This paper explores the immune-inflammatory regulatory mechanism of colorectal cancer cachexia and corresponding traditional Chinese medicine （TCM） intervention strategies based on the TCM theory of reinforcing healthy qi and dispelling pathogenen. It is proposed that depletion of healthy qi is the root cause of colorectal cancer cachexia， while cancer toxins exuberance is the symptomatic manifestation of the disease， and failure of the spleen and stomach is the core pathogenesis. In terms of treatment， a TCM treatment system is constructed based on the principles of reinforcing healthy qi to consolidate the foundation and regulate immunity， and dispelling pathogen to remove toxins and alleviate inflammation. The system clarifies the healty qi-reinforcing method as fortifying spleen and boosting qi to enhance immune function， and nourishing blood and enriching yin to consolidate yin essence and healthy qi. It also emphasizes the pathogen-dispelling method as clearing heat and removing toxins to regulate the secretion of inflammatory cytokines， and promoting blood circulation and resolving stasis to improve the immune microenvironment and microcirculation. This therapeutic approach may provide valuable insights for TCM interventions in colo-rectal cancer cachexia.

Based on the theory of "spleen functions as wei （卫） qi"， this paper discusses the mechanism of "inflammation-metabolism-immunity" regulation in colorectal cancer cachexia and the therapeutic strategy. It is proposed that spleen deficiency with failure in transportation， leading to the maldistribution of wei （卫） qi and pathogenic constraint transforming into fire， is the source of inflammation. Spleen deficiency with failure in transportation， leading to the maldistribution of subtle essences and loss of nourishment to the physical body， is the root of metabolic depletion. Spleen deficiency with failure in transportation， leading to wei qi depletion and healthy qi decline， is the cause of immune impairment. Accordingly， a spleen-centered strategy of fortifying the spleen and restoring its defensive function is established. The specific therapeutic approaches include fortifying the spleen and boosting qi， restoring defensive function and securing the exterior to replenish the source of wei qi， with modified Sijunzi Decoction （四君子汤）， fortifying the spleen and removing toxin， resolving phlegm and stasis to restrain exuberant internal toxin and constrained fire， with modified Baitouweng Decoction （白头翁汤）， activating the spleen and harmonizing the stomach， promoting the transportation and distribution of food essence to correct nutritional and metabolic disorders， with modified Xiangsha Liujunzi Decoction （香砂六君子汤）， and fortifying the spleen and nourishing the kidney， replenishing primordial qi and consolidating the root to restore immune competence， with Buzhong Yiqi Decoction （补中益气汤） and Zuogui Beverage （左归饮） as the basic prescription.

Based on the theory of "spleen functions as wei （卫） qi"， this paper discusses the mechanism of "inflammation-metabolism-immunity" regulation in colorectal cancer cachexia and the therapeutic strategy. It is proposed that spleen deficiency with failure in transportation， leading to the maldistribution of wei （卫） qi and pathogenic constraint transforming into fire， is the source of inflammation. Spleen deficiency with failure in transportation， leading to the maldistribution of subtle essences and loss of nourishment to the physical body， is the root of metabolic depletion. Spleen deficiency with failure in transportation， leading to wei qi depletion and healthy qi decline， is the cause of immune impairment. Accordingly， a spleen-centered strategy of fortifying the spleen and restoring its defensive function is established. The specific therapeutic approaches include fortifying the spleen and boosting qi， restoring defensive function and securing the exterior to replenish the source of wei qi， with modified Sijunzi Decoction （四君子汤）， fortifying the spleen and removing toxin， resolving phlegm and stasis to restrain exuberant internal toxin and constrained fire， with modified Baitouweng Decoction （白头翁汤）， activating the spleen and harmonizing the stomach， promoting the transportation and distribution of food essence to correct nutritional and metabolic disorders， with modified Xiangsha Liujunzi Decoction （香砂六君子汤）， and fortifying the spleen and nourishing the kidney， replenishing primordial qi and consolidating the root to restore immune competence， with Buzhong Yiqi Decoction （补中益气汤） and Zuogui Beverage （左归饮） as the basic prescription.

