ObjectiveTo explore the clinical efficacy and mechanism of Bupi Qingfei prescription （BPQF） in treating stable bronchiectasis in the patients with syndromes of lung-spleen Qi deficiency and phlegm-heat accumulation in the lungs. MethodsA randomized， double-blind， placebo-controlled trial was conducted. Patients were randomized into BPQF and placebo control （PC） groups. On the basis of conventional Western medicine treatment， the BPQF granules and placebo were respectively administered at 10 g each time， twice a day， for a course of 24 weeks. The TCM symptom scores， Quality of Life Questionnaire for Bronchiectasis （QOL-B） scores， lung function indicators， T lymphocyte subsets， level of inflammatory factors in the sputum， level of neutrophil elastase （NE） in the sputum， and occurrence of adverse reactions were observed before and after treatment in the two groups. ResultsA total of 64 patients completed the study， encompassing 32 in the BPQF group and 32 in the PC group. After treatment， the BPQF group showed decreased TCM symptom scores （P<0.01）， increased QOL-B scores （P<0.01）， and declined levels of tumor necrosis factor （TNF）-α and NE （P<0.05， P<0.01）. The PC group showed decreased TCM symptom （except spleen deficiency） scores （P<0.01）， increased the QOL-B health cognition and respiratory symptom domain scores （P<0.05， P<0.01）， and a declined TNF-α level （P<0.01）. Moreover， the BPQF group had lower TCM symptom （except chest tightness） scores （P<0.05， P<0.01）， higher QOL-B （except treatment burden） scores （P<0.05， P<0.01）， and lower levels of interleukin-6 and TNF-α （P<0.05） than the PC group. Neither group showed serious adverse reactions during the treatment process. ConclusionBPQF can ameliorate the clinical symptoms of stable bronchiectasis patients who have lung-spleen Qi deficiency or phlegm-heat accumulation in the lungs by regulating the immune balance and inhibiting airway inflammatory responses.

Xuanfuhua Decoction （旋覆花汤） is considered as the theoretical prototype of the method of unbloc-king collaterals with acrid and moistened medicinals. Guided by the theories of "chronic disease entering the collaterals" and "collaterals performing their functions when there is free flow"， YE Gui further developed this approach into a systematic method. The core of this approach lies in dispersing and opening constraint with acrid medicinals， nourishing and harmonizing collaterals with moistened medicinals， eliminating pathogens and unblocking collaterals with insect medicinals. The disease course of idiopathic pulmonary fibrosis （IPF） is prolonged， with a complex of deficiency and excess， and chronic disease entering the collaterals. The core pathogenesis involves lung collaterals obstruction， fluid depletion with blood stasis， and chronic disease entering the collaterals. Treatment can be guided by the method of unblocking collaterals with acrid and moistened medicinals based on Xuanfuhua Decoction， following a strategy of "dispersing and unblocking， moistening and nourishing， penetrating and venting". Specifically， for lung collaterals obstruction， acrid medicinals can be used to disperse lung qi and open bi （痹）. In case of fluid depletion and blood stasis， moistened medicinals for nourishing lung collaterals are suggested to restore vitality. For chronic disease ente-ring collaterals， it is advised to search and eliminate collateral pathogens in order to dissipate masses.

Objective To explore a feasible simplified premedication protocol for preventing hypersensitivity reactions to taxanes. Methods The electronic medical record system was used to search for data from 49 patients with advanced gastric cancer who received paclitaxel liposome treatment for the first time in the gastroenterology department of Shanghai Changhai Hospital from 2021-06-01 to 2024-06-30, including premedication protocols, allergic reactions, and other adverse reactions. Results Among 31 patients, the premedication regimen included oral dexamethasone 9 mg at 12 h and 6 h prior to liposomal paclitaxel, plus oral loratadine 10 mg and oral ranitidine 150 mg at 12 h prior to treatment. Among 18 patients, the regimen included oral dexamethasone 9 mg at 12 h and 6 h prior to treatment, and oral loratadine 10 mg at 12 h prior to treatment. None of the patients experienced allergic reactions. The incidence of other adverse reactions did not differ significantly between the two groups（P>0.05）. Conclusion Based on literature and practice, a dual simplified premedication protocol of oral corticosteroids（GC）combined with oral H1 receptor blockers（H1RA）was proposed, which provided a new idea for doctors. Further clinical studies are needed to verify its effectiveness.

