ObjectiveBased on the theory of "spleen governing transportation and transformation"， this study investigates the efficacy of Atractylodis Macrocephalae Rhizoma processed with Aurantii Fructus Immaturus juice（AMR-AFI） in improving slow-transit constipation（STC）， as well as the synergistic regulatory mechanism involving the microbiota-metabolism axis， thereby elucidating the scientific basis of its processing theory. MethodsAnimals were randomly divided into the control group， model group， positive drug（mosapride） group（3 mg·kg^-1）， and low-， medium-， and high-dose groups of AMR-AFI（3.9， 7.8， 15.6 g·kg^-1）. Except for the control group， the remaining five groups were induced with STC using loperamide hydrochloride. Following modeling， interventions were administered. All groups received continuous administration for 15 d， during which fecal samples， colon tissue， and serum were collected. Constipation improvement was assessed by measuring fecal moisture content and small intestinal propulsion rate， histological morphology of colonic tissue was observed via hematoxylin-eosin（HE） staining， and the levels of interleukin（IL）-6， tumor necrosis factor（TNF）-α， and IL-2 in serum were detected using enzyme-linked immunosorbent assay（ELISA）. Furthermore， the microbial community structure in mouse feces was analyzed by 16S rRNA sequencing， while transcriptomic sequencing was employed to screen differentially expressed genes in colonic tissue， followed by gene ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） enrichment analyses. Finally， Spearman correlation analysis was conducted to explore the association between differential microbiota and differential genes. ResultsCompared with the control group， the intestinal propulsion rate and fecal moisture content in the model group were significantly decreased（P<0.01）， while serum levels of IL-6， TNF-α， and IL-2 were significantly elevated（P<0.01）. HE staining showed damage and shedding of colonic mucosal epithelial cells， along with a reduction in goblet cells in the model group. In comparison with the model group， all treatment groups improved the pathological state of the colonic mucosa to varying degrees and reduced serum levels of IL-6， TNF-α， and IL-2（P<0.01）. Among these， the high-dose group of AMR-AFI significantly increased the intestinal propulsion rate and fecal moisture content of rats（P<0.05， P<0.01）. Further transcriptomic analysis revealed that a total of 104 differentially expressed genes were identified from comparisons between the model group and the control group， as well as between the model group and the high-dose group of AMR-AFI. These genes were mainly enriched in pathways closely related to STC pathogenesis， such as arachidonic acid metabolism and aldosterone-regulated sodium reabsorption. 16S rRNA sequencing results indicated that AMR-AFI reversed the structural imbalance of the gut microbiota in model mice， increased species richness， downregulated the relative abundance of pro-inflammatory bacteria such as Parasutterella， and enriched beneficial and butyrate-producing bacteria， including Lachnospiraceae_NK4A136_group， Ruminococcaceae， and Lachnospiraceae. Spearman correlation analysis further showed that the beneficial bacteria enriched in the AMR-AFI group were negatively correlated with genes involved in the arachidonic acid metabolic pathway and positively correlated with genes in the aldosterone-regulated sodium reabsorption pathway. In contrast， pro-inflammatory bacteria in the model group exhibited the opposite correlation trends. ConclusionAMR-AFI can effectively exert synergistic therapeutic effects on STC by regulating intestinal microbiota， arachidonic acid-mediated inflammatory metabolism， and aldosterone-regulated water-salt balance pathways.

