Functional dyspepsia （FD） is a prioritized disease category where traditional Chinese medicine （TCM） demonstrates distinct therapeutic advantages. The current western medicine treatment for FD is mainly based on proton pump inhibitors and prokinetic agents， with digestive enzymes， probiotics and antidepressants serving as adjuvant medication， yet such therapies still have certain limitations. TCM treatment for FD includes oral administration of Chinese herbal formulas and Chinese patent medicines， as well as external TCM therapies such as acupuncture and moxibustion， acupoint application， hot medicinal compress therapy， rubbing with ointment， medicinal iontophoresis， auricular acupoint therapy and tui na （Chinese medical massage）. The combined treatment of FD with integrated TCM and western medicine can significantly improve clinical effectiveness and reduce adverse reactions. The common mechanisms underlying the therapeutic effects of both TCM and western medicine revolve around the core pathological processes of FD， mainly focusing on restoring gastrointestinal motility， regulating the levels of brain-gut peptides， modulating intestinal microecology， and ameliorating inflammatory status. The differential mechanisms lie in the precise targeting feature of western medicine versus the holistic-regulating and multi-target characteristics of TCM， and the two approaches exert a synergistic effect to enhance efficacy. This paper proposes to leverage the advantages of TCM in holistic regulation and the strengths of western medicine in targeted treatment， so as to provide personalized and comprehensive treatment regimens for FD patients.

The chapter Zhouyu in Guoyu says "Qi of the heaven and the earth moves without losing its order." With lucidity ascending and turbidity descending， Qi moves in a normal state， and Yin and Yang consolidate the foundation of the body. The mutual interference between lucidity and turbidity leads to the disorder of Qi movement， thus causing diseases. It is a pathological state of disorder between ascending and descending， as well as between entering and exiting， gradually evolving into a state of turbidity affecting lucidity and transforming into pathogen， which can be used to interpret and analyze the core of disease pathogenesis. The theory of lucidity and turbidity is connected with the harmony of nutrient and defensive aspects， Qi circulation， and sweat pore associating with Qi movement， and it has common implications with immune responses and nutrient metabolism system， intestinal mucosal barrier function， and mitochondrial energy synthesis. Modern studies have shown that intestinal flora imbalance， bile acid receptor inactivation， macrophage polarization imbalance， epithelial-mesenchymal transition， ferroptosis and other related microscopic pathological mechanisms are involved in the development and progression of ulcerative colitis. By delving into the common meaning of the classic theory of mutual interference between lucidity and turbidity in traditional Chinese medicine and modern medical pathological mechanisms， this paper summarizes the correspondence between the micropathological mechanism and the theory of mutual interference between lucidity and turbidity in the regulation and mamagement of ulcerative colitis. The combined use of sweet and warm medicinal materials consolidates the middle Qi and activates Qi circulation， thus ascending lucidity and descending turbidity. The combined use of pungent medicinal materials for dispersing and bitter medicinal materials for descending simultaneously raises warm and clear Qi. Wind-extinguishing medicinal materials facilitate the ascending of Qi and the opening of sweat pores. Accordingly， turbidity descends and lucidity ascends. The prescriptions incorporating these medication principles are in agreement with the therapeutic approach of following the normal flow of lucidity and turbidity. This paper clarifies the scientific connotation and micropathologic mechanism of ulcerative colitis from the perspective of mutual interference between lucidity and turbidity， providing new theories and prescriptions for the clinical diagnosis， treatment， and prevention of ulcerative colitis.

ObjectiveTo evaluate the clinical efficacy of Shenqi Yangxin decoction in the treatment of ischemic cardiomyopathy （ICM） with Qi and Yin deficiency and blood stasis syndrome and its effect on serum hydrogen sulfide （H₂S） and calcium ion （Ca²⁺）. MethodsA total of 64 ICM patients with Qi and Yin deficiency and blood stasis syndrome who met the inclusion criteria were randomly divided into a control group （n=32） and a treatment group （n=32）. All patients received conventional Western medicine treatment. The treatment group was additionally given Shenqi Yangxin decoction. The TCM syndrome score， Minnesota Living with Heart Failure Questionnaire （MLHFQ） score， left ventricular ejection fraction （LVEF）， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， 6-minute walk test （6MWT）， New York Heart Association （NYHA） cardiac function classification， and serum H₂S and Ca²⁺ levels were compared between the two groups pre- and post-treatment. ResultsTwo cases dropped out from each group during the study. Finally， 30 patients in each group were included in the analysis. There were no significant differences in age， gender， course of coronary heart disease， underlying diseases， and laboratory tests between the two groups. Compared with baseline， the TCM syndrome score， MLHFQ score， and NT-proBNP in both treatment group and control group decreased significantly （P<0.01）， LVEF， 6MWT， and H₂S increased significantly （P<0.01）， and serum Ca²⁺ increased （P<0.05）. Compared with the control group after treatment， the MLHFQ score and NT-proBNP in the treatment group decreased （P<0.05）， the TCM syndrome score decreased significantly （P<0.01）， LVEF， 6MWT， and serum Ca²⁺ increased （P<0.05）， and H₂S increased significantly （P<0.01）. The improvement degree of the NYHA cardiac function classification in the treatment group was higher than that in the control group， but there was no significant difference. ConclusionShenqi Yangxin decoction is effective in treating ICM patients with Qi and Yin deficiency and blood stasis， which could significantly improve cardiac function and quality of life， and its therapeutic effect may be related to the regulation of serum H₂S and Ca²⁺ levels.

