ObjectiveTo investigate the effect and mechanism of long intergenic non-coding RNA02086 （LINC02086） overexpression mediated macrophage polarization on the proliferation， migration and invasion of gastric cancer cells. MethodsThe expression levels of LINC02086 in the human gastric epithelial cell line GES-1 and human gastric cancer cell lines HCG-27， NCI-N87， and AGS were determined by qRT-PCR. Human acute monocytic leukemia cells （THP-1） were induced to differentiate into M0 macrophages using phorbol 12-myristate 13-acetate （PMA）. HGC-27 cells were infected with either LINC02086 overexpression lentivirus （OE-LINC02086） or its negative control lentivirus （Vector）， and the culture supernatants were collected as conditioned medium （CM1）. M0 macrophages were co-cultured with the infected HGC-27 cells， and the resulting supernatants were designated as conditioned medium 2 （CM2）. M0 macrophages were treated with CM1 alone or in combination with Wnt/β-catenin pathway inhibitor IWR-1， forming the Vector+CM1， OE-LINC02086+CM1， and OE-LINC02086+CM1+IWR-1 groups， respectively. Flow cytometry was used to detect mannose receptor C-type 1 （CD206） expression， and qRT-PCR was employed to measure mRNA levels of interleukin-10 （IL⁃10）， transforming growth factor-β （TGF⁃β）， vascular endothelial growth factor （VEGF）， and chemokine ligand 22 （CCL22）. Western blot was performed to evaluate protein expression of CD206， VEGF， and key components of the Wnt/β-catenin pathway—Wnt family member 3a （Wnt3a）， glycogen synthase kinase-3β （GSK-3β）， and β-catenin. HGC-27 cells were treated with CM2 alone or combined with IWR-1， establishing the Vector+CM2， OE-LINC02086+CM2， and OE-LINC02086+CM2+IWR-1 groups. CCK-8 assay was used to evaluate cell proliferation， and Transwell assays were conducted to assess migration and invasion capabilities. ResultsCompared with GES-1 cells， the expression levels of LINC02086 were upregulated in HCG-27， NCI-N87， and AGS cells （P < 0.05）， with the smallest increase observed in HCG-27 cells. Compared with Vector+CM1 group， the level of CD206 and the expression levels of IL⁃10， TGF⁃β， VEGF and CCL22 mRNA in macrophages stimulated by OE-LINC02086+CM1 increased （P<0.05）. Meanwhile， the expression levels of Wnt3a and β-catenin proteins in cells increased （P<0.05）， and the expression level of GSK-3β protein decreased （P<0.05）. However， co-treatment with IWR-1 markedly reversed the promoting effects of LINC02086 overexpression on the expression of M2 polarization markers， including CD206， IL⁃10， and TGF⁃β mRNA， in macrophages （P<0.05）， as well as its activation of the Wnt/β-catenin signaling pathway （P<0.05）. Compared with Vector+CM2 group， HGC-27 cells infected with OE-LINC02086+CM2 had increased proliferation activity and increased number of migration and invasion cells （P<0.05）. However， the combined intervention of IWR-1 significantly reversed the promotion of LINC02086 overexpression on the proliferation， migration and invasion of HGC-27 cells （P<0.05）. ConclusionLINC02086 overexpression promotes the proliferation， migration and invasion of gastric cancer cells by activating Wnt/β-catenin pathway to mediate M2 polarization of macrophages.

