This paper summarizes Professor AI Rudi's experience in the diagnosis and treatment of skin pruritus based on the "unity of restoring form， regulating qi， and harmonizing spirit"， employing internal herbal medicine combined with external treatments. It is believed that the core pathogenesis of pruritus is the "imbalance of form， qi， and spirit"， with disturbed spirit as the onset， disordered qi as the key pathogenic factor， and physical changes as the manifestation of the disease. The treatment principle follows "restoring form-regulating qi-harmonizing spirit"， with a combination of internal and external therapies， and differentiation based on deficiency and excess. For excess conditions caused by pathogenic disturbances to the heart spirit， treatment is based on different patterns of wind-heat， damp-heat， and blood-heat， using Sangye （Morus alba）-Sangbaipi （Morus alba cortex）-Longchi （Draconis os） to disperse wind and clear heat， calm the spirit； Difuzi （Kochia scoparia）-Qinghao （Artemisia annua）-Tanxiang （Santalum album） to clear damp-heat and aromatically open the spirit； Mudanpi （Paeonia suffruticosa）-Chuanxiong （Ligusticum chuanxiong）-Shuiniujiao （Bubalus bubalis cornua） to cool the blood， activate circulation， and calm the spirit. For deficiency conditions caused by insufficient nourishment of the heart spirit， treatment is based on patterns of qi deficiency or blood deficiency， using Huangqi （Astragalus membranaceus）-Fuping （Lemna minor）-Wuweizi （Schisandra chinensis） to tonify the qi and stabilize the exterior； Heshouwu （Polygonum multiflorum）-Jili （Tribulus terrestris）-Shouwuteng （Polygonum multiflorum vine） to nourish the blood， moisten dryness， and calm the spirit. External treatments integrate traditional Chinese medicine therapies such as medicinal baths， gua sha， and ear acupuncture， with custom herbal wash formulas for restoring form， jojoba oil gua sha for regulating qi， and ear seed therapy using Wangbuliuxing （Vaccaria segetalis） for harmonizing the spirit， achieving a holistic treatment effect for form， qi， and spirit.

This paper summarizes Professor AI Rudi's clinical experience in treating skin abscesses using the method of "three parts and six methods"， which emphasize a combined internal and external therapeutic approach. He identifies retained pathogenic heat in the skin as the key etiological factor and proposes treatment principles tailored to the anatomical location of the lesions. For abscesses in the upper part of the body （head， face and neck）， wind-heat and blood-heat are considered dominant， and the treatment focuses on dispersing the exterior， clearing heat， cooling the blood， and reducing swelling， with custom formulations such as self-fomulated Shufeng Xiaodu Decoction （疏风消毒饮） and Jiedu Xiaozhong Decoction （解毒消肿汤）. For those in the middle part of the body （chest， abdomen， back and upper limbs）， constrained heat and deficiency-heat predominate， and the treatment aims to relieve internal heat stagnation， reduce swelling， and expel toxins， using formulations like self-fomulated Qinggan Jiedu Decoction （清肝解毒汤） and Xiaozhong Erchen Decoction （消肿二陈汤）. For abscesses in the lower part of the body in the （buttocks， perineum and lower limbs）， damp-heat and stagnant heat are the main patterns， and the strategy is to clear damp-heat and resolve blood stasis， with formulations such as self-fomulated Jiedu Simiao Powder （解毒四妙散） and Qingjie Sanyu Decoction （清解散瘀汤）. External therapies are equally emphasized： for unruptured lesions， self-fomulated Wumiao Ointment （五妙膏） is used to detoxify and reduce swelling， while for ruptured lesions， Danhuang Oil （蛋黄油） is applied to promote wound healing and relieve pain.

Objective To investigate the relationship between tooth loss and the occurrence of esophageal cancer in a natural village in Wenfeng District, Anyang City, Henan Province. Methods A prospective cohort study was conducted to observe the occurrence of tooth loss and esophageal cancer among the asymptomatic residents of the natural village for 16 years from January 2008 to July 2024. Data were analyzed by chi-square test, binary logistic regression, and restricted cubic spline. Results Among the total population of 711 cases, 136 cases were lost to follow-up and 575 cases were included in the final statistics, including 45 cases with esophageal cancer. Significant statistical difference was found between esophageal cancer patients with and without tooth loss (P<0.05). Logistic regression analysis showed that tooth loss was associated with the occurrence of esophageal cancer (OR=3.977, 95%CI: 1.543-10.255). After the adjustment for confounders, tooth loss remained significantly associated with the occurrence of esophageal cancer (OR=3.038, 95%CI: 1.035-8.914). A nonlinear dose-response relationship was observed between the number of teeth lost and the incidence of esophageal cancer. When the number of teeth lost was less than 12, the risk of esophageal cancer increased with the number of teeth lost. When more than 12 teeth were lost, the risk of esophageal cancer decreased as the number of teeth lost increased. Conclusion Tooth loss is a risk factor for the occurrence of esophageal cancer in this natural village. When the number of teeth lost is less than 12, the risk of esophageal cancer increases with the number of teeth lost.

