Liver failure （LF） is a great trouble to the majority of patients due to its severe onset， many complications， difficult treatment， poor prognosis and other characteristics. This disease is liver injury caused by infection， hepatotoxic substances， autoimmunity， circulation disorders and other factors. It is a group of common clinical symptoms mainly manifested by coagulation disorders， jaundice， hepatic encephalopathy， ascites， and so on. In traditional Chinese medicine， it falls under the categories of "tympanites"， "jaundice" and other diseases. At present， the research progress of Western medicine in the treatment of LF is slow， and its clinical application effect is still not ideal. In contrast， traditional Chinese medicine has a long history in the treatment of this disease， with over thousands of years of clinical practice and verification. It is characterized by exact efficacy and fewer side effects. The pathological mechanism of LF is extremely complex， involves a variety of signaling pathways， and is mainly related to inflammation， oxidative stress， liver fibrosis， cell apoptosis and other processes. In recent years， many studies have shown that traditional Chinese medicine can intervene in the occurrence and development of LF by mediating relevant signaling pathways in vivo， but there is still a lack of relevant summary. Therefore， this review summarized several signaling pathways related to the intervention of traditional Chinese medicine in LF by referring to and sorting out relevant literature worldwide， including nuclear factor kappa B （NF-κB）， mitogen-activated protein kinase （MAPK）， phosphatidylin-ositol-3-kinase/protein kinase B （PI3K/Akt）， transforming growth factor-β/ drosophila mothers against decapentaplegic proteins （TGF-β/Smads）， and nuclear factor erythroid 2-related factor 2/heme oxygenase-1 （Nrf2/HO-1）， and elaborated the specific mechanism of their intervention in LF. This paper aims to provide practical and effective pathways and corresponding mechanisms for the treatment of LF by traditional Chinese medicine， and to provide new ideas and a theoretical basis for the clinical treatment of LF and further scientific research.

Objective To investigate the design of cuffed pediatric tracheal tubes and compare the effects of different tracheal intubation depth placement strategies on the position of the tracheal tube tip and cuff of 5 tracheal tube brands.Methods A total of 180 children who were admitted to Tianjin Children's Hospital from October 2020 to December 2021,with endotracheal intubation under general anesthesia,aged 1-6 years,were enrolled.The length of the subglottic airway was measured by electronic bronchoscopy.Dimensional data from 5 cuffed pediatric tracheal tube brands were recorded,including the length of the tracheal tube cuff,the distance from the tip of the tracheal tube to the upper edge of the cuff,and the tip of the tracheal tube to the lower edge of the tube glottis marker line the distance.Calculation of the required cuffed endotracheal tube internal diameter(ID)for 180 pediatric patients was performed based on the Motoyama formula,the positions of tracheal tube tip and upper cuff border were calculated for each of the 180 tracheas using depth mark to based tracheal tube placement,placement of the tracheal tube tip at 2 cm above the carina,and mid-tracheal tube placement.Results There were differences in the dimensional data of the 5 cuffed pediatric tracheal tube brands.Depth mark-based tracheal tube placement resulted in the incidence rate of tube tip to carina placement less than 1 cm was 3.9%-67.8%,and the highest incidence of bronchial intubation is Ruijing,up to 17.8%.The tracheal tube tip was placed 2 cm above the carina,and no improper placement of the tracheal tube cuff and tube tip was found in all brands.Mid-tracheal tube placement led to 100%subglottic and supraglottic tracheal tube cuff positions,except Weili.Conclusions There are differences in design between different brands of cuffed pediatric tracheal tube,and some of the design deficiencies may lead to the risk of airway complications.The method used to guide the insertion depth and the brand of cuffed tracheal tubes can affect the tracheal tube position.Placement of the tracheal tube tip at 2 cm above the carina allowed safe tracheal tube placement in children aged 1-6 years.

Cancer genomics has led to the discovery of numerous oncogenes and tumor suppressor genes that play critical roles in cancer development and progression.Oncogenes promote cell growth and proliferation,whereas tumor suppressor genes inhibit cell growth and division.The dysregulation of these genes can lead to the development of cancer.Recent studies have focused on non-coding RNAs(ncRNAs),including circular RNA(circRNA),long non-coding RNA(lncRNA),and microRNA(miRNA),as therapeutic targets for cancer.In this article,we discuss the oncogenes and tumor suppressor genes of ncRNAs associated with different types of cancer and their potential as therapeutic targets.Here,we highlight the mechanisms of action of these genes and their clinical applications in cancer treatment.Understanding the molecular mechanisms underlying cancer development and identifying specific therapeutic targets are essential steps towards the development of effective cancer treatments.

