Rheumatoid arthritis （RA） is a common chronic systemic autoimmune disease with synovitis as the main manifestation， which often causes joint swelling and pain or even deformity. It is considered to be an incurable lifelong disease. Although the current Western medicine treatment can alleviate the progression of the disease， it has the clinical limitations of liver injury， cardiovascular complications， and other adverse reactions， along with easy recurrence. Traditional Chinese medicine （TCM） has a long history and has the advantages of individualized treatment and fewer adverse reactions. It can effectively relieve the symptoms of joint swelling and pain in RA patients and slow down the progression of bone destruction， which has attracted wide concern in the medical community. Janus kinase （JAK）/signal transducer and activator of transcription （STAT） signaling pathway is an important intracellular pathway involved in cell proliferation， differentiation， apoptosis， immune regulation， and other biological behaviors， and plays an important role in the pathophysiological process of RA. In recent years， many studies have confirmed that TCM monomers and compounds can inhibit inflammation and angiogenesis by regulating the JAK/STAT signaling pathway， induce apoptosis and inhibit proliferation of fibroblast-like synoviocytes （FLS）， regulate immune response， and thus exert an effect in the treatment of RA. However， there is still a lack of comprehensive and systematic induction and overview. Therefore， by searching the relevant literature in China National Knowledge Infrastructure （CNKI） and PubMed databases from 2009 to 2024， this study described the mechanism of the JAK/STAT signaling pathway in the occurrence and development of RA and summarized the research progress of TCM monomers and compounds in regulating the JAK/STAT signaling pathway in RA intervention. The study aims to provide new ideas and strategies for the clinical treatment of RA with TCM and the research and development of new drugs.

Dry eye disease(DED)is a common ocular surface disorder worldwide, primarily characterized by a loss of homeostasis of the tear film, and frequently associated with meibomian gland dysfunction(MGD), decreased tear film stability, ocular discomfort, and visual impairment. In recent years, factors such as the widespread use of digital devices,the aging population, and environmental changes have contributed to a significant increase in its global prevalence, making it a major public health concern. Red light therapy(RLT), also known as low-level laser therapy(LLLT)or photobiomodulation(PBM), is a non-invasive treatment that utilizes low-energy red or near-infrared light to irradiate tissues. It exerts photobiomodulatory effects to promote cellular repair and functional recovery. This therapy has demonstrated considerable potential in treating various ocular conditions. Its broader clinical application could improve therapeutic outcomes, alleviate patient discomfort and financial burden, and reduce the consumption of healthcare resources, thereby yielding significant socio-economic benefits. This paper systematically reviews the multifaceted mechanisms and application prospects of RLT in managing DED, including its anti-inflammatory effects, improvement of meibomian gland function, promotion of conjunctival goblet cell repair, and alleviation of visual fatigue, aiming to provide a theoretical foundation and practical reference for its clinical adoption.

ObjectiveTo evaluate the clinical efficacy and safety of acupuncture in treating severe Bell's palsy and to explore its potential mechanism by investigating the effect on serum levels of glial cell line-derived neurotrophic factor （GDNF） and nerve growth factor （NGF）. MethodsA randomized， subject-blinded， sham-acupuncture controlled trial was conducted. A total of 130 patients with severe Bell's palsy were randomly allocated into a treatment group or a control group at a 1∶1 ratio. Both groups received conventional western medicine. In addition， the treatment group received acupuncture， while the control group received sham acupuncture， with each session lasting 30 minutes. The treatment course lasted 8 weeks for both groups， followed by a follow-up assessment at week 12. The primary outcome was the proportion of patients achieving House-Brackmann （H-B） grade Ⅱ or lower at week 8. Secondary outcomes included Sunnybrook facial grading system scores at week 0， 4， 8， and 12， the time to satisfactory recovery（the time required to achieve H-B grade≤Ⅱ）， distribution of H-B grades and facial disability index （FDI） scores including the physical function subscale （FDIP） and social/well-being function subscale （FDIS） scores at week 0， 4， 8， and 12， and serum GDNF and NGF levels at week 0， 4， and 8. Adverse events and participants' self-assessments of treatment efficacy were also recorded. ResultsA total of 122 participants completed the study， including 62 in the treatment group and 60 in the control group. An intention-to-treat （ITT） analysis was performed， and missing data were handled using the last observation carried forward （LOCF） method. The proportion of patients achieving H-B grade ≤grade Ⅱ at week 8 was 78.5% （51/65） in the treatment group， significantly higher than 49.2% （32/65） in the control group （P＜0.05）. The Sunnybrook scores， FDIP and FDIS scores increased， while H-B grades decreased at week 4， 8， and 12 in both groups compared to week 0； moreover， improvements in all outcome measures were significantly greater in the treatment group than in the control group （P＜0.05）. The median time to satisfactory recovery was 6 weeks （95%CI： 5.697-6.303） in the treatment group， significantly shorter than 12 weeks （95%CI： 8.314-15.686） in the control group （P＜0.05）. Serum levels of GDNF and NGF were significantly higher in the treatment group at weeks 4 and 8 （P＜0.05）. No serious acupuncture-related adverse events occurred in either group. Adverse events were reported in 5 patients （7.69%） in the treatment group and 4 patients （6.15%） in the control group， with no statistically significant difference between groups （P＞0.05）. Patients' self-assessment of treatment efficacy after 8 weeks treatment was significantly better in the treatment group （P＜0.05）. ConclusionAcupuncture can effectively improve facial nerve function and shorten recovery time in patients with severe Bell's palsy， with a favorable safety profile. The therapeutic mechanism may be associated with the upregulation of serum GDNF and NGF levels.

