OBJECTIVE To explore the influence of human cytomegalovirus(HCMV)infection on transforming growth factor β(TGF-β)/Smad signaling pathway and helper T cell(Th)1/Th2 cytokines of the patients with di-abetic retinopathy(DR)so as to provide guidance for clinical treatment of the DR patients with HCMV infection.METHODS Totally 100 DR patients complicated with HCMV infection who were treated in Xinyu People's Hospi-tal from Jan.2021 to Dec.2023 were assigned as the HCMV infection group and were divided into the non-prolif-erative DR group(NPDR group)and the proliferative DR group(the PDR group)according to the degree of path-ological change of retina.Meanwhile,100 DR patients without HCMV infection were chosen as the no HCMV in-fection group.The levels of serum TGF-β,interferon-γ(IFN-γ)and interleukin(IL)-4 as well as the relative ex-pression levels of Smad2 and Smad3 mRNA were observed.RESULTS The levels of serum TGF-β,IFN-γ and IL-4 of the HCMV infection group were respectively 1.41±0.43,(92.68±15.86)ng/L and(593.91±84.67)ng/L,higher than those of the no HCMV infection group;the relative expression levels of Smad2 mRNA and Smad3 mRNA of the HCMV infection group were respectively(1.54±0.44)and(1.68±0.50),higher than those of the no HCMV infection group(P＜0.05);the levels of the above indexes of the PDR group were higher than those of the NPDR group(P＜0.05).Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of the joint detection of TGF-β,IFN-γ,IL-4,Smad2 and Smad3 was 0.961 in prediction of HC-MV infection in the DR patients,with the sensitivity 90.70％,the specificity 85.10％.CONCLUSION The HC-MV infection may aggravate the degree of retinopathy,which may be associated with the regulation of TGF-β/Smad signaling pathways and imbalance of Th1/Th2 function.

Objective To retrospectively analyze the clinical efficacy of Xiazhu Sanjie Prescription in treating pulmonary nodules.Methods A retrospective study was conducted on 58 patients of pulmonary nodules with spleen deficiency and excessive dampness syndrome who received Xiazhu Sanjie Prescription for 3 months or more at Dongzhimen Hospital,Beijing University of Chinese Medicine,from January 2021 to September 2024 were set as the observation group.Another 58 patients of pulmonary nodules with spleen deficiency excessive dampness syndrome who did not receive TCM intervention during the same period were selected as the control group.Basic information,TCM syndromes,and the diameters of pulmonary nodules on chest HRCT at the first and last visit were collected.Changes in nodule diameter,TCM syndrome scores,and TCM syndrome efficacy were compared between the two groups.Results Compared with the control group,the nodule diameter in the observation group significantly decreased(P<0.05),and the proportion of nodule disappearance or reduction was significantly higher than the control group(P<0.05).The TCM syndrome scores for symptoms such as excessive phlegm,fatigue,loss of appetite,pale complexion,irregular bowel movements,chest tightness,shortness of breath,heaviness of the head and limbs,and abdominal distention showed significant improvement in the observation group both compared to pre-treatment and the control group(P<0.05).The total effective rate of TCM syndromes in the observation group was 93.10%(54/58),while the control group was 17.24%(10/58).The observation group was significantly better than the control group(P<0.05).Conclusion Xiazhu Sanjie Prescription can reduce the diameter of pulmonary nodules to some extent and improve TCM syndromes in patients with pulmonary nodules.

