ObjectiveThis paper aims to observe the syndrome improvement and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome）. MethodsThrough a multi-center randomized controlled methodology design，confirmed influenza cases were collected from October 2022 to April 2023 in the pediatrics department of eight hospitals，such as Dongfang Hospital of Beijing University of Chinese Medicine. A total of 180 children with influenza and heat accumulation in the lung and stomach syndrome conforming to the standard were recruited through the clinic. The sick children meeting the inclusion criteria were randomly divided into groups by a block-randomized method. The children in the experimental group were treated with Qingxuan Daozhi formula for five days，and those in the control group were treated with Oseltamivir Phosphate Granules for five days. The primary efficacy indicator was the negative conversion rate of influenza antigen detection. Secondary efficacy indicators were the Canadian acute respiratory illness and flu scale （CARIFS） and the incidence of complications，severe cases， and critical cases. Follow-up observation was conducted on the day of enrollment，48 hours after medication，72 hours after medication， and （6+1） d after medication. ResultsOne hundred and eighty participants were randomly assigned to the experimental group （90 cases） or the control group （90 cases）. All participants were followed up during the study. Comparison of influenza antigen detection results in the primary efficacy indicators showed that the average time of negative influenza antigen conversion in the experimental group was （5.29±1.25） d，and that in the control group was （5.40±1.68） d，without a statistically significant difference. After five days of intervention，52 cases in the experimental group and 51 cases in the control group converted to negative，without a statistically significant difference. CARIFS score results in the secondary efficacy indicators showed that during 72 hours after intervention，there were statistically significant differences between the experimental group and the control group in three dimensions， including headache，muscle soreness， and the need for extra care （P<0.05）. On the （6+1） days after the intervention，the differences in both the experimental group and the control group were statistically significant in 10 dimensions， including sore throat，bad sleep，uncomfortable feeling，poor spirit and fatigue，crying more than usual，the need for extra care，symptom，function，influence on parents，and total score （P<0.05）. The comparison results within the group in the dimensional scores of symptom， function， and influence on parents，as well as the CARIFS total score showed that with the delay of follow-up time，scores of both groups decreased significantly，with a statistically significant difference （P<0.01）. Inter-group comparison results showed that the mean score of the experimental group was higher than that of the control group at the time of enrollment. With the progress of intervention，the score of the experimental group was significantly decreased compared with that of the control group. At the end of follow-up，the mean score of the experimental group was lower than that of the control group，with no statistically significant difference. In terms of the incidence of complications，severe cases， and critical cases， there were no complications，severe cases， and critical cases in the two groups，without a statistically significant difference. ConclusionThe symptom improvement effect and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome） are not inferior to Oseltamivir Phosphate granules， and children's acceptance is better. It can be more widely used in clinical treatment of influenza in children （heat accumulation in the lung and stomach syndrome）.

As a new manner of cell death,cuproptosis depends on the accumulation of copper ions in cells.Copper ion is an essential trace element in normal physiological state of organisms.The excess of free copper in cells not only has toxic effect on normal cells,but also plays its specific killing function on tumor cells.Copper transporter 1(CTR1)is a key transporter of transmembrane uptake of copper ions by cells.As a regulator of cuproptosis,its mutation and expression changes in tumors have an impact on the distribution of copper ions inside and outside the cells.It may participate in multiple biological processes such as proliferation,invasion and migration of tumor cells by regulating the pathway of cuproptosis.This article reviews the cuproptosis pathway mediated by CTR1 and the potential value of CTR1 in tumor treatment,elaborates the importance of copper ion homeostasis regulation for normal life activities and the mechanism of CTR1 in regulating cuproptosis,and discusses the potential value of CTR1 as a new target for tumor therapy,so as to provide a theoretical basis for the treatment of tumor patients.

