OBJECTIVE: To evaluate the dynamic changes of glucocorticoid (GC) dose and the feasibility of GC discontinuation in rheumatoid arthritis (RA) patients under the background of Chinese medicine (CM). METHODS: This multicenter retrospective cohort study included 1,196 RA patients enrolled in the China Rheumatoid Arthritis Registry of Patients with Chinese Medicine (CERTAIN) from September 1, 2019 to December 4, 2023, who initiated GC therapy. Participants were divided into the Western medicine (WM) and integrative medicine (IM, combination of CM and WM) groups based on medication regimen. Follow-up was performed at least every 3 months to assess dynamic changes in GC dose. Changes in GC dose were analyzed by generalized estimator equation, the probability of GC discontinuation was assessed using Kaplan-Meier curve, and predictors of GC discontinuation were analyzed by Cox regression. Patients with <12 months of follow-up were excluded for the sensitivity analysis. RESULTS: Among 1,196 patients (85.4% female; median age 56.4 years), 880 (73.6%) received IM. Over a median 12-month follow-up, 34.3% (410 cases) discontinued GC, with significantly higher rates in the IM group (40.8% vs. 16.1% in WM; P<0.05). GC dose declined progressively, with IM patients demonstrating faster reductions (median 3.75 mg vs. 5.00 mg in WM at 12 months; P<0.05). Multivariate Cox analysis identified age <60 years [P<0.001, hazard ratios (HR)=2.142, 95% confidence interval (CI): 1.523-3.012], IM therapy (P=0.001, HR=2.175, 95% CI: 1.369-3.456), baseline GC dose ⩽7.5 mg (P=0.003, HR=1.637, 95% CI: 1.177-2.275), and absence of non-steroidal anti-inflammatory drugs use (P=0.001, HR=2.546, 95% CI: 1.432-4.527) as significant predictors of GC discontinuation. Sensitivity analysis (545 cases) confirmed these findings. CONCLUSIONS RA patients receiving CM face difficulties in following guideline-recommended GC discontinuation protocols. IM can promote GC discontinuation and is a promising strategy to reduce GC dependency in RA management. (Trial registration: ClinicalTrials.gov, No. NCT05219214).
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Arthritis, Rheumatoid/drug therapy* ; Glucocorticoids/therapeutic use* ; Medicine, Chinese Traditional ; Retrospective Studies

Objective:To investigate the expressions of matrix metalloproteinase 7(MMP7)and secretory leukocyte protease inhibitor(SLPI)in papillary thyroid carcinoma(PTC)and their signifi-cances.Methods:Based on the gene expression data of thyroid cancer in the tumor Genome Atlas(TCGA)database,a total of 567 samples were collected,including 509 cancer tissues and 58 normal tissues.The gene matrix data were extracted and sorted out.Two groups of differentially expressed genes were screened by using the R language edger package,and the potential key genes were screened by the mcode plug-in in Cytoscape.Select a key gene and mine closely related genes through the UALCAN database.Immunohistochemical SABC method was used to detect the ex-pressions of MMP7 and SLPI proteins in PTC tissues and their paracancerous tissues collected from 69 patients in Binzhou People's Hospital Affiliated to Shandong First Medical University from January 2020 to June 2021,and the association of expression levels of MMP7 and SLPI with the clinico-pathological factors of PTC patients was also analyzed.Results:Based on the data of TCGA database,1471 genes were obtained,of which 1000 were up-regulated and 471 were down-regu-lated.Through the mcode plug-in in Cytoscape,20 key genes were screened(MMP7,CCL18,CYR61,SPECC1,CRABP2,PLXNA3,KRT17,TMEM59L,RETN,SRF,ITGB4,PPL,PLEKHN1,RMI2,LCN6,SPX,NRIP1,ARHGEF28,SLC39A14,SNCA).Through the UALCAN database,the correlation between MMP7 and SLPI was retrieved(Pearson correlation coefficient was 0.5,P＜0.05).The results of immunohistochemistry showed that the positive expression rates of MMP7 and SLPI proteins in PTC tissues were significantly higher than those in paracancerous tissues[82.6％(57/69)vs 29.0％(20/69),71.0％(49/69)vs 15.9％(11/69)],and the differences were statistically significant(x2 val-ues were 40.222 and 42.579,both P＜0.01).The expressions of MMP7 and SLPI in PTC tissues were correlated with TNM stage,differentiation,extramembranous invasion and lymph node metastasis(all P＜0.05).There was a positive correlation between MMP7 and SLPI proteins expressions in PTC(r=0.381,P=0.001).Conclusions:The interaction between MMP7 and SLPI proteins can be in-volved in the development and progression of PTC.

