Objective To explore the model of decreased ovarian reserve(DOR)induced by experimental autoimmune thyroiditis(EAT)in mice and investigate the protective mechanism of Jiexu Zichong Granules(ZCWS).Methods Ninety-six Kunming female mice were randomly divided into the J control group,BIW control group,J model group,and BIW model group.The mice were immunized with antigen(0.1 mg,once or twice per week)combined with high iodine water(0.64 g/L)for 7-19 weeks to validate the model.Subsequently,30 mice were randomly divided into the ZCWS group,model group,and control group.The DOR model was established by immunization with the antigen(0.2 mg per week)combined with high iodine water feeding for 13 weeks.The ZCWS group received oral administration of traditional Chinese medicine suspension(0.64 g/mL),while the remaining groups received an equivalent volume of physiological saline for 7 weeks.Thyroid and ovarian tissue morphology and related indicators were detected using HE staining,ELISA,IHC,and Western blot.Results Antigen immunization for 13 weeks(0.1-0.2 mg per week)combined with high iodine water feeding stably constructed the EAT DOR model.ZCWS reduced thyroid lymphocyte infiltration,follicular structure destruction,and serum TPOAb and TGAb levels(P<0.01).It inhibited MDA activity(P<0.01),increased GSH-Px and SOD activities(P<0.05),increased primordial,primary,and secondary follicles(P<0.05),and reduced atretic follicles(P<0.01).ZCWS upregulated AMH and downregulated FSH(P<0.01),regulated the expression of Bcl-2,Bax,and Caspase-3 proteins in ovarian tissue,downregulated Keap1 protein(P<0.01),and upregulated Nrf2(P<0.01),HO-1,and LONP1 proteins(P<0.05).It upregulated Bcl-2 protein(P<0.05),downregulated Bax(P<0.01),and Caspase-3(P<0.05)proteins,downregulated Keap1 protein(P<0.01),and upregulated Nrf2(P<0.01),HO-1,and LONP1 proteins(P<0.05)in ovarian tissue.Conclusion ZCWS improves ovarian reserve function in EAT mice by activating the Nrf2 pathway,inhibiting oxidative stress,and reducing follicular atresia.

This paper summarizes Professor WANG Xiuxia's clinical experience in treating hyperprolactinemia using the liver soothing therapy. Professor WANG identifies liver qi stagnation and rebellious chong qi （冲气） as the core pathomechanisms of hyperprolactinemia. Furthermore， liver qi stagnation may transform into fire or lead to pathological changes such as spleen deficiency with phlegm obstruction or kidney deficiency with essence depletion. The treatment strategy centers on soothing the liver， with a modified version of Qinggan Jieyu Decoction （清肝解郁汤） as the base formula. Depending on different syndrome patterns such as liver stagnation transforming into fire， liver stagnation with spleen deficiency， or liver stagnation with kidney deficiency， heat clearing， spleen strengthening， or kidney tonifying herbs are added accordingly. In addition， three paired herb combinations are commonly used for symptom specific treatment， Danggui （Angelica sinensis） with Chuanxiong （Ligusticum chuanxiong）， Zelan （Lycopus lucidus） with Yimucao （Leonurus japonicus） ， and Jiegeng （Platycodon grandiflorus） with Zisu （Perilla frutescens）.

Objective To Study the value of effected ejection fraction(eEF)in assessment of cardiac function in elderly patients with heart failure.Methods A total of 1 134 elderly inpatients in this hospital from January 2019 to December 2023 were selected as the research subjects.After admission,relevant examinations and tests were completed,and the cardiac function classification of the New York Heart Association(NYHA)was carried out.Sequential electrocardiogram(ECG)and echocardiogram examinations were completed before treatment.Age,under-lying diseases,left ventricular ejection fraction(LVEF),N-terminal pro-brain natriuretic peptide(NT-proB-NP),and QT interval(QTc)of the ECG were included for classification and statistics,and eEF was obtained,and the evaluation value of eEF on cardiac function was analyzed.Results The numbers of patients with NY-HA cardiac function grades Ⅰ—Ⅳ were 86,434,454 and 160,respectively,and LVEF decreased with the in-crease of the NHYA cardiac function grade.There was statistically significant differences in LVEF among dif-ferent NHYA cardiac function classifications(P＜0.05).The QTc of the patients was(434.71±40.96)ms,the eEF was(8.73±2.03)ms,and the ln(NT-proBN)was 7.05±1.70.QTc,eEF,and ln(NT-proBN)all in-creased with the increase of the NHYA cardiac function classification,and there were statistically significant differences in indicators above among different NHYA cardiac function classfications(P＜0.05).There was a low correlation between QTc of the ECG,age and cardiac insufficiency(r＜0.5,P＜0.05);there was a high correlation between eEF,LVEF,and ln(NT-proBNP)and cardiac insufficiency(r≥0.5,P＜0.05).Conclusion eEF still has discriminatory value for patients with heart failure with preserved ejection fraction,and it is a good indicator for evaluating the cardiac function of elderly patients with heart failure.

