Insulin is an important protein hormone that participates in multiple metabolic pathways.Biosynthetic insulin has been widely used in the treatment of type 1 and type 2 diabetes.Currently,the number of reported cases of insulin overdose both at home and abroad is gradually increasing,and insulin homicide is no longer a means of"committing murder without leaving a trace".At present,there are no systematic protocols for the identification of insulin overdose in the field of forensic medi-cine in China.This article introduces the causes,toxicological characteristics,forensic examination,labo-ratory testing methods and indicator reference of insulin overdose.Based on the identification practice and research results and referring to relevant studies on insulin overdose at home and abroad,this pa-per aims to provide recommendations and references for the formulation of forensic identification guide-lines for insulin overdose cases.

Moringa oleifera, widely utilized in Ayurvedic medicine, is recognized for its leaves, seeds, and velamen possessing traditional effects such as vātahara(wind alleviation), sirovirecaka(brain clearing), and hridya(mental nourishment). This study aims to identify the medicinal part of ■ in the Sārasvata ghee formulation as described in the Bower Manuscript, while investigating the ameliorative effects of different medicinal parts of M. oleifera on learning and memory deficits in mice and elucidating the underlying molecular mechanisms. A total of 144 male ICR mice were randomly assigned to the following groups: control, model(scopolamine hydrobromide, Sco, 2 mg·kg~(-1)), donepezil(donepezil hydrochloride, Don, 3 mg·kg~(-1)), M. oleifera leaf low-, medium-, and high-dose groups(0.5, 1, 2 g·kg~(-1)), M. oleifera seeds low-, medium-, and high-dose groups(0.25, 0.5, 1 g·kg~(-1)), and M. oleifera velamen low-, medium-, and high-dose groups(0.31, 0.62, 1.24 g·kg~(-1)). Learning and memory abilities were assessed using the passive avoidance test and Morris water maze. Nissl and HE staining were employed to examine histopathological changes in the hippocampus. Transcriptomics and targeted metabolomics were used to screen differential genes and metabolites, with MetaboAnalyst 6.0 and O2PLS methods applied to identify key disease-related targets and pathways. RESULTS:: demonstrated that M. oleifera leaf(1 g·kg~(-1)) significantly ameliorated Sco-induced learning and memory deficits, outperforming M. oleifera seeds(0.25 g·kg~(-1)) and M. oleifera velamen(1.24 g·kg~(-1)). This was evidenced by improved behavioral performance, reversal of neuronal damage, and reduced acetylcholinesterase(AChE) activity. Multi-omics analysis revealed that M. oleifera leaf upregulated Tuba1c gene expression through the synaptic vesicle cycle, enhancing glutamate(Glu), dopamine(DA), and acetylcholine(ACh) release via Tuba1c-Glu associations for neuroprotection. M. oleifera seeds targeted the dopaminergic synapse pathway, promoting memory consolidation through Drd2-ACh associations. M. oleifera velamen was associated with the cocaine addiction pathway, modulating dopamine metabolism via Adora2a-DOPAC, with limited relevance to learning and memory. In conclusion, M. oleifera leaf exhibits superior efficacy and mechanistic advantages over M. oleifera seeds and velamen, suggesting that the ■ in the Sārasvata ghee formulation is likely M. oleifera leaf, providing scientific evidence for its identification in ancient texts.
Animals ; Moringa oleifera/chemistry* ; Male ; Mice ; Seeds/chemistry* ; Plant Leaves/chemistry* ; Mice, Inbred ICR ; Memory Disorders/psychology* ; Transcriptome/drug effects* ; Memory/drug effects* ; Learning/drug effects* ; Metabolomics ; Humans ; Drugs, Chinese Herbal/administration & dosage* ; Maze Learning/drug effects*

