Treatment Strategy of Leukopenia After Chemotherapy with Traditional Chinese Medicine from the Generation and Transmission of Defense Qi / 中医杂志

By analysing the similarity between defense qi and leukocytes in terms of function， site of action， and circadian rhythm， it is proposed that in traditional Chinese medicine （TCM）， the pathogenesis of leukopenia is defense qi deficiency. By analyzing the relevant discussions on the generation and transmission of defense qi in TCM classics， it is believed that the original qi in lower jiao （焦） is the source of defense qi， while the water and grain qi in middle jiao enriches defense qi， and the upper jiao transmits and distributes defense qi to the whole body. Therefore， when treating leukopenia after chemotherapy with TCM， Guilu Erxian Gelatin （龟鹿二仙胶） and Yougui Pill （右归丸） are often used to tonify the kidney and supplement essence， and moxibustion at Guanyuan （CV 4） and Qihai （CV 6） is usually accompanied to replenish the original qi in lower jiao and enrich the source of defense qi. Guipi Decoction （归脾汤）， Buzhong Yiqi Decoction （补中益气汤）， Shenling Baizhu Powder （参苓白术散）， and Sijunzi Decoction （四君子汤） are often suggested to strengthen spleen and replenish qi， in combination with moxibustion at Zhongwan （CV 12） and Zusanli （ST 36） to transport the spleen and stomach in the middle jiao to enrich the defense qi. Modified Guizhi Decoction （桂枝汤） to harmonize nutrient and defensive aspects is often used， and moxibustion at Dazhui （GV 14） and Feishu （BL 13） or scraping is added to dredge the striae and interstice in the upper jiao and promote transmission and dissemination of the defense qi. Considering the whole process of generation and distribution of defense qi， it is suggested to choose the most appropriate treatment modality flexibly， and combine internal treatment with external treatment， in order to provide ideas for the treatment of leukopenia in tumour patients.

Standard on classification of Traditional Chinese Medicine ancient books / 国际中医中药杂志

The standardization of classification methods of Traditional Chinese Medicine(TCM) ancient books can provide a clear and reliable reference for all kinds of TCM ancient books collection units, which can also promote the sharing and utilization of TCM ancient books. We studied and investigated the classification methods of TCM ancient books in past dynasties. The standard on classification of TCM ancient books was formulated by compared with the classification table of Zhongguo Zhongyi Guji Zongmu, and referred to the classification table of Zhonghua Guji Zongmu. This standard specified three-level categories and classification principles of TCM ancient books, and mainly composed of basic categories, three-level category table, classification principles and examples, and instructions for use.

Application of targeted capture high depth sequencing and transcriptome sequencing in childhood B-cell acute lymphoblastic leukemia / 白血病·淋巴瘤

