ObjectiveTo investigate the efficacy of Xingpi capsules （XPC） in treating diarrhea-predominant irritable bowel syndrome （IBS-D） with spleen deficiency and elucidate its potential molecular mechanisms. MethodsA rat model of IBS-D with spleen deficiency was established by administering senna leaf in combination with restrained stress and swimming fatigue for 14 d. Ten specific pathogen free （SPF）-grade healthy rats were used as the normal control group. After successful modeling， SPF-grade rats were randomly divided into a model group， a pinaverium bromide group （1.5 mg·kg^-1）， and low- and high-dose XPC groups （0.135 and 0.54 g·kg^-1）， with 10 rats in each group. Rats in the normal control group and the model group were given distilled water by gavage， while the remaining groups were administered corresponding drug solutions by gavage once a day for 14 consecutive days. The rat body weights and fecal condition were observed every day， and the Bristol score was recorded. Enzyme-linked immunosorbent assay （ELISA） was used to determine the levels of 5-hydroxytryptamine （5-HT） in serum and colon tissue. Transmission electron microscopy was used to observe the microvilli and tight junctions in the colon. The integrity of the colonic barrier， intestinal motility， and expression of related pathway proteins were evaluated by hematoxylin-eosin （HE） staining， immunohistochemistry， and Western blot. ResultsCompared with those in the normal control group， rats in the model group showed a significantly decreased body weight and increased diarrhea rate， diarrhea grade， and Bristol score （P<0.01）. HE staining revealed incomplete colonic mucosa in the model group， with evident congestion and edema observed. Electron microscopy results indicated decreased density and integrity of the colonic barrier， shedding and disappearance of microvilli， and significant widening of tight junctions. The expression levels of colonic tight junction proteins Occludin and Claudin-5 were downregulated （P<0.01）， and the levels of 5-HT in serum and colon tissue were elevated （P<0.01）. The small intestine propulsion rate significantly increased （P<0.01）， and the expression of contractile proteins Ras homolog family member A （RhoA） and Rho-associated coiled-coil containing protein kinase 2 （ROCK2） in colon and phosphorylation of myosin light chain （MLC₂₀） were upregulated （P<0.01）. Compared with the model group， the treatment groups showed alleviated diarrhea， diarrhea-associated symptoms， and pathological manifestations of colon tissue to varying degrees. Specifically， high-dose XPC exhibited effectively relieved diarrhea， promoted recovery of colonic mucosal structure， significantly reduced congestion and edema， upregulated expression of Occludin and Claudin-5 （P<0.01）， decreased levels of 5-HT in serum and colon tissue （P<0.05，P<0.01）， significantly slowed small intestine propulsion rate （P<0.01）， and significantly downregulated expression of contractile proteins RhoA and ROCK2 in colon and phosphorylation of MLC₂₀ （P<0.05，P<0.01）. ConclusionXPC effectively alleviates symptoms of spleen deficiency and diarrhea and regulates the secretion of brain-gut peptide. The characteristics of XPC are mainly manifested in alleviating IBS-D with spleen deficiency from the aspects of protecting intestinal mucosa and inhibiting smooth muscle contraction， and the mechanism is closely related to the regulation of the 5-HT-RhoA/ROCK2 pathway expression.

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Objective To evaluate the prevention and control effectiveness of four major chronic diseases in Youyang County, and find the weak link of prevention and control, and to provide theoretical support for improving prevention and control strategies. Methods Based on the death data of permanent residents from 2012 to 2020 extracted from the cause-of-death registration and reporting system of Youyang County, a statistical analysis was conducted using SPSS19.0. The annual percentage change (APC) was tested by t-test. Results From 2012 to 2020, the mortality rate of and the standardized mortality rate of the four major chronic diseases and the premature mortality rate of diabetes in males showed an increasing trend (APC was 3.05%, 1.82% and 27.12%, respectively, P < 0.05). The mortality rate of the four chronic diseases in females increased (APC was 2.53%, P < 0.05), while the proportion of premature death of the four chronic diseases and the probability of premature death of cardiovascular and cerebrovascular diseases in females decreased (APC was -2.37%, -5.73%, P < 0.05). The standardized mortality rate and premature death rate of the four major chronic diseases were higher in males than those in females. The mortality rate of the four major chronic diseases and the premature death rate of diabetes in the whole population were on the rise (APC was 2.84% and 12.86%, P < 0.05). It was expected that the early death probability of the four major chronic diseases in Youyang County would be 12.65% in 2030, higher than the target value of 12.59% of ^“Healthy China 2030^”. Conclusion The future focus of Youyang County is to prevent and control malignant tumors and diabetes, especially to strengthen the prevention and control of male diabetes.

