The abnormal accumulation of neutrophil extracellular traps （NETs） can promote the initiation and progression of pancreatic cancer， which is considered a potential therapeutic target for this disease. The Miraculous Pivot·Inquiry About Statement （《灵枢·口问》） have recorded the concept of "defensive qi stagnation". Based on the recognition that the function of defensive qi is similar to the immune function of neutrophils， and combining traditional Chinese medicine theory with clinical practice， it is proposed that the abnormal accumulation of NETs may be a pathological product of "defensive qi stagnation"， with the spleen being the critical site of pathology. Further exploring the application strategy of cleaning spleen and restoring defensive qi method in pancreatic cancer treatment， it is proposed to employ three approaches such as dredging method to eliminate spleen stagnation and inhibit pancreatic cancer proliferation， cleaning method to remove spleen dampness and suppress the inflammatory micro-environment， and tonifying method to strengthen Weiqi and to improve the immune microenvironment， which aims to provide new insights for the clinical treatment of pancreatic cancer with traditional Chinese medicine.

Objective: To analyze the trend in burden of rheumatoid arthritis (RA) in China from 1990 to 2021, so as to provide insights into reducing the RA burden in China. Methods: Data of Global Burden of Disease Study 2021 were collected, and the incidence, mortality and disability-adjusted life years (DALY) of RA in China from 1990 to 2021 were analyzed and compared with global and different Socio-demographic Index (SDI) regions. The trend in burden of RA was analyzed using average annual percent change (AAPC). Results: The crude incidence rates of RA in China increased from 10.87/105 in 1990 to 17.38/105 in 2021, the crude mortality rates increased from 0.41/105 to 0.72/105, and the crude DALY rates increased from 34.26/105 to 58.61/105, with the increases of 59.98%, 77.95% and 71.06%, respectively. From 1990 to 2021, the standardized incidence rates of RA in China showed an increasing trend (AAPC=0.545%, P<0.05), the standardized mortality rates showed a decreasing trend (AAPC=-0.783%, P<0.05), and the standardized DALY rates showed no significant trend (AAPC=-0.017%, P>0.05). In 2021, the standardized incidence rate, standardized mortality rate and standardized DALY rate of RA were higher in females than in males; from 1990 to 2021, the standardized DALY rates of RA showed a decreasing trend in females (AAPC=-0.200%, P<0.05) and an increasing trend in males (AAPC=0.316%, P<0.05). The crude incidence rates of RA first increased and then decreased with age in 2021, reaching the highest in the age group of 75-<80 years at 34.36/105. Both the crude mortality rates and the crude DALY rates increased with age, reaching the highest in the age group of 95 years and older at 26.72/105 and 285.67/105, respectively. The standardized incidence rates and standardized DALY rates of RA in China in 2021 were lower than those in high SDI regions, while the standardized mortality rate was lower than that in medium-low SDI regions. Conclusions The burden of RA in China from 1990 to 2021 showed an upward trend, and was at a high level compared to different SDI regions. Higher disease burden of RA was seen in females and the elderly.

