Irritable bowel syndrome （IBS） is a functional bowel disorder characterized primarily by abdominal pain and altered defecation habits. In recent years， traditional Chinese medicine （TCM） has made progress in multiple aspects of IBS research and treatment， including syndrome distribution， development of TCM formulas， clinical efficacy evaluation， external therapies， and psychosocial regulation. However， it still faces challenges such as over-reliance on symptomatic manifestations rather than biomarkers for diagnostic criteria， and the lack of high-quality evidence-based data supporting the efficacy of TCM formulas in treating IBS. This paper proposed that TCM diagnosis and treatment of IBS should adhere to the strategy of integrating the holistic concept with syndrome differentiation and treatment， combining TCM external therapies such as acupuncture， moxibustion and acupoint application）， and emphasizing individualized diagnosis and treatment for psychosomatic abnormalities. Future research should integrate multi-omics technologies， artificial intelligence and other methods to deepen the understanding of the pathogenesis of IBS and the mechanisms of TCM formulas， so as to promote the standardization and internationalization of TCM in the diagnosis and treatment of IBS.

Chronic gastritis is a chronic inflammation of the gastric mucosa caused by various etiologies and can be categorized into chronic non-atrophic gastritis and chronic atrophic gastritis.Chronic atrophic gastritis is a common disorder of the digestive system characterized by gastric mucosal gland atrophy,mucosal thinning,and basal layer thickening.The development of intestinal metaplasia and atypical hyperplasia on this basis is recognized as a precancerous lesion of gastric cancer and represents a key stage in the"inflammation-cancer transformation"of chronic gastritis.However,universally recognized and effective treatment strategies for this"inflammation-cancer transformation"process are lacking in clinical practice.This study integrates Correa′s cascade reaction with clinical practice,summarizing the pathogenesis of the"inflammation-cancer transformation"of chronic gastritis as weakness of the middle jiao and blood stasis.It suggests that the"inflammation-cancer transformation"process involves the pathological development of spleen and stomach deficiency,transportation and transformation dysfunction,turbid phlegm,blood stasis,and the gradual formation of cancerous toxins,with spleen and stomach weakness as the core mechanism and phlegm and blood stasis as the crucial pathological link.Based on an in-depth exploration of the deficiency of the middle jiao and blood stasis,supported by pharmacological research and clinical experience,this paper proposes the therapeutic approach of strengthening the spleen and replenishing qi,expelling phlegm and activating blood.It discusses the related prescriptions in preventing and treating the"inflammation-cancer transformation"of chronic gastritis.This study aims to provide new perspectives and insights for the prevention and treatment of chronic gastritis with traditional Chinese medicine,offering a novel framework for clinical treatment.

To analyze the impact of salt reduction interventions on the knowledge, attitude and behavior regarding the salt reduction of students′ parents based on the home-school interaction model. In April 2021, parents of students in grades 3-5 from three primary schools in Yichang City were selected as the target population using a cluster sampling method, and the parent population was divided into an intervention group and a control group. In the intervention group, a comprehensive home-school interaction salt reduction intervention was implemented, and in the control group, no intervention measures were taken for students′ parents. Baseline and final surveys were conducted before and after the intervention period, which included general information, previous salt reduction interventions received, and salt reduction knowledge, attitude and behavior. Difference-in-difference (DID) method was used to compare the knowledge, attitude and behavior status of two groups before and after the intervention, and stratified analysis of parents with different literacy levels was conducted to assess the net effect of intervention implementation. The results showed that 740 parents completed the baseline and final surveys, with 231 in the intervention group and 509 in the control group. After propensity score matching, there were 231 (33.33%) in the intervention group and 462 (66.67%) in the control group. After the intervention, the proportion of the intervention group who obtained salt control spoons and pots, as well as salt reduction knowledge and advice through school, was 87.45%, 86.58% and 75.45%, respectively, which was significantly higher than that in the control group ( P<0.05). After the intervention, the proportion of parents with a high school and lower education who obtained salt control pots was higher in the intervention group (89.23%) than in the control group (74.49%), with significant differences ( P<0.05). The proportion of parents with a college degree or above who obtained salt control spoons and pots, as well as salt reduction knowledge and advice through school, was higher than that of the control group ( P<0.05). The results of DID method showed that after controlling for monthly income and other factors, the scores of parents′ salt reduction-related knowledge and low-salt behavior in the intervention group increased significantly higher than those in the control group, with DID values (95% CI) of 1.18 (0.15-2.21) and 0.62 (0.16-1.09), respectively, indicating a significant net effect of intervention implication. After stratification according to the education level of parents, this difference still existed in the college degree or above group, with DID values (95% CI) of 1.39 (0.13-2.66) and 0.76 (0.16-1.36), respectively. The home-school interaction model for salt reduction measures can improve the salt-related knowledge and low-salt behavioral choices of students′ parents.

