Objective To explore the epidemiological characteristics of gouty arthritis in Northwest China from 2023 to 2025, and to formulate preventive intervention measures. Methods By retrospectively analyzing the case data of medical institutions in Northwest China from January 2023 to June 2025 (a total of 8 139 cases), the incidence trend and population distribution characteristics of gouty arthritis in this area were analyzed. Multivariate logistic regression analysis was performed to identify risk factors. Results From 2023 to 2025, the prevalence rate of gouty arthritis in adult residents in Northwest China was 3.74% (304/8 139). Among the sites affected by gouty arthritis, the metatarsophalangeal joint accounted for the highest proportion (P<0.05). From the perspective of age distribution, the prevalence rate was the highest in 40-59 years old group (5.90%), followed by 66-80 years old group (4.21%) and >80 years old group (2.75%). The incidence rate in 40-65 years old group was higher than that in the other age groups (P<0.05). High blood uric acid and creatinine, alcohol drinking, obesity, high purine diet, concurrent chronic kidney disease and metabolic syndrome were risk factors affecting gouty arthritis in Northwest China (P<0.05). Conclusion High blood uric acid level, high creatinine level, alcohol drinking, obesity, high purine diet, concurrent chronic kidney disease and metabolic syndrome are risk factors influencing gouty arthritis in Northwest China. Based on the above factors, this study proposes comprehensive prevention strategies from the individual, community and public health levels to provide a scientific basis for reducing the incidence rate of gouty arthritis.

AIM: To analyze the pathological features, immunophenotype, and imaging findings of conjunctival lymphangiectasia(CL), and to explore the etiological mechanisms and provide a theoretical basis for clinical diagnosis and treatment. METHODS:This single-center descriptive cross-sectional study enrolled postoperative specimens from patients with CL who underwent surgical treatment in the hospital between Feb. 2023 and Sept. 2025. Routine hematoxylin and eosin(HE)staining and immunohistochemical staining(D2-40, CD31, CD34, CK)were performed. Anterior segment optical coherence tomography(AS-OCT)was used to observe the lesion morphology. The pathological results were comprehensively analyzed combined with clinical data. RESULTS: A total of postoperative specimens from 32 eyes of 32 patients with CL were enrolled, including 23 females(72%)and 9 males(28%), with a mean age of 53.03±12.47 y. All patients presented with single or multiple transparent cystic elevations beneath the bulbar conjunctiva. The postoperative pathological manifestations were characterized by dilation of conjunctival lymphatic vessels lined with a single layer of flattened endothelial cells, accompanied by edema and inflammatory infiltration in the surrounding stroma. All cases were positive for D2-40, confirming a lymphatic origin; some cases also expressed CD31 and CD34. AS-OCT revealed the lesions as unilocular or multilocular cystic spaces with low reflectivity. After complete surgical resection, the mean follow-up period was 16.2 mo with no recurrence.CONCLUSION:CL is a benign ocular surface lesion characterized by lymphatic vessel dilation. The endothelium co-expresses lymphatic and some vascular markers, suggesting that CL may belong to the spectrum of vascular malformations. AS-OCT has adjunctive diagnostic value, and surgical resection has definitive therapeutic efficacy.

The prevention and treatment of chronic obstructive pulmonary disease （COPD） pose a major global challenge， with difficulties in effectively integrating holistic regulation and precise micro-intervention. The traditional Chinese medicine （TCM） theory of state-target pattern differentiation and treatment advocates the combination of state regulation and target intervention， offering a new paradigm for integrated TCM and Western medicine. This article systematically reviews the theoretical connotations of this theory and constructs a dynamic correspondence framework linking TCM pattern states， signaling pathways， and targeted interventions across different stages of COPD. At the acute exacerbation stage， the phlegm-heat obstructing the lung state is characterized by hyperactivation of the nuclear factor （NF）-κB/NOD-like receptor protein 3 （NLRP3） inflammation pathway， and formulas for clearing heat and resolving phlegm suppress the cytokine storm through multi-component synergy. At the stable stage， the lung-spleen Qi deficiency state is characterized by functional decompensation of the nuclear factor erythroid 2-related factor 2 （Nrf2）/Kelch-like ECH-associated protein 1 （Keap1） antioxidative stress pathway， and therapies for tonifying the lung and spleen repair the essence of Qi deficiency through antioxidative defense and energy metabolism. At the severe/very severe stable stage， the lung-kidney deficiency state is pathologically based on dysregulation of the transforming growth factor （TGF）-β/Wnt repair network and depletion of stem/progenitor cells， and therapies for tonifying the kidney and reinforcing Qi absorption achieve simultaneous regulation of deficiency and stasis by inhibiting aberrant fibrosis and guiding ordered regeneration. These three pathways are not isolated but exhibit dynamic shifts in dominance and cross-talk， constituting the molecular network basis of deficiency causing excess and intermingled deficiency and excess. Furthermore， this article points out the current shortcomings in quantitative evidence， objective syndrome standardization， and coverage of syndrome states， and proposes future directions including building multi-omics databases， conducting biomarker-stratified randomized controlled trials， and developing disease-pattern combined animal models， aiming to provide a theoretical perspective that integrates holism and micro-targeting for precision prevention and treatment of COPD.

