ObjectiveTo conduct a comparative quality analysis of Inulae Flos， fuzz of Inulae Flos and calyx of Inulae Flos， elucidating the scientific connotation of the "removing calyx" process in the traditional processing of Inulae Flos. MethodsInulae Flos decoction pieces were collected， and the fuzz and calyx of Inulae Flos were prepared according to the experiences of old medicine workers. Subsequently， according to the methods under the "Inulae Flos" item in the 2025 edition of the Pharmacopoeia of the People's Republic of China， the appearance characteristics and thin-layer chromatography（TLC） identification of these samples were tested， and the moisture content， total ash content， extract content were also measured. The characteristic fingerprint patterns of Inulae Flos and fuzz of Inulae Flos were established by high-performance liquid chromatography（HPLC）， followed by similarity evaluation， principal component analysis（PCA）， and partial least squares-discriminant analysis（PLS-DA）. The contents of cryptochlorogenic acid， caffeic acid， 1，3-O-dicaffeoylqunic acid， 1，5-O-dicaffeoylqunic acid， and 1-O-acetyl britannilactone were determined to compare the quality differences of Inulae Flos， fuzz of Inulae Flos， and calyx of Inulae Flos. ResultsThe moisture content of Inulae Flos， fuzz of Inulae Flos， and calyx of Inulae Flos was all<10%. The determination results of total ash content were as follows：Calyx of Inulae Flos>Inulae Flos>fuzz of Inulae Flos， and the determination results of alcohol-soluble extract content were as follows：Fuzz of Inulae Flos>Inulae Flos>calyx of Inulae Flos. HPLC fingerprint patterns of Inulae Flos and fuzz of Inulae Flos were established， and 22 common peaks were identified. The similarity analysis and PCA showed that the overall quality of Inulae Flos and fuzz of Inulae Flos was similar， while the overall quality of calyx of Inulae Flos differed significantly from that of Inulae Flos and fuzz of Inulae Flos. PLS-DA results showed that Inulae Flos， fuzz of Inulae Flos， and calyx of Inulae Flos clustered into distinct groups， indicating significant differences among them. Cryptochlorogenic acid and caffeic acid had relatively high contents in calyx of Inulae Flos， the contents of 1，3-O-dicaffeoylqunic acid and 1，5-O-dicaffeoylqunic acid in Inulae Flos and fuzz of Inulae Flos were higher than those in calyx of Inulae Flos. The order of 1-O-acetyl britannilactone content was determined as follows：fuzz of Inulae Flos>Inulae Flos>calyx of Inulae Flos. ConclusionThe scientific nature of "Removing Calyx" process in the cleansing of Inulae Flos by old medicine workers is demonstrated by the resulting fuzz of Inulae Flos decoction pieces exhibiting enhanced cleanliness and higher content of the index component 1-O-acetyl britannilactone. This study provides a reference basis for further improving and enhancing the processing method and quality control standards of Inulae Flos.

Objective:To investigate the endocardial myocardial biopsy and ultrastructural features of heart failure patients with reduced ejection fraction, to determine their histopathologic phenotype, and to explore the diagnostic utility of endomyocardial biopsy in such patients.Methods:A total of 35 patients with heart failure with reduced ejection fraction diagnosed at Beijing Anzhen Hospital and underwent endomyocardial biopsy were collected between January 2022 and December 2023. The clinical features, histopathological, and ultrastructural characteristics were analyzed and compared with 11 patients with heart failure with preserved ejection fraction.Results:The age ranged from 35-58 years, with median age of 51 years; there were 26 males and 9 females. Myocardial fibrosis and myocardial fiber disorders were the most common histopathologic changes [97.1% (34/35) and 74.3% (26/35), respectively]. Myocardial fibrosis was not statistically different between the heart failure with reduced ejection fraction group and the heart failure with preserved ejection fraction group [13.3% (5.7%-21.4%) vs. 13.2% (9.3%-34.2%), P=0.279]. Significant ultrastructural changes were dense mitochondrial proliferation, vacuolar degeneration, and disorganized arrangement of myocardial fibers with localized lysis and fracture. After endomyocardial biopsy, the etiology was identified in 11 patients (31.4%,11/35), with a prevalence of cardiac amyloidosis of 17.1% (6/35). Conclusions:Endomyocardial biopsy is useful for early diagnosis and precise treatment in patients presenting with heart failure with reduced ejection fraction. Histopathological and ultrastructural analyses can uncover potential treatments, and predict and improve prognosis by providing relevant information for understanding the pathogenesis and clinical evolution.

