Traditional Chinese medicine(TCM), a treasure of the Chinese nation, contains abundant chemical components and demonstrates unique pharmacological activities, showing important values in clinical applications. With profound connotations and broad application prospects, TCM urgently needs us to further explore and conduct systematic research. Puerarin is a small-molecule natural isoflavonoid carbon glycoside extracted from plants of Pueraria. It is also the main active ingredient of Puerariae Lobata Radix, a Chinese herbal medicine with both medicinal and edible values. Puerarin has a variety of pharmacological effects such as blood pressure-lowering, anti-atherosclerosis, anti-ischemia-reperfusion injury, antithrombotic, anti-tumor, anti-inflammatory, liver-protecting, nerve cell-protecting, and intestinal microbiota-regulating effects. It is also an active ingredient that has been widely studied. This article comprehensively reviews the research progress in the pharmacological effects and molecular mechanisms of puerarin over the years, aiming to provide references and theoretical support for the in-depth research and development as well as clinical application of puerarin.
Isoflavones/chemistry* ; Humans ; Animals ; Drugs, Chinese Herbal/chemistry* ; Pueraria/chemistry*

OBJECTIVE: To investigate the effectiveness of free palmaris longus tendon graft reconstruction in the treatment of gouty tophus erosion lesions in flexor tendon of wrist and hand. METHODS: A retrospective analysis was conducted on 8 patients with gouty tophus erosion lesions in flexor tendon of wrist and hand who underwent free palmaris longus tendon graft reconstruction between June 2017 and December 2023. All patients were male, aged 22-65 years, with an average of 45.9 years. The duration of gout history ranged from 2 to 18 years, with an average of 8.8 years. The duration from the discovery of gouty tophus to operation ranged from 12 to 26 months, with an average of 17.6 months. The gouty tophus eroded the flexor pollicis longus tendon in 4 cases, with Verdan flexor tendon zones being Ⅰ-Ⅱ in 1 case and Ⅳ-Ⅴ in 3 cases. The flexor digitorum profundus tendons were affected in 2 cases for the index finger, 1 for the middle finger, and 1 for the ring finger, all located in zone Ⅳ-Ⅴ. The long axis of the gouty tophus ranged from 2.3 to 4.5 cm, with an average of 3.4 cm. All 8 patients presented with limited finger flexion and extension. Among them, 4 cases were accompanied by median nerve compression symptoms, and 1 case had associated bone and joint destruction in the hand. The total active motion (TAM) of the affected finger was (81.3±30.2)° before operation according to the hand function evaluation criteria for tendon repair by the Chinese Society of Hand Surgery of the Chinese Medical Association, and the functional evaluation was poor. The harvested palmaris longus tendon intraoperatively was 7-9 cm in length. RESULTS: Surgical incisions in all 8 patients healed by first intention, with no infections, graft non-union, or significant adhesion complications. All patients were followed up 8-25 months, with an average of 14.8 months. Numbness symptoms resolved in all 4 patients who presented with median nerve compression symptoms. Patients did not experience wrist pain or other discomfort, and function was not compromised. At last follow-up, according to the hand function evaluation criteria for tendon repair by the Chinese Society of Hand Surgery of the Chinese Medical Association, the TAM of 8 patients was (197.5±55.8)°, which significantly improved when compared with that before operation ( t=11.638, P<0.001); the hand function of 1 patient with gouty tophus in zone Ⅰ-Ⅱ flexor pollicis longus tendon was good, and the other 7 patients were excellent. CONCLUSION Free palmaris longus tendon graft reconstruction demonstrates good effectiveness in treating gouty tophus erosion lesions in flexor tendon of wrist and hand.
Humans ; Middle Aged ; Male ; Adult ; Tendons/surgery* ; Retrospective Studies ; Aged ; Gout/complications* ; Wrist/surgery* ; Plastic Surgery Procedures/methods* ; Hand/surgery* ; Treatment Outcome ; Young Adult

