ObjectiveTo develop a standardized classification model for traditional Chinese medicine （TCM） syndrome patterns of mixed hemorrhoids using multi-center real-world data， and unveil their distribution patterns and core risk factors， thereby providing evidence-based support for standardizing TCM syndrome differentiation and implementing precision interventions. MethodsA multi-center cross-sectional study was conducted， enrolling 13 283 mixed hemorrhoid patients from eight hospitals in Jiangsu Province between September 1st， 2023 and December 31st， 2024. DeepSeek-R1-Distill-Qwen-7B and LLaMA-3.3 large language models （LLM） were integrated with latent class analysis （LCA） to perform unsupervised learning and latent class modeling of TCM symptomatology. Potential risk factors were screened via univariate analysis， followed by logistic regression to identify independent risk factors for each syndrome pattern. ResultsThe model's performance indicators were stable and reliable across different clinical data types，i.e. in the outpatient records， past medical history （F1=99.7%）， current medical history （F1=94.9%）， and specialist examination （F1=90.7%）； in inpatient records， past medical history （F1=98.2%）， current medical history （F1=91.2%）， specialist examination （F1=90.3%）， and discharge status （F1=90.6%）. Latent class mode-ling identified four core TCM syndrome patterns including spleen deficiency and qi sinking syndrome （915 cases， 6.89%）， damp-heat pouring downward syndrome （10 820 cases， 81.46%）， qi stagnation and blood stasis syndrome （1252 cases， 9.43%）， and wind injuring intestinal collaterals syndrome （296 cases， 2.22%）， with respective latent class probabilities of 0.069， 0.815， 0.094， and 0.022. Logistic regression demonstrated that gender， age， disease duration， hypertension， diabetes， hyperlipidemia， constipation， smoking history， and alcohol consumption were independent risk factors for pattern differentiation （P＜0.05）. The efficacy validation evaluation revealed that the cure rates for patients with spleen deficiency and qi sinking syndrome and qi stagnation and blood stasis syndrome were higher than those for patients with damp-heat pouring downward syndrome （adjusted P＜0.05）， with no statistically significant differences among other syndrome patterns. ConclusionDamp-heat pouring downward syndrome is the predominant syndrome in mixed hemorrhoids. Gender， age， disease duration， hypertension， diabetes， hyperlipi-demia， constipation， smoking history， and alcohol consumption are independent risk factors for the differentiation of syndrome types.

ObjectiveTo study the pharmacological substances and mechanisms through which sesquiterpene ZH-13 from Aquilariae Lignum Resinatum improves neuroinflammation. MethodsBV-2 microglial cells were stimulated with lipopolysaccharide （LPS） to induce neuroinflammation. The cells were divided into the normal group， the model group， and the ZH-13 low- and high-dose treatment groups （10， 20 μmol·L^-1）. The model group was treated with 1 μmol·L^-1 LPS. Cell viability was assessed using the cell proliferation and activity assay （CCK-8 kit）. Nitric oxide （NO） release in the cell supernatant was measured using a nitric oxide kit （Griess method）. The mRNA expression levels of interleukin-1β （IL-1β）， tumor necrosis factor-α （TNF-α）， inducible nitric oxide synthase （iNOS）， and interleukin-6 （IL-6） were detected by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. The phosphorylation of mitogen-activated protein kinase （MAPK） pathway proteins was assessed by Western blot. ResultsCompared with the model group， ZH-13 dose-dependently reduced NO release from BV-2 cells under LPS stimulation （P<0.05， P<0.01）. In the 20 μmol·L^-1 ZH-13 treatment group， the mRNA expression levels of IL-1β， TNF-α， iNOS， and IL-6 were significantly reduced compared to the model group （P<0.05， P<0.01）. In both the low- and high-dose ZH-13 groups， the expression of the inflammatory factor TNF-α and the phosphorylation of c-Jun N-terminal kinase （JNK） in the upstream MAPK pathway were significantly reduced （P<0.05）. After stimulation with the JNK agonist anisomycin （Ani）， both low- and high-dose ZH-13 treatment groups showed reduced phosphorylation of JNK proteins compared to the Ani-treated group （P<0.01）. ConclusionThe sesquiterpene compound ZH-13 from Aquilariae Lignum Resinatum significantly ameliorates LPS-induced neuroinflammatory responses in BV-2 cells by inhibiting excessive JNK phosphorylation and reducing TNF-α expression. These findings elucidate the pharmacological substances and mechanisms underlying the sedative and calming effects of Aquilariae Lignum Resinatum.

