Objective To investigate the clinical efficacy of Huoxue Jiedu Runzao Formula(HJRF)and its impact on biomarkers in patients with primary Sj?gren's syndrome(pSS)complicated by pulmonary fibrosis(PF)presenting with yin deficiency and fluid depletion syndrome(YDFDS).Methods A prospective study was conducted on 134 pSS-PF patients with YDFDS treated at Harrison International Peace Hospital from January 2021 to January 2024.Patients were randomly assigned to the control group(n=67)or the observation group(n=67)using a random number table.The control group received oral use of hydroxychloroquine sulfate,while the observation group received hydroxychloroquine sulfate combined with HJRF,both groups were treated for 12 weeks.Changes in traditional Chinese medicine(TCM)syndrome scores,serum inflammatory factors[interleukin-4(IL-4),interleukin-6(IL-6),C-reactive protein(CRP)],immunoglobulin(Ig)levels,pulmonary function parameters[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),diffusing capacity of the lung for carbon monoxide per unit alveolar volume(DLco/VA),total lung capacity(TLC)],EULAR Sj?gren's Syndrome Patient Reported Index(ESSPRI),EULAR Sj?gren's Syndrome Disease Activity Index(ESSDAI),and modified Medical Research Council(mMRC)dyspnea scale scores were observed before and after treatment.The clinical efficacy was evaluated in both groups.Results(1)After 12 weeks of treatment,the overall response rate in the observation group was 97.01％(65/67),while that in the control group was 83.58％(56/67).The intergroup comparison(by chi-square test)revealed that the efficacy of the observation group was significantly superior to that of the control group(P＜0.01).(2)After treatment,the TCM syndromes scores regarding to vexing heat in the chest,plams and soles,dryness of the mouth and throat,dry stools,dry and cracked tongue,dry and sore eyes,parotid swelling and pain,skin dryness and cracking,sticky mouth and eyes,fatigue and lassitude,and joint pain were all significantly reduced compared to those before treatment(P＜0.05).Additionally,the reduction in scores for all TCM syndromes except dry and cracked tongue in the observation group was significantly greater than that in the control group(P＜0.05 or P＜0.01).(3)After treatment,the serum IL-4,IL-6,and CRP levels in both groups decreased compared to those before treatment(P＜0.05),and the reduction in the observation group was significantly greater than that in the control group(P＜0.01).(4)After treatment,the FEV1,FVC,DLco/VA,TLC,and other lung function indicators in both groups of patients increased compared to those before treatment(P＜0.05),and the increase in the observation group was significantly greater than that in the control group(P＜0.01).(5)After treatment,serum IgA and IgG levels in both groups decreased compared to those before treatment(P＜0.05),and the reduction in the observation group was significantly greater than that in the control group(P＜0.01).(6)After treatment,the ESSPRI,ESSDAI,and mMRC scores in both groups decreased compared to those before treatment(P＜0.05),and the reduction in the observation group was significantly greater than that in the control group(P＜0.01).Conclusion Compared to conventional western therapy alone,HJRF combined with hydroxychloroquine sulfate more effectively alleviates TCM syndromes,reduces inflammatory and immunoglobulin levels,improves pulmonary function,mitigates pSS symptoms and disease activity,and enhances overall treatment efficacy.This provides a superior therapeutic strategy for pSS-PF patients with YDFDS.

