AIM:To investigate the effects of modified Danggui Yinzi decoction combined with diclofenac sodium eye drops on tear film stability and tear protein levels in patients with allergic conjunctivitis.METHODS:Prospective study. Patients with allergic conjunctivitis who attended Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from March 2021 to August 2024 were enrolled as study subjects. They were divided into two groups based on their treatment regimen: a control group(treated with diclofenac sodium eye drops alone)and an observation group(treated with modified Danggui Yinzi decoction combined with diclofenac sodium eye drops). Propensity score matching was used to balance baseline characteristics between the two groups. Log-binomial regression was performed to estimate the risk of adverse reactions. Repeated-measures analysis of variance(ANOVA)was used to assess tear film stability indicators. A difference-in-differences(DID)model was employed to assess the net effect of the combined therapy on changes in tear protein levels.RESULTS:After propensity score matching, a total of 172 patients(344 eyes)were finally enrolled, with 86 patients(172 eyes)in each of the control and observation groups. In the control group, there were 51 males and 35 females, with a mean age of 35.91±10.10 y; in the observation group, there were 49 males and 37 females, with a mean age of 37.87±8.09 y. After treatment, symptom scores decreased in both groups compared with baseline(all P<0.05). At 2 and 4 wk after treatment, symptom scores in the observation group were significantly lower than those in the control group(all P<0.05). The overall response rate was significantly higher in the observation group(89.5%)than in the control group(77.9%)(P<0.05), while the incidence of total adverse reactions was significantly lower in the observation group(7.0%)than in the control group(36.0%)(RR=0.133, P<0.001). Compared with baseline, both groups showed increases in BUT and SⅠt, and a decrease in FL score at 2 and 4 wk after treatment(P<0.017). At 2 and 4 wk after treatment, the BUT and SⅠt levels in the observation group were higher than those in the control group, and the FL score was significantly lower(all P<0.05). The DID model showed that the observation group had greater increases than the control group in lactoferrin(0.411 g/L), total protein(2.792 g/L), secretory immunoglobulin A(14.610 mg/L), and lysozyme(0.419 g/L), respectively(all P<0.05), and these differences remained significant after adjusting for covariates.CONCLUSION:Modified Danggui Yinzi decoction combined with diclofenac sodium eye drops significantly improves tear film stability indicators and tear protein levels in patients with allergic conjunctivitis, and its therapeutic efficacy is superior to that of diclofenac sodium eye drops alone.

Objective:To elucidate the role of solute carrier protein 7,family member 11(SLC7A11)/Glutathione peroxi-dase 4(glutathione peroxidase 4,GPx4)regulated ferroptosis pathway in the improvement of sarcopenia through aerobic exercise,and to identify a new target for the prevention and treatment of sarcopenia with exercise.Method:Twenty 52-week-old Specific pathogen Free(SPF)C57BL/6 male mice were randomly divided into the old control group(OC)and the old exercise group(OE).There were 10 mice in each group.Following one week of adaptive exercise,moderate-intensity exercise with incremental load was implemented as follows:14 m/min at 1-2 weeks,15 m/min at 3-4 weeks,16m/min at 5-10weeks,17m/min at 11-16weeks,60min/d,all with a slope of 0°.Gastrocnemius was harvested for ultrathin electron microscope sections.The levels of Glutathione(GSH),muscle glycogen and non-heme iron(non-heme iron)were measured by spectro-photometer.The serum ferritin(SF),mitochondrial 8-hydroxy-2 deoxyguanosine(8-OHdG)and 4-Hydroxynone-na(4-HNE)were measured by enzyme-linked immunosorbent assay(ELISA).Western blot was used to detect the expression of iron metabolism-related proteins,such as GPx4,SLC7A11,ferroportin 1(FPN1)and ferri-tin heavy chain 1(FTH1)in gastrocnemius muscle.Result:①Compared with OC,the wet weights of quadriceps femoris and gastrocnemius in OE were signifi-cantly increased(P＜0.01).In the exercise group,mitochondrial cristae arranged neatly and densely,and the light and dark bands of myofilaments were clear.In the aged control group,the mitochondrial cristae of gas-trocnemius muscle were disrupted,vacuolated or pyknotic,showing typical features of ferroptosis.② The SF and the iron content of gastrocnemius muscle were decreased in OE(P＜0.01).③ The levels of 4-HNE and 8-OHdG in gastrocnemius muscle of OE were significantly lower than those of OC(P＜0.01).The GSH content in gastrocnemius of OE was significantly higher than that of OC(P＜0.01).④ The expressions of SLC7A11,GPx4,FPN1 and FTH1 in gastrocnemius muscle of OE were significantly higher than those of OC(P＜0.01).Conclusion:Moderate aerobic exercise can prevent age-related sarcopenia by activating the SLC7A11/GPx4 pathway and inhibiting mitochondrial ferroptosis.

