Patients with Takayasu arteritis combined with aortic valve disease often have a poor prognosis following surgical valve replacement, frequently encountering complications such as perivalvular leakage, valve detachment, and anastomotic aneurysm. This article presents a high-risk case wherein severe aortic valve insufficiency associated with Takayasu arteritis was successfully managed through transcatheter aortic valve implantation via the transapical approach. The patient had satisfactory valve function with no complications observed during the six-month postoperative follow-up. This case provides a minimally invasive and feasible alternative for the clinical management of such high-risk patients.

Objective: To quantify the spatiotemporal factors and built environment effects on daily blood collection volumes at fixed sites using multi-source spatiotemporal data, explore the influence radii of different point of interest(POI) categories, and develop a classification framework for sites, thereby providing data references for efficiency diagnosis and network optimization of blood collection sites. Methods: We collected daily blood donation records from 16 fixed whole blood collection sites in Guangzhou in 2023, constructing a balanced “site-day” panel dataset (16 sites × 365 days = 5 840 observations). Multi-source geospatial data, including Amap POI, OpenStreetMap (OSM) road network, and meteorological data were integrated to establish 300 m, 500 m, 800 m, and 1 000 m buffer zones around each site. Variables extracted included counts of surrounding commercial facilities, distance to the nearest subway station, rainfall, and temperature. A two-way fixed effects panel model was employed with a first-order lag term of the dependent variable to capture the inertial effect of blood donation behavior. Based on the significant regression coefficients, a "Structure-Function Index (SFI)" was constructed for each site to identify its optimal buffer radius. Combining inherent site capacity (fixed effects) with the optimal SFI, a two-dimensional quadrant diagram was created to classify the sites. Results: The optimized model showed an adjusted R of 0.89 and a Durbin-Watson statistic of 1.90, with the lag term coefficient stable at 0.36 (P<0.05). Temporal effects were significant: campaign days increased blood collection by 1 717.75 mL, holidays by 3 755.53 mL, and overlapping holidays with campaign days by 5 650.49 mL (P<0.05). Rainy days reduced collection by approximately 419 mL (P<0.05), and each 1℃ rise in daily average temperature decreased collection by approximately 31 mL (P<0.05). Distance to the nearest subway station was significantly positive (coefficient 0.95-1.39, P<0.05). POI effects showed scale-dependent differences: within 300 m, leisure and entertainment (+173.65 mL/unit) and shopping (+2.95 mL/unit) were significantly positive; within 500 m, tourist attractions (+72.55 mL/unit) and hotels (+40.09 mL/unit) were significantly positive; within 1 000 m, these effects diminished. Based on the two-dimensional classification of inherent collection capacity and optimal SFI, sites were categorized into four types: core, potential, adjustment, and resource-dependent. Conclusion: This study elucidates the multidimensional determinants of blood collection site efficiency, and provides quantitative evidence for performance diagnosis. It proposes a "concentric-zone planning" approach for site selection assessment alongside a" station-specific strategy" classification framework, offering data-driven references for network planning and resource allocation in blood collection and supply institutions. It should be noted that blood donation site selection also involves complex factors such as budgetary constraints, interdepartmental coordination, and venue conditions. This study provides a spatial econometric perspective for the quantitative optimization of blood collection networks.

Puerariae Lobatae Radix and Puerariae Thomsonii Radix are the dried roots of Pueraria lobata and Pueraria thomsonii of the Leguminosae family， respectively. Since their separate inclusion in the 2005 edition of Pharmacopoeia of the People's Republic of China， the two herbs have been individually recorded. Although they share the same functions and indications， the required content of puerarin differs by a factor of up to eightfold between them. The current quality standard relies solely on a single indicator， puerarin， which fails to reflect the correlation between chemical constituents and core therapeutic effects. This has resulted in prominent issues of mixed use in clinical practice and production， thereby constraining the high-quality development of the industry. Modern research has demonstrated that Puerariae Lobatae Radix contains a comprehensive range and higher content of isoflavonoid constituents， while Puerariae Thomsonii Radix is rich in starch and polysaccharides. Puerariae Lobatae Radix exhibits stronger effects in antipyresis， cardiovascular and cerebrovascular protection， and central analgesia， while Puerariae Thomsonii Radix demonstrates greater advantages in anti-inflammation， hypoglycemia， and peripheral analgesia. Based on this， the chemical material bases of Puerariae Lobatae Radix and Puerariae Thomsonii Radix at both the macromolecule and micromolecule levels were systematically reviewed and compared. The pharmacodynamic material bases and mechanisms of action underlying their three core therapeutic effects， namely "relieving exterior syndrome and clearing heat"， "promoting fluid production to quench thirst"， and "dredging channels and activating collaterals"， were summarized. The most highly correlated common metabolic pathway shared by both herbs for these three therapeutic effects is the arachidonic acid metabolic pathway， and their common core target is prostaglandin-endoperoxide synthase 2 （PTGS2）. This review provided clinical application recommendations based on the therapeutic differences between the two herbs， elucidated the scientific connotation of their "same origin but different effects"， and， grounded in the quality marker （Q-Marker）， proposed the concept of efficacy-related Q-Marker based on "substance-efficacy-syndrome" association， as well as a novel strategy for efficacy-oriented quality evaluation. Preliminary screening of quality markers associated with different therapeutic effects was also conducted. This study aims to provide critical scientific evidence for the precise clinical application of Puerariae Lobatae Radix and Puerariae Thomsonii Radix， the improvement of quality standards， and the high-quality development of the industry.

