Moyamoya vasculopathy (MMV) refers to a chronic cerebrovascular disease characterized by progressive stenosis or occlusion of the arteries around the circle of Willis, accompanied by the formation of collateral vessels. In traditional Chinese medicine (TCM), MMV falls into the categories of “stroke”, “vertigo”, and “headache”, among others. Its core etiology is related to congenital insufficiency and acquired malnourishment, with wind, fire, phlegm, deficiency, and stasis as the key pathogenic factors. Current Western medical diagnosis and treatment of MMV remain suboptimal, and TCM pattern differentiation has yet to be standardized. The most common clinical patterns are liver yang hyperactivity (associated with hemorrhagic symptoms) and qi deficiency with blood stasis (associated with ischemic symptoms). Treatment modalities include acupuncture, Chinese herbal formulas, and TCM–Western medicine integrated therapy. Clinical trial results have confirmed that integrated therapy offers certain benefits for MMV; however, there is a lack of relevant diagnostic and treatment guidelines as well as in-depth mechanistic studies. This article reviews the progress in TCM and Western medicine for the diagnosis and treatment of MMV and proposes a trinity diagnostic and therapeutic approach integrating “disease differentiation–pattern differentiation–staging”, which provides a reference for TCM–Western medicine integration management.

Neuroblastoma is a common extracranial solid tumors in children，and patients with high-risk disease have poor prognosis. Since the pathogenesis of neuroblastoma has not been fully elucidated，early diagnosis and timely，effective clinical intervention are key strategies to improve survival in affected children. As a neuroendocrine tumor，neuroblastoma is characterized by abnormal secretion of catecholamine compounds，the synthesis and release of which are closely associated with both diagnosis and prognosis. This review summarizes the biosynthetic and metabolic pathways of catecholamines and their clinical applications in neuroblastoma，and further discusses the molecular mechanisms by which catecholamines contribute to neuroblastoma progression.

Objective:To explore the relationship between the expression levels of succinate receptor 1 (SUCNR1) and Y-box binding protein 1 (YBX1) in colorectal cancer tissues of patients with colorectal cancer liver metastases (CRLM) and their clinicopathological characteristics and prognosis.Methods:One hundred and five CRLM patients who underwent surgical treatment in Suzhou Kowloon Hospital of Shanghai Jiao Tong University School of Medicine from January 2016 to May 2020 were taken as the study subjects. The high expression rates of SUCNR1 and YBX1 in cancer tissues and adjacent tissues were compared. Clinicopathological characteristics and prognosis of patients with high and low SUCNR1 and YBX1 expression were compared. Univariate and multivariate Cox proportional risk regression models were applied to analyze prognostic influencing factors.Results:SUCNR1 staining was mainly located on the cell membrane in colorectal cancer tissues, and positive staining showed yellow or brownish yellow; YBX1 was mainly located in the cytoplasm of colorectal cancer tissues, and positive staining showed yellow or brownish yellow. The high expression rate of SUCNR1 in cancer tissues (74.29%, 78/105) of CRLM patients was obviously higher than that in adjacent tissues (27.62%, 29/105), and the high expression rate of YBX1 in cancer tissues (84.76%, 89/105) was obviously higher than that in adjacent tissues (32.38%, 34/105), with statistically significant differences ( χ2=45.75, P<0.001; χ2=59.36, P<0.001). There were statistically significant differences in histological grade ( χ2=7.43, P=0.006) and the time from colorectal cancer diagnosis to liver metastasis ( χ2=9.19, P=0.002) between patients with high and low expression of SUCNR1; there was a statistically significant difference in time from colorectal cancer diagnosis to liver metastasis ( χ2=13.08, P<0.001) between patients with high and low expression of YBX1. The 3-year overall survival (OS) rates of patients with high and low expression of SUCNR1 were 52.56% and 77.78%, respectively, with a statistically significant difference ( χ2=6.10, P=0.014) ; the 3-year OS rates of patients with high and low expression of YBX1 were 53.93% and 87.50%, respectively, with a statistically significant difference ( χ2=6.02, P=0.014). Univariate analysis showed that, histological grade ( HR=4.69, 95% CI: 1.14-19.36, P=0.033), time from colorectal cancer diagnosis to liver metastasis ( HR=4.05, 95% CI: 1.02-16.62, P=0.048), cancer tissues SUCNR1 ( HR=5.12, 95% CI: 1.17-22.34, P=0.030), and YBX1 expression ( HR=6.29, 95% CI: 1.55-25.47, P=0.010) were all influencing factors for OS in CRLM patients. Multivariate analysis showed that, histological grade ( HR=4.16, 95% CI: 1.12-15.54, P=0.034), time from colorectal cancer diagnosis to liver metastasis ( HR=5.59, 95% CI: 1.25-24.99, P=0.024), expression of SUCNR1 in cancer tissues ( HR=3.68, 95% CI: 1.28-10.54, P=0.015), and expression of YBX1 in cancer tissues ( HR=3.42, 95% CI: 1.56-7.52, P=0.002) were all independent influencing factors for OS in CRLM patients. Conclusions:The high expression rates of SUCNR1 and YBX1 in cancer tissues of CRLM patients are higher than those in adjacent tissues. Patients with high and low SUCNR1 expression have differences in tumor histological grade, time from colorectal cancer diagnosis to liver metastasis, patients with high and low YBX1 expression has a difference in time from colorectal cancer diagnosis to liver metastasis. The 3-year OS rates of patients with low expression of SUCNR1 and YBX1 are higher than those of patients with high expression. The histological grade, the time from colorectal cancer diagnosis to liver metastasis, and the expression of SUCNR1 and YBX1 in cancer tissues are all independent influencing factors for OS in CRLM patients.

