Radiation enteritis(RE)is an inflammatory reaction caused by radiation exposure,commonly observed following radiotherapy for malignancies in the abdominal,pelvic and retroperitoneal regions.The authors believe that the pathogenesis of RE is complex,involving factors such as deficiency and excess,cold and heat,as well as qi and blood.The general pathogenesis can be summarized as"instability of the Zhongzhou,depletion of essence and blood,dysregulation of ascending and descending,and accumulation of heat-toxins".And"the instability of the Zhongzhou and subsequent malnutrition of the intestines"are the key drivers of disease progression.Based on theoretical exploration and clinical observations,this article proposed a comprehensive diagnostic and therapeutic approach centered on"stabilizing the Zhongzhou,replenishing essence and blood,regulating ascending and descending functions,and clearing heat-toxins".These four methods are often applied simultaneously,with"stabilizing the Zhongzhou and regulating the intestines"serving as the core of treatment.The approach is tailored according to the individual patient's condition of blood,qi and body fluids.A medical case was attached as evidence for verification.

Radiation enteritis(RE)is an inflammatory reaction caused by radiation exposure,commonly observed following radiotherapy for malignancies in the abdominal,pelvic and retroperitoneal regions.The authors believe that the pathogenesis of RE is complex,involving factors such as deficiency and excess,cold and heat,as well as qi and blood.The general pathogenesis can be summarized as"instability of the Zhongzhou,depletion of essence and blood,dysregulation of ascending and descending,and accumulation of heat-toxins".And"the instability of the Zhongzhou and subsequent malnutrition of the intestines"are the key drivers of disease progression.Based on theoretical exploration and clinical observations,this article proposed a comprehensive diagnostic and therapeutic approach centered on"stabilizing the Zhongzhou,replenishing essence and blood,regulating ascending and descending functions,and clearing heat-toxins".These four methods are often applied simultaneously,with"stabilizing the Zhongzhou and regulating the intestines"serving as the core of treatment.The approach is tailored according to the individual patient's condition of blood,qi and body fluids.A medical case was attached as evidence for verification.

Objective:To explore the role of cytokines and glucocorticoid receptors (GR) in adolescent depression and childhood trauma.Methods:Using convenient sampling,80 adolescents with depression were recruited from the in-patient department of the Mental Health Center,First Hospital of Hebei Medical University from August 2021 to December 2022. Meanwhile,70 healthy adolescents were recruited to participate in the study. Life and learning stress,childhood trauma,anxiety and depression symptoms were evaluated using adolescent Life Events Scale,Childhood Trauma Questionnaire,Hamilton Depression Scale-17 (HAMD 17) and Hamilton Anxiety Scale(HAMA). Serum glucocorticoid receptor and plasma 12 cytokines were also detected. SPSS 25.0 and AMOS 26.0 was used for statistical analysis. The rank sum test or Chi-square test was used to compare the demographic data and blood indicators between adolescents with and without depression. Spearman method was used to examine the correlation between childhood trauma,GR,cytokines and depression. Maximum likelihood estimation method was performed to test the mediating effect,and the average path coefficient was obtained after testing the indirect path by Bootstrap method. If the 95% confidence interval ( CI) does not contain 0,the intermediary effect is significant. Results:There was significant difference in GR concentration between adolescents with and without depression ( Z=-10.50, P<0.001). IL-1β,IL-2,IL-5,IL-10,IL-12,IL-17 and IFN-α were also significantly different between the two groups. Spearman correlation analysis showed that HAMD 17 and HAMA scores were associated with emotional abuse,emotional neglect,physical abuse,CTQ total score and cytokine level IL-5,IFN-α were positively correlated. Physical neglect and IL-1β were only positively correlated with HAMD 17 score. GR was negatively associated with emotional abuse ( r=-0.523, P<0.001),emotional neglect ( r=-0.245, P=0.002),sexual abuse ( r=-0.172, P=0.035),physical abuse score ( r=-0.180, P=0.027),CTQ total score ( r=-0.562, P<0.001),HAMD 17 score ( r=-0.783--0.271, P<0.001),HAMA score( r=-0.741--0.602, P<0.001),IL-1β ( r=-0.217, P=0.008),IL-5 ( r=-0.334, P<0.001),and IFN-α ( r=-0.276, P=0.001). IL-5 level was positively correlated with emotional abuse score ( r=0.211, P=0.009) and CTQ total score ( r=0.201, P=0.014). IFN-α level was positively correlated with emotional abuse score ( r=0.207, P=0.011) and CTQ total score ( r=0.166, P=0.042). The mediating effect showed that GR played a partial mediating role between childhood trauma and depression (indirect effect: effect size 0.294, S.E. 0.043,95 %CI=0.236-0.398). GR and cytokine IL-5 play a chain mediating role between childhood trauma and depression (indirect effect: effect size 0.067, S.E. 0.040,95 %CI=0.023-0.147). Conclusion:GR,and cytokine IL-5 play a mediating role between adolescent depression and childhood trauma.

