OBJECTIVE To analyze the differences in chemical composition of mussels from Shengsi,Zhoushan in different har-vest months,and to compare the differences in the composition of mussels from different origins,so as to provide ideas for the compre-hensive utilization of its resources.METHODS Ultra-high performance liquid chromatography-triple quadrupole mass spectrometry(UHPLC-QqQ-MS)and spectrophotometry were used to analyze and evaluate the contents of nucleosides,amino acids,water-soluble proteins,total sugars and polysaccharides in mussels from Shengsi,Zhoushan in 12 months of the year and from 5 different origins;principal component analysis(PCA),partial least squares discriminant method(PLS-DA)and TOPSIS method were used to compre-hensively evaluate mussels.RESULTS A total of 16 amino acids and 11 nucleosides were detected in mussels.The average content of total amino acids in Shengsi mussels throughout the year was 4 851.74 μg·g-1,the average content of total nucleosides was 921.40 μg·g-1,and the average contents of water-soluble protein,polysaccharides,and total sugars were 51.32 mg·g-1,74.39 μg·g-1,and 417.22 mg·g-1,respectively.The nucleosides of Shengsi mussels were the highest in March and April,the ami-no acids and water-soluble proteins were the highest in April and May,and the polysaccharides and total sugars were the highest in Oc-tober and November.The PCA and PLS-DA results of the chemical components of different resources showed that there were great differences in Shengsi mussel samples harvested in different seasons.The entropy weight TOPSIS analysis showed that the comprehen-sive scores of Shengsi mussels in March and April(S7 and S8)were better than those in other areas,and the comprehensive score of Shengsi mussels in April(S8)was the highest,which was determined to be the best harvesting month.CONCLUSION The comparison results of multi-type resource chemistry show that there are great differences in the chemical compo-sition of Shengsi mussels in different harvesting seasons;the quality of Shengsi mussels is better than that of other areas;April is the best harvesting season,providing a reference for the quality evaluation and comprehensive development and utilization of mussels.

[Objective] To compare the clinical efficacy of super pulse thulium laser enucleation of the prostate (SPThuLEP) with "open tunnel" and transurethral holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH), in order to provide reference for the treatment options of BPH. [Methods] The clinical data of 112 BPH patients treated in our hospital during Jan.2023 and Jul.2023 were retrospectively analyzed, including 65 treated with SPThuLEP with "open tunnel" and 57 with HoLEP.The operation time, postoperative hemoglobin decrease, postoperative bladder irrigation, catheter indwelling time, hospitalization time and complications were compared between the two groups.The changes of maximum urine flow rate (Qmax), international prostate symptom score (IPSS), quality of life score (QoL), postvoid residual (PVR) and prostate-specific antigen (PSA) were compared between the two groups before operation and one month after operation. [Results] All operations were successful without conversion to open or transurethral plasmakinetic resection.The postoperative decrease of hemoglobin in SPThuLEP group was lower than that in HoLEP group [(13.12±6.72) g/L vs. (21.02±6.51) g/L], with statistical difference (P<0.05). There were no significant differences in the operation time [(63.35±15.73) min vs.(61.02±17.55) min], postoperative bladder irrigation time [(1.07±0.45) d vs. (1.06±0.36) d], catheter indwelling time [(2.98±0.56) d vs. (3.01±0.63) d] and hospitalization time [(3.63±0.61) d vs.(3.79±0.76) d] between the two groups (P>0.05). No blood transfusion, secondary bleeding or unplanned hospitalization occurred, and there were no serious complications such as transurethral electroresection syndrome (TURS), urethral stricture and urinary incontinence.One month after operation, the Qmax, IPSS, QoL, PVR and PSA of the two groups were significantly improved compared with those before operation (P<0.05), but with no statistical difference between the two groups (P>0.05). [Conclusion] SPThuLEP with "open tunnel" has comparable efficacy as HoLEP in the treatment of BPH.With advantages of small amount of bleeding and high safety, this minimally invasive technique can be widely popularized in clinical practice.

