This study aims to explore the effects and mechanisms of the traditional Chinese medicine Cordyceps sinensis(CS) in ameliorating heart aging and injury in mice based on animal experiments and network pharmacology. A mouse model of heart aging was established by continuously subcutaneous injection of D-galactose(D-gal). Thirty mice were randomly assigned into a normal group, a model group, a low-dose CS(CS-L) group, a high-dose CS(CS-H) group, and a vitamin E(VE) group. Mice in these groups were administrated with normal saline, different doses of CS suspension, or VE suspension via gavage daily. After 60 days of treatment with D-gal and various drugs, all mice were euthanized, and blood and heart tissue samples were collected for determination of the indicators related to heart aging and injury in mice. Experimental results showed that both high and low doses of CS and VE ameliorated the aging phenotype, improved the heart index and myocardial enzyme spectrum, restored the expression levels of proteins associated with cell cycle arrest and senescence-associated secretory phenotypes(SASP), and alleviated the fibrosis and histopathological changes of the heart tissue in model mice. From the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),259 active ingredients of CS were retrieved. From Gene Cards and OMIM, 2 568 targets related to heart aging were identified, and 133common targets shared by CS and heart aging were obtained. The Gene Ontology(GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes( KEGG) pathway enrichment revealed that the pathways related to heart aging involved oxidative stress,apoptosis, inflammation-related signaling pathways, etc. The animal experiment results showed that both high and low doses of CS and VE ameliorated oxidative stress and apoptosis in the heart tissue to varying degrees in model mice. Additionally, CS-H and VE activated the nuclear factor E2-related factor 2(Nrf2)/heme oxygenase-1(HO-1) pathway and inhibited the expression of key proteins in the nuclear factor-κB(NF-κB) pathway in the heart tissue of model mice. In conclusion, this study demonstrated based on network pharmacology and animal experiments that CS may alleviate heart aging and injury in aging mice by reducing oxidative stress,apoptosis, and inflammation in the heart via the Nrf2/HO-1/NF-κB pathway.
Animals ; Cordyceps/chemistry* ; Mice ; NF-E2-Related Factor 2/genetics* ; NF-kappa B/genetics* ; Aging/genetics* ; Male ; Signal Transduction/drug effects* ; Network Pharmacology ; Drugs, Chinese Herbal/pharmacology* ; Heme Oxygenase-1/genetics* ; Heart/drug effects* ; Humans ; Myocardium/metabolism* ; Membrane Proteins/genetics*

Jiuwei Xifeng Granules have become a Chinese patent medicine in the market. Because the formula contains Os Draconis, a top-level protected fossil of ancient organisms, the formula was to be improved by replacing Os Draconis with Ostreae Concha. To evaluate whether the improved formula has the same effectiveness and safety as the original formula, a randomized, double-blind, parallel-controlled, equivalence clinical trial was conducted. This study enrolled 288 tic disorder(TD) of children and assigned them into two groups in 1∶1. The treatment group and control group took the modified formula and original formula, respectively. The treatment lasted for 6 weeks, and follow-up visits were conducted at weeks 2, 4, and 6. The primary efficacy endpoint was the difference in Yale global tic severity scale(YGTSS)-total tic severity(TTS) score from baseline after 6 weeks of treatment. The results showed that after 6 weeks of treatment, the declines in YGTSS-TSS score showed no statistically significant difference between the two groups. The difference in YGTSS-TSS score(treatment group-control group) and the 95%CI of the full analysis set(FAS) were-0.17[-1.42, 1.08] and those of per-protocol set(PPS) were 0.29[-0.97, 1.56], which were within the equivalence boundary [-3, 3]. The equivalence test was therefore concluded. The two groups showed no significant differences in the secondary efficacy endpoints of effective rate for TD, total score and factor scores of YGTSS, clinical global impressions-severity(CGI-S) score, traditional Chinese medicine(TCM) response rate, or symptom disappearance rate, and thus a complete evidence chain with the primary outcome was formed. A total of 6 adverse reactions were reported, including 4(2.82%) cases in the treatment group and 2(1.41%) cases in the control group, which showed no statistically significant difference between the two groups. No serious suspected unexpected adverse reactions were reported, and no laboratory test results indicated serious clinically significant abnormalities. The results support the replacement of Os Draconis by Ostreae Concha in the original formula, and the efficacy and safety of the modified formula are consistent with those of the original formula.
Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Double-Blind Method ; Drugs, Chinese Herbal/therapeutic use* ; Tic Disorders/drug therapy* ; Treatment Outcome

Objective: To establish a machine learning-based precision blood donor recruitment model at the county level and assess its generalizability and applicability. Methods: A retrospective study was conducted using blood donation and SMS recruitment data from the Taicang Branch of the Suzhou Blood Center between 2019 and 2024. Multiple machine learning algorithms were employed, including extreme gradient boosting, support vector machine, k-nearest neighbor, logistic regression, decision tree, random forest, and multilayer perceptron. These were combined with techniques such as synthetic minority oversampling, undersampling, and cost-sensitive learning (using MFE and MSFE loss functions). Model parameters were optimized through grid search to identify the best-performing model. Results: In a prospective comparative study against conventional methods, the machine learning models increased the recruitment success rate among high-willingness donors by an average of 129.15%, and the recruitment efficiency per SMS improved by 125.02% compared with the traditional method. Under full-scale SMS sending, the recruitment rate per SMS increased by 42.61%, and SMS sending efficiency improved by 31.77%, significantly enhancing recruitment performance. Conclusion: This study represents the first application of a machine learning-based precision donor recruitment model at the county-level in China. The precise recruitment framework not only improves recruitment efficiency and reduces recruitment costs but also demonstrates strong scalability and generalizability. It provides a scientific and feasible intelligent pathway to ensure the safety and sustainability of the blood supply.

OBJECTIVES: To determine the pharmacological impact of hesperidin, the main component of Citri Reticulatae Pericarpium, on depressive behavior and elucidate the mechanism by which hesperidin treats depression, focusing on the gut-brain axis. METHODS: Fifty-four Sprague Dawley male rats were randomly allocated to 6 groups using a random number table, including control, model, hesperidin, probiotics, fluoxetine, and Citri Reticulatae Pericarpium groups. Except for the control group, rats in the remaining 5 groups were challenged with chronic unpredictable mild stress (CUMS) for 21 days and housed in single cages. The sucrose preference test (SPT), immobility time in the forced swim test (FST), and number in the open field test (OFT) were performed to measure the behavioral changes in the rats. Enzyme-linked immunosorbent assay was used to determine the levels of 5-hydroxytryptamine (5-HT) and brain-derived neurotrophic factor (BDNF) in brain tissue, and the histopathology was performed to evaluate the changes of colon tissue, together with sequencing of the V3-V4 regions of 16S rRNA gene on feces to explore the changes of intestinal flora in the rats. RESULTS: Compared to the control group, the rats in the model group showed notable reductions in body weight, SPF, and number in OFT (P<0.01). Hesperidin was found to ameliorate depression induced by CUMS, as seen by improvements in body weight, SPT, immobility time in FST, and number in OFT (P<0.05 or P<0.01). Regarding neurotransmitters, it was found that at a dose of 50 mg/kg hesperidin treatment upregulated the levels of 5-HT and BDNF in depressed rats (P<0.05). Compared to the control group, the colon tissue of the model group exhibited greater inflammatory cell infiltration, with markedly reduced numbers of goblet cells and crypts and were significantly improved following treatment with hesperidin. Simultaneously, the administration of hesperidin demonstrated a positive impact on the gut microbiome of rats treated with CUMS, such as Shannon index increased and Simpson index decreased (P<0.01), while the abundance of Pseudomonadota and Bacteroidota increased in the hesperidin-treated group (P<0.05). CONCLUSION The mechanism responsible for the beneficial effects of hesperidin on depressive behavior in rats may be related to inhibition of the expressions of BDNF and 5-HT and preservation of the gut microbiota.
