Objective:To investigate the efficacy and underlying mechanism of modified Wubei powder combined with Banxia Xie Xin decoction in the treatment of reflux esophagitis (RE). Methods:A case-control study was conducted involving 82 patients with RE who received treatment at Department of Spleen and Stomach Diseases, Xi'an Hospital of Traditional Chinese Medicine from June 2022 to June 2023. The patients were randomly assigned to either a control group or an observation group, with 41 patients in each group. The control group received conventional treatment, while the observation group was given Wubei powder combined with modified Banxia Xie Xin decoction orally in addition to the conventional treatment. The traditional Chinese medicine symptom scores, lower esophageal sphincter relaxation rate (LESR), percentage of abnormal esophageal contractions, and levels of substance P (SP), cholecystokinin (CCK), motilin (MTL), gastrin (GAS), serum ghrelin, and vasoactive intestinal peptide (VIP) were compared between the two groups before treatment and at 2 and 4 weeks after treatment. Results:There was no statistically significant difference in traditional Chinese medicine symptom scores between the two groups before treatment ( P > 0.05). However, both groups showed lower symptom scores at 2 and 4 weeks after treatment compared with before treatment ( t = 6.87, 10.87, 9.59, 15.39, all P < 0.05). The observation group demonstrated significantly greater improvement in symptom scores at 2 and 4 weeks compared with the control group [(17.68 ± 2.13) vs. (23.76 ± 2.48); (11.44 ± 1.12) vs. (18.82 ± 1.85), t = 4.18, 4.35, both P < 0.05]. There were no statistically significant differences in LESR or percentage of abnormal contractions between the two groups before treatment (both P > 0.05). However, both LESR and the percentage of abnormal esophageal contractions improved at 2 and 4 weeks after treatment compared with before treatment ( t = 4.25, 5.73, 5.86, 6.49, 3.79, 4.84, 4.48, 5.56, all P < 0.05). Additionally, the observation group had significantly lower LESR at 2 and 4 weeks compared with the control group [(71.62 ± 6.37)% vs. (75.46 ± 6.89)%, (64.92 ± 5.82)% vs. (70.78 ± 6.45)%, t = 5.43, 5.86, both P < 0.05]. The percentage of abnormal esophageal contractions was also significantly lower in the observation group [(45.28 ± 5.18)% vs. (59.56 ± 5.84)%; (33.53 ± 4.24)% vs. (47.74 ± 5.31)%, t = 6.08, 7.24, both P < 0.05]. Before treatment, there were no statistically significant differences in levels of SP, MTL, GAS, or CCK between the two groups (all P > 0.05). The levels of SP, MTL, GAS, and CCK improved in both groups at 2 and 4 weeks compared with before treatment ( t = 4.67, 7.15, 7.24, 9.87, 3.62, 5.85, 4.58, 7.17, 3.55, 5.41, 5.42, 6.89, 3.53, 5.43, 5.39, 6.82, all P < 0.05). Furthermore, the observation group had significantly higher levels of SP, MTL, and GAS at 2 and 4 weeks compared with the control group ( t = 3.65, 4.12, 3.86, 4.25, 4.48, 5.36, all P < 0.05), while CCK levels were significantly lower in the observation group ( t = 4.38, 4.51, both P < 0.05). There were no statistically significant differences in ghrelin or VIP levels between the two groups before treatment (both P > 0.05). However, both ghrelin and VIP levels improved in both groups at 2 and 4 weeks after treatment compared with before treatment ( t = 3.35, 3.72, 3.69, 4.28, 3.76, 4.88, 4.11, 5.69, all P < 0.05). Additionally, the observation group had significantly higher levels of ghrelin compared with the control group ( t = 3.43, 4.11, both P < 0.05), while VIP levels were significantly lower in the observation group ( t = 4.59, 5.71, both P < 0.05). Conclusions:The addition of modified Wubei powder combined with Banxia Xie Xin decoction to conventional treatment can considerably alleviate clinical symptoms in patients with RE and improve esophageal pressure. Furthermore, this combined therapy can effectively regulate serum levels of SP, CCK, MTL, GAS, ghrelin, and VIP, thereby modulating the contraction and relaxation of gastrointestinal smooth muscle, enhancing lower esophageal sphincter pressure, and reducing reflux.

This study was aimed at understanding the relationships among the drug resistance and genome characteristics of group A Streptococcus in Jiangsu Province.A total of 149 group A Streptococcus strains were collected from hospitals between 2016 and 2023.Thirteen antimicrobial minimal inhibitory concentrations were detected with the micro-dilution broth method.The GAS strains were typed with emm genotyping analysis and whole genome sequencing,to determine the carriage rates of drug resistance genes and the evolutionary relationships among strains.The resistance rates of 149 GAS strains to erythromy-cin,tetracycline,and clindamycin exceeded 90％,whereas the strains showed sensitivity to 8 different antibiotics,including penicillin.Notably,the resistance rates to erythromycin,tetracycline,and clindamycin consistently increased over time.All strains were classified into 9 emm types,among which emm12 accounted for the highest proportion(77/149;51.68％).Signifi-cant statistical differences were observed among emm types,in terms of the drug resistance rate,number of resistant species,and prevalence of drug resistance genes.Furthermore,SNP evolutionary tree analysis revealed 3 distinct clusters within the GAS strains:emm12,emm1,and other emm types.emm 12 and emm1 were the dominant GAS strains in Jiangsu Province.Most isolates were resistant to erythromycin,tetracycline,and clindamycin.Differences in phenotypes and genomic characteris-tics were observed among emm types.

