ObjectiveTo explore the correlation between the occurrence of cardiovascular events in rheumatoid arthritis（RA） and traditional Chinese medicine（TCM） syndrome. MethodsThe cross-sectional study selected 6713 RA patients from 122 centres nationwide， in which general information such as name， gender， age， height， body weight， and course of disease were collected by completing a questionnaire； patients were classified into eight types of syndrome according to the information of their four examinations，i.e. wind-dampness obstruction syndrome， cold-dampness obstruction syndrome， dampness-heat obstruction syndrome， phlegm-stasis obstruction syndrome， stasis-blood obstructing collateral syndrome， qi-blood deficiency syndrome， liver-kidney insufficiency syndrome， and qi-yin deficiency syndrome. According to the occurrence of cardiovascular events， they were divided into the occurrence group and the non-occurrence group， and the condition assessment data and laboratory examination indexes were recorded. The test of difference between groups was used to analyse the possible risk factors for the occurrence of RA cardiovascular events， and binary logistic regression was used to analyse the correlation between TCM syndromes and RA cardiovascular events. ResultsA total of 6713 RA patients were included， including 256 cases in occurrence group and 6457 in non-occurrence group. There was no statistically significant difference between groups in terms of height， gender， insomnia， appetite， white blood cell（WBC）， hemoglobin（HGB）， platelets（PLT）， rheumatoid factor（RF）， anti-cyclic peptide containing citrulline（CCP）， alanine aminotransferase（ALT）， aspartate aminotransferase（AST）， γ-glutamyl transpeptidase（GGT）， urea creatinine（CREA）， and glucose（GLU）（P＞0.05）. The TCM syndromes between groups showed significant statistic differences（P＜0.05）. Patients in occurrence group had longer disease duration， heavier body weight， and older age； more severe conditions such as disease activity（DAS-28）， number of painful joints（TJC）， number of swollen joints（SJC）， health questionnaire scores（HAQ）， visual analog scores（VAS）， restlessness， and fatigue； higher blood sedimentation rate（ESR）， low-density lipoprotein（LDL-C）， triglyceride（TG）， total cholesterol（TC）， D-Dimer， and lower high-density lipoprotein（HDL-C）（P＜0.05）. The distribution of syndrome types showed that dampness-heat obstruction syndrome accounted for the largest proportion of patients in both groups and was higher in RA cardiovascular events. Logistic regression analysis showed that the occurrence of RA cardiovascular events was strongly associated with dampness-heat obstruction syndrome［OR=5.937， 95%CI （4.434， 7.949）， P＜0.001］. ConclusionThe occurrence of RA cardiovascular events were associated with TCM syndromes， and the probability of cardiovascular events in the RA patients with dampness-heat obstruction syndrome was 5.937 times higher than patients with other TCM syndromes.

Objective To establish the fingerprints of Buyang Huanwu Decoction;To find the quality markers of Buyang Huanwu Decoction by integrating the total statistical moment method,factor analysis and chemical pattern recognition;To provide a reference for its quality control and evaluation methods.Methods Under the conditions of an ACQUITY UPLC HSS T3 column(2.1 mm×100 mm,1.8 μm),the fingerprint chromatogram was developed.The fingerprints of 15 batches of Buyang Huanwu Decoction were established under the conditions of acetonitrile-0.4%phosphoric acid aqueous solution as the mobile phase;the flow rate was 0.3 mL/min;column temperature was 40℃;detection wavelength was 235 nm.Information entropy,information quantity,total statistical moment and similarity parameters were calculated.The quality stability of different batches of Buyang Huanwu Decoction was evaluated from a macroscopic perspective;the samples were comprehensively ranked by combining factor analysis,and further screened for the components of quality difference by using hierarchical cluster analysis(HCA),principal component analysis(PCA)and partial least squares-discriminant analysis(PLS-DA).Results Fingerprint patterns for 15 Buyang Huanwu Decoction batches were established.The information quantity,total zero-order moment and number of peaks varied greatly among the samples of each batch(RSD values of 32.788%,24.976%and 22.882%),whereas the information entropy,total first-order moment and second-order moment did not vary much(RSD values of 20.697%,18.544%and 9.413%),which indicated that the chemical constituents of each batch content was significantly different,and the composition ratio of components did not differ much.The overall statistical moments exhibited a similarity exceeding 0.727,in which the similarity of the two batches of samples,S2 and S7,was lower;the results of the composite scores from the factor analysis method showed that the top 5 samples of each batch of the quality ranking were S2>S7>S1>S15>S10;HCA and PCA could classify the 15 batches of samples into 2 categories;PLS-DA showed that paeoniflorin,ferulic acid and hydroxy saffron yellow pigment A were the three constituents that contributed more to the batch variation of Buyang Huanwu Decoction.Conclusion The multidimensional quality evaluation method integrated in this study is accurate,efficient and comprehensive,which can provide an objective basis for the overall quality control of Buyang Huanwu Decoction.

