As one of the core pathogenesis during treatment with traditional Chinese medicine，liver heat runs through different stages of liver disease. The interpretation of its meaning in different medicine categories（traditional Chinese medicine，Tibetan medicine，Mongolian medicine，Uygur medicine，Dai medicine，Yao medicine，etc.） is not unified， and the phenomena of the same name with different meanings，confusion， and misappropriation emerge. This seriously restricts the inheritance，innovation， and clinical application of traditional Chinese medicine and ethnomedicine. By tracing and analyzing liver heat， it is found that liver heat in traditional Chinese medicine is caused by disordered rest and diet， as well as internal injury due to emotional disorder， which leads to liver dysfunction， Qi stagnation， and heat turning to fire in the liver meridian. The liver heat in Tibetan medicine is caused by the accumulated heat of the liver nature and the evil heat in the liver， which stimulates the toxin of Chiba fever. The liver heat in Mongolian medicine derives from the abnormal diet and rest， making excessive Sheila accumulate in the liver and causing disease. The above etiologies are all related to diet， rest，exogenous evil，emotion，and so on， and the pathogenesis is related to the imbalance of Qi and the metabolic disorder of organs. The clinical symptoms are pain in the liver region，yellow eyes， bitter mouth， fever，digestion，and loss of appetite. The principle of treatment and compatibility of prescription are heat-based， with auxiliary detoxification. Other ethnomedicine， such as Uygur medicine， Dai medicine， Yao Medicine，Miao medicine， and She medicine do not have a clear discussion on liver heat，and their etiology， pathogenesis， treatment，and prescription are not systematic，mostly based on a single drug or proven prescriptions.Through the systematic tracing，mining，induction，analysis， and arrangement of the liver heat based on existing literature information database in China，this paper regarded syndrome as the outline and disease as the goal，clarified the similarities and differences of the pathogenesis of liver heat in traditional Chinese medicine，and determined the relationship between liver heat and liver disease and the status quo of syndrome and treatment.This review provides evidence and reference for clinical prevention and treatment，as well as drug development for liver disease.

Objective To explore the optimization strategy of Qishen Granules in treating coronary heart disease with heart failure(CHD-HF)based on data mining and the pathogenic"toxin"theory,and to predict its active components and mechanisms using network pharmacology.Methods Literature on traditional Chinese medicine(TCM)for treating CHD-HF was collected from relevant databases,and prescriptions were screened and established into a database according to inclusion and exclusion criteria.Frequency,association rules,and hierarchical clustering analyses were performed using the Ancient and Modern Medical Case Cloud Platform.Network pharmacology techniques were applied to screen potential targets of the optimized combination for treating CHD-HF,and carry out the targets and pathways enrichment analysis.Results A total of 336 articles and 339 prescriptions involving 191 herbs were included,with 12 herbs used more than 100 times.The core drug combinations for treating CHD-HF included Astragali Radix,Poria,Salviae Miltiorrhizae Radix et Rhizoma,Glycyrrhizae Radix et Rhizoma,Chuanxiong Rhizoma,etc,while commonly used detoxifying herbs included Leonuri Herb,Coptidis Rhizoma,etc.Association rule analysis yielded 10 two-item associations and 17 three-item associations;clustering analysis grouped the data into 5 categories.Based on data mining and the pathogenic"toxin"theory,the combination for treating CHD-HF was optimized to include Astragali Radix,Salviae Miltiorrhizae Radix et Rhizoma,Aconiti Lateralis Radix Praeparata,Glycyrrhizae Radix et Rhizoma,Coptidis Rhizoma,and Taraxaci Herba.Network pharmacology analysis identified 366 common targets between the optimized combination and CHD-HF,with 16 core targets screened out.Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis revealed significant enrichment in pathways such as cancer pathways,lipid and atherosclerosis,Rap1 signaling pathway,hypoxia-inducible factor 1(HIF-1)signaling pathway,phosphatidylinositol-3-kinase/protein kinase B(PI3K/Akt)signaling pathway,Ras signaling pathway,and mitogen-activated protein kinase(MAPK)signaling pathway.Conclusion TCM treatment for CHD-HF primarily focuses on replenishing qi and warming yang,activating blood circulation and resolving fluid retention.Based on data mining results and the pathogenic"toxin"theory,the formulation strategy of Qishen Granules for treating CHD-HF was optimized,potentially exerting therapeutic effects through anti-inflammatory,anti-apoptotic,and anti-hypoxia physiological processes.

