Employing bibliometric methods and adhering to principles of textual research， this study systematically investigated prescription source， formula name， composition evolution， dose evolution， origin， processing， ancient and modern applications of Xiaofengsan. Xiaofengsan， also known as Renshen Xiaofengsan and Chantui Xiaofengsan， was first recorded in the Taiping Huimin Hejijufang（hereafter referred to as Jufang） of the Southern Song dynasty. The formula composition included Schizonepetae Spica， Glycyrrhizae Radix et Rhizoma， Chuanxiong Rhizoma， Notoptery Rhizoma et Radix， Bombyx Batryticatus， Saposhnikoviae Radix， Poria， Cicadae Periostracum， Pogostemonis Herba， Ginseng Radix et Rhizoma， Magnoliae Officinalis Cortex and Citri Reticulatae Pericarpium， a total of 12 medicinal materials. In terms of the evolution of formula composition， formulas across dynasties largely aligned with those recorded in Jufang， with only minor variations in application. The results of the formula dosage research indicated that one dose of medication in Jufang corresponded to the following modern dosages：Schizonepetae Spica of 82.6 g， Glycyrrhizae Radix et Rhizoma of 82.6 g， Chuanxiong Rhizoma of 82.6 g， Notoptery Rhizoma et Radix of 82.6 g， Bombyx Batryticatus of 82.6 g， Saposhnikoviae Radix of 82.6 g， Poria of 82.6 g， Cicadae Periostracum of 82.6 g， Pogostemonis Herba of 82.6 g， Ginseng Radix et Rhizoma of 82.6 g， Magnoliae Officinalis Cortex of 20.65 g and Citri Reticulatae Pericarpium of 20.65 g， the origins of all the constituent drugs were consistent with the 2020 edition of Pharmacopoeia of the People's Republic of China. The results of the investigation into the decoction method indicated that the aforementioned drugs should be finely ground into powder（pass through the No.5 sieve）， and 8.26 g was taken for each dose， which was taken with the clear liquid obtained by steeping tea leaves in boiling water for several minutes. This mixture was administered three times daily， 30 min after meals. The ancient functional indications of this formula mainly involved dispelling wind-heat， eliminating pathogenic factors and regulating the middle Jiao. It primarily treated all wind-heat syndromes manifesting as skin diseases， predominantly affecting the upper body， especially the head and face. The diseases involved in modern applications were mostly dermatological diseases， including urticaria， eczema， atopic dermatitis and others. In this paper， by combing the relevant ancient literature， the key information of Xiaofengsan was textual researched， in order to provide reference for the modern application and development of this formula.

Background/Aims: Obesity is associated with several gastrointestinal (GI) disorders and has been identified as a potential risk factor for various GI symptoms. Bowel frequency is an important indicator of bowel function. However, the causal link between obesity and gastrointestinal motility remains uncertain. This study aims to determine the causal effect of overall and central obesity on stool frequency. Methods: Four obesity-related anthropometric indicators–body mass index, body fat percentage, waist circumference (WC), and waist-tohip ratio (WHR)–were investigated. Individual-level baseline information from the UK Biobank was used to explore observational associations between obesity and stool frequency. Additionally, summary-level data from published genome-wide association studies were subjected to two-sample Mendelian randomization (MR) analyses to examine causal associations. Results: For all 4 indicators of obesity, higher levels of obesity were associated with more frequent bowel movements after adjusting for demographic characteristics, lifestyle, and dietary factors. After rigorous screening, 482 body mass index single nucleotide polymorphisms (SNPs), 7 body fat percentage SNPs, 48 WC SNPs, and 287 WHR SNPs were identified as instrument variables for MR analysis. The MR results were generally consistent with observational findings, proving that the associations observed in the overall obesity indicators were causal. For central obesity, the association between WHR and stool frequency remained consistent in both analysis phases, whereas WC showed a multidirectional association. Conclusions Obesity-related anthropometric indicators were causally associated with increased stool frequency in the overall and central obesity groups. Weight loss could be a potential approach to improve gastrointestinal regularity in individuals with obesity.

