OBJECTIVE To analyze the prototype components absorbed into blood and brain of Lithocarpus litseifolius leaves， so as to provide a reference for clarifying the pharmacological material basis of its prevention and treatment of central nervous system dis eases. METHODS The ethanol extract of L. litseifolius leaves， as well as the gastric lavage fluid and perfusion solution were prepared. Using rats as subjects， plasma samples of intestinal wall metabolism， intestinal flora metabolism and hepatic metabolism were prepared via in situ intestinal perfusion and closed intestinal loop method； while comprehensive metabolic plasma samples， brain tissue samples， and cerebrospinal fluid samples were collected after intragastric administration. UPLC-HRMS technology was utilized to analyze and identify chemical components and prototype components absorbed into blood and brain of L. litseifolius leaves. RESULTS A total of 66 chemical constituents were identified in L. litseifolius leaves， primarily consisting of flavonoids， organic acids， and others. A total of 16， 13， 11， and 5 prototype components were identified in intestinal wall metabolism， intestinal flora metabolism， hepatic metabolism， and comprehensive metabolic plasma samples， respectively. Additionally， 4 prototype components were detected in brain tissue and 9 in cerebrospinal fluid. Phloridzin， trilobatin， phloretin-2- O -malonyl hexoside， and phloretin were identified as common components across all sample types. CONCLUSIONS Prototype components absorbed into blood and brain of L. litseifolius leaves， such as phloridzin， trilobatin， phloretin， and other components may serve as the pharmacological material basis for their therapeutic effects on central nervous system diseases.

This paper introduces a real-world cohort research model for community-acquired pneumonia （CAP） based on the Jiangsu Traditional Chinese Medicine （TCM） Dominant Diseases Diagnosis and Treatment Data Platform. Firstly， data cleaning is performed by standardizing diagnosis， symptoms， treatment and imaging， intelligently extracting unstructured information， and cleaning and constructing a standardized database. Secondly， for cohort establishment， CAP patients across the province are screened in accordance with CAP diagnostic criteria to build a high-quality disease-specific cohort. Lastly， in terms of protocol design， the characteristics of TCM research and the CAP disease profile are considered to determine appropriate inclusion and exclusion criteria， estimate sample size， define interventions， outcomes and economic evaluations， providing a reference for real-world TCM research on CAP.

This paper introduces a real-world cohort research model for community-acquired pneumonia （CAP） based on the Jiangsu Traditional Chinese Medicine （TCM） Dominant Diseases Diagnosis and Treatment Data Platform. Firstly， data cleaning is performed by standardizing diagnosis， symptoms， treatment and imaging， intelligently extracting unstructured information， and cleaning and constructing a standardized database. Secondly， for cohort establishment， CAP patients across the province are screened in accordance with CAP diagnostic criteria to build a high-quality disease-specific cohort. Lastly， in terms of protocol design， the characteristics of TCM research and the CAP disease profile are considered to determine appropriate inclusion and exclusion criteria， estimate sample size， define interventions， outcomes and economic evaluations， providing a reference for real-world TCM research on CAP.

Objective:To analyze research trends, hotspots, and international collaboration in temporomandibular disorders (TMD) from 2010 to 2024 using bibliometric methods.Methods:A total of 4 368 articles published between January 2010 to December 2024 were retrieved from PubMed using the search strategy temporomandibular disorders[MeSH Terms] OR temporomandibular joint disorders[Title/Abstract]. The R package"bibliometrix" was employed to analyze publication statistics, author collaboration networks, and keyword co-occurrence.Results:The annual publication volume in the TMD field increased 3.4-fold from 2010 to 2024, with an average annual output of 291.2 articles. MANFREDINI DANIELE was identified as the most prolific author (74 articles). The Journal of Oral Rehabilitation ranked first in terms of publication quantity (454 articles). The University of S?o Paulo (Brazil) emerged as the leading contributor, followed by Sichuan University (China) globally. Research hotspots predominantly focused on the DC/TMD diagnostic criteria and pain mechanisms. Analysis of international collaboration networks revealed that core authors (e.g., Lobbezoo F, Manfredini D) have driven advancements in the field through multidisciplinary collaboration (dentistry+psychology+medical imaging). The high-frequency occurrence of the imaging keyword "magnetic resonance imaging (MRI)" underscores its pivotal role in diagnosing disc displacement. Chinese institutions (Sichuan University, Peking University) ranked second globally in research output; however, interdisciplinary international collaboration remained limited, with multiple-country publications (MCP) accounting for only 13.0%. Conclusions:TMD research demonstrates interdisciplinary integration, highlighting the need for future emphasis on Asian population studies and innovative diagnostic/therapeutic technologies.