Animals ; Hesperidin/therapeutic use* ; Rats, Sprague-Dawley ; Depression/drug therapy* ; Male ; Stress, Psychological/drug therapy* ; Brain/metabolism* ; Brain-Derived Neurotrophic Factor/metabolism* ; Serotonin/metabolism* ; Gastrointestinal Microbiome/drug effects* ; Behavior, Animal/drug effects* ; Rats ; Brain-Gut Axis/drug effects* ; Chronic Disease ; Colon/drug effects*

Objective:To screen for patients with mixed-lineage leukemia (MLL) fusion gene-positive with acute myeloid leukemia (AML), analyze the clinical characteristics and prognosis of patients with AML with positive fusion genes, and report two cases with rare breakpoint sites.Methods:This study included 287 patients with AML (non-acute promyelocytic leukemia) admitted to the Hematology and Oncology Research Center of Harbin First Hospital from October 2021 to October 2023. The cohort involved 157 males and 130 females, with a median age of 48 years (range: 19-80 years). All 287 patients underwent screening for 56 fusion genes and chromosome karyotyping analysis. Fluorescence in situ hybridization (FISH) and RNA seq were further performed on patients with negative fusion genes but positive 11q23.3 chromosomal translocation. Patient observation indicators included remission, recurrence, and others.Results:Among the 287 patients with AML, 15 were positive for the MLL fusion gene, with a positivity rate of 5.2%. Among the 11 types of MLL fusion genes detected, the most prevalent fusion types were MLL-ENL (4 cases), MLL-ELL (4 cases), MLL-AF9 (3 cases), and MLL-AF6 (3 cases). Of the 15 patients with positive MLL fusion gene, 2 demonstrated negative fusion gene while exhibiting positive chromosome and FISH. RNA-seq testing in these two patients revealed an uncommon breakpoint in the MLL fusion gene and a novel breakpoint fusion site, respectively. Complete remission (CR) was achieved in 6 patients with positive MLL fusion genes during the first chemotherapy cycle. After two cycles, eight patients achieved CR, with 50% of them experiencing recurrence within 2 months.Conclusion:RNA seq technology is useful for screening fusion genes with unconventional or novel cleavage sites, and patients with positive MLL fusion genes demonstrated a poorer prognosis.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Objective:To investigate the value of preoperative intestinal ultrasound parameters in predicting early postoperative recurrence（EPR）in patients with Crohn's disease（CD）.Methods:Ninety-five patients with CD who underwent I-stage intestinal resection at the Sixth Affiliated Hospital， Sun Yat-sen University from March 2015 to December 2020 were retrospectively enrolled. The patients were divided into EPR group （ n=50） and non-EPR （NEPR） group （ n=45） based on recurrence within one year postoperatively. Differences in preoperative intestinal ultrasound parameters including bowel wall thickness，bowel wall stratification， color Doppler grading， mesenteric fat hypertrophy （MFH） ， mesenteric lymphadenopathy， abscess/fistula， abdominal effusion， and clinical factors such as preoperative C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR） were compared between the two groups. The predictive values of ultrasound parameters with statistically significant differences between the two groups were analyzed. Univariate and multivariate Logistic regression analyses were used to identify independent predictive factors associated with EPR in patients with CD. Results:During the 1-year follow-up，EPR occurred in 52.6%（50/95）patients with CD. Among clinical factors，preoperative CRP and ESR levels showed statistically significant differences between the EPR and NEPR groups（all P<0.05）. For ultrasound parameters，the incidences of mesenteric fat hypertrophy（MFH）and abscess/fistula were significantly higher in the EPR group than the NEPR group（all P<0.05）. MFH demonstrated a significantly higher AUC value for predicting EPR compared to abscess/fistula（0.797 vs.0.617， P=0.002）. Univariate Logistic analysis showed that CRP，ESR，MFH and abscess/fistula were candidate variables for diagnosing EPR（all P<0.05）. Multivariate Logistic regression analysis indicated that MFH（ OR=13.800， P<0.001）and the laboratory measure CRP（ OR=1.015， P=0.030）were effective predictive factors for EPR. Conclusions:Preoperative intestinal ultrasound parameter MFH may serve as a valuable predictor for assessing EPR risk in patients with CD.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Objective:To screen for patients with mixed-lineage leukemia (MLL) fusion gene-positive with acute myeloid leukemia (AML), analyze the clinical characteristics and prognosis of patients with AML with positive fusion genes, and report two cases with rare breakpoint sites.Methods:This study included 287 patients with AML (non-acute promyelocytic leukemia) admitted to the Hematology and Oncology Research Center of Harbin First Hospital from October 2021 to October 2023. The cohort involved 157 males and 130 females, with a median age of 48 years (range: 19-80 years). All 287 patients underwent screening for 56 fusion genes and chromosome karyotyping analysis. Fluorescence in situ hybridization (FISH) and RNA seq were further performed on patients with negative fusion genes but positive 11q23.3 chromosomal translocation. Patient observation indicators included remission, recurrence, and others.Results:Among the 287 patients with AML, 15 were positive for the MLL fusion gene, with a positivity rate of 5.2%. Among the 11 types of MLL fusion genes detected, the most prevalent fusion types were MLL-ENL (4 cases), MLL-ELL (4 cases), MLL-AF9 (3 cases), and MLL-AF6 (3 cases). Of the 15 patients with positive MLL fusion gene, 2 demonstrated negative fusion gene while exhibiting positive chromosome and FISH. RNA-seq testing in these two patients revealed an uncommon breakpoint in the MLL fusion gene and a novel breakpoint fusion site, respectively. Complete remission (CR) was achieved in 6 patients with positive MLL fusion genes during the first chemotherapy cycle. After two cycles, eight patients achieved CR, with 50% of them experiencing recurrence within 2 months.Conclusion:RNA seq technology is useful for screening fusion genes with unconventional or novel cleavage sites, and patients with positive MLL fusion genes demonstrated a poorer prognosis.