Fermented traditional Chinese medicine(TCM) has a long history of medicinal use, such as Sojae Semen Praeparatum, Arisaema Cum Bile, Pinelliae Rhizoma Fermentata, red yeast rice, and Jianqu. Fermentation technology was recorded in the earliest TCM work, Shen Nong's Classic of the Materia Medica. Microorganisms are essential components of the fermentation process. However, the contamination of fermented TCM by toxigenic fungi and mycotoxins due to unstandardized fermentation processes seriously affects the quality of TCM and poses a threat to the life and health of consumers. In this paper, the characteristics, microbial composition, and mycotoxin profile of fermented TCM are systematically summarized to provide a theoretical basis for its quality and safety control.
Fermentation ; Mycotoxins/analysis* ; Drugs, Chinese Herbal/analysis* ; Fungi/classification* ; Bacteria/genetics* ; Drug Contamination ; Medicine, Chinese Traditional

Nitrofurantoin(NFT)is a nitrofuran antibiotic commonly used as a veterinary drug to treat bacterial infections in animals.However,due to the low solubility and bioaccumulation properties,NFT is prone to leave excessive residues in animal-derived foods and water systems,posing serious threats to human health and ecosystems.Therefore,there is an urgent need to develop an efficient and rapid detection method for NFT.In this work,nitrogen-doped carbon nanomaterials with unique bowl-like structures(N-CNBs)were synthesized via a hydrothermal-carbonization method.The morphology,surface structure,and specific surface area of N-CNBs were characterized using transmission electron microscopy(TEM),scanning electron microscopy(SEM),and X-ray photoelectron spectroscopy(XPS).The N-CNB modified glassy carbon electrode(N-CNB/GCE)was prepared,and the electrochemical test revealed that the N-CNB/GCE exhibited higher conductivity and larger electrochemical active surface area compared to bare GCE and nitrogen-doped hollow carbon nanosphere-modified electrode(N-HCNS/GCE).Additionally,the N-CNB/GCE demonstrated superior electrocatalytic activity toward NFT.An NFT electrochemical sensor was constructed based on N-CNB/GCE.The detection conditions of the sensor were optimized,and differential pulse voltammetry(DPV)was employed for NFT detection under optimal experimental conditions.The established NFT electrochemical sensor had a wide linear range of 0.4-500 μmol/L,a low detection limit(S/N=3)of 0.015 μmol/L and high selectivity,with excellent stability and reproducibility.The practical feasibility of this sensor was confirmed by analysis of NFT in milk and tap water samples,with spiked recoveries ranging from 94.2%to 108.9%.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective To explore the role of miR-1260b targeting activating transcription factor 6β(ATF6β)in osteogenic differentia-tion of human periodontal ligament stem cells(hPDLSCs).Methods The periodontal ligament tissue was scraped from the third molar extracted from the patient with periodontitis,and hPDLSCs were isolated and cultured.The proportions of positive cells of CD34,CD45,CD29,CD90 and CD105 were detected by flow cytometry,and the expression of vimentin and pan-cytokeratin were detected by immunofluo-rescence staining.The cellular luciferase activities of ATF6β-WT and ATF6β-MUT in the miR-1260b mimic+WT/MUT group(transfected with miR-1260b mimic and ATF6β-WT/MUT)and the mimic-NC group(transfected with miR-NC and ATF6β-WT/MUT)were analyzed by the dual luciferase reporter gene assay.In addition,the cells were divided into the miR-1260b mimic group(transfected with miR-1260b mimic alone),the ATF6β-OE group(transfected with the ATF6β overexpression vector alone),the combined group(transfected with miR-1260b mimic and ATF6β overexpression vector simultaneously),and the NC group(transfected with empty vector).Alizarin red S staining and alkaline phosphatase staining were performed on hPDLSCs in the NC group,the miR-1260b mimic group,the ATF6β-OE group and the combined group.Meanwhile,the mRNA expression levels of miR-1260b,ATF6β,Runt-related transcription factor 2(Runx2),osteocalcin(OCN),and osteopontin(OPN)in each group of cells were detected by qRT-PCR.The protein expressions of glucose-regulated protein 78(GRP78),C/EBP homologous protein(CHOP),and protein kinase R-like endoplasmic reticulum kinase(PERK)in each group of cells were detected by Western blot.Results The flow cytometry detection showed that CD29,CD90 and CD105 on the surface of the isolated and cultured cells were positive,while CD34 and CD45 were negative.Immunofluorescence staining showed that vimentin in the cells was positive