Traditional Chinese medicine (TCM) represents a paradigmatic approach to personalized medicine, developed through the systematic accumulation and refinement of clinical empirical data over more than 2000 years, and now encompasses large-scale electronic medical records (EMR) and experimental molecular data. Artificial intelligence (AI) has demonstrated its utility in medicine through the development of various expert systems (e.g., MYCIN) since the 1970s. With the emergence of deep learning and large language models (LLMs), AI's potential in medicine shows considerable promise. Consequently, the integration of AI and TCM from both clinical and scientific perspectives presents a fundamental and promising research direction. This survey provides an insightful overview of TCM AI research, summarizing related research tasks from three perspectives: systems-level biological mechanism elucidation, real-world clinical evidence inference, and personalized clinical decision support. The review highlights representative AI methodologies alongside their applications in both TCM scientific inquiry and clinical practice. To critically assess the current state of the field, this work identifies major challenges and opportunities that constrain the development of robust research capabilities-particularly in the mechanistic understanding of TCM syndromes and herbal formulations, novel drug discovery, and the delivery of high-quality, patient-centered clinical care. The findings underscore that future advancements in AI-driven TCM research will rely on the development of high-quality, large-scale data repositories; the construction of comprehensive and domain-specific knowledge graphs (KGs); deeper insights into the biological mechanisms underpinning clinical efficacy; rigorous causal inference frameworks; and intelligent, personalized decision support systems.
Medicine, Chinese Traditional/methods* ; Artificial Intelligence ; Humans ; Precision Medicine ; Decision Support Systems, Clinical

OBJECTIVE To analyze the differences in chemical composition of mussels from Shengsi,Zhoushan in different har-vest months,and to compare the differences in the composition of mussels from different origins,so as to provide ideas for the compre-hensive utilization of its resources.METHODS Ultra-high performance liquid chromatography-triple quadrupole mass spectrometry(UHPLC-QqQ-MS)and spectrophotometry were used to analyze and evaluate the contents of nucleosides,amino acids,water-soluble proteins,total sugars and polysaccharides in mussels from Shengsi,Zhoushan in 12 months of the year and from 5 different origins;principal component analysis(PCA),partial least squares discriminant method(PLS-DA)and TOPSIS method were used to compre-hensively evaluate mussels.RESULTS A total of 16 amino acids and 11 nucleosides were detected in mussels.The average content of total amino acids in Shengsi mussels throughout the year was 4 851.74 μg·g-1,the average content of total nucleosides was 921.40 μg·g-1,and the average contents of water-soluble protein,polysaccharides,and total sugars were 51.32 mg·g-1,74.39 μg·g-1,and 417.22 mg·g-1,respectively.The nucleosides of Shengsi mussels were the highest in March and April,the ami-no acids and water-soluble proteins were the highest in April and May,and the polysaccharides and total sugars were the highest in Oc-tober and November.The PCA and PLS-DA results of the chemical components of different resources showed that there were great differences in Shengsi mussel samples harvested in different seasons.The entropy weight TOPSIS analysis showed that the comprehen-sive scores of Shengsi mussels in March and April(S7 and S8)were better than those in other areas,and the comprehensive score of Shengsi mussels in April(S8)was the highest,which was determined to be the best harvesting month.CONCLUSION The comparison results of multi-type resource chemistry show that there are great differences in the chemical compo-sition of Shengsi mussels in different harvesting seasons;the quality of Shengsi mussels is better than that of other areas;April is the best harvesting season,providing a reference for the quality evaluation and comprehensive development and utilization of mussels.

