Traditional Chinese medicine （TCM）， through its multi-target and systematic regulatory effects， has demonstrated unique advantages in the treatment of gastric precancerous lesions （GPL）. At present， TCM theoretical research on GPL is mainly reflected in three aspects， the integration of macroscopic syndrome differentiation， the inflammation-carcinoma transformation mechanism， as well as the systematization and scientization of theoretical inheritance from famous TCM practitioners. High-quality evidence-based research findings serve as the foundation for clinical practice guidelines on GPL， and TCM has gained international academic recognition in the field of GPL prevention and treatment. Research on TCM mechanisms has yielded a series of important outcomes in the aspects of signaling pathways， gene expression regulation， cellular epigenetics， histone modification， and intestinal microecology. It is proposed that future research on GPL should focus on four key directions， establishing multi-omics data， exploring targeted intervention strategies on key regulatory nodes， advancing the standardization process of integrated traditional Chinese and western medicine prevention and treatment technologies， and constructing stratified screening and intervention platforms. The in-depth integration of TCM microcosmic mechanism of action with its macroscopic syndrome differentiation and treatment system， coupled with interdisciplinary research， will provide valuable references for the clinical treatment and scientific research of GPL.

ObjectiveThis paper aims to explore the risk factors for chronic atrophic gastritis （CAG） with turbidity toxin accumulation syndrome and establish a prediction model. MethodsClinical data of 180 patients with CAG who participated in the "clinical study of Xianglian Huazhuo Particles blocking CAG cancer transformation" of Hebei Sheng Zhong Yi Yuan from July 2021 to March 2022 were collected. After confounding factors were controlled by propensity score matching， patients were divided into a training set （namely dev） and a validation set （namely vad） in a seven to three ratio. The risk factors for CAG with turbidity toxin accumulation syndrome in the training set were investigated by using univariate Logistic regression analysis and least absolute shrinkage and selection operator （namely Lasso） regression algorithms. Subsequently， a model， named model 1se， was developed by using the training set data to predict the risk factors for CAG with turbidity toxin accumulation syndrome. The accuracy of the prediction model was assessed by using various methods， including the receiver operating characteristic （ROC） curve， Hosmer-Lemeshow test （H-L）， calibration plot， and decision curve analysis （DCA）. ResultsAge， body mass index （BMI）， family history of cancer， job and life satisfaction， yellow and greasy fur with slippery pulse， and heavy body sensation were independent risk factors of the model. The prediction model showed excellent predictive value for both the training and validation sets. ConclusionThe established prediction model for CAG with turbidity toxin accumulation syndrome has high discrimination and excellent calibration， which could provide an excellent clinical basis for disease diagnosis and individualized treatment of patients.

ObjectiveThis paper aims to explore the risk factors for chronic atrophic gastritis （CAG） with turbidity toxin accumulation syndrome and establish a prediction model. MethodsClinical data of 180 patients with CAG who participated in the "clinical study of Xianglian Huazhuo Particles blocking CAG cancer transformation" of Hebei Sheng Zhong Yi Yuan from July 2021 to March 2022 were collected. After confounding factors were controlled by propensity score matching， patients were divided into a training set （namely dev） and a validation set （namely vad） in a seven to three ratio. The risk factors for CAG with turbidity toxin accumulation syndrome in the training set were investigated by using univariate Logistic regression analysis and least absolute shrinkage and selection operator （namely Lasso） regression algorithms. Subsequently， a model， named model 1se， was developed by using the training set data to predict the risk factors for CAG with turbidity toxin accumulation syndrome. The accuracy of the prediction model was assessed by using various methods， including the receiver operating characteristic （ROC） curve， Hosmer-Lemeshow test （H-L）， calibration plot， and decision curve analysis （DCA）. ResultsAge， body mass index （BMI）， family history of cancer， job and life satisfaction， yellow and greasy fur with slippery pulse， and heavy body sensation were independent risk factors of the model. The prediction model showed excellent predictive value for both the training and validation sets. ConclusionThe established prediction model for CAG with turbidity toxin accumulation syndrome has high discrimination and excellent calibration， which could provide an excellent clinical basis for disease diagnosis and individualized treatment of patients.