Objective To gain insights into the biological characteristics of different populations of Culex tritaeniorhynchus within and around the Yellow Sea wetland from the perspective of the occurrence of resistance, we investigated the levels of resistance to deltamethrin and kdr gene mutation in the wetland and its peripheral areas. Methods Specimens were collected from Cx. tritaeniorhynchus populations at two monitoring sites in the Rare Bird National Nature Reserve and Tiaozi Ni Wetland Scenic Area, and also from two populations in Yancheng City and the Liuhe District of Nanjing, and the resistance of these mosquitoes to deltamethrin was determined using the CDC biotest bottle method. For each concentration of deltamethrin assessed, a random subset of exposed specimens was selected for amplification of the kdr gene fragment, followed by Sanger sequencing to identify and analyze resistance-associated mutations. Results The LC50 levels of deltamethrin among mosquitoes from the four populations in Luhe, Yancheng, the Rare Bird National Nature Reserve and the Tiaozi Ni Wetland Scenic Area were 2.048 5, 7.798 2, 3.473 3, and 17.695 5 mg/mL, respectively, with corresponding concentrations of deltamethrin ranging from 0.005 to 5.000,0.050 to 50.000,0.050 to 25.000 and 0.050 to 50.000 mg/mL, respectively. Furthermore, the ranges of the KT50 values were 11.76-107.43, 67.05-216.30,29.77-107.43 and 28.40-329.51 min; the 1-h knockdown rates were 34.58%-99.15%, 9.52%-43.80%, 55.09%-73.01%, and 10.09%-68.07%; and the 24-h mortality rates were 12.15%-67.52%,9.52%-79.56%,13.17%-82.21%, and 11.01%-78.99%, respectively. With respect to kdr gene mutation, we assayed a total of 63,70,59, and 57 mosquitoes for the four populations, for which we detected L1014F mutation frequencies of 14.29%, 35.00%, 20.34%, and 31.58%, respectively, with a majority of these mutations being heterozygous for resistance. In addition, five adult mosquitoes were identified has having synonymous mutations at site 1011[i. e. , AAT(asparagine)mutation to AAC(asparagine)]. Conclusions Our findings revealed the clear resistance of Cx. tritaeniorhynchus to deltamethrin in the Yancheng region of the Yellow Sea wetland, and the resistance phenotype and kdr frequency of Cx. tritaeniorhynchus in the wetland environment were comparable to those of Cx. tritaeniorhynchus in the wetland environment, thereby indicating that the resistance of different populations of Cx. tritaeniorhynchus was homogeneous under the pressure of different insecticide selection within and around the wetland. However, the underlying mechanisms need to be further studied.