To investigate the effects of Pithecellobium clypearia extract on the tissue structure,in-flammatory lesions as well as microbial diversity in the intestinal of yellow-feathered broilers.2401-day-old yellow-feathered broilers were randomly divided into four groups(groups A,B,C and D),groups A,B and C were supplemented with Pithecellobium clypearia extract in basal diets with concentrations of 0.5,1.0 and 2.0 g/kg,respectively.Group D served as the control group without adding Pithecellobium clypearia extract in diets,and the full trial period lasted for 70 d.Duodenum and jejunum samples were collected on the 20th,40th and 70th days of the test,the vil-lous/crypt ratio of duodenum and jejunum were calculated,and the mRNA expression level of in-flammatory cytokine as well as related pathways were detected in each group,respectively.In addition,the contents of cecum were collected at 70 th day of the experiment and the microbial di-versity in cecum were also analysed by 16S rDNA sequencing.The results showed that adding 0.5 and 1.0 g/kg of Pithecellobium clypearia extract in the diet could significantly increase the veloci-ty height/crypt depth ratio of duodenum and jejunum(P＜0.05)compared to control group,as well as the mRNA expression level of tight junction protein(CLDN1 and CLDN5)in jejunum,which further improved the structure of mucous of intestinal.Pithecellobium clypearia extract could significantly(P＜0.05)decrease the mRNA expression level of inflammatory cytokine inclu-ding IL-1β,IL-8 and TNF-α,as well as the related pathway genes such as TLR4,MyD88 and NF-κB in jejunum,thus reduced the inflammatory lesions in intestinal.Pithecellobium clypearia ex-tract also could significantly increase the abundance of beneficial microbial such as Parabacteroide and Prevotellaceae,while significantly decrease the abundance of pathogenic microbial such as Proteobacteria in cecum(P＜0.05)and improve the microbial diversity in intestinal.In summary,Pithecellobium clypearia extract could improve the structure of intestinal tissue and the gut barri-er function,as well as the microbial diversity in cecum,and also decrease the inflammatory lesions in jejunum,which is helpful to the intestinal health for yellow-feathered broilers.The present study provides scientific basis for the development of Pithecellobium clypearia as a safe feed additive in the future.

Objective : To investigate a cluster of coronavirus disease 2019 (COVID-19) in Pingyang County,and to put forward targeted prevention and control suggestions. Methods: According to the Prevention and Control Plan of COVID-19 (Third Edition),we carried out epidemiological investigation to collect the information of demographic features,diagnosis and treatment,clinical manifestations,laboratory examination,exposure history and close contact. We analyzed the mode and frequency of exposure,so as to figure out the route of transmission. Results: This epidemic resulted in 6 confirmed cases of COVID-19 and 3 asymptomatic cases,with an attack rate of 6.52% (9/138). The median age of the cases was 48 years old. The confirmed cases mainly had imaging features of pneumonia, fever and cough. Their incubation period ranged from 4 to 9 days,and the median was 6 days. The first case,Wang,returned for the funeral of her grandmother from Wuhan with his husband and son on January 18 and lived with her mother. She had cough on January 19,and went to see her grandmother during January 19 to 23. She had contact with 6 cases,and the other 2 cases were Wang's mother and husband,who lived with Wang. All the cases except Wang had no COVID-19 related symptoms before the funeral,no contact history of COVID-19 cases or no other common exposure history except during the funeral. Therefore,Wang was determined as the source of the epidemic,staying in the same room and eating at the same table with her were risk factors for the infection of COVID-19 in this epidemic (P<0.05). Conclusions This was a local clustering epidemic caused by COVID-19 imported cases from Wuhan. It spread mainly by close contacts like staying in the same room and eating at the same table.

