Wilson disease （WD） is an autosomal recessive disorder of copper metabolism， and decoppering therapy and symptomatic treatment are the main Western medicine therapies for WD. This article systematically reviews the understanding of the etiology and pathogenesis of WD in traditional Chinese medicine （TCM） and points out that abnormal natural endowment is the core etiology and pathogenesis of WD， with internal accumulation of copper toxicity as the manifestation， liver/spleen/kidney dysfunction as the root cause， and intermingled “toxin， stasis， phlegm， and deficiency” as the key pathogenesis. Literature research and clinical observation are conducted to summarize the common TCM syndromes of WD， including stagnation of liver Qi， internal retention of damp-heat， phlegm-stasis-heat accumulation syndrome， liver-kidney Yin deficiency syndrome， spleen-kidney Yang deficiency， and syndrome of deficiency damage and phlegm stasis. This article proposes the corresponding therapies and representative prescriptions for each syndrome and discusses the advantages of treatment by stage and integrated traditional Chinese and Western medicine therapy. This article aims to provide a systematic reference for the syndrome differentiation-based treatment of WD in clinical practice of TCM， thereby giving full play to the advantages of TCM in the treatment of this disease.

ObjectiveTo compare the differences in fungal community composition between lesional and non-lesional scalp areas in patients suffering from severe alopecia areata （AA）， and compare these with healthy scalp areas in control subjects. Additionally， to preliminarily explore the changes in scalp fungal communities in severe AA patients and their potential underlying immunological mechanisms. MethodsA total of 20 severe AA patients and 18 healthy controls were enrolled. Skin swab samples were collected from lesional and non-lesional scalp areas of severe AA patients， as well as from the normal scalp of healthy controls. The fungal internal transcribed spacer （ITS） region was amplified and analyzed using high-throughput sequencing. ResultsThe lesional scalp areas of severe AA patients exhibited higher α-diversity and species richness in fungal communities. Notably， the relative abundance of Ascomycota， along with genera such as Mycosphaerella， Aspergillus， Penicillium， and Wallemia， significantly increased in the bald regions. In contrast， Acremonium and Schizophyllum were more predominant in the non-lesional areas of severe AA patients. ConclusionDistinct region-specific differences in scalp fungal microbiota in severe AA patients suggests that fungal dysbiosis may play a potential role in the pathogenesis of alopecia areata. These findings provide new insights into the disease characteristics of severe AA from the perspective of scalp microecology.

To comprehend the genetic evolutionary characteristics and biological properties of the H4N1 subtype avian influenza virus(AIV)in China,this study conducted whole genome sequen-cing,genetic evolutionary analysis,and pathogenicity test in BALB/c mice of a duck-derived H4N1 subtype AIV strain(DK/GX/E1424/20)isolated from the live poultry market in the southern re-gion in 2020.The results indicated that the cleavage site motif of the HA protein was PEKASR/GLF,which conformed to the characteristics of low pathogenic AIV.All the eight gene fragments were situated in the Eurasian lineage,and the homology of AIV-related genes of the H1N1,H3N8,H4N6,H6N1,and H10N8 subtypes isolated from wild waterfowl was the highest,representing a recombinant virus strain.Without prior adaptation,it replicated effectively in the lungs and turbi-nates of mice,with viral titers of 3.00 and 2.08 log10EID50/mL respectively,and induced weight loss in infected mice.This study suggested that this virus had significant genetic diversity and low pathogenicity in mice,posing a potential risk for mammalian infection.

