ObjectiveTo investigate the effects of hypoxia-treated mesenchymal stem cell （MSCs） exosomes （Exo） and their loading with curcumin on microglial inflammatory responses， and to explore the enhancing effect of hypoxia treatment on the function of MSCs Exo. MethodsThe supernatants of human umbilical cord （hUC）-MSCs cultured under normal and hypoxic conditions were collected， and Exo were isolated using ultracentrifugation. After identification by transmission electron microscopy and Western blot， curcumin was loaded using the co-incubation method. The lipopolysaccharide （LPS）-induced microglial inflammation model was treated with dimethyl sulfoxide （DMSO）， curcumin， normoxia Exo， hypoxia Exo， normoxic Exo loaded with curcumin， and hypoxic Exo loaded with curcumin， respectively. The expression of the M1-type marker inducible nitric oxide synthase （iNOS） in BV2 cells was detected by immunofluorescence （IF）. Western blot and enzyme-linked immunosorbent assay （ELISA） were used to measure the expression and secretion levels of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and IL-6 in the cells and their culture supernatants. ResultsNormoxia Exo， hypoxia Exo， normoxic Exo loaded with curcumin， and hypoxic Exo loaded with curcumin exhibited a "saucer-like" shape with a diameter ranging from 30~150 nm， and the expression of exosomal markers CD9， CD81， and TSG101 were positive. After treating the BV2 cell inflammation model， IF results showed that， compared with the normoxia Exo group， treatment with hypoxic Exo significantly reduced the expression of iNOS. Moreover， when compared with the curcumin group and the normoxic Exo loaded with curcumin group， the expression level of iNOS significantly decreased after treatment with hypoxic Exo loaded with curcumin. The results of Western blot and ELISA indicated that， in comparison with the normoxia Exo group， treatment with hypoxic Exo significantly reduced the expression and secretion of the inflammatory cytokines TNF-α， IL-1β， and IL-6. Additionally， when compared with the curcumin group and the normoxic Exo loaded with curcumin group， both the expression and secretion of TNF-α， IL-1β， and IL-6 significantly decreased after treatment with hypoxic Exo loaded with curcumin. ConclusionHypoxia preconditioning can enhance the ability of hUC-MSCs-Exo in the inhibition of microglial polarization and inflammatory factors’ secretion. Additionally， using Hypoxia-MSCs-Exo as a drug-delivery carrier of curcumin can improve its solubility and stability， facilitating its absorption by cells and exerting the therapeutic effect of combination therapy.

Objective:To observe the clinical efficacy of Tuina(Chinese therapeutic massage)plus Liu Zi Jue for adenoid hypertrophy(AH)due to Qi deficiency of lung and spleen and its effects on the adenoid-nasopharyngeal cavity ratio(A/N value)and traditional Chinese medicine(TCM)constitution scale score.Methods:A total of 64 children with AH due to Qi deficiency of the lung and spleen were randomized into a trial group and a control group,with 32 cases in each group.The trial group was treated with Tuina plus Liu Zi Jue,and the control group was treated with Tuina alone.The Tuina manipulations were the same in the two groups.Tuina treatment was performed 3 times a week,with an interval of at least 1 d.Liu Zi Jue was performed 2 sets each time and 5 times a week.After 8 weeks of treatment and at the 2-month follow-up,the clinical efficacy was compared between the two groups,and the changes in the main clinical symptom score,A/N value,and TCM constitution scale score were observed.Results:After treatment,the total effective rate of the trial group and the control group was 96.9%and 93.8%,respectively.The difference between the two groups was not statistically significant(P>0.05).At the follow-up,the total effective rate of the trial group was 93.8%,higher than 90.6%in the control group(P<0.05).After treatment and at the follow-up,the main clinical symptom score in both groups was lower than that before treatment(P<0.05);at the follow-up,the main clinical symptom score in the trial group was lower than that in the control group(P<0.05).After treatment,the A/N value in both groups was lower than that before treatment(P<0.05),and the value in the trial group was lower than that in the control group;however,the difference between the two groups was not statistically significant(P>0.05).After treatment and at the follow-up,the TCM constitution scale score in both groups was lower than that before treatment(P<0.05);the score after treatment in the trial group was lower than that in the control group(P<0.05).Conclusion:Tuina plus Liu Zi Jue can effectively improve the main clinical symptoms in children with AH due to Qi deficiency of lung and spleen,reduce the A/N value and TCM constitution scale score,with stable efficacy.

