Da Chaihutang， first recorded in Shanghanlun by Zhang Zhongjing of the Eastern Han dynasty， is composed of eight medicinal herbs， namely Bupleuri Radix， Scutellariae Radix， Rhei Radix et Rhizoma， Aurantii Fructus Immaturus， Paeoniae Radix Alba， Pinelliae Rhizoma， Zingiberis Rhizoma Recens， and Jujubae Fructus. It features a well-defined hierarchy of sovereign， minister， assistant， and courier ingredients. The prescription is characterized by its balanced compatibility， mutually restrained cold and warm properties， and combined use of harmonizing and purging therapeutic strategies. As a renowned classical formula indicated for harmonizing Shaoyang and purging internal heat accumulation， it is the core prescription for the treatment of Shaoyang-Yangming combined disease. A comprehensive review of modern research literature on Da Chaihutang reveals that its chemical composition is notably diverse. The core pharmacologically active material bases of its constituent single herbs have been clearly identified， including saikosaponins from Bupleuri Radix， flavonoids from Scutellariae Radix， anthraquinones from Rhei Radix et Rhizoma， flavonoids and alkaloids from Aurantii Fructus Immaturus， monoterpene glycosides from Paeoniae Radix Alba， alkaloids and organic acids from Pinelliae Rhizoma， gingerols from Zingiberis Rhizoma Recens， and polysaccharides and triterpenoid acids from Jujubae Fructus. In the compound formula， a total of 163 chemical constituents have been comprehensively identified， among which flavonoids and their glycosides constitute the most abundant component category. Flavonoids and their glycosides， monoterpene glycosides， and pentacyclic triterpenoid saponins are regarded as the core pharmacologically active substances of the whole formula. In addition， 9 potential quality markers that can comprehensively characterize the overall quality and core therapeutic efficacy of the whole formula have been screened out. Modern pharmacological studies have shown that the pharmacological effects of Da Chaihutang exhibit synergistic characteristics involving multiple components， multiple targets， and multiple pathways. Its core pharmacological activities encompass the regulation of digestive system disorders， including pancreatic protection， intervention in biliary tract diseases， and protection of gastrointestinal mucosa； intervention in hepatobiliary diseases such as non-alcoholic fatty liver disease and cholestatic liver injury； and regulation of metabolic disorders such as hypoglycemic effect， improvement of insulin resistance， and regulation of lipid metabolism. Furthermore， it also possesses multiple pharmacological activities， including intervention in atherosclerosis， regulation of immune and inflammatory responses， multi-organ protection， and anti-hepatocellular carcinoma effect. In modern clinical practice， Da Chaihutang and its modified formulas are mostly used in combination with conventional Western medical regimens. They have demonstrated notable therapeutic advantages in the treatment of digestive system diseases such as cholecystitis， acute pancreatitis， cholelithiasis， and non-alcoholic fatty liver disease， but also have shown definite curative efficacy in the management of diseases affecting multiple other systems， including cardiovascular， endocrine， dermatological， reproductive， respiratory， neurological， urinary， pediatric， and immune systems. These combined applications can effectively improve the overall clinical response rate， shorten the time to symptom relief， and reduce both the disease recurrence rate and the incidence of adverse reactions. This review systematically summarized the formula compatibility， chemical constituents， pharmacological mechanisms， and modern clinical applications of Da Chaihutang and its modified formulas， to provide a theoretical basis and practical reference for the secondary development of classic formulas， the research and development of new drugs， and the precise and safe clinical application of this classical prescription.

BACKGROUND:Chronic rotator cuff injury is often companied by tendon degeneration and impaired function of tendon-derived stem cells.As am important cytokine,platelet-derived growth factor-DD has a regulatory effect on the proliferation and differentiation of tendon-derived stem cells.OBJECTIVE:To investigate the effect of platelet-derived growth factor-DD on the proliferation and multilineage differentiation of tendon-derived stem cells in human chronic rotator cuff injury.METHODS:Tendon-derived stem cells were isolated from human chronic rotator cuff injury tissue and cultured in vitro.Immunofluorescence staining was used to observe the cytoskeletal morphology of tendon-derived stem cells.Flow cytometry was used to identify the phenotype of tendon-derived stem cells.Tendon-derived stem cells were divided into two groups.The control group did not receive any intervention.The platelet-derived growth factor-DD group was treated with 5 μg/mL platelet-derived growth factor-DD.The effect of platelet-derived growth factor-DD on the proliferation and multilineage differentiation of tendon-derived stem cells was evaluated by cell proliferation assay and three-lineage differentiation assay.RESULTS AND CONCLUSION:(1)The number of EdU-positive cells in the platelet-derived growth factor-DD group was significantly increased compared with the control group(P＜0.05).Tendon-derived stem cells entered the rapid proliferation phase earlier,and the cell growth was logarithmic.(2)The positive areas of Oil Red O staining,Alcian Blue staining,and Alizarin Red staining in the platelet-derived growth factor-DD group were significantly larger than those in the control group(P＜0.05).(3)The above results show that platelet-derived growth factor-DD significantly promotes the proliferation and adipogenic,osteogenic,and chondrogenic differentiation of tendon-derived stem cells.

