BackgroundSchizophrenia is a complex， chronic and severe mental disorder， and the pathogenesis of which has not been fully elucidated. The abnormalities in lipid metabolism and circulating metabolomes have already been implicated in the pathophysiology of schizophrenia. However， available studies have mainly focused on a few liposomes and circulating metabolites， failing to systematically reveal the mediating role of circulating metabolomes in the causal relationship between liposomes and schizophrenia. ObjectiveTo uncover mediating role of circulating metabolomes in the causal relationship between liposomes and schizophrenia， thereby providing biomarkers and potential therapeutic targets for the prevention and treatment of schizophrenia. MethodsData from Genome-Wide Association Studies （GWAS） were analyzed， taking data on 179 liposomes as exposure variables， data on 123 circulating metabolites as intermediate variables， and data on schizophrenia as outcome variable. A two-step， two-sample Mendelian randomization analysis was conducted using the inverse-variance weighted （IVW）， MR- Egger， Weighted median， and Weighted mode methods to study the causal relationship of liposomes with schizophrenia and the mediating role of circulating metabolomes in the relationship. ResultsIVW model identified 8 lipids associated with schizophrenia without reverse causality. There were 5 circulating metabolomes strongly associated with schizophrenia. Acetate played a significant mediating role in the causal relationship between phosphatidylinositol （18：0_18：2） and schizophrenia （P=0.023， 95% CI： 0.036~0.532）， accounting for 28.4% of the causal relationship. ConclusionThis study demonstrates a causal relationship between liposomes and schizophrenia， with phosphatidylinositol being a risk factor in the progression of schizophrenia， and acetate playing a mediating role in this process. ［Fund by National Natural Science Foundation of China General Program （number， 82271546）； Shanxi Merit Funding for Overseas Students Sci-Tech Activities Project （number， 20240041）； Shanxi Province Science and Technology Innovation Leading Talent Team Project （number， 202304051001049）； Shanxi Scientific Research Foundation for the Returned Overseas Chinese Scholars （number， 2022-190）； "Six Measures for Health Care Prosperity" Specialized Research Program （number， Y2024008）］

OBJECTIVE: To observe the clinical efficacy and safety of acupuncture combined with blade needle therapy for knee osteoarthritis (KOA). METHODS: A total of 60 patients with KOA were randomly divided into an observation group and a control group, 30 cases each group. The control group received acupuncture at Neixiyan (EX-LE4)，Dubi (ST35), Yinlingquan (SP9), Liangqiu (ST34), Xuehai (SP10), Yanglingquan (GB34) and Zusanli (ST36) on the affected side, once every other day, 3 times a week. The observation group received blade needle therapy on the basis of the treatment in the control group, once every 3 days, 2 times a week. Both groups were treated for 4 weeks. Before treatment, after 2, 4 weeks of treatment, and after 1 month of treatment completion (in follow-up), the scores of pain visual analogue scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and Lequesne index were observed in the two groups, and the clinical efficacy and safety were evaluated. RESULTS: After 2, 4 weeks of treatment and in follow-up, the pain VAS scores, Lequesne index scores, and pain, stiffness, function scores of WOMAC in both groups were decreased compared with those before treatment (P<0.05), and the VAS scores, Lequesne index scores and pain, function scores of WOMAC in the observation group were lower than those in the control group (P<0.05). The effective response rate in the observation group was 76.7% (23/30), while that in the control group was 70.0% (21/30), there was no statistically significant difference in the effective response rates between the two groups (P>0.05). No adverse reactions were observed in either group. CONCLUSION Acupuncture combined with blade needle therapy could alleviate pain and promote functional recovery in KOA patients, and achieve long-lasting improvements.
Humans ; Osteoarthritis, Knee/physiopathology* ; Acupuncture Therapy/instrumentation* ; Male ; Female ; Middle Aged ; Aged ; Acupuncture Points ; Treatment Outcome ; Adult ; Needles ; Combined Modality Therapy

Accurate prediction of molecular properties is crucial for selecting compounds with ideal properties and reducing the costs and risks of trials. Traditional methods based on manually crafted features and graph-based methods have shown promising results in molecular property prediction. However, traditional methods rely on expert knowledge and often fail to capture the complex structures and interactions within molecules. Similarly, graph-based methods typically overlook the chemical structure and function hidden in molecular motifs and struggle to effectively integrate global and local molecular information. To address these limitations, we propose a novel fingerprint-enhanced hierarchical graph neural network (FH-GNN) for molecular property prediction that simultaneously learns information from hierarchical molecular graphs and fingerprints. The FH-GNN captures diverse hierarchical chemical information by applying directed message-passing neural networks (D-MPNN) on a hierarchical molecular graph that integrates atomic-level, motif-level, and graph-level information along with their relationships. Additionally, we used an adaptive attention mechanism to balance the importance of hierarchical graphs and fingerprint features, creating a comprehensive molecular embedding that integrated hierarchical molecular structures with domain knowledge. Experiments on eight benchmark datasets from MoleculeNet showed that FH-GNN outperformed the baseline models in both classification and regression tasks for molecular property prediction, validating its capability to comprehensively capture molecular information. By integrating molecular structure and chemical knowledge, FH-GNN provides a powerful tool for the accurate prediction of molecular properties and aids in the discovery of potential drug candidates.