Objective To investigate the value of machine learning models based on contrast-enhanced CT radiomics in differentia-ting renal oncocytoma(RO)from chromophobe renal cell carcinoma(chRCC).Methods A total of 65 patients with RO and chRCC confirmed by pathology with complete clinical and imaging data were analyzed retrospectively.The patients were randomly divided into training set(n=45)and test set(n=20)according to a ratio of 7︰3.The tumor boundaries were delineated on the preoperative CT images using 3D Slicer software,and radiomics features were extracted using the Radiomics plugin.Univariate analysis,recursive fea-ture elimination(RFE),least absolute shrinkage and selection operator(LASSO)algorithms were used to select the best radiomics features.Three machine learning models were constructed on the training set and the grid search method was used to select the best combination of hyperparameters.The receiver operating characteristic(ROC)curve,calibration curve and decision curve were used to evaluate the performance of each machine learning model on the training set and test set.Results Random forest model,logistic regres-sion model and support vector machine model can better identify RO and chRCC.In the training set,the area under the curve(AUC)of random forest model and support vector machine model were 0.950[95%confidence interval(CI)0.901-0.998]and 0.955(95%CI 0.908-1.000),respectively,which were higher than the AUC of logistic regression model 0.882(95%CI 0.806-0.956).Statistical differences were found by DeLong test(P<0.05);In the test set,the AUC of random forest model,logistic regression model and support vector machine model were 0.876(95%CI 0.758-0.993),0.883(95%CI 0.768-0.997)and 0.883(95%CI 0.768-0.997),respectively.There was no significant statistical difference in the AUC of each model by DeLong test(P>0.05).The decision curve showed that all three models had significant net clinical benefits.Conclusion The machine learning model based on contrast-enhanced CT radiomics can effectively distinguish RO from chRCC.

To analyze the impact of salt reduction interventions on the knowledge, attitude and behavior regarding the salt reduction of students′ parents based on the home-school interaction model. In April 2021, parents of students in grades 3-5 from three primary schools in Yichang City were selected as the target population using a cluster sampling method, and the parent population was divided into an intervention group and a control group. In the intervention group, a comprehensive home-school interaction salt reduction intervention was implemented, and in the control group, no intervention measures were taken for students′ parents. Baseline and final surveys were conducted before and after the intervention period, which included general information, previous salt reduction interventions received, and salt reduction knowledge, attitude and behavior. Difference-in-difference (DID) method was used to compare the knowledge, attitude and behavior status of two groups before and after the intervention, and stratified analysis of parents with different literacy levels was conducted to assess the net effect of intervention implementation. The results showed that 740 parents completed the baseline and final surveys, with 231 in the intervention group and 509 in the control group. After propensity score matching, there were 231 (33.33%) in the intervention group and 462 (66.67%) in the control group. After the intervention, the proportion of the intervention group who obtained salt control spoons and pots, as well as salt reduction knowledge and advice through school, was 87.45%, 86.58% and 75.45%, respectively, which was significantly higher than that in the control group ( P<0.05). After the intervention, the proportion of parents with a high school and lower education who obtained salt control pots was higher in the intervention group (89.23%) than in the control group (74.49%), with significant differences ( P<0.05). The proportion of parents with a college degree or above who obtained salt control spoons and pots, as well as salt reduction knowledge and advice through school, was higher than that of the control group ( P<0.05). The results of DID method showed that after controlling for monthly income and other factors, the scores of parents′ salt reduction-related knowledge and low-salt behavior in the intervention group increased significantly higher than those in the control group, with DID values (95% CI) of 1.18 (0.15-2.21) and 0.62 (0.16-1.09), respectively, indicating a significant net effect of intervention implication. After stratification according to the education level of parents, this difference still existed in the college degree or above group, with DID values (95% CI) of 1.39 (0.13-2.66) and 0.76 (0.16-1.36), respectively. The home-school interaction model for salt reduction measures can improve the salt-related knowledge and low-salt behavioral choices of students′ parents.

