ObjectiveTo evaluate the clinical efficacy of Huayu Tongluo Formula （化瘀通络方， HTF） in patients with mid-stage diabetic kidney disease of blood stasis syndrome and explore its potential mechanisms. MethodsA multi-center， randomized， double-blind， placebo-controlled clinical trial was conducted. Ninety patients of mid-stage diabetic kidney disease of blood stasis syndrome were divided into a control group of 46 cases and a treatment group of 44 cases. Both groups received conventional western medicine treatment， the treatment group additionally taking HTF， while the control group taking a placebo of the formula. The treatment was administered once daily for 24 weeks. The primary outcomes included 24-hour urine total protein （24 h-UTP）， serum albumin （Alb）， glycated hemoglobin （HbA1c）， and serum creatinine （Scr）.The secondary outcomes included changes in levels of endothelin-1 （ET-1）， nitric oxide （NO）， vascular endothelial growth factor （VEGF）， and traditional Chinese medicine （TCM） syndrome scores before and after treatment. Clinical efficacy was evaluated based on TCM syndrome scores and overall disease outcomes. Adverse reactions and endpoint events were recorded. ResultsIn the treatment group after treatment， 24 h-UTP， ET-1， and VEGF levels significantly decreased （P＜0.05）， Alb and NO levels significantly increased （P＜0.05）； while the TCM syndrome scores for edema， lumbar pain， numbness of limbs， dark purple lips， dark purple tongue or purpura， and thin， rough pulse all significantly decreased （P＜0.05）. In the control group， no significant changes were observed in any of the indicators after treatment （P＞0.05）.Compared with the control group， the treatment group showed significant reductions in 24 h-UTP， ET-1， and VEGF levels， and increases in Alb and NO levels （P＜0.05）. The TCM syndrome scores for edema， lumbar pain， dark purple tongue or purpura， and thin， rough pulse were all lower in the treatment group than in the control group （P＜0.05）. The total effective rate of TCM syndrome in the treatment group was 59.09% （26/44）， and the overall clinical effective rate was 45.45% （20/44）. In the control group， these rates were 15.22% （7/46） and 8.7% （4/46）， respectively， with the treatment group showing significantly better outcomes （P＜0.05）. A total of 7 adverse events occurred across both groups， with no significant difference （P＞0.05）. No endpoint events occurred during the study. ConclusionOn the basis of conventional treatment of Western medicine， HTF can further reduce urinary protein levels and improve clinical symptoms in patients with mid-stage diabetic kidney disease of blood stasis syndrome. The mechanism may be related to its effects on endothelial function.

Objectives: This study evaluates the efficacy of a new temporomandibular joint (TMJ) capsule suspension technique for stabilizing the TMJ after free fibular flap reconstruction of the mandibular condyle. Patients and Methods: Patients undergoing the TMJ capsule suspension technique during free fibular flap reconstruction after mandibulectomy with condylectomy (study group; n=9) were compared with a control group (n=9). Mandibular movement trajectory and surface electromyographic signals of bilateral masseters were recorded. The neocondyle–disc relationship was examined with magnetic resonance imaging (MRI) at 6 months after surgery. Results: Maximal mouth opening and bilateral marginal movement distances were comparable between the two groups (P>0.05). The asymmetry index of the condyle path length was significantly higher in controls (P=0.02). Bilateral mouth opening trajectories were symmetric in 7 patients and deviated to the affected side in 2 patients in the study group; they deviated to the affected side in all controls. The mean electromyographic values of the masseter on the affected side in resting, maximum bite, and chewing states were comparable between the two groups (P=0.13, P=0.65, and P=0.82, respectively). On MRI at 6 months, the thicknesses of the anterior, medial, and posterior bands and TMJ disc length were similar on the affected and normal sides in the study group (P=0.57, P=0.13, P=0.48, and P=0.87, respectively). Conclusion The proposed TMJ capsule suspension technique could improve postoperative TMJ structure and function after fibular free flap reconstruction following mandibulectomy with condylectomy.

