It is proposed that the pathogenesis of rheumatoid arthritis （RA） is centered on deficiency， dampness， and blood stasis， which interact with and evolve into one another during the onset and progression of the disease. The development of RA is closely associated with insufficiency of healthy qi and the interbinding of dampness and blood stasis. Accordingly， treatment emphasizes an integrated approach that combines tonifying deficiency， eliminating dampness， and resolving blood stasis， and is implemented in three main stages. In the initial stage， therapy focuses on supporting healthy qi， dispelling dampness， and relieving impediment， with modified Huangqi Guizhi Wuwu Decoction （黄芪桂枝五物汤） combined with Yiyiren Decoction （薏苡仁汤）. In the active stage， treatment aims to eliminate dampness， resolve blood stasis， and unblock the collaterals， using modified Wutou Decoction （乌头汤） or Guizhi Shaoyao Zhimu Decoction （桂枝芍药知母汤）. In the remission stage， therapy emphasizes strengthening the spleen and reple-nishing qi to prevent recurrence， with modified Shenling Baizhu Powder （参苓白术散） combined with Guipi Decoction （归脾汤）.

ObjectiveTo investigate the effect of Toxoplasma gondii infection on copper metabolism in the kidneys of mice. MethodsA total of 80 7-8-week-old C57BL/6 female mice were randomly divided into four groups of 20 mice in each group after one week of adaptation， including Control group， Cu group， TgCtwh6 group and Cu+TgCtwh6 group. Mice that were not infected and fed with normal diet and water were used as the Control group； Mice fed with 1 g/kg of copper chloride processing diet and 0.1% copper chloride water for 60 consecutive days were used as Cu group； Mice infected with 25-30 TgCtwh6 cysts （one of the predominant genotype Chinese 1 in China） fed with normal diet and water were used as the TgCtwh6 group； mice infected with 25-30 TgCtwh6 cysts and fed with a processed diet containing 1 g/kg of copper chloride and water with 0.1% copper chloride for 60 consecutive days were used as the Cu+TgCtwh6 group. ICP-MS was used to determine the changes in copper content in kidney tissues. Hematoxylin-eosin （HE） staining was used to observe the pathological changes of mouse kidney tissue. The number of apoptotic cells was observed by PI staining. Western blot was used to detect the protein expression levels of glutathione peroxidase 4 （GPX4） and superoxide dismutase （SOD1， SOD2）. RT-qPCR was used to detect the mRNA expression of cuproptosis-related genes. ResultsPathological manifestations such as inflammatory cell infiltration in the Cu group and TgCtwh6 group were seen under the microscope， and the inflammatory infiltrating cells of the renal interstitial were reduced in the Cu+TgCtwh6 group， and the pathological manifestations

Diabetic foot is one of the most common and serious chronic complications in diabetic patients.With the advancement of digital healthcare,digital therapy has been gradually implemented and promoted among diabetic foot patients as an emerging tool with the advantages of safety,efficiency,and intelligence that can make up for the shortcomings of traditional diabetic foot risk assessment,health education,and self-management.This study provides an overview of digital therapeutics,summarizes its application in patients with diabetic foot,and proposes relevant recommendations,aiming to provide a reference for improving the quality of life and satisfaction of patients with diabetic foot and reducing the recurrence of diabetic foot.