Background/Aims: Obesity is associated with several gastrointestinal (GI) disorders and has been identified as a potential risk factor for various GI symptoms. Bowel frequency is an important indicator of bowel function. However, the causal link between obesity and gastrointestinal motility remains uncertain. This study aims to determine the causal effect of overall and central obesity on stool frequency. Methods: Four obesity-related anthropometric indicators–body mass index, body fat percentage, waist circumference (WC), and waist-tohip ratio (WHR)–were investigated. Individual-level baseline information from the UK Biobank was used to explore observational associations between obesity and stool frequency. Additionally, summary-level data from published genome-wide association studies were subjected to two-sample Mendelian randomization (MR) analyses to examine causal associations. Results: For all 4 indicators of obesity, higher levels of obesity were associated with more frequent bowel movements after adjusting for demographic characteristics, lifestyle, and dietary factors. After rigorous screening, 482 body mass index single nucleotide polymorphisms (SNPs), 7 body fat percentage SNPs, 48 WC SNPs, and 287 WHR SNPs were identified as instrument variables for MR analysis. The MR results were generally consistent with observational findings, proving that the associations observed in the overall obesity indicators were causal. For central obesity, the association between WHR and stool frequency remained consistent in both analysis phases, whereas WC showed a multidirectional association. Conclusions Obesity-related anthropometric indicators were causally associated with increased stool frequency in the overall and central obesity groups. Weight loss could be a potential approach to improve gastrointestinal regularity in individuals with obesity.

Background/Aims: Obesity is associated with several gastrointestinal (GI) disorders and has been identified as a potential risk factor for various GI symptoms. Bowel frequency is an important indicator of bowel function. However, the causal link between obesity and gastrointestinal motility remains uncertain. This study aims to determine the causal effect of overall and central obesity on stool frequency. Methods: Four obesity-related anthropometric indicators–body mass index, body fat percentage, waist circumference (WC), and waist-tohip ratio (WHR)–were investigated. Individual-level baseline information from the UK Biobank was used to explore observational associations between obesity and stool frequency. Additionally, summary-level data from published genome-wide association studies were subjected to two-sample Mendelian randomization (MR) analyses to examine causal associations. Results: For all 4 indicators of obesity, higher levels of obesity were associated with more frequent bowel movements after adjusting for demographic characteristics, lifestyle, and dietary factors. After rigorous screening, 482 body mass index single nucleotide polymorphisms (SNPs), 7 body fat percentage SNPs, 48 WC SNPs, and 287 WHR SNPs were identified as instrument variables for MR analysis. The MR results were generally consistent with observational findings, proving that the associations observed in the overall obesity indicators were causal. For central obesity, the association between WHR and stool frequency remained consistent in both analysis phases, whereas WC showed a multidirectional association. Conclusions Obesity-related anthropometric indicators were causally associated with increased stool frequency in the overall and central obesity groups. Weight loss could be a potential approach to improve gastrointestinal regularity in individuals with obesity.

Objective In this study,patients with idiopathic intracranial hypertension(IIH)were selected as a model for spaceflight-associated neuro-ocular syndrome(SANS)to conduct an eye movement manipulation intervention experiment.The aim was to explore whether eye movements have an effect on reducing the subarachnoid space around the optic nerve.Methods Twenty-three patients with IIH who met the inclusion criteria were subjected to history taking,collection of basic systemic data including age,height,weight,and blood pressure,and baseline data collection including intraocular pressure(prone)and transorbital ultrasound optic nerve sheath complex image acquisition.The subjects were then subjected to the eye movements intervention and IOP(prone)and transorbital ultrasound optic nerve sheath complex image acquisition were measured at 10 minutes,30 minutes and again 3 days after the intervention.Results The study enrolled 23 subjects with an average age of(29.58±11.25)years and a mean BMI of(28.56±6.3)kg/m2.The average cerebrospinal fluid pressure through lumbar puncture was(310.25±20.78)mmH2O.There were no significant changes in intraocular pressure at various time points before and after the eye movement exercises(P=1.000).Similarly,there were no significant changes in the diameter of the optic nerve at 3 mm and 5 mm posterior to the globe(P=1.000).However,the diameter of the optic nerve sheath at 5 mm posterior to the globe,as well as the width of the subarachnoid space of the optic nerve at 3 mm and 5 mm posterior to the globe,and the area of the subarachnoid space of the optic nerve from 3 mm to 5 mm posterior to the globe,all decreased significantly after performing eye movement exercises for 10 minutes and 30 minutes.These measures returned to baseline levels after three days of eye movement exercises,with significant differences observed across time points(P<0.05).Specifically,compared to baseline values,the diameter of the optic nerve sheath at 5 mm posterior to the globe decreased by 0.33 mm(95%CI:0.034-0.624,P=0.02)after performing 30 minutes of eye movement exercises.Additionally,the width of the subarachnoid space of the optic nerve at 3 mm and 5 mm posterior to the globe decreased by 0.2 mm(95%CI:?0.037-0.452,P=0.034)and 0.29 mm(95%CI:?0.265-0.344,P=0.01),respectively.Finally,the area of the subarachnoid space of the optic nerve from 3 mm to 5 mm posterior to the globe decreased by 0.21 mm2(95%CI:0.155-0.762,P=0.02).Conclusion This study initially proposes an eye movement manipulation method(eye movement exercise)that can reduce the subarachnoid space gap of the optic nerve posterior to the globe,including the direction,duration,rhythm,and frequency of eye movements.It was found that regular eye movements for a certain period of time can deform the optic nerve sheath,compress the subarachnoid space of the optic nerve posterior to the globe,and narrow its gap.As the duration and frequency of eye movement exercises increase,the width or area of the subarachnoid space of the optic nerve decreases more significantly.However,eye movement exercises cannot maintain the deformation of the optic nerve sheath for a long time,and after a certain period of time,the gap of the optic nerve sheath returns to baseline levels.

