AIM: To investigate the expression of Ficolin-3 and secreted frizzled-related protein 5(SFRP5)in the serum of patients with type 2 diabetes mellitus(T2DM)combined with diabetic retinopathy(DR)and their diagnostic value.METHODS: Prospectively selected patients with T2DM combined with DR admitted to the hospital from May 2023 to May 2025 were divided into non-proliferative and proliferative groups according to the severity of DR. Another patients with T2DM alone during the same period were selected as the T2DM group. ELISA was used to detect Ficolin-3 and SFRP5 levels; Correlation of serum Ficolin-3, SFRP5 levels, and inflammatory markers in T2DM patients with DR were analyzed using Pearson method; Logistic regression was used to analyze related influencing factors; ROC curve analysis was used to evaluate the diagnostic value of serum Ficolin-3 and SFRP5 for DR in T2DM patients.RESULTS: This study included a total of 108 patients with T2DM combined with DR(57 cases in the non-proliferative group, 51 cases in the proliferative group)and 108 cases in the T2DM group. The non-proliferative group had an average age of 59.01±6.28 y, with 34 males and 23 females. The proliferative group had an average age of 59.09±6.35 y, with 30 males and 21 females. The T2DM group had an average age of 58.96±6.18 y, with 62 males and 46 females.The serum levels of Ficolin-3, TNF-α, and IL-6 in the non-proliferative and proliferative groups were higher than those in the T2DM group(all P<0.05), while the level of SFRP5 was lower than that in the T2DM group(all P<0.05). The serum levels of Ficolin-3, TNF-α, and IL-6 in the proliferative group were higher than those in the non-proliferative group(all P<0.05), and the level of SFRP5 was lower than that in the non-proliferative group(P<0.05).Complying with Pearson correlation analysis showed that serum Ficolin-3 was negatively correlated with SFRP5(P<0.05), and both were related to TNF-α and IL-6(all P<0.001). Logistic analysis showed that the course of diabetes, SUA, HbA1c, Ficolin-3, TNF-α, and IL-6 were the risk factors for T2DM patients with DR(all P<0.05), and SFRP5 was a protective factor(P<0.05). Complying with the ROC curve, the AUC values of serum Ficolin-3 and SFRP5 alone and their combination for diagnosing T2DM patients with DR were 0.774, 0.793, and 0.864, respectively. The AUC of combined diagnosis was better than that of single diagnosis(Z=2.694, Z=2.708, both P<0.05).CONCLUSION: In patients with T2DM complicated by DR, serum levels of Ficolin-3 and SFRP5 are abnormally expressed. Both are influencing factors for T2DM with DR, and the combined detection can improve the diagnostic value in these patients.

BACKGROUND:Leonurine has many biological activities such as improving microcirculation,anti-oxidation,anti-apoptosis,scavenging free radicals,anti-inflammation,and anti-fibrosis,and can promote osteogenic differentiation of bone marrow mesenchymal stem cells,which has the potential to be applied in the treatment of periodontitis. OBJECTIVE:To explore the anti-inflammatory and osteogenic effects of leonurine loading into chitosan/sodium glycerophosphate/sodium alginate hydrogel. METHODS:(1)Chitosan/sodium glycerophosphate/sodium alginate hydrogel(blank hydrogel)and chitosan/sodium glycerophosphate/sodium alginate/leonurus alkali hydrogel were prepared respectively.RAW 264.7 and MC3T3-E1 cells were inoculated with the two kinds of hydrogel.The cytotoxicity of hydrogels was detected by CCK-8 assay and live/dead cell staining.(2)RAW 264.7 cells were cultured in five groups.The blank group was cultured for 24 hours routinely.The lipopolysaccharide group was treated with lipopolysaccharide.The simple hydrogel group was treated with lipopolysaccharide and blank hydrogel.The drug-loaded hydrogel group was treated with lipopolysaccharide and drug-loaded hydrogel.The inhibitor group was treated with lippolysaccharide,drug-loaded hydrogel,and PI3K inhibitor LY294002.24 hours later,mRNA expression of inflammation-related factors was detected by qRT-PCR.Western blot assay was utilized to detect the protein expression of inflammation-related factors and PI3K/AKT signaling pathway.(3)MC3T3-E1 cells were inoculated in four groups.The blank group was cultured without any material.The simple hydrogel group was treated with blank hydrogel.The drug-loaded hydrogel group was treated with drug-loaded hydrogel.The inhibitor group was treated with drug-loaded hydrogel and PI3K inhibitor LY294002 for 7 days.Alkaline phosphatase staining was performed.mRNA expression levels of osteogenic factors were detected by qRT-PCR.The protein expression levels of the PI3K/AKT signaling pathway were detected by western blot assay. RESULTS AND CONCLUSION:(1)The results of CCK-8 assay and live/dead cell staining showed that the two kinds of hydrogels had no cytotoxic effect and had good cytocompatibility.(2)Compared with the blank group,the mRNA and protein expression levels of interleukin 6,tumor necrosis factor α,and interleukin 1β were significantly increased(P<0.05),and the protein expression levels of p-AKT,p-PI3K,p-p65,and p-IκBα were significantly increased in the lipopolysaccharide group(P<0.05).Compared with lipopolysaccharide group,mRNA and protein expression levels of the above indexes were decreased in drug-loaded hydrogel group(P<0.05).Compared with the drug-loaded hydrogel group,the mRNA and protein expression levels of the above indexes were decreased in the inhibitor group(P<0.05).(3)The activity of alkaline phosphatase in drug-loaded hydrogel group was higher than that in the blank group,simple hydrogel group,and inhibitor group(P<0.05).Compared with blank group,the mRNA expression levels of alkaline phosphatase,Runx2,osteocalcin,and type I collagen were increased(P<0.05),and the protein expression levels of p-AKT and p-PI3K were increased in the simple hydrogel group(P<0.05).Compared with the simple hydrogel group,the mRNA and protein expression levels of the above indexes were increased in the drug-loaded hydrogel group(P<0.05).Compared with the drug-loaded hydrogel group,the mRNA and protein expression levels of the above indexes were decreased in the inhibitor group(P<0.05).(4)These findings conclude that chitosan/sodium glycerophosphate/sodium alginate/leonurine hydrogel has anti-inflammatory and osteogenic effects,which may be related to the regulation of PI3K/AKT signaling pathway.

