Objective To explore the magnetic resonance(MR)imaging characteristics of joint damage caused by Chikungunya virus(CHIKV)and its correlation with pain severity,and analyze the value of T2-Mapping in asse-ssing the severity and prognosis of such damage.Methods A multicenter retrospective study design was adopted,and patients with CHIKV infection accompanied by joint pain were included in analysis.Multi-joint MR scans were performed to assess joint effusion,synovial thickening,bone marrow edema,and cartilage damage.T2-Mapping values were measured.Pain severity was assessed using the Visual Analog Scale(VAS),and imaging findings were independently assessed by two radiologists.Results A total of 131 patients were included in the study.The inci-dence of joint cavity and/or synovial sac effusion was the highest(77.1％,n=101),with knee and ankle joint effu-sion accounting for 81.2％(severe,mild-moderate were 17 and 65 cases,respectively),other joint effusion were mild.78 cases had synovial thickening(14 and 64 were severe and mild-moderate cases,respectively),27 cases had tenosynovitis,21 cases had bone marrow edema(primarily in the knee and ankle joints).19 cases had cartilage damage,114 cases presented muscle soft tissue edema(17 and 97 were severe and mild-moderate cases,respective-ly),28 cases had Kager's fat pad edema.Patients with elevated T2-Mapping values exhibited more pronounced chronic joint pain,with T2-Mapping values in the cartilage damage site increasing by 40％-60％compared with normal cartilage site(19 cases in total).The T2-Mapping value for severely damaged soft tissue was(52.3+6.7)ms,while for mildly to moderately damaged soft tissue was(42.3±5.2)ms,both significantly higher than normal refe-rence values(＜35 ms,both P＜0.05).Among 17 patients with severe soft tissue damage,12 experienced persistent pain for over one month,with statistically significant differences in T2 values compared with those with mild-mode-rate damage(P＜0.05).This further suggested that the degree of elevation in T2-Mapping values was closely related to the duration of pain and the severity of damage.After one-month follow-up,103 patients had pain relief.Among the 28 patients with ongoing pain,17 developed into subacute bone joint pain.Bone marrow edema(81.0％),ele-vation of T2-Mapping value of cartilage(89.5％),and severe synovial thickening(71.4％)were high-risk MR manifestations of subacute bone joint pain.The incidences of subacute joint cavity/sac effusion and subacute tenosy-novitis were 3.0％and 7.4％,respectively.Conclusion MR can clearly display the inflammatory and structural changes in CHIKV joint damage,and T2-Mapping values may serve as a potential imaging measurement parameter for assessing severity and prognosis of damage.

Objective To investigate the effect of long non-coding RNA,LINC00839,on the malignant biological behavior of endome-trial cancer(EC)cells via regulating miR-625-5p/MSI1 axis.Methods The expression of LINC00839,miR-625-5p,and MSI1 mRNA in EC tissues and cells was detected by real-time quantitative PCR.Ishikawa cells were selected,and bioinformatics,dual-luciferase reporter gene assay,and RNA-binding protein immunoprecipitation assay were performed to verify the targeting relationship between LINC00839,MSI1,and miR-625-5p.CCK-8,colony formation assay,flow cytometry,and Transwell assay were performed to detect cell proliferation,apoptosis,migration,and invasion.Western blotting was used to detect the expression of MSI1,Bcl-2,Bax,MMP-2,and MMP-9 protein.In vivo tumor formation experiments were conducted to verify the effect of LINC00839 on transplanted tumors in nude mice.Results The expression of LINC00839 and MSI1 mRNA in EC tissues was higher,whereas the expression of miR-625-5p was lower(P＜0.05).LINC00839 and MSI1 targeted miR-625-5p.LINC00839 knockdown or miR-625-5p overexpression suppressed malignant behavior of cells(P＜0.05).Inhibition of miR-625-5p expression or overexpression of MSI1 reversed the inhibitory effect of LINC00839 knockdown or miR-625-5p overexpression on the malignant behavior of cells(P＜0.05).LINC00839 knockdown decreased the volume and mass of transplanted tumors,increased the expression of miR-625-5p,and inhibited the expression of MSI1.Conclusion LINC00839 can target the miR-625-5p/MSI1 axis and regulate the proliferation,apoptosis,migration,and invasion of EC cells.

