The Huangdi Neijing proposes the " using bitter herbs to nourish or purge" theory to guide clinical prescription and formulation of herbal remedies based on the physiological characteristics and functions of the five zang viscera, along with the properties and flavors of medicinal herbs. This study explored diabetic kidney disease pathogenesis and treatment based on the " using bitter herbs to nourish or purge" theory. Kidney dryness is a key pathological factor in diabetic kidney disease, and the disharmony of kidney dryness is an essential aspect of its pathogenesis. Strengthening is the primary therapeutic principle, and kidney dryness is a persistent factor throughout the occurrence and progression of diabetic kidney disease. In the early stage, the pathogenesis involves heat-consuming qi and injuring yin, leading to kidney dryness. In the middle stage, the pathogenesis manifests as qi deficiency and blood stasis in the collaterals, resulting in turbidity owing to kidney dryness. In the late stage, the pathogenesis involves yin and yang deficiency, with kidney dryness and disharmony. This study proposes the staging-based treatment based on the " need for firmness" characteristic of the kidney. The aim is to provide new insights for clinical diagnosis and treatment in traditional Chinese medicine by rationally using pungent, bitter, and salty medicinal herbs to nourish and moisturize the kidney. This approach seeks to promote precise syndrome differentiation and personalized treatment for different stages of diabetic kidney disease, thereby enhancing clinical efficacy.

Background/Aims: With the obesity pandemic, metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease and a leading cause of end-stage liver disease and liver-related deaths in the USA. Therefore, we aimed to compare the long-term outcomes of patients with MASLD and cirrhosis with and without bariatric surgery. Methods: Patients were retrospectively identified from the California Department of Healthcare Access and Information database, 2005 to 2019, for a population-based cohort study. Propensity score matching (PSM) was used to balance background risks between patients with cirrhosis who underwent bariatric surgery and those who did not. Overall, liver-related and non-liver-related mortality were analyzed. Results: Of 91,708 eligible patients with MASLD and cirrhosis, PSM yielded 2,107 patients who underwent bariatric surgery and 8,428 non-bariatric controls. Compared to matched controls, patients who underwent bariatric surgery had lower 5-year overall (24.9% vs. 37.1%; p<0.0001), liver-related (3.3% vs. 14%; p<0.0001), and non-liver-related mortality (22.3% vs. 26.9%; p=0.046). In multivariable analysis, bariatric surgery was associated with decreased overall mortality (adjusted hazard ratio [aHR]=0.63; p<0.0001), liver-related (aHR=0.24; p<0.0001), and non-liverrelated (aHR=0.81; p=0.0026) mortality. However, only laparoscopic surgeries were associated with lower overall mortality (aHR=0.39; p<0.0001) whereas open surgeries were associated with higher overall mortality (aHR=1.24; p=0.022). Conclusions Patients with MASLD and cirrhosis who underwent bariatric surgery, specifically laparoscopic approaches, had significantly lower mortality risk than non-surgical counterparts.

