ObjectiveThis paper aims to assess the effects of Wenfei Guyuan umbilical moxibustion on the quality of life and immune function in patients with chronic obstructive pulmonary disease （COPD） in stable phase. MethodsA multi-center randomized controlled trial design was employed，and the 220 cases of patients with COPD in stable phase from three grade A class-Ⅲ hospitals were included as research objects. The patients were randomly divided into the test group and control group，with each group consisting of 110 cases. Both groups received standardized treatment of western medicine，and the test group received Wenfei Guyuan umbilical moxibustion twice weekly for 13 weeks，followed by a 26-week follow-up period. Quality of life was evaluated by using the COPD assessment test （CAT），the modified COPD patient-reported outcomes （mCOPD-PRO） measure，and the modified effectiveness satisfaction questionnaire for COPD （mESQ-COPD） before treatment，four weeks， eight weeks， and 13 weeks of the treatment period，as well as 13 weeks and 26 weeks of the follow-up period. The number of acute exacerbation cases of patients in both groups was recorded during study period to evaluate the effect of Wenfei Guyuan umbilical moxibustion on acute exacerbations. 30 cases were randomly selected in both observation group and control group. Peripheral blood samples were collected before treatment and at 13 weeks of treatment. Enzyme-linked immunosorbent assay （ELISA） was used to detect the levels of immunoglobulin A （IgA），immunoglobulin G （IgG），immunoglobulin M （IgM），interleukin 10 （IL-10），interleukin 17A （IL-17A），transforming growth factor β1 （TGF-β1），and tumor necrosis factor α （TNF-α）. Flow cytometry was used to detect cluster of differentiation 4 positive （CD4⁺），cluster of differentiation 8 positive （CD8⁺），T helper 17 （Th17），and Treg levels， thereby preliminarily exploring the effect of Wenfei Guyuan umbilical moxibustion on immune function. ResultsA total of 220 patients were included，with five cases dropping out. 215 cases were finally included in the per-protocol set，including 107 in the treatment group and 108 in the control group. Baseline characteristics of the first two groups before treatment were compared between the two groups. In terms of life quality evaluation， the main effect of group differences on the CAT scores was significant （F=15.108，P<0.01）. The main effects of group differences on the physical domain （F=38.807，P<0.01），psychological domain （F=38.996，P<0.01），environmental domain （F=17.436，P<0.01），and total score of mCOPD-PRO （F=41.972，P<0.01） were significant. The main effects of group difference on clinical symptoms domain of mESQ-COPD （F=81.516，P<0.01），work-life ability domain （F=36.549，P<0.001），environmental adaptation ability domain （F=22.677，P<0.01），therapeutic effect domain （F=74.055，P<0.01），and total score of mESQ-COPD （F=73.251，P<0.01） were significant. Regarding acute exacerbations，during the entire study period，as well as the treatment period and follow-up period，the observation group showed fewer patients experiencing acute exacerbations compared to the control group，but the difference between the two groups was not statistically significant. In terms of immune indicators，after 13 weeks of treatment，the levels of IgA，IgG，and IgM in the observation group were significantly better than those in the control group （P<0.05）. The level of IL-10 was significantly higher than that in the control group （P<0.05），and the levels of IL-17A，TGF-β1，and TNF-α were significantly lower than those in the control group （P<0.05）. Compared with those in the control group，the level of CD4⁺/CD8⁺ in the observation group was significantly increased （P<0.05），while the levels of CD4⁺ and Treg were slightly increased，but the difference was not statistically significant. The levels of CD8⁺，Th17，and Th17/Treg were significantly decreased （P<0.05）. ConclusionWenfei Guyuan umbilical moxibustion can improve the quality of life， and immune function in patients with COPD in stable phase. It is worth promoting in clinical practice.

ObjectiveTo investigate the relationship between the vasodilation and hydrogen sulfide （H₂S） mechanism of total flavonoids of chrysanthemum （TFCC） and the large conductance Ca²⁺- activated K⁺ （BK_Ca） channels on vascular smooth muscle cells （VSMCs） of the middle cerebral artery in rats. In addition， this study will also investigate the effect of TFCC on the expression of BK_Ca channel alpha protein in rat middle cerebral artery VSMCs. MethodsThe primary method employed was acute digestion to isolate VSMCs from the middle cerebral artery of rats； whole-cell patch-clamp techniques were used to measure BK_Ca channel currents； primary tissue adherence culture was utilized to cultivate VSMCs from the middle cerebral artery of rats； Western blot were employed to determine protein expression levels. ResultsIn whole-cell patch-clamp experiments， both the H₂S donor NaHS （100 μmol/L） and endogenous H₂S enhanced BK_Ca channel currents. TFCC （30， 90， and 270 mg/L） also activatedBK_Ca channels and exhibited a certain concentration-dependent effect. Even after blocking endogenous H₂S production， TFCC （270 mg/L） still activated BK_Ca channels in VSMCs of the middle cerebral artery in rats. In Western blot experiments， the α-subunit of BK_Ca channel proteins was expressed in all groups of cells， but TFCC （30， 90， and 270 mg/L） and inhibitor IBTX group did not affect the expression of channel protein content.Conclusion TFCC can promote the opening of BK_Ca channels by promoting the generation of endogenous H₂S， or directly activate BK_Ca channels， thereby playing a role in relaxing cerebral blood vessels. However， TFCC had no significant effect on the expression of BK_Ca channel proteins.

