This article reports a rare case of autoinflammatory disease presenting initially with skin induration and swelling after trauma as the initial manifestation, followed by progressive limb weakness. The patient was a middle-aged female who developed skin induration and swelling after trauma, which gradually progressed to limb weakness, dysarthria and bilateral facial paralysis, accompanied by livedo reticularis of the lower extremities, diffuse skin induration of the limbs, and beaded subcutaneous nodules in the right upper limb. The patient had a susceptibility to infection since childhood and a history of chronic livedo reticularis. Skin pathological examination revealed panniculitis. A comprehensive etiological screening for special infections and autoimmune diseases was completed with an unremarkable results, and whole-exome sequencing showed no abnormal findings. Following a multidisciplinary discussion combined with RNA sequencing results, the patient was diagnosed with an autoinflammatory disease, with a suspected type Ⅰ interferonopathy. Treatment with tofacitinib resulted in gradual improvement of clinical symptoms. This case highlights the importance of detailed medical history collection, systematic physical examination and multidisciplinary collaborative diagnosis and treatment, and underscores the pivotal role of molecular diagnosis in the confirmation of rare diseases. It can provide a reference for the clinical diagnosis and management of similar rare cases.

Objective To observe the value of spectral CT material separation technology for diagnosing traumatic bone marrow edema in limbs.Methods Totally 51 patients with limb traumatic bone marrow edema were retrospectively enrolled and divided into young group(n=26,18-43 years)and middle-aged group(n=25,46-74 years).Taken MRI as reference standard,the efficacy of spectral CT Water-hydroxyapatite(HAP)image for diagnosing bone marrow edema in trauma area was analyzed,and the Water-HAP density values were compared between groups.Results No significant difference of diagnosing bone marrow edema was found between spectral CT and MRI(x2=0.201,P=0.654),and the consistency was high(Kappa=0.774).Water-HAP density value in bone marrow edema area was higher than that in non bone marrow edema area(t=24.634,P＜0.05),and no significant difference of Water-HAP density values in bone marrow edema area nor non bone marrow edema area was found between young group and middle-aged group(both P＞0.05).Conclusion Spectral CT material separation technology was helpful for diagnosing traumatic bone marrow edema in limbs.

Objective To establish a highly sensitive and specific method for detecting human DNA based on real time quantitative PCR(qPCR)technique for the rapid detection of potential DNA con-tamination sources in DNA laboratories.Methods Primers and probes were designed with Primer Ex-pressTM software using the reference sequence of human 18S rRNA gene as a template,and the opti-mal prime-probe combination was screened by matrix method.The PCR products of the target se-quence of human 18S rRNA gene were used to construct the plasmid,and a plasmid standard was used to draw the standard curve of the qPCR system.According to the Minimum Information for Pub-lication of Quantitative Real-time PCR Experiments(MIQE)guidelines,the specificity,sensitivity,re-peatability and application effect of the qPCR system were evaluated.Results The sensitivity of the qPCR system established in this study was 5.3×10-5 ng/μL,which showed good specificity for human DNA samples.The correlation coefficient of the qPCR system was-0.999,and amplification efficiency was 100％.Both the intra-batch and inter-batch variation coefficients were less than 2％.Conclusion The established human DNA detection method based on qPCR technique has good specificity,high sen-sitivity,and robust stability.It can be used for rapid detection of DNA contamination and daily moni-toring of the accumulated human DNA in the laboratory environment.

