Thyroid-associated ophthalmopathy(TAO)is a refractory orbital disease.The pathogenesis of Western medicine is complex and diverse,and it is difficult to take into account all aspects of medication.Traditional Chinese medicine(TCM)pays attention to the overall concept and syndrome differentiation and treatment,which has certain advantages in the diagnosis and treatment of TAO.The theory of"liver opens at the eyes"in TCM suggests that abnormal liver function is involved in the entire stage of TAO onset.This article summarizes and discusses the dialectical treatment approach of treating TAO from the perspective of physiological basis,key pathological mechanisms,and general principles of treatment,which hope to expand the clinical diagnosis and treatment ideas of TCM for TAO,and leverage the advantages of TCM in TAO prevention and control.

Thyroid-associated ophthalmopathy(TAO)is a refractory orbital disease.The pathogenesis of Western medicine is complex and diverse,and it is difficult to take into account all aspects of medication.Traditional Chinese medicine(TCM)pays attention to the overall concept and syndrome differentiation and treatment,which has certain advantages in the diagnosis and treatment of TAO.The theory of"liver opens at the eyes"in TCM suggests that abnormal liver function is involved in the entire stage of TAO onset.This article summarizes and discusses the dialectical treatment approach of treating TAO from the perspective of physiological basis,key pathological mechanisms,and general principles of treatment,which hope to expand the clinical diagnosis and treatment ideas of TCM for TAO,and leverage the advantages of TCM in TAO prevention and control.

Objective:To evaluate the clinical efficacy and safety of stereotactic surgery in patients with refractory mental disorders.Methods:A retrospective analysis was performed; clinical data, postoperative complications and medication intake of 149 patients with refractory mental disorders accepted stereotactic surgery in Department of Neurosurgery, People's Hospital, Wuhan University from August 2019 to December 2023 were collected. Outcomes were assessed at 1, 6, 12, and 24 months after surgery by Clinical Global Impression-Global Improvement (CGI-GI). Before and 1, 6, and 12 months after surgery, severities were assessed by Clinical Global Impression-Severity of Illness (CGI-SI); cognition was assessed by Montreal Cognitive Assessment (MoCA); positive and negative symptoms were evaluated by Positive and Negative Symptom Scale (PANSS); psychotic symptoms were evaluated by Brief Psychiatric Rating Scale (BPRS) and Symptom Checklist 90 (SCL-90); obsessive-compulsive symptoms, depressive symptoms, anxiety symptoms and manic symptoms were assessed by Yale-Brown Obsessive-Compulsive Symptoms Scale (Y-BOCS), Beck Depression Inventory (BDI)-II, Beck Anxiety Inventory (BAI), and Young Mania Rating Scale (YMRS), respectively; social functioning and quality of survival were evaluated by Social Disability Screening Schedule (SDSS) and World Health Organization Quality of Life-Bref Form (WHOQOL-BREF).Results:(1) Increased sleep was noted in 47 patients and fatigue in 38 patients within 1 week after surgery. Behavioral laziness and emotional apathy were still presented at 1 month after surgery in 6 patients, and complications disappeared in the rest patients. Mildly reduced initiative was presented at 12 months after surgery in 5 patients. (2) CGI-GI indicated that 149 patients were followed up 1 month after surgery with an overall efficiency of 85.90%; 135 patients were followed up at 6 months after surgery with an overall efficiency of 83.21%, 106 patients were followed up at 12 months after surgery with an overall efficiency of 79.24%, and 63 patients were followed up at 24 months after surgery with an overall efficiency of 80.95%. (3) Compared with those before surgery, significantly lower BPRS scores, significantly lower PANSS positive, negative, and overall scores, statistically lower BAI, BDI-II, YMRS, and MOAS scores, significantly lower Y-BOCS obsessional thinking, compulsive behavior and total scores, significantly higher WHOQOL-BREF (physical and psychological domains) scores, and significantly lower SDSS and SCL-90 scores were noted in patients at 1, 6, and 12 months after surgery ( P<0.05). (4) At 12 months after surgery, withdrawal drug was noted in 13 patients, reduced drug in 38, same dose in 52, and increased drug in 2 patients. Conclusion:Stereotactic surgery can obviously improve obsession, anxiety, depression, mania and aggression, and modify social functioning and quality of survival in patients with refractory mental disorders, enjoying good safety.

