Osteoporosis(OP) is a senile bone disease characterized by an imbalance between bone remodeling and bone formation. Targeting pathogenesis of kidney deficiency, spleen deficiency, and blood stasis, Bushen Jianpi Huoxue Decoction has a significant effect on the treatment of OP by tonifying kidney, invigorating spleen, and activating blood circulation. MicroRNA(miRNA) and the anti-apoptotic protein B-cell lymphoma-2-like protein 1(BCL2L1) are closely related to bone cell metabolism. Therefore, in this study, the binding of miR-140-5p to BCL2L1 was detected by dual luciferase assay and polymerase chain reaction(PCR). After silencing or overexpressing miR-140-5p, the apoptosis, autophagy, and osteogenic function of human fetal osteoblast cell line 1.19(HFOB1.19) were observed by flow cytometry and Western blot. Bushen Jianpi Huoxue Decoction-containing serum was prepared by intragastric administration of Bushen Jianpi Huoxue Decoction in rats. Different concentrations of Bushen Jianpi Huoxue Decoction-containing serum were used to treat HFOB1.19 with or without miR-140-5p mimic. The expression of osteogenic proteins in each group was observed, and the role of miR-140-5p/BCL2L1 in apoptosis and autophagy of HFOB1.19 was studied, along with the effect of Bushen Jianpi Huoxue Decoction on these processes. As indicated by the dual luciferase assay, miR-140-5p bound to BCL2L1. Flow cytometry and Western blot showed that miR-140-5p promoted apoptosis and inhibited autophagy in HFOB1.19. After intervention with high, medium, and low doses of Bushen Jianpi Huoxue Decoction-medicated serum, compared with the miR-140-5p NC group, the expression of osteocalcin(OCN), osteopontin(OPN), Runt-related transcription factor 2(RUNX2), and transforming growth factor beta 1(TGF-β1) decreased in the miR-140-5p mimic group, while the expression of bone morphogenetic protein 2(BMP2) showed no significant difference under high-dose intervention. Therefore, miR-140-5p/BCL2L1 can promote apoptosis and inhibit autophagy in HFOB1.19. Bushen Jianpi Huoxue Decoction can affect the osteogenic effect of miR-140-5p through BMP2.
MicroRNAs/metabolism* ; Autophagy/drug effects* ; Apoptosis/drug effects* ; Humans ; Drugs, Chinese Herbal/administration & dosage* ; Animals ; Cell Line ; bcl-X Protein/metabolism* ; Osteoblasts/metabolism* ; Rats ; Osteoporosis/physiopathology* ; Male ; Rats, Sprague-Dawley ; Osteogenesis/drug effects*

The COVID-19 epidemic has spread to the whole world for three years and has had a serious impact on human life, health and economic activities. China's epidemic prevention and control has gone through the following stages: emergency unconventional stage, emergency normalization stage, and the transitional stage from the emergency normalization to the "Category B infectious disease treated as Category B" normalization, and achieved a major and decisive victory. The designated hospitals for prevention and control of COVID-19 epidemic in Tianjin has successfully completed its tasks in all stages of epidemic prevention and control, and has accumulated valuable experience. This article summarizes the experience of constructing a hospital infection prevention and control system during the "Category B infectious disease treated as Category A" period in designated hospital. The experience is summarized as the "Cluster" hospital infection prevention and control system, namely "three rings" outside, middle and inside, "three districts" of green, orange and red, "three things" before, during and after the event, "two-day pre-purification" and "two-director system", and "one zone" management. In emergency situations, we adopt a simplified version of the cluster hospital infection prevention and control system. In emergency situations, a simplified version of the "Cluster" hospital infection prevention and control system can be adopted. This system has the following characteristics: firstly, the system emphasizes the characteristics of "cluster" and the overall management of key measures to avoid any shortcomings. The second, it emphasizes the transformation of infection control concepts to maximize the safety of medical services through infection control. The third, it emphasizes the optimization of the process. The prevention and control measures should be comprehensive and focused, while also preventing excessive use. The measures emphasize the use of the least resources to achieve the best infection control effect. The fourth, it emphasizes the quality control work of infection control, pays attention to the importance of the process, and advocates the concept of "system slimming, process fattening". Fifthly, it emphasizes that the future development depends on artificial intelligence, in order to improve the quality and efficiency of prevention and control to the greatest extent. Sixth, hospitals need to strengthen continuous training and retraining. We utilize diverse training methods, including artificial intelligence, to ensure that infection control policies and procedures are simple. We have established an evaluation and feedback mechanism to ensure that medical personnel are in an emergency state at all times.