OBJECTIVE To evaluate the efficacy and safety of Weiyan Tongluo Granules in treating chronic atrophic gastritis(CAG)and explore its potential mechanisms.METHODS From June 2020 to December 2022,100 CAG patients with spleen defi-ciency and blood stasis syndrome were enrolled and randomly divided into a trial group(n=50)and a control group(n=50)using a random number table.The trial group received Weiyan Tongluo Granules plus a folic acid placebo,while the control group received fo-lic acid tablets plus a traditional Chinese medicine granule placebo.The treatment course for both groups was 24 weeks,with 8 and 10 dropouts in the trial and control groups,respectively.Post-treatment comparisons included OLGA/OLGIM staging reversal rates,low-grade intraepithelial neoplasia regression rate,SSDPRO-CG(Patient-Reported Outcome Scale for Chronic Gastritis in Spleen-Stomach Diseases)scores,TCM syndrome scores,and safety indicators.Serum levels of PG I,PGⅡ,PGR,and G-17 were measured via ELISA before and after treatment.Gastric mucosal p-NF-κB and CDX2 protein expression levels were analyzed by Western blot,while mRNA levels of IL-1β,IL-6,VIL1,and MUC2 were quantified via qPCR.RESULTS After treatment,the trial group showed sig-nificantly higher OLGA and OLGIM stage reversal rates than the control group(P<0.05,P<0.01),though no significant difference was observed in low-grade intraepithelial neoplasia regression.Both groups exhibited significant improvements in physiological domain scores and total SSDPRO-CG scores(P<0.01),with the trial group outperforming the control group in physiological,independence,psychological domains,and total scores(P<0.05,P<0.01).TCM syndrome scores(total and sub-items:gastric distension,pain,poor appetite,bloating)decreased significantly in both groups(P<0.01),while the trial group showed greater reductions in loose stools and dull complexion(P<0.01).After-treatment,the trial group had significantly lower TCM syndrome scores than the control group(P<0.05,P<0.01).Serum PG I,PGⅡ,PGR,G-17,gastric mucosal p-NF-κB,CDX2,and IL-1β,IL-6,VIL1,MUC2 mRNA levels improved significantly in the trial group(P<0.05,P<0.01),while the control group improved only in PGⅡ(P<0.05,P<0.01).The trial group's improvements in these biomarkers surpassed the control group's(P<0.05,P<0.01).No treatment-related adverse events occurred in either group.CONCLUSION Weiyan Tongluo Granules ameliorate gastric mucosal pathology,clinical symptoms,psychological state,and quality of life in CAG patients without significant adverse effects.Its mechanism may involve sup-pressing the NF-κB pathway to reduce IL-1β and IL-6 expression,downregulating CDX2 to inhibit VIL1 and MUC2 transcription,thereby reversing the vicious cycle of inflammation-intestinal metaplasia.

Objective Taking into account the physical and mental characteristics of patients with COPD,we develop and implement a lung rehabilitation education game software,aiming to explore more effective health education practices for COPD.Methods Drawing on the Health Belief Model theory,the game content was developed by semi-structured interviews,brainstorming sessions,and expert consultations,and it was implemented via a WeChat mini program.Patients with COPD from the respiratory department of a tertiary general hospital of Luzhou city between March and October 2023 were conveniently selected as the study subjects.Among them,40 patients from July to October 2023 were designated as an experimental group,and another 40 from March to June 2023 constituted a control group.The experimental group was provided with routine health education combined with pulmonary rehabilitation games,whereas the control group received standard health education.After the intervention,the researchers compared the COPD knowledge questionnaire scores and pulmonary rehabilitation adherence between the 2 groups,and assessed the satisfaction of both patients and nurses with the software.Results No sample detachment.The score of the COPD knowledge questionnaire in the experimental group was higher than that in the control group,and the difference was statistically significant(Z=5.361,P＜0.001).The proportion of patients in the experimental group with good adherence to pulmonary rehabilitation(85％)was significantly higher than it in the control group(25％),(x2=29.091,P＜0.001).The patients'overall satisfaction rate with the game was 95％,with operational effectiveness receiving the highest satisfaction rating at 97％.Conclusion The pulmonary rehabilitation education game for patients with COPD can improve their knowledge of COPD,enhance their compliance with pulmonary rehabilitation.Patients have high satisfaction with the software.The software enriches the clinical health education methods,which can be used in clinical practice.

