Traditional Chinese medicine （TCM） constitution theory， with its focus on individualized diagnosis and treatment， provides the theoretical foundation and practical pathways for the prevention and control of comorbidities in the elderly， mental health interventions， and rehabilitation for functional impairment， based on the principle of "treating different diseases with the same approach and preventing multiple diseases simultaneously". Addressing the current issues of insufficient accuracy in identifying elderly constitutions and a lack of targeted prevention and treatment strategies， this paper proposes the construction of a precision identification system characterized by data-driven， dynamic tracking， and human-machine collaboration. It also establishes a dynamic regulatory framework based on classification-based foundation， grad-based quantification， and tiered collaboration. These approaches aim to expand the application of TCM constitution theory in promoting elderly health promotion.

ObjectiveTo explore the mechanism by which Xiaoyaosan regulates HPT axis dysfunction in the rat model with the syndrome of liver depression and spleen deficiency by observing its effect on the glycoprotein hormone α-subunit （CGA）/glutathione peroxidase 2 （GPX2）/thyroid-stimulating hormone β-subunit （TSHβ） pathway for thyroid hormone synthesis. MethodsSeventy-two male SD rats were randomized into six groups： normal， model， high-dose （16.7 g·kg^-1）， medium-dose （8.35 g·kg^-1）， and low-dose （4.175 g·kg^-1） Xiaoyaosan， and fluoxetine （0.001 8 g·kg^-1） groups， with 12 rats in each group. The rat model of liver depression and spleen deficiency was induced by chronic restraint stress for 21 days. The intervention groups were treated with Xiaoyaosan decoctions or fluoxetine suspension， respectively. After modeling， hematoxylin-eosin staining was employed to observe morphological changes in the thyroid and pituitary tissue of the rats. Serum levels of triiodothyronine （T3）， tetraiodothyronine （T4）， and thyroid-stimulating hormone （TSH） were measured by enzyme-linked immunosorbent assay （ELISA）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot were employed to determine the mRNA and protein levels， respectively， of TSH receptor （TSHR） in the thyroid tissue， thyrotropin-releasing hormone receptor （TRHR） and TSHβ in the pituitary tissue， and thyrotropin-releasing hormone （TRH）， CGA， GPX2， and TSHβ in the hypothalamic tissue. ResultsCompared with the normal group， the model group showed significant atrophy and irregularity of thyroid follicles， a marked reduction in colloid secretion， extensive vacuolar degeneration of adenocytes in the anterior pituitary， lowered serum levels of T3， T4， and TSH （P<0.01）， and down-regulated mRNA and protein levels of TSHR in the thyroid tissue， TRHR and TSHβ in the pituitary tissue， and TRH， CGA， GPX2， and TSHβ in the hypothalamic tissue （P<0.01）. Compared with the model group， high- and medium-dose Xiaoyaosan and fluoxetine alleviated the pathological changes in the thyroid and pituitary tissue， outperforming the low-dose Xiaoyaosan group. Moreover， they elevated the serum levels of T3， T4， and TSH （P<0.05， P<0.01）. The serum TSH level was also elevated in the low-dose Xiaoyaosan group （P<0.05）. The mRNA and protein levels of TSHR in the thyroid， TRHR and TSHβ in the pituitary， and TRH， CGA， GPX2， and TSHβ in the hypothalamus were up-regulated in the high- and medium-dose Xiaoyaosan groups （P<0.05， P<0.01）. Additionally， the mRNA and protein levels of TSHβ in the hypothalamus were up-regulated in the low-dose Xiaoyaosan group （P<0.01）. In the fluoxetine group， the mRNA and protein levels of TSHR in the thyroid， TRHR in the pituitary， and TRH， CGA， and GPX2 in the hypothalamus were up-regulated （P<0.05， P<0.01）. ConclusionThe downregulation of CGA/GPX2/TSHβ pathway may be one of the biological mechanisms underlying HPT axis dysfunction in the rat model with the syndrome of liver depression and spleen deficiency. Xiaoyaosan may regulate the HPT axis dysfunction by up-regulating the CGA/GPX2/TSHβ pathway.

