AIM:To observe the changes of Th17 related cytokines in tears of conjunctivochalasis(CCH)patients with liver-kidney yin deficiency treated with traditional Chinese medicine Qi Jing Mingmu decoction combined with artificial tears.METHODS:A total of 56 CCH patients(56 eyes)with liver-kidney yin deficiency of grade Ⅱ to Ⅲ were collected and randomly divided into treatment group(treated with Qi Jing Mingmu decoction combined with artificial tears)of 26 cases(26 eyes)and control group(treated with pure artificial tears)of 30 cases(30 eyes). The treatment course was 1 mo, and international ocular surface disease index(OSDI), tear film break-up time(BUT), tear meniscus height(TMH)and conjunctival congestion index of the patients were observed before and after treatment. The patients' tears were collected before and after treatment, and Th17 related cytokines in tears were detected using flow cytometry immunofluorescence luminescence method.RESULTS:After treatment, the OSDI, BUT and conjunctival congestion index of CCH patients in the treatment group and control group were significantly improved(all P<0.01). After treatment, the TMH of CCH patients in the treatment group was significantly reduced(P<0.01), while there was no statistically significant difference in TMH of the control group before and after treatment(P=0.41). After treatment, the levels of Th17 related cytokines IL-17A, IL-22, IFN-γ, IL-17F, and IL-1β in tears of CCH patients in the treatment group were significantly reduced after treatment(all P<0.01), and the changes in the treatment group were more significant(all P<0.05). There was no significant difference in the control group before and after treatment(all P>0.05). After treatment, the levels of IL-6 and TNF-α in the tears of both groups of CCH patients decreased compared to those before treatment(both P<0.05), but the changes in the treatment group were more significant(both P<0.01).CONCLUSION:Qi Jing Mingmu decoction combined with artificial tears can effectively improve the ocular surface microenvironment, enhance tear film stability, and inhibit ocular surface inflammation in CCH patients with liver-kidney yin deficiency. This may be related to its reduction in the secretion of Th17 related cytokines in tears.

Fecal microbiota transplantation (FMT) technology originated in China during the Eastern Jin Dynasty and has rapidly developed over the past two decades, becoming a primary method for studying the causal relationship between gut microbiota and the occurrence and progression of diseases. At the same time, the therapeutic effects of FMT in the field of gastrointestinal diseases have gained widespread recognition and are gradually expanding into other disease areas. The FMT procedure is relatively complex, and there is currently no standardized method; its success is influenced by various factors, including the donor, recipient, processing of the fecal material, and the method of implantation. Given the increasingly recognized relationship between gut microbiota and various diseases, FMT has become a research hotspot in both scientific studies and clinical applications, achieving a series of significant advancements. To help researchers better understand this technology, this paper will outline the development history of FMT, summarize common operational methods in research and clinical settings, review its application progress, and look forward to future development directions.

Parkinson's disease (PD) is a chronic neurodegenerative disease. At present, levodopa and other drugs are mainly used for dopamine supplementation therapy. However, the absorption of levodopa in the gastrointestinal tract is unstable and its half-life is short, and long-term use of levodopa will lead to the end-of-dose deterioration, dyskinesia, the "ON-OFF" phenomenon and other symptoms. Therefore, new preparations need to be developed to improve drug efficacy, reduce side effects or improve compliance of patients. Based on the above clinical needs, this review briefly introduced the preparation modification strategies for the treatment of PD through case analysis, in order to provide references for the research and development of related preparations.

Objective To analyze the diagnostic quality of imported malaria in Hubei Province from 2019 to 2022, and to further improve the diagnostic level and consolidate the achievements in eliminating malaria. Methods The samples of reported malaria cases in Hubei were collected by the provincial reference laboratory (PRL) from 2019 to 2022. The microscopy and fluorescent PCR were performed to confirm the infection of plasmodium species of each case．The positive coincidence rate and species coincidence rate were analyzed and compared． Results A total of 257 imported malaria cases were reported in Hubei Province from 2019 to 2022. Among 229 malaria cases were confirmed, the overall coincidence for malaria diagnosis was 91.24% (229/251), and the overall coincidence rate for parasite species identification was 86.03% (197/229). The difference in species coincidence rate among different years was statistically significant (χ²=10.458, P<0.05). The coincidence rates of malaria diagnosis and parasite species identification in different cities (prefectures) of Hubei Province were 71.43% to 100.00% and 50.00% to 100.00%, respectively, with significant differences among different regions (χ²=29.283, P<0.05). The coincidence rates of malaria diagnosis and parasite species identification were 72.73% to 100.00% and 0.00% to 100.00% in different diagnostic institutions, and the coincidence rate of species identification in hospitals (87.61%) was higher than that in Centers for Disease Control institutions (54.55%) (χ²=81.275, P<0.05). The coincidence rates of Plasmodium falciparum, P. vivax, P. malariae, and P. ovale identification were 91.50%, 88.57%, 80.00%, and 58.06%, respectively (χ²=19.777, P<0.05). Conclusion The quality of the qualitative diagnosis of malaria cases reported online from 2019 to 2022 is generally high. However, the ability of Plasmodium typing needs to be improved. In the future, technical training and quality control should be strengthened to improve the malaria surveillance capability during the post-elimination stage.

