Hygroscopicity research has long been a key focus and hot topic in Chinese materia medica（CMM）. Elucidating hygroscopic mechanisms plays a vital role in formulation design， process optimization， and storage condition selection. Hygroscopic models serve as essential tools for characterizing CMM hygroscopic mechanisms， with various types available. The double exponential model is a kinetic mathematical model constructed based on the law of conservation of energy and Fick's first law of diffusion， tailored to the physical properties of CMM extracts. In recent years， this model has been extensively applied to simulate the dynamic moisture absorption behavior of CMM extracts and solid dosage forms under varying humidity conditions. It has revealed the correlation between moisture absorption kinetic parameters and material properties， offering a new perspective for characterizing the moisture uptake behavior of CMM. This paper systematically reviews the application progress of this model in the field of CMM， analyzes its advantages， disadvantages， and challenges in this domain， and explores its potential application trends in other fields. It aims to provide references for elucidating the moisture absorption mechanisms of CMM and researching moisture-proofing technologies， while also offering insights for its broader application in food and polymer materials.

Objective To investigate the role of activating transcription factor 4 (ATF4) in benign prostatic hyperplasia (BPH) in order to elucidate the molecular mechanism underlying BPH progression. Methods Firstly, we analyzed the correlation between the expression of ATF4 and the volume of prostate transition zone in BPH tissues using publicly available datasets. Subsequently, we explored the potential association among ATF4, epithelial-mesenchymal transition (EMT) and BPH through single-cell RNA sequencing (scRNA-seq). Finally, we validated the findings by silencing ATF4 and treating BPH cells with ATF4 protein inhibitors, followed by reverse transcription quantitative polymerase chain reaction (RT-qPCR), CCK-8 assay, and Western blot. Results The expression of ATF4 in BPH tissues exhibited a significant positive correlation with the volume of prostate transition zone (r=0.64, P＜0.05). scRNA-seq analysis revealed that ATF4 was significantly upregulated in the prostate epithelial cells of BPH patients (P＜0.05), and its expression demonstrated a significant positive correlation with the Hallmark EMT singscore (r=0.14, P＜0.05). In vitro experiments further indicated that knockdown of ATF4 led to a significant reduction in the proliferative activity of BPH-1 cells (P＜0.05). Similarly, inhibition of ATF4 activity resulted in a marked decrease in the proliferative capacity and EMT of BPH-1 cells (P＜0.05). Conclusion ATF4 may exert a promoting effect on BPH by modulating the EMT signaling pathway;therefore, ATF4 may serve as a novel therapeutic target of BPH.

As a chronic and lifelong disease， diabetes mellitus occurs across all age groups and gender groups. Since the disease requires lifelong treatment， it seriously affects the quality of life of patients. With the rising incidence on a global scale， diabetes mellitus has become a global problem that seriously affects public health. Moreover， the complications of this disease have aroused concern from the global medical research community， the World Health Organization， and the public. In the past， Western medicine was used in the clinical treatment of diabetes mellitus， which， however， had drug dependence， unsatisfactory efficacy， and side effects. Long-term oral administration of antidiabetics may cause liver and kidney function damage， hypoglycemia and other adverse symptoms. The treatment of diabetes mellitus has been faced with challenges such as limited efficacy and obvious side effects. Therefore， exploring more effective treatment means， especially tapping the potential of traditional Chinese medicine （TCM） in the treatment of diabetes mellitus， is a major issue to be solved. TCM has shown a great application value and a broad prospect in the treatment of diabetes mellitus because of multi-target regulation， a holistic view， synergistic effects， and high safety. TCM has a history of thousands of years in the prevention and treatment of diabetes mellitus， with rich experience accumulated and remarkable results achieved. Particularly， TCM demonstrates definite therapeutic effects on the complications. The application of TCM in the treatment of complications has been recognized and accepted by patients because of the definite therapeutic effect. In recent years， great progress has been achieved in the treatment of diabetes mellitus by the combination of Chinese and western medicine， which has made important contributions to the control of diabetes mellitus. This paper reviews the articles about the treatment of diabetes mellitus with TCM classic prescriptions， summarizes the treatment of clinical cases regarding the indications of these prescriptions， and provides an overview of the treatment mechanisms， aiming to offer fresh insights and strategies for the clinical diagnosis and treatment of diabetes mellitus.

