ObjectiveTo investigate the characteristics and potential mechanisms of Luotong Xianrong Yin （LTXRY） in improving lung injury in rats with idiopathic pulmonary fibrosis （IPF） by regulating glycolysis. MethodsForty specific pathogen-free （SPF） Sprague-Dawley （SD） rats were randomly divided into a sham-operated group （10 mL·kg^-1）， model group （10 mL·kg^-1）， LTXRY group （15.18 g·kg^-1）， and nintedanib group （0.1 g·kg^-1）， with 10 rats in each group. The IPF rat model was established by intratracheal instillation of bleomycin. After 28 days of gavage intervention， pulmonary function was assessed. Lung pathological changes were observed by hematoxylin-eosin （HE） and Masson staining. Enzyme-linked immunosorbent assay （ELISA） was used to determine the levels of inflammatory factors， including tumor necrosis factor-α （TNF-α）， interleukin （IL）-1β， and IL-6， in lung tissue. Chemiluminescence assays were employed to detect lactate content and lactate dehydrogenase activity in lung tissue. Western blot was used to measure the protein expression of transforming growth factor-β₁ （TGF-β₁）， CollagenⅠ and CollagenⅢ to evaluate collagen deposition， as well as hexokinase 2 （HK2）， pyruvate kinase M2 （PKM2）， and 6-phosphofructo-2-kinase/fructose-2，6-bisphosphatase 3 （PFKFB3） to assess glycolysis levels. Network pharmacology was applied to analyze the potential targets and signaling pathways of LTXRY in IPF， and molecular docking was conducted to evaluate the binding energy between active components and potential targets. Western blot was further used to detect the expression of target- and pathway-related proteins. ResultsCompared with the sham-operated group， rats in the model group showed significantly increased main airway resistance （Rn） and respiratory system resistance （Rrs）， and significantly decreased respiratory system compliance （Crs）. Inflammatory infiltration and collagen deposition were observed in lung tissue， with significantly increased levels of TNF-α， IL-1β， and IL-6， as well as elevated protein expression of TGF-β₁， CollagenⅠ and CollagenⅢ. Lactate content， lactate dehydrogenase activity， and the protein expression of HK2， PKM2， and PFKFB3 in lung tissue were significantly increased. Network pharmacology analysis indicated that signal transducer and activator of transcription 3 （STAT3） was a key target of LTXRY in IPF， and hypoxia-inducible factor-1 （HIF-1） was a critical signaling pathway. The expression levels of phosphorylated STAT3 （p-STAT3） and HIF-1α in lung tissue were significantly higher than those in the sham-operated group. Compared with the model group， rats in the LTXRY group showed significantly decreased Rn and Rrs and significantly increased Crs. Lung inflammatory infiltration and collagen deposition were markedly alleviated， with significantly reduced levels of TNF-α， IL-1β， and IL-6， and decreased protein expression of TGF-β₁， CollagenⅠ and CollagenⅢ. Lactate content， lactate dehydrogenase activity， and the protein expression of HK2， PKM2， and PFKFB3 were significantly decreased， accompanied by markedly reduced expression of p-STAT3 and HIF-1α. ConclusionLTXRY alleviates lung tissue injury in IPF rats by regulating glycolysis mediated by the STAT3/HIF-1α signaling pathway.

BACKGROUND:Spondylolisthesis is a common disease,and there is a lack of effective drugs to treat it.There is still a need to further define the pathogenesis and screen out more suitable therapeutic targets for spondylolisthesis.Mendelian randomization analysis can be used to explore the drugable genes associated with spondylolisthesis and provide valuable guidance for the development of more effective and targeted therapeutic drugs.OBJECTIVE:To explore potential therapeutic targets and effective drugs for spondylolisthesis by means of pharmaceutically available genome-wide Mendelian randomization analysis.METHODS:Using the Finnish database,eQTLGen consortium,drug signature database,drug-gene interaction database,protein-protein interaction database,organic small molecule biological activity database and protein structure database,which contains genome and health information of half a million Finns,data on druggable genes were subjected to two-sample Mendelian randomization analysis and co-localization analysis with data from genome-wide association studies of spondylolisthesis to identify genes highly associated with spondylolisthesis.In addition,GO and KEGG enrichment analysis,protein network construction,drug prediction and molecular docking were performed to provide valuable guidance for the development of more effective and targeted therapeutic agents.RESULTS AND CONCLUSION:In this study,we identified 34 potential drug target genes that were significantly associated with spondylolisthesis,particularly the gene APOBEC3G.This gene showed a significant association with spondylolisthesis outcomes through Mendelian analysis and co-localization analysis,suggesting that APOBEC3G may be a priority therapeutic target.As for other potential mechanisms and drugs,we still need to conduct more in-depth research to determine their roles.This study used a database from a European population,which can be used as a reference for the study of population genetics in China.

