With the deepening of population aging and the rising prevalence of chronic diseases among the elderly in China， the traditional elderly care models are facing challenges. This paper proposed a community-integrated medical-nursing-rehabilitation-care service model， characterized by “integration， flexibility， community orientation， and demand orientation.” This model optimizes and combines various service resources such as healthcare， elderly care， rehabilitation， and nursing at the community level， providing more comprehensive and targeted services for the elderly with chronic diseases in the community. However， a series of challenges existed in dimensions such as the service integration， benefit distribution， resources and funds， as well as policies and systems， hindering the sustainable development of the community-integrated medical-nursing-rehabilitation-care service model. Future efforts should focus on constructing a more standardized collaborative system， clarifying standards for resource investment and benefit distribution， as well as strengthening policy guidance， financial support， and talent team development.

Objective:To explore the research status and hotspots of TCM syndrome differentiation and treatment for headache using bibliometrics.Methods:Literature about TCM syndrome differentiation and treatment for headache was retrieved from CNKI, VIP, Wanfang Data, and CBM from the establishment of the databases to July 18, 2024. Excel 2023 was used to extract information such as publication time, author, unit and keywords of the literature. The authors' affiliation and keywords were preprocessed. VOSviewer software was used for keyword co-occurrence analysis and clustering analysis, and a keyword temporal overlay network was constructed.Results:Totally 1 513 articles were finally included. The journal with the largest number of publications was Henan Traditional Chinese Medicine. 346 authors were involved, initially forming research teams represented with Cao Kegang, Zhou Jianwei, Ni Jinjun, etc., mainly from Beijing University of Chinese Medicine, Henan University of Chinese Medicine, Shandong University of Traditional Chinese Medicine, etc.; the included literature included a total of 2 153 keywords, which the frequency of 5 931 times in total. The top three keywords in frequency were acupuncture and moxibustion therapy, clinical efficacy, and experience of famous doctors. Current research hotspots included data mining, network pharmacology, literature research, syndrome elements, medication law, venturing and bloodletting therapy, calcitonin gene-related peptide, classic prescriptions, nitric oxide, etc. Conclusions:At present, research on TCM syndrome differentiation and treatment for headache mainly focuses on three major sections: acupuncture, moxibustion and massage, clinical efficacy of TCM syndrome differentiation and treatment, and experience of famous doctors. Future research mainly focuses on data mining, medication law, network pharmacology, syndrome elements, and pathogenesis.

Objective: To investigate whether armillariella tabescens polysaccharides (ATPS) alleviates inflamma- tory responses and tissue damage in 5-fluorouracil ( 5-FU ) -induced chemotherapy-induced intestinal mucositis ( CIM) by inhibiting the TLR4 /MyD88 /NF-κB signaling pathway． Methods: Thirty 8-weeks-old male C57BL/6J mice were randomly divided into five groups ( n = 6 per group) : control group，model group ，and ATPS-treated groups (low，medium，high dose : 100，200，400 mg / kg) ．Body weight changes were recorded ; Disease activity in- dex (DAI) scores were evaluated ; small intestinal length and histopathology were measured ; HE staining and his- topathological scoring were performed ; immunohistochemistry was used to detect the expression of tight junction pro- teins (ZO-1，Occludin) in the small intestine ; serum levels of inflammatory cytokines interleukin-6 ( IL-6 ) and tumor necrosis factor-alpha (TNF-α) were analyzed by enzyme-linked immunosorbent assay (ELISA) kit ; Western blot was employed to quantify ZO-1，Occludin，and TLR4 /MyD88 /NF-κB pathway-related protein TLR4，MyD88，NF-κB p65，IκBα , p-NF-κB p65，p-IκBα protein expression． Results : Compared with the control group，mice in the model group exhibited significant reductions in body weight ，elevated DAI scores ，shortened small intestinal length，increased histopathological scores，marked downregulation of ZO-1 and Occludin expression，and elevated levels of inflammatory cytokines TNF-α and IL-6．Additionally，protein expression levels of TLR4，MyD88，p-NF- κB p65，and p-IκBα were significantly upregulated ( all P ＜0. 01 ) ． In contrast ，mice in ATPS-treated groups showed dose-dependent improvements，attenuated weight loss，reduced DAI scores，restored intestinal length，de- creased histopathological scores，upregulated ZO-1 and Occludin expression，reduced TNF-α and IL-6 levels，and downregulated TLR4，MyD88，p-NF-κB p65，and p-IκBα protein expression (all P＜0. 01) ． Conclusion ATPS alleviates 5-FU-induced CIM by inhibiting the TLR4 /MyD88 /NF-κB signaling pathway．

