Guishenwan （GSW）， originating from Jingyue Quanshu （Zhang Jingyue's Complete Works）， is a classic traditional Chinese medicine （TCM） formula with a history of over 400 years. Designed for kidney essence deficiency syndrome， it is clinically applied to treat diseases associated with essence-blood deficiency， such as ovarian insufficiency diseases in women， oligospermia-induced infertility in men， and lumbar disc herniation. Numerous studies have confirmed its significant efficacy and advantages in managing ovarian insufficiency diseases， including diminished ovarian reserve （DOR）， premature ovarian insufficiency （POI）， and premature ovarian failure （POF）. According to recent literature， the therapeutic mechanisms of GSW in treating ovarian insufficiency diseases involve regulating the hypothalamic-pituitary-ovarian axis （HPOA） function， ameliorating reproductive endocrine disorders， improving ovarian function， modulating relevant signaling pathways， and exerting immunoregulatory and anti-inflammatory effects. A review of GSW in clinical treatment revealed that clinical applications of GSW， particularly in combination with Western medicine， not only alleviate symptoms but also compensate for the limitations of hormone replacement therapy， thereby reducing recurrence， minimizing adverse reactions， and enhancing safety. This review aims to provide a scientific basis for the rational clinical use of GSW in ovarian insufficiency diseases， offer innovative TCM strategies for developing novel ovarian-protective drugs， promote the integration of TCM and Western medicine in reproductive medicine， and ultimately contribute a Chinese approach to global management of ovarian insufficiency diseases.

Objective To investigate the relationship between the levels of Versican(VCAN)and Cyclin D1(CCND1)in peripheral blood and the progression and prognosis of multiple myeloma(MM).Methods A total of 121 patients with MM(MM group)and 109 healthy volunteers(control group)were selected and admitted to the Department of Hematology of Suzhou Municipal Hospital from January 2018 to May 2022.According to the International Staging System(ISS),the patients with MM were divided into a stage I group(n=46),a stage II group(n=41),and a stage III group(n=34).Real time fluorescence quantitative PCR(RT-PCR)was used to detect the expression levels of VCAN mRNA and CCND1 mRNA in peripheral blood,the patients were followed up for 24 months after discharge to make statistics on the survival of MM patients.The VCAN mRNA and CCND1 mRNA expression in the peripheral blood of MM patients with different ISS was compared.Kaplan-Meier method was used to draw the survival curve of MM,and multi-factor COX proportional regression analysis was established to analyze the factors affecting the prognosis of MM patients.Results The expressions of VCAN mRNA(2.69±0.63)and CCND1 mRNA(3.29±0.63)in peripheral blood of MM group were higher than those of control group(1.32±0.46,1.53±0.37),and the differences were statistically significant(t=18.659,25.473,all P<0.05).The expressions of VCAN mRNA(3.05±0.31)and CCND1 mRNA(3.75±0.21)in peripheral blood of stage Ⅲ group were higher than those of stage Ⅱ(2.76±0.31,3.29±0.36)and stage Ⅰ groups(2.36±0.25,2.95±0.29),and the differences were statistically significant(t=7.626～16.831,all P<0.05).During the follow-up period,1 case was lost to follow-up,36 cases died and 84 cases survived.The overall survival rate of patients with high VCAN mRNA(58.06%)and CCND1 mRNA(57.14%)expression MM was lower than that of patients with low VCAN mRNA(82.76%)and CCND1 mRNA(84.21%),and the differences were statistically significant(χ2=8.727,10.820,all P<0.05).The age of the death group was higher than that of the survival group(t=3.020),ISS stage III,and bone marrow cells proportion≥60%,chromosome karyotype 1q21+proportion,peripheral blood VCAN mRNA and CCND1 mRNA i expression were all higher than those of the survival group(t/χ2=5.988～8.589),and the differences were statistically significant(all P<0.05),respectively.Multivariate COX risk ratio analysis,ISS stage III,high expression of VCAN mRNA and CCND1 mRNA were risk factors for death in MM patients during follow-up(Wald χ2=10.672,5.682,5.969,all P<0.05).Conclusion The expression of VCAN mRNA and CCND1 mRNA in peripheral blood of MM patients is significantly increased,which is related to high clinical stage and poor prognosis.

A 15-year-old boy developed abdominal pain and melena two weeks after COVID-19 infection, which was followed by gross hematuria and proteinuria. Laboratory studies revealed significantly elevated inflammatory markers. Endoscopic examinations showed multiple jejunal and ileal ulcers. Renal biopsy suggested mesangial proliferative glomerulonephritis with crescent formation, necrosis of capillary loops, and mesangial IgA deposits. IgA vasculitis without purpura was considered as a possible diagnosis, and the treatment with prednisone led to remission of both gastrointestinal and renal diseases.

