Objective To investigate the therapeutic effect of Huangkui capsules on targeted drug-related proteinuria in patients with hepatocellular carcinoma (HCC). Methods A retrospective analysis was conducted on clinical data of HCC patients with targeted drug-related proteinuria from June 2023 to December 2024 at Zhongshan Hospital, Fudan University. According to the treatment plan, patients were divided into the conventional treatment group and the Huangkui combination treatment group (Huangkui capsules combined with conventional treatment), and the clinical efficacy between the two groups was compared. The logistic regression analysis was used to identify the main factors affecting treatment efficacy. Results The Huangkui combination treatment group (n＝29) showed a significantly higher overall effective rate (79.3% vs 42.3%, P＝0.005), and an earlier proteinuria improvement (median time: 3 months vs 6 months, P＝0.008) than the conventional treatment group (n＝26) . The multivariate logistic regression analysis showed angiotensin-converting enzyme inhibitor (ACEI) or angiotensin Ⅱ receptor blocker (ARB) using (OR＝0.190, 95%CI 0.045-0.808, P＝0.025), targeted drug adjustment (OR＝0.132, 95%CI 0.030-0.581, P＝0.007), and Huangkui capsules using (OR＝0.168, 95%CI 0.039-0.730, P＝0.017) were protective factors for treatment efficacy of targeted drug-related proteinuria. Conclusions On the basis of conventional treatment, additive treatment with Huangkui capsules can alleviate targeted drug-related proteinuria faster and more effectively in HCC patients.

Objective To investigate the effects of electroacupuncture(EA)at"Baihui(GV 20),""Pishu(BL 20),"and"Zusanli(ST 36)"on the learning and memory functions of rats with Alzheimer's disease(AD)induced by Aβ1-42.Additionally,the mechanism of EA in treating AD was explored from the perspective of the inflammatory cascade mediated by the NF-κ B/NLRP3/Caspase-1 signaling pathway.Methods A rat model of Alzheimer's disease was established by bilateral injection of Aβ1-42 solution into the C1 region of the hippocampus.According to the random number table method,32 male SPF-grade rats were divided into four groups(n=8 per group):a sham-operated group,a model group,an electroacupuncture(EA)group,and a Western medicine group(donepezil hydrochloride).The EA group received electroacupuncture at the"Baihui","Pishu",and"Zusanli"acu-points;the Western medicine group received donepezil hydrochloride via gavage.After the treatment period,Morris water maze experiments were conducted to evaluate learning and memory abilities.Hematoxylin and eosin(HE)staining was used to examine morphological changes in hippocampal tissues.Enzyme-linked immunosorbent assay(ELISA)was employed to measure serum levels of TNF-α and IL-1β.Western blotting and immunofluorescence staining were utilized to assess the co-expression levels of NF-κB p65,NLRP3,and Caspase-1 proteins in the hippocampal region.Results Compared with the sham-operated group,rats in the post-modeling group exhibited significantly prolonged escape latency(P<0.05),reduced crossings of the original platform location,and decreased time spent in the target quadrant(P<0.05).Additionally,nuclear morphology was altered,neurons surrounding the hippocampus displayed necrosis,vacuolar degeneration,and chromatin marginalization.Serum levels of TNF-α and IL-1β were elevated(P<0.05),and protein expression levels as well as fluorescent positivity for NF-κB p65,NLRP3,and caspase-1 in the hippocampus were increased(P<0.05).Compared with the model group,rats in both the EA and Western medicine groups showed a trend toward shorter escape latency(P<0.05),increased crossings of the original platform location and time spent in the target quadrant(P<0.05).Cell structures were largely intact,with only a few nuclei showing slight irregularities and some chromatin accumulation at the edges.Serum levels of TNF-α and IL-1β were reduced(P<0.05),and protein expression levels and fluorescence positivity for NF-κB p65,NLRP3,and caspase-1 in the hippocampus were also decreased(P<0.05).Conclusion EA enhances the learning and memory capabilities of AD rats,potentially by downregulating the NF-κ B/NLRP3/Caspase-1+signaling+pathway and decreasing the release of neuroinflammatory factors,thereby alleviating cognitive dysfunction in AD rats.

