It is proposed that the pathogenesis of rheumatoid arthritis （RA） is centered on deficiency， dampness， and blood stasis， which interact with and evolve into one another during the onset and progression of the disease. The development of RA is closely associated with insufficiency of healthy qi and the interbinding of dampness and blood stasis. Accordingly， treatment emphasizes an integrated approach that combines tonifying deficiency， eliminating dampness， and resolving blood stasis， and is implemented in three main stages. In the initial stage， therapy focuses on supporting healthy qi， dispelling dampness， and relieving impediment， with modified Huangqi Guizhi Wuwu Decoction （黄芪桂枝五物汤） combined with Yiyiren Decoction （薏苡仁汤）. In the active stage， treatment aims to eliminate dampness， resolve blood stasis， and unblock the collaterals， using modified Wutou Decoction （乌头汤） or Guizhi Shaoyao Zhimu Decoction （桂枝芍药知母汤）. In the remission stage， therapy emphasizes strengthening the spleen and reple-nishing qi to prevent recurrence， with modified Shenling Baizhu Powder （参苓白术散） combined with Guipi Decoction （归脾汤）.

ObjectiveTo investigate the effect of Toxoplasma gondii infection on copper metabolism in the kidneys of mice. MethodsA total of 80 7-8-week-old C57BL/6 female mice were randomly divided into four groups of 20 mice in each group after one week of adaptation， including Control group， Cu group， TgCtwh6 group and Cu+TgCtwh6 group. Mice that were not infected and fed with normal diet and water were used as the Control group； Mice fed with 1 g/kg of copper chloride processing diet and 0.1% copper chloride water for 60 consecutive days were used as Cu group； Mice infected with 25-30 TgCtwh6 cysts （one of the predominant genotype Chinese 1 in China） fed with normal diet and water were used as the TgCtwh6 group； mice infected with 25-30 TgCtwh6 cysts and fed with a processed diet containing 1 g/kg of copper chloride and water with 0.1% copper chloride for 60 consecutive days were used as the Cu+TgCtwh6 group. ICP-MS was used to determine the changes in copper content in kidney tissues. Hematoxylin-eosin （HE） staining was used to observe the pathological changes of mouse kidney tissue. The number of apoptotic cells was observed by PI staining. Western blot was used to detect the protein expression levels of glutathione peroxidase 4 （GPX4） and superoxide dismutase （SOD1， SOD2）. RT-qPCR was used to detect the mRNA expression of cuproptosis-related genes. ResultsPathological manifestations such as inflammatory cell infiltration in the Cu group and TgCtwh6 group were seen under the microscope， and the inflammatory infiltrating cells of the renal interstitial were reduced in the Cu+TgCtwh6 group， and the pathological manifestations

This article presents the anti-infective treatment and pharmaceutical care of an elderly patient with liver cirrhosis complicated with severe psittacosis.Based on the pathophysiological characteristics of infection in patients with severe liver diseases and in combination with relevant guidelines,the combined regimen of omadacycline+moxifloxacin was adopted to treat psittacosis.In case of recurrent episodes,Aspergillus fumigata was detected in the metagenomic next-generation sequencing of bronchoalveolar lavage fluid.Initially,voriconazole was administered for treatment,and later switched to posaconazole.Additionally,clinical pharmacists provided pharmaceutical care encompassing adverse reaction monitoring and voriconazole therapeutic drug monitoring.The patient's infection was effectively controlled,body temperature returned to normal,white blood cell counts and platelet counts basically returned to normal range,serum high-sensitive C-reactive protein,procalcitonin,and other inflammatory indicators significantly decreased,and the patient was discharged.Clinical pharmacists assisted clinicians in formulating a reasonable anti-psittacosis treatment plan and provided individualized pharmaceutical care to ensure the effectiveness and safety of clinical drug treatment.

