Abstract:Objective To observe the effect of glucosamine hydrochloride tablets combined with traditional Chinese medicine preparations fragrant tablets in the prevention and treatment of mild to moderate knee osteoarthritis(KOA).Methods A total of 110 patients with mild to moderate KO A admitted to Sichuan Province Orthopedic Hospital from May 2021 to December 2023 were selected.They were completely randomized into conventional group and combination group,with 55 cases in each group.The conventional group was treated with glucosamine hydrochloride tablets,while the combination group was treated with traditional Chinese medicine preparations fragrant tablets in addition to the conventional group.The knee joint pain visual analogue scale(VAS)score,osteoarthritis index score of Western Ontario and McMaster Universities(WOMAC),knee joint function,daily living activity,clinical efficacy,and adverse reactions were compared between two groups.Results After treatment,the VAS scores of both groups were lower than those before treatment,and the combination group was significantly lower than the conventional group[(2.4±0.6)vs(3.2±1.3)],with a statistically significant difference(t=3.491,P=0.003).After treatment,the WOMAC score of the combined group was lower than that of the conventional group,and the range of motion score in the Lysholm knee joint function score was higher in the combined group than in the conventional group,with statistically significant differences(all P＜0.05).At 6 months of treatment,the activities of daily living score of the combination group was higher than that of the conventional group[(95±5)vs(77±5)],and the difference was statistically significant(t=19.986,P＜0.001).The total effective rate of the combined group was higher than that of the conventional group[90.9％(50/55)vs 76.4％(42/55)],and the difference was statistically significant(x2=4.251,P=0.039).No serious adverse reactions occurred in both groups.Conclusions The combination of glucosamine hydrochloride tablets and traditional Chinese medicine preparations fragrant tablets can effectively promote pain relief,improve activities of daily living and knee joint function,reduce limited knee joint mobility,and is safe and effective in the treatment of mild to moderate knee osteoarthritis.

Abstract:Chronic hepatitis B is a global epidemic disease.It is caused by hepatitis B virus infection and can develop into liver disease at different stages such as cirrhosis,liver failure,and hepatocellular carcinoma.At present,chronic hepatitis B cirrhosis is mainly treated with antiviral therapy,combined with immunotherapy and liver protective therapy.Antiviral drugs can inhibit virus replication and alleviate disease progression.Liver protec-tive therapy mainly reduces liver injury by anti-oxidation,anti-inflamumation and promoting hepatocyte regenera-tion.Emerging therapeutic approaches such as gene editing technology,immunotherapy drugs,immune agents combined with antiviral drugs,and RNA interference therapy have also shown great potential in pre-clinical and clinical studies.In this paper,the current research progress of drugs for chronic hepatitis B cirrhosis is summa-rized,and the research progress,mechanism and clinical application prospect of these treatment methods are discussed in detail.

Abstract:The emergence of immune checkpoint inhibitors(ICI)marks the arrival of a new era in cancer immunotherapy,bringing unprecedented long-term survival benefits to cancer patients.ICI is currently widely used in multi-line treatment of cancer,but a large amount of clinical data shows that it may also lead to the occurrence of immune-related adverse events(irAEs)while bringing therapeutic benefits.Among them,ICI-related hypothy-roidism(irH)is one of the most common irAEs.Because it has a hidden onset and the disease progresses relatively slowly,it is often missed in clinical practice.Severe cases may lead to mucous edema coma,heart failure,and respiratory failure,which pose significant challenges for treatment and prognosis.Therefore,it is crucial to correctly understand and effectively manage irH to improve the safety and prognosis of cancer patients.This article will provide a comprehensive review of irH,including its pathogenesis,risk factors,diagnostic criteria,modern medical treatment,and Chinese medicine intervention.