Recently， Gastroenterological Society of Australia convened a multidisciplinary group and applied a modified Delphi process to develop the first Australian consensus statement on the application of transjugular intrahepatic portosystemic shunt （TIPS） in portal hypertension. To address the current issues of insufficient application and a lack of standardized protocols for TIPS in Australia， this consensus provides evidence-based recommendations across the key domains of preoperative preparation and assessment for TIPS， surgical standards， postoperative care and follow-up， and specific clinical indications， in order to provide standardized guidance for the comprehensive management of TIPS in liver disease patients with portal hypertension. This article gives an excerpt of the key statements in the consensus.

Alzheimer's disease(AD)is a chronic neurodegenerative disease that severely affects the quality of life of the elderly.Its main pathological features include the deposition of β-amyloid protein to form senile plaques,neurofibrillary tangles caused by abnormal phosphorylation of tau pro-tein,as well as extensive neuronal loss and synaptic dysfunction.In recent years,mesenchymal stem cells(MSCs)and their exosomes(MSC-Exos)have attracted extensive attention due to their poten-tial in the treatment of neurodegenerative diseases.MSCs possess multidirectional differentiation po-tential,immunomodulatory capacity,and significant neuroprotective and repair effects.As an impor-tant signaling mediator of MSCs,MSC-Exos are a type of nanoscale double-layer membrane-structured vesicles secreted by MSCs,capable of carrying and delivering various bioactive substances.MSCs and their derived MSC-Exos have demonstrated good safety and efficacy in the treatment of AD.This arti-cle systematically reviewed the basic and translational research progress on MSCs and MSC-Exos in the treatment of AD in recent years.

Objective To investigate the effect of serum expression of immune-related guanosine triphosphatase M(IRGM)and Syndecan-1levels in patients with acute ST-segment elevation myocardial infarction(ASTEMI)on the prognosis after percutaneous coronary intervention(PCI).Methods 135 patients with ASTEMI admitted to Suzhou Jiulong Hospital of Shanghai Jiaotong University School of Medicine from January 2021 to January 2023(ASTEMI group)were selected and divided into the poor prognosis group(n=37)and the good prognosis group(n=98)after PCI treatment for 3 months,and 65 physically examined and healthy people(control group)were also selected during the same period.The enzyme-linked immunosorbent assay(ELISA)was used to detect serum IRGM,Syndecan-1 levels,Logistic regression was used to analyze the influencing factors of poor prognosis after PCI in ASTEMI patients,and receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value of serum IRGM,Syndecan-1 levels on poor prognosis after PCI in ASTEMI patients.Results Compared with the control group,serum IRGM(6.17±2.50 ng/ml vs 2.59±0.94 ng/ml),Syndecan-1(420.97±123.65 ng/ml vs 278.89±43.06 ng/ml)levels were higher in the ASTEMI group,and the differences were statistically significant(t=14.628,11.932,all P<0.001).During a three-month follow-up,the incidence of poor prognosis after PCI in 135 patients with ASTEMI was 27.41%(37/135).The age,proportion of KILLIP grade≥II,Gensini score,white blood cell count,LDL-C,IRGM and Syndecan-1 levels in the poor prognosis group were higher than those in the good prognosis group,and the LVEF scores was lower than those in the good prognosis group,and the differences were statistically significant(χ2/t/Z=2.119～8.042,all P<0.05).Independent risk factors for poor prognosis after PCI in patients with ASTEMI were KILLIP classification≥II,high Gensini score,high IRGM,high Syndecan-1,and high LVEF were the independent protective factors(Wald χ2=4.225～11.413,all P<0.05).The AUC(95%CI)of serum IRGM combined with Syndecan-1 level in predicting poor prognosis in patients with ASTEMI after PCI was larger than that of IRGM,and Syndecan-1 alone predictsed poor prognosis,and the differences were statistically significant(Z=3.400,2.905,all P<0.05).Conclusion High serum IRGM,Syndecan-1 level is an independent risk factor for poor prognosis after PCI in pa-tients with ASTEMI,and the combination of serum IRGM,Syndecan-1 level has a high predictive value for it.