ObjectiveMagnetoencephalography (MEG), a non-invasive neuroimaging technique, meticulously captures the magnetic fields emanating from brain electrical activity. Compared with MEG based on superconducting quantum interference devices (SQUID), MEG based on optically pump magnetometer (OPM) has the advantages of higher sensitivity, better spatial resolution and lower cost. However, most of the current studies are clinical studies, and there is a lack of animal studies on MEG based on OPM technology. Pain, a multifaceted sensory and emotional phenomenon, induces intricate alterations in brain activity, exhibiting notable sex differences. Despite clinical revelations of pain-related neuronal activity through MEG, specific properties remain elusive, and comprehensive laboratory studies on pain-associated brain activity alterations are lacking. The aim of this study was to investigate the effects of inflammatory pain (induced by Complete Freund’s Adjuvant (CFA)) on brain activity in a rat model using the MEG technique, to analysis changes in brain activity during pain perception, and to explore sex differences in pain-related MEG signaling. MethodsThis study utilized adult male and female Sprague-Dawley rats. Inflammatory pain was induced via intraplantar injection of CFA (100 μl, 50% in saline) in the left hind paw, with control groups receiving saline. Pain behavior was assessed using von Frey filaments at baseline and 1 h post-injection. For MEG recording, anesthetized rats had an OPM positioned on their head within a magnetic shield, undergoing two 15-minute sessions: a 5-minute baseline followed by a 10-minute mechanical stimulation phase. Data analysis included artifact removal and time-frequency analysis of spontaneous brain activity using accumulated spectrograms, generating spectrograms focused on the 4-30 Hz frequency range. ResultsMEG recordings in anesthetized rats during resting states and hind paw mechanical stimulation were compared, before and after saline/CFA injections. Mechanical stimulation elevated alpha activity in both male and female rats pre- and post-saline/CFA injections. Saline/CFA injections augmented average power in both sexes compared to pre-injection states. Remarkably, female rats exhibited higher average spectral power 1 h after CFA injection than after saline injection during resting states. Furthermore, despite comparable pain thresholds measured by classical pain behavioral tests post-CFA treatment, female rats displayed higher average power than males in the resting state after CFA injection. ConclusionThese results imply an enhanced perception of inflammatory pain in female rats compared to their male counterparts. Our study exhibits sex differences in alpha activities following CFA injection, highlighting heightened brain alpha activity in female rats during acute inflammatory pain in the resting state. Our study provides a method for OPM-based MEG recordings to be used to study brain activity in anaesthetized animals. In addition, the findings of this study contribute to a deeper understanding of pain-related neural activity and pain sex differences.

OBJECTIVE: This study examines utilizes the advantages of machine learning algorithms to discern key determinants in prognosticate postoperative circulatory complications (PCCs) for older patients. METHODS: This secondary analysis of data from a randomized controlled trial involved 1,720 elderly participants in five tertiary hospitals in Beijing, China. Participants aged 60-90 years undergoing major non-cardiac surgery under general anesthesia. The primary outcome metric of the study was the occurrence of PCCs, according to the European Society of Cardiology and the European Society of Anaesthesiology diagnostic criteria. The analysis metrics contained 67 candidate variables, including baseline characteristics, laboratory tests, and scale assessments. RESULTS: Our feature selection process identified key variables that significantly impact patient outcomes, including the duration of ICU stay, surgery, and anesthesia; APACHE-II score; intraoperative average heart rate and blood loss; cumulative opioid use during surgery; patient age; VAS-Move-Median score on the 1st to 3rd day; Charlson comorbidity score; volumes of intraoperative plasma, crystalloid, and colloid fluids; cumulative red blood cell transfusion during surgery; and endotracheal intubation duration. Notably, our Random Forest model demonstrated exceptional performance with an accuracy of 0.9872. CONCLUSION We have developed and validated an algorithm for predicting PCCs in elderly patients by identifying key risk factors.
Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Cardiovascular Diseases/etiology* ; Machine Learning ; Postoperative Complications/etiology* ; Risk Factors ; Randomized Controlled Trials as Topic ; Secondary Data Analysis