Objective To explore the model of decreased ovarian reserve(DOR)induced by experimental autoimmune thyroiditis(EAT)in mice and investigate the protective mechanism of Jiexu Zichong Granules(ZCWS).Methods Ninety-six Kunming female mice were randomly divided into the J control group,BIW control group,J model group,and BIW model group.The mice were immunized with antigen(0.1 mg,once or twice per week)combined with high iodine water(0.64 g/L)for 7-19 weeks to validate the model.Subsequently,30 mice were randomly divided into the ZCWS group,model group,and control group.The DOR model was established by immunization with the antigen(0.2 mg per week)combined with high iodine water feeding for 13 weeks.The ZCWS group received oral administration of traditional Chinese medicine suspension(0.64 g/mL),while the remaining groups received an equivalent volume of physiological saline for 7 weeks.Thyroid and ovarian tissue morphology and related indicators were detected using HE staining,ELISA,IHC,and Western blot.Results Antigen immunization for 13 weeks(0.1-0.2 mg per week)combined with high iodine water feeding stably constructed the EAT DOR model.ZCWS reduced thyroid lymphocyte infiltration,follicular structure destruction,and serum TPOAb and TGAb levels(P<0.01).It inhibited MDA activity(P<0.01),increased GSH-Px and SOD activities(P<0.05),increased primordial,primary,and secondary follicles(P<0.05),and reduced atretic follicles(P<0.01).ZCWS upregulated AMH and downregulated FSH(P<0.01),regulated the expression of Bcl-2,Bax,and Caspase-3 proteins in ovarian tissue,downregulated Keap1 protein(P<0.01),and upregulated Nrf2(P<0.01),HO-1,and LONP1 proteins(P<0.05).It upregulated Bcl-2 protein(P<0.05),downregulated Bax(P<0.01),and Caspase-3(P<0.05)proteins,downregulated Keap1 protein(P<0.01),and upregulated Nrf2(P<0.01),HO-1,and LONP1 proteins(P<0.05)in ovarian tissue.Conclusion ZCWS improves ovarian reserve function in EAT mice by activating the Nrf2 pathway,inhibiting oxidative stress,and reducing follicular atresia.

Background and aims:Primary sclerosing cholangitis(PSC)is an autoimmune liver disease characterized by complex pathogenesis and limited available therapeutic options.The mechanisms underlying the development and progression of PSCs remain unclear.Liver X receptor beta(LXR-β)is recognized to modulate lipid metabolism and immune response,but its specific involvement in the PSC has not been elucidated.Here,we explored the role and mechanism of LXR-β in PSC induced by 3,5-diethoxycarbonyl-1,4-dihydro-2,4,6-collidine(DDC).Methods:CRISPR-Cas9 technology was applied to generate Abcb4(coding MDR2,next named as Mdr2),Nr1h2(coding LXR-β,next named as Lxrβ),and Rag2(coding RAG2)knockout mice.DDC was used to induce PSC.Hematoxylin and eosin and Sirius red staining were used to assess the extent of hepatic injury and fibrosis.Flow cytometry was used to observe immune cell subsets.Results:We observed a declining trend in hepatic Lxrβ in the PSC model.Unexpectedly,Lxrβ knockout failed to modulate DDC-induced PSC pathogenesis.Concomitantly,assessment of the influence of Rag2 deficiency on PSC progression revealed the absence of aggravated or alleviated hepatic injury or fibrosis in the Rag2-/-DDC mice.However,Lxrβ depletion intensified DDC-induced PSC in the Rag2-/-mice,with more abundant infiltrative inflammatory cells and more severe liver fibrosis.Compared with Rag2-/-DDC mice,Lxrβ-/-Rag2-/-DDC mice had higher serum ALT and AST levels and mRNA expression of proinflammatory and profibrotic genes.Flow cytometry showed that LXR-β deficiency resulted in a diminished population of hepatic innate immune cells.Conclusion:This study indicated innate immune cell LXR-β deficiency can exacerbate hepatic injury and fibrosis in murine models of PSC suggesting that LXR-β may regulate the function of innate immunity in the fibrotic advancement of PSC.

