Objective To define the operation scale of the biochemical test project based on the risk model,and design the statistical quality control(SQC)strategy by rationally adjusting the risk factors.Methods The σ(σ)values for the biochemistry test items were calculated based on the imprecision(CV)of internal quality control(IQC),external quality assessment(EQA)offset bias(Bias)and allowable total error(TEa)of CLIA 2019.By evaluating and adjusting the patient risk factors,designed the SQC for multiple test biochemical items representing high σ,medium σ and low σ categories.Results Clinical biochemistry testing items with different QC levels showed different σ performance,with values for P and K quality control levels 2 higher than level 1 and the remaining items all had very similar.18 projects for risk σ≥4.96:CK,LDH,GGT,AMY,AST,MG,TG,TBIL,FE,NA,UA,CREA,P,ALP,K,ALT and CA,respectively.Controlled with a QC program 13s N=2,run size was 179～1 000 samples.ALB,GLU,CL,TP and UREA need to achieve the expected operational scale by adjusting for risk factors.Conclusion The laboratory can combine program testing performance and patient safety goals,design SQC strategies for clinical biochemistry testing programs by rationally adjusting risk factors,apply as few SQC procedures for as much testing as possible,and align the laboratory workload and reporting interval with the number of patient samples.

Lower extremity arteriosclerosis obliterans(LEASO)is a disease characterized by the formation of atherosclerotic plaques in the lower extremity arteries,leading to arterial stenosis,occlusion,and consequent chronic limb ischemia.This article analyzes the clinical data of a patient with LEASO complicated by an iodine contrast agent allergy,along with the treatment involving intravascular ultrasound(IVUS)-guided endovascular intervention performed without contrast agent,and reviews relevant literature.The patient,a 53-year-old female,presented with coldness and numbness in the left lower extremity and pain after walking for 2 years,symptoms which had worsened over the past 2 months,with a maximum claudication distance of less than 50 meters.The lower extremity arterial CT angiography(CTA)results indicated"left iliac artery occlusion and left superficial femoral artery stenosis."After examination,the patient exhibited allergic symptoms.Upon admission,other diseases were ruled out.Given that the lower extremity symptoms severely impacted the patient's daily life and considering the potential for contrast agent allergy,the use of contrast agent was abandoned.IVUS guidance alone was employed to assess the intravascular condition for the interventional procedure.The surgical interventions chosen were drug-coated balloon angioplasty of the left superficial femoral artery and stent implantation in the left iliac artery.Postoperatively,the patient was able to walk normally,the discomfort resolved,and the treatment outcome was satisfactory.For LEASO patients with contrast agent allergy or other contraindications to contrast use,the sole use of IVUS guidance combined with invasive blood pressure monitoring to intraoperatively assess efficacy can effectively avoid contrast agent administration,providing a valuable reference for clinicians managing such cases.

Objective:To explore the current therapeutic status of rhythm control versus rate control in elderly patients with atrial fibrillation(AF)and the related factors that may influence treatment decisions.Methods:A retrospective study was conducted on AF patients aged ≥75 years old who were hospitalized in the Healthcare Department of Beijing Hospital from January 2010 to May 2020.The patients were grouped and compared according to whether they underwent rhythm control or rate control.Multivariate logistic regression analysis was used to investigate the factors that may influence the treatment decision of rhythm control or rate control.Results:A total of 167 patients was included, with a median age of 90 years old.Among them, 21 patients(12.6%)received rhythm control, and 109 patients(65.3%)received rate control.Compared with the group not receiving rhythm control, the rhythm control group had a younger age, higher BMI, higher diastolic blood pressure, a higher proportion of multiple medication use, a lower proportion of chronic kidney disease stage 3 or above, and higher hemoglobin levels(all P<0.05). Compared with the group not receiving rate control, the rate control group had a lower proportion of paroxysmal AF, a faster resting ventricular rate, a higher proportion of smoking history, a higher proportion of multiple medication use, coronary heart disease, pacemaker treatment, chronic obstructive pulmonary disease and/or asthma, and a lower proportion of cognitive impairment(all P<0.05). Multivariate logistic regression analysis revealed that multiple drug use( OR=11.578, 95% CI: 1.341-99.993, P=0.026)was positively associated with rhythm control therapy, while chronic kidney disease stage 3 or above( OR=0.248, 95% CI: 0.063-0.968, P=0.045)was negatively associated with rhythm control therapy.For rate control therapy, multiple drug use( OR=5.056, 95% CI: 2.253-11.347, P<0.001), resting ventricular rate( OR =1.033, 95% CI: 1.005-1.062, P=0.021), and chronic obstructive pulmonary disease(COPD)and/or asthma( OR=2.739, 95% CI: 1.124-6.672, P=0.027)showed positive associations. Conclusions:The application rate of rhythm control therapy is low in elderly AF patients, and ventricular rate control is the main treatment.Complex clinical conditions are the main constraints, and it is urgent to optimize individualized strategies based on prospective studies and develop new treatment techniques to improve clinical practice.

