ObjectiveThis paper aims to clarify the material basis of Gualou Niubangtang and establish a quantitative analysis method for its main constituents， providing a reference for the overall quality control of this preparation. MethodsThe constituents in the formula were systematically characterized based on ultra-performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry （UPLC-Q-TOF-MS/MS）. Identification was performed by matching with the UNIFI 9.6 software and utilizing database platforms such as PubChem， ChemicalBook， and ChemSpider， combined with relevant literature reports. A quantitative analysis method for the seven main constituents in Gualou Niubangtang was established by using high performance liquid chromatography （HPLC）. ResultsUPLC-Q-TOF-MS/MS analysis identified 155 constituents， including 69 flavonoids， 36 terpenoids， 23 phenylpropanoids， 8 phenylethanoid glycosides， and 19 other types of constituents. In the established quantitative analysis method， the seven main constituents showed good linearity within their respective linear ranges. The precision， repeatability， stability， and spike recovery all met the required standards. The results showed that the content ranges of geniposide， liquiritin， hesperidin， arctiin， baicalin， oroxylin A-7-O-β-D-glucuronide， and wogonoside in 15 batches of Gualou Niubangtang were 13.67-21.25， 1.20-7.64， 5.45-7.45， 22.97-33.51， 29.95-39.07， 2.58-4.80， and 6.56-9.31 mg·g^-1， respectively. ConclusionThis study successfully characterizes and attributes multi-category constituents in Gualou Niubangtang， clarifying that its material basis is primarily composed of flavonoids， terpenoids， phenylethanoid glycosides， and phenylpropanoids. Furthermore， it enables the quantification of seven constituents within the formula. This work lays a foundation for research on the quality control， action mechanism， and clinical application of this formula.

This study aimed to identify mutations in the human insulin receptor gene (INSR) and investigate their role in the pathogenesis of severe insulin resistance syndrome. Sanger sequencing of the INSR gene was performed on a patient clinically suspected of having type A insulin resistance syndrome admitted to the Department of Endocrinology, the First Medical Center of Chinese PLA General Hospital. Upon identifying mutations, relevant exons were sequenced in her first-degree relatives. Additionally, control groups consisting of individuals with type 2 diabetes and those with normal glucose tolerance were screened for the mutation detected in the patient. Functional predictions of the INSR protein were made using MutationTaster, SIFT, and PolyPhen2 software. A previously unreported heterozygous missense mutation, c.3652G/A (Asp1218Asn), in exon 20 was identified in both the proband and her father. This mutation was not present in any of the control individuals. Multiple prediction tools indicate that this mutation likely disrupts gene/protein structure or function. The c.3652G/A (Asp1218Asn) heterozygous mutation in INSR is a novel variant that plays a significant role in the pathogenesis of severe insulin resistance in this Chinese family.

Objective To analyze the focus and shortcomings of provincial-level digitalization policies for Traditional Chinese Medicine(TCM),and to provide references for improving relevant policies.Methods A three-dimensional analytical framework—comprising"digitalization policy coverage-economic level-TCM development level"was constructed to quantitatively analyze provincial TCM digitalization policy documents issued over the past five years.Results A total of 750 policy items were extracted.Among them,digital applications accounted for the largest proportion(58.13%),while digital governance(26.53%)and digital infrastructure(15.33%)were relatively less emphasized.Two-dimensional analysis revealed that 48.4%of provinces had both low economic levels and low digital policy coverage,while 45.2%had both low TCM development levels and low policy coverage.Multiple linear regression result showed a positive association between digitalization policies coverage and TCM development level,with no significant correlation to economic level.Conclusion Most provincial TCM digitalization policies prioritize application while neglecting governance and infrastructure.There is a need to strengthen talent development and standard system construction,The extent of policy coverage is closely related to the level of TCM development,indicating the need to enhance top-level policy design,Provincial policies vary in focus and can be categorized into three types:industry-driven,technology-driven,and demand-driven.

In recent years,the microorganisms residues in endoscopes have frequently resulted in cross transmis-sion or even the outbreak of hospital-associated infections.It is of great importance to carry out standardized bio-logical surveillance of endoscopes,find out the high-risk links of cleaning and disinfection,and take targeted inter-vention measures to reduce the incidence of endoscopy-related infection.Based on the related guidelines in China and abroad as well as the latest clinical practice researches,the biological surveillance sampling and culture for en-doscopes were summarized in the article so as to enhance the surveillance quality,ensure the reprocessing effect and guarantee the endoscopy-related quality and safety.

In the context of the development of transplant oncology,it is of great clinical significance to find a drug with both antitumor and immunosuppressive effects for liver transplantation patients with hepatocellular carcinoma(HCC).The antitumor effect of ginkgolic acid(GA)has been confirmed,and some studies suggest that GA may also have an immunosuppressive effect.The immunosuppressive effect of GA was evaluated by histopathology,T-cell subpopulation,and cytokine detection in rat liver transplantation and mouse cardiac transplantation models,and transcriptomic and metabolomic analysis was used to explore the underlying mechanism of the GA immunosuppressive effect.Metabolites,activation,and ferroptosis markers of CD8+T cells were detected in vivo and in vitro.Based on rat liver transplantation and mouse cardiac transplantation models,the immunosuppressive effect of GA was first confirmed by histopathology,T-cell subpopulation,and cytokine detection.In the mouse cardiac transplantation model,transcriptomics combined with metabolomics demonstrated for the first time that GA inhibited lactate dehydrogenase A(LDHA)expression and pyruvate metabolism in CD8+T cells.It was confirmed in vivo and in vitro that GA inhibited pyruvate metabolism of CD8+T cells through LDHA,inhibiting their activation and inducing ferroptosis.Over-expression of LDHA partially reversed the effect of GA on the metabolism,activation,and ferroptosis of CD8+T cells in vitro.GA mediates metabolic reprogramming through LDHA to inhibit the activation and induce ferroptosis of CD8+T cells to exert an immunosuppressive effect,which lays an experimental foundation for the future clinical application of its immunosuppressive effect.

