ObjectiveTo investigate the effect of Gelian Tiaotang pills on renal fibrosis in db/db mice based on the nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 （NLRP3）/cysteinyl aspartate-specific proteinase （Caspase）-1/gasdermin D （GSDMD） signaling pathway. MethodsForty db/db mice were randomly assigned into model， positive control （0.001 3 g·kg·d^-1 dapagliflozin suspension）， and high-， medium-， and low-dose Gelian Tiaotang pills （3.12， 1.56， and 0.78 g·kg·d^-1 suspension of Gelian Tiaotang pills， respectively） groups， with 8 mice in each group. Eight db/m mice were selected as the normal group. The normal group and model group were given equal volumes of pure water， while the drug interventions groups were administrated with corresponding agents by gavage once a day for 12 consecutive weeks. The general conditions of mice were observed daily. The fasting blood glucose （FBG） and body mass were measured every 4 weeks. Kidneys were weighed after sampling， and the kidney index was calculated. An automatic biochemical analyzer was used to measure the serum levels of triglyceride （TG）， total cholesterol （TC）， serum creatinine （SCr）， and blood urea nitrogen （BUN）. The pathological changes， extracellular matrix deposition， and renal fibrosis degree were examined by hematoxylin-eosin， periodic acid-schiff （PAS）， and Masson staining， respectively. Enzyme-linked immunosorbent assay was employed to measure the levels of interleukin （IL）-1β and IL-18 in the renal tissue. Immunohistochemistry （IHC） was used to detect the localization and expression of fibronectin and collagen Ⅰ in the renal tissue. Western blot was employed to determine the protein levels of NLRP3， Caspase-1， cleaved Caspase-1， GSDMD， and GSDMD-N in the renal tissue. ResultsCompared with the normal group， the model group generally had poor general states and increases in the body mass， kidney weight， kidney index， and levels of FBG， TG， TC， SCr， and BUN （P<0.01）. In addition， glomerular pyknosis， increased matrix， vacuolar degeneration of renal tubular epithelial cells， and interstitial infiltration of inflammatory cells were observed in the model group （P<0.01）， together with rises in the levels of IL-1β and IL-18 in the renal tissue （P<0.01） and up-regulated protein levels of NLRP3， Caspase-1， cleaved Caspase-1， GSDMD， GSDMD-N， fibronectin， and collagen Ⅰ in the renal tissue （P<0.01）. Compared with the model group， 12 weeks of drug interventions reduced the body mass， kidney weight， and kidney index and lowered the levels of FBG， TG， TC， SCr， and BUN in the serum and IL-1β and IL-18 in the renal tissue （P<0.05， P<0.01）. Furthermore， drug interventions ameliorated the renal lesions and down-regulated the protein levels of NLRP3， Caspase-1， cleaved Caspase-1， GSDMD， GSDMD-N， fibronectin， and collagen Ⅰ in the renal tissue （P<0.05， P<0.01）. The high-dose group of Gelian Tiaotang pills had the best effects. ConclusionGelian Tiaotang pills may inhibit pyroptosis and reduce inflammatory responses by regulating the NLRP3/Caspase-1/GSDMD signaling pathway， thus delaying the process of renal fibrosis in diabetes.

Objective To explore the clinical efficacy of the medicated stick massage at meridian knot points in treating Qi stagnation and blood stasis type lumbar disc herniation(LDH)based on the meridian theory.Methods The patients with LDH in the ward 5 of orthopedics department in this hospital from Sep-tember 2024 to April 2025 were selected as the research subjects.On the basis of routine treatment and care,the control group adopted the medicated stick massage at points,while the experimental group adopted the medicated stick massage at meridian knots.The visual analogue scale(VAS)scores,Japanese Orthopaedic So-ciety(JOA)score,TCM syndrome scores and TCM syndrome therapeutic effects before intervention and in two weeks after intervention were compared between the two groups.Results The VAS scores,each item score and total score of JOA,TCM syndrome scores and TCM therapeutic effects after 2-week intervention in the experimental group all were superior to those in the control group,and the differences were statistically significant(P＜0.05).Conclusion Selecting the medicated stick massage at the meridian knots under the guidance of meridian theory could significantly improve the pain symptoms,lumbar function,TCM syndrome scores,the therapeutic effects are definite,and is worthy of clinical promotion and application.

