Objective To summarize the clinical and genetic characteristics of children with sodium taurocholate co-transporting polypeptide(NTCP)deficiency.Methods Clinical data of children with NTCP deficiency diagnosed and treated at the First People's Hospital of Yunnan Province from July 2022 to March 2025 were retrospectively analyzed.Results A total of 14 children were included(6 males,8 females),all with normal growth and development.Reasons for initial consultation included elevated serum bile acids in 7 cases,jaundice in 4 cases,cholestatic hepatitis in 1 case,and one case each of pneumonia and cow's milk protein allergy.At the first visit,all patients had elevated serum total bile acids beyond the normal range,with a mean of 152.5 μmol/L.Elevated alanine aminotransferase was observed in 1 case,elevated aspartate aminotransferase in 2 cases,and elevated total bilirubin in 10 cases.Genetic sequencing revealed that all children carried the homozygous SLC10A1 variant c.800C>T(p.Ser267Phe),classified as likely pathogenic.Conclusions NTCP deficiency often lacks obvious clinical symptoms and signs.Some children present with transient hyperbilirubinemia,cholestasis,or other liver function abnormalities.Persistent isolated elevation of serum bile acids warrants suspicion for this disease.Biallelic pathogenic variants in SLC10A1 constitute the basis for definitive diagnosis.There is no specific treatment for this disease,and management is mainly symptomatic.

Objective:To investigate the effects of apixaban on cardiac function,serum levels of soluble suppression of tumorigenicity 2(sST2),fibroblast growth factor-23(FGF-23)and inflammatory factors in patients with atrial fibrillation(AF)and coronary artery disease(CAD).Methods:This randomized controlled study enrolled 120 pa-tients with AF and CAD who admitted Changzhou Wujin Hospital of Traditional Chinese Medicine between July 2022 and December 2023.Patients were randomly divided into control group(n=60,warfarin therapy)and inter-vention group(n=60,apixaban therapy).Each group received corresponding medication based on routine therapy for 8 weeks.Cardiac function indicators,levels of serum sST2,FGF-23,inflammatory factors,myocardial fibrosis indicators,and incidence of adverse reactions were compared between the two groups.Results:Compared to those in the control group,participants in the intervention group had significantly higher left ventricular ejection fraction(LVEF)[(52.22±3.69)％vs.(48.37±4.14)％]and 6-minute walking distance(6MWD)[(456.29±56.47)m vs.(415.25±11.32)m](P＜0.001 all),and significantly lower left ventricular end-diastolic diameter(LVEDd)[(44.98±4.55)mm vs.(50.26±3.61)mm],levels of N-terminal pro B-type natriuretic peptide(NT-proB-NP)[(341.16±29.51)pg/ml vs.(392.33±32.27)pg/ml],cardiac troponin I(cTnI)[(3.76±1.12)ng/ml vs.(5.22±1.36)ng/ml],creatine kinase isoenzyme-MB(CK-MB)[(25.71±6.51)U/L vs.(39.13±6.33)U/L],high sensitive C-reactive protein(hsCRP)[(1.63±0.51)mg/L vs.(1.98±0.46)mg/L],tumor necrosis fac-tor-alpha(TNF-α)[(27.17±5.11)ng/Lvs.(34.19±5.32)ng/L],sST2[(52.11±5.87)μg/L vs.(62.37±5.82)μg/L]and FGF-23[(45.73±4.29)μg/L vs.(56.09±5.25)μg/L](P＜0.001 all).We detected signifi-cant lower incidence of adverse reactions in intervention group compared to control group(6.9％vs.26.3％,P=0.005).Conclusion:Apixaban could alleviate myocardial fibrosis,improve cardiac function,and reduce levels of heart failure biomarkers and inflammatory factors in patients with coronary artery disease and atrial fibrillation.