A scoping review was performed to systematically search and summarize the clinical research in the treatment of dysmenorrhea with oral Chinese patent medicines. The oral Chinese patent medicines for treating dysmenorrhea in three major drug lists, guidelines, and textbooks were screened, and the relevant clinical trials were retrieved from eight Chinese and English databases. The key information of the included trials was extracted and visually analyzed. A total of 50 Chinese patent medicines were included, among which oral Chinese patent medicines for the dysmenorrhea patients with the syndrome of Qi stagnation and blood stasis accounted for the highest proportion, and the average daily cost varied greatly among Chinese patent medicines. A total of 150 articles were included, involving 22 Chinese patent medicines, among which Guizhi Fuling Capsules/Pills, Sanjie Zhentong Capsules, and Dan'e Fukang Soft Extract were the most frequently studied. These articles mainly reported randomized controlled trial(RCT), which mainly focused on the comparison of the intervention effect between Chinese patent medicines combined with western medicine and western medicine alone, and the sample size was generally 51-100 cases. The high-frequency outcome indicators belonged to nine domains such as effective rate, adverse reactions, and laboratory examinations. This study showed that oral Chinese patent medicines had advantages in the treatment of dysmenorrhea, and the annual number of related clinical trials showed an overall growing trend. However, there were still problems such as insufficient safety information and vague description of traditional Chinese medicine(TCM) syndromes types in the instructions of Chinese patent medicines. The available clinical research had shortcomings such as uneven distribution of Chinese patent medicines, limited research scale, poor methodological rigor, and insufficient standardization of outcome indicators. In the future, it is necessary to deepen the development of high-quality clinical research and improve the contents of the instructions to ensure the effectiveness and safety of the clinical application of oral Chinese patent medicines in the treatment of dysmenorrhea.
Dysmenorrhea/drug therapy* ; Humans ; Drugs, Chinese Herbal/administration & dosage* ; Female ; Administration, Oral ; Nonprescription Drugs/administration & dosage*

This study aims to systematically review and evaluate the quality of clinical research on the treatment of adenomyosis(AM) with traditional Chinese medicine(TCM) in recent ten years, using evidence graphs. Computer searches were conducted on eight Chinese and English databases, commonly used guideline databases, and guideline-related websites, covering the period from January 1, 2014, to October 1, 2024. Two researchers independently screened, extracted information, and evaluated the quality of the evidence. The distribution and quality of the clinical research evidence were presented using both text and charts. A total of 565 articles were included in the study, comprising 523 intervention studies, 23 observational studies, 18 systematic reviews/Meta-analysis, and 1 guideline. The overall publication volume has shown a downward trend in past two years. The sample sizes of the intervention and observational studies primarily focused on 60 to 120 cases. The intervention schemes mainly involved multi-therapy combinations, including 33 classic prescriptions and 25 Chinese patent medicines. Among these, 48 studies related to 17 classic prescriptions and 45 studies related to 10 types of Chinese patent medicines involved TCM syndrome types. Randomized controlled trial(RCT) tended to focus on overall clinical efficacy and the degree of dysmenorrhea as key outcome measures. Methodological quality issues were found in 97 RCTs related to TCM decoctions and 131 RCTs related to Chinese patent medicines, primarily involving unclear explanations of some information. The AMSTAR scores for the 18 systematic reviews/Meta-analysis ranged from 1 to 8 points, with 16 studies suggesting "evidence of potential therapeutic efficacy". The recommended level for the one included guideline was B-level. TCM shows significant advantages in treating AM. Future clinical research should further standardize study designs, reference relevant reporting guidelines, improve the quality of clinical research, generate higher-level evidence-based results, and promote the high-quality development of clinical research on TCM for treating AM.
Humans ; Adenomyosis/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Female ; Medicine, Chinese Traditional ; Randomized Controlled Trials as Topic

