ObjectiveTo explore the potential mechanism of Changji'an Formula （肠激安方） on intestinal permeability for rats with diarrhea-predominant irritable bowel syndrome （IBS-D） of liver depression and spleen deficiency syndrome by the microRNA-29b-3p （miR-29b-3p）/tumor necrosis factor receptor-associated factor 3 （TRAF3）/nuclear factor-κB （NF-κB）/myosin light chain kinase （MLCK） axis. MethodsTwenty-four 1-day-old male Sprague-Dawley （SD） suckling rats were selected， and the IBS-D rat model of liver depression and spleen deficiency syndrome was established via a three-factor method，i.e. maternal separation plus acetic acid stimulation and restraint stress， for 6 consecutive weeks. After successful modeling， the rats were randomly divided into a model group， pinaverium bromide group， low-dose and high-dose Changji'an Formula groups， with 6 rats in each group. Another 6 age-matched non-modeled SD rats were included as the control group. The low-dose and high-dose Changji'an Formula groups were given intragastric administration of Changji'an Formula solution at doses of 16.74 g/（kg·d） and 33.48 g/（kg·d）， respectively； the pinaverium bromide group received intragastric administration of pinaverium bromide tablets at 0.018 g/（kg·d）； and the control group was given distilled water at 10 ml/（kg·d） via intragastric gavage. The intervention was conducted once daily for 14 consecutive days. After the gavage treatment， the fecal water content of rats in each group was measured. Enzyme-linked immunosorbent assay （ELISA） was used to detect the serum levels of intestinal permeability indicators， including D-lactic acid （D-LA）， diamine oxidase （DAO）， and lipopolysaccharide （LPS）. Quantitative real-time polymerase chain reaction （qRT-PCR） was conducted to determine the mRNA expression levels of miR-29b-3p， TRAF3， tumor necrosis factor-α （TNF-α）， p65， p50， and MLCK in colonic tissues. Western Blot analysis was employed to detect the protein expression levels of TRAF3， TNF-α， p65， phosphorylated p65 （p-p65）， MLCK， myosin light chain （MLC）， phosphorylated MLC （p-MLC）， and tight junction proteins including junctional adhesion molecule-A （JAM-A）， Occludin， and Claudin-1 in colonic tissues. ResultsCompared with the control group， the model group exhibited significantly increased fecal water content and serum levels of D-LA， DAO， and LPS， along with decreased protein expression levels of JAM-A， Occludin， and Claudin-1 in colonic tissues （P＜0.05 or P＜0.01）. Additionally， in the model group， the mRNA expression levels of miR-29b-3p， TNF-α， p65， p50， and MLCK in colonic tissues were up-regulated， while the mRNA and protein expression levels of TRAF3 were down-regulated； the protein levels of TNF-α and MLCK， as well as the ratios of p-p65/p65 and p-MLC/MLC， significantly elevated （P＜0.01）. Compared with the model group， all treatment groups showed reduced fecal water content and serum levels of D-LA， DAO， and LPS， along with down-regulated mRNA expression levels of miR-29b-3p， TNF-α， p65， p50， and MLCK， and up-regulated TRAF3 mRNA expression in colonic tissues. Moreover， the pinaverium bromide group and high-dose Changji'an Formula group presented increased protein levels of Occludin， Claudin-1， and TRAF3， as well as decreased protein levels of TNF-α and MLCK， and reduced ratios of p-p65/p65 and p-MLC/MLC in colonic tissues （P＜0.05 or P＜0.01）. Compared with the low-dose Changji'an Formula group， the high-dose group had lower fecal water content and serum levels of DAO and LPS （P＜0.01）. In comparison with the pinaverium bromide group， the high-dose Changji'an Formula group showed a significant decrease in serum DAO level （P＜0.01）. ConclusionsChangji'an Formula can reduce intestinal permeability and restore intestinal barrier function in IBS-D rats of liver depression and spleen deficiency syndrome by regulating the miR-29b-3p/TRAF3/NF-κB/MLCK axis.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Acute pancreatitis(AP)is a frequently encountered acute abdominal syndrome in clinical settings,and the integrated model of traditional Chinese and Western medicine(TCM-WM)has demonstrated notable advantages in the diagnosis and treatment of AP.To systematize and standardize clinical practices related to develop clinical pathway for integrated TCM-WM diagnosis and treatment of AP,which enhances the efficiency and quality of patient care.This pathway focuses on AP,a common acute and life-threatening disease within the digestive system,and outlines that the central pathological mechanism involves pancreatic injury and localized inflammation resulting from the abnormal activation of pancreatic enzymes.It has the characteristics of rapid onset,multiple causes,and complex manifestations.Severe cases can be life-threatening.At present,conventional treatments encompass a diverse range of modalities.Moreover,traditional Chinese medicine(TCM)holds distinct advantages in alleviating relevant symptoms,and TCM-WM is gaining increasing prevalence.To enhance the standardization and consistency of diagnostic and therapeutic practices,this clinical pathway clearly delineates the target patient population,which includes individuals diagnosed with abdominal pain disorder according to TCM and with AP in accordance with WM criteria,as well as the corresponding inclusion standards.The diagnostic framework integrates both TCM and WM guidelines,and further incorporates disease staging,severity grading,and syndrome differentiation to support a comprehensive and integrated diagnostic strategy.The treatment integrates approaches from both TCM and WM.Within the WM framework,interventions consist of basic supportive care,infection control,nutritional support,and the management of complications.In the context of TCM,the protocol includes syndrome differentiation and corresponding therapeutic strategies(Distinct syndrome patterns are identified and managed during the acute and convalescent phases),such as acupuncture and retention enema.This clinical pathway addresses multiple key components,including preventive strategies,post-treatment follow-up,criteria for evaluating therapeutic efficacy,admission and discharge,admission examination protocols,discharge criteria,and the rationale for deviations or withdrawal from the pathway.It is designed to provide a systematic and standardized reference framework for relevant clinical practices.

