Diabetic kidney disease （DKD）， one of the leading causes of end-stage renal disease， shows increasing prevalence and mortality， seriously affecting the physical and mental health of patients. As a crucial link in the occurrence and development of DKD， pyroptosis can lead to kidney cell injury and inflammation through the abnormal activation of reactive oxygen species （ROS）/thioredoxin-interacting protein （TXNIP）/NOD-like receptor protein 3 （NLRP3）， Toll-like receptor 4 （TLR4）/nuclear factor-κB （NF-κB）/NLRP3， nuclear factor erythroid 2-related factor 2 （Nrf2）/heme oxygenase-1 （HO-1）， mitogen-activated protein kinase （MAPK）/NLRP3， and hypoxia-inducible factor-1α （HIF-1α）/NLRP3 signaling pathways， which accelerate the progression of DKD. In recent years， traditional Chinese medicine （TCM） has demonstrated definite efficacy in the treatment of DKD via multiple targets and pathways. Studies have shown that various TCM active components， including glycosides， flavonoids， polyphenols， terpenoids， and alkaloids， as well as TCM compound prescriptions for clearing heat and detoxifying， tonifying deficiency and consolidating root， and eliminating stasis and descending turbidity， can target relevant signaling pathways to inhibit pyroptosis and intervene in the development of DKD， providing new possibilities for precision treatment of DKD. This article systematically reviews the relevant pathways of pyroptosis and summarizes the research achievements and mechanisms of TCM active components and compound prescriptions in the treatment of DKD via pyroptosis in recent years. This review aims to provide new directions and ideas for the treatment and research of DKD with TCM and promote the modernization and development of TCM.

Objective To analyse the clinical efficiency of endolymphatic sac surgery (ESS) in the management of Meniere’s disease (MD). Methods A retrospective analysis was conducted on 274 patients with MD who were hospitalized for treatment in Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University from January 2009 to August 2023. All patients received lifestyle management and drug treatment such as diuretics. For those whose conditions were not well controlled 3 to 6 months after the initial treatment, intratympanic glucocorticoid (ITG) or ESS treatment was carried out. Six months after the treatment, the classes of vertigo relief and hearing changes in the patients were evaluated. After adjusting the confounding factors through propensity score matching (PSM), the impact of ESS on the prognosis of MD patients was evaluated. Results Among 274 patients, 194 and 80 patients underwent ITG and ESS, respectively. Eighty patients were enrolled into each group after PSM. Before and after PSM, the rate of patients reaching vertigo relief class A in ESS group was higher than that in the ITG group (P＝0.004); there was no significant difference in hearing preservation between the two groups. Kaplan-Meier curve analysis showed that vertigo relief in the ESS group was better than that in the ITG group (P=0.029); there was no statistically significant difference in hearing preservation between the two groups. Conclusion When the initial treatment for patients with MD is ineffective, choosing ESS is more beneficial than ITG for controlling vertigo.

