Discussion on the Four-Season Pathogenesis and Treatment of Insomnia Based on the “Circular Movement of Yang Qi Ascending and Descending” / 中医杂志

In the perspective of the theory of “circular movement of yang qi ascending and descending”， the author explores the four-season pathogenesis and treatment of insomnia based on the seasonal changes of the body's yin-yang balance. It is believed that the core pathogenesis of insomnia lies in the spleen and stomach deficiency and the internal buildup of dampness. The four-season pathogenesis of insomnia focuses can be categorized into four aspects： abnormal ascending of yang qi in the spring， leading to the liver fire inflammation or the liver qi stagnation； Predominance of yang qi in the upper side of the heart and gallbladder fire in the summer； Lung disorder and abnormal descent of yang qi， resulting in yang-heat conversion into dryness or disharmony between nutrient qi and defensive qi； Abnormal hiding of yang qi， manifesting as floating yang or deficiency in both yin and yang in the winter. It is advocated to dynamically grasp the pathogenesis of insomnia in accordance with the changes in time. A treatment framework called “restoring ascending and descending of yang qi” is proposed， with the core focus on resolving dampness and strengthening the spleen， while also addressing the liver and strengthen the spleen， clearing and descending the heart and gallbladder， purifing and descending the lung qi， and suppressing hyperactive the yang and invigorating the kidneys in different seasons. This enrichment of the traditional Chinese medicine time medicine research in insomnia treatment， based on the characteristics of seasonal rhythmic time， aims to better serve clinical practice and provide ideas for the clinical diagnosis and treatment of insomnia.

Application of Modified FuMai Decoction （复脉汤加减方） based on Sanjiao （三焦） Theory / 中医杂志

Review of historical literature showed that the understanding of the indicated disease location of Modified FuMai Decoction （复脉汤加减方） has evolved from the upper jiao （焦） to the middle and lower jiao. Initially， it is used for the treatment of yin deficiency of both yin and yang in the upper jiao， changes to supplement stomach and produce fluids in the middle jiao， and is used to protect yin， clear the pathogens， conslidate yin and subdue yang so as to store the true yin of lower jiao. The unchanging principle of Fumai Decoction modifications is nourishing yin， while the changing aspects are determining the secondary treatment methods based on disease location of sanjiao， concomitant disease natures， internal injury or external contraction， warm disease or cold damage， thereby choosing the corresponding added or subtracted herbs， and providing reference for the application of classical formulas.

Impact of Bayesian penalized likelihood algorithm on the metabolism parameters and image quality in 18F-FDG PET/CT background tissues / 中华核医学与分子影像杂志

Objective:To investigate the impact of Bayesian penalized likelihood (BPL) PET reconstruction method on the uptake of 18F-fluorodeoxyglucose (FDG) and signal to noise ratio (SNR) of lungs, liver, aorta and bones. Methods:From March 2019 to June 2019, the 18F-FDG PET/CT images of 60 patients with clinical diagnosed tumors (29 males, 31 females, age: 24-89 (60.4±15.2) years) in Yuhuangding Hospital were retrospectively analyzed. PET images were reconstructed with ordered subset expectation maximization (OSEM), time of flight (TOF)+ point spread function (PSF) and BPL (β=350) algorithms. Volumes of interest (VOIs) were delineated on the right upper lung lobe, the right liver, aortic root and lumbar vertebra. The mean standardized uptake value (SUV mean), maximum standardized uptake value (SUV max), peak of lean body standardized uptake value (SUL peak), standard deviation of standardized uptake value (SUV SD) and the SNR were measured. The percentage of SNR change (%ΔSNR) between the BPL method and non-BPL methods were calculated. The correlations between body mass index (BMI) and %ΔSNR were analyzed by Pearson correlation analysis. One-way analysis of variance and the least significant difference (LSD) t test were used to analyze the data. Results:There were no significant differences of SUV mean and SUL peak in lung, aorta, liver and lumbar vertebra among 3 methods ( F values: 0.04-1.95, all P>0.05). The SUV max in lung, aorta, liver and lumbar vertebra of BPL reconstruction (1.14±0.82, 2.13±0.37, 2.95±0.50 and 2.76±0.87) was significantly lower than those of TOF+ PSF (1.56±0.61, 2.99±0.75, 4.32±0.94 and 4.05±1.48) and OSEM (1.51±0.67, 3.00±0.70, 4.45±1.12 and 3.81±1.06) reconstructions ( F values: 20.59-52.24, all P<0.001) and SUV SD (0.13±0.07, 0.20±0.05, 0.26±0.06, 0.38±0.17) was also significantly lower than those of TOF+ PSF (0.24±0.11, 0.43±0.11, 0.58±0.15, 0.67±0.21) and OSEM (0.21±0.09, 0.42±0.10, 0.58±0.14, 0.63±0.20) reconstructions ( F values: 24.46-124.95, all P<0.001), while the SNR (4.67±1.34, 7.74±2.22, 8.17±1.77, 4.45±1.22) was significantly higher than those of TOF+ PSF (2.54±0.72, 3.55±0.82, 3.77±0.91, 2.49±0.69) and OSEM (2.65±0.64, 3.67±0.80, 3.75±0.87, 2.60±0.67) reconstructions ( F values: 83.04-247.73, all P<0.001). However, there were no significant differences between OSEM and TOF+ PSF reconstructed images in SUL peak, SUV mean, SUV SD and SNR (all P>0.05). In BPL group, SNR increased with the increase of BMI, and there were statistically differences of aortic SNR (7.07±2.21 vs 9.67±2.26) and liver SNR (7.75±1.85 vs 9.32±0.70) between BMI<25 kg/m 2 and BMI≥30 kg/m 2 ( F values: 3.46 and 4.19, both P<0.05). Positive correlations were found between %ΔSNR of lung, aorta, liver and lumbar vertebra in OSEM and TOF+ PSF and BMI ( r value: 0.042-0.354, all P<0.05). Conclusion:In background tissues, BPL algorithm has no significant impact on absolute quantification compared with OSEM and TOF + PSF reconstruction methods but it can significantly improve SNR, especially for the patients with large body weight.

