OBJECTIVE To evaluate the efficacy and safety of total glucosides of paeonia （TGP） in the treatment of systemic lupus erythematosus （SLE）. METHODS Randomized controlled trial （RCT） about TGP combined with western medicine versus western medicine alone for SLE treatment were retrieved from PubMed， Embase， Cochrane Library， Web of Science， CNKI， VIP， Wanfang Data， and CBM. The search period spanned from the inception of each database to June 1， 2025. After literature screening， data extraction， and quality assessment of the included studies， Meta-analysis was performed using RevMan 5.4 software. RESULTS Fifteen RCTs， involving 1 318 patients， were included. Meta-analysis results showed that compared with western medicine alone， TGP combined with western medicine significantly improved clinical efficacy [OR＝4.96， 95%CI（3.41， 7.23）， P＜0.000 01]， complement 3 [MD＝0.18， 95%CI （0.13， 0.23）， P＜0.000 01] and complement 4[MD＝0.08， 般021） 95%CI （0.04， 0.11）， P＜0.000 01]， and reduced the levels of immunoglobulin G （IgG） [MD＝－3.10， 95%CI （－3.59，－2.62）， P＜0.000 01]， IgA [MD＝－0.68， 95%CI （－0.78， －0.58）， P＜0.000 01]， IgM [MD＝－0.43， 95%CI （－0.53，－0.34）， P＜0.000 01]， systemic lupus erythematosus disease activity index （SLEDAI） [MD＝－1.59， 95%CI （－2.20， －0.99）， P＜0.000 01]， recurrence rate [OR＝0.23， 95%CI （0.13， 0.42）， P＜0.000 01] and the incidence of adverse drug reactions [OR＝ 0.54， 95%CI （0.36， 0.82）， P＝0.004]. CONCLUSIONS TGP therapy can improve clinical efficacy of SLE patients， promote the restoration of immunoglobulins and complements， reduce SLEDAI and recurrence rate and has good safety.

OBJECTIVE:Repetitive transcranial magnetic stimulation and transcranial direct current stimulation have shown positive effects in improving gross motor function in children with cerebral palsy.A network meta-analysis was performed to analyze the clinical efficacy of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on the improvement of lower limb motor function and gait in children with cerebral palsy.METHODS:Randomized controlled trials(RCT)about repetitive transcranial magnetic stimulation and transcranial direct current stimulation on lower limb motor function and gait in children with cerebral palsy were collected from CNKI,WanFang,VIP,SinoMed,PubMed,Web of Science,Medline.The search time limit was from the inception to October 5,2024.After screening literature,extracting data and evaluating the risk of bias of included studies,Stata 15.0 software was used for network meta-analysis,AND GRADE profiler was used for quality evaluation.RESULTS:A total of 19 studies were included,involving 4 treatment measures:conventional therapy,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation and anodic transcranial direct current stimulation.The results of network meta-analysis showed that in terms of improving gross motor function,low-frequency repetitive transcranial magnetic stimulation[mean difference(MD)=9.48,95％confidence interval(CI)(6.61,12.34),P＜0.05]was the most effective.In terms of alleviating spasticity,high-frequency repetitive transcranial magnetic stimulation[MD=-0.63,95％CI(-1.72,0.45),P＜0.05]had the best efficacy.In terms of improving ankle joint range of motion and step speed,transcranial direct current stimulation[MD=2.27,95％CI(1.37,3.17),P＜0.05;MD=0.11,95％CI(0.05,0.17),P＜0.05]was the most effective.CONCLUSION:Existing clinical evidence suggests that low-frequency repetitive transcranial magnetic stimulation has the best therapeutic effect compared with other intervention measures in terms of improving lower limb gross motor function.In terms of reducing spasticity,high-frequency repetitive transcranial magnetic stimulation has a more significant effect.In terms of improving gait,transcranial direct current stimulation has more advantages.