Objective To explore the diagnostic value of 18F-fluorodeoxyglucose(FDG)PET/CT in primary pulmonary enteric adenocarcinoma.Methods The clinical and imaging data of 9 patients with primary pulmonary enteric adenocarcinoma who under-went 18F-FDG PET/CT examination were retrospectively analyzed,including lesion distribution,morphology,maximum standardized uptake value(SUVmax),clinical symptoms and signs,gastroscopy finding,puncture pathological results,and serum tumor markers[carbohydrate antigen 72-4(CA72-4),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carcinoembryonic antigen(CEA),carbo-hydrate antigen 199(CA199)].Results Pathological examination confirmed a diagnosis of primary pulmonary enteric adenocarcinoma after excluding gastrointestinal primary tumors through clinical evaluation.In all nine patients,18F-FDG PET/CT examination did not reveal any evidence of digestive system malignancies,and gastrointestinal microscopy was negative.Primary lesions were observed as masses or nodular types in 6 cases(5 in the left lung and 1 in the right lung),while 3 cases exhibited diffuse bilateral pulmonary involvement(manifested as multiple patchy opacities,nodules,ground-glass opacities,and consolidations).All pulmonary primary lesions showed increased 18F-FDG uptake,with SUVmax ranging from 2.7 to 12.8,mean 8.6±3.7.The six masses-or nodular-type primary lesions showed maximum diameters ranging from 2.1 to 10.5 cm,mean(5.23±3.06)cm.Four cases demonstrated hilar and mediastinal lymph node metastases,intrapulmonary metastases,and distant metastases,while 1 case showed only distant metastasis.Elevated levels of serum tumor markers were observed as follows:CA72-4 in 7 cases(10-273.3 U/mL),CEA in 7 cases(5-147.4 ng/mL),CA199 in 6 cases(31.22-4 364 U/mL),and CYFRA21-1 in 5 cases(8.31-99.7 ng/mL).Conclusion When pathological biopsy of a pulmonary lesion suggests primary pulmonary enteric adenocarcinoma after excluding gastrointestinal primary tumors,and 18F-FDG PET/CT shows no gastrointestinal masses,this may support the diagnosis of primary pulmonary enteric adenocarcinoma.

Objective To explore the diagnostic value of 18F-fluorodeoxyglucose(FDG)PET/CT in primary pulmonary enteric adenocarcinoma.Methods The clinical and imaging data of 9 patients with primary pulmonary enteric adenocarcinoma who under-went 18F-FDG PET/CT examination were retrospectively analyzed,including lesion distribution,morphology,maximum standardized uptake value(SUVmax),clinical symptoms and signs,gastroscopy finding,puncture pathological results,and serum tumor markers[carbohydrate antigen 72-4(CA72-4),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carcinoembryonic antigen(CEA),carbo-hydrate antigen 199(CA199)].Results Pathological examination confirmed a diagnosis of primary pulmonary enteric adenocarcinoma after excluding gastrointestinal primary tumors through clinical evaluation.In all nine patients,18F-FDG PET/CT examination did not reveal any evidence of digestive system malignancies,and gastrointestinal microscopy was negative.Primary lesions were observed as masses or nodular types in 6 cases(5 in the left lung and 1 in the right lung),while 3 cases exhibited diffuse bilateral pulmonary involvement(manifested as multiple patchy opacities,nodules,ground-glass opacities,and consolidations).All pulmonary primary lesions showed increased 18F-FDG uptake,with SUVmax ranging from 2.7 to 12.8,mean 8.6±3.7.The six masses-or nodular-type primary lesions showed maximum diameters ranging from 2.1 to 10.5 cm,mean(5.23±3.06)cm.Four cases demonstrated hilar and mediastinal lymph node metastases,intrapulmonary metastases,and distant metastases,while 1 case showed only distant metastasis.Elevated levels of serum tumor markers were observed as follows:CA72-4 in 7 cases(10-273.3 U/mL),CEA in 7 cases(5-147.4 ng/mL),CA199 in 6 cases(31.22-4 364 U/mL),and CYFRA21-1 in 5 cases(8.31-99.7 ng/mL).Conclusion When pathological biopsy of a pulmonary lesion suggests primary pulmonary enteric adenocarcinoma after excluding gastrointestinal primary tumors,and 18F-FDG PET/CT shows no gastrointestinal masses,this may support the diagnosis of primary pulmonary enteric adenocarcinoma.