OBJECTIVE To screen potential adverse drug event （ADE） signals for the treatment of multiple sclerosis （MS） with ofatumumab， and to provide reference for the safe use of drugs in clinical practice. METHODS Using “ofatumumab” and the trade name “Kesimpta” as the search keywords， adverse event （AE） reports related to ofatumumab included in FDA Adverse Event Reporting System database from January 2009 to December 2023 were screened， and their reason contained the “multiple sclerosis”； ADE signal mining and analysis were conducted by reporting odds ratio method and proportional reporting ratio method. RESULTS A total of 21 759 eligible AE reports were selected， involving 62 449 AE cases； 27 system organ classes included general diseases and various reactions at the site of administration （15 021 cases）， neurological diseases （9 668 cases）， infectious and invasive diseases （5 967 cases）， injury， poisoning and surgical complications （4 952 cases）， musculoskeletal and connective tissue disorders （4 647 cases）. A total of 21 759 AE reports correspond to 606 ADE signals， including 234 ADE positive signals. A total of 107 ADE positive signals were not included in drug instruction of ofatumumab， including flu-like diseases， nasopharyngitis， cough， urinary tract infection， sore throat， insomnia， runny nose， anemia， hair loss， atrial fibrillation， and thrombocytopenia， etc. CONCLUSIONS In the process of using ofatumumab for MS， sufficient attention should be paid to ADE included in drug instructions. The ADE with strong signal strength screened in this study should also be paid special attention to， such as flu-like diseases， hemocytopenia， temperature intolerance， optic neuritis， and moyamoya disease. The increased risk of infection， cardiovascular disease， and potential damage to the respiratory and spiritual systems caused by ofatumumab can not be ignored.

Objective:To systematically evaluate the relationship between maternal arsenic exposure and neonatal mortality (NM) and infant mortality (IM).Methods:Literature searches were conducted through PubMed, Web of Science, Embase, Cochrane Library, CNKI database, Wanfang Data Knowledge Service Platform, VIP Chinese Journal Service Platform, and the Chinese Biomedical Literature Database to include case-control, cohort, and cross-sectional studies on the relationship between maternal arsenic exposure and NM, IM published domestically and internationally. The search period was from database establishment to June 4, 2023. Data analysis was conducted using Stata MP 16.0 software, and heterogeneity tests were performed using I2 statistics and Q-test. Fixed effect model (no significant heterogeneity, I2≤50%, P≥0.100) or random effect model (significant heterogeneity, I2 > 50%, P < 0.100) was selected according to heterogeneity among study results for meta-analysis. The OR value (95% CI) was used as the effect value, and subgroup analysis was performed based on different exposure index, arsenic exposure levels in drinking water and study types. At the same time, the dose-response relationship between maternal arsenic exposure and NM, IM was analyzed using generalized least square method. Results:Finally, 9 English literature articles (including 3 053 women and 74 172 maternal and infant pairs) were included, including 6 articles on NM outcomes and 8 articles on IM outcomes. After heterogeneity testing, there was significant heterogeneity in NM ( I2 = 75.20%, P = 0.001) and IM ( I2 = 62.50%, P = 0.009) among all studies. Random effect model was used for meta-analysis, and the combined OR values (95% CI) of NM and IM were 1.38 (1.11 - 1.73) and 1.51 (1.21 - 1.89), respectively. According to the exposure index grouping, in the NM outcome, all studies used drinking water arsenic as the exposure index, and the combined OR value (95% CI) of drinking water arsenic was 1.38 (1.11 - 1.73). In the IM outcome, the combined OR values (95% CI) for urinary arsenic and drinking water arsenic were 3.42 (1.38 - 8.47) and 1.44 (1.16 - 1.79), respectively. According to the grouping of arsenic exposure levels in drinking water, the combined OR values (95% CI) for high and low exposure levels ( > 50 and > 10 - 50 μg/L) in NM and IM outcomes were 1.18 (0.97 - 1.44), 1.54 (1.41 - 1.67), and 1.22 (1.03 - 1.43), 1.55 (1.18 - 2.03), respectively. According to the study types grouping, the combined OR values (95% CI) for retrospective, prospective, and cross-sectional studies in NM and IM outcomes were 1.54 (1.41 - 1.67), 1.11 (0.96 - 1.28), 1.90 (1.01 - 3.55), and 1.55 (1.18 - 2.03), 2.01 (0.82 - 4.94), 1.58 (0.87 - 2.88), respectively. The dose-response relationship analysis showed that the dose-response relationship between maternal arsenic exposure and IM exhibited a non-linear trend (χ 2 = 5.75, P = 0.017). Conclusion:Maternal arsenic exposure is correlated with NM and IM, and there is a non-linear dose-response relationship with IM.

