ObjectiveTo observe the changes in the levels of different subtypes of epidermal growth factor receptor （ErbB）， namely ErbB1， ErbB2， ErbB3， and ErbB4， in the spinal dorsal horn of inflammatory pain model rats， and to explore their mechanism of mediating hyperalgesia as well as the intervention mechanism of electroacupuncture at "Zusanli （ST 36）" and "Kunlun （BL 60）". MethodsThe study was divided into five parts. In experiment 1， 14 Sprague Dawley （SD） rats were randomly divided into control and inflammatory pain group （7 rats each group） to observe the pain behavior and the protein expression of different ErbB receptor subtypes in the spinal dorsal horn. In experiment 2， 30 rats were randomly divided into control group 1， inflammatory pain group 1， and low-， medium-， and high-concentration TX1-85-1 groups， with 6 rats in each group， to observe the effect of inhibiting spinal ErbB3 on inflammatory pain. In experiment 3， 12 rats were randomly divided into control virus group and ErbB3 knockdown virus group， with 6 rats in each group， to observe the effect of knocking down ErbB3 in the spinal dorsal horn on inflammatory pain. In experiment 4， 44 rats were randomly divided into control group 2， inflammatory pain group 2， electroacupuncture group， and sham electroacupuncture group， with 11 rats in each group， to observe the effect of electroacupuncture. In experiment 5， 40 rats were randomly divided into control group 3， inflammatory pain group 3， electroacupuncture group 1， and electroacupuncture + NRG1 group， with 10 rats in each group， to observe the effect of activating ErbB3 on electroacupuncture. A rat model of inflammatory pain was established by subcutaneous injection of 100 μl of complete Freund's adjuvant into the sole of the unilateral hind foot of SD rats. Rats in the low-， medium-， and high-concentration TX1-85-1 groups were intrathecally injected with ErbB3 inhibitor TX1-85-1 on day 5 to day 7 after modeling. Rats in the ErbB3 knockdown virus group were injected with ErbB3 knockdown virus packaged with adenovirus vector-based short hairpin RNA （shRNA） into the spinal dorsal horn in situ 3 weeks before modeling. Rats in each electroacupuncture group received electroacupuncture at bilateral "Zusanli （ST 36）" and "Kunlun （BL 60）" from day 1 to day 7 after modeling， with dense-sparse waves at a frequency of 2 Hz/100 Hz and a current of 0.5-1.5 mA for 30 minutes once a day. Rats in the electroacupuncture + NRG1 group were intrathecally injected with ErbB3 ligand recombinant human neuregulin-1 （NRG1） after electroacupuncture intervention from day 5 to day 7 after modeling. The mechanical withdrawal threshold and thermal withdrawal latency of rats were measured on day 1， 3， 5， and 7 after modeling to evaluate behavior， and Western Blot was used to detect the protein and phosphorylation levels of each ErbB subtype in the spinal dorsal horn. ResultsCompared with the control group， rats in the inflammatory pain group showed decreased mechanical withdrawal threshold and thermal withdrawal latency of rats， and increased expression of phosphorylated ErbB3 （p-ErbB3） protein in the spinal dorsal horn on days 1， 3， 5， and 7 after modeling （P＜0.01）. On day 5 and day 7 after modeling， compared with the inflammatory pain group 1， the mecha-nical withdrawal threshold and thermal withdrawal latency of rats in the medium- and high-concentration TX1-85-1 groups increased， and the expression of p-ErbB3 protein decreased （P＜0.05）. On day 1， 3， 5， and 7 after modeling， compared with the control virus group， the mechanical withdrawal threshold and thermal withdrawal latency of rats in the ErbB3 knockdown virus group increased （P＜0.05）. On day 5 and day 7 after modeling， compared with the inflammatory pain group 2 and the sham electroacupuncture group， the mechanical withdrawal threshold and thermal withdrawal latency of rats in the electroacupuncture group increased， and the expression of p-ErbB3 protein decreased （P＜0.05）. On day 5 and day 7 after modeling， compared with the electroacupuncture + NRG1 group， the mechanical withdrawal threshold and thermal withdrawal latency of rats in the electroacupuncture group 1 increased （P＜0.05）. ConclusionThe p-ErbB3 in the spinal dorsal horn involved in hyperalgesia in rats with inflammatory pain， and electroacupuncture at "Zusanli （ST 36）" and "Kunlun （BL 60）" can alleviate inflammatory pain by inhibiting the expression of p-ErbB3 protein in the spinal dorsal horn of rats.

