Colorectal cancer （CRC） is one of the most common cancers， with its incidence ranking high among cancers. It stands as the second leading cause of cancer-related death worldwide. In the early stages， CRC lacks specific symptoms， and most patients are diagnosed at advanced stages， making it a major research focus in the field of gastrointestinal tumors. Currently， clinical CRC treatments face several common challenges， including high surgical risks， frequent metastasis and recurrence， drug resistance， and significant side effects from chemotherapy and radiation therapy. With the development and application of traditional Chinese medicine （TCM）， it has been found that TCM and its active ingredients can effectively inhibit CRC cell proliferation， invasion， migration， and angiogenesis， and promote apoptosis and autophagy， thereby slowing the progression of CRC. This has become a key focus of CRC treatment research. Salvia Miltiorrhiza has multiple pharmacological effects， including activating blood circulation to dispel blood stasis， unlocking meridians to relieve pain， clearing heat to calm irritability， and cooling blood to reduce abscesses. It contains a variety of chemical components， including diterpenoids， phenolic acids， flavonoids， polysaccharides， nitrogen-containing compounds， steroids， and lactone compounds. This review summarized the molecular mechanisms of Salvia miltiorrhiza and its active ingredients in the treatment of CRC. It is found that these ingredients exert anti-CRC effects through various molecular mechanisms， including cell cycle arrest， promotion of apoptosis， inhibition of cell invasion and migration， induction of autophagy， suppression of tumor angiogenesis， and remodeling of the tumor microenvironment. The review aims to provide new insights for the drug development and clinical application of Salvia miltiorrhiza in CRC treatment.

Objective: To identify biomolecular markers closely related to the occurrence of kidney renal clear cell carcinoma (KIRC) and verify their expression levels in clinical samples. Methods: Stage Ⅰ KIRC mRNA sequencing data were obtained from The Cancer Genome Atlas (TCGA).Principal component analysis (PCA) was used for dimensionality reduction to screen differentially expressed genes (DEGs)，which then underwent GO and KEGG analyses.Weighted gene co-expression network analysis (WGCNA) was used to screen genes significantly related to KIRC，and a protein-protein interaction (PPI) network was constructed to screen hub genes.The diagnostic value of hub genes was evaluated with receiver operating characteristic (ROC) curve，and their prognostic value was analyzed using survival curve plots.The correlation between the mRNA expressions of hub genes and the pathological stages of KIRC was analyzed.Clinical samples of 20 patients with stage Ⅰ KIRC treated in our hospital were included，and the expressions of the hub genes in cancerous and adjacent tissues were detected with reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR)，Western blotting，and enzyme-linked immunosorbent assay (ELISA). Results: A total of 8223 DEGs were screened out，including 4092 up-regulated ones and 4131 down-regulated ones.GO analysis showed that DEGs were related to bioadhesion，plasma membrane composition，and transporter activity.KEGG analysis showed that DEGs were related to pathways such as cell adhesion molecules，cytokine-cytokine receptor interactions，and interactions between viral proteins and cytokines and cytokine receptors.WGCNA analysis obtained 171 genes that were significantly related to stage Ⅰ KIRC.The hub gene，lymphocyte cytosolic protein 2 (LCP2)，screened out by the PPI network，was significantly related to stage Ⅰ KIRC.The area under the ROC curve was 0.96.The expression level was negatively correlated with the overall survival rate of patients.The expression of LCP2 was related to the stage and lymph node metastasis.Clinical verification showed that the mRNA and protein relative expressions of LCP2 in KIRC tissues were significantly higher than those in adjacent tissues (P<0.000 1). Conclusion: LCP2 is significantly up-regulated in stage Ⅰ KIRC tissues and can be used as a potential biomarker for the early diagnosis and treatment of KIRC.