To comprehend the genetic evolutionary characteristics and biological properties of the H4N1 subtype avian influenza virus(AIV)in China,this study conducted whole genome sequen-cing,genetic evolutionary analysis,and pathogenicity test in BALB/c mice of a duck-derived H4N1 subtype AIV strain(DK/GX/E1424/20)isolated from the live poultry market in the southern re-gion in 2020.The results indicated that the cleavage site motif of the HA protein was PEKASR/GLF,which conformed to the characteristics of low pathogenic AIV.All the eight gene fragments were situated in the Eurasian lineage,and the homology of AIV-related genes of the H1N1,H3N8,H4N6,H6N1,and H10N8 subtypes isolated from wild waterfowl was the highest,representing a recombinant virus strain.Without prior adaptation,it replicated effectively in the lungs and turbi-nates of mice,with viral titers of 3.00 and 2.08 log10EID50/mL respectively,and induced weight loss in infected mice.This study suggested that this virus had significant genetic diversity and low pathogenicity in mice,posing a potential risk for mammalian infection.

OBJECTIVE To establish the HPLC fingerprint and content determination of five components in Ranunculus sceleratus L.. METHODS The separation was developed on an Agilent ZORBAX SB C18 chromatographic (4.6 mm×250 mm, 5 μm)column by gradient elution with methanol(A)-0.1 % phosphoric acid aqueous solution(B) as mobile phase to establish HPLC fingerprint of Ranunculus sceleratus L.. Combined with similarity evaluation, cluster analysis, principal component analysis, and orthogonal partial least squares-discriminant analysis, the quality of 13 batches of Ranunculus sceleratus L. was evaluated. RESULTS Thirteen batches of Ranunculus sceleratus L. samples were calibrated with 20 common peaks, of which 5 common peaks were identified, and the similarity ranged from 0.874 to 0.984. The results of cluster analysis and principal component analysis were basically the same, indicating that there might be differences in the content of chemical components of Ranunculus sceleratus L. in different regions. Protocatechuic aldehyde, caffeic acid, ferulic acid, hyperoside and isoquercitrin were determined in thirteen batches of Ranunculus sceleratus L., and their contents were 0.016−0.035, 0.010−0.070, 0.010−0.029, 0.016−0.051, 0.028−0.086 mg·g–1, respectively. CONCLUSION The established HPLC fingerprint and content determination method is simple, stable, and reliable, which can be used for qualitative analysis and provide reference to quality evaluation and resource utilization of Ranunculus sceleratus L..

Objective:To investigate the clinical efficacy of individualised microvascular decompression (MVD) for trigeminal neuralgia (TN), so as to provide individualised treatment strategies and new thoughts for treatment.Methods:Clinical data of 46 patients who had TN and treated in the Department of Neurosurgery at the First Affiliated Hospital of Anhui Medical University from January 2021 to September 2023 were retrospectively studied. The study consisted of 19 males and 27 females, with an average age of morbidity at (58.3 ± 9.0) years old. Preoperative pain ratings and surgical outcomes were evaluated using the Barrow Neurological Institute (BNI) pain rating scale, and of which 27 patients were rated at BNI grade IV and 19 at grade V before surgery. A posterior trans-sigmoid sinus approach was applied in surgery on all patients, which could be performed in various ways depending on the vascular conditions identified during surgery. Ten patients were treated with microsurgery, 12 with endoscopic surgery and 24 with combined endoscopic surgery and microsurgery. After having identified the responsible vessel(s), a vascular decompression for the affected trigeminal nerve was performed and the nerve decompression was achieved by a polyester pad. Long-term postoperative follow-ups were conducted via telephone interviews or outpatient visits.Results:A total of 46 patients received the microvascular decompression surgery. Among them, 43 cases (93.5%) achieved immediate and complete pain relief of BNI grade I after surgery, and 3 cases (6.5%) achieved partial pain relief of BNI grade Ⅱ. Four patients developed facial numbness and sensory reduction, 2 developed facial paralysis (of House-Brackmann grade Ⅱ of 1 patient and grade Ⅲ of the other), 8 developed pneumocephalus, 4 developed postoperative fever, and 2 developed subcutaneous effusion. After treatment, the pneumocephalus and fever were cured, subcutaneous effusion was disappeared in 1 patient, but remained in the other. The mean follow-up period for the 46 patients was 16.2 (1-33) months. During the follow-up, 2 of the 3 patients of BNI grade Ⅱ immediately after surgery had complete remission to BNI grade Ⅰ and the other had recurrence and aggravation at BNI grade Ⅳ.Conclusion:The complexity of the responsible vessels is one of the important factors to be considered in the microvascular decompression strategy for trigeminal neuralgia. An individualised surgical plan according to a specific vascular condition identified in the surgery, is a best possible or worthiness surgical strategy in the treatment for a TN.