Objective:To evaluate the effect of smoking on the sedative potency of remimazolam combined with alfentanil in patients undergoing painless gastroscopy.Methods:This was a prospecctive single-center study. American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ male patients, aged 30-75 yr, with a body mass index of 18-28 kg/m 2, undergoing elective painless gastroscopy at Baoding First Central Hospital from October to December 2023, were divided into non-smoking group, mild smoking group (smoking index≤200), moderate smoking group (200 1 after 3 min of remimazolam injection or development of bucking, swallowing, body movement and other responses that affected operations during insertion of the endoscope. Results:A total of 85 patients were finally included, with 21 in non-smoking group, 21 in mild smoking group, 20 in moderate smoking group and 23 in heavy smoking group. The ED 50 of remimazolam was significantly higher in smoking groups than in non-smoking group ( P<0.05). The ED 50 of remimazolam gradually increased in mild, moderate and heavy smoking groups ( P<0.05). Conclusions:Smoking can decrease the sedative potency of remimazolam when combined with alfentanil in patients undergoing painless gastroscopy.

Objective To investigate the relationship between the levels of Versican(VCAN)and Cyclin D1(CCND1)in peripheral blood and the progression and prognosis of multiple myeloma(MM).Methods A total of 121 patients with MM(MM group)and 109 healthy volunteers(control group)were selected and admitted to the Department of Hematology of Suzhou Municipal Hospital from January 2018 to May 2022.According to the International Staging System(ISS),the patients with MM were divided into a stage I group(n=46),a stage II group(n=41),and a stage III group(n=34).Real time fluorescence quantitative PCR(RT-PCR)was used to detect the expression levels of VCAN mRNA and CCND1 mRNA in peripheral blood,the patients were followed up for 24 months after discharge to make statistics on the survival of MM patients.The VCAN mRNA and CCND1 mRNA expression in the peripheral blood of MM patients with different ISS was compared.Kaplan-Meier method was used to draw the survival curve of MM,and multi-factor COX proportional regression analysis was established to analyze the factors affecting the prognosis of MM patients.Results The expressions of VCAN mRNA(2.69±0.63)and CCND1 mRNA(3.29±0.63)in peripheral blood of MM group were higher than those of control group(1.32±0.46,1.53±0.37),and the differences were statistically significant(t=18.659,25.473,all P<0.05).The expressions of VCAN mRNA(3.05±0.31)and CCND1 mRNA(3.75±0.21)in peripheral blood of stage Ⅲ group were higher than those of stage Ⅱ(2.76±0.31,3.29±0.36)and stage Ⅰ groups(2.36±0.25,2.95±0.29),and the differences were statistically significant(t=7.626～16.831,all P<0.05).During the follow-up period,1 case was lost to follow-up,36 cases died and 84 cases survived.The overall survival rate of patients with high VCAN mRNA(58.06%)and CCND1 mRNA(57.14%)expression MM was lower than that of patients with low VCAN mRNA(82.76%)and CCND1 mRNA(84.21%),and the differences were statistically significant(χ2=8.727,10.820,all P<0.05).The age of the death group was higher than that of the survival group(t=3.020),ISS stage III,and bone marrow cells proportion≥60%,chromosome karyotype 1q21+proportion,peripheral blood VCAN mRNA and CCND1 mRNA i expression were all higher than those of the survival group(t/χ2=5.988～8.589),and the differences were statistically significant(all P<0.05),respectively.Multivariate COX risk ratio analysis,ISS stage III,high expression of VCAN mRNA and CCND1 mRNA were risk factors for death in MM patients during follow-up(Wald χ2=10.672,5.682,5.969,all P<0.05).Conclusion The expression of VCAN mRNA and CCND1 mRNA in peripheral blood of MM patients is significantly increased,which is related to high clinical stage and poor prognosis.