Objective:To observe the clinical efficacy of Tuina(Chinese therapeutic massage)plus Liu Zi Jue for adenoid hypertrophy(AH)due to Qi deficiency of lung and spleen and its effects on the adenoid-nasopharyngeal cavity ratio(A/N value)and traditional Chinese medicine(TCM)constitution scale score.Methods:A total of 64 children with AH due to Qi deficiency of the lung and spleen were randomized into a trial group and a control group,with 32 cases in each group.The trial group was treated with Tuina plus Liu Zi Jue,and the control group was treated with Tuina alone.The Tuina manipulations were the same in the two groups.Tuina treatment was performed 3 times a week,with an interval of at least 1 d.Liu Zi Jue was performed 2 sets each time and 5 times a week.After 8 weeks of treatment and at the 2-month follow-up,the clinical efficacy was compared between the two groups,and the changes in the main clinical symptom score,A/N value,and TCM constitution scale score were observed.Results:After treatment,the total effective rate of the trial group and the control group was 96.9%and 93.8%,respectively.The difference between the two groups was not statistically significant(P>0.05).At the follow-up,the total effective rate of the trial group was 93.8%,higher than 90.6%in the control group(P<0.05).After treatment and at the follow-up,the main clinical symptom score in both groups was lower than that before treatment(P<0.05);at the follow-up,the main clinical symptom score in the trial group was lower than that in the control group(P<0.05).After treatment,the A/N value in both groups was lower than that before treatment(P<0.05),and the value in the trial group was lower than that in the control group;however,the difference between the two groups was not statistically significant(P>0.05).After treatment and at the follow-up,the TCM constitution scale score in both groups was lower than that before treatment(P<0.05);the score after treatment in the trial group was lower than that in the control group(P<0.05).Conclusion:Tuina plus Liu Zi Jue can effectively improve the main clinical symptoms in children with AH due to Qi deficiency of lung and spleen,reduce the A/N value and TCM constitution scale score,with stable efficacy.

Objective To compare the image quality of readout-segmented diffusion weighted imaging(RESOLVE-DWI)and integrated slice-by-slice shimming diffusion weighted imaging(iShim-DWI)in patients with nasopharyngeal carcinoma.Methods A retrospective study was conducted on 26 patients with nasopharyngeal carcinoma confirmed by pathology.The imaging data included RESOLVE-DWI and iShim-DWI.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the two sequences were compared by one deputy chief imaging technician.And two experienced radiologists used the 5-point scoring scheme to compare the lesion clarity,image artifacts,and antideformation ability of the two sequences,repectively.Results The SNR and CNR of the iShim-DWI sequence were significantly higher than those of RESOLVE-DWI sequence(P＜0.01).While the subjective scores of lesion clarity,image artifacts,and antideformation ability on RESOLVE-DWI were significantly better than those of iShim-DWI,and the differences were statistically significant(P＜0.01).Conclusion Both RESOLVE-DWI and iShim-DWI obtained good images.With sufficient SNR and CNR,RESOLVE-DWI has clearer lesions and surrounding structures,higher image resolution,fewer artifacts,and better antideformation ability,thus providing clinical advantages in evaluating patients with good physical tolerance.

