ObjectiveTo investigate the effects of Qizhujianwei granules （QZJW） on abnormal proliferation and malignant transformation of gastric mucosal cells in rats with gastric intraepithelial neoplasia （GIN） and to explore the related mechanisms. MethodsA total of 80 SPF male Wistar rats were used. A GIN rat model was established using a four-factor comprehensive method consisting of methylnitronitrosoguanidine （MNNG）， ranitidine， irregular feeding patterns， and sodium salicylate. Except for the normal group， after successful modeling， the rats were randomly divided according to body weight into a model group， a Moluodan group （0.55 g·kg^-1）， and a QZJW group （7.34 g·kg^-1）， with 12 rats in each group. All groups were treated for 8 weeks. The general characteristics of the rats and morphological changes of the gastric mucosa were observed. Histopathological changes of the gastric mucosa were examined by hematoxylin-eosin （HE） staining. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum levels of pepsinogenⅠ （PGⅠ）， pepsinogenⅡ （PGⅡ）， and gastrin （G-17）， as well as the expression level of transforming growth factor-β₁ （TGF-β₁） in gastric mucosal tissue， and the PGⅠ/PGⅡ ratio was calculated. Immunohistochemistry （IHC） was used to detect the localization and expression levels of proliferating cell nuclear antigen （Ki-67） and Vimentin in gastric mucosal tissue. Western blot analysis was used to determine the protein expression levels of Wnt family member 3A （Wnt3a）， β-catenin， CyclinD₁， proto-oncogene Cmyc， transforming growth factor-β receptor Ⅰ （TGFβRⅠ）， intracellular signaling transducers Smad2/3， phosphorylated （p）-Smad2/3， twist family transcription factor （Twist1）， and Vimentin in gastric mucosal tissue. ResultsCompared with the normal group， the model group showed characteristic changes including dim eyes， pale ears and claws， dark-red tongue， and reduced luster of the tail. The gastric mucosa appeared pale， with surface congestion and erosion. The gastric mucosal glands were disordered， the nuclear-to-cytoplasmic ratio increased， and local tumor cells were observed. Serum PGⅠ and PGⅡ levels and the PGⅠ/PGⅡ ratio were significantly decreased （P<0.01）， while the level of G-17 was significantly increased （P<0.01）. The protein expression levels of Ki-67， Wnt3a， β-catenin， CyclinD₁， Cmyc， TGF-β₁， TGFβRⅠ， Smad2/3， Twist1， and Vimentin in gastric mucosal tissue were significantly increased （P<0.05， P<0.01）， whereas the ratio of p-Smad2/3 to Smad2/3 was significantly decreased （P<0.05）. Compared with the model group， the general characteristics and gastric mucosal conditions of rats in the Moluodan group and the QZJW group were improved. HE staining showed that QZJW could effectively block the malignant progression of GIN. Serum PGⅠ and PGⅡ levels and the PGⅠ/PGⅡ ratio were significantly increased （P<0.05， P<0.01）， while the level of G-17 was significantly decreased （P<0.01）. The protein expression levels of Ki-67， Wnt3a， β-catenin， CyclinD₁， Cmyc， TGF-β₁， TGFβRⅠ， Smad2/3， Twist1， and Vimentin in gastric mucosal tissue were significantly decreased （P<0.05， P<0.01）. ConclusionQZJW have a therapeutic effect on rats with GIN. The mechanism may involve inhibition of the Wnt/β-catenin signaling pathway to regulate the cell cycle and suppress abnormal cell proliferation. Meanwhile， it may inhibit epithelial-mesenchymal transition by suppressing the TGF-β₁/Smad/Twist1 signaling pathway， thereby blocking the malignant progression of GIN.