Abstract:Objective To investigate the relationship between the ratio of non-high-density lipoprotein cholesterol(non-HDL-C)to high density lipoprotein cholesterol(HDL-C)and the prognosis of patients with non ST segment elevation acute coronary syndrome(NSTE-ACS)and chronic kidney disease(CKD)after coronary stent implantation.Methods This study retrospectively enrolled 565 NSTE-ACS patients with CKD who under-went successful coronary stent implantation in Beijing Anzhen Hospital,Capital Medical University from January 2018 to December 2020.They were divided into four groups based on non-HDL-C/HDL-C quartiles:group 1(non-HDL-C/HDL-C ≤2.32,n=141),group 2(2.32＜non-HDL-C/HDL-C ≤2.96,n=142),group 3(2.96＜non-HDL-C/HDL-C ≤3.78,n=141),group 4(non-HDL-C/HDL-C＞3.78,n=141).The patients were followed up for 3 years.The primary endpoint was major adverse cardiovascular events(MACE),including all-cause death,nonfatal myocardial infarction,and revascularization.Cox proportional hazards regression model,Kaplan-Meier curve,receiver operating characteristic curve,local weighted regression scatter smoothing method(Lowess)curve were used for statistical analysis.Results Cox proportional hazards regression model analysis showed that the risks of MACE[hazard ratio(HR)=2.06,95％confidence interval(CI):1.28-3.29,P=0.001],all-cause death(HR=2.09,95％CI:1.03-4.22,P=0.004),and repeat revascularization in group 4 were significantly higher than those in group 1.The Kaplan-Meier curve showed that the risk of MACE,all-cause mortality and repeat revascularization increased significantly with the increase of non-HDL-C/HDL-C quartiles(all Log-rank P＜0.05).The predictive ability of the non-HDL-C/HDL-C[the area under the curve(AUC)=0.68]was superior to HDL-C(AUC=0.60)and LDL-C(AUC=0.51).Lowess curve showed that non-HDL-C/HDL-C was positively correlated with MACE.Conclusions Increased levels of non-HDL-C/HDL-C significantly increase the risk of MACE,all-cause death and repeat revascularization in NSTE-ACS patients with CKD after coronary stent implantation,and it was better than HDL-C and LDL-C in predicting the risk of MACE.

Abstract:Objective To explore the effect of glycyrrhizic acid preparation combined with anti-tuberculosis drugs in the treatment of patients with pulmonary tuberculosis and its preventive effect on liver injury.Methods A total of 120 patients with pulmonary tuberculosis in Chest Hospital of Guangxi Zhuang Autonomous Region from May 2021 to May 2023 were selected and divided into the control group(59 cases)and the observation group(61 cases)according to the random number table method.The control group was treated with basic anti-tuberculosis drugs(2HRZE/4HR),and the observation group was treated with glycyrrhizic acid preparation on the basis of the control group.Both groups were treated for 6 months.The degree of chest CT lesion absorption,inflammatory factors,serum markers of liver injury,incidence of drug-induced liver injury(DILI),and Child grade of liver function in patients with liver injury were compared between the two groups.Results The degree of chest CT absorption in the observation group was significantly better than that in the control group(P=0.003).After treatment,the levels of interferon-γ and interleukin-2 in the two groups were lower than those before treatment,and the level of interleukin-2 in the observation group was lower than that in the control group(all P＜0.05).After treatment,the alanine aminotransferase,aspartate aminotransferase and total bilirubin in the two groups were higher than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).The incidence of DILI in the observation group was lower than that in the control group[8.2％(5/61)vs 22.0％(13/59)](P＜0.05).The Child grade of liver function in the observation group was better than that in the control group(P=0.016).Conclusion Glycyrrhizic acid preparation combined with anti-tuberculosis drugs in the treatment of pulmonary tuberculosis can promote the absorption of lesions,obtain better effect,and reduce the risk of DILI.

Abstract:Traditional oncology teaching has some shortcomings,such as lagging knowledge update,monotone teaching model,and difficulty in cultivating the interdisciplinary collaboration consciousness of clinicians,which can not meet the requirements of comprehensive quality of clinicians in the new era of tumor diagnosis and treatment.Under the multidisciplinary diagnosis and treatment(MDT)model,by forming a multidis-ciplinary consultation expert team,the most suitable individualized comprehensive treatment plan can be formulated for the patient according to the patient's tumor stage,preoperative various tumor markers and histopathological examination results,and it is of great significance to improve the treatment effect and prognosis of patients.The MDT model is mainly formulated around the problems in oncology teaching practice,including four parts:discipline modular integration,teaching method innovation,clinical practice and ideological and moral construction,and teacher team training.The practice shows that the MDT model-based oncology teaching reform and practice program can enhance students' comprehensive diagnosis and treatment ability,clinical decision-making ability and team cooperation ability,but there are still some defects in teacher collaboration and teaching evaluation.Therefore,it is proposed that through the integration of medicine and engineering or the combination of online and offline teaching models,together with the support of relevant policies,the reform of oncology teaching can be further deepened,the highland of oncology medical education can be built,and the construction of Healthy China can be promoted.

