This paper introduces professor WU Rongzu's clinical experience in using Fuyang Tongmi Decoction （扶阳通秘汤， FTD） to treat irritable bowel syndrome with constipation （IBS-C）. It is believed that yang qi depletion， water cold， earth dampness， and wood constraint are the key pathogenesis.The treatment principle is warming water， drying the earth and venting wood， with the basic formula FTD adjusted according to the symptoms. This approach aims to transport the qi movement of the middle jiao （焦） and support the recovery of intestinal function of directing turbidity downward， providing a treatment strategy for IBS-C caused by yang deficiency.

Objective To explore the correlation between non-migraine symptoms and patent foramen ovale(PFO)in adults.Methods A retrospective analysis was conducted on clinical data of patients who underwent contrast transthoracic echocardiography in the echocardiography room of the department of cardiovascular medicine in our hospital from February to December 2024.The patients were divided into a migraine symptom group(n=527),a non-migraine symptom group(including unexplained dizziness,tinnitus,transient hearing loss,syncope,limb numbness,and transient visual field defect symptoms,n=144),and an asymptomatic control group(n=87)based on their symptoms.Differences in PFO positive rates and right to left shunting(RLS)in PFO positive patients among the three groups were compared.Multivariate logistic regression was used to identify independent factors associated with PFO.Results The PFO-positive rates were 85.0%(448/527),84.0%(121/144),and 26.4%(23/87)in the migraine,non-migraine,and control groups,respectively,with significant differences among the three groups(χ2=153.434,P=0.000).Both migraine and non-migraine groups had significantly higher PFO-positive rates than the control group(both P=0.000).Among the 592 patients diagnosed with PFO,the degree of RLS differed significantly among the three groups(H=18.762,P=0.000).Migraine and non-migraine groups showed higher RLS degree than the control group(both P=0.000).Multivariate analysis identified that age less than or equal to 40(OR=2.221,95%CI:1.515-3.256,P=0.000),migraine(OR=3.373,95%CI:2.322-4.899,P=0.000),dizziness(OR=2.499,95%CI:1.694-3.685,P=0.000),and limb numbness(OR=1.981,95%CI:1.052-3.729,P=0.034)were independent factors associated with PFO.Conclusions Non-migraine symptoms including dizziness and limb numbness correlate with PFO in adults.Contrast transthoracic echocardiography is recommended for patients presenting with such symptoms.

Frostbite is the most common cold injury and is caused by both immediate cold-induced cell death and the gradual development of localized inflammation and tissue ischemia. Delayed healing of frostbite often leads to scar formation, which not only causes psychological distress but also tends to result in the development of secondary malignant tumors. Therefore, a rapid healing method for frostbite wounds is urgently needed. Herein, we used a mouse skin model of frostbite injury to evaluate the recovery process after frostbite. Moreover, single-cell transcriptomics was used to determine the patterns of changes in monocytes, macrophages, epidermal cells, and fibroblasts during frostbite. Most importantly, human-induced pluripotent stem cell (hiPSC)-derived skin organoids combined with gelatin-hydrogel were constructed for the treatment of frostbite. The results showed that skin organoid treatment significantly accelerated wound healing by reducing early inflammation after frostbite and increasing the proportions of epidermal stem cells. Moreover, in the later stage of wound healing, skin organoids reduced the overall proportions of fibroblasts, significantly reduced fibroblast-to-myofibroblast transition by regulating the integrin α5β1-FAK pathway, and remodeled the extracellular matrix (ECM) through degradation and reassembly mechanisms, facilitating the restoration of physiological ECM and reducing the abundance of ECM associated with abnormal scar formation. These results highlight the potential application of organoids for promoting the reversal of frostbite-related injury and the recovery of skin functions. This study provides a new therapeutic alternative for patients suffering from disfigurement and skin dysfunction caused by frostbite.
Animals ; Organoids/metabolism* ; Mice ; Humans ; Wound Healing ; Frostbite/metabolism* ; Skin/pathology* ; Induced Pluripotent Stem Cells/cytology* ; Cicatrix/pathology* ; Fibroblasts/metabolism* ; Disease Models, Animal ; Mice, Inbred C57BL ; Extracellular Matrix/metabolism* ; Male

