ObjectiveTo observe the clinical efficacy and safety of Huatan Quyu formula in treating cerebral small vessel disease （CSVD） with phlegm and blood stasis blocking collateral pattern via randomized controlled trial， and explore its mechanism of improving CSVD by regulating glymphatic system （GS） circulation. MethodsSixty-eight CSVD patients with phlegm and blood stasis blocking collateral pattern in the Department of Encephalopathy， Affiliated Hospital of Shaanxi University of Chinese Medicine from April to December 2024 were selected and randomly divided into an experimental group （34 cases） and a control group， with 34 cases in each group. Both groups received basic Western medicine treatment， while the experimental group additionally received Huatan Quyu formula. After a course of 12 weeks， the following parameters were compared between the two groups before and after treatment. Clinical outcomes were assessed using the Tinetti performance-oriented mobility assessment （POMA）， Montreal Cognitive Assessment （MoCA）， Scales for Outcomes in Parkinson's Disease-Autonomic （SCOPA-AUT）， and traditional Chinese medicine （TCM） syndrome scores of phlegm and blood stasis blocking collateral pattern. Perivascular space （PVS） in the frontal lobe/basal ganglia and cerebrospinal fluid （CSF） flow parameters in the cerebral aqueduct were evaluated by 3.0T brain MRI， cerebrospinal fluid flow imaging， and phase-contrast magnetic resonance imaging （PC-MRI）. Then， safety indicators were monitored， and SPSS 25.0 was used for statistical analysis. ResultsSixty-four patients completed the study （32 in each group）. ①Baseline data： No statistically significant difference was found between the two group. ②Efficacy indicators： After treatment， the experimental group exhibited significantly improved total POMA， SCOPA-AUT， and TCM syndrome scores （P<0.01）， outperforming the control group （P<0.05）. No significant change was observed in MoCA scores between the two groups. ③Imaging indicators： The experimental group showed a reduced PVS area alongside significantly increased CSF flow parameters （including downward flow during the systolic period， and upward flow during the diastolic period） （P<0.01）， which were superior to the control group （P<0.01）. ④Safety： The laboratory indicators were normal in both groups， with no drug-related adverse reactions. ConclusionFor CSVD patients with phlegm and blood stasis blocking collateral pattern， Huatan Quyu formula can safely and effectively improve motor function， autonomic nerve function， and TCM syndromes， with potential mechanisms related to pulsatile CSF flow enhancement and GS circulation efficiency improvement.

Objective To evaluate the results of anorectal dynamics in patients with severe rec-tocele.Methods A retrospective analysis was conducted on the clinical data of 38 patients defini-tively diagnosed with severe rectocele at the pelvic floor center of the anorectal department of Nanjing Hospital of Traditional Chinese Medicine from January 2020 to January 2023.All patients underwent anorectal manometry,and the results of anorectal dynamics were analyzed.Results A total of 15 pa-tients(39.47％)had elevated anal resting pressure(ARP),20(52.63％)had normal ARP,and 3(7.89％)had decreased ARP.Five patients(13.16％)had elevated maximum anal sphincter pressure(MASP),9(23.68％)had normal MASP,and 24(63.16％)had decreased MASP.Nor-mal defecation relaxation reflex was observed in 15 patients(39.47％),and abnormal defecation re-laxation reflex was observed in 23 patients(60.53％).Ten patients(26.32％)had normal rectal defecation pressure,and 28(73.68％)had decreased rectal defecation pressure.Eleven patients(28.95％)had elevated rectal initial sensory threshold(RIST),27(71.05％)had normal RIST.Fifteen patients(39.47％)had elevated rectal defecation sensory threshold,21(55.26％)had normal rectal defecation sensory threshold,and 2(5.26％)had decreased rectal defecation sensory threshold.Three patients(7.89％)had elevated rectal maximum tolerable volume,26(68.42％)had normal rectal maximum tolerable volume,and 9(23.68％)had decreased rectal maximum tolerable vol-ume.ARP was moderately positively correlated with the chronic constipation severity(CSS)score(P=0.007,r=0.429),and abnormal defecation relaxation reflex was moderately negatively correla-ted with the CSS score(P=0.019,r=-0.329).In 3 patients(7.89％),both ARP and MASP were decreased,and both ARP and MASP were elevated in 5 patients(13.16％).Conclusion Pre-operative anorectal dynamics analysis is necessary for patients with severe rectocele to formulate a reasonable individualized surgical plan and postoperative rehabilitation program.