Liver transplantation is a radical treatment for progressive and irreversible end-stage liver disease. However, its clinical application has always been restricted by the core bottleneck of donor liver shortage. Living donor liver transplantation can alleviate the shortage of donor livers to a certain extent, but it requires simultaneous assurance of sufficient residual liver volume in donors to avoid liver insufficiency, as well as an adequate graft-to-recipient weight ratio to prevent small-for-size syndrome, which limits its clinical application. Dual-donor liver transplantation utilizes partial liver tissues from two donors as grafts. While ensuring donor safety, avoiding small-for-size syndrome in recipients, and expanding the donor pool, this technique significantly improves the utilization rate of donor livers and effectively eases the clinical contradiction of donor liver shortage. Based on recent domestic and international clinical practices and the latest diagnosis and treatment guidelines, this article systematically reviews the developmental background, donor and recipient evaluation and selection, surgical procedures and postoperative complications of dual-donor liver transplantation, aiming to provide references for the standardized promotion and clinical optimization of this technique.

ObjectiveTo examine the effects of Chaihu Jia Longgu Muli Tang （CLMT）-containing serum on Neuro-2A cell damage when exposed to conditioned medium from lipopolysaccharide （LPS）-stimulated microglia （BV-2） and explore the underlying mechanism. MethodsBV-2 cells were activated by LPS at a concentration of 1 mg·L^-1 to generate conditioned medium. Concurrently， a blank control group， a model group and groups treated with varying concentrations of CLMT （5%， 10%， and 15%）， dexamethasone （2.5 μmol·L^-1）， stimulator of interferon genes （STING） agonist （MSA-2， 10 μmol·L^-1）， and STING inhibitor （STING-IN-4， 4 μmol·L^-1） were established. Neuro-2A cells were subsequently cultured in the conditioned medium from each treatment group. The viability of BV-2 cells following interventions was assessed by the cell counting kit-8 （CCK-8） assay. The levels of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and interleukin-6 （IL-6） in the supernatant of Neuro-2A cells from each group were measured through enzyme linked immunosorbent assay （ELISA）. Additionally， the expression of tyrosine hydroxylase （TH） in Neuro-2A cells was evaluated through immunohistochemistry （IHC）， while the expression of phosphorylated alpha-synuclein （p-α-Syn） was assessed by immunofluorescence （IF） assay. The expression levels of STING， interferon regulatory factor 3 （IRF3）， phosphorylated interferon regulatory factor 3 （p-IRF3）， nuclear transcription factor-kappa B p65 （NF-κB p65）， and phosphorylated nuclear transcription factor-kappa B p65 （p-NF-κB p65） in Neuro-2A cells were determined by Western blot. ResultsIn comparison to the control group， both the model group and the MSA-2 group exhibited reduced viability of Neuro-2A cells （P<0.01）， elevated concentrations of TNF-α， IL-1β， and IL-6 in the cell supernatant （P<0.01）， reduced expression of TH （P<0.01）， increased expression of p-α-Syn （P<0.01）， and upregulated relative protein levels of STING， p-IRF3， and p-NF-κB p65 （P<0.01）. Compared with the model group， medium- and high-dose CLMT enhanced the viability of Neuro-2A cells （P<0.01）， lowered the levels of TNF-α， IL-1β， and IL-6 （P<0.01）， promoted TH expression， and suppressed p-α-Syn expression （P<0.01）. In the dexamethasone group， the levels of IL-6， TNF-α， and IL-1β were reduced （P<0.05， P<0.01）. In the STING-IN-4 group， the levels of TNF-α and IL-1β were decreased （P<0.01）. The expression of TH was increased in both the dexamethasone group and the STING-IN-4 group （P<0.01）， while the expression of p-α-Syn was reduced （P<0.01）. The relative protein levels of p-IRF3， STING， and p-NF-κB p65 were reduced in medium- and high-dose CLMT groups （P<0.05， P<0.01）. Similarly， the dexamethasone group exhibited decreases in the expression levels of STING， p-IRF3， and p-NF-κB p65 （P<0.01）. In the STING-IN-4 group， the expression levels of p-NF-κB p65， STING， and p-IRF3 were also diminished （P<0.05， P<0.01）. However， no statistically significant differences were observed in the expression of IRF3 or NF-κB p65 across the groups. ConclusionCLMT has the potential to suppress the activation of BV-2 microglial cells， consequently mitigating the inflammatory response induced by LPS and further preventing inflammation-mediated damage to Neuro-2A cells. The underlying mechanism is likely associated with the modulation of the STING/NF-κB signaling pathway， which results in reduced inflammation and confers neuroprotective effects.