Objective:To investigate the differences among targeted capture high depth sequencing (Panel-seq), transcriptome sequencing (RNA-seq) and traditional detection methods in cytogenetic and molecular genetic typing of childhood B-cell acute lymphoblastic leukemia (B-ALL) and their significances.Methods:The clinical data of 152 newly diagnosed childhood B-ALL cases in Guangzhou Women and Children's Medical Center from September 2020 to December 2021 were retrospectively analyzed. Along with traditional cytogenetic and molecular detection methods including karyotyping, fluorescence in situ hybridization (FISH) and 43 kinds of fusion gene quantitative screening for traditional cells and molecular genetic detection, both Panel-seq and RNA-seq were also performed. Panel-seq covered more than 600 genes with common mutations in hematological tumors, from which fusion genes and gene mutations were both analyzed. RNA-seq was used to analyze fusion genes, gene mutations, gene expression, and copy number variation at the chromosome level. High hyperdiploid karyotype was estimated by using gene expression profile clustering and copy number variations. The cytogenetic typing results of all detection methods were also analyzed.Results:Among 152 patients, 93 cases were males and 59 cases were females, with the median age of 4.0 years (0.8-13.0 years). The median blast cell ratio was 0.855 (0.215-0.965). The traditional detection methods could identify 4 cases (2.6%) with BCR-ABL1, 2 cases (1.3%) with CRLF2 gene-related fusion, 27 cases (17.8%) with ETV6-RUNX1, 1 case (0.7%) with iAMP21, 5 cases (3.3%) with MLL rearrangement, 8 cases (5.3%) with TCF3-PBX1 and 22 cases (14.5%) with high hyperdiploid karyotype. Panel-seq could identify 4 cases (2.6%) with BCR-ABL1, 2 cases (1.3%) with CRLF2 gene-related fusions, 27 cases (17.8%) with ETV6-RUNX1, 3 cases (2.0%) with MEF2D gene-related fusions, 1 case (0.7%) with MEIS1-FOXO1, 5 cases (3.3%) with MLL rearrangement, 5 cases (3.3%) with PAX5 gene-related fusions, 8 cases (5.3%) with TCF3-PBX1 fusions, 4 cases (2.6%) with ZNF384 gene-related fusions, and 2 cases (1.3%) with IKZF1 N159Y mutations. Among 152 patients, 1 case with MLL rearrangement didn't receive RNA-seq detection because of sample quality; in other 151 B-ALL cases, 1 case (0.7%) with ACIN1-NUTM1, 4 cases (2.6%) with BCR-ABL1, 3 cases (2.0%) with CRLF2 gene-related fusions, 8 cases (5.3%) with DUX4 gene-related fusions, 27 cases (17.9%) with ETV6-RUNX1, 3 cases (2.0%) with MEF2D gene-related fusions, 1 case (0.7%) with MEIS1-FOXO1, 4 cases (2.6%) with MLL rearrangement, 5 cases (3.3%) with PAX5 gene-related fusions, 1 case (0.7%) with ZMIZ1-ABL1, 8 cases (5.3%) with TCF3-PBX1,4 cases (2.6%) with ZNF384 gene-related fusions, 61 cases (40.4%) with hyperdiploid karyotypes, and 2 cases (1.3%) with IKZF1 N159Y mutations were detected; RNA-seq had obvious advantage in detecting fusion gene and hyperdiploid karyotype. The cytogenetic and molecular genetic typing rates of traditional method, Panel-seq and RNA-seq were 45.4% (69/152), 40.1% (61/152) and 87.4% (132/151), respectively. The combination of the three could identify 89.5% (136/152) of childhood B-ALL patients.Conclusions:The combination of Panel-seq and RNA-seq can increase the detection rate of genetic abnormality in childhood B-ALL, which provides a more accurate molecular genetic classification for B-ALL and the basis for treatment guideline and prognosis judgement.

Influence of exophthalmos on design of double eyelid incision / 中华医学美学美容杂志

Objective:To compare the postoperative effects of double eyelid surgery with different exophthalmos to find its influence on the surgery and necessary changes in preoperative design and during operation.Methods:A total of 50 female patients with single eyelid seeking beauty from June 2021 to March 2022 were selected from the Department of Plastic Surgery, Affiliated Hospital of Qingdao University. The ocular protrusion was measured by HETEL ophthalmostatometer before surgery. Both eyes at 12-15 mm were taken as normal group ( n=26), both eyes at 16-18 mm as mild protrusion group ( n=14) and both eyes at 19-22 mm as severe protrusion group ( n=10). All the patients were treated with double-eyelid surgery by orbital septum and unified postoperative nursing. Results:After six months of follow-up, there was no difference in eyelid width with closed eyes (all P>0.05). The width of double eyelid with open eyes in normal group was smaller than that in mild protrusion group ( F=23.23, all P<0.05), and the width of double eyelid with open eyes in mild protrusion group was smaller than that in severe protrusion group ( F=47.70, all P<0.05). There was no difference in the improvement rate of facial aesthetics among the three groups ( P>0.05). The " feeling of meet" and scar formation in the normal group were less than those in the mild protrusion group ( F=16.92, F=33.45, all P<0.05), and the " feeling of meet" and scar formation in the mild protrusion group were less than those in the severe protrusion group ( F=27.93, F=28.53, all P<0.05). The improvement rate of normal group was higher than that of mild and severe protrusion group (χ 2=7.25, 7.89, all P<0.05). There was no difference in the improvement rate between the mild and severe protrusion groups ( P>0.05). Conclusions:In clinical practice, it is necessary to make corresponding changes in the preoperative design and operation of double eyelid surgery for patients with high eyeball protrusion.

