ObjectiveTo investigate the effects of Huanglian Jiedutang （HLJDT） on cognitive function in mice with ischemic stroke （IS） and to elucidate whether its neuroprotective effects are mediated by inhibition of the nuclear factor-κB （NF-κB） signaling pathway and subsequent suppression of NF-κB-regulated neuronal apoptosis. MethodsAn IS model was established using middle cerebral artery occlusion （MCAO）. Sixty C57BL/6J mice were randomly assigned to five groups （n =12 per group）， i.e.， sham operation， model， HLJDT low-dose （3.9 g·kg^-1·d^-1）， HLJDT high-dose （7.8 g·kg^-1·d^-1）， and Ginkgo biloba extract （GBE， 31.2 mg·kg^-1·d^-1）. Post-operatively， neurological deficit scores （Longa score）， cerebral infarct volume assessed by 2，3，5-triphenyltetrazolium chloride （TTC） staining， and brain water content were evaluated. Learning and memory were assessed using new object recognition （NOR） and fear conditioning （FC） tests. Hippocampal pathology was examined via hematoxylin and eosin （HE） staining. Immunofluorescence detected expression of glial fibrillary acidic protein （GFAP， astrocyte marker）， cellular oncogene Fos （c-Fos， neuronal activation marker）， and glutamate decarboxylase 65 （GAD65）. Western blot measured nuclear factor-κB inhibitor protein α （IκBα）， phosphorylated IκBα （p-IκBα）， NF-κB p65， phosphorylated NF-κB p65 （p-NF-κB p65）， ionic calcium binding adapter molecule 1 （Iba-1）， tumor necrosis factor （TNF）-α， interleukin （IL）-1β， and apoptosis-related proteins， such as cleaved cysteinyl aspartate-specific protease 3 （Caspase-3）， B-cell lymphoma 2 （Bcl-2）， and Bcl-2-associated X protein （Bax）. Real-time quantitative PCR （Real-time PCR） was used to assess mRNA levels of Iba-1， TNF-α， IL-1β， NF-κB p65， cleaved Caspase-3， Bax， and Bcl-2. ResultsCompared with the sham group， the model group exhibited significantly increased neurological deficit scores， brain water content， and cerebral infarct volume （P<0.01）. Hippocampal CA1 neurons were disorganized， showing nuclear pyknosis and karyolysis. NOR exploration time and FC freezing time were significantly reduced （P<0.01）. GFAP and c-Fos expression were increased， while GAD65 expression was decreased （P<0.01）. Cleaved Caspase-3 and Bax were upregulated， Bcl-2 was downregulated， and the Bax/Bcl-2 ratio was elevated （P<0.01）. Expression levels of p-IκBα， p-NF-κB p65， IL-1β， TNF-α， and Iba-1 were significantly increased （P<0.01）. Compared with the model group， HLJDT high-dose， low-dose， and GBE groups showed significant improvements in all parameters （P<0.01）. Among them， the HLJDT high-dose group showed the most pronounced neuronal structural recovery and superior performance in NOR and FC tests （P<0.01）. In this group， GFAP and c-Fos decreased， GAD65 increased （P<0.01）， apoptosis-related protein expression was reversed， and NF-κB signaling and related inflammatory factor expression were suppressed （P<0.01）. ConclusionHLJDT ameliorates cognitive dysfunction in mice after IS， potentially by inhibiting the NF-κB signaling pathway， thereby reducing neuroinflammation and hippocampal neuronal apoptosis.