Huangqintang， with its accurate efficacy， is a classic formula specialized in treating dysentery recommended and promoted by medical experts from successive generations， and it was included in the Catalogue of Ancient Classic Prescriptions （the Second Batch， Han Chinese medicine prescriptions） published by the National Administration of Traditional Chinses Medicine （TCM） in 2023. The method of bibliometrics was applied in this study to conduct textual research on the classic formula Huangqintang and provide a literature reference for the development of modern preparations of Huangqintang. A total of 2 026 pieces of ancient literature were searched with "Huangqintang" as the key word， and 23 pieces of effective data were selected， involving 15 ancient TCM books. The historic evolution， composition， dosage， origin， processing methods， preparation and decocting methods， efficiency， and application of Huangqintang were carefully reviewed. The results showed that Huangqintang was first recorded in the Treatise on Febrile Diseases written by ZHANG Zhongjing. It has the effect of clearing heat， stopping dysentery， regulating the middle， and downbearing counterflow and has become one of the classic formulas widely used in clinical practice. Because of its accurate efficacy， medical experts from later generations have modified it from its original composition. Though many prescriptions have different names， it is the manifestation of physicians' inheritance and development of the thought of ZHANG Zhongjing. Ancient literature showed this prescription had wide indications yet centered on digestive system diseases such as dysentery and abdominal pain. Modern applications of Huangqintang involve digestive， respiratory， ophthalmology and otolaryngology， gynecological， skin， musculoskeletal system， and connective tissue， and this prescription has great potential in treating ulcerative colitis， diarrhea， acute enteritis， and damp-heat dysentery. Through a systematic textual excavation and review of the ancient literature about Huangqintang， the paper has confirmed its key information， so as to provide a scientific basis for the clinical application and new drug development of classic formulas.

Objective:To evaluate the application value of the Supply-Processing-Distribution(SPD)supply chain mode in the refined management for medical consumables in hospital on the basis of SPD supply chain mode.Methods:An integrated efficiency index system was constructed based on SPD,and the Analytic Hierarchy Process(AHP)and Entropy Method were used to determine index weights by combined weighting.Medical consumables were classified and managed according to the index weight values.A total of 63,461 types of medical consumables(included low-value medical consumables and high-value medical consumables)that was used in clinical practice at Beijing Anzhen Hospital,Capital Medical University from January to June 2021 and January to June 2023 were selected.In them,the 54,632 types of medical consumables that were used between January and June 2021 were managed by adopting conventional supply chain mode,while 56,471 types of medical consumables that were used(included 47,642 types of medical consumables that were managed by conventional supply chain made at the first stage,and 8,829 types of new medical consumables)between January and June 2023 were managed by adopting the SPD supply chain mode.The inventory amount,inventory quantity,loss rate,and return or change rate of medical consumables of the two management modes were compared.A self-designed satisfaction questionnaire was used to evaluate the satisfaction of medical staffs,who used these medical consumables,for the two kinds of management modes.Results:The inventory amount of low-value medical consumables that were managed by the SPD supply chain mode was(1,424.09±75.68)million CNY,which was lower than(2,290.79±215.93)million CNY of adopting conventional supply chain mode,with a statistically significant difference(t=8.85,P<0.05).The inventory amount of high-value medical consumables that were managed by the SPD supply chain mode was 0,which was lower than(7,692.32±360.53)million CNY of adopting conventional supply chain mode,with a statistically significant difference(Z=-2.201,P<0.05).The inventory quantities of both low-value and high-value medical consumables of adopting SPD supply chain mode were significantly lower than those of adopting conventional supply chain mode,with statistically significant differences(t=10.443,11.225,P<0.05).The average loss rates of both low-value and high-value medical consumables of adopting SPD supply chain mode were significantly lower than those of adopting conventional supply chain mode,with statistically significant differences(Z=-2.207,-2.201,P<0.05).The average return or change rates of both low-value and high-value medical consumables of adopting SPD supply chain mode were significantly lower than those of adopting conventional supply chain mode,with statistically significant differences(t=14.685,8.716,P<0.01).The satisfaction scores of medical staffs from different departments for medical consumables of adopting the SPD supply chain mode were higher than those of adopting conventional supply chain mode,with a statistically significant difference(t=7.674,P<0.05).Conclusion:The application of the SPD supply chain mode for medical consumables in hospital can reduce the inventory amount,inventory quantity,loss rate,and return or change rate of medical consumables,and improve the satisfaction of medical staffs.

