Co-infection of hepatitis D virus （HDV） and hepatitis B virus （HBV） is the most severe form of viral hepatitis and is associated with accelerated progression of liver disease and a significant increase in the risk of liver cirrhosis and hepatocellular carcinoma. Nucleo（s）tide analogues for HBV treatment are ineffective against HDV infection， necessitating the urgent need for developing specific and effective antiviral therapies for HDV. In recent years， significant advances have been made in the research and development of specific antiviral drugs against HDV， including entry inhibitors targeting viral entry （Bulevirtide） and monoclonal antibody drugs （Libevitug）， which bring ground-breaking advances in the treatment of HDV infection. This article briefly reviews the latest research advances in therapeutic drugs for HDV， introduces the mechanism of action and clinical research data of new drugs recently approved for the treatment of HDV， and discusses the challenges that need to be solved in the field of HDV treatment， in order to provide a reference for understanding the current status of hepatitis D treatment.

Gorham-Stout disease(GSD) is a rare osteolytic disorder characterized by spontaneous and progressive osteolysis, along with abnormal angiogenesis and lymphangiogenesis, with no new bone formation. We present a case of a 15-year-old female admitted due to " recurrent right leg pain for 5 years, 11 months after undergoing right femoral fracture surgery". Through comprehensive integration of the patient's clinical phenotype, laboratory tests, imaging findings, pathological examinations, and molecular biological test results, GSD was considered highly likely. A multidisciplinary treatment approach was conducted, including a combination of zoledronic acid and sirolimus to inhibit osteolysis, along with rehabilitation training and orthopedic intervention, providing a personalized and comprehensive treatment strategy.

Myelodysplastic syndrome (MDS) is a chronic hematologic disorder characterized by ineffective hematopoiesis, dysplasia of one or more cell lines with or without definite genetic changes. Its diagnosis requires a comprehensive analysis combining morphology, immunology, cytogenetics, and molecular biology findings. In recent years, the development of second-generation sequencing (NGS) has provided great assistance in exploring the molecular pathogenesis of hematological malignancies and guidance for clinical practice. Mutations of a series of gene involved in RNA splicing, DNA methylation, transcriptional regulation, signal transduction, chromatin modification and cohesin complex have been identified as important mechanisms for the development of MDS, among which some mutations have been found to play important roles in the diagnosis, treatment, and prognosis of MDS. This article has provided a comprehensive review the the common molecular genetic abnormalities involved in MDS.
Humans ; Myelodysplastic Syndromes/diagnosis* ; Mutation ; DNA Methylation ; RNA Splicing ; High-Throughput Nucleotide Sequencing

"Sinew prescription correspondence" is the principle of selecting prescriptions for channel sinew diseases. On the basis of the theory of syndrome differentiation and treatment， the pulse manifestation corresponds to the channel sinew syndrome， which can improve the flexibility and standardization of clinical prescriptions. From the perspective of systematic dialectical sphygmology， this paper explains the dialectical relationship between channel sinew theory and pulse body elements， pulse wall elements， pulse elements and blood flow elements， and clarifies the internal relationship between pulse manifestation and prescriptions at the level of channel sinew disease. The prescription is derived from the method， while the method is established with the syndrome， and the prescription is unified by the method. According to the theory of "sinew prescription correspondence"， the treatment ideas of channel sinew diseases were analyzed from the perspective of channel sinew distribution， functional characteristics and structural changes. On this basis， the diagnosis of channel sinew disease and the application of prescriptions are expanded， and the research on the internal treatment and diagnosis mode of "pulse manifestation-channel sinew-zang fu （脏腑）" is prospected， so as to expand the differentiation and treatment methods of channel sinew theory.