Objective To evaluate the efficacy of Puerariae lobatae radix （PLR） and Anemarrhenae Rhizoma （AR） in preventing and treating Alzheimer’s disease （AD） and explore its potential mechanism of action by LC-MS serum metabolomics strategy. Methods The AD rat model was established by administering aluminum chloride （AlCl₃） and D-galactose （D-gal） for 20 weeks. The traditional Chinese medicine intervention group was given the PLR, AR, and PLR-AR extracts for 8 weeks by gavage. The model effect and efficacy were evaluated by Morris water maze test and biochemical indicators including SOD, NO, and MDA; Metabolomics research based on the UHPLC-Q/TOF-MS method was conducted, and relevant metabolic pathways were analyzed through the MetaboAnalyst online website. Results The learning and memory abilities of AD model rats were significantly decreased compared with the control group, and the levels of oxidative stress and lipid peroxides were significantly increased （P<0.05）, while the SOD content was decreased considerably （P<0.01）. The learning and memory abilities of AD model rats were improved, oxidative stress and lipid peroxidation levels were reversed, and serum SOD content was increased significantly after the intervention of PLR-AR, with better effects than single drugs. Through metabolomics, 70 differential metabolites were identified between the AD model group and the control group, mainly involving 10 pathways, including phenylalanine, tyrosine, and tryptophan biosynthesis, phenylalanine metabolism, and unsaturated fatty acid biosynthesis, et.al. The intervention of PLR-AR could adjust 47 metabolites, with 20 metabolites showing significant differences （P<0.05）. The significantly adjusted metabolites involve 6 pathways, including phenylalanine, tyrosine, and tryptophan biosynthesis, et al. Conclusion The combination of PLR and AR could significantly improve the learning and memory abilities of AD rat models. The mechanism may be related to the improvement of oxidative stress and lipid peroxidation levels, the increase of serum SOD content, and the regulation of phenylalanine, tyrosine, and tryptophan biosynthesis pathways.

Objective:To investigate the awareness of Chinese gastroenterologists regarding the treatment targets of inflammatory bowel disease (IBD) as defined by the STRIDE-Ⅱ consensus and to identify challenges encountered in clinical practice.Methods:A nationwide cross-sectional survey was conducted via an online questionnaire distributed to gastroenterologists between February 16 and March 31, 2024. The survey encompassed demographic data, recognition and adherence to the STRIDE-Ⅱ consensus, perceived importance of IBD treatment targets, and clinical challenges.Results:A total of 203 valid questionnaires were collected from 28 provinces (autonomous regions/municipalities). The majority of participants (177/203, 87.2%) reported routinely referencing the STRIDE-Ⅱ consensus in IBD management. Over 90% of physicians identified endoscopic mucosal healing as the core treatment target. Additionally, approximately 80% emphasized the importance of clinical remission, endoscopic remission, quality-of-life improvement, disability prevention, and normalization of growth in pediatric patients. The challenges reported by more than half of physicians in acheiving the goals of the treatment process included lack of a standardized definition for mucosal healing (69.5%), management of psychological comorbidities (89.2%), drug failure (74.4%), penetrating Crohn's disease (72.4%), perianal fistulizing Crohn's disease (65.0%), and IBD management during pregnancy (61.1%).Conclusions:Chinese gastroenterologists demonstrate high awareness and adherence to the STRIDE-Ⅱ consensus, prioritizing mucosal healing as the cornerstone of IBD management. However, numerous challenges remain in clinical practice, particularly regarding operational definitions of therapeutic endpoints and complex disease phenotypes.

Primary biliary cholangitis (PBC) is a type of autoimmune liver disease characterized by chronic intrahepatic cholestasis. Although portal hypertension is a common complication in patients with cirrhotic PBC, portal hypertension and its related complications can occur in the early stage of the disease, that is, before the cirrhosis onset. Therefore, early identification and long-term management are of great significance to reduce the occurrence of portal hypertension and decompensation events and improve long-term prognosis in patients with PBC. This paper focuses on the epidemiology, pathophysiological mechanism, clinical characteristics, non-invasive diagnosis, and treatment strategies for portal hypertension in early-stage PBC patients.

