OBJECTIVE To investigate the effects and mechanisms of Buyang huanwu decoction （BYHWD） and its active fractions in ameliorating non-alcoholic fatty liver disease. METHODS BYHWD and its effective fractions obtained through ethanol precipitation， as well as 30% ethanol， 50% ethanol， and 75% ethanol fractions （namely， the CC effective fraction， 30YC effective fraction， 50YC effective fraction， and 75YC effective fraction）， were prepared. These preparations were administered to rats via intragastric administration to prepare corresponding drug-containing serum （blank serum and simvastatin-containing serum were prepared using the same protocol）. Human L02 hepatocytes were divided into control group， model group， simvastatin-containing serum group， BYHWD-containing serum group， CC-containing serum group， 30YC-containing serum group， 50YC-containing serum group， and 75YC-containing serum group. Except for the control group， other groups were given 0.2 mol/L oleic acid for 24 h to induce a lipid accumulation model， and then intervened with 20% drug-containing serum/blank serum for 24 h. The lipid deposition in cells was observed， and the proportion of lipid droplet area was calculated； the levels of triglycerides （TG） and indicators of oxidative stress [malondialdehyde （MDA）， superoxide dismutase （SOD）] as well as liver function [alanine amino- transferase （ALT）， aspartate amino-transferase （AST）] in cells were detected； protein and mRNA expressions of AMP-activated protein kinase （AMPK）/sterol regulatory element-binding protein-1 （SREBP-1）/glycerol-3-phosphate acyltransferase （GPAT） signaling pathway were also measured. RESULTS Compared with the control group， cells in the model group exhibited severe cellular steatosis， with a significantly increased proportion of lipid droplet area， as well as the elevated levels of TG， ALT， AST， and MDA in cells， along with significantly up-regulated mRNA and protein expression levels of SREBP-1 and GPAT （P＜0.05）. The level of SOD， mRNA expression of AMPK， as well as the protein phosphorylation level of AMPK were decreased significantly （P＜0.05）. Compared with the model group， cellular steatosis was alleviated in all drug-containing serum groups， and the levels of most of the aforementioned quantitative indicators were significantly reversed （P＜0.05）. CONCLUSIONS BYHWD and its active fractions can exert a therapeutic effect on improving non-alcoholic fatty liver disease by regulating the AMPK/SREBP-1/GPAT signaling pathway， inhibiting oxidative stress responses， and reducing lipid deposition.

To investigate the mutations of NF1 and clinical phenotypes in patients with sporadic neurofibromatosis type 1 (NF1). This is aimed to evaluate the efficacy of high-throughput sequencing in diagnosing atypical cases, to expand the mutational spectrum of NF1, and to provide early diagnosis of NF1. Clinical data from 11 sporadic NF1 patients without family history treated at the Fifth Affiliated Hospital of Sun Yat-sen University (2019-2023) were collected. The mutations of NF1 gene were detected using whole-exome sequencing or chip-capture high-throughput sequencing, followed by bioinformatics analysis. Novel mutations were screened against normal population databases to exclude benign polymorphisms, and pathogenicity of the mutations was classified according to ACMG guidelines. The results showed that two novel frameshift mutations were identified: c.7904del (p.Asp2635Valfs*9) and c.5122_5123del (p.Phe1708Hisfs*9). The patient carrying c.7904del exhibited an undocumented phenotype of posterior medullary ischemic degeneration. Among the 11 NF1 patients, the types of mutations included frameshift (4/11), nonsense (3/11), intronic (2/11), splicing (1/11), and start codon variants (1/11). Common phenotypes were cafe-au-lait macules (8/11) and neurofibromas (6/11), yet significant phenotypic heterogeneity existed among patients sharing identical mutations. In conclusion, this study discovered two novel NF1 mutations and an unreported phenotype, expanding both the NF1 mutational spectra and highlights the need for attention to cerebrovascular status in patients carrying NF1 mutations. High-throughput sequencing significantly enhances molecular diagnostic efficacy for atypical NF1, providing a critical basis for clinical NF1 diagnosis.

