The ambiguity of symptom information in traditional Chinese medicine （TCM） syndrome differentiation can be amplified in the direct reasoning process from symptoms to syndromes in the absence of constraints， which affects the accuracy and stability of intelligent syndrome differentiation. TCM disease concepts， while historically rational， are structurally ambiguous in both their connotation and extension， making it difficult to serve as stable prior knowledge in intelligent modeling. In contrast， modern medical diseases， based on objective testing and quantifiable indicators， have relatively clear boundaries and reproducible standards. This study proposes a disease-syndrome combination model， adopting modern medical diseases as structural prior variables to reconstruct the hierarchical relationships among disease， symptoms， and syndromes. By applying disease constraints， effective screening of information from the four examinations and compressing the reasoning space are achieved. Furthermore， by integrating artificial intelligence technologies， such as multimodal fusion and knowledge graphs， an intelligent syndrome differentiation model driven by both prior knowledge and clinical data is constructed， providing a feasible path to enhance the accuracy of syndrome differentiation and realize the intelligentization of TCM diagnosis and treatment.

OBJECTIVES: To evaluate the protective effect of Schistosoma japonicum cystatin (rSj-Cystatin) in a mouse mode of "two-hit" sepsis. METHODS: Sixty male C57BL/6 mice randomized equally into sham-operated group, protein group, "two-hit" modeling group, and protein intervention group. In the former two groups, the mice received an intraperitoneal injection of 100 μL PBS followed by exposure of the cecum and then by intraperitoneal injection of 100 μL PBS or 25 μg rSj-Cystatin 30 min later; In the latter two groups, 100 μL PBS containing LPS (5 mg/kg) was injected intraperitoneally 24 h before cecal ligation and puncture (CLP), and 100 μL PBS or 25 μg rSj-Cystatin were injected 30 min after CLP. At 12 h after rSj-Cystatin treatment, 6 mice from each group were sacrificed for detection of TNF-α, IL-6, IL-10, TGF-β, iNOS and Arg-1 in the serum, spleen, liver, lung and kidney tissues using ELISA, for examinations of liver, lung and kidney pathologies with HE staining, and for analysis of CD3⁺CD4⁺CD25⁺Foxp3⁺ T cell percentage in the spleen using flow cytometry. The remaining mice were observed for general condition and 72-h survival. RESULTS: The 72-h survival rates in the 4 groups were 100%, 100%, 0% and 20%, respectively, showing significant differences between the latter two groups. The mouse models of "two-hit" sepsis exhibited obvious tissue pathologies and significant elevations of TNF-α and IL-6 in both the serum and tissue homogenate, which were significantly ameliorated by rSj-Cystatin treatment. Treatment with rSj-Cystatin also increased IL-10 and TGF-β levels and spleen CD3⁺CD4⁺CD25⁺Foxp3⁺ T cell percentage. The septic mouse models also showed increased iNOS levels in all the detected tissues and a decreased Arg-1 level in the kidney, and these changes were obviously improved by rSj-Cystatin treatment. CONCLUSIONS rSj-Cystatin has a protective effect against "two-hit" sepsis in mice by regulating the inflammatory microenvironment.
Animals ; Mice ; Sepsis/drug therapy* ; Male ; Schistosoma japonicum/chemistry* ; Mice, Inbred C57BL ; Cystatins/therapeutic use* ; Interleukin-10/metabolism* ; Interleukin-6/blood* ; Tumor Necrosis Factor-alpha/blood* ; Disease Models, Animal ; Transforming Growth Factor beta/metabolism*

