ObjectiveTo investigate the effects of Jianpi Qinghua granules on blood glucose fluctuations in patients with newly diagnosed overweight/obese type 2 diabetes mellitus （T2DM） and Qi-Yin deficiency syndrome from the perspective of skeletal muscle mass and function， while providing new insights for the treatment of diabetes. MethodsThis study employed a randomized， double-blind， placebo-controlled design. A total of 110 newly diagnosed overweight/obese T2DM patients meeting the inclusion criteria were randomly assigned to either the traditional Chinese medicine （TCM） group （54 cases） or the control group （56 cases）. Patients in the TCM group received Jianpi Qinghua Granules， while those in the control group received a placebo. Both groups underwent dietary and exercise guidance. After 12 weeks of intervention， blood glucose fluctuations were assessed using the following parameters： time in the target blood glucose range （TIR）， mean daily blood glucose （MBG）， standard deviation of mean daily blood glucose （SDBG）， mean amplitude of glycemic excursions （MAGE）， coefficient of variation of blood glucose （CV）， glycated hemoglobin （HbA1c） achievement rate， fasting plasma glucose （FPG）， and 2 hour postprandial glucose （2 hPG）. Skeletal muscle mass was measured by dual-energy X-ray absorptiometry （DXA）， while skeletal muscle function was evaluated using a handheld dynamometer for distal muscle strength and a 5-time sit-to-stand test for lower limb function. Additionally， pancreatic islet function and TCM syndrome scores were analyzed. ResultsNo significant differences were observed in baseline data between the two groups before intervention， ensuring comparability. After treatment， compared to the control group， the TCM group showed a significant increase in TIR （P<0.01）. While the SDBG and CV decreased， and MBG and MAGE increased in the TCM group， these differences were not statistically significant. Notably， the TCM group exhibited significant reductions in 2 hPG （P<0.01） and HbA1c （P<0.05）， though the decrease in FPG was not statistically significant. The HbA1c achievement rate in the TCM group was significantly higher than that in the control group （χ²=45.498， P<0.01）. In terms of skeletal muscle mass and function， the TCM group demonstrated a significant increase in handgrip strength （P<0.01） and a significant reduction in the 5-time sit-to-stand duration （P<0.05）. However， although body fat percentage increased， leading to a decrease in skeletal muscle mass and the ratio of skeletal muscle to fat， these changes were not statistically significant. For pancreatic islet function， the TCM group showed significant reductions in fasting insulin （FINS） and homeostasis model assessment of insulin resistance （HOMA-IR） （P<0.01）. Additionally， the TCM syndrome score in the TCM group was significantly reduced （P<0.01）. ConclusionJianpi Qinghua granules may reduce blood glucose fluctuations in newly diagnosed overweight/obese T2DM patients with Qi-Yin deficiency syndrome by enhancing skeletal muscle function， improving pancreatic islet function， and ameliorating related TCM syndromes.

Objective To evaluate the safety and efficacy of a self-developed micro-normothermic machine perfusion (NMP) system (micro-perfusion device) for preserving isolated porcine limbs. Methods Five healthy Landrace pigs were selected, and their left and right forelimbs were randomly divided into the NMP group and static cold storage (SCS) group. The NMP group was perfused with the self-developed micro-perfusion device and polymerized hemoglobin perfusate for 32 hours at normothermia, while the SCS group was preserved at 4 ℃. Hemodynamic parameters such as perfusion pressure and flow were monitored. The pH value, partial pressure of oxygen (PO₂), lactic acid (Lac), creatine kinase (CK) and lactate dehydrogenase (LDH) in the perfusate were measured. Hematoxylin-eosin staining was used to assess the muscle tissue structure, terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling was employed to evaluate muscle cell apoptosis, and immunohistochemistry staining was applied to detect the expressions of tumor necrosis factor (TNF)-α and interleukin (IL)-6. A mixed-effects model was used to analyze the effects of time and treatment methods on tissue structure, cell apoptosis and inflammatory factors. Results The device could stably maintain a perfusion pressure of (69±15) mmHg and a flow rate of (117±42) mL/min. The pH value and electrolytes of the perfusate were generally stable, with PO₂ maintained at a high level. Lac was maintained at 5.38(3.81, 6.45) mmol/L, while CK and LDH increased over time. After 32 hours of perfusion in the NMP group, both the myocyte spacing and apoptosis rate were better than those in the SCS group. Mixed-effects model analysis showed that there were statistically significant differences in the effects of NMP treatment and SCS treatment on myocyte spacing and apoptosis rate per unit time (both P < 0.05). There were no statistically significant differences in TNF-α and IL-6 between the two groups, and mixed-effects model analysis showed no statistically significant differences in the effects of NMP treatment and SCS treatment on TNF-α and IL-6 per unit time (both P > 0.05). Conclusions The micro-perfusion device used in this study may achieve 32-hour normothermic preservation in a porcine limb amputation model, maintain basic metabolism and ionic homeostasis, reduce muscle structural damage and cell apoptosis without inducing additional inflammatory responses. This technology is expected to significantly extend the time window for replantation of amputated limbs in disaster rescue and long-distance transportation, providing an important technical basis for clinical translation and subsequent replantation research.

