Purpose/Significance To summarize the application progress of artificial intelligence (AI) in the field of digestive endoscopy, to analyze the key challenges and look forward to future trends, so as to provide guidance for clinical practice and research. Method/Process Domestic and international literature databases such as PubMed, Web of Science, and CNKI are retrieved. The application research of AI in the auxiliary diagnosis, process optimization and treatment precision of digestive endoscopy is sorted out. Result/Conclusion Although AI has significant clinical value in the field of digestive endoscopy, its application still faces major challenges, and its prospects and limitations need to be further discussed.

Objective To investigate the status quo of health management behaviors in elderly patients with type 2 diabetes mellitus(T2DM)complicating chronic complications and the influencing factors based on health ecology theory.Methods The convenience sampling method was used to select elderly patients with T2DM complicating chronic complications in the Shanghai City from January to July 2022 as the respondents.Based on the health ecology theory,the five aspects of personality traits,psychological and behavioral traits,family and community interpersonal networks,living and working conditions and policy environment were in-vestigated.The Pearson correlation coefficient was used to analyze the correlation of various variables.The hi-erarchical linear regression was used to analyze the influencing factors of health management behaviors in eld-erly patients with T2DM complicating chronic complications.Results A total of 272 questionnaires were dis-tributed and 264 valid questionnaires were recovered,with an effective recovery rate of 97.06％(264/272).There were statistically significant differences in DSMB-Oscores among the patients with different chronic complications number,sleep quality,per capita monthly household income and medical payment methods(P＜0.05).The DSMB-Oscore in elderly patients with T2DM complicating chronic complications was positively correlated with HLSCP,DES,PACIC and CIRS scores(P＜0.05),and negatively correlated with the PAID-5 score(P＜0.05).Conclusion The health management behaviors of elderly patients with T2DM complicating chronic complications is jointly affected and acted by many factors,and it is necessary to identify and manage the related influencing factors from different aspects and different levels.

Objective To investigate the impact of different δ-catenin expression levels on brain small-world network alterations before and after chemotherapy in breast cancer patients using resting-state function-al MRI(rs-fMRI).Methods A total of 66 breast cancer patients who were pathologically diagnosed and did not receive the first chemotherapy were included and divided into the high-expression(DH)group(n=31)and the low-expression(DL)group(n=35)according to the expression level of δ-catenin.rs-fMRI were per-formed before and after chemotherapy respectively to calculate the attributes of the brain small-world net-work,including parameters such as node local efficiency(NE),betweenness centrality(BC),degree centrality(DC)and the changes in the attributes of the brain small-world network of patients before and after chemo-therapy were analyzed.Results There was no statistically significant difference in the longitudinal comparison of network indicators such as small-world coefficient(σ),characteristic path length(λ),cluster coefficient(γ),local clustering coefficient(Cp),average shortest path length(Lp),global efficiency(Eg),and local effi-ciency(Eloc)before and after chemotherapy between the DL group and the DH group(P>0.05).In the DL group,post-chemotherapy NE values was decreased in the left olfactory cortex,bilateral orbital superior fron-tal gyri,right gyrus rectus,and left caudate nucleus,while increased in the bilateral central operculum,left su-perior parietal gyrus,right superior temporal gyrus,and temporal pole of the right superior temporal gyrus.In the DH group,post-chemotherapy NE values was decreased in the bilateral supplementary motor area and right angular gyrus,and right superior temporal gyrus,but increased in the left globus pallidus.Post-chemo-therapy BC values in the DL group was decreased in the left pericalcarine cortex,right lingual gyrus,and left caudate nucleus,and increased in the left medial superior frontal gyrus.In the DH group,post-chemotherapy BC values was decreased in the right supplementary motor area and right caudate nucleus,while increased in the right posterior cingulate gyrus and left globus pallidus.Post-chemotherapy DC values in the DL group was decreased in the left supplementary motor area,right gyrus rectus,and left caudate nucleus,but increased in the right opercular part of the inferior frontal gyrus,right central operculum,right temporal pole of the superi-or temporal gyrus,right superior temporal gyrus,left superior parietal gyrus,left angular gyrus,and bilateral supramarginal gyri.In the DH group,post-chemotherapy DC values was decreased in the left precentral gyrus,bilateral supplementary motor areas,left fusiform gyrus,right angular gyrus,and right superior temporal gy-rus,while increased in the left globus pallidus.Conclusion The high expression of δ-catenin may further ag-gravate the damage of chemotherapy to the brain small-world network of breast cancer patients,mainly invol-ving motor and cognition-related brain regions.