Objective: To investigate the association between outdoor light at night (LAN) exposure and sleep quality among primary and secondary school students, and to examine the pathways of negative affects including depressive, stress and anxiety symptoms, so as to provide a theoretical basis for optimizing the school environment and enhancing the physical and mental well being of students. Methods: In December 2024, a total of 36 885 students from 154 primary and secondary schools in Suzhou, Nantong, and Changzhou were included via a stratified cluster sampling method. Sleep quality and negative affect were assessed by using the Pittsburgh Sleep Quality Index (PSQI), Center for Epidemiologic Studies Depression Scale (CES-D), Generalized Anxiety Disorder-7 (GAD-7), and Depression, Anxiety and Stress Scale-21 (DASS-21), respectively. Outdoor LAN exposure data were obtained from the national polar orbiting partnership visible infrared imaging radiometer suite nighttime light(NPP-VIIRS NTL) dataset provided by the National Earth System Science Data Center. Multivariate Logistic regression model was employed to analyze the association between LAN exposure and sleep quality across different regions, with stratification by monitoring site. Spearman correlation analysis was used to examine the relationships between LAN, negative affect, and sleep quality. The mediating role of negative affect was tested by using Model 4 of the PROCESS macro. Results: The detection rates among students were 13.95%( n =5 147) for depressive symptom, 16.72%( n =6 166) for stress symptom, and 17.49%( n =6 451) for anxiety symptom. The median outdoor LAN exposure was 28.85(19.10, 41.44)nW/(cm 2 · ( sr). After adjusting for confounders, multivariate Logistic regression analysis showed that high LAN exposure ( Q 4) was positively associated with sleep problems (urban areas: OR =1.28, 95% CI = 1.17- 1.41; rural areas: OR =1.21, 95% CI =1.07-1.36; both P <0.05). Spearman correlation analysis revealed significant positive correlations between LAN exposure, depressive symptoms, stress symptoms, anxiety symptoms, and sleep quality ( r =0.03-0.75, all P < 0.01). The mediation analysis indicated that all dimensions of negative affect significantly mediated the relationship between high LAN exposure and poor sleep quality (all P <0.01). Specifically, the indirect effects were 0.03 (95% CI =0.02-0.05) for depressive symptom, 0.05(95% CI =0.03-0.08) for stress symptom, and 0.07(95% CI =0.05-0.09) for anxiety symptom. Overall, 31.9% of the total effect was mediated by negative affect, with anxiety (14.89%) being the strongest mediator, followed by stress (10.64%) and depression(6.38%). Conclusion Reducing high levels of outdoor LAN exposure and implementing interventions targeting negative affect may contribute to improved sleep quality among primary and secondary school students.

Objective To explore the correlation between non-migraine symptoms and patent foramen ovale(PFO)in adults.Methods A retrospective analysis was conducted on clinical data of patients who underwent contrast transthoracic echocardiography in the echocardiography room of the department of cardiovascular medicine in our hospital from February to December 2024.The patients were divided into a migraine symptom group(n=527),a non-migraine symptom group(including unexplained dizziness,tinnitus,transient hearing loss,syncope,limb numbness,and transient visual field defect symptoms,n=144),and an asymptomatic control group(n=87)based on their symptoms.Differences in PFO positive rates and right to left shunting(RLS)in PFO positive patients among the three groups were compared.Multivariate logistic regression was used to identify independent factors associated with PFO.Results The PFO-positive rates were 85.0%(448/527),84.0%(121/144),and 26.4%(23/87)in the migraine,non-migraine,and control groups,respectively,with significant differences among the three groups(χ2=153.434,P=0.000).Both migraine and non-migraine groups had significantly higher PFO-positive rates than the control group(both P=0.000).Among the 592 patients diagnosed with PFO,the degree of RLS differed significantly among the three groups(H=18.762,P=0.000).Migraine and non-migraine groups showed higher RLS degree than the control group(both P=0.000).Multivariate analysis identified that age less than or equal to 40(OR=2.221,95%CI:1.515-3.256,P=0.000),migraine(OR=3.373,95%CI:2.322-4.899,P=0.000),dizziness(OR=2.499,95%CI:1.694-3.685,P=0.000),and limb numbness(OR=1.981,95%CI:1.052-3.729,P=0.034)were independent factors associated with PFO.Conclusions Non-migraine symptoms including dizziness and limb numbness correlate with PFO in adults.Contrast transthoracic echocardiography is recommended for patients presenting with such symptoms.

