Atherosclerosis （AS） is the main pathological basis of cardiovascular diseases and seriously threatens human quality of life. Its prevention and treatment urgently need breakthroughs. The inflammatory response， which runs through the physiological and pathological evolution process of AS， is one of the important mechanisms for AS occurrence. Currently， the treatment methods for AS in Western medicine are relatively mature. However， they have adverse reactions such as abnormal liver and kidney function， drug tolerance， target vessel restenosis， and stent thrombosis， which remain the key bottleneck restricting clinical efficacy. Traditional Chinese medicine （TCM）， characterized by multiple components， multiple targets， and multi-pathway synergy， shows unique clinical application potential and efficacy advantages in the intervention of AS. This article reviewed the research progress of TCM in intervening in AS by regulating inflammatory-related signaling pathways， such as nuclear factor-κB （NF-κB）， Toll-like receptors （TLRs）， mitogen-activated protein kinase （MAPK）， and Janus kinase/signal transducer and activator of transcription （JAK/STAT）， in the past five years. It summarized the combined mechanism of action of TCM monomers， TCM pairs， and compound preparations in inhibiting the inflammatory cascade reaction through multiple targets， regulating lipid metabolism disorders， and improving vascular endothelial dysfunction and the imbalance of the microenvironment. It deepened the research on the molecular mechanism of TCM in anti-AS， so as to provide a scientific basis for the clinical transformation application and related theoretical research of TCM in anti-AS.

Atherosclerosis （AS） is the main pathological basis of cardiovascular diseases and seriously threatens human quality of life. Its prevention and treatment urgently need breakthroughs. The inflammatory response， which runs through the physiological and pathological evolution process of AS， is one of the important mechanisms for AS occurrence. Currently， the treatment methods for AS in Western medicine are relatively mature. However， they have adverse reactions such as abnormal liver and kidney function， drug tolerance， target vessel restenosis， and stent thrombosis， which remain the key bottleneck restricting clinical efficacy. Traditional Chinese medicine （TCM）， characterized by multiple components， multiple targets， and multi-pathway synergy， shows unique clinical application potential and efficacy advantages in the intervention of AS. This article reviewed the research progress of TCM in intervening in AS by regulating inflammatory-related signaling pathways， such as nuclear factor-κB （NF-κB）， Toll-like receptors （TLRs）， mitogen-activated protein kinase （MAPK）， and Janus kinase/signal transducer and activator of transcription （JAK/STAT）， in the past five years. It summarized the combined mechanism of action of TCM monomers， TCM pairs， and compound preparations in inhibiting the inflammatory cascade reaction through multiple targets， regulating lipid metabolism disorders， and improving vascular endothelial dysfunction and the imbalance of the microenvironment. It deepened the research on the molecular mechanism of TCM in anti-AS， so as to provide a scientific basis for the clinical transformation application and related theoretical research of TCM in anti-AS.

The surgical management of gastroesophageal reflux disease (GERD) has completed a paradigm shift from symptomatic palliation to curative intervention. For high-risk patients with pathological acid exposure (AET>6%), progressive anatomical destruction (e.g., ≥2 cm hiatal hernia or Hill grade III/IV lesions), or those requiring interruption of carcinogenic progression (such as Barrett's esophagus with dysplasia), anti-reflux surgery provides superior long-term efficacy compared to pharmacotherapy. Surgical indications require a three-dimensional assessment integrating anatomical, functional, and risk factors: patients with dominant anatomical defects are recommended to undergo combined hernia repair and fundoplication (biological mesh reinforcement for recurrent hernias reduces recurrence rates to 16.7%); functionally decompensated groups require decision-making based on objective reflux metrics (e. g.,>75 reflux events/24 hours); special populations such as post-bariatric GERD should preferentially undergo Roux-en-Y gastric bypass (reflux control rate: 93%), while those with motility disorders (e. g., scleroderma) are suitable for partial fundoplication to mitigate dysphagia risk (OR=0.285). Precision decision-making is achieved through a stepwise evaluation pathway (endoscopy→pH-impedance monitoring→high-resolution manometry). Intraoperative strategies are individualized based on motility status: patients with normal esophageal motility undergo the Nissen procedure, the elderly or those with ineffective esophageal motility are prioritized for Toupet fundoplication for optimized long-term safety, and magnetic sphincter augmentationenables 96% of PPI-responsive but medication-averse patients to discontinue drug dependency. The core value of surgical intervention lies in simultaneously achieving anatomical restoration and functional reconstruction, along with blocking Barrett's esophageal carcinogenesis (OR=0.41). This dual mechanism signifies a fundamental transformation in GERD management strategy.

