The movement of wei qi （defensive qi） follows the circadian rhythm of "circulating on the yang during the day， and on the yin at night" and serves a defensive function to "protect the body". Guided by the theory of wei qi， it is believed that time rhythms and the immune system play significant roles in the pathogenesis of ulcerative colitis （UC）. Dysfunction in wei qi circulation， particularly when "yang fails to enter yin，" can lead to the onset of UC； the cyclical nature of wei qi's movement results in disease patterns characterized by "morning relief， daytime stability， evening aggravation， and nighttime worsening"， which align with the rhythmic characteristics of immune responses. The defensive function of wei qi is crucial in maintaining intestinal immunity of patients with UC， and the spleen and stomach， which are the sources of wei qi， are key to sustaining intestinal mucosal immune homeostasis； additionally， obstruction in the ascending and descending movements of wei qi， internal disruption， and latent pathogen in the intestines lead to the development of UC. Based on the theory of wei qi， treatment approaches for UC are proposed， including time-based dietary adjustments and chronotherapy to harmonize human activities with natural rhythms； these approaches emphasize protecting the spleen and stomach while also considering the lungs and kidneys， balancing sanjiao， and harmonizing ying qi and wei qi， so as to improve the clinical effectiveness of UC treatment.

OBJECTIVE To provide standardized whole-process guidance on drug traceability codes for medical institutions in Sichuan province， ensuring medication safety and compliance with medical insurance supervision requirements. METHODS Based on evidence-based principles and expert consensus， Expert Consensus on Whole-process Management of Drug Traceability Codes in Medical Institutions of Sichuan Province （hereinafter referred to as the Consensus） was formulated through systematic literature review， field investigations， establishment of a multidisciplinary expert committee and multiple rounds of questionnare consultation via the modified Delphi method， and finalized through consensus meetings. RESULTS & CONCLUSIONS The Consensus clarifies key operating procedures for code verification， code assignment and code return， whole-process operational standards for drug warehouse acceptance and storage， drug warehouse outbound delivery and pharmacy acceptance check， drug distribution and dispensing in pharmacy and intravenous admixture center， medication administration in nursing units and examination departments， as well as drug return process. Key recommendations are proposed such as improving the core functions of the drug traceability system， unifying the hospital-wide traceability code database， strengthening the management of traceability codes for backup medications， establishing a management organization and institutional framework， and optimizing the architectural design and data governance requirements of the drug traceability system. The release of the Consensus will provide scientific， standardized and implementable practical guidelines for medical institutions of Sichuan province， helping to improve closed-loop management of the drug traceability system， strengthen medication safety and fulfil medical insurance fund supervision.

AIM:To investigate the role of serum high-sensitivity C-reactive protein(hsCRP)in the pathogenesis and progression of diabetic retinopathy(DR)in patients with type 2 diabetes mellitus(T2DM).METHODS:A nested case-control study was conducted involving 187 T2DM patients(187 eyes)who attended at Eye Center, Beijing Tongren Hospital, Capital Medical University from June 2017 to October 2024. Patients were categorized into three groups: the diabetes mellitus(DM)group, non-proliferative DR(NPDR)group, and proliferative DR(PDR)group. Baseline information was collected, including age, sex, duration of DM, and duration of hypertension. All patients underwent fasting biochemical tests and comprehensive ophthalmic examinations.RESULTS: A positive correlation was observed between hsCRP and fasting blood glucose(FBG; P=0.004)and glycated hemoglobin A1c(HbA1c; P=0.048)by Spearman's rank correlation coefficient analysis. After adjusting for confounding factors, multivariable Logistic regression identified hsCRP as a significant risk factor for DR(OR=2.67, 95% CI: 1.19-5.96, P=0.017). CONCLUSION:Serum hsCRP is positively correlated with FBG and HbA1c and can serve as an important predictor of the severity of DR.

