OBJECTIVE To investigate the effects and mechanisms of Buyang huanwu decoction （BYHWD） and its active fractions in ameliorating non-alcoholic fatty liver disease. METHODS BYHWD and its effective fractions obtained through ethanol precipitation， as well as 30% ethanol， 50% ethanol， and 75% ethanol fractions （namely， the CC effective fraction， 30YC effective fraction， 50YC effective fraction， and 75YC effective fraction）， were prepared. These preparations were administered to rats via intragastric administration to prepare corresponding drug-containing serum （blank serum and simvastatin-containing serum were prepared using the same protocol）. Human L02 hepatocytes were divided into control group， model group， simvastatin-containing serum group， BYHWD-containing serum group， CC-containing serum group， 30YC-containing serum group， 50YC-containing serum group， and 75YC-containing serum group. Except for the control group， other groups were given 0.2 mol/L oleic acid for 24 h to induce a lipid accumulation model， and then intervened with 20% drug-containing serum/blank serum for 24 h. The lipid deposition in cells was observed， and the proportion of lipid droplet area was calculated； the levels of triglycerides （TG） and indicators of oxidative stress [malondialdehyde （MDA）， superoxide dismutase （SOD）] as well as liver function [alanine amino- transferase （ALT）， aspartate amino-transferase （AST）] in cells were detected； protein and mRNA expressions of AMP-activated protein kinase （AMPK）/sterol regulatory element-binding protein-1 （SREBP-1）/glycerol-3-phosphate acyltransferase （GPAT） signaling pathway were also measured. RESULTS Compared with the control group， cells in the model group exhibited severe cellular steatosis， with a significantly increased proportion of lipid droplet area， as well as the elevated levels of TG， ALT， AST， and MDA in cells， along with significantly up-regulated mRNA and protein expression levels of SREBP-1 and GPAT （P＜0.05）. The level of SOD， mRNA expression of AMPK， as well as the protein phosphorylation level of AMPK were decreased significantly （P＜0.05）. Compared with the model group， cellular steatosis was alleviated in all drug-containing serum groups， and the levels of most of the aforementioned quantitative indicators were significantly reversed （P＜0.05）. CONCLUSIONS BYHWD and its active fractions can exert a therapeutic effect on improving non-alcoholic fatty liver disease by regulating the AMPK/SREBP-1/GPAT signaling pathway， inhibiting oxidative stress responses， and reducing lipid deposition.

Cholesterol is a crucial lipid in the human body.Elevated levels of cholesterol can result in condi-tions such as hypercholesterolemia.3-hydroxy-3-methylglutaryl coenzyme A reductase(HMGCR)serves as a pivotal en-zyme in the synthesis of cholesterol,acting as a rate-limiting factor.As a result,HMGCR plays a critical role in maintain-ing cholesterol balance,with the regulatory processes being intricate in vivo.This review outlines the advancements in un-derstanding the regulatory mechanisms of HMGCR,encompassing transcriptional control,degradation pathways,and en-zyme activity.

Uterine arteriovenous fistula (UAVF), a relatively rare vascular anomaly, may lead to life-threatening hemorrhage and poses diagnostic and management challenges for primary hospitals during initial encounters. This article reports four cases of UAVF treated with Drospirenone and ethinyl estradiol tablets at Department of Gynaecology, Zhuji Maternal and Child Health Hospital between 2023 and 2024. Combined with literature review, we systematically analyzed the etiological mechanisms, clinical characteristics, and diagnostic-therapeutic strategies of this condition, with particular focus on evaluating the efficacy and safety of conservative pharmacological management. By summarizing case features and individualized treatment protocols, this study aims to provide clinical references for early identification, accurate diagnosis, and rational intervention of UAVF, thereby reducing risks of massive hemorrhage and long-term complications while improving patient prognosis.

