Obesity and its related metabolic diseases have become a major global public health threat, and its rising incidence significantly increases the risk of cardiovascular and cerebrovascular diseases, diabetes and other complications. Pancreatic lipase is a key enzyme that converts food-borne lipids into triglycerides and fatty acids, and the effective inhibition of its activity has become an important strategy for the treatment of obesity. This paper discusses the screening methods of pancreatic lipase inhibitors, and summarizes and reviews the basic principles, advantages and disadvantages and application status of traditional screening methods, modern new screening methods and virtual screening methods. In view of the problems faced by the screening methods of pancreatic lipase inhibitors, future research urgently needs to move towards a collaborative innovation path of multi-technology integration, intelligent screening and complex systematization of traditional Chinese medicine, so as to open up new research paradigms.

ObjectiveTo compare the differences in fungal community composition between lesional and non-lesional scalp areas in patients suffering from severe alopecia areata （AA）， and compare these with healthy scalp areas in control subjects. Additionally， to preliminarily explore the changes in scalp fungal communities in severe AA patients and their potential underlying immunological mechanisms. MethodsA total of 20 severe AA patients and 18 healthy controls were enrolled. Skin swab samples were collected from lesional and non-lesional scalp areas of severe AA patients， as well as from the normal scalp of healthy controls. The fungal internal transcribed spacer （ITS） region was amplified and analyzed using high-throughput sequencing. ResultsThe lesional scalp areas of severe AA patients exhibited higher α-diversity and species richness in fungal communities. Notably， the relative abundance of Ascomycota， along with genera such as Mycosphaerella， Aspergillus， Penicillium， and Wallemia， significantly increased in the bald regions. In contrast， Acremonium and Schizophyllum were more predominant in the non-lesional areas of severe AA patients. ConclusionDistinct region-specific differences in scalp fungal microbiota in severe AA patients suggests that fungal dysbiosis may play a potential role in the pathogenesis of alopecia areata. These findings provide new insights into the disease characteristics of severe AA from the perspective of scalp microecology.

OBJECTIVES: To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application. Methods and. RESULTS: Recommendations were formulated based on literature review and expert group discussion, and consensus was reached following expert consultation. The consensus recommendations are comprehensive, covering the entire treatment procedures from preoperative assessment and preparation, surgical operation process, postoperative management and traditional Chinese medicine treatment to individualized treatment planning. The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain, reduced the use of opioid drugs, and significantly improved the quality of life and enhanced immune function of the patients. Postoperative follow-up suggested good treatment tolerance among the patients without serious complications. CONCLUSIONS The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy. The combined treatment has a high clinical value with a good safety profile for management of cancer pain.
Humans ; Medicine, Chinese Traditional ; Cancer Pain/therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Drug Delivery Systems ; Pain Management/methods* ; China

Dermacentor abaensis(D.abaensis)is a tick species distributed only in Qinghai,Gansu,and other provinces of China.It is more harmful because it can carry pathogens such as Borrelia burgdorferi and Piroplasm.However,morphological descriptions and image data for this tick spe-cies are still insufficiently detailed,and data related to molecular markers such as COX 1 and ITS2 are still missing.The ticks were collected from the body surface of yaks in Diebu County,Gannan Tibetan Autonomous Prefecture,Gansu Province.The morphological characteristics of various parts of the ticks were carefully observed using a stereomicroscope ultra-depth-of-field system.At the same time,the total DNA of the tick body wall was extracted,then the primers for COX 1 and ITS2 genes were designed,and PCR amplification was performed before sequencing.The sequen-cing results were compared with related sequences in GenBank for homology analysis,and the phy-logenetic tree was constructed to provide a basis for accurate identification of this tick species.The results showed that the female ticks were subrounded.The basic capituli were rectangular in shape.The porose area was ovoid in shape,cornua short and blunt,palps thick and short,with a slightly pointed front end.A slightly rounded scutum,and the enamel color was slightly lighter towards the back.The cervial groove was short,and in deeply concave.The festoon was obvious.The peritreme was in comma-shaped.The trailing edge was slightly curved.The genital opening had a ala.The anus was located in the posterior quarter of the middle of the abdomen,and there is a semicircular anal groove surrounded.Male ticks were slightly elongated ovoid,with no porose area.The entire surface was covered with enamel color except the cornua.The genital opening was opposite to the coxall,and there is no ala.The anal groove was deeper,and the external spur of the coxa Ⅳ was narrower and longer.All other body characteristics are similar to those of female ticks.Based on the comparative analysis of COX 1 and ITS2 gene sequences and the construction of phylogenetic tree,it was found that D.abaensis is more closely related to Dermacentor nuttalli and Dermacentor marginatus than other Dermacentor spp.The results suggested that D.abaensis have unique mor-phological and molecular marker characteristics,and the combination of the two characteristics will make it easier to rapidly and accurately identify this tick species.

