Objective To assess the clinical efficacy of sodium hyaluronate （0.3%） eye drops combined with herbal self-heating steam eye mask in the treatment of dry eye disease. Methods A prospective randomized controlled clinical trial was performed on 60 patients diagnosed with dry eye at the ophthalmic clinic of a Grade A, Class Ⅲ hospital in Shanghai from June 2023 to September 2024. Specifically, patients were randomly divided into control group and study group. Patients in the control group were treated with sodium hyaluronate （0.3%） eye drops for six weeks; while in the study group, patients received the eye drops combined with the herbal self-heating steam eye mask mainly containing powders of Flos Buddlejae. Subsequently, comparisons and analysis were performed before and after treatment between the two groups in the clinical symptom questionnaire score traditional Chinese medicine （TCM syndrome score），the Chinese dry eye questionnaire score and determination of tear film fluorscein breakup time （FBUT）, and curative effect. Results The quality control standard of the herbal powder in the self-heating steam eye mask was established through TLC and HPLC, and good heating behavior of the herbal self-heating steam eye mask was ascertained heating temperature （43±5）℃; heating duration （≥20 min）, meeting requirements of the product quality control. After treatment for 6 weeks, FBUT was increased, while TCM syndrome score and the Chinese dry eye questionnaire score were both decreased in the study group （P<0.001）. Besides, compared with the control group, TCM syndrome score and the Chinese dry eye questionnaire score were much lower, while the FBUT were higher in the study group （P<0.001）. Moreover, the overall response rate in the study group （81.7%） was much better than that in the control group （25.9%）. Conclusion The combination of sodium hyaluronate （0.3%） eye drops with herbal self-heating steam eye mask could be applied to the clinical treatment of dry eye disease due to its good clinical effects on relieving dry eye symptoms.

ObjectiveTo establish a mouse model of particulate matter 2.5 （PM_2.5）-induced dry eye and investigate whether Chufeng Yisuntang can ameliorate the PM_2.5-induced ocular surface damage by regulating the reactive oxygen species （ROS）/p38 mitogen-activated protein kinase （p38 MAPK） signaling pathway. MethodsSixty 8-week-old male C57BL/6J mice were used. Ten were randomly selected as the control group. The remaining 50 mice received topical instillation of 1 drop （0.1 mL） of 5 g·L^-1 PM_2.5 suspension in both eyes， four times daily. Successfully modeled mice were randomized into four groups （n=10）： Model， p38 MAPK inhibitor， Chufeng Yisuntang， and combination （Chufeng Yisuntang at 7.3 g·kg^-1 + p38 MAPK inhibitor SB203580 at 5 mg·kg^-1）. Chufeng Yisuntang was administered via gavage， and the inhibitor group via intraperitoneal injection. The control and model groups received equal volumes of distilled water by gavage. All treatments lasted for 4 weeks. General conditions were dynamically observed. Tear secretion， tear film break-up time， and corneal fluorescein staining were assessed. After intervention for 4 weeks， hematoxylin and eosin （HE） staining was used to examine the histopathological changes. Enzyme-linked immunosorbent assay （ELISA） was adopted to measure serum levels of ROS， malondialdehyde （MDA）， superoxide dismutase （SOD） 1， and SOD2. Western blot and Real-time PCR were employed to determine the protein and gene levels， respectively， of p38 MAPK， B-cell lymphoma-2 （Bcl-2）， Bcl-2-associated X protein （Bax）， and cysteinyl aspartate-specific proteinase-3 （Caspase-3） in the corneal tissue. ResultsCompared with the control group， the model group exhibited reduced tear secretion volume and tear film breakup time， along with increased corneal fluorescein staining scores （P<0.01）. Compared with the model group， the Chufeng Yisuntang group， p38 MAPK inhibitor group， and combination group demonstrated increased tear secretion volume and tear film breakup time， along with decreased corneal fluorescein staining scores （P<0.01）. HE staining revealed that compared with the control group， the model group exhibited marked increases in corneal epithelial cell layers and epithelial thickness， along with