This paper has constructed a traditional Chinese medicine （TCM） specialized disease dataset platform for mixed hemorrhoids based on a multimodal large model， and the preliminary application has been validated. The platform uses StarRocks to establish a four-level data warehouse system， enabling the aggregation， cleaning， and standardization of multi-source heterogeneous data. Using DeepSeek-R1-Distill-Qwen-7B as the base model， domain fine-tuning is performed through low-rank adaptation （LoRA） technology. Combined with LLaMA-3.3 natural language processing and reasoning chain techniques， the platform enables intelligent parsing and structured extraction of unstructured TCM medical records. It accurately identifies six major categories and 28 subcategories of entities， including symptoms and syndromes， with a fine-tuned model F1 score of 93.8%. The platform has established a high-quality specialized disease dataset containing more than 50,000 medical records and has been applied in a real-world study involving 17,831 patients， preliminarily verifying the efficacy of TCM heritage surgery.

Objective To explore the association of diabetes status with the development of tuberculosis (TB) among the community population in Shanghai, and to provide evidence for the formulation of tuberculosis prevention and control strategies. Methods This population-based cohort study was based on Shanghai Suburban Adult Cohort and Biobank (SSACB) in China. The baseline data were acquired by questionnaires, physical examinations and blood biochemistry tests. TB incidence was obtained by matching with TB management information system data. A Cox proportional risk model was established to assess the risk of tuberculosis. Results A total of 36 014 research subjects were included, with an average age of 56.3±11.3 years, of which 14 587 (40.5%) were male. Over 6 years of follow-up, 47 individuals progressed to tuberculosis (incidence rate: 19.8 per 100 000 person-year, 95% CI: 14.6 -26.4). An increased risk of TB was observed in participants with newly diagnosed diabetes compared with those without diabetes (adjusted hazard ratio [aHR], 2.73; 95% CI, 1.19 - 6.28). Conclusion The risk of tuberculosis in newly diagnosed diabetic patients is significantly increased, and strengthening tuberculosis screening for this population should be considered in practical work.

Objective To study the spatial distribution of the incidence of pulmonary tuberculosis in Hubei Province and its influencing factors, so as to improve the theoretical basis for scientific development of tuberculosis prevention and control measures in the future. Methods The data of reported incidence of tuberculosis and related influencing factors in various counties and districts of Hubei Province in 2020 were collected. Global Moran's I index, hotspot analysis and geographically weighted regression (GWR) model analysis were used to calculate the spatial autocorrelation of the incidence of tuberculosis, and to analyze the influencing factors affecting the incidence rate of tuberculosis. Results There were obvious regional differences in the space distribution of the incidence rate of tuberculosis. Hot spot analysis showed positive spatial correlation and obvious clustering. The GWR model (AICc=784.251) in this study had higher AICc value compared to the ordinary least squares regression (OLS) model (AICc=804.2585). The GWR model showed that the increase in the proportion of the population aged 65 and above and the proportion of the ethnic minority population had a significant promoting effect on the increase of the incidence rate of tuberculosis, and there was significant spatial heterogeneity. The effect of PM_2.5 concentration on the incidence rate of pulmonary tuberculosis varied in different regions, and the degree of effect was also different. Conclusion The proportion of people aged 65 and above and the proportion of ethnic minorities may significantly influence the incidence of pulmonary tuberculosis. The effect of PM_2.5 concentration varies in different regions, so targeted measures should be formulated according to the situation in different regions.

