ObjectiveTo observe the short-term and long-term efficacy of traditional Chinese medicine （TCM） surgical operations in treating mixed hemorrhoids. MethodsA multi-center retrospective cohort study was conducted， collecting clinical data from 17，831 mixed hemorrhoid surgery patients in 8 top-tier TCM hospitals in Jiangsu Province. Standardized and structured datasets were obtained through artificial intelligence models. Patients who underwent western surgical treatment were categorized into the western surgery group （11,646 cases）， and those receiving TCM surgical operations were categorized into the TCM surgery group （6185 cases）. Propensity score matching （1∶1 matching） was used to balance baseline data between groups. The primary outcome was the one-year recurrence rate， and secondary outcomes included the main symptoms （rectal bleeding， degree of prolapse） and secondary symptoms （anal distension， anal edema， wound secretion and exudation， anal stenosis， residual skin tags， perianal itching， and anal pain） measured on days 7， 28， and 60 after discharge. ResultsAfter matching， 2194 patients were included in each group. Symptom scores showed that at 28 days after discharge， the TCM surgical group had superior improvement in rectal bleeding ［OR=5.786， 95%CI （3.092，10.827）］， degree of prolapse ［OR=4.510， 95%CI （1.649，12.333）］， and anal edema ［OR=3.188， 95%CI （1.295，7.845）］ compared to the western surgical group. At 60 days post-discharge， the TCM group still showed advantages in improving rectal bleeding ［OR=5.237， 95%CI （1.077，25.464）］ and anal pain ［OR=11.697， 95%CI （1.186，115.336）］ （P＜0.05）. Long-term follow-up showed that the one-year recurrence rate in the TCM surgery group was 1.1% （8/726）， while that in the western surgery group was 2.3% （10/444）， with no statistically significant difference between the two groups （P＞0.05）. ConclusionBased on real-world data， TCM surgical treatment for mixed hemorrhoids shows significant short-term symptom improvement， particularly in terms of hemostasis， reducing swelling， and alleviating prolapse of anal masses.

Objective To explore the syndrome differentiation rules of the Yin Dan and Yang Dan method,and summarize Professor Yang Zhimin's valuable experience in the treatment of insomnia.Methods The case data of 11390 insomnia patients treated by Professor Yang Zhimin was retrospectively analyzed,and the distribution of symptoms,signs,pathogenesis and syndrome differentiation rules of insomnia patients was examined based on latent structure analysis.Result A total of 44 symptoms and signs can explain the overall situation of insomnia patients,showing the characteristics of both excess and deficiency,cold and heat.A total of 36 hidden categories(symptom clusters and pathogenesis)was composed.Symptoms and signs such as fear of wind and cold can explain the overall situation of insomnia patients with cold syndrome due to weakness of Wei Qi,symptoms and signs such as pale eyelid can explain the overall situation of insomnia patients with heat syndrome due to weakness of Ying Xve,and established diagnostic criteria for insomnia patients with cold syndrome due to weakness of Wei Qi and heat syndrome due to weakness of Ying Xve.Conclusion Based on the Yang Dan and Yin Dan method to distinguish and treat insomnia from the perspective of disharmony between Ying and Wei,it is in line with the basic understanding of the pathogenesis of insomnia in the classics of traditional Chinese medicine.The pattern differentiation rules obtained through the latent structure analysis method are helpful to summarize valuable clinical experience and provide a certain reference and basis for clinical practice.

Objective:To study the level of regulatory T cell(Treg)in peripheral blood of diffuse large B-cell lymphoma(DLBCL)patients at initial diagnosis,and its value in the evaluation of efficacy and prognosis.Methods:A total of 72 newly diagnosed DLBCL patients admitted to the Second Affiliated Hospital of Anhui Medical University from January 2018 to February 2022 were selected as research objects,and 17 healthy volunteers were taken as the control group.The level of CD4+CD25+CD127lowTreg in peripheral blood of patients was detected by flow cytometry,and a comparative analysis was conducted in conjunction with the clinical characteristics of patients.Results:The percentage of Treg in peripheral blood before treatment was correlated with Ann Arbor stage,IPI score,ECOG score and hemoglobin(HB).The levels of Treg in peripheral blood at initial diagnosis were significantly lower than that of healthy con-trols(3.85±0.22 vs 5.15±0.31,P=0.007).DLBCL patients were divided into high Treg group and low Treg group according to the me-dian percentage of CD4+CD25+CD127lowTreg in peripheral blood to CD4+T cells at initial diagnosis,the total effective rate of high Treg group was significantly higher than that of low Treg group(P=0.035).ECOG score(P=0.040)and low level of Treg before treatment(P=0.014)were independent risk factors for progression-free survival(PFS)in DLBCL patients.Having B symptom(P=0.028),ECOG score≥2(P=0.041)and low level of Treg before treatment(P=0.036)were independent risk factors for OS.PFS(P=0.020)and OS(P=0.036)in low Treg group were significantly lower than those in high Treg group.Conclusion:The low percentage of CD4+CD25+CD127lowTreg in peripheral blood of newly diagnosed DLBCL patients indicates a poor prognosis.

