Objective To investigate the effect of asperuloside(ASP)on the malignant progression and chemotherapy resistance of hepatocellular carcinoma(HCC)cells by regulating the supersonic hedgehog(SHH)/glioma-associated oncogene homolog 1(GLI1)signaling pathway.Methods The expression of SHH and GLI1 protein in human hepatocellular carcinoma cell line(SMMC-7721)/adriamycin(ADM)and SMMC-7721 cell line were detected by Western blot(WB).The HCC drug-resistant cell line SMMC-7721/ADM were divided into Control group,ADM group,L-ASP group(1 mmol/L ASP),M-ASP group(2 mmol/L ASP),H-ASP group(3 mmol/L ASP),ASP+PM group(1 μmol/L SHH/GLI1 signaling pathway activator PM).Ex-cept for Control group,5 μg/mL ADM was added to each group.The effect of ASP on the proliferation of SMMC-7721/ADM cells was detected by cell counting kit-8(CCK8)assay and plate cloning assay.The effect of ASP on the invasion and migration of SMMC-7721/ADM cells were detected by Transwell assay.The effect of ASP on the apoptosis of SMMC-7721/ADM cells was detected by flow cytometry.The expression of SHH,GLI1,proliferating cell nuclear antigen(PCNA),matrix metalloproteinase-9(MMP-9)and B cell lymphoma-2 associated X protein(Bax)in SMMC-7721/ADM cells were detected by WB.Animal experiments verified the effect of ASP on the growth of HCC xenografts and the expression of SHH/GLI1 signaling pathway proteins.Results The expression of SHH and GLI1 in SMMC-7721/ADM cells were higher than those in SMMC-7721 cells(P＜0.05).L-ASP group,M-ASP group and H-ASP group decreased the proliferation,migration and in-vasion of SMMC-7721/ADM cells in a dose-dependent manner,decreased the expression of SHH,GLI1,PCNA and MMP-9,and promoted cell apoptosis and Bax expression(P＜0.05).SHH/GLI1 signaling pathway acti-vator PM could reverse the inhibitory effect of H-ASP treatment on malignant progression and chemotherapy resistance of SMMC-7721/ADM cells(P＜0.05).ASP could inhibit the growth of HCC transplanted tumor and the expression of SHH and GLI1(P＜0.05).Conclusion ASP can inhibit the malignant progression of HCC cells and enhance the sensitivity of chemotherapy,which may be achieved by inhibiting the SHH/GLI1 signaling pathway.

ObjectiveTo observe the clinical efficacy of Tongfu Kuanzhong decoction （TFKZ） in the treatment of constipation-predominant irritable bowel syndrome （IBS-C） with spleen deficiency and Qi stagnation and its effects on anorectal manometry and colonic electrical activity parameters. MethodsSixty-four patients with IBS-C of the spleen deficiency and Qi stagnation type were included as research subjects and were randomized into the observation group （thirty-two cases） and control group （thirty-two cases）. The control group was orally administered mosapride citrate tablets， and the observation group was orally administered TFKZ. Both groups were treated for 4 weeks. The traditional Chinese medicine （TCM） syndrome scores， patient assessment of constipation symptoms （PAC-SYM） score， general anxiety disorder-7 （GAD-7） score， patient health questionnaire-9（PHQ-9）score， anorectal manometry， and colonic electrical activity parameters were observed before and after treatment in the two groups. ResultsThe total points of TCM syndromes were significantly lower in both groups after treatment （P<0.01） and lower in the observation group （P<0.05）. The fecal symptoms， rectal symptoms， abdominal symptoms， and total symptom scores of the patients in both groups were significantly decreased after treatment （P<0.01）， and the rectal symptoms， abdominal symptoms， and total symptom scores of the observation group were lower （P<0.05，P<0.01）. In both groups， the forced anal residual pressure and the initial rectal sensation threshold decreased after treatment （P<0.05，P<0.01）， and forced anal residual pressure in the control group was lower （P<0.01）. After treatment， the GAD-7 and PHQ-9 scores of patients in both groups decreased significantly （P<0.01）， and the GAD-7 score of the observation group was significantly lower （P<0.01）. After treatment， the average wave amplitude at different time points of each lead increased significantly in both groups， compared with that before treatment （P<0.01）. The average wave amplitude of each lead of the ascending colon， descending colon， sigmoid colon， and rectum in the observation group at 5 min before the meal and 10 min after the meal， as well as that of the ascending colon and rectum at 20 min and 30 min after the meal， was higher than that of the control group （P<0.05）. ConclusionTFKZ is effective in the treatment of IBS-C. Its mechanism may be related to the regulation of colonic function by down-regulating the forced anal residual pressure and the initial rectal sensation threshold and up-regulating the amplitude and frequency of intestinal electrical activity in each intestinal segment of the colon.