Objective To investigate the post-intervention experiences in elderly stroke patients who received the group-based acceptance and commitment therapy(ACT)and to provide a reference to improve the group-based ACT intervention strategies for the patients.Methods With the descriptive phenomenological research,the semi-structured in-depth interviews were conducted with 15 elderly stroke patients who had received the group-based ACT intervention for 6 months in a Tier-IIIA hospital in Hunan Province between May and July 2023.The data acquired from the interviews were analysed using the Colaizzi method.Results The experiences in elderly stroke patients with the group-based ACT intervention were categorised into three main themes and ten sub-themes:(1)The impact of intervention on the psychology and spirit(change cognition and accept oneself;enhance awareness and reflect on oneself;clarify values and adapt to oneself;disengage from suffering and achieve dissociation;understand suffering and discover a sense of meaning in life);(2)Behavioural changes brought by the intervention(change approaches to improve health;engage in rehabilitation exercises and build confidence;enhance social interactions and integrate into life);(3)Suggestions for the intervention program(tailor to the physiological characteristics of the elderly;adapt to the psychological characteristics of the elderly).Conclusion The group-based ACT intervention has a beneficial effect on the psychological,spiritual and behavioural changes in the elderly stroke patients.The intervention programs should be improved according to the physical and mental characteristics therefore to improve the mental health of elderly stroke patients.

OBJECTIVE: To investigate the effect of miR-483-5p on hepatocellular carcinoma (HCC) cells proliferation and stemness, as well as the attenuating effect of Pien Tze Huang (PZH). METHODS: Differentially expressed miRNA between HepG2 cells and hepatic cancer stem-like cells (HCSCs) were identified by a miRNA microarray assay. miR-483-5p mimics were transfected into HepG2 cells to explore the effects of miR-483-5p on cell proliferation and stemness. HepG2 cells and HCSCs were treated with PZH (0, 0.25, 0.50 and 0.75 mg/mL) to explore the effects of PZH on the proliferation and stemness, both in non-induced state and the state induced by miR-483-5p mimics. RESULTS: miR-483-5p was significantly up-regulated in HCSCs and its overexpression increased cell proliferation and stemness in HepG2 cells (P<0.05). PZH not only significantly inhibited proliferation in HepG2 cells, but also significantly suppressed the cell proliferation and self-renewal of HCSCs (P<0.05). The effects of miR-483-5p mimics on proliferation and stemness of HepG2 cells were partially abolished by PZH. CONCLUSIONS miR-483-5p promotes proliferation and enhances stemness of HepG2 cells, which were attenuated by PZH, demonstrating that miR-483-5p is a potential molecular target for the treatment of HCC and provide experimental evidence to support clinical use of PZH for patients with HCC.
Humans ; MicroRNAs/metabolism* ; Cell Proliferation/drug effects* ; Liver Neoplasms/drug therapy* ; Carcinoma, Hepatocellular/drug therapy* ; Hep G2 Cells ; Neoplastic Stem Cells/metabolism* ; Drugs, Chinese Herbal/therapeutic use* ; Gene Expression Regulation, Neoplastic/drug effects*

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective:To document the effectiveness of ultrasound-guided genicular nerve block (GNB) in treating knee osteoarthritis (KOA).Methods:A total of 92 KOA patients were randomly divided into an observation group and a control group with 46 in each. Those in both groups were treated conventionally, including with non-steroidal anti-inflammatory drugs, acupuncture, ultrasound, laser irradiation and manipulation therapy. The observation group additionally underwent ultrasound-guided genicular nerve block treatment, once a week for 2 weeks. Pain scoring on a visual analog scale (VAS), the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and a 6-minute walk test (6MWT) were used to evaluate everyone before and after the treatment, and then 8 weeks later.Results:In the observation group the average VAS rating [(3.54±2.00) at week 2 and (4.13±2.04) at week 8] and the average WOMAC subscale and total scores [(36.91±16.91) at week 8] had improved significantly right after the experiment and 8 weeks later. But in the control group this was true only right after the treatment. The observation group also demonstrated superior improvements in 6MWT distance at week 2 [(434.22±125.19)m] and week 8 [(446.35±126.45)m] compared to both its own baseline and the control group.Conclusions:Ultrasound-guided genicular nerve block is a rapid, precise, effective, and long-lasting intervention for alleviating pain, improving knee function and enhancing walking endurance in KOA patients.