Asarum forbesii is a perennial herb born in a shaded and humid environment, which is warm in nature. With the efficacy of warming lung, resolving fluid retention, and relieving coughs, it can be used to treat the syndrome of cold fluid accumulating in lung. To investigate the effects of different shading conditions on the composition and efficacy of A. forbesii, this study planted A. forbesii under 20% natural light(NL20), 40% natural light(NL40), 60% natural light(NL60), and 80% natural light(NL80) and utilized ultra performance liquid chromatography(UPLC) and micro broth 2-fold dilution method to detect the volatile chemical compounds and the minimum inhibitory concentration. At the same time, the study investigated the effects of A. forbesii grown under different shading conditions on the signs, pathological changes of lung tissues, serum cytokine levels, activities of mitochondrial respiratory chain complexes Ⅰ-Ⅴ in lung tissues, and relative expression of related genes of mice with syndrome of cold fluid accumulating in lung. The results indicated that with the increase of shading, the content of kakuol, methyl eugenol, and asarinin in A. forbesii and the antibacterial effect showed a tendency of increasing first and then decreasing, and the NL40 group was significantly better than the other groups. Under the conditions of NL20 and NL40, A. forbesii significantly alleviated the pathological damage to lung tissues, restored the homeostasis of the lung, and enhanced the energy metabolism level of mice with syndrome of cold fluid accumulating in lung. In addition, A. forbesii planted under the two conditions reduced the content of interleukin-8(IL-8), interleukin-13(IL-13), tumor necrosis factor-α(TNF-α), and mucin 5AC(MUC5AC), increased the levels of interleukin-10(IL-10) and aquaporin 1(AQP1), lowered the expression of MMP9, VEGF, TGF-β, and MAPK3. In conclusion, the therapeutic effect of A. forbesii on the syndrome of cold fluid accumulating in lung was positively correlated with the degree of shading, and the chemical composition and efficacy of warming lung and resolving fluid retention were optimal under the conditions of NL20-NL40. This study can provide reference for the pharmacological research and cultivation of A. forbesii.
Animals ; Mice ; Lung/pathology* ; Drugs, Chinese Herbal/administration & dosage* ; Male ; Light ; Cytokines/genetics* ; Humans

Objective To explore the application value of a novel portable endoscope to perform upper gastrointestinal tract examinations in primary medical units.Methods A total of 532 subjects receiving portable endoscope examination were enrolled for analysis.The primary outcome was the success rate of operation.The secondary outcomes were the operation time,examination results,polyp removal and biopsy pathology results,and the subjective evaluation.Results In 532 cases,2 were withdrawn midway after the endoscope was inserted into the esophagus due to the patients'inability to tolerate the examination.Additionally,6 cases did not undergo examination of the descending part of the duodenum because of serious reactions during the procedure.Ultimately,524 cases successfully completed the upper gastrointestinal examination,and the success rate was 98.5％.The average examination time was(4.7±1.8)min,and the average time for disposal sheath wearing and removing was(4.2±1.4)min.The most common lesions were chronic non-atrophic gastritis(85.1％,451/530),reflux esophagitis(14.7％,78/530)and bile reflux(14.0％,74/530).A total of 10 cases of polyp removal were completed,and the polyp removal rate was 71.4％(10/14).Biopsy pathological diagnosis was completed in 44 cases,and the biopsy rate was 8.3％(44/530).The main discomfort symptoms during the examination were nausea(53.6％,285/532),vomiting(51.1％,272/532),and sore throat(38.5％,205/532),the main discomfort symptoms after the examination were sore throat(27.8％,148/532),nausea(19.5％,104/532),and vomiting(14.7％,78/532).No serious adverse events such as gastrointestinal bleeding,perforation,cardiac or pulmonary complications occurred.Conclusion The novel portable endoscope can safely and effectively complete the diagnosis and treatment of upper gastrointestinal diseases in primary medical units,while saving the decontamination process.However,the incidence of discomfort is high during examinations.Further optimization of the operation methods is needed.

