BACKGROUND:Studies have shown that there is a close relationship between pyroptosis,inflammatory factors and osteoporosis.OBJECTIVE:To review the effects of pyroptosis and inflammatory factors on the pathogenesis of osteoporosis from the perspectives of osteogenic differentiation and osteoclastic differentiation,based on an overview of pyroptosis in relation to the interaction of relevant inflammatory factors.METHODS:The first author used the computer to search the literature published by each database until 2024,and searched CNKI,WanFang,VIP and PubMed databases with the search terms of"pyroptosis,inflammatory factors,osteoporosis,osteoblast,osteoclast,bone metabolism,signaling pathway,review"in Chinese and English.A total of 79 papers were finally included according to the inclusion criteria.RESULTS AND CONCLUSION:The progression of osteoporosis is closely related to inflammation,in which pyroptosis plays a key role.Immune cells induce pyroptosis through apoptosis pathway,promote the secretion of inflammatory factors such as interleukin-18,interleukin-1β and NLRP3,build an inflammatory immune microenvironment,and regulate bone metabolism through complex signaling pathways,resulting in enhanced bone absorption and reduced bone formation,thereby leading to osteoporosis.Previous studies have shown that inhibiting pyroptosis is anti-inflammatory and slows the progression of osteoporosis,and it has been shown to improve inflammatory bone loss in vitro and in animal models.At present,research on pyroptosis and osteoporosis is limited.On the one hand,the exact mechanism of osteoporosis and the pathogenesis of pyroptosis are unknown,and the specific pathways and regulatory mechanisms remain to be understood.On the other hand,therapeutic strategies targeting pyroptosis are still theoretical,not clinically proven,and drug side effects are unknown.In the future,the research focus is to further explore the pathogenesis,especially the mechanism of pyroptosis,identify potential therapeutic targets,further study the pyroptosis signaling pathway and Gasdermin protein,and develop new drugs to improve the therapeutic effect in patients with osteoporosis.

BACKGROUND:Studies have shown that there is a close relationship between pyroptosis,inflammatory factors and osteoporosis.OBJECTIVE:To review the effects of pyroptosis and inflammatory factors on the pathogenesis of osteoporosis from the perspectives of osteogenic differentiation and osteoclastic differentiation,based on an overview of pyroptosis in relation to the interaction of relevant inflammatory factors.METHODS:The first author used the computer to search the literature published by each database until 2024,and searched CNKI,WanFang,VIP and PubMed databases with the search terms of"pyroptosis,inflammatory factors,osteoporosis,osteoblast,osteoclast,bone metabolism,signaling pathway,review"in Chinese and English.A total of 79 papers were finally included according to the inclusion criteria.RESULTS AND CONCLUSION:The progression of osteoporosis is closely related to inflammation,in which pyroptosis plays a key role.Immune cells induce pyroptosis through apoptosis pathway,promote the secretion of inflammatory factors such as interleukin-18,interleukin-1β and NLRP3,build an inflammatory immune microenvironment,and regulate bone metabolism through complex signaling pathways,resulting in enhanced bone absorption and reduced bone formation,thereby leading to osteoporosis.Previous studies have shown that inhibiting pyroptosis is anti-inflammatory and slows the progression of osteoporosis,and it has been shown to improve inflammatory bone loss in vitro and in animal models.At present,research on pyroptosis and osteoporosis is limited.On the one hand,the exact mechanism of osteoporosis and the pathogenesis of pyroptosis are unknown,and the specific pathways and regulatory mechanisms remain to be understood.On the other hand,therapeutic strategies targeting pyroptosis are still theoretical,not clinically proven,and drug side effects are unknown.In the future,the research focus is to further explore the pathogenesis,especially the mechanism of pyroptosis,identify potential therapeutic targets,further study the pyroptosis signaling pathway and Gasdermin protein,and develop new drugs to improve the therapeutic effect in patients with osteoporosis.

