OBJECTIVE To systematically evaluate the quality of the Heat-clearing and symptom-relieving formula and screen potential marker components that influence the quality of the formula. METHODS The contents of 11 components （calycosin-7- O - β -D-glucoside， ononin， hyperoside， isoquercitrin， baicalin， baicalein， cryptotanshinone， tanshinone Ⅱ A ， tanshinone Ⅰ， senkyunolide A， ferulic acid） in the Heat-clearing and symptom-relieving formula were determined by high-performance liquid chromatography-tandem mass spectrometry （HPLC-MS/MS）. Using the contents of the aforementioned components as variables， cluster analysis （CA）， principal component analysis （PCA）， and orthogonal partial least squares-discriminant analysis （OPLS-DA） were conducted using OriginPro 2024 software and SIMCA 14.1 software； marker components affecting the quality of the Heat-clearing and symptom-relieving formula were then screened based on the criteria of variable importance in the projection （VIP） value＞1 and P ＜0.05. The comprehensive evaluation of 20 batches of samples was carried out using the entropy weight-technique for order preference by similarity to ideal solution（TOPSIS） and grey correlation analysis （GCA） methods. RESULTS The contents of the above 11 components were 7.993-72.866， 4.542-31.228， 727.666-1 901.884， 496.846-1 293.279， 1 995.501-6 779.150， 54.500-241.280， 150.302-304.339， 79.698-189.206， 257.118-682.418， 5.498-21.687， 7.524-26.935 μg/g. CA， PCA and OPLS-DA results showed that 20 batches of samples were grouped into 2 categories. Q1， Q3， Q4， Q7-Q9， Q12， Q15， Q16 were grouped into one category， and the rest were grouped into another category； VIP values of ferulic acid， tanshinone Ⅱ A ， baicalin， cryptotanshinone， calycosin-7- O - β -D-glucoside and ononin were all greater than 1 （ P ＜0.05）. Both the entropy weight-TOPSIS and GCA methods showed that the samples ranked in the top 11 according to the euclidean distance and relative correlation degree were Q2， Q5， Q6， Q10， Q11， Q13， Q14， Q17-Q20. CONCLUSIONS The established HPLC-MS/MS method is rapid， accurate and highly sens itive. Combined with chemical pattern recognition analysis， entropy weight-TOPSIS and GCA methods， this method can be used to evaluate the quality of the Heat-clearing and symptom-relieving formula. Ferulic acid， tanshinone Ⅱ A ， baicalin， cryptotanshinone， calycosin-7- O - β -D-glucoside and ononin may be the marker components that affect the quality of this formula. The overall quality of 11 batches of the Heat-clearing and symptom-relieving formula， including Q17， is relatively superior.

Objective To understand the status of body image disturbance and its influencing factors in patients with ankylosing spondylitis (AS), so as to provide a scientific basis for the clinical management of AS. Methods A total of 353 AS patients admitted from January 2022 to December 2024 were selected as research subjects. Chinese version of Body Image Disturbance Questionnaire (BIDQ) was used to investigate the body image disturbance in AS patients. Single factor analysis was performed by t test and analysis of variance, and multiple factors were analyzed by multivariate linear regression. Results The total score of BIDQ in 342 AS patients was (25.01±4.22). Multivariate linear regression analysis results showed that self-paid medical expense, nighttime VAS score and negative emotion PANAS score could positively predict body image disturbance in AS patients (standardized regression coefficient=0.413, 0.413, 0.460, P<0.05), and PSSS score, positive emotion PANAS score and exercise management CDSSM score could negatively predict body image disturbance (standardized regression coefficient=-0.245, -0.134, -0.247, P<0.05). Conclusion The body image disturbance in AS patients is worthy of clinical attention. Nighttime pain, negative emotion and self-paid medical treatment can increase the risk of body image disturbance. Positive emotion, social support and high self-management level of exercise behavior can reduce the formation of body image disturbance, which can provide new ideas for clinical management of AS patients.

