Premature ovarian insufficiency （POI） is a reproductive endocrine disorder that severely affects female reproductive health. However， there remains a lack of clinically effective and safe therapeutic options to restore ovarian function. Traditional Chinese medicine （TCM）， with its advantages of multi-component and multi-target holistic regulation， has shown unique potential in the prevention and treatment of POI. Among TCM monomers， curcumin， resveratrol， and icariin exert antioxidant， anti-inflammatory， and anti-ovarian granulosa cell apoptosis effects by regulating signaling pathways such as nuclear factor-erythroid 2-related factor 2/heme oxygenase-1， phosphoinositide 3-kinase/protein kinase B， and mitogen-activated protein kinase. Single TCM herbs， including American ginseng， Cuscutae Semen， and Cistanches Herba， can regulate sex hormone levels， and alleviate ovarian oxidative stress and immune damage. TCM compound formulas such as Yijing decoction， Siwu decoction， Zuogui pill， and Kuntai capsule modulate multiple signaling pathways， including vascular endothelial growth factor/vascular endothelial growth factor receptor-2， phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin， and silence information regulator 1/p53， thereby promoting angiogenesis， inhibiting mitochondrial apoptosis， and regulating autophagy and ferroptosis， which ultimately delay follicular atresia and improve ovarian reserve function. Further studies are suggested to apply artificial intelligence to deeply explore the underlying mechanisms and carry out high-quality clinical trials， so as to promote the standardized application of TCM in the prevention and treatment of POI.

The early diagnosis of prostate cancer(PCa)heavily relies on advances of biopsy techniques.Traditional transrectal ultrasound(TRUS)-guided biopsy is associated with high infection risks and significant miss rates.Transperineal prostate biopsy,with the advantage of spatial sampling,can reduce infection and has the potential for image fusion.With the development of image-guided technology,multimodal image fusion technology has achieved a paradigm shift from"probabilistic sampling"to"precise localization"through the visualization of lesion structure and function.Among them,ultrasound-guided techniques,including transrectal real-time elastography(TRTE),transrectal contrast-enhanced ultrasound(TRCEUS),micro-ultrasound(Micro-US),and multiparametric ultrasound(mpUS),have significantly improved the accuracy of prostate biopsy.MRI-guided techniques,including multiparametric magnetic resonance imaging(mpMRI),MRI-fusion targeted biopsy(MRI-fusion-TB),and the integration of MRI-guided targeted biopsy and systematic biopsy can enhance the specificity of detection and reduce the misdiagnosis rate of clinically significant prostate cancer(csPCa).PET-guided technology can integrate metabolic function information of lesions with high-resolution structural features,demonstrating significant advantages in PCa diagnosis.AI-assisted technology also shows great potential in prostate targeted biopsy.Future research should focus on the integration of targeted biopsy with emerging imaging technologies or AI tools to improve the early diagnosis rate of PCa and optimize clinical decision-making.

