Traditional Chinese medicine (TCM) exerts integrative effects on complex diseases owing to the characteristics of multiple components with multiple targets. However, the syndrome-based system of diagnosis and treatment in TCM can easily lead to bias because of varying medication preferences among physicians, which has been a major challenge in the global acceptance and application of TCM. Therefore, a standardized TCM prescription system needs to be explored to promote its clinical application. In this study, we first developed a gradient weighted disease-target-herbal ingredient-herb network to aid TCM formulation. We tested its efficacy against intracerebral hemorrhage (ICH). First, the top 100 ICH targets in the GeneCards database were screened according to their relevance scores. Then, SymMap and Traditional Chinese Medicine Systems Pharmacology (TCMSP) databases were applied to find out the target-related ingredients and ingredient-containing herbs, respectively. The relevance of the resulting ingredients and herbs to ICH was determined by adding the relevance scores of the corresponding targets. The top five ICH therapeutic herbs were combined to form a tailored TCM prescriptions. The absorbed components in the serum were detected. In a mouse model of ICH, the new prescription exerted multifaceted effects, including improved neurological function, as well as attenuated neuronal damage, cell apoptosis, vascular leakage, and neuroinflammation. These effects matched well with the core pathological changes in ICH. The multi-targets-directed gradient-weighting strategy presents a promising avenue for tailoring precise, multipronged, unbiased, and standardized TCM prescriptions for complex diseases. This study provides a paradigm for advanced achievements-driven modern innovation in TCM concepts.

Objective:To investigate disease characteristics of patients with psoriatic arthritis (PsA) based on the PsA cohort in West China Hospital, so as to provide a reference for clinicians in its diagnosis, treatment, and evaluation strategy formulation.Methods:A cross-sectional study was carried out, and a descriptive analysis was conducted on clinical data from PsA patients who were treated at the Department of Dermatology, West China Hospital, Sichuan University between April 2, 2020, and January 21, 2025. Demographic characteristics, clinical manifestations, laboratory and imaging findings, and treatment modalities were analyzed.Results:A total of 530 PsA patients were included, of whom 332 (62.6%) were males and 198 (37.4%) were females, with ages of 44.1 ± 12.4 years. Skin lesions preceded joint symptoms in 452 patients (85.3%), with time intervals ( M [ Q1, Q3]) of 8.0 (3.0, 15.0) years. Overweight or obesity was observed in 319 patients (60.2%), and 188 (35.5%) had comorbid fatty liver. Peripheral joint involvement was common (485 cases, 91.5%), with the proximal interphalangeal joints being most frequently affected by tenderness (172 cases, 35.5%) and swelling (119 cases, 24.5%) ; the number of enthesitis cases identified by ultrasonography (116 cases, 23.9%) was significantly higher than that by clinical examination (82 cases, 15.5%) ; axial joint involvement was observed in 258 patients (48.7%), with the sacroiliac joints most commonly affected (201 cases, 77.9%). Regarding treatment, conventional systemic drugs were predominant in the treatment of psoriasis prior to the diagnosis of PsA; after the diagnosis of PsA, the number of patients receiving targeted therapies increased to 334 (63.0%), with interleukin-17 inhibitors being the most common (140 cases, 26.4%), followed by tumor necrosis factor-α inhibitors (106 cases, 20.0%) and Janus kinase inhibitors (39 cases, 7.4%) . Conclusions:PsA predominantly affects males over 40 years old and is characterized by preceding skin lesions, delayed diagnosis, and multiple comorbidities. High-frequency ultrasound has advantages in the early detection of peripheral enthesitis. Further attention is needed for managing comorbidities such as fatty liver and obesity-related metabolic conditions.

Traditional Chinese medicine(TCM)exerts integrative effects on complex diseases owing to the char-acteristics of multiple components with multiple targets.However,the syndrome-based system of diagnosis and treatment in TCM can easily lead to bias because of varying medication preferences among physicians,which has been a major challenge in the global acceptance and application of TCM.Therefore,a standardized TCM prescription system needs to be explored to promote its clinical application.In this study,we first developed a gradient weighted disease-target-herbal ingredient-herb network to aid TCM formulation.We tested its efficacy against intracerebral hemorrhage(ICH).First,the top 100 ICH targets in the GeneCards database were screened according to their relevance scores.Then,SymMap and Traditional Chinese Medicine Systems Pharmacology(TCMSP)databases were applied to find out the target-related ingredients and ingredient-containing herbs,respectively.The relevance of the resulting ingredients and herbs to ICH was determined by adding the relevance scores of the corresponding targets.The top five ICH therapeutic herbs were combined to form a tailored TCM prescriptions.The absorbed components in the serum were detected.In a mouse model of ICH,the new prescription exerted multifaceted effects,including improved neurological function,as well as attenuated neuronal damage,cell apoptosis,vascular leakage,and neuroinflammation.These effects matched well with the core pathological changes in ICH.The multi-targets-directed gradient-weighting strategy presents a promising avenue for tailoring precise,multipronged,unbiased,and standardized TCM prescriptions for complex diseases.This study provides a paradigm for advanced achievements-driven modern innovation in TCM concepts.