Objective:To investigate the relationship between serum progranulin(PGRN),pentraxin 3(PTX3),krebs von den lungen-6(KL-6)and the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)combined with type Ⅱ respiratory failure(RF)after nasal high-flow humidified oxygen therapy.Methods:160 patients with AECOPD combined with type Ⅱ RF who were treated in Zigong First People's Hospital from June 2022 to June 2024 were retrospectively selected,all patients received nasal high-flow humidified oxygen therapy,and they were divided into death group(38 cases)and survival group(122 cases)according to the prognosis of patients after treatment.The differences of serum PGRN,PTX3 and KL-6 levels and clinical data between two groups before treatment were compared.Logistic regression was applied to analyze the influencing factors of the poor prognosis of patients,and the receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of related risk factors for the poor prognosis of patients.Results:According to the prognosis evaluation,122 cases(76.25％)were in survival group,and 38 cases(23.75％)were in death group.Compared with survival group,serum PGRN,PTX3,KL-6,C-reactive protein(CRP),arterial partial pressure of carbon dioxide(PaCO2)and the number of AECOPD episodes in the past 1 year before treatment in death group were significantly increased,while the arterial partial pressure of oxygen(PaO2)was significantly decreased,the differences were statistically significant(P＜0.05).Logistic multivariate regression analysis showed that,elevated PGRN(OR=1.138),elevated PTX3(OR=1.182)and elevated KL-6(OR=1.162)were risk factors for death in patients with AECOPD combined with type Ⅱ RF after nasal high-flow humidified oxygen therapy(P＜0.05),and elevated PaO2(OR=0.758)was protective factor(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of serum PGRN,PTX3 and KL-6 in predicting the death of patients with AECOPD combined with type Ⅱ RF after nasal high-flow humidified oxygen therapy was 0.816,0.731 and 0.695 respectively,the AUC of the combined prediction of the three was 0.893,which was significantly higher than that of the single prediction.Conclusion:The levels of serum PGRN,PTX3 and KL-6 in patients with AECOPD combined with type Ⅱ RF are increased,which have high predictive value for the poor prognosis of patients with AECOPD combined with type Ⅱ RF after nasal high-flow humidified oxygen therapy.

Objective:To analyze the characteristics and general patterns of adverse drug reactions associated with aripiprazole, and to identify potential risk signals, thereby providing references for the safe and rational use of medications in clinical practice.Methods:This is a descriptive study that collected and summarized reports of adverse reactions to aripiprazole submitted by medical institutions in Anhui Province to the National Center for Adverse Drug Reaction Monitoring, China from January 2019 to December 2024. The basic characteristics of patients, the treatment regimens used, the timing of adverse drug reaction occurrence, the clinical manifestations of the affected systems, and the outcomes of these adverse drug reactions were statistically analyzed to identify the clinical characteristics and risk factors of adverse drug reactions associated with aripiprazole.Results:A total of 1 106 adverse reaction case reports related to aripiprazole were collected, with a male-to-female ratio of 1:1.29 ( χ2 = 8.64, P = 0.003) and an average age of (35 ± 16) years. The primary diseases treated included schizophrenia (768 cases, 69.44%), bipolar affective disorder (96 cases, 8.68%), and depressive disorder (75 cases, 6.78%). Adverse reactions occurred within the first 2 weeks of medication in 689 cases (62.29%). All medications were oral formulations, with 978 cases (88.43%) falling within the recommended daily dose range of 10-30 mg/d, while 15 cases (1.36%) exceeding the maximum recommended dose of 30 mg/d. The most common clinical manifestations were related to the nervous system (696 cases, 62.93%), followed by cardiovascular system manifestations (146 cases, 13.20%). The majority of adverse reactions showed improvement or recovery (1 052 cases, 95.12%). Conclusions:Aripiprazole is widely used in clinical practice, and the occurrence of adverse reactions is correlated with patient characteristics and treatment regimens. It is advisable to enhance the rational clinical use and monitoring of aripiprazole. Such measures will aid in preventing or reducing the occurrence of severe adverse reactions.