Xiang thinking is a cognitive approach that reflects the relationships between phenomena and their underlying principles by analyzing their external manifestations through methods such as analogy， reasoning， deduction， and symbolism. This article applied xiang thinking to analyze the etiology and pathogenesis of "wind， fire， phlegm， and blood stasis" in stroke， thereby exploring its impact on the principles of syndrome differentiation and treatment of this condition. Meanwhile， the article traced the construction process of xiang thinking， and interpreted the concept of "toxin pathogen" in traditional Chinese medicine from four perspectives， state， attribute， origin， and law. Furthermore， the relationship between the process of constructing xiang thinking and the origin of etiology， identification methods， pathogenesis evolution， and treatment strategies for stroke with syndrome of combined blood stasis and toxin was explored， so as to provide insights into research on the etiology and pathogenesis of stroke， as well as clinical diagnosis and treatment approaches.

Objective To investigate the effects of Nel-like type 1 molecule(NELL-1)on the proliferation and osteogenic differenti-ation of stem cells from human exfoliated deciduous teeth(SHEDs).Methods SHEDs was isolated,cultured,and identified.The third generation SHEDs were used for subsequent experiments.SHEDs were divided into 4 groups,and NELL-1 was added to each group at concentrations of 0(control group),50,100,and 200 ng/mL.Cell activity was measured by CCK-8 assay and crystal violet staining.The changes in osteogenic ability were detected by alkaline phosphatase activity.The expression levels of osteogenesis-related genes ALP,OCN and Runx-2 by RT-qPCR were detected.Western blot was used to detect the expression of osteogenesis-related pro-teins ALP,Runx-2 and Col-Ⅰ.Results SHEDs exhibited stem cell characteristics,and 50 ng/mL of NELL-1 protein had a promo-ting effect on SHEDs proliferation(P＜0.01).Alkaline phosphatase activity assay showed that after the addition of NELL-1,the osteo-genic effect of each group was better than that of the control group and 50 ng/mL of NELL-1 was the best(P＜0.05).RT-qPCR and Western blot results showed that 50 ng/mL of NELL-1 significantly promoted the expression of osteoblast-related genes including ALP,OCN and Runx-2 and the protein expression of ALP,Runx-2 and Col-Ⅰ(P＜0.05).Conclusion NELL-1 can promote the prolifera-tion and osteogenic differentiation of SHEDs.

