Objective To investigate the therapeutic effect of Huangkui capsules on targeted drug-related proteinuria in patients with hepatocellular carcinoma (HCC). Methods A retrospective analysis was conducted on clinical data of HCC patients with targeted drug-related proteinuria from June 2023 to December 2024 at Zhongshan Hospital, Fudan University. According to the treatment plan, patients were divided into the conventional treatment group and the Huangkui combination treatment group (Huangkui capsules combined with conventional treatment), and the clinical efficacy between the two groups was compared. The logistic regression analysis was used to identify the main factors affecting treatment efficacy. Results The Huangkui combination treatment group (n＝29) showed a significantly higher overall effective rate (79.3% vs 42.3%, P＝0.005), and an earlier proteinuria improvement (median time: 3 months vs 6 months, P＝0.008) than the conventional treatment group (n＝26) . The multivariate logistic regression analysis showed angiotensin-converting enzyme inhibitor (ACEI) or angiotensin Ⅱ receptor blocker (ARB) using (OR＝0.190, 95%CI 0.045-0.808, P＝0.025), targeted drug adjustment (OR＝0.132, 95%CI 0.030-0.581, P＝0.007), and Huangkui capsules using (OR＝0.168, 95%CI 0.039-0.730, P＝0.017) were protective factors for treatment efficacy of targeted drug-related proteinuria. Conclusions On the basis of conventional treatment, additive treatment with Huangkui capsules can alleviate targeted drug-related proteinuria faster and more effectively in HCC patients.

OBJECTIVE: To evaluate the dynamic changes of glucocorticoid (GC) dose and the feasibility of GC discontinuation in rheumatoid arthritis (RA) patients under the background of Chinese medicine (CM). METHODS: This multicenter retrospective cohort study included 1,196 RA patients enrolled in the China Rheumatoid Arthritis Registry of Patients with Chinese Medicine (CERTAIN) from September 1, 2019 to December 4, 2023, who initiated GC therapy. Participants were divided into the Western medicine (WM) and integrative medicine (IM, combination of CM and WM) groups based on medication regimen. Follow-up was performed at least every 3 months to assess dynamic changes in GC dose. Changes in GC dose were analyzed by generalized estimator equation, the probability of GC discontinuation was assessed using Kaplan-Meier curve, and predictors of GC discontinuation were analyzed by Cox regression. Patients with <12 months of follow-up were excluded for the sensitivity analysis. RESULTS: Among 1,196 patients (85.4% female; median age 56.4 years), 880 (73.6%) received IM. Over a median 12-month follow-up, 34.3% (410 cases) discontinued GC, with significantly higher rates in the IM group (40.8% vs. 16.1% in WM; P<0.05). GC dose declined progressively, with IM patients demonstrating faster reductions (median 3.75 mg vs. 5.00 mg in WM at 12 months; P<0.05). Multivariate Cox analysis identified age <60 years [P<0.001, hazard ratios (HR)=2.142, 95% confidence interval (CI): 1.523-3.012], IM therapy (P=0.001, HR=2.175, 95% CI: 1.369-3.456), baseline GC dose ⩽7.5 mg (P=0.003, HR=1.637, 95% CI: 1.177-2.275), and absence of non-steroidal anti-inflammatory drugs use (P=0.001, HR=2.546, 95% CI: 1.432-4.527) as significant predictors of GC discontinuation. Sensitivity analysis (545 cases) confirmed these findings. CONCLUSIONS RA patients receiving CM face difficulties in following guideline-recommended GC discontinuation protocols. IM can promote GC discontinuation and is a promising strategy to reduce GC dependency in RA management. (Trial registration: ClinicalTrials.gov, No. NCT05219214).
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Arthritis, Rheumatoid/drug therapy* ; Glucocorticoids/therapeutic use* ; Medicine, Chinese Traditional ; Retrospective Studies