AIM:To investigate the potential mechanism of licorice on liver injury induced by Se-men Strychni based on network pharmacology,mo-lecular docking combined with animal experiments,providing an effective strategy for prevention and treatment of liver injury induced by Semen Strych-ni.METHODS:Firstly,the active ingredients of Se-men Strychni and licorice were obtained through the ETCM,TCMSP database and analysis platform,CTD database and literature supplementation.Then,the potential toxic ingredients of Semen Strychni were further screened based on the Swis-sADME platform,and the targets corresponding to the active ingredients were predicted through the SwissTargetPrediction platform.By using the Gene-Cards and OMIM databases to collect DILI-related targets,the potential targets for licorice to alleviate liver injury caused by Semen Strychni were ob-tained.By constructing the active ingredient-target network,the core ingredients of licorice in alleviat-ing liver injury caused by Semen Strychni were screened.The key targets obtained were used to construct and analyze the protein-protein interac-tion networks(PPI)through the STRING database and Cytoscape 3.9.0 software.The potential targets were subjected to GO and KEGG pathway enrich-ment analysis with the aid of the DAVID database,and constructed a network of active ingredient-tar-get-pathway.Molecular docking study was ap-proved for the core targets and the active ingredi-ents by using Schrodinger 2023-1 software,and the visualization operation was conducted through Py-mol.Finally,the regulatory effect of licorice on the key pathway of liver injury caused by Semen Strych-ni was validated by establishing a rat model of liver injury induced by Semen Strychni.RESULTS:After screening,6 potential toxic components of Semen Strychni and 104 corresponding targets,89 active components of licorice and 347 corresponding tar-gets,and 3 200 DILI targets were obtained.A total of 23 intersection targets were obtained through Venn analysis.By constructing the active ingredi-ent-target network,it was found that the main core ingredients were 7-methoxy-2-methyl isofla-vone,medicarpin,shinpterocarpin,quercetin,for-mononetin and isoliquiritigenin.The PPI network indicated that the core targets were protein kinase B1(AKT1),epidermal growth factor receptor(EG-FR),human epidermal growth factor receptor 2(ERBB2),glycogen synthase kinase 3 beta(GSK3B),kinase insert domain receptor(KDR)and Janus ki-nase 2(JAK2).A total of 39 relevant pathways were enriched in KEGG(P＜0.01),among which the phos-phatidylinositol 3-kinase(PI3K)-protein kinase B(AKT)(PI3K-AKT)signaling pathway,which has been confirmed and ranks first in enrichment,and was closely related to liver injury.Molecular docking re-sults showed that the core components have good binding ability with the core targets.In vivo animal experiments demonstrated that,compared to the model group,licorice significantly reduced the liver index(P＜0.01),serum levels of alkaline phospha-tase(ALP),alanine aminotransferase(ALT),aspar-tate aminotransferase(AST),indirect bilirubin(IBIL),and total bilirubin(TBIL)in rats with liver in-jury,while increasing total protein(TP)levels(P＜0.05 or P＜0.01).Additionally,licorice alleviated con-gestion in the central veins and hepatic sinusoids,improved the alignment of hepatocytes,and re-duced inflammatory cell infiltration.Furthermore,licorice significantly decreased the levels of malo-ndialdehyde(MDA),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and interleukin-6(IL-6)in the liver tissue of injured rats,while elevating the levels of superoxide dismutase(SOD)and glutathi-one peroxidase(GSH-Px)(P＜0.01).It also markedly downregulated the phosphorylation levels of PI3K and AKT(P＜0.01).CONCLUSION:Licorice has multi-component and multi-target properties in the treat-ment of liver injury induced by Semen Strychni,which may play a hepatoprotective role by inhibit-ing the activation of PI3K-AKT signaling pathway.

