Objective To study the mechanism of miR-424-5p/Rictor/mammalian target of rapamycin(mTORC)signaling axis inducing autophagic death of hepatoma cells.Methods Hep-3B was selected as liver cancer cell,the control group was treated with PBS,and the overexpression miR-424-5p group,interference miR-424-5p expression group,overexpression Rictor group and interference Rictor expression group were respectively transfected with miR-424-5p mimics,miR-424-5p inhibitor,Rictor overexpression plasmid,Rictor siRNA.Cell viability,apoptosis and cycle were detected,the shape of autophagosomes in slices was observed,Lc3-Ⅱ,Lc3-Ⅰ,Beclin1,P62 mRNA and protein were detected in cells,and the mRNA expression of miR-424-5p/Rictor/mTORC2/Akt/mTORC1 was determined by RT-PCR,Western blot method was used to detect related proteins,and to verify the targeting relationship between miR-424-5p and Rictor.Results The expression of miR-424-5p in Hep-3B cells was low(0.45±0.05).After transfection,the G0+G1 phase cells in the overexpression miR-424-5p group were higher than those in the control group,and the cell viability was lower than that in the control group,the differences were statistically significant(P<0.05).The proportion of cells in G0+G1 phase in the interference miR-424-5p expression group and overexpression Rictor group were lower than those in the overexpression miR-424-5p group,and the cell viability was higher than that in the overexpression miR-424-5p group,interference Rictor expression group,the differences were statistically significant(P<0.05).The autophagosomes and autophagolysosomes in the overexpression miR-424-5p group at excitation wavelengths of 488 nm and 587 nm were higher than those in the interference miR-424-5p expression group and overexpression Rictor group,the differences were statistically significant(P<0.05).The expression levels of Rictor,mTORC2,Akt and mTORC1 in the overexpression miR-424-5p group were lower than those in the interference miR-424-5p expression group and the overexpression Rictor group,but higher than those in the interference Rictor expression group,the differences were statistically significant(P<0.05).The expression levels of Lc3-II,Lc3-I and Beclin1 in the overexpression miR-424-5p group were lower than those of the other four groups,and the expression level of P62 was higher than that of the other four groups,the differences were statistically significant(P<0.05).Dual luciferase experiments confirmed that miR-424-5p could directly inhibit Rictor expression,and Western blot showed that miR-424-5p could inhibit Rictor expression in Hep-3B cells.Conclusion MiR-424-5p can affect autophagy by regulating the expression of Rictor/mTORC2/Akt/mTORC1,thereby inhibiting the proliferation of liver cancer cells and promoting their apoptosis.

Objective To establish the high performance liquid chromatograghy method for the content determination of Geniposide in Mongolian medicine Ganlu Jiangtang Pills.Methods The chromatographic column was SHIMADZU Shim-pack GIST C18(250 mm×4.6 mm,5 μm),the mobile phase was acetonitrile-water(15∶85,V/V),the flow rate was 0.8 ml/min,detection wavelength was 238 nm,the column temperature was 30℃,and the injection volume was 10 μl.Results Geniposide showed a good linearity in the range of 19.69-78.77 μg/ml(r=0.999 8,n=14).The average recovery was 93.87% with RSD of 1.52%(n=9).The RSD of precision and stability were 0.15% and 0.74%.The average content of 2 batches samples was 5.85 mg/g，with RSD of 1.66%.Conclusion The method is accurate,strong specificity and reproducible which can be used for the quantitation control of Ganlu Jiangtang Pills.

Objective To investigate the curative effect of Wenyuan moxibustion combined with electric stimulation,biofeedback and Kegel exercise in the treatment of pelvic organ prolapse in postpartum women with kidney deficiency.Methods A total of 80 patients with kidney deficiency and postpartum pelvic organ prolapse treated in the Department of Women′s Health Care of Jiangxi Maternal and Child Health Hospital from January 2020 to December 2021 were selected as the research subjects.They were divided into control group and experimental group by random number table method,with 40 cases in each group.The control group received electrical stimulation,biofeedback therapy and Kegel exercise.The observation group was treated with Wenyuan moxibustion on the basis of the control group,and both groups were treated for one course.The improvement of pelvic floor muscle strength and pelvic organ prolapse before and after treatment were compared between the two groups.The improvement of traditional Chinese medicine syndrome and the total effective rate were compared between the two groups.Results The improvement of muscle strength,pelvic organ prolapse and traditional Chinese medicine syndrome in the observation group were better than those in the control group,and the differences were statistically significant(P＜0.05).The total effective rate of observation group was higher than that of control group,and the difference was statistically significant(P＜0.05).Conclusion For the improvement of pelvic organ prolapse and traditional Chinese medicine syndrome of kidney deficiency in patients with postpartum pelvic organ prolapse,Wenyuan moxibustion combined with electric stimulation,biofeedback therapy and Kegel exercise are superior to electrical stimulation,biofeedback therapy and Kegel exercise alone,which can provide a new combined treatment method for the treatment of pelvic organ prolapse.

Objective To analyze the clinicopathological characteristics of duodenal stromal tumors(D-GIST)and jejunoileum stromal tumors(JI-GIST)and the risk factors for postoperative recurrence and prognosis.Methods The data of 92 patients with small intestinal stromal tumors admitted to Suzhou Dushu Lake Hospital from January 2008 to August 2017 were retrospectively analyzed,including 23 cases of D-GIST and 69 cases of JI-GIST.The clinicopathological features,recurrence and prognostic factors were analyzed.Results In terms of clinicopathological characteristics,the first symptoms of the two groups were different.The most common first symptom of D-GIST was gastrointestinal bleeding(52.2%),while the most common first symptom of JI-GIST was abdominal pain(39.1%),and the difference was statistically significant(P<0.05).The proportion of JI-GIST tumor diameter>5 cm and the proportion of high-risk patients were higher than those of D-GIST,and the differences were statistically significant(P<0.05).The total recurrence rate of JI-GIST was higher than that of D-GIST group,and the difference was statistically significant(P<0.05).There was no significant difference in overall survival rate between the two groups(P>0.05).Multivariate Cox analysis showed that tumor diameter>5 cm and mitotic figure>5/50 HPF were independent risk factors for recurrence of small intestinal stromal tumor.Age>60 years,tumor diameter>5 cm,mitotic figure>5/50 HPF were independent risk factors for survival and prognosis of patients with small intestinal stromal tumors.Conclusion Compared with JI-GIST,D-GIST is easier to be diagnosed early and has a lower risk of postoperative recurrence.To reduce recurrence and improve prognosis,we should pay more attention to tumor diameter>5 cm,mitotic figure>5/50 HPF and elderly patients.

Objective To analyze the clinical data of 98 cases of pregnant women with intrahepatic cholestasis(ICP)of Buyi nationality in Guizhou province,and to explore the clinical characteristics of ICP.Methods The clinical data of 98 buyi pregnant women with ICP who delivered in the Department of Obstetrics and Gynecology of the People′s Hospital of Ceheng County from January 2018 to January 2022 were selected as the case group.According to the severity of the disease,the case group was divided into mild group(67 cases)and severe group(31 cases).According to the presence or absence of skin pruritus,the patient group was divided into itch group(50 cases)and non-itch group(48 cases).Another 110 healthy pregnant women of Buyi nationality who gave birth in this hospital were selected as the control group,and the skin pruritus,liver function and adverse pregnancy outcome among the groups were analyzed.Results The incidence of pruritus,alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels,amniotic fluid contamination,fetal growth restriction,fetal distress,premature delivery and neonatal asphyxia in case group were higher than those in control group,and the differences were statistically significant(P<0.05).The incidence of pruritus,ALT and AST levels,amniotic fluid contamination,fetal distress,fetal growth restriction,premature delivery,neonatal asphyxia and perinatal death in severe group were higher than those in mild group,and the differences were statistically significant(P<0.05).The levels of total bile acid(TBA),ALT and AST in pruritus group were higher than those in non-pruritus group,with statistical significances(P<0.05).Conclusion Strengthening the awareness of pregnancy health care,advocating healthy diet,paying attention to pruritus symptoms and potential hazards during pregnancy,early diagnosis,active treatment,close monitoring,and choosing the best delivery time and way are the keys to reduce the adverse pregnancy outcome of local ICP.

