Osteoporosis(OP) is a senile bone disease characterized by an imbalance between bone remodeling and bone formation. Targeting pathogenesis of kidney deficiency, spleen deficiency, and blood stasis, Bushen Jianpi Huoxue Decoction has a significant effect on the treatment of OP by tonifying kidney, invigorating spleen, and activating blood circulation. MicroRNA(miRNA) and the anti-apoptotic protein B-cell lymphoma-2-like protein 1(BCL2L1) are closely related to bone cell metabolism. Therefore, in this study, the binding of miR-140-5p to BCL2L1 was detected by dual luciferase assay and polymerase chain reaction(PCR). After silencing or overexpressing miR-140-5p, the apoptosis, autophagy, and osteogenic function of human fetal osteoblast cell line 1.19(HFOB1.19) were observed by flow cytometry and Western blot. Bushen Jianpi Huoxue Decoction-containing serum was prepared by intragastric administration of Bushen Jianpi Huoxue Decoction in rats. Different concentrations of Bushen Jianpi Huoxue Decoction-containing serum were used to treat HFOB1.19 with or without miR-140-5p mimic. The expression of osteogenic proteins in each group was observed, and the role of miR-140-5p/BCL2L1 in apoptosis and autophagy of HFOB1.19 was studied, along with the effect of Bushen Jianpi Huoxue Decoction on these processes. As indicated by the dual luciferase assay, miR-140-5p bound to BCL2L1. Flow cytometry and Western blot showed that miR-140-5p promoted apoptosis and inhibited autophagy in HFOB1.19. After intervention with high, medium, and low doses of Bushen Jianpi Huoxue Decoction-medicated serum, compared with the miR-140-5p NC group, the expression of osteocalcin(OCN), osteopontin(OPN), Runt-related transcription factor 2(RUNX2), and transforming growth factor beta 1(TGF-β1) decreased in the miR-140-5p mimic group, while the expression of bone morphogenetic protein 2(BMP2) showed no significant difference under high-dose intervention. Therefore, miR-140-5p/BCL2L1 can promote apoptosis and inhibit autophagy in HFOB1.19. Bushen Jianpi Huoxue Decoction can affect the osteogenic effect of miR-140-5p through BMP2.
MicroRNAs/metabolism* ; Autophagy/drug effects* ; Apoptosis/drug effects* ; Humans ; Drugs, Chinese Herbal/administration & dosage* ; Animals ; Cell Line ; bcl-X Protein/metabolism* ; Osteoblasts/metabolism* ; Rats ; Osteoporosis/physiopathology* ; Male ; Rats, Sprague-Dawley ; Osteogenesis/drug effects*

Objective:To analyze the research hotspots and trends of Yupingfeng Powder from 2000 to 2023; To provide reference for related research.Methods:The research literature related to Yupingfeng Powder was retrieved from CNKI, VIP, Wanfang Data and SinoMed from January 1, 2000 to December 20, 2023. Excel 2022 software was used to analyze the annual number of publications. CiteSpace 6.1.R6 software was used for visualization analysis on the authors, research institutions and key words.Results:A total of 2 522 articles were included, and the number of published articles showed a fluctuating growth trend in recent years. The journal with the largest number of articles was New Chinese Medicine (55 articles). The authors with the most publications were Hong Min from Nanjing University of Chinese Medicine (9 articles) and Zhang Zhonglin from Chengdu Medical College (9 articles). Yunnan University of Chinese Medicine (13 articles) had the largest number of publications. High-frequency keywords included allergic rhinitis, children, urticaria, recurrent respiratory tract infection, etc. The clustering analysis generated 11 labels. Conclusions:The research hotspots of Yupingfeng Powder focus on clinical application, integrated traditional Chinese and Western medicine therapy, syndrome type research and pharmacological research. Predicting potential drug targets with the help of network pharmacology and molecular docking technology and exploring its mechanism are the research trends in this field.

