Vascular endothelial growth factor (VEGF) inhibitors are drugs that target and inhibit tumor angiogenesis. By blocking the signaling pathway of VEGF and its receptor, they suppress tumor proliferation and play a crucial role in tumor treatment. However, their side effects, such as hypertension, proteinuria, hand-foot skin reactions, and myelosuppression, during treatment seriously affect patients' treatment compliance and quality of life. The development of intervention strategies for the side effects of VEGF inhibitors is of great importance for tumor treatment. This article reviews the clinical characteristics and toxic mechanisms of common side effects caused by VEGF inhibitors during tumor treatment and summarizes intervention strategies that combine traditional Chinese and Western medicines. Drug dosages were precisely monitored and adjusted to achieve antitumor treatment. Patients' discomfort symptoms are improved through prescriptions that act by tonifying qi and promoting blood circulation, strengthening the spleen, and tonifying the kidney. The combination of traditional Chinese and Western medicines is used to treat patients, thus providing a safe and effective treatment plan for patients with cancer.

The herb pair Hedysari Radix-Angelicae Sinensis Radix is a classic combination embodying the theory of replenishing Qi and tonifying blood in traditional Chinese medicine. The two herbs are often used together to achieve the effects of replenishing Qi， tonifying blood， activating blood， and unblocking collaterals. Clinically， this herb pair is widely applied in the treatment of blood deficiency syndrome and hematopoietic dysfunction disorders such as myelosuppression induced by radiotherapy and chemotherapy. Modern research indicates that Hedysari Radix-Angelicae Sinensis Radix and their active components can synergistically promote hematopoiesis through multiple targets and pathways. At the cellular level， the active components directly activate hematopoietic stem cells （HSCs） and hematopoietic progenitor cells （HPCs）， promoting their proliferation and differentiation， while simultaneously stimulating the production and release of peripheral blood cells. Regarding molecular regulation， this herb pair can regulate the expression of various hematopoietic-related cytokines， such as stem cell factor and erythropoietin. Additionally， it modulates key signaling pathways， including phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） and Wnt/β-catenin， providing signal support for the hematopoietic process. Furthermore， Hedysari Radix-Angelicae Sinensis Radix can improve the hematopoietic microenvironment， protect bone marrow stromal cells， and eliminate free radicals through antioxidant effects， thereby reducing damage to hematopoietic cells. Furthermore， this herb pair regulates apoptosis-related proteins to inhibit excessive apoptosis of hematopoietic cells and increase their survival rate. Its material basis primarily includes active components such as Hedysarum polybotrys polysacchcrides and flavonoids， as well as Angelica sinensis polysaccharides and ferulic acid， which synergistically contribute to its hematopoietic-promoting effects. By elaborating on the active components and mechanisms of Hedysari Radix-Angelicae Sinensis Radix in promoting hematopoiesis， this paper aims to elucidate the molecular mechanisms underlying their hematopoietic effects and provide a reference for further research and clinical application.

Biosensors based on acetylcholinesterase (AChE) are crucial for early diagnosis, less invasive treatment, and drug evaluation of Alzheimer's disease (AD). However, existing technologies often suffer from enzyme conformational changes, leading to altered activity and loss and reduced sensor efficacy. To address this challenge, we developed a novel right-side-out-oriented red blood cell membrane-coated electrochemical biosensors (ROCMCBs) to evaluate AChE inhibitors from traditional Chinese medicines (TCMs) as potential anti-AD agents. The developed right-side-out-oriented coating based on immunoaffinity not only fully exposed the binding sites of AChE on the cell membrane but also ensured its conformation and stability as a peripheral membrane-anchoring protein, which was conducive to maintaining its biological activity and producing optimal interaction with drugs. At the same time, the biosensors exhibited a satisfactory sensitivity (limit of detection = 0.41 pmol/L). Ultimately, six potentially active compounds against AD (baicalin, geniposide, gastrodin, berberine, rhynchophylline, and senkyunolide A) were rapidly identified and evaluated from TCMs. This project provides a promising strategy for developing cell membrane-coated electrochemical biosensors. The application of cell membrane-coated electrochemical biosensors with well-defined cell membrane orientation further expands new perspectives and methods for AChE-targeted anti-AD research.

