OBJECTIVE To investigate the effect of astragaloside Ⅳ（AST） on the injury of arterial endothelial tissue in rats with intracranial aneurysms （IA）， and to explore its mechanism of action based on the nuclear factor κB （NF-κB）/nucleotide- binding domain leucine-rich repeat and pyrin domain-containing protein 3 （NLRP3） signaling pathway. METHODS Rats were divided into Sham group （intragastric administration and intraperitoneal injection of the same volume of normal saline）， IA group （intragastric administration and intraperitoneal injection of the same volume of normal saline）， AST low-dose group （AST-L group， intragastric administration of 40 mg/kg AST）， AST high-dose group （AST-H group， intragastric administration of 80 mg/kg AST）， AST-H+HY-N2485 group [intragastric administration of 80 mg/kg AST and intraperitoneal injection of 25 mg/kg HY-N2485 （activator of NF-κB/NLRP3 signaling pathway）]. They were given relevant medicine， once a day， for 8 consecutive weeks. After last medication， the levels of inflammatory factors [serum tumor necrosis factor-α （TNF-α）， interleukin-18 （IL-18）， IL-6] and vascular endothelial growth factor （VEGF） and endothelin （ET） were detected； the morphology of IA was observed； the expressions of von Willebrand factor （vWF）， vascular cell adhesion molecule-1 （VCAM-1）， endothelial nitric oxide synthase （eNOS）， and NF-κB/NLRP3 pathway related proteins in vascular tissue were also determined. RESULTS Compared with the Sham group， the basilar arterial ring of rats in the IA group had obvious protrusions， and the arterial vascular endothelial cells were significantly damaged. The levels of inflammatory factors， VEGF and ET in serum， as well as the expression levels of vWF， VCAM-1 and NLRP3 proteins and the phosphorylation level of NF-κB protein in vascular tissues were increased significantly （P＜ 0.05）. Aneurysms and ruptures of the internal elastic layer were significantly increased （P＜0.05）， while the expression level of eNOS protein was significantly decreased （P＜0.05）. Compared with IA group， the morphology of IA and the levels of above indexes were all improved significantly in AST-L and AST-H groups （P＜0.05），and the improvement in the AST-H group was more significant than that in the AST-L group （P＜0.05）； HY-N2485 could attenuate the improvement effect of AST on vascular endothelial tissue damage in IA rats （P＜0.05）. CONCLUSIONS AST may inhibit the expression of inflammatory factors， alleviate inflammation and vascular endothelial tissue damage in IA rats by inhibiting NF- κB/NLRP3 signaling pathway，thereby inhibiting the formation of IA. active_999@sina.com

Objective: To explore the intervention effect of group counseling integrating teadrinking on depression, social avoidance and distress, coping styles and selfesteem among college students, so as to provide references for promoting the psychological health of students. Methods: From March to June 2021, a convenience sampling method was used to recruit 46 college students from a university in Nanjing for intervention project. There were 23 students in intervention group and control group, respectively. The intervention was conducted for 2.5 hours per week across a 6 week period. The intervention group received two sessions of group counseling that incorporated teadrinking experience, and the sessions involved tea knowledge explanation, observation and learning, embodied experience, emotional expression, interpersonal assistance and emotional support, cultural customs and life integration. After the intervention was completed, the control group received onetime group counseling that integrated teadrinking. The Wilcoxon difference test and Mann-Whitney U test were performed to compare the scores of each scale within and between the groups, and the χ2 test was used to compare the detection rates. Results: There were no statistically significant differences in the scores of positive coping, negative coping, selfesteem, social avoidance and distress between the intervention group and the control group (Z=-1.20, -0.33, -0.35, 1.31,P>0.05). There were statistically significant differences in positive coping styles, selfesteem, social avoidance and distress between the intervention group and the control group after the intervention(27.70±5.60，22.05±4.30；30.52±3.63，28.27±4.06；7.43±7.38，13.64±6.79) (Z=-3.31, -2.10, 3.22, P<0.05). The intervention group showed statistically significant differences in social avoidance and distress scores before and after the intervention(11.96±7.47,7.43±7.38) (Z=-2.88), and the depression detection rate decreased(60.9%，30.4%) (χ2=4.29) (P<0.05). There were no statistically significant differences in positive coping, negative coping, selfesteem, social avoidance and distress scores, and depression detection rate between the control group before and after the intervention (Z/χ2=-0.28, -0.42, -1.24, -1.25；1.39, P>0.05). The followup results 1year later showed that there was a statistically significant difference in social avoidance and distress(6.57±6.21,14.16±9.22), and in the detection rates of depression(21.7%,52.2%) between the intervention group and the control group (Z/χ2=2.70,4.57,P<0.05). Conclusions Group counseling integrating teadrinking could improve interpersonal relationships, emotional states, selfesteem levels and coping strategies among college students. Group psychological counseling that incorporates teadrinking can be adopted to improve the mental health status of college students.

