Puerariae Lobatae Radix and Puerariae Thomsonii Radix are the dried roots of Pueraria lobata and Pueraria thomsonii of the Leguminosae family， respectively. Since their separate inclusion in the 2005 edition of Pharmacopoeia of the People's Republic of China， the two herbs have been individually recorded. Although they share the same functions and indications， the required content of puerarin differs by a factor of up to eightfold between them. The current quality standard relies solely on a single indicator， puerarin， which fails to reflect the correlation between chemical constituents and core therapeutic effects. This has resulted in prominent issues of mixed use in clinical practice and production， thereby constraining the high-quality development of the industry. Modern research has demonstrated that Puerariae Lobatae Radix contains a comprehensive range and higher content of isoflavonoid constituents， while Puerariae Thomsonii Radix is rich in starch and polysaccharides. Puerariae Lobatae Radix exhibits stronger effects in antipyresis， cardiovascular and cerebrovascular protection， and central analgesia， while Puerariae Thomsonii Radix demonstrates greater advantages in anti-inflammation， hypoglycemia， and peripheral analgesia. Based on this， the chemical material bases of Puerariae Lobatae Radix and Puerariae Thomsonii Radix at both the macromolecule and micromolecule levels were systematically reviewed and compared. The pharmacodynamic material bases and mechanisms of action underlying their three core therapeutic effects， namely "relieving exterior syndrome and clearing heat"， "promoting fluid production to quench thirst"， and "dredging channels and activating collaterals"， were summarized. The most highly correlated common metabolic pathway shared by both herbs for these three therapeutic effects is the arachidonic acid metabolic pathway， and their common core target is prostaglandin-endoperoxide synthase 2 （PTGS2）. This review provided clinical application recommendations based on the therapeutic differences between the two herbs， elucidated the scientific connotation of their "same origin but different effects"， and， grounded in the quality marker （Q-Marker）， proposed the concept of efficacy-related Q-Marker based on "substance-efficacy-syndrome" association， as well as a novel strategy for efficacy-oriented quality evaluation. Preliminary screening of quality markers associated with different therapeutic effects was also conducted. This study aims to provide critical scientific evidence for the precise clinical application of Puerariae Lobatae Radix and Puerariae Thomsonii Radix， the improvement of quality standards， and the high-quality development of the industry.

ObjectiveTo investigate the association between single and combined exposure to arsenic （As）， mercury （Hg）， and cadmium （Cd） in urine and hearing loss in adults. MethodsA total of 400 adult patients were recruited for the study， comprising 200 participants in the normal hearing group and 200 in the hearing loss group. General demographic information of the study subjects was collected by a self-administered questionnaire， morning urine samples were tested for As， Hg， and Cd concentrations， and hearing status was assessed by Pure Tone Audiometry. A binary Logistic regression model was used to explore the association between the concentrations of the three metals in urine and hearing loss， and a Bayesian kernel-machine regression （BKMR） model was used to further explore the association between the concentrations of the three metal mixtures and hearing loss. ResultsAfter correction for urinary creatinine， As， Hg， and Cd concentrations were higher in the hearing loss group than those in the normal hearing group （P<0.05）. Binary Logistic regression indicated that concentrations of As， Hg， and Cd were positively associated with hearing loss， and the risk of hearing loss was significantly higher in the second quartile of Cd concentration compared to the first quartile （OR=2.000， 95%CI： 1.009-3.964）. BKMR modeling analysis showed that the combined exposure levels of As， Hg， and Cd significantly increased the risk of hearing loss， with Cd being the most important contributor （posterior inclusion probability=0.412）， and that there were potential interactions between As and Cd， and Cd and Hg. ConclusionCombined exposure to As， Hg， and Cd in urine is significantly associated with adult hearing loss， with Cd being the primary contributor in the exposure combination. The interactions between As and Cd， as well as Cd and Hg， may have adverse effects on hearing loss.

