Objective To analyze chemical constituents of compound Maxing Shigan decoction by ultra-high perfor-mance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF/MS). Methods The separation was performed on a UPLC BEH C₁₈ column (2.1 mm×100 mm, 2.5 µm)，with a gradient elution applying 0.1% aqueous formic acid solution and 0.1% formic acid acetonitrile as a mobile phase. The column temperature was 40 °C. The flow rate was 0.4 ml/min and the analysis time was 15 min. Mass spectrometry (MS) data were collected in both positive and negative ESI ion modes. Results Through UPLC-QTOF/MS analysis and reference validation, a total of 59 chemical components in Maxing Shigan decoction were identified. Conclusion An ultra-high performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC-QTOF/MS) method was established to identify the chemical components of Maxing Shigan decoction. This method is simple, efficient, sensitive and accurate, and provides a basis for the elucidation of the pharmacodynamic material basis and mechanism of Maxing Shigan decoction. It can provide data reference for the optimization of the compatibility of traditional Chinese medicine in the treatment of COVID-19.

Objective: To examine the mediating effect of resilience on AIDS-related stress and patient-reported outcome among elderly cases with HIV/AIDS, so as to provide the basis for promoting mental health and improving health outcomes of this population. Methods: From June to July 2024, elderly cases with HIV/AIDS receiving treatment in the infectious diseases department of a tertiary-level hospital in Sichuan Province and undergoing follow-up management at 12 community health service centers in Wuhou District, Chengdu City, Sichuan Province, were selected as study participants using convenience sampling method. Data on demographic information, duration since confirmed diagnosis and the most recent CD4+T lymphocyte count were collected through questionnaire surveys. The Chinese versions of the HIV/AIDS Stress Scale, the Chinese versions of the 10-item Connor-Davidson Resilience Scale, and the Patient-Reported Outcome Scale for Elderly HIV/AIDS Patients were used to assess AIDS-related stress, resilience, and patient-reported outcome, respectively. Structural equation modeling was performed using Mplus 8.3 software to analyze the mediating effect of resilience on AIDS-related stress and patient-reported outcome. The Bootstrap method was employed to test the significance of the mediating effect. Results: A total of 424 elderly HIV/AIDS cases were included, with a mean age of (62.04±8.73) years. Among them, 315 (74.29%) were males and 109 (25.71%) were females. The median scores were 23.00 (interquartile range, 11.00) points for AIDS-related stress, 30.00 (interquartile range, 7.00) points for resilience, and 363.45 (interquartile range, 53.03) points for the total score of patient-reported outcome. Resultsof the mediation effect analysis revealed that AIDS-related stress had a direct negative effect on patient-reported outcome (β=-0.608, 95%CI: -0.742 to -0.465). It also exerted an indirect negative effect on patient-reported outcome through the mediating role of resilience (β=-0.258, 95%CI: -0.364 to -0.158), with the mediating effect accounting for 29.79% of the total effect. Conclusion AIDS-related stress among elderly cases with HIV/AIDS can directly or indirectly negatively affect patient-reported outcome through resilience.

Nonobstructive azoospermia (NOA), one of the most severe types of male infertility, etiology often remains unclear in most cases. Therefore, this study aimed to detect four biallelic detrimental variants (0.5%) in the minichromosome maintenance domain containing 2 ( MCMDC2 ) genes in 768 NOA patients by whole-exome sequencing (WES). Hematoxylin and eosin (H&E) demonstrated that MCMDC2 deleterious variants caused meiotic arrest in three patients (c.1360G>T, c.1956G>T, and c.685C>T) and hypospermatogenesis in one patient (c.94G>T), as further confirmed through immunofluorescence (IF) staining. The single-cell RNA sequencing data indicated that MCMDC2 was substantially expressed during spermatogenesis. The variants were confirmed as deleterious and responsible for patient infertility through bioinformatics and in vitro experimental analyses. The results revealed four MCMDC2 variants related to NOA, which contributes to the current perception of the function of MCMDC2 in male fertility and presents new perspectives on the genetic etiology of NOA.
Humans ; Male ; Azoospermia/genetics* ; Meiosis/genetics* ; Spermatogenesis/genetics* ; Adult ; Exome Sequencing ; Microtubule-Associated Proteins/genetics* ; Alleles ; Infertility, Male/genetics*