Objective To analyze the efficacy of modified transvaginal rectal repair(MTVRR)in patients with moderate to severe rectocele(RC).Methods A retrospective analysis was conducted on the clinical data of 21 female patients with RC who underwent MTVRR.The Constipation Scoring System(CSS)scale was used to assess patients'constipation symptoms before surgery and at 3,6,12 and 24 months after surgery,and the efficiency of symptom improvement was recorded.The occurrence of postoperative complications in RC patients was observed.Results All 21 patients successfully un-derwent the surgery,with surgical duration ranging from 25 to 135 minutes,with average of(83.14±30.39)minutes,and hospital stay ranging from 10 to 21 days,with average of(14.10±2.34)days.Postoperatively,one patient was lost during follow-up among 21 patients.The CSS scores of the remai-ning 20 patients were lower than those before surgery,with a statistically significant difference(P＜0.05).The overall effective rates of constipation symptom improvement at 3,6 and 12 months postop-eratively were 100.00％,90.00％and 80.00％,respectively.Among 20 patients,15 patients com-pleted 24-month follow-up after surgery,and the CSS score after surgery was lower than that before sur-gery,the difference was statistically significant(P＜0.05).The CSS scores of the remaining 15 pa-tients were lower than those before surgery,with a statistically significant difference(P＜0.05).The overall effective rate of constipation symptom improvement at 24 months postoperatively was 80.00％among 15 patients.During postoperative follow-up,it revealed that no complications occurred in any patient.Conclusion MTVRR can improve constipation symptoms in patients with RC,demonstra-ting good therapeutic efficacy.

Objective To explore the effects of Emotional Freedom Techniques combined with PERMA model intervention on fear of disease progression and quality of life in postoperative liver cancer patients.Methods A total of 58 liver cancer patients admitted from September 2023 to February 2024 were randomly divided into the experimental group(n=29)and the control group(n=29)using a random number table method.The experimental group received Emotional Freedom Techniques combined with PERMA-based positive psychological intervention,while the control group received the holistic nursing and routine psychological guidance.Both groups underwent the continuous intervention for 8 weeks.Outcomes were assessed using the Fear of Progression Questionnaire-Short Form(FoP-Q-SF),Distress Thermometer(DT),Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Cancer Fatigue Scale(CFS),Athens Insomnia Scale(AIS)and Index of Well-Being(IWB).Results After the intervention,the experimental group showed the significantly lower scores than those in the control group in FoP-Q-SF(24.97±2.34/34.10±8.46),DT(2.24±0.95/2.93±1.33),SAS(49.55±1.35/58.55±4.60),SDS(51.86±1.58/61.79±4.00),CFS(4.03±0.94/5.10±1.18),and AIS(2.45±1.12/4.07±0.96)(all P<0.05),while the IWB score(10.56±1.74/7.39±2.05)was significantly higher than that in the control group(P<0.05).Conclusion The combination of Emotional Freedom Techniques and PERMA model intervention can effectively alleviate the disease-related fears,improve the negative emotions,reduce the physical symptoms and enhance the subjective well-being in postoperative liver cancer patients,and it has a significant clinical application value.

Objective:To establish an inductively coupled plasma mass spectrometry (ICP-MS) method for the rapid determination of total bromine in whole blood, and to provide technical support for the monitoring of bromine exposure in occupational populations.Methods:In September 2023, 0.25 ml of whole blood sample was added with 0.25% tetramethylammonium hydroxide solution to a volume of 5.0 ml, ultrasonicated and homogenized, and then quantified by ICP-MS with rhodium solution as the online internal standard solution.Results:The linear relationship of bromine in blood was good within the range of 0~10.00 mg/L, with a correlation coefficient ( r) >0.999. The limit of detection of the method was 0.07 mg/L, and the quantification limit was 0.22 mg/L. The recoveries of the total bromine in whole blood were in the range of 95.5%-102.9%, and the relative standard deviations (RSDs) were in the range of 3.1%-4.7% ( n=7) . Conclusion:An ICP-MS method was established for the rapid determination of total bromine in whole blood, which is accurate, simple, rapid, highly automated, and can be used for the determination of total bromine in whole blood of occupationally exposed people.

