Compounds isolated from Epimedium include the total flavonoids of Epimedium , icariin, and its metabolites (icaritin, icariside I, and icariside II), which have similar molecular structures. Modern pharmacological research and clinical practice have proved that Epimedium and its active components have a wide range of pharmacological effects, especially in improving sexual function, hormone regulation, anti-osteoporosis, immune function regulation, anti-oxidation, and anti-tumor activity. To date, we still need a comprehensive source of knowledge about the pharmacological effects of Epimedium and its bioactive compounds on the male reproductive system. However, their actions in other tissues have been reviewed in recent years. This review critically focuses on the Epimedium , its bioactive compounds, and the biochemical and molecular mechanisms that modulate vital pathways associated with the male reproductive system. Such intrinsic knowledge will significantly further studies on the Epimedium and its bioactive compounds that protect the male reproductive system and provide some guidances for clinical treatment of related male reproductive disorders.
Male ; Epimedium/chemistry* ; Humans ; Genitalia, Male/drug effects* ; Flavonoids/therapeutic use* ; Animals

Objective To investigate gender differences and age-related changes in body composition(BC)among Miao adults in Rongshui,Guangxi Province,and to provide the basis for assessing nutritional status and health.Methods With informed consent,630 Miao adults(218 males,412 females)were randomly selected for this study.Body composition was assessed using bioelectrical impedance analysis(BIA).Results Weight,fat-free mass,muscle mass,trunk muscle mass,limb muscle mass,waist-to-hip ratio(WHR),body water,presumtion of bone mass and protein were significantly higher in males than in females.And the fat mass,trunk fat mass,limb fat mass,visceral fat content,subcutaneous fat content and percentage of body fat were significantly higher in females than in males.According to the evaluation of body mass index(BMI)and WHR,the proportion of overweight and obesity of Miao adults was higher than the average level of Miao residents,and their obesity was characterized by central obesity.With age,weight,fat mass,muscle mass,fat-free mass,limb muscle mass,limb fat mass,subcutaneous fat content,percentage of body fat,body water,presumtion of bone mass,and protein of Rongshui Miao adults showed a gradual decreasing trend,while visceral fat content and WHR increased progressively.BMI in male Miao adults,along with BMI,fat mass,trunk fat mass,subcutaneous fat content,percentage of body fat,and body water in female Miao adults,showed a trend of increasing followed by decreasing,peaking at the age of 40-49 years.Conclusion The body composition of Miao adults in Rongshui,Guangxi,exhibits significant gender differences and age-related variation change patterns,which may increase the risk of sarcopenia and metabolic diseases with aging.

Objective To investigate the expression of T cell immunoglobulin and mucin domain-containing protein 3(TIM-3)in peripheral blood mononuclear cells and its relationship with non-small cell lung cancer(NSCLC).Methods TIM-3 expression in monocytes from the peripheral blood of 116 NSCLC patients and 37 healthy volunteers was analyzed via flow cytometry.The expression of TIM-3 in macrophages from tissues was detected via multiplex immunohistochemical staining.Transwell migration experiments were used to detect the migration ability of monocytes.Real-time PCR and ELISA were used to detect the mRNA and protein expression of TIM-3 in monocytes.Results Compared with that in healthy volunteers,TIM-3 expression was upregulated in the peripheral blood monocytes of NSCLC patients(P＜0.05).TIM-3 was expressed mainly in macrophages in adjacent tissues and positively correlated with its expression in monocytes in NSCLC patients(P＜0.05).Furthermore,high TIM-3 expression promoted monocyte migration in NSCLC patients(P＜0.05),and high TIM-3 expression in peripheral blood monocytes indicated poor prognosis(P＜0.05).Conclusion TIM-3 expression in peripheral blood monocytes may be a useful indicator of the disease prognosis of NSCLC patients and TIM-3 could be a new target for immunotherapeutic strategies.

In the field of dental aesthetics,digital aesthetic design plays a crucial role in helping dentists to predict treatment outcomes vis-ually,as well as in enhancing the consistency of knowledge and understanding of aesthetic goals between dentists and patients.It serves as the foundation for achieving ideal aesthetic effects.However,there is no clear standard for this digital process currently in China and abroad.Many dentists lack of systematic understanding of how to carry out digital aesthetic design for treatment.To establish standardized processes for dental aesthetic design and to improve the homogeneity of treatment outcomes,Chinese Society of Digital Dental Industry(CSD-DI)convened domestic experts in related field to compile this consensus.This article elaborates on the key aspects of digital aesthetic data collection,integration steps,and the digital aesthetic design process.It also formulates a decision tree for dental aesthetics at macro level and outlines corresponding workflows for various clinical scenarios,serving as a reference for clinicians.

