Traditional Chinese medicine (TCM) is an ancient medical system distinctive and effective in treating cancer, depression, coronavirus disease 2019 (COVID-19), and other diseases. However, the relatively abstract diagnostic methods of TCM lack objective measurement, and the complex mechanisms of action are difficult to comprehend, which hinders the application and internationalization of TCM. Recently, while breakthroughs have been made in utilizing methods such as network pharmacology and virtual screening for TCM research, the rise of machine learning (ML) has significantly enhanced their integration with TCM. This article introduces representative methodological cases in quality control, mechanism research, diagnosis, and treatment processes of TCM, revealing the potential applications of ML technology in TCM. Furthermore, the challenges faced by ML in TCM applications are summarized, and future directions are discussed.

Objective To study the appropriate concentration of oral Gadovist solution for improving the image quality of three-dimensional sampling perfection with application optimized contrasts using different flip angle evolutions magnetic resonance cholangiopancreatography(3D-SPACE-MRCP).Methods In vitro experiments,0.05％,0.1％,0.15％and 0.2％Gadovist solution and direct drinking water were put into 100 mL plastic containers respectively for 3D-SPACE-MRCP scanning to measure the signal intensity(SI)of Gadovist solutions in each group.The concentration and the SI of Gadovist solution were analyzed with Spearman correlation,and one-way variance analysis was performed to compare the SI of different concentration Gadovist solutions.In clinical experiments,128 subjects were randomly divided into 4 groups,and then taken orally 300 mL of 0.05％,0.1％,0.15％and 0.2％Gadovist solutions respectively.The 3D-SPACE-MRCP scanning was performed,and the image quality was evaluated by two physicians and compared by one-way variance analysis.Results In vitro experiments,there was an extremely strong negative correlation between the concentration and the SI of Gadovist solution(r=-0.969,P＜0.05),and there were significant differences in the SI among different concentrations of Gadovist solution(P＜0.05).In clinical experiments,among the 26 cases with first-level images,24 cases were distributed in the 0.1％Gadovist solution group.There was a statistically significant difference in image quality of the 3D-SPACE-MRCP with different oral concentrations of Gadovist solution(F=89.57,P＜0.05),however,there was no statistically significant difference between the 0.15％and the 0.2％Gadovist solution groups using the Tukey test(P＞0.05).Conclusion Oral Gadovist solution can significantly improve the images quality of 3D-SPACE-MRCP,and 0.1％solution is the appropriate dilution concentration.

BACKGROUND:The Pilon fracture has a complex fracture line and a comminuted fracture fragment.It is often associated with bone loss and soft tissue damage and is one of the most difficult fractures to treat clinically. OBJECTIVE:To analyze the correlation between tibial and fibular fractures in Pilon fractures. METHODS:A retrospective analysis was conducted on 188 patients with Pilon fracture in the Department of Trauma Orthopedics,The Second People's Hospital of Lianyungang City from January 2014 to January 2022.Imaging data of these patients were collected.Fibular fracture level,fibular fracture type,number of fibular fracture blocks,tibial position status,main fracture blocks of the tibia,size of medial fracture blocks of the tibia,tibial fracture angle,Topliss classification(sagittal plane)and Topliss classification(coronal plane)were summarized into a database.SPSS 25.0 was used to analyze the data of tibia and fibula in Pilon fractures by Spearman correlation analysis.On the basis of the correlation,multiple disordered Logistic regression was used to further analyze the correlation. RESULTS AND CONCLUSION:(1)Spearman correlation analysis showed that tibial fracture angle was positively correlated with fibular fracture type,fibular fracture level and fibular fracture number.Tibial position status was positively correlated with tibial fracture angle and Topliss classification(coronal plane),but negatively correlated with major tibial fracture blocks and Topliss classification(sagittal plane).The level of fibular fracture was positively correlated with the type of fibular fracture and the number of fibular fractures.The main fracture blocks of the tibia were positively correlated with Topliss classification(coronal plane)and negatively correlated with Topliss classification(sagittal plane).(2)Multiple Logistic regression analysis showed that:the level of fibular fracture was correlated with the type of fibular fracture(P<0.05);the number of fibular fractures was correlated with the main fracture block of tibia(P<0.05).(3)It is indicated that the more inclined the ankle joint was to the valgus,the more likely it was to lead to fibular fracture,and the higher the fibular fracture level,the more serious the fibular fracture degree,the more complex the fibular fracture type,the larger the tibial fracture angle,the more the tibia presented Topliss classification(coronal plane)fracture.(4)When the ankle joint was more inclined to be in varus or varus + dorsiflexion,the fibula often did not fracture or simple fracture occurred,and the lower the fracture level,the smaller the tibial fracture angle,the more Topliss classification of the tibia(sagittal plane),the more main fracture blocks of the tibia,the larger the medial fracture block.When the ankle joint is in the dorsiflexion,it often results in a simple fibular fracture with a posterolateral tibial fracture.