Mitochondrial diabetes mellitus(MDM)is a genetically heterogeneous disorder caused by mitochondrial DNA(mtDNA)or nuclear DNA mutations,characterized by multi-system involvement and diverse clinical phenotypes.We report a pediatric case presenting with growth retardation followed by subsequent development of diabetes mellitus.Systematic evaluation revealed concurrent bilateral sensorineural hearing loss,bilateral basal ganglia calcification,and electroencephalographic abnormalities.A post-exercise lactate test demonstrated significant elevation of serum lactate levels immediately after physical exertion.Genetic analysis identified a large-scale mitochondrial DNA deletion spanning from m.8649 to m.16084.This case re-port is complemented by a literature review focusing on the pathogenesis,genetic characteristics,and therapeu-tic approaches of mitochondrial diabetes,with particular emphasis on mitochondrial disorders exhibiting large-scale mtDNA deletions alongside diabetic manifestations.Our comprehensive analysis aims to enhance clinical understanding and inform diagnostic strategies for this complex disease entity.

Objective:To analyze the epidemiological and clinical characteristics of leptospirosis in Wenzhou City, and to provide a scientific basis for formulating prevention and control strategies of leptospirosis in Wenzhou City.Methods:Information on leptospirosis case from 2019 to 2023 was collected from the China Information System for Disease Control and Prevention. Descriptive epidemiological methods were used to analyze the three-dimensional distribution and clinical manifestations of leptospirosis.Results:From 2019 to 2023, the annual average incidence rate of leptospirosis in Wenzhou City was 0.43/100 000, and the annual average mortality was 0.01/100 000. The incidence rate was the highest in 2021 (0.74/100 000), and there was a statistically significant difference in the incidence rate over the five years ( χ2 = 35.48, P < 0.001). Cases were reported in all regions in Wenzhou City except for Dongtou District and Longgang City, with Yongjia County had the highest number of cases (114 cases). The impact rate of streets/townships was 35.14% (65/185), among them Yongjia County had the highest impact rate of steets/townships (86.36%, 19/22). The onset season was from August to October (88.83%, 159/179), with a male to female ratio of 4.97 ∶ 1.00 (149/30). The age group of 61 - 70 years old was the most affected (39.66%, 71/179), and farmers were the main occupation (70.95%, 127/179). Twenty-six point eighty-two per cent (48/179) of the cases had a clear history of animal contact within one month before onset, and 68.16% (122/179) had a history of contact with contaminated water. The main clinical type was influenza-typhoid type (23.46%, 42/179), with the main clinical manifestations being fever (84.92%, 152/179), chills (55.87%, 100/179), and fatigue (62.57%, 112/179). Twelve point twenty-nine per cent 12.29% (22/179), 8.38% (15/179), and 22.91% (41/179) of cases showed conjunctival congestion, lymph node enlargement, and gastrocnemius muscle tenderness, respectively. Clinical outcomes showed that 73.74% (132/179) of the cases recovered or improved, and 3 cases died. Conclusions:From 2019 to 2023, the overall prevalence of leptospirosis in Wenzhou City is at a low level, but there are deaths that need to be taken seriously. In order to control the disease, continuous monitoring should be carried out, health education for relevant populations should be strengthened, and the risk of leptospirosis should be reduced.

Objective:To analyze the epidemiological and clinical characteristics of leptospirosis in Wenzhou City, and to provide a scientific basis for formulating prevention and control strategies of leptospirosis in Wenzhou City.Methods:Information on leptospirosis case from 2019 to 2023 was collected from the China Information System for Disease Control and Prevention. Descriptive epidemiological methods were used to analyze the three-dimensional distribution and clinical manifestations of leptospirosis.Results:From 2019 to 2023, the annual average incidence rate of leptospirosis in Wenzhou City was 0.43/100 000, and the annual average mortality was 0.01/100 000. The incidence rate was the highest in 2021 (0.74/100 000), and there was a statistically significant difference in the incidence rate over the five years ( χ2 = 35.48, P < 0.001). Cases were reported in all regions in Wenzhou City except for Dongtou District and Longgang City, with Yongjia County had the highest number of cases (114 cases). The impact rate of streets/townships was 35.14% (65/185), among them Yongjia County had the highest impact rate of steets/townships (86.36%, 19/22). The onset season was from August to October (88.83%, 159/179), with a male to female ratio of 4.97 ∶ 1.00 (149/30). The age group of 61 - 70 years old was the most affected (39.66%, 71/179), and farmers were the main occupation (70.95%, 127/179). Twenty-six point eighty-two per cent (48/179) of the cases had a clear history of animal contact within one month before onset, and 68.16% (122/179) had a history of contact with contaminated water. The main clinical type was influenza-typhoid type (23.46%, 42/179), with the main clinical manifestations being fever (84.92%, 152/179), chills (55.87%, 100/179), and fatigue (62.57%, 112/179). Twelve point twenty-nine per cent 12.29% (22/179), 8.38% (15/179), and 22.91% (41/179) of cases showed conjunctival congestion, lymph node enlargement, and gastrocnemius muscle tenderness, respectively. Clinical outcomes showed that 73.74% (132/179) of the cases recovered or improved, and 3 cases died. Conclusions:From 2019 to 2023, the overall prevalence of leptospirosis in Wenzhou City is at a low level, but there are deaths that need to be taken seriously. In order to control the disease, continuous monitoring should be carried out, health education for relevant populations should be strengthened, and the risk of leptospirosis should be reduced.

