Polycystic ovary syndrome （PCOS） is a common endocrine and metabolic disorder among women of reproductive age. Hyperandrogenism （HA）， one of its core pathological features， is closely associated with the clinical manifestations and metabolic complications of the disease. Current western medical treatments for PCOS-HA mainly include anti-androgen therapy and ovulation induction， such as short-acting oral contraceptives like Diane-35 and Yasmin. However， long-term use of these medications may result in adverse reactions like increasing the risk of liver dysfunction and exacerbating lipid metabolism disorders， with unsatisfactory long-term efficacy when used alone. Traditional Chinese medicine offers unique advantages in the treatment of PCOS-HA due to its holistic approach and multi-target regulatory mechanisms. In the view of traditional Chinese medicine， PCOS-HA is classified under the categories such as "delayed menstruation"， "amenorrhea"， and "infertility"， with kidney deficiency as the root， as well as liver stagnation and spleen deficiency as the manifestations. Phlegm and blood stasis are considered to be intertwined throughout the disease course. Modern studies have shown that traditional Chinese medicine is significantly effective in improving the androgen levels， restoring ovulation， and improving insulin resistance in PCOS-HA patients. Representative prescriptions， such as Erxian Tang， Jiawei Xiaoyaosan， Guizhi Fulingwan， and Cangfu Daotantang， exert therapeutic effects through various mechanisms including regulation of the hypothalamic-pituitary-ovarian axis， reduction of ovarian androgen synthase activity， improvement of insulin signaling pathways， and inhibition of inflammation and oxidative stress， which demonstrates the characteristics of comprehensive treatment with traditional Chinese medicine. Based on the perspectives of etiology and pathogenesis of traditional Chinese medicine， modern medical cognition， typical prescriptions， and action mechanisms， this paper reviewed the research progress of traditional Chinese medicine in the treatment of PCOS-HA， aiming to provide a reference for in-depth research and clinical applications in this field.

Polycystic ovary syndrome （PCOS） is a common endocrine and metabolic disorder among women of reproductive age. Hyperandrogenism （HA）， one of its core pathological features， is closely associated with the clinical manifestations and metabolic complications of the disease. Current western medical treatments for PCOS-HA mainly include anti-androgen therapy and ovulation induction， such as short-acting oral contraceptives like Diane-35 and Yasmin. However， long-term use of these medications may result in adverse reactions like increasing the risk of liver dysfunction and exacerbating lipid metabolism disorders， with unsatisfactory long-term efficacy when used alone. Traditional Chinese medicine offers unique advantages in the treatment of PCOS-HA due to its holistic approach and multi-target regulatory mechanisms. In the view of traditional Chinese medicine， PCOS-HA is classified under the categories such as "delayed menstruation"， "amenorrhea"， and "infertility"， with kidney deficiency as the root， as well as liver stagnation and spleen deficiency as the manifestations. Phlegm and blood stasis are considered to be intertwined throughout the disease course. Modern studies have shown that traditional Chinese medicine is significantly effective in improving the androgen levels， restoring ovulation， and improving insulin resistance in PCOS-HA patients. Representative prescriptions， such as Erxian Tang， Jiawei Xiaoyaosan， Guizhi Fulingwan， and Cangfu Daotantang， exert therapeutic effects through various mechanisms including regulation of the hypothalamic-pituitary-ovarian axis， reduction of ovarian androgen synthase activity， improvement of insulin signaling pathways， and inhibition of inflammation and oxidative stress， which demonstrates the characteristics of comprehensive treatment with traditional Chinese medicine. Based on the perspectives of etiology and pathogenesis of traditional Chinese medicine， modern medical cognition， typical prescriptions， and action mechanisms， this paper reviewed the research progress of traditional Chinese medicine in the treatment of PCOS-HA， aiming to provide a reference for in-depth research and clinical applications in this field.

