ObjectiveQi deficiency and phlegm dampness syndrome is a common type of clinical traditional Chinese medicine（TCM） syndrome. However， there is no standard， scientific， and accurate report on the construction of animal models of Qi deficiency and phlegm dampness syndrome. This study aims to construct a mouse model of Qi deficiency and phlegm dampness syndrome by using a multi-factor composite modeling method and to evaluate the model. MethodsTwenty-one C57BL/6 mice were randomly divided into three groups with seven mice in each group， which were the normal group， model group， and Shenling Baizhusan （SLBZ） group. The control group was fed with ordinary diet and kept in a normal environment. The model group and SLBZ group were fed with a high-fat diet in a high-humidity environment. Swimming with heavy weights until exhaustion and gavage with cold water or lard were used to establish the mouse model of Qi deficiency and phlegm dampness syndrome. In order to test the syndrome by prescription， mice in the SLBZ group were treated with SLBZ for 14 days after model construction. The exhaustive swimming time， body weight， serum lipid levels， tongue changes， "Qi deficiency and phlegm dampness" assessment scale score， and cecal index of mice in each group were measured. The feces of each group of mice were sent for metagenomics and metabolome sequencing， and the changes in intestinal flora and metabolites were analyzed. ResultsAfter the modeling of Qi deficiency and phlegm dampness syndrome， the exhaustive swimming time of mice was obviously shortened （P<0.01）. The serum total cholesterol， low density lipoprotein cholesterol， and non-high density lipoprotein cholesterol of mice were significantly increased （all P<0.01）. The tongue of mice was significantly different from that of the normal group， and the score of the assessment scale was significantly higher than that of the control group （P<0.01）. Cecal index decreased significantly （P<0.01）. The serum lipid level， tongue image， assessment scale score， and cecal index were reversed in the SLBZ group. Metagenomic and metabolome sequencing results showed that intestinal flora and fecal metabolites were significantly changed in mice with Qi deficiency and phlegm dampness syndrome. Akkermansia_muciniphila， Faecalibaculum_rodentium， Eubacterium_plexicaudatum， Eubacterium sp 14_2， Candida glabrata， Romboutsia_ilealis， Turicibacter sp TS3， and other bacteria had significant changes， and the expressions of intestinal metabolites such as chenodeoxycholic acid， choline， L-phenylalanine betaine， and 2-phenylbutyric acid were significantly changed. Related metabolic pathways such as linoleic acid metabolism， primary bile acid biosynthesis， lysine degradation， arginine biosynthesis， and alpha-linolenic acid metabolism were affected. ConclusionThe Qi deficiency and phlegm dampness model of mice can be constructed by the multi-factor composite modeling method of high-fat diet feeding， high-humidity environment feeding， exhaustive swimming with heavy weight， and intragastric administration with cold water or lard. The blood lipid level， tongue change， score of "Qi deficiency and phlegm dampness assessment scale"， cecal index， and changes in related intestinal flora and metabolites of mice can be used as key indicators for model evaluation.

As a corneal ectatic disease, keratoconus is characterized by increased corneal curvature, progressive thinning, and anterior protrusion of the cornea. Initially, patients often experience progressive myopia and irregular astigmatism. As the disease progresses, severe visual impairment may occur. Corneal collagen cross-linking(CXL)is currently recognized internationally as the only effective treatment to halt the progression of keratoconus. After the surgery, changes in stromal curvature subsequently lead to the regeneration and redistribution of corneal epithelial cells. It has been observed that the process of epithelial remodeling plays a crucial role in maintaining the smoothness and symmetry of the corneal surface, as well as in improving the visual recovery. However, the specific mechanism of epithelial remodeling in the visual recovery and efficacy maintenance after CXL surgery is still unclear. This review comprehensively summarizes the morphological characteristics, temporal patterns and clinical significance of corneal epithelial remodeling after CXL surgery, compares the effects of different CXL protocols on epithelial thickness, and explores the potential value of epithelial remodeling in the assessment of postoperative efficacy and the design of personalized surgical strategies, aiming to provide directions for further clinical practice and research.

