ObjectiveTo observe the effectiveness and safety of modified Taohong Siwu Decoction （桃红四物汤） for patients of chronic heart failure with lower limb deep vein thrombosis in the chronic stage of blood stasis syndrome. MethodsA total of 120 patients of chronic heart failure with lower limb deep vein thrombosis in chronic stage of blood stasis syndrome were randomly divided into 60 cases each in control group and observation group. Both groups were given basic treatment of western medicine， and the observation group was additionally given modified Taohong Siwu Decoction （桃红四物汤） for oral administration， one dose per day. The treatment course for both groups lasted for 4 weeks. The total effective rate and the incidence of adverse reactions were compared between the two groups after treatment. Cardiac function indexes including left ventricular ejection fraction （LVEF）， and left ventricular end-systolic internal diameter （LVESd）， left ventricular end-diastolic internal diameter （LVEDd）， serological indexes including N-terminal natriuretic natriuretic peptide precursor （NT-proBNP）， high sensitivity C-reactive protein （hs-CRP） and vascular endothelial growth factor （VEGF）， score of traditional Chinese medicine （TCM） symptom including chest pain， swelling of the affected limb， fixed tenderness， and bruising， haemodynamics indicators including high cut whole blood viscosity， low cut whole blood viscosity， and erythrocyte pressure， and coagulation indices including activated partial thromboplastin time （APTT）， plasminogen time （PT）， and fibrinogen （FIB） levels were compared before and after treatment. ResultsDuring the study， 3 cases were excluded and 2 cases lost follow-up in the observation group， while 2 cases were excluded and 3 cases lost follow-up in the control group. A total of 110 patients completed the trial， 55 cases in each of the two groups. The total effective rate in the observation group was 92.73% （51/55）， which was significantly higher than that of the control group， 78.18% （43/55， P＜0.05）. Compared within group before treatment， LVEF， APTT and PT levels increased， LVESd， LVEDd， NT-proBNP， hs-CRP， VEGF， high cut whole blood viscosity， low cut whole blood viscosity， erythrocyte pressure volume and FIB levels decreased， chest pain， swelling of the affected limbs， stationary pressure pain and bruising score decreased in both groups after treatment， and the improvement of all above indexes was better in the observation group than that in control group （P＜0.05 or P＜0.01）. The incidence of adverse reactions was 7.27% （4/55） in the observation group and 21.82% （12/55） in the control group， and the incidence of adverse reactions in the observation group was significantly lower than that in the control group （P＜0.05）. ConclusionModified Taohong Siwu Decoction （桃红四物汤） as adjuvant treatment for patients of chronic heart failure with lower limb deep vein thrombosis in the chronic stage of blood stasis syndrome showed better clinical effectiveness when compared with western basic treatment， which can improve the clinical symptoms， cardiac function， haemodynamics， and coagulation， with good safety.

