OBJECTIVE: To observe the clinical efficacy of thread-embedding at the combined lower he-sea and front-mu points for functional constipation with intestinal excess heat. METHODS: A total of 80 patients with functional constipation of intestinal excess heat were randomly divided into a thread-embedding group (40 cases, 2 cases dropped out) and a Chinese patent medication group (40 cases, 1 case dropped out). Based on the theory of combined lower he-sea and front-mu points for diseases of fu organs, Zhongwan (CV12), Guanyuan (CV4) and bilateral Zusanli (ST36), Shangjuxu (ST37), Tianshu (ST25), Xiajuxu (ST39) were selected and thread-embedding therapy was delivered in the thread-embedding group, once a week. Maren Runchang pill was given orally in the Chinese patent medication group, 6-12 g each time, twice a day. Both groups were treated for 4 weeks. Before and after treatment, the scores of constipation assessment scale (CAS), Bristol stool form scale (BSFS), patient-assessment of constipation quality of life (PAC-QOL) and TCM syndrome were observed, and the clinical efficacy was evaluated after treatment in the two groups. RESULTS: After treatment, the CAS scores and the TCM syndrome scores were decreased compared with those before treatment (P<0.05), while the BSFS scores were increased compared with those before treatment (P<0.05) in the two groups; the total scores, as well as the physical discomfort and psychosocial discomfort scores of PAC-QOL were decreased compared with those before treatment (P<0.05) in the two groups, the worry and anxiety, and the satisfaction scores of PAC-QOL were decreased compared with those before treatment (P<0.05) in the thread-embedding group. After treatment, the CAS score, the total score and item-scores of PAC-QOL, as well as the TCM syndrome score in the thread-embedding group were lower than those in the Chinese patent medication group (P<0.05). The total effective rate was 78.9% (30/38) in the thread-embedding group, which was higher than 56.4% (22/39) in the Chinese patent medication group (P<0.05). CONCLUSION Thread-embedding at the combined lower he-sea and front-mu points can effectively treat functional constipation with intestinal excess heat and improve quality of life.
Humans ; Constipation/physiopathology* ; Male ; Female ; Middle Aged ; Acupuncture Points ; Adult ; Acupuncture Therapy ; Aged ; Treatment Outcome ; Young Adult ; Intestines/physiopathology* ; Quality of Life

Neutralizing antibodies have been designed to specifically target and bind to the receptor binding domain (RBD) of spike (S) protein to block severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus from attaching to angiotensin converting enzyme 2 (ACE2). This study reports a distinctive nanobody, designated as VHH21, that directly catalyzes the S-trimer into an irreversible transition state through postfusion conformational changes. Derived from camels immunized with multiple antigens, a set of nanobodies with high affinity for the S1 protein displays abilities to neutralize pseudovirion infections with a broad resistance to variants of concern of SARS-CoV-2, including SARS-CoV and BatRaTG13. Importantly, a super-resolution screening and analysis platform based on visual fluorescence probes was designed and applied to monitor single proteins and protein subunits. A spontaneously occurring dimeric form of VHH21 was obtained to rapidly destroy the S-trimer. Structural analysis via cryogenic electron microscopy revealed that VHH21 targets specific conserved epitopes on the S protein, distinct from the ACE2 binding site on the RBD, which destabilizes the fusion process. This research highlights the potential of VHH21 as an abzyme-like nanobody (nanoabzyme) possessing broad-spectrum binding capabilities and highly effective anti-viral properties and offers a promising strategy for combating coronavirus outbreaks.
Single-Domain Antibodies/immunology* ; Spike Glycoprotein, Coronavirus/metabolism* ; SARS-CoV-2/immunology* ; Animals ; Humans ; Antibodies, Neutralizing/immunology* ; Camelus ; COVID-19/immunology* ; Antibodies, Viral/immunology* ; Angiotensin-Converting Enzyme 2

