OBJECTIVE To provide an experimental basis for quality control， clinical application and development of hepatoprotective drugs derived from Thesium chinense Turcz.METHODS Network pharmacology was adopted to predict and screen potential hepatoprotective constituents and their action targets of T. chinense Turcz. A liver-injured model of transgenic zebrafish Tg （ fabp10a ： dsRed ） with fluorescent-labeled liver was induced by 4 mmol/L isoniazid. The relative liver fluorescence area and relative fluorescence intensity of zebrafish larvae， as well as the levels of aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， glutathione （GSH） and interleukin-6 （IL-6） were taken as indexes to evaluate the hepatoprotective activity of potential active constituents. High-performance liquid chromatography was used to determine the contents of hepatoprotective active constituents in 17 batches of T. chinense Turcz. medicinal materials from different producing areas.RESULTS Four potential hepatoprotective constituents including kaempferol-3- O -glucorhamnoside （KOG）， kaempferol-3，7-di- O -glucoside （KDG）， buddleoside （BUD） and apigenin-5- O -neohesperidoside （AON） were screened out via network pharmacology， and their core targets involved mitogen-activated protein kinase 1， nuclear factor-κB subunit 1， etc. Pharmacodynamic verification results showed that 25 μmol/L KOG， BUD， AON and 50 μmol/L KDG could significantly increase the relative liver fluorescence area and relative fluorescence intensity of liver-injured model larvae （ P ＜0.05）， reduce the levels of AST， ALT and IL-6 （ P ＜0.05）， and elevate the GSH level （ P ＜0.05）. Content determination results indicated that KOG could be detected in all 17 batches of T. chinense Turcz. medicinal materials， with contents ranging from 0.097 0 to 8.082 0 mg/g；KDG， AON and BUD were not detected in partial batches of samples， and their contents in detectable batches were 0.019 3-0.123 2 mg/g， 0.018 4-0.109 1 mg/g and 0.385 1-1.189 3 mg/g， respectively.CONCLUSIONS KOG， KDG， AON and BUD in T.chinense Turcz. may be its potential hepatoprotective active constituents. Among them， KOG can be detected in T.chinense Turcz. medicinal materials from different producing areas with relatively high content， which can be used as the main marker constituent for evaluating the hepatoprotective effect of T.chinense Turcz.

OBJECTIVE To analyze the risk factors contributing to piracetam-associated thrombocytopenia and develop a predictive model for risk prediction. METHODS The electronic medical record information of inpatients treated with piracetam was collected retrospectively from the First Affiliated Hospital of Guangxi Medical University from January 2021 to December 2023， including gender， age， underlying diseases， combined medication， and laboratory data， etc. Patients were divided into the occurrence group and the non-occurrence group according to whether thrombocytopenia occurred， and the differences in clinical data between the two groups were compared. The independent risk factors were determined through univariate/multivariate Logistic regression analysis. A nomogram was drawn to visually present the independent risk factors， and a risk prediction model was constructed. The predictive efficacy of the model was evaluated using the receiver operating characteristic （ROC） curve， Bootstrap internal validation and calibration curve. RESULTS A total of 224 patients were included， among which 196 cases were in the non- occurrence group and 28 cases in the occurrence group. The incidence of thrombocytopenia was 12.50%. The results of the univariate Logistic regression analysis showed that the proportion of patients using three or more combined antibiotics and the level of serum creatinine in the occurrence group were significantly higher than those in the non-occurrence group， while the level of hemoglobin was significantly lower （P＜0.05）. The results of the multivariate Logistic regression analysis revealed that the use of three or more combined antibiotics， low hemoglobin level and high serum creatinine level were independent risk factors for piracetam-associated thrombocytopenia （P＜0.05）. The constructed risk prediction model was LogitP＝ －1.114+1.256×three or more combined antibiotics－0.017×hemoglobin level+0.009×serum creatinine level. The AUC of the ROC curve of this model was 0.757， and the optimal cut-off value was 0.474； the AUC of the ROC curve of the Bootstrap internal validation was 0.733； the apparent curve and the bias-corrected curve were close to the ideal curve. CONCLUSIONS The use of three or more antibiotics， along with low hemoglobin level and high serum creatinine level， are identified as independent risk factors for piracetam-associated thrombocytopenia. The developed risk prediction model demonstrates good predictive value.

