ObjectiveThis paper aims to investigate and evaluate the staged efficacy and safety of the representative empirical prescription of the “Zhu Ke Jiao” theory， Qijia Rougan prescription， combined with entecavir in the treatment of hepatic fibrosis in chronic hepatitis B. MethodsA multicenter randomized controlled clinical study was conducted， and 101 patients diagnosed with chronic hepatitis B-related hepatic fibrosis （CHB-HF） who met the diagnosis and inclusion criteria were randomly assigned to an observation group （Qijia Rougan prescription + entecavir） and a control group （entecavir）. The treatment duration was 24 weeks. Liver stiffness measurement （LSM）， fibrosis-4 index （FIB-4）， portal vein diameter， hepatitis B serology， biochemical indicators， hepatic fibrosis markers in serum ［hyaluronic acid （HA）， laminin （LN）， procollagen Ⅲ peptide （PⅢP）， and type Ⅳ collagen （Ⅳ-C）］， and traditional Chinese medicine syndrome scores were used as efficacy evaluation indicators. Efficacy assessments and explorations of different staged subgroups of Qijia Rougan prescription were conducted according to LSM values based on the Metavir pathological staging standard. ResultsA total of 98 cases were included for statistical analysis， with 49 cases in the observation group and 49 in the control group. The general data of the patients in both groups were comparable. Compared with the same group before treatment， the observation group showed a significant reduction in LSM and FIB-4 （P<0.01）， as well as notable improvements in LN， Ⅳ-C， and various TCM syndrome scores （P<0.05， P<0.01）. When compared to the control group after treatment， the observation group demonstrated significant improvements in LSM， FIB-4， and various TCM syndrome score indicators （P<0.05， P<0.01）， indicating that the observation group performed better than the control group. Subgroup analysis of the regression of hepatic fibrosis stages showed that compared to the same group before treatment， the observation group had better improvement in regression of stages F2 and F3 （P<0.05）. When compared to the control group after treatment， the observation group exhibited superior improvement in regression of stage F3 （P<0.05）. No adverse events occurred in either group during the treatment period. ConclusionCompared with entecavir alone， the combination of Qijia Rougan prescription and entecavir significantly improves the degree of hepatic fibrosis and clinical TCM symptoms in patients. The optimal intervention period is primarily during stage F3， which is a potential “interception” point of the “Zhu Ke Jiao” theory.

AIM: To explore the value of the corneal/refractive analyzer OPD-Scan III in assessing visual quality after Nd:YAG laser surgery in patients with posterior capsular opacification.METHODS: A total of 98 patients(98 eyes)with posterior capsular opacification who underwent Nd:YAG laser posterior capsulotomy in our hospital from May 2021 to April 2023 were retrospectively selected as the research subjects, and higher-order aberration parameters(coma, spherical aberration and trefoil aberration)and visual quality parameters [Strehl ratio(SR)and 4 mm area ratio(AR)in the human eye modulation transfer function(MTF)curve] were obtained using the corneal/refractive analyzer OPD-Scan III. The patient's visual acuity, higher-order aberration parameters and visual quality before surgery, and at 1 wk and 3 mo after surgery were compared.RESULTS: There were statistically significant differences in uncorrected distance visual acuity(UDVA), uncorrected intermediate visual acuity(UIVA)and uncorrected near visual acuity(UNVA), coma, spherical aberration, trefoil aberration, SR and AR before and after surgery(all P<0.001), and there were statistically significant differences in UDVA, UIVA, UNVA, coma, spherical aberration, trefoil aberration, SR and AR at 1 wk and 3 mo postoperatively(all P<0.05). Additionally, there were differences in the UDVA, UIVA, UNVA, SR and AR at 3 mo postoperatively compared with those parameters at 1 wk postoperatively(all P<0.05), while there were no statistical significance in coma, spherical aberration, trefoil aberration at 3 mo postoperatively and those at 1 wk postoperatively(all P>0.05). Furthermore, the spherical aberration, trefoil aberration were negatively correlated with SR(rs=-0.427, P=0.009; rs=-0.436, P=0.010), and the trefoil aberration was negatively correlated with AR(rs=-0.406, P=0.015).CONCLUSION: The visual acuity of patients with posterior capsular opacification improved after Nd:YAG laser surgery, and the corneal/refractive analyzer OPD-Scan III system has a high clinical value in reflecting patient's visual quality.

