The article explores the common pathogenesis and transmission mechanism of exogenous febrile diseases.It points out that the invasion of external evils leads to the wei qi resisting evils,the struggle between good and evil,and the stagnation of yang qi,thus showing a series of febrile disease syndromes,and the pathogenesis is characterized by"stagnation-deficiency".The theory of"qi-blood and body-function"is used to summarize the transmission and change patterns of febrile disease syndromes,and the course of febrile diseases is summarized into two stages:qi and blood.The qi phase includes the wei phase,mainly characterized by functional disorders;the blood phase includes the nutrient phase,mainly characterized by substantial damage and accompanied by more severe functional disorders.The pathogenesis of severe exogenous febrile diseases transformation includes excessive heat stimulating blood cir-culation,heat inducing pericardium closure,excessive heat activating wind,the source of generation and transformation being cut off,asthenia cold syndrome of Shaoyin,and collapse of healthy qi,etc.

Pathogenesis and treatment methods of qi-ying fen transformation in warm diseases are explored.It is believed that warm diseases are caused by yang pathogenic factors and are most likely to damage the organs and body fluids.Body fluids,as important components of human body's healthy qi,are usually present in the lungs as lung fluids,in the stomach as stomach fluids,in the intes-tines as intestinal fluids,and in blood vessels as nutrient yin.During the transformation from qi fen syndrome to ying fen syndrome,vis-ceral parenchymal damage acts as its important pathological mechanism and fluid depletion in blood vessels is an important reason for exacerbating qi-ying fen transformation.Excessive fire-toxicity,as an initial factor,promotes qi-ying fen transformation.Fluid deple-tion is the pathological basis for exacerbating qi-ying fen transformation.Clearing heat and protecting fluids,with sweet-flavored and cold-natured drugs to generate fluids,salty-flavored and cold-natured drugs to clear heat,and combination of sweet-flavored and bit-ter-flavored drugs,is an inevitable treatment method for preventing and treating qi-ying fen transformation in warm diseases,and it al-so has important clinical guidance value for internal miscellaneous diseases and acute severe cases.

Epstein-Barr virus(EBV)is the first virus discovered to be associated with human tumors,and its association with gastric cancer has received widespread attention in recent years.In 2014,The Cancer Genome Atlas initially classified gastric cancer into four subtypes based on molecular characteristics,with EBV positive individuals grouped into a distinct subtype known as EBV-positive gastric cancer,which has unique molecular and clinicopathological characteristics.While EBV infection in malignant gastric epithelial cells and the induction of host genetic mutations and epigenetic abnormalities were generally considered as important bases for EBV carcinogenesis,the mechanisms un-derlying the relationship between EBV infection and gastric cancer risk remain unclear.We here summarize the existing epidemiological data supporting associations between different indicators of EBV infection and gastric cancer and provide an overview of the potential roles and mechanisms of EBV in gastric cancer carcinogenesis,which is expected to offer significant guidance for future studies elucidating the rela-tionship between EBV infection and gastric cancer development.

A colon-specific drug delivery system has great potential for the oral administration of colorectal cancer. However, the uncontrollable in vivo fate of liposomes makes their effectiveness for colonic location, and intratumoral accumulation remains unsatisfactory. Here, an oral colon-specific drug delivery system (CBS-CS@Lipo/Oxp/MTZ) was constructed by covalently conjugating Clostridium butyricum spores (CBS) with drugs loaded chitosan (CS)-coated liposomes, where the model chemotherapy drug oxaliplatin (Oxp) and anti-anaerobic bacteria agent metronidazole (MTZ) were loaded. Following oral administration, CBS germinated into Clostridium butyricum (CB) and colonized in the colon. Combined with colonic specifically β-glucosidase responsive degrading of CS, dual colon-specific release of liposomes was achieved. And the accumulation of liposomes at the CRC site furtherly increased by 2.68-fold. Simultaneously, the released liposomes penetrated deep tumor tissue via the permeation enhancement effect of CS to kill localized intratumoral bacteria. Collaborating with blocking the translocation of intestinal pathogenic bacteria from lumen to tumor with the gut microbiota modulation of CB, the intratumoral pathogenic bacteria were eliminated fundamentally, blocking their recruitment to immunosuppressive cells. Furtherly, synchronized with lipopolysaccharide (LPS) released from MTZ-induced dead Fusobacterium nucleatum and the tumor-associated antigens produced by Oxp-caused immunogenic dead cells, they jointly enhanced tumor infiltration of CD8⁺ T cells and reactivated robust antitumor immunity.

