OBJECTIVE To investigate the mechanism by which Qiaobai cold compress solution （QBCS） improves acne vulgaris （AV） based on transcriptomics and animal experiments. METHODS Rats were randomly divided into a blank control group （ n ＝6） and a modeling group （ n ＝30）. AV models were established in the modeling group by topical application of oleic acid to the inner surface of both ears， combined with subcutaneous injection of Cutibacterium acnes suspension into the auricle. Successfully modeled rats were further divided into the model group， positive control group （Tretinoin cream， 0.045 g/kg）， and QBCS low-， medium-， high-dose groups [3.55， 7.11， 14.22 g/kg （calculated by the amount of crude drug） ] ， with 6 rats in each group. Rats in each d rug group were treated with the corresponding drugs once daily for 14 consecutive days. After the final administration， changes in the appearance of the ears and histopathological changes in the ear tissues were observed， and serum levels of inflammatory factors， including tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6） and IL-1β， were measured. Auricular tissues from the blank control group， model group and QBCS medium-dose group were collected for transcriptome sequencing. Differential expressed genes （DEGs） were screened and subjected to Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis， followed by validation using real-time quantitative polymerase chain reaction and Western blot assay. RESULTS Compared with the model group， rats in all QBCS groups showed alleviated auricular acne symptoms， with reduced epidermal thickening， sebaceous gland hyperplasia， and inflammatory cell infiltration. Serum levels of TNF-α （except for the QBCS low-dose group）， IL-6 （except for the QBCS low-dose group） and IL-1β were significantly decreased （ P ＜0.05）. A total of 590 DEGs were identified （blank control group vs. model group）， and 596 DEGs were identified （model group vs. QBCS medium-dose group）. Above DEGs （blank control group vs. model group） were mainly enriched in Toll-like receptor （TLR） and nuclear factor-kappa B （NF-κB） signaling pathways， etc. Validation experiments showed that， compared with model group， low-， medium- and high-dose of QBCS reduced， to varying degrees， the mRNA expression of TNF-α， TLR2， interferon-γ and CXC chemokine ligand 8 in the auricular tissues of AV rats， increased the mRNA expression of peroxisome-proliferator-activated receptor gamma and tumor protein 53， and inhibited the phosphorylation of NF-κB p65 protein as well as the expressions of TLR2 and myeloid differentiation primary response protein 88（MyD88） （ P ＜0.05）. CONCLUSIONS QBCS can alleviate auricular inflammation and skin lesions in AV rats. This effect may be related to inhibition of the TLR/MyD88/NF-κB signaling pathway， thereby suppressing the expression of downstream inflammatory factors such as TNF-α.