Objective To analyzing the correlation between serum microRNA(miRNA,miR)-128-3p,miRNA(miR)-126 expression and Gensini score in patients with coronary artery disease.Methods A retrospective study was conducted on 60 patients with coronary artery disease who were treated in the Department of Cardiology,Harrison International Peace Hospital from June 2020 to 2022.They were selected as the observation group,and another 60 patients with non-coronary artery disease who were treated in the hospital during the same period were selected as the control group.Serum miR-128-3p,miR-126 and Gensini scores were measured and compared between the two groups,and compared the serum miR-128-3p,miR-126 and Gensini scores of patients with single,double,and multiple vessel lesions in the observation group.According to the stenosis rate of coronary arteries,they were divided into I degree,II degree,III degree and IV degree groups.The serum miR-128-3p,miR-126 and Gensini scores were compared among different stenosis grading groups.According to the Gensini score,patients were divided into mild and severe lesion groups.According to the Gensini score,patients were divided into mild and severe lesion groups.The serum miR-128-3p and miR-126 levels were compared between the mild and severe lesion groups.Pearson analysis determined the correlation between serum miR-128-3p and miR-126 levels and Gensini score.Receiver operating characteristic curve(ROC)was plotted,and the area under curve(AUC)was calculated to analyze the predictive efficacy of the combined detection of serum miR-128-3p and miR-126 levels for coronary artery disease.Logistic regression analysis of influencing factors of coronary artery disease.Results Compared with the control group,the observation group showed an increase in serum miR-128-3p(4.28±0.52 vs 2.61±0.36)and Gensini score(31.29±5.62 score vs 6.16±1.04 score),observation group showed a decrease in serum miR-126,with statistically significant differences(t=21.678,34.058,11.002,all P<0.05).Compared with the double vessel disease and single vessel disease groups,the serum miR-128-3p and Gensini score in the multi vessel disease group increased(t=4.945,7.171;6.795,11.686),the serum miR-126 decreased(t=3.104,5.033),and the differences were statistically significant(all P<0.05).Compared with the I～II group,the serum miR-128-3p and Gensini score in the III～IV group increased significantly(t=5.590,12.961),the serum miR-126 decreased significantly(t=6.021),with statistical significance differences(all P<0.05).Compared with the mild lesion group,the serum miR-128-3p level increased in the severe lesion group(t=4.056),the serum miR-126 level decreased(t=4.806),and the differences were statistically significant differences(all P<0.05).There was a positive correlation between serum miR-128-3p and Gensini score(r=0.404,P<0.05),and a negative correlation between serum miR-126 and Gensini score(r=-0.393,P<0.05).The AUC of combined detection of serum miR-128-3p and miR-126 was higher than that of single detection,and the differences were statistically significant(Z=2.768,2.152,all P<0.05).The differences in smoking,triglycerides(TG),uric acid(UA),fibrinogen(FIB)between the observation group and the control group were statistically significant(t/χ2=4.231～28.732,all P<0.05).Conclusion Patients with coronary artery disease have high expression of serum miR-128-3p and low expression of serum miR-126,which is correlated with Gensini score.The combined detection of serum miR-128-3p and miR-126 can improve the predictive efficiency of coronary artery disease,and the occurrence of coronary artery disease is related to multiple factors,which should be given clinical attention.

This study investigated the regulatory effects of carvacrol on lipopolysaccharide(LPS)-induced inflammatory response and endoplasmic reticulum(ER)stress in bovine mammary epithe-lial cells using in vitro cell culture techniques.Western blot analysis revealed significantly elevated expression levels of NF-κB pathway-related proteins and ER stress marker proteins in mastitis samples compared to healthy mammary tissues(P＜0.05).Cells were divided into a blank control group and carvacrol(CAV)treatment groups with varying concentrations(50,100,250,500,750,1 000 μmol/L).After 24 hours of culture,cell proliferation was assessed using the CCK-8 assay.An inflammatory model was established by stimulating MAC-T cells(a bovine mammary epithelial cell line)with LPS(10 mg/L)for 12 h,followed by measurement of the transcriptional levels of inflammatory-related genes(IL-6,IL-1β,and TNFα).MAC-T cells were pretreated with low,medi-um,and high doses of CAV for 12 h before LPS stimulation.Molecular docking analysis was per-formed to examine the interaction between CAV and GRP78,a key ER stress protein.Real-time quantitative PCR(qPCR)was used to analyze the mRNA expression levels of inflammatory cyto-kines(IL-6,IL-1β,TNFα),while Western blot was employed to assess the expression levels of NF-κB pathway proteins(p-IκB,p-NF-κB p65)and ER stress-related proteins(p-PERK,p-IRE1α,ATF6,GRP78,CHOP).The results from Western blot and qPCR demonstrated that CAV alleviated LPS-induced inflammatory response and cellular damage by inhibiting the NF-κB signa-ling pathway and ER stress.

In recent years,the intensification of dairy farming has significantly improved production efficiency but has also led to a rise in the incidence of metabolic diseases.Conditions such as keto-sis,fatty liver,and hypocalcemia pose serious threats to dairy cattle health and productivity.These diseases not only profoundly affect individual physiological function but also impose considerable economic pressures and challenges on farm management.As research advances,exosomes have e-merged as a novel intercellular signaling molecule,showing unique potential in regulating dairy cattle's nutritional metabolism.Studies suggest that exosomes hold promise as biomarkers for dis-ease and can even serve as carriers for disease detection and prevention.Acting as a crucial mediator of intercellular communication,exosomes play an important role in modulating the metabolic processes of dairy cattle.This review aims to systematically explore the role of exosomes in bovine nutritional metabolism and to provide new perspectives and theoretical support for their potential as tools for diagnosing,treating,and preventing metabolic diseases in dairy cattle,thus advancing research and practice in this field.