Objective To compare the efficacy of stenting in the treatment of idiopathic intracranial hypertension(IIH)complicated by different types of venous sinus stenosis(VSS).Methods The clinical data of 48 patients with IIH complicated by VSS,who received stenting therapy at the First Affiliated Hospital of Zhengzhou University of China from January 2019 to September 2023,were retrospectively analyzed.According to the type of VSS,the patients were divided into intrinsic stenosis group(n=20)and the extrinsic stenosis group(n=28).The improvement of symptoms,Frisén grade of papilledema,lumbar puncture opening pressure(LPOP),trans-stenosis pressure gradient(△P)of VSS,and surgery-related complications were compared between the two groups.Results The mean age of the patients in the intrinsic stenosis group was greater than that of the patients in the extrinsic stenosis group(41.60 years vs.35.25 years,P=0.049).The length of the narrowed segment in the extrinsic stenosis group was 22.5 mm,which was significantly longer than 19.0 mm in the intrinsic stenosis group(P=0.007).The postoperative Frisén grade of papilledema in the extrinsic stenosis group was obviously lower than that in the intrinsic stenosis group(P=0.037).No statistically significant differences in the other clinical data existed between the two groups(all P＞0.05).After stenting,all of the median △P,mean LPOP,and median Frisén grade of papilledema were decreased significantly when compared with their preoperative values(all P＜0.001),and the postoperative 3-day median Frisén grade of papilledema in the extrinsic stenosis group was much lower(P=0.037).The patients were followed up for one year,the clinical symptoms of the patients in both groups were improved to varying degrees.At the time of discharge,the proportion of patients having no symptoms of papilledema in the extrinsic stenosis group was 57.1％,which was higher than 22.2％in the intrinsic stenosis group(P=0.049),and no statistically significant differences in the improvements of other symptoms existed between the two groups(all P＞0.05).There was no significant difference in the incidence of complications between the two groups(P=0.563).Conclusion Venous sinus stenting can effectively treat patients with IIH complicated by different types of VSS.

Objective To compare the clinical efficacy of medication and stenting in treating patients with idiopathic intracranial hypertension complicated by venous sinus stenosis.Methods The clinical data of 74 patients with idiopathic intracranial hypertension complicated by venous sinus stenosis,who were admitted to the First Affiliated Hospital of Zhengzhou University of China from January 2020 to June 2023,were retrospectively analyzed.The patients were divided into medication group(n=35,receiving drug therapy)and stenting group(n=39,receiving stent implantation therapy).Before and after treatment,lumbar puncture and fundus examinations were performed,and the postoperative improvements in intracranial pressure and papillary oedema were evaluated.The changes in the median papillary oedema Frisén grade and the average opening pressure of lumbar puncture were compared between the two groups during hospitalization period.The improvement degrees of the clinical symptoms determined at discharge,as well as at the 6 months and 12 months after discharge were compared between the two groups.The incidence of complications during the follow-up period in the two groups was recorded.Results The time interval from onset to treatment in the stenting group was longer than that in the medication group(2 months vs.one month,P=0.021),and the differences in the other baseline data between the two groups were not statistically significant(all P＞0.05).After treatment,different degrees of improvement were obtained in both groups(all P＞0.05).At the time of discharge,the degree of median papillary oedema in the stenting group was Frisén grade I,which was lower than Frisén grade Ⅱ in the medication group(P=0.011);the average opening pressure of lumbar puncture in the stenting group was 205.26 mm H2O,which was lower than 248.14 mm H2O in the medication group(P=0.002).The proportions of patients having no symptom or showing symptom improvement in the stenting group and in the medication group at the time of discharge were 74.4％and 45.7％respectively(P=0.017),which at the time of 6 months after discharge were 84.6％and 48.6％respectively(P=0.001)and at the time of 12 months after discharge were 87.2％and 57.1％respectively(P=0.004).No statistically significant difference in the incidence of complications existed between the two groups(10.3％and 8.6％respectively,P=1.000).Conclusion For the treatment of patients with idiopathic intracranial hypertension complicated by venous sinus stenosis,stent implantation therapy is superior to medication therapy in quickly and effectively relieving papillary oedema,decreasing lumbar puncture opening pressure,and improving their corresponding symptoms and signs,with satisfactory patient's prognosis and clinical safety.