Objective:To compare the clinical curative effects of saphenous artery flap and retrograde anterolateral femoral perforator flap in repairing full-thickness electric burn wounds deep to tendon and bone in the knee.Methods:This study was a retrospective observational study. From July 2018 to February 2022, 34 patients with full-thickness electric burn wounds deep to tendon and bone in the knee and conformed to the inclusion criteria were admitted to Zhengzhou First People's Hospital, including 26 males and 8 females, aged 18 to 54 years. According to the repair method of the electric burn wounds in the knee, the patients were divided into saphenous artery flap group (18 cases) repaired with saphenous artery flap and anterolateral femoral flap group (16 cases) repaired with retrograde anterolateral femoral perforator flap. The exposed area of bone and/or tendon after debridement was 5 cm×4 cm to 12 cm×7 cm, 5 patients were combined with open joint, and the resected area of the flap was 9 cm×6 cm to 25 cm×12 cm in saphenous artery flap group; the exposed area of bone and/or tendon after debridement was 7 cm×5 cm to 15 cm×7 cm, 6 patients were combined with open joint, and the resected area of the flap was 15 cm×10 cm to 39 cm×25 cm in anterolateral femoral flap group. According to the resected width of the flap, the wounds in the flap donor areas were repaired by direct suture or medium thickness skin graft in the trunk. The survival of the flap was observed after surgery. At the last follow-up, the color and texture of the flap were observed, and the two-point discrimination distance of the flap was detected. The sensory recovery of the flap was evaluated using the trial standards for evaluation of partial function of upper extremity by the Hand Surgery Society of Chinese Medical Association, and the excellent ratio of sensory recovery was calculated. The function of knee joint was assessed using the Knee Subjective Score Scale of International Knee Documentation Committee. The repairing effect of the flap was evaluated using comprehensive evaluation scale of flap, and the excellent ratio was calculated.Results:Most of the flaps in patients in the 2 groups survived well after surgery, only 2 patients in the anterolateral femoral flap group had distal flap necrosis of 3 to 5 cm 2, which healed after skin grafting or local suture. At the last follow-up of 12 to 18 months after surgery, the color and texture of the flap in patients in the two groups were similar to those of the skin tissue in the knee. The excellent ratio of sensory recovery of the flap was 18/18 in patients in saphenous artery flap group, which was significantly higher than 5/16 in anterolateral femoral flap group ( P<0.05). The two-point discrimination distance of the flap was (11.7±1.5) mm in patients in saphenous artery flap group, which was significantly shorter than (21.5±1.7) mm in anterolateral femoral flap group ( t=-1.84, P<0.05). The score of the knee joint function and the excellent ratio of the repairing effect of the flap had no statistically significant differences in patients in the two groups ( P>0.05). Conclusions:The full-thickness electric burn wounds deep to tendon and bone in the knee can be repaired with saphenous artery flap and retrograde anterolateral femoral perforator flap. After being repaired with those two types of flaps, the function of the knee joint recovers well, while the sensory recovery is better after being repaired by the saphenous artery flap.

Objective:To compare the clinical curative effects of saphenous artery flap and retrograde anterolateral femoral perforator flap in repairing full-thickness electric burn wounds deep to tendon and bone in the knee.Methods:This study was a retrospective observational study. From July 2018 to February 2022, 34 patients with full-thickness electric burn wounds deep to tendon and bone in the knee and conformed to the inclusion criteria were admitted to Zhengzhou First People's Hospital, including 26 males and 8 females, aged 18 to 54 years. According to the repair method of the electric burn wounds in the knee, the patients were divided into saphenous artery flap group (18 cases) repaired with saphenous artery flap and anterolateral femoral flap group (16 cases) repaired with retrograde anterolateral femoral perforator flap. The exposed area of bone and/or tendon after debridement was 5 cm×4 cm to 12 cm×7 cm, 5 patients were combined with open joint, and the resected area of the flap was 9 cm×6 cm to 25 cm×12 cm in saphenous artery flap group; the exposed area of bone and/or tendon after debridement was 7 cm×5 cm to 15 cm×7 cm, 6 patients were combined with open joint, and the resected area of the flap was 15 cm×10 cm to 39 cm×25 cm in anterolateral femoral flap group. According to the resected width of the flap, the wounds in the flap donor areas were repaired by direct suture or medium thickness skin graft in the trunk. The survival of the flap was observed after surgery. At the last follow-up, the color and texture of the flap were observed, and the two-point discrimination distance of the flap was detected. The sensory recovery of the flap was evaluated using the trial standards for evaluation of partial function of upper extremity by the Hand Surgery Society of Chinese Medical Association, and the excellent ratio of sensory recovery was calculated. The function