Objective:To explore the influencing factors for skin pruritus and to construct a nomogram prediction model in peritoneal dialysis (PD) patients.Methods:It was a retrospective cross-sectional investigation study. The PD patients who were regularly followed up between July, 2023 and April, 2024 in PD center of the First Affiliated Hospital of Sun Yat-sen University were enrolled in this study. The pruritus status was evaluated by the 14-Item UP-Dial Scale. The general demographic data and clinical data were collected. The patients were divided into pruritus group and non-pruritus group according to the presence or absence of skin itching. The differences of clinical data and laboratory results were compared between the two groups. Logistic regression was used to analyze the associated factors for pruritus in PD patients. The nomogram model was constructed by R software. The receiver operating characteristic (ROC) curve analysis and the Hosmer-Lemeshow goodness-of-fit test were used to evaluate the performance of the model, and its clinical effectiveness was evaluated using the calibration curve.Results:A total of 315 PD patients were enrolled in this study, with age of (48.0±12.9) years, including 134 females (42.5%). Among them, 161 patients (51.1%) experienced skin pruritus. Of whom, 111 patients (68.9%) had mild pruritus, 34 patients (21.1%) had moderate pruritus, 16 patients (9.9%) had severe pruritus. The age ( t=-2.266, P=0.024), proportion of diabetes mellitus ( χ2=3.910, P=0.048), Charson comorbidity index ( Z=-2.458, P=0.014), blood eosinophil percentage ( Z=-2.385, P=0.017), C-reactive protein ( Z=-2.590, P=0.010), serum phosphorus ( Z=-3.233, P=0.001) and β2 microglobulin ( Z=-2.756, P=0.006) level in the pruritus group were higher than those in the non-pruritus group, and the measured glomerular filtration rate (mGFR) level ( Z=-3.708, P<0.001) of patients in the pruritus group was lower than that in the non-pruritus group. There were 262 patients in the training set and 53 patients in the validation set. The multivariate logistic regression analysis in the training set revealed that advanced age ( OR=1.032, 95% CI 1.010-1.054, P=0.004), lower mGFR ( OR=0.758, 95% CI 0.648-0.886, P<0.001), higher serum phosphorus ( OR=2.761, 95% CI 1.282-6.024, P=0.010), and elevated blood eosinophil percentage ( OR=1.098, 95% CI 1.012-1.191, P=0.025) were independent factors associated with pruritus in PD patients. The nomogram model constructed based on these indicators demonstrated good discrimination and calibration. In the training set, the area under the ROC curve ( AUC) was 0.757 (95% CI 0.699-0.816), with Hosmer-Lemeshow test χ2=4.979, P=0.760. In the validation set, the AUC was 0.779 (95% CI 0.651-0.907), and Hosmer-Lemeshow test χ2=12.938, P=0.114. Conclusions:The prevalence of skin pruritus is 51.1% in PD patient. Advanced age, lower mGFR, higher serum phosphorus and higher blood eosinophil percentage are the independent influencing factors for pruritus in PD patients. The nomogram model constructed based on these indicators shows excellent predictive performance for skin pruritus in PD patients.

Globally,emerging zoonotic diseases have revealed the close links among human,animal and environmental health,and the difficulties in addressing such complex health problems through a single entity.The concept of One Health has emerged,emphasizing the common strength of cross-sectoral,multidisciplinary,and social participation in addressing global health threats from a holistic perspective.China's action to address emerging infectious diseases since 2020 are reviewed,and the current status of and challenges in China's One Health governance of emerging infectious disease prevention and control systems are analyzed and summarized.The outlook for the development of a One Health governance system to help prepare for future pandemic diseases is also discussed.

Objective To explore the reliability of the reagent burstbead for field blood transfusion compatibility testing by applying it to bloodtype detection,antibody screening and cross matching tests and conduting parallel contrast with the existing arrays.Methods A field treatment shelter was used as the testing site to simulate the scene of emergency blood transfusion for the wounded under the conditions of field blood station,and 1 358 pieces of blood samples sent to some hospital for examination before transfusion were considered as the objects.Parallel contrast tests were carried out between the reagent burstbead method and the tube method for bloodtype detection and between the reagent burstbead method and the manual polybrene method for antibody screening and cross matching.The reagent burstbead method was compared with other methods in terms of the coin-cidence rate of the bloodtype detection results,the detection rate of positive samples for antibody screening and crossmatch incompatibility.Results The reagent burstbead method and the tube method had high consistency when used for bloodtype detection,with the coincidence rate being 100％.During antibody screening and cross matching tests,the reagent burstbead method found 5 cases of antibody-positive samples leading to major crossmatch incompatibility(positive rate being 0.37％),the manual polybrene method detected 2 cases of irregular antibody-positive samples(positive rate being 0.15％),and the two methods both identified 3 cases of minor crossmatch incompatibility.Conclusion The reagent burstbead has high accuracy and reliability when applied to bloodtype detection,antibody screening and cross matching tests,and thus can be used for blood transfusion compatibility testing in field conditions.[Chinese Medical Equipment Journal,2025,46(2):39-42]