Objective To investigate the protective effects of Wuling capsule on mice with autoimmune hepatitis(AIH).Methods Mice were randomly divided into control group,AIH model group,Wuling capsule low-dose group(0.5 g·kg-1·d-1),Wuling capsule middle-dose group(1.0 g·kg-1·d-1),and Wuling capsule high-dose group(2.0 g·kg-1·d-1),with 10 mice in each group.The Wuling capsule groups were administered with Wuling capsule suspension of different doses orally at a volume of 10 mL/kg once daily;the control group and AIH model group were given the same volume of saline by gavage.After 14 d of administration,mice in the AIH model group and Wuling capsule groups were injected with concanavalin A(20 mg/kg)via the tail vein,and the serum,liver,and spleen were collected 8 h after injection.Serum alanine transaminase(ALT)and aspartate transaminase(AST)levels were measured using an automatic biochemical analyzer;hematoxylin-eosin staining was used to observe the pathological structure of the liver tissue;the contents of interleukin(IL)-6,IL-4,and tumor necrosis factor(TNF)-α in liver were determined by enzyme-linked immunosorbent assay,and quantitative polymerase chain reaction was used to determine the relative mRNA expression levels of IL-6,IL-4,TNF-α,Toll-like receptor 4(TLR4),and nuclear factor κB(NF-κB)in the liver.Fluorescence immunoassay was used to analyze the expression and nuclear translocation of NF-κB p65 protein in the liver.Results Compared with the control group,the AIH model group showed abnormal liver morphology and structure,increased serum ALT and AST levels,increased contents of IL-4,IL-6,and TNF-α in the liver,upregulated mRNA expression levels of IL-6,IL-4,TNF-α,TLR4,and NF-κB in the liver,and increased nuclear entry of NF-κB p65.Wuling capsule significantly improved the pathological structure of the liver in AIH mice,reduced serum ALT and AST levels,decreased the contents of IL-4,IL-6,and TNF-α in the liver and the mRNA expression levels of TLR4,NF-κB,IL-4,IL-6,and inhibited the nuclear activation of NF-κB p65.Conclusion Wuling capsule has significant protective effects on AIH mice,which may be related to the TLR4/NF-κB signaling pathway.

Objective To investigate the genetic characteristics of the VP1 region of Coxsackievirus A10 (CVA10) in Yunnan Province. Methods Fecal samples of suspected hand, foot and mouth disease (HFMD) were subjected to real-time fluorescent quantitative PCR for detection of enterovirus CVA10. Positive samples were subjected to VP1 gene sequence amplification and Sanger sequencing. Sequence splicing was performed with DNAstar7.1 Seqman software, and nucleotide sequence and amino acid site analysis were performed using Mega 6.0 software. Results The sequencing of VP1 gene of CVA10 obtained a sequence of 894 nucleotides, encoding 298 amino acids. Compared with the original strain, there were mainly three active amino acid mutation regions, 13-33, 141-142, and 283-285. The nucleotide difference rate between the Yunnan isolates and the reference strain ranged from 16.92% to 30.90%, and the amino acid difference rate ranged from 2.58% to 4.00%. C1 and C2 group nucleotide difference was 10.58%, and the amino acid difference rate was 1.80%. The VP1 150-176 region exhibited highly conserved characteristics. Six CVA10 strains and Sichuan strain MW178898 belonged to the C1 group of the C genotype. The other 14 CVA10 strains belonged to the C2 group. Conclusion VP1 gene mutation is active and CVA10 is an important pathogen of HFMD in Yunnan. C2 genotype of CVA10 is dominant in this study, and C1 and C2 have co-circulated in Yunnan. It is necessary to strengthen monitoring and develop multivalent vaccines containing CVA10 epidemic genotype.