The prevention and treatment of chronic obstructive pulmonary disease （COPD） pose a major global challenge， with difficulties in effectively integrating holistic regulation and precise micro-intervention. The traditional Chinese medicine （TCM） theory of state-target pattern differentiation and treatment advocates the combination of state regulation and target intervention， offering a new paradigm for integrated TCM and Western medicine. This article systematically reviews the theoretical connotations of this theory and constructs a dynamic correspondence framework linking TCM pattern states， signaling pathways， and targeted interventions across different stages of COPD. At the acute exacerbation stage， the phlegm-heat obstructing the lung state is characterized by hyperactivation of the nuclear factor （NF）-κB/NOD-like receptor protein 3 （NLRP3） inflammation pathway， and formulas for clearing heat and resolving phlegm suppress the cytokine storm through multi-component synergy. At the stable stage， the lung-spleen Qi deficiency state is characterized by functional decompensation of the nuclear factor erythroid 2-related factor 2 （Nrf2）/Kelch-like ECH-associated protein 1 （Keap1） antioxidative stress pathway， and therapies for tonifying the lung and spleen repair the essence of Qi deficiency through antioxidative defense and energy metabolism. At the severe/very severe stable stage， the lung-kidney deficiency state is pathologically based on dysregulation of the transforming growth factor （TGF）-β/Wnt repair network and depletion of stem/progenitor cells， and therapies for tonifying the kidney and reinforcing Qi absorption achieve simultaneous regulation of deficiency and stasis by inhibiting aberrant fibrosis and guiding ordered regeneration. These three pathways are not isolated but exhibit dynamic shifts in dominance and cross-talk， constituting the molecular network basis of deficiency causing excess and intermingled deficiency and excess. Furthermore， this article points out the current shortcomings in quantitative evidence， objective syndrome standardization， and coverage of syndrome states， and proposes future directions including building multi-omics databases， conducting biomarker-stratified randomized controlled trials， and developing disease-pattern combined animal models， aiming to provide a theoretical perspective that integrates holism and micro-targeting for precision prevention and treatment of COPD.