Aiming at the problems of missing important features, inconspicuous details and unclear textures in the fusion of multimodal medical images, this paper proposes a method of computed tomography (CT) image and magnetic resonance imaging (MRI) image fusion using generative adversarial network (GAN) and convolutional neural network (CNN) under image enhancement. The generator aimed at high-frequency feature images and used double discriminators to target the fusion images after inverse transform; Then high-frequency feature images were fused by trained GAN model, and low-frequency feature images were fused by CNN pre-training model based on transfer learning. Experimental results showed that, compared with the current advanced fusion algorithm, the proposed method had more abundant texture details and clearer contour edge information in subjective representation. In the evaluation of objective indicators, Q ^AB/F, information entropy (IE), spatial frequency (SF), structural similarity (SSIM), mutual information (MI) and visual information fidelity for fusion (VIFF) were 2.0%, 6.3%, 7.0%, 5.5%, 9.0% and 3.3% higher than the best test results, respectively. The fused image can be effectively applied to medical diagnosis to further improve the diagnostic efficiency.
Image Processing, Computer-Assisted/methods* ; Neural Networks, Computer ; Tomography, X-Ray Computed ; Magnetic Resonance Imaging/methods* ; Algorithms

Objective:To compare the clinical and imaging outcomes of fascia lata autograft bridging repair reinforecd with an artificial ligament as the internal brace with the autograft bridging repair for the treatment of irreparable massive rotator cuff tears (IMRCTs).Methods:The data of 26 patients with IMRCT who underwent fascia lata autograft bridging repair augmented with artificial ligament as the internal brace (internal brace group) and of 24 patients with IMRCT who underwent bridging autograft repair alone (control group) were retrospectively evaluated preoperatively and at 2-year follow-up. Clinical outcomes were assessed using shoulder activity, the American Shoulder and Elbow Surgeons (ASES) Score, University of California Los Angeles (UCLA) Score, and visual analogue scale (VAS) for pain. Imaging outcomes were evaluated using acromiohumeral distance (AHD), Goutallier grade, and status of fascia lata grafts according to radiographs or magnetic resonance imaging results.Results:All 50 cases were followed up for 34.2±7.2 months (range 24-45 months). Compared to the control group, the internal brace group showed better ASES score (93.5±5.3 vs. 89.5±5.7, P<0.05), UCLA score (31.7±3.8 vs. 28.5±5.6, P<0.05), improvement in UCLA score (19.6±4.2 vs. 15.9±5.7, P<0.05), active elevation (167.3°±8.4° vs. 159.4°±13.6°, P<0.05), abduction strength (8.9±1.2 vs. 8.2±1.2, P<0.05), improvement in abduction strength (4.1±1.2 vs. 3.3± 1.0, P<0.05), AHD (7.0±1.4 mm vs. 5.9±1.0 mm, P<0.05), improvement in AHD (3.3±1.5 mm vs. 2.0±0.6 mm, P<0.05), and healing rate of fascia lata autografts (92% vs. 54%, P<0.05) at 2-year follow-up. Conclusion:Fascia lata autograft bridging repair reinforced with an artificial ligament as the internal brace improves healing rate of bridging graft and postoperatively short-term clinical outcomes of patients with IMRCT.

OBJECTIVE To understand the safety of Ilaprazole sodium for injection in clinical practice. METHODS From Jan. 1st 2019 to Feb. 29th 2020， the data of 3 926 valid hospitalized patients receiving Ilaprazole sodium for injection were collected prospectively from 5 third-level hospitals through CHPS， and the post-marketing safety analysis was performed by using retrospective multicenter single cohort study. At the same time， a nested case-control study （the ratio of trial group and control group was 1∶4） was used to confirm the baseline stability of this study cohort and the correlation between adverse reactions and Ilaprazole sodium for injection. RESULTS Among 3 926 patients， 3 patients experienced 5 adverse drug events after using Ilaprazole sodium for injection， with the incidence of 0.076%. There was no serious adverse event， and the occurrence time was 2 days after medication； adverse drug events mainly include elevated liver function indicators （alanine transaminase， aspartate transaminase， total bilirubin）， which were mild and untreated， and all adverse drug events were improved. The results of the nested case-control study showed that the trial group and the control group belonged to the same background baseline， and the occurrence of adverse drug events was more closely related to Ilaprazole sodium for injection. CONCLUSIONS The overall safety of Ilaprazole sodium for injection is relatively high， and the occurrence of adverse events is more related to it.

