OBJECTIVES: To develop a risk prediction model for the transformation of chronic atrophic gastritis to high-grade intraepithelial neoplasia (HGIN) based on traditional Chinese medicine (TCM) syndrome patterns. METHODS: Clinical data of 201 chronic atrophic gastritis patients who visited the Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine and Dong'erhuan Branch between January 2022 and March 2023 were retrospectively analyzed, including 32 patients with HGIN (HGIN group) and 169 patients with moderate and severe chronic atrophic gastritis (non-HGIN group). The information of demographic characteristics, dietary habits, lifestyle factors, social and psychosocial factors, family history of tumors, medical history and comorbidities, long-term medication, endoscopic findings, histopathological examination results, as well as TCM syndrome types were collected. Potential HGIN risk factors were screened using LASSO regression, and the significant risk factors for establishing an HGIN risk prediction model were identified using logistic regression analysis. The final model was visually presented using a nomogram, and its diagnostic performance was evaluated through receiver operating characteristic curve analysis. RESULTS: Spleen-stomach Qi deficiency was the most common TCM syndrome in both HGIN and non-HGIN groups. LASSO-logistic regression model analysis showed that heavy alcohol consumption (X1), syndrome of static blood in stomach collaterals (X2), low-grade intraepithelial neoplasia (X3), high-salt diet (X4), and age (X5) were independent risk factors related to the occurrence of HGIN, and the predictive model was ln［P/(1－P)］=2.159X1+2.230X2+1.664X3+2.070X4+0.122X5- 11.096. The model demonstrated good discriminative ability, calibration, and goodness-of-fit, with area under the curve values of 0.940 and 0.891 in the training and validation sets, respectively. CONCLUSIONS The TCM syndrome of static blood in stomach collaterals shows correlation with the transformation from chronic atrophic gastritis to HGIN. The HGIN prediction model based on TCM syndrome patterns developed in the study demonstrates potential value in clinical application.
Humans ; Gastritis, Atrophic/diagnosis* ; Medicine, Chinese Traditional ; Retrospective Studies ; Female ; Male ; Middle Aged ; Stomach Neoplasms/diagnosis* ; Adult ; Risk Factors ; Carcinoma in Situ/diagnosis* ; Aged ; Nomograms ; Chronic Disease ; Logistic Models

Medical equipment, as an important indicator of smart hospital evaluation, plays a vital role in hospital operations. To ensure the safe and efficient operation of medical equipment, a reasonable performance evaluation system is indispensable. This study introduces a platform based on Internet of Things (IoT) technology that connects medical devices and collects data, achieving standardized and structured data processing, and supporting online operational supervision. Through the Delphi method, a performance evaluation system for large medical equipment is constructed, including 4 primary indicators and 22 secondary indicators. DICOM data acquisition devices are used to achieve functions such as efficiency analysis, benefit analysis, usage evaluation, and decision-making support for medical equipment. The study is still in its early stages, and in the future, it is expected to integrate more types of equipment, achieve rational resource allocation, and significantly impact decision-making for the development of public hospitals.
Internet of Things ; Delphi Technique

Objective:To investigate the effect of ear acupoint bean pressing on gastrointestinal motility and related hormones after laparoscopic surgery in patients with hysteromyoma,and to explore the therapeutic mechanism of ear acupoint bean pressing.Methods:Patients undergoing laparoscopic myomectomy in the Department of Gynecology of The People's Hospital Affiliated to Fujian Univer-sity of Traditional Chinese Medicine from May 2022 to December 2023 were randomly divided into an experimental group and a control group,with 57 patients in each group.The experimental group was treated with postoperative routine nursing and ear acupoint bean pressing(targeting the spleen,stomach,and sympathetic),and the control group was treated with postoperative routine nursing and sham ear acupoint bean pressing(containing no Vaccaria seed,targeting the spleen,stomach,and sympathetic).After the intervention,the time to first postoperative passing of flatus and defecation,clinical efficacy,and changes in gastrointestinal hormone levels were compared between the two groups.Results:The time to first postoperative passing of flatus[20.31(17.52,22.38)h vs.21.51(18.53,28.15)h]and defecation[35.32(31.47,39.17)h vs.38.12(33.44,42.78)h]in the experimental group was lower than that in the control group(P<0.05),and the clinical efficacy was better than that in the control group(P<0.05).There were no significant differ-ences in motilin(MTL),gastrin(GAS),somatostatin(SS),and substance P(SP)levels between the two groups before operation(P>0.05).The MTL and GAS levels were increased and the SS and SP levels were decreased after operation.The MTL[(451.52±54.33)pg/mL vs.(476.24±56.35)pg/mL]and GAS[150.50(133.93,164.52)pg/mL vs.173.44(154.45,184.63)pg/mL]levels at 24 h after operation in the experimental group were lower than those in the control group(P<0.05),and the SS[38.34(33.24,40.23)pg/mL vs.33.36(29.13,38.76)pg/mL]level at 24 h after operation was higher than that in the control group(P<0.05),with no significant change in the SP level(P>0.05).The results of repeated measures analysis of variance and generalized estimation equation showed that there were significant differences in the time effect and interaction effect of MTL(P<0.05),a significant difference in the time effect of SP(P<0.05),and significant differences in the time effect,intergroup effect,and interaction effect of GAS and SS(P<0.05).Conclusion:Ear acupoint bean pressing has significant effect on abdominal distension after laparoscopic surgery in patients with hysteromyoma,ef-fectively regulates the level of gastrointestinal motility related hormones,and promotes the recovery of gastrointestinal function.