Objective To screen and analyze key genes in rabbit corneal alkali burns based on transcriptomics se-quencing technology and bioinformatics techniques.Methods Thirty healthy male New Zealand rabbits were randomly di-vided into 2 groups(n=15 per group):The control group received no intervention,while the alkali burn group underwent corneal alkali burn modeling.Histological evaluation of corneal tissues was performed via hematoxylin-eosin(HE)stai-ning.Transcriptome sequencing was conducted for library construction and sequencing.Differentially expressed genes(DEGs)were identified using DESeq2,followed by Gene Ontology(GO)functional enrichment analysis and Kyoto Ency-clopedia of Genes and Genomes(KEGG)pathway analysis.A protein-protein interaction(PPI)network was constructed to screen hub genes,and RT-PCR was employed to validate mRNA expression levels of key genes.Results HE staining revealed orderly arranged corneal stromal layers and scattered stromal cells in the control group,whereas the alkali burn group exhibited stromal edema,thickened collagen fibers with loose/disorganized alignment,and increased fibroblast and inflammatory cell infiltration.Compared to the control group,1 827 significant DEGs were identified in the alkali burn group,including 1 495 upregulated and 332 downregulated genes.GO analysis showed biological processes such as immune response,plasma membrane,and identical protein binding.KEGG analysis indicated that DEGs were enriched in pathways related to cancer,lipid and atherosclerosis,and neuroactive ligand-receptor interaction.The PPI network screened 11 key genes:neutrophil cytosolic factor 1(NCF1),neutrophil cytosolic factor 2(NCF2),matrix metallopeptidase 2(MMP2),ma-trix metallopeptidase 9(MMP9),interleukin-1α(IL-1α),interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-8(CXCL8),cluster of differentiation 4(CD4),C-C motif ligand 2(CCL2)and tumor necrosis factor(TNF).RT-PCR valida-tion revealed that the mRNA expression levels of key genes in the corneal tissues of the alkali burn group were significantly higher than those in the control group(all P＜0.05),consistent with the transcriptomic sequencing results.Conclusion Based on the rabbit corneal alkali burn model,this study identified 11 key genes(NCF1,NCF2,MMP2,MMP9,IL-1α,IL-1β,IL-6,CXCL8,CD4,CCL2 and TNF)through transcriptomics and bioinformatics analysis.

Objective:To analyze the clinical characteristics and gene variations of children with cystic fibrosis (CF), and to improve the understanding of pediatrician on CF.Methods:The data of 7 children with CF admitted to Xi'an Children 's Hospital from July 2018 to January 2024 were retrospectively analyzed. Results:The 7 patients (2 males and 5 females) were diagnosed at a median age of 3 years and 9 month(ranging from 1 year and 1 month to 10 years).The main clinical manifestations included recurrent respiratory tract infection (7 cases), bronchiectasis (3 cases), malnutrition (5 cases), steatosis (5 cases), false Bartter syndrome(2 cases), cirrhosis (1case),infantile vomiting (1 case),and meconium intestinal obstruction (1 case). A total of 14 mutation sites were found in 7 cases by whole exon sequencing and Sanger sequencing verification, including 7 missense mutations, 4 nonsenses mutations, 2 shear mutations, and 1 frameshift mutation which was a new mutation. After symptomatic treatment including anti-infection, chest physical therapy, hypertonic saline atomization, fat-soluble vitamin supplementation and pancreatic enzyme supplementation, the respiratory symptoms were controlled, the number of hospitalization due to respiratory infection was significantly reduced. However，the nutritional status of the 7 children did not reach the expected improvement.Conclusion:The clinical manifestations of CF are varied, among which recurrent respiratory tract infection, bronchiectasis and malnutrition are common.Timely targeted anti-infection and other symptomatic treatments can improve the prognosis. The compliance of the confirmed children with nutritional support is poor, and it is still necessary to strengthen the intervention of nutritional support.

Allergic rhinitis(AR)affects 10%-40%of the population in the world.Because CLOCK genes regulate the circadian rhythms of AR,the symptoms in parts of the patients are aggravated in the morning and evening and relieved at moon.Although lots of studies showed that traditional Chinese medicine is effective for AR,further explores are still needed to analyze the circadian rhythm of AR based on Chinese Chronological Medicine for controlling the circadian outbreak point of symptoms of AR in daily cycle.We supposed that Weiyang might play an important role for controlling the circadian rhythm of AR with closed similarities with the tidal variation of the expressions of CLOCK genes.Thus based on Weiyang theory,we tried to clarify the mechanism of circadian rhythm of AR and explore the relationship between Weiyang and the CLOCK genes so as to further expand the treatment methods of adjusting the circadian cycle of AR with TCM and improve the corresponding therapeutic efficacy.

