Nanozymes are a distinct category of nanomaterials that exhibit catalytic properties resembling those of enzymes such as peroxidase (POD), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx). Nanozymes derived from Chinese herbal medicines exhibit the catalytic functions of their enzyme mimics, while retaining the specific medicinal properties of the herb (termed "herbzymes"). These nanozymes can be categorized into three main groups based on their method of synthesis: herb carbon dot nanozymes, polyphenol-metal nanozymes, and herb extract nanozymes. The reported catalytic activities of herbzymes include POD, SOD, CAT, and GPx. This review presents an overview of the catalytic activities and potential applications of nanozymes, introduces the novel concept of herbzymes, provides a comprehensive review of their classification and synthesis, and discusses recent advances in their biomedical applications. Furthermore, we also discuss the significance of research into herbzymes, including the primary challenges faced and future development directions.
Nanostructures/chemistry* ; Humans ; Herbal Medicine/methods* ; Superoxide Dismutase/chemistry* ; Catalase/chemistry* ; Drugs, Chinese Herbal/chemistry* ; Catalysis ; Glutathione Peroxidase/chemistry*

Sonodynamic therapy (SDT) can potentially induce immunogenic cell death in tumor cells, leading to the release of ATP, and facilitating the initiation of an immune response. Nevertheless, the enzymes CD39 and CD73 can swiftly convert ATP into immunosuppressive adenosine (ADO), resulting in an immunosuppressive tumor microenvironment (TME). This study introduced a nanomedicine (QD/POM1@NP@M) engineered to reprogram TME by modulating the CD39/CD73/ADO pathway. The nanomedicine encapsulated sonosensitizers silver sulfide quantum dots, and the CD39 inhibitor POM1, while also incorporating homologous tumor cell membranes to enhance targeting capabilities. This integrated approach, on the one hand, stimulates the release of ATP via SDT, thereby initiating the immune response. In addition, it reduced the accumulation of ADO by inhibiting CD39 activity, which ameliorated the immunosuppressive TME. Upon administration, the nanomedicine demonstrated substantial anti-tumor efficacy by facilitating the infiltration of anti-tumor immune cells, while reducing the immunosuppressive cells. This modulation effectively transformed the TME from an immunologically "cold" state to a "hot" state. Furthermore, combined with the checkpoint inhibitor α-PDL1, the nanomedicine augmented systemic anti-tumor immunity and promoted the establishment of long-term immune memory. This study provides an innovative strategy for combining non-invasive SDT and ATP-driven immunotherapy, offering new ideas for future cancer treatment.

Background::Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography (ERCP), the benefits and safety of high-carbohydrate fluid diet (CFD) intake 2 h before ERCP remain unclear. This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’ recovery.Methods::This prospective, multicenter, randomized controlled trial involved 15 tertiary ERCP centers. A total of 1330 patients were randomized into CFD group ( n = 665) and fasting group ( n = 665). The CFD group received 400 mL of maltodextrin orally 2 h before ERCP, while the control group abstained from food/water overnight (>6 h) before ERCP. All ERCP procedures were performed using deep sedation with intravenous propofol. The investigators were blinded but not the patients. The primary outcomes included postoperative fatigue and abdominal pain score, and the secondary outcomes included complications and changes in metabolic indicators. The outcomes were analyzed according to a modified intention-to-treat principle. Results::The post-ERCP fatigue scores were significantly lower at 4 h (4.1 ± 2.6 vs. 4.8 ± 2.8, t = 4.23, P <0.001) and 20 h (2.4 ± 2.1 vs. 3.4 ± 2.4, t= 7.94, P <0.001) in the CFD group, with least-squares mean differences of 0.48 (95% confidence interval [CI]: 0.26–0.71, P <0.001) and 0.76 (95% CI: 0.57–0.95, P <0.001), respectively. The 4-h pain scores (2.1 ± 1.7 vs. 2.2 ± 1.7, t = 2.60, P = 0.009, with a least-squares mean difference of 0.21 [95% CI: 0.05–0.37]) and positive urine ketone levels (7.7% [39/509] vs. 15.4% [82/533], χ2 = 15.13, P <0.001) were lower in the CFD group. The CFD group had significantly less cholangitis (2.1% [13/634] vs. 4.0% [26/658], χ2 = 3.99, P = 0.046) but not pancreatitis (5.5% [35/634] vs. 6.5% [43/658], χ2 = 0.59, P = 0.444). Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla (odds ratio [OR]: 0.61, 95% CI: 0.39–0.95, P = 0.028) in the multivariable models. Conclusion::Ingesting 400 mL of CFD 2 h before ERCP is safe, with a reduction in post-ERCP fatigue, abdominal pain, and cholangitis during recovery.Trail Registration::ClinicalTrials.gov, No. NCT03075280.

