OBJECTIVE: Citri Reticulatae Pericarpium (Chenpi, CRP) is one of the most used traditional Chinese medicines with great medicinal, dietary and collection values, among which the Citrus reticulata cv. 'Chachi' (Citrus reticulata cv. Chachiensis) from Guangdong Xinhui is the geoherb of CRP. Xinhui CRP in the market was often counterfeited with other varieties or origins, molecular identification method can effectively distinguish different CRP varieties, but it's still a difficult problem to identify the same CRP variety from different origin. It is necessary to discover a new molecular marker to ensure the safe and effective application of Xinhui CRP. METHODS: We selected one of the most studied transcription factor families in Citrus genus, MYB, to design the specific candidate primers on the conserved region. The primers with good band repeatability and high polymorphism were screened for PCR amplification of the test materials, and the genetic similarity coefficient among different families, genera, species, and origins were calculated. The cluster analysis was performed by unweighted pair group method using arithmetic average (UPGMA). RESULTS: A total of ten MYB primers were screened out to identify Xinhui CRP from plants from different family (Panax ginseng and Morus alba), genus (Clausena lansium and Zanthoxylum schinifolium), and species (Citrus reticulata, C. sinensis and C. maxima). Furthermore, two from the ten primers, M1 and M10, were found to distinguish Xinhui CRP from other origins. There were 169, 113, 133 and 134 polymorphic bands in the identification of different families, genera, species, and origins respectively, and the accordingly polymorphism ration were 79.88%, 76.87%, 79.20% and 82.84%. Moreover, M1 was discovered to be the best primer to identify Xinhui CRP from other seven origins, the cluster analysis results based on the genetic similarity coefficients were consistent with the geographical distribution. CONCLUSION This study established a novel molecular identification method according to MYB transcription factor, which can analyze the potential parental relationship of CRP germplasm, as well as identify the quality and origins of Xinhui CPR.

Objective:To explore the application effects of a four-in-one blended teaching model integrating artificial intelligence, virtual reality, 3D printing, and case-based learning (CBL) in the clinical teaching of spinal tumors.Methods:We divided 89 students on training in the Department of Orthopedics of Peking University Third Hospital from September 2022 to August 2024 into control group ( n=47) and experimental group ( n=42). The control group adopted traditional teaching, and the experimental group adopted the four-in-one teaching model. At the end of clinical teaching, an artificial intelligence test and a questionnaire survey were administered to the students to evaluate the teaching effects. The two groups were compared using the independent samples t-test with the use of SPSS 27.0. Results:The experimental group was superior to the control group with significant improvements in the answer accuracy rate (66.67%, χ2=9.44, P=0.002), learning interest [(4.50±0.63), t=2.75, P=0.007], theoretical knowledge mastery [(4.64±0.69), t=7.74, P<0.001], clinical thinking [(4.48±0.71), t=9.08, P<0.001], practical skills [(4.13±0.89), t=2.69, P=0.009], scientific research innovation [(4.71±0.59), t=9.28, P<0.001], teacher-student interaction [(4.74±0.54), t=12.76, P<0.001], and classroom attention [(4.69±0.52), t=12.64, P<0.001]. At the same time, the students in the experimental group put forward numerous constructive feedback. Conclusions:The four-in-one blended teaching model combining artificial intelligence, virtual reality, 3D printing, and CBL can help undergraduate medical students better recognize and diagnose spinal tumors with a correct clinical thinking path, achieving good teaching effects.

Aim To investigate the role of triggering receptor expressed on myeloidcells 2(TREM2)in syn-aptic plasticity induced by cocaine addiction.Methods C57BL/6J mice and Trem2 knockout mice were uti-lized in this study to evaluate the alterations in postsyn-aptic density protein 95(PSD-95)and synapsin 1(SYN1)within the cortex and hippocampus of co-caine-addicted mice by using immunological tech-niques.Results HE staining and Nissl staining showed increased neuronal damage in the hippocampus and cortex of mice after cocaine addiction.The results of immunohistochemistry and fluorescence of PSD-95 and SYN1 were consistent with the expression trend of Western blot.In the wild type mouse model,the ex-pression level of PSD-95 in the hippocampus and cortex was lower than that in the saline group,and the ex-pression of SYN1 was higher than that in the saline group.In the knockout mouse model,the expression levels of PSD-95 and SYN1 in the hippocampus and cortex were significantly higher than those in the saline group after cocaine addiction.The expression levels of PSD-95 and SYN1 in the hippocampus and cortex of cocaine knockout mice were higher than those of co-caine wild type mice.Conclusion Cocaine addiction can change the synaptic plasticity,and TREM2 plays a regulatory role in the synaptic plasticity of hippocampus and cortex in mice with cocaine injury.TREM2 is ex-pected to be a new target for studying the mechanism of cocaine addiction.

