Chronic obstructive pulmonary disease （COPD） is a common disease with a high incidence and mortality rate in the world. It is characterized by chronic inflammation and structural obstruction and is not completely reversible which will lead to shortness of breath caused by air retention and physical exertion. Traditional Chinese medicine proposes the concept of "lung collaterals"， which refers to the collateral vessels scattered throughout the lungs and lung system. The lung collaterals include the pulse collaterals and Qi collaterals. The blood circulation in the pulse collaterals belongs to Yin， distributed internally along the way. The Qi circulation in the Qi collateral belongs to Yang and is distributed externally. In western medicine， the pulse collaterals have an identity with large， medium， and small blood vessels， microvessels， and especially microcirculation. The Qi collateral encompasses systems such as the nervous， endocrine， and immune system. Pulmonary microvascular endothelial cells （HPMECs） are an important component of the pulmonary microvascular endothelium. Recent studies have found that HPMECs are the main damaged cells in the pathogenesis of COPD， mediating the occurrence and development of COPD. Traditional Chinese medicine can regulate HPMECs to treat COPD through multiple components， targets， and pathways， and has the advantage of reducing western medicine resistance and many side effects. Based on the "lung collateral theory"， this paper focused on HPMECs， and elaborated on the new connotation of traditional Chinese medicine in protecting HPMECs to treat COPD， aiming to provide new insights for the clinical treatment of COPD by protecting HPMECs.

Chronic obstructive pulmonary disease （COPD） is a common disease with a high incidence and mortality rate in the world. It is characterized by chronic inflammation and structural obstruction and is not completely reversible which will lead to shortness of breath caused by air retention and physical exertion. Traditional Chinese medicine proposes the concept of "lung collaterals"， which refers to the collateral vessels scattered throughout the lungs and lung system. The lung collaterals include the pulse collaterals and Qi collaterals. The blood circulation in the pulse collaterals belongs to Yin， distributed internally along the way. The Qi circulation in the Qi collateral belongs to Yang and is distributed externally. In western medicine， the pulse collaterals have an identity with large， medium， and small blood vessels， microvessels， and especially microcirculation. The Qi collateral encompasses systems such as the nervous， endocrine， and immune system. Pulmonary microvascular endothelial cells （HPMECs） are an important component of the pulmonary microvascular endothelium. Recent studies have found that HPMECs are the main damaged cells in the pathogenesis of COPD， mediating the occurrence and development of COPD. Traditional Chinese medicine can regulate HPMECs to treat COPD through multiple components， targets， and pathways， and has the advantage of reducing western medicine resistance and many side effects. Based on the "lung collateral theory"， this paper focused on HPMECs， and elaborated on the new connotation of traditional Chinese medicine in protecting HPMECs to treat COPD， aiming to provide new insights for the clinical treatment of COPD by protecting HPMECs.

ObjectiveBy exploring the influencing factors of readmission in patients with stable angina of coronary heart disease （CHD） based on real-world clinical data， to establish a risk prediction model of integrated traditional Chinese and western medicine， in order to provide a basis for early identification of high-risk populations and reducing readmission rates. MethodsA prospective clinical study was conducted involving patients with stable angina pectoris of CHD， who were divided into a training set and a validation set at a 7∶3 ratio. General information， traditional Chinese medicine （TCM）-related data， and laboratory test results were uniformly collected. After a one-year follow-up， patients were classified into a readmission group and a non-readmission group based on whether they were readmitted. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for readmission. A risk prediction model of integrated traditional Chinese and western medicine was constructed and visualized using a nomogram. The model was validated and evaluated in terms of discrimination， calibration， and clinical decision curve analysis. ResultsA total of 682 patients were included， with 477 in the training set and 205 in the validation set， among whom 89 patients were readmitted. Multivariate logistic regression analysis identified heart failure history ［OR = 6.93， 95% CI （1.58， 30.45）］， wiry pulse ［OR = 2.58， 95% CI （1.42， 4.72）］， weak pulse ［OR = 3.97， 95% CI （2.06， 7.67）］， teeth-marked tongue ［OR = 4.38， 95% CI （2.32， 8.27）］， blood stasis constitution ［OR = 2.17， 95% CI （1.06， 4.44）］， phlegm-stasis mutual syndrome ［OR = 3.64， 95% CI （1.87， 7.09）］， and elevated non-high-density lipoprotein cholesterol ［OR = 1.30， 95% CI （1.01， 1.69）］ as influencing factors of readmission. These factors were used as predictors to construct a nomogram-based risk prediction model for readmission in patients with stable angina. The model demonstrated moderate predictive capability， with an area under the receiver operating characteristic curve （AUC） of 0.818 ［95% CI （0.781， 0.852）］ in the training set and 0.816 ［95% CI （0.779， 0.850）］ in the validation set. The Hosmer-Lemeshow test showed good calibration （χ² = 4.55， P = 0.80）， and the model's predictive ability was stable. When the threshold probability exceeded 5%， the clinical net benefit of using the model to predict readmission risk was significantly higher than intervening in all patients. ConclusionHistory of heart failure， teeth-marked tongue， weak pulse， wiry pulse， phlegm-stasis mutual syndrome， blood stasis constitution， and non-high-density lipoprotein cholesterol are influencing factors for readmission in patients with stable angina of CHD. A clinical prediction model was developed based on these factors， which showed good discrimination， calibration， and clinical utility， providing a scientific basis for predicting readmission events in patients with stable angina.