Objective:To understand the whole genome and genetic evolution characteristics of the first epidemic influenza A (H3N2) viruses in Wuxi from 2022-2023.Methods:Real time fluorescence quantitative RT-PCR method was used to perform typing on respiratory samples of influenza cases. Virus isolation was performed on samples with positive nucleic acid of subtype A H3N2 influenza virus detected. After cell culture, nucleic acid was extracted from strains with red blood cell agglutination test (HA) ≥ 1∶8, whole genome sequence was amplified, library was constructed, and computer sequencing was performed using MiSeq sequencer. Using NC_007366.1 as reference strain, the data were analyzed using CLC Genomics Workbench (Version 23) software. The phylogenetic tree was constructed using MEGA 7.0 software, and the N-glycosylation sites were predicted by NetNGlyc 1.0 Server software.Results:The nucleotide homology and amino acid homology among 35 strains of influenza A H3N2 virus from 2022 to 2023 were 96.4%-100% and 95.2%-100%, respectively. The 16 epidemic strains in 2022 belong to the 3C.2a1b.2a.1a evolutionary branch, while the 19 epidemic strains in 2023 belong to the 3C.2a1b.2a.2a.3a.1 evolutionary branch. There are 7 differences in the nucleotide sequence of the HA gene between the 2022 epidemic strain and the corresponding vaccine strain, sharing 15 mutation sites; There are 28 differences in the nucleotide sequence of the HA gene between the 2023 epidemic strain and the corresponding vaccine strain, sharing 17 mutation sites. The HA genes of 35 epidemic strains all lack N-glycosylation site 61: NSS, while in 2023, the HA genes of 19 epidemic strains added N-glycosylation site 110: NSS.Conclusions:The HA and NA genes of influenza A H3N2 virus in 2022 and 2023 belong to two evolutionary branches, respectively, and both show specific amino acid site changes compared to the corresponding vaccine strains. The antigen matching between the 2022 epidemic strain and the vaccine strain is relatively good, while there is a risk of low antigen matching between the 2023 epidemic strain and the vaccine strain.

Objective To explore the correlation between serum lipid levels of total cholesterol(TC)and triglyceride(TG)and the survival prognosis in postoperative patients with early lung cancer,and to observe the effect of Fuzheng Quxie Prescription on serum lipid levels in postoperative patients with early lung cancer,so as to explore the mechanism of Fuzheng Quxie Prescription in improving the survival prognosis of postoperative patients with early lung cancer.Methods The correlation of serum TC and TG levels with survival prognosis of 257 postoperative patients with early lung cancer admitted in Shanghai Municipal Hospital of Traditional Chinese Medicine from July 2010 to December 2015 was retrospectively analyzed.The changes of serum TC and TG levels in postoperative patients with early lung cancer before and after treatment with Fuzheng Quxie Prescription were statistically analyzed.From January 2017 to April 2021,a prospective analysis of the one-year,two-year,three-year and four-year disease-free survival rates and serum TC and TG levels was carried out in 281 postoperative patients with early lung cancer treated with Fuzheng Quxie Prescription orally in Shanghai Municipal Hospital of Traditional Chinese Medicine(treatment group)and in 287 postoperative patients with early lung cancer who were followed up in clinic while had no medciation in Shanghai Pulmonary Hospital(control group).Results(1)The retrospective study showed that pre-treatment TC level was correlated with progression-free survival(PFS)in postoperative patients with early lung cancer,and the patients with high TC level had longer PFS.There was no significant correlation between pre-treatment TG level and PFS in postoperative patients with early lung cancer.The patients with high TG level had higher short-term survival rate while the patients with low TG level had higher long-term survival rate.(2)The prospective study showed that there were nine cases of recurrence in the treatment group and 24 cases of recurrence in the control group till the last follow-up time on April 1,2021.The one-year,two-year,three-year and four-year disease-free survival rates in the treatment group were 99.3％,96.8％,95.7％and 95.7％,respectively,which were superior to 97.6％,92.3％,89.2％and 87.1％in the control group(P＜0.05),indicating that the recurrence and metastasis in the postoperative patients with early lung cancer treated by Fuzheng Quxie Prescription were significantly reduced when compared with the control group,and the disease-free survival rate was significantly improved.After treatment,the serum levels of TC and TG in the treatment group were increased when compared with those before treatment(P＜0.05)while the control group showed no obvious changes(P＞0.05).The intergroup comparison showed that the increase of serum TC and TG levels in the treatment group was superior to that in the control group(P＜0.05),indicating that Fuzheng Quxie Prescription had regulatory effect on the blood lipid level of patients to a certain extent.Conclusion The analysis of the correlation between pre-treatment blood lipids and PFS prognosis in postoperative patients with early lung cancer indicated that lung cancer patients with high TC level had longer PFS;Fuzheng Quxie Prescription can regulate the blood lipid level of postoperative patients with early lung adenocarcinoma.It is speculated that Fuzheng Quxie Prescription may improve the survival prognosis of postoperative patients with early lung cancer probably by regulating the blood lipid level of the patients.

