Objective: To investigate the objective characteristics of tongue manifestation in different stages of damp-heat syndrome in diabetic kidney disease (DKD). Methods: A cross-sectional study enrolled 134 patients with DKD G3-5 stages who met the diagnostic criteria for damp-heat syndrome in DKD. The patients were treated at Dongzhimen Hospital, Beijing University of Chinese Medicine, from May 2023 to January 2024. The patients were divided into three groups: DKD G3, DKD G4, and DKD G5 stage, with 53, 33, and 48 patients in each group, respectively. Clinical general data (gender, age, and body mass index) and damp-heat syndrome scores were collected from the patients. The YZAI-02 traditional Chinese medicine (TCM) AI Tongue Image Acquisition Device was used to capture tongue images from these patients. The accompanying AI Open Platform for TCM Tongue Diagnosis of the device was used to analyze and extract tongue manifestation features, including objective data on tongue color, tongue quality, coating color, and coating texture. Clinical data and objective tongue manifestation characteristics were compared among patients with DKD G3-5 based on their DKD damp-heat syndrome status. Results: No statistically significant difference in gender or body mass index was observed among the three patient groups. The DKD G3 stage group had the highest age (P<0.05). The DKD G3 stage group had a lower score for symptoms of poor appetite and anorexia(P<0.05) than the DKD G5 group. No statistically significant difference was observed in damp-heat syndrome scores among the three groups. Compared with the DKD G5 stage group, the DKD G3 stage group showed a decreased proportion of pale color at the tip and edges of the tongue (P<0.05). The DKD G4 stage group exhibited an increased proportion of crimson at the root of the tongue, a decreased proportion of thick white tongue coating at the root, a decreased proportion of pale color at the tip and edges of the tongue, an increased hue value (indicating color tone) of the tongue color in the middle, an increased brightness value (indicating color lightness) of the tongue coating color in the middle, and an increased thickness of the tongue coating (P<0.05). No statistically significant difference was observed in other tongue color proportions, color chroma values, body characteristics, coating color proportions, coating color chroma values, and coating texture characteristics among the three groups. Conclusion Tongue features differ in different stages of DKD damp-heat syndrome in multiple dimensions, enabling the inference that during the DKD G5 stage, the degree of qi and blood deficiency in the kidneys, heart, lungs, liver, gallbladder, spleen, and stomach is prominent. Dampness is more likely to accumulate in the lower jiao, particularly in the kidneys, whereas heat evil in the spleen and stomach is the most severe. These insights provide novel ideas for the clinical treatment of DKD.

Oral squamous cell carcinoma (OSCC), the most common type of head and neck malignancy, has a poor prognosis owing to its high invasiveness and high rate of cervical lymph node metastasis. The tumor microenvironment (TME) is a complex microenvironment that is essential for tumor cell survival. Tumor-associated immune cell (TAIC), the main stromal cell of TME, regulates the proliferation, invasion, epithelial-mesenchymal transformation (EMT), and anti-tumor immunity of OSCC. M2-tumor-associated macrophages (TAMs) promote the invasion and metastasis of OSCC through the macrophage migration inhibitory factor/NOD-like receptor family pyrin domain containing 3/interleukin (IL)-1β axis, while N2-tumor-associated neutrophils (TANs) regulate the proliferation and EMT of OSCC through the Janus kinase 2/signal transducer and activator of transcription 3 pathway. Meanwhile, myeloid-derived suppressor cells (MDSCs) accelerate the progression of OSCC by secreting IL-6, IL-10, and transforming growth factor (TGF)-β; T cells promote inflammation by secreting IL-17 and inhibit inflammation-mediated tumor immune response by secreting IL-10 and TGF-β; and natural killer (NK) cells recognize and attack OSCC cells to inhibit OSCC progression. TAIC interaction network also regulates OSCC progression. M2-TAMs regulate the invasion and metastasis of OSCC by promoting T cell apoptosis through the secretion of IL-10 and programmed death-ligand (PD-L) -1, while N2-TANs inhibit T cell proliferation and cytotoxicity by secreting LOX-1 and arginase-1. MDSCs inhibit the proliferation and anti-tumor effects of CD8+ T cells through the inactivation of programmed cell death (PD)-1/PD-L1 signaling. Additionally, MDSCs inhibit the proliferation of T cells by decreasing the expression of the CD3-zeta chain and interferon-γ (IFN-γ). Moreover, tumor-infiltrating lymphocytes and NK cells were found to be positively correlated in OSCC progression. Therefore, target regulation, related signaling pathways, and the interaction network of TAIC may serve as promising therapeutic targets in the immunotherapy of OSCC. In this review, we summarize the recent research on the effects of TAIC and their interaction network in the TME in the progression of OSCC and explore its application in the early diagnosis and treatment of OSCC