Objective : To generate heterozygous TRAF2 knockout mice, the CRISPR/Cas9 technology was successfully employed. These mice were served as a valuable model to explore the pathological mechanisms underlying inflammatory and immune disorders mediated by abnormal TNF-α-TRAF2 signaling and to develop new therapeutic targets. Methods : A vector targeting the knockout of the TRAF2 gene was constructed. Lead RNA and Cas9 Mrna were introduced into the fertilized eggs of C57BL/6JGpt mice through microinjection to mediate the TRAF2 gene mutation in mice. The mouse tail protein was extracted and the genotype of the F0 generation was determined by PCR and Western blot. TRAF2+/- mice were successfully obtained. F0 generation mice were backcrossed with C57BL/6JGpt wild-type mice to obtain stable TRAF2+/- mice for propagation and subsequent experiments. The body weight of TRAF2+/- mice was detected; Western blot was used to detect the expression of TRAF2 in the spleen, liver and kidney tissues of TRAF2+/- mice. The development of spleen, liver and kidney tissues in TRAF2+/- mice was detected by HE staining. Results : PCR identification using specific primers demonstrated that TRAF2+/- mice exhibited a target band at 679 bp. Western blot analysis results indicated that, compared with the WT group, the expression of TRAF2 in the tail protein of TRAF2+/- mice was significantly reduced(P+/- mice had a lower body weight compared to their littermate WT mice(P+/- mice was decreased(P+/- mice and WT mice. Conclusion The successful construction of TRAF2+/- mice has provided an important animal model for exploring the role of TRAF2 in developmental regulation, revealing the mechanism of inflammatory immune diseases mediated by abnormal TNF-α-TRAF2 signaling, and screening related drug targets.

Objective:To investigate the characteristics, influencing factors, consequences, coping strategies, and preventive measures of workplace violence in medical consortiums.Methods:Medical professionals from a specialized hospital in South China and its consortium members (2 primary-level, 1 secondary-level, and 1 tertiary-level hospitals) were surveyed in December 2022 and July 2023. Quantitative research included 1013 participants, while qualitative research involved 35 participants. Workplace violence was assessed using the "National Case Study Tool for Workplace Violence in Healthcare Institutions-Survey Questionnaire", with qualitative analysis conducted through semi-structured interviews. Inter-group comparisons employed chi-square tests or Fisher's exact probability test, with logistic regression models for bivariate analysis.Results:The overall incidence rates of violence, psychological violence, and physical violence in this medical consortium were 31.7% (321/1, 013) , 30.6% (310/1, 013) , and 3.3% (33/1, 013) , respectively. Specifically, the overall violence rates in Level 1, Level 2, and Level 3 hospitals were 22.7% (41/181) , 27.4% (43/157) , and 35.1% (237/675) . The physical violence rates were 1.1% (2/181) , 10.2% (16/157) , and 2.2% (15/675) , respectively. The psychological violence rates stood at 22.7% (41/181) , 24.8% (39/157) , and 34.1% (230/675) . The total violence in tertiary hospitals was significantly higher than that in tertiary hospitals ( F=10.10, P=0.002) , and the incidence of psychological violence in tertiary hospitals was significantly higher than that in tertiary hospitals ( Flevel 1 vs level 3=8.61, P=0.003; Flevel 2 vs level 3=4.96, P=0.026) , incidence of verbal insults ( Flevel 1 vs level 3=8.25, P=0.004; Flevel 2 vs level 3=6.36, P= 0.012) was significantly higher than that of level 1 and level 2 hospitals. The incidence of physical violence in secondary hospitals was significantly higher than that of other two-level hospitals ( P<0.001) . Compared with other types of violence, the incidence of verbal insults is highest in hospitals at all levels. Higher anxiety about violence was a risk factor for psychological violence in hospitals at all levels ( Flevel1 hospital=15.44, P=0.004; Flevel2 hospital=22.87, P<0.001; Flevel3 hospital=84.12, P<0.001) . Health workers in all three levels of hospitals has a high level of approval of existing workplace violence interventions. The main causes of workplace violence were poor communication between doctors and patients (13.2%) , service attitude problems (12.5%) and patient illness (16.9%) . Conclusion:Workplace violence remains prevalent within this medical consortium. Targeted measures should be implemented based on hospital size, functions, and patient demographics.

