Objective:To develop habitat radiomics models to predict early treatment responses to the hepatic arterial infusion chemotherapy (HAIC) combined with targeted therapy or immunotherapy in advanced hepatocellular carcinoma (HCC) patients, and to guide clinical diagnosis and treatment.Methods:From October 2021 to Decemeber 2023, at Army Characteristic Medical Center of PLA (Chongqing Daping Hospital) and the First Affiliated Hospital of Chongqing Medical University, 94 patients with advanced HCC who received HAIC combined with targeted therapy or immunotherapy were retrospectively enrolled. According to the treatment results, the patients were divided into response group and non-response group. Univariate and multivariate logistic regression were performed to analyze the clinical data of the patients. Based on contrast-enhanced CT images, tumor habitats were delineated and habitat features were extracted with k-means clustering, and the imaging features of arterial and venous phases were also extracted. The least absolute shrinkage and selection operator (LASSO) was used for dimensionality reduction. Feature selection was performed using LASSO to reduce dimensions, and then the selected features were further refined through stepwise logistic regression analysis.Binary logistic regression models were conducted to develop the habitat radiomics model, arterial phase radiomics model (APRM), venous phase radiomics model (VPRM), clinical data model, as well as the combination of radiomics model and clinical data model to predict early treatment (after 2 treatment cycles) response. Receiver operating characteristic curves (ROC) were plotted, and model performance was evaluated by the area under the curve (AUC), calibration curves, and decision curve. The models were validated through Bootstrap methods (1 000 times). DeLong test was used to compare AUC values.Results:The results of cluster analysis identified 3 characteristic habitats in HCC imaging: low-, medium-, and high-enhancement tumor habitats. The proportion of high-enhancement habitats was higher than that in the non-response group. A predictive model was established based on the proportions of these 3 habitats. Based on the proportion of low-, medium-, and high-enhancement habitats within the tumor, a habitat radiomics model was constructed. After LASSO selection and logistic regression analysis, 3 arterial phase and 3 venous phase radiomic features were selected to build the APRM and VPRM, respectively. Logistic regression analysis identified the following factors for the clinical data model: comorbidities ( OR=0.275, P=0.031), maximum tumor diameter ( OR=1.149, P=0.019), red blood cell count ( OR=0.463, P=0.022), alpha fetoprotein >400 μg/L ( OR=3.452, P=0.017), and tyrosine kinase inhibitor therapy ( OR=3.072, P=0.048). Among the single predictive model′s comparison, the AUC of habitat radiomics model was 0.860 (95% confidence interval(95% CI): 0.789 to 0.932), while those of the APRM、VPRM and clinical data model were 0.850 (95% CI: 0.773 to 0.926), 0.855 (95% CI: 0.782 to 0.928), and 0.774 (95% CI: 0.681 to 0.867), respectively, and there were no statistically significant among these models (all P>0.05). Among the combination models, the AUC of the habitat rediomic-clinical data combination model was 0.881 (95% CI: 0.814 to 0.947); the AUC of arterial phase rediomic-clinical data combination model was 0.897 (95% CI: 0.833 to 0.961); and the AUC of venous phase rediomic-clinical data combination model was 0.888 (95% CI: 0.826 to 0.951), but there were no statistically significant among the 3 models (all P>0.05). The calibration curve showed that the habitat rediomic-clinical data combination model had the most accurate predictive probability. Internal validation showed that the AUC of habitat rediomic-clinical data combination model was 0.848 (95% CI: 0.772 to 0.922), and the predictive performance was better than that of the clinical-data model (0.733 (95% CI: 0.670 to 0.863)). Conclusion:The habitat radiomics model based on enhanced CT can effectively predict early treatment responses to the HAIC combined with targeted therapy or immunotherapy in advanced HCC patients, which provides theoretical basis for individualized treatment in advanced HCC.