In recent years, corneal neuralgia in dry eye patients has received more and more clinical attention.Corneal neuralgia refers to the increasing pain of cornea in response to normal painless stimuli, which has a serious negative effect on patients' work and daily life.Corneal neuralgia is often one of the common symptoms of dry eye.Dry eye can also cause corneal sensation decline and the mechanism is still unclear.Patients with dry eye often exhibit structural and functional changes in ocular surface nerve, so understanding the mechanism of dry eye-related neurological abnormalities will help to treat and prevent dry eye-related neurological abnormalities.Various factors such as instability of tear film, abnormal tear secretion, ocular surface inflammation, and increased osmotic pressure of tear film may be involved in dry eye-associated corneal neuralgia.Clinically, anti-inflammatory therapy, lubricating ocular surface, promoting regeneration of corneal nerve fibers, analgesic therapy targeting receptors, palpebral edge treatment, and systemic intervention if necessary are mainly performed based on the pathogenesis of dry eye related corneal neuralgia.In this article, the pathologic and influencing factors of corneal neuralgia were summarized, and the pathogenesis of dry eye-related corneal neuralgia were investigated to help the clinical diagnosis and treatment of dry eye-related corneal neuralgia.

OBJECTIVE To investigate the effects and mechanism of atractylodin on inflammatory injury of periodontal tissue and alveolar bone loss in periodontitis rats. METHODS A total of 144 SD rats were divided into control group （intragastric and intraperitoneal injection of normal saline）， model group （intragastric and intraperitoneal injection of normal saline）， atractylodin low-dose， medium-dose and high-dose groups （intraperitoneal injection of 6.665， 13.33， and 26.66 mg/kg atractylodin）， metronidazole group （positive control group， intragastric injection of 0.05 g/kg metronidazole， intraperitoneal injection of normal saline）， AMD3100 [stromal cell-derived factor-1 （SDF-1）/CXC chemokine receptor-4 （CXCR4） pathway inhibitor] group （intragastric injection of 1 mg/kg AMD3100， intraperitoneal injection of normal saline）， atractylodin high-dose+AMD 3100 group （intraperitoneal injection of 26.66 mg/kg atractylodin， intragastric injection of 1 mg/kg AMD3100）， with 18 rats in each group. Except for the control group， all other groups of rats were inoculated with Porphyromonas gingivalis to construct a periodontitis model. After successful modeling， they were given relevant medicine or normal saline， once a day， for 4 consecutive weeks. The gingival index of rats was detected； the levels of interleukin-6 （IL-6） and tumor necrosis factor α （TNF-α） in rat serum were also determined； alveolar bone resorption， periodontal histopathologic changes and the number of osteoclasts were detected by methylene blue staining， HE staining and TRAP staining， respectively. The expressions of osteoprotegerin （OPG）， receptor activator of NF-κB ligand （RANKL）， SDF-1 and CXCR4 proteins were determined. RESULTS Compared with the control group， serious pathological injury of periodontal tissue was found in the model group， the gingival index， the levels of IL-6 and TNF- α， alveolar bone absorption value， the number of osteoclasts， and the expression of RANKL protein were all increased significantly （P＜0.05）， while the expressions of OPG， SDF-1 and CXCR4 proteins were decreased significantly （P＜0.05）. Compared with the model group， pathological injury of periodontal tissue in rats was reduced； the gingival index， the levels of IL-6 and TNF-α， alveolar bone resorption value， osteoclast number and RANKL protein expression were decreased significantly， while protein expressions of OPG， SDF-1 and CXCR4 were increased significantly in atractylodin low-dose， medium-dose and high-dose groups and metronidazole group （P＜0.05）. The change trend of corresponding indexes in the AMD3100 group was opposite to the above （P＜0.05）. AMD3100 attenuated the inhibitory effect of high-dose atractylodin on inflammatory response and alveolar bone loss in rats with periodontitis （P＜0.05）. CONCLUSIONS Atractylodin may improve the inflammatory response and alveolar bone loss in periodontitis rats by activating the SDF-1/CXCR4 signaling pathway.

The heavily harsh plateau environment including low pressure, hypoxia, cold, dryness and strong ultraviolet radiation, seriously threatens the physical and mental health of those who quickly enter the plateau area. Lungs are the sensitive organs for high altitude injury. High-altitude lung diseases include the acute high-altitude lung disease (i.e., high-altitude pulmonary edema), the chronic high-altitude lung disease (i.e., high-altitude pulmonary artery hypertension) and the high-altitude de-adapted reaction. This review summarizes the pathogenic mechanisms and the main therapeutic drugs of high-altitude lung diseases based on the recent research. Moreover, the related formulations and administration routes are also reviewed here. It will provide support and counsel for the diagnosis and treatment of high-altitude lung diseases.