The multimorbidity of rheumatoid arthritis （RA） and periodontitis （PD） has drawn increasing attention， as both conditions are characterized by chronic inflammation， immune dysregulation， and progressive bone destruction. Modern research confirms that PD is a significant risk factor for RA development， and their coexistence mutually exacerbates disease progression. However， traditional Chinese medicine （TCM） currently lacks a systematic theoretical explanation for this complex multimorbid relationship. This study， based on the TCM theory of abnormal collateral， thoroughly examines the intrinsic connection between RA and PD multimorbidity， proposing "abnormal collateral as the pivot， with accumulated toxins eroding bone" as the core TCM pathogenesis. The research elucidates PD as the "origin of abnormal collateral"， where its pathogens act as toxic factors that invade the joints through collaterals， triggering RA via mechanisms such as molecular mimicry. The dynamic pathological progression of RA-PD multimorbidity can be described as follows： the displacement of Ying and Wei at the microscopic level manifests as immune hyperactivation， leading to collateral malnutrition； heat-toxins traversing collaterals induce collateral hyperactivity， resulting in pathological angiogenesis； ultimately， toxin accumulation at the pivotal abnormal collateral site erodes bone， activating the receptor activator of nuclear factor kappa-B ligand （RANKL）-receptor activator of nuclear factor kappa-B （RANK） signaling pathway-driven osteoclast differentiation. This theoretical framework innovatively integrates modern findings in oral microbiology， immune-inflammation， and bone metabolism， offering a holistic and dynamic perspective to understand the complexity of multimorbidity. Given the limited efficacy of current periodontal treatments for RA and the scarcity of reported TCM compound interventions for multimorbidity， the abnormal collateral theory proposes a systematic intervention strategy centered on "governing diseases through collaterals and regulating collaterals with herbs"， along with TCM therapeutic principles such as "unblocking， clearing， and nourishing collaterals". Potential herbal treatments for multimorbidity are also highlighted. Future research should focus on refining TCM syndrome patterns in multimorbid patients and leveraging omics technologies for deeper exploration， thereby providing a theoretical foundation and research direction for TCM in addressing complex multimorbid conditions.

The multimorbidity of rheumatoid arthritis （RA） and periodontitis （PD） has drawn increasing attention， as both conditions are characterized by chronic inflammation， immune dysregulation， and progressive bone destruction. Modern research confirms that PD is a significant risk factor for RA development， and their coexistence mutually exacerbates disease progression. However， traditional Chinese medicine （TCM） currently lacks a systematic theoretical explanation for this complex multimorbid relationship. This study， based on the TCM theory of abnormal collateral， thoroughly examines the intrinsic connection between RA and PD multimorbidity， proposing "abnormal collateral as the pivot， with accumulated toxins eroding bone" as the core TCM pathogenesis. The research elucidates PD as the "origin of abnormal collateral"， where its pathogens act as toxic factors that invade the joints through collaterals， triggering RA via mechanisms such as molecular mimicry. The dynamic pathological progression of RA-PD multimorbidity can be described as follows： the displacement of Ying and Wei at the microscopic level manifests as immune hyperactivation， leading to collateral malnutrition； heat-toxins traversing collaterals induce collateral hyperactivity， resulting in pathological angiogenesis； ultimately， toxin accumulation at the pivotal abnormal collateral site erodes bone， activating the receptor activator of nuclear factor kappa-B ligand （RANKL）-receptor activator of nuclear factor kappa-B （RANK） signaling pathway-driven osteoclast differentiation. This theoretical framework innovatively integrates modern findings in oral microbiology， immune-inflammation， and bone metabolism， offering a holistic and dynamic perspective to understand the complexity of multimorbidity. Given the limited efficacy of current periodontal treatments for RA and the scarcity of reported TCM compound interventions for multimorbidity， the abnormal collateral theory proposes a systematic intervention strategy centered on "governing diseases through collaterals and regulating collaterals with herbs"， along with TCM therapeutic principles such as "unblocking， clearing， and nourishing collaterals". Potential herbal treatments for multimorbidity are also highlighted. Future research should focus on refining TCM syndrome patterns in multimorbid patients and leveraging omics technologies for deeper exploration， thereby providing a theoretical foundation and research direction for TCM in addressing complex multimorbid conditions.

