Rheumatoid arthritis （RA） is a chronic systemic autoimmune disease characterized by symmetrical polyarthritis， which may lead to joint deformity and loss of joint function in the long term， severely impairing patients' quality of life. Danggui Niantongtang， originated from Medical Revelations by Zhang Yuansu in the Jin Dynasty， has the effects of clearing heat and draining dampness， dispelling wind and alleviating pain， and serves as a classic formula for treating RA damp-heat stagnation syndrome. By searching CNKI， Wanfang， PubMed and other databases， the author systematically reviewed the clinical efficacy and experimental research of Danggui Niantongtang in the treatment of RA， and elucidated its mechanisms of action， so as to provide a valuable reference for future clinical and basic research of Danggui Niantongtang in the field of RA. Clinical studies demonstrated that Danggui Niantongtang can improve core symptoms in RA patients with the damp-heat stagnation syndrome， including joint swelling and pain， morning stiffness and limited joint mobility， decrease inflammatory markers such as C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR）， and facilitate postoperative rehabilitation in RA patients undergoing total knee arthroplasty （TKA）. When combined with Western medicines such as methotrexate， it can enhance the anti-inflammatory efficacy and mitigate adverse reactions， including gastrointestinal discomfort and hepatic injury. Experimental studies revealed that this formula can modulate the inflammatory cytokine network， promote synoviocyte apoptosis， inhibit abnormal synoviocyte autophagy， suppress synovial angiogenesis， and maintain intestinal flora homeostasis. However， several limitations exist in current research， such as insufficient clinical quality， unclear interaction between mechanisms and networks， and insufficient research on dosage form optimization. In the future， high-quality clinical research， multi-omics mechanistic studies， and dosage form improvement are needed to provide scientific basis for its clinical promotion and in-depth research.

Objective: To explore the relationship between socio ecological risk factors (SERF), physical activity (PA) developmental trajectories, and depressive symptoms among junior and senior high school students in Tianjin, in order to provide theoretical support for comprehensive interventions for adolescent depression. Methods: A longitudinal follow up design was adopted. In September 2022, a baseline survey was conducted using a stratified cluster random sampling method in two junior high schools and two senior high schools in Tianjin, collecting data on students basic information, SERF, PA, and depressive symptoms. Two follow up surveys were conducted in September 2023 and 2024, yielding 588 valid participants. Latent class growth analysis (LCGA) was used to identify PA developmental trajectory categories among junior and senior high school students. Logistic regression was applied to examine the associations between depressive symptoms and SERF as well as PA trajectories. Results: The detection rates of depressive symptoms among Tianjin junior and senior high school students over the three years were 26.53%, 20.24%, and 21.26 %, respectively. Depressive symptoms were positively correlated with SERF ( OR=1.04, 95%CI=1.03-1.05, P <0.05). The highest risks were observed in the individual dimension and family dimension ( OR =1.28, 1.21, both P <0.05). LCGA identified three PA trajectory groups:persistently low level (80.65%), persistently high level (4.58%), and slowly increasing group ( 14.77 %). Multivariate regression analysis showed that compared with the persistently low level PA, the slowly increasing PA significantly reduced the risk of depressive symptoms ( OR=0.44, 95%CI =0.20-0.88), while SERF still increased the risk of depressive symptoms ( OR=1.04, 95%CI =1.03-1.05) (both P <0.05). Conclusion SERF are risk factors for depression symptoms among junior and senior high school students, whereas slowly increasing PA development trajectory demonstrates a protective effect.

ObjectiveTo evaluate the effects of modified Baohe Pill （保和丸） formula added to conventional pulmonary rehabilitation on thoracic drainage volume， chest tube duration， and peripheral blood inflammatory indices after video-assisted thoracoscopic surgery （VATS） for lung cancer. MethodsIn this randomized parallel-controlled study， 118 post-VATS patients were enrolled， with 59 cases in each group. The control group received conventional pulmonary rehabilitation， while the treatment group additionally received an oral decoction of modified Baohe Pill formula until chest tube removal and discharge. The primary outcome was total postoperative thoracic drainage volume， while the secondary outcomes included chest tube duration and inflammatory indices including the pre-treatment and post-treatment levels and relative changes in platelet-to-lymphocyte ratio （PLR）， neutrophil-to-lymphocyte ratio （NLR）， lymphocyte-to-monocyte ratio （LMR）， systemic immune-inflammation index （SII）， aggregate index of systemic inflammation （AISI）， and systemic inflammation response index （SIRI）. Adverse events during the treatment period were recorded. ResultsThe total postoperative thoracic drainage volume was 850 （430， 1410） ml in the treatment group， lower than 1085 （660， 1720） ml in the control group （P＜0.05）. Total postoperative chest tube duration was 8 （6， 11） days in the treatment group， shorter than 10 （7， 11） days in the control group （P＜0.05）， whereas the interval from enrollment to removal did not differ significantly between groups （P＞0.05）. The postoperative NLR in the treatment group was lower than that in the control group， and the relative change in NLR was greater than that in the control group （P＜0.05）. No significant between-group differences were found in post-treatment levels or relative changes of the other five inflammatory indices （P＞0.05）. No treatment-related serious adverse events were reported in either group. ConclusionModified Baohe Pill formula plus conventional pulmonary rehabilitation has lower total postoperative thoracic drainage volume， shorter total postoperative chest tube duration， and lower NLR levels in lung cancer patients following VATS， while demonstrating a more favorable safety profile than conventional pulmonary rehabilitation alone.

