Based on the typical cases from Case Records as a Guide to Clinical Practice （《临证指南医案》） where YE Tianshi applied the "morning and evening differential treatment"， the main types are summarized as follows. When there is middle-lower interlocking injury， and yin deficiency with wind stirring， the method of restraining and consolidating in the morning can be used to restrict jueyang （厥阳）. For deficiency of the extraordinary vessels and heart-spleen ying （营） impairment， the method of consolidating should be used to raise yang in the morning， while the method of moistening and nourishing ying-yin in the evening is used. For lower jiao （焦） depletion with phlegm turbidity obstructing the orifices， it is recommended to tonify lower jiao in the morning and fortify spleen and dissolve phlegm in the evening. If there is kidney-yin depletion with dampness obstructing the qi， it is suggested to supplement kidney and improve qi reception in the morning， while purify upper jiao in the evening. For deficiency and impairment of the collateral vessels， the method of moistening and nourishing ying-yin in the evening can be used. For heart-spleen qi knot， it is recommended to dissolve phlegm and dispel stasis in the evening. In clinical practice， the same medicinal formula can be used with different methods which change according to the syndrome. Taking Sishen Pills （四神丸） and Yuhu Elixir （玉壶丹） as examples， employing different methods in accordance with the primary and secondary pathomechanisms can help transform complex， multiple pathomechanisms into organized treatment steps， providing ideas for managing complicated syndromes with modern Chinese medicine in clinical practice.

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality, characterized by poor prognosis due to its high proliferative and invasive potential. Tumor metabolic reprogramming, particularly involving glucose metabolism, is essential for tumor survival. This study investigates the role of the Hippo pathway effector transcriptional co-activator with PDZ-binding motif (TAZ) in regulating gluconeogenesis and promoting tumorigenesis in HCC. Methods: TAZ expression in HCC was analyzed using The Cancer Genome Atlas data and validated in clinical samples and cell lines. TAZ was overexpressed or silenced in HCC cell lines to evaluate its effects on cell proliferation, apoptosis, migration, and invasion. The expression and prognostic relevance of the gluconeogenesis-related genes phosphoenolpyruvate carboxykinase 1 (PCK1) and glucose-6-phosphatase (G6PC) were examined, along with their correlation with TAZ expression. Tumor growth was assessed in nude mice. Interactions between TAZ and the glucocorticoid receptor (GR) were investigated using co-immunoprecipitation, immunofluorescence, and chromatin immunoprecipitation assays. Results: TAZ was significantly upregulated in HCC tissues and cell lines. TAZ overexpression enhanced proliferation, reduced apoptosis, and promoted migration and invasion. In contrast, PCK1 and G6PC were downregulated in HCC and showed a negative correlation with TAZ expression. Conclusion TAZ modulates gluconeogenesis and accelerates tumor growth, whereas its knockdown attenuates tumor progression. TAZ interacts with GR, suppressing its transcriptional activity on gluconeogenic gene promoters.

Combined small cell lung cancer(C-SCLC)accounts for approximately 20%of all SCLC cases,while the propotion of C-SCLC mixed with squamous cell carcinoma component comprises less than 3%.At the pathological level,accurate diagnosis requires to distinguish it from other lung tumor types,and even rely on molecular testing.This article presents a case of a 67-year-old patient initially diagnosed with a peripheral lung tumor.The patient underwent comprehensive multidisciplinary management,including surgical resection,postoperative pathological differential diagnosis,chemotherapy,thoracic radiotherapy,brain metastasis,cranial radiotherapy,dynamic follow-up of imaging changes after cranial radiotherapy,and cranial surgery.Molecular residual disease(MRD)monitoring was integrated at critical time points during dynamic monitoring to inform personalized treatment decisions.The early MDT has brought the patient′s condition under control,and the overall survival of the patient exceeded 30 months.Through the introduction of the diagnosis and treatment process of this patient,we aim to offer novel perspectives on clinical decision-making for C-SCLC.

