It is proposed that the pathogenesis of rheumatoid arthritis （RA） is centered on deficiency， dampness， and blood stasis， which interact with and evolve into one another during the onset and progression of the disease. The development of RA is closely associated with insufficiency of healthy qi and the interbinding of dampness and blood stasis. Accordingly， treatment emphasizes an integrated approach that combines tonifying deficiency， eliminating dampness， and resolving blood stasis， and is implemented in three main stages. In the initial stage， therapy focuses on supporting healthy qi， dispelling dampness， and relieving impediment， with modified Huangqi Guizhi Wuwu Decoction （黄芪桂枝五物汤） combined with Yiyiren Decoction （薏苡仁汤）. In the active stage， treatment aims to eliminate dampness， resolve blood stasis， and unblock the collaterals， using modified Wutou Decoction （乌头汤） or Guizhi Shaoyao Zhimu Decoction （桂枝芍药知母汤）. In the remission stage， therapy emphasizes strengthening the spleen and reple-nishing qi to prevent recurrence， with modified Shenling Baizhu Powder （参苓白术散） combined with Guipi Decoction （归脾汤）.

ObjectiveTo investigate the effect of Toxoplasma gondii infection on copper metabolism in the kidneys of mice. MethodsA total of 80 7-8-week-old C57BL/6 female mice were randomly divided into four groups of 20 mice in each group after one week of adaptation， including Control group， Cu group， TgCtwh6 group and Cu+TgCtwh6 group. Mice that were not infected and fed with normal diet and water were used as the Control group； Mice fed with 1 g/kg of copper chloride processing diet and 0.1% copper chloride water for 60 consecutive days were used as Cu group； Mice infected with 25-30 TgCtwh6 cysts （one of the predominant genotype Chinese 1 in China） fed with normal diet and water were used as the TgCtwh6 group； mice infected with 25-30 TgCtwh6 cysts and fed with a processed diet containing 1 g/kg of copper chloride and water with 0.1% copper chloride for 60 consecutive days were used as the Cu+TgCtwh6 group. ICP-MS was used to determine the changes in copper content in kidney tissues. Hematoxylin-eosin （HE） staining was used to observe the pathological changes of mouse kidney tissue. The number of apoptotic cells was observed by PI staining. Western blot was used to detect the protein expression levels of glutathione peroxidase 4 （GPX4） and superoxide dismutase （SOD1， SOD2）. RT-qPCR was used to detect the mRNA expression of cuproptosis-related genes. ResultsPathological manifestations such as inflammatory cell infiltration in the Cu group and TgCtwh6 group were seen under the microscope， and the inflammatory infiltrating cells of the renal interstitial were reduced in the Cu+TgCtwh6 group， and the pathological manifestations

Oral lichen planus (OLP) is a chronic inflammatory disease occurring in the oral mucosa. Clinically, OLP presents with various lesion morphologies, attributed to differences in host immune responses. T-helper 17 cells (Th17) are a crucial component of the cellular immune response, primarily functioning through the secretion of interleukin 17 (IL-17). IL-17 plays a dual role in the oral mucosa: on one hand, it exerts a protective effect by promoting the recruitment of neutrophils driven by chemokines, enhancing the secretion of antimicrobial peptides, and strengthening the mucosal barrier; on the other hand, it binds to target cells in the mucosal tissue, activating downstream inflammatory signaling pathways such as nuclear factor kappa-B(NF-κB) and mitogen-activated protein kinase(MAPK), thereby initiating a pro-inflammatory cascade. This process increases the secretion of pro-inflammatory factors and promotes the recruitment and activation of immune cells, exacerbating inflammation. Current research extensively explores the correlation between the Th17/IL-17 axis and the pathogenesis and progression of OLP. This paper aims to review these developments to provide a research foundation for further elucidating the immunological mechanisms of OLP. Literature review results indicate that upregulation of Th17 and IL-17 in local lesion tissues and peripheral blood of OLP patients may be a key molecular event in the development of OLP. Compared to non-erosive OLP, higher expression levels of Th17 and IL-17 in the tissues and blood of patients with erosive OLP suggest a positive correlation between Th17/IL-17 and disease severity. Clinical studies demonstrate that targeted drugs against the Th17/IL-17 axis, by directly blocking IL-17 or inhibiting the production of Th17 cells, can effectively improve mucosal damage in OLP patients, showcasing potential as a new target for immune therapy. However, whether Th17 and IL-17 influence the pathogenesis of OLP by regulating the oral microbiome remains unclear. In summary, the Th17/IL-17 axis holds potential value as a new target for the immune therapy of OLP, warranting further in-depth research into its biological functions and signaling mechanisms within the inflammatory process of OLP.