Perimenopausal generalized anxiety disorder belongs to the category of"depression syndrome"in traditional Chinese medicine.It is caused by disharmony of blood vessels,stagnation of qi,and disturbance of the mind and brain,leading to excessive or insufficient qi in the five zang organs.Based on different clinical manifestations,it can be divided into five types of depression.In clinical treatment,Professor Zhuang Lixing applies the mind-regulating acupuncture therapy,with the main acupoints being Sishenzhen,Shenting(GV24),Yintang(EX-HN3),Shenmen(HT7),and Sanyinjiao(SP6).Additional acupoints can be selected according to the patient's symptoms.During the manipulation,the"guiding qi and harmonizing essence"reinforcing and reducing technique is used to regulate emotions and guide qi to relieve depression.This method has shown excellent clinical efficacy and is suitable for clinical promotion.

This study aimed to investigate the effects of Zhiwei Fuwei Pills on mitochondrial apoptosis in the rat model of precancerous lesions of gastric cancer(PLGC) based on the microRNA-21(miRNA-21)/B-cell lymphoma-2(Bcl-2) signaling pathway. Eighty-five 5-week-old male SPF-grade SD rats were selected, of which 75 were fed with N-methyl-N'-nitro-N-nitrosoguanidine(MNNG) for multifactorial modeling, and the PLGC model was established after 26 weeks. The rats were randomly grouped as follows: model, folic acid(0.002 g·kg~(-1)), low-dose(0.42 g·kg~(-1)) Zhiwei Fuwei Pills, medium-dose(0.84 g·kg~(-1)) Zhiwei Fuwei Pills, and high-dose(1.67 g·kg~(-1)) Zhiwei Fuwei Pills, with 15 rats in each group. Additionally, 10 rats were assigned to a blank group and administrated with an equivalent volume of normal saline by gavage. After four weeks of continuous drug administration, the gastric mucosal tissue was collected. Hematoxylin-eosin(HE) staining was performed to reveal the pathological changes in the gastric mucosa. Terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL) was employed to detect apoptosis in gastric mucosal epithelial cells. RT-PCR was adopted to determine the mRNA levels of miRNA-21, phosphatase and tensin homolog(PTEN), Bcl-2, Bcl-2-associated X protein(Bax), and cysteinyl aspartate-specific protease 3(caspase-3). Western blot was employed to determine the protein levels of PTEN, Bcl-2, Bax, and caspase-3. Immunohistochemistry(IHC) was used to detect the positive expression of PTEN, Bcl-2, and Bax in the gastric mucosal tissue. Transmission electron microscopy(TEM) was employed to observe the morphological and structural changes in mitochondria. The results showed that compared with model group, the drug administration groups showed alleviated pathological changes, with increased apoptotic cells, down-regulated mRNA levels of miRNA-21 and Bcl-2, up-regulated mRNA and protein levels of PTEN, Bax, and caspase-3, and down-regulated protein level of Bcl-2. In addition, the drug administration groups exhibited mitochondrial swelling and rupture and reduction of cristae, which indicated mitochondrial apoptosis. These findings suggest that Zhiwei Fuwei Pills can effectively improve mitochondrial apoptosis in PLGC cells by regulating the miRNA-21/Bcl-2 signaling pathway.
Animals ; MicroRNAs/metabolism* ; Male ; Apoptosis/drug effects* ; Stomach Neoplasms/physiopathology* ; Proto-Oncogene Proteins c-bcl-2/genetics* ; Rats ; Rats, Sprague-Dawley ; Drugs, Chinese Herbal/administration & dosage* ; Mitochondria/genetics* ; Signal Transduction/drug effects* ; Precancerous Conditions/drug therapy* ; Humans ; PTEN Phosphohydrolase/genetics*

