Epimedium sagittatum is a perennial herb of Berberidaceae. Its leaves have a long history of medicinal use in China. This plant is widely used as a Chinese traditional medicine，with the main functions of tonifying kidney Yang，strengthening bones and muscles，and dispelling wind and dampness. It can be used for treating kidney Yang deficiency，impotence，spermatorrhea，flaccidity of bones and muscles，rheumatic arthralgia，numbness，and spasms. The chemical constituents of this plant include flavonoids，polysaccharides，lignans，and alkaloids. Flavonoids are the main active ingredients. These compounds show a wide range of biological activities，including cartilage repair，anti-aging，anti-fatigue，cough-relieving，blood glucose-lowering，and anti-tumor effects. Modern pharmacological research has shown that E. sagittatum has definite pharmacological effects on the reproductive system，respiratory system，nervous system，cardiovascular system，skeletal system，etc. It has remarkable effects of helping pregnancy，resisting osteoporosis，controlling diabetes，improving immunity，and inhibiting tumor. Under the background of advocating one health and Chinese medicine，E. sagittatum is widely used in health care products，serving as the main raw material of various products. It has great market potential and is a Chinese medicinal herb with great clinical application and research value. This paper reviews the main chemical constituents and pharmacological effects of E. sagittatum based on domestic and foreign reports， providing a theoretical basis for further study on E. sagittatum and its safe clinical application.

Epimedium sagittatum is a perennial herb of Berberidaceae. Its leaves have a long history of medicinal use in China. This plant is widely used as a Chinese traditional medicine，with the main functions of tonifying kidney Yang，strengthening bones and muscles，and dispelling wind and dampness. It can be used for treating kidney Yang deficiency，impotence，spermatorrhea，flaccidity of bones and muscles，rheumatic arthralgia，numbness，and spasms. The chemical constituents of this plant include flavonoids，polysaccharides，lignans，and alkaloids. Flavonoids are the main active ingredients. These compounds show a wide range of biological activities，including cartilage repair，anti-aging，anti-fatigue，cough-relieving，blood glucose-lowering，and anti-tumor effects. Modern pharmacological research has shown that E. sagittatum has definite pharmacological effects on the reproductive system，respiratory system，nervous system，cardiovascular system，skeletal system，etc. It has remarkable effects of helping pregnancy，resisting osteoporosis，controlling diabetes，improving immunity，and inhibiting tumor. Under the background of advocating one health and Chinese medicine，E. sagittatum is widely used in health care products，serving as the main raw material of various products. It has great market potential and is a Chinese medicinal herb with great clinical application and research value. This paper reviews the main chemical constituents and pharmacological effects of E. sagittatum based on domestic and foreign reports， providing a theoretical basis for further study on E. sagittatum and its safe clinical application.

Objective This study aims to investigate the association between remnant cholesterol(RC)and the risk of metabolic-associated fatty liver disease(MAFLD)under the optimal triglyceride(TG)levels recom-mended by different guidelines.Methods The data were derived from the annual physical examinations of elderly people aged 65 and above in a community in 2023.Regression analysis was used to evaluate the association between RC and MAFLD risk.According to the TG normal level(<1.7 mmol/L)recommended by the Chinese Lipid Management Consensus and the TG ideal target(<1.2 mmol/L)proposed by the European Atherosclerosis Society,the individuals were divided into subgroups with different TG levels to explore the association between RC and MAFLD risk in each subgroup.Results A total of 2,800 elderly individuals aged 65 and above were included in this study.The proportion of the individuals meeting the diagnostic criteria for MAFLD was 20.85%,and RC was identified as an independent risk factor for MAFLD(P<0.001).In the elderly individuals with TG<1.7 mmol/L,RC level was not significantly associated with MAFLD risk(P=0.888).In contrast,in the elderly individuals with TG≥1.7 mmol/L,RC level was significantly and positively correlated with MAFLD risk(P<0.001).Interaction tests revealed no significant interaction between the stratification factor and the effect size of RC(P=0.115).In the elderly individuals with TG<1.2 mmol/L,RC level was not associated with MAFLD risk(P=0.505),while in the elderly individuals with TG≥1.2 mmol/L,RC level was significantly associated with MAFLD risk(P<0.001).Interaction tests showed a significant interaction between the stratification factor and the effect size of RC(P=0.011).Conclusion RC is an independent risk factor for MAFLD in older individuals.To reduce the risk of MAFLD related to RC in the elderly,a triglyceride level of<1.2 mmol/L can serve as a reference for identifying early-stage risk.

