Objective: To investigate the epidemic status and influencing factors of colorectal polyps among urban residents in Lanxi. Methods: A representative urban community was selected from Lanxi. A total of 935 local residents aged 18-80 years received questionnaire survey,physical examination,laboratory tests and colonoscopy. Multivariate Logistic regression analysis was applied to exam the potential influencing factors for colorectal polyps. Results : Eventually 880 residents were involved into the statistical analysis. Colorectal polyps were detected in 167 participants with a crude prevalence of 18.98% and adjusted prevalence for age and gender of 13.28%. The prevalence of colorectal polyps in men（28.70%）was significantly higher than that in women（12.92%,P<0.05）. The results of logistic regression analysis showed that age（OR=1.038,95%CI：1.018-1.057）,males（OR=1.919,95%CI：1.303-2.826）,the middle school level of education（OR=2.443,95%CI：1.507-3.961）and constitution of Yin-Asthenia（OR=0.203,95%CI：0.057-0.720）were influencing factors for colorectal polyps;among male participants,hypertension（OR=1.721,95%CI：1.018-2.908）was a risk factor for colorectal polyps;among female participants,age（OR=1.076,95%CI：1.042-1.111）,BMI（OR=1.099,95%CI：1.001-1.207）,the middle school level of education（OR= 3.507,95%CI：1.794-6.856）and constitution of Yin-Asthenia（OR=0.160,95%CI：0.033-0.770）were influencing factors for colorectal polyps. Conclusion Age,sex,education level and constitution of Yin-Asthenia were associated with the risk of colorectal polyps among residents in Lanxi;hypertension was associated with the risk of colorectal polyps in males,while age,BMI,education level and constitution of Yin-Asthenia were associated with the risk of colorectal polyps in females.

Objective: To identify the functional connectivity characteristics of insula, sensory and social related brain regions in boys with autism spectrum disorder(ASD), to explore the central nervous basis of sensory abnormality affecting core symptoms in boys with ASD. Methods: Resting state functional magnetic resonance imaging (rs fMRI) data were collected from 34 boys with ASD and 29 typical development boys (TD group). Based on functional connectivity analysis, the sensory related brain regions, insula, and social related brain regions were taken as regions of interest to calculate the functional connectivity (FC) level between the regions of interest, the differences between the two groups were compared and the results were corrected by FDR. The Autism Diagnostic Observation Schedule (ADOS), Childhood Autism Rating Scale (CARS) and Autism Spectrum Quotient-Children s Version (AQ-Child) were used to assess the core phenotypes of boys with ASD. Results: Compared with the TD group, the levels of FC between tactile brain regions and insula, olfactory brain regions and insula, auditory brain regions and insula in boys with ASD group were significantly increased. The level of FC between the insula and bilateral amygdala，insula and the medial prefrontal cortex(mPFC) were significantly increased( P <0.05).Pearson correlation analysis showed that the level of FC between auditory brain region(BA42)and left insula in ASD group was negatively correlated with the scores of communication subscale of ADOS( r =-0.44)，social interaction subscale of ADOS( r =-0.43), communication & social interaction subscale of ADOS( r =-0.49),attention to details subscale of AQ-Child( r =-0.41). The level of FC between the right insula and right amygdala was positively correlated with the attention switch subscale of AQ-Child( r =0.38), the level of FC between right insula and mPFC was positively correlated with the scores of repetitive behavior subscale of ADOS( r =0.48), the attention switch subscale of AQ-Child( r =0.49), total scale subscale of AQ-Child( r =0.41), total scale of CARS( r =0.41)( P < 0.05 ). Conclusion The levels of FC between insula and sensory related, social related brain regions are abnormal in children with ASD, which have significant correlations with clinical symptoms. In depth studies can be conducted to explore underlying neutral mechanisms.