Uncariae Ramulus Cum Uncis has the effects of wind-extinguishing and convulsion resolving,clearing heat and liver smoothing It can be used to treat cancer,cardio-cerebrovascular diseases,neurodegenerative diseases,depression and other diseases.Studies have shown that Uncariae Ramulus Cum Uncis has significant anti-tumor activity and has inhibitory effects on many kinds of cancers,and monoterpene indole alkaloids are the main source of pharmacological effects of Uncariae Ramulus Cum Uncis.This paper reviewed the research related to the anti-tumor effect of monoterpene indole alkaloids from Uncariae Ramulus Cum Uncis in the last decade,and the anti-tumor mechanism was summarized to offer theoretical basis for the further study of monoterpene indole alkaloids in Uncariae Ramulus Cum Uncis.

Ovulatory dysfunction (OD) is one of the main causes of infertility in women of childbearing age, which not only affects their reproductive ability, but also physical and mental health. Traditional treatment strategies have limited efficacies, and the emergence of biomedicines provides a promising alternative solution via the strategies of combining engineered design with modern advanced technology. This review explores the pathophysiological characteristics and related induction mechanisms of OD, and evaluates the current cutting-edge advances in its treatments. It emphasizes the potentials of biomedicines strategies such as hydrogels, nanoparticles and extracellular vesicles in improving therapeutic precision and efficacy. By mimicking natural physiological processes, and achieving controlled drug release, these advanced drug carriers are expected to address the challenges in ovarian microenvironment reprogramming, tissue repair, and metabolic and immune regulation. Despite the promising progress, there are still challenges in terms of biomedical complexity, differences between animal models and human physiology, and the demand for intelligent drug carriers in the therapy of OD. Future researches are mainly dedicated to developing precise personalized biomedicines in OD therapy through interdisciplinary collaboration, promoting the development of reproductive regenerative medicine.

OBJECTIVE To observe the clinical efficacy of Xuefu Zhuyu Decoction(XFZY)in the prevention and treatment of radiation-induced lung fibrosis(RILF)in esophageal cancer patients with blood stasis type underwent concurrent chemoradiotherapy(CRT).METHODS A total of 130 esophageal cancer patients with blood stasis type who treated with concurrent CRT were randomly divided into an experimental group and a control group,with 65 cases in each group.No patients dropped out during the study period.Patients in both groups received CRT and standardized symptomatic treatment was given according to the condition if radiation-induced lung injury occurred during treatment.On the basis of the treatment of the control group,the patients in the experimental group received XFZY from the beginning day until 30 days after the completion of CRT.The TCM syndrome score of the two groups were compared before and after treatment.The incidence of acute radiation pneumonia(RP)and chronic RILF and changes in pulmo-nary function indicators[forced expiratory volume in the first second as a percentage of predicted value(FEV1%pred),forced vital ca-pacity(FVC),FVC as a percentage of predicted value(FVC%pred),FEV1/FVC ratio,and carbon monoxide diffusing capacity as a per-centage of predicted value(DLCO%pred)]and serum cytokine levels[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),hypoxia-inducible factor-1α(HIF-1α),vascular endothelial growth factor(VEGF),and transforming growth factor β1(TGF-β1)]were compared at 6 months and 12 months after the completion of CRT.The occurrence of adverse reaction during treatment was recorded.RESULTS The total score of TCM syndrome of the two groups was significantly improved and the experimental group was better than that of the control group(P<0.01)after treatment.The efficacy of TCM syndrome was better in the experimental group than that of the control group(P<0.01).There was no statistically significant difference in the incidence rate of acute RP between the two groups(P>0.05)at 6 months after the completion of CRT.The levels of lung function indicators FEV1%pred,FVC%pred,and DLCO%pred in the experimental group were higher than those in the control group(P<0.05),and the levels of various cytokines in the experimental group were lower than those in the control group(P<0.05).The incidence rate of chronic RILF in the experimental group was significantly lower than that of the control group(P<0.05)at 12 months after the completion of CRT.The DLCO%pred level in the experimental group was higher than that in the control group(P<0.01),and the levels of cytokines HIF-1α,VEGF,and TGF-β1 were lower than those in the control group(P<0.05,P<0.01).There was no serious adverse event observed in either group of patients during the treat-ment.CONCLUSION XFZY can effectively prevent and treat RILF in esophageal cancer patients with blood stasis type underwent CRT,reducing the loss to lung function caused by radiotherapy,and its mechanism may be related to downregulating the levels of cyto-kines of HIF-1α,VEGF,and TGF-β1.

