To summarise the clinical experience of Professor TONG Xiaolin in treating prediabetes combined with overweight or obesity using the method of relieving depression and reducing turbidity. It is believed that prediabetes belongs to the category of "spleen-heat syndrome" in traditional Chinese medicine， and its core pathogenesis is center fullness with internal heat， while obesity is the initiating factor for exacerbating center fullness and internal heat， therefore， it is of great significance to reduce the risk of diabetes by interrupting the transformation between overweight， obesity and glucose metabolism abnormality. It is proposed that the main pathogenesis of prediabetes combined with overweight or obesity is qi depression and turbidity obstruction in middle jiao， with qi depression as the root and turbidity obstruction as the cause， forming a treatment idea with the method of relieving depression and reducing turbidity as the core. In clinic， Dahuang Huanglian Xiexin Decoction （大黄黄连泻心汤） is used as the basic prescription， with a primary focus on directing the turbid downward， supplemented by regulating qi， which embodies the concept of "promoting movement through descent， then figuring out the root of spleen-heat syndrome. Furthermore， the treatment is flexibly modified based on the patient's deficiency-excess syndrome to ensure individualized therapy.

Objective To explore the shared potential targets and molecular mechanisms of obesity and type 2 diabetes mellitus(T2DM)using bioinformatics methods,to validate the expression of core targets through animal experiments,and to analyze the intervention potential of active components of traditional Chinese medicine(TCM).Methods The obese population datasets(GSE151839 and GSE162653)were obtained from the Gene Expression Omnibus(GEO)database to screen for differentially expressed genes,which were then intersected with T2DM-related targets from the GeneCards database to identify shared targets.A protein-protein interaction(PPI)network was constructed using the STRING database.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analyses were performed to identify enriched biological processes and signaling pathways.The expression of core targets in adipose tissue from patients with obesity and T2DM was validated using the GEO database.A total of 12 specific-pathogen-free(SPF)male Sprague-Dawley(SD)rats,aged 8 weeks and weighing between 180 and 200 g,were randomly assigned to a control group and a model group(n=6 each).A T2DM rat model was established,and the mRNA and protein expression levels of core targets in adipose tissue were measured.Molecular docking and molecular dynamics simulations were performed to assess the binding ability of TCM active components to core targets.Results A total of 460 and 796 obesity-related differentially expressed genes were identified in the GSE151839 and GSE162653 datasets,respectively,and 109 shared targets were obtained by intersection with T2DM-related targets.According to PPI network analysis,PTPRC,MMP9,ITGB2,CD86,CCR5,and CCR2 were identified as the core targets.GO and KEGG analysis showed that these targets are mainly enriched in biological processes such as inflammatory response,immune regulation,and cell adhesion.Animal experiments confirmed that the mRNA and protein expression of core targets,including PTPRC,ITGAX,MMP9,ITGB2,CCR2,and CXCL1,were significantly upregulated in the adipose tissue of T2DM rats(P<0.05).Molecular docking and molecular dynamics simulations revealed that berberine and puerarin had good binding ability with PTPRC,MMP9,and ITGB2.Conclusion This study reveals the shared molecular mechanisms between obesity and T2DM and shows that core targets,such as PTPRC and MMP9,may promote disease progression by regulating the inflammation-immune network.These findings provide a theoretical basis for the development of targeted therapeutic strategies based on TCM active ingredients.

This paper summarized TONG Xiaolin's clinical experience in using "poisonous" Chinese material medica to treat metabolic diseases， who believes that toxicity reducing and efficacy enhancing can be achieved through carefully considered dosage， reasonable combination of medicinals， and appropriate preparation and administration ways.By analyzing the functions of Chinese material medica and findings from modern pharmacology and toxicology， the clinical dosage features， combination of medicinals and medication， preparation and administration methods and other precautions have been summarized regarding Huanglian （Rhizoma Coptidis） in treating diabetes， Xixin （Radix et Rhizoma Asari）， Dahuang （Radix et Rhizoma Rhei） and Shuizhi （Hirudo） in treating diabetic kidney diseases， Zhichuanwu （Radix Aconiti Praeparata）， Zhicaowu （Radix Aconiti Kusnezoffii Praeparata）， Xixin and Zhimaqianzi （Semen Strychni Praeparata） in treating diabetic peripheral neuropathy， Yinyanghuo （Herba Epimedii） and Wugong （Scolopendra） in treating diabetic erectile dysfunction， Fuzi （Radix Aconiti Lateralis Praeparata） and Banxia （Rhizoma Pinelliae） in treating diabetic gastroparesis， Hongqu （Monascus purpureus Went） and Weilingxian （Radix et Rhizoma Clematidis） in treating metabolic syndrome， as well as Leigongteng （Radix Tripterygii Wilfordii） and Huangyaozi （Rhizoma Dioscoreae Bulbiferae） in treating Hyperthyroidism， thereby providing reference for precise clinical medication.