Objective To investigate the predictive value of neutrophil-to-lymphocyte ratio(NLR)and other factors for hemorrhagic transformation(HT)after intravenous thrombolysis in acute ischemic stroke(AIS).Methods A retrospective study was conducted on 260 AIS patients who received intravenous thrombolysis with alteplase in Department of Neurology of Hexian People's Hospital from August 2020 to June 2024.According to HT occurred or not after thrombolysis,they were divided into HT group(n=42)and non-HT group(n=218).The clinical baseline data were compared between the two groups.Multivariate logistic regression analysis was used to iden-tify the risk factors of HT,and ROC curve was drawn to analyze the predictive value of NLR and other risk factors for HT in AIS patients after intravenous thrombolysis.Results Among the 260 AIS patients,42 cases(16.2％)had HT.The proportion of atrial fibrillation and cardioembolism type(TOAST subtype CE),white blood cell count,neutrophils count,NLR,and baseline NHISS score were significantly higher,and the lymphocyte count was obviously lower in the HT group than the non-HT group(all P＜0.05).Multivariate logistic regression analysis showed that atrial fibrillation(OR=3.361,95％CI:1.015-15.381),NHISS score ≥15(OR=7.785,95％CI:1.348-21.312),TOAST classification CE(OR=4.104,95％CI:1.156-17.256),and NLR(OR=3.165,95％CI:1.231-5.265)were independent risk factors for HT(all P＜0.05).ROC curve analysis showed that the AUC value of NLR combined with above other factors was 0.841(95％CI:0.763-0.967,P＜0.01).In Hosmer-Lemeshow goodness of fit test on the model(P=0.354),the best critical value was 0.701,the sensitivity was 86.3％,and the specificity was 84.3％.Conclu-sion NLR combined with TOAST etiological classification and other factors have a certain pre-dictive value for the occurrence of HT after intravenous thrombolysis.