ObjectiveThis paper aims to investigate the potential molecular biological mechanism of Buyang Huanwu Tongfeng decoction in treating hyperuricemia and gouty arthritis by network pharmacology and molecular docking technology and preliminarily verify the mechanism through animal experiments. MethodsThe active ingredients and targets in the Buyang Huanwu Tongfeng decoction were obtained by the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） and ETCM databases. The DisGeNET and GeneCards databases were utilized to acquire disease targets associated with hyperuricemia and gouty arthritis. These disease targets were then intersected with drug targets to identify key targets. The R language ClusterProfiler package and Python were employed for conducting gene ontology（GO） enrichment analysis and Kyoto encyclopedia of genes and genomes（KEGG） enrichment analysis. The regulatory network diagram of the drug-key target-function-pathway was visualized using Cytoscape 3.9.1 software， and the protein-protein interaction （PPI） network for key targets was depicted. Finally， the hub gene was determined through topological analysis. Auto Dock， PyMOL， and other software were used for molecular docking to explore the possible therapeutic mechanism of Buyang Huanwu Tongfeng decoction for hyperuricemia and gouty arthritis. In animal experiments， a composite rat model of hyperuricemia induced by intraperitoneal injection of oteracil potassium combined with gouty arthritis induced by the modified Coderre method was established. Through hematoxylin-eosin（HE） staining， uric acid test， enzyme linked immunosorbent assay（ELISA）， Western blot， and real-time polymerase chain reaction（Real-time PCR）， the molecular mechanism and key targets of Buyang Huanwu Tongfeng decoction for treating hyperuricemia and gouty arthritis were observed. ResultsAfter screening and removing duplicate values， 76 active ingredients and 15 key targets were finally obtained. GO enrichment analysis yielded that the treatment of hyperuricemia and gouty arthritis with Buyang Huanwu Tongfeng decoction was significantly associated with acute inflammatory response， astrocyte activation， regulation of interleukin （IL）-8 production， nuclear receptor activity， and binding of growth factor receptor. KEGG pathway enrichment analysis obtained that the key target genes were significantly associated with the IL-17 signaling pathway， advanced glycosylation end/receptor of advanced glycation endproducts（AGE/RAGE） signaling pathway， anti-inflammatory， and other pathways. PPI network indicated that albumin（ALB）， peroxisome proliferator-activated receptor-γ （PPAR-γ）， IL-6， IL-1β， and C-reactive protein（CRP） were the key protein targets. The molecular docking results showed that ALB had the strongest binding force with beta-carotene （β-carotene）. Biochemical results showed that blood uric acid decreased in the Buyang Huanwu Tongfeng decoction groups. HE staining results showed that the low-dose （7.76 g·kg^-1·d^-1）， medium-dose （15.53 g·kg^-1·d^-1）， and high-dose （31.05 g·kg^-1·d^-1） groups of Buyang Huanwu Tongfeng decoction had different degrees of remission， and the remission of the high-dose group was the most obvious. Fibroblastic tissue hyperplasia in synovial joints accompanied with inflammatory cell infiltration， as well as inflammatory cell infiltration in renal tissue of the high-dose group was significantly reduced， followed by the medium-dose and low-dose groups， and the expression of ALB， PPAR-γ， IL-6， IL-1β， and CRP was down-regulated to different degrees. ConclusionBy regulating the targets such as ALB， PPAR-γ， IL-6， IL-1β， and CRP， inhibiting the PPAR-γ/nuclear transcription factor （NF）-κB pathway， and reducing AGEs/RAGE-mediated inflammation， Buyang Huanwu Tongfeng decoction exerts anti-inflammatory and analgesic effects and activates blood circulation and diuresis in the treatment of hyperuricemia and gouty arthritis.

