Syringa pinnatifolia, belonging to the family Oleaceae, is a species endemic to China. It is predominantly distributed in the Helan Mountains region of Inner Mongolia and Ningxia of China. The peeled roots, stems, and thick branches have been used as a distinctive Mongolian medicinal material known as "Shan-chen-xiang", which has effects such as suppressing "khii", clearing heat, and relieving pain and is employed for the treatment of cardiovascular and pulmonary diseases and joint pain. Over the past five years, significant increase was achieved in research on chemical constituents and pharmacological effects. There were a total of 130 new constituents reported, covering sesquiterpenoids, lignans, and alkaloids. Its effects of anti-myocardial ischemia, anti-cerebral ischemia/reperfusion, sedation, and analgesia were revealed, and the mechanisms of agarwood formation were also investigated. To better understand its medical value and potential of clinical application, this review updates the research progress in recent five years focusing on the chemical constituents and pharmacological effects of S. pinnatifolia, providing reference for subsequent research on active ingredient and support for its innovative application in modern medicine system.
Medicine, Mongolian Traditional ; Humans ; Drugs, Chinese Herbal/pharmacology* ; Animals ; Syringa/chemistry*

OBJECTIVES: To investigate the epidemiological characteristics of human metapneumovirus (hMPV) and the risk factors for severe pneumonia in hospitalized children. METHODS: The epidemiological characteristics of hMPV in hospitalized children at Hebei Children's Hospital from January 2019 to December 2023 were retrospectively analyzed. The clinical data of hospitalized children with hMPV infection from April to December 2023 were included, and independent risk factors for severe pneumonia were identified through logistic regression. RESULTS: A total of 44 092 children were tested, with an hMPV positive rate of 7.30% (3 220/44 092). Children aged 3-6 years constituted the largest proportion (40.93%, 1 318/3 220) among hMPV-positive cases. The detection rate varied significantly by year (P<0.001), peaking in 2022 (12.35%, 978/7 919). The peak season of the epidemic was winter and spring from 2019 to 2021, but shifted to spring and summer from 2022 to 2023. The proportion of co-infection was 38.70% (1 246/3 220), primarily with rhinovirus (600/1 246, 48.15%), Mycoplasma pneumoniae (217/1 246, 17.42%), and respiratory syncytial virus (182/1 246, 14.61%). The main manifestations of hMPV pneumonia were cough, expectoration, and fever. Children with severe pneumonia were significantly younger (P<0.05). Wheezing, underlying diseases, co-infection, and younger age were identified as independent risk factors for severe pneumonia (P<0.05). CONCLUSIONS There are significant annual and seasonal differences in the epidemiological characteristics of hMPV in hospitalized children. Young age, underlying diseases, wheezing, and co-infection are independent risk factors for severe pneumonia.
Humans ; Risk Factors ; Metapneumovirus ; Child, Preschool ; Child ; Male ; Female ; Paramyxoviridae Infections/complications* ; Pneumonia/epidemiology* ; Retrospective Studies ; Child, Hospitalized ; Infant ; Logistic Models ; Seasons ; Hospitalization

Objective To explore the diagnosis and treatment strategies for elderly patients with ground-glass opacity (GGO). Methods The imaging features and postoperative pathological findings of the elderly patients with pulmonary GGO receiving surgery in our hospital from 2017 to 2019 were retrospectively analyzed. The patients were divided into an elderly patient group and a non-elderly patient group based on their age. Results Finally 575 patients were included in the study. There were 281 elderly patients, including 83 males and 198 females, with an average age of (67.0±5.3) years. There were 294 non-elderly patients, including 88 males and 206 females, with an average age of (49.1±7.3) years. Compared with the non-elderly patients, elderly GGO patients showed the following distinct clinical features: long observation time for lesions (P=0.001), high proportion of rough edges of GGO (P<0.001), significant pleural signs (P＜0.001) and bronchial signs (P＜0.001), and high proportion of type Ⅱ-Ⅳ GGO (P<0.001), lobectomy type (P=0.013), and invasive lesions reported in postoperative pathology (P<0.001). There was no statistical difference in the average hospital stay between the two groups (P=0.106). Multivariate logistic regression analysis showed that GGO diameter and GGO type were the main factors affecting the operation. Observation time, GGO diameter, GGO type and pleural signs were the main influencing factors for postoperative pathological infiltrative lesions. The cut-off value of GGO diameter in predicting infiltrating lesions was 10.5 mm in the elderly patients group. Conclusion The size and type of GGO are important factors in predicting invasive lesions and selecting surgical methods. Elderly patients with radiographic manifestations of type Ⅱ-Ⅳ GGO lesions with a diameter greater than 10.5 mm should be closely followed up.