Objective To identify biomarkers that characterize its bitter-cold properties of Scutellaria Radix on the basis of evaluating its cold and hot properties,as well as possible metabolic pathways and related targets;To explore its molecular mechanism.Methods Totally 40 mice were randomly divided into a control group and a treatment group,and were orally administered with normal saline and Scutellaria Radix decoction,respectively,for 4 consecutive days.The cold and hot plate differential method was used to evaluate the cold and hot tendencies of the mice;UPLC-MS/MS technology was used to analyze mouse blood samples,differential metabolites were screened using principal component analysis,partial least squares discriminant analysis and orthogonal partial least squares discriminant analysis methods,and metabolic pathway analysis was performed;network modular analysis of differential metabolites was performed using Cytoscape 3.9.0 software to identify potential molecular targets.Results On the second day of administration,the anal temperature of mice in the treatment group decreased significantly compared to the control group(P<0.01);in the cold and hot tendency test,the mice in the treatment group showed an overall increase in high-temperature tendency and a higher proportion of high-temperature zone retention.There was a statistically significant difference(P<0.01,P<0.05)between the treatment group and the control group on the 2nd and 3rd day of treatment;the pattern recognition analysis of serum metabolome data showed that the serum samples of the treatment group and the control group could be completely separated,and a total of 14 differential metabolites were screened out;metabolic pathway analysis identified 16 related pathways,including unsaturated fatty acid biosynthesis,linoleic acid metabolism,citric acid cycle(TCA cycle),arachidonic acid metabolism,glycine,serine and threonine metabolism,steroid hormone biosynthesis,etc.;a total of 16 modules were obtained through network modular analysis,among which the arachidonic acid metabolism pathway and linoleic acid metabolism pathway modules were larger;the nodal degree values of arachidonic acid and linoleic acid were greater than the mean,involving arachidonic acid metabolism and linoleic acid metabolism pathways;by screening 26 genes associated with the cytochrome P450 enzyme system were obtained.Conclusion Scutellaria Radix may regulate the body's energy metabolism,achieve its biological effects,and characterize its medicinal properties by intervening in metabolic pathways such as arachidonic acid and linoleic acid.

Objective To identify biomarkers that characterize its bitter-cold properties of Scutellaria Radix on the basis of evaluating its cold and hot properties,as well as possible metabolic pathways and related targets;To explore its molecular mechanism.Methods Totally 40 mice were randomly divided into a control group and a treatment group,and were orally administered with normal saline and Scutellaria Radix decoction,respectively,for 4 consecutive days.The cold and hot plate differential method was used to evaluate the cold and hot tendencies of the mice;UPLC-MS/MS technology was used to analyze mouse blood samples,differential metabolites were screened using principal component analysis,partial least squares discriminant analysis and orthogonal partial least squares discriminant analysis methods,and metabolic pathway analysis was performed;network modular analysis of differential metabolites was performed using Cytoscape 3.9.0 software to identify potential molecular targets.Results On the second day of administration,the anal temperature of mice in the treatment group decreased significantly compared to the control group(P<0.01);in the cold and hot tendency test,the mice in the treatment group showed an overall increase in high-temperature tendency and a higher proportion of high-temperature zone retention.There was a statistically significant difference(P<0.01,P<0.05)between the treatment group and the control group on the 2nd and 3rd day of treatment;the pattern recognition analysis of serum metabolome data showed that the serum samples of the treatment group and the control group could be completely separated,and a total of 14 differential metabolites were screened out;metabolic pathway analysis identified 16 related pathways,including unsaturated fatty acid biosynthesis,linoleic acid metabolism,citric acid cycle(TCA cycle),arachidonic acid metabolism,glycine,serine and threonine metabolism,steroid hormone biosynthesis,etc.;a total of 16 modules were obtained through network modular analysis,among which the arachidonic acid metabolism pathway and linoleic acid metabolism pathway modules were larger;the nodal degree values of arachidonic acid and linoleic acid were greater than the mean,involving arachidonic acid metabolism and linoleic acid metabolism pathways;by screening 26 genes associated with the cytochrome P450 enzyme system were obtained.Conclusion Scutellaria Radix may regulate the body's energy metabolism,achieve its biological effects,and characterize its medicinal properties by intervening in metabolic pathways such as arachidonic acid and linoleic acid.

