Over the past two decades, genome-wide association study(GWAS) has identified numerous genetic variants and loci associated with heritable diseases. With the gradual maturation and saturation of GWAS methodologies, transcriptome-wide association study(TWAS) offers a novel perspective by linkinggenetic phenotypes to gene expression levels. By integrating TWAS with other multi-omics analyses, researchers can gain a deeper understanding of heritable diseases. This article provides an overview of recent groundbreaking and representative TWAS methods and tools, analyzes their strengths and limitations, and discusses future trends in TWAS development.

ObjectiveTo explore the application of virtual reality biofeedback training combined with oral localization therapy in dysphagia after oral cancer surgery. MethodsFrom May, 2023 to July, 2024, 86 patients with dysphagia after oral cancer surgery in Zhejiang Provincial People's Hospital were randomly divided into control group (n = 43) and experimental group (n = 43). The control group received conventional swallowing function training, while the experimental group added virtual reality biofeedback training combined with oral positioning therapy, for four weeks. The Standardized Swallowing Function Assessment Scale (SSA), Functional Oral Intake Scale (FOIS) and M.D.Anderson Dysphagia Inventory (MDADI) were used for evaluation before intervention, and two weeks, four weeks and eight weeks after intervention. ResultsFor scores of SSA , the main effects of group (F = 150.190, P < 0.001, η²_p = 0.641) and time (F = 230.870, P < 0.001, η²_p = 0.733), as well as the interaction effect (F = 16.910, P < 0.001, η²_p = 0.168) were all significant. For scores of FOIS, the main effects of group (F = 59.601, P < 0.001, η²_p = 0.415) and time (F = 89.464, P < 0.001, η²_p = 0.516), as well as the interaction effect (F = 7.990, P < 0.001, η²_p = 0.087) were all significant. For scores of MDADI, the main effects of group (F = 33.133, P < 0.001, η²_p = 0.283) and time (F = 49.650, P < 0.001, η²_p = 0.371), as well as the interaction effect (F = 3.224, P = 0.023, η²_p = 0.037) were all significant. ConclusionVirtual reality biofeedback training combined with oral localization therapy could improve the swallowing function, oral feeding ability and overall quality of life of patients with dysphagia after oral cancer surgery.

Objective To study the mini-character and microscopic features of Plantago asiatica from different populations and summarize the exclusive features to provide a reference for the effective identification of Plantago asiatica. Methods Stereomicroscope and optical microscope were used to identify 30 batches of Plantago asiatica from different populations.The similarities and differences in mini-character and microscopic features of Plantago asiatica among different populations were identified. Results The differences in mini character between the Plantago asiatica from different populations were mainly reflected in whether there was fluff on the surface of leaves, inflorescence peduncles, and persistent sepals, as well as whether the epidermis of fibrous roots was flaky. The differences in microscopic characteristics between the Plantago asiatica from different populations were mainly reflected in the number of non-glandular hairs on the leaf surface, the shape of the petiole endothelial layer cells, and the number of large vascular bundles, and the number of layers of mesophyll palisade tissue cells, etc. Conclusion Plantago asiatica from different populations can be identified through mini-character and microscopic; by comparing the relevant identification features, which can provide a basis for revising and improving the standards of Plantago asiatica.

