Addressing the enduring challenge of evaluating traditional Chinese medicines (TCMs), the integrated evidence chain-based effectiveness evaluation of TCMs (Eff-iEC) has emerged. This paper explored its capacity through a demonstration study that evaluated the effectiveness evidence of six commonly used anti-hepatic fibrosis Chinese patent medicines (CPMs), including Biejiajian Pill (BP), Dahuang Zhechong Pill (DZP), Biejia Ruangan Compound (BRC), Fuzheng Huayu Capsule (FHC), Anluo Huaxian Pill (AHP), and Heluo Shugan Capsule (HSC), using both Eff-iEC and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. The recognition of these CPMs within the TCM academic community was also assessed through their inclusion in relevant medical documents. Results showed that the evidence of BRC and FHC received higher assessments in both Eff-iEC and GRADE system, while the assessments for others varied. Analysis of community recognition revealed that Eff-iEC more accurately reflects the clinical value of these CPMs, exhibiting superior evaluative capabilities. By breaking through the conventional pattern of TCMs effectiveness evaluation, Eff-iEC offers a novel epistemology that better aligns with the clinical realities and reasoning of TCMs, providing a coherent methodology for clinical decision-making, new drug evaluations, and health policy formulation.

OBJECTIVES: To detect prfA and hly toxin genes of Listeria monocytogenes using polymerase chain reaction (PCR) and colloidal gold technology. METHODS: L. monocytogenes DNA was extracted by boiling method. With prfA and hly of L. monocytogenes as the target genes, the 5' ends of upstream and downstream primers of prfA gene were labeled with 6-FAM and biotin, and the 5' ends of upstream and downstream primers of hly gene were labeled with digoxin and biotin, respectively, to establish the toxin gene detection method. Using cloning transformation, sequencing analysis, cloning of positive control products, the detection kid was developed and its specificity, sensitivity, reproducibility and stability were tested, followed by verification with sample testing. RESULTS: The concentration of L. monocytogenes DNA extracted by boiling method was 148.81±0.97 ng/μL, and the A₂₆₀/A₂₈₀ ratio ranged from 1.8 to 2.0. The PCR products showed a 100% homology with the gene sequences in GenBank database after cloning, transformation and sequencing. The colloidal gold strip yielded positive results only for L. monocytogenes samples without cross-reactions with Staphylococcus aureus, Escherichia coli or Bacillus cereus, and its minimum detection limit was 10^-2 ng/μL, demonstrating a 10-fold greater sensitivity of the test than agarose gel electrophoresis. The test also showed good reproducibility of the results when performed by different operators with good stability of the test strips after storage for 6 to 12 months. The test results showed that this kit could accurately and quickly detect L.monocytogenes in the test samples. CONCLUSIONS The detection kit developed in this study can simultaneously detect prfA and hly toxin genes of L. monocytogenes with good specificity, sensitivity, reproducibility and stability for use in food safety inspection.
Listeria monocytogenes/isolation & purification* ; Gold Colloid ; Bacterial Toxins/genetics* ; Polymerase Chain Reaction/methods* ; Hemolysin Proteins/genetics* ; Bacterial Proteins/genetics* ; DNA, Bacterial/genetics* ; Food Microbiology ; Heat-Shock Proteins

Coronary artery bypass grafting (CABG) is one of the most effective revascularization treatments for coronary heart disease. Secondary prevention strategies, which rely on antiplatelet and lipid-lowering drugs, are crucial after CABG to ensure the durability of revascularization treatment effects and prevent adverse cardiovascular and cerebrovascular events in the medium to long term. Previous research conducted by Professor Zhao Qiang's team from Ruijin Hospital of Shanghai Jiao Tong University, known as the DACAB study, indicated that dual antiplatelet therapy (DAPT, specifically ticagrelor+aspirin) after CABG can enhance venous graft patency. However, it remains uncertain whether DAPT can further improve the medium to long-term clinical outcomes of CABG patients. Recently, the team reported the medium to long-term follow-up results of the DACAB study, termed the DACAB-FE study, finding that DAPT administered after CABG can reduce the incidence of major cardiovascular events over five years and improve patients' medium to long-term clinical outcomes. This article will interpret the methodological highlights and significant clinical implications of the DACAB-FE study.

Objective To investigate the effect of Gexia Zhuyu decoction combined with diosmin on coagulation mechanism in patients with great saphenous varicose vein surgery.Methods A total of 60 patients who received great saphenous varicose vein surgery in Shaoxing Hospital of Traditional Chinese Medicine from January 2019 to April 2022 were selected and divided into control group and observation group according to random number table method,with 30 patients in each group.Control group was treated with diosmin,and observation group was treated with diosmin + Gexia Zhuyu decoction.Coagulation indexes,vascular endothelial function and inflammatory factor levels were compared between two groups.Results After treatment,Krüppel-like factor 2,activated partial thromboplastin time,thrombin time,prothrombin time,nitric oxide,and interleukin(IL)-10 in observation group were significantly higher than those in control group,while plasminogen activator inhibitor type 1,von Willebrand factor,endothelin 1,hypersensitive C-reactive protein,IL-2 and IL-6 were significantly lower than those in control group(P<0.05).Conclusion Gexia Zhuyu decoction combined with diosmin can improve the hypercoagulable state and vascular endothelial function in patients with great saphenous varicose vein surgery,and reduce the level of inflammatory factors in the body,which is worth popularizing.

