This article systematically reviews and verifies the medicinal materials of Dioscoreae Hypoglaucae Rhizoma（DHR）， Dioscoreae Spongiosae Rhizoma（DSR）， Smilacis Chinae Rhizoma（SCR） and Smilacis Glabrae Rhizoma（SGR） from the aspects of name， origin， producing area， quality， harvesting， processing and efficacy by consulting historical literature， in order to provide reference for the development and utilization of famous classical formulas containing the four medicinal materials. DHR， DSR， SCR and SGR have a long history of application as medicinal materials. However， due to their similar growth environment and medicinal properties， as well as their functions of promoting dampness， dispelling wind and removing numbness， there have been instances of homonymous foreign objects and homonymous synonyms throughout history， resulting in confusion of the origin. Therefore， it is necessary to conduct comparative analysis and systematic research for clarifying the historical development and changes of the four， in order to provide a basis for safe and effective medication. According to research， Bixie was first recorded in Shennong Bencaojing and has been historically known as Baizhi， Chijie， Zhumu， and other aliases. From ancient times to the mid-20th century， there has always been a situation where the rhizomes of Dioscorea plants and Smilax plants， and even the rhizomes of Heterosmilax plants， were mixed together to be used as medicinal herbs for Bixie. However， since the Tang dynasty， it has been clearly advocated that the rhizomes of Dioscorea plants have excellent quality and have been the mainstream throughout history. The 2020 edition of Chinese Pharmacopoeia categorized it into two types of medicinal herbs（DHR and DSR）. Among them， the origin of DHR is the dry rhizomes of Dioscorea hypoglauca， and the origins of DSR are the dry rhizomes of D. spongiosa and D. futschauensis. In ancient times， due to different types， the corresponding production areas of DHR and DSR were also different. Nowadays， They are mainly produced in the southern region of the Yangtze River. Since the Tang dynasty， the quality of Bixie has been characterized by its white color and soft nature. In modern times， it has been summarized that those with white color， large and thin pieces， powdery texture， tough and elastic texture， and neat and unbreakable are the best. The harvesting times of DHR and DSR are in spring or autumn， with the best quality harvested in autumn. The mainstream processing methods of them are slicing and then using the raw products or wine-processed products. SCR was first recorded in Mingyi Bielu and has been known as Jinganggen， Tielingjiao， Tieshuazi， and other aliases in history. The mainstream source is the dry rhizomes of Smilax china in the past dynasties， with the best quality being those that are tough and rich in powder. The harvesting time is from the late autumn to the following spring， and the main processing method throughout history has been slicing for raw use. SGR was first recorded under the item of Yuyuliang in Variorum of Shennong's Classic of Materia Medica. It was listed as an independent medicinal material from Bencao Gangmu. In history， there were such aliases as Cao Yuyuliang， Lengfantuan， Xianyiliang， Tubixie， etc. The main source of the past dynasties was dry rhizomes of S. glabra. In history， there have also been instances of multiple plants belonging to the same genus， and even cases of mixing the rhizomes of plants in the genus Heterosmilax. It is mainly produced in Guangdong， Hunan， Hubei， Zhejiang， Sichuan， Anhui and other regions， its quality has been summarized as large in size， powdery in texture， with few veins， and light brown in cross-section since modern times. The harvesting time is in spring or autumn， and the main processing method throughout history has been slicing for raw use. DHR， DSR， SCR and SGR all have the effects of promoting dampness， dispelling wind， relieving rheumatism and detoxifying. However， their detoxification abilities are ranked as follows：SGR>SCR>Bixie（DHR and DSR）. Especially for the treatment of limb spasms， arthralgia and myalgia， scrofula， and scabies caused by syphilis and mercury poisoning， SGR has a unique effect. Based on the research results， DHR is recommended to develop the famous classical formulas containing Bixie as the first choice for medicinal herbs. It should be harvested in autumn， sliced thinly while fresh， and processed according to the requirements of the famous classical formulas， without any requirements for raw use. Selecting the rhizomes of S. china， harvested in late autumn， and thinly sliced while fresh. If there are no special processing requirements in the formulas， use it raw. Selecting the rhizomes of S. glabra， it is harvested in autumn and thinly sliced while fresh. If there are no special processing requirements in the formulas， raw products can be used.