Objective To investigate the clinical characteristics and management strategies of spinal infarction(SCI)combined with hypoxic-ischemic encephalopathy(HIE).Methods We report a case of SCI induced by cardiopulmonary arrest in a patient admitted to the General Hospital of Southern Theater Command in June 2021.A review of the relevant literature published in PubMed and CNKI from January 2014 to March 2024,was conducted to summarize the etiology,features,and treatment approaches for SCI.Results The patient presented with clinical features of quadriplegia accompanied by paresthesia,lumbar and cervical pain with paresthesia,dysphagia,dysphonia,and urinary and fecal incontinence.Spinal MRI revealed abnormal signals in the anterior and lateral columns at the C2-T1 spinal level,with no enhancement observed in contrast-enhanced scan.The patient was diagnosed as SCI combined with HIE,and was treated with antiplatelet therapy and rehabilitation.Literature review revealed that SCI is a rare central nervous system disease with multiple causes,often related to aortic surgery or pathology,presenting with segmental sensory disturbances among other clinical manifestations.MRI plays a significant role in its diagnosis,and there is currently no specific effective treatment available.Conclusions SCI has a sudden onset and is often insidious,frequently accompanying other diseases,leading to a high risk of misdiagnosis.In this case,SCI was considered to be caused by low blood pressure and vertebral artery tenuity.Clinical manifestations include paraplegia at the lesion level along with back/neck pain or limb paresthesia.Diagnosis primarily relies on MRI imaging while treatment involves secondary stroke prevention measures,rehabilitation training,complication prevention strategies as well as hyperbaric oxygen therapy.

Objective To comparatively analyze the clinical characteristics of primary bilateral macronodular adrenal hyperplasia(PBMAH)and adrenal cortisol-producing Adenoma(CPA),and enhance the understanding of two diseases.Methods The clinical data of 85 PBMAH patients(PBMAH group)and 195 CPA patients(CPA group)diagnosed at Department of Endocrinology,the First Medical Center of Chinese PLA General Hospital,from September 2014 to August 2024 were retrospectively analyzed.The demographic characteristics,comorbidities,biochemical indicators,adrenocorticotropic hormone-cortisol(ACTH-F)levels,and adrenal imaging features and treatment conditions were compared between the two groups.Results(1)General characteristics:Compared with CPA group,PBMAH group had older age at diagnosis and a higher proportion of male patients.(2)Clinical characteristics:Compared with CPA group,PBMAH group had a longer disease duration,a higher proportion of subclinical Cushing's syndrome(CS),and a higher proportion of hypertension,impaired glucose tolerance/diabetes,bone mass reduction or osteoporosis,with higher serum potassium levels,and the differences were statistically significant(P<0.01).(3)Hormone levels:Both PBMAH and CPA groups showed ACTH-F rhythm disorder,significantly increased cortisol levels and suppressed ACTH.Compared with PBMAH group,CPA group had stronger autonomous cortisol secretion ability,manifested by increased midnight serum cortisol(F0:00),16:00 serum cortisol(F16:00),24-hour urinary free cortisol(24 h UFC)levels and lower 8:00 serum ACTH(ACTH8:00)and 16:00 serum ACTH(ACTH16:00)(P<0.01).After low-dose dexamethasone suppression test(LDDST),CPA group showed lower suppression rates of ACTH and cortisol,and higher proportions of paradoxical elevation in serum cortisol and 24 h UFC compared with PBMAH(P<0.01).Conclusions PBMAH has a longer disease course and higher proportions of comorbid metabolic disorders than CPA,mostly manifested as subclinical Cushing's syndrome.CPA has stronger autonomous cortisol secretion ability,with cortisol less likely to be suppressed after LDDST and more obvious paradoxical elevation of cortisol and 24 h UFC.