BackgroundBipolar disorder is a severe mental disorder characterized by alternating episodes of mania and depression. It has a high recurrence rate and a high rate of disability. Elderly patients often suffer from more severe cognitive impairment due to neurodegenerative changes. The clinical intervention for bipolar disorder mainly relies on drug treatment， but drugs have limited effects on improving cognitive function， and some drugs may even aggravate cognitive impairment. Aerobic exercise， as a non-drug intervention method， has shown positive effects in improving cognitive function in patients with mental disorders. However， there are still insufficient studies on elderly patients with bipolar disorder. ObjectiveTo explore the impact of aerobic exercise on the cognitive function of elderly patients with bipolar disorder， so as to provide references for the formulation of strategies to improve the cognitive function of this population. MethodsA randomized controlled trial was conducted. A total of 60 elderly patients who were hospitalized at the Third People's Hospital of Lanzhou from January 2024 to March 2025 and met the diagnostic criteria for bipolar disorder as defined in the International Classification of Diseases，tenth edition （ICD-10） were selected. They were divided into the study group and the control group， with 30 cases in each group， based on the random number table method. Both groups were given quetiapine fumarate tablets and magnesium valproate sustained-release tablets. The study group additionally received aerobic exercise （including slow walking， doing exercises， and running）， three times a week， for 30 minutes each time. At the baseline and at the end of the 3^rd， 6^th， 9^th， and 12^th week of the intervention， the Hamilton Depression Scale -24 item （HAMD-24）， the Young Manic Rating Scale （YMRS）， the Montreal Cognitive Assessment （MoCA）， and Wechsler Adult Intelligence Scale Revised in China （WMS-RC） were used for assessment. ResultsThe time effect of the HAMD-24 score was statistically significant （Wald χ²=124.564， P<0.01）. The time effect of the YMRS score was also statistically significant （Wald χ²=145.608， P<0.01）， and the interaction effect between time and group was statistically significant （Wald χ²=14.968， P<0.05）. At the 3^rd， 9^th， and 12^th week of the intervention， the YMRS score of the study group was lower than that of the control group in the same period， and the differences were statistically significant （P<0.05）. The time effect and group effect of the MoCA score were both statistically significant （F=99.347， 16.623， P<0.01）. The time effect， group effect， and interaction effect between time and group of the WMS-RC memory quotient were all statistically significant （F=64.678， 10.197， 12.472， P<0.01）. At the 6^th， 9^th， and 12^th weeks of the intervention， the MoCA score and WMS-RC memory quotient of the study group were higher than those of the control group， and the differences were statistically significant （P<0.05）. ConclusionAerobic exercise may help improve the manic symptoms and cognitive functions （especially memory ability） of elderly patients with bipolar disorder. ［Funded by Science and Technology Project of Gansu Province （number， 24JRRA775）； Science and Technology Project of Lanzhou City（number， 2022-5-155）］

This study was aimed at preliminarily assessing the prevalence of latent tuberculosis infection(LTBI)among cattle farming and slaughterhouse workers across Wuxue,Xianning,and Yichang Cities in Hubei Province,and exploring associated risk factors.Data on cattle farming and slaughterhouse workers were gathered via a questionnaire.LTBI detection was performed with a tu-berculin skin test and interferon-gamma release assay,and influencing factors were subsequently analyzed.The LTBI prevalence among cattle farming and slaughterhouse personnel in the three cities was 30.50%,and a higher rate was observed in slaughterhouse workers(39.01%)than cattle farmers(21.63%)(P<0.01).Multifactor analysis indicated that working in slaughterhouses(95%CI:1.582-3.878),having a history of tuberculosis(95%CI:1.377-25.057)or BCG vaccination(95%CI:1.229-3.285),and having a college education or above(95%CI:0.303-0.859)were significant factors influencing LTBI positivity in these personnel.Having more than 30 years of work experience(95%CI:1.303-18.782)was a risk factor for personnel at cattle breeding farms.Among slaugh-terhouse personnel,having a college education or above(95%CI:0.164-0.894),11-20 years of work experience(95%CI:0.122-0.994),or a history of tuberculosis(95%CI:1.661-64.397);performing logistics work(95%CI:3.234-126.424);and working in slaughter-related positions(95%CI:1.209-19.639)were associated with LTBI positivity.Therefore,the slaughterhouse workers in the three cities had higher LTBI rates than the cattle farming workers,thus underscoring the need for increased attention to personnel in logistics and slaughter-related positions.

Objective To develop a rehabilitation nursing model for knee osteoarthritis(KOA)of external treatment in traditional Chinese medicine(TCM).Methods Between February and June 2023,a preliminary KOA rehabilitation nursing model was developed through literature search and semi-structured interview method.Two rounds of Delphi consultations were conducted with the selected experts,to establish a rehabilitation nursing model for KOA of TCM external treatment.Results A total of 24 experts from different regions participated in the consultation.The final rehabilitation nursing model of TCM external treatment for KOA included 3 primary indicators,16 secondary indicators and 91 tertiary indicators.The response rates from the two rounds of expert consultation were 96.00%and 100.00%,respectively,and the rates of expert opinion proposal were 58.33%and 8.33%,respectively.The expert authority coefficient were 0.906 and 0.923.The two rounds of expert consultation were 0.137 and 0.236 in Kendall's coefficient of concordance(W),with statistically significant differences(both P<0.001).The importance scores of each item in the second inquiry ranged from 3.75 to 4.88,and the coefficient of variation ranged from 0.07 to 0.30,and the full score ratio ranged from 20.83%to 87.50%.Conclusion The rehabilitation nursing model for KOA of TCM external treatment developed in this study is significant,scientific and feasible.It provides a guidance for medical professionals.

