Retinal microcirculatory disorder is a key factor in the occurrence and development of diabetic retinopathy （DR）， and also an important link in the prevention and treatment of DR. The theory of "Gaozhuo" holds that the microcirculatory disorder in DR is based on the deficiency of spleen Qi and is characterized by the obstruction caused by "Gaozhuo" and blood stasis. The deficiency of spleen Qi is an essential precondition for the endogenous formation and accumulation of Gaozhuo， while Gaozhuo invasion is the direct cause of microcirculatory disorders in DR. The deficiency of spleen Qi and the endogenous formation of Gaozhuo mean the process in which glucose metabolism dysfunction induces an excessive production of inflammatory factors and lipid metabolites. The obstruction caused by "Gaozhuo" and blood stasis is the direct pathogenesis of microcirculatory disorders in DR， encompassing two stages： Gaozhuo obstruction and turbidity and stasis stagnation. Gaozhuo obstruction and turbidity and stasis stagnation represent the process in which inflammatory factors and lipid metabolites damage the retinal microcirculation and induce thrombosis， thus mediating microcirculatory disorders. Turbidity and stasis stagnation and blood extravasation outside the vessels reveal the progression to microvascular rupture and hemorrhage resulting from the microcirculatory disorders. According to the pathogenesis evolution of the theory of "Gaozhuo"， microcirculatory disorders in DR can be divided into deficiency of spleen Qi with Gaozhuo obstruction， deficiency of spleen Qi with turbidity and stasis stagnation， and turbidity and stasis stagnation with blood extravasation outside the vessels. Clinically， treatment principles should focus on strengthening the spleen and benefiting Qi， resolving turbidity， and dispersing stasis. Different syndrome patterns should be addressed with tailored therapies， such as enhancing the spleen and benefiting Qi while regulating Qi and reducing turbidity， strengthening the spleen and benefiting Qi while resolving turbidity and dispelling stasis， and strengthening the spleen and resolving turbidity while removing stasis and stopping bleeding. Representative prescriptions include modified Wendantang， modified Buyang Huanwutang， modified Danggui Buxuetang， Zhuixue Mingmu decoction， Tangmuqing， Shengqing Jiangzhuo Tongluo Mingmu prescription， Danhong Huayu decoction， and Yiqi Yangyin Huoxue Lishui formula.

Objective: To elucidate the potential mechanisms by which Chinese herbal medicine (CHM) regulates gut microbiota (GM) to influence the development of primary open-angle glaucoma (POAG). Methods: Data mining, network pharmacology, and Mendelian randomization (MR) analyses (two-sample design) were conducted in integration to systematically explore the CHM-GM-POAG axis. Literature-based data mining method was applied to identify frequently used herbs and herb pairs for POAG, and the properties and meridian tropism of the herbs were analyzed as well. Target prediction and pathway enrichment analyses were performed to identify shared molecular pathways among CHM components, GM, and POAG. MR analysis was performed to assess the genetically predicted causal associations between specific microbial taxa and POAG risk. Results: Our data mining work indicated that commonly used CHMs were mainly bitter and sweet in flavors and cold in property, with meridian tropism toward the liver, lung, and kidney. The predominant therapeutic effects of the CHMs included soothing the liver and regulating Qi, promoting blood circulation, and reducing fluid retention. Representative herb pairs were Shudihuang (Rehmanniae Radix Praeparata)-Gouqi (Lycii Fructus) with Zexie (Alismatis Rhizoma), Gouqi (Lycii Fructus)-Fuling (Poria) with Shudihuang (Rehmanniae Radix), and Juhua (Chrysanthemi Flos)-Gouqi (Lycii Fructus) with Zexie (Alismatis Rhizoma). Network pharmacology revealed overlapping targets involving antioxidative, anti-inflammatory, and metabolic regulation pathways. MR analysis demonstrated that higher abundances of Ruminiclostridium 6 [odds ratio (OR) = 0.73, 95% confidence interval (CI): 0.58 – 0.92, P = 0.007], Ruminococcaceae UCG-002 (OR = 0.77, 95% CI: 0.63 – 0.96, P = 0.018), Ruminococcus torques group (OR = 0.71, 95% CI: 0.57 – 0.90, P = 0.004), and Victivallis (OR = 0.82, 95% CI: 0.70 – 0.96, P = 0.016) were causally associated with reduced POAG risk, whereas Actinomyces (OR = 1.34, 95% CI: 1.06 – 1.68, P = 0.013) and Blautia (OR = 1.39, 95% CI: 1.01 – 1.90, P = 0.042) showed positive associations. Conclusion This study revealed potential causal links between GM and POAG and provided integrative evidence that CHM may modulate the microbiota to exert neuroprotective effects. These findings offer new integrative insights into the gut-eye axis and a theoretical basis for developing microbiota-targeted CHM strategies in glaucoma management.