Duodenum-preserving pancreatic head resection， also known as Beger surgery， has a high incidence rate of bile duct injury after surgery， while the treatment modality for bile duct injury depends on the severity of the injury， and endoscopic therapy is often challenging in case of severe bile duct injury. Recently a patient with biliary fistula after Beger surgery was admitted to Affiliated Hangzhou First People’s Hospital， Westlake University， and successful diagnosis and treatment were achieved through oral choledochoscopy-assisted percutaneous-endoscopic rendezvous technique.

N-acetyl-p-aminophenol （APAP） is an antipyretic analgesic commonly used in clinical practice， and APAP overdose can cause severe liver injury and even death. In recent years， the incidence rate of APAP-induced liver injury （AILI） tends to increase， and it has become the second most common cause of liver transplantation worldwide. Autophagy is a highly conserved catabolic process that removes unwanted cytosolic proteins and organelles through lysosomal degradation to achieve the metabolic needs of cells themselves and the renewal of organelles. A large number of studies have shown that autophagy plays a key role in the pathophysiology of AILI， involving the mechanisms such as APAP protein conjugates， oxidative stress， JNK activation， mitochondrial dysfunction， inflammatory response and apoptosis. This article elaborates on the biological mechanism of autophagy in AILI， in order to provide a theoretical basis for the treatment of AILI and the development of autophagy regulators.

Micro/nanoplastics (MNPs), recognized as emerging environmental pollutants, are widely distributed in natural environments. Due to their small particle size and significant migratory capacity, MNPs can infiltrate diverse environmental matrices, then invade and accumulate in the organism via the skin, respiration, and digestion. Recently, concerns have grown over the detrimental effects and potential toxicity of MNPs on reproductive health. This review summarized published epidemiological and toxicological studies related to MNPs exposure and their effects on reproductive health. Firstly, this review critically examined the current landscape of epidemiological evidence and found that MNPs (e.g., polystyrene, polypropylene, polyvinyl chloride, polyethylene, etc.) are present in various biological specimens from both males and females, and their presence may be associated with an increased risk of reproductive disorders. Secondly, extensive toxicological studies revealed that MNPs exposure induces reproductive health damage through mechanisms such as disrupting the microstructure of reproductive organs and altering molecular-level expressions. Oxidative stress, inflammatory responses, and apoptosis are identified as potential links between MNPs exposure and reproductive damage. Finally, this review addressed the prevalent shortcomings in existing studies and proposed future directions to tackle the challenges posed by MNPs-induced reproductive harm. These insights aim to inform strategies for safeguarding public reproductive health and ecological security, providing a scientific foundation for mitigating risks associated with MNPs pollution.

Objective To investigate the factors that influence ocular surface biology and visual acuity in individuals with diabetic dry eye(DDE)and analyze how these factors contribute to changes in visual quality.Methods Based on the disease duration,fasting blood glucose(FBG),and glycated hemoglobin(HbA1c)levels of patients with type 2 diabe-tes mellitus(T2DM),the DDE patients were divided into different groups.Logistic regression analysis was used to identify influencing factors related to ocular surface biology and visual quality in each group of DDE patients.Tear film stability was evaluated based on the tear film rupture time(BUT),Schirmer I test(SIt),and ocular surface disease index(OSDI).Lip-iview? Surface interferometers were used to measure tear film lipid layer thickness(LLT),meibomian gland loss rate(MGP),meibomian gland opening number(MGYLS),and meibomian gland secretion score(MGYSS).Wavefront aber-rometry was used to measure corneal wavefront aberration values at 4 mm and 6 mm pupil diameters.Ocular response ana-lyzer(ORA)was adopted to analyze corneal hysteresis(CH)and corneal resistance factor(CRF).Moreover,ELISA ex-periment to evaluate the trend of changes in inflammatory factors in tears.Results Logistic regression analysis revealed that T2DM duration,smoking history,FBG,HbA1c,total cholesterol(TC),triglycerides(TG),OSDI score,LLT,BUT,SIt,MGP,MGYLS,MGYSS,total higher-order aberrations,spherical aberration,coma aberration,trefoil aberration,tumor necrosis factor-α,interleukin-6,matrix metalloproteinase-9,receptor for advanced glycation end products,and insu-lin were all influencing factors for the risk of DDE(all P＜0.05).As the T2DM course prolonged and FBG or HbA1 c levels rose,tear film-related indicators(LLT,BUT,and SIt)and meibomian gland-related indicators(MGYLS and MGYSS)inpa-tients gradually decreased,while OSDI scores and MGP gradually increased(all P＜0.05).As the T2DM course prolonged and FBG or HbA1c levels rose,the total higher-order aberrations,spherical aberration,coma aberration,and trefoil aber-ration in DDE patients under 4 mm and 6 mm pupil diameters gradually increased;Meanwhile,best corrected visual acuity,corneal hysteresis,and corneal resistance factor gradually decreased;The contents of tumor necrosis factor-α,interleukin-6,matrix metalloproteinase-9,receptor for advanced glycation end products,and insulin in tears all gradually increased,while mucin-5AC gradually decreased(all P＜0.05).Conclusion With the prolongation of T2DM duration and the in-crease of FBG or HbA1c,the ocular surface inflammatory response in DDE patients gradually worsens,corneal biological function decreases,and visual quality deteriorates.Timely systemic and local interventions are of great significance for im-proving dry eye symptoms and visual quality in DDE patients.

