ObjectiveTo investigate the efficacy and safety of Babaodan Capsule （BBD） in the treatment of patients with chronic hepatitis B virus （HBV） infection with damp-heat in the liver and gallbladder comorbid with gallbladder polyps. MethodsA randomized， double-blinded， placebo-controlled single-center trial was conducted among 120 patients with chronic HBV infection who were admitted to Beijing YouAn Hospital， Capital Medical University， from August 2020 to April 2023， and they were divided into treatment group （BBD） and control group （placebo）， with 60 patients in each group. The course of treatment was 24 weeks， and follow-up assessments were conducted every 4 weeks. The primary outcome measures were the number and maximum diameter of gallbladder polyps （assessed by ultrasound）， and the secondary outcome measures included traditional Chinese medicine （TCM） syndrome score， blood lipid levels， and liver function parameters. The independent-samples t test or the Wilcoxon rank-sum test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups； the Wilcoxon rank-sum test was used for comparison of ranked data between two groups； the generalized estimating equation was used to analyze repeated measures data. ResultsAfter 8 weeks of treatment， the treatment group had a significantly smaller diameter of polyps and a significantly lower number of polyps than the control group （Z=-1.76 and -1.80， both P<0.05）， and after 24 weeks of treatment， the treatment group had a significantly higher polyp reduction rate than the control group （30.51% vs 10.91%， P<0.05）. The subgroup analysis showed that patients receiving combined antiviral therapy， male patients， patients with a diameter of polyps of <5 mm， and patients with multiple polyps tended to achieve significantly greater benefits. At week 8 of treatment， the treatment group had a significantly better TCM syndrome score than the control group （Z=-2.35， P<0.05）； after treatment， compared with the control group， the treatment group had a significantly greater increase in high-density lipoprotein （Z=-1.85， P<0.05） and significantly lower levels of alanine aminotransferase （Z=-2.06， P <0.05）， aspartate aminotransferase （Z=-2.13， P<0.05）， total bilirubin （Z=-2.12， P<0.05）， and direct bilirubin （Z=-3.09， P<0.05）. No serious adverse events were reported in either group. ConclusionBBD can effectively reduce the size of gallbladder polyps， improve TCM syndrome score， and reduce the level of bilirubin in patients with chronic HBV infection with damp-heat in the liver and gallbladder， with a favorable safety profile， and it may be more suitable for patients receiving combined antiviral therapy and specific subgroups （male patients， patients with a diameter of polyps of <5 mm， and patients with multiple polyps.

From the theoretical perspective of "body fluids and blood stasis mixing"， environmental microplastics （MPs） are conceptualized as a "novel turbid-toxin". This study aims to elucidate the complete pathogenic pathway through which MPs act as a key driving force （the "crucible" of pathogenesis） in the initiation and progression of atherosclerosis （AS）. By tracing the classical theories in the Chapter The Occurrence of All Diseases of Miraculous Pivot （Ling Shu）， this paper clarifies the core connotations of "body fluids"-it not only refers to endogenous pathological fluids and lipid turbidity but also provides a theoretical basis for incorporating "exogenous turbid fluids"， thereby laying a logical foundation for conceptualizing MPs as a "novel turbid-toxin". Meanwhile， the implications of "blood" （encompassing both blood quality abnormalities and blood stasis） and the dynamic process of "mixing" are elucidated. Drawing upon modern toxicological evidence， this paper demonstrates the high homology between MPs and "exogenous turbid-fluids" from three aspects： Morphology， toxicity， and invasion routes. The micro/nano-scale particle morphology of MPs enables mobility within the bloodstream. The multiple exposure pathways of MPs correspond to the traditional Chinese medicine understanding of pathogens invading through the mouth， nose， and skin. The characteristics of accumulating in vivo while inducing oxidative stress and inflammatory responses of MPs fully embody the pathogenic features-adhesion， binding， and vessel damage-of "turbid-toxin". On this basis， the dynamic pathogenesis of MP-induced AS is systematically interpreted. Initially， MPs with the "turbid-toxin" nature impair nutrient-defense harmony and cause endothelial dysfunction. Subsequently， as the core of "mixing"， they interact with blood lipids and immune cells， generating heat and phlegm to form a major pathological hub of chronic inflammation. Ultimately， this process drives the coalescence of phlegm， stasis， and turbid-toxin into tangible plaques， evolving from stable lesions to vulnerable masses and accumulations. By integrating classical pathogenic model with contemporary environmental medicine， this study establishes an analytical framework that bridges macro-theory and micro-mechanisms for understanding the cardiovascular risks of MPs through an integrative Chinese-Western medicine lens.