Objective:To explore the clinical characteristics of patients with brucellosis complicated with epididymo-orchitis (Brucellar epididymo-orchitis, BEO), so as to provide reference for clinical diagnosis and treatment of BEO.Methods:General and clinical data of 293 male patients with acute brucellosis admitted to the Beidahuang Industry Group General Hospital from January 2023 to December 2024 were retrospectively collected. They were divided into a BEO group (30 cases) and a non-BEO group (263 cases) based on the presence or absence of epididymo-orchitis. Epidemic characteristics, clinical manifestations and laboratory examination results were compared and analyzed.Results:Among 293 male patients with acute brucellosis, the incidence of BEO was 10.24% (30/293). Their age was mainly concentrated in 45 - < 60 years old (53.33%, 16/30), and occupation was mostly farmers (63.33%, 19/30). There were no statistically significant differences in the distribution of age, occupation, exposure history and onset season between the BEO group and the non-BEO group ( P > 0.05). The distribution of abdominal pain and urinary frequency/urgency/pain symptoms was compared, and the differences were statistically significant ( P < 0.05). White blood cell count (WBC), neutrophil count (NEUT), and C-reactive protein (CRP) levels in the BEO group were higher than those in the non-BEO group ( P < 0.05), while the levels of cytokines interleukin (IL)-6 and interferon-γ (IFN-γ) were lower than those in the non-BEO group ( P < 0.05). After 6 - 8 weeks of hospitalization, the levels of WBC, NEUT, CRP, albumin, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase, alkaline phosphatase, α-hydroxybutyrate dehydrogenase, lactate dehydrogenase, IL-4, IL-6, IL-10, IL-17, tumor necrosis factor-α, and IFN-γ in patients of the BEO group were significantly different from before treatment ( P < 0.05). Twenty-eight patients were cured, 1 patient underwent orchiectomy, and 1 patient experienced recurrence. Conclusions:Middle-aged male patients with brucellosis are more prone to BEO. Clinical manifestations and laboratory tests have certain diagnostic value for BEO. Suspected BEO patients should be diagnosed and treated as early as possible to reduce the occurrence of adverse prognosis.

Objective:To learn about the clinical characteristics of patients with neurobrucellosis (NB) and provide references for clinical diagnosis and treatment of NB.Methods:The clinical data of 22 NB patients diagnosed and treated at Beidahuang Industry Group General Hospital from January 2018 to November 2024 and 178 healthy individuals undergoing physical examinations during the same period were retrospectively collected. The epidemiological characteristics, clinical manifestations, laboratory tests, treatment and prognosis of NB patients were analyzed.Results:Among the 22 NB patients, 12 were males (54.55%) and 10 were females (45.45%). The age was (51.77 ± 12.75) years old, ranging from 27 to 80 years old. Most of the patients were farmers (95.45%, 21/22), and 16 cases (72.73%) had contacted with cattle/sheep. The onset seasons were mainly in summer (40.91%, 9/22) and spring (31.82%, 7/22). Among all NB patients, there were 10 cases of encephalitis/meningoencephalitis, 9 cases of myelitis, and 3 cases of meningitis. The general symptoms were mainly fever (68.18%, 15/22), the neurological symptoms were mainly nausea and vomiting (36.36%, 8/22), and the physical signs were mainly muscle weakness (50.00%, 11/22) and pathological signs (45.45%, 10/22). The laboratory test results showed that the levels of hemoglobin, hematocrit, C-reactive protein, total protein, albumin, γ-glutamyl transpeptidase, α-hydroxybutyric acid dehydrogenase, lactate dehydrogenase, and glutathione reductase in NB patients were significantly different from those in healthy individuals ( P < 0.001). Brain magnetic resonance imaging revealed ischemic changes in 5 cases (22.73%), abnormal brain signals in 2 cases (9.09%), and demyelinating lesions in white matter in 1 case (4.55%). After treatment, 18 NB patients were followed up and showed good prognosis, with only 2 cases exhibiting varying degrees of sequelae (walking disorders or memory impairment). Conclusions:The clinical manifestations of NB patients are diverse. A comprehensive judgment should be made by combining epidemiological characteristics, clinical manifestations, laboratory tests and imaging examinations.

