The concept of "qi deficiency with stagnation" refers to a pathological state characterized by the depletion of primordial qi， impaired qi transformation， and the development of internal stagnation. Under the cyclic chemotherapy regimen in oncology， chemotherapy-induced myelosuppression follows a progressive pathological course from qi deficiency to increasing stagnation. This sequential evolution from mild to severe myelosuppression closely aligns with the dynamic syndrome differentiation and treatment framework of "qi deficiency with stagnation". "Qi deficiency" reflects the gradual depletion of qi， blood， and essence， while "stagnation" refers to the accumulation of phlegm， turbid dampness， and blood stasis. These two components interact reciprocally， forming a vicious cycle where deficiency leads to stagnation， and stagnation further damages the healthy qi. In the early stage of mild myelosuppression， chemotoxicity begins to accumulate in the bone marrow， leading to qi consumption， blood deficiency， yin injury， and the gradual formation of turbid phlegm and damp stagnation. In the advanced stage of severe myelosuppression， the accumulation of toxicity causes qi sinking， exhaustion of essence， and marrow depletion， along with blood stasis obstructing the collaterals. Treatment strategies should be based on syndrome differentiation， with an emphasis on assessing the severity of the condition， balancing deficiency and excess， and achieving both symptomatic relief and root cause resolution.

Background Salidroside (SAL) has a protective effect on multiple organ systems. Exposure to fine particulate matter (PM_2.5) in the atmosphere may lead to disruptions in gut microbiota and impact intestinal health. The regulatory effect of SAL on the gut microbiota of mice exposed to PM_2.5 requires further investigation. Objective To evaluate gut microbiota disruption in mice after being exposed to PM_2.5 and the potential effect of SAL. Methods Forty male C57BL/6 mice, aged 6 to 8 weeks, were randomly divided into four groups: a control group, an SAL group, a PM_2.5 group, and an SAL+PM_2.5 group, each containing 10 mice. In the SAL group and the SAL+PM_2.5 group, the mice were administered SAL (60 mg·kg⁻¹) by gavage, while in the control group and the PM_2.5 group, sterile saline (10 mL·kg⁻¹) was administered by gavage. In the PM_2.5 group and the SAL+PM_2.5 group, PM_2.5 suspension (8 mg·kg⁻¹) was intratracheally instilled, and in the control group and SAL group, sterile saline (1.5 mL·kg⁻¹) was intratracheally administered. Each experiment cycle spanned 2 d, with a total of 10 cycles conducted over 20 d. Histopathological changes in the ileum tissue of the mice were observed after HE staining. Colon contents were collected for gut microbiota sequencing and short-chain fatty acids (SCFAs) measurements. Results The PM_2.5 group showed infiltration of inflammatory cells in the ileum tissue, while the SAL+PM_2.5 group exhibited only a small amount of inflammatory cell infiltration. Compared to the control group, the PM_2.5 group showed decreased Shannon index (P<0.05) and increased Simpson index (P<0.05), indicating that the diversity of gut microbiota in this group was decreased; the SAL+PM_2.5 group showed increased Shannon index compared to the PM_2.5 group (P<0.05) and decreased Simpson index (P<0.05), indicating that the diversity of gut microbiota in mice intervened with SAL was increased. The principal coordinates analysis (PCoA) revealed a significant separation between the PM_2.5 group and the control group, while the separation trend was less evident among the control group, the SAL group, and the SAL+PM_2.5 group. The unweighted pair-group method with arithmetic means (UPGMA) clustering tree results showed that the control group and the SAL group clustered together first, followed by clustering with the SAL+PM_2.5 group, and finally, the three groups clustered with the PM_2.5 group. The PCoA and UPGMA clustering results indicated that the uniformity and similarity of the microbiota in the PM_2.5 group were significantly decreased. Compared to the control group, the PM_2.5 group showed decreased abundance of phylum Bacteroidetes and Candidatus_Saccharimonas (P<0.05) and increased abundance of phylum Proteobacteria, genus Escherichia, genus Bacteroides, genus Prevotella, genus Enterococcus, and genus Proteus (P<0.05). Compared to the PM_2.5 group, the SAL+PM_2.5 group showed decreased abundance of phylum Proteobacteria, phylum Actinobacteria, genus Prevotella, and genus Proteus (P<0.05), and increased abundance of Candidatus_Saccharimonas (P<0.05). The PM_2.5 group showed reduced levels of propionic acid, valeric acid, and hexanoic acid compared to the control group (P<0.05), while the SAL+PM_2.5 group showed increased levels of propionic acid, isobutyric acid, butyric acid, valeric acid, and hexanoic acid compared to the PM_2.5 group (P<0.05). Conclusion Exposure to PM_2.5 can cause pathological alterations, microbial dysbiosis, and disturbing production of SCFAs in intestinal tissue in mice. However, SAL can provide a certain degree of protective effect against these changes.

