This paper introduces professor WU Rongzu's clinical experience in using Fuyang Tongmi Decoction （扶阳通秘汤， FTD） to treat irritable bowel syndrome with constipation （IBS-C）. It is believed that yang qi depletion， water cold， earth dampness， and wood constraint are the key pathogenesis.The treatment principle is warming water， drying the earth and venting wood， with the basic formula FTD adjusted according to the symptoms. This approach aims to transport the qi movement of the middle jiao （焦） and support the recovery of intestinal function of directing turbidity downward， providing a treatment strategy for IBS-C caused by yang deficiency.

Objective To observe the intervention effect of acupuncture at"Zusanli"(ST36)or"Neiguan"(PC6)on the ulcerative colitis(UC)model mice.And to analyze the similarities and differences of gene transcription expression between the diseased colon and the non-diseased heart after acupuncture intervention by using transcriptomics,to explore whether there are efficacy differences between the two acupoints.Methods The UC mouse model was established by inducing dextran sulfate sodium salt(DSS).After successful modeling,the mice were randomly divided into model group,Zusanli group,and Neiguan group,with 9 mice in each group.Zusanli group and Neiguan group intervened with acupuncture at"Zusanli"and"Neiguan",respectively,30 min each time,once a day,for 5 consecutive days.The control and model groups were only bound without acupuncture.Observe the general situation of mice in each group,calculate the disease activity index(DAI),observe the morphological changes of colon tissue by HE staining.Use transcriptome sequencing technology to sequence and biologically analyze the colon tissue of mice in each group,and compare and study whether the two acupoints have differences in acupoint efficacy from the perspective of diseased tissue.At the same time,take the heart tissues of each group for comparative analysis,and discuss whether the effects of the two acupoints are different from the perspective of non-diseased tissue.Results Compared with control group,the DAI score of the model group increased significantly(P<0.001),and HE staining results showed significant pathological damage;after acupuncture at Zusanli or Neiguan,the DAI scores of UC mice were reduced considerably(P<0.05),and the pathological damage was significantly improved.The results of transcriptome sequencing and bioinformatics analysis showed that the effects of acupuncture at Zusanli or Neiguan on the colon of diseased tissue involved multiple genes,and 825 differential genes with similar changes(co-DEGs)were mainly enriched in white blood cells and chemokine pathways;there were 168 differentially expressed genes(ST36 only-DEGs)affected only by Zusanli,which were enriched to gastric acid secretion and other pathways;there were 325 differentially expressed genes(PC6 only-DEGs)only affected by Neiguan,which were enriched in cytokine-cytokine receptor interaction and other pathways.There were 95 co-DEGs in the heart of non-diseased tissue,which were mainly enriched in positive regulation of defense response and response to interleukin-1;there were 28 ST36 only-DEGs;there were114 PC6 only-DEGs,which were enriched in cardiovascular diseases and other pathways.Conclusion Acupuncture of"Zusanli"and"Neiguan"could improve UC mice's symptoms and pathological colon changes.However,through transcriptomic analysis,it was found that the two acupoints had differences in gene transcription effects on the colon of diseased tissue and the heart of non-diseased tissue,suggesting that acupoints with different distribution positions had some similarities in macro efficacy.Still,there were some differences at a micro level.

Objective To explore the effects of different acupoints,different target organs,and different interventions on acupoint efficacy based on ACU&MOX-DATA platform;To illustrate and visualize whether the above factors have the characteristics of"specific effect"or"common effect"of acupoint efficacy.Methods The multi-source heterogeneous data were integrated from the original omics data and public omics data.After standardization,differential gene analysis,disease pathology network analysis,and enrichment analysis were performed using Batch Search and Stimulation Mode modules in ACU&MOX-DATA platform under the conditions of different acupoints,different target organs,and different interventions.Results Under the same disease state and the same intervention,there were differences in effects among different acupoints;under the same disease state,the same acupoint and intervention,the responses produced by different target organs were not completely consistent;under the same disease state and acupoint,there were differences in effects among different intervention measures.Conclusion Based on the analysis of ACU&MOX-DATA platform,it is preliminary clear that acupoints,target organs,and interventions are the key factors affecting acupoint efficacy.Meanwhile,the above results have indicated that there are specific or common regulatory characteristics of acupoint efficacy.Applying ACU&MOX-DATA platform to analyze and visualize the critical scientific problems in the field of acupuncture and moxibustion can provide references for deepening acupoint cognition,guiding clinical acupoint selection,and improving clinical efficacy.

