ObjectiveTo observe the effect of modified Huanglian Wendantang on oxidative stress in metabolic syndrome. MethodsA total of 180 patients with metabolic syndrome treated in the outpatient clinics and wards of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from October 2023 to May 2025 were enrolled in this study. According to the randomized numerical table method， the patients were assigned into two groups （90 cases）. The basic treatment of the two groups was the same， and the observation group was additionally treated with modified Huanglian Wendantang. The course of treatment was 3 months. The two groups were compared in terms of traditional Chinese medicine （TCM） efficacy， obesity degree ［waist circumference （WC）， body mass index （BMI）， waist-to-hip ratio （WHR）， waist-to-height ratio （WHtR）］， blood pressure indicators ［systolic blood pressure （SBP） and diastolic blood pressure （DBP）］， lipids and glucose indicators ［total cholesterol （TC）， triglycerides （TG）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， fasting insulin （FINS）， fasting glucose （FPG）， 2-hour postprandial glucose （2 h PG）， and glycosylated hemoglobin （HbA1c）］， insulin resistance indicators ［homeostatic model assessment for insulin resistance （HOMA-IR）， triglyceride-glucose index （TYG index）， triacylglycerol-to-high-density lipoprotein cholesterol （TG/HDL） ratio］， oxidative stress indicators ［malondialdehyde （MDA）， superoxide dismutase （SOD）， glutathione （GSH）， glutathione peroxidase （GSH-Px）， catalase （CAT）， and reactive oxygen species （ROS）］， and the safety of treatment. ResultsIn terms of TCM efficacy， the treatment in the observation group was significantly effective in 46 cases， effective in 30 cases， and ineffective in 10 cases， with the total effective rate of 88.4%. The treatment in the control group was significantly effective in 33 cases， effective in 28 cases， and ineffective in 23 cases， with the total effective rate of 72.6%. The observation group had higher total effective rate than the control group （χ²=11.26，P<0.05）. After treatment， both groups showed declined levels of WC， BMI， WHR， WHtR， SBP， DBP， TC， TG， LDL-C， FPG， FINS， 2 h PG， HbA1c， HOMA-IR， TG/HDL ratio， TYG index， MDA， and ROS and elevated levels of HDL-C， SOD， GSH， GSH-Px， and CAT （P<0.05）. After treatment， the observation group showed lower levels of WC， BMI， WHR， WHtR， TC， TG， LDL-C， FPG， FINS， 2 h PG， HbA1c， HOMA-IR， TG/HDL ratio， TYG index， MDA， and ROS and higher levels of HDL-C， SOD， GSH， GSH-Px， and CAT than the control group （P<0.05）. However， after treatment， there was no significant difference in SBP or DBP between the observation group and the control group. No significant adverse reactions were observed in either group. ConclusionModified Huanglian Wendantang can significantly alleviate metabolic syndrome symptoms and reduce oxidative stress， exhibiting antioxidant effects. Moreover， it does not induce adverse reactions， demonstrating safety.