Objective To explore the brain damage of SD rats under different time points of hypobaric hypoxia exposure.Methods A rat high-altitube cerebral edema(HACE)model was constructed by simulating an altitude of 6 000 m in a hypobaric hypoxia animal experimental chamber.Thirty-six SD male rats were randomly divided into the control group and the hypobaric hypoxia exposure 3,7 and 14 d groups,with 9 rats in each group.Except for the control group,the rats in each group were continuously exposed to hypobaric hypoxia for 3,7,and 14 d.At the end of the modeling period,serum was collected by blood sampling via the abdominal aorta,and brain tissue samples were taken.The wet-to-dry ratio(W/D)of brain tissue was calculated,and the levels of relevant oxidative enzymes in serum and brain tissue were measured.The expression levels of hypoxia-inducible factor-1α(HIF-1α)and aquaporin 4(AQP4)mRNAs in brain tissue were detected by real-time fluorescence quantitative polymerase chain reaction.Results The W/D of brain tissues in the control group and the group exposed to hypobaric hypoxia for 3,7 and 14 d were 4.46±0.12,4.98±0.16,5.07±0.18 and 4.95±0.07;the superoxide dismutase contents were(111.86±2.45),(90.73±1.48),(79.64±2.56)and(55.33±1.45)U·g-1;the glutathione contents were(126.91±5.18),(125.26±1.53),(56.20±2.17)and(122.73±1.78)μg·mL-1;the malondialdehyde contents were(230.94±2.00),(362.65±3.28),(407.34±3.47)and(237.50±1.59)nmol·g-1;the relative expression levels of HIF-1 α mRNA were 1.00±0,2.99±0.49,4.72±0.49 and 1.91±0.28;the relative expression levels of AQP4 mRNA were 1.00±0,2.62±0.34,8.38±0.84 and 5.27±0.42,respectively.Statistically significant differences were found between the above indexes in the 3,7 and 14 d of hypobaric hypoxia exposure group compared with the control group(P＜0.05,P＜0.01).Conclusion Different time of hypobaric hypoxia exposure can up-regulate the expression of AQPs proteins in HACE rats and cause the disruption of the blood-brain barrier,and the HACE model constructed in the hypobaric hypoxia chamber with 6 000 m intervention for 7 d was more stable.

Objective:To investigate the effects of apixaban on cardiac function,serum levels of soluble suppression of tumorigenicity 2(sST2),fibroblast growth factor-23(FGF-23)and inflammatory factors in patients with atrial fibrillation(AF)and coronary artery disease(CAD).Methods:This randomized controlled study enrolled 120 pa-tients with AF and CAD who admitted Changzhou Wujin Hospital of Traditional Chinese Medicine between July 2022 and December 2023.Patients were randomly divided into control group(n=60,warfarin therapy)and inter-vention group(n=60,apixaban therapy).Each group received corresponding medication based on routine therapy for 8 weeks.Cardiac function indicators,levels of serum sST2,FGF-23,inflammatory factors,myocardial fibrosis indicators,and incidence of adverse reactions were compared between the two groups.Results:Compared to those in the control group,participants in the intervention group had significantly higher left ventricular ejection fraction(LVEF)[(52.22±3.69)％vs.(48.37±4.14)％]and 6-minute walking distance(6MWD)[(456.29±56.47)m vs.(415.25±11.32)m](P＜0.001 all),and significantly lower left ventricular end-diastolic diameter(LVEDd)[(44.98±4.55)mm vs.(50.26±3.61)mm],levels of N-terminal pro B-type natriuretic peptide(NT-proB-NP)[(341.16±29.51)pg/ml vs.(392.33±32.27)pg/ml],cardiac troponin I(cTnI)[(3.76±1.12)ng/ml vs.(5.22±1.36)ng/ml],creatine kinase isoenzyme-MB(CK-MB)[(25.71±6.51)U/L vs.(39.13±6.33)U/L],high sensitive C-reactive protein(hsCRP)[(1.63±0.51)mg/L vs.(1.98±0.46)mg/L],tumor necrosis fac-tor-alpha(TNF-α)[(27.17±5.11)ng/Lvs.(34.19±5.32)ng/L],sST2[(52.11±5.87)μg/L vs.(62.37±5.82)μg/L]and FGF-23[(45.73±4.29)μg/L vs.(56.09±5.25)μg/L](P＜0.001 all).We detected signifi-cant lower incidence of adverse reactions in intervention group compared to control group(6.9％vs.26.3％,P=0.005).Conclusion:Apixaban could alleviate myocardial fibrosis,improve cardiac function,and reduce levels of heart failure biomarkers and inflammatory factors in patients with coronary artery disease and atrial fibrillation.

