It is believed that Shengyang Yiwei Decoction （升阳益胃汤， SYD） is effective in regulating the flow of Qi （气）， and can treat various diseases caused by the disorder of the spleen and stomach Qi. In clinical practice， based on the pathological characteristics of children often having insufficient spleen， and adhering to the principle of treating different diseases with the same method， the focus is placed on the core pathogenesis of spleen and stomach Qi disharmony. We use SYD in various pediatric conditions such as allergic rhinitis， post COVID-19 condition， urethral syndrome， and dysfunctional uterine bleeding in adolescence， and emphasize the treatment is flexibly tailored to the symptoms.

With the evolving understanding of the diagnosis and treatment of coronary artery disease （CAD）， current syndrome differentiation systems in traditional Chinese medicine （TCM） are increasingly insufficient in capturing the dynamic progression of the disease and often overlook clinical prognosis. This paper proposes the establishment of a TCM syndrome element differentiation system for CAD based on disease progression. Syndrome elements are categorized into core elements， fundamental elements， and evolutionary elements. The core element is blood stasis， which is regarded as the primary pathogenic factor in the onset of CAD. The fundamental elements， qi stagnation， cold congealment， phlegm turbidity， qi deficiency， yin deficiency， and yang deficiency， are commonly coexisting factors throughout the course of CAD. The evolutionary elements， collateral wind and latent toxin， are key pathogenic factors driving the transformation from chronic to acute stages of the disease. This new system aims to emphasize the evolution of disease over time， with a focus on improving long-term clinical outcomes.

BACKGROUND:Rheumatoid arthritis is an inflammatory disease.Many studies have shown that wogonin has a good anti-inflammatory effect on rheumatoid arthritis,but its exact efficacy and specific mechanism of action remain to be clarified. OBJECTIVE:To investigate the mechanism of wogonin ameliorating joint inflammation by regulating endoplasmic reticulum stress pathway in rats with collagen-induced arthritis. METHODS:(1)At the animal level:Female Wistar rats were divided into healthy control group,arthritis model group and wogonin treatment group.Rat models of arthritis in the latter two groups were established by subcutaneous injection of bovine type Ⅱ collagen and adjuvant.In the wogonin group,wogonin was given by gavage for 28 consecutive days after modeling.During this period,the rats in each group were weighed,and arthritis score and ankle swelling were measured every 7 days.After the experiment,the pathological changes of the joint were observed,the mRNA and protein levels of endoplasmic reticulum stress pathway GRP78 and CHOP were detected by qRT-PCR,western blot,and immunohistochemistry.(2)At the cellular level,cell counting kit-8 was used to detect the cytotoxic effect of wogonin on fibroblast-like synoviocytes from rats with collagen-induced arthritis.The fibroblast-like synoviocytes induced by thapsigargin were treated with different concentrations of wogonin.The levels of interleukin-1β and tumor necrosis factor-α in the cell supernatant were detected by ELISA,and the intracellular reactive oxygen species in each group were determined by DCFH-DA probe method.The mRNA and protein levels of GRP78,IRE1α,XBP1s and CHOP were detected by qRT-PCR and western blot,respectively. RESULTS AND CONCLUSION:Compared with the healthy control group,arthritis index score and ankle swelling degree in the arthritis model group were increased(P<0.01),synovial hyperplasia,inflammatory cell infiltration,cartilage destruction and bone erosion were observed in pathological sections,and the mRNA and protein expressions of GRP78 and CHOP in the ankle were significantly increased(P<0.01),which were mainly located in synovial tissue and articular surface.Compared with the arthritis model group,the arthritis index score and ankle swelling degree in the wogonin treatment group were decreased(P<0.05),synovial hyperplasia and the number of inflammatory cells were decreased,cartilage destruction and bone erosion were alleviated,the mRNA and protein expression levels of GRP78 and CHOP in the ankle were decreased(P<0.05),particularly in synovial tissue and on the articular surface.There was no significant difference in body mass among the three groups(P>0.05).In the cell experiment,200 μmol/L wogonin significantly reduced the survival rate of fibroblast-like synoviocytes(P<0.01).Compared with the blank control group,the levels of interleukin-1β,tumor necrosis factor-α,content of reactive oxygen species,and mRNA and protein expression of GRP78,IRE1α,XBP1s,and CHOP in the thapsigargin group were significantly increased(P<0.05);compared with the thapsigargin group,50 and 100 μmol/L wogonin significantly reduced the levels of interleukin-1β and tumor necrosis factor-α in the cell supernatant(P<0.05,P<0.01),and 100 μmol/L wogonin significantly reduced the content of reactive oxygen species(P<0.01)and down-regulated the mRNA and protein expression levels of GRP78,IRE1α,XBP1s and CHOP(all P<0.05).These results suggest that wogonin can effectively alleviate joint inflammatory responses in rats with collagen-induced arthritis,and the endoplasmic reticulum stress pathway may be the key target of its intervention.