During sudden outbreaks of major infectious diseases,traditional vaccine clinical trials often fail to deliver timely and meaningful outcomes.To address this,innovative trial designs are essential to accelerate or restructure the traditional three-phase clinical trial process while maintaining adherence to scientific principles of drug candidate safety and efficacy.This paper presents various innovative vaccine clinical trial designs and concepts,along with critical considerations for their application,to serve as a methodological reference for related research.Adaptive designs provide flexibility by dynamically adjusting trial parameters—such as dose selection,population stratification,and sample size reestimation—based on interim analysis results.Bayesian designs incorporate historical data and prior information,reducing sample size requirements.Master protocol designs enable the evaluation of multiple treatments or target populations within a unified framework,significantly improving efficiency.Additionally,real-world data(RWD),including electronic health records vaccination records and insurance claims,supports the creation of virtual control groups,addressing ethical concerns while enhancing trial feasibility.A hybrid design combining randomized controlled trials(RCTs)with RWD is also proposed to leverage the strengths of both methodologies.These innovative designs optimize the research process,accelerating vaccine development and regulatory approval.By integrating these approaches,robust evidence-based insights can be generated,advancing precision medicine goals and strengthening public health responses to emerging infectious diseases.

Langerhans cell histiocytosis of bone is a rare tumor disease characterized by the large accumulation of CD1a⁺ and CD207⁺ dendritic cells in tissues of unknown cause.It mainly occurs in children aged 1-4 years old,with incidences of 4-6 per million in children and 1-2 per million in adults.Due to its low incidence,diverse clinical manifestations,and no obvious specificity of imaging manifestations,the definitive diagnosis and early treatment of this type of tumor are challenging.In this paper,we report 8 cases of Langerhans cell histiocytosis of bone and review the relevant literature published in the past five years to summarize the clinical characteristics,pathological features,diagnosis,treatment,and prognosis of this disease.
Humans ; Bone Diseases/therapy* ; Histiocytosis, Langerhans-Cell/therapy*

Listeria brainstem encephalitis with myelitis is extremely rare in clinical practice.Since the clinical manifestations are non-specific,MRI is helpful for diagnosis.Positive cerebrospinal fluid culture is considered the gold standard for diagnosis.This article reports a case of an immunocompetent individual with listeria brainstem encephalitis with myelitis,aiming to enhance the awareness of this condition.
Humans ; Brain Stem/pathology* ; Diagnostic Errors ; Encephalitis/complications* ; Encephalomyelitis, Acute Disseminated/diagnosis* ; Listeriosis/complications* ; Myelitis/complications*

