Salvia miltiorrhiza (S. miltiorrhiza) represents a crucial component of traditional Chinese medicine, demonstrating effects on blood circulation activation and stasis removal, and has been widely utilized in asthma treatment. This study isolated a novel phenolic acid (S1) from S. miltiorrhiza and investigated its anti-asthmatic activity and underlying mechanisms for the first time. An allergic asthma (AA) model was established using ovalbumin (OVA). The mechanism of S1's effects on AA was investigated using multi-factor joint analysis, flow cytometry, and co-culture systems to facilitate clinical asthma treatment. S1 (10 or 20 mg·kg^-1) was administered daily to mice with OVA-induced AA (OVA-AA) during days 21-25. The study examined airway responsiveness, lung damage, inflammation, and levels of immunoglobulin E (IgE), PGD2, interleukins (IL-4, 5, 10, 13, 17A), tumor necrosis factor α (TNF-α), GM-CSF, CXCL1, CCL11, and mMCP-1. Additionally, mast cell (MC) activation and degranulation were explored, along with T helper type 17 (Th17)/Treg immune cells and TLR4 pathway biomarkers. The antagonistic activity of that specific antagonist of TLR4 (TAK-242) (1 µmol·L^-1), a specific TLR4 blocker, against S1 (10 µmol·L^-1) was examined in co-cultured 16HBE cells and bone marrow-derived cells (BMDCs) or splenic lymphocytes (SLs) induced with LPS (1 µg·mL^-1) to elucidate the TLR4 pathway's mediating role. S1 demonstrated reduced airway responsiveness, lung damage, and inflammation, with downregulation of IgE, PGD2, interleukins, TNF-α, GM-CSF, CXCL1, CCL11, and mMCP-1. It also impeded MC activation and degranulation, upregulated IL-10, and influenced Th17/Treg immune cell transformation following OVA challenge. Furthermore, S1 inhibited the TLR4 pathway in OVA-AA mice, and TLR4 antagonism enhanced S1's positive effects. Analysis using an OVA-AA mouse model demonstrated that S1 alleviates AA clinical symptoms, restores lung function, and inhibits airway response. S1's therapeutic effects occur through regulation of Th17/Treg immune cells and inflammation, attributable at least partially to the TLR4 pathway. This study provides molecular justification for S1 in AA treatment.

Perimenopausal women are more susceptible to fire pathogen disturbances,often resulting in the restlessness of the mind owing to the deficiency and decline of the thoroughfare and conception vessels,as well as the insufficiency of the essence and blood of the viscera.CHENG Zhongling's theory of thief and child fire in Medical Insights proposes that thief fire primarily arises from exogenous pathogen invasion and improper diet,leading to syndromes such as food retention in the stomach or phlegm-fire stagnation.In contrast,child fire is generated endogenously,often owing to liver and kidney deficiency,resulting in an imbalance of water and fire and liver dysfunction,leading to excessive fire transformation.This theory provides a novel perspective for understanding the pathogenesis of perimenopausal insomnia.An in-depth exploration of the role of thief fire and child fire in perimenopausal insomnia is presented,along with a detailed discussion of corresponding treatment strategies.For the invasion of thief fire,therapeutic approaches include ascending and dispersing stagnant fire,clearing and moistening to remove interior heat,purging the heat accumulation to unblock the bowels,and subduing the fire and nourishing yin to eliminate depression.When child fire disturbs the spirit,treatment methods involve smoothing and relieving the liver qi to clear the stagnant heat,nourishing the true yin to restrain the yang,warming and nurturing the primordial qi and harmonizing the nutrient and defensive qi,and guiding and reducing the deficient heat to remove the floating fire.Clinical practice necessitates precise identification of thief and child fire,thorough investigation of exogenous pathogens and internal damage,and careful differentiation between deficiency and excess,as well as the superficial and internal aspects.Strict adherence to the treatment principle of"nourishing the child fire can drive out the thief fire,but driving out the thief fire should not harm the child fire"ensures a balanced approach.By harmonizing the yin and yang of the viscera and allowing the mind to be at ease,this strategy effectively alleviates perimenopausal insomnia.The application of these principles provides a practical and feasible theoretical foundation and practical guidance for the treatment of perimenopausal insomnia using traditional Chinese medicine.