AIM: To evaluate the clinical efficacy of intense pulsed light(IPL)therapy in patients with primary Sjogren's syndrome-related dry eye(SS-DE).METHODS:In this prospective randomized trial, 82 cases(82 eyes)diagnosed with moderate-to-severe SS-DE at our hospital from January 2023 to December 2023 were selected. If both eyes meet the criteria, one eye will be randomly selected for inclusion, and if one eye meets the inclusion criteria, the eye will be selected for enrollment. They were randomly assigned to either an experiment group receiving dextran hydroxypropyl methylcellulose eye drops and 0.05% cyclosporine A eye drops plus IPL therapy, or a control group receiving dextran hydroxypropyl methylcellulose eye drops and 0.05% cyclosporine A eye drops. Ocular surface disease index(OSDI)score, tear meniscus height(TMH), noninvasive tear breakup time(NITBUT), meibomian gland loss score, Schirmer I test(SⅠt), corneal fluorescein staining(CFS)score, conjunctival lissamine green staining(CLGS)score, lipid layer thickness(LLT), blink frequency, corneal Langerhans cell density(CLCD)and complications of both groups were assessed at baseline and at 4, 8, and 12 wk after treatment.RESULTS:There were 6 cases lost to follow-up in the experiment group, with a missing rate of 14.6%, and 1 case was lost to follow-up in the control group, with a missing rate of 2.4%, and valid data were eventually obtained from 35 cases(35 eyes)in the experiment group and 40 cases(40 eyes)in the control group. Baseline parameters did not differ significantly between the two groups of patients(all P>0.05). At 4, 8 and 12 wk after treatment, both groups showed significant reductions in OSDI scores, CFS scores, CLGS score, blink frequency, and CLCD, while the reductions were significantly greater in the experiment group compared to the control group(all P<0.05). The experiment group also demonstrated significant increases in TMH, SⅠt, and NITBUT at 4, 8 and 12 wk after treatment, which were significantly greater than those observed in the control group(all P<0.05). No significant intergroup differences were observed in LLT, meibomian gland loss score in the experiment group at any time point(all P>0.05). Furthermore, no severe ocular or cutaneous complications were associated with IPL treatment.CONCLUSION:IPL significantly improves ocular signs and symptoms, enhances aqueous tear secretion, and reduces ocular surface inflammation in patients with SS-DE, with no significant adverse reactions observed.