Objective:To evaluate the postoperative denture restoration and denture function in pa-tients with mandibular defect reconstructed with vascularized free fibula flap.Methods:In the study,154 patients who underwent mandibular segment resection and used vascularized free fibula flap to repair mandibular defects due to inflammation,trauma and tumor from January 2015 to December 2020 were collected.These patients had common inclusion criteria which were stable occlusal relationship before operation,segmental defects of mandibular bone caused by lesions of mandible and adjacent parts(such as floor of mouth,tongue,cheek),free fibula flap used for repair and surviving after operation.Relevant data were reviewed and situation of denture restoration was followed up.A questionnaire related to den-ture functional evaluation had been proposed for those who had completed the denture rehabilitation.The evaluation index of denture restoration function was assigned by expert authority to obtain the denture function score.SPSS 18.0 software was used for statistical analysis of the basic information of the patients included in the study and the denture restoration of the patients.Results:The rate of postoperative den-ture restoration in the patients with mandibular defects repaired by free fibula flap was 17.5％,and the rate of postoperative denture restoration in the patients with benign mandibular tumors was 25.0％(18/72),which was significantly greater than that in the patients with malignant tumors 11.0％(9/82,P＜0.05).There was no significant difference in denture function score between the patients with condylar defect and those without condylar defect in denture repair rate and denture function score(P＞0.05).The functional score of implant denture was significantly greater than that of removable denture(P＜0.05).According to Brown classification,the denture function score of the patients with the defect invo-lving the anterior mandibular region was significantly greater than that of the patients without the anterior mandibular region involved(P＜0.05).The poor oral conditions,such as less amount of remaining teeth,insufficient retention strength,large mobility of soft tissue in the surgical area,poor oral vestibular groove condition became the main reason of not receiving denture restoration(37.86％).Conclusion:The denture rehabilitation of mandibular defect reconstructed with vascularized free fibula flap is closely rela-ted to pathological properties and oral conditions.The clinical outcome of implant denture has been con-firmed effectively and it is a better choice for future denture restoration after mandibular reconstruction.

Objective:To analyze the robustness of the dose of clinical target volume (CTV) and tolerance dose of normal tissues after applying in-room CT before carbon ion radiotherapy for prostate cancer.Methods:Thirty prostate cancer patients treated with carbon ion in Shanghai Proton and Heavy Ion Center from January 2020 to June 2021 were enrolled in this study. Five in-room CT images of each patient were selected randomly before treatment. Dose distributions were recalculated using the original plan on in-room CT images and dose volume histogram (DVH) parameters were obtained, including V 95% and V 90% of CTV and V 80% of rectum. The values were compared with the dosimetric parameters of the original plan. Statistical analysis was performed by paired or two independent samples t-tests. Results:The dose distribution was recalculated by applying in-room CT. The mean values of V 95% and V 90% of CTV and V 80% of rectum were 98.1%±1.2% ( P<0.001), 99.9%±0.2% ( P=0.001) and (5.8±1.6) ml ( P<0.001), respectively. The differences were statistically significant compared with those of the original plan. The frequency of V 95%≥95%, V 90%≥98% of CTV, and V 80%<10 ml of rectum was 148 (98.7%), 150 (100.0%) and 147 (98.0%), respectively. Conclusion:Based on in-room CT analysis and the patient management and positioning methods of our research center, the uncertainty of target dose and normal tissue dose in the entire process of prostate cancer carbon ion therapy is small, and the robustness is good.