ObjectiveTo observe the clinical efficacy and safety of Tangning Tongluo tablets in the treatment of nonproliferative diabetic retinopathy （DR）. MethodsFourteen research centers participated in this study， which spanned a time interval from September 2021 to May 2023. A total of 240 patients with nonproliferative DR were included and randomly assigned into an observation group （120 cases） and a control group （120 cases）. The observation group was treated with Tangning Tongluo tablets， and the control group with calcium dobesilate capsules. Both groups were treated for 24 consecutive weeks. The vision， DR progression rate， retinal microhemangioma， hemorrhage area， exudation area， glycosylated hemoglobin （HbA1c） level， and TCM syndrome score were assessed before and after treatment， and the safety was observed. ResultsThe vision changed in both groups after treatment （P<0.05）， and the observation group showed higher best corrected visual acuity （BCVA） than the control group （P<0.05）. The DR progression was slow with similar rates in the two groups. The fundus hemorrhage area and exudation area did not change significantly after treatment in both groups， while the observation group outperformed the control group in reducing the fundus hemorrhage area and exudation area. There was no significant difference in the number of microhemangiomas between the two groups before treatment. After treatment， the number of microhemangiomas decreased in both the observation group （Z=-1.437， P<0.05） and the control group （Z=-2.238， P<0.05）， and it showed no significant difference between the two groups. As the treatment time prolonged， the number of microhemangiomas gradually decreased in both groups. There was no significant difference in the HbA1c level between the two groups before treatment. After treatment， the decline in the HbA1c level showed no significant difference between the two groups. The TCM syndrome score did not have a statistically significant difference between the two groups before treatment. After treatment， neither the TCM syndrome score nor the response rate had significant difference between the two groups. With the extension of the treatment time， both groups showed amelioration of TCM syndrome compared with the baseline. ConclusionTangning Tongluo tablets are safe and effective in the treatment of nonproliferative DR， being capable of improving vision and reducing hemorrhage and exudation in the fundus.

Diabetic kidney disease(DKD)is one of the common microvascular complications of diabetes mellitus,and it has become the main cause of chronic kidney disease and end stage renal disease.Traditional Chinese medicine can delay the progress of DKD by inhibiting oxidative stress,improving renal tissue damage,restoring renal function.This paper will summarize the relationship between oxidative stress and DKD and the prevention and treatment of DKD by traditional Chinese medicine,so as to provide reference for clinical drug application,basic research and new drug research and development of DKD.

Objective To investigate the impacts of epidural anesthesia with ropivacaine combined with dezocine on lower limb motor nerve block and maternal and infant outcomes in primipara undergoing painless delivery.Methods A total of 159 primiparas who delivered in Nanjing Jiangbei Hospital were selected as the research objects,and divided into the blank group(53 cases),the ropivacaine group(53 cases)and the combined group(53 cases)by the random number table method.Parturients in the blank group were given natural delivery mode,parturients in the ropivacaine group were given ropivacaine epidural anesthesia,and parturients in the combined group were given dezocine anesthesia on the basis of ropivacaine.Analgesic effect at different time points,time of the first,second and third stage of labor,pressing times of analgesic pump,lower limbs motor nerve block,maternal and infant outcomes,and adverse reactions of parturients were compared among the three groups.Results At 10 minutes after analgesia,60 minutes after analgesia,when the cervix was fully dilated and when the fetus was delivered,the VAS scores of the parturients in the ropivacaine group and the combined group were lower than those in the blank group(P<0.05),and the VAS scores of the parturients in the combined group were significantly lower than those in the ropivacaine group(P<0.05).There was no significant difference in the time of the first,second or third stage of labor of parturients among the three groups(P>0.05);The pressing times of analgesic pump of parturients in the combined group was significantly less than that in the ropivacaine group(P<0.05).There was no statistically significant difference in terms of low limb motor nerve block after painless labor of parturients among the three groups(P>0.05).There were no statistically significant differences in the perineal incision rate or the Apgar scores of newborns at 1 minute and 5 minutes after birth among the three groups(P>0.05).The usage rate of forceps and the rate of conversion to cesarean section in the combined group were significantly lower than those in the ropivacaine group and the blank group(P<0.05).There was no statistically significant difference in the incidence of total adverse reactions among the blank group,the ropivacaine group and the combined group(P>0.05).Conclusion The combination of ropivacaine and dezocine for epidural anesthesia has a better analgesic effect on primiparas with painless delivery,has a smaller impact on lower limb motor nerve block in parturients,and can achieve better maternal and infant outcomes.