Objective To systematically summarize the pharmacological characteristics and clinical applications of antithrombotic medications in ischemic stroke， as well as their interactions with drugs used for common comorbidities， and to provide a reference for clinical medication. Methods Based on the UpToDate database and the integration with pharmacokinetic and pharmacodynamic mechanisms， this study systematically analyzed interactions between antithrombotic agents and between antithrombotics and drugs for comorbid conditions. Interactions were categorized and evaluated based on the level of evidence. Results The distinct pharmacological mechanisms of different antithrombotic drugs determine their patterns of drug-drug interactions. Combination antithrombotic therapy produces synergistic antithrombotic effects but increases the risk of hemorrhage. Extensive interactions exist when antithrombotics are co-administered with medications for cardiovascular diseases， metabolic disorders， neuropsychiatric conditions， and infectious diseases. These interactions primarily involve the cytochrome P450 enzyme system and P-glycoprotein pathways， which may compromise therapeutic efficacy or elevate the risk of bleeding and thrombosis. Conclusion Multiple drug interactions are present in antithrombotic therapy for ischemic stroke. In clinical practice， it is essential to consider the impact of pharmacokinetic and pharmacodynamic mechanisms. By integrating tools such as pharmacogenomics and therapeutic drug monitoring， individualized medication strategies should be implemented to achieve an optimal balance between antithrombotic efficacy and safety.

This paper summarizes Professor WANG Yaoxian's experience in treating diabetic kidney disease （DKD） from the perspective of spleen and stomach based on the "internal heat leading to concretions" theory. It is considered that internal heat leading to concretions constitutes the core pathogenesis of DKD， with the spleen and stomach serving as the source of internal heat； therefore， treatment should be based on regulating the spleen and stomach. In the early stage of DKD， dysfunction of the spleen and stomach leads to the initial generation of internal heat. Common syndrome patterns include gastrointestinal heat accumulation and constrained heat in the liver and stomach， for which modified Gegen Qinlian Decoction （葛根芩连汤） can be used to clear heat bind while modified Dachaihu Decoction （大柴胡汤） is used to clear stomach and soothe liver， respectively. In the middle stage of DKD， weakness of the spleen and stomach results in the initial formation of concretions and conglomerations. Common patterns include spleen deficiency with prevalence of dampness and deficiency of both the spleen and kidney. Treatment emphasizes strengthening the spleen and resolving dampness， raising yang and boosting the stomach with modified Shengyang Yiwei Decoction （升阳益胃汤）， or supplementing spleen and boosting kidney， dissipating bind and dispe-ring concretions with modified Shenqi Dihuang Decoction （参芪地黄汤）， respectively. In the late stage of DKD， it is characterized by spleen and stomach depletion， and rampant accumulation of turbidity and toxin， and the common syndrome patterns are damp-turbidity obstruction in the middle jiao （焦） and spleen-kidney yang deficiency. Treatment aims to remove turbidity and harmonize the stomach， or to warm the kidney and strengthen the spleen while elimina-ting turbidity， using modified Dahuang Gancao Decoction（大黄甘草汤） and Jupi Zhuru Decoction （橘皮竹茹汤） or modified Baoyuan Decoction （保元汤） and Lizhong Decoction （理中汤）， respectively. In clinical practice， appropriate formulas and medications are flexibly selected according to specific syndromes.

