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.

Objective:To investigate the anti-inflammatory effects of Duhuo Jisheng Decoction on type Ⅱ collagen emulsion induced arthritis (CIA) model rats from the perspective of M1/M2 macrophage balance mediated development of rheumatoid arthritis.Methods:SD rats were divided into a normal group of 8 and a model group of 32. The CIA model was established using collagen antibody induction method for modeling. The successfully modeled rats were randomly divided into model group, methotrexate group, and Duhuo Jisheng Decoction medium- and high-dosage groups using a random number table method, with 8 rats in each group. Duhuo Jisheng Decoction medium- and high-dosage groups were orally administered with Duhuo Jisheng Decoction at dosages of 13.5 and 27.0 g/kg, once a day; methotrexate group received oral administration of 2.0 mg/kg methotrexate twice a week; normal group and model group were given equal volumes of physiological saline by gavage once a day for 28 consecutive days. The general condition of each group of rats was observed, the degree of swelling in the right knee joint was measured, and the arthritis index was scored; HE was used to observe pathological changes in synovial tissue; immunofluorescence was used to detect the expressions of markers CD86 and CD206 in synovial macrophages; Real time PCR was used to detect the mRNA levels of IL-6, TNF-α, IL-10, and TGF-β in synovial tissue.Results:Duhuo Jisheng Decoction could significantly improve the mental state of the rats and reduced the swelling of the knee joints and the arthritis index ( P<0.01). Compared with the model group, the cartilage structure in the knees of rats in the Duhuo Jisheng Decoction group was more intact and clearer. The expression level of the M1 macrophage marker CD86 significantly decreased, and the expression level of the M2 macrophage marker CD206 significantly increased; the mRNA expressions of IL-6 and TNF-α in the knee joint synovial tissue were significantly reduced ( P<0.05), while IL-10 and TGF-β levels significantly increased ( P<0.05). Conclusion:Duhuo Jisheng Decoction may promote macrophage polarization towards M2 type, thereby achieving M1/M2 macrophage balance, alleviating inflammatory response in rheumatoid arthritis rats, and exerting therapeutic effects on rheumatoid arthritis.

Objective To investigate the quality of life status in patients with type 2 diabetes mellitus and its influencing factors,understand their demands for continuous nursing services,analyze the correlation,and provide a reference for formulating and implementing continuous nursing plans for diabetes in the later stage.Methods From May to December 2024,a cross-sectional survey was conducted among 294 patients with type 2 diabetes mellitus in this hospital by using the Self-Rating Anxiety Scale(SAS),the Diabetes Pa-tient-Specific Quality of Life Scale(DSQL),and the Questionnaire on the Need for Continuous Care.Results The SAS score of patients with type 2 diabetes was 45.76±7.45,DSQL score was 54.68±10.99,and the score of continuous care needs was 32.98±5.79.The quality of life of patients with type 2 diabetes mellitus is mainly influenced by factors such as age,family type,educational level,average monthly family in-come,duration of diabetes,blood glucose control,dietary compliance,intensity of physical exercise,and diabet-ic complications.The quality of life of patients with type 2 diabetes mellitus was positively correlated with need for continuous care(P<0.05).Conclusion The quality of life of patients with type 2 diabetes mellitus is influenced by multiple factors and is related to the need for continuous care.Professional continuous care plans can be formulated and implemented based on the needs of patients with type 2 diabetes mellitus.

Enamel demineralization, the formation of white spot lesions, is a common issue in clinical orthodontic treatment. The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment. The prevention, diagnosis, and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties. This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment, advocating for proactive prevention, early detection, timely treatment, scientific follow-up, and multidisciplinary management of white spot lesions throughout the orthodontic process, thereby maintaining the dental health of patients during orthodontic treatment.
Humans ; Consensus ; Dental Caries/etiology* ; Dental Enamel/pathology* ; Tooth Demineralization/etiology* ; Tooth Remineralization