Objective To analyze the characteristics of adult body composition and obesity status of three ethnic groups:Ewenki,Daur and Mongolian Buryat.Methods The bioelectrical impedance analysis(BIA)was used to measure 18 body composition components in three adults ethnic groups:245(male 124,female 121)Ewenki,207(male 90,female 117)Daur,and 181(male 74,female 107)Mongolian Buryat.The data were processed using Excel 2016 and SPSS 24.0 statistical software.Results The result of correlation analysis showed that visceral fat level was significantly and positively correlated with age(P＜0.01).Stature,total body muscle mass,estimated bone mass and trunk muscle mass were all significantly and negatively correlated with age(P＜0.01)in males and females of the three ethnic groups.The percent body fat,percent left upper limb fat and percent trunk fat were positively correlated with age in Ewenki males(P＜0.05 or P＜0.01)and the percent body fat,body mass index(BMI),percent limb fat and percent trunk fat were positively correlated with age in Ewenki females(P＜0.05 or P＜0.01).Body weight,BMI,percent left upper limb fat,left upper limb muscle mass,bilateral lower limb fat and muscle mass were all negatively correlated with age in Daur males(P＜0.05 or P＜0.01).Body weight,upper limb muscle mass and left lower limb muscle mass were negatively correlated with age(P＜0.05 or P＜0.01)in Mongolian Buryat males and percent trunk fat was positively correlated with age(P＜0.05)in Mongolian Buryat females.Comparison between ethnic groups showed that most of the body composition index values of the Ewenki and Mongolian Buryat divisions were closest to each other,and the body fat content was higher than that of the Daur.BMI,percent body fat and visceral fat level were all manifested in the Mongolian Buryat Department＞Ewenki＞Daur.Cluster analysis showed that Ewenki,Daur and Mongolian Buryat were closer to the northern groups and further from the southern groups.Conclusion The Ewenki is most similar to the Mongolian Buryat in body composition characteristics all three ethnic groups has a more serious obesity problem.

Objective:To investigate the association of serum levels of tumor necrosis factor receptor-related factor 6(TRAF6)and histone deacetylase 3(HDAC3)with severity of coronary artery disease and prognosis in patients with acute myocardial infarction(AMI).Methods:A total of 122 AMI patients admitted Macheng Traditional Chinese Medicine Hospital between July 2019 and December 2020 were selected,divided into low score group(n=73,＜20 points)and high score group(n=49,≥20 points)according to Gensini score.Association of serum levels of TRAF6 and HDAC3 with Gensini score was analyzed by Pearson method.According to survival condition during hospitalization within 28d,they were divided into survival group(n=85)and death group(n=37).Cox regression model was used to analyze the influencing factors for death within 28d in AMI patients;receiver operating charac-teristic(ROC)curve was used to analyze the predictive efficacy of TRAF6 and HDAC3 for death within 28d in AMI patients.Results:Patients in high score group had significant higher serum levels of TRAF6[(6.01±2.39)μg/ml vs.(5.06±1.74)μg/ml,P=0.012]and HDAC3[(4.14±1.94)ng/ml vs.(2.87±1.37)ng/ml,P＜0.001]compared with low score group.Pearson correlation analysis indicated that serum levels of TRAF6 and HDAC3 were positively correlated with Gensini score(r=0.879,0.837,P＜0.001 all).Patients in death group had significant higher serum levels of TRAF6[(6.89±1.67)μg/ml vs.(4.81±1.24)μg/ml,P＜0.001]and HDAC3[(5.37±1.77)ng/ml vs.(2.52±0.76)ng/ml,P＜0.001]compared with those in survival group.Cox regression analysis indicated that Gensini score[HR=1.857,95％CI 1.259～2.737,P=0.001],TRAF6[HR=1.659,95％CI 1.083～2.543,P=0.022],HDAC3[HR=1.779,95％CI 1.192～2.653,P=0.004]were independent risk factors for death within 28d in AMI patients.ROC curve analysis indicated that AUC of TRAF6,HDAC3 and their combina-tion predicting death within 28d in AMI patients was 0.862,0.859 and 0.971 respectively,and AUC of combination was significantly higher than those of TRAF6 and HDAC3 alone(Z=2.535,2.032,P=0.011,0.042).Conclu-sion:Serum levels of TRAF6 and HDAC3 are closely related to severity of coronary artery disease and prognosis in AMI patients,and dual combination possesses good predictive value for prognosis in AMI patients.

