Diabetic nephropathy（DN） is a common and severe microvascular complication of diabetes. In recent years， the classical herbal formula Shenqi dihuang decoction has demonstrated unique advantages in the clinical treatment of DN. This article conducts a systematic review of the mechanisms of action and clinical applications of Shenqi dihuang decoction in the treatment of DN. It reveals that the mechanism by which this formula improves DN involves multi-target synergistic regulation. For instance, Shenqi dihuang decoction exerts multiple pharmacological effects by regulating signaling pathways including phosphatidy linostiol 3-kinase/protein kinase B， AMP-activated protein kinase/silent information regulator 1/forkhead box O1， and nuclear factor erythroid 2-related factor 2/heme oxygenase-1 pathways.These effects include regulating glucose and lipid metabolism， inhibiting oxidative stress， reducing inflammation， improving insulin resistance， modulating cell death （apoptosis/autophagy/ferroptosis/pyroptosis）， and preventing renal fibrosis. Existing clinical studies indicate that Shenqi dihuang decoction and its modified formulas， alone or in combination with other therapeutic methods， can significantly improve glucose and lipid metabolism， reduce proteinuria， and delay renal function decline in patients with DN. These effects are superior to those of Western medicines such as irbesartan， valsartan， and empagliflozin， and the treatment demonstrates good safety. Future research should leverage systems biology and artificial intelligence technologies to further elucidate the integrated mechanisms in the treatment of DN by Shenqi dihuang decoction， thereby advancing the precision and standardization of its clinical application.

OBJECTIVE: To investigate the effectiveness of nickel-titanium shape memory staples in treating multiple metatarsal fractures. METHODS: The clinical data of 27 patients with multiple metatarsal fractures who were treated between January 2022 and June 2023 and met the selection criteria were retrospectively analysed. The cohort consisted of 16 males and 11 females, aged 33-65 years (mean, 47.44 years). The causes of injury included heavy object impact in 11 cases, traffic accidents in 9 cases, and crush in 7 cases. Simultaneous fractures of 2, 3, 4, and 5 bones occurred in 6, 6, 4, and 8 cases, respectively, with tarsometatarsal joint injury in 3 cases. Fixation was performed using staples for 16, 22, and 9 fractures in the metatarsal neck, shaft, and the base, respectively, and 5 tarsometatarsal joint injuries. Preoperative soft tissue injuries were identified in 8 cases and classified according to the Tscherne-Oestern closed soft tissue injury classification as type Ⅰ in 5 cases and type Ⅱ in 3 cases. One case of type Ⅱexhibited preoperative skin necrosis. The patients were treated with fixation using nickel-titanium shape memory staples. Complications and fracture healing were documented. At last follow-up, the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was used to evaluate the function, and the visual analogue scale (VAS) score was used to evaluate the pain. RESULTS: The 27 patients were followed up 9-19 months (mean, 12.4 months). Postoperative X-ray films revealed no loss of fracture reduction, and all fractures achieved bony union. No internal fixator loosening, breakage, or other mechanical failures was observed. The mean fracture healing time was 3.13 months (range, 3-4 months). Postoperatively, 4 cases (2 of Tscherne-Oestern type Ⅰ, 2 of type Ⅱ) developed superficial skin necrosis, which resolved with dressing changes. No infection was observed in the remaining patients, and all wounds healed. At last follow-up, the AOFAS forefoot score ranged from 70 to 95, with an average of 86.6, of which 19 cases were excellent, 6 cases were good, and 2 cases were fair, with an excellent and good rate of 92.6%; the VAS score ranged from 0 to 3, with an average of 0.9, of which 24 cases were excellent, and 3 cases were good, with an excellent and good rate of 100%. CONCLUSION The use of nickel-titanium shape memory staples in the treatment of multiple metatarsal fractures can effectively protect local skin and soft tissues and minimize secondary damage associated with internal fixator insertion. It is a viable surgical option for management of multiple metatarsal fractures.
Humans ; Male ; Female ; Middle Aged ; Adult ; Titanium ; Nickel ; Retrospective Studies ; Fracture Fixation, Internal/instrumentation* ; Aged ; Metatarsal Bones/surgery* ; Fractures, Bone/surgery* ; Treatment Outcome ; Sutures ; Fractures, Multiple/surgery*