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Limited-stage small cell lung cancer(SCLC)is a highly malignant and rapidly progressing neuroendocrine tumor,while uremia is a complication of the end-stage of chronic renal failure.The patients with SCLC complicated with uremia have poor treatment tolerance,limited options for anti-tumor treatment regimens,and great difficulty in diagnosis and treatment.This study analyzed one case of a 69-year-old male patient with limited-stage SCLC complicated with uremia(with a history of regular hemodialysis,3 times per week),to discuss his first-line treatment regimen,efficacy,and the impact of hemodialysis on the plasma concentrations of the anti-tumor drugs,and reviewed the relevant literature to provide a reference for the treatment of similar patients.The patient was admitted to the hospital due to"cough and hemoptysis for half a month"and was diagnosed with limited-stage SCLC stage ⅢA(T2aN2M0)by computed tomography(CT)and lung puncture biopsy.After discussion by the multi-disciplinary treatment(MDT)team,the patient received 6 cycles of Etoposide(VP-16)+carboplatin chemotherapy combined with adebrelimab immunotherapy,followed by sequential adebrelimab maintenance therapy.The efficacy was evaluated as partial response(PR)and the response is ongoing.During the treatment,level 4 hemoglobin decrease,level 3 neutropenia,and level 2 leukopenia occurred,which were alleviated after symptomatic treatment.The blood concentration monitoring results showed that the plasma concentrations of etoposide and carboplatin increased rapidly during drug infusion,and gradually decreased after the end of infusion.Hemodialysis could rapidly reduce the plasma concentration of carboplatin,but had no significant effect on the plasma concentration of etoposide.Therefore,the immunotherapy combined with reduced-dose chemotherapy regimen is safe and effective for this type of patient.Plasma drug concentration monitoring can be used to observe drug metabolism,but the optimal monitoring time points and clinical value need further study and validation.

Objective To assess the global and Chinese disease burden of early-onset lung cancer(di-agnosed in patients aged 15-49 years)and its major risk factors.Methods Based on the GLOBOCAN 2022 and Global Burden of Disease(GBD)2021 datasets,we evaluated the disease burden and associated risk fac-tors of early-onset lung cancer globally and in China,stratified by age,sex,geographic location,and human development index(HDI).Key indicators included age-standardized incidence rate(ASIR),age-standardized mortality rate(ASMR),and disability adjusted life years(DALYs)attributable to risk factors.Results In 2022,there were 137 705 new cases and 72 646 deaths from early-onset lung cancer globally,with ASIR and ASMR of 3.43 per 100 000 and 1.82 per 100 000 population,respectively.The disease burden was higher in males than in females(ASIR:3.72 per 100 000 vs.3.14 per 100 000;ASMR:2.31 per 100 000 vs.1.33 per 100 000).High-HDI regions exhibited the highest ASIR(5.51 per 100 000)and ASMR(2.57 per 100 000),with health inequality analysis revealing a concentration of disease burden in higher-HDI areas.China bore the heaviest burden,accounting for 48.69%of global new cases and 35.77%of deaths.China's ASIR(8.21 per 100 000)and ASMR(3.17 per 100 000)exceeded global averages,with incidence higher in fe-males(8.78 per 100 000 vs.7.67 per 100 000)but mortality higher in males(4.01 per 100 000 vs.2.29 per 100 000).Smoking and ambient particulate matter pollution were the leading risk factors globally(DALYs contribution:42.01%and15.62%)and in China(DALYs contribution:46.78%and 20.84%).Globally,household air pollution ranked third,whereas in China,secondhand smoke replaced it as the third leading risk factor,with household air pollution dropping to fifth.Risk factor profiles varied significantly across age groups,with modifiable risks contributing less to disease burden in the 15-24 age group.Conclusions The burden of early-onset lung cancer varies markedly by sex,region,and HDI,with China facing a disproportionately high burden.Policymakers should prioritize equitable resource allocation and targeted interventions,particularly in tobacco control and air pollution mitigation,to enhance cancer prevention and control efforts.

As a pediatric radiation oncologist, it is necessary to master and evaluate the sedative/anesthesia indications, adverse reactions and solutions and deliver whole-course management of sedation/anesthesia in pediatric radiotherapy under sedation. Although significant progress has been made in sedation/anesthesia, the psychological stress and family burden of sedation/anesthesia still exist. There is still great research potential in the field of investigating effective nonpharmacological interventions to reduce sedation/anesthesia use. In this article, the issues and challenges of sedative management and complications of pediatric radiotherapy and interventions for reducing sedation/anesthesia of radiotherapy were reviewed.