To promote the development of extracellular vesicles of herbal medicine especially the establishment of standardization, led by the National Expert Committee on Research and Application of Chinese Herbal Vesicles, research experts in the field of herbal medicine and extracellular vesicles were invited nationwide with the support of the Expert Committee on Research and Application of Chinese Herbal Vesicles, Professional Committee on Extracellular Vesicle Research and Application, Chinese Society of Research Hospitals and the Guangdong Engineering Research Center of Chinese Herbal Vesicles. Based on the collation of relevant literature, we have adopted the Delphi method, the consensus meeting method combined with the nominal group method to form a discussion draft of "Consensus statement on research and application of Chinese herbal medicine derived extracellular vesicles-like particles (2023)". The first draft was discussed in online and offline meetings on October 12, 14, November 2, 2022 and April and May 2023 on the current status of research, nomenclature, isolation methods, quality standards and research applications of extracellular vesicles of Chinese herbal medicines, and 13 consensus opinions were finally formed. At the Third Academic Conference on Research and Application of Chinese Herbal Vesicles, held on May 26, 2023, Kewei Zhao, convenor of the consensus, presented and read the consensus to the experts of the Expert Committee on Research and Application of Chinese Herbal Vesicles. The consensus highlights the characteristics and advantages of Chinese medicine, inherits the essence, and keeps the righteousness and innovation, aiming to provide a reference for colleagues engaged in research and application of Chinese herbal vesicles at home and abroad, decode the mystery behind Chinese herbal vesicles together, establish a safe, effective and controllable accurate Chinese herbal vesicle prevention and treatment system, and build a bridge for Chinese medicine to the world.

Objective To investigate the mechanism of astragaloside Ⅰ,the active constituent of milkvetch root,in inhibiting podocyte injury and improving diabetic kidney disease.Methods According to the body weight,60 male db/db mice were randomly divided into the model group,astragaloside Ⅰ low-dose group(10 mg/kg),astragaloside Ⅰ medium-dose group(20 mg/kg),astragaloside Ⅰ high-dose group(40 mg/kg),and valsartan group(10mg/kg),with 12 mice per group.Twelve db/db littermate control db/m mice were used as the control group.The drug was administered by gavage for 8 weeks.Transmission electron microscope was used to observe the ultrastructure of the kidney;immunohistochemistry and Western blotting were used to detect the expression of nephrotic protein(nephrin),a marker of renal podocytes;enzyme-linked immunosorbent assay was used to detect the contents of interleukin-1β(IL-1β)and interleukin-18(IL-18)in the serum of mice;Western blotting was used to detect the protein expressions of NOD-like receptor thermoprotein domain-related protein 3(NLRP3),cysteinyl aspartate specific proteinase 1(Caspase-1),and Gasdermin D(GSDMD)in kidney tissue.Results Compared with the control group,the glomeruli of the model group showed obvious podocyte loss and foot process fusion;the protein expression of nephrin was decreased(P＜0.05);the contents of IL-1 β and IL-18 in serum were increased(P＜0.05);the protein expressions of NLRP3,Cleaved-Caspase-1,and GSDMD-N were increased(P＜0.05).Compared with the model group,the renal pathological damage in the astragaloside Ⅰ administration groups were alleviated;the protein expression of nephrin was increased(P＜0.05);the contents of IL-1β and IL-18 in serum were decreased(P＜0.05);the protein expressions of NLRP3,Cleaved-Caspase-1,and GSDMD-N were decreased(P＜0.05).Conclusion Astragaloside Ⅰ may play a role in intervening diabetic kidney disease by inhibiting pyroptosis and improving podocyte injury.

