The chronicity of infectious diseases is an important field in the collaborative research of traditional Chinese and Western medicine. The warm disease theory of pathogen invading nutrient and blood aspects in traditional Chinese medicine （TCM） takes the struggle between healthy Qi and pathogenic Qi and cementation of Yin as the core pathogenesis， providing a unique theoretical framework for explaining the common pathology of infectious chronic diseases. This theory originated from Yin-Yang interaction in the Internal Classic and was enriched with WU Youke's theory of intruding pathogen interacting and lingering in blood vessels and YE Tianshi's theory of long-term illness entering collaterals. Combining the theory with modern medical knowledge， our team has condensed the dynamic pathogenesis model of deficiency （nutrient and blood aspects） and excess （pathogen） interacting in the blood collaterals of Yin aspect， the core feature of which is the four-dimensional interactions of cause （pathogen characteristics）， location （three Yin locations of diseases）， nature （deficiency and excess）， and potential （transmission trend）. The common pathology of infectious chronic diseases is reflected in interactions. That is， the interactions between nutrient and blood deficiency （immune exhaustion and metabolic disorder） and pathogen excess （pathogen persistence and fibrous hyperplasia） in the liver collaterals （Jueyin）， kidney collaterals （Shaoyin）， lung collaterals （Taiyin） and other blood collaterals of Yin aspect form the pathological damage characterized by immune inflammatory response-continuous tissue damage with excessive repair. Taking the inheritance and innovative development of classics as the main line， this paper systematically discusses the scientific connotation of the theory of pathogen invading nutrient and blood aspects and the paths of inheritance and innovation and clarifies the original significance of this theory in the chronic development of infectious diseases. Furthermore， taking clinical diseases as an example， this paper reflects the guiding value of this classical theory in the modern diagnosis and treatment of infectious diseases with integrated traditional Chinese and Western medicine and the application potential of this theory in solving complex medical problems through the construction of the innovative paradigm of precise diagnosis and treatment with integrated traditional Chinese and Western medicine.

Purpose: Erectile dysfunction (ED) is a common male sexual dysfunction. Gut microbiota plays an important role in various diseases. To investigate the effects and mechanisms of intestinal flora dysregulation induced by high-fat diet (HFD) on erectile function. Materials and Methods: Male Sprague–Dawley rats aged 8 weeks were randomly divided into the normal diet (ND) and HFD groups. After 24 weeks, a measurement of erectile function was performed. We performed 16S rRNA sequencing of stool samples. Then, we established fecal microbiota transplantation (FMT) rat models by transplanting fecal microbiota from rats of ND group and HFD group to two new groups of rats respectively. After 24 weeks, erectile function of the rats was evaluated and 16S rRNA sequencing was performed, and serum samples were collected for the untargeted metabolomics detection. Results: The erectile function of rats and the species diversity of intestinal microbiota in the HFD group was significantly lower, and the characteristics of the intestinal microbiota community structure were also significantly different between the two groups. The erectile function of rats in the HFD-FMT group was significantly lower than that of rats in the ND-FMT group. The characteristics of the intestinal microbiota community structure were significantly different. In the HFD-FMT group, 27 metabolites were significantly different and they were mainly involved in the several inflammation-related pathways. Conclusions Intestinal microbiota disorders induced by HFD can damage the intestinal barrier of rats, change the serum metabolic profile, induce low-grade inflammation and apoptosis in the corpus cavernosum of the penis, and lead to ED.

Objective:To investigate the efficacy and safety of fluoroscopically-guided percutaneous gastrostomy (FGPG) for establishing enteral nutrition access in the treatment of esophageal fistula after radiotherapy for cervical esophageal cancer (CEC).Methods:A retrospective analysis was conducted on the clinical data of 54 patients who underwent FGPG due to esophageal fistula after radiotherapy for CEC at our department from November 2009 to August 2019. All patients received endoscopy before radiotherapy, and CEC was pathologically confirmed. Enteral nutrition support was offered through a gastrostomy tube postoperatively. The success rate of FGPG, complications, and healing of perforation were recorded and analyzed.Results:FGPG was successfully performed in all 54 patients (100%). During the 12-month follow-up, 50 patients (92.6) survived while four (7.4%) died. Among 36 patients with esophagomediastinal fistula, 32 (88.9%) healed in a median of 12 weeks; of 18 patients with esophagotracheal fistula, 8 (44.4%) healed in a median of 18 weeks. Thus, patients with esophagomediastinal fistula had a significantly higher healing rate ( P<0.01) and shorter healing time ( P=0.017). Gastrostomy tube-related complications were minimal, and no serious complication was noted. Conclusions:FGPG is effective for the treatment of esophageal fistula after CEC radiotherapy and may be an alternative treatment for esophageal fistula.