Objective To estimate the lifetime attributable risk (LAR) of thyroid cancer due to radiation in individuals undergoing chest computed tomography (CT) examinations. Methods Scanning parameters were retrospectively collected from DICOM files of 660 individuals who underwent chest CT scans between 2022 and 2024. Individuals were stratified by age and sex. Size-specific dose estimates were calculated using a formula based on the volume CT dose index for each individual. The radiation doses received by the thyroid were estimated. The cancer risk prediction model from the US National Academy of Sciences report on the Biological Effects of Ionizing Radiation was referenced to predict the LAR of thyroid cancer. Results The LAR of thyroid cancer for males/females was 25.170/100 000 and 140.177/100 000 in the ≥ 0 and<5 years of age group, 21.779/100 000 and 102.498/100 000 in the ≥5 and <10 years of age group, 22.987/100 000 and 128.934/100 000 in the ≥10 and <15 years of age group, and 4.979/100 000 and 12.490/100 000 in the ≥15 years of age group. A Spearman correlation analysis showed that age was highly correlated with volume CT dose index, size-specific dose estimates, radiation dose received by the thyroid, and thyroid cancer LAR, with correlation coefficients of 0.887, 0.737, 0.737, and −0.41 (P<0.01), respectively. Sex was correlated with radiation dose received by the thyroid and thyroid cancer LAR, with correlation coefficients of 0.179 and 0.441 (P<0.01), respectively. Conclusion Chest CT scan leads to an increased LAR of thyroid cancer. Appropriate protective measures for the thyroid should be considered during chest CT scan to reduce the impact of radiation on the thyroid.

ObjectiveTo investigate the effects of hand-arm bimanual intensive training （HABIT） based on the FITT-CORRECT principles on upper limb function and functional independence in children with spastic hemiplegic cerebral palsy. MethodsA total of 87 children with spastic hemiplegia were enrolled and randomly divided into an observation group （n=44）， which received HABIT based on the FITT-CORRECT principles， and a control group （n=43）， which received conventional HABIT. Both groups received intervention for 6 weeks. The quality of upper extremity skills test （QUEST）， peabody developmental motor scales-fine motor （PDMS-FM）， and the functional independence measure for children （WeeFIM） were administered before and after treatment. The root mean square （RMS） values of the biceps and triceps brachii during maximum isometric contraction of elbow flexion and extension on the affected side were also measured. ResultsBefore treatment， there were no significant differences between the two groups in QUEST， PDMS-FM， WeeFIM scores， or RMS values of the biceps and triceps during maximum isometric contraction of the affected elbow （P>0.05）. After 6 weeks of treatment， no significant change was observed in the RMS values of the triceps during elbow flexion in either group （P>0.05）. All other outcome measures improved significantly in both groups （P<0.05）. The observation group showed significantly greater improvements in dissociated movement and grasp scores of QUEST， grasp and visual-motor integration scores of PDMS-FM， WeeFIM scores， as well as RMS values of the biceps during elbow flexion and both the biceps and triceps during elbow extension on the affected side （P<0.05）. ConclusionCompared with conventional HABIT， HABIT based on the FITT-CORRECT principles is more effective in improving upper limb function and functional independence in children with spastic hemiplegia.

AIM To prepare the borneol-menthol eutectic mixture-loaded nanoemulsion gel of tetramethylpyrazine.METHODS The equilibrium solubilities of tetramethylpyrazine in different oil phases,emulsifiers and co-emulsifiers were determined,after which compatibility experiment was performed,and pseudo-ternary phase diagram was drawn.With Km value,oil phase proportion and water phase consumption as influencing factors,particle size,PDI and saturated drug loading as evaluation indices,the formulation was optimized by central composite design-response surface method.The drug-loaded nanoemulsion was dispersed into carbomer 940 gel matrix to prepare nanoemulsion gel,then the physicochemical properties,in vitro drug release and transdermal absorption properties were investigated.RESULTS The optimal formulation was determined to be 3.31∶6.16∶1.56∶88.97 for eutectic mixture-EL-40-1,2-propylene glycol-water ratio,the particle size,PDI and saturated drug loading were 37.85 nm,23.04 and 5.82 mg/g,respectively.The obtained white,semi-solid nanoemulsion gel demonstrated the average pH value and viscosity of 6.68±0.07 and(289.69±1.06)mPa·s,respectively,whose in vitro drug release accorded with Higuchi equation,and the accumulative permeability per unit area was(2 048.23±55.6)μg/cm2 within 24 h,which were 3.72 and 1.21 times higher than those of hydrogel and aqueous solution,respectively.CONCLUSION The borneol-menthol eutectic mixture-loaded nanoemulsion gel of tetramethylpyrazine meets preparation requirements,thus can achieve the effective transdermal delivery of raw medicine.