Objective:To explore the correlation between inflammatory factor levels in gingival crevicular fluid and pain degree, stress response and masticatory function in patients with combined periodontal and pulpal lesions.Methods:A retrospective selection of 92 patients with combined periodontal and pulpal lesions admitted to Yan ′an People′s Hospital from May 2022 to May 2023 was divided into mild group (60 cases) and moderate-severe group (32 cases) according to the degree of combined periodontal and pulpal lesions. Periodontal clinical indicators were compared between the two groups; enzyme-linked immunosorbent assay (ELISA) was used to detect inflammatory factors in gingival crevicular fluid and serum cortisol (Cor) and adrenocorticotropic hormone (ACTH) levels; Visual Analogue Scale (VAS) was used to evaluate pain degree; and weighing method was used to evaluate masticatory efficiency. Pearson correlation analysis was used to evaluate the correlation between inflammatory factor levels in gingival crevicular fluid and pain degree, stress response and masticatory function.Results:The probing depth (PD), attachment loss (AL), Plaque Index (PLI) and Bleeding Index (BI) in the moderate-severe group [(5.35±0.40)mm, (5.98±0.59)mm, 1.22±0.42, 1.28±0.43] were all higher than those in the mild group [(4.23±0.36)mm, (2.53±0.29)mm, 1.05±0.34, 0.80±0.40] (all P<0.05). The levels of interleukin-1β (IL-1β), interleukin-17 (IL-17) and high-sensitivity C-reactive protein (hs-CRP) in gingival crevicular fluid in the moderate-severe group [(41.87±11.78)μg/L, (606.32±59.33)pg/ml, (58.64±10.63)mg/L] were higher than those in the mild group [(30.35±10.53)μg/L, (478.63±43.18)pg/ml, (43.15±9.85)mg/L], and the level of transforming growth factor-β (TGF-β) [(53.98±6.98)μg/L] was lower than that in the mild group [(121.67±12.87)μg/L] ( P<0.05). The serum Cor and ACTH levels in the moderate-severe group [(165.68±34.64)μg/L, (25.97±6.37)ng/L] were higher than those in the mild group [(148.73±29.65)μg/L, (17.97±5.34)ng/L] (all P<0.05). The VAS score in the moderate-severe group [(5.03±1.20)points] was higher than that in the mild group [(3.57±1.01)points] ( P<0.05). The bite force and masticatory efficiency in the moderate-severe group [(95.32±23.73)lbs, (65.97±13.34)%] were lower than those in the mild group [(113.75±26.46)lbs, (75.89±16.86)%], and the gingival index (1.41±0.50) was higher than that in the mild group (0.85±0.36) (all P<0.05). Correlation analysis showed that IL-1β was positively correlated with disease degree, periodontal indexes, IL-17 and inflammatory factors, and negatively correlated with TGF-β; IL-17 was positively correlated with disease degree and multiple indexes, and negatively correlated with TGF-β, bite force and masticatory efficiency; TGF-β was positively correlated with bite force and masticatory efficiency, and negatively correlated with disease degree and multiple indexes. Conclusions:Inflammatory factors in gingival crevicular fluid of patients with combined periodontal and pulpal lesions are closely related to pain and stress response, and affect masticatory function. In diagnosis and treatment, inflammatory status should be comprehensively considered to provide a basis for personalized treatment.

Objective:To explore the correlation between inflammatory factor levels in gingival crevicular fluid and pain degree, stress response and masticatory function in patients with combined periodontal and pulpal lesions.Methods:A retrospective selection of 92 patients with combined periodontal and pulpal lesions admitted to Yan ′an People′s Hospital from May 2022 to May 2023 was divided into mild group (60 cases) and moderate-severe group (32 cases) according to the degree of combined periodontal and pulpal lesions. Periodontal clinical indicators were compared between the two groups; enzyme-linked immunosorbent assay (ELISA) was used to detect inflammatory factors in gingival crevicular fluid and serum cortisol (Cor) and adrenocorticotropic hormone (ACTH) levels; Visual Analogue Scale (VAS) was used to evaluate pain degree; and weighing method was used to evaluate masticatory efficiency. Pearson correlation analysis was used to evaluate the correlation between inflammatory factor levels in gingival crevicular fluid and pain degree, stress response and masticatory function.Results:The probing depth (PD), attachment loss (AL), Plaque Index (PLI) and Bleeding Index (BI) in the moderate-severe group [(5.35±0.40)mm, (5.98±0.59)mm, 1.22±0.42, 1.28±0.43] were all higher than those in the mild group [(4.23±0.36)mm, (2.53±0.29)mm, 1.05±0.34, 0.80±0.40] (all P<0.05). The levels of interleukin-1β (IL-1β), interleukin-17 (IL-17) and high-sensitivity C-reactive protein (hs-CRP) in gingival crevicular fluid in the moderate-severe group [(41.87±11.78)μg/L, (606.32±59.33)pg/ml, (58.64±10.63)mg/L] were higher than those in the mild group [(30.35±10.53)μg/L, (478.63±43.18)pg/ml, (43.15±9.85)mg/L], and the level of transforming growth factor-β (TGF-β) [(53.98±6.98)μg/L] was lower than that in the mild group [(121.67±12.87)μg/L] ( P<0.05). The serum Cor and ACTH levels in the moderate-severe group [(165.68±34.64)μg/L, (25.97±6.37)ng/L] were higher than those in the mild group [(148.73±29.65)μg/L, (17.97±5.34)ng/L] (all P<0.05). The VAS score in the moderate-severe group [(5.03±1.20)points] was higher than that in the mild group [(3.57±1.01)points] ( P<0.05). The bite force and masticatory efficiency in the moderate-severe group [(95.32±23.73)lbs, (65.97±13.34)%] were lower than those in the mild group [(113.75±26.46)lbs, (75.89±16.86)%], and the gingival index (1.41±0.50) was higher than that in the mild group (0.85±0.36) (all P<0.05). Correlation analysis showed that IL-1β was positively correlated with disease degree, periodontal indexes, IL-17 and inflammatory factors, and negatively correlated with TGF-β; IL-17 was positively correlated with disease degree and multiple indexes, and negatively correlated with TGF-β, bite force and masticatory efficiency; TGF-β was positively correlated with bite force and masticatory efficiency, and negatively correlated with disease degree and multiple indexes. Conclusions:Inflammatory factors in gingival crevicular fluid of patients with combined periodontal and pulpal lesions are closely related to pain and stress response, and affect masticatory function. In diagnosis and treatment, inflammatory status should be comprehensively considered to provide a basis for personalized treatment.