Objective To gain insights into the biological characteristics of different populations of Culex tritaeniorhynchus within and around the Yellow Sea wetland from the perspective of the occurrence of resistance, we investigated the levels of resistance to deltamethrin and kdr gene mutation in the wetland and its peripheral areas. Methods Specimens were collected from Cx. tritaeniorhynchus populations at two monitoring sites in the Rare Bird National Nature Reserve and Tiaozi Ni Wetland Scenic Area, and also from two populations in Yancheng City and the Liuhe District of Nanjing, and the resistance of these mosquitoes to deltamethrin was determined using the CDC biotest bottle method. For each concentration of deltamethrin assessed, a random subset of exposed specimens was selected for amplification of the kdr gene fragment, followed by Sanger sequencing to identify and analyze resistance-associated mutations. Results The LC50 levels of deltamethrin among mosquitoes from the four populations in Luhe, Yancheng, the Rare Bird National Nature Reserve and the Tiaozi Ni Wetland Scenic Area were 2.048 5, 7.798 2, 3.473 3, and 17.695 5 mg/mL, respectively, with corresponding concentrations of deltamethrin ranging from 0.005 to 5.000,0.050 to 50.000,0.050 to 25.000 and 0.050 to 50.000 mg/mL, respectively. Furthermore, the ranges of the KT50 values were 11.76-107.43, 67.05-216.30,29.77-107.43 and 28.40-329.51 min; the 1-h knockdown rates were 34.58%-99.15%, 9.52%-43.80%, 55.09%-73.01%, and 10.09%-68.07%; and the 24-h mortality rates were 12.15%-67.52%,9.52%-79.56%,13.17%-82.21%, and 11.01%-78.99%, respectively. With respect to kdr gene mutation, we assayed a total of 63,70,59, and 57 mosquitoes for the four populations, for which we detected L1014F mutation frequencies of 14.29%, 35.00%, 20.34%, and 31.58%, respectively, with a majority of these mutations being heterozygous for resistance. In addition, five adult mosquitoes were identified has having synonymous mutations at site 1011[i. e. , AAT(asparagine)mutation to AAC(asparagine)]. Conclusions Our findings revealed the clear resistance of Cx. tritaeniorhynchus to deltamethrin in the Yancheng region of the Yellow Sea wetland, and the resistance phenotype and kdr frequency of Cx. tritaeniorhynchus in the wetland environment were comparable to those of Cx. tritaeniorhynchus in the wetland environment, thereby indicating that the resistance of different populations of Cx. tritaeniorhynchus was homogeneous under the pressure of different insecticide selection within and around the wetland. However, the underlying mechanisms need to be further studied.

Objective To explore the associations among smoking behavior,cognitive function,and personality traits in first-episode male patients with schizophrenia,thereby providing theoretical underpinnings for individualized treatment strategies in clinical settings.Methods A total of 140 first-episode male inpatients with schizophrenia admitted to the hospital from January 2022 to December 2023 were recruited.According to their smoking behavior,they were categorized into a smoking group(n=80)and a non-smoking group(n=60).Moreover,healthy controls were recruited and classified into a healthy smoking group(n=62)and a healthy non-smoking group(n=67)based on their smoking status.The Positive and Negative Syndrome Scale(PANSS)was employed to evaluate psychiatric symptoms in the schizophrenia groups.Nicotine dependence was measured using the Fagerstr?m Test for Nicotine Dependence(FTND)in the two smoking groups.Cognitive function and personality traits were assessed in all participants using the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)and the Eysenck Personality Questionnaire(EPQ),respectively.Results Regarding cognitive function,the smoking group among schizophrenia patients demonstrated significantly higher scores than the non-smoking group in immediate memory,attention,and delayed memory(all P<0.05).Among schizophrenia patients,FTND scores were moderately negatively correlated with attention and delayed memory(r=-0.552 and-0.657 respectively;both P<0.001).Concerning personality traits,smokers had significantly higher scores in neuroticism and psychoticism compared to non-smokers(both P<0.001).Both patient groups had significantly lower lie scale scores when contrasted with healthy controls(P<0.01),while the healthy smoking group showed significantly higher extraversion scores than the other groups.Conclusions The smoking behavior of male patients during their first episode of schizophrenia exhibits specific characteristics in relation to cognitive performance and personality traits.Smokers demonstrate relatively superior performance in cognitive domains including attention,immediate memory,and delayed memory.However,higher degrees of nicotine dependence are associated with poorer cognitive function,especially in the aspects of attention and delayed memory.Regarding personality,smoking patients display elevated levels of neuroticism and psychoticism.These findings indicate that smoking behavior may be closely associated with cognitive functioning and personality traits,thus meriting clinical attention in the management of schizophrenia.

Tumor-related insomnia is one of the common complications of tumor patients,which is secondary to tumor disease and related to tumor disease itself or tumor treatment.Combined with the unique pathogenesis of"heat-toxicity internal stagnation"of tumor-related insomnia,the important treatment methods are to clear away heat,attack toxicity,regulate qi and supplement healthy qi.This article explained the research status,etiology and pathogenesis,treatment principles of the disease,in order to provide new ideas and methods for the differentiation and treatment of tumor-related insomnia in TCM.