Objective To explore the regulatory role of hederagenin(HG)on glutamate(Glu)-in-duced ferroptosis and corresponding inflammatory responses in mouse hippocampal neuron HT22 cells and investigate its potential mechanisms.Methods HT22 cells were randomly divided into control,Glu and HG groups(n=3).The cells of the control group received no treatment,the cells of the Glu group were treated with 35 mmol/L Glu for 24 h to establish a cellular model of ferroptosis in Alzheimer's disease,and the cells of the HG group were treated with 0.5 μmol/L HG and 35 mmol/L Glu for 24 h simultaneously.FerroOrange fluorescent probe was used to de-tect intracellular Fe2+.The production of reactive oxygen species(ROS),mitochondrial membrane potential,and levels of inflammatory factors TNF-α,IL-1β and IL-6 in the cells were assessed.Finally,the expression of the key regulator of iron death,glutathione peroxidase 4(GPX4)was measured.Results Compared to the control group,the levels of intracellular Fe2+,ROS,TNF-α,IL-1β,and IL-6 were significantly elevated,while the mitochondrial membrane potential was obvi-ously reduced in the Glu group(P＜0.05,P＜0.01).The HG group had significantly decreased Fe2+,ROS,TNF-α,IL-1β,and IL-6 and enhanced mitochondrial membrane potential than the Glu group(P＜0.05,P＜0.01).The GPX4 expression was significantly lower in the Glu group than the control group(1.00±0.02 vs 0.46±0.04,P＜0.01),and was notably higher in the 0.5 and 1.0 μmol/L HG groups when compared to the Glu group(0.64±0.03 and 0.59±0.05 vs 0.46±0.04,P＜0.01).Conclusion HG inhibits ferroptosis by regulating GPX4 expression,and thereby effec-tively alleviates the inflammatory response.

Objective: To explore the differences of sensory manifestations between ASD children and typical development children, and to clarify the characteristics of sensory abnormalities in ASD and their relationship with various clinical symptoms, so as to provide scientific basis for early identification and specific intervention. Methods: A total of 265 ASD children who received rehabilitation training in autism rehabilitation institutions in Heilongjiang Province were collected as the case group, and 223 typical development children in ordinary kindergartens and schools in Harbin were taken as the control group. Short Sensory Profile (SSP) was used to evaluate the difference of children s sensory perception level between the two groups, and Social Response Scale (SRS) and Autism Behavior Checklist (ABC) were used to evaluate the severity of symptoms including social disorder of autistic children. The correlation between SSP scores in ASD group and clinical scales was analyzed. Results: The comparison of SSP scores between the two groups found that the median scores of all sensory dimensions in ASD group (tactile=33, taste/smell=18, motion sensitivity=13, Low response/sensation seeking=28, auditory filtering=19, low strength=22, visual/auditory=20) were lower than those of the healthy control group( Z =-2.73,-4.36,-3.17,-5.09,-11.00,-10.45,-3.43, P <0.05). The abnormal rate of multisensory score in children in ASD group was 55.1%, and that in control group was 21.2%, with significant difference( χ 2=57.15, P <0.05). Correlation analysis showed that SSP score in ASD group was negatively correlated with all dimensions of SRS, nonverbal communication, and social function of ADI-R scale, ADOS communication and social interaction, and total scores of ABC and CARS( P < 0.05 ). Conclusion Children with ASD have atypical sensory experiences, especially in auditory filtering dimension, and the level of atypical sensation is related to the severity of clinical symptoms of autism. In the future clinical diagnosis, treatment and research, it is necessary to strengthen the ability to recognize the sensory symptoms of children with ASD, so as to realize the early diagnosis and intervention.

Objective:To investigate the alterations of brain resting-state functional connectivity in patients with leukoaraiosis(LA), and to explore its neuropathological mechanism of cognitive dysfunction.Methods:From August 2022 to February 2023, 28 patients with LA(LA group) and 30 gender, age and education level matched normal controls(NC group) in Jiangsu Shengze Hospital affiliated to Nanjing Medical University were prospectively recruited.Mini mental state examination, trail-making test, and Stroop color-word test were used to evaluate the cognitive function of participants, rs-fMRI images were processed by DPABI V6.1 based on MATLAB R2022a.Voxel-mirrored homotopic connectivity(VMHC) values were calculated and two-sample t test were performed to compare the differences in local brain activity between the two groups.The brain regions with significant differences were selected as the seeds to calculate the functional connectivity(FC) values of the whole brain, and Pearson correlation analyses were performed to evaluate the correlation between the FC values and neuropsychological scores. Results:The VMHC values of the calcarine fissure and surrounding cortex(CAL) (x=±18, y=-63, z=15), postcentral gyrus(PoCG) (x=±39, y=-27, z=48), lingual gyrus(LING) (x=±12, y=-51, z=-6), middle occipital gyrus(x=±27, y=-75, z=24) and insula(x=±36, y=6, z=3) in the LA group were lower than those in the NC group( P<0.05). The seed points FC results showed, FC values between right CAL(CAL.R) and bilateral precuneus(PCUN), right dorsolateral prefrontal cortex(DLPFC.R) and right temporal_mid were reduced in the LA group( P<0.05); FC values between PoCG.R and left CAL, left temporal_mid and right LING were reduced too( P<0.05). Additionally, the FC value in the LA group between CAL.R and DLPFC.R was negatively correlated with the Stroop C score( r=-0.39, P<0.05). The FC value in LA group and NC group between CAL.R and DLPFC.R was negatively correlated with the Stroop C score( r=-0.48, P<0.001)and also negatively correlated with the trail making test B(TMT-B) score( r=-0.40, P<0.01), and the FC value between CAL.R and PCUN.L was negatively correlated with the TMT-B score( r=-0.45, P<0.001). Conclusion:Desynchronized interhemispheric functional connectivity and abnormal cortical circuit functional connectivity were probably associated with the underlying neural mechanisms of cognitive impairment in LA.