Objective To investigate alterations in serum NOV/CCN3 levels among women during mid-to-late pregnancy and elucidate its association with gestational diabetes mellitus(GDM)and pregnancy outcomes.Methods Based on the results of an oral glucose tolerance test(OGTT),we categorized 252 pregnant women into two groups:the GDM group and the control group.Within the GDM group,participants were further stratified based on pre-pregnancy body mass index levels and pregnancy outcomes.We collected clinical data for all study subjects and compared differences in general information,biochemical indicators,as well as NOV/CCN3 levels between these groups.Results The serum levels of NOV/CCN3 in the GDM group were significantly higher compared to those in the control group(P<0.001).Spearman correlation analysis revealed a positive association between serum NOV/CCN3 and pre-pregnancy body weight,pre-pregnancy body mass index,insulin resistance index,and total cholesterol;while a negative correlation was observed with insulin sensitivity index(P<0.05).Logistic regression analysis demonstrated that NOV/CCN3 is an independent risk factor for the development of GDM[OR=1.097,95%CI(1.020～1.179),P=0.013],as well as adverse pregnancy outcomes in GDM patients[OR=1.032,95%CI(1.020～1.045),P<0.001].ROC analysis indicated AUCs of 0.840 and 0.784 for these associations respectively(P<0.05).Conclusions Serum levels of NOV/CCN3 in pregnant women at mid-to late-stage are associated with obesity,insulin resistance,and glucose-lipid metabolism,suggesting a potential role of NOV/CCN3 in glycolipid metabolism during gestational diabetes mellitus(GDM).These findings provide novel insights for assessing the occurrence of GDM and predicting pregnancy outcomes in mid-to late-stage pregnancies.

Objective:To investigate the efficacy and safety of R0 surgery combined with PARP inhibitors in the treatment of advanced epithelial ovarian cancer in 52 patients.Methods:A retrospective analysis was performed on 104 patients with International Federation of Gynecology and Obstetrics Ⅲ-Ⅳ epithelial ovarian cancer who received treatment at the Department of Gynecology and Obstetrics, Xinhua Hospital, Huainan Xinhua Medical Group from January 2021 to December 2023. The patients were divided into a control group and an observation group ( n = 52/group). Patients in the control group underwent non-R0 surgery followed by six cycles of chemotherapy with platinum and paclitaxel, along with maintenance therapy using olaparib or niraparib. Patients in the observation group underwent R0 surgery followed by the same chemotherapy and maintenance therapy as those in the control group. Comparisons were made between the two groups regarding general data, perioperative conditions, and postoperative levels of cancer antigen 125, human epididymis protein 4, vascular endothelial growth factor, interleukin-15, gamma interferon, and recurrence rates measured within 1 year after chemotherapy. Results:There was no statistically significant difference in age, underlying diseases, or pathological types according to International Federation of Gynecology and Obstetrics staging between the two groups (all P > 0.05). However, compared with the control group, the observation group had a longer surgical time [(290.17 ± 36.72) minutes vs. (206.58 ± 22.57) minutes, t = 171.20, P < 0.001]. The intraoperative blood loss in the observation group was significantly greater than that in the control group [(800.44 ± 134.22) mL vs. (743.16 ± 87.85) mL, t = 1 094.00, P = 0.003]. The interval between surgery and the start of chemotherapy in the observation group was longer than that in the control group [(13.00 ± 0.94) days vs.(12.04 ± 0.92) days, t = 3.07, P < 0.001]. There was no statistically significant difference in postoperative complications ( P > 0.05). Compared with the control group, the observation group had lower levels of cancer antigen 125 [(14.27 ± 2.16) IU/mL vs. (188.57 ± 30.74) IU/mL, t = 40.794, P < 0.001], human epididymis protein 4 [(25.29 ± 2.49) pmol/L vs. (74.21 ± 0.52) pmol/L, t = 138.68, P < 0.001], vascular endothelial growth factor [(23.70 ± 3.01) ng/mL vs. (51.66 ± 4.67) ng/mL, t = 36.28, P < 0.001], and recurrence rate [17.30% (9/52) vs. 88.46% (46/52), χ2 = 52.83, P < 0.001]. Compared with the control group, the observation group showed higher levels of interleukin-15 [(57.36 ± 9.48) pg/mL vs. (24.24 ± 4.04) pg/mL, t = -23.17, P < 0.001] and gamma interferon [(50.16 ± 4.43) pg/mK vs. (12.99 ± 1.30) pg/mL, t = -763.17, P < 0.001]. Conclusions:R0 surgery is effective and safe. R0 surgery followed by maintenance therapy with PARP inhibitors can significantly improve chemotherapy outcomes and delay tumor recurrence in patients with advanced epithelial ovarian cancer non-R0 surgery combined with chemotherapy plus maintenance therapy with PARP inhibitors.