Objective:To build a systematic,uninterrupted and all-round continuous collaborative protection strategy for network security control of gene sequencing equipment.Methods:The network transmission,electronic interface,data system and other parts were incorporated into the comprehensive consideration of network security control of gene sequencing equipment.Based on the"overall network security",the risk points that manufacturers of genetic sequencing equipment and institutions using the testing need to pay attention to and control at this stage were proposed from seven aspects including product data architecture,security capability system construction,residual risk maintenance plan,malicious attack defense,vulnerability assessment,cyber security of off-the-shelf software,and remote operation and maintenance support,and further expanded to the whole lifecycle network security control of gene sequencing equipment.Results:By sorting out the risk points of gene sequencing,a systematic,uninterrupted and all-round continuous collaborative protection strategy of network security control of gene sequencing equipment was constructed.Conclusion:Network security supervision of gene sequencing equipment is an important tool to ensure product quality.It is necessary to pay attention to comprehensive risk points in product development,production and maintenance,and network security control should be implemented throughout the whole life cycle of gene sequencing equipment.

Cardiovascular diseases， with high incidence and high mortality， belong to the category of "chest impediment and heart pain" in traditional Chinese medicine （TCM）. Chinese medicines have unique effect on the prevention and treatment of cardiovascular diseases with little side effects. Huoxin pills， one of the National Essential Drugs， is formulated based on the basic pathogenesis of weak pulse at Yang and wiry pulse at Yin and the pathological basis of myocardial ischemia and hypoxia and used for treating angina pectoris of coronary heart disease （Qi deficiency and blood stasis syndrome）. This medicine is derived from the classic famous prescription and is composed of ten precious Chinese medicinal herbs. It can replenish Qi， activate blood， and warm collaterals to diffuse impediment by enhancing myocardial contractility and cardiac output to improve micro-circulation and increase coronary blood flow， regulating immune functions， alleviating inflammation， detoxifying， and tranquilizing mind. Clinically， it is suitable for patients with angina pectoris caused by the lack of heart Yang， chest tightness， shortness of breath， palpitation， fear of cold for limbs and so on， especially for the elderly with Yang deficiency or the patients with a history of myocardial infarction. On the basis of the available research reports， this paper explains the formula meaning of Huoxin pills from the perspective of the basic pathogenesis of coronary heart disease and predicts its action targets， location and links. Furthermore， we expound the mechanism of action of Huoxin pills based on basic research and clinical evidence-based research， aiming to provide data support and evidence for the clinical application of this medicine.

Objective:To analyze the trend of mortality and incidence of colorectal cancer among urban residents in Guangzhou from 1972 to 2015 and to predict the mortality of colorectal cancer from 2016 to 2025.Methods:The mortality data of colorectal cancer among urban residents in Guangzhou were collected from the death registration of malignant tumors of Guangzhou Health Statistics Bureau (1972-1979), Guangzhou Health Statistics (1980-2001), Guangzhou Cancer Registration Annual Report (2002-2009) and China Cancer Registration Annual Report (2010-2015). The incidence of colorectal cancer was collected from Guangzhou Cancer Registration Annual Report (2002-2009) and China Cancer Registration Annual Report (2010-2015). The incidence and mortality data of colorectal cancer coded as C18-C21 in 10th Edition of International Classification of Diseases (ICD-10) were obtained from the above data, and the demographic data were from the Guangzhou Municipal Bureau of Statistics. Joinpoint model was used to calculate the annual change percentage (APC) and average annual change percentage (AAPC) of colorectal cancer mortality and incidence among urban residents in Guangzhou from 1972 to 2015 and from 2002 to 2015. ARIMA model was used to predict colorectal cancer mortality from 2016 to 2025.Results:There were 19 309 colorectal cancer deaths among urban residents in Guangzhou from 1972 to 2015. The crude mortality rate of colorectal cancer increased from 4.33/100 000 to 24.89/100 000 (AAPC=4.2%, P<0.001). A total of 24 033 new cases of colorectal cancer were reported in Guangzhou from 2002 to 2015. The crude incidence rate of colorectal cancer increased from 22.95/100 000 to 52.81/100 000 (AAPC=6.6%, P<0.001). The mortality rate of colorectal cancer among urban residents of Guangzhou would continuously increase from 2016 to 2025 and reach 29.53/100 000 in 2025. Conclusion:The mortality rate of colorectal cancer among urban residents of Guangzhou from 1972 to 2015 and the incidence rate of colorectal cancer from 2002 to 2015 both show an upward trend. The mortality rate will increase from 2016 to 2025.

