Objective: To investigate the resistance to rifampicin and isoniazid and the changing trends among patients with pulmonary tuberculosis in Luohu District, Shenzhen City, Guangdong Province from 2012 to 2022, so as to provide insights into improving drug-resistant pulmonary tuberculosis control and prevention strategies. Methods: Basic information, treatment classification and drug resistance data of patients with pulmonary tuberculosis and positive pathogenic detection in Luohu District from 2012 to 2022 were collected through the Tuberculosis Surveillance System of Chinese Disease Prevention and Control Information System, and resistance rates of rifampicin and isoniazid and the changing trends were analyzed. Results: A total of 2 126 patients with pulmonary tuberculosis were collected and had a median age of 34 (interquartile range, 25) years, including 1 334 males (62.75%) and 792 females (37.25%). There were 302 patients with drug-resistance in Luohu District from 2012 to 2022, with a resistance rate of 14.21%. Among them, 60 patients were monoresistant to rifampicin (2.82%), 113 patients were monoresistant to isoniazid (5.32%), and 129 patients were multidrug resistant (6.07%). The rate of rifampicin monoresistance showed a downward trend from 2012 to 2022, while the rate of multidrug resistance showed an upward trend (both P<0.05). There was no significant tendency in the rate of isoniazid monoresistance (P>0.05). The rate of multidrug resistance among patients without Shenzhen residence was higher than that among patients with Shenzhen residence; the rates of rifampicin resistance and multidrug resistance among retreated patients were higher than those among treatment-naïve patients (all P<0.05). Conclusions The rate of rifampicin monoresistance appeared a downward trend and the rate of multidrug resistance appeared an upward trend among patients with pulmonary tuberculosis in Luohu District from 2012 to 2022. Attention should be given to non-Shenzhen residence and retreated patients.

After systematically reviewing the syndrome distribution， evolution， diagnostic criteria， effectiveness evaluation and genomics study on acute exacerbation of chronic obstructive pulmonary disease （AECOPD） in the past decade， we found that there are problems such as inconsistency in the nomenclature of syndrome， lack of quantitative diagnostic tools for syndrome， less developed evaluation tools for syndrome efficacy， and singularity of genomics technique. Based on this， it was proposed that we should pay attention to the standardisation of syndrome naming， strengthen the research on quantitative diagnostic methods， establish standardised and quantitative diagnostic tools， further improve the existing assessment tools of syndrome effectiveness， and integrate the existing genomics techniques to conduct research， so as to support the further research on AECOPD syndromes.

OBJECTIVE：To investigate the effects of Shenfu yixin decoction on the utilization of fatty acid in primary hypoxic cardiomyocytes and its potential mechanism. METHODS ：The apical tissue of neonatal SD rats with 1-3 days old were collected ， and the primary cardiomyocytes were isolated ，cultured and identified. The cardiomyocytes were randomly divided into normal group，model group ，coenzyme Q 10 group（positive control ，1×10－4 mol/L），Shenfu yixin decoction low-dose and high-dose groups（0.25，0.5 mg/mL）. Except for normal group ，cells in other groups were cultured under 5％O2，5％CO2 and 90％N2 for 6 hours to induce hypoxic injury model. After 6 hours of hypoxia ，the content of ATP was detected by luciferase luminescence assay. Western blotting assay was adopted to detect the expression of FAT/CD 36，PPARα and PPARβ/δ. RESULTS：Compared with normal group ，the content of ATP and relative expression of FAT/CD 36 protein were decreased significantly in model group （P＜ 0.05）. Compared with model group ，the content of ATP was increased significantly in coenzyme Q 10 group and Shenfu yixin decoction high-dose group ，while the relative expression of FAT/CD 36 and PPARα protein in coenzyme Q10 group，the relative expression of FAT/CD 36 protein in Shenfu yixin decoction high-dose group as well as the relative expression of PPARα and PPARβ/δ protein in Shenfu yixin decoction groups were decreased significantly （P＜0.05）. CONCLUSIONS ：Shenfu yixin decoction can inhibit the utilization of fatty acid of primary hypoxic cardiomyocytes and improve their energy metabolism by inhibiting the expression of FAT/CD 36，PPARα and PPARβ/δ protein.

