ObjectiveTo investigate the effect of Yaoshu Zhuyu Fang on the regulation of the microRNA-17-5P (miR-17-5P)/murine double minute 2 (MDM2)/p53 axis in the proliferation and apoptosis of rat intervertebral disc annulus fibrosus cells, and its potential molecular mechanism. MethodsIntervertebral disc annulus fibrosus tissues were obtained from 8-week-old SPF-grade male SD rats, and annulus fibrosus cells were isolated and obtained by enzyme digestion and mechanical dispersion. Annulus fibrosus cells were divided into 6 groups: Group C was the blank control group, in which annulus fibrosus cells were not treated with interleukin-1β (IL-1β) but were cultured in RPMI 1640 complete medium. Group β was the degeneration model group constructed by treating annulus fibrosus cells with 10 ng/mL IL-1β for 24 h. Group β+B was the IL-1β + blank serum group, in which annulus fibrosus cells were first treated with IL-1β to construct the degeneration model, then treated with RPMI 1640 medium containing 5% blank serum for 24 h. Group β+W was the IL-1β + Yaoshu Zhuyu Fang-containing serum group, in which annulus fibrosus cells were first treated with IL-1β to construct the degeneration model, then treated with RPMI 1640 medium containing 5% Yaoshu Zhuyu Fang-containing serum for 24 h. Group β+I was the IL-1β + miR-17-5P inhibitor group, in which annulus fibrosus cells were first treated with IL-1β to construct the degeneration model, then transfected with miR-17-5P inhibitor. Group β+I+W was the IL-1β + miR-17-5P inhibitor + Yaoshu Zhuyu Fang-containing serum group, in which annulus fibrosus cells were first treated with IL-1β to construct the degeneration model, then transfected with miR-17-5P inhibitor, and finally treated with RPMI 1640 medium containing 5% Yaoshu Zhuyu Fang-containing serum for 24 h. CCK-8 assay was used to detect cell survival rate. Flow cytometry was used to detect cell apoptosis. Real-time quantitative PCR was used to detect the expression levels of miR-17-5P, MDM2 mRNA, and p53 mRNA in cells. Western blotting was used to detect the protein expression levels of MDM2 and p53 in cells. Dual-luciferase reporter system was used to analyze the targeting relationship between miR-17-5P and MDM2. ResultsCompared with Group C, Group β showed a significant decrease in cell survival rate (P<0.001), a significant increase in cell apoptosis rate (P<0.001), significantly increased expression of miR-17-5P, p53 mRNA, and p53 protein (P<0.001), and significantly decreased expression of MDM2 mRNA and protein (P<0.001). Compared with Group β, Group β+W, Group β+I, and Group β+I+W showed significantly increased cell survival rate, significantly decreased apoptosis rate, significantly decreased expression of miR-17-5P, p53 mRNA, and p53 protein, and significantly increased expression of MDM2 mRNA and protein (P<0.001). Moreover, changes in the above indicators were greater in Group β+I+W (P<0.001). Circular RNA Interactome predicted that miR-17-5P had specific binding sites with the 3' untranslated region (3'UTR) of MDM2. Transfection of miR-17-5P mimic significantly reduced the luciferase expression level of co-transfected luciferase reporter plasmid containing wild-type MDM2 3'UTR (P<0.05), but had no significant effect on luciferase expression in cells co-transfected with luciferase reporter plasmid containing mutant MDM2 3'UTR (P>0.05). ConclusionYaoshu Zhuyu Fang down-regulates the expression of miR-17-5P, promotes the synthesis of MDM2 protein, thereby down-regulates p53, promotes proliferation, and inhibits the apoptosis of rat intervertebral disc annulus fibrosus cells.