Inflammatory bowel disease (IBD) is a group of chronic, non-specific inflammatory diseases of the gastrointestinal tract including primarily Crohn’s disease and ulcerative colitis, which are affected by multiple factors. Periodontitis is a type of disease characterized by plaque biofilm as the initiating factor and chronic destruction of alveolar bone via resorption. An increasing number of studies have reported a correlation between periodontitis and IBD, but the relationship between the two remains unclear. In this study, we explore the internal relationships between the two diseases from three dimensions, including epidemiological, biological, and associated treatment evidence. Based on epidemiological evidence, periodontitis was found to be associated with an increased risk of IBD, which also affects periodontal health, although the bidirectional correlation needs to be further studied by expanding the number of data sources. From the biological evidence, both clinical studies and animal experiments show that IBD and periodontitis are interconnected. Based on evidence from association therapy, drugs that are beneficial for the treatment of IBD are also effective in the prevention and treatment of periodontitis. In addition, drugs that are good for improving periodontitis can also significantly alleviate IBD. The interaction mechanism between IBD and periodontitis includes the microbial pathway and the immunization route. The microbial pathway refers to the increase in the probability of intestinal tract ectopic colonization by oral bacteria transmitted through the mouth-gut axis or blood, resulting from the increase in the proportion of opportunistic pathogens in the oral cavity of patients with periodontitis and the influence of IBD on the secretion of gastric juice and the balance of intestinal flora. These microorganisms further aggravate IBD inflammation by releasing virulence factors, destroying the intestinal mucosal barrier, and triggering inflammatory responses. In periodontitis, adaptive immunity is activated in the mouth, leading to the production of a large number of immune cells, including Th17 containing the intestinal homing marker α4β7 integrin on their surface. Increased ligand expression of α4β7 integrin in the intestinal mucosa of patients with IBD accelerates oral Th17 cell transfer to the intestine, thereby worsening intestinal inflammation. In parallel, the abnormal expression of cytokines, such as TNF-α, IL-1β, IL-10, IL-6, IL-21, soluble CD40 ligand (sCD40L), IL-23, and INF-γ, in the oral cavity of patients with IBD was observed, suggesting that IBD may affect periodontitis through immunity. These cytokines represent targets for the treatment of both diseases and provide a research direction for their prevention and treatment in the future.

Urine is not sterile but contains a complex urinary microbiome that is established as early as infancy and gradually refines with age. There are great differences in urinary microbiome of different ages and gender. At present，the core urinary microbiome of children has not reached a consensus. The urinary microbiome plays an important role in maintaining the integrity of urothelium，reducing the overgrowth of pathogenic bacteria，and local immune function. Changes in microbial diversity and composition are associated with various diseases of the urinary system，especially in urinary tract infections. In recent years，research on the relationship between urinary microbiome composition，microbiome，and urinary tract infection in children has been deepening. Therefore，this review aims to provide an overview of the urinary microbiome and its role in urinary tract infection in children，and to summarize the methods of intervening and reshaping the urinary microbiome in children to prevent recurrent urinary tract infections.

According to the relevant requirements of the Chinese Pharmacopoeia and relevant reports, this article briefly introduces the basic principles, research ideas, and precautions for the revision of the “characteristics” standards of Chinese medicinal materials and decoction pieces. In recent years, enterprises and social media reported that the characteristics of Chinese medicinal materials in the market did not fully comply with the characteristics specified in the Chinese Pharmacopoeia. Therefore, this article explored the variation in the characteristics of Chinese medicinal materials and decoction pieces and its main reasons, scientific and reasonable revision of the “characteristics” of Chinese medicinal materials and decoction pieces, the new methods for identifying properties, as well as the issues that need to be noted in revising the characteristics of Chinese medicinal materials and decoction pieces, which provided reference for the revision of the “characteristics” standards of Chinese medicinal materials and decoction pieces.