of knee joint was assessed using the Knee Subjective Score Scale of International Knee Documentation Committee. The repairing effect of the flap was evaluated using comprehensive evaluation scale of flap, and the excellent ratio was calculated.Results:Most of the flaps in patients in the 2 groups survived well after surgery, only 2 patients in the anterolateral femoral flap group had distal flap necrosis of 3 to 5 cm 2, which healed after skin grafting or local suture. At the last follow-up of 12 to 18 months after surgery, the color and texture of the flap in patients in the two groups were similar to those of the skin tissue in the knee. The excellent ratio of sensory recovery of the flap was 18/18 in patients in saphenous artery flap group, which was significantly higher than 5/16 in anterolateral femoral flap group ( P<0.05). The two-point discrimination distance of the flap was (11.7±1.5) mm in patients in saphenous artery flap group, which was significantly shorter than (21.5±1.7) mm in anterolateral femoral flap group ( t=-1.84, P<0.05). The score of the knee joint function and the excellent ratio of the repairing effect of the flap had no statistically significant differences in patients in the two groups ( P>0.05). Conclusions:The full-thickness electric burn wounds deep to tendon and bone in the knee can be repaired with saphenous artery flap and retrograde anterolateral femoral perforator flap. After being repaired with those two types of flaps, the function of the knee joint recovers well, while the sensory recovery is better after being repaired by the saphenous artery flap.

Objective:To explore the curative effects of foot microflap free transplantation in the repair of full-thickness electric burn wounds deep to tendon or even bone in fingers.Methods:A retrospective observational study was conducted. From July 2017 to February 2022, 20 patients with full-thickness electric burn wounds deep to tendon or even bone in fingers who met the inclusion criteria were admitted to Zhengzhou First People's Hospital, including 19 males and 1 female, aged 18 to 64 years. Among the 20 wounds, 15 wounds were located on the palm side, including 8 on the thumb, 5 on the index finger, and 2 on the middle finger; 5 wounds were located on the back, including 1 on the index finger and 4 on the middle finger. After debridement, the wound area ranged from 4.5 cm×2.0 cm to 7.0 cm×3.0 cm. According to the principle of tissue structure similarity, 10 wounds were repaired with plantar medial flaps, 5 wounds were repaired with hallux peroneal flaps, and 5 wounds were repaired with dorsalis pedis artery flaps, with flap area of 5.0 cm×2.5 cm-8.0 cm×3.5 cm. The flaps were transplanted freely and arteries and veins and/or nerves were anastomosed at the same time. The wound in the donor site was repaired with thigh medium-thick skin graft. The survival of flaps and skin grafts were observed after surgery. The appearance of flap, temperature and color of the distal end in the affected finger were observed during follow-up. At the last follow-up, the joint function and flap sensory recovery of the affected finger were evaluated with the trial standard for the evaluation of the functions of the upper limbs of the Hand Surgery Society of the Chinese Medical Association; the two-point discrimination distance of skin in the area of flaps with nerve anastomosis was measured; the satisfaction of patients with the curative effect was investigated by using the curative effect satisfaction rating scale, and the very satisfied rate was calculated; the repair effect of flap was evaluated by the comprehensive evaluation scale, and the excellent and good rate was calculated.Results:All the flaps and skin grafts survived after surgery. During the follow-up of 10-18 months after surgery, the appearance of flap was natural and not bloated; the temperature and color of the distal end in the affected finger were basically the same as that of normal finger skin. At the last follow-up, the function recovery of the affected finger joints was as follows: 11 affected fingers were within the normal range of motion, 6 affected fingers had their total active range of motion recovered to 85% of the healthy side, and 3 affected fingers had their total active range of motion recovered to 75% of the healthy side; the flap sensory recovery was as follows: the sense of 15 flaps with nerve anastomosis all recovered to grade S3 +, and the two-point discrimination distance of skin in the flap area was 7.0-9.0 mm; the sense of 1 flap without nerve anastomosis recovered to grade S2 and the sense of 4 flaps recovered to grade S1. The satisfaction with curative effect of 20 patients was very satisfied in 16 cases and moderately satisfied in 4 cases, with the very satisfied rate of 80%; the repair result of 20 flaps was excellent in 16 cases, good in 2 cases, and fair in 2 cases, with excellent and good rate of 90%. Conclusions:Due to the similar tissue structure of donor site and recipient site, foot microflap free transplantation in the repair of full-thickness electric burn wounds deep to tendon or even bone in fingers can achieve good appearance and function, with better functional and sensory recovery of the affected finger in the case of nerve anastomosis. Patients have high degree of satisfaction with the curative effects, which is worthy of promotion.