Survey study on the classification methods of TCM ancient books / 国际中医中药杂志

The surveys of the number of TCM ancient books, the bibliography classification methods, the bibliography publication, the bibliography network sharing and access, the evaluation of the classification method of subject bibliography on TCM ancient books and the relevant opinions and suggestions were sent to 30 TCM libraries and 24 comprehensive libraries in China. The questionnaires’ data and responses were analyzed, in order to understand the classification methods of TCM ancient books, the use situation, and the needs in the classification and cataloging work. The results showed that compared with the comprehensive libraries, the collection of TCM ancient books were concentrated in TCM libraries, the classification methods for TCM libraries were seldomly reported, and the classification methods were mainly self-compiled. Thus, the uniformity of the classification methods was poor, and there was also a significant gap in the standardization of the bibliography arrangement in TCM libraries. The result recommended that the domestic library industry urgently needed a unified and standardized classification for TCM ancient books. It was significant for promoting the sharing and exchange of TCM ancient books, promoting the standardization process of TCM information, and promoting the efficient implementation of Zhonghua Yizang compilation project.

Compiling principles and methods of standard on Classification of Traditional Chinese Medicine Ancient Books / 国际中医中药杂志

It is urgent to establish a standard for the classification and management of ancient books for Traditional Chinese Medicine (TCM) industry. This paper formulated the compiling principles on classification of TCM ancient books through the investigation and research. The categories were set and adjusted by comparing with the classification of Zhongguo Zhongyi Guji Zongmu and Zhonghua Guji Zongmu. Based on the comparason, the standard on classification of TCM ancient books was established. According to the classification standard, 8 663 kinds of TCM ancient books were reclassified. This standard can provide a clear and reliable reference for all kinds of collection units, promote the unification of classification methods of TCM ancient books, and promote the sharing and utilization of TCM ancient books.

Meta-analysis of Efficacy and Safety of Decitabine Monotherapy in the Treatment of Myelodysplastic Syndrome / 中国药房

OBJECTIVE：To systematically evaluate the efficacy and safety of decitabine monotherapy in the treatment of myelodysplastic syndrome （MDS），and to provide evidence-based reference to the clinic. METHODS ：Retrieved from Embase ， Cochrane Library ，PubMed，Medline，Clinical Key ，Google Scholar ，CNKI，CBM and Wanfang data ，during the inception to Jun. 26th， 2020， randomized controlled trials （RCTs） about decitabine （decitabine group ） versus traditional combined chemotherapy（control group ）in the treatment of MDS were collected. After literature screening and data extraction ，literature quality evaluation with bias risk evaluation tool recommended by Cochrane systematic evaluator manual 5.2.2，Meta-analysis was performed by using Rev Man 5.3 software. RESULTS ：A total of 590 patients with 11 RCTs were included. Meta-analysis results showed that complete remission rate [OR ＝1.82，95％ CI（1.23，2.70），P＝0.003] and total response rate [OR ＝1.54，95％ CI（1.05， 2.27），P＝0.03] of decitabine group were significantly higher than those of control group ；the incidence of ADR [OR ＝0.26，95％ CI（0.16，0.40），P＜0.000 01]，the incidence of infection [OR ＝0.48，95％ CI（0.27，0.85），P＝0.01] and the incidence of myelosuppression [OR＝0.37，95％ CI（0.17，0.81），P＝0.01] in decitabine group were significantly lower than control group. The results of subgroup analysis according to the course of treatment showed that there was no significant difference in the complete remission rate and total response rate between 2 groups in the treatment course of 3 and 4 months（P＞0.05）；but there was significant difference in the treatment course of 1 month or 2 months，the decitabine group was significantly higher than control group（P＜0.05）. CONCLUSIONS：Decitabine has good efficacy and safety in the treatment of MDS patients ，and when the treatment time is less than or equal to 2 months，the complete remission rate and total response rate of decitabine in MDS lis1270755@163.com patients are better.