ObjectiveTo investigate the effects of Qizhujianwei granules （QZJW） on abnormal proliferation and malignant transformation of gastric mucosal cells in rats with gastric intraepithelial neoplasia （GIN） and to explore the related mechanisms. MethodsA total of 80 SPF male Wistar rats were used. A GIN rat model was established using a four-factor comprehensive method consisting of methylnitronitrosoguanidine （MNNG）， ranitidine， irregular feeding patterns， and sodium salicylate. Except for the normal group， after successful modeling， the rats were randomly divided according to body weight into a model group， a Moluodan group （0.55 g·kg^-1）， and a QZJW group （7.34 g·kg^-1）， with 12 rats in each group. All groups were treated for 8 weeks. The general characteristics of the rats and morphological changes of the gastric mucosa were observed. Histopathological changes of the gastric mucosa were examined by hematoxylin-eosin （HE） staining. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum levels of pepsinogenⅠ （PGⅠ）， pepsinogenⅡ （PGⅡ）， and gastrin （G-17）， as well as the expression level of transforming growth factor-β₁ （TGF-β₁） in gastric mucosal tissue， and the PGⅠ/PGⅡ ratio was calculated. Immunohistochemistry （IHC） was used to detect the localization and expression levels of proliferating cell nuclear antigen （Ki-67） and Vimentin in gastric mucosal tissue. Western blot analysis was used to determine the protein expression levels of Wnt family member 3A （Wnt3a）， β-catenin， CyclinD₁， proto-oncogene Cmyc， transforming growth factor-β receptor Ⅰ （TGFβRⅠ）， intracellular signaling transducers Smad2/3， phosphorylated （p）-Smad2/3， twist family transcription factor （Twist1）， and Vimentin in gastric mucosal tissue. ResultsCompared with the normal group， the model group showed characteristic changes including dim eyes， pale ears and claws， dark-red tongue， and reduced luster of the tail. The gastric mucosa appeared pale， with surface congestion and erosion. The gastric mucosal glands were disordered， the nuclear-to-cytoplasmic ratio increased， and local tumor cells were observed. Serum PGⅠ and PGⅡ levels and the PGⅠ/PGⅡ ratio were significantly decreased （P<0.01）， while the level of G-17 was significantly increased （P<0.01）. The protein expression levels of Ki-67， Wnt3a， β-catenin， CyclinD₁， Cmyc， TGF-β₁， TGFβRⅠ， Smad2/3， Twist1， and Vimentin in gastric mucosal tissue were significantly increased （P<0.05， P<0.01）， whereas the ratio of p-Smad2/3 to Smad2/3 was significantly decreased （P<0.05）. Compared with the model group， the general characteristics and gastric mucosal conditions of rats in the Moluodan group and the QZJW group were improved. HE staining showed that QZJW could effectively block the malignant progression of GIN. Serum PGⅠ and PGⅡ levels and the PGⅠ/PGⅡ ratio were significantly increased （P<0.05， P<0.01）， while the level of G-17 was significantly decreased （P<0.01）. The protein expression levels of Ki-67， Wnt3a， β-catenin， CyclinD₁， Cmyc， TGF-β₁， TGFβRⅠ， Smad2/3， Twist1， and Vimentin in gastric mucosal tissue were significantly decreased （P<0.05， P<0.01）. ConclusionQZJW have a therapeutic effect on rats with GIN. The mechanism may involve inhibition of the Wnt/β-catenin signaling pathway to regulate the cell cycle and suppress abnormal cell proliferation. Meanwhile， it may inhibit epithelial-mesenchymal transition by suppressing the TGF-β₁/Smad/Twist1 signaling pathway， thereby blocking the malignant progression of GIN.