Objective To establish an animal model of osteoporosis combined with liver cirrhosis and conduct preliminary investigation into the effect of liver cirrhosis on bone loss in mice and the underlying mechanisms.Methods The experimental animals were 25 6-week-old female C57BL/6 mice with a body weight of approximately 20-22 g.A comorbidity model of liver cirrhosis and osteoporosis was established in the mice by ovariectomy combined with carbon tetrachloride(CCl4)induction.The mice were randomly assigned to 4 groups(n=5 in each group),including a control group,a liver cirrhosis group,an osteoporosis group,and a cirrhosis and osteoporosis comorbidity group.Pathological changes in the liver were observed via HE staining,Sirius Red staining,and serum liver function indicators.Bone mass and morphological changes were assessed using micro-CT and HE staining.ELISA,Western blot,and immunohistochemistry were performed to assess the expression of insulin-like growth factor-1(IGF-1)in serum and liver tissues.An additional IGF-1 intervention group was established to investigate the potential role of IGF-1 in the comorbidity of liver cirrhosis and osteoporosis,and changes in bone mass and morphology were analyzed via micro-CT and HE staining.Results Compared with the control and osteoporosis groups,the liver cirrhosis and cirrhosis-osteoporosis comorbidity groups exhibited significant inflammatory cell infiltration and collagen fiber deposition in liver tissues,along with markedly increased serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBIL)(P＜0.05).According to the Micro-CT and HE staining results,the cirrhosis-osteoporosis comorbidity group showed reduced bone mass and decreased trabecular numbers in the distal femur compared to those in the osteoporosis group,with the differences being statistically significant(P＜0.05).ELISA,Western blot,and immunohistochemistry demonstrated significantly reduced expression of IGF-1 in the liver and serum of the cirrhosis-osteoporosis comorbidity group(P＜0.05).Notably,exogenous IGF-1 treatment restored bone mass in mice with liver cirrhosis combined with osteoporosis(P＜0.05).Conclusion Through ovariectomy combined with CCl4 induction,a mouse model of liver cirrhosis combined with osteoporosis was successfully established.IGF-1 may serve as a potential molecular mechanism and therapeutic target mediating the liver cirrhosis-osteoporosis comorbidity.

The early diagnosis of prostate cancer(PCa)heavily relies on advances of biopsy techniques.Traditional transrectal ultrasound(TRUS)-guided biopsy is associated with high infection risks and significant miss rates.Transperineal prostate biopsy,with the advantage of spatial sampling,can reduce infection and has the potential for image fusion.With the development of image-guided technology,multimodal image fusion technology has achieved a paradigm shift from"probabilistic sampling"to"precise localization"through the visualization of lesion structure and function.Among them,ultrasound-guided techniques,including transrectal real-time elastography(TRTE),transrectal contrast-enhanced ultrasound(TRCEUS),micro-ultrasound(Micro-US),and multiparametric ultrasound(mpUS),have significantly improved the accuracy of prostate biopsy.MRI-guided techniques,including multiparametric magnetic resonance imaging(mpMRI),MRI-fusion targeted biopsy(MRI-fusion-TB),and the integration of MRI-guided targeted biopsy and systematic biopsy can enhance the specificity of detection and reduce the misdiagnosis rate of clinically significant prostate cancer(csPCa).PET-guided technology can integrate metabolic function information of lesions with high-resolution structural features,demonstrating significant advantages in PCa diagnosis.AI-assisted technology also shows great potential in prostate targeted biopsy.Future research should focus on the integration of targeted biopsy with emerging imaging technologies or AI tools to improve the early diagnosis rate of PCa and optimize clinical decision-making.

Objective: This study characterized the resistance phenotype and genotype of K. intermedia L-40-1, isolated from a pig in Jilin Province, China, and investigated the genomic determinants of its antibiotic resistance. Methods: 16S rRNA sequencing was performed to identify the strain. The resistance phenotype was assessed by determining minimum inhibitory concentrations (MICs), and resistance determinants were characterized by whole-genome sequencing. Comparative genomic analysis against the national center for biotechnology information (NCBI) database of K. intermedia strains was conducted to determine phylogenetic relationships and resistance gene profiles. Results: L-40-1 exhibited high resistance to β-lactams, cephalosporins, macrolides, aminoglycosides, and sulfonamides. Comparative analysis identified 19 high-frequency resistance genes (e.g., arnT, rsmA, emrR, and acrA). A 159,618 bp plasmid (PYL-8) harbored multiple resistance genes (e.g., sul1, dfrA27, qnrB6, and tet(D)) and transposons (e.g., IS6, IS1, and Tn3), contributing to its multidrug resistance. Chromosomal and plasmid-borne resistance mechanisms were identified. Conclusions and Relevance: K. intermedia L-40-1 uses a combination of chromosomal and plasmid-mediated resistance genes, facilitated by transposons, to confer multidrug resistance. This highlights the need for surveillance of K. intermedia in livestock to mitigate the spread of antibiotic resistance.

