AIM To evaluate the quality of Gegen Formula Granules.METHODS Linear calibration with two reference substances(LCTRS)was adopted in the predicting of retention time with puerarin and daidzein as internal standards.UPLC characteristic chromatograms were established.The contents of 3'-hydroxy puerarin,puerarin(internal standard),3'-methoxy puerarin,puerarin 6"-O-xyloside,puerarin apioside and daidzin were determined by quantitative determination analysis multi-components by a single marker(QAMS),after which their transfer rates were calculated.RESULTS Compared with relative retention time method,LCTRS demonstrated higher positional accuracy for characteristic peaks and wider application range for columns.There were 9 characteristic peaks in the characteristic chromatograms for 14 batches of formula granules and 15 batches of standard decoctions with the similarities of more than 0.95.The contents and transfer rates of various constituents in formula granules and standard decoctions were basically consistent.CONCLUSION The chemical constituents in formula granules and their standard decoctions of Puerariae lobatae Radix display good consistency,reliable preparation process is observable in the former.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Water-soluble silver nanoclusters(DHLA-AgNCs)with red fluorescence emission were synthesized using silver nitrate(AgNO3)as silver source,dihydrolipoic acid(DHLA)as ligand and sodium borohydride(NaBH4)as reducing agent by one-pot method.Based on the selective quenching of DHLA-AgNCs by tetracycline(TC),a rapid and selective fluorescence analysis method for detection of TC was constructed by monitoring the fluorescence intensity change at 650 nm.Under the optimal detection conditions,the fluorescence quenching efficiency of DHLA-AgNCs showed good linear relationship with concentration of TC within the range of 10.0-120.0 μmol/L,and the limit of detection(LOD)was 0.39 μmol/L.This method was successfully applied to detection of TC in milk samples,with spiked recoveries ranging from 99.5%to 102.5%,and relative standard deviations(RSDs)less than 5%.This method had the advantages of simplicity,rapidity,strong specificity and low cost,and thus provided a simple and feasible strategy for selective detection of TC.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To evaluate the clinical outcomes of right vertical infra-axillary thoracotomy technique (RVIAT) versus traditional median sternotomy (MS) for ventricular septal defect (VSD) repair in infants weighing ≤5 kg.The study further investigates the safety and feasibility of these two surgical approaches.Methods:Retrospective case-series study.Three hundred and fourteen children weighing no more than 5 kg who received VSD repair in Fuwai Central China Cardiovascular Hospital from January 2020 to June 2024 were analysized.Of these children, 252 cases who underwent RVIAT were included in the RVIAT group, and 62 cases who received traditional MS were classified as the MS group.Clinical data such as day age, body mass, the VSD type and diameter were compared between the 2 groups.The operation time, extracorporeal circulation time, block and postoperative mechanical ventilation time, intensive care unit (ICU) treatment time, 24-hour postoperative chest drainage volume and intraoperative bleeding, postoperative secondary intubation, and cardiac arrhythmia of the 2 groups of patients were recorded.Children with unstable blood pressure and active bleeding after taking vasoactive and hemostatic drugs underwent a secondary surgery.The peak airway pressure, oxygenation index, and lung dynamic compliance of the 2 groups of children were recorded before chest opening, immediately after surgery, and 24 hours after surgery. t test, χ2 test and rank sum test were used to compare the clinical data, perioperative results, complications and lung function data of the two groups. Results:(1) No significant differences were observed between the two groups in gender, age, body mass, VSD type and diameter, preoperative pneumonia, and mechanical ventilation rate (all P>0.05).(2) One-stage VSD repair was successfully completed in all cases.In the MS group, 1 infant required a secondary surgery for pericardial tamponade due to excessive bleeding.In the RVIAT group, 1 case necessitated a secondary surgery for third-degree atrioventricular block.Two cases in the MS group and 3 cases in the RVIAT group suffered postoperative arrhythmia, all of who supplemented electrolytes, received a secondary surgery to remove patches and adjust suture positions, and took antiarrhythmic drugs to restore sinus rhythm.