Objective To investigate the relationship between serum uric acid level and renal function decline by retrospective cohort study.Methods Through the physical examination system of the First People's Hospital of Foshan,the physical examination data from 2015 to 2018 of a public institution in Foshan city were obtained.The gender,age,blood cell analysis,liver function,serum creatinine,uric acid,fasting blood glucose were obtained.The change of eGFR (△eGFR=eGFR2018-eGFR2015) was analyzed.Results A total of 2505 subjects were followed up for four years.The subjects were divided into △eGFR ≥0 group and △eGFR ＜ 0 group.There were 845 subjects in △eGFR ≥0 group,and 1660 subjects in △eGFR ＜ 0 group.Compared with that in △eGFR ＜ 0 group,the base-level of uric acid in △eGFR ≥ 0 group was higher [(349.48±87.62) μmol/L vs (325.72±82.58) μmol/L,t=6.669,P ＜ 0.001],but the rate of uric acid decline was greater [-15.00(-53.50,17.00) μmol/L vs 15.50(-18.00,49.00) μmol/L,Z=-13.470,P ＜ 0.001].According to the levels of uric acid in 2015 and 2018,then the subjects were divided into four groups,normal to normal group (N-N,1551 cases),normal change into high uric acid group (N-H,299 cases),high uric acid drop to normal group (H-N,238 cases),and high to high uric acid group (H-H,417 cases).The △eGFR was-1.58(-4.17,1.01) ml · min-1 · (1.73 m2) 1 in N-N group,and-3.60(-7.24,-0.98) ml · min-1 · (1.73 m2)-1 in N-H group,-0.20(-3.14,3.27) ml· min-1· (1.73 m2)-1 in H-N group,-0.96(-4.07,1.93) ml· min-1· (1.73 m2)-1 in H-H group,respectively.The △eGFR decreased most significantly in N-H group than the other three groups (x2=103.130,P ＜ 0.001).Multivariate logistic regression analysis showed that elevated uric acid was an independent risk factor for eGFR decline (OR=1.739,95％CI 1.587-1.906,P ＜ 0.001),while elevated indirect bilirubin (OR=0.968,95％CI 0.943-0.993,P=0.013),elevated red blood cells (OR=0.815,95％ CI 0.680-0.976,P=0.026) were independent protective factors for eGFR decline.Conclusion Elevated uric acid is an independent risk factor for the decline of renal function.Good control of hyperuricemia is beneficial to the protection of renal function.

Objective To investigate the expressions of DEAD-box (DDX) 5 and hepatoma-derived growth factor (HDGF) in glioma samples and their relations with prognoses of the patients.Methods Seventy-eight samples from the lesions and 78 samples from the adjacent tissues of glioma patients,admitted to hospital from February 2013 to June 2017,were selected.The protein expressions of DDX5 and HDGF were detected by immunohistochemistry.The positive expression rates of DDX5 and HDGF in the glioma tissues of patients with different clinical characteristics were compared.Kaplan-Meier method was used to plot the survival curves of patients with DDX5 positive expression and DDX5 negative expression;Log-rank test was used to compare the survival rates of these patients.Results Among 78 patients,the positive expression rates of DDX5 and HDGF in the lesion group were 85.9％ and 80.8％,which were significantly higher than those in the paracancerous group (24.4％ and 28.2％,P＜0.05).There were no significant differences in the positive expression rates of DDX5 and HDGF in patients of different genders,ages,or body mass indexes (P＞0.05);patients with tumor size ＞ 3 cm had significantly higher positive expression rates of DDX5 and HDGF as compared with those with tumor size＜3 cm (P＜0.05);patients with WHO grading Ⅲ-Ⅳ had significantly higher positive expression rates of DDX5 and HDGF as compared with those with WHO grading Ⅰ-Ⅱ (P＜0.05);patients with intracranial cerebrospinal fluid metastasis had significantly higher positive expression rates of DDX5 and HDGF as compared with those without intracranial cerebrospinal fluid metastasis (P＜0.05).Log-rank analysis showed that the overall survival of patients from the DDX5 positive expression group was significantly lower than that of patients from the DDX5 negative expression group (P＜0.05).Conclusion DDX5 and HDGF are highly expressed in glioma tissues,and their expressions are related to tumor sizes,WHO grading and intracranial metastasis;patients with positive DDX5 expression have poor prognosis.

Objective To investigate the effect of serum uric acid level on outcomes after intravenous thrombolysis in patients with acute ischemic stroke. Methods From April 2014 to January 2018I, patients with acute ischemic stroke received intravenous thrombolysis at the stroke unit of Shenzhen Second People's Hospital were enrolled retrospectively. The clinical outcomes were assessed according to the modified Rankin scale at 3 months after onset, > 2 were defined as poor outcome. The demographic and clinical data were compared between the good outcome group and the poor outcome group. Multivariate logistic regression analysis was used to determine the independent influencing factors of clinical outcomes. Results A total of 155 patients were enrolled, including 92 (59. 4％) in the good outcome group and 63 (40. 6％) in the poor outcome group. The serum uric acid level in the good outcome group was significantly higher than that in the poor outcome group (365. 465 ±100. 055 μmol/L vs. 325. 958 ±114. 704 μmol/L; t = -2. 227,P = 0. 027). Multivariate logistic regression analysis showed that there was a significant positive correlation between low serum uric acid levels and poor outcomes (They were divided into 4 levels according to the quantiles. ≥416. 01 μmol/L as reference; 350. 11- 416. 00 μmol/L: odds ratio [ OR ] 1. 414, 95％ confidence interval [CI] 0. 375-5. 339, P = 0. 609; 278. 61-350. 10 μmol/L: OR 3. 020, 95％ CI 0. 878- 10. 390, P = 0. 080; ≤ 278. 60 μmol/L: OR 4. 194, 95％ CI 1. 194-14. 726, P = 0. 025; trend test P =0. 013]. Conclusion Higher serum uric acid level is independently associated with good outcomes after intravenous thrombolysis in patients with acute ischemic stroke.