Background::To date, there is still a lack of standardized management strategies for gastric low-grade dysplasia (LGD), which is a direct neoplastic precancerous lesion and requires specifically superficial destruction. Radiofrequency ablation (RFA) is expected to be an effective method for gastric LGD, but post-RFA pain may affect patients’ satisfaction and compliance. The current study aimed to evaluate the value of a submucosal injection prior to RFA (SI-RFA) for postoperative pain and treatment outcomes.Methods::Between October 2014 and July 2021, gastric LGDs without risk factors (size >2 cm, unclear boundary, and abnormal microsurface and microvascularity) undergoing regular RFA and SI-RFA were retrospectively analyzed. Postoperative pain scores, wound healing, and clinical efficacy were compared. Propensity score matching, stratified analysis, and multivariable logistic regression were performed to control the confounding variables.Results::One hundred and ninety-seven gastric LGDs in 151 patients received regular RFA. Forty-nine gastric LGDs in 36 patients received SI-RFA. Thirty-six pairs of patients were selected for the assessment of postoperative pain by propensity score matching. Compared to regular RFA, SI-RFA significantly decreased the degree and duration of postoperative pain (OR, 0.32; 95% CI, 0.13-0.84; P = 0.020), improved wound healing rate (80.0% [36/45] vs. 58.9% [89/151], P = 0.012), increased the complete ablation rate (91.8% [45/49] vs. 86.3% [170/197], χ 2 = 1.094, P = 0.295), but correlated with higher rates of local recurrence and progression (25.6% [10/39] vs. 13.2% [18/136], χ 2 = 3.471, P = 0.062; 8.3% [3/36] vs. 0.9% [1/116], P = 0.042). The multivariable logistic regression model confirmed that submucosal injection was associated with local recurrence (OR, 2.93; 95% CI, 1.13-7.58; P = 0.027). Conclusions::Submucosal injections prior to RFA may reduce postoperative pain and scar formation while ensuring complete ablation of gastric LGD. However, local recurrence and progression should be considered seriously.

Background::Biliary tract carcinoma (BTC) is relatively rare and comprises a spectrum of invasive tumors arising from the biliary tree. The prognosis is extremely poor. The incidence of BTC is relatively high in Asian countries, and a high number of cases are diagnosed annually in China owing to the large population. Therefore, it is necessary to clarify the epidemiology and high-risk factors for BTC in China. The signs associated with BTC are complex, often require collaborative treatment from surgeons, endoscopists, oncologists, and radiation therapists. Thus, it is necessary to develop a comprehensive Chinese guideline for BTC.Methods::This clinical practice guideline (CPG) was developed following the process recommended by the World Health Organization. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess the certainty of evidence and make recommendations. The full CPG report was reviewed by external guideline methodologists and clinicians with no direct involvement in the development of this CPG. Two guideline reporting checklists have been adhered to: Appraisal of Guidelines for Research and Evaluation (AGREE) and Reporting Items for practice Guidelines in Healthcare (RIGHT).Results::The guideline development group, which comprised 85 multidisciplinary clinical experts across China. After a controversies conference, 17 clinical questions concerning the prevention, diagnosis, and treatment of BTC were proposed. Additionally, detailed descriptions of the surgical principles, perioperative management, chemotherapy, immunotherapy, targeted therapy, radiotherapy, and endoscopic management were proposed.Conclusions::The guideline development group created a comprehensive Chinese guideline for the diagnosis and treatment of BTC, covering various aspects of epidemiology, diagnosis, and treatment. The 17 clinical questions have important reference value for the management of BTC.