Objective:To analyze the clinical characteristics and gene variations of children with cystic fibrosis (CF), and to improve the understanding of pediatrician on CF.Methods:The data of 7 children with CF admitted to Xi'an Children 's Hospital from July 2018 to January 2024 were retrospectively analyzed. Results:The 7 patients (2 males and 5 females) were diagnosed at a median age of 3 years and 9 month(ranging from 1 year and 1 month to 10 years).The main clinical manifestations included recurrent respiratory tract infection (7 cases), bronchiectasis (3 cases), malnutrition (5 cases), steatosis (5 cases), false Bartter syndrome(2 cases), cirrhosis (1case),infantile vomiting (1 case),and meconium intestinal obstruction (1 case). A total of 14 mutation sites were found in 7 cases by whole exon sequencing and Sanger sequencing verification, including 7 missense mutations, 4 nonsenses mutations, 2 shear mutations, and 1 frameshift mutation which was a new mutation. After symptomatic treatment including anti-infection, chest physical therapy, hypertonic saline atomization, fat-soluble vitamin supplementation and pancreatic enzyme supplementation, the respiratory symptoms were controlled, the number of hospitalization due to respiratory infection was significantly reduced. However，the nutritional status of the 7 children did not reach the expected improvement.Conclusion:The clinical manifestations of CF are varied, among which recurrent respiratory tract infection, bronchiectasis and malnutrition are common.Timely targeted anti-infection and other symptomatic treatments can improve the prognosis. The compliance of the confirmed children with nutritional support is poor, and it is still necessary to strengthen the intervention of nutritional support.

Objective:To investigate the effect of pelvic floor reconstructive surgery on improving sexual func-tion in premenopausal women with pelvic organ prolapse(POP).Methods:Clinical data from 79 premenopausal patients who underwent pelvic floor reconstructive surgery for POP in Affiliated Hospital of Chengde Medical Uni-versity from January 2019 to June 2023 were collected.The patients'sexual function was assessed with the classic Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire(PISQ-12)preoperatively and 12 months post-operatively.The patients'quality of life was assessed with Pelvic Floor Distress Inventory-Short Form 20(PFDI-20).Compare the changes in quality of life and sexual function preoperatively and 12 months postopera-tively,and analyze the related factors of postoperative sexual function improvement.Results:The preoperative PFDI-20 was 53.13(29.17,75.00),while the postoperative PFDI-20 was 8.33(0,16.67),the difference is statisti-cally significant(P＜0.05).The preoperative PISQ-12 was 33.46±7.68,while the postoperative PISQ-12 was 37.20±4.81,the difference is statistically significant(P＜0.05).The postoperative scores in terms of emotional factors,physical factors,and partner factors have all increased(P＜0.05).Univariate analysis of postoperative im-provement of sexual function showed that there were significant difference in age,POP duration and uterine pres-ervation between the improved group and the non-improved group(P＜0.05),while there was no significant differ-ence in surgical methods(P＞0.05).Logistic regression multivariate analysis showed that the duration of pro-lapse＜2 years was an independent factor influencing the improvement of postoperative sexual function(OR 3.689,95％CI 1.355-10.047,P=0.011).Conclusions:The quality of life and sexual life of premenopausal POP patients can be significantly improved after pelvic floor surgery,and the pelvic floor reconstructive surgery with u-terine preservation within 2 years of symptom onset in young patients can improve postoperative sexual function.

Objective Text mining of content characteristics of original science popularization articles on the WeChat public account"PSM Medicine Shield Public Welfare"based on LDA model and Linear Regression.Methods Through web crawling techniques,we collected 4,292 original pharmaceutical science popularization articles and associated comment data from the"PSM Drug Shield Public Welfare"WeChat Official Account to analyze the content distribution patterns and characteristics of pharmaceutical science communication.Employing Latent Dirichlet Allocation(LDA)modeling,we systematically categorized and mined article themes to identify public demand for science literacy and explore strategic directions for precision-targeted phar-maceutical science dissemination.Results The analysis of 4 292 original science popularization articles from the"PSM Medi-cine Shield Public Welfare"account showed an average readership of 1 815.73±4 385.31.Articles in headline positions,pub-lished on weekends,or using exclamatory titles achieved higher readership.Most articles(1 000-2 000 words)used direct-open-ing title strategies.Traditional Chinese medicines had the highest readership among drug categories.Top content categories in-cluded drug monographs,medicinal diets,disease medication guidance,myth clarification,and disease science.Linear regres-sion analysis identified headline placement,word count,title phrasing,title strategy,target audience,drug category,and content type as potential factors influencing readership.The LDA model with 9 s revealed key themes:management of drug adverse reac-tions,dermatological medication dosing,anti-infection effects of medicinal diets,and pediatric vaccination/health monitoring.Conclusion The"PSM Medicine Shield Public Welfare"WeChat account primarily disseminates pharmaceutical science content focusing on adverse drug reactions,pediatric medication safety,TCM-based health preservation,disease treatment protocols,symptom recognition guidelines,dosage optimization,and toxicity management.Pharmaceutical professionals should prioritize content length control,evidence-based title strategies,and thematic alignment with public health priorities during science commu-nication content creation.