Hepatocellular carcinoma(HCC),as the most common type of liver cancer,poses a significant threat to global public health due to its high incidence and mortality rates.This paper delves into the etiology,pathogenesis,and syndrome differentiation of liver cancer from the perspective of"dispersing qi and fortifying the body resistance",based on the clinical experience of renowned traditional Chinese medicine(TCM)practitioner,Prof.Changquan Ling.Prof.Ling believes that the development of liver cancer is closely related to the disruption of liver qi flow,the accumulation of blood stasis over time,and the generation of toxin from long-term stagnation,accompanied by pathological changes such as imbalance of yin and yang,deficiency of the body's vital qi and accumulation of pathogenic factors,and internal blazing of cancer toxins.In terms of treatment,he emphasizes the principles of dispersing qi and fortifying the body resistance,addressing both the root cause and symptoms.This is achieved by regulating the functions of viscera,improving the stagnation of qi flow,and supplemented by methods such as clearing heat and detoxifying,and softening and dispersing hard masses,aiming to break the vicious cycle of qi stagnation,deficiency of vital qi,and pathogenic factor generation,thereby promoting the recovery from the disease.Through detailed analysis of clinical cases,this paper demonstrates Prof.Ling's unique insights and significant efficacy in treating liver cancer through"dispersing qi"to"fortify the body resistance",ultimately achieving"tumor suppression".This provides new references and perspectives for the clinical diagnosis and treatment of liver cancer in TCM.

Objective To explore the relationship between gut microbiota and adult hippocampal neu-rogenesis(AHN)in the prevention of age-related neurological decline by aerobic exercise,and to clar-ify the role of microbiota-gut-brain axis in exercise enhancing AHN.Methods Sixteen 52-week-old SPF C57BL/6 male mice were randomly divided into an old control group(OC)and an old aerobic ex-ercise group(OE),each of 8.The OE group underwent 16-week incremental load treadmill exercise,while the control group kept quiet.After the intervention,the contents of 5-Hydroxytryptamine(5-HT),γ-aminobutyric acid(GABA)and Dopamine(DA)in hippocampus were detected using ELISA,while those of glutamic amino acid(Glu)in hippocampus,as well as Acetylcholine(Ach)in hippocam-pus and serum was determined by using the ultraviolet colorimetric method.Moreover,hippocampal in-sulin-like growth factors 1(IGF1)and vascular epithelial growth factor(VEGF)and brain-derived neurotrophic factor(BDNF)proteins expression were measured using Western blotting.Meanwhile,fe-cal samples were collected for microbiota analysis by 16S rDNA sequencing.Results① After 16-week aerobic exercise,compared with the OC group,the contents of 5-HT and Glu(P<0.01),DA and GA-BA(P<0.05)in hippocampus increased in the OE group.Moreover,the hippocampal and serum Ach levels in the OE group increased significantly,compared to the OC group(P<0.01).②Compared with the OC group,the expression of BDNF,VEGF and IGF1 in the OE group increased significantly(P<0.01)after 16-week aerobic exercise.③Compared with the OC group,the diversity of microbiota in the OE group increased significantly(P<0.01)after the intervention.Moreover,the relative abundance of bacteroidetes and tenericutes increased,while that of proteobacteria decreased significantly in the OE group(P<0.01).Conclusions The composition of gut microbiota and the expression of central neu-rotransmitters in aged mice were significantly improved after 16-week incremental load aerobic exer-cise.Moreover,the expression of hippocampal neurogenesis related factors and the content of central neurotransmitters in adult individuals were promoted.The microbiota-gut-brain axis plays an important role in exercise improving AHN in aged mice.