Objective:To explore the clinical efficacy of super-selective ophthalmic artery thrombolysis in the treatment of central retinal artery occlusion (CRAO).Methods:This is a retrospective case series study,based on the analysis of clinical data of 50 non-arteritic CRAO patients. The patients were advised to be treated with super-selective intra-ocular arterial thrombolysis at the Neurosurgery Department, Shenyang No. 4 People′s Hospital from May to December 2024, and treated with intra-arterial thrombolysis and postoperative management guidance by the Department of Neurosurgery, General Hospital of the Northern Theater Command. There were 36 males and 14 females, aged (59.5±10.2)years (range: 41 to 75 years). There were 5 cases of complete obstruction of the central retinal artery and 45 cases of subtotal obstruction.Before the operation, all patients underwent optical coherence tomography angiography (OCTA)+ocular vascular ultrasonography, and their visual acuity was measured using a standard visual acuity logarithmic scale, visual field was measured using the contrast visual field examination method;One week after the operation, all patients were rechecked for OCTA, visual acuity and visual field. The patients′ preoperative and postoperative visual field recovery status were compared. Significant effect was defined as an improvement of more than 3 lines of visual acuity or a complete improvement of visual field defects after treatment compared with pretreatment visual acuity; effectiveness was defined as an improvement of 1 to 2 lines of visual acuity or an improvement of visual field defects after treatment compared with pretreatment visual acuity.Results:The overall effective rate of 50 patients with CRAO treated with super-selective ophthalmic artery urokinase thrombolysis was 94.0% (47/50), with 29 very effective, 18 effective and 3 ineffective. The time from onset to surgery was 0 to 6 hours in 5 patients, with an effective rate of 5/5; >6 to 24 hours in 11 patients, with an effective rate of 10/11; >1 to 7 days in 21 patients, with an effective rate of 90.5%(19/21); >7 to 14 days in 9 patients, with an effective rate of 9/9; and >14 to 21 days in 4 patients, with an effective rate of 4/4, and the difference in effective rate between the different time windows of thrombolytic therapy was not statistically significant ( P=0.961). There were 3 cases of intraoperative and postoperative complications, including 1 case of ophthalmic artery entrapment, 1 case of femoral artery pseudoaneurysm and 1 case of fundus hemorrhage, but all of them were cured after symptomatic treatment. Conclusions:Intra-arterial thrombolysis for CRAO patients has a high effective rate and a low complication rate. The surgical time window can be extended to 21 days after the onset, which is of positive significance for the recovery and improvement of the patient′s final visual acuity.

In the progression process of liver diseases, pathological changes occur in the vascular endothelium, platelets, coagulation, anticoagulation, fibrinolysis systems of patients, and "rebalancd haemostasis" is formed. The coexistence of hypocoagulation and hypercoagulation tendency in the peripheral blood of patients made the laboratory testing data complex and difficult to interpret, especially prothrombin time and activated partial thromboplastin time could not truly reflect the net effect of haemostasis disorder in patients with liver diseases, which often led to misjudgment and overtreatment by doctors and led to adverse clinical consequences. In recent years, thromboelastography, rotational thromboelastometry and thrombin generation assay had been used to assess bleeding risk in patients with liver diseases and had made progress in transfusion management. On the other hand, von Willebrand factor and thrombospondin type 1 motif member 13 has been shown to be closely related to the progression of liver diseases and could warn the adverse clinical outcomes effectively.