Objective To explore the injury process of retinal ganglion cells(RGCs)after glucocorticoid(GC)-in-duced ocular hypertension(OHT),as well as the protective effect and mechanism of estradiol(E2)in RGC injury in rats with OHT.Methods Atotalof36(36 eyes)12-week-old male Sprague-Dawley(SD)rats were randomly divided into the blank control group,the GC-OHT group,and the OHT-E2 group,with 12 rats in each group.Rats in the GC-OHT group and the OHT-E2 group were subconjunctivally injected with GC,while those in the blank control group were subconjuncti-vally injected with an equal volume of normal saline.Two weeks after modeling,in addition to being injected with GC,rats in the OHT-E2 group were also provided with E2 eye drops.Before modeling and 1,2,3,and 4 weeks after modeling,the intraocular pressure of rats in each group was measured.The visual acuity changes of rats in each group were detected by pattern electroretinogram(P-ERG)and flash visual evoked potential(F-VEP)4 weeks after modeling.After the eyeballs were removed,the distribution and number of RGCs in rats of each group were observed by immunofluorescence staining.Immunohistochemistry,Western blot,and real-time fluorescence-based quantitative polymerase chain reaction were used to detect the relative protein and mRNA expression levels of NOD-like receptor protein 3(NLRP3),cysteine aspartate prote-ase-1(Caspase-1),and gasdermin-D(GSDMD)in rats in each group.Results There was no statistically significant difference in the intraocular pressure of rats in each group before modeling(P＞0.05).Compared with the blank control group,the intraocular pressure of rats in the GC-OHT group increased 1,2,3,and 4 weeks after modeling,and the differ-ences were all statistically significant(all P＜0.01).Compared with the GC-OHT group,the intraocular pressure of rats in the OHT-E2 group decreased 3 and 4 weeks after modeling,and the differences were all statistically significant(all P＜0.01).The P-ERG and F-VEP results showed that compared with the blank control group,the amplitudes of P50 and P1 waves of rats in the GC-OHT group decreased,and the differences were both statistically significant(both P＜0.05).Com-pared with the GC-OHT group,the amplitudes of P50 and Pl waves of rats in the OHT-E2 group increased,and the differ-ences were both statistically significant(both P＜0.05).The immunofluorescence staining results showed that compared with the blank control group,the number of RGCs of rats in the GC-OHT group decreased,and the difference was statisti-cally significant(P＜0.001).Compared with the GC-OHT group,the number of RGCs of rats in the OHT-E2 group in-creased,and the difference was statistically significant(P＜0.001).The results of immunohistochemistry,Western blot,and real-time fluorescence-based quantitative polymerase chain reaction showed that compared with the blank control group,the relative protein and mRNA expression levels of NLRP3,Caspase-1,and GSDMD in the retina of rats in the GC-OHT group all increased,and the differences were all statistically significant(all P＜0.05).Compared with the GC-OHT group,the relative protein and mRNA expression levels of NLRP3,Caspase-1,and GSDMD in the retina of rats in the OHT-E2 group all decreased,and the differences were all statistically significant(all P＜0.01).Conclusion GC-induced OHT can cause pyroptosis of RGCs,and E2 may alleviate the injury of RGCs in rats with OHT by inhibiting the pyroptosis-related NLRP3/Caspase-1/GSDMD signaling pathway.

