Autoimmune liver diseases （AILD） are a group of chronic liver diseases caused by abnormal activation of the immune system， mainly including autoimmune hepatitis， primary biliary cholangitis， primary sclerosing cholangitis， IgG4-related sclerosing cholangitis， and overlap syndrome. Clinical studies have shown that patients with AILD are often comorbid with thyroid diseases， especially autoimmune thyroid diseases （AITD）， such as Graves’ disease and Hashimoto’s thyroiditis. This article systematically reviews the epidemiological association， potential shared pathogenesis， and overlapping features between AILD and thyroid diseases. A deeper understanding of the immunological links between AILD and AITD may provide a theoretical basis for precision medicine and future research.

Objective To investigate the risk factors associated with mortality in patients undergoing surgical treatment for myocardial infarction complicated by ventricular septal rupture, and to establish a prediction model. Methods A retrospective analysis was conducted on clinical data of patients who underwent surgical treatment of myocardial infarction with ventricular septal rupture at Beijing Anzhen Hospital from 2008 to 2022. Patients were followed up and divided into a survival group and a death group based on perioperative and follow-up outcomes. Univariate analysis was performed for all variables, followed by least absolute shrinkage and selection operator (LASSO) regression to screen risk factors affecting postoperative mortality. A Cox regression model was constructed and a Nomogram was developed. Results A total of 83 surgical patients were included, comprising 49 males and 34 females, with a mean age of (64.4±7.7) years. There were 13 perioperative deaths, and among the 70 surviving patients, 6 additional deaths occurred during follow-up. Consequently, 64 patients were assigned to the survival group and 19 to the death group. Univariate analysis revealed statistically significant differences between groups in age, culprit vessel patency status, intra-aortic balloon pump use, Killip classification, time from myocardial infarction to surgery, and time from perforation to surgery (all P<0.05). LASSO regression identified three independent predictors: age [HR=1.092, 95%CI (1.005, 1.187), P=0.039], Killip classification [HR=2.024, 95%CI (1.009, 4.059), P=0.047], and culprit vessel patency [HR=0.110, 95%CI (0.014, 0.869), P=0.036]. The Nomogram based on these variables demonstrated good discriminative ability, with area under the receiver operating characteristic curve of 0.907 at 1 month and 0.876 at 1 year postoperatively. Follow-up revealed cumulative survival rates of 78.2%, 78.2%, 74.6%, and 74.6% at 2, 5, 8, and 10 years postoperatively for all patients, and 92.7%, 92.7%, 88.5%, and 88.5% for perioperative survivors. Conclusion Patients with myocardial infarction complicated by ventricular septal rupture demonstrate favorable mid-to-long-term prognosis after surgical repair. Age, Killip classification, and culprit vessel patency are independent predictors of postoperative mortality, and the established prediction model shows satisfactory prognostic performance.

To introduce the general thinking, guidelines, work objectives and elaboration process of the general technical requirements adopted by volume Ⅳ of the Chinese Pharmacopoeia 2025 Edition, and to summarize and figure out the main characteristics on dosage forms, physico-chemical testing, microbial and biological testing, reference standards and guidelines The newly revised general chapters of pharmacopoeia give full play to the normative and guiding role of the Chinese Pharmacopoeia standard, track the frontier dynamics of international drug regulatory science and the elaboration of monographs, expand the application of state-of-the-art technologies, and steadily promote the harmonization and unification with the ICH guidelines； further enhance the overall capacity of TCM quality control, actively implement the 3 R principles on animal experiments, and practice the concept of environmental-friendly； replace and/or reduce the use of toxic and hazardous reagents, strengthen the requirements of drug safety control This paper aims to provide a full-view perspective for the comprehensive, correct understanding and accurate implementation of general technical requirements included in the Chinese Pharmacopoeia 2025 Edition.