Expression and clinical significance of Wnt2 and Dvl protein in esophageal aquamous carcinoma / 天津医药

Objective To detect the expressions of Wnt2 and dishevelled (Dvl) protein in esophageal squamous carci-noma, and analyze their relationship with the occurrence and development of esophageal squamous cell carcinoma. Meth-ods The expression levels of Wnt2 and Dvl protein were detected by Western blot assay in 60 samples of esophageal carci-noma and adjacent non-carcinomatous esophageal tissues, and their relationship with clinical pathological features were ana-lyzed. Results The relative expression levels of Wnt2 and Dvl protein were higher in esophageal squamous carcinoma tis-sue (0.512 ± 0.406, 1.218±1.082) than those of esophageal tissue adjacent to carcinoma (0.153 ± 0.189, 0.505±0.358). There were significant differences in the expression levels of Wnt2 and Dvl protein between different infiltration depth, different TNM stages, and lymph node metastasis (P<0.01). There was a positive correlation between Wnt2 and Dvl protein in esopha-geal squamous carcinoma (r=0.718, P<0.01). Conclusion The high expression levels of Wnt2 and Dvl protein promote the development and metastasis of esophageal squamous cell carcinomas collaboratively via Wnt2 signal transduction path-ways.

The effect of microRNAs on dendritic cells function and its role in sepsis / 中华急诊医学杂志

MicroRNAs ( miRNAs ) , a highly conserved and non coding RNA, modulates gene expression via inhibiting the translation of protein and thereby influences cell fate and function.A large body of literature demonstrates that miRNAs plays a critical role in the maintenance of immune homeostasis through modulating immune cell differentiation, function as well as apoptosis.As important antigen presentation cells, dendritic cells ( DCs) play a central role in the initiation and control of the adaptive immune response in the peripheral lymphatic system.Uncontrolled inflammatory response and immunosuppressive response followed by tissue and organ dysfunction were associated with DC loss and apoptosis after septic challenge.This review will focus on the effect of miRNAs on DC function and apoptosis, and its potential role in sepsis.