Abstract:Objective To investigate the value of regional cerebral oxygen saturation(rScO2)combined with serum soluble triggering receptor expressed on myeloid cells 2(sTREM-2)in the diagnosis of sepsis-associated encephalopathy(SAE).Methods A total of 197 patients with sepsis admitted to the Intensive Care Unit of Jiamusi Central Hospital,Heilongjiang Province from January 2021 to October 2023 were selected.According to the occurrence of SAE in the hospital,the patients were divided into SAE group(80 cases)and non-SAE group(117 cases).The clinical data,rScO2 and serum sTREM-2 levels were compared between the two groups.Logistic regression method was used to analyze the risk factors of SAE.The receiver operating characteristic curve was used to analyze the diagnostic value of rScO2 combined with serum sTREM-2 for SAE.Results The proportion of septic shock,sequential organ failure assessment(SOFA)score,and blood lactate level in the SAE group were higher than those in the non-SAE group,and the heart rate and respiratory rate were faster than those in the non-SAE group(all P＜0.05).The rScO2 in SAE group was lower than that in non-SAE group[(0.57±0.11)vs(0.67±0.06)],and the serum sTREM-2 level was higher than that in non-SAE group[(25±4)ng/L vs(21±4)ng/L](t=-7.222,7.869,both P＜0.05).Logistic regression analysis showed that septic shock,increased SOFA score,increased heart rate,increased blood lactic acid,and increased sTREM-2 were independent risk factors for SAE,and increased rScO2 was an independent protective factor(all P＜0.05).The receiver operating characteristic curve showed that the Youden index of rScO2,serum sTREM-2 and their combination were 0.454,0.452 and 0.575,respectively,and the combination of the two had the highest diagnostic value.Conclusions Decreased rScO2 and increased serum sTREM-2 level are independently associated with the occurrence of SAE.The combination of rScO2 and serum sTREM-2 level has a high diagnostic value for SAE.

Abstract:Objective To investigate the therapeutic effect of intrapulmonary oscillation and lung expansion(OLE)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 108 AECOPD patients admitted to the Department of Critical Care Medicine,Sir Run Run Hospital,Nanjing Medical University from April 2022 to December 2023 were selected as the research objects.The patients were divided into observation group and control group by random number table method,with 54 cases in each group.The control group was given conventional chest physical therapy.The observation group was treated with OLE.Sputum volume,partial pressure of oxygen,partial pressure of carbon dioxide,respiratory rate,heart rate,forced expiratory volume in the first second(FEV1),ratio of FEV1to forced vital capacity(FEV1/FVC)and percentage of FEV,to predicted value(FEV1％)were compared between the two groups at the 1,3 and 5 d after treatment.The utilization rate of non-invasive ventilator(NIV),length of stay in intensive care unit(ICU)and 28 d mortality were compared between the two groups.Results The sputum volume of the observation group was higher than that of the control group 1 and 3 d after treatment,and was lower than that of the control group 5 d after treatment(all P＜0.05).At the 1,3 and 5 d after treatment,the partial pressure of oxygen in the two groups increased,and in the observation group was higher than that in the control group,and the partial pressure of carbon dioxide,respiratory rate and heart rate in the two groups decreased,and in the observation group were lower than those in the control group.At the 1,3 and 5 d after treatment,FEV1,FEV1/FVC and FEV1％in the two groups increased,and those in the observation group were higher than those in the control group at each time point(all P＜0.05).The utilization rate of NIV and the length of ICU stay in the observation group were lower/shorter than those in the control group[11.1％(6/54)vs 24.1％(13/54),(6.2±2.2)dvs(8.5±3.8)d](both P＜0.05).There was no significant difference in 28 d mortality between the observation group and the control group[1.9％(1/54)vs3.7％(2/54)](x2=1.025,P=0.074).Conclusion OLE can promote sputum excretion,improve oxygenation and ventilation function,reduce the utilization rate of NIV and shorten the length of ICU stay in patients with AECOPD.