Objective To investigate the acute toxicology and intervention effect of Panacis Majoris Rhizoma on rats with chronic pharyngitis.Methods A single,maximum dose of Panacis Majoris Rhizoma(74.4 g·kg-1)was administered to Kunming mice to evaluate its toxicity,involving the assessment of the survival status of the mice,organ indices,morphological changes in major organs,blood routine,and biochemical indicators.SD rats were randomly divided into the control group,model group,prednisone group(6.25 mg·kg-1),and low-,medium-,and high-dose Panacis Majoris Rhizoma groups(0.58,1.16,and 2.32 g·kg-1).All rats received the corresponding drugs(or normal saline)via intragastric administration once daily for a duration of 30 days.Except the control group,chronic pharyngitis was induced in rats of the other groups by using β-hemolytic streptococcus.Following euthanasia,serum inflammatory levels of interleukin-6(IL-6),cyclooxygenase-2(COX-2),interleukin-1β(IL-1β),intercellular adhesion molecule-1(ICAM-1),C-reactive protein(CRP),tumor necrosis factor(TNF-α),monocyte chemoattractant protein-1(MCP-1),and prostaglandin E2(PGE2)were measured.Additionally,pharyngeal tissues were stained with HE and pathological characteristics were observed.Results Toxicological studies have demonstrated that the administration of Panacis Majoris Rhizoma resulted in significant increase in plasma alanine transaminase levels and spleen index of mice,along with corresponding tissue pathological alterations.Nevertheless,no noteworthy pathological changes were observed in other organs,and there were no notable changes in blood routine and plasma biochemical indicators.Pharmacodynamic investigations have revealed that Panacis Maioris Rhizoma effectively reduces the serum levels of inflammatory factors and improves pathological changes in pharyngeal tissues.Conclusion Panacis Maioris Rhizoma alleviated β-hemolytic streptococcus-induced CP by inhibiting inflammatory responses,and may show potential toxicity to the spleen.

Objective:To investigate the application effects of a novel framework: the external septal retention bionic framework in East Asian rhinoplasty.Methods:A retrospective analysis was performed based on the clinical data of the patients who received treatments in Department of Plastic and Aesthetic ( Burn) Surgery, the Second Xiangya Hospital, Central South University from January 2022 to July 2023 using an external septal retention bionic framework with autologous costal cartilage rhinoplasty. The patients were all treated with a V-shaped incision at the nasal columella, which continued to both sides of the nose to form a bird-shaped incision. During the operation, the sixth or seventh costal cartilage was sculpted to form the nasal columella support grafts (sturt), external nasal septal graft, cap grafts, and shield grafts, in which the nasal column support graft and external nasal septal graft were implanted in a mortise-and-tenon joint structure to form a septum bionic retained external stent in order to lengthen the nasal columellar column and strengthen the septum. A capsular graft was used to shape the tip of the nose and the rectus abdominis fascia was covered to soften the tip of the nose, and the shield grafts were used to fill out the subnasal lobules. A bulb was sculpted, shaped and implanted in the dorsal space to elevate the nasal dorsum. To observe the postoperative results and complications, a postoperative satisfaction survey was completed using the rhinoplasty outcome evaluation (ROE) and the visual analogue scale (VAS) with regular follow-up. Comparison of preoperative and postoperative scale scores was performed using paired samples t-test. Nasal stent stability was assessed by measuring the patients’ preoperative and postoperative nasolabial angle and nasal tip protrusion. The comparison of preoperative and postoperative nasolabial angle was performed using the paired-sample t-test, and the comparison of nasal tip protrusion was performed using the Wilcoxon signed rank-sum test, P<0.05 considered a statistically significant difference. Results:A total of 33 patients were enrolled, including 4 males and 29 females, with average age of 23.8 years(15-42 years). The follow-up period is (14.52 ± 4.72) months (3 to 21 months). Thirty-three patients recovered well after surgery, and no short-term complications such as infection or bleeding occurred. The patients' nasal aesthetic problems such as saddle nose, deviated nasal columella, bilateral asymmetry of the nose, bilateral nasal base depression, and rounded shield of the nasal tip were improved after surgery. Satisfaction survey results: ROE and VAS scores were significantly higher than those before surgery, which were [(17.92±2.56) vs.(12.78±3.14)] and [(8.08±1.66)vs(5.15±1.99)], ( P<0.05), 87.9% (27/33)of the patients were satisfied with the aesthetic and functional outcomes of the nose. Comparisons of nasolabial angle [(87.28±2.58)° vs. (97.64±1.95)°] and tip protrusion [1.88 (1.78, 1.95) cm vs. 2.16(2.01, 2.32) cm] measurements between preoperative and postoperative period of the 33 patients, the differences were statistically significant ( P<0.05). Conclusion:Rhinoplasty for East Asians employs an external septal retention bionic framework to retain the nasal septum. This technique can avoid septal cartilage resorption caused by compression of grafts transplanted in the future, and cause less damage to the anatomy and physiology of the nose. The framework is relatively easy to construct, with a stable and strong stent, and good patient satisfaction. It can achieve a more desirable aesthetic effect of the nose.

