Objective: To investigate whether Tuina alleviates fibrotic symptoms in myofascial trigger points (MTrPs) by regulating transforming growth factor (TGF)-β1/Smad3 signaling pathway, thereby deactivating these points. Methods: This study comprised two experimental phases. In phase 1, 27 specific pathogen-free (SPF) grade female Sprague-Dawley (SD) rats were randomized into three groups: control 1, model 1, and Tuina 1 groups. Model 1 and Tuina 1 groups underwent an 8-week MTrPs modeling protocol involving blunt impact and eccentric exercise. After successful modeling, rats in Tuina 1 group received manual pressing on nodules or cord-like taut bands on the medial aspect of the left hindlimb. Pain sensitivity and tissue stiffness were evaluated via pressure pain threshold (PPT) and soft tissue tension (STT). Muscle histopathology and fibrosis were observed using hematoxylin and eosin (HE) and Masson staining. Inflammatory factors in muscle were measured by enzyme-linked immunosorbent assay (ELISA), while immunofluorescence (IF) and Western blot (WB) were used to detect the expression levels of α-smooth muscle actin (α-SMA), collagen Ⅲ, and TGF-β1. In phase 2, 45 SPF female SD rats were randomized into five groups: control 2, model 2, Tuina 2, TGF-β1 inhibitor (TI), and Tuina + TGF-β1 agonist (Tuina + TA) groups. All groups except control 2 underwent standardized MTrPs modeling. Rats in Tuina 2 group received consistent pressing manipulation. TI group received intraperitoneal injections of oxymatrine, while Tuina + TA group received intraperitoneal injections of SRI-011381 hydrochloride followed by the same pressing protocol as Tuina 2 group. WB was used to detect the expression of collagen I, collagen III, TGF-β1, and phosphorylated-Smad3 (p-Smad3)/Smad3. Results: In phase 1, Tuina significantly improved PPT and STT in MTrPs of rats (P < 0.01), reversed pathological damages including disorganized muscle fiber arrangement, abnormal myocyte morphology, and exacerbated fibrosis. In addition, in MTrPs of rats in model 1 group, expression levels of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, and fibrosis markers (α-SMA, collagen I, and collagen III) were upregulated, and all exhibited a significant downward trend after Tuina intervention (P < 0.05 or P < 0.01). This indicates that the therapeutic effects of Tuina are directly associated with reduced local inflammation and fibrosis in MTrPs. In phase 2, compared with model 2 group, rats in TI and Tuina 2 groups had decreased expression levels of TGF-β1 and p-Smad3/Smad3 in MTrPs, alongside reduced levels of inflammatory factors (IL-1β, IL-6, NF-κB, and TNF-α) and fibrosis markers (α-SMA, collagen I, and collagen III) (P < 0.05 or P < 0.01). When co-administered with TGF-β1 agonist, the therapeutic effects of Tuina were significantly attenuated, with rebounded TGF-β1 expression and p-Smad3/Smad3 in local MTrPs, and fibrosis and inflammatory responses were re-exacerbated (P < 0.05 or P < 0.01). Conclusion Tuina can effectively reduce inflammatory responses and fibrosis in MTrPs tissue, and its mechanism is closely related to the inhibition of the TGF-β1/Smad3 signaling pathway, which plays a critical role in Tuina-mediated regulation of MTrPs fibrosis.

