VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is an adult-onset, X-linked clonal autoinflammatory disease caused by somatic mutations in the UBA1 gene, characterized by systemic inflammation accompanied by hematologic clonal abnormalities. Somatic UBA1 mutations result in impaired ubiquitination, disruption of protein homeostasis, and sustained activation of inflammatory signaling pathways, including nuclear factor-κB and Janus kinase-signal transducer and activator of transcription (JAK-STAT), which together constitute the core pathogenic mechanism. The disease involves multiple systems and tissues including the hematologic system, skin, cartilage and respiratory system, showing remarkable clinical heterogeneity. Diagnosis depends primarily on the combination of characteristic clinical manifestations and molecular confirmation of UBA1 mutations. Current therapeutic strategies lack a unified standard: glucocorticoids can rapidly control inflammation but are associated with high relapse rates, whereas targeted therapies such as JAK inhibitors, interleukin inhibitors, and hypomethylating agents show variable efficacy, and allogeneic hematopoietic stem cell transplantation offers curative potential in patients with concomitant myelodysplastic syndrome. This review systematically summarizes the genetic background, molecular mechanisms, clinical spectrum, diagnostic criteria, and therapeutic advances of VEXAS syndrome.

Objective To investigate the exposure-response relationships and lag effects between air pollutants (PM_2.5, PM₁₀, O₃, and NO₂) and mortality in Jiading District, Shanghai, and to provide a scientific basis for the formulation of environmental health policies. Methods Using an individual-level time-stratified case-crossover design, conditional logistic regression models in conjunction with a distributed lag nonlinear model (DLNM) were employed to analyze the exposure-response relationship and temporal lag patterns of ambient air pollution on resident mortality in Jiading District (1994–2024). Results A total of 59 048 death cases were collected, including 18,701 deaths from cardiovascular diseases and 11 731 deaths from respiratory diseases. PM_2.5 and NO₂ had a significant impact on all-cause mortality, cardiovascular disease mortality, and respiratory disease mortality, with the most significant effects observed within a lag of 0–3 days. PM₁₀ also had some impact on these three types of mortality, but its effect was generally weaker than that of PM_2.5 and NO₂. The exposure-response curves showed that the risk of death increased rapidly with increasing concentrations of PM_2.5 and PM₁₀, while the effect of NO₂ plateaued at higher levels. No significant differences were found across age or gender subgroups. Conclusion Short-term exposure to PM_2.5, PM₁₀, and NO₂ significantly increases all-cause mortality risk in Jiading District, with effects persisting up to 7 days, highlighting the need for enhanced air pollution control measures, particularly targeting fine particulate matter.

To explore the clinical features, systematic diagnostic process, and iron chelation therapy strategies of secondary iron overload in aceruloplasminemia (ACP).

Colorectal cancer （CRC）， as a highly prevalent malignant tumor worldwide， continues to rank among the leading malignancies in both incidence and mortality. At present， the clinical treatment of CRC mainly relies on surgery， radiotherapy， chemotherapy， and drug therapy. However， due to individual differences among patients and the emergence of drug resistance in cancer cells， the postoperative recurrence rate remains high， significantly affecting patient prognosis. In recent years， traditional Chinese medicine （TCM） has attracted extensive attention in the field of tumor prevention and treatment because of its therapeutic advantages of multi-component， multi-target， multi-pathway， and holistic regulation. Aberrant activation of the Hedgehog signaling pathway is closely associated with the occurrence of various cancers. Studies have shown that the Hedgehog signaling pathway plays a key regulatory role in the occurrence and development of CRC. This pathway regulates the expression of downstream target genes through glioma-associated oncogene homolog （GLI） transcription factors and participates in biological processes such as tumor cell proliferation， apoptosis， invasion， and metastasis. It exerts anti- CRC effects through mechanisms including inducing apoptosis of CRC cells， inhibiting cancer cell proliferation， reversing drug resistance， and suppressing epithelial-mesenchymal transition （EMT）， thereby influencing the progression of CRC. This article systematically reviews the latest research progress in China and abroad and comprehensively discusses the molecular regulatory mechanisms of the Hedgehog signaling pathway in CRC. It particularly focuses on the specific mechanisms by which active components of Chinese medicine， such as alkaloids and terpenoids， and Chinese medicine compound formulas， such as Baitouwengtang and Zhizhenfang， exert anti-CRC effects by interfering with the Hedgehog-GLI signaling axis. By integrating and analyzing the molecular relationship between the Hedgehog signaling pathway and the pathological progression of CRC， and combining the TCM theories of "holistic concept" and "syndrome differentiation and treatment"， this article explores new TCM therapeutic strategies based on the Hedgehog signaling pathway， with the aim of providing innovative theoretical foundations and practical guidance for the prevention and treatment of CRC with TCM.