Objective To investigate the expression of ferritinophagy-related gene ELAV-like RNA binding protein 1(ELAVL1)in multiple myeloma(MM)and elucidate its diagnostic and prognostic value for MM.Methods First,we analyzed ELAVL1 expression level in healthy controls and MM patients using data from the GEO and TCGA databases.Subsequently,bone marrow specimens were collected from 28 newly diagnosed MM patients and 20 healthy controls,and qRT-PCR was employed to validate ELAVL1 expression.The diagnostic and prognostic potential of ELAVL1 was assessed using ROC curve analysis and Kaplan-Meier survival curves.Additionally,univariate and multivariate COX regression analyses were performed to identify independent risk factors for MM prognosis.Finally,KEGG and GO enrichment analyses were performed using the DAVID online platform.Results The level of ELAVL1 expression was significantly higher in newly diagnosed MM patients and refractory/relapsed MM patients than in the healthy controls(P＜0.001).Moreover,ELAVL1 expression was positively correlated with the International Staging System(ISS)stage of MM(P＜0.01).Furthermore,qRT-PCR validation confirmed that ELAVL1 expression was elevated in the 28 newly diagnosed MM patients compared to the 20 healthy controls(P＜0.001).ROC curve analysis demonstrated that ELAVL1 could effectively differentiate between newly diagnosed MM patients,healthy controls,and MGUS patients(P＜0.001 and P=0.000 2,respectively).Survival analysis revealed that high ELAVL1 expression was associated with shorter progression-free survival(P=0.0141)and overall survival(P=0.008 0).Univariate and multivariate COX regression analyses identified high ELAVL1 expression as an independent risk factor for poor MM prognosis(P=0.005 0).KEGG analysis suggested that ELAVL1 might be involved in the Hippo and MAPK signaling pathways.Conclusion High ELAVL1 expression in MM may serve as a biomarker for diagnosis and poor prognosis.ELAVL1 may promote MM initiation and progression via the Hippo and MAPK signaling pathways.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To clarify the natural course of renal angiomyolipoma and the risk factors for its progression.Methods:This was a retrospective case-control study that included 401 patients diagnosed several times by ultrasound examination in the hospital physical examination system from January 2012 to June 2024. All patients were untreated. There were 128 male cases (31.90%) and 273 female cases (68.10%). The average age at initial diagnosis was (44.04 ± 10.24) years (range 22-78 years). The median longest diameter of the tumor at initial diagnosis was 9.0 (7.0, 11.5) mm. There were 359 cases (89.50%) with single tumors and 42 cases (10.50%) with multiple tumors. The patients were divided into the progression group(≥1 mm/year) and the non-progression group (<1 mm/year)based on the average growth rate of tumor. The differences in gender, age at initial diagnosis, initial tumor size, number of lesions and lesion site between the two groups were compared. Univariate logistic regression analysis was used to explore the relationship between the above factors and the progression of renal angiomyolipoma. Multivariate logistic regression analysis was conducted to identify the risk factors for progression.Results:A total of 401 cases were followed up for an average of (88.15 ± 21.09) months (range 48-140 months). The median maximum diameter of the tumors at the initial diagnosis was 9.0 (7.0, 11.5) mm, and at the end of the follow-up, it was 11 (8, 14) mm. The average growth rate was 0.38 mm/year, and the median growth rate was 0.25 (0, 0.60) mm/year. Among them, 341 cases (85.04%) were in the non-progression group with an average growth rate of 0.14 mm/year, and 60 cases (14.96%) were in the progression group with an average growth rate of 1.74 mm/year. The age of the progression group was lower than that of the non-progression group [(41.43 ± 9.64) years vs. (44.50±10.29) years], the initial maximum diameter of the tumors in the progression group was larger than that in the non-progression group [11.0 (8.0, 16.0) mm vs. 9.0 (7.0, 11.0) mm], and the proportion of multiple tumors in the progression group was higher than that in the non-progression group [14 cases (23.30%) vs. 28 cases (8.20%)], and the differences were all statistically significant ( P<0.05). Age at initial diagnosis( OR=0.96, 95% CI 0.93-0.99), initial tumor size ( OR=1.08, 95% CI 1.04-1.12) and number of lesions ( OR=2.96, 95% CI 1.38-6.34) were the risk factors for the growth of renal angiomyolipoma ( P<0.05), according to the results of multivariate logistic regression analysis. Conclusions:The natural history of most renal angiomyolipoma shows slow growth or relative quiescence, with a small number showing a significant increasing trend. Age at initial diagnosis, initial tumor size and number of lesions were independent risk factors for the growth of renal angiomyolipoma.

Objectives:This study aims to investigate the correlation between urinary crystals and the components of urinary calculi in patients with urinary calculi，as well as the accuracy of urine crystals in predicting stone components.Methods:A retrospective analysis was performed on 280 patients with positive urine crystal and urinary calculi from January 2022 to December 2024. There were a total of 280 patients consisting of 185 males and 95 females，aged from 23 to 80 years，with an average age of（49.1 ± 12.3）years. Among them，there were 243 cases of renal stones or both renal and ureteral stones，25 cases of ureteral stones，and 12 cases of bladder stones. In all cases，10 ml of morning urine was collected preoperatively and sent for examination within one hour. After centrifuging at 400 g for 1 minute，the urine sediment was examined under a microscope. All positive crystals were categorized into calcium oxalate，uric acid，calcium phosphate，magnesium ammonium phosphate，and cystine based on the morphology of the crystals. Calculi were collected after endoscopic surgery，calculi composition was analyzed using infrared spectroscopy，and the main component（the first predominant component）was recorded. Statistical analysis was conducted using a 5×5 contingency table to analyze the correlation and contingency coefficient，and the positive predictive values of the urinary crystals for predicting calculi components were calculated. Results:Among the 280 patients，calcium oxalate crystals were found in 241 cases，uric acid in 25 cases，calcium phosphate in 7 cases，magnesium ammonium phosphate in 5 cases，and cystine in 2 cases. The main components of 280 calculi were calcium oxalate in 232 cases，uric acid in 21 cases，calcium phosphate in 24 cases，magnesium ammonium phosphate in 1 case，and cystine in 2 cases. There was a statistically significant correlation between urinary crystals and stone components（ χ2 = 152.46， P < 0.01），and the contingency coefficient between crystals and calculi components was 0.809. The overall positive expected value of urine crystals was 87.5%（245/280），among which the positive expected value of calcium oxalate crystals was 91.7%（221/241），uric acid crystals was 72.0%（18/25），calcium phosphate was 42.9%（3/7），magnesium ammonium phosphate was 20.0%（1/5），and cystine was 100.0%（2/2）. Conclusions:The urinary crystals of patients with calculi are significantly related to the main components of the calculi. Using urinary crystals to predict the components of the calculi has a relatively high accuracy.