Objective To investigate the current status of sleep quality,depression,anxiety and stress of special service convalescents and their correlation.Methods A questionnaire survey was conducted on 311 special service convalescents by the Pittsburgh sleep quality index(PSQI)and the depression-anxiety-stress self-rating scale-21(DASS-21)from May to July 2022.Results The mean total PSQI score of 311 special service convalescents was 4.93±3.14,and 63 of them(20.26%)had sleep quality problems(total score of PSQI>7).The proportions of respondents with the scores≥2 in sleep time,daytime dysfunction,subjective sleep quality,and fall-asleep time were 30.87%,26.05%,21.22%,and 20.26%,respectively.The proportions of respondents with mild depression,anxiety and stress were 6.11%,4.50%and 2.57%,respectively,which were higher than the other three grades(moderate,severe and very serious).The incidence of sleep quality problems,depression,anxiety,and stress in respondents aged 40 years and above was higher than those in the other age groups,and there was a tendency to increase with age.The total score of PSQI and all factors(except hypnotic drugs)were positively correlated with depression,anxiety,and stress in special service convalescents(all P<0.01).Regression analysis showed that depression and stress were the direct influencing factors of sleep quality.Conclusion The special service convalescents have varying degrees of sleep quality problems and negative emotions such as depression,anxiety,and stress,especially those aged 40 years and above.Sleep quality is closely related to depression,anxiety,and stress.

AIM: To explore the diagnostic value of combining the corneal stress-strain index(SSI)with corneal biomechanical parameters for early keratoconus.METHODS:A retrospective study was conducted on 34 patients(53 eyes)with early keratoconus diagnosed and treated in our hospital from March 2022 to February 2024. Additionally, 112 normal volunteers(112 eyes)who underwent physical examinations in our hospital during the same period were selected as a healthy control group. The CorvisST equipment was utilized for measurement and recorded deformation with Scheimpflug camera to obtain 10 biomechanical parameters: first applanation time(A1T), first applanation length(A1L), velocity of initial applanation(Vin), second applanation time(A2T), second applanation length(A2L), velocity of outward applanation(Vout), highest concavity time(HCT), highest concavity depth of applanation(HCDA), highest concavity radius(HCR), and peak distance(PD), as well as stress-strain index(SSI), and the corneal biomechanical parameters of the two groups were compared. Furthermore, Logistic regression analysis was used to identify the risk factors for keratoconus, and ROC curves were plotted to analyze the biomechanical parameters of the cornea for early diagnosis of keratoconus.RESULTS:The SSI(0.77±0.17)in patients with keratoconus was lower than that in healthy controls(1.01±0.24; P<0.001). Patients with keratoconus had lower A1T, A1L, A2L, and HCR, and higher Vout, HCDA, and PD compared to healthy controls(all P<0.001). Logistic regression analysis showed that decreased SSI, A1T, A1L, A2L, and HCR, as well as increased Vout, HCDA, and PD, were risk factors for the development of keratoconus(P<0.001). ROC curve analysis showed that the AUC value for combined diagnosis of early keratoconus was 0.997, with a Youden's index of 0.954, sensitivity and specificity of 98.1% and 97.3%, respectively, and a 95% CI of 0.994-1.000.CONCLUSION:The combination of SSI and corneal biomechanical parameters holds diagnostic significance for early keratoconus, and the joint diagnostic value is even higher. It can be considered as a diagnostic or screening indicator for early keratoconus.

