AIM: To explore the factors associated with significant corneal astigmatism during the perioperative period in patients with pterygium. METHODS: Patients with primary pterygium presenting at Shanxi Eye Hospital between February and June 2025 were enrolled. All patients underwent medical history collection. Pre- and postoperative data were obtained using Pentacam, anterior segment photography, Image J software, and anterior segment optical coherence tomography(AS-OCT). All patients underwent pterygium excision combined with autologous bulbar conjunctival flap transplantation under local infiltration anesthesia. RESULTS: A total of 76 patients(76 eyes)with pterygium were finally enrolled(30 males, 46 females)with a mean age of 62.2±8.2 y. The mean length of corneal invasion by pterygium was 3.61±0.89 mm, the mean depth of invasion into the anterior corneal surface was 0.15±0.09 mm, and the median area of corneal invasion was 10.25(6.90, 18.75)mm2. The median preoperative corneal astigmatism was 1.50(0.70, 5.45)D. Median astigmatism was 0.8(0.40, 1.28)D at 2 wk postoperatively and 0.60(0.30, 1.15)D at 1 mo postoperatively. Patient age showed a positive correlation with preoperative astigmatism, and with residual astigmatism at 2 wk and 1 mo postoperatively(all P<0.05). The length of corneal invasion was positively correlated with preoperative astigmatism and residual astigmatism at both postoperative timepoints(P<0.01). The depth of invasion showed no significant linear correlation with astigmatism at any stage(P=0.250, 0.761, 0.686). The area of corneal invasion was positively correlated with astigmatism at all stages(P<0.01). Patients were grouped based on significant astigmatism(≥1.0 D)and non-significant astigmatism(<1.0 D), after adjusting for other variables, age(P=0.031)and the area of corneal invasion(P=0.004)were identified as risk factors for significant astigmatism. Pterygium invasion length was not significant factors(P>0.05). Receiver operating characteristic(ROC)analysis showed the highest area under the curve(AUC)for the invasion area(AUC=0.915). CONCLUSION: Significant preoperative corneal astigmatism in pterygium patients is correlated with patient age, the length of corneal invasion, and the area of invasion. The area of pterygium invasion into the cornea is the strongest predictor of significant preoperative corneal astigmatism.

ObjectiveTo construct an automatic measurement model for palmar tilt and radial inclination suitable for traditional Chinese medicine （TCM） clinical scenarios， and to validate its accuracy and efficiency in TCM manipulative reduction settings. MethodsData on anteroposterior （AP） and lateral X-rays of distal radius fractures were collected from patients admitted to 18 TCM/ integrated TCM and western medicine hospitals in Jiangsu province between September 1st， 2023， and September 1st， 2024， via the Jiangsu Diagnosis and Treatment Big Data Platform for TCM Dominant Diseases. A medical image segmentation framework based on multi-scale feature fusion and edge-awareness was employed， combined with anatomical knowledge specific to TCM orthopedics， to optimize the feature extraction strategy of an artificial intelligence （AI） model. This framework enabled automatic segmentation of fracture regions and measurement of distal radius palmar tilt and radial inclination. The accuracy of the AI model in measuring radial inclination and volar tilt was validated， and the measurement time and average time gain rate of the AI model were compared to those of manual measurement. ResultsA total of 15,444 AP and lateral X-ray images of distal radius fractures were collected， and were divided into a training set （11,144 images， 5066 AP and 6078 lateral）， a validation set （3700 images， 1840 AP and 1860 lateral）， and an independent test set （600 images， 300 AP and 300 lateral） after preprocessing. In the measurement of 300 AP X-rays in the independent test set for radial inclination， when the degree error between AI measurement and manual measurement was ＜3° and ＜5°， AI measurement accuracy was 83% and 93%， respectively. In 300 lateral X-rays in the test set for palmar tilt， when AI measurements had an error of ＜3° and ＜5° compared to manual measurements， corresponding accuracy rate was 78% and 90%， respectively. For 50 X-ray images， AI measurement time was （1.37±0.05） min for radial inclination while manual measurement time was （22.57±2.52） min （P＜0.001）； in terms of palmar tilt， the AI measurement time was （1.33±0.14） min， shorter than （23.70±2.80） min for manual measurement time （P＜0.001）. Average time gain rates for manual and AI measurements were 93.93% and 94.39% respectively. ConclusionAn automatic measurement model for palmar tilt and radial inclination in distal radius fractures has been established， enabling more accurate and efficient assessment as well as providing a tool to support the quantitative evaluation of the efficacy of TCM manipulative reduction and large-sample clinical research.