Objective To assess the clinical value of a novel surgical technique—Tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device in the resection of anterior mediastinal masses. Methods Patients who underwent tubeless subxiphoid uniportal video-assisted thoracoscopic surgery via balance-shaped sternal elevation device in anterior mediastinal masses process at the Department of Thoracic Surgery, West China Hospital, Sichuan University from March to April 2025 were included, and their clinical data were analyzed. Results A total of 4 patients were included, with 2 males and 2 females, aged 58-75 years. The diameter of the tumor was 2.5-3.0 cm. The operation time was 60.0-150.0 min, intraoperative blood loss was 5-10 mL, pain score on the 3rd day after surgery was 0 points, and postoperative hospital stay was 2-3 days. All patients achieved complete resection of the masses and thymus without perioperative complications. Conclusion The tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device technique optimizes surgical visualization and instrument maneuverability while avoiding complications related to conventional anesthesia and tubing, thereby markedly enhancing the minimally invasive profile of anterior mediastinal masses resections. In addition to maintaining procedural safety, this approach effectively reduces postoperative pain and accelerates patient recovery, highlighting its potential for widespread clinical adoption.

This article systematically reviews and verifies the historical evolution of Stemonae Radix from the aspects of name， origin， harvesting and processing， quality and others by consulting ancient and modern literature， in order to provide reference for the development and utilization of famous classical formulas containing this medicinal herb. Stemonae Radix has a long history of application， and it derives its name from its distinctive growth pattern， featuring clusters of ten to several dozen underground tuberous roots. This morphology resembles that of certain plants in the genus Asparagus， leading to historical instances where tuberous roots from genus Asparagus were mistakenly used as Stemonae Radix. After the research， it can be concluded that Stemonae Radix was first recorded in Mingyi Bielu， and throughout history， Baidu has been recognized as its official name， though it also bears alternative names such as Baibing， Pofucao and Ye Tianmendong. The mainstream sources used throughout history have been the dried tuberous roots of Stemona sessilifolia， S. japonica or S. tuberosa from the family Stemonaceae. This aligns with the 2025 edition of Pharmacopoeia of the People's Republic of China（hereinafter referred to as Chinese Pharmacopoeia）. Additionally， Asparagus filicinus and A. officinalis from the genus Asparagus are common sources of confusion with Stemonae Radix. The three primitive plants are mainly distributed in the Yangtze River basin and southern China， exhibiting a wide distribution. Historically， wild harvesting was predominant， but cultivation is now established. In ancient times， the harvesting time was mostly in the second， third， and eighth lunar months， when roots were harvested and dried. Nowadays， it is more common to pick and excavate in the spring and autumn seasons. After excavation， the roots are washed， fibrous roots removed， briefly blanched in boiling water or steamed until no white core remains， and then sun-dried or oven-dried. In ancient times， the processing of Stemonae Radix primarily involved roasting（stir-frying）， wine roasting， or raw materials. Modern mainstream processing specifications include two types of raw and honey-roasted products. In terms of quality evaluation of the medicinal materials， ancient criteria of "preferring plump and moist roots" align with modern requirement favoring "thick， robust stems with firm texture". Evaluating quality with authenticity， since the Song dynasty， it has been highly praised to produce in Chuzhou and Hengyang as the best. It was an ancient method of fixing the production area to stabilize the medicinal origin， reflecting the ancient recognition of the therapeutic efficacy of plants belonging to the genus Stemona. The main functions of Stemonae Radix remain consistent throughout history， including relieving coughs， eliminating phlegm and parasites. Based on the research results， it is recommended that when developing famous classical formulas containing the medicinal material Stemonae Radix， the botanical source specified in the 2025 edition of Chinese Pharmacopoeia should be selected. The specific species can be determined according to the distribution of resources and the main production areas， and the origin and corresponding botanical source should be fixed. Processing methods should be chosen based on the prescription requirements. It is recommended to use raw products without specified requirements.