Objective:To investigate the characteristics, influencing factors, consequences, coping strategies, and preventive measures of workplace violence in medical consortiums.Methods:Medical professionals from a specialized hospital in South China and its consortium members (2 primary-level, 1 secondary-level, and 1 tertiary-level hospitals) were surveyed in December 2022 and July 2023. Quantitative research included 1013 participants, while qualitative research involved 35 participants. Workplace violence was assessed using the "National Case Study Tool for Workplace Violence in Healthcare Institutions-Survey Questionnaire", with qualitative analysis conducted through semi-structured interviews. Inter-group comparisons employed chi-square tests or Fisher's exact probability test, with logistic regression models for bivariate analysis.Results:The overall incidence rates of violence, psychological violence, and physical violence in this medical consortium were 31.7% (321/1, 013) , 30.6% (310/1, 013) , and 3.3% (33/1, 013) , respectively. Specifically, the overall violence rates in Level 1, Level 2, and Level 3 hospitals were 22.7% (41/181) , 27.4% (43/157) , and 35.1% (237/675) . The physical violence rates were 1.1% (2/181) , 10.2% (16/157) , and 2.2% (15/675) , respectively. The psychological violence rates stood at 22.7% (41/181) , 24.8% (39/157) , and 34.1% (230/675) . The total violence in tertiary hospitals was significantly higher than that in tertiary hospitals ( F=10.10, P=0.002) , and the incidence of psychological violence in tertiary hospitals was significantly higher than that in tertiary hospitals ( Flevel 1 vs level 3=8.61, P=0.003; Flevel 2 vs level 3=4.96, P=0.026) , incidence of verbal insults ( Flevel 1 vs level 3=8.25, P=0.004; Flevel 2 vs level 3=6.36, P= 0.012) was significantly higher than that of level 1 and level 2 hospitals. The incidence of physical violence in secondary hospitals was significantly higher than that of other two-level hospitals ( P<0.001) . Compared with other types of violence, the incidence of verbal insults is highest in hospitals at all levels. Higher anxiety about violence was a risk factor for psychological violence in hospitals at all levels ( Flevel1 hospital=15.44, P=0.004; Flevel2 hospital=22.87, P<0.001; Flevel3 hospital=84.12, P<0.001) . Health workers in all three levels of hospitals has a high level of approval of existing workplace violence interventions. The main causes of workplace violence were poor communication between doctors and patients (13.2%) , service attitude problems (12.5%) and patient illness (16.9%) . Conclusion:Workplace violence remains prevalent within this medical consortium. Targeted measures should be implemented based on hospital size, functions, and patient demographics.

Objective To establish the fingerprints of Buyang Huanwu Decoction;To find the quality markers of Buyang Huanwu Decoction by integrating the total statistical moment method,factor analysis and chemical pattern recognition;To provide a reference for its quality control and evaluation methods.Methods Under the conditions of an ACQUITY UPLC HSS T3 column(2.1 mm×100 mm,1.8 μm),the fingerprint chromatogram was developed.The fingerprints of 15 batches of Buyang Huanwu Decoction were established under the conditions of acetonitrile-0.4%phosphoric acid aqueous solution as the mobile phase;the flow rate was 0.3 mL/min;column temperature was 40℃;detection wavelength was 235 nm.Information entropy,information quantity,total statistical moment and similarity parameters were calculated.The quality stability of different batches of Buyang Huanwu Decoction was evaluated from a macroscopic perspective;the samples were comprehensively ranked by combining factor analysis,and further screened for the components of quality difference by using hierarchical cluster analysis(HCA),principal component analysis(PCA)and partial least squares-discriminant analysis(PLS-DA).Results Fingerprint patterns for 15 Buyang Huanwu Decoction batches were established.The information quantity,total zero-order moment and number of peaks varied greatly among the samples of each batch(RSD values of 32.788%,24.976%and 22.882%),whereas the information entropy,total first-order moment and second-order moment did not vary much(RSD values of 20.697%,18.544%and 9.413%),which indicated that the chemical constituents of each batch content was significantly different,and the composition ratio of components did not differ much.The overall statistical moments exhibited a similarity exceeding 0.727,in which the similarity of the two batches of samples,S2 and S7,was lower;the results of the composite scores from the factor analysis method showed that the top 5 samples of each batch of the quality ranking were S2>S7>S1>S15>S10;HCA and PCA could classify the 15 batches of samples into 2 categories;PLS-DA showed that paeoniflorin,ferulic acid and hydroxy saffron yellow pigment A were the three constituents that contributed more to the batch variation of Buyang Huanwu Decoction.Conclusion The multidimensional quality evaluation method integrated in this study is accurate,efficient and comprehensive,which can provide an objective basis for the overall quality control of Buyang Huanwu Decoction.

