This paper summarizes professor LI Guolie's clinical experience in treating orthostatic hypotension （OH） based on the theory of "raising the clear and directing the turbid downward". It is considered that the core pathogenesis of OH lies in the body's transition from a supine to an upright position， during which dysfunction of the middle jiao （焦） transformation and transportation， along with impaired pivot function， hinders the ascending of clear yang and the descending of turbid yin. Treatment should follow the general principle of "ascending the clear and directing the turbid downward"， placing emphasis on distinguishing the primary and secondary aspects. For cases where the clear yang fails to ascend， the self-formulated Li's Shengqing Jiangzhuo Decoction （李氏升清降浊汤）is used to supplement qi， raise the clear， and strengthen the middle jiao. For cases where the turbid yin fails to descend， the self-formulated Wuxiang Qingzhuo Beverage（五香清浊饮）with modifications is applied to resolve phlegm， eliminate stasis， harmonize the middle， and descend the turbid.

This paper summarizes professor LI Guolie's clinical experience in treating orthostatic hypotension （OH） based on the theory of "raising the clear and directing the turbid downward". It is considered that the core pathogenesis of OH lies in the body's transition from a supine to an upright position， during which dysfunction of the middle jiao （焦） transformation and transportation， along with impaired pivot function， hinders the ascending of clear yang and the descending of turbid yin. Treatment should follow the general principle of "ascending the clear and directing the turbid downward"， placing emphasis on distinguishing the primary and secondary aspects. For cases where the clear yang fails to ascend， the self-formulated Li's Shengqing Jiangzhuo Decoction （李氏升清降浊汤）is used to supplement qi， raise the clear， and strengthen the middle jiao. For cases where the turbid yin fails to descend， the self-formulated Wuxiang Qingzhuo Beverage（五香清浊饮）with modifications is applied to resolve phlegm， eliminate stasis， harmonize the middle， and descend the turbid.

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality, characterized by poor prognosis due to its high proliferative and invasive potential. Tumor metabolic reprogramming, particularly involving glucose metabolism, is essential for tumor survival. This study investigates the role of the Hippo pathway effector transcriptional co-activator with PDZ-binding motif (TAZ) in regulating gluconeogenesis and promoting tumorigenesis in HCC. Methods: TAZ expression in HCC was analyzed using The Cancer Genome Atlas data and validated in clinical samples and cell lines. TAZ was overexpressed or silenced in HCC cell lines to evaluate its effects on cell proliferation, apoptosis, migration, and invasion. The expression and prognostic relevance of the gluconeogenesis-related genes phosphoenolpyruvate carboxykinase 1 (PCK1) and glucose-6-phosphatase (G6PC) were examined, along with their correlation with TAZ expression. Tumor growth was assessed in nude mice. Interactions between TAZ and the glucocorticoid receptor (GR) were investigated using co-immunoprecipitation, immunofluorescence, and chromatin immunoprecipitation assays. Results: TAZ was significantly upregulated in HCC tissues and cell lines. TAZ overexpression enhanced proliferation, reduced apoptosis, and promoted migration and invasion. In contrast, PCK1 and G6PC were downregulated in HCC and showed a negative correlation with TAZ expression. Conclusion TAZ modulates gluconeogenesis and accelerates tumor growth, whereas its knockdown attenuates tumor progression. TAZ interacts with GR, suppressing its transcriptional activity on gluconeogenic gene promoters.

With the emergence of deep learning techniques based on convolutional neural networks, artificial intelligence (AI) has driven transformative developments in the field of medical image analysis. Recently, large language models (LLMs) such as ChatGPT have also started to achieve distinction in this domain. Increasing research shows the undeniable role of AI in reshaping various aspects of medical image analysis, including processes such as image enhancement, segmentation, detection in image preprocessing, and postprocessing related to medical diagnosis and prognosis in clinical settings. However, despite the significant progress in AI research, studies investigating the recent advances in AI technology in the aforementioned aspects, the changes in research hotspot trajectories, and the performance of studies in addressing key clinical challenges in this field are limited. This article provides an overview of recent advances in AI for medical image analysis and discusses the methodological profiles, advantages, disadvantages, and future trends of AI technologies.
Artificial Intelligence ; Humans ; Image Processing, Computer-Assisted/methods* ; Neural Networks, Computer ; Deep Learning ; Diagnostic Imaging/methods*

