OBJECTIVE: Rhodiolae Crenulatae Radix et Rhizoma (Hongjingtian in Chinese, RCRR), the roots and rhizomes of Rhodiola crenulata and its application in the medicinal market is very chaotic. In this study, DNA barcoding database and identification engine of Rhodiola species were established, decoction pieces from the medicinal market were identified, and the application and challenges of DNA barcoding in the rapid radiation of Rhodiola species were analyzed. This study provides reference for the protection, rational development, and utilization of endangered resources within Rhodiola species. METHODS: A total of 50 original plant samples from 20 species of the genus Rhodiola from Hebei, Xinjiang, Tibet, Jilin, and other major production areas were collected. Theses samples cover the typical distribution area (Qinghai-Tibetan Platea) of Rhodiola species and other scattered alpine regions (Changbai Mountain, Taibai Mountain, Lushan Mountain, etc.), it encompasses all Rhodiola species with thick rhizomes in China. ITS2 and psbA-trnH barcode of Rhodiola database (BORD) were established and an identification engine named Rhodiola-IDE was developed. The stability and accuracy of the standard DNA barcoding database were evaluated using two datasets. Rhodiola-IDE identified 31 decoction pieces of RCRR from the medicinal material market. RESULTS: The BORD containing 1 532 sequences of 88 Rhodiola species has been established, and the identification efficiency results showed good accuracy and stability. According to the Chinese Pharmacopoeia (2020 edition), 23 samples (74.2%) were identified as authentic R. crenulata, while the rest of the marketed varieties were R. kirilowii, R. dumulosa, and R. fastigiata. The product label "Larger flower, Hongjingtian" was identified as R. crenulata. Samples labeled as "Smaller flower, Hongjingtian" were identified as R. crenulata, R. kirilowii, and R. fastigiata. CONCLUSION ITS2 and psbA-trnH barcodes can identify monophyletic groups represented by R. crenulata. However, for non-monophyletic species, it is necessary to collect as many samples as possible and combine them with multiple markers for joint identification. This study discussed the application and challenges of DNA barcodes in Rhodiola under rapid radiation conditions, providing a scientific basis for the rational development and utilization of Rhodiola varieties.

In October 2024, a 36-year-old female patient with botulinum toxin type A intoxication for 15d was admitted to the Department of Neurology of Northern Jiangsu People’s Hospital. Although type A botulinum antitoxin (BAT) therapy remained effective, the patient developed a serum sickness-like reaction (SSLR) on day 4 of treatment after receiving eight consecutive desensitizing intramuscular injections of BAT. After stopping the injection of the drug and giving intravenous dexamethasone, the patient’s symptoms improved. On the 6th day after stopping the injection of botulinum antitoxin type A, the patient was followed up in the outpatient clinic and the skin symptoms had almost disappeared. This article analyzed the patient’s medical records and explored the association between BAT and SSLR, suggesting that medical personnel should be alert to the risk of adverse reactions when applying antitoxin therapy, and that they should identify and intervene in a timely manner in order to ensure the safety of the medication and therapeutic efficacy of the patients.