"Weibing" is a fundamental concept in traditional Chinese medicine (TCM), representing a transitional state characterized by diminished self-regulatory abilities without overt physiological or social dysfunction. This perspective delves into the biological foundations and quantifiable markers of Weibing, aiming to establish a research framework for early disease intervention. Here, we propose the "Health Quadrant Classification" system, which divides the state of human body into health, sub-health, disease-susceptible state, and disease. We suggest the disease-susceptible stage emerges as a pivotal point for TCM interventions. To understand the intrinsic dynamics of this state, we propose laboratory and clinical studies utilizing time-series experiments and stress-induced disease susceptibility models. At the molecular level, bio-omics technologies and bioinformatics approaches are highlighted for uncovering intricate changes during disease progression. Furthermore, we discuss the application of mathematical models and artificial intelligence in developing early warning systems to anticipate and avert the transition from health to disease. This approach resonates with TCM's preventive philosophy, emphasizing proactive health maintenance and disease prevention. Ultimately, our perspective underscores the significance of integrating modern scientific methodologies with TCM principles to propel Weibing research and early intervention strategies forward.

Objective:To evaluate the long-term effectiveness of lingual mucosal graft ureteroplasty (LMGU) for managing long-segment (≥5 cm) ureteral strictures in a multi-institutional cohort of patients.Methods:A multi-center retrospective case series study was conducted on clinical data from 42 patients undergoing LMGU for long-segment ureteral strictures (≥5 cm) across five institutions between February 2017 and June 2024. The cohort comprised 31 males and 11 females, with an age of (43.4±12.0) years (range: 15 to 64 years) and a body mass index of (24.6±2.6) kg/m2 (range: 16.0 to 30.0 kg/m2). Strictures involved the left ureter in 24 cases and right ureter in 18 cases, demonstrating a stricture length of (6.4±1.5) cm (range: 5.0 to 11.5 cm). Surgical interventions included either onlay ureteroplasty or augmented anastomotic ureteroplasty, selected according to intraoperative findings. Intraoperative parameters, postoperative complications, and follow-up outcomes were analyzed.Results:Laparoscopic surgery was performed in 22 cases and robot-assisted surgery in 20 cases. Among the 42 patients, 22 underwent onlay ureteroplasty while 20 received augmented anastomotic ureteroplasty. The graft length was (5.9±1.8) cm (range: 3.0 to 12.0 cm), operative time (191.5±55.6) minutes (range: 105.0 to 350.0 minutes), and intraoperative estimated blood loss (86.7±73.6) ml (range: 10.0 to 400.0 ml). All procedures were successfully completed without conversion to open surgery. The postoperative hospital stay was (7.6±2.0) days (range: 4.0 to 15.0 days), with double-J stent removal at 6 to 8 weeks postoperatively. During a follow-up of (49.1±25.0) months (range: 12.0 to 99.0 months), no stricture recurrence was observed in any patient.Conclusion:LMGU is a safe, feasible, and effective long-term technique for managing long-segment (≥5 cm) ureteral strictures.