Objective:To analyze the factors influencing the ADL ability and the improvement degree of ADL ability at discharge of hospitalized patients with TBI and to establish prediction models. Method:Data of 220 patients with traumatic brain injury hospitalized in the department of neurorehabilitation,Beijing Boai hospital from september 2017 to september 2020 were retrospectively collected.They were ran-domly divided into training set and validation set according to 3:1,and descriptive analysis was conducted for all variables.BI score at discharge and BI score difference between admission and discharge were used as out-come indexes.Firstly,univariate analysis was used to screen the statistically significant influencing factors,and then multivariate logistic regression analysis was used to establish the prediction model.Receiver operating characteristic(ROC)curve,calibration curve and Hosmer-Lemeshow test were used to evaluate the differentia-tion and calibration of the model in the training set and validation set. Result:Two prediction models were established by multivariate logistic regression:①Duration of disease at ad-mission,FMB at admission and BI at admission were significant influencing factors of BI at discharge.The ar-ea under the curves of the prediction model with BI at discharge was 0.957(95％CI:0.930-0.983)and 0.917(95％CI:0.839-0.994)in the training set and validation set,respectively,showing good model differentiation.Hosmer-lemeshow test results were P=0.196 and P=0.551,respectively,indicating a good calibration degree of the model.The sensitivity,specificity,and Youden index of the logistic regression model were 91.4％(95％CI:0.833-0.959)、83.3％(95％CI:0.723-0.907)and 0.747,respectively.②The duration of disease,length of stay and age at admission significantly affected the BI difference.The areas of the established prediction mod-el under the curves of training set and validation set were 0.773(95％CI:0.702-0.844)and 0.747(95％CI:0.613-0.881),and Hosmer-Lemeshow test results were P=0.721 and P=0.274,respectively,indicating good model differentiation and calibration.The sensitivity,specificity,and Youden index of the logistic regression model were 77.2％(95％CI:0.670-0.850)、64.4％(95％CI:0.522-0.750)and 0.416,respectively. Conclusion:The established two prediction models will help rehabilitation doctors to preliminarily judge the level of functional independence at discharge and the degree of functional improvement during hospitalization according to the status of patients with TBI at admission,and provide reference for rehabilitation medical work.

Objective To investigate the inhibitory effect of ursolic acid in Hippophae rhamnoides L. on hepatocyte apoptosis in rats with alcoholic liver disease based on the mitochondria-cytochrome c pathway. Methods A total of 50 specific pathogen-free male Wistar rats were divided into normal control group, alcohol model group, and low-, middle-, and high-dose ursolic acid groups using a random number table, with 10 rats in each group. The rats in the normal control group were given normal saline by gavage once a day for 8 weeks; the rats in the alcohol model group were given alcohol at increasing concentrations by gavage for 8 consecutive weeks; the rats in the low-, middle-, and high-dose ursolic acid groups were given ursolic acid at a dose of 50, 100, and 150 mg/kg, respectively, followed by an equal volume of alcohol as the model group 1 hour later. Serum liver function parameters were measured for each group; HE staining was used to observe liver histopathology; an electron microscope was used to observe hepatocyte ultrastructure; the TUNEL method was used to measure hepatocyte apoptosis; Western Blotting was used to measure the protein expression levels of cytochrome c and activated caspase-3 in hepatocyte mitochondria and cytoplasm. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups. Results Compared with the alcohol model group, the middle- and high-dose ursolic acid groups had significant reductions in the serum level of alanine aminotransferase, aspartate aminotransferase, and cholinesterase (all P < 0.05). The rats in the alcohol model group had disordered arrangement of hepatic cords with marked hepatocyte edema and fatty degeneration, while those in the middle- and high- dose ursolic acid groups had basically normal arrangement of hepatic cords and a significant improvement in hepatocyte fatty degeneration, as well as a significant increase in the number of hepatocyte mitochondria and a significant improvement in morphology. Compared with the alcohol model group, the middle- and high-dose ursolic acid groups had significantly lower hepatocyte apoptosis rate and protein expression levels of cytochrome c and caspase-3 in cytoplasm (all P < 0.05). Conclusion Ursolic acid in Hippophae rhamnoides L. can improve the liver function and histomorphology of rats with alcoholic liver disease, possibly by inhibiting the release of cytochrome c in hepatocyte mitochondria, the activation of caspase-3, and the apoptosis of hepatocytes via the mitochondria-cytochrome c pathway.