Chronic gastritis is a chronic inflammation of the gastric mucosa caused by various etiologies and can be categorized into chronic non-atrophic gastritis and chronic atrophic gastritis.Chronic atrophic gastritis is a common disorder of the digestive system characterized by gastric mucosal gland atrophy,mucosal thinning,and basal layer thickening.The development of intestinal metaplasia and atypical hyperplasia on this basis is recognized as a precancerous lesion of gastric cancer and represents a key stage in the"inflammation-cancer transformation"of chronic gastritis.However,universally recognized and effective treatment strategies for this"inflammation-cancer transformation"process are lacking in clinical practice.This study integrates Correa′s cascade reaction with clinical practice,summarizing the pathogenesis of the"inflammation-cancer transformation"of chronic gastritis as weakness of the middle jiao and blood stasis.It suggests that the"inflammation-cancer transformation"process involves the pathological development of spleen and stomach deficiency,transportation and transformation dysfunction,turbid phlegm,blood stasis,and the gradual formation of cancerous toxins,with spleen and stomach weakness as the core mechanism and phlegm and blood stasis as the crucial pathological link.Based on an in-depth exploration of the deficiency of the middle jiao and blood stasis,supported by pharmacological research and clinical experience,this paper proposes the therapeutic approach of strengthening the spleen and replenishing qi,expelling phlegm and activating blood.It discusses the related prescriptions in preventing and treating the"inflammation-cancer transformation"of chronic gastritis.This study aims to provide new perspectives and insights for the prevention and treatment of chronic gastritis with traditional Chinese medicine,offering a novel framework for clinical treatment.

Objective To investigate the value of machine learning models based on contrast-enhanced CT radiomics in differentia-ting renal oncocytoma(RO)from chromophobe renal cell carcinoma(chRCC).Methods A total of 65 patients with RO and chRCC confirmed by pathology with complete clinical and imaging data were analyzed retrospectively.The patients were randomly divided into training set(n=45)and test set(n=20)according to a ratio of 7︰3.The tumor boundaries were delineated on the preoperative CT images using 3D Slicer software,and radiomics features were extracted using the Radiomics plugin.Univariate analysis,recursive fea-ture elimination(RFE),least absolute shrinkage and selection operator(LASSO)algorithms were used to select the best radiomics features.Three machine learning models were constructed on the training set and the grid search method was used to select the best combination of hyperparameters.The receiver operating characteristic(ROC)curve,calibration curve and decision curve were used to evaluate the performance of each machine learning model on the training set and test set.Results Random forest model,logistic regres-sion model and support vector machine model can better identify RO and chRCC.In the training set,the area under the curve(AUC)of random forest model and support vector machine model were 0.950[95%confidence interval(CI)0.901-0.998]and 0.955(95%CI 0.908-1.000),respectively,which were higher than the AUC of logistic regression model 0.882(95%CI 0.806-0.956).Statistical differences were found by DeLong test(P<0.05);In the test set,the AUC of random forest model,logistic regression model and support vector machine model were 0.876(95%CI 0.758-0.993),0.883(95%CI 0.768-0.997)and 0.883(95%CI 0.768-0.997),respectively.There was no significant statistical difference in the AUC of each model by DeLong test(P>0.05).The decision curve showed that all three models had significant net clinical benefits.Conclusion The machine learning model based on contrast-enhanced CT radiomics can effectively distinguish RO from chRCC.

Objective:To investigate the influencing factors of major adverse cardiovascular events (MACE) in maintenance hemodialysis (MHD) patients, and to construct and verify the nomogram.Methods:The clinical data of 240 patients with MHD admitted to the First Affiliated Hospital of Hebei North University from July 2022 to October 2023 were retrospectively analyzed. According to whether the patients had MACE, they were divided into two groups, namely the occurrence group (with MACE, n=55) and the non-occurrence group (without MACE, n=185). After comparing the clinical data of the two groups, The independent risk factors of MHD patients with MACE were screened by binary logistic regression analysis, and the risk nomogram prediction model was constructed according to the risk factors, and the prediction efficiency of the model was analyzed by Bootstrap method. Results:There were significant differences in age, dialysis age, hyperlipidemia, hyperuricemia and hemodialysis flux between the two groups (all P<0.05). Binary logistic regression model analysis showed that dialysis age >12 months, combined with hyperlipidemia, combined with hyperuricemia, and low throughput hemodialysis were independent risk factors for MHD patients with MACE (all P<0.05). The neomorph risk prediction model was constructed based on independent risk factors. The area under the curve (AUC) of the prediction model was 0.842(95% CI: 0.789-0.896), the specificity was 69.1%, the sensitivity was 89.7%, the cutoff value was 13.128, and the Yoden index was 0.588, suggesting that the accuracy of the model was good. Conclusions:Dialysis age >12 months, combined with hyperlipidemia, combined with hyperuricemia and low throughput hemodialysis are independent risk factors for MACE in MHD patients. Intervention and control of risk factors can reduce the incidence of MACE.

