[Objective]To explore the patterns of diagnosis and prescription in traditional Chinese medicine(TCM),specifically using Polygala tenuifolia Willd formulas,for the treatment of Alzheimer's disease(AD),grounded in the fundamental theories of TCM.[Methods]The medical case documents containing"Poly gala tenuifolia Willd formula for dementia"were included in China National Knowledge Infrastructure(CNKI),VIP,Wanfang and Gujin Medical Case Cloud Platform databases.Furthermore,an Excel 2019 database was created and subsequently standardized.The database was then mined for patterns related to the administration and utilization of medications,by utilizing the Gujin Medical Case Cloud Platform and the Python programming language.Following standardization,the drug application rules were explored by using the Ancient and Modern Medical Case Cloud Platform and Python.[Results]It employed the Ancient and Modern Medical Case Cloud Platform and Python following standardization.A total of 211 kinds of drugs were recorded in 165 medical records,with warm being the most prevalent,followed by neutral.These drugs were mainly sweet,pungent and bitter in taste,and the main effects of the drugs were attributed to the liver,heart,kidney,spleen and lung meridians,and most of the drugs that were paired with Poly gala tenuifolia Willd had functions of opening the orifices,inducing drainage and seepage of dampness,invigorating blood circulation,removing blood stasis and tonifying the deficiency.Acorus calamus and Poly gala tenuifolia Willd were the core pair of drugs with the common dosage of 10 g and 15 g respectively,and the proportion of the two was mostly 1︰1,2︰3.Acorus calamus-Poly gala tenuifolia Willd was often paired with Poria,commonly used pairs were Radix Rehmanniae Preparata-Cornu Cervi,Ligusticum Chuanxiong-Salviae Miltiorrhizae,the complex network analysis showed that the core composition of treating AD was the prescription of Kaixin Powder which removed ginseng but added with the participation of the Radix Rehmanniae Preparata,Salviae Miltiorrhizae,Ligusticum Chuanxiong and Glycyrrhiza glabra.[Conclusion]In this study,among the formulas containing Polygala tenuifolia Willd for AD,the highest correlation was found between Polygala tenuifolia Willd and Acorus calamus,which was mainly used to replenish deficiency and for diarrhea,and focused on strengthening the spleen,resolving dampness and expelling phlegm,regulating the liver and activating the blood,and benefiting the kidneys and filling in the marrow on the basis of tranquilizing the spirit and opening up the aperture to awaken the mind.The preliminary clarification of the medication law of the formulas containing Polygala tenuifolia Willd for the treatment of AD can provide a basis for the clinical use of medication and the development of new prescriptions.

Objective To investigate the association between nutritional status and serum hepcidin and pentraxin 3(PTX3)levels in patients undergoing maintenance hemodialysis(MHD).Methods A total of 76 patients with MHD who met the inclusion criteria were recruited from the hemodialysis center at the Affiliated Hospital of Chengde Medical University.Nutritional status was assessed using the Subjective Global Assessment(SGA),which categorizes patients into three grades:SGA-A,SGA-B,and SGA-C.Serum levels of PTX3 and hepcidin were mea-sured by enzyme-linked immunosorbent assay(ELISA).Statistical analyses were conducted using SPSS software.One-way analysis of variance(ANOVA)was applied to compare differences across the three SGA groups.Logistic regression analysis was performed to identify influencing factors,and receiver operating characteristic(ROC)curve analysis was used to evaluate diagnostic value.Among the participants,45 patients were classified as malnourished based on SGA-B and SGA-C scores,while those with SGA-A constituted the well-nourished control group.Results Among the 76 MHD patients,59.2%were malnourished.We then compared clinical characteristics across the three groups.The results showed that the malnourished group was older and exhibited significantly higher levels of hs-CRP,PTX3,and hepcidin(P<0.05),while serum albumin,creatinine,and phosphorus levels were significantly lower(P<0.05).Pearson correlation analysis revealed positive correlations between SGA grades and hs-CRP,PTX3,and hepcidin levels(all P<0.05).Logistic regression analysis with"malnutrition"as the dependent variable indicated that elevated hs-CRP,PTX3,and hepcidin levels,along with age and male gender,were associated with increased risk of malnutrition in MHD patients,whereas higher serum phosphorus and creatinine levels were protec-tive factors.Further multivariate logistic regression analysis demonstrated that serum PTX3 level was an independent risk factor for malnutrition(P=0.032),while higher creatinine level was an independent protective factor(P=0.047).ROC curve analysis showed that the combination of serum PTX3 and creatinine levels had a high diagnostic value for identifying malnutrition in MHD patients,yielding an AUC of 0.789(P<0.001),a Youden index of 0.448,sensitivity of 77.8%,and specificity of 71.0%.Conclusions Elevated levels of PTX3 and hepcidin,along with reduced serum creatinine levels,are associated with an increased risk of malnutrition in patients undergoing MHD.Notably,elevated serum PTX3 and decreased serum creatinine independently predict malnutrition in this population and demonstrate high predictive value.