Objective To investigate the histological and cellular bases for the improvement of portal hypertension(PH)by observing liver histopathological changes after treatment in patients with cirrhotic portal hypertension,and to provide a basis for clinical drug development.Methods A total of 322 patients with hepatitis B cirrhosis who completed 48 weeks of antiviral therapy or combined anti-fibrotic treatment in 20 hospitals across 12 provinces in China from September 2014 to October 2018 were enrolled,and the noninvasive diagnostic criteria for clinically significant portal hypertension(CSPH)from Baveno Ⅶ were used to assess the severity of PH;43 patients with a confirmed diagnosis of CSPH were identified based on liver stiffness measurement(LSM)≥25 kPa before treatment,and according to whether the severity of PH was reduced by≥2 grades after treatment,the patients were divided into PH improvement(n=19)group and PH non-improvement group(n=24).Related data were collected,including demographic data,laboratory tests.Liver fibrosis were assessed,including HE staining and reticular fiber staining;liver microvascular lesions were assessed,including obliterative portal venopathy(OPV),nodular regenerative hyperplasia(NRH),and incomplete septal fibrosis(ISF).Single immunohistochemical staining was performed for von Willebrand factor(vWF),and fibronectin;multiplex immunohistochemical staining was performed for fibrinogen,CD32b,CD31,alpha-smooth muscle actin(α-SMA).The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups,and the chi-square test was used for comparison of categorical data between two groups.Results After 48 weeks of treatment,43 patients had significant improvements in red blood cell count,alanine aminotransferase,aspartate aminotransferase,aspartate aminotransferase-to-platelet ratio index score,liver fibrosis grade,and PH grade(all P<0.05),among whom 19 patients showed a reduction in PH severity by≥2 grades(PH improvement group),while the remaining patients were enrolled as the PH non-improvement group.There was no significant difference in the outcome of liver fibrosis between the two groups(χ2=3.380,P=0.066).Microvascular lesion assessment showed that compared with the PH non-improvement group,the PH improvement group had significantly lower OPV severity,microvascular density(the expression level of vWF),and expression of fibronectin(all P<0.05),while there were no significant differences in NRH severity,ISF severity,and the expression level of fibrinogen between the two groups(all P>0.05).Cytological evaluation showed no significant differences in the expression levels of CD32b,CD31,and α-SMA between the two groups before and after treatment(all P>0.05),and comparison of the expression levels before and after treatment showed that the PH improvement group had a significant increase in the expression level of CD32b(t=-2.007,P=0.045)and a significant reduction in the expression level of α-SMA(t=2.628,P=0.013).Conclusion The pathological features of PH improvement are associated with liver fibrosis regression and the improvement in liver microvascular lesions,and at the cellular level,PH improvement is associated with the dedifferentiation of liver sinusoidal endothelial cells and the activated phenotype of hepatic stellate cells.

Objective:To study the level of regulatory T cell(Treg)in peripheral blood of diffuse large B-cell lymphoma(DLBCL)patients at initial diagnosis,and its value in the evaluation of efficacy and prognosis.Methods:A total of 72 newly diagnosed DLBCL patients admitted to the Second Affiliated Hospital of Anhui Medical University from January 2018 to February 2022 were selected as research objects,and 17 healthy volunteers were taken as the control group.The level of CD4+CD25+CD127lowTreg in peripheral blood of patients was detected by flow cytometry,and a comparative analysis was conducted in conjunction with the clinical characteristics of patients.Results:The percentage of Treg in peripheral blood before treatment was correlated with Ann Arbor stage,IPI score,ECOG score and hemoglobin(HB).The levels of Treg in peripheral blood at initial diagnosis were significantly lower than that of healthy con-trols(3.85±0.22 vs 5.15±0.31,P=0.007).DLBCL patients were divided into high Treg group and low Treg group according to the me-dian percentage of CD4+CD25+CD127lowTreg in peripheral blood to CD4+T cells at initial diagnosis,the total effective rate of high Treg group was significantly higher than that of low Treg group(P=0.035).ECOG score(P=0.040)and low level of Treg before treatment(P=0.014)were independent risk factors for progression-free survival(PFS)in DLBCL patients.Having B symptom(P=0.028),ECOG score≥2(P=0.041)and low level of Treg before treatment(P=0.036)were independent risk factors for OS.PFS(P=0.020)and OS(P=0.036)in low Treg group were significantly lower than those in high Treg group.Conclusion:The low percentage of CD4+CD25+CD127lowTreg in peripheral blood of newly diagnosed DLBCL patients indicates a poor prognosis.