BACKGROUND:Spondylolisthesis is a common disease,and there is a lack of effective drugs to treat it.There is still a need to further define the pathogenesis and screen out more suitable therapeutic targets for spondylolisthesis.Mendelian randomization analysis can be used to explore the drugable genes associated with spondylolisthesis and provide valuable guidance for the development of more effective and targeted therapeutic drugs.OBJECTIVE:To explore potential therapeutic targets and effective drugs for spondylolisthesis by means of pharmaceutically available genome-wide Mendelian randomization analysis.METHODS:Using the Finnish database,eQTLGen consortium,drug signature database,drug-gene interaction database,protein-protein interaction database,organic small molecule biological activity database and protein structure database,which contains genome and health information of half a million Finns,data on druggable genes were subjected to two-sample Mendelian randomization analysis and co-localization analysis with data from genome-wide association studies of spondylolisthesis to identify genes highly associated with spondylolisthesis.In addition,GO and KEGG enrichment analysis,protein network construction,drug prediction and molecular docking were performed to provide valuable guidance for the development of more effective and targeted therapeutic agents.RESULTS AND CONCLUSION:In this study,we identified 34 potential drug target genes that were significantly associated with spondylolisthesis,particularly the gene APOBEC3G.This gene showed a significant association with spondylolisthesis outcomes through Mendelian analysis and co-localization analysis,suggesting that APOBEC3G may be a priority therapeutic target.As for other potential mechanisms and drugs,we still need to conduct more in-depth research to determine their roles.This study used a database from a European population,which can be used as a reference for the study of population genetics in China.

The high comorbidity and heterogeneity of obsessive-compulsive disorder (OCD) underscore the importance of better understanding its transdiagnostic features. Intolerance of uncertainty (IU), a transdiagnostic negative psychological trait, has been consistently linked to a variety of psychiatric disorders, including OCD. IU is hierarchically structured, comprising general IU, inhibitory IU and prospective IU, each of them potentially relating differently to OCD symptom dimensions. For example, inhibitory IU has shown specific associations with procrastination behaviors. Neuroimaging studies indicate that OCD patients demonstrate abnormal neural activity within the fronto-limbic circuit and salience network, including anterior insula, amygdala and ventromedial prefrontal cortex, during IU-related psychological processes. This review synthesizes findings across three key areas: symptom presentation, neurobiological mechanisms and intervention strategies, aiming to clarify the role of IU in OCD. Furthermore, the potential of targeting IU therapeutically to complement first-line treatment is discussed, ultimately enhancing clinical intervention outcomes.

The high comorbidity and heterogeneity of obsessive-compulsive disorder (OCD) underscore the importance of better understanding its transdiagnostic features. Intolerance of uncertainty (IU), a transdiagnostic negative psychological trait, has been consistently linked to a variety of psychiatric disorders, including OCD. IU is hierarchically structured, comprising general IU, inhibitory IU and prospective IU, each of them potentially relating differently to OCD symptom dimensions. For example, inhibitory IU has shown specific associations with procrastination behaviors. Neuroimaging studies indicate that OCD patients demonstrate abnormal neural activity within the fronto-limbic circuit and salience network, including anterior insula, amygdala and ventromedial prefrontal cortex, during IU-related psychological processes. This review synthesizes findings across three key areas: symptom presentation, neurobiological mechanisms and intervention strategies, aiming to clarify the role of IU in OCD. Furthermore, the potential of targeting IU therapeutically to complement first-line treatment is discussed, ultimately enhancing clinical intervention outcomes.