Aim To evaluate the right atrial function by two-dimensional speckle tracking imaging(2D-STI)combined with real-time three-dimensional echocardiography(RT-3DE)in patients with triple vessel coronary artery disease(TVCAD)without myocardial infarction.Methods Fifty-six patients with TVCAD without myocardial infarc-tion were selected and divided into two groups according to the results of coronary angiography:28 cases with a stenosis rate of 50％～75％and 28 cases with a stenosis rate of ≥75％.In addition,30 healthy volunteers were screened as control group.RT-3DE was performed to obtain the parameters of right atrial volume(RAVmax,RAVmin and RAVp)and then calculated right atrial passive ejection fraction(RAPEF)and right atrial active ejection fraction(RAAEF),and the maxi-mum of right atrial volume index(RAVImax).2D-STI was applied to measure right atrium strain rates during systole,ear-ly diastole and late diastole(RASRs,RASRe and RASRa).Correlation between 2D-STI parameters and N-terminal pro-brain natriuretic peptide(NT-proBNP),Gensini scores were analyzed by Pearson analysis.ROC curve analysis was used to evaluate the diagnostic value of 2D-STI,RT-3DE,and their combined use for right atrial function in TVCAD patients without myocardial infarction.Results Compared with control group,RAPEF and RASRe reduced in stenosis rate of 50％～75％group,while RAAEF and RASRa increased(all P＜0.05).Compared with control group and stenosis rate of 50％～75％group,RAPEF,RASRs,RASRe and RASRa decreased,while RAVmax,RAVmin,RAVp,RAVImax and RAAEF increased in stenosis rate of ≥75％group(all P＜0.05).There was a significant correlation between 2D-STI pa-rameters and NT-proBNP and Gensini scores.The area under the curve of right atrial function in TVCAD patients without myocardial infarction was 0.9048,0.8917 and 0.9564 for 2D-STI,RT-3DE and their combined use,respectively.The diagnostic efficacy of the two methods was significantly higher when used in combination than when used alone,and 2D-STI was superior to RT-3DE.Conclusion When evaluating the right atrial function of TVCAD patients without myocardial infarction,the diagnostic efficacy of 2D-STI combined with RT-3DE is higher than that of using it alone,and 2D-STI is su-perior to RT-3DE.

Objective To compare the differences in stress on maxillary anterior implants and labial cortical bone under varying thicknesses of palatal bone plates through three-dimensional finite element analysis.Methods Using CBCT scan data and finite ele-ment software,a three-dimensional finite element model of maxillary central incisor implant restoration was constructed.The thickness of the palatal bone plate at the cervical region of the implant was set to 0,0.5,1.0 mm,respectively.The effects of different palatal bone plate thicknesses on the equivalent stress of the implant and the minimum principal stress(compressive stress)of the labial corti-cal bone under normal occlusal conditions were simulated.Results Under normal occlusion,when the palatal cervical bone plate thickness was 0,0.5,1.0 mm,the maximum equivalent stress of the implant was consistently located at the midline of the labial cervi-cal region at the implant-abutment interface,with values of 106.8,103.5,99.71 MPa,respectively.Meanwhile,the minimum princi-pal stress of the cortical bone appeared at the alveolar crest at the junction of the implant-abutment and labial alveolar bone,measuring 107.8,103.2,95.55 MPa,respectively.The results indicated that as the palatal cervical bone plate thickness decreased,both the maximum equivalent stress of the implant and the minimum principal stress of the labial cortical bone exhibited an increasing trend,though they remained below their respective yield strengths.Conclusion From a biomechanical perspective,maxillary anterior implant restoration remains feasible even when the thickness of the palatal bone plate at the cervical region of the implant is 0 mm.