Objective:To observe the clinical efficacy of repetitive transcranial magnetic stimulation(rTMS)combined with mindfulness-based cognitive therapy(MBCT)in patients with alcohol withdrawal syndrome(AWS).Methods:The 120 patients with AWS who were observed in this study were all male patients admitted to our hospital from June 2021 to June 2024,the patients were divided into group A(conventional treatment,40 cases),group B(group A combined with rTMS,40 cases),and group C(group B combined with MBCT,40 cases)according to random number table method.The clinical efficacy,self-control ability[Modified Clinical Institution Alcohol Dependence Withdrawal Assessment Scale(CIWA-Ar)score,Visual Analog Scale of Psychological Craving for Alcohol(VAS)score and Pennsylvania Alcohol Craving Scale(PACS)score],anxiety and depression degree assessment[Hamilton Depression Scale(HAMD)score,Hamilton Anxiety Scale(HAMA)score]and quality of life[36 Short Form Health Survey(SF-36)Score],relapse rate and readmission rate were compared among the three groups.Results:The total effective rate of group A,group B and group C increased successively(P＜0.05).The CIWA-Ar,PACS and VAS scores in group B and group C after treatment were lower than those in group A,and group C was lower than that in group B(P＜0.05).The HAMD and HAMA scores of group B and group C after treatment were lower than those in group A,and group C was lower than that in group B(P＜0.05).The SF-36 score of group B and group C after treatment was higher than those in group A,and group C was higher than that in group B(P＜0.05).Relapse rate and readmission rate in groups B and C were lower than those in group A,and group C was lower than that in group B(P＜0.05).Conclusion:The application of rTMS combined with MBCT in patients with AWS can improve clinical efficacy and quality of life,alleviate anxiety and depression,improve patients' self-control ability,reduce relapse rate and readmission rate,with definite effects.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective To investigate the risk factors of mild cognitive impairment(MCI)in elderly pa-tients with hypertension.Methods 270 elderly hypertensive patients treated in the geriatrics department and cardiovascular department of our hospital from September 2023 to March 2024 were analyzed retrospectively.They were divided into hypertension group with MCI(n=142)and hypertension group without MCI(n=128)according to the score of the simple mental state examination(MMSE).The clinical data and laboratory indicators of the two groups were collected and compared.The risk factors of MCI in elderly hospitalized pa-tients with hypertension were analyzed by stepwise logistic regression,and the diagnostic efficiency was ana-lyzed by receiver operating characteristic(ROC)curve.Results The prevalence rate of MCI in elderly pa-tients with hypertension was 52.6％.The monofactor analysis showed that the two groups had different hy-pertension years,hypertension grade,education level,combined diabetes,fasting blood glucose(FBG),triglyc-eride(TG),high density lipoprotein-cholesterol(HDL-C),HDL-C/low density lipoprotein-cholesterol(LDL-C),neutrophil(NEU),lymphocyte(LYM),glycated hemoglobin(HbA1c),arteriosclerosis index(AI),atherogenic index of plasma(AIP)and lipid composite index(LCI),the differences were statistically signifi-cant(P＜0.05).Multivariate logistic regression results showed that hypertension grade(grade 3),diabetes melli-tus,NEU,HbA1c,LYM and AIP were the influencing factors for MCI in elderly hospitalized patients with hyperten-sion(P＜0.05).The area under the curve(AUC)of FBG,TG,HbA1c and AIP in the diagnosis of hypertension com-bined with MCI were 0.801,0.743,0.889 and 0.804,respectively.Conclusion Early management and intervention can be carried out on the influencing factors of MCI in elderly patients with hypertension.

Background: Isoliquiritigenin, a key pharmacologically active compound derived from the traditional Chinese medicine Glycyrrhizae Radix et Rhizoma, can be further modified into various high-value 5-deoxyflavones, demonstrating significant potential for pharmaceutical development. Currently, the supply of isoliquiritigenin primarily depends on plant extraction. However, heterologous synthesis using microbial cell factories presents a promising alternative, offering a solution to resource limitations caused by the dwindling availability of Glycyrrhiza uralensis. Objective: This study aimed to employ heterologous synthesis in yeast strains for the stable and high-efficiency production of isoliquiritigenin. Methods: First, a stable chassis strain for isoliquiritigenin production was constructed by integrating optimized biosynthetic pathway enzyme genes. A type IV noncatalytic chalcone isomerase-like protein and a synthetic protein scaffold system were employed to enhance the metabolic channeling of key pathway enzymes. Subsequently, yeast metabolism was fine-tuned to balance precursor supply, and cofactor engineering strategies were implemented to increase nicotinamide adenine dinucleotide phosphate hydrogen (NADPH) availability, thereby ensuring the catalytic efficiency of the key enzyme chalcone reductase. Results: The engineered strain Y21-2 achieved a 24.4-fold increase in isoliquiritigenin titer compared to the original strain. Additionally, the proportion of the by-product naringenin chalcone was reduced by 67.8%, marking the first instance in which the ratio of C-5 hydroxylated by-products was minimized to 10.4% during the microbial synthesis of 5-deoxyflavones. Conclusion: This work provides a valuable reference for the efficient and sustainable production of isoliquiritigenin, laying a solid foundation for further pathway optimization and the biotechnological synthesis of other high-value natural 5-deoxyflavones.