Objective To explore the relationship between serum miRNA-21 and miR-27b levels and prognosis of patients with renal clear cell carcinoma.Methods A total of 118 patients with renal clear cell carcinoma admitted to the Qinghai University Hospital from February 2019 to April 2021 were selected as the study subjects,and another 118 healthy patients in the same period as the control group.Real time fluorescence quantitative polymerase chain reaction(PCR)was used to detect the expression of miR-21 and miR-27b in the serum of all subjects.The relative expression levels of serum miR-21 and miR-27b between the patients with renal clear cell carcinoma and healthy control patients were compared.The expression and correlation of serum miR-21 and miR-27b in the patients with renal clear cell carcinoma of different pathological stages and Fuhrman grading were analyzed.The relationship between the expression of serum miR-21 and miR-27b and the survival and prognosis of the patients was explored as well.Results The expression levels of serum miR-21 and miR-27b in the patients with renal clear cell carcinoma were higher than those in the healthy control group(P＜0.05).The serum miR-21 expression level in stage Ⅲ patients was higher than in stageⅠ(P＜0.05),while the serum miR-21 expression level in the stage Ⅳ patients was higher than that in stagesⅠ,Ⅱ,and Ⅲ(P＜0.05).The expression level of miR-27b in the serum of patients gradually increased across the four stages,with a significant difference(P＜0.05).The pathological staging was positively correlated with the expression of miR-21 and miR-27b(P＜0.001).The expression levels of miR-21 and miR-27b in serum of patients gradually increased across grades Ⅰ,Ⅱ and Ⅲ by Fuhrman grading,with significant difference(P＜0.05).Fuhrman grading was positively correlated with the serum miR-21 and miR-27b expression(P＜0.001).There was a statistically significant difference in the survival curve between the miR-21 high expression group and the low expression group(P＜0.05).There was a statistically significant difference in the survival curve between the high expression group and the low expression group of miR-27b(P＜0.05).Conclusion The expression levels of serum miR-21 and miR-27b in patients with renal clear cell carcinoma is indicative of the progression and prognosis of the patient's condition.

Taking into consideration the characteristics and current development status of air medical rescue,an analysis is conducted from the perspective of hospitals to examine the focal points and challenges in establishing the capability of hospital air medical rescue.A capability framework comprising five modules,namely planning system,service model,professional teams,hardware platform,and operational procedures,is proposed.The key tasks for each module are sorted out.Furthermore,the ex-ploration and practical experience of The First Affiliated Hospital of Sun Yat-sen University are shared,with the aim of providing a reference for the construction of hospital air medical rescue capabilities in the modern era.

OBJECTIVE To evaluate the palatability and chewability of chewable tablets， and provide reference for the quality evaluation of various types of chewable tablets. METHODS Using self-made Glucosamine hydrochloride chewable tablets as the model drug， the quality test was conducted. The in vitro simulation system for chewable tablets was established by using a texture analyzer and rheometer， and an oral simulation experiment was conducted on chewable tablets. The texture analyzer was used to measure the force required for chewing and simulate the static disintegration process of chewable tablets； the rheometer was adopted to measure the viscoelasticity， thixotropy， and deformability of chewable tablets during the chewing process. RESULTS The disintegration time limit， principal component content， and dissolution of self-made Glucosamine hydrochloride chewable tablets all met the limit requirements. The in vitro simulation results of the texture analyzer showed that self-made chewable tablets were easy to chew in both axial and radial directions， and the force required for chewing was within the range of the chewing force of the teeth； chewable tablets could disintegrate at an appropriate time without being chewed and only taken in the oral cavity. The in vitro simulation results of the rheometer showed that the chewable tablets in the oral cavity exhibited a behavior of elasticity as the main factor and viscosity as the secondary factor through the continuous stirring of the tongue， and the viscosity of the chewable tablets gradually decreased with tongue stirring or tooth chewing； when chewing with teeth， the internal force of the chewing tablets decreased， causing plastic deformation and crushing. After being crushed， the shape couldn’t be restored， making it easy to chew and swallow. CONCLUSIONS The combination of texture analyzer and rheometer can be used to simulate the oral chewing process and evaluate the palatability and chewability of self-made Glucosamine hydrochloride chewable tablets. This model can provide reference for the evaluation of various chewable tablets.