AIM: To evaluate the efficacy of 0.01% hypochlorous acid as a conjunctival sac disinfectant before cataract phacoemulsification and its impact on the ocular surface.METHODS: Randomized controlled clinical trial. A total of 285 patients who were scheduled for cataract phacoemulsification surgery were randomly divided into the hypochlorous acid group and the povidone iodine group. Before and after disinfection, conjunctival sac swabs were taken, and bacterial culture and colony-forming units(CFUs)testing were performed using blood agar and chocolate agar media, respectively. All patients were evaluated for ocular symptom scores and pain severity scores 2 h, 1 d, and 1 wk after disinfection, and underwent corneal fluorescein staining, eye redness index, tear meniscus height, and noninvasive breakup time(NIBUT)examination. The incidence of endophthalmitis after surgery was recorded.RESULTS: Conjunctival sac disinfection with 0.01% hypochlorous acid significantly reduced the rate of positive bacterial cultures and colony-forming ability of the conjunctival sac, with statistically significant differences compared with the pre-disinfection period(both P<0.01), and the disinfecting ability of hypochlorous acid was comparable to that of povidone-iodine(χ2=0.811, P=0.368). The scores of ocular symptoms and pain severity in the hypochlorous acid group were significantly lower than those in the povidone-iodine group(both P<0.01). The corneal fluorescein staining and eye redness index in the hypochlorous acid group were significantly lower than those in the povidone-iodine group(all P<0.01). No endophthalmitis occurred in either group of patients. CONCLUSION: As a conjunctival sac disinfectant, 0.01% hypochlorous acid is safe and effective, with minimal discomfort and damage to the ocular surface in patients.

Purpose/Significance Based on the typical use scenario of sensitive personal information in medical and health institu-tions,the implementation of the secure use of sensitive personal information is explored.Method/Process For user registration,internal utilization and interaction,medical device/wearable device collection and information disclosure and other scenarios,the paper analyzes the risk of sensitive personal information leakage,explores the application scenarios,advantages and disadvantages of various technical means such as identity authentication,access control,data encryption,data desensitization and detection audit.Result/Conclusion The application of technical means can assist medical and health institutions to further protect the security of patients'personal information.

Objective Tto evaluate the effect of low intensity pulsed ultrasound(LIPUS)on the migration and phagocytosis ability of lipopolysaccharide(LPS)-induced RAW264.7 macrophages and on macrophage behavior under inflammation.Methods An in vitro activated RAW264.7 macrophage model was developed using LPS.Cell viability was assessed using a CCK-8 assay to explore the effect of LIPUS on activated and inactivated macrophages.Wound healing assays were employed to measure the effect of LIPUS on macrophage migration,and the Transwell assay was employed when LPS was used as a chemoattractant.Phagocytosis ability was examined using confocal microscopy and flow cytometry by observing the FITC fluorescence signal of internalized pHrodo Green E.coli BioParticles Conjugate.Results An activated RAW264.7 macrophage model was successfully developed using 100 ng/mL LPS.LIPUS inhibited the migration of inactivated macrophages into scratch areas as well as guided cell migration.However,cell viability and phagocytosis remained unchanged.Conclusion LIPUS may inhibit RAW264.7 migration but not affect the phagocytosis ability of the macrophages.

OBJECTIVE To observe the auxiliary analgesic effect of electroacupuncture at Hegu and Neiguan combined with in-domethacin suppository in patients undergoing transvaginal ultrasound-guided oocyte retrieval(TUGOR and its effect on the outcome of in vitro fertilization(IVF.METHODS 64 IVF-ET patients undergoing TUGOR were randomly divided into a treatment group and a control group,32 cases in each group.One case dropped out of the treatment group during the treatment.The control group was given indomethacin suppository rectal administration,and the treatment group was given electroacupuncture at Hegu and Neiguan in addition to the treatment of the control group.The patients'tenderness threshold,VAS score,pain grade score,respiratory rate,and pulse rate were evaluated before and after TUGOR operation.The number of oocytes obtained,the rate of two pronuclei(2PN,embryo utiliza-tion rate,and high-quality embryo rate were evaluated after TUGOR operation.The adverse reactions of the two groups were monitored during and after operation.RESULTS After TUGOR operation,the VAS score and pain grade of the treatment group were signifi-cantly lower than those of the control group(P<0.01;the tenderness threshold of the two groups was significantly reduced after opera-tion(P<0.05,P<0.01,and the treatment group was better than the control group(P<0.05;the incidence of nausea during opera-tion,abdominal distension and nausea 48 h after operation in the treatment group were better than those in the control group(P<0.05;the high-quality embryo rate in the treatment group was better than that in the control group(P<0.05.CONCLUSION Electroacupuncture at Hegu and Neiguan combined with indomethacin suppository can effectively assist in analgesia,and can reduce the incidence of adverse reactions during and after TUGOR to varying degrees,and may have certain advantages in improving the rate of high-quality embryos.