Objective Based on the SWOT analysis method,the temporary medical order dispensing service model of pharmacy intravenous admixture service(PIVAS)of M Hospital was constructed and its implementation effect was evaluated,so as to provide reference for other medical institutions to carry out PIVAS temporary dispensing services.Methods SWOT analysis was used to analyze the advantages,disadvantages,opportunities and threats of PIVAS in M Hospital,and targeted operation strategies and practices were proposed.The safety of intravenous medication,the level of pharmacy service and the cost-effectiveness of the department were used to evaluate the implementation effect of PIVAS temporary medical order dispensing service.Results After the operation strategy of PIVAS temporary medical order dispensing service was constructed and implemented based on SWOT analysis,the time of a single medical order for PIVAS labeling in M Hospital was significantly decreased from(7.19±0.06)s/bag to(6.06±0.09)s/bag(P＜0.05);and the number of errors was significantly reduced from(32.50±2.54)pieces/quarter to(19.75±0.59)pieces/quarter(P＜0.05);The qualified rate of temporary prescription increased from(60.52±1.17)％to(90.63±1.72)％(P＜0.05);The qualified rate of finished infusion delivery time increased from(80.63±1.66)％to(90.80±2.98)％(P＜0.05);The satisfaction rate of PIVAS service in the ward increased from 50％to 90％(P＜0.05);the cost of blending decreased from(3.50±0.05)yuan/bag to(3.00±0.12)yuan/bag(P＜0.05).Conclusion The operation strategy of PIVAS temporary medical order dispensing service of M Hospital based on SWOT analysis gives full play to its own advantages,provides more comprehensive and high-quality services for clinicians and patients,ensures the safety and timeliness of patients' medication,and improves the economic efficiency of the department,which is worthy of reference and promotion.

Objective To explore the effects and potential mechanism of electroacupuncture at acute phase on cognitive dysfunction at later stage in rats with middle cerebral artery occlusion(MCAO).Methods Totally 39 SD rats were randomly divided into sham-operation group,model group and electroacupuncture group,with 13 rats in each group.MCAO model was established by Zea Longa thread embolism method in model group and electroacupuncture group.The sham-operation group only separated blood vessels.Electroacupuncture group was treated with electroacupuncture at"Baihui"and"Shenting"acupoints at 5 min and 6 h after model establishment respectively,for 30 min.The body mass,modified neuropathy severity scale(mNSS),and percentage of stiff immobility time of rats were monitored weekly,Nissl staining was used to observe the morphology of hippocampal tissue on the 28 d,immunofluorescence staining was used to detect the expression of Ki67,dual cortin(DCX)and neuronal differentiation factor 1(NeuroD1)in dentate gyrus of the hippocampus,the expression of synaptic vesicle protein 2A(SV2A)protein in dentate gyrus of hippocampus was detected by Western blot.Results Compared with the sham-operation group,on the first day after operation,the body mass of the model group rats decreased,then gradually increased,and on the 28th day,the body mass was still lower than that of the sham-operation group(P<0.05);on the first day after operation,the mNSS score significantly increased,gradually decreased thereafter,and remained higher than the sham-operation group until the 28th day(P<0.01);the percentage of stiff immobility time significantly decreased on the first day after operation,gradually stabilized,and remained lower than the sham-operation group on the 28th day(P<0.05);the hippocampal tissue structure was significantly damaged,and the density of Ki67+DCX+NeuroD1 positive cells in the dentate gyrus of hippocampus was significantly increased(P<0.05),the expression of SV2A protein in the dentate gyrus of hippocampal was significantly decreased(P<0.05).Compared with the model group,the body mass of rats in the electroacupuncture group showed an increasing trend(P<0.05),the mNSS score decreased(P<0.01),and the percentage of stiff immobility time increased(P<0.05);the ischemic injury area was significantly reduced,the structure was clearer,and the disordered and irregularly cells arrangement were reduced,the density of Ki67+DCX+NeuroD1 positive cells in the dentate gyrus of hippocampus significantly increased(P<0.05),and the expression of SV2A protein in the dentate gyrus of hippocampal significantly increased(P<0.05).Conclusion Electroacupuncture at acute phase at"Baihui"and"Shenting"can promote the recovery of cognitive dysfunction in MCAO rats in the later stage,and its mechanism may be related to enhancing the proliferation and differentiation of neural precursor cells in the dentate gyrus of hippocampus,promoting neurogenesis.