Objective To understand the status of body image disturbance and its influencing factors in patients with ankylosing spondylitis (AS), so as to provide a scientific basis for the clinical management of AS. Methods A total of 353 AS patients admitted from January 2022 to December 2024 were selected as research subjects. Chinese version of Body Image Disturbance Questionnaire (BIDQ) was used to investigate the body image disturbance in AS patients. Single factor analysis was performed by t test and analysis of variance, and multiple factors were analyzed by multivariate linear regression. Results The total score of BIDQ in 342 AS patients was (25.01±4.22). Multivariate linear regression analysis results showed that self-paid medical expense, nighttime VAS score and negative emotion PANAS score could positively predict body image disturbance in AS patients (standardized regression coefficient=0.413, 0.413, 0.460, P<0.05), and PSSS score, positive emotion PANAS score and exercise management CDSSM score could negatively predict body image disturbance (standardized regression coefficient=-0.245, -0.134, -0.247, P<0.05). Conclusion The body image disturbance in AS patients is worthy of clinical attention. Nighttime pain, negative emotion and self-paid medical treatment can increase the risk of body image disturbance. Positive emotion, social support and high self-management level of exercise behavior can reduce the formation of body image disturbance, which can provide new ideas for clinical management of AS patients.

Objective To analyze the relationship between cognitive function, motor ability and the risk of falls in patients during the rehabilitation period after stroke. Methods A total of 330 patients with stroke who received rehabilitation treatment in the hospital from February 2022 to February 2025 were classified into fall group (n=105) and non-fall group (n=225) based on the occurrence of falls during rehabilitation period. The clinical data of patients were collected, and the motor function of patients was evaluated by Fugl-Meyer scale, and the cognitive function of patients was assessed by mini-mental state examination (MMSE). Univariate and logistic multivariate regression analyses were applied to analyze the factors affecting the occurrence of falls. Spearman correlation analysis was performed to analyze the relationship between motor ability, cognitive function and risk of falls. Results The proportions of osteoporosis, malnutrition, sleep disorder and history of falls in the fall group were higher while the education level, Fugl-Meyer score and MMSE score were lower compared to the non-fall group (P<0.05). After logistic multivariate analysis, it was found that osteoporosis, malnutrition, sleep disorder, history of falls, low education level, low Fugl-Meyer score and low MMSE score were risk factors for falls in patients during post-stroke rehabilitation period (P<0.05). Correlation analysis indicated that the motor ability and cognitive function in patients during post-stroke rehabilitation period were negatively associated with the occurrence of falls (r=-0.579, -0.438, P<0.001). Conclusion The cognitive function, motor ability of patients in the post-stroke rehabilitation period are closely related to the risk of falls. Clinically, the risk of falls in patients during post-stroke rehabilitation period can be reduced by improving the motor ability and cognitive function.

OBJECTIVE To provide data support and theoretical reference for drug-regulatory authorities to implement targeted supervision over internet-based pharmaceutical sales.METHODS Using keywords such as “internet-based pharmaceutical sales” and “online drug sales”， the official websites of the People’s Government， drug-regulatory authorities and databases including PKULaw and others were searched， so as to collect typical cases and public disclosure information of administrative penalties related to internet-based pharmaceutical sales from January 2014 to June 2024. Guided by accident-causation theory， the text-mining method was adopted to identify risk factors from four dimensions： human unsafe behaviors， unsafe state of substances， environmental factors and safety management. Grey relational analysis was performed to quantitatively evaluate and screen key risk factors， and targeted governance suggestions were subsequently put forward.RESULTS A total of 617 administrative penalty cases were included. The number of cases increased significantly since 2018. The regional distribution of cases presented a characteristic of “high in the east and low in the west”. Violations were mainly concentrated in the business qualification examination link， and online pharmaceutical retail enterprises were the dominant law-breaking subjects. A risk identification system for internet-based pharmaceutical sales was constructed， covering 4 primary-level， 17 secondary-level and 56 tertiary-level risk factors. Through grey relational analysis， 37 key tertiary-level risk factors （most of which belonged to the safety-management dimension） including inadequate bill management and illegal drug-advertising content， as well as 12 key secondary-level risk factors such as drug-advertising violations and non-standard drug storage， were screened out.CONCLUSIONS Inadequate capabilities and weak compliance awareness of practitioners， illegal drug advertising， non-standard drug storage and transportation， and imperfect quality-management systems of online-drug-sales enterprises and third-party platforms are prominent safety risk factors for internet-based pharmaceutical sales. It is recommended to strengthen qualification examination and competency training for practitioners， standardize drug-information display and drug advertising， improve the management system of drug warehousing and logistics， and refine institutional requirements for key links， so as to improve the supervision efficiency of internet-based pharmaceutical sales.

