Hyperthyroidism （HT） is frequently complicated by atrial fibrillation （AF） in clinical practice. Based on traditional Chinese medicine （TCM） zang-xiang （藏象） theory and clinical experience， both HT and AF are closely associated with dysfunction of the liver. The pathogenesis is initiated by the liver failing to govern the free flow of qi， and liver constraint and qi stagnation， with the key turning points being liver constraint transforming into fire and the internal stirring of liver wind， ultimately leading to liver blood depletion and insufficient nourishment of the heart spirit. Thus， it is proposed to treat the disease from the liver， with stage-specific therapeutic approaches according to the evolution of the disease. In the early stage， the treatment should focus on soothing the liver and relieving constraint to reduce goiter and calm the heart， while in the progressive stage， the method of clearing liver and draining fire is suggested to subdue yang and stabilize palpitations. In the acute stage， the strategy is calming the liver and nourishing yin to subdue yang and extinguish wind. In the later stage， it is suggested to soften the liver and benefit qi， so as to nourish yin and restore pulse. These methods are sequentially applied to synergistically reduce goiter and stabilize palpitations， providing a therapeutic approach for HT complicated by AF.

Sepsis-associated encephalopathy (SAE) is one of the complications of sepsis, causes cognitive dysfunction ranging from mild attention deficits to progression into coma, which severely impairs patients' ability to live and mental health, and increases the long-term disability and mortality rates. Although the clinical attention to SAE has been increasing in recent years, effective interventions to improve cognitive dysfunction in sepsis survivors are still in the preclinical stage. The pathogenesis of SAE is numerous and complex, and mitochondrial dysfunction, as one of the key pathogenic mechanisms, plays a role in the cognitive development process through oxidative stress imbalance, energy metabolism disorders, and activation of apoptosis signaling pathway. The present review systematically integrates the recent studies on mitochondrial dysfunction in the development of cognitive disorders. This review systematically integrates the cutting-edge research results in recent years, discusses the mitochondrial structural disruption, mitochondrial kinetic abnormalities, respiratory chain dysfunction, and comprehensively comprehends the research progress of mitochondria-targeted antioxidant, mitochondrial autophagy activator, mitochondrial biosynthesis modifier and other novel intervention strategies in improving cognitive function of SAE patients, with the aim of providing theoretical basis for the breakthrough of the current status of clinical treatment of SAE and the targeting of mitochondria for treatment. The aim is to provide theoretical basis for breaking through the status of SAE clinical treatment and targeting mitochondrial therapy.
Humans ; Sepsis-Associated Encephalopathy/metabolism* ; Mitochondria/metabolism* ; Sepsis/complications* ; Oxidative Stress ; Cognitive Dysfunction ; Autophagy

DNA methylation is an important epigenetic modification in mammals, playing a crucial role in various physiological processes, including cell differentiation and the gene expression regulation. The ten-eleven translocation (TET) protein family of DNA demethylases is integral to the regulation of DNA methylation, as it catalyzes the oxidation of 5-methylcytosine to form 5-hydroxymethylcytosine. During early embryonic development, the genome undergoes extensive DNA demethylation, and any aberration in this reprogramming process can result in abnormal embryonic development and physiological defects in offspring. The TET proteins, due to their unique dynamics and multifaceted roles, facilitate DNA demethylation and are involved in development and maturation of germ cells, the establishment of pluripotency, cell lineage differentiation, and transcriptional processes throughout mammalian embryogenesis. Furthermore, these proteins are closely associated with the maintenance of pregnancy and susceptibility of progeny to disease. Factors such as genetic mutations, maternal health conditions, and exposure to adverse environmental influences can impact TET protein activity, resulting in abnormal patterns of DNA demethylation. A comprehensive investigation of the related mechanisms of TET proteins is essential for enhancing our understanding of epigenetic regulation during early life, diagnosing and treating related diseases such as early fetal development retardation, and informing strategies for the prevention and management of pregnancy.This article reviews the regulatory role of DNA demethylation mediated by TET protein in mammalian embryonic development and pregnancy outcomes.