Osteoarthritis (OA) is a chronic degenerative joint disease whose main characteristic is the destruction of articular cartilage, causing pain and disability in patients and seriously affecting their quality of life. OA can be induced by a variety of causes, and pathological changes in articular cartilage are considered to be one of the key driving factors for the occurrence of OA. High mobility group box-1 protein (HMGB1), as a non-histone protein in eukaryotic cells, can participate in regulating the inflammation and apoptosis process of OA chondrocytes, thus leading to the occurrence of OA. This article reviews the research on the mechanism of HMGB1 in OA chondrocytes, with a view to providing new ideas for the clinical prevention and treatment of OA.

Objective:To assess the feasibility and application of mixed reality combined with surgical navigation technology in parapharyngeal space tumor surgery, and to provide a reference for the development and promotion of this technology.Methods:In this study, retrospective data collection was conducted on 16 patients with parapharyngeal space tumors who were treated at the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from June 2020 to June 2023. The patient′s age was (39.6±17.8) years, with 4 males and 12 females. Mixed reality combined with surgical navigation technology was utilized to assist physicians in the treatment of these patients. Mixed reality combined with surgical navigation technology was used to assist physicians in treatment of these patients. The application steps included acquisition of image data, processing of image data [three-dimensional (3D) reconstruction, image fusion, and virtual surgical design], development of surgical navigation plan, connection of mixed reality and navigation system, automatic registration and intraoperative guidance and validation. In the preoperative plan, landmark points were placed on the virtual tumor and surrounding important structures reconstructed using digital software, serving to guide the localization of crucial anatomical structures. Intraoperative positioning deviation, surgical time, intraoperative blood loss, and postoperative complications were recorded and analyzed to evaluate the clinical application effectiveness of mixed reality combined with surgical navigation technology.Results:With the assistance of mixed reality combined with surgical navigation technology, 16 patients successfully underwent tumor resection. All patients were accurately diagnosed preoperatively by 3D reconstruction and image fusion technology, and a comprehensive preoperative plan was formulated; intraoperatively, mixed reality combined with surgical navigation technology was utilized for the localization of important structures. The average localization deviation of 38 landmark points during the operation were (4.43±1.96) mm, with 62% (26/42) of the points having a deviation of ≥0 and<5 mm. The average duration of the operation was (149.6±53.9) min and the blood loss was 70 (45, 150) ml. The average postoperative follow-up was 16 months, and five patients experienced postoperative complications involving facial paralysis, hoarseness, and choking.Conclusions:Mixed reality combined with surgical navigation technology can achieve the three-dimensional visualization of oral and maxillofacial anatomical structures to achieve precise preoperative diagnosis. During surgery, the technology can real-time display the relationship between soft tissue tumors and the surrounding important anatomical structures, guide surgical operation, and enhance the safety of surgery.

