Under the background of the Healthy China strategy， the integration of traditional Chinese medicine （TCM） into the public health emergency response system has become an important measure to enhance the capacity for coping with public health emergencies. In recent years， the role of TCM in responding to such emergencies has become increasingly prominent. Taking major emerging epidemics as an example， TCM has developed a rich theoretical system and practical experience in epidemic prevention and treatment over thousands of years， and has played a significant role in successive outbreaks with its unique advantages. Based on the concept of ''preventing disease before its onset'' and the theoretical framework of treatment based on syndrome differentiation， TCM has achieved remarkable results through early intervention and full participation in the integrated model of TCM and Western medicine， from severe acute respiratory syndrome （SARS） to corona virus disease-2019 （COVID-19）， in improving clinical symptoms and outcomes， reducing adverse reactions， and promoting recovery. From the perspective of the Healthy China strategy， this paper systematically reviews the historical development of TCM in epidemic prevention and treatment， with particular attention to recent epidemics such as SARS， influenza A （H1N1）， and COVID-19. It further examines the similarities and differences between TCM and Western medicine in responding to major emerging epidemics， as well as relevant policies related to TCM in epidemic prevention and control. In addition， it summarizes the existing problems in TCM's role in the prevention and treatment of major emerging epidemics， and explores measures to improve its rapid response capacity under the Healthy China strategy. This study not only provides a ''Chinese solution'' for the prevention and control of newly emerging infectious diseases worldwide， but also offers theoretical and practical references for strengthening the public health emergency response system， carrying strategic significance for promoting the modernization and internationalization of TCM.

Objective:To explore the compatibility and medication law of Cinnamomi Ramulus-Alismatis Rhizoma medicinal pair in ancient and modern prescriptions.Methods:Ancient prescriptions and Chinese patent medicines containing Cinnamomi Ramulus-Alismatis Rhizoma medicinal pair were retrieved from the database of ancient classic famous prescriptions 1.0 and the database of listed Chinese patent medicines 1.0 developed by the Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences. Excel 2019 was used to establish a database. The ancient and modern medical record cloud platform V2.3.5 and SPSS Modeler 18.0 software were used to perform frequency statistics, association rule analysis, clustering analysis, etc. on the data.Results:Totally 79 ancient articles with Cinnamomi Ramulus-Alismatis Rhizoma medicinal pair were obtained, including 76 ancient prescriptions, involving 250 kinds of Chinese materia medica; 25 kinds of Chinese patent medicine were obtained, involving 186 kinds of Chinese materia medica. The drug properties of ancient prescriptions and modern TCM patent medicines were both mainly warm, cold and neutral. The main tastes of ancient prescriptions and modern Chinese patent medicines were pungent, sweet and bitter. And the drugs mainly belong to spleen, lung, liver and kidney meridians. Correlation analysis suggested the same high-frequency association compatibility of ancient and modern prescriptions, Poria-Cinnamomi Ramulus-Alismatis Rhizoma, Atractylodis Rhizoma-Cinnamomi Ramulus-Alismatis Rhizoma, Atractylodis Macrocephalae Rhizoma-Cinnamomi Ramulus-Alismatis Rhizoma. Both clinical symptoms and diseases associated with medicinal compatibility of ancient prescriptions were intestinal flora, edema and vomiting. The syndrome types included bladder impoundment, dampness trapped in the guardian surface, internal retention of phlegm and morbid fluid. The clinical symptoms associated with medicinal compatibility of modern TCM patent medicine were limb joints pain and edema. The diseases included rheumatic arthritis (RA) and kidney disease. The syndrome types included wind-cold-dampness RA, stagnation of collaterals and kidney yang deficiency. High frequency drug clustering yielded 4 clustered squares.Conclusion:The core indications treated by Cinnamomi Ramulus-Alismatis Rhizoma are exogenous diseases with dampness caused by syndrome types including internal storage of water-dampness, cold-dampness obstruction and so on, which can provide reference for further in-depth research and guidance on clinical medication.

