Xiaoji Yinzi is one of the classic prescriptions for treating urinary diseases， originated from the Yan's Prescriptions to Aid the Living （Yan Shi Ji Sheng Fang） written by YAN Yonghe in the Song dynasty. Xiaoji Yinzi is composed of Rehmanniae Radix， Cirsii Herba， Talcum， Akebiae Caulis， Typhae Pollen， Nelumbinis Rhizomatis Nodus， Lophatheri Herba， Angelicae Sinensis Radix， Gardeniae Fructus， and Glycyrrhizae Radix et Rhizoma and has the effects of cooling blood and stopping bleeding， draining water and relieving stranguria. The medical experts of later generations have inherited the original prescription recorded in the Yan's Prescriptions to Aid the Living， while dispute has emerged during the inheritance of this prescription. In this study， the method of bibliometrics was employed to review and analyze the ancient documents and modern clinical studies involving Xiaoji Yinzi. The results showed that Xiaoji Yinzi has two dosage forms： powder and decoction. According to the measurement system in the Song Dynasty， the modern doses of hers in Xiaoji Yinzi were transformed. In the prepration of Xiaoji Yinzi powder， 149.2 g of Rehmanniae Radix and 20.65 g each of Cirsii Herba， Talcum， Akebiae Caulis， stir-fried Typhae Pollen， Nelumbinis Rhizomatis Nodus， Lophatheri Herba， wine-processed Angelicae Sinensis Radix， stir-fried Gardeniae Fructus， and stir-fried Glycyrrhizae Radix et Rhizoma are grounded into fine powder with the particle size of 4-10 meshes and a decocted with 450 mL water to reach a volume of 240 mL. After removal of the residue， the decoction was taken warm before meals， 3 times a day （i.e.， 7.77 g Rehmanniae Radix and 0.97 g each of the other herbs each time）. In the preparation of Xiaoji Yinzi decoction， 20.65 g each of the above 10 herbs are used， with stir-fried Typhae Pollen， wine-processed Angelica Sinensis Radix， stir-fired Gardeniae Fructus， stir-fired Glycyrrhizae Radix et Rhizoma， and raw materials of other herbs. Xiaoji Yinzi is specialized in treating hematuresis and blood stranguria due to heat accumulation in lower energizer， which causes injury of the blood collaterals of gallbladder and dysfunction of Qi transformation. In modern clinical practice， Xiaoji Yinzi is specifically used for treating urinary diseases and can be expanded to treat diseases of the cardiovascular system and other systems according to pathogenesis. The comprehensive research on the key information could provide a scientific reference for the future development of Xiaoji Yinzi.

Objective:To evaluate the clinical outcomes of combined complete preservation of chordal structure mitral valve replacement (C-MVR) with total anatomical arterial myocardial revascularization (TACR) in coronary patients with moderate-to-severe or severe ischemic mitral regurgitation (IMR).Methods:This is a retrospective multi-center case series study. Data were retrospectively collected from 127 patients with coronary artery disease with moderate to severe or severe IMR who received TACR with C-MVR from July 2015 to April 2024 in 13 hospitals in China. There were 90 males and 37 females, aged (56.5±10.7) years (range: 33 to 74 years). Perioperative data and follow-up data including left ventricular ejection fraction, left ventricular end-diastolic diameter, and patency rate of arterial grafts of patients were collected. Comparisons were made using paired sample t-test or χ2 test. Results:In this cohort of 127 patients, 67 underwent concurrent tricuspid valve repair. During surgery, 113 grafts of the left internal mammary artery (LIMA), 127 grafts of the left radial artery, 80 grafts of the right radial artery, and 110 grafts of the right internal mammary artery (RIMA) were harvested. The number of the distal anastomosis was 4.2±0.4 (range: 3 to 5). The aortic cross-clamp time and cardiopulmonary bypass time were (97.5±23.4) minutes (range: 90 to 161 minutes) and (145.4±19.2) minutes (range: 101 to 210 minutes), respectively. There was one operative death. Intraoperative placement of an intra-aortic balloon pump was performed in 21 patients to improve the left ventricular ejection. No sternal ischemic occurred. All patients completed follow-up, with a mean follow-up period of (64.3±7.5) months (range: 4 to 110 months). No major cerebrovascular events occurred during the follow-up period, and all patients survived. Left ventricular ejection fraction improved postoperatively (55.0%±5.3% vs. 41.0%±15.3%, t=17.23, P<0.01). The proportion of patients with New York Heart Association functional class ≤2 increased postoperatively (23.6% (30/127) vs. 87.3% (110/126), χ2=103.77, P<0.01). The proportion of patients with Canadian Cardiovascular Society Angina Classification ≤3 decreased postoperatively (4.8% (6/126) vs. 78.7% (100/127), χ2=142.19, P<0.01). The left ventricular end-diastolic diameter decreased postoperatively ((5.70±4.50) cm vs. (6.10±0.23) cm, t=12.15, P<0.01). Coronary multi-detector computed tomography angiography (MDCTA) follow-up was conducted for (60.5±11.7) months (range: 6 to 109 months) postoperatively. MDCTA confirmed the patency rates of the grafts: 96.4% (108/112) for the LIMA grafts, 88.9% (112/126) for the left radial artery grafts, 93.7% (74/79) for the right radial artery grafts, and 90.9% (100/110) for the free RIMA grafts. No significant differences in graft patency rates were observed between the arterial grafts ( χ2=5.24, P=0.155). Conclusion:The results of this multi-centre study demonstrate satisfactory mid-term results of C-MVR with TACR for the treatment of coronary artery disease with moderate to severe or severe IMR.