Objective:To investigate the impact of deep learning image reconstruction (DLIR), adaptive statistical iterative reconstruction-veo (ASiR-V) and filtered back projection (FBP) on the histogram and wavelet features of portal venous phase abdominal CT in patients with hepatic tumor.Methods:The CT data of 68 patients with hepatic tumor who underwent enhanced CT scans were retrospectively collected. FBP, 30%ASiR-V, DLIR-L, DLIR-M and DLIR-H images were reconstructed. The images of portal venous phase were reconstructed with five algorithms, including FBP, ASIR-V at a level of 30% (ASiR-V 30%), DLIR at low (DLIR-L), medium (DLIR-M), and high (DLIR-H). Histogram and wavelet features were extracted from hepatic lesion, liver, spleen, kidney and erector spinae muscle, and compared using one-way analysis of variance or Kruskal-Wallis test. Two radiologists delineated the three-dimensional lesions independently and one of them repeated the delineation after one month. Intra-class correlation coefficients ( ICC) among five sets of images were calculated to evaluate the consistency of radiomics features of hepatic lesion. P<0.05 was considered to indicate statistical significance. Results:Most histogram and wavelet features extracted from hepatic lesion, liver, spleen, kidney and erector spinae muscle showed significant differences among five groups (all P<0.05). The number of features without significant differences decreased with the intensity of DLIR reconstruction increased. For histogram features, there were no significant differences of energy, mean, median, and total energy among five sets of images ( P>0.05). For wavelet features, there were no significant differences of mean and median among five sets of images ( P>0.05). The consistency of all histogram features was high except for the mean value of wavelet feature. The intra-and inter-observer ICC ranged from 0.756 to 1 and 0.767 to 1, respectively. Conclusion:Both 30%ASiR-V and DLIR at three levels algorithms had influence on the histogram and wavelet features of abdominal organs and hepatic tumors extracted from CT images in portal venous phase, and the effects expanded with the strengthening of levels. Median can be a reliable quantitative parameter for CT texture analysis of hepatic tumor.

Objective:To investigate the impact of deep learning image reconstruction (DLIR), adaptive statistical iterative reconstruction-veo (ASiR-V) and filtered back projection (FBP) on the histogram and wavelet features of portal venous phase abdominal CT in patients with hepatic tumor.Methods:The CT data of 68 patients with hepatic tumor who underwent enhanced CT scans were retrospectively collected. FBP, 30%ASiR-V, DLIR-L, DLIR-M and DLIR-H images were reconstructed. The images of portal venous phase were reconstructed with five algorithms, including FBP, ASIR-V at a level of 30% (ASiR-V 30%), DLIR at low (DLIR-L), medium (DLIR-M), and high (DLIR-H). Histogram and wavelet features were extracted from hepatic lesion, liver, spleen, kidney and erector spinae muscle, and compared using one-way analysis of variance or Kruskal-Wallis test. Two radiologists delineated the three-dimensional lesions independently and one of them repeated the delineation after one month. Intra-class correlation coefficients ( ICC) among five sets of images were calculated to evaluate the consistency of radiomics features of hepatic lesion. P<0.05 was considered to indicate statistical significance. Results:Most histogram and wavelet features extracted from hepatic lesion, liver, spleen, kidney and erector spinae muscle showed significant differences among five groups (all P<0.05). The number of features without significant differences decreased with the intensity of DLIR reconstruction increased. For histogram features, there were no significant differences of energy, mean, median, and total energy among five sets of images ( P>0.05). For wavelet features, there were no significant differences of mean and median among five sets of images ( P>0.05). The consistency of all histogram features was high except for the mean value of wavelet feature. The intra-and inter-observer ICC ranged from 0.756 to 1 and 0.767 to 1, respectively. Conclusion:Both 30%ASiR-V and DLIR at three levels algorithms had influence on the histogram and wavelet features of abdominal organs and hepatic tumors extracted from CT images in portal venous phase, and the effects expanded with the strengthening of levels. Median can be a reliable quantitative parameter for CT texture analysis of hepatic tumor.