Objective To explore the effects of S100 calcium-binding protein A9 (S100A9) gene knockout on the phenotype of systemic lupus erythematosus (SLE) in mice and to clarify the role of S100A9 in the pathogenesis of SLE. Methods Ten female C57BL/6 wild-type and S100A9 knockout (S100A9-KO ) mice were selected, with five wild-type and five S100A9-KO B6 mice receiving imiquimod (IMQ) cream to establish SLE mouse model. The other five wild-type and five S100A9-KO B6 mice were treated as control groups by wiping the skin of the right ear with a cotton swab. After 8 weeks, the mice were sacrificed. The serum was collected from each mouse to detect the levels of anti-double-stranded DNA (dsDNA) antibodies, immunoglobulin G (IgG), B cell activating factor (BAFF), and interleukin 6 (IL-6) using ELISA. The levels of serum creatinine were determined using a sarcosine oxidase method. Urine was collected to measure urinary protein concentration. Kidneys were collected and stained with hematoxylin and eosin (H&E) for evaluating histological changes. Results After IMQ treatment, the length and weight of spleen, levels of serum creatinine, anti-dsDNA antibodies, IgG, BAFF, IL-6, and urinary protein in the IMQ B6 group and IMQ S100A9-KO B6 group were significantly higher than those of the control groups. Lupus-like changes including increased glomerular volume and tubular epithelial swelling were observed in kidneys from the IMQ and IMQ S100A9-KO groups. However, compared with the IMQ B6 group, the IMQ S100A9-KO B6 group exhibited milder levels of serum and urine indicators as well as the lupus-like symptoms. Conclusion IMQ could induce lupus-like symptoms in both wild-type B6 mice and S100A9-KO B6 mice, but the lesions in S100A9 knockout mice are milder. Theses results suggested that S100A9 is involved in and promotes the pathogenesis of SLE.
Animals ; Lupus Erythematosus, Systemic/chemically induced* ; Female ; Calgranulin B/genetics* ; Mice, Knockout ; Mice, Inbred C57BL ; Phenotype ; Mice ; Interleukin-6/blood* ; Disease Models, Animal ; Antibodies, Antinuclear/blood* ; B-Cell Activating Factor/blood* ; Immunoglobulin G/blood* ; Kidney/pathology*

Objective:To explore the diagnosis and treatment of HIV infection complicated with acute lymphoblastic leukemia.Methods:The diagnosis and treatment of a patient with HIV infection and ALL who was admitted to Tianjin People's Hospital on February 13, 2021 were retrospectively analyzed, and the experience was summarized and the literature was reviewed.Results:The patient had a history of HIV infection for more than 3 years, and was diagnosed as acute lymphoblastic leukemia, and was treated with VCP (Vindesine 2 mg on days 1, 8, 15, 22, cyclophosphamide 600 mg on days 1-2, 15-16, dexamethasone 9 mg on days 1-14, 5 mg. 15-28 days) and died on the 8th day of chemotherapy. The cause of death was infection.Conclusion:Combined chemotherapy and hematopoietic stem cell transplantation on the basis of highly active antiretroviral therapy can improve the prognosis and survival rate of HIV-infected patients with acute lymphoblastic leukemia.

Recent research has presented emerging evidence of the involvement of intercellular communication, neuroplasticity, neuroinflammation, epigenetics and neural regeneration in the pathogenesis of mental disorders. Exosomes are nano-sized membrane vesicles secreted by different types of cells and contain a diverse suite of biomolecules including proteins, lipids, nucleic acids, especially micro-ribonucleic acid, and so on. Exosomes have been shown to play crucial roles in cell-to-cell communication and other pathophysiological processes because of their unique ability to carry biofunctional molecules. It may prove that exosomes are involved in the pathogenesis of psychiatric diseases. Moreover, recent findings have revealed that exosomes can be used as potential drug/gene carriers, therapeutic agents, and diagnostic tools. The purpose of this narrative literature review is to discuss the possible role of exosomes in mental disorders, providing strategies for further studies of exosomes as precision medicines and possible diagnostic biomarkers.

Objective:To characterize the distribution characteristics of choroidal thickness in healthy normal subjects and to define the diagnostic cut-off value for pachychoroid.Methods:A cross-sectional study design was carried out.Four hundred and forty-six eyes of 230 healthy subjects from the pachychoroid disease spectrum (PCD) cohort in Beijing Tongren Hospital from April 2018 to June 2021, were enrolled for the choroidal thickness distribution analysis.Three hundred and fourteen eyes of 274 patients with PCD including 149 eyes of 113 patients with central serous chorioretinopathy, 95 eyes of 81 patients with polypoid choroidal vasculopathy, 70 eyes of 60 patients with neovascular age-related macular degeneration, along with 382 eyes of 199 normal subjects matched for refractive error, age and gender with PCD were selected for likelihood ratio analysis.Routine eye examinations including the best corrected visual acuity, intraocular pressure, slit-lamp microscopy, dilated fundus examination and color fundus photography were performed in all subjects.Swept-source optical coherence tomography (SS-OCT) of 9 mm×9 mm scanning mode was used to measure the subfoveal choroidal thickness (SFCT) automatically in nine macular regions according to the Early Treatment Diabetic Retinopathy Study classification system using TOPCON Advanced Boundary Segmentation (TABS) software.Pearson linear correlation analysis and Spearman rank correlation analysis were adopted to evaluate the correlations between SFCT and age, diopter.Multiple linear regression was employed to analyze the factors affecting SFCT.After age and refractive error adjustment, the likelihood ratio test was used to determine the diagnostic cut-off value for pachychoroid.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Beijing Tongren Hospital (No.TRECKY2016-054). Written informed consent was obtained from each subject prior to entering the cohort.Results:A negative correlation was found between SFCT and age in normal eyes ( r=-0.34, P<0.001), in both normal male and female subjects ( r=-0.43, P<0.001; r=-0.38; P<0.001). A weak positive correlation was found between SFCT and diopter ( rs=0.19, P<0.001). It was found that age and diopter were strongly correlated with SFCT (both at P<0.001). The cut-off values for pachychoroid in 20-39 years group, 40-59 years group, 60-79 years group and ≥80 years group were 320-330 μm, 330-340 μm, 250-275 μm and 200-225 μm, respectively.The percentages of eyes with pachychoroid in 20-39 years group, 40-59 years group and ≥60 years group were 14.71%(10/68), 24.48%(47/192) and 28.89%(55/184), respectively, showing statistically significant differences among them ( χ2=6.170, P=0.046; LR=6.579, P=0.037). The proportion of pachychoroid in ≥60 years group was significantly higher than that of 20-39 years group, showing a statistically significant difference ( χ2=5.982, P=0.014; LR=6.479, P=0.011). Conclusions:The distribution characteristics of pachychoroid vary in normal subjects over age.Age and diopter are the independent influencing factors of SFCT.