Objective To investigate the effects of alcoholic extract of Hemerocallis citrina Baroni on the depressive-like behaviors in zebrafish larvae(Danio rerio)induced by reserpine.Methods Zebrafish larvae were divided into various groups:control(Con)group,reserpine group,fluoxetine group,H.citrina alcohol extract(HCE)low dose group(1.5 mg/L),HCE medium dose group(3 mg/L),and HCE high dose group(4.5 mg/L).Depressive-like behaviors were analyzed using sound and light stimulation.Real-time PCR was used to investigate the effects of HCE on depression related astrocyte markers(GFAP,C3,C4B,EMP-1,S100α-10)and the neurotrophic factor BDNF and its receptor genes(P75,TrkB).Results In comparison to the control group,the model group demonstrated significantly shorter movement distance and reduced movement time under sound and light stimulation(P＜0.05,P＜0.001,P＜0.0001).Following the administration of HCE,zebrafish larvae exhibited significantly heightened sensitivity to light and sound stimulation compared to the model group(P＜0.05,P＜0.0001).Astrocyte marker genes were up-regulated in the model group zebrafish brains compared to the control group(P＜0.0001).However,when the model group was administered HCE,the expression of astrocyte markers was significantly down-regulated compared to the model group(P＜0.0001).Neurotrophic factor and its receptor genes(BDNF,P75,TrkB)were down-regulated in zebrafish brains in the model group compared to those in the control group(P＜0.0001).However,in the group administered HCE,the expression of BDNF,P75,and TrkB was significantly up-regulated compared to that in the model group(P＜0.01,P＜0.0001).These findings suggest that HCE suppressed the inflammatory responses caused by astrocyte activation and promoted the production of neurotrophic factors and their receptor genes,thereby exerting an ameliorative effect on depression.Conclusions Alcoholic extracts of H.citrina can ameliorate the depression-like behavioral changes induced by reserpine in zebrafish larvae.They reduce the expression of astrocyte markers in the zebrafish brain and promote the production of neurotrophic factors and their receptor genes,playing an antidepressant role.

Vaccination is a main measure for protecting chickens against Marek's disease,while it is not able to suppress the infection,proliferation,transmission,and virulence enhancement on Marek's disease virus.Inhibiting the proliferation of Marek's disease virus in chicken is therefore an im-portant option for enhancing defense effectiveness.In this study,a compound,DUBs-IN-1,was found to inhibit the activity of MDV049,a protease encoded by Marek's disease virus,via screening a protease inhibitor library using MDV049 as target and ubiquitin probe.Molecular docking re-vealed that DUBs-IN-1 can interact with the residues which formed the catalytic pocket of MDV049,blocking the interaction between Ub substrate and the catalytic center of MDV049,then suppress the activity of MDV049 with competitive inhibition.Using the CPE model,it was found that DUBs-IN-1 at the concentration of 0.35 and 0.70 μmol/L significantly inhibited the CPE in-duced by Marek's disease virus in CEF cells.Quantitative analysis revealed that DUBs-IN-1 inhibi-ted the proliferation of Marek's disease virus in CEF cells(P＜0.01).Furthermore,it was found that the administration of 80 and 150 pg/(kg·d)of DUBs-IN-1 in chicken infected by Marek's disease virus significantly inhibited the proliferation of MDV in T cells(P＜0.01).In summary,this study demonstrated that the compound DUBs-IN-1 is able to inhibit the proliferation of Marek's disease virus in chicken cells,laying a theoretical and practical foundation for further de-velopment of the drugs against Marek's disease virus.