Cancer is one of the major causes of human death and poses a serious health threat.With the development of medical treatment,cancer has made major advances in diagnosis and treatment,however,patients still have somatic and psychological problems during the diagnostic and treatment process of cancer.Previous studies have shown that aerobic exercise can reduce the incidence of cancer and reduce the somatic symptoms and psychological problems of patients in the treatment,thus improving their quality of life.Much medical personnel in China currently lack advice on appropriate exercise for cancer patients at various stages of survival,judgment on the timing of exercise intervention,and the ability to develop exercise programs specifically for cancer patients.Based on the research of domestic and foreign literature,this paper reviews the concepts and contents related to aerobic exercise prescription,introduce the principles of developing aerobic exercise prescription for cancer patients,and the contents of the prescription,aiming to promote the application of aerobic exercise prescription among cancer patients in China and provide ideas for developing expert consensus on aerobic exercise prescription in line with cancer patients in China.

As chronic pain is widely recognized by the public,the thought of pain catastrophic has gradually become a hot topic of research.At present,there are many researches on catastrophic thought in the field of pain psychology in European countries,while domestic research on catastrophic thought starts late and lack of understanding.This paper reviewed the related concepts and mechanisms of pain catastrophic,and introduced assessment tools such as the pain catastrophic scale and coping strategy questionnaire.The factors that cause catastrophic pain in patients after surgery are summarized and analyzed,and the related intervention measures such as changing beliefs about catastrophic pain,current needs for pain relief,and family emotional support system are reviewed to comprehensively and systematically understand the catastrophic pain of patients after mixed hemorrhoid surgery.Rehabilitation care is carried out from multiple perspectives,and psychotherapy is applied on the basis of pain care.The aim is to attract the attention of nursing staff to the catastrophic pain,and to provide reference for the development of nursing clinical practice research and scientific research.

In December 2020,the International Agency for Research on Cancer(IARC)released global cancer statistics that for the first time the incidence of breast cancer has surpassed lung cancer as the most common cancer worldwide.The incidence of breast cancer is increasing year by year.Surgical treatment is still the preferred treatment for early breast cancer,and whether regional lymph node metastasis is an important indicator to evaluate the prognosis of breast cancer.Sentinel lymph node is the first station of lymph node metastasis of breast cancer,so sentinel lymph node biopsy has replaced axillary lymph node dissection as a routine surgical treatment for early breast cancer.The key to the accuracy and success rate of sentinel lymph node biopsy is the choice of tracer.excellent sentinel lymph node tracers should include the characteristics of targeting,visibility,simple operation,low cost and few adverse reactions.In recent years,with the continuous improvement of technology,methods to search for sentinel lymph nodes have emerged in an endless fashion.Although the current guidelines point out that dye method combined with radionuclide method is the gold standard for sentinel lymph node biopsy.dye method is the dominant method in clinical practice due to many shortcomings of the nuclide method.At present,methylene blue injection is widely used as a tracer.Methylene blue injection has poor targeting ability to lymph nodes and it has certain limitations.With the development and improvement of the tracer,it was found that the carbon nanoparticles suspension had well lymph node taxis in sentinel lymph node biopsy.In order to provide reference for clinical applicationand and improve the accuracy and success rate of sentinel lymph node biopsy,the article introduce the characteristics,action principle,injection dose,development and adverse reactions of methylene blue and nano-carbon for comparison.

Objective To explore the effect of inspiratory muscle strength training(IMST)on the quality of life of patients with pneumoconiosis.Methods A total of 80 patients with pneumoconiosis who were admitted to Ganzhou Fifth People′s Hospital from January to December 2021 were selected as the research objects,and they were divided into the treatment group and the control group by randomization of the central block,with 40 cases in each group.The patients in the control group were treated with conventional treatment,and the patients in the treatment group were treated with IMST on the basis of the treatment in the control group.The respiratory muscle contraction indexes(maximum inspiratory pressure[MIP]and maximum inspiratory flow[PIF]),walking condition(6 minute walking test[6MWT])and the pulmonary function index(maximal voluntary ventilation[MVV]),forced expiratory volume in one second[FEV1],forced vital capacity[FVC],total lung capacity[TLC]and FEV1/FVC)were compared between the two groups before and after treatment.Results After treatment,the MIP and PIF of the treatment group were higher than those before treatment,and the treatment group was higher than the control group,with statistically significant differences(P＜0.05).There were no statistically significant differences in MIP and PIF of the control group before and after treatment(P＞0.05).After treatment,the 6MWT of two groups was longer than that before treatment,and the treatment group was longer than that of the control group,and the differences were statistically significant(P＜0.05).After treatment,the MVV,FEV1,FVC,TLC and FEV1/FVC of two groups were higher than those before treatment,and the differences were statistically significant(P＜0.05).However,there were no statistically significant differences in the above indexes between the two groups after treatment(P＞0.05).Conclusion IMST can effectively increase the MIP and prolong the 6MWT of patients with pneumoconiosis.Although the improvement of pulmonary function indicators is not obvious,it can effectively improve the quality of life of patients,which is worthy of clinical practice and promotion.

Objective To analyze and observe the clinical effect of autohemotherapy combined with narrow spectrum ultraviolet radiation in the treatment of patients with chronic urticaria.Methods A total of 82 patients with chronic urticaria admitted to the Jiujiang Third People′s Hospital from January 2020 to August 2021 were selected as subjects and divided into study group and control group by random number table method,with 41 cases in each group.The control group was treated with narrow spectrum ultraviolet radiation,while the study group was treated with autohemotherapy combined with narrow spectrum ultraviolet radiation.The therapeutic effect and adverse reactions of the two groups were observed and compared,and the levels of interleukin-4(IL-4),immunoglobulin E(IgE)and eosinophilic cation(ECP)before and after treatment were compared between the two groups.Results Before treatment,there were no significant differences in the levels of IL-4,IgE and ECP between the two groups(P>0.05).The levels of IL-4,IgE and ESP in the two groups after treatment were higher than those before treatment,and the levels of IL-4,IgE and ECP in the study group were higher than those in the control group after treatment,and the differences were statistically significant(P<0.05).The total effective rate of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Autohemotherapy combined with narrow spectrum ultraviolet radiation in the treatment of chronic urticaria has a good clinical effect,which can effectively improve the levels of IL-4,IgE and ESP in patients,improve the treatment effect,and reduce the incidence of adverse reactions,which is worthy of clinical promotion.

Objective To explore the effect of systematic graded rewarming intervention in elderly patients undergoing orthopaedic surgery.Methods A total of 92 elderly patients who underwent orthopedic surgery in Jiujiang Hospital of Traditional Chinese Medicine from March 2019 to March 2022 were selected as the research objects and divided into control group and observation group according to the random number table method,with 46 cases in each group.The control group received routine rewarming intervention,the observation group implemented systematic and graded rewarming measures,and the two groups continued to intervene until the end of the operation.The temperature changes of the two groups were compared at different time periods(after entering the operating room[T1],after induction of anesthesia[T2],30 min of anesthesia[T3],60 min of operation[T4],and the end of operation[T5]).The cognitive function and coagulation function of the two groups were compared before and after intervention.The total incidence of complications was compared between the two groups.Results There was no significant difference in body temperature between the two groups after operation room(T1)(P>0.05).The temperature of the observation group at T2,T3,T4 and T5 were(36.52±0.26),(36.49±0.31),(36.47±0.37)and(36.56±0.32)℃respectively,which were higher than those of the control group of(36.21±0.24),(36.01±0.28),(35.82±0.35),(35.94±0.42)℃,with statistically significant differences(P<0.05).After the intervention,the score of mini-mental state examination(MMSE)in the observation group was(20.25±3.41)point,which was higher than that in the control group of(17.86±3.39)points,the difference was statistically significant(P<0.05).After the intervention,the thrombin time(TT)in the observation group was(18.56±1.30)s,prothrombin time(PT)in the observation group was(15.96±1.32)s,activated partial thromboplastin time(APTT)in the observation group was(31.25±2.83)s,which were longer than those in the control group of(14.89±1.29),(11.08±1.28),(25.39±2.54)s,and fibrinogen(FBG)in the observation group was(2.15±0.38)g/L,which was lower than that in the control group of(3.62±0.53)g/L,the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was 4.35%,which was lower than 17.39% in the control group,the difference was statistically significant(P<0.05).Conclusion Systematic graded rewarming intervention can maintain the body temperature of elderly orthopaedic patients in a constant state,improve postoperative cognitive function and coagulation function,and reduce the risk of complications such as shivering.