An electrochemical sensor based on a chitosan-carbon nanotube(CS-CNT)composite-modified glassy carbon electrode(GCE)was developed in this work for highly sensitive detection of sunset yellow(SY)in food.The CS-CNT composite dispersion was prepared via an ultrasonic dispersion method.Combined with quantum chemical calculations,the adsorption mechanism of SY molecules onto the electrode surface,facilitated by π-π conjugation and electrostatic interactions,was elucidated.The optimized experimental conditions were determined as follows:12 μL of CS-CNT dispersion modification volume,accumulation time of 300 s,and a phosphate buffer solution at pH 7.0 as supporting electrolyte solution.Experimental results demonstrated that CS significantly enhanced the dispersion of CNT,increasing the effective surface area of the modified electrode by 2.22 times(reaching 0.1587 cm2)compared to the bare GCE.The sensor exhibited a linear detection range of 3.0×10-7 mol/L to 1.0×10-5 mol/L,with a detection limit(S/N=3)of 5.0×10-10 mol/L.Satisfactory spiked recoveries ranging from 96.9%to 101.1%were achieved,along with good preparation reproducibility(relative standard deviation,RSD=4.96%).Interference tests indicated high selectivity of the sensor against citric acid,glucose,and common metal ions.The reliability of the sensor was validated through the detection of SY in actual beverage samples.This electrode design simplified operational procedures,avoiding cross-contamination between measurements,and provided an efficient solution for the on-site monitoring of food additives.

OBJECTIVE: To investigate the association of various polycyclic aromatic hydrocarbon (PAH) metabolites with diverse subtypes of cardiovascular disease (CVD) risk. METHODS: A novel predicting risk of cardiovascular disease EVENTs PREVENT equation was used to estimate the 10-year diverse subtypes of CVD risk, and their associations with PAH metabolites were analyzed using multiple logistic regression models, the weighted quantile sum (WQS) model, the quantile g-computation (qgcomp) model, and a stratified analysis of subgroups. RESULTS: For this study, six thousand seven hundred and forty-five participants were selected, and significant positive associations were observed between PAHs, naphthalene (NAP), and fluorene (FLU), and the risks of total CVD, atherosclerotic cardiovascular disease (ASCVD), and heart failure (HF). NAP and FLU were the primary contributors to the effects of PAH mixtures, and their associations with total CVD, ASCVD, and HF risk were significant in younger participants (30 ≤ age < 50 years); however, the associations of phenanthrene (PHEN) with ASCVD, HF, coronary heart disease (CHD), and stroke were dominant in aging participants (age ≥ 50 years). Notably, pyrene (PYR) was negatively associated with the risk of ASCVD, HF, CHD, and stroke. Similarly, negative associations of PYR with the four CVD subtypes were noticeable in aging participants. CONCLUSION Different PAHs metabolites had different impacts on each CVD subtype among different age groups. Notably, the protective effects of PYR on ASCVD, HF, CHD, and stroke were noticeable in aging individuals.
Humans ; Cardiovascular Diseases/chemically induced* ; Middle Aged ; Polycyclic Aromatic Hydrocarbons/metabolism* ; Male ; Female ; Adult ; Aged ; Risk Factors ; China/epidemiology*