Objective:To develop habitat radiomics models to predict early treatment responses to the hepatic arterial infusion chemotherapy (HAIC) combined with targeted therapy or immunotherapy in advanced hepatocellular carcinoma (HCC) patients, and to guide clinical diagnosis and treatment.Methods:From October 2021 to Decemeber 2023, at Army Characteristic Medical Center of PLA (Chongqing Daping Hospital) and the First Affiliated Hospital of Chongqing Medical University, 94 patients with advanced HCC who received HAIC combined with targeted therapy or immunotherapy were retrospectively enrolled. According to the treatment results, the patients were divided into response group and non-response group. Univariate and multivariate logistic regression were performed to analyze the clinical data of the patients. Based on contrast-enhanced CT images, tumor habitats were delineated and habitat features were extracted with k-means clustering, and the imaging features of arterial and venous phases were also extracted. The least absolute shrinkage and selection operator (LASSO) was used for dimensionality reduction. Feature selection was performed using LASSO to reduce dimensions, and then the selected features were further refined through stepwise logistic regression analysis.Binary logistic regression models were conducted to develop the habitat radiomics model, arterial phase radiomics model (APRM), venous phase radiomics model (VPRM), clinical data model, as well as the combination of radiomics model and clinical data model to predict early treatment (after 2 treatment cycles) response. Receiver operating characteristic curves (ROC) were plotted, and model performance was evaluated by the area under the curve (AUC), calibration curves, and decision curve. The models were validated through Bootstrap methods (1 000 times). DeLong test was used to compare AUC values.Results:The results of cluster analysis identified 3 characteristic habitats in HCC imaging: low-, medium-, and high-enhancement tumor habitats. The proportion of high-enhancement habitats was higher than that in the non-response group. A predictive model was established based on the proportions of these 3 habitats. Based on the proportion of low-, medium-, and high-enhancement habitats within the tumor, a habitat radiomics model was constructed. After LASSO selection and logistic regression analysis, 3 arterial phase and 3 venous phase radiomic features were selected to build the APRM and VPRM, respectively. Logistic regression analysis identified the following factors for the clinical data model: comorbidities ( OR=0.275, P=0.031), maximum tumor diameter ( OR=1.149, P=0.019), red blood cell count ( OR=0.463, P=0.022), alpha fetoprotein >400 μg/L ( OR=3.452, P=0.017), and tyrosine kinase inhibitor therapy ( OR=3.072, P=0.048). Among the single predictive model′s comparison, the AUC of habitat radiomics model was 0.860 (95% confidence interval(95% CI): 0.789 to 0.932), while those of the APRM、VPRM and clinical data model were 0.850 (95% CI: 0.773 to 0.926), 0.855 (95% CI: 0.782 to 0.928), and 0.774 (95% CI: 0.681 to 0.867), respectively, and there were no statistically significant among these models (all P>0.05). Among the combination models, the AUC of the habitat rediomic-clinical data combination model was 0.881 (95% CI: 0.814 to 0.947); the AUC of arterial phase rediomic-clinical data combination model was 0.897 (95% CI: 0.833 to 0.961); and the AUC of venous phase rediomic-clinical data combination model was 0.888 (95% CI: 0.826 to 0.951), but there were no statistically significant among the 3 models (all P>0.05). The calibration curve showed that the habitat rediomic-clinical data combination model had the most accurate predictive probability. Internal validation showed that the AUC of habitat rediomic-clinical data combination model was 0.848 (95% CI: 0.772 to 0.922), and the predictive performance was better than that of the clinical-data model (0.733 (95% CI: 0.670 to 0.863)). Conclusion:The habitat radiomics model based on enhanced CT can effectively predict early treatment responses to the HAIC combined with targeted therapy or immunotherapy in advanced HCC patients, which provides theoretical basis for individualized treatment in advanced HCC.

