OBJECTIVE To systematically evaluate the quality of the Heat-clearing and symptom-relieving formula and screen potential marker components that influence the quality of the formula. METHODS The contents of 11 components （calycosin-7- O - β -D-glucoside， ononin， hyperoside， isoquercitrin， baicalin， baicalein， cryptotanshinone， tanshinone Ⅱ A ， tanshinone Ⅰ， senkyunolide A， ferulic acid） in the Heat-clearing and symptom-relieving formula were determined by high-performance liquid chromatography-tandem mass spectrometry （HPLC-MS/MS）. Using the contents of the aforementioned components as variables， cluster analysis （CA）， principal component analysis （PCA）， and orthogonal partial least squares-discriminant analysis （OPLS-DA） were conducted using OriginPro 2024 software and SIMCA 14.1 software； marker components affecting the quality of the Heat-clearing and symptom-relieving formula were then screened based on the criteria of variable importance in the projection （VIP） value＞1 and P ＜0.05. The comprehensive evaluation of 20 batches of samples was carried out using the entropy weight-technique for order preference by similarity to ideal solution（TOPSIS） and grey correlation analysis （GCA） methods. RESULTS The contents of the above 11 components were 7.993-72.866， 4.542-31.228， 727.666-1 901.884， 496.846-1 293.279， 1 995.501-6 779.150， 54.500-241.280， 150.302-304.339， 79.698-189.206， 257.118-682.418， 5.498-21.687， 7.524-26.935 μg/g. CA， PCA and OPLS-DA results showed that 20 batches of samples were grouped into 2 categories. Q1， Q3， Q4， Q7-Q9， Q12， Q15， Q16 were grouped into one category， and the rest were grouped into another category； VIP values of ferulic acid， tanshinone Ⅱ A ， baicalin， cryptotanshinone， calycosin-7- O - β -D-glucoside and ononin were all greater than 1 （ P ＜0.05）. Both the entropy weight-TOPSIS and GCA methods showed that the samples ranked in the top 11 according to the euclidean distance and relative correlation degree were Q2， Q5， Q6， Q10， Q11， Q13， Q14， Q17-Q20. CONCLUSIONS The established HPLC-MS/MS method is rapid， accurate and highly sens itive. Combined with chemical pattern recognition analysis， entropy weight-TOPSIS and GCA methods， this method can be used to evaluate the quality of the Heat-clearing and symptom-relieving formula. Ferulic acid， tanshinone Ⅱ A ， baicalin， cryptotanshinone， calycosin-7- O - β -D-glucoside and ononin may be the marker components that affect the quality of this formula. The overall quality of 11 batches of the Heat-clearing and symptom-relieving formula， including Q17， is relatively superior.

ObjectiveTo investigate the effects of 7-dehydrocholesterol reductase （DHCR7） in promoting proliferation， migration， and invasion of lung adenocarcinoma cells and the underlying signaling mechanisms. MethodsThe expression level of DHCR7 in lung adenocarcinoma and its prognosis were analyzed by using public databases. DHCR7 protein expression levels in the lung adenocarcinoma cell lines H1299 and A549 were assessed by Western blot， using the normal lung epithelial cell line BEAS-2B as a control. Small interfering RNA （siRNA） was used to knock down DHCR7 expression in H1299 and A549 cells. Assays including colony formation， CCK-8， wound healing， and Transwell experiments were conducted to assess the proliferation， migration， and invasion of the knockdown cells. Next， Western blot was employed to assess the phosphorylation levels of key signaling molecules in the phosphoinositide 3-kinase/protein kinase B （PI3K/AKT）， janus kinase/signal transducer and activator of transcription 3 （JAK/STAT3），mitogen-activated protein kinase/extracellular signal-regulated kinase pathway （MAPK/ERK） （p-AKT， p-STAT3， p-ERK）. ResultsBioinformatics results indicated that both DHCR7 mRNA and protein were highly expressed in lung adenocarcinoma compared with normal tissues adjacent to cancer. Furthermore， higher DHCR7 mRNA level was associated with poor prognosis （P<0.001）. The expression levels of DHCR7 were significantly higher in both H1299 and A549 cells than that in BEAS-2B cells （P<0.05， P<0.01）. Compared with si-control， the proliferation， migration， and invasion abilities of si-DHCR7 H1299 and A549 cells significantly decreased. Among the phosphorylated signaling molecules detected， p-ERK was significantly downregulated （P<0.000 1， P<0.01） whereas p-AKT and p-STAT3 levels were not significantly changed. ConclusionDHCR7 has prominent effects in promoting the proliferation， migration， and invasion of lung adenocarcinoma cells， and the underlying mechanisms are related to the MAPK/ERK signaling pathway.