Background and Aims:Laparoscopic pancreaticoduodenectomy(LPD)has become a preferred approach for periampullary tumors,yet delayed gastric emptying(DGE)remains a frequent complication that hampers postoperative recovery.The nasojejunal feeding tube(NJT)is commonly used for early enteral nutrition,but its impact on DGE is controversial.This study aimed to evaluate whether intraoperative NJT placement increases the risk of DGE after LPD and to assess its influence on postoperative recovery outcomes.Methods:A retrospective cohort of 319 patients who underwent LPD at Provincial Hospital Affiliated to Shandong First Medical University from April 2017 to November 2023 was analyzed.Patients were divided into two groups based on intraoperative NJT placement(NJT group,n=200;non-NJT group,n=119).The incidence of DGE and postoperative outcomes were compared.Multivariate logistic regression and propensity score matching(PSM)were performed to identify independent risk factors for DGE.Results:The incidence of grade B/C DGE was significantly higher in the NJT group than in the non-NJT group(36.5%vs.21.8%,P=0.006).NJT placement was associated with longer postoperative hospital stay and higher hospitalization costs(both P<0.05).Multivariate analysis revealed intraoperative NJT placement(OR=1.960,95%CI=1.142-3.363,P=0.015)and intraoperative blood loss>400 mL(OR=1.921,95%CI=1.155-3.194,P=0.012)as independent risk factors for DGE.These findings were consistent after PSM.Conclusions:Prophylactic intraoperative NJT placement confers no additional benefit for postoperative recovery after LPD and is associated with a higher risk of DGE,prolonged hospitalization,and increased medical costs.Routine NJT placement should therefore be avoided,and individualized strategies should be adopted to minimize postoperative complications and enhance recovery.

Objectives:To explore the feasibility of zero-ray radiofrequency catheter ablation for paroxymal atrial fibrillation under the guidance of transthoracic echocardiography combined with three-dimensional mapping system.Methods:This is a single-center prospective observational study.A total of 12 patients with paroxysmal atrial fibrillation who underwent radiofrequency catheter ablation in Fuwai Hospital,Chinese Academy of Medical Sciences from June 1,2024 to September 30,2024 were included.All patients underwent successful percutaneous puncture,atrial septal puncture under the guidance of transthoracic echocardiography,and all patients underwent left atrial modeling and discharge ablation under the guidance of transthoracic echocardiography combined with three-dimensional mapping system.The disappearance of pulmonary vein potential was confirmed after the ablation operation and as the ablation endpoint and successful ablation marker.The operation results and 1-month and 3-month follow-up results of the patients were observed.Results:There were 12 patients with paroxysmal atrial fibrillation,9 males and 3 females,aged(56.8±11.2)years,with a history of paroxysmal atrial fibrillation(4.2±2.3)years.The mean left atrial diameter was(36.5±2.5)mm,the left ventricular end-diastolic diameter was(47.8±4.1)mm,and the left ventricular ejection fraction was 55%-65%.The mean overall operation time was(102.25±14.51)min,the ultrasound operation time was(29.58±6.23)min,and the catheter operation time was(33.08±4.10)min.All patients completed circumferential pulmonary vein isolation without intraoperative complications.The hospitalization time was 2-6 days.At the 1-month follow-up after ablation,all patients showed sinus rhythm on 24-hour ambulatory electrocardiogram,and 2 patients had occasional atrial premature contractions without recurrence of atrial fibrillation.At the 3-month follow-up,two patients had occasional premature atrial contractions,and no recurrence of atrial fibrillation was recorded on the electrocardiogram of all patients.Conclusions:It is feasible to complete radiofrequency catheter ablation of paroxysmal atrial fibrillation under the guidance of transthoracic echocardiography combined with three-dimensional mapping system.

Autoimmune diseases of the nervous system are a category of conditions in which a malfunction of the body's immune system leads to damage of nerve tissues, with B cells playing a critical role in their pathogenesis. Currently, the therapeutic approaches used in clinical practice (such as monoclonal antibodies targeting B cells) can effectively control the progression of these diseases, but fail to achieve a radical cure. Chimeric antigen receptor (CAR)-T cell therapy uses genetic engineering to modify T cells derived from either patients or donors, enabling them to specifically target and durably eliminate peripheral B cells, which might remit or even functionally cure these diseases. Currently, multiple clinical studies on efficacy and safety of CAR-T cell therapy in neurological autoimmune diseases have been carried out successively, and initial results have been achieved. This article reviews the clinical research progress in this field, discusses its application prospects and challenges, aiming to provide some references for in-depth research in this area.