Objective:To evaluate the mechanical stability of the bone block after LeFort Ⅰ osteotomy with maxillary advancement using absorbable plates fixed with tenon-and-mortise structures.Methods:This study developed three finite element models: one for the maxillary LeFort Ⅰ osteotomy with anterior advancement fixed with absorbable plates (Model 1); another for the maxillary LeFort Ⅰ osteotomy with anterior advancement fixed with absorbable plates assisted by tenon-and-mortise structures (Model 2); and the last one for the maxillary LeFort Ⅰ osteotomy with anterior advancement fixed with titanium plates and screws (Model 3). Simulated occlusal forces were applied on the anterior and posterior teeth in each model. The displacement changes of the nasal-palatine point (NP) and posterior nasal spine point (PNS) in the finite element coordinate system were compared and analyzed. The Mises equivalent stress distributions of the metal and absorbable plates were also examined to assess the mechanical stability of the three finite element models. Clinical data from 45 patients with dentofacial deformities treated from January 2017 to January 2023 at the Stomatology Hospital of China Medical University were collected. The age of the patients was 21±3 years. Among these, 15 patients had absorbable plates for fixation, 15 had absorbable plates assisted by tenon-and-mortise structures, and 15 had titanium plates and screws fixation after maxillary advancement. All patients underwent preoperative (T0), postoperative 3 days (T1), and 6 months (T2) spiral CT scans. The CT data in DICOM format were input into digital software, which was used to calculate the distances from the NP and PNS points to the horizontal plane (HP), right sagittal plane (FZSR), and coronal plane (CP) at T1 and T2. The distances at T1 and T2 were statistically analyzed using the Wilcoxon signed-rank test with SPSS 20.0, and a P value of<0.05 was considered statistically significant.Results:The finite element analysis showed that in the absorbable plate-only fixation group, the maximum displacement of the NP point (mm) under anterior and posterior tooth force conditions were 0.6 and 0.12, respectively, and for the PNS point, the maximum displacements were 0.5 and 0.11. In the tenon-and-mortise-assisted absorbable plate fixation group, the displacement of the NP point was 0.40 and 0.02 mm, and the displacement of the PNS point was 0.5 and 0.015 mm. In the titanium plate-screw fixation group, the NP point displacement was 0.33 and 0.055 mm, and the PNS point displacement was 0.16 and 0.1 mm. The Mises equivalent stress on the absorbable plates with tenon-and-mortise structure was significantly lower than that in the absorbable plate-only fixation group, while the titanium plate experienced the highest Mises equivalent stress. The clinical data analysis showed that in the horizontal direction, the postoperative stability of the three fixation methods was similar. However, in the vertical and anterior-posterior directions, the absorbable plate-only fixation group showed significant differences in the distances of PNS-HP, PNS-CP, and NP-CP between T1 and T2 ( P=0.018, P=0.009, P=0.017), suggesting significant postoperative bone displacement. In contrast, the tenon-and-mortise-assisted absorbable plate fixation group and the titanium plate-screw fixation group showed no significant differences in displacement during surgery and postoperatively(all P>0.05), demonstrating higher stability. Conclusions:The tenon-and-mortise-assisted absorbable plate fixation provides comparable stability to titanium plate fixation in clinical results, and it is more stable than absorbable plate-only fixation. In the mechanical study, when force was applied on the anterior teeth, the stability of the tenon-and-mortise-assisted absorbable plate fixation was slightly less than that of titanium plate fixation, but when posterior teeth were used, its stability exceeded both titanium plate fixation and absorbable plate-only fixation. The tenon-and-mortise-assisted absorbable plate fixation serves as an effective alternative to titanium plate fixation after LeFort Ⅰ osteotomy.

The paper summarizes the medication rules of Professor Zou Yanqin,a master of traditional Chinese medicine,in the treatment of membranous nephropathy by"sweet supplementation and bland percolation method".Professor Zou believes that spleen and kidney deficiency and damp-heat stasis are the basic pathogenesis of membranous nephropathy.The pathogenesis evolves in a com-plex way,leading to a variety of syndromes.Invigorating the spleen and kidney,clearing away damp-heat and removing blood stasis are the key to treatment.Therefore,she follows the concept of the"harmonizing method and gentle treatment"of the Menghe Medicine School and takes the"sweet supplementation and bland percolation method"as the basis of all treatment principles for membranous ne-phropathy.This article systematically expounds Professor Zou Yanqin's thinking and prescription rules for treating membranous ne-phropathy using the"sweet supplementation and bland percolation method"from three aspects:sweet and warm to tonify qi,sweet and cool to moistening,and bland flavor to promote diuresis and facilitate fluid expulsion.

Objective To explore the impact factors of volume reduction rate(VRR)of benign thyroid nodules after thermal ablation based on conventional ultrasound and contrast-enhanced ultrasound(CEUS)manifestations.Methods Totally 238 patients with benign thyroid nodules who underwent thermal ablation were retrospectively enrolled and divided into VRR＜75%group(n=93)and VRR≥75%group(n=145)according to VRR of lesions 12 months after treatment.Multivariate logistic regression analysis was used to screen the independent impact factors of VRR of lesions 12 months after thermal ablation based on conventional ultrasound and CEUS manifestations.Receiver operating characteristic curve was plotted,the area under the curve(AUC)was calculated to evaluate the efficacy of the combination of the above factors for predicting VRR of lesions.Results High echo,calcification,cystic and solid components,high enhancement,enhancement loss and high ablation energy were all independent risk factors,while circular enhancement was the independent protective factor of VRR of benign thyroid nodules 12 months after thermal ablation(all P＜0.05).The AUC of combination of the above factors for predicting VRR of benign thyroid nodules 12 months after thermal ablation was 0.926.Conclusion High echo,calcification,cystic and solid components,high enhancement,enhancement loss and high ablation energy were all independent risk factors,while circular enhancement was the independent protective factor of VRR of benign thyroid nodules 12 months after thermal ablation.