and pan-cytokeratin was negative,which was in line with the characteristics of hPDLSCs.Luciferase assay showed that miR-1260b mimic could significantly reduce the luciferase activity of ATF6β-WT(P<0.05),but had no significant effect on the luciferase activity of ATF6β-MUT(P>0.05).After alizarin red S staining,the staining of hPDLSCs gradually deepened after 3 days,5 days and 7 days of culture,suggesting an enhanced osteogenic differentiation ability.With the enhancement of osteogenic differentiation ability of hPDLSCs,the expression of miR-1260b in the cells showed a gradually increasing trend,while the mRNA and protein expression levels of ATF6β showed a gradually decreasing trend(P<0.05).The results of alizarin red S staining and alkaline phosphatase staining showed that the proportions of positive area in the miR-1260b mimic group were higher than those in the NC group(P<0.05),while the proportions of positive area in the ATF6β-OE group and the combined group were lower than those in the NC group(P<0.05).The mRNA and protein levels of ATF6β in the miR-1260b mimic group were lower than those in the NC group(P<0.05),while the mRNA and protein levels of ATF6β in the ATF6β-OE group and the combined group were higher than those in the NC group(P<0.05).The mRNA levels of Runx2,OCN and OPN in the miR-1260b mimic group were significantly higher than those in the NC group(P<0.05).The mRNA levels of Runx2,OCN and OPN in the ATF6β-OE group and the combined group were significantly lower than those in the NC group(P<0.05).The protein expression levels of GRP78,CHOP and PERK in the miR-1260b mimic group were significantly lower than those in the NC group(P<0.05).The protein expression levels of GRP78,CHOP and PERK in the ATF6β-OE group and the combined group were significantly higher than those in the NC group(P<0.05).Conclusion miR-1260b can inhibit endoplasmic reticulum stress level and promote osteogenic differentiation of hPDLSCs by targeting ATF6β.

Objective:To analyze the correlation between sex hormone levels and micropenis after mild hypospadias surgery in children.Methods:A case control study was carried out.The clinical data of 71 children aged 1 to 13 years who underwent mild hypospadias surgery at the First Affiliated Hospital of Xinxiang Medical University from April 2022 to April 2024 were analyzed.Preoperatively, the children were divided into a mild hypospadias group (Group A) and a mild hypospadias with micropenis group (Group B) based on the stretched penile length (SPL).Prolactin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, and testosterone (TES) levels of the 2 groups were measured.Multivariate Logistic regression analysis was used to construct a risk prediction model.The discrimination capability of the model was evaluated using the receiver operating characteristic (ROC) curve.SPL and sex hormone levels were measured again 6 months after surgery.The children were divided into a normal penile group (Group AA) and a micropenis group (Group BB) after mild hypospadias according to SPL.Multivariate Logistic regression analysis was used to construct a risk prediction model, which was evaluated using the ROC curve.Results:The levels of FSH, LH and TES in group A before the operation were 3.28(2.02, 4.46) IU/L, 0.53(0.25, 0.79) IU/L and 25.24(17.94, 36.67) ng/dL, respectively, and those in group B were 1.42(1.10, 1.84) IU/L, 0.14(0.09, 0.23) IU/L and 15.73 (12.92, 17.00) ng/dL, respectively.The difference was all statistically significant (all P<0.05).Multivariate Logistic regression analysis showed statistical significance ( OR=0.515, 95% CI: 0.271-0.977; OR=0.035, 95% CI: 0.002-0.542; OR=0.883, 95% CI: 0.796-0.980).The area under the ROC curve (AUC) of the prediction model was 0.906, with a sensitivity of 75.00% and a specificity of 95.74%.The levels of FSH, LH and TES in the postoperative AA group were 2.97 (1.88, 4.28) IU/L, 0.46 (0.23, 0.78) IU/L and 20.92 (17.34, 33.27) ng/dL, respectively.The median levels of FSH, LH and TES in the BB group were 1.52 (1.27, 1.82) IU/L, 0.17 (0.12, 0.26) IU/L and 15.08(11.68, 16.68) ng/dL, respectively.The difference was all statistically significant (all P<0.05).Multivariate Logistic regression analysis showed statistical significance ( OR=0.484, 95% CI: 0.236-0.992; OR=0.061, 95% CI: 0.004-0.939; OR=0.891, 95% CI: 0.795-0.999).The AUC of the prediction model constructed was 0.877, with a sensitivity of 94.12% and a specificity of 68.52%. Conclusions:Lower FSH, LH and TES levels are risk factors for the micropenis after mild hypospadias surgery, and preoperative hormone levels have higher predictive value.