INTRODUCTION: The aim of this study was to elucidate the epidemiology and distribution of hand fractures in Singapore. METHODS: A total of 701 hand fractures in 596 patients aged 21 years and above from a single centre were reviewed from 2010 to 2011. Details regarding the patient demographics, occupation, mechanism of injury, associated injuries and treatment were obtained. RESULTS: Hand fractures were particularly significant in patients between the ages of 21 and 40 years 58.9% of the total cases. The relative risk of hand fractures in males was 5.5 times greater than that in females. The majority of hand fractures occurred at the workplace (47.7%), with crush injury being the main mechanism of injury (33.6%). The most common locations of hand fracture were the little finger ray (31.2%) and distal phalanges (37.7%). There were 170 cases that underwent surgical fixation, which accounted for 24.3% of all fractures. Fixation rate was similar for both closed and open fractures but was significantly higher in the proximal and middle phalanges compared to the distal phalanx and metacarpal ( P < 0.001). With regards to surgical fixation methods, wires were commonly used in either tuft fractures (100.0%) or intra-articular fractures (69.9%), whereas plates and screws were commonly used in shaft fractures (65.5%). CONCLUSION The most significant population that sustained hand fractures in Singapore are young to middle-aged males who are skilled manual workers. The most commonly involved ray and location of hand fractures are the little finger ray and the distal phalanges, respectively, as they are in a relatively more exposed location.
Humans ; Singapore/epidemiology* ; Male ; Female ; Adult ; Middle Aged ; Fractures, Bone/surgery* ; Hand Injuries/surgery* ; Young Adult ; Aged ; Hand Bones/injuries* ; Retrospective Studies ; Fracture Fixation, Internal

Objective:To investigate the expression relationship of Survivin,Bad,Bax and Bcl-2 genes in esophageal squamous cell carcinoma patients and to explore their correlation with clinicopathological markers,moreover,compare with GEPIA cancer database.Methods:48 ESCC specimens were taken from patients and used in the study.Matched adjacent normal tissues were used as controls.The expression of Survivin,Bad,Bax,and Bcl-2 genes were detected by RT-PCR.Meanwile,genes expressions were analyzed with clinicopathological factors,including tumor differentiation degree,TNM classification,clinical stage and lymph node metastasis.GEPIA analyzes the correlation between Survivin,Bad,Bax and Bcl-2 online.Results:In 48 cases of cancer tissues,Survivin expression was detected in 85.4％(41/48)of cancer tissues and in 62.5％(30/48)of adjacent normal tissues,and Bad was 45.8％(22/48)and 25％(12/48)respectively.Survivin and Bad were both highly expressed in cancer tissues,and the difference was statistically significant(P＜0.05),but Bax and Bcl-2 genes had no statical significance(P＞0.05).The mRNA expression rates of Bad,Bax,and Bcl-2 increased with higher differentiation degree(P＜0.05),while the high expression rate of Survivin mRNA was correlated with lymph node metastasis(P＜0.05).However,none of these markers showed associations with TNM staging or clinical stage.The expression of Bad had a negative correlation with the expression of Survivin(r=-0.449,P＜0.05),but a positive correlation with the expression of Bcl-2(r=0.348,P＜0.05).The expressions of Bax,Bcl-2 and survivin were positively correlated(r=0.552,0.331,respectively,both P＜0.05).The results of the GEPIA cancer database show that Survivin was highly expressed in cancer tissues(P＜0.05),and the expressions of Bad,Bax and Survivin were negatively correlated(r=-0.19,-0.16,respectively,both P＜0.01).Conclusions:Survivin and Bad may synergistically promote esophageal squamous cell carcinogenesis,while Bad,Bax,and Bcl-2 are implicated in malignant transformation.

At present,reforming and innovating the public health talent training model are the challenges that the construc-tion of new medical in our country.Medical Immunology is the initial driving force in preventive medicine.Based on the course con-struction of Medical Immunology and centering on the core link of post competency of preventive medicine undergraduates,this study comprehensively reshapes the course system of Medical Immunology from the aspects of theoretical courses,practical courses,experi-mental courses,ideological and political courses and assessment methods,so as to provide reference for improving the teaching quality of preventive healthcare undergraduates.

Objective:To explore the effects of real-time feedback intervention based on ecological momentary assessment on health behaviors and quality of life in stroke patients, to provide new insights and evidence for secondary prevention of stroke and post-discharge rehabilitation management.Methods:This was a non synchronous controlled study. A total of 160 stroke patients admitted to the First Affiliated Hospital of Soochow University from January 2022 to June 2023 were selected by convenience sampling method and sequentially assigned to a control group (80 cases) and an intervention group (80 cases) according to the admission time. The control group received routine discharge follow-ups. The intervention group wore smart wristbands and received ecological momentary assessment -based real-time feedback intervention. Health behaviors and quality of life were compared between the two groups before discharge, 3 months and 6 months after discharge.Results:Both groups of patients completed the study. In the intervention group, there were 43 cases aged ≤ 65 years and 37 cases aged>65 years, with 55 males and 25 females. In the control group, there were 42 cases aged ≤ 65 years and 38 cases aged>65 years, with 53 males and 27 females. There were no significant differences in the level of health behaviors and quality of life before discharge between the two groups (both P>0.05). At both 3 and 6 months after discharge, the total scores of the health behaviors were (92.59 ± 7.12), (92.58 ± 5.77) points in the intervention group, and (86.15 ± 14.64), (83.40 ± 8.19) points in the control group, there were significant differences between the two groups ( t=-3.54, -7.72; both P<0.01). The quality of life in the intervention group at 3 months after discharge was 0.904 ± 0.123, which was higher than the control group's 0.845 ± 0.232, and the difference was statistically significant ( t=-2.01, P<0.05). However, there was no statistically significant difference in the quality of life between the two groups at 6 months after discharge ( P>0.05). The overall compliance rate with smart wristband usage in the intervention group was 100%(80/80). Conclusions:Ecological momentary assessment-based real-time feedback intervention effectively improves health behaviors in stroke patients and enhances their quality of life in the short term, demonstrating good feasibility and acceptability.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