Objective To explore the similarity between young fruits of Citrus aurantium'Changshan-huyou'and Pharmacopoeia origin Aurantii Fructus Immaturus.Methods The fingerprints of young fruits of Citrus aurantium'Changshan-huyou'and the Pharmacopoeia origin Aurantii Fructus Immaturus were established by high performance liquid chromatography(HPLC).The similarity analysis was carried out by using the software of Traditional Chinese medicine chromatographic fingerprint similarity evaluation system.The whole components of young fruit of Citrus aurantium'Changshan-huyou'and the Pharmacopoeia origin Aurantii Fructus Immaturus were compared by using chemometrics,and the 14 compounds were analyzed quantitatively.Results ①The results of similarity and cluster analysis were affected by the origin and producing area,for example,the similarity between citrus sinensis(L.)Osbeck and other origin was only 0.2,the similarity of citrus aurantium L.from different producing areas ranged from 0.802 to 0.986,with relative large dispersion;②young fruit of Citrus aurantium'Changshan-huyou',some citrus aurantium L.,citrus aurantium L.cv.Daidai,stink orange and citrus aurantium L.cv.Zhulan all belong to the same category,and the similarity was above 0.9;③VIP method screened out 21 common peaks that had important effects on quality,mainly including neohesperidin,naringin,umbellitin,tangeretin,hesperidin hydrate and hesperidin.The quantitative analysis results showed that Naringin and neohesperidin were abundant in young fruits of Citrus aurantium'Changshan-huyou'and Aurantii Fructus Immaturus,followed by hesperidin and naringin,there were significant differences in the content of principal components among Aurantii Fructus Immaturus from different origins,especially in citrus sinensis(L.)Osbeck,the young fruits of Citrus aurantium'Changshan-huyou'was relatively stable.Conclusion The young fruits of Citrus aurantium'Changshan-huyou'had good similarity with most origin of Aurantii Fructus Immaturus,so it is feasible to be used as Aurantii Fructus Immaturus.

Objective·To investigate the role and mechanism of sirtuin 5(SIRT5)in pulmonary microvascular endothelial cell injury in sepsis.Methods·Wild-type(WT)and Sirt5 gene knockout C57BL/6 male mice underwent cecal ligation and puncture(CLP)surgery.Following euthanasia,lung tissues were collected.Pulmonary inflammation was assessed using hematoxylin and eosin(H-E)staining;vascular leakage was evaluated by Evans blue(EB)staining;coagulation function in mice was analyzed via immunofluorescence staining of lung tissues.Immunohistochemical staining was employed to detect vascular cell adhesion molecule-1(VCAM-1)protein expression,thereby assessing endothelial inflammation in CLP-treated mice.By using gene editing technology,SIRT5 was knocked down or overexpressed in human umbilical vein endothelial cells(HUVECs),and the cells were subsequently stimulated with lipopolysaccharide(LPS)to induce endothelial inflammation.Protein expression levels of VCAM-1,tissue factor(TF),and other endothelial injury markers were detected by Western blotting,and inflammatory cytokines such as interleukin-6(IL-6)and IL-1β,were detected by quantitative real-time PCR(qPCR).In addition,transcriptomic sequencing was performed on HUVECs overexpressing SIRT5,and key genes including F2R-like thrombin or trypsin receptor 3(F2RL3),serpin family A member 3(SERPINA3),and transforming growth factor β2/β3(TGF-β2/3)were validated by qPCR.Results·Sirt5 knockout significantly aggravated lung injury in CLP mice,reducing their survival rates(P<0.001).H-E staining showed increased inflammatory infiltration in the lung tissue of the mice,while EB staining indicated increased vascular leakage(P<0.001).Immunofluorescence revealed elevated fibrinogen deposition.In HUVECs with SIRT5 knockdown,the protein levels of VCAM-1 and TF,as well as the mRNA levels of inflammatory factors including IL-6,IL-1β,VCAM-1,and E-selectin,were significantly upregulated(all P<0.001),whereas overexpression of SIRT5 reversed these effects.Transcriptome sequencing analysis indicated that SIRT5 regulated endothelial inflammation and coagulation responses by inhibiting the F2RL3/SERPINA3/TGF-β pathway.Conclusion·SIRT5 negatively regulates the F2RL3/SERPINA3/TGF-β signaling axis,thereby alleviating endothelial inflammation and promoting coagulation responses,suggesting its potential protective role in sepsis-induced lung injury.