Objective:To explore the clinical efficacy of metoprolol combined with trimetazidine on elderly patients with coronary heart disease(CHD)and chronic heart failure(CHF).Methods:This randomized controlled trial enrolled 120 elderly CHD+CHF patients admitted to Army 73rd Group Military Hospital of Chinese PLA between June 2020 and June 2023.Patients were divided into control group(metoprolol based on routine treatment)and in-tervention group(additional trimetazidine therapy).Each group consisted of 60 patients,treated for 1 month.The clinical efficacy,left ventricular ejection fraction(LVEF),cardiac index(CI),left ventricular end-systolic diame-ter(LVESd),left ventricular end-diastolic diameter(LVEDd),serum levels of brain natriuretic peptide(BNP),high sensitive C-reactive protein(hsCRP),platelet a granule membrane protein-140(GMP-140),intercellular adhesion molecule-1(ICAM-1)and growth differentiation factor 15(GDF-15),and incidence of adverse reac-tions were compared between the two groups.Results:The total effective rate of the intervention group was significant-ly higher than that of the control group(95.00％vs.81.67％,P=0.023).Compared to patients in the control group,those in the intervention group had significant lower LVESd[(35.03±5.14)mm vs.(40.63±3.87)mm],LVEDd[(43.53±4.27)mm vs.(48.36±5.22)mm],levels of BNP[(94.35±7.55)pg/ml vs.(127.86±45.11)pg/ml],hsCRP[(0.91±0.28)mg/L vs.(1.47±0.52)mg/L],GMP-140[(7.14±1.06)μg/L vs.(9.37±1.59)μg/L],ICAM-1[(43.81±5.75)pg/ml vs.(52.74±5.83)pg/ml]andGDF-15[(891.46±62.51)pg/ml vs.(1025.57±110.08)pg/ml],and significant higher LVEF[(55.62±5.11)％vs.(47.35±8.61)％]and CI[(3.41±0.38)L·min-1·m-2 vs.(3.08±0.31)L·min-1·m-2](P＜0.001 all).There was no significant difference in the total inci-dence of adverse reactions between the intervention group and control group(8.33％vs.11.67％,P=0.543).Conclu-sion:Metoprolol combined trimetazidine may relieve myocardial inflammatory response and injury,and inhibit ventricular remodeling,thereby improve cardiac function in elderly patients with CHD and CHF.

Objective:To explore a reasonable relationship between the survival of descending genicular artery (chimeric) perforator flap [DGAPF (-Ch)] and the preservation of the great saphenous vein (GSV), so as to optimise the protection and reduction of a damage to the donor site in clinical applications.Methods:From June 2015 to October 2022, the Division of Orthopaedics and Traumatology of Department of Orthopaedics of Nanfang Hospital, Southern Medical University, conducted cadaver perfusion studies on 15 fresh specimens of human lower extremity, and then on 31 patients who received free DGAPF (-Ch) transfer surgery. Among the patients, 13 had soft tissue defects in hand or forearm, 17 had soft tissue defects in foot or ankle and 1 had early femoral head necrosis after internal fixation for femoral neck fracture. Among them, 6 patients were complicated with bone defect. The size of soft tissue defect was 5.5 cm×3.0 cm-13.0 cm×6.5 cm, the size of flaps was 6.5 cm×3.5 cm-14.5 cm×7.5 cm, and bone flap volume was 3.5 cm×1.5 cm×1.5 cm-5.0 cm×1.5 cm×1.5 cm. All patients underwent preoperative evaluation of donor site by computed tomography angiography (CTA), and the CTA data were processed with Mimics 20.0 to design the flaps. Intraoperatively, the location of the descending genicular artery (DGA) was detected using Doppler ultrasound. When harvesting the flap, the P point (SP-p) was used as the centre to form an arteriovenous pedicle. A matching medial femoral condyle flap was designed to reconstruct the bone defect. The free flap (25 patients) or chimeric flap (6 patients) was transferred to the recipient site, and end-to-end vessel anastomoses were performed to establish the blood supply. After surgery, the patients were kept in bed for 7-9 days. Antibiotics were routinely administered to prevent infection, together with a symptomatic anticoagulation and anti-spasm treatment. The colour, temperature, capillary refilling and tension of the flap were closely observed. All patients were entered in postoperative follow-up at outpatient clinic for review at 1, 3, and 6 months after surgery to observe the appearance, texture and function of the flaps and the condition of the donor sites.Results:Through anatomy observation, cutaneous perforating branch of DGA was located in front of the main trunk of the GSV at the plane of medial femoral condyle. It was found that both of the perforators of cutaneous artery and the branches of osteoarticular artery originated from the DGA. Distance between SP-p and S-p(DSPS) of fresh samples was 2.9-4.1 (3.6±0.5) cm. The DSPS of 31 patients measured in surgery was 2.9-4.3 (3.7±0.4) cm. A total of 30 flaps survived completely. One flap had partial necrosis, which healed at 2 weeks after skin grafting. The postoperative follow-up lasted for 6-48 (mean, 11.23) months. X-rays of 5 patients with chimeric bone flaps showed the healing of bone defects at 3 months after surgery. All donor sites were directly sutured and left with linear scars after healing, except 5 donor sites that received skin grafting. Eight patients received further flap thinning surgery at 3 to 12 months after primary surgery without any complication. All donor sites healed well without numbness.Conclusion:If the GSV is preserved during harvest of a DGAPF(-Ch), it causes less damage to the donor site and does not affect the survival of the flap. The DGAPF(-Ch) without GSV is a better method in the surgical treatment of complex tissue defects.