Renal fibrosis represents the pivotal pathological process driving the progression of chronic kidney disease (CKD) towards end-stage renal disease. Its core manifestations include chronic inflammation, excessive deposition of extracellular matrix (ECM), and tubulointerstitial injury resulting in functional deterioration. Emerging research on the molecular mechanisms underlying renal fibrosis has established that, beyond the canonical Smad-dependent pathway, transforming growth factor-β1 (TGF-β1) also modulates fibrogenesis through non-canonical signaling pathways, notably the mitogen-activated protein kinase (MAPK) and phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) cascades. These non-canonical pathways engage in crosstalk with the canonical Smad pathway, synergistically regulating key processes such as ECM metabolism, inflammatory responses, and epithelial-mesenchymal transition (EMT), thereby collectively orchestrating the initiation and progression of renal fibrosis. Notably, various active components derived from traditional Chinese medicine have demonstrated anti-fibrotic efficacy by modulating these pathways, highlighting their promising multi-target therapeutic potential. This review aims to systematically summarize recent advances in understanding the roles of TGF-β1-mediated MAPK and PI3K/Akt non-canonical signaling pathways in renal fibrosis and to discuss potential therapeutic strategies targeting these pathways.

[Objective] To explore the feasibility of using whole blood as a source of NK cells for allogeneic CAR NK cell therapy and activated NK cell reinfusion therapy, and initially construct a technical system for the separation and purification of NK cells from whole blood. [Methods] All peripheral blood mononuclear cells (PBMCs) were enriched from 400 mL of whole blood by manual separation and machine separation, respectively. The erythrocyte loss rate, PBMCs number, NK cell purity of the two methods were compared. NK cells were sorted from PBMCs by three separation and enrichment methods as immunomagnetic bead negative selection method, platelet lysate culture expansion and PERCOLL density gradient separation method, and the purity and yield of NK cells, the activity of NK cells and the tumor-killing ability of the three separation and enrichment methods were compared. [Results] The proportion of NK cells in the lymphocyte population was higher in the manual separation method than in the machine separation method[(13.16±5.16)% vs (8.56±3.92)%, P<0.05]; the number PBMCs was lower in the manual separation method than in the machine separation method[(4.09±1.80)×10⁸vs (6.49±2.16)×10⁸, P<0.05], and there was no difference in the red blood cell loss between the two methods (P>0.05). The purity of NK cells isolated and enriched from PBMCs by manual separation method using immunomagnetic was (96.77±2.31)%; the yield was (56.27±10.47)%; the inhibition of tumor proliferation was (38.67±14.05)%; and the tumor killing rate was (19.90±8.05)%. The purity of NK cells isolated and enriched from PBMCs by manual separation method using platelet lysis culture expansion method was the highest at day 7, which was (54.84±15.80)%; the cell expansion multiple could reach 16.92±6.28 at day 7; the in vitro tumor killing rate of NK cells was (15.83±5.5)%; the tumor inhibition rate was (44.33±13.5)%; and there was no difference in the toxicity and activity of NK cells between the two methods (P>0.05). The purity of NK cells isolated and enriched by PERCOLL density gradient separation method was (15.83±5.82)%, and the yield was (14±6.25)%, which was significantly lower than the other two methods. [Conclusion] PBMCs isolated from whole blood by manual separation and NK cells enriched by negative selection with immunomagnetic beads have the potential to provide NK cell materials for CAR-NK cell therapy, and NK cells enriched by platelet lysate-conditioned medium have the potential to provide NK cells for large-scale NK cell activation reinfusion therapy.

