ObjectiveTo observe the clinical effectiveness and safety of Dingchan Granule （定颤颗粒） for paroxysmal atrial fibrillation with syndrome of qi stagnation and blood stasis. MethodsUsing a randomised， double-blind， placebo controlled study method， 90 patients with paroxysmal atrial fibrillation with qi stagnation and blood stasis syndrome were divided into 45 cases each in the treatment group and the control group. Both groups were given conventional western medicine treatment， and the treatment group was additionally treated with Dingchan Granule， while the control group was treated with Dingchan Granule placebo， both of which were taken orally for 8 g each time twice a day. Both groups were treated for 8 weeks. We compared the clinical effectiveness， the improvement of traditional Chinese medicine （TCM） symptoms and the recovery rate of atrial fibrillation between the two groups. We compared the number and duration of atrial fibrillation episodes， TCM symptoms score， atrial fibrillation symptom classification， 24-hour average ventricular rate， Pittsburgh Sleep Quality Index （PSQI）， anxiety index， depression index before and after treatment， and evaluated the safety of the two groups. ResultsThe total clinical effectiveness rate in the treatment group was 82.22% （37/45）， which was better than 60.00% （27/45） in the control group （P＜0.05）. The total effective rate of TCM syndrome effectiveness in the treatment group was 88.89% （40/45）， which was better than 66.67% （30/45） in the control group （P＜0.05）； and the rate of atrial fibrillation regression in the treatment group was 26.67% （12/45）， better than 6.67% （3/45） in the control group （P＜0.05）. The number and duration of atrial fibrillation episodes in both groups were significantly decreased （P＜0.01）， and the number and duration of atrial fibrillation episodes in the treatment group were lower than those in the control group （P＜0.01）. The TCM syndrome scores of both groups after treatment were significantly lower than before treatment （P＜0.01）， and the scores of the treatment group was lower than those of the control group （P＜0.05）. The severity of atrial fibrillation symptoms and the grading of atrial fibrillation symptoms in both groups after treatment were improved （P＜0.01）， and the degree of symptom improvement in the treatment group was better than that in the control group （P＜0.01）. The 24-hour average ventricular rate of both groups after treatment was significantly lower （P＜0.01）. The PSQI， anxiety index and depression index of the treatment group were all lower than before treatment （P＜0.01）， while the PSQI and anxiety index of the control group were both lower than before treatment （P＜0.01 or P＜0.05）， the PSQI， anxiety index and depression index of the treatment group being lower than those of the control group （P＜0.05 or P＜0.01）. No adverse events occurred in both groups， and no abnormalities were observed in blood， urine， stool routine， liver and kidney function， and coagulation function indexes. ConclusionDingchan Granule for paroxysmal atrial fibrillation with qi stagnation and blood stasis syndrome can alleviate clinical symptom， improve TCM symptom scores， increase atrial fibrillation recovery rate， stabilise the average ventricular rate， and significantly improve the quality of sleep， alleviate the anxiety and depression， with a good safety profile.

Objective To investigate the current status of frailty in liver transplant candidates and to analyze the influencing factors.Methods The convenience sampling method was used to select 150 liver transplant candidates who were hospitalized in the Department of Liver Transplantation of a tertiary hospital in Hangzhou from July 2022 to July 2023.They were investigated by the general patient data,Fried Frailty Phenotype,Barthel Index,Nutrition Risk Screening 2002,General Health Status Scale.Statistical methods including single factor and multifactor analysis were conducted for influencing factors of frailty in liver transplant candidates.Results The pre-frailty and frailty rates in 145 liver transplant candidates were 42.07％and 45.52％,respectively,and only 12.41％were non-frailty.The results of ordered multiple Logistic regression showed that age,total bilirubin,hemoglobin,and general health status were influential factors in the frailty of liver transplant candidates(P＜0.05).Conclusion Liver transplant candidates have a high incidence of frailty.Age,total bilirubin,hemoglobin,and general health status are influential factors in frailty.Nurses should pay attention to the assessment of frailty in liver transplant candidates,and take timely and targeted nursing interventions to prevent or delay the occurrence and development of frailty.