Objective To investigate the efficacy of early, short-term, low-dose corticosteroid administration for the prevention and treatment of early acute lung injury (EALI) in patients undergoing thoracoscopic lobectomy. Methods A retrospective analysis was conducted on the clinical data of patients who underwent thoracoscopic lobectomy at the Department of Thoracic and Cardiovascular Surgery, Taihe Hospital, Hubei University of Medicine, from January 2019 to January 2022. Patients were divided into an early steroid therapy group and an observation group based on whether they received corticosteroids in the early postoperative period. In the early steroid therapy group, in addition to standard postoperative care, patients received a low-dose intravenous push of methylprednisolone (80-120 mg/d) for 3 consecutive days. In the observation group, patients received standard postoperative care without intravenous corticosteroids for the first 3 days. Chest plain CT scans were performed on postoperative day (POD) 1 and POD 3 or 4 to evaluate lung injury. CT scores and the incidence of postoperative EALI were recorded. Results A total of 521 patients were included (268 males, 253 females; age range: 11-80 years). There were 318 patients in the observation group and 203 in the early steroid therapy group. On POD 1, the incidence of EALI was 16.0% in the observation group and 13.8% in the early steroid therapy group, with no statistical difference (P=0.486). Correspondingly, there was no statistical difference in chest CT scores among EALI-positive patients between the two groups (P=0.927). On POD 3-4, the incidence of EALI was significantly lower in the early steroid therapy group (22.7%) compared to the observation group (33.6%) (P=0.007). Although chest CT scores among EALI-positive patients were lower in the early steroid therapy group, the difference was not statistically significant (P=0.377). The overall incidence of EALI within the first 4 postoperative days was significantly lower in the early steroid therapy group (26.1%) than in the observation group (37.4%) (P=0.007). Radiological progression (defined as new-onset EALI or progression of existing EALI) occurred in 14.8% of the early steroid therapy group, significantly lower than the 28.9% in the observation group (P<0.001). The early steroid therapy group had a shorter postoperative length of stay (P<0.001), while there was no statistical difference in the incidence of poor wound healing between the groups (P=0.762). Conclusion Early postoperative corticosteroid use effectively reduces the incidence of EALI on POD 3-4, lowers the risk of radiological progression, and decreases the overall incidence of postoperative EALI. This is achieved without prolonging the length of stay or increasing the risk of poor wound healing. Therefore, early administration of low-dose corticosteroids is beneficial in suppressing the occurrence and progression of EALI. Its early use is recommended for patients at high risk for postoperative EALI.

This article summarized the clinical experience of professor XU Jingfan，a traditional Chinese medicine （TCM） master， in treating spleen and stomach diseases with aromatic herb Shichangpu （Rhizoma Acori Tatarinowii）， based on the theory of 'aromatics acting on the spleen'. Shichangpu is commonly combined with Peilan （Herba Eupatorii） to aromatically awaken the spleen， and self-made Xingpi Kaiwei Formula （醒脾开胃方） can be used for postprandial distress syndrome of the spleen-stomach disharmony type. It is paired with Diyu （Radix Sanguisorbae） to resolve turbidity and promote wound healing， with a self-made Changyu Decoction （菖榆煎） for retention enema in chronic colitis and inflammatory bowel disease. When paired with Yujin （Radix Curcumae）， it can be used to promote qi and resolve constraint， and can be combined with modified Sini Powder （四逆散） for epigastric pain of liver-stomach disharmony type. Paired with Fangfeng （Radix Saposhnikoviae） to dispel wind and resolve dampness， and together with Tongxie Important Formula （痛泻要方）， it is used to treat diarrhea-predominant irritable bowel syndrome of liver constraint and spleen deficiency type. It is paired with Yizhiren （Fructus Alpiniae Oxyphyllae） for its warming and astringing properties， and together with modified Linggui Zhugan Decoction （苓桂术甘汤） for phlegm-rheum due to spleen-stomach yang deficiency type. Clinically， great importance is also attached to tongue inspection related to Shichangpu， closely focusing on the pathogenesis of internal accumulation of damp turbidity in the middle jiao （焦）. Moreover， when treating spleen and stomach diseases， the dosage should be light and flexible.