Objective:To explore the degree of change in anteversion angle and related risk factors after intramedullary nail fixation of intertrochanteric femur fracture in the elderly.Methods:The data of 256 elderly patients who underwent intramedullary nail fixation for intertrochanteric fractures of the femur at Tianjin Hospital of Tianjin University from March 2020 to March 2023 were selected, including 114 males and 142 females, with an age of 75.40±10.69 years (range, 65-94 years). The degree of change in the anteversion angle of the affected hip before and after the surgery was measured by CT scan of the hip, the Receiver Operating Characteristic Curve (ROC) was plotted, the area under the ROC curve was analyzed, and the optimal degree of grouping was determined by calculating the Youden Index, then all the patients were divided into two groups. The correlation between various risk factors (age, sex, type of internal fixation, fracture AO type, quality of reduction, fracture medial cortical defect or not, cusp distance) and the change of anterior tilt angle was screened by univariate and multivariate logistic regression analyses.Results:All 256 patients were followed up for 20.7±2.1 months (range, 18-23 months). Anteversion on the healthy side was 12.68°±5.10° (range, 5°-28°); postoperative anteversion on the affected side was 15.04°±7.67° (range, 9°-36°). By comparing the difference in the anterior tilt angle between the affected side and the healthy side, it was found that the anterior tilt angle of 67 patients was completely restored to the healthy side level after the operation. The anteversion angle was enlarged in 131 cases, of which the mildly increased angle (1°-9°) was found in 106 cases, moderately increased (10°-15°) was found in 17 cases, and significantly increased (>15°) was found in 8 cases; 58 patients showed anteversion angle reduction, of which 45 cases were mildly reduced (1°-9°), 13 cases were moderately reduced (10°-14°). The area under the ROC curve for the patient's anteversion angle and its 95% CI were 0.714(0.559, 0.867), and the maximum value of its Youden Index was 0.221, which corresponded to the optimal critical angle of 4°. There was no statistically significant difference in age, gender, reduction quality or fracture AO classification between the group with an anteversion angle>4° and the group with an anteversion angle≤4° ( P>0.05). The types of internal fixation, medial cortical defect and insufficient tip apex distance (TAD) were included in the binary variable logistic regression analysis. The results showed that single-nail internal fixation [ OR=0.412, 95% CI(0.244, 0.695), P=0.007], medial cortical defect [ OR=0.471, 95% CI(0.279, 0.793), P=0.009] and TAD>25 mm [ OR=0.367, 95% CI(0.207, 0.651), P=0.003] are independent risk factors for changes in anteversion angle after intramedullary nail fixation of intertrochanteric femur fractures in elderly. Conclusion:Single-nail internal fixation, medial cortical defect and TAD >25 mm are independent risk factors for the change of anteversion angle after intramedullary nail internal fixation of intertrochanteric fractures in the elderly.