Objective To establish an ideal modeling method for diarrhea predominant irritable bowel syndrome(IBS-D)with anxiely and depression in rats,and to provide a basis for the clinical study of IBS-D.Methods 60 rats were used in this study.(1)At first,20 rats were randomly divided into blank,3%acetic acid enema,4%acetic acid enema,and 5%acetic acid enema groups.After the modeling and observation period,the diarrhea status and the degree of colon injury caused by different modeling concentrations were observed by diarrhea related index and colon histopathology.(2)After the optimal modeling concentration was assessed,40 rats were randomly divided into control(a),acetic acid enema(b),acetic acid+binding(c),and acetic acid+binding+tail clip(d)groups and correspondingly treated for 8 days.After the treatments,the general condition,diarrhea-related index,open field test(OFT)score,and colonic histopathology of rats were evaluated.Results(1)Compared with the blank group,the fecal trait score of 4%acetic acid enema group was increased on days 1 to 3 after intervention(P＜0.001),and gradually decreased on days 4 to 7 after intervention.After 1 week,there was no significant difference between the fecal trait score and that of the blank group(P＞0.05).Body weight was lower(P＜0.01),fecal water content was higher(P＜0.001).Compared with blank group,body weight of the 5%acetic acid enema group was decreased(P＜0.001),the fecal trait score and diarrhea index were increased(P＜0.01).No significant difference was found between 3%acetic acid enema and blank groups.The pathological colon tissue showed that,compared with the blank group,the mucosal structure of the 4%acetic acid enema group was complete with a small amount of inflammatory cell infiltration,and the pathological tissue score showed no significant difference(P＞0.05),whereas the 5%acetic acid enema had a medium to large amount of inflammatory cell infiltration,and the pathological tissue score was increased(P＜0.01).(2)Compared with group a,group b had lower body weight(P＜0.001),and higher fecal trait score,fecal water content and diarrhea index(P＜0.01).Compared with a and b groups,the body weight of c and d groups was lower(P＜0.001),the fecal traits score,fecal water content,and diarrhea index were increased(P＜0.01),and the colon running time was decreased(P＜0.01).Compared with group c,Fecal water content in group D was higher(P＜0.001).In the OFT score,compared with a and b groups,the OFT distance,standing times,and upright times in c and d groups were lower(P＜0.05).Compared with c,the OFT distance,standing times,and upright times in d group were lower(P＜0.05).The pathological tissue of colon showed that the mucosal structure of the four groups was complete,and there were different degrees of inflammatory cell infiltration.The pathological tissue scores of groups c and d were higher than those of groups a and b(P＜0.05).Conclusions The 4%acetic acid concentration is appropriate for IBS-D modeling.After superposition and binding,the IBS-D diarrhea and internal hypersensitivity characteristic state can be better simulated.After superposition of a tail clip,the IBS-D model of liver stagnation and spleen deficiency can be established successfully.

