Chaihu Guizhi Ganjiangtang was first recorded in the Treatise on Cold Damage （Shang Han Lun）. This prescription is composed of Bupleuri Radix， Scutellariae Radix， Cinnamomi Ramulus， Zingiberis Rhizoma， Trichosanthis Radix， Ostreae Concha， and Glycyrrhizae Radix et Rhizoma. It has the effects of soothing Lesser Yang， warming the spleen， and stimulating the generation of body fluid. It is mainly used to treat digestive tract diseases such as chronic cholecystitis （CC）， irritable bowel syndrome， and non-alcoholic fatty liver disease. Dyspepsia caused by CC presents a variety of gastrointestinal symptoms such as abdominal pain， poor appetite， postprandial fullness， aversion to greasy food， soft stool， and bitter mouth， being a type of biliary dyspepsia. In modern medicine， dyspepsia caused by CC is mainly managed by medical treatment and surgical treatment. Internal medicine mainly focuses on reducing inflammation， promoting the function of gallbladder， resolving stones， alleviating spasms， and relieving the pain for CC， demonstrating definite short-term efficacy but suffering from single effects， high recurrence rate， and poor compliance. Although surgical treatment can cure cholecystitis， it is accompanied by the increased incidence of adverse events such as abdominal pain， diarrhea， and dyspepsia. Modern clinical studies have confirmed that Chaihu Guizhi Ganjiangtang can significantly alleviate the symptoms such as abdominal pain and dyspepsia of CC patients. Pharmacological studies have found that Chaihu Guizhi Ganjiangtang mainly contains active ingredients such as Bupleuri Radix saponins， baicalin， cinnamaldehyde， gingerol， Trichosanthis Radix polysaccharide， Ostreae Concha polysaccharide， and Glycyrrhizae Radix et Rhizoma total flavonoids. Chaihu Guizhi Ganjiangtang can ameliorate the symptoms of dyspepsia caused by CC by inhibiting inflammatory responses， improving gallbladder contraction and gastrointestinal motility， regulating the bile acid-intestinal flora axis and the brain-gut axis， and modulating blood lipids through multiple targets. By reviewing the previous literature， this article summarizes the research progress in the treatment of dyspepsia caused by CC with Chaihu Guizhi Ganjiangtang and its main active ingredients as well as the pathogenesis of this disease and puts forward the shortcomings and improvement strategies for the current research. The review aims to provide a reference for the further research on Chaihu Guizhi Ganjiangtang in the treatment of dyspepsia caused by CC.

ObjectiveTo investigate the feasibility， safety， and efficacy of surgery-assisted transjugular intrahepatic portosystemic shunt （SA-TIPS） in the treatment of portal hypertension comorbid with complex portal vein thrombosis， including cavernous transformation of the portal vein （CTPV）. MethodsAn analysis was performed for the data of 36 patients with portal hypertension and complex portal vein thrombosis who underwent SA-TIPS in Beijing Shijitan Hospital， Capital Medical University， from November 2023 to January 2025， including general status， technical data of the surgical process （surgical success rate， puncture times， time of operation， the number of stents used， and the length of shunt）， perioperative complications， and surgical recovery. The change in portal pressure gradient （PPG） after shunt was compared， and the rate of reaching the standard for PPG reduction was calculated， as well as stent patency rate within 1 week after surgery. The paired samples t-test was used for comparison of continuous data between two groups. ResultsAmong the 36 patients， 34 （94.4%） underwent SA-TIPS successfully. The incidence rate of perioperative complications was 16.7% （6/36）， including 3 cases of thoraco-abdominal hemorrhage， 2 cases of intraoperative arrhythmia， and 1 case of incision infection. There was a significant reduction in PPG after SA-TIPS （t=19.85， P<0.01）， and the patients achieving a ≥50% reduction in PPG accounted for 76.5% （26/34）. Imaging reexamination within 1 week showed a shunt patency rate of 100%. ConclusionSA-TIPS has a high technical success rate， a favorable safety profile， and good efficacy in the treatment of portal hypertension comorbid with complex portal vein thrombosis （including CTPV）， and therefore， it holds promise for clinical application.

