Objective To predict and analyze the"properties-efficacy"of foreign medicinal resource Moringa oleifera leaves by taking"Xiang"based on plant phylogenetic relationships and component structural characteristics.Methods The properties of Moringa oleifera were determined by screening plants with its genetic relationship.Network pharmacology was used to study the biological network characteristics of Moringa oleifera leaves and related Chinese materia medica,and the"properties-efficacy"of Moringa oleifera leaves was studied based on the"xiang"of medicinal plants.Using"the relationship chart between the efficacy of Chinese materia medica and 12 types of chemical components",the possible efficacy and distribution of medicinal properties of Moringa oleifera leaves were predicted,and a study on the"properties-efficacy"characteristics of Moringa oleifera leaves was conducted based on the structural features of the components.Results Moringaceae and Caricaceae had a genetic relationship in plant classification;Moringa oleifera leaves,Carica papaya and Carica papaya leaves had a relatively high number of common targets,common clinical phenotypes and signaling pathways.The large proportion of coincidence showed that Moringa oleifera leaves might have similar functional performance and mechanism to Carica papaya and Carica papaya leaves;Moringa oleifera leaves contain flavonoids,tannins,monophenols,which were related to the efficacy of Chinese materia medica on tonifying qi,dispersing wind heat,cooling blood and regulating qi.Clustering analysis method was used to get the corresponding"properties-efficacy"relationship,and the results indicated that Moringa oleifera leaves were cool in property and sweet in taste,which belonged to lung meridian and had the efficacy of dispersing wind heat.Conclusion It is feasible to predict and analyze the"properties-efficacy"of foreign medicinal resources by taking"xiang".

BACKGROUND:Ovarian tissue vitrification cryopreservation is one of the important methods for preserving fertility.Tanshinone ⅡA has various pharmacological activities,including anti-oxidation,inhibition of inflammatory response,and reduction of apoptosis,but its role as an additive for vitrification cryoprotection of ovarian tissue is still unclear.OBJECTIVE:To explore the protective effect of tanshinone ⅡA on vitrification cryopreservation of mouse ovarian tissue.METHODS:Twenty-five 6-week-old female KM mice were randomly selected and their ovarian tissues were randomly divided into five groups,with 10 ovaries per group.The fresh group was not cryopreserved.The frozen control group used vitrification cryoprotectant.The 0.5,2.5,and 5 μmol/L tanshinone ⅡA groups used vitrification cryoprotectant containing 0.5,2.5,and 5 μmol/L tanshinone ⅡA,respectively,and were cryopreserved in liquid nitrogen.After 3 days of storage,the cryopreserved tubes were taken out and thawed.The ovarian tissue and follicle morphology of each group were observed by hematoxylin-eosin staining,and the normal follicle morphology and survival rate were analyzed.The levels of superoxide dismutase,catalase,malondialdehyde,tumor necrosis factor-α,interleukin-1β,and interleukin-17 in the ovary were detected by enzyme-linked immunosorbent assay.RT-qPCR and western blot assay were used to detect the mRNA and protein expressions of nuclear factor E2-related factor 2(Nrf2)and heme oxygenase 1(HO-1)in the mouse ovary.RESULTS AND CONCLUSION:(1)Compared with the fresh group,the frozen control group had abnormal morphology of follicles at all levels in the ovary,decreased follicle survival rate(P＜0.05),decreased superoxide dismutase and catalase activities(P＜0.05);the levels of malondialdehyde,and tumor necrosis factor α,interleukin 1β,and interleukin 17 were all increased(P＜0.05),and the mRNA and protein expressions of Nrf2 and HO-1 were decreased(P＜0.05).(2)Compared with the frozen control group,different concentrations of tanshinone ⅡA could improve the morphology of follicles at all levels in the ovary,increase the survival rate of follicles,enhance the activities of superoxide dismutase and catalase,and reduce the levels of malondialdehyde,tumor necrosis factor α,interleukin 1β,and interleukin 17,increased the mRNA and protein expression of Nrf2 and HO-1 in a concentration-dependent manner,with 5 μmol/L tanshinone ⅡA having the most significant effect.(3)The results show that tanshinone ⅡA may reduce the oxidative stress level and inflammatory response of mouse ovarian tissue by mediating the Nrf2/HO-1 signaling pathway,thereby alleviating the reproductive damage caused by vitrification cryopreservation of mouse ovaries.

