The chronicity of infectious diseases is an important field in the collaborative research of traditional Chinese and Western medicine. The warm disease theory of pathogen invading nutrient and blood aspects in traditional Chinese medicine （TCM） takes the struggle between healthy Qi and pathogenic Qi and cementation of Yin as the core pathogenesis， providing a unique theoretical framework for explaining the common pathology of infectious chronic diseases. This theory originated from Yin-Yang interaction in the Internal Classic and was enriched with WU Youke's theory of intruding pathogen interacting and lingering in blood vessels and YE Tianshi's theory of long-term illness entering collaterals. Combining the theory with modern medical knowledge， our team has condensed the dynamic pathogenesis model of deficiency （nutrient and blood aspects） and excess （pathogen） interacting in the blood collaterals of Yin aspect， the core feature of which is the four-dimensional interactions of cause （pathogen characteristics）， location （three Yin locations of diseases）， nature （deficiency and excess）， and potential （transmission trend）. The common pathology of infectious chronic diseases is reflected in interactions. That is， the interactions between nutrient and blood deficiency （immune exhaustion and metabolic disorder） and pathogen excess （pathogen persistence and fibrous hyperplasia） in the liver collaterals （Jueyin）， kidney collaterals （Shaoyin）， lung collaterals （Taiyin） and other blood collaterals of Yin aspect form the pathological damage characterized by immune inflammatory response-continuous tissue damage with excessive repair. Taking the inheritance and innovative development of classics as the main line， this paper systematically discusses the scientific connotation of the theory of pathogen invading nutrient and blood aspects and the paths of inheritance and innovation and clarifies the original significance of this theory in the chronic development of infectious diseases. Furthermore， taking clinical diseases as an example， this paper reflects the guiding value of this classical theory in the modern diagnosis and treatment of infectious diseases with integrated traditional Chinese and Western medicine and the application potential of this theory in solving complex medical problems through the construction of the innovative paradigm of precise diagnosis and treatment with integrated traditional Chinese and Western medicine.

ObjectiveTo explore the mechanism by which Qijia Rougan decoction ameliorates liver fibrosis through amino acid/fatty acid metabolic reprogramming and phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） pathway， based on the miRNA-mRNA regulatory network and the interaction between metabolism and signaling pathways. MethodsSprague-Dawley （SD） rats were randomized into four groups （n=8）： control， model， and low-dose and high-dose （7.0， 28.0 g·kg^-1·d^-1， respectively） Qijia Rougan decoction. Liver fibrosis was induced by subcutaneous injection of carbon tetrachloride （CCl₄）. From week 9， drug intervention was implemented for 7 weeks. After the final administration， the pathological changes in the liver were evaluated through hematoxylin-eosin （HE） and picrosirius red （PSR） staining. An automated biochemical analyzer was used to measure the serum levels of biochemical indicators， including alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， alkaline phosphatase （ALP）， total bile acid （TBA）， albumin （ALB）， and cholesterol （TC）. High-throughput miRNA sequencing was performed to identify differentially expressed miRNAs （DemiRs） during liver fibrosis. A miRNA-mRNA interaction network was constructed to identify key targets， which were then subjected to GO and KEGG enrichment analyses. The expression levels of selected DemiRs were validated by Real-time PCR. ResultsCompared with the control group， the model group showed marked hepatic lobular necrosis， increased collagen deposition， significant fibrosis， elevated serum levels of ALT， AST， ALP， and TBA （P<0.01）， and declined levels of ALB and TC （P<0.01）. Compared with the model group， Qijia Rougan decoction treatment reduced hepatic necrosis， collagen accumulation， and fibrosis， lowered the serum levels of ALT， AST， ALP， and TBA （P<0.01）， and raised the levels of ALB and TC （P<0.01）. Integrated miRNA-seq and RNA-seq analysis identified 31 DemiRs （6 upregulated and 25 downregulated） and 498 targets. The expression trends of four selected DemiRs， including rno-miRNA-376b-3p， were consistent with sequencing results （R²=0.93）. Functional annotation revealed that top 20 upregulated targets were enriched in amino acid and fatty acid metabolism， while top 20 downregulated targets were significantly associated with the PI3K/Akt signaling pathway and cancer progression. ConclusionQijia Rougan decoction alleviates liver fibrosis by reconstructing the miRNA-mRNA regulatory network， promoting metabolic reprogramming， and inhibiting the PI3K/Akt signaling pathway. These findings provide mechanism evidence supporting the multi-targeted antifibrotic effects of traditional Chinese medicine compound formulas.