Objective To investigate correlation between preoperative thyroid-related serological indicators and benign and malignant thyroid nodules.Methods Clinical data of 401 patients with thyroid nodules underwent surgical treatment in Guizhou Provincial People's Hospital from January to December 2020 were retrospectively analyzed.According to the results of postoperative pathological examination,they were divided into benign group(129 cases)and malignant group(272 cases).Clinical data and preoperative thyroid-related serological indicators were compared between two groups.Results Age and preoperative serum thyroglobulin(Tg)level in malignant group were significantly lower than those in benign group,and proportion of males was significantly higher than that in benign group(P<0.05).The receiver operating characteristic(ROC)curve showed that preoperative serum Tg value of 35.41ng/ml was cut-off point for the risk factor of distinguishing benign and malignant thyroid nodules.Subgroup analysis showed that serum Tg level in malignant group of patients≤40 years old was significantly lower than that in benign group,thyroid stimulating hormone(TSH)×thyroglobulin antibodies(TGAb),TGAb/thyroid peroxidase antibodies(TPOAb)values in malignant group of patients≤40 years old were significantly higher than those in benign group(P<0.05).Among patients over 40 years old,serum Tg level in malignant group was significantly lower than that in benign group(P<0.05).Serum Tg and TPOAb levels in malignant group of male patients were significantly lower than those in benign group(P<0.05).Serum Tg level in malignant group of female patients was significantly lower than that in benign group(P<0.05).ROC curve showed that preoperative serum TSH×TGAb value of 15.87,TGAb/TPOAb value of 1.06 were risk factor cut-off points for distinguishing benign and malignant thyroid nodules in young adults,and preoperative serum TPOAb value of 9.40IU/ml was risk factor cut-off point for distinguishing benign and malignant thyroid nodules in males.Conclusion Male,young age and decreased Tg value are independent risk factors for thyroid cancer.Serum Tg value has certain diagnostic value for differentiating benign and malignant thyroid nodules.Decrease of preoperative serum TPOAb level is a risk factor for male thyroid cancer.Preoperative elevated TSH×TGAb and TGAb/TPOAb are independent risk factors for development of thyroid cancer in young adults.

Objective To explore the causal relationship between educational attainment and chronic kidney disease(including chronic glomerulonephritis,nephrotic syndrome,diabetic nephropathy,chronic renal failure,and other clinical diagnoses of chronic kidney disease),and provide targeted guidance support for different populations in the prevention and treatment of chronic kidney disease.Methods The study used four regression models,random-effects inverse-variance weighted(IVW),MR-Egger regression,weighted median method,and weighted model,to perform Mendelian randomization analysis of the causal relationship between educational attainment and chronic kidney disease.Results All four regression models showed no statistical significance for the three models of chronic kidney disease,chronic glomerulonephritis,and nephrotic syndrome with P>0.05.The diabetic nephropathy model was seen to be statistically significant as the results of the three methods except IVW method(OR=0.520,P<0.05)were not significant,while the scatter plot showed that the direction of the total effect value was the same for all methods.Chronic renal failure model IVW method(OR=0.487,P<0.001),weighted median method(OR=0.503,P<0.001)showed a significant effect and the scatter plot showed that the direction of the total effect value was the same in all methods,which was statistically significant.Conclusion Using two-sample Mendelian randomization method to exclude confounding factors and reverse causal associations,unbiased estimation results were obtained to get that the education level is not related to the overall chronic kidney disease incidence,but has reverse causality for diabetic nephropathy and chronic renal failure among them.

Purpose/Significance The establishment of a specialized database for children with attention deficit hyperactivity disorder(ADHD)aims to address the issues of low data usage efficiency caused by scattered and low-quality diagnostic data.Method/Process Based on clinical diagnostic data of children with ADHD from March 2020 to April 2024,natural language processing(NLP)techniques are utilized to realize the post-structuring of the data.Furthermore,standardization of the database is performed according to industry standards and treatment guidelines.Result/Conclusion The specialized database for children with ADHD is established,comprising data from 75 835 ADHD children and 280 000 clinical visits.This database supports various applications such as the analysis of basic character-istics of the ADHD population,prediction model construction,resource allocation optimization,and clinical pathway optimization.

