Objective To analyze the prescription patterns of Professor Huang Feng,a nationally renowned traditional Chinese medicine(TCM)practitioner,in treating osteomyelitis using data mining methods.Methods Prescription data from effective medical records of osteomyelitis treated by Professor Huang Feng between January 2018 and December 2022 were collected and screened.Microsoft Excel,SPSS Modeler 18.0,and SPSS Statistics 25 were used to analyze the frequency and the distribution of properties,flavors,and meridian tropism of prescribed medications,along with association rule analysis and cluster analysis of high-frequency drugs.Results A total of 137 prescriptions involving 86 Chinese medicinals were included.Eighteen high-frequency medicinals(frequency＞30 times)were identified,namely Glycyrrhizae Radix et Rhizoma,Astragali Radix,Coicis Semen,Angelicae Sinensis Radix,Smilacis Glabrae Rhizoma,Achyranthis Bidentatae Radix,Bletillae Rhizoma,Rehmanniae Radix,Paeoniae Radix Alba,Dendrobii Caulis,Polygalae Radix,Lablab Semen Album,Corydalis Rhizoma,Angelicae Dahuricae Radix,Drynariae Rhizoma,Sanguisorbae Radix,Poria,and Mume Fructus.Most of the prescribed medicinals were neutral in nature,sweet,bitter,and pungent in flavor,and had the meridian tropism of liver,spleen,and lung meridians.Association rule analysis yielded 67 drug association rules,and the high-support combinations were the drug combinations of Astragali Radix respectively with Coicis Semen,Angelicae Sinensis Radix,Smilacis Glabrae Rhizoma and Achyranthis Bidentatae Radix,reflecting the compatibility principles of supplementing and invigorating qi-blood,activating blood circulation to resolve stasis,and draining dampness to remove toxins.Cluster analysis revealed three core clusters:Cluster 1 consisted of Glycyrrhizae Radix et Rhizoma,Astragali Radix,Coicis Semen,Smilacis Glabrae Rhizoma,Angelicae Sinensis Radix,Bletillae Rhizoma,Paeoniae Radix Alba,Angelicae Dahuricae Radix,Mume Fructus,Polygalae Radix and Sanguisorbae Radix;Cluster 2 consisted of Rehmanniae Radix and Dendrobii Caulis;Cluster 3 consisted of Achyranthis Bidentatae Radix,Lablab Semen Album,Corydalis Rhizoma and Poria.Conclusion For the treatment of osteomyelitis,Professor Huang Feng follows the principle of combining supporting healthy qi with eliminating pathogens,focuses on clearing damp-heat and pathogenic toxins accompanied by activating blood circulation to resolve stasis,and lays stress on adaptation to local condition and activating spleen-stomach to reinforce vital qi.

Objective To investigate the effects of Caenorhabditis elegans(C.elegans)endogenous U6 promoters on dpy-10 gene editing efficiency.Methods We screened endogenous U6 small nuclear RNA(snRNA)genes of C.elegans from the WormBase database and constructed 14 editing plasmids targeting dpy-10 by replacing the U6r07e5.16 promoter in the pSX524 plasmid(Peft-3::cas9::tbb-2 terminator::U6 r07e5.16::dpy-10 sgRNA)through molecular cloning.Gene editing was performed in wild-type C.elegans using a standardized microinjection protocol.Gene editing efficiency and the high-efficiency gene editing index were quantified based on the screening of dpy-10 mutant phenotypes in the F1 progeny.Results A total of 15 U6 snRNA genes(r07e5.16,f35c11.9,t20d3.13,k09b11.15,k09b11.16,w05b2.8,c28a5.7,f54c8.9,k09b11.11,k09b11.12,k09b11.14,t20d3.12,f54c8.8,f54c8.10,and k09b11.13)were identified from the WormBase database.Based on the editing efficiency and high-efficiency gene editing index,the activity of these promoters was evaluated,and 4 U6 promoters(w05b2.8,c28a5.7,f54c8.9,and k09b11.11)were found to have significantly enhanced gene editing success rates,outperforming other promoters,including U6r07e5.16 and U6k09b11.12,which are commonly used in the C.elegans research community.Notably,the gRNAF+E scaffold did not show superior editing efficiency over the gRNA scaffold when paired with the optimal U6w05b2.8 promoter.Conclusion In this study,U6 promoters that significantly improve gene editing efficiency in C.elegans are identified and the critical role of promoter optimization in CRISPR-Cas9 systems is highlighted.These findings provide a valuable foundation for improving genome editing strategies and offer new ideas for optimizing the CRISPR technology applied in nematode research.