Objective:To evaluate the outcome of Augmented reality technology in the recognizing of oral and maxillofacial anatomy.Methods:This study was conducted on the undergraduate students in Peking University School of Stomatology who were learning oral and maxillofacial anatomy.The image da-ta were selected according to the experiment content,and the important blood vessels and bone tissue structures,such as upper and lower jaws,neck arteries and veins were reconstructed in 3D(3-dimension-al)by digital software to generate experiment models,and the reconstructed models were encrypted and stored in the cloud.The QR(quick response)code corresponding to the 3D model was scanned by a net-worked mobile device to obtain augmented reality images to assist experimenters in teaching and subjects in recognizing.Augmented reality technology was applied in both the theoretical explanation and cadaveric dissection respectively.Subjects'feedback was collected in the form of a post-class question-naire to evaluate the effectiveness of augmented reality technology-assisted recognizing.Results:In the study,83 undergraduate students were included as subjects in this study.Augmented reality technology could be successfully applied in the recognizing of oral and maxillofacial anatomy.All the subjects could scan the QR code through a connected mobile device to get the 3D anatomy model from the cloud,and zoom in/out/rotate the model on the mobile.Augmented reality technology could provide personalized 3D model,based on learners'needs and abilities.The results of likert scale showed that augmented reality technology was highly recognized by the students(9.19 points),and got high scores in terms of forming a three-dimensional sense and stimulating the enthusiasm for learning(9.01 and 8.85 points respective-ly).Conclusion:Augmented reality technology can realize the three-dimensional visualization of impor-tant structures of oral and maxillofacial anatomy and stimulate students'enthusiasm for learning.Be-sides,it can assist students in building three-dimensional space imagination of the anatomy of oral and maxillofacial area.The application of augmented reality technology achieves favorable effect in the recog-nizing of oral and maxillofacial anatomy.

Objective:To explore the clinical safety and effectiveness of self-draining ureteral stent with thread in kidney transplant recipients in renal transplantation.Methods:This study is a prospective cohort clinical study in the Department of Urology of Peking University People's Hospital from November 2022 to January 2024.The ureteral stent with thread group,in which a 2-0 Mersilene suture of 20-30 cm was used at the bladder end of the ureteral stent during the operation.On the 9th day after the opera-tion,the suture attached to the end of the ureteral stent was expelled out of the urethral orifice with the urine when the catheter was removed.The ureteral stent could be removed along with the suture.As to the cystoscope group,a ureteral stent was routinely placed during kidney transplantation,and the ureteral stent was removed under local infiltration anesthesia through cystoscopy after the operation.The pain scores[numerical rating scale(NRS)-11]during catheter removal and the incidence of urinary tract in-fections were observed and compared between the two groups.t test was used to compare the pain scores of indwelling ureteral stents and ureteral stents removal between the two groups,and Chi-square test was used to compare the occurrence of urinary system complications within 3 months after operation between the two groups.P＜0.05 was considered statistically significant.Results:As of March 2024,all the re-cipients were followed up for an average of 6 months(3 to 12 months)postoperatively.A total of 46 kid-ney transplantation patients were included,with 21 in the ureteral stent with thread group and 25 in the cystoscope group.There were no statistically significant differences between the two groups in age distri-bution,male-to-female ratio,and deceased versus live donor grafts.Three months after renal transplanta-tion,there were 15 cases of urinary tract infection in the cystoscope group and 4 cases in the ureteral stent with thread group(P=0.007).No significant urinary fistula,wound infection,or ureteral stenosis occurred in either group.No stent-related complications,stent migration,or stone formation were ob-served.The postoperative bladder spasm symptom scores for indwelling ureteral stents in the cystoscope group and the ureteral stent with thread group were 4.4±2.5 and 4.6±2.4,respectively,with no sta-tistically significant difference(t=0.29,P=0.773).However,the pain scores during ureteral stent re-moval were 4.9±1.6 and 3.0±1.0 in the two groups,respectively,with a statistically significant diffe-rence(t=5.017,P＜0.001).The total costs of indwelling and removing ureteral stents in the cystosco-py group and the ureteral stent with thread group were 6 452.0(5 539.5,6 452.0)yuan and 3 225.0(3 225.0,3 225.0)yuan,respectively,and the difference was statistically significant(P＜0.001).Conclusion:Compared with the conventional transplanted kidney ureteral stent,the self-discharge ure-teral stent technique with sutures is simpler,has a shorter ureteral stent inlay time,reduces the symptoms of bladder spasms,significantly reduces the cost of catheterization,and has fewer postoperative urinary system complications.It is a worthy improved surgical method to be promoted.