Objective:To explore the effect of non-invasive intervention on preventing maternal breast tenderness, and to provide references for clinicians to select the optimal non-invasive intervention for the prevention of maternal breast tenderness.Methods:Literature focused on the effect of different non-invasive interventions to prevent maternal breast tenderness by randomized controlled trials design was searched in the databases, including China National Knowledge Infrastructure, VIP, Wanfang, SinoMed, PubMed, Web of Science, Embase and Cochrane Library, from inception to April 8, 2024. Two researchers independently screened the literature, extracted the data and evaluated the quality of the literature. Stata 16.0 was used to conduct a network Meta-analysis.Results:A total of 21 studies involving 2 298 women, covering 5 non-invasive interventions (low-frequency pulse electrotherapy, breast massage combined with low-frequency pulse electrotherapy, breast massage and acupoint massage, breast massage and acupoint massage combined with ear point pressure bean, breast massage and acupoint massage combined with external application of Chinese medicine). The network meta-analysis results showed that, compared with routine care, five non-invasive interventions had statistically significant differences in reducing the incidence of maternal breast tenderness ( OR values ranging from 0.20 to 0.39, all P<0.05). Breast massage combined with low-frequency pulse electrotherapy ranked first in terms of effectiveness on preventing of breast tenderness. Conclusions:All five non-invasive interventions are effective on preventing maternal breast tenderness, with breast massage combined with low-frequency pulse electrotherapy being the most effective.

OBJECTIVE To explore the clinical characteristics and risk factors for refractory drug-resistant Pseudo-monas aeruginosa infection and evaluate the prognosis so as to provide theoretical bases for effective prevention and control of the refractory drug-resistant P.aeruginosa infection.METHODS A total of 95 patients who were di-agnosed with refractory drug-resistant P.aeruginosa infection and were treated in People's Hospital of Guangdong Province from Jan.2019 to Dec.2023 were assigned as the infection group.Meanwhile,95 patients who did not have drug-resistant P.aeruginosa infection,matched by the age and hospitalization period,were chosen as the non-infection group in a case-control(1∶1 ratio).The basic information and clinical data were collected from the two groups of patients.The characteristics and risk factors for the drug-resistant P.aeruginosa infection were ana-lyzed,and the prognosis of the patients was evaluated.RESULTS Among the clinical isolates of drug-resistant P.aeruginosa,78 were isolated from respiratory secretions;there were 59 patients from intensive care unit(ICU),13 patients from respiratory medicine department and 8 patients from geriatrics department.Fever,dyspnea,moist rales and cough were the major clinical manifestations.The proportions of patients with history of respirato-ry tract disease(P＜0.001),renal disease(P=0.008),nervous system disease(P=0.005),diabetes mellitus(P=0.017),hepatic disease(P=0.007),previous utilization rate of aminoglycosides(P=0.002)and previous u-tilization rate of no less than 3 types of antibiotics were higher in the infection group than in the non-infection group.Multivariate analysis showed that the history of respiratory tract disease(OR=2.813,95％CI:1.366 to 5.792,P=0.005),history of diabetes mellitus(OR=2.465,95％CI:1.129 to 5.382,P=0.024)and history of nervous system disease(OR=2.386,95％CI:1.151 to 4.944,P=0.019)were the risk factors for the drug-resist-ant P.aeruginosa infection.The mortality rate of the infection group was 30.53％,higher than 6.32％of the non-infection group(x2=18.527,P＜0.001).CONCLUSIONS The mortality rate of the patients with drug-resistant P.aeruginosa infection is high.The history of respiratory tract disease,history of diabetes mellitus and history of nervous system disease are the major risk factors for the infection.It is necessary for the hospital to strengthen the awareness of prevention of the drug-resistant P.aeruginosa infection so as to curb the hospital-associated infection.

Precise preoperative assessment of cervical cancer facilitates personalized treatment and reduces the burden of retreatment.In recent years,various quantitative techniques of relaxation time,including T1 mapping,T2 mapping,T2*mapping,blood oxygenation level dependent MRI,synthetic MRI and MR fingerprinting,had demonstrated certain progresses,providing novel approaches for non-invasive evaluation of cervical cancer.The research progresses in quantitative MR relaxation time techniques of cervical cancer were reviewed in this article.