Objective:To evaluate the clinical outcomes of combined complete preservation of chordal structure mitral valve replacement (C-MVR) with total anatomical arterial myocardial revascularization (TACR) in coronary patients with moderate-to-severe or severe ischemic mitral regurgitation (IMR).Methods:This is a retrospective multi-center case series study. Data were retrospectively collected from 127 patients with coronary artery disease with moderate to severe or severe IMR who received TACR with C-MVR from July 2015 to April 2024 in 13 hospitals in China. There were 90 males and 37 females, aged (56.5±10.7) years (range: 33 to 74 years). Perioperative data and follow-up data including left ventricular ejection fraction, left ventricular end-diastolic diameter, and patency rate of arterial grafts of patients were collected. Comparisons were made using paired sample t-test or χ2 test. Results:In this cohort of 127 patients, 67 underwent concurrent tricuspid valve repair. During surgery, 113 grafts of the left internal mammary artery (LIMA), 127 grafts of the left radial artery, 80 grafts of the right radial artery, and 110 grafts of the right internal mammary artery (RIMA) were harvested. The number of the distal anastomosis was 4.2±0.4 (range: 3 to 5). The aortic cross-clamp time and cardiopulmonary bypass time were (97.5±23.4) minutes (range: 90 to 161 minutes) and (145.4±19.2) minutes (range: 101 to 210 minutes), respectively. There was one operative death. Intraoperative placement of an intra-aortic balloon pump was performed in 21 patients to improve the left ventricular ejection. No sternal ischemic occurred. All patients completed follow-up, with a mean follow-up period of (64.3±7.5) months (range: 4 to 110 months). No major cerebrovascular events occurred during the follow-up period, and all patients survived. Left ventricular ejection fraction improved postoperatively (55.0%±5.3% vs. 41.0%±15.3%, t=17.23, P<0.01). The proportion of patients with New York Heart Association functional class ≤2 increased postoperatively (23.6% (30/127) vs. 87.3% (110/126), χ2=103.77, P<0.01). The proportion of patients with Canadian Cardiovascular Society Angina Classification ≤3 decreased postoperatively (4.8% (6/126) vs. 78.7% (100/127), χ2=142.19, P<0.01). The left ventricular end-diastolic diameter decreased postoperatively ((5.70±4.50) cm vs. (6.10±0.23) cm, t=12.15, P<0.01). Coronary multi-detector computed tomography angiography (MDCTA) follow-up was conducted for (60.5±11.7) months (range: 6 to 109 months) postoperatively. MDCTA confirmed the patency rates of the grafts: 96.4% (108/112) for the LIMA grafts, 88.9% (112/126) for the left radial artery grafts, 93.7% (74/79) for the right radial artery grafts, and 90.9% (100/110) for the free RIMA grafts. No significant differences in graft patency rates were observed between the arterial grafts ( χ2=5.24, P=0.155). Conclusion:The results of this multi-centre study demonstrate satisfactory mid-term results of C-MVR with TACR for the treatment of coronary artery disease with moderate to severe or severe IMR.