Objectives: This study evaluates the efficacy of a new temporomandibular joint (TMJ) capsule suspension technique for stabilizing the TMJ after free fibular flap reconstruction of the mandibular condyle. Patients and Methods: Patients undergoing the TMJ capsule suspension technique during free fibular flap reconstruction after mandibulectomy with condylectomy (study group; n=9) were compared with a control group (n=9). Mandibular movement trajectory and surface electromyographic signals of bilateral masseters were recorded. The neocondyle–disc relationship was examined with magnetic resonance imaging (MRI) at 6 months after surgery. Results: Maximal mouth opening and bilateral marginal movement distances were comparable between the two groups (P>0.05). The asymmetry index of the condyle path length was significantly higher in controls (P=0.02). Bilateral mouth opening trajectories were symmetric in 7 patients and deviated to the affected side in 2 patients in the study group; they deviated to the affected side in all controls. The mean electromyographic values of the masseter on the affected side in resting, maximum bite, and chewing states were comparable between the two groups (P=0.13, P=0.65, and P=0.82, respectively). On MRI at 6 months, the thicknesses of the anterior, medial, and posterior bands and TMJ disc length were similar on the affected and normal sides in the study group (P=0.57, P=0.13, P=0.48, and P=0.87, respectively). Conclusion The proposed TMJ capsule suspension technique could improve postoperative TMJ structure and function after fibular free flap reconstruction following mandibulectomy with condylectomy.

Objectives: This study evaluates the efficacy of a new temporomandibular joint (TMJ) capsule suspension technique for stabilizing the TMJ after free fibular flap reconstruction of the mandibular condyle. Patients and Methods: Patients undergoing the TMJ capsule suspension technique during free fibular flap reconstruction after mandibulectomy with condylectomy (study group; n=9) were compared with a control group (n=9). Mandibular movement trajectory and surface electromyographic signals of bilateral masseters were recorded. The neocondyle–disc relationship was examined with magnetic resonance imaging (MRI) at 6 months after surgery. Results: Maximal mouth opening and bilateral marginal movement distances were comparable between the two groups (P>0.05). The asymmetry index of the condyle path length was significantly higher in controls (P=0.02). Bilateral mouth opening trajectories were symmetric in 7 patients and deviated to the affected side in 2 patients in the study group; they deviated to the affected side in all controls. The mean electromyographic values of the masseter on the affected side in resting, maximum bite, and chewing states were comparable between the two groups (P=0.13, P=0.65, and P=0.82, respectively). On MRI at 6 months, the thicknesses of the anterior, medial, and posterior bands and TMJ disc length were similar on the affected and normal sides in the study group (P=0.57, P=0.13, P=0.48, and P=0.87, respectively). Conclusion The proposed TMJ capsule suspension technique could improve postoperative TMJ structure and function after fibular free flap reconstruction following mandibulectomy with condylectomy.