BACKGROUND:In the occurrence and development of demyelinating diseases of the central nervous system,neuroinflammation caused by microglia is the main pathological feature,so inhibiting the inflammatory response is very important to alleviate demyelination.Hydroxysafflor yellow A can protect the blood-brain barrier,inhibit neuronal apoptosis,and improve neurological function.OBJECTIVE:To explore the mechanism of hydroxysafflor yellow A inhibiting bicyclohexanone oxalyl dihydrazone-induced demyelination in mice.METHODS:(1)In vivo:Thirty healthy male C57BL/6 mice were randomly divided into three groups:normal group,cuprizone group,and hydroxysafflor yellow A group.The mice in the cuprizone group and the hydroxysafflor yellow A group were fed with 0.2％cuprizone diet for 6 weeks to establish mouse models of demyelination.The mice in the normal group were fed with normal diet.At the end of the 4th week,the mice in the hydroxysafflor yellow A group were intraperitoneally injected with hydroxysafflor yellow A 20 mg/kg per day.The mice in the normal and cuprizone groups were intraperitoneally injected with normal saline for 2 weeks.The behavioral changes of mice were evaluated by open field test and elevated plus maze test.The loss of myelin sheath in corpus callosum was detected by black gold staining,myelin basic protein and degraded myelin basic protein immunofluorescence staining.The activation of microglia and the expression of inflammatory factors were detected by I ba-1 immunofluorescence staining and ELISA,respectively.The protein expression levels of Toll-like receptor 4,myeloid differentiation factor 88,and nuclear factor κB p65 in the brain of mice in each group were detected by western blot assay.(2)In vitro experiment:The inflammation model of BV2 microglia was established by lipopolysaccharide induction.BV2 cells were divided into normal group,lipopolysaccharide group(1 μg/mL),and lipopolysaccharide(1 μg/mL)+hydroxysafflor yellow A(25 μmol/L)group.The expression levels of tumor necrosis factor α and interleukin 6 in the supernatant were detected by ELISA.RESULTS AND CONCLUSION:(1)Compared with the normal group,the mice in the cuprizone group had severe anxiety,abnormal autonomic movement ability,and a large amount of myelin sheath loss in the corpus callosum.The average fluorescence intensity of myelin basic protein was significantly reduced,and the average fluorescence intensity of degraded myelin basic protein was significantly increased.The number of lba1+microglia increased,the contents of interleukin 1β,tumor necrosis factor α,and interleukin 6 in the brain increased,and the protein expression levels of Toll-like receptor 4,myeloid differentiation factor 88,and nuclear factor κB p65 increased significantly.The above symptoms and indexes of mice were reversed after hydroxysafflor yellow A treatment.(2)Hydroxysafflor yellow A significantly inhibited the expression of inflammatory factors such as tumor necrosis factor α,and interleukin 6 induced by lipopolysaccharide in BV2 microglia.(3)The above results demonstrate that hydroxysafflor yellow A can significantly improve cuprizone-induced demyelination in mice.The mechanism of action is related to the inhibition of microglial activation-mediated inflammatory response through the Toll-like receptor 4/myeloid differentiation factor 88/nuclear factor κB p65 signaling pathway.

