ObjectiveTo screen out the transcriptomes related to the intervention of Wuzi Yanzongwan on the spermatogenic function of semi-castrated male mice， and to explore its potential mechanism in the intervention of the progress of low spermatogenic function. MethodBalb/c mice were randomly divided into sham-operated group， model group， testosterone propionate group（0.2 mg·kg^-1·d^-1， intramuscular injection） and Wuzi Yanzongwan group（1.56 g·kg^-1·d^-1， intragastric administration） according to body weight， with 12 mice in each group. The right testicle and epididymis were extracted from the model group and the drug administration group to construct the semi-castrated model of low spermatogenic function， while the fur and the right scrotum of the sham-operated group were only cut and immediately sterilized and sutured. At the end of the intervention， hematoxylin-eosin（HE） staining was used to observe the histopathology of testis， enzyme-linked immunosorbent assay（ELISA） was used to detect the levels of serum testosterone（T）， luteinizing hormone（LH） and follicle stimulating hormone（FSH）. The sperm count and motility of epididymis were measured by automatic sperm detector of small animal. Transcriptomic microarray technology was used to detect the mRNA expression level of testicular tissue in each group， the transcriptome of genes related to the regulation of Wuzi Yanzongwan was screened， and three mRNAs were selected for Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR） to verify the transcriptome data. Through the annotation analysis of Gene Ontology（GO） and the signaling pathway analysis of Kyoto Encyclopedia of Genes and Genomes（KEGG）， the related functions of drugs regulating transcriptome were analyzed. ResultCompared with the sham-operated group， the testicular tissue of mice in the model group showed spermatogenic injury， contraction and vacuolization of the seminiferous tubules， reduction of spermatogenic cells at all levels， widening of the interstitial space， obstruction of spermatogonial cell development and other morphological abnormalities， and serum T significantly decreased， LH significantly increased（P<0.01）， and FSH elevated but no statistically significant difference， the count and vitality of epididymal sperm significantly decreased（P<0.01）. There were 882 differentially expressed mRNAs in the testicular tissues， of which 565 were up-regulated and 317 were down-regulated. Cluster analysis showed that these differentially expressed mRNA could effectively distinguish between the sham-operated group and the model group. Compared with the model group， the damage to testicular tissue in the Wuzi Yanzongwan group was reduced， the structure of the seminiferous tubules was intact， vacuolization was reduced， and the number of spermatogenic cells at all levels was significantly increased and arranged tightly. The serum T significantly increased， LH significantly decreased（P<0.01）， and FSH decreased but the difference was not statistically significant. The count and vitality of sperm in the epididymis were significantly increased（P<0.01）. Moreover， Wuzi Yanzongwan could regulate 159 mRNA levels in the testes of semi-castrated mice， of which 32 were up-regulated and 127 were down-regulated， and the data of the transcriptome assay was verified to be reliable by Real-time PCR. GO and KEGG analysis showed that the transcriptome functions regulated by Wuzi Yanzongwan were involved in the whole cell cycle process of sperm development such as sex hormone production of interstitial cells in testis， renewal， differentiation， metabolism， apoptosis and signal transduction of spermatogenic cells， and were closely related to the biological behaviors of signaling pathways such as spermatogenic stem cell function， endoplasmic reticulum protein processing and metabolic program. ConclusionWuzi Yanzongwan can effectively improve the low spermatogenic function of semi-castrated male mice， and its mechanism may be related to the regulation of testicular transcriptional regulatory network， the synthesis of sex hormones in testicular interstitial cells， the function of spermatogenic stem cells， the whole cell cycle process of spermatogenesis， as well as the expression of endoplasmic reticulum protein processing and metabolic program related genes transcription.

