Circadian rhythm is an endogenous biological clock mechanism that enables organisms to adapt to the earth’s alternation of day and night. It plays a fundamental role in regulating physiological functions and behavioral patterns, such as sleep, feeding, hormone levels and body temperature. By aligning these processes with environmental changes, circadian rhythm plays a pivotal role in maintaining homeostasis and promoting optimal health. However, modern lifestyles, characterized by irregular work schedules and pervasive exposure to artificial light, have disrupted these rhythms for many individuals. Such disruptions have been linked to a variety of health problems, including sleep disorders, metabolic syndromes, cardiovascular diseases, and immune dysfunction, underscoring the critical role of circadian rhythm in human health. Among the numerous systems influenced by circadian rhythm, the skin—a multifunctional organ and the largest by surface area—is particularly noteworthy. As the body’s first line of defense against environmental insults such as UV radiation, pollutants, and pathogens, the skin is highly affected by changes in circadian rhythm. Circadian rhythm regulates multiple skin-related processes, including cyclic changes in cell proliferation, differentiation, and apoptosis, as well as DNA repair mechanisms and antioxidant defenses. For instance, studies have shown that keratinocyte proliferation peaks during the night, coinciding with reduced environmental stress, while DNA repair mechanisms are most active during the day to counteract UV-induced damage. This temporal coordination highlights the critical role of circadian rhythms in preserving skin integrity and function. Beyond maintaining homeostasis, circadian rhythm is also pivotal in the skin’s repair and regeneration processes following injury. Skin regeneration is a complex, multi-stage process involving hemostasis, inflammation, proliferation, and remodeling, all of which are influenced by circadian regulation. Key cellular activities, such as fibroblast migration, keratinocyte activation, and extracellular matrix remodeling, are modulated by the circadian clock, ensuring that repair processes occur with optimal efficiency. Additionally, circadian rhythm regulates the secretion of cytokines and growth factors, which are critical for coordinating cellular communication and orchestrating tissue regeneration. Disruptions to these rhythms can impair the repair process, leading to delayed wound healing, increased scarring, or chronic inflammatory conditions. The aim of this review is to synthesize recent information on the interactions between circadian rhythms and skin physiology, with a particular focus on skin tissue repair and regeneration. Molecular mechanisms of circadian regulation in skin cells, including the role of core clock genes such as Clock, Bmal1, Per and Cry. These genes control the expression of downstream effectors involved in cell cycle regulation, DNA repair, oxidative stress response and inflammatory pathways. By understanding how these mechanisms operate in healthy and diseased states, we can discover new insights into the temporal dynamics of skin regeneration. In addition, by exploring the therapeutic potential of circadian biology in enhancing skin repair and regeneration, strategies such as topical medications that can be applied in a time-limited manner, phototherapy that is synchronized with circadian rhythms, and pharmacological modulation of clock genes are expected to optimize clinical outcomes. Interventions based on the skin’s natural rhythms can provide a personalized and efficient approach to promote skin regeneration and recovery. This review not only introduces the important role of circadian rhythms in skin biology, but also provides a new idea for future innovative therapies and regenerative medicine based on circadian rhythms.

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 explore the potential mechanism of Cigu Xiaozhi Prescription(CGXP)in the treatment of non-alco-holic steatohepatitis(NASH)liver fibrosis.METHODS A NASH mouse model was established.The degree of liver enlargement was evaluated by calculating the liver index.Hematoxylin-eosin(HE)and Masson staining were used to observe the degree of liver fibro-sis.In addition,immunohistochemistry was employed to detect the expression of liver fibrosis-related proteins,including α-SMA,Collagen 1,MMP2,and MMP9.Western blot and qPCR techniques were used to detect the expression levels of HIF-1α,E-cadher-in,N-cadherin,Shh,Smo,Gli1,and Gli2 in the mouse liver.The alkaline hydrolysis method was used to measure the content of liv-er hydroxyproline.RESULTS CGXP could effectively reduce the liver index(P<0.001),alleviate liver enlargement and inflamma-tion,and significantly improve the pathological damage of liver tissue in mice with liver fibrosis.CGXP significantly decreased the ex-pression levels of liver fibrosis-related proteins α-SMA,Collagen 1,MMP2 and MMP9(P<0.01,P<0.000 1);reduced the levels of HIF-1α,E-cadherin,N-cadherin,Shh,Smo,Gli1,and Gli2,and the therapeutic effect of high-dose CGXP was particularly significant(P<0.05,P<0.01,P<0.001,P<0.000 1).CONCLUSION CGXP can relieve NASH liver fibrosis in mice by reducing the liver index,alleviating inflammation,and improving tissue pathological damage.The mechanism may be related to the inhibition of the Hedgehog signaling pathway,which alters the activation and proliferation of hepatic stellate cells and reduces the synthesis and dep-osition of extracellular matrix.