Objective To analyze the medication patterns of Traditional Chinese Medicine(TCM)for high-risk human papilloma-virus(HR-HPV)infection using data mining and machine learning.Methods Clinical data from patients diagnosed with HR-HPV infection at Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine were collected and standardized through the hospital information system(HIS).A normalized clinical database was established.Python 3.11 was utilized as the primary programming language for herbal frequency analysis,feature engineering,association rule mining,and machine learning-based modeling for symptom-specific modification of herbal combinations.Results The study included 1650 patients,5585 visits and 4027 prescriptions,involving 332herbal medicines with 84 271 usage instances.High-frequency herbs included Atractylodes macrocephala(Bái Zhú)and Scutellaria barbata(Bàn Zhī Lián).Medicinal properties were predominantly warm,followed by neutral and cold;flavors were mainly sweet,then bitter and pungent.Herbs primarily targeted the liver meridian,followed by the lung and spleen meridians.Key therapeutic effects focused on tonify-ing deficiency and clearing heat,supplemented by activating blood circulation,resolving stasis,dispelling external pathogens,and promo-ting diuresis.Fifty-two herb pairs were identified,such as Rhodiola rosea(Hóng Jǐng Tiān)-Hedyotis diffusa(Bái Huā Shé Shé Cǎo),and a foundational formula derived from the top 10 high-frequency herbs was established,emphasizing"clearing heat,detoxif-ying,strengthening immunity,and consolidating the exterior."Conclusion HR-HPV infection is primarily caused by insufficient vital qi and invasion of pathogenic factors into the uterine cervix.The core pathogenesis involves dampness,heat,toxicity,stasis,and defi-ciency.Treatment principles include drying dampness,promoting diuresis,clearing heat,detoxifying,activating blood circulation,un-blocking collaterals,strengthening immunity,and consolidating the exterior.Particular emphasis is placed on using pungent-warm exteri-or-releasing herbs like Cinnamomum cassia(Guì Zhī)to guide meridians and expel pathogens.

Objective To analyze the medication patterns of Traditional Chinese Medicine(TCM)for high-risk human papilloma-virus(HR-HPV)infection using data mining and machine learning.Methods Clinical data from patients diagnosed with HR-HPV infection at Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine were collected and standardized through the hospital information system(HIS).A normalized clinical database was established.Python 3.11 was utilized as the primary programming language for herbal frequency analysis,feature engineering,association rule mining,and machine learning-based modeling for symptom-specific modification of herbal combinations.Results The study included 1650 patients,5585 visits and 4027 prescriptions,involving 332herbal medicines with 84 271 usage instances.High-frequency herbs included Atractylodes macrocephala(Bái Zhú)and Scutellaria barbata(Bàn Zhī Lián).Medicinal properties were predominantly warm,followed by neutral and cold;flavors were mainly sweet,then bitter and pungent.Herbs primarily targeted the liver meridian,followed by the lung and spleen meridians.Key therapeutic effects focused on tonify-ing deficiency and clearing heat,supplemented by activating blood circulation,resolving stasis,dispelling external pathogens,and promo-ting diuresis.Fifty-two herb pairs were identified,such as Rhodiola rosea(Hóng Jǐng Tiān)-Hedyotis diffusa(Bái Huā Shé Shé Cǎo),and a foundational formula derived from the top 10 high-frequency herbs was established,emphasizing"clearing heat,detoxif-ying,strengthening immunity,and consolidating the exterior."Conclusion HR-HPV infection is primarily caused by insufficient vital qi and invasion of pathogenic factors into the uterine cervix.The core pathogenesis involves dampness,heat,toxicity,stasis,and defi-ciency.Treatment principles include drying dampness,promoting diuresis,clearing heat,detoxifying,activating blood circulation,un-blocking collaterals,strengthening immunity,and consolidating the exterior.Particular emphasis is placed on using pungent-warm exteri-or-releasing herbs like Cinnamomum cassia(Guì Zhī)to guide meridians and expel pathogens.

In the progression process of liver diseases, pathological changes occur in the vascular endothelium, platelets, coagulation, anticoagulation, fibrinolysis systems of patients, and "rebalancd haemostasis" is formed. The coexistence of hypocoagulation and hypercoagulation tendency in the peripheral blood of patients made the laboratory testing data complex and difficult to interpret, especially prothrombin time and activated partial thromboplastin time could not truly reflect the net effect of haemostasis disorder in patients with liver diseases, which often led to misjudgment and overtreatment by doctors and led to adverse clinical consequences. In recent years, thromboelastography, rotational thromboelastometry and thrombin generation assay had been used to assess bleeding risk in patients with liver diseases and had made progress in transfusion management. On the other hand, von Willebrand factor and thrombospondin type 1 motif member 13 has been shown to be closely related to the progression of liver diseases and could warn the adverse clinical outcomes effectively.