Hepatitis D virus （HDV）， as a defective virus， relies on the envelope protein of hepatitis B virus （HBV） to complete replication and transmission. Chronic hepatitis B （CHB） patients comorbid with HDV infection may experience significant acceleration of liver disease progression and a significantly higher risk of serious complications such as liver cirrhosis and hepatocellular carcinoma （HCC） compared with the patients with CHB alone， which poses a serious threat to the life and health of patients. At present， the coverage rate of HDV screening needs to be improved， and some patients with HBV/HDV co-infection have not been found in time. Therefore， strengthening the understanding of HDV among clinicians， expanding the scope of HDV screening， identifying patients with infection in a timely manner， and performing standardized antiviral therapy and long-term follow-up management are of great significance for improving the prognosis of patients， reducing disease burden， improving the quality of life of patients， and achieving the global goal of “eliminating viral hepatitis as a public health threat by 2030”.

Medical institutions, with their clinical practice foundation and abundant human use experience data, have become important carriers for the inheritance and innovation of traditional Chinese medicine(TCM) and the "cradles" of the preparation of new TCM. To effectively promote the transformation of new TCM originating from the TCM clinical practice in medical institutions and establish an effective evaluation index system for the transformation of new TCM conforming to the characteristics of TCM, consensus experts adopted the literature research, questionnaire survey, Delphi method, etc. By focusing on the policy and technical evaluation of new TCM originating from the TCM clinical practice in medical institutions, a comprehensive evaluation from the dimensions of drug safety, efficacy, feasibility, and characteristic advantages was conducted, thus forming a comprehensive evaluation system with four primary indicators and 37 secondary indicators. The expert consensus reached aims to encourage medical institutions at all levels to continuously improve the high-quality research and development and transformation of new TCM originating from the TCM clinical practice in medical institutions and targeted at clinical needs, so as to provide a decision-making basis for the preparation, selection, cultivation, and transformation of new TCM for medical institutions, improve the development efficiency of new TCM, and precisely respond to the public medication needs.
Medicine, Chinese Traditional/standards* ; Humans ; Consensus ; Drugs, Chinese Herbal/therapeutic use* ; Surveys and Questionnaires

This study aimed to investigate the effects of Zhiwei Fuwei Pills on mitochondrial apoptosis in the rat model of precancerous lesions of gastric cancer(PLGC) based on the microRNA-21(miRNA-21)/B-cell lymphoma-2(Bcl-2) signaling pathway. Eighty-five 5-week-old male SPF-grade SD rats were selected, of which 75 were fed with N-methyl-N'-nitro-N-nitrosoguanidine(MNNG) for multifactorial modeling, and the PLGC model was established after 26 weeks. The rats were randomly grouped as follows: model, folic acid(0.002 g·kg~(-1)), low-dose(0.42 g·kg~(-1)) Zhiwei Fuwei Pills, medium-dose(0.84 g·kg~(-1)) Zhiwei Fuwei Pills, and high-dose(1.67 g·kg~(-1)) Zhiwei Fuwei Pills, with 15 rats in each group. Additionally, 10 rats were assigned to a blank group and administrated with an equivalent volume of normal saline by gavage. After four weeks of continuous drug administration, the gastric mucosal tissue was collected. Hematoxylin-eosin(HE) staining was performed to reveal the pathological changes in the gastric mucosa. Terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL) was employed to detect apoptosis in gastric mucosal epithelial cells. RT-PCR was adopted to determine the mRNA levels of miRNA-21, phosphatase and tensin homolog(PTEN), Bcl-2, Bcl-2-associated X protein(Bax), and cysteinyl aspartate-specific protease 3(caspase-3). Western blot was employed to determine the protein levels of PTEN, Bcl-2, Bax, and caspase-3. Immunohistochemistry(IHC) was used to detect the positive expression of PTEN, Bcl-2, and Bax in the gastric mucosal tissue. Transmission electron microscopy(TEM) was employed to observe the morphological and structural changes in mitochondria. The results showed that compared with model group, the drug administration groups showed alleviated pathological changes, with increased apoptotic cells, down-regulated mRNA levels of miRNA-21 and Bcl-2, up-regulated mRNA and protein levels of PTEN, Bax, and caspase-3, and down-regulated protein level of Bcl-2. In addition, the drug administration groups exhibited mitochondrial swelling and rupture and reduction of cristae, which indicated mitochondrial apoptosis. These findings suggest that Zhiwei Fuwei Pills can effectively improve mitochondrial apoptosis in PLGC cells by regulating the miRNA-21/Bcl-2 signaling pathway.
Animals ; MicroRNAs/metabolism* ; Male ; Apoptosis/drug effects* ; Stomach Neoplasms/physiopathology* ; Proto-Oncogene Proteins c-bcl-2/genetics* ; Rats ; Rats, Sprague-Dawley ; Drugs, Chinese Herbal/administration & dosage* ; Mitochondria/genetics* ; Signal Transduction/drug effects* ; Precancerous Conditions/drug therapy* ; Humans ; PTEN Phosphohydrolase/genetics*