Objective To investigate the application value of geriatric nutritional risk index(GNRI)in perioperative nutritional support in elderly patients with gastrointestinal tumors.Methods A total of 121 elderly patients with gastrointestinal tumor surgery who were admitted to Shangrao People′s Hospital from February 2021 to February 2022 were selected as research objects,and they were divided into the control group(60 cases)and the experimental group(61 cases)according to random number table method.Nutritional risk screening 2002(NRS-2002)was used in the control group,and GNRI was used in the experimental group.Nutritional support plan was formulated according to the results of nutritional screening.The hospital stay,medical expenses,postoperative complications,and mortality were compared between the two groups.Receiver operating characteristic(ROC)curve analysis was used to obtain GNRI on the 3rd postoperative day,peripheral blood neutrophil/lymphocyte ratio(NLR)on the 3rd postoperative day,and GNRI combined with NLR on the 3rd postoperative day to predict the predictive value of postoperative complications in patients with gastrointestinal tumors.Results The hospital stay in the experimental group was shorter than that in the control group,and the medical expenses in the experimental group was lower than that in the control group,with statistically significant differences(P＜0.05).The incidence of postoperative complications of anastomotic leakage and fever in the experimental group were lower than those in the control group,and the differences were statistically significant(P＜0.05).There was no significant difference in mortality between the two groups(P＞0.05).Through ROC curve analysis,the area under the curve(AUC)of GNRI for predicting postoperative complications in elderly patients with gastrointestinal tumors on the 3rd day after surgery was 0.782(95%CI:0.702-0.862,P＜0.05),and the sensitivity was 0.981,specificity was 0.529,and the critical value was 97.53 points.The AUC of NLR for predicting postoperative complications in elderly patients with gastrointestinal tumors on the 3rd day after surgery was 0.921(95%CI:0.873-0.969,P＜0.05),with a sensitivity of 0.811 and a specificity of 0.926,and the critical value was 11.86.The AUC of GNRI combined with NLR for predicting postoperative complications in elderly patients with gastrointestinal tumors on the 3rd day after surgery was 0.964,the sensitivity was 0.906,and the specificity was 0.912.Conclusion GNRI can better reflect the perioperative nutritional status of elderly patients with gastrointestinal tumors.GNRI combined with NLR can predict postoperative complications on the 3rd day after surgery,which is suitable for clinical application.

Objective To study the effect of Low Molecular Weight Heparin Calcium and Edaravone combined with hyperbaric oxygen on severe carbon monoxide(CO)poisoning.Methods A total of 60 patients with severe CO poisoning admitted to Yichun People′s Hospital from January to December 2021 were selected as the research objects and divided into control group and observation group by random number table method,with 30 cases in each group.After admission,patients in both groups were given routine symptomatic treatment such as hyperbaric oxygen and wake-up promotion.The control group was treated with Edaravone on this basis,and the observation group was treated with Low Molecular Weight Heparin Calcium.The clinical efficacy,consciousness recovery time,awake time,incidence of lateonset encephalopathy and changes of hemorheology were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P＜0.05).The consciousness recovery time and awake time of the patients in the observation group were shorter than those in the control group,and the incidence of delayed encephalopathy was lower than that in the control group after 3 months of follow-up,and the differences were statistically significant(P＜0.05).The plasma viscosity,whole blood high shear viscosity,whole blood low shear viscosity,hematocrit,erythrocyte deformation index and erythrocyte aggregation index in the observation group after treatment were lower than those in the control group,and the differences were statistically significant(P＜0.05).Conclusion Low Molecular Weight Heparin Calcium and Edaravone combined with hyperbaric oxygen can significantly improve the hemorheological indexes of patients with severe CO poisoning,with short awake time and low incidence of delayed encephalopathy.

Objective To investigate the therapeutic effect of extracorporeal membrane oxygenation(ECMO)combined with percutaneous percutaneous coronary intervention(PCI)in patients with acute myocardial infarction.Methods A total of 82 patients with acute myocardial infarction who were admitted to the ICU of Xiamen Third Hospital from January 2016 to August 2021 were selected as the subjects,and divided into control group and observation group by random number table method,with 41 cases in each group.The control group was treated with emergency PCI,and the observation group was combined with ECMO anticoagulation.Results After 7 days of treatment,the preoperative reaction time(R)and coagulation time(K value)of thromboelastography in the observation group were higher than those in the control group,and amplitude(MA)and coagulation time(CI)levels were lower than those in the control group,and the differences were statistically significant(P<0.05).The level of left ventricular ejection fraction in the observation group was higher than that in the control group after 7 days of treatment group,the left ventricular end-diastolic diameter and left ventricular end-systolic diameter were lower than the control group,the differences were statistically significant(P<0.05).Conclusion On the basis of PCI in patients with acute myocardial infarction,ECMO anticoagulation has an ideal effect,and thromboelastography can be used to evaluate the prognosis of patients and understand the recovery of cardiac function after treatment.

Objective To evaluate the effect of open bone grafting combined with negative pressure closed drainage technology on post-traumatic infectious bone defect.Methods A total of 92 patients with post-traumatic infectious bone defects admitted to Zaozhuang Municipal Hospital from September 2020 to September 2021 were selected as the research objects,they were divided into bone graft group and drainage group according to the lottery method,with 46 cases in each group,the bone graft group was treated with open bone grafting,and the drainage group was treated with negative pressure closed drainage.Detect inflammatory indicators,observe the function and recovery of bone and joints,and calculate the validity of two groups.Results There were no significant differences in C-reactive protein(CRP)and white blood cell(WBC)between the two groups before treatment(P>0.05).After treatment,CRP and WBC of the two groups were lower than those before treatment,and the CRP and WBC of drainage group were lower than those of the bone graft group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in Hospital for Special Surgery(HSS)score and visual analogue scale(VAS)between the two groups(P>0.05).After treatment,the HSS score in the drainage group was higher than that in the bone graft group,and the VAS score in the drainage group was lower than that in the bone graft group,the differences were statistically significant(P<0.05).The recovery time and hospital stay of the patients with bone defects in the drainage group were shorter than those in the bone graft group,and the differences were statistically significant(P<0.05).The treatment effect in the drainage group was higher than that in the bone graft group,and the difference was statistically significant(P<0.05).Conclusion Open bone grafting combined with negative pressure closed drainage can improve the treatment effectiveness,reduce inflammation,enhance bone and joint function,and promote the prognosis of patients with bone defects.

Objective To explore the application effect of needle warming moxibustion in the treatment of knee osteoarthritis patients.Methods A total of 100 patients with knee osteoarthritis admitted to the Third Ward of Orthopedics and Traumatology,Yunnan Provincial Hospital of Traditional Chinese Medicine from December 2020 to December 2021 were selected as research objects.They were divided into control group and experimental group by random lottery method,with 50 cases in each group.The patients in the control group were treated with joint cavity Sodium Hyaluronate injection,the patients in the experimental group were treated with needle warming moxibustion.The visual analogue scale(VAS)score,Hospital for Special Surgery(HSS)joint score and clinical effective rate of the two groups were compared and analyzed after 1 month of treatment.Results The clinical effective rate of patients in the experimental group was higher than that in the control group after 1 month of treatment,and the difference was statistically significant(P<0.05).The VAS score of patients in the experimental group was lower than that in the control group after 1 month of treatment,and the difference was statistically significant(P<0.05).The HSS joint score of patients in the experimental group was higher than that in the control group after 1 month of treatment,the difference was statistically significant(P<0.05).Conclusion The application of needle warming moxibustion in the treatment of knee osteoarthritis patients can promote the improvement of knee function,relieve the pain degree of patients,obtain higher treatment effect,and has significant clinical promotion value.

Objective To investigate the clinical effect of neoadjuvant concurrent chemoradiotherapy combined with surgery in the treatment of stageⅡ-Ⅲrectal cancer.Methods A total of 92 patients with stageⅡ-Ⅲrectal cancer admitted to Xinyu People′s Hospital from March 2017 to March 2021 were selected as the study subjects,and they were divided into the observation group(n=46)and the control group(n=46)by random ball-touching method.The control group was received surgery combined with postoperative concurrent chemoradiotherapy and postoperative chemotherapy,while the observation group was received neoadjuvant concurrent chemoradiotherapy combined with surgery and postoperative chemotherapy.The clinical efficacy,the incidence of acute toxic reactions,anal the retention rate,the incidence of complications,the local recurrence rate and the overall survival rate were compared between the two groups.Results The disease control rate(DCR)in the observation group was higher than that in the control group,the difference was statistically significant(P＜0.05).The incidence of acute toxicity in the observation group was lower than that in the control group,and the difference was statistically significant(P＜0.05).The anal retention rate in the observation group was higher than that in the control group,and the difference was statistically significant(P＜0.05).There was no significant difference in the total incidence of complications between the two groups(P＞0.05).The recurrence rate at 1,3,5 years in the observation group were lower than those in the control group,and the overall survival rate at 1,3,5 years in the observation group were higher than those in the control group,with statistical significance(P＜0.05).Conclusion Neoadjuvant concurrent chemoradiotherapy combined with surgeryin the treatment of stageⅡ-Ⅲrectal cancer can improve the clinical efficacy,reduce the incidence of acute toxic reactions and the local recurrence,avoid increasing the incidence of complications,and promote the improvement of anal retention rate and overall survival rate.