AIM: To evaluate the efficacy of 0.05% cyclosporine eye drops in promoting ocular surface recovery following pterygium excision combined with autologous corneal limbal stem cell transplantation.METHODS:This study is a prospective randomized controlled trial, selecting 104 cases(104 eyes)of primary pterygium with monocular onset admitted to Baoding First Central Hospital from September 2023 to September 2024 as the initial sample. The patients were divided into an experimental group and a control group using a random number table method, with 52 eyes in each group. Both groups underwent pterygium excision and autologous corneal limbal stem cell transplantation performed by the same surgeon. The control group received tobramycin dexamethasone eye drops combined with 0.3% sodium hyaluronate eye drops, while the experimental group was additionally treated with 0.05% cyclosporine eye drops. The corneal epithelial repair status, ocular surface function [corneal fluorescein staining(FL)score, Schirmer I test(SIt), break-up time of tear film(BUT)] at preoperative and postoperative time points(1 and 3 mo), and dry eye symptoms [ocular surface disease index(OSDI), standard patient evaluation of eye dryness(SPEED)scores]. Additionally, the recurrence rate and postoperative complications were recorded.RESULTS: During the follow-up period, there was 1 case of loss to follow-up in both the experimental group and the control group, with lost to follow-up rate of 1.9%. Finally, 51 cases in each group completed all followed-up. No statistically significant difference was observed in preoperative general characteristics of patients between the two groups(P>0.05), and there was no statistically significant difference in corneal epithelial repair time or suture removal time(all P>0.05). At 1 mo postoperatively, the SIt and BUT decreased in both groups compared to preoperative levels, with the experimental group showing higher values than the control group(all P<0.05). FL scores increased compared to preoperative levels but were lower in the experimental group(all P<0.05). By 3 mo, the SIt, BUT and FL score of the control group were not statistically different from preoperative levels(all P>0.05), whereas the experimental group showed increased SIt and BUT, which were higher than the control group, and reduced FL scores, and decreased FL scores, which was lower than the control group(all P<0.05). At 3 mo postoperatively, both groups showed increased SIt and BUT compared to 1-month values, with the experimental group outperforming the control group(all P<0.05). FL scores decreased in both groups compared to 1-month values, with the experimental group maintaining lower scores(P<0.05). At 1 mo postoperatively, OSDI and SPEED scores were higher than preoperative levels, with the experimental group higher than the control group(all P<0.05); at 3 mo postoperatively, the scores returned to preoperative level(all P>0.05), and the OSDI and SPEED scores of the control group increased and higher than those of the experiment group(all P<0.05); at 3 mo postoperatively, the OSDI and SPEED scores decreased when compared with 1-month preoperative level, and the experiment group was lower than the control group(all P<0.05). There was no difference in the total incidence of postoperative complications between the two groups(P>0.05). According to the statistics of 6 mo follow-up after operation, there was no recurrence in the experimental group, and the recurrence rate was 11.8% in the control group(P<0.05).CONCLUSION: Adjunctive use of 0.05% cyclosporine eye drops after pterygium excision with limbal stem cell transplantation enhances ocular surface recovery, reduces dry eye symptoms, and lowers recurrence rates without compromising corneal epithelial healing or safety.

Guidelines for Digital Ancient Books of TCM Indexing(T/CIATCM 119-2024)is based on the theoretical knowledge,disciplinary methods,and practical applications of TCM classical cataloging.Taking digital ancient books of TCM as the object,it systematically reveals the content of TCM knowledge,which is an essential indexing processing standard for building an intelligent retrieval system for TCM ancient books,and can provide support for the deep development and innovative utilization of TCM knowledge.It can not only promote the co-construction and sharing of ancient book resources in the TCM industry,but also promote the standardization construction and application of TCM information.This standard specifies the principles,methods,and examples of free indexing of digital ancient books of TCM based on their original content.It is applicable to the indexing and processing of digital ancient books of TCM for TCM professional libraries and related institutions,and to the data processing and construction of various types of TCM ancient book databases.

Objective:To understand the contract renewal willingness and its influencing factors among rural order-oriented medical students in Shaanxi Province. M ethods This study employed an explanatory sequential mixed methods design to examine contract renewal patterns among rural order-oriented medical graduates. From February to July 2024, a questionnaire survey was conducted among rural order-oriented medical students who graduated from 2015 to 2023 in Shaanxi Province. The participants were first stratified into three strata based on their year of graduation and stage of service, and one-third of each stratum was randomly selected as the research subjects. Univariate and multivariate analysis methods were used to explore the influencing factors of their willingness to renew their service in rural areas. Secondly, qualitative research methods were employed to conduct thematic interviews with 36 targeted medical students on the influencing factors of their willingness to renew their service. Results:A total of 513 valid questionnaires were collected during the quantitative research phase, including 224 males and 289 females. Of these, 14 were from the 2015-2017 cohort, 247 from the 2018-2020 cohort, and 252 from the 2021-2023 cohort. The results showed that only 30.4%(156/513) of the orientation medical students were willing to practice in primary care after the period of service. Univariate analysis showed that there were six factors related to the willingness to renew the contract, the consistency of the source and implementation of the contract, the completion of the standardized training of residents, the satisfaction with primary work, professional identity, the ability of primary diagnosis and treatment, and the training system and the suitability of primary work. Multivariate analysis showed that the willingness to renew the contract was significantly higher in the students who had the same place of origin and the place of performance( OR=1.7, 95% CI: 1.1-2.6, P=0.022). The willingness to renew the contract was significantly higher among students who participated in the standardized residency training than those who completed the training( OR=2.0, 95% CI: 1.3-3.0, P=0.003), and students with a better fit between the training system and working in primary care were more likely to renew their contract( OR=4.1, 95% CI: 2.8-6.0, P<0.001). Four themes were extracted from the interview: subjective factors, objective environment, policy factors and other factors. Conclusions:The study shows that improving the consistency of the source of students and the implementation of the contract, strengthening the standardized training of residents, and optimizing the adaptation of the training system to the primary work are the key measures to improve the willingness of directional medical students to renew their contract at the primary level.