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Objective To study the relationship of serum 25-hydroxyvitamin D3[25-(OH)D3],myostatin(MSTN),limb skeletal muscle index(ASMI)with osteopenia(OP)in patients with rheumatoid arthritis(RA)complicated with sarcopenia(SA).Methods A total of 244 RA patients selected as case group,and 123 healthy people who underwent physical examination in our hospital during the same period were selected as control group.The general data,serum levels of 25-(OH)D3,MSTN,ASMI and peripheral blood immune cells were compared among the two groups.The diagnostic value of serum 25-(OH)D3,MSTN and ASMI in RA patients with SA complicated with OP and the correlation between serum 25-(OH)D3,MSTN,ASMI and peripheral blood immune cells were analyzed.Results The levels of serum 25-(OH)D3,peripheral blood regulatory T lymphocyte(Treg)cells and ASMI in the case group were lower than those in the control group,while the levels of serum MSTN,peripheral blood helper T lymphocyte 17(Th17)cells and Th17/Treg were higher than those in the control group(P＜0.05).Among the 244 RA patients,171 had no SA,73 had SA,and the incidence of SA was 29.92％.The levels of serum 25-(OH)D3,peripheral blood Treg cells and ASMI in the SA group were lower than those in the non-SA group,and the levels of serum MSTN,peripheral blood Th17 cells and Th17/Treg were higher than those in the non-SA group(P＜0.05).The levels of serum 25-(OH)D3,peripheral blood Treg cells and ASMI in the OP group were lower than those in the non-OP group,while the levels of serum MSTN,peripheral blood Th17 cells and Th17/Treg were higher than those in the non-OP group(P＜0.05).The area under the curve(AUC)of combined detection of serum 25-(OH)D3,MSTN and ASMI for the diagnosis of OP in RA patients with SA was higher than that of the three alone(P＜0.05).Serum 25-(OH)D3 and ASMI in RA patients with SA complicated with or without OP were negatively correlated with peripheral blood Th17 cell level and Th17/Treg(P＜0.05),and positively correlated with peripheral blood Treg cell level(P＜0.05).The level of serum MSTN was positively correlated with the level of Th17 cells and Th17/Treg in peripheral blood(P＜0.05),and negatively correlated with the level of Treg cells in peripheral blood(P＜0.05).Conclusion The incidence of OP in RA patients with SA is high.At the same time,the occurrence of SA and OP can lead to the decrease of serum 25-(OH)D3,peripheral blood Th17 cell,Th17/Treg and ASMI,and the increase of serum MSTN and peripheral blood Treg cell.The combination detection of 25-(OH)D3,MSTN and ASMI can effectively improve the diagnosis of OP in RA patients with SA,and the levels of the three are significantly correlated with peripheral blood Th17 cells,Treg cells and Th17/Treg.

Objective:To explore the effect of the retrieval of previous rewarding episodic memories on current decision-making risk preference under negative and neutral emotional contexts.Methods:Thirty-three undergraduate college students from Henan Medical University were selected as subjects in May 2025. A two-option gambling paradigm was selected as the experimental task, and a two-factor within-subject experiment design of 2 (reward: rewarded, non-rewarded) × 2 (emotional background: negative, neutral) was adopted. The risk decision-making rate of the participants was recorded.Two-factor analysis of variance was conducted using SPSS 22.0 software.Results:There was a significant interaction between the reward of the item and the emotional background on risk decision-making rate ( F(1, 64)=6.67, P<0.05, ηP2=0.17). Under the negative and neutral emotional backgrounds, the high-risk selection rates for the rewarded items (0.60±0.22, 0.56±0.22) were significantly higher than those for non-rewarded items (0.30±0.18, 0.33±0.22) (both P<0.01). Additionally, the difference in high-risk choice rate between the rewarded and non-rewarded items under the negative emotional condition (0.30±0.28) was significantly greater than those under the neutral emotional condition (0.23±0.30) ( t(32)=2.451, P<0.05, d’=0.87). Conclusion:Different emotional backgrounds and reward-related episodic memories can influence the risk decision-making preference of individuals together.The retrieval of the rewarding episodic memory during decision making can increase the high risk propensity of the individuals.