Nanomedicine is an interdisciplinary area that utilizes nanoscience and technology in the realm of medicine. Rapid advances in science and technology have propelled the medical sector into a new era. The most commonly used nanotechnology in the field of medicine is nanoparticles. Due to their unique physicochemical properties, nanoparticles offer significant benefits of precision medicine for diseases such as inflammatory bowel disease that cannot be effectively treated by existing approaches. Nanomedicine has emerged as a highly active research field, with extensive scientific and technological studies being carried out, as well as growing international competition in the commercialization of this field. The accumulation of expertise in the key technologies relating to nanomedicine would provide strategic advantages in the development of cutting-edge medical techniques. This review presented a comprehensive analysis of the primary uses of nanoparticles in medicine, including recent advances in their application for the diagnosis and treatment of inflammatory bowel disease. Furthermore, we discussed the challenges and possibilities associated with the application of nanoparticles in clinical settings.
Inflammatory Bowel Diseases/diagnosis* ; Humans ; Precision Medicine/methods* ; Nanomedicine/methods* ; Nanoparticles/therapeutic use*

ObjectiveTo ascertain the causes of a food poisoning incident and provide references for the prevention of similar incidents in the future. MethodsCase investigation was conducted through field epidemiological investigation methods， and suspicious meals and foods were searched by the analytical epidemiological method. A food hygiene investigation was conducted in the establishment involved and samples of suspicious food， processing steps， and cases were collected for laboratory testing. ResultsA total of 91 individuals meeting the case definition were identified， resulting in an attack rate of 14.97% （91/608）. The main clinical manifestations included abdominal pain （97.80%）， diarrhea （84.62%）， nausea （62.64%）， vomiting （72.53%）， fever （12.09%）， and increased white blood cells （90.11%）. The peak incidence occurred from 16：00 to 18：00 on June 15. The epidemic curve showed a point-source exposure pattern， with an incubation period of 1 h minimum and 10 h maximum， and an average of 5 h. Analytical epidemiological studies indicated that lunch on June 15 was the suspicious meal （χ²=38.78， P<0.001）， and those who consumed cold-dressed tofu with preserved eggs had a significantly higher risk of falling ill compared to non-consumers （χ²=105.21， P<0.001）. Laboratory testing results revealed Vibrio parahaemolyticus detected in 1 employee’s anal swab and 18 cases’ anal swabs. Staphylococcus aureus was detected in 1 food ingredient and 1 case’s anal swab. The remaining samples tested negative. ConclusionThe cause of this food poisoning incident is Vibrio parahaemolyticus. The cause is the canteen’s supply of cold-dressed tofu with preserved eggs beyond its permissible business scope， potentially leading to cross-contamination during food processing. Regulatory authorities should strengthen routine law enforcement inspections and monitoring. Food service establishments should strengthen food safety awareness， standardize operational procedures in strict accordance with relevant national laws and regulations and food safety standards， and strive to reduce the occurrence of foodborne disease incidents at their source.

Objective:To explore the effectiveness of clinical pathway (CP) and team-based learning (TBL) teaching method in standardized residency training of gynecology.Methods:The research included 40 residents as objects who took standardized training in gynecological rotation in Luohe Central Hospital from July 2017 to July 2019, and they were randomized into experimental group and control group. The combination of CP and TBL teaching method was used in the experimental group ( n=20), while the traditional teaching method was applied in the control group ( n=20). All residents were tested for the professional theory and clinical skill after training. After the training, a survey about the teaching satisfaction and the effectiveness of teaching methods was conducted for both groups. Statistical analysis was performed by SPSS 23.0 software. Results:The average scores of professional theory and clinical practice skills in the experimental group were (85.55±5.96) points and (89.90±6.40) points respectively, which were better than the average scores of the control group [(76.36±6.68) points and (75.50±4.81) points, respectively], and there were significant differences between two groups ( P<0.05). The results of the questionnaire survey showed that the experimental group residents had a higher degree of satisfaction and a higher evaluation of the teaching method than the control group. Conclusion:CP and TBL teaching is beneficial to improve the quality of standardized residency training of gynecology, and it is suggested to make wide popularization and application in the training.