Objective To investigate the differences and influencing factors of chronic heart failure(CHF)with qi deficiency and blood stasis syndrome and with other TCM syndrome types.Methods Totally 354 CHF patients from Dongzhimen Hospital of Beijing University of Chinese Medicine were enrolled from January 2019 to December 2023,including 242 cases of qi deficiency and blood stasis syndrome,52 cases of qi and yin deficiency and blood stasis syndrome,and 60 cases of yang qi deficiency and blood stasis syndrome.The general demographic sociological characteristics of patients with each syndrome type,the New York Heart Association cardiac function classification(NYHA classification),and the heart failure classification were collected.The cardiac function-related indexes and laboratory examination indicators were detected.The Minnesota Heart Failure Patients'Life Questionnaire(MLHFQ)was used to evaluate the quality of life of the patients in three areas:physical,emotional and other three domains.The differences of the above factors among patients with different syndrome types were compared,and a disordered multi-categorical logistics regression model of TCM syndrome types was constructed to analyze the association between the above factors and qi deficiency and blood stasis syndrome.Traditional Chinese Medicine Inheritance Calculation Platform 3.0 was used to analyze the frequency,property,taste and meridian tropism of prescription drugs.Results The proportion of patients with NYHAⅡ qi deficiency and blood stasis syndrome was higher than that of the group with qi and yin deficiency and blood stasis syndrome(P<0.05);the left ventricular ejection fraction in patients with yang qi deficiency and blood stasis pattern was significantly lower than that in patients with qi deficiency and blood stasis pattern(P<0.05);and the scores of the body domain,other domain and the total score of the MLHFQ questionnaire in patients with qi deficiency and blood stasis pattern were lower than those of the other two syndrome types(P<0.05);the serum neutrophils(NE%),C-reactive protein(CRP)and interleukin-6(IL-6)in the qi and yin deficiency and blood stasis syndrome were higher than those in the group with qi deficiency and blood stasis syndrome(P<0.05).Multivariate Logistics regression analysis showed that arrhythmia,CRP and IL-6 were independent influencing factors for CHF with qi deficiency and blood stasis syndrome(P<0.05).Totally 284 prescriptions were included,involving 190 kinds of Chinese materia medica.The top 10 were Astragali Radix,Ophiopogonis Radix,Lonicerae Japonicae Flos,Pseudostellariae Radix,Hordei Fructus Germinatus,Galli Gigerii Endothelium Corneumm,Puerariae Lobatue Radix,Scrophulariae Radix,Ziziphi Spinosae Semen and Citri Reticulatae Pericarpium.Conclusion Qi deficiency and blood stasis syndrome is a relatively stable stage of CHF,with cardiac function mainly distributed in grade Ⅱ,Ⅲ,with a relatively high proportion of heart failure with preserved ejection fraction,fewer other underlying diseases,lower inflammatory indicators,and relatively good quality of life.Combined arrhythmia,CRP and IL-6 indicators can be used as an auxiliary basis for syndrome differentiation of qi deficiency and blood stasis syndrome.