ObjectiveBased on the theory of "spleen governing transportation and transformation"， this study investigates the efficacy of Atractylodis Macrocephalae Rhizoma processed with Aurantii Fructus Immaturus juice（AMR-AFI） in improving slow-transit constipation（STC）， as well as the synergistic regulatory mechanism involving the microbiota-metabolism axis， thereby elucidating the scientific basis of its processing theory. MethodsAnimals were randomly divided into the control group， model group， positive drug（mosapride） group（3 mg·kg^-1）， and low-， medium-， and high-dose groups of AMR-AFI（3.9， 7.8， 15.6 g·kg^-1）. Except for the control group， the remaining five groups were induced with STC using loperamide hydrochloride. Following modeling， interventions were administered. All groups received continuous administration for 15 d， during which fecal samples， colon tissue， and serum were collected. Constipation improvement was assessed by measuring fecal moisture content and small intestinal propulsion rate， histological morphology of colonic tissue was observed via hematoxylin-eosin（HE） staining， and the levels of interleukin（IL）-6， tumor necrosis factor（TNF）-α， and IL-2 in serum were detected using enzyme-linked immunosorbent assay（ELISA）. Furthermore， the microbial community structure in mouse feces was analyzed by 16S rRNA sequencing， while transcriptomic sequencing was employed to screen differentially expressed genes in colonic tissue， followed by gene ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） enrichment analyses. Finally， Spearman correlation analysis was conducted to explore the association between differential microbiota and differential genes. ResultsCompared with the control group， the intestinal propulsion rate and fecal moisture content in the model group were significantly decreased（P<0.01）， while serum levels of IL-6， TNF-α， and IL-2 were significantly elevated（P<0.01）. HE staining showed damage and shedding of colonic mucosal epithelial cells， along with a reduction in goblet cells in the model group. In comparison with the model group， all treatment groups improved the pathological state of the colonic mucosa to varying degrees and reduced serum levels of IL-6， TNF-α， and IL-2（P<0.01）. Among these， the high-dose group of AMR-AFI significantly increased the intestinal propulsion rate and fecal moisture content of rats（P<0.05， P<0.01）. Further transcriptomic analysis revealed that a total of 104 differentially expressed genes were identified from comparisons between the model group and the control group， as well as between the model group and the high-dose group of AMR-AFI. These genes were mainly enriched in pathways closely related to STC pathogenesis， such as arachidonic acid metabolism and aldosterone-regulated sodium reabsorption. 16S rRNA sequencing results indicated that AMR-AFI reversed the structural imbalance of the gut microbiota in model mice， increased species richness， downregulated the relative abundance of pro-inflammatory bacteria such as Parasutterella， and enriched beneficial and butyrate-producing bacteria， including Lachnospiraceae_NK4A136_group， Ruminococcaceae， and Lachnospiraceae. Spearman correlation analysis further showed that the beneficial bacteria enriched in the AMR-AFI group were negatively correlated with genes involved in the arachidonic acid metabolic pathway and positively correlated with genes in the aldosterone-regulated sodium reabsorption pathway. In contrast， pro-inflammatory bacteria in the model group exhibited the opposite correlation trends. ConclusionAMR-AFI can effectively exert synergistic therapeutic effects on STC by regulating intestinal microbiota， arachidonic acid-mediated inflammatory metabolism， and aldosterone-regulated water-salt balance pathways.

ObjectiveTaking Aurantii Fructus Immaturus juice（AFI）-processed Atractylodis Macrocephalae Rhizoma（AMR） as an example， this study aims to systematically compare the volatile and non-volatile components of AMR and its processed products， investigate the key differential components， evaluate their anti-inflammatory activities， and elucidate the synergistic mechanism of processing. MethodsThe chemical compositions of volatile and non-volatile components in AMR and AFI-processed AMR were systematically characterized using gas chromatography-mass spectrometry（GC-MS） and ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS）， with relative mass fractions and response values determined separately. Volatile components were identified through searches in the National Institute of Standards and Technology（NIST）17 database， comparison with retention index（RI） and fragmentation pattern matching. Non-volatile components were identified by searching Waters Traditional Chinese Medicine （TCM） spectral library， in conjunction with PubChem and MassBank， characteristic fragmentation patterns and response values were also used to support identification. Differential components were screened using principal component analysis（PCA）， orthogonal partial least squares-discriminant analysis（OPLS-DA）， with variable importance in the projection（VIP） value >1. Components with high log₂fold change（FC） among major differential groups were selected as those exhibiting significant changes before and after processing. The anti-inflammatory activity of the differential compounds was evaluated by assessing their effects on nitric oxide（NO） production in a lipopolysaccharide（LPS）-induced RAW264.7 macrophage model. Enzyme-linked immunosorbent assay（ELISA） was used to detect the effects of the differential components on tumor necrosis factor（TNF）-α， interleukin（IL）-1β， IL-6， and monocyte chemotactic protein（MCP）-1 levels， and immunofluorescence（IF） was employed to assess their effects on nuclear transcription factor（NF）-κB p65 translocation， thereby elucidating the underlying molecular mechanisms. ResultsA total of 36 compounds were identified in the volatile components of AMR and AFI-processed AMR， among which， sesquiterpenes and monoterpenes were significantly increased after processing. In the non-volatile components， 36 compounds were identified， and the main differential components were flavonoids， sesquiterpenoids， and triterpenoids. Flavonoids were the primary differential components distinguishing AMR from its processed products， representing compounds directly introduced during processing. Five compounds， including atractylenolide Ⅲ， tangeritin， nobiletin， hesperidin and narirutin， were selected as representatives of three classes based on their most prominent differential expression among different compound types for subsequent anti-inflammatory activity studies. The results showed that 100 μmol·L^-1 tangerine and narirutin could significantly inhibit LPS-induced NO production（P<0.01） in a concentration-dependent manner. Tangeritin was able to significantly inhibit the levels of TNF-α and MCP-1 secreted by RAW264.7（P<0.05）， while narirutin significantly inhibited the levels of TNF-α， IL-1β， MCP-1 and IL-6（P<0.01）. IF revealed that both tangeritin and narirutin significantly blocked the translocation of NF-κB p65 from the cytoplasm to the nucleus. ConclusionAFI-processed AMR significantly alters the chemical composition profile of AMR， and the newly introduced flavonoid components during processing may be key to its enhanced anti-inflammatory effects.