reduced meibomian gland acini and intensely stained， densely packed nuclei around the acini. Compared with the model group， the Chufeng Yisuntang group， p38 MAPK inhibitor group， and combination group showed intact corneal structure， improved cell morphology， and reduced damage severity. ELISA revealed elevated ROS and MDA levels （P<0.01） and decreased SOD1 and SOD2 levels （P<0.01） in the model group compared with the control group. Compared with the model group， Chufeng Yisuntang， p38 MAPK inhibitor， and the combination lowered ROS and MDA levels （P<0.01）， while raising SOD1 and SOD2 levels （P<0.05， P<0.01）. Western blot revealed that compared with the control group， the model group exhibited increased protein levels of p38 MAPK， Bax， and Caspase-3 （P<0.01） and reduced protein level of Bcl-2 （P<0.01）. Compared with the model group， Chufeng Yisuntang， p38 MAPK inhibitor， and the combination down-regulated the protein levels of p38 MAPK， Bax， and Caspase-3 （P<0.01）， while up-regulating the protein level of Bcl-2 （P<0.01）. Compared with the Chufeng Yisuntang group， the combination group exhibited decreased protein levels of p38 MAPK， Bax， and Caspase-3 （P<0.01） and increased protein level of Bcl-2 （P<0.01）. Real-time PCR revealed that compared with the control group， the model group exhibited upregulated mRNA levels of p38 MAPK， Bax， and Caspase-3 （P<0.01）， and downregulated mRNA level of Bcl-2 （P<0.01）. Compared with the model group， Chufeng Yisuntang， p38 MAPK inhibitor， and the combination down-regulated the mRNA levels of p38 MAPK， Bax， and Caspase-3 （P<0.01）， while up-regulating the mRNA level of Bcl-2 （P<0.05， P<0.01）. Compared with the Chufeng Yisuntang group， the combination group exhibited decreased mRNA levels of p38 MAPK， Bax， and Caspase-3 expression （P<0.05， P<0.01） and increased mRNA level of Bcl-2 （P<0.01）. ConclusionChufeng Yisuntang may partially protect against PM_2.5-induced corneal injury by inhibiting the ROS/p38 MAPK pathway， enhancing antioxidant defense， and reducing epithelial apoptosis.

With the continuous deepening of the concept of precision diagnosis and treatment for lung cancer, how to achieve higher efficiency and accuracy in the screening, diagnosis, and treatment pathways in clinical practice has become an important issue that urgently needs to be overcome. The current clinical difficulty lies in the fact that despite continuous advancements in imaging and molecular diagnostic technologies, there are still limitations in manual efficiency and subjective experience when it comes to massive data analysis and multi-scale feature extraction. Artificial intelligence (AI), especially algorithm systems based on deep learning, is an innovative technology capable of deeply empowering medical big data. This method utilizes algorithms such as convolutional neural networks, combined with radiomics, pathomics, and multi-modal data fusion analysis, demonstrating immense potential in early precise detection and benign-malignant differentiation of pulmonary nodules, digital pathological subtype recognition and non-invasive prediction of driver genes, precise 3D surgical planning and automatic delineation of radiotherapy target volumes, as well as dynamic risk warning during follow-up. This innovative technology provides a brand-new solution for realizing intelligent and individualized lung cancer diagnosis and treatment models. This consensus, based on the latest evidence from evidence-based medicine and combined with the development trends in the AI field and real-world clinical needs, was ultimately formed by gathering the consensus opinions of multidisciplinary experts in radiology, pathology, thoracic surgery, and other fields. The main content covers the application specifications of AI in the three core scenarios of lung cancer screening, diagnosis, and treatment, the technical standards for data collection and algorithm validation, as well as the ethical and regulatory challenges faced at the current stage. It aims to clarify the applicable boundaries of AI as a clinical auxiliary decision support tool, providing scientific guidance and standardized exploration directions for peers currently engaged in or planning to carry out AI-assisted clinical diagnosis, treatment, and translation of lung cancer.