Objective:To evaluate the mechanical stability of the bone block after LeFort Ⅰ osteotomy with maxillary advancement using absorbable plates fixed with tenon-and-mortise structures.Methods:This study developed three finite element models: one for the maxillary LeFort Ⅰ osteotomy with anterior advancement fixed with absorbable plates (Model 1); another for the maxillary LeFort Ⅰ osteotomy with anterior advancement fixed with absorbable plates assisted by tenon-and-mortise structures (Model 2); and the last one for the maxillary LeFort Ⅰ osteotomy with anterior advancement fixed with titanium plates and screws (Model 3). Simulated occlusal forces were applied on the anterior and posterior teeth in each model. The displacement changes of the nasal-palatine point (NP) and posterior nasal spine point (PNS) in the finite element coordinate system were compared and analyzed. The Mises equivalent stress distributions of the metal and absorbable plates were also examined to assess the mechanical stability of the three finite element models. Clinical data from 45 patients with dentofacial deformities treated from January 2017 to January 2023 at the Stomatology Hospital of China Medical University were collected. The age of the patients was 21±3 years. Among these, 15 patients had absorbable plates for fixation, 15 had absorbable plates assisted by tenon-and-mortise structures, and 15 had titanium plates and screws fixation after maxillary advancement. All patients underwent preoperative (T0), postoperative 3 days (T1), and 6 months (T2) spiral CT scans. The CT data in DICOM format were input into digital software, which was used to calculate the distances from the NP and PNS points to the horizontal plane (HP), right sagittal plane (FZSR), and coronal plane (CP) at T1 and T2. The distances at T1 and T2 were statistically analyzed using the Wilcoxon signed-rank test with SPSS 20.0, and a P value of<0.05 was considered statistically significant.Results:The finite element analysis showed that in the absorbable plate-only fixation group, the maximum displacement of the NP point (mm) under anterior and posterior tooth force conditions were 0.6 and 0.12, respectively, and for the PNS point, the maximum displacements were 0.5 and 0.11. In the tenon-and-mortise-assisted absorbable plate fixation group, the displacement of the NP point was 0.40 and 0.02 mm, and the displacement of the PNS point was 0.5 and 0.015 mm. In the titanium plate-screw fixation group, the NP point displacement was 0.33 and 0.055 mm, and the PNS point displacement was 0.16 and 0.1 mm. The Mises equivalent stress on the absorbable plates with tenon-and-mortise structure was significantly lower than that in the absorbable plate-only fixation group, while the titanium plate experienced the highest Mises equivalent stress. The clinical data analysis showed that in the horizontal direction, the postoperative stability of the three fixation methods was similar. However, in the vertical and anterior-posterior directions, the absorbable plate-only fixation group showed significant differences in the distances of PNS-HP, PNS-CP, and NP-CP between T1 and T2 ( P=0.018, P=0.009, P=0.017), suggesting significant postoperative bone displacement. In contrast, the tenon-and-mortise-assisted absorbable plate fixation group and the titanium plate-screw fixation group showed no significant differences in displacement during surgery and postoperatively(all P>0.05), demonstrating higher stability. Conclusions:The tenon-and-mortise-assisted absorbable plate fixation provides comparable stability to titanium plate fixation in clinical results, and it is more stable than absorbable plate-only fixation. In the mechanical study, when force was applied on the anterior teeth, the stability of the tenon-and-mortise-assisted absorbable plate fixation was slightly less than that of titanium plate fixation, but when posterior teeth were used, its stability exceeded both titanium plate fixation and absorbable plate-only fixation. The tenon-and-mortise-assisted absorbable plate fixation serves as an effective alternative to titanium plate fixation after LeFort Ⅰ osteotomy.