Objective This study aims to explore the characteristics and weight loss motivations of patients in the medi-cal nutrition weight loss clinic of a hospital in Ningxia.Methods This study is a cross-sectional study.Patients who visited the medical weight loss clinic at Ningxia Hui Autonomous Region People's Hospital from April to September 2023 were selected as the study subjects.A self-designed questionnaire was used to collect patients'demographic information,lifestyle,weight loss ex-periences,and motivations.The characteristics of weight loss patients were analyzed.Furthermore,the patients were divided into two groups,improvement of health group and improvement of body shape group,based on their weight loss motivations,in order to study the characteristics of different motivational groups.Results A total of 160 subjects were included in the study,with 97 females(60.6％)and 63 males(39.4％).The average age was 29.66±11.89 years,weight was 89.11±16.54 kg,and BM1 was 31.15±4.44 kg/m2.Most patients had comorbidities,with fatty liver being the most common(57.5％),followed by hype-ruricemia(30.6％)and hyperlipidemia(23.8％).Common problems among patients included unhealthy dietary habits,lack of physical activity,and irregular sleep patterns.72.5％of patients had attempted weight loss multiple times,and among different weight loss methods,combined interventions had a higher effectiveness rate,but rebound rates were generally high.In terms of weight loss motivations,81 patients aimed to improve health,while 79 aimed to improve body shape.There were statistically sig-nificant differences(P＜0.05)between the two groups in terms of age,education level,occupation,duration of obesity,and medical history.Conclusion Patients in the medical nutrition weight loss clinic often have comorbidities and have experienced multiple weight loss attempts and weight rebounds.Motivational interviews help patients recognize the dangers of obesity,estab-lish a belief in health,and promote the formation of a healthy lifestyle.

Objective To analyze the practical value of spiral CT three-dimensional reconstruction techniquein evaluating triplane fractures of the distal tibia.Methods A retrospective analysis was conducted on183 patients with triplane fractures of the distal tibia admitted to Sichuan Orthopedic Hospital from January 2021 to March 2023.All patients underwent both X-ray and spiral CT examinations.Taking surgical reduction results as the gold standard for diagnosis,the diagnostic accuracies of X-ray examination and spiral CT three-dimensional reconstruction technique for triplane fractures of the distal tibia were analyzed.Results Fracture classification according to the number of fracture fragments showed that among the 183 patients with triplane fractures of the distal tibial,there were 44 cases of four-part fractures,62 cases of three-part fractures,and 77 cases of two-part fractures.The classification by the location of epiphyseal injury in the distal tibia showed 175 cases of lateral type and 8 cases of medial type.According to whether the fracture line involved the articular surface,they were categorized into 94 cases of type I,60 cases of type II,and 29 cases of type III.For the classification of the number of fracture fragments,X-ray misdiagnosed 9 cases of four-part fractures as three-part or two-part fractures,and 21 cases of three-part fractures as two-part fractures,resulting in a diagnostic accuracy of 83.60%.For theclassification of fracture line and articular surface position,X-ray led to misdiagnosis or inaccurate diagnosis in 39 cases,with a diagnostic accuracy of 78.69%.When spiral CT three-dimensional reconstruction technique was used to classify the number of fracture fragments,only 1 case of four-part fracture was misdiagnosed as three-part fracture,and 2 cases of three-part fractures were misdiagnosed as four-part fractures or two-part fractures,yielding a diagnostic accuracy of 98.36%.For the diagnosis of the positional relationship of the fracture line to the articular surface,spiral CT three-dimensional reconstruction technique had 8 misdiagnoses,with a corresponding diagnostic accuracy of 95.63%.Conclusion Spiral CT three-dimensional reconstruction technique can stereoscopically display the spatial information of the triplane fractures of the distal tibia,such as the location,shape,type,and articular surface,exhibiting high accuracy for classification diagnosis and significant application value in the reduction and treatment of triplane fractures of the distal tibia.