Background/Aims: With the obesity pandemic, metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease and a leading cause of end-stage liver disease and liver-related deaths in the USA. Therefore, we aimed to compare the long-term outcomes of patients with MASLD and cirrhosis with and without bariatric surgery. Methods: Patients were retrospectively identified from the California Department of Healthcare Access and Information database, 2005 to 2019, for a population-based cohort study. Propensity score matching (PSM) was used to balance background risks between patients with cirrhosis who underwent bariatric surgery and those who did not. Overall, liver-related and non-liver-related mortality were analyzed. Results: Of 91,708 eligible patients with MASLD and cirrhosis, PSM yielded 2,107 patients who underwent bariatric surgery and 8,428 non-bariatric controls. Compared to matched controls, patients who underwent bariatric surgery had lower 5-year overall (24.9% vs. 37.1%; p<0.0001), liver-related (3.3% vs. 14%; p<0.0001), and non-liver-related mortality (22.3% vs. 26.9%; p=0.046). In multivariable analysis, bariatric surgery was associated with decreased overall mortality (adjusted hazard ratio [aHR]=0.63; p<0.0001), liver-related (aHR=0.24; p<0.0001), and non-liverrelated (aHR=0.81; p=0.0026) mortality. However, only laparoscopic surgeries were associated with lower overall mortality (aHR=0.39; p<0.0001) whereas open surgeries were associated with higher overall mortality (aHR=1.24; p=0.022). Conclusions Patients with MASLD and cirrhosis who underwent bariatric surgery, specifically laparoscopic approaches, had significantly lower mortality risk than non-surgical counterparts.

Background/Aims: With the obesity pandemic, metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease and a leading cause of end-stage liver disease and liver-related deaths in the USA. Therefore, we aimed to compare the long-term outcomes of patients with MASLD and cirrhosis with and without bariatric surgery. Methods: Patients were retrospectively identified from the California Department of Healthcare Access and Information database, 2005 to 2019, for a population-based cohort study. Propensity score matching (PSM) was used to balance background risks between patients with cirrhosis who underwent bariatric surgery and those who did not. Overall, liver-related and non-liver-related mortality were analyzed. Results: Of 91,708 eligible patients with MASLD and cirrhosis, PSM yielded 2,107 patients who underwent bariatric surgery and 8,428 non-bariatric controls. Compared to matched controls, patients who underwent bariatric surgery had lower 5-year overall (24.9% vs. 37.1%; p<0.0001), liver-related (3.3% vs. 14%; p<0.0001), and non-liver-related mortality (22.3% vs. 26.9%; p=0.046). In multivariable analysis, bariatric surgery was associated with decreased overall mortality (adjusted hazard ratio [aHR]=0.63; p<0.0001), liver-related (aHR=0.24; p<0.0001), and non-liverrelated (aHR=0.81; p=0.0026) mortality. However, only laparoscopic surgeries were associated with lower overall mortality (aHR=0.39; p<0.0001) whereas open surgeries were associated with higher overall mortality (aHR=1.24; p=0.022). Conclusions Patients with MASLD and cirrhosis who underwent bariatric surgery, specifically laparoscopic approaches, had significantly lower mortality risk than non-surgical counterparts.