Objective To investigate the influence of preservation of the intercostal brachial nerve on sensory function and prognosis after modified radical mastectomy for breast cancer.Methods A total of 84 female breast cancer patients admitted to the Putian Medical District of the 900th Hospital of the Joint Logistics Support Force from October 2019 to October 2020 were selected and divided into the observation group(42 cases)and the control group(42 cases)by random number table method.Both groups were treated with modified radical mastectomy for breast cancer.The intercostal brachial nerve was preserved in the observation group,while the intercostal brachial nerve was not preserved in the control group.The patients were followed up for 1 year.The clinical indicators,sensory function scores,complications and prognosis were compared between the two groups.Results There were no significant difference in operation time,in traoperative blood loss,number of lymph node dissection,the total incidence of complications and the recurrence rate between the two groups(P>0.05).The hospitalization time of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the preoperative sensory dysfunction scores between the two groups(P>0.05).The scores of the postoperative sensory dysfunction in the two groups after surgery were lower than those before surgery,and the scores of the postoperative sensory dysfunction in the observation group after surgery were higher than those in the control group,while the differences were statistically significant(P<0.05).Conclusion Preserving the intercostals brachial nerve in modified radical mastectomy for breast cancer can not prolong the operation time and increase the surgical trauma,and has no significant effect on the surgical effect and prognosis,and is more conducive to the recovery of postoperative sensory function of patients.The clinical application is safe and reliable.

Objective To investigate the efficacy of Compound Glycyrrhizin in children with cytomegalovirus(CMV)infection and liver damage.Methods A total of 120 children with CMV infection and liver damage admitted to Jiangxi Children′s Hospital from July 2020 to July 2021 were selected as the research objects and divided into control group(60 cases)and observation group(60 cases)according to the random number table method.The control group was treated with Ganciclovir Antiviral combined with Reduced Glutathione,and the observation group was treated with Compound Glycyrrhizin on the basis of the control group.The levels of CMV-DNA copy number,alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(AKP),lymphocyte subsets(CD3+,CD4+,CD8+and CD4+/CD8+)in peripheral blood,and the incidence of adverse reactions were compared between the two groups.Results There were no significant differences in CMV-DNA copy number,ALT,AST and AKP between the two groups before treatment(P>0.05).The CMV-DNA copy number,ALT,AST and AKP in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in lymphocyte subsets between the two groups before treatment(P>0.05).After treatment,the levels of CD3+and CD8+in the observation group were lower than those in the control group,while the levels of CD4+and CD4+/CD8+in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was 3.33%,which was lower than 25.00% in the control group,and the difference was statistically significant(P<0.05).Conclusion Basic treatment combined with Compound Glycyrrhizin is more effective in the treatment of CMV infection complicated with liver damage.

Objective To study the clinical effect of Mifepristone combined with Ethinyl Estradiol and Cyproterone in the treatment of patients with incomplete abortion.Methods A total of 56 patients with incomplete abortion admitted to the Fourth Hospital of Nanchang City and its cooperative hospitals from September 2021 to January 2022 were selected as the research objects for retrospective analysis.According to different treatment methods,they were divided into the observation group(n=26,treated with Mifepristone combined with Ethinyl Estradiol and Cyproterone)and the control group(n=30,treated with uterine cureturation).The clinical efficacy,abortion related indicators(menstrual recovery time,uterine content disappearance time,endometrial thickness,ovarian size),gastrointestinal and stress indicators(vasoactive intestinal peptide[VIP],motilin[MTL],gastrin[GAS],cortisol[Cor],angiotensin-Ⅱ[AngⅡ])were compared between the two groups.Results There was no significant difference in the total effective rate between the two groups(P>0.05).There were no significant differences in menstrual recovery time and uterine contents disappearance time between the two groups(P>0.05).The endometrial thickness and ovarian size of the observation group were greater than those of the control group,and the differences were statistically significant(P<0.05).There were no significant differences in MTL and GAS between the two groups before and after treatment(P>0.05).There were no significant differences in VIP,Cor and AngⅡbetween the two groups before treatment(P>0.05).The VIP,MTL and GAS of the two groups after treatment were lower than those before treatment,Cor and AngⅡof the two groups after treatment were higher than those before treatment,and the differences were statistically significant(P<0.05).After treatment,the VIP of the observation group was higher than that of the control group,while Cor and AngⅡwere lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion Compared with curettage,Mifepristone combined with Ethinyl Estradiol and Cyproterone is effective in treating patients with incomplete abortion,and it has less damage to endometrium and ovary function,and has a protective effect on gastrointestinal function,which should be paid attention to clinically.

Objective To analyze the effect of free body position combined with labor analgesia on vaginal delivery.Methods A total of 66 women with vaginal delivery admitted to the Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Gannan Medical University from July 2020 to November 2021 were selected as the research objects for retrospective analysis.According to different delivery methods,they were divided into the control group(n=33)and the observation group(n=33).The control group was delivered in the traditional supine position.The observation group took the first and second stage of labor to maintain free body position and labor analgesia.The pain degree,asphyxia of newborns,postpartum hemorrhage,adverse pregnancy outcomes,postpartum fatigue and the duration of each stage of labor were compared between the two groups.Results The total incidence of adverse pregnancy outcomes in the observation group(6.06%)was lower than that in the control group(24.24%),and the difference was statistically significant(P<0.05).The degree of pain in the observation group was lighter than that in the control group,and the incidence of neonatal asphyxia was lower than that in the control group,and the differences were statistically significant(P<0.05).The first and second stages of labor and total stage of labor in the observation group were shorter than those in the control group,and the amount of postpartum blood loss was less than that in the control group,and the differences were statistically significant(P<0.05).The postpartum fatigue score of the observation group was lower than that of the control group in the second and third trimester of labor,and the postpartum fatigue score of the two groups was higher than that of the early trimester of labor,and the postpartum fatigue score of the late trimester of labor was higher than that of the second trimester of labor,and the differences were statistically significant(P<0.05).Conclusion Free body position combined with labor analgesia is effective for vaginal delivery,which can significantly shorten the total labor process,reduce maternal pain and postpartum hemorrhage.

Objective To study the effect of self-made tourniquet on hemostasis in puerpera with three or more cesarean sections.Methods A total of 60 parturient women with three or more cesarean sections admitted to the Department of Obstetrics,Shangrao Maternal and Child Health Hospital from January to December 2021 were selected as the research objects.The parturient women were divided into observation group and control group by random number method,with 30 cases in each group.The control group was treated with intrauterine injection of Oxytocin+Ergocloine after removal of the fetus by cesarean section,and the observation group was treated with self-made tourniquet on the basis of the control group.The intraoperative,2 h and 24 h postoperative blood loss,operation time,postoperative hospital stay,rate of fundal descent and duration of lochia were compared between the two groups.Results The blood loss during operation,2 h and 24 h after operation in the observation group was less than that in the control group,and the differences were statistically significant(P<0.05).The operation time and postoperative hospital stay in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The fundus of the observation group decreased faster than that of the control group,and the duration of lochia was shorter than that of the control group,and the differences were statistically significant(P<0.05).Conclusion The self-made tourniquet can be used to stop bleeding during cesarean sections of three or more times,which can effectively reduce the amounts of intraoperative and postpartum bleeding and speed up postpartum recovery.