Epidermal growth factor receptor inhibitor (EGFRI) -related paronychia is a condition clearly related to EGFRI therapy, characterized by periungual erythema, edema, purulent exudates, periungual or subungual granulomatous lesions, and sometimes accompanied by thinning, fragility or even splitting and seperation of nail plates. Inhibition of epidermal function, inflammation and secondary infections, as well as angiogenesis are the core processes in the occurrence and development of EGFRI-related paronychia. This review summarizes epidemiology, pathogenesis, clinical manifestations, prevention and treatment of EGFRI-related paronychia.

In recent years,the intensification of dairy farming has significantly improved production efficiency but has also led to a rise in the incidence of metabolic diseases.Conditions such as keto-sis,fatty liver,and hypocalcemia pose serious threats to dairy cattle health and productivity.These diseases not only profoundly affect individual physiological function but also impose considerable economic pressures and challenges on farm management.As research advances,exosomes have e-merged as a novel intercellular signaling molecule,showing unique potential in regulating dairy cattle's nutritional metabolism.Studies suggest that exosomes hold promise as biomarkers for dis-ease and can even serve as carriers for disease detection and prevention.Acting as a crucial mediator of intercellular communication,exosomes play an important role in modulating the metabolic processes of dairy cattle.This review aims to systematically explore the role of exosomes in bovine nutritional metabolism and to provide new perspectives and theoretical support for their potential as tools for diagnosing,treating,and preventing metabolic diseases in dairy cattle,thus advancing research and practice in this field.

BACKGROUND:The clearance pathway of metabolic waste in the brain is crucial for maintaining neural homeostasis.The accumulation of metabolic waste disrupts this equilibrium,representing a common pathological feature of many central nervous system diseases.In recent years,research focusing on the glymphatic system has emerged as a hotspot in the nervous system field.OBJECTIVE:To construct a knowledge map of glymphatic system research,visually analyze the current state of research,main hotspots,and future development trends within this area.METHODS:Utilizing CiteSpace,VOSviewer,and the Bibliometrix package in the R language environment,this study conducted an in-depth visual analysis of glymphatic system-related literature from the Web of Science Core Collection database,spanning from January 2012 to March 2024.This analysis included authors,institutions,countries,journals,keywords,and co-citation frequencies.RESULTS AND CONCLUSION:A total of 687 related articles were included in this study.The number of publications in this field increased year by year,showing an explosive growth trend in the past three years.The countries,institutions,and authors with the largest number of publications in this research field were the United States,University of Rochester,and Professor Maiken Nedergaard.The journal with the highest number of publications was JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM.The high-frequent and high-central keywords mainly focused on the mechanism such as cerebrospinal fluid hydrodynamics,neurological diseases such as Alzheimer's disease,and imaging techniques such as diffusion tensor imaging.The literature with the highest co-citation frequency was a classic review of the glymphatic system.The above results show that the research of glymphatic system is an emerging and active field,which has attracted wide attention at home and abroad and gradually expand from theoretical research to clinical practice.