Objective To explore the experiences of children with Crohn's disease and their parents regarding the exclusion diet,and to provide a basis for formulating personalized dietary guidance programs.Methods A total of 12 children with Crohn's disease and their parents,hospitalized in the Department of Gastroenterology at a tertiary children's hospital in Guangzhou from June to December 2023,were selected as research subjects using objective sampling.Semi-structured interviews were conducted,and the data were analyzed and refined using Colaizzi's seven-step analysis method.Results Totally 3 themes and 14 sub-themes were extracted.①Lack of cognition and trust in Crohn's disease exclusion diet(unfamiliarity with the contents of the diet,misunderstanding of the diet's preparation,inadequate response to daily exclusion diet practices,parents' distrust in the exclusion diet).②The practical challenges of the Crohn's disease exclusion diet(the challenge of personal dietary preferences,the challenge of family meal preparation,the challenge of school feeding,food intolerance,feelings of monotony and weariness following the exclusion diet).③Innovations in practicing the Crohn's disease exclusion diet(managing taste fatigue,managing visual fatigue,innovative cooking methods,prioritizing exclusive enteral nutrition followed by the exclusion diet,overcoming the desire for universal food).Conclusion Children with Crohn's disease and their parents exhibit insufficient cognition and trust in the exclusion diet and face various challenges in practice.Clinical medical staff should adopt personalized coping strategies tailored to the specific circumstances of each child.

Objective To investigate the effect of benserazide combined with respiratory training on post-stroke dysphagia.Methods A total of 120 patients with dysphagia after stroke were prospectively selected and randomly divided into the combination group and the breathing exercise group,with 60 cases in each group.The breathing exercise group was treated with rehabilitation breathing training,and the combination group was treated with dopa serazide on the basis of rehabilitation breathing training,3 times a day,1 tablet once.The traditional Chinese medicine(TCM)syndrome scores,clinical efficacy and swallowing function indexes including dysphagia angiography score(VDS),osmotic-aspiration scale(PAS)score,Lowada drinking water test score and VFSS score were compared between the two groups.Nutritional indices[total cholesterol(TC),triglyceride(TG),albumin(ALB),hemoglobin(Hb)],related indexes of nerve function[nerve function and serum growth differentiation factor 15(GDF-15),central nerve specific protein soluble protein-100β(S100β)],quality of life and anxiety disorder score[Quality of Life Rating Scale(SF-36)score,Generalized Anxiety Disorder Scale(GAD-7)score]and adverse reactions were compared between the two groups.Results The total effective rate of the combination group(91.67%)was obviously increased(P＜0.05)compared to the breathing exercise group(58.33%).Compared with before treatment,after treatment,tongue flaccidity,slow swallowing,choke after drinking water,tongue coating ecchymosis,score of fine pulse,VDS,PAS,score of Lowada drinking water test,GDF-15 level and GAD-7 score were decreased in the two groups,and those of the combination group were significantly lower than the breathing exercise group(P＜0.05).The levels of TC,TG,ALB,Hb,S100β,VFSS and SF-36 were increased in the two groups,and those of the combination group were higher than the breathing exercise group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Benserazide combined with respiratory training has high clinical efficacy in patients with post-stroke dysphagia,which can effectively improve the TCM evidence score and nutritional indicators,improve swallowing function,reduce anxiety,improve quality of life,and have more ideal clinical application.

Objective To explore the experiences of children with Crohn's disease and their parents regarding the exclusion diet,and to provide a basis for formulating personalized dietary guidance programs.Methods A total of 12 children with Crohn's disease and their parents,hospitalized in the Department of Gastroenterology at a tertiary children's hospital in Guangzhou from June to December 2023,were selected as research subjects using objective sampling.Semi-structured interviews were conducted,and the data were analyzed and refined using Colaizzi's seven-step analysis method.Results Totally 3 themes and 14 sub-themes were extracted.①Lack of cognition and trust in Crohn's disease exclusion diet(unfamiliarity with the contents of the diet,misunderstanding of the diet's preparation,inadequate response to daily exclusion diet practices,parents' distrust in the exclusion diet).②The practical challenges of the Crohn's disease exclusion diet(the challenge of personal dietary preferences,the challenge of family meal preparation,the challenge of school feeding,food intolerance,feelings of monotony and weariness following the exclusion diet).③Innovations in practicing the Crohn's disease exclusion diet(managing taste fatigue,managing visual fatigue,innovative cooking methods,prioritizing exclusive enteral nutrition followed by the exclusion diet,overcoming the desire for universal food).Conclusion Children with Crohn's disease and their parents exhibit insufficient cognition and trust in the exclusion diet and face various challenges in practice.Clinical medical staff should adopt personalized coping strategies tailored to the specific circumstances of each child.