To analyze the epidemiological characteristics of COVID-19 in Fujian Province from the 49th week of 2022 to the 5th week of 2023,after further optimization of China's COVID-19 prevention and control measures on December 7,2022(the 49th week of 2022),this study used multi-dimensional surveillance data to dynamically assess population infection levels and their changing trends.The aim of the study was to provide a scientific basis for early warning of epidemic risk,medical resource allocation,and evalu-ation of socio-economic impact.A multi-source data surveillance system was constructed,encompassing surveillance of fever clinics at medical institutions(weekly collection of visits,positive nucleic acid and antigen test results,inpatients,and severe cases in sec-ondary or above hospitals),population nucleic acid test monitoring(weekly person-times and positivity rates of single-tube tests from the provincial system),sentinel hospital monitoring(weekly proportion of influenza-like illness visits at 18 sentinel hospitals and re-lated viral testing data),and monitoring of novel coronavirus variants(weekly systematic collection of genomic sequences of local and imported cases).Line charts were plotted weekly,and time series analysis,molecular epidemiological methods,and an improved SEIAR model were used to simulate epidemic spread.During the study period,the COVID-19 epidemic in Fujian Province exhibited three distinct stages.In the infection peak stage(52nd week of 2022),the provincial fever clinic visits reached 606 893 person-times,and a 49.2%positivity rate in population single-tube nucleic acid tests and 63.8%positivity rate in sentinel hospital monitoring were observed.In the medical load peak stage(2nd week of 2023),274 460 inpatients and 28 487 severe cases were recorded.In the epidemic decline stage(4th to 5th weeks of 2023),fever clinic visits decreased by 96.3%with respect to the peak,the single-tube nucleic acid test positivity rate decreased to 6.3%,and the sentinel hospital COVID-19 nucleic acid test positivity rate was 6.4%.All 508 sequenced local cases were Omicron variants,predominantly BA.5.2 and its sub-lineages(67.4%).Among 56 imported se-quenced cases,BA.5.2 and its sub-lineages accounted for 50.0%,and 16.1%comprised nine variants of interest including XBB and BQ.The model predicted the infection peak in the 52nd week of 2022,whereas the hospitalization peak lagged by approximately 10.6 days.Multi-source data monitoring revealed a three-stage development of the COVID-19 epidemic in Fujian.The BA.5.2 strain was dominant during the epidemic.The combination of multi-source monitoring data and modeling provides important references for epi-demic prevention and control,and highlights the need to improve the monitoring system in follow-up.

Objective:To determine the detection rate of myopia among primary and secondary school students in Hunan Province in 2022 and to analyze the influencing factors at both the school and individual levels, thereby providing a scientific basis for developing myopia prevention and control strategies.Methods:From October to November 2022, a multi-stage stratified cluster random sampling method was employed to select students from Year 4 of primary school to Year 3 of senior high school across 14 prefecture-level (autonomous prefecture) cities in Hunan Province for vision screening and questionnaire surveys. A multilevel regression model was utilized to analyze the influencing factors of myopia at both the school and individual levels.Results:A total of 189 343 primary and secondary school students were included in this study. The overall myopia detection rate was 55.56%, with a significantly higher prevalence observed in female students (60.49%) compared to males (51.03%) and in urban students (59.12%) versus those from rural areas (53.50%). A marked upward trend in myopia prevalence was identified with advancing grade levels (trend test χ2=16 246.13, P<0.001). Multilevel regression analysis revealed that at the individual level, female gender, higher grade level, parental myopia history, daily homework duration ≥2 hours after school, improper reading/writing postures, and taking breaks only after more than 15 minutes of near work were associated with an increased risk of myopia. Conversely, adequate sleep duration, outdoor activity ≥2 hours, and outdoor breaks during recess demonstrated protective effects. At the school level, non-compliant blackboard illumination uniformity emerged as a significant risk factor for myopia development. Conclusions:The detection rate of myopia among primary and secondary school students in Hunan Province remains relatively high and is associated with multiple factors at both the school and individual levels. Targeted interventions should be implemented at different levels to mitigate the risk of myopia.