Retinal vein occlusion (RVO) is a common retinal vascular disease, and macular edema (ME) is the most common cause of visual impairment in eyes with RVO.Intravitreal injection of anti-vascular endothelial growth factor (VEGF) has been advocated as a first-line therapy for ME secondary to RVO.After anti-VEGF treatment, the patient's visual function recovers well in the short term, but the long-term efficacy is unstable and the recurrence rate of ME is high.Therefore, it is of great clinical value to predict the factors influencing the recurrence of ME, which would help determine which patients should receive frequent follow-up and more aggressive treatment to achieve better clinical outcomes.In this paper, the influencing factors of recurrence of ME secondary to RVO are summarized, including disorganization of retinal inner layer, change in the macular microvascular structure, change in choroid thickness, the non-perfusion area between different areas of the retina, inflammatory cytokines, retinal blood flow and blood flow velocity, etc., which can provide an important basis for patient counseling, clinical diagnosis and treatment and prognostic follow-up.

Retinal vein occlusion (RVO) is a common retinal vascular disease, and macular edema (ME) is the most common cause of visual impairment in eyes with RVO.Intravitreal injection of anti-vascular endothelial growth factor (VEGF) has been advocated as a first-line therapy for ME secondary to RVO.After anti-VEGF treatment, the patient's visual function recovers well in the short term, but the long-term efficacy is unstable and the recurrence rate of ME is high.Therefore, it is of great clinical value to predict the factors influencing the recurrence of ME, which would help determine which patients should receive frequent follow-up and more aggressive treatment to achieve better clinical outcomes.In this paper, the influencing factors of recurrence of ME secondary to RVO are summarized, including disorganization of retinal inner layer, change in the macular microvascular structure, change in choroid thickness, the non-perfusion area between different areas of the retina, inflammatory cytokines, retinal blood flow and blood flow velocity, etc., which can provide an important basis for patient counseling, clinical diagnosis and treatment and prognostic follow-up.