The purpose of this investigation was to elucidate the clinical characteristics and genetic underpinnings of a pediatric patient with neurodevelopmental disorder with ataxic gait, absent speech, and decreased cortical white matter (NDAGSW, OMIM#617807). The affected individual, a 1-year-9-month-old male, displayed physical development retardation and distinctive facial features, notably periorbital puffiness, upward-gazing palpebral fissures, a shortened philtrum, a tented mouth, and conical-shaped digits. Clinically, the patient presented with profound global developmental retardation, marked language deficits, hypotonia, and an ataxic gait. Subtle, non-diagnostic alterations were identified in cranial magnetic resonance imaging and visual evoked potential assessments. The trio-whole exome sequencing analysis revealed a de novo heterozygous mutation, c.202G>A (p.A68T), within the RAB11B gene, a known pathogenic variant linked to NDAGSW. Neurodevelopmental disorders due to RAB11B gene variants are rare disorders with clinical manifestations of severe mental retardation, aphasia, motor retardation, gait abnormalities with peculiar phenotypical features, structural abnormalities of the brain, and reduced cerebral white matter, cerebellar hypoplasia, and hypoplasia of the corpus callosum as seen on cranial imaging. Based on the characteristics of the disease, the heterozygous missense mutation c.202G>A (p.Ala68Thr) in the RAB11B gene was identified as the genetic etiology of the child.

Objective:To investigate the clinical effectiveness of autologous hamstring tendon reconstruction with preserved synovial sheath combined with remnant suture in the treatment of anterior cruciate ligament (ACL) tears.Methods:A retrospective study was conducted to analyze the clinical data of 38 patients with ACL tear who had been admitted to Department of Sports Medicine, The Fourth Hospital of Wuhan from January 2016 to July 2020. There were 30 males and 8 females, with an age of (25.4±7.2) years. By the typing of MRI Sherman tear locations (MSTL) for anterior cruciate ligament, 7 cases were Type I and 31 cases type II. A total of 18 patients underwent single bundle reconstruction of autologous hamstring tendon combined with remnant suture (group A), and the other 20 patients underwent conventional reconstruction to clean the synovial sheath of ACL (group B). The operation time,Tenger scores, Lysholm scores, International Knee Documentation Committee (IKDC) subjective score and side-to-side differences in relaxation at pre- operation, 1 year and 2 years after operation, as well as ACL healing of the affected knee at 2 years after operation, were observed and compared between the 2 groups. The graft synovial coverage was evaluated by secondary arthroscopy in some cases.Results:There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). All patients were followed up for (38.5±8.4) months. No surgical site infection or knee stiffness occurred in the 2 groups after operation, and 2 patients in each group developed intermuscular venous thrombosis at a lower limb. There was no significant difference in operation time between the 2 groups ( P>0.05). There were significant differences in Tenger score [(6.3±1.6) points versus (4.7±1.7) points], Lysholm score [(93.4±4.2) points versus (85.9±4.3) points] and IKDC subjective score [(89.1±2.9) points versus (81.2±2.9) points] between group A and group B at 1 year after operation ( P<0.05), but there was no significant difference in Tenger score, Lysholm score or IKDC subjective score between the 2 groups at 2 years after operation ( P>0.05). There was no significant difference in side-to-side difference in relaxation between the 2 groups at 1 year or 2 years after operation ( P>0.05). MRI evaluation at 2 years after operation showed no recurrent rupture or no sign of impingement between the graft and the intercondylar fossa in either group. Conventional secondary arthroscopy for 2 patients in group A and 3 patients in group B revealed better synovial coverage in group A. Conclusion:In the treatment of ACL tears of MSTL types I and II, compared with conventional reconstruction to clean the synovial sheath of ACL, autologous hamstring tendon reconstruction with preserved synovial sheath combined with remnant suture can lead to better functional recovery at 1 year after operation, though there is no significant difference in function at 2 years after operation.