An automatic epileptic seizure detection model based on multi-channel recurrence plots and SE-VGG16 is proposed to enhance the accuracy of automatic detection of epileptic seizures.Firstly,triaxial accelerometer is used to collect patients'motion signals as a substitute of electroencephalogram signals,and these signals are converted into two-dimensional images through recurrence plots and then subjected to multi-channel fusion for generating multi-channel recurrence plots.Subsequently,squeeze-and-excitation module is employed to improve VGG16,which enhances the network's adaptability to different channels and enables precise classification.Experimental results show that the proposed model achieves the best performance across all indicators,attaining an accuracy of 99.3%,precision of 99.2%,recall rate of 98.9%,and F1-score of 99.0%.This model significantly boosts the accuracy and applicability of epileptic seizure detection,expands the potential of wearable devices for epileptic seizure monitoring in non-clinical settings,and provides a new technical pathway for epilepsy management and research.

Objective To evaluate the impact of medical service price adjustment policies on the economic operations of public hospitals.Methods Utilizing operational data from a provincial tertiary hospital in Anhui Province spanning December 2022 to December 2024,an interrupted time series analysis(ITS)was conducted,with the price adjustment policy implemented in December 2023 as the intervention node.This study quantified trends in surgical income,laboratory income,and cost structure changes before and after the policy implementation.Sensitivity analysis was performed to validate the robustness of findings.Results Following the surgical service price adjustment,income surged by 6.125 million(11.72％)in the first month,with adjusted items contributing 42.5％to this increase.The long-term monthly growth rate rose to 78.9 thousand,and the proportion of technical labor income increased from 6.1％to 10.1％.For laboratory services,the price adjustment led to an initial income decline of 10.324 million(P＜0.001).However,through domestic consumable substitution(provincially centralized procure-ment of testing reagents achieved an average price reduction of 53.9％)and process automation(reducing 30％-40％ of repeti-tive labor in testing personnel),the monthly decline narrowed to 195 thousand driving a transition toward technology-driven labo-ratory services.Conclusion The price adjustment policy optimized public hospital revenue structures through dual mechanisms of"technical value compensation"and"separation of technical services from consumables",effectively addressing the issue of"consumable-dependent revenue models".Public hospitals should enhance refined management,establish a technical labor val-ue-oriented pricing system,and coordinate with dynamic policy adjustments to achieve synergistic improvements in economic effi-ciency and healthcare quality.

Objective:To investigate the effect of a blended teaching mode based on medical knowledge graph and artificial intelligence (AI) teaching assistant on students' learning effectiveness and systematic thinking ability in teaching of pathogens and immunology.Methods:A controlled experimental design was employed, involving 114 clinical medical students ("5+3" integrated) enrolled in 2023 at Tianjin Medical University. They were divided into experimental group ( n=57) and control group ( n=57) based on their classes. A blended online-offline teaching mode based on medical knowledge graph and AI teaching assistant was used in the experimental group, and a blended online-offline teaching mode based on the online resources of this course was used in control group. Teaching effectiveness was assessed by comparing the scores of four chapter quizzes and the final exam between the two groups, as well as by analyzing student questionnaire responses. Data were analyzed using t test and χ2 test. Results:The experimental group achieved significantly higher scores in all four chapter quizzes and the final exam compared to the control group [(78.77±19.65) vs. (69.47±22.95), (84.56±14.02) vs. (76.49±16.20), (81.89±13.60) vs. (73.13±16.52), (81.56±21.28) vs. (73.16±16.27), (69.75±13.30) vs. (64.10±14.93), all P<0.05]. The questionnaire survey showed that 74.07% students ( n=40) believed that this blended teaching model stimulated their learning interest, 74.07% ( n=40) students believed that this blended teaching model enhanced their learning initiative, 81.48% ( n=44) students believed that this blended teaching model could help them construct the relationship between the old and new knowledge and thus improved memory retention, and 81.48% students b( n=44) elieved that this blended teaching model helped them integrate and summarize knowledge and construct systematic knowledge framework to improve their learning effectiveness. Conclusions:The blended teaching mode based on medical knowledge graph and AI teaching assistant is beneficial for cultivating students' systematic thinking ability and is helpful to improve their learning efficiency and effectiveness.