Rosai-Dorfman disease（RDD），also known as sinus histiocytosis with massive lymphadenopathy，rarely involves the urinary system. This article reports a case of a 63-year-old male patient who initially presented with lesions in the nasopharynx that later involved the thoracic spinal canal and the foramen magnum region. He was admitted to the hospital due to a pelvic space-occupying lesion. The patient had symptoms of urinary system obstruction，and imaging examinations showed right hydronephrosis and other findings，without typical lymphadenopathy. The pelvic mass was resected surgically，and the postoperative pathology confirmed the diagnosis of Rosai-Dorfman disease. During the 6-month postoperative follow-up，no urinary symptoms were observed.

Objective To investigate the effectiveness and safety of drug-eluting beads bronchial arterial chemoembolization(DEB-BACE)versus BACE for the treatment of stage Ⅲ-Ⅳ lung squamous cell carcinoma.Methods A total of 104 patients with stage Ⅲ-Ⅳ lung squamous cell carcinoma,who were admitted to the Lishui Municipal Central Hospital of China between January 2013 and August 2021,were enrolled in this study.According to the therapeutic scheme,the patients were divided into DEB-BACE group(n=41)and BACE group(n=63).For patients of DEB-BACE group,Cisplatin at 75 mg/m2 dose and gemcitabine at 1 000 mg/m2 dose(400 mg was used as loaded-drug dose)were injected through a microcatheter,which was followed by embolization with CalliSpheres microspheres loaded with 400 mg of gemcitabine.For patients of BACE group,Cisplatin at 75 mg/m2 and gemcitabatin at 1 000 mg/m2 were injected through a microcatheter,which was followed by arterial embolization with blank microspheres.Three weeks after DEB-BACE or BACE,the patients of both groups were started on intravenous chemotherapy.The primary study endpoint was overall survival(OS).The secondary study endpoints included progression-free survival(PFS),objective response rate(ORR),disease control rate(DCR),adverse reactions,and the remission rate of dyspnea.Results Of the 104 patients,63 received BACE sequential intravenous chemotherapy and 41 received DEB-BACE sequential intravenous chemotherapy.The median OS in DEB-BACE group was 23.0 moths,which was obviously longer than 12.0 months in BACE group(P=0.009).Multivariate Cox regression analysis showed that DEB-BACE treatment was an independent risk factor for OS(HR=0.59,95％ CI:0.38-0.91,Log-rank test P=0.018).Meanwhile,the remission rate of dyspnea in DEB-BACE group was significantly higher than that in BACE group(57.1％ vs 30.6％,P＜0.043).Conclusion Compared with BACE sequential intravenous chemotherapy,DEB-BACE sequential intravenous chemotherapy can significantly prolong the survival time of patients with stage Ⅲ-Ⅳ lung squamous cell carcinoma and significantly improve the symptoms of dyspnea,which has important applications in the treatment of patients with advanced lung squamous cell carcinoma.

Objective To investigate the clinical value of sarcopenia in predicting the efficacy of bronchial artery chemoembolization(BACE)in patients with lung cancer.Methods The clinical data of 160 patients with lung cancer,who received BACE treatment at the Lishui Municipal Central Hospital of China from December 2012 to August 2021,were retrospectively analyzed.Using CT images to measure and calculate the skeletal muscle index(SMI)at the 4th thoracic vertebra(T4)level,patients with T4-SMI below the gender specific quartile were classified in sarcopenia group(n=40),and patients with T4-SMI above the threshold were classified in non-sarcopenia group(n=120).Kaplan-Meier method was used to compare the differences in progression-free survival(PFS)and overall survival(OS)between the two groups after BACE treatment,and Cox regression analysis was used to determine the risk factors affecting prognosis.Results In the non-sarcopenia group and the sarcopenia group,the median PFS was 5.6 months and 3.0 months respectively(x2=5.141,P=0.023),and the postoperative 14-month PFS rates were 16.7％and 5.0％respectively.There was no statistically significant difference in OS between the two groups(P＞0.05).Cox multivariate analysis showed that sarcopenia(HR=1.557,95％CI=1.083-2.238,P=0.017)was an independent risk factor for postoperative PFS after BACE.Conclusion Sarcopenia is an independent risk factor affecting the efficacy of BACE in patients with lung cancer,and sarcopenia can be used as a predictive indicator for the postoperative efficacy of BACE.