ObjectiveTo observe the effect of modified Huanglian Wendantang on oxidative stress in metabolic syndrome. MethodsA total of 180 patients with metabolic syndrome treated in the outpatient clinics and wards of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from October 2023 to May 2025 were enrolled in this study. According to the randomized numerical table method， the patients were assigned into two groups （90 cases）. The basic treatment of the two groups was the same， and the observation group was additionally treated with modified Huanglian Wendantang. The course of treatment was 3 months. The two groups were compared in terms of traditional Chinese medicine （TCM） efficacy， obesity degree ［waist circumference （WC）， body mass index （BMI）， waist-to-hip ratio （WHR）， waist-to-height ratio （WHtR）］， blood pressure indicators ［systolic blood pressure （SBP） and diastolic blood pressure （DBP）］， lipids and glucose indicators ［total cholesterol （TC）， triglycerides （TG）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， fasting insulin （FINS）， fasting glucose （FPG）， 2-hour postprandial glucose （2 h PG）， and glycosylated hemoglobin （HbA1c）］， insulin resistance indicators ［homeostatic model assessment for insulin resistance （HOMA-IR）， triglyceride-glucose index （TYG index）， triacylglycerol-to-high-density lipoprotein cholesterol （TG/HDL） ratio］， oxidative stress indicators ［malondialdehyde （MDA）， superoxide dismutase （SOD）， glutathione （GSH）， glutathione peroxidase （GSH-Px）， catalase （CAT）， and reactive oxygen species （ROS）］， and the safety of treatment. ResultsIn terms of TCM efficacy， the treatment in the observation group was significantly effective in 46 cases， effective in 30 cases， and ineffective in 10 cases， with the total effective rate of 88.4%. The treatment in the control group was significantly effective in 33 cases， effective in 28 cases， and ineffective in 23 cases， with the total effective rate of 72.6%. The observation group had higher total effective rate than the control group （χ²=11.26，P<0.05）. After treatment， both groups showed declined levels of WC， BMI， WHR， WHtR， SBP， DBP， TC， TG， LDL-C， FPG， FINS， 2 h PG， HbA1c， HOMA-IR， TG/HDL ratio， TYG index， MDA， and ROS and elevated levels of HDL-C， SOD， GSH， GSH-Px， and CAT （P<0.05）. After treatment， the observation group showed lower levels of WC， BMI， WHR， WHtR， TC， TG， LDL-C， FPG， FINS， 2 h PG， HbA1c， HOMA-IR， TG/HDL ratio， TYG index， MDA， and ROS and higher levels of HDL-C， SOD， GSH， GSH-Px， and CAT than the control group （P<0.05）. However， after treatment， there was no significant difference in SBP or DBP between the observation group and the control group. No significant adverse reactions were observed in either group. ConclusionModified Huanglian Wendantang can significantly alleviate metabolic syndrome symptoms and reduce oxidative stress， exhibiting antioxidant effects. Moreover， it does not induce adverse reactions， demonstrating safety.

Objective: To evaluate the intervention effectiveness of co-occurrence and prevention for myopia and obesity among primary and secondary school students, so as to provide a scientific basis for the development of comprehensive intervention measures in myopia and obesity. Methods: From September 2022 to September 2023, a cluster random sampling method was used to select 6 primary schools and 6 junior high schools from Tongzhou District, Beijing. Participants were randomly assigned to an intervention group (914 before intervention and 754 after intervention) and a control group (868 before intervention and 652 after intervention), with an expected duration of one academic year. Based on the RE-AIM framework, integrate resources from families, schools, communities, and medical institutions to develop a school-based intervention technology packagefor the co-occurrence and prevention of myopia and obesity in children. The intervention group received intervention according to the comprehensive intervention technology package, while the control group did not receive any intervention measures. Relevant health indicators during the baseline period and after intervention were measured and collected, and groups were compared by Chi quest test, t-test and Wilcoxon rank sum test. Results: After intervention, the uncorrected visual acuity of primary and secondary school students in the intervention group (4.79±0.30) and the control group (4.77±0.33) both decreased compared to those before intervention (4.80±0.30, 4.90±0.32) ( t =-7.00,-5.24); the decrease in uncorrected visual acuity in the intervention group was smaller than that in the control group( t =5.33)( P <0.01). After intervention, body mass index, waist circumference, hip circumference, and body fat percentage of primary and secondary school students in the intervention group decreased compared to those before intervention. However, the changes in these indicators were not statistically significant ( t/Z =-0.03, - 0.36，- 0.30，- 0.01, P >0.05); the above indicators in the control group increased compared to those before intervention, but only hip circumference and body fat percentage showed statistically significant changes ( t/Z =2.17, 2.62, P <0.05). After intervention, both the intervention group and the control group showed increases in systolic and diastolic blood pressure compared to those before intervention(intervention group: t =2.16,5.29; control group: t =6.84,5.07); the intervention group had lower systolic and diastolic blood pressure than the control group( t = -5.27 , -2.08)( P <0.05). After intervention, the intervention and the control groups had statistically significant differences in cognitive accuracy(92.48%, 69.33%) in terms of "outdoor exercise can prevent myopia" and "having 5 servings of adult fist sized vegetables and fruits every day" ( χ 2=6.30, 7.86, P <0.05). There was a statistically significant difference in the proportion of primary and secondary school students in the intervention group (40.98%) and the control group (35.43%) for "who did not drink sugary drinks for every day in the past 7 days" ( χ 2=4.32, P <0.05). After intervention, the intervention group and the control group showed increases in "school outdoor activity duration on school days" and "outdoor activity duration on rest days" compared to those before intervention ( t/Z =-13.32,-9.71;- 2.59，-2.69）；the behavior rate of "visual acuity measurement frequency at least once every 3 months" in the intervention group (46.68%) and the control group (52.76%) increased compared to those before intervention (36.43%, 44.01%), and the increases in the intervention group were greater than that in the control group ( χ 2=17.52,11.08) ( P <0.05). Conclusions Comprehensive intervention measures have significant intervention effects on controlling the occurrence and development of comorbidity of myopia and obesity in children. It could actively promote collaboration and cooperation among families, schools, communities and medical institutions to reduce the occurrence of myopia and obesity among primary and secondary school students.