Aim To investigate the therapeutic effects of cinnamaldehyde on synovial lesions in mice with knee osteoarthritis(KOA)and its regulatory mecha-nism in the phagocytic function of synovial macropha-ges.Methods In the animal experiments,mouse ser-um and synovial tissue were extracted.HE staining was used to evaluate the inflammatory cell infiltration in the synovial tissue.ELISA was employed to detect the lev-els of inflammatory factors such as interleukins in the serum.Western blot was used to detect the expression of Ras homolog family member A(RhoA),Rho-associ-ated protein kinase 1(ROCK1),myosin light chain(MLC),and p-MLC proteins in the synovial tissue.RT-qPCR was utilized to detect the expression of in-flammatory factors and pathway-related mRNA in the synovial tissue.TUNEL staining was used to detect ap-optosis in the synovial tissue.In the cellular experi-ments,after the intervention,RAW267.4 cells were subjected to Western blot and RT-qPCR for the detec-tion of the aforementioned indicators,and confocal mi-croscopy was used to assess phagocytic function.Re-sults After cinnamaldehyde intervention,the synovial inflammatory infiltration was significantly reduced,the protein and mRNA expression of the RhoA/ROCK1/MLC signaling pathway was markedly downregulated,the fluorescence intensity of TUNEL staining signifi-cantly decreased,and the phagocytic function of macro-phages was enhanced.Conclusion Cinnamaldehyde can inhibit RhoA/Rock1/MLC signaling pathway,en-hance macrophage burial,improve synovial inflamma-tion,and delay the progression of KO A mice.

A young male patient was diagnosed with aplastic anemia accompanied by paroxysmal nocturnal hemoglobinuria(PNH),and achieved only partial remission after immunosuppressive therapy.Over the past year,his anemia worsened,leading to transfusion dependence,which was considered to be caused by active he-molysis of PNH.Despite switching to eculizumab treatment,his anemia continued to deteriorate.A detailed medical history revealed chronic periodontal infection,with periodontal pain,purulent discharge,and fever in the past month.Multidisciplinary discussion suggested that chronic odontogenic infection activating the comple-ment system was the primary cause of aggravated PNH hemolysis,and the acute infection affected the efficacy of eculizumab.Based on multidisciplinary consultation,a treatment plan was formulated,including intravenous antibiotics combined with periodontal irrigation and tooth extraction to control odontogenic infection,while con-tinuing regular eculizumab infusion.The patient's symptoms improved,hemoglobin levels rose rapidly,and he was no longer transfusion-dependent.This case provides an empirical reference for addressing difficulties en-countered in the treatment of rare diseases with new drugs through multidisciplinary collaborative diagnosis and treatment.

This study was aimed at understanding the relationships among the drug resistance and genome characteristics of group A Streptococcus in Jiangsu Province.A total of 149 group A Streptococcus strains were collected from hospitals between 2016 and 2023.Thirteen antimicrobial minimal inhibitory concentrations were detected with the micro-dilution broth method.The GAS strains were typed with emm genotyping analysis and whole genome sequencing,to determine the carriage rates of drug resistance genes and the evolutionary relationships among strains.The resistance rates of 149 GAS strains to erythromy-cin,tetracycline,and clindamycin exceeded 90％,whereas the strains showed sensitivity to 8 different antibiotics,including penicillin.Notably,the resistance rates to erythromycin,tetracycline,and clindamycin consistently increased over time.All strains were classified into 9 emm types,among which emm12 accounted for the highest proportion(77/149;51.68％).Signifi-cant statistical differences were observed among emm types,in terms of the drug resistance rate,number of resistant species,and prevalence of drug resistance genes.Furthermore,SNP evolutionary tree analysis revealed 3 distinct clusters within the GAS strains:emm12,emm1,and other emm types.emm 12 and emm1 were the dominant GAS strains in Jiangsu Province.Most isolates were resistant to erythromycin,tetracycline,and clindamycin.Differences in phenotypes and genomic characteris-tics were observed among emm types.

Gingivectomy and periodontal flap surgery are fundamental periodontal surgeries. Undergraduate students majoring in stomatology must master the basic principles of these two surgical procedures and be familiar with their key operational essentials. This article elaborates on how to conduct standardized fundamental periodontal surgery training step by step, including the significance of the two surgical methods in periodontal therapy, the scheduling and implementation strategies of surgical training, the training essentials, as well as common errors and countermeasures during the training process, providing guidance to improve the standardization of periodontal surgery in China.