Objective:To analyze the clinical characteristics of the Chikungunya fever outbreak in Shunde District, Foshan City, Guangdong Province in July 2025 and the risk factors associated with delayed viral RNA clearance.Methods:A total of 562 patients with Chikungunya fever admitted to three designated hospitals in Shunde District from July 10 to 30, 2025 were enrolled. Demographic data, clinical manifestations, and laboratory findings were collected. Patients were categorized into four age groups including minors (<18 years), young adults (18 to 39 years), middle-aged adults (40 to 64 years) and elderly adults (≥65 years). The differences of clinical characteristics among these age groups were analyzed. Intergroup comparisons were performed using chi-square test, one-way analysis of variance, or Kruskal-Wallis H test. Pairwise comparisons between groups were conducted using the Bonferroni or Games-Howell or Dunn method. Binary logistic regression was employed to analyze risk factors associated with delayed viral RNA clearance (>7 days). Results:The mean age of the 562 enrolled Chikungunya fever patients was (44.8±21.3) years. Fever, arthralgia and rash were the three core symptoms, with incidence rates of 87.5% (492/562), 88.4%(497/562) and 69.6%(391/562), respectively. At discharge, only 54.1%(304/562) of patients achieved complete symptom resolution, while 26.5%(149/562) still had arthralgia and 36.1%(203/562) had residual rash. Significant differences were observed among age groups in the incidence of fever ( χ2=9.43, P=0.024), peak body temperature ( F=6.54, P<0.001), incidence of arthralgia ( χ2=26.89, P<0.001), duration of arthralgia ( F=12.68, P=0.001), incidence of rash ( χ2=68.99, P<0.001), rate of residual rash at discharge ( χ2=32.37, P<0.001), lymphocyte count ( F=12.94, P<0.001), platelet count ( F=14.95, P<0.001), and C-reactive protein levels (CRP) ( H=94.18, P<0.001). Further pairwise comparisons revealed that compared to the middle-aged and elderly groups, the minor group had a higher incidence of fever and a lower incidence of arthralgia, and the duration of arthralgia was shorter than the elderly group (all P<0.008 3). Compared with the other three groups, the elderly group had lower incidence and residual rate of rash, and lower platelet counts (all P<0.008 3), and higher levels of CRP (all P<0.05). The elderly group had lower lymphocyte counts compared to the minor and young adult groups (both P<0.05). Significant differences were found among age groups in the time to viral RNA clearance ( F=5.77, P=0.003) and length of hospital stay ( F=11.64, P<0.001), with the elderly group having significantly longer duration for both compared to the other three groups (all P<0.05). Multivariate analysis showed that advanced age (odds ratio ( OR)=1.049, 95% confidence interval ( CI) 1.015 to 1.083), longer duration of fever ( OR=1.529, 95% CI 1.086 to 2.155) and longer duration of arthralgia ( OR=1.927, 95% CI 1.318 to 2.817) were independent risk factors for delayed viral RNA clearance (all P<0.05). Conclusions:Patients with Chikungunya fever in Shunde District primarily present with fever, arthralgia and rash. The incidence and characteristics of these three core symptoms show age-related variations. Elderly patients and those with longer durations of fever or arthralgia are more likely to experience delayed viral clearance.