Objective To develop a predictive model for postoperative mortality risk in patients with acute aortic dissection(AAD)using the Extreme Gradient Boosting(XGBoost)algorithm combined with Shapley Additive Explanation(SHAP),and to establish a prediction website to serve as a diagnostic and therapeutic support platform for clinicians and patients.Methods A retrospective cohort study design was adopted.Data from 782 AAD patients who underwent surgical treatment at the Fourth Hospital of Hebei Medical University from January 2013 to December 2023 were collected,including basic information and initial serum biomarker test results.Patients were randomly divided into training and test sets at a 7:3 ratio.An external validation set consisting of 313 AAD patients admitted to the Second Hospital of Hebei Medical University from January 2020 to December 2023 was also established for further model validation.Variables were screened using LASSO regression,and an XGBoost machine learning model was constructed and interpreted using SHAP.The predictive performance of the model was evaluated using receiver operating characteristic(ROC)curve analysis.Using the Shiny package,the XGBoost model was deployed to shinyapps.io to create a prediction website for postoperative mortality risk in AAD patients.One patient was selected by simple random sampling from the test set and the external validation set respectively for the prediction example on the Shiny webpage.Results The XGBoost model demonstrated high predictive performance for postoperative mortality in AAD patients,with area under the ROC curve(AUC)values of 0.928(95%CI 0.901-0.956)in the training set,0.919(95%CI 0.891-0.949)in the test set,and 0.941(95%CI 0.915-0.967)in the external validation set.SHAP values indicated the following order of variable importance in the model(from highest to lowest):"lactate dehydrogenase""blood chlorine""multiple organ injury""carbon dioxide combining power""prothrombin time""α-hydroxybutyric acid""creatine kinase isoenzyme""Stanford classification""combined use of bedside blood purification""gender""acute kidney injury""gastrointestinal bleeding""brain injury"and"shock".A risk prediction website for adverse postoperative outcomes in AAD patients was developed using XGBoost-SHAP method(https://dun-dunxiaolu.shinyapps.io/document/)and validated with examples.One randomly selected patient from each of the test and external validation sets was applied:the predicted mortality risk value for patient 1(who died postoperatively)was 0.9539,and that for patient 2(who survived postoperatively)was 0.0206.Conclusions The XGBoost-SHAP model demonstrates high accuracy in predicting postoperative mortality risk for AAD patients.The online prediction tool established based on this model enhances the identification efficiency of high-risk postoperative mortality patients.