Objective:To investigate the relationship between serum progranulin(PGRN),pentraxin 3(PTX3),krebs von den lungen-6(KL-6)and the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)combined with type Ⅱ respiratory failure(RF)after nasal high-flow humidified oxygen therapy.Methods:160 patients with AECOPD combined with type Ⅱ RF who were treated in Zigong First People's Hospital from June 2022 to June 2024 were retrospectively selected,all patients received nasal high-flow humidified oxygen therapy,and they were divided into death group(38 cases)and survival group(122 cases)according to the prognosis of patients after treatment.The differences of serum PGRN,PTX3 and KL-6 levels and clinical data between two groups before treatment were compared.Logistic regression was applied to analyze the influencing factors of the poor prognosis of patients,and the receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of related risk factors for the poor prognosis of patients.Results:According to the prognosis evaluation,122 cases(76.25％)were in survival group,and 38 cases(23.75％)were in death group.Compared with survival group,serum PGRN,PTX3,KL-6,C-reactive protein(CRP),arterial partial pressure of carbon dioxide(PaCO2)and the number of AECOPD episodes in the past 1 year before treatment in death group were significantly increased,while the arterial partial pressure of oxygen(PaO2)was significantly decreased,the differences were statistically significant(P＜0.05).Logistic multivariate regression analysis showed that,elevated PGRN(OR=1.138),elevated PTX3(OR=1.182)and elevated KL-6(OR=1.162)were risk factors for death in patients with AECOPD combined with type Ⅱ RF after nasal high-flow humidified oxygen therapy(P＜0.05),and elevated PaO2(OR=0.758)was protective factor(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of serum PGRN,PTX3 and KL-6 in predicting the death of patients with AECOPD combined with type Ⅱ RF after nasal high-flow humidified oxygen therapy was 0.816,0.731 and 0.695 respectively,the AUC of the combined prediction of the three was 0.893,which was significantly higher than that of the single prediction.Conclusion:The levels of serum PGRN,PTX3 and KL-6 in patients with AECOPD combined with type Ⅱ RF are increased,which have high predictive value for the poor prognosis of patients with AECOPD combined with type Ⅱ RF after nasal high-flow humidified oxygen therapy.

AIM To study the chemical constituents from ethyl acetate fraction of Balanophora harlandii Hook.f.and their tyrosinase inhibitory activity.METHODS Separation and purification were performed using silica gel,MCI,ODS,Sephadex LH-20 and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The monophenolase inhibitory activity was determined by the tyrosinase-catalyzed oxidation of L-tyrosine.RESULTS Twenty-four compounds were isolated and identified as sesamin(1),methyl caffeate(2),quercetin(3),5,7-dihydroxychromanone(4),methyl 3,4-dihydroxybenzoate(5),esculetin(6),kaempferol(7),naringenin(8),pyrogallic acid(9),pinosylvin(10),methyl propionate(11),caffeic acid(12),saccharinol(13),ferulic acid(14),trans-p-hydroxycinnamic acid(15),cinnamic acid(16),vanillic acid(17),vanillin(18),4-hydroxyacetophenone(19),4-hydroxybenzaldehyde(20),apigenin(21),(-)-isolariciresinol(22),(-)-secoisolariciresinol(23)and meso-2,3-di(3′,4′-methylenedioxybenzyl)butane-1,4-diol(24).The IC50 values of compounds 3,5,7,8,19,and 20 ranged from(0.246 5±0.028 3)to(1.278 2±0.021 3)mmol/L.CONCLUSION Compounds 1-9、11、15、17-21、24 are isolated from this plant for the first time,and 1,6,9,17-19,24 are first isolated from genus Balanophora.Compounds 3、5、7、8、19 and 20 have tyrosinase inhibitory activity.