Objective Exploring the current research status,research context,evolution,and future research directions of laboratory animal welfare and ethics in China.Methods Literature related to laboratory animal welfare and ethics was collected from journals in the China National Knowledge Infrastructure(CNKI)database from 2001 to 2023.A combination of a qualitative description based on a literature review and CiteSpace visual bibliometric analysis was used to summarize the achievements,hot topics,and directions of laboratory animal welfare and ethics research.Results The literature shows that the overall popularity of research into laboratory animal welfare and ethics is on the rise in China.The hot research topics in this field include basic theories of laboratory animal welfare and ethics,the legislation of laboratory animal welfare and ethics,technologies for improving laboratory animal welfare and ethics,reviews of laboratory animal welfare and ethics,and laboratory animal welfare and ethics education.In response to the ethical issues arising from emerging interdisciplinary fields,continuous innovation is being made via research into this topic.Conclusions Suggestions are put forward regarding changes to the legal system,review mechanisms,education and training,and innovative research using laboratory animals welfare and ethics to provide a reference and guidance on the welfare and ethics of laboratory animals.

Ictal asystole in epileptic seizure (IA) is one of the severe complications of epilepsy, which is associated with falls and traumatic injuries related to seizures. Epileptic patients with IA may require adjustment to their treatment, including antiseizure medications adjustment, evaluation for epilepsy surgery and consideration of cardiac pacemaker implantation. However, there is no consensus on treatment options for these patients. This review focuses on the mechanisms, clinical features, auxiliary examinations and the outcomes of different treatments in the IA patients. Machine learning has some application values in analyzing the long-term video electroencephalogram (EEG) results of such patients and exploring the correlated characteristics between EEG and heart rate variability, which may provide a new perspective for the research.

Diabetic nephropathy （DN） is one of the most serious microvascular complications of diabetes and the leading cause of end-stage kidney disease. The onset and progression of DN are linked to the progression of renal fibrosis which is an important pathological feature and final pathological result of various chronic kidney diseases. As a result， therapies against renal fibrosis can help delay the progression of DN. The transforming growth factor-β₁ （TGF-β₁）/Smad signaling pathway is one of the key pathways in renal fibrosis. TGF-β₁， a crucial mediator of renal fibrosis， is highly expressed in the case of fibrosis-associated kidney diseases， and Smads are the main effectors in the TGF-β₁ signal transduction pathway. By activating Smads， TGF-β₁ transports signals from the cytoplasm to the nucleus and regulates the transcription of fibrosis-related target genes， thus exerting the biological effects and promoting the progression of renal fibrosis. In recent years， Chinese medicine has become prominent in the prevention and treatment of DN， and there has been an explosion of research on Chinese medicine in the prevention and treatment of DN through the TGF-β₁/Smad signaling pathway. Based on literature research， this paper reviewed the basic structure of the TGF-β₁/Smad signaling pathway， the relationship with DN， and monomers and extract of Chinese medicine， Chinese patent medicine， and compound Chinese medicine prescriptions in improving and delaying the renal fibrosis based on the TGF-β₁/Smad signaling pathway， and in alleviating inflammatory response and oxidative stress， reducing the accumulation of extracellular matrix， and inhibiting epithelial-mesenchymal transition by regulating the TGF-β₁/Smad signaling pathway. Thereby， this study is expected to provide new mindset for the treatment of DN.