Aim To explore the effect of C1q/tumor necrosis factor-related protein 6(CTRP6)on cardio-myocyte pyroptosis in rats with acute myocardial infarc-tion(AMI)inhibited by quercetin(Que)and the un-derlying mechanism.Methods A rat model of AMI was established by ligation of the left anterior descend-ing coronary artery.Firstly,the rats were divided into the sham operation group(Sham),AMI group,low-dose quercetin group(Que-L,25 mg·kg-1),high-dose quercetin group(Que-H,100 mg·kg-1),fosino-pril sodium tablet group(fosinopril,4 mg·kg-1),with 10 rats in each group.Each group was orally ad-ministered with the corresponding drug dose or physio-logical saline once a day for 14 consecutive days.Doppler ultrasonography was used to detect the changes of cardiac function,the pathological changes of rat myo-cardial tissue were observed,and Western blot was used to detect the myocardial tissue pyroptosis-related proteins and CTRP6 expression.The optimal dosage of Que was determined through the screening of the above experimental indicators.Subsequently,the experiment was divided into the Sham,AMI,Que(100 mg·kg-1),Que+si-NC group,Que+si-CTRP6,with 10 rats in each group.After 14 days of intervention,myo-cardial infarction,myocardial injury indicators,pyropto-sis,CTRP6,and PI3K/Akt pathway protein expression were detected.Results Compared with the Sham group,the LVEDV and LVESV significantly increased,the EF and FS significantly decreased(P＜0.05),the myocardial tissue had obvious pathological damage,the degree of fibrosis increased,the myocardial infarction area,LDH,CK-MB,cTnI levels,TUNEL positive cell ratio increased,NLRP3,cleaved caspase-1,GSDMD-N,IL-1 β,IL-18 expression increased,and CTRP6 expres-sion,p-PI3K/PI3K,p-Akt/Akt ratio decreased in the AMI group(P＜0.05).Compared with the AMI group,Que-L and Que-H rats showed reduced cardiac function indicators and pathological damage to myocar-dial tissue,decreased myocardial infarction area,LDH,CK-MB,cTnI levels,decreased TUNEL positivity rate(P＜0.05),decreased expression of pyroptosis related proteins,and increased expression of CTRP6 and PI3K/Akt pathway proteins(P＜0.05),all of which were dose-dependent.Compared with the Que group,the changes in the above indicators in the Que+si-CTRP6 group rats were significantly reversed.Conclu-sions Que can inhibit cardiomyocyte pyroptosis and improve myocardial infarction in AMI rats,and its mechanism is related to up-regulating CTRP6 expres-sion and promoting the activation of PI3 K/Akt signa-ling pathway.

Objective:To explore the surgical efficacy of high position dacryocystorhinostomy (DCR) under nasal endoscopy in patients with chronic dacryocystitis secondary to failure of nasolacrimal duct stent implantation.Methods:A total of 101 patients with chronic dacryocystitis who were treated at People′s Hospital of Peking University from 2013 to 2024 were retrospectively selected, including 14 males and 87 females, aged (56.82±13.00) years (Mean±SD). The patients were divided into control group (53 cases, 59 eyes) and stent group (48 cases, 60 eyes). The control group consisted of randomly selected patients with simple dacryocystitis, while, the stent group included patients with secondary dacryocystitis after failure of nasolacrimal duct stent implantation. All patients underwent endoscopic high DCR with exposed the Rosenmüller valve, combined with intraoperative lacrimal silicone tube implantation. After the operation, the surgical efficacy was evaluated by methods such as Munk score, endoscopic observation of intranasal ostia, lacrimal duct irrigation, and fluorescein test. SPSS 27.0 software was used for data statistics.Results:All 101 patients were followed up for at least one year after DCR surgery. In the control group, one patient (two eyes) was lost to follow-up; while, in the stent group, three patients (three eyes) were lost to follow-up, with one case diagnosed with lacrimal sac cancer. Excluding the lost-to-follow-up cases and the patient with lacrimal sac cancer, anatomical success was achieved in 54 eyes (96.4%, 54/56) in the stent group, and both anatomical and functional success in 53 eyes (94.6%, 53/56); in the control group, 55 eyes (96.5%, 55/57) achieved both anatomical and functional success. No statistically significant difference was found in postoperative effectiveness efficacy between the two groups ( χ2=0.000, P=0.984). Conclusion:For patients with secondary dacryocystitis after nasolacrimal duct stent implantation, high position DCR with exposure of Rosenmüller valve combined with lacrimal duct silicone intubation can achieve better long-term efficacy.

