ObjectiveTo investigate the mechanism of Tangbikang dry paste in the prevention and treatment of type 2 diabetic peripheral neuropathy （DPN） based on the glyoxalase-1 （GLO-1）/advanced glycation end products （AGE）/receptor for advanced glycation end products （RAGE） pathway. MethodsA total of 56 Sprague-Dawley rats were randomly divided， with eight assigned to the normal group. The remaining 48 rats were fed a high-fat diet combined with intraperitoneal injection of streptozotocin （STZ） to induce a type 2 diabetes mellitus （T2DM） model. Based on blood glucose levels， the rats were randomly assigned to the model group， Tanglin group （13.5 mg·kg^-1）， metformin group （135 mg·kg^-1）， and Tangbikang dry paste low-， medium-， and high-dose groups （3， 6， 12 g·kg^-1）. Successful modeling of DPN was confirmed by a decrease in mechanical pain threshold in the model group at week 4. Fasting blood glucose， body weight， and mechanical pain threshold were measured every 4 weeks. After 16 weeks of intervention， the pathological morphology of the sciatic nerve was observed using hematoxylin-eosin （HE） staining. The expression of RAGE， AGE， protein kinase C （PKC）， and collagen （COL） in the sciatic nerve was assessed by immunohistochemistry. The mRNA expression of RAGE， PKC， Toll-like receptor （TLR）， COL， and GLO-1 was detected using real-time quantitative PCR （Real-time PCR）. Serum levels of aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， creatinine （CREA）， urea （UREA）， interleukin-6 （IL-6）， and tumor necrosis factor （TNF）-α were measured by enzyme-linked immunosorbent assay （ELISA）. ResultsCompared with the normal group， the model group showed significantly increased fasting blood glucose （P<0.01）， decreased body weight and mechanical pain threshold （P<0.01）， and elevated serum AST， ALT， CREA， UREA， IL-6， and TNF-α levels （P<0.01）. The expression of RAGE， AGE， and PKC in the sciatic nerve was significantly increased （P<0.01）， while COL expression was decreased （P<0.01）. The mRNA expression of TLR， RAGE， and PKC was upregulated （P<0.01）， whereas COL and GLO-1 mRNA levels were downregulated （P<0.01）. Histological examination showed irregular nerve morphology， axonal alterations， and myelin degeneration. Compared with the model group， fasting blood glucose levels in the Tangbikang dry paste high-dose group at all time points and in the medium-dose group at weeks 4 and 16 were significantly reduced （P<0.05， P<0.01）. No significant changes in body weight were observed across all Tangbikang dose groups. The mechanical pain threshold was elevated at different time points after administration in all Tangbikang groups （P<0.05， P<0.01）. Serum IL-6 and TNF-α levels were decreased in all dose groups （P<0.05， P<0.01）. The expression of RAGE， AGE， and PKC in the sciatic nerve was reduced （P<0.01）， while COL expression was increased （P<0.01）. The mRNA expression of TLR， RAGE， and PKC was downregulated （P<0.01）， whereas GLO-1 mRNA expression was upregulated （P<0.05， P<0.01）. Additionally， COL mRNA expression was significantly increased in the low- and high-dose groups （P<0.01）. Pathological changes in the sciatic nerve were milder in all Tangbikang groups compared to the model group. ConclusionTangbikang dry paste significantly improves DPN， and its mechanism may be associated with the regulation of the GLO-1/AGE/RAGE signaling pathway.