OBJECTIVE To investigate the anti-inflammatory mechanisms of demethylzeylasteral(Dem)in ulcerative colitis(UC)and collagen-induced arthritis(CIA),focusing on its regulation of Th17 cell differentiation and associated signaling pathways.METHODS UC was induced in C57BL/6 mice using dextran sulfate sodium(DSS),and Dem was administered by gavage at low(1 mg·kg-1)or high(2 mg·kg-1)doses.Disease severity was assessed by body weight loss,colon length,and stool consisten-cy.Serum cytokines(TNF-α,IL-1β,IL-6)were quantified by ELISA,and Th17 cell ratio in mesenteric lymph nodes was deter-mined by flow cytometry.The anti-inflammatory efficacy of Dem was further validated using a CIA mouse model.The efficacy of Dem was further verified in the CIA model,and the expression of JAK2 and STAT3 was intervened by siRNA to investigate its mechanism of action in Th17 differentiation.RESULTS Dem-treated mice showed reduced weight loss and colon shortening,and decreases in ser-um TNF-α,IL-1β,and IL-6 levels(P<0.01)and Th17 cell proportion(P<0.01).Western blot and siRNA assays showed that Dem significantly inhibited the differentiation and activation of Th17 cells by suppressing the phosphorylation of the JAK2-STAT3 path-way.Dem also significantly alleviated arthritis symptoms and related markers in the CIA model,confirming its anti-inflammatory effects.CONCLUSION Dem improves UC and rheumatoid arthritis by downregulating the JAK2-STAT3 signaling pathway,inhibi-ting Th17 cell differentiation and pro-inflammatory cytokine expression,suggesting its potential therapeutic value in immune-related diseases.

OBJECTIVE To investigate the anti-inflammatory mechanisms of demethylzeylasteral(Dem)in ulcerative colitis(UC)and collagen-induced arthritis(CIA),focusing on its regulation of Th17 cell differentiation and associated signaling pathways.METHODS UC was induced in C57BL/6 mice using dextran sulfate sodium(DSS),and Dem was administered by gavage at low(1 mg·kg-1)or high(2 mg·kg-1)doses.Disease severity was assessed by body weight loss,colon length,and stool consisten-cy.Serum cytokines(TNF-α,IL-1β,IL-6)were quantified by ELISA,and Th17 cell ratio in mesenteric lymph nodes was deter-mined by flow cytometry.The anti-inflammatory efficacy of Dem was further validated using a CIA mouse model.The efficacy of Dem was further verified in the CIA model,and the expression of JAK2 and STAT3 was intervened by siRNA to investigate its mechanism of action in Th17 differentiation.RESULTS Dem-treated mice showed reduced weight loss and colon shortening,and decreases in ser-um TNF-α,IL-1β,and IL-6 levels(P<0.01)and Th17 cell proportion(P<0.01).Western blot and siRNA assays showed that Dem significantly inhibited the differentiation and activation of Th17 cells by suppressing the phosphorylation of the JAK2-STAT3 path-way.Dem also significantly alleviated arthritis symptoms and related markers in the CIA model,confirming its anti-inflammatory effects.CONCLUSION Dem improves UC and rheumatoid arthritis by downregulating the JAK2-STAT3 signaling pathway,inhibi-ting Th17 cell differentiation and pro-inflammatory cytokine expression,suggesting its potential therapeutic value in immune-related diseases.

Objective To define the operation scale of the biochemical test project based on the risk model,and design the statistical quality control(SQC)strategy by rationally adjusting the risk factors.Methods The σ(σ)values for the biochemistry test items were calculated based on the imprecision(CV)of internal quality control(IQC),external quality assessment(EQA)offset bias(Bias)and allowable total error(TEa)of CLIA 2019.By evaluating and adjusting the patient risk factors,designed the SQC for multiple test biochemical items representing high σ,medium σ and low σ categories.Results Clinical biochemistry testing items with different QC levels showed different σ performance,with values for P and K quality control levels 2 higher than level 1 and the remaining items all had very similar.18 projects for risk σ≥4.96:CK,LDH,GGT,AMY,AST,MG,TG,TBIL,FE,NA,UA,CREA,P,ALP,K,ALT and CA,respectively.Controlled with a QC program 13s N=2,run size was 179～1 000 samples.ALB,GLU,CL,TP and UREA need to achieve the expected operational scale by adjusting for risk factors.Conclusion The laboratory can combine program testing performance and patient safety goals,design SQC strategies for clinical biochemistry testing programs by rationally adjusting risk factors,apply as few SQC procedures for as much testing as possible,and align the laboratory workload and reporting interval with the number of patient samples.

Uncariae Ramulus Cum Uncis has the effects of wind-extinguishing and convulsion resolving,clearing heat and liver smoothing It can be used to treat cancer,cardio-cerebrovascular diseases,neurodegenerative diseases,depression and other diseases.Studies have shown that Uncariae Ramulus Cum Uncis has significant anti-tumor activity and has inhibitory effects on many kinds of cancers,and monoterpene indole alkaloids are the main source of pharmacological effects of Uncariae Ramulus Cum Uncis.This paper reviewed the research related to the anti-tumor effect of monoterpene indole alkaloids from Uncariae Ramulus Cum Uncis in the last decade,and the anti-tumor mechanism was summarized to offer theoretical basis for the further study of monoterpene indole alkaloids in Uncariae Ramulus Cum Uncis.