Objective:To systematically evaluate the relationship between maternal arsenic exposure and neonatal mortality (NM) and infant mortality (IM).Methods:Literature searches were conducted through PubMed, Web of Science, Embase, Cochrane Library, CNKI database, Wanfang Data Knowledge Service Platform, VIP Chinese Journal Service Platform, and the Chinese Biomedical Literature Database to include case-control, cohort, and cross-sectional studies on the relationship between maternal arsenic exposure and NM, IM published domestically and internationally. The search period was from database establishment to June 4, 2023. Data analysis was conducted using Stata MP 16.0 software, and heterogeneity tests were performed using I2 statistics and Q-test. Fixed effect model (no significant heterogeneity, I2≤50%, P≥0.100) or random effect model (significant heterogeneity, I2 > 50%, P < 0.100) was selected according to heterogeneity among study results for meta-analysis. The OR value (95% CI) was used as the effect value, and subgroup analysis was performed based on different exposure index, arsenic exposure levels in drinking water and study types. At the same time, the dose-response relationship between maternal arsenic exposure and NM, IM was analyzed using generalized least square method. Results:Finally, 9 English literature articles (including 3 053 women and 74 172 maternal and infant pairs) were included, including 6 articles on NM outcomes and 8 articles on IM outcomes. After heterogeneity testing, there was significant heterogeneity in NM ( I2 = 75.20%, P = 0.001) and IM ( I2 = 62.50%, P = 0.009) among all studies. Random effect model was used for meta-analysis, and the combined OR values (95% CI) of NM and IM were 1.38 (1.11 - 1.73) and 1.51 (1.21 - 1.89), respectively. According to the exposure index grouping, in the NM outcome, all studies used drinking water arsenic as the exposure index, and the combined OR value (95% CI) of drinking water arsenic was 1.38 (1.11 - 1.73). In the IM outcome, the combined OR values (95% CI) for urinary arsenic and drinking water arsenic were 3.42 (1.38 - 8.47) and 1.44 (1.16 - 1.79), respectively. According to the grouping of arsenic exposure levels in drinking water, the combined OR values (95% CI) for high and low exposure levels ( > 50 and > 10 - 50 μg/L) in NM and IM outcomes were 1.18 (0.97 - 1.44), 1.54 (1.41 - 1.67), and 1.22 (1.03 - 1.43), 1.55 (1.18 - 2.03), respectively. According to the study types grouping, the combined OR values (95% CI) for retrospective, prospective, and cross-sectional studies in NM and IM outcomes were 1.54 (1.41 - 1.67), 1.11 (0.96 - 1.28), 1.90 (1.01 - 3.55), and 1.55 (1.18 - 2.03), 2.01 (0.82 - 4.94), 1.58 (0.87 - 2.88), respectively. The dose-response relationship analysis showed that the dose-response relationship between maternal arsenic exposure and IM exhibited a non-linear trend (χ 2 = 5.75, P = 0.017). Conclusion:Maternal arsenic exposure is correlated with NM and IM, and there is a non-linear dose-response relationship with IM.