ObjectiveTo investigate the mechanism of Tangbikang dry paste in the prevention and treatment of type 2 diabetic peripheral neuropathy （DPN） based on the glyoxalase-1 （GLO-1）/advanced glycation end products （AGE）/receptor for advanced glycation end products （RAGE） pathway. MethodsA total of 56 Sprague-Dawley rats were randomly divided， with eight assigned to the normal group. The remaining 48 rats were fed a high-fat diet combined with intraperitoneal injection of streptozotocin （STZ） to induce a type 2 diabetes mellitus （T2DM） model. Based on blood glucose levels， the rats were randomly assigned to the model group， Tanglin group （13.5 mg·kg^-1）， metformin group （135 mg·kg^-1）， and Tangbikang dry paste low-， medium-， and high-dose groups （3， 6， 12 g·kg^-1）. Successful modeling of DPN was confirmed by a decrease in mechanical pain threshold in the model group at week 4. Fasting blood glucose， body weight， and mechanical pain threshold were measured every 4 weeks. After 16 weeks of intervention， the pathological morphology of the sciatic nerve was observed using hematoxylin-eosin （HE） staining. The expression of RAGE， AGE， protein kinase C （PKC）， and collagen （COL） in the sciatic nerve was assessed by immunohistochemistry. The mRNA expression of RAGE， PKC， Toll-like receptor （TLR）， COL， and GLO-1 was detected using real-time quantitative PCR （Real-time PCR）. Serum levels of aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， creatinine （CREA）， urea （UREA）， interleukin-6 （IL-6）， and tumor necrosis factor （TNF）-α were measured by enzyme-linked immunosorbent assay （ELISA）. ResultsCompared with the normal group， the model group showed significantly increased fasting blood glucose （P<0.01）， decreased body weight and mechanical pain threshold （P<0.01）， and elevated serum AST， ALT， CREA， UREA， IL-6， and TNF-α levels （P<0.01）. The expression of RAGE， AGE， and PKC in the sciatic nerve was significantly increased （P<0.01）， while COL expression was decreased （P<0.01）. The mRNA expression of TLR， RAGE， and PKC was upregulated （P<0.01）， whereas COL and GLO-1 mRNA levels were downregulated （P<0.01）. Histological examination showed irregular nerve morphology， axonal alterations， and myelin degeneration. Compared with the model group， fasting blood glucose levels in the Tangbikang dry paste high-dose group at all time points and in the medium-dose group at weeks 4 and 16 were significantly reduced （P<0.05， P<0.01）. No significant changes in body weight were observed across all Tangbikang dose groups. The mechanical pain threshold was elevated at different time points after administration in all Tangbikang groups （P<0.05， P<0.01）. Serum IL-6 and TNF-α levels were decreased in all dose groups （P<0.05， P<0.01）. The expression of RAGE， AGE， and PKC in the sciatic nerve was reduced （P<0.01）， while COL expression was increased （P<0.01）. The mRNA expression of TLR， RAGE， and PKC was downregulated （P<0.01）， whereas GLO-1 mRNA expression was upregulated （P<0.05， P<0.01）. Additionally， COL mRNA expression was significantly increased in the low- and high-dose groups （P<0.01）. Pathological changes in the sciatic nerve were milder in all Tangbikang groups compared to the model group. ConclusionTangbikang dry paste significantly improves DPN， and its mechanism may be associated with the regulation of the GLO-1/AGE/RAGE signaling pathway.

The Internet of Bodies （IoB） refers to an embodied technology that treats the physical body as a network interface and embeds technological objects into the human body， aiming to collect massive body data. As an emerging technology， the widespread application of IoB in the field of smart healthcare will bring both advantages and disadvantages. It poses ethical risks in terms of physicality， psychology， and sociability， primarily manifested in the uncertainty of technology that may harm patients’ bodies， the easy restriction of patients’ autonomy by external technologies， and issues of fairness and equality caused by the technology gap. Faced with the realistic ethical dilemmas arising from IoB technology empowering smart healthcare， solutions were proposed across several levels. On the ethical mechanism level， an interdisciplinary and multi-field expert alliance should be established to promote the optimization of ethical governance mechanisms. In terms of ethical governance methods， a governance strategy prioritizing “pre-control” should be adopted to front-load ethical risks. On the practical application level， it was vital to clarify the reasonable application boundaries of technology in practice and integrate ethical morality into technology application behavior. Regarding social justice in technology resources， a dual approach of strengthening grassroots investment and educational guidance should be implemented to ensure ethical justice and accessibility in medical practice， thereby guiding the development of IoB technology to align with the fundamental principles of bioethics.

Objective To analyze the clinical and MR characteristics of fibroadenoma(FA)and phyllodes tumor(PT)with maxi-mum diameter≥5 cm.Methods A total of 33 cases with FA and 34 cases with PT were selected,and all lesions with maximum diameter≥5 cm were confirmed by surgical pathology.The clinical and MR characteristics were analyzed retrospectively.Results PT and FA with tumor maximum diameter≥5 cm were more common in perimenopausal women[(47.35±11.36)years old vs(49.42±11.73)years old,P>0.05],while the FA patient was with the wider age range(19-79 years old).There was statistically significant difference in tumor maximum diameter between PT group and FA group(P<0.001),and tumor maximum diameter of PT group(median 7.06 cm,tumor maximum diameter 17.3 cm)was significantly larger than that of FA group.Coarse calcification was more common in the FA group compared to the PT group(5 vs 0,P=0.011).High signal on T1WI was more common in PT group rela-tive to FA group(50%vs 9.1%,P<0.001).There were no significant differences between the two groups in four characteristics,including tumor margin lobulation(97.1%vs 81.8%),T2WI low signal separation(32.4%vs 30.3%),fibroglandular tissue(FGT),and background parenchymal enhancement(BPE)(P>0.05).Time-signal intensity curve(TIC)of FA group showed typeⅠ and Ⅱ curves,while 4 cases(11.8%)in PT group showed type Ⅲ curves,and there was statistically significant difference in TIC between the two groups(P=0.008).The apparent diffusion coefficient(ADC)values of PT group[(1.48±0.17)×10-3mm2/s]was slightly lower than that of FA group[(1.55±0.20)×10-3 mm2/s],and there was no significant difference in ADC between the two groups(P>0.05).The receiver operating characteristic(ROC)curve showed that the best diagnostic cut-off value for distinguishing between PT and FA with maximum diameter≥5 cm was 6.36 cm,the area under the curve(AUC)was 0.927[95%confidence in-terval(CI)0.860-0.994;P<0.001].The AUC of the T1 WI high signal was 0.705,and the standard error was 0.065(95%CI 0.578-0.831;P=0.004).Conclusion Among FA and PT with tumor maximum diameter≥5 cm,PT appear to be more larger lesion and prone to higher signal intensity on T1WI compared to FA,while coarse calcification is more common in FA.

