ObjectiveTo evaluate the effects of Tongnaoyin on the blood-brain barrier status and neurological impairment in acute ischemic stroke （AIS） patients with the syndrome of phlegm-stasis blocking collaterals by dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI）. MethodsA total of 63 patients diagnosed with AIS in the Jiangsu Province Hospital of Chinese Medicine from October 2022 to December 2023 were enrolled in this study. According to random number table method，the patients were assigned into a control group （32 cases） and an observation group （31 cases）. The control group received conventional Western medical treatment，and the observation group took 200 mL Tongnaoyin after meals，twice a day from day 2 of admission on the basis of the treatment in the control group. After 7 days of treatment，the patients were examined by DCE-MRI. The baseline data for two groups of patients before treatment were compared. The National Institute of Health Stroke Scale （NIHSS） score and modified Rankin Scale （mRS） score were recorded before treatment and after 90 days of treatment for both groups. The rKtrans，rKep，and rVe values were obtained from the region of interest （ROI） of the infarct zone/mirror area and compared between the two groups. ResultsThere was no significant difference in the NIHSS or mRS score between the two groups before treatment. After 90 days of treatment，the NIHSS and mRS scores declined in both groups，and the observation group had lower scores than the control group （P<0.05）. After treatment，the rKtrans and rVe in the observation group were lower than those in the control group （P<0.01）. ConclusionCompared with conventional Western medical treatment alone，conventional Western medical treatment combined with Tongnaoyin accelerates the repair of the blood-brain barrier in AIS patients，thereby ameliorating neurological impairment after AIS to improve the prognosis.

Objective: To investigate the prevalence and influencing factors of hyperuricemia among adults in Xinjiang Uygur Autonomous Region, so as to provide insights into the prevention and intervention of hyperuricemia. Methods: Permanent residents at ages of 18 years and above in 8 counties (cities, districts) of Xinjiang Uygur Autonomous Region were sampled using a multi-stage cluster random sampling method from July 2018 to November. Demographic data, smoking, alcohol consumption, body mass index and serum uric acid were collected through questionnaire surveys, physical examination and laboratory testing. Factors affecting hyperuricemia were analyzed using a multivariable logistic regression model. Results: A total of 4 690 residents were collected, including 2 093 males (44.63%) and 2 597 females (55.37%), and had a mean age of (49.45±14.57) years. There were 1 795 overweight residents (38.27%), 1 198 residents with obesity (25.54%), 983 smokers (20.96%), 1 224 drinkers (26.10%), and 268 residents with hyperuricemia (5.71%). Multivariable logistic regression analysis showed that a higher risk of hyperuricemia was seen among adults who were males (OR=1.409, 95%CI: 1.036-1.917), aged 60 years and above (OR=2.092, 95%CI: 1.495-2.928), had high school education or above (high school, OR=2.003, 95%CI: 1.366-2.937; college and above, OR=4.876, 95%CI: 3.196-7.438), were overweight (OR=2.343, 95%CI: 1.618-3.395) or obese (OR=4.754, 95%CI: 3.291-6.868) and had alcohol consumption (OR=1.494, 95%CI: 1.104-2.020). Conclusion The risk of hyperuricemia may be associated to gender, age, educational level, body mass index and alcohol consumption among adults in Xinjiang Uygur Autonomous Region.

Objective:To describe disability rates of dementia in community residents aged 65 years and over in China,and explore related risk factors of disability.Methods:This study conducted an in-depth data analysis of the China Mental Health Survey.World Health Organization Disability Assessment Schedule 2.0(WHODAS 2.0)was used to assess dementia disability,Community Screening Interview for Dementia(CSID)and Geriatric Mental Status Examination(GMS)were used for dementia screening and diagnosing.Univariate analysis was used to calcu-late the weighted disability rates of dementia in population and in patients,and their population distribution.Multiple linear regression and logistic regression were used to analyze the risk factors of the occurrence of dementia disability and its severity.Results:The weighted disability rate of dementia was 2.1％in population,and 38.6％in pa-tients.The disability rates of comorbid dementia in population and in patients were higher than those of patients with only dementia.Female,older age,lower education level,lower economic status,and lower cognitive test scores in CSID had higher disability rates of dementia in population.Female and urban resident had higher disability rates of dementia in patients.Multiple linear regression showed economic status(β=0.11),gender(β=0.11),age(β=0.10),and treatment in the last 12 months(β=-0.20)were statistically associated with WHODAS 2.0 scores.Multiple logistic regression showed female(OR=2.81)and treatment in the last 12 months(OR=2.38)were statistically associated with disability.Conclusions:Persons with low economic status,female and elderly peo-ple are the high-risk groups for dementia disability.It should be paid attention to prevent dementia and its conse-quential disabilities.

