Objective To investigate the distribution and evolutionary patterns of traditional Chinese medicine(TCM)syndromes and syndrome elements during the malignant transformation from chronic pancreatitis(CP)to pancreatic intraepithelial neoplasia(Pan IN)and pancreatic ductal adenocarcinoma(PDAC).Methods A retrospective analysis was conducted on 710 patients(330 of CP,104 of Pan IN,276 of PDAC)diagnosed pathologically or clinically at Shanxi Institute of Traditional Chinese Medicine from January 2021 to June 2024.Data including demographics,laboratory results,and TCM diagnostic information were recorded using EpiData 3.1.Syndrome and syndrome-element patterns were determined via factor analysis and K-means clustering using SPSS 27.0.Results The study identifies seven TCM syndrome types in CP,Pan IN,and PDAC.Among CP patients,the syndrome distribution was primarily liver-gallbladder damp-heat syndrome(22.42％)and gastrointestinal excess-heat syndrome(20.91％),with excess syndromes accounting for a higher proportion(43.33％);the syndrome elements were mainly heat(51.52％)and dampness(35.15％),with the disease location in the pancreas,related to the liver,spleen,and stomach.In Pan IN patients,the syndrome distribution was mainly spleen deficiency with dampness obstruction(23.08％)and liver-gallbladder damp-heat syndrome(17.31％),with mixed deficiency-excess syndrome accounting for a higher proportion(30.00％);the syndrome elements were mainly heat(41.35％),dampness(40.38％),and qi deficiency(37.50％),with the disease location in the pancreas,related to the spleen and liver.In PDAC patients,the syndrome distribution was mainly spleen deficiency with dampness obstruction(29.71％)and qi-blood deficiency syndrome(20.29％),with deficiency syndromes accounting for a higher proportion(49.82％);the syndrome elements were mainly qi deficiency(50.00％)and dampness(36.23％),with the disease location in the pancreas,related to the spleen,kidney,and liver.Chi-square tests revealed significant differences in syndrome types(TCM syndromes:x2=100.419,P＜0.001;deficiency-excess syndromes:x2=73.722,P＜0.001),syndrome elements(x2=117.384,P＜0.001),and disease locations(x2=127.191,P＜0.001)across different stages of CP malignant transformation.During CP malignant progression,the proportion of excess syndromes gradually decreased(43.33％→12.32％),while deficiency syndromes increased(26.67％→49.82％).Excess syndrome elements(fire,heat,qi stagnation,blood stasis)decreased(53.48％→25.36％),whereas deficiency syndrome elements(qi deficiency,yin deficiency,yang deficiency,blood deficiency)increased(25.15％→49.64％).The disease location shifted from primarily the liver,spleen,and stomach in the inflammatory stage to the spleen and kidney in the cancerous stage.Conclusion The malignant transformation of CP basically involves the pancreas,is correlated early with liver and spleen-stomach and later with kidney,and exhibits a progression from excess to deficiency in the pattern of"deficiency interweaved with excess syndrome,transition from excess to deficiency,and progressive spleen deficiency".

Objective To retrieve,evaluate and summarize the relevant evidences of oral health manage-ment in the community elderly people to provide reference for community medical staffs.Methods The evi-dences on oral health management of the comunity elderly people were systematically retrieved from various guide websites and Chinese and English databases.The retrieval limit was from the database establishment to September 2021.The research group conducted the evaluation and extracted the evidences according to the rel-evant literature evaluation criteria.Results A total of 17 literatures were included,including 5 guidelines,4 expert consensuses and 8 systematic reviews.A total of 28 pieces of evidences were summarized from the five aspects of assessment and examination,daily life management,management of special oral problems,denture management,and education and training.Conclusion Community medical staffs should fully consider the clin-ical situation,department resources and patient wishes,and conduct the evidence application to increase the o-ral health level of the community elderly people.

Rare diseases are characterized by extremely low incidence rate and small number of patients in total. The drugs used to treat rare diseases are called orphan drugs. Currently, 450 kinds of rare skin diseases have been identified, most of which lack in effective treatments. Supported by the policy-making from the country and pushed by all sectors of the society, drugs for rare skin diseases have been emerging continuously recently in China. This paper reviews the current accessibility of the orphan drugs for skin rare diseases that have been approved in China and in other countries and regions for a better understanding of rare dermatosis and orphan drugs for the diseases.

