Gastric cancer is a common malignant tumor of the digestive tract and can be classified as “fullness of the stomach”， “epigastric pain”， “noise” and other categories in the field of traditional Chinese medicine. Sijunzi decoction is composed of Panax ginseng， Poria cocos， Atractylodes macrocephala， and honey-fried Glycyrrhiza uralensis， and it has the effect of tonifying qi and strengthening the spleen. This article summarizes the active ingredients， mechanism of action， and clinical application research progress of Sijunzi decoction in treating gastric cancer. The results show that the main active ingredients of Sijunzi decoction include ginsenosides， atractylenolide， pachymic acid， glycyrrhizic acid， etc.； Sijunzi decoction and its effective ingredients can play an anti-gastric cancer role by inhibiting the proliferation of gastric cancer cell， inducing apoptosis of gastric cancer cell， enhancing gastric cancer cell chemotherapy sensitivity， and inhibiting invasion and metastasis of gastric cancer cell. In addition， Sijunzi decoction can enhance the efficacy of chemotherapy drugs， strengthen the immune function of the body and lower serum cancer marker levels during the clinical treatment of gastric cancer.

The Mofeng Ointment Formulation （MOF， 摩风膏方） is recorded in the Dunhuang manuscript Unnamed Treatise on the Pulse （《亡名氏脉经》） and stands as a representative ancient external therapeutic formula in traditional Chinese medicine （TCM）. Known for dispelling wind， activating blood circulation， warming the meridians， and relieving pain， it is particularly effective in treating rheumatic arthralgia. Through literature research， this paper systematically reviews the composition， preparation techniques， and clinical application characteristics of MOF. In recent years， advancements in modern pharmaceutical technology have led to the development of various innovative ointment-based formulations derived from the traditional recipe， such as Dunhuang Xiaoding Ointment （敦煌消定膏）， Dunhuang Xiaozhong and Zhentong Ointment （Patch） （敦煌消肿镇痛膏/贴）， Xiaoding Ointment （消定膏） gel patch， and Xiaoding Ointment （消定膏） cataplasm. These innovations explore pathways for transforming classical prescriptions into modern applications， providing a theoretical basis for the external TCM treatment of pain-related and orthopedic conditions.

OBJECTIVE: This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction (MI) in patients with both coronary heart disease (CHD) and type 2 diabetes (T2D). METHODS: We conducted a retrospective cohort study of 33,238 patients with both CHD and T2D in Shenzhen, China. Patients were categorized into 6 groups based on baseline fasting plasma glucose (FPG) levels and diabetes duration (from the date of diabetes diagnosis to the baseline date) to examine their combined effects on subsequent MI. Cox proportional hazards regression models were used, with further stratification by age, sex, and comorbidities to assess potential interactions. RESULTS: Over a median follow-up of 2.4 years, 2,110 patients experienced MI. Compared to those with optimal glycemic control (FPG < 6.1 mmol/L) and shorter diabetes duration (< 10 years), the fully-adjusted hazard ratio ( HR) (95% Confidence Interval [95% CI]) for those with a diabetes duration of ≥ 10 years and FPG > 8.0 mmol/L was 1.93 (95% CI: 1.59, 2.36). The combined effects of FPG and diabetes duration on MI were largely similar across different age, sex, and comorbidity groups, although the excess risk of MI associated with long-term diabetes appeared to be more pronounced among those with atrial fibrillation. CONCLUSION Our study indicates that glycemic control and diabetes duration significant influence the subsequent occurrence of MI in patients with both CHD and T2D. Tailored management strategies emphasizing strict glycemic control may be particularly beneficial for patients with longer diabetes duration and atrial fibrillation.
Humans ; Diabetes Mellitus, Type 2/blood* ; Male ; Female ; Middle Aged ; Aged ; Coronary Disease/complications* ; Myocardial Infarction/etiology* ; Retrospective Studies ; China/epidemiology* ; Glycemic Control ; Blood Glucose ; Adult ; Risk Factors ; Time Factors