Objective:To systematically analyze the relevant literature in the field of continuing medical education (CME) in China, summarize the co-occurrence clustering and research hotspots of CME research in China, and prospect its future development directions.Methods:This study employs bibliometric methods to visually analyze the data on the number of CME-related literature, the distribution of literature sources, researcher collaboration network relationships, and research hotspot literature in the CNKI database.Results:The academic hotspots of this study mainly focus on the following four areas: research on CME policy instruments, research on the diversification of CME service recipients, research on CME governance mechanisms, and research on the pursuit of CME values and efficiency improvement.Conclusions:To enhance the professional skills of healthcare personnel and achieve effective healthcare service delivery, future research needs to deepen in areas such as innovating research methods, establishing a multidisciplinary research perspective, emphasizing the rational use of policy instruments, improving the quality of policy implementation, exploring reasonable and feasible CME governance strategies, and strengthening research on the legal construction of CME, in order to promote the development of the healthcare industry.

Objective:To systematically analyze the relevant literature in the field of continuing medical education (CME) in China, summarize the co-occurrence clustering and research hotspots of CME research in China, and prospect its future development directions.Methods:This study employs bibliometric methods to visually analyze the data on the number of CME-related literature, the distribution of literature sources, researcher collaboration network relationships, and research hotspot literature in the CNKI database.Results:The academic hotspots of this study mainly focus on the following four areas: research on CME policy instruments, research on the diversification of CME service recipients, research on CME governance mechanisms, and research on the pursuit of CME values and efficiency improvement.Conclusions:To enhance the professional skills of healthcare personnel and achieve effective healthcare service delivery, future research needs to deepen in areas such as innovating research methods, establishing a multidisciplinary research perspective, emphasizing the rational use of policy instruments, improving the quality of policy implementation, exploring reasonable and feasible CME governance strategies, and strengthening research on the legal construction of CME, in order to promote the development of the healthcare industry.

Objective To investigate the differences in cortical activation and functional connectivity during speech under different cognitive loads in young individuals.Methods Twenty-one participants(mean age 21.9±1.33 years)were instructed to read short sentences embedded with color words under both congruent(where the color words matched the font color)and incongruent(where the color words did not match the font color)condi-tions.The color words required reading the font color instead of the word itself.Functional near-infrared spectros-copy(fNIRS)was utilized to analyze differences in cortical activation(changes in HbO concentration)and functional connectivity(Pearson correlation of HbO between brain regions)in the dorsolateral prefrontal cortex(DLPFC)and supplementary motor area(SMA)bilaterally.Results The fNIRS results revealed significant increase in HbO con-centration changes in the RDLPFC(t=3.4,P=0.003),LDLPFC(t=2.58,P=0.019),RSMA(t=3.59,P=0.002),and LSMA(t=4.06,P=0.001)under the incongruent condition compared to the congruent condition.Additionally,there was a significant enhancement in the correlation between RDLPFC and LDLPFC(t=2.44,P=0.025).However,the differences in correlation between left and right SMA,as well as between SMA and DLPFC,were not statistically significant(P＞0.05).Conclusion These findings suggest that during speech under incongru-ent conditions,increased cognitive load leads to elevated cortical activation in the DLPFC and SMA,along with in-creased functional connectivity between the left and right DLPFC.

