The Huangdi Neijing proposes the " using bitter herbs to nourish or purge" theory to guide clinical prescription and formulation of herbal remedies based on the physiological characteristics and functions of the five zang viscera, along with the properties and flavors of medicinal herbs. This study explored diabetic kidney disease pathogenesis and treatment based on the " using bitter herbs to nourish or purge" theory. Kidney dryness is a key pathological factor in diabetic kidney disease, and the disharmony of kidney dryness is an essential aspect of its pathogenesis. Strengthening is the primary therapeutic principle, and kidney dryness is a persistent factor throughout the occurrence and progression of diabetic kidney disease. In the early stage, the pathogenesis involves heat-consuming qi and injuring yin, leading to kidney dryness. In the middle stage, the pathogenesis manifests as qi deficiency and blood stasis in the collaterals, resulting in turbidity owing to kidney dryness. In the late stage, the pathogenesis involves yin and yang deficiency, with kidney dryness and disharmony. This study proposes the staging-based treatment based on the " need for firmness" characteristic of the kidney. The aim is to provide new insights for clinical diagnosis and treatment in traditional Chinese medicine by rationally using pungent, bitter, and salty medicinal herbs to nourish and moisturize the kidney. This approach seeks to promote precise syndrome differentiation and personalized treatment for different stages of diabetic kidney disease, thereby enhancing clinical efficacy.

OBJECTIVE: To investigate the mechanism of self-efficacy between self-management ability and self-management behavior and its differences among patients with different disease courses through mediation tests. METHODS: In the study, 489 patients with type 2 diabetes who attended the endocrinology departments of four hospitals in Shanxi Province and Inner Mongolia Autonomous Region from July to September 2022 were enrolled as the study population. They were investigated by General Information Questionnaire, Diabetes Self-Management Scale, Chinese version of Diabetes Empowerment Simplified Scale, and Diabetes Self-Efficacy Scale. Mediation analyses were performed using the linear regression model, Sobel test, and Bootstrap test in the software Stata version 15.0 and divided the patients into different disease course groups for subgroup analysis according to whether the disease course was > 5 years. RESULTS: In this study, the score of self-management behavior in the patients with type 2 diabetes was 6.16±1.41, the score of self-management ability was 3.99±0.74, and the score of self-efficacy was 7.05±1.90. The results of the study showed that self-efficacy was positively correlated with self-management ability (r=0.33) as well as self-management behavior (r=0.47) in the patients with type 2 diabetes (P < 0.01). The mediating effect of self-efficacy accounted for 38.28% of the total effect of self-management ability on self-management behaviors and was higher in the behaviors of blood glucose monitoring (43.45%) and diet control (52.63%). The mediating effect of self-efficacy accounted for approximately 40.99% of the total effect for the patients with disease course ≤ 5 years, while for the patients with disease course > 5 years, the mediating effect accounted for 39.20% of the total effect. CONCLUSION Self-efficacy enhanced the effect of self-management ability on the behavior of the patients with type 2 diabetes, and this positive effect was more significant for the patients with shorter disease course. Targeted health education should be carried out to enhance patients' self-efficacy and self-management ability according to their disease characteristics, to stimulate their inner action, to promote the development of their self-management behaviors, and to form a more stable and long-term mechanism for disease management.
Humans ; Diabetes Mellitus, Type 2/therapy* ; Self Efficacy ; Self-Management ; Blood Glucose Self-Monitoring ; Blood Glucose ; Self Care

Objective:To understand the molecular epidemic characteristics and genes of human astrovirus (HAstV) in infantile diarrhea patients in Jilin province from 2017 to 2020.Methods:Fecal samples of hospitalized infants with diarrhea under 5 years of age from January 2017 to December 2020 were collected. The nucleic acids of fecal samples were amplified by reverse transcription-polymerase chain reaction (RT-PCR), the positive amplification products were sequenced, and the phylogenetic tree was constructed.Results:A total of 2 019 fecal samples were collected, of which 71 were positive for HAstV, with a positive rate of 3.5%. Among the cases with positive samples of HAstV, 42 had mixed infection with other viruses causing diarrhea, accounting for 59.2% of the total number of positive cases, half of which were mixed infection with rotavirus and HAstV. From 2017 to 2020, the positive rates of HAstV were 4.69%, 1.98%, 5.93% and 0.43% per year, respectively. There were two epidemic peaks every year and one epidemic peak year every two years. The positive rate of 36-47 months old was the highest, followed by 0-2 months old. A total of 55 sequences were obtained in this study. Phylogenetic tree analysis showed that they all belonged to classical HAstV, including 42 HAstV-1a subtypes, 8 HAstV-1b subtypes and 5 HAstV-5 subtypes.Conclusions:HAstV is one of the important pathogens of diarrhea in children under 5 years of age in Jilin province. The epidemic law has obvious seasonal and age differences. The dominant strain is HAstV-1a.

