Hygroscopicity research has long been a key focus and hot topic in Chinese materia medica（CMM）. Elucidating hygroscopic mechanisms plays a vital role in formulation design， process optimization， and storage condition selection. Hygroscopic models serve as essential tools for characterizing CMM hygroscopic mechanisms， with various types available. The double exponential model is a kinetic mathematical model constructed based on the law of conservation of energy and Fick's first law of diffusion， tailored to the physical properties of CMM extracts. In recent years， this model has been extensively applied to simulate the dynamic moisture absorption behavior of CMM extracts and solid dosage forms under varying humidity conditions. It has revealed the correlation between moisture absorption kinetic parameters and material properties， offering a new perspective for characterizing the moisture uptake behavior of CMM. This paper systematically reviews the application progress of this model in the field of CMM， analyzes its advantages， disadvantages， and challenges in this domain， and explores its potential application trends in other fields. It aims to provide references for elucidating the moisture absorption mechanisms of CMM and researching moisture-proofing technologies， while also offering insights for its broader application in food and polymer materials.

Chronic mucocutaneous candidiasis (CMC) is an infectious phenotype characterized by recurrent or persistent infections caused by Candida species that affect the skin, nails, oral, and genital mucosae for a duration exceeding six months. Current research suggests that CMC is an immunodeficiency disease with a complex pathogenesis. Patients with CMC have various defects in nonspecific and/or specific immunity against Candida infection, resulting in the inability of patients to defend themselves against Candida infection. CMC can be stratified into primary CMC and secondary CMC based on etiology. Primary CMC is often associated with genetic mutations leading to immunodeficiencies in T helper cell 17 and interleukin-17, whereas secondary CMC is frequently linked to factors such as human immunodeficiency virus infection, diabetes mellitus, and immunosuppressive therapy. Primary CMC typically manifests as Candida infections, with distinct genetic mutations often correlating to varied concomitant symptoms. Secondary CMC may present with not only superficial mucosal Candida infections and manifestations of the underlying primary disease but also with invasive fungal infections. Diagnosing CMC requires an integration of medical history and clinical presentation, supplemented by the outcomes of auxiliary diagnostic procedures, including microscopic examination of fungal smear, fungal culture, immunological testing, and genetic sequencing and analysis. Furthermore, confirming primary CMC requires exclusion of the aforementioned secondary factors. At present, antifungal drugs such as triazoles, echinocandins, and polyenes are the main treatment for CMC. Moreover, immunotherapy with biologics such as Janus kinase (JAK) inhibitors provides more options for the clinical treatment of patients with CMC. Gene therapy also has potential clinical application value. In this review, we discuss the etiologies, pathogenesis, clinical manifestations, diagnosis, and treatments of CMC, aiming to provide a reference for the clinical diagnosis and treatment of CMC.

Introduction: With surgical advancements and improved implants and instrumentation, nailing is the procedure of choice in subtrochanteric fractures. However, failure in achieving reduction of the multidirectional displacement of the fragments prior to passing the nail, contributes to delayed/non-unions at the fracture site leading to implant failures. In this study, we aim to analyse the factors affecting union of closed subtrochanteric fractures treated by nailing. Materials and methods: In this retrospective study, closed subtrochanteric fractures treated with cephalomedullary nailing between 2015 and 2019 were included. Demographic, surgical and radiological data were retrieved and analysed. A total of 60 cases were eligible to be included in the study. Results: Majority of patients were male (50), with a mean age of 46.07±16.40 years. Twenty-two fractures were multifragmentary having a separate butterfly fragment. In 27 patients mini-open technique was used to get the anatomical alignment and to hold reduction until fixation. Overall, the mean time for union was 7.63±5.85 months. We had nine delayed unions and eight non-unions. Varus alignment in the coronal plane of more than 8.5° was the only significant factor associated with delayed or non-union apart from loss of medial continuity. Conclusion: We recommend achieving fracture reduction with less than 8.5° of varus malalignment in the coronal plane. Varus malalignment is poorly tolerated in fractures at this region. To achieve this, we suggest having a very low threshold to minimally open the fracture site for reduction of these fractures, which does not have any negative effect on the fracture union.