Objective To explore the magnetic resonance(MR)imaging characteristics of joint damage caused by Chikungunya virus(CHIKV)and its correlation with pain severity,and analyze the value of T2-Mapping in asse-ssing the severity and prognosis of such damage.Methods A multicenter retrospective study design was adopted,and patients with CHIKV infection accompanied by joint pain were included in analysis.Multi-joint MR scans were performed to assess joint effusion,synovial thickening,bone marrow edema,and cartilage damage.T2-Mapping values were measured.Pain severity was assessed using the Visual Analog Scale(VAS),and imaging findings were independently assessed by two radiologists.Results A total of 131 patients were included in the study.The inci-dence of joint cavity and/or synovial sac effusion was the highest(77.1％,n=101),with knee and ankle joint effu-sion accounting for 81.2％(severe,mild-moderate were 17 and 65 cases,respectively),other joint effusion were mild.78 cases had synovial thickening(14 and 64 were severe and mild-moderate cases,respectively),27 cases had tenosynovitis,21 cases had bone marrow edema(primarily in the knee and ankle joints).19 cases had cartilage damage,114 cases presented muscle soft tissue edema(17 and 97 were severe and mild-moderate cases,respective-ly),28 cases had Kager's fat pad edema.Patients with elevated T2-Mapping values exhibited more pronounced chronic joint pain,with T2-Mapping values in the cartilage damage site increasing by 40％-60％compared with normal cartilage site(19 cases in total).The T2-Mapping value for severely damaged soft tissue was(52.3+6.7)ms,while for mildly to moderately damaged soft tissue was(42.3±5.2)ms,both significantly higher than normal refe-rence values(＜35 ms,both P＜0.05).Among 17 patients with severe soft tissue damage,12 experienced persistent pain for over one month,with statistically significant differences in T2 values compared with those with mild-mode-rate damage(P＜0.05).This further suggested that the degree of elevation in T2-Mapping values was closely related to the duration of pain and the severity of damage.After one-month follow-up,103 patients had pain relief.Among the 28 patients with ongoing pain,17 developed into subacute bone joint pain.Bone marrow edema(81.0％),ele-vation of T2-Mapping value of cartilage(89.5％),and severe synovial thickening(71.4％)were high-risk MR manifestations of subacute bone joint pain.The incidences of subacute joint cavity/sac effusion and subacute tenosy-novitis were 3.0％and 7.4％,respectively.Conclusion MR can clearly display the inflammatory and structural changes in CHIKV joint damage,and T2-Mapping values may serve as a potential imaging measurement parameter for assessing severity and prognosis of damage.

AIM:To investigate the potential mechanism of licorice on liver injury induced by Se-men Strychni based on network pharmacology,mo-lecular docking combined with animal experiments,providing an effective strategy for prevention and treatment of liver injury induced by Semen Strych-ni.METHODS:Firstly,the active ingredients of Se-men Strychni and licorice were obtained through the ETCM,TCMSP database and analysis platform,CTD database and literature supplementation.Then,the potential toxic ingredients of Semen Strychni were further screened based on the Swis-sADME platform,and the targets corresponding to the active ingredients were predicted through the SwissTargetPrediction platform.By using the Gene-Cards and OMIM databases to collect DILI-related targets,the potential targets for licorice to alleviate liver injury caused by Semen Strychni were ob-tained.By constructing the active ingredient-target network,the core ingredients of licorice in alleviat-ing liver injury caused by Semen Strychni were screened.The key targets obtained were used to construct and analyze the protein-protein interac-tion networks(PPI)through the STRING database and Cytoscape 3.9.0 software.The potential targets were subjected to GO and KEGG pathway enrich-ment analysis with the aid of the DAVID database,and constructed a network of active ingredient-tar-get-pathway.Molecular docking study was ap-proved for the core targets and the active ingredi-ents by using Schrodinger 2023-1 software,and the visualization operation was conducted through Py-mol.Finally,the regulatory effect of licorice on the key pathway of liver injury caused by Semen Strych-ni was validated by establishing a rat model of liver injury induced by Semen Strychni.RESULTS:After screening,6 potential toxic components of Semen Strychni and 104 corresponding targets,89 active components of licorice and 347 corresponding tar-gets,and 3 200 DILI targets were obtained.A total of 23 intersection targets were obtained through Venn analysis.By constructing the active ingredi-ent-target network,it was found that the main core ingredients were 7-methoxy-2-methyl isofla-vone,medicarpin,shinpterocarpin,quercetin,for-mononetin and isoliquiritigenin.The PPI network indicated that the core targets were protein kinase B1(AKT1),epidermal growth factor receptor(EG-FR),human epidermal growth factor receptor 2(ERBB2),glycogen synthase kinase 3 beta(GSK3B),kinase insert domain receptor(KDR)and Janus ki-nase 2(JAK2).A total of 39 relevant pathways were enriched in KEGG(P＜0.01),among which the phos-phatidylinositol 3-kinase(PI3K)-protein kinase B(AKT)(PI3K-AKT)signaling pathway,which has been confirmed and ranks first in enrichment,and was closely related to liver injury.Molecular docking re-sults showed that the core components have good binding ability with the core targets.In vivo animal experiments demonstrated that,compared to the model group,licorice significantly reduced the liver index(P＜0.01),serum levels of alkaline phospha-tase(ALP),alanine aminotransferase(ALT),aspar-tate aminotransferase(AST),indirect bilirubin(IBIL),and total bilirubin(TBIL)in rats with liver in-jury,while increasing total protein(TP)levels(P＜0.05 or P＜0.01).Additionally,licorice alleviated con-gestion in the central veins and hepatic sinusoids,improved the alignment of hepatocytes,and re-duced inflammatory cell infiltration.Furthermore,licorice significantly decreased the levels of malo-ndialdehyde(MDA),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and interleukin-6(IL-6)in the liver tissue of injured rats,while elevating the levels of superoxide dismutase(SOD)and glutathi-one peroxidase(GSH-Px)(P＜0.01).It also markedly downregulated the phosphorylation levels of PI3K and AKT(P＜0.01).CONCLUSION:Licorice has multi-component and multi-target properties in the treat-ment of liver injury induced by Semen Strychni,which may play a hepatoprotective role by inhibit-ing the activation of PI3K-AKT signaling pathway.