Objective To investigate and analyze the construction and management status of drug clinical trial institu-tions in Jiangxi Province,and to provide a reference for institutions' standardized management and development.Methods The registered drug clinical trial institutions in Jiangxi Province were selected as the research objects in the"Drug and Medical De-vice Clinical Trial Institution Filing Management Information System",and the public data were retrieved.Questionnaires were sent to the registered medical institutions as"Questionnaire Star"to collect the questionnaire data.The data on the construction and management of drug clinical trial institutions were analyzed descriptively from multiple dimensions.Results By December 2023,52 drug clinical trial institutions and one vaccine clinical trial institution had been registered in Jiangxi Province.The organ-ization and management structure,personnel composition,hardware,and software of the registration institutions met the basic re-quirements for conducting drug clinical trials.In recent years,the number of drug clinical trial record institutions and the number of projects to undertake has increased year by year,and the management ability and comprehensive strength of clinical trial institu-tions have been continuously enhanced,and there is still a big gap compared with the developed areas of the pharmaceutical in-dustry.Conclusion There is unbalanced regional development,uneven ability of different institutions to undertake projects,a low level of clinical trial information management,and the comprehensive ability of clinical trials needs to be improved in Jiangxi Province.

The neonatal Fc receptor(FcRn)prolongs the half-life of immunoglobulin G(IgG)and promotes its recycling by binding to and making it an important receptor for maintaining serum IgG homeostasis.However,the abnormal accumulation of pathogenic IgG is closely related to the occurrence of various neuroimmune diseases.FcRn antagonists can significantly reduce the level of pathogenic IgG by blocking the binding of FcRn to IgG,thereby effectively alleviating the clinical symptoms of related diseases.As an emerging targeted therapeutic drug,FcRn antagonists have shown their potential in treating IgG-mediated neuroimmune diseases.This article summarizes the mechanism of action,types and clinical research progress of FcRn antagonists with the aim of providing new ideas for the precise treatment of IgG-mediated neuroimmune diseases.Future research should focus on the long-term safety of drugs,expansion of indications and individualized treatment strategies to further enhance their clinical application value.

Objective To investigate the establishment and evaluation of an idiopathic pulmonary fibrosis(IPF)mouse model induced by the intratracheal infusion of bleomycin(BLM)of different concentrations.Methods Male C57BL/6J mice were randomly divided into a control group,Model-L group(1.5 mg/kg,BLM),Model-M group(2.5 mg/kg,BLM),and Model-H group(3.5 mg/kg,BLM).An IPF mouse model was constructed by one-time intratracheal infusion of BLM.The general status,body mass,survival rate,and lung coefficient of mice in different groups were compared.Pathological changes in lung tissue,the hydroxyproline content,fibrosis markers and inflammatory factor levels were observed.Results Compared with the control group,the survival rate decreased and body weight showed a downward trend in the low-,medium-,and high-dose model groups,with significant increases in lung coefficients.Inflammatory infiltration(P＜0.01)and collagen deposition(P＜0.0001)were observed in the lung tissues of all model groups.Hydroxyproline levels in lung tissue and serum were significantly elevated(P＜0.05).The mRNA levels of fibrosis markers α-Sma,Fn1,and Col1a1 were upregulated(P＜0.001),with significant increases in corresponding protein expression(P＜0.05).The mRNA expression of the inflammatory factor Tgfb1 also increased(P＜0.0001).Conclusion 1.5,2.5 and 3.5 mg/kg BLM can induce an IPF model in C57BL/6J mice.Based on the results observed for survival rate,body mass,lung coefficient changes,lung tissue gross and pathological changes,and fibrosis-related biomarkers,2.5 mg/kg BLM is the optimal concentration for inducing an IPF mouse model.

N7-methylguanosine(m7G)modification occurs at the 5'cap of mRNA in eukaryotes,and is also found at specific sites on tRNA and rRNA,showing wide conservation across various biological organisms.Aberrant m7G modification is involved in the dysregulation of gene expression and serves as a biomarker for multiple cancers,with significant potential for applications in tumor diagnosis and therapy.This review summarizes the biological functions and regulatory mechanisms of m7G modification,and outlines its potential clinical applications.It also highlights the oncogenic roles of aberrant m7G modification and its association with prognosis,providing a detailed discussion of the role and molecular mechanisms of abnormal m7G modification in regulating drug resistance in various cancers.