(3) The operation time [(137.4±9.1) minutes], hospital stay [(8.2±2.1) days], postoperative mechanical ventilation time [8.0 (6.0, 13.0) hours], postoperative ICU stay [2.9 (2.0, 3.6) days], 24-hour postoperative chest drainage volume [(11.3±1.2) mL], intraoperative bleeding [(11.6±1.2) mL], and hospital costs [(70±7) thousand yuan], the postoperative incidence of incision infection [0.4%(1/252)] and the postoperative incidence of sternal malformation (0) in the RVIAT group were significantly lower than those in the MS group [(151.9±20.2) minutes, (13.1±1.7) days, 12.0 (9.0, 15.0) hours, 2.9 (2.5, 3.7) days, (14.3±1.6) mL, (15.8±2.0) mL, (78±4) thousand yuan, 4.8%(3/62), and 4.8%(3/62), respectively] (all P<0.05).There was no significant difference in extracorporeal circulation time, aortic occlusion time, postoperative arrhythmia rate, residual shunt, and atelectasis between the two groups (all P>0.05).(4) The peak airway pressure, oxygenation index and lung dynamic compliance before chest opening, immediately after surgery, and 24 hours after surgery did not differ significantly between the two groups (all P>0.05). Conclusions:In infants with low body mass (≤5 kg), RVIAT for VSD repair offers good exposure through a small incision, capable of reducing operation time, intraoperative bleeding, postoperative hospital stay, and hospital costs, and facilitating faster recovery.With high safety and effects, RVIAT can be considered as a viable alternative to MS.

Objective:To evaluate the clinical outcomes of right vertical infra-axillary thoracotomy technique (RVIAT) versus traditional median sternotomy (MS) for ventricular septal defect (VSD) repair in infants weighing ≤5 kg.The study further investigates the safety and feasibility of these two surgical approaches.Methods:Retrospective case-series study.Three hundred and fourteen children weighing no more than 5 kg who received VSD repair in Fuwai Central China Cardiovascular Hospital from January 2020 to June 2024 were analysized.Of these children, 252 cases who underwent RVIAT were included in the RVIAT group, and 62 cases who received traditional MS were classified as the MS group.Clinical data such as day age, body mass, the VSD type and diameter were compared between the 2 groups.The operation time, extracorporeal circulation time, block and postoperative mechanical ventilation time, intensive care unit (ICU) treatment time, 24-hour postoperative chest drainage volume and intraoperative bleeding, postoperative secondary intubation, and cardiac arrhythmia of the 2 groups of patients were recorded.Children with unstable blood pressure and active bleeding after taking vasoactive and hemostatic drugs underwent a secondary surgery.The peak airway pressure, oxygenation index, and lung dynamic compliance of the 2 groups of children were recorded before chest opening, immediately after surgery, and 24 hours after surgery. t test, χ2 test and rank sum test were used to compare the clinical data, perioperative results, complications and lung function data of the two groups. Results:(1) No significant differences were observed between the two groups in gender, age, body mass, VSD type and diameter, preoperative pneumonia, and mechanical ventilation rate (all P>0.05).(2) One-stage VSD repair was successfully completed in all cases.In the MS group, 1 infant required a secondary surgery for pericardial tamponade due to excessive bleeding.In the RVIAT group, 1 case necessitated a secondary surgery for third-degree atrioventricular block.Two cases in the MS group and 3 cases in the RVIAT group suffered postoperative arrhythmia, all of who supplemented electrolytes, received a secondary surgery to remove patches and adjust suture positions, and took antiarrhythmic drugs to restore sinus rhythm.(3) The operation time [(137.4±9.1) minutes], hospital stay [(8.2±2.1) days], postoperative mechanical ventilation time [8.0 (6.0, 13.0) hours], postoperative ICU stay [2.9 (2.0, 3.6) days], 24-hour postoperative chest drainage volume [(11.3±1.2) mL], intraoperative bleeding [(11.6±1.2) mL], and hospital costs [(70±7) thousand yuan], the postoperative incidence of incision infection [0.4%(1/252)] and the postoperative incidence of sternal malformation (0) in the RVIAT group were significantly lower than those in the MS group [(151.9±20.2) minutes, (13.1±1.7) days, 12.0 (9.0, 15.0) hours, 2.9 (2.5, 3.7) days, (14.3±1.6) mL, (15.8±2.0) mL, (78±4) thousand yuan, 4.8%(3/62), and 4.8%(3/62), respectively] (all P<0.05).There was no significant difference in extracorporeal circulation time, aortic occlusion time, postoperative arrhythmia rate, residual shunt, and atelectasis between the two groups (all P>0.05).(4) The peak airway pressure, oxygenation index and lung dynamic compliance before chest opening, immediately after surgery, and 24 hours after surgery did not differ significantly between the two groups (all P>0.05). Conclusions:In infants with low body mass (≤5 kg), RVIAT for VSD repair offers good exposure through a small incision, capable of reducing operation time, intraoperative bleeding, postoperative hospital stay, and hospital costs, and facilitating faster recovery.With high safety and effects, RVIAT can be considered as a viable alternative to MS.