OBJECTIVE To analyze the 7 species of common pathogens causing acute respiratory infection(ARI)in children in Zhongshan,Guangdong,from 2019 to 2023,and to provide references for preventive measures and clinical treatment of ARI.METHODS A total of 14 261 children with ARI aged 14 years and younger,hospital-ized in the Pediatric Department of Zhongshan City People's Hospital from Jan.2019 to Oct.2022 and from Mar.to Dec.2023,were selected as the study subjects.The positive detection rates of seven common respiratory pathogens were compared across three periods:pre-pandemic period(2019),pandemic control period(from 2020 to Oct.2022)and normalization period(from Mar.to Dec.2023)of COVID-19.RESULTS The overall detection rates of pathogens were 59.72％,37.83％and 85.82％in the pre-pandemic,control and normalization periods,respectively.The pathogens with the highest detection rates were Streptococcus pneumoniae(Spn)at 19.81％,respiratory syncytial virus(RSV)at 11.33％,Mycoplasma pneumoniae(MP)at 9.53％,Haemophilus influ-enzae(Hi)at 5.90％,influenza A virus(FluA)at 3.49％,adenovirus(ADV)at 3.30％and Bordetella pertussis(BP)at 0.72％.The mixed infection rate was 8.46％in the pre-pandemic period,mainly involving"MP+Spn"and"Spn+RSV".During the pandemic control period,the mixed infection rates were 4.95％,4.65％and 3.66％,respectively.After the pandemic normalization,the mixed infection rate rose to 17.75％,mainly invol-ving"Hi+Spn"and"Spn+RSV".The detection rates of RSV were 7.82％,11.90％and 14.44％in the pre-pan-demic,control and normalization periods,respectively,with a delayed epidemic pattern observed.The detection rates of Spn were 26.47％,17.45％and 16.99％in the three periods,respectively.The detection rates of MP were 12.53％,1.83％and 24.17％,respectively,with a delayed outbreak observed.CONCLUSIONS The preven-tion and control of COVID-19 involves non-pharmaceutical interventions,which are later lifted.The transmission of these seven common respiratory pathogens is affected,necessitating continuous monitoring of the pathogens.

Objective:To observe the effect of five element music therapy combined with progressive muscle relaxation(PMR)training on psychological stress and sleep quality in non-small cell lung cancer(NSCLC)chemotherapy patients.Methods:This was a prospective randomized controlled study,95 NSCLC chemotherapy patients were divided into control group(47 cases)and study group(48 cases)by random number table method.Both groups of patients received chemotherapy,the control group received PMR on this basis,while the study group received five element music therapy combined with PMR training.Self-rating depression scale(SDS),self-rating anxiety scale(SAS),sleep duration,Pittsburgh sleep quality Index(PSQI),Piper fatigue revised scale(PFS-R),European cancer research and treatment organization quality of life inventory(EORTC QLQ-C30),and Karnofsky Functional Status(KPS)scores were compared between the two groups.Results:Compared with the control group at 4 weeks after intervention,the study group had lower SAS,SDS,and PSQI scores,longer sleep duration,lower emotional,behavioral,cognitive,and sensory scores,and higher EORTC QLQ-C30 and KPS scores(P＜0.05).Conclusion:Five element music therapy combined with PMR training in non-small cell lung cancer(NSCLC)chemotherapy patients,can effectively improve the psychological stress,sleep quality,and healthy behavior,alleviate cancer-related fatigue,and enhance their quality of life.

At present,the drug substitutes represented by new psychoactive substances are gradually be-coming popular,leading to an increasing demand for identifying novel drugs with unknown structures in drug investigation.Nuclear magnetic resonance(NMR)spectroscopy is an important tool for ana-lyzing molecular structures.In the absence of standard substances,quantitative NMR(qNMR)can un-dertake the quantitative analysis of target substances in complex mixtures and has unique advantages in the research of new drugs and their precursor drugs.Due to the limitations of the site and mainte-nance costs,as well as relatively complex operation,high-field superconducting NMR is less com-monly applied in drug research.The desktop low-field NMR developed in recent years provides a new alternative solution.Due to the use of permanent magnets,its size is reduced,and the operation and maintenance costs are lowered.It has been widely used in various research fields.This article reviews the development of low-field NMR technology,summarizes the application of desktop low-field NMR in screening and identification of suspicious substances,rapid content determination,analysis of drug manufacturing processes and synthetic routes,and correlation traceability.It also looks forward to the prospects and development directions of this technology in drug research,aiming to provide a reference for researchers who work in analytical chemistry and drug research.