Purpose To evaluate the value of multimodality MRI-based nomogram model for predicting peritumoral brain tissue invasion in atypical meningioma.Materials and Methods A total of 187 patients with pathologically diagnosed atypical meningioma in the First Affiliated Hospital Fujian Medical University from January 2018 to January 2023 were retrospectively enrolled,including 130 cases of peritumoral brain tissue invasion and 57 cases of none peritumoral brain tissue invasion.Clinical data and multimodality MRI features,including age,gender,tumor location,maximum diameter,peritumoral oedema,tumor-brain interface,lobulated sign,dural tail sign,cyst degeneration/necrosis,relative minimum apparent diffusion coefficient(rADCmin)and intratumoral susceptibility signal were analyzed.Univariate and multivariate Logistic regression analysis were performed to screen the independent predictors of peritumoral brain tissue invasion in atypical meningioma,then a multimodality MRI prediction model was constructed,and was visualized as a nomogram.The prediction performance of multimodality MRI-based nomogram model and each independent predictor were assessed using receiver operating characteristic curve.Results The maximum diameter(OR=0.705,95%CI 0.539-0.920,P=0.010),peritumoral oedema(OR=1.333,95%CI 1.095-1.624,P=0.004),tumor-brain interface(OR=5.121,95%CI 2.045-12.806,P＜0.001)and rADCmin(OR=0.126,95%CI 0.033-0.483,P=0.002)were independent predictors of peritumoral brain tissue invasion in atypical meningioma.The area under the curve,sensitivity and specificity of the multimodality MRI-based nomogram model for predicting peritumoral brain tissue invasion in atypical meningioma was 0.80(95%CI 0.73-0.88),87.69%and 66.67%,respectively.The multimodality MRI-based nomogram model showed significantly higher area under the curve than that of the maximum diameter,peritumoral oedema,tumor-brain interface and rADCmin of atypical meningioma(all Z=3.665,3.904,4.359,3.701,P＜0.05).Conclusion The multimodality MRI-based nomogram model may be helpful for the prediction of peritumoral brain tissue invasion in atypical meningioma.

Objective:To explore the occurrence and clinical characteristics of nephrogenic systemic fibrosis (NSF) induced by gadolinium-based contrast agents (GBCA).Methods:CNKI, Wanfang, VIP and PubMed databases were searched (as of October 28, 2024) and case reports on GBCA-related NSF were collected; the following information was extracted, including the publication year of the literature, country, patient gender, age, basic kidney diseases and renal replacement therapy, variety of GBCA used, exposure frequency, time of occurrence or diagnosis of NSF, clinical manifestations, pathological examination, main intervention measures and outcomes. The data were analyzed by descriptive statistics.Results:A total of 45 case reports were collected, involving 97 patients. The literature were reported mainly from the United States and published mainly in 2006 and 2007. Number of the relevant literature decreased significantly after 2008, but there were still new cases reports in China in the following years (for example, in 2023). Among the 97 patients, 53 (54.6%) were male and 44 (45.4%) were female; the age ranged from 9 to 83 years with a median age of 53 years. One patient was with severe malnutrition, while the other 96 had severe basic kidney diseases, including chronic kidney disease in 85 (88.5%) patients and acute kidney injury in 11 (11.5%) patients. Variety of GBCA exposed was described in 76 patients, including gadodiamide in 67 (88.2%) patients. Exposure frequency of GBCA before NSF occurrence was described in 88 patients, 48 (54.5%) of which were exposed only once and 23 (26.1%) were exposed twice. Time from the first GBCA exposure to the occurrence of NSF was described in 92 patients, with the shortest time of 2 days and the longest time of more than 10 years; 70.7% (65/92) occurred within 3 months after GBCA exposure. All patients had typical skin symptoms of NSF, which were confirmed by pathological examination. Among them, 43 (44.3%) had joint disorders, 9 patients had eye involvement, a few patients had cardiac fibrosis, respiratory failure, metabolic acidosis, rhabdomyolysis, muscle necrosis, etc. Follow-up information was described in 82 patients with a range of 4 months to 11 years. Among them, 21 patients (25.6%) died, mainly due to the basic kidney diseases and complications; 11 (13.4%) were severely disabled; 7 (8.5%) were mildly disabled or slowly deteriorated; 43 (52.4%) had stable disease or slightly improved condition.Conclusion:NSF caused by GBCA mainly occurs in patients with severe basic renal diseases, mostly caused by gadodiamide. Severe skin damage is often accompanied by joint involvement or even disability, and the overall prognosis is poor.