Objective:To explore the risk assessment and intervention effect of WeChat platform-based health management in high-risk populations for cardiovascular diseases (CVD).Methods:It was a randomized controlled trial. A total of 480 individuals at high risk of CVD who underwent physical examinations at the Health Management Center of Sichuan Provincial People′s Hospital from February to April in 2023 were selected using a simple random sampling method. The participants were randomly assigned to either the intervention group or the control group (240 cases each) using a random number table. The control group received routine follow-up and health assessments, while the intervention group received an additional 12-month WeChat-based health management intervention. During the study, 28 participants were lost to follow-up, resulting in 227 participants in the intervention group and 225 in the control group being included in the final analysis. The 10-year CVD risk was assessed using the prediction for atherosclerotic cardiovascular disease risk in China (China-PAR) model, and psychological status was evaluated using the self-rating anxiety Scale (SAS) and the self-rating depression scale (SDS). Changes in health behaviors, adherence, life style, blood pressure, metabolic indicators, psychological status, and CVD risk were compared before and after the intervention in both groups to evaluate the intervention′s effectiveness.Results:Among the 452 high-risk participants analyzed, the intervention group included 227 individuals [mean age: (53.16±10.81) years; 117 males and 110 females], and the control group included 225 individuals [mean age: (52.60±10.25) years; 118 males and 107 females]. There was no significant differences in baseline characteristics between the two groups (all P>0.05). After 12 months of intervention, the intervention group showed significant improvements in medication adherence, intake of vegetables and fruits, exercise duration, sleep time, proportion of regular lifestyle, and high density lipoprotein cholesterol (HDL-C) levels, all of which were all higher than both the baseline values and those in the control group (all P<0.05). Conversely, the intervention group showed reductions in medical visit rate, smoking and drinking rates, high-salt diet, meat intake, body mass index (BMI), fasting blood glucose, systolic and diastolic blood pressure, low density lipoprotein cholesterol (LDL-C), total cholesterol, triglycerides, SAS and SDS scores when compared to the baseline values and those in the control group (all P<0.05). The proportions of participants with 10-year CVD risk levels of 10%-<20%, 20%-<30%, 30%-<40%, and ≥40% significantly decreased in the intervention group after intervention (18.94% vs 36.12%, 12.78% vs 26.43%, 7.93% vs 19.82%, 3.96% vs 17.63%), and were also significantly lower than those in the control group (18.94% vs 40.45%, 12.78% vs 30.67%, 7.93% vs 22.67%, 3.96% vs 16.89%) (all P<0.001). After 12 months, the intervention group showed significantly higher improvement rates in both medication adherence and non-medication-related compliance behaviors, including smoking, alcohol consumption, meat and salt intake, fruit and vegetable intake, exercise duration, sleep duration, and lifestyle regularity, when compared to those in the control group (16.74% vs -3.11%, 14.54% vs -0.89%, 16.74% vs -0.44%, 57.71% vs 8.44%, 21.15% vs -0.44%, 56.83% vs -6.67%, 51.54% vs -3.56%, 60.79% vs -7.11%, 26.87% vs -13.78%, 22.91% vs -1.78%) (all P<0.001). Conclusion:The WeChat platform-based health management intervention can effectively improve the behavioral patterns, compliance, control of CVD risk factors and psychological status of high-risk populations for CVD, and help reduce their 10-year risk of CVD.