Objective To analyze the pollution characteristics of PM_2.5-bound polycyclic aromatic hydrocarbons (PAHs) during the non-heating period, heating period, and haze period in Harbin, and infer their possible sources, and to evaluate their impact on population carcinogenesis. Methods From 2020 to 2022, sampling points were set up in different districts of Harbin. PM_2.5 samples were regularly collected every month to analyze the contents of 10 types of PM_2.5-bound 4-6 rings PAHs. The pollution characteristics of PAHs were analyzed during different monitoring periods (non-heating period, heating period, and haze period). The excess carcinogenesis risks of PM_2.5-bound PAHs were assessed according to the Technical Specifications for Health Risk Assessment of Ambient Air Pollution and the U. S. Environmental Protection Agency (US EPA) risk assessment method. The characteristic ratio method and the positive matrix factorization (PMF) model were used to infer the sources of PAHs. Results The median mass concentrations of ambient PM_2.5-bound 4-6 rings PAHs (ΣPAHs) during the non-heating period, heating period, and haze period were 6.44 ng/m³, 37.85 ng/m³, and 106.79 ng/m³, respectively. During the heating season and haze period, the concentrations of benzo[a]anthracene, benzo[k]fluoranthene, pyrene and fluoranthene were relatively high. The excess carcinogenic risks for ASF_>16, ASF_2-16 and ASF_<2 caused by exposure to PM_2.5-bound 4-6rings PAHs during the heating season were 2.34×10^-6, 1.82×10^-6, and 0.88×10^-6, respectively, while the excess carcinogenic risks for the whole population during the heating season and haze period were 5.05×10^-6 and 1.75×10^-6, respectively. The results of the two source methods showed that the main characteristic elements during the heating season were fluoranthene, pyrene, benzo[a]anthracene, benzo[b]fluoranthene, benzo[k]fluoranthene, and benzo[a]pyrene. According to the emission source standards, it was determined that the sources were mainly coal and biomass combustion, accompanied by traffic source emissions. Conclusion In Harbin, the PM_2.5-bound 4-6 rings PAHs during the haze period is significantly higher than that during the heating period. The pollution is mainly from coal combustion emissions, accompanied by continuous traffic source pollution. The exposure to PAHs during the heating period poses a potential carcinogenic risk to the population.

OBJECTIVE To explore the willingness to pay （WTP） of Urumqi residents for community pharmacies’ medication guidance services and its influencing factors， so as to provide data support for the optimization of community pharmacy services and the establishment of a fee structure for medication guidance services. METHODS A stratified quota sampling method was employed to select 14 communities in Urumqi City. From April to June 2025， a combined offline and online questionnaire survey was conducted among adult residents in these communities. The contingent valuation method was used to construct three hypothetical scenarios （namely， basic， enhanced and extended services） of medication counselling in community pharmacies to assess residents’ WTP for these services. Binary Logistic regression was employed to analyze the influencing factors of WTP. RESULTS A total of 576 valid questionnaires were obtained. Under the scenarios of basic， enhanced and extended services， 38.54%， 49.65% and 67.19% of the respondents expressed WTP for the services， respectively. Occupational type， type of basic medical insurance， annual income， perception of pharmacists’ profession， and acceptance level of the service were identified as major influencing factors for WTP （P＜0.05）. CONCLUSIONS The willingness of residents in Urumqi to pay for medication counseling services provided by pharmacists in community pharmacies significantly increases with the enrichment of service content. It is recommended to incorporate basic medication counselling services provided by pharmacists in community pharmacies into medical insurance payment， while value-added services should be partially or fully self-paid by residents. Additionally， efforts should be made to strengthen the promotion of the professional and service value of licensed pharmacists， so as to facilitate the high-quality development of pharmaceutical care.