This article systematically reviews and verifies the historical evolution of Stemonae Radix from the aspects of name， origin， harvesting and processing， quality and others by consulting ancient and modern literature， in order to provide reference for the development and utilization of famous classical formulas containing this medicinal herb. Stemonae Radix has a long history of application， and it derives its name from its distinctive growth pattern， featuring clusters of ten to several dozen underground tuberous roots. This morphology resembles that of certain plants in the genus Asparagus， leading to historical instances where tuberous roots from genus Asparagus were mistakenly used as Stemonae Radix. After the research， it can be concluded that Stemonae Radix was first recorded in Mingyi Bielu， and throughout history， Baidu has been recognized as its official name， though it also bears alternative names such as Baibing， Pofucao and Ye Tianmendong. The mainstream sources used throughout history have been the dried tuberous roots of Stemona sessilifolia， S. japonica or S. tuberosa from the family Stemonaceae. This aligns with the 2025 edition of Pharmacopoeia of the People's Republic of China（hereinafter referred to as Chinese Pharmacopoeia）. Additionally， Asparagus filicinus and A. officinalis from the genus Asparagus are common sources of confusion with Stemonae Radix. The three primitive plants are mainly distributed in the Yangtze River basin and southern China， exhibiting a wide distribution. Historically， wild harvesting was predominant， but cultivation is now established. In ancient times， the harvesting time was mostly in the second， third， and eighth lunar months， when roots were harvested and dried. Nowadays， it is more common to pick and excavate in the spring and autumn seasons. After excavation， the roots are washed， fibrous roots removed， briefly blanched in boiling water or steamed until no white core remains， and then sun-dried or oven-dried. In ancient times， the processing of Stemonae Radix primarily involved roasting（stir-frying）， wine roasting， or raw materials. Modern mainstream processing specifications include two types of raw and honey-roasted products. In terms of quality evaluation of the medicinal materials， ancient criteria of "preferring plump and moist roots" align with modern requirement favoring "thick， robust stems with firm texture". Evaluating quality with authenticity， since the Song dynasty， it has been highly praised to produce in Chuzhou and Hengyang as the best. It was an ancient method of fixing the production area to stabilize the medicinal origin， reflecting the ancient recognition of the therapeutic efficacy of plants belonging to the genus Stemona. The main functions of Stemonae Radix remain consistent throughout history， including relieving coughs， eliminating phlegm and parasites. Based on the research results， it is recommended that when developing famous classical formulas containing the medicinal material Stemonae Radix， the botanical source specified in the 2025 edition of Chinese Pharmacopoeia should be selected. The specific species can be determined according to the distribution of resources and the main production areas， and the origin and corresponding botanical source should be fixed. Processing methods should be chosen based on the prescription requirements. It is recommended to use raw products without specified requirements.

Objective To investigate the expression of leukocyte cell-derived chemotaxin 2(LECT2)and complement C3 in the serum of patients with autoimmune hepatitis(AIH),and their correlation with liver function grading and prognosis.Methods A total of 109 AIH patients admitted to our hospital from January 2022 to February 2024 were included as the observation group.According to the disease activity upon admission,they were grouped into the active group(59 cases)and the remission group(50 cases).According to the Child-Pugh grading,they were assigned into the grade A group(47 cases),the grade B group(40 cases),and the grade C group(22 cases).According to the prognosis,they were assigned into a poor prognosis group(35 cases)and a good prognosis group(74 cases),with 110 healthy volunteers who underwent physical checkup in our hospital as the control group.Enzyme linked immunosorbent assay(ELISA)was applied to measure serum LECT2 level.Immunoturbidimetry was applied to detect serum complement C3 level.The correlation between LECT2,complement C3 and clinical indexes was analyzed by Pearson correlation analysis.Spearman correlation analysis was applied to analyze the relationship between serum LECT2,complement C3,and Child-Pugh grading.Receiver operating characteristic(ROC)curves were established to evaluate the predictive value of LECT2 and complement C3 levels for poor prognosis in AIH patients.Results The serum level of LECT2 in the observation group was higher than that in the control group,and the level of complement C3 was lower than that in the control group(P＜0.05).The expression level of ELECT2 in the grade C group was prominently higher than that in the grade B group and grade A group,while the expression level of complement C3 was prominently lower than that in the grade B group and grade A group(P＜0.05).The level of serum LECT2 in poor prognosis group was higher than that in good prognosis group,and the level of serum complement C3 was lower than that in good prognosis group(P＜0.05).Pearson correlation analysis showed that LECT2 was positively correlated with IgG,IL-6,TNF-α and Th17/Treg,and negatively correlated with TGF-β,while complement C3 was negatively correlated(all P＜0.05);Spearman correlation analysis showed that LECT2 level was positively correlated with Child-Pugh grading,while complement C3 level was negatively correlated with Child-Pugh grading(rs=0.803,-0.875,both P＜0.05).ROC curve reveled that the AUC of serum LECT2 and complement C3 levels in predicting poor prognosis of AIH patients was 0.802 and 0.805,respectively,the AUC of their combined detection was 0.905,which was higher than that of single indicator detection(P＜0.05).Conclusion Serum LECT2 level is elevated and complement C3 level is reduced in AIH patients,and they are correlated with liver function grading and disease severity.The combined detection of the two can serve as serological indicators for evaluating liver function and predicting prognosis.