Objective:To investigate the association of serum levels of tumor necrosis factor receptor-related factor 6(TRAF6)and histone deacetylase 3(HDAC3)with severity of coronary artery disease and prognosis in patients with acute myocardial infarction(AMI).Methods:A total of 122 AMI patients admitted Macheng Traditional Chinese Medicine Hospital between July 2019 and December 2020 were selected,divided into low score group(n=73,＜20 points)and high score group(n=49,≥20 points)according to Gensini score.Association of serum levels of TRAF6 and HDAC3 with Gensini score was analyzed by Pearson method.According to survival condition during hospitalization within 28d,they were divided into survival group(n=85)and death group(n=37).Cox regression model was used to analyze the influencing factors for death within 28d in AMI patients;receiver operating charac-teristic(ROC)curve was used to analyze the predictive efficacy of TRAF6 and HDAC3 for death within 28d in AMI patients.Results:Patients in high score group had significant higher serum levels of TRAF6[(6.01±2.39)μg/ml vs.(5.06±1.74)μg/ml,P=0.012]and HDAC3[(4.14±1.94)ng/ml vs.(2.87±1.37)ng/ml,P＜0.001]compared with low score group.Pearson correlation analysis indicated that serum levels of TRAF6 and HDAC3 were positively correlated with Gensini score(r=0.879,0.837,P＜0.001 all).Patients in death group had significant higher serum levels of TRAF6[(6.89±1.67)μg/ml vs.(4.81±1.24)μg/ml,P＜0.001]and HDAC3[(5.37±1.77)ng/ml vs.(2.52±0.76)ng/ml,P＜0.001]compared with those in survival group.Cox regression analysis indicated that Gensini score[HR=1.857,95％CI 1.259～2.737,P=0.001],TRAF6[HR=1.659,95％CI 1.083～2.543,P=0.022],HDAC3[HR=1.779,95％CI 1.192～2.653,P=0.004]were independent risk factors for death within 28d in AMI patients.ROC curve analysis indicated that AUC of TRAF6,HDAC3 and their combina-tion predicting death within 28d in AMI patients was 0.862,0.859 and 0.971 respectively,and AUC of combination was significantly higher than those of TRAF6 and HDAC3 alone(Z=2.535,2.032,P=0.011,0.042).Conclu-sion:Serum levels of TRAF6 and HDAC3 are closely related to severity of coronary artery disease and prognosis in AMI patients,and dual combination possesses good predictive value for prognosis in AMI patients.

The clinical application of immune checkpoint inhibitors (ICIs) has significantly improved the prognosis of hepatocellular carcinoma (HCC) patients. With the widespread applica-tion of ICIs in HCC, the management of immune-related adverse events (irAE) gained more and more attention. However, the complicated disease characteristics and various combination therapies in HCC throw out challenges to irAE management. Therefore, the editorial board of the 'Chinese expert consensus on the management of immune-related adverse events of hepatocellular carcinoma treated with immune checkpoint inhibitors (2021 edition)' organizes multidisciplinary experts to discuss and formulate this consensus. The consensus focuses on issues related to HCC irAE manage-ment, and puts forward suggestions, in order to improve standardized and safety clinical medication, so as to maximize the benefits of immunotherapy for patients.

Objective: To investigate the safety and efficacy of ultrafiltration on diuretic sensitivity in heart failure patients with reduced ejection fraction and diuretic resistance. Methods: This was a single-center randomized controlled trial. A total of 148 heart failure patients with reduced ejection fraction admitted to the Hospital of Traditional Chinese Medicine of Xinjiang Uygur Autonomous Region from June 2010 to June 2020 were enrolled in this study, and these patients were randomly divided (ratio 1:1) into the ultrafiltration group (n=74) and the control group (n=74). All patients were treated with diuretics, cardiotonic, vasodilator and other comprehensive drugs according to relevant guidelines. After grouping, the patients in the control group were treated with standard treatment plan, while patients in the ultrafiltration group were treated with ultrafiltration on top of standard therapy. Diuretic drugs were discontinued during ultrafiltration, and intravenously furosemide (40 mg) was given immediately and 24 hours after the end of ultrafiltration. Clinical data including gender, age, complicated diseases, New York Heart Association (NYHA) function classification, etc. were collected. Effectiveness indicators include urine volume (the first 12-hour and 24-hour urine volume and the second 24-hour urine volume after using diuretic), body weight and dyspnea severity score. Safety indicators include systolic blood pressure, serum creatinine, serum Na⁺ concentration, blood K⁺ concentration and the number of deaths before and after intervention. Results: Two patients in the control group died due to worsening heart failure after randomization and were excluded in this study, 146 patients were finally analyzed (72 patients in the control group and 74 patients in the ultrafiltration group). There were 93 males, and the age was (68.3±11.2) years. There was no significant difference between patients in the ultrafiltration group and the control group in gender, age, body weight, course of disease, dyspnea severity score, NYHA function classification Ⅲ/Ⅳ, the proportion of patients with severe edema of both lower limbs, the proportion of patients with complicated diseases, and basic medication (all P>0.05). After using diuretics, the urine volume of the first 12-hour and 24-hour and the second 24-hour were significantly higher in the ultrafiltration group than in the control group (all P<0.05). Body weight decreased significantly after ultrafiltration treatment as compared with that before intervention in the ultrafiltration group (P<0.05). Compared with the control group, the dyspnea severity score was significantly improved in the ultrafiltration group (P<0.05). There was no significant difference in systolic blood pressure, serum creatinine, serum Na⁺ concentration, blood K⁺ concentration of patients between ultrafiltration group and control group before and after intervention (all P>0.05). During the clinical diagnosis and treatment, 2 male patients in the control group died, and the cause of death was aggravation of basic diseases complicated with acute heart failure and cardiogenic shock. There was no death in the ultrafiltration group, and there were no obvious clinical adverse events during and after ultrafiltration. Conclusion: Ultrafiltration therapy is safe and can improve diuretic sensitivity in heart failure patients with reduced ejection fraction and diuretic resistance.
Aged ; Diuretics/therapeutic use* ; Furosemide/therapeutic use* ; Heart Failure/drug therapy* ; Humans ; Male ; Middle Aged ; Stroke Volume ; Ultrafiltration

