ObjectiveTo investigate whether there are differences in the efficacy of Gegen Qinliantang with different contents of Puerariae Lobatae Radix on the acute enteritis （AE） model mice and provide a scientific basis for the interpretation of Gegen Qinliantang in the treatment of "Xie Re Li". MethodsA total of 112 male BALB/c mice were randomly divided into a blank group，model group，single Puerariae Lobatae Radix group，non-Puerariae Lobatae Radix group，regular dose Gegen Qinliantang group （regular dose group），half-dose Puerariae Lobatae Radix group，and doubled-dose Puerariae Lobatae Radix group， with 16 mice in each group. Hematoxylin-eosin （HE） staining was used to observe the pathological changes of the colon tissue. Western blot was employed to detect the expression of ZO-1 （a protein in the tight junction） and Occludin in the colon tissue， as well as the changes of tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β）. ResultsCompared with the blank group，the DAI scores of the mice in the model group were significantly higher （P<0.05），and the histopathological sections of their colon tissues showed mucosal damage，glandular atrophy，disordered arrangement，and a large number of inflammatory cells infiltration，and the expression of ZO-1 and Occludin proteins in their colon tissues was significantly down-regulated （P<0.05，P<0.01）. The expression of inflammatory factors TNF-α and IL-1β was significantly up-regulated （P<0.05，P<0.01）. Compared with the model group，the DAI scores of mice in all dosing groups decreased significantly （P<0.05），with the most significant effect in the regular dose group. After 7 d of drug administration，the regular dose group had the best impact on the repair of colonic mucosa in the AE mouse model. The regular dose group significantly down-regulated the expression of TNF-α （P<0.05） and significantly up-regulated the expression of ZO-1 protein （P<0.05）. The doubled-dose Puerariae Lobatae Radix group significantly down-regulated the expression of IL-1β protein （P<0.01），and there was no significant difference between all dosing groups and the model group in terms of the expression of Occludin protein. After 14 d of drug administration，the best effect on the repair of colonic mucosa in the AE mouse model was observed in the doubled dose Puerariae Lobatae Radix group. All groups except the non-Puerariae Lobatae Radix group significantly down-regulated the expression of TNF-α （P<0.01）. Meanwhile，the regular dose group and doubled-dose Puerariae Lobatae Radix group significantly elevated the expression level of Occludin protein （P<0.01）. The doubled-dose Puerariae Lobatae Radix group also significantly inhibited the expression of IL-1β protein （P<0.05） and up-regulated ZO-1 protein expression （P<0.05）. ConclusionGegen Qinliantang can reduce the pathological damage of colon tissue， protect the barrier function and structure of intestinal epithelial cells， and reduce the expression of inflammatory factors， so as to achieve the therapeutic effect of AE model mice. When comparing the therapeutic efficacy of Gegen Qinliantang containing different Gegen contents， Gegen Qinliantang with the proportion of the original formula of Zhongjing was the most effective in AE model mice.

ObjectiveTo investigate whether there are differences in the efficacy of Gegen Qinliantang with different contents of Puerariae Lobatae Radix on the acute enteritis （AE） model mice and provide a scientific basis for the interpretation of Gegen Qinliantang in the treatment of "Xie Re Li". MethodsA total of 112 male BALB/c mice were randomly divided into a blank group，model group，single Puerariae Lobatae Radix group，non-Puerariae Lobatae Radix group，regular dose Gegen Qinliantang group （regular dose group），half-dose Puerariae Lobatae Radix group，and doubled-dose Puerariae Lobatae Radix group， with 16 mice in each group. Hematoxylin-eosin （HE） staining was used to observe the pathological changes of the colon tissue. Western blot was employed to detect the expression of ZO-1 （a protein in the tight junction） and Occludin in the colon tissue， as well as the changes of tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β）. ResultsCompared with the blank group，the DAI scores of the mice in the model group were significantly higher （P<0.05），and the histopathological sections of their colon tissues showed mucosal damage，glandular atrophy，disordered arrangement，and a large number of inflammatory cells infiltration，and the expression of ZO-1 and Occludin proteins in their colon tissues was significantly down-regulated （P<0.05，P<0.01）. The expression of inflammatory factors TNF-α and IL-1β was significantly up-regulated （P<0.05，P<0.01）. Compared with the model group，the DAI scores of mice in all dosing groups decreased significantly （P<0.05），with the most significant effect in the regular dose group. After 7 d of drug administration，the regular dose group had the best impact on the repair of colonic mucosa in the AE mouse model. The regular dose group significantly down-regulated the expression of TNF-α （P<0.05） and significantly up-regulated the expression of ZO-1 protein （P<0.05）. The doubled-dose Puerariae Lobatae Radix group significantly down-regulated the expression of IL-1β protein （P<0.01），and there was no significant difference between all dosing groups and the model group in terms of the expression of Occludin protein. After 14 d of drug administration，the best effect on the repair of colonic mucosa in the AE mouse model was observed in the doubled dose Puerariae Lobatae Radix group. All groups except the non-Puerariae Lobatae Radix group significantly down-regulated the expression of TNF-α （P<0.01）. Meanwhile，the regular dose group and doubled-dose Puerariae Lobatae Radix group significantly elevated the expression level of Occludin protein （P<0.01）. The doubled-dose Puerariae Lobatae Radix group also significantly inhibited the expression of IL-1β protein （P<0.05） and up-regulated ZO-1 protein expression （P<0.05）. ConclusionGegen Qinliantang can reduce the pathological damage of colon tissue， protect the barrier function and structure of intestinal epithelial cells， and reduce the expression of inflammatory factors， so as to achieve the therapeutic effect of AE model mice. When comparing the therapeutic efficacy of Gegen Qinliantang containing different Gegen contents， Gegen Qinliantang with the proportion of the original formula of Zhongjing was the most effective in AE model mice.