Thyroid cancer is the most common malignant tumor of the endocrine system and head and neck region,mainly including papillary thyroid cancer(PTC),follicular thyroid cancer(FTC),medullary thyroid cancer(MTC)and anaplastic thyroid cancer(ATC).Over the past few decades,the global incidence of thyroid cancer has risen rapidly,nearly doubling in some developed countries.Geographically,thyroid cancer incidence is higher in economically developed regions.Although the fastest increase in incidence has been observed in high-income countries,certain middle-income countries have also reported significant growth.Demographically,the incidence rate is notably higher in women than in men.In China,the incidence of thyroid cancer has increased significantly in recent years,while the mortality rate has remained stable at a low level.Urban areas report higher incidence rates than rural areas,and eastern coastal regions have higher rates compared to central and western regions.The etiology of thyroid cancer is multifaceted,with major risk factors including genetic predisposition,radiation exposure,iodine intake levels,endocrine disruptions,environmental and lifestyle factors.Among these,radiation exposure(particularly ionizing radiation during childhood)is a recognized critical risk factor.In addition,both insufficient and excessive iodine intake can disrupt thyroid function,thereby increasing disease risk.Genetic factors,such as familial clustering and gene(BRAF,RET/PTC,etc.)mutations,have been widely studied,while environmental pollution and modern lifestyles may also contribute to disease onset.Therefore,it is beneficial to conduct early screening for people with a family history of thyroid cancer,reduce unnecessary medical radiation exposure and conduct intervention on lifestyle-related risk factors such as obesity to prevent and control thyroid cancer.Most patients with thyroid cancer have a favorable prognosis.The main factors influencing the prognosis include pathological typing(PTC has a relatively better prognosis,while MTC and ATC have poorer prognoses),clinical staging(patients at TNM stages Ⅰ and Ⅱ have better prognoses,while those at stages Ⅲ and Ⅳ have worse ones),physiological factors(the overall prognosis of females is superior to that of males),genetic factors and environmental factors.Understanding the epidemiological trends and identifying factors influencing the onset and prognosis of thyroid cancer are essential for its prevention,treatment and health management.Future research should focus on identifying high-risk populations and developing targeted interventions to prevent and control thyroid cancer,reduce its disease burden,improve quality of life for patients,and lower healthcare costs.

BACKGROUND:The clearance pathway of metabolic waste in the brain is crucial for maintaining neural homeostasis.The accumulation of metabolic waste disrupts this equilibrium,representing a common pathological feature of many central nervous system diseases.In recent years,research focusing on the glymphatic system has emerged as a hotspot in the nervous system field.OBJECTIVE:To construct a knowledge map of glymphatic system research,visually analyze the current state of research,main hotspots,and future development trends within this area.METHODS:Utilizing CiteSpace,VOSviewer,and the Bibliometrix package in the R language environment,this study conducted an in-depth visual analysis of glymphatic system-related literature from the Web of Science Core Collection database,spanning from January 2012 to March 2024.This analysis included authors,institutions,countries,journals,keywords,and co-citation frequencies.RESULTS AND CONCLUSION:A total of 687 related articles were included in this study.The number of publications in this field increased year by year,showing an explosive growth trend in the past three years.The countries,institutions,and authors with the largest number of publications in this research field were the United States,University of Rochester,and Professor Maiken Nedergaard.The journal with the highest number of publications was JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM.The high-frequent and high-central keywords mainly focused on the mechanism such as cerebrospinal fluid hydrodynamics,neurological diseases such as Alzheimer's disease,and imaging techniques such as diffusion tensor imaging.The literature with the highest co-citation frequency was a classic review of the glymphatic system.The above results show that the research of glymphatic system is an emerging and active field,which has attracted wide attention at home and abroad and gradually expand from theoretical research to clinical practice.

Objective To investigate the predictive value of matrix γ-carboxyglutamic acid protein(matrix GLA protein)expression in patients with acute myocardial infarction(AMI)for major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI).Methods A total of 157 AMI patients undergoing PCI in our department from November 2021 to Septem-ber 2023 were recruited,and divided into a MACE group(43 cases)and a non-MACE group(114 cases)based on the occurrence of MACE over a 12-month follow-up period post-surgery.Multiva-riate logistic regression analysis was used to screen the predictors of MACE and to verify their predictive value.Results The MACE group had significantly older age,larger proportion of diabe-tes,and higher low-density lipoprotein cholesterol(LDL-C)level,but lower matrix GLA protein level than the non-MACE group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that age(OR=1.168,95％CI:1.004-1.358,P=0.044),diabetes(OR=3.085,95％CI:1.024-9.301,P=0.045)and LDL-C(OR=2.473,95％CI:1.185-5.163,P=0.016)were risk factors,and matrix GLA protein(OR=0.527,95％CI:0.426-0.653,P=0.001)was a protective factor for MACE in AMI patients after PCI.ROC curve analysis indicated that matrix GLA pro-tein had the highest predictive value of MACE in AMI patients after PCI,with an AUC value of 0.838(95％CI:0.770-0.892).After adjusting for age,diabetes,and LDL C,the restricted cubic spline revealed that matrix GLA protein level was in a nonlinear negative correlation with MACE risk(x2=30.260,P＜0.05).Conclusion Matrix GLA protein can predict the occurrence of MACE in AMI patients after PCI.