Background Preterm birth-related complications are the leading cause of death in newborns and children under the age of 5 years. Maternal heat exposure has been associated with both sleep status during pregnancy and the increased risk of preterm birth. However, whether sleep status could mediate the association between heat exposure and preterm birth remains unclear. Objective To evaluate the association between maternal heat exposure in early pregnancy and preterm birth, and to further explore potential mediation effect of sleep status on the association between heat exposure and preterm birth. Methods A birth cohort was established in Guangzhou Panyu Maternal Child Health Hospital (Guangzhou Panyu District He Xian Memorial Hospital) from 2017 until now. Pregnant women (with gestational age between 8 and 13 weeks) were included in this study when they presented to the hospital for their first prenatal care visit and signed an informed consent. Then they were followed up until delivery. A total of 3 268 pregnant women were included for the final analysis. Questionnaires were distributed to collect the demographic characteristics, lifestyles, and sleep status of pregnant women. Daily meteorological data during the study period were collected from meteorological monitoring stations in Guangzhou and the average ambient mean temperature of four weeks before the survey was calculated and assigned for each pregnancy. The 75th, 80th, 85th, 90th, and 95th percentiles (P₇₅, P₈₀, P₈₅, P₉₀, and P₉₅) of the average ambient temperature of all pregnant women were used as the thresholds to define heat exposure. Logistic regression was used to evaluate the effects of heat exposure in different definitions on preterm birth and sleep status (sleep duration, night sleep timing, and wake up timing). The mediation effects of sleep status on the relationship between heat exposure and preterm birth were also analyzed. Results Among all the included participants, 165 newborns were preterm births with an incidence rate of 5.0%. Heat exposures with thresholds of P₉₀ and P₉₅ increased the risk of preterm birth, with ORs (95%CIs) of 1.66 (1.04-2.57) and 1.90 (1.03-3.33), respectively (P<0.05). Heat exposures with thresholds of P₇₅, P₈₀, P₈₅, P₉₀, and P₉₅ decreased the sleep duration (<9 h vs. ≥9 h, control group: ≥9 h), and the ORs (95%CIs) were 1.51 (1.25-1.83), 1.44 (1.17-1.77), 1.35 (1.08-1.70), 1.43 (1.09-1.87), and 1.45 (1.00-2.13), respectively. Heat exposures with P₇₅ and P₈₀ thresholds resulted in earlier wake up timing (<8: 00 vs. ≥8: 00, control group: <8: 00), with ORs (95%CIs) of 0.77 (0.63-0.93) and 0.76(0.61-0.93), respectively. No significant association was observed between heat exposure and night sleep timing. The mediation analyses showed that under heat exposure with P₉₀ threshold, a statistically significant mediation effect was observed for sleep duration, and the proportion mediated was 6.07% (95%CI: 0.17%-25.00%) (P<0.05). No significant mediation effect was observed for night sleep timing and wake up timing. Conclusion An elevated risk of preterm birth after heat exposure in early pregnancy may be partly mediated through reducing sleep duration.

Objective To discuss the efficacy ofcimetidine combined with acyclovir in treatment of children with varicella.Methods 80 cases ofvaricella were randomly divided into two groups.The observation group (40 cases) was treated with cimetidine combined with acyclovir treatment.The control group (40 cases) was given the acyclovir.Observe and record the two groups of children with clinical efficacy,fever time,rash scab,itching disappeared time after treatment,before and after treatment during the HAMA score and the treatment of adverse reactions.The clinical curative effect of cimetidine combined with acyclovir in treatment of children with varicella was evaluated.Results The observation group of total effective rate was 87.5％.The control group of total effective rate was 65％.The total effective rate of observation group was higher than the control group,the difference was statistically significant (P ＜ 0.05).After treatment,the fever time,skin rash,scab time and pruritus disappeared in the observation group were shorter than those in the control group,the difference was statistically significant (P ＜ 0.05).Before treatment,there was no statistical difference in HAMA scores between the two groups.After treatment,the scores of HAMA in the two groups were significantly lower than those in the same group before and after treatment (P ＜ 0.05),and the treatment group was significantly lower than the control group,the difference was statistically significant (P ＜ 0.05).There was no significant difference in adverse reactions between the two groups during the treatment.Conclusion Cimetidine combined with acyclovir have a good therapeutic effect on varicella.They can rapidly improve the clinical symptoms of pediatric varicella,reduce anxiety with high safety.It is worthy of clinical use.