OBJECTIVE To analyze the chemical constituents from classical prescription Xiehuang San(XHS)standard decoc-tion by UPLC-Q-TOF-MS technology,and classify the chemical composition and analyze the representative components.METHODS Acquity HSS T3 column(2.1 mm×100 mm,1.8 μm)was used as the chromatographic column,with 0.1%formic acid solution-0.1%formic acid acetonitrile as the mobile phase for gradient elution.The volume flow rate was 0.4 mL·min-1 and the column tem-perature was 40℃.Mass spectrometry data of XHS were collected in positive and negative ion modes.The chemical constituents from classical prescription XHS were analyzed and identified by Masslynx 4.1 software comparison with reference materials,mass spectrome-try data analysis and reference to relevant literature.RESULTS A total of 107 compounds were analyzed and identified from XHS,including 45 flavonoids,27 triterpenoids,11 monoterpenoids,10 phenylpropanoids,6 chromogenic ketones,5 alkaloids and 3 other other compounds.CONCLUSION The study provides an experimental basis for the further research on the substance basis and qual-ity control of XHS.

By sorting out and analyzing the contents about pulse diagnosis in Tanksuqnameh, it was found that in terms of pulse theory, the book contains academic viewpoints of different periods and doctors about three portions and nine readings pulse method and nutritive qi operation law in Huang Di Nei Jing, the Cunkou pulse-taking method and the Cunguanchi theory in Nan Jing, the Renying and Qikou pulse-taking method and the three-region pulse-taking method in Mai Jing, and the seven superficies-indicating, eight interior-indicating and nine channels pulse of Mai Jue, etc.; in terms of pulse theory interpretation, multiple annotations from famous doctors are cited, and TCM basic theories and knowledge of astronomy and mathematics are applied, combined with the background of ancient Iranian medicine and local medical experience for explanation; in terms of pulse diagnosis techniques, pulse diagnosis techniques such as "three fingers determining three guan", "adjusting finger density", "floating and sinking pulse", "foot back pulse breaking life and death" were recorded in books of Nan Jing, Mai Jue, Lei Zheng Huo Ren Shu, etc.; in terms of influencing pulse factors, the male and female pulse, physical pulse, and four time pulse were recorded. Tanksuqnameh is a universal work of Persian Traditional Chinese Medicine, compiled by the author Rashid-ul-Din based on his research on Chinese culture and medical knowledge, combined with the unique customs, language and culture, and way of thinking in the Middle East region, to reorganize various pulse theories from before the Han Dynasty to the Tang and Song Dynasties in China. The publication of this book indicates that TCM pulse diagnosis had been promoted to the Middle East in the 14th century and provided valuable experience for local medical development. The author's sense of identification and research spirit towards different cultures provide a historical example for achieving cross-cultural communication between TCM and medicine in different regions. The preserved literature from the Tang and Song Dynasties in the book can provide clues for a deeper understanding of ancient pulse theory in TCM, but some details do not explain thoroughly or does not match the current clinical practice. Therefore, attention should be paid to distinguishing in research and application.

Objective:To understand the satisfaction evaluation of contracted residents with " Internet plus" family doctor services and to explore its influencing factors.Methods:From November to December 2021, a stratified random sampling method was used to select 360 contracted residents who had utilized " Internet plus" family doctor services from community health service centers or township health clinics in various counties, cities, or districts of a city in Shandong Province for on-site questionnaire surveys. The purpose was to understand their awareness and satisfaction with the " Internet plus" family doctor services. At the same time, key informant interviews were conducted with contracted residents according to the principle of intensity sampling and information saturation, to collect their opinions and suggestions on the implementation process and model construction of " Internet plus" family doctor services. Descriptive analysis was performed on the data, and a binary logistic regression model was used to analyze the factors affecting the satisfaction of contracted residents with " Internet plus" family doctor services.Results:352 valid questionnaires were obtained. Among the respondents, 108 (30.6%) were very familiar or relatively familiar with the " Internet plus" family doctor service policy, and 251 (71.3%) expressed a high level of satisfaction with the overall " Internet plus" family doctor service. Gender, monthly income status, frequency of participation in health education activities, and satisfaction with the doctor′s daily service attitude, medical technical level, medical service charge level, and the level of communication between the service team and family members were factors affecting the satisfaction of contracted residents with " Internet plus" family doctor services ( P<0.05). Interview results showed that 38 people (95.0%) believed that there were issues with the current implementation of " Internet plus" family doctor services in China, such as the lack of an effective policy support environment, the need to improve the publicity and mobilization effects of contracting institutions, poor service cognition levels among the population, concerns about service quality, misunderstandings about internet-related concepts, network " panic" caused by electronic fraud phenomena, and cultural level differences among the elderly that limited the use of services. Conclusions:The overall satisfaction of contracted residents with the " Internet plus" family doctor services was relatively good. Various factors affected the satisfaction evaluation of contracted residents. It is important to focus on the differences in service psychological perception among contracted residents with different demographic characteristics, strengthen the construction of service teams and service platforms, and improve the public′s cognition and participation in " Internet plus" family doctor services to promote the continuous development of " Internet plus" family doctor services.