OBJECTIVE: Several epidemiological observational studies have related particulate matter (PM) exposure to Inflammatory bowel disease (IBD), but many confounding factors make it difficult to draw causal links from observational studies. The objective of this study was to explore the causal association between PM _2.5 exposure, its absorbance, and IBD. METHODS: We assessed the association of PM _2.5 and PM _2.5 absorbance with the two primary forms of IBD (Crohn's disease [CD] and ulcerative colitis [UC]) using Mendelian randomization (MR) to explore the causal relationship. We conducted two-sample MR analyses with aggregated data from the UK Biobank genome-wide association study. Single-nucleotide polymorphisms linked with PM _2.5 concentrations or their absorbance were used as instrumental variables (IVs). We used inverse variance weighting (IVW) as the primary analytical approach and four other standard methods as supplementary analyses for quality control. RESULTS: The results of MR demonstrated that PM _2.5 had an adverse influence on UC risk (odds ratio [ OR] = 1.010; 95% confidence interval [ CI] = 1.001-1.019, P = 0.020). Meanwhile, the results of IVW showed that PM _2.5 absorbance was also causally associated with UC ( OR = 1.012; 95% CI = 1.004-1.019, P = 0.002). We observed no causal relationship between PM _2.5, PM _2.5 absorbance, and CD. The results of sensitivity analysis indicated the absence of heterogeneity or pleiotropy, ensuring the reliability of MR results. CONCLUSION Based on two-sample MR analyses, there are potential positive causal relationships between PM _2.5, PM _2.5 absorbance, and UC.
Humans ; Mendelian Randomization Analysis ; Particulate Matter/analysis* ; Polymorphism, Single Nucleotide ; Inflammatory Bowel Diseases/genetics* ; Air Pollutants/analysis* ; Crohn Disease/genetics* ; Colitis, Ulcerative/genetics* ; Genome-Wide Association Study ; Risk Factors ; Environmental Exposure

OBJECTIVE: Cancer remains a significant global health challenge, necessitating the development of effective treatment approaches. Developing synergistic therapy can provide a highly promising strategy for anti-cancer treatment through combining the benefits of various mechanisms. METHODS: In this study, we developed a synergistic strategy for chemo-photothermal therapy by constructing nanocomposites using gold nanorods (GNRs) and tetrahedral framework nucleic acids (tFNA) loaded with the anti-tumor drug doxorubicin (DOX). RESULTS: Our in vitro studies have systematically clarified the anti-cancer behaviors of tFNA-DOX@GNR nanocomposites, characterized by their enhanced cellular uptake and proficient lysosomal escape capabilities. It was found that the key role of tFNA-DOX@GNR nanocomposites in tumor ablation is primarily due to their capacity to induce cytotoxicity in tumor cells via a photothermal effect, which generates instantaneous high temperatures. This mechanism introduces various responses in tumor cells, facilitated by the thermal effect and the integrated chemotherapeutic action of DOX. These reactions include the induction of endoplasmic reticulum stress, characterized by elevated reactive oxygen species levels, the promotion of apoptotic cell death, and the suppression of tumor cell proliferation. CONCLUSION This work exhibits the potential of synergistic therapy utilizing nanocomposites for cancer treatment and offers a promising avenue for future therapeutic strategies.
Doxorubicin/chemistry* ; Gold/chemistry* ; Nanotubes/chemistry* ; Humans ; Nanocomposites/chemistry* ; Cell Line, Tumor ; Nucleic Acids/chemistry* ; Antibiotics, Antineoplastic/pharmacology* ; Antineoplastic Agents/administration & dosage*