The coronavirus disease 2019 (COVID-19) pandemic has stimulated tremendous efforts to develop therapeutic agents that target severe acute respiratory syndrome coronavirus 2 to control viral infection. So far, a few small-molecule antiviral drugs, including nirmatrelvir-ritonavir (Paxlovid), remdesivir, and molnupiravir have been marketed for the treatment of COVID-19. Nirmatrelvir-ritonavir has been recommended by the World Health Organization as an early treatment for outpatients with mild-to-moderate COVID-19. However, the existing treatment options have limitations, and effective treatment strategies that are cost-effective and convenient for tackling COVID-19 are still needed. To date, four domestically developed oral anti-COVID-19 drugs have been granted conditional market approval in China. These drugs include azvudine, simnotrelvir-ritonavir (Xiannuoxin), leritrelvir, and mindeudesivir (VV116). Preclinical and clinical studies have explored the efficacy and tolerability of mindeudesivir and supported its early use in mild-to-moderate COVID-19 cases at high risk for progression. In this review, we discuss the most recent findings regarding the pharmacological mechanism and therapeutic effects focusing on mindeudesivir and other small-molecule antiviral agents for COVID-19. These findings will expand our understanding and highlight the potential widespread application of China's homegrown anti-COVID-19 drugs.
Humans ; Ritonavir/therapeutic use* ; COVID-19 ; Antiviral Agents/therapeutic use* ; China ; Nitriles ; Lactams ; Proline ; Adenosine/analogs & derivatives* ; Leucine

Objective:To summarize the case management of promoting the rehabilitation of oral and maxillofacial function of a patient with gingival cancer.Methods:The patient took the obturator prosthesis and orofacial myofunctional therapy to promote the rehabilitation of oral and maxillofacial function. The key points of nursing included: nursing of obturator prosthesis, orofacial myofunctional therapy, psychological nursing and evaluation of oral and maxillofacial function rehabilitation.Results:after one year of case management, the total score of the Chinese version of the obturator functioning scale was 18 points, the mouth opening was 4cm, and the speech distinctness was 98%. The quality of life of the patient was good.Conclusions:When the obturator prosthesis and orofacial myofunctional therapy are taken, all-round cooperation of the medical staff of different specialties from the perioperative period to the discharge follow-up should be strengthened in order to promote the rehabilitation of oral and maxillofacial function.

Objective To observe the levels of four bisphenols (bisphenol A,B,S and F) and their correlation with renal function in chronic kidney disease (CKD) patients.Methods Patients with CKD were identified according to Kidney Disease:Improving Global Outcomes (KDIGO) criteria.Sixty-three CKD patients and eleven healthy controls were enrolled.CKD patients were further classified as mild renal injury group (CKD stage 1 and 2,n=30),moderate renal injury group (CKD stage 3,n=19) and severe renal injury group (CKD stage 4 and 5,n=14).The levels of four bisphenols in serum were determined by high performance liquid chromatography (HPLC).The correlation between concentrations of four bisphenols and estimated glomerular filtration rate (eGFR) was assessed by Spearman's rank correlation analysis.The associations of four bisphenols with coronary heart disease,diabetes and hypertension in CKD patients were estimated by binary multivariate logistic regression.Results (1) Four bisphenols were not detected in serum of healthy control.In the mild renal injury group the bisphenol A and bisphenol S were not detected,and patients had 5.24 (5.24,9.38) μg/L bisphenol B and 0.74 (0.74,0.74) μg/L bisphenol F.In the moderate renal injury group bisphenol S was not detected,and patients had 2.79 (1.01,4.53) μg/L bisphenol A,5.24 (5.24,5.24) μg/L bisphenol B and 0.74 (0.74,0.74) μg/L bisphenol F.In severe renal injury group patients had 14.30 (7.97,18.17) μg/L bisphenol A,0 μg/L bisphenol B,23.73 (23.73,136.59) μg/L bisphenol S and 0.74 (0.74,1.42) μg/L bisphenol F.The levels of bisphenol A and bisphenol S in severe renal injury group were higher than those in the healthy control group,mild renal injury group and moderate renal injury group (all P ＜ 0.05).Bisphenol B and bisphenol F were not statistically different among four groups.(2) Bisphenol A and bisphenol S were negatively correlated with eGFR (r=-0.779,P ＜ 0.001;r=-0.546,P ＜ 0.001).(3) Among CKD patients,bisphenol A was correlated with diabetes (OR=4.951,95％CI 1.603-15.294,P=0.005),and bisphenol S was correlated with hypertension (OR=4.466,95％ CI 1.575-12.666,P=0.005).Conclusions CKD patients have a variety of bisphenol compounds,especially bisphenol A and bisphenol S.Bisphenol A and bisphenol S have high levels,and their exposures are correlated with renal function.