ObjectiveTo investigate the possible mechanism of action of Xibining Formula （膝痹宁） for cartilage damage in knee osteoarthritis （KOA） through the cyclic guanosine-adenosine monophosphate synthase （cGAS）- stimulator of interferon genes （STING） signaling pathway. MethodsFifty C57BL/6J mice were randomly divided into five groups （10 per group）， sham operation group， KOA model group， low-dose Xibining Formula group， high-dose Xibining Formula group， and high-dose Xibining Formula + agonist group. The KOA models were constructed using the destabilization of the medial meniscus （DMM） method in all groups but the sham surgery group. Two weeks after surgery， the low- and high-dose Xibining Formula groups were administered Xibining Formula at doses of 3.58 g/（kg·d） and 14.32 g/（kg·d） respectively via gavage. The high-dose Xibining Formula + agonist group received 14.32 g/（kg·d） of Xibining Formula via gavage followed by an intraperitoneal injection of Vadimezan （DMXAA） at 25 mg/kg. The sham surgery group and the KOA model group mice were given an equivalent volume of normal saline at 5 ml/（kg·d） via gavage， once daily for four consecutive weeks. Serum levels of tumor necrosis factor-alpha （TNF-α）， interleukin-1β （IL-1β）， and interleukin-6 （IL-6） were measured by ELISA； pathological changes in cartilage tissue were observed using hematoxylin-eosin （HE） staining and Safranin O-Fast Green staining. Pathological changes were scored according to the Mankin scoring system； the levels of cartilage tissue matrix regulation-related indicators such as matrix metalloproteinase 3 （MMP3）， matrix metalloproteinase 13 （MMP13）， a disintegrin and metalloproteinase with thrombospondin motifs 5 （ADAMTS）， type-Ⅱ collagen （CⅡ） and aggregated proteoglycan （Aggrecan）， and also cGAS-STING pathway-related protein and mRNA expression levels were detected by Western blot and qPCR methods. ResultsCompared with the sham surgery group， the KOA model group showed severe cartilage edge destruction， significantly increased Mankin scores， significantly decreased protein and mRNA expression levels of COLⅡ and Aggrecan， and significantly increased protein and mRNA expression levels of cGAS， STING， MMP3， MMP13， and ADAMTS5 （P＜0.01）. Compared with the control group， serum level of IL-6， IL-1β， TNF-α in all the intervented groups decreased （P＜0.01）， while compared with high-dose Xibining Formula group， level of IL-6， IL-1β， and TNF-α in low-dose Xibining Formula group and high-dose Xibining Formula + agonist group increased （P＜0.01）. Compared with the KOA model group， all the intervention groups exhibited alleviated cartilage pathological changes， signi-ficantly reduced Mankin scores， significantly increased protein and mRNA expression levels of COLⅡ and Aggrecan， and significantly decreased protein and mRNA expression levels of cGAS， STING， MMP3， MMP13， and ADAMTS5 （P＜0.01）. Compared with high-dose Xibining Formula group， high-dose Xibining Formula + agonist group showed cartilage edge destruction， significantly increased Mankin scores， significantly decreased protein and mRNA expression levels of COLⅡ and Aggrecan， and increased protein and mRNA expression levels of cGAS， STING， MMP3， MMP13， and ADAMTS5 （P＜0.01）. ConclusionXibining Formula may improve KOA cartilage damage by inhibiting the cGAS-STING signaling pathway， decreasing matrix degradation-related proteins， and elevating matrix composition-related proteins.

Objective: To investigate the mediating role of children s sleep quality in the association between mother-child relationship and the executive function of preschool children, providing a reference for promoting the development of the executive function of preschool children. Methods: A stratified cluster sampling method was used to select 842 preschoolers from 12 kindergartens in Wuhu City, Anhui Province in December 2021 as the subjects of the first follow up study with follow up every six months thereafter. Finally, 746 children were included in the study after 3 follow up. Spearman correlation analysis was used to explore the associations among mother-child relationship, sleep quality and executive function in preschool children. Bootstrap program and PROCESS software were applied to test the mediating effect of sleep quality in the association between mother-child relationship and the executive function of preschool children. Results: Conflictual mother-child relationship was positively correlated with the total score of executive function, as well as scores of inhibitory, shifting, emotional control, working memory, and organizational planning ( r=0.40, 0.37, 0.36, 0.41, 0.38 , 0.34, all P <0.05). Dependent mother-child relationship was positively correlated with the total score of executive function, as well as scores of inhibitory, shifting, emotional control, working memory , and organizational planning ( r=0.23, 0.20, 0.21, 0.22 , 0.22, 0.19, all P <0.05). Sleep quality was positively correlated with the total executive function score ( r=0.27, P <0.01). After adjusting for confounding factors, sleep quality played a partial mediating role in the associations between dependent and conflictual mother-child relationships and executive function, the mediating effects were 19.40% and 11.22% respectively. Conclusions Sleep quality plays a mediating role in the association between mother-child relationship and the executive function of preschool children. Improving sleep quality in the early stage can promote the executive function of preschool children.