Objective To explore its application value of LNM in patients with gastric adenocarcinoma based on the construction of a radiomic nomogram prediction model for preoperative lymph node metastasis in gastric adenocarcinoma using enhanced CT imaging features and parameters.Methods 131 patients with gastric adenocarcinoma who underwent radical gastric cancer surgery(Billroth Ⅱ)+lymph node dissection in our hospital from August 2019 to October 2023 were retrospectively analysed,and the preoperative enhancement CT extracted lesions,histological features of lymph node images,and pathological examination of LNM were recorded respectively,and the statistically significant Enhanced CT image histological features and parameters,multifactorial logistic regression to analyse the independent risk factors of gastric adenocarcinoma LNM(+)and construct a column-line diagram,and evaluate its performance.The performance and clinical value of the prediction model were evaluated using subject work characteristic(ROC)curves,and the column-line diagram was internally validated.Results The results of univariate analysis showed that the maximum diameter of the tumour,the lymph node status,the short-axis length and volume of the largest lymph node in the lymph node group and the sum of the short-axis lengths of all the lymph nodes were associated with the occurrence of LNM,and the difference was statistically significant(P＜0.05);multifactorial logistic regression analysis suggested that the maximum diameter of the tumour was ≥15 mm and the lymph node status was positive in the enhanced CT imaging examination,maximum lymph node short-axis length ≥ 7 mm in the lymph node group,the sum of short-axis lengths of all lymph nodes ≥ 11 mm,and the maximum lymph node short-axis volume ≥ 300 mm3 in the lymph node group were the independent risk factors for gastric adenocarcinoma patients with LNM(+)(P＜0.05);the area under the curve of the model was plotted using a ROC curve with an AUC=0.816(95％ CI 0.810-0.939),with the sensitivity of 0.91 and the specificity of 0.86.Model validation was performed using the BOOTSTRAP method containing 500 resamples,and the results suggested that the differences between the fitted curves and the ideal curves of the constructed column-line graphical model were not significant,and the validity and reliability were good.Conclusion The radiomic nomogram prediction model based on enhanced CT imaging features and parameters can effectively predict preoperative lymph node metastasis in gastric adenocarcinoma,providing strong support for clinical decision-making in gastric adenocarcinoma patients.

Various therapeuti modailities have been engineered for lung cancer treatment, but their clinic application is severely impeded by the poor therapy efficiency and immunosuppressive microenvironment. Herein, we fabricated a library of small molecule redox-labile nanoparticles (NPs) (i.e., diPTX-2C NPs, diPTX-2S NPs, and diPTX-2Se NPs) by the self-assembly of dimer paclitaxel (PTX) prodrug, and then utilized these NPs with the traditional Chinese medicine (TCM) Qi-Yu-San-Long-Fang (Q) for effective chemoimmunotherapy on Lewis lung carcinoma (LLC)-bearing mice models. Under the high concentration of glutathione (GSH) and H₂O₂, diPTX-2Se NPs could specifically release PTX in cancer cells and exert a higher selectivity and toxicity than normal cells. In LLC tumor-bearing mice, oral administration of Q not only effectively downregulated programmed death ligand-1 (PD-L1) expression, but also remodeled the immunosuppressive tumor immune microenvironment via the increase of CD4⁺ T and CD8⁺ T cell proportion and the repolarization of M2 into M1 macrophages in tumor tissues, collectively achieving superior synergistic treatment outcomes in combination with intravenous PTX prodrug NPs. Besides, we found that the combination regimen also demonstrated excellent chemoimmunotherapeutic performances on low-dose small established tumor and high-dose large established tumor models. This study may shed light on the potent utilization of Chinese and Western-integrative strategy for efficient tumor chemoimmunotherapy.