BACKGROUND:Unicompartmental knee arthroplasty has been paid more and more attention because of its advantages of fewer traumas,less blood loss,less complications,faster recovery,excellent knee function and high prosthetic survival rate.Most of the relevant reports focused on its clinical effect,but the changes in the levels of relevant inflammatory cytokines in patients after unicompartmental knee arthroplasty were rarely reported. OBJECTIVE:To investigate the effect of unicompartmental knee arthroplasty in patients with medial compartment osteoarthritis of the knee and the changes of interleukin-1,interleukin-6,and tumor necrosis factor-α levels. METHODS:A total of 30 patients with medial compartment osteoarthritis of the knee who received unicompartmental knee arthroplasty from September 2021 to March 2023 and met the inclusion criteria were selected as the study subjects.Medial angle of proximal tibia,femoral and tibial angle,pain visual analog scale score,hospital for special surgery score,knee joint range of motion,synovial fluid interleukin-1,interleukin-6,and tumor necrosis factor-α levels before and after surgery were compared and statistically analyzed. RESULTS AND CONCLUSION:(1)All 30 patients had grade I wound healing.All patients were followed up for more than 6 months after surgery.There were no complications such as prosthesis loosening and dislocation of prosthesis liner in all patients.(2)The medial proximal tibia angle and the femoral and tibial angles measured after operation were significantly improved(P<0.05).(3)The visual analog scale score,hospital for special surgery score and range of motion measured at 1,3,and 6 months after operation were better than those before operation(P<0.05),and showed a gradual improvement(P<0.05).(4)The levels of interleukin-1,interleukin-6,and tumor necrosis factor-α in synovial fluid at 3 and 6 months after operation were decreased gradually compared with those before operation(P<0.05)and showed a gradual downward trend at each time point after operation.(5)It is indicated that unicompartmental knee arthroplasty can effectively treat medial compartment osteoarthritis of the knee,significantly relieve pain,restore knee joint function,improve knee varus deformity and lower limb strength line,and reduce the levels of inflammatory cytokines interleukin-1,interleukin-6,and tumor necrosis factor-α in joints to a certain extent.

Multimodal fusion research in traditional Chinese medicine （TCM） inspection has greatly improved the accuracy of identification results with the help of emerging technologies in science and technology. At present， multimodal fusion technology is used in the integration of the parameters collected by the inspection instruments and the analysis of the parameters， which is represented by the development and application of the tongue inspection instrument， the face inspection instrument and the eye inspection instrument. However， the multimodal fusion research of TCM inspection has problems such as insufficient comprehensiveness and accuracy of parameter acquisition， difficulty in parameter integration for fusion analysis， and low clinical practicability of identification results. It is believed that， while keeping up with the cutting-edge science and technology， research on multimodal fusion of TCM inspection should be guided by the holism concept of TCM， and should focus on the enhancement of comprehensiveness and accuracy of multimodal parameter acquisition， standardisation of parameter fusion， and fusion of identification results， so as to gradually promote the objectivity， intelligence and modernisation of the four diagnostic methods of TCM.

Objective This study aims to analyze the proteomic characteristics of peripheral blood in patients with lung cancer coexistent with pulmonary tuberculosis(LC-PTB),identify the differential proteins compared with lung cancer(LC)patients,and conduct functional analysis on these proteins.Methods The study included 8 LC-PTB patients and 10 LC patients.The LC patients were newly diagnosed and confirmed by pathology and did not receive any anti-tumor treatment before,while the PTB patients were Mycobacterium tuberculosis positive at the time of sampling.Liquid chromatography-tandem mass spectrometry(LC-MS/MS)was applied to perform proteomic mass spectrometry to assess the differential proteins,and then functional analysis was conducted via bioinformatics.Results A total of 5,185 proteins were detected between two groups.Through differential expression screening,190 proteins(58 upregulated and 132 downregulated)were identified to be differentially expressed.Subcellular localization analysis revealed that the differential proteins were mainly concentrated in the cytoplasm,nucleus,and extracellular matrix.KEGG pathway and GO analysis showed the roles of differential proteins in biological processes including immune response,metabolism,and secretion regulation.Protein interaction network analysis highlighted the importance of SORT1,SAR1B,RPS6KB1,VWF,SHC1,SRPRB,CTSD,TARDBP,RPLP0,PSMA2,RPS6,XPO1,PRKACB,and HLA-DRB1 in LC-PTB.Additionally,the expression changes in proteins like ADA2,MAP3K1,and GLS2 might be closely associated with the development of LC-PTB.Conclusions The proteomic profile comprehensively described the proteomic characteristics of LC-PTB and identified numerous differentially expressed proteins,which could provide further clues for research on biological mechanism of LC-PTB.