The Fragment of Dunhuang Ancient Tibetan Moxibustion Therapy contains rich content on fire moxibustion therapy of Tubo-period Tibetan medicine, characterized by distinctive clinical features of Tibetan acupuncture and strong regional attributes. This paper systematically reviews the relevant materials on moxibustion in the Fragment and summarizes the findings as follows: Tibetan fire moxibustion mainly uses mugwort as the material, and terms like "fine mugwort", "broad bean" and "sheep dung pellet" refer to the size of the moxa cone. The number of moxa cones used is predominantly odd numbers, usually ranging from 5 to 21. The main indications for fire moxibustion cover internal medicine, external medicine, gynecology, pediatrics, and various pain syndromes. The therapy advocates for treating acute conditions and heat syndromes with moxibustion. The manuscript also records detailed contraindications, including time-based and seasonal taboos. Moxibustion is applied to both local and distal acupoints, reflecting the therapeutic concept of treating both proximal and distal regions. Furthermore, it documents simple and practical acupoint localization methods such as surface anatomical markers, proportional bone measurement, finger measurement, and hand-span measurement. Compared with contemporaneous Chinese medical moxibustion techniques, the moxibustion methods recorded in this Fragment are rich in content and present unique Tibetan theoretical characteristics. It provides valuable data and evidence for the excavation, application, and further research of Tibetan acupuncture and moxibustion.
Moxibustion/instrumentation* ; Humans ; History, Ancient ; Medicine, Tibetan Traditional/history* ; Tibet ; Acupuncture Points

BACKGROUND: The primary limitation to kidney transplantation is organ shortage. Recent progress in gene editing and immunosuppressive regimens has made xenotransplantation with porcine organs a possibility. However, evidence in pig-to-human xenotransplantation remains scarce, and antibody-mediated rejection (AMR) is a major obstacle to clinical applications of xenotransplantation. METHODS: We conducted a kidney xenotransplantation in a brain-dead human recipient using a porcine kidney with five gene edits (5GE) on March 25, 2024 at Xijing Hospital, China. Clinical-grade immunosuppressive regimens were employed, and the observation period lasted 22 days. We collected and analyzed the xenograft function, ultrasound findings, sequential protocol biopsies, and immune surveillance of the recipient during the observation. RESULTS: The combination of 5GE in the porcine kidney and clinical-grade immunosuppressive regimens prevented hyperacute rejection. The xenograft kidney underwent delayed graft function in the first week, but urine output increased later and the single xenograft kidney maintained electrolyte and pH homeostasis from postoperative day (POD) 12 to 19. We observed AMR at 24 h post-transplantation, due to the presence of pre-existing anti-porcine antibodies and cytotoxicity before transplantation; this AMR persisted throughout the observation period. Plasma exchange and intravenous immunoglobulin treatment mitigated the AMR. We observed activation of latent porcine cytomegalovirus toward the end of the study, which might have contributed to coagulation disorder in the recipient. CONCLUSIONS 5GE and clinical-grade immunosuppressive regimens were sufficient to prevent hyperacute rejection during pig-to-human kidney xenotransplantation. Pre-existing anti-porcine antibodies predisposed the xenograft to AMR. Plasma exchange and intravenous immunoglobulin were safe and effective in the treatment of AMR after kidney xenotransplantation.
Transplantation, Heterologous/methods* ; Kidney Transplantation/methods* ; Heterografts/pathology* ; Immunoglobulins, Intravenous/administration & dosage* ; Graft Survival/immunology* ; Humans ; Animals ; Sus scrofa ; Graft Rejection/prevention & control* ; Kidney/pathology* ; Gene Editing ; Species Specificity ; Immunosuppression Therapy/methods* ; Plasma Exchange ; Brain Death ; Biopsy ; Male ; Aged