Objective:To investigate the efficacy and safety of R0 surgery combined with PARP inhibitors in the treatment of advanced epithelial ovarian cancer in 52 patients.Methods:A retrospective analysis was performed on 104 patients with International Federation of Gynecology and Obstetrics Ⅲ-Ⅳ epithelial ovarian cancer who received treatment at the Department of Gynecology and Obstetrics, Xinhua Hospital, Huainan Xinhua Medical Group from January 2021 to December 2023. The patients were divided into a control group and an observation group ( n = 52/group). Patients in the control group underwent non-R0 surgery followed by six cycles of chemotherapy with platinum and paclitaxel, along with maintenance therapy using olaparib or niraparib. Patients in the observation group underwent R0 surgery followed by the same chemotherapy and maintenance therapy as those in the control group. Comparisons were made between the two groups regarding general data, perioperative conditions, and postoperative levels of cancer antigen 125, human epididymis protein 4, vascular endothelial growth factor, interleukin-15, gamma interferon, and recurrence rates measured within 1 year after chemotherapy. Results:There was no statistically significant difference in age, underlying diseases, or pathological types according to International Federation of Gynecology and Obstetrics staging between the two groups (all P > 0.05). However, compared with the control group, the observation group had a longer surgical time [(290.17 ± 36.72) minutes vs. (206.58 ± 22.57) minutes, t = 171.20, P < 0.001]. The intraoperative blood loss in the observation group was significantly greater than that in the control group [(800.44 ± 134.22) mL vs. (743.16 ± 87.85) mL, t = 1 094.00, P = 0.003]. The interval between surgery and the start of chemotherapy in the observation group was longer than that in the control group [(13.00 ± 0.94) days vs.(12.04 ± 0.92) days, t = 3.07, P < 0.001]. There was no statistically significant difference in postoperative complications ( P > 0.05). Compared with the control group, the observation group had lower levels of cancer antigen 125 [(14.27 ± 2.16) IU/mL vs. (188.57 ± 30.74) IU/mL, t = 40.794, P < 0.001], human epididymis protein 4 [(25.29 ± 2.49) pmol/L vs. (74.21 ± 0.52) pmol/L, t = 138.68, P < 0.001], vascular endothelial growth factor [(23.70 ± 3.01) ng/mL vs. (51.66 ± 4.67) ng/mL, t = 36.28, P < 0.001], and recurrence rate [17.30% (9/52) vs. 88.46% (46/52), χ2 = 52.83, P < 0.001]. Compared with the control group, the observation group showed higher levels of interleukin-15 [(57.36 ± 9.48) pg/mL vs. (24.24 ± 4.04) pg/mL, t = -23.17, P < 0.001] and gamma interferon [(50.16 ± 4.43) pg/mK vs. (12.99 ± 1.30) pg/mL, t = -763.17, P < 0.001]. Conclusions:R0 surgery is effective and safe. R0 surgery followed by maintenance therapy with PARP inhibitors can significantly improve chemotherapy outcomes and delay tumor recurrence in patients with advanced epithelial ovarian cancer non-R0 surgery combined with chemotherapy plus maintenance therapy with PARP inhibitors.

Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

Objective To explore the impact of the TINCR-MAF:MAFB transcription factor network on the expression of proliferation and differentiation-related genes in keratinocytes,to verify the role of this network in the occurrence and development of psoriasis and its potential mechanisms.Methods Employed RNA interference technology to knock down TINCR gene expression,and the proliferation ability of keratinocytes was assessed using the CCK-8 method.Additionally,qRT-PCR and Western blot analyses were conducted to evaluate the RNA and protein expression levels of TINCR,MAFB,and KLF4 genes.Immunohistochemical methods were used to detect the expression of KLF4 protein in psoriasis tissues.Results After TINCR gene siRNA interference,the proliferation ability of keratinocytes significantly decreased at 24,48,and 72 hours(P<0.001),indicating that the TINCR gene plays a critical role in cell proliferation.The results of qRT-PCR and Western blot analyses showed that the RNA and protein expression levels of TINCR,MAFB,and KLF4 genes were significantly reduced(P<0.001),suggesting that TINCR may influence the differentiation of keratinocytes by regulating the expression of MAFB transcription factor and KLF4 differentiation-related genes.Furthermore,immunohistochemical results indicated that the expression of KLF4 protein was significantly elevated in psoriasis tissues compared to normal skin tissues,suggesting that KLF4 plays an important role in the pathogenesis of psoriasis.Conclusions The TINCR-MAF:MAFB transcription factor network may participate in the occurrence and development of psoriasis by affecting the proliferation and differentiation of keratinocytes.This finding provides a new perspective on the pathogenesis of psoriasis and potential targets for future therapeutic strategies.

AIM:To investigate the mechanism by which exosomes(EXOs)derived from neural stem cells(NSCs)pretreated with astragaloside IV(ASIV)alleviate brain damage in rats after ischemic stroke.METHODS:Rat NSCs were isolated from fetal rats within 24 h of birth,cultured for 3 d,and subsequently treated with ASIV for additional 5 d.The EXOs from untreated NSCs and ASIV-pretreated NSCs(ASIV-EXOs)were isolated via ultracentrifugation of the cell supernatant.These EXOs were characterized using Western blot to detect specific markers such as CD63,tumor sus-ceptibility gene 101(TSG101)and calnexin.Nanoparticle analysis was employed to determine the size,and the morpholo-gy of the EXOs was observed under electron microscope.Six to eight-week-old SD male rats were randomly assigned to 6 groups:sham group,middle cerebral artery occlusion/reperfusion(MCAO/R)model group,edaravone(EDA)treatment(MCAO/R+EDA)group,EXOs treatement(MCAO/R+EXOs)group and ASIV-EXOs treatment(MCAO/R+ASIV-EXOs)group.Tail vein injections were administered within 2 h following the successful establishment of the MCAO/R model.The Zea Longa method was utilized to evaluate neurological deficits,while the TTC method was employed to assess brain infarc-tion.Pathological changes were examined through HE staining,and TUNEL and caspase-1 immunofluorescence double staining were conducted to detect cellular pyroptosis.Serum levels of interleukin-1β(IL-1β)and IL-18 were measured us-ing ELISA,and Western blot was performed to evaluate the expression of caspase-1,nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3),apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),gasdermin D(GSDMD),and IL-18 proteins in the ischemic area of the rat cerebral cortex across all groups.RE-SULTS:The MCAO/R group exhibited significantly higher neurological deficit scores compared to the sham group(P＜0.01)and lower scores in the administered groups relative to the MCAO/R group(P＜0.05).Cerebral infarction was mark-edly increased in the MCAO/R group compared to the sham group(P＜0.01),whereas the infarction area was reduced in the administered groups compared to the MCAO/R group(P＜0.05).Serum levels of IL-1β and IL-18 were significantly el-evated in the MCAO/R group versus the sham group(P＜0.01)and were lower in the administered groups compared to the MCAO/R group(P＜0.01).Moreover,IL-1β and IL-18 levels in the MCAO/R+ASIV-EXOs group were lower than those in the MCAO/R+EXOs group(P＜0.05).HE staining revealed pronounced sieve-like infarction foci in the ischemic area of the rat cerebral cortex in MCAO/R group,characterized by disorganized neuronal arrangements,reduced or absent Nys-trom's vesicles,shrunken or fragmented nuclei,and numerous red neurons.In contrast,drug-treated groups exhibited milder pathological changes with clearer neuronal structures and a significant reduction in red neuron counts.Immunofluo-rescence double staining indicated a significant increase in double-positive cells in the MCAO/R group compared to the sham group(P＜0.01),with a decrease in double-positive cells in the administered groups relative to the MCAO/R group(P＜0.05)and a further reduction in the MCAO/R+ASIV-EXOs group compared to the MCAO/R+EXOs group(P＜0.05).The expression levels of caspase-1,NLRP3,ASC,IL-18 and GSDMD proteins in the ischemic region of the rat cerebral cortex were significantly reduced in the administered groups compared to the MCAO/R group(P＜0.01),with further re-duction observed in the MCAO/R+ASIV-EXOs group compared to the MCAO/R+EXOs group(P＜0.05).CONCLU-SION:Exosomes derived from ASIV-pretreated NSCs attenuate brain damage in ischemic stroke rats,potentially through a mechanism involving the inhibition of pyroptosis mediated by the NLRP3/caspase-1 pathway.