Objective To compare the effects of different statistical protocols on the results of external quality assessment(EQA)of se-men,and select appropriate statistical protocols for the promotion of EQA of semen.Methods Taking sperm concentration as an ex-ample,the semen EQA data of 20 laboratories in Hunan Province in 2022 were selected,and the advantages and disadvantages of the traditional statistical scheme(TSS),robust statistical scheme(RSS)and traditional statistical scheme after eliminating the"outliers"(TSEOS)combined with robust statistical technology were analyzed and compared.Results The"outliers"could not be excluded from the sperm concentration data of the four groups in the TSS,which led to the difference between TSS and RSS or TSEOS.The num-ber of qualified laboratories for TSS and RSS were 19 vs 16,19 vs 16,19 vs 19,and 19 vs 19,respectively.Conclusion The results of RSS are similar to those of TSEOS.Compared with TSS,RSS do not need to remove outlier data steps,and are more suitable for se-men EQA data analysis with small data volume.

Objective:To investigate the effects of blood pressure variability (BPV), serum reactive oxygen species (ROS) and superoxide dismutase (SOD) levels on cognitive function in patients with subcortical ischemic vascular disease (SIVD).Methods:A total of 133 patients with SIVD confirmed by craniocranial MRI admitted to Department of Neurology, Red Flag Hospital Affiliated to Mudanjiang Medical University from October 2021 to October 2022 were selected. According to Montreal Cognitive Assessment scores, they were divided into SIVD without cognitive impairment group (SIVD-NC group, n=39) and subcortical vascular cognitive impairment group (SVCI group, n=94); and 23 healthy volunteers with normal cognition who had normal brain MRI in the Physical Examination Center during the same period were chosen as control group. General data of all subjects and vascular risk factors in each group were collected, routine biochemical indexes of peripheral blood were detected, 24 h ambulatory blood pressure monitoring was performed, and serum ROS and SOD levels were detected by enzyme-linked immunosorbent assay. Statistical methods were used to analyze the risk factors for cognitive impairment, correlations of independent risk factors with cognitive function, and diagnostic value of risk factors in cognitive impairment in patients with SIVD. Results:(1) Compared with control group, SIVD-NC group had significantly increased percentages of patients with hypertension history or lacunar stroke history, and significantly increased hypersensitive C-reactive protein (hs-CRP) level ( P<0.05). Compared with control group and SIVD-NC group, patients in SVCI group had significantly older age, lower years of education, higher proportion of patients with lacunar stroke history, and increased hs-CRP level ( P<0.05). Compared with control group, SVCI group had significantly higher proportion of patients with hypertension history ( P<0.05). (2) SIVD-NC group had significantly higher ROS level than control group ( P<0.05); Compared with control group and SIVD-NC group, SVCI group had significantly increased ROS level ( P<0.05). (3) SIVD-NC group had significantly increased nighttime systolic blood pressure (nSBP) compared with control group ( P<0.05); SVCI group had significantly increased 24 h SBP, nSBP and nSBP-variable coefficient (CV) compared with control group and SIVD-NC group ( P<0.05). Compared with SIVD-NC group, SVCI group had significantly increased 24 h SBP-CV ( P<0.05). (4) The nSBP, nSBP-CV, serum hs-CRP and ROS, and lacunar stroke history were independent risk factors for cognitive impairment in SIVD patients ( OR=1.096, P<0.001, 95% CI: 1.042-1.154; OR=1.231, P=0.010, 95% CI: 1.050-1.443; OR=2.303, P=0.004, 95% CI: 1.311-4.039; OR=1.026, P<0.001, 95% CI: 1.014-1.039; OR=2.954, P=0.041, 95% CI: 1.045-8.348), and education level was a protective factor for that ( P<0.05). (5) Serum ROS and hs-CRP, nSBP, and nSBP-CV were negatively correlated with MoCA scores in SIVD patients ( r s=-0.336, P<0.001; r s=-0.503, P<0.001; r s=-0.204, P=0.018; r s=-0.309, P=0.001). (6) Serum ROS and hs-CRP, nSBP, and nSBP-CV had high diagnostic values in cognitive impairment in SIVD patients (areas under the curves: 0.874, 0.847, 0.804 and 0.702, P<0.05); combined diagnosis efficacy of multiple indexes was better (area under the curve: 0.948, P<0.05). Conclusion:Serum ROS and hs-CRP, nSBP and nSBP-CV are highly likely to be hemodynamic and serological monitoring indexes for screening of cognitive impairment in SIVD patients.