This paper summarized the experience of integrated acupuncture and moxibustion program in the treatment of bipolar disorder （BD）. The pathogenesis of BD is a complex of deficiency and excess， which is closely related to the liver failing to govern the free flow of qi， the spleen failing to transport， phlegm-heat harassing the heart spirit. The pathogenesis of depressive episode is mainly qi constraint， and the most common syndromes are liver qi constraint， liver constraint accompanied by spleen deficiency， phlegm and qi constraint， qi stagnation and blood stasis. The pathogenesis of manic episode is mainly fire-heat， and the most common syndromes are exuberant heat in yangming （阳明）， intense heart-liver fire， phlegm-fire disturbing heart， and exuberant fire damaging yin. BD can be treated by the integrated acupuncture and moxibustion program， in which acupuncture is used to soothe the liver and regulate the mind， and refined moxibustion is to unblock and replenish yang； collateral bloodletting and cupping is used to move qi and drain fire， and needle-embedding therapy can be used to consolidate the curative effect. These therapies together have the effects of soothing the liver and regulating qi， fortifying the spleen and dissolving phlegm， calming the heart and draining fire.

Artificial vascular graft(AVG)fistula is widely used for hemodialysis treatment in patients with renal failure.However,it has poor elasticity and compliance,leading to stenosis and thrombosis.The ideal artificial blood vessel for dialysis should replicate the structure and components of a real artery,which is primarily maintained by collagen in the extracellular matrix(ECM)of arterial cells.Studies have revealed that in hepatitis B virus(HBV)-induced liver fibrosis,hepatic stellate cells(HSCs)become hyperactive and produce excessive ECM fibers.Furthermore,mechanical stimulation can encourage ECM secretion and remodeling of a fiber structure.Based on the above factors,we transfected HSCs with the hepatitis B viral X(HBX)gene for simulating the process of HBV infection.Subsequently,these HBX-HSCs were implanted into a polycaprolactone-polyurethane(PCL-PU)bilayer scaffold in which the inner layer is dense and the outer layer consists of pores,which was mechanically stimulated to promote the secretion of collagen nanofiber from the HBX-HSCs and to facilitate crosslinking with the scaffold.We obtained an ECM-PCL-PU composite bionic blood vessel that could act as access for dialysis after decellularization.Then,the vessel scaffold was implanted into a rabbit's neck arteriovenous fistula model.It exhibited strong tensile strength and smooth blood flow and formed autologous blood vessels in the rabbit's body.Our study demonstrates the use of human cells to create biomimetic dialysis blood vessels,providing a novel approach for creating clinical vascular access for dialysis.

