ObjectiveTo investigate the effects of Huangqi Jianzhongtang （HQJZ） on macrophage polarization and fat consumption in cancer cachexia （CC） mice. MethodsUltra-performance liquid chromatography-quadrupole/electrostatic field Orbitrap high-resolution mass spectrometry （UPLC-Q-Orbitrap HRMS） was used to control the quality of HQJZ. （1） In vitro experiment： HQJZ-containing serum was prepared， and the optimal concentration was determined by cytotoxicity assay. Mouse monocyte-derived macrophages （RAW264.7） were cultured and randomly divided into six groups， including a blank group， a classically activated macrophages （M1） group， an alternatively activated macrophages （M2） group， a HQJZ + blank group， a HQJZ+M1 group， and a HQJZ + M2 group. The relative expression of macrophage marker genes CD86， inducible nitric oxide synthase （iNOS）， CD206， and arginase-1 （Arg1） was detected by real-time quantitative polymerase chain reaction （Real-time PCR ）. （2） In vivo experiment： Thirty-two BALB/c mice were randomly divided into a control group， a model group， a medroxyprogesterone acetate （MPA） group， and a HQJZ group. Except for the control group， the other mice were injected with CT-26 colon cancer cells to establish a CC model. Mice in the MPA and HQJZ groups were given MPA （0.13 g·kg^-1·d^-1） or HQJZ （13.13 g·kg^-1·d^-1） by gavage， respectively， while mice in the control and model groups were given an equal volume of saline by gavage， with interventions continued for 10 d. Real-time PCR was used to detect the expression of macrophage markers （iNOS， Arg1， CD86， CD206） and fat browning-related genes uncoupling protein 1 （UCP1） and peroxisome proliferator-activated receptor γ （PPARγ） in epididymal adipose tissue. Western blot （WB） was used to detect protein expression levels of UCP1 and PPARγ. Micro-computed tomography （micro-CT） was used to measure residual fat volume， and hematoxylin-eosin （HE） staining was used to assess fat browning and calculate pathological scores. ResultsIn vitro， the dominant effective concentration of HQJZ-containing serum was 12.5%. Real-time PCR results showed that， compared with the blank group， Arg1 expression decreased in the HQJZ+blank group （P<0.05）， CD206 showed a downward trend without statistical significance， while iNOS and CD86 expression were significantly increased （P<0.05）. Compared with the M1 group， Arg1 and CD206 expression decreased in the HQJZ+M1 group （P<0.05）. Compared with the M2 group， CD206 expression decreased in the HQJZ+M2 group （P<0.05）， CD86 expression increased significantly （P<0.01）. In vivo， Real-time PCR results showed that， compared with the control group， CD86 and CD206 expression levels were significantly increased in the model group （P<0.01）. Compared with the model group， CD206 expression in the MPA group was significantly decreased （P<0.01）. In the HQJZ group， CD206 was significantly decreased （P<0.01）. WB results showed that， compared with the model group， protein expression of UCP1 and PPARγ was significantly reduced in the HQJZ group （P<0.05， P<0.01）. micro-CT results showed that the total white fat volume in the HQJZ group was greater than that in the model group （P<0.05）. HE staining results showed that pathological scores in the HQJZ group were lower than those in the model group （P<0.05）. ConclusionHQJZ may inhibit white adipose tissue browning by promoting macrophage M1 polarization and suppressing M2 polarization， thereby delaying fat consumption in CC mice.