Objective To evaluate the CT features and differential value of gastric leiomyomas(GLs)and gastric stromal tumors(GSTs)after propensity score matching.Methods Twenty-six GLs were 1∶1 propensity score matched to GSTs based on sex,age,tumor site and size.Tumor shape and contour,mucosal ulcer,tumor growth patterns,enhancement pattern and degree,the lon-gest diameter(LD)of the tumor,and the ratio of the LD to the vertical diameter(VD)were analyzed.CT signs included hemor-rhage,calcification,peripheral invasion,and distant metastasis,etc.Regression analysis was used to determine the best quantitative evaluation for differentiation of them.Results The presence of mucosal ulcer was significantly more frequent in GSTs than in GLs(P=0.032).Both tumors showed progressive enhancement;however,the enhancement degree of GSTs was significantly higher than GLs in the arterial and portal venous phases(P=0.004,P=0.002,respectively).The above influential factors were included in a regression analysis using enhancement degree of 18 HU and 23 HU in the arterial and portal venous phases as cutoff values respectively.An enhancement degree≤18 HU in the arterial phase was identified as an independent influential factor in the diagnosis of GLs[odds ratio(OR)=12.776,95％confidence interval(CI)1.270-128.535].No significant difference was found in other morphological characteristics(P＞0.05).Conclusion Less ulceration on the tumor surface and mild enhancement in arterial phase are characteristic features of GLs compared with GSTs.

Objective To investigate the expression of fibroblast growth factor (FGF)19 in neonatal hyperbilirubinemia and its correlation with intestinal flora characteristics and β-glucuronidase (β-GD) activity. Methods Seventy-five neonates with hyperbilirubinemia in Daqing Longnan Hospital from January 2022 to January 2023 were selected as the observation group and 45 neonates with non-hyperbilirubinemia during the same period were selected as the control group.Serum FGF19,total bilirubin and total bile acid levels,intesti-nal flora characteristics and β-GD activity were compared between the two groups.The correlation between FGF19,intestinal flora and β-GD activity with serum total bilirubin level and total bile acid (TBA) level in newborns with hyperbilirubinemia and the correlation between FGF19 with the intestinal flora characteristics and β-GD activity were analyzed by the Pearson method.Results The serum FGF19 level in the observation group was lower than that in the control group,the total bilirubin and TBA levels and β-GD activity were higher,the number of bifidobacterium and Lactobacillus were much less,the number of Escherichia coli was more,and the differences were statistically significant (P<0.05).The FGF19 level and number of bifidobac-terium and Lactobacillus in newborns with hyperbilirubinemia were negatively correlated with the levels of se-rum total bilirubin and TBA levels,while the number of Escherichia coli and β-GD activity were positively cor-related with the levels of serum total bilirubin and TBA (P<0.05).FGF19 in hyperbilirubinemia neonates was positively correlated with the number of bifidobacterium and Lactobacillus,and negatively correlated with Escherichia coli and β-GD activity (P<0.05).Conclusion The serum FGF19 in neonates with hyperbilirubinemia is abnormally low expressed,moreover which is related to intestinal flora disturbance and β-GD activity.

OBJECTIVE To investigate effects of children with allergic rhinitis on physical and mental condition of their family caregivers.METHODS The family caregivers of 149 children with allergic rhinitis were enrolled,and fatigue,anxiety and depression scales were investigated and risk factors were analyzed through questionnaires.RESULTS The symptoms of fatigue,anxiety and depression in family caregivers were more frequent in family caregivers whose children had more severe symptoms of allergic rhinitis(r=0.426,P=0.000;r=0.479,P=0.000;r=0.358,P=0.000).Family caregivers with children aged＜3 years or with other allergic diseases combined had higher levels of fatigue(P=0.000,P=0.000),anxiety(P=0.000,P=0.000)and depression(P=0.003,P=0.001),while the family caregivers of children with perennial/persistent symptoms had higher levels of depression(P=0.021).The degree of fatigue,anxiety and depression in females was significantly higher than that in males(P=0.032,P=0.018,P=0.021).CONCLUSION Children with allergic rhinitis in children had significant impact on the fatigue,anxiety and depression of their family caregivers.The symptoms of fatigue,anxiety and depression were related to age of children,characteristics of disease,whether they were combined with other allergic diseases,and gender and education level of the family caregivers.