Objective To observe the clinical efficacy of Tongyuan acupuncture in the treatment of acute gouty arthritis.Methods A total of 126 cases of patients with definitive diagnosis of acute gouty arthritis admitted to the wards and outpatient clinics of Guangzhou Nansha District Hospital of Traditional Chinese Medicine from November 2023 to June 2024 were selected as the study subjects.The patients were randomly divided into observation group and control group according to the random number table method,with 63 cases in each group.The control group was given health training and conventional treatment,while the observation group was given Tongyuan acupuncture on the basis of treatment in the control group.Patients in both groups were treated for 14 consecutive days.After two weeks of treatment,the clinical efficacy of the two groups was evaluated.The changes in the clinical symptom scores,the Visual Analogue Scale(VAS)scores of pain,the levels of musculoskeletal ultrasonography(synovial proliferation,blood flow signals,and joint fluid)before and after the treatment were observed in patients of both groups.The changes of blood uric acid(UA),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),tumor necrosis factor α(TNF-α),and interleukin 1(IL-1)before and after treatment were compared between the two groups.Results(1)The total effective rate was 95.24%(60/63)in the observation group and 84.13%(53/63)in the control group.The efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(2)After treatment,the clinical symptom scores and VAS scores of the patients in the two groups were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(3)After treatment,the serum UA,ESR,and CRP levels of patients in the two groups were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(4)After treatment,the TNF-α and IL-1 levels of patients in the two groups were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(5)After treatment,the musculoskeletal ultrasound indicators of the two groups of patients were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).Conclusion Tongyuan acupuncture in the treatment of acute gouty arthritis can significantly improve the clinical symptoms of patients,reduce the level of patients'blood UA and inflammatory factor.

ObjectiveTo investigate the effects of Dihuang Yinzi on the cognitive function in the mouse model of learning and memory impairments induced by scopolamine （SCOP） and explore the treatment mechanism. MethodsA mouse model of learning and memory impairment was induced by intraperitoneal injection of SCOP. Sixty male C57BL/6J mice were randomized into six groups： control （0.9% NaCl， n=10）， model （SCOP 1 mg·kg^-1·d^-1， n=10）， low-， medium-， and high-dose Dihuang Yinzi （SCOP 1 mg·kg^-1·d^-1 + Dihuang Yinzi 5.5， 11.0， and 22.0 g·kg^-1·d^-1， n=10）， and donepezil （SCOP 1 mg·kg^-1·d^-1 + donepezil 0.84 mg·kg^-1·d^-1， n=10）. Mice were administrated with corresponding drugs for 6 weeks. Modeling started in the 4th week， and mice in other groups except the control group were injected with SCOP intraperitoneally 40 min after daily gavage. Behavioral testing began in the 5th week， 30 min after modeling each day. The Morris water maze and novel object recognition tests were carried out to evaluate the spatial learning and memory function of mice. Nissl staining was employed to observe the survival of neurons and Nissl bodies in the hippocampal CA1 region. Western blot was employed to determine the protein levels of silent information regulator 2 （SIRT2）， α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid （AMPA） receptor 1 （GluA1）， protein kinase A （PKA）， cAMP response element-binding protein （CREB）， phosphorylated-CREB （p-CREB）， postsynaptic density protein 95 （PSD95）， growth-associated protein-43 （GAP-43）， and synaptophysin （SYN） in the hippocampus. Immunofluorescence was used to detect the expression of doublecortin （DCX） in the hippocampal dentate gyrus （DG） region. ResultsCompared with the control group， the model group showed impaired learning and memory （P<0.01）， obvious neuronal damage in the hippocampal CA1 region， a reduction in neuron survival （P<0.01）， a decrease in DCX expression in the hippocampal DG region （P<0.01）， down-regulated proteins levels of GluA1， PKA， p-CREB/CREB， PSD95， SYN， and GAP-43 in the hippocampal tissue （P<0.05， P<0.01）， and an up-regulated protein level of SIRT2 （P<0.01）. Compared with the model group， the medium- and high-dose Dihuang Yinzi groups and the donepezil group showed improvements in learning and memory （P<0.05， P<0.01）， while the low-， medium-， and high-dose Dihuang Yinzi groups and the donepezil group had increased neuron survival （P<0.05， P<0.01）. The medium-dose Dihuang Yinzi group and the donepezil group showed increased DCX expression （P<0.05， P<0.01）. The medium- and high-dose Dihuang Yinzi groups and the donepezil group showed up-regulation in the protein levels of GluA1， PKA， p-CREB/CREB， PSD95， SYN， and GAP-43 （P<0.05， P<0.01） and down-regulation in the protein level of SIRT2 （P<0.01）. ConclusionDihuang Yinzi can improve the cognitive function in the mouse model of learning and memory impairments induced by SCOP by inhibiting the upregulation of SIRT2， activating the PKA/CREB signaling pathway， improving synaptic plasticity， and reducing hippocampal neuronal damage.