Astrocytes(AS)are the most abundant glial cells in the central nervous system and are involved in many physiological and pathological processes in the nervous system.Alterations in their phenotype are particularly important for the health of the CNS.Epigenetic mechanisms,including DNA methylation,histone modification,non-coding RNA regulation,and chromatin remodeling,are closely linked to alterations in AS proliferation,differentiation,inflammation,and other phenotypic features,but how these mechanisms function needs to be explored and summarized.By reviewing the recent advances in the role of epigenetic mechanisms in AS under various physiological and pathological states,we aim to provide new ideas for the understanding and treatment of related diseases.

Objective:To investigate and analysis of the occurrence and influencing factors of sarcopenia in elderly critically ill patients in the intensive care unit (ICU).Methods:A prospective cohort study was conducted. Elderly patients (aged ≥ 60 years) admitted to the ICU of Tianjin Medical University General Hospital from November 2023 to June 2024 were enrolled. Clinical records were collected, and conduct muscle mass and strength measurements, as well as upper arm circumference and calf circumference were measured. Appendicular skeletal muscle index (ASMI) of less than 7.0 kg/m 2 for males and less than 5.7 kg/m 2 for females was defined as reduced muscle mass, grip strength of less than 28 kg for males and less than 18 kg for females was defined as decreased muscle strength, patients meeting both low muscle mass and low muscle strength criteria were diagnosed with sarcopenia. According to the diagnostic criteria for sarcopenia, patients were divided into sarcopenia group and non-sarcopenia group. Multivariate Logistic regression analysis was applied to identify risk factors for sarcopenia in the elderly and to develop a predictive model for the occurrence of sarcopenia. The predictive value of various risk factors for sarcopenia in elderly critically ill patients were evaluated by receiver operator characteristic curve (ROC curve). The Kaplan-Meier curve for the length of ICU stay of two groups patients were drawn. Results:Finally, 540 elderly critically ill patients were included, including 43 patients with sarcopenia, and the incidence of sarcopenia was 8.0%. Univariate analysis showed that there were significantly differences in body mass index (BMI), number of hospitalizations in the past year, the length of ICU stay, ventilation mode, duration of mechanical ventilation, pre-admission exercise habits, nutritional support methods, upper arm circumference, calf circumference, and albumin infusion between the sarcopenia group and the non-sarcopenia group. Multivariate Logistic regression analysis showed that BMI [odds ratio ( OR) = 0.79, 95% confidence interval (95% CI) was 0.67-0.93, P = 0.004], calf circumference ( OR = 0.64, 95% CI was 0.54-0.76, P < 0.001), and duration of mechanical ventilation ( OR = 1.06, 95% CI was 1.01-1.12, P = 0.034) were associated with an increased risk of sarcopenia in elderly critically ill patients. The ROC curve results showed that the area under the curve (AUC) and 95% CI of BMI, calf circumference, and duration of mechanical ventilation for predicting sarcopenia in elderly critically ill patients were 0.828 (0.767-0.888), 0.889 (0.844-0.933), and 0.397 (0.299-0.496), respectively, with cut-off values of 22.95 kg/m 2, 28.25 cm, and 50.50 days, respectively. The Kaplan-Meier curve showed that the cumulative survival rate of patients with sarcopenia was significantly lower than that of the non-sarcopenia group (Log-Rank test: χ 2 = 5.619, P = 0.018). Conclusion:Lower BMI, smaller calf circumference, and longer duration of mechanical ventilation are associated with an increased risk of sarcopenia in critically ill elderly patients.