Objective To propose an EBT3 film technology-based quality control measurement method for the INTRABEAM PRS500 intraoperative radiotherapy equipment to solve the problems of the traditional methods in cumbersome operation and setup error.Methods According to HJ 1198-2021 Requirements of radiation safety and protection for radiotherapy and GBZ 121-2020 Requirements for radiological protection in radiotherapy,the environmental radiation testing of the INTRABEAM PRS500 intraoperative radiotherapy equipment was carried out point by point by means of the radiation inspection instrument.The INTRABEAM PRS500 intraoperative radiotherapy equipment was characterized by a point X-ray source(XRS),and the XRS was detected in terms of the probe linearity,radiation dose,dynamic deviation,isotropy and dose rate.The EBT3 film technology was used to verify the symmetry and isotropy of the XRS planar dose of INTRABEAM PRS500 intraoperative radiotherapy equipment.Results The X-γ dose equivalent rate of each monitoring site of the INTRABEAM PRS500 intraoperative radiotherapy device was lower than the method detection limit(MDL).The results of SQA quality control showed that the INTRABEAM PRS500 intraoperative radiotherapy equipment XRS met the quality control requirements in terms of the probe linearity,radiation dose,dynamic deviation and etc,and the isotropy differences in the+X,-X,+Y,and-Y axis directions ranged from-1.40％to 1.79％,which were all within the allowable range of measurement tolerance(5.60％to 5.65％).The results of measuring the isotropy of the INTRABEAM PRS500 intraoperative radiotherapy equipment based on the EBT3 film technology showed that the dose distribution of the XRS in the directions of the+X,-X,+Y,and-Y axes at the same plane was well isotropic,and that the doses in the directions of the X and Y axes were symmetrically distributed,and that the maximum skewness value for the isotropy of the XRS in the XY plane was-1.581％,which met the requirements of AAPM TG61 report on the reference dosimetry of low-energy and medium-energy X-rays for radiotherapy and radiobiology of≤±5.3％.Conclusion The EBT3 film technology-based measurement method gains high simplicity and feasibility for the isotropy of the INTRABEAM PRS500 intraoperative radiotherapy equipment in the directions of the+X,-X,+Y,and-Y axes at the same planet,which realizes the dynamic monitoring of the dosimetric changes and facilitates the whole-process quality control management of the intraoperative radiotherapy equipment.[Chinese Medical Equipment Journal,2025,46(6):47-53]

Myocardial infarction(MI)is one of the most common cardiovascular diseases(CVD)in clinic.Its morbidity,disability rate and mortality are remain high,making it an urgent challenge to address.In recent years,a growing number of studies have found that gut microbiota and their metabolites are closely related to the occurrence and development of MI.Some gut metabolites such as trimethylamine N-oxide(TMAO)and phenylacetylglutamine(PAGln)can predict major adverse cardiovascular events(MACE),including MI.In this review,the effects of gut microbiota on MI were investigated based on microbial-gut-heart-axis(MGHA).The results showed that plasma concentrations of gut metabolites(short-chain fatty acids,TMAO,PAGln、bile acids)had significant clinical correlation with MI,and had different effects on the occurrence of MI.Additionally,drug therapy,fecal microbial transplantation,changes in living and eating habits can all affect the composition of gut microbiota and the concentration of metabolites,thus providing new insights for the treatment of MI.