Objective:To characterize and compare the polysaccharide components of Panax japonicus with its common counterfeits (Dysosma versipellis, Lycopus lucidus and Dysosma pleiantha); To provide a scientific basis for the quality evaluation of polysaccharides of Panax japonicu.Methods:Crude polysaccharides were extracted using water and subsequently precipitated with ethanol. Three batches of total polysaccharides from Panax japonicus, Dysosma versipellis, Lycopus lucidus and Dysosma pleiantha were prepared using the savage deproteinization method. The molecular weight distribution, functional group characteristics and monosaccharide composition of each batch were analyzed using high performance gel filtration chromatography (HPGFC), fourier-transform infrared spectroscopy (FT-IR) and derivatization of 1-phenyl-3-methyl-5-pyrazolinone with high performance liquid chromatography (PMP-HPLC). Using DEAE column chromatography purification and specific enzymolysis, combined with high performance thin layer chromatography and carbohydrate gel electrophoresis, the saccharide profiles of polysaccharides of Panax japonicus and its counterfeits were analyzed and compared.Results:The molecular weight distribution of total polysaccharides from three batches of Panax japonicus exhibited high similarity, with a concentrated distribution ranging from 2.05×10 4 - 1.87×10 3 Da. However, the molecular weight distribution of total polysaccharides from Dysosma versipellis was scattered in regions 5.08×10 6-6.47×10 5 Da and 6.47×10 5-2.05×10 4 Da, while Lycopus lucidus and Dysosma pleiantha was scattered in regions 6.47×10 5-2.05×10 4 Da and 2.05×10 4-1.87×10 3 Da; the infrared spectra of all samples exhibited similarity, indicating that the sugar chains of each polysaccharide were predominantly linked by α-glycosidic bonds, with no significant differences was observed. In terms of monosaccharide composition, the polysaccharides from Panax japonicus, Dysosma versipellis and Dysosma pleiantha were mainly composed of glucose, galactose, arabinose, galacturonic acid, rhamnose and mannose. In contrast, the polysaccharides from Lycopus lucidus were distinct, primarily consisting of galactose and glucose; glycosidic linkage analysis revealed that the polysaccharides purified by DEAE column chromatography from Panax japonicus and its counterfeits were resistant to hydrolysis by β- galactosidase, but could be hydrolyzed by α-amylase and pectinase (except for Lycopus lucidus). The oligosaccharides produced by α-amylase hydrolysis of three batches of Panax japonicus polysaccharides were similar, showing clear differences from those of the counterfeits. The results of pectinase hydrolysis were correlated with the content of uronic acids. Conclusions:The total polysaccharides from Panax japonicus, Dysosma versipellis, Lycopus lucidus and Dysosma pleiantha exhibit significant differences in their molecular weight distributions. The monosaccharide composition of Lycopus lucidus polysaccharides is notably distinct, making it easily distinguishable from other species; purification using DEAE column chromatography, combined with HPTLC and polysaccharide analysis using carbohydrate gel electrophoresis (PACE), effectively differentiates the polysaccharides of Panax japonicus from its counterfeits. This approach provides a valuable reference for the quality analysis of polysaccharides in TCM. Additionally, it lays a foundation for the development and utilization of Panax japonicus polysaccharides.

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 investigate the quality of life status in patients with type 2 diabetes mellitus and its influencing factors,understand their demands for continuous nursing services,analyze the correlation,and provide a reference for formulating and implementing continuous nursing plans for diabetes in the later stage.Methods From May to December 2024,a cross-sectional survey was conducted among 294 patients with type 2 diabetes mellitus in this hospital by using the Self-Rating Anxiety Scale(SAS),the Diabetes Pa-tient-Specific Quality of Life Scale(DSQL),and the Questionnaire on the Need for Continuous Care.Results The SAS score of patients with type 2 diabetes was 45.76±7.45,DSQL score was 54.68±10.99,and the score of continuous care needs was 32.98±5.79.The quality of life of patients with type 2 diabetes mellitus is mainly influenced by factors such as age,family type,educational level,average monthly family in-come,duration of diabetes,blood glucose control,dietary compliance,intensity of physical exercise,and diabet-ic complications.The quality of life of patients with type 2 diabetes mellitus was positively correlated with need for continuous care(P<0.05).Conclusion The quality of life of patients with type 2 diabetes mellitus is influenced by multiple factors and is related to the need for continuous care.Professional continuous care plans can be formulated and implemented based on the needs of patients with type 2 diabetes mellitus.