Objective To investigate the effect of long non-coding RNA,LINC00839,on the malignant biological behavior of endome-trial cancer(EC)cells via regulating miR-625-5p/MSI1 axis.Methods The expression of LINC00839,miR-625-5p,and MSI1 mRNA in EC tissues and cells was detected by real-time quantitative PCR.Ishikawa cells were selected,and bioinformatics,dual-luciferase reporter gene assay,and RNA-binding protein immunoprecipitation assay were performed to verify the targeting relationship between LINC00839,MSI1,and miR-625-5p.CCK-8,colony formation assay,flow cytometry,and Transwell assay were performed to detect cell proliferation,apoptosis,migration,and invasion.Western blotting was used to detect the expression of MSI1,Bcl-2,Bax,MMP-2,and MMP-9 protein.In vivo tumor formation experiments were conducted to verify the effect of LINC00839 on transplanted tumors in nude mice.Results The expression of LINC00839 and MSI1 mRNA in EC tissues was higher,whereas the expression of miR-625-5p was lower(P＜0.05).LINC00839 and MSI1 targeted miR-625-5p.LINC00839 knockdown or miR-625-5p overexpression suppressed malignant behavior of cells(P＜0.05).Inhibition of miR-625-5p expression or overexpression of MSI1 reversed the inhibitory effect of LINC00839 knockdown or miR-625-5p overexpression on the malignant behavior of cells(P＜0.05).LINC00839 knockdown decreased the volume and mass of transplanted tumors,increased the expression of miR-625-5p,and inhibited the expression of MSI1.Conclusion LINC00839 can target the miR-625-5p/MSI1 axis and regulate the proliferation,apoptosis,migration,and invasion of EC cells.

OBJECTIVE To standardize the strategies for prevention and control of Chikungunya(CHIK)in healthcare in-stitutions so as to reduce the risk of transmission in the institutions.METHODS A working group comprising the ex-perts in hospital infection control,infectious diseases,and microbiology systematically reviewed domestic and international evidence and current guidelines,integrated China's vector ecology and healthcare realities,conducted two rounds of Delphi to achieve expert consensus,and graded the evidence and recommendation strength using the Oxford Centre for Evidence Based Medicine system.RESULTS The consensus issues 18 actionable recommendations on triage,patient mosquito-proof isolation,integrated vector control,protection of susceptible populations,environmental cleaning and disinfection,specimen management,medical textile handling,and outbreak emergency response,with each statement assigned an evi-dence level and recommendation strength.CONCLUSION This consensus is for the first time in China to provide evidence-graded strategies for control of CHIK in healthcare institutions,offering work flow-oriented,implementable guidance for clinicians,laboratorians,and infection-control personnel under different risk scenarios and enhancing the comprehensive coping capacity of the healthcare institutions.

OBJECTIVE To standardize the strategies for prevention and control of Chikungunya(CHIK)in healthcare in-stitutions so as to reduce the risk of transmission in the institutions.METHODS A working group comprising the ex-perts in hospital infection control,infectious diseases,and microbiology systematically reviewed domestic and international evidence and current guidelines,integrated China's vector ecology and healthcare realities,conducted two rounds of Delphi to achieve expert consensus,and graded the evidence and recommendation strength using the Oxford Centre for Evidence Based Medicine system.RESULTS The consensus issues 18 actionable recommendations on triage,patient mosquito-proof isolation,integrated vector control,protection of susceptible populations,environmental cleaning and disinfection,specimen management,medical textile handling,and outbreak emergency response,with each statement assigned an evi-dence level and recommendation strength.CONCLUSION This consensus is for the first time in China to provide evidence-graded strategies for control of CHIK in healthcare institutions,offering work flow-oriented,implementable guidance for clinicians,laboratorians,and infection-control personnel under different risk scenarios and enhancing the comprehensive coping capacity of the healthcare institutions.