Objective:To investigate the effect of three-layer suturing of myometrium on the size of diverticu-lum after cesarean section and the related factors of the formation of uterine incision diverticulum(CSD).Meth-ods:The clinical data of 240 parturients who underwent cesarean section in Wuhu Hospital affiliated to East China normal University from April to November 2022 were analyzed retrospectively.According to the different suture methods of myometrium,they were divided into three-layer suture group(n=124)and double-layer suture group(n=116).According to the formation of CSD after operation,the parturients were divided into CSD group(n=23)and non-CSD group(n=217).The clinical characteristics of parturients in three-layer suture group and doub-le-layer suture group were compared.Multivariate Logistic regression were used to analyze the independent fac-tors affecting the formation of CSD and an artificial neural network model was constructed.The model was verified by receiver operating characteristics(ROC),calibration curve and clinical decision curve.Results:①The thick-ness of myometrium scar in the three-layer suture group was significantly higher than that in the double-layer su-ture group(7.06±2.09 mm vs.5.68±1.97 mm),while the formation of CSD(4.03％vs.15.52％)and the size of diverticulum(0.36±0.09 ml vs.0.47±0.12 ml)were significantly lower than those in the double-layer suture group(P＜0.05).②Multivariate analysis showed that retroflexion of uterus,cesarean section frequency ≥2 times,premature rupture of membranes,perinatal infection and timing of cesarean section were independent risk factors for the formation of CSD(OR＞1,P＜0 05),while three layer suture of myometrium was a protective factor(OR＜1,P＜0.05).③The artificial neural network prediction model showed that the weights of cesarean section frequency,premature rupture of membranes and three-layer suture were higher.The ROC curve,calibration curve,and clinical decision curve validation showed that the model had good predictive ability.Conclusions:The formation of CSD is related to indicators such as retroflexion of uterus,times of cesarean section,premature rup-ture of membranes,perinatal infection and timing of cesarean section.Clinical attention should be focused on this.In addition,three-layer suture of myometrium can reduce the probability of formation of CSD,which is worth popu-larizing and application in clinic.

Objective:To investigate the effect of three-layer suturing of myometrium on the size of diverticu-lum after cesarean section and the related factors of the formation of uterine incision diverticulum(CSD).Meth-ods:The clinical data of 240 parturients who underwent cesarean section in Wuhu Hospital affiliated to East China normal University from April to November 2022 were analyzed retrospectively.According to the different suture methods of myometrium,they were divided into three-layer suture group(n=124)and double-layer suture group(n=116).According to the formation of CSD after operation,the parturients were divided into CSD group(n=23)and non-CSD group(n=217).The clinical characteristics of parturients in three-layer suture group and doub-le-layer suture group were compared.Multivariate Logistic regression were used to analyze the independent fac-tors affecting the formation of CSD and an artificial neural network model was constructed.The model was verified by receiver operating characteristics(ROC),calibration curve and clinical decision curve.Results:①The thick-ness of myometrium scar in the three-layer suture group was significantly higher than that in the double-layer su-ture group(7.06±2.09 mm vs.5.68±1.97 mm),while the formation of CSD(4.03％vs.15.52％)and the size of diverticulum(0.36±0.09 ml vs.0.47±0.12 ml)were significantly lower than those in the double-layer suture group(P＜0.05).②Multivariate analysis showed that retroflexion of uterus,cesarean section frequency ≥2 times,premature rupture of membranes,perinatal infection and timing of cesarean section were independent risk factors for the formation of CSD(OR＞1,P＜0 05),while three layer suture of myometrium was a protective factor(OR＜1,P＜0.05).③The artificial neural network prediction model showed that the weights of cesarean section frequency,premature rupture of membranes and three-layer suture were higher.The ROC curve,calibration curve,and clinical decision curve validation showed that the model had good predictive ability.Conclusions:The formation of CSD is related to indicators such as retroflexion of uterus,times of cesarean section,premature rup-ture of membranes,perinatal infection and timing of cesarean section.Clinical attention should be focused on this.In addition,three-layer suture of myometrium can reduce the probability of formation of CSD,which is worth popu-larizing and application in clinic.