Animals ; Macaca mulatta ; Optic Disk ; Glaucoma ; Craniocerebral Trauma ; Intraocular Pressure ; Low Tension Glaucoma

Xianfang Huomingyin is known as the first prescription of surgery， also known as Shenxian Huomingyin and Zhenren Huomingyin. The earliest one was from Renzhai Zhizhi in the Southern Song dynasty. It was composed of 13 mainstream medicines such as Angelicae Dahuricae Radix， Saposhnikoviae Radix， Paeoniae Radix Rubra， and three modified medicines such as Rhei Radix et Rhizoma， Momordicae Semen and Astragali Radix. It has the effects of clearing heat and detoxifying， detumescence and ulceration， promoting blood circulation and relieving pain， and is mainly used to treat Yang syndrome. In this study， the bibliometrics method was used to systematically study the historical evolution， prescription composition， dosage， indications， decocting methods， administration methods， drug processing and ancient and modern applications of Xianfang Huomingyin. As for the drug origin， pangolin is consistent with the 2015 edition of Chinese Pharmacopoeia， the origins of the remaining drugs are consistent with the 2020 edition of Chinese Pharmacopoeia. According to the ancient and modern dosage conversion， the dosage of each drug is as follows：Angelicae Dahuricae Radix， Paeoniae Radix Rubra， Fritillariae Thunbergii Bulbus， Glycyrrhizae Radix et Rhizoma and Trichosanthis Radix， Olibanum of 4.13 g， Gleditsiae Spina and Myrrha of 2.07 g， Angelicae Sinensis tail（stir-fried with wine） and Citri Reticulatae Pericarpium of 6.2 g， Saposhnikoviae Radix（removing reed） of 2.89 g， pangolin（stir-fried with clam powder） of 4.14 g， Lonicerae Japonicae Flos of 12.39 g， or adding Rhei Radix et Rhizoma of 4.13 g and Momordicae Semen（shelled） of 3.3 g， adding Astragali Radix of 4.13 g for body deficiency. The above medicines were decocted with 450 mL of yellow rice wine to 300 mL， 1 dose for each time， 3 doses for each day， and warmed before or 0.5 h after meals， 1-6 doses， and discontinue medication as soon as get effect. Because this formula is easy to hurt the spleen and stomach， it should not be taken more. In the follow-up， it should be used in conjunction with Tuoli Xiaodusan， and other related symptoms of patients can be further improved through dialectical addition and subtraction. This formula has the efficacy of disinfection and pus discharge， removing blood stasis and relieving pain. All carbuncle gangrene without ulceration at the beginning， and for the empirical and heat syndrome. Modern applications involve more than 200 kinds of diseases with heat syndrome， emergency and excess syndrome as the main syndrome differentiation points in dermatology， peripheral vascular department and other departments. In a word， this paper studies the literature of Xianfang Huomingyin in order to provide a basis for its wider and deeper clinical application and development research.

Objective:To analysis the necessity of additional surgical intervention for non-curative endoscopic resection patients with early gastric cancer.Methods:A retrospective analysis was conducted on 73 patients with early gastric cancer who underwent additional surgical procedures after non-curative endoscopic resection at Chinese PLA General Hospital from July 2009 to May 2023. The main outcome measures included pathological classification, positive horizontal margins, positive vertical margins, invasion depth, vascular and lymphatic invasion, eCura grade, lymph node metastasis, and overall survival rate.Results:A total of 73 patients with early gastric cancer who were determined to have non-curative endoscopic resection underwent additional surgical procedures, including 58 males and 15 females with a mean age of 61 (53-67) years. In terms of the site of onset, 37 cases were located in the upper part of the stomach, 24 cases in the lower part, 11 cases in the middle part, and 1 case had multiple lesions. In terms of pathological classification, 43 cases were highly differentiated tubular adenocarcinoma, 16 cases were mucinous/signet ring cell carcinoma, 10 cases were poorly differentiated tubular adenocarcinoma, and 4 cases were high-grade intraepithelial neoplasia. In terms of morphological classification, 22 cases were type 0-Ⅱa, 43 cases were type 0-Ⅱb, and 8 cases were type 0-Ⅲ. In terms of invasion depth, 17 cases were mucosal cancer, 23 cases had submucosal invasion less than 500 μm, and 33 cases had submucosal invasion more than 500 μm. In terms of vascular and lymphatic invasion, 8 cases had lymphatic vessel invasion and 8 cases had venous invasion. Among the 73 patients, 4 were diagnosed as having eCura A, 5 as eCuraB, 4 as eCura C1, and 60 as eCura C2. Among the 60 patients diagnosed as having eCura C2, only 2 cases (3.3%) were found to have lymph node metastasis around the stomach based on postoperative pathological evaluation. Among the 73 endoscopic specimens, 7 patients had positive horizontal margins, 21 had positive vertical margins, and 2 had positive margins in both directions, totaling 30 patients with positive horizontal or vertical margins. According to postoperative pathological evaluation, 9 cases (30.0%) had residual tumors in the original site. Among the 73 patients, 5 were lost to follow-up and 4 died, resulting in an overall survival rate of 94.12% (64/68) and disease-specific survival rate of 98.53% (67/68). The follow-up time of patients was 61.37 (10-166) months.Conclusion:For early gastric cancer patients with eCura C2 following non-curative endoscopic resection, additional surgery is feasible. However, the proportion of patients with actual lymph node metastasis is relatively low.