Macrophages are closely related to tumor progression,and can promote tumor growth and pro-liferation by promoting inflammation,angiogenesis and immunosuppression and so on,as well as killing tumors by directly killing tumor cells and triggering specific immune responses.Iron death,as an iron-depend-ent cell death caused by lipid peroxidation,can effectively kill tumor cells when regulated from the perspective of iron homeostasis,and can also release pro-inflammatory factors,trigger inflammatory reactions,change the survival environment of tumors as well as reduce the immune susceptibility of tumor cells.In recent years,more and more studies have shown that macrophages and iron death are closely related.In this paper,the rela-tionship between macrophages and iron death in terms of their functional properties and targeting of tumors are mainly introduced,and an overview of the functional properties of the two differentiated phenotypes of macrophages for the treatment of iron death in tumors is provided.

Objective To analyze the factors influencing iodine nutritional status in pregnant women dur-ing pregnancy,based on thyroid function and thyroid autoantibody levels,and to explore the association between iodine nutritional abnormalities and pregnancy outcomes.Methods A total of 838 pregnant women who underwent routine prenatal checkups at Qinghai Provincial People's Hospital between January 2021 and June 2023 were pro-spectively enrolled in this study.All participants were followed until delivery.Seven cases were lost to follow-up,resulting in a final sample size of 831 participants.Among them,276 were in the first trimester,384 in the second trimester,and 171 in the third trimester.Data on urinary iodine concentration(UIC),urinary creatinine(UCr),thyroid function indicators,and thyroid autoantibodies were collected.Based on their iodine nutritional status,the participants were categorized into either the iodine-sufficient group or the iodine-abnormal group(including iodine-deficient,iodine-hyper-sufficient,and iodine-excessive subgroups).This study analyzed the iodine nutritional sta-tus of pregnant women during different gestational periods,compared thyroid function indices,prevalence of thy-roid diseases,and the positivity rates of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb),and thyroid-stimulating hormone receptor antibody(TRAb)among different iodine status groups.Additionally,ad-verse pregnancy outcomes were compared across groups.Multivariate logistic regression analysis was conducted to identify risk factors associated with iodine abnormalities during pregnancy,and a predictive model was developed to assess its potential predictive value.Results Among the 831 pregnant women included in the study,373 cases(44.89％)exhibited iodine sufficiency,while 458 cases(55.11％)presented with iodine abnormalities,including 282 cases of iodine deficiency,144 cases of iodine hypersufficiency,and 32 cases of iodine excess.No statistically significant differences were observed in the iodine nutritional status across different trimesters(P>0.05).The se-rum level of thyroid-stimulating hormone(TSH)was significantly higher in the iodine abnormal group compared to the iodine sufficient group(P<0.05).Additionally,the iodine abnormal group demonstrated higher positivity rates of TPOAb alone,TGAb,and TRAb,as well as increased incidence of thyroid dysfunction and total adverse pregnancy outcomes compared to the iodine sufficient group(all P<0.05).These adverse indicators were also sig-nificantly elevated in the iodine-deficient,iodine super-sufficient,and iodine overdose subgroups compared to the iodine sufficient group(P<0.05).Elevated serum TSH levels and the presence of TPOAb,TGAb,and TRAb were identified as risk factors for iodine abnormalities during pregnancy(P<0.05).The predictive model con-structed for identifying iodine abnormalities in pregnant women demonstrated an area under the curve(AUC)of 0.876,with a sensitivity of 72.27％and a specificity of 89.01％.Conclusions The prevalence of iodine nutritional abnormalities among pregnant women during pregnancy was high,with most cases presenting iodine deficiency.These abnormalities were associated with thyroid function,thyroid autoimmunity,and pregnancy outcomes,but showed no significant correlation with gestational age.Furthermore,the prediction model developed based on iden-tified risk factors demonstrated effective performance in predicting iodine nutritional abnormalities during preg-nancy.