Objective To examine the changing prevalence and antimicrobial resistance profiles of Burkholderia cepacia in 52 hospitals across China from 2015 to 2021.Methods A total of 9 261 strains of B.cepacia were collected from 52 hospitals between January 1,2015 and December 31,2021.Antimicrobial susceptibility of the strains was tested using Kirby-Bauer method or automated antimicrobial susceptibility testing systems according to a unified protocol.The results were interpreted according to the breakpoints released in the Clinical & Laboratory Standards Institute(CLSI)guidelines(2023 edition).Results A total of 9 261 strains of B.cepacia were isolated from all age groups,especially elderly patients.The proportion was 11.1％(1 032 strains)in children,significantly lower than the proportion in adults.About half(46.5％,4 310/9 261)of the strains were isolated from patients at least 60 years old and 42.3％(3 919/9 261)of the strains were isolated from young adults.Most isolates(71.1％)were isolated from sputum and respiratory secretions,followed by urine(10.7％)and blood samples(8.1％).B.cepacia isolates were highly susceptible to the five antimicrobial agents recommended in the CLSI M100 document(33rd edition,2023).B.cepacia isolates showed relatively higher resistance rates to meropenem and levofloxacin.However,the resistance rates to ceftazidime,trimethoprim-sulfamethoxazole,and minocycline remained below 8.1％.The percentage of B.cepacia strains resistant to levofloxacin was the highest compared to other antibiotics in any of the three age groups(from 12.4％in the patients＜18 years old to 20.6％in the patients aged 60 years or older).Conclusions B.cepacia is one of the clinically important non-fermenting gram-negative bacteria.Accurate and timely reporting of antimicrobial susceptibility test results and ongoing antimicrobial resistance surveillance are helpful for rational prescription of antimicrobial agents and proper prevention and control of nosocomial infections.

Objective:To investigate the clinical features, diagnostic and therapeutic methods, and prognosis of patients with acute myeloid leukemia (AML) who are positive for multiple genes.Methods:The clinical data of a 35-year-old male AML patient, who was admitted to The 940 th Hospital of the PLA Joint Logistics Support Force on October 10, 2021, were analyzed based on related literature. Results:The patient was admitted due to rhinorrhea for 1 month and sore throat with cervical lymph node enlargement for 3 days. Based on laboratory test results, the patient was diagnosed with acute myelomonocytic leukemia with eosinophilia and mutations in the core-binding factor β subunit gene ( CBFβ-MYH11), located on the long arm of chromosome 16, as well as mutations in the Wilms' tumor 1 gene ( WT1), the stem cell factor receptor gene ( KIT), and the neuroblastoma RAS viral oncogene homolog ( NRAS). The patient was treated multiple times with a regimen of idarubicin combined with cytarabine (Ara-C), achieving complete remission with negative minimal residual disease detection. The patient tolerated the treatment well. However, after the fourth cycle of chemotherapy with Ara-C, the patient developed grade Ⅳ bone marrow suppression. Following treatment to increase white blood cells and platelets, as well as blood component transfusions, the patient's condition improved. Subsequently, after receiving intensified Ara-C treatment, the patient's condition stabilized. Conclusions:AML with a positive CBFβ- MYH11 fusion gene has a favorable prognosis. However, the presence of a concomitant KIT mutation and a high proportion of primitive white blood cells in the peripheral blood at initial diagnosis may affect the prognosis of this type of AML. Additionally, WT1 is an independent prognostic factor for AML. RAS gene mutations do not impact overall survival, disease-free survival, complete remission, or relapse rates.