The recombinant human thyroid-stimulating hormone (rhTSH) can be used for differentiated thyroid cancer (DTC) preparation before ¹³¹I therapy, and follow-up. Since its approval by the American Food and Drug Administration (FDA) in 1998, rhTSH has been clinically used in European countries, the United States, and other countries for nearly 30 years. In April 2024, China’s first independently developed rhTSH agent was approved. Based on clinical experience and evidence from domestic and international studies, an expert consensus on the application of rhTSH has been developed following thorough consultations among experts. The consensus offers evidence-based recommendations to guide the appropriate use of rhTSH in clinical practice.

Ferroptosis of chondrocytes is a significant contributor to osteoarthritis(OA),for which there is still a lack of safe and effective therapeutic drugs targeting ferroptosis.Here,we screen for anti-ferroptotic drugs in Food and Drug Administration(FDA)-approved drug library via a high-throughput manner in chondrocytes.We identified a group of FDA-approved anti-ferroptotic drugs,among which vitamin K showed the most powerful protective effect.Further study demonstrated that vitamin K effectively inhibited ferroptosis and alleviated the extracellular matrix(ECM)degradation in chondrocytes.Intra-articular injection of vitamin K inhibited ferroptosis and alleviated OA phenotype in destabilization of the medial meniscus(DMM)mouse model.Mechanistically,transcriptome sequencing and knockdown experiments revealed that the anti-ferroptotic effects of vitamin K depended on growth arrest-specific 6(Gas6).Furthermore,exogenous expression of Gas6 was found to inhibit ferroptosis through the AXL receptor tyrosine kinase(AXL)/phosphatidylinositol 3-kinase(PI3K)/AKT serine/threonine kinase(AKT)axis.Together,we demonstrate that vitamin K inhibits ferroptosis and alleviates OA progression via enhancing Gas6 expression and its downstream pathway of AXL/PI3K/AKT axis,indicating vitamin K as well as Gas6 to serve as a potential therapeutic target for OA and other ferroptosis-related diseases.

Objective:To investigate the value of phase-resolved functional lung MRI (PREFUL-MRI) in identifying pulmonary perfusion and ventilation defects in patients with restrictive ventilatory dysfunction (RVD).Methods:This study was a cross-sectional study. Participants were prospectively enrolled from March 2023 to July 2024 at Beijing Chaoyang Hospital, Capital Medical University, where they underwent pulmonary function testing [indicators including first second forced expiratory volume (FEV 1), forced vital capacity(FVC), FVC percent predicted(FVC%pred), FEV 1 percent predicted(FEV 1%pred),et al] and low-dose CT examinations. Based on pulmonary function results, all participants were divided into an RVD group and a control group. The RVD group was further subdivided into a mild RVD subgroup (FEV 1%pred≥70%) and a moderate-to-severe RVD subgroup (FEV 1%pred<70%). All participants underwent PREFUL-MRI examination. Quantitative lung perfusion parameters were measured, including perfusion quantified (Q Quantified) and perfusion defect percentage (QDP). Ventilation parameters were also acquired, including regional ventilation (RVent), flow-volume loop correlation metric (FVL-CM), and ventilation defect percentages (VDP RVent and VDP FVL-CM). Comparisons of continuous variables between groups were performed using the Mann-Whitney U test, while categorical variables were compared using the χ2 test or Fisher′s exact test. Spearman correlation analysis was used to assess the relationships between pulmonary function parameters and lung perfusion and ventilation parameters. Variables showing statistically significant differences between the RVD and control groups, or between the mild and moderate-to-severe RVD subgroups in univariate analyses, were included in multivariate binary logistic regression analysis to identify independent risk factors for the occurrence of RVD and moderate-to-severe RVD, and predictive models were constructed. The predictive performance of the models was evaluated using receiver operating characteristic curves and the area under the curve (AUC). Results:A total of 37 patients were included in the RVD group (23 males and 14 females), with a median age of 59 (52, 75)years. Among them, 18 had mild RVD and 19 had moderate-to-severe RVD. The control group consisted of 49 individuals (39 males and 10 females), with a median age of 55(46.5, 60) years. The RVD group had lower FEV 1%pred, FVC%pred, and Q Quantified, and higher RVent and QDP compared to the control group ( P<0.05). The moderate-to-severe RVD subgroup had lower FEV 1%pred, FVC%pred, and Q Quantified, and higher RVent and QDP than the mild RVD subgroup ( P<0.05). In the RVD group, FEV 1%pred and FVC%pred showed significant positive correlations with RVent and Q Quantified, and significant negative correlations with QDP ( P<0.05). The FEV 1/FVC ratio was positively correlated with RVent and FVL-CM, and negatively correlated with VDP RVent, VDP FVL-CM, and QDP ( P<0.05). Logistic regression analysis revealed that Q Quantified ( OR=0.97, 95% CI 0.94-0.99, P=0.005) and QDP ( OR=1.23, 95% CI 1.07-1.41, P=0.003) were independent predictors of RVD, and the AUC of the predictive model was 0.823. QDP ( OR=1.23, 95% CI 1.07-1.41, P=0.003) was identified as an independent predictor of moderate-to-severe RVD, with the model achieving an AUC of 0.825. Conclusions:PREFUL-MRI facilitates the noninvasive assessment of pulmonary perfusion abnormalities in RVD. The quantitative perfusion parameter serves as a valuable biomarker for detecting RVD and evaluating its severity, offering a novel tool for both pathophysiological research and clinical assessment.