Objective To explore the effect of ultrasound-guided individualized respiratory management on pulmonary ventilation in neonates with severe respiratory diseases in neonatal intensive care unit(NICU).Methods A total of 96 children with severe respiratory disease in NICU of the hospital were selected as research subjects.According to the random number table method,they were divided into the observation group and the control group,with 48 cases in each group.The control group was treated with routine respiratory management,and the observation group was treated with severe ultrasound-guided individualized nursing management on the basis of the control group.The clinical indexes,blood gas analysis and respiratory dynamics indexes including arterial partial pressure of oxygen[p(O2)],partial pressure of carbon dioxide[p(CO2)],arterial blood pH,airway resistance,chest lung compliance and severity of disease[pediatric critical illness score(PCIS),simple neonatal acute physiology score II(SNAP-II)]and occurrence of complications were compared between the two groups before and after intervention.Results The mechanical ventilation time,antipyretic time,white blood cell count(WBC)recovery time,ICU stay and hospitalization time were significantly shorter in the observation group than those in the control group(P＜0.05).After intervention,p(O2),pH and chest lung compliance were significantly increased in the two groups(P＜0.05),while p(CO2)and airway resistance were significantly decreased(P＜0.05).Moreover,the improvement was better in the observation group than that of the control group.After intervention,the PCIS scores were significantly increased in both groups(P＜0.05),while the SNAP-II scores were significantly reduced(P＜0.05),and the improvement was better in the observation group than that of the control group(P＜0.05).The total complication rate was significantly lower in the observation group than that in the control group(P＜0.05).Conclusion Severe ultrasound-guided individualized respiratory management can significantly enhance the pulmonary ventilation of NICU children with severe respiratory disease,improve the blood oxygen status and accelerate the improvement of disease condition.

Objective To analyze the latent classes of social alienation in colorectal cancer patients and further explore the influencing factors and cumulative effects of risk factors across different classes,thereby providing a reference for individualized interventions.Methods Convenience sampling was used to select colorectal cancer patients hospitalized in the gastrointestinal surgery and oncology departments of 3 tertiary-level hospitals in Shandong Province from January to June 2023 as the study subjects.A questionnaire survey was conducted using the General Information Questionnaire,Social Avoidance Scale,Social Anxiety Scale,UCLA Loneliness Scale,Sense of Coherence Scale,Family Cohesion Scale,and Social Support Rating Scale.Data analysis was performed using latent profile analysis and multivariate logistic regression analysis.Results A total of 292 questionnaires were distributed,with 270 valid responses collected,yielding a response rate of 92.47％.The results of the latent profile analysis indicated that social alienation among colorectal cancer patients could be categorized into 3 latent groups:the"low alienation group"(42.59％),the"high alienation-high social avoidance group"(14.08％),and the"moderate alienation-high social anxiety group"(43.33％).Results of logistic regression analysis revealed that employment status,stoma status,metastasis,sense of coherence,family cohesion,and social support were influencing factors across different categories.Moreover,a cumulative effect of sense of coherence,family cohesion,and social support on distinct categories was observed(P＜0.05).Conclusion Social alienation among colorectal cancer patients exhibits group heterogeneity.Healthcare professionals should identify the characteristic differences among patients,prioritise those with multiple risk factors,and develop targeted intervention measures to help them better integrate into society.

Objective:To establish a similarity measurement model for patients with dentofacial deformity based on 3D craniofacial features and to validate the similarity results with quantifying subjec-tive expert scoring.Methods:In the study,52 cases of patients with skeletal Class Ⅲ malocclusions who underwent bimaxillary surgery and preoperative orthodontic treatment at Peking University School and Hospital of Stomatology from January 2020 to December 2022,including 26 males and 26 females,were selected and divided into 2 groups by sex.One patient in each group was randomly selected as a reference sample,and the others were set as test samples.Three senior surgeons rated the similarity scores between the test samples and the reference sample.Similarity scores ranged from 1 to 10,where 1 was completely different,and 10 was exactly the same.Scores larger than 7.5 was considered as clinical-ly similar.Preoperative cone beam computed tomography(CBCT)and 3D facial images of the patients were collected.The three-dimensional hard and soft tissue features,including distances,angles and 3D point cloud features were extracted.The similarity measurement model was then established to fit with the experts'similarity scoring by feature selection algorithm and linear regression model.To verify the relia-bility of the model,14 new patients were selected and input to similarity measurement model for finding similar cases.The similarity scoring of these similar cases were rated by experts,and used to evaluate the reliability of the model.Results:The similarity metric models indicated that the features of the middle and lower craniofacial features were the main features to influence the craniofacial similarity.The main features that were related to the expert's similarity scoring included distance of anterior nasal spine-menton(ANS-Me),distance of right upper canion point-Frankfurt horizontal plane(U3RH),distance of left superior point of the condyle-left gonion(CoL-GoL),distance of left gonion-menton(CoL-Me),dis-tance of pogonion-midsagittal plane(Pog-MSP),distance of right alar base-left alar base(AlR-AlL),angle of pronasale-soft tissue pogonion-labrale inferius(Pn-Pog'-Li),distance of trichion-right tragus(Tri-TraR),distance of left exocanthion-left alar base(ExL-AlL),lower 1/3 of skeletal face,middle and lower 2/3 of skeletal face and upper lip region of soft tissue.Fourteen new patients were chosen to evaluate the model.The similar cases selected by the model had an average experts'similarity scoring of 7.627±0.711,which was not significantly different with 7.5.Conclusion:The similarity measurement model established by this model could find the similar cases which highly matched experts'subjective simi-larity scoring.The study could be further used for similar cases retrieval in skeletal Ⅲ malocclusion patients.