OBJECTIVE To explore the influence of human cytomegalovirus(HCMV)infection on transforming growth factor β(TGF-β)/Smad signaling pathway and helper T cell(Th)1/Th2 cytokines of the patients with di-abetic retinopathy(DR)so as to provide guidance for clinical treatment of the DR patients with HCMV infection.METHODS Totally 100 DR patients complicated with HCMV infection who were treated in Xinyu People's Hospi-tal from Jan.2021 to Dec.2023 were assigned as the HCMV infection group and were divided into the non-prolif-erative DR group(NPDR group)and the proliferative DR group(the PDR group)according to the degree of path-ological change of retina.Meanwhile,100 DR patients without HCMV infection were chosen as the no HCMV in-fection group.The levels of serum TGF-β,interferon-γ(IFN-γ)and interleukin(IL)-4 as well as the relative ex-pression levels of Smad2 and Smad3 mRNA were observed.RESULTS The levels of serum TGF-β,IFN-γ and IL-4 of the HCMV infection group were respectively 1.41±0.43,(92.68±15.86)ng/L and(593.91±84.67)ng/L,higher than those of the no HCMV infection group;the relative expression levels of Smad2 mRNA and Smad3 mRNA of the HCMV infection group were respectively(1.54±0.44)and(1.68±0.50),higher than those of the no HCMV infection group(P＜0.05);the levels of the above indexes of the PDR group were higher than those of the NPDR group(P＜0.05).Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of the joint detection of TGF-β,IFN-γ,IL-4,Smad2 and Smad3 was 0.961 in prediction of HC-MV infection in the DR patients,with the sensitivity 90.70％,the specificity 85.10％.CONCLUSION The HC-MV infection may aggravate the degree of retinopathy,which may be associated with the regulation of TGF-β/Smad signaling pathways and imbalance of Th1/Th2 function.

Objective To retrospectively analyze the clinical efficacy of Xiazhu Sanjie Prescription in treating pulmonary nodules.Methods A retrospective study was conducted on 58 patients of pulmonary nodules with spleen deficiency and excessive dampness syndrome who received Xiazhu Sanjie Prescription for 3 months or more at Dongzhimen Hospital,Beijing University of Chinese Medicine,from January 2021 to September 2024 were set as the observation group.Another 58 patients of pulmonary nodules with spleen deficiency excessive dampness syndrome who did not receive TCM intervention during the same period were selected as the control group.Basic information,TCM syndromes,and the diameters of pulmonary nodules on chest HRCT at the first and last visit were collected.Changes in nodule diameter,TCM syndrome scores,and TCM syndrome efficacy were compared between the two groups.Results Compared with the control group,the nodule diameter in the observation group significantly decreased(P<0.05),and the proportion of nodule disappearance or reduction was significantly higher than the control group(P<0.05).The TCM syndrome scores for symptoms such as excessive phlegm,fatigue,loss of appetite,pale complexion,irregular bowel movements,chest tightness,shortness of breath,heaviness of the head and limbs,and abdominal distention showed significant improvement in the observation group both compared to pre-treatment and the control group(P<0.05).The total effective rate of TCM syndromes in the observation group was 93.10%(54/58),while the control group was 17.24%(10/58).The observation group was significantly better than the control group(P<0.05).Conclusion Xiazhu Sanjie Prescription can reduce the diameter of pulmonary nodules to some extent and improve TCM syndromes in patients with pulmonary nodules.

Background and Objectives: This study aims to clarify the systems underlying regulation and regulatory roles of hydrogen combined with 5-Aza in the myogenic differentiation of adipose mesenchymal stem cells (ADSCs). Methods: and Results: In this study, ADSCs acted as an in vitro myogenic differentiating mode. First, the Alamar blue Staining and mitochondrial tracer technique were used to verify whether hydrogen combined with 5-Aza could promote cell proliferation. In addition, this study assessed myogenic differentiating markers (e.g., Myogenin, Mhc and Myod protein expressions) based on the Western blotting assay, analysis on cellular morphological characteristics (e.g., Myotube number, length, diameter and maturation index), RT-PCR (Myod, Myogenin and Mhc mRNA expression) and Immunofluorescence analysis (Desmin, Myosin and β-actin protein expression). Finally, to verify the mechanism of myogenic differentiation of hydrogen-bound 5-Aza, we performed bioinformatics analysis and Western blot to detect the expression of p-P38 protein. Hydrogen combined with 5-Aza significantly enhanced the proliferation and myogenic differentiation of ADSCs in vitro by increasing the number of single-cell mitochondria and upregulating the expression of myogenic biomarkers such as Myod, Mhc and myotube formation. The expressions of p-P38 was up-regulated by hydrogen combined with 5-Aza. The differentiating ability was suppressed when the cells were cultivated in combination with SB203580 (p38 MAPK signal pathway inhibitor). Conclusions Hydrogen alleviates the cytotoxicity of 5-Aza and synergistically promotes the myogenic differentiation capacity of adipose stem cells via the p38 MAPK pathway. Thus, the mentioned results present insights into myogenic differentiation and are likely to generate one potential alternative strategy for skeletal muscle related diseases.

