ObjectiveTo observe the clinical efficacy of modified Jinwei Guben Decoction （金卫固本汤， MJGD） combined with Bailing Capsule （百令胶囊， BC） in the treatment of chronic obstructive pulmonary disease （COPD） patients in the stable stage with qi deficiency， blood stasis and phlegm obstruction syndrome， in addition to conventional western medicine treatment. MethodsA total of 102 patients with stable COPD and qi deficiency， blood stasis， and phlegm obstruction syndrome were included in the study. According to the patients'preferences， they were divided into treatment group （49 cases） and control group （53 cases）. The control group received conventional western medicine treatment， while the treatment group was given MJGD （1 dose daily） combined with BC （2.0 g each time， three times a day） additionally. The treatment period was 3 months， and the patients were followed up for 1 year after the treatment. The acute exacerbation frequency （mild， moderate， severe） before treatment， during treatment， at 6-month follow-up， and at 1-year follow-up was compared between groups. Additionally， the lung function indicators such as FEV₁， FEV₁%pred， FVC， and FEV₁/FVC ratio， traditional Chinese medicine （TCM） syndrome scores， modified British Medical Research Council （mMRC） dyspnea scale， and the COPD Assessment Test （CAT） scores before and after treatment were compared. A logistic regression model was constructed to analyze the impact of MJGD combined with BC on clinical efficacy. ResultsFour patients dropped out from the treatment group and eight from the control group， leaving 45 patients of each group for statistical analysis. The number of mild and moderate acute exacerbations in the treatment group was lower than that in the control group during the treatment period， at 6-month follow-up and within 1 year of follow-up （P＜0.05） .The number of severe acute exacerbations was only lower in the treatment group than in the control group at 6-month follow-up （P＜0.05）. Compared with that before treatment， the number of acute exacerbations of all degrees in the treatment group was significantly reduced within 1 year of follow-up （P＜0.05），while only the number of mild acute exacerbations in the control group was significantly reduced within 1 year of follow-up （P＜0.05）. The treatment group showed significant improvement in FEV₁ and FEV₁%pred and FEV₁/FEV， while the control group showed a significant decline in FEV₁ and FVC （P＜0.05）. After treatment， both groups showed significant reductions in TCM syndrome scores， including coughing， sputum， wheezing， chest tightness， shortness of breath， and fatigue， as well as mMRC and CAT scores （P＜0.05）， with the treatment group having significantly lower scores than the control group （P＜0.05）. The overall clinical effective rate of in the treatment group was 93.33% （42/45）， significantly higher than that of the control group， 75.56% （34/45， P＜0.05）. Multivariate logistic regression analysis showed that the use of MJGD combined with BC （OR = 4.68， 95%CI： 1.15 - 19.09， P = 0.03） was positively correlated with clinical efficacy. ConclusionsIn addition to conventional western medicine treatment， the combination of MJGD and BC can reduce the frequency of acute exacerbations， delay the decline of lung function， improve clinical symptoms， and significantly enhance the clinical efficacy in patients with stable COPD and qi deficiency， blood stasis， and phlegm obstruction syndrome.