The sensitive scalp is a complex syndrome characterised by abnormal nerve sensations, such as stinging, itching, burning, and tightness, and diminished tolerance to physical or chemical stimuli that would not typically cause such unpleasant responses, with its pathology involving physical barrier destruction at the stratum corneum level, neural hyperreactivity and sensory nerve sensitization, and local immunological dysregulation and chronic low‑grade inflammation. The homeostasis of the scalp microenvironment plays a crucial regulatory role in maintaining the hair follicle growth cycle, yet this “soil” factor has long been underappreciated in hair loss research, which has traditionally centered on intrinsic follicular defects, such as genetic predisposition or androgen-driven mechanisms. In this review, we summarized the potential mechanisms underlying the imbalance in the “barrier-neural-immune” network in sensitive scalps. Sensitive scalp is further manifested as impaired skin barrier, including increased transepidermal water loss and abnormal lipid secretion. These alterations are accompanied by increased surface pH, excessive secretion of sebum rich in free fatty acids, reduced microbial diversity, and dysbiosis characterized by a reduction in Cutibacterium and an increase in Staphylococcus colonization. Mechanistically, we also analyzed how neurogenic inflammation, mediated by substances such as substance P (SP) and calcitonin gene-related peptide (CGRP), along with persistent low-grade inflammation, disrupts the microenvironment of the hair follicle stem cell niche through mechanisms involving mechanosensitive ion channels (e.g., Piezo1), oxidative stress, and cytokine cascades. When the barrier is compromised, the weakened stratum corneum may facilitate the penetration of external stimuli, sensitizing cutaneous nerve endings. Those hyperresponsive nerves then fire off neuropeptides like substance P and CGRP. These peptides activate mast cells and other immune cells via the MrgprB2 receptor, prompting degranulation and a wave of pro-inflammatory mediators that kick off neurogenic inflammation. At the same time, oxidative stress and inflammatory cytokines drive a persistent low-grade inflammation that directly damages the hair follicle stem cell niche. Physical compression from shrinking hair shafts activates Piezo1 channels, setting off calcium influx and Caspase‑3‑dependent apoptotic signaling. We primarily considered the interactions between inflammatory signaling and the sensitization of the androgen receptor (AR) pathway, as well as the inhibition of the Wnt/β‑catenin pathway, which may subsequently contribute to hair follicle miniaturization and disruption of the growth cycle. The inflammatory microenvironment appears to boost AR expression in dermal papilla cells, making them more sensitive to dihydrotestosterone (DHT). This heightened sensitivity may promote the expression of transforming growth factor-β1 (TGF-β1), TGF-β2, and Dickkopf-1 (DKK1), which suppress the Wnt/β‑catenin pathway—essential for follicle growth and regeneration—potentially accelerating follicular miniaturization and stalling the growth cycle. Coupled with direct inflammatory apoptosis, oxidative stress, and circadian disruption, these routes may collectively speed up hair follicle stem cell depletion and diffuse hair thinning. These findings point to the need for more mechanistic and translational research to test the proposed pathways and explore therapies that target the microenvironment in sensitive scalp-related hair loss. Ultimately, we hope to provide theoretical support for the intervention of hair loss by restoring the steady state of the scalp microenvironment and combining with new precision delivery technologies such as microneedles.

Conjunctival lymphangiectasia is a low-incidence ocular surface disease that is currently rarely reported in the relevant literature. It may be related to cosmetic eyelid surgery, tumor, radiation or chemotherapy and other factors and often causes a foreign body sensation, lacrimation, eye pain, visual fatigue and other discomfort. These symptoms of constant eye irritation affect the patient's quality of life. At present, anterior segment optical coherence tomography can be used for clinical diagnosis, and the novel monoclonal antibody D2-40, as a marker of lymphatic endothelial cell dilatation, has high specificity in pathological diagnosis. Previous studies have not fully defined the pathogenesis of the disease, and treatment methods vary. Conventional treatment has resulted in varying degrees of damage to the conjunctiva in patients. In recent years, anti-vascular endothelial growth factor drugs have been reported to be effective in treating the disease with few complications. This article reviews the pathogenesis, diagnosis and treatment of this rare disease in order to gain a better understanding of conjunctival lymphangiectasia and provide more support for clinical diagnosis and treatment.

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.

Objective To analyze the effect of graded exercise rehabilitation in patients with acute exacerbation of chronic obstructive pulmonary disease,and to provide references for clinical nursing practice.Methods A total of 70 patients with acute exacerbation of chronic obstructive pulmonary disease who met the criteria in the Department of Respiratory Medicine of a tertiary hospital in Zunyi City from September to December 2023 were randomly divided into an experimental group and a control group(with 35 cases in each group).The experimental group implemented graded exercise rehabilitation based on the Global Chronic Obstructive Pulmonary Initiative guidelines,and the control group implemented routine exercise rehabilitation.After intervention,the lung function,blood gas analysis,oxygenation index,6 min walking test and the incidence of complications related to non-invasive mechanical ventilation were compared between the 2 groups.Results Finally,34 cases were included in the experimental group and 35 cases in the control group.After intervention,the forced expiratory volume in the first second of the experimental group was improved compared with the control group(P＜0.05).The 6-minute walking test of the experimental group was higher than that of the control group(P＜0.05).The total incidence of non-invasive mechanical ventilation-related complications in the experimental group was lower than that in the control group(P＜0.05).There was no significant difference in blood gas analysis and oxygenation index between the 2 groups(P＜0.05).Conclusion The implementation of graded exercise rehabilitation based on the Global Chronic Obstructive Pulmonary Initiative guidelines can help patients with acute exacerbation of chronic obstructive pulmonary disease improve their respiratory function,improve their exercise endurance,and reduce non-invasive mechanical ventilation-related complications.

