BACKGROUND: Based on the China-VHD database, this study sought to develop and validate a Valvular Heart Disease- specific Age-adjusted Comorbidity Index (VHD-ACI) for predicting mortality risk in patients with VHD. METHODS & RESULTS: The China-VHD study was a nationwide, multi-centre multi-centre cohort study enrolling 13,917 patients with moderate or severe VHD across 46 medical centres in China between April-June 2018. After excluding cases with missing key variables, 11,459 patients were retained for final analysis. The primary endpoint was 2-year all-cause mortality, with 941 deaths (10.0%) observed during follow-up. The VHD-ACI was derived after identifying 13 independent mortality predictors: cardiomyopathy, myocardial infarction, chronic obstructive pulmonary disease, pulmonary artery hypertension, low body weight, anaemia, hypoalbuminaemia, renal insufficiency, moderate/severe hepatic dysfunction, heart failure, cancer, NYHA functional class and age. The index exhibited good discrimination (AUC, 0.79) and calibration (Brier score, 0.062) in the total cohort, outperforming both EuroSCORE II and ACCI (P < 0.001 for comparison). Internal validation through 100 bootstrap iterations yielded a C statistic of 0.694 (95% CI: 0.665-0.723) for 2-year mortality prediction. VHD-ACI scores, as a continuous variable (VHD-ACI score: adjusted HR (95% CI): 1.263 (1.245-1.282), P < 0.001) or categorized using thresholds determined by the Yoden index (VHD-ACI ≥ 9 vs. < 9, adjusted HR (95% CI): 6.216 (5.378-7.184), P < 0.001), were independently associated with mortality. The prognostic performance remained consistent across all VHD subtypes (aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation, tricuspid valve disease, mixed aortic/mitral valve disease and multiple VHD), and clinical subgroups stratified by therapeutic strategy, LVEF status (preserved vs. reduced), disease severity and etiology. CONCLUSION The VHD-ACI is a simple 13-comorbidity algorithm for the prediction of mortality in VHD patients and providing a simple and rapid tool for risk stratification.

Objective To organize and summarize the medication rules of GU Nai-fang in treating skin diseases through real-world data.Methods We collected traditional Chinese medicine prescriptions for GU Nai-fang's treatment of skin diseases from the outpatient medical record system of Shanghai Traditional Chinese Medicine Hospital to establish a database.Statistical analysis of disease types,performance,and efficacy was conducted,and association rules and systematic clustering analysis were performed using SPSS Modeler 18.0 and SPSS 26.0 software,respectively.Results A total of 5 020 patients were included,and 5 020 prescriptions were collected,involving 241 traditional Chinese medicines with a total frequency of 85 758 uses.The frequency of using heat clearing drugs,deficiency tonifying drugs,blood activating and stasis removing drugs,surface clearing drugs,and wind and dampness dispelling drugs was relatively high;most drugs tended to be cold and warm,mainly targeting the heart,lungs,and colon meridians.The top 15 Chinese medicines with the highest frequency of use were Smilacis Glabrae Rhixoma,Cortex Moutan,Radix Paeoniae Rubra,Rehmanniae Radix,Scutellariae Radix,Cynanchi Paniculati Radix et Rhizoma,Schisandrae Chinensis Fructus,Violsse Herba,Mume Fructus,Herba Pyrolae,Hedyotis Diffusae Herba,Lonicerae Japonicae Flos,Cicadae Periostracum,Bombyx Batryticatus,Radix Salviae.Association rule analysis obtained 15 high-frequency combinations of 2 traditional Chinese medicines and 3 traditional Chinese medicines.Cluster analysis resulted in 7 clustered prescriptions.Conclusion GU Nai-fang commonly used heat clearing drugs,deficiency tonifying drugs,blood activating and stasis removing drugs,surface resolving drugs,and wind and dampness dispelling drugs in the treatment of skin diseases,and Smilacis Glabrae Rhixoma,Cortex Moutan,Radix Paeoniae Rubra,Rehmanniae Radix,and Scutellariae Radix were the most frequently used drugs.