Objective To explore the role of miR-1260b targeting activating transcription factor 6β(ATF6β)in osteogenic differentia-tion of human periodontal ligament stem cells(hPDLSCs).Methods The periodontal ligament tissue was scraped from the third molar extracted from the patient with periodontitis,and hPDLSCs were isolated and cultured.The proportions of positive cells of CD34,CD45,CD29,CD90 and CD105 were detected by flow cytometry,and the expression of vimentin and pan-cytokeratin were detected by immunofluo-rescence staining.The cellular luciferase activities of ATF6β-WT and ATF6β-MUT in the miR-1260b mimic+WT/MUT group(transfected with miR-1260b mimic and ATF6β-WT/MUT)and the mimic-NC group(transfected with miR-NC and ATF6β-WT/MUT)were analyzed by the dual luciferase reporter gene assay.In addition,the cells were divided into the miR-1260b mimic group(transfected with miR-1260b mimic alone),the ATF6β-OE group(transfected with the ATF6β overexpression vector alone),the combined group(transfected with miR-1260b mimic and ATF6β overexpression vector simultaneously),and the NC group(transfected with empty vector).Alizarin red S staining and alkaline phosphatase staining were performed on hPDLSCs in the NC group,the miR-1260b mimic group,the ATF6β-OE group and the combined group.Meanwhile,the mRNA expression levels of miR-1260b,ATF6β,Runt-related transcription factor 2(Runx2),osteocalcin(OCN),and osteopontin(OPN)in each group of cells were detected by qRT-PCR.The protein expressions of glucose-regulated protein 78(GRP78),C/EBP homologous protein(CHOP),and protein kinase R-like endoplasmic reticulum kinase(PERK)in each group of cells were detected by Western blot.Results The flow cytometry detection showed that CD29,CD90 and CD105 on the surface of the isolated and cultured cells were positive,while CD34 and CD45 were negative.Immunofluorescence staining showed that vimentin in the cells was positive and pan-cytokeratin was negative,which was in line with the characteristics of hPDLSCs.Luciferase assay showed that miR-1260b mimic could significantly reduce the luciferase activity of ATF6β-WT(P<0.05),but had no significant effect on the luciferase activity of ATF6β-MUT(P>0.05).After alizarin red S staining,the staining of hPDLSCs gradually deepened after 3 days,5 days and 7 days of culture,suggesting an enhanced osteogenic differentiation ability.With the enhancement of osteogenic differentiation ability of hPDLSCs,the expression of miR-1260b in the cells showed a gradually increasing trend,while the mRNA and protein expression levels of ATF6β showed a gradually decreasing trend(P<0.05).The results of alizarin red S staining and alkaline phosphatase staining showed that the proportions of positive area in the miR-1260b mimic group were higher than those in the NC group(P<0.05),while the proportions of positive area in the ATF6β-OE group and the combined group were lower than those in the NC group(P<0.05).The mRNA and protein levels of ATF6β in the miR-1260b mimic group were lower than those in the NC group(P<0.05),while the mRNA and protein levels of ATF6β in the ATF6β-OE group and the combined group were higher than those in the NC group(P<0.05).The mRNA levels of Runx2,OCN and OPN in the miR-1260b mimic group were significantly higher than those in the NC group(P<0.05).The mRNA levels of Runx2,OCN and OPN in the ATF6β-OE group and the combined group were significantly lower than those in the NC group(P<0.05).The protein expression levels of GRP78,CHOP and PERK in the miR-1260b mimic group were significantly lower than those in the NC group(P<0.05).The protein expression levels of GRP78,CHOP and PERK in the ATF6β-OE group and the combined group were significantly higher than those in the NC group(P<0.05).Conclusion miR-1260b can inhibit endoplasmic reticulum stress level and promote osteogenic differentiation of hPDLSCs by targeting ATF6β.