Objective This study focused on the preparation of air plasma-activated water and its application in the field of disinfection.By developing single-layer and double-layer dielectric barrier discharge(DBD)devices,we aimed to prepare plasma-activated liquid with high-efficiency disinfection ability.Methods We constructed single-layer and double-layer DBD devices using air as the working gas to generate activated water.The plasma temperature variation,discharge process and emission spectrum were captured and analyzed by a thermal imager,a time-resolved enhanced camera and a high-resolution spectrometer to evaluate the efficient energy conversion and particle excitation capabilities of the device.In addition,disinfection experiments were conducted on typical microorganisms such as Bacillus subtilis,Escherichia coli and Staphylococcus aureus to verify the disinfection effect of the activation solution.Results We adjusted the plasma treatment time for accurate disinfection of typical microorganisms such as Bacillus subtilis,Escherichia coli,and Staphylococcus aureus.Compared with a single-layer DBD device,the double-layer DBD device could produce higher concentrations of reactive species,significantly improving the disinfection effect of the activated liquid.Conclusion By using the air plasma activated water technology,an activated solution with highly efficient disinfection capability was successfully prepared.This study not only improves the disinfection efficiency,but also has potential environmental friendliness and economy,which provides a scientific basis and technical support for the application of plasma technology in the field of disinfection.

Objective:To analyze the genetic characteristics of the VWF gene c.7332G＞A nonsense mutation and explore its molecular pathogenesis.Methods:Phenotypic diagnosis of the proband was performed using VWF:Ag,VWF:RCo,FⅧ:C and multimeric analysis.The probands were genotyped by NGS whole-exome sequencing,and the sequencing results were validated by sanger sequencing.The family members were genotyped by Sanger sequencing.The VWF gene c.7332G＞A nonsense mutant plasmid was constructed.After transfection,the function of VWF gene c.7332G＞A mutant plasmid was verified at cell level in vitro.The mRNA level was detected by qRT-PCR,and the expression level of protein was detected by Western blot,the function of multimerization was verified by the multimeric analysis.Results:VWF:Ag and VWF:RCo were all less than 3％in the proband,and the multimeric analysis showed multimer deficiency.The proband was diagnosed as type 3 VWD.The homozygous nonsense mutation of VWF gene c.7332G＞A was detected by gene sequencing.The VWF mRNA level of the mutant plasmid was decreased,and the VWF protein expression in the cell supernatant was decreased,the mutant protein was truncated and the function of VWF multimerization was impaired.Conclusion:A homozygous mutation in exon 43 of VWF gene,c.7332G＞A,was responsible for the probands type 3 VWD in the proband.The mutation caused a decrease in the relative level of VWF mRNA and protein,and impaired the function of VWF multimerization.