Objective:To construct prediction model based on particle swarm optimization long short-term memory(PSO-LSTM)algorithm for medical consumables,so as to predict the consumption of medical consumables and realize the fine management for medical consumables.Methods:The consumption of medical consumables was analyzed through constructed the PSO-LSTM prediction model,and then,the consumption of medical consumables was assessed.A total of 900 medical consumables which were clinically used in the Center of Endoscopy of Nanjing Tianyinshan Hospital Affiliated to China Pharmaceutical University from March to August 2024 were selected,and they were randomly divided into conventional management mode group(n=450 consumables)and PSO-LSTM management mode group(n=450 consumables)by random number table method,so as to conduct management for consumables.The management time,management timeliness,situation of monthly management of medical consumables,and predicted accuracy of consumption amount of medical consumables of two management mode in single diagnosis and treatment were compared.Results:The prepared time,delivered time,response time of temporary application,and the time of returning storehouse of medical consumables in PSO-LSTM model management mode were respectively(3.36±1.66),(9.54±2.69),(3.69±1.65)and(3.47±1.87)min,which were all less than those in conventional management mode,and the differences were statistically significant(t=7.76,13.811,28.147,39.105,P<0.05).The timeliness of supplementing medical consumables,shortage warning and proposing treatment methods of using PSO-LSTM model management mode were respectively(0.87±0.23),(3.26±0.87)and(14.98±2.65)min,which were all less than those of using conventional management mode,and the differences of them were statistically significant(t=4.228,15.482,13.420,P<0.05).In 450 medical consumables of the center of endoscopy,the amounts of the monthly average emergency purchasing and monthly average shortage were respectively 20 and 22 in using PSO-LSTM model management mode,accounting for 4.44%and 4.89%,all of which were lower than those of conventional management mode,and the differences of them were statistically significant(x2=10.364,11.835,P<0.05).The prediction results of using PSO-LSTM model management mode for disposable infusion device and disposable auxiliary kit of gastroscopy were closer to the actual consumption than the conventional management mode,while the differences of them were not significant(P>0.05).Conclusion:The application of the management mode of predictive model of medical consumables based on PSO-LSTM algorithm in the management of medical consumables of the center of endoscopy in hospital can accurately assess the consumption of medical consumables,and provide scientific basis for the procurement decision of medical consumables,and achieve fine management for various kinds of medical consumables,and reduce the cost of medical consumables in the center of endoscopy.

Objective:To construct prediction model based on particle swarm optimization long short-term memory(PSO-LSTM)algorithm for medical consumables,so as to predict the consumption of medical consumables and realize the fine management for medical consumables.Methods:The consumption of medical consumables was analyzed through constructed the PSO-LSTM prediction model,and then,the consumption of medical consumables was assessed.A total of 900 medical consumables which were clinically used in the Center of Endoscopy of Nanjing Tianyinshan Hospital Affiliated to China Pharmaceutical University from March to August 2024 were selected,and they were randomly divided into conventional management mode group(n=450 consumables)and PSO-LSTM management mode group(n=450 consumables)by random number table method,so as to conduct management for consumables.The management time,management timeliness,situation of monthly management of medical consumables,and predicted accuracy of consumption amount of medical consumables of two management mode in single diagnosis and treatment were compared.Results:The prepared time,delivered time,response time of temporary application,and the time of returning storehouse of medical consumables in PSO-LSTM model management mode were respectively(3.36±1.66),(9.54±2.69),(3.69±1.65)and(3.47±1.87)min,which were all less than those in conventional management mode,and the differences were statistically significant(t=7.76,13.811,28.147,39.105,P<0.05).The timeliness of supplementing medical consumables,shortage warning and proposing treatment methods of using PSO-LSTM model management mode were respectively(0.87±0.23),(3.26±0.87)and(14.98±2.65)min,which were all less than those of using conventional management mode,and the differences of them were statistically significant(t=4.228,15.482,13.420,P<0.05).In 450 medical consumables of the center of endoscopy,the amounts of the monthly average emergency purchasing and monthly average shortage were respectively 20 and 22 in using PSO-LSTM model management mode,accounting for 4.44%and 4.89%,all of which were lower than those of conventional management mode,and the differences of them were statistically significant(x2=10.364,11.835,P<0.05).The prediction results of using PSO-LSTM model management mode for disposable infusion device and disposable auxiliary kit of gastroscopy were closer to the actual consumption than the conventional management mode,while the differences of them were not significant(P>0.05).Conclusion:The application of the management mode of predictive model of medical consumables based on PSO-LSTM algorithm in the management of medical consumables of the center of endoscopy in hospital can accurately assess the consumption of medical consumables,and provide scientific basis for the procurement decision of medical consumables,and achieve fine management for various kinds of medical consumables,and reduce the cost of medical consumables in the center of endoscopy.