Objective To explore the predictive value of glucose metabolism and lipid metabolism indexes for in-stent restenosis(ISR)in patients with arteriosclerosis obliterans(ASO)of lower limbs after surgery.Methods A total of 160 patients with ASO of lower limbs admitted to the Second Affiliated Hospital of Zhengzhou University and Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from January 2018 to October 2021 were selected as the research subjects.All patients were treated with percutaneous transluminal angioplasty combined with stent implantation and were followed up for 1 year.Patients were divided into the ISR group(n=59)and the non-ISR group(n=101),according to the incidence of ISR during the follow-up period.General clinical data of patients in the two groups were collected.Univariate analysis was performed to preliminarily screen out the influencing factors for ISR,and the selected indexes were further analyzed by multivariate logistic regression to analyze the influencing factors for the occurrence of ISR in patients with ASO of lower limbs after surgery.The receiver operating characteristic(ROC)curve was used to analyze the value of the glucose metabolism and lipid metabolism indexes one day before discharge alone and their combination in predicting the occurrence of ISR in patients with ASO of lower limbs after surgery.The net benefit rate of predicting the occurrence of ISR in patients with ASO of lower limbs by the levels of glucose metabolism and lipid metabolism indexes one day before discharge alone and their combination was analyzed through the decision curve.Results Among the 160 patients,59 developed ISR,with an incidence rate of 36.88％.There was no significant difference in age,gender,alcohol consumption,complications,affected side,Fontaine stage,fasting plasma glucose,and serum triglycerides of patients between the ISR group and the non-ISR group(P＞0.05);the proportion of smokers and the levels of glycosylated hemoglobin A1c(HbA1c)in peripheral blood and low-density lipoprotein(LDL)in serum of patients in the ISR group were significantly higher than those in the non-ISR group,while the level of high-density lipoprotein(HDL)in serum was significantly lower than that in the non-ISR group(P＜0.05).Multivariate logistic regression analysis showed that the elevated levels of HbA1 c in peripheral blood and LDL in serum were risk factors for ISR in patients with ASO of lower limbs after surgery(odds ratio＞1.00,P＜0.05),and the increased level of HDL in serum was the protective factor for ISR in patients with ASO of limbs after surgery(odds ratio＜1.00,P＜0.05).The ROC curve showed that the area under the curve of peripheral blood HbA1c,serum LDL and HDL levels alone and their combination in predicting the occurrence of ISR in patients with ASO of lower limbs after surgery was 0.717,0.761,0.654,and 0.824,respectively;the specificity was 0.861,0.792,0.851,and 0.663,respectively;and the sensitivity was 0.525,0.678,0.424,and 0.864,respectively.The decision curve showed that the net benefit rate for the combination of peripheral blood HbA1c,serum LDL and HDL levels one day before discharge in predicting the occurrence of ISR in patients with ASO of lower limbs after surgery was higher than that of prediction by the said indexes alone.Conclusion Glucose metabolism index peripheral blood HbA1c and lipid metabolism indexes serum LDL and HDL have certain predictive values for the occurrence of ISR in patients with ASO of lower limbs after surgery,and the net benefit rate of the joint prediction of the three indexes is higher.

Objective:To investigate the clinical characteristics and treatment of patients with perianal necrotizing fasciitis.Methods:This study was a retrospective cohort study. Twenty patients with perianal necrotizing fasciitis who met the inclusion criteria were admitted to the Department of Burn and Plastic Surgery of the First Affiliated Hospital of Guangxi Medical University (hereinafter referred to as our department) from August 2013 to September 2023, including 19 males and 1 female, aged 24-74 (56±11) years. Based on the spreading route of perianal infection to the lower abdomen, the patients were divided into perianal-inguinal-lower abdominal wall group (12 cases) and perianal-pelvic cavity-retroperitoneal group (8 cases). The following clinical data were compared between the two groups of patients: general data, including gender, age, combined underlying diseases, blood glucose level and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score when admitted to our department, and laboratory risk indicator for necrotizing fasciitis (LRINEC) score when admitted to our department and at 14 d after admitted to our department; infection indicators when admitted to our department, including C-reactive protein level, white blood cell count, lymphocyte count, procalcitonin level, and lactic acid level; clinical outcome-related indicators, including time from onset to definite infection range, number of surgery, treatment in intensive care unit (ICU), length of hospital stay, treatment outcome, and recurrence of necrotizing fasciitis during follow-up; detection of pathogen and bacterial drug resistance in wound necrotic tissue specimen when admitted to our department.Results:Compared with those in perianal-inguinal-lower abdominal wall group, the APACHE Ⅱ score and lactic acid level when admitted to our department and LRINEC score at 14 d after admitted to our department (with t values of -5.98, -5.01, and -2.86, respectively, P<0.05) and ICU treatment ratio ( P<0.05) were significantly increased, the time from onset to definite infection range was significantly prolonged ( Z=-3.75, P<0.05), and the number of surgery was significantly increased ( Z=2.80, P<0.05) in patients in perianal-pelvic cavity-retroperitoneal group. There were no statistically significant differences in other data between the two groups of patients ( P>0.05). Eighteen patients were cured, and no recurrence of perianal necrotizing fasciitis was observed during follow-up of 6 months in 18 cured patients. The main bacteria were Escherichia coliand Klebsiella pneumoniae, and the fungui were Aspergillus and Candida albicans detected in wound necrotic tissue specimens in two groups of patients when admitted to our department. The ratio of multiple drug resistance of bacteria in wound necrotic tissue specimens in perianal-pelvic cavity-retroperitoneal group of patients was significantly higher than that in perianal-inguinal-lower abdominal wall group ( P<0.05). Conclusions:Perianal necrotizing fasciitis can spread to the lower abdomen through two routes: the perianal-inguinal-lower abdominal wall route and the perianal-pelvic cavity-retroperitoneal route. The latter is more insidious in disease progression and more challenging in treatment. Establishing a mechanism of multi-disciplinary team diagnosis and treatment can achieve the goal of early diagnosis and precise treatment of perianal necrotizing fasciitis.