The analysis presented here is based on the blood components of Guanxin Qiwei tablets, the key anti-atherosclerosis pathway of Guanxin Qiwei tablets was screened by network pharmacology, and the anti-atherosclerosis mechanism of Guanxin Qiwei tablets was clarified and verified by cell experiments. HPLC-Q-Exactive-MS/MS technique was used to analyze the components of Guanxin Qiwei tablets into blood, to determine the precise mass charge ratio of the compounds, and to conduct a comprehensive analysis of the components by using secondary mass spectrometry fragments and literature comparison. Finally, a total of 42 components of Guanxin Qiwei tablets into blood were identified. To better understand the interactions, we employed the Swiss Target Prediction database to predict the associated targets. Atherosclerosis (AS) disease targets were searched in disease databases Genecard, OMIM and Disgent, and 181 intersection targets of disease targets and component targets were obtained by Venny 2.1.0 software. Protein interactions were analyzed by String database. The 32 core targets were selected by Cytscape software. Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed in DAVID database. It was found that the anti-atherosclerosis pathways of Guanxin Qiwei tablets mainly include lipid metabolism and atherosclerosis and AGE-RAGE signaling pathway in diabetic complications and other signal pathways. The core targets and the core compounds were interlinked, and it was found that cryptotanshinone and tanshinone ⅡA in Guanxin Qiwei tablets were well bound to TNF, PPARγ, AKT1, PTG2 and other targets. The lipid metabolism and atherosclerotic pathway was verified using human hl-7702 hepatocytes. This study preliminarily identified the potential pharmacodynamic components of Guanxin Qiwei tablets in the treatment of AS diseases and predicted their pathways of action, and verified the relationship between regulating lipid metabolism and atherosclerosis of Guanxin Qiwei tablets in vitro, providing a reference for the further study of the pharmacodynamic material basis and mechanism of action of this prescription. This experiment was approved by the Medical Ethics Committee of Inner Mongolia Medical University (No. YKD202401262).

Purpose: We report the diagnosis and conservative treatment of a patient with dacryocystitis accompanied by a congenital lacrimal sac diverticulum.Case summary: An 11-year-old boy presented with itching and redness in his right eye. His best-corrected visual acuity was 0.8 in the right eye and 1.2 in the left. Physical examination revealed redness, swelling, and tenderness around the right lacrimal sac area. Probing of the nasolacrimal duct showed no obstruction. Additional tests were performed under the diagnosis of acute dacryocystitis. Computed tomography and magnetic resonance imaging suggested inflammation of the soft tissue with abscess formation around the right orbit, with inflammation extending to the lower eyelid. After 7 days of inpatient treatment, the symptoms improved. Dacryocystography performed after the symptoms improved showed a small amount of residual contrast in a space near the lacrimal sac, leading to the diagnosis of a right lacrimal sac diverticulum. Conclusions In patients with dacryocystitis without nasolacrimal duct obstruction, congenital lacrimal diverticulum should be suspected.

Objective:To explore and demonstrate the effect of general-specialty hierarchical management mode for chronic heart failure (CHF) in community.Methods:This was a single-blind, randomized, controlled study. A total of 530 CHF inpatients who attended Weifang Community Health Service Center (WCHSC) in Pudong New Area from February 2018 to September 2019 were consecutively enrolled. A random number table method was used to divide the patients into the management group ( n=265) and control group ( n=265). The demographic data and past medical history were collected 1 day before enrolment (baseline), and patients were assessed for New York Heart Association (NYHA) cardiac function classification and tested for blood N-terminal B-type natriuretic peptide proteins (NT-proBNP) levels, while Doppler echocardiography was performed to obtain the relevant indexes. The management group used a comprehensive management mode, co-delivered by both WCHSC (offering primary care) and RHSJUSM (offering specialty care) at Renji-Weifang CHF Studio in WCHSC , using the jointly developed CHF hierarchical CHF diagnosis and treatment criteria and referral procedure under the condition of sharing drugs and laboratory test results for CHF. The control group received routine heart failure care. Intergroup comparisons were made on baseline data obtained before follow-up and on NT-proBNP , left ventricular ejection fraction (LVEF), NYHA functional class , re-hospitalization rate and mortality rate at the end of the 6-month follow-up. Results:A total of 506 cases completed the follow-up. There were 253 patients in the management group, aged (68.26±9.41) years, 117 males (46.2%); 253 were in the control group, aged (66.98±9.63) years, 115 males (45.5%). There were no statistically significant differences in age, sex, marital status, education level, and comorbidities between the two groups (all P>0.05). At baseline, the differences in LVEF and NT-proBNP between the two groups were not statistically significant (all P>0.05), and at 6 months of intervention, LVEF, and NT-proBNP had significantly improved in both groups (all P<0.05) . Moreover, LVEF was higher in the management group than in the control group, and NT-proBNP was lower than in the control group (both P<0.01). At baseline, there were 166 cases (65.6%) in the control group with NYHA class Ⅲ/Ⅳ, and 145 cases (57.3%) in the comprehensive management group. There was no statistically significant difference between the two groups ( P>0.05). At 6 months of intervention, the percentage of NYHA class Ⅲ/Ⅳ patients in the comprehensive management group was lower than at baseline ( P<0.01),while that in the control group was higher than at baseline ( P<0.01), and the comprehensive management group was lower than that in the control group ( P<0.01). During the follow-up period, the rehospitalization rate for CHF in the management group was 13.83%(35/253), which was lower than that in the control group, which was 26.88%(68/253) ( P<0.001). Conclusion:The comprehensive management mode of CHF in the community through collaboration between general and specialized departments can significantly improve the management effect, suggesting that this mode is effective and can be promoted.