Aim To evaluate the right atrial function by two-dimensional speckle tracking imaging(2D-STI)combined with real-time three-dimensional echocardiography(RT-3DE)in patients with triple vessel coronary artery disease(TVCAD)without myocardial infarction.Methods Fifty-six patients with TVCAD without myocardial infarc-tion were selected and divided into two groups according to the results of coronary angiography:28 cases with a stenosis rate of 50％～75％and 28 cases with a stenosis rate of ≥75％.In addition,30 healthy volunteers were screened as control group.RT-3DE was performed to obtain the parameters of right atrial volume(RAVmax,RAVmin and RAVp)and then calculated right atrial passive ejection fraction(RAPEF)and right atrial active ejection fraction(RAAEF),and the maxi-mum of right atrial volume index(RAVImax).2D-STI was applied to measure right atrium strain rates during systole,ear-ly diastole and late diastole(RASRs,RASRe and RASRa).Correlation between 2D-STI parameters and N-terminal pro-brain natriuretic peptide(NT-proBNP),Gensini scores were analyzed by Pearson analysis.ROC curve analysis was used to evaluate the diagnostic value of 2D-STI,RT-3DE,and their combined use for right atrial function in TVCAD patients without myocardial infarction.Results Compared with control group,RAPEF and RASRe reduced in stenosis rate of 50％～75％group,while RAAEF and RASRa increased(all P＜0.05).Compared with control group and stenosis rate of 50％～75％group,RAPEF,RASRs,RASRe and RASRa decreased,while RAVmax,RAVmin,RAVp,RAVImax and RAAEF increased in stenosis rate of ≥75％group(all P＜0.05).There was a significant correlation between 2D-STI pa-rameters and NT-proBNP and Gensini scores.The area under the curve of right atrial function in TVCAD patients without myocardial infarction was 0.9048,0.8917 and 0.9564 for 2D-STI,RT-3DE and their combined use,respectively.The diagnostic efficacy of the two methods was significantly higher when used in combination than when used alone,and 2D-STI was superior to RT-3DE.Conclusion When evaluating the right atrial function of TVCAD patients without myocardial infarction,the diagnostic efficacy of 2D-STI combined with RT-3DE is higher than that of using it alone,and 2D-STI is su-perior to RT-3DE.

Objective:To investigate disease characteristics of patients with psoriatic arthritis (PsA) based on the PsA cohort in West China Hospital, so as to provide a reference for clinicians in its diagnosis, treatment, and evaluation strategy formulation.Methods:A cross-sectional study was carried out, and a descriptive analysis was conducted on clinical data from PsA patients who were treated at the Department of Dermatology, West China Hospital, Sichuan University between April 2, 2020, and January 21, 2025. Demographic characteristics, clinical manifestations, laboratory and imaging findings, and treatment modalities were analyzed.Results:A total of 530 PsA patients were included, of whom 332 (62.6%) were males and 198 (37.4%) were females, with ages of 44.1 ± 12.4 years. Skin lesions preceded joint symptoms in 452 patients (85.3%), with time intervals ( M [ Q1, Q3]) of 8.0 (3.0, 15.0) years. Overweight or obesity was observed in 319 patients (60.2%), and 188 (35.5%) had comorbid fatty liver. Peripheral joint involvement was common (485 cases, 91.5%), with the proximal interphalangeal joints being most frequently affected by tenderness (172 cases, 35.5%) and swelling (119 cases, 24.5%) ; the number of enthesitis cases identified by ultrasonography (116 cases, 23.9%) was significantly higher than that by clinical examination (82 cases, 15.5%) ; axial joint involvement was observed in 258 patients (48.7%), with the sacroiliac joints most commonly affected (201 cases, 77.9%). Regarding treatment, conventional systemic drugs were predominant in the treatment of psoriasis prior to the diagnosis of PsA; after the diagnosis of PsA, the number of patients receiving targeted therapies increased to 334 (63.0%), with interleukin-17 inhibitors being the most common (140 cases, 26.4%), followed by tumor necrosis factor-α inhibitors (106 cases, 20.0%) and Janus kinase inhibitors (39 cases, 7.4%) . Conclusions:PsA predominantly affects males over 40 years old and is characterized by preceding skin lesions, delayed diagnosis, and multiple comorbidities. High-frequency ultrasound has advantages in the early detection of peripheral enthesitis. Further attention is needed for managing comorbidities such as fatty liver and obesity-related metabolic conditions.

