Objective To optimize the extraction, separation and purification process of Actinoside E. Methods Single factor experiment combined with orthogonal test was used to determine the optimal extraction process of Actinoside E using its content as an index. The extracts were separated and purified by optimizing the chromatographic conditions of macroporous resin, silica gel and ODS column. Results 25 times amount of 55% ethanol with heating reflux at 95℃ for one hour were used as the optimal extraction process of Actinoside E. The optimum separation and purification process was as follows: D101 macroporous resin column was eluted with 7 BV of 50% ethanol, silica gel column was eluted with 5 BV of ethyl acetate-ethanol（10∶1）and 50% methanol eluted fraction was purified repeatedly by ODS column to obtain Actinoside E. The transfer rate of Actinoside E in the whole process was 53.70%, the yield was 0.35%, and the purity was 99.9%. Conclusion The process is stable and viable, which can provide material foundation for the development and utilization of Actinoside E.

Hyperuricemia （HUA） is a common metabolic disorder characterized by persistently elevated serum uric acid levels, leading to uric acid-related renal injury through complex mechanisms involving inflammation, oxidative stress, and fibrosis. Key traditional Chinese medicine （TCM） formulas （e.g., Simiao Powder, Tongfengning） and individual herbal compounds （alkaloids, flavonoids, polysaccharides） with urate-lowering and renal protective properties were systematically summarized, including their mechanisms of regulating uric acid transporters （organic anion transporter 3, urate anion transporter 1, glucose transporter type 9）, inhibiting inflammatory responses （via NF-κB signaling）, reducing oxidative stress （via mitochondrial pathways and antioxidant enzyme enhancement）, and attenuating renal fibrosis （via PI3K/AKT signaling）. The challenges of current studies mainly focus on unclear mechanisms of action and insufficient clinical research. Future research may further explore TCM resources, clarify dual-action mechanisms of urate reduction and renal protection, and identify new therapeutic strategies for hyperuricemia-related renal injury.

BACKGROUND: Generalized pustular psoriasis (GPP), a rare and recurrent autoinflammatory disease, imposes a substantial burden on patients and society. Awareness of GPP in China remains limited. METHODS: This cross-sectional survey, conducted between September 2021 and May 2023 across 14 hospitals in China, included GPP patients of all ages and disease phases. Data collected encompassed demographics, clinical characteristics, economic impact, disease severity, quality of life, and treatment-related complications. Risk factors for GPP recurrence were analyzed. RESULTS: Among 127 patients (female/male ratio = 1.35:1), the mean age of disease onset was 25 years (1st quartile [Q1]-3rd quartile [Q3]: 11-44 years); 29.2% had experienced GPP for more than 10 years. Recurrence occurred in 75.6% of patients, and nearly half reported no identifiable triggers. Younger age at disease onset ( P  = 0.021) and transitioning to plaque psoriasis ( P  = 0.022) were associated with higher recurrence rates. The median diagnostic delay was 8 months (Q1-Q3: 2-41 months), and 32.3% of patients reported misdiagnoses. Comorbidities were present in 53.5% of patients, whereas 51.1% experienced systemic complications during treatment. Depression and anxiety affected 84.5% and 95.6% of patients, respectively. During GPP flares, the median Dermatology Life Quality Index score was 19.0 (Q1-Q3: 13.0-23.5). This score showed significant differences between patients with and without systemic symptoms; it demonstrated correlations with both depression and anxiety scores. Treatment costs caused financial hardship in 55.9% of patients, underscoring the burden associated with GPP. CONCLUSIONS The substantial disease and economic burdens among Chinese GPP patients warrant increased attention. Patients with early onset disease and those transitioning to plaque psoriasis require targeted interventions to mitigate the high recurrence risk.
Humans ; Male ; Female ; Psoriasis/pathology* ; Adult ; Cross-Sectional Studies ; Adolescent ; Child ; Young Adult ; Quality of Life ; Middle Aged ; China/epidemiology* ; Recurrence ; Risk Factors ; Surveys and Questionnaires ; East Asian People