Proanthocyanidin (PA), as a kind of natural plant polyphenol, have a variety of biological functions, such as promoting remineralization, inducing collagen cross-linking, inhibiting protease activity and inhibiting bacteria. Therefore, PA could be broadly used in the clinical application of treatment and repair of deep caries in the future; for example, PA could promote dentin remineralization, improve resin-dentin bonding durability and improve the dentin acid erosion effect. This application potential of PA arises from several features, firstly, PA can not only promote dentin remineralization on its own or with other remineralizers but also exhibits antibacterial effects, which can inhibit acid production while reducing the formation of cariogenic pathogens and their biofilms. Based on the above features, PA can reduce the incidence of caries disease; thus, PA improves deep caries and long-term effects after treatment. In addition, PA added to adhesives or etch agents can improve the etching and bonding effect of dentin by inducing collagen cross-linking and inhibiting protease activity, thus achieving the ultimate goal of improving the bonding performance of deep caries. This paper summarizes recent progress of research on PA for the treatment and repair of deep caries, including the promotion of dentin remineralization and antibacterial activity as well as the improvement in dentin bonding and acid etching effect, to provide a more comprehensive reference for treating and restoring deep caries in clinical practice.

Corona Virus Disease 2019 (Corona Virus Disease 2019,COVID-19) has become a public health emergency that has attracted global attention because of its large-scale outbreak resulting in numerous human infections and deaths. COVID-19 is a highly contagious respiratory disease caused by novel coronavirus 2019-nCoV. Due to a large number of infections and fast transmission speed, it's significant to diagnose the infected people quickly and detect the asymptomatic infected people as soon as possible. At present, the preliminary screening is judged by the clinical manifestations of the patients, mainly involving the respiratory system, but recent studies have found that the patients infected with COVID-19 have unique oral manifestations, such as taste disturbance, xerostomia, halitosis, inflammation of salivary glands, necrotizing periodontal disease and some of them are earlier than typical symptoms such as dry cough, fever, etc. Paying attention to the oral manifestations of patients can further improve the COVID-19 screening procedure. At present, symptomatic treatment is mainly used for these oral symptoms.

In China and abroad, Traditional Chinese Medicine (TCM) have been applied and developed. That is depended on doctors and scholars of the past dynasties to inseparable from the inheritance, protection, development, and innovation of Traditional Knowledge of Chinese Medicine. With the progress of modern society and people's awareness of traditional culture protection, people are also improving the understanding of TCM. Through the analysis of the situation and significance of the protection of Traditional Knowledge of Chinese Medicine and the development of Japanese Kampo medicines, recognized that the development of Kampo medicines ignored the source. Their original intention and purpose of protection the Traditional Knowledge of Medicine are completely different from China. The protection of Traditional Knowledge of Chinese Medicine should be in accordance with the basic national conditions, and the system of the protection of Traditional Knowledge of Chinese Medicine should be formulated and perfected to ensure the sustainable development of TCM.