The surveys of the number of TCM ancient books, the bibliography classification methods, the bibliography publication, the bibliography network sharing and access, the evaluation of the classification method of subject bibliography on TCM ancient books and the relevant opinions and suggestions were sent to 30 TCM libraries and 24 comprehensive libraries in China. The questionnaires’ data and responses were analyzed, in order to understand the classification methods of TCM ancient books, the use situation, and the needs in the classification and cataloging work. The results showed that compared with the comprehensive libraries, the collection of TCM ancient books were concentrated in TCM libraries, the classification methods for TCM libraries were seldomly reported, and the classification methods were mainly self-compiled. Thus, the uniformity of the classification methods was poor, and there was also a significant gap in the standardization of the bibliography arrangement in TCM libraries. The result recommended that the domestic library industry urgently needed a unified and standardized classification for TCM ancient books. It was significant for promoting the sharing and exchange of TCM ancient books, promoting the standardization process of TCM information, and promoting the efficient implementation of Zhonghua Yizang compilation project.

Objective: To investigate the clinical effects of Kangai-Guben-Xiaozheng decoction based on pathogenesis theory of cancerous toxin combined with TP scheme in the treatment of advanced ovarian carcinoma in elderly patients. Methods: A total of 218 elderly patients with advanced ovarian carcinoma in our hospital were randomly divided into the observation and control group, 109 in each group. The control group was treated by TP scheme, while the observation group was treated by Kangai-Guben-Xiaozheng decoction based on pathogenesis theory of cancerous toxin combined with TP scheme. Both groups received 1 chemotherapy cycle at 3 weeks, and a total of 4 cycles of chemotherapy were followed up for 2 years. Quality of life was assessed by Functional Assessment of Cancer Therapy- ovarian Cancer v4.0 (FACT-OV4). Enzyme-linked immunosorbent assay (ELISA) was used to detect tumor markers, including Integrin-Linked Kinase (ILK), Hypoxic Inducible Factor-α (HIF-α), Human Epididymal Protein (HE4) and Epithelial-type calcium mucin (E-cadherin). The toxic and side effects of two groups were observed and the clinical efficacy was evaluated. The survival rate, total survival time and disease-free survival time were observed and recorded during follow-up. Results: The control rate and effective rate of the observation group were 90.8% (99/109) and 41.3% (45/109), respectively, and those of the control group were 64.2% (70/109) and 28.4% (31/109), respectively. The comparison of control rate and effective rate between the two groups were statistically significant (Z value were 4.002, 3.401, respectively, all Ps<0.05). After treatment, the ILK (12.31 ± 1.15 ng/L vs. 23.57 ± 2.32 ng/L, t=3.245), HIF-α (2.41 ± 0.22 mg/L vs. 6.67 ± 0.67 mg/L, t=3.596), HE4 (0.34 ± 0.03 pg/L vs. 1.24 ± 0.12 pg/L, t=3.621) levels in the observation group are significantly lower than those in the control group (P<0.05), while the E-cadherin (5.25 ± 0.56 ng/L vs. 2.52 ± 0.26 ng/L, t=3.434) was significantly higher than that in the control group (P<0.05). After treatment, the scores of functional status and social/family status in the observation group were significantly higher than those in the control group (t values were 3.282, 3.214, all Ps<0.05), and the scores of additional attention, emotional status and physiological status were significantly lower than those in the control group (t values were 3.121, 3.512, 3.526, all Ps<0.05). During the treatment period, the incidence of cardiac toxicity, liver toxicity, renal toxicity, bone marrow suppression, nausea and vomiting, abdominal pain and diarrhea in the observation group were significantly lower than those in the control group (χ² value were 4.947, 4.893, 4.525, 4.692, 4.637, 4.905, respectively, all Ps<0.05). During the follow-up, the 1, 2 year survival rate in the observation group was higher than those in the control group (χ² value were 3.782, 3.893, respectively, all Ps<0.05). Conclusions The Kangai-Guben-Xiaozheng decoction based on the theory of cancer pathogenesis, combined with TP regimen show effectiveness for the Ⅳ stage of ovarian cancer of the elderly patients.