Objective::To analyze fetal renal abnormality genetic features and the prenatal characteristics of the 17q12 microdeletion syndrome.Methods::This prospective cohort study examined prenatal ultrasound findings of renal abnormalities in pregnant women who underwent single nucleotide polymorphism (SNP) array or copy number variation sequencing (CNV-seq) testing on amniotic fluid or fetal tissue at Tianjin Central Obstetrics and Gynecology Hospital between January 2016 and August 2022. The study cohort comprised women with advanced maternal age, fetal ultrasound anomalies, high-risk non-invasive prenatal testing results, or suspected 17q12 microdeletion syndrome. Comprehensive clinical data, including maternal age, detailed ultrasound findings, and pregnancy outcomes, were systematically collected. SNP-array analysis was conducted using an Affymetrix CytoScan 750 K Array Chip to identify CNVs and loss of heterozygosity, while CNV-seq was performed on the Illumina HiSeq 2000 platform. Detected variants were classified according to the American College of Medical Genetics and Genomics guidelines. Statistical analyses were performed using SPSS version 27.0.Results::Abnormal renal development was identified in 141 patients, among whom 26 exhibited hyperechogenic kidneys (HCK). Of these, 12 cases were associated with 17q12 microdeletion syndrome, while the remaining 14 were linked to other chromosomal abnormalities. When excluding patients with HCK, those diagnosed with polycystic kidney disease demonstrated a higher prevalence of chromosomal abnormalities compared to those with multicystic dysplastic kidney and renal dysplasia. Although isolated conditions such as horseshoe kidney, hydronephrosis, ectopic kidney, and unilateral kidney typically presented with normal chromosomal findings, the incidence of chromosomal abnormalities increased when these conditions coexisted with other anomalies. A detailed analysis of the correlation between 17q12 microdeletion syndrome and HCK revealed that 12 out of the 14 patients diagnosed with 17q12 microdeletion syndrome exhibited HCK. Genetic testing confirmed the syndrome in seven patients, with five cases attributed to novel mutations and two cases resulting from inherited mutations.Conclusion::Fetal HCK was closely associated with the 17q12 microdeletion syndrome, and polycystic kidney disease showed a higher rate of chromosomal abnormalities. Chromosome test results were mostly normal in patients with other renal abnormalities, such as kidney dysplasia, horseshoe kidneys, hydronephrosis, kidney deficiency, and ectopic kidneys. Prenatal diagnosis is recommended, especially in cases of non-isolated fetal renal abnormalities. This study provides strong evidence supporting a link between fetal renal abnormalities and genetic syndromes.

Atopic dermatitis is a common chronic,relapsing,inflammatory skin disease;however,its pathogenesis remains unclear.The theory of"clear-turbid interference"originates from the Inner Canon of Yellow Emperor and refers to a pathological condition in which clear yang and turbid yin intermingle,and qi movement becomes disordered.This paper elucidates the theoretical connotation of"clear-turbid interference"and its core mechanism in triggering atopic dermatitis,as well as the role of the"gut-skin axis"in atopic dermatitis development.Internal dampness-turbidity and disharmony between ying and wei constitute the core pathological mechanisms linking clear-turbid interference to atopic dermatitis.Treatment for different stages and syndromes should be guided by syndrome differentiation.For example,for spleen deficiency with a dampness syndrome in subacute or chronic stages,Chushi Weiling Decoction may be used to fortify the spleen,eliminate dampness,lift the clear,and downbear the turbid.For patterns with prominent heat manifestations,such as dampness-heat immersion or heart fire with spleen deficiency,bitter-cold dampness-drying herbs can be added on this basis.For wind-dampness-heat accumulation in the acute stage,Mahuang Lianyao Chixiaodou Decoction can be used to release the exterior,expel pathogens,and harmonize ying and wei.In cases of spleen deficiency with blood dryness or liver-kidney insufficiency during the chronic stage,in addition to nourishing yin to moisten the skin and tonifying the liver-kidney,wind-medicinals should also be employed to open the sweat pores and promote qi movement.These approaches restore the physiological state without clear-turbid interference while regulating intestinal flora,providing new approaches and perspectives for integrating traditional Chinese and Western medicine in treating atopic dermatitis.