OBJECTIVE： To observe the effects of Shenfu yixin decoction on reactive oxygen species （ROS） and energy metabolism in primary hypoxic cardiomyocytes. METHODS： After isolation， culture and identification， primary cardiomyocytes of neonatal SD rats were randomly divided into normal group， model group， positive control group （coenzyme Q10， 0.1 mmol/L） and Shenfu yixin decoction low-dose and high-dose groups （0.25， 0.5 mg/mL）. Except for normal group， other groups were cultured with 5％O2， 5％CO2 and 90％N2 for 6 h to induce hypoxic injury model. After 6 hours of hypoxia， ROS contents in cardiomyocytes and mitochondria of each group were detected by ROS probe and flow cytometry. Luciferase luminescence and Western blotting were used to detect ATP content and CK protein expression of each group. Transmission electron microscope was used to observe ultrastructure of cardiomyocytes in each group. RESULTS： Compared with normal group， the expression of ROS in primary hypoxic cardiomyocytes and mitochondria as well as the content of ROS were increased significantly， while the content of ATP and expression levels of CK protein were decreased significantly （P＜0.05）； there were swelling of endoplasmic reticulum and mitochondria， dissolution or even disappearance of mitochondrial ridge， obvious cardiomyocytes injury. Compared with model group， the expression of ROS in primary hypoxic cardiomyocytes and mitochondria of administration groups， the contents of ROS in primary hypoxic cardiomyocytes of positive control group and Shenfu yixin decoction high-dose group as well as the content of ROS in primary hypoxic cardiomyocytes mitochondria of administration groups were all decreased significantly， while ATP contents in primary hypoxic cardiomyocytes of positive control group and Shenfu yixin decoction high-dose group as well as expression levels of CK protein in primary hypoxic cardiomyocytes of administration groups were all increased significantly （P＜0.05）. The primary hypoxic cardiomyocytes injury was relieved significantly in positive control group and Shenfu yixin decoction high-dose group. CONCLUSIONS： Shenfu yixin decoction can improve primary hypoxic cardiomyocytes， down-regulate the expression of ROS in cardiomyocytes and mitochondria and also improve its energy metabolism.

Objective To compare the dosimetric differences between intracavitary brachytherapy in combination with interstitial brachytherapy or not for locally advanced cervical cancer.Methods From May 2016 to March 2017,35 patients with locally advanced cervical cancer treated with combined external beams and intracavitary/interstitial brachytherapy were selected in this study.The prescription of intensity-modulated radiation therapy was:46.8-50.4 Gy/26-28 fractions,1.8 Gy/fraction.The prescription for combined intracavitary/interstitial brachytherapy was 7 Gy/fraction × 4,once per week.Each patient was first implanted with a three tube applicator for brachytherapy,and the CT images were acquired for treatment planning.The three tube applicator was removed before a uterine tube and needles were implanted,thereafter planning images were acquired again.Dose to the targets and organs at risk were evaluated respectively for the two groups.Results A total of 212 brachytherapy plans were developed,including 106 intracavitary and 106 endoluminal combined interstitial plans.The target dose in endoluminal combined interstitial brachytherapy was significantly higher than that of intracavitary treatment alone,where D90 of the high-risk clinical target volume (CTV) and moderate CTV were both significantly increased (t =-6.01,-2.73,P ＜ 0.05).The D2 cm3 of the bladder,rectum and sigmoid colon were significantly reduced (t=3.07,4.52,2.91,P＜0.05).Conclusions The application of the endoluminal combined interstitial brachytherapy for locally advanced cervical cancer can significantly increase the target dose,and reduce the dose to organs at risk such as the bladder,rectum and sigmoid colon.

Objective To explore the influences of the teaching mode based on working process systematization on teaching results of geriatric nursing. Methods A totally of 209 students of 2013 higher vocational nursing major in four classes were selected and divided into the experimental group and the control group by simple random methods, among which the experimental group contains 103 students who were taught in teaching mode based on working process systematization while the control group contains 106 students who were taught in the traditional teaching mode. The new teaching mode′s design and development linked closely to working situations and tasks; adopt the teaching mode combining teaching, learning and practicing together aimed at the position requirements of old-age nursing service system at the core of the true clinic old-age nursing work-post-skills, which were based on nurse practice qualification. Students′ performance achievement between two groups after teaching were compared. The thinking ability of students was evaluated by judging thought scale, and the students′ evaluation of the new teaching method in the experimental group was accessed by a self-designed questionnaire based on working process systematization.Results After the implementation of teaching, there were significant differences between students in two groups in their performance in theory examination and practice examination based on statistics tests ( P<0. 05 ); after the intervention, there were statistically significance in the differences in students′critical thinking ability between two groups by comparison in term of each aspect such as reasoning, agree on the assumptions, explanation, deduction, discoursing ( t=7. 452, 6. 964,10.220,4.771,4.765;P<0.05);the students in the experimental group made a positive evaluation on the teaching method based on working process systematization.Conclusions The teaching method based on working process systematization is available for the teaching of geriatric nursing in higher vocational institutions, and is helpful for students to master professional skills, cultivate their spirit of innovation, strengthen their team spirit, communication skills, critical thinking ability and other qualities. This new method is worth learning in the teaching of geriatric nursing course in higher vocational colleges.