Objective To investigate the impact of diabetes stratification on the recovery of shoulder joint function following arthroscopic rotator cuff repair.Methods Between January 2020 and April 2024,a total of 216 patients who underwent arthroscopic rotator cuff repair at our hospital were enrolled in this study.According to preoperative blood glucose control status,the patients were categorized into four groups:Group A(non-diabetic patients),Group B(diabetic patients with well-controlled blood glucose),Group C(diabetic patients with mild dysglycemia),and Group D(diabetic patients with severe dysglycemia).All participants received standardized arthroscopic rotator cuff repair surgery and followed the same postoperative rehabilitation protocol.We assessed inflammatory factor levels,shoulder joint range of motion,Visual Analog Scale(VAS)pain scores,and Constant-Murley scores both preoperatively and at 1,2,3,and 6 months post-surgery.Furthermore,we examined rotator cuff thickness,axillary pouch width,and complication rates at the 6-month follow-up.A multivariate logistic regression model was employed to identify factors influencing shoulder function recovery after arthroscopic rotator cuff repair.Results At 1,3,and 6 months post-surgery,the levels of ESR(erythrocyte sedimentation rate)and CRP(C-reactive protein)in Groups A,B,C,and D exhibited a gradual increase(P<0.05).Simultaneously,the shoulder joint flexion,abduction,external rotation,internal rotation,and extension angles in all groups dem-onstrated a gradual decrease(P<0.05).The VAS pain scores in Group D were significantly higher at 1,3,and 6 months compared to Groups A,B,and C(P<0.05),while the Constant-Murley scores in Group D were signifi-cantly lower than those in Groups A,B,and C(P<0.05).No significant differences in VAS or Constant-Murley scores were observed between Groups A,B,and C(P>0.05).The rotator cuff thickness and axillary pouch width in Group D were significantly greater than those in Groups A and B(P<0.05).Furthermore,the incidence of superficial incision infection in Group D was significantly higher than that in Group A(P<0.05).Multivariate Logistic regression analysis revealed that age,HbA1c levels,and complete tear were risk factors for impaired shoulder function recovery after arthroscopic rotator cuff repair(P<0.05),whereas early repair served as a protective factor(P<0.05).Conclusion Poor blood glucose control in diabetic patients markedly compromises shoulder joint function and structural recovery after arthroscopic rotator cuff repair,leading to more severe postoperative pain,a higher incidence of incision infections,and a delayed resolution of the inflammatory response.

Objective To observe the effect of Huaiqihuang granules(HQH)containing serum on the proliferation in rat glomerular mesangial cells(HBZY-1)cultured with high glucose,and to explore its possible mechanism.Methods HQH and physiological saline were administered orally to SPF grade male SD rats for preparing HQH containing serum and normal serum.HBZY-1 cells were divided into normal glucose group,high glucose group,high glucose+low,medium,and high concentration HQH drug containing serum group(HQH drug containing serum concentration was 5%,10%,and 15%,respectively).The cell proliferation rate of each group was measured by CCK-8 method,and effective HQH drug containing serum was screened for subsequent experiments;Observe the morphology of HBZY-1 cells in each group using an inverted optical microscope and take photos;Flow cytometry was used to detect the apoptosis rate;The assay kit was used to detect the activities of superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GSH-Px),and malondialdehyde(MDA)in each group of cells;Western blot was used to detect the expression of TLR4/NF-κB/NLRP3 inflammatory pathway related proteins in each group of cells.Results Compared with the high glucose group,the 5%medicated serum group showed no significant change in cell proliferation rate,while the 10%medicated serum group and 15%medicated serum group showed a significant decrease in cell proliferation rate(P<0.05 or P<0.01).Therefore,10%and 15%concentrations of HQH medicated serum were selected as the subsequent experimental drug treatment groups.After intervention with 10%medicated serum and 15%medicated serum on HBZY-1 cells in a high glucose environment,compared with the high glucose group,the 10%medicated serum group and 15%medicated serum group showed a decrease in cell proliferation,a gradual increase in cell apoptosis,an increase in cell SOD,CAT,GSH-Px activity(P<0.05 or P<0.01),a decrease in MDA levels(P<0.01),the protein expression of TLR4,NLRP3,p-NF-κB p65 and p-IκBα significantly decreased(P<0.01).Conclusion Huaiqihuang granules containing serum can inhibit high glucose induced proliferation and induce apoptosis of HBZY-1 cells,which may be related to the inhibition of cellular oxidative stress and TLR4/NF-κB/NLRP3 mediated inflammatory signaling pathway.