Objective Through studying the chemical composition changes before and after the compatibility of Hedysari Radix Paeparata Cum Melle(HRPCM)-vinegar processed Curcumae Rhizoma(VPCR);To discuss the significance of the compatibility of HRPCM and VPCR;To establish the fingerprints before and after their compatibility.Methods ZORBAX Eclipse Plus C18 column was used;acetonitrile-0.01%phosphoric acid water was set as mobile phase,with gradient elution;column temperature was 30℃;detection wavelength was 214 nm;sample injection was 10 μL,which was used to investigate the content difference of major chemical components such as vanillic acid,calycosin-O-β-D-glucopyranoside,ononin,calycosin,onocerin,curdione,cincumol and germacrone,and establish the fingerprint of HRPCM,VPCR and HRPCM-VPCR.Results HPLC chromatographic conditions were established for the determination of 8 components in HRPCM-VPCR.Meanwhile,fingerprints were established before and after the compatibility of HRPCM-VPCR.26 common peaks were identified,among which 11 components such as vanillic acid were derived from HRPCM,14 components such as curcuma zedoariae were derived from VPCR,and 1 component was shared by both.Conclusion The material basis of the compatibility of HRPCM-VPCR differs from that of HRPCM and VPCR.The content of most chemical components decreases while the content of some components increases.The established HPLC method for content determination and fingerprint is simple,stable and reproducible,which can be used to evaluate and control the quality of HRPCM and VPCR.

Objective:To construct a thyroid nodule segmentation model using ultrasound dynamic images and explore its potential for assisting in the screening of thyroid nodules.Methods:A total of 126 patients with thyroid nodules（comprising 150 nodules）who were diagnosed and treated at Xuzhou Cancer Hospital from April 2024 to December 2024 were prospectively enrolled. Two-dimensional ultrasound was performed to capture short-axis and long-axis video images of thyroid nodules，forming a dynamic ultrasound image dataset. The dataset was divided into training，validation，and test sets in a ratio of 6∶1∶3. After the training loss curve converged，the model that performed well on the validation set was selected for testing. Three-fold cross-validation was employed for training and testing. All 300 ultrasound videos were divided into three subsets. In each experiment，two subsets were used as the training set，and one subset was used as the test set to evaluate the model's generalization ability. A collaborative spatiotemporal diffusion model was established based on the dynamic trends and tissue texture details of thyroid nodules. Six widely used segmentation metrics were employed to evaluate the model's application capabilities.Results:The study included 126 patients with 150 thyroid nodules，300 dynamic ultrasound images，and video lengths of 3-4 seconds per nodule，resulting in 12 312 segmented images. The size of the thyroid nodules was（10.7 ± 10.6）mm（transverse diameter）×（8.4 ± 6.3）mm（anteroposterior diameter）. Among the nodules，62（41.3%）had clear boundaries，while 88（58.7%）had indistinct boundaries；61（40.7%）exhibited regular shapes，while 89（59.3%）were irregular；66（44.0%）had a taller-than-wide aspect ratio；and 70（46.7%）showed microcalcifications. The collaborative diffusion model based on dynamic ultrasound image segmentation achieved the following scores：a Jaccard score of（69.22 ± 0.03）%，a Dice score of（79.16 ± 0.18）%，a Precision score of（86.70 ± 0.17）%，a Recall score of（77.82 ± 0.04）%，an Sα score of（85.26 ± 0.01）%，and an Eθmn score of（90.58 ± 0.17）%. Compared to other models，this model demonstrated significant improvements across all evaluation metrics，achieving the highest values in each metric with increments of over 8% and 1%，respectively. Conclusions:The collaborative diffusion model with a dynamic controller，constructed based on dynamic ultrasound images of thyroid nodules，demonstrates excellent performance in ultrasound image segmentation. It improves the accuracy of thyroid nodule screening，thereby providing a valuable auxiliary diagnostic tool for clinical practice.