Objective To investigate the correlation between vaginal microecology and sex hormones in polycystic ovary syndrome(PCOS)patients.Methods A total of 101 patients with PCOS admitted to Xiaolan People′s Hospital of Zhongshan from November 2020 to August 2021 were selected as the research group,and 100 healthy women who underwent gynecological examination during the same period were selected as the control group.The vaginal microecology and serum levels of testosterone(T),follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),progesterone(P)and prolactin(PRL)were compared between the two groups,the relationship between vaginal microecology and sex hormones in PCOS were analyzed.Results The proportion of lactic acid bacteria≥70%,the detection rate of pH 3.8-4.5 and Nugent score in the study group were lower than those in the control group,and the rate of vaginal microecological imbalance was higher than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the serum levels of FSH,LH,PRL and T between PCOS patients with normal and dysregulated vaginal microecology(P>0.05).The levels of serum P and E2 in patients with vaginal microecology disorder were higher than those in patients with normal vaginal microecology,and the differences were statistically significant(P<0.05).Nugent score had no correlation with serum levels of FSH,LH,PRL and T(P>0.05),but was negatively correlated with serum P level,and positively correlated with serum E2 level(P<0.05).Conclusion The status of vaginal microecological imbalance and sex hormone changes existed in patients with PCOS,and the vaginal microecological edge of PCOS patients and some correlation with sex hormones existed in patients,it is possible that hormone changes are involved in the formation of vaginal microecological imbalance in patients.

Objective To analyze the correlation between vitamin D,body mass index(BMI)and sex hormone levels in girls with idiopathic central precocious puberty(ICPP).Methods The clinical data of 100 girls with ICPP who were treated in the Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 2019 to January 2021 were retrospectively analyzed,and they were set as the ICPP group,and 80 girls with normal development during the same period were selected as the control group.The changes of vitamin D level,BMI,gonadotropin and sex hormone levels in the ICPP group before and after treatment were compared with those in the control group,and the relationship between vitamin D level and BMI and sex hormone levels was analyzed.Results The levels of 25-hydroxyvitamin D3[25(OH)D3]in the ICPP group before treatment were lower than those in the control group,BMI,body mass index standard deviation score(BMI SDS),luteinizing hormone(LH),the levels of follicle-generating hormone(FSH)and estradiol(E2)were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in BMI SDS,FSH and E2 between the ICPP group and the control group after treatment(P>0.05).The levels of 25(OH)D3 and LH in the ICPP group after treatment were lower than those in the control group,and the BMI was higher than that in the control group,and the differences were statistically significant(P<0.05).The level of 25(OH)D3 in the ICPP group after treatment was higher than that before treatment,the levels of BMI SDS,LH,FSH and E2 were lower than those before treatment in ICPP group,and the differences were statistically significant(P<0.05).In ICPP group,25(OH)D3 in ICPP girls before treatment was negatively correlated with BMI,BMI SDS,LH,FSH,E2 levels(P<0.05).Conclusion ICPP girls generally have vitamin D deficiency,which is closely related to the increase of BMI and the increase of sex hormone levels.

Objective To analyze the diagnostic value of hysteroscopy for abnormal vaginal bleeding in perimenopausal women.Methods A total of 313 patients with perimenopausal bleeding who were treated in the Department of Gynecology and Obstetrics,Chengxiang District Hospital of Putian City,Fujian Province from January 2020 to December 2021 were selected as the research objects.All patients underwent vaginal B-ultrasound and hysteroscopy.The gold standard is to compare the detection rates of different methods for abnormal vaginal bleeding with different etiologies,and to compare the diagnostic efficacy of different methods.Results The results of pathological examination showed that among the 313 perimenopausal women,253 were endometrial lesions,60 were endometrial normal.90 were endometrial hyperplasia,67 were endometrial polyps,45 were endometrial polyps,27 were subendometrial fibroids,and 24 were endometrial carcinomas in endometrial lesions patients.The coincidence rate of hysteroscopy in the diagnosis of abnormal vaginal bleeding was 96.84%,which was higher than 83.40% of vaginal ultrasound,and the difference was statistically significant(P<0.05).The sensitivity of hysteroscopy in the diagnosis of abnormal uterine bleeding was 96.84%,the specificity was 90.00%,the accuracy was 95.53%,the positive predictive value was 97.61% and the negative predictive value was 87.10%,which were higher than 83.40%,75.00%,81.79%,93.36% and 51.72% of vaginal B-ultrasound,and the differences were statistically significant(P<0.05).Conclusion Hysteroscopy can accurately detect abnormal vaginal bleeding in perimenopausal women,identify the cause of bleeding,and provide a basis for the development of disease treatment,which has promotion value.

Objective To investigate the clinical efficacy of Ginkgo Biloba Extract combined with Betastine in the treatment of acute unilateral vestibular hysfunction(UVH).Methods A total of 60 patients with acute UVH who were admitted to the Department of Otolaryngology and Vertigo Clinic of the Dalian Third People′s Hospital from October 2020 to April 2021 were selected as the study subjects.They were divided into observation group and control group by random number table method,30 cases in each group.Patients in the control group were treated with Betahistine Mesylate Tablets and conventional vestibular rehabilitation,while patients in the observation group were treated with Ginkgo Biloba Extract Tablets on the basis of the control group.Both groups were treated for 1 month.The scores of dizziness rating scale(DHI),cold and heat test results and adverse reactions during treatment were compared between the two groups before and after treatment.Results There were no significant differences in semicircular canal paresis index(UW)and DHI score between the two groups before treatment(P>0.05).The UW and DHI scores of the two groups after treatment were lower than those before treatment,and the differences were statistically significant(P<0.05).After treatment,the DHI score and UW value of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The combined treatment of Ginkgo Biloba Extract and Betastine can significantly improve the dizziness symptoms of patients with acute unilateral vestibular dysfunction,with no obvious adverse reactions and high safety.

Objective To evaluate the clinical effect of aspheric and spherical intraocular lens implantation in the treatment of cataract.Methods A total of 324 cataract patients admitted to Gansu Rehabilitation Center Hospital from January 2020 to July 2021 were selected as the research objects.They were divided into observation group and control group by random number table method,with 162 cases in each group.Both groups were treated with phacoemulsification combined with intraocular lens implantation.The control group was treated with spherical intraocular lens,while the observation group was treated with aspheric intraocular lens.The visual acuity recovery effect and operation satisfaction were compared between the two groups at 3 months after operation.Results The visual acuity of the observation group was better than that of the control group 3 months after operation,and the difference was statistically significant(P<0.05).The operation satisfaction of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Both aspherical and spherical intraocular lens can play a role in the treatment of cataract patients,but aspherical intraocular lens implantation is helpful to improve postoperative visual acuity and improve patient satisfaction,which is worthy of further promotion.

Objective To explore the clinical value and guiding role of Tei index in evaluating right ventricular function of patients with neonatal pneumonia.Methods From January 2020 to December 2021,120 cases of neonatal pneumonia admitted to the Department of Neonatal Pediatric Ward of Zhaoqing First People′s Hospital were selected as the observation group,and they were divided into the common pneumonia group and the severe pneumonia group according to the severity of neonatal pneumonia,with 60 cases in each group.Another 60 neonatal of Neonatology Department(excluding heart and lung diseases)were selected as the control group.The three groups were examined by transthoracic echocardiography,and the right ventricular end-diastolic anteroposterior diameter(RVDd),right atrial diameter(RA),right ventricular anteroposterior diameter(RV),and pulmonary artery systolic pressure(PASP)were measured.The right ventricular Tei index was measured and calculated by tissue Doppler technology.Plasma N-terminal probrain natriuretic peptide(NT-proBNP)was measured simultaneously.The levels of RVDd,RA,RV,PASP and NTproBNP in the three groups were compared.Results Upon 24 h of admission,the levels of NT-proBNP,Tei index,PASP values in the common pneumonia group and the severe pneumonia group were higher than those in the control group,the differences were statistically significant(P＜0.05).The levels of NT-proBNP,Tei index and PASP values in the severe pneumonia group were higher than those in the common pneumonia group,the differences were statistically significant(P＜0.05).The levels of RV and RA values in the severe pneumonia group were higher than those in the control group,the level of RVDd value in the severe pneumonia group was lower than that in the control group,the differences was statistically significant(P＜0.05).But there were no significant differences with the common pneumonia group(P＞0.05).After one week of systematic treatment,the levels of NT-proBNP,Tei index and PASP values in the common pneumonia group and the severe pneumonia group were lower than those upon admission,and the levels of NT-proBNP,Tei index and PASP values in the severe pneumonia group were higher than those in the common pneumonia group,the differences were statistically significant(P＜0.05).There were no significant differences in the RV,RA and RVDd between the two groups(P＞0.05).Tei index and NT proBNP concentration of patients in the observation group was significant positive correlation(r=0.45,P＜0.05).Conclusion Tei index of neonatal pneumonia patients is abnormally high,and Tei index and NT-proBNP have a good correlation.The combination of the two indexes can provide relevant disciplinary basis for the evaluation,diagnosis,treatment and efficacy evaluation of clinical neonatal pneumonia.