Objective To investigate the efficacy of leaflet augmentation technique to repair the recurrent mitral valve (MV) regurgitation after mitral repair in children. Methods A retrospective analysis was conducted on the clinical data of children who underwent redo MV repair for recurrent regurgitation after initial MV repair, using a leaflet augmentation technique combined with a standardized repair strategy at Fuwai Hospital, Chinese Academy of Medical Sciences, from 2018 to 2022. The pathological features of the MV, key intraoperative procedures, and short- to mid-term follow-up outcomes were analyzed. Results A total of 24 patients (12 male, 12 female) were included, with a median age of 37.6 (range, 16.5–120.0) months. The mean interval from the initial surgery was (24.9±17.0) months. All children had severe mitral regurgitation preoperatively. The cardiopulmonary bypass time was (150.1±49.5) min, and the aortic cross-clamp time was (94.0±24.2) min. There were no early postoperative deaths. During a mean follow-up of (20.3±9.1) months, 3 (12.5%) patients developed moderate or severe mitral regurgitation (2 severe, 1 moderate). One (4.2%) patient died during follow-up, and one (4.2%) patient underwent a second MV reoperation. The left ventricular end-diastolic diameter was significantly reduced postoperatively compared to preoperatively [ (43.5±8.6) mm vs. (35.8±7.8)mm, P<0.001]. Conclusion The leaflet augmentation technique combined with a standardized repair strategy can achieve satisfactory short- to mid-term outcomes for the redo mitral repair after previous MV repair. It can be considered a safe and feasible technical option for cases with complex valvular lesions and severe pathological changes.

Objective To evaluate the clinical characteristics of human immunodeficiency virus (HIV) infected patients with peripheral lung masses (PLMs), and to assess the diagnostic utility of contrast-enhanced ultrasound (CEUS) in differentiating benign and malignant PLMs. Methods A retrospective analysis was performed on the clinical data of 69 patients with PLM treated in Shanghai Public Health Clinical Center from January 2020 to December 2023. All patients underwent percutaneous biopsy, and were categorized into benign group (n＝36) and malignant group (n＝33). 25 patients were HIV-positive and 44 patients were HIV-negative. The clinical features and CEUS parameters in patients were compared across these groups. Results Patients with malignant masses were significantly older than those with benign masses (P＜0.05). In the malignant group, HIV-negative patients exhibited significantly larger tumor diameters compared to HIV-positive patients (P＜0.05); in the HIV-positive patients, no significant difference in tumor size was observed between benign and malignant masses. 19 patients underwent CEUS. 10 malignant masses, irrespective of HIV status (10 positive and 9 negative), commonly presented with indistinct margins, delayed enhancement, heterogeneous perfusion, and delayed peak enhancement on CEUS. 9 benign masses showed earlier peak enhancement compared to 10 malignant masses (P＜0.05); no significant differences were observed in the initiation and washout time of enhancement between benign and malignant masses. In HIV-positive patients, 5 benign masses frequently demonstrated discrepancies between CEUS findings and pathological results. Conclusions The clinical and CEUS characteristics were different between benign and malignant PLMs. However, CEUS shows limited accuracy in distinguishing benign and malignant PLMs, underscoring the need for pathological confirmation.

Dipsaci Radix is a commonly used yang tonifying medicine in clinical practice.Ancient books record that its preparation methods are diverse,mainly concentrated in the Ming and Qing dynasties,including wine soaking,wine washing,wine baking,wine stir frying,stir frying,wine mixing,and salt water stir frying.Wine roasting can promote blood circulation,dispel cold stagnation,and has been used throughout history;salt roasting has been seen in modern times,which can induce Chinese materia medica to descend and enhance liver and kidney tonifying effects;at present,it is mainly used for slicing raw materials,but there are also processed products such as wine fried products,salt fried products,stir fried slices,and charcoal slices.This article reviewed the herbal monographs,TCM ancient books,processing standards and modern literature,and combed the related elaboration of the processing history and modern processing research of Dipsaci Radix in the literature,so as to provide references for the processing mechanism,method research,clinical application and resource development and utilization of Dipsaci Radix.