Objective:To investigate the diagnostic efficacy of artificial intelligence(AI)software combined with contrast-enhanced ultrasound(CEUS)on portal hypertension of cirrhosis.Methods:A retrospective analysis was conducted on 106 patients with cirrhosis who admitted to Handan Communicable Disease Hospital from January 2024 to June 2024 and were confirmed by surgical pathology.In them,60 cases with positive portal hypertension were included in positive group,and 46 cases with negative portal hypertension were included in negative group.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic values of ultrasound characteristics via preoperative AI quantization,enhanced ultrasound mode and the combination of them for portal hypertension of cirrhosis.Results:The mean peak intensity,mean vessel density and branching morphology index of AI software were respectively 201.23±10.18,0.62±0.11 and 1.23±0.24 in diagnosing portal hypertension of positive group,all of which were significantly higher than those of negative group(t=8.551,3.707,2.054,P<0.05).However,the mean peak reaching time,uniformity of flow perfusion,mean flow velocity and uniformity of microcirculation perfusion of the positive group were respectively(18.22±2.18)seconds,(75.22±5.46)%,(10.09±2.22)cm/s,(80.78±5.11)%,all of which were significantly lower than those in the negative group(t=3.729,5.237,4.969,4.491,P<0.05).The enhancement speed and degree of liver parenchyma,the enhancement speed of portal vein,and the enhancement speed and degree of spleen in CEUS of positive group were significantly higher than those of negative group,and the differences were significant(t=4.770,12.781,7.313,5.501,4.645,7.513,P<0.05).ROC curve analysis showed that the area under curve(AUC)value of CEUS combined with AI algorithm was 0.926 in diagnosis,which was significantly better than single CEUS and single AI analysis(0.853,0.925).Conclusion:CEUS technique combines with AI software can show higher diagnostic efficacy in the diagnosis for portal hypertension of cirrhosis,which diagnostic effect was better than single either of two methods.

Objective To investigate the protective effect of Linggui Zhugan Decoction on myocardial injury in diabetic rats;To explore its molecular mechanism.Methods The diabetes myocardial injury rat model was established by intraperitoneal high fat diet combined with injection of streptozotocin.Successfully modeled rats were randomly divided into model group,simvastatin group(5 mg/kg)and Linggui Zhugan Decoction low-and high-dosage group(3.75,7.5 g/kg).Normal rats were set as blank group,and each medication group was intervened with corresponding drugs.Fasting and random blood glucose were monitored using a glucometer,the left ventricular ejection fraction(LVEF)was measured,serum contents of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),superoxide dismutase(SOD)and malondialdehyde(MDA)were detected by biochemical kits,the contents of cardiac troponin I(cTnI)and creatine kinase-MB(CK-MB)were detected by ELISA,the myocardial morphology and fibrosis were observed by HE and Masson staining,the positive expression of PDCD4 was detected by immunohistochemistry,the mRNA expressions of miR-21,PDCD4,PTEN and p53 were detected by RT-qPCR,and the protein expressions of PDCD4,PTEN and p53 were detected by Western blot.Results Compared with the blank group,fasting blood glucose and random blood glucose significantly increased at different time points in the model group(P<0.05,P<0.01),LVEF significantly decreased(P<0.01),the contents of serum TC,TG,LDL-C,HDL-C,MDA,cTnI,CK-MB significantly increased(P<0.05,P<0.01),and the content of SOD significantly decreased(P<0.01);the inflammatory cells infiltration and fibrosis injury in myocardial tissue were significantly aggravated(P<0.01),the expression of miR-21 in myocardial tissue significantly decreased,and the mRNA and protein expressions of PDCD4,PTEN,p53 significantly increased(P<0.05,P<0.01).Compared with the model group,fasting blood glucose significantly decreased in simvastatin group and Linggui Zhugan Decoction high-dosage group(P<0.05),LVEF significantly increased(P<0.01),the contents of serum TC,TG,LDL-C,HDL-C,MDA,cTnI and CK-MB significantly decreased(P<0.05,P<0.01),the content of SOD significantly increased(P<0.05,P<0.01);the inflammatory cells infiltration and fibrosis injury in myocardial tissue were significantly improved(P<0.01),the expression of miR-21 in myocardial tissue significantly increased,and the mRNA and protein expressions of PDCD4,PTEN,p53 significantly decreased(P<0.05,P<0.01).Conclusion Linggui Zhugan Decoction may inhibit the expressions of PDCD4,PTEN and p53 by increasing miR-21,thereby alleviating myocardial injury in diabetic rats.