Objective To investigate the ultrasonographic characteristics of primary parathyroid adenoma and its correlation with parathyroid hormone(PTH),serum calcium and phosphorus.Methods A total of 185 patients with primary parathyroid adenoma admitted to Fujian Provincial Hospital from January 2015 to December 2021 were selected as the research objects.All patients underwent ultrasound examination,and the relevant clinical information of the patients and the ultrasonic morphological characteristics of the primary parathyroid adenoma,such as size,echo,calcification,liquefaction,full or flat shape,and the location of the lesion were recorded.The correlation of echocardiography,calcification and liquefaction with PTH,serum calcium and phosphorus was analyzed.Results The levels of PTH and serum calcium in patients with liquefaction were higher than those in patients without liquefaction,the differences were statistically significant(P<0.05).There were no significant differences in PTH,serum calcium and serum phosphorus among patients with other different ultrasound characteristics(P>0.05).Correlation analysis showed that PTH and serum calcium levels were positively correlated with adenoma liquefaction(P<0.05),but not with calcification and morphology(P>0.05).Serum phosphorus levels were not significantly correlated with common ultrasound signs(P>0.05).Among 185 patients,9 cases(4.8%)developed hypercalcium crisis.The proportion of liquefaction in patients with high calcium crisis was higher than that in those without,and the difference was statistically significant(P<0.05).Correlation analysis showed that hypercalcium crisis was positively correlated with adenoma liquefaction(P<0.05),but not with echo intensity and calcification(P>0.05).Conclusion There is a certain correlation between the characteristic manifestations of parathyroid adenoma under ultrasound and and main test indicators.Knowledge and understanding can help improve the localization and identification of parathyroid nodules under ultrasound,and at the same time help to screen and prompt primary hyper-parathyroidism patients with potential hypercalcemia crisis,and improve the clinical prognosis of such patients.

Objective To explore the diagnostic value of 256-slice spiral CT coronary angiography(CTA)in coronary artery stenosis.Methods A total of 168 patients with suspected coronary artery stenosis who were examined in Department of Imaging of Zhongshan Hospital of Traditional Chinese Medicine from January 2020 to December 2021 were selected.All patients underwent 256-slice spiral CTA and coronary angiography(CAG)examination,with CAG examination as the“gold standard”.The situation of coronary artery stenosis detected by 256-slice spiral CTA and CAG and the diagnostic value of 256-slice spiral CTA in coronary artery stenosis were analyzed,and the consistency between 256-slice spiral CTA and CAG was calculated.Results Among 168 suspected patients,137 patients with definite diagnosis of coronary artery stenosis,a total of 1 420 vascular segments were detected.The specificity,accuracy and positive predictive value of 256-slice spiral CTA in the diagnosis of severe stenosis were higher than those of mild and moderate stenosis,and the differences were statistically significant(P＜0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of 256-slice spiral CTA in the diagnosis of coronary artery stenosis were 94.89%,90.32%,94.05%,97.74% and 80.00%,respectively.Kappa test showed that 256-slice spiral CTA was in good agreement with CAG(Kappa=0.812,P＜0.001).Conclusion 256-slice spiral CTA has high application value in the differential diagnosis of coronary artery stenosis,and it has a strong consistency with CAG in the differential diagnosis of coronary artery stenosis.It can provide a reliable reference for clinical diagnosis and treatment,and is worthy of popularization and application.

Gouty arthritis(GA)is a common rheumatoid immune disease.Western medicine has its limitations in treating gout.Traditional Chinese medicine has unique advantages in improving the clinical symptoms of GA and delaying the progression of the disease.Based on the study of the theories of ancient scholars and literature review,combining clinical practice and western gout staging,ZHANG Yanzhen,rheumatology department deputy chief physician who works in Shunyi Hospital,Beijing Traditional Chinese Medicine Hospital divides the pathological process of GA into acute stage,intermittent stage and chronic stage.In the acute stage,the syndrome of dampness and heat is more common.The treatment is to clear heat and remove dampness.The intermittent period is mixed with the deficiency and the pathogens,and it is necessary to fill the deficiency and reduce the pathogens.The chronic phase is characterized by the incidence of deficiency.It is treated by warming Yang and strengthening spleen as well as tonifying liver and kidney.ZHANG Yanzhen physician takes different treatments according to the characteristics of each syndrome type as well as attaching importance to the application of anti-inflammatory Chinese medicine and external treatments.The curative effect is remarkable.

Objective To explore the effect of Erchen Decoction and Sanzi Yangqin Decoction on thoracic and pulmonary compliance and gas exchange parameters in the treatment of phlegm dampness blocking lung syndrome of chronic obstructive pulmonary disease.Methods A total of 80 patients with phlegm dampness blocking lung syndrome of chronic obstructive pulmonary disease treated in Jiujiang Third People′s Hospital from January 2020 to January 2022 were selected as the research objects.The patients were divided into control group and observation group by random number table method,with 40 cases in each group.The patients in the control group were treated with conventional symptomatic Western medicine,and the patients in the observation group were treated with Erchen Decoction and Sanzi Yangqin Decoction on the basis of the control group.The symptom relief time,serum inflammatory factors,thoracopulmonary compliance indexes,gas exchange parameters,quality of life score,and incidence of adverse reactions were compared between the two groups.Results The remission time of all symptoms in the observation group was shorter than that in the control group,the difference was statistically significant(P<0.05).The levels of serum C-reactive protein,procalcitonin,interleukin-6 and tumor necrosis factor-α after treatment in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The total chest and lung compliance,thoracic compliance,lung compliance,forced breathing volume in one second,forced breathing volume/vital capacity ratio and quality of life score after treatment in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Erchen Decoction combined with Sanzi Yangqin Decoction can alleviate the symptoms of patients with phlegm dampness blocking lung syndrome of chronic obstructive pulmonary disease,reduce the inflammatory reaction in the patient,improve the chest and lung compliance and lung ventilation function,and improve the quality of life,with no increase in adverse reactions and good drug safety.

Edible and medicinal fungi not only have a certain number of species,but also have unique nutrients and pharmacological effects,which have attracted more and more attention in academic research.There are many contents about the application of edible and medicinal fungi in the traditional Chinese medicine materia medica classics,including drug determination,quantity record,clinical application of traditional Chinese medicine and prescriptions,etc.At present,there have been edible and medicinal fungi as the main raw material or molecular source of drugs in clinical use,or are undergoing clinical trials,or have obtained official approval to make health food.It can be seen that edible and medicinal fungi have played an important role in clinical and health care,and have high application value to improve human health.Although the resources of the medicinal food bacteria is very rich,but now the use value of medicinal food bacteria discovered only a small part,should be through various efforts to turn their potential for practical application of broader,deeper,in nutrition,food science,TCM,clinical medicine,philology,opening up a new topic,advancing the medicinal food bacteria in clinical and health care function of related research.

Objective To observe the clinical effect of Ma′s warm moxibustion combined with acupuncture in the treatment of migraine with cold coagulation and blood stasis syndrome.Methods A total of 48 patients with migraine with cold coagulation and blood stasis syndrome in Beijing Mentougou Hospital of TCM from January to December 2021 were selected as the research objects.They were divided into observation group and control group by random number table method,with 24 cases in each group.Patients in the control group were treated with acupuncture combined with conventional moxa stick moxibustion,while patients in the observation group were treated with acupuncture combined with Ma′s warm moxibustion.The visual analogue scale(VAS)score and clinical efficacy were compared between the two groups.Results There was no significant difference in VAS score between the two groups before treatment(P>0.05).The VAS score of the observation group after treatment was lower than that of the control group,and the difference was statistically significant(P<0.05).The effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Ma′s warm moxibustion combined with acupuncture in the treatment of migraine with cold coagulation and blood stasis syndrome could reduce the VAS score of patients,and got high clinical efficacy,which is worthy of clinical promotion.

Objective To investigate the expression difference of circular RNA CDR1as in peripheral blood mononuclear cells in patients with atherosclerosis(AS)and its possible clinical significance.Methods Twenty patients with AS who visited the Hongqi Hospital Affiliated To Mudanjiang Medical University from September 2020 to January 2021 were selected as the research objects,and twenty healthy subjects who visited the clinic during the same period were selected as the control.Peripheral blood mononuclear cells of the two groups were detected by Real-time quantitative Polymerase Chain Reaction.CDR1as expression level,and establish a receiver operating characteristic curve to evaluate the diagnostic value of CDR1as for AS.Results The expression level of CDR1as in the peripheral blood of the AS patient group was lower than that in the control group,and the difference was statistically significant(P<0.01).The area under the curve of CDR1as for AS diagnostic performance was 0.827(P<0.05),and the sensitivity and specificity were 70% and 85%,respectively.Conclusion The expression of circular RNA CDR1as in the peripheral blood of AS patients is significantly reduced;the expression level of CDR1as in the peripheral blood has a certain diagnostic value for AS,and may become a new molecular marker of AS.