Objective:To analyze the fitness of zirconia and lithium disilicate glass-ceramic onlays fab-ricated with direct and indirect computer-aided design and computer-aided manufacturing(CAD/CAM)technology in vitro.Methods:In the study,48 standardised typodont left mandibular first molars re-ceived standardised onlay preparation.Then,all the specimens were randomly divided into 4 groups.There were 12 specimens in each group.The preparation quality was checked under the stereo-microscope.All the specimens were fixed in typodonts.Subsequently,the typodonts were fixed in the dental simulators to simulate the oral conditions.In groups A and B,the digital impressions were ob-tained by using the intraoral scanner.In groups C and D,conventional impressions of polyether impres-sion material were obtained according to the instructions of the manufacturer using individual trays.The stone casts were made with type Ⅳ gypsum later.Then,all casts were digitized with the model scanner.Based on the data obtained from the scan,onlay restorations of all the groups were designed using the cor-responding software,the simulated cement thickness was set to 50 μm.Then,the final onlays restora-tions of all the groups were machined with the milling machines in lab.The fabrication materials were dif-ferent in groups.The specimens of groups A and C were fabricated with zirconia.While,the specimens of groups B and D were fabricated with lithium disilicate glass-ceramic.The marginal gap and internal gap of all restorations were analyzed by 3D replica technique,for each measurement,the specimen was digitised using the model scanner.Results:The marginal gap of the onlays fabricated with indirect digital impressions were smaller than that with direct digital impressions(P＜0.05).At the same time,the in-ternal gap of the onlays fabricated with indirect digital impressions were smaller than that with direct digi-tal impressions(P＜0.05).The marginal gap was larger in distal gingival than that in the other regions in all the groups(P＜0.05).Different fabrication materials,zirconia or lithium disilicate reinforced glass-ceramic,had no effect on onlay marginal and internal fit(P＞0.05).Conclusion:The marginal and in-ternal adaptation of the onlays fabricated with indirect digital impressions was better than with direct digital impressions.Zirconia and lithium disilicate reinforced glass-ceramic had no effect on the onlay adaptation.

Objective:To investigate the mediating effect of family resilience on the relationship between psychological resilience and demoralization in leukemia patients undergoing chemotherapy.Methods:A total of 240 leukemia patients hospitalized for chemotherapy in the Department of Hematology, the First Affiliated Hospital of Zhengzhou University, from January to December 2024 were selected by convenience sampling. The Basic Information Questionnaire, Family Hardiness Index (FHI), Connor-Davidson Resilience Scale (CD-RISC), and the Chinese version of the Demoralization Scale Ⅱ (DS-Ⅱ) were administered. Pearson correlation analysis was used to examine the associations among family resilience, psychological resilience, and demoralization. A structural equation model was constructed with AMOS 21.0 to verify the mediating effect. A total of 240 questionnaires were distributed, of which 232 were valid, yielding a valid response rate of 96.67% (232/240) .Results:The mean scores of the 232 patients were as follows: FHI (51.41±8.27), CD-RISC (51.84±7.96), and DS-Ⅱ (21.03±4.19). FHI was positively correlated with CD-RISC ( P<0.05), while DS-Ⅱ was negatively correlated with both FHI and CD-RISC ( P<0.05). Psychological resilience had a direct negative effect on demoralization ( P<0.01), and family resilience also had a direct negative effect on demoralization ( P<0.01). Family resilience partially mediated the relationship between psychological resilience and demoralization ( P<0.01), accounting for 59.96% (-0.289/-0.482) of the total effect. Conclusions:Psychological resilience and family resilience in leukemia patients undergoing chemotherapy were both at moderate levels, while demoralization was relatively high. Family resilience partially mediated the relationship between psychological resilience and demoralization.

Chikungunya fever is spreading continuously worldwide，posing a growing public health challenge alongside other arboviral diseases. This article systematically reviews the epidemiological characteristics of chikungunya fever，analyzes the pandemic potential of Aedes mosquito-borne diseases and discusses integrated prevention and control strategies for China in the context of increasing importation risk，drawing on containment practices from multiple countries and regions.

Objective:To investigate the predictive value of anti-Müllerian hormone (AMH) on the outcome of microscopic testicular sperm extraction (micro-TESE) in patients with non-mosaic Klinefelter syndrome (KS) of the clinical data and to identify effective predictors for successful micro-TESE.Methods:A retrospective case-control study was conducted on the clinical data of 118 non-mosaic KS patients treated at the Center for Reproductive Medicine of the First Affiliated Hospital of Zhengzhou University between May 2018 and September 2023. Patients were divided into two groups based on whether sperm were successfully retrieved via micro-TESE: the sperm retrieved group ( n=45) and the no sperm retrieved group ( n=73). Differences between the two groups were compared, and multivariate logistic regression analysis was used to identify factors influencing sperm retrieval. Changes in testicular volume and sex hormone levels before and after surgery were also assessed. Results:The sperm retrieval rate was 38.1% (45/118). Patients in the sperm retrieved group were significantly younger [(26.93±3.80) years] than those in the no sperm retrieved group [(28.27±3.92) years, P=0.029], and the AMH level was significantly higher [0.44 (0.18, 1.13) μg/L] than that in the no sperm retrieved group [0.10 (0.03, 0.22) μg/L, P<0.001]. AMH was identified as an independent predictor of micro-TESE outcome in non-mosaic KS patients ( OR=7.867, 95% CI: 2.727-27.242, P=0.001). The area under the receiver operating characteristic curve was 0.802 (95% CI: 0.722-0.883), and the optimal reference threshold for AMH was ≥0.265 μg/L. Postoperatively, testosterone levels decreased significantly by a median of 0.27 μg/L ( P=0.019), while luteinizing hormone levels increased by a median of 2.08 U/L ( P=0.049), with a more significant decline in testosterone levels observed in the no sperm retrieved group by a median of 0.29 μg/L ( P=0.022). Conclusion:AMH can predict successful micro-TESE in non-mosaic KS patients, with higher AMH levels indicating a higher likelihood of success.