Objective To explore the relationship between glycemic controls with periodontal diseases and disease conditions in patients with type 2 diabetes mellitus (T2DM).Methods Glycated hemoglobin A1c(HbA1c) and serum monocyte chemoattractant protein 1 (MCP-1) levels were measured in 34 normal subjects (control group) and 85 T2DM patients.The patients were assigned to four groups according to MCP-1 levels and complicating periodontal diseases.Both Pearson correlation analysis and univariate Logistic regression analysis were used.Results The levels of HbA1c and MCP-1 in T2DM group were significantly higher than those in control group (P ＜0.01);and the levels of HbA1c and MCP-1 in patients with periodontal disease were significantly higher than those without periodontal disease (P ＜ 0.01).In both normal MCP-1 with periodontal diseases and elevated MCP-1 without periodontal diseases groups,HbA1c level was significantly higher than that in normal MCP-1 without periodontal diseases group (P ＜ 0.01).In elevated MCP-1 with periodontal diseases group,patients had significantly higher HbA1 c levels than that in either periodontal diseases group or elevated MCP-1 group,respectively (P ＜ 0.01).In HbA1c≥7.0％ group,MCP-1 levels and the incidence of periodontal diseases were significantly higher than that in HbA1c ＜7.0％ group (P ＜0.01).HbA1c levels were positively correlated with MCP-1 levels in HbA1c≥7.0％ group (R2 =0.6004,P ＜ 0.01).Univariate regression analysis showed that HbA1c ≥7.0％ was the risk factor for complicating periodontal diseases in T2DM patients (OR =1.65,95％ CI:1.12 ～ 2.56,P ＜ 0.01).Conclusions Poor glycemic control is related to periodontal disease and the disease conditions in T2DM patients.Elevated HbA1c levels can be used as the assessing indicator for periodontal diseases of T2DM patients.

Objective To evaluate the X-ray diagnosis value of intestinal malrotation in adults.Methods The X-ray findings of 16 cases with intestinal malrotation confirmed by surgery were analyzed retrospectively. All of them were taken X-ray plain films, 11 cases were taken alimentary tract barium meal,and 5 cases were taken barium enema. Results Eight cases were found incomplete obstruction of the duodenum, and 2 cases were found low small intestine obstruction on the X-ray plain films. The alimentary tract barium meal showed 4 cases with dilatation and incomplete obstruction of the duodenal bulb to horizontal segment,and the distal end of narrowing intestine appeared as a rat tail,7 cases showed the abnormal duodenal location and shape,called "strip" sign. Four cases were found abnormal duodenojejunal flexure by barium enema examination. Conclusion The alimentary tract barium meal and barium enema examination has great diagnosis value for intestinal malrotation in adults.

BACKGROUNDFinding the cancer cells in pleural fluid of patients with lung can-cer by conventional cytology is always a difficult point. In order to enhance the diagnostic rate of pleural fluid with lung cancer, carcinoembryonic antigen (CEA) and cancer antigen 153 (CA153) were detected in serum and pleural fluid, and their diagnostic values on lung cancer were analyzed.

METHODSQuantities of CEA and CA153 were detected by chemiluminescence in both serum and pleural fluid of patients with lung cancer (74 cases) and without lung cancer (34 cases).

RESULTSThe levels of CEA and CA153 in pleural fluid of patients with lung cancer were significantly higher than those without lung cancer (P < 0.01). The levels of CEA and CA153 in serum of patients with lung cancer were distinctly higher than those without lung cancer (P < 0.01). The levels of CEA and CA153 in pleural fluid were obviously higher than those in serum (P < 0.01). The optimal diagnostic assay of lung cancer was CEA+CA153 combination: sensitivity and specificity were 85.1% and 97.1% respectively.

CONCLUSIONSIt could be of important clinical significance for diagnosing lung cancer by assaying CEA and CA153 in pleural fluid of patients with lung cancer.