Objective To explore the value of agglutination method in the identification of positive and negative blood type inconsistency and the analysis of the positive and specific results of irregular antibodies.Methods A total of 181 patients undergoing blood transfusion treatment in the Department of Blood Transfusion of Pingxiang People′s Hospital from April 2018 to May 2020 were selected as the research subjects.The agglutination method was used to complete the positive and negative blood type typing and Rh type analysis,and the identification results and reasons for the inconsistency of the positive and negative blood type typing were analyzed.The positive and specific results of irregular antibodies were analyzed.Results The positive-type serum samples were detected,among which 46 cases were red blood cells of type A,the detection rate of serum antibodies was 73.91%,and the difference between positive and negative typing was 15.22%.78 cases of red blood cells were type B,the detection rate of serum antibodies was 67.95%,and the positive rate was 67.95%.The inconsistency rate of reverse typing was 8.97%.57 patients with red blood cells were type O,the serum antibody detection rate was 73.68%,and the inconsistency between positive and negative typing was 7.02%.181 patients who received blood transfusion were all analyzed by agglutination method to complete positive and negative blood typing analysis.The results showed that the positive and negative types of 18 patients did not match,accounting for 9.94%.The top two causes of ABO blood type inconsistency were hematopoietic stem cell transplantation and antigen weakening or deletion,accounting for 50.0% and 27.78%,respectively.181 patients who underwent blood transfusion completed Rh typing analysis,and the results showed that 21 cases of patients had irregular antibodies,accounting for 11.60%.There was no significant difference in the detection rate of irregular antibodies in the Rh typing analysis between male patients and female patients(P>0.05).Conclusion Agglutination method has high accuracy in positive and negative blood typing and Rh typing,has the advantages of accuracy and reliability,can effectively save reagents,improve the automation level of blood typing and improve the safety of blood transfusion.

Objective To explore the diagnostic value of chemiluminescence immunoassay in clinical examination.Methods A total of 50 cases of patients with suspected hepatitis B admitted to Linyi Maternal and Child Health Hospital from May 2020 to April 2021 were selected as research objects.All of them were examined by chemiluminescent immunoassay and hepatitis B virus DNA load.The positive rates of serum markers,and hepatitis B virus DNA load and application values were analyzed.Clinical diagnosis was the gold standard.Results The positive rates of hepatitis B surface antigen(HBsAg),hepatitis B e antigen(HBeAg),hepatitis B e antibody(HBeAb)detected by chemiluminescent immunoassay were higher than those of hepatitis B virus DNA load,and the differences were statistically significant(P＜0.05).The sensitivity,accuracy and negative predictive value of chemiluminescent immunoassay were higher than those of hepatitis B virus DNA load,and the differences were statistically significant(P＜0.05).However,there were no statistically significant differences in specificity and positive predictive value between the two groups(P＞0.05).Conclusion The application value of chemiluminescence immunoassay is higher than that of hepatitis B virus DNA load,and the sensitivity,accuracy and positive predictive value are higher,which is worth popularizing.

Objective To explore a new mode of intervention of medical social workers in hypertension management and provide reference for chronic disease management.Methods A total of 180 cases of community hypertension patients in Luzhou from July to August 2021 were selected as the research objects.A cross-sectional survey was conducted using typical sampling method,and questionnaires were used to evaluate their self-management ability and demand for medical social workers.Results The scores of the three dimensions of self-management in community hypertension patients in Luzhou were cognition(15.15±3.93),belief(13.83±2.55)and behavior(30.44±4.40),indicating that the selfmanagement ability was at the medium level.Community hypertension patients scored(22.75±6.31)in terms of personal knowledge and skill guidance needs,and(17.92±3.81)in terms of community service support needs,indicating that they generally had different service needs for medical social workers.Conclusion The self-management of community hypertension patients is affected by many factors,and there is a need for medical social workers.The intervention of medical social workers in hypertension management can improve patients′self-management ability through personalized services,thus improving the status quo of hypertension management.

Objective The purpose of this study was to survey the dialysis status of maintenance hemodialysis(MHD)patients in Jiujiang area,and to provide data support for the further development of hemodialysis in Jiujiang area.Methods The gender,age,dialysis age,primary disease diagnosis and vascular access of end-stage renal disease(ESRD)patients in Jiujiang area in June 2021 were retrospectively selected for a cross-sectional survey.Results A total of 3 818 MHD patients were investigated in this study,including 2 237 males and 1 581 females.The main age was 18-59 years old(58.64%),and the dialysis age was mainly 1-4 years(43.27%).The top three primary renal diseases in dialysis patients were chronic glomerulonephritis(51.49%),diabetic nephropathy(18.07%)and hypertensive nephropathy(17.84%).In terms of composition of dialysis pathway,arteriovenous fistula(AVF)accounted for 82.77%,arteriovenous graft(AVG)accounted for 2.02%,tunneled cuff catheter(TCC)accounted for 12.13%,and non-cuffed catheter(NCC)accounted for 3.09%,AVF and TCC were mainly used for 1-4 years,and the first-time dialysis AVF usage rate was 16.95%.The use of AVF and TCC were related to patients′educational level and economic level.Conclusion The prevalence of MHD and the proportion of MHD patients in elderly groups are high in Jiujiang.The composition of renal disease is similar to most studies in China.The utilization rate of AVF at the first dialysis and the proportion of TCC and AVG in the MHD pathway still lag behind the target.

Since entering the new era,the demand of the state and society for talents has been further strengthened.As a high-level talent,the training of postgraduate is also facing new changes.It is an important direction of social development and the development of higher education to explore the ways and systems for the training of graduate students'innovation ability.With the increasing degree of internationalization of scientific research and academic exchange,and the increasing expectation of the practical application ability of graduate students,it is worthy of serious exploration by higher education workers how to integrate international cooperation and university-enterprise cooperation effectively to improve the international innovation ability of graduate students.Starting with the concept of joint training mechanism of the international cooperation and university-enterprise association,combining with the present problems existing in the postgraduate innovation ability training process,this article discusses the importantance and the feasibility of the organic combination of international cooperation and university-enterprise association joint.Then,the main ways of joint cultivation mechanism construction were put forward.This Practice is hoped to provide a good reference for the cultivation of pharmaceutical postgraduate innovation ability.

Objective To explore the application effect of Double-Subject scheme in teaching practice of nursing interns.Methods A total of 380 nursing interns who were interned in Jiangxi Province Children′s Hospital from June 2019 to July 2021 were selected as the research objects.According to the order of admission practice,177 nursing students who were interned from June 2019 to March 2020 were set as the control group,and 203 nursing students who were interned from July 2020 to March 2021 were set as the intervention group.The control group used conventional teaching method,and the intervention group used Double-Subject scheme teaching method.The operation and theoretical achievements,clinical communication ability and clinical adaptability of the two groups of nursing students after training were compared.Results The scores of operation assessment and theoretical assessment of the two groups of nursing interns after training were higher than those before training,and the differences were statistically significant(all P＜0.05).The scores of operation assessment and theoretical assessment of nursing interns in the intervention group after training were higher than those in the control group,and the differences were statistically significant(P＜0.05).The scores of harmonious relationship,keen listening,confirming patients′problems,verifying feelings and the total scores of nursing interns in the scores of clinical adaptability in the intervention group were higher than those in the control group,and the differences were statistically significant(P＜0.05).However,there were no statistically significant difference in the scores of common participation dimension and transmitting effective information between the two groups(P＞0.05).The scores of professional cognition and emotion in the clinical adaptability scores of nursing interns in the intervention group were higher than those in the control group,and the differences were statistically significant(P＜0.05).There were no significant difference in the scores of interpersonal relationship,behavioral performance dimension and total score of clinical adaptation between the two groups(P＞0.05).Conclusion Double-Subject scheme teaching method can improve the professional level and communication ability of nursing interns,but it has no obvious effect on improving their clinical adaptability.

