ObjectiveTo explore the effects of Wumeiwan on liver metastasis and lung metastasis of colorectal cancer and its potential mechanism. MethodsFirstly， mice were randomized into control， low-dose （20 g·kg^-1） Wumeiwan， high-dose （40 g·kg^-1） Wumeiwan， and paclitaxel （10 mg·kg^-1） groups. Secondly， liver metastasis and lung metastasis models of colorectal cancer were established in mice. After 4 weeks of intervention， the body weight of each mouse was recorded， and the lung weight， liver weight， and survival time of mice with metastatic colorectal cancer were determined. Hematoxylin-eosin （HE） staining was employed to detect the effects of Wumeiwan on liver metastasis and lung metastasis. Real-time PCR was employed to determine the mRNA levels of M1 and M2 macrophage markers in the liver tissue. Finally， the content of M1 macrophage markers CD80 and CD86 in the liver tissue was measured by flow cytometry. ResultsCompared with the control group， Wumeiwan and paclitaxel reduced the body weight （P<0.01） and liver weight （P<0.01） and prolonged the survival of the mouse model of liver metastasis of colorectal cancer （P<0.01）. In the mouse model of lung metastasis of colorectal cancer， Wumeiwan and paclitaxel also reduced the body weight （P<0.01） and lung weight （P<0.01） and extended the survival time （P<0.01）. Histopathological results showed that compared with the control group， Wumeiwan inhibited the liver and lung metastases of colorectal cancer. Real-time PCR results showed that compared with the control group， Wumeiwan upregulated the mRNA levels of M1 macrophage markers IL-1β， IL-6， tumor necrosis factor-α （TNF-α）， inducible nitric oxide synthase （iNOS）， and prostaglandin-endoperoxide synthase 2 （PTGS2） in the liver and lung tissue of mice with liver metastasis and lung metastasis of colorectal cancer （P<0.01）. Meanwhile， Wumeiwan downregulated the mRNA levels of M2 macrophage markers Arg1， CD163， and CD206 （P<0.01）. Meanwhile， the flow cytometry results showed that compared with the control group， Wumeiwan increased the content of CD86 and CD80 （P<0.01）. In addition， immunohistochemical results showed that Wumeiwan promoted the expression of CD86 and inhibited the expression of CD206 in the liver and lung tissue of mice with liver metastasis and lung metastasis. ConclusionWumeiwan can inhibit the liver metastasis and lung metastasis of colorectal cancer by promoting the M1 polarization of macrophages in the liver and lung of the model mice.

Climate change is altering the Earth's water cycle system. The resulting three extreme weather events—heatwaves, droughts, and extreme precipitation—impacts urban and rural water security through multi-layered mechanisms. A primary structural disparity exists between urban and rural systems: while urban areas benefit from comprehensive and standardized pipe networks that ensure terminal water quality, rural areas often suffer from "last mile" vulnerability due to inadequate infrastructure and outdated purification facilities. Extreme weather can directly alter the microbial community structure, concentrations of chemical pollutants and physicochemical properties of source water. These alterations interfere with the efficiency of water treatment processes and ultimately compromise the integrity of distribution systems. Because distribution networks often lack real-time monitoring and adaptive response capabilities, they have emerged as the most vulnerable link in the "water source-water treatment-distribution system" chain. Based on a systematic analysis of these chain-wide impacts, this paper proposed a series of control strategies, including security frameworks based on multi-model coupling and water source protection measures, improvement of water treatment technologies, optimization of distribution systems, and development of new water quality monitoring methods. These strategies aim to enhance the climate adaptability of urban and rural drinking water systems through multi-dimensional intervention, providing a theoretical basis for constructing climate-resilient water infrastructure.