Ulcerative colitis （UC） is a chronic recurrent inflammatory bowel disease which primarily affects the colonic mucosa. The UC patients mainly present diarrhea， abdominal pain， tenesmus， and mucous bloody stools， and even malnutrition and systemic symptoms in severe cases， with rising incidence， which has a significant impact on the health and quality of life of patients. The pathogenesis of UC is not clear， and the Western medical therapies include sulfasalazine， glucocorticoids， and immunosuppressants， which， however， have side effects and unsatisfactory effects. Chinese medicine with high safety， mild adverse reactions， and a multi-component， multi-target， and multi-pathway treatment manner has garnering increasing attention. Therefore， finding the Chinese medicine to treat UC has become a hot spot. Glycyrrhizae Radix et Rhizoma is one of the commonly used Chinese herbal medicines， with the effects of tonifying spleen and reinforcing qi， clearing heat and detoxifying， dispelling phlegm and relieving cough， relieving pain， and harmonizing medicines. Glycyrrhizae Radix et Rhizoma mainly contains glycyrrhizic acid， glycyrrhetinic acid， diammonium glycyrrhizinate and other active ingredients. Modern pharmacological studies have shown that Glycyrrhizae Radix et Rhizoma has anti-inflammatory， antioxidant， antimicrobial， and immunomodulatory activities. According to statistics， Glycyrrhizae Radix et Rhizoma is among the top three Chinese herbal medicines for the treatment of UC. The recent years have witnessed progress in the treatment of UC with Glycyrrhizae Radix et Rhizoma and the related prescriptions. The present study summarized the mechanisms underlying the anti-inflammatory， immunomodulatory， intestinal flora-regulating， cell apoptosis-inducing， and oxidative stress-reducing effects of the key chemical constituents （glycyrrhetinic acid， diammonium glycyrrhizinate， polysaccharide， glycyrrhetinic acid， and isoglycyrrhizin） and compound prescriptions of Glycyrrhizae Radix et Rhizoma. The findings provide a solid foundation for further development and clinical application of Glycyrrhizae Radix et Rhizoma.

Objective To analyze the role of telehealth?based dialysis registration systems in real?time and dynamic reflection of renal anemia in hemodialysis (HD) patients, and discuss the prospect of its application in dialysis registration management. Methods The Red China project was to build up a dialysis registration system based on the WeChat mobile terminal platform. Demographic and baseline laboratory parameters such as age, gender, primary disease, dialysis age, creatinine were recorded in this system. Hemoglobin (Hb) level was monthly recorded. The platform generated Hb statistics report for each HD center monthly, including the detection rate, target rate and the distribution level of Hb, and released it to physicians through the WeChat terminal of mobile phone. After that, physicians could change the treatment of anemia individually on basis of this report. Here the demographic and baseline laboratory parameters, the detection rate, target rate, the average level and the distribution of Hb from June 2015 to October 2017 after the project launched were analyzed. Results From June 2015 to October 2017, 8392 maintenance HD patients from 28 HD centers in Shanghai were enrolled, of whom 5059(60.3％) were male.The average rate age was (60.5 ± 13.7) years old. Baseline average Hb was (108.3±16.0) g/L. Baseline detection rate and target rate were 54.2％and 47.5％, respectively. After 28 months follow?up, the detection rate of Hb increased from 54.2％ to 73.6％ (P<0.001), the target rate of Hb increased from 47.5％ to 56.1％ (P<0.001), and the level of average Hb rose from (108.3±16.0) g/L to (110.7±16.0) g/L. The difference between average Hb in two consecutive months was less than 1.3 g/L. Conclusions The telehealth?based dialysis registration system can timely report the anemia situation of HD patients, which may improve the awareness rate of anemia, the degree of attention and the compliance of anemia monitoring, so as to improve the detection rate and target rate of Hb and reduce the fluctuation of Hb, which helps to maintain the HD patients to correct anemia in a timely, stable and long?term way. The telehealth?based dialysis registration system, as an improved mode of dialysis registration is a promising way for long?term management of renal anemia in dialysis patients.