Acute-on-chronic liver failure （ACLF） is a syndrome of multiple organ failure on the basis of underlying chronic liver disease and has an extremely high short-term mortality rate， while there is still a lack of unified diagnostic criteria around the world. Radiology plays an important role in the evaluation and prognostic prediction of ACLF， constituting a multi-dimensional assessment system covering morphology， function， and hemodynamics. Computed tomography can be used for the measurement of liver volume and the diagnosis of sarcopenia by providing key morphological and nutritional parameters. Magnetic resonance imaging （MRI）， especially gadobenate dimeglumine-enhanced MRI， enables quantitative assessment of liver function and has critical significance for predicting short-term survival rate. Ultrasonography and elastography techniques facilitate the early warning of ACLF onset and the dynamic monitoring of its progression through noninvasive measurement of liver stiffness and hemodynamic parameters. This article systematically reviews the pivotal role of these three imaging modalities in the diagnosis and monitoring of ACLF， and integrating the strengths of multiple imaging techniques with clinical indicators to construct diagnostic and prognostic models may become a key future direction for achieving early intervention and improving clinical outcomes in ACLF.

ObjectiveTo identify the pathogen species responsible for the wilt disease of Tetradium ruticarpum in Chongqing， investigate there biological characteristics， and screen effective fungicides， so as to provide a theoretical basis for disease control in production. MethodsThe pathogen was isolated via the tissue culture method. Pathogenicity was verified according to Koch's postulates. The pathogen was identified based on morphological characteristics and multi-gene phylogenetic analysis. The mycelial growth rate method was used for biological characterization of the pathogen and fungicide screening. ResultsThe pathogen colonies were nearly circular with irregular edges， white， short， velvety aerial hyphae， and pale purple undersides. Macroconidia were colorless， sickle-shaped， with 3-5 septa， while microconidia were transparent， elliptical， aseptate or with 1-2 septa. Multi-gene phylogenetic analysis showed that the pathogen clustered in the same clade as Fusarium fujikuroi with 100% support， which， combined with morphological characteristics， identified the pathogen causing wilt of T. ruticarpum in Chongqing as F. fujikuroi. The optimal conditions for the mycelial growth of F. fujikuroi were mung bean agar （MBA） with glucose as the carbon source， beef extract and yeast powder as nitrogen sources， 28 ℃， pH 7.0， and alternating light/dark conditions. The optimal conditions for sporulation were potato dextrose agar （PDA） with glucose as the carbon source， beef extract as the nitrogen source， 28 ℃， pH 7.0， and complete darkness. Among chemical fungicides， phenazine-1-carboxylic acid exhibited the strongest inhibitory effect on F. fujikuroi. Shenqinmycin and tetramycin were the most effective bio-fungicides. ConclusionThis study is the first to report F. fujikuroi as the causal agent of wilt disease in T. rutaecarpa. The chemical fungicide phenazine-1-carboxylic acid and the bio-fungicides shenqinmycin and tetramycin showed strong inhibitory effects against F. fujikuroi.