Objective:To explore the efficacy and safety of sivelestat sodium in patients with acute respiratory distress syndrome (ARDS) in the intensive care unit (ICU).Methods:Sixty patients with ARDS admitted to the ICU of the Fuyang Hospital Affiliated to Anhui Medical University from August 1, 2023 to November 1, 2024 were selected and divided into the control group (conventional treatment, 30 cases) and the sivelestat sodium group (treated with sivelestat sodium in addition to conventional treatment, 30 cases) by the random number table method. The clinical data such as inflammatory factors, blood gas analysis indicators, Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score and Sequential Organ Failure Assessment (SOFA) score of the two groups of patients before treatment and 3 days after treatment were compared. The prognostic indicators such as mechanical ventilation time, ICU stay time, total hospital stay time, 28-day mortality rate and clinical efficacy of the two groups of patients were compared.Results:Before treatment, there were no statistically significant differences in inflammatory factors, blood gas analysis indicators, APACHE Ⅱ score and SOFA score between the two groups of patients (all P>0.05). After 3 days of treatment, the improvement degrees of APACHE Ⅱ score, SOFA score, arterial partial pressure of oxygen (PaO 2), oxygenation index (PaO 2/FiO 2), procalcitonin (PCT), interleukin-6 (IL-6), and C-reactive protein (CRP) in the sivelestat sodium group were all greater than those in the control group. The differences were all statistically significant (all P<0.05); The mechanical ventilation time [(5.31±4.12) d vs (7.17±2.32)d] and ICU stay [(6.31±3.42)d vs (8.93±5.26)d] of patients in the sivelestat sodium group were significantly shorter than those in the control group, and the differences were statistically significant (all P<0.05). There was no statistically significant difference in the 28-day mortality rate between the sivelestat sodium group [20.00%(6/30)] and the control group [43.33%(13/30)] ( P>0.05). The total effective rate of treatment in the sivelestat sodium group was significantly higher than that in the control group [80.00%(24/30) vs 56.67%(17/30)], and the difference was statistically significant (χ 2=4.167, P=0.041). Conclusions:Sivelestat sodium is helpful in improving the physiological parameters of patients with ARDS, effectively reducing the levels of inflammatory factors in the body, shortening the duration of mechanical ventilation and ICU stay, but has no significant effect on the 28-day mortality rate.

Background and purpose:Next generation sequencing-identified genetic alterations of diffuse large B cell lymphoma(DLBCL)and baseline SUVmax detected by 18F-FDG PET/CT were correlated with patients'prognosis.However,their relationship and the associations with R-CHOP response of DLBCL are still unclear.This study aimed to analyze the association bewteen genetic alterations and 18F-FDG PET/CT SUVmax and their correlations with clinicopathological characteristics and R-CHOP response of DLBCL.Methods:A total of 225 cases of primary DLBCL detected by next generation sequencing using 481 lymphoma gene panel and examined by 18F-FDG PET/CT before treatment between 2022 and 2023 were collected.This study was approved by the Ethics Committee of Fudan University Shanghai Cancer Center(Ethical No.:050432-4-2307E)and acquired the informed consent of the patients.The translocations of BCL2,BCL6 and MYC were identified by fluorescence in situ hybridization.The clinicopathological characteristics and the PET/CT scan after R-CHOP chemotherapy were collected.Results:Finally,191 patients were enrolled in this study.The frequency of MYD88 mutation,TP53 mutation,copy number variations of CDKN2A/2B,CD79B mutation in the 191 DLBCL patients were 24.6%,27.2%,32.5%and 16.8%,respectively.The range of baseline SUVmax was 5.10-63.10(24.44±10.70,median 22.80).The baseline SUVmax of MYD88L265P DLBCL was significantly higher than that of MYD88 wild type(P=0.039).There were no significant associations of SUVmax with other gene alterations including TP53 mutation,CDKN2A/B loss,CD79B mutation,KMT2D mutation,TNFAIP3 mutation,B2M mutation,EZH2 mutation,BTG1/2 mutation,CREBBP mutation,gene translocations of MYC,BCL2 and BCL6.The higher SUVmax before treatment was correlated with higher serum lactate dehydrogenase(LDH)level(P=0.012)and non-germinal center B-cell-like(non-GCB)DLBCL(P=0.040).However,there was no significant association of SUVmax with R-CHOP response(P=0.714).TP53 mutation was significantly associated with the poor response of R-CHOP(P=0.001)and was an independent predictor of non-complete metabolic response(non-CMR).TP53 mutation combined with Ann Arbor stage,International Prognostic Index(IPI)score and serum LDH level could better predict R-CHOP response than each factor alone.Conclusion:MYD88L265P DLBCL had higher baseline 18F-FDG PET/CT SUVmax.The baseline SUVmax was not associated with R-CHOP response.However,TP53 mutation was significantly correlated with poor response of R-CHOP in DLBCL patients.TP53 mutation combined with clinicopathological characteristics could better predict R-CHOP response.The associations of gene alterations and SUVmax with prognosis of DLBCL patients needed to be explored in the future.