OBJECTIVE:Repetitive transcranial magnetic stimulation and transcranial direct current stimulation have shown positive effects in improving gross motor function in children with cerebral palsy.A network meta-analysis was performed to analyze the clinical efficacy of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on the improvement of lower limb motor function and gait in children with cerebral palsy.METHODS:Randomized controlled trials(RCT)about repetitive transcranial magnetic stimulation and transcranial direct current stimulation on lower limb motor function and gait in children with cerebral palsy were collected from CNKI,WanFang,VIP,SinoMed,PubMed,Web of Science,Medline.The search time limit was from the inception to October 5,2024.After screening literature,extracting data and evaluating the risk of bias of included studies,Stata 15.0 software was used for network meta-analysis,AND GRADE profiler was used for quality evaluation.RESULTS:A total of 19 studies were included,involving 4 treatment measures:conventional therapy,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation and anodic transcranial direct current stimulation.The results of network meta-analysis showed that in terms of improving gross motor function,low-frequency repetitive transcranial magnetic stimulation[mean difference(MD)=9.48,95％confidence interval(CI)(6.61,12.34),P＜0.05]was the most effective.In terms of alleviating spasticity,high-frequency repetitive transcranial magnetic stimulation[MD=-0.63,95％CI(-1.72,0.45),P＜0.05]had the best efficacy.In terms of improving ankle joint range of motion and step speed,transcranial direct current stimulation[MD=2.27,95％CI(1.37,3.17),P＜0.05;MD=0.11,95％CI(0.05,0.17),P＜0.05]was the most effective.CONCLUSION:Existing clinical evidence suggests that low-frequency repetitive transcranial magnetic stimulation has the best therapeutic effect compared with other intervention measures in terms of improving lower limb gross motor function.In terms of reducing spasticity,high-frequency repetitive transcranial magnetic stimulation has a more significant effect.In terms of improving gait,transcranial direct current stimulation has more advantages.

OBJECTIVE:It has been confirmed that neuromodulation technology can improve the clinical symptoms of patients with Parkinson's disease,and there are differences in the efficacy of different neuromodulation stimulation methods.Herein,a network meta-analysis was used to evaluate the efficacy of different neuromodulation stimulation modalities in improving non-motor symptoms such as sleep disorders and depression and anxiety in patients with Parkinson's disease,thereby exploring the optimal neuromodulation stimulation regimen.METHODS:The Chinese Biomedical Literature Database,WanFang Database,VIP Database,CNKI Database,Web of Science,PubMed,The Cochrane Library,and EMbase databases were searched for randomized controlled trials on neuromodulation techniques to improve sleep disorders,depression and anxiety in patients with Parkinson's disease.The control group was treated with conventional treatments(drugs,conventional rehabilitation therapy,etc.)or sham stimulation,and the experimental group was supplemented with neuromodulation technology on the basis of the control group.The quality of the included studies was evaluated using the PEDro scale and the deviation risk assessment tool recommended by the Cochrane Collaboration.RevMan 5.4 and Stata 17.0 were used for network meta-analysis of the four outcomes(sleep disorders,anxiety symptoms,depressive symptoms,and quality of life).RESULTS:(1)Twenty-nine randomized controlled trials involving six neuromodulation stimulation modalities were included.These modalities were transcranial direct current stimulation,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation,deep brain stimulation of the subthalamic nucleus,deep brain stimulation of the globus pallidus,multi-target deep brain stimulation.(2)The results of network meta-analysis showed that compared with conventional treatment,transcranial direct current stimulation[standardized mean difference(SMD)=-2.57,95％confidence interval(CI)=-4.52 to-0.63,P＜0.05)had the best effect in improving sleep disorders in patients with Parkinson's disease.In terms of improving depressive symptoms,deep brain stimulation of the globus pallidus(SMD=-1.00,95％CI=-1.87 to-0.14,P＜0.05)had the best effect,followed by low-frequency repetitive transcranial magnetic stimulation(SMD=-0.91,95％CI=-1.60 to-0.23,P＜0.05),deep brain stimulation of the subthalamic nucleus(SMD=-0.82,95％CI=-1.56 to-0.08,P＜0.05),and high-frequency repetitive transcranial magnetic stimulation(SMD=-0.75,95％CI=-0.97 