ObjectiveTo address the challenges of unstructured classical Chinese expressions， nested entity relationships， and limited annotated data in famous traditional Chinese medicine（TCM） case records， this study proposes a joint relation extraction framework that integrates data augmentation and entity mapping， aiming to support the construction of TCM diagnostic knowledge graphs and clinical pattern mining. MethodsWe developed an annotation structure for entities and their relationships in TCM case texts and applied a data augmentation strategy by incorporating multiple ancient texts to expand the relation extraction dataset. A cascade binary tagging framework for relation triple extraction（CasRel） model for TCM semantics was designed， integrating a pre-trained bidirectional encoder representations from transformers（BERT） layer for classical TCM texts to enhance semantic representation， and using a head entity-relation-tail entity mapping mechanism to address entity nesting and relation overlapping issues. ResultsExperimental results showed that the CasRel model， combining data augmentation and entity mapping， outperformed the pipeline-based Bert-Radical-Lexicon（BRL）-bidirectional long short-term memory（BiLSTM）-Attention model. The overall precision， recall， and F₁-score across 12 relation types reached 65.73%， 64.03%， and 64.87%， which represent improvements of 14.26%， 7.98%， and 11.21% compared to the BRL-BiLSTM-Attention model， respectively. Notably， the F₁-score for tongue syndrome relations increased by 22.68%（69.32%）， and the prescription-syndrome relations performed the best with the F₁-score of 70.10%. ConclusionThe proposed framework significantly improves the semantic representation and complex dependencies in TCM texts， offering a reusable technical framework for structured mining of TCM case records. The constructed knowledge graph can support clinical syndrome differentiation， prescription optimization， and drug compatibility， providing a methodological reference for TCM artificial intelligence research.

Objective To construct prostate cancer(PCa)prediction models based on machine learning algorithms, so as to improve the accuracy of early diagnosis of PCa. Methods A retrospective analysis was performed on the clinical data of 504 patients who underwent prostate biopsy at our hospital during Jan. 2020 and Nov. 2024. Patients' age, body mass index(BMI), history of hypertension, diabetes and smoking, total prostate-specific antigen(tPSA), free prostate-specific antigen(fPSA), f/tPSA, prostate volume(PV), neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio(NLR), Prostate Imaging Reporting and Data System(PI-RADS)score, digital rectal examination(DRE)results, and pathological findings were collected. The patients were divided into the training and testing sets at a ratio of 7:3. Ten early diagnosis prediction models of PCa were constructed using 10 supervised machine learning algorithms. Model performance was evaluated and validated using metrics including area under the receiver operating characteristic curve(AUC), accuracy, sensitivity, specificity, calibration curves, and decision curve analysis(DCA). SHAP analysis was used to interpret the models, and to clarify the importance of each feature and the basis for model decisions. Results All models showed good predictive value, with the gradient boosting machine(GBM)model performing the best(AUC=0.905, accuracy=84.1%, sensitivity=90.2%, specificity=80.0%). Calibration curves indicated good calibration and fitting of the GBM model, while DCA demonstrated favorable clinical net benefits. SHAP analysis identified the most significant features affecting PCa occurrence in descending order:tPSA, f/tPSA, PIRADS score, PV, age, and DRE. Conclusion The GBM model exhibits the optimal performance among the 10 models. The importance of features for predicting the occurrence of PCa, from the highest to the lowest, is as follows:tPSA, f/tPSA, PIRADS score, PV, age, and DRE.

The knowledge graph has the characteristic of visualizing structural knowledge and has gradually become a research hotspot in the field of TCM diagnosis and treatment.This article reviewed the development trend and construction techniques of knowledge graph,summarized its application status in the field of TCM diagnosis and treatment,and provided a comprehensive review from the aspects of basic knowledge of TCM,inheritance of experience of renowned doctors,TCM question answering systems,and exploration of auxiliary decision-making.It also summarized the problems of knowledge graph technology in solving the informationization and intelligence process of TCM,and discussed and prospect the research and application directions of knowledge graph in the field of informationization and intelligence of TCM based on the characteristics of TCM knowledge.

A case of small cerebral vascular disease and moderate hyperhomocysteinemia caused by methylenetetrahydrofolate reductase gene mutation is reported.The patient was a 61-year-old man who presented with tongue stiffness and slurred speech,bilateral hand numbness and lower limb weakness.He had a history of recurrent cerebral infarction,cerebral hemorrhage,accompanied by leukoencephalopathy and cerebral microhemorrhage etc.Blood homocysteine(Hcy)66.2 μmol/L.Head magnetic resonance imaging revealed subacute cerebral infarction and white matter lesions in right parieto-occipital lobe and left pressor corpus callosum.The skin pathology showed normal density of small fibers,infiltration of perivasculitis cells in the epidermis and dermis,and swelling of endothelial cells in a wide range of small vessels in the dermis.Whole exon sequencing indicated homozygous pathogenic mutation of MTHFR gene c.665C>T(p.A222V).After 1 month of treatment,Hcy decreased to 20.5 μmol/L.This report suggests that HHcy is not only associated with leucoencephalopathy,but also can lead to skin small vessel lesions.Attention should be paid to peripheral vascular screening in this population for early intervention of potential risks.