Objective To investigate the preoperative predictive value of clinical-radiomics nomogram on N1-N2 lymph node metastasis in patients with stage Ⅰ to Ⅲ A primary lung adenocarcinoma(PL A).Methods A total of 164 PLA patients were divided into a training set(n=114)and an validation set(n=50).Three logistic regression models were created separately and the predictive efficacy of the model was evaluated using the receiver operating characteristic(ROC)curve and area under the curve(AUC)respectively.The AUC difference between models was tested by the DeLong test.The calibration degree was evaluated by the calibration curve.Decision curve analysis was performed to evaluate the benefits of clinical application.Results The radiomics model consisted of 8 imaging features[Radiomics score(Radscore)].The clinical model was composed of tumor type(central or peripheral)and tumor size.The tumor type,tumor size and Radscore formed the nomogram model.In the training set,the prediction of the nomogram model was more effective(AUC=0.909)than the clinical model(AUC=0.748)and the radiomics model(AUC=0.814),while the differences in AUC were statistically significant(P＜0.05).In the validation set,the prediction of the nomogram model was more effective(AUC=0.875)than the clinical model(AUC=0.682),and the difference in AUC was statistically significant(P＜0.05).The prediction of the nomogram model was also more effective than the radiomics model(AUC=0.799),but the difference in AUC was not statistically significant(P＞0.05).The calibration curve showed that the clinical-radiomics nomogram had a high level of calibration and the decision curve analysis showed good benefits from clinical application.Conclusion The clinical-radiomics nomogram is proven to be more effective than radiomics or clinical factors alone in the preoperative prediction of stage Ⅰ to Ⅲ A PLA N1-N2 lymph node metastasis.

Objective:To investigate the risk factors of white matter damage（WMD）in premature infants，especially intraventricular hemorrhage（IVH）.Methods:This retrospective study included 639 premature infants admitted to the neonatal intensive care unit of Shanxi Children's Hospital from June 2022 to June 2023.The premature infants were divided into WMD group（145 cases）and control group（494 cases）according to the results of head MRI.Univariate analysis and multivariate logistic regression analysis were used to explore the risk factors for WMD in premature infants.Results:There were no significant differences in gender，gestational age，fetal distress，cesarean section，asphyxia，Apgar 1min，umbilical artery pH，maternal age，number of pregnancy，infants of assisted reproductive technology，gestational hypertension，gestational diabetes mellitus，acute chorioamnionitis and prelabor rupture of membranes between the two groups（all P>0.05）.Compared the WMD group with the control group，birth weight［（1 571±611）g vs（1 438±489）g， t=-2.393］，umbilical artery base excess［-5.9（-8.2，-3.9）mmol/L vs -5.3（-7.2，-3.5）mmol/L， Z=-2.538］，umbilical artery lactate［3.7（2.4，5.3）mmol/L vs 2.8（2.0，4.1）mmol/L， Z=-4.607］，sepsis（28.5% vs 15.6%， χ 2=12.280），patent ductus arteriosus（82.6% vs 74.7%， χ 2=3.911），hypocarbia（57.2% vs 45.0%， χ 2=6.696），invasive ventilation（75.9% vs 53.0%， χ 2= 24.010），multifetal pregnancy（19.3% vs 30.6%， χ 2=7.111），antenatal corticosteroids（51.0% vs 61.9%， χ 2=5.451），lowest PaCO 2 value［（28.4±6.7）mmHg vs（31.4±8.0）mmHg， t=4.471］were different significantly（all P<0.05）.There was significant difference in the distribution of IVH between the two groups（ χ 2 =40.015， P<0.01）and multiple comparisons showed that the proportion of grade Ⅲ-Ⅳ IVH in the WMD group was higher than that in the control group（ P<0.05）.Multiple logistic regression analysis showed that umbilical artery lactate，grade Ⅲ-Ⅳ IVH，sepsis and invasive ventilation were high risk factors of WMD，and multifetal pregnancy was protective factor of WMD，with OR（ 95%CI）1.121（1.023，1.228），11.435（3.925，33.314），1.758（1.064，2.904），1.640（1.004，2.680），and 0.587（0.358，0.962），respectively. Conclusions:Umbilical artery lactate，grade Ⅲ-Ⅳ IVH，sepsis，and invasive ventilation are independent risk factors for WMD.