to-0.53,P＜0.05).In terms of improving anxiety symptoms,high-frequency repetitive transcranial magnetic stimulation(SMD=-0.86,95％CI=-1.54 to-0.18,P＜0.05)had the best effect.In terms of improving the quality of life,deep brain stimulation of the globus pallidus(SMD=-0.79,95％CI=-1.55 to-0.04,P＜0.05)had the best efficacy,followed by high-frequency repetitive transcranial magnetic stimulation(SMD=-0.63,95％CI=-0.90 to-0.36,P＜0.05)and transcranial direct current stimulation(SMD=-0.50,95％CI=-0.80 to-0.19,P＜0.05).CONCLUSION:Neuromodulation technology has significant efficacy in improving non-motor symptoms in patients with Parkinson's disease.Transcranial direct current stimulation has the best efficacy in improving sleep disorders,deep electrical stimulation of the medial cerebral part of the globus pallidus has the best efficacy in improving depressive symptoms,high-frequency repetitive transcranial magnetic stimulation has the best efficacy in improving anxiety symptoms,and deep electrical stimulation of the globus pallidus has the best efficacy in improving quality of life.

OBJECTIVE:It has been confirmed that neuromodulation technology can improve the clinical symptoms of patients with Parkinson's disease,and there are differences in the efficacy of different neuromodulation stimulation methods.Herein,a network meta-analysis was used to evaluate the efficacy of different neuromodulation stimulation modalities in improving non-motor symptoms such as sleep disorders and depression and anxiety in patients with Parkinson's disease,thereby exploring the optimal neuromodulation stimulation regimen.METHODS:The Chinese Biomedical Literature Database,WanFang Database,VIP Database,CNKI Database,Web of Science,PubMed,The Cochrane Library,and EMbase databases were searched for randomized controlled trials on neuromodulation techniques to improve sleep disorders,depression and anxiety in patients with Parkinson's disease.The control group was treated with conventional treatments(drugs,conventional rehabilitation therapy,etc.)or sham stimulation,and the experimental group was supplemented with neuromodulation technology on the basis of the control group.The quality of the included studies was evaluated using the PEDro scale and the deviation risk assessment tool recommended by the Cochrane Collaboration.RevMan 5.4 and Stata 17.0 were used for network meta-analysis of the four outcomes(sleep disorders,anxiety symptoms,depressive symptoms,and quality of life).RESULTS:(1)Twenty-nine randomized controlled trials involving six neuromodulation stimulation modalities were included.These modalities were transcranial direct current stimulation,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation,deep brain stimulation of the subthalamic nucleus,deep brain stimulation of the globus pallidus,multi-target deep brain stimulation.(2)The results of network meta-analysis showed that compared with conventional treatment,transcranial direct current stimulation[standardized mean difference(SMD)=-2.57,95％confidence interval(CI)=-4.52 to-0.63,P＜0.05)had the best effect in improving sleep disorders in patients with Parkinson's disease.In terms of improving depressive symptoms,deep brain stimulation of the globus pallidus(SMD=-1.00,95％CI=-1.87 to-0.14,P＜0.05)had the best effect,followed by low-frequency repetitive transcranial magnetic stimulation(SMD=-0.91,95％CI=-1.60 to-0.23,P＜0.05),deep brain stimulation of the subthalamic nucleus(SMD=-0.82,95％CI=-1.56 to-0.08,P＜0.05),and high-frequency repetitive transcranial magnetic stimulation(SMD=-0.75,95％CI=-0.97 to-0.53,P＜0.05).In terms of improving anxiety symptoms,high-frequency repetitive transcranial magnetic stimulation(SMD=-0.86,95％CI=-1.54 to-0.18,P＜0.05)had the best effect.In terms of improving the quality of life,deep brain stimulation of the globus pallidus(SMD=-0.79,95％CI=-1.55 to-0.04,P＜0.05)had the best efficacy,followed by high-frequency repetitive transcranial magnetic stimulation(SMD=-0.63,95％CI=-0.90 to-0.36,P＜0.05)and transcranial direct current stimulation(SMD=-0.50,95％CI=-0.80 to-0.19,P＜0.05).CONCLUSION:Neuromodulation technology has significant efficacy in improving non-motor symptoms in patients with Parkinson's disease.Transcranial direct current stimulation has the best efficacy in improving sleep disorders,deep electrical stimulation of the medial cerebral part of the globus pallidus has the best efficacy in improving depressive symptoms,high-frequency repetitive transcranial magnetic stimulation has the best efficacy in improving anxiety symptoms,and deep electrical stimulation of the globus pallidus has the best efficacy in improving quality of life.