Objective: To investigate the association between habitual reading/writing postures and the co-occurrence of common health conditions (overweight/obesity, visual impairment, hypertension, and scoliosis) and comorbidities among children and adolescents, in order to provide data support for the joint prevention of common diseases and comorbidities among children and adolescents. Methods: From September 2021 to June 2022, a multi-stage cluster random sampling method was used to select a total of 4 577 children and adolescents from 16 primary and secondary schools in Ningxia: Jinfeng District of Yinchuan City, Shapotou District of Zhongwei City, Yanchi County of Wuzhong City, and Pingluo County of Shizuishan City. A weighted complex sampling design was used to investigate the association of habitual reading and writing postures with common comorbidities in children and adolescents. Results: The prevalence rates of common diseases among children and adolescents in Ningxia were as follows: overweight/obesity was 22.87%, visual impairment was 62.52%, scoliosis was 2.30%, and hypertension was 1.30%. The prevalence of multimorbidity (co-occurrence of ≥2 conditions) among Ningxia children and adolescents was 15.95%. Multivariate unconditional Logistic regression analysis showed that frequent/always collapsing waist and sitting forward with head lowered increased the risk of common comorbidities in children and adolescents ( OR =1.90, P <0.05). Compared with the corresponding reference group, male children and adolescents aged 9 to 12 years and boys had relatively lower risks of overweight/obesity ( OR =0.71, 0.70); the risk of poor vision among children and adolescents aged 9 to 12 years, male, and urban was relatively low ( OR =0.59, 0.60, 0.73)( P < 0.05 ). Children and adolescents who often/always sat leaning to the left or right were at higher risk of poor vision ( OR =1.78); urban children and adolescents had a higher risk of developing scoliosis ( OR =3.71); children and adolescents aged 9 to 12 had a relatively low risk of developing hypertension ( OR =0.09), and children and adolescents who often/always bent their backs and sat forward on their knees had a higher risk of hypertension ( OR =5.03)( P <0.05). Conclusions Ningxia has a high incidence of common diseases and multiple diseases among children and adolescents, frequent or always collapsing waist and sitting forward with head lowered is associated with common comorbidities in children and adolescents in Ningxia. Proper postural measures for reading and writing should be carried out as soon as possible to encourage children and adolescents to develop good reading and writing habits for effectively preventing and controlling the occurrence of common diseases.

Pancreatic cancer is a highly lethal malignancy that is usually diagnosed at an advanced stage because of its absence of early symptoms and lack of effective screening tools. Although existing treatments (e.g., surgery, chemotherapy, and radiotherapy) can provide temporary relief, the therapeutic effect of pancreatic cancer remains limited, with major issues related to drug resistance and recurrence. In recent years, immunotherapy and targeted therapy have provided renewed hope to the treatment of pancreatic cancer. The immune microenvironment of pancreatic cancer is complex and strongly immunosuppressive. Immune cells such as tumor-associated macrophages and regulatory T cells can weaken the antitumor function of the immune system by secreting inhibitory factors, thereby enabling the tumor to evade immune surveillance. Meanwhile, immune escape is exacerbated by the infiltration of hypo-immune cells and the role of tumor-associated fibroblasts in the tumor microenvironment of pancreatic cancer. In response to these immune escape mechanisms, combining immunotherapy with targeted therapy has emerged as a focal point of current research. This review compiles the characteristics of the immune microenvironment in pancreatic cancer based on current literature, aiming to provide a basis and insights for related drug development.