OBJECTIVE To observe the effect of Shixiang plaster on promoting the wound healing of diabetic foot ulcer.METHODS Totally 50 male SPF grade SD rats were prepared to establish the diabetic models by feeding with high glucose and high fat forage and intraperitoneal injection of streptozotocin,the rats models that were es-tablished successfully were randomly divided into the model group,the Shixiang plaster group and the Kangfuxin solution group.The models of diabetic ulcers were established.The Shixiang plaster group was treated with exter-nal Shixiang plaster,the Kangfuxin solution group was given external Kangfuxin solution,and the model group was treated with coverage with sterile gauze.The wound healing status of the rats was observed,the wound tis-sues were collected for bacterial culture and hematoxylin-eosin(HE)staining after drug administration for 14 and 28 days,respectively.The expression levels of nuclear factor-red cell-2-related factor 2(Nrf-2),heme oxygenase-1(HO-1),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and vascular endothelial growth factor(VEGF)were detected by immunohistochemistry(IHC),the expression levels of Nrf-2 and HO-1 were detected with the use of Western Blot,and the levels of serum malondialdehyde(MDA),superoxide dismutase(SOD)and reactive oxygen species(ROS)were detected by enzyme-linked immunosorbent assay(ELISA).RESULTS After the drug administration for 14 and 28 days,the wound healing rates of the Shixiang plaster group were(62.15±3.82)％and(81.68±3.83)％,respectively,higher than(47.14±2.80)％and(69.96±6.49)％of the Kangfuxin solu-tion group and(29.14±9.52)％and(57.91±6.63)％of the model group,and there were significant differences(F=21.716,12.626,P=0.002,0.007).The bacterial colony counts of the Shixiang plaster group were less than those of the Kangfuxin solution group and the model group after the drug administration for 14 and 28 days(P＜0.05).The result of HE staining showed that the Shixiang plaster group had a better wound healing.The result of IHC indicated that the expression levels of Nrf-2,HO-1 and VEGF of the Kangfuxin solution group and the Shix-iang plaster group were up-regulated after the drug administration for 28 days,while the expression levels of TNF-α and IL-6 were down-regulated.The expression levels of Nrf-2 and HO-1 proteins of the Shixiang plaster group were higher than those of the Kangfuxin solution group and the model group after the drug administration for 14 and 28 days,the levels of serum MDA and ROS of the Shixiang plaster group were lower than those of the Kangfuxin solution group and the model group,and the serum SOD level of the Shixiang plaster group was higher than that of the model group(P＜0.05).CONCLUSIONS Shixiang plaster can effectively promote the wound heal-ing of the rats with diabetic foot ulcers and reduce the bacterial colony counts of wound surfaces.The mechanism may be associated with the alleviation of oxidative stress injury by mediating the Nrf-2/HO-1 signaling pathways,promotion of angiogenesis and inhibition of excessive inflammatory reactions.

Objective To investigate the effect of long non-coding RNA small nucleolar RNA host gene 14(LncRNA SNHG14)on high glucose-induced podocyte injury by targeting microRNA-30a-5p(miR-30a-5p).Methods Podocytes were cultured in vitro and were divided into the following groups:the standard glucose(NG)group,the high glucose(HG)group,the si-NC+HG group,the si-SNHG14+HG group,the miR-NC+HG group,the miR-30a-5p mimics+HG group,the si-SNHG14+inhibitor NC+HG group and the si-SNHG14+miR-30a-5p inhibitor+HG group.Quantitative real-time polymerase chain reaction(RT-qPCR)was performed to detect expression levels of LncRNA SNHG14 and miR-30a-5p.Flow cytometry was used to determine cell apoptosis.Enzyme-linked immunosorbent assay(ELISA)was applied to measure levels of tumor necrosis factor-alpha(TNF-α),interleukin(IL)-6 and IL-1β.Xanthine oxidase method,ammonium molybdate colorimetry and thiobarbituric acid method were respectively used to detect superoxide dismutase(SOD),catalase(CAT)and malondialdehyde(MDA).Dual-luciferase reporter gene was conducted to verify the targeting relationship between LncRNA SNHG14 and miR-30a-5p.Western blot assay was performed to detect expression levels of apoptosis-related proteins.Results Compared with the NG group,the HG group exhibited increased expression levels of LncRNA SNHG14,cell apoptosis rate,as well as levels of TNF-α,IL-6,IL-1β and MDA,whereas the expression level of miR-30a-5p and levels of SOD and CAT were decreased(P＜0.05).Compared with the HG group and the si-NC+HG group,the si-SNHG14+HG group exhibited decreased expression levels of LncRNA SNHG14,apoptosis rate,levels of TNF-α,IL-6,IL-1β and MDA,as well as expression levels of Bax and cleaved caspase-3 proteins,while the expression level of miR-30a-5p,levels of SOD and CAT and the expression level of Bcl-2 protein were increased(P＜0.05).Compared with the HG group and the miR-NC+HG group,the miR-30a-5p mimics+HG group showed no significant difference in the expression level of LncRNA SNHG14(P＞0.05).Meanwhile,the expression level of miR-30a-5p,levels of SOD and CAT,and expression level of Bcl-2 protein were increased,whereas the cell apoptosis rate,levels of TNF-α,IL-6,IL-1β and MDA,as well as expression levels of Bax and cleaved caspase-3 proteins were decreased(P＜0.05).Compared with the si-SNHG14+HG group and the si-SNHG14+inhibitor NC+HG group,the si-SNHG14+miR-30a-5p inhibitor+HG group showed no significant difference in the expression level of LncRNA SNHG14(P＞0.05),meanwhile,the expression level of miR-30a-5p,levels of SOD and CAT,and expression level of Bcl-2 protein were reduced,whereas the cell apoptosis rate,levels of TNF-α,IL-6,IL-1β and MDA,as well as expression levels of Bax and cleaved caspase-3 proteins were increased(P＜0.05).The dual-luciferase reporter gene assay confirmed that LncRNA SNHG14 targeted and negatively regulated miR-30a-5p.Conclusion The inhibition of LncRNA SNHG14 can target miR-30a-5p to alleviate high glucose induced podocyte injury.