Objective:To investigate auricular acupressure combined with massage-tapping exercises on body indicators, blood lipids, and liver function in patients with obesity-related fatty liver disease.Methods:This retrospective study included 78 patients with obesity-related fatty liver disease admitted to Hangzhou Hospital of Traditional Chinese Medicine from April to December 2023. The patients were divided into two groups based on different treatment methods: the conventional group (36 patients receiving conventional interventions) and the combined group (36 patients receiving auricular acupressure combined with massage-tapping exercises in addition to conventional interventions). The total response rates, physical indicators (body weight, body mass index), blood lipid levels (triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol), and liver function indicators (aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyltransferase were recorded and compared between the two groups.Results:The total response rate in the combined group was 94.87% (37/39), which was significantly higher than the 76.92% (30/39) in the conventional group ( χ2 = 5.19, P < 0.05). After intervention, the combined group showed lower body weight [(70.42 ± 8.32) kg vs. (75.84 ± 8.46) kg], lower body mass index [(24.32 ± 1.26) kg/m2 vs. (25.48 ± 1.30) kg/m2], lower triglycerides [(1.62 ± 0.42) mmol/L vs. (2.94 ± 0.78) mmol/L], lower total cholesterol [(5.24 ± 0.54) mmol/L vs. (6.72 ± 0.66) mmol/L], lower low-density lipoprotein cholesterol [(2.14 ± 0.46) mmol/L vs. (2.78 ± 0.50) mmol/L], lower aspartate aminotransferase [(35.32 ± 4.38) U/L vs. (40.16 ± 5.14) U/L], lower alanine aminotransferase [(31.05 ± 4.20) U/L vs. (37.24 ± 4.56) U/L], and lower gamma-glutamyltransferase [(43.35 ± 8.74) U/L vs. (57.62 ± 9.04) U/L] levels compared with the conventional group. The combined group showed higher high-density lipoprotein cholesterol level compared with the conventional group [(1.85 ± 0.26) mmol/L vs. (1.26 ± 0.30) mmol/L]. All differences were statistically significant ( t = 2.85, 4.00, 9.31, 10.84, 5.88, 4.48, 6.24, 7.09, 9.28, all P < 0.05). Conclusions:The combination of auricular acupressure and massage-tapping exercises is effective in treating obesity-related fatty liver disease in patients. This approach can regulate physical indicators, improve lipid metabolism, and enhance liver function, making it a method worth promoting in clinical practice.

With the extended survival period of breast cancer patients and the increasing health demands, the concomitant diseases of breast cancer have gradually attracted the attention of both doctors and patients, and it is imperative to conduct comprehensive management of these diseases, in which the general practitioners, as the more comprehensive and complex medical talents, have not yet played their due roles. In this article, we report two cases of comprehensive management of concomitant diseases of breast cancer through collaboration of general practitioners and specialists (integrated general and specialist care). The role and function of general practitioners in this process were deeply analyzed, and the establishment of a consultation-liaison general practice model to further promote the role of integrated general and specialist care in integrated oncology care was advocated.

With the improvement of diagnosis and treatment level, most breast cancer patients survive in a chronic state for a long time, and the issue of concomitant diseases of breast cancer (CDBC) has become increasingly prominent. All-round and full-cycle management of these comorbidities can help improve patients’ quality of life and prognosis. General practice, with its long-term, comprehensive and responsible health care that is person-centered, family-based, community-wide and oriented to the maintenance and promotion of overall health, presents new opportunities for the health management of CDBC. This article will explore the application of consultation-liaison general practice through the integrated general and specialist care in the comprehensive management of CDBC, aiming to raise people’s awareness of it and promote the development of consultation-liaison general practice and the management model of the "Internet plus general practitioner team" , which will surely contribute to the all-round management of concomitant diseases in breast cancer patients.

With the extended survival period of breast cancer patients and the increasing health demands, the concomitant diseases of breast cancer have gradually attracted the attention of both doctors and patients, and it is imperative to conduct comprehensive management of these diseases, in which the general practitioners, as the more comprehensive and complex medical talents, have not yet played their due roles. In this article, we report two cases of comprehensive management of concomitant diseases of breast cancer through collaboration of general practitioners and specialists (integrated general and specialist care). The role and function of general practitioners in this process were deeply analyzed, and the establishment of a consultation-liaison general practice model to further promote the role of integrated general and specialist care in integrated oncology care was advocated.

With the improvement of diagnosis and treatment level, most breast cancer patients survive in a chronic state for a long time, and the issue of concomitant diseases of breast cancer (CDBC) has become increasingly prominent. All-round and full-cycle management of these comorbidities can help improve patients’ quality of life and prognosis. General practice, with its long-term, comprehensive and responsible health care that is person-centered, family-based, community-wide and oriented to the maintenance and promotion of overall health, presents new opportunities for the health management of CDBC. This article will explore the application of consultation-liaison general practice through the integrated general and specialist care in the comprehensive management of CDBC, aiming to raise people’s awareness of it and promote the development of consultation-liaison general practice and the management model of the "Internet plus general practitioner team" , which will surely contribute to the all-round management of concomitant diseases in breast cancer patients.