For the past 30 years,percutaneous balloon mitral valve dilatation has been performed under the guidance of X-rays and bedside ultrasound.However,there are still some cases of mitral valve stenosis in the large atrium where balloon dilation failed.Intraperitoneal ultrasound-guided percutaneous balloon mitral valve plasty is accurate and feasible,which can reduce the occurrence of complications and improve the success rate of such elderly complex cases.Two patients with severe mitral stenosis underwent percutaneous balloon mitral valve plasty guided by intracardiac ultrasound.The operations were successful without any complications,which can provide reference for clinical treatment of mitral stenosis.

Despite significant advancements in treatments for heart failure,the overall prognosis for patients remains poor.Hemodynamic abnormalities in heart failure manifest as elevated left atrial pressure and pulmonary congestion.Previous studies have shown that reducing left atrial pressure can improve symptoms and prognosis for heart failure patients,suggesting that left-sided heart overload may be a potential target for heart failure treatment.Atrial shunting procedures aim to create a stable and controlled left-to-right intracardiac shunt,restoring the decompensated left heart volume and pressure load in heart failure patients to a compensatory state,thereby improving heart failure symptoms and prognosis.Currently,this treatment is still in the clinical research stage globally.Existing data indicate that atrial shunting procedures can lower left atrial pressure at rest or during exercise in heart failure patients,improve pulmonary congestion,enhance patients'exercise tolerance,and clinical cardiac function.However,no studies have yet confirmed that it can improve clinical endpoints such as rehospitalization and mortality due to heart failure.Future research will focus on identifying heart failure patients who may benefit from atrial shunting,with assessments of heart failure etiology,right heart function,and reversibility of pulmonary vascular resistance,as well as heart failure classification based on ejection fraction,serving as potential key factors for patient selection.

Objective:To investigate the effect of different isoforms of RBBP6 on the proliferation of multiple myeloma (MM) cells after alternative splicing mediated by splicing factor SRSF1. Methods:RT-PCR was used to detect the expression levels of RBBP6 mRNA splicing isoforms regulated by SRSF1. The GEO database was used to analyze the changes of RBBP6 isoform 1 in the progression of plasma cell disease,and survival analysis was used to evaluate the value of this gene in the prognosis of MM patients. In vitro loss-of-function and gain-of-function experiments were conducted by transfecting control siRNA,RBBP6 isoform 1 siRNA,empty vector (EV),OE-RBBP6 isoform 3 into MM.1S cells,then the expression levels of RBBP6 isoform 1 and RBBP6 isoform 3 were detected by real-time PCR and Western blot. CCK-8 assay was performed to detect the cell proliferation ability. Results:Knockdown of SRSF1 increased the expression of RBBP6 isoform 3 and decreased the expression of RBBP6 isoform 1. RBBP6 isoform 1 was closely related to the progression of plasma cell disease,and the high expression of RBBP6 isoform 1 was associated with poor prognosis in patients with MM. Downregulation of RBBP6 isoform 1 expression and overexpression of RBBP6 isoform 3 both reduced the proliferation ability of MM cells. And after downregulating the expression of RBBP6 isoform 1,the level of p53 protein in MM cells was significantly increased (P<0.05). Conclusion:In MM,splicing factor SRSF1 can cause alternative splicing abnormalities in RBBP6. The RBBP6 isoform 1 promotes MM cell proliferation,while the RBBP6 isoform 3 inhibits MM cell proliferation,and the mechanism may be related to regulating the p53 pathway.

