ObjectiveTo systematically evaluate the efficacy and safety of Qi-reinforcing and blood-activating/stasis-expelling Chinese patent medicines in the treatment of coronary microvascular disease （CMD）. MethodsPubMed， Cochrane Library， CNKI， Wanfang Data， and VIP were searched for the randomized controlled trials （RCTs） on the treatment of CMD with Chinese patent medicines for reinforcing Qi and activating blood/expelling stasis with the time interval from inception to December 31， 2023. The primary outcome indicators included the index of microcirculatory resistance （IMR）， coronary flow reserve （CFR）， and corrected TIMI flow frame count （cTFC）. The secondary outcome indicators included symptomatic efficacy， left ventricular ejection fraction （LVEF）， hypersensitive C-reactive protein （hs-CRP）， nitric oxide （NO）， and adverse events. Cochrane risk-of-bias assessment tool 2.0 （RoB 2.0） and Stata 17.0 were used for literature quality evaluation and meta-analysis of the included RCTs. The Grading of Recommendations， Assessment， Development and Evaluation （GRADE） was used to evaluate the quality of evidence. ResultsA total of 36 RCTs were included in this study， involving 3 029 patients. Compared with conventional Western medicine alone， the combined use of Chinese patent medicines for reinforcing Qi and activating blood/expelling stasis and Western medicine reduced the IMR ［mean difference （MD）=-5.93， 95% confidence interval （95%CI） ［-8.73，-3.14］， n=382， P<0.01］， cTFC （MD=-9.35， 95%CI ［-13.94，-4.76］， n=618， P<0.01）， and hs-CRP ［standard mean difference （SMD）=-1.50， 95%CI ［-1.90，-1.11］， n=1 483， P<0.01］， improved the CFR （SMD=1.14， 95%CI ［0.08，2.19］， n=304， P=0.03）， symptomatic efficacy ［relative risk （RR）=1.36， 95%CI ［1.21，1.53］， n=756， P<0.01］， LVEF （MD=4.39， 95%CI ［2.31，6.47］， n=533， P<0.01）， and NO （SMD=3.16， 95%CI ［2.07，4.25］， n=946， P<0.01） of CMD patients. In terms of safety， the combined therapy reduced the occurrence of adverse events in CMD patients （RR=0.49， 95%CI ［0.29，0.82］， n=591， P=0.01）. GRADE showed moderate quality evidence for adverse events， low quality evidence for cTFC， symptomatic efficacy， LVEF， and NO， and very low quality evidence for IMR， CFR， and hs-CRP. ConclusionBased on microcirculatory function indicators， the combined use of Qi-reinforcing and blood-activating/stasis-expelling Chinese patent medicines and Western medicine may further improve the coronary microvascular function in CMD patients with good safety. The above conclusions remain to be verified with high-quality clinical trials.

Sophorae Flavescentis Radix is one of the commonly used traditional Chinese medicine in China, and a large amount of pharmaceutical residue generated during its processing and production is discarded as waste, which not only wastes resources but also pollutes the environment. Therefore, elucidating the chemical composition of the residue of Sophorae Flavescentis Radix and the differences between the residue and Sophorae Flavescentis Radix itself is of great significance for the comprehensive utilization of the residue. This study, based on ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS) technology combined with multivariate statistical methods, provides a thorough characterization, identification, and differential analysis of the overall components of Sophorae Flavescentis Radix and its residue. Firstly, 61 compounds in Sophorae Flavescentis Radix were rapidly identified based on their precise molecular weight, fragment ions, and compound abundance, using a self-constructed compound database. Among them, 41 compounds were found in the residue, mainly alkaloids and flavonoids. Secondly, through principal component analysis(PCA) and orthogonal partial least squares discriminant analysis(OPLS-DA), 15 key compounds differentiating Sophorae Flavescentis Radix from its residue were identified. These included highly polar alkaloids, such as oxymatrine and oxysophocarpine, which showed significantly reduced content in the residue, and less polar flavonoids, such as kurarinone and kuraridin, which were more abundant in the residue. In summary, this paper clarifies the overall composition, structure, and content differences between Sophorae Flavescentis Radix and its residue, suggesting that the residue of Sophorae Flavescentis Radix can be used as a raw material for the extraction of its high-activity components, with promising potential for development and application in cosmetics and daily care. This research provides a scientific basis for the future comprehensive utilization of Sophorae Flavescentis Radix and its residue.
Drugs, Chinese Herbal/chemistry* ; Chromatography, High Pressure Liquid/methods* ; Mass Spectrometry/methods* ; Sophora/chemistry* ; Flavonoids/chemistry* ; Alkaloids/chemistry*