OBJECTIVE: To explore the effectiveness of multi-segment inverted Y-shaped vein transplantation using the anterior lateral malleolar venous network for repair of amputated palm injury distal to the superficial palmar arch. METHODS: Between September 2018 and July 2023, 5 patients with amputated palm injury distal to the superficial palmar arch were treated. There were 3 males and 2 females with an average age of 35.4 years (range, 29-52 years). The time from injury to admission was 1-6 hours (mean, 3.2 hours). The multi-segment inverted Y-shaped vein transplantation in the anterior lateral malleolar venous network were used to repair the common and proper palmar digital arteries; the another anterior lateral malleolar venous network was used to repair the dorsal vein of the hand. The soft tissue defect of dorsal hand in 1 patient was repaired with the pedicled ilioinguinal flap, and the wound at the donor site was directly sutured. Postoperative treatment included anti-infection therapy, antispasmodic therapy, and thrombosis prevention measures. RESULTS: The partial necrosis of the fingertip of the thumb occurred in 1 case, and the marginal necrosis of the abdominal flap after operation occurred in 1 case. The remaining fingers showed good blood supply with normal tension. The incision at donor site of the abdominal flap healed by first intention. All patients were followed up 8-41 months (median, 19 months). At last follow-up, the hand contour was satisfactory; the grasping function, opposition function, and proprioception recovered, and two-point discrimination ranged from 5 to 7 mm (mean, 6 mm). According to the upper extremity function evaluation criteria issued by Hand Surgery Society of the Chinese Medical Association, the functional outcomes were excellent in 3 cases, good in 1 case, and fair in 1 case. CONCLUSION The multi-segment inverted Y-shaped vein transplantation using the anterior lateral malleolar venous network for repairing defects in the common and proper palmar digital arteries distal to the superficial palmar arch offers advantages such as superficial location, flexible harvesting, and high compatibility. This technique has demonstrated favorable outcomes in complex transmetacarpal amputation reconstruction.
Humans ; Adult ; Male ; Female ; Hand Injuries/surgery* ; Middle Aged ; Plastic Surgery Procedures/methods* ; Veins/transplantation* ; Surgical Flaps/blood supply* ; Hand/surgery* ; Treatment Outcome ; Soft Tissue Injuries/surgery*

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Alzheimer's disease(AD)is the most common cause of cognitive impairment in the elderly,and the formation of intracellular neurofibrillary tangles(NFT)due to the hyperphos-phorylation of Tau is one of its important pathological features.Compared to β-amyloid,the hyperphosphorylation of Tau and the resulting NFT are more closely related to the decline in cognitive ability.This review focuses on anti-AD drugs targeting Tau,em-phasizing the latest progress in inhibiting the hyperphosphoryla-tion of Tau protein,alleviating the aggregation of Tau protein,re-ducing the cytoskeletal damage caused by the hyperphosphoryla-tion of Tau protein by stabilizing microtubules,and immunothera-py,in the hope of providing new insights into drug research for AD and related cognitive disorders associated with Tau protein.

Objective:To evaluate a transhiatal tunnel flap designed to reconstruct the cardiac functional structure in proximal gastric cancer patients in our center.Methods:A descriptive case study method was used to select the data of 11 patients undergoing surgery for upper gastric cancer from Jan to Jul 2024. After laparoscopic dissection is completed, the esophagus is transected 2 cm from the upper edge of the tumor and the specimen is removed. The distance from the lower edge of the tumor is 5 cm. The cutting width is 4 cm, and the length of sleeve distal stump stomach is 20 cm. A seromuscular flap tunnel was made with a length of 2 cm and a width of 2 cm, 2 cm away from the top of the remnant stomach. The digestive tract was reconstructed using the Overlap hybridization method.Results:The median operation time was 175 (139-285) minutes. The median muscle flap production time and reconstruction time was 10.5 (5.5-21.0) minutes and 15.0 (11.8-33.6) minutes, respectively. The median blood loss is 50 (20-100) ml. The median postoperative hospitalization was 8 (6-25) days. The median tumor size was 2.5 (1.0-4.0) cm, and 31 (15-52) lymph nodes were dissected. The median follow-up after surgery was 3.5 (0.7-6.0) months, and no tumor recurrence or metastasis was found. Postoperative anastomotic leakage (Clavien-Dindo grade Ⅱ) occurred in one case, and there was no perioperative death. The Visick score of the whole group was 1 point in 8 cases and 2 points in 3 cases, and there was no anastomotic stenosis. Reflux esophagitis (Los Angeles classification grade B) was found in 1 case after gastroscopy, and the symptoms were relieved by conservative treatment.Conclusion:The transhiatal tunnel flap arthroplasty method has high surgical safety, low reconstruction difficulty, and an reliable anti-reflux effect.