Objective:To explore the correlation between the elevation of glycated hemoglobin A1c (HbA1c) in the first trimester and its change from the first to the second trimester and adverse pregnancy outcomes.Methods:This was a bidirectional cohort study. Singleton pregnant women who delivered in the First Affiliated Hospital, Sun Yat-sen University from March 1, 2021, to July 31, 2024, and had HbA1c results in the first and second trimesters were included. Those with HbA1c<5.7% in the first trimester were described as group E1, and those with HbA1c between 5.7% and 6.4% were described as group E2. Those with HbA1c<5.2% in the second trimester were described as group S1, and those with HbA1c between 5.2% and 6.4% were described as group S2. Accordingly, the changing trend of HbA1c from the first to the second trimester was divided into group E1-S1, group E1-S2, group E2-S1, and group E2-S2. Clinical indicators such as gestational diabetes mellitus (GDM), preeclampsia, preterm birth, preterm premature rupture of membranes (PPROM), polyhydramnios, large for gestational age infants, small for gestational age infants, neonatal hypoglycemia, and neonatal transfer were collected. Comparisons between groups were performed using t-tests, analysis of variance, Mann-Whitney U tests, Kruskal-Wallis tests, Chi square tests, and Fisher's exact test. Multivariate logistic regression analysis was used to analyze the impact of HbA1c in the first trimester and the changing trend of HbA1c from the first to the second trimester on pregnancy outcomes. Results:During the study period, a total of 6 500 pregnant women were included for analysis, among which 209 (3.2%) had HbA1c between 5.7% and 6.4% in the first trimester. Taking those with HbA1c<5.7% as a reference, HbA1c between 5.7% and 6.4% in the first trimester was an independent risk factor for GDM, preterm birth, and PPROM [ OR (95% CI) were 3.304 (2.465-4.427), 1.545 (1.008-2.368), and 1.872 (1.042-3.361), respectively]. Taking group E1-S1 as a reference, HbA1c<5.7% in the first trimester and 5.2%-6.4% in the second trimester (group E1-S2) was an independent risk factor for GDM, preterm birth, PPROM, and neonatal hypoglycemia [ OR (95% CI) were 2.770 (2.370-3.237), 1.424 (1.132-1.791), 1.614 (1.179-2.211), and 2.047 (1.024-4.092), respectively]; HbA1c between 5.7% and 6.4% in the first trimester and<5.2% in the second trimester (group E2-S1) was an independent risk factor for PPROM [ OR (95% CI) was 3.408 (1.187-9.784)]; HbA1c between 5.7% and 6.4% in the first trimester and 5.2%-6.4% in the second trimester (group E2-S2) was an independent risk factor for GDM and preterm birth [ OR (95% CI) were 4.651 (3.282-6.592) and 1.724 (1.066-2.786), respectively]. Conclusions:HbA1c between 5.7% and 6.4% in the first trimester was significantly associated with an increased risk of GDM, preterm birth, and PPROM. For those with HbA1c between 5.7% and 6.4% in the first trimester, if the HbA1c level decreased in the second trimester, only the risk of PPROM increased significantly; conversely, if the HbA1c level continued to increase in the second trimester, the risks of GDM and preterm birth both increased significantly.