BACKGROUND: The clinical impact of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in patients treated with PCI for chronic total occlusion (CTO) was still undetermined. METHODS: All CTO vessels treated with successful anatomical PCI in patients from PANDA III trial were retrospectively measured for post-PCI QFR. The primary outcome was 2-year vessel-oriented composite endpoints (VOCEs, composite of target vessel-related cardiac death, target vessel-related myocardial infarction, and ischemia-driven target vessel revascularization). Receiver operator characteristic curve analysis was conducted to identify optimal cutoff value of post-PCI QFR for predicting the 2-year VOCEs, and all vessels were stratified by this optimal cutoff value. Cox proportional hazards models were employed to calculate the hazard ratio (HR) with 95% CI. RESULTS: Among 428 CTO vessels treated with PCI, 353 vessels (82.5%) were analyzable for post-PCI QFR. 31 VOCEs (8.7%) occurred at 2 years. Mean value of post-PCI QFR was 0.92 ± 0.13. Receiver operator characteristic curve analysis shown the optimal cutoff value of post-PCI QFR for predicting 2-year VOCEs was 0.91. The incidence of 2-year VOCEs in the vessel with post-PCI QFR < 0.91 (n = 91) was significantly higher compared with the vessels with post-PCI QFR ≥ 0.91 (n = 262) (22.0% vs. 4.2%, HR = 4.98, 95% CI: 2.32-10.70). CONCLUSIONS Higher post-PCI QFR values were associated with improved prognosis in the PCI practice for coronary CTO. Achieving functionally optimal PCI results (post-PCI QFR value ≥ 0.91) tends to get better prognosis for patients with CTO lesions.

Objective To investigate the therapeutic effects of focused ultrasound and ATP-infrared bioeffect for non-neoplastic epithelial disorders of the vulva(NNEDV),aiming to provide references for the clinical study and selection of individualized treatment plans of NNEDV patients.Methods The clinical data of 278 NNEDV patients attending the gynecology department of some hospital from May 2020 to December 2023 were retrospectively analyzed,who were divided into an observation group receiving focused ultrasound treatment and a control group receiving ATP-infrared bioeffect treatment with the single random grouping mmethod.The observation group enrolled in 143 patients including 84 cases of lichen simplex chronicus(LSC)and 59 cases of vulvar lichen sclerosus(VLS),and the control group had 135 patients including 71 LSC cases and 64 VLS cases.Comparisons were carried out in terms of the therapeutic effect and safety in the two groups,the efficacy for LSC and VLS between and within the two groups,and the clinical symptom scores and the quality of life scores before and after treatment of the two groups.SPSS 23.0 software was used for statistical analysis.Results The two groups had no significant differences in response rate and recurrence rate(P>0.05),while the observation group had the cure rate higher and the complication rate higher than those of the control group(P<0.05).In the observation group,the overall response rates for LSC and VLS were not significantly different(P>0.05);in the control group,the overall response rate for LSC was higher than that for VLS significantly(P<0.05).The cure rate for LSC in the observation group was higher than that in the control group,with the differences being statistically significant(P<0.05);the two groups had no significant differences in the cure rate for VLS(P>0.05).The two groups had significant differences in the skin color socre,vitiligo area scoring index and skin elasticity one month,three months and six months after treatment(P<0.05),with the differences being statistically significant in the tissue structure score three months and six months after treatment(P<0.05);there were no significant differences found between the two groups in the pruritus score one month,three months and six months after treatment and in tissue structure score one month after treatment(P>0.05).In the two groups the differences were all statistically significant in the quality of life score three and six months after treatment(P<0.05);the two groups had significant differences in the quality of life score before and after treatment(P>0.05).Conclusion Focused ultrasound and ATP-infrared bioeffect are both effective for NNEDV.Focused ultrasound gains advantages in restoring the color and tissue structure of vulvar skin,and the physical therapy is the first choice for NNEDV that has failed drug therapy and risks for recurrence and canceration;ATP-infrared bioeffect with a low complication rate can be used for the patients with mild symptoms,cracked skin inflammation or those unable to tolerate ultrasound.[Chinese Medical Equipment Journal,2025,46(6):59-64]