Objective To investigate the quantitative evaluation efficiency of gadolinium?ethoxybenzyl?diethylenetriamine pentaacetic acid (Gd?EOB?DTPA) enhanced T1 mapping in staging hepatic fibrosis caused by viral hepatitis B. Methods One hundred and fifty patients with chronic hepatitis B were prospectively enrolled in Shanghai Public Health Clinical Center, Fudan University from August 2016 to August 2018.These patients underwent liver aspiration biopsy were divided into four subgroups: S1 (n=38), S2 (n=30), S3 (n=33), S4 (n=49) according to Scheuer?Ludwig scoring system. Non?enhanced and Gd?EOB?DTPA?enhanced MRI were performed in all subjects. Look?Locker sequences were performed to acquire T1 mapping of pre and post?contrast at 20 minutes after Gd?EOB?DTPA administration. The T1 value after 20 minutes of Gd?EOB?DTPA administration (T1 20 min), the reduction rate of T1 value (ΔT1 20 min% ), the increase of 1/T1 value (ΔR1 20 min% ) were measured and calculated. The one?way ANOVA was applied to compare the difference in T1 20 min, ΔT1 20 min%, ΔR1 20 min% of various fibrosis stages. ROC curves were used to assess the efficacy of T1 20 min, ΔT1 20 min%, ΔR1 20 min% for diagnosing≥S2,≥S3,≥S4. P<0.05 was considered to be statistically significant. Results The T1 20 min raised with fibrosis stage increased, ΔT1 20 min% and ΔR1 20 min% reduced with fibrosis stage increased. Areas under the curves of T1 20 min, ΔT1 20 min%, ΔR1 20 min% for diagnosing≥S2 were 0.844, 0.905, 0.869; and diagnosing≥S3 were 0.832, 0.907, 0.862; and diagnosing≥S4 were 0.853, 0.897, 0.873, respectively. The diagnostic efficiency of ΔT1 20 min% was the best. Conclusion Gd?EOB?DTPA?enhanced T1 mapping could be regarded as a reliable diagnostic tool for the evaluation of hepatic fibrosis caused by viral hepatitis B.

Objective: To investigate the quantitative evaluation efficiency of gadolinium- ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced T₁ mapping in staging hepatic fibrosis caused by viral hepatitis B. Methods: One hundred and fifty patients with chronic hepatitis B were prospectively enrolled in Shanghai Public Health Clinical Center, Fudan University from August 2016 to August 2018.These patients underwent liver aspiration biopsy were divided into four subgroups: S1 (n=38), S2 (n=30), S3 (n=33), S4 (n=49) according to Scheuer-Ludwig scoring system. Non-enhanced and Gd-EOB-DTPA-enhanced MRI were performed in all subjects. Look-Locker sequences were performed to acquire T₁ mapping of pre and post-contrast at 20 minutes after Gd-EOB-DTPA administration. The T₁ value after 20 minutes of Gd-EOB-DTPA administration (T_{1 20 min}), the reduction rate of T₁ value (ΔT_{1 20 min}%), the increase of 1/T₁ value (ΔR_{1 20 min}%) were measured and calculated. The one-way ANOVA was applied to compare the difference in T_{1 20 min}, ΔT_{1 20 min}%, ΔR_{1 20 min}% of various fibrosis stages. ROC curves were used to assess the efficacy of T_{1 20 min}, ΔT_{1 20 min}%, ΔR_{1 20 min}% for diagnosing ≥ S2, ≥ S3, ≥ S4. P<0.05 was considered to be statistically significant. Results: The T_{1 20 min} raised with fibrosis stage increased, ΔT_{1 20 min}% and ΔR_{1 20 min}% reduced with fibrosis stage increased. Areas under the curves of T_{1 20 min}, ΔT_{1 20 min}%, ΔR_{1 20 min}% for diagnosing ≥ S2 were 0.844, 0.905, 0.869; and diagnosing ≥ S3 were 0.832, 0.907, 0.862; and diagnosing ≥ S4 were 0.853, 0.897, 0.873, respectively. The diagnostic efficiency of ΔT_{1 20 min}% was the best. Conclusion Gd-EOB-DTPA-enhanced T₁ mapping could be regarded as a reliable diagnostic tool for the evaluation of hepatic fibrosis caused by viral hepatitis B.