[Objective]To comb the origin and flow of the Sachet therapy,chasing the past and thinking of the present,summarize the application characteristics in contemporary Zhejiang school of TCM pediatric fragrance therapy.[Methods]Using the methods of textual research of historical materials,study ancient books,literature analysis and questionnaire survey,trace the origin and development of Sachet therapy,analyze the characteristics of contemporary Zhejiang school of TCM pediatricians using Sachet therapy.[Results]Sachet therapy originated in pre-Qin,Tang,Song and Yuan Dynasties was rapidly improved and developed,and reached its peak in Ming and Qing Dynasties. Zhejiang is located in the southeast coast,the climate is humid,and people like wetland walking and water bath,easy to be invaded by external dampness,so the successive Zhejiang school doctors attach importance to the application of aromatic drugs to wake up the spleen and relieve dampness. After Lin 'an,the capital of the Southern Song Dynasty,Sachet therapy was widely used in court and folk,and had been passed down to the present.The contemporary TCM pediatricians of Zhejiang school inherited the experience of their ancestors,followed the changes of the times,fully integrated the regional characteristics,physical characteristics and humanistic feelings of Zhejiang,and formed the clinical application characteristics of adapting to local conditions,suiting measures according to the time and applying medicine according to the disease.[Conclusion]Sachet therapy has a long history,and contemporary Zhejiang school of TCM pediatricians have formed the characteristics of "three basis" in the long-term clinical application:adapting to local conditions,suiting measures according to the time and applying medicine according to the disease.

Background At present, the practice of pulmonary rehabilitation for pneumoconiosis in China is in a primary stage. The basis for formulating an individualized comprehensive pulmonary rehabilitation plan is still insufficient, which is one of the factors limiting the development of community-level rehabilitation work. Objective To formulate an exercise prescription based on maximum heart rate measured by cardiopulmonary exercise test (CPET), conduct an individualized comprehensive pulmonary rehabilitation program with the exercise prescription for patients with stable pneumoconiosis, and evaluate its role in improving exercise endurance and quality of life, thus provide a basis for the application and promotion of pulmonary rehabilitation. Methods A total of 68 patients were recruited from the Occupational Disease Prevention Hospital of Jinneng Holding Coal Industry Group Co., Ltd. from April to August 2022 , and were divided into an intervention group and a control group by random number table method, with 34 cases in each group. All the pneumoconiosis patients participated in a baseline test. The control group was given routine drug treatment, while the intervention group received multidisciplinary comprehensive pulmonary rehabilitation treatment on the basis of routine drug treatment, including health education, breathing training, exercise training, nutrition guidance, psychological intervention, and sleep management, whose exercise intensity was determined according to the maximum heart rate provided by CPET. The rehabilitation training lasted for 24 weeks. Patients were evaluated at registration and the end of study respectively. CPET was used to measure peak oxygen uptake per kilogram (pVO₂/kg), anaerobic threshold (AT), carbon dioxide equivalent of ventilation (EqCO₂), maximum metabolic equivalent (METs), and maximum work (W_max). The modified British Medical Research Council Dyspnea Questionnaire (mMRC), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Chronic Obstructive Pulmonary Disease Assessment Test (CAT), and Short Form of Health Survey (SF-36) were used to evaluate the potential effect of the comprehensive pulmonary rehabilitation program. Results Among the included 68 patients, 63 patients were having complete data, then 31 cases were assigned in the control group and 32 cases in the interventional group. Before the intervention, there was no significant difference in pVO₂/kg, AT, EqCO₂, METs, or W_max between the two groups (P>0.05). At the end of the trail, the indicators like pVO₂/kg [(19.81±2.38) mL·(min·kg)⁻¹], AT [(14.48±2.33) mL·(min·kg)⁻¹], METs (5.64±0.69), and W_max [(85.25±14) W] of patients in the intervention group were all higher than those [(13.90±2.37) mL·(min·kg)⁻¹, (11.70±1.94) mL·(min kg)⁻¹, (3.97±0.70), and (61.77±14.72) W, respectively] in the control group (P<0.001); there was no significant difference in EqCO₂ between the two groups (P=0.083). Before the trial, there was no significant difference in mMRC, SAS, SDS, PSQI, or CAT scores between the two groups (P>0.05). At the end of the trail, the mMRC score (1.16±0.57), SAS score (27.93±2.12), SDS score (26.48±1.44), PSQI score (1.08±0.88), and CAT score (4.34±3.28) of patients in the intervention group were lower than those [(2.03±0.83), (35.87±6.91), (34.23±6.65), (5.37±3.03), and (13.87±7.53), respectively] in the control group (P<0.001). The SF-36 scores of bodily pain (94.13±10.72), general health (87.50±5.68), vitality (95.31±5.53), mental health (99.88±0.71), and health changes (74.22±4.42) in the intervention group were higher than those [(71.87±32.72), (65.81±15.55), (74.52±16.45), (86.97±16.56), and (29.84±13.50), respectively] in the control group (P<0.001), and no significant difference was found in social functioning and role emotional scores (P>0.05). Conclusion Comprehensive pulmonary rehabilitation can increase the oxygen intake and exercise endurance of pneumoconiosis patients, ameliorate dyspnea symptoms, elevate psychological state and sleep quality, and improve the quality of life.