Objective The characteristics of supramolecular"imprinting template"of volatile oil of Curcuma kwangsiensis and Curcuma phaeocaulis were analyzed and studied based on the supramolecular"qixi"theory of Chinese materia medica combined with chemometrics.Methods The volatile oil of C.kwangsiensis and C.phaeocaulis were extracted by steam distillation,and the fingerprint and composition information of each batch were obtained by GC-MS.Total statistical moment method was used to compare the imprinting characteristics of the"imprinting template"of C.kwangsiensis and C.phaeocaulis.The core index(CI)of each batch of essential oil of C.kwangsiensis and C.phaeocaulis was calculated,and the topological characteristics of types of"imprinting template"of C.kwangsiensis and C.phaeocaulis were compared by chemometrics.Results There was no significant difference in the extraction rate of volatile oil between C.kwangsiensis and C.phaeocaulis.The average values of total zero order moment(AUCT)were(1.907±0.177)×108,(1.979±0.413)×108 μV·s,respectively,showing that there was no significant difference in the total content of volatile oil between the two groups.The mean values of the total first order moment(MCRTT)were(30.969±0.962)and(33.198±0.409)min.The average value of total second order moment(VCRTT)was(56.176±11.368)and(43.891±4.113)min2,respectively,indicating that there were significant differences in the content ratio and species of volatile oils between the two groups.The similarity of total statistical moments of C.kwangsiensis and C.phaeocaulis was mostly lower than the defined value,indicating that the chemical composition and composition ratio of the volatile oil were different.Principal component analysis and orthogonal partial least squares discriminant analysis could obviously divide C.kwangsiensis and C.phaeocaulis into two categories.Through the analysis of P value and VIP value,the CI values of Xvp 4th order,Xvpc 5th order,Xvpc 6th order,Xvpc 7th order,Xvc 3rd order,Xvpc 4th order were the main difference values of C.kwangsiensis and C.phaeocaulis.Conclusion Through the characterization of"imprinting property"and"topological characteristics"of the supramolecular"imprinting template"and combining with chemometric analysis,it is possible to successfully distinguish C.kwangsiensis and C.phaeocaulis,and find the different CI values between two"imprinting templates".

Objective:To investigate the correlation between the promoter methylation level of Dickkopf-related protein 1 (DKK1) gene and diabetic microangiopaopathy complicated with osteoporosis.Methods:Patients with type 2 diabetes mellitus (T2DM) microangiopathopathy who were admitted to our hospital from Jan. 2019 to Dec. 2022 were collected as research objects, and divided into observation group (44 cases) and control group (58 cases) according to whether they were complicated with osteoporosis. Bone mineral density (BMD) of lumbar spine (L1-4) was measured, and bone metabolism indexes, including serum calcium, serum phosphorus, 25-hydroxy vitamin D3[25-hydroxy vitamin D3, 25- (OH) D3], PTH, C-terminal telopeptide of typeI collagen (CTX), procollagen of aminoterminal propeptide (PINP) and tartrate resistant acid phosphatase (TRACP) levels were detected; The promoter methylation level of DKK1 gene was determined.Results:The methylation level of DKK1 gene promoter in the observation group was 5.17%±0.73%, which was significantly higher than that in the control group (3.81%±0.61%), with statistical significance ( t=5.22, P<0.001). The 25- (OH) D3 level, PTH and lumbar bone density in the observation group were significantly lower than those in the control group, while the CTX and TRACP levels were significantly higher than those in the control group ( t was 5.58, 4.35, 4.12, 4.05 and 4.17, respectively, P<0.001). In all patients, the promoter methylation level of DKK1 gene was significantly positively correlated with CTX and TRACP ( r was 0.41 and 0.39, P was 0.006 and 0.027, respectively), and significantly negatively correlated with PTH and lumbar bone density ( r was -0.38 and -0.43, respectively). P=0.015 and 0.003, respectively). ROC curve analysis showed that the area under the curve of DKK1 methylation level to distinguish type 2 diabetes microangionopathy with and without osteoporosis was 0.841 (0.762-0.921), and the sensitivity and specificity were 86.4% and 72.4%, respectively. Conclusion:The methylation level of DKK1 gene promoter is associated with osteoporosis and bone metabolism in T2DM patients with microangiopathia.

