It is proposed that the pathogenesis of rheumatoid arthritis （RA） is centered on deficiency， dampness， and blood stasis， which interact with and evolve into one another during the onset and progression of the disease. The development of RA is closely associated with insufficiency of healthy qi and the interbinding of dampness and blood stasis. Accordingly， treatment emphasizes an integrated approach that combines tonifying deficiency， eliminating dampness， and resolving blood stasis， and is implemented in three main stages. In the initial stage， therapy focuses on supporting healthy qi， dispelling dampness， and relieving impediment， with modified Huangqi Guizhi Wuwu Decoction （黄芪桂枝五物汤） combined with Yiyiren Decoction （薏苡仁汤）. In the active stage， treatment aims to eliminate dampness， resolve blood stasis， and unblock the collaterals， using modified Wutou Decoction （乌头汤） or Guizhi Shaoyao Zhimu Decoction （桂枝芍药知母汤）. In the remission stage， therapy emphasizes strengthening the spleen and reple-nishing qi to prevent recurrence， with modified Shenling Baizhu Powder （参苓白术散） combined with Guipi Decoction （归脾汤）.

ObjectiveTo evaluate the efficacy and safety of Janus kinase （JAK） inhibitors combined with Chinese herbal medicine （CHM） in treating rheumatoid arthritis （RA）. MethodsClinical data from 169 RA patients were retrospectively collected. Among them， 71 cases received JAK inhibitors as the control group， while 98 cases received JAK inhibitors plus CHM as the observation group， both treated for 24 weeks. The rheumatoid factor （RF）， cyclic citic peptide antibody （anti-CCP）， erythrocyte sedimentation rate （ESR）， C-reactive protein （CRP）， and white blood cell count （WBC） were recorded before and after treatment. Databases including CNKI， Wanfang， VIP， PubMed and Web of Science were searched from inception till August 31st， 2025 for randomized controlled trials （RCTs） on the combined use of JAK inhibitors and CHM for RA. The methodological quality of the included studies was evaluated using the risk of bias assessment tool. Meta-analyses were performed for RF， anti-CCP， ESR， CRP， 28-joint disease activity score （DAS28）， overall clinical effective rate， and incidence of adverse events. Sensitivity analysis were also performed. ResultsThe retrospective study demonstrated that after treatment， ESR， CRP， and anti-CCP levels decreased in the observation group， while ESR and CRP levels decreased in the control group （P＜0.05）. Moreover， ESR and RF levels in the observation group were lower than those in the control group （P＜0.05）. A total of 9 RCTs involving 770 patients were included in the meta-analysis. The results indicated that the JAK inhibitors plus CHM group was superior to the JAK inhibitors group in reducing RF （MD=-8.97， 95%CI -15.01 to -2.94， P=0.004）， CRP （MD=-3.34， 95%CI -3.82 to -2.86， P＜0.001）， ESR （MD=-5.33， 95%CI -7.98 to -2.69， P＜0.001）， and DAS28 score （MD=-0.54， 95%CI -0.74 to -0.34， P＜0.001）， as well as in improving the overall clinical effective rate （OR=4.53， 95%CI 2.55 to 8.03， P＜0.001）. No statistically significant differences were observed between groups in anti-CCP levels （SMD=-2.08， 95%CI -4.41 to 0.24， P=0.080） or incidence of adverse events （OR=0.93， 95%CI 0.55 to 1.57， P=0.790）. ConclusionThe combination of JAK inhibitors and CHM demonstrates remarkable efficacy in treating RA， contributing to improved disease activity and reduced inflammatory markers with a favorable safety profile.