Background The high work intensity and possible subsequently increased susceptibility to occupational hazards of calcium carbide plants may lead to hypertension in workers, but there are few studies on the relationship between occupational hazard exposure and hypertension in workers involving the production process of calcium carbide. Objective To explore the influence of occupational hazards on the incidence of hypertension in calcium carbide plants. Methods Using historical cohort design, the employees of a calcium carbide factory in the western part of Inner Mongolia Autonomous Region were selected as research subjects. According to the pre-determined inclusion and exclusion criteria, the study population comprised an exposure group of 377 employees (including furnace workers, inspection workers, and maintenance workers) exposed to dust, noise & carbon monoxide, and a control group of 388 employees (including central control workers, electricians, and administrative personnel) without above-mentioned exposure. The total sample size was 765 participants. The follow-up period was from April 2011 to October 2022, and the study endpoint was defined as the conclusion of the follow-up period or diagnosed hypertension in annual occupational health examination. Information on general demographic characteristics, living habits, and work status was collected from all study subjects. Cox proportional hazards regression model was used to analyze the association between occupational hazard exposure and the risk of hypertension among the calcium carbide plant employees. Results The average age, mean systolic and diastolic blood pressure, proportion of males, smoking rate, and alcohol consumption rate in the exposure group were higher than those in the control group (P<0.05). Compared to baseline, both systolic and diastolic blood pressure levels increased in the exposure group and the control group at the end of the follow-up (P<0.05). At the end of the follow-up, the average differences between systolic/ diastolic blood pressure and baseline values in the exposure group were higher than those in the control group (P<0.05). During the follow-up period, a total of 223 cases of hypertension occurred, with a total follow-up of 2785 person-years, resulting in an incidence density of 8007.18 per 100000 person-years, an average age of onset of (35.90±8.22) years, and an average working age of onset of (2.69±1.97) years. The incidence density in the exposure group was 128.71% higher than that in the control group, and the risk of hypertension in the exposure group was 2.115 times that of the control group. The risk of hypertension was 2.199 times higher for men than for women, 1.344 times higher for those aged 30 and above than for those under 30, 1.546 times higher for smokers than for non-smokers, and 1.750 times higher for drinking workers than for non-drinking ones. The results of Cox proportional hazards regression modeling indicated that the hazard ratio (95%CI) of hypertension among the employees exposed to dust, noise, and carbon monoxide was 2.254 (1.703, 2.982), 1.594 (1.107, 2.295), and 1.567 (1.079, 2.274), respectively, when different covariates (gender, age, smoking, and alcohol consumption) were included. The results of Log-rank test showed that there were statistically significant differences in the distribution of disease-free survival between the exposure group and the control group (P<0.05). Conclusion Occupational exposures to dust, noise, and carbon monoxide may increase the risk of hypertension among calcium carbide plant workers.

Objective:To evaluate the efficacy and safety of upadacitinib in the real-world treatment of difficult-to-treat Crohn's disease (DTT-CD) .Methods:This multicenter, retrospective cohort study included patients diagnosed with DTT-CD according to the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) criteria, and treated at eight Chinese inflammatory bowel disease centers between January 2023 and March 2025. Clinical outcomes were assessed after 12 weeks of induction therapy with upadacitinib (45 mg qd), including clinical remission rate, clinical response rate, and incidence of adverse events.Results:Among 151 enrolled DTT-CD patients, the clinical remission rate was 47.0%, and the clinical response rate was 90.7% after 12 weeks of treatment. Adverse events occurred in 42 cases (27.8%) .Conclusion:Upadacitinib demonstrated favorable efficacy in inducing clinical remission in DTT-CD patients, with a good safety profile at the induction dose (45 mg qd) .

Objective:To investigate the mechanism of Compound Mufurong Nasal Ointment in interfering with allergic rhinitis in young rats based on the Th1/Th2 cytokines and c-jun N-terminal kinase (JNK) signaling pathway.Methods:Totally 60 young SD male rats were divided into normal group, model group, experimental group, Western medicine group, and combination group according to random number table method, with 12 rats in each group. Except for the normal group, allergic rhinitis rat models were prepared by intraperitoneal injection of ovalbumin and nasal instillation of ovalbumin sensitization in all other groups of rats. After successful modeling, the normal group and the model group were given 0.9% sodium chloride injection 50 μl nasal drip, and the experimental group, the Western medicine group and the combination group were given compound Mufurong Nasal Ointment, fluticasone propionate nasal spray, compound Mufurong Nasal Ointment and fluticasone propionate nasal spray respectively. HE staining was used to observe the pathological morphology of nasal mucosal tissue; ELISA method was used to detect the levels of total IgE, interferon - γ (IFN - γ), IL-1 β, and IL-4 in the serum and nasal lavage fluid of rats in each group; Western blot was used to detect the expressions of JNK and p-JNK proteins in nasal tissues of rats in each group; Immunohistochemistry was used to detect the expressions of p-JNK and p-c-Jun proteins in nasal mucosal tissue.Results:Compared with model group, the levels of IgE, IL-1β and IL-4 in serum and nasal lavage solution of experimental group, western medicine group and combination group decreased ( P<0.05), IFN-γ level increased ( P<0.05); the expressions of JNK and p-JNK protein decreased ( P<0.05), and the expressions of p-JNK and p-c-Jun decreased ( P<0.05). Conclusion:Compound Mufurong Nasal Ointment may regulate Th1/Th2 cytokines through the JNK signaling pathway, inhibit Th2 over-expression, thereby reducing IgE, IL-1 β, IL-4 levels in serum and nasal lavage fluid, up-regulating IFN - γ levels, and intervening in the occurrence of allergic rhinitis.