Objective:To investigate the effect of "four-staff co-management" follow-up mode on risk factor control and medium-term prognosis improvement in patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods:This was a intervention study. Patients with coronary heart disease who were admitted to the Xiamen Cardiovascular Hospital of Xiamen University from June 2021 to January 2022 and successfully discharged after PCI were included. According to the different types of follow-up after discharge, patients were divided into the traditional follow-up group and the "four-staff co-management" follow-up group. The "four-staff co-management" follow-up mode means that specialists, specialist managers in third-level A hospitals and general practitioners and health managers in basic hospitals were jointly responsible for post-discharge follow-up of PCI patients. Baseline clinical data were collected. The primary endpoints were the rate of compliance of coronary heart disease risk factor control at 12 months after surgery, the rate of secondary surgery, and the incidence of mid-term major adverse cardiovascular and cerebrovascular events (MACCE). Unplanned secondary PCI included symptom-driven secondary PCI and asymptomatic secondary PCI. MACCE includes myocardial infarction, hospitalization for heart failure, stroke, major bleeding, all-cause death, and composite endpoints including these events.Results:A total of 2 181 patients were enrolled, including 1 097 patients in the traditional follow-up group and 1 084 patients in the "four-staff co-management" follow-up group. At baseline, there were no statistically significant differences in gender, age, discharge diagnosis, co-existing diseases, echocardiographic indexes, and coronary artery lesions between the two groups (all P>0.05). There were no significant differences between the two groups in total PCI stent length, maximum internal diameter of stent, proportion of patients using drug balloon, proportion of patients with a planned second surgery during hospitalization, and discharge with drugs (all P>0.05). Twelve months after PCI, the reduction in HbA1c and low-density lipoprotein cholesterol was greater in the "four-staff co-management " follow-up group than that in the traditional follow-up group (all P<0.05), and the rate of reaching the standard for low-density lipoprotein cholesterol was higher than that in the traditional follow-up group ( P=0.001), but there was no statistical significance between the two groups for blood pressure and blood glucose (all P>0.05). During the follow-up period, the proportion of symptom-driven second operation patients was lower in the "four-staff co-management" follow-up group than that in the traditional follow-up group ( P<0.001), and there was no significant difference in the proportion of asymptomatic second operation patients between the two groups ( P=0.191). The proportion of hospitalized patients with heart failure in the "four-staff co-management" follow-up group was lower than that in the traditional follow-up group ( P=0.029), and there was no significant difference in the proportion of myocardial infarction, cerebral infarction, cerebral hemorrhage, massive hemorrhage, death and complex endpoint events between the two groups (all P>0.05). Conclusion:The "four-staff co-management" follow-up mode can effectively improve the control of risk factors and medium-term prognosis in patients with coronary heart disease after PCI.