Silicosis is one of the most common forms of pneumoconiosis globally. Workers who engage in mining, construction, ceramics, and many other industries have a high risk of developing silicosis. Chronic and repeated inhalation of free silica (SiO₂) dust (<5 μm) during working can lead to inflammatory reactions, resulting in interstitial lung disease characterized by extensive nodular fibrosis in both lungs. Once silicosis occurs, it will develop progressively even when the workers are removed from the silica dust environment. The pathogenesis of silicosis is complex, especially the role of nod-like receptor family protein 3 (NLRP3) inflammasome in the pathogenesis and progression of silicosis remains to be further studied. NLRP3 inflammasome, a multi-protein complex composed of NLRP3, apoptosis-associated speck-like protein, and cysteinyl aspartate specific proteinase 1 is involved in oxidative stress, inflammatory response, apoptosis, and pyroptosis, and has become one of the hot spots in silicosis research. This review summarized the structure, function, and activation mechanism of NLRP3 inflammasome. Furthermore, the cellular and molecular mechanisms of NLRP3 in mediating oxidative stress, inflammatory response, apoptosis, and pyroptosis in the progression of silicosis were reviewed. Finally, the potential therapeutic drugs for silicosis based on NLRP3-associated mechanisms were outlined. More attention should be paid to the role of NLRP3 inflammasome in the pathogenesis and progression of silicosis in the future, which will provide new ideas for the prevention and treatment of silicosis.

Objective:To investigate the effect of art behavior intervention of yoga training on patients with insomnia comorbid depressive disorder.Methods:Totally 66 patients with insomnia comorbid depressive disorder were randomly divided into the study group( n=36) and the control group( n=30). All patients in two groups were given pharmacotherapy, while the patients in the study group were received art behavior intervention of yoga training for 20 times.Using self-made general information questionnaire to collect the patients' demographic and clinical characteristics.Polysomnography(PSG) was performed to measure objective sleep parameters.The Pittsburgh sleep quality index(PSQI), Hamilton depression scale(HAMD) and Hamilton anxiety scale(HAMA) were used to measure subjective sleep quality, depressive symptoms and anxiety symptoms at baseline and at the end of the interventions. Results:The score differences of pre-and post-intervention in the two group of PSQI total score((11.00±2.72) vs(9.00±2.22)), habitual sleep efficiency((2.02±0.81) vs (1.53±0.77)), daytime dysfunction((1.75±0.90) vs(0.96±0.85)), HAMD total score((12.19±6.25) vs(8.03±5.67)) and HAMA total score(13.00(8.25, 16.75) vs 7.00(5.00, 9.25))in the study group were obviously higher than those in the control group( t=3.220, 2.516, 3.595, 2.806, Z=-3.616, all P<0.05). Conclusion:Art behavior intervention of yoga training can improve sleep quality, depression and anxiety symptoms in patients with insomnia comorbid depressive disorder, which will be applied and popularized in clinical practice.

Objective The experiment was designed to study the therapeutic mechanism of "Tong Tiao" acupuncture in the treatment of mammary gland hyperplasia (MGH) on the rat model.Methods A total of 75 healthy unpregnant female SD rats were randomly divided into six groups: blank, model, control group, vagus cutting therapy, sham operation, and vagus cutting with non-treatment group. All the groups except the blank group were prepared by MGH rat model. The vagus cutting therapy and vagus cutting with non-treatment group were treated by cutting the right cervical vagus nerve, while the sham operation group was treated by exposing the vagus nerve without any operation. All the treatment groups were treated with "Tong Tiao". The rat papillary height was measured. The breast tissue morphology and breast ultrastructure were observated. And the flow cytometry in rat peripheral blood T lymphocyte subsets CD3+, CD4+, CD8+, CD4+/CD8+ were calculated. Results Compared with the model group, the papillary height (1.22 mm ± 0.21 mm,1.24 mm ± 0.20 mmvs. 1.53 mm ± 0.16 mm) in the normal treatment and the sham treatment group decreased significantly the vagus cutting therapy and vagus cutting non-treatment group showed no difference (P>0.05). Compared with the model group, the Mammary gland morphology and ultrastructure in the normal treatment group, the sham operation group and the vagus cutting therapy groups were improved, but the vagus cutting non-treatment group showed on improvement. Compared with model group, the serum CD3+(61.5％ ± 10.5％, 61.1％ ± 12.4％, 59.8％ ± 11.8％vs. 57.7％ ± 9.4％), CD4+(37.2％ ± 8.9％, 37.9％ ± 10.9％, 36.1％ ± 12.2％ vs. 34.6％ ± 6.9％), CD4+/CD8+(1.59 ± 0.8, 1.58 ± 0.8, 1.38 ± 0.6vs. 1.23 ± 0.7) in the normal treatment group, the sham treatment group and vagus cutting therapy group, elevated significantly (P<0.01,P<0.05), while the vagus cutting non-treatment group showed no difference (P>0.05). Compared with model group, the serum CD8+ (24.2％ ± 11.3％, 24.5％ ± 10.6％,25.5％ ± 8.8％vs. 27.7％ ± 9.9％) in the normal treatment group, sham treatment group and vagus cutting therapy group decreased significantly lower (P<0.01,P<0.05), but vagus cutting non treatment group showed no difference (P>0.05). Conclusions the mechanism of acupuncture treatment for MGH may be related to the vagus nerve by regulating the CD3+, CD4+, CD8+ and CD4+/CD8+ levels of T lymphocytes.