This article focused on the revision and application of General Rule 0982 Determination of Particle Size and Size Distribution by Light Scattering Method in the Chinese Pharmacopoeia(2025 edition).By referencing domestic and international technical requirements and considering practical applications,the structure and content of this general rule were analyzed,and specific revisions were proposed.Key recommendations included adding sections on method validation and results reporting to the current general rule,incorporating the appendix content into the main text,and revising/supplementing the method name,introduction,instrument requirements,and determination procedures.The revised light scattering method would strengthen China's capacity for pharmaceutical quality control.

Objective:To explore the potential profile characteristics of family health in patients with chronic diseases, analyze the influencing factors of different family health categories, and further investigate the relationship between family health categories and the quality of life in patients with chronic diseases, providing a scientific basis for targeted intervention strategies.Methods:This study was a cross-sectional survey. The data for the study were obtained from the Chinese Residents' Psychology and Behavior Survey Research Database. A multistage sampling method was employed to select 1 808 patients with chronic diseases as survey respondents from July to September 2021. Data were collected using the General Information Questionnaire, the Family Health Scale, and the European 5-Dimensional 5-Level Health Scale(EQ-5D-5L). Potential profiles of family health in patients with chronic diseases were identified using latent profile analysis. Univariate analysis and multiple Logistic regression were used to examine influencing factors, and generalized linear regression was performed to analyze the impact of different family health categories on quality of life.Results:A total of 1 808 chronic disease patients were enrolled, comprising 986 males and 822 females, with a age of (55.23 ± 7.02) years. The scores of family health, EQ-5D-5L, EuroQol Visual Analogue Scale were 38(34, 43), 0.94(0.84, 1.00), and 78(63, 87) points. The family health of patients with chronic diseases were categorized into three potential profiles: the low family health group (418 cases accounting for 23.1%), the medium family health group (747 cases accounting for 41.3%), and the high family health group (643 cases accounting for 35.6%). Multivariate Logistic regression analysis showed that family type, marital status, nature of household, education level, number of siblings and type of health insurance were significant factors influencing family health categories ( OR values were 0.464-2.503, all P<0.05). The family health was an important factor influencing quality of life ( χ2 values were 4.05-100.68, all P<0.05). Conclusions:There is significant heterogeneity in the family health of patients with chronic diseases, which can be divided into three distinct categories. Patients with higher family health levels have better quality of life. Medical professionals should develop precise intervention programs tailored to the characteristics of each category to improve family health levels and enhance the quality of life of patients with chronic diseases.

Objective:To evaluate the efficacy and safety of upadacitinib in the real-world treatment of difficult-to-treat Crohn's disease (DTT-CD) .Methods:This multicenter, retrospective cohort study included patients diagnosed with DTT-CD according to the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) criteria, and treated at eight Chinese inflammatory bowel disease centers between January 2023 and March 2025. Clinical outcomes were assessed after 12 weeks of induction therapy with upadacitinib (45 mg qd), including clinical remission rate, clinical response rate, and incidence of adverse events.Results:Among 151 enrolled DTT-CD patients, the clinical remission rate was 47.0%, and the clinical response rate was 90.7% after 12 weeks of treatment. Adverse events occurred in 42 cases (27.8%) .Conclusion:Upadacitinib demonstrated favorable efficacy in inducing clinical remission in DTT-CD patients, with a good safety profile at the induction dose (45 mg qd) .