Methods: This study established the MFSM method. To demonstrate its effectiveness, we applied this novel approach to analyze Danxi Granules (丹膝颗粒, DXG) and its constituent herbal materials. To begin with, the ultra-performance liquid chromatography (UPLC) was applied to obtain the chromatographic fingerprints of DXG and its constituent herbal materials. Next, the MFSM was leveraged to compress and integrate them into a new fingerprint with fewer analytical units. Then, we characterized the properties and variability of both the original and integrated fingerprints by calculating total quantum statistical moment (TQSM) parameters, information entropy and information amount, along with their relative standard deviation (RSD). Finally, we compared the TQSM parameters, information entropy and information amount, and their RSD between the traditional and novel fingerprints to validate the new analytical method. Results: The chromatographic peaks of DXG and its 12 raw herbal materials were divided and integrated into peak families by the MFSM method. Before integration, the ranges of the peak number, three TQSM parameters, information entropy and information amount for each peak or peak family of UPLC fingerprints of DXG and its 12 raw herbal materials were 95.07 − 209.73, 9390 − 183064 μv·s, 5.928 − 21.33 min, 22.62 − 106.69 min2, 4.230 − 6.539, and 50530 − 974186 μv·s, respectively. After integration, the ranges of these parameters were 10.00 − 88.00, 9390 − 183064 μv·s, 5.951 − 22.02 min, 22.27 − 104.73 min2, 2.223 − 5.277, and 38159 − 807200 μv·s, respectively. Correspondingly, the RSD of all the aforementioned parameters before integration were 2.12% − 9.15%, 6.04% − 49.78%, 1.15% − 23.10%, 3.97% − 25.79%, 1.49% − 19.86%, and 6.64% − 51.20%, respectively. However, after integration, they changed to 0.00%, 6.04% − 49.87%, 1.73% − 23.02%, 3.84% − 26.85%, 1.17% − 16.54%, and 6.40% − 48.59%, respectively. The results demonstrated that in the newly integrated fingerprint, the analytical units of constituent herbal materials, information entropy and information amount were significantly reduced (P < 0.05), while the TQSM parameters remained unchanged (P > 0.05). Additionally, the RSD of the TQSM parameters, information entropy, and information amount didn’t show significant difference before and after integration (P > 0.05), but the RSD of the number and area of the integrated analytical units significantly decreased (P < 0.05). Conclusion The MFSM method could reduce the analytical units of constituent herbal materials while maintain the properties and variability from their original fingerprint. Thus, it could serve as a feasible and reliable tool to reduce difficulties in analyzing multi-components within CMMs and facilitating the evaluation of their quality.

Objective:To establish the clinical laboratory genetic diagnosis procedures for Marfan syndrome (MFS) and carry out clinical laboratory genetic diagnosis for MFS families.Methods:The second generation high-throughput sequencing was used to sequence and analyze the FBN1 gene of two MFS families who visited to Fuwai Central China Cardiovascular Hospital (Heart Center of Henan People′s Hospital) from January to December 2020, and then Sanger sequencing was used to verify the second generation high-throughput sequencing results. At the same time, the sanger sequencing of mutation sites was performed on normal family members and 100 healthy people to identify the pathogenic mutations of FBN1 gene in the MFS families. The pregnant women of two families were guided for prenatal diagnosis in the second trimester of pregnancy.Results:The clinical laboratory diagnosis of MFS showed that two MFS patients had the pathogenic mutation of c.2560T>C heterozygous mutation and c.6772T>C heterozygous mutation in FBN1 gene, respectively. The mutation was not observed in 100 healthy people and normal members in two families. The prenatal diagnosis showed that there was a heterozygous mutation of FBN1 gene c.2560T>C in the first fetus of the MFS family, which was MFS. There was no mutation in the FBN1 gene in the second fetus of the MFS family, so it was recommended to continue the pregnancy. The results of postpartum follow-up were consistent with the results of clinical laboratory diagnosis.Conclusion:The clinical laboratory genetic diagnosis procedures for MFS have been established successfully, which provides an important reference for clarifying the clinical diagnosis of MFS.