ObjectiveTo investigate the microbiological characteristics of bile in patients with common bile duct stones alone or comorbid with juxtapapillary duodenal diverticula （JPDD）. MethodsA prospective study was conducted among 30 patients with common bile duct stones who were admitted to Department of Gastroenterology， Hebei General Hospital， from January to May 2024， and according to the presence or absence of JPDD， they were divided into JPDD group and simple common bile duct stones group （CBD group）， with 15 patients in each group. Bile samples were collected during endoscopic retrograde cholangiopancreatography， and 16S rRNA microbial sequencing was performed to compare the differences in microbial composition， diversity， and metabolic pathways between the two groups. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. Pearson correlation analysis or Spearman correlation analysis was used to analyze the correlation between clinical indicators and microbial species abundance. ResultsClinical data showed that compared with the CBD group， the JPDD group had significantly greater maximum diameter of stones （10.87±3.42 mm vs 6.80±2.08 mm， t=3.94， P0.01） and common bile duct diameter （14.73±3.95 mm vs 9.67±2.64 mm， t=4.13， P0.01）. The microbiological analysis of the bile showed that Proteobacteria， Bacteroidetes， Firmicutes， and Actinobacteria were the most common phyla in both groups， and Proteobacteria was the dominate phylum in the JPDD group. At the genus and species levels， the JPDD group had higher relative abundances of Escherichia-Shigella， Enterococcus， and Escherichia coli. Alpha diversity was similar between the two groups， and there was a significant difference in beta diversity between the two groups （Adonis test， P0.05）. The LEfSe analysis identified 25 differentially expressed species （LDA2） between the two groups， and the JPDD group had enrichment of 7 flora such as Enterobacter， Enterococcaceae， and Klebsiella， while the CBD group had significant enrichment of 18 flora such as Peptococcaceae， Roseburia， and Alistipes （P0.05）. The correlation analysis showed that Enterococcaceae and Enterococcus significantly enriched in the JPDD group were positively correlated with the diameter of the common bile duct and the maximum diameter of stones （P0.01）， whereas Peptococcaceae， Acinetobacter， and Alistipes with reductions in expression were negatively correlated with the diameter of the common bile duct and the maximum diameter of stones （P0.05）. The enrichment analysis of biliary microbial metabolic pathways showed that there were significant differences between the two groups in 10 metabolic pathways such as cell growth and death， transportation and decomposition， nervous system， biosynthesis of valine， leucine， and isoleucine， and histidine metabolism （P0.05）. ConclusionThe presence of JPDD may lead to alterations in bile microbiota， such as an increase in Enterococcus and a reduction in Roseburia， and specific flora and metabolism can promote the formation of common bile duct stones.

Neurodegenerative diseases are a group of diseases caused by degeneration and dysfunction of the cells and tissues of the central nervous system， mainly including Alzheimer's disease （AD）， Parkinson's disease （PD）， and epilepsy. A common clinical manifestation of these diseases is cognitive decline. Neurodegenerative diseases are more common in the elderly. As population aging is aggravating， neurodegenerative diseases have aroused increasing concern since they seriously affect human health and quality of life. The pathogenesis of neurodegenerative diseases is complex， mainly related to mitochondrial dysfunction， apoptosis， neurotoxin， neurotransmitter abnormalities， oxidative stress， and inflammation. Although western drugs on the market can attenuate the symptoms of neurodegenerative diseases， they may induce severe adverse reactions and are thus not conducive to long-term use by the patients. The Chinese herbal medicine Angelicae Sinensis Radix was first recorded in the Shennong's Classic of Materia Medica （Shen Nong Ben Cao Jing）. It has the functions of activating blood， tonifying blood， modulating the immune system， regulating menstruation， and relieving pain. This paper summarizes the research progress in the effects of Angelicae Sinensis Radix and the prescriptions containing this medicine on neurodegenerative diseases in recent 10 years， aiming to provide a reference for the future application and research of Angelicae Sinensis Radix in the treatment of neurodegenerative diseases.

Objective To provide pharmaceutical care for patients with hepatitis B cirrhosis by using the medication therapy management(MTM)model combined with Pharmaceutical Care Network Europe(PCNE),and to analyze the effectiveness of pharmaceutical care from clinical efficacy,safety,humanistic effect and drug-related problems(DRPs).Methods Patients with hepatitis B cirrhosis were randomly divided into the pharmaceutical care group and the control group who received only conventional treatment.Clinical pharmacists used MTM combined with PCNE to provide pharmaceutical care in the pharmaceutical care group.Economic effects,clinical indicators,safety,medication compliance and quality of life were compared between the two groups during the treatment and follow-up period.DRPs were analyzed in the pharmaceutical care group.Results The cost-utility ratio and clinical indicators in the pharmaceutical care group were better than those in the control group,and the adverse drug reactions of the former were statistically significant compared with the latter at the three months follow-up,and medication compliance and quality of life were statistically significant after intervention and during follow-up(P＜0.05).There were 52 DRPs in the pharmaceutical care group,mainly in the category of poor treatment outcome.The main reasons were poor drug selection and excessive usage and dosage.There were 46 DRPs accepted by intervention,and 45 DRPs were completely and partially solved.Conclusion The pharmaceutical care model of MTM combined with PCNE classification system for patients with hepatitis B cirrhosis played a positive role in the treatment and follow-up period.