Objective To characterize multimodal metabolic disorders in subclinical Cushing's syndrome(SCS)patients with different cortisol levels,providing a reference for clinical diagnosis and treatment.Methods A retrospective analysis was conducted on the clinical data of 165 SCS patients diagnosed at the First Medical Center of Chinese PLA General Hospital due to adrenal masses from January 2014 to October 2024.Using the serum cortisol levels after the midnight 1 mg dexamethasone suppression test(1 mg DST)as the cut-off point,SCS patients were divided into high-level group(1 mg DST-F>138 nmol/L,n=96)and low-level group(50 nmol/L<1 mg DST-F≤138 nmol/L,n=69).The differences in age,gender,body mass index(BMI),blood pressure,glucolipid metabolism indices,electrolytes,hormone levels,and imaging features of adrenal adenoma(such as CT values)were compared between the two groups.Multivariate linear regression was used to analyze the correlation between CT values and metabolic indices.Results Compared with low-level group,patients in high-level group were younger(54.0±11.3 vs.57.7±10.3,P=0.034),while there were no statistically significant differences in gender ratio or BMI between the two groups(P>0.05).Both groups exhibited decreased adrenocorticotropic hormone(ACTH)levels and disrupted circadian rhythm.Compared with low-level group,high-level group showed significantly higher F0:00 levels[250.00(170.07,422.53)nmol/L vs.110.00(82.74,133.90)nmol/L]and 24-hour urinary free cortisol(24 h UFC)[568.40(377.80,875.45)nmol/24 h vs.369.40(265.40,494.69)nmol/24 h](P<0.001),with no significant differences in serum F8:00,or 1 mg DST ACTH0:00 levels(P>0.05).Except for the fasting C-peptide level in the high-level group being higher than that in low-level group[(2.88±1.01)ng/ml vs.(2.46±0.78)ng/ml,P=0.024],there were no significant differences in blood pressure,blood lipids,glycated hemoglobin(HbA1c),fasting blood glucose,fasting insulin,serum electrolytes,uric acid,and other indices between the two groups(P>0.05).The CT value of adrenal adenoma during contrast-enhanced scanning was higher in high-level group[80.00(17.80,93.00)Hu vs.52.00(35.50,75.00)Hu,P=0.006]compared with low-level group.Multivariate linear regression analysis revealed that diastolic blood pressure was positively correlated with CT values of adrenal adenomas in both plain scanning(β=0.49,95%CI 0.09-0.90)and contrast-enhanced scanning(β=2.08,95%CI 0.76-3.39),while triglyceride levels were negatively correlated with plain scanning CT values(β=-5.77,95%CI-10.88--0.66).Conclusion Patients with SCS at different cortisol levels differ in age,fasting C-peptide levels,and CT values.CT values may serve as potential imaging markers to assess metabolic risk in SCS patients.

In recent years,more and more researches has focused on the correlation between cognitive activity and physiological variables.The change of pupil is regarded as an important target in the cognitive process,and has become a hot research field.This review focuses on the three key brain regions that regulate pupil change,and reflects the neurophysiological mechanism behind pupil change by elaborating the neural pathways related to pupil change and cognitive performance.Based on recent studies on pupil change in cognitive diseases,it aims to promote the application of pupil change in the field of cognitive science in the future.

Objective To investigate the correlation between the epidermal growth factor receptor(EGFR)gene polymorphisms and non-small cell lung cancer(NSCLC)in Yunnan Han population.Methods A total of 407 NSCLC patients and 526 healthy controls were included.Five SNPs(rs1050171,rs2072454,rs2227983,rs1140475 and rs2293347)in EGFR were genotyped using TaqMan assay.The association between SNPs and NSCLC,as well as pathological types,were analyzed.Results In dominant mode,rs2072454 C/T-T/T may be a risk factor for NSCLC(P=0.004;OR=1.50,95%CI 1.14～1.96).There was a significant difference in genotype frequency between the SCC group and the control group(P=0.007),but no difference in allele frequency after Bonferroni correction(P>0.01);In the dominant mode,C/T-T/T at this locus relative to C/C was a risk for AC(P=0.002;OR=1.86,95%CI 1.24～2.80).rs1050171 A/A had a significantly higher risk of SCC in recessive mode(P=0.006,OR=2.66,95%CI 1.33～5.33).In dominant mode,rs2227983 A/G-G/G/G was a risk factor for the development of SCC relative to A/A(P=0.007;OR=1.83,95%CI 1.15～2.89).Conclusion The SNPs rs2072454,rs1050171 and rs2227983 in EGFR gene may be associated with the risk of NSCLC development as well as the type of pathology in Yunnan Han population.