Taxifolin (TAX) is a natural compound known for its liver protection effect, but the mechanism remains unknown. Phosphorylated proteomics analyses discovered that the phosphorylation level of NDRG1 at T328 was a key event of TAX-improved liver fibrosis. We established models with NDRG1 knockout (KO) in vivo and in vitro, demonstrating that NDRG1 KO attenuated the development of hepatocyte injury, and combining NDRG1 KO and TAX administration did not result in a reduction in protection against liver injury. Cellular thermal shift assay and surface plasma resonance analysis showed that TAX directly binds to NDRG1 rather than its upstream kinase, subsequently demonstrating that TAX regulated phosphorylation of NDRG1 at T328 through binding to its C289 site. NDRG1 T328A (phosphorylated mutation) and T328E (mimic phosphorylation) in vivo and in vitro confirmed that pNDRG1_T328 exacerbates hepatocyte injury along with DNA damage, inflammatory response, and apoptosis, thereby contributing to hepatic stellate cells (HSCs) activation. In contrast, TAX can inhibit the above pathological abnormalities and block hepatocyte injury-triggered HSCs activation and fibrosis. Overall, TAX is a potent liver protection drug primarily targeting NDRG1 and inhibiting pNDRG1_T328 in hepatocytes.

Objective:To analyze the condition of subclinical atherosclerosis (SCA) in patients with psoriatic arthritis (PsA) and to provide a reference for better management of the associated cardiovascular risk in patients with PsA.Methods:Based on the cohort of PsA patients (PKUPsA) in the Department of Rheumatism and Immunology, Peking University First Hospital, 240 PsA patients without previous clinical atherosclerotic disease between July 2018 and June 2024 were included. The demographic data traditional cardiovascular disease risk factors, PsA related indicators and medications were collected when all patients were entered into the cohort. Increased intima-media thickness and/or arterial plaque formation in bilateral carotid arteries examined by ultrasonography are defined as the presence of SCA. Based on this, patients were divided into SCA and no SCA groups, and the two groups were compared and analyzed. Statistics were performed using the Mann-Whitney U test, independent sample t test, χ2 test and Logistic regression analysis. Results:Eighty-five of 240 patients (35.4%) had SCA, including 55 (22.9%) with cIMT thickening and 51 (21.2%) with carotid plaque. Compared with the PsA patients without SCA, patients with SCA were older [55.0 (42.0, 62.5) vs. 42.0(35.0, 53.0) year of age, Z=-4.90, P<0.001], had longer disease course of arthritis [4.6 (1.0, 10.1) vs. 3.0(1.0, 6.1) years, Z=-1.98, P=0.048], more patients with combined hypertension [34.1%(29/85) vs. 15.5%(24/155), χ2=11.08, P<0.001], hyperlipidemia [47.1%(40/85) vs. 27.1%(42/155), χ2=1.22, P=0.002] and the taking of statins [14.1%(12/85) vs. 5.8%(9/155), χ2=4.75 , P=0.029], hypoglycemic agents [10.6%(9/85) vs. 3.9%(6/155), χ2=4.23, P=0.040] and antihypertensive drugs [17.6%(15/85) vs 6.5%(10/155), χ2=7.37, P=0.007]. They also had a higher blood glucose level[5.37 (5.17, 6.09)mmol/L vs. 5.26(4.97, 5.67)mmol/L, Z=-2.82 , P=0.005], low-density lipoprotein [(3.05± 0.76)mmol/L vs. (2.78±0.75)mmol/L, t=2.60, P=0.010] and blood uric acid level[351 (312, 412)μmol/L vs. 333(279, 408)μmol/L, Z=-2.10, P=0.036]. Multivariate analysis showed that older [ OR (95% CI) =1.059 (1.033, 1.086), P<0.001], increased low density lipoprotein [ OR (95% CI) =1.519 (1.018, 2.267), P=0.041] and increased blood uric acid levels [ OR (95% CI)=1.004 (1.001, 1.007), P=0.017] were an independent risk of SCA in PsA patients. Conclusion:More than 1/3 of PsA patients with SCA without past history of clinical atherosclerosis with SCA, advanced age, increased blood low density lipoprotein level, and elevated uric acid level are independent risk factors for PsA with SCA, so attention should be paid to the assessment and management of cardiovascular-related risk. Early intervention can help to improve patient prognosis.