Objective:To explore the influence of Internet diversified rehabilitation medicine education on self-efficacy and quality of life in newly diagnosed breast cancer patients.Methods:A prospective study was performed in 130 newly diagnosed breast cancer patients admitted to Beijing Friendship Hospital, Capital Medical University from February 2020 to February 2021. According to the method of randomly number table, these patients were divided into control group and intervention group, 65 cases in each group.The control group was treated with routine treatment scheme, and the intervention group added the intervention of Internet diversified education of rehabilitation medicine on the basis of routine treatment scheme. Compared the general data of the two groups, the General Self-Efficacy Scale (GSES) and the cancer patients′ Quality of Life Questionnaire-Core 30 (QLQ-C30) were used to compare the self-efficacy levels of the two groups before operation, 4 months and 8 months after operation, evaluate the quality of life. Measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used for comparison between groups; Chi-square test was used for comparison of enumeration data between groups. Results:Before operation, there was no significant difference in general data, GSES score and QLQ-C30 score between the two groups ( P> 0.05). Four months after operation, GSES scores [(27.39±4.68) score vs (25.91±3.18)score], somatic function [(65.50±4.34) score vs (63.07±5.42) score], cognitive function [(67.63±10.32) score vs (63.29 ± 11.36) score], role function [(50.82±10.80) score vs (45.59±13.94) score], and total quality of life [(63.47 ± 6.98) score vs (59.26±7.98)score] were compared between the intervention group and the control group, the difference was statistically significant ( P< 0.05). There was no significant difference in the scores of emotional function [(57.60±11.72) score vs (55.53±10.61) score] and social function [(49.86±12.11) score vs (46.13±10.25) score] ( P> 0.05). Eight months after operation, the GSES score [(28.82±3.31) score vs (26.73 ± 3.06) score] of patients in the intervention group and the control group, and the scores of functional areas and overall quality of life in QLQ-C30 score were significantly different ( P< 0.01). Conclusion:the Internet diversified rehabilitation medicine education has a significant effect on improving the self-efficacy of new breast cancer patients, and can improve the quality of life of patients.