Objective:To establish a portable gastrointestinal endoscopy telemedicine platform that enables the real-time transmission of endoscopy audio and video data to the consulting physicians through 5G communication technology, and to evaluate the effectiveness of this platform.Methods:From October 10 to October 20, 2023, 30 cases (16 cases from Sanya, Hainan Province, and 14 cases from Zhanjiang, Guangdong Province) from primary health institutions were selected for portable gastrointestinal endoscopy telemedicine consultations with a tertiary hospital in Shanghai. 5G network transmission parameters were recorded, and the lesion detection rate of the examination side and the consultation side, as well as the quality of the videos and images were compared.Results:The 5G network transmission parameters for telemedicine from Sanya and Zhanjiang to Shanghai included download network speeds of 168.3 Mbps and 160.4 Mbps, upload network speeds of 75.1 Mbps and 72.4 Mbps, and delays of 28 ms and 25 ms, respectively. There was no significant difference in the lesion detection rate [43.3% (13/30) VS 36.7% (11/30), χ2=0.792, P=0.598] between the physicians on the examination side and the consultation side. The endoscopic video quality (2.92±0.59 points VS 2.88±0.64 points, t=0.302, P=0.763) and picture quality (3.10±0.57 points VS 3.05±0.53 points, t=0.424, P=0.622) were compared by two senior endoscopists between the examination side and the consultation side, indicating no significant difference. Conclusion:The utilization of portable gastrointestinal endoscopy for telemedicine based on 5G network technology is effective in enabling telemedicine consultations and providing operational guidance. This approach enhances the procedural skills and diagnostic capabilities of physicians in primary healthcare settings, facilitating the equitable distribution of high-quality medical resources.

Objective:To establish a portable gastrointestinal endoscopy telemedicine platform that enables the real-time transmission of endoscopy audio and video data to the consulting physicians through 5G communication technology, and to evaluate the effectiveness of this platform.Methods:From October 10 to October 20, 2023, 30 cases (16 cases from Sanya, Hainan Province, and 14 cases from Zhanjiang, Guangdong Province) from primary health institutions were selected for portable gastrointestinal endoscopy telemedicine consultations with a tertiary hospital in Shanghai. 5G network transmission parameters were recorded, and the lesion detection rate of the examination side and the consultation side, as well as the quality of the videos and images were compared.Results:The 5G network transmission parameters for telemedicine from Sanya and Zhanjiang to Shanghai included download network speeds of 168.3 Mbps and 160.4 Mbps, upload network speeds of 75.1 Mbps and 72.4 Mbps, and delays of 28 ms and 25 ms, respectively. There was no significant difference in the lesion detection rate [43.3% (13/30) VS 36.7% (11/30), χ2=0.792, P=0.598] between the physicians on the examination side and the consultation side. The endoscopic video quality (2.92±0.59 points VS 2.88±0.64 points, t=0.302, P=0.763) and picture quality (3.10±0.57 points VS 3.05±0.53 points, t=0.424, P=0.622) were compared by two senior endoscopists between the examination side and the consultation side, indicating no significant difference. Conclusion:The utilization of portable gastrointestinal endoscopy for telemedicine based on 5G network technology is effective in enabling telemedicine consultations and providing operational guidance. This approach enhances the procedural skills and diagnostic capabilities of physicians in primary healthcare settings, facilitating the equitable distribution of high-quality medical resources.