Objective To evaluate the protective effect of Schistosoma japonicum cystatin(rSj-Cystatin)in a mouse mode of"two-hit"sepsis.Methods Sixty male C57BL/6 mice randomized equally into sham-operated group,protein group,"two-hit"modeling group,and protein intervention group.In the former two groups,the mice received an intraperitoneal injection of 100 μL PBS followed by exposure of the cecum and then by intraperitoneal injection of 100 μL PBS or 25 μg rSj-Cystatin 30 min later;In the latter two groups,100 μL PBS containing LPS(5 mg/kg)was injected intraperitoneally 24 h before cecal ligation and puncture(CLP),and 100 μL PBS or 25 μg rSj-Cystatin were injected 30 min after CLP.At 12 h after rSj-Cystatin treatment,6 mice from each group were sacrificed for detection of TNF-α,IL-6,IL-10,TGF-β,iNOS and Arg-1 in the serum,spleen,liver,lung and kidney tissues using ELISA,for examinations of liver,lung and kidney pathologies with HE staining,and for analysis of CD3+CD4+CD25+Foxp3+T cell percentage in the spleen using flow cytometry.The remaining mice were observed for general condition and 72-h survival.Results The 72-h survival rates in the 4 groups were 100％,100％,0％and 20％,respectively,showing significant differences between the latter two groups.The mouse models of"two-hit"sepsis exhibited obvious tissue pathologies and significant elevations of TNF-α and IL-6 in both the serum and tissue homogenate,which were significantly ameliorated by rSj-Cystatin treatment.Treatment with rSj-Cystatin also increased IL-10 and TGF-β levels and spleen CD3+CD4+CD25+Foxp3+T cell percentage.The septic mouse models also showed increased iNOS levels in all the detected tissues and a decreased Arg-1 level in the kidney,and these changes were obviously improved by rSj-Cystatin treatment.Conclusion rSj-Cystatin has a protective effect against"two-hit"sepsis in mice by regulating the inflammatory microenvironment.

【Objective】 To investigate the suicidal attitude, ideation of adolescent patients with depression, and to analyze their relationships with family environment, in order to provide evidence for the clinical treatment of adolesent depression and to reduce the suicide rate. 【Methods】 Totally 376 adolescents diagnosed with depression in Lu′an area from March 2019 to October 2021 were selected as the case group, and 376 normal adolescents were selected as the control group.The suicide attitude questionnaire (QSA), Beck scale for suicide ideation (BSS) and family environment scale (FES-CV) were used to investigate the suicide attitude, suicidal ideation and family environment of adolescents in two groups. Logistic regression analysis was used to analyze the influencing factors of suicide attitude and ideation of adolescent depression patients.Pearson correlation test was used to analyze the correlations between suicidal attitude, ideation and family environment of adolescent patients with depression. 【Results】 The scores of QSA and BSS in the case group were significantly higher than those in the control group (t=43.352, 96.527, P<0.001).The scores of intimacy, emotional expression, knowledge and entertainment in FES-CV of the case group were lower than those of the control group (t=25.487, 14.573, 22.160, 18.906), the score of contradiction was higher than that of the control group (t=30.311), and the differences were statistically significant (P<0.001).Logistic regression analysis showed that age of 20 - 25 years old (OR=2.016,2.261), severe illness (OR=2.115, 2.192), dwelling in city (OR=2.442, 2.557) were all risk factors for suicidal attitude and ideation in adolescent depression patients (P<0.05).The scores of QSA and BSS in the case group were negatively correlated with the scores of intimacy, emotional expression, knowledge and entertainment in FES-CV (QSA: r=-0.891,-0.933,-0.788,-0.698, BSS: r=-0.901,-0.832,-0.725,-0.637, P<0.05), but they were positively correlated with the score of contradiction (r=0.848, 0.883, P<0.05). 【Conclusions】 The suicidal attitude, ideation of adolescents with depression are higher than those of normal adolescents. Age, illness and growth environment are all influencing factors for suicidal attitudes and ideation in adolescent depression patients, of which the suicide attitude, ideation of patients are closely related to family environment.

Objective To summarize the research status and hotspots of Wumei Pills;To provide ideas and methods for the follow-up research of Wumei Pills.Methods Related literature about Wumei Pills was retrieved from CNKI,VIP,Wanfang Data and CBM from the establishment of the databases to January 12,2023.The publication time,author,author unit and keywords were collected and extracted through NoteExpress 3.0 software to manage bibliographic data.VOSviewer 1.6.18 software was used to conduct co-occurrence and clustering analysis,and construct keyword time superposition network.Results After screening,a total of 2 105 articles were included,involving 3 554 authors,such as Yan Shuguang,Fan Heng,and Hui Yi.They were from 1 135 units,such as Dongzhimen Hospital of Beijing University of Chinese Medicine,Shandong University of Traditional Chinese Medicine and Beijing University of Chinese Medicine.The included articles contained 2 565 keywords,which appeared 7 061 times,and the research involved 4 main directions:digestive system diseases(ulcerative colitis),study on TCM classics(Shang Han Za Bing Lun),medical cases and experience,and biliary ascariasis.The hotspots of Wumei Pills were scattered in recent years.Six meridian disease to appear,opening and closing pivots,intestinal microbiota,serum inflammatory factors and insomnia were research hotspots in recent 3 years.Conclusion The research of Wumei Pills mainly focus on the research of digestive system diseases,TCM classics,medical cases and experience,and biliary ascariasis.Theoretical research of TCM and mechanism research possibly become new hotspots of this field.