Objective To analyze the habitat suitability status of Rhododendron anthopogonoides Maxim.in Gansu and Qinghai Provinces;To predict its potential suitable areas in different climate scenarios;To provide references for the protection and rational utilization of Rhododendron anthopogonoides Maxim.Methods The MaxEnt model,combined with ArcGIS 10.3,was used to simulate and analyze the potential habitat suitability and spatial distribution of Rhododendron anthopogonoides Maxim.under current and future climate conditions,using species distribution data and environmental factors.Additionally,the habitat suitability was classified,and key environmental factors influencing the distribution of Rhododendron anthopogonoides Maxim.under current climate conditions were identified through a comprehensive evaluation of factor contribution rates and validation using the Jackknife method.Results The predicting results showed that under the current climate,the total area of potential suitable habitat for Rhododendron anthopogonoides Maxim.was 21.27×104 km2,primarily distributed in Lanzhou,Linxia Hui Autonomous Prefecture and Gannan Tibetan Autonomous Prefecture in Gansu Province,and in Xining,Haidong,Huangnan Tibetan Autonomous Prefecture and Hainan Tibetan Autonomous Prefecture in Qinghai Province.Under different future climate scenarios,the potential suitable habitat area was projected to increase by 4.51%to 21.91%,and migrating to high altitude areas.Elevation,precipitation in the driest month,annual precipitation and the average temperature in the driest quarter were identified as the main environmental factors influencing the distribution of Rhododendron anthopogonoides Maxim.Conclusion Under different climate scenarios in the future,the habitat area of Rhododendron anthopogonoides Maxim.in Gansu and Qinghai Provinces is showing an increasing trend,which can provide reference for the protection and rational utilization of Rhododendron anthopogonoides Maxim.resources under climate change.

AIM To establish a quantitative analysis of multi-components by single-marker(QAMS)method for the simultaneous content determination of baicalin,baicalin,hesperidin,naringin,neohesperidin,rosinic acid,glycyrrhizin,ammonium glycyrrhizate and prehumetin in Tongxuan Lifei Pills.METHODS The analysis was performed on a 30 ℃ thermostatic SVEA C18 column(4.6 mm × 250 mm,5 μm),with the mobile phase comprising of acetonitrile-water(containing 0.1％phosphoric acid)flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 250 nm.Baicalin was used as an internal standard to calculate the relative correction factors of the other eight constituents,after which the content determination was made.RESULTS Nine constituents showed good linear relationships within their own ranges(r ≥ 0.999 1),whose average recoveries were 96.15％-101.58％with the RSDs of 0.75％-1.74％.The result obtained by QAMS approximated those obtained by external standard method.CONCLUSION This accurate,stable and reproducible method can be used for the quality control of Tongxuan Lifei Pills.

[Objective]To explore the rules of cold syndrome treatment in the medical records of Qing Palace.[Methods]By collecting and sorting out the cold medical cases in Medical Records Integration of Palace in Qing Dynasty,the database and data standardization were established,and then imported into the Ancient and Modern Medical Records Cloud Platform for data mining,and combined with case analysis.[Results]A total of 196 medical records,196 prescriptions,133 symptoms,43 syndrome elements and 159 Chinese medicines were included.The most frequent syndrome elements were heat,wind,cool and fluid retention,and the most common Zang-Fu elements were stomach and lung.The top three commonly used treatment methods were expelling,dredging and resolving fluid retention.Radix glycyrrhizae and zingiberis rhizoma recens were the most commonly used,followed by saposhnikovia divaricata,platycodon grandiflorum,fructus aurantii,tangerine peel and radix scutellariae.The drug properties were warm,slightly cold and flat,and the spicy,bitter and sweet tastes were more common.The lung meridian was the most common,followed by the spleen meridian,stomach meridian and liver meridian.Fifteen groups of commonly used drug pairs were obtained,and the group with the highest confidence was saposhnikovia divaricata,platycodon grandiflorum-radix glycyrrhizae,schizonepeta-saposhnikovia divaricata,magnolia officinalis-tangerine peel,radix glycyrrhizae,and fructus aurantii-platycodon grandiflorum.Three groups of Chinese medicines were obtained by cluster analysis of 12 kinds of high frequency drugs.Through complex network analysis,12 core drugs were obtained,which were radix glycyrrhizae,zingiberis rhizoma recens,platycodon,saposhnikovia divaricata,scutellaria,fructus aurantii,schizonepeta,perilla leaf,poria,tangerine peel,radix notophylla and magnolia officinalis.[Conclusion]Cold in the Qing Dynasty often caused internal injury to the spleen and stomach.In the treatment,both the external and internal were often treated,especially the spleen and stomach.For the cases of phlegm,drink and dampness,spicy drugs were used to disperse,and bitter was used to dry.The clamping method was to invigorate the spleen and stomach,and push the old for the new.The medical records with interior heat should protect the heart and liver.The prescription of Magui was used less than the prescription of Qiangfang.For menstrual colds,cooling blood,clearing heat and moistening were very important.