A young male patient was diagnosed with aplastic anemia accompanied by paroxysmal nocturnal hemoglobinuria(PNH),and achieved only partial remission after immunosuppressive therapy.Over the past year,his anemia worsened,leading to transfusion dependence,which was considered to be caused by active he-molysis of PNH.Despite switching to eculizumab treatment,his anemia continued to deteriorate.A detailed medical history revealed chronic periodontal infection,with periodontal pain,purulent discharge,and fever in the past month.Multidisciplinary discussion suggested that chronic odontogenic infection activating the comple-ment system was the primary cause of aggravated PNH hemolysis,and the acute infection affected the efficacy of eculizumab.Based on multidisciplinary consultation,a treatment plan was formulated,including intravenous antibiotics combined with periodontal irrigation and tooth extraction to control odontogenic infection,while con-tinuing regular eculizumab infusion.The patient's symptoms improved,hemoglobin levels rose rapidly,and he was no longer transfusion-dependent.This case provides an empirical reference for addressing difficulties en-countered in the treatment of rare diseases with new drugs through multidisciplinary collaborative diagnosis and treatment.

Aim To study the effect of evodiamine(EVO)regulating forkhead box protein Ml(FOXM1)on the proliferation and apoptosis of colorectal cancer-resistant cells HCT8/5-FU.Methods CCK-8 assay and EdU assay were used to detect the effect of EVO on cell proliferation ability.Clone formation assay was employed to detect the effect of EVO on the clone for-mation ability of cells.Flow cytometric counting was applied to detect apoptosis.Western blot was utilized to detect the expression of cellular Bcl-2,Bax,FOXM1,β-catenin,c-MYC,and CyclinD1;Molecular docking was used to explore the EVO-FOXM1 interac-tion.Nude mouse transplant tumor model was estab-lished to validate the effect of EVO on HCT8/5-FU cells in vivo.Results CCK-8 assay showed that EVO inhibited the proliferation of HCT8/5-FU cells in a time-and concentration-dependent manner.EdU assay found that the newly proliferated cells in the EVO-trea-ted group were significantly reduced.The results of the clone formation assay showed that EVO inhibited the clone-forming ability of HCT8/5-FU cells.Flow cyto-metric counting found that apoptosis rate of the cells in the EVO group significantly increased.Western blot showed that FOXM1 and β-catenin were significantly highly expressed in HCT8/5-FU cells,and EVO down-regulated the expression of FOXM1,β-cateniin,c-MYC,CyclinD1,and Bcl-2,and up-regulated the ex-pression of Bax.Molecular docking revealed strong in-teractions between EVO and FOXM1.The in vivo ex-perimental results demonstrated that EVO exerted a substantial inhibitory effect on the growth of subcutane-ously implanted HCT8/5-FU xenograft tumors and regulated the expression of related proteins.HE stai-ning revealed significant nuclear consolidation and fragmentation of tumor cells in the EVO group.Con-clusions The findings suggest that EVO could sup-press the activation of the Wnt signaling pathway through a mechanism involving the downregulation of FOXM1 protein expression,thus inhibiting the prolifer-ation of HCT8/5-FU cells and induce their apoptosis.

19 cinnamamide/ester-triazole compounds were designed, synthesized and evaluated for their anti-Alzheimer's disease (AD) activity. Among them, compound 4f displayed excellent anti-β-amyloid protein (Aβ)-mediated cytotoxicity (EC₅₀ = 2.03 ± 2.45 μmol·L^-1) in APPswe cells and acetylcholinesterase inhibiton (IC₅₀ = 4.88 ± 4.70 μmol·L^-1). Further study indicated that, at dosages of (1, 5 and 25 mg·kg^-1), compound 4f was effective in improving spatial learning and memory deficits in Aβ_1-42-impaired mice, which was achieved by promoting the nonamyloidogenic signaling and inhibiting the amyloidogenic pathway, along with the suppression of Aβ-induced Tau phosphorylation. All animal experiments in this study were approved by the Experimental Animal Care and Use Committee of the Institute of Medicinal Biotechnology (IMB-20220908D701). In conclusion, compound 4f holds promise as a lead candidate for AD treatment, and the present study lays the foundation for its subsequent development.

Clinical practice guidelines represent the best recommendations for patient care. They are developed through systematically reviewing currently available clinical evidence and weighing the relative benefits and risks of various interventions. However, clinical practice guidelines have to go through a long translation cycle from development and revision to clinical promotion and application, facing problems such as scattered distribution, high duplication rate, and low actual utilization. At present, the clinical practice guideline information platform can directly or indirectly solve the problems related to the lengthy revision cycles, decentralized dissemination and limited application of clinical practice guidelines. Therefore, this paper systematically examines different types of clinical practice guideline information platforms and investigates their corresponding challenges and emerging trends in platform design, data integration, and practical implementation, with the aim of clarifying the current status of this field and providing valuable reference for future research on clinical practice guideline information platforms.