The development of atherosclerosis （AS） is closely associated with endothelial dysfunction and mitochondrial metabolic abnormalities. These alterations are fundamentally characterized by metabolic reprogramming， in which the tricarboxylic acid （TCA） cycle serves as a central regulatory hub. Disruption of the homeostasis of TCA cycle intermediates， including succinate， α -ketoglutarate， and itaconate， contributes to AS progression through multiple mechanisms， such as the modulation of oxidative stress， inflammation， and glucose and lipid metabolic networks. Owing to their multi-target and multi-pathway regulatory properties， bioactive compounds derived from traditional Chinese medicine （TCM） have demonstrated unique advantages in correcting metabolic dysregulation. Flavonoids， glycosides， and other bioactive constituents of TCM can target key enzymes and metabolites involved in the TCA cycle， thereby restoring aberrant metabolic reprogramming， alleviating endothelial injury induced by oxidative stress， inflammation， and glucose and lipid metabolic disorders， ultimately improving metabolic homeostasis and attenuating the progression of AS.

The development of atherosclerosis （AS） is closely associated with endothelial dysfunction and mitochondrial metabolic abnormalities. These alterations are fundamentally characterized by metabolic reprogramming， in which the tricarboxylic acid （TCA） cycle serves as a central regulatory hub. Disruption of the homeostasis of TCA cycle intermediates， including succinate， α -ketoglutarate， and itaconate， contributes to AS progression through multiple mechanisms， such as the modulation of oxidative stress， inflammation， and glucose and lipid metabolic networks. Owing to their multi-target and multi-pathway regulatory properties， bioactive compounds derived from traditional Chinese medicine （TCM） have demonstrated unique advantages in correcting metabolic dysregulation. Flavonoids， glycosides， and other bioactive constituents of TCM can target key enzymes and metabolites involved in the TCA cycle， thereby restoring aberrant metabolic reprogramming， alleviating endothelial injury induced by oxidative stress， inflammation， and glucose and lipid metabolic disorders， ultimately improving metabolic homeostasis and attenuating the progression of AS.

Objective:To examine the regulatory effects of a potential antifibrotic tetrapeptide called N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP) on the expression of epidermal growth factor (EGFR) and signal transducer and activator of transcription 3 (STAT3) in lung tissues with fibrosis induced by silicosis in rats. This study aims to explore the potential therapeutic benefits of Ac-SDKP in the prevention and treatment of fibrotic lung diseases associated with silicosis.Methods:In January 2024, disease targets and Ac-SDKP active ingredients were predicted through GeneCards (https://www.genecards.org) and OMIM (https://www.omim.org) databases. Using R 4.2.1 software, we identified overlapping targets between pulmonary fibrosis and AC-SDKP. Cytoscape 3.10.2 was employed to visualize interactions between active chemical components and these targets, followed by GO enrichment analysis and KEGG pathway analysis using R 4.2.1. Forty healthy adult Wistar rats were selected to establish silicosis models through single-dose gavage with 50 mg/ml silica suspension (1. 0 ml per rat). The rats were randomly divided into four groups: model control group (4 weeks), silicosis model group (4 weeks), Ac-SDKP preventive treatment group (acquired via intraperitoneal injection of a micro-release pump containing Ac-SDKP [800 μg/ (kg·d) ] during modeling, maintained for 4 weeks), and Ac-SDKP anti-fibrosis treatment group (acquired via intraperitoneal injection of the same pump after 2 weeks of modeling, continued maintenance for 2 weeks). Each group contained 10 rats. The pathological changes in rat lung tissues were observed. Western blot technology was used to detect the protein expression levels of α-smooth muscle actin (α-SMA), epidermal growth factor receptor (EGFR), signal transduction and activation transcription factor 3 (STAT 3), caspase 3, and caspase 8 in lung tissues. Immunohistochemical techniques were employed to assess the expressions of EGFR, STAT3, caspase 3, and caspase 8. Overall differences between groups were compared using one-way ANOVA.Results:Compared with the control group in the silicosis model, rats in the 4-week group exhibited significant fibrotic nodules. The lung tissues of these rats showed statistically significant increases in α-SMA, EGFR, STAT 3, Caspase 3, and Caspase 8 protein expression ( P<0.05). In contrast, the Ac-SDKP prevention and anti-fibrosis treatment group demonstrated markedly reduced expression levels of these proteins compared to the 4-week silicosis model group, with statistically significant differences ( P<0.05). Immunohistochemical staining revealed that brownish-yellow expression of EGFR, STAT3, Caspase3, and Caspase8 was significantly enhanced in silicotic nodules within the silicosis model group. Conversely, this brownish-yellow expression was notably decreased in the Ac-SDKP prevention and anti-fibrosis treatment group compared to the 4-week silicosis model group. Conclusion:Ac-SDKP may exert antifibrotic effects on the lungs of rats with silicosis by regulating the EGFR/STAT3 pathway.