OBJECTIVE: To investigate the clinical efficacy and advantages of robot-assisted total knee arthroplasty (TKA) in patients with varus knee osteoarthritis. METHODS: Between October 2022 and June 2023, a total of 59 patients with severe knee osteoarthritis resulting in varus were treated with total knee arthroplasty, aged from 59 to 81 years with an average (70.90±4.63) years, including 19 mals and 40 females. The patients were divided into two groups based on the surgical method used:28 patients in the robot group and 31 patients in the traditional group. The robot group consisted of 8 males and 20 femalse patients, with an average age of (70.54±4.80) years and an average disease duration of (14.89±8.72) months. The traditional group consisted of 11 males and 20 females patients, with an average age of (71.39±4.5) years and an average disease duration of (12.32±6.73) months. The operative duration, amount of bleeding during the operation, postoperative activity time after the operation, hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and complications were compared between the two groups before and after the operation. Lateral tibia component (LTC), frontal tibia component (FTC), frontal femoral component (FFC) and lateral femoral component (LFC) were measured 6 months after operation Additionally, the degree of knee joint motility, American Knee Society score (KSS), and visual analogue scale(VAS) were compared before and after the operation. RESULTS: All patients had gradeⅠwound healing without any complications, and all patients were followed up for 6 to 8 months, with an average of (6.5±1.5) months. There were no significant differences preoperative imaging evaluation indexes (including HKA, LDFA, and MPTA), preoperative knee mobility, preoperative VAS, and preoperative KSS between the two groups (P>0.05). Comparing the operation time (109.11±7.16) min vs. (83.90±7.85) min, length of the incision (16.60±2.33) cm vs. (14.47±1.41) cm, intraoperative bleeding (106.93±6.15) ml vs. (147.97±7.62) ml, postoperative activity time (17.86±1.84) h vs. (21.77±2.68) h, between the two groups showed statistically significant differences (P<0.05). There were significant differences in FFC (88.96±0.84)° vs. (87.93±1.09)° and LFC (88.57±1.10)° vs. (87.16±1.2)° between the two groups at 6 months after operation (P<0.05). The robotic group 1, 3, 6 months after KSS (75.96±3.96), (81.53±3.78), (84.50±3.29) scores, VAS (3.68±0.67), (2.43±0.79), (0.54±0.64), knee joint mobility (113.32±4.72) °, (123.93±3.99) °, (135.36±2.34) °;Traditional group KSS (73.77±4.18), (76.48±3.60), (80.19±3.28) scores, VAS (4.16±1.04), (3.03±0.75), (1.42±0.76) scores, knee joint mobility (109.19±6.95) °, (119.94±6.08) °, (134.48±2.14) °. Compared to before surgery, both groups showed significant improvement in KSS, VAS and knee mobility during the three follow-up visits (P<0.001). Additionally, postoperative HKA (180.39±1.95)° vs. (178.52±2.23)°, LDFA (89.67±0.63) ° vs. (89.63±0.63)°, and MPTA (89.44±0.55)° vs. (89.29±0.60)° were significantly improved in both groups compared to before surgery (P<0.001). The robotic group had higher KSS than the traditional group at 1, 3, and 6 months after surgery (P<0.05). The robotic group also had lower VAS than the traditional group at 1, 3, and 6 months after surgery (P<0.05). Furthermore, knee mobility was higher in the robotic group than those in the traditional group at 1 and 6 months after surgery (P<0.05), but there was no significant difference between the two groups at 6 months after surgery. CONCLUSION Robot-assisted total knee arthroplasty is a safe and effective method for total knee replacement. The use of robotics can improve the limb axis and prosthesis alignment for patients with preoperative varus deformity, resulting in better clinical and imaging outcomes compared to the conventional group.
Humans ; Female ; Male ; Arthroplasty, Replacement, Knee/methods* ; Aged ; Middle Aged ; Osteoarthritis, Knee/physiopathology* ; Aged, 80 and over ; Robotic Surgical Procedures/methods*

OBJECTIVE: To evaluate the mid-term efficacy of talonavicular joint fusion alone combined with navicular stress adjustment in Müller-Weiss disease with significant paradoxical flatfoot deformity. METHODS: Between January 2016 and March 2021, a total of 13 patients diagnosed with Müller-Weiss disease underwent simple talonavicular joint fusion combined with navicular stress adjustmentadjustment.Among them, 5 patients were male and 8 patients were female;age ranged from 42 to 67 years old. The duration of the disease ranged from 8 to 20 years. According to Maceira staging system, 5 patients were in stage III and 8 patients were in stage IV. The American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, visual analogue scale (VAS), and foot length were evaluated preoperatively and 10 months postoperatively. Additionally, the talonavicular coverage angle, the talus-first metatarsal angle, and the calcaneal inclination angle were assessed preoperatively and 6 months postoperatively. RESULTS: All 13 patients were followed up a period ranging from 24 to 40 months. All patients achieved clinical healing within a period of 3 to 6 months. However, one patient experienced a screw fracture. The VAS decreased from a range of 3 to 7 points preoperatively to a range of 0 to 2 points at the 10 months postoperative. The AOFAS midfoot score improved from a preoperative range of 12 to 66 points to a range of 72 to 100 points at the 10 months postoperative. Based on the AOFAS midfoot score evaluated at 10 months postoperatively, the outcomes were rated as excellent in 3 feet, good in 6 feet, and fair in 4 feet. The talo-navicular coverage angle, the preoperative talus-first metatarsal angle, calcaneal inclination angle were 14.3° to 33.4°, -4.6° to -19.6°, and 3.0°to 16.4° respectively. Six months postoperatively, these angles improved to 2.7°to 9.6°, -8.4°to 1.1°, and 18.8°to 24.9°respectively. Additionally, the foot length increased by 0 to 6 mm at 10 months post-surgery. CONCLUSION Simple talonavicular arthrodesis combined with scaphoid stress adjustment has satisfactory clinical efficacy in Müller-Weiss disease in terms of deformity, foot length, foot function and pain.
Humans ; Male ; Female ; Adult ; Middle Aged ; Arthrodesis/methods* ; Aged ; Flatfoot/physiopathology* ; Tarsal Bones/physiopathology* ; Tarsal Joints/surgery* ; Treatment Outcome