Recent research has presented emerging evidence of the involvement of intercellular communication, neuroplasticity, neuroinflammation, epigenetics and neural regeneration in the pathogenesis of mental disorders. Exosomes are nano-sized membrane vesicles secreted by different types of cells and contain a diverse suite of biomolecules including proteins, lipids, nucleic acids, especially micro-ribonucleic acid, and so on. Exosomes have been shown to play crucial roles in cell-to-cell communication and other pathophysiological processes because of their unique ability to carry biofunctional molecules. It may prove that exosomes are involved in the pathogenesis of psychiatric diseases. Moreover, recent findings have revealed that exosomes can be used as potential drug/gene carriers, therapeutic agents, and diagnostic tools. The purpose of this narrative literature review is to discuss the possible role of exosomes in mental disorders, providing strategies for further studies of exosomes as precision medicines and possible diagnostic biomarkers.

Objective:To investigate the relationship between hypertension with hyperhomocysteinemia (HHcy) and early neurological deterioration (END) in patients with intracerebral hemorrhage.Methods:Patients with acute intracerebral hemorrhage admitted to the Department of Neurology, the First People's Hospital of Huainan from January 2017 to December 2018 were enrolled prospectively. END was defined as the National Institutes of Health Stroke Scale (NIHSS) score increased by ≥4 or Glasgow Coma Scale (GCS) score decreased by ≥2 at any time within 72 h after onset from baseline. The baseline data of the END and non-END groups were compared, and multivariate logistic regression analysis was use to evaluate the independent risk factors for END. Results:A total of 238 patients with acute intracerebral hemorrhage were enrolled, and 64 of them (26.9%) developed END. The baseline hematoma volume, NIHSS score, blood glucose, homocysteine level, neutrophil count, and the proportion of hypertension, hemorrhage into ventricle and hematoma enlargement in the END group were significantly higher than those in the non-END group, while the baseline GCS score was significantly lower than that in the non-END group (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for the confounding factors, the baseline hematoma volume (odds ratio [ OR] 1.086, 95% confidence interval [ CI] 1.029-1.146; P=0.003), baseline GCS score ( OR 0.420, 95% CI 0.245-0.719; P=0.002) and hypertension with HHcy ( OR 2.441, 95% CI 1.185-5.029; P=0.016) had significant independent correlation with END. Conclusion:Hypertension with HHcy is an independent predictor of END in patients with intracerebral hemorrhage.

Objective To investigate the different exposure and treatment methods for the chorda tympanic nerve in middle ear surgery, and discuss the surgery techniques and the feasibility of the chorda tympanic nerve protection.Methods From September 2013 to March 2016, 155 cases of middle ear surgeries at Zhujiang hospital were included in this study, including 24 cases of type I tympanoplasty, 6 cases of atticotomy and type I tympanoplasty, 22 cases of atticotomy and type II tympanoplasty, 23 cases of canal-wall-up mastoidectomy and tympanoplasty,74 cases of canal-wall-down mastoidectomy and tympanoplasty, 6 cases of stapedotomy.The conditions of exposure and protection of the chorda tympanic nerve in the operation were compared, and their taste function at 3 days to 1 months postoperatively through questionnaires were evaluated.Results The preservation rate of the chorda tympanic nerve was up to 89.03%(138/155).There were 17 cases of chorda tympanic nerve injuries, of which 15 cases suffered hypogeusia with the rate being 88.2%(15/17).In 126 cases of the complete protection of the chorda tympanic nerve, 13 of them appeared hypogeusia at 10.3% (13/126), but they recovered within 1 months postoperatively.One case of delayed facial paralysis occurred in 16 days postoperatively, and recovered completely after 2 weeks of treatment with glucocorticoids.There was a significant difference in the incidence of postoperative abnormal taste between the complete protection of the chorda tympanic nerve and fracture during operation.Conclusion According to the different position and exposure of chorda tympanic nerve, the individual measures should be taken in middle ear surgery to protect the chorda tympanic nerve.