Objective:To retrospectively analyze and study the clinical characteristics, imaging manifestations, laboratory tests, electroencephalography (EEG) results, immunotherapy efficacy, and prognosis of 48 patients with autoimmune encephalitis (AE) in the Hengyang area.Methods:Clinical data of 48 AE patients admitted to the First Affiliated Hospital, the Second Affiliated Hospital, and the Affiliated Nanhua Hospital, University of South China from January 2020 to April 2024 were collected. Retrospective analysis was conducted on age, gender, prodromal symptoms, initial symptoms, main clinical manifestations, cranial magnetic resonance imaging (MRI), electroencephalogram, cerebrospinal fluid routine biochemistry, serum and cerebrospinal fluid antibody detection results, and immunotherapy efficacy.Results:Among the 48 patients, there were 24 males and 24 females, with a median age of onset of 50 years. In terms of clinical manifestations, abnormal mental behavior is the most common initial symptom, accounting for 37.5%(18/48); The next was epileptic seizures, accounting for 35.4%(17/48); 16.7%(8/48) of patients experienced cognitive impairment; Rare initial symptoms included movement disorders, blurred vision, and loss of consciousness. In terms of neuroimaging, 47.9%(23/48) of patients had abnormal signals on cranial MRI, including 47.8%(11/23) of abnormal signals in the temporal lobe or hippocampus, 39.1%(9/23) in the frontal and parietal regions, 17.4%(4/23) in the occipital region, 13.0%(3/23) in the basal ganglia, and 8.7%(2/23) in the thalamus. In terms of EEG, 33.3%(16/48) of patients showed varying degrees of EEG abnormalities, manifested as diffuse slow waves, focal slow waves, epileptic like discharges, or increased fast waves. In terms of laboratory testing, 60.4%(29/48) of patients had routine biochemical abnormalities in cerebrospinal fluid, including elevated white blood cell count (>10×10 6 cells/L) in 33.3%(16/48), elevated protein (>0.45 g/L) in 37.5%(18/48), and elevated IgG in 33.3%(16/48). In terms of antibody testing, 27 cases were positive for antibodies, including 17 cases of N-methyl-D-aspartate receptor (NMDAR) antibody, 3 cases of anti-contactin associated protein 2 (CASPR2) antibody, 3 cases of anti-metabotropic glutamate receptors 5 (mGluR5) antibody, 2 cases of anti-dipeptidyl-peptidase-like protein (DPPX) antibody, 1 case of anti-GlyR antibody, and 1 case of anti-GAD65 antibody. In terms of treatment, 33 patients received immunotherapy on the basis of symptomatic treatment, and 13 of them showed improvement in clinical symptoms. Conclusions:The clinical manifestations of AE patients are highly heterogeneous, with typical initial clinical manifestations including mental abnormalities, epileptic seizures, cognitive and motor disorders. Neuroimaging changes are mainly in the temporal lobe or hippocampus, and antibody detection can timely confirm the diagnosis of AE. Early immunotherapy is the key to improving the prognosis of AE.

Objective:To observe the changes in the nutritional status of pediatric patients after allogeneic hematopoietic stem cell transplantation(allo-HSCT)for one year,and to analyze the risk factors.Methods:We collected data from 88 pediatric patients who underwent allo-HSCT at the Department of Hematology and Oncology in Children's Hospital of Nanjing Medical University between May 2018 and November 2022.All pediatric patients underwent nutritional status analysis before transplantation,at enrollment,3 months,6 months and 1 year after allo-HSCT.Linear regression model was used to analyze the risk factors for growth rate.Results:The body mass index Z score(BMI-Z)before allo-HSCT was(0.096±1.349),and decreased to(-0.258±1.438)、(-0.715±1.432)、(-0.584±1.444)at enrollment,3 months,6 months after allo-HSCT,and(-0.130±1.317)at 1 year after allo-HSCT(P<0.001).There was no significant change in BMI-Z between pre-transplantation and 1 year after transplantation(P=1.000).Height for age Z score(HAZ)before transplantation was(0.137±1.305)and decreased to(-0.083±1.267)、(-0.221±1.299)、(-0.269±1.282)in 3 months,6 months and 1 year after allo-HSCT(P<0.001).Multivariate linear regression showed that age≥10 years old(P=0.015)and chronic graft-versus-host disease(cGVHD)(P=0.005)were independent risk factors for change in HAZ.Conclusion:The BMI-Z of pediatric patients treated with allo-HSCT returned to the pre-transplantation level after one year,while HAZ continued to decrease.Allo-HSCT may cause impaired growth rate in pediatric patients.Attention should be paid to HAZ changes in pediatric patients before and after allo-HSCT,especially in pediatric patients≥10 years old of age and those with cGVHD.Effective nutritional intervention should be provided in time.