Objective:To construct a structural equation model for neck work-related musculoskeletal disorders (WMSDs) in the footwear industry and analyze the mediating effect of fatigue in the model.Methods:From November 2018 to December 2019, stratified cluster sampling was adopted to select all the workers (3565 people) from 7 footwear enterprises in Fujian Province as the research subjects. The incidence of WMSDs, fatigue and work-related condition were investigated by using the Chinese version of the Musculoskeletal Disorders Questionnaire. A structural equation model of individual factors, work type, work posture, work organization factors, and fatigue on neck WMSDs was constructed to analyze the mediating effect of fatigue among them.Results:The incidence rate of WMSDs in the neck of footwear workers was 39.6% (1413/3565) , and the incidence rate of neck fatigue was 46.6% (1662/3565) .The final structural equation model was constructed with a χ2/ df of 9.927, a goodness-of-fit index of 0.961, an adjusted goodness-of-fit index of 0.946, and a root mean square error of approximation of 0.050. Except for the χ2/ df, all other fit indicators met the standard. Individual factors and work posture factors had a direct effect on neck WMSDs, with standardized path coefficients of 0.101 and 0.077, respectively ( P<0.05) . Individual factors, work type, work posture, and work organization had indirect effects on neck WMSDs through fatigue, the standardized path coefficients of indirect effects were 0.163, 0.090, 0.206, 0.105, respectively, and the standardized path coefficients of the total effect were 0.264, 0.090, 0.282, and 0.105 respectively ( P<0.05) . The indirect effects of individual factors and work posture factors on neck WMSDs through fatigue accounted for 61.74% and 73.05% of the total effects, respectively. The standardized path coefficient of fatigue on WMSDs was 0.689 ( P<0.001) , with the highest coefficient among all paths. Conclusion:Individual factors, work type, work posture, and work organization factors are important influencing factors in the occurrence and development of neck WMSDs in the footwear industry, and fatigue plays an important mediating role in them.

Objective:To construct a structural equation model for neck work-related musculoskeletal disorders (WMSDs) in the footwear industry and analyze the mediating effect of fatigue in the model.Methods:From November 2018 to December 2019, stratified cluster sampling was adopted to select all the workers (3565 people) from 7 footwear enterprises in Fujian Province as the research subjects. The incidence of WMSDs, fatigue and work-related condition were investigated by using the Chinese version of the Musculoskeletal Disorders Questionnaire. A structural equation model of individual factors, work type, work posture, work organization factors, and fatigue on neck WMSDs was constructed to analyze the mediating effect of fatigue among them.Results:The incidence rate of WMSDs in the neck of footwear workers was 39.6% (1413/3565) , and the incidence rate of neck fatigue was 46.6% (1662/3565) .The final structural equation model was constructed with a χ2/ df of 9.927, a goodness-of-fit index of 0.961, an adjusted goodness-of-fit index of 0.946, and a root mean square error of approximation of 0.050. Except for the χ2/ df, all other fit indicators met the standard. Individual factors and work posture factors had a direct effect on neck WMSDs, with standardized path coefficients of 0.101 and 0.077, respectively ( P<0.05) . Individual factors, work type, work posture, and work organization had indirect effects on neck WMSDs through fatigue, the standardized path coefficients of indirect effects were 0.163, 0.090, 0.206, 0.105, respectively, and the standardized path coefficients of the total effect were 0.264, 0.090, 0.282, and 0.105 respectively ( P<0.05) . The indirect effects of individual factors and work posture factors on neck WMSDs through fatigue accounted for 61.74% and 73.05% of the total effects, respectively. The standardized path coefficient of fatigue on WMSDs was 0.689 ( P<0.001) , with the highest coefficient among all paths. Conclusion:Individual factors, work type, work posture, and work organization factors are important influencing factors in the occurrence and development of neck WMSDs in the footwear industry, and fatigue plays an important mediating role in them.