Background Polycyclic aromatic hydrocarbons (PAHs) are widely known atmospheric pollutants, which can cause serious harm to human body and ecological environment. Objective To analyze the concentrations and sources of PAHs in atmospheric PM_2.5 in Zhifu District and Longkou City during the heating period in Yantai. Methods Two monitoring sites in Zhifu District and Longkou City of Yantai were selected, and PM_2.5 sample collection was carried out from April 2023 to March 2024. Gas chromatography-mass spectrometry was applied to analyze the concentrations of PAHs in atmospheric PM_2.5 during the heating period (from November 2023 to March 2024) and the non-heating period (from April to October 2023). The concentrations of PAHs in the two periods were compared and the sources of PAHs during the heating period were analyzed by characteristic ratio method. Results During the heating period, the total concentration ranges of PAHs in atmospheric PM_2.5 at the monitoring sites in Zhifu District and Longkou City of Yantai were (1.59-23.70) ng·m⁻³ and (2.08-149.72) ng·m⁻³ respectively, and the medians (M) and the 25th and 75th percentiles (P₂₅, P₇₅) were 4.99 (2.61, 8.09) ng·m⁻³ and 15.46 (8.15, 29.05) ng·m⁻³ respectively. The PAHs concentrations in Longkou City were significantly higher than those in Zhifu District in all months (P<0.05). The highest median total concentrations of PAHs in both sites were reported in January (8.14 ng·m⁻³ and 81.56 ng·m⁻³ respectively). In the non-heating period, the M (P₂₅, P₇₅) of the total PAHs concentrations at the two sites were 1.59 (1.59, 2.78) ng·m⁻³ and 4.11 (2.94, 7.97) ng·m⁻³ respectively, much lower than those in the heating period (P<0.01). The order of composition of PAHs by ring number in PM_2.5 at both sites was 4-ring> 5-ring> 6-ring, with the 4-ring contributing the largest proportion (65.33% and 46.39% respectively). Fluoranthene had the highest concentration among PAHs at both sites, with concentrations M (P₂₅, P₇₅) of 1.29 (0.51, 1.78) ng·m⁻³ and 2.32 (1.30, 3.82) ng·m⁻³ respectively. The characteristic ratios of fluoranthene/(fluoranthene + pyrene), fluoranthene/pyrene, benzo[a]anthracene/(benzo[a]anthracene + chrysene), pyrene/benzo[a]pyrene, benzo[a]pyrene/(benzo[a]pyrene + chrysene), benzo[a]pyrene/benzo[g,h,i]pyrene, and indeno[1,2,3-c,d]pyrene/(indeno[1,2,3-c,d]pyrene + benzo[g,h,i]pyrene) in Zhifu District were 0.62, 1.65, 0.41, 4.48, 0.50, 0.93 and 0.47 respectively, and those in Longkou were 0.57, 1.35, 0.40, 2.89, 0.29, 0.79 and 0.47 respectively. The results showed that PAHs pollutants were generated by combination of coal combustion, vehicle exhaust emissions and gasoline combustion. Conclusion During the heating period in Yantai area, the total concentration of PAHs in atmospheric PM_2.5 is significantly higher than that in the non-heating period. Among them, during the heating period, the pollution level in Longkou City is significantly higher than that in Zhifu District. The local PAHs may be sourced from mixed pollution, and the main sources include gasoline, and coal combustion and vehicle exhaust emissions.