Objective Jejunal interposition is an important option for restoring gastrointestinal continuity in patients with complex esophageal cancer in whom the stomach is unavailable for reconstruction due to previous gastrectomy, tumor involvement, failed gastric conduit, or other constraints. Although the jejunum offers a caliber similar to the esophagus, a rich blood supply, and preserved peristaltic function, anatomical variations in mesenteric length and vascular arcades render long-segment and high-level reconstruction susceptible to excessive tension, mesenteric torsion, venous congestion, and inadequate distal perfusion. This consensus aims to provide standardized recommendations for the application of jejunal interposition in this specific patient population. Methods This consensus was developed in accordance with the WHO Handbook for Guideline Development and Chinese national guideline development standards, with reference to the Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ), Reporting Items for Practice Guidelines in Healthcare (RIGHT), and Scientific, Transparent and Applicable Rankings (STAR) checklists. The project was registered on the international practice guidelines registry platform (PREPARE-2026CN1384). The working group systematically searched Chinese and English evidence addressing 12 clinical questions. Evidence was graded using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2009 system, with structured appraisal of risk of bias, inconsistency, indirectness, and imprecision. Recommendations were formulated through two rounds of Delphi surveys and a face-to-face consensus meeting, with an agreement threshold of ≥75%. Results The consensus generated 12 recommendations covering indications, selection between jejunum and colon, preoperative assessment, surgical approach and reconstruction route, pedicled jejunal interposition (PJI), supercharged pedicled jejunal interposition (SPJ), indocyanine green (ICG) perfusion assessment, perioperative nutrition, management of anastomotic leakage, long-term follow-up, and special treatment scenarios. Given that the available direct evidence is predominantly derived from single-center retrospective cohorts and case series, recommendations extrapolated from general esophagectomy or other gastrointestinal surgical evidence are deliberately phrased with caution. Conclusion Jejunal interposition is a safe and effective approach for digestive tract reconstruction in patients with complex esophageal cancer in whom the stomach is unavailable. This consensus emphasizes that clinical decision-making should be individualized based on the patient's prior treatment history, reconstruction height, vascular anatomy, technical availability, and institutional experience in the Chinese context.