BackgroundObsessive-compulsive disorder （OCD） carries a considerable disability burden. Intolerance of uncertainty （IU） is associated with the severity of obsessive-compulsive symptoms， yet its neural underpinnings remain unclear. The cerebellum has been implicated in uncertainty processing and demonstrates structural and functional abnormalities in OCD， but direct evidence linking its spontaneous activity to the relationship between IU and obsessive-compulsive symptoms is still lacking. ObjectiveTo explore the pathway through which spontaneous cerebellar neural activity mediates the relationship between IU and obsessive-compulsive symptoms in OCD patients， with the aim of providing a new perspective for understanding the neural mechanisms of OCD. MethodsA total of 51 patients with OCD who visited the Mental Health Center outpatient clinic of the General Hospital of Ningxia Medical University from November 2022 to November 2024 and met the diagnostic criteria for OCD according to the International Classification of Diseases， tenth edition （ICD-10）. During the same period， 43 community-based volunteers matched for gender and age were enrolled as the control group. Resting-state functional magnetic resonance imaging data were collected from two groups. Amplitude of low-frequency fluctuation （ALFF） analysis was used to compare whole-brain spontaneous neural activity between two groups. Clinical assessments were conducted using the Yale-Brown Obsessive Compulsive Scale （Y-BOCS） and the Intolerance of Uncertainty Scale-12 （IUS-12）. Pearson correlation analysis was used to examine correlations between cerebellar ALFF values and scale scores in OCD patients. Using IU as the independent variable， obsessive-compulsive symptoms as the dependent variable， and ALFF values from between-group difference brain regions as the mediator， Process 4.0 for SPSS 24.0 （model 4） was used to examine the mediating role of these ALFF values between IU and obsessive-compulsive symptoms. The Bootstrap method was used to test the mediation effect. ResultsA total of 47 OCD patients and 40 controls completed this study. Compared with the control group， the OCD group showed decreased ALFF values in the right cerebellar Crus Ⅱ （t=-5.254， FWE-corrected P<0.01）. Correlation analysis revealed that ALFF value in the right cerebellar Crus Ⅱ was negatively correlated with Y-BOCS total score （r=-0.851）， compulsive behavior subscale score （r=-0.647）， IUS-12 total scores （r=-0.617）， and prospective IU subscale scores （r=-0.717） in OCD group （P<0.01）. Prospective IU subscale scores were positively correlated with Y-BOCS total scores （r=0.811） and compulsive behavior subscale score （r=0.535） （P<0.01）. Mediation analysis showed that ALFF value in the right cerebellar Crus Ⅱ region partially mediated the effect of prospective IU on obsessive-compulsive behavior， with a mediation effect of 0.064 （95% CI： 0.004–0.136）， accounting for 24.57% of the total effect. ConclusionPatients with OCD showed reduced spontaneous neural activity in the right cerebellar Crus Ⅱ region， which was significantly associated with IU and obsessive-compulsive symptoms. This region partially mediated the effect of IU on compulsive behaviors. ［Funded by Basic Conditions and Innovation Platform Construction Project of Ningxia Hui Autonomous Region in 2023 （number， 2022YXGCJS001）］

ObjectiveTo investigate the potential mechanism of action of the Qufeng Tongqiao Cough-relieving Decoction （祛风通窍止咳方， QTCD） in the treatment of upper airway cough syndrome （UACS）. MethodsTwenty-four guinea pigs were randomly divided into blank group， model group， traditional Chinese medicine （TCM） group， and inhibitor group， with six guinea pigs in each group. Except for the blank group， guinea pigs were sensitized with ovalbumin and aluminum hydroxide via intraperitoneal injection， followed by ovalbumin nasal drops combined with smoke exposure to establish the UACS model. After modeling， the TCM group was administered QTCD 0.9 g/（100 g·d） by gavage， the inhibitor group received the transient receptor potential vanilloid receptor 4 （TRPV4） inhibitor GSK2193874 1 mmol/L， 5 min by nebulisation， and the blank group and model group were given 2 ml/（100 g·d） normal saline by gavage once daily. After 7 days of treatment， a cough provocation test was performed using 0.4 mol/L citric acid. The levels of IgE in serum and inflammatory cytokines， including interleukin-6 （IL-6）， interleukin-8 （IL-8） in serum， bronchoalveolar lavage fluid （BALF）， and nasal lavage fluid （NLF） were detected by enzyme-linked immunosorbent assay （ELISA）. Histopathological changes in lung and nasal mucosal tissues were observed by hematoxylin-eosin （HE） staining. Immunohistochemistry