Abstract:Osteoporosis(OP)is one of the common chronic diseases in orthopedics,which is characterized by bone loss and bone structure destruction.Fracture is its most serious complication,which greatly affects the quality of life of patients.The physiological mechanism involved in the occurrence and development of OP is extremely complex,and the increase of oxidative stress level caused by age and estrogen deficiency is an important reason for the occurrence of OP.Although there are many drugs for the treatment of osteoporosis,they all have mild or severe adverse reactions,and may even aggravate the suffering of patients.Resveratrol,a naturally occurring plant compound with antioxidant properties,can reduce oxidative stress in the body through a variety of pathways,and silent information regulator 1 is one of the targets.This article reviews the research progress of resveratrol in the treatment of OP by activating silent information regulator 1 and exercising its anti-oxidative stress effect through different mechanisms,in order to provide new ideas for researchers and new directions for clinicians in the treatment of OP.

Abstract:Objective To investigate the effect of esketamine on trigeminal cardiac reflex(TCR)in patients with trigeminal neuralgia undergoing percutaneous balloon compression(PBC).Methods A total of 80 patients with trigeminal neuralgia who underwent PBC in Hebei General Hospital from January to August 2023 were selected,and they were divided into esketamine group and control group according to the random number table method,with 40 cases in each group.The control group was induced with midazolam,sufentanil,benzenesulfonate cisatracurium,and propofol.The esketamine group was induced with midazolam,sufentanil,benzenesulfonate cisatracurium,propofol,and esketamine.The heart rate and mean arterial pressure(MAP)before induction of anesthesia(T0),before the start of surgery(T1)and at the time of foramen ovale puncture(T2),the incidence of TCR at the time of foramen ovale puncture,and the incidence of perioperative adverse reactions were compared between the two groups.Results The heart rate and MAP of patients in the two groups at time points T1 and T2 were significantly lower than those at time point T0,and the heart rate and MAP of the esketamine group at time points T1 and T2 were significantly higher than those of the control group(all P＜0.05).The incidence of TCR was significantly lower in the esmketamine group than that in the control group[15.0％(6/40)vs 45.0％(18/40)](P＜0.05).There was no significant difference in the total incidence of adverse reactions between the esmketamine group and the control group[22.5％(9/40)vs 12.5％(5/40)](P＞0.05).Conclusion Esketamine can reduce the incidence of TRC in patients with trigeminal neuralgia undergoing PBC,and improve the perioperative safety of patients.

Abstract:Objective To observe the effect of biomimetic electrical stimulation combined with cognitive-behavioral therapy on female patients with stress urinary incontinence(SUI).Methods This study was a prospective randomized controlled study.A total of 160 patients with female SUI admitted to Peking University Third Hospital from March 2019 to June 2023 were selected as the research objects,and they were divided into observation group and control group by random number table method,with 80 cases in each group.The control group was treated with cognitive-behavioral therapy(CBT),and the observation group was given bionic electrical stimulation of pelvic floor on the basis of the control group.The intervention lasted for 8 weeks.The pelvic floor functional ultrasound indicators,pelvic floor electromyography values,scores of urinary incontinence questionnaire brief form(ICI-Q-SF),self-rating anxiety scale(SAS),and self-rating depression scale(SDS)were compared between the two groups before and after the intervention.The total effective rate was compared between the two groups after the intervention.Results During the research process,one case in the control group and three cases in the study group were lost.Finally,79 cases in the control group completed the study,and 77 cases in the observation group completed this research.After intervention,bladder urethral posterior angle and bladder neck mobility,scores of ICI-Q-SF,SAS and SDS in both groups were Iess/lower than before intervention,and those in the observation group were less/lower than those in the control group,the electromyographic values during the rapid contraction stage,sustained contraction stage,and endurance contraction stage of the pelvic floor were all higher than before intervention,and those in the observation group were higher than those in the control group(all P＜0.05).After intervention,the total effective rate of the observation group was significantly higher than that of the control group[97.4％(75/77)vs 88.6％(70/79)](P＜0.05).Conclusion The combination of biomimetic electrical stimulation and cognitive-behavioral therapy can effectively improve pelvic floor function,reduce urinary incontinence symptoms and negative emotions in female patients with SUI.

