domestic animals and the positive rate of Echinococcus coproantigens in dogs and a rise in the awareness of the echinococcosis control knowledge following the implementation of the central government-funded echinococcosis control programme in Tianzhu Tibetan Autonomous County, Gansu Province; however, integrated echinococcosis control measures are still required for further control of the prevalence of echinococcosis.

Objective:To investigate the amyloid precursor protein (APP) expression in brain glioma tissues and cerebrospinal fluid of glioma patients and their significances.Methods:(1) Fifty-six brain glioma specimens surgically resected and pathologically confirmed in our hospital from January 2015 to December 2020 were collected, including 9 with WHO grading I, 14 with WHO grading II, 18 with WHO grading III, and 15 with WHO grading IV. In addition, the necrotic brain tissues of 4 patients with hypertensive intracerebral hemorrhage during hematoma removal at the same time period were collected as controls. Western blotting and real-time quantitative PCR (RT-qPCR) were used to detect the APP protein and mRNA expressions in glioma tissues and control brain tissues, respectively. (2) The cerebrospinal fluid of above 56 patients with glioma, 4 patients with viral meningitis, 4 patients with bacterial meningitis, 4 patients with autoimmune encephalitis, 5 patients with epilepsy, 3 patients with migraine and 3 normal subjects were collected at the same time period, and the APP content in the cerebrospinal fluid of all subjects were detected by ELISA.Results:(1) Western blotting and RT-qPCR showed that the APP protein and mRNA expressions in glioma tissues of WHO grading I, II, III and IV were significantly higher than those in control brain tissues, and the APP protein and mRNA expressions in glioma tissues of WHO grading I, II, III and IV increased successively, with statistical differences ( P<0.05). There were no significant differences in APP protein and mRNA expressions between first-onset glioma and recurrent glioma in glioma tissues of WHO grading I and II ( P>0.05); while in glioma tissues of WHO grading III and IV, APP mRNA expression in recurrent glioma was statistically higher than that in first-onset glioma ( P<0.05). (2) ELISA results showed that APP content in patients with viral meningitis, bacterial meningitis, autoimmune encephalitis, epilepsy or migraine was not significantly different as compared with that in normal controls ( P>0.05). The APP content in cerebrospinal fluid of patients with WHO grading I, II, III and IV gliomas was significantly higher than that in normal controls, and the APP content in cerebrospinal fluid of patients with WHO grading I, II, III and IV gliomas increased successively, with statistical differences ( P<0.05). Conclusion:APP is highly expressed in glioma tissues and cerebrospinal fluid of patients with glioma, and its expression is significantly correlated with the pathological grades of glioma; the detection of APP expression in cerebrospinal fluid can be used as a new screening method for glioma patients.

Objective : To determine expression profile of VISTA on lymphocyte and the potential regulatory effects on immune response in a murine model of sepsis. Methods : Expression profile of VISTA on T lymphocytes in the spleen and peripheral blood was examined. Mice wereintravenously injected with an agonistic VISTA mAb(MH5A) or isotype control , and then the survival rate , cytokine expression , bacterial burden and lymphocyte apoptosiswere determined. Results : VISTA was substantially expressed on T cell from the spleen and peripheral blood , septic peritonitis did not induce significant changes in the expression profiles at 24h post surgery(P > 0. 05 in each comparison) . Treatment with MH5A improved the survival of septic mice(8/12 vs 2/12 , P = 0. 01) , accompanied by reduced lymphocyte apoptosis [(30 123 ± 6 400) vs (45 482 ± 8 652) , P = 0. 03] , decreased bacterial burden and lessened cytokines expression , such as TNF⁃α , IL⁃6 , IL⁃1β and IFN⁃γ(P < 0. 05 in each comparison) . Conclusion The present study identified VISTA as a novel immune checkpoint in the regulation of T cell apoptosis and inflammatory response during sepsis. VISTA agonism might offer a promising approach in the immunotherapy for sepsis.