Objective To explore the effect of PDCA cycle teaching method in the standardized residents training in the Department of Gastroenterology for clinical medicine professional postgraduates.Methods From January to December 2021,a total of 120 clinical medicine professional postgraduate students who entered the Department of Gastroenterology of the First Affiliated Hospital of Nanchang University to participate in the standardized residents training were selected as the research objects.There were 12 teachers,all of whom have obtained the qualification certificate of residential training teachers,and have been engaged in clinical teaching of Gastroenterology for more than 5 years.The students and teachers were divided into the experimental group and the control group by random number table method,with 60 students and 6 teachers in each group.The PDCA cycle teaching method was adopted in the experimental group.The main reasons for the low satisfaction of teachers and students with the standardized residents training were found by fishbone diagram and pareto chart,and continuous improvements were made.The traditional teaching method was adopted in the control group.The examination pass rate of the students and the satisfaction of teachers and students with the training were compared between the two groups.Results The main reasons for the low satisfaction of teachers and students with the standardized resident training included low attention to the training by students,low motivation to teaching by teachers,the lack of reward and punishment system for the teachers,and the lack of communication between teachers and students.After the continuous improve ment of the above-mentioned reasons through the PDCA cycle,in terms of the satisfaction of the students with the residential training,the satisfaction of the teachers with the students in the training,and the pass rate of the students in the exam,the experimental group were significantly higher than the control group(P＜0.05).Conclusion Application of PDCA cycle teaching method in the standardized residents training in the department of Gastroenterology can significantly improve the effect of training and the satisfaction of teachers and students with the training.PDCA cycle teaching method is worthy of promotion in the training of clinical medicine professional postgraduates.

Objective To explore the application effect of flipped classroom combined with massive open online course(MOOC)and automatic delivery system in normal delivery teaching in obstetrics and gynecology departmenty.Methods From May 2018 to July 2020,a total of 74 intern nursing students who participated in normal childbirth teaching in the Department of Obstetrics and Gynecology of Shenzhen University General Hospital were selected as the research objects,and they were divided into the control group(37 cases)and the observation group(37 cases)according to the random number table method.All of them were given flipped classroom teaching,and the control group was given MOOC teaching on this basis.The observation group was combined with the automatic delivery system teaching method on the basis of the control group.The teaching effect and teaching satisfaction were compared between the two groups.Results The scores of theoretical knowledge,operation skills,mastery of normal childbirth,independent problem-solving ability,teamwork ability and thinking ability of the observation group were higher than those of the control group,and the differences were statistically significant(P＜0.05).The teaching satisfaction of the observation group was higher than that of the control group,and the difference was statistically significant(P＜0.05).Conclusion The application of flipped classroom+MOOC and automatic delivery system teaching can effectively improve the success rate of normal delivery,and further improve the teaching quality and teaching satisfaction

Nuclear medicine is a comprehensive clinical discipline that uses radiopharmaceuticals and nuclear medicine imaging equipment to diagnose and treat diseases,mainly reflecting the function and metabolic changes of tissues and organs.At present,multimodal medical imaging has become the mainstream equipment and technology of clinical nuclear medicine.However,the current teaching content and syllabus of clinical nuclear medicine still mainly remain in the traditional teaching mode and lack of integration of multimodal imaging which is not conducive to the cultivation and development of nuclear medicine students.Therefore,it is urgent to reform and explore the current education of nuclear medicine.In order to improve the teaching effect and stimulate students′learning enthusiasm,the authors suggest to establish a perfect picture archiving and communication system(PACS)conducive to teaching practice and rewrite nuclear medicine textbooks/teaching plans based on multimodal imaging.This reformation can lay a solid foundation for the goal of training a new generation of comprehensive nuclear medicine physicians who meet clinical needs and can drive the development of the discipline,so as to provide better homogenous and high-quality medical services for the patients.

Objective To explore application effect of humanized nursing in acquired immune deficiecy syndrome(AIDS)patients.Methods A total of 100 AIDS patients from the Department of Infection,Pingxiang NO.2 People′s Hospital from January 2019 to December 2020 were selected as the research objects and divided into control group(50 cases)and observation group(50 cases)by random number table method.The control group received routine nursing,while the observation group received humanized nursing.The 36-item short form health survey(SF-36)score,medical coping style inventory(MCMQ)score,mental health degree,Pittsburgh sleep quality index(PSQI),treatmentrelated indicators(human immunodeficiency virus[HIV]viral load,T lymphocyte cells(CD4+)])and compliance degree were compared between the two groups.Results After nursing,the scores of emotional function(RE),social function(SF)and physiological function(PF)of the two groups were higher than those before nursing,and the scores of RE,SF and PF of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).After nursing,the yield and avoidance scores of the two groups were lower than those before nursing,and the face score was higher than that before nursing,and the yield and avoidance scores of the observation group were lower than those of the control group,and the face score was higher than that of the control group,and the differences were statistically significant(P<0.05).After nursing,the scores of self-rating anxiety scale(SAS),self-rating depression scale(SDS)and PSQI in the two groups were lower than those before nursing,and the scores of SAS,SDS and PSQI in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After nursing,the HIV viral load of the two groups was lower than that before nursing,and the CD4+was higher than that before nursing,and the HIV viral load of the observation group was lower than that of the control group,and the CD4+was higher than that of the control group,and the differences were statistically significant(P<0.05).The total compliance rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Implementing humanized nursing for AIDS patients can improve disease coping style,mental health,compliance,sleep quality,CD4+level,reduce HIV viral load,and improve quality of life,which is worthy of promotion.

Objective To explore the effect of meridian flow combined with giant needling on the recovery of lower limb function in patients with ischemic stroke and hemiplegia.Methods A total of 78 patients with ischemic stroke and hemiplegia admitted to Shenzhen Luohu District Hospital of Traditional Chinese Medicine from January 2021 to may 2021 were randomly divided into control group and observation group,with 39 patients in each group.The control group was intervened with giant needling,routine rehabilitation training and routine nursing for 30 days.On the basis of routine rehabilitation training and routine nursing,the observation group was intervened with giant needling under the guidance of meridian flow for 30 days.The Fugl-Meyer lower limb motor function score(FMA),modified Barthel Index(MBI)and modified Ashworth scale spasticity were compared between the two groups before and after intervention.Results The FMA score and MBI index of the two groups 30 days after intervention were higher than those before intervention,and the differences were statistically significant(P<0.05).30 days after intervention,the FMA score and MBI index of the observation group were higher than those of the control group,and the spasm grading of Ashworth scale was better than that of the control group,and the differences were statistically significant(P<0.05).Conclusion Meridian flow giant needling can improve the recovery of lower limb function,self-care ability of daily life and alleviate muscle spasm in patients with ischemic stroke and hemiplegia.The effect is better than that of simple giant needling.

Objective To investigate the effect of evidence-based care in patients with diabetic retinopathy(DR).Methods A total of 120 DR patients admitted to the First People′s Hospital of Fuzhou from January 2020 to January 2022 were selected as research objects,they were divided into control group and observation group according to random number table method,with 60 cases in each group.The control group received routine nursing,the observation group received routine nursing combined with evidence-based nursing,and the blood glucose levels and quality of life were compared between the two groups before and 2 months after nursing.Results After nursing,fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PG)and glycosylated hemoglobin(HbA1c)of two groups were lower than those before treatment,and the indexes in the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).After nursing,all dimensions and total scores of the Chinese version of low vision quality of life(CLV-QOL)in two groups were higher than those before nursing,and the scores of observation group were higher than the those of control group,the differences were statistically significant(P<0.05).Conclusion Evidencebased nursing intervention in DR patients can effectively regulate blood glucose levels and improve quality of life.

Objective To explore the effect of quality control circle on reducing the incidence of catheter-associated urinary tract infection(CAUTI)in critically ill patients based on multidisciplinary team cooperation.Methods A total of 721 critically ill patients with indwelling catheterization in the First People′s Hospital of Changzhou from January to December 2019 were selected as the control group,and routine nursing intervention was implemented.A total of 599 critically ill patients with indwelling catheterization admitted from October 2020 to September 2021 were selected as the intervention group,and a multidisciplinary team was established to implement quality control circle management.The incidence of CAUTI and hand hygiene of medical staff were compared between the two groups.Results The incidence of CAUTI in the intervention group was 1.26‰,which was lower than 4.22‰ in the control group,and the difference was statistically significant(P<0.05).The implementation of hand hygiene and the qualified rate of hand hygiene microorganisms of medical staff after the management of multidisciplinary team collaboration quality control circle were better than those before the management,and the differences were statistically significant(P<0.05).Conclusion The quality control circle activities established by multidisciplinary team cooperation model can effectively reduce the incidence of CAUTI in ICU patients,and the maintenance effect is good.