The analysis presented here is based on the blood components of Guanxin Qiwei tablets, the key anti-atherosclerosis pathway of Guanxin Qiwei tablets was screened by network pharmacology, and the anti-atherosclerosis mechanism of Guanxin Qiwei tablets was clarified and verified by cell experiments. HPLC-Q-Exactive-MS/MS technique was used to analyze the components of Guanxin Qiwei tablets into blood, to determine the precise mass charge ratio of the compounds, and to conduct a comprehensive analysis of the components by using secondary mass spectrometry fragments and literature comparison. Finally, a total of 42 components of Guanxin Qiwei tablets into blood were identified. To better understand the interactions, we employed the Swiss Target Prediction database to predict the associated targets. Atherosclerosis (AS) disease targets were searched in disease databases Genecard, OMIM and Disgent, and 181 intersection targets of disease targets and component targets were obtained by Venny 2.1.0 software. Protein interactions were analyzed by String database. The 32 core targets were selected by Cytscape software. Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed in DAVID database. It was found that the anti-atherosclerosis pathways of Guanxin Qiwei tablets mainly include lipid metabolism and atherosclerosis and AGE-RAGE signaling pathway in diabetic complications and other signal pathways. The core targets and the core compounds were interlinked, and it was found that cryptotanshinone and tanshinone ⅡA in Guanxin Qiwei tablets were well bound to TNF, PPARγ, AKT1, PTG2 and other targets. The lipid metabolism and atherosclerotic pathway was verified using human hl-7702 hepatocytes. This study preliminarily identified the potential pharmacodynamic components of Guanxin Qiwei tablets in the treatment of AS diseases and predicted their pathways of action, and verified the relationship between regulating lipid metabolism and atherosclerosis of Guanxin Qiwei tablets in vitro, providing a reference for the further study of the pharmacodynamic material basis and mechanism of action of this prescription. This experiment was approved by the Medical Ethics Committee of Inner Mongolia Medical University (No. YKD202401262).

BACKGROUND: Spatiotemporal disparities exist in the disease burden of non-communicable diseases (NCDs) attributable to kidney dysfunction, which has been poorly assessed. The present study aimed to evaluate the spatiotemporal trends of the global burden of NCDs attributable to kidney dysfunction and to predict future trends. METHODS: Data on NCDs attributable to kidney dysfunction, quantified using deaths and disability-adjusted life-years (DALYs), were extracted from the Global Burden of Diseases Injuries, and Risk Factors (GBD) Study in 2019. Estimated annual percentage change (EAPC) of age-standardized rate (ASR) was calculated with linear regression to assess the changing trend. Pearson's correlation analysis was used to determine the association between ASR and sociodemographic index (SDI) for 21 GBD regions. A Bayesian age-period-cohort (BAPC) model was used to predict future trends up to 2040. RESULTS: Between 1990 and 2019, the absolute number of deaths and DALYs from NCDs attributable to kidney dysfunction increased globally. The death cases increased from 1,571,720 (95% uncertainty interval [UI]: 1,344,420-1,805,598) in 1990 to 3,161,552 (95% UI: 2,723,363-3,623,814) in 2019 for both sexes combined. Both the ASR of death and DALYs increased in Andean Latin America, the Caribbean, Central Latin America, Southeast Asia, Oceania, and Southern Sub-Saharan Africa. In contrast, the age-standardized metrics decreased in the high-income Asia Pacific region. The relationship between SDI and ASR of death and DALYs was negatively correlated. The BAPC model indicated that there would be approximately 5,806,780 death cases and 119,013,659 DALY cases in 2040 that could be attributed to kidney dysfunction. Age-standardized death of cardiovascular diseases (CVDs) and CKD attributable to kidney dysfunction were predicted to decrease and increase from 2020 to 2040, respectively. CONCLUSION NCDs attributable to kidney dysfunction remain a major public health concern worldwide. Efforts are required to attenuate the death and disability burden, particularly in low and low-to-middle SDI regions.
Humans ; Noncommunicable Diseases/epidemiology* ; Global Burden of Disease ; Disability-Adjusted Life Years ; Male ; Female ; Risk Factors ; Middle Aged ; Kidney Diseases/epidemiology* ; Bayes Theorem ; Adult ; Aged ; Global Health ; Quality-Adjusted Life Years