ObjectiveThis paper aims to investigate the traditional Chinese medicine syndrome types in patients with chronic hepatitis B （CHB） complicated by metabolic dysfunction-associated fatty liver disease （MAFLD） and explore the correlations between these syndrome types and clinical indicators， as well as ocular manifestation characteristics， thereby providing a reference for syndrome differentiation and treatment strategies in traditional Chinese medicine. MethodsGeneral data， information from the four diagnostic methods of traditional Chinese medicine， clinical indicators， and ocular manifestation data were collected from 506 patients with CHB complicated by MAFLD enrolled at the Public Health Clinical Center of Chengdu between June 2024 and December 2024. Cluster analysis， principal component analysis， and complex network models were employed to identify the distribution patterns of traditional Chinese medicine syndromes. Correlations between different syndrome types and clinical indicators， as well as ocular manifestation characteristics， were further analyzed. ResultsThe predominant syndromes identified in patients with CHB complicated by MAFLD were dampness and heat accumulation （51.58%）， liver depression with spleen deficiency （31.62%）， blood stasis obstructing collaterals （8.89%）， and Qi-Yin deficiency （7.91%）. No statistically significant differences were found among the four syndrome types in routine blood tests and liver function indicators. However， patients with the dampness and heat accumulation type exhibited significantly higher levels of total cholesterol （TC）， triglycerides （TG）， low-density lipoprotein cholesterol （LDL-C）， liver stiffness measurement （LSM）， controlled attenuation parameter （CAP）， and alpha-fetoprotein （AFP）， along with lower levels of high-density lipoprotein cholesterol （HDL-C）， compared with those with other syndrome types. Regarding ocular manifestations， the incidence of moon halo signs was significantly higher in patients with the blood stasis obstructing collaterals type than in those with other syndrome types. Additionally， the incidence in scleral zone 3 （corresponding to the large intestine） was higher in patients with the damp and heat accumulation type. ConclusionDampness and heat accumulation is the core syndrome type in patients with CHB complicated by MAFLD， commonly accompanied by spleen deficiency， liver depression， blood stasis， and Yin deficiency. A complex syndrome pattern characterized by a predominance of dampness and heat， along with a mixture of deficiency and excess， is formed. Different traditional Chinese medicine syndrome types are associated with distinct clinical indicators and ocular manifestation characteristics. Among them， patients with the dampness and heat accumulation type exhibit more pronounced metabolic disturbances and liver injury， whereas those with the blood stasis type show a higher incidence of moon halo signs. Abnormalities in scleral zone 3 are also more prevalent in patients with dampness and heat type.