Objective: To evaluate the efficacy and safety of the single-use hemoperfusion device (UA230) in treating refractory gout (RG) via plasma perfusion. Methods: Thirty-four RG patients aged 18-65 years were recruited and randomly divided into a control group (febuxostat therapy, n=17) and an experimental group (plasma perfusion combined with febuxostat therapy, n=17). Differences in serum uric acid (SUA) levels and urate-lowering rates between the two groups were analyzed using t-tests. Between-group differences in incidence of adverse reactions were analyzed using chi-square tests. Results: At 7 and 14 days post-treatment, SUA levels in the experimental group were significantly lower than those in the control group, with a higher urate-lowering rate (all P<0.05). However, no statistically significant differences in SUA levels or urate-lowering rate were observed at 28 days post-treatment (all P>0.05). The incidence of adverse reactions showed no significant difference between the two groups (χ =0.15, P>0.05). Conclusion: The single-use hemoperfusion device (UA230), combined with plasma perfusion technology, is a safe and effective treatment for RG. It may serve as a novel therapeutic approach for RG patients in clinical practice.

3D printing technology, with a layer-by-layer construction method, enables the fabrication of intricately shaped and customizable bolus. In contrast to traditional preparation methods, 3D printing technology addresses challenges such as poor bolus fit and cumbersome production processes, offering a novel approach to efficient and personalized bolus fabrication. This article discusses the research progress of 3D printing technology in radiotherapy bolus from aspects such as the preparation process, clinical application, and research advancements, combined with the actual printing experience of Department of Radiation Oncology in Chongqing University Cancer Hospital.
Printing, Three-Dimensional ; Humans ; Radiotherapy/methods*

Psoriasis is an incurable chronic inflammatory disease that requires new interventions. Here, we found that fibroblasts exacerbate psoriasis progression by promoting macrophage recruitment via CCL2 secretion by single-cell multi-omics analysis. The natural small molecule celastrol was screened to interfere with the secretion of CCL2 by fibroblasts and improve the psoriasis-like symptoms in both murine and cynomolgus monkey models. Mechanistically, celastrol directly bound to the low-density lipoprotein receptor-related protein 1 (LRP1) β-chain and abolished its binding to the transcription factor c-Jun in the nucleus, which in turn inhibited CCL2 production by skin fibroblasts, blocked fibroblast-macrophage crosstalk, and ameliorated psoriasis progression. Notably, fibroblast-specific LRP1 knockout mice exhibited a significant reduction in psoriasis like inflammation. Taken together, from clinical samples and combined with various mouse models, we revealed the pathogenesis of psoriasis from the perspective of fibroblast-macrophage crosstalk, and provided a foundation for LRP1 as a novel potential target for psoriasis treatment.

Objective To investigate the application value of ankle-brachial index(ABI)combined with Wagner scale in the prognosis assessment in patients with diabetic foot(DF).Methods A total of 120 patients with DF were enrolled in this study from in our hospital from June 2020 to December 2021.All the patients were divided into good prognosis group(n=92)and poor prognosis group(n=28)according to the prognosis after 6 months.The ABI and related clinical indicators were compared between the two groups.Logistic regression analysis and receiver operating characteristic(ROC)curve were used to analyze the prognostic value of each index in patients with DF.Results The DF duration,HbA1c,white blood cell count,Wagner grade 3 to 5,antibiotic type≥3,defibration times≥3 were higher in the poor prognosis group than in the good prognosis group(P<0.05),while the albumin,TG,ABI,hemoglobin and revasectomy rates were lower in the poor prognosis group than in the good prognosis group(P<0.05).Logistic regression analysis showed that HbA1c(OR 3.232,95%CI 1.063～9.830),ABI(OR 0.150,95%CI 0.038～0.588),Wagner grading(OR 5.032,95%CI 1.258～20.128)were the prognostic factor for patients with DF.The driving equation was established:Logit(P)=1.908×Wagner grading-1.978×ABI-1.945.ROC curve analysis showed that the area under the curve(0.897)of driving equation was higher than ABI(0.754)and Wagner grading(0.810)(P<0.05)in predicting poor prognosis in patients with DF.Conclusions ABI and Wagner grading are both factors affecting the poor prognosis of patients with DF,and ABI combined with Wagner grading is more effective in predicting the prognosis of patients with DF.