Objective:To quantitatively analyze the primary research characteristics and keywords of international and domestic papers in the field of capsule endoscopy with bibliometric methods, and to illustrate the progression of capsule endoscopy research and offer insights for researchers in this domain.Methods:The Stork and visualized software CiteSpace were used to search and analyze the literature on "capsule endoscopy" in the English database of PubMed and the Chinese database of CNKI from 2002 to 2022.Results:A total of 6 011 English articles were identified in the PubMed database during the specified period. Both the number of publications and their citation frequencies displayed an upward trend on a global and domestic scale. The growth rates of global and domestic English publications were 5% and 15%, respectively, with major contributions coming from the United States, Japan, China, Italy and Germany. Key areas of global research interest included magnetic capsule endoscopy, colon capsule endoscopy, inflammatory bowel disease, small bowel capsule endoscopy, capsule endoscopy images, and obscure gastrointestinal bleeding, etc. A total of 2 027 articles were retrieved in the CNKI database, with top three research institutions including Department of Gastroenterology, Changhai Hospital, Naval Medical University; Department of Gastroenterology, Nanfang Hospital, Southern Medical University; School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University. Emerging research keywords encompassed artificial intelligence, deep learning, and guidelines.Conclusion:The study reveals a gradual increase in global research activities related to capsule endoscopy, with China demonstrating significant international academic influence in this field.

Objective To explore the feelings and needs of patients with pancreatic duct stones undergoing endoscopic treatment,and to provide a basis for formulating personalized methods.Methods Purposive sampling method was used to select 15 patients who were treated in the Department of Gastroenterology of a Class Ⅲ Grade A hospital in Shanghai from February to April 2023 for semi-structured interviews.Colaizzi 7-step analysis method was used to code and summarize the data to refine the theme.Results The treatment experience and needs of patients were summarized into four themes.① Inadequate pain cognition and coping management before treatment:characterized by persistent or intermittent abdominal pain;The location of onset is hidden and easy to be misdiagnosed.Ineffective coping style;Affecting daily life and reducing the quality of life.② Changes of physiological comfort during the diagnosis and treatment period:abdominal soft tissue injury;Postoperative complications.③ Attitude changes after treatment:expectant treatment before diagnosis and treatment;Disappointment and doubt when expectations are not met;Belief after symptom improvement;④ Needs during treatment:professional guidance;Continuous nursing support.Conclusion Patients with pancreatic duct stones have insufficient knowledge of pain before endoscopic treatment.During the treatment,their attitudes may change and they may seek external support.Medical staff should pay attention to the dynamic changes of their physiological,psychological and social needs,and take corresponding measures to reduce pain,improve comfort and promote rehabilitation of patients.

Chronic lumbar and back pain caused by degenerative vertebral endplates presents a challenging issue for pa-tients and clinicians.As a new minimally invasive spinal treatment method,radiofrequency ablation of vertebral basal nerve in bone can denature the corresponding vertebral basal nerve through radiofrequency ablation of degenerative vertebral endplate.It blocks the nociceptive signal transmission of the vertebral base nerve,thereby alleviating the symptoms of low back pain caused by the degenerative vertebral endplate.At present,many foreign articles have reported the operation principle,opera-tion method,clinical efficacy and related complications of radiofrequency ablation of the vertebral basal nerve.The main pur-pose of this paper is to conduct a comprehensive analysis of the current relevant research,and provide a reference for the follow-up clinical research.

Autoimmune pancreatitis(AIP)is an immune-mediated,special type of chronic pancreatitis,which can involve multiple organs.The clinical manifestation of AIP is complex and varied,making the diagnosis and treatment challenging.With reference to the latest guidelines and studies from both domestic and international sources,this guideline comprises 20 recommendations regarding the diagnosis,treatment,follow-up,and prognosis of AIP.The aim of this guideline is to promote the care capability and improve the outcome of patients with AIP in China.