Objective To explore the correlation between the location of adult peptic ulcers and Helicobacter pylori(Hp)infection and antibody typing,as well as its clinical significance.Methods A retrospective analysis was conducted on the serum Hp antibody typing results of adult patients 850 cases with peptic ulcers at Xuzhou Central Hospital from 2017 to 2024.According to the location of ulcers:duodenal ulcer group(DU group,n=429),gastric ulcer group(GU group,n=291)and ulcerative colitis group(UC group,n=130)were divided into three groups,and the relationship between ulcer location and Hp immunophenotyping was analyzed.The test results of 232 adult health examinees were used as the control group.Results The overall Hp infection rate in peptic ulcers patients was 79.76%(678/850),mainly with high virulence type I,with an rate of 62.71%(533/850),and type II was 17.06%(145/850).The Hp infection rates in the DU group,GU group,UC group and control groups were 86.48%(371/429),79.04%(230/291),59.23%(77/130)and 56.47%(131/232)respectively.The infection rates of type I were 72.96%,57.73%,40.00%and 47.41%,respectively.The infection rates of type II were 13.52%,21.31%,19.23%and 9.05%,respectively.The total infection rate,type I infection rate and type II infection rate of Hp were compared among the DU group,GU group,UC group and control group,and the differences were all statistically significant(χ2=91.838,67.169,17.647,all P<0.05).Compared with the UC group,the overall infection rate and type I infection rate of Hp in the DU group were the highest,followed by the GU group,and the differences were statistically significant(χ2=11.324～47.800,all P<0.05).However,the overall infection rate and the infection rate of type I were compared between the UC group and the control group,and the differences were not statistically significant(χ2=0.261,1.852,all P>0.05).The infection rate of type Ⅱ in GU group and UC group was significantly higher than that in controls groups,and the differences were statistically significant(χ2=14.518,7.782,all P<0.05).In addition,the positive rate of dual antibodies against CagA+VacA in the four groups was significantly higher than that of single antibody against CagA,VacA,and the differences were statistically significant(χ2=7.538～407.569,all P<0.05).Conclusion Adult patients with peptic ulcers are mainly infected with Hp type I strains,and the infection rate of type I strains is the highest in the DU group,followed by GU,while the infection rate of type I strains in UC is the lowest.UC is closely related to type II strain infection,and the infection rate is similar to that of GU patients.

OBJECTIVE To investigate the current status of cleaning and disinfection of digestive endoscopes in vari-ous grades of hospitals of Hubei Province so as to improve the quality of cleaning and disinfection of the digestive endoscopes.METHODS A survey was conducted by the hospital infection management department of Tongji Hos-pital Affiliated to Tongji Medical College,Huazhong University of Science and Technology from Mar.25,2024 to Mar.29,2024.A questionnaire was formulated by brainstorming and literature review.The electronic question-naire was distributed through the"Wenjuanxing"platform.The questionnaire survey aimed to investigate the per-sonnel,training,equipment and facilities,cleaning and disinfection operations,monitoring and recording of the digestive endoscopy centers of the medical institutions in the province.RESULTS Totally 185 medical institutions were finally included,113 of which were tertiary hospitals,and 72 were secondary and lower-grade hospitals.The tertiary hospitals were superior to the secondary and lower-grade hospitals in the quantity of endoscopes,daily di-agnosis and treatment volume of patients,participation in external training(including continuous training,further education,hospital-level training),provision of some facilities and equipment(ultrasonic cleaners,full pipeline perfusion devices,cleaning brushes,high-pressure water guns,transport containers),some cleaning and disinfec-tion operations(changing the cleaning enzyme solution one time for one endoscope,disinfecting the cleaning brush one time after one-time use),implementation of surveillance of cleaning quality and preservation of surveil-lance records(P＜0.05).However,the tertiary hospital were inferior to the secondary and lower-grade hospitals in standardized use of transferring containers(65.49％)and drying time of air guns(57.52％)(P＜0.05).CONCLUSIONS The quality of cleaning and disinfection of the digestive endoscopes remains large room to be im-proved in the medical institutions of Hubei Province.It is necessary for the medical institutions to strengthen the supervision and training of personnel based on the their actual condition,complete the provision of facilities and e-quipment,standardize the cleaning and disinfection operations,and complete the surveillance and recordings.

