Autoimmune pancreatitis is a special type of chronic pancreatitis that can lead to abnormal pancreatic exocrine function in patients. Autoimmune pancreatitis comorbid with pancreatic exocrine insufficiency has a complex pathogenesis， and there is limited research on this topic， leading to the lack of understanding of such patients in clinical practice. This article introduces the epidemiology of autoimmune pancreatitis， briefly describes the pathogenesis of pancreatic exocrine insufficiency caused by autoimmune pancreatitis， and summarizes the various detection methods for pancreatic exocrine function， nutritional assessments， lifestyle management， and drug therapy， in order to strengthen the understanding of autoimmune pancreatitis comorbid with pancreatic exocrine insufficiency and improve the clinical diagnosis and treatment of pancreatic exocrine insufficiency.

Irritable bowel syndrome (IBS) is an extremely common chronic intestinal disorder characterized by recurrent abdominal pain and altered bowel habits, significantly impacting patients' quality of life. The etiology of IBS remains incompletely understood. Research has identified low-grade intestinal inflammation and immune activation, primarily manifested as an imbalance between pro-inflammatory and anti-inflammatory cytokines, as key pathogenic mechanisms in IBS. Among these, interleukin-6 (IL-6), a core pro-inflammatory cytokine, is significantly elevated in IBS patients. IL-6 contributes to the pathogenesis of IBS through various mechanisms, including altering individual susceptibility to IBS, promoting gastrointestinal motility and secretion, activating the hypothalamic-pituitary-adrenal axis, inducing visceral hypersensitivity, and impairing intestinal mucosal barrier function. Furthermore, IL-6 levels are closely associated with the severity of IBS symptoms. This review summarizes the role and mechanisms of IL-6 in IBS, aiming to provide insights and references for clinicians and researchers investigating the etiology of IBS.

Intravitreal injection of anti-vascular endothelial growth factor(VEGF)agents has become the primary treatment for macular edema associated with retinal vascular disease such as diabetic retinopathy and retinal vein occlusion, but there are limitations such as variable treatment efficacy and insufficient durability of therapeutic effects. As the first bispecific antibody applied in ophthalmic treatment, Faricimab achieves favorable outcomes by simultaneously targeting both VEGF-A and angiopoietin-2(Ang-2)pathways. Based on evidence from recent clinical trials and real-world studies, this article reviews the research progress on Faricimab for the treatment of diabetic macular edema(DME), retinal vein occlusion-associated macular edema(RVO-ME)and refractory macular edema compared to the therapeutic effects of other agents. Additionally, based on Faricimab's safety characteristics and future potential, its therapeutic prospects for macular edema associated with retinal vascular diseases are discussed. This review aims to provide evidence-based references for optimizing clinical treatment strategies, thereby contributing to mitigating the risk of vision loss due to macular edema.