Objective:To explore the changes of atlantoaxial joint spaces and pharyngeal airway after combined orthodontic-orthognathic treatment in skeletal class Ⅲ patients with mandibular deviation.Methods:A total of 34 adult skeletal class Ⅲ patients (10 males and 24 females) with mandibular deviation who received combined orthodontic-orthognathic treatment at the Department of Orthodontics and the Department of Orthognathic Surgery in the Stomatological Hospital of Chongqing Medical University from August 2014 to October 2021 were retrospectively selected. The patients were 22 (5) years old (18-33 years). Cone-beam CT data of patients taken before treatment (T0), after preoperative orthodontics (T1), and 6 to 12 months after orthognathic surgery (T2) were collected. The anterior atlanto-dental interval (ADI), variance of bilateral lateral atlanto-dental interval (VBLADI), the anterior posterior length (APL), maximum transverse width (LTW), aspect ratio (L/W), cross-sectional area (CSA) of each airway cross-section, the airway volumes, as well as the positions of the maxillofacial landmark points [subspinale (point A), supramental (point B), posterior nasal spine (point PNS), the most anterior and superior point of the hyoid bone (point H)] were measured at different time points. The correlations between airway changes, maxillofacial movements as well as the changes in the atlantoaxial joint spaces were also analyzed.Results:During the combined orthodontic-orthognathic treatment, no statistically significant differences were found in the ADI and VBLADI among different treatment time points (all P>0.05). After preoperative orthodontics, the volume of total airway increased from 20 868 (6 669) mm 3 to 21 302 (8 911) mm 3 ( P<0.05). After orthognathic surgery, there were no statistically significant differences in the APL, CSA of the PNS plane, the L/W of the uvula plane, and the nasopharyngeal airway volume compared with those after preoperative orthodontics (all P>0.05). The L/W of the PNS plane after surgery was significantly increased compared with that after preoperative orthodontics ( P<0.05), while other airway parameters were all significantly decreased compared with those after preoperative orthodontics (all P<0.05). Compared with before treatment, the nasopharyngeal airway volume after surgery [6 186 (1 707) mm3] increased significantly ( P<0.05) and the palatopharyngeal airway volume [8 145 (2 594) mm3] and the glossopharyngeal airway volume [5 605 (4 395) mm3] decreased significantly (all P<0.05). There was no statistically significant difference in the total airway volume between after surgery and before treatment ( P>0.05). Correlation analysis showed that after preoperative orthodontics, the amount of the sagittal movement of point B was moderately positively correlated with the total airway volume change ( r=0.40, P=0.022). Before and after orthognathic surgery, the amount of the sagittal movement of point PNS was moderately positively correlated with the changes in the palatopharyngeal airway volume and the total airway volume ( r=0.43, P=0.015; r=0.46, P=0.008). In addition, the change in VBLADI before and after orthognathic surgery was weakly positively correlated with the changes in the CSA of the PNS plane and the APL of the uvula plane ( r=0.35, P=0.029; r=0.38, P=0.016). Conclusions:During the combined orthodontic-orthognathic treatment, the anterior atlanto-dental interval in skeletal class Ⅲ patients with mandibular deviation remained stable among different treatment time points. The total airway volume increased after preoperative orthodontics. After orthognathic surgery, the backward movement of the mandible tended to reduce the size of the pharyngeal airway, and the morphology of the glossopharyngeal airway tended to become more flattened. The changes in the pharyngeal airway dimensions were correlated with the maxillomandibular movements and the atlantoaxial joint space changes.