Objective To investigate the clinical efficacy of national famous traditional Chinese medicine doctor prof.Wang Tan's application of Yang-assisting Lung Repairing and Paralysis Removing Soup combined with pulmonary rehabilitation on patients with idiopathic pulmonary fibrosis.Method A total of 79 patients with pulmonary arthralgia who met the inclusion criteria and visited the inpatient Department of Pulmonary Disease in the Affiliated Hospital of Changchun University of Traditional Chinese Medicine and Professor Wang Tan's Changjiang Scholar Studio from January 2024 to November 2024 were retrospectively analyzed.There were 30 cases in control group and 49 cases in treatment group.Among them,the control group received routine treatment and was given Zhuyang Bufei Chubi decoction and the observation group was added lung rehabilitation treatment on this basis(walking,dumbbell exercises,climbing stairs,resistance bands,breathing trainers,sandbags,abdominal breathing exercises),the course of treatment was 1 month.Compare the recovery of lung function,six-minute walking test(6MWT),C-reactive protein(CRP),quality of life assessment,and overall therapeutic efficacy of the two groups of patients before and after treatment.Result After treatment,the pulmonary function index,exercise endurance,total therapeutic effect,inflammatory response and quality of life of the two groups were analyzed,and the curative effect of the treatment group was better than that of the control group(P<0.05).Conclusion The treatment of idiopathic pulmonary fibrosis patients with Zhuyang Bufei Chubi decoction combined with pulmonary rehabilitation helps patients with various indexes to improve their lung function,exercise endurance,and quality of life.

BACKGROUND:Mammary stem cells are vital for the development and homeostasis of mammary gland tissue.The occurrence of breast cancer has a close relationship with the mammary stem cells.Recent studies have shown that Hopx,as an important transcriptional regulator of morphogenesis and cell differentiation,has been confirmed to be expressed in a variety of adult stem cells such as nerves,intestines,hair follicles and lungs.However,its role in mammary stem cells has not been reported so far.OBJECTIVE:To investigate whether Hopx expression marks mammary stem cells.METHODS:(1) Female Hopx-LacZ transgenic mice aged 8 weeks were selected to detect the background expression of Hopx in breast tissue by β-galactosidase staining.(2) Female wild-type mice at 4,6,and 8 weeks of age and 14.5 days of gestation were selected for whole-tissue magenta staining and K14 and K8 immunofluorescence staining,respectively.(3) Female Hopx-CreERT2;Rosa26LacZ transgenic mice aged 8 weeks and 17.5 days of gestation were selected and stained with breast β-galactosidase.(4) The 4-week-old female Hopx-CreERT2;Rosa26LacZ transgenic mice were selected.The Cre/loxp system was activated by intraperitoneal injection of tamoxifen (once every other day,three times),and breast β-galactosidase staining was performed 4 weeks after injection.The 8-week-old female Hopx-CreERT2;Rosa26LacZ transgenic mice were selected.The Cre/loxp system was activated by intraperitoneal injection of tamoxifen (once every other day,three times),and breast β-galactosidase staining was performed 4 and 10 weeks after the last injection.(5) Female Hopx-CreERT2;Rosa26LacZ transgenic mice aged 8 weeks were selected.The Cre/loxp system was activated by intraperitoneal injection of tamoxifen (once every other day,three times).Hopx-CreERT2;Rosa26LacZ transgenic mice were pregnant 2 weeks after injection.The mammary tissue of mice at 17.5 days of the first pregnancy and 17.5 days of the third pregnancy was stained with β-galactosidase.RESULTS AND CONCLUSION:(1) The results of β-galactosidase staining showed that the mammary ducts of Hopx-LacZ transgenic mice at 8 weeks of age did contain Hopx-positive cells and were located in the basal epithelia,with a small number.