Objective:To investigate the protective effects of incremental hemodialysis (iHD) combined with furosemide on residual kidney function (RKF) in end-stage renal disease patients who initiate dialysis with preserved RKF.Methods:This was a randomized controlled trial. The patients diagnosed with end-stage renal disease who initiated hemodialysis at the Department of Nephrology, the Affiliated Hospital of Qingdao University from May 2021 to May 2023 were enrolled. The clinical data were collected and analyzed. The patients were randomly assigned to either iHD group (two 4-hour sessions per week or three 3-hour sessions per week, with oral furosemide 40-80 mg twice daily) or the standard HD group (three 4-hour sessions per week, with oral furosemide 40-80 mg twice daily). Differences in clinical characteristics and RKF were assessed between the two groups of patients at 3 months and 6 months, and the differences between the clinical characteristic and the baseline level at 6 months were analyzed, along with the incidence of adverse events.Results:A total of 87 patients met the inclusion and exclusion criteria, of whom 75 completed this study. The mean age was (53.45±12.57) years old, with 37 females (49.33%) and 38 males (50.67%). The patients were assigned to iHD group (39 cases) and standard HD group (36 cases). At 3 months of the trial, compared with standard HD group, the level of serum C-reactive protein was significantly decreased, and the level of eGFR was significantly increased in the iHD group. At 6 months of the trial, the levels of systolic blood pressure, serum β 2-microglobulin, average ultrafiltration volume and C-reactive protein were significantly decreased, and the levels of eGFR, 24-hour urine volume were significantly increased in the iHD group ( P<0.05). The difference in eGFR, urine volume and systolic blood pressure between the iHD group and the baseline level was significantly smaller than that between the standard HD group and the baseline level (all P<0.05). In contrast, the differences in C-reactive protein was significantly greater than that in standard HD group and the baseline level ( P<0.05). At the 3rd, 6th month of the trial, the 24-h urine volumes of iHD group and standard HD group were (955±219) ml/24 h vs. (847±143) ml/24 h, (914±151) ml/24 h vs. (827±124) ml/24 h, showing statistically significant differences ( t=2.510, P=0.014; t=2.729, P=0.008). Adverse events mainly included pulmonary infections (22 cases), fluid overload during the dialysis interval (or more than 5% of the ideal dry weight, 12 cases), heart failure (4R or 4NR grade, 7 cases), hyperkalemia (6 cases), and thrombosis or failure of vascular access (3 cases). The incidence of adverse events did not differ statistically between the two groups ( P>0.05). Conclusion:iHD combined with furosemide helps preserve RKF and maintain urine output within 6 months compared with standard HD in patients with end-stage renal disease.