Objective:To calculate the reference intervals of immune globulinG (IgG), IgA, IgM, complement 3 (C3) and C4 for adults using Hoffmann and refineR methods, and to compare them with the reference interval reported by WS/T 645 of the People′s Republic of China, exploring the clinical application value of the indirect methods.Methods:Cross-sectional study. The physical examination data were collected at Peking Union Medical College Hospital from 2013 to 2023. Box-Cox was used to normalize the data distribution, and the Tukey method was used to remove outliers. Mann-Whitney test and Kruskal-Wallis test were used to compare the differences between gender and age, respectively. Quantile regression analysis was used to examine the effects of age and gender. Hoffmann and refineR methods were employed to calculate RIs of the five parameters.Results:There were 82 251, 82 483, 49 236, 20 027 and 19 942 test results for IgG, IgA, IgM, C3 and C4, respectively. Gender was significantly correlated with IgG, IgA, IgM, C3, and C4 levels, and age was significantly correlated with IgA, IgM, C3, and C4 levels. Reference intervals were calculated using both Hoffmann and refineR methods, yielding comparable results: IgG (7.58-16.85 g/L; 7.54-16.88 g/L), IgA (0.97-4.26 g/L; 0.97-4.34 g/L), C3 (0.73-1.43 g/L; 0.73-1.44 g/L), and C4 (0.11-0.32 g/L). Gender-specific intervals were established for IgM: women (0.44-2.57 g/L; 0.44-2.62 g/L) and men (0.33-1.91 g/L; 0.31-1.87 g/L). Gender and/or age-specific reference intervals were further calculated according to the bias ratio values. The reference intervals calculated by Hoffmann and refineR are in good agreement. The upper and lower limits of reference intervals for IgA and C3, the lower limits of IgG, the upper limits of IgM and C3 calculated by the indirect methods have good comparability with those reported by standards.Conclusions:The total and gender/age-specific reference intervals of IgG, IgA, IgM, C3 and C4 in our hospital population were established by Hoffmann and refineR methods, and the reference intervals established by the two indirect methods were comparable. The reference intervals calculated using these indirect methods were also comparable with those established using the direct method reported in current health standards.