Objective:To observe the clinical efficacy and safety of Jianpi Bushen Jiedu Prescription combined with 5-fluorouracil (5-FU)-based chemotherapy and targeted therapy for the treatment of advanced colorectal cancer patients with liver and kidney yin deficiency combined with spleen deficiency pattern.Methods:A randomized controlled trial was conducted. A total of 72 hospitalized patients with advanced colorectal cancer treated at the Department of Oncology, Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from October 2022 to January 2024 were enrolled as study subjects. Using a random number table method, they were allocated into two groups, with 36 patients in each group. The control group received the mFOLFOX6/FOLFIRI combined with bevacizumab regimen, while the treatment group was administered additional oral Jianpi Bushen Jiedu Prescription on the basis of the control group. Two weeks was a cycle in both groups, with a total of 6 cycles of treatment. Serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), and carbohydrate antigen 724 (CA724) were detected using electrochemiluminescence; the Karnofsky Performance Status (KPS) scale was utilized to evaluate patients' functional status; vital signs were continuously monitored, and adverse reactions were recorded. The short-term efficacy and TCM syndrome efficacy of patients were evaluated.Results:The treatment group demonstrated higher objective response rate (ORR) [31.25% (10/32) vs. 21.88% (7/32), χ2=0.72] and disease control rate (DCR) [84.38% (27/32) vs. 71.88% (23/32), χ2=1.46] compared to the control group, without statistical significance ( P>0.05). Post-treatment levels of CEA [4.09 (3.31,8.57) μg/L vs. 10.07 (4.55,22.35) μg/L, Z=-2.10] and CA72-4 [4.54 (2.04,10.99) mU/L vs. 9.48 (4.34,18.95) mU/L, Z=-2.52] in the treatment group were significantly lower than those in the control group ( P<0.05). The total effective rate of TCM syndrome was significantly higher in the treatment group [78.13% (25/32)] compared with the control group [50.00% (16/32)], with statistical significance ( χ2=5.50, P=0.019). Post-treatment KPS scores in the treatment group [80.0 (80.0, 80.0) vs. 70.0 (62.5, 80.0), Z=-2.76] were significantly higher compared with the control group ( P<0.01). During the treatment period, the treatment group showed statistical significance compared with the control group in the incidence of hemoglobin decrease ( χ2=4.66), leukopenia decrease ( χ2=4.27), and peripheral neuropathy ( χ2=3.93), with statistical significance ( P<0.05). Conclusion:The addition of Jianpi Bushen Jiedu Prescription to 5-FU-based chemotherapy combined with targeted therapy demonstrates significant clinical benefits in advanced colorectal cancer patients, including reducing tumor marker levels, alleviating clinical symptoms, improving quality of life, and mitigating treatment-related toxicities, with a good safety.

Objective To understand the clinical applicability and implementation of expert consensus on the implementation and removal of protective restraints in psychiatry,and to provide references for promoting the standardized practice of psychiatric protective restraints and updating the consensus.Methods By the convenience sampling method,a questionnaire survey was conducted among nurses from 480 hospitals in 30 provinces from June 15 to July 15,2024.The survey was conducted using the instrument for evaluating clinical applicability of guide-lines(version 2.0)and a self-compiled questionnaire on the clinical implementation of the restraint consensus.Results A total of 7,844 valid questionnaires were collected,with a valid questionnaire recovery rate of 93.78％.The results of clinical applicability scoring showed that the consensus had the lowest availability score(64.72％)and the highest acceptability score(76.74％).The results showed that nurses' receiving training and the level of their hospitals were the main influencing factors for scores in various dimensions(P＜0.05).4,774 participants(87.42％)believed that the application of consensus could enhance the standardization of nurses' restraint operations.The safety rate of the restraint consensus was 79.51％,and the economic ratio was 76.87％.Among the evaluators,1,739(22.17％)believed that there were implementation obstacles in the consensus.Conclusion The clinical applicability of the consensus is relatively good,and the application of the consensus helps to improve the standardization of clinical operations.In the future,efforts should be made to strengthen the promotion and training of the consensus,develop hierarchical promotion strategies according to the characteristics of medical institutions,and improve the quality of evidence for the consensus,so as to further enhance the clinical application effect of the consensus.

Objective To investigate the clinical efficacy of the traditional Chinese medicine(TCM)throat opening and brightening method in treating unilateral vocal cord paralysis(UVCP).Methods Sixty patients with UVCP were prospectively collected and randomly assigned to two groups:the Chinese herbal medicine group(trea-ted with Buyang Huanwu Decoction,n=30)and the throat opening and brightening method group(treated with TCM throat opening and brightening method,n=30).The clinical studies that had utilized injection laryngoplasty for the treatment of UVCP(historical control group).Evaluation indicators included the voice handicap index-10(VHI-10),GRBAS-G,objective acoustic measurements of voice(vocal intensity,F0,shimmer,jitter,HNR),and aerodynamic measurements(maximum phonation time,MPT).Results Before treatment,no significant differences were observed between the two groups in all the evaluation indicators(P＞0.05).Post-treatment,the throat open-ing and brightening method group demonstrated significant improvements in VHI-10,GRBAS-G,shimmer,jitter,HNR,and MPT compared to pre-treatment values(P＜0.01),and these improvements were superior to those in the Chinese herbal medicine group.Pre-treatment VHI-10,GRBAS-G,and shimmer scores in the throat opening and brightening method group were significantly higher than those in the historical literature group(P＜0.01).Af-ter treatment,no significant differences were noted in any assessed parameters between the two groups(P＞0.05).Conclusion The TCM throat opening and brightening method significantly enhances phonatory function and quality of life in patients with UVCP,showing comparable efficacy to injection laryngoplasty.