Objective To explore the clinical features,treatment and prognosis of traumatic subdural effusion(TSE)in infants.Methods Data of 51 cases of traumatic subdural effusion in infants admitted to the single center of Dalian Women and Children Medical Center(Group)from February 2013 to February 2020 were retrospectively analyzed,and their clinical manifestations,imaging features,treatment methods and prognosis were summarized and analyzed.Results Fifty-one cases(26 males and 25 females),ranging in age from 1 month to 3 years old of traumatic subdural effusion in infants were reviewed in our hospital,all cases were confirmed by Computed Tomography(CT)examination.31 cases were treated conservatively,29 cases were cured,and 2 cases were treated surgically due to poor conservative treatment.Surgical treatment was performed in 22 cases(including 2 cases who received surgical treatment due to poor conservative treatment).One patient underwent puncture and continuous drainage at the lateral Angle of the anterior fontanelle and was cured.Twenty-one cases underwent cranial drilling,subdural space catheterization for external drainage,and 17 cases(80.95％,17/21)were cured at one time.There were 4 cases(19.05％,4/21)of recurrence after external drainage with catheterization.Two cases were cured by external drainage with Ommaya capsule insertion and intermittent aspiration and fluid drainage.It was changed to subdural peritoneal shunt surgery,and 2 cases were cured after the operation.There was no surgical infection or death in all the children in the group.The median follow-up time ranged from 3 months to 60 months,and the conditions were all stable.Conclusion Traumatic subdural effusion is a common complication after craniocerebral injury in infants and young children.Due to its lack of self-expression,the hidden condition is often ignored.Moreover,the brain tissue of infants and young children is in the growth and development stage,which will affect the development of brain tissue after its onset.

With the rapid development of artificial intelligence, computational pathology has been seamlessly integrated into the entire clinical workflow, which encompasses diagnosis, treatment, prognosis, and biomarker discovery. This integration has significantly enhanced clinical accuracy and efficiency while reducing the workload for clinicians. Traditionally, research in this field has depended on the collection and labeling of large datasets for specific tasks, followed by the development of task-specific computational pathology models. However, this approach is labor intensive and does not scale efficiently for open-set identification or rare diseases. Given the diversity of clinical tasks, training individual models from scratch to address the whole spectrum of clinical tasks in the pathology workflow is impractical, which highlights the urgent need to transition from task-specific models to foundation models (FMs). In recent years, pathological FMs have proliferated. These FMs can be classified into three categories, namely, pathology image FMs, pathology image-text FMs, and pathology image-gene FMs, each of which results in distinct functionalities and application scenarios. This review provides an overview of the latest research advancements in pathological FMs, with a particular emphasis on their applications in oncology. The key challenges and opportunities presented by pathological FMs in precision oncology are also explored.
Humans ; Precision Medicine/methods* ; Medical Oncology/methods* ; Artificial Intelligence ; Neoplasms/pathology* ; Computational Biology/methods*

Alzheimer's disease(AD)is the most common cause of cognitive impairment in the elderly,and the formation of intracellular neurofibrillary tangles(NFT)due to the hyperphos-phorylation of Tau is one of its important pathological features.Compared to β-amyloid,the hyperphosphorylation of Tau and the resulting NFT are more closely related to the decline in cognitive ability.This review focuses on anti-AD drugs targeting Tau,em-phasizing the latest progress in inhibiting the hyperphosphoryla-tion of Tau protein,alleviating the aggregation of Tau protein,re-ducing the cytoskeletal damage caused by the hyperphosphoryla-tion of Tau protein by stabilizing microtubules,and immunothera-py,in the hope of providing new insights into drug research for AD and related cognitive disorders associated with Tau protein.

Objective To explore the clinical features,treatment and prognosis of traumatic subdural effusion(TSE)in infants.Methods Data of 51 cases of traumatic subdural effusion in infants admitted to the single center of Dalian Women and Children Medical Center(Group)from February 2013 to February 2020 were retrospectively analyzed,and their clinical manifestations,imaging features,treatment methods and prognosis were summarized and analyzed.Results Fifty-one cases(26 males and 25 females),ranging in age from 1 month to 3 years old of traumatic subdural effusion in infants were reviewed in our hospital,all cases were confirmed by Computed Tomography(CT)examination.31 cases were treated conservatively,29 cases were cured,and 2 cases were treated surgically due to poor conservative treatment.Surgical treatment was performed in 22 cases(including 2 cases who received surgical treatment due to poor conservative treatment).One patient underwent puncture and continuous drainage at the lateral Angle of the anterior fontanelle and was cured.Twenty-one cases underwent cranial drilling,subdural space catheterization for external drainage,and 17 cases(80.95％,17/21)were cured at one time.There were 4 cases(19.05％,4/21)of recurrence after external drainage with catheterization.Two cases were cured by external drainage with Ommaya capsule insertion and intermittent aspiration and fluid drainage.It was changed to subdural peritoneal shunt surgery,and 2 cases were cured after the operation.There was no surgical infection or death in all the children in the group.The median follow-up time ranged from 3 months to 60 months,and the conditions were all stable.Conclusion Traumatic subdural effusion is a common complication after craniocerebral injury in infants and young children.Due to its lack of self-expression,the hidden condition is often ignored.Moreover,the brain tissue of infants and young children is in the growth and development stage,which will affect the development of brain tissue after its onset.