Objective:To explore the influence of proactive personality on medical attitude and the mediating role of health belief and physician trust.Methods:A total of 703 adults were surveyed by proactive personality scale, Chinese adult health belief scale, Wake Forest physician trust scale and medical attitude scale from Octomber to November 2019.Descriptive statistics and correlation analysis were conducted by SPSS 23.0 software, and mediating effects were analyzed by SPSS macro program PROCESS 3.3.Results:(1)For all subjects, the score of proactive personality was(55.12±11.00), the score of health belief was(74.88±10.31), the score of doctor trust was(33.23±5.63), and the score of medical attitude was(56.55±13.07). Proactive personality was significantly positively correlated with health belief ( r=0.535), physician trust ( r=0.298) and medical attitude ( r=0.406) (all P<0.01), and health belief was significantly positively correlated with physician trust ( r=0.363) and medical attitude ( r=0.696) (both P<0.01). There was a significant positive correlation between physician trust and medical attitude ( r=0.452, P<0.01). (2) Proactive personality had an impact on medical attitude through three pathways. The single mediating effect value of health belief was 0.326, accounting for 82.74% of the total indirect effect. The single mediating effect value of physician trust was 0.040, accounting for 10.15% of the total indirect effect. The chain mediating effect value of health belief and physician trust was 0.028, accounting for 7.11% of the total indirect effect. Conclusion:Health belief and physician trust play multiple mediating roles in proactive personality and medical attitude in adults.

Object:To observe the characteristics and predictors of alanine aminotransferase (ALT) flare in postpartum women with chronic HBV infection and high viral load who were prevented from mother-to-child transmission of HBV by anti-HBV intervention during pregnancy.Methods:Data of pregnant women seen at the Third People’s Hospital of Shenzhen liver disease outpatient clinic who met inclusion and exclusion criteria of chronic hepatitis B virus (HBV) infection were collected, including data recorded before and after antiviral therapy during pregnancy, postpartum regular 4 to 6 weeks, 12, 36, 48, 72, and 96 weeks of follow-up, results of liver function tests, HBV serological markers and HBV DNA quantitative examinations. The characteristics of normal and abnormal postnatal ALT groups were compared, and the risk factors of abnormal postnatal ALT were analyzed by logistic regression.Results:A total of 100 women with chronic HBV infection were enrolled from September 1, 2018 to December 31, 2020. All 94 women with chronic HBV infection experienced virological recurrence within 12 weeks after delivery and continued to be HBeAg positive. The rate of ALT flare (>ULN) was 60%, most of which occurred within 12-24 weeks after delivery, and most of which returned to normal without special treatment. However, ALT flare still occurred in 27% of cases within 48-96 weeks after delivery. A total of 24 patients with postnatal ALT≥5×ULN were treated with antiviral therapy again. Logistic multifactor regression analysis suggested that elevation of ALT (>ULN) after delivery and drug discontinuation was associated with ALT elevation occurred during delivery, the odds ratio (OR) was 1.089.Conclusions:ALT flare in postpartum women is common, and most of them can return to normal without special treatment. However, ALT flare still occurs after 48 weeks of delivery, and antiviral therapy is needed again. Therefore, long-term follow-up should be standardized for pregnant women with high viral load and chronic HBV infection after delivery.

A 66-year-old female patient presented with blisters on the scalp and neck for 1 month. She had a history of type 2 diabetes for 6 years, and started taking the dipeptidyl peptidase-4 inhibitor linagliptin at a dose of 5 mg once a day 6 months before the onset of eruption. Skin examination showed scattered mung bean- to peanut-sized blisters on the scalp, and some blisters broke with exudation and crusts. There was a pigeon egg-sized bulla and two mung bean-sized blisters on the left neck, with tense blister walls, clear blister fluids, non-erythematous base, and Nikolsky′s sign was negative. Enzyme-linked immunosorbent assay revealed that the serum levels of anti-BP180 NC16A and anti-BP230 antibodies were 5.81 and 139.76 kU/L respectively. Histopathological examination of the blister on the neck showed subepidermal blister formation, and infiltration with neutrophils and a few eosinophils in the blister. The patient was finally diagnosed with localized anti-BP230-type bullous pemphigoid. This case of anti-BP230-type bullous pemphigoid associated with the dipeptidyl peptidase-4 inhibitor linagliptin was firstly reported in China.