OBJECTIVE:To assess the efficacy and safety of transcranial magnetic stimulation in the treatment of refractory depression and to compare the differences in efficacy between various transcranial magnetic stimulation treatment protocols in refractory depression,thereby providing a theoretical basis for the clinical selection of transcranial magnetic stimulation treatment protocols.METHODS:A comprehensive search was conducted across multiple databases,including PubMed,Embase,Cochrane Library,Web of Science,CNKI,WanFang Data,CBM and VIP.The search terms were"transcranial magnetic stimulation,treatment-resistant depression,randomized controlled trial"in Chinese,and"depressive disorder,treatment-resistant,transcranial magnetic stimulation,randomized controlled trial"in English.The objective was to identify randomized controlled trials on the treatment of patients with refractory depression published from the establishment of the databases to September 2024.The quality of the included studies was evaluated using the Cochrane risk of bias assessment tool,version 5.1.0,and the Physiotherapy Evidence Database scale.Meta-analysis of the outcome indicators was conducted using the Review Manager 5.4 and Stata 18.0 software.RESULTS:(1)Following a comprehensive review,20 randomized controlled trials were included in the analysis.All of the trials were assessed to be of high or very high quality according to the Physiotherapy Evidence Database scale.(2)Meta-analysis results showed that,compared with the sham stimulation group,high-frequency repetitive transcranial magnetic stimulation could significantly reduce the scores of Hamilton Depression Rating Scale[mean difference(MD)=-3.89,95％confidence interval(CI):-6.14 to-1.65,P＜0.05)or the Montgomery Depression Rating Scale(MD=-3.97,95％CI:-6.57 to-1.36,P＜0.05).(3)The probability ranking results of the network Meta-analysis showed that,in terms of the Hamilton Depression Rating Scale score,the probability ranking results were as follows:high-frequency repetitive transcranial magnetic stimulation(69.9％)＞intermittent theta burst stimulation(62.8％)＞bilateral theta pulse stimulation(57.5％)＞low-frequency repetitive transcranial magnetic stimulation(54.9％)＞bilateral sequential transcranial magnetic stimulation(49.0％)＞transcranial pulsed electromagnetic field(37.0％)＞sham stimulation(18.9％).And in terms of the Montgomery Depression Rating Scale score,the probability ranking results were as follows:high-frequency repetitive transcranial magnetic stimulation(93.3％)＞bilateral theta pulse stimulation(50.3％)＞sham stimulation(45.9％)＞low-frequency repetitive transcranial magnetic stimulation(32.1％)＞bilateral sequential transcranial magnetic stimulation(28.4％).CONCLUSION:Transcranial magnetic stimulations can improve the depressive symptoms of patients with treatment-resistant depression.Among them,the high-frequency repetitive transcranial magnetic stimulation mode has the best effect on improving the depressive symptoms of patients with treatment-resistant depression,followed by the intermittent θ burst stimulation mode.

Inflammatory bowel disease (IBD) is a chronic and nonspecific disease affected by both genetic and environmental factors. Ecological and social environmental factors, including air pollutants, heavy metals, industrial pollutants and organic pollutants, diet, and lifestyle, influence the occurrence and development of IBD and regulate IBD gene expression through epigenetics and gut microbiota. This article summarizes the role of environmental factors in IBD and explores the ways in which they influence the regulation of gene expression.

Inflammatory bowel disease (IBD) is a chronic gastrointestinal inflammatory disorder with unclear etiology. Existing studies indicate that diet plays an important role in both the pathogenesis and prognosis of IBD. This review summarizes clinical evidence regarding the association between diet and the development of IBD, analyze the current nutritional status of the IBD population at the prognosis level and underlying mechanisms of dietary interventions in disease management, and explores the application of precision nutrition in personalized care. The review ultimately aims to provide guidance for developing more precise and personalized dietary management strategies for IBD patients.