Background In the context of global climate change, heatwaves pose an increasing threat to human health. Emergency ambulance calls are an important outcome indicator of acute health response in populations during heatwave weather. However, studies on the association between emergency ambulance calls and heatwaves in China have primarily focused on the southern regions, and less attention is paid to the northern regions, which hinders a comprehensive assessment of acute health impact posed by extreme heat. Objective To quantify the association between heatwaves and emergency ambulance calls in Dezhou City, Shandong Province. Methods The data on daily records of emergency ambulance calls, meteorological factors, and air pollution from May to September of 2020 to 2022 in Dezhou City, Shandong Province were collected. Heatwaves were defined by combining thresholds at the 90th, 92.5th, 95th, and 97.5th percentiles (P₉₀, P_92.5, P₉₅, and P_97.5) of the year-round daily mean temperature and durations of ≥2, 3, or 4 consecutive days, respectively. A generalized additive model with a distributed lag nonlinear model was used to estimate the relative risk of emergency ambulance calls during heatwave days compared with non-heatwave days. Results During the study period, a total of 143393 emergency ambulance calls were analyzed, with 59.75% of individuals aged <65 years, 53.38% male, and 44.94% due to respiratory causes. Compared to non-heatwave periods, all 12 types of defined heatwaves were significantly associated with an increased risk of emergency ambulance calls. The heatwave effect intensified progressively with higher temperature thresholds and longer durations. The cumulative relative risk rose from 1.12 (95%CI: 1.07, 1.17) for the P₉₀_2d type to 1.26 (95%CI: 1.14, 1.40) for the P_97.5_4d type. No significant gender difference was observed in the association between heatwaves and emergency ambulance calls. Regarding age, older adults were more vulnerable, with a relative risk of 1.60 (95%CI: 1.42, 1.81) for the most severe heatwave type P_97.5_4d compared with non-heatwave periods. Among the different causes of calls, the association between respiratory diseases and heatwaves was the most pronounced, with the relative risk increasing from 1.22 (95%CI: 1.15, 1.29) for the mildest heatwave type P₉₀_2d to 1.72 (95%CI: 1.54, 1.93) for the most severe heatwave type P_97.5_4d. Conclusion In Dezhou City, Shandong Province, heatwaves are significantly associated with an increased risk of emergency ambulance calls. The effects of heatwaves on emergency ambulance calls vary by age and disease type, with the elderly and patients with respiratory diseases being more susceptible. These groups should take protective measures.

Objective To observe the reproducibility of radiomics feature(RF)extracted from virtual monoenergetic image(VMI)of rabbit VX2 hepatoma models obtained with 3 different dual-energy CT(DECT)systems,and to explore relationship of reproducibility and diagnostic performance of RF.Methods Fifteen rabbits with VX2 hepatoma were randomly divided into 3 groups(each n=5).Contrast-enhanced abdominal CT scanning under volume CT dose index(CTDIvol)levels of 6,9 and 12 mGy were performed with dual-source DECT(dsDECT),rapid kV switching DECT(rsDECT)and dual-layer detector DECT(dlDECT),respectively.VMI were reconstructed at 10 keV increments from 40 to 140 keV.RF were extracted from VMI,the reproducibility was assessed using intra-class correlation coefficient(ICC),and those with ICC≥0.8 were considered as reproducible RF.The percentage of reproducible features(denoted by R)were compared among different scanner pairings and different CTDIvol levels.Within each CTDIvol group,the reconstruction energy levels yielding the maximum number(denoted by N)of common RF across different scanner pairings were identified.The receiver operating characteristic(ROC)curve was drawn,the area under the curve(AUC)was calculated,and the diagnostic efficacies of reproducible RF and other RF were compared under optimal reproducible conditions.Spearman correlation coefficient between ICC and the corresponding AUC of RF were calculated.Results RrsDECT-dsDECT(6.45％,95％CI[2.36％,8.87％])was higher than RdlDECT-dsDECT(0.72％,95％CI[0.15％,1.79％])and RrsDECT-dlDECT(1.43％,95％CI[0.60％,4.06％])(all adjusted P＜0.05),R9mGy(3.70％,95％CI[1.31％,5.73％])and R12mGy(2.63％,95％CI[0.60％,6.69％])were higher than R6mGy(1.31％,95％CI[0.12％,1.55％])(all adjusted P＜0.05).The optimal reproducible reconstruction energy levels of RF under CTDIvol of 6,9 and 12 mGy concentrated at 50-70 keV.AUC of reproducible RFs were higher than of other RF(all adjusted P＜0.05)and had certain correlation with the reproducibility(rs=0.102-0.516,P＜0.05).Conclusion The reproducibility of RF extracted from contrast-enhanced VMI CT images of rabbit VX2 hepatoma models associated with DECT scanner,CTDIvol level and reconstruction energy level.RF with higher reproducibility might have better diagnostic performance.