Objective To investigate how miR-30b regulates mitophagy independently of the PINK1/Parkin pathway by targeting ubiquitin specific peptidase 14(USP14)in neuronal oxygen-glucose deprivation/reoxygenation(OGD/R)injury,and to provide new insights for the treatment of neonatal hypoxic-ischemic encephalopathy.Methods Fetal rat cortical neurons were isolated and an OGD/R model was established.Experiments were conducted in two parts.In part 1,cells were randomized into control,OGD/R,OGD/R+microRNA(miR)-negative control(NC),OGD/R+miR-30b mimic,OGD/R+miR-30b mimic+oe-NC,and OGD/R+miR-30b mimic+oe-USP14 groups.In part 2,cells were randomized into control,OGD/R,OGD/R+miR-NC,OGD/R+miR-30b mimic,OGD/R+miR-30b mimic+si-NC,OGD/R+miR-30b mimic+si-Parkin,and OGD/R+miR-30b mimic+si-Drp1(dynamin-related protein 1)groups.miR-30b and USP14 mRNA levels were measured by real-time quantitative PCR.Cell viability was assessed using the CCK-8 assay and cell death by propidium iodide staining.Protein levels of USP14,microtubule-associated protein 1 light chain 3(LC3)Ⅱ/LC3 Ⅰ,translocase of outer mitochondrial membrane 20(TOMM20),PINK1,Parkin,and Drp1 were determined by Western blot.MitoTracker Green staining was used to evaluate mitochondrial morphology,and mitochondrial reactive oxygen species(ROS)were measured using the MitoSOX Red probe.AGO2-RNA immunoprecipitation and dual-luciferase reporter assays were performed to validate the targeting relationship between miR-30b and USP14.Results Compared with the OGD/R group,the OGD/R+miR-30b mimic group showed higher cell viability,miR-30b expression,LC3 Ⅱ/LC3 Ⅰ ratio,and Drp1 protein expression(P<0.05),and lower PI positivity,mitochondrial ROS,USP14 mRNA and protein expression,TOMM20 protein expression,mitochondrial fragmentation index,and mitochondrial volume(P<0.05).PINK1 and Parkin protein levels did not differ significantly between these two groups(P>0.05).Compared with the OGD/R+miR-30b mimic+oe-NC group,the OGD/R+miR-30b mimic+oe-USP14 group exhibited reduced cell viability,miR-30b expression,and LC3 Ⅱ/LC3 Ⅰ ratio(P<0.05),and increased PI positivity,mitochondrial ROS,USP14 mRNA and protein expression,TOMM20 protein expression,mitochondrial fragmentation index,and mitochondrial volume(P<0.05).miR-30b was confirmed to target USP14.In addition,no significant differences were observed between the OGD/R+miR-30b mimic+si-NC and OGD/R+miR-30b mimic+si-Parkin groups in LC3 Ⅱ/LC3 Ⅰ ratio,fragmentation index,or average mitochondrial volume(P>0.05).Compared with the OGD/R+miR-30b mimic+si-NC group,the OGD/R+miR-30b mimic+si-Drp1 group showed a decreased LC3 Ⅱ/LC3 Ⅰ ratio and increased fragmentation index and average mitochondrial volume(P<0.05).Conclusions miR-30b regulates mitophagy by targeting USP14 independently of the PINK1/Parkin pathway,and confers protection against neuronal OGD/R injury.

Objective To investigate the influence of helical tomographic radiotherapy plans with different combinations of lead gate width,pitch and algorithms on threading effects.Methods A target model was established with a Cheese Phantom used as the simulated human body,then three lead gate widths(1.0,2.5,and 5.0 cm),six screw pitches(0.143,0.172,0.215,0.287,0.430,and 0.500)and two computational grids(Fine algorithm and Normal algorithm)were respectively combined for designing the helical tomography radiotherapy plans.The radiotherapy plans with a pitch of 0.143,0.172,0.215,0.287 or 0.430 were enrolled into an experimental group,and the plans with a pitch of 0.500 were divided into a control group.The dosimetric parameters including maximum dose(Dmax),minimum dose(Dmin)and mean dose(Dmean)of the target area PTV1 and PTV2 were evaluated by the dose volume histogram(DVH).The dose homogeneity index(HI)of the target area was calculated,and the single rotation time and total treatment time of each plan were recorded and counted.SPSS 27.0 software was used for statistical analysis.Results No significant threading effect appeared regardless of the pitch value when the lead gate width was 1.0 cm.The threading effects in the experimental group were weaker than those in the control group when the lead gate width was 2.5 or 5.0 cm.The threading effect gradually rose with the pitch increased when the lead gate width was 5.0 cm.The most significant difference was found between the threading effect in case of the screw pitch being 0.500 and that with the screw pitch being 0.143,with the differenes being statistically obvious(P<0.05).The lead gate width had significant effects on the Dmax,Dmin,Dmean and HI of PTV1 and PTV2.When the lead gate width was 5.0 cm,high HI value and uneven dose distribution were detected and lowered screw pitch weakened the threading effect.The single rotation time first remained constant and then increased with the screw pitch was enlarged,with the changing points occurring in case of the screw pitches of 0.287 and 0.430.With a certain lead gate width,the treatment time for plans was shortened with the decrease of the pitches in case of the pritches lower than 0.287,and tended to be constant after the screw pitches reached 0.287.The changes of the computational grid had no significant effects on the results of radiotherapy plans when the lead gate width and screw pitch were kept constant.Conclusion When designing a spiral tomotherapy plan with conventional doses,a lead gate width of 1.0 or 2.5 cm and a screw pitch of 0.287 or 0.430 should be selected in order to minimize the threading effect while ensuring the efficiency of plan implementation.[Chinese Medical Equipment Journal,2025,46(8):58-66]