ObjectiveTo study the effect of Jinwei Pingchuan decoction combined with conventional Western medicine on the number of acute exacerbations， lung function， and clinical symptoms in patients with acute exacerbation of chronic obstructive pulmonary disease （COPD） with phlegm-heat obstruction in lung syndrome. MethodsA non-randomized controlled trial was conducted to include 60 patients with acute exacerbation of COPD with phlegm-heat obstruction in lung syndrome. Patients were divided into a treatment group and a control group based on whether they received Jinwei Pingchuan decoction， with 30 patients in each group. The treatment group received Jinwei Pingchuan decoction combined with conventional Western medicine therapy， while the control group received conventional Western medicine therapy alone. Both groups received treatment for 7 days. The number of acute exacerbations and lung function indices were followed up and recorded before treatment and three months after treatment. The following outcomes were observed before and after treatment： the number of acute exacerbations， lung function indices （forced expiratory volume in one second ［FEV₁］， percentage of predicted value ［FEV₁%pred］， forced vital capacity ［FVC］， and FEV₁/FVC ratio）， the degree of acute exacerbation， TCM syndrome score， COPD assessment test （CAT） score， modified British Medical Research Council Dyspnea Questionnaire （mMRC） score， C-reactive protein （CRP）， and white blood cell （WBC） count. ResultsAfter 3 months of follow-up， the treatment group showed a significant reduction in the number of acute exacerbations compared with the pre-treatment values （P<0.05）. After treatment， the treatment group had fewer acute exacerbations than the control group （P<0.05）. The degree of acute exacerbation in the treatment group improved significantly compared with the pre-treatment values （P<0.05）. After treatment， the degree of acute exacerbation in the treatment group was improved compared to the control group （P<0.05）. Regarding lung function， FEV₁， FEV₁%pred， FVC， and FEV₁/FVC ratio increased significantly in the treatment group compared with the pre-treatment values （P<0.05）， and similar improvements were observed in the control group （P<0.05）. After treatment， FEV₁ and FVC were higher in the treatment group than the control group （P<0.05）. Regarding TCM syndrome scores， the scores for individual symptoms such as wheezing， cough， expectoration， chest tightness， shortness of breath， and fatigue， as well as the total score， decreased significantly in the treatment group compared with the pre-treatment values （P<0.05）. In the control group， the scores for cough， expectoration， chest tightness， fatigue， and palpitation， as well as the total score， also decreased （P<0.05）. After treatment， the treatment group showed significantly lower scores for wheezing， cough， chest tightness， shortness of breath， and the total score than the control group （P<0.05）. Regarding the CAT score， the scores for cough， expectoration， chest tightness， climbing stairs， going out， activity， and energy， as well as the total score， decreased significantly in the treatment group compared with the pre-treatment values （P<0.05）. In the control group， the scores for cough， expectoration， chest tightness， sleep， energy， and the total score decreased （P<0.05）. After treatment， the treatment group showed significantly lower scores for cough， expectoration， chest tightness， activity， and going out than the control group （P<0.05）. Regarding the mMRC score， CRP level， and WBC count， all these parameters decreased significantly in the treatment group compared with the pre-treatment values （P<0.05）， and similar reductions were observed in the control group （P<0.05）. ConclusionJinwei Pingchuan decoction can reduce the number of acute exacerbations and the degree of acute exacerbation in patients with acute exacerbation of COPD with phlegm-heat obstruction in lung syndrome. It also improves lung function and symptoms such as cough and chest tightness， thereby enhancing the quality of life of patients.

ObjectiveTo study the effect of Jinwei Pingchuan decoction combined with conventional Western medicine on the number of acute exacerbations， lung function， and clinical symptoms in patients with acute exacerbation of chronic obstructive pulmonary disease （COPD） with phlegm-heat obstruction in lung syndrome. MethodsA non-randomized controlled trial was conducted to include 60 patients with acute exacerbation of COPD with phlegm-heat obstruction in lung syndrome. Patients were divided into a treatment group and a control group based on whether they received Jinwei Pingchuan decoction， with 30 patients in each group. The treatment group received Jinwei Pingchuan decoction combined with conventional Western medicine therapy， while the control group received conventional Western medicine therapy alone. Both groups received treatment for 7 days. The number of acute exacerbations and lung function indices were followed up and recorded before treatment and three months after treatment. The following outcomes were observed before and after treatment： the number of acute exacerbations， lung function indices （forced expiratory volume in one second ［FEV₁］， percentage of predicted value ［FEV₁%pred］， forced vital capacity ［FVC］， and FEV₁/FVC ratio）， the degree of acute exacerbation， TCM syndrome score， COPD assessment test （CAT） score， modified British Medical Research Council Dyspnea Questionnaire （mMRC） score， C-reactive protein （CRP）， and white blood cell （WBC） count. ResultsAfter 3 months of follow-up， the treatment group showed a significant reduction in the number of acute exacerbations compared with the pre-treatment values （P<0.05）. After treatment， the treatment group had fewer acute exacerbations than the control group （P<0.05）. The degree of acute exacerbation in the treatment group improved significantly compared with the pre-treatment values （P<0.05）. After treatment， the degree of acute exacerbation in the treatment group was improved compared to the control group （P<0.05）. Regarding lung function， FEV₁， FEV₁%pred， FVC， and FEV₁/FVC ratio increased significantly in the treatment group compared with the pre-treatment values （P<0.05）， and similar improvements were observed in the control group （P<0.05）. After treatment， FEV₁ and FVC were higher in the treatment group than the control group （P<0.05）. Regarding TCM syndrome scores， the scores for individual symptoms such as wheezing， cough， expectoration， chest tightness， shortness of breath， and fatigue， as well as the total score， decreased significantly in the treatment group compared with the pre-treatment values （P<0.05）. In the control group， the scores for cough， expectoration， chest tightness， fatigue， and palpitation， as well as the total score， also decreased （P<0.05）. After treatment， the treatment group showed significantly lower scores for wheezing， cough， chest tightness， shortness of breath， and the total score than the control group （P<0.05）. Regarding the CAT score， the scores for cough， expectoration， chest tightness， climbing stairs， going out， activity， and energy， as well as the total score， decreased significantly in the treatment group compared with the pre-treatment values （P<0.05）. In the control group， the scores for cough， expectoration， chest tightness， sleep， energy， and the total score decreased （P<0.05）. After treatment， the treatment group showed significantly lower scores for cough， expectoration， chest tightness， activity， and going out than the control group （P<0.05）. Regarding the mMRC score， CRP level， and WBC count， all these parameters decreased significantly in the treatment group compared with the pre-treatment values （P<0.05）， and similar reductions were observed in the control group （P<0.05）. ConclusionJinwei Pingchuan decoction can reduce the number of acute exacerbations and the degree of acute exacerbation in patients with acute exacerbation of COPD with phlegm-heat obstruction in lung syndrome. It also improves lung function and symptoms such as cough and chest tightness， thereby enhancing the quality of life of patients.