Homoharringtonine synergy with oridonin in treatment of t(8; 21) acute myeloid leukemia / 医学前沿

Collaboration of c-KIT mutations with AML1-ETO (AE) has been demonstrated to induce t(8; 21) acute myeloid leukemia (AML). Targeted therapies designed to eliminate AE and c-KIT oncoproteins may facilitate effective treatment of t(8; 21) AML. Homoharringtonine (HHT) features activity against tumor cells harboring c-KIT mutations, whereas oridonin can induce t(8; 21) AML cell apoptosis and AE cleavage. Therefore, studies should explore the efficacy of combination therapy with oridonin and HHT in t(8; 21) AML. In this study, we investigated the synergistic effects and mechanism of oridonin combined with HHT in t(8; 21) AML cell line and mouse model. The two drugs synergistically inhibited cell viability and induced significant mitochondrial membrane potential loss and apoptosis. Oridonin and HHT induced significant downregulation of c-KIT and its downstream signaling pathways and promoted AE cleavage. HHT increased intracellular oridonin concentration by modulating the expressions of MRP1 and MDR1, thus enhancing the effects of oridonin. The combination of oridonin and HHT prolonged t(8; 21) leukemia mouse survival. In conclusion, oridonin and HHTexert synergistic effects against t(8; 21) leukemia in vivo and in vitro, thereby indicating that their combination may be an effective therapy for t(8; 21) leukemia.

Influencing factors of quality of life of patients with osteoradionecrosis of the jaws / 现代临床护理

Objective To investigate the level and influencing factors of quality of life in patients with osteoradionecrosis of the jaws (ORNJ) in order to provide theory basis for nursing intervention. Methods Ninety-five patients hospitalized from January 2015 to Febury 2017 and participated in the investigation by a convenient sampling method. The functional assessment of cancer therapy-head and neck (FACT-H&N), social support rating scale (SSRS) and general information questionnaire were used to assess the quality of life, social support and basic information in ORNJ patients in our hospital respectively. Results The score of quality of life was (79.99 ±15.72). The index value of common module of quality of life was higher than that of additional concern. The average scores of each dimension of common module from low to high were as follows: functional well-being, social/family well-being, physical well-being and emotional well-being. The multiple linear regression analysis showed that the influencing factors of quality of life were social support, severe mouth opening difficulty (grade Ⅲ and Ⅳ), the course of primary disease (3 ～5 years, 5 ～10 years), which explained 35.6％variation in the quality of life. Conclusions The quality of life of ORNJ patients is generally lower than that of other head and neck cancer patients. The social support, severe mouth opening difficulty and course of primary disease can affect the patients' quality of life.The smaller the mouth opening (≤1 cm), the longer the course of primary disease (3～5 years) and the worse the quality of life is. Thus, nursing staff should pay attention to the quality of life of ORNJ patients and give prospective nursing intervention to improve the quality of life according to the characteristics of the development of the disease.

Gynecologic imaging reporting and data system combined with three-dimensional contrast-enhanced ultrasonography for differential diagnosis of benign and malignant ovarian masses / 中国医学影像技术

Objective To evaluate the efficacy of the combination of gynecologic imaging reporting and data system (GI-RADS) uhrasonographic stratification and 3D contrast-enhanced ultrasonography (3D-CEUS) in identifying malignant lesions from benign ovarian masses.Methods Both of 2D ultrasound (2D-US) and 3D-CEUS were performed on 102 patients with ovarian masses.The perfusion characteristics of ovarian masses were observed with 3D-CEUS,and the 2D-US features of ovarian masses were analyzed based on GI-RADS.Simple and multiple Logistic regression analysis were used to investigate whether the independent risk predictors in differential diagnosis of benign and malignant ovarian could be confirmed.In addition,ROC curves were drawn.The diagnostic efficacy of GI-RADS combined with 3D-CEUS scoring system was evaluated and compared with that of only GI-RADS.Results Simple and multiple Logistic regression analysis confirmed that there were 8 independent predictors of malignant masses,including large papillary projections (≥7 mm),separated or wall thickness ≥3 mm,central blood flow,the proportion of solid part ≥50％,combination of ascites,high level enhancement,uneven distribution of contrast media in enhanced solid part and the vascular with characteristics as dense,tortuous and anfractuous.When using 4 points as the cut-off,the area under the curve (AUC) of GI-RADS combined with 3D-CEUS scoring system in identifying malignant ovarian masses was 0.969,higher than that of only GI-RADS (0.839;Z=1.64,P=0.029).Furthermore,the scoring system showed higher sensitivity,specificity,positive predictive value,negative predictive value and accuracy (all P＜0.001).Conclusion The combination of GI-RADS with 3D-CEUS can be more effective to distinguish malignant lesions from benign ovarian masses.