Objective To investigate the effect and mechanism of miR-155-5p targeting suppressor of cytokine signaling 1(SOCS1)in regulating the Janus kinase 2(JAK2)/signal transducer and activator of transcrip-tion 3(STAT3)signaling pathway in renal injury associated with lupus nephritis(LN).Methods Thirty female MRL-faslpr lupus model mice were randomly divided into five groups(n=6 per group):the model group,the antagomir NC group,the miR-155-5p antagomir group,the miR-155-5p antagomir+shRNA control group,and the miR-155-5p antagomir+SOCS1 shRNA group.The mice were treated with adeno-associated virus vectors carrying miR-155-5p antagomir,antagomir NC,SOCS1 shRNA,or shRNA control.Additionally,six age-matched C57BL/6 mice served as a control group and received an equivalent volume of saline.Serum blood urea nitrogen(BUN)and creatinine(Scr)levels,renal histopathological changes,and the expression levels of miR-155-5p,SOCS1,phosphorylated JAK2(p-JAK2),and phosphorylated STAT3(p-STAT3)in renal tissues were evaluated.Results Compared with the normal group,the model group exhibited significantly elevated levels of BUN,Scr,miR-155-5p,p-JAK2,and p-STAT3 proteins in the kidneys(P<0.01),while the expression level of SOCS1 was markedly reduced(P<0.01).Compared with both the model group and the antagomir NC group,the miR-155-5p antagomir group showed decreased levels of BUN,Scr,miR-155-5p,p-JAK2,and p-STAT3 proteins(P<0.01),along with a significant increase in SOCS1 expression(P<0.01).Similarly,compared with the miR-155-5p antagomir group and the miR-155-5p antagomir+shRNA control group,the miR-155-5p antagomir+SOCS1 shRNA group demon-strated significantly higher levels of BUN,Scr,miR-155-5p,p-JAK2,and p-STAT3 proteins(P<0.01),while SOCS1 expression was notably decreased(P<0.01).Renal pathology analysis revealed that,compared to the normal group,the model group exhibited glomerular atrophy,extensive infiltration of inflammatory cells in the renal tubulointerstitial region,and partial renal tubular necrosis.In contrast,the miR-155-5p antagomir group showed marked improvements in glomerular atrophy,tubular necrosis,and inflammatory cell infiltration compared with the model group and antagomir NC group.Furthermore,compared with the miR-155-5p antagomir group and the miR-155-5p antagomir+shRNA control group,the miR-155-5p antagomir+SOCS1 shRNA group exhibited more severe glomerular atrophy,tubular necrosis,and inflammatory cell infiltration.Conclusion MiR-155-5p exacerbates renal damage in MRL-faslpr lupus model mice by targeting SOCS1,potentially through the activation of the JAK2/STAT3 signaling pathway.