Objective To study the changes of Toll like receptor 4,7 (TLR4,TLR7) protein in cervical squamous cell carcinoma ( CSCC) tissues and the relationship between expression and clinical pathological characteristics of the patients. Methods A total of 67 pa-tients with CSCC carcinoma( CSCC group) ,30 patients with cervical intraepithelial neoplasia( CIN group) and 30 patients with normal cervi-cal tissues(normal group) were detected by immunohistochemical method. The expression of TLR4,TLR7 protein and its clinical pathological characteristics of patients with CSCC in the samples were analyzed. Results TLR4,TLR7 protein positive rate of CSCC group were respec-tively 80. 60% and 76. 12%,which were significantly higher than those of CIN group (46. 67%,40. 00%) and the normal group(13. 33%, 10. 00%),the difference was statistically significant (P<0. 05). TLR4,TLR7 protein positive expression rate in CIN group was significantly higher than that in the normal group (P<0. 05). The positive expression of TLR4 protein and CSCC in patients with FIGO stage,pathological grade,depth of invasion had a significant relationship(P<0. 05),pathological grade,the positive expression of TLR7 protein and CSCC in pa-tients with invasive depth had a significant relationship(P<0. 05). Conclusion There is increased expression of TLR4,TLR7 protein in cervical tissues of CSCC patients,and a certain relationship between the factors and clinical staging,pathological grading.

This study was aimed to explore the characteristics of urine metabolomics among HIV/AIDS patients with spleen-lung qi-deficiency. H-NMR technique was combined with principal component analysis and cluster analysis in the comparison of urine metabolic products among 24 HIV/AIDS cases with spleen-lung qi-deficiency and 20 healthy control cases. The results showed that urine metabolic products of HIV/AIDS patients with spleen-lung qi-deficiency and healthy people by H-NMR technique detection and PLS-DA analysis can classify the outline of urine metabolites. There were about 20 variables in the difference between two groups. The speculated substances contained glycyl-L-leucine, L-valine, α-aminobutyric acid, methyl succinic acid, glycine propionyl, and etc. It was concluded that H-NMR technique was able to classify the outline of urine metabolites between HIV/AIDS cases with spleen-lung qi-deficiency and healthy people. Part of the potential existed characteristic markers contributed to the clinical diagnosis of traditional Chinese medicine (TCM) syndrome differentiation of AIDS. It had certain effect in its quantitative analysis.

This article was aimed to determine effects of Jia-Shen prescription (JSP) on infarct size (IS), cardiac function and myocardial cytokine in the early phase of myocardial infarction (MI) in rats. Acute MI models were induced by the ligation of left anterior descending coronary artery in Sprague-Dawley (SD) rats. The rats were ran-domly divided into five groups, which were the sham-operated group, model group, JSP-3 g (3 g·kg-1·day-1) group, JSP-6 g (6 g·kg-1·day-1) group, and the losartan (10 mg·kg-1·day-1) group. IS was determined by Evans blue and 2,3,5-Triphenyltetrazolium chloride (TTC) 3 days after MI. The left ventricular structure and contractility were measured by echocardiography performed 7 days after MI. And contents of myocardial inflammatory mediators in-cluding tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), and monocyte chemoattractant protein-1 (MCP-1) were measured by ELISA. The results showed that compared with the model group, treatment with JSP at the dose of 6 g significantly reduced myocardial IS (P<0.05);left ventricular end diastolic diameter (LVEDD) and left ventricu-lar end systolic diameter (LVESD) were significantly decreased (P<0.05); left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were significantly increased (P<0.05).The results were similar as the losartan group. Compared with the model group, JSP can significantly reduce the production of TNF-α, IL-1βand MCP-1 in cardiac tissues (P<0.05). Except TNF-α, these effects of JSP were in a dose-dependent manner. JSP (6 g) had equal effectiveness with losartan. It was concluded that consistent with losartan-induced cardioprotection, JSP administered after MI reduced myocardial IS, improved cardiac function, and decreased inflammatory mediators in ischemic myocardium. The data indicated that JSP exerted its cardioprotection possibly via inhibiting inflammatory response.