A scoping review was performed to systematically search and summarize the clinical research in the treatment of dysmenorrhea with oral Chinese patent medicines. The oral Chinese patent medicines for treating dysmenorrhea in three major drug lists, guidelines, and textbooks were screened, and the relevant clinical trials were retrieved from eight Chinese and English databases. The key information of the included trials was extracted and visually analyzed. A total of 50 Chinese patent medicines were included, among which oral Chinese patent medicines for the dysmenorrhea patients with the syndrome of Qi stagnation and blood stasis accounted for the highest proportion, and the average daily cost varied greatly among Chinese patent medicines. A total of 150 articles were included, involving 22 Chinese patent medicines, among which Guizhi Fuling Capsules/Pills, Sanjie Zhentong Capsules, and Dan'e Fukang Soft Extract were the most frequently studied. These articles mainly reported randomized controlled trial(RCT), which mainly focused on the comparison of the intervention effect between Chinese patent medicines combined with western medicine and western medicine alone, and the sample size was generally 51-100 cases. The high-frequency outcome indicators belonged to nine domains such as effective rate, adverse reactions, and laboratory examinations. This study showed that oral Chinese patent medicines had advantages in the treatment of dysmenorrhea, and the annual number of related clinical trials showed an overall growing trend. However, there were still problems such as insufficient safety information and vague description of traditional Chinese medicine(TCM) syndromes types in the instructions of Chinese patent medicines. The available clinical research had shortcomings such as uneven distribution of Chinese patent medicines, limited research scale, poor methodological rigor, and insufficient standardization of outcome indicators. In the future, it is necessary to deepen the development of high-quality clinical research and improve the contents of the instructions to ensure the effectiveness and safety of the clinical application of oral Chinese patent medicines in the treatment of dysmenorrhea.
Dysmenorrhea/drug therapy* ; Humans ; Drugs, Chinese Herbal/administration & dosage* ; Female ; Administration, Oral ; Nonprescription Drugs/administration & dosage*

Purpose To evaluate the classification criteria of triple negative breast cancer(TNBC)based on histomorphol-ogy and immunohistochemistry(IHC),and to provide theoreti-cal basis for the classification and treatment of TNBCs.Methods TNBC subtyping was performed according to the histomorphologi-cal characteristics and the expression of immune markers AR,CD8 and FOXC1,and the clinicopathological features and prog-nostic differences were compared.Results Among 93 cases of TNBC,there were 23 cases(24.7％)of luminal androgen re-ceptor subtypes,24 cases(25.8％)of immunomodulatory type,39 cases(42.0％)of basal immunosuppressive type,and 7 ca-ses(7.5％)of mesenchymal type.There were significant differ-ences in the clinicopathological features of subtypes,including pT stage(P=0.030),histological grade(P＜0.001),intersti-tial lymphocyte infiltration pattern(P＜0.001),expression of PD-L1(P＜0.001),and HER2-low(P=0.024).There was no significant difference in disease-free survival among the sub-types(P＞0.05).Univariate survival analysis showed there was significant difference in disease-free survival among the subtypes at pT1 stage(P=0.011),and other clinicopathological features were not independent prognostic factors.Conclusion The clini-copathological characteristics of TNBC subtypes are different,which are expected to be an alternative choice for complex gene expression profile analysis and to provide theoretical basis for subtypic therapy and targeted therapy.