Objective To investigate whether evodiamine(EVO)can alleviate liver injury in septic rats by influencing the nucleo-tide-binding and oligomerization domain(NOD)-like receptor protein 3(NLRP3)/interleukin-1 β(IL-1β)/caspase-1 signaling pathway.Methods A rat model of sepsis-induced liver damage was constructed,and the successfully modeled rats were assigned to the model,L-EVO,M-EVO,H-EVO(administered orally at 4,8,and 16 mg/kg of EVO),and H-EVO+NLRP3(administered orally at 16 mg/kg of EVO+intraperitoneal injection of 1 mg/kg of NLRP3 signaling pathway activator sodium salt)groups,each with ten rats.In addition,ten normal rats were selected as the control group(that is,the sham surgery group,without ligation or puncture,using the same steps as for the model group).The control and model groups were administered with equal amounts of physiological saline once daily for 28 d,consecutively.A reagent kit was used to assess rat liver function.Hematoxylin and eosin(HE)staining was used to analyze pathological changes in the liver tissue.Terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL)staining was used to assess apoptosis in liver tissue cells.ELISA was used to analyze IL-6,tumor necrosis factor α(TNF-α),and IL-1β levels in serum.Western blotting was used to detect changes in protein expression of the NLRP3/IL-1β/caspase-1 signaling pathway components in liver tissues.Results For the control group,the liver tissues of rats in the model group lost their normal structure,with an uneven distribution of liver cells accompanied by edema and vacuoles.For the model group,the L-EVO,M-EVO,and H-EVO groups exhibited a relatively neat arrangement of liver tissue cells,reduced edema,and vacuoles.As the dose increased,the morphology of liver tissue cells recovered significantly.For the H-EVO group,the H-EVO+NLRP3 group exhibited a disordered arrangement of liver tissue cells with edema and vacuoles.For the control group,the model group showed increased alanine aminotransferase(ALT),aspartate aminotransferase(AST),liver tissue cell apoptosis rate,serum IL-6,TNF-α,and IL-1β levels,and expression of NLRP,IL-1β,and caspase-1 protein in the liver tissue(P＜0.05).For the model group,the L-EVO,M-EVO,and H-EVO groups showed lower ALT,AST,liver tissue cell apoptosis rate,serum IL-6,TNF-α,and IL-1β levels,and expression of NLRP,IL-1β,and caspase-1 protein in the liver tissue(P＜0.05).For the H-EVO group,the H-EVO+NLRP3 group had higher ALT,AST,liver tissue cell apoptosis rate,serum IL-6,TNF-α,and IL-1β levels,and expression of NLRP,IL-1β,and caspase-1 pro-tein in the liver tissue(P＜0.05).Conclusion EVO can alleviate liver injury in septic rats by influencing the NLRP3/IL-1β/caspase-1 signaling pathway.

Objective:To explore the effect of the retrieval of previous rewarding episodic memories on current decision-making risk preference under negative and neutral emotional contexts.Methods:Thirty-three undergraduate college students from Henan Medical University were selected as subjects in May 2025. A two-option gambling paradigm was selected as the experimental task, and a two-factor within-subject experiment design of 2 (reward: rewarded, non-rewarded) × 2 (emotional background: negative, neutral) was adopted. The risk decision-making rate of the participants was recorded.Two-factor analysis of variance was conducted using SPSS 22.0 software.Results:There was a significant interaction between the reward of the item and the emotional background on risk decision-making rate ( F(1, 64)=6.67, P<0.05, ηP2=0.17). Under the negative and neutral emotional backgrounds, the high-risk selection rates for the rewarded items (0.60±0.22, 0.56±0.22) were significantly higher than those for non-rewarded items (0.30±0.18, 0.33±0.22) (both P<0.01). Additionally, the difference in high-risk choice rate between the rewarded and non-rewarded items under the negative emotional condition (0.30±0.28) was significantly greater than those under the neutral emotional condition (0.23±0.30) ( t(32)=2.451, P<0.05, d’=0.87). Conclusion:Different emotional backgrounds and reward-related episodic memories can influence the risk decision-making preference of individuals together.The retrieval of the rewarding episodic memory during decision making can increase the high risk propensity of the individuals.