Objective:To explore the effect of recombinant human brain natriuretic peptide(rhBNP)combined with dopamine on cystatin C(CysC),homocysteine(Hcy)and cardiac function in patients with severe heart failure(HF).Methods:This randomized controlled study enrolled 110 severe HF patients admitted in Aerospace Center Hospital between December 2021 and December 2022.They were divided into control group(n=55,nitroglycerin combined dopamine)and combined treatment group(n=55,rhBNP combined dopamine).Each group received corresponding therapy based on basic treatment for one week.Therapeutic effect,levels of CysC,Hcy,left ventric-ular end-systolic diameter(LVESd),left ventricular end-diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF),and incidence of adverse reactions were compared between two groups.Results:Compared with patients in control group,those in combined treatment group had significant higher total effective rate(81.82％vs.58.18％)and LVEF[(54.68±4.59)％vs.(44.79±4.37)％],and significant lower CysC[(1.02±0.19)mg/L vs.(1.40±0.21)mg/L],Hcy[(15.98±2.17)μmol/L vs.(21.05±2.82)μmol/L],LVESd[(35.13±3.51)mm vs.(41.71±3.28)mm]and LVEDd[(41.33±4.26)mm vs.(50.51±4.37)mm](P＜0.01 all).There was no significant difference in total incidence of adverse reactions between two groups(16.36％vs.7.27％,P=0.180).Conclusion:rhBNP combined with dopamine could significantly improve the clinical therapeutic effect,im-prove levels of CysC,Hcy and cardiac function with good safety in the treatment of severe HF.

Protein-protein interactions play an extremely important role in the biochemical functions of cells,and in-depth analysis of protein interactions is the key to understanding cellular life activities.In this study,we systematically mined the interacting proteins of Golgi protein 73(GP73)using classical immunoprecipitation combined with mass spectrometry,and sought to further analyze the molecular func-tion of GP73.Hepatocellular carcinoma cell line HepG2 was selected,and a stable cell line overexpress-ing GP73-3Flag was constructed using lentiviral infection technology.A total of 78 high-confidence GP73 interacting proteins were identified by immunoprecipitation coupled with mass spectrometry.Bioinformat-ics analyses suggested that GP73 interacted with nearly 40 cytosolic proteins and participated in the bio-logical processes of RNA transport,splicing,and translation.Further immunofluorescence and cytosolic protein isolation experiments confirmed the cytosolic localization of GP73 in a variety of tumor cells.Based on the 78 interacting proteins,we further screened protein interaction networks related to mRNA splicing and verified the existence of interactions between GP73 and seven proteins,including HNRN-PH3,SMN1,RBM14,andNCBP1,by co-immunoprecipitation experiments.In addition,minigene spli-cing assay results indicated that GP73 inhibited the splicing efficiency of pre-mRNA by cells.This study contributes to the expansion of knowledge regarding the function of GP73 and aids in elucidating its criti-cal role in cell biology and its potential association with diseases.

Protein-protein interactions play an extremely important role in the biochemical functions of cells,and in-depth analysis of protein interactions is the key to understanding cellular life activities.In this study,we systematically mined the interacting proteins of Golgi protein 73(GP73)using classical immunoprecipitation combined with mass spectrometry,and sought to further analyze the molecular func-tion of GP73.Hepatocellular carcinoma cell line HepG2 was selected,and a stable cell line overexpress-ing GP73-3Flag was constructed using lentiviral infection technology.A total of 78 high-confidence GP73 interacting proteins were identified by immunoprecipitation coupled with mass spectrometry.Bioinformat-ics analyses suggested that GP73 interacted with nearly 40 cytosolic proteins and participated in the bio-logical processes of RNA transport,splicing,and translation.Further immunofluorescence and cytosolic protein isolation experiments confirmed the cytosolic localization of GP73 in a variety of tumor cells.Based on the 78 interacting proteins,we further screened protein interaction networks related to mRNA splicing and verified the existence of interactions between GP73 and seven proteins,including HNRN-PH3,SMN1,RBM14,andNCBP1,by co-immunoprecipitation experiments.In addition,minigene spli-cing assay results indicated that GP73 inhibited the splicing efficiency of pre-mRNA by cells.This study contributes to the expansion of knowledge regarding the function of GP73 and aids in elucidating its criti-cal role in cell biology and its potential association with diseases.