Myocardial fibrosis is a serious cause of heart failure and even sudden cardiac death. However, the mechanisms underlying myocardial ischemia-induced cardiac fibrosis remain unclear. Here, we identified that the expression of sterile alpha and TIR motif containing 1 (SARM1), was increased significantly in the ischemic cardiomyopathy patients, dilated cardiomyopathy patients (GSE116250) and fibrotic heart tissues of mice. Additionally, inhibition or knockdown of SARM1 can improve myocardial fibrosis and cardiac function of myocardial infarction (MI) mice. Moreover, SARM1 fibroblasts-specific knock-in mice had increased deposition of extracellular matrix and impaired cardiac function. Mechanically, elevated expression of SARM1 promotes the deposition of extracellular matrix by directly modulating P4HA1. Notably, by using the Click-iT reaction, we identified that the increased expression of ZDHHC17 promotes the palmitoylation levels of SARM1, thereby accelerating the fibrosis process. Based on the fibrosis-promoting effect of SARM1, we screened several drugs with anti-myocardial fibrosis activity. In conclusion, we have unveiled that palmitoylated SARM1 targeting P4HA1 promotes collagen deposition and myocardial fibrosis. Inhibition of SARM1 is a potential strategy for the treatment of myocardial fibrosis. The sites where SARM1 interacts with P4HA1 and the palmitoylation modification sites of SARM1 may be the active targets for anti-fibrosis drugs.

Frostbite is the most common cold injury and is caused by both immediate cold-induced cell death and the gradual development of localized inflammation and tissue ischemia. Delayed healing of frostbite often leads to scar formation, which not only causes psychological distress but also tends to result in the development of secondary malignant tumors. Therefore, a rapid healing method for frostbite wounds is urgently needed. Herein, we used a mouse skin model of frostbite injury to evaluate the recovery process after frostbite. Moreover, single-cell transcriptomics was used to determine the patterns of changes in monocytes, macrophages, epidermal cells, and fibroblasts during frostbite. Most importantly, human-induced pluripotent stem cell (hiPSC)-derived skin organoids combined with gelatin-hydrogel were constructed for the treatment of frostbite. The results showed that skin organoid treatment significantly accelerated wound healing by reducing early inflammation after frostbite and increasing the proportions of epidermal stem cells. Moreover, in the later stage of wound healing, skin organoids reduced the overall proportions of fibroblasts, significantly reduced fibroblast-to-myofibroblast transition by regulating the integrin α5β1-FAK pathway, and remodeled the extracellular matrix (ECM) through degradation and reassembly mechanisms, facilitating the restoration of physiological ECM and reducing the abundance of ECM associated with abnormal scar formation. These results highlight the potential application of organoids for promoting the reversal of frostbite-related injury and the recovery of skin functions. This study provides a new therapeutic alternative for patients suffering from disfigurement and skin dysfunction caused by frostbite.
Animals ; Organoids/metabolism* ; Mice ; Humans ; Wound Healing ; Frostbite/metabolism* ; Skin/pathology* ; Induced Pluripotent Stem Cells/cytology* ; Cicatrix/pathology* ; Fibroblasts/metabolism* ; Disease Models, Animal ; Mice, Inbred C57BL ; Extracellular Matrix/metabolism* ; Male

Objective: To validate the analytical performance, operational performance, and process control measures of a domestic fully automatic nucleic acid testing (NAT) system, thereby ensuring an efficient and orderly blood screening workflow. Methods: The concordance rate and sensitivity of WanTag-Vortex Plus system were verified using WHO standard reference panels of HIV-1, HCV and HBV, while precision was assessed using weak positive samples of HIV-1, HCV and HBV. As for its operational performance evaluation, cross-contamination resistance was assessed using strong positive samples, and throughput and stress testing were conducted using negative samples. Reagent stability was verified using weak positive samples, and inter-system performance consistency was assessed using verification panels. In addition, the process control measures were verified using the laboratory quality control demand scale. Results: 1) Verification of concordance rate: The detection results of negative and positive samples of HIV-1, HCV and HBV by WanTag-Vortex Plus system were all consistent with expectations, and the concordance rate was 100%. 