Protrusive facial deformities, characterized by the forward displacement of the teeth and/or jaws beyond the normal range, affect a considerable portion of the population. The manifestations and morphological mechanisms of protrusive facial deformities are complex and diverse, requiring orthodontists to possess a high level of theoretical knowledge and practical experience in the relevant orthodontic field. To further optimize the correction of protrusive facial deformities, this consensus proposes that the morphological mechanisms and diagnosis of protrusive facial deformities should be analyzed and judged from multiple dimensions and factors to accurately formulate treatment plans. It emphasizes the use of orthodontic strategies, including jaw growth modification, tooth extraction or non-extraction for anterior teeth retraction, and maxillofacial vertical control. These strategies aim to reduce anterior teeth and lip protrusion, increase chin prominence, harmonize nasolabial and chin-lip relationships, and improve the facial profile of patients with protrusive facial deformities. For severe skeletal protrusive facial deformities, orthodontic-orthognathic combined treatment may be suggested. This consensus summarizes the theoretical knowledge and clinical experience of numerous renowned oral experts nationwide, offering reference strategies for the correction of protrusive facial deformities.
Humans ; Orthodontics, Corrective/methods* ; Consensus ; Malocclusion/therapy* ; Patient Care Planning ; Cephalometry

The prevalence of Class III malocclusion varies among different countries and regions. The populations from Southeast Asian countries (Chinese and Malaysian) showed the highest prevalence rate of 15.8%, which can seriously affect oral function, facial appearance, and mental health. As anterior crossbite tends to worsen with growth, early orthodontic treatment can harness growth potential to normalize maxillofacial development or reduce skeletal malformation severity, thereby reducing the difficulty and shortening the treatment cycle of later-stage treatment. This is beneficial for the physical and mental growth of children. Therefore, early orthodontic treatment for Class III malocclusion is particularly important. Determining the optimal timing for early orthodontic treatment requires a comprehensive assessment of clinical manifestations, dental age, and skeletal age, and can lead to better results with less effort. Currently, standardized treatment guidelines for early orthodontic treatment of Class III malocclusion are lacking. This review provides a comprehensive summary of the etiology, clinical manifestations, classification, and early orthodontic techniques for Class III malocclusion, along with systematic discussions on selecting early treatment plans. The purpose of this expert consensus is to standardize clinical practices and improve the treatment outcomes of Class III malocclusion through early orthodontic treatment.
Humans ; Malocclusion, Angle Class III/classification* ; Orthodontics, Corrective/methods* ; Consensus ; Child