Objective To observe the predictability of the corneal stromal reduction with smart pulse technology-as-sisted transperitoneal photorefractive keratomileusis(SPT-TPRK)and femtosecond laser-assisted in situ keratomileusis(FS-LASIK).Methods Patients undergoing laser surgery in the Department of Ophthalmology of the First Affiliated Hos-pital of Xinxiang Medical College from February to September 2023 were selected and divided by surgical modalities into an SPT-TPRK group(21 cases,37 eyes)and an FS-LASIK group(18 cases,32 eyes).The uncorrected visual acuity(UCVA),intraocular pressure,corneal thickness,and corneal epithelial thickness were measured before surgery,1 week,1 month and 3 months after surgery.The cutting deviation was calculated,and the change of corneal stromal thickness was ob-served.The correlation between the predicted corneal stromal reduction and the cutting deviation was analyzed.Results There were significant differences in UCVA among different time points in both SPT-TPRK and FS-LASIK groups(all P＜0.001).The UCVA of patients in the FS-LASIK group was significantly higher than that in the SPT-TPRK group 1 week after surgery(P＜0.001).The difference in UCVA was not statistically significant between the two groups 1 month and 3 months after surgery(all P＞0.05).There were significant differences in intraocular pressure among different time points in both SPT-TPRK and FS-LASIK groups(all P＜0.001).The FS-LASIK group had a lower intraocular pressure than the SPT-TPRK group 1 week after surgery(P＜0.05),but the difference in intraocular pressure was not statistically significant between the two groups 1 month and 3 months after surgery(all P＞0.05).There was significant difference between predicted cor-neal stromal reductions and actual corneal stromal reductions measured at different time points postoperatively in both SPT-TPRK and FS-LASIK groups(all P＜0.001).The actual corneal stromal reductions were higher than the predicted ones in the SPT-TPRK group at all postoperative time points(all P＜0.05).In the FS-LASIK group,the actual corneal stromal re-ductions were higher than the predicted ones 1 week and 1 month after surgery(all P＜0.05),but the actual and predicted corneal stromal reductions were not significantly different 3 months after surgery(P＞0.05).The cutting deviations were not significantly different between SPT-TPRK and FS-LASIK groups 1 month after surgery(P＞0.05),while the cutting de-viations were significantly different between the two groups 1 week and 3 months after surgery(all P＜0.05).There were significant differences in the change of the stromal thickness among different time points in both SPT-TPRK and FS-LASIK groups(all P＜0.05).There was no significant difference in the change of the stromal thickness among different time points in the SPT-TPRK group(all P＞0.05).The stromal thickness showed greater changes 1 month after surgery than that 1 week after surgery in the FS-LASIK group(P＜0.05).There were no significant differences in the change of the stromal thickness between 1 month and 3 months after surgery in the FS-LASIK group(P＞0.05).Correlation analysis showed a positive correlation between the predicted corneal stromal reduction and the cutting deviation in the SPT-TPRK group 1 week after surgery(P＜0.05),but they had no correlation 1 month and 3 months after surgery(all P＞0.05).There was no correlation between the predicted corneal stromal reduction and the cutting deviation in the FS-LASIK group at all post-operative time points(all P＞0.05).Conclusion Patients who receive SPT-TPRK or FS-LASIK can both achieve good visual acuity and a reduction in intraocular pressure.FS-LASIK has better predictability in refractive error correction than SPT-TPRK.