AIM To investigate the effects of Shuyu Pills combined with evolimus on the epithelial mesenchymal transformation of triple negative breast cancer cells 4T1 and MDA-MB-231 induced by TGF-β1.METHODS The 4T1 and MDA-MB-231 cells were divided into the blank group and the induction group to induce the epithelial mesenchymal transformation with TGF-β1 cytokine treatment,followed by the assignment into the model group,the Shuyu Pills group,the everolimus group and the Shuyu Pills combined with everolimus group.CCK8 method,plate cloning method,cell scratch test and Transewll test were used to detect the proliferation,cloning formation,migration and invasion ability of the cells whose expressions of E-cadherin,N-cadherin,Vimentin,MMP9,MMP2 and pathway proteins PTEN,PI3K,Akt and mTOR were detected by Western blot.RESULTS Compared with the blank group,the induction group displayed a cell morphological change from epithelioid to stromal,decreased expression of E-cadherin protein(P＜0.01);and increased protein expressions of N-cadherin and Vimentin(P＜0.05).Compared with the model group,each group intervened with the medicine displayed decreased proliferation,clone formation,migration and invasion ability of both kinds of cells(P＜0.01);increased protein expressions of PTEN and E-cadherin(P＜0.05,P＜0.01);and decreased protein expressions of PI3K,Akt,mTOR,N-cadherin,Vimentin,MMP9 and MMP2(P＜0.05,P＜0.01);and more significantly in the Shuyu Pills combined with evolimus group(P＜0.05,P＜0.01).CONCLUSION With a more ideal effect than the single uses in inhibiting the TGF-β1-induced epithelial mesenchymal transformation of triple-negative breast cancer cells,the combination use of Shuyu Pills and everolimus may work through the regulation of PI3K/Akt/mTOR signaling pathway.