To summarize Professor TU Jinwen's clinical experience in the treatment of severe influenza based on the “heat toxin theory”. He believed that “heat toxin” is the main disease mechanism of severe influenza， emphasized the pathogenesis process that toxin enters with the pathogenic qi， heat generates by the toxin， and changes initiate from the toxin， and proposed simultaneous treatment of warmth and toxin and combination of multiple methods as the treatment principles. Syndrome differentiation in clinic should combine with wei-qi-ying-blood. The disease in the early stage located in wei （defensive） and qi level， treated by clearing heat and resolving toxins， releasing the exterior and expelling pathogen， harmonizing the exterior and interior， dredging the bowels with diarrhea， and combining other methods to get rid of the heat and toxin， and modified Self-Prescribed Tuire No. 1 Formula （自拟退热1号方） is recommended； the disease in progression stage located in ying-blood， treated by relieving heat and resolving toxins， and clearing the ying level and cool the blood， with prescriptions as modified Self-Prescribed Tuire No. 1 Formula plus Qingying Decoction （清营汤）， or Xijiao Dihuang Decoction （犀角地黄汤）； the disease in the late stage with of yin fluid consumption， and heat toxin in the blood level， treated by eliminating heat and resolving toxins， and enriching yin and cooling the blood， with prescriptions as modified Shashen Maidong Decoction （沙参麦冬汤） and Zhuye Shigao Decoction （竹叶石膏汤）. At the same time， it is emphasised that heat-clearing and fire-draining method and harmonising methods are important， and that dispelling pathogen should not injure healthy qi， and that the selection of prescriptions and medicines need consider syndrome differentiation and treatment.

Pain is an unpleasant sensory and emotional experience involving multi-level neural processing, with a highly complex neural activity pattern. Recent advancements in non-invasive brain functional imaging techniques have enhanced our understanding of the neural mechanisms underlying pain processing in humans at the whole-brain level. Functional magnetic resonance imaging (fMRI), in particular, plays an important role due to its high spatial resolution and has driven significant advancements in this field. This review focused on fMRI studies of pain in humans. We first summarized research that explored brain responses to pain and showing that pain processing involves neural activities across multiple brain regions, constituting the pain matrix, which includes the somatosensory cortex, thalamus, insula, anterior cingulate cortex, and other areas. However, modulating the activity of a single brain region has limited effects on pain experiences, suggesting that pain processing entails communications among multiple brain regions. Thus, we reviewed research investigating interactions between brain regions, finding that multiple neural pathways spanning the whole brain are involved in pain processing. Beyond interactions between pairs of regions, understanding how these interactions construct a pain-related network is crucial for fully comprehending the neural representation of pain. Two main approaches are used to describe neural networks across the whole brain. The first one is theory-driven, such as graph theory. Using this method, researchers explored how network properties evolve during pain processing and identified a tightly connected network that emerges during pain, encompassing the somatosensory, salience, and fronto-parietal networks, forming a pain-related super-system. As pain is modulated or diminishes, this system becomes less connected. The second approach relies on data-driven methods, such as methods based on independent component analysis or principal component analysis, and machine learning. These methods are not constrained by pre-defined brain networks. Advancements in machine learning have provided valuable insights, enabling researchers to develop pain biomarkers with promising clinical potential. Theory-driven and data-driven approaches provide complementary insights into our understanding of the neural mechanisms of pain. In recent years, two rapidly advancing and promising techniques have further enhanced the precision and comprehensiveness of pain neural network. One is ultra-high-field magnetic resonance imaging, and the other is simultaneous brain-spinal imaging. Ultra-high-field magnetic resonance imaging has overcome previous spatial resolution limitations in fMRI. In subcortical regions, it helps distinguish neural activities of different nuclei. In cortical regions, high resolution enables the differentiation of neural activities across cortical layers, thereby providing a more in-depth and detailed understanding of the neural mechanisms of pain. Simultaneous brain-spinal imaging technology enables the exploration of brain-spinal networks involved in pain processing, making it possible to construct a comprehensive neural network representation of pain throughout the entire central nervous system. Based on current findings, we suggested that in the clinical treatment of pain using neuromodulation techniques, the selection of stimulation targets could be guided by the pain neural network. Targeting hubs within the pain network could significantly impact the network and may efficiently influence pain experiences. Finally, we discussed the limitations of current research on the neural representation of pain and proposed future directions, including exploring pain-specific representation, systematically comparing experimental and clinical pain, and examining individualized neural representations.

To sum up integrative nursing experience of a case with chronic refractory wound formation caused by drug extravasation.The essentials of integrative nursing are:structured nursing intervention of"assessment-management-treatment"based on the Triangle of Wound Assessment;determination of the timing for integrative nursing according to the theory of TCM sores and ulcers;implementation of copper board scraping method to promote circulation of qi and blood;use of Huo-long Comprehensive Moxibustion Therapy to promote muscle regeneration.With the help of the cooperation of the multidisciplinary specialist nursing team,the wound was completely healed after 59 days of integrated traditional Chinese and Western medicine nursing interventions.