Objective To study the effects and the possible mechanism of the hearing loss of offspring mice with chronic intrauterine hypoxia.Methods Ten healthy SD pregnant mice with SPF level were selected to establish an intrauterine hypoxia model as the hypoxia group,while another ten healthy SD pregnant mice without hypoxia treatment were selected as the control group.Arterial blood gas analysis was performed on pregnant mice and audi-tory brainstem response(ABR)testing was performed on their offspring after birth,and the results of each group were compared.Results The PaO2 and SaO2 of the hypoxic group were significantly lower than those of in the con-trol group.The hearing loss rate and wave Ⅲ response threshold of the offspring mice of the hypoxia group were significantly higher than those of in the control group at 21 and 56 days,but over time,the hearing loss rate and wave Ⅲ response threshold of the hypoxia group improved compared to before.Although some offspring mice in the hypoxic group at 21 day and 56 day had normal Ⅲ wave response thresholds,their wave Ⅱ and Ⅲ latency,as well as the latency between Ⅰ-Ⅱ,Ⅱ-Ⅲ,and Ⅰ-Ⅲ,were still significantly higher,while the amplitude of wave Ⅲ and the ratio of Ⅲ/Ⅰ were significantly lower than those of in the control group during the same period.For hypoxic off-spring mice with abnormal wave Ⅲ response threshold at 21 days and normal wave Ⅲ response threshold at 56 days,the latency of waves Ⅱ and Ⅲ,as well as the latency between Ⅰ-Ⅱ,Ⅱ-Ⅲ,and Ⅰ-Ⅲ were significantly higher,while the amplitude of wave Ⅲ and the ratio of Ⅲ/Ⅰ were significantly lower than those of in the control group and hypoxic group with normal wave Ⅲ response thresholds at 21 days and 56 days.The hearing loss of offspring mice in the hypoxia group was mainly bilateral.Conclusion Chronic intrauterine hypoxia can lead to varying degrees of hearing loss,but this type of hearing loss has a certain degree of retrogression in the early stages,and the body can undergo limited developmental compensation and repair.

Purpose To investigate the predictive value of the ratio of the square of the cross-sectional perimeter(C2)to the area(A)of the venous lumen(C2/A)in relation to lower extremity deep venous thrombosis(DVT)among orthopaedic inpatients.Materials and Methods A total of 150 inpatients without DVT from the Orthopedics Department of Xijing Hospital Affiliated to the Air Force Military Medical University were prospectively chosen from June 2020 to June 2021.Before the operation,the parameters including A,C,C2/A,inner diameter values,venous flow velocity and blood flow volume of the common femoral vein(CFV),superficial femoral vein(SFV)and popliteal vein(POV)were examined by ultrasound.After the operation,the formation of thrombus was monitored using ultrasound.Subsequently,the clinical data and ultrasound parameters of the thrombus group and the non-thrombus group were compared.Moreover,the receiver operating characteristic(ROC)curve was plotted to assess the efficacy and cut-off values of each parameter in predicting DVT.Results There were statistically significant differences between the two groups in CFV inner diameter,CFV blood flow,CFV-C,CFV-A,CFV-C2/A,SFV blood flow,SFV-C,SFV-C2/A,POV blood flow,POV-C,POV-A and POV-C2/A(t=2.64-10.41,all P＜0.05).When the cut-off values of the ultrasonic parameters CFV-C2/A,SFV-C2/A,and POV-C2/A were＞16.01,＞16.53,and＞16.54 respectively,the area under the curve for predicting DVT was the largest,which were 0.906,0.920,and 0.870 respectively.The sensitivities were 83.8%,78.4%,and 81.1%respectively,and the specificities were 82.3%,89.4%,and 85.8%respectively.Conclusion The novel ultrasonic parameter C2/A exhibits a relatively high predictive efficacy for DVT,and it is capable of furnishing novel reference information for the implementation of early DVT prevention in the clinical setting.

In recent years,Artificial Intelligence(AI)has been recognized as a key driving force behind the new wave of technological revolution and industrial transformation,gaining significant attention in national top-level strategic planning.Sup-ported by AI technologies,the biopharmaceutical industry has experienced rapidly development,with unprecedented transforma-tions in key areas such as drug discovery,disease diagnosis,bioinformatics,and personalized medicine.This paper primarily summarizes the latest research progress and contributions of AI in these key areas of the biopharmaceutical industry,showcasing the remarkable achievements of AI in the sector.At the same time,it analyzes the challenges faced by AI technologies in the bio-pharmaceutical field,including data privacy protection,algorithm interpretability,and technological ethics,and explores the ur-gent issues that need to be addressed.The paper also looks ahead to new opportunities for AI to further drive innovation and de-velopment in the biopharmaceutical field,offering new perspectives for applied research in this domain.