Objective:To explore the optimal index of rotational displacement of femoral neck fractures by modeling the axial rotational displacement of femoral neck fractures after reduction and based on X-ray projections.Methods:Six dry human femur specimens, comprising 2 males and 4 females, were utilized in the study. Design and manufacture a proximal femur ortholateral and oblique X-ray casting jigs and mounts. The femoral neck fracture was modeled on the femoral specimen, with Pauwells 30°, 50°, and 70° models (2 each) made according to Pauwells typing. The fractures were manually repositioned with residual anterior 20°, 40° and 60° axial rotational displacements. Each fracture model was projected at different angles (pedicled 40°, pedicled 20°, vertical 0°, cephalad 20°, and cephalad 40°), and the trabecular angle and Garden's alignment index of the model were measured to observe the imaging characteristics of the fracture line on the medial oblique and lateral oblique radiographs.Results:In the presence of a 20° and 40° anterior rotational displacement following reduction of a femoral neck fracture, the trabecular angle in the rotationally displaced group was not significantly different from that of the anatomically repositioned group in various projection positions. However, when a residual rotational displacement of 60° was present, the trabeculae appeared blurred at most projection angles in the Pauwells 30° and 50° models, failing to measure trabecular angles. In the Pauwells 70° fracture model, the trabecular angle in the rotational displacement group was significantly different from that in the anatomical reduction group. In anteroposterior radiographs, when the anterior rotation displacement was 60° in the Pauwells 70° group, Garden's contralateral index showed an unsatisfactory restoration (150°, 142°), whereas all rotationally displaced models in the Pauwells 30° and Pauwells 50° groups had a Garden's contralateral index of >155°, which achieved an acceptable restoration. In lateral radiographs, all rotational displacement models with Garden's alignment index>180° failed to achieve acceptable repositioning, and the larger the Pauwells angle the greater the Garden's alignment index at the same rotational displacement. In the internal oblique position with a bias towards the foot side, the image showed partial overlap between the femoral head and the shaft, making it difficult to assess the quality of the reduction. Conversely, when projected cephalad, the femoral neck appeared longer, particularly at a projection angle of 40° cephalad, allowing for clear observation of the fracture line and the anatomy of the proximal femur. The trabeculae were not well visualized in the external oblique position.Conclusion:There are limitations in applying the trabecular angle to assess the axial rotational displacement of the femoral head after reduction of femoral neck fractures. The Pauwells 70° with residual rotational anterior displacement of 60° was the only way to detect axial rotational displacement of the femoral head on anteroposterior radiographs Garden's alignment index. For the determination of axial rotational displacement of the femoral head, the Garden's alignment index on lateral radiographs provides higher reliability.

Examining mechanisms involved in the mutual regulation between the muscular system and the skeletal system, elucidating the key issues responsible for loss of muscle and bone mass and strength, and thus halting the progression of these conditions are critical measures for reducing fractures caused by falls and subsequent disability and mortality.At present, most studies have treated the muscular system and the skeletal system separately, often ignoring the mutual regulation and connections between them.This article reviews the current research progress on the mechanisms of interaction between the two systems, aiming to provide a basis for the prevention, diagnosis and treatment of disuse-related diseases in the elderly population.