Background Multi-slice spiral computerized tomography (MSCT) can be used as an auxiliary diagnosis of chest radiography in diagnosis of pneumoconiosis, but there are few studies on the correlations between interstitial images and stage classification of coal workers' pneumoconiosis in the existing literature. Objective To present MSCT imaging manifestations and distribution characteristics of coal workers' pneumoconiosis and complications, evaluate correlations between coal workers' pneumoconiosis stages and pulmonary interstitial lesions, and provide a reliable imaging diagnosis basis for pneumoconiosis interstitial lesions. Methods From June 2022 to June 2023, a total of 1002 patients with coal workers' pneumoconiosis confirmed by the pneumoconiosis diagnostic and identification group in the Department of Occupational Diseases of the Emergency General Hospital were enrolled. MSCT was used to observe the abnormal imaging manifestations of the lungs of coal workers' pneumoconiosis patients and the diseases of pulmonary fibrosis related to their own diseases (thickening of the interlobular septum, bronchial perivascular interstitial mass thickening, parenchymal banding, subpleural line, intralobular interstitial thickening, honeycomb, and subpleural interstitial thickening), the occurrence of coal workers' pneumoconiosis and complications (old tuberculosis, active tuberculosis, pneumonia, atelectasis, lung cancer, bronchiectasis), and the density, size, and location of pneumoconiosis nodules. Imaging data were analyzed and statistically processed. Results All 1002 patients were male, with an average age of (60.71±6.87) years and an average dust exposure time of (23.01±7.80) years. Among them, there were 470 patients with stage I, 422 patients with stage II, and 110 patients with stage III. There were significant differences in the distribution of thickening of the interlobular septum, bronchial perivascular interstitial mass thickening, parenchymal banding, intralobular interstitial thickening, subpleural interstitial thickening, and honeycomb across different stages (P<0.05). Statistically significant differences in p, q, and r subsets of round nodules were found in patients with pneumoconiosis at different stages (P<0.05). Observed nodule types included solid nodules, pure ground-glass shadow nodules, and partial solid nodules. There were statistically significant differences in pulmonary tuberculosis and bronchiectasis among different stages of coal workers' pneumoconiosis (P<0.05). There were statistically significant differences in interstitial shadows and patches combined with interstitial shadows among different stages of pneumoconiosis complicated with pneumonia (P<0.05). Conclusion MSCT provides images of the progression of coal workers' pneumoconiosis and have a certain relationship with the stages of coal workers' pneumoconiosis, which is conducive to the formulation of reasonable treatment plans in the early clinical stage. Therefore, in the diagnosis and treatment of pneumoconiosis, a great attention should be paid to the imaging technology of chest computerized tomography, especially the use of MSCT examination.