OBJECTIVE To explore the expressions of eosinophilic chemotactic factor 11(CCL11),leukotriene B4(LTB4),percentage of neutrophils(NEUT％)and C-reactive protein(CRP)in peripheral blood of the children with Mycoplasma pneumoniae(MP)infection complicated with plastic bronchitis and analyze the clinical signifi-cance.METHODS A total of 80 children with MP pneumonia complicated with plastic bronchitis who were trea-ted in the Second Hospital of Longyan City,Fujian Province from Jan.2020 to Dec.2023 were assigned as the study group,and 115 patients with MP pneumonia were chosen as the control group.The clinical data,manifesta-tions and Pediatric Risk of Mortality Ⅲ(PRISM Ⅲ)score were statistically analyzed.The levels of peripheral blood CCL11,LTB4,NEUT％and CRP were observed and compared between the two groups.Pearson analysis was performed for the associations of the levels of CCL11,LTB4,NEUT％and CRP with the PRISM Ⅲscore.The value of the joint detection of CCL11,LTB4,NEUT％and CRP in diagnosis of the MP pneumoni-a-induced plastic bronchitis was analyzed.RESULTS There were significant differences in reduction of bronchial breathing sound,pleural effusion and PRISM Ⅲ score between the two groups(P＜0.05).There were significant differences in the levels of peripheral blood CCL11,LTB4,NEUT％and CRP between the study group and the control group(P＜0.05);the CRP level of the study group was(29.42±8.14)mg/L,higher than that of the control group(t=10.138,P＜0.001).The levels of CCL11,LTB4,NEUT％and CRP were positively correlated with the PRISM Ⅲ score(r=0.723,0.710,0.771,0.754,respectively,all P＜0.001).The area under the curve(AUC)of the single detection of CCL11,LTB4,NEUT％and CRP was remarkably higher in diagnosis of MP pneumonia-induced plastic bronchitis than that of the joint detection of the four markers(P＜0.05).CONCLUSIONS The children with MP pneumonia complicated with plastic bronchitis show increased expressions of CCL11,LTB4,NEUT％and CRP.The four markers are positively correlated with the PRISM Ⅲ score.The four markers have high values in diagnosis of the MP pneumonia complicated with plastic bronchitis.

Objective:To investigate the clinical efficacy of hair follicle-bearing microskin transplantation as a novel therapeutic approach for subacute wounds.Methods:A prospective randomized controlled trial was conducted from June to October 2024, involving patients with subacute wounds treated in the Department of Plastic and Reconstructive Surgery, Hand Microsurgery at Ningbo No.6 Hospital, and the Medical Aesthetics Center at Hangzhou First People’s Hospital. Participants were randomly assigned via a random number table into two groups: the observation group received hair follicle-bearing microskin transplantation, while the control group received conventional treatment including debridement, dressing changes, antimicrobial therapy, and local pressure relief. The observation endpoint was set at 6 weeks post-treatment. Outcome measures included time to complete wound healing, wound healing score (comprising five items: wound area, appearance, exudate, signs of infection, and condition of surrounding skin; total score 0-15, with a higher score indicating poorer healing), donor site recovery, adverse reactions, and patient satisfaction [rated on a 4-level scale: very satisfied, satisfied, basically satisfied, dissatisfied; satisfaction rate was calculated as (very satisfied + satisfied) cases/total cases×100%]. Data were analyzed using SPSS 25.0 software, with continuous variables expressed as Mean±SD and compared via t-test; enumeration data were expressed as cases (relative numbers) and analyzed using Fisher’s exact test. P<0.05 was considered statistically significant. Results:Sixteen patients were enrolled (8 per group), including 12 males and 4 females, with a mean age of 46 years (range: 41-71). No significant differences in baseline characteristics (gender, age, wound duration, and wound area) were observed between the two groups (all P>0.05). All procedures in the observation group were completed successfully without intraoperative or short-term postoperative complications. The donor site area was (28.2±11.8) cm 2 (9.0-50.0 cm 2). All wounds in the observation group healed completely within 2-5 weeks post-treatment, with a mean healing time of (26.2±5.0) d. The donor sites healed within two weeks, leaving only pinpoint scars. In contrast, only 4 cases in the control group achieved complete healing within the observation period (6 weeks post-treatment), with a mean healing time of (33.2±5.7) d. The other 4 patients showed no tendency to heal at 6 weeks and progressed to chronic wounds. Before treatment, no significant difference in wound healing scores was found between the two groups (9.6±2.6 vs. 9.1±2.0, t=0.43, P=0.676). At 6 weeks post-treatment, the observation group showed significantly lower wound healing scores than the control group (1.2±1.5 vs. 7.9±3.9, t=-4.48, P=0.001). At 6 weeks post-treatment, patient satisfaction in the observation group was significantly higher than that in the control group (8/8 vs. 4/8, P=0.006). Conclusion:Hair follicle-bearing microskin transplantation demonstrates significant clinical advantages in treating subacute wounds, including accelerated healing, improved aesthetic outcomes, minimal donor site morbidity, and rapid recovery.