Abstract:Objective To analyze the effect of salidroside on the expression levels of serum proline hydroxylase 2(PHD2),protein phosphatase 2A(PP2A),and mitogen activated protein kinase(MAPK)in patients with rheumatoid arthritis(RA).Methods A total of 96 RA patients admitted to Qinghai Provincial Hospital of Traditional Chinese Medicine from December 2022 to July 2023 were selected.They were randomly divided into control group and observation group according to the random number table,with 48 cases in each group.The control group was treated with conventional western medicine,while the observation group was treated with salidroside in addition to conventional western medicine,all for 3 months.The traditional Chinese medicine syndrome scores,clinical symptoms and signs,laboratory indicators[including erythrocyte sedimentation rates(ESR),C-reactive protein(CRP),rheumatoid factor(RF),anti cyclic citrulline peptide antibody(anti-CCP)],clinical efficacy,Health Assessment Questionnaire(HAQ)and Disease Activity Score 28(DAS28)scores and serum PHD2,PP2A,MAPK levels and gene expressions,before and after treatment,as well as adverse reactions was compared.Results After treatment,the scores of the main and secondary symptoms in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).After treatment,the clinical symptoms and signs of the observation group were milder than those of the control group,and the levels of ESR,CRP,RF,and anti-CCP were lower than those of the control group(all P＜0.05).The total effective rate of the observation group was higher than that of the control group[95.8％(46/48)vs 80.4％(37/46)](P=0.020).After treatment,the HAQ and DAS28 scores in the observation group were lower than those in the control group[(5.0±1.0)vs(7.2±1.2),(3.1±0.5)vs(4.1±0.7)](t=9.528,7.444,both P＜0.001).After treatment,the levels and gene expression of PHD2 and MAPK in the observation group were lower than those in the control group,while the level and gene expression of PP2A were higher than those in the control group(all P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P=0.528).Conclusion The treatment of RA with salidroside can enhance clinical efficacy,alleviate patients'symptoms,improve laboratory indicators,and be safe.It is speculated that it is related to the decrease of PHD2 and MAPK expression and the increase of PP2A expression.

Abstract:Objective To investigate the changes in the local myocardial oxygen and nutrient metabolism in patients with microvascular angina.Methods A total of 22 patients with primary microvascular angina pectoris admitted to Fuwai Central China Vascular Hospital from January 2020 to June 2022 were selected as the observation group,and 18 patients without clinical symptoms of angina pectoris who underwent radiofrequency ablation due to parsmal supraventricular tachycardia during the same period were selected as the control group.The changes of local oxygen,substance metabolism,internal environment and myocardial microvascular function before and after myocardial microcirculation were observed in the two groups.Results The pH value and blood glucose level of the ostium of the coronary artery in observation group were lower than those in control group,and the lactic acid,oxygen partial pressure and oxygen saturation were higher than those in control group(all P＜0.05).The levels of pH value,lactic acid,blood glucose and oxygen saturation in blood of coronary sinus were lower than those of control group,and the PCO2 was higher than that of control group(all P＜0.05).The glucose uptake rate,lactate production rate,frame number of corrected thrombolysis test(TCFC),coronary sinus filling time(CSFT),micro-circulation resistance index(IMR)and plasma endothelin-1 level in observation group were higher than those in control group,and the level of nitric oxide was lower than that in control group(all P＜0.05).Pearson correlation analysis showed that microvascular angina pectoris was positively correlated with coronary TCFC(r=0.327,P=0.040),CSFT(r=0.435,P=0.006),IMR(r=0.826,P＜0.001)and endothelin-1(r=0.517,P=0.001).There was a negative correlation with nitric oxide(r=-0.504,P＜0.001).In addition,IMR was positively correlated with endothelin-1(r=0.480,P=0.002)and negatively correlated with nitric oxide(r=-0.505,P=0.001).Conclusion The overall myocardial oxygen supply and metabolism are normal in patients with micro vascular angina pectoris.Regional myocardial hypoperfusion,local hypoxia,internal environment acidification,myocardial glucose anaerobic colysis enhancement,microvasomotor dysfunction.