Objective:To investigate different regulatory effects of S100A8/A9 expressed by keratinocytes in 3 common inflammatory skin injury modes: UVB-induced skin injury, allergic contact dermatitis, and psoriasis.Methods:Wild-type C57BL/6JGpt mice aged 6 to 8 weeks were selected for the following experiments: (1) mouse models of UVB-induced skin injury were established by single exposure to ultraviolet B (UVB) radiation on the shaved dorsal skin of mice (UVB group, n = 4), with the mice receiving no UVB radiation serving as a control group ( n = 4) ; (2) mouse models of allergic contact dermatitis were established by application of 2,4-dinitrochlorobenzene (DNCB) to the right ears of mice (DNCB group, n = 4), with the left ears of mice treated with a vehicle control serving as a control group ( n = 4) ; (3) mouse models of psoriasis-like skin inflammation were established by topical application of imiquimod cream to the depilated dorsal skin of mice (imiquimod group, n = 4), with the mice treated with vaseline serving as a control group ( n = 4). Hematoxylin-eosin (HE) staining was performed to assess histopathological changes in mouse skin tissues obtained from each group, and immunohistochemical study and Western blot analysis were performed to determine the expression of S100A8 and S100A9 in the mouse dorsal epidermis or ear skin lesions. In vitro cultured HaCaT cells were subjected to the following experiments: (1) cells in the UVB group were treated with a single UVB irradiation at a dose of 50 mJ/cm 2, and cells in the control group received no irradiation; (2) some cells were treated with tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) (collectively referred to as TI), and named as the TI group, which simulated the inflammatory environment in allergic contact dermatitis, while cells treated with corresponding solvents served as the control group; (3) cells were treated with 5 cytokines (interleukin 17A [IL-17A], IL-22, IL-1α, oncostatin M, and TNF-α, collectively referred to as M5), and named as the M5 group, which simulated the inflammatory environment in psoriasis, while cells treated with corresponding solvents served as the control group. Real-time fluorescence-based quantitative PCR, Western blot analysis, and enzyme-linked immunosorbent assay were performed to determine the mRNA and protein expression of S100A8 and S100A9, and to detect the extracellular secretion level of S100A8/A9, respectively. Results:Immunohistochemical study and Western blot analysis revealed that S100A8 and S100A9 expression levels were significantly higher in the skin lesions of mouse models of UVB-induced skin injury, allergic contact dermatitis, and psoriasis-like skin inflammation than in their corresponding control groups; immunohistochemical study further demonstrated that the increase in the expression of the two proteins was more pronounced in the mouse models of psoriasis-like skin inflammation. In the in vitro cell experiments, the mRNA expression of S100A8 and S100A9 in HaCaT cells at 12 and 24 hours were markedly higher in the UVB group (e.g., at 24 hours, 6.14 ± 0.60 vs. 1.00 ± 0.08, 2.58 ± 0.06 vs. 1.02 ± 0.22, respectively, both P < 0.01), TI group (e.g., at 24 hours, 3.90 ± 0.75 vs. 1.00 ± 0.02, 2.42 ± 0.30 vs. 1.01 ± 0.13, respectively, both P < 0.05), and M5 group (e.g., at 24 hours, 157.59 ± 9.30 vs. 1.00 ± 0.11, 251.37 ± 6.63 vs. 1.00 ± 0.03, both P < 0.001) than in the corresponding control groups, so were the extracellular secretion levels of S100A8/A9 at 24 and 48 hours (all P < 0.001), with some differences observed in their response patterns; notably, the response was more pronounced in the mouse model of psoriasis-like skin inflammation. Additionally, the protein expression levels of S100A8 and S100A9 in HaCaT cells were significantly higher in the M5 group than in the control group ( t = 4.66, 4.63, respectively, both P < 0.01), but were significantly lower in the UVB group ( t = -3.75, -3.34, P = 0.020, 0.029, respectively) and TI group ( t = -3.30, -4.50, P = 0.030, 0.011, respectively) than in the control groups. Conclusion:Keratinocytes exhibited active responses following 3 common inflammatory skin injuries, with their effector molecules S100A8 and S100A9, as damage-associated molecular patterns, playing crucial roles in UVB-induced skin injury, allergic contact dermatitis, and psoriasis, and the response seemed to be more pronounced in psoriasis-like dermatitis.

