Ophiopogon japonicus, a precious medicinal plant endemic to Zhejiang Province. Its tuberous roots are rich in bioactive components such as flavonoids, possessing anti-inflammatory, antioxidant, and immunomodulatory properties. To elucidate the impact of cadmium (Cd) stress on the accumulation and biosynthetic pathway of flavonoids in O. japonicus, this study exposed O. japonicus to different concentrations of Cd stress and explored the changes through integrated transcriptomics and metabolomics analysis. The results demonstrated that Cd stress (1 mg/L and 10 mg/L) significantly increased the content of flavonoids in O. japonicus in a concentration-dependent manner. The metabolomics analysis revealed a total of 110 flavonoids including flavones, flavanols, flavonols, flavone and flavonol derivatives, flavanones, isoflavonoids, chalcones and dihydrochalcones, and anthocyanins in O. japonicus, among which flavones, flavonols, flavone and flavonol derivatives, and anthocyanins increased under Cd stress. The transcriptomics analysis identified several key flavonoid biosynthesis-associated genes with up-regulated expression under Cd stress, including 14 genes encoding 4-coumarate CoA ligase (4CL), 2 genes encoding chalcone isomerase (CHI), and 14 genes encoding phenylalanine ammonia lyase (PAL). The gene-metabolite regulatory network indicated significant positive correlations of 4CL (Cluster-21637.5012, Cluster-21637.90648, and Cluster-21637.62637) and CHI (Cluster-21637.111909 and Cluster-21637.123300) with flavonoid metabolites, suggesting that these genes promoted the synthesis of specific flavonoid metabolites, which led to the accumulation of total flavonoids under Cd stress. These findings provide theoretical support for the cultivation and utilization of medicinal plants in Cd-contaminated environments and offered new perspectives for studying plant responses to heavy metal stress.
Cadmium/toxicity* ; Flavonoids/biosynthesis* ; Metabolomics ; Ophiopogon/drug effects* ; Stress, Physiological ; Transcriptome ; Gene Expression Profiling ; Gene Expression Regulation, Plant

Intestinal aging is central to systemic aging, characterized by a progressive decline in intestinal structure and function. The core mechanisms involve dysregulation of epithelial cell renewal and gut microbiota dysbiosis. In addition to previous results in model organisms like Drosophila melanogaster, recent studies have shown that in mammalian models, aging causes increased intestinal permeability and intestinal-derived systemic inflammation, thereby affecting longevity. Therefore, anti-intestinal aging can be an important strategy for reducing frailty and promoting longevity. There are three key gaps remaining in the study of intestinal aging: (1) overemphasis on aging-related diseases rather than the primary aging mechanisms; (2) lack of specific drugs or treatments to prevent or treat intestinal aging; (3) limited aging-specific dysbiosis research. In this review, the basic structures and renewal mechanisms of intestinal epithelium, and mechanisms and potential therapies for intestinal aging are discussed to advance understanding of the causes, consequences, and treatments of age-related intestinal dysfunction.