Objective:To analyze the mediating effect of post-traumatic growth between medical coping styles and compliance with rehabilitation exercise in young and middle-aged stroke patients.Methods:By convenience sampling, 217 stroke patients admitted to the Department of Neurology, Xinxiang Central Hospital from March 2023 to February 2024 were selected as the research objects. The investigation was carried out using a basic information questionnaire, Medical Coping Style Questionnaire (SCSQ), Post-Traumatic Growth Inventory (PTGI), and Exercise Compliance Questionnaire. Pearson correlation analysis was used to analyze the relationships among post-traumatic growth, medical coping styles, and compliance with rehabilitation exercise. The structural equation model was established using AMOS 21.0 software and the mediating effect was verified.Results:A total of 217 questionnaires were distributed, and 209 valid questionnaires were collected, with the valid questionnaire recovery rate being 96.31%. The PTGI score of the 209 patients was (45.62±10.52) ; the positive coping score in SCSQ was (14.05±3.46), and the negative coping score was (15.23±3.67) ; the compliance score with rehabilitation exercise was (31.62±4.38). Post-traumatic growth was positively correlated with the total and dimensional scores of positive coping and rehabilitation exercise compliance ( P<0.05), and negatively correlated with negative coping ( P<0.05) ; positive coping was positively correlated with the total scores and scores of each dimension of compliance with rehabilitation exercise ( P<0.05). Post-traumatic growth played a partial mediating role between medical coping styles and compliance with rehabilitation exercise, and the mediating effect accounted for 25.00% (0.037/0.148) of the total effect. Conclusions:In the early stage of the stable period, young and middle-aged stroke patients show obvious negative coping, have insufficient post-traumatic growth levels, and have good compliance with rehabilitation exercise, with room for improvement. Post-traumatic growth plays a partial mediating role between medical coping styles and compliance with rehabilitation exercise in young and middle-aged stroke patients.

Objective:To explore the effectiveness of shared decision-making intervention with nurses as "decision coaches" in perioperative decision management of bladder cancer patients.Methods:From March 2023 to February 2024, 152 bladder cancer patients in the Department of Urology Surgery of Xinxiang Central Hospital for surgical treatment were selected by convenience sampling. The patients were divided into control group and observation group of 76 cases each using the randomized numerical table method. Control group implemented conventional bladder cancer surgical decision management, and observation group implemented a shared decision-making intervention with nurses as "decision coaches" on this basis, and the intervention period was one week before surgery. Decisional Conflict Scale (DCS), Preparation Decision Making (PrepDM), Patients Satisfaction with Participation in Medical Decision-making Scale, and Decision Regret Scale (DRS) scores were compared between the two groups of patients before and after intervention.Results:Finally 74 patients in control group and 75 patients in observation group completed the study. After the intervention, the DCS scores of observation group were lower than those of control group and before the intervention, and the differences were statistically significant (all P<0.05). After the intervention, the PrepDM scores of observation group were higher than those of control group and before the intervention, and the differences were statistically significant (all P<0.05). One week after surgery, observation group had higher decision-making participation satisfaction scores and lower DRS scores than control group, and the differences were statistically significant (all P<0.05) . Conclusions:Preoperative shared decision-making interventions with nurses as "decision coaches" in bladder cancer patients can effectively reduce preoperative decision conflicts, increase preoperative decision readiness and participation satisfaction with decision-making, and decrease patients' postoperative decision regret.