Objective To investigate the possible mechanism of action of Jinqi Qingshu granules(JQQSG)in the treatment of community-acquired pneumonia(CAP)by network pharmacology and molecular docking technology.Methods The TCMSP database and SwissTargetPrediction database were used to obtain and screen the active ingredients and targets of JQQSG,and GeneCards,OMIM,TTD,and DisGeNET databases were used to search for the predicted targets of CAP,and the two targets were mapped and then imported into STRING database to construct a PPI network to screen the key targets,and then the GO and KEGG pathway enrichment were analyzed by the DAVID database,and molecular docking was carried out by the AutoDock Tools software.Results 209 active ingredients and 1 041 targets of JQQSG were obtained after screening;312 targets were co-activated with CAP,and 64 core targets were obtained after PPI network screening.571 biological processes,68 cellular components,and 199 molecular functions were analyzed by GO enrichment,and 165 KEGG pathways were analyzed by KEGG pathway enrichment,mainly involved in protein action,apoptosis and MAPK signaling pathway.Molecular docking suggests that the core target and the core components all have good binding ability.Conclusion The mechanism of action of JQQSG in the treatment of CAP may be related to its regulation of Akt,MAPK signaling pathway,improvement of oxidative stress,and other pathways to exert anti-inflammatory and antioxidant effects,which could lay the foundation for further in-depth study of its specific mechanism of action.

Objective To observe the influence of functional ankle instability(FAI)on balance and lower limb explosive power. Methods A total of 26 male FAI participants,13 bilateral(bilateral group)and 13 left(left group),who regularly en-gaged in high-intensity exercise,were recruited at Harbin Sport University in May,2024.Meanwhile,13 unin-jured male participants who engaged in high-intensity exercise were recruited as control group.They were mea-sured the moving area of the left foot,right foot and body center of gravity standing on feet with the eyes opened and closed;as well as the sway angle,confidence ellipse diameter(maximum and minimum)to circle area ratio,sway ratio and confidence ellipse standing on single foot,with Gaitview plantar pressure analysis system.They were also tested with Y-balance test(YBT),and were measured flight time and center of gravity height during jumps single leg left/right drift,stiffness and counter movement jump using Opto-jump Optical Measurement of Motor Quality. Results There were significant differences among the groups in swing angle,confidence ellipse diameter(maximum and minimum)to circle area ratio,swing ratio and confidence ellipse as left-leg stance with eyes closed(F>3.300,P<0.05),which was the least in the control group(P<0.05).Swing angle,swing ratio and confidence ellipse were also different among the groups as right-leg stance with eyes closed(F>4.404,P<0.05),and they were less in the control group than in the bilateral group(P<0.05),and less in the left group than in the bilateral group(P<0.05),except swing angle.There was a significant difference in YBT results(F>3.649,P<0.05),which was the least in the bilateral group(P<0.05).There were significant differences in the flight time and center of gravity height during counter movement jump(F>7.458,P<0.01),which was the least in the bilateral group(P<0.05). Conclusion FAI may impair the static balance as single-leg stance with eyes closed,dynamic balance and lower limb ex-plosive power.

Objective:To investigate the clinical application value of commonly used preoperative indicators of sarcopenia in predicting postoperative pneumonia in patients aged 70 years and above with esophageal cancer.Methods:A retrospective analysis was conducted on the clinical data of 398 elderly patients(≥70 years old)with esophageal squamous cell carcinoma who underwent thoracic laparoscopic radical resection of esophageal cancer in our hospital from January 2020 to December 2021.The study aimed to investigate the correlation between clinical pathological indicators and commonly used measurement indicators of sarcopenia and postoperative pneumonia.Statistical analysis was performed to analyze the data.Results:The study found that the proportion of postoperative pneumonia in esophageal squamous cell carcinoma patients aged 70 years and above was 27.9%(111 out of 398). The pneumonia group had significantly lower preoperative BMI and peak expiratory flow(PEF)measurements compared to the non-pneumonia group, with statistically significant differences( t=2.799, 2.674, both P<0.05). Logistic multivariate analysis revealed that low PEF, low psoas major muscle index(PMI), and low psoas muscle density(PMD)were the primary risk factors for postoperative pneumonia in esophageal cancer patients aged 70 years and above(Wald χ2 values were 7.577, 6.091, 6.845, all P<0.05). The risk of postoperative pneumonia in esophageal cancer patients aged 70 years and above with low PEF, low PMI, and low PMD was found to be 1.969 times higher(95% CI: 1.215-3.185, P=0.006), 1.912 times higher(95% CI: 1.143-3.205, P=0.014), and 1.832 times higher(95% CI: 1.164-2.882, P=0.009)respectively, compared to patients with high PEF, high PMI, and high PMD. Conclusions:Low PEF, low PMI, and low PMD are significant risk factors for postoperative pneumonia in esophageal cancer patients aged 70 years and older.Preoperative PEF, PMI, and PMD, which are commonly utilized measurement indicators for sarcopenia, can be utilized as early screening indicators for postoperative pneumonia.