Adult ; Asymptomatic Diseases/epidemiology* ; Autoimmune Diseases/etiology* ; China/epidemiology* ; Female ; Humans ; Hypothyroidism/etiology* ; Male ; Metabolic Syndrome/epidemiology* ; Middle Aged ; Obesity/epidemiology* ; Risk Factors ; Thyroid Diseases/etiology* ; Young Adult

Objective:To analyze the trend of mortality and incidence of colorectal cancer among urban residents in Guangzhou from 1972 to 2015 and to predict the mortality of colorectal cancer from 2016 to 2025.Methods:The mortality data of colorectal cancer among urban residents in Guangzhou were collected from the death registration of malignant tumors of Guangzhou Health Statistics Bureau (1972-1979), Guangzhou Health Statistics (1980-2001), Guangzhou Cancer Registration Annual Report (2002-2009) and China Cancer Registration Annual Report (2010-2015). The incidence of colorectal cancer was collected from Guangzhou Cancer Registration Annual Report (2002-2009) and China Cancer Registration Annual Report (2010-2015). The incidence and mortality data of colorectal cancer coded as C18-C21 in 10th Edition of International Classification of Diseases (ICD-10) were obtained from the above data, and the demographic data were from the Guangzhou Municipal Bureau of Statistics. Joinpoint model was used to calculate the annual change percentage (APC) and average annual change percentage (AAPC) of colorectal cancer mortality and incidence among urban residents in Guangzhou from 1972 to 2015 and from 2002 to 2015. ARIMA model was used to predict colorectal cancer mortality from 2016 to 2025.Results:There were 19 309 colorectal cancer deaths among urban residents in Guangzhou from 1972 to 2015. The crude mortality rate of colorectal cancer increased from 4.33/100 000 to 24.89/100 000 (AAPC=4.2%, P<0.001). A total of 24 033 new cases of colorectal cancer were reported in Guangzhou from 2002 to 2015. The crude incidence rate of colorectal cancer increased from 22.95/100 000 to 52.81/100 000 (AAPC=6.6%, P<0.001). The mortality rate of colorectal cancer among urban residents of Guangzhou would continuously increase from 2016 to 2025 and reach 29.53/100 000 in 2025. Conclusion:The mortality rate of colorectal cancer among urban residents of Guangzhou from 1972 to 2015 and the incidence rate of colorectal cancer from 2002 to 2015 both show an upward trend. The mortality rate will increase from 2016 to 2025.

Objective:To study on the material basis of Sanguisorbae Radix by column chromatography and liquid chromatography-ion trap-time-of-flight mass spectrometry (LCMS-IT-TOF), and analyze the distribution of different components in Sanguisorbae Radix water extract on D101 macroporous resin and polyamide resin. Method:Sanguisorbae Radix water extract was separated by D101 macroporous resin and polyamide resin, and LCMS-IT-TOF was used for detection, chromatography separation was achieved on an ACQUITY UPLC HSS T3 column (2.1 mm×100 mm, 1.8 μm) with the mobile phase consisted of water (A) and acetonitrile (B) for gradient elution (0-10 min, 5%-20%B; 10-18 min, 20%-35%B; 18-23 min, 35%-50%B; 23-28 min, 50%-90%B; 28-30 min, 90%B; 30-33 min, 90%-5%B; 33-35 min, 5%B), the flow rate was 0.3 mL·min^-1, the column temperature was 30 ℃. Data acquisition was carried out in electrospray ionization (ESI) under the positive and negative ion modes, the scanning range was m/z 100-1 200. According to mass spectrometry data such as accurate molecular mass and fragment information, combined with literature, different chemical components in loading effluents and ethanol eluents of Sanguisorbae Radix water extract were identified. A heat map of the distribution of components in each fraction was drawn by extracting mass spectrum peak intensity data of each sample. The elution rules of various components were compared visually. Result:The enrichment and separation of D101 macroporous resin and polyamide resin were obvious. Tannins in Sanguisorbae Radix water extract was mainly concentrated in loading effluent of macroporous resin and its water eluent, triterpenoids were mainly distributed in the 90% ethanol eluent of macroporous resin. In the above effluents and eluents, a total of 63 compounds (including isomers) were identified. Among them, 6 compounds, ellagic acid-4-pyranoarabinoside or its isomer, 6-O-galloylnorbergerin, 3-O-galloylnorbergerin, (6-acetyloxy-5,7-dihydroxy-8-methoxy-4-oxochromen-2-yl) acetate, ethyl 2-methyl-5,6-bis (sulfooxy) benzofuran-3- carboxylate were first discovered in Sanguisorbae Radix. Conclusion:The method can quickly and accurately identify the distribution of components in aqueous extract of Sanguisorbae Radix after column chromatography, providing experimental basis for exploring the pharmacodynamic components and mechanism of Sanguisorbae Radix.