Objective To analyze the biomechanical characteristics of cannulated screws internal fixation models with different spatial distribution in the treatment of PauwelsⅡ fracture of the femoral neck through finite element analysis.Methods One healthy male volunteer was selected as the research subject.A thin-layer scan from the femoral head to the distal femur of the volunteer was performed using 128-slice spiral CT to preliminarily construct a three-dimensional mesh model of the femur.Through subsequent processing,a cannulated screw internal fixation model conforming to human anatomical characteristics was obtained.A horizontal line was drawn based on the center line of the femoral shaft,and the fracture line was set at the center of the femoral neck with an angle of 50° to the horizontal line to construct the Pauwels Ⅱ femoral neck fracture model.Five kinds of cannulated screw internal fixation models with different spatial distribution were simulated and designed in SolidWorks 2021 software,and the assembly models were imported into Ansys 2021R1 software to establish the finite element model.The stress distribution of the femur and its internal fixator in the five models were evaluated,and the displacement of the femoral neck fracture cross-section in the X,Y,and Z directions,as well as the overall displacement of the femur and the internal fixator were analyzed.Results The stresses of the proximal femur of the five models concentrated below the femoral neck fracture line,and the stress peak of the inverted equilateral triangle configuration was the smallest(19.179 MPa).The total stresses of the internal fixator in the five models all concentrated in the middle region of the ventral cannulated screw at the proximal femur,and the stress peak of the inverted equilateral triangle configuration was the lowest(61.742 MPa).The maximum displacement of the femoral neck fracture cross-section in the X and Y directions of the five models all appeared in the anterior and upper regions of the cross-section,and the displacement of the inverted equilateral triangle configuration was the smallest(X axis:0.446 54 mm,Y axis:0.704 21 mm).The maximum displacement of the femoral neck fracture cross-section in the Z direction of the five models all occurred in the posterior upper part of the cross-section,among which the displacement of the inverted equilateral triangle configuration was the smallest(0.225 62 mm).The overall displacement of the proximal femur of the five models concentrated in the stress-loading area of the femoral head,and the displacement of the inverted equilateral triangle configuration was the smallest(0.721 16 mm).The maximum displacement of the internal fixator of the five models located at the tip of the cannulated screw fixed at the top of the femoral neck near the posterior wall,and the displacement of the inverted equilateral triangle configuration was the smallest(0.686 83 mm).Conclusion Among the five different cannulated screws internal fixation models for Pauwels Ⅱ femoral neck fractures,the inverted equilateral triangle configuration has the best stress dispersion effect,the smallest displacement of fracture end,and the best biomechanical stability.

Objective To investigate the awareness of female patients with pelvic floor dysfunction regarding minimally invasive laser treatment of the reproductive tract and analyze the factors influencing their decision-making intentions,this study aims to provide a foundation for early treatment of pelvic floor dysfunction and further development in reproductive health management.Methods A convenience sampling method was employed to select 164 female patients with pelvic floor dysfunction who sought treatment at the Pelvic Rehabilitation Center of Dongguan Maternal and Child Health Care Hospital between June 2023 and August 2024.The study utilized the Female Sexual Function Index,Incontinence Quality of Life Questionnaire,and Family Support Self-Assessment Scale to conduct a survey.Binary logistic stepwise regression analysis was conducted to investigate the factors influ-encing patients'inclination towards undergoing genital laser minimally invasive treatment.Results Among the 164 female patients,143(87.2%)expressed an intention to receive treatment,with 22.6%demonstrating a rela-tively clear understanding of genital laser minimally invasive treatment.Logistic regression analysis revealed that occupation significantly influenced treatment intention(P<0.05).Compared to healthcare professionals,individuals in the teaching profession(OR=10.81,95%CI:1.04～112.21),self-employed individuals(OR=20.34,95%CI:3.46～119.43),and those in other professions(OR=16.26,95%CI:4.05～65.29)were more inclined to express willingness for undergoing treatment.Furthermore,a lower score on the Incontinence Quality of Life scale was found to positively correlate with treatment intention(OR=0.96,95%CI:0.93～0.99).Conclusion Although patients express a high intention to undergo minimally invasive genital laser treatment,their overall awareness of the procedure remains insufficient.