Objective To compare the hemodynamic effects of anesthesia induction with remimazolam tosylate and etomidate in elderly frail patients.Methods This study was a single-center,prospective,randomized,single-blind trial.From January to April 2024,96 elderly frail patients undergoing elective surgery in Fuyang People's Hospital were recruited.After excluding 6 cases(3 refused to participate,1 had tracheal intubation time＞30 s,and 2 had missing data),90 patients were finally included.They were randomly divided into remimazolam tosylate group(intravenous injection of 0.2 mg/kg remimazolam tosylate for anesthesia induction,n=45)and etomidate group(intravenous injection of 0.3 mg/kg etomidate for anesthesia induction,n=45)by the random number table method.The area under the curve for mean arterial pressure(MAP)below or above baseline values(AUCMAP-and AUCMAP+),the heart rate(HR)below or above baseline values by 10％(AUCHR-and AUCHR+)within 10 minutes of anesthesia induction,the time to loss of consciousness,the time from the start of anesthesia induction to a bispectral index(BIS)＜60,the incidence of drug-related adverse reactions,the incidence of cardiovascular adverse events,and the usage of vasoactive drug administrations were compared between the two groups.Results Compared with the etomidate group,the AUCMAP-(145.10±35.75 vs.178.52±39.78)and AUCHR-[43.20(26.58,56.35)vs.54.99(43.01,65.85)]in remimazolam tosylate group were significantly reduced(P＜0.001,P=0.001).The time to loss of consciousness and the time from the start of anesthesia induction to BIS＜60 were prolonged(P＜0.001).The incidence of drug-related adverse reactions was significantly decreased(P＜0.05),and the number of norepinephrine administrations was significantly reduced(P＜0.05)in remimazolam tosylate group.However,there were no statistically significant differences in AUCMAP+,AUCHR+,the incidence of cardiovascular adverse events,and the usages of atropine,urapidil,and esmolol between the two groups(P＞0.05).Conclusion The use of remimazolam tosylate during anesthesia induction in elderly frail patients can provide more stable hemodynamic parameters and results in fewer adverse reactions than etomidate.

Oral health is closely related to facial aesthetics, mastication, pronunciation, and systemic diseases. Flexible sensors can improve current deficiencies in clinical diagnosis and treatment through oral health monitoring. This paper reviews the research on and application of flexible sensors in oral health monitoring in recent years, providing a reference for the further development of flexible sensors in the oral field. The structural basis of flexible sensors includes a flexible substrate, stretchable electrodes, and an active layer, and each part is designed through material selection to adapt to the oral environment. The sensing mechanisms of sensors involve electricity, optics, electrochemistry, and immunology, among which electro-chemical, biological, and optical sensors are particularly prominent in the oral field. The monitored signals include physical signals such as orthodontic force, bite force, respiratory humidity, and implant temperature; chemical signals such as saliva metabolites and oral gases; and biological signals such as periodontal disease and oral cancer markers. At present, flexible sensors still face many challenges in this special oral environment. Future research directions include improving the biocompatibility, moisture resistance, and flexible fitting ability of sensors in the oral cavity; using temperature-insensitive materials and protective films to improve stability; and introducing artificial receptors and sensor arrays to improve factors such as selectivity. In addition, multi-disciplinary cooperation is crucial for breaking through current bottlenecks and achieving more accurate disease diagnosis and health monitoring. In the field of stomatology, finding specific biomarkers related to corresponding oral diseases is the key to sensor health monitoring. Through these efforts, flexible sensors are expected to gain more extensive applications in the field of oral health monitoring.

Objective To investigate the efficacy of combined telephone and WeChat follow-up for patients discharged with an indwelling closed thoracic drainage tube after surgery for stage Ⅲ tuberculous empyema. Methods Patients with stage Ⅲ tuberculous empyema who were discharged with an indwelling drainage tube from the Department of Thoracic Surgery, Public Health Clinical Center of Chengdu, between November 2021 and November 2022 were enrolled in this study. They were divided into an observation group (combined telephone and WeChat follow-up) and a control group (telephone-only follow-up). The quality of life (QoL), treatment adherence, and recovery outcomes were compared between the two groups. Results A total of 81 patients were included. The observation group consisted of 49 patients (31 males, 18 females) with a mean age of (38.63±15.86) years. The control group consisted of 32 patients (27 males, 5 females) with a mean age of (36.91±17.33) years. The observation group showed significantly better postoperative QoL outcomes in the domains of physical functioning, emotional functioning, physical symptoms, global health status, and overall QoL compared to the control group (all P<0.05). Regarding treatment adherence, the observation group demonstrated superior performance in daily activity duration, use of a respiratory trainer, and adherence to coughing exercises compared to the control group (all P<0.001). The duration of chest tube indwelling was significantly shorter in the observation group (P<0.001). Furthermore, the observation group showed better recovery in albumin and hemoglobin levels (both P<0.05). Conclusion A combined telephone and WeChat follow-up approach can significantly improve the QoL and treatment adherence for patients discharged with an indwelling drainage tube. This method effectively shortens the duration of postoperative tube drainage, promotes nutritional recovery, and accelerates overall postoperative rehabilitation.