Objective:To investigate the relationship between the Myers-Briggs Type Indicator(MBTI)personality traits,empathy ability,and emotion regulation among medical students,and to advocate for medical students to conduct in-depth self-analysis using MBTI,and to enhance their empathy ability in a targeted manner,thereby more effectively building harmonious doctor-patient relationships.Methods:A total of 664 medical students were investigated using the MBTI,the Chinese version of the Emotion Regulation Questionnaire(ERQ),and the Chinese version of the Interpersonal Reactivity Index(IRI).The mediation analysis in SPSSAU employed the product coefficient test method,utilizing Bootstrap sampling for data analysis.Results:The MBTI personality traits of medical students were generally inclined to Introversion-Sensing-Thinking-Judging(ISTJ).Medical students tended to use cognitive reappraisal,and the level of empathy needed to be strengthened.Males exhibited higher expressive inhibition than females,while females experienced greater personal distress than males.Expressive inhibition was also higher in only children compared to non-only children,and only children showed lower emotional empathy than non-only children.Cognitive reappraisal played a partial mediating role in the relationship between introverted/extraverted personality traits and personal distress among medical students(mediating effect=-0.017,accounting for 14.217%of the total effect),and a complete mediating effect between introverted/extraverted personality traits and emotional empathy(mediating effect=0.024,accounting for 100%of the total effect).Cognitive reappraisal partially mediated the relationship between life attitude orientation and emotional empathy(mediating effect=0.017,accounting for 15.727%of the total effect),and served as a partial mediator in the relationship between life attitude orientation and cognitive empathy(mediating effect=0.171,accounting for 25.827%of the total effect).Conclusion:Cognitive reappraisal has a mediating effect on the relationship between medical students'MBTI personality traits and empathy,guiding medical students to improve empathy abilities using cognitive reappraisal.Medical students can further understand their strengths and weaknesses by identifying their MBTI types,and improve their empathy ability in a targeted manner,to better adapt to future medical work.

Objective:To detect pathogenic gene mutations in a patient with CARD14-associated papulosquamous eruption (CAPE) and his family, and to evaluate the short-term and long-term efficacy and safety of ustekinumab treatment.Methods:Clinical data were collected from a 6-year-old child presenting with erythroderma secondary to pityriasis rubra pilaris and from his family members. Peripheral blood samples were collected from the patient, his parents and younger brother, and DNA was extracted from these peripheral blood samples. A next-generation skin-targeted sequencing panel was used to detect gene mutations, and Sanger sequencing was performed for verification. Genomic DNA was also extracted from 100 unrelated healthy controls using the same method.Results:A heterozygous mutation c.349+1G>A in intron 6 of the CARD14 gene was identified in the proband and his mother, but was not identified in his father, younger brother or 100 healthy controls, leading to a diagnosis of CAPE in the proband. The patient received subcutaneous injections of ustekinumab at a dose of 45 mg at weeks 0 and 4, and every 12 weeks thereafter. After 1-week treatment, the skin lesions and symptoms improved markedly. No adverse events were reported during the 18-month treatment and follow-up.Conclusion:The heterozygous mutation c.349+1G>A in the CARD14 gene may be the cause of the disease in this family, and ustekinumab was effective and safe for the treatment of CAPE.

Objective:To evaluate the clinical process of fragment reattachment in crown-root fractures (CRF) of teeth that the fracture occurred between sub-gingival and supra-alveolar ridge (sub-gingival & supra-alveolar ridge) in the esthetic zone, and to analyze the feasibility of this minimally invasive technique for sub-gingival & supra-alveolar ridge CRF involving anterior teeth.Methods:Fourteen sub-gingival & supra-alveolar ridge CRF involving anterior teeth in 12 patients received fragment reattachment in the Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University from January 2016 to August 2024. The success rate of the fractured teeth 3 years after reattachment and the complications during the follow-up period were retrospectively analyzed. The 3-year success rate and complications during follow-up were evaluated to assess the clinical efficacy of this technique.Results:The 14 treated teeth were followed for an average of (36.0±33.7) months (range: 4-99 months). Complications occurred in 2 teeth: one was extracted due to debonding and replaced with a removable partial denture, while the other developed a palatal sinus post-reattachment, which healed after local saline irrigation and medication (followed for 12 months without recurrence). The remaining 12 teeth exhibited no complications, resulting in a success rate of 13/14.Conclusions:Fragment reattachment is a minimally invasive, rapid, and cost-effective treatment option for sub-gingival & supra-alveolar ridge CRF in the anterior esthetic zone. With strict case selection, it delivers favorable outcomes and extends the clinical lifespan of affected teeth.