Objective To investigate the executive condition of Enhanced Recovery After Surgery(ERAS)measures among the hospitalized surgical patients in secondary and tertiary medical institutions of Chongqing City.Methods Using a multicenter cross-sectional survey approach,patients undergoing elective surgeries admitted and treated in 40 member units under the Chongqing Anesthesiology and Perioperative Medicine Specialized Alliance from July 11 to 30,2024 were selected as the survey subjects.Adherence to and completion of ERAS measures were calculated.Factors influencing measures with low completion rates were analyzed.Results A total of 2 100 questionnaires were issued,1 708 effective questionnaires were recovered with an effective recovery rate of 81.33％.Among them,there were 1 017 questionnaires in the tertiary medi-cal institutions and 691 questionnaires in the secondary medical institutions.The age of 1 708 patients ranged from 19-78 years old with a median age of 52 years old.Females were dominant.The proportion of patients from gastrointestinal surgery and those with secondary school education or above was high.Hypertension and diabetes were the main complication types.The surgical grade was concentrated at grades Ⅲ and Ⅳ.The ASA grading was concentrated at the grade Ⅰ/Ⅱ.The NYHA heart function grade was mainly the grade Ⅰ/Ⅱ.The ERAS measures compliance rate ranged from 36.36％to 95.45％,averaged 73.47％.The compliance rate of ERAS measures in the tertiary hospitals was higher than that in the secondary hospitals(75.82％vs.70.01％),and the difference was statistically significant(P<0.05).The average completion rate of ERAS measures was 74.08％.The top three in the completion rate were preoperative education(95.78％),preven-tive antibiotics and skin preparation(92.62％),and preoperative interview and evaluation(88.58％).The completion rates of Prehabilitation(55.27％)and preoperative fasting(57.67％)urgently needed to be in-creased.The completion rate of other measures was lower than 60％.Conclusion The compliance rate of ERAS measures needs to be increased,moreover there are significant differences among various hospitals.Fu-ture practices should focus on two measures:preoperative pre-rehabilitation exercises and preoperative oral intake of carbohydrates.

Objective To construct a trajectory model for the changes in body roundness index(BRI)of elderly people in China from 2011 to 2018 based on the data derived from Chinese Longitudinal Healthy Longevity Survey(CLHLS),and analyze the influencing factors of different BRI trajectories.Methods Based on the longitudinal cohort data from the CLHLS platform,group-based trajectory model(GBTM)analysis was used to construct longitudinal change trajectories of 3 waves of BRI(2011,2014,and 2018)that meet our research criteria.Unordered multinomial logistic regression analysis was employed to identify the influencing factors of different BRI trajectories.Results A total of 2 512 valid samples were included in the analysis.The BRI trajectory of Chinese elderly people fitted by GBTM was optimally grouped into low-,medium-,and high-level growth trajectory models.There were statistically significant differences among different BRI trajectory groups in gender,length of education,resident place,living with spouse,retirement pension,sleep quality,smoking history,drinking history,continuous exercise,frequency of fruit consumption,frequency of salt-preserved vegetables consumption,and"fruit+protein"dietary patterns(P<0.05).Disordered multiclass logistic regression analysis found that,using the low-level growth trajectory model as a reference,males and those with a history of smoking were less likely to exhibit moderate to high growth levels of BRI trajectories;Elderly people with retirement pensions were more likely to exhibit a moderate to high growth level of BRI trajectory;People with a history of alcohol consumption were more likely to exhibit a moderate steady growth level of BRI trajectory;People with longer than 10 years of education were less likely to exhibit a high level of growth in the BRI trajectory,while urban residents and those who frequently consumed fruits and salted vegetables were more likely to exhibit a high level of growth in the BRI trajectory.Conclusion The trajectory of BRI changes among elderly people in China from 2011 to 2018 can be divided into 3 groups,which are influenced by multiple factors such as gender,resident place,and length of education.It is necessary to pay attention to and make measures in advance to improve the quality of life in the elderly.Countermeasures It is advisable to incorporate BRI as a core indicator in elderly health monitoring systems,establish a dynamic management mechanism for high-risk populations,and implement precision-targeted lifestyle interventions and health guidance.