Objective:To explore the relapse-related genes and their clinicopathological connections of diffuse large B cell lymphoma (DLBCL).Methods:Targeted panel sequencing was conducted on 32 eligible DLBCL samples; the patients were diagnosed, treated, and went into complete remission at the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2019, including 14 cases with recurrence (relapsed group) and 18 cases with long-term complete remission of over five years (remission group). Clinical and pathological data were further reviewed. Fisher′s exact test was employed to compare the differences in clinicopathological characteristics and mutation patterns between the two groups.Results:Among the 32 patients, there were 18 males and 14 females, with a male to female ratio of 1.3∶1.0 and a median age of 53 (45.5, 67.0) years. In the relapsed group, PIM1 (11/14), KMT2D (7/14), PRDM1 (6/14), MYD88 (6/14), DTX1 (6/14) emerged as the most frequently mutated genes. In the remission group, while recurrent PIM1, KMT2D and MYD88 mutations were also observed, the TP53 gene exhibited the highest mutation frequency (6/18). Compared to the remission group, relapsed group showed elevated mutation frequencies of PIM1 ( P=0.013) and FAT4 ( P=0.010), alongside a reduced incidence of TP53 mutations. In all 32 patients, DLBCL with CD79B, CCND3, DTX1, KMT2D and PRDM1 mutations demonstrated a propensity towards advanced clinicopathologic stage. Conclusions:Relapsed DLBCL has distinctive clinicopathological and genetic features. PIM1 and FAT4 may be served as potential biomarkers for screening relapsed DLBCL-NOS and as targets for novel therapeutic strategies.

" Mutual recognition and sharing of medical examination and test results in Zhejiang Province" (MRZJ) holds significant value in rationally utilizing healthcare resources, reducing patient costs, streamlining treatment procedures, and enhancing patient satisfaction. This study reviewed the development of medical test result mutual recognition in China and summarized the implementation of MRZJ at Zhejiang Provincial People′s Hospital. Since its launched in October 2021, the hospital had achieved interoperability through enhanced organizational leadership, standardized coding, process optimization, capacity building, quality control reinforcement, and public awareness campaigns. By March 2024, MRZJ covered all outpatient departments of the pilot hospital, with 936 items recognized daily, improving healthcare efficiency and generating notable social and economic benefits. These outcomes provided references for advancing nationwide medical test mutual recognition. Future efforts should focused on strengthening standardized training, refining performance evaluation mechanisms, developing MRZJ early warning functions, and safeguarding patients′ informed consent and choice rights.

Objective:To explore the correlations of sleep quality and architecture with heart rate variability (HRV) in patients with stenoses of vertebrobasilar artery system and internal carotid artery system.Methods:A retrospective study was performed; 72 patients with stenosis or occlusion of the head and neck arteries (not resulting in cerebral infarction) admitted to Department of Neurology, Second Affiliated Hospital of Zhengzhou University from June 2023 to June 2024 were chosen, including 33 patients with moderate-to-severe stenosis or occlusion of the vertebrobasilar system (VB group) and 39 patients with moderate-to-severe stenosis or occlusion of the internal carotid artery system (ICA group). Pittsburgh sleep quality index (PSQI) and polysomnography (PSG) were used to evaluate the sleep quality and architecture, respectively; and 24-hour ambulatory electrocardiogram was used to assess the HRV. Differences in PSQI score, PSG and HRV parameters between the two groups were compared; partial correlation analysis was used to explore the correlations of HRV parameters with PSQI scores and PSG parameters; multivariate linear regression was used to analyze the independent influencing factors for HRV.Results:(1) Compared with the ICA group, the VB group exhibited significantly higher PSQI scores, spontaneous arousal index (SAI), ratio of time of stage 1 non-rapid eye movement sleep/total sleep time (T N1/T t), and apnea-hypopnea index (AHI), while significantly lower ratio of time of rapid eye movement sleep/total sleep time (T R/T t), spindle wave density in stage 2 non-rapid eye movement sleep (N2), lowest blood oxygen saturation, standard deviation of normal to normal intervals (SDNN) of all sinus beats, low-frequency power (LF), and high-frequency power (HF, P<0.05). (2) In both VB group and ICA group, SDNN was negatively correlated with PSQI score ( r=-0.461, P=0.020; r=-0.378, P=0.036). In the VB group, SDNN was negatively correlated with T N1/T t ( r=-0.467, P=0.019) and SAI ( r=-0.551, P=0.004), and positively correlated with ratio of time of stage 3 non-rapid eye movement sleep/total sleep time (T N3/T t, r=0.686, P<0.001) and spindle wave density in N2 ( r=0.518, P=0.008); LF and HF were negatively correlated with SAI ( r=-0.481, P=0.015; r=-0.564, P=0.003). In the ICA group, HF was negatively correlated with spindle wave density in N2 ( r=-0.369; P=0.041). (3) Multivariate linear regression results indicated that T N3/T t (β=0.348, P=0.018), SAI (β=-0.330, P=0.018), and spindle wave density in N2 (β=0.286, P=0.013) were independent influencing factors for Ln_SDNN in patients with moderate-to-severe stenosis or occlusion of the vertebrobasilar system. Conclusion:Patients with stenosis or occlusion of the vertebrobasilar system exhibit poorer subjective sleep quality, increased light sleep, heightened arousal, and reduced sleep stability compared with those with stenosis or occlusion of the internal carotid artery system, which may be caused by the imbalance of autonomic nerve function.