Objective To construct a model for predicting ki-67 expression in hepatocellular carcinoma using the intratumoral and peritumoral radiomic features of contrast enhanced magnetic resonance imaging(CEMRI)in the arterial phase as well as clinical imaging features.Methods A total of 120 patients pathologically diagnosed with hepatocellular carcinoma(HCC)from January 2016 to December 2024 in No.910 Hospital of the Joint Logis-tics Support Force of the Chinese People's Liberation Army were retrospectively enrolled and randomly divided into a training set(84 cases)and a test set(36 cases)in a ratio of 7∶3.ITK-SNAP software was used to delineate the global region of interest(ROI)of HCC on the arterial phase MR images.The ROIs of all patients were automatically expanded outward by 2 mm,and then the intratumoral ROI areas were eliminated to obtain the peritumoral ROI.With the help of PyRadiomics software,1 198 intratumoral and peritumoral radiomic features were extracted.Spearman correlation analysis,maximum relevance-minimum redundancy(mRMR),and least absolute shrinkage and selection operator(LASSO)regression were used to reduce the data dimension and select the best features.Then,a radiomics model of the logistic regression(LR)machine learning algorithm was constructed.A combined model including clinical imaging features and radiomics features was established.The area under the curve(AUC),accuracy,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),calibration curve and decision curve analysis(DCA)were used to evaluate the efficacy of the intratumoral and peritumoral radiomics features combined with clinical imaging features model in predicting ki-67 expression in hepatocellular car-cinoma.Results The intratumor model exhibited an efficacy in predicting the expression of ki-67 in hepatocellular carcinoma with AUC values of 0.817 and 0.787 in the training set and test set,respectively.The peritumoral model showed an efficacy with AUC values of 0.805 and 0.633 in the training set and test set,respectively.The intratumoral and peritumoral model demonstrated AUC values of 0.874 and 0.836 in the training set and test set,respectively.The combined model constructed by integrating the intratumoral and peritumoral model with clinical imaging features yielded AUC values of 0.877 and 0.849 in the training set and test set,respectively,indicating clinical imaging features improved the performance of the model.DCA showed that the combined models all had good clinical benefits,with the intratumoral and peritumoral model performing the best.Conclusion The intratumoral and peritumoral radiomics model based on CEMRI arterial phase combined with clinical imaging data can accurately predict the expression of ki-67 in hepatocellular carcinoma.This combined model yields the best clinical benefit.

The phrase"wood element characterized by spreading harmony"from the Huangdi Neijing five-phase theory summarizes the fundamental nature and functions of the wood element,emphasizing the crucial significance of the harmonious virtue of wood in promoting the generation and transformation of all things.In human physiology,"wood element characterized by spreading harmony"corresponds to the harmonious spreading of liver-gallbladder qi,ensuring smooth liver qi regulation and proper functioning of the ascending-descending movement mechanisms.Bipolar disorder,categorized in traditional Chinese medicine as"depression"or"manic depressive psychosis,"primarily arises from hepatic wood dysfunction.Insufficient wood qi dispersion typically manifests as a depressive phase,whereas excessive dispersion leads to a manic phase,with alternating manic-depressive phase indicating qi movement disorder.By integrating wood qi characteristics,disease pathogenesis of bipolar disorder,and our team's clinical experience in treating emotional disorders,this study developed an integrated acupuncture and moxibustion diagnosis and treatment approach for bipolar disorder,focusing on soothing the liver and regulating spirit,structured as"acupuncture-moxibustion-consolidation."Based on the physiological characteristics of"wood element characterized by spreading harmony,"from liver failing to controll conveyance and dispersion:depressive phase should apply warm-nourishing growth method,manic phase should suppress hyperactive liver for tranquillizing mind method,and alternating manic-depressive phase should apply harmonized rigidity-flexibility method.These methods aim to regulate the spirit of the heart and brain,harmonize the qi movement of the spleen and stomach,and replenish the essence and blood of the liver and kidney.Clinical application through syndrome differentiation has demonstrated satisfactory therapeutic outcomes.