Collaboration of c-KIT mutations with AML1-ETO (AE) has been demonstrated to induce t(8; 21) acute myeloid leukemia (AML). Targeted therapies designed to eliminate AE and c-KIT oncoproteins may facilitate effective treatment of t(8; 21) AML. Homoharringtonine (HHT) features activity against tumor cells harboring c-KIT mutations, whereas oridonin can induce t(8; 21) AML cell apoptosis and AE cleavage. Therefore, studies should explore the efficacy of combination therapy with oridonin and HHT in t(8; 21) AML. In this study, we investigated the synergistic effects and mechanism of oridonin combined with HHT in t(8; 21) AML cell line and mouse model. The two drugs synergistically inhibited cell viability and induced significant mitochondrial membrane potential loss and apoptosis. Oridonin and HHT induced significant downregulation of c-KIT and its downstream signaling pathways and promoted AE cleavage. HHT increased intracellular oridonin concentration by modulating the expressions of MRP1 and MDR1, thus enhancing the effects of oridonin. The combination of oridonin and HHT prolonged t(8; 21) leukemia mouse survival. In conclusion, oridonin and HHTexert synergistic effects against t(8; 21) leukemia in vivo and in vitro, thereby indicating that their combination may be an effective therapy for t(8; 21) leukemia.

Aim To investigate the effect of Ding''s herb enema prescription on intestinal tissue related target in rat colitis induced by dextran sulfate sodium(DSS), and to elucidate the mechanism of Ding''s herb enema prescription in improving the intestinal inflammation and intestinal fibrosis.Methods Rats were fed with 3.5％ DSS.The rats were randomly divided into positive drug group, model group, Control group, and Ding''s herb enema prescription group.The positive drug group was treated with mesalazine enema, and Ding''s herb enema prescription group was treated with Ding''s herb enema prescription.The colon mucosa was taken once a day for 6 weeks.The changes of intestinal inflammatory response and intestinal fibrosis related proteins were detected by GSR-CAA-67 antibody protein array, and the differentially expressed proteins were screened out.Results Eight proteins showed statistical differences, including IFN-γ, erythropoietin(EPO), TIMP-2, TIM-1, IL-6, TIMP-1, TNF-α, IL-22 (P<0.05).On the other hand, Ding''s herb enema prescription and mesalazine significantly antagonized the effect of IL-6 and TIMP-1 (P<0.05).The antagonized effect of Ding''s embolization enema on TNF-α and IL-22 was also significant(P<0.05), but mesalazine had no similar effect (P>0.05).Conclusions Ding''s herb enema prescription has the effect of multiple targets, which may improve the intestinal inflammatory response and intestinal fibrosis to achieve the purpose of treatment of ulcerative colitis(UC).

Objective To explore the application effect of preoperative interview by collective multidisciplinary education model in patients with breast cancer.Methods 126 patients with breast cancer, having undergone radical surgery from February 2015 to February. 2016, were selected and divided, by random number table method, into observation group and control group, each with 63 cases. Traditional mode of preoperative interview was conducted to patients in the control group, while preoperative interview by collective multidisciplinary education model was conducted to patients in the observation group. Anxiety, depression, stress response and satisfaction toward nursing between patients in the two groups were compared before and after intervention.Results After the interview, scores of anxiety and depression of patients in the observation group were (11.2±1.5) and (15.9±0.8) points, while the scores in the control group were (12.5±1.3) and (22.4±1.4) (t=2.032,5.007;P<0.01). Relief of anxiety and depression in the observation group was significantly better than that in the control group (P<0.05). Inside the operating room, before anesthesia was done, heart rate and systolic pressure of patients in the observation group were (71.5±3.9) time/min and (127.3±10.8) mmHg, all lower than that in the control group, which were (81.2±4.7) time/min and (145.2±12.6) mmHg (t=2.975 and 3.382,P<0.05). Satisfaction toward nursing in the observation group was 96.8%, higher than that in the control group, 82.5% (χ2=6.892,P<0.01).Conclusions Preoperative interview by collective multidisciplinary education model to patients with breast cancer can reduce their anxiety and depression, relieve stress response and improve satisfaction towards nursing.

Objective To compare the effects of PICC catheter heterotopias in the traditional turning neck method with finger-pressing method. Methods From October 2010 to October 2014, 596 patients were randomly divided into two groups, 296 cases in observation group using traditional turning neck method, and the other 300 patients in control group using finger-pressing method. We compared the differences between these two groups by the operation time for subclavian vena to brachiocephalica and rate of ectopic catheter tip. Results The incidences of ectopic catheter tip were 15. 00% and 5. 41% in control group and observation group, which was lower in observation group comparing with control group (χ2 =14. 929, P <0. 05). The operation time was (16.94±3.03)sand(7.24±4.70)sincontrolgroupandobservationgroup(t=29.900,P<0.01). Conclusions Finger-pressing method decreases the rate of ectopic catheter tip and operation time of PICC catheter technique.