Objective:To investigate the biological characteristics of triple negative breast cancer (TNBC) with low expression of HER2 (HER2-low).Methods:A total of 93 TNBC cases in Shanxi Cancer Hospital from 2017 to 2019 were collected and divided into HER2-negative and HER2-low groups according to HER2 expression status. The clinicopathological features and prognostic differences between the two groups were retrospectively analyzed and compared, and genetic detection of tumor tissues was performed to clarify somatic mutation status and differences between the two groups.Results:Ninety-three patients aged 26 to 86 years were enrolled, including 60 patients in the HER2-negative group and 33 patients in the HER2-low group. The distribution of HER2-low in luminal androgen receptor (LAR) subtype (14/23, 60.87%) and non-LAR subtype (19/70, 27.14%) was significantly different ( P=0.005). There were no significant differences in age, pT stage, histological grade, infiltration mode, lymph node metastasis and survival analysis. The expression of HER2-low in the tumor was heterogeneous, including different proportions of weak, weak to moderate intensity, and incomplete to intact membrane staining. With the change of the proportion of HER2-positive cells, the different distribution of those cells in the total tumor cells was noted, including cluster, mosaic and scattered patterns. The concentration and quality of DNA extracted from 71 of the 93 samples met the requirements for making libraries, including 43 in the HER2-negative group and 28 in the HER2-low group. Genetic mutations were mainly missense mutations, single nucleotide mutations, and point mutations in which base C was replaced by base T. There was no significant difference in genes with mutation frequency>3 times between the two groups. CTNNB1 and FGFR3 genes were only mutated in HER2-low group; while ALK, CYP2D6 and FAT1 genes were only mutated in HER2-negative group. HER2-low group included 18 HER2 1+ cases and 10 HER2 2+ cases. Genes with mutation frequency>3 times between the two groups included PIK3CA, TP53, SLX4, ATM and BRCA1. The mutation frequency of PIK3CA in HER2 2+ was significantly higher than that in HER2 1+ group ( P<0.05), and SLX4 gene was only mutated in HER2 1+ group. Conclusions:There are some differences of histological morphology and genetic variation between HER2-negative group and HER2-low group, and also differences in genetic variation between HER2 1+ and HER2 2+ in HER2-low group, which are helpful for more accurate stratification of TNBC and useful for finding the therapeutic target and precise treatment of HER2-low TNBC.

Objective:To assess the predictive accuracy and practical utility of established risk prediction models for enteral nutrition intolerance in critically ill patients. Methods:A meta-analysis was conducted to identify existing risk prediction models for enteral nutrition intolerance in critically ill patients. Eligible patients admitted to the Department of Critical Care Medicine and various ICUs of General Hospital of Eastern Theater Command from March 2023 to August 2023, meeting natriuresis criteria, were included in the study. The discrimination and calibration of the two models were assessed using the area under the receiver operating characteristic curve (AUROC) and the Hosmer-Lemeshow goodness-of-fit test (H-L test). Results:Two models were analyzed, encompassing a total of 395 patients, among whom 161 experienced intolerances, resulting in an incidence rate of 40.8％. Model 1 demonstrated an AUROC of 0.838 (95％CI:0.798 ～ 0.873), while model 2 yielded an AUROC of 0.744 (95％CI:0.698 ～ 0.786). The Delong method was utilized to compare the AUROC values of the two models, revealing a statistically significant difference (P=0.0043). Notably, the model 1 exhibited superior performance compered to model 2. The H-L test for model 1 indicated fair calibration (X2=61.116, P<0.001), whereas model 2 demonstrated better calibration (X2=3.659, P=0.887). Conclusion:Model 1 exhibits superior discriminatory ability compared tomodel 2, while the calibration of model 2 surpasses that of model 1. Model 1 is well-suited for dynamic prediction, accommodating changes in patient condition over time. Conversely, Model 2 is appropriated for initial prediction following enteral nutrition initiation. Healthcare professionals can integrate bothmodels based on the specific clinical conditions to enhance predictive accutacy. Additionally, they can undertake high-quality research to develop a novel risk prediction model.