Objective To construct a model for predicting ki-67 expression in hepatocellular carcinoma using the intratumoral and peritumoral radiomic features of contrast enhanced magnetic resonance imaging(CEMRI)in the arterial phase as well as clinical imaging features.Methods A total of 120 patients pathologically diagnosed with hepatocellular carcinoma(HCC)from January 2016 to December 2024 in No.910 Hospital of the Joint Logis-tics Support Force of the Chinese People's Liberation Army were retrospectively enrolled and randomly divided into a training set(84 cases)and a test set(36 cases)in a ratio of 7∶3.ITK-SNAP software was used to delineate the global region of interest(ROI)of HCC on the arterial phase MR images.The ROIs of all patients were automatically expanded outward by 2 mm,and then the intratumoral ROI areas were eliminated to obtain the peritumoral ROI.With the help of PyRadiomics software,1 198 intratumoral and peritumoral radiomic features were extracted.Spearman correlation analysis,maximum relevance-minimum redundancy(mRMR),and least absolute shrinkage and selection operator(LASSO)regression were used to reduce the data dimension and select the best features.Then,a radiomics model of the logistic regression(LR)machine learning algorithm was constructed.A combined model including clinical imaging features and radiomics features was established.The area under the curve(AUC),accuracy,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),calibration curve and decision curve analysis(DCA)were used to evaluate the efficacy of the intratumoral and peritumoral radiomics features combined with clinical imaging features model in predicting ki-67 expression in hepatocellular car-cinoma.Results The intratumor model exhibited an efficacy in predicting the expression of ki-67 in hepatocellular carcinoma with AUC values of 0.817 and 0.787 in the training set and test set,respectively.The peritumoral model showed an efficacy with AUC values of 0.805 and 0.633 in the training set and test set,respectively.The intratumoral and peritumoral model demonstrated AUC values of 0.874 and 0.836 in the training set and test set,respectively.The combined model constructed by integrating the intratumoral and peritumoral model with clinical imaging features yielded AUC values of 0.877 and 0.849 in the training set and test set,respectively,indicating clinical imaging features improved the performance of the model.DCA showed that the combined models all had good clinical benefits,with the intratumoral and peritumoral model performing the best.Conclusion The intratumoral and peritumoral radiomics model based on CEMRI arterial phase combined with clinical imaging data can accurately predict the expression of ki-67 in hepatocellular carcinoma.This combined model yields the best clinical benefit.

Objective To explore its application value of LNM in patients with gastric adenocarcinoma based on the construction of a radiomic nomogram prediction model for preoperative lymph node metastasis in gastric adenocarcinoma using enhanced CT imaging features and parameters.Methods 131 patients with gastric adenocarcinoma who underwent radical gastric cancer surgery(Billroth Ⅱ)+lymph node dissection in our hospital from August 2019 to October 2023 were retrospectively analysed,and the preoperative enhancement CT extracted lesions,histological features of lymph node images,and pathological examination of LNM were recorded respectively,and the statistically significant Enhanced CT image histological features and parameters,multifactorial logistic regression to analyse the independent risk factors of gastric adenocarcinoma LNM(+)and construct a column-line diagram,and evaluate its performance.The performance and clinical value of the prediction model were evaluated using subject work characteristic(ROC)curves,and the column-line diagram was internally validated.Results The results of univariate analysis showed that the maximum diameter of the tumour,the lymph node status,the short-axis length and volume of the largest lymph node in the lymph node group and the sum of the short-axis lengths of all the lymph nodes were associated with the occurrence of LNM,and the difference was statistically significant(P＜0.05);multifactorial logistic regression analysis suggested that the maximum diameter of the tumour was ≥15 mm and the lymph node status was positive in the enhanced CT imaging examination,maximum lymph node short-axis length ≥ 7 mm in the lymph node group,the sum of short-axis lengths of all lymph nodes ≥ 11 mm,and the maximum lymph node short-axis volume ≥ 300 mm3 in the lymph node group were the independent risk factors for gastric adenocarcinoma patients with LNM(+)(P＜0.05);the area under the curve of the model was plotted using a ROC curve with an AUC=0.816(95％ CI 0.810-0.939),with the sensitivity of 0.91 and the specificity of 0.86.Model validation was performed using the BOOTSTRAP method containing 500 resamples,and the results suggested that the differences between the fitted curves and the ideal curves of the constructed column-line graphical model were not significant,and the validity and reliability were good.Conclusion The radiomic nomogram prediction model based on enhanced CT imaging features and parameters can effectively predict preoperative lymph node metastasis in gastric adenocarcinoma,providing strong support for clinical decision-making in gastric adenocarcinoma patients.