Objective To explore the value of dual factor combined detection using tuberculosis(TB)specific cy-tokines interferon-γ(IFN-γ)and interleukin-2(IL-2)in TB diagnosis in patients with human immunodeficiency vi-rus(HIV)infection,and the influencing factors for underdiagnosis.Methods HIV-infected patients admitted to and underwent TB-related examination in the Department of Infectious Diseases in Hezhou People's Hospital from July 2022 to September 2024 were collected.According to the clinical diagnosis criteria,patients were divided into the HIV infection with TB group(HIV/TB group)and the HIV infection without TB group(control group).Diag-nostic efficacy of dual factor combined detection was evaluated.HIV/TB group was further divided into a true-posi-tive group and a false-negative group based on the detection results.The independent influencing factors for underdia-gnosis was analyzed using multivariate logistic regression.Results A total of 306 patients were included in the analysis,with an average age of(55.69±14.02)years.There were 105 patients in the HIV/TB group and 201 in the control group.The sensitivity and specificity of dual factor combined detection for TB in all HIV-infected pa-tients were 72.4％(76/105)and 87.1％(175/201),respectively.There was a statistically significant difference in sensitivity(x2=9.488,P=0.009)and no statistically significant difference in specificity(x2=5.846,P=0.054)among the three CD4+T lymphocyte count gradients in the dual factor detection.Among them,patients with CD4+T cell count＜100 cells/μL had lower sensitivity(58.8％)in dual factor detection than patients with CD4+T cell count ≥200 cells/μL(88.9％)and 100-199 cells/μL(81.5％),differences were both statistically significant(both P＜0.05).In HIV/TB co-infected patients with CD4+T lymphocyte count ≥100 cells/μL,the general sensi-tivity and the specificity of dual factor combined detection were 85.2％(46/54)and 82.0％(91/111),respectively.Multivariate analysis showed that CD4+T lymphocyte count was an independent influencing factor for the underdia-gnosis in HIV/TB patients conducting dual factor combined detection(P＜0.05),while age,gender,pathogen re-sults,and the presence or absence of TB had no statistically significant impact on the results of dual factor combined detection(all P＞0.05).Conclusion Dual factor combined detection using tuberculosis-specific cytokines IFN-γand IL-2 has a high diagnostic value in the diagnosis of TB in HIV-infected patients,especially in those with CD4+T lymphocyte count ≥100/μL,which can provide auxiliary diagnostic value for the clinical diagnosis of HIV infection combined with TB.

Objective To investigate the association between nutritional status and serum hepcidin and pentraxin 3(PTX3)levels in patients undergoing maintenance hemodialysis(MHD).Methods A total of 76 patients with MHD who met the inclusion criteria were recruited from the hemodialysis center at the Affiliated Hospital of Chengde Medical University.Nutritional status was assessed using the Subjective Global Assessment(SGA),which categorizes patients into three grades:SGA-A,SGA-B,and SGA-C.Serum levels of PTX3 and hepcidin were mea-sured by enzyme-linked immunosorbent assay(ELISA).Statistical analyses were conducted using SPSS software.One-way analysis of variance(ANOVA)was applied to compare differences across the three SGA groups.Logistic regression analysis was performed to identify influencing factors,and receiver operating characteristic(ROC)curve analysis was used to evaluate diagnostic value.Among the participants,45 patients were classified as malnourished based on SGA-B and SGA-C scores,while those with SGA-A constituted the well-nourished control group.Results Among the 76 MHD patients,59.2%were malnourished.We then compared clinical characteristics across the three groups.The results showed that the malnourished group was older and exhibited significantly higher levels of hs-CRP,PTX3,and hepcidin(P<0.05),while serum albumin,creatinine,and phosphorus levels were significantly lower(P<0.05).Pearson correlation analysis revealed positive correlations between SGA grades and hs-CRP,PTX3,and hepcidin levels(all P<0.05).Logistic regression analysis with"malnutrition"as the dependent variable indicated that elevated hs-CRP,PTX3,and hepcidin levels,along with age and male gender,were associated with increased risk of malnutrition in MHD patients,whereas higher serum phosphorus and creatinine levels were protec-tive factors.Further multivariate logistic regression analysis demonstrated that serum PTX3 level was an independent risk factor for malnutrition(P=0.032),while higher creatinine level was an independent protective factor(P=0.047).ROC curve analysis showed that the combination of serum PTX3 and creatinine levels had a high diagnostic value for identifying malnutrition in MHD patients,yielding an AUC of 0.789(P<0.001),a Youden index of 0.448,sensitivity of 77.8%,and specificity of 71.0%.Conclusions Elevated levels of PTX3 and hepcidin,along with reduced serum creatinine levels,are associated with an increased risk of malnutrition in patients undergoing MHD.Notably,elevated serum PTX3 and decreased serum creatinine independently predict malnutrition in this population and demonstrate high predictive value.

This report described a periviable extremely preterm infant who received Nirsevimab before discharge for preventing respiratory syncytial virus infection. The infant was born at 22?3 weeks' gestation with a birth weight of 360 g. Nirsevimab was administered on January 12, 2025 (110 days after birth, corrected gestational age of 38?2 weeks) at the Women and Children's Medical Center of Southern Medical University (Shenzhen Maternity & Child Healthcare Hospital). No local or systemic adverse reactions were observed following administration. Follow-up until 1 year and 2 months of age (November 2025) revealed no occurrence of respiratory syncytial virus infection.