Objective To design a Five-Elements Music Software based on Traditional Chinese Medicine's(TCM)theory of five elements music therapy and music emotion classification.The software is intended to provide appropriate music selections tailored to the negative emotional states of cancer patients and evaluate its effectiveness in psychological rehabilitation.Methods ①Music screening and classification:Qualitative analysis was used by six experts in TCM,psychology,nursing,and musicology to screen five elements music and classify corresponding emotional categories.②Software design and development:Based on screening and classification of music materials,design and develop a"Five Elements Music Software Based on Emotion Classification".③Software application evaluation:Recruit 50 cancer patients from the"Beijing Anti Cancer Paradise"as participants to have a trial listening experience with music software,and fill out a satisfaction questionnaire to evaluate its application effect.Results This study established a music database containing 150 pieces of five-elements musical tunes and completed the classification of emotional categories.Among the included subjects,80%of the recruited objects were satisfied with the experience of the five elements music software,of which the application experience of female patients was significantly better than that of male patients,and breast cancer patients were better than other cancer patients,with a statistically significant difference(P<0.05).The five elements music Software in clinic showed comparing with other two groups after four weeks,there was a significant difference for HAMD when comparing five elements music software group and the other two groups(P<0.05).Conclusion The five-element music software designed based on emotion classification effectively meets the psychological rehabilitation needs of cancer patients.It provides appropriate music selections and convenient listening method to regulate cancer-related negative emotions,extending psychological rehabilitation from the hospital to the home.

Objective To evaluate the efficacy of human papillomavirus E6/E7(HPV E6/E7)mRNA combined with colposcopy in screening cervical cancer and precancerous lesions.Methods A total of 480 patients with suspected cervical precancerous lesions in the hospital from July 2022 to De-cember 2024 were retrospectively selected as research objects.All the patients underwent HPV E6/E7 mRNA testing,colposcopy,and pathological examination.Taking the pathological examination results as the diagnostic golden standard,the diagnostic values of HPV E6/E7 mRNA and colposcopy alone as well as their combination were analyzed.Results The pathological examination results of 480 pa-tients showed that there were 192 negative cases,including 1 case of normal cervix and 191 cases of benign lesions;there were 288 positive cases,including 133 cases of low-grade squamous intraepithe-lial lesions(LSIL),110 cases of high-grade squamousintraepithelial lesions(HSIL),and 45 cases of cervical squamous cell carcinoma(SCC).The colposcopy results showed 211 true-positive cases and 138 true-negative cases;the HPV E6/E7 mRNA test results showed 199 true-positive cases and 137 true-negative cases;the combined test results showed 239 true-positive cases and 174 true-negative cases.The sensitivity(95.22％),specificity(75.98％),accuracy(86.04％),positive predic-tive value(81.29％),and negative predictive value(93.55％)of the combined test were signifi-cantly higher than those of each individual test(P＜0.001).Moreover,the consistency between the combined test and pathological results(Kappa=0.718,P＜0.001)was also significantly high-er than that of each individual test.Conclusion Compared with HPV E6/E7 mRNA or colposcopy alone,the combined test has higher clinical application value in screening of cervical precancerous lesions and cervical cancer,shows stronger consistency with pathological results,and is of great sig-nificance for the early differential diagnosis of cervical precancerous lesions and cervical cancer.