Forsythia suspensa is a traditional Chinese medicine and a commonly used landscaping plant. Its dried fruit is used in medicine for its functions of clearing heat, removing toxins, reducing swelling, dissipating masses, and dispersing wind and heat. It possesses extremely high medicinal and economic value. However, the genetic differentiation and diversity of its wild populations remain unclear. In this study, chloroplast genome sequences were obtained from 15 wild individuals of F. suspensa using high-throughput sequencing technology. The sequence characteristics and intraspecific variations were analyzed. The results were as follows:(1) The full length of the F. suspensa chloroplast genome ranged from 156 184 to 156 479 bp, comprising a large single-copy region, a small single-copy region, and two inverted repeat regions. The chloroplast genome encoded a total of 132 genes, including 87 protein-coding genes, 37 tRNA genes, and 8 rRNA genes.(2) A total of 166-174 SSR loci, 792 SNV loci, and 63 InDel loci were identified in the F. suspensa chloroplast genome, indicating considerable genetic variation among individuals.(3) Population structure analysis revealed that F. suspensa could be divided into five or six groups. Both the population structure analysis and phylogenetic reconstruction results indicated significant genetic variation within the wild populations of F. suspensa, with no obvious correlation between intraspecific genetic differentiation and geographical distribution. This study provides new insights into the genetic diversity and differentiation within F. suspensa species and offers additional references for the conservation of species diversity and the utilization of germplasm resources in wild F. suspensa.
Genome, Chloroplast ; Forsythia/classification* ; Phylogeny ; Genetic Variation ; Chloroplasts/genetics* ; Microsatellite Repeats

OBJECTIVE: To evaluate the effects of posterior cruciate ligament(PCL) resection on soft tissue elasticity and knee stability in total knee arthroplasty(TKA). METHODS: Six adult cadaveric knee specimens (involving 10 knees) were included in the study. With the assistance of the robotic system(TiRobot Recon, TINAVI, Beijing), total knee arthroplasty (TKA) was performed sequentially using cruciate retaining (CR) prostheses and posterior stabilizing (PS) prostheses. Between the two surgical procedures, the femoral and tibial osteotomy surfaces were not altered;only the posterior cruciate ligament (PCL) was resected and the intercondylar fossa was treated. After installing the femoral trial component, a soft tissue balance solver was used to apply tension ranging from 30 N to 90 N in 5 N increments at 0°, 10°, and 90° of knee flexion. Meanwhile, the medial and lateral joint gaps were measured synchronously. Based on the tension-gap coupling data, the equivalent elastic coefficients of the medial and lateral soft tissue sleeves at different knee flexion angles, as well as the range of the joint line convergence angle (JLCA) under fixed varus-valgus stress, were calculated. Additionally, the gap balance status under 80 N of tension was analyzed. Self-control comparisons of each indicator were conducted before and after PCL resection to analyze the change patterns. RESULTS: After PCL resection, in the fully extended position (knee flexion 0°). The medial equivalent elastic coefficient was 32.2 (25.7, 63.3) N·mm^-1 for the CR prosthesis and 27.7 (22.0, 51.9) N·mm^-1 for the PS prosthesis, and the statistically significant difference (P=0.013). The range of JLCA was 0.41°(0.26, 0.55)° for the CR prosthesis, which was smaller than 0.75° (0.40, 0.98)° for the PS prosthesis, and the difference was statistically significant(P=0.041). At 90° of knee flexion, the medial joint gap was 10.7(10.1, 11.7) mm for the CR prosthesis, which was smaller than 12.1(10.9, 15.1) mm for the PS prosthesis, with a statistically significant difference(P=0.011). No statistically significant differences were observed in other joint gaps. CONCLUSION PCL resection reduces the rigidity of the medial soft tissues in the fully extended knee and increases the medial joint gap in the flexed position, thereby affecting knee stability and balance. This finding suggests that PS and CR prostheses may require different morphological designs, and there should be differences in indications and osteotomy strategies between CR-TKA and PS-TKA. CR-TKA is more suitable for patients with preoperative medial soft tissue laxity.