Objective:To investigate the etiological diagnostic value of metagenomic sequencing in central nervous system (CNS) infectious diseases.Methods:A total of 170 patients with central nervous system infection admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2020 were selected as the study subjects according to inclusion and exclusion criteria. General clinical data and pathogen test results were collected. All included patients underwent routine examination and mNGS test, and were divided into the conventional method test group and mNGS test group according to the test results. The measurement data conforming to normal distribution were represented by ± s; The measurement data that did not conform to normal distribution were represented by median and interquartile range. The classification data were expressed by the number of cases and percentage( n,%), and were compared by χ2 test or Fisher's exact test. Consistency test was represented by Kappa value. The detection of pathogenic microorganisms by the two methods and the rule of pathogen spectrum were compared and analyzed. Results:The overall positive rate of mNGS in CNS infectious diseases was higher than that of conventional methods (58.23% vs. 18.82%), and the difference was statistically significant ( P<0.01). Among the 20 samples which were both positive by the two methods, 10 cases were completely pathogenic, 5 cases were partially consistent and 5 cases were completely inconsistent. In the detection of tuberculous nervous system infection, the positive rates were 66.7%, 53.8%, 44.0%, 40.0%, 4.0% in blood T-SPOT, cerebrospinal fluid mNGS, ADA, Mycobacterium tuberculosis DNA and tuberculous specific antibody, respectively. The positive rate of acid-fast staining was 0. The positive rate of mNGS combined with conventional method was 80.8%. Conclusions:The detection rate of mNGS in CNS infection is better than that of conventional methods. However, it does not show obvious superiority in the detection rate of Mycobacterium tuberculosis associated nervous system infection. In general, mNGS detection of pathogenic bacteria is more extensive, which is conducive to a thorough and comprehensive understanding of the bacterial characteristics of central nervous system infection. The combination of the two methods can make up for the deficiency of clinical routine detection to a certain extent, and can maximize the detection rate.

The poorly water-soluble drug curcumin was prepared into oral nanocrystalline solid preparation by nanocrystal technology to improve the solubility, dissolution rate, and bioavailability. Curcumin nanocrystals were prepared by media grinding technology, and two types of stable curcumin nanocrystal suspension formulations were developed. The stabilizers in the two formulations were polyvinylpyrrolidone (PVP K30)/sodium lauryl sulfate (SDS)(1∶1) and Tween 80, respectively. The prepared curcumin nanocrystal suspension was loaded onto microcrystalline cellulose pellets through fluidized bed coating technology, and the nanocrystalline capsules were obtained after filling. The results of nanocrystal redispersion stability and scanning electron microscope (SEM) showed that the morphology of drug-loaded pellets was uniform when PVP K30 and SDS were used as stabilizers, and the diameter of nanocrystals before and after redispersion was about 200 nm, which was determined as the optimal formulation. In vitro dissolution study showed that curcumin nanocrystals at the size of 200 nm exhibited significantly promoted dissolution. The results of X-ray powder diffraction (XRPD) and differential scanning calorimetry (DSC) showed that the curcumin crystalline partly turned amorphous during the preparation of nanocrystals.Pharmacokinetic studies in rats showed that the bioavailability of curcumin nanocrystals was 9.3 times higher than that of the bulk drug. The curcumin nanocrystalline capsules developed in this research can significantly improve the dissolution rate and bioavailability, which is of great significance in improving the poor solubility of drugs, and is expected to become a new dosage form for clinical treatment.

Objective:To explore the effect of video stereoscopic health education combined with biofeedback relaxation training in computed tomography (CT) examination patients.Methods:From July 2018 to December 2019, we selected 300 patients who underwent cardiac CT examinations in the First Affiliated Hospital of Zhengzhou University. All patients were randomly divided into control group and observation group, with 150 cases in each group. Both groups of patients received routine care and video stereoscopic health education, and observation group added biofeedback relaxation training intervention on this basis. We compared the coordination of patients, occurrence of adverse events during the examination and the operation time between two groups.Results:The degree of cooperation of the observation group was higher than that of the control group, and the difference was statistically significant between two groups ( Hc=27.31, P<0.05) . The occurrence of adverse events during the examination in observation group was 2.67% (4/150) and that in control group was 8.00% (12/150) with a statistical difference (χ 2=4.225, P<0.05) . The operation time of observation group and control group was (5.48±2.34) min and (8.45±2.47) min respectively also with a statistical difference ( t=10.691, P<0.05) . The nursing satisfaction of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05). Conclusions:Combined biofeedback relaxation training can improve the coordination of patients during the examination, reduce the operation time and the occurrence of adverse events during the examination which has good effects.