AIM To evaluate the quality of Gegen Formula Granules.METHODS Linear calibration with two reference substances(LCTRS)was adopted in the predicting of retention time with puerarin and daidzein as internal standards.UPLC characteristic chromatograms were established.The contents of 3'-hydroxy puerarin,puerarin(internal standard),3'-methoxy puerarin,puerarin 6"-O-xyloside,puerarin apioside and daidzin were determined by quantitative determination analysis multi-components by a single marker(QAMS),after which their transfer rates were calculated.RESULTS Compared with relative retention time method,LCTRS demonstrated higher positional accuracy for characteristic peaks and wider application range for columns.There were 9 characteristic peaks in the characteristic chromatograms for 14 batches of formula granules and 15 batches of standard decoctions with the similarities of more than 0.95.The contents and transfer rates of various constituents in formula granules and standard decoctions were basically consistent.CONCLUSION The chemical constituents in formula granules and their standard decoctions of Puerariae lobatae Radix display good consistency,reliable preparation process is observable in the former.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective The aim of this study is to explore the potential modulatory role of quercetin against Endotoxin or lipopolysaccharide (LPS) induced septic cardiac dysfunction.Methods Specific pathogen-free chicken embryos (n = 120) were allocated untreated control, phosphate buffer solution (PBS) vehicle, PBS with ethanol vehicle, LPS (500 ng/egg), LPS with quercetin treatment (10, 20, or 40 nmol/egg, respectively), Quercetin groups (10, 20, or 40 nmol/egg). Fifteen-day-old embryonated eggs were inoculated with abovementioned solutions via the allantoic cavity. At embryonic day 19, the hearts of the embryos were collected for histopathological examination, RNA extraction, real-time polymerase chain reaction, immunohistochemical investigations, and Western blotting.Results They demonstrated that the heart presented inflammatory responses after LPS induction. The LPS-induced higher mRNA expressions of inflammation-related factors (TLR4, TNFα, MYD88, NF-κB1, IFNγ, IL-1β, IL-8, IL-6, IL-10, p38, MMP3, and MMP9) were blocked by quercetin with three dosages. Quercetin significantly decreased immunopositivity to TLR4 and MMP9 in the treatment group when compared with the LPS group. Quercetin significantly decreased protein expressions of TLR4, IFNγ, MMP3, and MMP9 when compared with the LPS group. Quercetin treatment prevented LPS-induced increase in the mRNA expression of Claudin 1 and ZO-1, and significantly decreased protein expression of claudin 1 when compared with the LPS group. Quercetin significantly downregulated autophagy-related gene expressions (PPARα, SGLT1, APOA4, AMPKα1, AMPKα2, ATG5, ATG7, Beclin-1, and LC3B) and programmed cell death (Fas, Bcl-2, CASP1, CASP12, CASP3, and RIPK1) after LPS induction. Quercetin significantly decreased immunopositivity to APOA4, AMPKα2, and LC3-II/LC3-I in the treatment group when compared with the LPS group. Quercetin significantly decreased protein expressions of AMPKα1, LC3-I, and LC3-II. Quercetin significantly decreased the protein expression to CASP1 and CASP3 by immunohistochemical investigation or Western blotting in treatment group when compared with LPS group.Conclusion Quercetin alleviates cardiac inflammation induced by LPS through modulating autophagy, programmed cell death, and myocardiocytes permeability.