ObjectiveTo investigate the regulatory effect and potential mechanisms of isocitrate dehydrogenase 3A （IDH3A） on cardiomyocyte hypertrophy. MethodsThe expression of IDH3A in the myocardium of healthy volunteers （n=10） and patients with heart failure （HF） （n=10）， and in the myocardium of mice subjected to transverse aortic constriction （TAC） surgery and sham operation， as well as in phenylephrine （PE）-induced neonatal rat ventricular cardiomyocytes （NRVCs）， was assessed by real-time quantitative polymerase chain reaction （RT-qPCR） and Western blot assay. The effect of adenovirus-mediated overexpression of IDH3A on the expression of hypertrophy-related genes in PE-induced NRVCs was also evaluated. The effect of IDH3A on NRVCs area was examined by phalloidin staining assay. A mutant of IDH3A with abolished enzymatic activity， IDH3A_D208A， was generated through site-directed mutagenesis. The impact of this IDH3A mutant on the hypertrophic phenotype， ATP and ROS levels in NRVCs was evaluated to investigate whether the regulatory role of IDH3A in cardiomyocyte hypertrophy was dependent on its enzymatic activity. The effect of exogenous α-ketoglutaric acid （AKG） on cardiomyocyte hypertrophy was also detected by Western blot and phalloidin staining assay， respectively. ResultsIDH3A was significantly decreased in the myocardium of HF patients， in the myocardium of TAC-operated mice， and in PE-induced NRVCs （P = 0.005 2，P = 0.026 6，P = 0.041 3 and P = 0.006 6， respectively）. Overexpression of IDH3A markedly suppressed the expression of hypertrophy-related genes and the increase of cell size of PE-induced NRVCs （P < 0.000 1， P = 0.000 1 and P = 0.000 2， respectively）. The ATP and ROS analysis indicated that IDH3A inhibited the increases of ATP and ROS levels in PE-induced NRVCs （P = 0.001 2 and P<0.000 1， respectively）， whereas the enzymatically inactive IDH3A mutant lacked this effect. Exogenous AKG provision could， but overexpression of IDH3A mutant failed to suppress PE-induced NRVCs hypertrophy. ConclusionIDH3A inhibits cardiomyocyte hypertrophy via elevating AKG level， providing scientific evidence for study on IDH3A-based treatment of cardiac hypertrophy.

Objective:To investigate the mechanism of Compound Mufurong Nasal Ointment in interfering with allergic rhinitis in young rats based on the Th1/Th2 cytokines and c-jun N-terminal kinase (JNK) signaling pathway.Methods:Totally 60 young SD male rats were divided into normal group, model group, experimental group, Western medicine group, and combination group according to random number table method, with 12 rats in each group. Except for the normal group, allergic rhinitis rat models were prepared by intraperitoneal injection of ovalbumin and nasal instillation of ovalbumin sensitization in all other groups of rats. After successful modeling, the normal group and the model group were given 0.9% sodium chloride injection 50 μl nasal drip, and the experimental group, the Western medicine group and the combination group were given compound Mufurong Nasal Ointment, fluticasone propionate nasal spray, compound Mufurong Nasal Ointment and fluticasone propionate nasal spray respectively. HE staining was used to observe the pathological morphology of nasal mucosal tissue; ELISA method was used to detect the levels of total IgE, interferon - γ (IFN - γ), IL-1 β, and IL-4 in the serum and nasal lavage fluid of rats in each group; Western blot was used to detect the expressions of JNK and p-JNK proteins in nasal tissues of rats in each group; Immunohistochemistry was used to detect the expressions of p-JNK and p-c-Jun proteins in nasal mucosal tissue.Results:Compared with model group, the levels of IgE, IL-1β and IL-4 in serum and nasal lavage solution of experimental group, western medicine group and combination group decreased ( P<0.05), IFN-γ level increased ( P<0.05); the expressions of JNK and p-JNK protein decreased ( P<0.05), and the expressions of p-JNK and p-c-Jun decreased ( P<0.05). Conclusion:Compound Mufurong Nasal Ointment may regulate Th1/Th2 cytokines through the JNK signaling pathway, inhibit Th2 over-expression, thereby reducing IgE, IL-1 β, IL-4 levels in serum and nasal lavage fluid, up-regulating IFN - γ levels, and intervening in the occurrence of allergic rhinitis.