Salvia miltiorrhiza (Danshen) is a traditional Chinese herb that is commonly known for its cardiovascular and hepatoprotective benefits. Recent studies have confirmed that Danshen and its bioactive components can influence gut microbial homeostasis, thereby affecting Helicobacter pylori (HP) colonization in the human stomach. HP is a bacterial pathogen associated with various gastrointestinal diseases. Current HP treatments mainly involve antibiotics and proton pump inhibitors. However, their efficacy is strongly compromised by the rapid emergence of antibiotic resistance in HP and genetic heterogeneity among patients. The interaction between Danshen and gut microbial status provides a novel perspective for HP treatment. Understanding the medical properties of Danshen in altering gut microbiota and eliminating HP, as well as the underlying mechanisms, is important for improving human gastrointestinal healthcare. This review investigates the interaction between Danshen and gut microbiota and its impact on HP infection using databases including Web of Science, PubMed, and Google Scholar. We explored the unconventional intersection between Danshen, gut microbiota, and HP infection, shedding light on their intricate interplay and potential therapeutic implications. A comprehensive understanding of this interaction provides valuable insights into developing novel therapeutic strategies that target the gut microbiota to mitigate HP-associated gastrointestinal disorders. Please cite this article as: Li SJ, Miao JX, Wang F, Wang HY, Ma YW, Jiang Y, Xue X. Salvia miltiorrhiza components and gut microbiota interactions in Helicobacter pylori infection. J Integr Med. 2025; 23(5):462-470.
Salvia miltiorrhiza/chemistry* ; Gastrointestinal Microbiome/drug effects* ; Humans ; Helicobacter Infections/microbiology* ; Helicobacter pylori/drug effects* ; Drugs, Chinese Herbal/therapeutic use*

Objective To analyze the external radiation dose rate and radiation protection measures during treatment of a patient with hepatocellular carcinoma (HCC) who underwent ⁹⁰Y selective internal radiotherapy (⁹⁰Y-SIRT). Methods A male HCC patient who received ⁹⁰Y-SIRT with an activity of 4.65×10⁹ Bq was selected as the research subject using retrospective analysis. External radiation dose rate meters were used to detect ambient dose equivalent rates around the radiation worker, the HCC patient, and the workplace during treatment. Surface contamination meters were used to detect surface contamination levels of the radiation worker and the workplace. Results The ambient dose equivalent rate around the interventional radiology staff during treatment ranged from 3.7 to 39.0 μSv/h. The patient's ambient dose equivalent rate of surgical site at distances of 30, 100, and 200 cm ranged from 45.0 to 5.6, 4.4 to 0.4, and 0.4 to 0.1 μSv/h respectively without protection, and 14.0 to 3.4, 3.2 to 0.3, and 0.4 to 0.1 μSv/h respectively when the surgical site was covered with a 1.0 mmPb lead rubber drape after 0.0 to 161.0 hours of the surgery. In the nuclear medicine department, ambient dose equivalent rate of the workplace ranged from 0.4 to 740.0 μSv/h. The ambient dose equivalent rate around all monitoring points in the digital subtraction angiography operating room accounted at 0.1 μSv/h, and the observation ward ranged from 0.1 to 0.2 μSv/h. The β surface contamination levels of the radiation worker and workplace were below the minimum detection limit (0.16 Bq/cm²). Conclusion Radiation doses for both HCC patients and radiation worker remained within acceptable limits when appropriate protective equipment was used. A well-designed workplace layout is essential to ensure effective implementation of radiation protection.