Objective:To observe any therapeutic effect of combining early pulmonary rehabilitation training with acupuncture at the back-shu and front-mu acupoints in treating stroke-associated pneumonia (SAP).Methods:Eighty SAP patients were randomly divided into a treatment group and a control group, each of 40. Both groups were given routine symptomatic treatment for pneumonia, nutritional support, lipid-lowering and anti-infection measures, as well as acupuncture at the back-shu and front-mu acupoints. The treatment group additionally received pulmonary rehabilitation training. Before and after 14 days of the treatment, both groups were evaluated in terms of their forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak flow rate (PEF), white blood cell count (WBC), C-reactive protein (CRP), and procalcitonin (PCT). Chinese medicine (TCM) scores for expectoration of phlegm, shortness of breath, pulmonary rales, cough, fever and weakness were also assigned. The duration of antibiotic use and intensive care unit (ICU) stay were compared between the two groups.Results:Treatment efficacy was significantly higher in the treatment group (97.5%) than in the control group (85.0%). The treatment group′s average duration of antibiotic use and ICU stay were significantly shorter than in the control group. The treatment improved the average FVC, FEV1, PEF, WBC, CRP and PCT of both groups significantly leaving the average FVC and PEF of the treatment group significantly higher than the control group′s average, but its average WBC, CRP, PCT and the total TCM syndrome score significantly lower.Conclusions:Combining early pulmonary rehabilitation training with acupuncture at the back-shu and front-mu acupoints has a definite therapeutic effect on SAP patients. It can significantly shorten the use of antibiotics and ICU stay, promote the recovery of lung function, reduce inflammation and relieve clinical symptoms.

In this research,a new phospholipid based monolith was fabricated by in situ co-polymerization of 1-dodecanoyl-2-(11-methacrylamidoundecanoyl)-sn-glycero-3-phosphoethanolamine and ethylene dimethacrylate to mimick bio-membrane environment.Excellent physicochemical properties of this novel monolith that were achieved included column efficiency,stability,and permeability.Moreover,the biomimetic monolith showed outstanding separation capability for a series of intact proteins and small molecules.In particular,it exhibited good potential as an alternative to the commercial immobilized artificial membrane(IAM)column(IAM.PC.DD2)for studying drug-membrane interactions.This study not only enriched the types of IAM stationary phases,but also provided a simple model for the prediction of phosphatidylethanolamine related properties of drug candidates.

Objective To investigate the clinical value of laboratory markers in the diagnosis and treatment of light chain multi-ple myeloma (MM) .Methods Collected 31 cases of light chain MM patients and 60 cases of control group ,the control group con-sisted of 20 health subjects (healthy group) ,20 cases of type IgG κMM ,20 cases of type IgA κMM .The immune globulin ,serum protein electrophoresis ,immunofixation electrophoresis ,UREA ,Cr ,β2-microglobulin ,flow cytometry immunophenotyp and bone marrow cytology was detected .Results The positive rate of serum protein electrophoresis was 29 .03% ,the difference of the M protein comparison in Durie-Salmon stage of phase Ⅱ and phase Ⅲ was statistically significant(P<0 .05);light chain multiple mye-loma patient′s immunofixation electrophoresis results required reviewing by agarose gel electrophoresis plusing IgD and IgE anti-body ;the IgG ,IgA ,IgM ,UREA ,Cr ,β2-microglobulin of light chain MM patients were different compared with healthy group (P<0 .05);the morphological characteristics of MM cells changed significantly ,and the expression of cell antigen was mainly CD38 , CD138 and CD56 .Conclusion Quantitative of immunoglobulins and immunofixation electrophoresis could be used as screening method of M protein ,serum protein electrophoresis can be used for clinical staging and clinical observation of patients .Bone marrow smears plays an important role in the diagnosis of light chain MM .Light chain MM has more severe renal damage than other types of M M .