Occlusal rehabilitation is an effective means of treating tooth wear, edentulous jaws and other oral diseases. Among them, full-mouth fixed occlusal reconstruction can effectively restore aesthetics and function, but the complexity of the clinical process, the high sensitivity of the technique, and the high incidence of various complications have always drawn much attention. With the application and development of digital technology in occlusal rehabilitation, the treatment outcome has been improved compared with traditional treatment. However, there are many kinds of digital technology with different efficacy, how to build an efficiently standardized digital clinical technical solution is a current difficulty. Therefore, combined with the long-term work of the department of prosthodontics in our hospital, in this paper, the minimum (occlusal perception of thickness) and maximum (centric relation) geometric quantities which should be paid attention to during reconstruction are put forward. We systematically organized the clinical procedure of digital full-mouth fixed occlusal rehabilitation used in our department for a long time. In conclusion, a 5-stage 19-step or n-step solution (5-19N for short) characterized by "from large to small" restorative space splitting logic is proposed. It has a certain reference value for the future use of digital technology to deal with complex occlusal rehabilitation cases.
Humans ; Dental Occlusion ; Computer-Aided Design ; Mouth, Edentulous/rehabilitation*

Objective:To investigate the differences in clinical outcomes of septic children with varying serum zinc levels,and to analyze the relationship between reduced serum zinc levels and organ dysfunction as well as 28-day mortality in septic children.Methods:This study conducted a retrospective analysis of clinical data from pediatric patients diagnosed with sepsis or septic shock in the Department of critical care medicine of the children's Hospital of Soochow University between January 2017 and December 2022.Clinical characteristics,organ dysfunction,and prognosis were compared between two groups:children with low serum zinc levels and those with normal zinc levels.Results:The serum zinc level of septic children within 24 hours of admission was 9.60(5.52,13.80)μmol/L,with 50.54%(94/186)of the children exhibiting low serum zinc levels(<10.07 μmol/L).Compared to the normal serum zinc group,the low serum zinc group had a significantly lower Pediatric Critical Illness Score(PCIS)[(78.71±9.35)vs.(85.12±8.51),P=0.005]and higher 28-day mortality(46.80%vs.14.13%,P<0.001).The low serum zinc group also had a higher proportion of invasive mechanical ventilation(64.89%vs.47.82%,P=0.019),renal replacement therapy(15.59%vs.3.26%,P=0.003),and use of vasoactive drugs(56.38%vs.30.43%,P<0.001).The rate of underlying conditions in the low serum zinc group was significantly higher than that in the normal serum zinc group(57.44%vs.36.95%,P=0.005).Additionally,the low serum zinc group had a higher incidence of disseminated intravascular coagulation(DIC),respiratory failure,acute kidney injury,shock,and multiple organ dysfunction syndrome(MODS)compared to the normal serum zinc group(P<0.05).Serum zinc levels had predictive value for 28-day mortality in septic children(AUC=0.813;95%CI:0.725～0.902;P<0.001).A serum zinc level of less than 6.950 μmol/L predicted the death of septic children with a sensitivity of 0.618 and a specificity of 0.902.Conclusion:Sepsis in children is commonly associated with low serum zinc levels,especially in those with underlying conditions such as hematologic and oncologic disorders.Sepsis patients hypozincemia with a higher incidence of DIC,respiratory failure,acute kidney injury,shock,and MODS.A serum zinc level below 6.95 μmol/L serves as a significant predictor of 28-day mortality in children with severe sepsis.

Objective To compare the efficacy of anticoagulation treatment(AT)alone and combining mechanical thrombectomy(MT)for cerebral venous sinus thrombosis(CVST).Methods Totally 150 patients with CVST were collected,including 90 underwent only AT(AT group)and 60 underwent MT+AT(combined group).The rate of venous sinus recanalization at discharge,the prognosis at discharge and 6,12 months after discharge(modified Rankin scale[mRS]score of 0 to 2 was considered as good prognosis)were compared between groups,and relative complications were recorded.Results At discharge,the rate of complete and partial recanalization of venous sinuses in combined group were both higher than that in AT group(both P＜0.001).No significant difference of the rate of good prognosis at discharge was found between groups(P=0.191),while 6 and 12 months after discharge,the rate of good prognosis in combined group were both higher than that in AT group(P=0.046,0.028).During the treatment and follow-up period,no significant difference of the incidence of complications was found between groups(5.00%[3/60]vs.11.11%[10/90],P=0.245).Conclusion Compared with AT alone,AT combining with MT could improve revascularization rate and prognosis of CVST without increasing the risk of complications.