was used to detect the protein levels of TRPV4， substance P （SP）， and calcitonin gene-related peptide （CGRP） in lung and nasal mucosal tissues. Real-time polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of TRPV4， SP， and CGRP in lung tissues. ResultsHE staining showed significant structural damage and infiltration of inflammatory cells in the lung and nasal mucosal tissues in the model group， while the TCM group and inhibitor group showed improved pathological changes. Compared with the blank group， the model group showed increased cough frequency， serum IgE level， and IL-6 and IL-8 levels in serum， BALF， and NLF. The protein levels of TRPV4， SP， and CGRP in lung and nasal mucosal tissues and their mRNA expression were elevated （P＜0.05 or P＜0.01）. Compared with the model group， the TCM group and inhibitor group showed reduced cough frequency， serum IgE level， and TRPV4 and SP mRNA expression in lung tissues. The TCM group showed reduced IL-6 and IL-8 levels in serum， BALF， and NLF， and reduced TRPV4 and CGRP protein levels in lung and nasal mucosal tissues. The inhibitor group showed reduced IL-6 and IL-8 levels in serum， BALF， and NLF， reduced IL-6 in BALF， reduced IL-8 in NLF， and decreased TRPV4， SP， and CGRP protein levels in lung tissues and SP and CGRP protein levels in nasal mucosal tissues （P＜0.05 or P＜0.01）. Compared with the TCM group， the inhibitor group had increased serum IgE， IL-6， and IL-8 levels， increased IL-6 level in BALF， and increased IL-8 levle in NLF， but decreased SP protein level in lung tissues and increased TRPV4 and SP mRNA expression in lung tissues （P＜0.01）. ConclusionQTCD effectively reduces cough frequency in the UACS guinea pig model. Its mechanism may involve inhibiting the activation of the TRPV4 pathway， improving airway neurogenic inflammation， alleviating inflammatory responses， and reducing cough hypersensitivity.

Objective To observe the clinical efficacy of Ziwu Liuzhu(midnight-midday ebb and flow,the movement of qi and blood in the meridians following heavenly-stems and earthly-branches cycle)timing point application in treating pediatric pneumonic cough of phlegm-heat obstructing lung syndrome.Methods A total of 300 cases of children with pediatric pneumonic cough of phlegm-heat obstructing lung syndrome admitted to the First Clinical Hospital of Jilin Academy of Traditional Chinese Medicine from January 2023 to April 2024 were randomly divided into observation group and control group according to random number table method,150 cases in each group,and both groups of children were given the conventional symptomatic treatment with western medicine,while the control group was given Cefuroxime Sodium intravenous drip.The observation group was treated with Ziwu Liuzhu timing point application on the basis of treatment of the control group.After treatment,the clinical efficacy of the two groups was evaluated,and the changes in traditional Chinese medicine(TCM)syndrome scores before and after treatment were observed,and the symptoms such as disappearance time of lung rale,recovery time of body temperature,recovery time of heart rate,and return to normal time of X-ray findings of the two groups were observed.The changes of red blood cell count(RBC),white blood cell count(WBC),platelet count(PLT)and C-reactive protein(CRP)levels before and after treatment were compared between the two groups.The safety and occurrence of adverse reactions in the two groups were also evaluated.Results(1)The total effective rate was 94.67%(142/150)in the observation group and 84.67%(127/150)in the control group.The efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(2)After treatment,the TCM syndrome scores of the children in the two groups were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(3)After treatment,the observation group was superior to the control group in the disappearance time of lung rales,recovery time of body temperature,recovery time of heart rate,and return to normal time of X-ray findings,the difference being statistically significant(P<0.05).(4)After treatment,the RBC,WBC,PLT and CRP levels of the children in the two groups were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(5)The incidence rate of adverse reactions in the observation group was 10.67%,and that in the control group was 16.00%;the intergroup comparison showed that the difference being not statistically significant(P>0.05).Conclusion Ziwu Liuzhu timing point application in treating pediatric pneumonic cough of phlegm-heat obstructing lung syndrome can effectively improve the children's clinical symptoms,promote their recovery of lung function,alleviate the inflammatory reaction,which is safety,and with less adverse reaction.