Objective:To investigate the effects of golden cicada anti-itch capsules combined with tacrolimus ointment on clinical symptoms and T helper cell type 1/T helper cell type 2 (Th1/Th2) cytokine balance in older adult patients with itchy skin.Methods:This prospective study included 80 older adult patients with itchy skin who attended No. 215 Hospital of Shaanxi Nuclear Industry from January 2022 to January 2024. The patients were randomly divided into two groups ( n = 40 per group) using a random number table method. The ointment group received tacrolimus ointment, while the combination group was treated with golden cicada anti-itch capsules plus tacrolimus ointment. Both groups were treated for 4 weeks. Clinical symptom scores, Dermatology Life Quality Index (DLQI) scores, traditional Chinese medicine (TCM) syndrome scores, and the cytokine profiles of Th1 [interleukin-2 (IL-2) and interferon-gamma (IFN-γ)]/Th2 [interleukin-5 (IL-5), interleukin-13 (IL-13)] and skin barrier function were compared before and after 4 weeks of treatment. The incidence of adverse reactions and recurrence rates were recorded. Results:Before treatment, there were no statistically significant differences in clinical symptom scores, DLQI scores, or TCM syndrome scores between the ointment and combination groups ( t = -0.76, 0.76, -0.54, 0.33,-0.16, -0.36, all P > 0.0.5). After treatment, both groups showed reductions in severity of itching, duration, frequency of episodes, and area of skin lesions, as well as DLQI scores and TCM syndrome scores ( t = 16.14, 24.18, 14.65, 19.98, 18.21, 25.03, 15.42, 19.55, 12.36, 18.14, 15.65, 22.05, all P < 0.05). After treatment, the combination group had lower scores for severity of itching [(0.88 ± 0.24) points], duration [(0.91 ± 0.22) points], frequency of episodes [(1.06 ± 0.21) points], area of skin lesions [(1.18 ± 0.31) points], DLQI [(7.93 ± 2.17) points], and TCM syndrome scores [(8.89 ± 1.47) points] compared with the ointment group [(1.17 ± 0.33) points, (1.44 ± 0.26) points, (1.43 ± 0.25) points, (1.72 ± 0.44) points, (11.41 ± 3.05) points, (13.32 ± 2.06) points, t = 4.50, 9.84, 7.17, 6.35, 5.88, 11.07, all P < 0.05]. Before treatment, there was no statistically significant difference in Th1/Th2 cytokine level between the ointment and combination groups ( t = -0.15, -0.07, 0.21, -0.23, all P > 0.05). Both groups showed significant decreases in IL-2 and IFN-γ levels, and increases in IL-5 and IL-13 levels after treatment compared with their pre-treatment levels ( t = 4.56, 9.02, 11.11, 15.20, -5.63, -9.14, -6.01, -8.88, all P < 0.05). After treatment, the combination group had significantly lower IL-2 and IFN-γ levels and significantly higher IL-5 and IL-13 levels compared with the ointment group ( t = 7.25, 7.13, -6.69, -7.67, all P < 0.05). Before treatment, there was no statistically significant difference in skin barrier function between the two groups ( t = -0.16, 0.25, P > 0.05). After treatment, both groups exhibited significant reductions in transepidermal water loss and significant increases in stratum corneum hydration compared with their pre-treatment levels ( t = 6.25, 11.04, -4.82, -9.77, all P < 0.05). After treatment, the combination group demonstrated significantly lower transepidermal water loss and significantly greater stratum corneum hydration than the ointment group ( t = 4.13, 7.73, both P < 0.05). There was no significant difference in incidence of adverse reactions between the ointment group [7.50% (3/40)] and the combination group [12.50% (5/40), χ2 = 0.56, P = 0.456]. The recurrence rate was 27.50% (11/40) in the ointment group and 10.00% (4/40) in the combination group. Six months after treatment, the difference in recurrence rate between the ointment and combination groups was statistically significant ( χ2 = 4.02, P = 0.045). Conclusions:The use of Golden Cicada anti-itch capsules combined with tacrolimus ointment for treating itchy skin in older adult patients can help relieve clinical symptoms, improve skin barrier function, promote Th1/Th2 cytokine balance, and decrease the recurrence rate.