Objective To examine the anti-central-fatigue function of maca and its underlying mechanism.Methods Forty Sprague-Dawley rats were divided randomly into a negative control group,model control group,and low-,medium-,and high-dose maca groups(0.6,1.2,and 2.4 g/kg·body weight).Rats in all groups except the negative control group were subjected to multi-factor stimulation,including cold-water swimming,sleep deprivation,restraining,and tail-clamping,to establish central fatigue rat models.Rats in the low-,medium-,and high-dose maca groups received 0.6,1.2,or 2.4 g/kg maca,respectively,by gavage for 35 days.Behavioral testing was carried out using the Morris water-maze,sucrose-preference,and tail-suspension tests.Markers of oxidative stress in the hippocampus,including superoxide dismutase(SOD),malondialdehyde(MDA),and catalase(CAT),were detected using test kits.Proteins connected with the AMP-activated protein kinase(AMPK)/sirtuin 1(SIRT1)/peroxisome proliferator-activated receptor γ coactivator 1-α(PGC-1α)signaling pathway in the hippocampus were detected by Western blot.Results Rats in the low-,medium-,and high-dose maca groups spent significantly more time in the target quadrant compared with the model control group(P＜0.05 or P＜0.01),but there was no significant dose-effect relationship.Rats in the medium-and high-dose maca groups showed decreased escape latency(P＜0.05),increased time crossing the platform location(P＜0.05),increased sucrose preference(P＜0.05),decreased tail suspension time(P＜0.05),increased the activities of CAT(P＜0.01)and SOD(P＜0.05),and decreased MDA content(P＜0.01).Rats in the low-,medium-,and high-dose maca groups also showed significantly increased protein expression levels of AMPK and nuclear respiratory factor 1(P＜0.01 or P＜0.05),but no significant dose-effect relationship was observed.Rats in the medium-and high-dose maca groups showed increased protein expression of PGC-1α(P＜0.05 or P＜0.01),and rats in the high-dose maca group showed increased protein expression of SIRT1 and mitochondrial transcription factor A(P＜0.05 or P＜0.01).Conclusions Maca can improve the indicators of central fatigue in rats,determined by behavioral testing and oxidative stress-related factors.The underlying mechanism may be related to its regulatory effects on the AMPK/SIRT1/PGC-1α signaling pathway.