Irritable bowel syndrome(IBS)is a kind of gastrointestinal dysfunction disease characterized by abdominal pain and abnormal defecation accompanied by changes in frequency or fecal character as the main clinical symptoms,and diarrhea-type irritable bowel syndrome(IBS-D)is the most common.It has been found that Chinese medicine therapy has achieved good results in the treatment of IBS-D through multi-component,multi-target and multi-pathway targeted regulation of intestinal flora.Therefore,based on intestinal flora,this paper reviews the relationship between intestinal flora and IBS-D,the understanding of Chinese medicine on IBS-D and intestinal flora,and the role of Chinese medicine therapy on intestinal flora.

Objective This study aims to investigate the association between remnant cholesterol(RC)and the risk of metabolic-associated fatty liver disease(MAFLD)under the optimal triglyceride(TG)levels recom-mended by different guidelines.Methods The data were derived from the annual physical examinations of elderly people aged 65 and above in a community in 2023.Regression analysis was used to evaluate the association between RC and MAFLD risk.According to the TG normal level(<1.7 mmol/L)recommended by the Chinese Lipid Management Consensus and the TG ideal target(<1.2 mmol/L)proposed by the European Atherosclerosis Society,the individuals were divided into subgroups with different TG levels to explore the association between RC and MAFLD risk in each subgroup.Results A total of 2,800 elderly individuals aged 65 and above were included in this study.The proportion of the individuals meeting the diagnostic criteria for MAFLD was 20.85%,and RC was identified as an independent risk factor for MAFLD(P<0.001).In the elderly individuals with TG<1.7 mmol/L,RC level was not significantly associated with MAFLD risk(P=0.888).In contrast,in the elderly individuals with TG≥1.7 mmol/L,RC level was significantly and positively correlated with MAFLD risk(P<0.001).Interaction tests revealed no significant interaction between the stratification factor and the effect size of RC(P=0.115).In the elderly individuals with TG<1.2 mmol/L,RC level was not associated with MAFLD risk(P=0.505),while in the elderly individuals with TG≥1.2 mmol/L,RC level was significantly associated with MAFLD risk(P<0.001).Interaction tests showed a significant interaction between the stratification factor and the effect size of RC(P=0.011).Conclusion RC is an independent risk factor for MAFLD in older individuals.To reduce the risk of MAFLD related to RC in the elderly,a triglyceride level of<1.2 mmol/L can serve as a reference for identifying early-stage risk.

Irritable bowel syndrome(IBS)is a kind of gastrointestinal dysfunction disease characterized by abdominal pain and abnormal defecation accompanied by changes in frequency or fecal character as the main clinical symptoms,and diarrhea-type irritable bowel syndrome(IBS-D)is the most common.It has been found that Chinese medicine therapy has achieved good results in the treatment of IBS-D through multi-component,multi-target and multi-pathway targeted regulation of intestinal flora.Therefore,based on intestinal flora,this paper reviews the relationship between intestinal flora and IBS-D,the understanding of Chinese medicine on IBS-D and intestinal flora,and the role of Chinese medicine therapy on intestinal flora.

OBJECTIVE: To explore the immunological mechanisms underlying spermatogenetic malfunction in patients with non-obstructive azoospermia (NOA) based on bioinformatics and machine learning, and to screen out the key genes associated with spermatogenesis failure. METHODS: NOA-related datasets were obtained from the GEO database, and the differentially expressed genes identified by differential analysis and weighted gene co-expression network analysis (WGCNA). A model of spermatogenesis scoring was established for analysis of the immunological microenvironment and cell interaction networks related to spermatogenesis failure. The key genes were screened out by machine learning, followed by analysis of their correlation with T cells and macrophages. An NOA mouse model was constructed for validation of transcriptome sequencing. RESULTS: Seventy-five differentially expressed genes were identified for the establishment of the spermatogenesis scoring model. The low spermatogenesis score group showed a higher infiltration of the immune cells, with an increased proportion of T cells and macrophages and a correlation of cell interaction signals with immunity. SOX30, KCTD19, ASRGL1 and DRC7 were identified by machine learning as the key genes related to spermatogenesis, with down-regulated expressions in the NOA group, and their expression levels negatively correlated with the infiltration of T cells and macrophages. The accuracy of the spermatogenesis scoring and machine learning models, as well as the trend of the expression levels of the key genes, was successfully validated with the transcriptome sequencing data on the NOA mouse testis. CONCLUSION The development of NOA is closely associated with enhanced immunological microenvironment in the testis. T cells and macrophages may play important roles in spermatogenesis failure. SOX30, KCTD19, ASRGL1 and DRC7 are potential biomarkers for the diagnosis and treatment of NOA.
Male ; Azoospermia/genetics* ; Machine Learning ; Animals ; Computational Biology ; Mice ; Humans ; Spermatogenesis/genetics* ; Gene Expression Profiling ; Macrophages/immunology* ; Gene Regulatory Networks ; T-Lymphocytes/immunology* ; Transcriptome