Objective:To compare the feasibility and safety of a new portable endoscopic system and the conventional endoscopic system for the detection and emergency treatment of abdominal trauma in animal models.Methods:Three healthy Bama pigs, which were fasted and water deprivation for 8 h before surgery and then underwent induction anesthesia. A layer-by-layer incision was made into the abdominal cavity of Bama pigs. An artificial pneumoperitoneum was established using a laparoscopic pneumoperitoneum machine. A bullet model was inserted into the abdominal cavity to build the bullet wound model. After the bullet model was removed, a shrapnel model was inserted into the mid-abdomen to build the shrapnel wound model. The two types of endoscopic system were used to detect, remove bullet model or shrapnel model of the three Bama pigs respectively. The procedure order of the two systems was assigned according to the random number table method. The surgical success, operation time, endoscopy pipeline patency, endoscopic operation satisfaction, adverse events and equipment defects were recorded.Results:Three surgeries were performed using the new portable endoscopic system and three other surgeries using the conventional endoscopic system, all of which were successful. The time of the new portable endoscopic system to find and remove the bullet model, and the shrapnel model were 232.33±11.68 s, 300.33±57.70 s, 170.00±44.44 s and 52.67±2.52 s, respectively. The corresponding time of the conventional endoscopic system were 232.67±21.20 s ( t=-0.054, P=0.962), 256.67±67.00 s ( t=0.880, P=0.472), 176.00±52.42 s ( t=-0.111, P=0.922), 58.67±14.84 s ( t=-0.832, P=0.493), respectively. There was no significant difference between the two systems ( P>0.05). The endoscopy tubes of the two endoscopic systems were both smooth. The operator was satisfied with the endoscopic procedures of both endoscopic systems, and no adverse event or device defect occurred. Conclusion:The portable endoscopic system proves to be safe and feasible for the diagnosis and treatment of abdominal trauma in animal models.

Objective:To analyze the mutation spectrum and regional distribution of susceptibility pathogenic genes in Chinese chronic pancreatitis (CP) patients.Methods:A retrospective analysis was conducted on 1 758 sporadic CP patients who underwent gene sequencing for pathogenic mutations of four major susceptibility genes ( SPINK1, PRSS1, CTRC, and CFTR) at the First Affiliated Hospital of Naval Medical University from December 2010 to November 2022. Pathogenic mutations of four major susceptibility genes were detected by using the next-generation sequencing, and both known and novel pathogenic mutations were validated by Sanger sequencing. The ethnic and regional distributions of pathogenic mutations across different ethnic groups were compared. The ArcMap 10.7 software was used to provide the distribution map of common CP pathogenic mutations in China, and regional differences of these mutations were assessed. According to seven major geographical regions in China, we also evaluated the enrichment differences of CP pathogenic mutations in North China region, Northeast China region, East China region, Central China region, South China region, Southwest China region, and Northwest China region. Results:Among 1 758 CP patients, 50.23% (883/1 758) carried pathogenic mutations, and the SPINK1 pathogenic mutations were most predominated (39.31%). Among them, c.194+2T>C mutations accounted for 94.21% of all SPINK1 mutations. 32.59% (573/1 758) of patients carried single heterozygous mutation of one susceptibility gene, and 4.61% carried homozygous mutation of SPINK1 c.194+2T>C. There was no statistically significant difference on the overall pathogenic mutation carrying rate between Han and ethnic minority patients, whereas the mutation carrying rate of SPINK1 c.194+2T>C was significantly higher among Han patients than among ethnic minorities (37.48% vs 20.00%, P<0.05). Among 31 provinces and cities, the mutation carrying rate of CP patients in Tianjin, Guangdong, Yunnan, Hubei and Anhui were all higher than 60.00%. The SPINK1 mutations accounted for the highest proportion of pathogenic mutations across all provinces (33.33% to 61.54%), and SPINK1 c.194+2T>C was the most prevalent mutation. The mutation carrying rate of SPINK1 c.194+2T>C was higher than 40.00% in Jilin, Liaoning, Tianjin, Anhui, Jiangxi, Hubei, Henan, and Guangdong. Distribution analysis of seven geographic regions showed that the overall carrying rate of pathogenic mutations in North China region was significantly lower than that in Central China region (represented by Henan, Hubei, and Hunan; 38.38% vs 58.15%), and the differences were statistically significant ( P<0.05). Additionally, although the carrying rate of SPINK1 c.194+2T>C was highest in Central (41.85%) and Northeast China region (38.78%), no significant differences were found among different regions. Conclusions:Genetic factors was the main etiology of CP in China, with SPINK1 c.194+2T>C mutations being most prevalent. The carrying rates of common susceptibility genes of CP were highest in Central China region as well as SPINK1 c.194+2T>C mutation.