Objective To investigate the effects and molecular mechanism of Homer protein homolog 1a (Homer 1a) overexpression on nerve injury in mice with traumatic brain injury (TBI). Methods Sixty male C57BL/6 mice were randomly divided into five groups: sham group, TBI group, empty lentivirus (Lv-NC) group, Homer 1a overexpression lentivirus (Lv-Homer 1a) group and Lv-Homer 1a + 740 Y-P group, with 12 mice in each group. The lentivirus was orthotopic injected into the cerebral cortex of mice 5 d before modeling, while 740 Y-P was injected intraperitoneally 1 d before modeling. The TBI model was established using the free-fall impact method, and the modified neurological severity scores (mNSS) of the mice was assessed 72 h post-surgery. The water content of brain tissue was quantified, and the histopathological damage and neuronal loss in brain tissue were assessed using HE staining and Nissl staining respectively. The formation of autophagosomes in brain tissue was observed by transmission electron microscopy. The protein expression levels of Homer 1a, microtubule-associated protein 1 light chain 3B (LC3B), Beclin 1, phosphatidylinositol 3-kinase (PI3K), phosphorylation PI3K(p-PI3K), protein kinase B (AKT), p-AKT, mammalian target of rapamycin (mTOR), and p-mTOR in brain tissue were detected by Western blot analysis. Results Compared to the sham group, the mice in the TBI group exhibited a significant increase in mNSS and cerebral water content. Moreover, severe brain tissue pathological damage was observed, accompanied by a substantial loss of neurons and an increase in autophagosome formation. The protein expressions of Homer 1a and Beclin 1, as well as the protein ratio of LC3B-II/LC3B-I, in brain tissues were significantly elevated, while the protein ratios of p-PI3K/PI3K, p-AKT/AKT, and p-mTOR/mTOR were significantly reduced. Compared to the TBI group, the Lv-Homer 1a group exhibited reduced mNSS and brain water content. Additionally, there was an improvement in pathological brain tissue damage and neuron loss. Furthermore, there was an increase in autophagosome formation and expression of autophagy-related proteins, while the protein ratios of p-PI3K/PI3K, p-AKT/AKT, and p-mTOR/mTOR were decreased. Compared to the Lv-Homer 1a group, the nerve injury in the Lv-Homer 1a+740 Y-P group was exacerbated, accompanied by a reduction in autophagosome formation and expression of autophagy-related proteins, while the PI3K/AKT/mTOR signaling pathway was activated. Conclusion Overexpression of Homer 1a effectively mitigates neurological damage in TBI mice, potentially through modulation of autophagy mediated by the PI3K/AKT/mTOR signaling pathway.
Animals ; TOR Serine-Threonine Kinases/genetics* ; Autophagy ; Brain Injuries, Traumatic/pathology* ; Male ; Proto-Oncogene Proteins c-akt/genetics* ; Phosphatidylinositol 3-Kinases/genetics* ; Homer Scaffolding Proteins/metabolism* ; Mice, Inbred C57BL ; Signal Transduction ; Mice

Objective: To explore the relationship between sleep quality and executive function among middle school students, so as to provide theoretical support for the promotion of adolescents physical and mental health development. Methods: From September to December 2023, 5 713 junior and senior high school students aged 13 to 18 were selected by stratified cluster random sampling method from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi, and Urumqi. Pittsburgh Sleep Quality Index was used to conduct sleep quality survey. And conduct executive function was tested on middle school students, including inhibitory function, refresh function and conversion function tests. Spearman correlation and linear regression were used to analyze the relationship between sleep quality and executive function of middle school students. Results: The total Pittsburgh Sleep Quality Index (PSQI) score of boys was [4.0(2.0,6.0)] and that of girls was [5.0(3.0,6.0)], and the difference was statistically significant ( Z=-10.90, P < 0.01 ). The total PSQI score of boys was positively correlated with both 2-back reaction time and conversion function of executive function ( r =0.04, 0.04); the total PSQI score of girls was negatively correlated with 2-back reaction time ( r =-0.04) ( P <0.05). After controlling for variables such as mental health, physical activity and nutritional status,linear regression analyses showed that PSQI total score of middle school students was positively correlated with the inhibitory function and the conversion function response time [ B (95% CI )=1.28(0.21-2.34), 7.62(2.34-12.90), P <0.05]; the associations of total PSQI scores among middle school students with both 2-back and 1-back response time were not statistically significant [ B (95% CI )=-5.88(-16.14-4.37), 8.05( -3.39 -19.50), P >0.05]. Conclusion Positive correlations are observed on sleep quality with inhibitory and conversion functions of executive function among middle school students.