Objective:To explore the changes in nutritional status and body composition of cervical cancer patients during concurrent chemoradiotherapy (CCRT) and their correlation with CCRT toxicities.Methods:In this prospective and observational clinical study, eligible treatment -na?ve patients with stage IB-IV primary cervical cancer were consecutively enrolled in the Department of Radiotherapy of Peking Union Medical College Hospital from September 2022 to August 2023. The patients were screened for nutritional risks, received dietary assessment, and were measured for body composition using multi-frequency bioelectrical impedance at baseline (prior to treatment), 4 weeks, and 8 weeks since treatment initiation. Insufficient muscle mass was diagnosed ccording to the Asian Working Group for Sarcopenia 2019 criteria. The severity of nausea, vomiting, abdominal pain, diarrhea, and hematological toxicity was assessed by the U.S. National Cancer Institute Common Terminology Criteria for Adverse Events (version 5.0).Results:A total of 109 patients were included. At baseline, there were 11 (10.1%) patients who were lean, 17 (15.6%) patients with insufficient muscle mass, and 28 patients (25.7%) at nutritional risk; at Week 8 of CCRT, patients at nutritional risk increased to 61 (56.0%). Compared to baseline, weight [(59.34±9.67) kg vs. (61.30±9.64) kg, P<0.001], skeletal muscle index [SMI, (6.15±0.74) kg/m 2vs. (6.39±0.74) kg/m 2, P<0.001], body fat percentage [(31.13±7.67) % vs. (32.07±7.70) %, P=0.004] were significantly decreased at Week 8 of CCRT. Besides, ≥10% SMI loss was only related to baseline body fat percentage ( HR=0.216, 95% CI: 0.001-0.724, P=0.038), but not related to age, nutritional status, or muscle mass (all P>0.05). At baseline and 8 weeks since CCRT, 8 (28.6%) and 40 (65.6%) patients at nutritional risk received nutritional support, respectively. During CCRT, the rates of grade ≥2 nausea and vomiting, diarrhea, and grade 3/4 hematological toxicity were 37.6%, 28.4% and 44.0%, respectively. Baseline nutritional risk was a risk factor for diarrhea ( HR=2.447, 95% CI: 1.017-6.068, P=0.047), and an advanced International Federation of Gynecology and Obstetrics (FIGO) stage was a risk factor for severe nausea and vomiting ( HR=1.735, 95% CI: 1.005-2.995, P=0.048). Patients presenting with severe nausea and vomiting had more significant reductions in body mass index [(-1.44±1.29) kg/m 2vs. (-0.59±0.84) kg/m 2, P<0.001] and SMI [(-0.37±0.41) kg/m 2vs. (-0.12±0.27) kg/m 2, P=0.013] compared to those without nausea and vomiting, while there was no significant difference in visceral fat area between these two groups [(-9.95±19.48) cm 2vs. (-5.12±15.79) cm 2, P=0.161]. Conclusions:Patients with cervical cancer have increased nutritional risk and more loss of body weight and muscle mass during CCRT. The presence of nutritional risk at baseline is a risk factor for diarrhea, while nausea and vomiting exacerbate the losses of body weight, muscle, and fat. Close monitoring, intensive symptomatic therapy, and appropriate nutritional interventions should be performed in the clinical setting to improve patients' tolerance of treatment and maintenance of body weight.

Neuroinflammatory responses play an important role in the pathogenesis of various diseases, particularly those affecting the central nervous system. Inhibition of neuroinflammation is a crucial therapeutic strategy for the management of central nervous system disorders. The intestinal microbial-gut-brain axis serves as a key regulatory pathway that modulates neuroinflammatory processes. Intestinal flora metabolites such as short-chain fatty acids, indoles and their derivatives, lipopolysaccharides, trimethylamine oxide, and secondary bile acids exert direct or indirect effects on neuroinflammation. Studies have shown that electroacupuncture (EA) modulates the composition of the intestinal microbiota and its metabolites, while also suppressing neuroinflammation by targeting the TLR4/NF- κ B, NLRP3/caspase-1, and microglial cell M2-type transformation pathways. This review discusses the mechanisms by which EA regulates neuroinflammation via intestinal microbiota and its metabolites, providing information and a foundation for further investigation of the precise therapeutic mechanisms of EA in neurological disorders.