ObjectiveThe present study aimed to investigate alterations in white matter microstructure and spontaneous neural activity in male college smokers, and to further explore their associations with nicotine dependence. Given that adolescence and early adulthood represent critical periods for brain maturation, particularly for white matter development, understanding the neural correlates of smoking behavior during this stage is of substantial importance for both neuroscience and public health. MethodsA total of 115 male undergraduate students were initially recruited for this study. After quality control and exclusion procedures, 52 male college smokers and 42 demographically matched healthy non-smokers were included in the final analysis. All participants underwent multimodal magnetic resonance imaging (MRI), including diffusion tensor imaging (DTI) and resting-state functional MRI (rs-fMRI). White matter fiber tracts were reconstructed using the automated fiber quantification (AFQ) method, which enables precise identification and quantification of major fiber bundles. Eighteen major white matter tracts were segmented for each participant. Along the core trajectory of each tract, 100 equidistant nodes were sampled. Fractional anisotropy (FA) was calculated at each node to assess white matter microstructural integrity, while amplitude of low-frequency fluctuation (ALFF) was computed to evaluate spontaneous neural activity within white matter tracts. Between-group differences in FA and ALFF were assessed using two-sample t-tests, with appropriate corrections applied for multiple comparisons. Furthermore, Pearson correlation analyses were conducted to examine the relationships between imaging-derived metrics (FA and ALFF values in regions showing significant group differences) and nicotine dependence severity, as measured by the Fagerström test for nicotine dependence (FTND). ResultsCompared with healthy non-smokers, male college smokers exhibited significantly increased FA values in several white matter tracts, including the left thalamic radiation, right corticospinal tract, forceps major of the corpus callosum, left uncinate fasciculus, and right arcuate fasciculus. These findings suggest altered microstructural organization or increased directional coherence within these pathways. In addition, smokers demonstrated significantly elevated ALFF values in the forceps major, right uncinate fasciculus, and left arcuate fasciculus, indicating enhanced spontaneous neural activity in these white matter regions. Correlation analyses revealed that FA values in the left thalamic radiation and right corticospinal tract were negatively correlated with FTND scores, suggesting that higher levels of nicotine dependence were associated with reduced microstructural integrity or altered fiber organization in these regions. In contrast, ALFF values in the forceps major and right uncinate fasciculus were positively correlated with FTND scores, indicating that greater nicotine dependence was associated with increased spontaneous neural activity in specific white matter pathways. ConclusionThe present study provides evidence that male college smokers exhibit distinct alterations in both white matter microstructure and functional activity. These abnormalities are not uniformly distributed but rather localized to specific fiber tracts implicated in sensorimotor processing, interhemispheric communication, and higher-order cognitive and emotional regulation. Importantly, the observed associations between imaging metrics and nicotine dependence severity suggest that these structural and functional alterations may reflect neurobiological mechanisms underlying addiction. The combination of AFQ-based tract profiling and multimodal MRI offers a sensitive approach for detecting subtle changes along white matter pathways, highlighting its potential utility in identifying neuroimaging biomarkers of nicotine dependence. Overall, these findings indicate that smoking during early adulthood may disrupt ongoing white matter maturation, potentially leading to long-term consequences for brain function. This study provides novel insights into the neural basis of nicotine dependence and underscores the importance of early intervention and prevention strategies targeting young smokers.