Objective: To summarize the clinical anatomical features and surgical technique of the submental artery perforator flap (SMAPF), and to evaluate the outcome and value of the flap for oral cavity reconstruction after cancer ablation. Methods: A total of 56 patients with oral cancer were included in this study. The modified SMAPF excluded the anterior belly of the digastric muscle and submental fatty tissue. The primary sites of malignancy were buccal mucosa (n=24), tongue (n=21), mandibular gingiva (n=6), mouth floor (n=3), soft palate (n=2). Results: The flap size varied from 3 cm×5 cm to 5 cm×12 cm. Four flaps presented mild venous congestion, which was salvaged with conservative measures such as acupuncture and blood letting. Overall flap survival rate was 100%. The SMAPF with septocutaneous perforator was used in 49 cases and with musculocutaneous perforator in seven cases. External jugular vein and internal jugular vein provides venous drainage were applied in half cases respectively. All the patients showed a good recovery of tongue mobility and mouth opening with a follow-up of 3-41 months. Local recurrence was detected in one patient 4 months after operation. Conclusions The SMAPF is a reliable flap for oral cavity reconstruction with outstanding functional and aesthetic outcomes.

Nrf2,a key transcriptional factor in regulating endog-enous antioxidant signaling pathway,maintains the redox bal-ance by controlling the expression of a battery of antioxidant en-zymes,phase-Ⅱ detoxification enzymes and phase-Ⅲ transport-ers.Furthermore,Nrf2 regulates inflammation.Recent resear-ches have confirmed that Nrf2 provides a vital physiological role in kidney diseases,activation of Nrf2 enhances the antioxidant and anti-inflammatory ability in cellular and tissue levels,thusalleviates renal injury.Here,this article aims to summarize the protective effect of Nrf2 on various models of kidney impairment and explore the potential of Nrf2 as a therapeutic target to pre-vent kidney diseases.

Objective:To investigate and explore the science management mode for high- value medical consumables in order to solve the problem of management deficiency in purchase and using of high-value medical consumables.Methods: To strengthen the management for high value consumables on 5 aspects: systematized institution, normalized processes, standardized operation, scientific evaluation and informationalized management.Results:The normalized, standardized and programmed management mode for high-value medical consumables has been established and improved throughout the whole process monitoring and management of total life cycle for the consumables. This research normalized the management for these consumables and formed a new science management mode.Conclusion: The exploration and implementation of new management method and path for medical high-value consumables can effectively improve the level of hospital material management, reduce management loopholes, decrease the cost of high-value consumables and increase work efficiency.

Aim To study the apoptotic inducing effects of deguelin on SH-SY5Y cells.Methods SH-SY5Y cells were treated with 0,0.625,1.25,2.5,5,10 and 20 μmol·L-1 deguelin for different time(24,48,72 h);cell viability was detected by CCK-8 assay.SH-SY5Y cells were treated with 0,8,20,50 μmol·L-1 deguelin for 24 h;light microscope and AO/EB double stained method were employed for observing the morphology and apoptotic morphology of treated cells.Apoptotic rate of treated cells was determined by flow cytometry.Cells were stained by DCFH-DA,and the whole reactive oxygen species(ROS)was determined by flow cytometry.Spectrophotometry was employed to determine the activation degree of caspase-3.Results Deguelin inhibited cell growth in a time-and dose-dependent manner,and the IC50 value of deguelin was(26.07±2.18),(18.33±0.94),(12.5±1.49)μmol·L-1 when treated with 24,48,72 h respectively.After treated with 8,20,50 μmol·L-1 deguelin for 24 h,cell apoptotic rate,ROS and activation rate of caspase-3 increased markedly(P<0.05),all of which performed a dose related effect.Conclusion Deguelin can inhibit SH-SY5Y cell proliferation and induce cell apoptosis,and the mechanism may be concerned with the elevated ROS and activated caspase-3.