Objective To discuss the application of enhanced MRI-based radiomics nomogram in predicting the efficacy of initial transcatheter arterial chemoembolization(TACE)in patients with intermediate to advanced hepatocellular carcinoma(HCC).Methods A total of 195 patients with advanced HCC(CNLC Ⅱ b-Ⅲb),who received initial TACE at the Affiliated Fifth Hospital of Wenzhou Medical University(Center 1)from January 2019 to March 2024,at the Lishui Municipal People's Hospital(Center 2)from July 2021 to June 2023,and at the Rui'an Municipal People's Hospital(Center 3)from January 2022 to January 2024,were enrolled in this study.A total of 134 patients from Center 1 were randomly divided into a training set(n=94)and an internal validation set(n=40)at a 7∶3 ratio;and other 61 patients from Center 2 and Center 3 were selected as the external validation set.Based on the modified Response Evaluation Criteria in Solid Tumors(mRECIST)criteria,the early efficacy of the initial TACE procedure was evaluated.The patients were divided into an effective group and an ineffective group.The tumor contours were delineated on the arterial,portal,and equilibrium phase images of enhanced MRI,and the corresponding radiomics features were extracted.Based on reduced-dimensional features,the Logistic regression,support vector machine,lightweight gradient boosting machine,and multi-layer perceptron models were established.Univariate analysis and multivariate logistic regression analysis were used to screen independent predictive factors,and a nomogram was established in conjunction with the optimal radiomics score.The area under the receiver operating characteristic curve(AUC)was used to evaluate the performance of the model,and decision curve analysis was adopted to calculate the net benefits.Results After screening,9 key radiomics features were obtained.The lightweight gradient boosting machine model showed good prediction performance.The AUCs of the training set,internal validation set,and external validation set were 0.909,0.836 and 0.783 respectively,which was selected as the optimal radiomics model.The nomogram constructed based on AFP level,peritumoral enhancement,and optimal radiomics score could further improve its performance,with AUC values of 0.962,0.890 and 0.821 in the training set,internal validation set,and external validation set respectively.Decision curve analysis showed that this model could bring higher net benefits to patients.Conclusion The nomogram constructed based on the enhanced MRI-based radiomics combined with AFP level and peritumoral enhancement can effectively predict the efficacy of the initial TACE in patients with intermediate to advanced HCC.

Oral submucous fibrosis (OSF), characterized by excessive deposition of extracellular matrix (ECM) that causes oral mucosal tissue sclerosis, and even cancer transformation, is a chronic, progressive fibrosis disease. However, despite some advancements in recent years, no targeted antifibrotic strategies for OSF have been approved; likely because the complicated mechanisms that initiate and drive fibrosis remain to be determined. In this review, we briefly introduce the epidemiology and etiology of OSF. Then, we highlight how cell-intrinsic changes in significant structural cells can drive fibrotic response by regulating biological behaviors, secretion function, and activation of ECM-producing myofibroblasts. In addition, we also discuss the role of innate and adaptive immune cells and how they contribute to the pathogenesis of OSF. Finally, we summarize strategies to interrupt key mechanisms that cause OSF, including modulation of the ECM, inhibition of inflammation, improvement of vascular disturbance. This review will provide potential routes for developing novel anti-OSF therapeutics.
Humans ; Oral Submucous Fibrosis/immunology* ; Extracellular Matrix/metabolism* ; Myofibroblasts