Objective To investigate the feasibility and safety of transoral transgastric natural orifice transluminal endoscopic surgery(TG-NOTES)cholecystectomy in miniature pigs.Methods A total of 11 miniature pigs were selected as the experimental subjects and underwent TG-NOTES cholecystectomy.These pigs were divided into the Group A and Group B according to the surgical procedures.Among them,7 miniature pigs in the Group A underwent endoscopic cholecystectomy without dissecting the gallbladder triangle,while 4 miniature pigs in the Group B underwent endoscopic cholecystectomy after dissecting the gallbladder triangle.The success rate of surgery,the time of each stage of surgery,the incidence of complications,the success rate of cholecystectomy and the survival rate of miniature pigs in the two groups were counted.One miniature pig in the Group A and 4 miniature pigs in the Group B were selected for survival experiments.After surviving for 1 week,they were killed and dissected to observe the healing of incision and incidence of complications.Results The surgical survival rate of experimental animals was 100%,and the success rate of cholecystectomy was 100%.There was no significant difference in the surgical time,time of cut the stomach into the abdomen,time of gallbladder exploration or time of gallbladder removal of miniature pigs between the two groups(P>0.05).The time of ligating gallbladder artery of miniature pigs in the Group B was longer than that in the Group A,and the time of isdating gallbladder was shorter than that in the Group A,with statistically significant differences(P<0.05).There was no significant difference in the average number of complications of miniature pigs between the two groups(P>0.05).The dissection of animals after survival experiments revealed that the incisions healed well without serious complications.Conclusion This study successfully establishes the surgical model of TG-NOTES cholecystectomy,and confirms the safety and feasibility of TG-NOTES cholecystectomy.

Objective To analyse the mediating effect of the pain beliefs on pain and fear of disease progression in patients with trigeminal neuralgia.Methods A convenience sampling method was employed to select hospitalised 220 patients with trigeminal neuralgia as research objects from 3 Grade IIIA hospitals.The selected study subjects were surveyed with a general information questionnaire,the numeric pain rating scale,pain beliefs and perceptions scale,and fear of disease progression short form.Structural equation model was used to verify the pathways that affected the pain and pain beliefs on fear of disease progression in patients with trigeminal neuralgia.Results A total of 214 patients with trigeminal neuralgia completed the survey.The mean score of fear of disease progression was 33.38±8.47,the mean score of pain was 8.25±1.44,and the mean score of pain beliefs was-2(-9,8).Spearman correlation analysis showed that fear of disease progression was positively correlated with the pain beliefs(r=0.746,P<0.01)and pain(r=0.838,P<0.01),and the pain beliefs were positively correlated with pain intensity(r=0.704,P<0.01).Pain beliefs partially mediated between the pain and fear of disease progression in patients with trigeminal neuralgia,with a mediating effect of 0.442,a direct effect of 0.482,and a total effect of 0.924.The mediating effect accounted for 47.84%of the total effect.Conclusion Patients with trigeminal neuralgia generally have a critical state of psychologicol disfunction of fear of disease progression,with a moderate to severe pain,and moderate pain beliefs.Pain intensity in patients with trigeminal neuralgia not only directly affects fear of disease progression but also indirectly affects it through pain beliefs.

Objective To design a multifunctional moxibustion device in order to prevent moxibustion treatment from pollution and skin burns and to enhance its comfort and safety.Methods The new multifunctional moxibustion device was mainly composed of a master controller,a smoke exhaust mechanism and a moxibustion oil collection mechanism.The master controller consisted of control buttons,a type LX400 lifting motor,a lifting rod,a rotating arm,a smoke exhaust pipe and a type 8025 external exhaust fan.The smoke exhaust mechanism consisted of smoke exhaust holes and a cover.The moxibustion oil collection mechanism comprised a cover of the smoke exhaust mechanism,a fixation unit and a holding tank,which had its cover made of stainless steel with baking varnish treatment.Fifty outpatients from the department of rehabilitation and physical therapy of some hospital in the past 1 year were selected and divided into a control group and an experimental group using the randomized grouping method,with 25 patients in each group.The control group was treated with the conventional moxibustion apparatus,and the experimental group was treated with the device developed.The two groups were compared in terms of patient comfort and complications.Results The two groups had significant differences in patient comfort and complications,of which,the control group had all the patients with degrees of syptoms including dizziness,coughing and sneezing and 21 ones feeling uncomfortable,and the experimental group had most of the patients with no adverse reactions and only 2 ones feeling uncomfortable(P<0.05).Conclusion The new multifunctional moxibustion device developed gains advantages in safety and practicability,which enhances patient comfort and prevents complications and thus is of great practical value.[Chinese Medical Equipment Journal,2025,46(9):118-120]