Objective To establish a citrate pharmacokinetics model which is applied to evaluate the risk of citrate accumulation in patients with liver dysfunction in the continuous renal replacement treatment (CRRT) with regional citrate anticoagulation (RCA). Methods The source of citrate for extracorporeal anticoagulation, the body clearance and filter elimination of citrate, which were the three major citrate fluxes of systemic citrate level, were combined into a single-pool, first order kinetic equation. The data from a published clinical study of systemic citrate kinetics in the intensive care unit patients with or without liver cirrhosis were adapted and the citrate kinetic equation was applied to predict the risk of systemic citrate accumulation in patients with normal, impaired and absent liver clearance while different RCA-CRRT protocols were carried out. Results The single pool, first order citrate kinetic modeling equation was as follows:Csys=C(0)·e-[(clb+clf)·t/V]+G/CLb+CLf×(1-e-[(clb+clf)·t/V])There was excellent agreement between published citrate measurements and our predictions. Kinetic modeling showed that the plasma citrate concentration of patients with normal citrate body clearance was no more than 1 mmol/L during common RCA-CRRT. The model predicted that when the single pass fractional extraction of citrate on the artificial kidney was above 66％, systemic steady citrate concentration would be among the safe range even in patients of impaired body metabolism of citrate.Conclusions The citrate kinetic model of RCA-CRRT can predict the risk of systemic citrate accumulation and provide the basis for designing the safe RCA-protocols for the patients with impaired body clearance of citrate.

Objective To study whether the uremic toxins accumulated long-term in uremia patients may be involved in oxidation of protein by forming advanced oxidative protein products (AOPPs). Methods Malonylaldehyde (MDA), hippuric acid (HA) and p-cresol were used as the representatives of uremic toxins. Human albumin serum (HSA), plasma specimens from normal or uremia patients were incubated respectively with MDA (10 retool/L), HA (20 mmol/L) and p-cresol (10 retool/L) or PBS (20 retool/L, pH 7.4, as control groups) at 37℃ for 30 minutes or 24 hours, respectively. Those indices such as AOPPs, protein thiol groups (Pt-SH) and dityrosine were used as biomarkers of protein injury. High performance liquid chromatography (HPLC) was employed to identify the aggregation and cross-links of modified proteins. Results AOPPs levels in all groups containing poison compounds were significantly increased by 121.5%(P<0.05) compared to that in control groups. Uremic toxins also resulted in over 14.7% loss in Pt-SH (P< 0.05) and 119.2% increment in dityrosine, respectively (P<0.05). Meanwhile, the formation of HMW-AOPPs in a time-dependent manner was observed by HPLC and cross-linked protein levels were significantly increased by 148.45%～333.3% in comparison with control groups. Conclusion Uremic toxins can directly mediate the damage of proteins by inducing the formation of HMW- AOPPs in a time-dependent manner, which is also one of the mechanism of AOPPs production in vivo besides the activation of the myeloperoxidase-H2O2-Cl pathway.

Objective To study the effect of oxidative modification of hydrochlorous acid (HOCl) on human serum albumin (HSA) and the relationship between the AOPPs and HOCl-treated HSA. Methods Purified HSA (60 mg/ml) was treated with HOCl (0, 1, 5, 10, 20, 30, 40, 50 and 60 mmol/L). Size-exclusion chromatography was applied to estimate molecular weights of oxidized products of HSA by HOCl and spectrum scan from 190 nm -400 nm was performed to observe the spectrum characteristics of all variants of HSA. Results Major products of HSA after exposure to HOC1 were dimer and hexmer of HSA. The first-order process could be employed to describe the oxidative dynamics of monomer and dimer of HSA oxidized by HOCl. To AOPPs formation mediated by oxidant was identified as pseudo first-order reaction. However, formation hexmer was much in accordance with second-order reaction. Hexmer was also a major contributor to AOPPs in all types of modified HSA. Spectral analysis showed that red shift of absorbance maximum of polymers of HSA occurred, suggesting that a possibility that polymers of HSA were cross linked by tyrosine residues in protein. Conclusions Protein aggregation is primary consequence of HSA after its exposure to HOCl. Hexmer of HSA is the major contributor to AOPPs.