Objective:To investigate the clinical characteristics of patients with hepatitis B virus（HBV）-related primary hepatocellular carcinoma（HCC）who were treated in a multidisciplinary team（MDT）for liver cancer，so as to provide a basis for clinical optimization of the diagnosis and treatment of patients with chronic hepatitis B（CHB）.Methods:A retrospective analysis was performed for 482 HBV-related HCC patients who were treated with HCC-MDT every Thursday afternoon in The First Affiliated Hospital of the Army Medical University from January 2022 to May 2024，aged 18-87（55.54±10.84）years，86.93%（419/482）males and 13.07%（63/482）females. According to the different underlying liver diseases at the time of initial medical treatment and the different prognostic outcomes at the later follow-up，the differences in clinical characteristics between groups under different conditions were compared and analyzed，and the influencing factors of HCC prognosis were understood by Logistic regression analysis. Results:At the time of MDT presentation，the differences in HBeAg status（ χ2=6.311 ，P=0.043），γ-glutamyl traspeptidase（GGT）（ Z=6.277， P=0.043），alkaline phosphatase（ALP）（ Z=7.236 ，P=0.027），and model for end-stage liver disease（MELD）scores（ Z=6.111， P=0.047）among patients with different underlying liver diseases were statistically significant. At follow-up，6.75%（11/163）of HBV-related HCC patients who presented to MDT had a family history of HCC，and their cumulative mortality rate was as high as 60.8%（205/337）at least for 1 year. Mulitivariate Logistic regression analysis showed that different underlying liver disease at the time of initial medical treatment，HBV DNA replication level，MELD score and choice of anti-cancer treatment regimen were the influencing factors for the prognosis of HCC（all P<0.05）. The worse the degree of cirrhosis at the initial presentation，the higher the level of HBV DNA replication，and the higher the MELD score，the worse the prognosis for HCC. Conclusion:Advancing the diagnosis and treatment of CHB，maximizing the inhibition of HBV DNA replication，reducing the MELD score，and optimizing the anti-cancer treatment regimen can reduce the mortality rate of HBV-related HCC.

Objective To explore the relationship between developmental endothelial locus-1(Del-1)and inflammatory response and disease severity in patients with chronic obstructive pulmonary disease(COPD).Method 82 COPD patients admitted to Huai'an Fifth People's Hospital from January 2023 to July 2023 were selected as the COPD group.Among them,40 patients with acute exacerbation were included in the acute exacerbation group,and 42 patients in the stable phase were included in the stable group.Another 40 healthy volunteers who underwent physical examinations during the same period were selected as the control group.The levels of serum Del-1,C-reactive protein(CRP),interleukin-1β(IL-1β)and neutrophil to lymphocyte ratio(NLR)in all study subjects were detected.Pearson's method was used to analyze the correlation between serum Del-1 and inflammatory markers.The predictive value of serum Del-1 for acute exacerbation in COPD patients was analyzed using receiver operating characteristic(ROC)curves.Result The serum CRP,IL-1β and NLR levels in the COPD group were higher than those in the control group(t=12.047,13.107,9.404),the serum Del-1 level in the COPD group was 386.87±42.34 pg/ml,lower than that in the control group 512.63±60.21 pg/ml(t=13.343),and the differences were statistically significant(all P<0.05).The serum CRP,IL-1β and NLR levels in the acute exacerbation group were higher than those in the stable group(t=4.170,5.292,5.919),the serum Del-1 level in the acute exacerbation group was 347.64±40.69 pg/ml,lower than that in the stable group 424.23±48.31 pg/ml(t=7.746),and the differences were statistically significant(all P<0.05).Pearson analysis showed that the serum Del-1 level in COPD patients were negatively correlated with serum CRP,IL-1β and NLR levels(r=-0.534,-0.587,-0.612,all P<0.05).ROC analysis showed that serum Del-1 had a high predictive value for acute exacerbation in COPD patients,with an AUC(95%CI)of 0.886(0.812～0.960).When the optimal cutoffvalue was 380.65 pg/ml,the sensitivity and specificity were 82.50%and 85.00%,respectively.Conclusion Serum Del-1 is low expression in COPD patients and is ngeatively correlated with their inflammatory response and disease severity,it is expected to become a new biomarker for predicting the risk of acute exacerbation of COPD.