Objective:To develop a nomogram to predict the probability of prostate cancer after transeperineal prostate biopsy, and verify the diagnostic efficacy and clinical applicable value of the model.Methods:The clinicopathologic data of 475 patients who underwent prostate biopsy at Yijishan Hospital of Wannan Medical College between January 2019 to August 2021 were retrospectively reviewed. Of all the patients, 367 patients from January 2019 to December 2020 were in the development cohort and 108 patients from January 2021 to August 2021 were in the validation cohort. Patients in the development cohort were (68.86±9.00) years old. The tPSA level was 13.6(8.6, 23.3)ng/ml, and Prostate Imaging Reporting and Data System (PI-RADS) score was 4(3, 4) points. Patients in the validation cohort were (68.89±8.67) years old. The tPSA was 13.1(8.7, 25.6)ng/ml, and PI-RADS score was 4 (3, 5) points. Univariate and multivariate logistic regression were used to analyze prostate cancer risk factors in the development cohort. Then the nomogram prediction model was established by the risk factors. The prediction model's performance was evaluated using receiver operating characteristic (ROC) curves, calibration maps, and decision curve (DCA) analysis in the development cohort. The performance of the model was verified in the validation cohort.Results:The pathological results showed 180 patients with prostate cancer and 187 patients without prostate cancer in the development cohort. The validation cohort included 53 patients with and 55 without prostate cancer. Based on the results of the univariate and multivariate logistic regression analysis, this model incorporates factors including age ( OR=1.059, P=0.003), platelet-to-monocyte ratio (PMR) ( OR=0.002, P=0.011), f/tPSA ( OR=0.009, P=0.020), and PI-RADS score ( OR= 3.076, P<0.001). The calibration curve revealed a great agreement. Internal validation of the nomogram showed that the area under the ROC curve was 0.845 (95% CI 0.794-0.895). The Hosmer-Lemeshow test was also performed( χ2=1.476, P=0.224). The validation group with an area under the ROC curve was 0.869 (95% CI 0.797-0.941). The results of the decision curve analysis indicated that the decision curve was located above the positive and negative lines in the threshold range of 10% to 90%, within which the model has clinical application. Conclusions:The nomogram, which combines patient age, PMR, f/t PSA, and PI-RADS scores, has high predictive efficacy for prostate cancer and has clinical application value.

Bladder clear cell carcinoma is a rare variant of epithelial carcinoma of the lower urinary tract. This manuscript reported a case of 71-year-old female patient with the main complaint of gross hematuria. Transurethral resection of baldder tumor(TURBT) was performed after Gynecological consultation, and postoperative pathology results revealed clear cell carcinoma in bladder. Four months after surgery, the pelvic CT showed tumor recurrence in bladder. Another TURBT was performed followed with gemcitabine infusion chemotherapy. At 5 months after the second surgery, the tumor recurred again, and also resected by TURBT. No relapse or metastasis occurred during the 5-month follow-up after the third operation.