AIM: To analyze the recovery of stereopsis and its influencing factors in children with intermittent exotropia(IXT)after binocular vision training.METHODS: A total of 166 cases of IXT children who were treated in our hospital from October 2021 to October 2023(2 cases lost their follow-up, and 164 cases were finally included)were included as the research object, taking 36 cases with no stereopsis after binocular vision training in eye position correction surgery as no stereopsis group, and other 128 cases as stereopsis group. All the children underwent eye position correction surgery under general anesthesia, and all received binocular vision training for 6 mo after surgery. The recovery of stereoscopic vision of IXT children after binocular vision training was counted, and the influencing factors of stereoscopic vision recovery of IXT children after binocular vision training were analyzed by single factor and multi-factor Logistic regression analysis.RESULTS: The incidence of postoperative no stereopsis was 22.0%. The proportion of children with an age ≥9 years old, course of disease ≥1 a and anisometropia in the group without stereoscopic vision after operation was larger than the group with stereoscopic vision(all P<0.05). Multivariate Logistic regression analysis showed that the course of disease ≥1 a, age ≥9 years old and anisometropia were independent influencing factors for the recovery of stereoscopic vision in IXT children after binocular vision training(OR=1.470, 1.626, 1.539, all P<0.05).CONCLUSION: Age ≥9 years old, course of disease ≥1 a, and anisometropia are the independent influencing factors of stereopsis recovery of IXT children after binocular vision training. Therefore, targeted intervention measures can be given to high-risk children to improve the stereopsis recovery of IXT children after binocular vision training.

Background and Aims:Complex biliary stones are often accompanied by hilar adhesions,distorted anatomy,biliary variations,or biliary-enteric fistulas.Conventional laparoscopic surgery is limited in such settings,with high conversion and complication rates.Robotic surgical systems provide high-definition 3D vision and enhanced dexterity,potentially improving surgical outcomes.This study compared the clinical efficacy of robotic vs.laparoscopic surgery for complex biliary stones.Methods:A retrospective analysis was performed on 145 patients with complex biliary stones who underwent minimally invasive surgery at Fujian Provincial Hospital,Fuzhou University,from January 2023 to January 2025.Patients were divided into a robotic group(n=62)and a laparoscopic group(n=83).Intraoperative outcomes,postoperative complications,and recovery parameters were compared.Stone recurrence was assessed during follow-up.Results:Baseline characteristics were comparable between groups(all P＞0.05).The conversion rate was 0 in the robotic group vs.7.2％in the laparoscopic group(P=0.038).The postoperative complication rate was significantly lower in the robotic group(1.6％vs.10.7％,P=0.044).Time to first oral intake,first flatus,and postoperative hospital stay were all shorter in the robotic group(all P＜0.05).No stone recurrence was observed in either group during follow-up until June 2025.Conclusion:Robotic surgery is a safe and feasible approach for complex biliary stones,offering reduced conversion and complication rates and faster recovery compared with laparoscopy.It holds promise for wider clinical application in complex biliary disease.

Objective Exploring the behavioral changes induced by quinpirole in obsessive-compulsive disorder(OCD)mouse,investigating the activation of neurons in different brain regions,and identifying differentially expressed genes(DEGs)and enriched biological pathways through transcriptome sequencing technology to elucidate the pathogenesis of OCD.Methods Randomly assign 32 male C57BL/6J mice,aged two months,to an OCD group and a control group(n=16).Administering quinpirole(0.75 mg/kg)via subcutaneous injection to the OCD group mice every other day for a total of 19 injections,while the control group mice received an equivalent volume of saline solution.Following the completion of the model construction,open field testing,elevated plus maze testing,and marble burying tests were conducted.After the completion of behavioral studies,tissue samples were collected.Neuronal damage was assessed using Nissl staining,while the expression of c-Fos and Iba1 proteins was examined through immunofluorescence staining.Transcriptome sequencing technology was utilized to screen for differentially expressed genes and to enrich relevant signaling pathways.The expression of inflammatory cytokines,including TNF-α,NF-κB p65,phosphorylated NF-κB p65(p-NF-κB p65),and IL-6,was detected using Western Blot analysis.Results Mouse induced with OCD by quinpirole exhibit anxiety-like behaviors and compulsive-like behaviors.Neurons in the hippocampal and hypothalamic regions exhibit signs of damage.The expression of c-Fos and Iba1 proteins is increased in the cortex,striatum,hypothalamus,and other brain regions.Western Blot result indicate a significant increase in the expression of pro-inflammatory cytokines such as TNF-α,p-NF-κB p65,and IL-6.Conclusions In OCD mouse,neurons in multiple brain regions are abnormally activated,microglia exhibit dysfunction,and neuroinflammation induced by the activation of the NF-κB signaling pathway accompanies the development of OCD.