Objective:To evaluate the impact of roxadustat on thyroid function and to identify the associated factors in patients undergoing maintenance peritoneal dialysis (PD).Methods:This study was a single-center retrospective study. PD patients who received roxadustat or recombinant human erythropoietin (rHuEPO) treatment at Nanjing Drum Tower Hospital between January 2020 and June 2024 were included. The general and clinical information as well as laboratory indexes were collected. Serum free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were compared before and after treatment initiation. Hemoglobin (Hb) responses were also observed between the two groups. Logistic regression analysis was performed to explore the factors associated with thyroid function changes.Results:A total of 120 patients were enrolled, with an age of (55.17±16.42) years, including 66 males (55.0%). There were 81 patients received roxadustat (roxadustat group) and 39 patiens received rHuEPO (rHuEPO group). Compared to the rHuEPO group, the roxadustat group had a higher proportion of patients with diabetes ( χ 2= 4.172, P=0.041), a shorter PD vintage ( Z=-3.406, P=0.002), a lower serum level of total cholesterol ( Z=-2.082, P=0.037) and a lower level of fasting blood glucose ( Z=-2.589, P=0.010). Following treatment with roxadustat, the levels of FT4 ( Z=-5.349, P<0.01) and TSH ( Z=-3.720, P<0.01) decreased significantly. In contrast, no significant changes in FT4 or TSH levels were observed in the rHuEPO group (both P>0.05). For both roxadustat and rHuEPO groups, there were no significant changes in FT3 levels after treatment (both P>0.05). Multivariate analysis identified that higher baseline TSH (TSH≥2.27 μIU/ml, OR=1.581, 95% CI 1.196-2.089, P=0.001) and roxadustat exposure ( OR=3.432, 95% CI 1.410-8.355, P=0.007) as independent associated factors of subsequent TSH decline, and identified that higher baseline FT4 (FT4≥14.9 pmol/L, OR=1.390, 95% CI 1.162-1.662, P=0.001) and roxadustat exposure ( OR=5.798, 95% CI 2.225-15.113, P=0.001) as independent associated factors of subsequent FT4 decline. The degrees of hemoglobin changes after roxadustat or rHuEPO treatment did not differ significantly between roxadustat group and rHuEPO group ( t=-1.062, P=0.290). Of the 31 patients who underwent a second thyroid function test during roxadustat treatment, 24 continued with the original regimen, while 7 discontinued roxadustat. Among 24 patients who maintained roxadustat treatment, TSH ( Z=-0.400, P=0.689) and FT4 ( t=0.143, P=0.888) remained stable between the second and third tests. All 7 patients who discontinued roxadustat treatment showed TSH rebound and the changes of TSH levels were more significant than that in continuers ( Z=-2.505, P=0.012). FT4 recovery occurred in only 3 of them, with no significant difference in FT4 change between discontinuers and continuers ( Z=-0.685, P=0.493). Conclusions:Roxadustat commonly suppresses TSH and FT4, but not FT3, in PD patients. Baseline levels of TSH and FT4 are key associated factors of the inhibitory effect of roxadustat on thyroid function. This suppression does not intensify with prolonged exposure and is reversible after discontinuation, with TSH levels normalizing more quickly than FT4. Roxadustat-induced thyroid suppression does not compromise its efficacy in treating renal anemia.

Objective:To detect pathogenic gene mutations in a patient with CARD14-associated papulosquamous eruption (CAPE) and his family, and to evaluate the short-term and long-term efficacy and safety of ustekinumab treatment.Methods:Clinical data were collected from a 6-year-old child presenting with erythroderma secondary to pityriasis rubra pilaris and from his family members. Peripheral blood samples were collected from the patient, his parents and younger brother, and DNA was extracted from these peripheral blood samples. A next-generation skin-targeted sequencing panel was used to detect gene mutations, and Sanger sequencing was performed for verification. Genomic DNA was also extracted from 100 unrelated healthy controls using the same method.Results:A heterozygous mutation c.349+1G>A in intron 6 of the CARD14 gene was identified in the proband and his mother, but was not identified in his father, younger brother or 100 healthy controls, leading to a diagnosis of CAPE in the proband. The patient received subcutaneous injections of ustekinumab at a dose of 45 mg at weeks 0 and 4, and every 12 weeks thereafter. After 1-week treatment, the skin lesions and symptoms improved markedly. No adverse events were reported during the 18-month treatment and follow-up.Conclusion:The heterozygous mutation c.349+1G>A in the CARD14 gene may be the cause of the disease in this family, and ustekinumab was effective and safe for the treatment of CAPE.