2) Precision verification: the repeatability and intermediate precision were extremely high, and the coefficient of variation was less than 5%. 3) Verification of analytical sensitivity: The detection limit of 95% for standard strains of HIV-1, HCV and HBV by WanTag-Vortex Plus system in our laboratory was consistent with the analytical sensitivity provided by reagent manufacturers. 4) Verification of cross-contamination resistance: Five strong positive samples and 87 negative samples were placed according to the actual working conditions and equipment operation design, and the test results were consistent with expectations, with no cross-contamination in the testing system. 5) Throughput and stress testing: Each system completed the individual donor-nucleic acid amplification testing (ID-NAT) of 276 samples in three batches within 12 hours, and successfully completed the ID-NAT test of 828 samples in three consecutive days. 6) Verification of reagent stability: After extreme storage (unsealed storage for 1 week with 4 freeze-thaw cycles), the reagents maintained 100% detection rate in the weak positive samples of HIV-1, HCV, and HBV, showing no significant differences from the control group (Kappa=1). 7) Verification of inter-system performance consistency: The system has stable operation performance, and the performance comparison results across the four devices were consistent (Kappa=1). 8) Process control measures: WanTag-Vortex Plus system software accurately controlled the equipment operation process with strict quality control measures, and correctly interpreted and safely reported the test results. Conclusion: The analytical and operational performance of the WanTag-Vortex Plus system complies with manufacturer design standards and essential laboratory workflow requirements. Integrated with laboratory information system (LIS), the system's control software meets standard process control requirements, yet requires further improvement.

Objective To evaluate the efficiency of intra-tumor and peri-tumor ultrasound radiomics models based on machine learning algorithms for predicting benign and malignant Breast Imaging Reporting and Data System (BI-RADS) 4 breast lesions, and provide insights into early diagnosis of breast cancer. Methods A retrospective analysis was conducted based on the medical records of 450 female patients who underwent breast ultrasound examination in the Affiliated Cancer Hospital of Xinjiang Medical University from June 2020 to April 2022. The patients were divided into the benign (n = 199) and malignant (n = 195) groups according to pathological examination, and randomized into the training (n = 275) and validation (n = 119) sets at a ratio of 7∶3. Radiomics features were extracted and screened. Intra-tumor, peri-tumor, and intra-tumor + peri-tumor ultrasound radiomics models were constructed based on three machine learning algorithms, including logistic regression (LR), support vector machine (SVM), and multi-layer perceptron (MLP). Receiver operating characteristics (ROC) curves, calibration curves, and decision curves were plotted to evaluate the efficacy of the radiomics models for prediction of benign and malignant breast lesions. Results A total of 17 intra-tumor, 16 peri-tumor, and 17 intra-tumor + peri-tumor radiomics features were selected for model construction. Based on LR, MLP, and SVM algorithms, the intra-tumor + peri-tumor radiomics models showed higher predictive efficacy than intra-tumor and peri-tumor radiomics models. The predictive efficacy of intra-tumor, peri-tumor, and intra-tumor + peri-tumor radiomics models were higher based on the SVM algorithm than based on LR and MLP algorithms. For the intra-tumor radiomics model based on the SVM algorithm, the area under the ROC curve (AUC), accuracy, sensitivity, and a specificity were 0.909, 0.851, 0.860, and 0.842, respectively, in the training set and 0.866, 0.832, 0.847, and 0.817, respectively, in the validation set. For the peri-tumor radiomics model based on the SVM algorithm, these values were 0.899, 0.855, 0.882, and 0.827, respectively, in the training set and 0.844, 0.815, 0.847, and 0.783, respectively, in the validation set. For the intra-tumor + peri-tumor radiomics model based on the SVM algorithm, these values were 0.943, 0.876, 0.860, and 0.892, respectively, in the training set and 0.881, 0.849, 0.915, and 0.783, respectively, in the validation set. Conclusion The intra-tumor and peri-tumor ultrasound radiomics models based on machine learning algorithms are highly valuable for prediction of benign and malignant BI-RADS 4 breast lesions. The intra-tumor + peri-tumor ultrasound radiomics model based on the SVM algorithm has the optimal efficacy for prediction of benign and malignant BI-RADS 4 breast lesions.