Objective To build an automatic segmentation model of temporomandibular joint(TMJ)based on magnetic resonance im-aging(MRI)using deep learning method.Methods The MRI data of TMJ of 104 subjects were collected,with the articular disc,con-dyle and glenoid fossa marked.The adaptive U-Net framework(nnU-Net)was used to construct a segmentation model,which was sub-jected to both quantitative and qualitative assessments.Results The segmentation model demonstrated excellent accuracy in segmenta-tion.In the segmentation of different joint structures,the model achieved Dice of 0.77 for the articular disc,0.85 for the condyle,and 0.66 for the glenoid fossa.The model showed similar segmentation performance when processing MRI images in both open-mouth and closed-mouth states.Conclusion This study developed an automatic segmentation model for TMJ MRI based on deep learning,which can assist clinicians in diagnosing anterior displacement of the TMJ disc.

Purpose To investigate the clinical and pathological characteristics of synchronous multiple primary malignancy(sMPM)with lymphoid hematopoietic tissue tumors.Methods A retrospective analysis was conducted on the clinical and pathological data of 20 cases of sMPM associated with lymphoma.Immunohistochemistry using the En-Vision two-step method was performed to detect the expression of relevant proteins,while FISH and next-generation se-quencing technologies were used to identify gene mutations.Relevant literature was also reviewed.Results There were 14 females and 6 males,aged from 30 to 75 years(median 67 years).All of them manifested as solid organ mas-ses complicated by lymphadenopathy.Lymphohematopoietic tissue tumors consisted of:7 cases of Hodgkin lymphoma(6 cases of classic Hodgkin lymphoma,1 case of nodular lymphocyte predominant Hodgkin lymphoma),13 cases of non-Hodgkin lymphoma(4 cases of Follicular lymphoma,2 cases of small lymphocytic lymphoma/chronic lymphocytic leukemia,2 cases of diffuse large B-cell lymphoma,1 case of plasmablastic plasmacytoma,1 case of marginal zone B-cell lymphoma,1 case of B-lymphoblastic lymphoma,2 cases of peripheral T-cell lymphoma,NOS).Solid tumors con-sisted of:9 cases of papillary thyroid carcinoma,1 case of medullary thyroid carcinoma,2 cases of adenocarcinoma of the lung,2 cases of gallbladder adenocarcinoma,2 cases of invasive carcinoma of the breast,2 cases of gastrointestinal adenocarcinoma,1 case of pleomorphic undifferentiated sarcoma of the lower extremity,and 1 case of oropharyngeal squamous cell carcinoma.17 patients underwent surgical resection,and 3 patients were diagnosed by core needle biop-sy or excision biopsy.10 cases of lymphoma involved in the lymph nodes of the tumor drainage area,and 10 cases were found to have lymph node involvement in other areas by imaging examination.Among the 5 cases analyzed by targeted next generation sequencing,no revelent genetic changes were founded,and no germline mutations or chromosomal kar-yotype abnormalities were founded.Based on the tumor types,patients received varying degrees of radiotherapy,chem-otherapy,or follow-up.Follow-up information was available in all cases and ranged from 5 to 96 months,15 were sur-vived and four patients died of the tumor,and 1 case was lost to follow-up.Conclusion MPMs with lymphoid hemato-poietic tissue tumors are rare,clinicians and pathologists should be careful to avoid missing the diagnosis of lymphoma.

Cerebral small vessel disease (CSVD) and large artery atherosclerosis (LAA) are two types of cerebrovascular diseases. Their pathogenesis is closely related, with common risk factors, but there are differences. Early detection and effective management of common risk factors, while taking into account differentiated risk factors, are of great significance for stroke prevention. This article reviews the similarities and differences in the major risk factors between CSVD and LAA.