Aim To explore the therapeutic effect and mechanism of Qingjie Huagong decoction in modulating PI3K/AKT/NF-κB signaling pathway in inflammatory response of acute pancreatitis(AP)mice.Methods Twenty-four mice were randomly divided into Blank group,Model group,Ustekin group,and Qingjie Hua-gong decoction group,with six mice in each group.The AP model was prepared by using rain frogin.Serum α-AMS,PNLP,IL-1β,IL-6,IL-8,IL-18,and TNF-α lev-els were detected by ELISA;the pancreatic pathology was detected by HE staining;the expressions of PI3K,AKT,and NF-κB-related proteins and mRNAs were de-tected by immunohistochemistry,Western blot,and RT-qPCR.Results Compared with the blank group,the model group showed obvious pathological damage to the pancreas,with significantly higher serum α-AMS,PN-LP,IL-1β,IL-6,IL-8,IL-18,and TNF-α levels(P＜0.01),and significantly higher levels of PI3K,AKT,and NF-κB-related proteins and mRNA expression(P＜0.01).Compared with the model group,both the Qingjie Huagong decoction group and the ustekin group improved the histopathological changes in the pancreas of AP mice,decreased the serum α-AMS,PNLP,IL-1β,IL-6,IL-8,IL-18,and TNF-α levels,and down-reg-ulated the expression levels of pancreatic PI3K,AKT,NF-κB-related proteins and mRNA(P＜0.05 or P＜0.01).Conclusion Qingjie Huagong decoction may inhibit the inflammatory response and protect pancreat-ic tissues by regulating the expression of PI3K/AKT/NF-κB signaling pathway.

Aim To explore the therapeutic effect and mechanism of Qingjie Huagong decoction in modulating PI3K/AKT/NF-κB signaling pathway in inflammatory response of acute pancreatitis(AP)mice.Methods Twenty-four mice were randomly divided into Blank group,Model group,Ustekin group,and Qingjie Hua-gong decoction group,with six mice in each group.The AP model was prepared by using rain frogin.Serum α-AMS,PNLP,IL-1β,IL-6,IL-8,IL-18,and TNF-α lev-els were detected by ELISA;the pancreatic pathology was detected by HE staining;the expressions of PI3K,AKT,and NF-κB-related proteins and mRNAs were de-tected by immunohistochemistry,Western blot,and RT-qPCR.Results Compared with the blank group,the model group showed obvious pathological damage to the pancreas,with significantly higher serum α-AMS,PN-LP,IL-1β,IL-6,IL-8,IL-18,and TNF-α levels(P＜0.01),and significantly higher levels of PI3K,AKT,and NF-κB-related proteins and mRNA expression(P＜0.01).Compared with the model group,both the Qingjie Huagong decoction group and the ustekin group improved the histopathological changes in the pancreas of AP mice,decreased the serum α-AMS,PNLP,IL-1β,IL-6,IL-8,IL-18,and TNF-α levels,and down-reg-ulated the expression levels of pancreatic PI3K,AKT,NF-κB-related proteins and mRNA(P＜0.05 or P＜0.01).Conclusion Qingjie Huagong decoction may inhibit the inflammatory response and protect pancreat-ic tissues by regulating the expression of PI3K/AKT/NF-κB signaling pathway.