Objective To explore the efficacy of unilateral biportal endoscopy(UBE)for lumbar intervertebral foramen stenosis combined with lumbar disc herniation through Sublamina approach.Methods From October 2021 to June 2022,7 elderly patients with typical symptoms of lumbar disc herniation in the intervertebral foramen area accompanied by spinal stenosis were retrospectively analyzed.There were 6 patients with lumbar disc herniation and nerve root canal stenosis at L4/5 and 1 patient at L5/S1.The mean course of disease was(8.6±2.5)months.All the patients were treated by UBE through Sublamina approach.Results Postoperative limb radicular symptoms of 7 patients were relieved.The visual analogue scale(VAS)of limb pain was significantly decreased from preoperative(8.6±1.3)to(2.1±1.1)at 2 d after the surgery(P<0.05),the Japanese Orthopaedic Association(JOA)score was significantly increased from preoperative(10.1±2.4)to(17.3±1.8)at 2 d after the surgery(P<0.05).Conclusion UBE for lumbar intervertebral foramen stenosis combined with lumbar disc herniation through Sublamina approach has a satisfactory therapeutic effect,providing a new idea for the surgical treatment of this disease.

Objective:To evaluate the feasibility of low radiation dose and low contrast dosage in coronary CT angiography (CCTA) of class I obese patients.Methods:This prospective study enrolled 57 patients (male/female, 50/7, age, 25-77 years) with body mass index (BMI) of 30-38 kg/m 2 and body weight of 85-119 kg scheduled for CCTA from August 2022 to March 2023 in our hospital. The patients were divided into two groups: control group (group A, n = 20) and low-dose group (group B, n = 37). Group A employed a standard-dose protocol: tube voltage 120 kVp and IDR 2.2 g I/s, while group B were scanned using the low-dose protocol: tube voltage 100 kVp and IDR 1.5 g I/s. Images in Group A and Group B were reconstructed with hybrid iterative reconstruction (HIR) at strength 4 and 8, respectively. Other scanning and reconstruction parameters were the same in two groups. Methods:The image quality was assessed by measuring the CT values and noise in the aortic root, left anterior descending artery and right coronary artery, and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Subjective image quality was evaluated for vessels according to the 18-segment classification system using a 4-point scale (1. poor, 4. excellent). The effective dose E and contrast dosage were compared. Statistical analysis was performed using independent samples t-test, Mann-Whitney U test or χ 2 test. Results:The BMI of groups A and B were 31.89 (30.77, 33.81) and 31.22 (30.46, 32.83) kg/m 2, respectively ( P>0.05). No statistically significant differences in CT values, noise, SNR, CNR were noticed between the two groups (all P>0.05). The mean subjective score of all coronary artery segments in the two groups were not less than 3, meeting the requirement of clinical diagnosis. There was no statistically significant difference in the overall subjective image quality between the two groups ( P>0.05). The radiation dose E in groups A and B were 7.58 and 4.49 mSv, respectively ( Z=-5.46, P<0.05). The contrast dosage in groups A and B were 66 and 45 ml, respectively. The radiation dose E and contrast dosage in group B were 41% and 32% lower than that in group A, respectively. Conclusions:For class I obese patients, it was feasible to use a low tube voltage (100 kVp) and low IDR (1.5 gI/s) protocol in CCTA. Radiation dose and contrast dosage can be reduced reasonably without compromising the CCTA image quality.