Acute type A aortic dissection is a lethal disease that requires immediate surgical intervention and lifesaving measures. The treatment of this condition primarily involves addressing the complex structure and vital role of the aortic root. Since 1968, surgical techniques for aortic dissection type A have rapidly advanced, significantly improving patients' outcomes. In recent years, various approaches to aortic root management have emerged. This article provides a comprehensive overview of these approaches.

Traditional development of small protein scaffolds has relied on display technologies and mutation-based engineering, which limit sequence and functional diversity, thereby constraining their therapeutic and application potential. Protein design tools have significantly advanced the creation of novel protein sequences, structures, and functions. However, further improvements in design strategies are still needed to more efficiently optimize the functional performance of protein-based drugs and enhance their druggability. Here, we extended an evolution-based design protocol to create a novel minibinder, BindHer, against the human epidermal growth factor receptor 2 (HER2). It not only exhibits super stability and binding selectivity but also demonstrates remarkable properties in tissue specificity. Radiolabeling experiments with ^99mTc, ⁶⁸Ga, and ¹⁸F revealed that BindHer efficiently targets tumors in HER2-positive breast cancer mouse models, with minimal nonspecific liver absorption, outperforming scaffolds designed through traditional engineering. These findings highlight a new rational approach to automated protein design, offering significant potential for large-scale applications in therapeutic mini-protein development.

OBJECTIVES: To explore the risk factors for malnutrition in patients with ulcerative colitis complicated with pyoderma gangrenosum and establish a nutritional risk prediction model for these patients. METHODS: A total of 277 patients with ulcerative colitis complicated with pyoderma gangrenosum treated from 2019 to 2024 were divided into malnutrition group (n=185) and normal nutrition group (n=92) according to whether malnutrition occurred. The data of 25 potential related factors pertaining to general demography, living and eating habits, and disease-related data were compared between the two groups. Lasso regression was used to screen the risk factors, and a nomogram model was established based on the screened factors and its prediction performance was assessed. RESULTS: The patients in the malnutrition group and normal nutrition group showed significant differences in 21 factors including gender, age, education level, BMI, place of residence, course of disease, and SAS language score (P<0.05). Lasso regression analysis identified 6 factors associated with malnutrition in these patients, namely the duration of ulcerative colitis, activity of ulcerative colitis, duration of pyoderma gangrenosum, number of chronic diseases, SAS score, and sleep quality. The nomogram prediction model established based on these 6 factors had an AUC of 0.992 (95% CI: 0.984-1.000) for predicting malnutrition in these patients, and its application in 14 clinical cases achieved an accuracy rate of 100%. CONCLUSIONS The duration of ulcerative colitis, activity of colitis, duration of pyoderma gangrenosum, number of chronic diseases, anxiety, and sleep quality are closely related with malnutrition in patients with ulcerative colitis complicated by pyoderma gangrenosum, and the nomogram prediction model based on these factors can provide assistance for predicting malnutrition in these patients.
Humans ; Colitis, Ulcerative/complications* ; Malnutrition/etiology* ; Risk Factors ; Pyoderma Gangrenosum/complications* ; Female ; Male ; Adult ; Nomograms ; Middle Aged ; Nutritional Status ; Regression Analysis

LC-MS/MS methods for the quantitative determination of mecobalamin and ceftriaxone in rat plasma were established, and utilized to assess the pharmacokinetic behaviors of the two drugs in rats and to determine whether there were pharmacokinetics-based drug-drug interactions between them. Methanol was used as a protein precipitant to process rat plasma samples. For mecobalamin, acetonitrile containing 0.1% formic acid was used as the organic phase, while an aqueous solution of 0.1% formic acid and 2 mmol/L ammonium acetate served as the aqueous phase. For ceftriaxone, the organic phase was acetonitrile with 0.1% formic acid, and the aqueous phase was a 1% formic acid aqueous solution. LC-MS/MS quantitative analysis methods for both drugs were developed under the positive ion mode, followed by comprehensive methodological validation. Single-dose administration (either alone or in combination) was carried out via caudal vein injection. The dosing regimens were 0.03, 0.1, and 0.3 mg/kg for mecobalamin and 90 mg/kg for ceftriaxone. The results of methodological validation indicated that mecobalamin exhibited good linearity in the range of 3−3000 ng/mL (r = 0.9991), and ceftriaxone showed excellent linearity in the range of 0.5~500 μg/mL (r = 1). The selectivity, precision, accuracy, extraction recovery, matrix effect, and stability of the analytical methods for both substances met the relevant requirements. The pharmacokinetic study revealed that, compared with single-drug administration, the average plasma concentration-time profiles of the two drugs almost overlapped during single-dose combined administration. Statistical analysis, specifically one-way analysis of variance, demonstrated no significant differences in major pharmacokinetic parameters (t1/2, AUC0−∞, etc.) (P > 0.05). This study confirmed that no pharmacokinetic-based drug-drug interactions occurred when mecobalamin and ceftriaxone were co-administered in rats. The findings of this research offer a reliable pharmacokinetic foundation for the rational clinical co-use of these two drugs, thus providing valuable insights into optimizing therapeutic strategies.

