The theory of "holism of five organs" highly encapsulates the understanding of TCM on the integrity, connectivity, and unity of the internal life functions and morphological structures of the human body. Functional gastrointestinal disorders (FGIDs) frequently overlap, and TCM has significant advantages in their prevention and treatment based on the theory of the holistic view and syndrome differentiation and treatment. Exosomes are extracellular vesicles whose secretory form and biological functions fully reflect the "holism of five organs", and they are of great value in the pathogenesis, diagnosis and treatment of overlap of symptoms of FGIDs. This article interpreted the relationship between exosomes and overlap of symptoms of FGIDs with the "holism of five organs", aiming to provide new ideas and methods for the prevention and treatment of overlap of symptoms of FGIDs, as well as partly explain the scientific connotation of the theory of "holism of five organs".

Hemoglobin A1c (HbA1c) has a unique structure that makes monoclonal antibody (mAb) preparation challenging. This study aims to develop a method for preparing HbA1c mAbs and establish a fluorescent immunochromatographic assay (FICA) for rapid detection of HbA1c. Three glycosylated peptides were synthesized and used to prepare complete antigens, which were identified by dot enzyme-linked immunosorbent assay (Dot-ELISA) and ultraviolet absorption spectroscopy. The complete antigens and natural HbA1c were used for cross-immunization of mice, and the optimal complete antigen was selected. The mouse with the highest serum titer was chosen for mAb preparation. The purity and specificity of the mAbs were verified, and a FICA method was developed. The optimal complete antigen, with a titer of 1:512 000, was successfully prepared and selected. Fusion with splenocytes resulted in four specific HbA1c antibodies (purity > 90%). The best antibody exhibited a binding constant (Ka) of 1.67×10¹⁰ L/mol with the antigen. Based on this antibody, a FICA method was successfully established, capable of producing results within 15 min. The method demonstrated a good linear range (3%-13% HbA1c, y=0.071 3x+0.005 6, R²=0.993 7), recovery rates of 98%-102%, precision < 10.00%, and no nonspecific reactions. Clinical testing of 210 samples showed positive agreement of 96.36%, negative agreement of 97.00%, and overall agreement of 96.68%. The receiver operating characteristic (ROC) curve analysis yielded an area under curve (AUC) of 0.980 9 [95% confidence interval (CI): 0.961 0-1.000 0], with high consistency verified in multicenter studies. We successfully developed a key technique for preparing HbA1c monoclonal antibodies and established a FICA method for rapid detection of HbA1c. It will provide an efficient and convenient detection method for the early diagnosis and long-term management of diabetes and its complications.
Antibodies, Monoclonal/biosynthesis* ; Animals ; Mice ; Glycated Hemoglobin/immunology* ; Mice, Inbred BALB C ; Humans ; Antibody Specificity ; Chromatography, Affinity/methods* ; Enzyme-Linked Immunosorbent Assay/methods* ; Female

Objective To investigate the clinical characteristics,diagnosis and treatment of ileal injury secondary to percutaneous nephrolithotomy percutaneous nephrolithotomy(PCNL).Methods The diagnosis and treatment of a patient were reviewed,and relevant literature were retrieved.Results The patient was a 41-year-old male,who underwent stage PCNL(initial percutaneous nephrostomy,followed by secondary PCNL)due to right ureteral calculi with severe hydronephrosis.On postoperative day 1,he developed abdominal distension and pain.Abdominal X-ray revealed subdiaphragmatic free gas,and CT showed pelvic and abdominal fluid and gas accumulation,suggesting peritonitis due to intestinal perforation.Emergency exploratory laparotomy identified a 3 mm×3 mm ileal perforation approximately 30 cm from the ileocecal valve,which was repaired surgically.The patient recovered well and was discharged after one week,with no discomfort reported during a 6-month follow-up.Conclusion The clinical features of ileal injury secondary to PCNL include early postoperative abdominal distension,pain and peritonitis.Diagnosis relies on clinical manifestations,abdominal X-ray and CT,with surgical exploration if necessary.Conservative management under vigilant observation can be cautiously adopted for localized injuries,while surgical repair is required for peritonitis or failed conservative therapy.

Objective To investigate the clinical characteristics,diagnosis and treatment of ileal injury secondary to percutaneous nephrolithotomy percutaneous nephrolithotomy(PCNL).Methods The diagnosis and treatment of a patient were reviewed,and relevant literature were retrieved.Results The patient was a 41-year-old male,who underwent stage PCNL(initial percutaneous nephrostomy,followed by secondary PCNL)due to right ureteral calculi with severe hydronephrosis.On postoperative day 1,he developed abdominal distension and pain.Abdominal X-ray revealed subdiaphragmatic free gas,and CT showed pelvic and abdominal fluid and gas accumulation,suggesting peritonitis due to intestinal perforation.Emergency exploratory laparotomy identified a 3 mm×3 mm ileal perforation approximately 30 cm from the ileocecal valve,which was repaired surgically.The patient recovered well and was discharged after one week,with no discomfort reported during a 6-month follow-up.Conclusion The clinical features of ileal injury secondary to PCNL include early postoperative abdominal distension,pain and peritonitis.Diagnosis relies on clinical manifestations,abdominal X-ray and CT,with surgical exploration if necessary.Conservative management under vigilant observation can be cautiously adopted for localized injuries,while surgical repair is required for peritonitis or failed conservative therapy.

Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

Objective To compare the clinical efficacies among three surgical methods in the treatment of stage Ⅲ Kümmell's disease without neurological symptoms.Methods A total of 71 patients with stage Ⅲ Kümmell's disease without neurological symptoms admitted and treated in the orthopedics department of Af-filiated Yueyang Hospital of Hunan Normal University from September 2019 to April 2022 were selected and divided into three groups:29 cases in the percutaneous vertebroplasty (PVP) group (group A),19 cases in the percutaneous pedicle screw+lesioned vertebral PVP group (group B) and 21 cases in the percutaneous bone cement screw combined with lesioned vertebral PVP group (group C) according to the operation methods.The imaging,perioperative and follow-up indexes were compared among the three groups.Results All patients successfully completed the operation,no serious complications occurred after operation,and the follow-up time was more than 1 year.The sagittal position index (SI value) in the affected vertebra,visual analogue scale (VAS) score and Oswestry Disability Index (ODI) score at each time point (postoperative 1,3 months,1 year) after surgery in the group A were improved compared with before operation (P<0.05).The affected vertebra SI value,kyphosis Cobb angle,spinal canal stenosis rate,VAS score and ODI score at postoperative time points in the group B and C were improved compared with before operation (P<0.05).The affected ver-tebra SI value,kyphosis Cobb angle,spinal canal stenosis rate and ODI score at postoperative time points in the group B and C all were superior to those in the group A (P<0.05),while the affected vertebra SI value,kyphosis Cobb angle and spinal canal stenosis rate in postoperative 1 year in the group C were superior to those in the group B (P<0.05).The operative time,intraoperative bleeding volume,postoperative hospitaliza-tion duration and affected vertebral cement injection volume in the group A were significantly less than those in the group B and C (P<0.05).The operation time in the group B was less than that in the group C (P<0.05).Conclusion The three surgical methods for the treatment of stage Ⅲ Kümmell's disease without neu-rological symptoms all could relieve the symptoms and restore the function.The two surgical methods of pedi-cle screw reduction could more effectively restore the height of the affected vertebra,correct kyphosis malfor-mation and improve spinal stenosis than PVP alone.The pedicle screw has more advantages in maintaining mechanical support and stability after bone cement reinforcement.

To explore the epidemiological characteristics of public health emergency events (PHEE) of varicella in the Beijing-Tianjin-Hebei region and analyze its related influencing factors. Excel was used to organize the varicella data in the Beijing-Tianjin-Hebei region from 2006 to 2021, reported by the management information system of PHEE, to describe the epidemiological characteristics of varicella events. Spatial autocorrelation and spatial scanning methods were used to test and determine its spatial clusters. Geographic detectors were used to analyze the impact of socio-economic factors. From 2006 to 2021, there were 644 reported varicella events in the Beijing-Tianjin-Hebei region, with a total of 18 052 cases and an incidence rate of 2.78%. The number, duration and response time M ( Q1, Q3) of each reported event were 22 (15, 35) cases, 19 (7, 34) days and 7 (4, 17) days, respectively. Hebei Province had a shorter response time and duration of events compared to Beijing and Tianjin. The most reported varicella events were in 2006 and 2007, with 112 and 106 events, respectively. By 2014, the number of events had decreased yearly, and there was a small peak from 2017 to 2019 between 2014 and 2021. From 2006 to 2021, the PHEE of varicella showed a seasonal bimodal distribution from March to June and from October to January of the following year, with peaks in May and December. There was a total of 500 reported varicella events in primary schools, including 218 events in rural primary schools (34%), 142 events in county and town primary schools (22%) and 140 events in urban primary schools (22%). The distribution of varicella events showed a positive spatial autocorrelation and strong spatial clustering, with Moran′s I of 0.31. The Class 1 clustering area was centered in Kuancheng Manchu Autonomous County, Chengde City, with a radius of 207 km and included 58 districts ( LLR=3 550.23, RR=3.78). The most explanatory factor among socio-economic factors was the proportion of the population aged 0-24 years old ( q=0.22), and the interaction effect between each factor was stronger than the independent effect. Overall, there are differences in the level of handling varicella events across Beijing, Tianjin and Hebei. The main occurrence of varicella events is in primary schools, especially in rural areas. Varicella events exhibit spatial clustering. Population structure-related factors have a strong impact on the risk of the incidence of varicella events.