The paper summarizes the medication rules of Professor Zou Yanqin,a master of traditional Chinese medicine,in the treatment of membranous nephropathy by"sweet supplementation and bland percolation method".Professor Zou believes that spleen and kidney deficiency and damp-heat stasis are the basic pathogenesis of membranous nephropathy.The pathogenesis evolves in a com-plex way,leading to a variety of syndromes.Invigorating the spleen and kidney,clearing away damp-heat and removing blood stasis are the key to treatment.Therefore,she follows the concept of the"harmonizing method and gentle treatment"of the Menghe Medicine School and takes the"sweet supplementation and bland percolation method"as the basis of all treatment principles for membranous ne-phropathy.This article systematically expounds Professor Zou Yanqin's thinking and prescription rules for treating membranous ne-phropathy using the"sweet supplementation and bland percolation method"from three aspects:sweet and warm to tonify qi,sweet and cool to moistening,and bland flavor to promote diuresis and facilitate fluid expulsion.

Objective To explore the impact factors of volume reduction rate(VRR)of benign thyroid nodules after thermal ablation based on conventional ultrasound and contrast-enhanced ultrasound(CEUS)manifestations.Methods Totally 238 patients with benign thyroid nodules who underwent thermal ablation were retrospectively enrolled and divided into VRR＜75%group(n=93)and VRR≥75%group(n=145)according to VRR of lesions 12 months after treatment.Multivariate logistic regression analysis was used to screen the independent impact factors of VRR of lesions 12 months after thermal ablation based on conventional ultrasound and CEUS manifestations.Receiver operating characteristic curve was plotted,the area under the curve(AUC)was calculated to evaluate the efficacy of the combination of the above factors for predicting VRR of lesions.Results High echo,calcification,cystic and solid components,high enhancement,enhancement loss and high ablation energy were all independent risk factors,while circular enhancement was the independent protective factor of VRR of benign thyroid nodules 12 months after thermal ablation(all P＜0.05).The AUC of combination of the above factors for predicting VRR of benign thyroid nodules 12 months after thermal ablation was 0.926.Conclusion High echo,calcification,cystic and solid components,high enhancement,enhancement loss and high ablation energy were all independent risk factors,while circular enhancement was the independent protective factor of VRR of benign thyroid nodules 12 months after thermal ablation.

In October 2024, a 36-year-old female patient with botulinum toxin type A intoxication for 15d was admitted to the Department of Neurology of Northern Jiangsu People’s Hospital. Although type A botulinum antitoxin (BAT) therapy remained effective, the patient developed a serum sickness-like reaction (SSLR) on day 4 of treatment after receiving eight consecutive desensitizing intramuscular injections of BAT. After stopping the injection of the drug and giving intravenous dexamethasone, the patient’s symptoms improved. On the 6th day after stopping the injection of botulinum antitoxin type A, the patient was followed up in the outpatient clinic and the skin symptoms had almost disappeared. This article analyzed the patient’s medical records and explored the association between BAT and SSLR, suggesting that medical personnel should be alert to the risk of adverse reactions when applying antitoxin therapy, and that they should identify and intervene in a timely manner in order to ensure the safety of the medication and therapeutic efficacy of the patients.

Objective:To construct a diabetes foot prediction model for adult patients with type 2 diabetes based on retrospective cohort study using data from a regional health data platform.Methods:Using Yinzhou Health Information Platform of Ningbo, adult patients with newly diagnosed type 2 diabetes from January 1, 2015 to December 31, 2022 were included in this study and divided randomly the train and test sets according to the ratio of 7∶3. LASSO regression model and bidirectional stepwise regression model were used to identify risk factors, and model comparisons were conducted with net reclassification index, integrated discrimination improvement and concordance index. Univariate and multivariate Cox proportional hazard regression models were constructed, and a nomogram plot was drawn. Area under the curve (AUC) was calculated as a discriminant evaluation indicator for model validation test its calibration ability, and calibration curves were drawn to test its calibration ability.Results:No significant difference existed between LASSO regression model and bidirectional stepwise regression model, but the better bidirectional stepwise regression model was selected as the final model. The risk factors included age of onset, gender, hemoglobin A1c, estimated glomerular filtration rate, taking angiotensin receptor blocker and smoking history. AUC values (95% CI) of risk outcome prediction at year 5 and 7 were 0.700 (0.650-0.749) and 0.715(0.668-0.762) for the train set and 0.738 (0.667-0.801) and 0.723 (0.663-0.783) for the test set, respectively. The calibration curves were close to the ideal curve, and the model discrimination and calibration powers were both good. Conclusions:This study established a convenient prediction model for diabetic foot and classified the risk levels. The model has strong interpretability, good discrimination power, and satisfactory calibration and can be used to predict the incidence of diabetes foot in adult patients with type 2 diabetes to provide a basis for self-assessment and clinical prediction of diabetic foot disease risk.