ObjectiveTo evaluate pharmacological effects of Shengmai injection（SMI）on cerebral ischemia and study its neuroprotective mechanism. MethodsMale specific pathogen-free （SPF） Sprague-Dawley （SD） rats were randomly divided into a sham group， a model group， a low-dose SMI group（3 mL·kg^-1）， a middle-dose SMI group（6 mL·kg^-1）， a high-dose SMI group（12 mL·kg^-1）， and a Ginaton group（4 mL·kg^-1）according to the random number table method， with 12 rats in each group. The rat model of cerebral ischemia-reperfusion（MCAO/R）was prepared via the suture method. The administration groups were intraperitoneally injected with corresponding concentrations of SMI or Ginaton injection after reperfusion， which was conducted for 3 consecutive days. The sham group and model group were administered the equivalent volume of physiological saline. The pharmacological effects of SMI on brain injury in MCAO/R rats were evaluated by neurological function scores， cerebral infarction area， hematoxylin-eosin （HE） staining， Nissl staining， terminal deoxynucleotidyl transferase dUTP nick-end labeling （TUNEL） staining， and Western blot. The dominant link and key protein of SMI treating cerebral injury were explored using proteomic analysis. The related mechanisms of SMI were further validated using enzyme-linked immunosorbent assay （ELISA）， Western blot， and chloride ion fluorescence probe with oxygen-glucose deprivation/reoxygenation（OGD/R）-treated PC12 cells and MCAO/R rats. ResultsCompared with the sham group， the model group showed significantly increased neurological function scores， cerebral infarction area， neuronal apoptosis rate， and expression levels of apoptosis related proteins （P<0.05， P<0.01）and significantly decreased density of Nissl bodies and neurons（P<0.01）. Compared with the model group， the SMI groups exhibited significantly decreased neurological function scores， cerebral infarction area， neuronal apoptosis rate， and expression levels of apoptosis related proteins （P<0.05， P<0.01）and significantly increased density of Nissl bodies and neurons （P<0.05）. The proteomic analysis results showed that oxidative stress and inflammatory response were important processes of SMI intervening in MCAO/R injury， and the chloride intracellular channel protein 1 （CLIC1） was one of key proteins in its action network. The levels of representative indicators of oxidative stress and inflammatory response in the MCAO/R rats of the SMI groups were significantly reduced， compared with those in the model group（P<0.05， P<0.01）， and the expression levels of CLIC1 and downstream NOD-like receptor protein 3 （NLRP3） decreased （P<0.01）. In addition， the experimental results based on the OGD/R PC12 cells showed that SMI significantly increased the cell survival rate（P<0.01） and significantly decreased the intracellular chloride ion concentration（P<0.05）. ConclusionSMI has neuroprotective effects. Oxidative stress and inflammatory response are key processes of SMI intervening in MCAO/R injury. The potential mechanism is closely related to the regulation of CLIC1.

Renally inappropriate medication (RIM)refers to the administration of drugs without proper dosage adjustment based on renal function or the use of contraindicated agents, primarily including nephrotoxic agents and renally excreted medications.Such practices may accelerate disease progression and increase the risk of adverse drug events, posing a significant burden on China's healthcare system.Early identification and intervention for RIM in elderly patients provide critical opportunities to mitigate the decline in abnormal renal function.Currently, there is a lack of specific, actionable guidelines for preventing RIM in elderly patients with chronic kidney disease(CKD)in China.This expert consensus systematically reviews evidence-based medical literature from domestic and international studies over the past two decades, integrates expertise and clinical insights from geriatric medicine and clinical pharmacology specialists to establish practical recommendations for preventing RIM in elderly patients with CKD.

Objective To observe the value of venous phase CT radiomics combined with clinical features for predicting breast cancer susceptibility gene(BRCA)mutation in patients with epithelial ovarian cancer(EOC).Methods A total of 111 EOC patients diagnosed by surgical pathology and BRCA detection were retrospectively enrolled and divided into training set(n=90,35 BRCA mutations[+]and 55 BRCA mutations[-])and test set(n=21,8 BRCA mutations[+]and 13 BRCA mutations[-])at the ratio of 8∶2.Clinical and CT data were analyzed using univariate and multivariate logistic regression(LR)to screen independent predictors of BRCA mutations in EOC patients,and then a clinical model was established.Based on venous phase CT,the best radiomics features of EOC lesions were extracted and screened,radiomics score(Radscore)was calculated.Machine learning(ML)models were established using random forest(RF),support vector machine(SVM)and LR,respectively,and the optimal ML model was screened.Finally a combined model was constructed based on Radscore and independent predictors.The predictive efficacy and clinical value of each model were evaluated.Results Human epididymis protein 4 was the independent predictor of BRCA mutation in EOC patients,and the area under the curve(AUC)of clinical model was 0.648 and 0.742 in training and test sets,respectively.AUC of RF,SVM and LR model was 0.726,0.763 and 0.860 in training set,0.708,0.750 and 0.700 in test set,respectively,and SVM model was the optimal ML model.AUC of combined model was 0.819 and 0.783 in training and test set,respectively,which in training set was higher than that of clinical model(P=0.022).No significant difference of AUC was found by pairwise comparison of other models in both training and test set(all P＞0.05).Decision curve analysis showed that when the threshold was larger than 0.15,the clinical value of combined model was higher than that of clinical and SVM models.Conclusion Venous phase CT radiomics combined with clinical features could effectively predict BRCA mutation in EOC patients.