OBJECTIVE:To assess the efficacy and safety of transcranial magnetic stimulation in the treatment of refractory depression and to compare the differences in efficacy between various transcranial magnetic stimulation treatment protocols in refractory depression,thereby providing a theoretical basis for the clinical selection of transcranial magnetic stimulation treatment protocols.METHODS:A comprehensive search was conducted across multiple databases,including PubMed,Embase,Cochrane Library,Web of Science,CNKI,WanFang Data,CBM and VIP.The search terms were"transcranial magnetic stimulation,treatment-resistant depression,randomized controlled trial"in Chinese,and"depressive disorder,treatment-resistant,transcranial magnetic stimulation,randomized controlled trial"in English.The objective was to identify randomized controlled trials on the treatment of patients with refractory depression published from the establishment of the databases to September 2024.The quality of the included studies was evaluated using the Cochrane risk of bias assessment tool,version 5.1.0,and the Physiotherapy Evidence Database scale.Meta-analysis of the outcome indicators was conducted using the Review Manager 5.4 and Stata 18.0 software.RESULTS:(1)Following a comprehensive review,20 randomized controlled trials were included in the analysis.All of the trials were assessed to be of high or very high quality according to the Physiotherapy Evidence Database scale.(2)Meta-analysis results showed that,compared with the sham stimulation group,high-frequency repetitive transcranial magnetic stimulation could significantly reduce the scores of Hamilton Depression Rating Scale[mean difference(MD)=-3.89,95％confidence interval(CI):-6.14 to-1.65,P＜0.05)or the Montgomery Depression Rating Scale(MD=-3.97,95％CI:-6.57 to-1.36,P＜0.05).(3)The probability ranking results of the network Meta-analysis showed that,in terms of the Hamilton Depression Rating Scale score,the probability ranking results were as follows:high-frequency repetitive transcranial magnetic stimulation(69.9％)＞intermittent theta burst stimulation(62.8％)＞bilateral theta pulse stimulation(57.5％)＞low-frequency repetitive transcranial magnetic stimulation(54.9％)＞bilateral sequential transcranial magnetic stimulation(49.0％)＞transcranial pulsed electromagnetic field(37.0％)＞sham stimulation(18.9％).And in terms of the Montgomery Depression Rating Scale score,the probability ranking results were as follows:high-frequency repetitive transcranial magnetic stimulation(93.3％)＞bilateral theta pulse stimulation(50.3％)＞sham stimulation(45.9％)＞low-frequency repetitive transcranial magnetic stimulation(32.1％)＞bilateral sequential transcranial magnetic stimulation(28.4％).CONCLUSION:Transcranial magnetic stimulations can improve the depressive symptoms of patients with treatment-resistant depression.Among them,the high-frequency repetitive transcranial magnetic stimulation mode has the best effect on improving the depressive symptoms of patients with treatment-resistant depression,followed by the intermittent θ burst stimulation mode.

Objective:To explore the experiences and needs of discharged patients with ischemic stroke during the implementation of home-based digital-intelligent blood pressure management.Methods:Using purposive sampling method, 13 acute ischemic stroke patients admitted to the Department of Neurology of Xuanwu Hospital of Capital Medical University and discharged to receive home-based digital-intelligent blood pressure management were selected for face-to-face semi-structured interviews between March and May 2024. Colaizzi 7-step analysis was used for the analysis.Results:A total of three themes and six sub-themes were extracted, namely, the double-edged effect under digital-intelligent empowerment (current situation of collision between technological novelty and cognitive generation gap, and contradiction between precision priority and lagging user experience), inertial resistance and behavioral reshaping in the process of digital-intelligent intervention (behavioral intervention exclusion under life inertia and self-efficacy enhancement driven by digital intelligence), and the "support disconnection" and the need for system reconstruction in home-based rehabilitation (professional guidance "vacuum" identity anxiety, and imbalance in the tension of family support networks) .Conclusions:Home-based blood pressure digital-intelligent management devices and programs for ischemic stroke patients need to be improved and developed. The role of multidisciplinary teams should be actively utilized, the digital divide should be emphasized, and post-disease family relationships should be reconstructed to further enhance patients' awareness of long-term blood pressure management.

Abstract Traditional Chinese medicine (TCM) has demonstrated unique advantages in the prevention and treatment of chronic diseases such as glycolipid metabolism disorder. However, its widespread application has been hindered by the unclear biological essence of TCM syndromes and therapeutic mechanisms. As an emerging interdisciplinary field, phenomics integrates multi-dimensional data including genome, transcriptome, proteome, metabolome, and microbiome. When combined with TCM's holistic philosophy, it forms TCM phenomics, providing novel approaches to reveal the biological connotation of TCM syndromes and the mechanisms of herbal medicine. Taking glycolipid metabolism disorder as an example, this paper explores the application of TCM phenomics in glycolipid metabolism disorder. By analyzing molecular characteristics of related syndromes, TCM phenomics identifies differentially expressed genes, metabolites, and gut microbiota biomarkers to elucidate the dynamic evolution patterns of syndromes. Simultaneously, it deciphers the multi-target regulatory networks of herbal formulas, demonstrating their therapeutic effects through mechanisms including modulation of insulin signaling pathways, improvement of gut microbiota imbalance, and suppression of inflammatory responses. Current challenges include the subjective nature of syndrome diagnosis, insufficient standardization of animal models, and lack of integrated multi-omics analysis. Future research should employ machine learning, multimodal data integration, and cross-omics longitudinal studies to establish quantitative diagnostic systems for syndromes, promote the integration of precision medicine in TCM and western medicine, and accelerate the modernization of TCM.