A total of 269 non-diabetic chronic kidney disease (CKD) patients were enrolled in this study. Among them, 175 patients (65.1%) were assigned to the control group and received conventional therapy with maximally tolerated doses of renin-angiotensin-aldosterone system inhibitors, while 94 patients (34.9%) were assigned to the dapagliflozin group and received oral dapagliflozin 10 mg/day in addition to the conventional therapy. The results showed that the urine protein quantity in the dapagliflozin group was lower than those in the control group at 3, 6, 12, 18, and 24 months of follow-up (all P<0.05), and the blood albumin level was higher than those in the control group at 18 and 24 months of follow-up (all P<0.05). The Kaplan-Meier survival curve analysis results showed that the cumulative renal survival rate of the dapagliflozin group was significantly higher than that of the control group (Log-rank test, χ2=5.078, P=0.024). Multivariable Cox regression analysis results revealed that using dapagliflozin was independently associated with a reduced risk of the composite endpoint in non-diabetic CKD patients ( HR=0.400, 95% CI 0.163-0.983, P=0.046). There was no statistical difference in adverse reactions between the two groups (all P>0.05). It is indicated that dapagliflozin has a renal protective effect independent of hypoglycemic action and good safety.

Objective To explore the neuroprotective effects and mechanisms of asiaticoside(AS)in rats with transient cerebral ischemia.Methods One hundred male Sprague-Dawley(SD)rats were randomly divided into five groups:sham-operated(Sham)group,transient middle cerebral artery occlusion(tMCAO)group,and low-,medium-,and high-dose AS(AS-L,AS-M,AS-H)groups,with 20 rats in each group.Except for the Sham group,rats in the other four groups under-went tMCAO surgery.Rats in the AS-L,AS-M,and AS-H groups received intragastric administration of 20,40 and 80 mg/kg AS respectively,once daily for 7 days starting 1 hour post-surgery.Rats in the Sham and tMCAO groups received equivalent volumes of saline.Neurological deficit score,brain water content,and TTC staining were used to evaluate neurological impairment,cerebral edema,and infarct volume.HE staining and Nissl staining wereused to assess histopathological changes and neu-ronal damage.Autophagy was detected via transmission electron microscopy.Immunofluorescence staining was usedto analyze the expression and localization of microtubule-associated protein light chain 3B(LC3B).TUNEL staining was used to evaluate apoptosis,and Western blot was used to measure protein expression.Results Compared with the Sham group,rats in the tMCAO group ex-hibited significantly increased neurological deficit score,brain water content,infarct volume,and histopathological damage,as well as significantly decreased Nissl body counts(P＜0.05).AS dose-dependently reduced neurological deficits,brain water content,infarct volume,and histopatho-logical damage while increased Nissl body numbers.The tMCAO group showed significantly higher numbers of autophagosomes,lysosomes,and LC3B-positive cells,along with significantly elevated LC3-Ⅱ/LC3-Ⅰ,Beclin-1,Bax,cleaved caspase-3 compared to the Sham group;in contrast,p-PI3K,p-Akt,and p-mTOR protein levels,intact mitochondria count and p62 and Bcl-2 protein levels were significantly lower inthe tMCAO group(P＜0.05).Compared with the tMCAO group,AS treatment dose-dependently significantly decreased autophagosomes,lysosomes,LC3B-positive cells,and the expression of LC3-Ⅱ/LC3-Ⅰ,Beclin-1,Bax,cleaved caspase-3 while significantly increased p-PI3K,p-Akt,and p-mTOR protein,intact mitochondria and p62 and Bcl-2 levels(P＜0.05).Conclusion AS exerts neuroprotective effects by inhibiting excessive autophagy and apopto-sis in rats with transient cerebral ischemia via activation of the PI3K/Akt/mTOR signaling pathway.