Objective:To analyze and compare the reporting data of adverse events following immunization (AEFI) of influenza vaccines in Fujian Province from 2019 to 2023.Methods:Using the National Immunization Program Information Management System, the AEFI reports and vaccination data of influenza vaccines in Fujian Province from 2019 to 2023 were collected, and the reporting rates and clinical characteristics of AEFI of 6 types of influenza vaccines were compared. The 6 types of vaccines in the analysis were as follows: trivalent inactivated influenza vaccines (IIV3) for 6-35 months old people, IIV3 for ≥3 years old people, trivalent live attenuated nasal spray vaccine (LAIV3) for 3-17 years old people, quadrivalent inactivated influenza vaccines (IIV4) for 6-35 months old people, IIV4 for ≥6 months old people, and IIV4 for ≥3 years old people.Results:From 2019 to 2023, a total of 87 687.21 million doses of influenza vaccine were vaccinated in Fujian Province, and 510 cases of AEFI were reported, with a reporting rates of 5.82 per 100 000 doses. Among the 510 cases, 443 (86.86%) were general reactions, 56 (10.98%) were abnormal reactions, 1 (0.20%) was psychogenic reactions, and 10 (1.96%) were coincidence. There were no reports of vaccination accidents and vaccine quality accidents. The reporting rates of AEFI were relatively higher in 2019 and 2020 (18.38 and 18.00 per 100 000 doses, respectively), and lower in 2021, 2022 and 2023 (8.91, 10.68 and 2.30 per 100 000 doses, respectively); the differences were statistically significant (all P<0.05). The differences of reporting rates of AEFI between IIV3 for 6-35 months old people and IIV4 for 6-35 months old people, the injectable vaccines and nasal spray vaccines were not statistically significant. However, the reporting rates of overall AEFI, general reactions and abnormal reactions of IIV3 for ≥3 years old people were all higher than those of IIV4 for ≥3 years old people (7.77 per 100 000 doses vs. 3.88 per 100 000 doses, 6.18 per 100 000 doses vs. 3.59 per 100 000 doses, 1.41 per 100 000 doses vs. 0.19 per 100 000 doses). The reporting rates of overall AEFI and general reaction of IIV3 for 6-35 months old people were both higher than those of IIV3 for ≥3 years old (16.47 per 100 000 doses vs. 7.77 per 100 000 doses, 13.05 per 100 000 doses vs. 6.18 per 100 000 doses), and the differences were statistially significant (all P<0.05). The reporting rates of general abnormal reactions of IIV4 for 6-35 months old and ≥ 6 months old people were both higher than those of IIV4 for ≥3 years old people (14.73 per 100 000 doses and 9.52 per 100 000 doses vs. 3.88 per 100 000 doses); the reporting rates of general reactions and abnormal reactions of IIV4 for ≥6 months old people were both higher than those of IIV4 for ≥3 years old people (12.94 per 100 000 doses vs. 3.59 per 100 000 doses, 1.34 per 100 000 doses vs. 0.19 per 100 000 doses), the differences were statistcially significant (all P<0.05). In terms of clinical features, the reporting rates of fever (37.6-38.5 ℃ and ≥ 38.5 ℃), local redness and swelling (diameter 2.6-5.0 cm), and local induration (diameter ≤2.5 cm and 2.6-5.0 cm) after vaccination of IIV3 for ≥3 years old people were higher than those of IIV4 for ≥ 3 years old people (1.41 per 100 000 doses vs. 0.64 per 100 000 doses, 3.00 per 100 000 doses vs. 1.16 per 100 000 doses); the reporting rates of allergic rash and angioedema of IIV3 for ≥ 3 years old people were higher than those of IIV4 for ≥3 years old people (0.53 per 100 000 doses vs. 0.12 per 100 000 doses, 0.35 per 100 000 doses vs. 0); the differences were statistically significant (all P<0.016 7). Conclusions:The reporting rates of AEFI for influenza vaccines in Fujian Province from 2019 to 2023 was showing a downward trend. The AEFI was mainly general reactions. The reporting rates of AEFI were different among different influenza vaccines, but the overall safety was good.

Cholesterol is a crucial lipid in the human body.Elevated levels of cholesterol can result in condi-tions such as hypercholesterolemia.3-hydroxy-3-methylglutaryl coenzyme A reductase(HMGCR)serves as a pivotal en-zyme in the synthesis of cholesterol,acting as a rate-limiting factor.As a result,HMGCR plays a critical role in maintain-ing cholesterol balance,with the regulatory processes being intricate in vivo.This review outlines the advancements in un-derstanding the regulatory mechanisms of HMGCR,encompassing transcriptional control,degradation pathways,and en-zyme activity.

Objective:To analyze the effect of joint management of type 2 diabetes mellitus (T2DM) between specialty and community under the model of National Diabetes Prevention and Control Center (DPCC).Methods:A total of 2 527 T2DM patients managed by DPCC Pingshan Center of Shenzhen from January 1, 2022 to December 31, 2024 were retrospectively included. After management, the rate of downturn, reexamination rate, blood pressure compliance rate, metabolic indicators (waist circumference, body mass index, fasting blood glucose, glycosylated hemoglobin, blood lipids) and screening rate of chronic complications of diabetes (atherosclerotic cardiovascular disease, microvascular disease, diabetic peripheral neuropathy) were analyzed. Those included 2022 ( n=564), 2023 ( n=1 477), and 2024 ( n=2 527). Results:The downturn rate in 2022, 2023 and 2024 increased year by year (22.8% vs 67.2% vs 89.9%, P<0.01), and the review rate (41.1% vs 62.2% vs 52.7%, P<0.01), complication screening rate (51.6% vs 85.3% vs 62.2%, P<0.01), blood pressure compliance rate (53.1% vs 78.0% vs 67.2%, P<0.01), body mass index compliance rate (13.2% vs 17.3% vs 28.6%, P<0.01), fasting blood glucose meeting rate (46.4% vs 60.2% vs 68.5%, P<0.01), glycated hemoglobin meeting rate (58.4% vs 63.2% vs 45.6%, P<0.01) were relatively improved. Waist circumference compliance rate (30.6% vs 27.7% vs 21.6%) and blood lipid compliance rate (33.6% vs 35.5% vs 31.9%) were not significantly improved, and the review rate, blood pressure compliance rate and complication screening rate in 2024 were lower than those in 2023 and higher than those in 2022. Conclusions:The combined management of type 2 diabetes under the DPCC model has significant effects on improving the down-conversion rate, rediagnosis rate, blood pressure compliance rate, metabolic index compliance rate and the screening rate of diabetes-related chronic complications in patients with diabetes. At the same time, it was also found that with the progress of hierarchical diagnosis and treatment, the review rate, complication screening rate, blood pressure, waist circumference, blood lipid and glycosylated hemoglobin reached the standard of patients decreased compared with the previous situation, which needs to be further analyzed and improved.