Objective To establish the fingerprints and predict the quality markers of Sanqi Shenfeng oral liquid based on fingerprint and network pharmacology.Methods The fingerprints of 12 batches of Sanqi Shenfeng oral liquid were established by using HPLC,and their peaks were identified and assigned.The candidate components were selected by multiple statistical analysis methods such as similarity evaluation,hierarchical cluster analysis,principal component analysis and orthogonal partial least squares discrimination analysis(OPLS-DA).The"component-target-pathway"network diagram was constructed by network pharmacology,and the quality markers of Sanqi Shenfeng oral liquid were predicted.Results The 13 common peaks were identified from the established fingerprint.Compared with the reference material,eight common peaks were identified as 3(tetrahydroxystilbene glucoside),5(sodium benzoate),6(lobetyolin),7(notoginsenoside Ri),9(ginsenoside Rgi),10(ginsenoside Re),12(10-hydroxy-2-decenoic acid),13(ginsenoside Rb1).The similarity of 12 batches of Sanqi Shenfeng oral liquid samples was higher than 0.997,and 12 batches of samples were grouped into two categories.OPLS-DA analysis showed that peaks 2,3,4,7,9,10,11,12 were the main signature components affecting the quality of Sanqi Shenfeng oral liquid.Network pharmacology predicted that lobetyolin,notoginsenoside R1,ginsenoside Rg1,ginsenoside Rb1,ginsenoside Re and 10-hydroxy-2-decenoic acid were potential Q-markers of Sanqi Shenfeng oral liquid.The traditional functions are performed through STAT3/AKT1-Drp1,HIF-1 and PI3K-AKT signaling pathway.Conclusion The established fingerprint has good reproducibility,stability and feasibility.The six components have great influence on the quality of Sanqi Shenfeng oral liquid,which are transferable and traceable,and are closely related to the efficacy.They can be used as potential quality markers to provide a scientific basis for the quality control and evaluation of Sanqi Shenfeng oral liquid.

Objective:To explore the mediating effect of illness acceptance between self-compassion and rehabilitation motivation in stroke patients with partial disability.Methods:By convenience sampling method, stroke patients who attended the neurology outpatient clinic of Xinxiang Central Hospital from February to December 2024 were selected as the research subjects. The General Information Questionnaire, Self-Compassion Scale (SCS), Chinese version of Acceptance of Illness Scale (AIS-CHI), and Stroke Rehabilitation Motivation Scale (SRMS) were used for the survey. Pearson correlation analysis was applied to analyze the relationships among self-compassion, illness acceptance, and rehabilitation motivation. AMOS 21.0 software was used to establish a structural equation model and verify the mediating effect.Results:A total of 300 questionnaires were distributed, and 289 valid ones were recovered, with an effective recovery rate of 96.33%. Among the 289 stroke patients with partial disability, the total score of SCS was (65.73±5.50), the total score of AIS-CHI was (17.46±5.62), and the total score of SRMS was (77.18±10.97). Pairwise positive correlations were found between self-compassion, illness acceptance, and rehabilitation motivation (all P<0.05). Self-compassion had a direct positive effect on rehabilitation motivation ( β=0.328, P<0.01) and a direct positive effect on illness acceptance ( β=0.439, P<0.01). Illness acceptance played a partial mediating role between self-compassion and rehabilitation motivation, and the mediating effect accounted for 31.38% of the total effect (0.150/0.478) . Conclusions:The levels of self-compassion, illness acceptance, and rehabilitation motivation in stroke patients with partial disability need to be further improved. Illness acceptance exerts a partial mediating effect between self-compassion and rehabilitation motivation. Clinically, the rehabilitation motivation of patients can be enhanced by improving their levels of self-compassion and illness acceptance.

Excessive ionizing radiation can disrupt the molecular structures of organisms,leading to health issues such as acute radiation syndrome and cancer,posing serious threats to human health.The development of radioprotective drugs holds significant importance for mitigating ionizing radiation damage and safeguarding public health,yet its research process faces multidimensional ethical challenges.This paper systematically explores the ethical issues involved in the full lifecycle of radioprotective drug development,focusing on the ethical particularities of animal experimentation,ethical dilemmas in human trials,data privacy and security risks,as well as challenges in managing conflicts of interest.Targeted solutions are proposed,including strengthening ethical review mechanisms,promoting interdisciplinary collaboration,constructing data security management systems,and establishing conflict-of-interest mediation mechanisms.These comprehensive measures aim to build a scientifically rigorous ethical framework for radioprotective drug research,fostering sustainable development in this field.