OBJECTIVES: To propose a hypothesis that aloe-emodin may inhibit scar tissue fibrosis through thrombospondin-1(THBS1)-PI3K-Akt pathway. METHODS: By cultivating fibroblasts derived from scar tissue after cleft palate surgery in humans, aloe emodin of different concentrations (10, 20, 30, 40 and 50 μmol/L) was added to the cells which activity was detected. At the same time, transcriptome sequencing was performed on scar tissue and cells, and bioinformatics methods were used to explore potential targets and signaling pathways of scar tissue fibrosis. RESULTS: Aloe-emodin had a concentration dependent inhibitory effect on fibroblast proliferation,with the 40 μmol/L concentration group showing the most significant effect. The results of tissue and cell sequencing indicated that differentially expressed genes were significantly enriched in extracellular matrix-receptor interaction pathway, and shared a common differential gene which was THBS1. The ORA analysis results indicated that differentially expressed genes, including THBS1, were significantly enriched in the PI3K-Akt signaling pathway. CONCLUSIONS Aloe emodin may inhibit the PI3K-Akt pathway by downregulating THBS1, thereby reducing the proliferation activity of fibroblasts derived from postoperative palatal scar tissue.
Thrombospondin 1/genetics* ; Humans ; Signal Transduction/drug effects* ; Fibroblasts/cytology* ; Proto-Oncogene Proteins c-akt/metabolism* ; Fibrosis ; Phosphatidylinositol 3-Kinases/metabolism* ; Cicatrix/metabolism* ; Cell Proliferation/drug effects* ; Anthraquinones/pharmacology* ; Cells, Cultured

Objective: To establish anin vitromodel of ferroptosis induced by Erastin and RAS-selective lethal 3(RSL3) in hepatoma cells, and to provide theoretical basis for the development of novel therapeutic strategies for HCC. Methods: Hepatoma cells(HCCLM3, HepG2, Hep3B, Huh7 and PLC/PRF/5) in logarithmic growth phase were treated with Erastin(0-40 μmol/L) and RSL3(0-10 μmol/L) at double concentrations respectively. After 24 h, CCK-8 method was used to detect cell viability, draw growth curve, calculate IC50, and HCC cells sensitive to inducers were selected for follow-up experiments. The effect of inducer on the state of hepatoma cells was observed under light microscope, and immunoblotting and flow cytometry were used to verify whether the ferroptotic modelin vitrowas successfully constructed. Results: Huh7, Hep3B and HepG2 cells were sensitive to Erastin and RSL3, but HCCLM3 and PLC/PRF/5 were insensitive to Erastin and RSL3. When the concentration of Erastin and RSL3 reached the maximum, the survival rate was still above 65%. Huh7, Hep3B and HepG2 cells were selected for subsequent experiments. Compared with the control group, the expression of Glutathione peroxidase 4(GPX4), a ferroptotic marker, was down-regulated in a concentration-dependent manner. In Huh7, Hep3B and HepG2 cells, lipid reactive oxygen species(ROS) levels significantly increased after 24 h treatment with 10 μmol/L and 20 μmol/L Erastin, respectively; in Huh7 cells, lipid ROS levels significantly increased after 24 h treatment with 0.5 μmol/L and 1 μmol/L RSL3, respectively; in Hep3B and HepG2 cells, lipid ROS levels significantly increased after 24 h treatment with 1 μmol/L and 2 μmol/L RSL3, respectively, compared with control group. Conclusion Huh7, Hep3B and HepG2 cells are highly sensitive to Erastin and RSL3. Huh7, Hep3B and HepG2 cells treated with 10 μmol/L Erastin for 24 h are good models for simulating ferroptosis induced by Erastinin vitro, Huh7 cells treated with 0.5 μmol/L RSL3 for 24 h and Hep3B and HepG2 cells treated with 1 μmol/L RSL3 for 24 h are good models for simulating ferroptosis induced by RSL3in vitro.

Objective To investigate the positive detection and epidemic characteristics of enter ovirus(EV),the pathogen of hand-foot-mouth disease(HFMD),in Hangzhou,and to provide scientific basis for formulating prevention and control strategies of HFMD in the future.Methods From January 2016 to December 2022,14 259 positive cases of enterovirus universal nucleic acid detected in Hangzhou Children's Hospital were collected and analyzed retrospectively by age,gender,detection time and other factors.Results The average positive detection rate of EV was 45.48%(14 259/31 354),among which the positive detection rate of boys was 27.20%and that of girls was 18.28%,the difference was statistically significant(P<0.01).The positive detection rate of EV in children of different ages decreased with the increase of age,and the positive detection rate of EV in children under 5 years old accounted for 90.38%of all positive children.Seasonally,enteroviruses were detected throughout the year,but the incidence was high in summer,and the total positive number from May to July accounted for 49.16%of the total detected number.In terms of year,the positive detection rate of EV has shown a downward trend year by year since 2016.Conclusion There are gender differences in enterovirus infection in Hangzhou,and boys are more susceptible to enterovirus infection,especially children under 5 years old need to pay attention to EV protection.In addition,HFMD has a certain seasonality,with a high incidence in summer,and the annual detection rate has declined year by year since 2016,which may be related to the promotion of vaccines and the improvement of health awareness.