ObjectiveTo compare the effects of different formulations of Yinqiao Powder （银翘散， YP） on inflammation and immune function in a rat model of acute pharyngitis induced by ammonia water. MethodsA rat model of acute pharyngitis was established by spraying 15% ammonia water into the pharynx of male SD rats using a laryngeal atomizer twice daily （three sprays each time） for three consecutive days. Successfully modeled rats were randomly divided into 5 groups， including a model group （normal saline， 10 ml/kg）， YP decoction group （10.73 g/kg）， YP granule group （10.73 g/kg）， cydiodine group （0.39 mg/kg） and blank control group （normal saline， 10 ml/kg）， with 12 rats in each group. All groups received intragastric administration once daily for 10 consecutive days. After the final gavage administration， frequency of back arching per minute， frequency of vibrissae grooming per minute， and grooming episodes per five minutes were recorded in rats. The cumulative body weight change was calculated as the difference in body weight between day 10 and day 1 of gavage administration. Behavioral observations were performed using the open field test， and the total distance traveled was recorded. After sample collection， the lung index and thymus index were calculated. Histopathological changes in the pharyngeal and tracheal tissues were observed using HE staining. Serum inflammatory markers including eosinophil cationic protein （ECP）， angiotensin-converting enzyme 2 （ACE2）， and C-reactive protein （CRP）， as well as immune parameters including immunoglobulin M （IgM）， immunoglobulin A （IgA）， immunoglobulin G （IgG）， CD4， CD4/CD8 ratio， and CD8 were measured by ELISA. In addition， ELISA was used to determine the levels of inflammatory mediators in pharyngeal tissues， including phospholipase A2 （PLA2）， cyclooxygenase-1 （COX-1）， cyclooxygenase-2 （COX-2）， prostaglandin E2 （PGE2）， vascular cell adhesion molecule-1 （VCAM-1）， C-X-C motif chemokine ligand 1 （CXCL1）， vascular endothelial growth factor （VEGF）， and matrix metalloproteinase-9 （MMP-9）. ResultsCompared to the blank control group， the model group exhibited significantly increased frequencies of back arching per minute， vibrissae grooming per minute， and grooming episodes per five minutes， and lung index， and decreased cumulative body weight change， thymus index， and total distance traveled， as well as elevated serum levels of ECP， ACE2， and CD8， reduced levels of IgM， IgA， IgG， CD4， and CD4/CD8 ratio， and increased levels of PLA， COX-1， COX-2， PGE2， VCAM-1， CXCL1， VEGF， and MMP-9 in pharyngeal tissues （P＜0.05）. Histopathological examination revealed keratinization of the superficial epithelial layer of the pharyngeal mucosa， accompanied by congestion and edema in the lamina propria and infiltration of inflammatory cells； in the tracheal mucosa， extensive inflammatory cell infiltration， ciliary disruption， and goblet cell damage were observed. Compared to the model group， except for CRP， IgG， and CD4， all above mentioned indicators were improved in the YP granule group， YP decoction group， and cydiodine group （P＜0.05）. Histopathological lesions in the pharyngeal and tracheal tissues were also alleviated. Compared to the YP decoction group， rats in the YP granule group exhibited decreased frequencies of back arching per minute， vibrissae grooming per minute， and grooming episodes per five minutes， as well as reduced serum ECP levels. Meanwhile， the cumulative body weight gain and serum levels of IgM， IgA， IgG， and CD4/CD8 increased， whereas CD8 levels decreased （P＜0.05）. ConclusionYP can effectively alleviate symptoms of acute pharyngitis in a rat model， improve inflammatory responses and immune-related indicators， demonstrating superior therapeutic effects in the dosage form of granule.

Huaihuasan， first recorded in Experiential Prescriptions for Universal Relief （Pu Ji Ben Shi Fang）， is a classic prescription for the treatment of ''hematochezia due to intestinal wind''. In 2018， it was included by the National Administration of Traditional Chinese Medicine as one of the first 100 classic prescriptions. This formula consists of four ingredients， i.e.， Sophorae Flos， Platycladi Cacumen， Schizonepetae Spica， and Aurantii Fructus. It is known for its ability to clear the intestines， dispel wind， cool the blood， and stop bleeding. In modern clinical practice， Huaihuasan， often with modifications， is widely used to treat various digestive tract diseases， including ulcerative colitis （UC）， with significant long-term effects. UC is a chronic， non-specific inflammatory bowel disease. Currently， Western medicine primarily treats UC with glucocorticoids， aminosalicylates， and immunosuppressants， which have good short-term efficacy but numerous adverse reactions， high recurrence rates， and the need for lifelong medication. Modern clinical studies have shown that Huaihuasan can significantly improve symptoms of UC， such as abdominal pain and diarrhea， reduce disease activity scores （Sutherland）， promote intestinal mucosal healing， alleviate anxiety and depression， and significantly improve the quality of life of patients. Pharmacological studies have shown that the main active components of Huaihuasan include quercetin， rutin， kaempferol， naringenin， and volatile oils. These compounds exert their effects by inhibiting inflammatory responses and protecting the intestinal mucosal barrier. They also exhibit antioxidant properties and regulate various signaling pathways， including tumor necrosis factor-α （TNF-α）， interleukin-2 （IL-2）， interleukin-4 （IL-4）， interleukin-1β （IL-1β）， monocyte chemoattractant protein-1 （MCP-1）， nuclear factor-κB （NF-κB）， Janus kinase （JAK）/signal transducer and activator of transcription （STAT）， and the KRAS-regulated mitogen-activated protein kinase （MEK）-extracellular signal-regulated kinase （ERK） pathway. These multi-target pathways improve UC symptoms， inhibit inflammation-cancer transition， and help maintain intestinal homeostasis. However， the precise mechanism of action has not yet been systematically elucidated. This paper reviews the research progress on Huaihuasan and main ingredients from its component drugs， focusing on their effects against UC. It also discusses current research limitations and suggests strategies for improvement， aiming to provide a reference for further studies on Huaihuasan in the treatment of UC and the development of new drugs.