Objective This study explores the clinical correlation between different low-density lipoprotein cholesterol(LDL-C)levels and prognosis,providing evidence-based guidance for the development of personalized lipid-lowering goals.Methods Patients who underwent elective percutaneous coronary intervention(PCI)treatment at Beijing Anzhen Hospital from January 2020 to June 2023 and received lipid-lowering therapy with the addition of Evolocumab were selected.Based on the results of blood lipid rechecks 3 to 6 months after surgery,the patients were divided into five groups:low-density lipoprotein＜0.5 mmol/L,0.5 to＜1.0 mmol/L,1.0 to＜1.4 mmol/L,1.4 to＜1.8 mmol/L,and above 1.8 mmol/L.All patients were followed up for more than one year,and clinical conditions and major adverse cardiovascular events(MACE)were recorded.Results A total of 1 106 patients undergoing PCI were enrolled;after propensity score matching and exclusion of patients lost to follow up,550 remained(110 per group).During 12 months of follow-up,58 patients(10.5％)experienced a MACE,with incidence rising step-wise across LDL-C categories.In multivariable Cox models adjusted for age,sex,diabetes,hypertension,baseline LDL-C,follow-up LDL-C,estimated glomerular filtration rate(eGFR),and left ventricular ejection fraction,the hazard ratios[HR(95％CI)]for MACE,relative to the＜0.5 mmol/L group,were 1.810(0.507-6.454,P=0.361),3.036(0.945-9.749,P=0.062),5.228(1.737-15.735,P=0.003),7.708(2.633-22.565,P＜0.001)for LDL-C levels of 0.5 to＜1.0,1.0 to＜1.4,1.4 to＜1.8 and≥ 1.8 mmol/L,respectively.A restricted cubic spline model demonstrated a significant non-linear positive association between LDL-C and MACE(P-overall≤0.001;P-non-linear=0.008).Stratified analyses by age,sex,hypertension and diabetes showed consistent HR with no significant interactions(all P＞0.05).There were no statistically significant differences among the groups in the incidence of bleeding events,elevated creatinine levels,or abnormal liver function(all P＞0.05).Conclusions In patients using PCSK9 after PCI,there is a significant positive correlation between LDL-C levels and the risk of MACE,and no correlation was observed between different LDL-C levels and the risk of adverse events such as bleeding.

Objective To investigate the feasibility and safety of transoral transgastric natural orifice transluminal endoscopic surgery(TG-NOTES)cholecystectomy in miniature pigs.Methods A total of 11 miniature pigs were selected as the experimental subjects and underwent TG-NOTES cholecystectomy.These pigs were divided into the Group A and Group B according to the surgical procedures.Among them,7 miniature pigs in the Group A underwent endoscopic cholecystectomy without dissecting the gallbladder triangle,while 4 miniature pigs in the Group B underwent endoscopic cholecystectomy after dissecting the gallbladder triangle.The success rate of surgery,the time of each stage of surgery,the incidence of complications,the success rate of cholecystectomy and the survival rate of miniature pigs in the two groups were counted.One miniature pig in the Group A and 4 miniature pigs in the Group B were selected for survival experiments.After surviving for 1 week,they were killed and dissected to observe the healing of incision and incidence of complications.Results The surgical survival rate of experimental animals was 100%,and the success rate of cholecystectomy was 100%.There was no significant difference in the surgical time,time of cut the stomach into the abdomen,time of gallbladder exploration or time of gallbladder removal of miniature pigs between the two groups(P>0.05).The time of ligating gallbladder artery of miniature pigs in the Group B was longer than that in the Group A,and the time of isdating gallbladder was shorter than that in the Group A,with statistically significant differences(P<0.05).There was no significant difference in the average number of complications of miniature pigs between the two groups(P>0.05).The dissection of animals after survival experiments revealed that the incisions healed well without serious complications.Conclusion This study successfully establishes the surgical model of TG-NOTES cholecystectomy,and confirms the safety and feasibility of TG-NOTES cholecystectomy.