Objective:To compare the clinical efficacy of helical tomotherapy in the treatment of esophageal cancer, explore its influence on nutrition status, blood routine indexes, inflammatory factors and immune function, and analyze its safety.Methods:A total of 124 patients with esophageal cancer treated in Liyang People's Hospital of Jiangsu Province from May 2021 to April 2023 were selected as the study objects, and the patients were divided into the helical tomotherapy group ( n=62) and the modulated arc therapy group ( n=62) according to random number table method. The clinical efficacy, nutritional status [transferrin (TRF), prealbumin (PAB), serum albumin (ALB) ], blood routine indexes [hemoglobin (HGB), neutrophils count, white blood cells (WBC) count, platelets count], the inflammatory factors [C-reactive protein (CRP), interleukin (IL) -6, IL-18, tumor necrosis factor-α (TNF-α) ], immune function indexes [CD3 + T cells, CD4 + T cells, CD4 + T cells/CD8 + T cells ratio, natural killer (NK) cells], and the rate of adverse reactions were statistically analyzed. Results:The disease control rate of treatment in the helical tomotherapy group (88.71%, 55/62) was significantly higher than that in the modulated arc therapy group (74.19%, 46/62), with a statistically significant difference ( χ2=4.32, P=0.038). After treatment, TRF [(178.42±19.24) μg/dl vs. (171.27±18.19) μg/dl, t=2.13, P=0.035], PAB [(0.37±0.11) g/L vs. (0.31±0.09) g/L, t=3.32, P=0.001], ALB [(4.25±0.52) g/dl vs. (4.01±0.58) g/dl, t=2.43, P=0.017] in the helical tomotherapy group were higher than those in the modulated arc therapy group, with statistically significant differences. After treatment, HGB [(125.49±13.87) g/dl vs. (112.37±14.49) g/dl, t=5.21, P<0.001] in the helical tomotherapy group were higher than those in the modulated arc therapy group; neutrophils count [(4.91±0.75) ×10 9/L vs. (5.37±0.84) ×10 9/L, t=3.22, P=0.002], WBC count [(4.96±0.52) ×10 9/L vs. (5.26±0.61) ×10 9/L, t=2.95, P=0.004], platelets count [(227.15±25.38) ×10 9/L vs. (241.37±26.91) ×10 9/L, t=3.03, P=0.003] in the helical tomotherapy group were lower than those in the modulated arc therapy group, with statistically significant differences. After treatment, CRP [(7.76±0.84) mg/dl vs. (8.11±1.01) mg/dl, t=2.10, P=0.038], IL-6 [(6.47±0.81) μg/L vs. (7.16±0.93) μg/L, t=4.41, P<0.001], IL-18 [(191.01±23.14) μg/L vs. (201.62±22.96) μg/L, t=2.56, P=0.012, ) and TNF-α [(3.65±0.41) μg/L vs. (3.82±0.43) μg/L, t=2.25, P=0.026] in the helical tomotherapy group were lower than those in the modulated arc therapy group, with statistically significant differences. After treatment, the proportion of CD3 + T cells [(41.27±5.45) % vs. (35.48±5.17) %, t=6.07, P<0.001], the proportion of CD4 + T cells [(36.11±4.49) % vs. (29.24±9.52) %, t=9.48, P<0.001], CD4 + T cells/CD8 + T cells ratio (1.35±0.19 vs. 1.21±0.13, t=4.79, P<0.001), the proportion of NK cells [(14.68±2.79) % vs. (12.37±1.86) %, t=5.42, P<0.001] in the helical tomotherapy group were higher than those in the modulated arc therapy group, with statistically significant differences. The rate of adverse reactions in the helical tomotherapy group (80.65%, 50/62) was significantly lower than that in the modulated arc therapy group (93.55%, 58/62), with a statistically significant difference ( χ2=4.59, P=0.032) . Conclusion:Helical tomotherapy is more effective than modulated arc therapy in the treatment of esophageal cancer, which can improve nutrition levels, reduce immunity decline, and has high safety.

Objective The occurrence of chickenpox in rapidly developing areas poses substantial seasonal risk to children.However,certain factors influencing local chickenpox outbreaks have not been studied.Here,we examined the relationship between spatial clustering,heterogeneity of chickenpox outbreaks,and socioeconomic factors in Southern China. Methods We assessed chickenpox outbreak data from Southern China between 2006 and 2021,comprising both relatively fast-growing parts and slower sub-regions,and provides a representative sample of many developing regions.We analyzed the spatial clustering attributes associated with chickenpox outbreaks using Moran's I and local indicators of spatial association and quantified their socioeconomic determinants using Geodetector q statistics. Results There were significant spatial heterogeneity in the risk of chickenpox outbreaks,with strong correlations between chickenpox risk and various factors,particularly demographics and living environment.Furthermore,interactive effects among specific are factors,such as population density and per capita residential building area,percentage of households with toilets,percentage of rental housing,exhibited q statistics of 0.28,0.25,and 0.24,respectively. Conclusion This study provides valuable insights into the spatial dynamics of chickenpox outbreaks in rapidly developing regions,revealing the socioeconomic factors affecting disease transmission.These implications extend the formulation of effective public health strategies and interventions to prevent and control chickenpox outbreaks in similar global contexts.