(2) Whole-mount staining of mammary glands and immunofluorescence staining results exhibited that the mammary glands of mice had different characteristics with corresponding developmental stages such as puberty,maturity,and pregnancy,and underwent a series of complex epithelial remodeling processes.(3) The results of β-galactosylase staining showed that Hopx-labeled positive cells in the mammary duct of Hopx-CreERT2;Rosa26LacZ transgenic mice at 17.5 days of gestation increased compared with female Hopx-CreERT2;Rosa26LacZ transgenic mice at 8 weeks of age.(4) The results of β-galactosylase staining showed that the Hopx-labeled positive cells in the mammary glands of 4-and 8-week-old female Hopx-CreERT2;Rosa26LacZ transgenic mice after tamoxifen injection were located in the basal epithelium with a small number.(5) The results of β-galactosidase staining showed that Hopx-labeled positive cells in the mammary glands of mice at 17.5 days of the first and third gestation were located in the basal epithelia around the alveoli,and the number of Hopx-labeled positive cells at 17.5 days of the third gestation was more.(6) In conclusion,Hopx reporter-marked basal epithelial cells belong to dormant mammary stem cells,which are responsible for the growth of the mammary glands during pregnancy and contribute to acinar formation.

Objective To explore the correlation between the location of adult peptic ulcers and Helicobacter pylori(Hp)infection and antibody typing,as well as its clinical significance.Methods A retrospective analysis was conducted on the serum Hp antibody typing results of adult patients 850 cases with peptic ulcers at Xuzhou Central Hospital from 2017 to 2024.According to the location of ulcers:duodenal ulcer group(DU group,n=429),gastric ulcer group(GU group,n=291)and ulcerative colitis group(UC group,n=130)were divided into three groups,and the relationship between ulcer location and Hp immunophenotyping was analyzed.The test results of 232 adult health examinees were used as the control group.Results The overall Hp infection rate in peptic ulcers patients was 79.76%(678/850),mainly with high virulence type I,with an rate of 62.71%(533/850),and type II was 17.06%(145/850).The Hp infection rates in the DU group,GU group,UC group and control groups were 86.48%(371/429),79.04%(230/291),59.23%(77/130)and 56.47%(131/232)respectively.The infection rates of type I were 72.96%,57.73%,40.00%and 47.41%,respectively.The infection rates of type II were 13.52%,21.31%,19.23%and 9.05%,respectively.The total infection rate,type I infection rate and type II infection rate of Hp were compared among the DU group,GU group,UC group and control group,and the differences were all statistically significant(χ2=91.838,67.169,17.647,all P<0.05).Compared with the UC group,the overall infection rate and type I infection rate of Hp in the DU group were the highest,followed by the GU group,and the differences were statistically significant(χ2=11.324～47.800,all P<0.05).However,the overall infection rate and the infection rate of type I were compared between the UC group and the control group,and the differences were not statistically significant(χ2=0.261,1.852,all P>0.05).The infection rate of type Ⅱ in GU group and UC group was significantly higher than that in controls groups,and the differences were statistically significant(χ2=14.518,7.782,all P<0.05).In addition,the positive rate of dual antibodies against CagA+VacA in the four groups was significantly higher than that of single antibody against CagA,VacA,and the differences were statistically significant(χ2=7.538～407.569,all P<0.05).Conclusion Adult patients with peptic ulcers are mainly infected with Hp type I strains,and the infection rate of type I strains is the highest in the DU group,followed by GU,while the infection rate of type I strains in UC is the lowest.UC is closely related to type II strain infection,and the infection rate is similar to that of GU patients.