Objective:Observation of the therapeutic effect of Yugu Ju detergent combined with fusidic acid cream on the repair of wounds infected with Staphylococcus aureus,as well as its impact on serum inflammatory markers TNF-α,IL-6,IL-1β,oxidative stress markers MDA,ROS,SOD and Nrf2 levels.Methods:96 patients with skin defects and SA U infection caused by trauma admitted to the hospital from June 2021 to December 2023 were randomly divided into a control group and an observation group.Both groups were treated with debridement,while the control group was treated with external application of fusidic acid cream.The treatment group received external washing with Yugu Ju detergent in addition to the control group.One course of treatment lasted for 7 days,with three consecutive courses of treatment.Observe the wound healing rate,bacterial clearance rate,and changes in TNF-α,IL-6,IL-1β,SOD,MDA,ROS,and Nrf2 before and after treatment to evaluate clinical efficacy and safety.Results:The total clinical effective rate of the observation group after treatment was 93.75％(45/48),while that of the control group was 75％(36/48).The observation group was significantly better than the control group(P＜0.05);The wound healing rate and bacterial clearance rate of the observation group at each time point after treatment were higher than those of the control group(P＜0.05);After treatment,the Nrf2 and SOD values in the observation group were higher than those in the control group,while the TNF-α,IL-6,IL-1β,MDA,and ROS values were lower than those in the control group(P＜0.05).No adverse reactions occurred during the treatment of both groups.Conclusion:The combination of Yugu Ju detergent and Fusidic acid cream can inhibit SA U and promote the healing of infectious wounds,which may be related to the activation of Nrf2 expression to inhibit oxidative stress and inflammatory response.It is safe and effective,and worthy of promotion and application.

Objective To observe the effect of acupuncture synchronized with speech training on speech function of patients with post-stroke motor aphasia.Methods Sixty inpatients with post-stroke motor aphasia were selected from the Affiliated Hospital of Shandong Univer-sity of Traditional Chinese Medicine,from January to August,2023.They were randomly divided into control group(n=30)and synchronous group(n=30).Both groups received acupuncture and speech training;the con-trol group received acupuncture in the morning and speech training in the afternoon,while the synchronous group received acupuncture and speech training synchronously,for three weeks.They were assessed with Chi-nese Rehabilitation Research Center Standard Aphasia Examination(CRRCAE),Non-Language-Based Cognitive Assessment(NLCA)and Communication Activities of Daily Living(CADL)before and after treatment.Results The subscores of CRRCAE and NLCA,and score of CADL increased in both groups(|t|>2.081,P<0.05)after treatment,and they were better in the synchronous group than in the control group(|t|>2.680,P<0.05).Conclusion Synchronous mode of acupuncture and speech training is more effective on post-stroke motor aphasia than time-sequence mode.

Objective To observe the effect of synchronous acupuncture and articulation training on spastic dysarthria after stroke.Methods From January to August,2023,64 stroke patients in the Affiliated Hospital of Shandong University of Tradi-tional Chinese Medicine were selected,and randomly divided into control group(n=32)and synchronous group(n=32).Both groups received routine neurological treatment and basic articulation training.The control group added asynchronous acupuncture,while the synchronous group added synchronous acupuncture,for four weeks.Before and after treatment,the modified Frenchay Dysarthria Assessment(m-FDA),Speech Intelligibility Test(SIT),maximum phonation time(MPT)and maximum counting ability(MCA)were used to evaluate the curative effects.Results After treatment,the scores of m-FDA in all the dimensions decreased in both groups(t>2.882,P<0.01);ex-cept for the jaw dimension,the scores of m-FDA in reflexes,respiration,lips,soft palate,larynx,tongue and speech dimensions were significantly lower in the synchronous group than in the control group(t>2.050,P<0.05).After treatment,the results of SIT,and MPT and MCA significantly increased in both groups(t>21.061,P<0.001),and they were better in the synchronous group than in the control group(t>11.412,P<0.001).Conclusion Synchronous acupuncture and articulation training can effectively alleviate the severity of spastic dysarthria after stroke,which was superior to asynchronous acupuncture and articulation training.