Objective:To investigate the effect of three-layer suturing of myometrium on the size of diverticu-lum after cesarean section and the related factors of the formation of uterine incision diverticulum(CSD).Meth-ods:The clinical data of 240 parturients who underwent cesarean section in Wuhu Hospital affiliated to East China normal University from April to November 2022 were analyzed retrospectively.According to the different suture methods of myometrium,they were divided into three-layer suture group(n=124)and double-layer suture group(n=116).According to the formation of CSD after operation,the parturients were divided into CSD group(n=23)and non-CSD group(n=217).The clinical characteristics of parturients in three-layer suture group and doub-le-layer suture group were compared.Multivariate Logistic regression were used to analyze the independent fac-tors affecting the formation of CSD and an artificial neural network model was constructed.The model was verified by receiver operating characteristics(ROC),calibration curve and clinical decision curve.Results:①The thick-ness of myometrium scar in the three-layer suture group was significantly higher than that in the double-layer su-ture group(7.06±2.09 mm vs.5.68±1.97 mm),while the formation of CSD(4.03％vs.15.52％)and the size of diverticulum(0.36±0.09 ml vs.0.47±0.12 ml)were significantly lower than those in the double-layer suture group(P＜0.05).②Multivariate analysis showed that retroflexion of uterus,cesarean section frequency ≥2 times,premature rupture of membranes,perinatal infection and timing of cesarean section were independent risk factors for the formation of CSD(OR＞1,P＜0 05),while three layer suture of myometrium was a protective factor(OR＜1,P＜0.05).③The artificial neural network prediction model showed that the weights of cesarean section frequency,premature rupture of membranes and three-layer suture were higher.The ROC curve,calibration curve,and clinical decision curve validation showed that the model had good predictive ability.Conclusions:The formation of CSD is related to indicators such as retroflexion of uterus,times of cesarean section,premature rup-ture of membranes,perinatal infection and timing of cesarean section.Clinical attention should be focused on this.In addition,three-layer suture of myometrium can reduce the probability of formation of CSD,which is worth popu-larizing and application in clinic.

Objective:To investigate the effect of three-layer suturing of myometrium on the size of diverticu-lum after cesarean section and the related factors of the formation of uterine incision diverticulum(CSD).Meth-ods:The clinical data of 240 parturients who underwent cesarean section in Wuhu Hospital affiliated to East China normal University from April to November 2022 were analyzed retrospectively.According to the different suture methods of myometrium,they were divided into three-layer suture group(n=124)and double-layer suture group(n=116).According to the formation of CSD after operation,the parturients were divided into CSD group(n=23)and non-CSD group(n=217).The clinical characteristics of parturients in three-layer suture group and doub-le-layer suture group were compared.Multivariate Logistic regression were used to analyze the independent fac-tors affecting the formation of CSD and an artificial neural network model was constructed.The model was verified by receiver operating characteristics(ROC),calibration curve and clinical decision curve.Results:①The thick-ness of myometrium scar in the three-layer suture group was significantly higher than that in the double-layer su-ture group(7.06±2.09 mm vs.5.68±1.97 mm),while the formation of CSD(4.03％vs.15.52％)and the size of diverticulum(0.36±0.09 ml vs.0.47±0.12 ml)were significantly lower than those in the double-layer suture group(P＜0.05).②Multivariate analysis showed that retroflexion of uterus,cesarean section frequency ≥2 times,premature rupture of membranes,perinatal infection and timing of cesarean section were independent risk factors for the formation of CSD(OR＞1,P＜0 05),while three layer suture of myometrium was a protective factor(OR＜1,P＜0.05).③The artificial neural network prediction model showed that the weights of cesarean section frequency,premature rupture of membranes and three-layer suture were higher.The ROC curve,calibration curve,and clinical decision curve validation showed that the model had good predictive ability.Conclusions:The formation of CSD is related to indicators such as retroflexion of uterus,times of cesarean section,premature rup-ture of membranes,perinatal infection and timing of cesarean section.Clinical attention should be focused on this.In addition,three-layer suture of myometrium can reduce the probability of formation of CSD,which is worth popu-larizing and application in clinic.