ObjectiveTo review the ancient and modern literature of Huanglian Ejiaotang and learn about the historical evolution and clinical application， thereby providing a theoretical basis for the modern application of the classical prescription. MethodLiterature in the Chinese Medical Classics Database was retrieved with "Huanglian Ejiaotang" as the keyword. In China National Knowledge Infrastructure （CNKI） and PubMed， "Huanglian Ejiaotang" in Chinese and English was used as the keyword to retrieve literature. The items and modern clinical application studies related to the prescription， medicine， dosage， syndrome， and treatment of Huanglian Ejiaotang were selected and recorded. The inclusion and exclusion criteria were used to screen out literature. The information about the dynasty， book title， function， and indication was integrated to understand the history， evolution， and clinical application of Huanglian Ejiaotang. ResultFinally， 89 ancient books were included with 111 items. Huanglian Ejiaotang was initially recorded in ZHANG Zhongjing's Treatise on Cold Damage and Miscellaneous Diseases in the Han dynasty. It was composed of five herbs， namely Coptidis Rhizoma， Scutellariae Radix， Paeoniae Radix Alba， Asini Corii Colla， and egg yolk. With the change of historical dynasties， the composition， origin basis， dosage， and preparation method of Huanglian Ejiaotang all changed， but the changes in the processing were not obvious， which was basically consistent with Treatise on Cold Damage and Miscellaneous Diseases. In addition， 48 studies were included to analyze the clinical application of Huanglian Ejiaotang， which was mainly used for insomnia， anxiety， depression， diabetes， and so on. ConclusionAccording to the ancient and modern literature， the origin basis， dosage， processing， decoction， administration， and other content of Huanglian Ejiaotang are consistent with Treatise on Cold Damage and Miscellaneous Diseases. The present clinical application has expanded the usage scale of the ancient record， which promotes the innovation and development of the classic prescription and provides references for later research， development， and accurate application.

Objective:To explore the method of fertility preservation in severe β-thalassemia prepubertal boys who cannot produce sperm before gonadotoxicity therapy.Methods:Three cases of severe β-thalassemia patients who were going to undergo hematopoietic stem cell transplantation (HSCT) were reported. They were received testis cryopreservation by slow-rate freezing. The necessity of fertility preservation in prepubertal boys and the methods of fertility persevation, testicular cryopreservation and the downstream techniques were stated.Results:Totally 31, 31, 20 pieces of testicular tissue were frozen by slow-rate freezing in three boys respectively and the freezing process went smoothly.Conclusion:The cryopreservation of testicular tissue can preserve the fertility of severe β-thalassemia prepuberty boys who will receive HSCT, leaving hope for offspring.

Objective:To explore the method of fertility preservation in severe β-thalassemia prepubertal boys who cannot produce sperm before gonadotoxicity therapy.Methods:Three cases of severe β-thalassemia patients who were going to undergo hematopoietic stem cell transplantation (HSCT) were reported. They were received testis cryopreservation by slow-rate freezing. The necessity of fertility preservation in prepubertal boys and the methods of fertility persevation, testicular cryopreservation and the downstream techniques were stated.Results:Totally 31, 31, 20 pieces of testicular tissue were frozen by slow-rate freezing in three boys respectively and the freezing process went smoothly.Conclusion:The cryopreservation of testicular tissue can preserve the fertility of severe β-thalassemia prepuberty boys who will receive HSCT, leaving hope for offspring.