Humans ; Phosphorylation ; Serine ; Protein Serine-Threonine Kinases/metabolism* ; Spasms, Infantile

ObjectiveTo summarize the thinking of treatment of headache based on syndrome differentiation by reviewing the literature of materia medica in the past dynasties， so as to guide the clinical practice. MethodAll the literature of materia medica in the Chinese Medical Dictionary， involving 76 works from Han to Qing Dynasties， were searched， and the information of the herbs for treating headache was extracted. According to Chinese Materia Medica （11th Edition） and Pharmacopoeia of the People's Republic of China （2020 Edition）， the nature， taste， and meridian tropism of the selected herbs were statistically analyzed， and the syndrome elements of headache were classified and counted. In addition， the contents of syndrome differentiation and treatment of headache by different herbs were extracted. ResultFrom the 76 monographs of materia medica in the past dynasties， 114 herbs for treating headache were selected. The herbs mainly had cold or warm nature， pungent or bitter taste， and tropism to the lung and live meridians. The syndrome elements of headache treated by the herbs mainly included wind attack， fire disturbance， turbid obstruction， stagnation， cold coagulation， and healthy Qi deficiency. ConclusionHeadache is mainly treated with the herbs with the effects of dispelling pathogenic wind， clearing heat and purging fire， eliminating phlegm and resolving dampness， regulating Qi movement and activating blood， warming Yang and dispelling cold， and tonifying deficiency and reinforcing healthy Qi， and the herbs are often used in combinations. Headache is treated following the principles of dispelling wind and pathogen， regulating Qi and blood， and tonifying deficiency and purging excess， which is in line with the laws of obstruction and nutrient deficiency causing pain.

ObjectiveTo evaluate the changes of the usage of oil， salt， sugar and nutritional knowledge and behavior intervention among diners before and after the establishment of healthy canteens and restaurants in Shanghai. MethodsA comprehensive intervention was conducted through the establishment of healthy canteens and restaurants， encompassing interventions such as oil， salt， and sugar management， improvement of nutritional environment， staffing and training activities， and nutrition labeling guidance. A pre-post self-controlled study design was used to compare changes in oil， salt and sugar usage， as well as diners’ knowledge and behaviors related to nutrition and nutrition labeling， before and after the intervention. ResultsAfter intervention， the total usage of oil， salt， and sugar per meal in the canteens and restaurants decreased by 18.33%， 14.83%， and 13.66%， respectively，and all had statistically significance differences（P<0.001）. The awareness rate of "cooking oil intake"， "salt intake"， and "added sugar intake" among diners increased from 24.07% to 38.04%， 58.52% to 71.28%， and 26.85% to 45.01%， respectively. The awareness rate of "daily food types" and "weekly food types" increased from 43.07% to 56.53% and 49.52% to 64.32%， with significant differences （P<0.001）. The rate of understanding the content of nutrition labels increased from 66.91% to 76.90%， the awareness rate of nutrition labels increased from 53.59% to 69.06%， the rate of active reading of nutrition labels among diners increased from 73.38% to 81.23%， and the rate of selecting and purchasing food based on the information of nutrition labels increased from 69.27% to 77.79%， all of which were statistically significant （P<0.001）. ConclusionThe comprehensive interventions carried out through the creation of healthy canteens and restaurants have significantly impact on usage of oil， salt， and sugar， as well as on the nutritional knowledge and behaviors of diners.

As the guiding theory for the diagnosis and treatment of encephalopathy in traditional Chinese medicine （TCM）， The marrow sea theory has important theoretical connotation and clinical value. This paper summarized the clinical research literature on the differentiation and treatment of common encephalopathy based on the marrow sea theory published in recent years， analyzed the treatment method and effects from eight aspects in terms of stroke， dizziness， insomnia， headache， constraint syndrome， dementia， tremor syndrome， and atrophy syndrome， and discussed the possible mechanism based on the relevant basic research. It is believed that marrow sea depletion is the common pathogenesis of encephalopathy in TCM. Guided by the method of supplementing essence and boosting marrow， the corresponding formulas and medicinals are recommended in accordance with differentiated syndromes， which can effectively improve the symptoms of the disease， delay the progression， increase the daily life ability of the patients， and improve the quality of life. Based on the marrow sea theory， the method of supplementing essence and boosting marrow， rectifying healthy qi and dispelling pathogen can be used to highlight the advantages of TCM and provide ideas for the diagnosis and treatment of encephalopathy in TCM.