Feasibility of performing fiberoptic bronchoscopy in critically ill hypoxemic patients with acute respiratory failure / 中国中西医结合急救杂志

Objective To analyze the recurrence rate of intubation and increase of ventilator support rate within 24 hours after using fiberoptic bronchoscopy (FOB) in critically ill patients with hypoxemia complicated with respiratory failure, and to approach the feasibility of FOB in such patients.Methods A prospective study was conducted, including 200 critically ill patients with acute respiratory failure using FOB [oxygenation index (PaO2/FiO2) ≤ 300 mmHg (1 mmHg = 0.133 kPa)] admitted to the intensive care unit (ICU) of the First Affiliated Hospital of Xinxiang Medical College. The rates of intubation and increased ventilatory support and the reasons for bronchoscopy related complications after using FOB 24 hours were recorded, the main risk factors leading to these changes and complications were analyzed and screened by logistic regression analytic method.Results Within 24 hours after using FOB for 200 patients with respiratory failure, an increase in mechanical ventilatory support was required in 68 patients (34%) of that 28 (14%) led to endotracheal intubation. With the extension of time, the rates of intubation and ventilatory support showed a tendency of elevation, the rise in ventilatory support rate being faster. The reasons for bronchoscopy related complications after FOB consisted of cardiovascular disease (41%), coronary artery disease (17%), chronic obstructive pulmonary disease (COPD, 17%), chronic restrictive pulmonary disease (10%), immunity suppression (54%), malignant neoplastic hematologic disorder (20%), acquired immune deficiency syndrome (AIDS, 12%), solid organ transplantation (3%), solid tumor (10%), corticosteroid therapy (25%), immunosuppressive drug (16%), diabetes (15%), chronic renal failure (14%), swallowing nerve injury (37%), anticoagulant therapy (19%), antiplatelet therapy (13%). In the patients with occurrence of COPD or immunosuppression, the rate of invasive ventilation used was significantly higher than that without using invasive ventilation [COPD: 35% (10/28) vs. 14% (24/172),χ2 = 8.081,P = 0.004; immunosuppression: 75% (21/28) vs. 50% (86/172),χ2 = 6.051,P = 0.014]. The logistic regression analysis showed that the occurrence of COPD or immunosuppression was obviously related to whether the intubation being necessary or not [COPD: odds ratio (OR) = 5.200, 95% confidence interval (95%CI) = 1.500 - 17.700,P = 0.006; immunosuppression:OR = 5.300, 95%CI =1.600 - 17.100,P = 0.004].Conclusions In patients with hypoxemia using FOB, they often require addition of mechanical ventilatory support, but the intubation rate is not high. Under the ventilatory support, FOB has certain feasibility for treatment of critically ill patients with hypoxemia and acute respiratory failure.

Value of interleukin-27 as a diagnostic biomarker of sepsis in critically ill adults / 中华危重病急救医学

Objective To evaluate interleukin-27 ( IL-27 ) as a sepsis diagnostic biomarker in critically ill adults with sepsis. Methods A retrospetive study was conducted. A total of 176 systemic inflammatory response syndrome ( SIRS ) patients in Department of Critical Care Medicine of Xinxiang Medical College First Affiliated Hospital from March to November in 2014 were enrolled. The patients were divided into no sepsis group ( n=66 ), pulmonary originated sepsis group ( n=65 ), and non-pulmonary originated sepsis group ( n=45 ). Plasma IL-27 and procalcitonin ( PCT ) were determined with enzyme linked immunosorbent assay ( ELISA ). Receiver operating characteristic curve ( ROC ) and classification and regression tree methodology was used to evaluate diagnostic biomarker performance. Results The proportion of patients in pulmonary original sepsis group whose body temperature in line with SIRS criteria was significantly higher than no sepsis group ( 66.2%vs. 44.5%, P<0.05 ), and they were easy to suffer from tumor ( 44.6%vs. 22.7%, P<0.05 ). The proportion of patients in non-pulmonary originated sepsis group whose white blood cell count in line with SIRS criteria was significantly higher than no sepsis group ( 68.9%vs. 42.7%, P<0.05 ). It indicated that patients in pulmonary originated sepsis group and non-pulmonary originated sepsis group were more in line with SIRS criteria compared with no sepsis group. It was shown by ROC curve that IL-27 and PCT was not effective in discriminating sepsis among unselected patients showing symptoms and signs of SIRS. The area under the curve ( AUC ) was 0.59 [ 95%confidence interval ( 95%CI )=0.49-0.65 ] and 0.61 ( 95%CI=0.55-0.71 ). According to the further analysis from different infection sources, the highest AUC was 0.71 ( 95%CI=0.59-0.79 ) for IL-27 in patients with a non-pulmonary originated sepsis. A decision tree incorporating IL-27, PCT, and age had an AUC of 0.78 ( 95%CI = 0.71-0.87 ) in patients with a non-pulmonary originated sepsis, which was higher than IL-27 [ 0.71 ( 95%CI = 0.59-0.79 ) ] or PCT [ 0.65 ( 95%CI = 0.57-0.78 ) ]. Compared to that of pediatric cohort with sepsis, lower expression of IL-27 was found in adult patients. Conclusions IL-27 performed overall poorly as a sepsis diagnostic biomarker in adults. IL-27 may be a more reliable diagnostic biomarker for sepsis in children than in adults. The combination of IL-27 and PCT can reasonably estimate the risk of sepsis in subjects with a non-pulmonary originated sepsis.