Objective To investigate the effects and mechanisms of Tiaoqi Zhike Prescription(Ephedrae Herba,Armeniacae Semen Amarum,Fritillariae Thunbergii Bulbus,Scutellariae Radix,Trichosanthis Semen,etc.)on airway inflammation in cough variant asthma rats based on the MAPK/NF-κB signaling pathway.Methods Cough variant asthma rat model was established by ovalbumin sensitization.SD rats were randomly divided into blank group,model group,Dexamethasone group(0.5 mg·kg-1),Montelukast group(1.0 mg·kg-1)and Tiaoqi Zhike Prescription low-,medium-and high-dose groups(9.6,19.2,38.4 g·kg-1),with 10 rats in each group.Intragastric administration was given once a day for 14 consecutive days.The general condition of rats was observed and the number of coughs in rats within two minutes after atomization was recorded.HE staining and Masson staining were used to observe the pathological changes of lung tissue in rats.The levels of serum interleukin-1β(IL-1β),IL-6 and tumor necrosis factor-α(TNF-α)were detected by ELISA.The protein expression levels of p38 MAPK,p-p38,NF-κB p65 and p-p65 in lung tissue were detected by Western Blot.The mRNA expression levels of p38 MAPK and NF-κB p65 in lung tissue were detected by RT-qPCR.Results Compared with the blank group,the times of coughs in the model group was significantly increased(P＜0.01),and the pathological score of lung injury and the area ratio of collagen fibers were significantly increased(P＜0.01).The levels of serum IL-1β,IL-6 and TNF-α were significantly increased(P＜0.01).The protein expressions of p-p38,p-p65,p-p38/p38 and p-p65/p65 in lung tissue were significantly up-regulated(P＜0.01),and the mRNA expressions of p38 MAPK and NF-κB p65 were significantly up-regulated(P＜0.01).Compared with the model group,the cough frequency of rats in each administration group was significantly decreased(P＜0.01),the pathological score of lung injury and the area ratio of collagen fibers were significantly decreased(P＜0.01),the levels of serum IL-1β,IL-6 and TNF-α were significantly decreased(P＜0.01),and the protein expressions of p-p38 and p-p65 and the mRNA expressions of p38 MAPK and NF-κB p65 in lung tissue were significantly down-regulated(P＜0.05,P＜0.01).The protein expression ratios of p-p3/p38 and p-p65/p65 in the lung tissue of rats in the high-dose group of Tiaoqi Zhike Prescription were significantly down-regulated(P＜0.01).Compared with the Dexamethasone group and the Montelukast group,the number of coughs in the high-dose group of Tiaoqi Zhike Prescription was significantly reduced(P＜0.05).Compared with the Dexamethasone group,the serum levels of IL-1β,IL-6 and TNF-α in the high-dose group of Tiaoqi Zhike Prescription were significantly decreased(P＜0.01).Compared with the Montelukast group,the levels of serum IL-1β and TNF-α in the high-dose group of Tiaoqi Zhike Prescription were significantly decreased(P＜0.05,P＜0.01).Conclusion Tiaoqi Zhike Prescription can improve the cough symptoms of ovalbumin-induced cough variant asthma model rats,reduce airway inflammatory cell infiltration and airway remodeling,and reduce the levels of inflammatory cytokines IL-1β,IL-6 and TNF-α.The mechanism may be related to the regulation of MAPK/NF-κB signaling pathway.