Background Although hand-arm vibration syndrome has traditionally been reported more frequently in colder northern regions, recent cases in Guangdong Province, a subtropical region in the south, exhibit a certain degree of clustering in terms of industry distribution and company size, and for a period of time, they account for a high proportion of the total number of cases reported nationwide. Objective To describe the occupational exposure profile of hand-transmitted vibration (HTV) in Guangdong Province in 2025 and to compare exposure levels across industries, enterprise sizes, and occupational categories. Methods Data were sourced from the Guangdong Provincial Occupational Health Quality Control Platform, to which occupational health technical service institutions across Guangdong Province submitted relevant reports in 2025. The dataset included employers with documented HTV hazards, measurement results, and the number of exposed workers. Exposure levels were categorized into four grades according to the 4-h energy-equivalent frequency-weighted vibration acceleration: Grade I (<1 m·s⁻²), Grade II (1-2.5 m·s⁻²), Grade III (>2.5-5 m·s⁻²), and Grade IV (>5 m·s⁻²). Results A total of 12468 employers with identifiable HTV exposure were identified through the platform in 2025, of which 11710 (93.92%) were in the manufacturing sector. By enterprise scale, 274 (2.20%) were large, 934 (7.49%) were medium-sized, 8 749 (70.17%) were small, and 2511 (20.14%) were micro-sized enterprises, with small enterprises accounting for the largest proportion. Among 22298 job posts with identified HTV exposure, grinding, assembly, polishing, burnishing, and welding were the most common tasks. The M (P₂₅, P₇₅) 4-h energy-equivalent frequency-weighted acceleration [a(4)] was 2.1 (1.5, 2.7) m·s⁻², with values ranging from 0.1 to 16.2 m·s⁻². Exposure levels were distributed as follows: Grade I, 2835 posts (12.71%); Grade II, 12761 posts, (57.23%); Grade III, 6690 posts, (30.00%); and Grade IV, 12 posts (0.05%), with Grade Ⅱ posts accounting for the largest proportion. Within the manufacturing sector, 21013 exposed job posts were identified, accounting for 94.24% of all exposed posts. Twelve job posts exceeded the occupational exposure limit, of which nine were polishing positions. A total of 115955 workers were exposed to HTV, primarily in manufacturing (110879; 95.62%). Among the exposed workers, 21237, 23454, 65047, and 6217 were employed in large, medium, small, and micro-sized enterprises, respectively. Grinding, assembly, polishing, deburring, and welding were the five most common occupational categories among the exposed workers. The distribution of worker by exposure grade was similar to that of exposed posts: Grade I, 11921 workers (10.28%); Grade II, 65463 workers (56.46%); Grade III, 38447 workers (33.16%); and Grade IV, 124 workers (0.11%). Conclusion In Guangdong Province, HTV exposure is mainly concentrated in the manufacturing sector, particularly in metal product manufacturing, and commonly involves tasks such as grinding, assembly, and polishing. Both exposed enterprises and exposed workers are predominantly concentrated in small enterprises. Grade II exposure accounts for the largest proportion of both exposed job posts and exposed workers, and some workers are at a risk of developing hand-arm vibration syndrome. These findings suggest that targeted occupational management and comprehensive control measures should be strengthened to reduce HTV exposure and prevent hand-arm vibration syndrome.

ObjectiveThis study examined KCCQ symptom score trajectories during the vulnerable phase of heart failure and their association with readmission within 6 months. MethodsThis prospective cohort study included 1 109 patients hospitalized for chronic heart failure at a tertiary hospital in Nanchang， China， between August 2020 and July 2025. KCCQ scores were assessed at six time points： day 3 after admission， discharge， and 1， 2， 3， and 6 months after discharge. Group-based trajectory modeling was used to identify patterns of change in KCCQ scores. Multiple logistic regression was used to assess the association between trajectory membership and readmission risk. ResultsDuring follow-up， 229 patients were readmitted， accounting for 20.6% of the cohort. Four KCCQ trajectories were identified： persistently declining scores （n=228， 20.6%）， persistently improving scores （n=110， 9.9%）， stable intermediate scores （n=545， 49.1%）， and stable high scores （n=226， 20.4%）. Compared with the stable intermediate group， the persistently declining group had a higher risk of readmission in the fully adjusted model （OR=2.099， 95% CI： 1.027–4.315， P=0.043）， whereas the stable high-score group had a lower risk （OR=0.260， 95% CI： 0.127–0.494， P<0.001）. The association between the persistently improving trajectory and readmission was not statistically significant （OR=0.614， 95% CI： 0.306–1.154， P=0.147）. ConclusionsKCCQ symptom score trajectories during the vulnerable phase of heart failure show marked heterogeneity and are associated with readmission within 6 months. A persistently declining trajectory is associated with higher readmission risk， whereas a stable high-score trajectory is associated with lower risk. Longitudinal monitoring of KCCQ score changes may help inform post-discharge risk stratification and follow-up management in patients with heart failure.