Traditional acute kidney injury (AKI) classifications, which are centered around semi-anatomical lines, can no longer capture the complexity of AKI. By employing strategies to identify predictive and prognostic enrichment targets, experts could gain a deeper comprehension of AKI’s pathophysiology, allowing for the development of treatment-specific targets and enhancing individualized care. Subphenotyping, which is enriched with AKI biomarkers, holds insights into distinct risk profiles and tailored treatment strategies that redefine AKI and contribute to improved clinical management. The utilization of biomarkers such as N-acetyl-β-D-glucosaminidase, tissue inhibitor of metalloprotease-2·insulin-like growth factor-binding protein 7, kidney injury molecule-1, and liver fatty acid-binding protein garnered significant attention as a means to predict subclinical AKI. Novel biomarkers offer promise in predicting persistent AKI, with urinary motif chemokine ligand 14 displaying significant sensitivity and specificity. Furthermore, they serve as predictive markers for weaning patients from acute dialysis and offer valuable insights into distinct AKI subgroups. The proposed management of AKI, which is encapsulated in a structured flowchart, bridges the gap between research and clinical practice. It streamlines the utilization of biomarkers and subphenotyping, promising a future in which AKI is swiftly identified and managed with unprecedented precision. Incorporating kidney biomarkers into strategies for early AKI detection and the initiation of AKI care bundles has proven to be more effective than using care bundles without these novel biomarkers. This comprehensive approach represents a significant stride toward precision medicine, enabling the identification of high-risk subphenotypes in patients with AKI.

Modern Chinese medicine studies have confirmed that the interaction between traditional Chinese medicine(TCM)and intestinal flora is the key to the treatment of diseases with tradi-tional Chinese medicine.This interplay includes such activities as:traditional Chinese medicine can be metabolized by intestinal flora into effective components with different biological activities from its precursors;TCM chemicals improve the composition of gut microbiota,consequently ameliorating its dysfunction as well as associated pathological conditions;and gut microbiota mediate the interactions between the multiple chemicals in TCM.There-fore,it becomes an important way to understand the modern sci-entific connotation of traditional Chinese medicine theory to study the pharmacological mechanism of the efficacy of traditional Chi-nese medicine by targeting Gut microbiota.

Objective To analyze the clinical outcomes of extended thymectomy for myasthenia gravis (MG) patients under different surgical approaches, and to determine the factors affecting the prognosis of MG. Methods The MG patients who underwent extended thymectomy from January 2014 to March 2021 in our hospital were retrospectively collected. According to the surgical approach, they were divided into a subxiphoid group and an intercostal group, and the perioperative results and prognosis were compared between the two groups. A “good outcome” was defined as complete stable remission (CSR), pharmacological remission (PR) or minimal manifestations state (MMS); a “poor outcome” was defined as outcomes worse than MMS. Univariate and multivariate logistic regression analyses were performed to assess the factors associated with the good outcomes. Results A total of 187 MG patients were included in the study, including 82 males and 105 females, with a median age of 50 (36, 60) years. There were 134 patients in the intercostal group and 53 patients in the subxiphoid group. Compared with the intercostal group, although the operation time of the subxiphoid group was longer [200.0 (172.0, 232.0) min vs. 141.0 (118.0, 169.0) min, P<0.001], the intraoperative blood loss was less [10.0 (10.0, 20.0) mL vs. 20.0 (10.0, 50.0) mL, P<0.001], the postoperative hospital stay was shorter [3.0 (2.5, 4.0) d vs. 5.0 (3.0, 7.0) d, P<0.001], and the incidence of complications was lower [1 (1.9%) vs. 26 (19.4%), P=0.001]. A total of 159 (85.0%) patients were followed up for a median period of 46 (13, 99) months, with a good outcome rate of 90.6% and CSR rate of 33.3%. There were no statistical differences in PR, MMS or overall good outcome rates between the two groups (P>0.05). Multivariate logistic analysis showed that age≤50 years was an independent predictor for "good outcome" of MG patients. Conclusion Extended thymectomy via subxiphoid for MG is a safe, feasible and effective surgical approach.