Objective:To investigate the expression of chondroitin sulfate proteoglycan 4 pseudogene 12(CSPG4P12)in the small cell lung cancer(SCLC)tissue,its relationship with immune infiltration,and its effect on cell biological functions,and to clarify its effect in the occurrence and development of SCLC.Methods:The E-GEOD-60052 cohort was obtained by searching the ArrayExpress database for SCLC.The R language Bioconductor package was used to complete data filtering standardization,and 63 samples of SCLC tumor tissues and 7 samples of normal tissues were obtained.The Mann-Whitney U test was used to analyze the difference in CSPG4P12 expression levels between two groups.Pearson correlation analysis was used to evaluate the associations between CSPG4P12 expression levels and 47 immune checkpoint genes.The ESTIMATE algorithm and CIBERSORT algorithm were used to evaluate the correlations between CSPG4P12 expression and tumor immune cell infiltration.A case-control study was used to analyze the clinical data.A total of 230 patients with SCLC were selected as case group,and 230 healthy subjects were selected as control group.The genotyping of CSPG4P12 rs2880765,rs6496932 and rs8040855 was performed using TaqMan-MGB fluorescent probe labeling method.Odds ratio(OR)and 95％confidence interval(CI)were calculated by unconditional Logistic regression model to analyze the association between polymorphic genetic variation of CSPG4P12 gene and the risk of SCLC.The SCLC DMS114 cells were transfected with pUC-57 plasmid(control group)and CSPG4P12 over-expression plasmid(OV-CSPG4P12 group),respectively.The efficiencies of CSPG4P12 over-expression in two groups were verified by real-time fluorescence quantitative PCR(RT-qPCR)method.Cell counting kit-8(CCK-8)method was used to detect the cell proliferation activities of cells in two groups.Transwell chamber assay was used to detect the numbers of migration and invasion cells in two groups,respectively.Hoechst 33342 fluorescence staining was used to observe the cell apoptosis in two groups.Results:The ArrayExpress database E-GEOD-60052 cohort analysis showed that the expression level of CSPG4P12 mRNA in SCLC tissue was decreased compared with normal tissue(P＜0.001).The expression of CSPG4P12 had positive correlations with the immune checkpoint genes including leukocyte associated immunoglobulin like receptor 1(LAIR1)(r=0.47,P＜0.001),tumor necrosis factor(TNF)receptor superfamily member 9(TNFRSF9)(r=0.38,P＜0.01),and TNF superfamily member 9(TNFSF9)(r=0.44,P＜0.001).The ESTIMATE algorithm results showed that the matrix score,immune score and ESTIMATE composite score of the patients in CSPG4P12 low expression group were lower than those in CSPG4P12 high expression group(P＜0.01).The CIBERSORT algorithm results showed that compared with CSPG4P12 high expression group,the infiltration of M0 macrophages in CSPG4P12 low expression group was increased(P＜0.05)and the infiltration of mast cells resting was decreased(P＜0.05).The CSPG4P12 expression level had positive correlations with infiltration of mast cells resting(r=0.35,P=0.03)and mononuclear cell infiltration(r=0.34,P=0.034).In case-control studies,compared with AA genotype,CSPG4P12 rs2880765 AT and TT genotype carriers had a higher risk of SCLC(OR=1.68,95％CI=1.15-2.45,P＜0.01).The stratified analysis showed that genetic variation of rs2880765 A＞T increased the risk of SCLC in the male,younger age group(≤60 years)and smoking subgroups(males:OR=1.86,95％CI=1.18-2.93,P＜0.01;≤60 years:OR=1.73,95％CI=1.11-2.68,P＜0.01;smoking:OR=2.76,95％CI=1.49-5.13,P=0.001).The cell biology experiment showed that compared with control group,the proliferation abilities of the cells in OV-CSPG4P12 group were significantly decreased at 48 and 72 h(P＜0.01),while the number of migration cells at 24 h was significantly decreased(P＜0.01),the number of apoptotic cells at 24 h was increased(P＜0.05)and the number of invasion cells at 48 h was significantly decreased(P＜0.01).Conclusion:CSPG4P12 is lowly expressed in SCLC tumor tissue,which is associated with immune infiltration.The genetic variation of CSPG4P12 rs2880765 A＞T can increase the risk of SCLC,and its over-expression can inhibit cell proliferation,migration and invasion,and promote apoptosis.

In February 2024,the European Society of Cardiology(ESC)Working Group on Aortic and Peripheral Vascular Diseases,in collaboration with the European Society for Vascular Medicine(ESVM)and the European Society for Vascular Surgery(ESVS),published the Consensus on Exercise Therapy for Chronic Symptomatic Peripheral Artery Disease.This document provides evidence-based recommendations for estab-lishing comprehensive exercise programs,offering optimal therapeutic strategies for symptomatic chronic pe-ripheral artery disease(PAD)patients.Specifically,it proposes different exercise training regimens.This re-view interprets the consensus core components to inform evidence-based exercise therapy recommendations for PAD management in China.

Follicular Helper T Cells(TFH)are a specialized subset of CD4+T cells that predominantly lo-calize within lymphoid follicles.These cells play a crucial role in facilitating B cell proliferation,differentia-tion,and antibody production,thereby thereby serving as a pivotal component of the adaptive immune re-sponse against infections.Given the significant function of TFH cells in regulating humoral immunity,they have become a focal point in the research of infectious diseases and related vaccine development in recent years.This review summarizes the surface markers of T follicular helper(Tfh)cells,their differentiation reg-ulatory mechanisms,and the latest research progress of Tfh cells in SARS-CoV-2 infection and vaccine stud-ies.It aims to provide new theoretical foundations and research insights for optimizing the design of SARS-CoV-2 vaccines and enhancing the cross-protection ability against SARS-CoV-2 variants.