As research delves deeper into the mechanisms of tumor immune responses,studies reveal the importance of microbial com-munities within the tumor microenvironment in tumor progression and their interactions with the host immune system.Intratumoral micro-biota could influence the tumor microenvironment,thereby promoting or inhibiting tumor growth and development.Despite this import-ance,the specific role of intratumoral microbiota impacting cancer immunotherapeutic efficacy remains largely unexplored.A deeper under-standing of the characteristics and biological functions of tumor-specific microbiota heralds a potential revolutionary innovation in cancer treatment.In this review,we introduce the discovery and sources of intratumoral microbiota,also addressing its composition,and discuss tumor tissue characteristics.Moreover,we briefly review the history of cancer immunotherapy development with a particular focus on the research progress concerning the impact of intratumoral microbiota on cancer immunotherapy.Furthermore,we explore emerging strategies that combine targeting intratumoral microbiota with immunotherapy to enhance immune efficacy,inhibit tumor progression,and improve cure rates,anticipating that this approach could represent a new direction for enhancing treatment outcomes and prospects.

Objective:To investigate the influencing factors of prolonged postoperative ileus (PPOI) in patients undergoing pancreaticoduodenectomy (PD) during hospitalization.Methods:The data of 339 patients underwent PD admitted to the Department of Hepatobiliary Surgery of the Second Hospital of Hebei Medical University from January 2018 to September 2023 were retrospectively analyzed, including 204 males and 135 females, aged (60.6±11.2) years. Among the 339 patients, 112 (33.0%) had pancreatic tumors, 94 (27.7%) had Vater ampullary tumors, 82 (24.2%) had common bile duct tumors, and 51 (15.0%) had duodenal tumors. A total of 339 patients with PPOI were included in the PPOI group ( n=43) and those without PPOI were included in the control group ( n=296). The two groups were compared in terms of age, PD operation (open or laparoscopic), gastrojejunostomy (retrocolic or antecolic gastrojejunostomy), grade B or C pancreatic fistula, hypokalemia, and postoperative use of patient-controlled intravenous analgesia (PCIA). The index comparing P<0.05 between the two groups was further included in the multivariate logistic regression analysis to analyze the influencing factors of PPOI in PD patients. Results:There were statistically significant differences in age >70 years, PD operation, gastrojejunostomy, grade B or C pancreatic fistula, hypokalemia, and postoperative use of PCIA between the two groups (all P<0.05). Multivariate logistic regression analysis showed grade B or C pancreatic fistula ( OR=3.17, 95% CI: 1.48-6.82), open surgery ( OR=2.90, 95% CI: 1.35-6.24), retrocolic gastrojejunostomy ( OR=2.47, 95% CI: 1.23-4.95), postoperative usage of PCIA ( OR=2.61, 95% CI: 1.21-5.62), age >70 years ( OR=2.47, 95% CI: 1.71-5.19) had a high risk of PPOI during postoperative hospitalization (all P<0.05). Conclusion:Postoperative grade B or C pancreatic fistula, open surgery, retrocolic gastrojejunostomy (compares with antecolic gastrojejunostomy), postoperative using PCIA, and age >70 years are independent risk factors for PPOI in patients undergoing PD during postoperative hospitalization.

Since outbreak of the coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)at the end of 2019,hundreds of millions of people were infected and millions of people around the world were killed.SARS-CoV-2 is highly prone to present rapid mutations that can render vaccines ineffective.Drug therapy is currently an effective mean to prevent and treat COVID-19,and traditional Chinese medicine therapy based on clinical char-acteristics and syndrome differentiation has played an extremely important role in the prevention and treatment of COVID-19 in China.Therefore,the characteristics and mechanism of the various prescrip-tions via multiple approaches and targets used in the treatment of COVID-19,including drugs with func-tions of heat-clearing,exterior-resolving,aromatic flavor and damp-resolving,and deficiency-tonifying,based on the clinical experience of Chinese traditional medicine in preventing and treating COVID-19,in order to provide reference for the clinical treatment of such diseases with symptomatic prescriptions.