Parkinson's disease(PD)is a common neurodegenerative disorder prevalent among the elderly,characterized primarily by motor impairments and non-motor symptoms.In recent years,exercise therapy has gained widespread recognition for its efficacy in treating motor symptoms of PD as well as alleviating non-motor symptoms such as depression,anxiety,and improving quality of life.Traditional Chinese exercises have also garnered attention as a potential therapeutic approach.This paper provides an overview of recent research progress,with a focus on the roles of three types of traditional Chinese exercises—Wuqinxi,Baduanjin,and Tai Chi—in ameliorating both motor and non-motor symptoms in PD patients.It is hoped that this synthesis will contribute to the integration of traditional exercises into comprehensive treatment plans for PD,providing a reference basis for the scientific implementation of stand-ardized exercise programs and enhancing the feasibility and effectiveness of treatment.

Objective:Exploring the clinical effects of silicone silver ion foam dressing in managing scalp donor site wounds in burn patients.Methods:A retrospective analysis was conducted on the clinical data of burn patients admitted to the 940th Hospital of Joint Logistics Support Force of PLA from January 2020 to January 2023. Patients underwent intraoperative harvesting of split-thickness skin grafting to repair deep burn wounds, with the denuded scalp area covered by either silicone silver ion foam dressing (Group A) or petrolatum gauze (Group B). Comparison of the following 5 parameters between the two groups: (1) Postoperative wound healing time. (2) Initial dressing change pain score was assessed using the numeric rating scale (NRS). 0 points indicated no pain, 1-3 points indicated mild pain, 4-6 points indicated moderate pain, and 7-10 points indicated severe pain. (3) Number of dressing changes. (4) Secondary trauma score, with a total score ranging from 1 to 3, where a higher score indicates more severe trauma. (5) Proportion of wounds healed to grade A (number of grade A healed cases/total number of cases in each group×100%). Depending on the data type, between-group comparisons were performed using t-test, Wilcoxon rank-sum test, or chi-square test. P<0.05 was considered a statistically significant difference. Results:A total of 60 patients, with 30 in each Group A and Group B, were included in the study. Group A was comprised of 18 males and 12 females, with an average age of (29.4±16.6) years. The burn area was (21.43±5.66)% of the total body surface area (TBSA), and the area of skin taken from the scalp was (1.80±0.61)% of TBSA. Group B was comprised of 20 males and 10 females, with an average age of (30.2±16.2) years. The burn area was (21.37±5.67)% of TBSA, and the area of skin taken from the scalp was (1.78±0.63)% of TBSA. No statistically significant differences were observed in gender distribution, age, burn area, and scalp area between the two groups( P>0.05). The wound healing time in the denuded scalp area was shorter in Group A than in Group B [(5.97±0.41) days vs. (6.93±0.58) days, t=-7.40, P<0.001]. The initial NRS pain score during dressing change was lower in Group A than in Group B [3.0 (2.0, 4.0) points vs. 5.5 (4.0, 6.0) points, Z=-4.82, P<0.001]. Group A had fewer frequency of dressing changes compared to Group B [2 (2, 2) vs. 4 (3, 5), Z=-6.64, P<0.001]. The secondary injury score was lower in Group A than in Group B [1 (1, 1) points vs. 3 (3, 3) points, Z=-7.08, P<0.001]. The proportion of grade A healing was 96.7% (29/30) in Group A and 90.0% (27/30) in Group B, with no statistically significant difference between the two groups ( χ2=0.27, P=0.605). Conclusion:The application of silicone silver ion foam dressing to cover the denuded scalp area of burn patients significantly improves therapeutic efficacy compared to petrolatum gauze. It can shorten wound healing time, reduce the frequency of dressing changes, alleviate pain, minimize the occurrence of secondary injuries, and enhance patient comfort.