Objective:To explore the occurrence and clinical characteristics of nephrogenic systemic fibrosis (NSF) induced by gadolinium-based contrast agents (GBCA).Methods:CNKI, Wanfang, VIP and PubMed databases were searched (as of October 28, 2024) and case reports on GBCA-related NSF were collected; the following information was extracted, including the publication year of the literature, country, patient gender, age, basic kidney diseases and renal replacement therapy, variety of GBCA used, exposure frequency, time of occurrence or diagnosis of NSF, clinical manifestations, pathological examination, main intervention measures and outcomes. The data were analyzed by descriptive statistics.Results:A total of 45 case reports were collected, involving 97 patients. The literature were reported mainly from the United States and published mainly in 2006 and 2007. Number of the relevant literature decreased significantly after 2008, but there were still new cases reports in China in the following years (for example, in 2023). Among the 97 patients, 53 (54.6%) were male and 44 (45.4%) were female; the age ranged from 9 to 83 years with a median age of 53 years. One patient was with severe malnutrition, while the other 96 had severe basic kidney diseases, including chronic kidney disease in 85 (88.5%) patients and acute kidney injury in 11 (11.5%) patients. Variety of GBCA exposed was described in 76 patients, including gadodiamide in 67 (88.2%) patients. Exposure frequency of GBCA before NSF occurrence was described in 88 patients, 48 (54.5%) of which were exposed only once and 23 (26.1%) were exposed twice. Time from the first GBCA exposure to the occurrence of NSF was described in 92 patients, with the shortest time of 2 days and the longest time of more than 10 years; 70.7% (65/92) occurred within 3 months after GBCA exposure. All patients had typical skin symptoms of NSF, which were confirmed by pathological examination. Among them, 43 (44.3%) had joint disorders, 9 patients had eye involvement, a few patients had cardiac fibrosis, respiratory failure, metabolic acidosis, rhabdomyolysis, muscle necrosis, etc. Follow-up information was described in 82 patients with a range of 4 months to 11 years. Among them, 21 patients (25.6%) died, mainly due to the basic kidney diseases and complications; 11 (13.4%) were severely disabled; 7 (8.5%) were mildly disabled or slowly deteriorated; 43 (52.4%) had stable disease or slightly improved condition.Conclusion:NSF caused by GBCA mainly occurs in patients with severe basic renal diseases, mostly caused by gadodiamide. Severe skin damage is often accompanied by joint involvement or even disability, and the overall prognosis is poor.

Purpose To evaluate the value of multimodality MRI-based nomogram model for predicting peritumoral brain tissue invasion in atypical meningioma.Materials and Methods A total of 187 patients with pathologically diagnosed atypical meningioma in the First Affiliated Hospital Fujian Medical University from January 2018 to January 2023 were retrospectively enrolled,including 130 cases of peritumoral brain tissue invasion and 57 cases of none peritumoral brain tissue invasion.Clinical data and multimodality MRI features,including age,gender,tumor location,maximum diameter,peritumoral oedema,tumor-brain interface,lobulated sign,dural tail sign,cyst degeneration/necrosis,relative minimum apparent diffusion coefficient(rADCmin)and intratumoral susceptibility signal were analyzed.Univariate and multivariate Logistic regression analysis were performed to screen the independent predictors of peritumoral brain tissue invasion in atypical meningioma,then a multimodality MRI prediction model was constructed,and was visualized as a nomogram.The prediction performance of multimodality MRI-based nomogram model and each independent predictor were assessed using receiver operating characteristic curve.Results The maximum diameter(OR=0.705,95%CI 0.539-0.920,P=0.010),peritumoral oedema(OR=1.333,95%CI 1.095-1.624,P=0.004),tumor-brain interface(OR=5.121,95%CI 2.045-12.806,P＜0.001)and rADCmin(OR=0.126,95%CI 0.033-0.483,P=0.002)were independent predictors of peritumoral brain tissue invasion in atypical meningioma.The area under the curve,sensitivity and specificity of the multimodality MRI-based nomogram model for predicting peritumoral brain tissue invasion in atypical meningioma was 0.80(95%CI 0.73-0.88),87.69%and 66.67%,respectively.The multimodality MRI-based nomogram model showed significantly higher area under the curve than that of the maximum diameter,peritumoral oedema,tumor-brain interface and rADCmin of atypical meningioma(all Z=3.665,3.904,4.359,3.701,P＜0.05).Conclusion The multimodality MRI-based nomogram model may be helpful for the prediction of peritumoral brain tissue invasion in atypical meningioma.