OBJECTIVE To observe the clinical efficacy and safety of tofacitinib combined with hydroxychloroquine in the treatment of refractory rheumatoid arthritis （RA）. METHODS From January 1， 2021 to January 1， 2022， 120 patients with refractory RA were selected as the study objects. According to the principle of random allocation， the patients were divided into group A， group B and group C， with 40 patients in each group. Group A was given Tofacitinib citrate tablet + Hydroxychloroquine sulfate tablet； group B was given Tofacitinib citrate tablet + Methotrexate tablet； group C was given Tofacitinib citrate tablet + Leflunomide tablet. Three groups were given relevant medicine for 6 months. Therapeutic efficacy and disease activity score 28 （DAS 28） of 3 groups as well as Sharp score， the levels of biochemical indicators [erythrocyte sedimentation rate （ESR）， C- reactive protein （CRP）]， immune indexes [rheumatoid factor （RF）， anti-cyclic peptide containing citrulline （anti-CCP） antibody]， serum cytokine indicators [interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α）] before and after treatment were observed； the occurrence of adverse drug reactions during treatment was recorded. RESULTS After treatment， the proportions of ACR50 and ACR70 patients in group A were significantly higher than groups B and C （P＜0.05）； DAS28 score， Sharp score， biochemical indicators， immune indexes and serum cytokine indicators of 3 groups were significantly lower than before treatment （P＜0.05）， and gradually decreased with prolonged treatment time； after 6 months of treatment， DAS28 score， Sharp score， RF， anti-CCP antibody， the levels of IL-6 and TNF-α in group A were significantly lower than group B and C （P＜0.05）. There was no significant difference in the incidence of diarrhea， nausea and vomiting， leukopenia， rash， abnormal liver and kidney function， or dizziness among 3 groups （P＞0.05）. CONCLUSIONS Tofacitinib combined with hydroxychloroquine shows good efficacy and safety for refractory RA.

Objective To systematically analyze the clinical pharmaceutical rehabilitation model based on data mining,so as to explore its role in improving drug treatment efficacy,reducing drug side effects,and optimizing rehabilitation experience.Methods We retrieved published literatures related to clinical pharmaceutical rehabilitation from CNKI,Wanfang,VIP,and PubMed,with a search time from inception to June 30,2022.Results Totally 11 articles were enrolled in this study.A study involving 69 randomized controlled trials(RCTs)demonstrated that the involvement of pharmacists in medication reviews significantly improved the control of hypertension,type 2 diabetes,and high cholesterol.The odds ratio(OR)for improved control was 2.71(95%confidence interval[CI]:1.03-7.01)for hypertension,3.12(95%CI:1.12-5.84)for type 2 diabetes,and 1.90(95%CI:1.05-3.35)for high cholesterol.A study involving 6 RCTs and 2 573 patients with chronic kidney disease(CKD)showed that pharmacist-led blood pressure monitoring,lifestyle,and medication regimen assessments significantly improved blood pressure control in CKD patients,with an OR of 1.51(95%CI:1.13-2.03).A Meta-analysis,including 5 RCTs and 3 observational studies,explored the impact of medication education and behavioral interventions on the treatment outcomes of gout.The results revealed that patients receiving medication education and behavioral interventions had a significantly higher rate of uric acid control and a higher proportion of patient with uric acid less than 360 μmol/L.A Meta-analysis of 14 RCTs involving 4 509 patients showed that pharmacist interventions such as medication education and counseling significantly reduced the 30-day readmission rates for hypertension and diabetes patients,with a relative risk(RR)of 0.75(95%CI:0.53-0.96).Eighteen RCTs involving 7 244 patients investigated the impact of pharmacist-led discharge counseling on the readmission rate.The findings showed that discharge counseling significantly reduced readmission rate,with a RR of 0.864(95%CI:0.763-0.997,P=0.020).Eight studies assessed the impact of pharmacist services on readmission rate,and the result showed that patients receiving pharmacy-related services had significantly reduced readmission rates,with a 32%reduction in the risk of readmission(OR=0.74,95%CI:0.62-0.89).A Meta-analysis including 123 studies investigated the effect of pharmacist interventions in patient care on the readmission rate,and the result indicated that pharmacist interventions led to a decrease in readmission rates,with the maximum decrease of 44.5%.A Meta-analysis of 23 RCTs evaluated the impact of pharmacist interventions on medication-related adverse events in elderly residents of nursing homes.The study found that pharmacist-led medication reviews and education significantly reduced adverse events.Another Meta-analysis of 14 RCTs and intervention studies explored the effect of pharmacist involvement in multidisciplinary care on medication-related adverse events.The analysis showed that pharmacist participation in multidisciplinary care was significantly associated with a reduction in the incidence of adverse events(RR=0.47,95%CI:0.28-0.77,P<0.01).A Meta-analysis of 6 RCTs involving 29 291 pediatric inpatients revealed that pharmacist interventions effectively reduced the risk of medication errors in hospitalized children(OR=0.27,95%CI:0.15-0.49).A literature analysis on the effectiveness of clinical pharmaceutical services in patient drug treatment showed that introducing a clinical pharmaceutical service model can reduce the use of antibiotics,lower medical costs,and improve medication satisfaction among patients treated with antibiotics.Conclusion In-depth exploration of clinical pharmaceutical rehabilitation model plays an important role in clinical treatment,which can improve the effectiveness of rehabilitation and reduce the incidence of adverse reactions.