OBJECTIVE To provide help for further exploring the mechanism of action of traditional Chinese herb by constructing a complex network of traditional Chinese herb-gene-protein,optimizing the mining method of potential associated genes of traditional Chinese herb and improving the mining efficiency of traditional Chinese herb system biology information.METHODS A graph neural network model HERBGAT with an attention mechanism was proposed.A small amount of traditional Chinese herb-related gene data in the public data platform was used as input,and deep mining was performed in the traditional Chinese herb-gene-protein complex net-work to output potential traditional Chinese herb-related genes.The prediction results were analyzed by disease association analysis and KEGG signaling pathway analysis on the bioinformatics platform to clarify their mechanism of action,and the prediction results were verified by the literature retrieval platform.RESULTS The training results showed that the average prediction accuracy of the HERB-GAT model could reach 94%.Compared with the other two advanced complex network mining methods,HERBGAT showed better per-formance in the three indicators of ACC,AUC and AUPR.In the literature verification stage,the model prediction results were verified by TCM clinical literature and modern pharmacology literature,showing the good effect of HERBGAT in practical application.At the end of this paper,taking the HERBGAT model and the improved EMOGI model to explore the mechanism of action of Pinellia ternata in treating lung cancer as an example,199 potential associated genes of Pinellia ternata in treating lung cancer were found,and these potential associated genes were preliminarily analyzed and discussed with the help of bioinformatics methods.CONCLUSION The HERBGAT model can effectively mine potential traditional Chinese herb-associated genes,improve the mining efficiency of traditional Chinese herb-gene-protein complex networks,provide new ideas and references for the optimization of traditional Chinese herb system biology information mining methods,and provide data basis and experimental direction for exploring the mechanism of action of tradi-tional Chinese herb.

OBJECTIVE To explore the expressions of eosinophilic chemotactic factor 11(CCL11),leukotriene B4(LTB4),percentage of neutrophils(NEUT％)and C-reactive protein(CRP)in peripheral blood of the children with Mycoplasma pneumoniae(MP)infection complicated with plastic bronchitis and analyze the clinical signifi-cance.METHODS A total of 80 children with MP pneumonia complicated with plastic bronchitis who were trea-ted in the Second Hospital of Longyan City,Fujian Province from Jan.2020 to Dec.2023 were assigned as the study group,and 115 patients with MP pneumonia were chosen as the control group.The clinical data,manifesta-tions and Pediatric Risk of Mortality Ⅲ(PRISM Ⅲ)score were statistically analyzed.The levels of peripheral blood CCL11,LTB4,NEUT％and CRP were observed and compared between the two groups.Pearson analysis was performed for the associations of the levels of CCL11,LTB4,NEUT％and CRP with the PRISM Ⅲscore.The value of the joint detection of CCL11,LTB4,NEUT％and CRP in diagnosis of the MP pneumoni-a-induced plastic bronchitis was analyzed.RESULTS There were significant differences in reduction of bronchial breathing sound,pleural effusion and PRISM Ⅲ score between the two groups(P＜0.05).There were significant differences in the levels of peripheral blood CCL11,LTB4,NEUT％and CRP between the study group and the control group(P＜0.05);the CRP level of the study group was(29.42±8.14)mg/L,higher than that of the control group(t=10.138,P＜0.001).The levels of CCL11,LTB4,NEUT％and CRP were positively correlated with the PRISM Ⅲ score(r=0.723,0.710,0.771,0.754,respectively,all P＜0.001).The area under the curve(AUC)of the single detection of CCL11,LTB4,NEUT％and CRP was remarkably higher in diagnosis of MP pneumonia-induced plastic bronchitis than that of the joint detection of the four markers(P＜0.05).CONCLUSIONS The children with MP pneumonia complicated with plastic bronchitis show increased expressions of CCL11,LTB4,NEUT％and CRP.The four markers are positively correlated with the PRISM Ⅲ score.The four markers have high values in diagnosis of the MP pneumonia complicated with plastic bronchitis.