Medical Physics is an interdiscipline which is formed by applying the basic principles, methods, and techniques of physics to clinical medical research such as prevention, diagnosis, and treatment of human diseases, and it is a compulsory professional basic course for medical students. However, there are many medical students reflect that the content of this course is obscure and difficult to understand. Teaching effect is not ideal. The main reasons are that the teaching method is single and the reference materials are few. Based on the actual situation of the course, Hebei Medical University, China promotes formative evaluation from the content of teaching materials, teaching means, and other aspects. At the same time, by combining with the Internet, the digital construction has been realized, deepening the reform of the Medical Physics curriculum, and remarkable results have been achieved.

Objectives:To evaluate the efficacy and safety of adalimumab (ADA) biosimilar in the treatment of Crohn′s disease (CD) .Methods:A retrospective cohort study was conducted. The patients with CD treated with ADA biosimilar in the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to March 2022 with complete data were enrolled. The disease activity of patients at baseline was evaluated by Harvey-Bradshaw index (HBI) . The patients were divided into active group and remission group according to the activity. The primary endpoints were clinical response rate and remission rate at the 12th week in patients with active CD. The secondary endpoints included the clinical response rate and the remission rate in patients with active CD at the 26th week, maintenance remission rate at the 12th and the 26th weeks in patients with remission CD, and safety report.Results:Forty-eight patients were included. There were 20 patients whose HBI was 7 (6, 8) points in active group and 28 whose HBI was 3 (2, 4) points in remission group. In patients with active CD, the clinical response rate was 70.0% (14/20) and clinical remission rate was 60.0% (12/20) at the 12th week. The clinical response rate and clinical remission rate were both 61.5% (8/13) at the 26th week. The maintain remission rate of patients with remission CD was 96.4% (27/28) and 92.3% (12/13) at the 12th and the 26th weeks respectively. During the follow-up period, adverse reactions occurred in 2 patients (4.2%) and no serious adverse reaction was found.Conclusion:ADA biosimilar has good efficacy and safety in short-term induction and maintenance of clinical remission in Chinese patients with mild to moderate active CD.

Objective:To evaluate the efficacy, predictive factors, and safety of thalidomide monotherapy in the maintenance treatment of intestinal Behcet's disease.Methods:From January 2013 to March 2022, patients with intestinal Behcet's disease received thalidomide in the Sixth Affiliated Hospital of Sun Yat-sen University were retrospectively enrolled for analysis. The primary end points were the maintained steroid-free remission at 6 and 12 months. The secondary end points were the mucosal healing at 6 and 12 months, the long-term maintained steroid-free remission, predictive factors and adverse events.Results:A total of 28 patients with active intestinal Behcet's disease were enrolled. The maintained steroid-free remission at month 6, 12, 24 and 36 were 85.7%, 74.0%, 63.5% and 50.4% respectively. The median duration of maintained steroid-free remission was 49.5 (35.4, 63.6) months. Mucosal healing was 40.0% and 35.0% at month 6 and 12 respectively. Multivariate Cox regression analysis indicated that high disease activity index for intestinal Behcet's disease at baseline ( P = 0.014, HR = 1.057, 95% CI 1.011-1.104) was independently associated with lower likelihoods of maintaining steroid-free remission. During follow-up, 14 patients (50.0%) got adverse reactions and the incidence of limb numbness was 28.6%, with a median duration of 9.5 (5.5, 22.5) months. The drug dosage reduction rate was 14.3%, and the drug discontinuation rate was 17.9% due to side effects respectively. The median duration of drug discontinuation was 10.5 (23.5, 40.3) months. Conclusion:Thalidomide shows good effectiveness in maintaining long term steroid-free remission in intestinal Behcet′s disease, but the high incidence of limb numbness deserves attention.