Objective:To develop a predictive model for intrapartum fever related to chorioamnionitis in parturients undergoing epidural labor analgesia.Methods:This was a retrospective study. The parturients with intrapartum fever (axillary temperature ≥38 ℃) who received epidural labor analgesia from January 2020 to December 2022 in Sichuan Maternal and Child Health Hospital were selected as model group, and parturients with intrapartum fever who received epidural labor analgesia from January to October 2023 in Sichuan Maternal and Child Health Hospital were selected as validation group. The parturients in model group were divided into histological chorioamnionitis stage ≥Ⅱ group (HCA≥Ⅱ group) and histological chorioamnionitis stage <Ⅱ group (HCA<Ⅱ group) according to the results of placental histopathological examination. Logistic regression analysis was used to screen the independent risk factors for intrapartum fever related to chorioamnionitis in parturients, and then a nomogram model was established. The discrimination of the model was verified by the area under the the receiver operating characteristic curve. The consistency of the model was verified by the calibration curve, and the clinical effectiveness of the model was determined by the decision curve. The validation dataset was used to further evaluate the model.Results:A total of 308 parturients were finally included in model group and 99 parturients in validation group. Multivariate logistic regression analysis showed that the gestational age, meconium-stained amniotic fluid, c-reactive protein concentration and maximum body temperature were independent risk factors for intrapartum fever related to chorioamnionitis in parturients undergoing epidural labor analgesia ( P<0.05). Based on this, a nomogram risk prediction model was developed. The area under the curve (95% confidence interval) was 0.844 (0.744-0.944) in model group and 0.812 (0.674-0.950) in validation group. The calibration curve showed that the prediction probability of the model had good consistency with the actual probability of diagnosis. The decision curve showed that the threshold probability of the prediction model in model group and validation group was 10%-98% and 10%-78%, respectively. Conclusions:A nomogram prediction model for intrapartum fever related to chorioamnionitis is successfully established based on the gestational age, c-reactive protein concentration, meconium-stained amniotic fluid and maximum body temperature in parturients undergoing epidural labor analgesia. The model has good predictive performance and clinical value.

Ossification of the posterior longitudinal ligament (OPLL) is a condition comprising ectopic bone formation from spinal ligaments. This disease is a leading cause of myelopathy in the Asian population. However, the molecular mechanism underlying OPLL and efficient preventive interventions remain unclear. Here, we performed single-cell RNA sequencing and revealed that type I interferon (IFN) signaling was activated in the ossified ligament of patients with OPLL. We also observed that IFN-β stimulation promoted the osteogenic differentiation of preosteoblasts in vitro and activated the ossification-related gene SPP1, thereby confirming the single-cell RNA sequencing findings. Further, blocking the IFN-α/β subunit 1 receptor (IFNAR1) using an anti-IFNAR1 neutralizing antibody markedly suppressed osteogenic differentiation. Together, these results demonstrated that the type I IFN signaling pathway facilitated ligament ossification, and the blockade of this signaling might provide a foundation for the prevention of OPLL.
Humans ; Signal Transduction ; Interferon Type I/metabolism* ; Ossification of Posterior Longitudinal Ligament/genetics* ; Gene Expression Profiling ; Single-Cell Analysis ; Osteogenesis/genetics* ; Receptor, Interferon alpha-beta/metabolism* ; Male ; Female ; Cell Differentiation ; Middle Aged

Ulcerative colitis （UC） is a commonly seen digestive system disease with unclear pathogenesis. The condition is complex and variable， often chronic， and has a long treatment period with no specific cure. Currently， the treatment of UC often involves the use of corticosteroids， aminosalicylates， and biologics in western medicine， which provide fast-acting and definite efficacy in the short term. However， with prolonged medication， some patients may develop drug resistance and worsening of the disease， leading to the occurrence of colon cancer. Research has found that oxidative stress is one of the important pathogenic factors in UC and influences its onset and development. Oxidative stress is a state of imbalance between oxidative products and the antioxidant system in the body， characterized by overexpression of oxidative products such as malondialdehyde （MDA）， reactive oxygen species （ROS）， nitric oxide （NO）， or deficiency of antioxidant enzymes such as superoxide dismutase （SOD）， catalase （CAT）， and glutathione （GSH）. It is worth noting that traditional Chinese medicine （TCM）， as a unique characteristic medicine of China， has achieved significant efficacy in the treatment of UC. Studies have shown that TCM effectively inhibits the occurrence of UC by suppressing the accumulation of metabolites and antagonizes the development of UC by enhancing the antioxidant system. Therefore， using TCM to regulate the oxidative balance as a diagnostic and therapeutic approach may be a new method and direction for the treatment of UC in the future. Based on the above research， this article summarized the mechanisms of key pathogenic proteins in oxidative stress and the occurrence and development of UC， and compiled the effective ingredients of Chinese medicine， single drugs， prescriptions， and acupuncture and moxibustion in regulating upstream and downstream target proteins of oxidative stress. These interventions can reduce pathological damage to the intestinal mucosa， lower the colon injury index， enrich the intestinal microbiota， increase colon length， and improve clinical symptoms of UC. The article is expected to expand the application of TCM in the treatment of UC and provide a reliable scientific theoretical basis.