Objective To explore the surgical techniques and therapeutic effects of hematoma evacuation for hypertensive cerebral hemorrhage(HCH)with different bleeding sites under neuroendoscopy.Methods This study enrolled 101 patients with HCH treated in our hospital from May 2022 to January 2024.Based on CT imaging results,patients were divided into lobar cerebral hemorrhage group(n=43)and basal ganglia hemorrhage group(n=58).The Pearson was used to analyze the correlations between cerebral microcirculation indicators and the scores of national institutes of health stroke scale(NIHSS),mini mental state examination(MMSE),and the Barthel index(BI)of activities of daily living.The generalized estimating equation was employed to analyze the improvement effects of neuroendoscopic hematoma evacuation on cerebral microcirculation indicators in patients with different hemorrhage locations.A difference-in-differences equation model with full specifications was applied to analyze the improvement effects of neuroendoscopic hematoma evacuation on NIHSS score,MMSE score,and BI score in patients with different hemorrhage locations,incorporating baseline indicators as control variables.Results The operative time of basal ganglia hemorrhage group was significantly longer than those of lobar cerebral hemorrhage group,and the differences of NIHSS,MMSE,BI,mean transit time(MTT),cerebral blood flow(CBF),cerebral blood volume(CBV)and mean arterial pressure(MAP)before and after treatment were significantly smaller than those of lobar cerebral hemorrhage group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).The correlation analysis results showed that MTT was positively correlated with NIHSS,and negatively correlated with BI and MMSE;CBF,CBV and MAP were negatively correlated with NIHSS,but positively correlated with BI and MMSE,the differences were statistically significant(P<0.05).The result of generalized estimating equation analysis showed that the improvement of MTT,CBF,CBV and MAP in patients with lobar cerebral hemorrhage group was better than those in patients with basal ganglia hemorrhage group,the differences were statistically significant(P<0.05).The result of difference-in-differences equation model analysis showed that increase of age,prolongation of MTT and prolongation of the time from onset to operation had positive effects on NIHSS score(B=0.884,1.291,0.758,P<0.05),and had negative effects on MMSE score(B=-1.014,-1.569,-0.821,P<0.05).The prolongation of MTT had a negative effect on BI score(B=-0.973,P<0.05).The increase of CBV,CBF and MAP had a negative effect on NIHSS score(B=-0.841,-0.767,-1.213,P<0.05),and had a positive effect on MMSE and BI score(MMSE:B=0.932,0.738,0.874;BI:B=0.897,0.751,0.842,P<0.05).Conclusion Neuroendoscopic hematoma evacuation can improve the NIHSS score,MMSE score,BI score of patients with HCH by adjusting MTT,CBF,CBV and MAP,and the improvement effect of patients with lobar cerebral hemorrhage is significantly better than that of patients with basal ganglia hemorrhage.