Objective To investigate the effectiveness and safety of infarct core resection combined with decompressive craniectomy(DC)based on corticospinal tract(CST)protection in the treatment of massive cerebral infarction(MCI)with malignant brain edema.Methods This study retrospectively enrolled MCI patients with malignant brain edema who underwent internal decompression combined with DC at Xingtai Central Hospital from January 2021 to June 2024.The enrolled patients were divided into a control group and an experimental group base on the intracranial internal decompression method used.All patients underwent CT perfusion(CTP),CT angiography(CTA),diffusion-weighted imaging(DWI),and diffusion tensor imaging(DTI)within 24 h of admission.Preoperative imaging data was automatically processed using an artificial intelligence diagnostic system.For the experimental group,the imaging data was fused within a neuro-navigation system preoperatively to visualize the spatial relationships between the infarct core,ischemic penumbra,and CST and infarct core resection combined with DC was performed while protecting the CST through neuro-navigation.The control group underwent anterior temporal lobectomy combined with DC.Baseline and clinical data were collected from both groups,including gender,age,smoking history,alcohol consumption history,diabetes,hypertension,hyperlipidemia,hyperhomocysteinemia,atrial fibrillation history,responsible occluded vessel(internal carotid artery,middle cerebral artery),preoperative infarct volume on DWI,preoperative ischemic penumbra volume,preoperative the National Institutes of Health stroke scale(NIHSS)score,time from onset to surgery,intraoperative procedure duration,intraoperative blood loss,preoperative and 1-month postoperative fraction anisotropy(FA)values of the CST on the affected side,modified Rankin scale(mRS)score at 6 months postoperatively,and surgery-related complications within 1 month postoperatively(intracranial hemorrhage[operative site oozing,hemorrhagic transformation]and intracranial infection[surgical incision site infection,empyema,brain abscess,meningitis]).6-month follow-up after surgery were conducted through outpatient visit or telephone calls and prognosis of patients was evaluated using the mRS(with mRS of 0-3 defined as good prognosis,4-6 as poor prognosis,and 6 indicating death).The effectiveness indicators included FA value of the affected CST at 1 month postoperatively,good prognosis rate after surgery at 6 months,and 6-month mortality rate after surgery.The safety indicators included the incidence rates of surgical complications(intracranial hemorrhage and infection)within 1 month postoperatively.Based on preoperative DTI images,all patients were further divided into a CST-intact(infarct core did not invade CST,CST morphology intact or deformed/shifted)and a CST-damaged(infarct core invaded CST,CST disrupted or interrupted)subgroup for analysis.Results A total of 62patients(37 males,25 females,age 49-60 years,mean[55±4]years)were enrolled in this study.With 28 patients in the experimental group and 34 in the control group.(1)No significant differences were found in baseline or clinical data between the experimental and control groups(all P＞0.05),and the reoperative FA values of the affected CST were showed no significant differences(P=0.588).(2)The efficacy and safety metrics were evaluated.For the efficacy indices,at 1 month after the surgery,FA values of the affected CST increased significantly compared to preoperative values in both groups(0.409±0.051 vs.0.312±0.052 in the experimental group,and,0.381±0.048 vs.0.319±0.049 in control group;both P＜0.05),and the FA value was significantly higher in the experimental group than that in the control group(0.409±0.051 vs.0.381±0.048,P=0.030).At the 6-month follow-ups,the good prognosis rate was significantly higher in the experimental group than that in the control group(39.3％[11/28]vs.14.7％[5/34],P=0.028).No significant difference in the 6-month mortality rate were observed between the two groups(P=0.787).For the safety indices,no significant differences were found in the incidence rates of intracranial hemorrhage or intracranial infection within 1 month postoperatively between the two groups(both P＞0.05).(3)For further subgroup analysis,no significant differences were found in baseline or clinical data between the CST-damaged subgroup and the CST-intact subgroup in both the experimental and control groups(all P＞0.05).In CST-intact subgroup,FA values of the affected CST increased significantly at 1 month postoperatively compared to preoperatively in the study group(0.428±0.047 vs.0.342±0.045,P＜0.05)and the control group(0.401±0.051 vs.0.347±0.048,P＜0.05).While in the CST-damaged subgroup,no significant differences were found in FA value of the affected CST 1 month postoperatively compared with that preoperatively in both the experimental and control groups(bothP＞0.05).A significantly higher FA values 1 month postoperatively(0.428±0.047 vs.0.401±0.051,P=0.036)and good prognosis rate(9/12 vs.4/16,P=0.020)were observed in the CST-intact subgroup of the experimental group comparing with that of the control group,while there was no statistically significant difference in the 6-month mortality rate between the groups within the CST-intact subgroup(P=1.000).There were no statistically significant differences between the experimental group and the control group in both efficacy and safety indices within the CST-damaged subgroup(all P＞0.05).Conclusions Infarct core resection combining DC with CST protection demonstrates superior neurological functional improvement in comparison with anterior temporal lobectomy combining DC in treating MCI with malignant brain edema,particularly for patients with an intact CST before surgery(as indicated in patients'preoperative imaging results).This(infarct core resection combining DC with CST protection)approach does not increase the incidence of surgical complications.Prospective large sample controlled studies are required for further validation.