Objective To explore a feasible simplified premedication protocol for preventing hypersensitivity reactions to taxanes. Methods The electronic medical record system was used to search for data from 49 patients with advanced gastric cancer who received paclitaxel liposome treatment for the first time in the gastroenterology department of Shanghai Changhai Hospital from 2021-06-01 to 2024-06-30, including premedication protocols, allergic reactions, and other adverse reactions. Results Among 31 patients, the premedication regimen included oral dexamethasone 9 mg at 12 h and 6 h prior to liposomal paclitaxel, plus oral loratadine 10 mg and oral ranitidine 150 mg at 12 h prior to treatment. Among 18 patients, the regimen included oral dexamethasone 9 mg at 12 h and 6 h prior to treatment, and oral loratadine 10 mg at 12 h prior to treatment. None of the patients experienced allergic reactions. The incidence of other adverse reactions did not differ significantly between the two groups（P>0.05）. Conclusion Based on literature and practice, a dual simplified premedication protocol of oral corticosteroids（GC）combined with oral H1 receptor blockers（H1RA）was proposed, which provided a new idea for doctors. Further clinical studies are needed to verify its effectiveness.

Breast cancer is a kind of malignant tumor with a complex mechanism， and its morbidity and mortality are increasing year by year， which seriously threatens women's health. At present， the main clinical treatments are surgical resection， radiotherapy， chemotherapy， and drug therapy， but they are often accompanied by side effects and adverse reactions， which affect the therapeutic effect. Traditional Chinese medicine （TCM） has the advantages of multi-component and multi-target treatment in the fight against breast cancer. The wnt/β-catenin signaling pathway is one of the classic pathways in cancer research. Abnormally activated Wnt/β-catenin signaling pathway inhibits β-catenin degradation by blocking the formation of Axin/glycogen synthase kinase 3β/adenomatous polyposis coli complex， thus promoting β-catenin nuclear metastasis， and it binds to T cell transcription factor/lymphoenhancer factor-1 to initiate downstream target genes and further interfere with the proliferation， migration， and invasion of tumor cells to affect the tumor process. Previous studies have shown that TCM monomers and compounds can mediate the Wnt/β-catenin signaling pathway to inhibit the malignant phenotype of breast cancer cells， thus playing an anti-breast cancer role， and the biochemical process involved in the regulation of therapeutic drugs has not been systematically combed. By analyzing and collating Chinese and foreign literature at the present stage， this paper discussed the association mechanism between Wnt/β-catenin signaling pathway and breast cancer and analyzed the internal mechanism of TCM monomers and compounds in mediating Wnt/β-catenin signaling pathway to exert anti-breast cancer effect. The statistical results showed that the flavonoids， alkaloids， and terpenoids in TCM monomers could target the Wnt/β-catenin signaling pathway and block the further development of malignant phenotype of breast cancer cells. TCM compounds with functions of clearing heat and detoxifying， promoting blood circulation and removing blood stasis， and tonifying kidney and liver were commonly used to intervene in the Wnt/β-catenin signaling pathway to prevent breast cancer. Compared with the current inhibitors of Wnt/β-catenin signaling pathway， the application of TCM monomers and compounds is expected to bring low-toxicity and high-efficiency breast cancer treatment drugs to the clinical practice， and the existing results provide a reference for the subsequent screening， research， and development of TCM small-molecule compounds and TCM compounds against breast cancer.

Mesenchymal stem cells (MSCs) have been widely used in the treatment of various autoimmune and inflammation-related diseases due to their potent immunomodulatory properties. Several studies have demonstrated that MSC-mediated immunomodulation is complex and bidirectional, with the in vivo microenvironment influencing the direction of this modulation. Indoleamine-2,3-dioxygenase (IDO), an immunosuppressive factor, has been identified as a key "switch" in the immunomodulatory role of MSCs. In this review, we explore how IDO functions as a critical regulator of MSC immunoregulatory plasticity. We delve into the mechanisms by which changes in IDO expression affect the function of various immune cells, summarize relevant research and clinical advances regarding the role of IDO expression in MSC-based therapies for various diseases, and discuss potential therapeutic strategies that target IDO to enhance the stability of MSC therapeutic effects. This provides a theoretical foundation for optimizing MSCs as safer and more effective clinical therapeutic agents.

Primary female genital system lymphoma(PFGSL)is a rare subtype of extranodal lymphoma and patients commonly present in the department of gynecology.At present,there is a lack of uniform standards for the treatment of PFGSL.Although the classification of lymphoid neoplasmas was updated by the World Health Organization classification of haematolymphoid tumors in 2016,PFGSL was still not elaborated in sufficient detail.Most cases of PFGSL are non-Hodgkin lymphoma,involving the ovary and cervix.In some cases,involvement of uterine corpus,vagina,and vulva is reported.In this article,we report two cases of non-Hodgkin lymphoma in the female genital system,one from the uterus and the other from the ovary.By presenting the diagnosis and treatment of the two cases and reviewing the literature,we aim to provide a reference for clinicians in recognizing and treating rare cases.
Female ; Humans ; Genital Neoplasms, Female/diagnosis* ; Lymphoma, Non-Hodgkin/diagnosis* ; Ovarian Neoplasms