The ventral anterior (VA) nucleus of the thalamus is a major target of the basal ganglia and is closely associated with the pathogenesis of Parkinson's disease (PD). Notably, the VA receives direct innervation from the hypothalamic histaminergic system. However, its role in PD remains unknown. Here, we assessed the contribution of histamine to VA neuronal activity and PD motor deficits. Functional magnetic resonance imaging showed reduced VA activity in PD patients. Optogenetic activation of VA neurons or histaminergic afferents significantly alleviated motor deficits in 6-OHDA-induced PD rats. Furthermore, histamine excited VA neurons via H1 and H2 receptors and their coupled hyperpolarization-activated cyclic nucleotide-gated channels, inward-rectifier K⁺ channels, or Ca²⁺-activated K⁺ channels. These results demonstrate that histaminergic afferents actively compensate for Parkinsonian motor deficits by biasing VA activity. These findings suggest that targeting VA histamine receptors and downstream ion channels may be a potential therapeutic strategy for PD motor dysfunction.
Animals ; Histamine/metabolism* ; Male ; Oxidopamine/toxicity* ; Rats ; Ventral Thalamic Nuclei/physiopathology* ; Rats, Sprague-Dawley ; Disease Models, Animal ; Parkinson Disease/metabolism* ; Neurons/physiology* ; Humans ; Optogenetics

Objective:To evaluate the clinical outcomes of mandibular angle osteotomy combined with wing-shaped genioplasty for the correction of low-angle mandibular prominence with microgenia.Methods:A retrospective analysis was conducted on patients who underwent mandibular angle osteotomy and wing-shaped genioplasty at the Second Hospital of Nanjing between January 2020 and December 2022. Preoperative three-dimensional computed tomography and lateral cephalograms were obtained, and relevant parameters were measured, including the Frankfort horizontal plane to mandibular plane angle (∠FH-MP), the lower lip to soft tissue pogonion angle (∠LiaV-Pog) and the facial height index (FHI). Based on the measurements, surgical experience, and patient preference, the osteotomy lines for the mandibular angle and the wing-shaped genioplasty were designed. During the procedure, mandibular angle osteotomy and wing-shaped genioplasty were performed in accordance with the preoperative surgical plan. The distal genial segment was advanced and inferiorly repositioned according to the predetermined measurements and rigidly fixed to the bilateral mental tubercles using titanium plates and screws. The bone segments resected from the mandibular angle were then longitudinally split into either single- or double-layer bone grafts. These grafts were meticulously implanted into the interpositional gap at the genial region to optimize chin projection and refine the lower facial contour. Postoperative monitoring included assessments of wound healing, complications and lower facial contour. At the final follow-up, lateral cephalograms were taken for remeasurement, and patient satisfaction was surveyed. Statistical analysis was performed using SPSS 22.0 software. Pre- and postoperative data for ∠FH-MP, ∠LiaV-Pog, and FHI were presented as Mean ± SD and compared using paired t-tests, with a P-value < 0.05 considered statistically significant. Results:Twelve female patients, aged 22-35 years (mean 28.3), were included. The follow-up period ranged from 6 to 24 months. All surgical sites achieved primary healing without early complications such as hemorrhage, hematoma, or wound infection. However, all patients experienced transient mental numbness, which resolved within 3 to 6 months. All patients achieved a smooth and natural mandibular contour. CT scans confirmed satisfactory survival of the grafted bone. All patients expressed satisfaction with the aesthetic outcomes. Postoperative measurements of ∠FH-MP, ∠LiaV-Pog, and FHI were (25.2±4.6)°, (24.0±1.2)°, and (52.0±1.3)%, respectively, which were significantly improved compared to the preoperative values of (16.8±5.9)°, (36.5±4.8)°, and (66.0±4.3)% (all P < 0.01). Conclusion:The combination of mandibular angle osteotomy and wing-shaped genioplasty is an effective and safe procedure for correcting low-angle mandibular prominence with microgenia. This technique significantly increases the mandibular plane angle, creates a natural and smooth mandibular contour, and yields stable result with high patient satisfaction.

Objective To develop the Evidence-Based Health Care Related Competence Assessment Scale for Health Professionals(hereinafter referred to as the Scale),and to test its validity and reliability.Methods Based on the JBI evidence-based health care model as the theoretical framework,the initial items of the Scale were formed by reviewing the literature.Through the discussion of the research group,two rounds of Delphi expert consultation and pre-inspection,the items of the Scale were optimized.The convenience sam-pling method was adopted to extract 928 health professionals as the research subjects.The Scale conducted the validity and reliability testing.Results The Scale included the four dimensions of evidence generation,evi-dence synthesis,evidence transfer and evidence implementation,including 47 entries in total.The cumulative variance contribution rate was 59.08%.The confirmatory factor analysis results indicated that the model had good fitness.The convergent validity of all dimensions reached the standard,and the distinguishing validity was good.Finally,the Cronbach's α coefficient of the Scale was 0.971,and the split-half reliability was 0.928.Conclusion The developed Scale possesses good reliability and validity,which can be used to evaluate the competence of health professionals carrying the evidence-based healthcare related link works.