Objective:To identify and validate the key genes of ferroptosis in phospholipase A2 receptor (PLA2R) associated membranous nephropathy through bioinformatics analysis and in vitro experiments, and to explore the potential role of ferroptosis in PLA2R associated membranous nephropathy (PMN). Methods:The GSE115857 dataset obtained by retrieving the Gene Expression Omnibus (GEO) database and the ferroptosis-related genes obtained by retrieving the FerrDb database were intersected. The intersected genes were subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. The key ferroptosis genes associated with PMN were identified by intersecting genes selected using support vector machines-recursive feature elimination and least absolute shrinkage and selection operator regression. The results were validate by real-time PCR, cell counting kit-8, Western blotting and immunofluorescence in human renal podocyte line AB 8/13 from both the control group and model group.Results:A total of 25 genes related to ferroptosis of PMN were obtained, and GO and KEGG analysis showed that these genes were mainly involved in cell ferroptosis metabolism. The key ferroptosis genes of PMN obtained by machine learning method were activating transcription factor 3 ( ATF3) and coiled coil domain containing 6 ( CCDC6). The results of in vitro experiments showed that the human renal podocyte line AB 8/13 in the model group was significantly deformed and retracted compared with the control group. The surface area density of foot processes was significantly reduced, and the podocyte cytoskeleton was allosteric. The morphology of F-actin was disordered and the expression of synaptopodin was decreased. The cell proliferation activity was significantly decreased ( P<0.05). The expression of PLA2R protein was increased ( P<0.05), and the expression of GPX4 protein was decreased ( P<0.01). The protein and mRNA levels of ATF3 and CCDC6 were significantly up-regulated (all P<0.05). Conclusions:Ferroptosis may be one of the key mechanisms in the occurrence and development of PMN. In vitro experiments show that ATF3 and CCDC6 are the key genes in the ferroptosis of PMN podocytes, which provides new insights and ideas for the pathogenesis of PMN.

Objective To investigate the renal function recovery and perioperative risk factors for chronic kidney disease in patients after acute Stanford type A aortic dissection (ATAAD) repair. Methods A retrospective study was conducted on patients who underwent ATAAD repair at the Xiamen Cardiovascular Hospital, Xiamen University from 2020 to 2021, and their clinical data were analyzed. Results A total of 255 patients were included, with 200 males and 55 females, and an average age of (52.80±12.46) years. The incidence of acute kidney injury (AKI) after ATAAD repair was 43.9%. Dissection involving the renal artery [OR=2.144, 95%CI (1.234, 3.765), P=0.007], intraoperative urine output [OR=0.761, 95%CI (0.625, 0.911), P=0.004], and intraoperative red blood cell transfusion [OR=1.288, 95%CI (1.088, 1.543), P=0.004] were significantly associated with early AKI after ATAAD repair. Long-term renal function follow-up data were available for 232 patients, among whom 40 (17.2%) patients developed chronic kidney disease (CKD). Independent predictors for CKD included lower body mass index [OR=0.827, 95%CI (0.723, 0.931), P=0.003], preoperative cardiac tamponade [OR=5.344, 95%CI (1.65, 17.958), P=0.005], preoperative renal hypoperfusion syndrome [OR=12.629, 95%CI (5.003, 35.373), P<0.001], postoperative peak serum creatinine time>3 d [OR=7.566, 95%CI (2.799, 22.731), P<0.001], and AKI grade [grade 1: OR=4.418, 95%CI (1.339, 15.361), P=0.016; grade 2: OR=8.345, 95%CI (1.762, 40.499), P=0.007; grade 3: OR=9.463, 95%CI (2.602, 37.693), P<0.001]. Conclusion AKI related to ATAAD repair can recover in the early postoperative period, but both the duration and severity of AKI will affect long-term renal function. In addition, patients' nutritional status, preoperative cardiac tamponade, and renal hypoperfusion syndrome are also independent risk factors for long-term renal dysfunction.