Objective : To investigate the factors affecting concurrent sarcopenia among patients with cardiovascular diseases, so as to provide insights into early identification and prevention of cardiovascular diseases complicated with sarcopenia. Methods: A total of 250 inpatients with cardiovascular diseases in the Sixth Division Hospital of Xinjiang Production and Construction Corps were recruited and divided into the sarcopenia and non-sarcopenia groups according to the diagnostic criteria of sarcopenia. Subjects' basic characteristics, body mass index, blood biochemical indicators and human body composition parameters were collected using questionnaire surveys, and factors affecting concurrent sarcopenia among patients with cardiovascular diseases using a multivariable logistic regression model. Results: Among the 250 patients with cardiovascular diseases, there were 149 males (59.60%) and 101 females (40.40%). The overall prevalence of sarcopenia was 8.40% among the study subjects. The mean age and body mass index were (75.19±9.74) and (20.77±2.19) kg/m2 in the sarcopenia group and (65.24±11.50) years and (25.85±2.87) kg/m2 in the non-sarcopenia group. Multivariable logistic regression analysis identified age (OR=1.115, 95%CI: 1.030-1.207) and body mass index (OR=0.582, 95%CI: 0.445-0.761) were as factors affecting concurrent sarcopenia among patients with cardiovascular diseases. Conclusion Advanced age and low body mass index may increase the risk of concurrent sarcopenia among patients with cardiovascular diseases.

Pemphigus vulgaris is the most common and serious type of pemphigus, and timely treatment can change its prognosis. This review comprehensively analyzes considerations in the treatment of pemphigus vulgaris during pregnancy and lactation as well as during the prevention and control of COVID-19 pandemic, including treatment particularities and comprehensive nursing care, in order to provide better guidance and treatment for patients.

Objective:To investigate prognostic factors for acral lentiginous melanoma (ALM) , and to construct a nomogram to verify the predictive value of these factors.Methods:Clinical data on 1 573 patients with ALM were collected from the Surveillance, Epidemiology, and End Results (SEER) database of National Cancer Institute in United States between 2004 and 2015. Data about patients′ age, gender, ulcer status, SEER staging, surgical protocols, T-, N- and M-staging, overall survival rates and disease-specific survival rates were extracted. Chi-square test was used to analyze the correlation of clinical characteristics with overall survival rates and melanoma-specific survival rates, and univariate and multivariate Cox proportional hazards regression models were used to investigate prognostic factors and establish predictive models.Results:Among the 1 537 patients with ALM, 714 were males, 823 were females, 818 were under 64 years of age, and 1 363 were Caucasian. Skin lesions occurred on the lower limbs and buttocks in 1 205 cases, and 974 cases had ulcers; according to the SEER staging, non-spread localized skin lesions were observed in 1 048 cases. There were significant differences in the mortality rate among patients of different ages at diagnosis, different gender, with different ulcer status, surgical status, and at different SEER stages, T-stages, N-stages and M-stages (all P < 0.001) . Univariate and multivariate Cox regression analysis showed that age ≥ 65 years, male, ulcers and distant lymph node metastasis in the SEER staging were associated with increased risk of death in the patients (all P < 0.05) , and the mortality rate was significantly higher in the patients with T2-, T3- or T4-stage ALM than in those with T1-stage ALM (all P < 0.05) , and higher in the patients with N1-, N2- and N3-stage ALM than in those with N0-stage ALM (all P < 0.05) . Conclusion:Age, gender, ulcer status, SEER stage, T-stage and N-stage are independent prognostic factors for overall survival rates and disease-specific survival rates of ALM.