Objectives:To evaluate the efficacy and safety of adalimumab (ADA) biosimilar in the treatment of Crohn′s disease (CD) .Methods:A retrospective cohort study was conducted. The patients with CD treated with ADA biosimilar in the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to March 2022 with complete data were enrolled. The disease activity of patients at baseline was evaluated by Harvey-Bradshaw index (HBI) . The patients were divided into active group and remission group according to the activity. The primary endpoints were clinical response rate and remission rate at the 12th week in patients with active CD. The secondary endpoints included the clinical response rate and the remission rate in patients with active CD at the 26th week, maintenance remission rate at the 12th and the 26th weeks in patients with remission CD, and safety report.Results:Forty-eight patients were included. There were 20 patients whose HBI was 7 (6, 8) points in active group and 28 whose HBI was 3 (2, 4) points in remission group. In patients with active CD, the clinical response rate was 70.0% (14/20) and clinical remission rate was 60.0% (12/20) at the 12th week. The clinical response rate and clinical remission rate were both 61.5% (8/13) at the 26th week. The maintain remission rate of patients with remission CD was 96.4% (27/28) and 92.3% (12/13) at the 12th and the 26th weeks respectively. During the follow-up period, adverse reactions occurred in 2 patients (4.2%) and no serious adverse reaction was found.Conclusion:ADA biosimilar has good efficacy and safety in short-term induction and maintenance of clinical remission in Chinese patients with mild to moderate active CD.

Objective:To evaluate the efficacy, predictive factors, and safety of thalidomide monotherapy in the maintenance treatment of intestinal Behcet's disease.Methods:From January 2013 to March 2022, patients with intestinal Behcet's disease received thalidomide in the Sixth Affiliated Hospital of Sun Yat-sen University were retrospectively enrolled for analysis. The primary end points were the maintained steroid-free remission at 6 and 12 months. The secondary end points were the mucosal healing at 6 and 12 months, the long-term maintained steroid-free remission, predictive factors and adverse events.Results:A total of 28 patients with active intestinal Behcet's disease were enrolled. The maintained steroid-free remission at month 6, 12, 24 and 36 were 85.7%, 74.0%, 63.5% and 50.4% respectively. The median duration of maintained steroid-free remission was 49.5 (35.4, 63.6) months. Mucosal healing was 40.0% and 35.0% at month 6 and 12 respectively. Multivariate Cox regression analysis indicated that high disease activity index for intestinal Behcet's disease at baseline ( P = 0.014, HR = 1.057, 95% CI 1.011-1.104) was independently associated with lower likelihoods of maintaining steroid-free remission. During follow-up, 14 patients (50.0%) got adverse reactions and the incidence of limb numbness was 28.6%, with a median duration of 9.5 (5.5, 22.5) months. The drug dosage reduction rate was 14.3%, and the drug discontinuation rate was 17.9% due to side effects respectively. The median duration of drug discontinuation was 10.5 (23.5, 40.3) months. Conclusion:Thalidomide shows good effectiveness in maintaining long term steroid-free remission in intestinal Behcet′s disease, but the high incidence of limb numbness deserves attention.

To report a case of cutaneous metaplastic synovial cyst. A 14-year-old male patient presented with a cystic mass on the forehead for more than 6 months. Histopathological findings revealed an intradermal cystic structure with multiple intraluminal broad band-like villiform protuberances, which was lined with a membrane resembling hyperplastic synovium and composed of a variety of cellular structures; some areas of the cystic wall were covered with fibrin-like hyaline connective tissues, and some areas were highly cellularized and lined with multiple layers of epithelioid cells and spindle cells. Immunohistochemical study revealed diffuse expression of vimentin and positive staining for the histocyte marker CD68, but negative staining for cytokeratin and smooth muscle actin in epithelioid cells and spindle cells. According to the clinical manifestations and histopathological findings, the diagnosis of cutaneous metaplastic synovial cyst was confirmed.

A 44-year-old male patient presented with a subcutaneous nodule in the left little finger for 3 years. Skin examination showed a subcutaneous nodule with rubber-like hardness but no tenderness on palpation, measuring 0.4 cm × 0.4 cm in size at the dorsal distal aspect of the left little finger, and the movement of the distal interphalangeal joint was unrestricted. Postoperative histopathological examination revealed that the tumor contained abundant stroma consisting of variable fiberous, chondroid and myxoid materials; tumor cells were oval to short spindle-shaped with inconspicuous nucleoli but no mitosis; cells were arranged haphazardly or in small clusters. Immunohistochemical study showed positive staining for vimentin, CD34 and transcription factors ERG and SOX9, but negative staining for S100, P63, broad-spectrum cytokeratin AE1/AE3, epithelial membrane antigen, smooth muscle actin and desmin in tumor cells, and the Ki67 labeling index was below 1%. Finally, the patient was diagnosed with acral fibrochondromyxoid tumor.