Objective To explore the therapeutic effect and potential mechanism of CA330 and OXIRIS adsorbent columns in septic shock.Methods Patients who met the diagnostic criteria for septic shock and admitted to the De-partment of Critical Care Medicine of Shenzhen Third People's Hospital from February 2022 to June 2024 were se-lected.They were randomly divided into an OXIRIS group and a CA330 group according to the random number table method.The CA330 group received hemoperfusion combined with hemodiafiltration using CA330 adsorbent co-lumn,while the OXIRIS group was treated with OXIRIS adsorbent column.Relevant markers of the two groups of patients before and after treatment were collected and compared,including inflammatory markers,bilirubin(total bilirubin[TBil],direct bilirubin[DBil]),coagulation functions(prothrombin time[PT],activated partial throm-boplastin time[APTT],etc),endotoxin(ETX),organ function scores(acute physiology and chronic health score Ⅱ[APACHE Ⅱ],sequential organ failure assessment[SOFA],etc).Molecular biology techniques were adopted to detect changes in inflammation-related gene expression(nuclear factor kappa B[NF-κB],toll-like receptor 4[TLR4],myeloid differentiation factor 88[MyD88]),and oxidative stress factors(glutathione peroxidase[GSH-Px],superoxide dismutase[SOD])in the blood of patients before and after treatment.The safety and effectiveness of two types of adsorbent columns during the treatment process was evaluated.Results A total of 92 patients were included and randomly divided into the OXIRIS group and the CA330 group,with 46 cases in each group.After treatment,the levels of TBil,DBil,and ETX in two groups of patients all showed significant decreases compared with before treatment(all P＜0.01),the levels of TBil,DBil,and ETX in patients in the OXIRIS group after treat-ment were all lower than those in the CA330 group during the same period(all P＜0.05);PT and APTT in both groups shortened significantly compared with before treatment(both P＜0.01),PT and APTT in the OXIRIS group after treatment were both shorter than those in the CA330 group during the same period(both P＜0.05);The APACHE Ⅱ score and SOFA score in patients in the OXIRIS group after treatment were both lower than those in the CA330 group during the same period(both P＜0.05);The levels of serum high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,IL-5,and IL-8 in patients in both groups showed significant decreases compared with before treatment(all P＜0.05),and the levels of these serum markers in the CA330 group after treatment were all lower than those in the OXIRIS group during the same period(all P＜0.05).The gene expression levels of NF-κB,TLR4,and MyD88 in patients in the CA330 group after treatment were all lower than those in the OXIRIS group during the same period(all P＜0.05);The levels of GSH-Px and SOD in pa-tients in the OXIRIS group after treatment were both higher than those in the CA330 group(both P＜0.01).No serious adverse event occurred in patients in the CA330 group and the OXIRIS group during the treatment process.Conclusion OXIRIS may be better in clearing bilirubin and endotoxin,improving coagulation function,protecting organ function,and regulating oxidative stress response in patients,while CA330 may be more prominent in clearing inflammatory markers and regulating inflammation-related gene expression in patients.

Objective:To analyze the association between remnant cholesterol (RC) and the risk of atherosclerotic cardiovascular disease (ASCVD) in community population in Shanghai.Methods:Using baseline and follow-up data from the Shanghai Suburban Adult Cohort and Biobank, individuals with ASCVD (including coronary heart disease, stroke, myocardial infarction, and peripheral artery disease) at baseline were excluded. A Cox proportional hazards regression model was employed to analyze the relationship between RC and ASCVD risk and the association under different LDL-C levels.Results:A total of 57 281 participants were included, with a median follow-up of 5.61 person-years. During the follow-up, 1 436 ASCVD events (2.51%) were recorded. After adjusting for potential confounders, individuals with moderate ( HR=1.18, 95% CI: 1.03-1.36) or high RC levels ( HR=1.32, 95% CI: 1.15-1.51) had an increased risk of ASCVD. The association was stronger in participants younger than 60 years-old (interaction P=0.048). Participants with RC ≥0.97 mmol/L and LDL-C <3.40 mmol/L demonstrated a 19% ( HR=1.19, 95% CI: 1.06-1.35) increased risk of ASCVD. When RC ≥0.97 mmol/L and LDL-C ≥3.40 mmol/L, ASCVD risk increased by 42% ( HR=1.42, 95% CI: 1.21-1.67). Conclusions:Elevated RC increases ASCVD risk, regardless of LDL-C levels. RC can serve as a valuable predictor and intervention target for ASCVD.