OBJECTIVE: To investigate the genetic characteristics and clinical utility of Optical genome mapping (OGM) in resolving complex genomic rearrangements in families with recurrent pregnancy loss. METHODS: A recurrent miscarriage family which presented at both the People's Hospital of Qianxinan Buyi and Miao Autonomous Prefecture and the Affiliated Women and Children's Hospital of Ningbo University in September 2024 was selected as the study subject. Relevant clinical information was collected. Peripheral blood samples of the couple were collected for G banding karyotyping analysis, and copy number variation sequencing (CNV-seq) and OGM were used for verification. This study was approved by the Medical Ethics Committee of the Affiliated Women and Children's Hospital of Ningbo University (Ethics No.: EC2024-148). RESULTS: CNV-seq in an external hospital detected a 10.67 Mb deletion in the 16q12.1q21 region, a 142.4 kb deletion in the 5p15.2 region, and a 359.55 kb duplication in the 7p22.2 region. No abnormality was found in the chromosomal karyotype of the male partner, and the initial karyotyping of the female partner suggested 46,XX,?del(16)(q12.1q22). The CNV-seq verification of her indicated only variations in the 5p15.2 and 7p22.2 fragments, and no deletion of 16q was detected. As indicated by precise OGM analysis, multiple intrachromosomal and interchromosomal translocation variations had occurred between chromosomes 10 and 16 in the female partner, with complex balanced rearrangements (including 5 transchromosomal breakpoints). CONCLUSION The complex balanced rearrangements of the female partner's chromosomes had occurred during meiosis, the resultant unbalanced gametes may be the cause of repeated miscarriage in this family. OGM can delineate complex rearrangement breakpoints and directions that are difficult to reveal by conventional karyotyping analysis and provide a basis for accurate reproductive genetic counseling.
Humans ; Abortion, Habitual/etiology* ; Female ; Pregnancy ; Male ; DNA Copy Number Variations/genetics* ; Adult ; Karyotyping ; Pedigree ; Gene Rearrangement ; Chromosome Mapping

Objective To analyze the electromyography(EMG)characteristics of high-level male speed climbers using Tomoa skip technique,and provide a theoretical basis for the determination of special strength training methods and means.Methods Ten male speed climbers at national first level or above were recruited,and their kinematics and surface EMG signal data using Tomoa skip technique during climbing the official route were collected.Results For using Tomoa skip technique,the order of the main muscle contribution rate for high-level male speed climbers was biceps brachii,triceps brachii,flexor digitorum superficialis,latissimus dorsi,anterior tibial,vastus lateralis,gluteus maximus,medial head of gastrocnemius muscle.The sum of all muscle contribution rates of the left side,the contribution rate of biceps brachii and triceps brachii were significantly lower than that of the right side(P＜0 05).The contribution rate of medial head of left gastrocnemius muscle was significantly higher than that of right side(P＜0.05).The level of activation of the left biceps brachii was significantly lower than that of the right side(P＜0.05).The co-contraction indexes of left elbow joint and ankle joint,right elbow joint and ankle joint were 0.93±0.21,1.33±0.14,0.72±0.10,2.08±0.59,respectively.The co-contraction level of the left elbow joint and ankle joint was significantly higher than that of the right side(P＜0.05).Conclusions High-level male speed climbers using Tomoa skip technique showed obvious EMG characteristics,and the contribution rate of the upper limb muscles and latissimus dorsi were higher than that of the lower limb.The activation mode of elbow joint was dominated by biceps brachii,and that of ankle joint was dominated by anterior tibial muscle.There exsited differences between the left and right limbs in coordinated movement modes.The difference of contribution rate and activation level of the upper limb between the left and right side was more than that of the lower limb.