Objective:To investigate the clinical characteristics and risk factors associated with secondary systemic capillary leak syndrome (SSCLS) induced by acute organophosphorus pesticide poisoning (AOPP). The goal is to enhance clinical understanding of this complication and provide a theoretical foundation for the early identification of high-risk patients and the optimization of individualized treatment strategies.Methods:Clinical data were collected from patients admitted to the Emergency Department of Fuyang People’s Hospital Affiliated to Anhui Medical University between October 2019 and October 2024, who were diagnosed with acute dichlorvos poisoning. The clinical features of SSCLS were described, and patients were categorized into SSCLS and non-SSCLS groups. Binary multivariate logistic regression analysis was conducted on statistically significant indicators to identify independent risk factors for SSCLS. Receiver operating characteristic (ROC) curves were generated to evaluate the predictive value of these factors.Results:Among the 96 patients studied, 37 (38.5%) developed SSCLS. The median time from toxin ingestion to the onset of SSCLS was 3.0 (2.0-5.0) hours. In the 14 SSCLS survivors, the median duration of SSCLS was 50.0 (24-72) hours, whereas in the 23 non-survivors, it was 24.0 (12.0-35.0) hours. The mortality rate in the SSCLS group (62.16%, 23/37) was significantly higher than that in the non-SSCLS group (1.69%, 1/59) ( χ2=44.343, P<0.001). Blood toxin analysis detected trichlorfon components in 92 patients (95.83%). Binary multivariate logistic regression identified APACHE Ⅱ score and trichlorfon concentration (≥706.35 ng/mL) as independent risk factors for SSCLS ( P<0.05). ROC analysis revealed that the combination of these two factors had a higher predictive value ( P<0.05). Conclusions:In the diagnosis and treatment of acute dichlorvos (organophosphorus pesticide) poisoning, particular attention should be given to the combined toxic effects of dichlorvos and trichlorfon, which can lead to SSCLS. The onset and progression of SSCLS are rapid, and the condition is associated with a high mortality rate. Both APACHE Ⅱ scores and trichlorfon concentrations (≥706.35 ng/mL) are independent risk factors for the development of SSCLS, and their combined use enhances predictive accuracy. Early identification of high-risk patients and timely administration of individualized treatment are critical for reducing mortality rates. This revised abstract maintains the original meaning while improving clarity, flow, and readability. It ensures that the key points are presented in a structured and professional manner, suitable for a clinical audience.

OBJECTIVE To establish HPLC methods with different separation principles to analyze the relevant impurities in the APIs of bivalirudin from seven enterprises, to provide a basis for the comprehensive control of related substances of bivalirudin. METHODS Reversed-phase high performance liquid chromatography(RP-HPLC) was used to separate and analyze 11 kinds of impurities. Hydrophilic chromatography(HILIC)-HPLC was used to control four process impurities. Polymers were determined by size exclusion chromatography(SEC)-HPLC. RESULTS The established RP-HPLC could effectively separate the principal component and 11 impurities, the correction factors of 11 impurities were between 0.8−1.2, the detection concentration of bivalirudin was 0.1 μg·mL−1, and the detection limit was 0.004%. The established HILIC-HPLC could effectively separate the principal components and four process impurities, and the detection concentration of bivalirudin was 0.3 μg·mL−1, and the detection limit was 0.01%. Under SEC-HPLC conditions, the polymer and bivalirudin peaked sequentially, the resolution of the two was 2.9, the detection concentration of bivalirudin was 6 ng·mL−1, and the detection limit was 0.000 6%. Fifteen kinds of known impurities and polymers in 15 batches of samples from 7 enterprises were calculated by the self-control method of principal components, and the impurity contents from different enterprises had a certain correlation with their production processes. CONCLUSION The three different principles of the method have good specificity, high sensitivity, good durability, and reliable results, and can be used for quality control of substances related to bivalirudin.