Abstract:Objective To explore the therapeutic effect of Duzhong Jiangu granules combined with teriparatide on osteoporosis(OP)in elderly women.Methods Totally 100 elderly female OP patients who were treated in Tangshan Central Hospital,Hebei Province from June 2021 to October 2022 were selected as research subjects.According to the random number table method,they were divided into western medicine group and traditional Chinese and western medicine group,with 50 cases in each group.All patients were treated with basic treatment,and the western medicine group was treated with teriparatide subcutaneous injection on the basis of basic treatment,and the traditional Chinese and western medicine group was treated with oral Duzhong Jiangu granules on the basis of the western medicine group.The bone density,bone metabolism indicators[C-telopeptide of type Ⅰcollagen(CTX-Ⅰ),intact parathyroid hormone(iPTH),tartrate resistant acid phosphatase 5b(TRACP-5b)],traditional Chinese medicine syndrome scores,and serum chemerin levels before treatment and 6 months after treatment were compared between the two groups.At the same time,the efficacy and occurrence of adverse drug reactions(ADR)were compared between the two groups.Results During the study period,2 and 3 cases dropped out in the western medicine group and the traditional Chinese and western medicine group,respectively,48 and 47 cases were finally included in the evaluation,respectively.After 6 months of treatment,the bone density of the 2nd to 4th lumbar vertebrae,femoral neck,and greater trochanter in both groups were higher than those before treatment,and those in the traditional Chinese and western medicine group were significantly higher than those in the western medicine group;the levels of CTX-Ⅰ,iPTH,TRACP-5 b,traditional Chinese medicine syndrome scores and serum chemerin level were lower than those before treatment,and those in the traditional Chinese and western medicine group were significantly lower than those in the western medicine group(all P＜0.05).The total effective rate of the traditional Chinese and western medicine group was significantly higher than that of the western medicine group[95.7％(45/47)vs 81.2％(39/48)](x2=4.873,P=0.027).There was no significant difference in the total incidence of ADR between the two groups(x2=0.080,P=0.777).Conclusion The application of Duzhong Jiangu granules combined with teriparatide in the treatment of elderly female OP patients can improve the anti-OP effect,obviously alleviate symptoms,increase bone density,effectively reduce bone metabolism indicators and serum chemerin level,and has high safety.

Abstract:Objective To investigate the protective effect of Yixiao decoction on sciatic nerve in mice with diabetic peripheral neuropathy.Methods Twenty-four KKAy mice aged 8 weeks were completely random divided into model group,lipoic acid group and Yixiao decoction group,with 8 mice in each group.Eight C57BL/6J mice of the same age were used as the control group.The lipoic acid group was given lipoic acid 60 mg/(kg·d)by gavage,the Yixiao decoction group was given Yixiao decoction 7.7 g/(kg·d)by gavage,and the control and model groups were given distilled water by gavage.The drug was administered once daily for 12 weeks.The fasting blood glucose,body weight and neurological function of mice in each group were compared before and 4,8,12 weeks after intervention.Results The fasting blood glucose and body weight of the model group,lipoic acid group and Yixiao decoction group were higher than those of the control group at 8 and 12 weeks after intervention(all P＜0.05).The fasting blood glucose of the lipoic acid group was lower than that of the model group at 12 weeks after intervention.The fasting blood glucose and body weight of the Yixiao decoction group were lower than those of the model group at 8 and 12 weeks after intervention.The body weight at 12 weeks after intervention in the Yixiao decoction group was lower than that in the lipoic acid group(all P＜0.05).The mechanical pain thresholds of the model group,the lipoic acid group and the Yixiao decoction group were lower than those of the control group at before and 8,12 weeks after intervention(all P＜0.05).The tail flick times of before and 4,8,12 weeks after intervention in the model group,lipoic acid group and Yixiao decoction group were higher than those in the control group(all P＜0.001).The mechanical pain thresholds of the lipoic acid group and the Yixiao decoction group were higher than those of the model group at 8 and 12 weeks after intervention,and the tail flick times of the lipoic acid group and the Yixiao decoction group were lower than those of the model group at 4,8 and 12 weeks after intervention.The mechanical pain threshold at 12 weeks after intervention in the Yixiao decoction group was higher than that in the lipoic acid group[(2.54±0.24)g vs(1.95±0.28)g],and the tail flick times at 4,8 and 12 weeks after intervention were lower than those in the lipoic acid group(all P＜0.001).Conclusion Yixiao decoction can reduce sciatic nerve injury in mice with diabetic peripheral neuropathy,and its mechanism may be related to the regulation of Keap1-Nrf2-ARE signaling pathway and the downstream expression of superoxide dismutase and catalase.