BACKGROUND:SOX5 is an important transcription factor of the SRY-related HMG-box(SOX)family,which plays a key role in regulating the expression of genes related to bone development and remodeling,especially during osteoblast differentiation and chondrocyte maturation,through its unique HMG box DNA structural domains in concert with SOX6 and SOX9.In addition,the expression and activity of SOX5 and its family are regulated by a variety of diseases and different forms of exercise,among other factors,suggesting that SOX5 and its family have the potential to be effective as drugs and therapeutics to ameliorate related diseases in the future.OBJECTIVE:To provide new perspectives for future research on SOX5 and to provide scientific basis for the application of exercise intervention and drug therapy in the prevention and treatment of bone diseases.METHODS:CNKI and PubMed databases were searched for relevant literature published from 2001 to June 2024,and the search terms were"SRY-related HMG-box5,SOX5,Bone"in Chinese and English,respectively.After screening,analysis and summarization,105 articles were included in the final review.RESULTS AND CONCLUSION:(1)Role of SOX5 in bone development:SOX5 is an important member of the SOX family,which plays a central role in the regulation of skeletal development,bone metabolism and cartilage formation.In synergy with SOX6 and SOX9,SOX5 activates gene expression in osteoblasts and chondrocytes by binding to specific DNA sequences to regulate bone formation and bone remodeling.(2)Abnormal expression of SOX5 is closely related to bone and joint diseases such as chondrodysplasia,osteoporosis and osteoarthritis,suggesting that it may be a key regulator of these diseases.Currently,a variety of drugs may be used to treat bone metabolism-related diseases by regulating SOX5 and its family,and upregulation of SOX5 in mesenchymal stem cells may be effective in improving the symptoms of bone metabolism disease patients in bone tissue engineering.(3)Exercise may effectively prevent osteoporosis and related bone diseases by enhancing bone metabolism and promoting osteoblast differentiation and bone density increase.This mechanism of action may be related to the specific regulatory mechanism of SOX5,especially in different types,intensities and durations of exercise need to be further explored and studied.In conclusion,SOX5 has an important regulatory role in bone development,chondrogenesis,and prevention of bone diseases,and its activity is regulated by a variety of factors,while exercise intervention provides a new scientific basis for the treatment of bone diseases.

Atopic dermatitis is a common chronic,relapsing,inflammatory skin disease;however,its pathogenesis remains unclear.The theory of"clear-turbid interference"originates from the Inner Canon of Yellow Emperor and refers to a pathological condition in which clear yang and turbid yin intermingle,and qi movement becomes disordered.This paper elucidates the theoretical connotation of"clear-turbid interference"and its core mechanism in triggering atopic dermatitis,as well as the role of the"gut-skin axis"in atopic dermatitis development.Internal dampness-turbidity and disharmony between ying and wei constitute the core pathological mechanisms linking clear-turbid interference to atopic dermatitis.Treatment for different stages and syndromes should be guided by syndrome differentiation.For example,for spleen deficiency with a dampness syndrome in subacute or chronic stages,Chushi Weiling Decoction may be used to fortify the spleen,eliminate dampness,lift the clear,and downbear the turbid.For patterns with prominent heat manifestations,such as dampness-heat immersion or heart fire with spleen deficiency,bitter-cold dampness-drying herbs can be added on this basis.For wind-dampness-heat accumulation in the acute stage,Mahuang Lianyao Chixiaodou Decoction can be used to release the exterior,expel pathogens,and harmonize ying and wei.In cases of spleen deficiency with blood dryness or liver-kidney insufficiency during the chronic stage,in addition to nourishing yin to moisten the skin and tonifying the liver-kidney,wind-medicinals should also be employed to open the sweat pores and promote qi movement.These approaches restore the physiological state without clear-turbid interference while regulating intestinal flora,providing new approaches and perspectives for integrating traditional Chinese and Western medicine in treating atopic dermatitis.