Intra-articular injection of Sox9-transfected bone marrow mesenchymal stem cells for treatment of knee osteoarthritis / 中国组织工程研究

BACKGROUND:Bone marrow mesenchymal stem cel s are considered to have good proliferation and differentiation potentials. Sox9 is a transcription factor that is essential for chondrogenesis and has been termed as a“master regulator”of the chondrocyte phenotype. OBJECTIVE:To study the therapeutic effects of Sox9-transfected bone marrow mesenchymal stem cel s on knee osteoarthritis. METHODS:The bone marrow mesenchymal stem cel s were transfected with Lenti-Sox9-EGFP in vitro. The model of murine knee osteoarthritis was established by cutting off the anterior cruciate ligament. Thirty model mice were randomly divided into three groups, as normal saline group, bone mesenchymal stem cel group and Sox9-transfected bone mesenchymal stem cel group. 0.1 mL of normal saline, 0.1 mL of normal saline containing non-transfected bone marrow mesenchymal cel s (non-transfected group), or 0.1 mL of normal saline containing Sox9-transfected bone marrow mesenchymal cel s (Sox9-transfected group) was injected into the knee joint cavity of mice in the corresponding group, respectively. After 4, 8, 12 weeks, the repair of articular cartilage lesions was evaluated by toluidine blue and immunohistochemical staining. RESULTS AND CONCLUSION:The lesions of articular cartilage were more serious in the normal saline group, compared with the other two groups, and the difference became more obvious over time. Damaged articular cartilage was improved in the non-transfected group, but the improvement was less than that in the Sox9-transfected group. Immunohistochemistry staining revealed that in the Sox9-transfected group, the positive type II col agen expression was stronger than that in the other two groups, but this positive expression was decreased over time in al the three groups. These results suggest that Sox9-transfected bone marrow mesenchymal stem cel s promote the repair of damaged cartilage in mice with knee osteoarthritis.

Quantitative indicators of diagnosis research on BI-RADS 3～5 classification in the 2013 edition of BI-RADS / 中华超声影像学杂志

Objective To explore the value of BI-RADS scoring system based on the sonographic features in the breast nodules.Methods In order to build a Logistic regression model,regression was made to analyse 401 patients ' sonographic features of breast nodules.A scoring system was developed based on the results of regression's filter and the weight of each factor,used to score and classify the other 243 patients.It's diagnostic value was evaluated through comparing all types of theoretic risk ranges of BI-RADS.Results Age,morphology,orientation,margin,echo pattern and microcalcifications in a mass were selected in the final step of the logistic regression analysis.By means of scoring system,the scores corresponding to BI-RADS 3,4a,4b,4c,5 classes are 6,7-8,9-15,16-22 and ≥23 respectively.Case study comprehensive score of BI-RADS 3-5 classification' s positive predictive values were 0,4.17％,21.43％,84.85％,1 00％,and the area under the ROC curve scoring system was 0.947.Conclusions The scoring system can objectively score and classify breast nodules,and therefore provide an effective reference for clinical evaluation of benign and malignant breast.

Analysis of influence factors on hospitalization expenses with hip arthroplasty / 中国实用护理杂志

Objective To discuss the effect of rehabilitation nursing for total knee arthroplasty by discussing hospitalization expenses and its factors of rehabilitation nursing.Methods 305 patients who were underwent total knee arthroplasty from 2011 to 2013 were recruited and recovered according to rehabilitation nursing and training requirements established by our hospital.Patients admitted in 2011 were designated as control group.The comparison of American knee society knee score and knee rang of motion of patients were made and analyzed.Results The annual comparison of sores of pre-and post-operative KSS (t=5.30,7.99,11.20),and knee ROM of patients (t=8.21,4.57,7.86) showed that the difference was statistically significant (P＜0.05).The total costs and rehabilitation nursing expenses inreased year by year (P＜0.05).The proportion of rehabilitation and rehabilitation nursing expenses each year were 5.77％ (3 157/54 679),4.60％ (2 847/61 831),5.15％ (3 341/64 930) and 0.51％ (280/54 679),0.64％ (393/61 831),0.52 ％(338/64 930),respectively.Conclusions Pre-and post-operative correct rehabilitation exercises are one of the most important guarantee of curative effect.There is a lower percentage of rehabilitation nursing expenses in total costs,and the value of the nursing staff has not been fully reflected.