Objective This study explores the clinical correlation between different low-density lipoprotein cholesterol(LDL-C)levels and prognosis,providing evidence-based guidance for the development of personalized lipid-lowering goals.Methods Patients who underwent elective percutaneous coronary intervention(PCI)treatment at Beijing Anzhen Hospital from January 2020 to June 2023 and received lipid-lowering therapy with the addition of Evolocumab were selected.Based on the results of blood lipid rechecks 3 to 6 months after surgery,the patients were divided into five groups:low-density lipoprotein＜0.5 mmol/L,0.5 to＜1.0 mmol/L,1.0 to＜1.4 mmol/L,1.4 to＜1.8 mmol/L,and above 1.8 mmol/L.All patients were followed up for more than one year,and clinical conditions and major adverse cardiovascular events(MACE)were recorded.Results A total of 1 106 patients undergoing PCI were enrolled;after propensity score matching and exclusion of patients lost to follow up,550 remained(110 per group).During 12 months of follow-up,58 patients(10.5％)experienced a MACE,with incidence rising step-wise across LDL-C categories.In multivariable Cox models adjusted for age,sex,diabetes,hypertension,baseline LDL-C,follow-up LDL-C,estimated glomerular filtration rate(eGFR),and left ventricular ejection fraction,the hazard ratios[HR(95％CI)]for MACE,relative to the＜0.5 mmol/L group,were 1.810(0.507-6.454,P=0.361),3.036(0.945-9.749,P=0.062),5.228(1.737-15.735,P=0.003),7.708(2.633-22.565,P＜0.001)for LDL-C levels of 0.5 to＜1.0,1.0 to＜1.4,1.4 to＜1.8 and≥ 1.8 mmol/L,respectively.A restricted cubic spline model demonstrated a significant non-linear positive association between LDL-C and MACE(P-overall≤0.001;P-non-linear=0.008).Stratified analyses by age,sex,hypertension and diabetes showed consistent HR with no significant interactions(all P＞0.05).There were no statistically significant differences among the groups in the incidence of bleeding events,elevated creatinine levels,or abnormal liver function(all P＞0.05).Conclusions In patients using PCSK9 after PCI,there is a significant positive correlation between LDL-C levels and the risk of MACE,and no correlation was observed between different LDL-C levels and the risk of adverse events such as bleeding.

Objective To analyse the mediating effect of the pain beliefs on pain and fear of disease progression in patients with trigeminal neuralgia.Methods A convenience sampling method was employed to select hospitalised 220 patients with trigeminal neuralgia as research objects from 3 Grade IIIA hospitals.The selected study subjects were surveyed with a general information questionnaire,the numeric pain rating scale,pain beliefs and perceptions scale,and fear of disease progression short form.Structural equation model was used to verify the pathways that affected the pain and pain beliefs on fear of disease progression in patients with trigeminal neuralgia.Results A total of 214 patients with trigeminal neuralgia completed the survey.The mean score of fear of disease progression was 33.38±8.47,the mean score of pain was 8.25±1.44,and the mean score of pain beliefs was-2(-9,8).Spearman correlation analysis showed that fear of disease progression was positively correlated with the pain beliefs(r=0.746,P<0.01)and pain(r=0.838,P<0.01),and the pain beliefs were positively correlated with pain intensity(r=0.704,P<0.01).Pain beliefs partially mediated between the pain and fear of disease progression in patients with trigeminal neuralgia,with a mediating effect of 0.442,a direct effect of 0.482,and a total effect of 0.924.The mediating effect accounted for 47.84%of the total effect.Conclusion Patients with trigeminal neuralgia generally have a critical state of psychologicol disfunction of fear of disease progression,with a moderate to severe pain,and moderate pain beliefs.Pain intensity in patients with trigeminal neuralgia not only directly affects fear of disease progression but also indirectly affects it through pain beliefs.

Objective To design a multifunctional moxibustion device in order to prevent moxibustion treatment from pollution and skin burns and to enhance its comfort and safety.Methods The new multifunctional moxibustion device was mainly composed of a master controller,a smoke exhaust mechanism and a moxibustion oil collection mechanism.The master controller consisted of control buttons,a type LX400 lifting motor,a lifting rod,a rotating arm,a smoke exhaust pipe and a type 8025 external exhaust fan.The smoke exhaust mechanism consisted of smoke exhaust holes and a cover.The moxibustion oil collection mechanism comprised a cover of the smoke exhaust mechanism,a fixation unit and a holding tank,which had its cover made of stainless steel with baking varnish treatment.Fifty outpatients from the department of rehabilitation and physical therapy of some hospital in the past 1 year were selected and divided into a control group and an experimental group using the randomized grouping method,with 25 patients in each group.The control group was treated with the conventional moxibustion apparatus,and the experimental group was treated with the device developed.The two groups were compared in terms of patient comfort and complications.Results The two groups had significant differences in patient comfort and complications,of which,the control group had all the patients with degrees of syptoms including dizziness,coughing and sneezing and 21 ones feeling uncomfortable,and the experimental group had most of the patients with no adverse reactions and only 2 ones feeling uncomfortable(P<0.05).Conclusion The new multifunctional moxibustion device developed gains advantages in safety and practicability,which enhances patient comfort and prevents complications and thus is of great practical value.[Chinese Medical Equipment Journal,2025,46(9):118-120]