OBJECTIVE To analyze the 7 species of common pathogens causing acute respiratory infection(ARI)in children in Zhongshan,Guangdong,from 2019 to 2023,and to provide references for preventive measures and clinical treatment of ARI.METHODS A total of 14 261 children with ARI aged 14 years and younger,hospital-ized in the Pediatric Department of Zhongshan City People's Hospital from Jan.2019 to Oct.2022 and from Mar.to Dec.2023,were selected as the study subjects.The positive detection rates of seven common respiratory pathogens were compared across three periods:pre-pandemic period(2019),pandemic control period(from 2020 to Oct.2022)and normalization period(from Mar.to Dec.2023)of COVID-19.RESULTS The overall detection rates of pathogens were 59.72％,37.83％and 85.82％in the pre-pandemic,control and normalization periods,respectively.The pathogens with the highest detection rates were Streptococcus pneumoniae(Spn)at 19.81％,respiratory syncytial virus(RSV)at 11.33％,Mycoplasma pneumoniae(MP)at 9.53％,Haemophilus influ-enzae(Hi)at 5.90％,influenza A virus(FluA)at 3.49％,adenovirus(ADV)at 3.30％and Bordetella pertussis(BP)at 0.72％.The mixed infection rate was 8.46％in the pre-pandemic period,mainly involving"MP+Spn"and"Spn+RSV".During the pandemic control period,the mixed infection rates were 4.95％,4.65％and 3.66％,respectively.After the pandemic normalization,the mixed infection rate rose to 17.75％,mainly invol-ving"Hi+Spn"and"Spn+RSV".The detection rates of RSV were 7.82％,11.90％and 14.44％in the pre-pan-demic,control and normalization periods,respectively,with a delayed epidemic pattern observed.The detection rates of Spn were 26.47％,17.45％and 16.99％in the three periods,respectively.The detection rates of MP were 12.53％,1.83％and 24.17％,respectively,with a delayed outbreak observed.CONCLUSIONS The preven-tion and control of COVID-19 involves non-pharmaceutical interventions,which are later lifted.The transmission of these seven common respiratory pathogens is affected,necessitating continuous monitoring of the pathogens.

Objective:To detect the expression of autophagy-related genes (ATGs) involved in the late stage of autophagy in peripheral blood mononuclear cells (PBMCs) of patients with ankylosing spondylitis (AS), analyze the difference and explore its possible clinical significance.Methods:① Peripheral blood specimens and clinical data were collected from 90 AS patients (AS group) who attended the outpatient clinic of the Department of Rheumatology and Immunology of the Affiliated Hospital of North Sichuan Medical College from March 2022 to August 2023, among which 30 patients were treated with secukinumab monoclonal antibody for 24 weeks (the treatment group), and clinical data and peripheral blood specimens from 45 healthy individuals (the HC group) who had medical checkups in the Affiliated Hospital of Chuanbei Medical College during the same period were used as the control group. As the control group, the mRNA expression levels of six ATGs (ATG5, ATG7, LC3-Ⅱ, ATG4B, ATG2A, ATG10) involved in the late autophagy stage were detected in PBMCs of peripheral blood specimens by RT-qPCR, and were compared among different groups, and the measured data conformed to the normal distribution were analyzed using the paired t-test, and the abnormal distribution date were analyzed using the Wilcoxon signed-rank test. Wilcoxon signed-rank test was used for measurement data, and Spearman correlation analysis was used for correlation analysis. ② Receiver operating curve (ROC) was used to verify the difference in the expression of ATGs in the late stage of autophagy between AS group and HC group to evaluate its value in the diagnosis of AS and the inflammatory state of the disease. Results:① Compared with the HC group, ATG2A [2.00(1.10, 2.70)×10 -3, 7.50(4.60, 10.0)×10 -3, Z=-6.67, P<0.001], ATG5 [3.60 (2.30, 5.30)×10 -3, 7.20(5.50, 9.20)×10 -3, Z=-3.63, P=0.001], LC3Ⅱ[25.70(8.50, 35.00)×10 -3, 52.20(45.00, 69.10)×10 -3, Z=-5.87, P<0.001] and ATG7[5.50(3.20, 8.10)×10 -3, 8.30(5.20, 9.80)×10 -3, Z=-2.38, P=0.017] the mRNA expressions were significantly decreased in the AS group. ②ATG5 mRNA expression was negatively correlated with platelet count ( r=-0.35, P=0.008), LC3-Ⅱ was negatively correlated with estimated glomerular filtration rate ( r=-0.33, P=0.017), ATG7 was positively correlated with absolute basophil count ( r=0.33, P=0.011),ATG10 was negatively correlated with estimated glomerular filtration rate and C-reactive protein (CRP) was negatively correlated ( r=-0.30, P=0.032). ③ The area under the ROC curve (AUC) of ATG2A mRNA expression level for predicting AS was 0.910, and the sensitivity and specificity were 94.6% and 83.8% respectively. ④ After 24 weeks of treatment with secukinumab, the mRNA expression levels of ATG2A[2.00(1.20, 2.90)×10 -3, 4.90(0.10, 7.40)×10 -3, Z=-3.75, P<0.001] and LC3-Ⅱ[2.00(1.20, 2.90)×10 -3, 4.90(0.10, 7.40)×10 -3, Z=-3.75, P<0.001]were elevated in the AS patients. Conclusion:Late autophagy-related genes ATG2A, ATG5, LC3II, ATG7 may be involved in AS development.The AUC of ATG2A in AS is 0.91, suggesting that ATG2a is expected to be a biological indicator for early diagnosis of AS. Secukinumab may be involved in the regulation of autophagy by affecting the expression of late autophagy genes, but the specific mechanism needs to be further explored.