Objective:The prediction model of postoperative recurrence of ovarian endometriosis cyst(OEM)was constructed to provide a reference for evaluating postoperative recurrence of OEM patients.Methods:The clinical,pathological and follow-up data of 342 patients who underwent the initial laparoscopic ovarian cystectomy for OEM at The Second Hospital of Hebei Medical University from January 1,2017 to October 31,2021 were retro-spectively analyzed.Based on univariate and multivariate Cox regression analysis,the relevant factors affecting OEM recurrence were identified.According to the results of multivariate analysis,a nomogram was drawn.The C index and receiver operating characteristic(ROC)curve were used to test the efficiency of the prediction model.Results:The 2-year recurrence rate of OEM patients was 20.4%and the 5-year recurrence rate was 35.2%.Uni-variate and multivariate Cox regression analysis showed that menstrual cycle(HR 0.916,95%CI 0.860-0.976,P=0.006),delivery≥1(HR 0.376,95%CI 0.171-0.827,P=0.015),CA125≥100 U/ml(HR 1.790,95%CI 1.167-2.746,P=0.008),total cyst diameter≥10 cm(HR 2.254,95%CI 1.318-3.854,P=0.003),and postoperative medications(HR 0.434,95%CI 0.292-0.644,P=0.000)were associated with OEM recurrence and were included in the no-mogram prediction model.The C-index of the nomogram prediction model was 0.710(95%CI 0.665-0.754),and the area under the curve(AUC)of the ROC for OEM patients with recurrence at 2 years after surgery was 0.786 and 0.708 at 5 years.Conclusions:In this study,we developed a nomogram to predict the probability of recur-rence at 2 years and 5 years for OEM patients under 45 years who underwent conservative surgery,which has i-deal predictive performance and helps clinicians to screen high-risk patients,and thus give high-risk OEM patients additional attention and intervention.

Objective To develop a rapid and accurate ultra-performance liquid chromatography tandem mass spectrometry(UPLC-MS/MS)method for the detection of etomidate,metomidate,propoxate,and isopropoxate in human hair.Methods Hair samples containing etomidate,metomidate,propoxate,and isopropoxate were extracted with methanol containing the internal standard orthoxine,filtered with a 0.22 μm organic filter membrane and detected vio UPLC-MS/MS.All components were separated by using a gradient elution procedure consisting of 0.01％formic acid(1 mmol/L ammonium acetate)and acetonitrile.Positive electrospray ionization was performed using multiple reaction monitoring(MRM)mode.Results The linear relationships of etomidate,metomidate,propoxate,and isopropoxate were good in the range of 0.01～1 ng/mg(r ≥ 0.997 9),with recovery rates ranging from 87.9％to 101.5％.The accuracy was between 80.0％and 110.0％.The intra-day and inter-day relative standard deviations(RSD)were 2.9％～9.6％and 3.6％～19.9％.Conclusion This method is easy to operate and has high recovery efficiencies.It is sufficiently simple and sensitive to be applied to detect etomidate,metomidate,propoxate,and isopropoxate in hair.