Objective To observe the predictability of the corneal stromal reduction with smart pulse technology-as-sisted transperitoneal photorefractive keratomileusis(SPT-TPRK)and femtosecond laser-assisted in situ keratomileusis(FS-LASIK).Methods Patients undergoing laser surgery in the Department of Ophthalmology of the First Affiliated Hos-pital of Xinxiang Medical College from February to September 2023 were selected and divided by surgical modalities into an SPT-TPRK group(21 cases,37 eyes)and an FS-LASIK group(18 cases,32 eyes).The uncorrected visual acuity(UCVA),intraocular pressure,corneal thickness,and corneal epithelial thickness were measured before surgery,1 week,1 month and 3 months after surgery.The cutting deviation was calculated,and the change of corneal stromal thickness was ob-served.The correlation between the predicted corneal stromal reduction and the cutting deviation was analyzed.Results There were significant differences in UCVA among different time points in both SPT-TPRK and FS-LASIK groups(all P＜0.001).The UCVA of patients in the FS-LASIK group was significantly higher than that in the SPT-TPRK group 1 week after surgery(P＜0.001).The difference in UCVA was not statistically significant between the two groups 1 month and 3 months after surgery(all P＞0.05).There were significant differences in intraocular pressure among different time points in both SPT-TPRK and FS-LASIK groups(all P＜0.001).The FS-LASIK group had a lower intraocular pressure than the SPT-TPRK group 1 week after surgery(P＜0.05),but the difference in intraocular pressure was not statistically significant between the two groups 1 month and 3 months after surgery(all P＞0.05).There was significant difference between predicted cor-neal stromal reductions and actual corneal stromal reductions measured at different time points postoperatively in both SPT-TPRK and FS-LASIK groups(all P＜0.001).The actual corneal stromal reductions were higher than the predicted ones in the SPT-TPRK group at all postoperative time points(all P＜0.05).In the FS-LASIK group,the actual corneal stromal re-ductions were higher than the predicted ones 1 week and 1 month after surgery(all P＜0.05),but the actual and predicted corneal stromal reductions were not significantly different 3 months after surgery(P＞0.05).The cutting deviations were not significantly different between SPT-TPRK and FS-LASIK groups 1 month after surgery(P＞0.05),while the cutting de-viations were significantly different between the two groups 1 week and 3 months after surgery(all P＜0.05).There were significant differences in the change of the stromal thickness among different time points in both SPT-TPRK and FS-LASIK groups(all P＜0.05).There was no significant difference in the change of the stromal thickness among different time points in the SPT-TPRK group(all P＞0.05).The stromal thickness showed greater changes 1 month after surgery than that 1 week after surgery in the FS-LASIK group(P＜0.05).There were no significant differences in the change of the stromal thickness between 1 month and 3 months after surgery in the FS-LASIK group(P＞0.05).Correlation analysis showed a positive correlation between the predicted corneal stromal reduction and the cutting deviation in the SPT-TPRK group 1 week after surgery(P＜0.05),but they had no correlation 1 month and 3 months after surgery(all P＞0.05).There was no correlation between the predicted corneal stromal reduction and the cutting deviation in the FS-LASIK group at all post-operative time points(all P＞0.05).Conclusion Patients who receive SPT-TPRK or FS-LASIK can both achieve good visual acuity and a reduction in intraocular pressure.FS-LASIK has better predictability in refractive error correction than SPT-TPRK.

Aim To investigate the role of triggering receptor expressed on myeloidcells 2(TREM2)in syn-aptic plasticity induced by cocaine addiction.Methods C57BL/6J mice and Trem2 knockout mice were uti-lized in this study to evaluate the alterations in postsyn-aptic density protein 95(PSD-95)and synapsin 1(SYN1)within the cortex and hippocampus of co-caine-addicted mice by using immunological tech-niques.Results HE staining and Nissl staining showed increased neuronal damage in the hippocampus and cortex of mice after cocaine addiction.The results of immunohistochemistry and fluorescence of PSD-95 and SYN1 were consistent with the expression trend of Western blot.In the wild type mouse model,the ex-pression level of PSD-95 in the hippocampus and cortex was lower than that in the saline group,and the ex-pression of SYN1 was higher than that in the saline group.In the knockout mouse model,the expression levels of PSD-95 and SYN1 in the hippocampus and cortex were significantly higher than those in the saline group after cocaine addiction.The expression levels of PSD-95 and SYN1 in the hippocampus and cortex of cocaine knockout mice were higher than those of co-caine wild type mice.Conclusion Cocaine addiction can change the synaptic plasticity,and TREM2 plays a regulatory role in the synaptic plasticity of hippocampus and cortex in mice with cocaine injury.TREM2 is ex-pected to be a new target for studying the mechanism of cocaine addiction.