OBJECTIVE：To establish a method for the determination of 8 glycosides（astragaloside Ⅰ，Ⅱ，Ⅲ，Ⅳ and calycosin glucopyranoside ，2′-hydroxy-3′，4′-dimethoxy-isoflavan-glucoside and 9，10-dimethoxy-pterocarpan-glucoside） and 4 aglycones（calycosin，formononetin，7，2′-dihydroxy-3′，4′-dimethoxy-isoflavan and 3-hydroxy-9，10-dimethoxy-pterocarpan） in Astragalus membranaceus ，and to investigate the effects of different processing temperatures on the contents of above 12 components. METHODS ：The contents of 12 components in A. membranaceus and samples processed under different temperatures（120，140，160，180，200 ℃）were determined by UPLC-MS/MS. The determination was performed on ACQUITY UPLC HSS T 3 column with mobile phase consisted of 0.1 mol/L formic acid water solution -0.1 mol/L formic acid acetonitrile solution （gradient elution ）at the flow rate of 0.5 mL/min. The column temperature was 30 ℃. The detection wavel ength was 260 nm，and sample size was 2 μL. Electrospray ion source（ESI）was used under positive ion mode （ESI+）. The mass scanning range was mass ratio （m/z）of 50-1 500，with capillary voltage of 2 000 V and ion source temperature of 100 ℃. The desolvation temperature was 400 ℃；flow rate of atomizing gas （N2） was 40 L/h，and that of desolvation was 800 L/h；collision energy （CE）was 20-30 V；data acquisition rate was 0.5 s/scan. RESULTS：The linear range of astragaloside Ⅰ，astragaloside Ⅱ，astragaloside Ⅲ，astragaloside Ⅳ，calycosin-glucopyranoside， calycosin，ononin，formononetin，2′-hydroxy-3′，4′-dimethoxy-isoflavan-glucoside，7，2′-dihydroxy-3′，4′-dimethoxy-isoflavan，9， 10-dimethoxy-pterocarpan-glucoside and 3-hydroxy-9，10-dimethoxy-pterocarpan were 0.001 16-0.232 0，0.000 276-0.055 2， 0.000 22-0.044 0，0.000 225-0.045 0，0.000 734-0.587 0，0.001 17-0.234 0，0.000 742- 0.148 0，0.001 30-0.260，0.003 98-0.795 0， 0.000 476-0.476 0，0.001 89-0.378 0，0.000 336-0.336 0 μg（all R2≥0.999 2），respectively. The limits of detection were 6.2×10－6， 4.8×10－6，3.8×10－6，3.4×10－6，5.8×10－6，4.8×10－6，4.2×10－6，3.2×10－6，5.8×10－6，2.6×10－6，4.2×10－6，6.4×10－6 μg，respectively. The limits of quantitation were 12.6×10－6，16.2×10－6，14.4×10－6，14.8×10－6，18.8×10－6，16.4×10－6，15.4×10－6，10.8×10－6，20.2×10－6， 12.4×10－6，14.6×10－6，23.4×10－6 μg，respectively. RSDs of precision ，stability（24 h）and repetition tests were all lower than 3.0％（n＝6）. The average recoveries were 99.1％，100.2％，98.7％，101.9％，98.6％，102.1％，99.2％，100.3％，98.7％， 99.2％，99.3％ and 100.8％，with the RSDs of 1.9％，2.2％，2.4％，1.8％，2.1％，1.7％，2.3％，1.9％，2.4％，1.8％，2.2％ and 1.9％（n＝6），respectively. The results showed that the contents of astragaloside Ⅰ，Ⅱ and Ⅲ decreased gradually with the increase of processing temperature ；the content of astragaloside Ⅳ increased gradually with the increase of temperature. The content of flavonoid glycosides ，such as calycosin glucopyranoside ，ononin，2′-hydroxy-3′，4′-dimethoxy-isoflavan-glucoside and 9， 10-dimethoxy-pterocarpan-glucoside decreased with the increase of temperature ；the corresponding aglycone components as flavonoid glycosides ，formononetin，3-hydroxy-9，10-dimethoxy- pterocarpan increased firstly and then decreased with the increase ； the content of 7，2′-dihydroxy-3′，4′- dimethoxy-isoflavan decreased with the increase of temperature. CONCLUSIONS ：Established UPLC-MS/MS method can be used for determination of 12 components in A. membranaceus . After processed under different temperature，the contents of glycosides decreased in general ，while the contents of aglycones increased in general.

Objective:To construct a care system for stroke patients based on the management mode of the Siebens domain to guide nursing practice.Methods:Taking the Siebens field management model as the research framework, applying Johns Hopkins′ evidence-based nursing method to synthesize the evidence, and determining the care system for stroke patients through two rounds of expert consultation.Results:The positive coefficients of the two rounds of expert consultation were 100%, the coefficients of expert authority were 0.808 and 0.865, and the coordination coefficients of expert opinions were 0.428 and 0.409. The finally constructed index system for the care of stroke patients includes 4 primary indicators, 11 secondary indicators, and 60 tertiary indicators.Conclusion:The constructed index system for the care of stroke patients is a scientific, reliable and credible evaluation system, which can provide a theoretical basis for the development of intervention measures for the care of stroke patients.