OBJECTIVE:  To estimate the population attributable disease burden (PAD) of low bone mineral density (LBMD) related fractures (fragility fractures) among Chinese people over 50 years old from 1990 to 2023, using data from the Global Burden of Disease Study 2023 (GBD 2023), and to provide evidence for prevention strategies and health resource allocation. METHODS:   Based on the GBD 2023, the LBMD summary exposure values (SEV), fracture incidence, years lived with disability (YLDs), and LBMD-related falls YLDs of Chinese people over 50 years old from 1990 to 2023 were extracted. PAD was calculated with population attributable fraction (PAF), and an entropy-weight method was applied to evaluate the contribution of individual fracture sites. Temporal trends and sex differences were examined with Joinpoint regression. RESULTS:  From 1990 to 2023, the age-standardized SEV of LBMD in people over 50 years old showed an overall decline [average annual percent change (AAPC)=-0.564%]. Age-standardized fracture incidence, fracture YLDs rate, and LBMD-related falls YLDs rate all exhibited W-shaped upward trends (AAPC=1.045%, 0.296%, and 0.724%, respectively). PAF-based estimates indicated that LBMD-attributable fracture incidence likewise increased in a "W-shaped" manner (AAPC=0.558%), whereas the corresponding YLDs rate showed an overall W-shaped decline (AAPC=-0.193%). In international comparison, China and the global average displayed broadly concordant directions of change, with greater volatility in China and a progressive narrowing of the gap after 2015. Regarding sex differences, fracture YLDs rates were consistently higher in the males, whereas the other burden indicators were higher in the females; the temporal patterns were similar in both sexes. Entropy weight method identified hip fractures as contributing most to incidence (weight 0.133), and pelvic fractures as the largest contributor to YLDs rate (weight 0.115). CONCLUSION Since 1990, the LBMD attributable fracture burden in China's older population has risen, with female and hip or pelvic fractures bearing the heaviest load. Strengthened osteoporosis screening, improved insurance coverage, and targeted health education are urgently needed to curb further increases in disease burden.
Humans ; China/epidemiology* ; Middle Aged ; Female ; Male ; Bone Density ; Aged ; Incidence ; Osteoporotic Fractures/epidemiology* ; Aged, 80 and over ; Accidental Falls/statistics & numerical data* ; Cost of Illness ; Global Burden of Disease ; Osteoporosis/complications* ; Disability-Adjusted Life Years ; Fractures, Bone/epidemiology*

OBJECTIVE: Evaluate the clinical application effect of low-field infant MRI. METHODS: Using literature review, expert consultation, and two rounds of Delphi to determine the evaluation index system. Then retrospectively analyze and compare the data of low-field infant MRI and high-field MRI from January 2023 to December 2024. RESULTS: There is a certain gap between low-field infant MRI and high-field MRI in terms of signal-to-noise ratio, image uniformity, software system reliability, scanning time, user interface friendliness and image result consistency. However, there was no difference in terms of spatial resolution and image quality. The noise, hardware system reliability, mean time between failure and the rate of examination completed without sedation are better than that of high-field MRI. CONCLUSION Low-field infant MRI meets needs of clinical diagnostic and has stable performance. It can be used as a routine screening tool for brain diseases near the bed.
Magnetic Resonance Imaging/methods* ; Humans ; Infant ; Retrospective Studies ; Signal-To-Noise Ratio ; Reproducibility of Results ; Brain Diseases/diagnostic imaging* ; Brain/diagnostic imaging* ; Software

Objective:To investigate the preventive and therapeutic effects and mechanisms of Dachaihu decoction(DCD)on dextran sodium sulfate(DSS)-induced ulcerative colitis(UC)and liver injury in mice,as well as the association between DCD benefits and gut microbiota modulation.Methods:Mice were treated with DCD(20.10 and 10.05 g/kg)for 2 weeks,with free access to drinking water containing 3%DSS in the second week to induce UC.Histopathological examination,RT-qPCR and 16S rRNA sequencing were used to investigate the effect of DCD on UC mice.Results:DCD pretreatment significantly alleviated weight loss,bloody diarrhea with mucus,histopathological abnormalities of the colon,and colon shortening in mice with DSS-induced UC.In addition,DCD pretreat-ment significantly upregulated the levels of Occludin,ZO-1,and MUC-2 in the colon and protected the intestinal barrier of mice.DCD pretreatment also alleviated inflammatory cell infiltration in the colon and the liver and significantly reduced the expression levels of the proinflammatory factors such as IL-1β,IL-6,TNF-α,iNOS,COX-2,and NLRP3,thereby exerting a protective effect against UC and liver injury.It should be noted that DCD corrected gut micro-biota imbalance in UC mice by enriching probiotic bacteria such as Lactobacillus and Bifidobacterium and reducing harmful bacteria such as Norank_f_Desulfovibrionaceae and Escherichia-Shigella.Conclusion:DCD can alleviate DSS-induced UC and exert a liver-protecting effect by protecting intestinal barrier,inhibiting inflam-mation,and regulating gut microbiota.