Under the"New Medicine"context,how to integrate medical engineering technology into modern teaching methods has become a key approach to enhancing the quality and efficiency of medical education.This paper aims to advance medical education and teaching reforms,promote the comprehensive improvement in the quality of higher education,and focus on enhancing the quality of medical talent cultivation.For this purpose,the authors proposed an innovative intelligent classroom teaching model,based on artificial intelligence technology.This model utilized advanced camera technology to capture students'facial expressions in real-time,combining artificial intelligence algorithms to analyze students'understanding of medical concepts,and assisted teachers in adjusting classroom teaching strategies in real-time to improve learning effectiveness.This approach has significantly enhanced the overall quality and efficiency of medical education and is of great significance for cultivating versatile medical professionals with high levels of expertise and practical skills.

Objective To analyze the risk factors for hyperuricemia in patients with primary IgA nephropathy(IgAN).Methods A total of 186 patients with primary IgAN admitted to the Department of Nephrology of the First Affiliated Hospital of Xinjiang Medical University from March 2018 to February 2021 were selected as the research subjects.The patients were divided into the IgAN group(n=104)and IgAN with hyperuricemia group(n=82)according to the blood uric acid(UA)level.The clinical data of patients in the two groups were compared.Univariate and multivariate logistic regression were used to analyze the risk factors of IgAN with hyperuricemia,and Pearson correlation was used to analyze the relationship between blood UA levels and clinical indicators in patients with primary IgAN.Results The results of univariate analysis showed that there was no significant difference in gender,age,body mass index(BMI),blood albumin,plasma total protein,high-density lipoprotein,serum IgA,serum complement C3,and serum complement C4 between the two groups(P＞0.05).The systolic blood pressure(SBP),diastolic blood pressure(DBP),low-density lipoprotein,serum creatinine,total cholesterol,triglycerides,blood urea nitrogen,24-hour urine protein quantification,and blood UA level of patients in the IgAN with hyperuricemia group were significantly higher than those in the IgAN group,while hemoglobin and estimated glomerular filtration rate(eGFR)were significantly lower than those in the IgAN group(P＜0.05).Pearson correlation analysis showed that there was no significant association between primary IgAN with hyperuricemia and age,BMI,blood albumin,plasma total protein,high-density lipoprotein,serum IgA,and serum complement C3(r=-0.020,-0.067,-0.064,-0.037,-0.103,0.008,0.042,P＞0.05);primary IgAN with hyperuricemia was positively correlated with SBP,low-density lipoprotein,DBP,serum creatinine,total cholesterol,triglycerides,blood urea nitrogen,and 24-hour urine protein quantification(r=0.392,0.296,0.552,0.713,0.452,0.787,0.599,0.655,P＜0.05),and was negatively correlated with hemoglobin level,serum complement C4 level,and eGFR(r=-0228,-0663,-0516,P＜0.05).Multivariate logistic regression analysis showed that high SBP,DBP,triglyceride level,and blood UA level were independent risk factors for hyperuricemia in IgAN patients(P＜0.05).Conclusion High SBP,DBP,triglyceride level,and blood UA level are independent risk factors for hyperuricemia in patients with primary IgAN.

Over-expression of glutathione S-transferase(GST)can promote Cisplatin resistance in hepatocellular carcinoma(HCC)treatment.Hence,inhibiting GST is an attractive strategy to improve Cisplatin sensi-tivity in HCC therapy.Although several synthesized GST inhibitors have been developed,the side effects and narrow spectrum for anticancer seriously limit their clinical application.Considering the abundance of natural compounds with anticancer activity,this study developed a rapid fluorescence technique to screen"green"natural GST inhibitors with high specificity.The fluorescence assay demonstrated that schisanlactone B(hereafter abbreviated as C1)isolated from Xue tong significantly down-regulated GST levels in Cisplatin-resistant HCC cells in vitro and in vivo.Importantly,C1 can selectively kill HCC cells from normal liver cells,effectively improving the therapeutic effect of Cisplatin on HCC mice by down-regulating GST expression.Considering the high GST levels in HCC patients,this compound demon-strated the high potential for sensitizing HCC therapy in clinical practice by down-regulating GST levels.