Branch atheromatous disease(BAD)is a type of ischemic stroke that is prone to early neurological deterioration(END),which profoundly impacts patient prognosis and remains a focus of clinical research and practice.This article reviews the diagnosis,risk factors,risk prediction,along with imaging and prevention strategies of END in BAD patients,aiming to provide a theoretical basis for the early clinical identification and intervention of END to improve the prognosis of patients with BAD.

Objective:To investigate the effects of traditional Chinese curve-correcting and rotation-reducing spinal manipulation on biomechanical parameters and factors influencing herniated disc resorption in lumbar disc herniation(LDH).Methods:A retrospective analysis of 51 LDH patients treated between January 2022 and May 2024 was conducted.Lumbosacral parameters(vertebral rotation angle[α],disc angle[β],sacral slope[SS],lumbar lordosis[LL])were measured via MRI before treatment and at final follow-up.Disc resorption was assessed using Michigan State University(MSU)classification.Multivariate logistic regression identified factors associated with resorption.Results:Post-treatment α angle significantly decreased(3.02°→1.86°,P=0.002),while SS(28.4°→30.0°,P＜0.001)and LL angles(31.0°→35.12°,P＜0.001)increased;Disc resorption occurred in 56.86％(29/51)of patients.Longer disease course(OR=0.79,95％CI:0.69-0.91)and disc calcification(OR=0.03,95％CI:0.00-0.25)were independent inhibitors of resorption(P＜0.001).Conclusion:Spinal manipulation restores lumbosacral biomechanics by reducing vertebral rotation and increasing lumbar curvature,with higher resorption rates in patients with short duration(≤6 months),non-calcified discs,and MSU type 2-3 herniations.

Aim To study the protective effect of the silibinin derivative Sil-1 on acute myocardial ischemia in SD rats and its mechanism of action.Methods Af-ter 18 hours of oxygen-glucose deprivation and treat-ment of H9c2 cells,the protective effect of Sil-1 on rat cardiomyocytes was examined.SD rats were treated 30 minutes before surgery,followed by 24 h ligation of the left anterior descending coronary artery.The cardiopro-tective effects of Sil-1 and its mechanisms for improving myocardial ischemic injury were investigated using pro-teomics technology.Results In vitro,compared with the control group,the activity of H9c2 cells in the mod-el group showed reduced cell viability,increased dead cells,elevated ROS and higher levels of LDH and in-flammatory cytokines TNF-α,IL-1β and IL-6 in the culture medium.Sil-1 could improve the above condi-tions to different degrees.In vivo,compared with the control group,rats in the model group showed signifi-cantly higher T waves on electrocardiogram,significant ischemic areas in the heart section,disorganized ar-rangement of cardiomyocytes,increased inflammatory factor infiltration and elevated CK,CK-MB,LDH and inflammatory factors TNF-α,IL-6 and IL-1β.Besides,NF-κB phosphorylation levels in myocardial tissue in-creased.Sil-1 improved the above conditions to varying degrees.The results of proteomics showed that 90 pro-teins were found between the control vs model group and the Sil-1 vs model group,and KEGG enrichment a-nalysis showed that MAPK,chemokines,VEGF and other signaling pathways were abundant.Western blot results showed that Sil-1 blocked the phosphorylation of ERK,JNK and p38 MAPK.Conclusions Sil-1 inhib-its the MAPK pathway by blocking the phosphorylation of JNK,ERK,and p38 MAPK,and achieves a protec-tive effect on rats with acute myocardial infarction.