ObjectiveThis study aims to explore the mechanism of action of Huangqi Guizhi Wuwutang in treating rheumatoid arthritis （RA）-associated sarcopenia by regulating autophagy and improving skeletal muscle homeostasis based on network pharmacology，bioinformatics，machine learning，and animal experiments. MethodsActive ingredients and targets of Huangqi Guizhi Wuwutang were screened using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP），PubChem，and SwissTargetPrediction databases. RA-related datasets were retrieved from the GEO database，and differential genes were screened. Sarcopenia-related targets were searched through GeneCards and the Comparative Toxicology Database （CTD），and autophagy-related gene sets were downloaded from the Human Autophagy Database （HADb）. Their intersection was analyzed to identify autophagy-related therapeutic targets，followed by enrichment analysis. A protein-protein interaction （PPI） network was constructed using the STRING database，and key targets were selected using multiple methods. Machine learning was applied to predict models based on the expression profiles of intersecting targets，and nomogram models were constructed based on key targets. Molecular docking of the top four active ingredients with key targets was performed using AutoDockVina. A collagen-induced arthritis （CIA） rat model was established using bovine type Ⅱ collagen，with SD rats divided into groups including a blank group，a model group，and low-，medium-，and high-dose groups of Huangqi Guizhi Wuwutang （2.44，4.88，and 9.76 g·kg^-1） and administered for five consecutive weeks. Joint scores and gastrocnemius muscle mass were recorded and analyzed after modeling. Hematoxylin and eosin （HE） staining and Masson's staining were used to observe pathological changes in muscle tissue. Immunofluorescence staining was applied to observe the protein expression levels of myosin heavy chain （MYHC） and insulin-like growth factor-1 （IGF-1） in skeletal muscle. Western blot was used to detect the protein expression levels of autophagy-related proteins ATG5，Beclin1，LC3B，muscle-specific proteins （MuRF1），MaFbx，and MYHC. Real-time quantitative reverse transcription PCR （Real-time PCR） was performed to measure the mRNA expression levels of ATG5，Beclin1，LC3B，MuRF1，MaFbx，and MYHC in muscle tissue. ResultsNetwork pharmacology revealed that Huangqi Guizhi Wuwutang shared 25 common targets with autophagy genes related to RA-associated sarcopenia. The PPI network and machine learning identified six key targets，which were primarily involved in autophagy and inflammatory pathways. Animal experiments showed that compared to the blank group，the model group had significantly higher joint scores （P<0.01） and lower gastrocnemius muscle index （P<0.01）. HE staining indicated a significant reduction in the cross-sectional area of gastrocnemius muscle fibers，with notable inflammatory cell infiltration and muscle atrophy in the model group. Masson's staining revealed obvious collagen fiber proliferation and deposition，with significant muscle fibrosis in the model group. The protein and mRNA expression levels of ATG5，Beclin1，LC3B，MuRF1，and MaFbx were significantly increased （P<0.01），while the protein expression of MYHC and IGF1 was significantly downregulated （P<0.01）. Compared with the model group，the high-dose group of Huangqi Guizhi Wuwutang showed significantly reduced protein and mRNA expression levels of ATG5，Beclin1，LC3B，MuRF1，and MaFbx （P<0.01） and increased protein expression levels of MYHC and IGF1 （P<0.01）. The cross-sectional area of muscle fibers increased，and the muscle cell morphology approached normal. Moreover，pathological abnormalities in the gastrocnemius muscle were significantly improved，with reduced collagen fiber proliferation （P<0.01）. ConclusionHuangqi Guizhi Wuwutang can mediate autophagy by regulating the expression of ATG5，Beclin1，LC3B，and IGF1，thereby reducing skeletal muscle catabolism and improving skeletal muscle homeostasis，which contributes to the treatment of RA-associated sarcopenia. The findings provide insight into the mechanisms underlying the effects of Huangqi Guizhi Wuwutang in the treatment of RA-related sarcopenia and offer a reference for its enhanced clinical application.

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*

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective To analyze the risk factors for iatrogenic pseudoaneurysm(PSA)occurring after cardiovascular interventional procedures.Methods The clinical data of 48 patients,who developed PSA after receiving cardiovascular interventional procedure at the Yantai Yuhuangding Hospital of China between January 2018 and December 2022,were retrospectively analyzed.The control group included 192 patients who had no PSA.At a case-control ratio of 1∶4,the PSA patients and non-PSA patients were paired,and the paired indicators included age,and puncture site.Univariate and multivariate logistic regression analyses were used to analyze the patients'basic data,hematological examination,and situation of the interventional procedure,and the independent risk factors were screened out.Results Multivariate logistic regression analysis showed that the high body mass index(BMI,OR=1.324,95％CI=1.097-1.598,P=0.003),smoking history(OR=4.477,95％CI=1.599-12.536,P=0.004),use of antiplatelet agents(OR=4.861,95％CI=1.018-23.214,P=0.047),combination use of antiplatelet and anticoagulant(OR=26.994,95％CI=2.353-309.686,P=0.008),the operator of the interventional procedure being an attending physician(OR=5.817,95％CI=1.139-29.717,P=0.034),low haemoglobin level(OR=0.946,95％CI=0.922-0.971,P＜0.01),elevated D-dimer level(OR=2.407,95％CI=1.367-4.239,P=0.002),long-time interventional operation(OR=1.019,95％CI=1.005-1.033,P=0.009),and sheath size＞6 F(OR=4.368,95％CI=1.196-15.947,P=0.026)were the independent risk factors for PSA occurring after cardiovascular interventional surgery.Conclusion High BMI,smoking history,use of antiplatelet agents,combination use of antiplatelet and anticoagulant,the operator of the interventional procedure being an attending physician,low haemoglobin level,elevated D-dimer level,long-time interventional operation,and sheath size＞6 F are the independent risk factors for PSA occurring after cardiovascular interventional procedure,which can provide a basis for the early prevention of PSA.(J Intervent Radiol,2024,33:646-650)