Objective:To analyze the correlation between sex hormone levels and micropenis after mild hypospadias surgery in children.Methods:A case control study was carried out.The clinical data of 71 children aged 1 to 13 years who underwent mild hypospadias surgery at the First Affiliated Hospital of Xinxiang Medical University from April 2022 to April 2024 were analyzed.Preoperatively, the children were divided into a mild hypospadias group (Group A) and a mild hypospadias with micropenis group (Group B) based on the stretched penile length (SPL).Prolactin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, and testosterone (TES) levels of the 2 groups were measured.Multivariate Logistic regression analysis was used to construct a risk prediction model.The discrimination capability of the model was evaluated using the receiver operating characteristic (ROC) curve.SPL and sex hormone levels were measured again 6 months after surgery.The children were divided into a normal penile group (Group AA) and a micropenis group (Group BB) after mild hypospadias according to SPL.Multivariate Logistic regression analysis was used to construct a risk prediction model, which was evaluated using the ROC curve.Results:The levels of FSH, LH and TES in group A before the operation were 3.28(2.02, 4.46) IU/L, 0.53(0.25, 0.79) IU/L and 25.24(17.94, 36.67) ng/dL, respectively, and those in group B were 1.42(1.10, 1.84) IU/L, 0.14(0.09, 0.23) IU/L and 15.73 (12.92, 17.00) ng/dL, respectively.The difference was all statistically significant (all P<0.05).Multivariate Logistic regression analysis showed statistical significance ( OR=0.515, 95% CI: 0.271-0.977; OR=0.035, 95% CI: 0.002-0.542; OR=0.883, 95% CI: 0.796-0.980).The area under the ROC curve (AUC) of the prediction model was 0.906, with a sensitivity of 75.00% and a specificity of 95.74%.The levels of FSH, LH and TES in the postoperative AA group were 2.97 (1.88, 4.28) IU/L, 0.46 (0.23, 0.78) IU/L and 20.92 (17.34, 33.27) ng/dL, respectively.The median levels of FSH, LH and TES in the BB group were 1.52 (1.27, 1.82) IU/L, 0.17 (0.12, 0.26) IU/L and 15.08(11.68, 16.68) ng/dL, respectively.The difference was all statistically significant (all P<0.05).Multivariate Logistic regression analysis showed statistical significance ( OR=0.484, 95% CI: 0.236-0.992; OR=0.061, 95% CI: 0.004-0.939; OR=0.891, 95% CI: 0.795-0.999).The AUC of the prediction model constructed was 0.877, with a sensitivity of 94.12% and a specificity of 68.52%. Conclusions:Lower FSH, LH and TES levels are risk factors for the micropenis after mild hypospadias surgery, and preoperative hormone levels have higher predictive value.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

Objective To investigate the efficacy and safety of nusinersen sodium in the treatment of children with spinal muscular atrophy(SMA).Methods A retrospective analysis was conducted on the clinical data of 50 children with 5q SMA who received nusinersen sodium treatment and multidisciplinary treatment management in Shanxi Children's Hospital from February 2022 to February 2024.Results Compared with the baseline data,67%(8/12),74%(35/47),and 74%(35/47)of the SMA children had a clinically significant improvement in the scores of Philadelphia Infant Test of Neuromuscular Disorders,Hammersmith Functional Motor Scale Expanded,and Revised Upper Limb Module,respectively,and the distance of 6-minute walking test increased from 207.00(179.00,281.50)meters to 233.00(205.25,287.50)meters(P<0.05)after nusinersen sodium treatment.Of all 50 children with SMA,24(48%)showed good tolerability after administration,with no significant or persistent abnormalities observed in 2 034 laboratory test results,and furthermore,there were no serious or immunological adverse events related to the treatment.After treatment,there was a significant change in forced vital capacity as a percentage of the predicted value in 27 children with restrictive ventilatory dysfunction,as well as a significant change in the level of 25-(OH)vitamin D in 15 children with vitamin D deficiency(P<0.05).Conclusions For children with SMA,treatment with nusinersen sodium can continuously improve the response rates of motor function scales,with good tolerability and safety.