OBJECTIVE: To investigate the clinical effect on functional dyspepsia differentiated as liver-stomach disharmony treated with acupoint application of Chinese herbal medicine and wax therapy on the basis of Professor TIAN Conghuo's theory, "regulating qi movement". METHODS: A total of 120 patients with functional dyspepsia of liver-stomach disharmony were randomly assigned to a combined therapy group (30 cases, 1 case dropped out), an acupoint application group (30 cases, 1 case dropped out), a wax therapy group (30 cases, 1 case dropped out) and a basic therapy group (30 cases, 2 cases dropped out). In the basic therapy group, omeprazole magnesium enteric-coated tablets were administered orally, 20 mg each time, once daily. Besides the treatment as the basic therapy group, the Chinese herbal acupoint application was used at Zhongwan (CV12) and Shenque (CV8) in the acupoint application group, and remained for 4 h in each intervention; and in the wax therapy group, wax therapy was delivered at the sites of Zhongwan (CV12) and Shenque (CV8) of the abdominal region and remained for 20 min in each intervention; and in the combined therapy group, the acupoint application was combined with wax therapy, administered once every other day or every two days, 3 times weekly. The duration of treatment was 4 weeks in the four groups. Before and after treatment, the score of main symptoms, the score of 36-item short-form health survey (SF-36) and the score of liver-stomach disharmony pattern were observed; and the clinical effect was evaluated in the four groups. RESULTS: After treatment, regarding main symptoms and liver-stomach disharmony pattern, the score of every item was lower than that before treatment in the 4 groups (P<0.01). The score for each dimension in SF-36 was higher than that before treatment in the combined therapy group and the acupoint application group (P<0.01, P<0.05). In the wax therapy group, the scores for physiological activities, bodily pain, general health, vitality, social activities and mental health in SF-36 were higher than those before treatment (P<0.01, P<0.05). In the basic therapy group, the scores for physiological performance, bodily pain, general health and mental health in SF-36 were higher than those before treatment (P<0.05, P<0.01). After treatment, in the combined therapy group, the score for gastric distension and discomforts was lower than those of the basic therapy group and the wax therapy group (P<0.01), and the scores for gastric fullness in the morning, pain in the upper abdominal region and burning sensation in the upper abdominal region, as well as the score for liver-stomach disharmony pattern were lower than those in the rest 3 groups (P<0.01, P<0.05). In the combined therapy group, the scores for physiological activities, physiological performance, and bodily pain were higher than those of the basic therapy group (P<0.01, P<0.05), the scores for physiological activities and bodily pain were higher when compared with those in the acupoint application group (P<0.01, P<0.05) and the scores for physiological activities and vitality were higher when compared with those in the wax therapy group (P<0.05). After treatment, the score for each item of main symptoms, the score for liver-stomach disharmony pattern in the acupoint application group, and the score for liver-stomach disharmony pattern in the wax therapy group were all lower in comparison with those in the basic therapy group (P<0.01, P<0.05). The total effective rates was 93.3% (28/30), 73.3% (22/30), 66.7% (20/30) and 50.0% (15/30) in the combined therapy group, the acupoint application group, the wax therapy group and the basic therapy group, respectively; and the total effective rate in the combined therapy group was superior to the other 3 groups (P<0.01); the total effective rates in the acupoint application group and the wax therapy group were higher than that in the basic therapy group (P<0.01). CONCLUSION The combination of acupoint application with Chinese herbal medicine and wax therapy, based on Professor TIAN Conghuo's theory of "regulating qi movement", can effectively treat functional dyspepsia, alleviate main symptoms and improve the quality of life in the patients.
Humans ; Acupuncture Points ; Dyspepsia/therapy* ; Male ; Drugs, Chinese Herbal/therapeutic use* ; Female ; Adult ; Middle Aged ; Liver/drug effects* ; Combined Modality Therapy ; Stomach/drug effects* ; Young Adult ; Aged ; Waxes

Identifying drug-drug interactions (DDIs) is essential to prevent adverse effects from polypharmacy. Although deep learning has advanced DDI identification, the gap between powerful models and their lack of clinical application and evaluation has hindered clinical benefits. Here, we developed a Multi-Dimensional Feature Fusion model named MDFF, which integrates one-dimensional simplified molecular input line entry system sequence features, two-dimensional molecular graph features, and three-dimensional geometric features to enhance drug representations for predicting DDIs. MDFF was trained and validated on two DDI datasets, evaluated across three distinct scenarios, and compared with advanced DDI prediction models using accuracy, precision, recall, area under the curve, and F1 score metrics. MDFF achieved state-of-the-art performance across all metrics. Ablation experiments showed that integrating multi-dimensional drug features yielded the best results. More importantly, we obtained adverse drug reaction reports uploaded by Xiangya Hospital of Central South University from 2021 to 2023 and used MDFF to identify potential adverse DDIs. Among 12 real-world adverse drug reaction reports, the predictions of 9 reports were supported by relevant evidence. Additionally, MDFF demonstrated the ability to explain adverse DDI mechanisms, providing insights into the mechanisms behind one specific report and highlighting its potential to assist practitioners in improving medical practice.