Objective:To understand the composition of infectious pathogens and the changes in the epidemic characteristics of inpatients with acute respiratory tract infections in Pudong New Area of Shanghai, from 2018 to 2023.Methods:Specimens of inpatients with acute respiratory infection cases were collected from 14 healthcare institutions in Pudong New Area, Shanghai, from 2018-2023 and tested for eight respiratory pathogens: influenza virus, adenovirus, rhinovirus, parainfluenza virus, respiratory syncytial virus, common coronavirus, metapneumovirus, and bocavirus. The groups were divided into three periods,2018-2019, 2020-2022 and 2023, and the chi-square or Kruskal-Wallis rank sum test was used to compare the group differences. The SPSS 22.0 software was used for statistical analysis.Results:Among the 3 023 inpatients with acute respiratory infection, the positive rate of any virus was 24.25% (733/3 023). The positive rates of any virus in 2018-2019, 2020-2022, and 2023 were 33.40% (336/1 006), 12.01% (116/966), and 26.74% (281/1 051), respectively, and the differences were statistically significant ( χ2=128.20, P<0.001). Among the age groups, in 2018-2019 and 2020-2022, the positive rate of any virus was the highest in the <5 years age group (46.20% and 14.64%), while in 2023, the 15-59 years age group had the highest positive rate (32.97%). The positive rate of any virus in winter was the highest in 2018-2019 (53.21%) and 2020-2022 (17.58%), and the highest in autumn was in 2023 (31.53%). The peak positive rate of respiratory syncytial virus was in winter of 2018-2019 and 2020-2022, as well as the summer of 2023.The positive rates of influenza virus in 2018-2019, 2020-2022 and 2023 were 9.84%, 1.55% and 9.71%, respectively. Conclusions:The pathogen epidemic characteristics of inpatients with acute respiratory infection in Pudong New Area from 2018 to 2023 have shown certain changes. It is necessary to strengthen monitoring. Targeted prevention and control strategies should be developed and implemented in a timely manner.

ObjectiveTo investigate the infection characteristics of respiratory syncytial virus (RSV) in children with acute respiratory tract infection (ARI) in Pudong New Area, Shanghai, from 2013 to 2023, so as to provide an evidence for the prevention and control of RSV in Shanghai. MethodsChildren who sought medical care at sentinel healthcare facilities in Pudong New Area, Shanghai, between January 2013 and December 2023 and met the case definition of ARI were included in the study. Nasopharyngeal swab samples were collected and tested for viral pathogens using real-time fluorescene PCR, and the clinical information of whom was collected simultaneously. ResultsA total of 4 980 children were included in the ARI surveillance, among whom 231 tested positive for RSV, with an overall detection rate of 4.64%. Of these, 106 cases were type A and 125 were type B. From 2013 to 2023, the detection rate of RSV in children showed an overall trend of initial increase followed by a decline, with higher detection rates in autumn and winter and lower rates in spring and summer. The RSV detection rate gradually decreased with age, with the highest rate observed in children <1 year old, accounting for 16.33% (80/490) of RSV-detection cases. Cough was the most common clinical symptom. Among the RSV-positive cases, 36 involved co-infection with another virus, 6 co-infected with three viruses, and 1 with mixed infection of four viruses. The most frequent co-infection was RSV and human coronavirus. ConclusionChildren under 1 year of age are more susceptible to RSV infection, with cough being the predominant symptom. RSV infection in Pudong New Area, Shanghai, mainly occurs in winter. Targeted prevention and control measures should be taken for children under 1 year old during the winter season to reduce the risk of both RSV infection and co-infection with human coronavirus and influenza virus.