BACKGROUND:Currently,electrospun nanofibers,which are biomimetic materials of natural extracellular matrix and contain a three-dimensional network of interconnected pores,have been successfully used as scaffolds for various tissue regeneration,but are still faced with the challenge of extending the biomaterials into three-dimensional structures to reproduce the physiological,chemical as well as mechanical properties of the tissue microenvironment. OBJECTIVE:To summarize the process and principles of electrostatic spinning and to explore the applications of the resulting electrospun nanofibers in tissue regeneration of skin,blood vessels,nerves,bone,cartilage and tendons/ligaments. METHODS:With"electrospinning,electrospun nanofibers,electrospun nanofiber scaffolds,tissue regeneration"as the Chinese and English search terms,Google Academic Database,PubMed,and CNKI were searched,and finally 88 articles were included for review. RESULTS AND CONCLUSION:(1)The electrospun nanofibers are a natural fibrous extracellular matrix mimetic material and contain a three-dimensional network of interconnected pores that have been successfully used as scaffolds for a variety of tissue regeneration applications.(2)Several papers have described the great potential of electrospun nanofiber scaffolds applied to the regeneration of skin,blood vessels,nerves,bones,cartilage and tendons/ligaments,providing a solid theoretical basis for its final application in clinical disease treatment,or for its transformation into practical products to enter the market.(3)However,the current research results are mostly based on cell experimental research results in vitro,and whether it can be finally applied to human body still needs clinical verification.(4)At present,many kinds of electrospun products for various clinical needs have been commercialized in and outside China,indicating that the research field of electrospun nanofiber scaffolds for soft and hard tissue regeneration has great research value and application potential.

Objective To investigate the common symptoms and associated disease characteristics of hyperhomocysteinemia in cere-bral infarction patients and the correlation analysis of influencing factors.Methods A total of 151 participants with blood homocysteine≥15μmol/L and 86 participants with blood homocysteine＜15μmol/L were identified as the hyperhomocysteinemia with cerebral infarction group(H group)and the normal cerebral infarction group(N group),respectively.The symptoms and influence factors in the two groups were compared.Results Among cerebral infarction patients,patients in H group were older(P=0.049),more male(P=0.002),had a history of smoking(P=0.025),diabetes(P=0.008),hyperlipidemia(P=0.034),folate deficiency(P=0.002)and associated cognitive impairment(P=0.009)and language barrier(P=0.043).Binary Logistic regression analysis showed that age(P=0.023),diabetes(P=0.018),folate deficiency(P=0.026),and cognitive impairment(P=0.019)were independent related factors of in-creased blood homocysteine level.Conclusion Cerebral infarction patients with hyperhomocysteinemia are elderly,and most of them have diabetes,folate deficiency,and cognitive impairment.

Objective:To investigate the efficacy of an extracorporeal diaphragm pacemaker (EDP) combined with airway clearance technology (ACT) in the treatment of pulmonary infection in older adult patients with dementia and its impact on diaphragmatic mobility and thickness.Methods:A total of 60 patients with dementia and pulmonary infections who received treatment at The Second Hospital of Jinhua from June 2022 to February 2023 were included in this prospective study. These patients were randomly divided into an observation group and a control group, with 30 patients in each group. The control group received ACT treatment, while the observation group received EDP treatment on the basis of ACT treatment. Two groups were treated for 4 successive weeks. Efficacy was compared between the two groups. Before and after treatment, sputum color score, sputum quality score, diaphragmatic mobility, and diaphragmatic thickness were compared between the two groups.Results:The overall response rate in the observation group was 93.33% (28/30), which was significantly higher than 73.33% (22/30) in the control group ( Z = 2.08, P = 0.038). After treatment, the sputum color score, sputum quality score, and sputum volume in the observation group were (0.46 ± 0.12) points, (0.34 ± 0.10) points, and (8.47 ± 1.23) mL, respectively, which were significantly lower than (0.89 ± 0.17) points, (0.76 ± 0.18) points, and (13.25 ± 2.87) mL, respectively, in the control group ( t = 11.32, 11.17, 8.38, all P < 0.001). After treatment, the diaphragmatic mobility and thickness in the observation group were (13.52 ± 0.51) mm and (0.52 ± 0.06) mm, respectively, which were significantly greater than (12.76 ± 0.41) mm and (0.44 ± 0.04) mm, respectively, in the control group ( t = -6.36, -6.08, both P < 0.001). Conclusion:The combined application of EDP and ACT shows a significant therapeutic effect on patients with dementia and pulmonary infection, effectively improving their pulmonary function, increasing the mobility and thickness of the diaphragm, and alleviating difficulties in breathing.