Cervical spine health issues not only seriously affect patients' quality of life but also impose a heavy burden on the social healthcare system. Existing guidelines lack sufficient clinical guidance on lifestyle and work habits, such as exercise, posture, daily routine, and diet, making it difficult to meet practical needs. To address this, relying on the China Association of Chinese Medicine, Wangjing Hospital of China Academy of Chinese Medical Sciences took the lead and joined hands with more than ten institutions to form a multidisciplinary guideline development group. For the first time, the group developed the Guidelines for Cervical Spine Health Intervention based on evidence-based medicine methods, strictly following the standardized procedures outlined in the World Health Organization Handbook for Guideline Development and the Guiding Principles for the Formulation/Revision of Clinical Practice Guidelines in China (2022 Edition). This proposal systematically explains the methods and steps for developing the guideline, aiming to make the guideline development process scientific, standardized, and transparent.
Humans ; Practice Guidelines as Topic/standards* ; Cervical Vertebrae ; China

Objective : To explore the expression profile of core 1 β1,3-galactosyltransferase 1(C1GALT1) in glioblastoma(GBM) and to elucidate its impact on the initiation and progression of GBM. Methods : The expression levels and prognostic significance of C1GALT1 in GBM were analyzed using the GEPIA and CGGA databases. Two representative glioblastoma cells(U251 and LN18) were selected to construct C1GALT1-knockdown cell lines and performed in vitro experiments. The Cell Counting Kit-8(CCK-8) and Transwell assays were employed to evaluate the impact of C1GALT1 on proliferation, migration and invasion of GBM cells. Transcriptome data were analyzed to identify potential signaling pathways. Senescence β-Galactosidase Staining Kit was used to detect β-galactosidase activity. Results : nalysis of GEPIA and CGGA databases revealed that C1GALT1 was significantly upregulated in GBM tissues compared to adjacent non-cancerous tissues (P < 0. 05) , and its high expression was associated with poor prognosis of patients (P < 0. 000 1) . The CCK-8 experiment demonstrated a significant reduction in prolifera- tion rate following C1GALT1 knockdown (P < 0. 05) . Transwell assay showed that cell migration and invasion de- creased after C1GALT1 was knocked down ( P < 0. 001) . Transcriptome sequencing and senescence β-galactosi- dase staining showed that C1GALT1 was involved in the cellular senescence signaling pathway , and the activity of β-galactosidase associated with cellular senescence significantly increased after C1GALT1 was knocked down(P < 0. 05) . Conclusion C1GALT1 is overexpressed in GBM tissues and may promote the proliferation , migration and invasion of GBM cells by inhibiting cellular senescence .

Under the trend of increasing aging， integrated elderly care and medical services is an important measure to optimize the supply of elderly care services and promote the good death of the elderly. Using the cooperative production theory and the classical grounded theory， a qualitative analysis was conducted on 38 cases of elderly palliative care and 25 cases of hospital-based palliative care under the integrated elderly care and medical services model from a hospital in Nanning City using Nvivo 20.0 software. This paper found that the integrated elderly care and medical services mode emphasized the deep integration of medical and elderly care services by integrating resources and improving service efficiency， to achieve the basic experience of comprehensive health care for the elderly. The promotion of these experiences has a positive significance for building a multi-agent cooperative production system， strengthening personnel training， perfecting the performance distribution mechanism， and further promoting the development of the national palliative care pilot.

The paper introduces Professor ZHUANG Lixing's academic thought on Daoqi Tongjing (directing qi to preserve essence) needling technique and the clinical experience. Based on Huangdi Neijing (the Yellow Emperor's Inner Classic), Dongyuan needling technique and Professor JIN Rui 's Daoqi Tongjing needling method, and by inheriting the valuable experience from the ancient masters and associating with his own clinical practices, Professor ZHUANG Lixing fully displayes the characteristics of principles, methods, formulas, acupoints and techniques of acupuncture in diagnosis and treatment of diseases. He integrates the thought of regulating the mind with Daoqi Tongjing needling. This needling method focuses on directing qi through mind regulation and needle manipulation, in which, the operation steps are refined. Besides, this needling method involves both the reinforcing and reducing techniques. The satisfactory effect of this needling has been obtained in clinical treatment for many disorders such as qi reversion and disharmony of yin and yang.
Acupuncture Therapy/instrumentation* ; Humans ; Acupuncture Points ; China ; Qi ; History, Ancient ; Medicine in Literature