[Abstract] [Objective] To establish a detection method for complement C3d-sensitized platelets. [Methods] Parallel detection of the same platelet sample under conditions of complement C3d sensitization and non-sensitization was conducted using microcolumn gel immunoagglutination inhibition assay technology. The supernatant obtained after the reaction between anti-C3d monoclonal antibodies and platelet samples was then reacted with C3d-sensitized red blood cells to observe whether agglutination occurs. Subsequently, this method was used to test samples from 22 clinical patients to determine whether their platelets were sensitized by complement C3d. [Results] The same platelet sample, after being sensitized with complement C3d, showed negative or weakened aggregation, which was determined as a positive result, whereas platelets that were not sensitized with complement C3d exhibited aggregation, which was determined as a negative result. A total of 22 clinical patient samples were tested, of which 16 were negative and 6 were positive. [Conclusion] A microcolumn gel immunoagglutination inhibition test was established to detect whether platelets are sensitized by complement C3d, which aids in the auxiliary diagnosis of complement-related immune diseases involving platelets.

【Objective】 To analyze the causes and solutions of ABO forward and reverse grouping discrepancy, and to ensure the safety of blood transfusion in clinical. 【Methods】 Samples from 75 patients with discrepancy between forward and reverse grouping in December 2019 and March 2022 were tested and analyzed in combination with saline method(forward and reverse grouping), direct antiglobulin test, antibody screening, antibody identification, increasing plasma volume, incubation enhancement test at 4℃, absorption-eluation test and molecular biological tests. 【Results】 Causes for abnormal reverse typing were as follows : weak antibody in 11 cases(14.67%), unexpected antibody in 19 cases(25.33%), inverted albumin and globulin ratios in 9 cases(12.00%), increased white blood cells in 3 cases(4.00%), inadequate anticoagulation in 3 cases(4.00%), bone marrow transplantation in 2 cases(2.67%), multiple myeloma in 4 cases(5.33%), acute gastrointestinal bleeding in 3 cases(4.00%). Causes for abnormal forward typing were as follows: self-coagulating in 1 case(1.33%), acute leukemia in 7cases(9.34%), post-transplantation in 1 case(1.33%). Causes for abnormal forward/reverse typing: acute leukemia in 1 case(1.33%), condensin syndrome in 1 case(1.33%), autoimmune hemolytic anemia in 6 cases(8.00%), subtype in 4 cases(5.33%). Results of genotying in 7 cases were as follows: B(A) 04 for 1 case, B(A)02 2 cases, AB3 1case, A1 2 cases, and 1case with new genotype. 【Conclusion】 For patients with forward and reverse typing discrepancy for ABO blood group, several studying methods, such as clinical/serological tests inquiring, absorption-eluation tests and molecular biological tests, should be combined to ensure blood transfusion safety.

【Objective】 To analyze the effects of IgG subtypes(IgG 1 and IgG3) of antibodies contained in infant serum and erythrocyte eluates on hemolytic disease of the newborn(HDN), so as to provide reference for its early clinical diagnosis and treatment. 【Methods】 49 newborns with HDN in our hospital from June 2019 to March 2020 were detected for three hemolytic tests(direct antiglobulin test, elution test and indirect antiglobulin test), as well as the components of IgG1 and IgG3 in eluates. The correlation analysis was conducted by combining birth hours (physiological jaundice) and hemolytic degrees (total bilirubin, indirect bilirubin, and hemoglobin). 【Results】 In the 44 cases of IgG1 and IgG3 subtype detection of infant RBC eluates, regression equations could be established between total bilirubin, indirect bilirubin and birth hours, and between hemoglobin and elution test, and linear regression relationships were found (P<0.05). In the 28 cases of IgG1 and IgG3 subtype detection of infant serum, regression equations could be established between total bilirubin, indirect bilirubin, birth time and IgG3 subtype, and between hemoglobin and IgG1 subtype (P<0.05), and linear regression relationships were found (all P<0.05). Three infants, presenting IgG1 and IgG2 subtypes(+ ) and three hemolysis tests(-), were all second pregnancy, constituted by Rh-HDN of 2 case and other-system-HDN 1. 【Conclusion】 The degree of HDN is directly related to IgG1 and IgG3 antibodies in infant blood plasma. In addition to the total bilirubin and indirect bilirubin, the changes of IgG3 antibodies in infant plasma and IgG1 antibody in anemic infants should be monitored. If IgG1 and IgG3 antibodies are yielded even with all negative ABO-HDN hemolysis tests, non-ABO-HDN should be considered in time to achieve accurate diagnosis and treatment.