Retinopathy caused by myopia is the first cause of irreversible blinding eye disease in China.The TCM methods to prevent and control myopia mainly include Chinese materia medica and TCM appropriate techniques,which have the advantages of good efficacy,simple operation,and few adverse reactions.This paper believed that internal and external pathogenic factors act on the brain and eyes,breaking their homeostasis,leading to rhythmic disorders,and imbalance of essence,qi and blood is the main pathogenesis of myopia.Based on the idea of"nature and human in the same rhythm"and"the same treatment for common diseases",targeting the above pathogenesis,the method of"brain-eye synchronization"was proposed to restore the homeostasis of the brain and eyes to prevent and control myopia in children and adolescents,and the treatment rules were to regulate the rhythms of the time,harmonize the qi and blood,nourish the blood to soften the tendons,and replenish the essence and blood,so as to achieve the effect of brain-eye synchronization and the treatment of the spirit and the body together.This article summarized the theoretical basis of"brain-eye synchronization"and its clinical application in traditional Chinese and Western medicine,with a view to providing new ideas for the prevention and control of myopia in children and adolescents.

Objective To evaluate the efficacy and safety of the dose-adjusted etoposide,doxorubicin and cyclophosphamide with vincristine,prednisone and rituximab without radiotherapy(DA-EPOCH-R)regimen versus the modified cyclophosphamide,vincristine,doxorubicin,high-dose methotrexate(CODOX-M/IVAC-R)regimen in the treatment of patients with acquired immune deficiency syndrome(AIDS)-related Burkitt lymphoma(BL).Methods This single-center retrospective cohort study included 41 patients diagnosed with AIDS-related BL at Beijing Ditan Hospital,Capital Medical University,from December 2010 to June 2022.Among them,26 patients received the DA-EPOCH-R regimen(observation group),and 15 patients received the modified CODOX-M/IVAC-R regimen(control group).Clinical characteristics,laboratory findings,toxicities,and treatment outcomes were analyzed.Prognostic risk factors were assessed using a multivariate Cox proportional hazards model.Results Of the 41 enrolled patients,97.6％were male,with a median age of 43 years.The baseline median CD4+cell count was below 200 cells/μL in 41.5％of patients.After a median follow-up of 17 months,the complete response(CR)rate was significantly higher in the observation group compared to the control group(57.7％vs 33.3％).The median overall survival(OS)was also significantly prolonged in the observation group(18.0 months)versus the control group(6.7 months,95％CI:5.0-16.6)(P＜0.001).Treatment-related mortality was notably lower in the observation group(0％vs.26.7％,P＜0.01).Conclusion Compared to the modified CODOX-M/IVAC-R regimen,the DA-EPOCH-R regimen demonstrates superior survival benefits and enhanced safety in the treatment of AIDS-related BL,suggesting it as the preferred chemotherapy option for this patient population.

Objective To investigate the heterogeneity between left-and right-sided colorectal cancer(CRC)in terms of clinical pathological features and gene expression,thereby providing a foundation for personalized treatment.Methods A retrospective analysis was conducted on the clinical data,next-generation sequencing(NGS)results,and treatment plans of 186 CRC patients treated at the forth hospital affiliated of guangxi medical university from July 2020 to August 2023.Patients were categorized into left-sided CRC(n=134)and right-sided CRC(n=52)based on tumor location.Clinical and pathological characteristics were analyzed using SPSS 24.0 software,and Kaplan-Meier survival curves were generated to compare overall survival(OS)between groups using the Log-rank test.Additionally,this study compared the clinical and pathological features,NGS-based gene mutation profiles,and prognostic differences between left-and right-sided CRC patients.Results In the clinical and patho-logical characteristics,no significant differences were observed between left-and right-sided CRC patients regarding gender,distant metastasis,ECOG performance status,TNM stage,or levels of carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)(P>0.05).However,there were significant differences in age(P<0.05).In terms of gene mutation characteristics,the mutation frequencies of NRAS,BRAF,and APC genes did not differ significantly between left-and right-sided CRC patients(P>0.05).However,right-sided CRC patients exhibited significantly higher mutation frequencies of PIK3CA and SMAD4 genes,as well as a higher prevalence of microsat-ellite instability(MSI),compared to left-sided CRC patients(P<0.05).Conversely,left-sided CRC patients had significantly higher TP53 mutation frequencies than right-sided CRC patients(P<0.05).In prognostic analysis,af-ter a three-year follow-up,no significant difference in OS was observed between the two groups.Conclusions Significant disparities are observed in the clinical pathological features and gene expression profiles between left-and right-sided CRC.These findings indicate that distinct approaches should be adopted in clinical diagnosis and treatment to facilitate personalized and precise care.

Uterine arteriovenous fistula (UAVF), a relatively rare vascular anomaly, may lead to life-threatening hemorrhage and poses diagnostic and management challenges for primary hospitals during initial encounters. This article reports four cases of UAVF treated with Drospirenone and ethinyl estradiol tablets at Department of Gynaecology, Zhuji Maternal and Child Health Hospital between 2023 and 2024. Combined with literature review, we systematically analyzed the etiological mechanisms, clinical characteristics, and diagnostic-therapeutic strategies of this condition, with particular focus on evaluating the efficacy and safety of conservative pharmacological management. By summarizing case features and individualized treatment protocols, this study aims to provide clinical references for early identification, accurate diagnosis, and rational intervention of UAVF, thereby reducing risks of massive hemorrhage and long-term complications while improving patient prognosis.

Community general practitioners are the main force of primary health care, however, the lack of effective incentive mechanisms would affect their work enthusiasm. Therefore, to enhance incentive mechanisms,particularly from the perspective of the career development,will improve the work enthusiasm and post competeny of general practitioners in primary health care services. This article summarizes five major influencing factors of the incentives for community general practitioners, namely salary and benefits, performance evaluation, promotion and development, working conditions and interpersonal relationships, and proposes the operational strategies of incentive improvement, to provide reference for improving working conditions and strengthening incentive measures for community general practioners in primary community hospitals.

Traditional Chinese medicine upholds the unity of nature and humanity as its fundamental principle,asserting that man is in harmony with heaven and earth and corresponds to the sun and moon.Human life processes align with the circadian rhythms of nature,exhibiting periodic temporal changes-concepts that Western medicine defines as biological rhythms.The"opening-closing-pivot"of the three yin and three yang meridians represents the primary mode of interaction between nature and humanity.This mechanism regulates the transformation of yin and yang to qi within the body,ensuring synchronization with the circadian rhythm.Building upon this foundation,the concept of"the harmony of rhythms and states"was proposed to explain human growth and aging."Rhythms"encompass not only circadian cycles but also the movement of qi and blood,as well as the contraction rhythm of muscle fascia,among other physiological processes."States"refer to the dynamic evolution and transformation of qi during the"opening-closing-pivot"stages in both time and space."Harmony"pertains not only to the individual physiological balance of"rhythms"or"states"but also to their coherent interaction.The fundamental cause of myopia is"the disharmony of rhythms and states",considering that rhythm disorders,qi and blood disorders,and fascia imbalances contribute to this disease.Based on this understanding,myopia prevention and treatment should center on"regulating rhythms and states",with adjusting the pivot to brighten the eyes as the core therapeutic principle throughout the entire cycle of myopia.Treatment should be tailored to different disease stages and supplemented with methods such as time-based regulation,qi and blood harmonization,tendon relaxation and collateral dredging,and essence and blood nourishment to prevent and manage myopia effectively.

Gastric cancer is one of the most common malignant tumors of the digestive tract worldwide,and its early diagnosis and treatment have always been the focus of clinical research.In recent years,the rapid progress and wide application of proteomics technology have opened up a new perspective for the early screening,diagnosis,prognosis assessment,and mechanism exploration of gastric cancer.With the rapid development of bioinformatics,a series of innovative methods and cutting-edge results based on proteomics related to gastric cancer have emerged.This article reviewed the application progress of proteomics in gastric cancer from three dimensions:experimental techniques,analysis strategies,and major achievements,and discussed the challenges and opportunities in this field.In the future,with the integration of technologies and the deepening of interdisciplinary research,proteomics of gastric cancer is expected to make more breakthroughs,achieve clinical transformation,and provide more precise diagnosis and treatment plans for patients.