Objective To investigate the effect of interaction between serum neutrophil gelatinase-associat-ed lipid carrier protein(NGAL)and complications after percutaneous coronary intervention(PCI)on poor prognosis in patients with ST-segment elevation myocardial infarction(STEMI),and to provide reference for improving prognosis.Methods From January 2017 to January 2020,a total of 400 STEMI patients admitted to this hospital were selected and divided into good prognosis group(n=378)and poor prognosis group(n=22)according to their 2-year prognosis.Logistic regression equations were used to analyze the prognostic fac-tors of STEMI patients,and multiplicative and additive effects were established to analyze the effect of the in-teraction between serum NGAL and post-PCI complications on poor prognosis.Results Gender,age,heart rate,Gensini score,number of lesions ≥2,Killip grade,complications after PCI and NGAL level after PCI were associated with poor prognosis in STEMI patients(P＜0.05).Gender(female),age,heart rate,Gensini score,number of lesions ≥2,Killip grade,complications after PCI and NGAL level after PCI were all inde-pendent influencing factors of poor prognosis in STEMI patients(P＜0.05).There was interaction between serum NGAL after PCI and complications after PCI,both of which had an adverse effect on the prognosis of STEMI patients(P＜0.05).There was no multiplicative interaction between serum NGAL and complications after PCI(P＞0.05).When serum NGAL and complications after PCI were exposed at the same time,the risk of poor prognosis in STEMI patients was higher than the sum of the two exposures alone,and the interaction was 2.611 times the sum of the effects of the two exposures alone.Conclusion Serum NGAL and postopera-tive complications after PCI are independent factors influencing poor prognosis in STEMI patients.There is a additive interaction between the two factors,and exposure can increase the risk of poor prognosis.

Objective:To evaluate the efficacy and safety of SPOT (GI Supply, USA), a new carbon-based permanent marker approved by the Food and Drug Administration (FDA), in the endoscopic marking for gastrointestinal lesions.Methods:A total of 115 patients with gastrointestinal lesions who underwent endoscopic treatment or surgery in Beijing Friendship Hospital or Beijing Chao-Yang Hospital from April 2019 to November 2019 were enrolled in the study. SPOT was used to mark the lesions, and marking points were found during endoscopic treatment or surgery to calculate the effective marking rate by single-group target value method. Adverse events after marking were recorded, and the changes of blood routine test, liver and kidney functions before and after marking were compared.Results:The effective rate of endoscopic marking with SPOT was 99.13% (114/115). The longest marking time was 57 days. There was no puncture of intestinal wall or injection into abdominal cavity during the marking process. One patient developed mild fever after marking. The incidence of adverse events was 23.48% (27/115), which were all unrelated to the test equipment. There was no significant difference in blood routine tests or liver and kidney functions before and after marking ( P>0.05). Conclusion:SPOT produced by GI Supply can effectively mark gastrointestinal lesions without serious adverse events, which meets the requirements of clinical use.

Objective ::To investigate the role of trehalose in hepatic ischemia-reperfusion injury and its underlying mechanisms.Methods:C57BL/6J mice were randomly divided into no-ischemia group, ischemia-reperfusion group, trehalose-treated group and normal saline control group. After ischemia for 90 minutes, reperfusion immediately or 6h, blood and liver tissues were collected, and serum was separated. The liver function parameters of ALT, AST, the inflammatory factors of TNF-α, IL-1β and IL-2, and the pathological changes of liver were detected to study the role of trehalose during hepatic ischemia-reperfusion injury. Hypoxia-reoxygenation cell model was established by AML12 mouse hepatocyte line, and divided into experimental group and control group. The experimental group was divided into low dose group and high dose group according to the concentration of trehalose administrated. And the control group had no use of trehalose. The level of apoptosis was measured to study the effect of trehalose on apoptosis induced by hepatic ischemia-reperfusion injury with flow cytometry. Western blot was utilized for detecting the levels of Caspase-3, Cleaved Caspase-3 and Bcl-2 protein to understand the molecular mechanisms of trehalose in apoptosis during hepatic ischemia-reperfusion injury.Results:In vivo animal experiments showed that liver function and such inflammatory factors as ALT, AST, TNF-α, IL-1β and IL-2 increased in ischemia-reperfusion group after hepatic ischemia-reperfusion ( P<0.05), and liver tissue became necrotic. After a treatment of trehalose, the levels of ALT, AST, TNF-α, IL-1β and IL-2 were lower than those of normalsaline control group and the area of liver tissue necrosis also decreased ( P<0.05). In vitro cell experiments showed that the apoptosis level of hepatocytes in the experimental group decreased compared with the control group.And the level of activated pro-apoptotic protein Cleaved Caspase-3 decreased, the level of anti-apoptotic protein Bcl-2 increased. Conclusions:Trehalose has protective effects on hepatic ischemia-reperfusion injury in vivo and in vitro. The mechanism may be involved in inhibiting inflammation induced by hepatic ischemia-reperfusion injury, suppressing the activation of Caspase-3 and promoting the expression of Bcl-2, thus played a protective role by extenuation of hepatocyteapoptosis.