Diabetic encephalopathy(DE)is a complication of the central nervous system induced by diabetes,characterized by insidious onset and complex pathological mechanisms.Recent research has revealed that the pathological mechanisms of DE are closely associated with the imbalance of intercellular communica-tion across multiple organs.Exosomes,serving as vital media-tors of intercellular communication,are involved in the patholog-ical progression of DE and hold promise as diagnostic biomarkers and therapeutic targets for DE.Traditional Chinese medicine(TCM)can improve communication between brain cells and be-tween peripheral and brain tissues by regulating exosomes and their contents,thereby preventing and treating DE.Meanwhile,exosomes,as targeted delivery carriers of active molecules,can carry TCM monomers more easily across the blood-brain barrier to prevent and treat DE.In light of this,this review summarizes the regulatory role of exosomes in the pathological progression of DE and explores the enormous potential of TCM in the preven-tion and treatment of DE by regulating exosomes and using exo-somes as traditional Chinese medicine carriers,aiming to pro-vide new evidence for the prevention and treatment of DE with TCM.

Objective To analyze the risk factors for catheter-related thrombosis(CRT)in the upper arm infusion port(UAP)and to construct a machine-learning prediction model.Methods A total of 6028 patients,who received UAP implantation at Shanghai Renji Hospital of China from February 2014 to February 2023,were enrolled in this study.The patients were divided into training set(n=4 219)and validation set(n=1 809).Six machine-learning prediction models,including Least Absolute Shrinkage and Selection Operator(LASSO)regression,random forest,decision tree,neural network,XGBoost and logistic,were constructed,and the model having best performance was selected as the optimal model.SHapely Additive exPlanations(SHAP)analysis was used to explain the neural network model,and DALEXtra package was used to explain the continuous variables.Results The neural network model was chosen as the final model.The variables,in order of the degree of importance from high to low,included sex,the diameter of catheter,catheter tip confirmation method,the length of catheter,inpatient or outpatient status,history of central venous catheter implantation,the length of subcutaneous tunnel,age,body mass index(BMI),primary tip displacement,and left or right venous approach.The learning curve,i.e.the area under curve(AUC)of the receiver operating characteristic(ROC)curve,for the training set was＞0.6,and the Delong testing and Bootstrap Methods Test showed that the neural network model performed well(P＜0.05).The Kolmogorov-Smirnov plot(KS plot)value was 0.313 5,indicating that the model had the good ability of discrimination.The clinical impact curve(CIC)assessment revealed that the model had good clinical value.Conclusion The machine-learning prediction model of upper arm infusion port with CRT has been successfully constructed.For minimizing the risk of CRT,it is recommended to prioritize the use of 5 F diameter catheters,adopt left-sided venous approach and positioning the tip of the catheter based on anatomical measurements,besides,the catheter length should be not shorter than 36.56 cm,and the subcutaneous tunnel length should not be less than 5 cm.The basic features associated with higher CRT risk include age of 50-65 years,BMI being between 18.69 kg/m2 and 20.81 kg/m2 or between 23.68 kg/m2 and 23.94 kg/m2 and male.

Purpose: We report the diagnosis and conservative treatment of a patient with dacryocystitis accompanied by a congenital lacrimal sac diverticulum.Case summary: An 11-year-old boy presented with itching and redness in his right eye. His best-corrected visual acuity was 0.8 in the right eye and 1.2 in the left. Physical examination revealed redness, swelling, and tenderness around the right lacrimal sac area. Probing of the nasolacrimal duct showed no obstruction. Additional tests were performed under the diagnosis of acute dacryocystitis. Computed tomography and magnetic resonance imaging suggested inflammation of the soft tissue with abscess formation around the right orbit, with inflammation extending to the lower eyelid. After 7 days of inpatient treatment, the symptoms improved. Dacryocystography performed after the symptoms improved showed a small amount of residual contrast in a space near the lacrimal sac, leading to the diagnosis of a right lacrimal sac diverticulum. Conclusions In patients with dacryocystitis without nasolacrimal duct obstruction, congenital lacrimal diverticulum should be suspected.