Objective:To explore the role of cytokines and glucocorticoid receptors (GR) in adolescent depression and childhood trauma.Methods:Using convenient sampling,80 adolescents with depression were recruited from the in-patient department of the Mental Health Center,First Hospital of Hebei Medical University from August 2021 to December 2022. Meanwhile,70 healthy adolescents were recruited to participate in the study. Life and learning stress,childhood trauma,anxiety and depression symptoms were evaluated using adolescent Life Events Scale,Childhood Trauma Questionnaire,Hamilton Depression Scale-17 (HAMD 17) and Hamilton Anxiety Scale(HAMA). Serum glucocorticoid receptor and plasma 12 cytokines were also detected. SPSS 25.0 and AMOS 26.0 was used for statistical analysis. The rank sum test or Chi-square test was used to compare the demographic data and blood indicators between adolescents with and without depression. Spearman method was used to examine the correlation between childhood trauma,GR,cytokines and depression. Maximum likelihood estimation method was performed to test the mediating effect,and the average path coefficient was obtained after testing the indirect path by Bootstrap method. If the 95% confidence interval ( CI) does not contain 0,the intermediary effect is significant. Results:There was significant difference in GR concentration between adolescents with and without depression ( Z=-10.50, P<0.001). IL-1β,IL-2,IL-5,IL-10,IL-12,IL-17 and IFN-α were also significantly different between the two groups. Spearman correlation analysis showed that HAMD 17 and HAMA scores were associated with emotional abuse,emotional neglect,physical abuse,CTQ total score and cytokine level IL-5,IFN-α were positively correlated. Physical neglect and IL-1β were only positively correlated with HAMD 17 score. GR was negatively associated with emotional abuse ( r=-0.523, P<0.001),emotional neglect ( r=-0.245, P=0.002),sexual abuse ( r=-0.172, P=0.035),physical abuse score ( r=-0.180, P=0.027),CTQ total score ( r=-0.562, P<0.001),HAMD 17 score ( r=-0.783--0.271, P<0.001),HAMA score( r=-0.741--0.602, P<0.001),IL-1β ( r=-0.217, P=0.008),IL-5 ( r=-0.334, P<0.001),and IFN-α ( r=-0.276, P=0.001). IL-5 level was positively correlated with emotional abuse score ( r=0.211, P=0.009) and CTQ total score ( r=0.201, P=0.014). IFN-α level was positively correlated with emotional abuse score ( r=0.207, P=0.011) and CTQ total score ( r=0.166, P=0.042). The mediating effect showed that GR played a partial mediating role between childhood trauma and depression (indirect effect: effect size 0.294, S.E. 0.043,95 %CI=0.236-0.398). GR and cytokine IL-5 play a chain mediating role between childhood trauma and depression (indirect effect: effect size 0.067, S.E. 0.040,95 %CI=0.023-0.147). Conclusion:GR,and cytokine IL-5 play a mediating role between adolescent depression and childhood trauma.

Objective:To evaluate the influence of manual digitorum sensory stimulation (MDSS) of hemiplegic fingers in median nerve F-wave in stroke patients.Methods:Thirty patients with hemiplegia after stroke, admitted to Department of Rehabilitation Medicine, Second Affiliated Hospital of Anhui Medical University from June 2019 to October 2022 were selected; all patients had thumb flexor modified Ashworth scale (MAS) grading≥1. Hemiplegic MDSS was given; bilateral median nerve F-wave before MDSS and median nerve F-wave at the hemiplegic side immediately after MDSS were recorded.Results:Compared with that at the healthy side before MDSS, amplitude of median nerve F-wave at the hemiplegic side was significantly increased ( P<0.05). Compared with that before MDSS, amplitude of F-wave at the hemiplegic side after MDSS in patients with thumb flexor MAS grading≤2 were significantly decreased ( P<0.05), while that in patients with thumb flexor MAS grading≥3 was significantly increased ( P<0.05). Conclusion:Amplitudes of median nerve F-wave at the hemiplegic side in patients with different thumb flexor MAS grading show that MDSS can not only inhibit the excitability of tonic motor unit related to muscle spasm, but also enhance the excitability of kinetic-motor unit mainly related to explosive power in severe muscle spasm.