Moyamoya disease(MMD)is a rare cerebral arterial steno-occlusive disease of unknown etiology.In recent years,the impact of MMD on cognitive function has gradually become an area of active investigation.The clinical manifestations of the disease predominantly involve cognitive domains such as executive function,memory and processing speed,and with the progression of the disease,some patients may develop vascular dementia.Although preliminary researches have been conducted to explore the cognitive impairment associated with MMD in adults,the underlying pathogenesis remains unclear,and the lack of standardized diagnostic and treatment protocols poses challenges in the early identification and intervention of MMD in clinical practice.This article systematically reviewed the clinical features,pathogenesis,and existing treatment options of MMD,aiming to provide a foundation for the diagnosis and treatment of patients with MMD.

The development of Traditional Chinese Medicine(TCM)medical alliances plays a pivotal role in enhancing grassroots TCM service capabilities and meeting public demand for TCM healthcare.However,challenges persist in establishing these alliances,including insufficient Party leadership at primary TCM institutions and deficiencies in clinical services,talent de-velopment,and emergency care capacity.This study examines innovative Party building approaches in public hospitals within the new era context,analyzing practical cases of alliance development.Our findings demonstrate that integrating Party building into the governance structure of medical alliances not only strengthens Party leadership at primary TCM institutions but also significant-ly promotes TCM service development.Systematic analysis of case hospital practices reveals several key insights.Firstly,strengthening top-level design through Party committee leadership is crucial.Secondly,addressing the most pressing public healthcare concerns with genuine commitment forms the foundation.Thirdly,deep integration of Party building with core medical services represents the essential approach.Lastly,policy-responsive innovation based on consolidated achievements serves as the key driver.

Objective To investigate the effects of sample transport and sorting system on the detection results of common clinical bio-chemical and immunological items carried out in our laboratory.Methods A total of 25 patients admitted to Zidong Hospital of Jiangsu Provincial Hospital of Traditional Chinese Medicine in June 2024 were included in this study,and four blood samples were collected from each patients using vacuum blood vessels with separation gel containing coagulant.These samples were transferred to the laboratory department through manual transport or pneumatic logistics transmission,and the manual sorting approach or intelligent blood vessel sorting system was used to encode the samples.The effects of different sample transportation methods and sorting methods on the detec-tion results of 46 clinical biochemical parameters,12 tumor markers and 5 thyroid hormone items,which were carried out in our labora-tory,were analyzed and compared.Results No significant change on hemolytic index(HI)was found through pneumatic tube system(PTS)and intelligent blood vessel sorting system(P＞0.05).The results of AST,CK-MB,α-HBDH,and LDH in clinical biochemical parameters following PTS were significantly different from those in artificial transport group(all P＜0.05).Both the results of Cyfra21-1 and NSE in immunological items in the samples after PTS transport were significantly different from those obtained by either manual transport or intelligent sorting system,with statistical significance(all P＜0.05).Conclusion PTS basically meets the requirements of clinical laboratories,but it can lead to the increase of AST,CK-MB,α-HBDH and LDH in clinical biochemistry,as well as Cyfra21-1 and NSE in immunology,which needs to be further improved,refined,and validated in order to meet the clinical requirements.

Objective:To conduct a Meta-synthesis on the characteristics of symptom help-seeking behavior in adult cancer patients, so as to provide evidence-based guidance for early intervention of symptom help-seeking behavior in cancer patients in China.Methods:Qualitative studies on symptom help-seeking behavioral characteristics of cancer patients were systematically searched in PubMed, Cochrane Library, Web of Science, ProQuest, Nature, ScienceDirect, China National Knowledge Infrastructure, WanFang Data, China Biology Medicine disc, and VIP. The search period was from database establishment to December 31, 2024. Included literature was independently evaluated using the Australian Joanna Briggs Institute Center for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. The results were integrated through the Meta-synthesis method.Results:A total of 15 papers were included, and 30 findings were distilled and grouped into nine categories, resulting in three integrated findings of low symptom perception and interpretation bias, coping styles of symptom disclosure, and factors influencing symptom help-seeking behaviors.Conclusions:Symptom help-seeking behaviors of cancer patients are influenced by a variety of factors, and understanding their behavioral characteristics is useful in informing the development of intervention strategies.