ObjectiveTo compare the contents and relative molecular weight distributions of proteins and polypeptides in Naoxuekang dropping pills， Huoxue Tongmai capsules and Maixuekang capsules of Hirudo single medicinal preparations， to evaluate the in vitro anticoagulant， antiplatelet and fibrinolytic activities of the three preparations， and to investigate the effects of temperature， pH and digestive enzymes on the anticoagulant activities of the three preparations. MethodsThe contents of soluble proteins and polypeptides in the three preparations were determined by bicinchoninic acid assay（BCA） and Bradford method， and the relative molecular weight distributions of the three preparations were determined by electrophoresis combined with gel chromatography. The antithrombin activity of the three preparations was evaluated by fibrinogen-thrombin time（Fibg-TT） method， and their anticoagulant activities were further assessed by the elongations of activated partial thromboplastin time（APTT）， prothrombin time（PT） and thrombin time（TT）. The antiplatelet aggregation activities of the three preparations were measured by turbidimetry and the fibrinolytic activities were measured by fibrin plate method. Relative TT was used as index to investigate the effects of temperature， pH and digestive enzyme buffer on anticoagulant activities of the three preparations. ResultsAt the lowest single dosage， the contents of proteins and polypeptides were in the order of Maixuekang capsules>Huoxue Tongmai capsules>Naoxuekang dropping pills. Both Huoxue Tongmai capsules and Maixuekang capsules had 11 electrophoretic bands between 4.0 kDa and 90 kDa， the bands of Maixuekang capsules were more clear in the range of >25 kDa， and there was 1 obvious band at 14 kDa for the two capsules. Huoxue Tongmai capsules had one specific band at 9.0 kDa and Maixuekang capsules had one specific band at 48.0 kDa. Naoxuekang dropping pills only had 2 electrophoretic bands at 6.5 kDa and 8.5 kDa， primarily containing peptides below 2 kDa， most of which were oligopeptides. The anticoagulant activity concentrations of the three preparations exhibited a certain dose-dependent effect. At the lowest single dosage， The anticoagulant activity concentrations were ranked as Naoxuekang dropping pills>Huoxue Tongmai capsules>Maixuekang capsules. The prolongation effect of the three preparations on coagulation time was dose-dependent. At the same concentration， the prolongation effect of Naoxuekang dropping pills and Huoxue Tongmai capsules was APTT prolongation rate>TT prolongation rate>PT prolongation rate， whereas for Maixuekang capsules， the sequence was TT prolongation rate>APTT prolongation rate>PT lengthening rate. At the single minimum dosage， the order of APTT prolongation rate was Maixuekang capsules>Huoxue Tongmai capsules≈Naoxuekang dropping pills， the order of PT prolongation rate was Naoxuekang dropping pills≈Maixuekang capsules>Huoxue Tongmai capsules， and the order of TT prolongation rate was Maixuekang capsules>Huoxue Tongmai capsules>Naoxuekang dropping pills. The three preparations showed dose-dependent effects on platelet aggregation induced by adenosine diphosphate（ADP） and arachidonic acid（AA）， and the effect induced by ADP was stronger than that induced by AA. The anti-platelet aggregation effect of Naoxuekang dropping pills was significantly stronger than that of Maixuekang capsules（P<0.01）， whereas Huoxue Tongmai capsules had the effect of promoting platelet aggregation. None of the three preparations had the ability to dissolve fibrin. The anticoagulant activity of Naoxuekang dropping pills was least affected by heating， while the activities of the two capsules decreased significantly within 5 min above 80 ℃， and continued to decrease within 2 h. Compared with pure water， the anticoagulant activities of the three preparations could be increased by 1-3 times under strong acidity（pH 1-3）. In the pepsin buffer， the anticoagulant activity of Naoxuekang dropping pills could be increased by 1-3 times， while the anticoagulant activities of Huoxue Tongmai capsules and Maxuekang capsules were significantly decreased， the lowest levels were about 60% and 20%， respectively. In trypsin buffer， the anticoagulant activities of Naoxuekang dropping pills， Huoxue Tongmai capsules and Maixuekang capsules decreased significantly， and the lowest levels decreased to about 41%， 41% and 35%， respectively. ConclusionThe contents of proteins and polypeptides and relative molecular weights of the preparations derived from lyophilized fresh Hirudo powder， dried Hirudo powder and reflux extract of Hirudo decrease sequentially， and the anticoagulant activity decrease gradually， but the anticoagulant pathway is different. And the anti-platelet aggregation activity of the reflux extract is significantly enhanced. The heat resistance and gastrointestinal stability of the three preparations increase successively， and the first two are suitable for enteric-soluble preparations， while the latter is suitable for routine oral administration. The above results can provide data reference for the rationality of different preparation methods， active substances， pharmacodynamics and mechanism of Hirudo preparations.

Objective To explore characteristics of time-domain and time-frequency of task-related electroencephalogram(EEG)in patients with post-stroke aphasia(PSA).Methods From January,2018 to December,2021,18 PSA patients(PSA group)were recruited from Dongzhimen Hospi-tal,Beijing University of Chinese Medicine,and nine healthy subjects(control group)were recruited with matched gender,age and education level.EEG data based on the Chinese word-picture matching task were col-lected,and the average amplitude of N400 and event-related synchronization(ERS)/desynchronization(ERD)were analyzed.The PSA group was assessed with Chinese Rehabilitation Research Center Aphasia Examination(CRRCAE).Results The effect of N400 was significant on left frontal,central frontal,right frontal,left central and central areas.The average amplitude of N400 was higher on the frontal area in PSA group than in the control group,and it was low-er on right temporal-parietal area.For word-picture mismatching,average amplitude of N400 at FPZ was moder-ately correlated with auditory comprehension(r=0.483,P<0.05),the average amplitude of N400 at T8 was moderately correlated with repetition(r=0.584,P<0.05)and reading aloud(r=0.556,P<0.05),and the aver-age amplitude of N400 at P6 was moderately correlated with speaking(r=0.476,P<0.05)and reading(r=0.502,P<0.05).For word-picture matching,the average amplitude of N400 at P7 was moderately negatively cor-related with calculation(r=-0.481,P<0.05).Compared with the control group,the energy decreased in θ and αfrequency bands with absence of ERS in PSA group,and it increased in β frequency band with absence of ERD.Conclusion The activities of Chinese word-picture matching task-related EEG have been inhibited on right temporal-pa-rietal area for PSA patients,and it compensatively increases on frontal area,while the energy decreases in θ and αfrequency bands with ERS deficiency,and increases in β frequency band with ERD deficiency.