This article presents the anti-infective treatment and pharmaceutical care of an elderly patient with liver cirrhosis complicated with severe psittacosis.Based on the pathophysiological characteristics of infection in patients with severe liver diseases and in combination with relevant guidelines,the combined regimen of omadacycline+moxifloxacin was adopted to treat psittacosis.In case of recurrent episodes,Aspergillus fumigata was detected in the metagenomic next-generation sequencing of bronchoalveolar lavage fluid.Initially,voriconazole was administered for treatment,and later switched to posaconazole.Additionally,clinical pharmacists provided pharmaceutical care encompassing adverse reaction monitoring and voriconazole therapeutic drug monitoring.The patient's infection was effectively controlled,body temperature returned to normal,white blood cell counts and platelet counts basically returned to normal range,serum high-sensitive C-reactive protein,procalcitonin,and other inflammatory indicators significantly decreased,and the patient was discharged.Clinical pharmacists assisted clinicians in formulating a reasonable anti-psittacosis treatment plan and provided individualized pharmaceutical care to ensure the effectiveness and safety of clinical drug treatment.

Objective:To investigate the mediating effect of family resilience on the relationship between psychological resilience and demoralization in leukemia patients undergoing chemotherapy.Methods:A total of 240 leukemia patients hospitalized for chemotherapy in the Department of Hematology, the First Affiliated Hospital of Zhengzhou University, from January to December 2024 were selected by convenience sampling. The Basic Information Questionnaire, Family Hardiness Index (FHI), Connor-Davidson Resilience Scale (CD-RISC), and the Chinese version of the Demoralization Scale Ⅱ (DS-Ⅱ) were administered. Pearson correlation analysis was used to examine the associations among family resilience, psychological resilience, and demoralization. A structural equation model was constructed with AMOS 21.0 to verify the mediating effect. A total of 240 questionnaires were distributed, of which 232 were valid, yielding a valid response rate of 96.67% (232/240) .Results:The mean scores of the 232 patients were as follows: FHI (51.41±8.27), CD-RISC (51.84±7.96), and DS-Ⅱ (21.03±4.19). FHI was positively correlated with CD-RISC ( P<0.05), while DS-Ⅱ was negatively correlated with both FHI and CD-RISC ( P<0.05). Psychological resilience had a direct negative effect on demoralization ( P<0.01), and family resilience also had a direct negative effect on demoralization ( P<0.01). Family resilience partially mediated the relationship between psychological resilience and demoralization ( P<0.01), accounting for 59.96% (-0.289/-0.482) of the total effect. Conclusions:Psychological resilience and family resilience in leukemia patients undergoing chemotherapy were both at moderate levels, while demoralization was relatively high. Family resilience partially mediated the relationship between psychological resilience and demoralization.

Objective To study the influence of laser diffraction ultrasound parameters on the determination of particle size and particle size distribution of budesonide suspension for inhalation,and explore the rationality of ultrasound parameter settings of the laser diffraction method.Methods The Mastersizer 3000 was set to measure the particle size and particle size distribution of budesonide suspension for inhalation from 6 companies at different ultrasonic times,and the FlowCam was used to test the samples simultaneously.Results The ultrasound parameters have a significant impact on the particle size and particle size distribution of budesonide suspension for inhalation in some companies,and the FlowCam test results show that particles in some samples exhibit aggregation,which can be dispersed by ultrasound and affect the results.Conclusion It is necessary to optimize the ultrasound parameters of laser diffraction to determine the particle size and particle size distribution of suspension for inhalation,and verify the rationality of the ultrasound parameter settings through microscopic techniques.