Objective To investigate the effects of Shechuangzi San on Th1/Th2 immune function in eczema rats and analyze its mechanisms in treating eczema.Methods Fifty SD rats were randomly divided into blank group,model group,Shechuangzi San high dose group,Shechuangzi San low dose group,and Bingbaiye liquid group,with 10 rats in each group.The rat eczema model was established using 2,4-dinitrochlorobenzene.The blank group and model group were topically treated with 0.9%saline,the Shechuangzi San high dose group was topically treated with a decoction of Shechuangzi San at a concentration of 2.32 g·mL-1,and the low dose group was topically treated with a decoction of Shechuangzi San at a concentration of 1.16 g·mL-1.And the Bingbaiye liquid group was topically treated with the original liquid of Bingbaiye,once in the morning and once in the evening,for a total of 14 days.After the last administration,the skin lesions on the rats'backs were observed and the skin lesion scores were evaluated.The pathological changes of eczema lesions were observed by HE staining,and semi-quantitatively scored.ELISA method was used to detect the levels of IFN-γ,IL-4,IL-18,and IL-33 in rat serum.Flow cytometry was used to determine the Th1/Th2 ratio in the serum.Results Compared to the blank group,the rat skin lesion score in the model group was significantly increased(P<0.05),with a series of skin lesions including edema,erythema,scaling,lichenification appearing on the back.Pathological sections showed excessive keratosis,thickening of cuticular layer,edema of epidermis sponge,infiltration of a large number of inflammatory cells in epidermis,and the semi-quantitative score of skin lesions was significantly increased(P<0.05).Serum levels of IL-4,IL-18,and IL-33 were significantly increased(P<0.05),while the level of IFN-γ was significantly decreased(P<0.05).Serum Th1/Th2 ratio decreased(P<0.05).Compared to the model group,the rat skin lesions in the Shechuangzi San high and low dose groups and the Bingbaiye liquid group were significantly improved(P<0.05),Pathological sections showed that the structure of epidermis was restored to normal,the cuticle became thinner,the spongy edema of epidermis disappeared,epidermal inflammatory cells disappeared,and the semi-quantitative score of skin lesions decreased(P<0.05).Serum levels of IL-4,IL-18,and IL-33 were decreased(P<0.05),while the level of IFN-γ was increased(P<0.05),serum Th1/Th2 ratio increased significantly(P<0.05).and the therapeutic effect of the Shechuangzi San high and low dose groups was superior to that of the Bingbaiye liquid group(P<0.05).Conclusion Shechuangzi San can effectively improve the skin lesions of rats with eczema,repair the pathological damage of skin lesions,and reduce the levels of inflammatory factors.Its mechanism may be related to the inhibition of secretion of inflammatory factors such as IL-4,IL-18,and IL-33,promotion of IFN-γ release,and restoration of Th1/Th2 imbalance.