Objective To analyze the risk factors,traditional Chinese medicine(TCM)syndromes,and pathogen distribution in patients with bronchiectasis(BE)complicated with type 2 diabetes mellitus(T2DM).Methods From June 2022 to June 2024,a total of 299 patients with acute exacerbation of BE admitted to Guangdong Integrated Chinese and Western Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine were selected.Based on the presence of T2DM,the patients were divided into the BE-T2DM group(74 cases)and the BE-only group(225 cases).Clinical data of the patients were collected,and univariate analysis and multivariate logistic regression models were used to identify risk factors for BE complicated with T2DM.TCM syndromes and pathogen distribution were statistically analyzed.Results(1)Univariate analysis showed that there were statistically significant differences between the two groups in gender,age,body mass index(BMI),hypertension,coronary atherosclerotic heart disease(shortened to coronary heart disease),atherosclerosis,the ratio of forced expiratory volume in one second to forced vital capacity(FEV1/FVC),white blood cell count(WBC),neutrophil count analysis for the risk factors showed that gender,BMI,hypertension,and FEV1/FVC were the independent risk factors for BE complicated with T2DM.(2)In terms of the distribution of TCM syndromes,both groups were mainly characterized by phlegm-heat accumulating in the lung syndrome and phlegm-damp obstructing the lung syndrome,and BE-T2DM group had a higher proportion of phlegm-heat accumulating in the lung syndrome.(3)For the infection of pathogens,BE-T2DM group had a higher infection rate of Haemophilus influenzae,Acinetobacter baumannii,and Klebsiella pneumoniae,while the BE-only group was predominantly infected with Pseudomonas aeruginosa;BE-T2DM group had a significantly higher rate of viral infections,mainly infected with influenza A virus,rhinovirus,and SARS-CoV-2;BE-T2DM group also suffered from fungal infections,usually infected with Candida albicans.Conclusion For BE patients complicated with T2DM,the independent risk factors are gender,BMI,hypertension,and FEV1/FVC;the common TCM syndromes are phlegm-heat accumulating in the lung and phlegm-damp obstructing the lung;pathogen infections are mainly caused by Gram-negative bacteria,viruses,and fungi.

Objective To evaluate the value of Bushen Qianggu Formula(BSQGF)applying in the treatment of patients with postmenopausal osteoporotic lumbar vertebral compression fracture(PM-OLVCF)of kidney deficiency and blood stasis type,and to observe its effects on lumbar function and sex hormone profiles.Methods A total of 162 patients with PM-OLVCF of kidney deficiency and blood stasis type treated at Haikou Traditional Chinese Medicine Hospital from February 2023 to June 2024 were collected.The patients were equally randomized into a control group and an observation group by using a table of random numbers,with 81 cases in each group.Both groups received percutaneous kyphoplasty and conventional western treatment with analgesics and antibiotics after the operation.Moreover,the control group received oral use of Alfacalcidol+Calcium Carbonate D3 Tablets postoperatively,while the observation group received additional BSQGF decoction orally for 12 weeks.Primary outcomes included Cobb angle,Oswestry Disability Index(ODI),traditional Chinese medicine(TCM)syndrome scores,bone mineral density(BMD),and serum levels of preadipocyte factor 1(Pref-1),thromboxane B2(TXB2),cyclooxygenase 2(COX-2),interleukin 6(IL-6),prostaglandin E2(PGE2),bone morphogenetic protein 2(BMP-2),and relative sex hormones.After treatment,therapeutic effects of patients in both groups were evaluated.Results(1)After 12 weeks of treatment,the total effective rate in the observation group was 93.83%(76/81)and that in the control group was 83.95%(68/81),and the observation group showed significantly better therapeutic efficacy than the control group(χ2=8.134,P＜0.05).(2)After 12 weeks of treatment,both groups showed reductions in Cobb angle,ODI scores,and total TCM syndrome scores compared to those before treatment(P＜0.05),and the observation group demonstrated significantly greater reductions than the control group(P＜0.05).(3)After 6 and 12 weeks of treatment,BMD values were increased in both groups compared to those before treatment(P＜0.05),and the observation group showed significantly greater increase of BMD at both 6 and 12 weeks than the control group(P＜0.05).(4)After 2 weeks of treatment,serum TXB2,COX-2,Pref-1,PGE2,and IL-6 levels were decreased while serum BMP-2 level was increased in both groups compared to those before treatment(P＜0.05),and the observation group showed significantly greater reductions in TXB2,COX-2,Pref-1,PGE2,and IL-6 levels and greater increase of BMP-2 level than the control group(P＜0.05).(5)After 12 weeks of treatment,the control group showed no significant changes in serum levels of luteinizing hormone(LH),estradiol(E2),or follicle-stimulating hormone(FSH)(P＞0.05),while the observation group showed decreased serum LH and FSH levels(P＜0.05)and increased serum E2 level(P＜0.05)compared to those before treatment.The intergroup comparison showed that the observation group had more improvements in all these sex hormone indicators than the control group(P＜0.05).Conclusion BSQGF combined with conventional western medicine therapy is effective on inhibiting the secretion of inflammatory factors,promoting fracture healing,and improving lumbar function in patients with PM-OLVCF of kidney deficiency and blood stasis type,and enhances the therapeutic efficacy compared to western medicine treatment alone.