Objective To investigate the effects of 0.5 Gy 60Co γ-ray irradiation on intestinal tissue injury and intestinal microflora in mice.Methods C57BL/6N mice were irradiated with 0.5 Gy 60Co γ-ray at 1 d,3 d,7 d and 14 d after irradiation.Jejunum tissues were fixed and frozen,and feces were frozen.Hematoxylin-eosin staining was used to observe the pathological injury to jejunum after irradiation,ki67 immunohistochemical staining was adopted to detect the proliferation of jejunum crypt cells,and TdT-mediated dUTP nick end labeling was employed to detect the apoptosis of jejunum crypt cells.The expressions of TNF-α,IL-1β,IL-6 and IL-10 cytokines in small intestines were detected via radioimmunoassay.The changes of intestinal flora in mice after irradiation were analyzed by metagenomic sequencing,and LEfSe analysis and ROC analysis were used to screen the bacteria with significant differences.Results After 0.5 Gy 60Co γ-ray irradiation,the proliferative cells of the jejunal crypt were significantly decreased at 1 d after irradiation(P＜0.05),while the apoptotic cells were significantly increased at 1 and 3 d after irradiation(P＜0.01).The expression of TNF-α at 7 and 14 d after irradiation,that of IL-1 β at 1,3,7 and 14 d after irradiation and that of IL-6 at 3,7 and 14 d after irradiation were significantly increased(P＜0.05),while the expression of IL-10 at 7 and 14 d after irradiation was significantly decreased(P＜0.05).After 0.5 Gy 60Co γ-ray irradiation,intestinal flora composition changed significantly at phylum,genus and species levels,and Lactobacillus murinus,Lactobacillus johnsonii,Alistipes-unclassified,Mucispirillum schaedleri underwent the most significant changes and had higher LDA scores.Conclusion The whole body irradiation of 0.5 Gy 60Co γ-ray can cause intestinal tissue damage and change the composition of intestinal flora in mice.

Objective To investigate the effectiveness of intravenous thrombolytic therapy mode led by fast-track specialist nurses on patients with acute ischemic stroke(AIS).Methods This study involved 124 AIS patients who underwent intravenous thrombolytic therapy in the Department of Emergency of our hospital from March 2021 to February 2023.Among the patients,61 admitted between March 2021 and February 2022 received conventional AIS thrombolytic therapy were assigned to a control group.While the 63 patients who received AIS thrombolytic therapy under the specialist nurse-led intravenous thrombolytic therapy mode between March 2022 and February 2023 were assigned to an observation group.The two groups were compared in terms of the time from admission to completion of CT examination,time for signing the informed consent for thrombolytic therapy,door to needle time and percentage of DTN<60 minutes,as well as the post-thrombolysis scores according to the National Institute of Health Stroke Scale(NIHSS)and satisfaction to medical consultation.Results The observation group exhibited a significantly shorter time from admission to completion of CT examination,a shorter time for signing an informed consent for thrombolytic therapy,a shorter door to needle time and a higher percentage of DTN<60 minutes,all with significant difference in comparison with those in the control group.After thrombolysis,the NIHSS score of the observation group decreased more than that of the control group(P<0.05).The patients and their families in the observation group reported significantly higher satisfaction compared to those in the control group(both P<0.05).Conclusion The fast-track specialist nurse-led intravenous thrombolytic therapy mode demonstrates the superiority in reduction of the time from admission to completion of CT examination,time for signing an informed consent for thrombolytic therapy,door to needle time and the NIHSS scores,higher percentage of DTN<60 minutes as well as improvement of patient satisfaction.