A case of small cerebral vascular disease and moderate hyperhomocysteinemia caused by methylenetetrahydrofolate reductase gene mutation is reported.The patient was a 61-year-old man who presented with tongue stiffness and slurred speech,bilateral hand numbness and lower limb weakness.He had a history of recurrent cerebral infarction,cerebral hemorrhage,accompanied by leukoencephalopathy and cerebral microhemorrhage etc.Blood homocysteine(Hcy)66.2 μmol/L.Head magnetic resonance imaging revealed subacute cerebral infarction and white matter lesions in right parieto-occipital lobe and left pressor corpus callosum.The skin pathology showed normal density of small fibers,infiltration of perivasculitis cells in the epidermis and dermis,and swelling of endothelial cells in a wide range of small vessels in the dermis.Whole exon sequencing indicated homozygous pathogenic mutation of MTHFR gene c.665C>T(p.A222V).After 1 month of treatment,Hcy decreased to 20.5 μmol/L.This report suggests that HHcy is not only associated with leucoencephalopathy,but also can lead to skin small vessel lesions.Attention should be paid to peripheral vascular screening in this population for early intervention of potential risks.

Objective To analyze the characteristics of coronary atherosclerosis(CAS)and the gender differences in type 2 diabetes mellitus(T2DM)patients without cardiovascular disease symptoms using coronary artery computed tomography(CCTA).Methods A total of 178 asymptomatic individuals with T2DM who underwent CCTA examination due to CAS risk factors were included in this analysis in 2019,and they were divided into male group(n=105)and female group(n=73)according to sex.The general data and biochemical indicators of patients of different genders were compared.Logistic regression was used to analyze the influencing factors of high-risk signs of CAS in patients with T2DM.The incidences of coronary artery involvement score(SIS)≥4 and segmental stenosis score(St.S)≥3 in male and female patients with different courses of DM were compared.Results The age and the proportion of hypertension in female patients with T2DM were higher than those in male patients(P<0.05),while the body mass index(BMI),smoking history,triglyceride(TG),total cholesterol(TC)/high-density lipoprotein cholesterol(HDL-C),and proportions of SIS≥4 were lower than those in male patients(P<0.05).Logistic regression analysis showed that the hypertension duration was an influencing factor for the occurrence of high-risk signs of CAS in patients with T2DM.The proportion of SIS≥4 in the female DM duration was higher than<5 years(P<0.05),and the proportion of SIS≥4 in>15 years was lower than<5 years(P<0.05).Conclusions The incidence of CAS high-risk signs in T2DM patients without cardiovascular symptoms is different between different sexes,the number of affected segments in women was related to the DM duration.

BACKGROUND:With the increase of age,the function of bone marrow-derived mesenchymal stem cells is gradually reduced,and delaying the aging of bone marrow-derived mesenchymal stem cells itself has become an important topic.OBJECTIVE:To explore ways to delay the aging of bone marrow-derived mesenchymal stem cells by changing the expression of telomerase Cajal body protein 1(TCAB1)gene.METHODS:Mouse bone marrow-derived mesenchymal stem cells were cultured by cell adhesion method.TCAB1 gene in bone marrow-derived mesenchymal stem cells was overexpressed and interfered by recombinant lentivirus technique.The expression of aging related genes P16,P21,P53,and P27 was detected by qPCR.The relative length of telomeres was detected by qPCR.The expression of aging proteins P16,P21,P53,and P27 was detected by western blot assay.Cell proliferation was detected by CCK-8 assay.Annexin V-PE/7-AAD apoptosis kit was used to detect the degree of cell apoptosis.RESULTS AND CONCLUSION:Bone marrow-derived mesenchymal stem cell lines overexpressing TCAB1 gene had decreased expression of senescence related genes and proteins,increased Telomere relative length,stronger cell proliferation,less apoptosis,and a youthful state.The expression of age-related genes and proteins in bone marrow mesenchymal stem cells interfering with TCAB1 gene increased,and the relative telomere length decreased;cell proliferation ability was weak;cell apoptosis was more,and cells showed senescence.These results indicate that increasing the expression of TCAB1 in an appropriate range can delay the rate of cell senescence.

Objective To analyze the characteristics of coronary atherosclerosis(CAS)and the gender differences in type 2 diabetes mellitus(T2DM)patients without cardiovascular disease symptoms using coronary artery computed tomography(CCTA).Methods A total of 178 asymptomatic individuals with T2DM who underwent CCTA examination due to CAS risk factors were included in this analysis in 2019,and they were divided into male group(n=105)and female group(n=73)according to sex.The general data and biochemical indicators of patients of different genders were compared.Logistic regression was used to analyze the influencing factors of high-risk signs of CAS in patients with T2DM.The incidences of coronary artery involvement score(SIS)≥4 and segmental stenosis score(St.S)≥3 in male and female patients with different courses of DM were compared.Results The age and the proportion of hypertension in female patients with T2DM were higher than those in male patients(P<0.05),while the body mass index(BMI),smoking history,triglyceride(TG),total cholesterol(TC)/high-density lipoprotein cholesterol(HDL-C),and proportions of SIS≥4 were lower than those in male patients(P<0.05).Logistic regression analysis showed that the hypertension duration was an influencing factor for the occurrence of high-risk signs of CAS in patients with T2DM.The proportion of SIS≥4 in the female DM duration was higher than<5 years(P<0.05),and the proportion of SIS≥4 in>15 years was lower than<5 years(P<0.05).Conclusions The incidence of CAS high-risk signs in T2DM patients without cardiovascular symptoms is different between different sexes,the number of affected segments in women was related to the DM duration.

BACKGROUND:Human umbilical cord mesenchymal stem cell-derived exosomes are involved in multiple injury repair processes,and the effects and the specific mechanisms of renal ischemia/reperfusion injury have not been fully elucidated.OBJECTIVE:To investigate the molecular mechanism of human umbilical cord mesenchymal stem cell-derived exosomes in the treatment of renal ischemia/reperfusion injury.METHODS:(1) Human umbilical cord mesenchymal stem cells were cultured and exosomes were obtained and identified using an exosome extraction kit.(2) The distribution of exosomes in the kidney of mice with renal ischemia/reperfusion injury was examined by intravital fluorescence imaging.(3) Thirty C57/BL6 male mice were divided into five groups according to the random number table method:sham operation group,renal ischemia/reperfusion group,sham operation group+Compound C group,renal ischemia/reperfusion+exosome group (exosome group),and renal ischemia/reperfusion+exosome+Compound C group (exosome+Compound C group),with 6 mice in each group.Except the sham operation group,bilateral renal pedicles were clamped for 45 minutes and a mouse model of renal ischemia/reperfusion injury was established after 24 hours of reperfusion.In sham operation+Compound C group and exosome+Compound C group,AMPK inhibitor Compound C was intraperitoneally injected 30 minutes before model establishment.In the exosome group and exosome+Copmpound C group,exosomes were injected through the tail vein 15 minutes before renal pedicle clipping.The levels of serum creatinine and urea nitrogen,interleukin 6,and tumor necrosis factor α in renal tissue,and the expression of apoptosis-related factors in renal tissue were detected after 24 hours of reperfusion in each group.RESULTS AND CONCLUSION:(1) Human umbilical cord mesenchymal stem cell exosomes had the typical tea tray morphology,with the diameter distribution in the range of 40-160 nm,and expressed the specific marker membrane protein of exosome surface.(2) Murine kidneys after renal ischemia/reperfusion injury were more likely to gather human umbilical cord mesenchymal stem cell exosomes compared with the sham operation group.(3) Exosome pretreatment reduced renal injury and the level of renal cell apoptosis in mice treated with renal ischemia/reperfusion injury.Moreover,this protective effect could be reversed by AMPK inhibitors.These findings verify that human umbilical cord mesenchymal stem cell-derived exosomes exerting a protective effect on renal ischemia/reperfusion injury may be related to the activation of the AMPK/YAP1 pathway to antiapoptosis.

Objective:To evaluate the effects of nasal endoscopy in curettage of large mandibular cyst.Methods:20 cases of large mandibular cyst admitted to Xianyang Hosptial of Yan'an University from January 2022 to December 2023 were included.The curet-tage of mandibular cyst was performed under general anesthesia through intraoral incision by nasal endoscopy-assisted illumination and enlargement of the lesion area during the operation.The application effects were evaluated from the aspects of surgical incision length,nerve injury and cyst recurrence.Results:During operation,the surgical filed of view was clear and the operation was suc-ceeded in all cases.There was no complication in and after the nasal endoscopy-assisted curettage,no cyst recurrence was observed during 1-year follow-up.Conclusion:Nasal endoscopy-assisted curettage of large mandibular cyst is effective and safe.