Objective To study the relationship of serum 25-hydroxyvitamin D3[25-(OH)D3],myostatin(MSTN),limb skeletal muscle index(ASMI)with osteopenia(OP)in patients with rheumatoid arthritis(RA)complicated with sarcopenia(SA).Methods A total of 244 RA patients selected as case group,and 123 healthy people who underwent physical examination in our hospital during the same period were selected as control group.The general data,serum levels of 25-(OH)D3,MSTN,ASMI and peripheral blood immune cells were compared among the two groups.The diagnostic value of serum 25-(OH)D3,MSTN and ASMI in RA patients with SA complicated with OP and the correlation between serum 25-(OH)D3,MSTN,ASMI and peripheral blood immune cells were analyzed.Results The levels of serum 25-(OH)D3,peripheral blood regulatory T lymphocyte(Treg)cells and ASMI in the case group were lower than those in the control group,while the levels of serum MSTN,peripheral blood helper T lymphocyte 17(Th17)cells and Th17/Treg were higher than those in the control group(P＜0.05).Among the 244 RA patients,171 had no SA,73 had SA,and the incidence of SA was 29.92％.The levels of serum 25-(OH)D3,peripheral blood Treg cells and ASMI in the SA group were lower than those in the non-SA group,and the levels of serum MSTN,peripheral blood Th17 cells and Th17/Treg were higher than those in the non-SA group(P＜0.05).The levels of serum 25-(OH)D3,peripheral blood Treg cells and ASMI in the OP group were lower than those in the non-OP group,while the levels of serum MSTN,peripheral blood Th17 cells and Th17/Treg were higher than those in the non-OP group(P＜0.05).The area under the curve(AUC)of combined detection of serum 25-(OH)D3,MSTN and ASMI for the diagnosis of OP in RA patients with SA was higher than that of the three alone(P＜0.05).Serum 25-(OH)D3 and ASMI in RA patients with SA complicated with or without OP were negatively correlated with peripheral blood Th17 cell level and Th17/Treg(P＜0.05),and positively correlated with peripheral blood Treg cell level(P＜0.05).The level of serum MSTN was positively correlated with the level of Th17 cells and Th17/Treg in peripheral blood(P＜0.05),and negatively correlated with the level of Treg cells in peripheral blood(P＜0.05).Conclusion The incidence of OP in RA patients with SA is high.At the same time,the occurrence of SA and OP can lead to the decrease of serum 25-(OH)D3,peripheral blood Th17 cell,Th17/Treg and ASMI,and the increase of serum MSTN and peripheral blood Treg cell.The combination detection of 25-(OH)D3,MSTN and ASMI can effectively improve the diagnosis of OP in RA patients with SA,and the levels of the three are significantly correlated with peripheral blood Th17 cells,Treg cells and Th17/Treg.

Objective:To evaluate long-term outcomes of endoscopic papillectomy (EP) for duodenal papillary adenomas and to identify risk factors for incomplete resection.Methods:Clinical data of 180 patients diagnosed as having duodenal papillary adenoma via postoperative pathology after EP in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January 2010 to December 2022 were retrospectively analyzed. Patients were divided into two groups based on their postoperative margin status: the complete resection group (negative resection margins) and the incomplete resection group (positive/uncertain resection margins). Recurrence rates were compared between the two groups, and logistic regression analysis was performed to identify risk factors for incomplete resection.Results:Among the 180 patients included in the study, 137 underwent complete resection, and 43 had incomplete resections. Recurrence rate was significantly higher in the incomplete resection group than that in the complete resection group (30.2% VS 15.3%, χ2=4.75, P=0.029). logistic regression analysis indicated that high-grade intraepithelial neoplasia was an independent risk factor for incomplete resection ( OR=2.43, 95% CI:1.12-5.26, P=0.024). Conclusion:Patients with incomplete resection after EP have a higher recurrence rate in the long-term follow-up. High-grade intraepithelial neoplasia is an independent risk factor for incomplete resection. Close surveillance and aggressive management are warranted for patients with positive or uncertain resection margins to mitigate the recurrence risk.

Objective:To systematically evaluate the unmet needs and challenges of caregivers of cancer patients at home and clarify their unmet needs.Methods:A computerized search was conducted in PubMed, Web of Science, Embase, Cochrane Library, ProQuest, Scopus, CINAHL, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc for qualitative studies on the unmet needs and challenges of caregivers of cancer patients in the home environment. The search time limit was from the establishment of the databases to April 30, 2024. The Joanna Briggs Institute Centre for Evidence-Based Healthcare's quality assessment criteria for qualitative research were used to evaluate the quality of the literatures, and the aggregative integration method was used to summarize and integrate the research results.Results:A total of 17 articles were finally included, which were summarized into eight new categories. Further synthesis yielded three integrated results: caregivers in the home environment face multi-dimensional unmet needs and challenges related to patients; caregivers in the home environment face challenges and unmet needs in self-care; caregivers in the home environment are hesitant to obtain external support, and continuity and sustainability are hindered.Conclusions:Medical staff should accurately assess the unmet needs of caregivers of cancer patients at home, pay attention to their negative experiences, promote positive coping, optimize the patient-and family-centered cancer care model, and strengthen social support.