This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder (ASD) in Chinese children. We targeted the population of 6 to 12-year-old children for this prevalence study by multistage convenient cluster sampling. The Modified Chinese Autism Spectrum Rating Scale was used for the screening process. Of the target population of 142,086 children, 88.5% (n = 125,806) participated in the study. A total of 363 children were confirmed as having ASD. The observed ASD prevalence rate was 0.29% (95% CI: 0.26%-0.32%) for the overall population. After adjustment for response rates, the estimated number of ASD cases was 867 in the target population sample, thereby achieving an estimated prevalence of 0.70% (95% CI: 0.64%-0.74%). The prevalence was significantly higher in boys than in girls (0.95%; 95% CI: 0.87%-1.02% versus 0.30%; 95% CI: 0.26%-0.34%; P < 0.001). Of the 363 confirmed ASD cases, 43.3% were newly diagnosed, and most of those (90.4%) were attending regular schools, and 68.8% of the children with ASD had at least one neuropsychiatric comorbidity. Our findings provide reliable data on the estimated ASD prevalence and comorbidities in Chinese children.

Indigenous knowledge and traditional culture for sustainable use of native plants in Juenang cultural region of Rangtang county, Aba Zang and Qiang Prefecture of Sichuan province, have been characterized in this paper followed the principles and methods of ethnobotany. The results indicate that 38 species from 27 families(including 6 species of fungi) are ethnobotanically used commonly in this area. Of 38 species of the native plants, 13 species from 12 families are collected for eatables and vegetables, 12 families and 16 species of indigenous plants for medicinal and edible use, 4 species from 4 families for decoration, 4 species from 4 families used for building materials or firewood, and 1 species from 1 families used for religious folklore. Under the influence of Juenang culture and Tibetan culture, indigenous knowledge such as instinctive reverence and gratitude for nature, protection ecological environment and habitats, and moderate use of natural resources(especially wild bioresource), have been gotten passed on from generation to generation in Juenang culture region of Rangtang county, which is of great significance to the protection of local bioresources and environment, including ethnic medicinal plants, and also to provide practical guidance for biodiversity conservation and ecological restoration in those alpine ecological vulnerable areas.
Biodiversity ; China ; Conservation of Natural Resources ; Ethnobotany ; Fungi/classification* ; Humans ; Knowledge ; Phytotherapy ; Plants, Medicinal/classification*

Objective: To obtain the glycosyltransferase gene involved in modification reaction of phytoalexin from Sorbus pohuashanensis suspension cell,and conduct sequence analysis and prokaryotic expression analysis. Method: Based on the transcriptome data,specific primers were designed to obtain 2 cDNA sequences of SaUGTs genes,construct prokaryotic expression vector HIS-MBP-pET28a-SaUGTs and induce the expression of recombinant SaUGTs protein. Result: SaUGT1 and SaUGT2 sequences were cloned and obtained from glycosyltransferases,then bioinformatic analysis of the sequence and prokaryotic expression analysis were conducted. SaUGT1 gene contained 1 458 bp open reading frame (ORF),encoding a polypeptide of 485 amino acids,with a relative molecular weight of 54.27 kDa and theoretical isoelectric point (pI) of 5.50.SaUGT2 gene contained 1 431 bp ORF,encoding a polypeptide of 476 amino acids,with a relative molecular weight of 53.49 kDa and theoretical pI of 5.63. Bioinformatics analysis indicated that SaUGT1 and SaUGT2 protein had no signal peptide,and the conserved domains of glycosyltransferase family were detected. Phylogenetic results showed that SaUGT1 and SaUGT2 proteins had the closest relationship with the UGT85 family of A. thaliana. Differential expression analysis revealed that the relative expression levels of SaUGT1 and SaUGT2 were increased significantly after being induced by yeast extract (YE), with the highest expression level found at 24 h and 12 h. The recombinant SaUGT1 and SaUGT2 proteins were successfully expressed in Escherichia coli DE3 cells and finally,the recombinant SaUGT1 and SaUGT2 proteins were purified through Ni²⁺ affinity chromatography. Conclusion: The glycosyltransferase gene was cloned from the S. aucuparia for the first time,and the prokaryotic expression vector was successfully constructed,laying foundation for further study of the function of this gene.