As the most aggressive breast cancer, triple-negative breast cancer (TNBC) is still incurable and very prone to metastasis. The transform growth factor β (TGF-β)-induced epithelial-mesenchymal transition (EMT) is crucially involved in the growth and metastasis of TNBC. This study reported that a natural compound isotoosendanin (ITSN) reduced TNBC metastasis by inhibiting TGF-β-induced EMT and the formation of invadopodia. ITSN can directly interact with TGF-β receptor type-1 (TGFβR1) and abrogated the kinase activity of TGFβR1, thereby blocking the TGF-β-initiated downstream signaling pathway. Moreover, the ITSN-provided inhibition on metastasis obviously disappeared in TGFβR1-overexpressed TNBC cells in vitro as well as in mice bearing TNBC cells overexpressed TGFβR1. Furthermore, Lys232 and Asp351 residues in the kinase domain of TGFβR1 were found to be crucial for the interaction of ITSN with TGFβR1. Additionally, ITSN also improved the inhibitory efficacy of programmed cell death 1 ligand 1 (PD-L1) antibody for TNBC in vivo via inhibiting the TGF-β-mediated EMT in the tumor microenvironment. Our findings not only highlight the key role of TGFβR1 in TNBC metastasis, but also provide a leading compound targeting TGFβR1 for the treatment of TNBC metastasis. Moreover, this study also points out a potential strategy for TNBC treatment by using the combined application of anti-PD-L1 with a TGFβR1 inhibitor.

Objective:To explore the predictive value of multi-slice spiral CT (MSCT) arterial enhancement fraction (AEF) in the risk degree of gastrointestinal stromal tumors (GIST).Methods:The clinical data of 178 patients with GIST in Shanxi Province Cancer Hospital from January 2013 to May 2021 were retrospectively analyzed. According to tumor size, primary site, mitotic figure and whether the tumor was ruptured or not, the patients were divided into extremely low risk group (24 cases), low risk group (44 cases), medium risk group (48 cases), and high risk group (62 cases). One-way ANOVA was used to compare MSCT AEF value and conventional plain and enhanced scan values among the 4 groups. The receiver operating characteristics (ROC) curve was drawn to assess the predictive efficacy of AEF value, conventional plain value, enhanced scan value, Ki-67 and AEF value combined with Ki-67 for high-risk GIST.Results:Except for CT value in the venous phase and CT value in added arterial phase, the comparison of AEF value, plain scan CT value, arterial phase CT value, and added venous phase CT value of GIST patients in the 4 groups showed statistically significant differences (all P < 0.05). In the predictive efficacy evaluation of high-risk GIST, the area under the curve (AUC) of the ROC curve for AEF value was 0.753, which was higher than that for plain scan CT value (0.593), arterial phase CT value (0.592) and added venous phase CT value (0.631), lower than AEF combined with Ki-67 (0.799). Kappa consistency test showed that the AEF value, plain scan CT value and arterial phase CT value were consistent with the pathological examination results (Kappa values were 0.375, 0.168 and 0.168, respectively), however, the added venous phase CT value was inconsistent with the pathological examination results (Kappa = -0.224). The AUC of AEF value combined with Ki-67 for predicting high-risk GIST was 0.799, and the Kappar value was 0.528. Conclusions:MSCT AEF value varies in GIST with different risk degree, and its preoperative efficacy in predicting high-risk GIST is superior to that of conventional plain scan and enhanced scan; especially the combination of AEF value with Ki-67 shows a higher predictive efficacy.

Objective: To investigate the prevalence of autonomic dysfunction and its influencing factors in the elderly in Jizhou community of Tianjin. Methods: By using a cross-sectional study, a questionnaire survey was conducted in the elderly in order to investigate the prevalence of autonomic dysfunction and its influencing factors. Results: A total of 1 292 elderly patients were enrolled.Of them, 196 cases had autonomic dysfunction(15.2%, 196/1 292). The main symptoms of autonomic dysfunction were frequent urination, urination urgency, urination incontinence(19.7%, 255/1 292)and constipation(15.9%, 205/1 292). Multivariate Logistic regression analysis showed that women(OR=1.808, 95%CI: 1.253~2.607), 75-85 years of age(OR=1.573, 95%CI: 1.109~2.232), general anesthesia history(OR=1.552, 95%CI: 1.044~2.307), sleep disorders(OR=2.906, 95%CI: 1.506~2.916), diabetes(OR=1.791, 95%CI: 1.197~2.678)and headache(OR=2.589, 95%CI: 1.482~4.520)were risk factors for autonomic dysfunction. Conclusions The prevalence of autonomic dysfunction is high in the elderly in Jizhou community of Tianjin city.It is necessary to pay great attention to potential risk factors of autonomic dysfunction in the elderly.And the autonomic dysfunction symptoms should be diagnosed and treated as early as possible.