Objective:To investigate the effects of deep learning-based AiContour ??versus atlas-based Raystation ?? automatic contouring methods on the contouring of organs-at-risk on CT images of patients with rectal cancer who undergo radiotherapy, providing evidence for clinical application. Methods:Fifty patients with rectal cancer who received treatment during January to June 2020 in Zhejiang Provincial People's Hospital (Affiliated Hospital of Hangzhou Medical College) were included in this study. The CT images from 20 patients with rectal cancer that had been contoured by experienced radiotherapist were selected as target images and automatically contoured using the data template library of AiContour ?? and Raystation ?? automatic contouring methods. Hausdorff distance, mean distance to agreement, dice similarity coefficient, Jaccard coefficient were used to quantitatively evaluate the accuracy of the volume of contour of organs-at-risk automatically sketched by the two methods. Results:There was no significant difference in Hausdorff distance in left femoral head [(6.81 ± 2.66) vs. (7.24 ± 2.10)], right femoral head [(7.38 ± 3.91) vs. (8.14 ± 3.71)], pelvis [(24.00 ± 9.01) vs. (24.66 ± 9.67)] between AiContour ?? and Raystation ?? automatic contouring methods ( tleft femoral head = -0.831, tright femoral head = -0.821, tpelvis = -0.357, all P > 0.05). Significant differences were observed in mean distance to agreement, dice similarity coefficient and Jaccard coefficient of organs-at-risk (all P < 0.05). The mean values of dice similarity coefficient automatically sketched by AiContour ?? method were > 0.7. The DSC of left kidney, right kidney, rectum and bladder automatically sketched by Raystation ?? method were < 0.7, and the dice similarity coefficient values of other organs-at-risk automatically sketched by Raystation ?? method were > 0.7. In addition, Hausdorff distance, mean distance to agreement and Jaccard coefficient values of organs-at-risk automatically sketched by AiContour ?? method were superior to those automatically sketched by Raystation ??. Conclusion:After slight modification, the organs-at-risk automatically sketched by AiContour ?? and Raystation ?? methods can meet clinical requirement. The contouring effects provided byAiContour ?? method were superior to those provided by Raystation ?? method.

Objective:To study whether aspirin has inhibitory effect on microglia activation induced by Poly-IC and its mechanism.Methods:Microglia cell line BV2 were cultured in vitro to establish a Poly-IC stimulation-induced microglia cell immune activation model. The experiment groups were divided into control group (no treatment), model group (Poly-IC 10 μg/ml), high dose aspirin group (1 mmol/L aspirin), low dose aspirin group (0.1 mmol/L aspirin), high dose aspirin pretreatment group (Poly-IC 10 μg/ml + 1 mmol/L aspirin) and low dose aspirin pretreatment group (Poly-IC 10 μg/ml + 0.1 mmol/L aspirin). The phagocytosis ability of microglia cells, reactive oxygen species (ROS) and Iba1 protein expression were detected by using immunofluorescence method. The expression of the inflammatory cytokines Il-1β, Il-6, Il-10, TNF-α and cox-2 mRNA in microglia cells were detected by real-time quantitative PCR (RT-qPCR).Results:Compared with the control group, the morphology of microglia cells in model group changed significantly, and the phagocytosis ability and production of reactive oxygen species (ROS) increased. At the meantime, the expression of Iba1 protein was strongly decreased. In the model group, The mRNA expressions of IL-1β(20.55±1.92), IL-6 (63.98±7.83), TNF-α (16.84±3.19), COX-2 (6.78±0.42) were higher than IL-1β(1.01±0.14), IL-6 (0.95±0.17), TNF-α (1.22±0.38), COX-2 (0.87±0.11) in the control group. (Il-1β ( t=26.14), Il-6 ( t=10.22), TNF-α ( t=17.06) and COX-2 ( t=37.07), all P<0.01). In the aspirin pretreatment group, the phagocytic ability of microglia cells was inhibited compared with the model group, and the production of reactive oxygen species (ROS) reduced. The expression of Iba1 protein was also partly recovered. Meanwhile, the effect of the high aspirin dose pretreatment group on pro-inflammatory factors IL-1β(9.95±0.52), IL-6 (39.64±6.89), TNF-α(1.57±0.42), COX-2 (2.47±0.14)were lower than those in the model group significantly.(IL-1β: t=14.18, IL-6: t=3.69, TNF-α: t=16.68, COX-2: t=27.03, all P<0.01). Conclusion:Aspirin has an inhibitory effect on microglial activation induced by Poly-IC, which may be related with inhibiting the expression of inflammatory factors.