Objective:To investigate the effect of three-layer suturing of myometrium on the size of diverticu-lum after cesarean section and the related factors of the formation of uterine incision diverticulum(CSD).Meth-ods:The clinical data of 240 parturients who underwent cesarean section in Wuhu Hospital affiliated to East China normal University from April to November 2022 were analyzed retrospectively.According to the different suture methods of myometrium,they were divided into three-layer suture group(n=124)and double-layer suture group(n=116).According to the formation of CSD after operation,the parturients were divided into CSD group(n=23)and non-CSD group(n=217).The clinical characteristics of parturients in three-layer suture group and doub-le-layer suture group were compared.Multivariate Logistic regression were used to analyze the independent fac-tors affecting the formation of CSD and an artificial neural network model was constructed.The model was verified by receiver operating characteristics(ROC),calibration curve and clinical decision curve.Results:①The thick-ness of myometrium scar in the three-layer suture group was significantly higher than that in the double-layer su-ture group(7.06±2.09 mm vs.5.68±1.97 mm),while the formation of CSD(4.03％vs.15.52％)and the size of diverticulum(0.36±0.09 ml vs.0.47±0.12 ml)were significantly lower than those in the double-layer suture group(P＜0.05).②Multivariate analysis showed that retroflexion of uterus,cesarean section frequency ≥2 times,premature rupture of membranes,perinatal infection and timing of cesarean section were independent risk factors for the formation of CSD(OR＞1,P＜0 05),while three layer suture of myometrium was a protective factor(OR＜1,P＜0.05).③The artificial neural network prediction model showed that the weights of cesarean section frequency,premature rupture of membranes and three-layer suture were higher.The ROC curve,calibration curve,and clinical decision curve validation showed that the model had good predictive ability.Conclusions:The formation of CSD is related to indicators such as retroflexion of uterus,times of cesarean section,premature rup-ture of membranes,perinatal infection and timing of cesarean section.Clinical attention should be focused on this.In addition,three-layer suture of myometrium can reduce the probability of formation of CSD,which is worth popu-larizing and application in clinic.

Objective:To investigate the effect of three-layer suturing of myometrium on the size of diverticu-lum after cesarean section and the related factors of the formation of uterine incision diverticulum(CSD).Meth-ods:The clinical data of 240 parturients who underwent cesarean section in Wuhu Hospital affiliated to East China normal University from April to November 2022 were analyzed retrospectively.According to the different suture methods of myometrium,they were divided into three-layer suture group(n=124)and double-layer suture group(n=116).According to the formation of CSD after operation,the parturients were divided into CSD group(n=23)and non-CSD group(n=217).The clinical characteristics of parturients in three-layer suture group and doub-le-layer suture group were compared.Multivariate Logistic regression were used to analyze the independent fac-tors affecting the formation of CSD and an artificial neural network model was constructed.The model was verified by receiver operating characteristics(ROC),calibration curve and clinical decision curve.Results:①The thick-ness of myometrium scar in the three-layer suture group was significantly higher than that in the double-layer su-ture group(7.06±2.09 mm vs.5.68±1.97 mm),while the formation of CSD(4.03％vs.15.52％)and the size of diverticulum(0.36±0.09 ml vs.0.47±0.12 ml)were significantly lower than those in the double-layer suture group(P＜0.05).②Multivariate analysis showed that retroflexion of uterus,cesarean section frequency ≥2 times,premature rupture of membranes,perinatal infection and timing of cesarean section were independent risk factors for the formation of CSD(OR＞1,P＜0 05),while three layer suture of myometrium was a protective factor(OR＜1,P＜0.05).③The artificial neural network prediction model showed that the weights of cesarean section frequency,premature rupture of membranes and three-layer suture were higher.The ROC curve,calibration curve,and clinical decision curve validation showed that the model had good predictive ability.Conclusions:The formation of CSD is related to indicators such as retroflexion of uterus,times of cesarean section,premature rup-ture of membranes,perinatal infection and timing of cesarean section.Clinical attention should be focused on this.In addition,three-layer suture of myometrium can reduce the probability of formation of CSD,which is worth popu-larizing and application in clinic.