Dynamic changes in the physiochemical, structural, and flavor characteristics of ginger-juice milk curd were explored by texture analysis, scanning electron microscopy, rheometry, electronic tongue, and gas chromatography-mass spectrometry (GC-MS). Protein electrophoresis showed that ginger juice could hydrolyze α_s-, β-, and κ-casein. Curd formation was initiated at 90 s, marked by significant changes in intensity detected via intrinsic fluorescence. The contents of soluble protein and calcium decreased rapidly during coagulation, while the caseinolytic activity, storage moduli, loss moduli, hardness, adhesiveness, and water-holding capacity increased, resulting in a denser gel structure with smaller pores and fewer cavitations as observed by scanning electron microscopy. Electronic tongue analysis indicated that milk could neutralize the astringency and saltiness of ginger juice, rendering the taste of ginger-juice milk curd more akin to that of milk. Approximately 70 volatile components were detected in ginger-juice milk curd. α‍-Zingiberene, α‍-curcumene, β‍-sesquiphellandrene, and β‍-bisabolene were the predominant volatile flavor compounds, exhibiting an initial decrease in content followed by stability after 90 s. Decanoic acid, γ-elemene, and caryophyllene were identified as unique volatile compounds after mixing of milk and ginger juice. Understanding the dynamic changes in these characteristics during coagulation holds significant importance for the production of ginger-juice milk curd.
Zingiber officinale/chemistry* ; Milk/chemistry* ; Animals ; Taste ; Gas Chromatography-Mass Spectrometry ; Caseins/chemistry* ; Microscopy, Electron, Scanning ; Rheology ; Flavoring Agents

OBJECTIVE To investigate the impact of Tongxinluo capsules on the pharmacokinetics of rivaroxaban in rats. METHODS Rats were randomly divided into rivaroxaban alone group （2.70 mg/kg）， low-dose Tongxinluo capsules combined with rivaroxaban group （Tongxinluo capsules 0.28 g/kg+rivaroxaban 2.70 mg/kg）， and high-dose Tongxinluo capsules combined with rivaroxaban group （Tongxinluo capsules 0.84 g/kg+rivaroxaban 2.70 mg/kg）， with five rats in each group. Following seven consecutive days of gavage with normal saline or the corresponding doses of Tongxinluo capsules， the rats were subjected to a final gavage administration of rivaroxaban. Blood samples were collected at 0 h prior to the final administration and at 0.16， 0.33， 0.50， 0.75， 1， 1.5， 2， 4， 8， 12 and 24 h post-final administration. The plasma concentration of rivaroxaban in rats was determined by high-performance liquid chromatography-tandem mass spectrometry. The pharmacokinetic parameters [peak concentration （cmax）， half-life （t1/2）， area under the drug concentration time curve （AUC）， mean residence time （MRT）， clearance （CL）， apparent volume of distribution （Vd） and peak time （tmax）] of each group were calculated using a non-compartmental model of MonolixSuite 2023R1 pharmacokinetic software. RESULTS Compared with rivaroxaban alone group， AUC₀₋ₜ and AUC0-∞ of rivaroxaban in rats were increased significantly in high-dose Tongxinluo capsules+rivaroxaban group （P＜0.05）， while CL was decreased significantly （P＜0.05）； t1/2 and MRT were shortened， tmax was extended， cmax was increased， while Vd was decreased， but there was no statistical significance （P＞0.05）. CONCLUSIONS Rivaroxaban combined with Tongxinluo capsules significantly increases the plasma exposure of rivaroxaban in rats. Potential drug-drug interactions should be considered in clinical practice based on the co-administration conditions.