Objective To investigate the expression of leukocyte cell-derived chemotaxin 2(LECT2)and complement C3 in the serum of patients with autoimmune hepatitis(AIH),and their correlation with liver function grading and prognosis.Methods A total of 109 AIH patients admitted to our hospital from January 2022 to February 2024 were included as the observation group.According to the disease activity upon admission,they were grouped into the active group(59 cases)and the remission group(50 cases).According to the Child-Pugh grading,they were assigned into the grade A group(47 cases),the grade B group(40 cases),and the grade C group(22 cases).According to the prognosis,they were assigned into a poor prognosis group(35 cases)and a good prognosis group(74 cases),with 110 healthy volunteers who underwent physical checkup in our hospital as the control group.Enzyme linked immunosorbent assay(ELISA)was applied to measure serum LECT2 level.Immunoturbidimetry was applied to detect serum complement C3 level.The correlation between LECT2,complement C3 and clinical indexes was analyzed by Pearson correlation analysis.Spearman correlation analysis was applied to analyze the relationship between serum LECT2,complement C3,and Child-Pugh grading.Receiver operating characteristic(ROC)curves were established to evaluate the predictive value of LECT2 and complement C3 levels for poor prognosis in AIH patients.Results The serum level of LECT2 in the observation group was higher than that in the control group,and the level of complement C3 was lower than that in the control group(P＜0.05).The expression level of ELECT2 in the grade C group was prominently higher than that in the grade B group and grade A group,while the expression level of complement C3 was prominently lower than that in the grade B group and grade A group(P＜0.05).The level of serum LECT2 in poor prognosis group was higher than that in good prognosis group,and the level of serum complement C3 was lower than that in good prognosis group(P＜0.05).Pearson correlation analysis showed that LECT2 was positively correlated with IgG,IL-6,TNF-α and Th17/Treg,and negatively correlated with TGF-β,while complement C3 was negatively correlated(all P＜0.05);Spearman correlation analysis showed that LECT2 level was positively correlated with Child-Pugh grading,while complement C3 level was negatively correlated with Child-Pugh grading(rs=0.803,-0.875,both P＜0.05).ROC curve reveled that the AUC of serum LECT2 and complement C3 levels in predicting poor prognosis of AIH patients was 0.802 and 0.805,respectively,the AUC of their combined detection was 0.905,which was higher than that of single indicator detection(P＜0.05).Conclusion Serum LECT2 level is elevated and complement C3 level is reduced in AIH patients,and they are correlated with liver function grading and disease severity.The combined detection of the two can serve as serological indicators for evaluating liver function and predicting prognosis.

Objective:To calculate the reference intervals of immune globulinG (IgG), IgA, IgM, complement 3 (C3) and C4 for adults using Hoffmann and refineR methods, and to compare them with the reference interval reported by WS/T 645 of the People′s Republic of China, exploring the clinical application value of the indirect methods.Methods:Cross-sectional study. The physical examination data were collected at Peking Union Medical College Hospital from 2013 to 2023. Box-Cox was used to normalize the data distribution, and the Tukey method was used to remove outliers. Mann-Whitney test and Kruskal-Wallis test were used to compare the differences between gender and age, respectively. Quantile regression analysis was used to examine the effects of age and gender. Hoffmann and refineR methods were employed to calculate RIs of the five parameters.Results:There were 82 251, 82 483, 49 236, 20 027 and 19 942 test results for IgG, IgA, IgM, C3 and C4, respectively. Gender was significantly correlated with IgG, IgA, IgM, C3, and C4 levels, and age was significantly correlated with IgA, IgM, C3, and C4 levels. Reference intervals were calculated using both Hoffmann and refineR methods, yielding comparable results: IgG (7.58-16.85 g/L; 7.54-16.88 g/L), IgA (0.97-4.26 g/L; 0.97-4.34 g/L), C3 (0.73-1.43 g/L; 0.73-1.44 g/L), and C4 (0.11-0.32 g/L). Gender-specific intervals were established for IgM: women (0.44-2.57 g/L; 0.44-2.62 g/L) and men (0.33-1.91 g/L; 0.31-1.87 g/L). Gender and/or age-specific reference intervals were further calculated according to the bias ratio values. The reference intervals calculated by Hoffmann and refineR are in good agreement. The upper and lower limits of reference intervals for IgA and C3, the lower limits of IgG, the upper limits of IgM and C3 calculated by the indirect methods have good comparability with those reported by standards.Conclusions:The total and gender/age-specific reference intervals of IgG, IgA, IgM, C3 and C4 in our hospital population were established by Hoffmann and refineR methods, and the reference intervals established by the two indirect methods were comparable. The reference intervals calculated using these indirect methods were also comparable with those established using the direct method reported in current health standards.