Objective To investigate the prevalence of scoliosis and congenital heart disease(CHD)and their correlation among children and adolescents of Drung nationality in Yunnan Province.Methods A cross-sectional survey was conducted in November 2022 among all Drung school-aged children and adolescents aged 5-18 years in Gongshan Drung and Nu Autonomous County,Yunnan Province.Visual inspection,Adams for-ward flexion test,and trunk rotation angle(ATR)measurement were comprehensively used for school prelim-inary screening of scoliosis.Individuals who tested positive in the school preliminary screening underwent fur-ther X-ray examination for auxiliary diagnosis.Cardiac auscultation and echocardiography were used for school preliminary screening of CHD.The personal information of the screening subjects,the screening results,etc.were recorded.The prevalence of scoliosis and CHD among children and adolescents of the Drung nationality and the relationship between the two diseases were statistically analyzed,and the positive predictive value of school-based scoliosis screening and its influencing factors were also analyzed.Results A total of 1 036 chil-dren and adolescents of Drung nationality were enrolled,with a mean age of(10.72±3.75)years,icluding 542 males and 494 females.A total of 45 subjects tested positive for scoliosis in the school preliminary screening,with a preliminary positive rate of 4.34%.A total of 22 cases were finally diagnosed with scoliosis,with a prevalence rate of 2.12%.Among them,21 cases were idiopathic scoliosis(accounting for 95.45%),and 1 case was congenital scoliosis(accounting for 4.55%).The prevalence rate was higher in females(2.83%)than that in males(1.48%),higher in the 10 to 18-year-old group(2.30%)than that in the 5 to<10-year-old group(1.87%),and higher in the secondary school group(2.78%)than that in the primary school group(1.78%),hut there were no statistically significant differences(P>0.05).Most idiopathic scoliosis cases were mild(Cobb angle 10° to<20°,90.48%)and classified as Lenke type Ⅴ(57.14%).Two cases of CHD were confirmed,both of which were atrial septal defects,with a prevalence rate of 0.19%.The co-occurrence rate of idiopathic scoliosis and CHD was 4.76%(1/21).The positive predictive value of school-based scoliosis pre-liminary screening was only 48.89%.When the BMI was<18.5 kg/m2,the positive predictive value was sig-nificantly higher than that for BMI≥18.5 kg/m2(P<0.05).Conclusion The prevalence rate of scoliosis a-mong adolescents of the Drung ethnic group in Yunnan Province is 2.12%,predominantly idiopathic scoliosis,with Lenke type V being the most common classification.The prevalence rate of congenital heart disease is 0.19%.BMI is a significant influencing factor for the positive predictive value of school-based scoliosis prelimi-nary screening.

Objective:To investigate the efficacy and safety of endovascular therapy (EVT) for early neurological deterioration (END) in patients with minor stroke due to acute anterior circulation large vessel occlusion.Methods:Consecutive patients with mild stroke due to acute anterior circulation large vessel occlusion admitted to Mianyang Central Hospital from October 2015 to October 2023 were included retrospectively. Minor stroke was defined as a baseline National Institutes of Health Stroke Scale (NIHSS) score <6. END was defined as an increase of ≥4 in NIHSS score compared to baseline within 12 hours of onset. According to whether EVT was performed or not, they were divided into EVT group and standard medical treatment (SMT) group. At 90 days after onset, the modified Rankin Scale was used to evaluate the outcome. 0-1 was defined as excellent outcome (primary outcome measure) and 0-2 was defined as good outcome (secondary outcome measure). The safety endpoints included symptomatic intracranial hemorrhage (sICH) within 72 hours after EVT and all-cause mortality within 90 days. Multivariate logistic regression analysis was used to determine the correlation between EVT and clinical outcome. Results:A total of 164 patients with minor stroke due to acute anterior circulation large vessel occlusion were included. Eighty-four patients (51.2%) developed END, of which 52 (61.9%) underwent EVT and 32 (38.1%) received SMT; 60 patients (71.4%) had excellent outcome, and 64 (76.2%) had good outcome. There was no significant difference in demographic and baseline clinical data between the EVT group and the SMT group. The excellent outcome rate of the EVT group at 90 days after onset showed a trend higher than that of SMT group (78.8% vs. 59.4%; χ2=3.680, P=0.055), but there was no significant difference in the good outcome rate and safety endpoints between the two groups. Multivariate logistic regression analysis showed that after adjusting for confounding factors, EVT was significantly and independently associated with excellent outcome at 90 days (odds ratio 4.955, 95% confidence interval 1.331-22.284; P=0.024). Conclusion:For patients with minor stroke due to anterior circulation large vessel occlusion who experience END, EVT may improve their functional outcome without increasing the risk of sICH and mortality.