The clinical phenotype heterogeneity of epilepsy patients with ADGRV1 gene mutation is significant, ranging from self limiting febrile seizures to developmental epileptic encephalopathy, even causing sudden epileptic death. A case of infantile epileptic spasms syndrome with a novel heterozygous variant of the ADGRV1 gene c.4100C>A (p.Thr1367Lys) was reported in this article. The site of this variant had not been reported yet, and the clinical manifestations of the child mainly included epileptic spasms (first onset at 4 months old), mild growth and development delay, highly irregular video electroencephalogram, and effective treatment with adrenocorticotropic hormone.

Objective:To explore the changes of atlantoaxial joint spaces and pharyngeal airway after combined orthodontic-orthognathic treatment in skeletal class Ⅲ patients with mandibular deviation.Methods:A total of 34 adult skeletal class Ⅲ patients (10 males and 24 females) with mandibular deviation who received combined orthodontic-orthognathic treatment at the Department of Orthodontics and the Department of Orthognathic Surgery in the Stomatological Hospital of Chongqing Medical University from August 2014 to October 2021 were retrospectively selected. The patients were 22 (5) years old (18-33 years). Cone-beam CT data of patients taken before treatment (T0), after preoperative orthodontics (T1), and 6 to 12 months after orthognathic surgery (T2) were collected. The anterior atlanto-dental interval (ADI), variance of bilateral lateral atlanto-dental interval (VBLADI), the anterior posterior length (APL), maximum transverse width (LTW), aspect ratio (L/W), cross-sectional area (CSA) of each airway cross-section, the airway volumes, as well as the positions of the maxillofacial landmark points [subspinale (point A), supramental (point B), posterior nasal spine (point PNS), the most anterior and superior point of the hyoid bone (point H)] were measured at different time points. The correlations between airway changes, maxillofacial movements as well as the changes in the atlantoaxial joint spaces were also analyzed.Results:During the combined orthodontic-orthognathic treatment, no statistically significant differences were found in the ADI and VBLADI among different treatment time points (all P>0.05). After preoperative orthodontics, the volume of total airway increased from 20 868 (6 669) mm 3 to 21 302 (8 911) mm 3 ( P<0.05). After orthognathic surgery, there were no statistically significant differences in the APL, CSA of the PNS plane, the L/W of the uvula plane, and the nasopharyngeal airway volume compared with those after preoperative orthodontics (all P>0.05). The L/W of the PNS plane after surgery was significantly increased compared with that after preoperative orthodontics ( P<0.05), while other airway parameters were all significantly decreased compared with those after preoperative orthodontics (all P<0.05). Compared with before treatment, the nasopharyngeal airway volume after surgery [6 186 (1 707) mm3] increased significantly ( P<0.05) and the palatopharyngeal airway volume [8 145 (2 594) mm3] and the glossopharyngeal airway volume [5 605 (4 395) mm3] decreased significantly (all P<0.05). There was no statistically significant difference in the total airway volume between after surgery and before treatment ( P>0.05). Correlation analysis showed that after preoperative orthodontics, the amount of the sagittal movement of point B was moderately positively correlated with the total airway volume change ( r=0.40, P=0.022). Before and after orthognathic surgery, the amount of the sagittal movement of point PNS was moderately positively correlated with the changes in the palatopharyngeal airway volume and the total airway volume ( r=0.43, P=0.015; r=0.46, P=0.008). In addition, the change in VBLADI before and after orthognathic surgery was weakly positively correlated with the changes in the CSA of the PNS plane and the APL of the uvula plane ( r=0.35, P=0.029; r=0.38, P=0.016). Conclusions:During the combined orthodontic-orthognathic treatment, the anterior atlanto-dental interval in skeletal class Ⅲ patients with mandibular deviation remained stable among different treatment time points. The total airway volume increased after preoperative orthodontics. After orthognathic surgery, the backward movement of the mandible tended to reduce the size of the pharyngeal airway, and the morphology of the glossopharyngeal airway tended to become more flattened. The changes in the pharyngeal airway dimensions were correlated with the maxillomandibular movements and the atlantoaxial joint space changes.