Considerable evidence has indicated that psychological factors,such as anxiety,nervousness and mental stress,can induce or exacerbate psoriasis and affect therapeutic effects to a certain degree,suggesting that psychological factors may play an important role in the occurrence of psoriasis.Current researches on neuropsychiatry-related pathogenesis of psoriasis mainly include two aspects:on the one hand,acting as stressors,psychological factors can activate the following two neuroendocrine systems,including hypothalamic-pituitary-adrenocortical axis and sympathetic-adrenal medullary system;on the other hand,neuropeptides and nerve growth factors induce in vivo neurogenic inflammation.Neuropsychiatric factors may participate in the occurrence of psoriasis through the above pathways.

Objective To observe Hedgehog signaling pathways of liver cancer cell growth and the influence of the metastatic potential targeted inhibit Hedgehog.Methods Construction of Smo shRNA plasmid,The stable and low-expressed Smo-expressing HCC QGY-7701 cell line was screened after lipofection.The stable and low-expressed Smo-expressing HCC QGY-7701 cell line was screened,The cell cycle,apoptosis,invasion and metastasis of QGY-7701 cells were detected by Western blot,flow cytometry,CCK8 and transwell assay.Subcutaneous implantation of hepatocarcinoma cells in nude mice.Study on the growth and metastasis of hepatocarcinoma cells with low expression of Smo in.The ultrastructural changes of hepatoma cells with low expression of Smo were observed under electron microscope.Results RT-PCR and Western blot showed stable shR-Smo cell line was successfully constructed.Cell cycle test showed that compared with the control group,G0/G1 cells increased in shR-Smo,cells in S phase decreased;apoptosis,CCK8 and Transwell tests showed that Smo-gene silencing could significantly increase the apoptosis percentage of the hepatic cancer cells to (5.46％ ± 1.46％),proliferation activity decreasedand and the migration rates reduced to (7.82％ ±2.14)％;nude mice model showed that Smo-gene silencing could inhibit the growth of hepatocellular carcinoma cells in vivo,electron microscopy revealed that lysosomes increased significantly in Smo-gene silence cells.Conclusions Blocking Hh signaling pathways,liver cancer cells in vitro malignant degree of decline.Hedgehog in treating liver cancer have hidden meaning.

Objective: To explore the feasibility and therapeutic effect of single-staged Han-uvulopalatopharyngoplasty with septoplasty in adults with obstructive sleep apnea-hypopnea syndrome. Methods: Ninety six cases with OSAHS were diagnosed by polysomnography, and they all had retropalatal obstruction and deviation of nasal septum. Patients were divided into study group(48 cases) and control group(48 cases) randomly. Cases in study group were simultaneously treated with Han-uvulopalatopharyngoplasty and septoplasty, while cases in control group were only treated with Han-uvulopalatopharyngoplasty. U saturation skill and coblation-assisted were applied in Han-uvulopalatopharyngoplasty. And nasal septum suture technique was applied in septoplasty. The observation index included the intranasal changes with acoustic rhinometry, the prevalence of common postoperation complications and curative effects after six months follow-up period. SPSS 18.0 was used for statistical analysis. Results: In study group the overall response rate was 83.33%(40/48), while in control group the overall response rate was 62.50%(30/48). There was statistical significance of response rate between test group and control group(χ²=5.275, P<0.05). There was no statistical significance on complication rate between study group and control group(P>0.05). There was no statistical significance on preoperative measurement data(P>0.05). Conclusion For OSAHS patients with obstructive level at retropalatal plane and nasal plane, Han-uvulopalatopharyngoplasty combined with septoplasty in one stage is safe and effective.

Extraction process plays an important role in Chinese herbal medicine applications. Traditional extraction method has some disadvantages, such as long processing time, high solvent consumption and low efficiency. Thus, some new technologies and methods have been introduced in this paper, including ultrasonic extraction, microwave extraction, supercritical fluid extraction. On the basis of advantages and disadvantages of traditional Soxhlet extrac-tion, this paper mainly described the principles, characteristics, influencing parameters and applications.