A centrifugation-free,single-reaction colorimetric method for detection of glucose,utilizing a dual nanozyme cascade system based on gold nanoparticles(AuNPs)and iron-doped carbon dots(FeCDs),was developed in this work.The AuNPs exhibited glucose oxidase-like activity to catalyze glucose oxidation for generation of H2O2,while the FeCDs demonstrated peroxidase-like activity to subsequently catalyze the H2O2-mediated oxidation of 3,3',5,5'-tetramethylbenzidine(TMB).To prevent interference from the blue signal generated by self-aggregation of AuNPs in subsequent quantitative detection,the reaction system was terminated with HCl,converting oxTMB into a stable yellow product.Based on changes in the absorbance at 450 nm of this yellow solution,a quantitative relationship was established between glucose concentration and absorbance at 450 nm(A450).Experimental results demonstrated that this sensor achieved a linear detection range of 44 μmol/L to 11.11 mmol/L(R2=0.993)with a detection limit of 30.68 μmol/L and spiked recoveries of 97.9%-104.7%.By integrating smartphone-based color recognition capabilities,a rapid visual detection platform was established for quantification of glucose through RGB analysis.The validation experimental results using commercial glucose injection samples further confirmed the practical application potential of this methodology.

This study aims to explore the mechanism through which Yishen Jiangtang Decoction(YSJTD) regulates endoplasmic reticulum stress(ERS)-mediated NOD-like receptor thermal protein domain associated protein 3(NLRP3) inflammasome to improve diabetic nephropathy(DN) in db/db mice. Thirty db/db mice were randomly divided into the model group, YSJTD group, ERS inhibitor 4-phenylbutyric acid(4-PBA) group, with 10 mice in each group. Additionally, 10 db/m mice were selected as the control group. The YSJTD group was orally administered YSJTD at a dose of 0.01 mL·g~(-1), the 4-PBA group was orally administered 4-PBA at a dose of 0.5 mg·g~(-1), and the control and model groups were given an equal volume of carboxylmethyl cellulose sodium. The treatments were administered once daily for 8 weeks. Food intake, water consumption, and body weight were recorded every 2 weeks. After the intervention, fasting blood glucose(FBG), glycosylated hemoglobin(HbA1c), urine microalbumin(U-mALB), 24-hour urine volume, serum creatinine(Scr), and blood urea nitrogen(BUN) were measured. Inflammatory markers interleukin-1β(IL-1β) and interleukin-18(IL-18) were detected using the enzyme-linked immunosorbent assay(ELISA). Renal pathology was assessed through hematoxylin-eosin(HE), periodic acid-Schiff(PAS), and Masson staining, and transmission electron microscopy(TEM). Western blot was used to detect the expression levels of glucose-regulated protein 78(GRP78), C/EBP homologous protein(CHOP), NLRP3, apoptosis-associated speck-like protein containing CARD(ASC), cysteinyl aspartate-specific proteinase(caspase-1), and gasdermin D(GSDMD) in kidney tissues. The results showed that compared to the control group, the model group exhibited poor general condition, increased weight and food and water intake, and significantly higher levels of FBG, HbA1c, U-mALB, kidney index, 24-hour urine volume, IL-1β, and IL-18. Compared to the model group, the YSJTD and 4-PBA groups showed improved general condition, increased body weight, decreased food intake, and lower levels of FBG, U-mALB, kidney index, 24-hour urine volume, and IL-1β. Specifically, the YSJTD group showed a significant reduction in IL-18 levels compared to the model group, while the 4-PBA group exhibited decreased water intake and HbA1c levels compared to the model group. Although there was a decreasing trend in water intake and HbA1c in the YSJTD group, the differences were not statistically significant. No significant differences were observed in BUN, Scr, and kidney weight among the groups. Renal pathology revealed that the model group exhibited more severe renal damage compared to the control group. Kidney sections from the model group showed diffuse mesangial proliferation in the glomeruli, tubular edema, tubular dilation, significant inflammatory cell infiltration in the interstitium, and increased glycogen staining and blue collagen deposition in the basement membrane. In contrast, the YSJTD and 4-PBA groups showed varying degrees of improvement in renal damage, glycogen staining, and collagen deposition, with the YSJTD group showing more significant improvements. TEM analysis indicated that the model group had extensive cytoplasmic edema, homogeneous thickening of the basement membrane, fewer foot processes, and widening of fused foot processes. In the YSJTD and 4-PBA groups, cytoplasmic swelling of renal tissues was reduced, the basement membrane remained intact and uniform, and foot process fusion improved.Western blot results indicated that compared to the control group, the model group showed upregulation of GRP78, CHOP, GSDMD, NLRP3, ASC, and caspase-1 expression. In contrast, both the YSJTD and 4-PBA groups showed downregulation of these markers compared to the model group. These findings suggest that YSJTD exerts a protective effect against DN by alleviating NLRP3 inflammasome activation through the inhibition of ERS, thereby improving the inflammatory response in db/db DN mice.
Animals ; Endoplasmic Reticulum Stress/drug effects* ; Diabetic Nephropathies/metabolism* ; NLR Family, Pyrin Domain-Containing 3 Protein/genetics* ; Drugs, Chinese Herbal/administration & dosage* ; Mice ; Inflammasomes/drug effects* ; Male ; Kidney/pathology* ; Endoplasmic Reticulum Chaperone BiP ; Humans ; Interleukin-18/genetics* ; Mice, Inbred C57BL

