This study investigated the therapeutic effects and mechanisms of Modified Yiyi Fuzi Baijiang Powder on ulcerative colitis(UC) in rats from the perspective of dampness. SD rats were randomly allocated into six groups(n=10): control, model, mesalazine, and Modified Yiyi Fuzi Baijiang Powder at low(3.96 g·kg~(-1)·d~(-1)), medium(7.92 g·kg~(-1)·d~(-1)), and high(15.84 g·kg~(-1)·d~(-1)) doses. UC was induced in all groups except the control by administration with 3% dextran sulfate sodium(DSS) solution for 7 days. The disease activity index(DAI) was recorded, and the colon tissue was collected for analysis. Histopathological changes were assessed by hematoxylin-eosin staining. Serum levels of D-lactic acid(D-LA) and diamine oxidase(DAO) were measured by ELISA. Immunohistochemistry and PCR were employed to evaluate the expression of aquaporins(AQP3, AQP4) and tight junction proteins [zonula occludens-1(ZO-1) and occludin] at both protein and mRNA levels. Compared with the control group, the model group showed an increased DAI scores(P<0.05), intestinal mucosal damage, elevated serum levels of DAO and D-LA(P<0.05), and decreased expression of AQP3, AQP4, ZO-1, and occludin(P<0.05). Treatment with Modified Yiyi Fuzi Baijiang Powder reduced the DAI scores(P<0.05), lowered the serum levels of D-LA and DAO(P<0.05), and upregulated the expression of AQP3, AQP4, ZO-1, and occludin at both protein and mRNA levels compared with the model group. These findings suggest that Modified Yiyi Fuzi Baijiang Powder exerts therapeutic effects on UC by reducing the intestinal mucosal permeability, promoting colonic mucosal repair, and regulating abnormal intestinal water metabolism, which may involve the upregulation of AQP3 and AQP4 expression.
Animals ; Colitis, Ulcerative/genetics* ; Drugs, Chinese Herbal/administration & dosage* ; Rats, Sprague-Dawley ; Rats ; Intestinal Mucosa/metabolism* ; Male ; Aquaporin 3/metabolism* ; Aquaporin 4/metabolism* ; Permeability/drug effects* ; Humans ; Powders ; Intestinal Barrier Function

OBJECTIVES: To study the clinical characteristics of pediatric Behçet syndrome (BS). METHODS: A retrospective review was conducted on the medical records of children hospitalized in the Department of Pediatrics at the Second Hospital of Hebei Medical University between December 2014 and December 2024 who met diagnostic criteria for BS. RESULTS: Among 45 children with BS, 26 (58%) were male. Oral aphthous ulcers were the most common manifestation (43/45, 96%), followed by genital ulcers (23/45, 51%) and gastrointestinal involvement (18/45, 40%). Genital ulcers were more frequent in girls, whereas ocular involvement was more common in boys (P<0.05). The pathergy test was positive in 10 (22%), and HLA-B51 was positive in 13 (29%). Fecal calprotectin (FC) was elevated in 16 (36%); gastrointestinal involvement was more frequent in children with elevated FC than in those with normal FC (P<0.05). According to the respective criteria, 17 (38%) patients met the International Study Group criteria (1990), 33 (73%) met the International Criteria for Behçet Disease (2014), and 13 (29%) met the Pediatric Behçet Disease criteria (2015). CONCLUSIONS Pediatric BS shows marked clinical heterogeneity. HLA-B51 is associated with disease susceptibility.
Humans ; Behcet Syndrome/genetics* ; Male ; Female ; Child ; Retrospective Studies ; Adolescent ; Child, Preschool ; Leukocyte L1 Antigen Complex/analysis* ; HLA-B51 Antigen