Aim To investigate the effect of CDR132L(miR-132 antisense oligonucleotide)on vascular remode-ling and function in mice with hypertension and hyperlipidemia,and explore its possible mechanism.Methods A total of 30 8-week-old male C57BL/6 mice were randomly divided into three groups:control group,model group and CDR132L group,with 10 mice in each group.The control group received with a standard diet while the model group and CDR132L group received N-nitro-L-arginine methyl ester(L-NAME)and high-fat diet to induce hypertension and hyperlip-idemia.The CDR132L group was administered with intraperitoneal injection of CDR132L at a dose of 20 mg/kg once weekly for six consecutive weeks,whereas the control group and the model group were given intraperitoneal injection of an equivalent volume of normal saline.The tail-cuff method was utilized for blood pressure measurement,blood lipid and glucose levels were assayed by an automatic biochemical analyzer,the thoracic aorta structure was observed by HE staining,endothelium-dependent relaxation of the thoracic aorta was evaluated by the vascular ring test,the expression level of miR-132 in the thoracic aorta was measured by qPCR,the protein expression levels of Gab1 and endothelial nitric oxide synthase(eNOS)in the thoracic aorta were determined by Western blot.Results Compared with the control group,the model group demonstrated notable rises in systolic and diastolic blood pressure,serum triglyceride,total cholesterol lev-els,and body weight.Moreover,the intima of thoracic aorta and the thickness of vascular wall was uneven,the smooth muscle cells of the tunica media were arranged irregularly,with a large amount of fat deposition in the vascular wall,and the endothelium-dependent relaxation response of thoracic aorta was decreased(P＜0.05).The expression level of miR-132 in the thoracic aorta was significantly increased(P＜0.05),while the expression level of Gabl and eNOS protein was markedly decreased(P＜0.05).Compared with the model group,the CDR132L group showed no significant differences in systolic and diastolic blood pressure,serum triglyceride and total cholesterol levels,as well as body weight(P＞0.05).However,the CDR132L group exhibited a complete and smooth intima of the thoracic aorta with minimal intravascular lipid deposition,the thickness of the vascular wall was uniform,the smooth muscle cells of the tunica media were arranged order-ly,accompanied by enhanced endothelium-dependent relaxation response of the thoracic aorta(P＜0.05).The expression level of miR-132 in the thoracic aorta was significantly decreased(P＜0.05),while the expression levels of Gab1 and eNOS protein were significantly increased(P＜0.05).Conclusion CDR132L can improve vascular remodeling and endothelium-dependent relaxation in hypertensive and hyperlipidemia mice,which may be related to the decrease of miR-132 expression level and the up-regulation of Gab1 and eNOS protein expression levels in the thoracic aorta.

Objective To observe the effects of different concentrations of glucose on the proliferation and differentiation of primary osteoblasts.Methods The identification of mouse primary osteoblasts was performed by alkaline phosphatase (ALP)staining and Von Kossa staining.Treating osteoblasts with different dose of glucose (5.5,15.5,25.5 mmol/L),the osteoblasts proliferation,ALP staining,and Runx2,OB markers ALP and OCN mRNA expression were observed.Real-time PCR was used for the determination of Runx2,OB markers ALP and OCN mRNA expression.Results With the increasing glucose concentrations,the osteoblasts cell proliferation was decreased.Compared with 5.5 mmol/L normal glucose,the ALP staining in 15.5 mmol/L group and 25.5 mmol/L group were decreased.The expressions were decreased by (36.7±6.2)％ and (38.3±2.2)％ in Runx2 mRNA,(26.7±7.2)％ and (40.4±4.3)％ in OCN mRNA respectively.ALP in 15.5 mmol/L group was reduced by (33.3±10.2)％,but increased by(50.8±10.4) ％ in 15.5 mmol/L group.Conclusions High glucose may decrease osteoblasts proliferation and activity,which may be one of the key pathogenesis factors of diabetic osteoporosis.