Wenpi decoction is a classic prescription published in the Catalogue of Ancient Classic Prescriptions(First Batch).By sorting out and analyzing the ancient and modern literature on Wenpi decoction,the key information of Wenpi decoction in terms of its origin,drug composition,function,dosage,processing,preparation method,decoction method,prescription meaning,main indica-tions,and clinical application was systematically verified.A total of 165 relevant ancient literature data,114 modern clinical litera-ture,and 66 ancient Chinese medical books were obtained.The inductive analysis found that Wenpi decoction was first seen in the Ex-cerpts of prescriptions of the Eastern Jin Dynasty,and Sun Simiao of the Tang Dynasty included it in the Important Formulas Worth a Thousand Gold Pieces for Emergency.The current version is based on the Wenpi decoction in Volume 15 of Important Formulas Worth a Thousand Gold Pieces for Emergency,Spleen Heat Dysentery.The formula is composed of rhubarb,ginseng,licorice,dried ginger,and aconite.The medicinal origin follows the 2020 edition of the Chinese Pharmacopoeia,with raw products of rhubarb,ginseng,and dried ginger,stir fried licorice,and dried aconite slices being used;in terms of drug dosage,rhubarb is 18.40 g,ginseng is 9.20 g,licorice is 9.20 g,dried ginger is 9.20 g,and aconite is 5.00 g;the preparation method is to add 1400 mL of water,decoct 600 mL,and take it warm in 3 times.This prescription was often used in ancient times to treat dysentery,cholera and other diseases.After be-ing developed by doctors in later generations,it is now also used to treat gastrointestinal diseases,renal failure,hypertension,insomnia and other diseases.The above research results can provide a reference for the development and subsequent research of Wenpi decoc-tion.

Objective: To analyze the serotypes and drug resistance of Salmonella isolated from food-borne disease surveillance samples in Longwan District, Wenzhou City, Zhejiang Province, so as to provide evidence for the prevention and treatment of Salmonella infection. Methods: Salmonella strains isolated from feces or anal swabs of patients with foodborne diarrhea in Longwan District People's Hospital from 2018 to 2024 were collected. After re-identification, slide agglutination test was used to identify serotypes. The drug susceptibility test of live Salmonella strains was performed using the broth microdilution method, and the resistance patterns were analyzed. Results: A total of 2 293 samples were collected, and 186 strains of Salmonella were isolated, with a detection rate of 8.11%. The detection rate was higher from May to October. A total of 28 Salmonella serotypes were identified, with S. typhimurium (72 isolates, 38.71%), S. enteritidis (31 isolates, 16.67%), and S. London (30 isolates, 16.13%) being dominant. Among the 121 Salmonella live strains, 20 strains were susceptible to 14 antibacterial drugs. A total of 101 strains were resistant to antibacterial drugs, and the drug resistance rate was 1.65%-67.77%, with the drug resistance rate of ampicillin being the highest, and the drug resistance rate of imipenem was the lowest. S. typhimurium had the highest resistance rate to tetracycline (78.26%). S. enteritidis had the highest resistance rate to ampicillin (100.00%). S. London had the highest resistance rate to tetracycline (66.67%). Fifty-five types of drug resistance patterns were detected, showing a number of drug resistance of 1-10, of which 76 strains were multi-drug resistant, accounting for 75.25%. The predominant multidrug resistance patterns were ampicillin/sulbactam-cefazolin-ampicillin-nalidixic acid (10.53%), tetracycline-ampicillin-nalidixic acid (9.21%), and ampicillin/sulbactam-ampicillin-nalidixic acid (7.89%). Conclusions Salmonella strains isolated from foodborne diseases in Longwan District were mainly detected in summer and autumn. S. typhimurium, S. enteritidis, and S. London were the predominant serotypes. The drug resistance of Salmonella to different antibacterial drugs was different, and the drug resistance spectrum showed diversity.