Objective:To investigate the difference in clinical characteristics of drug-induced liver injury (DILI) between patients of different gender.Methods:Through the hospital electronic medical record system, clinical data of patients hospitalized because of DILI at Liver Research Center, Beijing Friendship Hospital, Capital Medical University from January 2005 to January 2021 were collected and retrospectively analyzed. The collected information included gender, age, body mass index, underlying diseases, medication, results of the first laboratory tests after admission, clinical manifestation and types of DILI, etc. The patients were divided into 2 groups according to gender and the clinical characteristics of DILI were compared. The factors affecting death/liver transplantation in DILI patients were analyzed by Cox regression method.Results:A total of 616 patients with DILI were entered, including 139 males (22.6%) and 477 females (77.4%). The median age was 56 (47, 64) years, ranging from 18 to 80 years. Drugs that caused DILI were traditional Chinese medicine and/or health care products (TCMHCP) in 345 patients (56.0%), western drugs in 148 patients (24.0%), and TCMHCP and western drugs in 123 patients (20.0%). Death/liver transplantation occurred in 42 patients (6.8%), including 3 liver transplantation, 19 death directly caused by the liver disease, and 20 death with causes other than liver disease. The incidences of dark urine and abdominal distension, severe liver injury, and death/liver transplantation in male patients were all higher than those in female patients, respectively [71.9% (100/139) vs. 60.0% (286/477), P=0.010; 28.8% (40/139) vs. 18.7% (89/477), P=0.010; 46.8% (65/139) vs. 40.5% (193/477), P<0.001; 15.1% (21/477) vs. 4.4% (21/139), P<0.001]. Laboratory test results such as the white blood cell count, hemoglobin, total bilirubin, direct bilirubin, total bile acid, triglyceride, and low density lipoprotein cholesterol in male patients were all higher than those in female patients, while the levels of pre-albumin, immunoglobulin G, immunoglobulin M, and serum creatinine were lower (all P<0.05). Cox regression analysis showed that male, older age, low albumin, high total bile acid, high serum creatinine, and prolonged international normalized ratio (INR) were the independent influencing factors of death/liver transplantation in patients with DILI. Conclusions:Clinical manifestation are different in DILI patients of different gender hospitalized in the Liver Research Center, Beijing Friendshop Hospital, Capital Medical University. In male patients, cholestasis is more obvious, the disease condition is more serious, and death/liver transplantation is more common. Male patients and patients with older age, lower albumin, higher total bile acid, higher serum creatinine, and higher INR are more prone to death/liver transplantation, which should be paid attention to in clinic.