ObjectiveTo observe the clinical efficacy of Shentong Zhuyutang combined with Dilongtang in the treatment of lumbar disc herniation （LDH） with Qi stagnation and blood stasis syndrome， and its effect on nucleus pulposus reabsorption and immune-inflammatory factors， exploring its therapeutic mechanism from the perspective of reabsorption. MethodsA total of 120 patients with LDH from the Fourth Clinical Medical College of Guangzhou University of Chinese Medicine， treated between June 2020 and January 2023， were randomly divided into the control group （52 cases， with 8 dropouts） and the observation group （49 cases， with 11 dropouts） according to a random number table. The control group received routine treatment， while the observation group was treated with Shentong Zhuyutang combined with Dilongtang in addition to routine treatment. Visual Analogue Scale （VAS）， Oswestry Disability Index （ODI）， Japanese Orthopaedic Association （JOA） score， and traditional Chinese medicine （TCM） syndrome score were measured before treatment and after 3 courses of treatment. Venous blood samples were collected for the determination of serological indexes. MR examination was performed during the 6-month follow-up to calculate the absorption rate. ResultsAfter treatment， both groups showed significant reductions in VAS， ODI， TCM syndrome score， serum tumor necrosis factor （TNF）-α， matrix metalloproteinase （MMP）-9， and vascular endothelial growth factor （VEGF） levels， and a significant increase in JOA score compared with pre-treatment values （P<0.05）. Compared with the control group， the observation group showed significantly lower VAS， ODI， TCM syndrome score， serum TNF-α， MMP-9， and VEGF levels， and a significantly higher JOA score （P<0.05）. The proportion of nucleus pulposus reabsorption in the observation group was 57.14% （28/49）， significantly higher than 21.15% （11/52） in the control group （χ²=6.161， P<0.05）. ConclusionShentong Zhuyutang combined with Dilongtang can effectively relieve pain， improve lumbar function， and alleviate TCM clinical symptoms in LDH patients with Qi stagnation and blood stasis syndrome. Imaging findings suggest that the treatment promotes the reabsorption of nucleus pulposus protrusion， while laboratory testing shows reduced serum levels of TNF-α， MMP-9， and VEGF， which contribute to the rehabilitation of patients.

Objective To investigate the differences and influencing factors of chronic heart failure(CHF)with qi deficiency and blood stasis syndrome and with other TCM syndrome types.Methods Totally 354 CHF patients from Dongzhimen Hospital of Beijing University of Chinese Medicine were enrolled from January 2019 to December 2023,including 242 cases of qi deficiency and blood stasis syndrome,52 cases of qi and yin deficiency and blood stasis syndrome,and 60 cases of yang qi deficiency and blood stasis syndrome.The general demographic sociological characteristics of patients with each syndrome type,the New York Heart Association cardiac function classification(NYHA classification),and the heart failure classification were collected.The cardiac function-related indexes and laboratory examination indicators were detected.The Minnesota Heart Failure Patients'Life Questionnaire(MLHFQ)was used to evaluate the quality of life of the patients in three areas:physical,emotional and other three domains.The differences of the above factors among patients with different syndrome types were compared,and a disordered multi-categorical logistics regression model of TCM syndrome types was constructed to analyze the association between the above factors and qi deficiency and blood stasis syndrome.Traditional Chinese Medicine Inheritance Calculation Platform 3.0 was used to analyze the frequency,property,taste and meridian tropism of prescription drugs.Results The proportion of patients with NYHAⅡ qi deficiency and blood stasis syndrome was higher than that of the group with qi and yin deficiency and blood stasis syndrome(P<0.05);the left ventricular ejection fraction in patients with yang qi deficiency and blood stasis pattern was significantly lower than that in patients with qi deficiency and blood stasis pattern(P<0.05);and the scores of the body domain,other domain and the total score of the MLHFQ questionnaire in patients with qi deficiency and blood stasis pattern were lower than those of the other two syndrome types(P<0.05);the serum neutrophils(NE%),C-reactive protein(CRP)and interleukin-6(IL-6)in the qi and yin deficiency and blood stasis syndrome were higher than those in the group with qi deficiency and blood stasis syndrome(P<0.05).Multivariate Logistics regression analysis showed that arrhythmia,CRP and IL-6 were independent influencing factors for CHF with qi deficiency and blood stasis syndrome(P<0.05).Totally 284 prescriptions were included,involving 190 kinds of Chinese materia medica.The top 10 were Astragali Radix,Ophiopogonis Radix,Lonicerae Japonicae Flos,Pseudostellariae Radix,Hordei Fructus Germinatus,Galli Gigerii Endothelium Corneumm,Puerariae Lobatue Radix,Scrophulariae Radix,Ziziphi Spinosae Semen and Citri Reticulatae Pericarpium.Conclusion Qi deficiency and blood stasis syndrome is a relatively stable stage of CHF,with cardiac function mainly distributed in grade Ⅱ,Ⅲ,with a relatively high proportion of heart failure with preserved ejection fraction,fewer other underlying diseases,lower inflammatory indicators,and relatively good quality of life.Combined arrhythmia,CRP and IL-6 indicators can be used as an auxiliary basis for syndrome differentiation of qi deficiency and blood stasis syndrome.