At present,reforming and innovating the public health talent training model are the challenges that the construc-tion of new medical in our country.Medical Immunology is the initial driving force in preventive medicine.Based on the course con-struction of Medical Immunology and centering on the core link of post competency of preventive medicine undergraduates,this study comprehensively reshapes the course system of Medical Immunology from the aspects of theoretical courses,practical courses,experi-mental courses,ideological and political courses and assessment methods,so as to provide reference for improving the teaching quality of preventive healthcare undergraduates.

Objective:To investigate the expression relationship of Survivin,Bad,Bax and Bcl-2 genes in esophageal squamous cell carcinoma patients and to explore their correlation with clinicopathological markers,moreover,compare with GEPIA cancer database.Methods:48 ESCC specimens were taken from patients and used in the study.Matched adjacent normal tissues were used as controls.The expression of Survivin,Bad,Bax,and Bcl-2 genes were detected by RT-PCR.Meanwile,genes expressions were analyzed with clinicopathological factors,including tumor differentiation degree,TNM classification,clinical stage and lymph node metastasis.GEPIA analyzes the correlation between Survivin,Bad,Bax and Bcl-2 online.Results:In 48 cases of cancer tissues,Survivin expression was detected in 85.4％(41/48)of cancer tissues and in 62.5％(30/48)of adjacent normal tissues,and Bad was 45.8％(22/48)and 25％(12/48)respectively.Survivin and Bad were both highly expressed in cancer tissues,and the difference was statistically significant(P＜0.05),but Bax and Bcl-2 genes had no statical significance(P＞0.05).The mRNA expression rates of Bad,Bax,and Bcl-2 increased with higher differentiation degree(P＜0.05),while the high expression rate of Survivin mRNA was correlated with lymph node metastasis(P＜0.05).However,none of these markers showed associations with TNM staging or clinical stage.The expression of Bad had a negative correlation with the expression of Survivin(r=-0.449,P＜0.05),but a positive correlation with the expression of Bcl-2(r=0.348,P＜0.05).The expressions of Bax,Bcl-2 and survivin were positively correlated(r=0.552,0.331,respectively,both P＜0.05).The results of the GEPIA cancer database show that Survivin was highly expressed in cancer tissues(P＜0.05),and the expressions of Bad,Bax and Survivin were negatively correlated(r=-0.19,-0.16,respectively,both P＜0.01).Conclusions:Survivin and Bad may synergistically promote esophageal squamous cell carcinogenesis,while Bad,Bax,and Bcl-2 are implicated in malignant transformation.

Objective:To investigate the effects of TP53 genetic status(wild-type/mutated/null)on the drug resistance of decitabine(DAC)in myelodysplastic syndromes(MDS)and identify key resistance-associated genes.Methods:Two myeloid cell lines with distinct TP53 status(M-07e:wild-type;SKM-1:mutated;)were treated with gradient DAC concentrations(0-10 μmol/L)for 0-72 h.Cell viability was detected by CCK-8 assay.RNA-Seq transcriptomics,and methylation profiling were integrated to analyze differentially expressed genes.Results:Decitabine(DAC)treatment induced time-and dose-dependent inhibition of cell viability in CCK-8 assays,with SKM-1 cells exhibiting the highest resistance(IC50=5 μmol/L vs M-07e=0.5 μmol/L,P＜0.01).Transcriptomic analysis revealed 662 upregulated and 452 downregulated genes in DAC-treated M-07e cells,while SKM-1 cells showed 515 upregulated and 73 downregulated genes.By proteomic profiling,117 upregulated and 136 downregulated proteins were identified in M-07e cells,while 91 upregulated and 46 downregulated proteins were identified in SKM-1 cells following DAC exposure.Through integrated analysis of upregulated genes and proteins expression profiles,181 candidate genes were screened out,while methylation studies identified 884 hypomethylated genes with high-sensitivity loci and CpG density.Notably,31 genes overlapped between these datasets,and functional annotation indicated these drug-resistance-associated genes are primarily involved in positive regulation of cell differentiation,negative regulation of binding processes,and negative regulation of cellular component organization.Conclusion:TP53 mutations drive DAC resistance via epigenetic reprogramming.Targeting these genes may improve outcomes in TP53-mutated MDS.