OBJECTIVE To investigate the potential mechanism of the effect of ginkgo flavone aglycone （GA） against doxorubicin （DOX）-induced cardiotoxicity. METHODS The male ICR mice were randomized into control group （CON group）， model group （DOX group） and GA+DOX group （GDOX group）， with 12 mice in each group. The DOX group was injected with DOX solution at a dose of 3 mg/kg via tail vein every other day， and the GDOX group was given GA suspension intragastrically at a dose of 100 mg/kg every day+DOX solution at a dose of 3 mg/kg via tail vein every other day， for 15 consecutive days. After the end of administration， the serum levels of aspartate aminotransferase（AST）， creatine kinase（CK）， creatine kinase isoenzyme（CK- MB） and lactate dehydrogenase（LDH） in mice were detected in each group. Based on the metabolomics method， UHPLC-Q- Exactive Orbitrap HRMS method was used； based on principal component analysis （PCA） and orthogonal partial least squares- discriminant analysis （OPLS-DA）， the differentially expressed metabolites （DEMs） were screened using the criteria of variable importance in the projection≥1， fold change of peak area＞1 and P＜0.05； biological analysis was conducted based on databases such as HMDB and PubChem. RESULTS Compared with CON group， serum levels of AST， CK， CK-MB and LDH were increased significantly in DOX group （P＜0.05）； compared with DOX group， the serum levels of the above indicators （except for CK-MB） were decreased significantly in GDOX group （P＜0.05）. PCA and OPLS-DA showed that myocardial tissue samples of CON group， DOX group and GDOX group were isolated completely. After database matching， 37 common DEMs were identified， among which 17 DEMs were significantly up-regulated in the DOX group and significantly down- regulated in the GDOX group， and 8 DEMs were significantly down-regulated in the DOX group and significantly up-regulated in the GDOX group； pathway enrichment involved the biosynthesis of unsaturated fatty acids， arachidonic acid metabolism， linoleic acid metabolism， taurine and hypotaurine metabolism； the key metabolites in the above pathways included docosahexaenoic acid， arachidonic acid， phosphatidylcholine （16∶0/18∶3） and taurine. CONCLUSIONS GA may regulate the biosynthesis of unsaturated fatty acids， arachidonic acid metabolism and other metabolic pathways by acting on the core metabolites such as docosahexaenoic acid and arachidonic acid， thus alleviating the cardiotoxic effects of DOX.

Objective To study the serum laminin γ 2 monomer(LG2m),human circulating Gastrin(hPG80)in patients with hepatocellular carcinoma(HCC)and their clinical value.Methods 128 HCC patients admitted to the First People's Hospital of Shuangliu District from January 2016 to January 2018 were selected as the HCC group,70 patients with benign liver lesions diagnosed and treated at the same time were selected as the benign lesion group,and 70 healthy individuals who underwent physical examinations during the same time were selected as the control group.Use enzyme-linked immunosorbent assay to detect serum LG2m and hPG80 levels.The evaluation value of serum LG2m and hPG80 in predicting the prognosis of HCC patients were analyzed by receiver operating characteristic curve.Kaplan-Meier survival analysis was used to compare the survival prognosis of HCC patients with different serum LG2m and hPG80 levels.COX regression analysis was used to analyze the prognostic factors of HCC patients.Results The levels of serum LG2m(28.14±3.10 ng/L),hPG80(84.83±11.39 ng/L)in the HCC group were higher than those in the benign lesion group(9.18±1.74 ng/L,25.10±4.11 ng/L)and the control group(8.24±1.65 ng/L,23.15±3.26 ng/L),and the differences were statistically significant(t=68.240～76.635,all P＜0.05).The levels of serum LG2m and hPG80 in patients with TNM stage III,low differentiation degree,serum AFP＞400 μg/L were higher than those in TNM stage I to II,high differentiation,AFP≤400 μg/L,the differences were statistically significant(t=3.216～13.552,all P＜0.05).The area under the curve(95%CI)of the combined evaluation of serum LG2m and hPG80 for the prognosis of HCC patients was 0.934(0.889～0.961),which was greater than the single indicator of 0.813(0.774～0.849)and 0.896(0.840～0.937).The overall 5-year survival rates of HCC patients with high and low serum LG2m expression were 33.33%(21/63)and 67.69%(44/65),respectively.Compared with HCC patients with low expression of serum LG2m,HCC patients with high expression of serum LG2m had a lower 5-year cumulative survival rate(Log-Rankχ2=19.522,P＜0.05).The overall 5-year survival rates of HCC patients with high and low serum hPG80 expression were 35.48%(22/62)and 65.15%(43/66),respectively.Compared with HCC patients with low serum hPG80 expression,HCC patients with high serum hPG80 expression had a lower 5-year cumulative survival rate(Log-Rankχ2=12.546,P＜0.05).TNM stage III(OR=1.487,P＜0.05),low differentiation degree(OR=1.611,P＜0.05),serum AFP≥400μg/L(OR=1.416,P＜0.05),high expression of serum LG2m(OR=1.838,P＜0.05),and high expression of hPG80(OR=1.735,P＜0.05)were independent risk factors for poor prognosis in HCC patients.Conclusion The serum levels of LG2m and hPG80 in HCC patients increase,which are related to TNM staging,tumor differentiation,and serum AFP levels.They are serum biomarkers for evaluating the survival and prognosis of HCC patients.