Objective To evaluate the cost-effectiveness of the combination therapy of ribociclib plus fulvestrant compared to fulvestrant monotherapy as a second-line treatment for postmenopausal patients with hormone receptor-positive(HR+)/human epidermal growth factor receptor 2-negative(HER2-)advanced metastatic breast cancer from the perspective of the Chinese healthcare system.Methods A partitioned survival model was constructed based on MONALEESA-3 study data,with the model cycle of 4 weeks and the time range of 15 years.Total cost,quality-adjusted life years(QALYs)and incremental cost-effectiveness ratio(ICER)were compared between ribociclib combined with fulvestrant and fulvestrant monotherapy as a second-line treatment for postmenopausal patients with HR+/HER2-advanced metastatic breast cancer.The robustness of the models was validated through one-way sensitivity analysis and probabilistic sensitivity analysis.Results Compared with the fulvestrant monotherapy regimen,the ICER for the ribociclib combined with fulvestrant regimen was 187,958.06 yuan/QALY,which was below the willingness-to-pay(WTP)threshold of three times China's per capita gross domestic product(GDP)in 2024(287,247 yuan/QALY).The one-way sensitivity analysis revealed that the ICER was primarily influenced by the proportion of patients receiving subsequent treatments with the combination therapy or fulvestrant monotherapy,and the utility value of progression-free survival.The probabilistic sensitivity analysis showed that at a WTP threshold of three times China's per capita GDP in China in 2024(287,247 yuan/QALY),the probability of the ribociclib combination therapy being cost-effective was 100%.Conclusion In the context of the Chinese healthcare system,the combination therapy of ribociclib and fulvestrant is more cost-effective than fulvestrant monotherapy for the second-line treatment of postmenopausal patients with HR+/HER2-advanced metastatic breast cancer.

OBJECTIVE: To analyze the rules of moxibustion for low back pain by ZHOU Meisheng by using data mining and knowledge graph technology. METHODS: Taking the medical cases of moxibustion for low back pain from ZHOU Meisheng's legacy manuscripts and existing works as the research objects, information on disease types, symptoms, tongue manifestations, pulse conditions, syndrome patterns, moxibustion methods and acupoints were collected. Frequency statistics and community analysis were conducted by the ancient and modern medical record cloud platform V 2.3.7, cluster analysis of high-frequency acupoints was performed by SPSS26.0, association rule analysis of high-frequency acupoints was performed by SPSS Modeler 18.0, and the generated linked data were imported into Cytoscape 3.9.1 for complex network analysis. Knowledge graph of moxibustion for low back pain by ZHOU Meisheng was constructed based on the results of data mining. The data storage and display of knowledge graph were realized through the Neo4j 3.5.25 graph database, and the Cypher query language was used for knowledge graph retrieval and discovery. RESULTS: A total of 219 medical cases were collected, involving 14 disease types, 85 related clinical symptoms, 5 related TCM syndrome types, and 6 moxibustion methods. The acupoints were mostly attributed to the governor vessel, the bladder meridian of foot-taiyang, non-meridian and non-acupoint areas. The core prescription of acupoints derived from complex network analysis included tender points, Shenshu (BL23), Jinsuo (GV8), Yinjiao (CV7), Yaoyangguan (GV3), Yanglingquan (GB34), which were largely coincides with high-frequency acupoints. Cluster analysis obtained 4 cluster combinations. Community analysis yielded 6 communities, each corresponding to different acupoints.The constructed knowledge graph contained 187 nodes and 696 relationships, by retrieving clinical elements related to low back pain, the disease-moxibustion association graph, disease-acupoint association graph, accompanying symptom-acupoint association graph and syndrome type-matching point association graph were obtained. CONCLUSION When treating low back pain with moxibustion, ZHOU Meisheng adopts the principle of promoting circulation, distinguishing diseases to determine the treatment, selecting acupoints according to the diseases, and matching points according to the symptoms.And taking tender points, Shenshu (BL23), Jinsuo (GV8), Yinjiao (CV7), Yaoyangguan (GV3), Yanglingquan (GB34) as core acupoints, combined with tenderness point selection, acupoint selection based on meridian and zangfu syndrome differentiation, "sunshine area" acupoint selection, yin-yang acupoint matching. Additionally, he skillfully employs special points, such as Zhongzhu (KI15) and ear tips, pays attention to the reform of moxibustion tools, and innovates the moxibustion techniques, using distinctive moxibustion tools and methods to treat low back pain.
Moxibustion/methods* ; Humans ; Data Mining ; Low Back Pain/history* ; Acupuncture Points ; History, Ancient ; Female ; China ; Male ; Adult ; Middle Aged