The optimal cutoff point of waist-to-hip ratio for screening Uyghur population aged 35 years and over at high-risk of cardiovascular diseases in Xinjiang / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the appropriate waist-to-hip ratio (WHR) cutoffs to identify people at high risk of cardiovascular disease of Uygur population aged 35 years and over in Xinjiang.</p><p><b>METHODS</b>The cardiovascular risk survey (CRS) in Xinjiang was conducted from October 2007 to March 2010, using 4-stagestratified random sampling method and 14 618 representative participated this survey, and the questionnaire survey, anthropometric data, blood pressure, serum total cholesterol, triglyceride, low density lipoprotein (LDL-C), high density lipoprotein (HDL-C) and fasting glucose were measured. A total of 4 657 participants aged 35 years and over with complete anthropometric data were analyzed. The sensitivity, specificity and distance on the receiver operating characteristic (ROC) curve of different WHR levels predicting risk factors of cardiovascular disease were calculated. The analysis method of ROC curve was used to determine the optimum cut-off point of WHR predicting risk factors of cardiovascular disease.</p><p><b>RESULTS</b>(1) There were significantly differences in prevalence of hypertension, diabetes mellitus, hypercholesterolemia, low HDL-C level, and hypertriglyceridemia between WHR < 0.75,0.75 ≤ WHR < 0.80,0.80 ≤ WHR < 0.85,0.85 ≤ WHR < 0.90,0.90 ≤ WHR < 0.95,0.95 ≤ WHR < 1.00, WHR ≥ 1.00 in male participants (P < 0.01 or 0.05), LDL-C level was similar among groups in males (P = 0.139). There were significantly differences in prevalence of hypertension, diabetes mellitus, hypercholesterolemia and hypertriglyceridemia between WHR < 0.75,0.75 ≤ WHR < 0.80,0.80 ≤ WHR < 0.85,0.85 ≤ WHR < 0.90,0.90 ≤ WHR < 0.95,0.95 ≤ WHR < 1.00, WHR ≥ 1.00 in female participants (all P < 0.01), and there were no significantly differences in prevalence of high LDL-C level and low HDL-C level among groups in females (both P > 0.05). (2) ROC analysis for hypertension, dyslipidemia, diabetes and ≥ 2 of these risk factors suggested a WHR cutoff of 0.92 for men and 0.90 for women as the optimal cutoff value for predicting high risk of cardiovascular disease of Uygur population aged 35 years and over in Xinjiang.</p><p><b>CONCLUSION</b>Higher WHR cutoffs are needed for screening people at high risk of cardiovascular disease among Uygur population aged 35 years and over in Xinjiang.</p>

Detection the CD44v5 in serum for screening ESCC through ELISA / 实用医学杂志

Objective To detect the expression of CD44v5 in esophageal squamous carcinoma (ESCC) and analyze its relationship with clinical pathological features,so as to explore the value of detecting CD44v5 in serum for screening ESCC. Methods The CD44v5mRNA and protein in ESCC tissues and its corresponding adjacent non-carcinomatous tissues were detected by RT-PCR and Western-Blot. Enzyme-linked immunosorbent assay (ELISA) was applied to detect the protein in serum of 100 ESCC patients and 60 healthy subjects. Results (1)The expression of CD44v5 in esophageal squamous carcinoma tissues is higher than the tissue adjacent to carcinoma, and CD44v5 expression in different TNM stages, invasion depth, presence of lymph node metastasis and differentiation is with statistical differences(P < 0.05). (2)CD44v5 proteins in patients with ESCC (31.308 ± 10.123) μg/L is higher than healthy subjects (19.364 ± 1.680) μg/L, the difference is statistically significant (P < 0.01). (3)In the trial of using ELISA method to detect CD44v5 content in serum in the diagnosis of ESCC, the area under the ROC curve is 0.865. If the healthy subjects' serum content of the upper limit of 95%confidence interval was taken as a positive judgment standard, the diagnosis effect: sensitivity is 91.0%and speciality is 60.0%. Conclusion The expression of CD44v5 was related to the occurrence and lymph node metastasis of ESCC. Using ELISA method to detect the contents of CD44v5 proteins in serum, with a high sensitivity, can be used to screen ESCC.

