The patient was a 56-year-old man who presented with abnormal urinalysis findings of over one month’s duration. Serological tests revealed an elevated serum free light chain κ/λ ratio, and immunofixation electrophoresis detected an IgG-κ monoclonal band. Renal biopsy demonstrated membranous nephropathy, with electron-dense deposits observed in the subepithelial space and mesangium on electron microscopy. Immunofluorescence confirmed glomerular deposits of IgG_1/IgG₃-κ. Based on clinical manifestation, bone marrow flow cytology, and lymph node pathology, the patient was diagnosed with small lymphocytic lymphoma (SLL), and membranous nephropathy with light chain-restricted deposition (IgG₁/IgG₃-κ) secondary to SLL. After receiving obinutuzumab treatment, the patient’s proteinuria partially remitted, the lymph nodes significantly shrank, and clinical remission was achieved.

Background: Advances in intensive care have markedly improved survival after severe brain injury, leading to a growing population of patients with prolonged disorders of consciousness (pDOC). Current management of pDOC remains largely supportive, and evidence-based neuromodulatory interventions are limited; moreover, existing guidelines provide insufficiently explicit recommendations regarding mechanisms of action and objective biomarkers of treatment response. Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a potential noninvasive intervention; however, its modulatory effects on brain function in pDOC are not yet well characterized, and the paucity of integrative mechanistic evidence has constrained its translation into routine clinical practice. Objectives: Within a multimodal assessment framework, this study aims to systematically elucidate the neurobiological mechanisms by which taVNS modulates brain function and autonomic activity in patients with pDOC, and to evaluate its clinical potential to enhance levels of consciousness. Methods: In this randomized controlled trial, 60 patients with vegetative state/minimally conscious state will be enrolled and randomly allocated to a taVNS group, a transcutaneous nonauricular vagus nerve stimulation group (sham), or a control group (n = 20 per group) for a 4-week intervention. The primary outcome will be changes in the Coma Recovery Scale-Revised scores from baseline to weeks 1, 2, and 4 of treatment. Secondary outcomes will include functional brain activity assessed by electroencephalography and functional near-infrared spectroscopy, as well as autonomic modulation indexed by heart rate variability. Functional prognosis will be evaluated using the Glasgow Outcome Scale-Extended at the end of treatment and at a 6-month follow-up. Safety will be assessed by continuous monitoring and documentation of adverse events throughout the study period. Results and discussion: By integrating electroencephalography–functional near-infrared spectroscopy with heart rate variability, this study will characterize the effects of taVNS on functional brain networks and consciousness recovery in pDOC across complementary behavioral, electrophysiological, hemodynamic, and autonomic domains, while interrogating potential sources of clinical and neurobiological heterogeneity. The findings are expected to provide a mechanistic and evidence-based foundation for the mechanism-driven clinical implementation of taVNS and the optimization of stimulation protocols in pDOC. Clinical trial registration: International Traditional Medicine Clinical Trial Registry, ITMCTR20250021041, https://itmctr.ccebtcm.org.cn.

Objective To summarize the change law of tongue images in postoperative patients with anorectal disease by observing the postoperative tongue image changes in 400 patients with anorectal disease;To investigate the relationship between the severity of postoperative symptoms in anorectal disease and tongue symptoms.Methods Totally 400 patients meeting the inclusion criteria were selected from the first Department of Anorectal Medicine of Inner Mongolia Hospital of Traditional Chinese Medicine during January 2023 to December 2023.Tongue texture and tongue coating,postoperative wound pain degree,duration of pain,defecation situation and degree of wound edema of patients were observed and recorded before surgery,on the 1st,3rd,5th,7th and 10th days after surgery,respectively.Results The data recorded for 6 time spots of before surgery and 1,3,4,5,10 d after surgery showed significant differences in the tongue coating results of patients,indicating that the postoperative tongue image of patients with anorectal disease presented dynamic changes,with the general law being light red tongue or red tongue before surgery,thin white tongue or little fur,gradually changing into red tongue,blue tongue,thin white dry tongue or thin yellow tongue 1-3 days after operation,red tongue or purple tongue 3-7 days,white greasy tongue or yellow thick greasy tongue,and tongue coating subside after 10 days.Tongue quality gradually recovered,and tongue image changes were closely related to clinical symptoms.Conclusion The tongue image of anorectal patients after operation has obvious characteristic expression,and its change is regular,and it is related to the symptoms,degree and outcome of the disease.

Objective To construct an evaluation index system for the Medical Ethics Committee of Henan Province,and provide technical support for evaluating the construction of Medical Ethics Committee.Methods Delphi method was used to construct medical ethics evaluation indicators,and the AHP analytic hierarchy process was used to determine the weights of the indicators.Results After two rounds of expert consultation,it was determined that the evaluation indicators of the Medical Eth-ics Committee include 5 primary indicators and 30 secondary indicators;Basic conditions and management mechanisms are rela-tively important in primary indicators;The weight of the average number of training sessions conducted by the ethics committee per year and the number of training sessions received by the ethics committee per year is relatively high.Conclusion The evalu-ation index system for medical ethics committees constructed in this study has high authority and scientificity,providing a refer-ence for the evaluation of medical ethics committees at all levels.