Objective:To investigate the effect of nourishing yin and tonifying yang method on inflammatory response and bone metabolism in patients with T2DM complicated with osteoporosis (OP).Methods:A randomized controlled trial. From January 2022 to December 2023,80 patients with T2DM and OP in our hospital were selected as the observation objects, and they were divided into two groups by random number table method, with 40 cases in each group.On the basis of conventional treatment, the control group chewed vitamin D calcium chewable tablets, and the observation group added nourishing yin and tonifying yang Chinese medicine.Both groups were treated for 6 months. TCM syndrome scores were performed before and after treatment ;the levels of fasting blood glucose (FPG), 2 hPG and HbA1c were detected by intelligent blood glucose monitor;the levels of serum neutrophils and lymphocytes were detected by automatic blood analyzer, and the neutrophil/lymphocyte ratio (NLR) was calculated;the levels of serum IL-1β and TNF-α were detected by automatic chemiluminescence analyzer, the levels of type I procollagen amino terminal propeptide (PINP), type I collagen carboxy terminal peptide β special sequence (β-CTX) and 25-hydroxy vitamin D3 [25-(OH)D3] were detected by ELISA;Bone mineral density (BMD) was detected by bone mineral density detector. The adverse reactions during treatment were observed and recorded, and the clinical efficacy was evaluated.Results:The total effective rate was 92.5 %(37/40) in the observation group and 75.0 % (30/40) in the control group,the difference between the two groups was statistically significant ( χ2=4.50, P=0.034).After treatment, the scores of soreness and weakness of waist and knees, soreness and pain of waist and back, clear and long urine, pale tongue and white coating in the observation group were lower than those in the control group ( t=3.11, 3.75, 3.51, 3.74, P<0.01);the levels of serum FPG, 2 hPG and HbA1c in the observation group were lower than those in the control group ( t=3.11,3.20,3.39, P<0.01).The levels of serum NLR (2.63 ± 0.68 vs. 3.24 ± 0.79, t=3.70), IL-1β [(81.65 ± 8.30) ng/L vs. (89.03 ± 8.98) ng/L, t=3.82] and TNF-α [(35.14 ± 5.11) μg/L vs. (39.96 ± 5.38) μg/L, t=4.11] in the observation group were lower than those in the control group ( P<0.01). After treatment, the levels of PINP [(29.83 ± 3.92) ng/L vs. (34.02 ± 4.03) ng/L, t=4.71] and β-CTX [(21.30 ± 3.95 ) ng/L vs. (25.32 ± 4.18) ng/L, t=4.42] in the observation group were lower than those in the control group ( P<0.01), the levels of 25-(OH)D3 [(42.86 ± 5.12) μg/L vs. (38.08 ± 4.55) μg/L, t=4.41] and BMD [(0.90 ± 0.18) g/cm 3vs. (0.78 ± 0.16) g/cm 3, t=3.15] were higher than those in the control group ( P<0.01).During the treatment, the incidence of adverse reactions was 12.5% (5/40) in the observation group and 10.0 % (4/40) in the control group,there was no significant difference between the two groups ( χ2=0.13, P=0.723). Conclusion:The method of nourishing yin and tonifying yang can effectively improve the TCM syndromes of T2DM patients with OP, reduce the levels of blood glucose and inflammatory factors, improve bone metabolism, improve clinical efficacy and have good treatment safety.