Objective:To elucidate the role of solute carrier protein 7,family member 11(SLC7A11)/Glutathione peroxi-dase 4(glutathione peroxidase 4,GPx4)regulated ferroptosis pathway in the improvement of sarcopenia through aerobic exercise,and to identify a new target for the prevention and treatment of sarcopenia with exercise.Method:Twenty 52-week-old Specific pathogen Free(SPF)C57BL/6 male mice were randomly divided into the old control group(OC)and the old exercise group(OE).There were 10 mice in each group.Following one week of adaptive exercise,moderate-intensity exercise with incremental load was implemented as follows:14 m/min at 1-2 weeks,15 m/min at 3-4 weeks,16m/min at 5-10weeks,17m/min at 11-16weeks,60min/d,all with a slope of 0°.Gastrocnemius was harvested for ultrathin electron microscope sections.The levels of Glutathione(GSH),muscle glycogen and non-heme iron(non-heme iron)were measured by spectro-photometer.The serum ferritin(SF),mitochondrial 8-hydroxy-2 deoxyguanosine(8-OHdG)and 4-Hydroxynone-na(4-HNE)were measured by enzyme-linked immunosorbent assay(ELISA).Western blot was used to detect the expression of iron metabolism-related proteins,such as GPx4,SLC7A11,ferroportin 1(FPN1)and ferri-tin heavy chain 1(FTH1)in gastrocnemius muscle.Result:①Compared with OC,the wet weights of quadriceps femoris and gastrocnemius in OE were signifi-cantly increased(P＜0.01).In the exercise group,mitochondrial cristae arranged neatly and densely,and the light and dark bands of myofilaments were clear.In the aged control group,the mitochondrial cristae of gas-trocnemius muscle were disrupted,vacuolated or pyknotic,showing typical features of ferroptosis.② The SF and the iron content of gastrocnemius muscle were decreased in OE(P＜0.01).③ The levels of 4-HNE and 8-OHdG in gastrocnemius muscle of OE were significantly lower than those of OC(P＜0.01).The GSH content in gastrocnemius of OE was significantly higher than that of OC(P＜0.01).④ The expressions of SLC7A11,GPx4,FPN1 and FTH1 in gastrocnemius muscle of OE were significantly higher than those of OC(P＜0.01).Conclusion:Moderate aerobic exercise can prevent age-related sarcopenia by activating the SLC7A11/GPx4 pathway and inhibiting mitochondrial ferroptosis.

Hepatocellular carcinoma(HCC),as the most common type of liver cancer,poses a significant threat to global public health due to its high incidence and mortality rates.This paper delves into the etiology,pathogenesis,and syndrome differentiation of liver cancer from the perspective of"dispersing qi and fortifying the body resistance",based on the clinical experience of renowned traditional Chinese medicine(TCM)practitioner,Prof.Changquan Ling.Prof.Ling believes that the development of liver cancer is closely related to the disruption of liver qi flow,the accumulation of blood stasis over time,and the generation of toxin from long-term stagnation,accompanied by pathological changes such as imbalance of yin and yang,deficiency of the body's vital qi and accumulation of pathogenic factors,and internal blazing of cancer toxins.In terms of treatment,he emphasizes the principles of dispersing qi and fortifying the body resistance,addressing both the root cause and symptoms.This is achieved by regulating the functions of viscera,improving the stagnation of qi flow,and supplemented by methods such as clearing heat and detoxifying,and softening and dispersing hard masses,aiming to break the vicious cycle of qi stagnation,deficiency of vital qi,and pathogenic factor generation,thereby promoting the recovery from the disease.Through detailed analysis of clinical cases,this paper demonstrates Prof.Ling's unique insights and significant efficacy in treating liver cancer through"dispersing qi"to"fortify the body resistance",ultimately achieving"tumor suppression".This provides new references and perspectives for the clinical diagnosis and treatment of liver cancer in TCM.