Objective:To analyze the changes in electrical impedance tomography (EIT) during the extubation phase in critically ill patients undergoing invasive mechanical ventilation (MV),and evaluate the value of EIT and EAdi in predicting extubation failure in critically ill patients.Methods:The clinical data of patients undergoing invasive mechanical ventilation and SBT in the emergency intensive care unit (EICU) of the First Affiliated Hospital of Anhui Medical University from January 2022 to June 2024 were prospectively collected. The values of EIT were monitored and recorded at pressure support ventilation, 2 hours after extubation and 6 hours after extubation. According to whether the patient was re-intubated within 48 hours after extubation,patients were divided into successful extubation group and extubation failure group. The values of EIT were compared at the same time point between the two groups, and the correlation analysis of the values of EIT was carried out. The ROC curve was used to analyze the predictive ability of EIT at pressure support ventilation, 2 hours after extubation and 6 hours after extubation after SBT passage for extubation failure.Results:A total of 110 patients were included in the study, of which 52 patients failed to extubation. Patients in the failed extubation group had a smaller available ventilation area (SAV) before and after extubation compared to those in the successful extubation group, and had a higher Global Inhomogeneity Index (GI) ( P<0.001). The regional ventilation delay and the the center of ventilation were not different between groups. Conclusions:The values of EIT are valid predictors of extubation failure in critically ill patients and are suitable for clinical application.

Objective To investigate the food allergy situation of children in Changping District of Beijing,and to explore the influence of allergic family history,gender and mode of delivery on food allergy in children,the distribution of food allergy in different age groups,the types of food allergy that are easy to cause in this area,and the comorbidities of food allergy.Methods A total of 515 children aged 0 to 14 years who were admitted to the general pediatric outpatient and emergency department and inpatient of Beijing Changping Hospital from April to November 2023.Using immunoblotting to detect specific immunoglobulin E in the serum of pediatric patients,and using SPSS 26.0 statistical software to perform binomial tests on gender and delivery mode non parameters;Using custom Excel functions to statistically analyze the family history of allergies,the number of people in different age groups,and the frequency of allergic foods in each group;Use a self-made mini program to statistically analyze the combination of comorbid allergic diseases.Results ① The number of male children with food allergies(306 cases)was higher than that of female children(209 cases),and the difference was statistically significant(P＜0.05).(2)There were 109 cases of pediatric patients with parents who had no history of allergic diseases,accounting for 21.17％of the total cases;There were a total of 406 cases where at least one parent had a family history of allergies,accounting for 78.83％of the total cases.Among them,228 cases(44.27％)had one parent with a history of allergies,and 178 cases(34.56％)had both parents with a history of allergies.③ Among 515 children with positive food allergens,there were 10 cases(1.94％)in infancy,37 cases(7.19％)in early childhood,235 cases(45.63％)in preschool,192 cases(37.28％)in school age,and 41 cases(7.96％)in adolescence.The highest positivity rate for food allergens is in milk(444 times),followed by egg white(70 times),cashew nuts(57 times),crab(37 times),beef(26 times),mango(24 times),shrimp(21 times),pineapple(6 times),and shellfish(1 time).Milk protein is the most common allergen in all age groups.(4)Among 515 children with food allergies,399 cases were single food allergies,accounting for 77.47％;116 cases of multiple food allergies(2 or more types of food allergies),accounting for 22.53％.⑤ The most common comorbidity of food allergies is food allergy related gastrointestinal diseases combined with allergic rhinitis,with a total of 267 cases;Secondly,there were 192 cases of allergic rhinitis combined with chronic cough,and 124 cases of food allergy related gastrointestinal diseases combined with chronic cough.Conclusion Milk is the main allergen of food allergy in people of age 14 and under,and gastrointestinal symptoms are the most common in children with food allergy.

Objective This study was conducted to analyze the clinical characteristics and pituitary function of patients with primary empty sella (PES).Methods The clinical data from 123 hospitalized adult patients with PES from January 2010 to May 2016 were retrospectively studied.Results (1) The average age of the 123 (male 43,female 80) PES patients was (59.2 ± 13.6) years (ranging 24-92 years),among whom 61％ patients were in the age group between 50-69 years.(2) The symptoms of the patients included fatigue (56.1％),headache (34.1％),nausea and vomiting (17.9％),gonadal dysfunction (17.1％),visual disturbance (5.7％) and hypopituitarism crisis (3.3％).(3) Hypopituitarism was found in 66 of the 123 patients.Among them,36.6％,31.7％ and 17.1％ were central hypoadrenalism,hypogonadism,and hypothyroidism,respectively.The percentage of hypopituitarism in complete PES was significantly higher than that in partial PES (P ＜ 0.05).(4) Sixteen patients were concomitant with other autoimmune diseases including 11 patients with Graves' disease and 2 with Cushing's syndrome due to adrenal adenoma.Conclusions The incidence of hypopituitarism in PES was 53.7％,in which the pituitary-adrenal axis hypofunction was more common.An overall evaluation of the pituitary function was essential for the patients who had headache and fatigue,or with suspected PES.The patients with hypopituitarism should be given hormone replacement therapy in time and followed up afterword.