Successful embryo implantation requires high-quality embryos and endometrium with high receptivity. However, there is no universally recognized authoritative technique for evaluating endometrial receptivity (ER) at present. In recent years, the application of artificial intelligence (AI) technology in the assessment of ER has achieved remarkable progress. In ultrasound image analysis, AI has improved the accuracy of endometrial segmentation and measurement through deep learning technology, and can combine clinical data for pregnancy outcome prediction. In histological analysis, AI algorithms can quickly and accurately identify histological features of the endometrium and analyze the ratio of epithelial and stromal cells. In genomic diagnosis, AI analyzes endometrial gene expression through machine learning methods to provide scientific basis for personalized embryo transfer. Although AI shows great potential in the assessment of ER, its application still faces challenges such as data standardization and algorithm generalization ability. In the future, through multi-center data sharing and algorithm optimization, AI is expected to play a greater role in assisted reproductive technology. This article reviews the application of AI in ER assessment, summarizes the latest research progress, and provides references for further research.

Objective:To explore the degree of change in anteversion angle and related risk factors after intramedullary nail fixation of intertrochanteric femur fracture in the elderly.Methods:The data of 256 elderly patients who underwent intramedullary nail fixation for intertrochanteric fractures of the femur at Tianjin Hospital of Tianjin University from March 2020 to March 2023 were selected, including 114 males and 142 females, with an age of 75.40±10.69 years (range, 65-94 years). The degree of change in the anteversion angle of the affected hip before and after the surgery was measured by CT scan of the hip, the Receiver Operating Characteristic Curve (ROC) was plotted, the area under the ROC curve was analyzed, and the optimal degree of grouping was determined by calculating the Youden Index, then all the patients were divided into two groups. The correlation between various risk factors (age, sex, type of internal fixation, fracture AO type, quality of reduction, fracture medial cortical defect or not, cusp distance) and the change of anterior tilt angle was screened by univariate and multivariate logistic regression analyses.Results:All 256 patients were followed up for 20.7±2.1 months (range, 18-23 months). Anteversion on the healthy side was 12.68°±5.10° (range, 5°-28°); postoperative anteversion on the affected side was 15.04°±7.67° (range, 9°-36°). By comparing the difference in the anterior tilt angle between the affected side and the healthy side, it was found that the anterior tilt angle of 67 patients was completely restored to the healthy side level after the operation. The anteversion angle was enlarged in 131 cases, of which the mildly increased angle (1°-9°) was found in 106 cases, moderately increased (10°-15°) was found in 17 cases, and significantly increased (>15°) was found in 8 cases; 58 patients showed anteversion angle reduction, of which 45 cases were mildly reduced (1°-9°), 13 cases were moderately reduced (10°-14°). The area under the ROC curve for the patient's anteversion angle and its 95% CI were 0.714(0.559, 0.867), and the maximum value of its Youden Index was 0.221, which corresponded to the optimal critical angle of 4°. There was no statistically significant difference in age, gender, reduction quality or fracture AO classification between the group with an anteversion angle>4° and the group with an anteversion angle≤4° ( P>0.05). The types of internal fixation, medial cortical defect and insufficient tip apex distance (TAD) were included in the binary variable logistic regression analysis. The results showed that single-nail internal fixation [ OR=0.412, 95% CI(0.244, 0.695), P=0.007], medial cortical defect [ OR=0.471, 95% CI(0.279, 0.793), P=0.009] and TAD>25 mm [ OR=0.367, 95% CI(0.207, 0.651), P=0.003] are independent risk factors for changes in anteversion angle after intramedullary nail fixation of intertrochanteric femur fractures in elderly. Conclusion:Single-nail internal fixation, medial cortical defect and TAD >25 mm are independent risk factors for the change of anteversion angle after intramedullary nail internal fixation of intertrochanteric fractures in the elderly.