Objective To explore the impact of multi-model adaptive statistical iterative reconstruction (ASiR-V) algorithm on radiation dose and image quality in children’s ultra-low-dose chest CT examination. Methods A total of 72 children who underwent chest CT scans at Qingdao Municipal Hospital with admissions between January 2024 and January 2025 were selected as subjects and divided into two groups using a random number table. In the control group (n = 36), the tube voltage was set at 100 kVp and the conventional filtered back projection algorithm was used. In the observation group (n = 36), the tube voltage was set at 80 kVp and images were reconstructed using 30% ASiR-V (observation group 1), 60% ASiR-V (observation group 2), and 90% ASiR-V (observation group 3), respectively. Radiation doses were recorded for each group, and both subjective and objective evaluations of image quality were conducted. Results Compared with the control group, the observation group demonstrated significantly lower volume CT dose index [(0.86 ± 0.09) mGy], dose length product [(25.90 ± 3.55) mGy·cm], and effective dose [(0.01 ± 0.001) mSv] (P < 0.05). There was no significant difference in subjective evaluation scores of image quality among the four groups (z = −2.206, P = 0.530). Additionally, Fisher’s exact test showed that the proportion of images scoring 4-5 points was higher in observation group 2 than in observation group 3 (P = 0.024). The noise value of the ascending aorta in the mediastinal window and the noise values of the right and left middle lung fields and the right and left upper lung fields in the lung window were lower in observation groups 2 and 3 than in the control group, and these values were lower in observation group 3 than in observation group 2 (P < 0.05). The signal-to-noise ratios of the ascending aorta and liver in observation groups 2 and 3 were higher than those in the control group, and the ratios were higher in observation group 3 than in observation group 2 (P < 0.05). Conclusion Reconstruction using the 60% ASiR-V algorithm for pediatric ultra-low-dose chest CT examination can ensure good image quality while reducing radiation dose and improving examination safety.

Objective:To evaluate the clinical efficacy of Jianpi Bushen Prescription in treating acute gouty arthritis with spleen-kidney deficiency syndrome using propensity score matching method.Methods:A retrospective analysis method was used to select 156 patients with acute gouty arthritis with spleen kidney deficiency type admitted from March 2022 to March 2024. They were divided into an observation group of 89 cases and a control group of 67 cases according to the treatment method. Propensity score matching (PSM) was further adopted to balance the confounding factors before treatment in a 1:1 ratio. Finally, 42 patients in each group were successfully matched. The control group received conventional Western medicine, the observation group received additional treatment with Jianpi Bushen Prescription on the basis of the control group. The treatment for both groups lasted for 1 month. TCM syndrome scores were performed before and after treatment, and the levels of serum uric acid (UA), ESR, and pH were measured using an automatic dry biochemical analyzer. The VAS scale was used to assess the degree of pain, the Oswestry Disability Index (ODI) was used to evaluate the degree of joint function improvement, and the Quality of Life Scale-36 (SF-36) was used to evaluate the quality of life of patients. Adverse reactions during treatment were observed and recorded to evaluate clinical efficacy.Results:The total effective rate of the observation group 92.86% (39/42) was higher than that of the control group 73.81% (31/42), with statistical significance ( χ2=5.49, P<0.05). After treatment, the joint pain, soreness and weakness of the waist and knees, poor flexion and extension, and pale and greasy tongue coating, were lower than those in the control group ( t values were 3.38, 4.26, 3.96, 3.97, 4.41, respectively, P<0.01). After treatment, the serum uric acid (UA) [(351.84±36.46) μmol/L vs. (380.19±39.42) μmol/L, t=3.42] and erythrocyte sedimentation rate (ESR) [(17.91±3.71) mm/h vs. (21.43±3.90) mm/h, t=4.24] of the observation group were lower than those in the control group, and the pH value (7.24±0.49 vs. 6.98±0.57, t=2.24) was higher than that of the control group ( P<0.05). After treatment, the VAS and ODI of the observation group were lower than those of the control group ( t values were 5.80, 6.25, respectively, P<0.01), and the SF-36 score was higher than that of the control group ( t=3.23, P<0.05). During the treatment, the incidence of adverse reactions was 14.29% (6/42) in the observation group and 9.52% (4/42) in the control group. There was no statistical significance in the incidence of adverse reactions between the two groups ( χ2=0.45, P>0.05). Conclusions:Jianpi Bushen Prescription has good efficacy on the treatment of acute gouty arthritis with spleen-kidney deficiency syndrome. It can reduce the levels of uric acid, improve the life quality of patients, and enhance efficacy, with good treatment safety.