Mitochondrial diabetes mellitus (MDM) is a genetically heterogeneous disorder caused by mitochondrial DNA (mtDNA) or nuclear DNA mutations, characterized by multi-system involvement and diverse clinical phenotypes. We report a pediatric case presenting with growth retardation followed by subsequent development of diabetes mellitus. Systematic evaluation revealed concurrent bilateral sensorineural hearing loss, bilateral basal ganglia calcification, and electroencephalographic abnormalities. A post-exercise lactate test demonstrated significant elevation of serum lactate levels immediately after physical exertion. Genetic analysis identified a large-scale mitochondrial DNA deletion spanning from m.8649 to m.16084. This case report is complemented by a literature review focusing on the pathogenesis, genetic characteristics, and therapeutic approaches of mitochondrial diabetes, with particular emphasis on mitochondrial disorders exhibiting large-scale mtDNA deletions alongside diabetic manifestations. Our comprehensive analysis aims to enhance clinical understanding and inform diagnostic strategies for this complex disease entity.

Objective To screen out the biomarkers linked to prognosis of breast invasive carcinoma based on the analysis of transcriptome data by random forest(RF),extreme gradient boosting(XGBoost),light gradient boosting machine(LightGBM),and categorical boosting(CatBoost).Methods We obtained the ex-pression data of breast invasive carcinoma from The Cancer Genome Atlas and employed DESeq2,t-test,and Cox univariate analysis to identify the differentially expressed protein-coding genes associated with survival prog-nosis in human breast invasive carcinoma samples.Furthermore,RF,XGBoost,LightGBM,and CatBoost mod-els were established to mine the protein-coding gene markers related to the prognosis of breast invasive cancer and the model performance was compared.The expression data of breast cancer from the Gene Expression Omnibus was used for validation.Results A total of 151 differentially expressed protein-coding genes related to survival prog-nosis were screened out.The machine learning model established with C3orf80,UGP2,and SPC25 demonstrated the best performance.Conclusions Three protein-coding genes(UGP2,C3orf80,and SPC25)were screened out to identify breast invasive carcinoma.This study provides a new direction for the treatment and diagnosis of breast invasive carcinoma.

Malignant insulinoma is a kind of rare and challenging neuroendocrine tumor. It is often accompanied by distant metastasis, among which liver metastasis is most common, and the prognosis is often non-promising. In this paper, we report a case of multiple liver metastases from malignant insulinoma. The patient, a 70-year-old male, was admitted to the hospital due to "episodic consciousness disorder for more than four months." Blood glucose monitoring revealed recurrent hypoglycemia in the early morning, after meals, and at night. Pancreatic perfusion CT and dynamic enhanced MRI of the liver revealed a mass in the uncinate process of the pancreatic head and multiple liver metastases. Percutaneous liver biopsy confirmed the diagnosis of insulinoma. After multidisciplinary discussions, hepatic artery embolization and radiofrequency ablation were performed in stages, in combination with everolimus treatment. Thereafter, the enhanced CT demonstrated that some liver metastases shrank. The patient had regular meals, and the blood sugar gradually increased and remained normal thereafter. This article discusses this case's clinical characteristics and multidisciplinary collaborative diagnosis and treatment, aiming to provide experience for the comprehensive clinical diagnosis and treatment of malignant insulinoma patients.

Objective:To collect and analyze the evaluation index of infertility treated by Traditional Chinese Medicine (TCM), which will lay a foundation for the establishment of the core index and evaluation index system of TCM treating infertility.Methods:By retriving the published literatures of randomized controlled trials of infertility treated by TCM in the database of CNKI, VIP, Wanfang, SinoMed, PubMed and Cochrane Library from January 1, 2011 to December 31, 2020, and after the screening according to the creteria of inclusion and exclusion, this paper analyzed the normal indexes of infertility and the pathogenic indexes of TCM.Results:A total of 95 RCTs were included, including 9 069 patients aged between 20-39 years old. The average sample size of each RCT study was 95, involving 78 evaluation criteria. The highest frequency of use was the total effective rate, etiological-index analysis found that the general indicators of infertility such as the total effective rate, pregnancy rate, TCM syndrome scores,and common etiological factors such as LH, FSH are the characteristic indicators.Conclusion:There are many problems in the evaluation indexes of clinical trials of treating infertility by TCM, such as great differences in number and not standardized usage. It is necessary to carry out research on the construction of core indicator and evaluation indicator systems of infertility according to different etiologies.