Objective:To explore the influencing factors for skin pruritus and to construct a nomogram prediction model in peritoneal dialysis (PD) patients.Methods:It was a retrospective cross-sectional investigation study. The PD patients who were regularly followed up between July, 2023 and April, 2024 in PD center of the First Affiliated Hospital of Sun Yat-sen University were enrolled in this study. The pruritus status was evaluated by the 14-Item UP-Dial Scale. The general demographic data and clinical data were collected. The patients were divided into pruritus group and non-pruritus group according to the presence or absence of skin itching. The differences of clinical data and laboratory results were compared between the two groups. Logistic regression was used to analyze the associated factors for pruritus in PD patients. The nomogram model was constructed by R software. The receiver operating characteristic (ROC) curve analysis and the Hosmer-Lemeshow goodness-of-fit test were used to evaluate the performance of the model, and its clinical effectiveness was evaluated using the calibration curve.Results:A total of 315 PD patients were enrolled in this study, with age of (48.0±12.9) years, including 134 females (42.5%). Among them, 161 patients (51.1%) experienced skin pruritus. Of whom, 111 patients (68.9%) had mild pruritus, 34 patients (21.1%) had moderate pruritus, 16 patients (9.9%) had severe pruritus. The age ( t=-2.266, P=0.024), proportion of diabetes mellitus ( χ2=3.910, P=0.048), Charson comorbidity index ( Z=-2.458, P=0.014), blood eosinophil percentage ( Z=-2.385, P=0.017), C-reactive protein ( Z=-2.590, P=0.010), serum phosphorus ( Z=-3.233, P=0.001) and β2 microglobulin ( Z=-2.756, P=0.006) level in the pruritus group were higher than those in the non-pruritus group, and the measured glomerular filtration rate (mGFR) level ( Z=-3.708, P<0.001) of patients in the pruritus group was lower than that in the non-pruritus group. There were 262 patients in the training set and 53 patients in the validation set. The multivariate logistic regression analysis in the training set revealed that advanced age ( OR=1.032, 95% CI 1.010-1.054, P=0.004), lower mGFR ( OR=0.758, 95% CI 0.648-0.886, P<0.001), higher serum phosphorus ( OR=2.761, 95% CI 1.282-6.024, P=0.010), and elevated blood eosinophil percentage ( OR=1.098, 95% CI 1.012-1.191, P=0.025) were independent factors associated with pruritus in PD patients. The nomogram model constructed based on these indicators demonstrated good discrimination and calibration. In the training set, the area under the ROC curve ( AUC) was 0.757 (95% CI 0.699-0.816), with Hosmer-Lemeshow test χ2=4.979, P=0.760. In the validation set, the AUC was 0.779 (95% CI 0.651-0.907), and Hosmer-Lemeshow test χ2=12.938, P=0.114. Conclusions:The prevalence of skin pruritus is 51.1% in PD patient. Advanced age, lower mGFR, higher serum phosphorus and higher blood eosinophil percentage are the independent influencing factors for pruritus in PD patients. The nomogram model constructed based on these indicators shows excellent predictive performance for skin pruritus in PD patients.

Objective To explore the reliability of the reagent burstbead for field blood transfusion compatibility testing by applying it to bloodtype detection,antibody screening and cross matching tests and conduting parallel contrast with the existing arrays.Methods A field treatment shelter was used as the testing site to simulate the scene of emergency blood transfusion for the wounded under the conditions of field blood station,and 1 358 pieces of blood samples sent to some hospital for examination before transfusion were considered as the objects.Parallel contrast tests were carried out between the reagent burstbead method and the tube method for bloodtype detection and between the reagent burstbead method and the manual polybrene method for antibody screening and cross matching.The reagent burstbead method was compared with other methods in terms of the coin-cidence rate of the bloodtype detection results,the detection rate of positive samples for antibody screening and crossmatch incompatibility.Results The reagent burstbead method and the tube method had high consistency when used for bloodtype detection,with the coincidence rate being 100％.During antibody screening and cross matching tests,the reagent burstbead method found 5 cases of antibody-positive samples leading to major crossmatch incompatibility(positive rate being 0.37％),the manual polybrene method detected 2 cases of irregular antibody-positive samples(positive rate being 0.15％),and the two methods both identified 3 cases of minor crossmatch incompatibility.Conclusion The reagent burstbead has high accuracy and reliability when applied to bloodtype detection,antibody screening and cross matching tests,and thus can be used for blood transfusion compatibility testing in field conditions.[Chinese Medical Equipment Journal,2025,46(2):39-42]