In 2024, significant advancements have been achieved in the field of pediatric rheumatic and immunological diseases, spanning key conditions such as juvenile idiopathic arthritis (JIA), systemic lupus erythematosus (SLE), and autoinflammatory diseases (AIDs). These developments encompass the indepth elucidation of disease pathogenesis, the expanded application of biomarkers, continuous updates to clinical practice guidelines, and the development of novel targeted therapies. These advances have markedly enhanced the precision and effectiveness of clinical diagnosis and treatment while laying a solid foundation for improving long-term patient outcomes. This article highlights the key research breakthroughs and significant progress in pediatric rheumatic and immunological diseases in 2024, aiming to advance clinical understanding, promote early recognition, and enable accurate diagnosis to optimize outcomes for affected children.

Objective:To analyze the clinical characteristics, treatment, response to treatment, prognosis, and the importance of early recognition and treatment of pediatric systemic lupus erythematosus (SLE) complicated with thrombotic microangiopathy (TMA).Methods:A retrospective summary of the clinical data of 5 children diagnosed with SLE complicated by TMA at Beijing Children′s Hospital, Capital Medical University, from November 2024 to January 2025.Results:Among the 5 children (1 boy and 4 girls, male-to-female ratio of 1∶4), the age of onset ranged from 11 years and 9 months to 14 years and 9 months. All cases had acute onset, rapid disease progression, severe illness, and involvement of multiple organs and systems. The disease activity of SLE was moderately to severely active when TMA was diagnosed. During the course of TMA, all 5 children exhibited varying degrees of hemolytic anemia, thrombocytopenia, renal dysfunction, and proteinuria. Elevated sC5b-9 levels were observed in all 5 children, with 3 showing severely reduced ADAMTS13 activity and 2 with elevated ADAMTS13 inhibitors. Two children had elevated sC5b-9, severely reduced ADAMTS13 activity, and elevated ADAMTS13 inhibitors simultaneously. Four children had newly diagnosed SLE with TMA and achieved stable condition within 2-3 weeks after aggressive treatment, including methylprednisolone pulse therapy, immunosuppressive agents, biologics, plasma infusion, plasma exchange, or dialysis. One child, who had been diagnosed with SLE for 8 years and had irregular oral medication for half a year, suddenly developed TMA with refractory hemolytic anemia and severe thrombocytopenia. This child responded poorly to methylprednisolone pulse therapy, cyclosporine, and eculizumab but showed improvement with plasma exchange. However, the condition was prone to relapse when the interval between plasma exchanges was prolonged. The child eventually responded well to low-dose rituximab and was discharged after 6 weeks of combined treatment. Four children were diagnosed with TMA within 1 week of admission and achieved stable condition after 3 months of follow-up, with no anemia or thrombocytopenia, negative proteinuria, normal complement C3 and C4 levels, and an SLE disease activity score of 0. One child, who had been treated with high-dose glucocorticoid, multiple immunosuppressive agents, and biologics at another hospital, was transferred and diagnosed with TMA 2 weeks after admission. The condition gradually stabilized after treatment with methylprednisolone pulse therapy, immunosuppressive agents, biologics, and plasma exchange. However, at 3-month follow-up, the child still had alopecia and proteinuria, with an SLE disease activity score of 6, indicating mild disease activity.Conclusion:For children with moderate to severe active SLE, especially those with acute onset, rapid disease progression, and prominent manifestations of anemia, thrombocytopenia, renal dysfunction, and poor response to high-dose methylprednisolone pulse therapy, the risk of TMA should be vigilantly monitored. Early diagnosis and aggressive treatment are crucial.