Objective To investigate the mechanism of mitochondrial autophagy regulating the expression of NLRP3 inflammasome in prostate tissue in experimental autoimmune prostatitis(EAP)rats and to provide a theoretical basis for the study of new drug development.Methods A numerical table of 40 SD male rats was randomly divided into 8 groups.Namely,normal group(N),model group(M),rapamycin group(RAP),rapamycin+mitochondrial autophagy inhibitor group(RAP+Mdivi-1),autophagy inhibitor group(3MA),mitochondrial autophagy inhibitor group(Mdivi-1),Caspase1 inhibitor group(Caspase1),NLRP3 inhibitor group(NLRP3),5 animals per group.After drug intervention,HE staining,immunofluorescence,colorimetry,and WB method were used to observe the relevant indexes.Results Compared with group N,the structural damage of prostate gland was obvious in group M.Compared with the M group,the prostate gland structure in RAP group,Caspase-1 group and NLRP3 group were improved.However,that in 3-MA group and Mdivi-1 group was not improved,and even destroyed more obvi-ously.Compared with group N,the co-expression of LC3-II and LAMP-1 was enhanced,mitochondrial membrane potential was decreased,ROS release level was significantly increased in prostate tissue of rats in group M.Com-pared with the M group,the above indexes in RAP group and NLRP3 group were significantly improved.However,the above indexes in 3-MA group and Mdivi-1 group became worse.Compared with group N,the protein expressions of DRP1,PINK1 and Parkin in prostate mitochondria of rats in group M were increased,and the protein expres-sions of OPA1 was decreased.Compared with group M,the protein expressions of DRP1,PINK1 and Parkin in RAP group and NLRP3 group were significantly increased,while those in 3-MA group and Mdivi-1 group were sig-nificantly decreased.OPA1 protein expression was significantly decreased in the RAP group.The protein expression of Parkin in Caspase-1 group was decreased,but the protein expression of DRP1,OPA1 and PINK1 had no significant difference.Compared with group N,the protein expressions of LC3II/LC3I,Beclin1,NLRP3,ASC,Cleaced-Caspase1,Cleaced-IL-1β,and IL-18 in prostate tissue of rats in group M were increased,while the protein expres-sions of P62 was decreased.Compared with M group,LC3II/LC3I and Beclin1 protein expressions in RAP group and NLRP3 group were significantly increased,while those in 3-MA group and Mdivi-1 group were significantly decreased.Compared with M group,P62,NLRP3,ASC,Cleaced-Caspase1,Cleaced-IL-1β and IL-18 protein expressions in RAP group and NLRP3 group were significantly decreased,while those in 3-MA group and Mdivi-1 group were significantly increased.Compared with M group,the protein expressions of NLRP3,ASC,Cleaced-Caspase1,Cleaced-IL-1β,and IL-18 in Caspase-1 group were significantly reduced,but the protein expressions of LC3Ⅱ/LC3Ⅰ,Beclin1,and P62 were not statistically significant.Conclusions NLRP3 inflammatosome is involved in the progression of chronic prostatitis in EAP rats.Mitochondrial autophagy mediates the occurrence and development of prostatitis in EAP by regulating the activation of NLRP3 inflammasome in prostate tissue.

Objective To explore the risk factors associated with the occurrence of dampness syndrome based on peripheral blood multiple laboratory indicators,construct predictive model and validate it.Methods A retrospective analysis was conducted on 180 patients who visited the Preventive Treatment Center of Guangdong Provincial Hospital of Chinese Medicine from May 2022 to December 2023.They were divided into two groups according to the diagnostic criteria:the damp syndrome of TCM group(n=118)and the balanced yin-yang constitution group(n=62),with the latter serving as the"non-syndrome"control group for dampness syndrome.Serum biochemical indicators were detected by electrochemiluminescence(ECL),immune cell subsets were analyzed through flow cytometer,and routine blood parameters were assessed using an automatic hematology analyzed.Logistic regression analysis was employed to screen risk factors and develop a predictive model.The Bootstrap method was used for data resampling to draw the receiver operating characteristic(ROC)curve,calibration curve,and clinical decision curve analysis(DCA)to evaluate the predictive value,consistency,and clinical efficacy of the model.Results Compared with the balanced yin-yang constitution group,the damp syndrome of TCM group showed increased levels of insulin(INS),non-high-density lipoprotein cholesterol(non HDL-C),red blood cells(RBC)and the proportion of CD4+T cells,the proportion of triglyceride(TG)>1.70 mmol/L,total cholesterol(TC)>5.20 mmol/L,low-density lipoprotein cholesterol(LDL-C)>3.37 mmol/L,and high-density lipoprotein cholesterol(HDL-C)≤1.15 mmol/L were also significantly higher,with statistical significance(U/t/χ2=-2.900～4 626,all P＜0.05).Logistic regression analysis showed that INS,TC>5.20 mmol/L,HDL-C≤1.15 mmol/L,and the proportion of CD4+T cells were independent risk factors for the occurrence of damp syndrome of TCM(all P＜0.05).Based on the screened risk factors,a forecasting model was established and a nomogram was plotted.The model had an area under the ROC curve area under curve(AUC)of 0.747(95%CI=0.672～0.822),a Brier score of 0.184 for the calibration curve,and demonstrated clinical net benefit at threshold probabilities ranging from 0.30 to 1.00.Conclusion The forecasting model constructed based on INS,TC>5.20 mmol/L,HDL-C≤1.15 mmol/L,and CD4+T cells ratio has a high predictive value for damp syndrome of TCM.