BACKGROUNDGenetic factors are important in the pathogenesis of osteoporosis, but less is known about the genetic determinants of osteoporosis treatment. We aimed to explore the association between the gene polymorphisms of key enzyme farnesyl diphosphate synthase (FDPS) in mevalonate signaling pathway of osteoclast and response to alendronate therapy in osteoporotic postmenopausal women in China.

METHODSThe study group comprised 639 postmenopausal women aged (62.2 ± 7.0) years with osteoporosis or osteopenia who had been randomly assigned to low dose group (70 mg/2 w) or standard dose group (70 mg/w) of alendronate in this 1-year study. We identified allelic variant of the FDPS gene using the polymerase chain reaction and restriction enzyme Faul. Before and after treatment, serum levels of calcium, phosphate, alkaline phosphatase (ALP), cross linked C-telopeptide of type I collagen (β-CTX) were detected. Bone mineral density (BMD) at lumbar spine and proximal femur was measured. The association was analyzed between the polymorphisms of FDPS gene and the changes of BMD, bone turnover biomarkers after the treatment.

RESULTSThe FDPS rs2297480 polymorphisms were associated with baseline BMD at femoral neck, and patients with CC genotype had significantly higher baseline femoral neck BMD ((733.6 ± 84.1) mg/cm(2)) than those with AC genotypes ((703.0 ± 86.9) mg/cm(2)) and AA genotypes ((649.8 ± 62.4) mg/cm(2)) (P < 0.01). No significant difference in BMD at lumbar spine was observed among different genotypes of FDPS. The percentage change of serum ALP level was significantly lower in patients with CC genotype (-22.9%) than that in those with AC genotype (-24.1%) and AA genotype (-29.8%) of FDPS after 12 months of alendronate treatment (P < 0.05). Neither percentage change of BMD nor β-CTX level after alendronate treatment had association with FDPS genotype.

CONCLUSIONSFDPS gene was probably a candidate gene to predict femoral neck BMD at baseline. FDPS gene alleles could predict change percentage of ALP after treatment of alendronate, but possibly had no significant relationship with the responsiveness of BMD to alendronate therapy.

Alendronate ; therapeutic use ; Asian Continental Ancestry Group ; Bone Density Conservation Agents ; therapeutic use ; Female ; Geranyltranstransferase ; genetics ; Humans ; Middle Aged ; Osteoporosis, Postmenopausal ; drug therapy ; genetics ; Polymorphism, Genetic

Objective To define dynamic changes of viral loads and antibody responses in ICR mice naturally infected with hepatitis virus in an MHV contaminative facility .Method A total 50 ICR were housed by different “dirty bedding” exposure.Antigen and antibody was detected after 2,4,8,14,21,28,35,42,56 and 84 days.Result Mouse hepatitis virus (MHV) was detected in lung after 2 days, and positive rate is 20% (1/5).MHV was detected in lung, liver, cecal and feces during 4 and 56 days.The positive rate was 0/5 in lung, liver, cecal and feces on 84 days after experiments.Antibody positive rates were 100%during 8 and 84 days.Conclusion Serological method can be used as the main method for the diagnosis of the daily supervision , and antigen detection method can only be applied to early diagnosis .

Objective To investigate the TCM syndrome of metabolic syndrome. Methods The clinic information of the patients with metabolic syndrome was systematically collected through questionnaire investigation. The information was gathered with EXECL and analyzed by the medical statistic software SPSS14.0. Results Metabolic syndrome was closely related to lung, spleen, and kidney, manifested as spleen deficiency, lung deficiency, kidney deficiency, deficiency of both lung and spleen, deficiency of both lung and kidney, and deficiency of both spleen and kidney. The most frequently seen dyndrome is Qi deficiency, and the syndrome with most serious manifestations is phlegm-dampness. Conelesions Metabolic syndrome has a most closed relationship with the three organs of lung, spleen, and kidney. Qi deficiency, phlegm dampness, and blood stasis are the most frequently seen manifestations.