Objective To explore the brain damage of SD rats under different time points of hypobaric hypoxia exposure.Methods A rat high-altitube cerebral edema(HACE)model was constructed by simulating an altitude of 6 000 m in a hypobaric hypoxia animal experimental chamber.Thirty-six SD male rats were randomly divided into the control group and the hypobaric hypoxia exposure 3,7 and 14 d groups,with 9 rats in each group.Except for the control group,the rats in each group were continuously exposed to hypobaric hypoxia for 3,7,and 14 d.At the end of the modeling period,serum was collected by blood sampling via the abdominal aorta,and brain tissue samples were taken.The wet-to-dry ratio(W/D)of brain tissue was calculated,and the levels of relevant oxidative enzymes in serum and brain tissue were measured.The expression levels of hypoxia-inducible factor-1α(HIF-1α)and aquaporin 4(AQP4)mRNAs in brain tissue were detected by real-time fluorescence quantitative polymerase chain reaction.Results The W/D of brain tissues in the control group and the group exposed to hypobaric hypoxia for 3,7 and 14 d were 4.46±0.12,4.98±0.16,5.07±0.18 and 4.95±0.07;the superoxide dismutase contents were(111.86±2.45),(90.73±1.48),(79.64±2.56)and(55.33±1.45)U·g-1;the glutathione contents were(126.91±5.18),(125.26±1.53),(56.20±2.17)and(122.73±1.78)μg·mL-1;the malondialdehyde contents were(230.94±2.00),(362.65±3.28),(407.34±3.47)and(237.50±1.59)nmol·g-1;the relative expression levels of HIF-1 α mRNA were 1.00±0,2.99±0.49,4.72±0.49 and 1.91±0.28;the relative expression levels of AQP4 mRNA were 1.00±0,2.62±0.34,8.38±0.84 and 5.27±0.42,respectively.Statistically significant differences were found between the above indexes in the 3,7 and 14 d of hypobaric hypoxia exposure group compared with the control group(P＜0.05,P＜0.01).Conclusion Different time of hypobaric hypoxia exposure can up-regulate the expression of AQPs proteins in HACE rats and cause the disruption of the blood-brain barrier,and the HACE model constructed in the hypobaric hypoxia chamber with 6 000 m intervention for 7 d was more stable.

Objective To develop and validate a fast Monte Carlo(MC)-based patient-specific quality assurance(PSQA)tool using the treatment log files that is suitable to be used in the online adaptive radiotherapy for pencil beam scanning proton therapy(PBSPT-ART).Methods The proposed tool first used the delivery log file of a PBSPT plan to reversely reconstruct the PBSPT(rPBSPT)plan,and then used an in-house developed graphic processing unit(GPU)-accelerated virtual particle MC(VPMC)dose engine to calculate the dose distribution of the rPBSPT plan.The rPBSPT dose calculated by VPMC was then compared to the rPBSPT dose calculated by another independent MC dose engine(MCsquare),using 3D gamma analysis to verify the accuracy of VPMC calculation.As a demonstration of the feasibility of developed log file-based PSQA,the VPMC calculated dose of the rPBSPT plan was compared to the pre-delivery second check dose of the corresponding PBSPT plan calculated by MCsquare,using 3D gamma analysis.3D gamma analysis employes a criterion of 2 mm/2%/10%.Twenty patients with different disease sites were representatively selected to validate the efficiency and accuracy of the tool.Results The average calculation time of a rPBSPT plan by VPMC was(5.88±4.00)s in the accuracy verification.Compared to MCsquare,the passing rate of the 3D gamma analysis was 99.47%±0.72%.In the proposed PSQA tool demonstration,the passing rate of comparing the VPMC calculated rPBSPT dose to MCsquare calculated second check dose of the corresponding PBSPT plan was 98.91%±0.92%.Conclusion The accuracy and efficiency of the tool can meet the requirements of PSQA in the online PBSPT-ART workflow.