Objective:To investigate the influencing factors of the therapeutic effect of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in patients with epidermal growth factor receptor (EGFR) mutant advanced non-small cell lung cancer (NSCLC).Methods:The clinical data of 104 EGFR mutant advanced NSCLC patients who received EGFR-TKI treatment in Wuxi No.2 Hospital Affiliated to Nanjing Medical University from January 2015 to October 2019 were collected. The correlation of different types of EGFR mutation with the clinicopathological characteristics, the hematological examination results and the treatment mode of patients was analyzed. Cox proportional hazard model was used to analyze the association of the progression-free survival (PFS) time of patients receiving EGFR-TKI treatment with the different types of EGFR mutation, the clinicopathological characteristics, hematological related indexes and treatment mode. Kaplan-Meier method was used to analyze the independent influencing factors for the PFS of the stratified patients.Results:The overall disease control rate (DCR) of patients receiving EGFR-TKI treatment was 92.3% (96/104). Cox univariate analysis showed that the levels of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), D-dimer, and previous surgical treatment history of patients receiving EGFR-TKI treatment were associated with PFS of patients (all P < 0.05). Cox multi-factor analysis showed that EGFR mutation type ( HR =2.371, 95% CI 1.298-4.332, P = 0.005), combination therapy ( HR = 0.489, 95% CI 0.245-0.978, P = 0.043) and choice of therapeutic drugs ( HR = 0.261, 95% CI 0.113-0.606, P = 0.002) were independent influencing factors for the PFS of patients receiving EGFR-TKI treatment. The PFS of EGFR 19 exon-mutant patients with advanced NSCLC was longer than that of those with EGFR 21 exon-mutant (median PFS time: 14.0 months vs.9.5 months, P<0.05); the PFS of combination of radiotherapy or chemotherapy was longer than that of EGFR-TKI single therapy (median PFS time: 15.0 months vs. 9.0 months, P<0.05), the PFS of patients receiving erlotinib was better than that of those receiving gefitinib ( P<0.05). According to EGFR mutation types, it was found that EGFR 19 exon-mutant patients receiving EGFR-TKI in first-line treatment could obtain better PFS than those who receiving EGFR-TKI in second-line and above treatment (median PFS time: 14.0 months vs. 9.5 months, P<0.05). When receiving EGFR-TKI, EGFR 19 exon-mutant patients with CA125 <85 U/ml could obtain longer PFS time than those with CA125 ≥85 U/ml (median PFS time: 14.0 months vs. 6.5 months, P<0.05). Conclusions:The therapeutic effect of EGFR-TKI in EGFR-mutant patients with advanced NSCLC is positive. EGFR 19 exon-mutant NSCLC patients with low-level CA125 receiving EGFR-TKI in first-line treatment can obtain better PFS.

Objective:To explore the associations of platelet parameters platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) with the risk for stroke in people with different blood pressure levels.Methods:All the participants were from Dongfeng-Tongji cohort, including 38 295 retired employees from Dongfeng Motor Corporation at the first follow-up survey. After excluding participants with coronary heart disease, stroke, cancer, history of platelet influential drug use and those with missed data of platelet parameters or blood pressure or lost to follow-up, finally a total of 21 294 participants were included in this study. All the participants completed baseline questionnaires, physical examinations, clinical biochemical tests, and blood sample collection. Cox proportional hazard models were used to estimate the hazard ratios ( HRs) and the corresponding 95% confident intervals ( CIs) for the associations between platelet parameters and risk for stroke in people with different blood pressure levels. Results:After a mean follow-up of 8.0 years, 1 578 participants developed incident stroke [1 266 ischemic stroke (IS) cases and 312 hemorrhagic stroke (HS) cases]. Compared with the participants with PLT<188×10 9/L, those with PLT≥188×10 9/L among hypertension cases were significantly associated with higher risks for stroke and IS (stroke: HR=1.27, 95% CI: 1.12-1.44; IS: HR=1.39, 95% CI: 1.21-1.60). Among hypertension group, compared with participants with PCT<0.165%, PCT≥0.165% were significantly associated with higher risk for stroke ( HR=1.15, 95% CI: 1.01-1.30) and lower risk for HS ( HR=0.70, 95% CI: 0.53-0.93); Among non-hypertension and hypertension group, PCT ≥0.165% were significantly associated with higher risks of IS ( HR=1.27, 95% CI: 1.05-1.54; HR=1.31, 95% CI: 1.14-1.50). MPV and PDW were not significantly associated with risk for stroke. Risk for stroke increased significantly in hypertension cases with different platelet parameters levels compared with non-hypertension cases with lower levels of each platelet parameters. Conclusion:Higher levels of PLT and PCT could increase the risks for stroke and IS in middle-aged and elderly hypertension patients, and lower levels of PCT could decrease the risk for HS in hypertension patients.