Sleep disorders is one of the most frequent and severe complications in patients with tinnitus and is highly correlated with the severity of tinnitus.Sleep disorders and tinnitus influence each other,forming a vicious circle.While in-terventions have been developed to alleviate tinnitus distress,these interventions are usually not effective in improving sleep in patients with tinnitus and sleep disorders.Helping tinnitus patients to resolve sleep disorders is the key to breaking the cycle and improving their quality of life.In this narrative review,we studyed the current state of research on sleep disorders in patients with tinnitus through three aspects:epidemiology,physiological and psychological mechanisms,and existing psychological,physical,and pharmacological interventions,and to provide a basis for further research on the relationship between tinnitus and sleep disorders and the precise treatment of tinnitus.

Objective To observe the effect of preoperative exercise on consciousness,lung function and recovery efficiency of patients undergoing ventriculoperitoneal shunt.Methods A total of 54 patients undergoing elective ventriculoperitoneal shunt in Beijing Bo'ai Hospital from October,2024 to March,2025 were randomly divided into control group(n=27)and prerehabilitation group(n=27).The control group received routine preoperative treatment and nursing,while the prerehabilitation group additionally received exercise for two weeks.They were assessed with Coma Recovery Scale-Revised(CRS-R),and observed diaphragm mobility with sonography,before and three days after operation;and the time to first ambulation after surgery and length of stay in hospital were compared between two groups.Results CRS-R scores improved in both groups after operation(|t|>5.451,P<0.001),and it was greater in the prehabilitation group than in the control group(t=2.812,P<0.01).CRS-R subscale scores improved in auditory and motor functions in the control group(|Z|>2.000,P<0.05),and they were improved in auditory,visual,motor,verbal and arousal functions in the prehabilitation group(|Z|>2.282,P<0.01).CRS-R subscale scores were greater in motor and arousal in the prehabilitation group than in the control group(|Z|>2.320,P<0.05).Diaphragmatic mobility improved in the prehabilitation group(t=-7.782,P<0.001),and it was better than in the control group(t=2.044,P<0.05).The time to first ambulation after surgery and length of stay in hospital were shorter in the prehabilitation group than in the control group(|t|>3.654,P<0.01).Conclusion Preoperative exercise for patients undergoing elective ventriculoperitoneal shunt can improve the consciousness after operation,especially the level of motor and arousal,as well as the lung function,and accelerate the recovery process.

OBJECTIVE To explore comprehensive management and potential issues associated with long-term prescriptions medications of psychiatry， in order to provide a reference for the comprehensive management of long-term prescriptions of psychiatry in psychiatric hospitals and other medical institutions’ pharmacies. METHODS Starting from the applicable principles for long-term prescriptions of psychiatry， this study introduced the standardized assessment and precautions before issuing long-term prescriptions， the formulation and adjustment of the drug list， as well as the rational management of the long-term prescriptions. It also analyzed potential issues that may arise in the comprehensive management of long-term prescription medications and proposed corresponding countermeasures and suggestions. RESULTS & CONCLUSIONS Prior to initiating long-term prescriptions， a standardized assessment should be conducted on patients from the aspects of their psychiatric condition and long-term potential risk factors， pharmacological treatment plans and other non-pharmacological therapies， physical illnesses. Additionally， healthcare providers should fulfill their obligation to inform patients or their family members. The comprehensive management of long-term prescription medications should be jointly established and improved by multiple departments， and the formulation of drug catalogs should avoid including drugs with potential social harm or medication risks while complying with policy requirements. Furthermore， measures such as adding special identifiers to long-term prescriptions， providing patients with reminders about （No.YGLX202537） prescription expiration， or offering online consultations can also effectively enhance the rationality of medication use under long-term prescriptions. Currently， the implementation of long-term prescriptions in psychiatry remains challenged by inconsistencies in prescription duration， incomplete coverage of diagnostic categories， poor patient adherence， and the risk of deviation in clinical assessments. In this regard， measures such as collaborating with multiple departments to strengthen long-term prescription information management， providing matching pharmaceutical services， ensuring the quality and rationality of long-term prescription implementation， and using modern methods to screen high-risk patients can be taken to improve patient medication compliance and safety.