Objective:To explore the clinical effect of using great toe fibular flaps of both feet on reconstruction of pulp defects of two neighbouring digits.Methods:A total of 14 digit pulp defects in 7 cases were repaired in Zhoukou Huaihai Hospital using great toe fibular flaps of both feet from August 2020 to January 2023. Of the 7 cases, there were 4 males and 3 females, with an average of 28 years old, ranging from 19 to 45 years old. Meanwhile, there were 4 cases in left hand and 3 cases in right hand. There were 3 cases of digit pulp defects in index and middle fingers, 2 in middle and ring fingers, and 2 in thumb and index fingers. The area of soft tissue defect in 1.2 cm×1.5 cm-3.0 cm×2.5 cm, and flap was 1.5 cm ×1.8 cm-3.2 cm×2.8 cm. Furthermore, 1 case underwent emergency surgery and 5 were repaired in elective surgery. The donor site of the flap was closed directly, and an intermediate-thickness skin graft was prepared from the medial plantar area for transfer in the case of high suture tension at the wound edge. After surgery, patients received postoperative by outpatient clinic and WeChat to observe the appearance, sensation, functional recovery and flap contracture of digits, as well as the movement of the great toes of both feet.Results:After the surgery, all flaps in the 7 cases survived smoothly and the donor sites healed. All patients entered scheduled follow-ups postoperatively for 6 months to 2 years, with an average of 9 months. The flap showed an aesthetic appearance and excellent sensation, with a TPD of 3-6 mm, and satisfactory digit function. The donor site of the great toe fibular flap left linear scars only, without abnormality in range of motion and gait in walking. In addition, there were 5 in excellent and 2 in good according to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association.Conclusion:Application of great toe fibular flaps of both feet is an ideal option for the simultaneous repair of pulp defects of two neighbouring digits, which can achieve good reconstructive results.

OBJECTIVE To construct an insulin-resistant(IR)small intestinal organoid model of mice and study the protective effect of flavanomarein(FM)on the intestinal mucosal barrier in the model.METHODS ①Small intestinal organoid models of C57BL/6J and db/db of mice were constructed.The expressions of Ki-67,E-cadherin(E-cad),lysozyme(Lyz)and mucin-2(Muc-2)in small intestinal organ-oids were detected by 3D immunofluorescence.RT-qPCR was used to detect the expressions of fibro-nectin(Fn),glucagon-like peptide-1(GLP-1)and peotide YY(PYY)mRNA while Western blotting was used to detect the expressions of Fn,GLP-1 and PYY protein.The Lyz secretion level was detected by ELISA.② Small intestinal organoids were divided into five groups:C57BL/6J mice 'small intestinal organ-oids as the normal control group,db/db mice' intestinal organoids as the IR model group,db/db mice small intestinal organoids with flavanomarein 25,50 and 100 μmol·L-1 intervention for 48 h as IR model+ FM groups.RT-qPCR was used to detect the expression of Lyz mRNA while Western blotting was used to detect the expression of Lyz protein.RESULTS ① On the 6th day of small intestinal organoid culture,a ring structure with a clear luminal structure was formed and an IR mouse small intestinal organoid model was established.3D Immunofluorescence detection showed that the established small intestinal organoids all expressed Ki-67,E-cad,Lyz and MUC-2.Compared with the normal control group,the expres-sion of Fn mRNA in the IR model group was significantly increased(P<0.05)while the expressions of GLP-1 and PYY mRNA were significantly decreased(P<0.05).Compared with the normal control group,the expression of Fn protein in the IR model group was significantly decreased(P<0.05)while the expressions of GLP-1 and PYY protein were significantly increased(P<0.05).ELISA results showed that compared with the normal control group,the secretion levels of Lyz in the IR model group were signifi-cantly decreased(P<0.01).② RT-qPCR results showed that compared with the normal control group,the expression of Lyz mRNA in the IR model group was significantly decreased(P<0.01).Compared with the IR model group,the expression of Lyz mRNA in the IR model+FM 50 and 100 μmol·L-1 groups was significantly increased(P<0.05,P<0.01).Western blotting results showed that compared with the normal control group,the expression of Lyz protein in the IR model group was significantly decreased(P<0.01).Compared with the IR model group,the expression of Lyz protein in the IR model+FM 50 and 100 μmol·L-1 groups was significantly increased(P<0.05,P<0.01).CONCLUSION The constructed IR mouse small intestinal organoid model provides a more complete in vitro research model for exploring the pathophysiological mechanism by which drug interventions help repair the intestinal mucosal barrier.FM may maintain the intestinal mucosal barrier by reversing the decrease in Lyz expression levels in IR mice,thereby improving IR.