Objective To explore the effect of diet therapy on alcohol-induced chronic liver injury in rats and its relationship with TLR4 pathway.Methods According to Pueraria:Poria:Amomum villosum:Pericarpium Citri Reticulatae:Codonopsis:Zingiberis Rhizoma=15∶15∶10∶10∶10∶6,the water extract of the therapeutic prescription was prepared.A total of 78 female SD rats were randomly divided into 6 groups:normal group(n=12),model group(n=18),Hugan tablet group(0.35 g·kg-1,n=12),low-,medium-and high-dose Shiliaofang groups(2,6,18 g·kg-1,n=12).Except for the normal group,the rats in each group were induced alcoholic liver disease(ALD)by gradient alcohol gavage.After 10 weeks of intervention,the changes of body weight and water intake of rats were observed.The whole blood routine,serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),triglyceride(TG),total cholesterol(TC)and liver malondialdehyde(MDA)were measured.The levels of serum alcohol dehydrogenase(ADH),aldehyde dehydrogenase(ALDH),lipopolysaccharide(LPS),D-lactic acid(D-LA),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-10(IL-10)were detected by enzyme-linked immunosorbent assay.HE staining was used to observe the pathological changes of liver and ileum.Oil red staining was used to observe liver fat deposition.Immunohistochemistry was used to detect the expression of ileal tight junction component occludin.Western blot was used to detect the expression of TLR4,MyD88 and NF-κB p65 protein in liver.Results Compared with the model group,the levels of WBC,LYC,TC,ALT,AST,LPS,D-LA,TNF-α and IL-6 in each diet group decreased,IL-10 increased,liver inflammatory cell infiltration and red lipid droplets decreased,intestinal villi were intact and densely arranged,the expression of occludin protein in ileum increased,and the expression of TLR4,MyD88 and NF-κB p65 protein in liver decreased.Conclusion The self-made dietotherapy prescription has a significant protective effect on chronic liver injury induced by alcohol in rats,which may be related to its down-regulation of TLR4-MyD88-NF-κB p65 protein expression and up-regulation of ileal occludin protein expression,improvement of intestinal mucosal barrier function,reduction of endotoxin entry into the liver,activation of TLR4/MyD88/NF-κB pathway,thereby reducing the second hit to the liver.This diet can be developed as a potential anti-alcoholic liver injury drug.

BACKGROUND:Irisin plays a crucial role in the physiological regulation of the body,advancing the browning process of white adipose tissue cells and exerting significant effects on the regulation of energy metabolism,thermogenesis,reduction of oxidative stress,and body mass loss.OBJECTIVE:To summarize the latest research progress in irisin and related diseases.METHODS:A computerized search of PubMed,MedReading,Web of Science,CNKI,WanFang,and VIP was performed to collect studies on the effect of irisin on relevant diseases.The search time was from January 1,2011 to April 13,2024.The search terms were"irisin,physical exercise,FNDC5,disease"in Chinese and English.According to the inclusion and exclusion criteria,71 papers were finally included for review.RESULTS AND CONCLUSION:Irisin has important roles in anti-inflammation,fat metabolism,bone metabolism,brain health,cancer,diabetes,cardiovascular disease and kidney disease.Moreover,exercise can promote the expression of irisin,and different forms of exercises have different effects on irisin levels.Acute exercise,long-term exercise,resistance exercise and high-intensity exercise can all enhance irisin levels.The discovery of irisin provides a new potential basis for exercise therapy,which is a promising therapeutic target due to the multiple biological functions of irisin,and shows potential therapeutic value in the treatment of human metabolic diseases and their complications,obesity,and cancer.Irisin has a promising application as a potential target for the treatment of obesity,cognitive function,cardiovascular,cancer and other diseases in clinical practice.However,its specific mechanism of action still needs to be studied in depth,and there may be side effects.In the future,an in-depth understanding of the mechanism of irisin is needed to provide a more adequate basis for the treatment of obesity,cognitive dysfunction,cardiovascular disease,and cancer.