OBJECTIVE: To investigate the characteristics of air-conducted ocular vestibular-evoked myogenic potential(oVEMP) in patients with sudden sensorineural hearing loss (SSHL). So as to understanding the range and the degree of the vestibular system damage in patients with SSHL. METHOD: Thirty-five cases of unilateral SSHL were enrolled as the observing group from December in 2013 to December in 2014. 500 Hz air-conducted tone burst was employed as stimulation. Fifity-five healthy young subjects were recruited as the control group. The results were compared between the affected ears, the contralateral ears and the normal controls. RESULT: Thirty-five patients with SSHL, 31 of them in both ears lead to oVEMP Waveform, 4 sick ears did not elicit oVEMP waveform, extraction rate of 88%. 95 dBHL air-conducted get the latencies of P1 and N1, P1-N1 interval, peak-to-peak P1-N1 amplitude in healthy ear were (11.92 ± 0.85)ms; (17.07 ± 1.04)ms, (5.15 ± 0.69)ms, (5.44 ± 2.53) µv. 95 dBHL air-conducted get the latencies of P1 and N1, P1-N1 interval, peak-to-peak P1-N1 amplitude in sick ear were (12.16 ± 0.76) ms; (16.94 ± 2.57)ms, (5.16 ± 0.73)ms, (2.89 ± 1.66) v. The 55 cases (110 ears) were elicited P1-N1 complex typical, extraction rate was 100%. The threshold of oVEMP examination was (82.23 ± 2.92) dBHL, 95 dBHL air-conducted get the latencies of P1 and N1, P1-N1 interval, peak-to-peak P1-N1 amplitude in these healthy young people were (11.53 ± 0.80)ms, (16.61 ± 0.87) ms, (5.18 ± 1.04) ms, (5.96 ± 2.59) µv, there were no significant differences between the affected ears, the contralateral ears and the normal controls in the latencies P1 and N1, P1-N1 interval. The wave amplitude in SSHL were lower than the healthy ear and the healthy control group. CONCLUSION Through the detection of oVEMP in patients with SSHL,we observed that P1-N1 wave amplitude decreased, and it may be related to the damage of the utricle and vestibular nerve.
Case-Control Studies ; Hearing Loss, Sensorineural ; physiopathology ; Humans ; Saccule and Utricle ; pathology ; Vestibular Evoked Myogenic Potentials ; Vestibular Nerve ; pathology ; Vestibule, Labyrinth ; physiopathology

OBJECTIVE: To investigate the characteristics of air-conducted ocular vestibular-evoked myogenic potential (oVEMP) in healthy young people , so as to establish the normative data of young people. METHOD: Fifty-five healthy young subjects were recruited as study participants, 500 Hz air-conducted tone burst was used as stimulation. The threshold of oVEMP in each ear was examined. The latencies of P1 and N1, P1-N1 interval, peak-to-peak of P1-N1 amplitude and asymmetry ratio were measured. Effects of gender on oVEMPs were also exam- ined. RESULT: The typical complex wave of N1 and P1 was observed in all subjects. The threshold of oVEMP examination was(82.23 ± 12.92) dBHL, 95 dBHL air-conducted get the latencies of P1 and N1, P1-N1 interval,peak-to-peak P1-N1 amplitude in these healthy young people were(11.53 ± 0.80)ms, (16.61 ± 0.87)ms, (5.18 ± 11.04)ms, (5.96 ± 2.59)μv, respectively. The peak-to-peak P1-N1 amplitude of male was (6.49 ± 2.67) μv ,the female was (5.21 ± 2.34) μv, there were significant differences between male and female subjects in the wave amplitude (P < 0.05). CONCLUSION Air-conduction induced oVEMP is a new method for vestibular function test. The amplitude of the oVEMP wave was different between male and female. Therefore it is necessary to establish the normal value according to genders.
Acoustic Stimulation ; Eye ; Female ; Head ; Humans ; Male ; Reference Values ; Vestibular Evoked Myogenic Potentials ; Vestibular Function Tests ; Vestibule, Labyrinth ; Young Adult