Objective To explore the variable pressure matress and thermoplastic mold applied to cone beam CT-guided radiotherapy of abdominal and pelvic cancer in terms of translation error,rotation angle error and setup reproducibility of patients with different body mass indexes(BMIs),so as to provide references for the selection of body fixation mode.Methods Totally 70 patients with abdominal and pelvic tumors admitted to some hospital from April 2021 to March 2022 were retrospectively selected,and divided into a variable pressure mattress group and a thermoplastic mold group according to the fixation method,with 35 patients in each group.All the patients in the two groups underwent examinations with cone beam computed tomography(CBCT)at the first radiotherapy treatment and during the course of the treatment,and the image registration was carried out between validation images and planning images.The two groups were compared in terms of rotation angle error and thranlation error at the directoins of x axis(lateral directions),y axis(cranial-caudal)and z axis(ventral-dorsal).Taking the center point image of the initial positioning as the reference,the errors of the center points of the two groups at z and y axes(Δz and Δy)were compared.The setup reproducibility was set as Δz≤5 mm and Δy≤3 mm,and the setup reproducibility rates of the two groups were summarized.All the patients were categorized into non-overweight ones(BMI<25 kg/m2)and overweight ones(BMI≥25 kg/m2),and the setup reproducibility rates of the patients with different BMIs were counted.SPSS 26.0 software was used for statistical analysis.Results The two groups had no significant differences in translation error at the directions of x and y axes(P>0.05).The variable pressure mattress group had the translation error at the direction of z axis statistically lower than that of the thermoplastic mold group(P<0.05).There were no significant differences between the two groups in rotation angle error(P=0.219 3).The two groups had significant differences in setup reproducibility(P=0.033 4).The non-overweight patients had the setup reproducibility rate being 40.00%in the variable pressure mattress group,and 77.14%in the thermoplastic mold group;the overweight patients had the setup reproducibility rate being 25.71%in the variable pressure mattress group and only 2.86%in the thermoplastic mold group,with the differences between the two groups being statistically significant(P=0.002 9).Conclusion The variable pressure mattress and thermoplastic mold both result in low setup errors when applied to fixation during the radiotherapy of abdominal and pelvic cancer,the thermoplastic mold fixation can be used for the patients with BMIs lower than 25 kg/m2 with decreased translation errors at the direction of z axis,and the variable pressure mattress fixation was suitable for the patients with BMIs not lower than 25 kg/m2.[Chinese Medical Equipment Journal,2025,46(7):45-50]

OBJECTIVE: To explore the clinical phenotype and genetic characteristics of a Chinese Han pedigree with Darier's disease (DD). METHODS: A DD pedigree, who visited Tongji Hospital of Tongji University on October 22, 2023, was selected as the study subject. Clinical data of the pedigree were collected, and whole exome sequencing was performed on the proband. Suspected variant loci were screened, and Sanger sequencing was used to validate the variant in pedigree members. Bioinformatics analysis was performed on the variant loci. This study was approved by the Medical Ethics Committee of Tongji Hospital of Tongji University Ethics No.K-W-2024-004). RESULTS: The proband is a 67-year-old female with clinical features of DD, such as keratotic papules in sebaceous areas. whole exome sequencing revealed a missense variant, c.68G>A (p.Gly23Glu), in the exon 1 of ATP2A2 gene of the proband. Sanger sequencing showed that the proband's eldest daughter also carried this variant. This variant was not detected in other pedigree members, indicating a co-segregation of the variant with the disease phenotype in the pedigree. According to the interpretation principles of gene variants by the American College of Medical Genetics and Genomics (ACMG), this variant was classified as pathogenic (PS1+PM1+PM2_Supporting+PP1+PP3+PP4). CONCLUSION The c.68G>A (p.Gly23Glu) variant in the ATP2A2 gene may be the genetic cause of the disease in this pedigree. This finding further enriches the genetic variant spectrum in DD patients and provides a basis for clinical diagnosis and genetic counseling for patients.
Aged ; Female ; Humans ; Male ; China ; Darier Disease/genetics* ; Exome Sequencing ; Mutation, Missense ; Pedigree ; Phenotype ; East Asian People ; Sarcoplasmic Reticulum Calcium-Transporting ATPases