Objective:To investigate the alterations in brain dynamic functional network connectivity (dFNC) and their significance in Parkinson's disease (PD) patients with postural instability/gait difficulty (PIGD).Methods:Ninety PD patients admitted to Department of Neurology, First Affiliated Hospital of Nanjing Medical University from May 2016 to August 2019 were recruited, and 54 healthy controls matched with gender and age were chosen; their clinical data and resting-state functional MRI (rs-fMRI) data were collected. PD patients were divided into PD with PIGD (PD-PIGD) group ( n=49) and PD without PIGD (PD-non-PIGD) group ( n=41) according to Unified Parkinson's Disease Rating Scale (UPDRS) scores. Independent component analysis (ICA), sliding window method and k-means clustering were used to analyze the dFNC and compare among groups. Correlations of dFNC alterations with clinical scales were verified by partial correlation analysis. Results:Four repeated recurring functional connectivity states were identified, and PD-PIGD patients had high frequency in state 3 (44%) and state 2 (23%) of the low dFNC. In terms of dFNC time attributes, PD-PIGD patients had longer mean dwell time in state 3 than PD-non-PIGD patients and had lower number of transitions in state 3 than PD-non-PIGD patients and healthy controls, with significant differences ( P<0.05); PD-PIGD patients had significantly higher fractional windows and statistically longer mean dwell time in state 2 than healthy controls ( P<0.05). In terms of dFNC strengths, compared with healthy controls, PD-PIGD patients showed significantly decreased functional connectivity within default mode network (DMN, between medial superior frontal gyrus and precuneus) and auditory network (AN, between superior temporal gyrus and middle temporal gyrus), but significantly increased functional connectivity between sensorimotor network (SMN, supplementary motor area) and DMN (precuneus) in state 2 ( P<0.05, false discovery rate [FDR]-corrected). Partial correlation analysis indicated positive correlation between mean dwell time in state 3 and PIGD scores in PD-PIGD patients ( r=0.450, P=0.039). Conclusion:PD-PIGD patients exhibit specific dFNC, mainly characterized by low connectivity of the brain functional network and prolonged dwell time; local functional network domains often separate between DMN, AN and SMN networks and within the networks.

The pandemic of Corona Virus Disease 2019 (COVID-19) continues, which shows the concentrated or sporadic cases in multiple places. Current COVID situation is still complex. During the COVID-19, routine diagnosis and treatment of liver cancer patients has been affected in different degrees. Under the premise of following the treatment guidelines, how to reduce the risk of infection of patients and medical staff, utilize limited medical resources to maximally ensure anti-tumor treatment and related emergency treatment, and help patients get through the epidemic period is a problem for liver oncologists. Thus, experts of liver cancer treatment related disciplines of Zhongshan Hospital, Fudan University have written the Expert guidance on overall management of liver cancer during the COVID-19, which aims to provide references for liver oncolo-gists to conduct clinical work safely and effectively under the epidemic prevention and control, and to help patients fight against the epidemic smoothly.