Objective:To investigate the effects of golden cicada anti-itch capsules combined with tacrolimus ointment on clinical symptoms and T helper cell type 1/T helper cell type 2 (Th1/Th2) cytokine balance in older adult patients with itchy skin.Methods:This prospective study included 80 older adult patients with itchy skin who attended No. 215 Hospital of Shaanxi Nuclear Industry from January 2022 to January 2024. The patients were randomly divided into two groups ( n = 40 per group) using a random number table method. The ointment group received tacrolimus ointment, while the combination group was treated with golden cicada anti-itch capsules plus tacrolimus ointment. Both groups were treated for 4 weeks. Clinical symptom scores, Dermatology Life Quality Index (DLQI) scores, traditional Chinese medicine (TCM) syndrome scores, and the cytokine profiles of Th1 [interleukin-2 (IL-2) and interferon-gamma (IFN-γ)]/Th2 [interleukin-5 (IL-5), interleukin-13 (IL-13)] and skin barrier function were compared before and after 4 weeks of treatment. The incidence of adverse reactions and recurrence rates were recorded. Results:Before treatment, there were no statistically significant differences in clinical symptom scores, DLQI scores, or TCM syndrome scores between the ointment and combination groups ( t = -0.76, 0.76, -0.54, 0.33,-0.16, -0.36, all P > 0.0.5). After treatment, both groups showed reductions in severity of itching, duration, frequency of episodes, and area of skin lesions, as well as DLQI scores and TCM syndrome scores ( t = 16.14, 24.18, 14.65, 19.98, 18.21, 25.03, 15.42, 19.55, 12.36, 18.14, 15.65, 22.05, all P < 0.05). After treatment, the combination group had lower scores for severity of itching [(0.88 ± 0.24) points], duration [(0.91 ± 0.22) points], frequency of episodes [(1.06 ± 0.21) points], area of skin lesions [(1.18 ± 0.31) points], DLQI [(7.93 ± 2.17) points], and TCM syndrome scores [(8.89 ± 1.47) points] compared with the ointment group [(1.17 ± 0.33) points, (1.44 ± 0.26) points, (1.43 ± 0.25) points, (1.72 ± 0.44) points, (11.41 ± 3.05) points, (13.32 ± 2.06) points, t = 4.50, 9.84, 7.17, 6.35, 5.88, 11.07, all P < 0.05]. Before treatment, there was no statistically significant difference in Th1/Th2 cytokine level between the ointment and combination groups ( t = -0.15, -0.07, 0.21, -0.23, all P > 0.05). Both groups showed significant decreases in IL-2 and IFN-γ levels, and increases in IL-5 and IL-13 levels after treatment compared with their pre-treatment levels ( t = 4.56, 9.02, 11.11, 15.20, -5.63, -9.14, -6.01, -8.88, all P < 0.05). After treatment, the combination group had significantly lower IL-2 and IFN-γ levels and significantly higher IL-5 and IL-13 levels compared with the ointment group ( t = 7.25, 7.13, -6.69, -7.67, all P < 0.05). Before treatment, there was no statistically significant difference in skin barrier function between the two groups ( t = -0.16, 0.25, P > 0.05). After treatment, both groups exhibited significant reductions in transepidermal water loss and significant increases in stratum corneum hydration compared with their pre-treatment levels ( t = 6.25, 11.04, -4.82, -9.77, all P < 0.05). After treatment, the combination group demonstrated significantly lower transepidermal water loss and significantly greater stratum corneum hydration than the ointment group ( t = 4.13, 7.73, both P < 0.05). There was no significant difference in incidence of adverse reactions between the ointment group [7.50% (3/40)] and the combination group [12.50% (5/40), χ2 = 0.56, P = 0.456]. The recurrence rate was 27.50% (11/40) in the ointment group and 10.00% (4/40) in the combination group. Six months after treatment, the difference in recurrence rate between the ointment and combination groups was statistically significant ( χ2 = 4.02, P = 0.045). Conclusions:The use of Golden Cicada anti-itch capsules combined with tacrolimus ointment for treating itchy skin in older adult patients can help relieve clinical symptoms, improve skin barrier function, promote Th1/Th2 cytokine balance, and decrease the recurrence rate.

Objective To systematically retrieve and integrate the best evidence of enteral and parenteral nutrition support in adult patients with severe bums.Methods 2 nursing master students who had studied evidence-based nursing systematically searched the clinical decisions,recommended practices,guidelines,expert consensuses,systematic reviews,evidence summaries and other evidences on enteral and parenteral nutrition support for adult patients with severe bums in domestic and foreign guideline networks,relevant institutional websites and databases.The retrieval time was from the establishment of the databases to April 2023.2 researchers who had obtained master's degrees and undergone systematic evidence-based training in Fudan University used the appraisal of guidelines for research and evaluation n and JBI critical appraisal tools to evaluate the methodological quality,and extracted and summarized the evidence according to the theme.Results A total of 28 articles were included,including l clinical decision,9 guidelines,3 expert consensuses,9 systematic reviews,and 6 evidence summaries.A total of 20 pieces of evidence were summarized from 6 aspects:nutritional risk screening and assessment,energy requirement calculation,timing and route of nutritional support,nutrient intake,nutritional support monitoring and effect evaluation.Conclusion The best evidence of enteral and parenteral nutrition support for adult patients with severe burns summarized in this study is more comprehensive and scientific.It is suggested that in clinical application,targeted screening should be carried out according to the promotion and hindering factors of evidence,so as to scientifically carry out nutritional support for adult patients with severe burns.