Objective: To establish a progressive research strategy for “colonic components analysis - efficacy verification and mechanism exploration - gut microbiota”, screen pharmacodynamic substances, and investigate their mechanism via gut microbiota. Methods: The pharmacodynamics of Gegen Qinlian decoction (GQD) were assessed using a mouse model of dextran sulfate sodium-induced ulcerative colitis (UC). Ultra-performance liquid chromatography-quadrupole-orbitrap mass spectrometer was used to identify the prototype and metabolic components of GQD in the colon during UC. To analyze the structure and function of characteristic genera of GQD and its active components, 16S rRNA sequencing was performed. Results: We identified 67 prototypic and 14 metabolic components of GQD in the UC colon. The primary prototype components are flavonoids and alkaloids, including puerarin (PUE), baicalin (BAI), and berberine (BER). The metabolism was predominantly sulfonation. Efficacy verification showed that the main active components, puerarin, baicalin, and berberine, had good therapeutic effects on UC. The results of 16S rRNA gene sequencing showed that GQD improved UC by regulating the structure and function of the gut microbiota. The abundance of gut microbiota involved in the metabolism of the prototype components was influenced by the corresponding components. The function prediction results showed that PUE was the most comparable to GQD, with 24 consistent pathways. BAI and BER showed comparable gut microbiota regulation pathways. Characteristic pathways of BER include glucometabolic processes. Conclusion This study focused on the key issues in the gut microbiota pathway and developed a progressive research strategy to understand the transformation mechanisms of colonic components. This research systematically analyzed the active components and metabolic transformation of GQD in the colon during the pathological state of UC, as well as changes in the structure and function of the gut microbiota, clarified the mechanism of GQD and its active components in improving UC via the gut microbiota pathway.

Objective: We employed Mendelian randomization (MR) to test the traditional Chinese medicine (TCM) theory of emotional pathogenesis concept and explore the causal relationship between negative emotions and chronic obstructive pulmonary disease (COPD). Methods: Data of negative emotions, bronchitis, emphysema, and C-reactive protein (CRP) levels were downloaded from genome-wide association study (GWAS) public database for a two-sample MR analysis. Independent single-nucleotide polymorphisms (SNPs) associated with negative emotions, bronchitis, and emphysema were selected as instrumental variables. Primary causal estimates were derived using inverse-variance weighting (IVW), supplemented by weighted median (WM), and simple mode (SM) methods. Sensitivity analyses included MR-Egger regression and MR-PRESSO to assess pleiotropy, Cochran’s Q test for heterogeneity, and multivariate MR to adjust for smoking. Mediation analysis evaluated the role of inflammatory markers. Reverse MR was tested for bidirectional causality. Weak instrument bias was mitigated via F-statistic thresholds (> 10). All analyses were conducted in RStudio. Results: MR analysis identified significant causal effects of several negative emotions on COPD. Genetically, the IVW analysis of seen doctors for nerves anxiety tension or depression [ORIVW = 1.006, 95% CI = (1.002, 1.010), P = 0.002], sensitivity/hurt feelings [ORIVW = 1.024, 95% CI = (1.004, 1.044), P = 0.017], and irritability [ORIVW = 1.019, 95% CI = (1.003, 1.035), P = 0.019 were robustly associated with increased risks of COPD. No heterogeneity was detected among the different instrumental variables (IVs) for depression (P = 0.655) and irritability (P = 0.163). MR-Egger regression intercepts for all emotional exposures were close to zero and statistically non-significant, indicating no evidence of directional pleiotropy. The horizontal pleiotropy results showed that except for worry (MR-PRESSO P = 0.006), other emotion exposures confirming no substantial pleiotropic bias. Multivariable MR demonstrated that anxiety remained independently associated with COPD after adjusting for smoking (P = 0.002), while associations with other negative emotions were attenuated post-adjustment. The mediation analysis revealed that CRP mediated 3.93% of the total effect of anxiety on COPD. However, reverse MR analysis found no evidence of reverse causality. Conclusion This study confirmed the causal effects of negative emotions on COPD through MR analysis and revealed that negative emotions may trigger CRP production, which plays an essential mediating role in this relationship. This study provides a reliable modern theoretical basis for emotion theory in TCM.