Objective To explore the five-circuit and six-qi features of birth time and onset time of children with acute lymphoblastic leukemia(ALL).Methods A total of 877 cases of children with ALL from Children's Hospital of Soochow University from June 2021 to February 2023 were collected,and their five-circuit and six-qi features of birth time and onset time were analyzed.And then the correlation of five-circuit and six-qi features of birth time and onset time with ALL was explored preliminarily,and the pathogenic characteristics of congenital factors and acquired pathogenic factors were revealed.Results(1)The children who were born in the year with the heavenly stems being bing(the 3rd of the ten heavenly stems)and ding(the 4th of the ten heavenly stems)and with the earthly branches being shen(the 8th of the twelve earthly branches)and you(the 9th of the twelve earthly branches)are prone to suffer from ALL,and the birth year of children with ALL had the five-circuit and six-qi features of the joining of guest circuit with dominant circuit being rebellious.ALL is commonly seen in the year with the heavenly stems being geng(the 7th of the ten heavenly stems)and xin(the 8th of the ten heavenly stems)and with the earthly branches being zi(the 1st of the twelve earthly branches)and chou(the 2nd of the twelve earthly branches),and the onset year of ALL in children had the five-circuit and six-qi features of the yearly circuit being gold-circuit and water-circuit,sitian-zaiquan yearly circuit qi being shaoyin monarch-fire with yangming dryness-gold,taiyin damp-earth with taiyang cold-water,and the qi-circuit assimilation relationship being celestial correspondence,same celestial correspondence,celestial correspondence in convergent year,disharmony,mildly-rebellious,and celestial restriction.Conclusion Gold-dryness and water-cold are the congenital factors and acquired pathogenic factors of ALL.The onset of ALL in children is closely related to qi insufficiency and qi stagnation of wood and fire in five-circuit and six-qi theory.

[This corrects the article DOI: 10.1016/j.apsb.2022.05.019.].

The clinical phenotype heterogeneity of epilepsy patients with ADGRV1 gene mutation is significant, ranging from self limiting febrile seizures to developmental epileptic encephalopathy, even causing sudden epileptic death. A case of infantile epileptic spasms syndrome with a novel heterozygous variant of the ADGRV1 gene c.4100C>A (p.Thr1367Lys) was reported in this article. The site of this variant had not been reported yet, and the clinical manifestations of the child mainly included epileptic spasms (first onset at 4 months old), mild growth and development delay, highly irregular video electroencephalogram, and effective treatment with adrenocorticotropic hormone.

Objective To assess the clinical value of a novel surgical technique—Tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device in the resection of anterior mediastinal masses. Methods Patients who underwent tubeless subxiphoid uniportal video-assisted thoracoscopic surgery via balance-shaped sternal elevation device in anterior mediastinal masses process at the Department of Thoracic Surgery, West China Hospital, Sichuan University from March to April 2025 were included, and their clinical data were analyzed. Results A total of 4 patients were included, with 2 males and 2 females, aged 58-75 years. The diameter of the tumor was 2.5-3.0 cm. The operation time was 60.0-150.0 min, intraoperative blood loss was 5-10 mL, pain score on the 3rd day after surgery was 0 points, and postoperative hospital stay was 2-3 days. All patients achieved complete resection of the masses and thymus without perioperative complications. Conclusion The tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device technique optimizes surgical visualization and instrument maneuverability while avoiding complications related to conventional anesthesia and tubing, thereby markedly enhancing the minimally invasive profile of anterior mediastinal masses resections. In addition to maintaining procedural safety, this approach effectively reduces postoperative pain and accelerates patient recovery, highlighting its potential for widespread clinical adoption.