Adipocytic tumors are the most common type of soft tissue tumors,which can be divided into lipomas and liposarcomas.Studies have found that benign lipomas resected from the same site can transform into liposarcomas,especially atypical lipomatous tumors(ALT),suggesting an underlying biological association.In this case,the patient underwent resection of a right neck mass in our hospital in 2017,and the pathology showed fibrolipoma.One year later,the mass recurred at the original site but was not treated.By 2023,the mass had significantly enlarged and extended deeply.MRI showed that the lesion had an unclear boundary with the surrounding fat,suggesting liposarcoma.Puncture and molecular pathology showed MDM2 gene amplification,and the diagnosis of ALT was made,which was confirmed by pathology after complete surgical resection.It can be seen that adipocytic tumors have great differences in biological behavior,and benign lipomas can transform into liposarcomas(especially ALT).Clinically,it is necessary to combine imaging,pathology and molecular detection(such as MDM2/CDK4)for differentiation to formulate treatment plans.

Objective To establish a HPLC method for determining thimerosal compounds in eye drops. Methods A gradient HPLC system was used in the quantitative analysis of thimerosal compounds on Shiseido MGII C₁₈ column （4.6 mm×250 mm，5 μm）, using 1% triethylamine solution （pH adjusted to 3.0 with phosphate） as mobile phase A, the methanol as mobile phase B, gradient elution, The column temperature was 40 ℃, the detection wavelength was 222 nm, the flow rate was 1 ml/min and the injection volume was 20 µl. Results The established method had good linearity within the concentration range of 4.3-216.7 μg/ml （r>0.999） for thimerosal, with average recoveries was 102.1%, RSD2.7%. Conclusion This method was simple, accurate and highly specific, and could be used for determination of thimerosal compound in eye drops.

OBJECTIVE To evaluate the efficacy and safety of letermovir in preventing cytomegalovirus(CMV)infection after allogeneic hematopoietic stem cell transplantation(allo-HSCT).METHODS A retrospective cohort study was conducted,enrolling patients who underwent allo-HSCT at the Department of Hematology,Shanghai General Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,from August 30,2022,to February 21,2024.Patients who initiated letermovir prophylaxis within 28 days post-transplantation were assigned to the experimental group(99 cases),while those who did not initiate letermovir within this period were assigned to the control group(18 cases).The incidence and clinical characteristics of CMV infection(including the number of CMV infection cases,the number of cases progressing to CMV disease,recurrent CMV disease,onset time of CMV infection,and treatment duration),immune function recovery within 120 days post-transplantation,and the occurrence of transplantation-related complications(including CD4+and CD8+T-cell recovery,Epstein-Barr virus infection,acute graft-versus-host disease,human herpesvirus 6 infection,and posttransplant lymphoproliferative disorders)and adverse events were recorded.Univariate and multivariate Cox regression analyses were performed to identify factors influencing CMV infection.RESULTS A total of 117 patients were included,among whom 15 developed CMV infection,5 progressed to CMV disease,and 2 experienced recurrent CMV disease.The CMV infection rate in the experimental group was significantly lower than that in the control group(P＜0.001),and the onset time of CMV infection was significantly delayed(P=0.014).The proportion of patients with CD4+T-cell counts≥200 cells/μL in the experimental group was significantly lower than that in the control group(P=0.022).During the follow-up period,elevated creatinine levels were observed in 1 patient,and nausea and vomiting were observed in 2 patients.Multivariate Cox regression analysis revealed that the use of high-dose corticosteroids was a risk factor for CMV infection(HR=6.230,95%CI of 1.255-30.926,P=0.025),while initiating letermovir within 28 days post-transplantation was a protective factor(HR=0.125,95%CI of 0.045-0.348,P＜0.001).CONCLUSIONS Early initiation of letermovir after allo-HSCT significantly reduces the CMV infection rate and delays the onset of infection,with favorable short-term safety.