Lung cancer is the most common cancer in China and even in the world, and it is also the main cause of cancer death. Patients with anaplastic lymphoma kinase (ALK) gene alterations have the opportunity to receive molecularly targeted therapies. The inhibitors of anaplastic lymphoma kinase, such as ALK-tyrosine kinase inhibitors (ALK-TKIs) significantly prolong the survival of patients. ALK gene variant types include point mutation, amplification, fusion/rearrangement, and ALK fusion is more common than other types. However, the effect of different types of gene changes in molecular targeted therapy is different. Therefore, this paper introduced the relevant contents of different variants of ALK gene, focused on the research progress of targeted therapy, and proposed the future development direction.
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Humans ; Lung Neoplasms/pathology* ; Anaplastic Lymphoma Kinase ; Molecular Targeted Therapy ; Receptor Protein-Tyrosine Kinases/antagonists & inhibitors* ; Protein Kinase Inhibitors/therapeutic use*

OBJECTIVE To comprehensively screen the optimal steaming time of salt-steaming Morinda officinalis （SSMO） based on Q-markers and anti-oxidative activities， and to establish characteristic quality standard of the decoction pieces. METHODS The contents of six Q-markers （1-kestose， nystose， 1F-fructofuranosylnystose， inulotriose， inulotetraose and inulopentaose） in SSMO at different steaming time were determined by HPLC-ELSD method simultaneously. The activity of sample extracts to scavenge 4 kinds of oxidative free radical and their iron reduction abilities were determined by visible UV spectrophotometer. The optimal steaming time of SSMO was screened by gray relevance degree and entropy weight technique for order preference by similarity to an ideal solution （TOPSIS）-fusion model method. The contents of six Q-markers in 10 batches of SSMO prepared at the optimal steaming time were determined. HPLC-ELSD fingerprints of SSMO decoction pieces were established. RESULTS The results showed that the contents of six Q-markers were the highest when SSMO was steamed for 3-5 h； and the ability of scavenging DPPH·， ABTS·， PTIO·， ·OH and iron reduction ability was the best at 5 h. There were 20 common peaks in the fingerprints for 10 batches of samples， and the similarities were higher than 0.990. A total of 9 chromatographic peaks were identified， which were D-fructose （peak 1）， D（+）-glucose （peak 2）， sucrose （peak 3）， 1-kestose （peak 4）， nystose （peak 5）， 1F-fructofuranosylnystose （peak 6）， inulotriose （peak X2）， inulotetraose （peak X3） and inulopentaose （peak X4）. Average contents of six Q-markers were 4.17%， 5.54%， 6.60%， 2.89%， 2.62% and 2.13%， respectively. CONCLUSIONS The optimal steaming time of SSMO is 5 h； the contents of six Q-markers are primarily determined on the basis of dry product， which are no less than 3.03%， 4.11%， 4.87%， 2.15%， 1.96% and 1.58%， respectively. The ratio of Inulin-/Inulo oligosaccharides content is no more than 2.5.

ObjectiveTo systematically evaluate the effect of action observation therapy (AOT) on upper limb function in children with cerebral palsy. MethodsRelevant literatures about the effect of AOT on upper limb function in children with cerebral palsy were retrieved from the databases of PubMed, Embase, Cochrane Library, Web of Science and CNKI, from the establishment to July 9, 2022. ResultsEleven articles involving 497 patients were included, which were mainly published in the past ten years. The studies included hospital-based studies with therapist supervision and home-based studies without therapist supervision, mainly related to the improvement of upper limb function of AOT in children with cerebral palsy. Experimental group performed actions related to activities of daily living, while control group mainly watched video clips excluding actions, 15 to 120 minutes a time, three to five times a week, with most of the intervention periods of three to four weeks. AOT improved the upper limb function of children with cerebral palsy in terms of body structure and function, and activity and participation, specifically grip strength, muscle tension, and hand dexterity and function. ConclusionHospital-based AOT with therapist supervision can improve upper limb function in children with cerebral palsy, while the effect of home-based AOT without therapist supervision and the long-term effect of AOT need to be further studied.

Clouston syndrome (OMIM #129500), also known as hidrotic ectodermal dysplasia type 2, is a rare autosomal dominant skin disorder. To date, four mutations in the GJB6 gene, G11R, V37E, A88V, and D50N, have been confirmed to cause this condition. In previous studies, the focus has been mainly on gene sequencing, and there has been a lack of research on clinical manifestations and pathogenesis. To confirm the diagnosis of this pedigree at the molecular level and summarize and analyse the clinical phenotype of patients and to provide a basis for further study of the pathogenesis of the disease, we performed whole-exome and Sanger sequencing on a large Chinese Clouston syndrome pedigree. Detailed clinical examination included histopathology, hair microscopy, and scanning electron microscopy. We found a novel heterozygous missense variant (c.134G>C:p.G45A) for Clouston syndrome. We identified a new clinical phenotype involving all nail needling pain in all patients and found a special honeycomb hole structure in the patients' hair under scanning electron microscopy. Our data reveal that a novel variant (c.134G>C:p.G45A) plays a likely pathogenic role in this pedigree and highlight that genetic testing is necessary for the diagnosis of Clouston syndrome.
Humans ; Connexin 30/genetics* ; Connexins/genetics* ; East Asian People ; Ectodermal Dysplasia/pathology* ; Phenotype