Objective:To investigate the endocardial myocardial biopsy and ultrastructural features of heart failure patients with reduced ejection fraction, to determine their histopathologic phenotype, and to explore the diagnostic utility of endomyocardial biopsy in such patients.Methods:A total of 35 patients with heart failure with reduced ejection fraction diagnosed at Beijing Anzhen Hospital and underwent endomyocardial biopsy were collected between January 2022 and December 2023. The clinical features, histopathological, and ultrastructural characteristics were analyzed and compared with 11 patients with heart failure with preserved ejection fraction.Results:The age ranged from 35-58 years, with median age of 51 years; there were 26 males and 9 females. Myocardial fibrosis and myocardial fiber disorders were the most common histopathologic changes [97.1% (34/35) and 74.3% (26/35), respectively]. Myocardial fibrosis was not statistically different between the heart failure with reduced ejection fraction group and the heart failure with preserved ejection fraction group [13.3% (5.7%-21.4%) vs. 13.2% (9.3%-34.2%), P=0.279]. Significant ultrastructural changes were dense mitochondrial proliferation, vacuolar degeneration, and disorganized arrangement of myocardial fibers with localized lysis and fracture. After endomyocardial biopsy, the etiology was identified in 11 patients (31.4%,11/35), with a prevalence of cardiac amyloidosis of 17.1% (6/35). Conclusions:Endomyocardial biopsy is useful for early diagnosis and precise treatment in patients presenting with heart failure with reduced ejection fraction. Histopathological and ultrastructural analyses can uncover potential treatments, and predict and improve prognosis by providing relevant information for understanding the pathogenesis and clinical evolution.

Objective To observe the value of radiomics models and nomogram model based on two-dimensional ultrasound and automated breast volume scanning(ABVS)for predicting molecular types of breast cancer.Methods Data of 326 female patients of single breast cancer confirmed by pathology were analyzed retrospectively.The patients were randomly divided into training set(n=260)or validation set(n=66)at the ratio of 8∶2,and further divided into Luminal subgroup and non-Luminal subgroup.Radiomics features were extracted based on two-dimensional ultrasound of breast and ABVS imaging,then model2DUS,modelABVS and modelcombined radiomics were constructed,respectively.Univariate analysis and multivariate logistic regression analysis were used to screen independent factors for predicting molecular types of breast cancer,and nomogram model(modelnomogram)was constructed combined with independent factors and radiomics Radscores.The receiver operating characteristic(ROC)curve was used to evaluate the efficacy of each model for molecular type of breast cancer.Results The maximum diameter of tumor(OR=1.029)and the retraction phenomenon(OR=0.408)were both independent predictive factors for molecular type of breast cancer(both P＜0.05).The area under the curve(AUC)of model2DUS,modelABVS.modelcombined radiomics and modelnomogram for predicting molecular type of breast cancer in validation set was 0.67,0.75,0.84 and 0.83,respectively.No significant difference of AUC of modelcombined radiomics and modelnomogram was found(P＞0.05),which were both higher than AUC of model2DUs and modelABVS(all P＜0.05).Conclusion Combined radiomics model and nomogram model based on two-dimensional ultrasound and ABVS could effectively predict molecular type of breast cancer.

Objective To investigate the effect of growth hormone(GH)pretreatment on the improvement of eu-ploid and pregnancy outcome.Methods A prospective analysis was conducted on 134 patients undergoing preim-plantation genetic testing for aneuploidy(PGT-A),among whom 30 patients were self-controlled and 104 patients were inter-group controlled.According to whether GH was added,the patients were divided into GH pretreatment group and GH non-pretreatment group.GH pretreatment included subcutaneous injection of GH 2U/day for 4-6 weeks before the start of gonadotropin(Gn),and the dose was doubled on the day of Gn until the trigger day.GH non-pretreatment meant no GH treatment,GH pretreatment was given when the previous PGT-A cycle failed within one year when the PGT-A was performed again,forming the self-control group.The basic situation,blastocyst situa-tion and pregnancy outcome were compared between the groups by inter-group and self-control.Results No matter in the group control or self-controlled group,the endometrial thickness on the day of HCG,ovarian sensitivity index(OSI),number of oocytes obtained,MII oocytes,2PN number,2PN fertilization rate,available oocyte rate,num-ber of biopsy blastocysts,number of euploid blastocysts,euploid blastocyst rate,and at least one euploid rate sig-nificantly increased after GH pretreatment,with statistically significant differences(P＜0.05).The total amount of Gn,Gn days,number of mosaic blastocysts,and mosaic blastocyst rate were not significantly changed after GH pretreatment,with no statistically significant differences.The implantation rate and clinical pregnancy rate in-creased after GH pretreatment,but with no statistically significant differences.Conclusion GH pretreatment can significantly improve the number and rate of euploid embryos in patients undergoing PGT-A,and has a tendency to improve pregnancy outcome.