Objective:To identify and validate the key genes of ferroptosis in phospholipase A2 receptor (PLA2R) associated membranous nephropathy through bioinformatics analysis and in vitro experiments, and to explore the potential role of ferroptosis in PLA2R associated membranous nephropathy (PMN). Methods:The GSE115857 dataset obtained by retrieving the Gene Expression Omnibus (GEO) database and the ferroptosis-related genes obtained by retrieving the FerrDb database were intersected. The intersected genes were subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. The key ferroptosis genes associated with PMN were identified by intersecting genes selected using support vector machines-recursive feature elimination and least absolute shrinkage and selection operator regression. The results were validate by real-time PCR, cell counting kit-8, Western blotting and immunofluorescence in human renal podocyte line AB 8/13 from both the control group and model group.Results:A total of 25 genes related to ferroptosis of PMN were obtained, and GO and KEGG analysis showed that these genes were mainly involved in cell ferroptosis metabolism. The key ferroptosis genes of PMN obtained by machine learning method were activating transcription factor 3 ( ATF3) and coiled coil domain containing 6 ( CCDC6). The results of in vitro experiments showed that the human renal podocyte line AB 8/13 in the model group was significantly deformed and retracted compared with the control group. The surface area density of foot processes was significantly reduced, and the podocyte cytoskeleton was allosteric. The morphology of F-actin was disordered and the expression of synaptopodin was decreased. The cell proliferation activity was significantly decreased ( P<0.05). The expression of PLA2R protein was increased ( P<0.05), and the expression of GPX4 protein was decreased ( P<0.01). The protein and mRNA levels of ATF3 and CCDC6 were significantly up-regulated (all P<0.05). Conclusions:Ferroptosis may be one of the key mechanisms in the occurrence and development of PMN. In vitro experiments show that ATF3 and CCDC6 are the key genes in the ferroptosis of PMN podocytes, which provides new insights and ideas for the pathogenesis of PMN.

Objective:To investigate the anemia conditions and characteristics of iron metabolism during different stages of pregnancy in women with different genotypes of thalassemia.Methods:This cohort study selected 3 303 singleton pregnant women who underwent regular prenatal examinations and genetic tests of thalassemia and were delivered at Maternal & Child Health Hospital of Guangxi Zhuang Autonomous Region from January 2019 to December 2023. According to the results of thalassemia gene testing, the women were divided into groups: those without thalassemia genes served as the control group (1 539 cases), and those with thalassemia genes (1 764 cases) were further divided based on genotype into the -α/αα group (326 cases), --/αα or -α/-α group (649 cases), point mutation α-thalassemia group (201 cases), β 0-thalassemia group (368 cases), β +-thalassemia group (91 cases), and α combined with β-thalassemia group (129 cases). Hemoglobin (Hb) and serum ferritin (SF) levels were measured in the first, second, and third trimester of pregnancy. Differences in anemia and iron reserves among the groups at different pregnancy stages were compared using repeated measures analysis of variance, LSD test, Kruskal-Wallis rank-sum test, and Bonferroni correction. Results:Compared to the first trimester, Hb levels decreased in the second and third trimester across all groups (LSD test, all P<0.05), and the severity of anemia increased (Bonferroni correction, all P<0.017). The severity of anemia varied among the groups at the same pregnancy stage ( Hfirst trimester=918.20, Hsecond trimester=1 224.50, Hthird trimester=980.19; all P<0.001), and Hb levels also differed ( Ffirst trimester=282.54, Fsecond trimester=352.31, Fthird trimester=239.02; all P<0.001). The β 0-thalassemia group had higher rates of moderate anemia in the first, second, and third trimester of pregnancy [38.6% (142/368), 85.3% (314/368), and 73.6% (271/368)] compared to other groups (Bonferroni correction, all P<0.002), and lower Hb levels [(102.1±8.9), (92.0±7.3), and (94.6±7.7) g/L] than other groups (LSD test, all P<0.05). As pregnancy progresses, SF levels in each group of pregnant women gradually decreased (LSD test, all P<0.05), and the degree of iron deficiency worsened (Bonferroni correction, all P<0.05). The iron deficiency rate in thalassemia pregnant women during the third trimester ranges from 21.5% (79/368) to 46.0% (150/326). The degree of iron deficiency varies among groups within the same gestational period ( Hfirst trimester=79.13, Hsecond trimester=203.98, Hthird trimester=130.55; all P<0.001), and SF levels also differ ( Ffirst trimester=17.28, Fsecond trimester=44.60, Fthird trimester=31.87; all P<0.001). Among them, the β 0-thalassemia group had the lowest iron deficiency rates in the second, and third trimesters [9.8% (36/368), and 21.5% (79/368)] (Bonferroni correction, all P<0.002). SF levels in the β 0-thalassemia and β +-thalassemia groups were higher than those in other groups during each gestational period (LSD test, all P<0.05). Conclusions:Pregnant women with thalassemia may experience varying degrees of iron deficiency during pregnancy, with the severity of iron deficiency and anemia increasing with gestational age. The degree of iron deficiency and anemia during pregnancy varies among pregnant women with different genotypes of thalassemia. Clinically, individualized management should be provided for pregnant women with thalassemia based on their genotypes, with dynamic monitoring of anemia and iron metabolism changes.