OBJECTIVE To evaluate the cost-effectiveness of the first-line treatment using the combination therapy of sugemalimab and chemotherapy （hereinafter referred to as the “combination therapy”） for advanced esophageal squamous cell carcinoma （ESCC） with high programmed death-ligand 1 （PD-L1） expression from the perspective of the Chinese healthcare system. METHODS A partitioned survival model was constructed based on data from the GEMSTONE-304 study. The model cycle was set at 3 weeks， with a study duration of 10 years and a discount rate of 5%. The primary output parameters of the model included total costs， quality-adjusted life year （QALY）， incremental costs， and incremental cost-effectiveness ratio （ICER）. Cost- utility analysis was employed to assess the economic feasibility of the combination therapy compared to chemotherapy alone. The robustness of the base case analysis results was evaluated through univariate sensitivity analysis， probabilistic sensitivity analysis， and scenario analysis. RESULTS The ICER of the combination therapy compared to chemotherapy alone was 288 430.35 yuan/QALY， significantly exceeding the willingness-to-pay （WTP） threshold of 173 354.52 yuan/QALY which was set at 1.94 times the per capita gross domestic product （GDP） in 2023. The price of sugemalimab was the primary factor influencing the ICER. When the WTP threshold was set at 1.94 times the per capita GDP （173 354.52 yuan/QALY）， the probability of the combination therapy being cost-effective compared to chemotherapy alone was 0. The combination therapy only became cost-effective compared to chemotherapy alone when the price of the drug dropped to 6 107.41 yuan per box （600 mg）. CONCLUSIONS From the perspective of the Chinese healthcare system， the combination therapy for first-line treatment of advanced ESCC with high PD-L1 expression is not cost-effective； the combination therapy is cost-effective when the price of sugemalimab decreas by 50.65%.

Objective To investigate the feasibility of constructing the risk index of Echinococcus infection based on the classification of echinococcosis lesions, so as to provide insights into the management of echinococcosis. Methods The imaging data of echinococcosis cases were collected from epidemiological surveys of echinococcosis in China from 2012 to 2016, and the detection of incident echinococcosis cases was captured from the annual echinococcosis prevention and control reports across provinces (autonomous regions) and Xinjiang Production and Construction Corps in China from 2017 to 2022. After echinococcosis lesions were classified, a risk index of Echinococcus infection was constructed based on the principle of discrete distribution marginal probability and multi-group classification data tests. The correlation between the risk index of Echinococcus infection and the detection of incident echinococcosis cases was evaluated in the provinces (autonomous regions and corps) from 2017 to 2022, and the correlations between the short and medium-term risk indices and between the medium and long-term risk indices of Echinococcus infection were examined using a univariate linear regression model. Results A total of 4 014 echinococcosis cases in China from 2012 to 2016 were included in this study. The short-, medium- and long-term risk indices of E. granulosus infection varied in echinococcosis-endemic provinces (autonomous regions and corps) of China (χ² = 4.12 to 708.65, all P values < 0.05), with high short- (0.058), medium- (0.137) and long-term risk indices (0.104) in Tibet Autonomous Region, and the short-, medium- and long-term risk indices of E. multilocularis infection varied in echinococcosis-endemic provinces (autonomous regions and corps) of China (χ² = 6.74 to 122.60, all P values < 0.05), with a high short-term risk index in Sichuan Province (0.016) and high medium- (0.009) and long-term risk indices in Qinghai Province (0.018). There were no significant correlations between the risk index of E. granulosus infection and the detection of incident cystic echinococcosis cases during the study period (t = −0.518 to 2.265, all P values > 0.05), and strong correlations were found between the risk indices of E. multilocularis infection and the detection of incident alveolar echinococcosis cases (including mixed type) in 2018, 2020, 2021, 2022, during the period from 2017 through 2020, from 2017 through 2021, from 2017 through 2022 (all r values > 0.7, t = 2.521 to 3.692, all P values < 0.05). Linear regression models were established between the risk index of E. multilocular infection and the detection of alveolar echinococcosis cases (including mixed type), and the models were all statistically significant (b = 0.214 to 2.168, t = 2.458 to 3.692, F = 6.044 to 13.629, all P values < 0.05). The regression coefficients for the correlations between the medium- and short-term, and between the long- and medium-term risk indices of E. granulosus infection were 2.339 and 0.765, and the regression coefficients for the correlations between the medium- and short-term, and between the long- and medium-term risk indices of E. multilocular infection were 0.280 and 1.842, with statistical significance seen in both the regression coefficients and regression models (t = 16.479 to 197.304, F = 271.570 to 38 928.860, all P values < 0.05). Conclusions The risk index of Echinococcus infection has been successfully established based on the classification of echinococcosis lesions, which may provide insights into the prevention and control, prediction, diagnosis and treatment, and classified management of echinococcosis.

The difficulty of wound healing in patients is a difficult problem that doctors in all clinical departments may encounter, and there is still no good solution. Resveratrol is a kind of natural active substance, which has anti-inflammatory, antioxidant, antibacterial, and angiogenesis promoting effects, and is a potential drug to promote wound healing. However, the clinical application of resveratrol is limited due to its low bioavailability. In this review, the molecular mechanism of resveratrol in promoting wound healing and its administration methods in wound treatment were reviewed to provide ideas for the redevelopment of resveratrol.