For centuries, people have been searching for ways to reconstruct the mutilated thumb and fingers. Among the hundreds of operation methods that have appeared, the method of toe transplantation to reconstruct the thumb and fingers, which appeared in the second half of the 19 th century, had the best effect. However, due to the limitation of technical level at that time, only the pedicled toe could be transplanted to reconstruct the thumb and fingers. During the treatment period, the patient was in an inappropriate position where the hand and foot were fixed together for a long time, and the nerve was not repaired, so the thumb and fingers reconstructed after surgery had poor feeling. Therefore, it has not been widely used. It was not until 1966 when Yang Dongyue succussed in reconstructing the thumb using a free toe transplant with blood vessel anastomosis that toe transplantation gradually became the mainstream method of thumb and finger reconstruction. The appearance and function of the thumb and finger reconstructed by toe transplantation are still very different from that of the normal thumb and finger. Moreover, when multiple thumbs and fingers are defective, the transplantation of multiple toes for repair will cause great damages to the foot, so it is not suitable to reconstruct more than three thumb and fingers using toes in the same period. In 2007, Wang Zengtao proposed the concept of "full-finger reconstruction of thumb and fingers" and a series of new operation methods: new fingers were designed and assembled by means of using a variety of tissue combination assembly, which changed the traditional method of toe transplantation to reconstruct thumb and fingers, and the method of replacing thumb and fingers by toes was changed to manufacturing new thumb and fingers so that the toes could be retained and the thumb and fingers could be reconstructed with approximately normal shape and function. In recent years, the concept and series of new operation methods of thumb and finger reconstruction have been popularized at home and abroad. This paper focuses on the development of full-finger reconstruction of thumb and fingers.

Objective:To investigate the clinical characteristics of urea cycle disorder (UCD), the efficacy and safety of glyceryl phenylbutyrate (GPB) therapy in pediatric patients with UCD.Methods:This study was a retrospective, single-arm, multicenter clinical study. The clinical data of 20 pediatric patients with UCD who received GPB treatment at 9 hospitals nationwide between December 2021 and August 2024 were collected. The clinical manifestations, laboratory results, and molecular genetic characteristics were analyzed, ammonia levels and other laboratory results were evaluated pre-post GPB therapy by paired t-tests or Wilcoxon tests. Results:Among the 20 pediatric patients with UCD, there were 8 males and 12 females, and the onset age was 2.8 (1.4, 5.7) years. The ammonia levels were 174 (125, 342) μmol/L at first onset. The symptoms included vomiting in 6 cases, drowsiness in 5 cases, epilepsy in 5 cases, developmental delay in 5 cases, psychiatric and behavioral abnormalities in 3 cases, and lethargy in 1 case, and 18 cases exhibited abnormal liver function. Twenty cases included 6 UCD subtypes, with 11 cases being ornithine transcarbamylase deficiency. A total of 27 variants were identified, 11 (41%) of which were novel. The age of patients who began GPB therapy was 4.0 (1.5, 6.6) years. Ten cases stopped GPB after 4.2 (3.4, 5.3) months, with 4 patients undergoing liver transplantation and 6 discontinuing for financial reasons. The remaining ten patients continued GPB therapy for 11.6 (8.6, 14.0) months. The duration of GPB treatment was 6.0 (4.2, 12.3) months, at the final visit, the levels of ammonia, platelets and aspartate aminotransferase were lower compared to those of pre-treatment (all P<0.05). The serum albumin level was higher than that of pre-treatment ( P=0.016). Two patients suffered only one episode of acute hyperammonaemia, with ammonia levels of 232 and 141 μmol/L, respectively. Nine cases experienced adverse effects potentially related to GPB, decreased appetite in 6 cases, vomiting in 3 cases, abnormal skin oil odor in 2 cases, somnolence, fatigue and diarrhea each in 1 case, with symptoms improved within 6 (3, 10) days. Conclusions:UCD primarily manifests with neurological and gastrointestinal symptoms, and early diagnosis of UCD could be achieved through the analysis of ammonia. GPB may effectively reduce ammonia levels in UCD pediatric patients, with favorable safety and tolerability.