BackgroundObsessive-compulsive disorder （OCD） is a common neuropsychiatric illness and is listed as one of the top ten disabling conditions causing loss of income and reduced quality of life. Psychological distress is an important cause of anhedonia in OCD patients， and is closely related to psychosomatic symptoms. Therefore， exploring the role of anhedonia in the relationship between psychological distress and psychosomatic symptoms is of great significance for optimizing clinical psychological treatment protocols for OCD patients. ObjectiveTo explore the role of anhedonia in the relationship between psychological distress and psychosomatic symptoms in OCD patients， with the aim of providing references for managing psychosomatic symptoms in patients. MethodsA total of 90 patients who met the diagnostic criteria for OCD according to the International Classification of Diseases， tenth edition （ICD-10）， and who visited the Mental Health Center outpatient clinic of General Hospital of Ningxia Medical University from September 2023 to November 2024 were selected as the study objects. The instruments and techniques used for the evaluation were： Dimensional Anhedonia Rating Scale （DARS）， 10-item Kessler Psychological Distress Scale （K10） and Psychosomatic Symptom Scale （PSSS）. Model 4 of the Process for SPSS 26.0 was used to test the mediating role of anhedonia in the relationship between psychological distress and psychosomatic symptoms， with Bootstrapping used to assess the significance of mediating effect. ResultsA total of 84 patients （93.33%） completed the valid questionnaire. K10 score was positively correlated with PSSS total score， psychological symptom score and physical symptom score （r=0.559， 0.460， 0.551， P<0.01）. K10 score was negatively correlated with DARS total score （r=-0.527， P<0.01）. The total score of DARS was negatively correlated with PSSS total score （r=-0.497， P<0.01）. Anhedonia mediated the relationship between psychological distress and psychosomatic symptoms， with an indirect effect value was 0.148 （95% CI： 0.042~0.278）， accounting for 26.48% of the total effect. ConclusionPsychological distress can affect the psychosomatic symptoms in OCD patients both directly and indirectly via anhedonia.

Objective To observe the effects of electroacupuncture at"Neiguan"and"Gongsun"on autophagy and apoptosis related indexes of interstitial cells of Cajal(ICC)in rats with functional dyspepsia(FD);To explore its possible mechanism on improving gastrointestinal motility of FD.Methods Totally 32 SPF grade SD rats were randomly divided into blank group,model group,electroacupuncture group and Western medicine group,with 8 rats in each group.An FD model was constructed using a composite etiology modeling method.The electroacupuncture group received electroacupuncture at"Neiguan"and"Gongsun",while the Western medicine group received oral administration of mosapride once a day for 7 consecutive days.The general condition,body mass and average daily intake of rats were observed every week,and gastric emptying rate and small intestine propulsion rate were detected,transmission electron microscopy was used to observe the structure of gastric antrum ICC,Western blot was used to observe the expressions of c-kit,Beclin1,LC3Ⅱ/Ⅰ,p62,Caspase-3 protein in gastric antrum tissue,qPCR was used to observe the mRNA expressions of Beclin1,LC3Ⅱ/Ⅰ,p62 and c-kit in gastric antrum tissue,TUNEL staining was used to detect the apoptosis rate of cells in gastric antrum tissue.Results Compared with the blank group,the model group rats were mentally lethargic,clustered and curled up,with reduced activity,rough and dull hair,loose and unformed feces,reduced body mass and daily food intake(P<0.05),and gastric emptying rate and small intestine propulsion rate decreased(P<0.01),ICC mitochondria swelled and dissolved,with varying degrees of vacuolar formation,rough endoplasmic reticulum dilation and destruction,and a large number of autophagosomes,the expressions of Beclin1 and LC3 Ⅱ/Ⅰ protein and mRNA in gastric antrum tissue increased(P<0.01),the expressions of p62,c-kit protein and mRNA decreased(P<0.01),while Caspase-3 protein expression increased(P<0.01),and the apoptosis rate of gastric antral tissue cells increased(P<0.01).Compared with the model group,the condition of rats in electroacupuncture group and the Western medicine group were improved,with increased responsiveness,increased mobility,neat hair,formed feces,increased body mass and daily food intake(P<0.01),and gastric emptying rate and small intestine propulsion rate increase(P<0.01),a normal ICC structure,and a small amount of autophagosomes were still visible,the expressions of Beclin1,LC3Ⅱ/Ⅰ protein and mRNA in gastric antrum tissue decreased(P<0.01),the expressions of p62,c-kit protein and mRNA increased(P<0.01),while Caspase-3 protein expression decreased(P<0.01),and the apoptosis rate of gastric antral tissue cells decreased(P<0.01).There was no statistically significant difference in various indicators between electroacupuncture group and Western medicine group(P>0.05).Conclusion Electroacupuncture at"Neiguan"and"Gongsun"can restore the number and structure of ICC and improve gastrointestinal motility,and its mechanism may be related to the inhibition of autophagy and apoptosis levels.