Objective:To analyze the disease-causing genes of families affected by retinitis pigmentosa (RP).Methods:A pedigree investigation study was performed.The clinical data of 51 Chinese families with RP treated at the Renmin Hospital of Wuhan University from June 2019 to December 2022 were collected, including patient history, family history and clinical data of ophthalmic examination.Ophthalmic examination including best corrected visual acuity, slit lamp microscopy, color fundus photography, fundus autofluorescence, macular optical coherence tomography, visual field and electroretinogram.Peripheral blood samples from patients and their family members were collected for DNA extraction and whole exome sequencing.The mutation sites found were analyzed by bioinformatics and verified by Sanger sequencing.The pathogenicity of the missense mutations was predicted using SIFT, Polyphen and other online software.Conservation of the missense mutation site was evaluated using Mutation Taster.The shear mutation was predicted using varSEAK and spliceAI.The amino acid sequences of the newly discovered mutation sites were compared using Clustalw software.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Renmin Hospital of Wuhan University (No.WDRY2019-K032).Results:Among the 51 families, two proband patients had hearing impairment and were diagnosed as Usher syndrome.In addition to typical RP features, the two proband patients also showed yellow-white crystalline substance deposits in fundus imaging, while the other proband patients showed typical RP.A total of 38 single nucleotide variants (SNVs) and 3 copy number variants were detected in 15 pathogenic genes in 29 of 51 families, including PRPF6, PRPF31, RHO, CYP4V2, USH2A, EYS, MERTK, PCDH15, ABCA4, BBS2, PROM1, SPATA7, RPE65, RPGR and OFD1 genes.There were 6 of the 38 SNVs that were novel variants that had not been reported, which were USH2A gene c.12523T>C(p.Trp4175Arg), c.1723T>C(p.Cys575Arg), c.1875C>G(p.Phe625Leu), CYP4V2 gene c.1441C>T(p.Leu481Phe), MERTK gene c.2487-8A>G and PCDH15 gene c. 5183del(p.Arg1728LysfsTer116).SIFT and Polyphen prediction software predicted that amino acid changes caused by the 4 missense variants, USH2A gene p. Trp4175Arg, p.Cys575Arg, p.Phe625Leu and CYP4V2 gene p. Leu481Phe, are all pathogenic or harmful.Conservation analysis showed that they are conserved in multiple species.The prediction software spliceAI and varSEAK suggested that MERTK gene c.2487-8A>G may lead to abnormal shear and affect protein function. PCDH15 gene c. 5183del(p.Arg1728LysfsTer116) is a frameshift variant that alters the downstream amino acid sequence and terminates translation early. CYP4V2, USH2A, and RPGR were frequently mutated genes in RP patients, accounting for more than 50% of the families with pathogenic genes detected.The proband with CYP4V2 variants had late onset, but severe visual impairment and retinal degeneration. Conclusions:Six previously unreported variants may be novel pathogenic variants of RP. CYP4V2, USH2A, and RPGR may be the most common pathogenic genes in Chinese RP patients.Patients with CYP4V2 variants have late onset, but faster disease progression.

Alzheimer′s disease (AD) is a neurodegenerative disorder. In the past few decades, the exact mechanisms underlying the onset of the disease have remained unclear, and treatment options are still lacking. Due to the inability of two-dimensional cell and animal models to fully simulate the pathogenesis of AD, there have been shortcomings in clinical trials of new drugs. The development of organoids and organ-on-a-chip technologies has improved the dilemma of AD research, providing reliable in vitro research models for studying pathogenic mechanisms and drug screening. This article elaborates on the applications and progress of organoids and organ-on-a-chip in AD modeling, pathogenesis, and drug development, and discusses the current limitations of organoids and organ-on-a-chip and their future perspectives.

Microcephaly is a common pediatric neurodevelopmental disorder with complex etiology. In recent years, with the development of brain organoid technology, there has been rapid progress in understanding the pathogenesis and treatment strategies of microcephaly using this technology. This article elucidates the advantages of brain organoids over traditional experimental models, reviews the research progress of brain organoid technology in disease modeling and drug screening for various causes of microcephaly, and discusses the limitations and future prospects of brain organoids.