A 20-year-old male patient presented to the Department of Dermatology of Peking Union Medical College Hospital with complaints of an 8-year history of facial scarring, swelling of the lower limbs, and a 4-year history of scalp thickening. Physical examination showed thickening furrowing wrinkling of the skin on the face and behind the ears, ciliary body hirsutism, blepharoptosis, and cutis verticis gyrate. Both lower limbs were swollen, especially the knees and ankles. The skin of the palms and soles of the feet was keratinized and thickened. Laboratory examination using bone and joint X-ray showed periostosis of the proximal middle phalanges and metacarpals of both hands, distal ulna and radius, tibia and fibula, distal femurs, and metatarsals.Genetic testing revealed two variants in SLCO2A1, c.1658T > A and c.96+4A > C.Through multidisciplinary consultation, we confirmed the diagnosis of pachydermoperiostosis.

Objective To explore the role of Erianin in atopic dermatitis(AD)and its regulatory mechanism involving the high-mobility group box 1(HMGB1)/receptor for advanced glycation end products(RAGE)-Ras homolog gene family member A(RhoA)/Rho-associated protein kinase 1(ROCK1)signaling pathway.Methods An AD model was induced in BALB/c mice using 1-chloro-2,4-dinitrobenzene(DNCB).Skin thickness and spleen and lymph node weight were measured and pathological changes in the back skin and ears were detected using methylamine blue and hematoxylin and eosin staining.Inflammatory factors were detected by enzyme-linked immunosorbent assay.An in vitro model of AD was established in HaCaT cells stimulated by tumor necrosis factor(TNF)-α.Cellular reactive oxygen species(ROS)were detected by flow cytometry and mitochondrial ROS(mtROS)were detected by immunofluorescence assay.Cell apoptosis was detected by terminal deoxynucleotidyl transferase dUTP nick-end labeling.HMGB1,RAGE,RhoA,and ROCK1 proteins were detected by Western blot.Results Erianin inhibited the increase in skin thickness,reduced the spleen and lymph node weights,improved the infiltration of inflammatory cells and the degranulation of mast cells,and reduced the levels of inflammatory factors(P＜0.05).Erianin also reduced the production of cellular ROS and mtROS induced by TNF-α in vitro(P＜0.01),and decreased the protein expression of HMGB1,RAGE,RhoA,and ROCK1(P＜0.01).Treatment of HMGB1-stimulated HaCaT cells with a RAGE-specific blocker(TFA)had no effect on HMGB1 expression,while expression levels of RAGE,RhoA,and ROCK1 were decreased(P＜0.01).Cells treated with the Rho kinase inhibitor Y-27632+r-HMGB1 group showed similar result to the TFA+r-HMGB1 group,except for RAGE.Conclusions Erianin relieves AD by regulating the HMGB1/RAGE-RhoA/ROCK signaling pathway.