OBJECTIVE: To elucidate how spinal manipulative therapy (SMT) exerts its analgesic effects through regulating brain function in lumbar disc herniation (LDH) patients by utilizing resting-state functional magnetic resonance imaging (rs-fMRI). METHODS: From September 2021 to September 2023, we enrolled LDH patients (LDH group, n=31) and age- and sex-matched healthy controls (HCs, n=28). LDH group underwent rs-fMRI at 2 distinct time points (TPs): prior to the initiation of SMT (TP1) and subsequent to the completion of the SMT sessions (TP2). SMT was administered once every other day for 30 min per session, totally 14 treatment sessions over a span of 4 weeks. HCs did not receive SMT treatment and underwent only one fMRI scan. Additionally, participants in LDH group completed clinical questionnaires on pain using the Visual Analog Scale (VAS) and the Japanese Orthopedic Association (JOA) score, whereas HCs did not undergo clinical scale assessments. The effects on the brain were jointly characterized using the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo). Correlation analyses were conducted between specific brain regions and clinical scales. RESULTS: Following SMT treatment, pain symptoms in LDH patients were notably alleviated and accompanied by evident activation of effects in the brain. In comparison to TP1, TP2 exhibited the most significant increase in ALFF values for Temporal_Sup_R and the most notable decrease in ALFF values for Paracentral_Lobule_L (voxelwise P<0.005; clusters >30; FDR correction). Additionally, the most substantial enhancement in ReHo values was observed for the Cuneus_R, while the most prominent reduction was noted for the Olfactory_R (voxelwise P<0.005; clusters >30; FDR correction). Moreover, a comparative analysis revealed that, in contrast to HCs, LDH patients at TP1 exhibited the most significant increase in ALFF values for Temporal_Pole_Sup_L and the most notable decrease in ALFF values for Frontal_Mid_L (voxelwise P<0.005; clusters >30; FDR correction). Furthermore, the most significant enhancement in ReHo values was observed for Postcentral_L, while the most prominent reduction was identified for ParaHippocampal_L (voxelwise P<0.005; clusters >30; FDR correction). Notably, correlation analysis with clinical scales revealed a robust positive correlation between the Cuneus_R score and the rate of change in the VAS score (r=0.9333, P<0.0001). CONCLUSIONS Long-term chronic lower back pain in patients with LDH manifests significant activation of the "AUN-DMN-S1-SAN" neural circuitry. The visual network, represented by the Cuneus_R, is highly likely to be a key brain network in which the analgesic efficacy of SMT becomes effective in treating LDH patients. (Trial registration No. NCT06277739).
Humans ; Magnetic Resonance Imaging ; Intervertebral Disc Displacement/diagnostic imaging* ; Male ; Female ; Brain/diagnostic imaging* ; Adult ; Manipulation, Spinal/methods* ; Middle Aged ; Lumbar Vertebrae/physiopathology* ; Pain Management ; Rest ; Case-Control Studies

OBJECTIVE: To evaluate the efficacy and safety of Shexiang Tongxin Dropping Pill (STDP) in treating stable angina patients with phlegm-heat and blood-stasis syndrome by exercise duration and metabolic equivalents. METHODS: This multicenter, randomized, double-blind, placebo-controlled clinical trial enrolled stable angina patients with phlegm-heat and blood-stasis syndrome from 22 hospitals. They were randomized 1:1 to STDP (35 mg/pill, 6 pills per day) or placebo for 56 days. The primary outcome was the exercise duration and metabolic equivalents (METs) assessed by the standard Bruce exercise treadmill test after 56 days of treatment. The secondary outcomes included the total angina symptom score, Chinese medicine (CM) symptom scores, Seattle Angina Questionnaire (SAQ) scores, changes in ST-T on electrocardiogram and adverse events (AEs). RESULTS: This trial enrolled 309 patients, including 155 and 154 in the STDP and placebo groups, respectively. STDP significantly prolonged exercise duration with an increase of 51.0 s, compared to a decrease of 12.0 s with placebo (change rate: -11.1% vs. 3.2%, P<0.01). The increase in METs was significantly greater in the STDP group than in the placebo group (change: -0.4 vs. 0.0, change rate: -5.0% vs. 0.0%, P<0.01). The improvement of total angina symptom scores (25.0% vs. 0.0%), CM symptom scores (38.7% vs. 11.8%), reduction of nitroglycerin consumption (100.0% vs. 11.3%), and all domains of SAQ, were significantly greater with STDP than placebo (all P<0.01). The changes in Q-T intervals at 28 and 56 days from baseline were similar between the two groups (both P>0.05). Twenty-five participants (16.3%) with STDP and 16 (10.5%) with placebo experienced AEs (P=0.131), with no serious AEs observed. CONCLUSION STDP could improve exercise tolerance in patients with stable angina and phlegm-heat and blood stasis syndrome, with a favorable safety profile. (Registration No. ChiCTR-IPR-15006020).
Humans ; Double-Blind Method ; Drugs, Chinese Herbal/adverse effects* ; Male ; Female ; Middle Aged ; Angina, Stable/physiopathology* ; Aged ; Syndrome ; Treatment Outcome ; Placebos ; Tablets