Osteoarthritis(OA),a common age-related chronic disease,is characterized by degenerative changes in the joints and surrounding tissues.Traditionally,research on OA has primarily focused on the pathological changes in articular cartilage and its repair.However,with the advancements in animal disease modeling in recent years,especially the widespread use of spatiotemporally specific transgenic mouse models,scholars have gradually come to realize that the subchondral bone also plays an important role in the occurrence and development of OA.That is,the pathological changes in articular cartilage and bone mutually affect and promote each other,jointly driving the progression of OA,involving such pathological processes as vascular invasion,ectopic calcification,nerve growth,and the occurrence of pain.Given the complexity of cartilage-bone pathological relationship,it is difficult to conduct in-depth research on subchondral bone pathology using clinical human samples,or to simulate the pathological processes of OA through in vitro cell experiments.Therefore,animal models play an irreplaceable role in investigating the pathological mechanisms of OA and developing clinical drugs.This review,in addition to providing an overview of OA animal models,synthesizes the latest progress in animal experimental research on OA,highlighting the active role of the cartilage-bone pathological relationship in OA progression.These new findings provide references for future in-depth investigations and also provide a theoretical basis for developing fundamental strategies for OA prevention and treatment.

ObjectiveTo analyze the clinical treatment plan and traditional Chinese medicine （TCM） medication rule of children with primary nephrotic syndrome （PNS） in the First Affiliated Hospital of Henan University of Chinese Medicine. MethodsThe gender and age of children firstly diagnosed with nephrotic syndrome in the pediatric nephrology department of the First Affiliated Hospital of Henan University of Chinese Medicine from November 2019 to December 2022 were collected， and the use of immunosuppressive agents and related frequencies were counted. According to the inclusion and exclusion criteria， an independent TCM prescription database for children with nephrotic syndrome was established. Excel was used to analyze the relevant information of the literature. The frequency counting， association rule analysis， and cluster analysis were carried out on TCM in the prescription， and the high-frequent drugs were analyzed. Results（1） General information： A total of 711 children were included， consisting of 522 males （73.42%） and 189 females （26.58%）. The ratio of male to female was about 2.76∶1. The disease mainly occurred in infants and preschool age， and the average age of onset was （4.74 ± 3.48） years old. （2） Clinical treatment plan and use of immunosuppressive agents： Of the 711 children with PNS， 237 were treated with hormone alone （32.33%）， and 474 （66.67%） received immunosuppressive agents combined with hormones. In the initial treatment， hormone combined with Tacrolimus （TAC） was the preferred treatment （32.91%）. For children with refractory PNS who exhibited poor clinical efficacy， Rituximab （RTX） was mostly used for treatment， with a ratio of up to 23.63%. （3） TCM syndrome and medication rule： In PNS syndrome differentiation， Qi and Yin deficiency was identified as the main syndrome. This involved a total of 477 cases， accounting for 67.09%. Yang deficiency of spleen and kidney was observed in 118 cases， accounting for 16.60%. A total of 711 children were included， of which 706 children were treated with TCM. This involved a total of 706 prescriptions， 226 TCM， and 9 793 frequencies. There were 30 herbs used more than 95 times. The top five TCM were Radix et Rhizoma Glycyrrhizae （81.16%）， Radix Astragali （71.81%）， Poria （68.84%）， Rhizoma Atractylodis Macrocephalae （63.60%）， and Fructus Corni （57.37%）. The drug association rules and network diagram showed that the combination of ''Radix Astragali-Rhizoma Atractylodis Macrocephalae-Poria'' was the closest， and five types of combinations were obtained by cluster analysis. ConclusionIn the diagnosis and treatment of PNS in children， TAC combined with hormones shows good clinical efficacy and high safety. For children with refractory PNS， RTX combined with hormones can be used. TCM medication for PNS should follow the basic principles of strengthening the body and vital Qi and make good use of drugs such as Radix Astragali， Poria， Rhizoma Atractylodis Macrocephalae， and cornus to regulate the Yin and Yang balance and achieve better clinical efficacy.