Objective To explore the impacts of different surgical methods under hysteroscopy on the surgical time and endometrial thickness of patients with endometrial polyp(EP).Methods 180 patients with EP from April 2021 to April 2023 were regarded as the subjects.They were separated into group A,group B,and group C according to surgical methods,with 60 cases in each.Group A underwent hysteroscopic resection,group B underwent hysteroscopic cold knife surgery,and group C underwent hysteroscopic curettage surgery.The pictorial blood loss assessment chart(PBAC)score before and after treatment,endometrial lesion,intraoperative bleeding volume,hospitalization time,surgical time,hospitalization cost,clinical efficacy,complications,pregnancy rate and recurrence rate were compared.Results The intraoperative bleeding volume in group C was obviously less than that in group A and group B,hospitalization time,and surgical time were obviously shorter than those in group A and group B,and the hospitalization cost was obviously higher than that in group A and group B,the differences were statistically significant(P<0.05).The PBAC score in groups C was obviously less than that in group A and group B,the endometrial thickness was obviously smaller than that in group A and group B,the differences were statistically significant(P<0.05).The clinical efficacy of group A was obviously lower than that of group B and group C,the differences were statistically significant(P<0.05),and there was no statistically obvious difference between group B and group C(P>0.05).The complication rate in group C and group B were obviously less than that in group A(P<0.05),and there was no statistically obvious difference between group B and group C(P>0.05).The recurrence rate within 12 months in three groups was not statistically significant(P>0.05).The pregnancy rate in group C was obviously higher than that in group B and group A,and group B was higher than group A,the differences were statistically significant(P<0.05).Conclusion Hysteroscopic curettage is more effective in clearing lesions,shortening surgical time,reducing intraoperative bleeding,lowering endometrial thickness,and promoting menstrual recovery in patients compared to other hysteroscopic surgical methods,with high safety.

AIM:To establish a cell model of visceral hypersensitivity and nerve hyperplasia in irritable bowel syndrome(IBS)by conducting an in vitro co-culture of mouse P815 mast cells and N2a nerve cells and explore its possible mechanism.METHODS:Enzyme-linked immunosorbent assay(ELISA)with three replicates was used to confirm the C48/80-induced P815 degranulation.The length of neurites was observed under bright field microscopy to determine the number of differentiated neurons,thereby selecting the concentration of retinoic acid(RA)for stimulating the differentia-tion of N2a cells,with four replicates.A co-culture system of P815 and N2a cells was established using Transwell cham-bers with four replicates.The following groups were established:N2a cells cultured alone,N2a cells co-cultured with P815 cells,N2a cells co-cultured with P815 cells plus C48/80,and N2a cells plus RA group.After co-culturing,the num-ber of differentiated N2a cells was observed under bright field.The expression of nerve growth factor(NGF),tyrosine ki-nase receptor A(TRKA),growth-associated protein-43(GAP43),neuron-specific enolase(NSE),synapsin(SYN),and postsynaptic density protein-95(PSD-95)at both protein and gene levels in N2a cells was detected using Western blot and polymerase chain reaction(PCR),with four replicates.RESULTS:The best condition for N2a differentiation was stimulation with 10 μmol/L RA for 24 hours,whereas the best condition for degranulation was stimulation of P815 cells with 20 mg/L C48/80 for 24 hours.Compared with N2a cells cultured alone,the differentiation ratio of the N2a+P815+C48/80 and N2a+RA groups was significantly increased(P<0.01),and the protein and mRNA expressions of NGF,TRKA,GAP43,NSE,SYN,and PSD-95 were significantly increased(P<0.05).CONCLUSION:Our results revealed that mast cell degranulation enhances the level of nerve hyperplasia in enteric nerve cells and promotes changes in nerve structure and function.Synaptic remodeling regulated by abnormal expression of key proteins such as NGF,TRKA,and GAP43 is involved in the nerve hyperplasia induced by mast cell degranulation.

Objective:To investigate the application effect of BOPPPS+team-based learning (TBL) based on the concept of outcome-based education (OBE) in the teaching of infectious rash and fever illnesses in children.Methods:A total of 199 undergraduate students of the class 2019 in the five-year program of Department of Pediatrics in Chongqing Medical University were selected as subjects, and they were divided into experimental group with 99 students and control group with 100 students using a random number table. The students in the experimental group received BOPPPS+TBL teaching based on the OBE concept, while those in the control group received traditional teaching. After the end of the curriculum, scores were compared between the two groups, and a questionnaire survey was conducted for self-evaluation of teaching and learning effectiveness and the acceptance of teaching models. SPSS 22.0 was used to perform the t-test and the chi-square test. Results:The experimental group had a significantly higher score of the course than the control group [(88.08±5.31) vs. (85.62±8.44), P=0.014]. The questionnaire survey showed that compared with the control group, the experimental group had significantly higher scores of the self-evaluation of teaching effectiveness [(4.40±0.75) vs. (3.36±1.13), P<0.001] and learning effectiveness [(4.31±0.84) vs. (3.35±1.19), P<0.001]. In the experimental group, 96.96% (96/99) of the students believed that BOPPPS+TBL teaching based on the OBE concept could help students to master and understand the knowledge points, and 93.93% (93/99) of the students were willing to use this teaching model in future learning. Conclusions:BOPPPS+TBL teaching based on the OBE concept can help to achieve teaching objectives and significantly improve student satisfaction and learning outcomes.