Objective:To explore the mediating effect of self-efficacy between social support and fear of dementia among middle-aged and elderly people in rural areas.Methods:This study was a cross-sectional study. A total of 271 middle-aged and elderly people from 5 rural villages in Hunan Province were selected as research objects by the convenient sampling method from January to March 2023. A questionnaire survey was conducted using General Information Questionnaire, Social Support Rating Scale (GSES), Social Support Rating Scale (SSRS), and Fear of Dementia Scale (FODS). Pearson correlation analysis was used to explore the correlation between self-efficacy, social support, and dementia fear of dementia among middle-aged and elderly people in rural areas. The mediation effect was tested using the SPSS macro program Process 4.1.Results:A total of 280 questionnaires were sent out, and 271 were effectively collected, with an effective recovery rate of 96.79% (271/280). The scores of GSES, SSRS, and FODS of 271 middle-aged and elderly people in rural areas were (22.86±6.94), (38.88±8.66) and (55.79±13.88), respectively. Pearson correlation analysis showed that social support was positively correlated with self-efficacy ( r=0.571, P<0.01), while fear of dementia was negatively correlated with social support and self-efficacy ( r=-0.368, -0.338; both P<0.01). Self-efficacy partially mediated between social support and fear of dementia, and the mediating effect was -0.111, accounting for 32.17% of the total effect. Conclusions:Self-efficacy partially mediates between social support and fear of dementia. Medical staff should pay attention to the improvement of self-efficacy of rural middle-aged and elderly people, provide continuous social support, and reduce the level of fear of dementia.

Chronic obstructive pulmonary disease (COPD) is the most prevalent chronic respiratory condition, often accompanied by various comorbidities. Sarcopenia is a significant comorbidity of COPD, impacting its progression and prognosis, therefore early intervention is crucial. Intervention for COPD with sarcopenia includes non-pharmacological and pharmacological measures. Non-pharmacological intervention encompass respiratory rehabilitation, nutritional interventions and exercise training; while pharmaceutical intervention is still in its nascent stages. This article presents a comprehensive review of the research progress on intervention measures for COPD with sarcopenia, aiming to provide insights for prevention and management of this condition.

The identification of pathogenic antigens in membranous nephropathy (MN) is a hot topic in the research field of kidney diseases. In recent years, the widespread application of mass spectrometry has brought a breakthrough in the identification of MN-pathogenic antigens. As the antigen spectrum continues to be refined, the diagnosis of MN has evolved from morphological level to molecular level. This article reviewed the research progress of currently identified antigens of MN, such as phospholipase A2 receptor (a major pathogenic antigen of primary MN), thrombospondin type 1 domain-containing 7A (a potential tumor-associated antigen), neural epidermal growth factor-like protein 1 (an antigen associated with various secondary factors), semaphorin 3B (an antigen specific to pediatric MN) and so on, and the pathogenic mechanisms and clinical significance of these antigens.