Sustainability is a critical issue in China's medical and health assistance and cooperation with Africa.As China enters a new phase in this field,achieving sustainability presents both opportunities and challenges.Summarizing past successes and identifying barriers are of great practical significance for future development.This study examines the current state of China's medical and health assistance and cooperation with Uganda and finds that China has actively sought to integrate into local communities by collaborating with Ugandan medical institutions.However,several factors continue to constrain the sustainability of these efforts,including Uganda's fragmented public-private healthcare system heavily reliant on external aid,the personnel structure of Chinese medical teams,and linguistic and cultural barriers between China and Uganda.Based on official policy documents from both countries and field research findings,this study recommends supporting and assisting Uganda in establishing an independent healthcare system,with a particular focus on maternal and child health,youth health,and chronic disease management.Furthermore,strengthening cultural exchanges can contribute to the sustainable development of China-Uganda and broader China-Africa medical and health assistance and cooperation.

Objective:To investigate the effect and mechanism of total glucosides of paeony(TGP)on intestinal ischemia reperfusion(IIR)injury in rats based on Ras homolog gene family member A(RhoA)/Rho-related coiled-coil protein kinase 1(Rock1)pathway.Method:The IIR rat models were established by clamping the superior mesenteric artery for 1 h,and the rats were randomly divided into Sham group,Model group,TGP group,TGP+Rhosin(RhoA inhibi-tor)group and TGP+LPA(RhoA agonistor)group,with 8 rats in each group.After 4 weeks of continuous administration once a day,the activity or level of intestinal barrier indexes[diamine oxidase(DAO),d-lactic acid(D-LA)and endotoxin(ET)]in plasma were detected by ELISA method,the wet/dry weight(W/D)ratio was calculated to evaluate the intestinal water content.The intestinal histopathological changes was observed by HE stainning,and the the degree of intestinal injury was evaluated by Chiu's score.The intestinal cells apoptosis was observed by TUNEL method.The inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-18(IL-18)and interleukin-1β(IL-1β)]in serum were detected by ELISA method.The oxidative stress indexes[malondialdehyde(MDA),superoxide dismutase(SOD)and catalase(CAT)]in serum were measured by spectrophotometry method.The expression of RhoA,ROCK1,nuclear factor-κB p65(NF-κB p65),hypoxia induciblefactor-1α(HIF-1α),zonula occludens protein-1(ZO-1),Occludin proteins were detected by Western blot method.Result:Compared with Model group,the activity of DAO and the content of D-LA,ET in plasma of TGP group and TGP+Rhosin group were significantly decreased,the W/D of intestinal were significantly decreased(P<0.05).The intestinal histopathological changes were significantly improved,the Chiu's score and cell poptosis index were significantly decreased(P<0.05).The content of TNF-α,IL-18,IL-1β,MDA in serum were significantly decreased,the activity of SOD,CAT were significantly increased(P<0.05).The expression of RhoA,ROCK1,NF-κB p65 proteins in in-testine tissue were significantly decreased,the expression of HIF-1α,ZO-1,Occludin proteins were significantly in-creased(P<0.05).Compared with TGP group,Rhosin significantly enhanced the effects of TGP on various detection indi-cators in IIR rats(P<0.05),while LPA significantly weakened the aforementioned effects of TGP(P<0.05).Conclusion:TGP could inhibiting inflammation,oxidative stress and improving intestinal barrier function by down-regulating RhoA/ROCK1 pathway,thus playing protective role against IIR injury in rats.