Objective:To investigate the feasibility and clinical efficacy of side-to-side anastomosis of superficial temporal artery (STA) and middle cerebral artery (MCA) bypass using in-situ intravascular suture technique.Methods:A retrospective analysis was conducted on the clinical data of 10 adult patients who were treated with side-to-side microvascular anastomosis of STA-MCA bypass to improve intracranial blood supply, between February 2024 and September 2024 in the Department of Neurosurgery of the Fourth Affiliated Hospital of Soochow University. Among the patients, 2 were of symptomatic MCA occlusion and 8 of Moyamoya disease. Diameter of STA and MCA, length of anastomosis and blocking time of MCA were recorded. Indocyanine green video angiography (ICG-VA) was performed to evaluate the immediate patency of the STA-MCA side-to-side anastomosis. Digital subtracted angiography (DSA) was performed at 1 week after the surgery to evaluate the patency of the STA-MCA bypass anastomosis, then follow-up DSA was performed at 1, 3 and 6 months after surgery to further evaluate the postoperative anastomotic patency. Neurological function was evaluated regularly with the modified Rankin Scale (mRS).Results:All of the 10 side-to-side STA-MCA bypass anastomoses were successfully performed using in-situ intravascular suture technique. The scalps of all patients healed well. The diameters of STA and MCA were 1.4-2.0 (1.76±0.27) mm and 0.8-1.4 (0.98±0.20) mm, respectively. The average length of the anastomoses was 3.5-5.0 (4.45±0.60) mm. The blocking time of MCA was 12.0-29.0 (21.50±6.62) min. A 100% vessel patency rate was achieved immediately after vessel anastomosis and at 1 month after surgery. DSA examinations were performed at 3 months after surgery on 6 patients and at 6 months after surgery on 1 patient, and all the anastomoses were found in full patency. All patients were included in the postoperative follow-up that lasted for 3 to 7 months. All patients recovered well without new neurological dysfunction. The mRS of 8 patients remained at 0 point before and after surgery. Two patients had improved postoperative mRS of 1 point from that of 2 points before surgery.Conclusion:STA-MCA side-to-side microvascular bypass anastomosis can be performed safely and efficiently using in-situ intravascular suture technique. It could efficiently reduce the incidence of perioperative complications. Meanwhile, it can self-regulate the blood flow and maximise the potential capability of STA.

Objective To investigate the clinical efficacy of the"dynamic and static combination"approach in the treatment of Hepple Ⅰ-Ⅲ type osteochondral lesions of the talus(OLT),utilizing external ankle shaking,pulling,and poking manipulations in conjunction with ankle brace fixation.Methods A total of 82 patients diagnosed with OLT,who sought treatment at four hospitals between June 2022 and December 2023,were included in the study.Both the experimental and control groups received ankle immobilization using braces through-out the treatment period.The control group was administered Voltaren Emulgel topically twice daily(morning and evening),with each treatment course lasting 30 days,for a total of one course.The experimental group received additional therapeutic intervention involving shaking,pulling,and poking manipulations,conducted twice weekly,with the same duration and number of treatment courses as the control group.Follow-up assessments were scheduled at 2 weeks,4 weeks,and 2 months post-treatment.Outcome measures included the pain rating index(PRI),visual analogue scale(VAS)for pain intensity,current pain intensity(PPI),American Orthopaedic Foot & Ankle Society(AOFAS)ankle and hindfoot scores,proprioceptive function,and the size of OLT.Results During the longitudinal assessment conducted at 2-week,4-week,and follow-up intervals,the experimental group exhibited superior clinical outcomes compared to the control group,with statistically significant decreases in PRI,PPI,and AOFAS scores(all P＜0.05).VAS scores showed progressive improvement over time,with significant intergroup differences observed at both the 4-week and follow-up assessments(P＜0.05).Biomechanical analysis performed post-intervention indicated improved kinematic repositioning accuracy in the experimental group,as reflected by significantly reduced active-passive error angles(P＜0.05).Importantly,measurements of OLT area revealed notable therapeutic effects in the experimental group(P＜0.05),whereas no statistically significant changes were observed in the control group throughout the study period(all P＞0.05).Conclusions Under the guidance of the"dynamic and static combination"concept,the integration of shaking,pulling,and poking manipu-lation with conventional Western medicine-based conservative treatment for OLT demonstrates more pronounced advantages in alleviating pain,improving ankle joint function,restoring proprioception,facilitating lesion recovery,and enhancing overall quality of life.