Objective To explore the surgical techniques and therapeutic effects of hematoma evacuation for hypertensive cerebral hemorrhage(HCH)with different bleeding sites under neuroendoscopy.Methods This study enrolled 101 patients with HCH treated in our hospital from May 2022 to January 2024.Based on CT imaging results,patients were divided into lobar cerebral hemorrhage group(n=43)and basal ganglia hemorrhage group(n=58).The Pearson was used to analyze the correlations between cerebral microcirculation indicators and the scores of national institutes of health stroke scale(NIHSS),mini mental state examination(MMSE),and the Barthel index(BI)of activities of daily living.The generalized estimating equation was employed to analyze the improvement effects of neuroendoscopic hematoma evacuation on cerebral microcirculation indicators in patients with different hemorrhage locations.A difference-in-differences equation model with full specifications was applied to analyze the improvement effects of neuroendoscopic hematoma evacuation on NIHSS score,MMSE score,and BI score in patients with different hemorrhage locations,incorporating baseline indicators as control variables.Results The operative time of basal ganglia hemorrhage group was significantly longer than those of lobar cerebral hemorrhage group,and the differences of NIHSS,MMSE,BI,mean transit time(MTT),cerebral blood flow(CBF),cerebral blood volume(CBV)and mean arterial pressure(MAP)before and after treatment were significantly smaller than those of lobar cerebral hemorrhage group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).The correlation analysis results showed that MTT was positively correlated with NIHSS,and negatively correlated with BI and MMSE;CBF,CBV and MAP were negatively correlated with NIHSS,but positively correlated with BI and MMSE,the differences were statistically significant(P<0.05).The result of generalized estimating equation analysis showed that the improvement of MTT,CBF,CBV and MAP in patients with lobar cerebral hemorrhage group was better than those in patients with basal ganglia hemorrhage group,the differences were statistically significant(P<0.05).The result of difference-in-differences equation model analysis showed that increase of age,prolongation of MTT and prolongation of the time from onset to operation had positive effects on NIHSS score(B=0.884,1.291,0.758,P<0.05),and had negative effects on MMSE score(B=-1.014,-1.569,-0.821,P<0.05).The prolongation of MTT had a negative effect on BI score(B=-0.973,P<0.05).The increase of CBV,CBF and MAP had a negative effect on NIHSS score(B=-0.841,-0.767,-1.213,P<0.05),and had a positive effect on MMSE and BI score(MMSE:B=0.932,0.738,0.874;BI:B=0.897,0.751,0.842,P<0.05).Conclusion Neuroendoscopic hematoma evacuation can improve the NIHSS score,MMSE score,BI score of patients with HCH by adjusting MTT,CBF,CBV and MAP,and the improvement effect of patients with lobar cerebral hemorrhage is significantly better than that of patients with basal ganglia hemorrhage.

Objective:To investigate the necessity of adaptive re-planning during radiotherapy for nasopharyngeal carcinoma (NPC) and its impact on dose improvement.Methods:Clinical data of 89 NPC patients admitted to Sun Yat-sen University Cancer Center from July 2014 to December 2017 were retrospectively analyzed. All patients received 25+7 rounds of adaptive re-planning during radiotherapy. Plan-A was defined as the initial CT scan-based 25-fraction radiotherapy plan, while plan-B was defined as the re-planned 7-fraction radiotherapy plan based on a subsequent CT scan. The changes in the target and parotid gland volumes were compared between plan-A and plan-B. Plan-I was a one-time simulation of plan-A extended to 32 fraction radiotherapy plan, and plan-II was generated through registration and fusion of the plan-A and plan-B for adaptive re-planning. The differences in dose metrics, homogeneity index (HI), conformity index (CI), and dose to organs at risk (OAR) were compared between plan-I and plan-II. Statistical analysis was performed by using paired t-test. Results:Compared with plan-A, the gross tumor volume of massive bleeding lesions (GTV nx) and parotid gland volume of plan-B were decreased by 13.14% and 11.12%, respectively (both P<0.001). While planning clinical target volume of metastatic lymph nodes (PCTV nd) of plan-B was increased by 7.75%( P<0.001). There were significant changes in the lymph nodes of plan-A and plan-B. The D mean, D 5%, D 95% of massive bleeding lesions planning target volume (PTV nx) and D 5% of high risk planning target volume (PTV1) in plan-II were all significantly higher than those in plan-I (all P<0.05). The CI of PTV nx and PTV1 in plan-II was closer to 1 than that in plan-I. In all assessed OAR, the D mean, D 50%, and D max of plan-II were significantly lower than those of plan-I (all P<0.05). Conclusions:During radiotherapy, NPC patients may experience varying degrees of primary tumor shrinkage, parotid gland atrophy, and lymph node changes. It is necessary to deliver re-planning and significantly improve the dose of target areas and OAR.