BACKGROUND:Ovarian tissue vitrification cryopreservation is one of the important methods for preserving fertility.Tanshinone ⅡA has various pharmacological activities,including anti-oxidation,inhibition of inflammatory response,and reduction of apoptosis,but its role as an additive for vitrification cryoprotection of ovarian tissue is still unclear.OBJECTIVE:To explore the protective effect of tanshinone ⅡA on vitrification cryopreservation of mouse ovarian tissue.METHODS:Twenty-five 6-week-old female KM mice were randomly selected and their ovarian tissues were randomly divided into five groups,with 10 ovaries per group.The fresh group was not cryopreserved.The frozen control group used vitrification cryoprotectant.The 0.5,2.5,and 5 μmol/L tanshinone ⅡA groups used vitrification cryoprotectant containing 0.5,2.5,and 5 μmol/L tanshinone ⅡA,respectively,and were cryopreserved in liquid nitrogen.After 3 days of storage,the cryopreserved tubes were taken out and thawed.The ovarian tissue and follicle morphology of each group were observed by hematoxylin-eosin staining,and the normal follicle morphology and survival rate were analyzed.The levels of superoxide dismutase,catalase,malondialdehyde,tumor necrosis factor-α,interleukin-1β,and interleukin-17 in the ovary were detected by enzyme-linked immunosorbent assay.RT-qPCR and western blot assay were used to detect the mRNA and protein expressions of nuclear factor E2-related factor 2(Nrf2)and heme oxygenase 1(HO-1)in the mouse ovary.RESULTS AND CONCLUSION:(1)Compared with the fresh group,the frozen control group had abnormal morphology of follicles at all levels in the ovary,decreased follicle survival rate(P＜0.05),decreased superoxide dismutase and catalase activities(P＜0.05);the levels of malondialdehyde,and tumor necrosis factor α,interleukin 1β,and interleukin 17 were all increased(P＜0.05),and the mRNA and protein expressions of Nrf2 and HO-1 were decreased(P＜0.05).(2)Compared with the frozen control group,different concentrations of tanshinone ⅡA could improve the morphology of follicles at all levels in the ovary,increase the survival rate of follicles,enhance the activities of superoxide dismutase and catalase,and reduce the levels of malondialdehyde,tumor necrosis factor α,interleukin 1β,and interleukin 17,increased the mRNA and protein expression of Nrf2 and HO-1 in a concentration-dependent manner,with 5 μmol/L tanshinone ⅡA having the most significant effect.(3)The results show that tanshinone ⅡA may reduce the oxidative stress level and inflammatory response of mouse ovarian tissue by mediating the Nrf2/HO-1 signaling pathway,thereby alleviating the reproductive damage caused by vitrification cryopreservation of mouse ovaries.