Objective To investigate the characteristics of changes in pain-anxiety-depression-fatigue symptom clusters and their possible associated factors in adolescents with acute lymphoblastic leukemia(ALL)during early chemotherapy.Methods A prospective longitudinal study was conducted from Nov 2019 to Oct 2021,enrolling newly diagnosed adolescent ALL patients from 5 tertiary or pediatric specialty hospitals in Shanghai,Zhejiang Province,Sichuan Province,Anhui Province and Guangdong Province.Patient-reported pain,anxiety,depression,and fatigue were collected at five time points within the first nine weeks of chemotherapy using the PROMIS Pediatric-25 instrument.Latent profile analysis(LPA)and latent transition analysis(LTA)were applied to explore the latent classes of symptom clusters,their transition probabilities over time,and possible risk or protective factors associated with class membership.Results A total of 134 ALL cases were enrolled,and symptom clusters at all the 5 time points(T1-T5)were consistently classified into three groups of mild,moderate and severe symptoms.The severe symptoms group accounted for the largest proportion at each time point(54.5%,59.7%,66.4%,49.3%,and 47.0%,respectively),while the mild and moderate symptoms groups showed an initial decline followed by an increase.Among participants,40.2%maintained the same symptom status,and 77.4%experienced at least one episode of severe symptom status during the trajectory.Religious affiliation(T5)and family monthly income>5 000 Yuan(T2,T4 and T5)served as protective factors against severe symptoms.Higher baseline fatigue(T1)was associated with membership in the severe symptoms group at subsequent time points.Conclusion Pain-anxiety-depression-fatigue symptoms in adolescents with ALL during early chemotherapy can be categorized into mild,moderate and severe symptoms with dynamic transitions over time.Higher baseline fatigue was associated with increased risk of severe symptoms,whereas higher family income and religious affiliation appeared protective effects.

Purpose To explore the value of tumor intratumoral and peritumoral radiomics models based on dynamic contrast-enhanced MRI in predicting benign and malignant breast tumors.Materials and Methods This retrospective study analyzed clinical data and MRI imaging features from 309 patients with pathologically confirmed solitary breast tumors at the Second Affiliated Hospital of Xiamen Medical College from August 2018 to December 2022.The cohort was randomly divided into training(n=248)and testing(n=61)cohorts in an 8∶2 ratio.Using second-phase dynamic contrast-enhanced MRI images,five distinct peritumoral regions were segmented through 3D-Slicer software:intratumoral region,peritumoral 2 mm region,peritumoral 4 mm region,intratumoral combined with peritumoral 2 mm region and intratumoral combined with peritumoral 4 mm region.Radiomic features were extracted from these regions of interest.Machine learning algorithms integrated with Logistic regression analysis were employed for feature selection,with cross-validation techniques determining the optimal radiomic signature combination.Results Of 309 patients,150 were benign tumors and 159 were malignant tumors.The age,maximum diameter and enhancement type of benign and malignant breast tumors were statistically significant(Z/χ2=-7.695,-5.775,30.248;all P<0.001).For the region of interest of intratumoral combined with peritumoral 4 mm region,the area under curve,sensitivity,specificity,accuracy and F1 scores of the training and validation were 0.893,89.1%,75.0%,82.3%,0.838 and 0.881,74.2%,86.7%,80.3%,0.793,respectively.In the training set,the area under curve of intratumoral combined with peritumoral 4 mm region was significantly higher than that of intratumoral,peritumoral 2 mm,peritumoral 4 mm and intratumoral combined with peritumoral 2 mm regional imaging models(Z=2.506,2.982,3.392,2.157;all P<0.05).The Hosmer-Lemeshow test showed that the calibration curve of the model combined with region of interest of intratumoral combined with peritumoral 4 mm region was highly consistent with the ideal curve(training P=0.381,validation P=0.159).The decision curve indicated that the net benefit of the radiomics model in the region of interest of intratumoral combined with peritumoral 4 mm region was the highest when the risk threshold was between 0 and 1.0.Conclusion The radiomics model has good predictive performance in predicting benign or malignant breast tumors,among them the combined region of interest of intratumoral combined with peritumoral 4 mm region provides the best performance and highest benefit.The technology clinical application will provide a non-invasive predictive method for the differential diagnosis of benign and malignant breast tumors.