Since outbreak of the coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)at the end of 2019,hundreds of millions of people were infected and millions of people around the world were killed.SARS-CoV-2 is highly prone to present rapid mutations that can render vaccines ineffective.Drug therapy is currently an effective mean to prevent and treat COVID-19,and traditional Chinese medicine therapy based on clinical char-acteristics and syndrome differentiation has played an extremely important role in the prevention and treatment of COVID-19 in China.Therefore,the characteristics and mechanism of the various prescrip-tions via multiple approaches and targets used in the treatment of COVID-19,including drugs with func-tions of heat-clearing,exterior-resolving,aromatic flavor and damp-resolving,and deficiency-tonifying,based on the clinical experience of Chinese traditional medicine in preventing and treating COVID-19,in order to provide reference for the clinical treatment of such diseases with symptomatic prescriptions.

Objective:To explore the effects of predictive nursing combined with integrated medical and care in the perioperative period of vagal nerve stimulation (VNS) for children with epilepsy.Methods:From January to June 2022, 63 children with epilepsy who received VNS in the Neurosurgery Department of the Emergency General Hospital were selected as the study subject by convenience sampling. According to the random number table method, the children were divided into a control group ( n=31) and an observation group ( n=32). The control group adopted conventional nursing, while the observation group adopted a predictive nursing combined with integrated medical and care on the basis of the control group. We observed the postoperative complications, empowerment of family members of children, and nursing satisfaction in both groups. Results:There was no statistically significant difference in the incidence of postoperative complications between the two groups of children ( P>0.05). Before discharge, the nursing satisfaction score of the family members of the observation group was higher than that of the control group, with a statistically significant difference ( P<0.01). The empowerment of the family members of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.01) . Conclusions:The predictive nursing combined with integrated medical and care in the perioperative period of VNS for epileptic children can improve the nursing satisfaction and empowerment of family members of children, and it is valuable for application.

OBJECTIVE: To explore the clinical and genetic characteristics of a Chinese pedigree affected with hereditary dentinogenesis imperfecta (DGI) type II. METHODS: Clinical data of the pedigree members were collected. Genomic DNA was extracted from peripheral blood samples and subjected to whole exome sequencing. RESULTS: Clinical characteristics of the affected family members have included amber teeth along with significant attrition, constricted roots and dentine hypertrophy leading to pulpal obliteration, which were suggestive of DGI type II. All of the affected members were found to have harbored a novel heterozygous c.2837delA (p.Asp946Valfs*368) variant of the DSPP gene which was predicted to be likely pathogenic. CONCLUSION The c.2837delA variant of the DSPP gene probably underlay the disease in this pedigree. Above finding has expanded the variant spectrum of DSPP gene and provided a basis for molecular diagnosis and genetic counseling for this pedigree.
Dentinogenesis Imperfecta/genetics* ; Extracellular Matrix Proteins/genetics* ; Humans ; Mutation ; Pedigree ; Phosphoproteins/genetics* ; Sialoglycoproteins/genetics*

Intervertebral disc degeneration (IDD) refers to the biomechanical and structural changes of intervertebral disc tissues due to the effects of a variety of factors. Theses physical or chemical factors lead to the rupture of the annulus fibrous, protrusion of the nucleus pulposus tissue, compression of the spinal cord and nerve roots and causing the patient's back and leg pain ultimately. Degeneration of intervertebral disc is a common condition in clinical practice, which affects working ability and daily living quality of patients seriously. Due to the change of living habits, the population with IDD tend to be younger recently. The etiology, pathogenesis and diagnosis and interventions of IDD have always been hot topics in spinal surgery. Thus, animal models of IDD close to the human body has a of great clinical significance for exploring the etiology, pathological mechanism and non-surgical treatment of IDD. At present, the establishment of IDD model mainly includes two following aspects, in vitro model and in vivo model. There are two main in vitro models, cell culture and tissue or organ culture. There are seven kinds of in vivo models, which can be divided into two categories, namely spontaneous and induced model. Among them, the spontaneous degeneration model is also regarded as age-related degeneration, while the induced model refers to the construction of the animal model of IDD by injuring the structure of the intervertebral disc, changing the biomechanical structure of the vertebral body, development spinal instability caused by surgery or constructing nerve root compression and gene knockout. Although there are many methods of animal modeling and literature reports, each method has its own advantages and disadvantages. The advantages and disadvantages should be weighed when choosing the animal models.