Objective To explore the risk factors of the stone-free rate after flexible ureteroscopy for lower pole calculi,develop a predictive model based on these identified factors,with subsequent validation and evalua-tion of the established model.Methods A retrospective analysis was conducted on 154 patients with lower pole renal calculi who underwent flexible ureteroscopy(FURS)at Guangdong Provincial Hospital of Traditional Chinese Medicine from 2020 to 2024.Based on postoperative stone clearance status,patients were categorized into a stone-free group and a residual stone group.Univariate analysis was performed to screen potential risk factors,while Pear-son correlation coefficients and variance inflation factor(VIF)were employed to assess multicollinearity,retaining the indicator with the highest area under the curve(AUC).Independent predictors were identified through multi-variate logistic regression analysis,and a nomogram model was constructed.Internal validation was conducd using the bootstrap resampling method.The predictive performance and clinical utility of the model were evaluated using receiver operating characteristic(ROC)curves and decision curve analysis(DCA).Results Univariate analysis demonstrated that largest stone diameter(LSD),cumulative stone diameter(CSD),stone volume(SV),stone surface area(SA),mean stone density(MSDE),and infundibular pelvic angle(IPA)were significantly associated with stone-free rate(SFR)following flexible ureteroscopy(FURS)for lower pole calculi(all P<0.05).After collinearity diagnostics,LSD(area under the curve[AUC]=0.724)was retained as the optimal stone burden parameter.Multivariate logistic regression analysis confirmed LSD,MSDE,and IPA as independent predictors of postoperative SFR.The nomogram model exhibited robust predictive performance with an AUC of 0.786(sensitivity:79.6%,specificity:71.0%).Internal validation via 1000 bootstrap resamples yielded an AUC of 0.792,and deci-sion curve analysis(DCA)confirmed clinical utility with net benefit across threshold probabilities of 4%—75%.Conclusions The nomogram model developed in this study,which incorporates both stone characteristics and renal anatomical parameters,demonstrates effective prediction of stone-free rate(SFR)following flexible ureteros-copy for lower pole calyceal stones.With stable predictive performance and high clinical applicability,this model provides a reliable tool for preoperative personalized decision-making in endourological management.

OBJECTIVE To provide help for further exploring the mechanism of action of traditional Chinese herb by constructing a complex network of traditional Chinese herb-gene-protein,optimizing the mining method of potential associated genes of traditional Chinese herb and improving the mining efficiency of traditional Chinese herb system biology information.METHODS A graph neural network model HERBGAT with an attention mechanism was proposed.A small amount of traditional Chinese herb-related gene data in the public data platform was used as input,and deep mining was performed in the traditional Chinese herb-gene-protein complex net-work to output potential traditional Chinese herb-related genes.The prediction results were analyzed by disease association analysis and KEGG signaling pathway analysis on the bioinformatics platform to clarify their mechanism of action,and the prediction results were verified by the literature retrieval platform.RESULTS The training results showed that the average prediction accuracy of the HERB-GAT model could reach 94%.Compared with the other two advanced complex network mining methods,HERBGAT showed better per-formance in the three indicators of ACC,AUC and AUPR.In the literature verification stage,the model prediction results were verified by TCM clinical literature and modern pharmacology literature,showing the good effect of HERBGAT in practical application.At the end of this paper,taking the HERBGAT model and the improved EMOGI model to explore the mechanism of action of Pinellia ternata in treating lung cancer as an example,199 potential associated genes of Pinellia ternata in treating lung cancer were found,and these potential associated genes were preliminarily analyzed and discussed with the help of bioinformatics methods.CONCLUSION The HERBGAT model can effectively mine potential traditional Chinese herb-associated genes,improve the mining efficiency of traditional Chinese herb-gene-protein complex networks,provide new ideas and references for the optimization of traditional Chinese herb system biology information mining methods,and provide data basis and experimental direction for exploring the mechanism of action of tradi-tional Chinese herb.

Objective To investigate the diagnostic value of peripheral blood lymphocyte subsets,interleu-kin-6(IL-6)and procalcitonin(PCT)levels for postoperative recurrence of gastric cancer.Methods A total of 206 patients with gastric cancer who have undergone radical operation from April 2021 to May 2023 in the Huangshi Central Hospital(Affiliated Hospital of Hubei Polytechnic University)were selected as the study subjects.The patients were divided into recurrent group(58 cases)and non-recurrent group(148 cases)ac-cording to whether they had recurrence or not.Venous blood samples were drawn from the recurrent group and the non-recurrent group,and the flow cytometry was used to measure peripheral blood T-cell subsets,nat-ural killer cells,and B cells,while the circulating enhanced fluorescence immunoluminescence method was em-ployed to detect peripheral blood IL-6 and PCT levels.The expression of various indicators was compared in the two groups,and the receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of peripheral blood lymphocyte subsets,as well as IL-6 and PCT levels,for postoperative recurrence of gastric cancer.Results There were no statistically significant differences in CD3+,CD3+CD8+,CD3+CD4+,CD4+/CD8+between recurrent group and non-recurrent group(P>0.05).The levels of CD3-CD19+,CD3-CD56+,IL-6,PCT in recurrent group were higher than those in non-recurrent group(P<0.05).The area un-der the curve(AUC)of CD3-CD19+,CD3-CD56+,IL-6,and PCT for diagnosing postoperative recurrence of gastric cancer was 0.656,0.682,0.888,and 0.868,respectively.The AUC of the combination of these four markers for diagnosing postoperative recurrence of gastric cancer was 0.919,which was superior to each indi-vidual marker(P<0.05).Conclusion Peripheral blood lymphocyte subsets,as well as levels of IL-6 and PCT,are closely associated with postoperative recurrence in patients with gastric cancer.Combined detection has a higher efficacy in diagnosing postoperative recurrence in gastric cancer patients.