Objective To evaluate the performance of two immunochromatography kits (lateral flow immunoassay) in detecting carbapenemases in carbapenem-resistant Enterobacterales (CRE).Methods A total of 390 nonduplicate clinical isolates of Enterobacterales were collected and tested.The carbapenemase gene was identified by polymerase chain reaction (PCR).The five common carbapenemases were tested by two immunochromatography kits.Results Overall,213 of the 390 Enterobacterales isolates were CRE and 177 strains were carbapenem-susceptible based on antimicrobial susceptibility testing.PCR assay confirmed that 207 of the 213 CRE strains carried carbapenemase genes,including KPC genotype in 119 strains,NDM genotype in 71 strains,IMP genotype in 9 strains,OXA-48-like genotype in 7 strains,both KPC and NDM genes in 1 strain,while none of the five common carbapenemases in 6 CRE strains.Two immunochromatography kits were used simultaneously to test the production of carbapenemases.The results of the two commercial kits were 100％ consistent with PCR results.The sensitivity and specificity of the two kits were 100％ (95％ CI,97.7％-100％) and 100％ (95％ CI,97.4％-100％) in detection of the five carbapenemases.Conclusions The immunochromatography method is rapid and easy to operate,and can be used to detect the production of carbapenmases in clinical isolates.

Objective:Exploratory study on the relationship between TCM syndrome types, TCM constitution and clinical symptoms of idiopathic central precocious puberty children and rapidly progressive early development children in Shanghai, so as to provide a basis for early intervention and syndrome differentiation and treatment.Methods:A cross-sectional study and retrospectively enrolled. Through questionnaire survey, the basic information, clinical symptoms and TCM constitution of children diagnosed with idiopathic central precocious puberty and rapidly progressive early development were collected from the Pediatric Endocrinology Clinic of Affiliated Shuguang Hospital of Shanghai University of Traditional Chinese Medicine from July to August 2022, and the correlation between the distribution, differentiation and clinical symptoms of TCM constitution in children with idiopathic central precocious puberty and children with rapidly progressive precocious puberty in Shanghai were explored through data analysis.Results:① Fast progressive early development children with higher BMI and age than idiopathic central precocious puberty were statistically significant ( P<0.05), and no significant difference in the sex composition ratio between the two groups. ② Among children with idiopathic central precocious puberty and children with rapid progressive early development, the proportion of liver depression fire syndrome was the highest, 59.15% (42/71) and 46.51% (60/129) respectively, and the proportion of Qi depression was the highest, 35.21% (25/71) and 36.43% (47/129) respectively. However, there was no significant difference in the TCM syndrome types and physical distribution of the two groups. ③ The TCM syndrome types of 200 precocious children weres correlated with physical distribution, among which Yin deficiency fire flourishing syndrome was significantly associated with Yin deficiency, liver stagnation fire syndrome was significantly correlated with qi depression, and phlegm dampness obstruction syndrome was significantly correlated with phlegm dampness and Yang deficiency ( P<0.01). ④ A total of 200 children with precocious puberty were more female than male, male BMI was higher than female, and the BMI of children with precocious puberty was higher than other syndrome types, and the differences were statistically significant ( P<0.01). Liver stasis fire syndrome was the highest proportion between boys and girls, but there was no obvious difference in TCM syndrome types between different genders. The highest proportion of breast pain in clinical symptoms was 22.19% (69/311). Conclusion:Children with idiopathic central precocious puberty and rapidly progressive early development children have differences in age and BMI, with no obvious difference in gender composition, TCM syndrome type and physical distribution, but there is a correlation between TCM syndrome type and physical constitution of precocious puberty children.

This paper summarized the experience of integrated acupuncture and moxibustion program in the treatment of bipolar disorder （BD）. The pathogenesis of BD is a complex of deficiency and excess， which is closely related to the liver failing to govern the free flow of qi， the spleen failing to transport， phlegm-heat harassing the heart spirit. The pathogenesis of depressive episode is mainly qi constraint， and the most common syndromes are liver qi constraint， liver constraint accompanied by spleen deficiency， phlegm and qi constraint， qi stagnation and blood stasis. The pathogenesis of manic episode is mainly fire-heat， and the most common syndromes are exuberant heat in yangming （阳明）， intense heart-liver fire， phlegm-fire disturbing heart， and exuberant fire damaging yin. BD can be treated by the integrated acupuncture and moxibustion program， in which acupuncture is used to soothe the liver and regulate the mind， and refined moxibustion is to unblock and replenish yang； collateral bloodletting and cupping is used to move qi and drain fire， and needle-embedding therapy can be used to consolidate the curative effect. These therapies together have the effects of soothing the liver and regulating qi， fortifying the spleen and dissolving phlegm， calming the heart and draining fire.