Objective To find the relationship between phthalates(PAEs)metabolite concentrations and body mass index(BMI)in infertile patients.Methods From December 2018 to January 2021,120 infertile pa-tients were selected from the Reproductive Medicine Centre of the 988th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army and the Reproductive Medicine Centre of the Henan Provincial People's Hospital,while 60 patients with no history of infertility and normal weight were selected from the Medical Check-up Centre as the normal group.According to BMI index,the infertility patients were divided into the control group(BMI＜28 kg/m2),obesity group(obesity,BMI≥28 kg/m2).The obesity group was divided into BHI(BMI≥32 kg/m2)and BH2(BMI≥28 kg/m2,＜32 kg/m2).The basic information of each group was collected.Serum level of PAEs metabolites diethyl phthalate(DEP),dibutyl phthalate(DBP)and di-isooctyl phthalate(DEHP)was detected using liquid chromatography/mass spectrometry(HPLC).The rela-tionship between PAEs metabolite concentration and body mass index(BMI)were analyzed by Spearman's analysis.Results The serum level of DEP,DBP and DEHP was significantly higher in obese group than in the control group(P＜0.05).The serum level of DEP,DBP and DEHP was significantly higher in the control group than in the normal group(P＜0.05);The metabolites level of PAEs was higher in patients with BHI than in the patients with BH2(P＜0.05).Spearman's analysis showed that the BMI of the patients in the obese group of infertility was positively correlated with DEP,DBP and DEHP content(P＜0.05).Conclusions Obesity and PAEs metabolite concentration in infertility patients are related,the higher the degree of obesity,the higher the content of related metabolites.

Objective To discuss the application value of comfort medical mode in patients with uterine fibroids receiving interventional embolization therapy during hospitalization.Methods A total of 27 patients with uterine fibroids,who received interventional embolization at the Third Affiliated Hospital of Zhengzhou University of China,were enrolled in this study.The patient's basic data,including age,the sum of the maximum diameter of the measurable uterine fibroids and the hemoglobin level at admission,were collected.After admission and before discharge,the self-efficacy scale score,Becker anxiety scale score,and positive and negative emotions scale score were determined in all the patients.According to the different medical management mode adopted during the hospitalization,the patients were divided into study group(n=14)and control group(n=13).Comfort medical mode guided by quantitative evaluation strategy was employed for the patients of the study group,while conventional management mode was adopted for the patients of the control group.SPSS 26.0 software was used for data analysis.Measurement data within group were analyzed by independent sample t-test,and measurement data between groups were analyzed by paired sample t-test,and P＜0.05 was defined as a statistically significant difference.Results There were no statistically significant differences in the basic data between the two groups,and no statistically significant differences in the self-efficacy scale score,Becker anxiety scale score,and positive and negative emotions scale score at admission existed between the two groups.In the study group,the self-efficacy score and positive emotion score at discharge were strikingly higher than those at admission(P＜0.001),and the anxiety degree and negative emotion score at discharge were obviously lower than those at admission(P＜0.001).In the control group,the scores of the above-mentioned scales at discharge did not differ from those at admission.Conclusion The comfort medical mode guided by quantitative evaluation strategy has better clinical effect in patients with uterine fibroids receiving interventional embolization therapy,it can improve patient's comfortableness degree during hospitalization period.

This study aims to explore protective effects of Lycium barbarum polysaccharides(LBP)on intestinal damage caused by lipopolysaccharide(LPS)-induced inflammatory bowel disease(IBD)in chicks.Network pharmacology was initially employed to determine the target proteins of wolfberry in the prevention and treatment of IBD.Following this,protein-protein interaction analy-sis,GO and KEGG pathway enrichment analysis,and molecular docking studies were conducted.Subsequently,an animal study was conducted:a total of 100 one-day-old male Hy-line brown lay-ing hens were randomly divided into five groups:a blank control group(CON),an LPS treatment group(LPS),a low-dose LBP group(LPS+LBP 0.25 g/L,L-LBP),a medium-dose LBP group(LPS+LBP 0.5 g/L,M-LBP),and a high-dose LBP group(LPS+LBP 1 g/L,H-LBP).Upon reac-hing 21 days old,duodenal,jejunal,ileal,and cecal tissues were collected to determine SOD and GSH-Px levels.Furthermore,the mRNA expression levels of TNF-α,AKT1,IL-6,IL-1β and TP53 in the intestinal tissues were measured using quantitative real-time PCR.The results demonstrated that network pharmacology identified 45 active ingredients in wolfberry that target 116 key protein sites,including TNF,AKT1 and IL6.The primary objectives focus on signaling pathways including AGE-RAGE,IL-17,TNF,HIF-1,and NF-κB.Molecular docking showed excellent ligand-receptor docking scores,with stable binding facilitated by hydrogen bonds and hydrophobic interactions.Compared to the LPS group,the 0.5 g/L LBP exhibited notably higher levels of SOD and T-AOC.In comparison with the LPS group,the medium and high-dose LBP experimental groups showed notably decreased the mRNA expressions of TNF-α,AKT1,IL-6,and IL-1β,while TP53 mRNA expression was significantly upregulated(P＜0.01).In summary,wolfberry exerts preventive and therapeutic effects on IBD through a multi-component,multi-target,and multi-pathway mecha-nism.