Crigler-Najjar syndrome (CNS) and Gilbert syndrome (GS; OMIM: 143500) are rare autosomal recessive diseases that cause unconjugated hyperbilirubinemia due to decreased UGT1A1 enzyme activity. Crigler-Najjar syndrome type 2 (CNS2; OMIM: 606785) increases the risk of gallbladder stone formation and cholecystitis, while GS seldom causes health issues. We found a 28-year-old male patient with recurring right upper abdomen pain who experienced persistent jaundice from birth. CNS2 with gallbladder stones and cholecystitis was diagnosed after genetic testing revealed rare double homozygous mutations A(TA)₇TAA (rs3064744) and P229Q (rs35350960) in the UGT1A1 gene. After pedigree investigation, we found that the patient's parents with modestly increased bilirubin had compound heterozygous mutations A(TA)₇TAA and P229Q, which were GS. Bioinformatics analysis showed that A(TA)₇TAA is in the TATA-box region of the gene UGT1A1 promoter, affecting gene transcriptional initiation, whereas P229Q modifies protein three-dimensional structure and may be harmful. In this pedigree, double homozygous mutations have a more severe phenotype than compound heterozygous mutations. Inherited causes of hyperbilirubinemia should be suspected after ruling out biliary obstruction, and early bilirubin reduction (< 103 µmol/L (6 mg/dL)) may reduce the risk of complications like cholecystitis in CNS2 patients, though further studies with longer follow-up are needed to confirm this observation.
Humans ; Male ; Glucuronosyltransferase/genetics* ; Adult ; Crigler-Najjar Syndrome/complications* ; Cholecystitis/etiology* ; Homozygote ; Mutation ; Pedigree

This articles summarized the clinical experience of national TCM master Professor Yan Shiyun in using ointment prescriptions to treat chronic pharyngitis.Professor Yan Shiyun believes that the etiology and pathogenesis of chronic pharyngitis are based on inflammation of the deficiency fire,with phlegm heat accumulation as the symptoms.Dysfunction of organs such as the liver,gallbladder,spleen and stomach,lungs and kidneys,as well as retention of wind pathogens,are also important pathological mechanisms.Based on the differentiation of Tibetan symptoms,the clinical approach advocates for a comprehensive understanding of the patients'condition,focusing on the core pathogenesis.The main treatment methods include regulating yin and yang,clearing phlegm and heat,regulating spleen and stomach,dispelling wind and clearing throat,and comprehensively considering other syndromes.The use of compound prescriptions for comprehensive treatment has shown significant therapeutic effects.The commonly used medicinal combination is Physalis Calyx Seu Fructus,Chebulae Fructus Immaturus and Arctii Fructus.

Astragaloside Ⅳ （AS-Ⅳ） is a natural triterpenoid saponin compound derived from Astragalus membranaceus and has shown significant potential in the regulation of liver diseases. This article reviews the latest research advances in AS-Ⅳ in the field of liver diseases in China and globally， and it is found that AS-Ⅳ exerts a liver-protecting effect by regulating lipid metabolism， exerting an anti-tumor/anti-inflammatory/anti-fibrotic effect， and modulating gut microbiota. Its mechanism of action involves multiple signaling pathways， such as AMPK， NLRP3， NF-κB， JAK2/STAT3， and Nrf2. These research findings provide a scientific basis for the development of liver-protecting drugs or functional foods based on the natural product AS-Ⅳ.

Objective To observe the clinical efficacy of Lingnan fire needling in the treatment of plaque psoriasis.Methods A total of 60 cases of patients with plaque psoriasis admitted to Bao'an Hospital of Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from August 2021 to January 2023 were selected,and the patients were randomly divided into the observation group and the control group according to the random number table method,with 30 cases in each group.The observation group was given Lingnan fire needling for treatment,and the control group was given topical application of Calcipotriol Ointment.The course of treatment covered eight weeks continuously.After eight weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes of Psoriasis Area and Severity Index(PASI)scores and Dermatology Life Quality Index(DLQI)scores,as well as the diameter of glomus under dermoscopy of the patients in the two groups were observed before the treatment and after 2,4,6,and 8 weeks of treatment.Changes in Generalized Anxiety Disorder Scale(GAD-7)scores before treatment and after 2,4,6,and 8 weeks of treatment were compared between the two groups.Results(1)After 2,4,6 and 8 weeks of treatment,the scores of PASI,DLQI and GAD-7 of patients in the two groups were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(2)The cured and markedly rate of the observation group was 86.67%(26/30);and that of the control group was 66.67%(20/30).The efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(3)After 2,4,6,and 8 weeks of treatment,the diameter of glomus under dermoscopy of the patients in the two groups were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).Conclusion Lingnan fire needling therapy for plaque psoriasis can effectively improve the clinical symptoms of the patients,relieve the anxiety symptoms induced by skin lesions and itching,so as to improve their quality of life.