With the accelerating process of population aging, binocular vision disorders have become increasingly prevalent, posing new challenges for both social aging strategies and ophthalmic clinical practice. Non-strabismic binocular vision anomalies(NSBVAs)are notably prevalent among elderly populations; however, current research predominantly focuses on the abnormality rates derived from individual binocular vision clinical tests, while data on the actual prevalence based on comprehensive diagnostic criteria remain limited. This review synthesizes existing scientific literature to provide a concise yet comprehensive overview of the prevalence, risk factors, and clinical diagnostic methods of NSBVAs in pre-presbyopic and presbyopic populations, with an in-depth examination of age-related changes in binocular vision function among older adults. By integrating and comparing analyses of the correlations between age and various binocular vision parameters, this review aims to enhance understanding of age-related binocular vision dysfunction and establish a theoretical foundation for developing targeted diagnostic and therapeutic approaches. Ultimately, these insights could contribute to improved visual performance and life satisfaction in elderly individuals.

Objective To investigate the clinical efficacy of Yinhuo Guiyuan moxibustion as an adjunc-tive therapy to Yaotongning Capsules in treating kidney deficiency-related lumbago in patients with stage 3-4 chronic kidney disease.Methods Sixty patients with stage 3-4 chronic kidney disease admitted from Janu-ary 2021 to June 2023 were randomly divided into a control group and an observation group,with 30 cases in each group.Both groups received basic treatment interventions during the study period.The control group re-ceived Yaotongning Capsules orally,while the observation group received additional Yinhuo Guiyuan moxibus-tion therapy.Clinical efficacy,pain scores,renal function indicators,satisfaction scores,and adverse reaction rates were compared between the two groups.Results The total effective rate was significantly higher in the observation group(93.33％)than in the control group(73.33％,P＜0.05).At the 4th,8th,and 12th weeks of treatment,the VAS scores of both groups were lower than baseline values,with the observation group dem-onstrating significantly lower scores compared to the control group at the same time points(P＜0.05).After treatment,both groups showed reductions in BUN,Scr,and 24hUP levels,with the observation group showing lower levels than the control group(P＜0.05).The observation group demonstrated higher satisfaction scores than the control group(P＜0.05).No significant difference was found in adverse reaction rates between groups(x2=0.218,P=0.640).Conclusion Yinhuo Guiyuan moxibustion combined with Yaotongning Cap-sules is effective in treating stage 3-4 chronic kidney disease patients,effectively alleviating low back pain,improving renal function indicators,enhancing treatment satisfaction,with lower incidence of adverse reac-tions.

OBJECTIVE: To analyze the clinical characteristics and prognosis of patients with adult T-cell leukemia/lymphoma (ATLL) in Ningde City, Fujian Province. METHODS: We retrospectively collected 23 cases diagnosed with adult T-cell leukemia/lymphoma in the Hematology Department of Ningde Hospital Affiliated to Ningde Normal University from 2014 to 2023, the clinical characteristics of patients were summarized and the prognosis was analyzed. The survival of patients treated with chemotherapy alone and chemotherapy combined with antiviral therapy was compared. RESULTS: All 23 patients were from the coastal endemic area of Fujian (Ningde City), 12 males and 11 females. The median age of onset was 59 (range: 31-84) years old. The clinical types were acute (18 cases) or lymphomatous (5 cases), and no smoldering or chronic type was seen. The most common clinical manifestations were, in order of prevalence, 20 cases of leukocytosis, 19 cases of lymph node enlargement, 13 cases of skin lesions, 13 cases of hypercalcemia. There was an elevation of lactate dehydrogenase (LDH) levels in more than 90% of cases, and β₂-microglobulin levels were elevated in 11 cases. Twelve of the 23 patients were treated with chemotherapy (partly in combination with antiviral therapy), one underwent allogeneic hematopoietic stem cell transplantation. The median overall survival of all patients was 2.3(0.2-13) months. Median survival was 3(2-11) months in the chemotherapy combined with antiviral therapy group, while that of the chemotherapy alone group was 2(0.2-13) months. CONCLUSION The clinical manifestations of adult T-cell leukemia/lymphoma in Ningde city, Fujian province are characteristic and the prognosis is unfavorable. Antiviral therapy may contribute to an improvement in the prognosis.