Objective:To investigate the neuroprotective effect of nicotinamide riboside(NR)on experimental autoimmune en-cephalomyelitis(EAE)mice.Methods:C57BL/6 female mice were induced by myelin oligodendrocyte glycoprotein(MOG35-55)to pro-duce EAE model and were randomly divided into EAE group and NR group.From day 3 to day 27 after immunization,each mouse in EAE group was given normal saline(200 μl/d)and each mouse in NR group was given NR(500 mg/kg,200 μl/d)by intragastric administration.Clinical score and body weight of mice in EAE group and NR group were recorded every day.On the 28th day after immunization,the spinal cord protein of mice in each group was extracted and the frozen sections of spinal cord of mice in each group were prepared.LFB staining was used to detect demyelination,immunofluorescence staining was used to detect the expression of MAP-2 and the number of positive cells of NeuN,BDNF,GDNF,NGF and NT-3,and Western blot was used to detect the expressions of BDNF,GDNF,NGF and NT-3 of spinal cord.Results:Compared with EAE group,NR significantly delayed the onset time of EAE mice(P<0.05),decreased clinical score(P<0.05),reduced weight loss,alleviated spinal cord demyelination(P<0.05),increased the expression of MAP-2(P<0.01)and the number of NeuN positive cells(P<0.01),and up-regulated the expressions of BDNF,GDNF,NGF and NT-3(P<0.05).Conclusion:NR shows a good neuroprotective effect on EAE mice.The mechanism may be related to NR significantly increasing the expression of spinal neurotrophic factors,improving the microenvironment of the central nervous sys-tem,nourishing nerves,promoting nerve repair and nerve growth,etc.

OBJECTIVE To explore the potential mechanism of Cigu Xiaozhi Prescription(CGXP)in the treatment of non-alco-holic steatohepatitis(NASH)liver fibrosis.METHODS A NASH mouse model was established.The degree of liver enlargement was evaluated by calculating the liver index.Hematoxylin-eosin(HE)and Masson staining were used to observe the degree of liver fibro-sis.In addition,immunohistochemistry was employed to detect the expression of liver fibrosis-related proteins,including α-SMA,Collagen 1,MMP2,and MMP9.Western blot and qPCR techniques were used to detect the expression levels of HIF-1α,E-cadher-in,N-cadherin,Shh,Smo,Gli1,and Gli2 in the mouse liver.The alkaline hydrolysis method was used to measure the content of liv-er hydroxyproline.RESULTS CGXP could effectively reduce the liver index(P<0.001),alleviate liver enlargement and inflamma-tion,and significantly improve the pathological damage of liver tissue in mice with liver fibrosis.CGXP significantly decreased the ex-pression levels of liver fibrosis-related proteins α-SMA,Collagen 1,MMP2 and MMP9(P<0.01,P<0.000 1);reduced the levels of HIF-1α,E-cadherin,N-cadherin,Shh,Smo,Gli1,and Gli2,and the therapeutic effect of high-dose CGXP was particularly significant(P<0.05,P<0.01,P<0.001,P<0.000 1).CONCLUSION CGXP can relieve NASH liver fibrosis in mice by reducing the liver index,alleviating inflammation,and improving tissue pathological damage.The mechanism may be related to the inhibition of the Hedgehog signaling pathway,which alters the activation and proliferation of hepatic stellate cells and reduces the synthesis and dep-osition of extracellular matrix.

Objective To investigate the clinical efficacy of the traditional Chinese medicine(TCM)throat opening and brightening method in treating unilateral vocal cord paralysis(UVCP).Methods Sixty patients with UVCP were prospectively collected and randomly assigned to two groups:the Chinese herbal medicine group(trea-ted with Buyang Huanwu Decoction,n=30)and the throat opening and brightening method group(treated with TCM throat opening and brightening method,n=30).The clinical studies that had utilized injection laryngoplasty for the treatment of UVCP(historical control group).Evaluation indicators included the voice handicap index-10(VHI-10),GRBAS-G,objective acoustic measurements of voice(vocal intensity,F0,shimmer,jitter,HNR),and aerodynamic measurements(maximum phonation time,MPT).Results Before treatment,no significant differences were observed between the two groups in all the evaluation indicators(P＞0.05).Post-treatment,the throat open-ing and brightening method group demonstrated significant improvements in VHI-10,GRBAS-G,shimmer,jitter,HNR,and MPT compared to pre-treatment values(P＜0.01),and these improvements were superior to those in the Chinese herbal medicine group.Pre-treatment VHI-10,GRBAS-G,and shimmer scores in the throat opening and brightening method group were significantly higher than those in the historical literature group(P＜0.01).Af-ter treatment,no significant differences were noted in any assessed parameters between the two groups(P＞0.05).Conclusion The TCM throat opening and brightening method significantly enhances phonatory function and quality of life in patients with UVCP,showing comparable efficacy to injection laryngoplasty.