Objective:To observe any effect of supplementing basic swallowing training with balloon catheter dilation on the swallowing function of tracheostomy patients with pontine hemorrhage.Methods:A total of 40 pontine hemorrhage patients with tracheostomy and swallowing disorders were divided randomly into an observation group and a control group, each of 20. Both groups were given nutritional neurodrugs and basic swallowing training, but the observation group also received 25 minutes of balloon catheter dilation, five times a week for 6 weeks. Before and after the 6 weeks of treatment one swallowing therapist evaluated the feeding ability and leakage-aspiration status of each subject assigning functional oral intake (FOIS) ratings and Rosenbek Leakage/Aspiration Rating Scale (PAS) ratings double-blinded. The Watian water swallowing test was also applied.Results:After the treatment the average FOIS and PAS scores of both groups had improved significantly, with those of the observation group then significantly better than among the control group on average. The total treatment effectiveness rate was 70% in the observation group, significantly better than the 30% in the control group.Conclusion:Supplementing swallowing training with balloon catheter dilation can better improve the swallowing of patients recovering from a tracheotomy after pontine hemorrhage.

OBJECTIVE To screen the potential active components of Polygonum orientale flower against myocardial ischemia- reperfusion injury （MIRI） in rats based on physiological and pathological states. METHODS SD rats were divided into normal control group， normal administration group， MIRI control group and MIRI administration group， with 5 rats in each group. After drug intervention or modeling and drug intervention， chromatographic separation plasma samples were collected， and chromatographic separation and mass spectrometry data collection were performed by using UPLC-Q-TOF/MS. The prototype components and metabolites were analyzed by comparing the reference substance maps， the maps of each plasma sample， and the relevant literature. At the same time， the common peaks in plasma samples of rats in normal administration group and MIRI administration group were identified. Combined with principal component analysis and orthogonal partial least square-discriminant analysis， the differential transitional components were screened out according to the value of variable importance in the projection （VIP）＞1， to speculate the potential active components of P. orientale flower in rats under physiological and pathological states. The SD rats were divided into control group， MIRI group， positive control group （Compound danshen tablets 0.2 g/kg， 3 times a day）， and potentially active compound groups （10 mg/kg， twice a day）， with 5 rats in each group. The rats in administration groups were given relevant medicine intragastrically， for 3 consecutive days. The activity of superoxide dismutase （SOD）， the leakages of lactate dehydrogenase （LDH）， creatine kinase isoenzyme-MB （CK-MB） and cardiac troponin Ⅰ （cTnⅠ） in plasma were detected after the last administration. RESULTS Twenty-six main chromatographic peaks were obtained from the total ion chromatogram of the extract of P. orientale flower， and 14 of them were determined， including gallic acid， catechin， protocatechuic acid and so on. There were fifteen （including 6 absorbed prototype components and 9 metabolites） and nineteen transitional components （including 6 absorbed prototype components and 13 metabolites） in the plasma sample of normal rats and MIRI rats. Eight transitional components were detected in both normal rats and MIRI rats， and the VIP values of kaempferol glucuronidation metabolites， quercetin carbonylation metabolites and N-p-paprazine to the corresponding peak were higher than 1. Compared with MIRI group， the activities of SOD were increased significantly in the plasma of MIRI rats in each potential active compound group （P＜0.01）， and the leakages of LDH， CK-MB， and cTnⅠ in the plasma of MIRI rats were reduced significantly （P＜0.01）. CONCLUSIONS The potential anti-MIRI active components in extract of P. orientale flower are N-p-paprazine， quercetin， kaempferol and kaempferol-3-O-β-D-glucoside.