Traditional pancreatobiliary endoscopy surgery is limited by the fact that capturing image information is time-consuming, inefficient, and susceptible to the level of the practitioner. Artificial intelligence, however, provides an efficient and accurate method of automatic image recognition for pancreaticobiliary endoscopic surgery, thus assisting clinicians to achieve rapid and accurate clinical predictions and guiding clinical decision-making. Moreover, artificial intelligence has great potential for applications in many aspects such as quality control and training of procedure. This paper provides an overview of the current status and research progress in the application of artificial intelligence in pancreatic and biliary endoscopic techniques, with the hope of offering new ideas and methods for improving the current clinical diagnosis and treatment pattern and realizing precision medicine for pancreatobiliary diseases.

Currently,human health due to corona virus disease 2019(COVID-19)pandemic has been seriously threatened.The coronavirus severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)spike(S)protein plays a crucial role in virus transmission and several S-based therapeutic approaches have been approved for the treatment of COVID-19.However,the efficacy is compromised by the SARS-CoV-2 evolvement and mutation.Here we report the SARS-CoV-2 S protein receptor-binding domain(RBD)inhibitor licorice-saponin A3(A3)could widely inhibit RBD of SARS-CoV-2 variants,including Beta,Delta,and Omicron BA.1,XBB and BQ1.1.Furthermore,A3 could potently inhibit SARS-CoV-2 Omicron virus in Vero E6 cells,with EC50 of 1.016 pM.The mechanism was related to binding with Y453 of RBD deter-mined by hydrogen-deuterium exchange mass spectrometry(HDX-MS)analysis combined with quan-tum mechanics/molecular mechanics(QM/MM)simulations.Interestingly,phosphoproteomics analysis and multi fluorescent immunohistochemistry(mIHC)respectively indicated that A3 also inhibits host inflammation by directly modulating the JNK and p38 mitogen-activated protein kinase(MAPK)path-ways and rebalancing the corresponding immune dysregulation.This work supports A3 as a promising broad-spectrum small molecule drug candidate for COVID-19.

Objective To study changes in immune cells and cytokines during the reactivation stage of varicella-zoster virus(VZV)in patients with herpes zoster.Methods A total of 50 patients with herpes zoster and 30 healthy individuals were selected from Xi'an Ninth Hospital between May 2022 and October 2022.Flow cytometry was used to detect the proportion of peripheral blood CD3+cells,CD4+cells,CD8+T cells,B cells and NK cells,as well as levels of cytokines IL-2,IFN-γ,IL-10 and IL-6.We analyzed the immune mechanism of VZV reactivation stage in herpes zoster patients.Results Compared with the healthy control group,the proportion of CD3+cells and CD4+T cells in herpes zoster patients decreased significantly;the proportion of NK cells significantly increased;the levels of IFN-γ,IL-10 and IL-6 significantly increased;the proportion of CD8+T cells,B cells and IL-2 content showed an increasing trend,but there was no significant difference.In addition,the severity of neurological involvement in herpes zoster patients might affect changes in cytokine levels.Conclusion During the reactivation period of VZV,changes in the proportion of immune cells and cytokine expression levels are closely related to the occurrence and development of herpes zoster.