Objective To investigate the FECH gene mutation in a Chinese family with erythropoietic protoporphyria, to explore the relationship between gene mutation and clinical manifestations so as to estab-lish a basis for the genetic diagnosis and treatment of erythropoietic protoporphyria. Methods Clinical data on a Chinese family with typical EPP was collected. Peripheral blood was obtained from patients, unaffected individuals in the family and 50 unrelated human controls. Genomic DNA was extracted and PCR was per-formed to amplify the whole coding regions (exons 1 to 11) of FECH gene and their flanking intron sequences followed by direct sequencing to detect possible mutations. Results Based on clinical symptom and por-phyrin levels, a diagnosis of erythropoietic protoporphyria was made in 3 family members. DNA fragments of expected size were amplified by PCR. Gene sequencing revealed a heterozygons mutation (IVS1 + 1G >C) in intron 1 of FECH gene in the proband, his sister and father, but not in unaffected family members or unrelated human controls. Also, an IVS1-23C/T polymorphism associated with low expression alleles was observed in intron 1 of FECH gene of the proband, his sister and mother. Conclusions A novel mutation in the donor splice site of intron 1 of FECH gene is first reported in a Chinese family with EPP; this muta-tion may lead to a deficiency of FECH gene and serve as a molecular basis of development of erythropoietic protoporphyria.

[Objective]To probe the efficacy of total hip arthroplasty(THA)in the treatment of patients with ankylosing spondilitis(AS).[Method]Ninety-eight THA were performed in 56 patients who had AS,and 42 patients(76 hips)were analyzed retrospectively with an average follow-up period of 5.6 years(ranged,2.5 to 5.5 years).The clinical results were evaluated by the Harris hip scoring system and radiographic analysis.[Result]For the latest follow-up,the average Harris hip score improved from 26.8 points(ranged,4 to 51 points)preoperatively to 85.2 points(ranged,55 to 94 points)at the final postoperatively evaluation.89.5% of the patients had an excellent or good results evaluated by Harris hip scoring system postoperatively.One patient was revised for infection,fissured fracture of neck of femur or calcar femorale above the lesser trochanter happended in two patients,one patient had footdrop and recovered 3 months later,1 patient had deep vein thrombosis.There was no sign of loosening,dislocation or fracture of the prosthesis.According to the system of Brooker,the incidence of heterotopic ossification was 9.2 %(7 hips).[Conclusion]THA can greatly relieve the pain of the patients who have AS and reconstruct the function of hip joint.Compared with THA operated for other cause of disease,THA in AS leads to no high risk.

Objective To explore the intervention of erythromycin(EM) on acute lung injury(ALI) in rat model MethodsALI rat model was established by intravenous i njection of oleic acid(OA) EM of 180 mg/kg was injected intraperitoneally t wo h ours before OA challenge in the prevention group and consecutive three days afte r OA challenge in the treatmen group ResultsCompared with con trol group,the aninmals in prevention group and treatmen group had lower lung extent,milder pathomorphological changes and pathologic integral The concentra tion of protein and the numbers of neutrophils and lymphocytes in bronchoalveola r lavage fluid(BALF) were also reduced ConclusionEM may part ly prevent the development of ALI by inhibiting the neutrophil and lymphocyte ac cumulatation in the lung

Bi-polar,bi-pedicled separation delayed flaps were designed on the backs of New Zealand rabbits with the application of a medical silicon membrane as the separation material. Values of glucose and lactic acid, PtcO 2 were measured separately at proximal,middle and distal areas of the flaps after the distal pedice was cut at 0,1,4,7,14,21 days,respectively, after the formation of flaps. After flap delaying,PtcO 2 in separated flap was always lower than that of the mormal control,accompanied with glucose decrease and lactic acid increase, although there were significant differences in different areas of the flap. The survived area of the flap increased after 7 days. Furthermore,all the length of the flap survived after 21 days,although the level of glucose in the flap was still lower and lactic acid was still higher.The results suggested that by separation and delaying the flap may adapt gradually to hypoxia via lowered metabolism.For flap survival,the threshold value of glucose in flap is 0 01mmol/L , lactic acid is 0 47mmol/L,and PtcO 2 is 3mmHg .