Diabetic foot(DF)is a common chronic complication in patients with diabetes.Fibrosis and degeneration occurred in fasciae in long term hyperglycemia and inflammatory environment.Fibrosis in fasciae may aggravate the development of diabetic foot due to the special cellular and molecular structure,physiological and biomechanical effects.Thus,we aimed at reviewing the research progress of fascial fibrosis in diabetic foot.

Objective:To analyze the safety and effectiveness of superselective embolization of the uterine arteries in the treatment of uterine fibroids.Methods:The clinical data of 60 patients with uterine fibroids who were admitted to Zhejiang Veteran Hospital from February 2020 to February 2022 were retrospectively analyzed. These patients were divided into a control group and an observation group ( n = 30/group) according to different surgical methods. The control group underwent conventional surgery. The observation group underwent superselective embolization of the uterine arteries. Uterine size, uterine fibroid size, postoperative hormone level, and complications were compared between the two groups. Results:There was no significant difference in total response rate between the observation and control groups [93.33 (28/30) vs. 83.33 (25/30), χ2 = 1.46, P > 0.05]. After surgery, serum estradiol, luteinizing hormone, follicle-stimulating hormone, and progesterone levels in the observation group were (164.14 ± 19.97) ng/L, (2.43 ± 1.47) IU/L, (2.51 ± 1.14) IU/L, and (5.05 ± 0.43) μg/L, respectively, which were significantly lower than (190.23 ± 21.62) ng/L, (3.78 ± 1.63) IU/L, (3.94 ± 1.23) IU/L, (8.22 ± 1.35) μg/L in the control group ( t = 4.86, 3.37, 4.67, 12.25, all P < 0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group [3.33% (1/30) vs. 20.00% (6/30), χ2 = 4.04, P < 0.05). Conclusion:Compared with conventional surgery, superselective embolization of the uterine arteries is more effective on uterine fibroids, better keep postoperative hormone level stable, and reduce or avoid short- and long-term complications. Therefore, superselective embolization of the uterine arteries for the treatment of uterine fibroids deserves the clinical promotion.

Objective:To compare the short-term efficacy between our self-designed intelligent robot-assisted minimally invasive reduction system and conventional freehand reduction assisted by fluoroscopy in the treatment of unstable pelvic fractures by robot or fluoroscopy-assisted internal fixation with percutaneous screws.Methods:A prospective randomized controlled trial was conducted to include eligible 35 patients with unstable pelvic fracture who were admitted to Department of Orthopaedic Trauma, Beijing Jishuitan Hospital from December 2021 to October 2022. They were randomized into 2 groups. The observation group[17 cases, 10 males and 7 females with an age of (44.0±17.4) years] was treated with robot-assisted minimally invasive reduction, followed by robot-assisted or fluoroscopic internal fixation with percutaneous screws; the control group[18 cases, 12 males and 6 females with an age of (38.8±15.0) years] was treated with freehand reduction assisted by fluoroscopy, followed by robot-assisted or fluoroscopic internal fixation with percutaneous screws. The 2 groups were compared in terms of operation time, intraoperative bleeding, successful reduction, reduction quality, incidence of surgical complications and postoperative functional scores.Results:The 2 groups were comparable because there were no significant differences in the preoperative general data between them ( P>0.05). The intraoperative fluoroscopy frequency[(32.4±17.5) times] and fluoroscopy time [(19.8±10.4) s] in the observation group were significantly lower or shorter than those in the control group [(60.8±26.6) times and (38.2±16.1) s], and the rate of successful reduction in the observation group was 100.0% (17/17), significantly higher than that in the control group[72.2% (13/18)] ( P<0.05). There was no significant difference between the 2 groups in intraoperative bleeding, operation time, reduction error, excellent and good rate of reduction after operation by Matta scoring, or Majeed functional score at 12 weeks after operation ( P>0.05). Conclusion:In the treatment of unstable pelvic fractures, since our self-designed intelligent robot-assisted minimally invasive reduction system can plan autonomously the reduction paths and accomplish minimally invasive reduction of the fracture with 3D images real-time monitoring, it is advantageous over conventional reduction methods in a higher success rate and less radiation exposure.