Objective: To investigate fusidic acid resistance in Staphylococcus aureus (S.aureus) strains and to analyze their molecular characteristics. Methods: A total of 1 333 strains of S. aureus isolated in the First Affiliated Hospital of Wenzhou Medical University from October 2013 to March 2016 were collected. Fusidic acid resistance in these strains was detected by K-B method. Minimum inhibitory concentrations (MIC) of fusidic acid were measured by agar dilution method. Resistance genes of fusB, fusC and fusD and S. aureus A protein-coding gene (spa) were detected by PCR. Strains that did not carry fusB, fusC or fusD were detected for mutations in fusA by sequencing. Housekeeping genes were detected by PCR and analyzed by multilocus sequence typing (MLST). Results: Among the 1 333 strains of S. aureus, 52 were resistant to fusidic acid, accounting for 3.90%. From 2013 to 2016, fusidic acid-resistant strains accounted for 5.3% (7/132), 3.5% (20/571), 4.1% (21/510) and 3.3% (4/120), respectively. The MIC values of fusidic acid against S. aureus were 2, 4, 8, 64 and >64 μg/ml, which inhibited the growth of 26.9% (14/52), 34.6% (18/52), 13.5% (7/52), 1.9% (1/52) and 23.1% (12/52) of strains, respectively. MLST revealed that there were 13 sequence types (STs), among which ST630 was the predominant type accounting for 50% (26/52), followed by ST5 accounting for 17.3% (9/52). There were 19 spa types, among which t4549 (11/52), t2460 (8/52), t377 (8/52) were the predominant types. Nine strains carried drug resistance genes accounting for 17.3% (9/52), including seven fusB-positive and two fusD-positive strains. No fusc-positive strains were detected. Mutations in fusA gene were detected in 11 strains (21.2%, 11/52) and the MIC values against them were all >64 μg/ml. The predominant type of the strains with fusA gene mutations was ST5-t2460. Conclusion Fusidic acid shows a good and relatively stable in vitro antibacterial activity against S. aureus. The mechanism of high resistance to fusidic acid is closely related to fusA gene mutation.

Objective To observe clinical curative effect of the external application of Wentong Paste plus local block therapy for the treatment of stenosing tendovaginitis at radial styloid. Methods A total of 108 cases of patients with stenosing tendovaginitis at the radial styloid were randomly divided into local block therapy group, combination group and Wentong Paste group, 36 cases in each group. The local block therapy group was given injection of blocking liquid into the tendon sheath, combination group was given external application of Wentong Paste(mainly composed of Radix Angelicae Sinensis, Fructus Psoraleae, Radix Angelicae Pubescentis, and Rhizoma et Radix Notopterygii) plus local block therapy, and Wentong Paste group was only given external application of Wentong Paste. Before treatment and after treatment for one and 2 week(s), visual analogue scale (VAS) scores of pain and range of motion (ROM) of wrist joint were observed for the evaluation of clinical effectiveness and safety. The patients were followed up for 3 months for the assay of recurrence rate. Results (1) After treatment for one week, the total effective rate of local block therapy group, combination group and Wentong Paste group was 77.8%, 100.0%, 72.2%respectively, and the total effective rate after treatment for 2weeks was 86.1%, 100.0%, 86.1% respectively. The combination group had better clinical efficacy than local block therapy group and Wentong Paste group (P < 0.05). (2) After treatment for one and 2 week (s), VAS scores of the 3 groups were obviously increased while ROM was much increased (P < 0.05 compared with those before treatment). The combination group had the lowest VAS scores and highest ROM(P < 0.05).(3) No adverse reaction was found in the 3 groups during the treatment. (4) The 3 month follow-up results showed that the recurrence rate of the three groups was 30.61%, 10.20%, 20.41% respectively, and the combination group had the lower rate than local block therapy group and Wentong Paste group(P<0.05). Conclusion The external application of Wentong Paste plus local block therapy is effective for the treatment of stenosing tendovaginitis at radial styloid by relieving pain, increasing the ROM, and reducing the recurrence rate. The one-week efficacy of Wentong Paste alone was inferior to that of local block therapy alone, but their two-week efficacy showed no obvious difference. Moreover, Wentong Paste has an obvious advantage in reducing the recurrence rate.