Objective To evaluate the bioequivalence of a single oral dose of ritonavir in fasted and fed conditions in healthy Chinese adult subjects with the test and reference formulations.Methods A single-center,open-label,randomized,single-dose,two-periods,two-sequence crossover design was used,and 64 subjects were enrolled in both the fasted and fed groups.The subjects received 100 mg of the test preparation or reference preparation orally per cycle,and the drug concentration of ritonavir in plasma was detected using the high performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS)method.Pharmacokinetic parameters were estimated by a non-compartment model,and SAS 9.4 software was used for statistical analysis.Results Arithmetic mean values of the main pharmacokinetic parameters of the subject formulation of ritonavir tablets and the reference formulation in the fasting group:Cmax were(791.90±400.20)and(809.60±449.14)ng·mL-1;AUC0_t were(6 072.61±2 631.98)and(6 296.30±3 388.95)ng·h·mL-1;AUC0-∞ were(6 129.59±2 655.57)and(6 347.26±3 434.12)ng·h·mL-1,respectively.Arithmetic mean values of the main pharmacokinetic parameters of the subject formulation of ritonavir tablets and the reference formulation in the fed group:Cmax were(512.37±233.60)and(521.74±223.87)ng·mL-1;AUC0_t were(4 203.43±2 221.33)and(4 200.13±1 993.50)ng·h·mL-1;AUC0_∞ were(4 259.21±2 266.88)and(4 259.63±2 044.12)ng·h·mL-1.The 90％confidence intervals for the geometric mean ratios of Cmax,AUC0_t and AUC0_∞ of the prototype drug ritonavir in plasma after oral administration of 100 mg of the test and reference formulations of ritonavir tablets under fasting and fed conditions fell within the 80.00％to 125.00％equivalence interval.Conclusion The test and reference formulations of ritonavir tablets were bioequivalent under fasting and postprandial conditions.

Objective To compare the performance of machine learning(ML)and individualized treatment effect(ITE)models based on deep learning in providing personalized treatment recommendations using real-world clinical datasets,and construct personalized drug treatment recommendation models for pegylated liposomal doxorubicin(PLD)and epirubicin(EPI)in postoperative breast cancer patients,and assist clinical decision-making by evaluating the treatment effects of these drugs.Methods Clinical data of 904 breast cancer patients admitted at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine was collected retrospectively,including 387 cases treated with PLD and 517 cases treated with EPI.The two groups were compared using propensity score matching to assess the 5-year disease free survival(DFS)outcome.Six ITE models,including CFR_WASS,were used to predict the 5-year DFS probability of patients under two drug treatments.Six machine learning(ML)models,including Random Forest,were used as baselines for performance analysis and comparison.Model's Predictive performance was evaluated based on the AUROC.The effectiveness of treatment recommendations was assessed by calculating the difference of 5-year rates between the group where the actual treatment used was consistent with the treatment recommended by the model and the control group.Results Among the 153 matched cases,there was no statistically significant difference in 5-year DFS outcomes between the two groups.In 16 pairs of cases,the PLD group showed better clinical outcomes than the EPI group,and in 12 pairs of cases,the EPI group had better clinical outcomes than the PLD group,confirming individual differences in treatment benefit between the two drugs.The CFR_WASS model achieved the optimal predictive performance(AUROC value was 0.736 8),and there was no significant difference in 5-year DFS rates between most ML groups and the control group;The 5-year DFS rate in the ITE group was lower than that in the control group(P<0.01),showing significant differences.Among them,the 5-year DFS rate in the CFR_WASS group was 2.13%lower than that in the control group.Conclusion The ITE model is more accurate in estimating the individualized treatment effects of two drugs compared to the ordinary ML model,providing effective individualized treatment recommendations,and has certain clinical application value.