Objective: To evaluate and describe the changes of core muscle groups based on DAVID spine biomechanics training system in ankylosing spondylitis (AS) patients. Methods: The clinical data of 100 patients of AS and 31 healthy controls were collected. Clinical symptoms, Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis function index (BASFI), Bath ankylosing spondylitis measurement index (BASMI), ankylosing spondylitis disease activity (ASDAS), and simultaneous detection of DAVID spine biomechanics training system, simple core muscle fitness test: Eight-grade abdominal bridge, PLANK exercise (flat support), Abdominal static muscle endurance test, Back static muscle endurance test were compared using t-test analysis and spearman correlation analysis. Results: ① Between AS and healthy male control o group, there were significant differences of spinal mobility in forward flexion, right rotation, left rotation (42±13 vs 48±1, 52±14 vs 69±12, 52±13 vs 58±11; all P values <0.05); and significant differences of spinal muscle strength in forward bending force, right rotation force, left rotation force, right bending force (103±42 vs 146±17, 87±34 vs 104±13, 80±35 vs 101±13, 161±55 vs 186±19; all P values <0.05), and significant differences in the left/right rotational force (1.17±0.21 vs 1.02±0.111, P<0.05) of spine balance strength comparison.② Between AS and healthy controls of female group, there were differences in forward bending force (49±23 vs 77±10, P<0.05) of spinal muscle strength; and significant differences in forward bending/backward extension strength, left and right rotation strength (0.32±0.11 vs 0.58±0.21, 1.29±0.21 vs1.03±0.11, all P values <0.05) of spine balance strength; ③ In AS group, the spinal mobility was correlated with age (Rear extension r=-0.28, right flexion r=-0.268, left flexion r=-0.404, right rotation r=-0.367, left rotation r=-0.235; all P values <0.05), course of disease (Rear extension r=-0.354, forward flexion r=-0.283, right flexion r=-0.204, left flexion r=-0.284, right rotation r=-0.339, left rotation r=-0.23; all P values <0.05), body mass index (BMI) (Rear extension r=-0.23, forward flexion r=-0.288, right flexion r=-0.22, left flexion r=-0.201, right rotation r=-0.26, left rotation r=-0.29; all P values <0.05), sacroiliac joint stage(Rear extension r=-0.375, forward flexion r=-0.446, right flexion r=-0.331, left flexion r=-0.367, right rotation r=-0.368, left rotation r=-0.314; all P values <0.05) and BASDAI (Rear extension r=-0.381, forward flexion r=-0.374; all P values <0.05). Spinal muscle strength was correlated with gender (Posterior extensor force r=0.344, flexor force r=0.507, right rotation force r=0.376, left rotation force r=0.399, right flexion force r=0.433, left flexion force r=0.445; all P values <0.05); the left/right spine rotation strength was correlated with gender (r=0.271, P<0.05). ④ In the simple core muscle fitness test, eight-grade abdominal bridge was correlated with spinal muscle strength (Rear extension force r=0.234, right rotation r=0.290, left rotation r=0.219, right flexion r=0.35, left flexion r=0.327; all P values <0.05); PLANK exercise was correlated with spinal muscle strength (Rear extension force r=0.234, right rotation r=0.290, left rotation r=0.219, right flexion r=0.35, left flexion r=0.327; all P values <0.05); abdominal static muscle endurance test was correlated with forward flexion strength (r=0.341, P<0.05); back static muscle endurance test was correlated with spinal mobility (Rear extension r=0.262, forward flexion r=0.23, right rotation r=0.455, left rotation r=0.426, right flexion r=0.387, left flexion r=0.46; all P values <0.05); correlated with spine strength (right flexion r=0.256, left flexion r=0.272; all P values <0.05). Conclusion Compared with healthy people, AS patients have decreased activity, strength and balance of spinal core muscle. There are significant decline in spinal mobility and muscle strength of male AS patients and muscle imbalance of female AS patients. Simple core muscle fitness test could be used in clinic to measure the changes of AS patients'core muscle group.

Taohe Chengqitang is a classical prescription published in The Catalogue of Ancient Classic Recipes (The First Batch). This study systematically summarized traditional Chinese medicine (TCM) ancient books and modern clinical reports on Taohe Chengqitang and investigated its origin， composition， basis, and historical evolution in processing requirements， dosage， preparation and administration， and functions. The findings indicated different opinions on drug basis， preparation of decoction pieces, and drug dosage conversion. Based on sufficient literature review, the actual development needs of classical prescriptions, and the usage habits of modern clinical practice， this study recommended dried mature seeds of Prunus persica or P. davidiana for Persicae Semen， dried twigs of Cinnamomum cassia for Cinnamomi Ramulus， honey-fried Glycyrrhiza uralensis for Glycyrrhizae Radix et Rhizoma, raw Rheum palmatum, R. tanguticum, or R. offìcinale for Rhei Radix et Rhizoma, and mirabilite for Natrii Sulfas. In terms of drug dosage， the doses directed converted from weights and measures in the Han dynasty were large. According to the common doses in modern clinical practice, conversion was carried out based on 6 g of Cinnamomi Ramulus, 6 g of Natrii Sulfas, 6 g of Glycyrrhizae Radix et Rhizoma, and 12 g of Rhei Radix et Rhizoma. The weight of Persicae Semen should be determined according to the actual measurement. In terms of preparation and administration, the drugs in the pot were decocted with 1 400 mL of water to obtain 500 mL of decoction, which was filtered and slightly boiled in the presence of Natrii Sulfas. About 100 mL of warm decoction was taken before meals， three times a day. It was recorded in the ancient books that Taohe Chengqitang was indicated for the syndromes of heat invading the bladder and accumulating inside in the case of released exterior syndrome in Taiyang. After symptom-based flexible application by doctors, it is currently commonly used in the treatment of diabetic nephropathy， constipation， chronic renal failure, and other diseases.