Arsenic (As) is a common toxic pollution element. The microorganism-mediated transformation of arsenic forms is an important part in the biogeochemical cycle of As. In the various microbial metabolic processes involving As, the coupling reduction of As has a great impact on the environment and is a process that is easily overlooked. From the biogeochemical cycle of As, this review introduces the microorganism-mediated methane oxidation, anaerobic ammonium oxidation, and iron (Fe)-sulfur (S) oxidation coupled with As reduction. Organic matter, pH, and redox potential are the main factors affecting the coupling reduction. After the coupling reduction, the toxicity and migration of As are greatly enhanced, which may increase the risk of As pollution. Therefore, it is of great significance to clarify the influences of carbon, nitrogen, Fe, S and other elements on the coupling process and explore more microbial processes coupled with As reduction for the prevention and control of As pollution.
Arsenic/metabolism* ; Oxidation-Reduction ; Bacteria/metabolism* ; Environmental Pollutants/metabolism* ; Biodegradation, Environmental ; Methane/metabolism* ; Iron/metabolism* ; Ammonium Compounds/metabolism*

Excessive levels of cadmium (Cd) in soil exert serious negative impacts on soil ecosystems. Microorganisms are a common component of soil and show great potential for mitigating soil Cd. This review summarizes the application and remediation mechanisms of microorganisms, microbial-plants, and microbial-biochar in Cd-contaminated soil. Microorganisms such as Bacillus, Acinetobacter, Pseudomonas, and arbuscular mycorrhizal fungi (AMF) can change the biological validity of Cd through adsorption, mineralization, precipitation and dissolution. Different factors such as pH, temperature, biomass, concentration, and duration have significant effects on Cd bioavailability by microorganisms. Pseudomonas, Burkholderia, and Flavobacterium can promote the uptake of Cd²⁺ by hyperaccumulator through promotion and activation. Biochar, a soil amendment, possesses unique physicochemical properties and could act as a shelter for microorganisms in agriculture. The use of combined microbial-biochar can further stabilize Cd compared to using biochar alone.
Cadmium ; Ecosystem ; Soil Pollutants ; Charcoal/chemistry* ; Soil/chemistry*

OBJECTIVE: To determine the genotype of an individual suspected for Aw through DNA sequencing. METHODS: Serologic testing was carried out with standard methods. Exons 6 and 7 of the ABO genes were amplified by PCR and subjected to direct sequencing or sequenced after gene cloning. RESULTS: Serological testing showed that the forward typing and reverse typing were Aw and A, respectively. DNA sequencing revealed that the individual has carried an Aw allele and an O allele. Haplotype sequencing of each allele has revealed a nt543 variant (543G>C) in the Aw allele. CONCLUSION The individual was verified as a rare A subtype, which was previously unreported in mainland China.
ABO Blood-Group System/genetics* ; Alleles ; Exons ; Genotype ; Humans ; Phenotype

Objective To improve the quality control of Dilong Shenmai oral liquid. Methods TLC was used for the qualitative identification of Astragali Radix, Ophiopogonis Radix and Schisandrae Chinensis Fructus in Dilong Shenmai oral liquid. HPLC was used to determine the contents of schisandrin and ethylparaben in the preparation. Wondasil C₁₈ column (250 mm×4.6 mm, 5 μm) was used with acetonitrile-water as the mobile phase at the flow rate of 1.0 ml/min for gradient elution. The detection wavelength was set at 254 nm, and column temperature was 30 ℃. Results TLC spots were clear and well-separated without negative interference. The linear ranges of schisandrin and ethylparaben were 5.81−58.06 μg/ml (r=0.999 9) and 25.29−252.94 μg/ml (r=0.999 9). The average recoveries were 99.35% (RSD=1.02%) and 99.72% (RSD=0.76%). Conclusion This method is simple, quick and accurate. It can be used for effective quality control of Dilong Shenmai oral liquid.

Objective: To understand the longitudinal changes of refractive errors in adolescent myopia screening in the suburb of Shanghai, and to provide reference for targeted measures of myopia prevention and intervention. Methods: By using the cluster sampling method, 1 346 students were selected from two primary schools in a town in the suburb of Shanghai. Physical development indicators and refractive examination parameters of non ciliary muscle paralysis, and uncorrected visual acuity in 2017 and 2020 were collected from the Shanghai adolescent refractive development file. Longitudinal change of spherical equivalent (SE) refractive were assessed. A linear regression model was used to examine the relationship between the rate of SE change with characteristics of the students. Results: The average annual incidence of myopia was 16.36%, and the SE degrees of the left and right eyes of myopia students decreased by 225 degrees for three years. Girls (right eye Z=-4.33; left eye Z=-3.75, P<0.01), newly-onset myopia and persistent myopia (right eye Z=634.45; left eye Z=638.85, P<0.01) was a key for the rapid progress of refractive power. Conclusion The proportion of students with severe low vision is relatively high, and the apparent shifts toward more hyperopia in myopia students call for effective prevention and control programs based on changes in refractive to slow the progression of adolescent myopia.