Objective:To explore the relapse-related genes and their clinicopathological connections of diffuse large B cell lymphoma (DLBCL).Methods:Targeted panel sequencing was conducted on 32 eligible DLBCL samples; the patients were diagnosed, treated, and went into complete remission at the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2019, including 14 cases with recurrence (relapsed group) and 18 cases with long-term complete remission of over five years (remission group). Clinical and pathological data were further reviewed. Fisher′s exact test was employed to compare the differences in clinicopathological characteristics and mutation patterns between the two groups.Results:Among the 32 patients, there were 18 males and 14 females, with a male to female ratio of 1.3∶1.0 and a median age of 53 (45.5, 67.0) years. In the relapsed group, PIM1 (11/14), KMT2D (7/14), PRDM1 (6/14), MYD88 (6/14), DTX1 (6/14) emerged as the most frequently mutated genes. In the remission group, while recurrent PIM1, KMT2D and MYD88 mutations were also observed, the TP53 gene exhibited the highest mutation frequency (6/18). Compared to the remission group, relapsed group showed elevated mutation frequencies of PIM1 ( P=0.013) and FAT4 ( P=0.010), alongside a reduced incidence of TP53 mutations. In all 32 patients, DLBCL with CD79B, CCND3, DTX1, KMT2D and PRDM1 mutations demonstrated a propensity towards advanced clinicopathologic stage. Conclusions:Relapsed DLBCL has distinctive clinicopathological and genetic features. PIM1 and FAT4 may be served as potential biomarkers for screening relapsed DLBCL-NOS and as targets for novel therapeutic strategies.

Objective:To explore the clinical characteristics of patients with brucellosis complicated with epididymo-orchitis (Brucellar epididymo-orchitis, BEO), so as to provide reference for clinical diagnosis and treatment of BEO.Methods:General and clinical data of 293 male patients with acute brucellosis admitted to the Beidahuang Industry Group General Hospital from January 2023 to December 2024 were retrospectively collected. They were divided into a BEO group (30 cases) and a non-BEO group (263 cases) based on the presence or absence of epididymo-orchitis. Epidemic characteristics, clinical manifestations and laboratory examination results were compared and analyzed.Results:Among 293 male patients with acute brucellosis, the incidence of BEO was 10.24% (30/293). Their age was mainly concentrated in 45 - < 60 years old (53.33%, 16/30), and occupation was mostly farmers (63.33%, 19/30). There were no statistically significant differences in the distribution of age, occupation, exposure history and onset season between the BEO group and the non-BEO group ( P > 0.05). The distribution of abdominal pain and urinary frequency/urgency/pain symptoms was compared, and the differences were statistically significant ( P < 0.05). White blood cell count (WBC), neutrophil count (NEUT), and C-reactive protein (CRP) levels in the BEO group were higher than those in the non-BEO group ( P < 0.05), while the levels of cytokines interleukin (IL)-6 and interferon-γ (IFN-γ) were lower than those in the non-BEO group ( P < 0.05). After 6 - 8 weeks of hospitalization, the levels of WBC, NEUT, CRP, albumin, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase, alkaline phosphatase, α-hydroxybutyrate dehydrogenase, lactate dehydrogenase, IL-4, IL-6, IL-10, IL-17, tumor necrosis factor-α, and IFN-γ in patients of the BEO group were significantly different from before treatment ( P < 0.05). Twenty-eight patients were cured, 1 patient underwent orchiectomy, and 1 patient experienced recurrence. Conclusions:Middle-aged male patients with brucellosis are more prone to BEO. Clinical manifestations and laboratory tests have certain diagnostic value for BEO. Suspected BEO patients should be diagnosed and treated as early as possible to reduce the occurrence of adverse prognosis.