To investigate the impact of preoperative serum follicle-stimulating hormone (FSH) levels on the probability of testicular sperm retrieval, we conducted a study of nonobstructive azoospermic (NOA) men with different testicular volumes (TVs) who underwent microdissection testicular sperm extraction (micro-TESE). A total of 177 NOA patients undergoing micro-TESE for the first time from April 2019 to November 2022 in Shenzhen Zhongshan Obstetrics and Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital, Shenzhen, China) were retrospectively reviewed. The subjects were divided into four groups based on average TV quartiles. Serum hormone levels in each TV group were compared between positive and negative sperm retrieval subgroups. Overall sperm retrieval rate was 57.6%. FSH levels (median [interquartile range]) were higher in the positive sperm retrieval subgroup compared with the negative outcome subgroup when average TV was <5 ml (first quartile [Q1: TV <3 ml]: 43.32 [17.92] IU l -1 vs 32.95 [18.56] IU l -1 , P = 0.048; second quartile [Q2: 3 ml ≤ TV <5 ml]: 31.31 [15.37] IU l -1 vs 25.59 [18.40] IU l -1 , P = 0.042). Elevated serum FSH levels were associated with successful micro-TESE sperm retrieval in NOA men whose average TVs were <5 ml (adjusted odds ratio [OR]: 1.06 per unit increase; 95% confidence interval [CI]: 1.01-1.11; P = 0.011). In men with TVs ≥5 ml, larger TVs were associated with lower odds of sperm retrieval (adjusted OR: 0.84 per 1 ml increase; 95% CI: 0.71-0.98; P = 0.029). In conclusion, elevated serum FSH levels were associated with positive sperm retrieval in micro-TESE in NOA men with TVs <5 ml. In men with TV ≥5 ml, increases in average TVs were associated with lower odds of sperm retrieval.
Humans ; Male ; Azoospermia/surgery* ; Sperm Retrieval/statistics & numerical data* ; Adult ; Follicle Stimulating Hormone/blood* ; Retrospective Studies ; Testis/pathology* ; Microdissection ; Organ Size

Objective To organize and summarize the medication rules of GU Nai-fang in treating skin diseases through real-world data.Methods We collected traditional Chinese medicine prescriptions for GU Nai-fang's treatment of skin diseases from the outpatient medical record system of Shanghai Traditional Chinese Medicine Hospital to establish a database.Statistical analysis of disease types,performance,and efficacy was conducted,and association rules and systematic clustering analysis were performed using SPSS Modeler 18.0 and SPSS 26.0 software,respectively.Results A total of 5 020 patients were included,and 5 020 prescriptions were collected,involving 241 traditional Chinese medicines with a total frequency of 85 758 uses.The frequency of using heat clearing drugs,deficiency tonifying drugs,blood activating and stasis removing drugs,surface clearing drugs,and wind and dampness dispelling drugs was relatively high;most drugs tended to be cold and warm,mainly targeting the heart,lungs,and colon meridians.The top 15 Chinese medicines with the highest frequency of use were Smilacis Glabrae Rhixoma,Cortex Moutan,Radix Paeoniae Rubra,Rehmanniae Radix,Scutellariae Radix,Cynanchi Paniculati Radix et Rhizoma,Schisandrae Chinensis Fructus,Violsse Herba,Mume Fructus,Herba Pyrolae,Hedyotis Diffusae Herba,Lonicerae Japonicae Flos,Cicadae Periostracum,Bombyx Batryticatus,Radix Salviae.Association rule analysis obtained 15 high-frequency combinations of 2 traditional Chinese medicines and 3 traditional Chinese medicines.Cluster analysis resulted in 7 clustered prescriptions.Conclusion GU Nai-fang commonly used heat clearing drugs,deficiency tonifying drugs,blood activating and stasis removing drugs,surface resolving drugs,and wind and dampness dispelling drugs in the treatment of skin diseases,and Smilacis Glabrae Rhixoma,Cortex Moutan,Radix Paeoniae Rubra,Rehmanniae Radix,and Scutellariae Radix were the most frequently used drugs.