Objective:To investigate the influencing factors of major adverse cardiovascular events (MACE) in maintenance hemodialysis (MHD) patients, and to construct and verify the nomogram.Methods:The clinical data of 240 patients with MHD admitted to the First Affiliated Hospital of Hebei North University from July 2022 to October 2023 were retrospectively analyzed. According to whether the patients had MACE, they were divided into two groups, namely the occurrence group (with MACE, n=55) and the non-occurrence group (without MACE, n=185). After comparing the clinical data of the two groups, The independent risk factors of MHD patients with MACE were screened by binary logistic regression analysis, and the risk nomogram prediction model was constructed according to the risk factors, and the prediction efficiency of the model was analyzed by Bootstrap method. Results:There were significant differences in age, dialysis age, hyperlipidemia, hyperuricemia and hemodialysis flux between the two groups (all P<0.05). Binary logistic regression model analysis showed that dialysis age >12 months, combined with hyperlipidemia, combined with hyperuricemia, and low throughput hemodialysis were independent risk factors for MHD patients with MACE (all P<0.05). The neomorph risk prediction model was constructed based on independent risk factors. The area under the curve (AUC) of the prediction model was 0.842(95% CI: 0.789-0.896), the specificity was 69.1%, the sensitivity was 89.7%, the cutoff value was 13.128, and the Yoden index was 0.588, suggesting that the accuracy of the model was good. Conclusions:Dialysis age >12 months, combined with hyperlipidemia, combined with hyperuricemia and low throughput hemodialysis are independent risk factors for MACE in MHD patients. Intervention and control of risk factors can reduce the incidence of MACE.

Objective:To analyze the concentration of formic acid,propionic acid and butyric acid in gingival crevicular fluid(GCF)of patients with stages Ⅲ and Ⅳ periodontitis,and their relationship with periodontitis.Methods:The study enrolled 37 systemically healthy patients with periodontitis and 19 healthy controls who visited Department of Periodontology,Peking University School and Hospital of Sto-matology from February 2008 to May 2011.Their GCFs were collected from the mesial-buccal site of one molar or incisor in each quadrant.Periodontal clinical parameters,including plaque index(PLI),probing depth(PD),bleeding index(BI),and attachment loss(AL).Concentrations of formic acid,propionic acid and butyric acid in the supernatant of the GCFs were analyzed by high-performance capil-lary electrophoresis(HPCE).The prediction ability of formic acid,propionic acid and butyric acid with the risk of periodontitis and the differences between grade B and grade C periodontitis were analyzed.Results:In this study,32 patients with stage Ⅲ and 5 patients with stage Ⅳ were enrolled,including 9 patients with grade B and 28 patients with grade C.Clinical periodontal variables in the patients with pe-riodontitis were significantly higher than those in the control group(P＜0.001).Formic acid was signifi-cantly lower in periodontitis than that in the control group[5.37(3.39,8.49)mmol/L vs.12.29(8.35,16.57)mmol/L,P＜0.001].Propionic acid and butyric acid in periodontitis were significantly higher than those in the control group:Propionic acid,10.23(4.28,14.90)mmol/L vs.2.71(0.00,4.25)mmol/L,P＜0.001;butyric acid,2.63(0.47,3.81)mmol/L vs.0.00(0.00,0.24)mmol/L,P＜0.001.There was no significant difference in formic acid,propionic acid and butyric acid concentrations between grade B and grade C periodontitis(P＞0.05).Propionic acid and butyric acid in the deep pocket were significantly higher than in the shallow pocket,while the concentration of formic acid decreased with the increase of PD.Propionic acid(OR=1.51,95％CI:1.29-1.75)and butyric acid(OR=3.72,95％CI:1.93-7.17)were risk factors for periodontitis,while formic acid(OR=0.87,95％CI:0.81-0.93)might be a protective factor for periodontitis.Propionic acid(AUC=0.852,95％CI:0.805-0.900),butyric acid(AUC=0.889,95％CI:0.841-0.937),f(formic acid,AUC=0.844,95％CI:0.793-0.895)demonstrated a good predictive capacity for the risk of periodontitis.Conclusion:The concentration of formic acid decrease in the GCF of periodontitis patients,which is a protective factor for periodontitis,its reciprocal have good predictive capacity.However,propionic acid and butyric acid increase,which are risk factors for periodontitis and have good predictive capacity.The concentration of formic acid,propionic acid,and butyric acid vary with probing depth,but there is no significant difference between grade B and grade C periodontitis.