Humans ; Posterior Cruciate Ligament/physiopathology* ; Knee Joint/physiopathology* ; Arthroplasty, Replacement, Knee ; Elasticity ; Male ; Female ; Middle Aged ; Aged ; Biomechanical Phenomena ; Adult

Background: Deceased donor liver transplantation (DDLT) and living donor liver transplantation (LDLT) are employed to address highly urgent patients, including those with acute liver failure (ALF), acute-on-chronic liver failure (ACLF), or critical cirrhosis. This study compares outcomes between LDLT and DDLT patients with ALF, ACLF, or critical cirrhosis in highly urgent LDLT (HU-LDLT) applications. Methods: This study conducted a retrospective analysis of the Korean Network for Organ Sharing (KONOS) data, which included 391 consecutive HU-LDLT applications from 2017 to 2021. Results: The proportion of DDLT was 15.1% (n=59) within the cohort of HU-LDLT applications. The prevalence of hepatorenal syndrome, duration of pre-transplant intensive care unit (ICU) care, incidence of pre-transplant continuous renal replacement therapy, and median model for end-stage liver disease scores were significantly greater and prolonged in DDLT patients compared to LDLT patients. Statistical analysis revealed no significant differences in postoperative complications or overall survival between the two groups. In the multivariate analysis, only pre-transplant ventilator care emerged as a significant predisposing factor for mortality. Conclusion The present study indicates that LDLT is a viable option, yielding comparable perioperative and long-term outcomes to DDLT for HU patients, which can encourage living liver donation to overcome organ shortages in HU patients.

ObjectiveTo observe the clinical effect of modified Huanglian Wendantang on cardiovascular risk factors in patients with metabolic syndrome under the guidance of treating disease before its onset. MethodsA total of 82 patients with metabolic syndrome treated in the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from July 2023 to July 2024 were selected and allocated into an observation group （41 cases） and a control group （41 cases） by the random number table method. The control group received routine treatment， and the observation group was treated with modified Huanglian Wendantang on the basis of routine treatment. Both groups were treated for 8 weeks. The therapeutic effects on TCM symptoms after treatment in the two groups were evaluated. The levels of obesity degree indicators， blood pressure indicators， glucose and lipid metabolism indicators， inflammatory factors， and vascular endothelial function indicators before and after treatment in the two groups were measured， and the treatment safety was evaluated. ResultsAfter treatment， the total response rate of TCM symptoms in the observation group was 97.56% （40/41）， which was higher than that （87.80%， 36/41） in the control group （χ²=5.205， P<0.05）. After treatment， both groups showed declines （P<0.05） in systolic blood pressure （SBD）， diastolic blood pressure （DBP）， triglyceride （TG）， total cholesterol （TC）， low density lipoprotein cholesterol （LDL-C）， fasting blood glucose， 2-hour postprandial blood glucose （2 h PG）， glycosylated hemoglobin （HbA1c）， fasting insulin （FINS）， Homeostatic Model Assessment for Insulin Resistance （HOMA-IR）， body mass index （BMI）， waist circumference （WC）， waist-to-hip ratio （WHR）， leptin （LEP）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， endothelin-1 （ET-1）， and inducible nitric oxide synthase （iNOS）. Moreover， the declines in the observation group were more obvious than those in the control group （P<0.05， P<0.01）. After treatment， both groups showed elevated levels of high density lipoprotein cholesterol （HDL-C）， adiponectin （ADP）， nitric oxide （NO）， and endothelial nitric oxide synthase （eNOS） （P<0.05）， and the above indexes in the observation group were higher than those in the control group （P<0.01）. ConclusionUnder the guidance of the thought of treating disease before its onset， modified Huanglian Wendantang was used to treat patients with metabolic syndrome. The decoction improved the clinical efficacy by ameliorating IR to improve insulin sensitivity， reducing inflammation， and protecting the vascular endothelial function. It inhibits cardiovascular risk factors without inducing adverse reactions， being worthy of clinical application and promotion.