Objective To provide a comprehensive and multi-dimensional objective assessment of the online medi-cal service quality supplied by public hospitals in China,and providing feasible suggestions for further improving.Methods It adopted a standardized patient method and relied on the IOM model to conduct a descriptive analy-sis of the online medical service quality from the perspectives of safety and effectiveness,efficiency,patient-cen-tered care,and accessibility.Results The process quality(adherence to checklist)in public hospital was 17.65％,the diagnostic accuracy was 66.04％,and the treatment correctness was 88.68％.The average consultation fee was 50 yuan.The patients'disease experience was 4.00 points,the social situation was 0,and the agreement between the physician and the patient was 12.00 points.The average time waiting for first response was about 1.60 hours,the average time waiting for each response was about 5.14 hours,and the patient's total time was about 20.32 hours.The time for response was 3,and the total words of providers was 149.50.Conclusion Internet medical ser-vices quality in public hospital are still insufficient in three aspects:the process quality(adherence to checklist),pa-tient-centered care,and accessibility.Improving online medical service quality can be achieved by strengthening"in-process supervision"and improving physicians'comprehensive clinical ability.

Neuroinflammation refers to a widespread immune response within central nervous system.T lymphocytes,as main effector cells in cellular immunity,regulate activity of astrocytes through cytokines secretion by various subgroups and participate in pathological process of neuroinflammation.Astrocytes are the most abundant glial cells in central nervous system.Astrocytes activated by T lymphocytes produce pro-inflammatory cytokines and other inflammatory mediators,alter structure of tight junction,contribute to breakdown of blood-brain barrier,and provide conditions for immune cells to migrate to central nervous system.This review is based on integrity of blood-brain barrier and briefly explores crosstalk mechanism between astrocytes and T lymphocytes in neuroinflammatory diseases,including Alzheimer's disease,multiple sclerosis,amyotrophic lateral sclerosis,viral encephalitis and migraine,in order to provide new potential biomarkers and directions for treatment of neuroinflammatory diseases.

Neuroinflammation refers to a widespread immune response within central nervous system.T lymphocytes,as main effector cells in cellular immunity,regulate activity of astrocytes through cytokines secretion by various subgroups and participate in pathological process of neuroinflammation.Astrocytes are the most abundant glial cells in central nervous system.Astrocytes activated by T lymphocytes produce pro-inflammatory cytokines and other inflammatory mediators,alter structure of tight junction,contribute to breakdown of blood-brain barrier,and provide conditions for immune cells to migrate to central nervous system.This review is based on integrity of blood-brain barrier and briefly explores crosstalk mechanism between astrocytes and T lymphocytes in neuroinflammatory diseases,including Alzheimer's disease,multiple sclerosis,amyotrophic lateral sclerosis,viral encephalitis and migraine,in order to provide new potential biomarkers and directions for treatment of neuroinflammatory diseases.