ObjectiveThis study examined KCCQ symptom score trajectories during the vulnerable phase of heart failure and their association with readmission within 6 months. MethodsThis prospective cohort study included 1 109 patients hospitalized for chronic heart failure at a tertiary hospital in Nanchang， China， between August 2020 and July 2025. KCCQ scores were assessed at six time points： day 3 after admission， discharge， and 1， 2， 3， and 6 months after discharge. Group-based trajectory modeling was used to identify patterns of change in KCCQ scores. Multiple logistic regression was used to assess the association between trajectory membership and readmission risk. ResultsDuring follow-up， 229 patients were readmitted， accounting for 20.6% of the cohort. Four KCCQ trajectories were identified： persistently declining scores （n=228， 20.6%）， persistently improving scores （n=110， 9.9%）， stable intermediate scores （n=545， 49.1%）， and stable high scores （n=226， 20.4%）. Compared with the stable intermediate group， the persistently declining group had a higher risk of readmission in the fully adjusted model （OR=2.099， 95% CI： 1.027–4.315， P=0.043）， whereas the stable high-score group had a lower risk （OR=0.260， 95% CI： 0.127–0.494， P<0.001）. The association between the persistently improving trajectory and readmission was not statistically significant （OR=0.614， 95% CI： 0.306–1.154， P=0.147）. ConclusionsKCCQ symptom score trajectories during the vulnerable phase of heart failure show marked heterogeneity and are associated with readmission within 6 months. A persistently declining trajectory is associated with higher readmission risk， whereas a stable high-score trajectory is associated with lower risk. Longitudinal monitoring of KCCQ score changes may help inform post-discharge risk stratification and follow-up management in patients with heart failure.

ObjectiveTo study the clinical characteristics and influencing factors of rheumatoid arthritis （RA） in the patients with cold dampness obstruction syndrome. MethodsThe RA patients treated in the Department of Traditional Chinese Medicine and Rheumatology of the China-Japan Friendship Hospital from August 2022 to June 2024 were selected. The demographic information， clinical data， laboratory test results， and traditional Chinese medicine （TCM） symptom information were collected for syndrome differentiation， on the basis of which the characteristics and influencing factors of cold dampness obstruction syndrome were analyzed. ResultsA total of 258 RA patients were selected in this study， including 88 （34.1%） patients with cold dampness obstruction syndrome， 53 （20.5%） patients with dampness and heat obstruction syndrome， 31 （12.0%） patients with wind dampness obstruction syndrome， 29 （11.2%） patients with liver-kidney deficiency syndrome， 19 （7.4%） patients with Qi-blood deficiency syndrome， 14 （5.4%） patients with phlegm-stasis obstruction syndrome， 15 （5.8%） patients with stasis obstructing collateral syndrome and 9 （3.5%） patients with Qi-Yin deficiency syndrome. The patients were assigned into two groups of cold dampness obstruction syndrome and other syndromes. The group of cold dampness obstruction syndrome had lower joint fever， 28-tender joint count （TJC28）， and 28-joint disease activity score （DAS28）-C-reactive protein （CRP） and higher central sensitization， cold feeling of joints， fear of wind and cold， cold limbs， and abdominal distention than the group of other syndromes （P<0.05）. The binary logistic regression analysis showed that central sensitization （OR 5.749， 95%CI 2.116-15.616， P<0.001） and DAS28-CRP （OR 0.600， 95% CI 0.418-0.862， P=0.006） were the independent factors influencing cold dampness obstruction syndrome in RA. ConclusionCold dampness obstruction syndrome is a common syndrome in RA patients. It is associated with central sensitization， cold feeling of joints， abdominal distension and may be a clinical syndrome associated with central sensitization.

AIM To optimize the cellulase-assisted ultrasound extraction process for total flavonoids from Plumbago zeylanica L.,and to evaluate their anti-oxidant activity.METHODS With extraction time,liquid-solid ratio,cellulase addition amount,extraction temperature and ultrasonic power as influencing factors,extraction rate of total flavonoids as an evaluation index,the extraction process was optimized by response surface method on the basis of single factor test.Subsequently,The scavenging rates of extract on DPPH,ABTS and OH free radicals were determined.RESULTS The optimal conditions were determined to be 34∶1 for liquid-solid ratio,3％for cellulase addition amount,51 ℃ for extraction temperature,38 min for extraction time,and 400 W for ultrasonic power,the extraction rate of total flavonoids was(33.411±0.97)％.The IC50 values of three free radicals were 0.13,0.042,3.29 mg/mL,respectively.CONCLUSION This reasonable and reliable method can be used for the cellulase-assisted ultrasound extraction of total flavonoids from P.zeylanica with strong anti-oxidant activity.