Objective To investigate the screening results and factors affecting abnormal detection rates among high-risk groups of esophageal cancer and to explore effective intervention measures. Methods We investigated and collected the information on gender, education level, age, marital status, symptoms of reflux esophagitis (heartburn, acid reflux, belching, hiccup, foreign body sensation in the pharynx, and difficulty swallowing), consumption of pickled vegetables, salt use, and esophageal cancer incidence of villagers in a natural village in Wenfeng District, Anyang City, Henan Province. Changes in reflux esophagitis symptoms in the high-incidence area of esophageal cancer before and after 16 years were observed, and the relationship of such changes with esophageal cancer was analyzed. Results In 2008, 711 cases were epidemiologically investigated, including 213 cases with one of the symptoms of reflux esophagitis such as heartburn, acid reflux, belching, hiccups, foreign body sensation in the pharynx, and difficulty swallowing (sorted in accordance with the abovementioned symptoms; if there are multiple symptoms, then the former is taken); 55 cases with at least two related symptoms, among which the most symptom was heartburn in 108 cases (15.1%); followed by acid reflux, belching, etc. In 2024, the same group of people was investigated, and eight people were missing because of relocation. A total of 703 people were successfully investigated, of which 189 cases (26.8%) had one of the symptoms of reflux esophagitis, such as heartburn (sorted in accordance with relevant symptoms, if there are multiple symptoms, then the former will be selected); 167 cases (23.7%) had at least two related symptoms, among which the most symptom was heartburn in 139 cases (19.7%); followed by acid reflux. Over 16 years, among the 703 people investigated, 45 cases had esophageal cancer and they had one or more of the abovementioned symptoms. No significant differences in the reflux esophagitis-like symptoms were found between 2008 and 2024 (P=0.26); no significant differences in the composition of reflux esophagitis-like symptoms were found between 2008 and 2024 (P=0.299). Conclusion The detection rate of reflux esophagitis-related symptoms in the population in a high-risk area of esophageal cancer has not decreased in the past 16 years, and the high-risk factors still exist. Esophageal cancer is closely related to reflux esophagitis, and clinical practice can provide early diagnosis and treatment for high-risk population.

ObjectiveTo construct a rat model of psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type）， and evaluate the macroscopic manifestations and microscopic indicators of the model. MethodsTwenty-two SD rats were divided into normal group （n=3）， common psoriasis group （n=5）， spleen deficiency and dampness obstruction syndrome （external dampness type） group （n=7）， and psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group （n=7）. The spleen deficiency and dampness obstruction syndrome （external dampness type） rat model was established through 32-week exposure to an artificially simulated high-humidity environment， while the common psoriasis model was developed via 7-day topical application of imiquimod cream， and these two approaches were combined to construct a composite model of psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type）. Rats in the normal group were housed under normal humidity conditions. The general state， tongue manifestation of rats were observed to evaluate the macroscopic syndrome manifestations； the microscopic syndrome manifestations of rats were evaluated through adipose tissue and liver tissue changes； the severity of psoriasis in rats was evaluated through skin pathological changes， psoriasis area and severity index （PASI）， proliferating cell nuclear antigen （PCNA） expression and spleen tissue changes； changes in rat CD4⁺ interferon-γ⁺ cells （CD4⁺IFN-γ⁺ cells）， CD4⁺ tumour necrosis factor-α+ cells （CD4⁺ TNF-α⁺ cells）， and forkhead framing protein P3⁺ regulatory T cells （CD3⁺CD4⁺FoxP3⁺ Treg cells） were detected by flow cytometry. ResultsMacroscopically， both the spleen deficiency and dampness obstruction syndrome （external dampness type） group and psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group exhibited manifestations of spleen deficiency and dampness obstruction， including lethargy， huddling behavior， dull and disheveled fur， as well as soft or loose stools and perianal soiling in some individuals； both these two groups displayed enlarged tongue， swollen， and moist tongue texture， accompanied by slippery tongue surface. Microscopically， compared to the common psoriasis group， the psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group showed increased epididymal fat index （P＜0.05）； compared to the normal group and spleen deficiency and dampness obstruction syndrome （external dampness type） group， the psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group demonstrated significantly elevated spleen mass （P＜0.05）， while hepatic gross morphology and HE staining revealed no significant histopathological changes across all groups. Dorsal skin lesions were markedly exacerbated in the psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group when compared to those in common psoriasis group. Both the common psoriasis group and psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group exhibited significantly higher erythema scores， scaling scores， infiltration scores， PASI total scores， and proportions of CD3⁺CD4⁺FoxP3⁺Treg cells compared to the normal group and spleen deficiency and dampness obstruction syndrome （external dampness type） group （P＜0.05）， with pronounced PCNA-positive expression observed in the epidermal basal layer and dermis； the psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group displayed significantly increased proportions of CD4⁺TNF-α⁺cells compared to the spleen deficiency and dampness obstruction syndrome （external dampness type） group （P＜0.05）； whereas no significant differences were detected in CD4⁺IFN-γ⁺cell proportions among groups （P＞0.05）. ConclusionThe rat model of psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） can be successfully constructed by artificially simulating a high-humidity environment combined with imiquimod induction.