Humans ; Gastrointestinal Microbiome ; Electroacupuncture ; Neuroinflammatory Diseases/metabolism* ; Animals

Osteoporosis is a prevalent skeletal condition characterized by reduced bone mass and strength, leading to increased fragility. Buqi-Tongluo (BQTL) decoction, a traditional Chinese medicine (TCM) prescription, has yet to be fully evaluated for its potential in treating bone diseases such as osteoporosis. To investigate the mechanism by which BQTL decoction inhibits osteoclast differentiation in vitro and validate these findings through in vivo experiments. We employed MTS assays to assess the potential proliferative or toxic effects of BQTL on bone marrow macrophages (BMMs) at various concentrations. TRAcP experiments were conducted to examine BQTL's impact on osteoclast differentiation. RT-PCR and Western blot analyses were utilized to evaluate the relative expression levels of osteoclast-specific genes and proteins under BQTL stimulation. Finally, in vivo experiments were performed using an osteoporosis model to further validate the in vitro findings. This study revealed that BQTL suppressed receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis and osteoclast resorption activity in vitro in a dose-dependent manner without observable cytotoxicity. The inhibitory effects of BQTL on osteoclast formation and function were attributed to the downregulation of NFATc1 and c-fos activity, primarily through attenuation of the MAPK, NF-κB, and Calcineurin signaling pathways. BQTL's inhibitory capacity was further examined in vivo using an ovariectomized (OVX) rat model, demonstrating a strong protective effect against bone loss. BQTL may serve as an effective therapeutic TCM for the treatment of postmenopausal osteoporosis and the alleviation of bone loss induced by estrogen deficiency and related conditions.
Animals ; NFATC Transcription Factors/genetics* ; Drugs, Chinese Herbal/pharmacology* ; Ovariectomy ; Osteoclasts/metabolism* ; Female ; Osteogenesis/drug effects* ; Rats, Sprague-Dawley ; Rats ; NF-kappa B/genetics* ; Osteoporosis/genetics* ; Signal Transduction/drug effects* ; Bone Resorption/genetics* ; Cell Differentiation/drug effects* ; Humans ; RANK Ligand/metabolism* ; Mitogen-Activated Protein Kinases/genetics* ; Transcription Factors

Objective:To evaluate the clinical efficacy of"Shibao Decoction"in the management of late-onset hypogonadism(LOH)caused by deficiency of kidney essence.Methods:Sixty male patients with late-onset hypogonadism of kidney essence defi-ciency type were randomly assigned to the treatment group and the control group,each with 30 cases.The patients in treatment group were treated with oral Shibao Decoction,while the control group was treated with oral Testosterone Undecanoate Capsules.The patients in both groups were treated for 12 weeks.The PADAM symptom score,TCM syndrome score,serum total testosterone(TT),serum free testosterone(FT),sex hormone binding globulin(SHBG),body mass index(BMI),total skeletal muscle mass index(SMI),appendicular skeletal muscle mass index(ASMI),FBG,FINS,and insulin resistance index(HOMA-IR)levels were compared be-tween the two groups.Results:After treatment,PADAM scores for each item and TCM symptoms score decreased,TT and FT in-creased in both groups,all with statistically significant differences from those of pre-treatment(P＜0.05).The level of SHBG in the control group decreased(P＜0.05),which had not changed significantly in the treatment group(P＞0.05).After treatment,SMI and ASMI increased in both groups significantly(P＜0.05).BMI decreased in the control group(P＜0.05),which had not changed significantly in the treatment group(P＞0.05).The level of FINS decreased in the control group(P＜0.05),which had not changed significantly in the treatment group(P＞0.05).FPG had not changed significantly in both groups(P＞0.05),and the insulin resist-ance index(HOMA-IR)had significantly improved in both groups,all with statistically significant differences from those of pre-treat-ment(P＜0.05).After treatment,the total effective rates of PADAM score and TCM syndrome score in the treatment group were 73.3％and 86.6％respectively,and the total effective rates in the control group were 66.7％and 76.6％respectively.The total ef-fective rates of the two scores in the treatment group were slightly higher than those in the control group(P＞0.05).There was no sig-nificant difference in the indicators between the two groups after treatment,and the treatment group is generally comparable with the control group in the therapeutic effects(P＞0.05).And no adverse reactions occurred during treatment in both groups.Conclu-sion:The"Shibao Decoction"has a remarkable therapeutic effect on late-onset hypogonadism caused by deficiency of kidney essence and has good safety.It can be used as an alternative to testosterone undecanoate and is worthy of clinical promotion and application.