An 80-year-old male patient with hypertension, arteriosclerosis, rheumatic heart disease, and atrial fibrillation long-term daily oral warfarin sodium 3 mg once daily.International normalized ratio (INR) was maintained at 2.00 to 3.00.An intravenous infusion of piperacillin sodium and tazobactam sodium 4.5 g every 8 hours, intramuscular injection of compound aminophenazone and barbital 2 ml, oral loxoprofen sodium 30 mg and other drugs were added to his regimen for pulmonary infection and high fever.Before the drug combination, prothrombin time (PT) was 27 s, and the INR was 2.45.Two days later, the patient developed hemoptysis.The next day, warfarin sodium was stopped.On the second day of discontinuation of warfarin sodium ,the patient suddenly felt a severe pain in the left upper abdomen with the sign of palpable mass and tenderness.Meanwhile, the PT was 42 s, and the INR was 4.46.On the next day, abdominal ultrasound examination showed that there was a cystic structure in the left abdominal rectus muscle with the size of 4.5 cm × 2.7 cm × 1.5 cm, and the internal circular high density shadow in the left rectus muscle was found on abdominal ultrasonography.Left abdominal rectus muscle hematoma was considered.Intramuscular injection of vitamin K1 10 mg once daily was given immediately, and ceftazidime was used instead of piperacillin sodium and tazobactam sodium.Two days later, the patient's symptoms of abdominal pain disappeared, PT fell to 16 s, INR fell to 1.11.One week later, oral warfarin sodium (initial dose 2.25 mg once daily)was given, and adjusted the dose according to INR.One month later, the abdominal ultrasound examination showed that the size of hematoma significantly decreased (3.5 cm × 0.8 cm).

An 80-year-old male patient with hypertension, arteriosclerosis, rheumatic heart disease, and atrial fibrillation long-term daily oral warfarin sodium 3 mg once daily.International normalized ratio (INR) was maintained at 2.00 to 3.00.An intravenous infusion of piperacillin sodium and tazobactam sodium 4.5 g every 8 hours, intramuscular injection of compound aminophenazone and barbital 2 ml, oral loxoprofen sodium 30 mg and other drugs were added to his regimen for pulmonary infection and high fever.Before the drug combination, prothrombin time (PT) was 27 s, and the INR was 2.45.Two days later, the patient developed hemoptysis.The next day, warfarin sodium was stopped.On the second day of discontinuation of warfarin sodium ,the patient suddenly felt a severe pain in the left upper abdomen with the sign of palpable mass and tenderness.Meanwhile, the PT was 42 s, and the INR was 4.46.On the next day, abdominal ultrasound examination showed that there was a cystic structure in the left abdominal rectus muscle with the size of 4.5 cm × 2.7 cm × 1.5 cm, and the internal circular high density shadow in the left rectus muscle was found on abdominal ultrasonography.Left abdominal rectus muscle hematoma was considered.Intramuscular injection of vitamin K1 10 mg once daily was given immediately, and ceftazidime was used instead of piperacillin sodium and tazobactam sodium.Two days later, the patient's symptoms of abdominal pain disappeared, PT fell to 16 s, INR fell to 1.11.One week later, oral warfarin sodium (initial dose 2.25 mg once daily)was given, and adjusted the dose according to INR.One month later, the abdominal ultrasound examination showed that the size of hematoma significantly decreased (3.5 cm × 0.8 cm).