Background/Aims: Despite the high efficacy of direct-acting antivirals (DAAs), approximately 1–3% of hepatitis C virus (HCV) patients fail to achieve a sustained virological response. We conducted a nationwide study to investigate risk factors associated with DAA treatment failure. Machine-learning algorithms have been applied to discriminate subjects who may fail to respond to DAA therapy. Methods: We analyzed the Taiwan HCV Registry Program database to explore predictors of DAA failure in HCV patients. Fifty-five host and virological features were assessed using multivariate logistic regression, decision tree, random forest, eXtreme Gradient Boosting (XGBoost), and artificial neural network. The primary outcome was undetectable HCV RNA at 12 weeks after the end of treatment. Results: The training (n=23,955) and validation (n=10,346) datasets had similar baseline demographics, with an overall DAA failure rate of 1.6% (n=538). Multivariate logistic regression analysis revealed that liver cirrhosis, hepatocellular carcinoma, poor DAA adherence, and higher hemoglobin A1c were significantly associated with virological failure. XGBoost outperformed the other algorithms and logistic regression models, with an area under the receiver operating characteristic curve of 1.000 in the training dataset and 0.803 in the validation dataset. The top five predictors of treatment failure were HCV RNA, body mass index, α-fetoprotein, platelets, and FIB-4 index. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the XGBoost model (cutoff value=0.5) were 99.5%, 69.7%, 99.9%, 97.4%, and 99.5%, respectively, for the entire dataset. Conclusions Machine learning algorithms effectively provide risk stratification for DAA failure and additional information on the factors associated with DAA failure.

Background/Aims: Chronic hepatitis C (CHC) patients who failed antiviral therapy are at increased risk for hepatocellular carcinoma (HCC). This study assessed the potential role of metformin and statins, medications for diabetes mellitus (DM) and hyperlipidemia (HLP), in reducing HCC risk among these patients. Methods: We included CHC patients from the T-COACH study who failed antiviral therapy. We tracked the onset of HCC 1.5 years post-therapy by linking to Taiwan’s cancer registry data from 2003 to 2019. We accounted for death and liver transplantation as competing risks and employed Gray’s cumulative incidence and Cox subdistribution hazards models to analyze HCC development. Results: Out of 2,779 patients, 480 (17.3%) developed HCC post-therapy. DM patients not using metformin had a 51% increased risk of HCC compared to non-DM patients, while HLP patients on statins had a 50% reduced risk compared to those without HLP. The 5-year HCC incidence was significantly higher for metformin non-users (16.5%) versus non-DM patients (11.3%; adjusted sub-distribution hazard ratio [aSHR]=1.51; P=0.007) and metformin users (3.1%; aSHR=1.59; P=0.022). Statin use in HLP patients correlated with a lower HCC risk (3.8%) compared to non-HLP patients (12.5%; aSHR=0.50; P<0.001). Notably, the increased HCC risk associated with non-use of metformin was primarily seen in non-cirrhotic patients, whereas statins decreased HCC risk in both cirrhotic and non-cirrhotic patients. Conclusions Metformin and statins may have a chemopreventive effect against HCC in CHC patients who failed antiviral therapy. These results support the need for personalized preventive strategies in managing HCC risk.

Artemisia argyi is a perennial herbaceous herb of the Artemisia family, with leaves for medical use. However, the germplasm of A. argyi is seriously unclear and mixed during production, and it is urgent to protect new varieties of A. argyi. The distinctness, uniformity, and stability(DUS) testing of the new varieties of plants is the basis for the protection of new varieties of plants, and the development of the DUS testing guidelines is the technical basis for DUS testing. To develop the DUS testing guidelines of A. argyi, A. argyi of 100 germplasm was used as the research objects, and their agronomic and medicinal quality characters were observed and measured during six growth stages, and each character was graded and described. A total of 53 test characters were determined, including 19 characters that must be tested; there were four plant characters, two rhizome characters, five stem characters, three branching characters, 29 leaf characters, three floral characters, five medicinal quality characters, and two other characters. It also involved 16 quality characters, 22 quantitative characters, and 15 pseudo-quantitative characters. Seven grouping characters were determined from 53 characters, including "emergence period" "plant-plant type" "branching-primary branching site" "stem-color" "middle leaf-number of leaf splits" "budding period", and "plant-height". By searching for standard characters, 16 standard varieties were ultimately determined. The preparation of this guideline was of great significance for the review and protection of new A. argyi varieties, the protection of breeders' rights, and the promotion of the development of A. argyi industry.
Artemisia/chemistry* ; Plant Leaves/chemistry* ; Quality Control ; Plants, Medicinal/classification* ; Guidelines as Topic