Objective:To investigate the drug resistance of newly diagnosed HIV-1 infected patients in Shanghai and to provide reference value for clinical antiretroviral therapy (ART).Methods:The peripheral venous blood plasma of 196 newly diagnosed HIV-1 infected patients screened according to the inclusion and exclusion criteria at the Shanghai Public Health Clinical Center from April to June 2023 was collected, HIV-1 RNA was extracted, the pol region was amplified by reverse transcription-polymerase chain reaction (RT-PCR) for sequencing, the mutation sites and ART drug resistance were analyzed.Results:The plasma of 196 newly diagnosed HIV-1 infected patients was amplified successfully in 162 cases (amplification success rate was 82.65%). The subtypes consisted of CRF07_BC(51.23%), CRF01_AE (27.78%), and others (6.79%), CRF55_01B (5.56%), B (3.70%), CRF01_AE/B (3.70%) and CRF08_BC (1.23%). The overall transmitted drug resistance rate was 7.41%, the protease inhibitors (PIs), non-nucleoside/nucleotide reverse transcriptase inhibitors (NNRTIs), nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), integrase inhibitors (INSTIs) resistance rates were 3.09%, 3.70%, 0.00% and 0.62%, respectively. The proportion of NNRTIs-related mutation sites in B (66.67%) and CRF55_01B (88.89%) was higher than that in CRF07_BC (13.25%); the proportion of NNRTIs-related mutation sites in CRF55_01B (88.89%) was higher than that in CRF01_AE (22.22%) and other subtypes (18.18%), the difference was statistically significant (all P<0.05). Multivariate logistic regression analysis showed that the probability of PIs-related mutation sites in CRF01_AE/B was 21.71 times that of CRF07_BC[odds ratio ( OR)=21.71, 95% confidence interval ( CI): 3.36-140.27, P=0.001]. Conclusions:The transmitted drug resistance among newly diagnosed HIV-1 infected patients in Shanghai is at the moderate epidemic level, mainly NNRTIs and PIs-related drug resistance, and the INSTIs resistance rate is low, the use of INSTIs in ART regimens should be considered.

Objective:To establish 30-day of age transcutaneous bilirubin (TcB) reference curves for healthy neonates, and to investigate regional variations in bilirubin dynamics.Methods:A multicenter retrospective cohort study was conducted. A total of 220 950 healthy neonates born at a gestational age of 35-<42 weeks, with a birth weight ≥2 000 g, who did not receive phototherapy within 60 h after birth were recruited. All of them underwent remote TcB monitoring using the Bilibaby remote jaundice monitoring system between August 1 st, 2020 and December 31 st, 2024 in 426 hospitals. TcB data were collected within the period from birth to 30-day of age. The P40, P75, and P95 of TcB values were calculated, and dynamic TcB curves for 30-day of age were constructed. Patterns of bilirubin change, rates of change, and transition outcomes were described. Regional comparisons between South and North were conducted using linear mixed-effects models for TcB trajectories and Pearson′s chi-square test for outcome differences. Results:A total of 220 950 neonates were included, of whom 101 711 (46.03%) were female. Gestational age at birth was (38.75±1.12) weeks, and birth weight was (3 272±417) g. TcB levels increased rapidly within 3-day of age, peaked at 4-6-day of age, with peak values at P40, P75, and P95 of 200.6, 239.7 and 275.4 μmol/L (11.8, 14.1 and 16.2 mg/dl), respectively. TcB levels gradually declined thereafter and stabilized after 13-day of age, with values at P40, P75, and P95 fluctuating between 147.9-159.8, 190.4-200.6, and 231.2-239.7 μmol/L (8.7-9.4, 11.2-11.8, 13.6-14.1 mg/dl), respectively. Notably, among neonates categorized as low-or low-intermediate-risk within 3-day of age, 6 700 (12.76%) progressed to intermediate-high or high risk between 4 and 30 days of age. Before 13-day of age, TcB levels in the southern regions were consistently higher than those in the northern regions ( P=0.039); from 14 to 30 days of age, the overall TcB levels had no statistically difference, but the temporal changes in TcB still showed regional differences (degrees of freedom=3, all interaction P<0.05). Among neonates classified as low-or low-intermediate risk within 3-day of age, 25 326 were from southern regions, of whom 4 254 (16.80%) progressed to intermediate-high or high risk between 4 and 30 days of age. In northern regions, 27 193 neonates were classified as low-or low-intermediate risk within 3-day of age, among whom 2 446 (8.99%) progressed to intermediate-high or high risk. The risk progression between the 2 regions had statistically difference ( χ2=716.49, P<0.001). Conclusions:A TcB percentile curve for neonates within 30-day of age was established, revealing that both the overall TcB level and its temporal trend were higher in southern than in northern newborns. These findings provide baseline data to support continuous management of neonatal jaundice.