Objective:To construct and validate a risk prediction model for early miscarriage during subsequent pregnancy in patients with recurrent spontaneous abortion (RSA) based on autoantibodies and ultrasound endometrial receptivity parameters.Methods:A retrospective analysis was performed on the clinical data of 124 RSA patients who became pregnant again and were admitted to the Xi ′an Daxing Hospital from July 2018 to July 2023. According to the occurrence of early miscarriage, the patients were divided into the early miscarriage group (46 cases) and the non-early miscarriage group (78 cases). The influencing factors for the occurrence of early miscarriage in RSA patients were analyzed, and a Nomogram model was constructed to predict the risk of early miscarriage. The area under the receiver operating characteristic (ROC) curve (AUC) was used to analyze the predictive efficacy of the prediction model for early miscarriage in RSA patients during subsequent pregnancy.Results:Univariate analysis showed that the positive rates of anti-β2-glycoprotein 1 antibody (aβ2-GP1), thyroglobulin antibody (TGAb), antisperm antibodies (AsAb), anticardiolipin antibodies (ACA), and the resistance index (RI) in the early miscarriage group were greater than those in the non-early miscarriage group, while the endometrial thickness, endometrial volume, vascularization index (VI), and vascularization flow index (VFI) were less than those in the non-early miscarriage group (all P<0.05). Binary logistic regression analysis showed that positive aβ2-GP1 and positive TGAb were independent risk factors for early miscarriage in RSA patients during subsequent pregnancy, while endometrial thickness, endometrial volume, and VFI were independent protective factors (all P<0.05). The Nomogram prediction model constructed based on the above-mentioned influencing factors was internally validated by the Bootstrap method, showing a C-index of 0.847 (95% CI: 0.765-0.958), and the calibration curve for predicting early miscarriage in RSA patients during subsequent pregnancy was close to the ideal curve ( P>0.05). The results of the ROC curve showed that the sensitivity, specificity, and AUC of the Nomogram model for predicting early miscarriage in RSA patients during subsequent pregnancy were 89.10%, 85.90%, and 0.889 (95% CI: 0.815-0.963), respectively ( P<0.05). Conclusions:The Nomogram prediction model established based on positive aβ2-GP1, positive TGAb, endometrial thickness, endometrial volume, and VFI can effectively evaluate the risk of early miscarriage in RSA patients during subsequent pregnancy.