Objective:To discuss the relationship between the systolic blood pressure (SBP) circadian rhythm and blood pressure variability (BPV) and the left ventricular ejection fraction (LVEF) among 178 patients with hypertension.Methods:This article was a retrospective study. Totally 178 patients with hypertension from January 2020 to January 2022 were selected based on incorporated basis. 24-hour dynamic blood pressure monitoring and echocardiography examination were performed. Data such as patients' SBP circadian rhythm, BPV, heart ultrasound heart dynamic maps were collected, and the relationship between SBP circadian rhythm and BPV and their LVEF was explored.Results:Among the 178 patients, the decreased proportion of SBP circadian rhythm>the proportion of existed SBP circadian rhythm>the proportion of inverted SBP circadian rhythm>the proportion of disappearance of SBP circadian rhythm; patients with disappearance of SBP circadian rhythm were the youngest (63.8 ± 14.5) years old, and patients with inverted SBP circadian rhythm were the oldest (71.5 ± 9.4) years old ( P<0.05); the 24-hour systolic blood pressure standard deviation of SBP circadian rhythm was observed in patients with (13.1 ± 2.8) mmHg

Blood-bi-syndrome is primarily characterized by localized numbness and mild pain in the limbs.Records about the diagnosis and treatment of blood-bi-syndrome are scattered throughout classical medical literature.According to the theory of Yindan and Yangdan formulas in the classical prescription system,when the body's ascending function of qi movement is insufficiency,Yangdan formulas which contain Astragali Radix can be used for warming and uplifting yang qi.Conversely,when the descending function of qi movement is insufficiency,Yindan formulas which contain containing Bupleuri Radix can be used for astringing,descending,clearing and purging.This article,based on the principles of Yindan and Yangdan formulas,analyzed the fundamental pathogenesis of blood-bi-syndrome developing from the transmission of superficial syndromes,as well as its clinical manifestations during the transmission and change between taiyin disease and yangming disease.And the therapeutic strategies for blood-bi-syndrome were also summarized.It is proposed that taiyin blood-bi-syndrome arises in individuals with constitutionally deficient cold after the attack of pathogenic factors,resulting from fluid depletion,blood insufficiency,and stomach deficiency,which should be treated by Yangdan Formulas with pungent-sweet-warm properties for warming and uplifting yang qi.For the treatment of patients with taiyin blood-bi-syndrome characterized by exterior syndrome,Astragali Radix-containing classical prescriptions like Astragali Radix and Cinnamomi Ramulus Five-Component Decoction(Huangqi Guizhi Wuwu Decoction)can be chosen;for the treatment of patients with taiyin blood-bi-syndrome characterized by interior syndrome,Zingiberis Rhizoma Recens-containing classical prescriptions like Citri Reticulatae Pericarpium and Bambusae Caulis in Taenia Decoction(Jupi Zhuru Decoction)is adopted.Conversely,yangming blood-bi-syndrome occurs in individuals with constitutionally excessive heat after the attack of pathogenic factors,resulting from the internal accumulation of blood stasis and heat and the impairment of the fluid and blood,which should be treated by Yindan Formulas with pungent-sweet-cold or sour-cold properties for astringing,descending,clearing and purging.For the treatment of patients with yangming blood-bi-syndrome characterized by exterior syndrome,Puerariae Lobatae Radix-containing classical prescriptions like Phyllostachydis Henonis Folium and Puerariae Lobatae Radix Decoction(Zhuye Gegen Decoction)can be used;for the treatment of patients with yangming blood-bi-syndrome characterized by interior syndrome,Paeoniae Radix Alba-containing classical prescriptions like Rhei Radix et Rhizoma and Eupolyphaga seu Steleophaga Decoction(Dahuang Zhechong Wan)is recommended.