Objective:To explore the characteristics of social skills and problem behaviors of children and adolescents with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), as well as the association with core symptoms.Methods:A total of 409 patients aged 5-18 years old with ASD or ADHD in the outpatient department of Nanjing Brain Hospital from 2023 to 2024, and 344 children and adolescents with typical development(TD) were recruited.All participants were matched in a ratio of 1∶1∶1 (ASD∶ADHD∶TD) according to gender and age, and 97 participants were included in each group for analysis.The Chinese version of the social skills improvement system rating scales(SSIS-RS-C) was used to evaluate social skills and problem behaviors, and autistic child behavior checklist(ABC), childhood autism rating scale(CARS), the Chinese version of the social communication questionnaire(SCQ) and the Chinese version of Swanson, Nolan, and Pelham, version Ⅳ scale-parent form(SNAP-Ⅳ) were used to evaluate the core symptoms of ASD and ADHD, respectively. SPSS 26.0 software was used to perform variance, Chi-square test, Spearman correlation analysis and multivariate Logistic regression analysis.Results:The social skills score of ASD group was lower than ADHD group ((61.53±24.26) vs (80.89±15.19), P<0.05), while the problem behavior score of ASD group was higher than ADHD group ((38.82±11.92) vs (34.00±12.45), P<0.05). In ASD group, the scores of ABC, CARS and SCQ were negatively correlated with the score of social skills ( r=-0.26--0.55, P<0.05). In ADHD group, the total score and each subscale of SNAP-Ⅳ were positively correlated with the score of problem behavior ( r=0.25-0.65, P<0.05). Multivariate Logistic regression analysis showed that empathy was a negative influencing factor of ASD ( B=-0.246, OR=0.782, P<0.05), and hyperactivity/inattention was a positive influencing factor of ASD ( B=0.589, OR=1.802, P<0.01), while only hyperactivity/inattention was a positive influencing factor of ADHD( B=0.779, OR=2.180, P<0.01). Conclusion:Children and adolescents with ASD and ADHD both have defects in social skills and problem behaviors, and these defects are associated with the core characteristics of their respective diseases.