With reference to the Information and Documentation-Resource Description (GB/T 3792-2021) and Bibliographical Description for Ancient Chinese Books (GB/T 3792.7-2008) and other cataloging standards and rules, drawing on the practical experience of cataloging ancient TCM books, Bibliographical Cataloging for Ancient TCM Books was formulated. This standard specifies the entry items and their order of ancient TCM books, cataloging identifier, cataloging text, cataloging information source, and cataloging item details. The standard can provide standardized and unified guiding principles and methods for the work of ancient TCM books, and promote the sharing and utilization of ancient TCM books.

Objective To explore the acupoint selection patterns in acupuncture treatment for cognitive impairment in Alzheimer's disease based on data mining technology,and to provide references for clinical practice.Methods Computer searches were conducted in major databases including the China National Knowledge Infrastructure(CNKI),Wanfang Academic Journal Full-Text Database(Wanfang),VIP China Science and Technology Journal Database(VIP),China Biology Medicine(CBM),PubMed,Web of Science,and Embase.Clinical research literature on acupuncture treatment for cognitive impairment in Alzheimer's disease from the inception of the databases to May 1,2024 was selected.Microsoft Excel 2019 was used to establish a database of acupuncture prescriptions,and SPSS Statistics 24.0 and SPSS Modeler 18.0 were used for association analysis and cluster analysis to explore the acupoint selection patterns in acupuncture treatment for cognitive impairment in Alzheimer's disease.Results A total of 48 articles were included,involving 73 acupoints with a total frequency of 327 uses.The analysis of acupoints showed that the selection of acupoints mainly focused on the governor vessel and head/neck regions.The top three most frequently used acupoints were Baihui(GV20),Sishencong(EX-HN1),and Shenting(GV24).The association rule analysis indicated that the acupoint groups with the highest confidence were Baihui-Dazhui(GV14),Baihui-Shenting,Baihui-Sishencong,Baihui-Neiguan(PC6),and Baihui-Shenshu(BL23).The high-frequency cluster analysis revealed four clusters:Sanyinjiao(SP6)-Benshen(GB13),Shenmen(HT7)-Yintang(EX-HN3)-Taichong(LR3)-Fenglong(ST40)-Shenshu-Dazhui(GV14),Taixi(KI3)-Neiguan-Zusanli(ST36)-Guanyuan(CV4),and Fengchi(GB20)-Shenting.Conclusion In acupuncture treatment for cognitive impairment in Alzheimer's disease,acupoint selection mainly focuses on the governor vessel and head/neck regions.The combination of"Baihui-Sishencong-Shenting-Fengchi"can be used as the core acupoint selection in clinical treatment,and it can be adjusted based on syndrome differentiation and treatment in clinical practice.

Objective To investigate the role of microRNA(miR)-299-3p in regulating the pro-liferation,invasion,and migration of nasopharyngeal carcinoma cells through phosphatidylinositol 3-ki-nase(PI3 K)/protein kinase B(AKT)signaling pathway.Methods The human nasopharyngeal car-cinoma cell line CNE2 was randomly divided into three groups:control group(no expression of miR-299-3 p),over-expression group overexpression of miR-299-3p,and miR-299-3p low-expression group(low expression of miR-299-3p).CCK-8 experiment was to detect cell proliferation rate,flow cytome-try was to detect apoptosis rate,Transwell chamber was to detect invasion and migration,Western blot was to detect p-PI3K and p-AKT protein expressions,real-time fluorescence quantitative polymerase chain reaction was to detect miR-299-3p expressions.Results Compared with the control group,the over-expression group showed significant decreases in cell proliferation rate,the number of cells with invasion and migration,increase in apoptosis rate;compared with the control group,the low-expres-sion group showed significant increases in cell proliferation rate,the number of cells with invasion and migration,phosphorylated PI3K(p-PI3K)and phosphorylated AKT(p-AKT)protein expression,de-crease in apoptosis rate(P＜0.05).Conclusion Over-expression of miR-299-3p may affect the pro-liferation,invasion,and migration behaviors of nasopharyngeal carcinoma cells by inhibiting PI3K/AKT signaling pathway activity.