Aim To identify the chemical components of Angelica sinensis(AS)and explore the mechanism of AS in activating blood circulation.Methods UP-LC-Q-TOF-MS was used to identify the chemical com-ponents of AS.The changes of syndrome and patholog-ical section of heart in rats were observed.Hemody-namics and proteomics were measured.Results A to-tal of 270 compounds were identified from AS.It showed that rats of Angelica sinensis group were greatly improved such as arched back,shrugged fur,huddled up and less mobile,purplish paws and tails,whitish ear margins and nasolabial lips,reduced drinking and feed-ing,and slow response to external stimuli;mildly disor-dered myocardial fibre arrangement,myofibre arrange-ment was tighter than that of model group,myocardial fibres were narrower and close to normal,and mild oe-dema,exudation,and inflammatory cell infiltration could be seen in the surrounding area;SAP was signif-icantly lower and LVSP was significantly higher in An-gelica sinensis group(P＜0.05).Proteomics showed that 62 differential proteins were screened in Angelica sinensis group compared to model,GO function were concentrated in the extracellular matrix,cytoskeletal proteins binding and protein hydrolysis negatively regu-lated.KEGG pathway were enriched in signalling path-ways such as complement and coagulation cascades,cellular focal adhesion,leukocyte transendothelial mi-gration and chemokine signalling pathways.Conclu-sions AS probably through the expression of proteins,which modulate the signalling pathways of the comple-ment and coagulation cascade reactions and the con-traction of vascular smooth muscle.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Objective:To investigate the detection rates of and risk factors for psycho-cardiological diseases in civil aviation aircrews.Methods:A total of 134 civil aviation aircrews with cardiovascular diseases detected during annual physical examinations at the Aviation Health Center of China Southern Airlines Co., Ltd. in 2023 were selected. Psychological evaluation was conducted using the Patient Health Questionnaire-9 for depression screening and the Generalized Anxiety Disorder-7 for anxiety screening. The results of psychological assessments were compared across civil aviation aircrews with cardiovascular diseases and of different types. Multiple Logistic regression analysis was used to identify risk factors to psycho-cardiological diseases.Results:Among the 134 aircrews with cardiovascular diseases, 30 were found to suffer from depression, 71 from anxiety, and 9 from both. The detection rate of psycho-cardiological diseases was 68.66% (92/134) and significantly different between crews who were different in age ( P=0.013), flying hours ( χ2=9.68, P=0.035), jobs ( χ2=16.33, P=0.008), and exercise habits ( χ2=11.35, P=0.042). No significant differences were observed in detection rates between genders or between those with a family history of disease and those without (both P>0.05). Multivariate Logistic regression analysis showed that ages 40-49 (compared to ages <30, OR=2.450, 95% CI: 1.324-4.563), flying hours of 10 000-20 000 h (compared to <5 000 h, OR=2.865, 95% CI: 1.452-5.683), pilots (compared to flight attendants, OR=3.123, 95% CI: 1.671-5.832), and inactivity (compared to regular physical activity, OR=2.156, 95% CI: 1.179-3.924) were risk factors for psycho-cardiological diseases. Conclusions:The detection rate of psycho-cardiological diseases is notably high among civil aviation aircrews, with a number of risk factors.

Objective:To explore the correlation between renal function and abdominal aortic hemodynamic parameters based on four-dimensional flow(4D Flow) MRI in patients with chronic kidney disease (CKD).Methods:A cross-section prospective study was conducted on 73 patients diagnosed with CKD at First People′s Hospital of Changzhou between March 2021 and May 2023, as well as 13 volunteers without kidney injury. According to the estimated glomerular filtration rate (eGFR), the subjects were divided into CKD 1-3 stage group ( n=34), CKD 4-5 stage group ( n=39), and control group ( n=13). All subjects underwent 4D Flow MRI examination of the abdominal aorta, measuring pulse wave velocity (PWV), peak velocity, and maximum wall shear stress (WSS) at the proximal plane (Plane_1) and the higher renal artery opening plane (Plane_2) of the abdominal aorta. The differences in 4D Flow MRI hemodynamic parameters among the three groups were compared using a one-way analysis of variance or the Kruskal-Wallis test. The correlation between 4D Flow MRI hemodynamic parameters and eGFR was analyzed by using the Spearman correlation coefficient. The independent influencing factors that affect eGFR were analyzed by using multivariate linear regression analysis. Results:There were significant differences in abdominal aortic PWV and maximal WSS of Plane_1 and Plane_2 among the three groups ( H=10.38, P=0.006; F=11.16, P<0.001; F=4.75, P=0.011). There were no significant differences in the peak velocity of Plane_1 and Plane_2 among the three groups (both P>0.05). Abdominal aortic PWV was negatively correlated with eGFR ( r s=-0.30, P=0.005). There was a positive correlation between the maximal WSS of Plane_1 and Plane_2 with eGFR ( r s=0.39, P<0.001; r s=0.29, P=0.006). Abdominal aortic PWV and maximal WSS of Plane_1 were independent influencing factors of eGFR (b=-4.32, P=0.018; b=132.23, P=0.004). Conclusions:There is an independent correlation between renal function and abdominal aortic hemodynamic parameters based on 4D Flow MRI in patients with CKD, and abdominal aortic PWV and maximal WSS of Plane_1 were independent influencing factors of eGFR.