ObjectiveTo analyze the clinical treatment plan and traditional Chinese medicine （TCM） medication rule of children with primary nephrotic syndrome （PNS） in the First Affiliated Hospital of Henan University of Chinese Medicine. MethodsThe gender and age of children firstly diagnosed with nephrotic syndrome in the pediatric nephrology department of the First Affiliated Hospital of Henan University of Chinese Medicine from November 2019 to December 2022 were collected， and the use of immunosuppressive agents and related frequencies were counted. According to the inclusion and exclusion criteria， an independent TCM prescription database for children with nephrotic syndrome was established. Excel was used to analyze the relevant information of the literature. The frequency counting， association rule analysis， and cluster analysis were carried out on TCM in the prescription， and the high-frequent drugs were analyzed. Results（1） General information： A total of 711 children were included， consisting of 522 males （73.42%） and 189 females （26.58%）. The ratio of male to female was about 2.76∶1. The disease mainly occurred in infants and preschool age， and the average age of onset was （4.74 ± 3.48） years old. （2） Clinical treatment plan and use of immunosuppressive agents： Of the 711 children with PNS， 237 were treated with hormone alone （32.33%）， and 474 （66.67%） received immunosuppressive agents combined with hormones. In the initial treatment， hormone combined with Tacrolimus （TAC） was the preferred treatment （32.91%）. For children with refractory PNS who exhibited poor clinical efficacy， Rituximab （RTX） was mostly used for treatment， with a ratio of up to 23.63%. （3） TCM syndrome and medication rule： In PNS syndrome differentiation， Qi and Yin deficiency was identified as the main syndrome. This involved a total of 477 cases， accounting for 67.09%. Yang deficiency of spleen and kidney was observed in 118 cases， accounting for 16.60%. A total of 711 children were included， of which 706 children were treated with TCM. This involved a total of 706 prescriptions， 226 TCM， and 9 793 frequencies. There were 30 herbs used more than 95 times. The top five TCM were Radix et Rhizoma Glycyrrhizae （81.16%）， Radix Astragali （71.81%）， Poria （68.84%）， Rhizoma Atractylodis Macrocephalae （63.60%）， and Fructus Corni （57.37%）. The drug association rules and network diagram showed that the combination of ''Radix Astragali-Rhizoma Atractylodis Macrocephalae-Poria'' was the closest， and five types of combinations were obtained by cluster analysis. ConclusionIn the diagnosis and treatment of PNS in children， TAC combined with hormones shows good clinical efficacy and high safety. For children with refractory PNS， RTX combined with hormones can be used. TCM medication for PNS should follow the basic principles of strengthening the body and vital Qi and make good use of drugs such as Radix Astragali， Poria， Rhizoma Atractylodis Macrocephalae， and cornus to regulate the Yin and Yang balance and achieve better clinical efficacy.

Objective:To analyze the clinical characteristics of adverse reactions caused by dinutuximab β for the treatment of neuro-blastoma(NB)in China and to provide safety evidence for the rational use of dinutuximab β in clinical practice.Methods:Clinical data were retrospectively collected from 16 pediatric patients with NB who had been treated with dinutuximab β at Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine from January 2022 to November 2023,and the adverse reactions caused by dinutuximab β were summarized and analyzed.Results:The male-to-female ratio was 5:3 among the 16 children with NB.The retroperitoneum was the main initial site of involvement,accounting for 75%.Thirteen(81.25%)patients had high-risk NB.The adverse reactions caused by dinutuximab β mainly included decreased hemoglobin,fever,vomiting,and diarrhea.The inci-dence of adverse reactions was highest in the first course of treatment,and the median time of adverse reactions was 2-5 days.Conclu-sion:Targeted monitoring should be carried out at an early stage during dinutuximab β administration.Adverse reactions should be de-tected and managed early to ensure the safety of medication for children.