Objective To investigate the surgery-related complications and risk factors of ileocolic Crohn's disease (CD).Methods The retrospective case-control study was conducted.The clinicopathological data of 52 patients with ileocolic CD who underwent surgery at the Peking Union Medical College Hospital from January 2010 to April 2016 were collected.Observation indicators:(1) surgery-related complications,(2) risk factors analysis of surgery-related complications:gender,age of onset,preoperative body mass index (BMI),course of disease,smoking history,history of appendectomy,perianal lesions,oral ulcer,C-reactive protein (CRP),erythrocyte sedimentation rate,disease behavior,short crohn's disease activity index (sCDAI),preoperative amino salicylic acid therapy,preoperative hormone therapy,preoperative antituberculosis therapy,preoperative immunosuppressive agents therapy,preoperative biologic agents therapy,emergency operation,surgical method and ileocolic anastomosis method,(3) follow-up.The follow-up using outpatient examination and telephone interview was performed to detect recurrence of disease up to August 2016.Measurement data with normal distribution were represented as-x ± s.The univariate analysis was done using the chi-square test,and multivariate analysis was done using the Logistic regression model.Results (1) Surgery-related complications:of 52 patients,12 had postoperative complications.Four patients complicated with wound infection had good healing of the wound after debridement and dressing change.Of 4 patients with abdominal infection,3 were improved by anti-infection symptomatic treatment and 1 die of septic shock at postoperative day 1.One patient with intestinal obstruction had a smooth recovery after open adhesiolysis.One patient with intestinal fistula discharged from hospital due to a critical condition under families' requestion.One patient with acute cholecystitis and 1 with acute pancreatitis were respectively improved by conservative treatment.(2) Risk factors analysis of surgery-related complications:theresult of univariate analysis showed that sCDAI and emergency operation were the factors infecting surgery-relatedcomplications of ileocolic CD (x2 =6.299,8.494,P ＜ 0.05).The result of multivariate analysis showed that sCDAI was an independent factor infecting surgery-related complications of ileocolic CD [OR =2.716,95％ confidence interval (CI):1.216-6.066,P ＜ 0.05].(3) Follow-up:all the 52 patients were followed up for 5-76 months with a median time of 39 months.During the follow-up,15 had recurrence of diseases and then underwent medical treatment.Conclusions Patients with ileocolic CD are easily complicated with wound infection and abdominal infection in the active period,and sCDAI is an independent factor infecting surgery-related complications of ileocolic CD.

Objective To investigate the availability and usefulness of echocardiography in piglet of experimental carotid-jugular shunting pulmonary hypertension.Methods Fifty-one 1-month-old piglets were randomly divided into surgical shunt group(CA-JV,n =45) and sham group(n =6).In shunt group,left CA-JV shunt was esteblished by end-to-side vascular anastomosis from left carotid artery to jugular vein.Piglets in sham group received a sham operation.Periodic hemodynamic evaluation of the carotidjugular shunt and heart were performed by ultrasound examination post-surgery.Tricuspid regurgitation and pulmonary regurgitation were monitored for evaluating pulmonary systolic pressure and mean pressure.Results In CA-JV group,32 piglets survived to end point of experiment and 27 maintained a persistent shunting (success rate 60％).Tricuspid regurgitation and pulmonary regurgitation occurred increasingly and pulmonary pressure had risen gradually since 4 months post-surgery (P ＜ 0.05).Those were coincided with the results of right catheterization and pulmonary pathology.Conclusions Ultrasound can monitor experimental carotid-jugular shunting pulmonary hypertension that shows practical value for further study in the mechanism and treatment of pulmonary hypertension due to increased pulmonary blood flow.