Objective To investigate the relationship between tooth loss and the occurrence of esophageal cancer in a natural village in Wenfeng District, Anyang City, Henan Province. Methods A prospective cohort study was conducted to observe the occurrence of tooth loss and esophageal cancer among the asymptomatic residents of the natural village for 16 years from January 2008 to July 2024. Data were analyzed by chi-square test, binary logistic regression, and restricted cubic spline. Results Among the total population of 711 cases, 136 cases were lost to follow-up and 575 cases were included in the final statistics, including 45 cases with esophageal cancer. Significant statistical difference was found between esophageal cancer patients with and without tooth loss (P<0.05). Logistic regression analysis showed that tooth loss was associated with the occurrence of esophageal cancer (OR=3.977, 95%CI: 1.543-10.255). After the adjustment for confounders, tooth loss remained significantly associated with the occurrence of esophageal cancer (OR=3.038, 95%CI: 1.035-8.914). A nonlinear dose-response relationship was observed between the number of teeth lost and the incidence of esophageal cancer. When the number of teeth lost was less than 12, the risk of esophageal cancer increased with the number of teeth lost. When more than 12 teeth were lost, the risk of esophageal cancer decreased as the number of teeth lost increased. Conclusion Tooth loss is a risk factor for the occurrence of esophageal cancer in this natural village. When the number of teeth lost is less than 12, the risk of esophageal cancer increases with the number of teeth lost.

Objective:To investigate the anatomic origin of juvenile nasopharyngeal angiofibroma（JNA） through radiologic analysis of tumor invasion patterns, providing insights into tumor etiology and surgical recurrence prevention. Methods:This retrospective cohort study included primary JNA cases at the Department of Otorhinolaryngology, Eye and ENT Hospital of Fudan University from March 2015 to September 2024. All patients underwent preoperative high-resolution CT（HRCT） scans, and some underwent enhanced magnetic resonance imaging. The study retrospectively analyzed the patients' imaging data to examine tumor invasion into the pterygopalatine fossa and the vidian canal. These sites were categorized into non-invaded, partially invaded, and completely invaded for the pterygopalatine fossa and the vidian canal. The study analyzed the proportions of invasion at these sites to further speculate on the origin of JNA. Results:A total of 105 JNA patients were included in the study. Among them, 100% of the patients had complete tumor invasion in the pterygopalatine fossa. For the vidian canal, the proportions of complete invasion, partial invasion, and non-invasion were 54.3%, 27.6%, and 18.1%, respectively. As the staging of JNA tumors increased, the proportion of vidian canal invasion also increased. Conclusion:Our evidence suggests that the pterygopalatine fossa, rather than the vidian canal, might be the likely origin of JNA, which is enlightening for the study of the etiological mechanisms of JNA.
Humans ; Nasopharyngeal Neoplasms/pathology* ; Retrospective Studies ; Angiofibroma/pathology* ; Neoplasm Invasiveness ; Pterygopalatine Fossa/pathology* ; Female ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed ; Adolescent