Hypersplenism is an important complication of cirrhotic portal hypertension, and splenectomy is an important means to treat hypersplenism in cirrhosis. It is realized that hypersplenism played a pathological role in the course of cirrhosis. This article analyzes and compares the changes in the condition of patients with cirrhosis between splenectomy with and without hyperfunction, and comprehensively discusses the pathological role and mechanism of hypersplenism in the course of cirrhosis, in order to strengthen the clinical prevention and treatment of hypersplenism in cirrhosis and to better improve the condition and prognosis of patients with cirrhosis.

The widespread application of next generation sequencing (NGS) in clinical settings has enabled testing, diagnosis, treatment and prevention of genetic diseases. However, many issues have arisen in the meanwhile. One of the most pressing issues is the lack of standards for reporting genetic test results across different service providers. The First Forum on Standards and Specifications for Clinical Genetic Testing was held to address the issue in Shenzhen, China, on October 28, 2017. Participants, including geneticists, clinicians, and representatives of genetic testing service providers, discussed problems of clinical genetic testing services across in China and shared opinions on principles, challenges, and standards for reporting clinical genetic test results. Here we summarize expert opinions presented at the seminar and report the consensus, which will serve as a basis for the development of standards and guidelines for reporting of clinical genetic testing results, in order to promote the standardization and regulation of genetic testing services in China.

Objective:To examine the role of LY294002 in cardiac function and myocardial structure in dilated cardiomyopathy (DCM) rats.Methods:Fifty-two male SD rats were randomly assigned to a control group (n=16) and a DCM group (n=36).The DCM rats were induced by intraperitoneal injection of adriamycin,and the control rats were given normal saline.After observation for 2 weeks,6 rats from each group were killed randomly.In the end of the 8th week,the 24 DCM rats were randomly assigned to a DCM group (n=12) and a LY294002 group (n=12),which were given normal saline and LY294002,respectively.In the end of the 8th week and 16th week,the cardiac function was analyzed by ultrasonic cardiogram (UCG) and the plasma was collected to test the level of N-terminal pro-brain natriuretic peptide (NT-pro BNP).HE and Van Gieson (VG) staining were performed to calculate the collagen volume fraction (CVF).Results:Compared with the control group,the left ventricular end-diastolic dimension (LVEDD),left ventricular end-systolic dimension (LVESD) and NT-proBNP level of in the DCM rats were increased obviously,while the left ventricular ejection fraction (LVEF),left ventricular fractional shortening (LVFS) in the DCM rats were decreased obviously (P＜0.01).These changes were consistent with DCM characteristics.Compared with the DCM group,the LVEDD,LVESD and NT-proBNP levels in the LY294002 group were decreased,while the LVEF and LVFS were increased (P＜0.05).Histopathology showed that the myocardium in the DCM rats was fibrotic and the CVF was increased compared with the control rats (P＜0.01).The myocardial structure was improved in the LY294002 group compared to the DCM group.Conclusion:LY294002 can reduce the myocardial fibrosis in the DCM rats and improve the cardiac function.

PURPOSE: MicroRNAs are small non-coding RNAs that play important roles in vascular smooth muscle cell (VSMC) function. This study investigated the role of miR-379 on proliferation, invasion, and migration of VSMCs and explored underlying mechanisms thereof. MATERIALS AND METHODS: MicroRNA, mRNA, and protein levels were determined by quantitative real-time PCR and western blot. The proliferative, invasive, and migratory abilities of VSMCs were measured by CCK-8, invasion, and wound healing assay, respectively. Luciferase reporter assay was used to confirm the target of miR-379. RESULTS: Platelet-derived growth factor-bb was found to promote cell proliferation and suppress miR-379 expression in VSMCs. Functional assays demonstrated that miR-379 inhibited cell proliferation, cell invasion, and migration. Flow cytometry results further showed that miR-379 induced apoptosis in VSMCs. TargetScan analysis and luciferase report assay confirmed that insulin-like growth factor-1 (IGF-1) 3'UTR is a direct target of miR-379, and mRNA and protein levels of miR-379 and IGF-1 were inversely correlated. Rescue experiments showed that enforced expression of IGF-1 sufficiently overcomes the inhibitory effect of miR-379 on cell proliferation, invasion, and migration in VSMCs. CONCLUSION: Our results suggest that miR-379 plays an important role in regulating VSMCs proliferation, invasion, and migration by targeting IGF-1.
Apoptosis ; Cell Movement/*physiology ; Cell Proliferation/*physiology ; Humans ; Insulin ; Insulin-Like Growth Factor I/*physiology ; MicroRNAs/*physiology ; Muscle, Smooth, Vascular/*cytology ; Proto-Oncogene Proteins c-sis/*physiology ; RNA, Messenger/metabolism ; Real-Time Polymerase Chain Reaction ; Sincalide/physiology ; Wound Healing/physiology

The study of vitiligo has made a huge progress due to the development of medical technology. Some new treatment idea, methods and integrated therapies have been considered as the trending alternatives. This paper summarized the treatment of different regular treatment combined with fire needling for vitiligo in clinic.