Objective:To understand the occurrence of different patterns of multimorbidity among children and adolescents aged 9-18 in Tianjin City and analyze the cumulative effects of lifestyle on these patterns of multimorbidity.Methods:From September to November 2022, a stratified cluster random sampling method was used to select students from primary schools, junior high schools, general high schools, and vocational schools in 16 districts of Tianjin to screen for height, weight, blood pressure, distant vision, and diopter. One year later, a follow-up measurement and questionnaire survey were conducted. The log-binomial model was used to analyze the strength of the association between lifestyle factors and different patterns of multimorbidity.Results:The age of 9 488 students was (12.37±2.49) years old, including 4 999 boys and 4 489 girls. The detection rates of three patterns of multimorbidity of overweight obesity and high blood pressure, overweight obesity and myopia, and overweight obesity with high blood pressure and myopia were 6.63%, 9.32%, and 4.21%, respectively. The detection rates of the three types of multimorbidity in boys were higher than those in girls (all P<0.001). The detection rate of overweight obesity and high blood pressure in suburban areas was higher than that in urban areas ( P=0.002). The detection rate of overweight obesity and myopia in suburban areas was lower than that in urban areas ( P=0.034). The detection rate of overweight obesity and myopia among those aged 9-12 years old was higher than other age groups (all P<0.001). The ARR (95% CI) for the association between favorable physical activity and the occurrence of overweight obesity and high blood pressure was 0.79 (0.68-0.92). The ARR (95% CI) for the association between favorable physical activity and the occurrence of overweight obesity with high blood pressure and myopia was 0.82 (0.67-0.99). Compared with children and adolescents with 0-2 favorable lifestyle factors, those with 4-5 favorable lifestyle factors had a lower risk of overweight obesity and high blood pressure ( ARR=0.84, 95% CI: 0.59-0.92). Conclusion:Boys aged 9-18 in Tianjin City are more prone to multimorbidity of overweight obesity and high blood pressure, overweight obesity and myopia, and overweight obesity with high blood pressure and myopia. Children and adolescents with 4-5 favorable lifestyle factors have a reduced risk of occurrence of overweight obesity and high blood pressure. Lifestyle has cumulative effects on multimorbidity of overweight obesity and high blood pressure.

Objective To investigate the relationship between the expression of serum long non coding RNA nuclear-enriched abundant transcript 1(lncRNA NEAT1)and microRNA-106a-5p(miR-106a-5p)and the severity and prognosis of sepsis patients.Methods A total of 185 patients with sepsis who were diagnosed and treated in this hospital from August 2021 to July 2024 were selected as the study group,and another 215 healthy volunteers who underwent physical examinations in this hospital during the same period were selected as the control group.The research group was divided into the mild group(n=92),the severe group(n=58)and the shock group(n=35)according to the severity of the disease.The research group was divided into the good prognosis group(n=121)and the poor prognosis group(n=64)according to the prognosis.The expres-sions of lncRNA NEAT1 and miR-106a-5p were detected by real-time fluorescence quantitative polymerase chain reaction,and the correlation of the expressions of lncRNA NEAT1 and miR-106a-5p in the study group was analyzed by Pearson correlation analysis.The binding sites of lncRNA NEAT1 and miR-106a-5p were an-alyzed by StarBase,and the influencing factors of poor prognosis in patients were analyzed by multivariate Lo-gistic regression.The receiver operating characteristic curve was used to analyze the diagnostic value of the combination of lncRNA NEAT1 and miR-106a-5p for poor prognosis in patients.Results The expression of lncRNA NEAT1 in the study group was higher than that in the control group,and the expression of miR-106a-5p was lower than that in the control group,the difference was statistically significant(P＜0.05).The expressions of lncRNA NEAT1 and miR-106a-5p in the study group were negatively correlated(r=-0.413,P＜0.001),and there were binding sites between the two.With the increase of the severity of sepsis,the ex-pression of lncRNA NEAT1 increased and the expression of miR-106a-5p decreased,and the difference was statistically significant(P＜0.05).The acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,sequential organ failure assessment(SOFA)score,tumor necrosis factor-α,C-reactive protein,and ln-cRNA NEAT1 in the poor prognosis group were higher than those in the good prognosis group,while the ex-pression of miR-106a-5p was lower than that in the good prognosis group,the difference was statistically sig-nificant(P＜0.05).Elevated APACHE Ⅱ score,SOFA score and lncRNA NEAT1 were independent risk fac-tors for poor prognosis in patients,and miR-106a-5p was an independent protective factor(P＜0.05).The ar-ea under the curve of the combined diagnosis of the two was 0.918(95％CI:0.868-0.953),which was supe-rior to the separate diagnosis of each(Zcombined with lncRNA NEAT1=4.112,Zcombined with miR-106a-5p=4.023,P＜0.05).Con-clusion With the increase of disease severity in patients with sepsis,the expression of lncRNA NEAT1 in-creases and the expression of miR-106a-5p decreases.The combined diagnosis of the two for poor prognosis in patients has a high clinical value.

At present, there is no effective drug treatment for obstructive sleep apnea hypopnea syndrome (OSAHS). It is usually treated by mechanical ventilation through a ventilator. In this paper, a non-invasive bi-level breathing therapy system suitable for home scenarios is developed. The system supports single-level and bi-level positive airway pressure therapies, and introduces the function of inspiratory synchronous trigger based on flow monitoring to enhance the synchrony of patient-ventilator synchronization. The test results show that the performance indicators of the system meet expectations. Each ventilation mode can operate normally and can meet the requirements for the use of home non-invasive ventilators.
Humans ; Sleep Apnea, Obstructive/therapy* ; Equipment Design ; Noninvasive Ventilation/instrumentation* ; Respiration, Artificial