We have isolated an intestinal probiotic strain, Pediococcus acidilactici HRQ-1. To improve its gastrointestinal fluid tolerance, transportation and storage stability, and slow-release properties, we employed the extrusion method to prepare the microcapsules with P. acidilactici HRQ-1 as the core material and sodium alginate and chitosan as the wall material. The optimal conditions for preparing the microcapsules were determined by single factor and orthogonal tests, and the optimal ratio was determined by taking the embedding rate, survival rate, storage stability, gastrointestinal fluid tolerance, and release rate as the evaluation indexes. The results showed that under the optimal embedding conditions, the embedding rate reached (89.60±0.02)%. Under the optimal formula of freeze-drying protective agent, the freeze-drying survival rate reached (76.42±0.13)%, and the average size of the microcapsules produced was (1.16±0.03) mm. The continuous gastrointestinal fluid simulation experiments confirmed that the microcapsules ensured the viable bacterial count and can slowly release bacteria in the intestinal fluid. The curve of the viable bacterial count during storage at 4 ℃ and room temperature indicated that the prepared microcapsules achieved strains' live number protection. The formula and preparation process of P. acidilactici microcapsules may provide a technological reserve for the preparation of more live bacterial drugs in the future.
Pediococcus acidilactici/chemistry* ; Probiotics/chemistry* ; Capsules/chemistry* ; Alginates/chemistry* ; Chitosan/chemistry* ; Drug Compounding/methods* ; Glucuronic Acid/chemistry* ; Hexuronic Acids/chemistry* ; Freeze Drying

Objective:To establish a menstrual prediction model after the first course of hormone replacement therapy(HRT)in premature ovarian insufficiency(POI)patients after allogeneic hematopoietic stem cell transplan-tation(allo-HSCT),and to provide certain reference value for formulating HRT plans.Methods:The retrospective analysis recruited 154 POI patients after allo-HSCT in the First Affiliated Hospital of Soochow University from Jan-uary 2017 to October 2022.They were divided into ideal menstruation group(n=116)and unideal menstruation group(n=38)according to menstruation after the first course of HRT.Basic characteristics and clinical data were compared in single-factor analysis to select predictive factors.Patients were randomly divided into training set and test set.The menstrual prediction model was developed based on random forest algorithm on the training set and the prediction efficiency was verified by the test set.Finally,we made a user interaction interface and deployed to the server for sharing.Results:The single-factor analysis suggested statistic difference of age of visit,body mass index(BMI),gravidity,parity,hematologic diseases,transplantation age,donor gender,follicle-stimulating hormone(FSH),Luteinizing Hormone(LH),lumbar bone mineral density(BMD)and HRT plan(P<0.05).According to mean decrease accuracy,the predictive factors included visit age,transplantation age,BMI,FSH,HRT plans,gravidity and parity.After the initial establishment of the random forest model,we improved it by adjusting ntree to 500,mtry to 6 and training/test set division to 80%/20% .We also used tenfold cross validation to reduce over-fitting.The area under curve(AUC)of the final constructed menstrual prediction model was 0.768,a sensitiv-ity of 0.695 and a specificity of 0.735.Conclusions:This study successfully established a menstrual prediction model for amenorrhea patients after allo-HSCT when finished the first course of HRT.The false positive rate was low,suggesting that if the prediction result of the model is non-ideal menstruation,we may consider adjusting HRT plans to promote menstruation in time.

ObjectiveTo understand the awareness of knowledge about chronic obstructive pulmonary disease （COPD） and influencing factors among residents in Yangpu District， Shanghai. MethodsWe used cluster random sampling method to conduct face-to-face questionnaire surveys on selected household residents in 12 streets of Yangpu District. The survey questions included their understanding of COPD name， lung function test， and COPD related knowledge. Multivariate logistic regression analysis was used to analyze the influencing factors of awareness rate. ResultsA total of 1 440 people were ultimately included in the analysis， and the awareness rates of COPD name， lung function test， and COPD awareness were 19.93%， 18.61%， and 14.95%， respectively. Among the people who knew the name of COPD， awareness rate of shortness of breath or dyspnea was the highest （84.12%） in the three main symptoms of COPD. Among the main risk factors of COPD， second-hand smoke（86.78%）and smoking （85.82%） were the highest. The main ways to obtain knowledge of COPD names were through television （12.60%） and the internet （11.97%）. The results of multivariate logistic regression analysis showed that men were significantly higher than women in the awareness of COPD name， lung function test， and COPD knowledge， with the OR values of （OR=1.39， 95%CI：1.08‒1.79）， （OR=1.47，95%CI：1.12‒1.92） and （OR=1.37，95%CI：1.02‒1.84）， respectively. The awareness rate of COPD names and lung function tests was the highest among people aged ≥ 65 years old， while the awareness rate of COPD knowledge was the highest among people aged 35‒50 years old. The awareness rate of COPD names was the highest among people with college education or above， civil servants， teachers， and medical staff， people with an annual household income of 100 000‒200 000 yuan. ConclusionThe overall awareness rate of COPD names， lung function tests， and COPD related knowledge among residents in Yangpu District is still at a low level. We should intensify the promotion and education of COPD among key groups such as women， young people， and those with low income， in order to improve the overall awareness rate of COPD among the population.