Objective:To investigate the association between high-risk human papillomavirus (hrHPV) persistent infection and vaginal microecology.Methods:A total of 53 women were enrolled in the gynecological clinic of Beijing Obstetrics and Gynecology Hospital from January 2020 to January 2021, including 7 women without HPV and 46 women with hrHPV infection. Among the hrHPV infected women, 24 woemn who did not use any drugs were classified as the observation group and the other 22 women who were given standardized interferon vaginal administration for 3 months were regarded as the treatment group. Vaginal secretions of all women were taken for Gram-stained microecological test at the time of enrollment and at the 4, 8, and 12 month follow-up. HPV turning negative was taken as the end point of follow-up.Results:(1) Women of hrHPV persistent infection in the observation and treatmnet groups had more times of abortions ( P=0.180). (2) The hrHPV negative conversion rate was 17% (4/24) in the observation group and 36% (8/22) in the treatment group, but the difference was not significant ( P=0.183). The median hrHPV negative conversion time were 11.0 months and 7.5 months in the observation and treatment groups, respectively, and the difference was statistically significant ( P=0.001). (3) Vaginal microecology was generally normal at the time of enrollment and at the end of follow-up in women with HPV natural negative conversion in the observation group. While vaginal microecological disorders were more common in women with hrHPV persistent infection in the observation and treatmnet groups, including high vaginal pH value, poor vaginal cleanliness, poor grade of Lactobacillus and increased vaginal clutter bacteria, and the vaginal microecological situation did not improve after the 12-month follow-up. (4) In the treatment group, women who turned HPV negative within six months all had normal vaginal microecology when enrollment (5/5). While those who turned negative six months later had a higher proportion of vaginal clutter bacteria (2/3), a poor grade of Lactobacillus (2/3) and a higher proportion of vaginal dysbiosis (2/3). Conclusions:(1) Interferon therapy could shorten the negative turning time of hrHPV. (2) Women with normal vaginal microecology have the ability to naturally clear hrHPV. (3) The vaginal microecological Gram-stain test has limited value in predicting hrHPV clearance, perhaps due to its inability to detect Lactobacillus subtypes.

Objective:To establish a rat model of vulvovaginal candidiasis (VVC) and to directly observe the histopathological and ultrastructural characteristics of vaginal mucosal barrier after Candida albicans infection and treatment with Lactobacillus crispatus.Methods:Female unmated SD rats were used to establish the VVC model and divided into three groups (normal group, VVC group, and Lactobacillus group; n=6 per group). Lactobacillus group received intravaginal administration of Lactobacillus crispatus suspension, while rats in VVC group and normal group were infused with phosphate buffered solution instead. Vaginal tissues were collected on day 4 post-treatment for HE staining and transmission electron microscopy (to observe ultrastructural pathological changes). Results:The results of HE staining revealed the disruption and desquamation of vaginal epithelium, necrotic epithelial tissues, neutrophil infiltration in Candida albicans-infected rats. Lactobacillus crispatus intervention restored the damaged vaginal mucosal structure (mucosal layers and thickness) to normal levels, mucosal layers of Lactobacillus group and normal group were 9.50±1.38 vs 10.67±1.03 ( P=0.226), mucosal thickness of Lactobacillus group and normal group were (116.50±12.14) vs (130.33±13.91) μm ( P=0.211). The results of transmission electron microscopy revealed intercellular desmosome rupture, loss of microvilli and glycocalyx on superficial cells, and mitochondrial swelling in Candida albicans-infected rats. Lactobacillus crispatus intervention restored the damaged vaginal mucosal ultrastructures (mitochondria and intercellular connections, etc.) to normal levels. Conclusions:Fungal infection severely disrupte the vaginal mucosal barrier in rats. Lactobacillus crispatus could restore the vaginal mucosal barrier and epithelial ultrastructures.

Radiomics represents a non-invasive, quantitative image analysis method, aimed at correlating high-throughput quantitative radiomics features with clinical and biological endpoints. This method enables comprehensive, multiple, and non-invasive tumor assessment based on different types of images in various stages of radiotherapy. Advancements have been made in the applications of radiomics combined with machine learning-based statistical method in multiple fields including individualized target delineation, the prediction of local recurrence and radiation-induced injuries, the assessment of distant metastasis risks, the prediction of tumor motion, adaptive radiotherapy (ART), and multi-omics analysis. These advancements provide more possibilities for personalized radiotherapy. This study presents a brief introduction to the applications of radiomics in personalized radiotherapy.