Objective:To investigate whether dual-energy computed tomography(DECT) measurement of monosodium urate(MSU) crystal loading can predict the risk of gout flares.Methods:A single-center, prospective, observational study included 229 gout patients initially diagnosed at the Gout Clinic of Qingdao University from August 2021 to February 2022. The patients underwent MSU assessment of the bilateral feet using DECT. Following enrolment, all patients commenced uric acid-lowering therapy(ULT) and were followed up at 3 and 6 months. Patients who experienced at least one flare within 6 months were compared with those who did not, and the odds ratio( OR) for the risk of gout flares was calculated. Results:Patients who experienced gout flare had a significantly longer disease duration[(6.69±5.42) vs(4.14±4.86) years, P<0.01], a higher number of flares in the past year(4.80±1.73 vs 2.02±1. 23, P<0.01), a higher proportion of fatty livers(11.0% vs 1.4%, P<0.05), and a greater volume of MSU crystals in the feet[(3.52±9.74) vs(0.29±0.98)cm 3,P<0.05] compared to patients without gout flare. The results of the multifactorial logistic regression analysis indicated that the number of flares in the past year( OR=1.295, 95% CI 1.032-1.613, P<0.05) and feet MSU crystal volume( OR=3.245, 95% CI 1.164-9.064, P<0.05) were independent risk factors for gout flares. The receiver operating characteristic(ROC) curve indicated the integration of the MSU prediction model into the clinical prediction model resulted in a comprehensive prediction model with an area under curve(AUC) value of 0.780(95% CI 0.710-0.840), sensitivity of 0.83, and specificity of 0.62. Internal validation of the comprehensive prediction model using the Bootstrap method yielded a C-index of 0.770(95% CI 0.701-0.833) for predicting flares. The calibration curve of the model demonstrated a good fit between the predicted probability of flares and the actual probability, indicating high calibration accuracy. Conclusion:The volume of MSU crystals in the feet is an independent risk factor for flares following ULT. A larger volume of MSU crystals in the foot increases the likelihood of a flare. This study provides a basis for early prediction of flare and a reference for early preventive treatment.

Objective To identify the pathogenic mutations in a family with piebaldism.Methods Clinical infor-mation and peripheral blood were collected from the patient with piebaldism and their parents.Whole exome se-quencing was performed to identify the potential pathogenic mutations.QPCR was used to determine the deletion of the target gene,while gap-PCR and Sanger sequencing was used to determine the size and the specific deletion site.Results The proband had a heterozygous deletion mutation of approximately 1.74 Mb located at chromosome 4,in-cluding a full length of the pathogenic gene KIT for mottled disease and it was the smallest micro deletion causing isolated piebaldism due to the loss of the KIT.Conclusions The heterozygous deletion including the KIT is a poten-tial cause of the piebaldism phenotype found in this family.

Objective: : Kinesin family member C1 (KIFC1), a non-essential kinesin-like motor protein, has been found to serve a crucial role in supernumerary centrosome clustering and the progression of several human cancer types. However, the role of KIFC1 in glioma has been rarely reported. Thus, the present study aimed to investigate the role of KIFC1 in glioma progression. Methods: : Online bioinformatics analysis was performed to determine the association between KIFC1 expression and clinical outcomes in glioma. Immunohistochemical staining was conducted to analyze the expression levels of KIFC1 in glioma and normal brain tissues. Furthermore, KIFC1 expression was knocked in the glioma cell lines, U251 and U87MG, and the functional roles of KIFC1 in cell proliferation, invasion and migration were analyzed using cell multiplication, wound healing and Transwell invasion assays, respectively. The autophagic flux and expression levels matrix metalloproteinase-2 (MMP2) were also determined using imaging flow cytometry, western blotting and a gelation zymography assay. Results: : The results revealed that KIFC1 expression levels were significantly upregulated in glioma tissues compared with normal brain tissues, and the expression levels were positively associated with tumor grade. Patients with glioma with low KIFC1 expression levels had a more favorable prognosis compared with patients with high KIFC1 expression levels. In vitro, KIFC1 knockdown not only inhibited the proliferation, migration and invasion of glioma cells, but also increased the autophagic flux and downregulated the expression levels of MMP2. Conclusion : Upregulation of KIFC1 expression may promote glioma progression and KIFC1 may serve as a potential prognostic biomarker and possible therapeutic target for glioma.