Objective:To explore the relapse-related genes and their clinicopathological connections of diffuse large B cell lymphoma (DLBCL).Methods:Targeted panel sequencing was conducted on 32 eligible DLBCL samples; the patients were diagnosed, treated, and went into complete remission at the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2019, including 14 cases with recurrence (relapsed group) and 18 cases with long-term complete remission of over five years (remission group). Clinical and pathological data were further reviewed. Fisher′s exact test was employed to compare the differences in clinicopathological characteristics and mutation patterns between the two groups.Results:Among the 32 patients, there were 18 males and 14 females, with a male to female ratio of 1.3∶1.0 and a median age of 53 (45.5, 67.0) years. In the relapsed group, PIM1 (11/14), KMT2D (7/14), PRDM1 (6/14), MYD88 (6/14), DTX1 (6/14) emerged as the most frequently mutated genes. In the remission group, while recurrent PIM1, KMT2D and MYD88 mutations were also observed, the TP53 gene exhibited the highest mutation frequency (6/18). Compared to the remission group, relapsed group showed elevated mutation frequencies of PIM1 ( P=0.013) and FAT4 ( P=0.010), alongside a reduced incidence of TP53 mutations. In all 32 patients, DLBCL with CD79B, CCND3, DTX1, KMT2D and PRDM1 mutations demonstrated a propensity towards advanced clinicopathologic stage. Conclusions:Relapsed DLBCL has distinctive clinicopathological and genetic features. PIM1 and FAT4 may be served as potential biomarkers for screening relapsed DLBCL-NOS and as targets for novel therapeutic strategies.

Objective:To explore the relapse-related genes and their clinicopathological connections of diffuse large B cell lymphoma (DLBCL).Methods:Targeted panel sequencing was conducted on 32 eligible DLBCL samples; the patients were diagnosed, treated, and went into complete remission at the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2019, including 14 cases with recurrence (relapsed group) and 18 cases with long-term complete remission of over five years (remission group). Clinical and pathological data were further reviewed. Fisher′s exact test was employed to compare the differences in clinicopathological characteristics and mutation patterns between the two groups.Results:Among the 32 patients, there were 18 males and 14 females, with a male to female ratio of 1.3∶1.0 and a median age of 53 (45.5, 67.0) years. In the relapsed group, PIM1 (11/14), KMT2D (7/14), PRDM1 (6/14), MYD88 (6/14), DTX1 (6/14) emerged as the most frequently mutated genes. In the remission group, while recurrent PIM1, KMT2D and MYD88 mutations were also observed, the TP53 gene exhibited the highest mutation frequency (6/18). Compared to the remission group, relapsed group showed elevated mutation frequencies of PIM1 ( P=0.013) and FAT4 ( P=0.010), alongside a reduced incidence of TP53 mutations. In all 32 patients, DLBCL with CD79B, CCND3, DTX1, KMT2D and PRDM1 mutations demonstrated a propensity towards advanced clinicopathologic stage. Conclusions:Relapsed DLBCL has distinctive clinicopathological and genetic features. PIM1 and FAT4 may be served as potential biomarkers for screening relapsed DLBCL-NOS and as targets for novel therapeutic strategies.

Neonatal hyperbilirubinemia constitutes one of the common symptoms during the neonatal period. If it is not controlled and effectively treated in time，bilirubin encephalopathy can occur in severe cases，leading to neurological dysfunction and other adverse consequences. Therefore，early detection and effective treatment of hyperbilirubinemia are particularly crucial. In recent years，with the advancement of medical technology，a variety of new detection and treatment methods have been developed and implemented in clinical practice. This article reviews the traditional tests for neonatal hyperbilirubinemia，including percutaneous bilirubinometry and serum bilirubin level testing，evaluates their accuracy and validity，and describes new advances in detection tools. Meanwhile，the application of phototherapy，medication，and other complementary therapies，as well as their efficacy，is also highlighted. This paper aims to enhance the management level of neonatal hyperbilirubinemia，reduce its potential complications，and improve the prognosis of newborns.