Objective:To analyze the epidemiological characteristics of the population receiving assisted reproductive technology (ART) therapy and the health status of their offspring in Shanghai from 2011 to 2020.Methods:Based on the birth cohort of the entire population in Shanghai, the proportion and trend changes of ART offspring in the birth cohort were analyzed. The characteristics of ART and naturally conceived populations, including household registration, education level, maternal age, and reproductive history, were examined. Additionally, the health status between ART offspring and naturally conceived offspring were compared.Results:From 2011 to 2020, a total of 70 729 ART offspring were born in Shanghai, accounting for 3.69% of the total births. In 2020, this proportion reached 7.79%. The ART conception rate for primiparous women was higher than that for multiparous women, with both showing upward trends and reaching 9.87% and 2.36%, respectively, in 2020. The ART conception rate was higher in women with higher education levels and local household registration than in those with lower education levels and non-local household registration. The incidence rates of preterm birth and low birth weight in ART singleton offspring were 7.76% and 4.82%, respectively, higher than the 4.69% and 2.87% in naturally conceived offspring, but no increasing trend was observed in naturally conceived offspring. Among twin and multiple newborns, the incidence rates of preterm birth and low birth weight were 56.98% and 46.82% for ART, lower than the 58.51% and 51.32% for natural conception.Conclusions:The difference in social and demographic characteristics was obvious in population receiving ART, suggesting that the differed demand of some people for ART therapy, and it is necessary to strengthen the construction of public health services and further expand the coverage and accessibility of ART services. With technological advancements, the rates of preterm birth and low birth weight remain relatively stable, and even decrease in twin and multiple newborns.

Objective:To investigate the acute effects of persistent high exposure to atmospheric fine particulate matter (PM 2.5) on residents' outpatient visits for respiratory diseases. Methods:We collected daily outpatient records from 92 hospitals in 13 cities across the Beijing-Tianjin-Hebei region, along with daily PM 2.5, nitrogen dioxide (NO 2), and meteorological data from 2013 to 2018. Five persistent high PM 2.5 exposure scenarios were defined in terms of daily mean PM 2.5 concentrations (>75 μg/m 3 and >150 μg/m 3), duration (≥2 days and ≥3 days), and whether or not there was concurrent exposure to high levels of NO 2 (daily mean NO 2 concentration >50 μg/m 3). A two-stage statistical analysis strategy based on a generalized linear model was applied to conduct a time-series analysis to assess the exposure-response relationship between persistent high PM 2.5 exposure scenarios and residents' outpatient visits for a variety of respiratory diseases, and to estimate excess outpatient visits. Results:During the period, M ( Q1, Q3) PM 2.5 and NO 2 concentrations were 61.2 (42.3, 95.1) μg/m 3 and 40.2 (31.4, 54.4) μg/m 3, respectively, and the daily respiratory disease outpatient visits were 57 (52, 66) cases. When compared with non-permanent high PM 2.5 exposure periods, exposure scenarios with PM 2.5 >75 μg/m 3 and lasting for ≥2 days caused an increased risk of outpatient visits for respiratory diseases by 2.10% (95% CI: 1.44%-2.77%), and resulted in 43 787 (95% CI: 30 025-57 757) excess visits; in this scenario, the concurrent exposure to high levels of NO 2 had a greater acute effect on respiratory disease visits than the absence of exposure to high levels of NO 2 ( P<0.001). The risk of respiratory disease visits increased substantially by 4.41% (95% CI: 3.15%-5.68%) when the daily mean PM 2.5 concentration exceeded 150 μg/m 3 for ≥2 days. Subgroup disease analyses showed that scenarios with daily mean PM 2.5 concentrations exceeding 75 μg/m 3 for ≥3 days caused a significant increase in the risk of lower respiratory tract infections, chronic lower respiratory disease, and asthma visits. Conclusions:Sustained persistent high PM 2.5 exposure increases the risk of outpatient visits for various respiratory diseases; concurrent exposure to high concentrations of NO 2 leads to a greater risk of visiting the clinic, suggesting that the prevention and control of PM 2.5 pollution should be synchronized with the control of mobile source emissions, to synergistically manage the compound pollution of PM 2.5 and NO 2 in the atmosphere.