Cardiovascular disease (CVD) is the leading cause of death worldwide. As the key pathological basis of CVD, arteriosclerosis holds great significance for early screening. However, existing clinical and homecare detection devices have many shortcomings; for instance, the commonly used non-invasive indicator PWV (pulse wave velocity) is easily interfered by blood pressure.This study developed a homecare arteriosclerosis monitoring system, which integrates the measurement functions of cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI). The hardware design of the system includes an integrated structure of flexible silver ion electrodes and clip-type cuffs, a contact heart sound sensor, and a stepped deflation blood pressure measurement module. Meanwhile, a high-precision analog-to-digital conversion module and the STM32F405 main control chip are used to realize the synchronous acquisition of multiple signals.In terms of software, the underlying driver program was designed through MDK (Keil5), and a user interface was built on the Visual Studio platform to achieve functions such as data acquisition, display, and storage. At the algorithm level, the system adopted algorithms like the Pan-Tompkins algorithm to identify key feature points of physiological signals, and then calculate CAVI and ABI.System test results show that the ECG input noise of the system is less than 20 μV, the common-mode rejection ratio is 95 dB, and the blood pressure measurement error does not exceed 2 mmHg, which meets the design goals. Clinical data analysis indicates that CAVI is highly positively correlated with pulse wave velocity (PWV) ( r=0.85, P<0.001), but CAVI is less affected by blood pressure fluctuations. In addition, with the increase of risk factors (such as hypertension, hyperlipidemia, coronary heart disease, etc.) and age, arteriosclerosis indicators (CAVI, PWV, ABI) all show an upward trend.In conclusion, the homecare arteriosclerosis monitoring system proposed in this study not only overcomes the problems of traditional devices that rely on professional operation and are susceptible to blood pressure interference, but also provides a reliable tool for arteriosclerosis screening in home scenarios, and has important reference value for clinical diagnosis.
Humans ; Cardio Ankle Vascular Index ; Home Care Services ; Atherosclerosis/diagnosis* ; Ankle Brachial Index ; Algorithms ; Pulse Wave Analysis ; Arteriosclerosis/diagnosis* ; Monitoring, Physiologic/instrumentation*

Objective To develop a nurse-led dynamic monitoring protocol for fluid responsiveness and to evaluate its effectiveness in preventing fluid accumulation syndrome in patients with septic shock.Methods A nurse-led dynamic monitoring protocol for fluid responsiveness was developed through literature review and expert panel discussion.Using convenience sampling,160 patients with septic shock admitted to the emergency department of a tertiary hospital in Hangzhou,Zhejiang Province,were enrolled.According to admission period,80 patients admitted from November 2023 to August 2024 were assigned to an intervention group,and 80 patients admitted from January 2023 to October 2023 were assigned to a control group.The intervention group received the nurse-led dynamic monitoring in addition to routine care,while the control group received routine care and conventional fluid responsiveness monitoring.The therapeutic outcomes and incidence of complications were compared between the 2 groups.Results All 80 patients in each group completed the study.The intervention group demonstrated higher lactate clearance rates at 6 and 24 hours after fluid resuscitation,lower incidences of acute pulmonary edema and fluid accumulation syndrome,and shortened durations of mechanical ventilation and ICU stay(all P＜0.05)compared to the control group.There was no statistically significant difference in 28-day mortality between the 2 groups(P=0.212).Conclusion The nurse-led dynamic monitoring protocol for fluid responsiveness in patients with septic shock is both scientific and practical.Its implementation can effectively improve lactate clearance,reduce the incidence of fluid accumulation syndrome and acute pulmonary edema,and shorten the duration of mechanical ventilation and ICU stay.

Drug addiction, a disorder characterized by chronic relapse and compulsive drug use, poses a significant threat to public safety and human health. Addictive substances can be categorized as natural, semi-synthetic, or synthetic based on their origin. Additionally, they can be classified into three groups according to their pharmacological targets: opioids, hallucinogens, and cannabinoids that act on G-protein-coupled receptors (GPCRs); alcohols, nicotine, ketamine, barbiturates, and benzodiazepines (BDZs) that affect ligand-gated ion channel-type receptors; and psychostimulants that interact with monoamine transporters. Current treatments for drug addiction primarily include substitution therapy and non-pharmacological approaches. However, these methods have limitations, particularly in addressing the underlying causes of relapse. Several drugs in clinical trials have demonstrated potential therapeutic effects for addiction to opioids, heroin, cocaine, and other substances. This review examines the origins and pharmacological mechanisms of addiction to naturally-derived psychoactive substances (NPS) and provides an overview of recent advancements in pharmacotherapy for drug addiction.
Humans ; Substance-Related Disorders/drug therapy* ; Psychotropic Drugs/therapeutic use* ; Animals