Objective:To explore the quantitative indexes of dual energy spectrum CT and related clinical data to establish a predictive model for predicting pneumoconiosis.Methods:In April 2024, the information of 203 pneumoconiosis patients diagnosed by the occupational disease appraisal expert group in the Third People's Hospital of Xinjiang Uygur Autonomous Region (Occupational Disease Hospital of Xinjiang Autonomous Region) from January 2022 to December 2023 was retrospectively analyzed. Another 207 non-pneumoconiosis patients with dust exposure history were selected as control group. The measurement data between the two groups were compared using T test or Wilcoxon in dependent quality test, count date asing chi-square or Fishers test, the energy spectrum related indicators and clinical indicators of the patients were compared between groups, and potential factors for diagnosis of pneumoconiosis were screened through univariate analysis, and independent risk factors were further determined by multivariate logistic regression. Based on the results of regression analysis, the machine learning model was constructed, and the reciver operating characteristic curve (ROC) was drawn to evaluate the efficiency of the model, and the Area under cruve (AUC) value, sensitivity and specificity were calculated.Results:Smoking, lung tissue mass, silicon dioxide (SiO 2) equivalent total mass and SiO 2 equivalent concentration were the risk factors for pneumoconiosis ( P<0.05) . Multivariate logistic regression analysis showed that smoking, lung tissue mass, total lung SiO 2 equivalent total volume and total lung SiO 2 equivalent total mass were independent predicators of the diagnosis of pneumoconiosis ( OR=0.53, 0.99, 1.13, 0.85, P<0.05) . Logistic regression machine learning was used to establish a predictive model, and the training set AUC was 0.74, and the verification set AUC was 0.72, indicating that the model had good accuracy and certain ability to diagnose pneumoconiosis. Conclusion:The machine learning prediction model established by the quantitative analysis index of dual energy spectrum CT and clinical related indexes has a good diagnostic performance for the diagnosis of pneumoconiosis.

The Mofeng Ointment Formulation （MOF， 摩风膏方） is recorded in the Dunhuang manuscript Unnamed Treatise on the Pulse （《亡名氏脉经》） and stands as a representative ancient external therapeutic formula in traditional Chinese medicine （TCM）. Known for dispelling wind， activating blood circulation， warming the meridians， and relieving pain， it is particularly effective in treating rheumatic arthralgia. Through literature research， this paper systematically reviews the composition， preparation techniques， and clinical application characteristics of MOF. In recent years， advancements in modern pharmaceutical technology have led to the development of various innovative ointment-based formulations derived from the traditional recipe， such as Dunhuang Xiaoding Ointment （敦煌消定膏）， Dunhuang Xiaozhong and Zhentong Ointment （Patch） （敦煌消肿镇痛膏/贴）， Xiaoding Ointment （消定膏） gel patch， and Xiaoding Ointment （消定膏） cataplasm. These innovations explore pathways for transforming classical prescriptions into modern applications， providing a theoretical basis for the external TCM treatment of pain-related and orthopedic conditions.

Objective:To evaluate the effect and causality of serum metabolites on the pathogenesis of ulcerative colitis (UC), so as to provide reference for nutritional programs for patients with UC.Methods:Two-sample Mendelian randomization (MR) analysis was performed to estimate the causal relationship between serum metabolites and UC. Genome-wide association studies (GWAS) of 1 400 metabolites were performed, with the metabolites as exposure and UC as outcome. Inverse-variance weighted (IVW) was used to calculate causal estimates. Four other MR methods with different modeling assumptions including MR-Egger, weighted median, weighted mode, and simple mode were used as additional analyses to improve the stability of the results. The results were validated through heterogeneity and pleiotropy tests. Finally, the possible causal metabolites were analyzed by metabolic pathway analysis.Results:MR analysis revealed that 85 metabolites had a possible causal relationship with UC. Among them, phosphatidylglycerol 1,2-dipalmitoyl-gpc (DPPC) ( P=2.75×10 -6) and isovaleryl carnitine (C5) ( P=1.84×10 -5) were significant risk factors for UC. Metabolic pathway analysis identified 5 metabolic pathways that might be affected by these metabolites (all P<0.05), among which the porphyrin ( P=0.004) and pyrimidine metabolic pathways ( P=0.008) had higher confidence in impacting UC. Conclusions:There are causal relationships between some serum metabolites (in particular 1,2-dipalmitoyl-GPC and isovalerylcarnitine) and the risk of UC. The porphyrin and pyrimidine metabolic pathways may impact the pathogenesis of UC.