Adipocytic tumors are the most common type of soft tissue tumors,which can be divided into lipomas and liposarcomas.Studies have found that benign lipomas resected from the same site can transform into liposarcomas,especially atypical lipomatous tumors(ALT),suggesting an underlying biological association.In this case,the patient underwent resection of a right neck mass in our hospital in 2017,and the pathology showed fibrolipoma.One year later,the mass recurred at the original site but was not treated.By 2023,the mass had significantly enlarged and extended deeply.MRI showed that the lesion had an unclear boundary with the surrounding fat,suggesting liposarcoma.Puncture and molecular pathology showed MDM2 gene amplification,and the diagnosis of ALT was made,which was confirmed by pathology after complete surgical resection.It can be seen that adipocytic tumors have great differences in biological behavior,and benign lipomas can transform into liposarcomas(especially ALT).Clinically,it is necessary to combine imaging,pathology and molecular detection(such as MDM2/CDK4)for differentiation to formulate treatment plans.

Objective:To evaluate the long-term effectiveness of lingual mucosal graft ureteroplasty (LMGU) for managing long-segment (≥5 cm) ureteral strictures in a multi-institutional cohort of patients.Methods:A multi-center retrospective case series study was conducted on clinical data from 42 patients undergoing LMGU for long-segment ureteral strictures (≥5 cm) across five institutions between February 2017 and June 2024. The cohort comprised 31 males and 11 females, with an age of (43.4±12.0) years (range: 15 to 64 years) and a body mass index of (24.6±2.6) kg/m2 (range: 16.0 to 30.0 kg/m2). Strictures involved the left ureter in 24 cases and right ureter in 18 cases, demonstrating a stricture length of (6.4±1.5) cm (range: 5.0 to 11.5 cm). Surgical interventions included either onlay ureteroplasty or augmented anastomotic ureteroplasty, selected according to intraoperative findings. Intraoperative parameters, postoperative complications, and follow-up outcomes were analyzed.Results:Laparoscopic surgery was performed in 22 cases and robot-assisted surgery in 20 cases. Among the 42 patients, 22 underwent onlay ureteroplasty while 20 received augmented anastomotic ureteroplasty. The graft length was (5.9±1.8) cm (range: 3.0 to 12.0 cm), operative time (191.5±55.6) minutes (range: 105.0 to 350.0 minutes), and intraoperative estimated blood loss (86.7±73.6) ml (range: 10.0 to 400.0 ml). All procedures were successfully completed without conversion to open surgery. The postoperative hospital stay was (7.6±2.0) days (range: 4.0 to 15.0 days), with double-J stent removal at 6 to 8 weeks postoperatively. During a follow-up of (49.1±25.0) months (range: 12.0 to 99.0 months), no stricture recurrence was observed in any patient.Conclusion:LMGU is a safe, feasible, and effective long-term technique for managing long-segment (≥5 cm) ureteral strictures.

Objective To evaluate the efficacy of Huachansu tablets combined with transarterial chemoembolization(TACE)for treatment of primary hepatocellular carcinoma(HCC)and prognostic influence factors.Methods One hundred and eight patients with HCC were recruited according to the inclusion and exclusion criteria.Patients were randomly divided into treatment group and control group.The treatment group was treated with Huachansu tablets combined with TACE,and the control group was treated with TACE alone,with overall survival time(OS)and progression-free survival time(PFS)as the evaluation indexes.The COX regression analysis was used to evaluate the survival and prognostic effects and their influence factors in both groups.Results A total of 108 HCC patients were enrolled.The OS was 13.5 months in treatment group and 9.2 months in control group;the PFS was 6.8 months in treatment group and 5.3 months in control group,and the differences were significant statistically(all P<0.05).Multivariate COX regression analysis showed that Child-Pugh grade and cirrhosis were the independent risk factors for PFS in HCC patients.Child-Pugh grade were the independent risk factors for OS in HCC patients.ALBI is a protective factor for OS in HCC patients.Conclusions The treatment of HCC by Huachansu tablets combined with TACE can delay the progression of HCC and prolong PFS and OS of the patients with HCC.Child-Pugh grade,cirrhosis status,and ALBI were important factors affecting the prognosis of the patients with HCC.