The phrase"wood element characterized by spreading harmony"from the Huangdi Neijing five-phase theory summarizes the fundamental nature and functions of the wood element,emphasizing the crucial significance of the harmonious virtue of wood in promoting the generation and transformation of all things.In human physiology,"wood element characterized by spreading harmony"corresponds to the harmonious spreading of liver-gallbladder qi,ensuring smooth liver qi regulation and proper functioning of the ascending-descending movement mechanisms.Bipolar disorder,categorized in traditional Chinese medicine as"depression"or"manic depressive psychosis,"primarily arises from hepatic wood dysfunction.Insufficient wood qi dispersion typically manifests as a depressive phase,whereas excessive dispersion leads to a manic phase,with alternating manic-depressive phase indicating qi movement disorder.By integrating wood qi characteristics,disease pathogenesis of bipolar disorder,and our team's clinical experience in treating emotional disorders,this study developed an integrated acupuncture and moxibustion diagnosis and treatment approach for bipolar disorder,focusing on soothing the liver and regulating spirit,structured as"acupuncture-moxibustion-consolidation."Based on the physiological characteristics of"wood element characterized by spreading harmony,"from liver failing to controll conveyance and dispersion:depressive phase should apply warm-nourishing growth method,manic phase should suppress hyperactive liver for tranquillizing mind method,and alternating manic-depressive phase should apply harmonized rigidity-flexibility method.These methods aim to regulate the spirit of the heart and brain,harmonize the qi movement of the spleen and stomach,and replenish the essence and blood of the liver and kidney.Clinical application through syndrome differentiation has demonstrated satisfactory therapeutic outcomes.

Perimenopausal women are more susceptible to fire pathogen disturbances,often resulting in the restlessness of the mind owing to the deficiency and decline of the thoroughfare and conception vessels,as well as the insufficiency of the essence and blood of the viscera.CHENG Zhongling's theory of thief and child fire in Medical Insights proposes that thief fire primarily arises from exogenous pathogen invasion and improper diet,leading to syndromes such as food retention in the stomach or phlegm-fire stagnation.In contrast,child fire is generated endogenously,often owing to liver and kidney deficiency,resulting in an imbalance of water and fire and liver dysfunction,leading to excessive fire transformation.This theory provides a novel perspective for understanding the pathogenesis of perimenopausal insomnia.An in-depth exploration of the role of thief fire and child fire in perimenopausal insomnia is presented,along with a detailed discussion of corresponding treatment strategies.For the invasion of thief fire,therapeutic approaches include ascending and dispersing stagnant fire,clearing and moistening to remove interior heat,purging the heat accumulation to unblock the bowels,and subduing the fire and nourishing yin to eliminate depression.When child fire disturbs the spirit,treatment methods involve smoothing and relieving the liver qi to clear the stagnant heat,nourishing the true yin to restrain the yang,warming and nurturing the primordial qi and harmonizing the nutrient and defensive qi,and guiding and reducing the deficient heat to remove the floating fire.Clinical practice necessitates precise identification of thief and child fire,thorough investigation of exogenous pathogens and internal damage,and careful differentiation between deficiency and excess,as well as the superficial and internal aspects.Strict adherence to the treatment principle of"nourishing the child fire can drive out the thief fire,but driving out the thief fire should not harm the child fire"ensures a balanced approach.By harmonizing the yin and yang of the viscera and allowing the mind to be at ease,this strategy effectively alleviates perimenopausal insomnia.The application of these principles provides a practical and feasible theoretical foundation and practical guidance for the treatment of perimenopausal insomnia using traditional Chinese medicine.