Objective To investigate the spatiotemporal distribution characteristics and potential influencing factors of newly diagnosed echinococcosis cases in Qinghai Province from 2016 to 2022, so as to provide insights into the formulation of the echinococcosis control strategy in Qinghai Province. Methods The number of individuals screened for echinococcosis, number of newly diagnosed echinococcosis cases, number of registered dogs and number of stray dogs were captured from the annual reports of echinococcosis control program in Qinghai Province from 2016 to 2022, and the detection of newly diagnosed echinococcosis cases was calculated. The number of populations, precipitation, temperature, wind speed, sunshine hours, average altitude, number of year-end cattle stock, number of year-end sheep stock, gross domestic product (GDP) per capita, and number of village health centers in each county (district) of Qinghai Province were captured from the Qinghai Provincial Statistical Yearbook, and county-level electronic maps in Qinghai Province were downloaded from the National Platform for Common Geospatial Information Services. The software ArcGIS 10.8 was used to map the distribution of newly diagnosed echinococcosis cases in Qinghai Province, and the spatial autocorrelation analysis of newly diagnosed echinococcosis cases was performed. In addition, the spacetime scan analyses of number of individuals screened for echinococcosis, number of newly diagnosed echinococcosis cases and geographical coordinates in Qinghai Province were performed with the software SaTScan 10.1.2, and the spatial stratified heterogeneity of the detection of newly diagnosed echinococcosis cases was investigated with the software GeoDetector. Results A total of 6 569 426 residents were screened for echinococcosis in Qinghai Province from 2016 to 2022, and 5 924 newly diagnosed echinococcosis cases were found. The detection of newly diagnosed echinococcosis cases appeared a tendency towards a decline over years from 2016 to 2022 (χ² = 11.107, P < 0.01), with the highest detection in Guoluo Tibetan Autonomous Prefecture in 2017 (82.12/10⁵). There were spatial clusters in the detection of newly diagnosed echinococcosis cases in Qinghai Province from 2016 to 2018 (Moran’s I = 0.34 to 0.65, all Z values > 1.96, all P values < 0.05), and the distribution of newly diagnosed echinococcosis cases appeared random distribution from 2019 to 2022 (Moran’s I = −0.09 to 0.04, all Z values < 1.96, all P values > 0.05). Local spatial autocorrelation analysis showed high-high clusters and low-low clusters in the detection of new diagnosed echinococcosis cases in Qinghai Province from 2016 to 2022, and space-time scan analysis showed that the first most likely cluster areas of newly diagnosed echinococcosis cases in Qinghai Province from 2016 to 2022 were mainly distributed in Yushu Tibetan Autonomous Prefecture and Guoluo Tibetan Autonomous Prefecture. GeoDetector-based analysis of the driving factors for the spatial stratified heterogeneity of detection of newly diagnosed echinococcosis cases in Qinghai Province showed that average altitude, number of village health centers, number of cattle and sheep stock, GDP per capita, annual average sunshine hours, and annual average temperature had a strong explanatory power for the spatial distribution of newly diagnosed echinococcosis cases, with q values of 0.630, 0.610, 0.600, 0.590, 0.588, 0.537 and 0.526, respectively. Conclusions The detection of newly diagnosed echinococcosis cases appeared a tendency towards a decline in Qinghai Province over years from 2016 to 2022, showing spatial clustering. Targeted control measures are required in cluster areas of newly diagnosed echinococcosis cases for further control of the disease.