OBJECTIVE To investigate the inhibitory effect of human β defensin-3(HBD3)on the replication of in-fluenza A virus(IAV)[A/PR/8/34(H1N1)virus strain]in human bronchial epithelial cells(BEAS-2B)via the mitochondrial autophagy pathway.METHODS BAS-2B cells were infected with IAV,and cell condition observa-tion:plaque assay and light microscopy.Drug treatment:HBD3,autophagy agonist rapamycin(Rapa),autoph-agy inhibitor LY294002;The expression levels of TUFM、MAVS、NP、M2 and PB1-F2 genes were detected by real-time fluorescence quantitative polymerase chain reaction(qPCR).Western blot was used to detect the protein expression levels of P62、LC3Ⅱ and LC3Ⅰ.RESULTS Plaque formation experiments showed that the number of plaques increased with the increase of viral titer.With the increase of viral titer or the prolongation of infection time,the expres-sion levels of TUFM,MAVS,NP,M2 and PB1-F2 genes in BEAS-2 B cells gradually increased,the expression levels of P62 protein decreased,and the protein expression levels of LC3Ⅱ/LC3Ⅰ increased(P＜0.05).Forty-eight hpi of BE-AS-2B cells with IAV,the number of cells in the IAV group was significantly lower than that in the IAV+HBD3 group,the intercellular space was enlarged,and the cells shrunk significantly.Compared with the IAV group,the expression lev-els of TUFM,MAVS,NP,M2 and PB1-F2 genes in BEAS-2B cells in the IAV+HBD3 group decreased,the expres-sion levels of P62 protein increased,and the protein levels of LC3Ⅱ/LC3Ⅰ decreased(P＜0.05).Gene expression levels of TUFM,MAVS,NP,M2 and PB1-F2 were in the IAV+Rapa+HBD3 group were lower than those in the IAV+Ra-pa group(P＜0.05).The protein expression level of P62 in the IAV+Rapa+HBD3 group was higher than that in the IAV+Rapa group(P＜0.05).The protein expression levels of LC3Ⅱ/LC3Ⅰ were lower in the IAV+Rapa+HBD3 group than in the IAV+Rapa group(P＜0.05).CONCLUSION With the increase of viral titer or the prolongation of in-fection time,the proliferation of IAV in BEAS-2B cells increases,and the cell damage exacerbates.HBD3 can inhibit the replication of IAV after its entry into the cells;HBD3 can protect host cells and inhibit IAV replication by inhibiting MA-VS,TUFM-mediated mitophagy pathways.

Purpose To investigate the clinical features of gastrointestinal leiomyomas(GLs)with scattered ex-pression of CD117 and DOG1,and to evaluate their biological behavior as well as their different diagnositic value from gastrointestinal stromal tumors(GISTs).Methods Clinical data from 17 cases of surgically resected GLs were col-lected.Immunohistochemistry using the EnVision method was performed to detect SMA,desmin,h-caldesmon,DOG1,CD117,and CD34.First-generation sequencing was performed to analyze exons 9-20 of the KIT gene and ex-ons 12 and 18 of the PDGFRA gene.Results Tumors occured in the stomach(8 cases)and esophagus(9 cases).Clinical manifestations included dull upper abdominal pain,dysphagia,chest pain,and fever.During a follow-up peri-od of 58-88 months,no recurrence was observed,and all patients had a favorable prognosis.Histologically,tumor cells were spindle-shaped and arranged in bundles or a woven pattern.Interstitial cells of Cajal appeared spindle-shaped or stellate with indistinct borders and dispersed chromatin.Tumor cells showed diffuse positivity for SMA,desmin,and h-caldesmon(100％).Interstitial cells of Cajal exhibited focal positive for CD117 and DOG1,with an o-verall positive rate of 9％for each marker.No pathogenic mutations of the KIT or PDGFRA genes were detected by first-generation sequencing.Conclusion Although some GLs contained interstitial cells of Cajal that showed focal pos-itivity for CD117 and DOG1,sequencing and long-term follow-up confirmed that their biological behavior differed from that of GISTs,with no malignant potential.Surgical resection remained the mainstay of treatment,and the prognosis was favorable.

Objective:To retrieve and summarize the best evidence for cognitive function improvement in Alzheimer's disease patients, so as to provide reference for clinical practice.Methods:Following the "6S" evidence model, guidelines, expert consensus, clinical decision, and systematic reviews on cognitive function improvement in Alzheimer's disease patients were systematically retrieved from domestic and foreign databases and websites. The search keywords included "Alzheimer's disease, cognitive function, improvement". Evidence-based nursing methods were used to evaluate the quality of literature and extract evidence. The search period was from July 1, 2000 to July 31, 2024.Results:A total of 15 articles were included, including five guidelines, four expert consensus, two clinical decision, and four systematic reviews. Sixteen pieces of best evidence were summarized from four aspects of evaluation and identification, pharmacological intervention, non-pharmacological intervention, and caregiver support.Conclusions:Patients with Alzheimer's disease require timely identification of symptoms related to cognitive impairment and assessment using standardized scales. Multiple intervention methods, such as pharmacological intervention, non-pharmacological intervention, and caregiver support, should be used to enhance patients' quality of life. Evidence application should be tailored to each patient's specific circumstances through individualized selection and adjustment to ensure the effectiveness and scientific rigor of cognitive function improvement strategies, thereby facilitating the translation of optimal evidence into clinical practice.