Objective:To evaluate respiratory muscle function before and after respiratory function training using surface electromyography(sEMG)in stroke patients with hemiplegia during recovery period.Method:Forty stroke patients with hemiplegia in the recovery phase were randomly divided into an observa-tion group and a control group,with 20 patients in each group.The control group was given routine rehabilita-tion treatment,while the observation group was given routine rehabilitation treatment combined with respirato-ry function training.Root Mean Square value(RMS)of respiratory muscle surface electromyography,pulmo-nary function indicators such as forced vital capacity(FVC),the forced expiratory volume in 1 second(FEV1),peak expiratory flow rate(PEF),and Fugl-Meyer Motor Scale(FMMS),Berg Balance Scale(BBS)were evaluated before and after 4 weeks of treatment in both groups.Result:After 4 weeks of treatment,the RMS of bilateral sternocleidomastoid muscles,parasternal external in-tercostal muscles,and diaphragmatic muscles,pulmonary function indicators including FVC,FEV1,PEF,FMMS and BBS in both groups were significantly improved(P＜0.05),and the scores of all indicators in the observation group were higher than those in the control group(P＜0.05).The correlation analysis showed that there was a certain correlation between the RMS of respiration muscles and indicators of pulmonary function,FMMS,BBS respectively in two groups after treatment(P＜0.05);the correlation between the RMS of respira-tion muscles and indicators of pulmonary function,FMMS,BBS in the observation group(r＞0.5,P＜0.05)was higher than that in the control group(r＜0.5,P＜0.05).Conclusion:Respiratory function training can significantly improve pulmonary function in stroke patients with hemiplegia during recovery period.Surface electromyography can be used to evaluate the respiratory muscle contraction function in stroke patients with hemiplegia.

Objective To explore the application effect of multimodal somatosensory exercise based on artificial intelligence technology in home rehabilitation exercise for elderly patients with chronic obstructive pulmonary dis-ease(COPD),so as to promote COPD patients to participate in home rehabilitation exercise.Methods Using the convenient sampling method,80 elderly patients with COPD admitted to the Department of Respiratory Medicine of a tertiary A hospital in Urumqi from November 2023 to February 2024 were selected as the research subjects.Ac-cording to the random number table method,they were divided into a control group and an experimental group,with 40 cases in each group.The control group adopted the traditional exercise training method,and the experimental group adopted the multi-modal somatosensory movement based on artificial intelligence technology for exercise in-tervention,with 5 times a week,and the intervention was implemented for 12 weeks.The pulmonary function index,modified Medical Research Council scale score,physical fitness level,Chronic Obstructive Pulmonary Disease As-sessment Test scale score and exercise compliance of the 2 groups were compared before intervention and 12 weeks after intervention.Results 77 patients completed the study,with 39 in the experimental group and 38 in the control group.The forced vital capacity,forced expiratory volume in one second,forced expiratory volume in one second to forced vital capacity ratio,physical fitness level and exercise compliance of the experimental group were higher than those of the control group,while the modified British Medical Research Council scale score and Chron-ic Obstructive Pulmonary Disease Assessment Test score were lower than those of the control group.The differences were statistically significant(P＜0.05).Conclusion Somatosensory exercise based on artificial intelligence technology can improve the lung function of the patients with COPD,improve the exercise compliance and physical fitness in-dicators of elderly patients and improve the quality of life of the patients.