OBJECTIVE To explore the clinical efficacy of the Yushen Yangluan Formula in treating diminished ovarian reserve(DOR)with kidney essence deficiency based on mitochondrial energy metabolism and oxidative stress.METHODS A total of 70 pa-tients diagnosed with DOR due to kidney essence deficiency,who visited the gynecology department of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine from September 2023 to June 2024,were selected.The patients were randomly divided into two groups according to the random number table method.The treatment group(35 cases)received the Yushen Yangluan Formula,while the control group(35 cases)received a Chinese herbal placebo,with treatment lasting for 3 months,and during the treatment pe-riod,one case dropped out from each group.Antral follicle count(AFC),traditional Chinese medicine(TCM)syndrome scores,and serum levels of anti-Mullerian hormone(AMH),follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),re-active oxygen species(ROS),and adenosine triphosphate(ATP)levels were compared between the two groups.RESULTS After treatment,the TCM syndrome scores for kidney deficiency in both groups decreased compared to before treatment(P<0.05,P<0.01),with the experimental group showing greater improvement than the control group(P<0.01).Following treatment,the FSH levels in the experimental group decreased compared to before treatment(P<0.05),while AMH levels increased(P<0.05),and the antral follicle count(AFC)also increased significantly(P<0.01),with the experimental group outperforming the control group(P<0.05,P<0.01).After treatment,serum ROS levels in the experimental group decreased(P<0.01),and ATP levels increased(P<0.01),with the experimental group showing superior results compared to the control group(P<0.01).CONCLUSION Yushen Yangluan Formu-la can improve the ovarian function and TCM syndrome score of patients with DOR of kidney essence deficiency type,which may be re-lated to improving mitochondrial energy metabolism and reducing oxidative stress.

Bone marrow suppression is one of the common adverse reactions to radiotherapy and chemotherapy. Anticancer treatments such as radiotherapy and chemotherapy first directly damage the patient′s peripheral blood cells, impairing qi and blood; further, they damage the actively proliferating cell populations in the bone marrow, impairing yin and blood; and then they interfere with hematopoietic stem cells, impairing essence and blood. This process is rapid and intense, consistent with the characteristics of " acute deficiency syndrome" , marked by sudden onset, rapid changes, critical condition, complexity and variability, multiple complications, and poor prognosis. Given this, its diagnosis and treatment should differ from those of general deficiency syndromes. This paper advocates the principles and ideas of diagnosis and treatment such as " preventing first and treating early to prevent changes; supplementing for deficiency and strengthening vital qi to eliminate pathogenic factor; urgent rescue for critical conditions, no time to lose; and comprehensive supplementing throughout the process, with severe cases requiring singular action" . This approach is intended to provide theoretical reference and practical guidance for bone marrow suppression after radiotherapy and chemotherapy.

OBJECTIVE To explore the clinical efficacy of the Yushen Yangluan Formula in treating diminished ovarian reserve(DOR)with kidney essence deficiency based on mitochondrial energy metabolism and oxidative stress.METHODS A total of 70 pa-tients diagnosed with DOR due to kidney essence deficiency,who visited the gynecology department of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine from September 2023 to June 2024,were selected.The patients were randomly divided into two groups according to the random number table method.The treatment group(35 cases)received the Yushen Yangluan Formula,while the control group(35 cases)received a Chinese herbal placebo,with treatment lasting for 3 months,and during the treatment pe-riod,one case dropped out from each group.Antral follicle count(AFC),traditional Chinese medicine(TCM)syndrome scores,and serum levels of anti-Mullerian hormone(AMH),follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),re-active oxygen species(ROS),and adenosine triphosphate(ATP)levels were compared between the two groups.RESULTS After treatment,the TCM syndrome scores for kidney deficiency in both groups decreased compared to before treatment(P<0.05,P<0.01),with the experimental group showing greater improvement than the control group(P<0.01).Following treatment,the FSH levels in the experimental group decreased compared to before treatment(P<0.05),while AMH levels increased(P<0.05),and the antral follicle count(AFC)also increased significantly(P<0.01),with the experimental group outperforming the control group(P<0.05,P<0.01).After treatment,serum ROS levels in the experimental group decreased(P<0.01),and ATP levels increased(P<0.01),with the experimental group showing superior results compared to the control group(P<0.01).CONCLUSION Yushen Yangluan Formu-la can improve the ovarian function and TCM syndrome score of patients with DOR of kidney essence deficiency type,which may be re-lated to improving mitochondrial energy metabolism and reducing oxidative stress.

To summarize and analyze the clinical data of one case of kidney transplantation in an HIV-positive child with end-stage renal disease (ESRD) in the Department of Transplantation, the People's Hospital of Guangxi Zhuang Autonomous Region, and to explore the safety and efficacy of kidney transplantation in HIV-positive children with ESRD. This pediatric recipient was found to be HIV-positive at birth and underwent kidney transplantation due to ESRD, with good postoperative recovery. During the 2.5-year follow-up, no rejection or rebound in HIV RNA levels was observed. The function of the transplanted kidney was good, and the quality of life was comparable to that of healthy individuals. It suggests that kidney transplantation in HIV-positive children with ESRD is safe and effective under adequate preoperative preparation and close postoperative follow-up.