Objective To develop a Treatment Burden Scale for patients with chronic heart failure(CHF)and evaluate its reliability and validity,aiming to provide an effective tool for assessing treatment burden levels in this population.Methods According to Cumulative Complexity Model,the study was conducted in 2 phases.A preliminary item pool was established through literature review and semi-structured interviews,from August 2022 to March 2023,followed by expert consultation to finalize the initial scale.A convenience sample of CHF patients from 4 tertiary A hospitals in Hunan and Hubei provinces was conducted to refine scale items and assess psychometric properties,from June 2023 to April 2024.Results The final scale contained 26 items.Exploratory factor analysis revealed 6 domains,including family financial support burden,healthcare utilization burden,the challenges patients face in acquiring knowledge about proper medication use and water/sodium dietary management,the behavioral burden associated with tracking daily water/sodium intake and symptom patterns,psychological burden,and medication management burden,cumulatively explaining 68.661％of variance.Confirmatory factor analysis demonstrated satisfactory model fit;the x2/df was 2.076;the root mean square error of approximation was 0.070;the normed fit index was 0.912;the content validity score was 0.974.The total Cronbach's α coefficient of the scale was 0.903;the split-half reliability was 0.785;the test-retest reliability was 0.936.Conclusion The Treatment Burden Scale for CHF patients developed in this study has good reliability and validity psychometric properties,and it can be used to evaluate treatment burden levels and influencing factors in clinical practice.

This study investigated the expression of the soluble nontoxic mutant CRM197 of diphtheria toxin,to prepare a safe and effective recombinant CRM197 protein.Codon-optimized CRM197 gene sequences were cloned into the pCold Ⅱ and pET-28a(+)prokaryotic expression vectors.The successfully cloned recombinant plasmids were screened and transformed into Escherichia coli BL21(DE3)competent cells.After induction of expression,the protein expression type was determined through SDS-PAGE analysis.The conditions for expression of the solublerecombinant protein were then optimized.The recombinant CRM197 protein was purified through two rounds of Ni-NTA affinity chromatography.The purified protein was used to immunize mice,and antibody levels in the se-rum were measured with ELISA.The codon adaptation index(CAI)of the optimized sequence increased from 0.72 to 0.93.The recom-binant plasmids pET-28a(+)-CRM197 and pCold Ⅱ-CRM197 were successfully constructed,as confirmed through colony PCR and double digestion.Expression analysis revealed that pET-28a(+)-CRM197 was expressed primarily as inclusion bodies,whereas pColdⅡ-CRM197 was expressed predominantly in soluble form.The conditions for soluble protein expression via pCold Ⅱ-CRM197 were optimized.When the inoculum was 3%and the IPTG concentration was 0.4 mmol/L,induction at 20 ℃ for 24 h significantly increased the expression of the soluble target protein.The pCold Ⅱ-CRM197 recombinant protein was purified from the supernatant with Ni-NTA affinity chromatography,thus resulting in a target protein with a purity greater than 98%.ELISA after three rounds of immuniza-tion indicated that the levels of IgG,IgM,IgG1,and IgG2a antibodies in the serum in immunized mice were significantly higher than those in the control group.In summary,the CRM197 recombinant protein was successfully prepared with the pCold Ⅱvector and exhib-ited high soluble expression,high purity,and favorable immunogenicity.

Successful embryo implantation requires high-quality embryos and endometrium with high receptivity. However, there is no universally recognized authoritative technique for evaluating endometrial receptivity (ER) at present. In recent years, the application of artificial intelligence (AI) technology in the assessment of ER has achieved remarkable progress. In ultrasound image analysis, AI has improved the accuracy of endometrial segmentation and measurement through deep learning technology, and can combine clinical data for pregnancy outcome prediction. In histological analysis, AI algorithms can quickly and accurately identify histological features of the endometrium and analyze the ratio of epithelial and stromal cells. In genomic diagnosis, AI analyzes endometrial gene expression through machine learning methods to provide scientific basis for personalized embryo transfer. Although AI shows great potential in the assessment of ER, its application still faces challenges such as data standardization and algorithm generalization ability. In the future, through multi-center data sharing and algorithm optimization, AI is expected to play a greater role in assisted reproductive technology. This article reviews the application of AI in ER assessment, summarizes the latest research progress, and provides references for further research.