Objective To compare the differences in stress on maxillary anterior implants and labial cortical bone under varying thicknesses of palatal bone plates through three-dimensional finite element analysis.Methods Using CBCT scan data and finite ele-ment software,a three-dimensional finite element model of maxillary central incisor implant restoration was constructed.The thickness of the palatal bone plate at the cervical region of the implant was set to 0,0.5,1.0 mm,respectively.The effects of different palatal bone plate thicknesses on the equivalent stress of the implant and the minimum principal stress(compressive stress)of the labial corti-cal bone under normal occlusal conditions were simulated.Results Under normal occlusion,when the palatal cervical bone plate thickness was 0,0.5,1.0 mm,the maximum equivalent stress of the implant was consistently located at the midline of the labial cervi-cal region at the implant-abutment interface,with values of 106.8,103.5,99.71 MPa,respectively.Meanwhile,the minimum princi-pal stress of the cortical bone appeared at the alveolar crest at the junction of the implant-abutment and labial alveolar bone,measuring 107.8,103.2,95.55 MPa,respectively.The results indicated that as the palatal cervical bone plate thickness decreased,both the maximum equivalent stress of the implant and the minimum principal stress of the labial cortical bone exhibited an increasing trend,though they remained below their respective yield strengths.Conclusion From a biomechanical perspective,maxillary anterior implant restoration remains feasible even when the thickness of the palatal bone plate at the cervical region of the implant is 0 mm.

Objective To evaluate the clinical efficacy of invisible orthodontic appliances without brackets for the distal movement of maxillary molars to improve the ability of orthodontists to predict treatment outcomes.Methods Web of Science,Cochrane Library,Embase,PubMed,Wanfang Database,CNKI Database,and VIP Database were searched for studies investigating the efficacy of invisible orthodontic appliances for distal movement of maxillary molars in adult patients and published from database inception to August 1,2023.A total of three researchers screened the studies and evaluated their quality and conducted a meta-analysis of those that met quality standards.Results This study included 13 pre-and postcontrol trials with a total sample size of 281 patients.The meta-analysis revealed no sig-nificant differences in the sagittal or vertical parameters of the jawbone after treatment when compared with those before treatment(P＞0.05).The displacement of the first molar was MD=-2.34,95％CI(-2.83,-1.85);the displacement was MD=-0.95,95％CI(-1.34,-0.56);and the inclination was MD=-2.51,95％CI(-3.56,-1.46).There was a statistically significant difference in the change in sagittal,vertical,and axial tilt of the first molar before and after treatment.After treatment,the average adduction distance of the incisors was MD=-0.82,95％CI(-1.54,-0.09),and the decrease in lip inclination was MD=-1.61,95％CI(-2.86,-0.36);these values were significantly different from those before treat-ment(P＜0.05).Conclusion Invisible orthodontic appliances can effectively move the upper molars in a distal direc-tion and control the vertical position of the molars.When the molars move further away,there is some degree of com-pression and distal tilt movement,which is beneficial for patients with high angles.The sagittal movement of incisors is beneficial for improving the patient's profile.

OBJECTIVE: To carry out genetic analysis for a fetus with confined placental mosaicism (CPM) for trisomy 2 (T2) in conjunct with fetal uniparental disomy (UPD). METHODS: Amniocentesis and chromosomal karyotyping was carried out for a pregnant woman with a high risk for chromosome 2 anomalies indicated by non-invasive prenatal testing (NIPT). Single nucleotide polymorphism array (SNP-array) and trio-whole exome sequencing (Trio-WES) were carried out. Ultrasonography was used to closely monitor the fetal growth. Multifocal sampling of the placenta was performed after delivery for copy number variation sequencing (CNV-seq). RESULTS: The fetus was found to have a normal chromosomal karyotype. SNP-array has revealed multiple regions with loss of heterozygosity (LOH) on chromosome 2. Trio-WES confirmed the presence of maternal UPD for chromosome 2. Ultrasonography has revealed intrauterine growth restriction and oligohydramnios. Intrauterine fetal demise had occurred at 23⁺⁴ weeks of gestation. Pathological examination had failed to find salient visceral abnormality. The placenta was proved to contain complete T2 by CNV-seq. CONCLUSION T2 CPM can cause false positive result for NIPT and may be complicated with fetal UPD, leading to adverse obstetric outcomes such as intrauterine growth restriction, oligohydramnios and intrauterine fetal demise.
Female ; Humans ; Pregnancy ; Amniocentesis ; Chromosomes, Human, Pair 2/genetics* ; DNA Copy Number Variations ; Fetal Death ; Fetal Growth Retardation/genetics* ; Fetus ; Mosaicism ; Oligohydramnios ; Placenta ; Trisomy/genetics* ; Uniparental Disomy/genetics*