Objective:To investigate the incidence of postoperative infection and its risk factors in patients with oral squamous cell carcinoma (OSCC), so that to provide a clinical basis for the prevention and management of postoperative infection in these patients.Methods:Ninety-seven patients pathologically diagnosed with OSCC who underwent surgical treatment in the Department of Oral and Craniomaxillofacial Oncology, Shanghai Ninth People′s Hospital, Shanghai Jiaotong University School of Medicine between December 2020 and March 2022 were included. This study was a clinical retrospective cohort study. The clinical characteristics and preoperative laboratory indicators of the included patients were collected. Based on the presence or absence of infection, the patients were divided into infection group and non-infection group. Chi-square test and independent samples t test were used for statistical methods. Binary logistic regression analysis was used to identify influencing factors for postoperative infection, and interaction terms were introduced to assess effect modification between variables. Results:Among the 97 patients, 46(47.42%) developed postoperative infections, of which 44(95.65%) were pulmonary infections. The proportion of hypertension in the infection group was 43.48%(20/46), which was higher than 23.53%(12/51) in the non-infection group, and the difference was statistically significant ( χ2=4.35, P=0.037). The preoperative glycosylated hemoglobin level in the infection group was 6.26%±0.85%, which was higher than that in the non-infection group (5.77%±0.57%), and the difference was statistically significant ( t=-2.81, P=0.007). Binary logistic regression analysis showed that male (odds ratio ( OR)=0.598, 95% confidence interval ( CI) 0.519 to 0.689, P<0.001), absence of diabetes ( OR=0.416, 95% CI 0.340 to 0.509, P<0.001), and absence of hypertension ( OR=0.647, 95% CI 0.569 to 0.735, P<0.001) were protective factors against postoperative infection. Age>60 years ( OR=1.159, 95% CI 1.031 to 1.304, P=0.014) and alcohol consumption ( OR=1.262, 95% CI 1.024 to 1.555, P=0.029) were risk factors for postoperative infection. Effect modification analysis found that males without diabetes ( OR=0.027, 95% CI 0.001 to 0.687, P=0.029) and the absence of both diabetes and hypertension ( OR=0.378, 95% CI 0.163 to 0.880, P=0.024) were also protective factors against postoperative infection. Conclusions:Risk factors for postoperative infection in OSCC include elder age, alcohol consumption, hypertension, and poor preoperative glycemic control. Therefore, clinical practice should enhance preoperative assessment, promote lifestyle modifications, optimize perioperative blood pressure management, implement glycemic control, and provide perioperative alcohol cessation interventions to reduce the risk of postoperative infection.

This paper expounds Professor Li Guolie's academic thought and clinical experience in treating the halitosis of spleen and stomach damp-heat type based on the theory of"lightness removing excess".It is proposed that"lightness"has five meanings:light and clear medicinal properties,light dosage,concise compatibility,light decoction method and light treatment method;"excess"covers the syndromes of external and internal injuries,obstruction of qi mechanism and mixed deficiency and excess.The location of the halitosis of spleen and stomach damp-heat type is centered on the spleen and stomach in the middle energizer,involving the lungs,liver,and kidneys,with syndromes of mixed deficiency and excess;the core pathogenesis is the stagnation of qi mechanism in the mid-dle energizer and the diffusion of damp-heat turbid evil in the triple energizers.The theory of"lightness removing excess"is used to guide the treatment of spleen and stomach diseases of damp-heat type,and the treatment principle of"triple energizers being divided and eliminated,and lightness being able to penetrate and reach the evil"is proposed.The upper energizer is promoted to activate the pivot of qi transformation,the middle energizer is adjusted to restore the mechanism of ascending and descending,and the lower energi-zer is penetrated to guide the turbid evil out.The self-made"Wuxiang Qingzhuo Yin"is used to gargle to quickly remove the turbid e-vil and symptoms,forming an internal and external coordinated diagnosis and treatment method of"light dosage to regulate the pivot,ingenious method to clear the obstruction",which provides new ideas and theoretical basis for the clinical diagnosis and treatment of spleen and stomach diseases of damp-heat type.

Objective:To investigate whether changes in CT pulmonary angiography (CTPA) parameters before and after balloon pulmonary angioplasty (BPA) are correlated with treatment effects in patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods:A retrospective study was conducted, including patients with CTEPH who underwent BPA treatment at Beijing Anzhen Hospital from November 2021 to Febbruary 2024. Clinical data and CTPA parameters were analyzed before the initial BPA session and at least 6 months after the final BPA session. Clinical data included WHO functional class, 6-minute walk distance (6MWD), and plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. The CTPA parameters included the widest diameter of the pulmonary artery diameter (dPA), ascending aorta diameter (dAA), the widest transverse diameter of the right atrium (dRA), the widest short-axis diameter of the right ventricle (dRV), the widest short-axis diameter of the left ventricle (dLV), and the diameter of right ventricular free wall thickness(dRVW). Multiple linear regression was applied to identify variables associated with the decrease in mean pulmonary artery pressure (mPAP) among the CTPA parameters.Results:All CTEPH patients underwent a total of 115 BPA treatments. Postoperatively, the WHO functional class of the patients improved compared to preoperative levels ( χ2=5.01, P<0.001), 6MWD improved ( t=4.50, P<0.001), and NT-proBNP levels decreased ( Z=4.47, P<0.001). Hemodynamic parameters, including mPAP, pulmonary vascular resistance, cardiac output, and cardiac index, were significantly improved postoperatively (all P<0.001). CTPA-related parameters, including dPA, dRA, dRV, dRVW, dPA/dAA, dRV/dLV, and dRA/dPA, significantly decreased compared to preoperative values (all P<0.001). Multiple linear regression analysis showed that the decrease in dPA ( β=0.314, P=0.037) and dRA ( β=0.334, P=0.046) were significantly correlated with the improvement in mPAP. Conclusions:Exercise tolerance, hemodynamics, and CTPA parameters in patients with CTEPH significantly improved after BPA treatment. The decrease in dPA and dRA were significantly correlated with the improvement in mPAP, suggesting that CTPA is a potentially novel, objective, effective, and noninvasive method for evaluating the therapeutic efficacy of BPA.