Prostate cancer is one of the malignant tumors with high incidence. Although most patients with prostate cancer respond well to standard treatment, they often have a poor prognosis once they develop hormone resistance. Radionuclide targeted therapy is an important method to treat malignant tumors after surgery and chemo-radiotherapy. New radioligand therapy (RLT), represented by 177Lu-prostate specific membrane antigen (PSMA)-RLT, effectively solves the problem of poor efficacy in advanced hormone-resistant prostate cancer, and has been widely recognized in the world. In this paper, the clinical practice of 177Lu-PSMA-RLT in the treatment of prostate cancer and its common adverse reactions are described in order to better understand and master its methods and lay the foundation for better clinical application and follow-up research.

Objective To summarize the clinical characteristics,diagnosis and treatment of autoimmune pancreatitis(AIP).Methods The retrospective descriptive study was adopted.The clinical data of 43 patients with AIP who were admitted to the First Affiliated Hospital of China Medical University between January 2010 and December 2014 were collected.All patients underwent laboratory tests and imaging examinations.For the patients who had the definite diagnosis of AIP,corticosteroid therapy was adopted,and for the patients who had the suspicion of pancreatic cancer,surgical operation was carried out.Observed indexes included clinical manifestations,laboratory findings,imaging findings,treatment,pathological findings and follow-up status.The follow-up of imaging examinations and laboratory tests via outpatient and inpatient examinations was performed on the patients until January 2016.Measurement data with skewed distribution were presented as average (range).Results (1) Clinical manifestations:of the 43 patients,33 demonstrated obstructive jaundice,19 had loss of weight,18 had upper abdominal pain and 5 had acute mild pancreatitis (the same patient with a variety of symptoms).Extrapancreatic organ involvement was detected in 23 of the 43 patients,including focal nephritis in 15 patients,sicca syndrome in 7 patients,pulmonary involvement in 5 patients,autoimmune thyroiditis in 5patients,hilar IgG4-associated cholangitis in 3 patients,retroperitoneal fibrosis in 3 patients and ulcerative colitis in 1 patient (the same patient with a variety of diseases).(2) Results of laboratory tests:17 patients underwent serum IgG4 detection and increased expression of IgG4 was found in 15 patients.(3) Imaging findings:all the 43patients underwent enhanced computed tomography (CT) scan of pancreas.Diffused enlargement of pancreas with appearance of sausage was observed in 34 patients and localized pancreatic head enlargement was observed in 9patients.Twenty patients had peripancreatic vascular involvement including stenosis or occlusion of splenic vein,stricture at the confluence of superior mesenteric vein,portal vein and splenic vein resulting in regional portal hypertension which led to gastric venous varices and splenomegaly.Three patients showed that superior mesenteric artery was surrounded by tissue masses with massive ascites.Five patients had pancreatic pseudocyst with splenic vein involvement and peripancreatic effusion.The abdominal CT examination of 15 patients with renal involvement showed renal cortical wedge or nodular lesions.Pulmonary inflammatory pseudotumor and interstitial pneumonia appeared in 5 patients,CT of whom showed solid pulmonary nodules or diffuse ground-glass opacities and patchy shadows in pulmonary interstitium.Thirty-two patients underwent magnetic resonance cholangiopancreatography and 28 patients underwent endoscopic retrograde cholangiopancreatography.The results showed the focal and diffuse or segmental stenosis of the main pancreatic duct were detected in 28 patients (diffuse stenosis in 23patients,local stenosis in 5 patients),stenosis of the intrapancreatic common bile duct in 32 patients,stenosis of hilar bile duct in 3 patients.Nine patients underwent endoscopic ultrasonography examination.The results showed 3 patients had hypoechoic mass in the head of pancreas and 6 patients had diffuse or heterogeneous hypoechoic of the pancreatic parenchyma.