Objective:To examine the regulatory effects of a potential antifibrotic tetrapeptide called N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP) on the expression of epidermal growth factor (EGFR) and signal transducer and activator of transcription 3 (STAT3) in lung tissues with fibrosis induced by silicosis in rats. This study aims to explore the potential therapeutic benefits of Ac-SDKP in the prevention and treatment of fibrotic lung diseases associated with silicosis.Methods:In January 2024, disease targets and Ac-SDKP active ingredients were predicted through GeneCards (https://www.genecards.org) and OMIM (https://www.omim.org) databases. Using R 4.2.1 software, we identified overlapping targets between pulmonary fibrosis and AC-SDKP. Cytoscape 3.10.2 was employed to visualize interactions between active chemical components and these targets, followed by GO enrichment analysis and KEGG pathway analysis using R 4.2.1. Forty healthy adult Wistar rats were selected to establish silicosis models through single-dose gavage with 50 mg/ml silica suspension (1. 0 ml per rat). The rats were randomly divided into four groups: model control group (4 weeks), silicosis model group (4 weeks), Ac-SDKP preventive treatment group (acquired via intraperitoneal injection of a micro-release pump containing Ac-SDKP [800 μg/ (kg·d) ] during modeling, maintained for 4 weeks), and Ac-SDKP anti-fibrosis treatment group (acquired via intraperitoneal injection of the same pump after 2 weeks of modeling, continued maintenance for 2 weeks). Each group contained 10 rats. The pathological changes in rat lung tissues were observed. Western blot technology was used to detect the protein expression levels of α-smooth muscle actin (α-SMA), epidermal growth factor receptor (EGFR), signal transduction and activation transcription factor 3 (STAT 3), caspase 3, and caspase 8 in lung tissues. Immunohistochemical techniques were employed to assess the expressions of EGFR, STAT3, caspase 3, and caspase 8. Overall differences between groups were compared using one-way ANOVA.Results:Compared with the control group in the silicosis model, rats in the 4-week group exhibited significant fibrotic nodules. The lung tissues of these rats showed statistically significant increases in α-SMA, EGFR, STAT 3, Caspase 3, and Caspase 8 protein expression ( P<0.05). In contrast, the Ac-SDKP prevention and anti-fibrosis treatment group demonstrated markedly reduced expression levels of these proteins compared to the 4-week silicosis model group, with statistically significant differences ( P<0.05). Immunohistochemical staining revealed that brownish-yellow expression of EGFR, STAT3, Caspase3, and Caspase8 was significantly enhanced in silicotic nodules within the silicosis model group. Conversely, this brownish-yellow expression was notably decreased in the Ac-SDKP prevention and anti-fibrosis treatment group compared to the 4-week silicosis model group. Conclusion:Ac-SDKP may exert antifibrotic effects on the lungs of rats with silicosis by regulating the EGFR/STAT3 pathway.

Objective:To analyze the clinical characteristics of warfarin-related nephropathy (WRN).Methods:Medical records of patients with WRN admitted to Linyi People′s Hospital Affiliated to Shandong Second Medical University from January 1, 2020 to December 31, 2024 were collected. The patients′ basic information (gender, age), warfarin medication details (indications, dosage, frequency, etc.), comorbidities, concomitant medication usage, international normalized ratio (INR) and serum creatinine (Scr) test results before and after the occurrence of WRN, as well as the clinical manifestations, interventions, and outcomes of WRN were extracted. The causal relationship between warfarin and renal dysfunction was evaluated according to the Adverse Drug Reaction Reporting and Monitoring Manual. The clinical data of patients were descriptively and statistically analyzed. Results:A total of 11 patients were entered in the analysis, including 7 males and 4 females; the age ranged from 49 to 85 years, with a median age of 70 years, and 9 cases were older than 60 years. The causality evaluation showed that 3 patients were definite and 8 patients were probable. All the 11 patients had at least one comorbidity, including 6 cases of heart failure, 6 cases of hypoproteinemia, 4 cases of chronic kidney disease, 3 cases of hypertension, 3 cases of pulmonary infection, and 1 case of diabetes. Seven patients were treated with warfarin combined with broad-spectrum antibiotics, 6 combined with diuretics, and 3 combined with renin angiotensin system blockers. The time from the highest INR to the highest Scr level was 0-6 days, with a median time of 2 days, and it was ≤2 days in 9 patients. Six patients had bleeding manifestations such as microscopic hematuria, melena, epistaxis, hematochezia, and skin ecchymosis. Among the 11 patients, 10 stopped warfarin immediately and 1 reduced dosage. All patients received different doses of vitamin K 1 according to the INR level. Among the 6 patients of bleeding, 4 received symptomatic treatments such as omeprazole, tranexamic acid, somatostatin, thrombin powder and octreotide, and 2 patients received hemodialysis due to high Scr level. One patient with severe anemia received blood transfusion. After 1-5 days of treatments (with a median time of 2 days), the INR in all patients decreased to <3.00, of which 5 patients continued to take warfarin, 1 changed warfarin to rivaroxaban, and 5 did not continue anticoagulation therapy. After 2 to 14 days of treatments, Scr in 8 patients recovered to the reference value range, and Scr in 3 patients was still at a high level, of which 1 patient died of unexplained cardiac arrest. Conclusions:WRN is a common adverse reaction of warfarin, with or without bleeding. After the occurrence of WRN, the drug should be stopped as soon as possible and symptomatic treatment should be given. The prognosis is generally good, but it may also lead to chronic kidney disease.