Objective To evaluate the cost-effectiveness of the combination therapy of ribociclib plus fulvestrant compared to fulvestrant monotherapy as a second-line treatment for postmenopausal patients with hormone receptor-positive(HR+)/human epidermal growth factor receptor 2-negative(HER2-)advanced metastatic breast cancer from the perspective of the Chinese healthcare system.Methods A partitioned survival model was constructed based on MONALEESA-3 study data,with the model cycle of 4 weeks and the time range of 15 years.Total cost,quality-adjusted life years(QALYs)and incremental cost-effectiveness ratio(ICER)were compared between ribociclib combined with fulvestrant and fulvestrant monotherapy as a second-line treatment for postmenopausal patients with HR+/HER2-advanced metastatic breast cancer.The robustness of the models was validated through one-way sensitivity analysis and probabilistic sensitivity analysis.Results Compared with the fulvestrant monotherapy regimen,the ICER for the ribociclib combined with fulvestrant regimen was 187,958.06 yuan/QALY,which was below the willingness-to-pay(WTP)threshold of three times China's per capita gross domestic product(GDP)in 2024(287,247 yuan/QALY).The one-way sensitivity analysis revealed that the ICER was primarily influenced by the proportion of patients receiving subsequent treatments with the combination therapy or fulvestrant monotherapy,and the utility value of progression-free survival.The probabilistic sensitivity analysis showed that at a WTP threshold of three times China's per capita GDP in China in 2024(287,247 yuan/QALY),the probability of the ribociclib combination therapy being cost-effective was 100%.Conclusion In the context of the Chinese healthcare system,the combination therapy of ribociclib and fulvestrant is more cost-effective than fulvestrant monotherapy for the second-line treatment of postmenopausal patients with HR+/HER2-advanced metastatic breast cancer.

Objective To predict and analyze the"properties-efficacy"of foreign medicinal resource Moringa oleifera leaves by taking"Xiang"based on plant phylogenetic relationships and component structural characteristics.Methods The properties of Moringa oleifera were determined by screening plants with its genetic relationship.Network pharmacology was used to study the biological network characteristics of Moringa oleifera leaves and related Chinese materia medica,and the"properties-efficacy"of Moringa oleifera leaves was studied based on the"xiang"of medicinal plants.Using"the relationship chart between the efficacy of Chinese materia medica and 12 types of chemical components",the possible efficacy and distribution of medicinal properties of Moringa oleifera leaves were predicted,and a study on the"properties-efficacy"characteristics of Moringa oleifera leaves was conducted based on the structural features of the components.Results Moringaceae and Caricaceae had a genetic relationship in plant classification;Moringa oleifera leaves,Carica papaya and Carica papaya leaves had a relatively high number of common targets,common clinical phenotypes and signaling pathways.The large proportion of coincidence showed that Moringa oleifera leaves might have similar functional performance and mechanism to Carica papaya and Carica papaya leaves;Moringa oleifera leaves contain flavonoids,tannins,monophenols,which were related to the efficacy of Chinese materia medica on tonifying qi,dispersing wind heat,cooling blood and regulating qi.Clustering analysis method was used to get the corresponding"properties-efficacy"relationship,and the results indicated that Moringa oleifera leaves were cool in property and sweet in taste,which belonged to lung meridian and had the efficacy of dispersing wind heat.Conclusion It is feasible to predict and analyze the"properties-efficacy"of foreign medicinal resources by taking"xiang".

In 2024, significant advancements have been achieved in the field of pediatric rheumatic and immunological diseases, spanning key conditions such as juvenile idiopathic arthritis (JIA), systemic lupus erythematosus (SLE), and autoinflammatory diseases (AIDs). These developments encompass the indepth elucidation of disease pathogenesis, the expanded application of biomarkers, continuous updates to clinical practice guidelines, and the development of novel targeted therapies. These advances have markedly enhanced the precision and effectiveness of clinical diagnosis and treatment while laying a solid foundation for improving long-term patient outcomes. This article highlights the key research breakthroughs and significant progress in pediatric rheumatic and immunological diseases in 2024, aiming to advance clinical understanding, promote early recognition, and enable accurate diagnosis to optimize outcomes for affected children.