Objective:To evaluate the nutritional status and its influencing factors in esophageal cancer patients for home-based care after surgery.Methods:A total of 153 patients with esophageal cancer who underwent surgery between July 2022 and October 2023 in the General Hospital of Eastern Theater Command were enrolled in this study.The nutritional status of the patients at home in 1-month post-surgery was evaluated according to the patient-generated subjective global assessment(PG-SGA),and the possible influencing factors were analyzed.Results:Among the 153 patients,47 were well-nourished and 106 were malnourished,with an overall malnutrition rate of 69.3%.For the malnutritional patients,71 were suspected or moderately malnourished and 35 were severely malnourished.The hemoglobin levels,serum albumin levels,the route for nutrition support delivery,nutrition impact symptoms(NIS),oral nutritional supplements(ONS)and nutritional behavior were independent influencing factors of nutritional status(P<0.05),in which NIS≥2 was a risk factor for malnutrition in the patients.Normal hemoglobin and albumin levels,enteral tube feeding,oral nutritional supplement and achieving standard of nutritional behavior were protective factors for avoiding the presence of malnutrition.Conclusion:The esophageal cancer patients for home-based care after surgery have a high incidence of malnutrition.Many factors,including nutrient delivery route and nutritional behavior,were related to the occurrence of in the patients.Certain measures to the related factors should be taken early for preventing malnutrition in clinical practice.

AIM To investigate the clinical effects of Modified Mahuang Lianqiao Chixiaodou Decoction on patients with chronic eczema.METHODS One hundred and ninety-five patients were randomly assigned into Chinese medicine group(65 cases)for 3-week administration of Modified Mahuang Lianqiao Chixiaodou Decoction,western medicine group(65 cases)for 3-week administration of Levocetirizine Hydrochloride,and combined group(65 cases)for 3-week administration of both Modified Mahuang Lianqiao Chixiaodou Decoction and Levocetirizine Hydrochloride.The changes in clinical effects,clinical indices(EASI score,DQOLS score,TCM syndrome score,PINS score),skin physiological function indicesssss(OCTS,TEWL,WCTC),inflammatory factors(EOT,EOS,NK-κB,CCR3),T lymphocyte subsets(Treg,Th1,Th17,Th22),p38MAPK signaling pathway indices(ERK1,ERK2,mMEK 1,MEK2),recurrence rate and incidence of adverse reactions were detected.RESULTS The combined group demonstrated higher total effective rate than the Chinese medicine group and the western medicine group(P＜0.05),along with lower recurrence rate(P＜0.05).After the treatment,the combined group displayed lower EASI score,TCM syndrome score,PINS,TEWL,inflammatory factors,Th1,Th17,Th22 and p38MAPK signaling pathway indices than the control group(P＜0.05),along with higher DQOLS score,OCTS,WCTC,Treg(P＜0.05).The Chinese medicine group exhibited lower incidence of adverse reactions than the other two groups(P＜0.05).CONCLUSION For the patients with chronic eczema,Modified Mahuang Lianqiao Chixiaodou Decoction can safely and effectively alleviate skin lesion degree,enhance skin physiological functions,improve T lymphocyte subset,inflammatory factors levels,and regulate p38MAPK signaling pathway based on"Four-in-One"therapy,which exhibits synergistic effect when combined with Levocetirizine Hydrochloride.

Humans ; Mitral Valve Stenosis/surgery* ; Transcatheter Aortic Valve Replacement ; Dilatation ; Catheterization ; Aortic Valve Stenosis/surgery* ; Aortic Valve/surgery* ; Treatment Outcome ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation

Humans ; Mitral Valve Stenosis/surgery* ; Transcatheter Aortic Valve Replacement ; Dilatation ; Catheterization ; Aortic Valve Stenosis/surgery* ; Aortic Valve/surgery* ; Treatment Outcome ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation