This article systematically analyzes the historical evolution of the name， origin， medicinal parts， processing and other aspects of Euphorbiae Pekinensis Radix（EPR） by referring to the herbal medicine， medical books， prescription books and other documents of the past dynasties， combined with the relevant modern research materials， so as to provide a basis for the development and utilization of famous classical formulas containing this herbal medicine. According to research， EPR was first recorded in the Shennong Bencaojing in the name of Daji， and it is the correct name of the herbal medicine in all dynasties， there are also other aliases such as Qiongju， Hongya Daji， and Xiamaxian. The dried roots of Euphorbia pekinensis from Euphorbiaceae was the mainstream of the past dynasties. Before the Ming dynasty， the above ground parts of E. pekinensis were used as Zeqi in herbal works. However， since LI Shizhen in the Ming dynasty proposed that the origin of Zeqi should be E. helioscopia， the aerial part of EPR is no longer used as medicine. Since modern times， the roots of Knoxia valerianoides has been used as EPR， and has become the mainstream of commodities， which should be corrected. Throughout history， it has been recorded that the main producing areas were Jiangsu， Anhui， Zhejiang， Shanxi and other regions， while modern botanical survey have shown that EPR is a widespread species distributed throughout the country. In ancient times， the harvesting time of EPR was mostly the twelfth lunar month， while in modern time， it is more common to harvest in autumn and winter. The main processing methods of EPR in ancient times were vinegar processing， wine processing， and stir frying， while in modern times， it is uniformly vinegar processing. In the medicinal properties and clinical aspects， the records are basically consistent throughout history， mainly characterized by bitter taste， cold and toxic nature. Its main efficacy is expelling water retention and reducing swelling. Based on the textual research， it is suggested to choose the dried roots of E. pekinensis when famous classical formulas containing EPR， processing method can be based on the original specified prescription requirements， if the processing method is not clear， it is recommended to use vinegar-processed products as medicine.

Cytochrome P450 (CYP450) enzymes, as versatile biocatalysts with the broadest range of catalytic reactions in nature, play critical roles in the metabolism of medicinal plants. They are involved in various oxidative modification processes of active ingredients, facilitating both the synthesis and degradation of bioactive substances. This review delves into the classification, structure, and catalytic mechanisms of CYP450 enzymes, emphasizing their indispensable roles in plant biosynthesis. Using representative cases, including the biosynthetic pathways of tanshinones, artemisinin, celastrol, paclitaxel, and berberine, this review highlights the functional importance of specific CYP450s. For instance, CYP71AV1 catalyzes the production of artemisinin and artemisinic aldehyde, with its activity directly affecting artemisinin yield. Similarly, CYP76AH1 and CYP76AK1 play pivotal roles in the backbone construction and postmodification of tanshinones, acting as key players in their metabolic network. In the case of celastrol, CYP712K1, CYP712K2, and CYP712K3 initiate the first oxidative reaction, providing a solid foundation for subsequent biosynthetic processes. These examples highlight the pivotal role of CYP450 enzymes in the biosynthesis of medicinal plants, showcasing both their complexity and significance in plant metabolic pathways. Furthermore, this review examines the oxidative metabolism of CYP450 enzymes under aerobic conditions and their reductive metabolism in specific environments, offering deeper insights into their catalytic mechanisms. A comprehensive understanding of these processes lays the groundwork for the effective application of CYP450 enzymes in biotechnology and plant metabolic engineering.

Severe open tibiofibular fractures account for approximately 28.1% of all open fractures. Among them, Gustilo-Anderson type IIIB/C fractures present significant clinical challenges due to associated bone and soft tissue defects, high infection rates, and risk of amputation. Inadequate preoperative assessment may lead to suboptimal emergency surgical planning or intraoperative complications. Historically, external fixation was often preferred, but this approach has been associated with limitations such as restricted joint mobility, delayed bone union, joint stiffness, and disuse osteoporosis, resulting in poor functional recovery. With advancements of debridement techniques, standardization of antibiotic use, and popularization of early soft tissue coverage, early internal fixation has gained broader acceptance. Nevertheless, controversies persist regarding the choice of fixation method, timing of definitive fixation, use of reamed versus unreamed intramedullary nailing, and necessity of fibular fixation. To standardize the diagnosis and early management of severe open tibiofibular fractures, reduce complication rates, and improve functional recovery, the Society of Microsurgery of the Chinese Medical Association organized a panel of domestic experts to develop the Evidence-based guideline for the diagnosis and early fixation of severe open tibiofibular fractures ( version 2025), using evidence-based methodology. The guidelines provided 12 recommendations covering diagnostic and early fixation strategies of severe open tibiofibular fractures, aiming to provide clinicians with scientifically grounded and standardized guidance.

BackgroundInvasive vagus nerve stimulation therapy has been approved for the adjunctive treatment of treatment-resistant depression， which may contribute to the anti-inflammatory properties of vagus nerve stimulation （VNS）， whereas the efficacy of non-invasive transcutaneous cervical vagus nerve stimulation （tcVNS） in treating major depressive disorder （MDD） and its impact on plasma inflammatory factors remain unclear. ObjectiveTo observe the effect of escitaloprom combined with tcVNS on the status of depression， anxiety and sleep quality as well as the plasma levels of interleukin-6 （IL-6） and interleukin-10 （IL-10） in MDD patients， in order to provide references for the recovery and treatment of MDD patients. MethodsFrom August 21， 2019 to April 17， 2024， 45 patients who met the diagnostic criteria for MDD in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） were recruited from the psychosomatic outpatient clinic of the First Affiliated Hospital of Air Force Military Medical University. Subjects were divided into study group （n=23） and control group （n=22） using random number table method. All patients were treated with escitalopram. On this basis， study group added a 30-minute tcVNS therapy once a day for 4 weeks. While control group was given corresponding sham stimulation， and the duration of each stimulation lasted 30 seconds. Before and after 4 weeks of treatment， Hamilton Depression Scale-17 item （HAMD-17） was used to assess depressive symptoms， and HAMD-17 anxiety/somatization subfactor and insomnia subfactor were used to assess patients' anxiety/somatization symptoms and sleep quality. Levels of plasma IL-6 and IL-10 were measured by enzyme-linked immunosorbent assay （ELISA）. ResultsThe generalized estimating equation model yielded a significant time effect for HAMD-17 total score， anxiety/somatization subfactor score and insomnia subfactor score in both groups （Wald χ²=315.226， 495.481， 82.420， P<0.01）. After 4 weeks of treatment， HAMD-17 total score and anxiety/somatization subfactor score of study group were lower than those of control group， with statistically significant differences （Wald χ²=4.967， 32.543， P<0.05 or 0.01）， while no statistically significant difference was found in the insomnia subfactor score between two groups （Wald χ²=0.819， P=0.366）. Significant time effects were reported on plasma IL-6 and IL-10 levels in both groups （Wald χ²=21.792， 5.242， P<0.05 or 0.01）. Compared with baseline data， a reduction in plasma IL-6 levels was detected in both groups （Wald χ²=22.015， 6.803， P<0.01）， and an increase in plasma IL-10 levels was reported in study group （Wald χ²=5.118， P=0.024） after 4 weeks of treatment. ConclusionEscitalopram combined with tcVNS therapy is effective in improving depressive symptoms， anxiety/somatization symptoms and sleep quality in patients with MDD. Additionally， it helps reduce plasma IL-6 levels and increase IL-10 levels. ［Funded by Shaanxi Provincial Key Research and Development Program-General Project （number， 2023-YBSF-185）， www.clinicaltrials.gov number， NCT04037111］

This study aims to investigate the isolate and identify of infectious bronchitis virus(IBV)in chickens,and study its genetic variation and pathogenicity.In 2023,two strains named CK/CH/HN/SQ202301 and CK/CH/HN/SQ202302 were obtained from suspected infectious bronchitis(IB)infected materials collected in a region of Henan Province,China.Further analysis showed that the two isolates belong to the G Ⅰ-13 and GⅥ genotypes,respectively.The cleavage sites of S protein were all RRSRR.The prediction of glycosylation sites showed that the two isolates had 18 and 12 N-glycosylation sites respectively,but no O-glycosylation site.Recombinant analysis shows that C2023-1 was a recombinant strain.Pathogenicity was assessed by infecting 1-day-old SPF chicks with the two isolates,and the results showed that C2023-1 strain infection could cause clini-cal symptoms such as depression and head shaking,as well as death in chicks,with a mortality rate of 37.5％.There were no clinical symptoms or deaths after infection with C2023-2 strain.Viral load test results showed that both isolates continued to detoxify until the 10th day,and had strong rep-lication capacity in the kidney,trachea and bursa of Fabricius.The results indicate significant differences in the genetic characteristics and pathogenicity of the two isolates due to their different genotypes.This study not only provides new epidemiological data on IB,which contributes to a bet-ter understanding of IBV's epidemiological features and control challenges,but also adds valuable bioinformatics resources for IBV by analyzing its variation mechanisms and biological information.

To verify whether the two B-cell epitopes Pep1 and Pep4 in the FAdV-4 WZ fiber can be used as candidate epitopes for multivalent epitope vaccines,epitopes Pep1 and Pep4 were tandemly linked with the chicken infectious bronchitis virus strain M41 S1 protein gene in different patterns,and a recombinant fusion plasmid was constructed and expressed in E.coli BL21(DE3).It was confirmed by Western blot and ELISA tests that all four expressed fusion proteins reacted specific-ally with anti-M41 whole virus serum and WZ strain anti-Fiber 2-knob protein serum.After purifi-cation and immunization of BALB/c mice,specific antibodies against the peptide epitopes were de-tected in mouse sera.The results showed that the Pep4 epitope induced a stronger immune re-sponse than the Pep1 epitope.When Pep1 was connected with the amino and carboxyl termini of the fusion protein,respectively,both resulted in the production of the same level of anti-Pep1 anti-bodies in the immunized animals,whereas when Pep4 was connected with the carboxyl terminus of the fusion protein,the immunized animals produced a higher level of anti-Pep4-specific antibodies.This research indicates that the B cell epitopes Pep1 and Pep4 of the reactive WZ strain Fiber 2,when conjugated with proteins to form fusion proteins,can enhance the immunogenicity of Pep1 and Pep4 without affecting the antigenicity of the carrier protein.This study provides technical support and serves as a reference for the design and development of a multivalent epitope vaccine for FAdV-4.

Aim To investigate the levels and clinical significance of serum galectin-3(Gal-3),soluble sup-pression of tumorigenicity 2(sST2)and proline dehydrogenase(ProDH)in elderly patients with heart failure.Meth-ods Using a single-center retrospective cohort study design,165 elderly patients with heart failure who were diagnosed and treated in our hospital from January 2022 to October 2023 were selected as the observation group,and 120 elderly patients with normal cardiac function and no heart disease who underwent physical examination in our hospital during the same peri-od were selected as the control group.Serum Gal-3,sST2,and ProDH levels were compared between the two groups.The ROC curve was drawn to analyze the diagnostic value of Gal-3,sST2 and ProDH levels in elderly patients with heart failure.Spearman rank correlation was used to analyze the correlation between Gal-3,sST2,ProDH and heart failure in the elderly.At the same time,the observation group was divided into a poor prognosis group(n=49)and a good progno-sis group(n=116)according to the prognosis.The general data of the two groups were compared.The associated risk factors influencing the poor prognosis of elderly heart failure were examined using Logistic regression model.ROC curve was created to examine the predictive value of associated risk factors for a poor prognosis of elderly heart failure.Re-sults The levels of Gal-3 and sST2 were significantly higher in observation group than those in control group,the level of ProDH was significantly lower than in control group,with statistical significance(P＜0.05).ROC curve results showed that Gal-3,sST2,ProDH and combined diagnosis were statistically significant for the diagnosis of heart failure in the elder-ly(P＜0.05).The AUC of the combined diagnosis was 0.996,95％CI was 0.992～1.000,the sensitivity was 0.970,the specificity was 0.975,and the diagnostic value was higher.Spearman rank correlation analysis showed that Gal-3 and sST2 were positively correlated with heart failure in the elderly(P＜0.05),and ProDH was negatively correlated with heart failure in the elderly(P＜0.05).Multivariate analysis of Logistic regression model showed that NYHA cardiac function grade IV,high level of Gal-3 and high level of sST2 were independent risk factors for poor prognosis of elderly patients with heart failure(P＜0.05),and elevated left ventricular ejection fraction(LVEF)and high level of ProDH were protective factors(P＜0.05).ROC curve results showed that NYHA cardiac function classification,LVEF,Gal-3,sST2,ProDH and combined prediction were statistically significant in predicting the poor prognosis of elderly heart failure(P＜0.05).The AUC of combined prediction was 0.983,95％CI was 0.969～0.998,the sensitivity was 0.939,the specificity was 0.948,and the predictive value was higher.Conclusion In this study,the combined predictive efficacy of Gal-3,sST2 and ProDH was systematically analyzed in elderly patients with heart failure for the first time,and it was found that the combination of the three had significant clinical value in diagnosis and prognosis evaluation.NYHA cardiac function grade Ⅳ,high level of Gal-3 and high level of sST2 were independent risk factors for poor prognosis of elderly patients with heart failure.Elevated LVEF and high level of ProDH were protective factors,all of which have certain predictive value,and the combined predictive value is higher.

To verify whether the two B-cell epitopes Pep1 and Pep4 in the FAdV-4 WZ fiber can be used as candidate epitopes for multivalent epitope vaccines,epitopes Pep1 and Pep4 were tandemly linked with the chicken infectious bronchitis virus strain M41 S1 protein gene in different patterns,and a recombinant fusion plasmid was constructed and expressed in E.coli BL21(DE3).It was confirmed by Western blot and ELISA tests that all four expressed fusion proteins reacted specific-ally with anti-M41 whole virus serum and WZ strain anti-Fiber 2-knob protein serum.After purifi-cation and immunization of BALB/c mice,specific antibodies against the peptide epitopes were de-tected in mouse sera.The results showed that the Pep4 epitope induced a stronger immune re-sponse than the Pep1 epitope.When Pep1 was connected with the amino and carboxyl termini of the fusion protein,respectively,both resulted in the production of the same level of anti-Pep1 anti-bodies in the immunized animals,whereas when Pep4 was connected with the carboxyl terminus of the fusion protein,the immunized animals produced a higher level of anti-Pep4-specific antibodies.This research indicates that the B cell epitopes Pep1 and Pep4 of the reactive WZ strain Fiber 2,when conjugated with proteins to form fusion proteins,can enhance the immunogenicity of Pep1 and Pep4 without affecting the antigenicity of the carrier protein.This study provides technical support and serves as a reference for the design and development of a multivalent epitope vaccine for FAdV-4.