BACKGROUND:Mongolian medicine Echinops sphaerocephalus L.is a commonly used medicine for bone injury in Mongolian medicine.It is effective for tendon injury,fracture,bone nonunion,bone fever,tingling,sore and other diseases.Our previous studies have confirmed that Mongolian medicine Echinops sphaerocephalus L.can promote the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells,but its effect on angiogenesis in the process of bone defect repair is unknown.OBJECTIVE:To investigate the effect of Echinops sphaerocephalus L.on in vitro angiogenesis in human umbilical vein vascular endothelial cells and to explore the angiogenesis-promoting active ingredients and their mechanisms of action of Echinops sphaerocephalus L.using network pharmacology technology.METHODS:The ethanol extract of Echinops sphaerocephalus L.was prepared and preserved by freeze-drying.The proliferation,migration,chemotaxis and angiogenesis of human umbilical vein endothelial cells were observed after treatment with different concentrations(1 000,100,and 10 μg/mL)of Echinops sphaerocephalus L.The active components and possible signaling pathways that promoted angiogenesis were enriched and analyzed by network pharmacology.RESULTS AND CONCLUSION:(1)The effect of Echinops sphaerocephalus L.on angiogenesis was regulated by its mass concentration:at low mass concentration(10 μg/mL),Echinops sphaerocephalus L.could promote the proliferation,migration,chemotaxis and angiogenesis of human umbilical vein vascular endothelial cells;on the contrary,Echinops sphaerocephalus L.inhibited the proliferation,migration,and chemotaxis of human umbilical vein endothelial cells at high mass concentration(1 000 μg/mL).However,the inhibitory effect of Echinops sphaerocephalus L.on angiogenesis was not significant at high mass concentration due to the limitation of experimental time.10 μg/mL Echinops sphaerocephalus L.could up-regulate the mRNA expression of angiogenesis-associated factors,including kinase insert domain receptor,vascular endothelial growth factor A,and hypoxia-inducible factor α,and thereby influenced angiogenesis during bone repair.(2)Network pharmacological analyses indicated that Echinops sphaerocephalus L.may bind to eight core targets(TGFB1,TNF,IL-6,STAT3,CTNNB1,IL-1B,AKT1,and HIF-1A)through four core active components(apigenin,caffeic acid,quercetin,and chlorogenic acid)to exert an effect on angiogenesis,atherosclerosis,multiple viral infections,and tumor angiogenesis-related signaling pathways.

Objective To investigate the effect of fraxetin(FXT)on the malignant biological behavior of ovarian cancer cells by regulating Toll-like receptor 4(TLR4)/signal transducer and activator of transcription 3(STAT3)pathway.Methods Ovarian cancer cell lines SKOV3 and SW626 and ovarian epithelial cell line IOSE80 were treated with different concentrations of FXT(0,10,20,40,60,80 and 100 μmol/L),and the cytotoxicity of FXT was detected by methylthiazolyl diphenyl-tetrazolium bromide(MTT)assay.SKOV3 and SW626 cells were randomly divided into control group,FXT low,medium,high dose(40,60,80 μmol/L)group and FXT(80 μmol/L)+colivelin(STAT3 agonist,0.5 μmol/L)group.Colony formation assay and Transwell assay were used to detect cell proliferation,invasion and migration.The expressions of epithelial-mesenchymal transition and TLR4/STAT3 pathway related proteins were measured by Western blot.Results Compared with IOSE80 cells,SKOV3 and SW626 cell survival gradually decreased with increasing FXT concentration,and the differences were statistically significant(F=134.283,146.831,P<0.001).Compared with the control group,the relative colony lineage rates of SKOV3 and SW626 cells in the FXT low-,medium-and high-dose groups,invasion rate and mobility were reduced(t=4.433～45.909),E-cadherin were increased(t=5.879～17.345),and the expression of N-cadherin,zinc finger transcription factors(snail),vimentin,TLR4,phosphorylated(p)-STAT3/STAT3,cell cycle protein D1(Cyclin D1)and MYC oncogenes(Cancer-myc,C-myc)expression were sequentially reduced(t=7.348～50.117),and the differences were statistically significant(all P<0.01),respectively.Compared with the high-dose FXT group,the relative colony formation rate,cell invasion rate and migration rate of SKOV3 and SW626 cells in the FXT+colivelin group increased(t=9.224～20.703),while the expression of E-cadherin protein decreased(t=3.104,5.041),the expression of N-cadherin,snail,vimentin,TLR4,p-STAT3/STAT3,Cyclin D1,and C-myc increased(t=8.403～42.175),and the differences were statistically significant(all P<0.05),respectively.Conclusion FXT may exert antitumor effects by antagonizing the activation of TLR4/STAT3 signaling pathway and inhibiting ovarian cancer cell proliferation,migration,invasion and epithelial mesenchymal transition.