Objective To explore clinical effect of closed reduction percutaneous elastic intramedullary nail assisted by arthrography in the treatment of radial neck fracture in children.Methods A retrospective analysis was performed on 23 chil-dren with radial neck fracture treated with arthrography assisted closed reduction and percutaneous elastic intramedullary nail internal fixation(arthrography with elastic nail group)from January 2019 to December 2022,including 12 males and 11 fe-males,aged from 2 to 12 years old with an average of(7.36±1.89)years old;According to Judet fracture types,14 children were type Ⅲ and 9 children were type Ⅳ.In addition,23 children with radial neck fracture were selected from January 2015 to December 2018 who were treated with closed reduction and percutaneous elastic intramedullary nail fixation(elastic nail group),including 11 males and 12 females,aged from 2 to 14 years old with an average of(7.50±1.91)years old;Judet classi-fication included 15 children were type Ⅲ and 8 children were type Ⅳ.Operative time and intraoperative fluoroscopy times were compared between two groups.Metaizeau evaluation criteria was used to evaluate fracture reduction,and Tibone-Stoltz evaluation criteria was used to evaluate functional recovery of elbow between two groups.Results Both groups were followed up for 12 to 24 months with an average of(16.56±6.34)months.Operative time and intraoperative fluoroscopy times of elastic nail group were(56.64±19.27)min and(21.13±7.87)times,while those of joint angiography with elastic nail group were(40.33±1 1.50)min and(12.10±3.52)times;there were difference between two groups(P＜0.05).According to Metaizeau evaluation,11 patients got excellent result,9 good and 3 fair in joint angiography with elastic nail group,while in elastic nail group,5 ex-cellent,13 good,4 acceptable,and 1 poor;the difference between two groups was statistically significant(P＜0.05).According to Tibone-Stoltz criteria,14 patients got excellent result,8 good,and 1 fair in joint arthrography with elastic nail group;while in elastic nail group,12 patients got excellent result,9 good,1 fair and 1 poor;there was no significant difference between two groups(P＞0.05).Conclusion Compared to percutaneous elastic intramedullary nail fixation,closed reduction assisted by arthrography has advantages of reduced operation time,decreased intraoperative fluoroscopy frequency,and improved fracture reduction.Arthrography enables clear visualization of the anatomical structures of radius,head,neck,bone,and cartilage in children,facilitating comprehensive display of fracture reduction and brachioradial joint alignment.This technique more pre-cisely guides the depth of elastic intramedullary nail implantation in radius neck,thereby enhancing surgical efficiency and success rate.

Objective To investigate the distribution and antimicrobial resistance profiles of the common pathogens isolated from urine from 2015 to 2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods The bacterial strains were isolated from urine and identified routinely in 51 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Antimicrobial susceptibility was determined by Kirby-Bauer method,automatic microbiological analysis system and E-test according to the unified protocol.Results A total of 261 893 nonduplicate strains were isolated from urine specimen from 2015 to 2021,of which gram-positive bacteria accounted for 23.8％(62 219/261 893),and gram-negative bacteria 76.2％(199 674/261 893).The most common species were E.coli(46.7％),E.faecium(10.4％),K.pneumoniae(9.8％),E.faecalis(8.7％),P.mirabilis(3.5％),P.aeruginosa(3.4％),SS.agalactiae(2.6％),and E.cloacae(2.1％).The strains were more frequently isolated from inpatients versus outpatients and emergency patients,from females versus males,and from adults versus children.The prevalence of ESBLs-producing strains in E.coli,K.pneumoniae and P.mirabilis was 53.2％,52.8％and 37.0％,respectively.The prevalence of carbapenem-resistant strains in E.coli,K.pneumoniae,P.aeruginosa and A.baumannii was 1.7％,18.5％,16.4％,and 40.3％,respectively.Lower than 10％of the E.faecalis isolates were resistant to ampicillin,nitrofurantoin,linezolid,vancomycin,teicoplanin and fosfomycin.More than 90％of the E.faecium isolates were ressitant to ampicillin,levofloxacin and erythromycin.The percentage of strains resistant to vancomycin,linezolid or teicoplanin was＜2％.The E.coli,K.pneumoniae,P.aeruginosa and A.baumannii strains isolated from ICU inpatients showed significantly higher resistance rates than the corresponding strains isolated from outpatients and non-ICU inpatients.Conclusions E.coli,Enterococcus and K.pneumoniae are the most common pathogens in urinary tract infection.The bacterial species and antimicrobial resistance of urinary isolates vary with different populations.More attention should be paid to antimicrobial resistance surveillance and reduce the irrational use of antimicrobial agents.