Objective:To analyze the iodine nutrition status of children and adolescents and influencing factors in Zhejiang Province, providing scientific basis for optimizing iodine deficiency disorders (IDD) prevention and control strategies.Methods:In June 2022, a multistage stratified sampling method was used to divide 16 counties (cities, districts, abbreviated as counties) in Zhejiang Province into three categories based on their geographical locations (average distance from the coastline): coastal areas (including Dinghai District, Jiaojiang District, Sanmen County, Cixi City and Lucheng District), sub-coastal areas (including Wuxing District, Haining City, Linping District, Fuyang District and Fenghua District), and inland areas(including Suichang County, Changshan County, Shengzhou City, Jindong District, Dongyang City and Yongjia County). One county was selected from each category, and one township (street) was selected from each county. Two administrative villages (neighborhood committees) were selected from each township (street). Ten households including all children and adolescents aged 6-17 in each household were selected from each administrative village (neighborhood committee). Demographic information and personal dietary characteristics were collected via questionnaires, while household salt and a random urine sample were tested for iodine level. Trend analysis was conducted using a χ 2trend test, and a multivariate logistic stepwise regression model was used to analyze the influencing factors of urinary iodine levels. Results:A total of 755 children and adolescents aged 6-17 were selected, including 387 males (51.26%) and 368 females (48.74%), with an age of (11.24 ± 3.32) years. There were 269 children and adolescents in coastal areas (35.63%) and 409 children and adolescents in urban areas (54.17%). A total of 755 household salt samples were collected, with a median salt iodine concentration of 21.80 mg/kg. These included 263 non-iodized salt samples, 38 unqualified iodized salt samples, and 454 qualified iodized salt samples. The coverage rate of iodized salt was 65.17% (492/755), and the consumption rate of qualified iodized salt was 60.13% (454/755). The distribution of salt iodine quality among children and adolescents in different geographical locations showed statistically significant differences (χ 2 = 111.95, P < 0.001), with the proportion of non-iodized salt gradually decreasing from coastal areas to inland areas (χ 2trend = 90.17, P < 0.001). A total of 755 urine samples were collected, with a median urinary iodine concentration of 186.60 μg/L. The proportions of urinary iodine < 100, 100-199, 200-299, and ≥300 μg/L were 16.95% (128/755), 37.62% (284/755), 24.37% (184/755), and 21.06% (159/755), respectively. The χ 2trend test revealed a nonlinear positive correlation between salt iodine level and urinary iodine level (χ 2regression = 21.98, P < 0.001; χ 2partial = 6.96, P < 0.001). The frequency distribution of urinary iodine in children and adolescents from different geographical locations and between urban and rural areas showed statistically significant differences (χ 2 = 29.63, 16.56, P < 0.001). Among them, the proportion of children and adolescents with urinary iodine < 100 μg/L gradually decreasing from coastal areas to inland areas (χ 2trend = 6.15, P = 0.013). The results of multivariate logistic regression analysis revealed that sub-coastal regions, inland regions, and urban-rural regions ( OR = 1.57, 1.53, 1.64, 95% CI: 1.11-2.24, 1.03-2.27, 1.17-2.32, P < 0.05) were significantly associated with urinary iodine levels in children and adolescents aged 6-17. Conclusions:In 2022, the iodine nutrition of children and adolescents in Zhejiang Province is generally suitable, but there is a risk of iodine deficiency among coastal children and adolescents. Geographic location and urban/rural areas are influencing factors on iodine nutrition status of children and adolescents in Zhejiang Province.

AIM:To observe the role of enoyl-coenzyme A hydratase/L-3-hydroxyacyl-coenzyme A dehydroge-nase(Ehhadh)in renal tubulointerstitial inflammation in high-fat diet(HFD)fed mice,and to explore its molecular mecha-nism.METHODS:Twenty-four C57BL/6N mice were randomly divided into 4 groups:standard diet(SD)group,HFD group,HFD with Ehhadh overexpression(HFD+Ehh)group and HFD with blank vector(HFD+Vec)group.Each group consisted of 6 mice.The HFD mice were fed with a diet containing 60%fat,20%protein,and 20%carbohydrates for 16 weeks.Briefly,at the end of 8 weeks,the mice in HFD+Ehh or HFD+Vec group were injected with adeno-associated virus 9(AAV9)-Ehhadh or AAV9-vector via the tail vein,and then continued another 8-week HFD feeding.At the end of the experiments,the renal function and morphological changes were observed.The protein expression levels of nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3),caspase-1 p10,interleukin-1β(IL-1β)and IL-18 in the kidney were detected by Western blot and immunohistochemistry.Immunofluorescence staining was used to detect the colocalization of Ehhadh and peroxisomal biogenesis factor 14(Pex14).ELISA was used to detect the content of IL-1β and IL-18 in the urine.Lipid droplet formation in renal tissues was detected by Nile red staining.Absolute quantitative lip-idomic analysis were used to detect the differential lipid species in renal cortices of the mice in SD,HFD and HFD+Ehh groups.RESULTS:Compared with SD group,the expression of Ehhadh protein was significantly decreased in the peroxi-some of renal tubular epithelium cells in HFD-fed mice(P<0.01).Overexpression of Ehhadh significantly improved renal function(P<0.01)and alleviated the morphological changes of renal tubular epithelial cells in HFD group.Moreover,it significantly inhibited the expression of inflammatory cytokines IL-1β and IL-18 and macrophage infiltration in renal tu-bule interstitium of HFD-fed mice(P<0.01).At the same time,Ehhadh overexpression inhibited HFD-induced NLRP3 inflammasome activation(P<0.01).It also attenuated lipid deposition in renal tubular epithelium cells(P<0.01)and promoted the β-oxidation of long-chain fatty acid such as cholesterol and phospholipids in peroxisomes.CONCLUSION:The Ehhadh inhibits tubulointerstitial inflammation by promoting long-chain fatty acid β-oxidation in peroxisomes and in-hibiting the activation of NLRP3 inflammasome in HFD-fed mice.