Objective To establish a brucellosis monitoring and testing technique applicable for the rapid field screening of natural epidemic diseases.Methods A rapid testing technique for Brucella was developed based on a double-antibody sandwich testing model using gradient-variant quantum dots as fluorescent tracers.The sensitivity,linearity,precision,and specificity of the technique were evaluated using suspensions of standard Brucella strains.Methodological comparisons across different sample types were conducted to assess the consistency of the test results.Results The gradient-variant quantum dots detection method was evaluated with standard Brucella strains,exhibiting a sensitivity of 1×103 CFU/mL and a linear correlation coefficient(r)of 0.994(95%CI,0.933-1.055).The maximum coefficient of variation was 12.94%in repeated tests,showing good specificity.A comparative assessment of 305 clinical samples was conducted using the Brucella gradient-variant quantum dots detection method,the Rose Bengal plate agglutination test(RBT),and the serum agglutination test(SAT),yielding a Kappa value of 0.95,indicating almost perfect agreement.Additionally,a comparative assessment of 110 environmental samples collected on-site was conducted using the Brucella gradient-variant quantum dots detection method and quantitative real-time PCR(qPCR).The Kappa values for aerosol collection fluid,surface wipes,and wool samples were all above 0.83,demonstrating near-perfect agreement.For fecal and soil samples,the Kappa values were above 0.62,indicating substantial agreement.Conclusion The Brucella detection method based on gradient-variant quantum dots technology is simple and can be conducted rapidly.The detection method demonstrates high sensitivity,linearity,precision,and specificity.It shows consistent performance in clinical sample testing.It is well-suited for field rapid screening of natural epidemic diseases in field settings and shows good application prospects in the monitoring,prevention,and rapid detection of zoonotic diseases.

Objective:To analyze the real-world practices of resecting sessile colorectal polyps of varying long diameters using cold forcep polypectomy (CFP), cold snare polypectomy (CSP), or endoscopic mucosal resection (EMR).Methods:A total of 12 290 nonpedunculated colorectal polyps of long diameter ≤19 mm (from 10 295 patients) were retrospectively enrolled from January 2022 to December 2023. Polypectomy was conducted by 30 endoscopists. The polyps were categorized into three groups based on long diameter: 1-5 mm, >5-10 mm and >10-19 mm, and the differences of polypectomy methods were compared in three groups. The usage of hemostatic clips in CSP among >5-10 mm polyps and the changes in resection methods between 2022 and 2023 were analyzed.Results:CFP (6 769 polyps, 81.7%) was the predominant method for resecting 1-5 mm sessile polyps (8 289 polyps). For sessile polyps sized >5-10 mm (2 455 polyps), CSP was used most (1 372, 55.9%), although its utilization varied significantly among physicians with the median usage rate of 52.9% (40.3%, 60.0%). EMR (1 349 poolyps, 87.3%) was the main method for >10-19 mm sessile polyps. The usage rate of CSP in sessile polypectomy for polyps >5-10 mm significantly increased from 45.7% (503/1 101) in 2022 to 64.2% (869/1 354) in 2023. The overall frequency of using clip in CSP for >5-10 mm sessile polyps was 40.1% (550/1 372), demonstrating notable variability among different endoscopists with median usage rate of 48.3% (29.8%, 67.9%).Conclusion:Varied resection methods are observed among endoscopists for sessile polyps measuring ≤19 mm. CFP is primarily utilized for polyps of 1-5 mm, while CSP is favored for polyps >5-10 mm, with an increasing annual usage rate. EMR is the main approach for the polyps >10-19 mm. Additionally, notable variations in the use of metal clips during CSP are observed among different physicians.

Objective:To evaluate the effect of smoking on the sedative potency of remimazolam combined with alfentanil in patients undergoing painless gastroscopy.Methods:This was a prospecctive single-center study. American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ male patients, aged 30-75 yr, with a body mass index of 18-28 kg/m 2, undergoing elective painless gastroscopy at Baoding First Central Hospital from October to December 2023, were divided into non-smoking group, mild smoking group (smoking index≤200), moderate smoking group (200 1 after 3 min of remimazolam injection or development of bucking, swallowing, body movement and other responses that affected operations during insertion of the endoscope. Results:A total of 85 patients were finally included, with 21 in non-smoking group, 21 in mild smoking group, 20 in moderate smoking group and 23 in heavy smoking group. The ED 50 of remimazolam was significantly higher in smoking groups than in non-smoking group ( P<0.05). The ED 50 of remimazolam gradually increased in mild, moderate and heavy smoking groups ( P<0.05). Conclusions:Smoking can decrease the sedative potency of remimazolam when combined with alfentanil in patients undergoing painless gastroscopy.

A 15-year-old boy developed abdominal pain and melena two weeks after COVID-19 infection, which was followed by gross hematuria and proteinuria. Laboratory studies revealed significantly elevated inflammatory markers. Endoscopic examinations showed multiple jejunal and ileal ulcers. Renal biopsy suggested mesangial proliferative glomerulonephritis with crescent formation, necrosis of capillary loops, and mesangial IgA deposits. IgA vasculitis without purpura was considered as a possible diagnosis, and the treatment with prednisone led to remission of both gastrointestinal and renal diseases.