Objective:To evaluate the efficacy and safety of oral anisodine hydrobromide tablets in the treatment of nonarteritic anterior ischemic optic neuropathy (NAION).Methods:A multicenter nonrandomized controlled trial was conducted.A total of 282 acute NAION patients (282 eyes) were recruited from 16 hospitals in China from July 2020 to May 2021.Patients were divided into two groups according to treatment methods, which were control group (124 cases, 124 eyes) receiving regular treatment including citicoline sodium plus Ginkgo biloba leaf liquid extract or Ginkgo biloba leaf extract tablets plus mecobalamin, and experimental group (158 cases, 158 eyes) receiving treatment in control group plus oral anisodine hydrobromide tablets 1 mg, twice daily for 2 to 3 months.Best corrected visual acuity (BCVA), visual field index (VFI), peripapillary retinal nerve fiber layer (pRNFL) and radial peripapillary capillary vessel density (RPC) were assessed at 1, 2, 3, and 6 months after enrollment using the standard decimal visual acuity chart, 750i Humphery visual field analyzer, Cirrus HD-OCT 4000/Cirrus HD-OCT 5000, RTVue-XR optical coherence tomography respectively.The primary outcomes were BCVA and VFI, and the secondary outcomes were pRNFL, RPC, and the side effects during the follow-up.The study adhered to the Declaration of Helsinki.All patients were fully informed about the treatment and purpose of this study and voluntarily signed the informed consent form.The study protocol was approved by Chinese PLA General Hospital (No.S2020-021-01). Results:In all, 242 patients (242 eyes) completed the follow-up of BCVA, and 98 patients (98 eyes) completed the VFI follow-up.In terms of visual function, BCVA and VFI improved significantly over time in the two groups, and BCVA and VFI were better in experimental group than in control group at various follow-up time points (all at P<0.05). In terms of structure, pRNFL gradually decreased in both groups with the extension of treatment, and pRNFL was significanthy thinner in experimental group than in control group at various follow-up time points (all at P<0.05). There was no significant difference in RPC between the two groups at the last follow-up ( P>0.05). There were two cases with side effects and one case was discontinued due to side effects 25 days after enrollment. Conclusions:Oral anisodine hydrobromide can improve visual acuity and visual field in NAION and accelerate the regression of optic disc edema, with good safety.

Objective:To clarify peripheral Th17 level in SSc patients and its correlation with disease.Methods:Chinese databases CNKI, CBM, Wanfang and VIP, and English databases PubMed, EMBASE, Web of Science, Cochrane Library and Science Direct were searched to collect a case-control study on the content of Th17 cells in peripheral blood of patients with SSc. The papers published when the database was first developed in 25 February 2021. Meta-analysis was conducted using Stata 12.0 software, and I2 and Egger tests were used to evaluate the heterogeneity and publication bias between studies. Results:A total of 26 case-controls were included in the study, including 1 160 patients with SSc and 778 healthy controls. Overall, the percentage of Th17 cells in SSc patients was higher than in healthy controls [SMD(95% CI)=1.85 (1.33, 2.38), P<0.001], which was most significant in IL-17 +Th17 concentration [SMD(95% CI)=1.88 (1.28, 2.48), P<0.001]. As for disease activity, the proportion of Th17 cells in active SSc patients was much higher than those of patients in remission [SMD(95% CI)=1.92 (1.12, 2.71), P<0.001]. SSc patients had a reduced Th17 level after receiving DMARDs treatment [SMD(95% CI)=-0.74 (-1.05, -0.42), P=0.029]. Conclusion:The number of Th17 cells increase significantly in the peripheral blood of patients with SSc, and is related to disease activity. DMARDs can be used to treat this disease by downregulating Th17 levels.

Objective To investigate the current situations and analyse the influencing factors of self-compassion in patients 3 months after colorectal cancer surgery,so as to provide a basis for clinical interventions.Methods This cross-sectional survey was conducted from August 2020 to January 2022 among 190 patients who were at 3 months after colorectal cancer surgery in a tertiary hospital in sichuan.General information questionnaire,self-compassion scale,Connor-Davidson resilience scale and meaning in life questionnaire were used in the survey.Results Total scores of self-compassion,mental toughness and meaning of life after colorectal cancer surgery were 76.69±9.68,58.01±12.54 and 36.02±12.22,respectively.With analysis of multiple linear regression,the influencing factors of self-compassion were found as comorbid chronic diseases,postoperative stoma,postoperative radiotherapy,mental toughness and meaning of life(all P<0.05),toally explaining 58.4%its varience.Conclusions The self-compassion of patients with colorectal cancer is at a moderately lower level and the influencing factors of it include comorbid chronic diseases,postoperative stoma,postoperative radiotherapy,mental toughness and meaning of life.Medical staff should assess the psychological status of the patients,strengthen a psychological care and help patients to gain correct cognitive views for the purpose to improve the self-compassion of patients.