Bibliometric analysis and research of succession and development of Yanjing medical school / 国际中医中药杂志

Objective To discusse the research status ofyanjing medical school experience method, and provide a reference for relative researchers.Methods Articles in TCM Database System, SinoMed and CNKI were retrieved refined and analyzed t from the year, author, journal, organization and so on after duplicate removing.Results There were 389 related articles published in journals from 1956 to 2012. With 41.90% articles published in 10 core journals, written by 14 main authors. There were 3 hot research areas including experience of famous doctor,syndrome differentiation and treatment and medical record.Conclusion There was lacking of combing on Yanjing medical school and inheritance system. The inheritance of Yanjing medical school was done far from good, and the study on how to inherit Yanjing medical school need strengthening.

Innovation and practice of employed staff management pattern in military hospital / 医学研究生学报

Employed staffs in military hospital are the basic power in the development of hospital, and they are playing an im-portant role in the military medical security.The article gives a detailed elaboration on the innovation and practice of employed staff man-agement in our hospital.In order to improve the efficiency and scientific management level of employed staffs, the innovative measure-ments in employment pattern, post management, education development, policy system, promotion passage are put forward in combination with current situation of employed staff in order to promote the construction of employed staffs and the development of the hospital.

Present situation investigation and literature analysis of unique copy TCM ancient books / 国际中医中药杂志

Objective To investigate the present condition of unique copy of TCM ancient books, and analyze the literature value. Methods Bibliographic research was underwent first, then investigation table was made, investigation team for spot investigation was organized, the bibliography was sorted, and on this basis analysis of the literatures was performed. Results 59 collection units at home and abroad and 1370 unique copy TCM ancient books were investigated, which including 57 books published by photocopy and 37 books published by proof reading. Conclusion The unique copy TCM ancient books have important academic value and can be effectively saved and sorted through in-depth investigation and analysis.

Combing and analyzing classification methods of ancient TCM literature / 国际中医中药杂志

In order to scientifically classify ancient TCM literature and promote the development and use of the literature, this paper combs the classification methods used in the bibliography literature, the modern databases and the libraries of TCM, analyzes the features of the classification methods, summarizes the existing problems in the classify of ancient TCM literature, and proposes the solutions.

Study and practice of post delimitation and personnel allocation in military hospital human resources / 医学研究生学报

Post delimitation and personnel allocation is the basis of human resource management system .Scientific and rea-sonable post delimitation and personnel allocation contribute greatly to the improvement of standardized human resource management , structural optimization , cost control and efficiency promotion .In order to realize the transformations from status management to post management , from quantity management to organization management , from extensive management to fine management in human re-source management , a series of measurements were adopted to scatter post levels , refine specialty series , clarify allocation standards and rationalize personnel quantity in order to adapt to military reform , prepare for medical services of military struggle and meet the needs of hospital development .The article analyzed the practice and effect of post delimitation and personnel allocation of human re -sources in our hospital , providing reference for other hospitals in the improvement of management mechanism , management level and management efficiency .

Study on the compiling and arrangement of medical literature in local chronicles / 国际中医中药杂志

With medical literature in local chronicles before 1949 as the research object,this paper introduces the existing research results and existing problems from two aspects of books and papers.Then it summarizes the compiling standard of all kinds of medical literature in local chronicles,and points out that the literature can be arranged by bibliography collection,database construction,information analysis,so as to support and complement the content of existing TCM classics,and provide new clues and basis for scientific research of traditional Chinese medicine.

Research on literature services of traditional Chinese medical books based on the needs of readers / 国际中医中药杂志

This article discussed the library services for readers from their needs of TCM ancient literature.We believed the library service should focus on the readers needs to elevate its knowledge service ability,to establish new service mode,and to meet the TCM ancient literature needs of readers greatly.