Objective To investigate the clinical characteristics and prognosis of pneumococcal meningitis(PM),and drug sensitivity of Streptococcus pneumoniae(SP)isolates in Chinese children.Methods A retrospective analysis was conducted on clinical information,laboratory data,and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country.Results Among the 160 children with PM,there were 103 males and 57 females.The age ranged from 15 days to 15 years,with 109 cases(68.1% )aged 3 months to under 3 years.SP strains were isolated from 95 cases(59.4% )in cerebrospinal fluid cultures and from 57 cases(35.6% )in blood cultures.The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87)and 27% (21/78),respectively.Fifty-five cases(34.4% )had one or more risk factors for purulent meningitis,113 cases(70.6% )had one or more extra-cranial infectious foci,and 18 cases(11.3% )had underlying diseases.The most common clinical symptoms were fever(147 cases,91.9% ),followed by lethargy(98 cases,61.3% )and vomiting(61 cases,38.1% ).Sixty-nine cases(43.1% )experienced intracranial complications during hospitalization,with subdural effusion and/or empyema being the most common complication[43 cases(26.9% )],followed by hydrocephalus in 24 cases(15.0% ),brain abscess in 23 cases(14.4% ),and cerebral hemorrhage in 8 cases(5.0% ).Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old,with rates of 91% (39/43)and 83% (20/24),respectively.SP strains exhibited complete sensitivity to vancomycin(100% ,75/75),linezolid(100% ,56/56),and meropenem(100% ,6/6).High sensitivity rates were also observed for levofloxacin(81% ,22/27),moxifloxacin(82% ,14/17),rifampicin(96% ,25/26),and chloramphenicol(91% ,21/23).However,low sensitivity rates were found for penicillin(16% ,11/68)and clindamycin(6% ,1/17),and SP strains were completely resistant to erythromycin(100% ,31/31).The rates of discharge with cure and improvement were 22.5% (36/160)and 66.2% (106/160),respectively,while 18 cases(11.3% )had adverse outcomes.Conclusions Pediatric PM is more common in children aged 3 months to under 3 years.Intracranial complications are more frequently observed in children under 1 year old.Fever is the most common clinical manifestation of PM,and subdural effusion/emphysema and hydrocephalus are the most frequent complications.Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates.Adverse outcomes can be noted in more than 10% of PM cases.SP strains are high sensitivity to vancomycin,linezolid,meropenem,levofloxacin,moxifloxacin,rifampicin,and chloramphenicol.[Chinese Journal of Contemporary Pediatrics,2024,26(2):131-138]

This paper summarized professor AI Rudi's clinical experience in treating primary cutaneous amyloidosis （PCA） from the perspective of "skin accumulation". The morphology and pathological characteristics of PCA are similar to those of accumulation diseases in traditional Chinese medicine， proposing the concept of "skin accumulation". It is believed that the core pathogenesis of PCA is the invasion of pathogenic factors while healthy qi is in deficiency， and phlegm and stasis consolidating the exterior， which can be mainly categorized into the type of root deficiency and branch excess. Depleted healthy qi and loose striae and interstices are the root， while pathogen lingering in the skin surface， fluids and blood failure to be distributed， and binding of phlegm and stasis are the branch of the disease. The main treatment principle is consolidating the root and clearing the source. For internal treatment， it is recommended to fortify the spleen and nourish kidney， dispel phlegm and dissolve stasis， soften hardness and dissipate masses， with Self-made Erxian Sishen Decoction （二仙四参汤）， Guizhi Fuling Pills （桂枝茯苓丸）， Huajian Erchen Pills （化坚二陈丸） and Modified Xiaolei Pills （加味消瘰丸）. For external treatment， it is important to dispel pathogens and disperse accumulation， scatter and unblock fluids and blood， and hot baking with self-made Ruiji Paste （润肌膏） can be used to promote softening and peeling of skin lesions， and medicinal bath with pig bile to open striae and dispel pathogen， bovine spinal cord sealing to nourish the skin.

[摘 要] 目的：探究桃叶珊瑚苷（AU）调控RhoA/ROCK信号通路对胃癌MGC803细胞上皮间质转化（EMT）进程和血管生成拟态（VM）形成的影响。方法：常规培养人胃癌MGC803细胞，将其随机分为对照组、AU-L组（20 μmol/L AU）、AU-M组（40 μmol/L AU）、AU-H组（80 μmol/L AU）、AU-H+RhoA激活剂水仙环素（Nar）组（AU-H+Nar组，80 μmol/L AU+30 μmol/L Nar）。采用CCK-8法、Transwell实验、细胞划痕实验分别检测不同浓度AU对细胞增殖、迁移和侵袭的影响，三维细胞培养法观察不同浓度AU对细胞体外VM管腔结构形成的影响，WB法检测AU对各组细胞RhoA、ROCK、VM与EMT相关蛋白表达的影响。结果：与对照组相比，AU-M组、AU-H组MGC803细胞增殖率（48、72 h时）、细胞迁移率、细胞侵袭数目、VM管腔结构数，以及RhoA、ROCK1、N-cadherin、vimentin、VE-cadherin的蛋白表达均显著降低（均P<0.05），E-cadherin表达显著升高（P<0.05）；同时，使用Nar处理显著减弱了AU对MGC803细胞EMT和VM形成的抑制作用（均P<0.05）。结论：AU通过下调RhoA/ROCK信号通路抑制胃癌MGC803细胞的增殖、迁移、侵袭、EMT和VM形成过程。