Objective:To investigate the effect of left colonic artery (LCA) preservation on rectal cancer patients' short-term postoperative anal function and quality of life.Methods:Two-hundred ninty-two patients with rectal cancer at the Department of Gastrointestinal Surgery of Peking University First Hospital between Jan 2022 and Dec 2023 were enrolled . The patients were divided into two groups according to whether the LCA was preserved during surgery or not. The LARS scale and EORTC QLQ-CR29 quality of life questionnaire were used to assess postoperative anal function and quality of life.Results:There were no significant differences between the two groups in terms of the amount of surgical blood loss and the number of lymph node dissections in the root No. 253 group and the time to postoperative voiding (all P>0.05). However, the LARS scores at 1 and 3 months postoperatively were significantly lower in the preserved LCA group than in the LCA nonpreserved group, especially for gas incontinence, loose stool leakage, and number of bowel movements (all P<0.05). The EORTC QLQ-CR29 scores showed that the LCA preserved group recovered significantly better than the non-preserved group in terms of postoperative voiding dysfunction ( P=0.007), urinary incontinence ( P=0.006), mucus discharge ( P=0.009), and fecal incontinence symptoms ( P<0.001). Male sexual dysfunction recovery was quicker in the preserved LCA group ( P=0.043), but there was no significant difference between the two groups at 3 months postoperatively( P>0.05). Conclusion:Preservation of the left colonic artery in low anterior resection of rectal cancer helps to reduce the incidence of postoperative low anterior resection syndrome, improve genitourinary symptoms, and improve patients' quality of life.

Understory planting of medicinal plants is a new planting mode that connects Chinese herbal medicine(CHM) with forest resources.The complex and variable understory environmental factors will inevitably affect the yield and quality of understory CHM.This research summarized the research progress on understory planting of medicinal plants based on forest types and environmental factors within the forest from the perspectives of understory light, air temperature and humidity, soil characteristics, and the interaction between crops within the forest.The results showed that the complex and variable light, temperature and humidity, and soil factors(such as fertility, acidity and alkalinity, and microorganisms) under the forest could affect the yield and quality of medicinal plants to varying degrees through physiological activities such as photosynthesis and respiration, resulting in a significant increase or decrease in yield and quality compared to open field cultivation.In addition, the competition or mutual benefit between different crops within the forest could lead to differences in the yield and quality of understory medicinal plants compared to open field cultivation.A reasonable combination of planting could achieve resource sharing and complementary advantages.Therefore, conducting systematic research on the effects of understory environmental factors on the yield and content of medicinal plants with different growth and development characteristics can provide theoretical guidance and technical references for formulating comprehensive strategies for understory planting of medicinal plants, such as selecting suitable medicinal plant varieties, optimizing planting density, and conducting reasonable forest management, thus contributing to the sustainable development and ecological protection of CHM.
Plants, Medicinal/growth & development* ; Forests ; Soil/chemistry* ; Environment ; Ecosystem ; Temperature

Transformer models have emerged as pivotal tools within the realm of drug discovery,distinguished by their unique architectural features and exceptional performance in managing intricate data landscapes.Leveraging the innate capabilities of transformer architectures to comprehend intricate hierarchical dependencies inherent in sequential data,these models showcase remarkable efficacy across various tasks,including new drug design and drug target identification.The adaptability of pre-trained trans-former-based models renders them indispensable assets for driving data-centric advancements in drug discovery,chemistry,and biology,furnishing a robust framework that expedites innovation and dis-covery within these domains.Beyond their technical prowess,the success of transformer-based models in drug discovery,chemistry,and biology extends to their interdisciplinary potential,seamlessly combining biological,physical,chemical,and pharmacological insights to bridge gaps across diverse disciplines.This integrative approach not only enhances the depth and breadth of research endeavors but also fosters synergistic collaborations and exchange of ideas among disparate fields.In our review,we elucidate the myriad applications of transformers in drug discovery,as well as chemistry and biology,spanning from protein design and protein engineering,to molecular dynamics(MD),drug target iden-tification,transformer-enabled drug virtual screening(VS),drug lead optimization,drug addiction,small data set challenges,chemical and biological image analysis,chemical language understanding,and single cell data.Finally,we conclude the survey by deliberating on promising trends in transformer models within the context of drug discovery and other sciences.