Objective To explore the safety and effects of alpha-lipoic acid (ALA) in patients with ischemic heart failure (IHF). Methods A randomized, double-blind, placebo-controlled trial was designed (ClinicalTrial.gov registration number NCT03491969). From January 2019 to January 2023, 300 patients with IHF were enrolled in four medical centers in China, and were randomly assigned at a 1∶1 ratio to receive ALA (600 mg daily) or placebo on top of standard care for 24 months. The primary outcome was the composite outcome of hospitalization for heart failure (HF) or all-cause mortality events. The second outcome included non-fatal myocardial infarction (MI), non-fatal stroke, changes of left ventricular ejection fraction (LVEF) and 6-minute walking distance (6MWD) from baseline to 24 months after randomization. Results Finally, 138 patients of the ALA group and 139 patients of the placebo group attained the primary outcome. Hospitalization for HF or all-cause mortality events occurred in 32 patients (23.2%) of the ALA group and in 40 patients (28.8%) of the placebo group (HR＝0.753, 95%CI 0.473-1.198, P＝0.231; Figure 1A-1C). The absolute risk reduction (ARR) was 5.6%, the relative risk reduction (RRR) associated with ALA therapy was approximately 19.4% compared to placebo, corresponding to a number needed to treat (NNT) of 18 patients to prevent one event. In the secondary outcome analysis, the composite outcome of the major adverse cardiovascular events (MACE) including the hospitalization for HF, all-cause mortality events, non-fatal MI or non-fatal stroke occurred in 35 patients (25.4%) in the ALA group and 47 patients (33.8%) in the placebo group (HR＝0.685, 95%CI 0.442-1.062, P＝0.091; Figure 1D). Moreover, greater improvement in LVEF (β＝3.20, 95%CI 1.14-5.23, P＝0.002) and 6MWD (β＝31.7, 95%CI 8.3-54.7, P＝0.008) from baseline to 24 months after randomization were observed in the ALA group as compared to the placebo group. There were no differences in adverse events between the study groups. Conclusions These results show potential long-term beneficial effects of adding ALA to IHF patients. ALA could significantly improve LVEF and 6MWD compared to the placebo group in IHF patients.

Objective To investigate the material basis and mechanism of Danshen Baizhu prescription in coronary heart disease, vascular dementia and idiopathic membranous nephropathy based on network pharmacology. Methods TCMSP, PubChem, UniProt, GeneCards, OMIM, and DrugBank databases were used to obtain drug and disease targets, and the TCM-compound-drug target network, compound-common target-disease network, and protein-protein interaction map were drawn by STRING database and Cytoscape software, and gene enrichment analysis was performed by Metascape database. Results A total of 164 active compounds, 509 potential targets, and 141 common targets were screened out. The main active ingredients were Tanshinone II A, Isorhamnetin, Quercetin, Luteolin, Kampferol, β-sitosterol, Stigmasterol, etc. The key targets were albumin, interleukin 6, Tumor necrosis factor , serine/threonine kinase 1, vascular endothelial growth factor A , mainly enriching in the positive regulation of cell migration, cell viability, protein phosphorylation, responsing to growth factors, oxidative stress and other biological processes and lipid and atherosclerosis, MAPK, atherosclerosis and fluid shear force, AGE-RAGE, IL-17, PI3K-Akt and other signaling pathways. Conclusion The mechanism of action of Danshen Baizhu prescription for coronary heart disease, vascular dementia and idiopathic membranous nephropathy may mainly play a role in multiple targets and pathways such as inhibition of inflammation, inhibition of oxidative stress, and vasodilation.

The method of promoting blood circulation and removing blood stasis refers to the use of traditional Chinese medicine with a dispersing effect that can eliminate blood stasis in the body to treat the syndrome of blood stasis, which has the effects of unblocking blood vessels, dissipating stasis, regulating menstruation and relieving pain and are widely used for conditions such as chest tightness, heartache, dementia, menstrual disorders caused by blood stasis. Common medicines include Salvia miltiorrhiza Bunge, Panax notoginseng （Burkill）, Ligusticum chuanxiong Hort, Radix Curcumae, etc. Blood activating and stasis removing drugs generally have the effects of improving microcirculation, relaxing blood vessels, inhibiting thromboxane formation, and inhibiting platelet aggregation. They have good therapeutic effects on blood stasis syndrome in diseases such as coronary heart disease, angina pectoris, and vascular dementia. The research progress on traditional Chinese medicine and modern medicine on the treatment of vascular dementia with blood activating and stasis removing drugs were reviewed, in order to provide reference for the clinical application of blood activating and stasis removing methods in the treatment of vascular dementia.

Porcine reproductive and respiratory syndrome(PRRS),an infectious disease,poses a significant threat to the swine industry.The causative agent of the disease is porcine reproductive and respiratory syndrome virus(PRRSV),which primarily infects porcine alveolar macrophages and destroys the immune system.In the absence of specific antiviral drugs targeting PRRSV,vacci-nation is of paramount importance for the prevention and control of this disease.Currently,there are numerous types of PRRS vaccines,such as attenuated live vaccines,inactivated vaccines,sub-unit vaccines,DNA vaccines,vector vaccines,and so forth.However,only attenuated live virus and inactivated virus vaccines are widely employed for the prevention and control of PRRS.Live vac-cines offer relatively better protection effects,but they have weak cross-protection and pose safety concerns.Inactivated vaccines are safe but have poor immunogenicity.This article conducts a com-prehensive review of the advantages,disadvantages,and applicability of PRRS vaccines,including attenuated live vaccines,inactivated vaccines,subunit vaccines,vector vaccines,DNA vaccines,mR-NA vaccines,virus-like particle vaccines,etc.,aiming to provide a theoretical basis for the research and development of the next generation of PRRS vaccines.