Objective: To provide high-quality clinical evidence of the efficacy of Tibetan medicine Honghua Ruyi (HHRY) pills for endometriosis-associated dysmenorrhea. Methods: This study constitutes a multicenter, randomized, double-blind, placebo-controlled trial encompassing a three-menstrual cycle intervention followed by a three-menstrual cycle follow-up period. A total of 164 eligible females with endometriosis-associated dysmenorrhea were randomly divided into HHRY pills and placebo groups in a 1:1 ratio. The primary outcome included dysmenorrhea symptoms assessed using Visual Analog Scale (VAS) scores and quality of life, whereas the secondary outcome measures included the maximum VAS for non-menstrual pelvic pain, duration of pain episodes (in days), frequency and quantity of the consumption of ibuprofen sustained-release capsules (or other non-steroidal anti-inflammatory drugs), and days off work/study for staff/student due to dysmenorrhea, ovarian cyst, and/or pelvic nodule size. The safety was monitored throughout the treatment period. All the analyses were based on the intention-to-treat principle. For continuous outcomes, simple or multiple linear regressions were used to estimate the differences between the HHRY pills and placebo groups, with categorical data expressed as the number and percentage of occurrences. Differences were compared using the chi-square test or Fisher's exact test. The predefined analysis was adjusted for concomitant treatment, a variable considered to be associated with outcomes but unaffected by treatment allocation. Estimates of treatment effects were reported with 95% confidence intervals. Two-tailed P values ≤ .05 were considered statistically significant. Conclusion Positive results from this trial, upon completion would provide robust evidence for the efficacy and safety of HHRY pills in treating dysmenorrhea in patients with endometriosis.

Objective:To investigate the safety and efficacy of maribavir for the treatment of CMV viremia and CMV disease refractory or intolerant to conventional antiviral drugs after allogeneic hematopoietic stem cell transplantation (allo-HSCT) .Methods:This study retrospectively analyzed the clinical characteristics and outcomes of CMV viremia and CMV disease refractory or intolerant to conventional antiviral drugs after allo-HSCT treated with maribavir at Hebei Yanda Lu Daopei Hospital from April 2024 to September 2024.Result:A total of 25 patients received maribavir, including 21 haploidentical transplants, two sibling HLA-matched transplants, and 2 HLA-matched unrelated transplants. Among them, 21, 2, and 2 patients received the first, second, and third transplants, respectively. The median time to the onset of CMV viremia and CMV disease was 120.5 (6-298) days post-transplantation. The median peak plasma CMV copy number was 6 400 copies/ml (range: 1 100-650 000 copies/ml). Six patients were diagnosed with CMV disease. Maribavir was administered after a median of 9.5 (1-41) days after CMV infection. The median duration of maribavir administration was 11.5 (6-43) days. Post-treatment, maribavir was effective in 25 (100%) patients. Two patients experienced grade 1 taste abnormalities, and one patient experienced grade 2 myelosuppression.Conclusion:The application of maribavir after allo-HSCT for treating refractory, drug-intolerant CMV viremia and CMV disease is safe and effective.