Objective:To explore the changes in nutritional status and body composition of cervical cancer patients during concurrent chemoradiotherapy (CCRT) and their correlation with CCRT toxicities.Methods:In this prospective and observational clinical study, eligible treatment -na?ve patients with stage IB-IV primary cervical cancer were consecutively enrolled in the Department of Radiotherapy of Peking Union Medical College Hospital from September 2022 to August 2023. The patients were screened for nutritional risks, received dietary assessment, and were measured for body composition using multi-frequency bioelectrical impedance at baseline (prior to treatment), 4 weeks, and 8 weeks since treatment initiation. Insufficient muscle mass was diagnosed ccording to the Asian Working Group for Sarcopenia 2019 criteria. The severity of nausea, vomiting, abdominal pain, diarrhea, and hematological toxicity was assessed by the U.S. National Cancer Institute Common Terminology Criteria for Adverse Events (version 5.0).Results:A total of 109 patients were included. At baseline, there were 11 (10.1%) patients who were lean, 17 (15.6%) patients with insufficient muscle mass, and 28 patients (25.7%) at nutritional risk; at Week 8 of CCRT, patients at nutritional risk increased to 61 (56.0%). Compared to baseline, weight [(59.34±9.67) kg vs. (61.30±9.64) kg, P<0.001], skeletal muscle index [SMI, (6.15±0.74) kg/m 2vs. (6.39±0.74) kg/m 2, P<0.001], body fat percentage [(31.13±7.67) % vs. (32.07±7.70) %, P=0.004] were significantly decreased at Week 8 of CCRT. Besides, ≥10% SMI loss was only related to baseline body fat percentage ( HR=0.216, 95% CI: 0.001-0.724, P=0.038), but not related to age, nutritional status, or muscle mass (all P>0.05). At baseline and 8 weeks since CCRT, 8 (28.6%) and 40 (65.6%) patients at nutritional risk received nutritional support, respectively. During CCRT, the rates of grade ≥2 nausea and vomiting, diarrhea, and grade 3/4 hematological toxicity were 37.6%, 28.4% and 44.0%, respectively. Baseline nutritional risk was a risk factor for diarrhea ( HR=2.447, 95% CI: 1.017-6.068, P=0.047), and an advanced International Federation of Gynecology and Obstetrics (FIGO) stage was a risk factor for severe nausea and vomiting ( HR=1.735, 95% CI: 1.005-2.995, P=0.048). Patients presenting with severe nausea and vomiting had more significant reductions in body mass index [(-1.44±1.29) kg/m 2vs. (-0.59±0.84) kg/m 2, P<0.001] and SMI [(-0.37±0.41) kg/m 2vs. (-0.12±0.27) kg/m 2, P=0.013] compared to those without nausea and vomiting, while there was no significant difference in visceral fat area between these two groups [(-9.95±19.48) cm 2vs. (-5.12±15.79) cm 2, P=0.161]. Conclusions:Patients with cervical cancer have increased nutritional risk and more loss of body weight and muscle mass during CCRT. The presence of nutritional risk at baseline is a risk factor for diarrhea, while nausea and vomiting exacerbate the losses of body weight, muscle, and fat. Close monitoring, intensive symptomatic therapy, and appropriate nutritional interventions should be performed in the clinical setting to improve patients' tolerance of treatment and maintenance of body weight.