N⁶-methyladenosine (m⁶A) modification plays a critical role in cell cycle regulation, while the mechanism of m⁶A in regulating mitosis remains underexplored. Here, we found that the total m⁶A modification level in cells increased during mitosis by the liquid chromatography-mass spectrometry/mass spectrometry and m⁶A dot blot assays. Silencing methyltransferase-like 3 (METTL3) or METTL14 results in delayed mitosis, abnormal spindle assembly, and chromosome segregation defects by the immunofluorescence. By analyzing transcriptome-wide m⁶A targets in HeLa cells, we identified polo-like kinase 1 (PLK1) as a key gene modified by m⁶A in regulating mitosis. Specifically, through immunoblotting and RNA pulldown, m⁶A modification inhibits PLK1 translation via YTH N⁶-methyladenosine RNA binding protein 1, thus mediating cell cycle homeostasis. Demethylation of PLK1 mRNA leads to significant mitotic abnormalities. These findings highlight the critical role of m⁶A in regulating mitosis and the potential of m⁶A as a therapeutic target in proliferative diseases such as cancer.
Humans ; Polo-Like Kinase 1 ; Cell Cycle Proteins/metabolism* ; Proto-Oncogene Proteins/metabolism* ; Protein Serine-Threonine Kinases/metabolism* ; Mitosis/physiology* ; HeLa Cells ; Adenosine/genetics* ; Methyltransferases/metabolism* ; RNA, Messenger/metabolism* ; RNA-Binding Proteins/metabolism*

Objective:To investigate the current situation and changing trends of coal-burning-borne endemic fluorosis (coal-burning-borne fluorosis) areas in Henan Province, and evaluate the effectiveness of prevention and control measures.Methods:From 2019 to 2021, monitoring was carried out in all villages affected by coal-burning-borne fluorosis in Henan Province. A simple random sampling method was used to select 30 households in each affected village each year to investigate the use of stoves and the formation of related healthy living behaviors. According to the criteria of "Diagnosis of Dental Fluorosis" (WS/T 208-2011), all children aged 8 to 12 in the affected villages were examined for dental fluorosis. The evaluation for control and elimination of the disease areas was carried out in accordance with the "Evaluation Approach for Control and Elimination of Priority Endemic Diseases (2019 Edition)".Results:From 2019 to 2021, a total of 7 472 households were monitored, the rate of qualified improved stoves were all ≥99.80%, the correct use rate of qualified improved stoves and correct drying of corn and pepper were reached 100%. From 2019 to 2021, the prevalence of dental fluorosis in children was 5.38% (237/4 405), 5.18% (232/4 477), and 3.68% (145/3 937), respectively, showing a declining trend (χ 2trend = 12.73, P < 0.001). The prevalence of dental fluorosis among children in affected villages was less than 15%. From 2019 to 2021, all affected villages in coal-burning-borne fluorosis in Henan Province had met the elimination criteria. Conclusion:Coal-burning-borne fluorosis areas in Henan Province have been continuously eliminated, with significant prevention and control effects, and the disease has been effectively controlled.