Objective:To analyze the effect of joint management of type 2 diabetes mellitus (T2DM) between specialty and community under the model of National Diabetes Prevention and Control Center (DPCC).Methods:A total of 2 527 T2DM patients managed by DPCC Pingshan Center of Shenzhen from January 1, 2022 to December 31, 2024 were retrospectively included. After management, the rate of downturn, reexamination rate, blood pressure compliance rate, metabolic indicators (waist circumference, body mass index, fasting blood glucose, glycosylated hemoglobin, blood lipids) and screening rate of chronic complications of diabetes (atherosclerotic cardiovascular disease, microvascular disease, diabetic peripheral neuropathy) were analyzed. Those included 2022 ( n=564), 2023 ( n=1 477), and 2024 ( n=2 527). Results:The downturn rate in 2022, 2023 and 2024 increased year by year (22.8% vs 67.2% vs 89.9%, P<0.01), and the review rate (41.1% vs 62.2% vs 52.7%, P<0.01), complication screening rate (51.6% vs 85.3% vs 62.2%, P<0.01), blood pressure compliance rate (53.1% vs 78.0% vs 67.2%, P<0.01), body mass index compliance rate (13.2% vs 17.3% vs 28.6%, P<0.01), fasting blood glucose meeting rate (46.4% vs 60.2% vs 68.5%, P<0.01), glycated hemoglobin meeting rate (58.4% vs 63.2% vs 45.6%, P<0.01) were relatively improved. Waist circumference compliance rate (30.6% vs 27.7% vs 21.6%) and blood lipid compliance rate (33.6% vs 35.5% vs 31.9%) were not significantly improved, and the review rate, blood pressure compliance rate and complication screening rate in 2024 were lower than those in 2023 and higher than those in 2022. Conclusions:The combined management of type 2 diabetes under the DPCC model has significant effects on improving the down-conversion rate, rediagnosis rate, blood pressure compliance rate, metabolic index compliance rate and the screening rate of diabetes-related chronic complications in patients with diabetes. At the same time, it was also found that with the progress of hierarchical diagnosis and treatment, the review rate, complication screening rate, blood pressure, waist circumference, blood lipid and glycosylated hemoglobin reached the standard of patients decreased compared with the previous situation, which needs to be further analyzed and improved.

Objective:To construct and validate a risk prediction model for early miscarriage during subsequent pregnancy in patients with recurrent spontaneous abortion (RSA) based on autoantibodies and ultrasound endometrial receptivity parameters.Methods:A retrospective analysis was performed on the clinical data of 124 RSA patients who became pregnant again and were admitted to the Xi ′an Daxing Hospital from July 2018 to July 2023. According to the occurrence of early miscarriage, the patients were divided into the early miscarriage group (46 cases) and the non-early miscarriage group (78 cases). The influencing factors for the occurrence of early miscarriage in RSA patients were analyzed, and a Nomogram model was constructed to predict the risk of early miscarriage. The area under the receiver operating characteristic (ROC) curve (AUC) was used to analyze the predictive efficacy of the prediction model for early miscarriage in RSA patients during subsequent pregnancy.Results:Univariate analysis showed that the positive rates of anti-β2-glycoprotein 1 antibody (aβ2-GP1), thyroglobulin antibody (TGAb), antisperm antibodies (AsAb), anticardiolipin antibodies (ACA), and the resistance index (RI) in the early miscarriage group were greater than those in the non-early miscarriage group, while the endometrial thickness, endometrial volume, vascularization index (VI), and vascularization flow index (VFI) were less than those in the non-early miscarriage group (all P<0.05). Binary logistic regression analysis showed that positive aβ2-GP1 and positive TGAb were independent risk factors for early miscarriage in RSA patients during subsequent pregnancy, while endometrial thickness, endometrial volume, and VFI were independent protective factors (all P<0.05). The Nomogram prediction model constructed based on the above-mentioned influencing factors was internally validated by the Bootstrap method, showing a C-index of 0.847 (95% CI: 0.765-0.958), and the calibration curve for predicting early miscarriage in RSA patients during subsequent pregnancy was close to the ideal curve ( P>0.05). The results of the ROC curve showed that the sensitivity, specificity, and AUC of the Nomogram model for predicting early miscarriage in RSA patients during subsequent pregnancy were 89.10%, 85.90%, and 0.889 (95% CI: 0.815-0.963), respectively ( P<0.05). Conclusions:The Nomogram prediction model established based on positive aβ2-GP1, positive TGAb, endometrial thickness, endometrial volume, and VFI can effectively evaluate the risk of early miscarriage in RSA patients during subsequent pregnancy.