Objective:To evaluate the clinical process of fragment reattachment in crown-root fractures (CRF) of teeth that the fracture occurred between sub-gingival and supra-alveolar ridge (sub-gingival & supra-alveolar ridge) in the esthetic zone, and to analyze the feasibility of this minimally invasive technique for sub-gingival & supra-alveolar ridge CRF involving anterior teeth.Methods:Fourteen sub-gingival & supra-alveolar ridge CRF involving anterior teeth in 12 patients received fragment reattachment in the Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University from January 2016 to August 2024. The success rate of the fractured teeth 3 years after reattachment and the complications during the follow-up period were retrospectively analyzed. The 3-year success rate and complications during follow-up were evaluated to assess the clinical efficacy of this technique.Results:The 14 treated teeth were followed for an average of (36.0±33.7) months (range: 4-99 months). Complications occurred in 2 teeth: one was extracted due to debonding and replaced with a removable partial denture, while the other developed a palatal sinus post-reattachment, which healed after local saline irrigation and medication (followed for 12 months without recurrence). The remaining 12 teeth exhibited no complications, resulting in a success rate of 13/14.Conclusions:Fragment reattachment is a minimally invasive, rapid, and cost-effective treatment option for sub-gingival & supra-alveolar ridge CRF in the anterior esthetic zone. With strict case selection, it delivers favorable outcomes and extends the clinical lifespan of affected teeth.

Objective:To detect the levels of sex hormones and insulin in follicular fluid(FF)and the expression level of phosphatase and tensin homolog deleted on chromosome ten(PTEN)in granulosa cells in the infertile patients with polycystic ovary syndrome(PCOS),and to preliminarily explain the correlations between the insulin level and the expression level of PTEN mRNA.Methods:Seventy infertile patients were selected as the subjects and divided into PCOS group and control group(tubal obstruction or infertility due to male factors)according to infertility factors.All patients received in vitro fertilization-embryo transfer(IVF-ET)treatment.FF and ovarian granulosa cells were collected on the day of ovulation.The expression levels of PTEN mRNA in ovarian granulosa cells of the patients in two groups were detected by real-time fluorescence quantitative PCR(RT-qPCR)method.The levels of sex hormone and insulin in FF were measured by electrochemiluminescence.The correlations of the PTEN mRNA expression level in ovarian granulosa cells and testosterone(T)in FF with the level of insulin in FF were analyzed by Spearman correlation analysis method.Results:There were no significant differences in age,infertility years,body mass index(BMI),basic sex hormone,total dose of gonadotropin(Gn)and days of ovulation induction in two groups(P＞0.05).Compared with control group,the anti-Mullerian hormone(AMH)and antral follicle counting(AFC)of the patients in PCOS group were significantly increased(P＜0.05).The RT-qPCR results showed that the PTEN mRNA expression level in ovarian granulosa cells of the patients in the PCOS group was higher than that in control group(P＜0.001).The electrochemiluminescence results showed that the levels of T and insulin in FF of the patients in PCOS group were higher than those in control group(P＜0.05),whereas the estrogen and progesterone levels were lower than those in control group(P＜0.05).The Spearman correlation analysis showed that that T level in FF was positively correlated with the insulin level of the patients in PCOS group(r=0.577,P＜0.001),and the PTEN mRNA expression level in ovarian granulosa cells was positively correlated with the insulin levels in FF(r=0.616,P＜0.001);in control group,there was no correlation between T level and insulin level in FF(r=0.266,P=0.123),and there was no correlation between the expression level of PTEN mRNA in granulosa cells and the insulin level in FF in control group(r=-0.214,P=0.216).Conclusion:The high expression of PTEN in granulosa cells of the infertile patients with PCOS may be related to the local hyperinsulin level in the ovary,and PTEN participates in the occurrence and development of PCOS.