Due to the insufficient understanding of the pathogenesis of Alzheimer disease(AD),investigating the early pathophysiological mechanisms underlying AD is particularly essential for advancing subsequent drug therapies. Abnormal protein accumulation is a hallmark characteristic of neurodegenerative diseases such as AD and a sign of proteostasis imbalance. The proteasome plays a remarkable role in maintaining proteostasis mainly by degrading abnormal proteins or polypeptides through ubiquitin-proteasome system (UPS). proteasomes interact with amyloid β-protein (Aβ) and Tau protein in β as both cause and effect which in turn affect neuronal function,glial homeostasis and neural circuit regulation. It has been found that proteasome interacts with Aβ and Tau proteins as both cause and effect,which in turn impacts neuronal function,glial homeostasis and neural circuit regulation. A thorough understanding of the relationship between the proteasome and AD not only provides new clues for exploring the pathogenesis of AD but also holds promise as a major therapeutic target in the future.

Due to the insufficient understanding of the pathogenesis of Alzheimer disease(AD),investigating the early pathophysiological mechanisms underlying AD is particularly essential for advancing subsequent drug therapies. Abnormal protein accumulation is a hallmark characteristic of neurodegenerative diseases such as AD and a sign of proteostasis imbalance. The proteasome plays a remarkable role in maintaining proteostasis mainly by degrading abnormal proteins or polypeptides through ubiquitin-proteasome system (UPS). proteasomes interact with amyloid β-protein (Aβ) and Tau protein in β as both cause and effect which in turn affect neuronal function,glial homeostasis and neural circuit regulation. It has been found that proteasome interacts with Aβ and Tau proteins as both cause and effect,which in turn impacts neuronal function,glial homeostasis and neural circuit regulation. A thorough understanding of the relationship between the proteasome and AD not only provides new clues for exploring the pathogenesis of AD but also holds promise as a major therapeutic target in the future.

This study aimed to evaluate the effectiveness and safety of eight oral Chinese patent medicines in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) by network Meta-analysis. Randomized controlled trial(RCT) on the treatment of AECOPD with eight oral Chinese patent medicines was retrieved from databases including CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, EMbase, and Cochrane Library from database inception to August 6, 2022. The information was extracted from the included literature and the quality of the included studies was evaluated using the Cochrane risk of bias assessment tool. The data were analyzed using Stata SE 15.1 and ADDIS 1.16.8 software. Finally, 53 RCTs were included, with 5 289 patients involved, including 2 652 patients in the experimental group and 2 637 patients in the control group. Network Meta-analysis showed that Lianhua Qingwen Capsules+conventional western medicine were optimal in improving clinical effective rate, Shufeng Jiedu Capsules+conventional western medicine in improving FEV1/FVC, Qingqi Huatan Pills+conventional western medicine in improving FEV1%pred, Feilike Mixture(Capsules)+conventional western medicine in improving PaO_2, Lianhua Qingwen Capsules+conventional western medicine in reducing PaCO_2, and Qingqi Huatan Pills+conventional western medicine in reducing C-reactive protein(CRP). In terms of safety, most of them were gastrointestinal symptoms, and no serious adverse reactions were reported. When the clinical effective rate was taken as the comprehensive index of efficacy evaluation, Lianhua Qingwen Capsules+conventional western medicine were the most likely to be the best treatment for AECOPD. There are some limitations in the conclusion of this study. It only provides references for clinical medication.
Humans ; Capsules ; Network Meta-Analysis ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Medicine, Chinese Traditional

Violet root rot is one of the main root diseases in the production process of Pseudostellaria heterophylla. To clarify the pathogenic species that cause the violet root rot of P. heterophylla in Fujian province, the roots and the sclerotia with violet root rot symptoms were collected from the main producing areas of P. heterophylla(Fujian province) from 2017 to 2021, and the pathogens were isolated by tissue separation method and identified by morphology and multi-gene phylogenetic analysis. Additionally, the biological characteristics of the pathogens were studied and the fungicides were determined. The results showed that 78 strains of violet root rot were isolated from the collected root samples, which belonged to one type after preliminary morphological identification. Two represen-tative strains were selected from the pathogens for multi-gene phylogenetic analysis, and they were clustered with Helicobasidium mompa together. The suitable culture conditions for the mycelium were OA medium, 25 ℃, pH 6, and ammonium oxalate as the nitrogen source. The lethal temperature of the mycelium was 50 ℃ for 10 minutes. Moreover, 99.1% propiconazole and 98.7% azoxystrobin had the optimal bacteriostatic effect, and the concentrations with the 50% bacteriostatic rate were 16.85 and 12.24 μg·mL~(-1), respectively. On the basis of the above results, the pathogen causing violet root rot of P. heterophylla in Fujian province was H. mompa. The medium type, growth temperature, pH value, nitrogen source, etc. had significant effect on the growth of mycelium.
Plant Roots ; Phylogeny ; Temperature ; Caryophyllaceae ; Nitrogen