Globally,emerging zoonotic diseases have revealed the close links among human,animal and environmental health,and the difficulties in addressing such complex health problems through a single entity.The concept of One Health has emerged,emphasizing the common strength of cross-sectoral,multidisciplinary,and social participation in addressing global health threats from a holistic perspective.China's action to address emerging infectious diseases since 2020 are reviewed,and the current status of and challenges in China's One Health governance of emerging infectious disease prevention and control systems are analyzed and summarized.The outlook for the development of a One Health governance system to help prepare for future pandemic diseases is also discussed.

The concept of'harmony'is the soul of traditional Chinese culture,which has a profound impact on the formation and development of traditional Chinese medicine(TCM).TCM is rooted in traditional Chinese culture,and the mode of thinking in TCM is in line with traditional Chinese culture.Based on the harmony culture,TCM has developed a unique view of health,disease and therapeutics.From the view of the harmony culture and by combining with years of clinical experience in treating dermatosis,Chinese medical master XUAN Guo-Wei has applied the concept of'harmony'in the TCM syndrome differentiation and treatment system in clinic,and has developed the academic thoughts of harmonizing therapy for removing toxins for the diagnosis and treatment of dermatosis.The thoughts of harmonizing therapy for removing toxins includes four aspects,namely harmonizing yin and yang,harmonizing healthy qi and pathogenic qi,harmonizing water and fire(i.e.,clod and hot),and harmonizing the administration of formula and drugs,aiming to remove toxins and expel pathogens and value the harmony.The thoughts of harmonizing therapy for removing toxins will beneficial to the comprehensive understanding of the unique health-disease-therapeutics concept in TCM,and will be helpful for managing the doctor-patient relationship,which is of enlightening significance to the modern clinical practice with TCM.

Purpose::The reconstruction of Allen's type IV fingertip amputation is a clinical challenge. Our team designed bilateral unequal-sized hallux osteo-onychocutaneous free flaps for the long-term reconstruction of Allen's type IV fingertip amputation and conducted a retrospective study with a 5-year follow-up aims to evaluate the effects of this technique.Methods::A retrospective analysis with a 5-year follow-up including 13 patients with Allen's type IV fingertip amputation who were admitted to our hospital from January 2010 to January 2017 was conducted. The patients were treated with bilateral unequal-sized hallux osteo-onychocutaneous free flaps. The operation time, intraoperative blood loss, and complications were recorded, and the survival rate of the transplanted flaps was calculated. During the 5-year follow-up after operation, the nail growth time was recorded and the finger appearance was observed. At the last follow-up appointment, the length, width, and girth of the reconstructed fingertip and contralateral normal fingertip, range of motion of the reconstructed fingertip and contralateral normal fingertip, Semmes-Weinstein test (for the evaluation of tactile sensation), and two-point discrimination testing results were recorded. SPSS 22.0 software was used for the statistical analysis and the data are presented as mean ± SD.Results::The mean operation time was (5.62 ± 0.51) h, the mean intraoperative blood loss was (34.15 ± 3.13) mL, and the survival rate of the transplanted flaps was 100%. During the 5-year follow-up, the average nail growth time was (10.14 ± 1.98) months and the average bone union time was (3.78 ± 0.91) months. The length, width, and girth of the reconstructed fingertip were (31.52 ± 3.73) mm, (17.82 ± 1.74) mm, and (59.75 ± 3.04) mm, respectively, which did not differ from those of the contralateral normal fingertip. The range of motion of the reconstructed fingertip was (12.15 ± 2.79) degrees which is different from that of the contralateral normal fingertip. The average tactile sensation evaluated via the Semmes-Weinstein test and the average two-point discrimination test of the reconstructed fingertip were (0.39 ± 0.17) g and (7.46 ± 1.14) mm, respectively, which were not different from those of the contralateral normal fingertip. The average Maryland score of feet in the donor area was 87.66 ± 7.39, which was satisfactory.Conclusion::Bilateral unequal-sized hallux osteo-onychocutaneous free flaps are an effective method to reconstruct Allen's type IV fingertip amputations with a satisfactory appearance and good sensory function.