Objective:To analyze the verification of Trilogy Varian linear accelerator system on tumor position of head and neck,chest and abdomen under electronic portal imaging device (EPID) mode and cone beam computed tomography (CBCT) mode of intensity modulated radiotherapy (IMRT),so as to confirm the most suitable body parts of verification plan of tumor position. Methods:The case data of 48 patients with tumor who underwent IMRT treatment on tumor at the Second Affiliated Hospital of Xi'an Jiaotong University from October 2022 to October 2023 were selected,which could be divided into tumor at head and neck (16 cases),tumor at chest (16 cases) and tumor at abdomen (16 cases),and all of them were intervened 5 times per week by IMRT. They received 3 times of verification of EPID and CBCT modes per week. The positioning deviation on three dimensional (3D) axis position included x (left and right),y (up and down) and z (head and foot) was evaluated. The verification of CBCT mode conducted automatic registration of grayscale registration method for receiving irradiation area (target area) with dose through the corresponding registration software of OBI system,and the target area and the adjacent area were registration area,and the diagnostic CT image obtained from the design of radiotherapy plan was used as reference image. The positioning deviations on 3D axis positions (x direction,y direction and z direction) of referred image and collected image were calculated by using statistic method. The application values of two verification plans of EPID and CBCT modes on tumor positions were compared. Results:There was no statistically significant in the verification effect of the position of patients with tumor on head and neck between CBCT and EPID of IMRT (P>0.05). Compared with positioning error of EPID mode,that of CBCT mode on x axis was smaller,but the difference was not statistically significant (P>0.05). In the position verification of patients with tumor on chest,the positioning errors of x,y and z axis of CBCT mode of IMRT were respectively less than those of EPID mode,and the differences were significant (t=4.546,15.445,15.961,P<0.05). In the position verification of patients with tumor on abdomen,the positioning errors of x,y and z axis of CBCT mode of IMRT were respectively less than those of EPID mode,and the differences were significant (t=30.402,11.766,12.047,P<0.05). Conclusion:EPID and CBCT modes have equal positioning errors in position verification of IMRT for tumor of head and neck,and the CBCT verification should be prioritized for tumors of chest and abdomen.

Objective:To analyze the verification of Trilogy Varian linear accelerator system on tumor position of head and neck,chest and abdomen under electronic portal imaging device (EPID) mode and cone beam computed tomography (CBCT) mode of intensity modulated radiotherapy (IMRT),so as to confirm the most suitable body parts of verification plan of tumor position. Methods:The case data of 48 patients with tumor who underwent IMRT treatment on tumor at the Second Affiliated Hospital of Xi'an Jiaotong University from October 2022 to October 2023 were selected,which could be divided into tumor at head and neck (16 cases),tumor at chest (16 cases) and tumor at abdomen (16 cases),and all of them were intervened 5 times per week by IMRT. They received 3 times of verification of EPID and CBCT modes per week. The positioning deviation on three dimensional (3D) axis position included x (left and right),y (up and down) and z (head and foot) was evaluated. The verification of CBCT mode conducted automatic registration of grayscale registration method for receiving irradiation area (target area) with dose through the corresponding registration software of OBI system,and the target area and the adjacent area were registration area,and the diagnostic CT image obtained from the design of radiotherapy plan was used as reference image. The positioning deviations on 3D axis positions (x direction,y direction and z direction) of referred image and collected image were calculated by using statistic method. The application values of two verification plans of EPID and CBCT modes on tumor positions were compared. Results:There was no statistically significant in the verification effect of the position of patients with tumor on head and neck between CBCT and EPID of IMRT (P>0.05). Compared with positioning error of EPID mode,that of CBCT mode on x axis was smaller,but the difference was not statistically significant (P>0.05). In the position verification of patients with tumor on chest,the positioning errors of x,y and z axis of CBCT mode of IMRT were respectively less than those of EPID mode,and the differences were significant (t=4.546,15.445,15.961,P<0.05). In the position verification of patients with tumor on abdomen,the positioning errors of x,y and z axis of CBCT mode of IMRT were respectively less than those of EPID mode,and the differences were significant (t=30.402,11.766,12.047,P<0.05). Conclusion:EPID and CBCT modes have equal positioning errors in position verification of IMRT for tumor of head and neck,and the CBCT verification should be prioritized for tumors of chest and abdomen.