(4) Treatment status:of 43 patients,30 patients received initial steroid treatment.After steroid treatment,the clinical symptoms of 27 patients gradually improved and laboratory and imaging findings were both improved.Eleven patients didn 't receive initial steroid treatment,of whom 2 patients with obstructive jaundice underwent endoscopic biliary stent implantation,7 patients underwent surgical biliary drainage and 2 received neither endoscopic treatment nor surgical treatment.Two patients underwent pancreatoduodenectomy due to suspicion of pancreatic adenocarcinoma and were diagnosed as AIP based on postoperative pathological results and treated with steroid after operation.(5) Pathological examination:of the 43 patients,22 underwent pathological examination.Results of pathological examination of superficial lymph nodes showed lymph follicles hyperplasia,and immunohistochemistry staining showed massive IgG4 positive plasmocytes in 5 patients,supporting the diagnosis.Results of fine needle aspiration cytology in 15 patients showed no cytological evidence were detected in 14 patients and epithelial cells of malignant tumors in 1 patient.Results of pathological examination of surgical specimens showed dense infiltration of lymphocyte and immunohistochemistry staining showed massive IgG4 positive plasmocytes.(6) Follow-up status:of 43 patients,41 were followed up for an average time of 28 months (range,12-71 months).Of the 30 patients who received steroid treatment,27 had complete response and 3 had partial response.Of the 27 with complete response,4 patients relapsed during followup and were cured by continuous steroid treatment and extending treatment course,3 patients did not relapse,1 patient relapsed again,and long-term low dose steroid maintenance therapy was needed.The 3 patients with partial response were treated with mycophenolate mofetil for 6,4,4 months and imaging abmormalities disappeaved absolutely.Eleven patients received no steroid for the initial treatment,in whom 2 patients were lost to follow-up,1 patient with common bile duct jejunum anastomosis died in 1 year after surgery.In the other 8 patients,the imaging abnormalities were spontaneous remission or clinical and imaging manifestations were improved after steroid treatment and no recurrence was found.Two patients who underwent pancreatoduodenectomy due to suspicion of pancreatic adenocarcinoma received steroid treatment after operation and no recurrence was observed.Conclusion Clinicians should combine clinical manifestations,serological examination,imaging findings and pathological examination to make definite diagnosis of AIP and make differential diagnosis of pancreatic cancer to avoid unnecessary surgical treatment by misdiagnosis.

[ Abstract] Objective To investigate the effect of IL-8 on the viability and migration of HepG2 cells and the potential effect of integrins (αsubunits ) on the migration of HepG2 cells.Methods HepG2 cells were stimulated by IL-8 at different concentrations ranging from 0 to 125 ng/ml in vitro.MTT assay was preformed to detect the viability of HepG2 cells.Scratch wound migration assay was used to explore the effect of IL-8 on the migration of HepG2 cells at the time points of 0, 4, 8, 12 and 24 h,respectively.Transwell assay was conducted to detect the vertical migration of HepG2 cells after stimulation with IL-8 for 24 h.The F-actin of HepG2 cells was observed by immunofluorescence analysis after treatment with IL-8 at different concentrations.The expression of αsubunits of integrins in HepG2 cells treated with IL-8 for 8h was detected using Western boltting assays.Results Compared with the control group, HepG2 cells treated with IL-8 showed improved proliferation activities, but there was no significant difference between the groups of HepG2 cells treated with IL-8 at different concentrations.The cell scratch healing assays and Transwell analysis both indicated that IL-8 promoted the migration of HepG2 cells in a dose-dependent manner.Meanwhile, the cytoskeleton of HepG2 cells was rearranged and the number of filopodium-like protrusions (FLPs) was increased rapidly after treatment with IL-8.Western blotting analysis showed that IL-8 up-regulated the expression of αsubunit of integrins and there was a concentration difference betweenαsubunits.Conclusion IL-8 promotes the migration of HepG2 cells by up-regulating the expression ofαsubunits, and different αsubunits may play different roles.