Immune checkpoint inhibitors (ICIs) play the role of anti-tumor by activating the immune system in human, but they can also cause immune-mediated liver injury, which is different from conventional drug-induced liver injury in the incidence, clinical manifestations, pathogenesis, and prognosis. The main pathogenesis is that ICIs block key nodes of negative regulation of the immune response, including cytotoxic T-lymphocyte-associated antigen 4 and programmed cell death 1 receptor/programmed cell death ligand 1. Liver-injury occurs when the immune system is overactivated and loses immune tolerance to the liver. Immune-mediated liver injury includes immune-mediated hepatitis and immune-mediated cholangitis. Histopathological examination of the liver shows damage in hepatocytes and bile ducts, accompanied by central venous dermatitis mostly and granulomatous lesions partially. After diagnosis of immune-mediated liver injury, treatment should be given based on the severity, and glucocorticoids or immunosuppressants are often necessary.

Objective:To explore the clinical characteristics and prognosis of drug-induced liver injury (DILI) in elderly patients.Methods:The clinical data (including demographic characteristics, clinical features and relevant laboratory tests, suspected pathogenic drugs, and prognosis of DILI, etc.) of patients hospitalized due to DILI from January 2009 to December 2020 were collected through the DILI Data-base in Liver Research Center of Beijing Friendship Hospital, Capital Medical University. The patients were divided into young group (<40 years old), middle-aged group (40-59 years old), and elderly group (≥ 60 years old) according to their ages. The demographic characteristics, clinical features, and prognosis of DILI were compared among the 3 groups. The risk factors for all-cause death/liver transplantation in DILI patients were analyzed using univariate and multivariate COX regression models.Results:A total of 620 patients were entered in the study, including 477 females (76.9%) and 143 males (23.1%), with a median age of 56 (46, 64) years. There were 101 patients (16.3%) in the young group, 273 (44.0%) in the middle-aged group, and 246 (39.7%) in the elderly group, respectively. Compared with the young and middle-aged group respectively, patients in the elderly group had less fever [5.7% (14/246) vs. 18.8% (19/101) and 11.4% (31/273)], more abdominal distension [26.8% (66/246) vs. 11.9% (12/101) and 18.7% (51/273)], higher levels of alkaline phosphatase [171 (127, 265) U/L vs. 146 (104, 218) U/L and 158 (114, 221) U/L], gamma-glutamyltransferase [211 (132, 361) U/L vs. 122 (67, 200) U/L and 167 (94, 291) U/L], and serum creatinine [70 (59, 81) μmol/L vs. 58 (49, 72) μmol/L and 63 (57, 71) μmol/L], lower levels of serum albumin [36.2 (32.0, 38.8) g/L vs. 38.4 (35.2, 41.3) g/L and 37.3 (34.1, 40.7) g/L], immunoglobulin M [840 (610, 1190) mg/L vs. 1 030 (820, 1 460) mg/L and 1 060 (700, 1 480) mg/L], and platelet counts [186 (143, 236)×10 9/L vs. 214 (174, 270)×10 9/L and 210 (160, 257)×10 9/L], higher proportion of cholestasis type [13.0% (32/246) vs. 3.0% (3/101) and 5.5% (15/273)], lower rate of normalized liver function [80.5% (198/246) vs. 88.1% (89/101) and 89.0% (243/273)], and higher proportion of all-cause death/liver transplantation [5.7% (14/246) vs. 3.0% (3/101) and 1.5% (4/273)]. The differences above mentioned were statistically significant (all P<0.05). Multivariate COX regression analysis showed that age [hazard ratio ( HR)=1.029, 95% confidence interval ( CI): 1.002-1.056, P=0.034), serum albumin ( HR=0.933, 95% CI: 0.883-0.985, P=0.012), cholesterol ( HR=1.006, 95% CI: 1.004-1.008, P<0.001), serum creatinine ( HR=1.007, 95% CI: 1.000-1.015, P=0.049), and severity of DILI ( HR=2.328, 95% CI: 1.692-3.202, P<0.001) were independent influencing factors of all-cause death/liver transplantation in DILI patients. Conclusions:Age, serum albumin, total cholesterol, serum creatinine, and severity of DILI are independent influencing factors for all-cause death/liver transplantation in DILI. Cholestatic liver injury is more common in elderly patients with DILI and the prognosis is poor, which needs more clinical attention.