Hepatic fibrosis is a pathological reparative response of the liver to chronic injury and a crucial step in the progression of chronic liver disease， characterized mainly by the activation of hepatic stellate cells and diffuse deposition of extracellular matrix. Currently， there is no ideal specific drug for the treatment of liver fibrosis in clinical practice. In recent years， with the development and progress of traditional Chinese medicine （TCM） in the treatment of liver fibrosis， TCM has been widely recognized for its significant therapeutic effect and fewer adverse reactions. The phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway is an important pathway that affects the formation and development of liver fibrosis. It mainly plays a role in liver fibrosis by inhibiting the activation and proliferation of hepatic stellate cells， promoting their apoptosis， reducing oxidative stress in liver cells， decreasing the deposition of extracellular matrix， and enhancing liver cell autophagy. This article summarized the mechanisms by which Chinese medicinal monomers regulated the PI3K/Akt pathway to exert their effects on liver fibrosis and their synergistic effects with other signaling pathways， providing a theoretical basis and references for the development of new drugs for the treatment of liver fibrosis with TCM.

Hepatocellular carcinoma （HCC） is one of the common malignant tumors of the digestive tract and seriously threatens the life of patients due to a high incidence rate， a high degree of malignancy， strong invasion and metastasis， and poor prognosis. At present， the main methods for the prevention and treatment of HCC include drugs， surgery， and interventional treatment， but all of these methods have certain adverse reactions and side effects. As an important intracellular signal transduction pathway in the human body， the JAK/STAT signaling pathway mainly exerts an anti-HCC effect by regulating cell invasion， metastasis， proliferation， growth， apoptosis， autophagy， angiogenesis， inflammation/immune response， iron metabolism， and drug resistance. Therefore， targeting the JAK/STAT signaling pathway plays an important role in the prevention and treatment of the development and progression of HCC. Traditional Chinese medicine has attracted wide attention due to its advantages of multiple targets， pathways， components， and levels in the treatment of HCC， and many cell or animal experiments on traditional Chinese medicine in the treatment of HCC have shown that the JAK/STAT signaling pathway is an important target for the prevention and treatment of HCC， with the effects of improving liver function， reducing HCC recurrence， and improving immunity. Based on this， this article analyzes the mechanism of action of the JAK/STAT signaling pathway in HCC， as well as the intervention effect of traditional Chinese medicine monomers， traditional Chinese medicine extracts， and traditional Chinese medicine compounds on the JAK/STAT signaling pathway， in order to provide theoretical basis and reference for the prevention and treatment of HCC and the research and development of new traditional Chinese medicine drugs.

Thyroid associated ophthalmopathy(TAO)is a refractory disease,which is related to Th17/Treg cellular immune imbalance."liver opens at the eyes"is a systematic summary of the theories of liver disease affecting the eye and eye disease affecting the liver in traditional Chinese medicine,which can guide the clinical diagnosis and treatment of TAO in traditional Chinese medicine.Studies have shown that the treatment of TAO from the perspective of"liver opens at the eyes"can regulate the immune imbalance of Th17/Treg cells to a certain extent,so as to achieve the purpose of disease prevention and treatment.This paper discusses the role of Th17/Treg cellular immune imbalance in TAO,from the aspects of Th17/Treg imbalance promoting the occurrence and development of TAO,the role of"liver opens at the eyes"theory in the etiology and pathogenesis of TAO,and the consistency between"liver opens at the eyes"physiology and Th17/Treg immune balance.In order to reveal the scientific connotation of traditional Chinese medicine in preventing and treating TAO by regulating Th17/Treg imbalance.

The pathogenesis of nonalcoholic fatty liver disease (NAFLD) remains unclear, and currently no effective drugs have been approved for the treatment of NAFLD. Polygonum cuspidatum is a natural traditional Chinese medicine with a long history of application, and studies have shown that it plays an important role in the treatment of NAFLD. This article summarizes related research findings in the active components of Polygonum cuspidatum applied in the treatment of NAFLD, and it is found that the active components of Polygonum cuspidatum can improve insulin resistance, exert an anti-oxidative stress effect, regulate lipid metabolism, improve endoplasmic reticulum stress, and alleviate inflammatory infiltration by regulating the signaling pathways including Nrf2, AMPK, NF-κB, SIRT1, and PPARα, thereby exerting a preventive and therapeutic effect on NAFLD, so as to provide a basis and ideas for developing drugs for NAFLD and exploring related mechanisms.