BACKGROUND:Muscle aging is closely related to various epigenetic changes,and exercise has a certain regulatory effect on these epigenetic changes.However,the specific mechanism is not fully understood. OBJECTIVE:To review the epigenetic mechanisms of skeletal muscle and how exercise can improve skeletal muscle aging and promote adaptive changes in muscle through these epigenetic mechanisms,aiming to provide a more comprehensive understanding of skeletal muscle aging and disease mechanisms. METHODS:During the period from June 1st to August 1st,2023,literature searches were conducted for relevant literature published from database inception to August 2023 in databases including Web of Science,PubMed,CNKI,WanFang,and VIP.The search terms used included"skeletal muscle,""muscle,""aging,""older adult,""aging,""exercise,""physical exercise,""epigenetic,"and"epigenetics"in Chinese as well as"skeletal muscle,muscle,aging,older adult,senescence,age,exercise,sports,physical activity,epigenetic,epigenetics"in English.Boolean logic operators were used to connect the search terms for retrieval,and corresponding strategies were developed.According to the predetermined inclusion and exclusion criteria,70 eligible articles were selected. RESULTS AND CONCLUSION:Epigenetics refers to the phenomenon where gene expression and function are regulated without changes in gene sequence,and epigenetic changes in skeletal muscle are an important field.The epigenetic mechanisms of skeletal muscle play an important role in muscle aging,mainly involving DNA methylation,histone modification,regulation of non-coding RNAs,chromatin remodeling,changes in mitochondrial function and expression changes of aging-related genes.Exercise significantly regulates the epigenetics of skeletal muscle,including promoting DNA methylation,muscle histone modification,regulating miRNA expression,and regulating lncRNA expression,regulating muscle factors(such as interleukin-6),regulating mitochondrial function(such as peroxisome proliferators-activated receptors γ co-activator 1α).Future studies are recommended for long-term,cross-diverse population-based exercise interventions;the application of multi-omics techniques such as proteomics and metabolomics;strengthening the understanding of epigenetic changes at the single-cell level;cross-species comparative studies as well as human clinical trials for the translation of animal model findings to humans;strategies for combining exercise and pharmacological interventions to assess their synergistic effects;and epigenetic studies of crosstalk interactions between skeletal muscle and different organs.

Objective: To explore the effects of a zerotime exercise (ZTEx) intervention on physical activity levels and sedentary behavior among college students, providing evidence for improving physical activity and reducing sedentary habits. Methods: In September 2023, 45 sedentary college students from a university in Fuzhou were recruited and randomly assigned to either the ZTEx group (23 students) or the control group (22 students) according to a random number table method. ZTEx group received two ZTEx focus group meetings for 3 months, while the control group received safety and health education. The International Physical Activity Questionnaire and a threeaxis accelerometer were used to evaluate the sedentary and physical activity levels of college students. At the same time, evaluations related to physical health and psychological questionnaires were completed. Mixed effects analysis of variance and nonparametric tests were used to statistically analyze the physical health, psychological questionnaire, and sedentary and physical activity data of the college students. Results: Postintervention, the ZTEx group showed significant improvements in the duration of lowintensity physical activity [pretest(1 492.78±369.50)min; posttest(1 918.93±354.63)min] and the number of sedentary interruptions [pretest(45.26±13.69)times; posttest(73.78±16.74)times]; grip strength [pretest(28.77±9.23)kg; posttest(31.78±8.00)kg]; sitting up continuously for 30 seconds [pretest(22.52±4.90)times; posttest(26.96±4.87)times]; general selfefficacy [pretest(26.52±4.14)points; posttest(32.96±5.24)points]; body composition summary [pretest(66.44±4.83)points; posttest(72.62±4.88)points]; and psychological composition summary [pretest(61.21±9.88)points; posttest(63.98±9.57)points], while reducing sedentary time [pretest(3 694.28±687.56)min; posttest(2 865.90±493.81)min] in the past 7 days, the differences were statistically significant(P<0.05). The control group exhibited no significant changes(P>0.05). Conclusion ZTEx effectively improve the lowintensity physical activity, increases sedentary breaks, and reduces prolonged sitting among college students, fostering healthier habits and improving physical/mental wellbeing.

By analyzing the current application of multi-modal data in the diagnosis of gastric "inflammation-cancer" transformation， this study explored the feasibility and strategies for constructing a disease-syndrome integrated diagnosis and treatment system. Based on traditional Chinese medicine （TCM） phenomics， we proposed utilizing multi-modal data from literature research， cross-sectional studies， and cohort follow-ups， combined with artificial intelligence technology， to establish a multi-dimensional diagnostic and treatment index system. This approach aims to uncover the complex pathogenesis and transformation patterns of gastric "inflammation-cancer" progression. Additionally， by dynamically collecting TCM four-diagnostic information and modern medical diagnostic information through a long-term follow-up system， we developed three major modules including information extraction， multi-modal phenotypic modeling， and information output， to make it enable real-world clinical data-driven long-term follow-up and treatment of chronic atrophic gastritis. This system can provide technical support for clinical diagnosis， treatment evaluation， and research， while also offering insights and methods for intelligent TCM diagnosis.