Objective:To develop a treatment-related quality of life scale for Chinese patients with multiple myeloma (MM) and to test its reliability and validity.Methods:The initial scale was constructed through a literature search, Delphi expert correspondence, and cognitive testing. This study conducted a preliminary survey of 379 patients with MM and a formal survey of 865 patients from the hematology departments of 155 hospitals nationwide from February 2024 to March 2024. The final scale was obtained after conducting item analysis and reliability and validity tests on the initial scale.Results:The constructed scale contains 36 items covering six domains: physiological, psychological, social, treatment side effects, general health, and others. In the preliminary survey, the Cronbach’s alpha coefficient of each item ranged from 0.597 to 0.939, and the test-retest reliability was 0.747 ( P<0.001). Exploratory factor analysis extracted eight common factors with a cumulative variance contribution of 60.058%. In the formal survey, the Cronbach’s alpha coefficient of each item ranged from 0.484 to 0.930, and the test-retest reliability was 0.835 ( P<0.001). Confirmatory factor analysis revealed a comparative fit index of 0.750, a root-mean-square error of approximation of 0.090, and a root-mean-square residual of 0.067. Conclusion:The treatment-related quality of life scale for Chinese patients with MM designed in this study exhibited good reliability and validity, reflecting the impact of treatment on the quality of life of patients. This scale can provide a reference to clinicians for assessing the disease status of patients.

Objective:To investigate the clinical phenotype and genetic characteristics of a family with Dentinogenesis imperfecta type Ⅰ(DGI-Ⅰ).Methods:Clinical data were collected from a patient with DGI-Ⅰ admitted to the Reproductive Medicine Department of the Affiliated Hospital of Jining Medical University in March 2024. Clinical and familial data were retrospectively collected. Peripheral blood samples (5 mL each) were obtained from the proband and her family members for genomic DNA extraction, followed by whole-exome sequencing (WES) and Sanger sequencing validation. The pathogenicity of the detected variants was assessed according to the Classification Standards and Guidelines for Genetic Variants formulated by the American Society of Medical Genetics and Genomics (ACMG) (hereinafter referred to as the " ACMG Guidelines" ). The study was approved by the Ethics Committee of the Affiliated Hospital of Jining Medical University (Ethics No. 2024-08-C012), and written informed consent for clinical research were obtained from all participants.Results:The proband, a 35-year-old female, presented with translucent yellow primary teeth and progressive browning, darkening, and loss of permanent teeth, without skeletal abnormalities. Affected family members exhibited similar phenotypes. Genetic testing revealed a heterozygous COL1A2 variant (c.1503+ 1G>A) in the patient and other members, while unaffected family all members lacked this variant. Based on the ACMG Guidelines, this variant was classified as likely pathogenic(PM4 + PP1_Strong + PM2_Supporting). Conclusion:The COL1A2 c. 1503+ 1G>A heterozygous variant is the disease-causing mutation in this family. Above finding has expanded the mutational spectrum of the COL1A2 gene and provided a basis for genetic counseling and diagnosis in similar cases.

Porcine reproductive and respiratory syndrome(PRRS),an infectious disease,poses a significant threat to the swine industry.The causative agent of the disease is porcine reproductive and respiratory syndrome virus(PRRSV),which primarily infects porcine alveolar macrophages and destroys the immune system.In the absence of specific antiviral drugs targeting PRRSV,vacci-nation is of paramount importance for the prevention and control of this disease.Currently,there are numerous types of PRRS vaccines,such as attenuated live vaccines,inactivated vaccines,sub-unit vaccines,DNA vaccines,vector vaccines,and so forth.However,only attenuated live virus and inactivated virus vaccines are widely employed for the prevention and control of PRRS.Live vac-cines offer relatively better protection effects,but they have weak cross-protection and pose safety concerns.Inactivated vaccines are safe but have poor immunogenicity.This article conducts a com-prehensive review of the advantages,disadvantages,and applicability of PRRS vaccines,including attenuated live vaccines,inactivated vaccines,subunit vaccines,vector vaccines,DNA vaccines,mR-NA vaccines,virus-like particle vaccines,etc.,aiming to provide a theoretical basis for the research and development of the next generation of PRRS vaccines.