Objective To investigate how miR-30b regulates mitophagy independently of the PINK1/Parkin pathway by targeting ubiquitin specific peptidase 14(USP14)in neuronal oxygen-glucose deprivation/reoxygenation(OGD/R)injury,and to provide new insights for the treatment of neonatal hypoxic-ischemic encephalopathy.Methods Fetal rat cortical neurons were isolated and an OGD/R model was established.Experiments were conducted in two parts.In part 1,cells were randomized into control,OGD/R,OGD/R+microRNA(miR)-negative control(NC),OGD/R+miR-30b mimic,OGD/R+miR-30b mimic+oe-NC,and OGD/R+miR-30b mimic+oe-USP14 groups.In part 2,cells were randomized into control,OGD/R,OGD/R+miR-NC,OGD/R+miR-30b mimic,OGD/R+miR-30b mimic+si-NC,OGD/R+miR-30b mimic+si-Parkin,and OGD/R+miR-30b mimic+si-Drp1(dynamin-related protein 1)groups.miR-30b and USP14 mRNA levels were measured by real-time quantitative PCR.Cell viability was assessed using the CCK-8 assay and cell death by propidium iodide staining.Protein levels of USP14,microtubule-associated protein 1 light chain 3(LC3)Ⅱ/LC3 Ⅰ,translocase of outer mitochondrial membrane 20(TOMM20),PINK1,Parkin,and Drp1 were determined by Western blot.MitoTracker Green staining was used to evaluate mitochondrial morphology,and mitochondrial reactive oxygen species(ROS)were measured using the MitoSOX Red probe.AGO2-RNA immunoprecipitation and dual-luciferase reporter assays were performed to validate the targeting relationship between miR-30b and USP14.Results Compared with the OGD/R group,the OGD/R+miR-30b mimic group showed higher cell viability,miR-30b expression,LC3 Ⅱ/LC3 Ⅰ ratio,and Drp1 protein expression(P<0.05),and lower PI positivity,mitochondrial ROS,USP14 mRNA and protein expression,TOMM20 protein expression,mitochondrial fragmentation index,and mitochondrial volume(P<0.05).PINK1 and Parkin protein levels did not differ significantly between these two groups(P>0.05).Compared with the OGD/R+miR-30b mimic+oe-NC group,the OGD/R+miR-30b mimic+oe-USP14 group exhibited reduced cell viability,miR-30b expression,and LC3 Ⅱ/LC3 Ⅰ ratio(P<0.05),and increased PI positivity,mitochondrial ROS,USP14 mRNA and protein expression,TOMM20 protein expression,mitochondrial fragmentation index,and mitochondrial volume(P<0.05).miR-30b was confirmed to target USP14.In addition,no significant differences were observed between the OGD/R+miR-30b mimic+si-NC and OGD/R+miR-30b mimic+si-Parkin groups in LC3 Ⅱ/LC3 Ⅰ ratio,fragmentation index,or average mitochondrial volume(P>0.05).Compared with the OGD/R+miR-30b mimic+si-NC group,the OGD/R+miR-30b mimic+si-Drp1 group showed a decreased LC3 Ⅱ/LC3 Ⅰ ratio and increased fragmentation index and average mitochondrial volume(P<0.05).Conclusions miR-30b regulates mitophagy by targeting USP14 independently of the PINK1/Parkin pathway,and confers protection against neuronal OGD/R injury.