Characteristics,diagnosis and treatment of interdigitating dendritic cell sarcoma / 国际肿瘤学杂志

Interdigitating dendritic cell sarcoma (IDCS)is a rare malignant tumor of the dendritic cell, derived from the hematopoietic tissue.The major clinical manifestation of IDCS is superficial lymphadenopathy, and the enlarged lymph nodes may appear in some atypical ereas,such as the lung,kidney,bladder and the pleura,etc.With the development of the pathological diagnosis and the application of immunohistochemical staining and electron microscopes,the case detection rate is apparently improved.With the high degree of malignant,rapid progress and poor prognosis of the disease,currently,surgical therapy is still the main approach to the treatment of IDCS.

Study on the appropriate cutoff points of waist-hip-ratio for Kazakh people over 35 years of age, in Xinjiang / 中华流行病学杂志

<p><b>OBJECTIVE</b>The aim of this study was to identify the appropriate cutoffs for waist-hip-ratio (WHR) for Kazakh adults at high risk of cardiovascular diseases in Xinjiang.</p><p><b>METHODS</b>A Cardiovascular Risk Survey (CRS) study was carried out from October 2007 to March 2010, with 14 618 representative participants selected, including 4 094 Kazakhs. Complete data on 4 004 participants were gathered. The age span of the participants was from 35 to 88 years old with the mean age as 48.60 years. Anthropometric data, blood pressure, serum concentration of serum total cholesterol, triglyceride, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and fasting glucose were documented. Prevalence rate, sensitivity, specificity and distance on the receiver operating characteristic (ROC) curve of each WHR values were calculated.</p><p><b>RESULTS</b>1) The prevalence rates of hypertension, hypertriglyceridemia were high, also with higher WHR seen in both men and women. 2) The prevalence of hypercholesterolemia was high with higher WHR seen in women. 3) The shortest distances in the receiver operating characteristic curves for hypertension, dyslipidemia, diabetes, or ≥ 2 of these risk factors suggested that the WHR cutoffs were 0.92 or 0.91 for men and 0.86 or 0.85 for women.</p><p><b>CONCLUSION</b>Higher cutoff for WHR was needed in the identification of patients over 35 at high risk of cardiovascular disease among Kazakh population.</p>

Induction of UGT1A1 expression by praeruptorin A and praeruptorin C through hCAR pathway / 药学学报

This study is purposed to investigate the effects of praeruptorin A (PA) and praeruptorin C (PC) on UGT1A1 in HepG2 cells through hCAR pathway. PA and PC were incubated with HepG2 cells for 24 h and 48 h, mRNA and protein expressions of UGT1A1 were determined by real-time PCR and Western blotting assays. Additionally, effects of PA and PC on UGT1A1 mRNA and protein expressions were also measured after transient transfection of a specific CAR siRNA for 72 h in HepG2 cells. UGT1A1 mRNA and protein expression levels were significantly increased by PA and PC after incubation for 48 h. Moreover, the mRNA and protein up-regulations of UGT1A1 were attenuated by transient transfection of a specific CAR siRNA, suggesting the induction was mediated by CAR. The results suggest that PA and PC can significantly up-regulate UGT1A1 expression partially via the CAR-mediated pathway.

Comparison of apparatus of inspired oxygen in hyperbaric oxygen chamber / 医疗卫生装备

Objective To discuss the apparatus of inspired oxygen in hyperbaric oxygen(HBO)chamber for patients after tracheotomy.Methods Many kinds of apparatus of inspired oxygen were analyzed,including composition,usage and characteristics.Results The apparatus of inspired oxygen play an active role in treating patients.But in the above apparatus,there are great differences in serving range,efficiency of inspired oxygen,curative effect,reliability and so on.Conclusions When serious patients after tracheotomy are treated in HBO chamber earlier,it is very important to select reasonable apparatus.

Application of sputum aspirators to hyperbaric oxygen chamber / 医疗卫生装备

This paper introduces the current situation of hyperbaric oxygen (HBO) therapy, the environment characteristics in HBO chamber and the qualification of sputum aspirators. What's more, this paper also describes the construction, principles and characteristics of all kinds of sputum aspirators in HBO chamber. When critical patients are treated in HBO chamber, it is very important to select reasonable sputum aspirators.