Objective To investigate the effect of benserazide combined with respiratory training on post-stroke dysphagia.Methods A total of 120 patients with dysphagia after stroke were prospectively selected and randomly divided into the combination group and the breathing exercise group,with 60 cases in each group.The breathing exercise group was treated with rehabilitation breathing training,and the combination group was treated with dopa serazide on the basis of rehabilitation breathing training,3 times a day,1 tablet once.The traditional Chinese medicine(TCM)syndrome scores,clinical efficacy and swallowing function indexes including dysphagia angiography score(VDS),osmotic-aspiration scale(PAS)score,Lowada drinking water test score and VFSS score were compared between the two groups.Nutritional indices[total cholesterol(TC),triglyceride(TG),albumin(ALB),hemoglobin(Hb)],related indexes of nerve function[nerve function and serum growth differentiation factor 15(GDF-15),central nerve specific protein soluble protein-100β(S100β)],quality of life and anxiety disorder score[Quality of Life Rating Scale(SF-36)score,Generalized Anxiety Disorder Scale(GAD-7)score]and adverse reactions were compared between the two groups.Results The total effective rate of the combination group(91.67%)was obviously increased(P＜0.05)compared to the breathing exercise group(58.33%).Compared with before treatment,after treatment,tongue flaccidity,slow swallowing,choke after drinking water,tongue coating ecchymosis,score of fine pulse,VDS,PAS,score of Lowada drinking water test,GDF-15 level and GAD-7 score were decreased in the two groups,and those of the combination group were significantly lower than the breathing exercise group(P＜0.05).The levels of TC,TG,ALB,Hb,S100β,VFSS and SF-36 were increased in the two groups,and those of the combination group were higher than the breathing exercise group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Benserazide combined with respiratory training has high clinical efficacy in patients with post-stroke dysphagia,which can effectively improve the TCM evidence score and nutritional indicators,improve swallowing function,reduce anxiety,improve quality of life,and have more ideal clinical application.

Objective To observe the effects of Yitangkang on brown fat thermogenesis and mitochondrial biogenesis of PGC1α-NRF1/2-TFAM pathway in db/db mice;To explore its mechanism of regulating glucose and lipid metabolism.Methods Totally 27 six-week-old db/db mice were randomly divided into model group,Yitangkang group(30 g/kg)and liraglutide group(200 μg/kg),another 9 db/m mice of the same age were set as normal group.All groups received intervention with drugs or saline for 6 weeks.The body mass and FBG were measured weekly.After intervention,oral glucose tolerance test(OGTT)was carried out,the contents of serum TC,TG,LDL-C and HDL-C were detected by biochemical analyzer,HE staining was used to observe the morphology of brown adipose tissue(BAT)in scapular region,RT-qPCR and Western blot were used to detect the expressions of UCP1,PRDM16,PGC1α related to BAT thermogenesis and NRF1,Nrf2,TFAM related to mitochondrial biogenesis.Results Compared with the normal group,the body mass,FBG,area under the curve of OGTT and serum TG,TC,LDL-C content of model group significantly increased(P<0.01),the content of HDL-C significantly decreased(P<0.01);the diameter of BAT cells in scapular region was larger,white vacuoles appeared,lipid droplets increased,and the mRNA and protein expressions of UCP1,PRDM16,PGC-1α,NRF1,NRF2 and TFAM in BAT decreased significantly(P<0.01).Compared with the model group,the body mass,FBG,area under the curve of OGTT and serum TG,TC,LDL-C contents of Yitangkang group and liraglutide group significantly decreased(P<0.01),the content of HDL-C increased(P<0.01);BAT cells were smaller in diameter,more closely arranged,more regular in shape,and more abundant in capillary,the mRNA and protein expressions of UCP1,PRDM16,PGC-1α,NRF1,NRF2 and TFAM in BAT increased significantly(P<0.01).Conclusion Yitangkang can regulate mitochondrial biogenesis through PGC1α-NRF1/2-TFAM pathway to activate brown fat in db/db mice and improve glucose and lipid metabolism in db/db mice.

Type 2 diabetes mellitus is a metabol-ic disease characterized by high blood sugar levels.Traditionally,amino acids are primarily viewed as the basic building blocks for proteins and peptide synthesis.However,in recent years,amino acids have gained increased attention as signaling mole-cules that play crucial roles in the maintenance and regulation of metabolic homeostasis.It has been found that there is a close correlation between the metabolism of branched-chain and/or aromatic amino acids and the occurrence or development of type 2 diabetes mellitus.Furthermore,there have been successive reports on the regulation mecha-nism involved.This article will focus on the meta-bolic processes,mechanisms and clinical value of branched-chain and aromatic amino acids in type 2 diabetes mellitus.It will also summarize and pro-vide an outlook on the current state of amino acid metabolism in the treatment of diabetes mellitus,with the aim of offering new ideas for the treat-ment of type 2 diabetes mellitus.

Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.