Abstract:Objective To investigate the relationship between left atrial strain and N-terminal pro-brain natriuretic peptide(NT-proBNP)level in ST-segment elevation myocardial infarction(STEMI)patients with mildly reduced or preserved left ventricular ejection fraction(LVEF).Methods Patients who were first diagnosed with acute STEMI and underwent percutaneous coronary intervention(PCI)within 24 h from March to December 2022 in Department of Cardiology,Beijing Jishuitan Hospital,Capital Medical University,with LVEF＞40％in the acute phase,were enrolled.The left atrial strain parameters were analyzed by two-dimensional speckle tracking imaging.According to the value of left atrial strain during reservoir phase(LASr),patients were divided into reduced LASr group and normal LASr group.The clinical data and ultrasound data of the two groups were compared.Multiple linear regression model was used to analyze the relationship between LASr and serum NT-proBNP peak value in STEMI patients with mildly reduced or preserved LVEF.Results Among 51 patients with acute STEMI and LVEF＞40％who underwent PCI,there were 22 cases(43.1％)in reduced LASr group and 29 cases(56.9％)in normal LASr group.Age and NT-proBNP peak value in the reduced LASr group were higher than those in the normal LASr group[(60±12)years vs(50±12)years,1 679.0(811.4,2 133.2)ng/L vs 584.2(201.5,1 524.0)ng/L](both P＜0.05).The longitudinal strain during left atrial channel phase and strain during left atrial systolic phase in the reduced LASr group were higher than those in the normal LASr group(both P＜0.05).Multiple linear regression analysis showed that after adjusting for anterior myocardial infarction,peak value of creatine kinase isoenzyme and LVEF,LASr was an independent predictor of serum NT-proBNP peak value in STEMI patients with mildly reduced or preserved LVEF(P=0.039).Conclusion LASr is an independent predictor of NT-proBNP peak value in STEMI patients with mildly reduced or preserved LVEF undergoing PCI.

Abstract:With the aggravation of population aging,coronary atherosclerotic heart disease(CHD)combined with cognitive impairment has gradually attracted attention.Epidemiological data show that there is a significant positive correlation between CHD and the risk of cognitive impairment.Patients with CHD show worse cognitive ability,and patients with cognitive impairment combined with CHD have a faster rate of cognitive decline.CHD combined with cognitive impairment not only seriously damages the physical and mental health of patients,but also increases the social burden.The causes of CHD combined with cognitive impairment are complex and the pathogenesis is diverse,including physiological mechanisms such as vascular endothelial dysfunction,cholesterol-25-hydroxylase mediated immune inflammation,and excessive activation of ceramide by platelets,as well as behavioral and psychological mechanisms such as education level,cardiac invasive surgery,and decreased perceived activity ability.This article aims to review the latest research progress on the physiological and behavioral psychological mechanisms of CHD combined with cognitive impairment,so as to provide ideas for the clinical diagnosis,treatment and prevention of CHD combined with cognitive impairment.

Abstract:Objective To observe the clinical effect of Yifei Jianpi granule combined with doxofylline in the treatment of chronic bronchitis of lung spleen Qi deficiency type.Methods The clinical data of 118 patients with chronic bronchitis of lung spleen Qi deficiency type admitted to the Affiliated Hospital of Nanjing University of Chinese Medicine from January 2021 to October 2023 were retrospectively collected and analyzed.According to different treatment regimens,they were divided into observation group(59 cases)and control group(59 cases).The control group was treated with doxofylline tablets on the basis of basic intervention,and the observation group was treated with Yifei Jianpi granules on the basis of the control group.The clinical efficacy,traditional Chinese medicine syndrome score,inflammatory factors,immune function index levels,and treatment safety were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[91.5％(54/59)vs 78.0％(46/59)](P=0.041).After treatment,the traditional Chinese medicine syndrome scores,levels of interleukin-17A,CXC chemokine ligand 9 and monocyte chemoattractant protein 4 in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).After treatment,the CD3+,CD4+,and CD4+/CD8+ratios in both groups were higher than those before treatment,and those in observation group were higher than those in control group;CD8+was lower than that before treatment,and that in observation group was lower than that in control group(all P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P=0.542).Conclusion Yifei Jianpi granule combined with doxofylline has significant clinical effect in the treatment of chronic bronchitis of lung spleen Qi deficiency type,which can reduce the main traditional Chinese medicine syndromes of patients,reduce the levels of inflammatory factors,improve the immune function of patients,and has good safety.