Background: s/Aims: Assessing surgical difficulty in laparoscopic cholecystectomy (LC) is challenging due to variations in surgeon proficiency and institutional protocols. This study evaluates surgeons’ perspectives on procedural difficulty and examines how intraoperative findings and preoperative imaging contribute to refining difficulty assessment criteria. Methods: A cross-sectional survey was conducted among 50 laparoscopic surgeons in India, providing insights into tolerances for surgical duration and blood loss, reasons for conversion, and predictors of complexity. Responses were analyzed using SPSS, with statistical significance set at p < 0.05. Results: Among surveyed surgeons, 82.0% were male, and 78.0% worked in private institutions and 52.0% had performed over 1,000 LCs. Conversion to open surgery was primarily influenced by significant blood loss (68.0%) and biliary injury (94.0%). While 38.0% preferred surgeries under 60 minutes, 26.0% imposed no time constraints. Key intraoperative challenges included dense adhesions, cholecysto-enteric fistulas, and fibrosis. Less experienced surgeons reported greater challenges with scarring adhesions and anatomical variations, but no significant differences were found for other factors like edematous or necrotic changes. Preoperative imaging was considered essential by most surgeons. Conclusions This study underscores the limited reliability of traditional parameters for assessing difficulty in LC. Surgeons highlighted the importance of objective intraoperative findings and preoperative imaging in predicting surgical challenges. Factors such as adhesions, fibrosis, and anatomical variations significantly impact LC difficulty, with decisions regarding conversion to open surgery largely driven by individual judgment rather than experience. Standardized grading systems incorporating these factors could improve surgical planning, reduce complications, and enhance patient outcomes.

Traumatic aneurysms represent less than 1 percent of intracranial aneurysms and middle meningeal artery pseudoaneurysms are even rare. Traumatic aneurysms are usually pseudoaneurysms formed by the rupture of all the layers of the vessel wall. They are associated with high mortality as they can present as epidural, subdural, and rarely intraparenchymal hematoma. However, only nine cases of traumatic pseudoaneurysms of middle meningeal artery are reported that have presented as an acute intracerebral hematoma. We report a case of ruptured pseudo aneurysm of middle meningeal artery presenting with intraparenchymal hematoma in which hematoma evacuation and aneurysm excision was done immediately. The patient recovered well in the post-operative period. In addition, we reviewed all cases of middle meningeal artery pseudoaneurysms reported in the literature either as extradural hematomas, subdural/intraparenchymal hematomas, or subarachnoid hemorrhages. However, identifying the location of the aneurysm intraoperatively may be challenging as the hematoma may obscure the same. Distance from the sphenoid ridge may serve as a good intraoperative guide. Intraoperative localization along with surgical evacuation if done immediately can lead to gratifying results.

Background: s/Aims: Assessing surgical difficulty in laparoscopic cholecystectomy (LC) is challenging due to variations in surgeon proficiency and institutional protocols. This study evaluates surgeons’ perspectives on procedural difficulty and examines how intraoperative findings and preoperative imaging contribute to refining difficulty assessment criteria. Methods: A cross-sectional survey was conducted among 50 laparoscopic surgeons in India, providing insights into tolerances for surgical duration and blood loss, reasons for conversion, and predictors of complexity. Responses were analyzed using SPSS, with statistical significance set at p < 0.05. Results: Among surveyed surgeons, 82.0% were male, and 78.0% worked in private institutions and 52.0% had performed over 1,000 LCs. Conversion to open surgery was primarily influenced by significant blood loss (68.0%) and biliary injury (94.0%). While 38.0% preferred surgeries under 60 minutes, 26.0% imposed no time constraints. Key intraoperative challenges included dense adhesions, cholecysto-enteric fistulas, and fibrosis. Less experienced surgeons reported greater challenges with scarring adhesions and anatomical variations, but no significant differences were found for other factors like edematous or necrotic changes. Preoperative imaging was considered essential by most surgeons. Conclusions This study underscores the limited reliability of traditional parameters for assessing difficulty in LC. Surgeons highlighted the importance of objective intraoperative findings and preoperative imaging in predicting surgical challenges. Factors such as adhesions, fibrosis, and anatomical variations significantly impact LC difficulty, with decisions regarding conversion to open surgery largely driven by individual judgment rather than experience. Standardized grading systems incorporating these factors could improve surgical planning, reduce complications, and enhance patient outcomes.

Traumatic aneurysms represent less than 1 percent of intracranial aneurysms and middle meningeal artery pseudoaneurysms are even rare. Traumatic aneurysms are usually pseudoaneurysms formed by the rupture of all the layers of the vessel wall. They are associated with high mortality as they can present as epidural, subdural, and rarely intraparenchymal hematoma. However, only nine cases of traumatic pseudoaneurysms of middle meningeal artery are reported that have presented as an acute intracerebral hematoma. We report a case of ruptured pseudo aneurysm of middle meningeal artery presenting with intraparenchymal hematoma in which hematoma evacuation and aneurysm excision was done immediately. The patient recovered well in the post-operative period. In addition, we reviewed all cases of middle meningeal artery pseudoaneurysms reported in the literature either as extradural hematomas, subdural/intraparenchymal hematomas, or subarachnoid hemorrhages. However, identifying the location of the aneurysm intraoperatively may be challenging as the hematoma may obscure the same. Distance from the sphenoid ridge may serve as a good intraoperative guide. Intraoperative localization along with surgical evacuation if done immediately can lead to gratifying results.