Chronic heart failure(CHF)is a common end-stage manifestation of cardiovascular disease,and the"spleen-small intestine-heart"axis is its important mechanism.Current studies have shown that the"spleen"in TCM and mitochondria function are similar,and the physiological dysfunction of the"small intestine"is also closely related to intestinal bacterial dysbiosis,and the pathology of the spleen and the small intestine will be transmitted to the heart to accelerate the occurrence and development of CHF.Based on the relevant theory of spleen-small intestine-heart,this article described the correlation between abnormal mitochondrial energy metabolism and imbalance of intestinal flora and CHF from the aspects of the spleen,small intestine and heart,and believed that the essence of CHF is a pathological condition formed by mitochondrial energy metabolism crisis and intestinal microecological disorders,which could provide theoretical references for the TCM prevention and treatment of CHF.

Objective:To build an evaluation index system for Huimin Insurance and provide reference for promoting the steady and sustainable development of Huimin Insurance.Methods:The evaluation indicators were initially constructed through literature analysis method and further revised and improved.The entropy weight TOPSIS method was used to evaluate and analyze 84 Huimin Insurance products with complete evaluation indicator data in 21 provinces across the country.Results:The constructed evaluation index system for Huimin Insurance includes 4 first-level indicators,10 second-level indicators and 28 third-level indicators.The weights of the first-level indicators,from high to low,are the sustainability indicator of Huimin Insurance(0.335 0),the guarantee ability indicator(0.235 1),the fairness indicator of participation in insurance(0.229 9)and the guarantee level indicator(0.200 0).The evaluation results show that the top ranked products are mainly concentrated in Zhejiang and Guangdong.Conclusion:The evaluation results of the entropy weight TOPSIS method are suitable for the comprehensive evaluation of Huimin Insurance and are comprehensive and scientific.They can be used to evaluate the operation and development of Huimin Insurance products,laying a good foundation for further evaluation of the sustainability of Huimin Insurance.

BACKGROUND:Gait analysis,as a radiation-free dynamic assessment method,may be able to assist imaging to evaluate patients with scoliosis,thereby reducing radiation exposure.OBJECTIVE:To analyze the correlation between gait parameters and imaging parameters in adolescent idiopathic scoliosis patients,and preliminarily explore the potential mechanism through OpenSim simulation modeling.METHODS:Twenty adolescent idiopathic scoliosis patients aged 10-18 years with Cobb angle of 10°-45° were selected as adolescent idiopathic scoliosisgroup. The control group was normal children of the same age and the same body mass index range,and a total of 40 subjects were included. The differences in spatiotemporal parameter,kinematic parameters,dynamic parameters,and gait deviation index of the two groups were compared to explore the correlation between pathological gait and coronal balance. The related mechanisms were preliminarily studied.RESULTS AND CONCLUSION:(1) The comparison of gait parameters between groups showed that the percentage of bilateral support phase and double support phase increased in adolescent idiopathic scoliosis patients,and the percentage of bilateral swing phase decreased (P<0.05). The maximum adduction angle of the left hip joint of patients in the adolescent idiopathic scoliosis group was greater than that of the control group,and the maximum abduction angle of the bilateral hip joints was significantly less than that of the control group (P<0.05). The ankle joints of the two groups when the bilateral heels initially touched the ground;the difference between angles was significant (P<0.05). The peak power of right hip flexor muscle group in adolescent idiopathic scoliosis patients was significantly decreased when they pushed off the ground (P<0.05). (2) The results of the correlation study showed that the maximum abductive angle of the right hip joint was significantly positively correlated with the Cobb angle (r=0.552,P=0.012),and the right peak power of right hip flexor muscle and C7 lateral offset were significantly negatively correlated (r=-0.475,P=0.034). There was a significant positive correlation between ankle angle and lateral pelvic tilt when left foot followed the ground (r=0.476,P=0.034). (3) The simulation results of muscle length showed that the change of muscle fiber length of gluteal medium muscle in adolescent idiopathic scoliosis patients was significantly reduced (P<0.05). The change of muscle fiber length of the bilateral internal oblique muscle was significantly reduced in adolescent idiopathic scoliosis patients (P<0.05). Comparing the muscle fiber length of the two groups when foot followed the ground,it was found that the muscle fiber length of the calf triceps of the adolescent idiopathic scoliosis patients was significantly shorter when foot followed the ground (P<0.05). (4) The results showed that the postural stability control of the trunk of adolescent idiopathic scoliosis patients was decreased,which was manifested as slow step frequency,increased percentage of double support phase and decreased percentage of swing phase. The common pattern of low foot striking pattern is caused by bilateral Achilles tendon tension. In adolescent idiopathic scoliosis patients,the ability of hip flexor muscle to do work is decreased,which may be related to joint angular velocity and main bend direction.