Objective:To evaluate respiratory muscle function before and after respiratory function training using surface electromyography(sEMG)in stroke patients with hemiplegia during recovery period.Method:Forty stroke patients with hemiplegia in the recovery phase were randomly divided into an observa-tion group and a control group,with 20 patients in each group.The control group was given routine rehabilita-tion treatment,while the observation group was given routine rehabilitation treatment combined with respirato-ry function training.Root Mean Square value(RMS)of respiratory muscle surface electromyography,pulmo-nary function indicators such as forced vital capacity(FVC),the forced expiratory volume in 1 second(FEV1),peak expiratory flow rate(PEF),and Fugl-Meyer Motor Scale(FMMS),Berg Balance Scale(BBS)were evaluated before and after 4 weeks of treatment in both groups.Result:After 4 weeks of treatment,the RMS of bilateral sternocleidomastoid muscles,parasternal external in-tercostal muscles,and diaphragmatic muscles,pulmonary function indicators including FVC,FEV1,PEF,FMMS and BBS in both groups were significantly improved(P＜0.05),and the scores of all indicators in the observation group were higher than those in the control group(P＜0.05).The correlation analysis showed that there was a certain correlation between the RMS of respiration muscles and indicators of pulmonary function,FMMS,BBS respectively in two groups after treatment(P＜0.05);the correlation between the RMS of respira-tion muscles and indicators of pulmonary function,FMMS,BBS in the observation group(r＞0.5,P＜0.05)was higher than that in the control group(r＜0.5,P＜0.05).Conclusion:Respiratory function training can significantly improve pulmonary function in stroke patients with hemiplegia during recovery period.Surface electromyography can be used to evaluate the respiratory muscle contraction function in stroke patients with hemiplegia.

Objective:To study the risk factors of thyroid nodules in patients with type 2 diabetes.Methods:Data of patients with type 2 diabetes with normal thyroid function admitted to the Department of Endocrinology of Heze Municipal Hospital from January to June 2024 were collected. Binary logistic regression was used to analyze the influencing factors of thyroid nodules in patients with type 2 diabetes, and the receiver operating characteristic curve (ROC curve) was used to evaluate the diagnostic efficacy of each influencing factor.Results:Among 162 patients with type 2 diabetes, 96 had thyroid nodules, accounting for 59.3%. The incidence of thyroid nodules in women was significantly higher than that in men (χ 2 = 4.56, P = 0.034). Multivariate logistic regression analysis showed that age (≥50 years old), overweight and obesity [body mass index (BMI)≥24.0 kg/m 2], high glycated hemoglobin (≥10%), and high total cholesterol ( > 6.5 mmol/L) were independent risk factors for thyroid nodules in patients with type 2 diabetes ( OR = 1.83, 1.67, 1.08, 3.65, P < 0.05), and men was an independent protective factor ( OR = 0.63, P = 0.039). The ROC curve results showed that total cholesterol and total cholesterol combined with glycated hemoglobin could distinguish patients with thyroid nodules from those without thyroid nodules, with AUC = 0.64 and 0.68, respectively, and the differences were statistically significant ( P < 0.05). Conclusions:The incidence of thyroid nodules in patients with type 2 diabetes is relatively high. Age, overweight and obesity, high glycated hemoglobin, and high total cholesterol are independent risk factors for thyroid nodules in patients with type 2 diabetes, and total cholesterol has the ability to distinguish patients with thyroid nodules.