Objective:To explore the neuroprotective effect and molecular mechanism of sulforaphane (SFN) on acute carbon monoxide poisoning (ACOP) in rats.Methods:A total of 135 healthy adult male Sprague-Dawley (SD) rats were randomly divided into normal control group, ACOP model group, and SFN intervention group, with 45 rats in each group. The ACOP animal model was reproduced using carbon monoxide (CO) inhalation in a hyperbaric oxygen chamber, while the normal control group was allowed to breathe fresh air freely. The rats in the SFN intervention group received intraperitoneal injection of SFN at a dose of 20 mg/kg once daily starting 2 hours after CO poisoning and continuing until euthanasia. The normal control group and the ACOP model group received equivalent volume of saline injection. Three rats from each group were sacrificed 1 day after intervention to observe the changes in the ultrastructure of neuronal mitochondria in brain tissues under transmission electron microscopy. Six rats from each group were evaluated for cognitive function using neurobehavioral test 7 days after intervention. Brain tissues of 6 rats in each group were collected 1, 3, and 7 days after intervention, and the expressions of phosphorylated-adenosine monophosphate-activated protein kinase (p-AMPK), mitofusin 2 (MFN2), and dynamin-related protein 1 (DRP1) were detected using immunohistochemistry staining and Western blotting. Linear regression analysis was performed to assess the correlations between the expression levels of above proteins.Results:In the normal control group, the rats did not exhibit any abnormalities in cognitive function or the ultrastructure of neuronal mitochondria in brain tissues. ACOP induced cognitive impairment and ultrastructural injury to neuronal mitochondria in rats. However, SFN significantly improved cognitive function in poisoned rats and mitigated the extent of neuronal mitochondrial damage. Over poisoning time, the expression levels of p-AMPK and MFN2 in the brain tissues of ACOP rats were gradually decreased, while the expression level of DRP1 was gradually increased. Compared with the normal control group, the ACOP model group showed significant differences in the expressions of p-AMPK, MFN2, and DRP1. After SFN intervention, the expression levels of above proteins were significantly reversed. Compared with the ACOP model group, the SFN intervention group exhibited a marked increase in the expressions of p-AMPK and MFN2 [p-AMPK positive expression ( A value): 0.226±0.003 vs. 0.177±0.033, p-AMPK protein (p-AMPK/GAPDH): 1.41±0.05 vs. 0.89±0.05, MFN2 positive expression ( A value): 0.241±0.004 vs. 0.165±0.007, MFN2 protein (MFN2/GAPDH): 1.33±0.04 vs. 0.79±0.03, all P < 0.05], along with a significant decrease in DRP1 expression [DRP1 positive expression ( A value): 0.103±0.002 vs. 0.214±0.011, DRP1 protein (DRP1/GAPDH): 1.00±0.03 vs. 1.50±0.03, both P < 0.05]. Linear regression analysis revealed a strong negative linear correlation between DRP1 protein expression and MFN2, p-AMPK protein expressions ( R2 values were 0.977 and 0.971, both P < 0.01), and a positive linear correlation between p-AMPK protein expression and MFN2 protein expression ( R2 = 0.985, P < 0.01). Conclusion:SFN can help maintain neuronal mitochondrial homeostasis by activating the adenosine monophosphate-activated protein kinase (AMPK) signaling pathway, thereby alleviating neuronal injury caused by ACOP.

Food toxicology plays a crucial role in supporting scientific and technical aspects of food safety risk assessment.However,traditional methods relying on animal testing are becoming increas-ingly inadequate for identifying and evaluating emerging foods and unknown risks.There is a strong push worldwide towards the development of new approach methodologies(NAMs)based on non-animal testing methods.Policies and regulations related to NAMs are being standardized gradually in the European Union,the United States,and China.Some progress has also been made in applying these methodologies in food toxicology research in China.For instance,within the"Food Toxicology Program"at the National Center for Food Safety Risk Assessment,high-content and high-throughput in vitro hazard identification models employing model organisms like human macrophages,hepatocytes,adipocytes,embryonic stem cells,and zebrafish,as well as Toxicological Thresholds of Concern and quantitative in vitro to in vivo extrapolation based on physiologically-based toxicokinetic models have been estab-lished and applied.Nonetheless,new toxicological hazard identification technologies still face challenges such as inadequate elucidation of toxic mechanisms,insufficient collaborative research efforts,and inef-ficient translation of these findings into practical applications.