Objective:The distribution and change characteristics of patients undergoing pelvic floor rehabilita-tion treatment were analyzed,the related influencing factors of patients with clinical symptoms and the characteris-tics of patients seeking treatment were preliminarily discussed.Methods:A retrospective analysis was conducted on the age,delivery mode,delivery times,treatment time and other data of patients(target population)who re-ceived pelvic floor rehabilitation treatment in the Third Affiliated Hospital of Guangzhou Medical University from January 2010 to December 2019.Results:①There were 3033 cases in the target population,72.8％(2209/3033)without clinical symptoms,showing a downward trend(P=0.000);The number of patients with clinical symptoms was 27.2％(824/3033),showing an increasing trend(P=0.000).Urinary incontinence accounted for 72.5％(597/824)of the eight categories.②In the past 10 years,the proportion of patients over 40 years old increased year by year(P=0.001).③The proportion of women giving birth through vagina was the highest(70.3％)and remained stable(P=0.054).④The proportion of first-time mothers was the highest(73.1％),and the number of patients with birth rate ≥2 showed an increasing trend(P=0.000);⑤84.8％(2573/3033)patients received pelvic floor rehabilitation treatment less than 1 year before the last delivery,and the treatment time more than 1 year before the last delivery showed an increasing trend(P=0.002,r=0.855).⑥Age ≥ 40 years old(OR 10.884,P＜0.001),3 pregnancies(OR 1.634,P=0.001),4 pregnancies(OR 1.908,P＜0.001),2 births(OR 1.305,P=0.038),3 births(OR 2.327,P=0.001),vaginal delivery(OR 2.079,P＜0.001)were risk factors for patients undergoing pelvic floor rehabilitation treatment.Conclusions:Urinary incontinence was the main symptom in patients with clinical symptoms after pelvic floor rehabilitation treatment,which showed an in-creasing trend.To strengthen early screening and intervention for women aged ≥40 years,with a history of vagi-nal delivery,≥3 times of pregnancy and≥2 times of birth,for women aged≥40 years and more than 1 year from the last delivery,the treatment time should be moved forward.

Objective:The distribution and change characteristics of patients undergoing pelvic floor rehabilita-tion treatment were analyzed,the related influencing factors of patients with clinical symptoms and the characteris-tics of patients seeking treatment were preliminarily discussed.Methods:A retrospective analysis was conducted on the age,delivery mode,delivery times,treatment time and other data of patients(target population)who re-ceived pelvic floor rehabilitation treatment in the Third Affiliated Hospital of Guangzhou Medical University from January 2010 to December 2019.Results:①There were 3033 cases in the target population,72.8％(2209/3033)without clinical symptoms,showing a downward trend(P=0.000);The number of patients with clinical symptoms was 27.2％(824/3033),showing an increasing trend(P=0.000).Urinary incontinence accounted for 72.5％(597/824)of the eight categories.②In the past 10 years,the proportion of patients over 40 years old increased year by year(P=0.001).③The proportion of women giving birth through vagina was the highest(70.3％)and remained stable(P=0.054).④The proportion of first-time mothers was the highest(73.1％),and the number of patients with birth rate ≥2 showed an increasing trend(P=0.000);⑤84.8％(2573/3033)patients received pelvic floor rehabilitation treatment less than 1 year before the last delivery,and the treatment time more than 1 year before the last delivery showed an increasing trend(P=0.002,r=0.855).⑥Age ≥ 40 years old(OR 10.884,P＜0.001),3 pregnancies(OR 1.634,P=0.001),4 pregnancies(OR 1.908,P＜0.001),2 births(OR 1.305,P=0.038),3 births(OR 2.327,P=0.001),vaginal delivery(OR 2.079,P＜0.001)were risk factors for patients undergoing pelvic floor rehabilitation treatment.Conclusions:Urinary incontinence was the main symptom in patients with clinical symptoms after pelvic floor rehabilitation treatment,which showed an in-creasing trend.To strengthen early screening and intervention for women aged ≥40 years,with a history of vagi-nal delivery,≥3 times of pregnancy and≥2 times of birth,for women aged≥40 years and more than 1 year from the last delivery,the treatment time should be moved forward.