Objective To investigate the correlation between insulin resistance markers[triglyceride-glucose(TyG)index],inflammatory indicators[neutrophil-to-lymphocyte ratio(NLR),C-reactive protein(CRP)],and traditional Chinese medicine(TCM)syndromes in patients with diabetic kidney disease(DKD)complicated by carotid atherosclerosis(CAS).Methods This retrospective study enrolled 300 DKD patients with CAS(case group)and 30 DKD patients without CAS(control group).Differences in TyG index,NLR,and CRP levels were compared between groups.The relationships between these markers and carotid intima-media thickness(IMT)/plaque area were analyzed,along with their variations across TCM syndromes.Logistic regression and receiver operating characteristic(ROC)curve analyses were performed to evaluate the predictive value of TyG index,NLR,and CRP for plaque stability and prognosis.Results(1)The TyG index,NLR,and CRP levels in patients with DKD and CAS were significantly higher than those in patients with DKD alone(P＜0.01).(2)The TyG index,NLR,and CRP were significantly positively correlated with IMT and plaque area(P＜0.01).(3)In patients with DKD combined with CAS,the TyG index,NLR,and CRP levels in those with unstable plaques were significantly higher than those with stable plaques(P＜0.01).(4)Among the distribution of TCM syndromes in patients with DKD combined with CAS,the qi and yin deficiency syndrome had the highest proportion(33.33％),followed by spleen and kidney yang deficiency syndrome(28.67％),yin and yang deficiency syndrome(22.00％),and turbid toxin and stasis obstruction syndrome(16.00％).(5)Among patients with DKD and CAS,the TyG index,NLR,and CRP levels in patients with different TCM syndromes decreased in the following order:turbid toxin and stasis obstruction syndrome,yin and yang deficiency syndrome,spleen-kidney yang deficiency syndrome,and qi and yin deficiency syndrome.(6)Logistic regression analysis results showed that TyG index,NLR,and CRP levels were closely associated with plaque stability in patients with DKD combined with CAS(P＜0.05 or P＜0.01).(7)ROC analysis showed that these markers have high prognostic value in DKD-CAS(P＜0.01).Conclusion TyG index,NLR,and CRP may serve as potential biomarkers for TCM syndrome differentiation and prognosis assessment in DKD-CAS.

Objective To establish a brucellosis monitoring and testing technique applicable for the rapid field screening of natural epidemic diseases.Methods A rapid testing technique for Brucella was developed based on a double-antibody sandwich testing model using gradient-variant quantum dots as fluorescent tracers.The sensitivity,linearity,precision,and specificity of the technique were evaluated using suspensions of standard Brucella strains.Methodological comparisons across different sample types were conducted to assess the consistency of the test results.Results The gradient-variant quantum dots detection method was evaluated with standard Brucella strains,exhibiting a sensitivity of 1×103 CFU/mL and a linear correlation coefficient(r)of 0.994(95%CI,0.933-1.055).The maximum coefficient of variation was 12.94%in repeated tests,showing good specificity.A comparative assessment of 305 clinical samples was conducted using the Brucella gradient-variant quantum dots detection method,the Rose Bengal plate agglutination test(RBT),and the serum agglutination test(SAT),yielding a Kappa value of 0.95,indicating almost perfect agreement.Additionally,a comparative assessment of 110 environmental samples collected on-site was conducted using the Brucella gradient-variant quantum dots detection method and quantitative real-time PCR(qPCR).The Kappa values for aerosol collection fluid,surface wipes,and wool samples were all above 0.83,demonstrating near-perfect agreement.For fecal and soil samples,the Kappa values were above 0.62,indicating substantial agreement.Conclusion The Brucella detection method based on gradient-variant quantum dots technology is simple and can be conducted rapidly.The detection method demonstrates high sensitivity,linearity,precision,and specificity.It shows consistent performance in clinical sample testing.It is well-suited for field rapid screening of natural epidemic diseases in field settings and shows good application prospects in the monitoring,prevention,and rapid detection of zoonotic diseases.