Uveitis is a group of immune-mediated,highly blinding ocular diseases.Its etiology and pathogenesis are complex,the condition is protracted and refractory,clinical treatment efficacy is limited,and there is still a lack of safe and effective therapeutic methods.Although immune cells,inflammatory responses,and the destruction of the blood-reti-nal barrier play important roles in the course of uveitis,microglia,as resident immune cells in the retina,play a key role in the pathophysiology of uveitis.However,against the background of immune inflammation in uveitis,the specific changes and mechanisms of microglial activation remain unclear.Therefore,this article reviews the dual nature and role of microgli-al activation in uveitis,focusing on specific target mechanisms and therapeutic strategies,and summarizes the potential of microglial markers as diagnostic and prognostic indicators.It aims to provide research insights for the treatment,progno-sis,and development of potential therapies for uveitis.

Objective:To investigate the practicality and clinical significance of quantitative indicators related to wide QRS complex in the diagnosis of atrial fibrillation (AF) with wide QRS complex.Methods:A retrospective study was conducted to analyze the dynamic electrocardiogram data of 93 patients who visited Ankang People's Hospital from January 2021 to December 2023. Based on the type of arrhythmia, the patients were divided into two groups: AF with premature ventricular contraction (PVC) group ( n = 65) and AF with intraventricular conduction abnormality group ( n = 28). The traditional diagnostic indicators and newly introduced quantitative indicators were compared between the two groups to analyze the clinical significance of the new quantitative indicators in identifying AF with wide QRS complex. Results:There were statistically significant differences in the occurrence of cannon waves, QRS duration > 140 ms, QRS morphology in lead V1, the R wave or qR pattern, or the deepest point of R being greater than r or rS in lead V1 being > 60 ms, R/S ratio in lead V6 < 1 or displaying QS pattern, the presence of a notching, a slow decline, or a prominent R wave in the QRS beginning in lead aVR, Vi/Vt in lead aVR ≤ 1, and the data regarding the electrical axis in the no man's land between the two groups ( χ2 = 11.83, 37.59, 26.05, 27.33, 5.30, 49.46, 34.95, 4.90, all P < 0.05). The premature interval/coupling interval in the AF with PVC group was (1.38 ± 0.32), which was significantly lower than (1.84 ± 0.43) in the AF with intraventricular condection abnormality group ( t = -5.71, P < 0.001). The quasi-compensatory pause/coupling interval and quasi-compensatory pause/premature interval in the AF with PVC group were (1.71 ± 0.36) and (1.28 ± 0.25), respectively, which were significantly higher than those in the AF with intraventricular conduction abnormality group ( t = 5.48, 5.06, both P < 0.001). The areas under the curve for the premature interval/coupling interval, quasi-compensatory pause /coupling interval, and quasi-compensatory pause/premature interval, and the combined three indicators (using logistic regression) in distinguishing AF with wide QRS complex were 0.810, 0.788, 0.818, and 0.953, respectively. The area under the curve for the combined three indicators was significantly greater than that for each individual indicator ( Z = -3.10, -3.92, -3.09, all P < 0.05). Conclusions:Premature interval/coupling interval, quasi-compensatory pause/coupling interval, and quasi-compensatory pause/premature interval show good value in the diagnosis of AF with wide QRS complex, and the combined use of the three can significantly improve the diagnostic accuracy.

This articles summarized the clinical experience of national TCM master Professor Yan Shiyun in using ointment prescriptions to treat chronic pharyngitis.Professor Yan Shiyun believes that the etiology and pathogenesis of chronic pharyngitis are based on inflammation of the deficiency fire,with phlegm heat accumulation as the symptoms.Dysfunction of organs such as the liver,gallbladder,spleen and stomach,lungs and kidneys,as well as retention of wind pathogens,are also important pathological mechanisms.Based on the differentiation of Tibetan symptoms,the clinical approach advocates for a comprehensive understanding of the patients'condition,focusing on the core pathogenesis.The main treatment methods include regulating yin and yang,clearing phlegm and heat,regulating spleen and stomach,dispelling wind and clearing throat,and comprehensively considering other syndromes.The use of compound prescriptions for comprehensive treatment has shown significant therapeutic effects.The commonly used medicinal combination is Physalis Calyx Seu Fructus,Chebulae Fructus Immaturus and Arctii Fructus.