Abstract:Objective To compare the clinical effect of rifampicin and rifapentine in the treatment of elderly patients with pulmonary tuberculosis.Methods The clinical data of 218 elderly patients with pulmonary tuberculosis admitted to the Department of Tuberculosis,Lishui Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from January 2020 to December 2022 were retrospectively collected and analyzed.Patients were divided into rifampicin group(109 cases)and rifapentine group(109 cases)according to different drugs.Both groups received conventional anti-tuberculosis treatment.The patients in the rifampicin group were treated with rifampicin on the basis of conventional treatment,and the patients in the rifapentine group were treated with rifapentine on the basis of conventional treatment.All patients were treated for 6 to 12 months.The clinical baseline data,adverse reactions,medication compliance and efficacy were compared between the two groups.Results There were no significant differences in clinical baseline data between the two groups(all P＞0.05).The incidence of adverse reactions in rifampicin group was higher than that in rifapentine group[17.4％(19/109)vs 8.2％(9/109)](x2=4.098,P=0.043).The Morisky medication adherence scale score of the rifampicin group was higher than that of the rifapentine group(P＜0.05).The success rate of rifampicin group was higher than that of rifapentine group(P＞0.05).Conclusion Rifapentine and rifampicin have similar efficacy in the treatment of elderly pulmonary tuberculosis,and with high safety.Rifapentine can be used instead of rifampicin in the selection of anti-tuberculosis regimens for elderly pulmonary tuberculosis.

Abstract:Objective To analyze the clinical application value of serum 25-hydroxy vitamin D[25-(OH)D]and interleukin-6(IL-6)in patients with type 2 diabetes mellitus(T2 DM)complicated with different degrees of non-alcoholic fatty liver disease(NAFLD).Methods From January to December 2023,90 inpatients and outpatients with T2DM or T2DM combined with NAFLD(case group)in the First Hospital of Harbin,Heilongjiang Province and 30 healthy people in the same period were selected as the research objects.In this study,30 healthy people who underwent physical examination during the same period were set as group A.The case group was divided into group B,group C and group D according to the results of liver color Doppler ultrasound and liver function test,with 30 cases in each group.Group B was T2DM without NAFLD,group C was T2DM with NAFLD but without abnormal liver function,and group D was T2DM with NAFLD and abnormal liver function.The changes of25-(OH)D and IL-6 levels in each group were compared,and the correlation between them and related metabolic indexes was analyzed.Results The levels of serum 25-(OH)D in group D were significantly lower than those in group A,group B and group C,while the levels of serum IL-6 in group D were significantly higher than those in groups A,B and C[(12.3±5.9)μg/L vs(23.7±2.5),(20.0±5.2),(16.0±3.1)μg/L;(12.9±4.8)ng/Lvs(3.8±2.0),(5.5±3.0),(8.0±5.3)ng/L](all P＜0.05).The levels of serum 25-(OH)D in group C were lower than those in group A and group B,while the levels of serum IL-6 were higher than those in group A and group B(all P＜0.05).The level of serum 25-(OH)D in group B was lower than that in group A(P＜0.05).Serum 25-(OH)D level was negatively correlated with IL-6,body weight,body mass index,waist circumference,hip circumference,systolic blood pressure,glycosylated hemoglobin(HbA1c),fasting blood glucose,2 h postprandial blood glucose(2 hPG),alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyl transpeptidase(γ-GGT),total cholesterol,triglyceride,fasting insulin(FINS),and homeo-stasis model assessment insulin resistance index(HOMA-IR)(all P＜0.05).IL-6 level was positively correlated with body weight,body mass index,waist circumference,hip circumference,HbA1c,fasting blood glucose,2 hPG,ALT,AST,γ-GGT,total cholesterol,triglyceride,β2-microglobulin,serum creatinine,FINS and HOMA-IR(all P＜0.05).Conclusions The level of serum 25-(OH)D is significantly decreased and the level of IL-6 is significantly increased in T2DM patients with NAFLD.Serum 25-(OH)D and IL-6 levels are related to a number of metabolic indicators.Combined detection of the two indicators is helpful for early monitoring of the disease and timely taking measures to prevent or delay the occurrence and development of T2DM combined with NAFLD.