Cancer represents a major worldwide disease burden marked by escalating incidence and mortality. While therapeutic advances persist, developing safer and precisely targeted modalities remains imperative. Nanomedicines emerges as a transformative paradigm leveraging distinctive physicochemical properties to achieve tumor-specific drug delivery, controlled release, and tumor microenvironment modulation. By synergizing passive enhanced permeation and retention effect-driven accumulation and active ligand-mediated targeting, nanoplatforms enhance pharmacokinetics, promote tumor microenvironment enrichment, and improve cellular internalization while mitigating systemic toxicity. Despite revolutionizing cancer therapy through enhanced treatment efficacy and reduced adverse effects, translational challenges persist in manufacturing scalability, longterm biosafety, and cost-efficiency. This review systematically analyzes cutting-edge nanoplatforms, including polymeric, lipidic, biomimetic, albumin-based, peptide engineered, DNA origami, and inorganic nanocarriers, while evaluating their strategic advantages and technical limitations across three therapeutic domains: immunotherapy, chemotherapy, and radiotherapy. By assessing structure-function correlations and clinical translation barriers, this work establishes mechanistic and translational references to advance oncological nanomedicine development.
Humans ; Neoplasms/radiotherapy* ; Immunotherapy/methods* ; Nanoparticles/chemistry* ; Animals ; Nanomedicine/methods* ; Drug Delivery Systems/methods* ; Drug Carriers/chemistry* ; Radiotherapy/methods*

Objective To explore the influence of the chronic disease management model based on wearable devices on the self-management ability,quality of life and physiological index control of patients after percutaneous coronary intervention(PCI).Methods Eighty patients with coronary heart disease who underwent PCI in Hefei BOE Hospital from April to September 2024 were selected as research objects.They were divided into control group and intervention group according to the random number table method,with 40 cases in each group.The control group received the conventional care model,while the intervention group adopted a postoperative chronic disease management model based on wearable devices,and the intervention period was 6 months for all.The coronary artery disease self-management scale(CSMS)was used to assess self-management ability,and the Seattle angina questionnaire(SAQ)was used to assess quality of life before and after the intervention.Additionally,the compliance rates of blood pressure,low density lipoprotein-cholesterol(LDL-C),and body mass index(BMI)were recorded.Results After the intervention,the scores of each dimension and total score of CSMS,as well as the scores of each dimension of SAQ of two groups of patients were significantly higher than those before the intervention(P＜0.05).Moreover,the scores of each dimension and total score of CSMS and the scores of each dimension of SAQ of intervention group were significantly higher than those of control group(P＜0.05).The compliance rates of blood pressure,LDL-C and BMI in intervention group were significantly higher than those in control group(P＜0.05).Conclusion The chronic disease management model based on wearable devices,through data monitoring,team collaboration and dynamic intervention,can significantly enhance the self-management ability of patients after PCI,improve their quality of life and the compliance rate of key physiological indicators,and has clinical promotion value.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

Objective:To identify the key differentially expressed gene, BTF3, in cutaneous squamous cell carcinoma(cSCC)using bioinformatics methods and to preliminarily explore the potential mechanisms of BTF3 and its co-expressed genes in cSCC development. Methods:The cSCC-related datasets(GSE98767, GSE42677, GSE45164)were obtained from the Gene Expression Omnibus(GEO)database.Differential expression analysis revealed BTF3 as a significantly differentially expressed gene in cSCC.A BTF3-related co-expressed gene network was constructed and subjected to gene ontology(GO)enrichment analysis to investigate the biological processes, molecular functions, and cellular components that were significantly enriched.The study selected 60 paraffin-embedded tissue samples from the First Affiliated Hospital of Jinzhou Medical University, collected between 2020 and 2024.This cohort included 30 samples from cSCC patients and 30 samples from patients who underwent excision of melanocytic nevi.Immunohistochemical experiments were conducted to assess the expression of BTF3 in cSCC tissues.Additionally, single-sample gene set enrichment analysis(ssGSEA)was performed to assess the relevance of BTF3 to immune cells, and protein-protein interaction(PPI)analysis was employed to identify critical gene networks. Results:BTF3 was significantly overexpressed in cSCC, as confirmed by immunohistochemistry.The receiver operating characteristic(ROC)curve indicated that BTF3 exhibited moderate classification accuracy.Co-expression analysis revealed that positively correlated genes with BTF3 included EIF3E and HSPA14, while negatively correlated genes included SZRD1 and ARHGEF2.GO analysis demonstrated that BTF3 was enriched in biological processes such as glucose metabolism, signaling in response to deoxyribonucleic acid (DNA)damage, endogenous apoptotic signaling pathways, platelet morphogenesis, and platelet formation.Additionally, ssGSEA indicated a significant association of BTF3 with memory B cells and a notable correlation with low CD56-expressing natural killer cells. Conclusions:BTF3 is significantly overexpressed in cSCC and may represent a promising diagnostic and therapeutic target by influencing key gene networks and modulating the immune microenvironment.