Objective:To investigate the application value of needle-knife accurate fistulo-tomy (NKAF) for difficult biliary cannulation during endoscopic retrograde cholangiopancreato-graphy (ERCP).Methods:The retrospective and descriptive study was conducted. The clinicopatho-logical data of 137 patients with difficult biliary cannulation during ERCP at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between January 2021 and December 2022 were collected. There were 51 males and 86 females, aged (69±13)years. All 137 patients received NKAF for cannulation during ERCP. Observation indicators: (1) surgical situations; (2) complications. Measurement data with normal distribution were represented as Mean± SD. Count data were repre-sented as absolute numbers. Results:(1) Surgical situations. Of 137 patients, 136 cases had succe-ssful cannulation, 1 case had failed cannulation with NKAF following unsuccessful double-guidewire technique. In the 136 successful cases, the endoscope was straightened in 42 cases, left in a long position in 37 cases, and maintained in the standard position in 57 cases. The cannulation time was (90±8)s. (2) Complications. The serum amylase at postoperative 6 hours in the 136 successful cases was (163±23)U/L. No patient developed post-ERCP pancreatitis. Of the 136 patients with successful cannulation, one case experienced post-sphincterotomy bleeding, which was observed oozing from the papillary orifice on emergency gastroscopy. The patient was successfully controlled with endoscopic clips.Conclusion:NKAF is safe and effective for difficult biliary cannulation during ERCP.

AIM To evaluate the quality of Rubi Fructus.METHODS UPLC-Q-TOF-MS/MS was adopted in the component identification,after which the HPLC fingerprints were established,cluster analysis,principal component analysis and orthogonal partial least squares discriminant analysis were used for chemical pattern recognition.and the contents of chlorogenic acid,ferulic acid,ellagic acid,isoquercitrin,kaempferol-3-O-rutinoside,astragalin,tiliroside quercetin,kaempferol were determined.RESULTS Total 34 constituents were identified.There were 19 common peaks in the fingerprints for 31 batches of medicinal materials with the similarities of more than 0.8.Wild varieties and cultivated varieties,and medicinal materials from different producing areas could be distinguished;4 principal components demonstrated the accumulative variance contribution rate of 84.142％;8 differential components were screened,2 of which were ellagic acid and astragalin.Ellagic acid and astragalin displayed higher contents in the wild varieties than those in the cultivated varieties(P＜0.05,P＜0.01).CONCLUSION UPLC-Q-TOF-MS/MS,HPLC fingerprints combined with content determination can be used for the quality control of Rubi Fructus.

AIM To compare total sugar,total protein,total phenol,total flavonoid,calycosin-7-O-β-D-glucoside,liquiritin,lobetyolin,quercetin,isoferulic acid,hesperidin,glycyrrhizic acid contents and their antioxidant activities,hypoglycemic activities of big honey pill,small honey pill,water pill,concentrated pill,granule,mixture and decoction of Buzhong Yiqi Recipe.METHODS Anthraquinone-sulfuric acid method,Coomassie brilliant blue method,Folin-phenol colorimetry method,sodium nitrite-aluminum nitrate method and HPLC were adopted in the content determination of total sugar,total protein,total phenol,total flavonoid and seven constituents,respectively,after which the scavenging capacities,reducing powers on DPPH·free radical,ABTS+free radical,hydroxyl free radical,and inhibition capacity on α-glucosidase activity were detected.Subsequently,correlation analysis was performed.RESULTS Total sugar,total protein,total phenol and total flavonoid contents demonstrated significant differences among different dosage forms(P＜0.05,P＜0.01).Calycosin-7-O-β-D-glucoside,glycyrrhizin,codonoside and quercetin displayed the highest contents in the decoction,while those of isoferulic acid,hesperidin and glycyrrhizin were observable in the mixture.The water pill exhibited the strongest antioxidant activity,while those of the concentrated pill and mixture were weak;the big honey pill exhibited the strongest hypoglycemic activity,while that of the decoction was the weakest.Total protein,total phenol,total flavonoid and liquiritin contents displayed significant positive correlations between antioxidant activity(P＜0.05,P＜0.01),while hesperidin content displayed significant negative correlation between the latter(P＜0.05);total protein,calycosin-7-O-β-D-glucoside,codonoside and quercetin contents displayed significant negative correlations between hypoglycemic activity(P＜0.05,P＜0.01).CONCLUSION Active constituent contents and their biological activities of Buzhong Yiqi Recipe with different dosage forms exist differences,total sugar,total protein,total flavonoids,calycosin-7-O-β-D-glucoside,licorice glycoside,hesperidin,codonoside and quercetin can be taken as quality control indices for this prescription.