Objective To determine the optimal conditions for CXCR4 upregulation by comparing the expression levels of chemokine(C-X-C motif)receptor 4(CXCR4)in MSCs cultured with varying concentrations of oxygen and hydrogen peroxide(H2O2).Methods MSCs were cultured with 0.1％,1％,or 3％O2 and 50 μmol/L H2O2 for different lengths of time(3,6,12,and 24 h).The mRNA and protein expressions of CXCR4 in MSCs were measured by real-time quantitative PCR(qPCR),Western blotting,and immunofluorescence staining.The viability and chemotactic ability of MSCs were measured using CCK-8,wound-healing and Transwell migration assays.Results Both hypoxia and H2O2 treatment were found to upregulate MSC expressions of CXCR4 to some extent.The mRNA and protein levels of CXCR4 were higher after 6-12 h of culture of MSCs with 3％O2,and significantly higher when treated with H2O2 for 6 h.Cell viability was significantly increased after culture with 3％O2 compared with the control group and both 3％O2 and H2O2 pretreatment could enhance chemotactic migration in MSCs.Conclusion Culture with 3％O2 and H2O2 pretreatment can upregulate CXCR4 expressions in MSCs and enhance migration in cells,with superior effects observed with 3％O2.Therefore,treatment with 3％O2 represents the best choice for upregulating the chemotactic ability of MSCs.

Background Maternal exposure to bisphenol A (BPA) during pregnancy is closely related to adverse growth and development conditions such as preterm birth and low birth weight, but the relevant mechanisms are still unclear. UDP-glucuronosyltransferases (UGTs) can regulate the excretion of BPA conjugating with glucuronic acid through urine, which is one of the important pathways for BPA elimination. Objective To explore the changes in the expression of UGTs in placenta and fetal liver of rats before birth induced by maternal exposure to BPA during pregnancy. Methods Thirty SPF-grade healthy SD pregnant rats were randomly divided into five groups: control group, 0.05, 0.5, 5, and 50 mg·kg⁻¹ BPA groups. The pregnant rats were exposed to BPA dissolved in corn oil via oral gavage daily from gestational day (GD) 5 to GD 19. After anesthesia, the pregnant rats were sacrificed on GD 20 and the placentas were collected. Body length, tail length, and weight of the fetal rats were measured. Fetal liver tissues were then separated, and organ weights were measured. Real-time quantitative polymerase chain reaction (RT-PCR) and Western blot (WB) were used to determine the mRNA and protein levels of UGT1A1, UGT1A6, UGT1A9, and UGT2B1 in the placenta and fetal liver tissues in each group. Results There were no differences in body length and tail length of the pups after maternal exposure to BPA during pregnancy. The fetal body weight and placenta weight in the 5 and 50 mg·kg⁻¹ BPA groups and the liver weight in the 5 mg·kg⁻¹ BPA group reduced compared with the control group (P<0.05). The results of UGTs expressions in placenta showed that compared with the control group, the UGT1A1 mRNA levels in placenta of the BPA groups (exposure dose≥0.5 mg·kg⁻¹) and the UGT1A1 protein level in placenta of the 50 mg·kg⁻¹ BPA group increased (P<0.05); the UGT1A6 mRNA and protein levels in placenta of each BPA group did not change (P>0.05); the UGT1A9 mRNA level in placenta of the 50 mg·kg⁻¹ BPA group and the UGT1A9 protein levels in placenta of the BPA groups (exposure dose≥0.5 mg·kg⁻¹) reduced (P<0.05); while the levels of UGT2B1 mRNA in placenta of the BPA groups (exposure dose≥0.5 mg·kg⁻¹) reduced (P<0.05). The results of UGTs expressions in fetal liver showed that compared with the control group, the UGT1A1, UGT1A6, UGT1A9, and UGT2B1 mRNA levels of each BPA group increased (P<0.05); no obvious alternation was observed in UGT1A6 protein levels in each BPA group (P>0.05); the relative protein levels of UGT1A9 in fetal liver in the 50 mg·kg⁻¹ BPA group increased (P<0.05); conversely, the relative protein levels of UGT2B1 in fetal liver in the BPA groups (exposure dose≥0.5 mg·kg⁻¹) reduced (P<0.05). Conclusion Maternal exposure to BPA during pregnancy can elevate the UGT1A1 gene and protein expressions, inhibit the UGT1A9 gene and protein expressions and UGT2B1 gene expressions in placenta. Besides, maternal exposure to BPA during pregnancy can raise the gene expressions of UGT1A1, UGT1A6, UGT1A9, and UGT2B1 in fetal liver, as well as the protein expression of UGT1A9, but inhibit the protein expression of UGT2B1. These changes may contribute to fetal developmental abnormalities after maternal exposure to BPA during pregnancy.