Objective:To investigate the efficacy and safety of fluoroscopically-guided percutaneous gastrostomy (FGPG) for establishing enteral nutrition access in the treatment of esophageal fistula after radiotherapy for cervical esophageal cancer (CEC).Methods:A retrospective analysis was conducted on the clinical data of 54 patients who underwent FGPG due to esophageal fistula after radiotherapy for CEC at our department from November 2009 to August 2019. All patients received endoscopy before radiotherapy, and CEC was pathologically confirmed. Enteral nutrition support was offered through a gastrostomy tube postoperatively. The success rate of FGPG, complications, and healing of perforation were recorded and analyzed.Results:FGPG was successfully performed in all 54 patients (100%). During the 12-month follow-up, 50 patients (92.6) survived while four (7.4%) died. Among 36 patients with esophagomediastinal fistula, 32 (88.9%) healed in a median of 12 weeks; of 18 patients with esophagotracheal fistula, 8 (44.4%) healed in a median of 18 weeks. Thus, patients with esophagomediastinal fistula had a significantly higher healing rate ( P<0.01) and shorter healing time ( P=0.017). Gastrostomy tube-related complications were minimal, and no serious complication was noted. Conclusions:FGPG is effective for the treatment of esophageal fistula after CEC radiotherapy and may be an alternative treatment for esophageal fistula.

Serine protease inhibitor Kazal-type (SPINK) is a skin keratinizing protease inhibitor, which was initially found in animal serum and is widely present in plants, animals, bacteria, and viruses, and they act as key regulators of skin keratinizing proteases and are involved in the regulation of keratinocyte proliferation and inflammation, primarily through the inhibition of deregulated tissue kinin-releasing enzymes (KLKs) in skin response. This process plays a crucial role in alleviating various skin problems caused by hyperkeratinization and inflammation, and can greatly improve the overall condition of the skin. Specifically, the different members of the SPINK family, such as SPINK5, SPINK6, SPINK7, and SPINK9, each have unique biological functions and mechanisms of action. The existence of these members demonstrates the diversity and complexity of skin health and disease. First, SPINK5 mutations are closely associated with the development of various skin diseases, such as Netherton’s syndrome and atopic dermatitis, and SPINK5 is able to inhibit the activation of the STAT3 signaling pathway, thereby effectively preventing the metastasis of melanoma cells, which is important in preventing the invasion and migration of malignant tumors. Secondly, SPINK6 is mainly distributed in the epidermis and contains lysine and glutamate residues, which can act as a substrate for epidermal transglutaminase to maintain the normal structure and function of the skin. In addition, SPINK6 can activate the intracellular ERK1/2 and AKT signaling pathways through the activation of epidermal growth factor receptor and protease receptor-2 (EphA2), which can promote the migration of melanoma cells, and SPINK6 further deepens its role in stimulating the migration of malignant tumor cells by inhibiting the activation of STAT3 signaling pathway. This process further deepens its potential impact in stimulating tumor invasive migration. Furthermore, SPINK7 plays a role in the pathology of some inflammatory skin diseases, and is likely to be an important factor contributing to the exacerbation of skin diseases by promoting aberrant proliferation of keratinocytes and local inflammatory responses. Finally, SPINK9 can induce cell migration and promote skin wound healing by activating purinergic receptor 2 (P2R) to induce phosphorylation of epidermal growth factor and further activating the downstream ERK1/2 signaling pathway. In addition, SPINK9 also plays an antimicrobial role, preventing the interference of some pathogenic microorganisms. Taken as a whole, some members of the SPINK family may be potential targets for the treatment of dermatological disorders by regulating multiple biological processes such as keratinization metabolism and immuno-inflammatory processes in the skin. The development of drugs such as small molecule inhibitors and monoclonal antibodies has great potential for the treatment of dermatologic diseases, and future research on SPINK will help to gain a deeper understanding of the physiopathologic processes of the skin. Through its functions and regulatory mechanisms, the formation and maintenance of the skin barrier and the occurrence and development of inflammatory responses can be better understood, which will provide novel ideas and methods for the prevention and treatment of skin diseases.