Objective:To investigate whether herb cake-insulated moxibustion affects the expression of cholesterol metabolism-related protein 3-hydroxy-3-methylglutaryl coenzyme A reductase(HMGR)and inhibits the development of atherosclerosis by regulating the exosomal miR-223 expression.Methods:Thirty-six male New Zealand rabbits were randomly assigned to a normal group,a model group,and an herb cake-insulated moxibustion group,with 12 rabbits in each group.The model and the herb cake-insulated moxibustion groups were fed a high-fat diet for 8 weeks to induce an atherosclerosis model.Following successful modeling,the herb cake-insulated moxibustion group was subjected to bundling and herb cake-insulated moxibustion intervention,while the other two groups were subjected only to bundling without moxibustion.After 8 weeks of intervention,hematoxylin-eosin(HE)staining was used to observe aortic morphology;the serum levels of total cholesterol(TC),triglyceride(TG),and low-density lipoprotein cholesterol(LDL-C)were detected using an automatic biochemical analyzer in each group.Exosome morphology was observed using the transmission electron microscope;Western blotting(WB)was used to detect the protein levels of serum exosomal CD63 and CD9 markers,as well as liver HMGR;additionally,real-time fluorescence quantitative polymerase chain reaction was used to quantify serum exosomal miR-223.Results:HE staining showed thickened aortic intima,lipid infiltration,foam cell aggregation,and structural damage to the arterial wall in the model group.Meanwhile,after modeling,the serum levels of LDL-C,TC,and TG increased significantly in the model and herb cake-insulated moxibustion groups compared to the normal group(P<0.05),suggesting successful atherosclerosis rabbit model preparation.The serum exosomes of rabbits in the model group exhibited a saucer-like or semi-concave spherical shape with diameters of 120-150 nm.WB detection results showed positive expression of the exosomal markers CD63 and CD9.After 8 weeks of intervention,the miR-223 level in the model group was significantly lower than that in the normal group(P<0.01).In contrast,the herb cake-insulated moxibustion group demonstrated significantly reduced serum levels of TC,TG,and LDL-C(P<0.05),increased miR-223 expression(P<0.01),and decreased relative liver HMGR protein expression(P<0.05)compared to the model group.Conclusion:Herb cake-insulated moxibustion may alleviate the progression of atherosclerosis by up-regulating exosomal miR-223 expression and down-regulating HMGR protein expression,thereby inhibiting cholesterol anabolic metabolism.

Objective:To identify and validate secreted effector proteins of Chlamydia psittaci ( C. psittaci) through bioinformatic prediction and experimental verification, and to characterize their subcellular localization in host cells. Methods:Potential effector proteins were predicted using bioinformatics tools. Candidate effectors were fused to β-lactamase through the constructed expression vectors, and these vectors were transformed into C. psittaci. The secretion of these candidate effectors was evaluated by β-lactamase translocation assays. Eukaryotic expression vectors of confirmed effectors were transfected into host cells to determine their intracellular localization patterns. Results:Bioinformatic analysis identified 29 candidate effector proteins. Experimental validation confirmed the secretion of five effectors, with four exhibiting cytoplasmic localization and one displaying nuclear localization in host cells.Conclusion:This study characterizes five novel C. psittaci secreted effector proteins, providing critical insights for investigating the molecular pathogenesis of psittacosis.