Objective To demonstrate the changes in flexor digitorum and extensor digitorum tension in the affected hands with shear-wave elastography (SWE) before and after manual digitorum sensory stimulation (MDSS) in hemiplegic patients with stroke. Methods A total of 51 hemiplegic post-stroke inpatients in the Department of Rehabilitation Medicine in Second Hospital of Anhui Medical University from April to June, 2020, underwent MDSS completed by a researcher who used a bare thumb and index finger to squeeze each nail bed as well as the sides of each fingertip in the affected hand. The stimulation intensity was the minimum that could cause finger extension without obvious pain, and the interval between two stimulations was five to ten seconds. Muscular tension of the flexor digitorum superficialis, flexor digitorum profundus, flexor pollicis longus and extensor digitorum were assessed with modified Ashworth Scale (MAS) and shear-wave velocity (SWV) of SWE on the affected side before and immediately after MDSS. MAS score was -1 as low muscular tension. Results The MAS scores of all the muscles significantly reduced after MDSS (|Z| > 2.843, P < 0.001); while the changes of SWV were not significantly in all the muscles with initially MAS score of 0 or -1 (t < 1.052, P > 0.05), and it reduced in those muscles with initial MAS scores of one to three (t > 2.672, P < 0.05). The SWV were positively correlated with the MAS scores both before and after MDSS (r > 0.334, P < 0.05). Conclusion MDSS can effectively, immediately, and safely relieves muscle spasms of the flexor digitorum and facilitate active finger extension in the affected hand for hemiplegic patients with stroke. SWE is useful for quantitatively and objectively evaluating muscular tension in the affected hand for hemiplegic patients with stroke.

ObjectiveTo investigate the changes of surface electromyography (sEMG) of the flexors and extensors of the affected fingers after manual digitorum sensory stimulation (MDSS) in the hemiplegic patients after stroke. MethodsFrom April to August, 2020, 50 stroke patients in Department of Rehabilitation Medicine, the Second Hospital of Anhui Medical University accepted MDSS on the nail beds and the third knuckles of affected fingers, until the fingers extended actively. The tension of affected flexor pollicis brevis, flexor digitorum superficialis and extensor digitorum were assessed with modified Ashworth Scale (MAS) before and immediately after stimulation; while the root mean square (RMS) of sEMG of bilateral flexor pollicis brevis, flexor digitorum superficialis and extensor digitorum were recorded. ResultsThe MAS score of all the muscles decreased after stimulation (|Z| > 2.699, P < 0.01), while the RMS of affected extensor digitorum increased (t = -2.069, P < 0.05). Compared with the unaffected ones, RMS of affected flexor pollicis brevis and extensor digitorum decreased before and after stimulation (t > 2.450, P < 0.05). ConclusionMDSS may immediately relieve the spasm of flexors of hemiplegic fingers after stroke, which associates with the promoting muscle strength of the extensors.

Objective:To establish a mice model of inflammatory bowel disease (IBD) induced by dextran sulfate sodium (DSS), and to analyze the changes in intestinal inflammation and macrophage subsets at different stages, so as to find a new target for the treatment of IBD.Methods:Thirty male C57BL/6 mice of 6-8 weeks were randomly divided into control group, activation stage group and resolution stage group.The latter 2 groups were given 25 g/L DSS for 5 consecutive days to establish the IBD model.After 5 days, the mice were given filtered and sterilized water and sacrificed on the 10 th and 15 th day, respectively.Colon inflammation in mice was evaluated, including body weight, disease activity index (DAI) score, changes in colon length, histopathology and histopathological score.Then the expression levels of interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β in colon tissues were detected by quantitative real-time PCR(qPCR). Finally, the changes of intestinal macrophage subsets were detected by flow cytometry. Results:The colon inflammation of mice in the activation stage group was significantly more severe than that in the control group, while the colon inflammation of mice in the resolution stage group was reduced.The colon length of mice in the activation stage group was (5.94±0.40) cm, which was significantly shorter than that in the control group [(7.25±0.29) cm], and the situation was slightly improved in the resolution stage with the colon length of [(6.87±0.95) cm], and the differences were statistically significant (all P<0.05). The mRNA expression levels of pro-inflammatory cytokines IL-1β, IL-6 and TNF-α in the activation stage were 53.40±6.58, 117.69±30.78 and 2.52±0.25, respectively, which were significantly higher than those in the control group (1.00±0.13, 1.00±0.39, 1.00±0.10); the mRNA expression levels of IL-1β, IL-6 and TNF-α in the resolution stage were 2.51±0.13, 5.43±0.51 and 1.73±0.14, respectively, which were significantly lower than those in the activation stages(all P<0.05). The expression level of anti-inflammatory cytokine TGF-β in the resolution stage was 2.41±0.17, which was significantly higher than that in the activation stage (0.94±0.12), and the diffe-rence was statistically significant ( P<0.05). During the progression of IBD, there were 3 groups of macrophages in the lamina propria of intestinal mucosa of mice, of which the number of F4/80 lowCD 64-MHCⅡ - macrophage subset with the lowest maturity increased significantly in the activation stage of IBD, accounting for (10.68±4.62)%, and it decreased and returned to the normal level in the resolution stage, accounting for (4.63±1.06)%, and the difference was statistically significant ( P<0.05). Conclusions:Macrophages play an important role in the progression of IBD, the hindrance of maturation and development may be the main cause of inflammatory injury in the activation stage of IBD, and the transformation of macrophage subsets may become a new target for the treatment of IBD.