Hypervirulent Klebsiella pneumoniae (hvKP) is a highly virulent variant of Klebsiella pneumoniae and can cause systemic invasive infection. The worldwide prevalence of hvKP infection continues to increase. Diabetic patients, especially those with poor glucose control, are at a higher risk for hvKP infection. The infection of hvKP in diabetic patients is characterized by high incidence, rapid progression and high fatality rate. The mechanisms underlying the susceptibility to hvKP in patients with diabetes include hyperglycemia-induced bacterial translocation, endothelial-epithelial barrier damage, immune evasion, high-load bacteremia, microthrombosis and hvKP carbon/iron metabolism-based regulation of virulence. A thorough understanding of the mechanisms underlying the susceptibility to hvKP in diabetic patients will be great significant to further improve clinical understanding and attention, and provide early prevention and effective diagnosis and treatment. This article summarizes the progress in the mechanisms of susceptibility to hvKP in diabetic patients in recent years.

Chronic obstructive pulmonary disease (COPD) is a chronic, heterogeneous inflammatory disease with high prevalence and mortality rate. Although current treatments can relieve symptoms, they cannot prevent further decline in lung function. With the development of stem cell therapy, mesenchymal stem cells and their extracellular vesicles have received widespread attention for their anti-inflammatory, immune regulation, tissue regeneration and repair functions, aging, and other applications in the treatment of lung diseases. This article reviews the role and clinical application prospects of mesenchymal stem cells and their derived exosomes in chronic obstructive pulmonary disease and its complications.

Mismatch repair-deficient/microsatellite instability-high(dMMR/MSI-H)gastric cancer represents a distinct molecular subtype of tumors characterized by pronounced sensitivity to immune checkpoint inhibitors(ICIs)attributed to its unique immune microenvironment and elevated mutation burden.Various clinical studies underscore the efficacy of ICIs in treating dMMR/MSI-H gastric cancer;however,chal-lenges such as primary and acquired resistance persist.Overcoming resistance and identifying optimal ICIs for its treatment remain critical clinical issues.This review delineates the mechanisms of ICIs,recent advances in their therapeutic application for dMMR/MSI-H gastric can-cer,and ongoing challenges in combating resistance,aiming to guide clinical practice effectively.

The accident at Fukushima Daiichi Nuclear Power Plant has had a severe and ongoing impact on the surrounding marine environment. Tokyo Electric Power Company (TEPCO) discharged contaminated water from the accident into the ocean in 2023. This has raised concerns among the public on radiation safety. It is necessary to review and analyze the limits and standards for radionuclide activity concentrations in food and drinking water. Different measures are applied to controlling internal exposure via ingestion pathway, respectively, in planned exposure situations, emergency exposure situations or existing exposure situations, with different dose levels and dose concepts being adopted. IAEA, FAO, WHO and other international organizations have issued standards on radionuclide activity concentrations in food and drinking water. These guidelines include Codex Alimentarius Commission guidelines, WHO guidelines for drinking-water quality, operational intervention levels. The methodologies underlying these guidelines are similar, but the exposure situations and the parameters are different. After the Fukushima accident, Japan enacted and revised domestic legislation and requirements in line with the exposure situation to control and limit the radionuclide activity concentrations in food and drinking water. Restrictions are imposed on food produced in Fukushima and other prefectures. Other countries and the local organizations in Japan have also taken a wide range of measures to restrict the circulation and sales of the food from Fukushima area. Based on the experience gained from Fukushima accident and comparison of various categories of standards, this paper aims to present the recommendations on revise of standards in China with respect to applicable exposure situation, dose level, radionuclides considered, types of food, standards on drinking-water. Needs are also discussed to build a continuous and consistent protection system for the internal exposure via ingestion pathway, together with some other issues present in current standards.

  Objective  To establish and evaluate the clinical teaching and training model for refresher anesthesiologists.  Methods  A total of 25 refresher anesthesiologists from the Department of Anesthesiology in Peking Union Medical College Hospital during the period of March to September 2023 were enrolled. They were taught with the clinical teaching and training model, namely "tutorial system-knowledge update-clinical practice". The refresher anesthesiologists completed the same structured pre-designed questionnaire at the beginning and the end of training respectively. The scores were recorded and compared to evaluate the effectiveness of the clinical training model. Feedback from refresher anesthesiologists about the teaching and training model was also collected.  Results  Altogether 84%(21/25) and 100%(25/25) of questionnaires distributed were completed respectively, and 92% students gave positive feedback. The mean score at the end of training (10.1±1.1) was significantly higher than that at the beginning (5.6±1.8)(P < 0.01).  Conclusion  The "tutorial system-knowledge update-clinical practice" clinical teaching and training model was significantly useful to elevate the effectiveness of training refresher anesthesiologists and their satisfaction.