To analyze the epidemiological characteristics of COVID-19 in Fujian Province from the 49th week of 2022 to the 5th week of 2023,after further optimization of China's COVID-19 prevention and control measures on December 7,2022(the 49th week of 2022),this study used multi-dimensional surveillance data to dynamically assess population infection levels and their changing trends.The aim of the study was to provide a scientific basis for early warning of epidemic risk,medical resource allocation,and evalu-ation of socio-economic impact.A multi-source data surveillance system was constructed,encompassing surveillance of fever clinics at medical institutions(weekly collection of visits,positive nucleic acid and antigen test results,inpatients,and severe cases in sec-ondary or above hospitals),population nucleic acid test monitoring(weekly person-times and positivity rates of single-tube tests from the provincial system),sentinel hospital monitoring(weekly proportion of influenza-like illness visits at 18 sentinel hospitals and re-lated viral testing data),and monitoring of novel coronavirus variants(weekly systematic collection of genomic sequences of local and imported cases).Line charts were plotted weekly,and time series analysis,molecular epidemiological methods,and an improved SEIAR model were used to simulate epidemic spread.During the study period,the COVID-19 epidemic in Fujian Province exhibited three distinct stages.In the infection peak stage(52nd week of 2022),the provincial fever clinic visits reached 606 893 person-times,and a 49.2%positivity rate in population single-tube nucleic acid tests and 63.8%positivity rate in sentinel hospital monitoring were observed.In the medical load peak stage(2nd week of 2023),274 460 inpatients and 28 487 severe cases were recorded.In the epidemic decline stage(4th to 5th weeks of 2023),fever clinic visits decreased by 96.3%with respect to the peak,the single-tube nucleic acid test positivity rate decreased to 6.3%,and the sentinel hospital COVID-19 nucleic acid test positivity rate was 6.4%.All 508 sequenced local cases were Omicron variants,predominantly BA.5.2 and its sub-lineages(67.4%).Among 56 imported se-quenced cases,BA.5.2 and its sub-lineages accounted for 50.0%,and 16.1%comprised nine variants of interest including XBB and BQ.The model predicted the infection peak in the 52nd week of 2022,whereas the hospitalization peak lagged by approximately 10.6 days.Multi-source data monitoring revealed a three-stage development of the COVID-19 epidemic in Fujian.The BA.5.2 strain was dominant during the epidemic.The combination of multi-source monitoring data and modeling provides important references for epi-demic prevention and control,and highlights the need to improve the monitoring system in follow-up.

OBJECTIVE To explore the potential mechanisms of astragalin （AG） in allevating ulcerative colitis （UC） in mice through modulation of the intestinal flora. METHODS Male C57BL/6 mice were randomly divided into normal group （CON group）， model group [dextran sodium sulfate （DSS） group]， 5-aminosalicylic acid group （5-ASA group）， AG low-dose group and high-dose group （AGL and AGH groups）， with 8 mice in each group. The mice UC model was established by drinking 3% DSS solution continuously for 7 days in all groups except the CON group. After that， 3% DSS solution was replaced by water， and the mice of each drug group were gavaged with the corresponding drug solution. Mice in the CON and DSS groups were gavaged with an equal volume of normal saline， once a day， for 7 days. After the last gavage， the body weight change index， disease activity index （DAI） score， colon length and spleen index， and levels of inflammatory factors （tumor necrosis factor-α， interleukin-1β， interleukin-6） were compared among the mice in each group； pathological changes in colonic tissues of the mice were observed in each group， and the pathological score and the percentage of goblet cells were compared； mRNA expressions of barrier-related factors [occludin and ZO-1] and inflammation-related factors [silencing information regulatory factor 1 （SIRT1）， c-Jun N-terminal kinase （JNK） and p38 mitogen-activated protein kinase （p38 MAPK）] were detected in each group of mice； the changes in the intestinal flora of mice in each group were analyzed and the contents of intestinal metabolites short-chain fatty acids （SCFAs） was determined. Using DSS and AG-treated fecal bacterial liquid as an intervention， the mechanism of anti-UC effect of AG was further verified by a fecal microbiota transplant experiment. RESULTS Compared with the CON group， the intestinal mucosal structure of mice in the DSS group was severely damaged， with obvious infiltration of inflammatory cells collapsing the wall； their body weight change index， colon length， the percentage of goblet cells， mRNA expressions of occludin， ZO-1 and SIRT1， Chao1 and Shannon indexes， and contents of acetic acid and butyric acid were significantly reduced， shortened or down-regulated （P＜0.05）； however， DAI score， spleen index， levels of inflammatory factors， pathological score， as well as mRNA expressions of p38 MAPK and JNK， were all significantly increased or up-regulated （P＜0.05）. Compared with the DSS group， colon tissue lesions of AG mice in all dose groups showed different degrees of improvement， and the above quantitative indexes were generally regressed （P＜0.05）， and the intervention effect of AG-treated fecal bacterial fluid was basically the same as that of AG. CONCLUSIONS AG can improve relevant symptoms in UC mice and reduce their inflammatory response and colonic histopathological changes. The above effects may be related to regulating the diversity of intestinal flora in mice， increasing the contents of butyric acid and propionic acid， and promoting the repair of the colonic mucosal barrier， thus regulating the expressions of genes related to the SIRT1/p38 MAPK inflammatory pathway.