OBJECTIVE To extract the-SH active fractions(SHF)from Bubali Cornu(water buffalo horn)and evaluate its an-tipyretic activity.METHODS SHF was extracted from Bubali Cornu by SDS-DTT,and the content of native thiols(-SH)was deter-mined by Ellman reagent method.SHF was identified based on nano LC-MS/MS technology.Evaluation of antipyretic activity of SHF was based on LPS-induced fever rat model.The levels of PGE2,IL-1β,and TNF-α in plasma as well as the levels of cAMP,PGE2,and TNF-α in the hypothalamus were measured by ELISA kits.An untargeted metabolomics approach was used to further investigate the intervention of SHF on plasma metabolites in febrile rats.RESULTS SDS-DTT could effectively extract SHF from Bubali Cornu,in which the main components were type Ⅰ,type Ⅱ keratins and keratin-associated proteins,which were rich in Cys,and the ratio of-SH to protein in SHF was increased about 20 times more than that of traditional decoction.SHF could significantly decrease(P＜0.01)the body temperature which lasted for 4.5 hours.SHF could also significantly decrease the levels of PGE2,IL-1β,TNF-α and cAMP in plasma and hypothalamic.A total of 137 potentially differential metabolites were identified from plasma samples of the control and model groups,of which 31 metabolites could be dialed back after SHF administration,including lysophosphatidic acid,phosphatidyli-nositol,phosphatidic acid,triglycerides,phosphatidylcholine and so on,which were mainly involved in the glycerophospholipid meta-bolic pathway.CONCLUSION SHF has precise antipyretic effect,and the dosage of 1/10 of the aqueous extract can show its com-parable antipyretic effect,which provides the direction and basis for the basic research on the antipyretic efficacy of Bubali Cornu.

Objective:To investigate the clinical value of open abdomen therapy in non-traumatic critically patients.Methods:The retrospective cohort study was conducted. The clinical data of 23 non-traumatic critically patients who underwent open abdomen therapy in 5 hospitals in China from July 2015 to July 2024 were collected. There were 17 males and 6 females, aged 70(range, 24-84)years. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Repeated measurement data were analyzed using the repeated ANOVA, and pairwise comparison within groups was conducted using the least significant difference method. The Boruta algorithm was applied for analyzing variables related to survival outcomes. Results:(1) Treatment of patients undergoing open abdomen therapy. ① The intra-abdominal pressure, lactate, heart rate, central venous pressure, mean arterial pressure, sequential organ failure assessment score of 23 patients from preoperation to postoperative day 3 were changed from (19.7±5.4)mmHg (1 mmHg=0.133 kPa), (6.1±1.9)mmol/L, (120±14)beats/minutes, (13.1±4.3)cmH 2O (1 cmH 2O=0.098 kPa), (58.8±6.8)mmHg, 13.2±1.8 to (10.6±1.3)mmHg, (2.3±0.6)mmol/L, (95±10)beats/minutes, (8.8±2.0)cmH 2O, (75.2±8.5)mmHg, 10.1±1.6, respectively, showing significant differences in the time effect of changes in the above indicators ( Ftime=46.40, 29.19, 24.91, 11.84, 27.81, 11.71, P<0.05). ② The oxygenation index, total intake, total output of 23 patients from preoperation to postoperative day 3 were changed from (255.0±54.2)mmHg, (5388±1562)mL, (2 520±630)mL to (291.7±25.0)mmHg, (2 886±866)mL, (3 221±923)mL, respectively, showing significant differences in the time effect of changes in the above indicators ( Ftime=7.61, 13.83, 2.97, P<0.05). ③The daily caloric intake, daily protein supplementation of 23 patients from preoperation to postoperative day 3 were changed from (465±116)kcal, (18±5)g to (1 628±472)kcal, (60±18)g, respectively, showing significant differences in the time effect of changes in the above indicators ( Ftime=40.31, 41.23, P<0.05). (2) Patients outcomes after open abdomen therapy. Of 23 patients, 18 cases survived and 5 cases died. The duration of intensive care unit stay and duration of hospital stay of 23 patients were 26(range, 5-82)days and 40(range, 5-98)days. Twelve of 23 patients received renal replacement therapy for 12 (range, 5-32)days. Time of pain and sedation management, mechanical ventilation, antimicrobial therapy, vasopressor therapy of 23 patients were 13(range, 5-74)days, 12(range, 5-74)days,20(range, 5-50)days, 6(range, 2-35)days. (3) Analysis of variables related to survival outcomes for patients after open abdomen therapy. Results of Boruta analysis showed that postoperative high-output enteric fistula, postoperative bile fistula, postoperative intra-abdominal hemorrhage, postoperative enteric air fistula, and preoperative mean arterial pressure were significantly associated with survival outcomes. Conclusions:Open abdomen therapy is effective in the treatment of non-traumatic critically patients. Postoperative high-output enteric fistula, postoperative bile fistula, postoperative intra-abdominal hemorrhage, postoperative enteric air fistula, and preoperative mean arterial pressure reduction are significantly associated with survival outcomes.