Aim To investigate the levels and clinical significance of serum galectin-3(Gal-3),soluble sup-pression of tumorigenicity 2(sST2)and proline dehydrogenase(ProDH)in elderly patients with heart failure.Meth-ods Using a single-center retrospective cohort study design,165 elderly patients with heart failure who were diagnosed and treated in our hospital from January 2022 to October 2023 were selected as the observation group,and 120 elderly patients with normal cardiac function and no heart disease who underwent physical examination in our hospital during the same peri-od were selected as the control group.Serum Gal-3,sST2,and ProDH levels were compared between the two groups.The ROC curve was drawn to analyze the diagnostic value of Gal-3,sST2 and ProDH levels in elderly patients with heart failure.Spearman rank correlation was used to analyze the correlation between Gal-3,sST2,ProDH and heart failure in the elderly.At the same time,the observation group was divided into a poor prognosis group(n=49)and a good progno-sis group(n=116)according to the prognosis.The general data of the two groups were compared.The associated risk factors influencing the poor prognosis of elderly heart failure were examined using Logistic regression model.ROC curve was created to examine the predictive value of associated risk factors for a poor prognosis of elderly heart failure.Re-sults The levels of Gal-3 and sST2 were significantly higher in observation group than those in control group,the level of ProDH was significantly lower than in control group,with statistical significance(P＜0.05).ROC curve results showed that Gal-3,sST2,ProDH and combined diagnosis were statistically significant for the diagnosis of heart failure in the elder-ly(P＜0.05).The AUC of the combined diagnosis was 0.996,95％CI was 0.992～1.000,the sensitivity was 0.970,the specificity was 0.975,and the diagnostic value was higher.Spearman rank correlation analysis showed that Gal-3 and sST2 were positively correlated with heart failure in the elderly(P＜0.05),and ProDH was negatively correlated with heart failure in the elderly(P＜0.05).Multivariate analysis of Logistic regression model showed that NYHA cardiac function grade IV,high level of Gal-3 and high level of sST2 were independent risk factors for poor prognosis of elderly patients with heart failure(P＜0.05),and elevated left ventricular ejection fraction(LVEF)and high level of ProDH were protective factors(P＜0.05).ROC curve results showed that NYHA cardiac function classification,LVEF,Gal-3,sST2,ProDH and combined prediction were statistically significant in predicting the poor prognosis of elderly heart failure(P＜0.05).The AUC of combined prediction was 0.983,95％CI was 0.969～0.998,the sensitivity was 0.939,the specificity was 0.948,and the predictive value was higher.Conclusion In this study,the combined predictive efficacy of Gal-3,sST2 and ProDH was systematically analyzed in elderly patients with heart failure for the first time,and it was found that the combination of the three had significant clinical value in diagnosis and prognosis evaluation.NYHA cardiac function grade Ⅳ,high level of Gal-3 and high level of sST2 were independent risk factors for poor prognosis of elderly patients with heart failure.Elevated LVEF and high level of ProDH were protective factors,all of which have certain predictive value,and the combined predictive value is higher.

This study aims to investigate the isolate and identify of infectious bronchitis virus(IBV)in chickens,and study its genetic variation and pathogenicity.In 2023,two strains named CK/CH/HN/SQ202301 and CK/CH/HN/SQ202302 were obtained from suspected infectious bronchitis(IB)infected materials collected in a region of Henan Province,China.Further analysis showed that the two isolates belong to the G Ⅰ-13 and GⅥ genotypes,respectively.The cleavage sites of S protein were all RRSRR.The prediction of glycosylation sites showed that the two isolates had 18 and 12 N-glycosylation sites respectively,but no O-glycosylation site.Recombinant analysis shows that C2023-1 was a recombinant strain.Pathogenicity was assessed by infecting 1-day-old SPF chicks with the two isolates,and the results showed that C2023-1 strain infection could cause clini-cal symptoms such as depression and head shaking,as well as death in chicks,with a mortality rate of 37.5％.There were no clinical symptoms or deaths after infection with C2023-2 strain.Viral load test results showed that both isolates continued to detoxify until the 10th day,and had strong rep-lication capacity in the kidney,trachea and bursa of Fabricius.The results indicate significant differences in the genetic characteristics and pathogenicity of the two isolates due to their different genotypes.This study not only provides new epidemiological data on IB,which contributes to a bet-ter understanding of IBV's epidemiological features and control challenges,but also adds valuable bioinformatics resources for IBV by analyzing its variation mechanisms and biological information.