ObjectiveTo investigate the efficacy of Xingpi capsules （XPC） in treating diarrhea-predominant irritable bowel syndrome （IBS-D） with spleen deficiency and elucidate its potential molecular mechanisms. MethodsA rat model of IBS-D with spleen deficiency was established by administering senna leaf in combination with restrained stress and swimming fatigue for 14 d. Ten specific pathogen free （SPF）-grade healthy rats were used as the normal control group. After successful modeling， SPF-grade rats were randomly divided into a model group， a pinaverium bromide group （1.5 mg·kg^-1）， and low- and high-dose XPC groups （0.135 and 0.54 g·kg^-1）， with 10 rats in each group. Rats in the normal control group and the model group were given distilled water by gavage， while the remaining groups were administered corresponding drug solutions by gavage once a day for 14 consecutive days. The rat body weights and fecal condition were observed every day， and the Bristol score was recorded. Enzyme-linked immunosorbent assay （ELISA） was used to determine the levels of 5-hydroxytryptamine （5-HT） in serum and colon tissue. Transmission electron microscopy was used to observe the microvilli and tight junctions in the colon. The integrity of the colonic barrier， intestinal motility， and expression of related pathway proteins were evaluated by hematoxylin-eosin （HE） staining， immunohistochemistry， and Western blot. ResultsCompared with those in the normal control group， rats in the model group showed a significantly decreased body weight and increased diarrhea rate， diarrhea grade， and Bristol score （P<0.01）. HE staining revealed incomplete colonic mucosa in the model group， with evident congestion and edema observed. Electron microscopy results indicated decreased density and integrity of the colonic barrier， shedding and disappearance of microvilli， and significant widening of tight junctions. The expression levels of colonic tight junction proteins Occludin and Claudin-5 were downregulated （P<0.01）， and the levels of 5-HT in serum and colon tissue were elevated （P<0.01）. The small intestine propulsion rate significantly increased （P<0.01）， and the expression of contractile proteins Ras homolog family member A （RhoA） and Rho-associated coiled-coil containing protein kinase 2 （ROCK2） in colon and phosphorylation of myosin light chain （MLC₂₀） were upregulated （P<0.01）. Compared with the model group， the treatment groups showed alleviated diarrhea， diarrhea-associated symptoms， and pathological manifestations of colon tissue to varying degrees. Specifically， high-dose XPC exhibited effectively relieved diarrhea， promoted recovery of colonic mucosal structure， significantly reduced congestion and edema， upregulated expression of Occludin and Claudin-5 （P<0.01）， decreased levels of 5-HT in serum and colon tissue （P<0.05，P<0.01）， significantly slowed small intestine propulsion rate （P<0.01）， and significantly downregulated expression of contractile proteins RhoA and ROCK2 in colon and phosphorylation of MLC₂₀ （P<0.05，P<0.01）. ConclusionXPC effectively alleviates symptoms of spleen deficiency and diarrhea and regulates the secretion of brain-gut peptide. The characteristics of XPC are mainly manifested in alleviating IBS-D with spleen deficiency from the aspects of protecting intestinal mucosa and inhibiting smooth muscle contraction， and the mechanism is closely related to the regulation of the 5-HT-RhoA/ROCK2 pathway expression.

BACKGROUND:SOX5 is an important transcription factor of the SRY-related HMG-box(SOX)family,which plays a key role in regulating the expression of genes related to bone development and remodeling,especially during osteoblast differentiation and chondrocyte maturation,through its unique HMG box DNA structural domains in concert with SOX6 and SOX9.In addition,the expression and activity of SOX5 and its family are regulated by a variety of diseases and different forms of exercise,among other factors,suggesting that SOX5 and its family have the potential to be effective as drugs and therapeutics to ameliorate related diseases in the future.OBJECTIVE:To provide new perspectives for future research on SOX5 and to provide scientific basis for the application of exercise intervention and drug therapy in the prevention and treatment of bone diseases.METHODS:CNKI and PubMed databases were searched for relevant literature published from 2001 to June 2024,and the search terms were"SRY-related HMG-box5,SOX5,Bone"in Chinese and English,respectively.After screening,analysis and summarization,105 articles were included in the final review.RESULTS AND CONCLUSION:(1)Role of SOX5 in bone development:SOX5 is an important member of the SOX family,which plays a central role in the regulation of skeletal development,bone metabolism and cartilage formation.In synergy with SOX6 and SOX9,SOX5 activates gene expression in osteoblasts and chondrocytes by binding to specific DNA sequences to regulate bone formation and bone remodeling.(2)Abnormal expression of SOX5 is closely related to bone and joint diseases such as chondrodysplasia,osteoporosis and osteoarthritis,suggesting that it may be a key regulator of these diseases.Currently,a variety of drugs may be used to treat bone metabolism-related diseases by regulating SOX5 and its family,and upregulation of SOX5 in mesenchymal stem cells may be effective in improving the symptoms of bone metabolism disease patients in bone tissue engineering.(3)Exercise may effectively prevent osteoporosis and related bone diseases by enhancing bone metabolism and promoting osteoblast differentiation and bone density increase.This mechanism of action may be related to the specific regulatory mechanism of SOX5,especially in different types,intensities and durations of exercise need to be further explored and studied.In conclusion,SOX5 has an important regulatory role in bone development,chondrogenesis,and prevention of bone diseases,and its activity is regulated by a variety of factors,while exercise intervention provides a new scientific basis for the treatment of bone diseases.