Objective To investigate the effect of 620 nm red light on chondrogenic differentiation in rat precartilaginous stem cells (PSCs). Methods Rats' PSCs were isolated and purified using magnetically activated cell sorting and cultured in vitro.The PSCs were exposed once to 620 nm wavelength red light from a light-emitting diode (LED) with an irradiation energy of 0.5 J/cm2,1 J/cm2,2 J/cm2 or 4 J/cm2.Any effect was confirmed by Alcian blue staining,immunohistochemistry and observing histomorphological changes under a light microscope,as well as detection using a reverse transcription polymerase chain reaction (RT-PCR). Results After being induced for 14 d,the PSCs exhibited polygonal and round shapes. Alcian blue and type Ⅱ collagen immunohistoehemistry staining showed positive results,but the control group had no significant change.RT-PCR showed that the mRNA expression of Sox9 and type Ⅱ collagen increased significantly compared with the control group. Conclusion Low energy 620 nm red light can enhance chondrogenic differentiation in PSCs significantly.

The effects of high-intensity pulsed electromagnetic stimulation (HIPEMS) on proliferation and differentiation of neonatal rat neural stem cells in vitro were investigated. Neural stem cells derived from neonatal rats were exposed to 0.1 Hz, 0.5-10 Tesla (T) [8 groups of B-I, respectively], 5 stimuli of HIPEMF. The sham exposure controls were correspondingly established. Inverted phase contrast microscope was used to observe the cultured cells, MTT assay to detect the viability of the cells as expressed by absorbance (A) value, and flow cytometry to measure differentiation of neural stem cells. The results showed that A values of neural stem cells in both 3.0 T and 4.0 T groups were significantly higher than the other groups 24 to 168 h post HPEMS, indicating a strong promotion of the growth of neural stem cells (P<0.05). The A values of neural stem cells in the 6.0 T, 8.0 T, and 10.0 T groups were lower than the sham exposure control group, indicating a restraint of the growth of neural stem cells. The rate of neuron-specific enolase-positive neurons revealed by flow cytometry in HPEMS groups was the same as that in control group (P>0.05). It was suggested that 0.1 Hz, 5 pulses stimulation of HPEMS within certain scale of intensity (0.5-10.0 T), significantly promoted the growth of neural stem cells with the rational intensity being 4.0 T.

The effects of high-intensity pulsed electromagnetic stimulation (HIPEMS) on proliferation and differentiation of neonatal rat neural stem cells in vitro were investigated. Neural stem cells derived from neonatal rats were exposed to 0.1 Hz,0.5-10 Tesla (T) [8 groups of B-I,respectively],5 stimuli of HIPEMF. The sham exposure controls were correspondingly established. Inverted phase contrast microscope was used to observe the cultured cells,MTT assay to detect the viability of the cells as expressed by absorhance (A) value,and flow cytometry to measure differentiation of neural stem cells. The results showed that A values of neural stem cells in both 3.0 T and 4.0 T groups were significantly higher than the other groups 24 to 168 h post HPEMS,indicating a strong promotion of the growth of neural stem cells (P＜0.05). The A values of neural stem cells in the 6.0 T,8.0 T,and 10.0 T groups were lower than the sham exposure control group,indicating a restraint of the growth of neural stem cells. The rate of neuron-specific enolase-positive neurons revealed by flow cytometry in HPEMS groups was the same as that in control group (P＞0.05). It was suggested that 0.1 Hz,5 pulses stimulation of HPEMS within certain scale of intensity (0.5-10.0 T),significantly promoted the growth of neural stem cells with the rational intensity being 4.0 T.