Background The mental health problems of employees in administrative organs and public institutions are highly valued.However,there is a lack of understanding regarding the mental health status of employees in provincial and municipal administrative organs and public institutions in Qinghai region.Objective To analyze the anxiety and depression of employees in provincial and municipal administrative organs and public institutions in Qinghai region,so as to provide references for promoting their mental health and intervening in psychological problems.Methods From October 23 to 28,2022,a total of 3 096 employees in provincial and municipal administrative organs and public institutions in Qinghai region were enrolled using stratified cluster sampling technique,and were assessed using Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS).Results A total of 1797(58.04％)employees in municipal and above administrative organs and public institutions in Qinghai region completed a valid questionnaire survey.Depressive symptoms were noted in 579(32.22％).SDS scores yielded statistical difference among the selected employees of different ethnicities,types of job positions and educational levels(F=9.074,101.488,4.477,P<0.01),and the severity of depressive symptoms also demonstrated statistical difference among the selected employees with different ethnicities,educational levels and types of job positions(H=49.196,17.028,160.848,P<0.01).Anxiety symptoms were detected in 711(39.57％)employees.SAS scores exhibited statistical difference among the employees with different genders,ages,ethnicities,educational levels,marital status and types of job positions(t=-4.571,F=6.648,3.950,5.243,12.008,22.253,P<0.01).Statistical differences were also illustrated in the severity of anxiety symptoms among the selected employees with different ages,genders,ethnicities,educational levels,marital status and types of job positions(H=24.361,-3.788,28.365,24.268,25.976,56.204,P<0.01).Conclusion About one-third of employees in municipal and above administrative organs and public institutions in Qinghai region may have symptoms of depression and anxiety.The depression symptoms are more severe among Tibetan people,those with low education levels and ordinary civil servants.The anxiety symptoms are more severe among employees aged 30 and below,those with low education levels,unmarried and those in technical positions.

In order to realize the diagnosis of slit lamp in cross-regional patients and improve the real-time and convenience of diagnosis,a remote slit lamp diagnosis platform based on Internet of Things(IoT)technology is designed.Firstly,the feasibility of remote slit lamp is analyzed.Secondly,the IoT platform architecture of doctor/server/facility(D/S/F)is proposed and a remote slit lamp is designed.Finally,the performance of the remote slit lamp diagnostic platform is tested.The platform solves the communication problem of distributed slit lamps and realizes respectively numerical control of multi-area slit lamp by multi-eye experts.The test results show that the remote control delay of the platform is less than 20 ms,which supports multiple experts to diagnose multiple patients separately.

Objective To explore the effect of ozone water acupoint injection combined intra-articular irrigation on pain and related factors in the patients with knee osteoarthritis(KOA).Methods Sixty-four eld-erly patients with KOA in the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from June to December 2023 were selected as the study subjects and divided into the observation group and control group by adopting the random number table method,32 cases in each group.The control group adopt-ed the ozone water acupoint injection,and the observation group was combined with ozone water intra-articu-lar irrigation on the basis of the control group.The both groups were treated once a week for 4 consecutive weeks.The Visual Analogue Scale(VAS)score,Lysholm knee function score,clinical effect and the levels of joint fluid PGE2,IL-1β and IL-6 before and after treatment were compared between the two groups.Results The VAS score,Lysholm knee function score and the levels of PGE2,IL-1β and IL-6 levels after treatment in the two groups were significantly improved compared with before treatment(P＜0.05),moreo-ver the improvement in the observation group was more significant than that in the control group(P＜0.05).The multiple linear regression analysis showed that the VAS score before treatment was related with the PGE2 level(P＜0.05)and had no relation with the age and level of IL-6 and IL-1β(P＜0.05).The total ex-cellence and good rate in the observation group was significantly higher than that in the control group(P＜0.05).The no adverse reactions such as fainting during acupuncture treatment,skin infection at injection site,symptom increase and joint discomfort appeared during the treatment process.Conclusion The ozone water acupoint injection combined intra-articular irrigation in treating KOA has better effect,which may improve the pain symptom by regulating the induced pain factors and inflammatory factors levels.