Objective:To investigate the clinical value of open abdomen therapy in non-traumatic critically patients.Methods:The retrospective cohort study was conducted. The clinical data of 23 non-traumatic critically patients who underwent open abdomen therapy in 5 hospitals in China from July 2015 to July 2024 were collected. There were 17 males and 6 females, aged 70(range, 24-84)years. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Repeated measurement data were analyzed using the repeated ANOVA, and pairwise comparison within groups was conducted using the least significant difference method. The Boruta algorithm was applied for analyzing variables related to survival outcomes. Results:(1) Treatment of patients undergoing open abdomen therapy. ① The intra-abdominal pressure, lactate, heart rate, central venous pressure, mean arterial pressure, sequential organ failure assessment score of 23 patients from preoperation to postoperative day 3 were changed from (19.7±5.4)mmHg (1 mmHg=0.133 kPa), (6.1±1.9)mmol/L, (120±14)beats/minutes, (13.1±4.3)cmH 2O (1 cmH 2O=0.098 kPa), (58.8±6.8)mmHg, 13.2±1.8 to (10.6±1.3)mmHg, (2.3±0.6)mmol/L, (95±10)beats/minutes, (8.8±2.0)cmH 2O, (75.2±8.5)mmHg, 10.1±1.6, respectively, showing significant differences in the time effect of changes in the above indicators ( Ftime=46.40, 29.19, 24.91, 11.84, 27.81, 11.71, P<0.05). ② The oxygenation index, total intake, total output of 23 patients from preoperation to postoperative day 3 were changed from (255.0±54.2)mmHg, (5388±1562)mL, (2 520±630)mL to (291.7±25.0)mmHg, (2 886±866)mL, (3 221±923)mL, respectively, showing significant differences in the time effect of changes in the above indicators ( Ftime=7.61, 13.83, 2.97, P<0.05). ③The daily caloric intake, daily protein supplementation of 23 patients from preoperation to postoperative day 3 were changed from (465±116)kcal, (18±5)g to (1 628±472)kcal, (60±18)g, respectively, showing significant differences in the time effect of changes in the above indicators ( Ftime=40.31, 41.23, P<0.05). (2) Patients outcomes after open abdomen therapy. Of 23 patients, 18 cases survived and 5 cases died. The duration of intensive care unit stay and duration of hospital stay of 23 patients were 26(range, 5-82)days and 40(range, 5-98)days. Twelve of 23 patients received renal replacement therapy for 12 (range, 5-32)days. Time of pain and sedation management, mechanical ventilation, antimicrobial therapy, vasopressor therapy of 23 patients were 13(range, 5-74)days, 12(range, 5-74)days,20(range, 5-50)days, 6(range, 2-35)days. (3) Analysis of variables related to survival outcomes for patients after open abdomen therapy. Results of Boruta analysis showed that postoperative high-output enteric fistula, postoperative bile fistula, postoperative intra-abdominal hemorrhage, postoperative enteric air fistula, and preoperative mean arterial pressure were significantly associated with survival outcomes. Conclusions:Open abdomen therapy is effective in the treatment of non-traumatic critically patients. Postoperative high-output enteric fistula, postoperative bile fistula, postoperative intra-abdominal hemorrhage, postoperative enteric air fistula, and preoperative mean arterial pressure reduction are significantly associated with survival outcomes.

Objective: To explore the molecular biological mechanism of curcumol in regulating ferroptosis and autophagy. Methods: The Pharm Mapper database was used to screen out curcumol targets, various known related databases were used to establish a database of ferroptosis and autophagy related targets, and the String database was used to construct a protein-protein interaction network. The key targets were enriched and analyzed using DAVID database. Results: 152 curcumol targets, 259 ferroptosis targets, and 796 autophagy targets were obtained; curcumol mainly regulated the ferroptosis process through PTGS2, ALB, MAPK1, MAPK8, and MAPK14 targets, and curcumol mainly through HSP90 AA1, MAPK1, MAPK8, ALB, NOS3 targets regulated the autophagy process, and curcumol mainly regulated the ferroptosis and autophagy process through ALB, MAPK1, MAPK8 targets. Conclusion Curcumol can exert pharmacological effects by regulating ferroptosis and autophagy.