Objective To analyze the external radiation dose rate and radiation protection measures during treatment of a patient with hepatocellular carcinoma (HCC) who underwent ⁹⁰Y selective internal radiotherapy (⁹⁰Y-SIRT). Methods A male HCC patient who received ⁹⁰Y-SIRT with an activity of 4.65×10⁹ Bq was selected as the research subject using retrospective analysis. External radiation dose rate meters were used to detect ambient dose equivalent rates around the radiation worker, the HCC patient, and the workplace during treatment. Surface contamination meters were used to detect surface contamination levels of the radiation worker and the workplace. Results The ambient dose equivalent rate around the interventional radiology staff during treatment ranged from 3.7 to 39.0 μSv/h. The patient's ambient dose equivalent rate of surgical site at distances of 30, 100, and 200 cm ranged from 45.0 to 5.6, 4.4 to 0.4, and 0.4 to 0.1 μSv/h respectively without protection, and 14.0 to 3.4, 3.2 to 0.3, and 0.4 to 0.1 μSv/h respectively when the surgical site was covered with a 1.0 mmPb lead rubber drape after 0.0 to 161.0 hours of the surgery. In the nuclear medicine department, ambient dose equivalent rate of the workplace ranged from 0.4 to 740.0 μSv/h. The ambient dose equivalent rate around all monitoring points in the digital subtraction angiography operating room accounted at 0.1 μSv/h, and the observation ward ranged from 0.1 to 0.2 μSv/h. The β surface contamination levels of the radiation worker and workplace were below the minimum detection limit (0.16 Bq/cm²). Conclusion Radiation doses for both HCC patients and radiation worker remained within acceptable limits when appropriate protective equipment was used. A well-designed workplace layout is essential to ensure effective implementation of radiation protection.

BACKGROUND:In orthodontic treatment,full-mouth treatment is usually used to treat single-root severely twisted teeth,and single-tooth treatment is less common.OBJECTIVE:To design a personalized orthodontic device based on biomechanical principles to address the rotation of teeth 11,12,13,21,22,and 23,and evaluate the device's impact on tooth movement using three-dimensional finite element method.METHODS:Based on the biomechanical principle of tooth rotation and movement,a personalized orthodontic device was made by digital design combined with three-dimensional printing,so that the personalized orthodontic device and the tooth formed an anchorage system.The absolute anchorage of the micro-implant was used to precisely control the single-root twisted tooth in the three-dimensional direction.The CBCT data of the maxillary alveolar bone and tooth tissue of a female volunteer were collected.The three-dimensional finite element models of the twisted tooth-periodontal ligament-maxillary bone-personalized orthodontic device were established using Mimics,Geomagic Wrap,SolidWorks,3-matic Research 15.0,and Ansys Workbench software.The equivalent stress distribution characteristics of the personalized orthodontic device,the movement trend of the tooth,and the equivalent stress distribution characteristics of the periodontal ligament were calculated under a thrust of 60 g.RESULTS AND CONCLUSION:(1)The maximum equivalent stress observed on the personalized orthodontic device was 47.71 MPa.(2)The initial tooth displacement under the device demonstrated a rotational trend.The peak equivalent stress in the periodontal ligament was concentrated at the neck,while lower stress was observed in the apex region.(3)The safety and feasibility of the personalized orthodontic device designed in this study for severely rotated single-rooted teeth were preliminarily verified through finite element analysis.

Objective:To measure the length and curvature of the external auditory canal (EAC) centerline using a three-dimensional (3D) measurement method based on high-resolution computed tomography (HRCT).Methods:A retrospective analysis was conducted on HRCT images of healthy EAC from 49 patients (64 ears) examined at the Sixth Medical Center of the PLA General Hospital from June to October 2024. The cohort included 25 males (28 ears) and 24 females (36 ears), aged 22-78 years (mean age 47.3 years), categorized into age groups: 18-30 years (20 ears), 31-60 years (22 ears), and 61-80 years (22 ears). The EAC comprised 29 left and 35 right ears. 3D reconstruction of the EAC was performed using medical software (3D Slicer), and the central curve of the EAC was extracted using an improved measurement method to determine its length and curvature. Statistical analysis was performed using Origin Pro 2023 software to compare differences across genders, sides, and age groups.Results:The measurements of EAC length and curvature revealed that the EAC was significantly longer in males than in females (27.46 mm vs. 25.44 mm, P=0.014) and longer on the right side than on the left (27.99 mm vs. 25.87 mm, P=0.031). No statistically significant difference in EAC length was observed among the different age groups ( P>0.05). Furthermore, no statistically significant differences in EAC curvature were found regarding gender, side, or age group (all P>0.05). Conclusion:The HRCT-based 3D reconstruction technique enables the establishment of a rapid and effective automated workflow for extracting the central curve of the EAC and systematically measuring its length and curvature. The data obtained provide a reference and methodological support for further research on anatomical variations of the human EAC and its potential clinical applications, such as the design of otological instruments or surgical planning.