Objective To compare the quality of life,nutritional status and immune function of gastric cancer patients with digestive tract reconstruction using Roux-en-Y anastomosis and uncut Roux-en-Y anastomosis after radical gastrectomy.Methods 86 patients with gastric cancer were selected from May 2015 to June 2017 with radical total gastrectomy.According to the different ways of the reconstruction of the digestive tract,the patients were divided into URY group (non-severed group,41 patients) and RY group (traditional group,45 patients).The quality of life of the two groups was compared at 1 month,3 months and 6 months after operation.The nutritional status of albumin,prealbumin,transferrin,hemoglobin,retinol binding protein and weight,as well as CD4+ lymphocyte,CD8+ lymphocyte,CD4+/CD8+ ratio,IgG,IgM,IgA and other immune related indexes were observed at pre-operation and 1 month,3 months and 6 months after operation.Results As for quality of life,the score of diet limitation in group URY was significantly lower than that in group RY at 1 month after operation (P＜0.05),and no significant difference at 3 months and 6 months after operation (P＞0.05);As for anxiety,the score of group URY was higher than that in group RY (P＜ 0.05) at 1 month after operation (P＜0.05),and was lower than that in group RY at 3 months and 6 months after operation (P＜0.05).As for dry mouth,group URY was higher than that in group RY (P＜0.05) at 3 months and 6 months after operation (P＜0.05),and the other indexes were not statistically significant (P＞ 0.05).As for the nutritional indexes,prealbumin in the URY group was higher than that in the RY group at 6 months after operation (P＜0.05),and the rest were not statistically significant (P＞0.05).There was no statistical significance in immune indexes between the two groups (P ＞ 0.05).The postoperative hospitalization time of URY group was less than that of RY group (P＜0.05),and the incidence of mild reflux symptoms was lower than that of RY group (P＜0.05).There was no significant difference in the incidence of other complications between the two groups (P＞0.05).Conclusion Except for the length of hospitalization and postoperative complications in which uncut Roux-en-Y anastomosis was superior to Roux-en-Y anastomosis,there is no significant difference in quality of life and nutritional and immune indicators between the two alimentary tract reconstruction methods.

Objective To investigate the effect of pre-implanted anti-adhesion patch under laparoscopic approach in a Miles' operation on the incidence of parastomal hernia in elderly patients.Methods A total of 68 patients with low rectal cancer admitted into our general surgery department were enrolled in the study from January 2012 to January 2015.All patients received laparoscopic assisted Miles operation.According to whether or not the pre-implanted anti adhesion patch was used during the operation,the 68 cases were divided into pre-implanted patch group(n=38)and the non-implanted patch group(n=30).The operation states,postoperative complications,complications during follow-up and 3-year survival rate were compared between the two groups.Results The operation duration was longer in the pre-implanted patch group than in the non-implanted patch group[(235.7± 33.6)min vs.(94.3±28.9)min,t =5.36,P=0.000].The incidence of complications was lower in the pre implanted patch group than in the non-implanted patch group at 3 years after operation[10.5％ (4/38)vs.90.0％(27/30),x2 =42.69,P =0.000].The local recurrence rate,distant metastasis rate and 3-year overall survival rate had no significant difference between the two groups[23.7 ％ (9/38)vs.23.3％ (7/30),31.6％ (12/38) vs.33.3％ (10/30) and 71.1％ (27/38) vs.70.0％ (21/30)respectively,x2=0.06,0.02 and 0.01,P=0.800,0.878 and 0.925].Conclusions Pre-implanted anti-adhesion patch under laparoscopic approach can significantly reduce the incidence of parastomal hernia in elderly patients after a Miles' operation,which is worthy of promotion.

Objective To observe the clinical effect of repairing the defect after extended resec-tion of lower lip cancer by modified lip and cheek fan-shaped flap .Methods Six cases of lower lip cancer were treated .The defect of the lower lip was about 1/3-1/2 after 1 cm of enlarged resection outside the margin of the mass .The defect was repaired with modified lip and cheek fan-shaped flaps . The morphology and function were observed 3-36 months after operation .Results All patients healed in one stage ,and the shape and function of lower lip recovered well without complications .Conclusions Lower lip defect about 1/3-1/2 of patients with modified lip and cheek fan-shaped flap is an ideal method of restoration and reconstruction ,with satisfactory results after surgery .