Blau syndrome is a rare genetic disorder characterized by the a mix of granulomatous arthritis, uveitis, and dermatitis. Patients typically manifest multisystem involvement, including ocular, skin, and skeletal abnormalities. Blau syndrome is extremely rare, with a global incidence of less than one in a million among children. In this multidisciplinary consultation, we present a case of a 21-year-old young female patient having multisystemic involvement since early childhood. She was presented with multiple joint swelling, skin lesions, increased eye discharge, and accompanied by hypertension and arterial abnormalities, and received a diagnosis of uveitis. The patient had been receiving steroid treatment since the age of 6 and has tried various medications, with some improvement in joint swelling and ocular symptoms. Through this rare disease multidisciplinary consultation, we aim to provide guidance in the molecular diagnosis of the patient, multisystem assessment, and the selection and formulation of treatment plans. Additionally, we hope that by reporting this case, clinical physicians can gain a better understanding of the diagnosis and comprehensive treatment strategies for Blau syndrome, thereby improving the management and treatment of rare diseases.

Objective:To investigate the clinical and electrophysiological characteristics of facial onset sensory motor neuronopathy (FOSMN) syndrome.Methods:Ten patients diagnosed with FOSMN syndrome in Peking Union Medical College Hospital from January 2012 to December 2022 were included. The clinical and electrophysiological characteristics of patients were analyzed and summarized, and the genetic testing was also performed in these patients.Results:The age of onset was (56.6±6.5) years, and the longest survival duration of disease was 10 years. All patients had numbness around the face and mouth as the first symptom and abnormal blink reflex. A total of 52 sensory nerve conduction nerves were detected, among which 2 median nerves and 2 μlnar nerves showed decreased amplitude of sensory nerve action potential. Needle electromyography showed neurogenic lesions, with both progressive and chronic denervation. Whole exome sequencing identified the heterozygous variant c.272A>C in the exon 4 of the SOD1 gene resulting in the amino acid change p.Asp90Ala in 1 patient. In all patients, the disease progressed relentlessly and eventually led to involvement of respiratory muscle. Conclusion:FOSMN syndrome is characterized by abnormal blink reflex and sometimes abnormal sensory nerve conduction may be shown on electrophysiologic testing.

We presented an adolescent with recurrent intracranial hemorrhage and skin lesion. The diagnosis was unclear and the treatment was difficult. Through a multidisciplinary effort type Ⅰ interferon disease was suspected and later, an interferon-stimulated gene was further detected. Considering the high morbidity and fatality rate of recurrent intracranial hemorrhage, tofacitinib and hydroxychloroquine were administered. After treatment, the livedo reticularis was significantly regressed. Unfortunately, the intracranial hemorrhage recurred due to a pre-existing cerebral aneurysm, leading to death of the patient. The diagnosis and treatment of this case highlight the importance of multidisciplinary collaboration in the diagnosis and treatment of difficult and rare diseases.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

The economic evaluation compares the costs and effectiveness of different strategies for osteoporosis prevention and treatment to facilitate decision-making. In this paper, international and Chinese economic evaluation studies on osteoporosis prevention strategies were reviewed and results were summarized. We have found that the research design and quality of reporting need to be improved. Furthermore, both general and osteoporosis-specific health economic evaluation guidelines were introduced to improve the quality of economic evaluation in osteoporosis in China. Accuracy and integrity of data used in economic evaluation also should be improved.