This paper analyzed the "non-standardization" phenomenon of syndrome differentiation in traditional Chinese medicine （TCM） from the diagnosis process. It is proposed that the symptoms and signs collected by the four examinations of inspection， listening/smelling， inquiry， and palpation naturally have a certain "ambiguity"， which can be reduced by the comparison and comprehensive condensation （comprehensive analysis of the four examinations） of a large amount of multi-dimensional clinical data， thereby realizing the sublimation of TCM diagnosis from "ambiguity" of four examinations to "accuracy" of diagnostic conclusion. Based on the above assumptions， this paper further proposed that a research idea of intelligent syndrome differentiation in TCM， that is， by taking the clinical thinking ability of TCM physicians as the core， adopting artificial intelligence technology based on knowledge graph visualization， integrating the complex network association and reasoning method of "symptom-pathogenesis-syndrome" linked by pathogenesis， and through the automatic analysis and reasoning process of a large amount of multi-dimensional and ambiguous clinical data， the intelligent TCM diagnosis based on syndrome differentiation can be realized.

Objective: To evaluate the intervention effectiveness of broken window effect combined with narrative nursing on non-suicidal self-injury (NSSI) in adolescents, so as to provide the basis for NSSI prevention in adolescents. Methods: Totally 134 adolescents with NSSI admitted to Mental Health Center of the Affiliated Hospital of Anhui West Health Vocational College from January 2022 to December 2023 were enrolled and randomly assigned into the control and treatment group. All were given narrative nursing and routine care, and the adolescents in the treatment group were given additional intervention based on broken window effect. The effects were evaluated using Self-Rating Depression Scale (SDS), Hamilton Depression Scale (HAMD), Self-Rating Idea of Suicide Scale (SIOSS), Ottawa Self-injury Inventory-Functions (OSI-F) and Nursing Satisfaction Scale, and the two groups were compared before and after intervention. Results: The treatment and control groups comprised 67 cases each, had a median age of 14.12 (interquartile range, 2.01) years and 14.10 (interquartile range, 1.52) years, included 71.64% and 68.66% girls, and 79.10% and 74.63% junior high school students, respectively. There were no statistically significant differences between the treatment and control groups in terms of gender, age or educational level (all P>0.05). The results of analysis of variance for repeated measures showed that there were interactions between time and group for SDS, HAMD and SIOSS scores (all P<0.05), and the decrease in scores before and after intervention was greater in the treatment group than in the control group. After intervention, the SDS, HAMD, SIOSS score and incidence of suicidal behaviors in the treatment group were all lower than the control group [SDS: (32.54±1.27) vs. (44.25±2.23); HAMD: (10.54±1.83) vs. (18.73±1.89); SIOSS: (10.37±2.20) vs. (15.76±1.62); incidence of suicidal behavior: 14.93% vs. 32.84%; all P<0.05]. The nursing satisfaction rate was significantly higher in the treatment group than in the control group (98.51% vs. 88.06%, P<0.05). Conclusion The broken window effect combined with narrative nursing would improve the depressive symptoms in adolescents with NSSI, and reduce the suicidal ideation and self injury.

Objective To explore the diagnostic value of MRI radiomics model for clinically significant prostate cancer(csPCa)in the transition zone with prostate imaging reporting and data system(PI-RADS)3-4.Methods According to the ratio of prostate cancer(PCa)∶benign prostatic hyperplasia(BPH)=1∶1,the relevant data of patients with transition zone lesions confirmed by pathology were retrospectively collected.Patients were divided into csPCa group and non-csPCa group according to pathological results.Region of interest(ROI)were drawn along the edge of the lesion in T2WI,diffusion weighted imaging(DWI),and apparent diffusion coeffi-cient(ADC)sequences,the radiomics features were extracted,and a single sequence logistic regression model was constructed and validated after feature cleaning and screening.The diagnostic performances of the radiomics model for transition zone csPCa were evaluated and compared.Results A total of 204 patients were included,and there were 94 cases in the csPCa group and 110 cases in the non-csPCa group.There were statistically significant differences in PI-RADS,prostate volume(PV),prostate specific antigen(PSA)and its derivative indicators between csPCa and non-csPCa groups.In the validation set,the area under the cunve(AUC)of the ADC model was 0.766,and the DeLong test showed that the diagnostic performance of the ADC model was significantly higher than that of the DWI and T2WI models.Conclusion When the PI-RADS classification of transition zone lesion is 3-4,the ADC radiomics model has good diag-nostic performance for csPCa,which can reduce unnecessary biopsy in some patients.Radiomics is expected to become a more objec-tive and accurate medical diagnostic tool.