Objective To investigate the impact of diabetes stratification on the recovery of shoulder joint function following arthroscopic rotator cuff repair.Methods Between January 2020 and April 2024,a total of 216 patients who underwent arthroscopic rotator cuff repair at our hospital were enrolled in this study.According to preoperative blood glucose control status,the patients were categorized into four groups:Group A(non-diabetic patients),Group B(diabetic patients with well-controlled blood glucose),Group C(diabetic patients with mild dysglycemia),and Group D(diabetic patients with severe dysglycemia).All participants received standardized arthroscopic rotator cuff repair surgery and followed the same postoperative rehabilitation protocol.We assessed inflammatory factor levels,shoulder joint range of motion,Visual Analog Scale(VAS)pain scores,and Constant-Murley scores both preoperatively and at 1,2,3,and 6 months post-surgery.Furthermore,we examined rotator cuff thickness,axillary pouch width,and complication rates at the 6-month follow-up.A multivariate logistic regression model was employed to identify factors influencing shoulder function recovery after arthroscopic rotator cuff repair.Results At 1,3,and 6 months post-surgery,the levels of ESR(erythrocyte sedimentation rate)and CRP(C-reactive protein)in Groups A,B,C,and D exhibited a gradual increase(P<0.05).Simultaneously,the shoulder joint flexion,abduction,external rotation,internal rotation,and extension angles in all groups dem-onstrated a gradual decrease(P<0.05).The VAS pain scores in Group D were significantly higher at 1,3,and 6 months compared to Groups A,B,and C(P<0.05),while the Constant-Murley scores in Group D were signifi-cantly lower than those in Groups A,B,and C(P<0.05).No significant differences in VAS or Constant-Murley scores were observed between Groups A,B,and C(P>0.05).The rotator cuff thickness and axillary pouch width in Group D were significantly greater than those in Groups A and B(P<0.05).Furthermore,the incidence of superficial incision infection in Group D was significantly higher than that in Group A(P<0.05).Multivariate Logistic regression analysis revealed that age,HbA1c levels,and complete tear were risk factors for impaired shoulder function recovery after arthroscopic rotator cuff repair(P<0.05),whereas early repair served as a protective factor(P<0.05).Conclusion Poor blood glucose control in diabetic patients markedly compromises shoulder joint function and structural recovery after arthroscopic rotator cuff repair,leading to more severe postoperative pain,a higher incidence of incision infections,and a delayed resolution of the inflammatory response.

Objective To observe the effect of Huaiqihuang granules(HQH)containing serum on the proliferation in rat glomerular mesangial cells(HBZY-1)cultured with high glucose,and to explore its possible mechanism.Methods HQH and physiological saline were administered orally to SPF grade male SD rats for preparing HQH containing serum and normal serum.HBZY-1 cells were divided into normal glucose group,high glucose group,high glucose+low,medium,and high concentration HQH drug containing serum group(HQH drug containing serum concentration was 5%,10%,and 15%,respectively).The cell proliferation rate of each group was measured by CCK-8 method,and effective HQH drug containing serum was screened for subsequent experiments;Observe the morphology of HBZY-1 cells in each group using an inverted optical microscope and take photos;Flow cytometry was used to detect the apoptosis rate;The assay kit was used to detect the activities of superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GSH-Px),and malondialdehyde(MDA)in each group of cells;Western blot was used to detect the expression of TLR4/NF-κB/NLRP3 inflammatory pathway related proteins in each group of cells.Results Compared with the high glucose group,the 5%medicated serum group showed no significant change in cell proliferation rate,while the 10%medicated serum group and 15%medicated serum group showed a significant decrease in cell proliferation rate(P<0.05 or P<0.01).Therefore,10%and 15%concentrations of HQH medicated serum were selected as the subsequent experimental drug treatment groups.After intervention with 10%medicated serum and 15%medicated serum on HBZY-1 cells in a high glucose environment,compared with the high glucose group,the 10%medicated serum group and 15%medicated serum group showed a decrease in cell proliferation,a gradual increase in cell apoptosis,an increase in cell SOD,CAT,GSH-Px activity(P<0.05 or P<0.01),a decrease in MDA levels(P<0.01),the protein expression of TLR4,NLRP3,p-NF-κB p65 and p-IκBα significantly decreased(P<0.01).Conclusion Huaiqihuang granules containing serum can inhibit high glucose induced proliferation and induce apoptosis of HBZY-1 cells,which may be related to the inhibition of cellular oxidative stress and TLR4/NF-κB/NLRP3 mediated inflammatory signaling pathway.