Objective To investigate the effect of polystyrene microplastics(PS-MPs)on myocardial injury in mice and its molecular mechanism.Methods A total of 60 male C57BL/6 mice were randomly divided into normal sa-line group,0.1,1,10 mg/kg PS-MPs exposed group,and doxorubicin[5 mg/(kg·w)]group treated for 8 weeks.After treatment,we measured blood pressure,cardiac organ coefficient,cardiac histopathological changes,oxidative stress markers reactive oxygen species(ROS),malondialdehyde(MDA),glutathione(GSH),4-hydroxynonenal(4-HNE)and nuclear factor E2-related factor 2(Nrf2),serum centroid injury markers creatine kinase MB(CK-MB)and troponin(cTnT),ferroptosis marker recombinant glutathione peroxidase 4(GPX4),Recombinant solute carrier family 7(SLC7 A11)as well as ferrous ions(Fe2+).Results Compared with the neg-ative control group,vacuolation,inflammatory infiltration and collagen fiber deposition were evident in the hearts of mice after PS exposure.The levels of myocardial injury markers CK-MB and cTnT significantly increased.Cardiac organ coefficient decreased,blood pressure increased,oxidative stress markers and ferroptosis markers increased.Conclusion PS-MPs exposure can induce oxidative stress and activate ferroptosis pathway,resulting in myocardial injury in mice.

Sustained inflammatory responses are closely related to various severe diseases, and inhibiting the excessive activation of inflammasomes and pyroptosis has significant implications for clinical treatment. Natural products have garnered considerable concern for the treatment of inflammation. Huanglian-Wumei decoction (HLWMD) is a classic prescription used for treating inflammatory diseases, but the necessity of their combination and the exact underlying anti-inflammatory mechanism have not yet been elucidated. Inspired by the supramolecular self-assembly strategy and natural drug compatibility theory, we successfully obtained berberine (BBR)-chlorogenic acid (CGA) supramolecular (BCS), which is an herbal pair from HLWMD. Using a series of characterization methods, we confirmed the self-assembly mechanism of BCS. BBR and CGA were self-assembled and stacked into amphiphilic spherical supramolecules in a 2:1 molar ratio, driven by electrostatic interactions, hydrophobic interactions, and π-π stacking; the hydrophilic fragments of CGA were outside, and the hydrophobic fragments of BBR were inside. This stacking pattern significantly improved the anti-inflammatory performance of BCS compared with that of single free molecules. Compared with free molecules, BCS significantly attenuated the release of multiple inflammatory mediators and lipopolysaccharide (LPS)-induced pyroptosis. Its anti-inflammatory mechanism is closely related to the inhibition of intracellular nuclear factor-kappaB (NF-κB) p65 phosphorylation and the noncanonical pyroptosis signalling pathway mediated by caspase-11.

Objective To summarize the change law of tongue images in postoperative patients with anorectal disease by observing the postoperative tongue image changes in 400 patients with anorectal disease;To investigate the relationship between the severity of postoperative symptoms in anorectal disease and tongue symptoms.Methods Totally 400 patients meeting the inclusion criteria were selected from the first Department of Anorectal Medicine of Inner Mongolia Hospital of Traditional Chinese Medicine during January 2023 to December 2023.Tongue texture and tongue coating,postoperative wound pain degree,duration of pain,defecation situation and degree of wound edema of patients were observed and recorded before surgery,on the 1st,3rd,5th,7th and 10th days after surgery,respectively.Results The data recorded for 6 time spots of before surgery and 1,3,4,5,10 d after surgery showed significant differences in the tongue coating results of patients,indicating that the postoperative tongue image of patients with anorectal disease presented dynamic changes,with the general law being light red tongue or red tongue before surgery,thin white tongue or little fur,gradually changing into red tongue,blue tongue,thin white dry tongue or thin yellow tongue 1-3 days after operation,red tongue or purple tongue 3-7 days,white greasy tongue or yellow thick greasy tongue,and tongue coating subside after 10 days.Tongue quality gradually recovered,and tongue image changes were closely related to clinical symptoms.Conclusion The tongue image of anorectal patients after operation has obvious characteristic expression,and its change is regular,and it is related to the symptoms,degree and outcome of the disease.

Objective To analyze the relationship between article content and user feedback on WeChat public numbers in hospitals,and to provide data support and theoretical basis for optimizing public number content and health communication strategy.Methods 1 279 tweets of WeChat public number of a tertiary public hospital from 2023 to 2024 were selected to ana-lyze the relationship between article categories and user feedback behavior,interactive behavior and article dissemination effect,and to assess the important influencing factors of user attention conversion behavior.Results The articles in the health science popularization category show significant advantages in the indicators of users' reading and sharing behaviors;the interactive indica-tors of users' liking and commenting have a significant positive effect on the dissemination effect of the articles,while the number of"watching"hurts the number of readings;the assessment of the random forest model shows that the number of readings genera-ted by sharing and the number of readings brought by each sharing are the most important factors influencing the users' attention.The random forest model assessment showed that the number of reads generated by sharing and the number of reads per share were the most important factors influencing users' attention.Conclusion Health science articles dominate users' reading and sharing behaviors,user interaction significantly improves the dissemination effect and attention conversion of the articles,and the number of reads generated by sharing is the key factor determining users' attention.This suggests that content dissemination strategies need to be combined with the content characteristics of the article,focusing on improving the interaction and sharing guidance of con-tent with high dissemination potential.

Objective To construct an evaluation index system for the Medical Ethics Committee of Henan Province,and provide technical support for evaluating the construction of Medical Ethics Committee.Methods Delphi method was used to construct medical ethics evaluation indicators,and the AHP analytic hierarchy process was used to determine the weights of the indicators.Results After two rounds of expert consultation,it was determined that the evaluation indicators of the Medical Eth-ics Committee include 5 primary indicators and 30 secondary indicators;Basic conditions and management mechanisms are rela-tively important in primary indicators;The weight of the average number of training sessions conducted by the ethics committee per year and the number of training sessions received by the ethics committee per year is relatively high.Conclusion The evalu-ation index system for medical ethics committees constructed in this study has high authority and scientificity,providing a refer-ence for the evaluation of medical ethics committees at all levels.