The etiology and pathogenesis of autoimmune hepatitis (AIH) remain unclear and are currently considered to be associated with genetic susceptibility and environmental factors. Regulatory T (Treg) cells play an immunosuppressive role by secreting IL-10 and TGFβ, while T helper 17 (Th17) cells mainly promote inflammatory response, suggesting that Treg cells, Th17 cells, and the dynamic balance between them may be involved in the development and progression of AIH; however, further studies are needed to explore related participation mechanisms. This article reviews the association between Treg/Th17 cells and AIH in recent years and elaborates on their mechanism of action and therapeutic targets.

Objective:To explore the clinical features of acute pancreatitis (AP) complicated with portal vein system thrombosis (PVST) and the clinical prediction of symptomatic PVST.Methods:From January 2014 to December 2019, at First Affiliated Hospital and Second Affiliated Hospital of Kunming Medical University, 152 hospitalized patients who met the diagnostic criteria of AP complicated with PVST and had complete clinical data were retrospectively analyzed, and the clinical characteristics of them were analyzed. According to whether there were clinical manifestations caused by PVST (esophago-gastric variceal bleeding, persistent ascites, intestinal ischemia), AP patients complicated with PVST were divided into symptomatic group ( n=48) and asymptomatic group ( n=104). The differences in general information, laboratory test indicators, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), Balthazar computed tomography (CT) score, local and systemic complications were compared between symptomatic group and asymptomatic group. Two independent sample t test, two sample rank sum test, and chi-square test were used for statistical analysis. The binary logistic regression was used for multivariate analysis. Results:The severe acute pancreatitis (SAP) complicated with PVST was common, accounted for 73.0% (111/152), and the hospital mortality rate was 14.5% (22/152). The splenic vein (46.1%, 70/152) was the most common single vessel involved. The hospital stay of the symptomatic group was longer than that of the asymptomatic group, the hospitalization costs and hospital mortality of the symptomatic group were both higher than those of the asymptomatic group ((26.31±19.38) d vs. (15.11±9.31) d, (103 463.68±15 312.74) yuan vs. (37 199.38±4 647.17) yuan, 25.0%, 12/48 vs. 9.6%, 10/104, respectively), and the differences were statistically significant ( t=-3.809 and -4.141, χ2=6.280; all P<0.05). The lactic acid dehydrogenase, C-reactive protein, and prothrombin time of the symptomatic group were all higher than those of the asymptomatic group (4.78 μmol·s -1·L -1, 2.96 μmol·s -1·L -1 to 7.82 μmol·s -1·L -1 vs. 4.42 μmol·s -1·L -1, 3.29 μmol·s -1·L -1 to 9.30 μmol·s -1·L -1; 69.53 mg/L, 29.49 mg/L to 147.14 mg/L vs. 40.90 mg/L, 8.88 mg/L to 104.89 mg/L; (16.88±8.23) s vs. (14.12±1.59) s), however the hematocrit and blood calcium in the symptomatic group were both lower than those of the asymptomatic group ((34.97±8.96)% vs. (39.18±7.17)%, (2.01±0.32) mmol/L vs. (2.17±0.19) mmol/L), and the differences were all statistically significant ( Z=-2.067 and -1.977, t=-2.281, 3.072 and 3.083; all P<0.05). The scores of APACHE Ⅱand Balthazar CT, the rate of local complications of pancreatic necrosis, and systemic complications including abdominal hemorrhage, septic shock, acute respiratory distress syndrome, lung infection and pleural effusion of the symptomatic group were higher than those of the asymptomatic group (7.21±3.84 vs. 5.27±2.31, 7.10±1.57 vs. 4.83±1.87, 87.5%, 42/48 vs. 28.8%, 30/104; 10.4%, 5/48 vs. 1.9%, 2/104; 18.8%, 9/48 vs. 1.9%, 2/104; 25.0%, 12/48 vs. 3.8%, 4/104; 91.7%, 44/48 vs. 60.6%, 63/104; 85.4%, 41/48 vs. 49.0%, 51/104; respectively), and the differences were statistically significant ( t=-3.241 and -7.331, χ2=45.320, 5.393, 13.852, 15.604, 15.323 and 18.191; all P<0.05). The results of binary logistic regression showed that Balthazar CT score was an independent risk factor for symptomatic PVST ( P<0.01), and odds ratio (95% confidence interval) was 1.79 (1.41 to 2.29). Conclusions:Balthazar CT score is an influencing factor of symptomatic PVST in AP patients, and patients with high scores should be treated early to improve the prognosis.