Objective:To describe the body mass index (BMI) level and long-term trends of Chinese older adults aged 65 and above.Methods:Older adults aged 65 and above from six waves (2002-2018) of the China Longitudinal Healthy Longevity Survey were selected as the study population. Multiple cross-sectional design with six survey waves conducted in 2002, 2005, 2008, 2011, 2014, and 2018 was adopted, enrolling 15 647, 15 358, 15 622, 9 166, 6 302, and 12 417 participants, respectively. Additionally, a total of 13, 755 participants were included in the cohort study design. Relevant information was collected through questionnaires and physical examinations. The χ2 trend test was used to compare the changes in the rates of underweight and overweight/obesity over the years, and the linear mixed-e?ects model (LMM) was used to fit trajectory curves of BMI changes with advancing age in older adults. Results:The baseline ages of the participants included in 2002, 2005, 2008, 2011, 2014, and 2018 were (85.16±11.26), (84.23±11.83), (84.99±12.16), (81.10±11.86), (78.89±11.30), and (83.08±12.42) years, respectively, with a relatively high proportion of females and rural residents. In the cohort study, the 13 755 participants had a median ( Q1, Q3) follow-up time of 6.5 (5.2, 10.0) years, with a cumulative follow-up duration of 109 041 person-years. In each wave, males had higher BMI than females, urban residents had higher BMI than rural residents, and BMI gradually decreased with increasing age (all P<0.001). The mean BMI of older adults in China increased from (19.37±3.80) kg/m2 in 2002 to (22.04±4.01) kg/m2 in 2018 ( P<0.001). Across all survey years, the prevalence of underweight was consistently higher in women than in men and in rural areas than in urban areas, with an upward trend as age increased (all P<0.001). In 2018, the underweight rates in the 65-79, 80-89, 90-99, and ≥100-year-old age groups were 8.0%, 16.7%, 26.2%, and 35.5%, respectively. Meanwhile, the prevalence of overweight/obesity was higher in men than in women and in urban areas than in rural areas, showing a declining trend with advancing age (all P<0.001). The prevalence of underweight among the older adults decreased significantly from 45.2% in 2002 to 18.9% in 2018 ( P<0.001), while the prevalence of overweight/obesity increased from 11.0% in 1998 to 29.6% in 2018 ( P<0.001). The trajectory curves fitted by the LMM model showed that individuals born in later decades had higher BMI levels at the same age compared to earlier cohorts. Conclusion:From 2002 to 2018, the BMI level among Chinese older adults showed an increasing trend. The prevalence of underweight showed a declining trend, while the rates of obesity and overweight increased. However, the underweight rate remained notably high among the oldest old.

This article summarizesd Professor Li Zhigang's experience in treating limb dysfunction after acute disseminated encephalomyelitis(ADEM)by acupuncture.Prof.Li respected the classical theory of Chinese medicine,which is to seek the root cause of the disease,clarified the disease mechanism of"deficiency of Yangming leads to longitudinal tendons and unfavorable belt veins",and followed the principle of"treating flaccidity syndrome only by taking advantage of Yangming",and combined with the morbidity characteristics of ADEM that occurs in children,emphasized the important influence of regulating the root of innate and acquired in the treatment of the disease.The importance of regulating the essence of congenital and acquired constitution in the treatment of this disease was emphasized,taking into account the importance of regulating the mind and spirit.The main acupoints of Yangming Stomach Meridian,Large Intestine Meridian,Spleen Meridian,and Governor Vessel,together with the five main points of the lower limbs and the main points of water-inducing,all together play the role of tonifying the middle energizer,benefiting the essence and filling in the marrow,and strengthening the muscles and bones.