Objective:To investigate the correlation between serum uric acid levels and thyroid hormones in hospitalized elderly gout patients.Methods:A total of 646 hospitalized gout patients, including 616 males and 30 females, aged(68.8±5.1)years, who were hospitalized at the Department of Gout, Chu Hsien-I Memorial Hospital from April 2014 to December 2019, were retrospectively analyzed.Clinical information was collected and relevant biochemical tests were conducted.Serum uric acid (SUA)levels were divided into quartiles and their associations with thyroid hormone levels were analyzed.Results:With the increase of SUA, body mass index, the prevalence of obesity, the prevalence of dyslipidemia, and the prevalence of fatty liver, the number of involved joints, cholesterol, low-density lipoprotein cholesterol, triacylglycerol, and homeostasis model assessment trended upward significantly( P<0.05); FUA showed a downward trend( F=9.42, P>0.05). The prevalence of subclinical hypothyroidism in older patients was 11.3%(73 cases). With the increase of SUA, the prevalence of subclinical hypothyroidism and free triiodothyronine levels showed an upward trend, whereas free thyroxine levels showed a downward trend( P<0.01). Conclusions:In elderly gout patients, the prevalence of subclinical hypothyroidism increases with SUA levels.Hyperuricemia and multiple metabolic disorders are independent risk factors for subclinical hypothyroidism in these patients.

Objective : To observe the dynamic changes of reactive oxygen species ( ROS) ，isocitrate dehydrogen- ase 2 (IDH2) and sirtuin 3 (SIRT3) in patients with acute myeloid leukemia (AML) before and after chemothera- py，and to explore the differences of ROS，IDH2 and SIRT3 levels in different AML patients and their application value in clinical diagnosis and efficacy evaluation． Methods : Bone marrow and peripheral blood samples were taken from 20 newly diagnosed AML ( non-APL) patients who had not received chemotherapy ( new diagnosis group) ; bone marrow and peripheral blood samples were taken from 40 AML (non-APL) patients who had received chemotherapy (by Treatment group) ; 20 normal human bone marrow and peripheral blood samples were taken as control (control group) ．The expression of ROS in bone marrow mononuclear cells and mitochondria of bone mar- row mononuclear cells in each group was observed under a fluorescence microscope，and the expressions of IDH2 and SIRT3 in peripheral blood of each group were determined by ELISA．The expression of AML1-ETO fusion gene in patients was summarized ，and the expression of SIRT3 in different groups was compared． The expression of SIRT3 in different treatment effects and treatment courses in the treated patients were compared. Results : The ex- pression of mitochondrial ROS in bone marrow mononuclear cells and cells in the three groups was higher in the newly diagnosed group than that in the control group (P＜0. 05) ，and lower in the treated group than that in the newly diagnosed group (P＜0. 05) ．The expression of IDH2 in peripheral blood of the three groups was higher in the newly diagnosed group than that in the control group (P＜0. 000 1) ，and lower in the treated group than that in the newly diagnosed group (P ＜0. 05 ) ．After peripheral blood samples were diluted 5 times ，the expression of SIRT3 in the newly diagnosed group was lower than that in the control group (P ＜0. 000 1 ) ; the expression of SIRT3 in the treated group was higher than that in the newly diagnosed group (P＜0. 01) ．The SIRT3 expression of fusion gene-positive patients was higher than that of fusion gene-negative patients ; the SIRT3 expression of partial remission patients was higher than that of complete remission patients ; the SIRT3 expression of patients with com- plete remission in the subgroup of previously treated patients was higher than that of patients with a longer treatment course than those with a short treatment course． Conclusion SIRT3 is an important protein that regulates metabol- ic function in the mitochondria of cells．Its expression is down-regulated in patients with acute myeloid leukemia， and the expressions of IDH2 and ROS increased accordingly．In AML，the abnormal expression of SIRT3 can accel- erate the occurrence and development of tumor and reduce the therapeutic effect.