Humans ; Retrospective Studies ; Middle Aged ; Leukemia-Lymphoma, Adult T-Cell/diagnosis* ; Male ; Adult ; Female ; Prognosis ; Aged ; Antiviral Agents/therapeutic use* ; Aged, 80 and over ; China

Acute lung injury (ALI) has been a kind of acute and severe disease that is mainly characterized by systemic uncontrolled inflammatory response to the production of huge amounts of reactive oxygen species (ROS) in the lung tissue. Given the critical role of ROS in ALI, a Fe₃O₄ loaded bovine serum albumin (BSA) nanocluster (BF) was developed to act as a nanomedicine for the treatment of ALI. Combining with NIR irradiation, it exhibited excellent ROS scavenging capacity. Significantly, it also displayed the excellent antioxidant and anti-inflammatory functions for lipopolysaccharides (LPS) induced macrophages (RAW264.7), and Sprague Dawley rats via lowering intracellular ROS levels, reducing inflammatory factors expression levels, inducing macrophage M2 polarization, inhibiting NF-κB signaling pathway, increasing CD4⁺/CD8⁺ T cell ratios, as well as upregulating HSP70 and CD31 expression levels to reprogram redox homeostasis, reduce systemic inflammation, activate immunoregulation, and accelerate lung tissue repair, finally achieving the synergistic enhancement of ALI immunotherapy. It finally provides an effective therapeutic strategy of BF + NIR for the management of inflammation related diseases.

Sophorae Flavescentis Radix is one of the commonly used traditional Chinese medicine in China, and a large amount of pharmaceutical residue generated during its processing and production is discarded as waste, which not only wastes resources but also pollutes the environment. Therefore, elucidating the chemical composition of the residue of Sophorae Flavescentis Radix and the differences between the residue and Sophorae Flavescentis Radix itself is of great significance for the comprehensive utilization of the residue. This study, based on ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS) technology combined with multivariate statistical methods, provides a thorough characterization, identification, and differential analysis of the overall components of Sophorae Flavescentis Radix and its residue. Firstly, 61 compounds in Sophorae Flavescentis Radix were rapidly identified based on their precise molecular weight, fragment ions, and compound abundance, using a self-constructed compound database. Among them, 41 compounds were found in the residue, mainly alkaloids and flavonoids. Secondly, through principal component analysis(PCA) and orthogonal partial least squares discriminant analysis(OPLS-DA), 15 key compounds differentiating Sophorae Flavescentis Radix from its residue were identified. These included highly polar alkaloids, such as oxymatrine and oxysophocarpine, which showed significantly reduced content in the residue, and less polar flavonoids, such as kurarinone and kuraridin, which were more abundant in the residue. In summary, this paper clarifies the overall composition, structure, and content differences between Sophorae Flavescentis Radix and its residue, suggesting that the residue of Sophorae Flavescentis Radix can be used as a raw material for the extraction of its high-activity components, with promising potential for development and application in cosmetics and daily care. This research provides a scientific basis for the future comprehensive utilization of Sophorae Flavescentis Radix and its residue.
Drugs, Chinese Herbal/chemistry* ; Chromatography, High Pressure Liquid/methods* ; Mass Spectrometry/methods* ; Sophora/chemistry* ; Flavonoids/chemistry* ; Alkaloids/chemistry*