Objective To explore the value of CT combined with MRI(hereinafter referred to as combined diagnosis)in diagnosing sacroiliac joint lesions in ankylosing spondylitis(AS).Methods A retrospective study selected CT and MRI examination data from 102 AS patients with sacroiliac joint lesions admitted to the Third People's Hospital of Haikou,Hainan Province between January 2021 and July 2023.The study compared the grading and detection rates of various signs using CT,MRI,and combined diagnosis.Results MRI showed higher detection rates for AS sacroiliac joint lesions in grades I-II,bone marrow edema,tendon and ligament attachment point inflammation,subchondral cartilage destruction,synovial thickening,and subchondral fat deposition compared to CT(P<0.05).In contrast,CT demonstrated higher accuracy in detecting joint surface sclerosis,subchondral bone erosion/destruction,and joint surface hyperplasia compared to MRI(P<0.05).Combined diagnosis showed significantly higher grading and detection rates of AS sacroiliac joint lesion signs compared to MRI or CT alone(P<0.05).Conclusion MRI has high detection rates for early AS sacroiliac joint lesions,CT exhibits high sensitivity for joint surface hyperplasia,sclerosis,erosion,and destruction,and combined diagnosis demonstrates superior efficacy compared to MRI or CT individually.

This article reviews the review articles and research papers related to biomanufacturing driven by engineered organisms published in the Chinese Journal of Biotechnology from 2023 to 2024. The content covers 26 aspects, including chassis cells; gene (genome) editing; facilities, tools and methods; biosensors; protein design and engineering; peptides and proteins; screening, expression, characterization and modification of enzymes; biocatalysis; bioactive substances; plant natural products; microbial natural products; development of microbial resources and biopesticides; steroidal compounds; amino acids and their derivatives; vitamins and their derivatives; nucleosides; sugars, sugar alcohols, oligosaccharides, polysaccharides and glycolipids; organic acids and monomers of bio-based materials; biodegradation of polymeric materials and biodegradable materials; intestinal microorganisms, live bacterial drugs and synthetic microbiomes; microbial stress resistance engineering; biodegradation and conversion utilization of lignocellulose; C1 biotechnology; bioelectron transfer and biooxidation-reduction; biotechnological environmental protection; risks and regulation of biomanufacturing driven by engineered organisms, with hundreds of technologies and products commented. It is expected to provide a reference for readers to understand the latest progress in research, development and commercialization related to biomanufacturing driven by engineered organisms.
Biotechnology/methods* ; Gene Editing ; Genetic Engineering ; Metabolic Engineering ; Protein Engineering ; Biosensing Techniques

Objective To develop a machine learning model integrating preoperative chest CT radiomic features with clinical data for predicting 5-year postoperative recurrence risk in stage Ⅰ non-small cell lung cancer(NSCLC)patients undergoing surgical resection.Methods A total of 217 patients with pathologically confirmed stage Ⅰ NSCLC(selected from 778 initially screened cases based on our inclusion and exclusion criteria)treated in Army Medical Center of PLA between January 2014 and December 2019 were retrospectively enrolled,including 53 recurrence cases and 164 non-recurrence cases within 5-year follow-up.They were randomly divided into a training set(n=173)and a validation set(n=44)in a ratio of 8:2.Radiomic models were established based on extracted features from tumor-dominant regions of interest(ROI)on CT images,while clinical models were developed using demographic characteristics and preoperative laboratory examinations.A combined model was further constructed by integrating both feature sets,and model performance was compared to identify the optimal predictive model.Results This study screened the features from non-contrast CT images and ultimately selected 7 radiomic features for constructing radiomic model.Among 6 machine learning algorithms,the adaptive boosting(Adaboost)model demonstrated the best overall predictive performance,with an area under the curve(AUC)of 0.866(95%CI:0.808～0.923;accuracy:0.832,specificity:0.884)in the training set and of 0.806(95%CI:0.630～0.983;accuracy:0.795,specificity:0.971)in the validation set.Univariate and multivariate logistic regression analyses identified 4 clinical features for clinical model construction.The clinical model achieved an AUC value of 0.874(95%CI:0.821～0.928;accuracy:0.827,specificity:0.891)in the training set and 0.813(95%CI:0.677～0.948;accuracy:0.636,specificity:0.600)in the validation set.By integrating the 7 radiomic features and 4 clinical features using a feature-level fusion strategy,the combined model exhibited further improved predictive performance,with an AUC value of 0.953(95%CI:0.924～0.983;accuracy:0.884,specificity:0.860)and 0.852(95%CI:0.729～0.976;accuracy:0.682,specificity:0.629),respectively in the training set and the validation set.Conclusion The combined model integrating preoperative CT radiomic features with clinical risk factors may provide an evidence-based framework for evaluating 5-year postoperative recurrence risk in stage Ⅰ NSCLC patients.