Objective:To prepare rabbit polyclonal antibody against human FAM21 and analyze antibody specificity.Methods:Using the plasmid encoding human FAM21 full-length gene as a template,the nucleotide sequence of its 2 431～3 006 base was amplified by PCR and connected to the pGEX-6p-1 prokaryotic expression vector to construct pGEX-6P-1-FAM21 recombinant plasmid expressing the 811～1 002 amino acid fragment of FAM21.The recombinant plasmid was transformed into BL21(DE3)compe-tent Escherichia coli and was expressed inductively,and the protein was purified using GST fusion protein purification magnetic beads.The purified GST fusion protein was used as an antigen to immunize New Zealand rabbits,and the collected antiserum was purified by an agarose column containing GST protein.The specificity of antibody was detected by Western blot and immunofluorescence assay in stable FAM21 knockdown HeLa cells.Results:The pGEX-6p-1-FAM21 prokaryotic expression plasmid was successfully constructed and induced to express in BL21(DE3)competent Escherichia coli.The purified GST fusion protein had a molecular weight of approxi-mately 50 kD,and the purified antibody titer from immunized New Zealand rabbits was greater than 1∶128 000,with high specificity.Conclusion:The pGEX-6p-1-FAM21 prokaryotic expression plasmid is successfully constructed,and the rabbit polyclonal antibody against human FAM21 is prepared for Western blot and immunofluorescence assay.

Chronic thromboembolic pulmonary hypertension(CTEPH)is a potentially life-threatening pulmonary vascular disease,which belongs to the fourth largest category of pulmonary hypertension as defined in the 2022 European Society of Cardiology guidelines.Percutaneous balloon pulmonary angioplasty(BPA)is an interventional technique,which uses continuous and phased balloon expansion to treat the narrowed site under pulmonary angiography guidance,providing a completely new therapeutic method for CTEPH patients who are unable to receive surgical treatment and for CTEPH patients who have post-surgical residual pulmonary hypertension.This paper comprehensively introduces the interventional therapeutic technology of BPA,focusing on the development history,the clinical indications and the development of operative technique of BPA,meanwhile,the latest development of BPA in the treatment of CTEPH is also introduced.

Objective To investigate the neuroprotective effect of TGP on PS rats and determine the impact on the Ste20-like proline/alanine-rich kinase/Na+-K+-Cl cotransport(SPAK/NKCC1)signaling pathway.Methods After PS model was successfully established in 60 male SD rats(7 weeks old),they were randomly divided into model group,low-and high-dose TGP groups,high-dose TGP+negative control group,and high-dose TGP+WNK3 overexpression group,with 12 rats in each group.Another 12 healthy rats served as the control group.After modeling,50 or 200 mg/kg TGP was given to the rats of corresponding groups intragastrically,the overexpression plasmids of WNK3 were given to the rats from the high-dose TGP+WNK3 overexpression group through tail vein injection,and same volume of normal saline was given to the control group.All of these agents were administrated once per day for 7 consecutive days.ELISA was applied to de-tect serum levels of IL-6,IL-1β,MDA and SOD.HE staining was applied to detect the pathological morphology of the substantia nigra region in brain tissue.TUNEL staining was used to observe neuronal apoptosis.Immunohistochemistry was conducted to measure the expression of α-synucle-in(α-syn),and Western blotting for the expression of Bax,Bcl-2 and SPAK/NKCC1 signaling pathway related proteins(WNK3,p-SPAK,SPAK,p-NKCC1 and NKCC1).Results Compared with the model group,the pathological damage of neurons in substantia nigra was reduced in low-and high dose TGP groups,reduced contents of IL-6,IL-1β and MDA,lower neuronal apoptotic rate,and declined expression of Bax,α-syn,WNK3,p-SPAK/SPAK,and p-NKCC1/NKCC1,but raised SOD content and Bcl-2 expression level(88.39±8.96 U/mg,119.57±12.01 U/mg vs 60.28±6.14 U/mg,P＜0.05;0.57±0.06,0.82±0.09 vs 0.38±0.04,P＜0.05).The intervention with WNK3 overexpression resulted in more severe pathological damage to neurons in the sub-stantia nigra,increased contents of IL-6,IL-1β and MDA,higher neuronal apoptotic rate,enhanced expression of Bax,α-syn,WNK3,p-SPAK/SPAK,and p-NKCC1/NKCC1,and reduced SOD con-tent and Bcl-2 expression level when compared with the high-dose TGP+negative control group(P＜0.05).Conclusion TGP exerts neuroprotective effects on PS rats,and its mechanism is re-lated to the inhibition of the SPAK/NKCC1 signaling pathway.