OBJECTIVE: To evaluate the effect of biodegradable magnesium alloy materials in promoting tendon-bone healing during rotator cuff tear repair and to investigate their potential underlying biological mechanisms. METHODS: Forty-eight 8-week-old Sprague Dawley rats were taken and randomly divided into groups A, B, and C. Rotator cuff tear models were created and repaired using magnesium alloy sutures in group A and Vicryl Plus 4-0 absorbable sutures in group B, while only subcutaneous incisions and sutures were performed in group C. Organ samples of groups A and B were taken for HE staining at 1 and 2 weeks after operation to evaluate the safety of magnesium alloy, and specimens from the supraspinatus tendon and proximal humerus were harvested at 2, 4, 8, and 12 weeks after operation. The specimens were observed macroscopically at 4 and 12 weeks after operation. Biomechanical tests were performed at 4, 8, and 12 weeks to test the ultimate load and stiffness of the healing sites in groups A and B. At 2, 4, and 12 weeks, the specimens were subjected to the following tests: Micro-CT to evaluate the formation of bone tunnels in groups A and B, HE staining and Masson staining to observe the regeneration of fibrocartilage at the tendon-bone interface after decalcification and sectioning, and Goldner trichrome staining to evaluate the calcification. Immunohistochemical staining was performed to detect the expressions of angiogenic factors, including vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2), as well as osteogenic factors at the tendon-bone interface. Additionally, immunofluorescence staining was used to examine the expressions of Arginase 1 and Integrin beta-2 to assess M1 and M2 macrophage polarization at the tendon-bone interface. The role of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway in tendon-bone healing was further analyzed using real-time fluorescence quantitative PCR. RESULTS: Analysis of visceral sections revealed that magnesium ions released during the degradation of magnesium alloys did not cause significant toxic effects on organs such as the heart, liver, spleen, lungs, and kidneys, indicating good biosafety. Histological analysis further demonstrated that fibrocartilage regeneration at the tendon-bone interface in group A occurred earlier, and the amount of fibrocartilage was significantly greater compared to group B, suggesting a positive effect of magnesium alloy material on tendon-bone interface repair. Additionally, Micro-CT analysis results revealed that bone tunnel formation occurred more rapidly in group A compared to group B, further supporting the beneficial effect of magnesium alloy on bone healing. Biomechanical testing showed that the ultimate load in group A was consistently higher than in group B, and the stiffness of group A was also greater than that of group B at 4 weeks, indicating stronger tissue-carrying capacity following tendon-bone interface repair and highlighting the potential of magnesium alloy in enhancing tendon-bone healing. Immunohistochemical staining results indicated that the expressions of VEGF and BMP-2 were significantly upregulated during the early stages of healing, suggesting that magnesium alloy effectively promoted angiogenesis and bone formation, thereby accelerating the tendon-bone healing process. Immunofluorescence staining further revealed that magnesium ions exerted significant anti-inflammatory effects by regulating macrophage polarization, promoting their shift toward the M2 phenotype. Real-time fluorescence quantitative PCR results demonstrated that magnesium ions could facilitate tendon-bone healing by modulating the PI3K/AKT signaling pathway. CONCLUSION Biodegradable magnesium alloy material accelerated fibrocartilage regeneration and calcification at the tendon-bone interface in rat rotator cuff tear repair by regulating the PI3K/AKT signaling pathway, thereby significantly enhancing tendon-bone healing.
Animals ; Rotator Cuff Injuries/metabolism* ; Rats, Sprague-Dawley ; Signal Transduction ; Wound Healing/drug effects* ; Alloys/pharmacology* ; Rats ; Proto-Oncogene Proteins c-akt/metabolism* ; Rotator Cuff/metabolism* ; Macrophages/metabolism* ; Magnesium/pharmacology* ; Phosphatidylinositol 3-Kinases/metabolism* ; Vascular Endothelial Growth Factor A/metabolism* ; Male ; Biocompatible Materials ; Bone Morphogenetic Protein 2/metabolism*