ObjectiveTo evaluate the efficacy and safety of various oral Chinese patent medicines in the adjuvant treatment of chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS） based on network Meta-analysis. MethodRandomized controlled trials （RCTs） of oral Chinese patent medicine in the adjuvant treatment of CP/CPPS were retrieved from the databases of China National Knowledge Infrastructure （CNKI）， Wanfang， VIP， SinoMed， PubMed， Cochrane Library， EMbase， and Web of Science from database inception to November， 2022. The quality of the included literature was evaluated according to the Cochrane risk-of-bias tool， and the data were analyzed by RevMan 5.4 and Stata 16 software. ResultA total of 63 RCTs were included， with 13 kinds of oral Chinese patent medicines involved， including Qianlie Shutong capsules， Ningmitai capsules， Qianlie Beixi capsules， Sanjin tablets， etc. The results of the network Meta-analysis showed that in terms of clinical effective rate， the intervention measure ranked first was Qianlie Beixi capsules combined with conventional western medicine. In terms of reducing pain， the intervention measure ranked first was Sanjin tablets combined with conventional western medicine. In terms of reducing urination disorder， the intervention measure ranked first was Relinqing granules combined with conventional western medicine. In terms of improving quality of life， the intervention measure ranked first was Qianlie Beixi capsules combined with conventional western medicine. In terms of reducing the total National Institutes of Health Chronic Prostatitis Symptom Index （NIH-CPSI） score， the intervention measure ranked first was Yinhua Miyanling tablets combined with conventional western medicine. In terms of reducing leukocyte count in prostatic secretions， the intervention measure ranked first was Qianlie Jiedu capsules combined with conventional western medicine. In terms of safety， the intervention measure with the least adverse reactions was Qianlie Shutong capsules combined with conventional western medicine. The cluster analysis results showed that Qianlie Shutong capsules combined with conventional western medicine had outstanding efficacy and high safety. ConclusionOral Chinese patent medicine in the adjuvant treatment of CP/CPPS can improve the comprehensive efficacy， reduce the NIH-CPSI score and leukocyte count in prostatic secretions， and improve the quality of life of patients. For clinical treatment， the preferred choice is Qianlie Beixi capsules or Qianlie Shutong capsules combined with conventional western medicine. Limited by the quantity and quality of literature included in this study， the results need to be verified by high-quality studies with a larger sample size.

BACKGROUND:Studies have found that nicotine can activate the dopamine system,slowing the progression of Parkinson's disease,but the specific mechanism is still unclear.Research on the neuroprotective mechanism of nicotine in animal models of Parkinson's disease is lacking. OBJECTIVE:To investigate the neuroprotective effect of nicotine on rotenone-induced Parkinson's disease in mice. METHODS:Twenty-eight C57BL/6 mice were randomly divided into vehicle group,rotenone group,autophagy agonist group and nicotine group,with seven mice in each group.Dopaminergic nerve damage was induced by rotenone in C57BL/6 mice,and the autophagy agonist(rapamycin)or nicotine was given before modeling.The spatial exploration function of the mice was observed by open field test.Western blot and Q-PCR were used to detect the expression of α-synuclein,autophagy related factors Beclin-1 and P62,and apoptosis-related factors Bax,Bcl-2 and Cleaved-caspase3 in the nigra of each group.The deposition of mitochondria,autophagosomes and lipofuscin in nigra cells were observed by transmission electron microscopy.The survival of neurons was observed by Nissl staining.The expression of tyrosine hydroxylase was observed by immunofluorescence and immunohistochemical staining. RESULTS AND CONCLUSION:The open field test showed that the distance,average speed and time of movement were reduced in the rotenone group compared with the solvent group.Compared with the rotenone group,the exercise distance,average speed and exercise time of mice were increased in the nicotine group and autophagy agonist group(P＜0.05).The results of immunofluorescence and immunohistochemistry showed that the mean fluorescence intensity and mean absorbance value of tyrosine hydroxylase in the rotenone group decreased compared with that in the solvent group.Compared with the rotenone group,the mean fluorescence intensity and mean absorbance value of tyrosine hydroxylase were increased in the nicotine group and autophagy agonist group.Western blot and Q-PCR results showed that compared with the solvent group,the expressions of α-synuclein and P62 in the rotenone group were increased,while Beclin-1 expression was decreased(P＜0.05);compared with the rotenone group,the expression of α-synuclein and P62 decreased in the nicotine group and autophagy agonist group,and the expression of Beclin-1 increased(P＜0.05).Compared with the solvent group,the expressions of Bax and Cleaved caspase3 were increased and Bcl-2 expression was decreased in the rotenone group(P＜0.05);compared with the rothenone group,the expressions of Bax and Cleaved-caspase3 were decreased and the expression of Bcl-2 was increased in the nicotine and autophagy agonist groups(P＜0.05).To conclude,nicotine may have a dopaminergic neuroprotective effect on rotenone-induced Parkinson's disease mouse models by improving autophagy dysfunction and reducing apoptosis.

Objective To analyze the competition status and spatial autocorrelation of Beijing medical market from 2015 to 2019.Methods The Herfindahl-Hirschman Index(HHI)was used to calculate the degree of market competi-tion in 16 districts of Beijing,and the Moran index was used to calculate the spatial autocorrelation of market compe-tition.Results Except for the number of discharged patients,the average HHI of the number of health technicians,the number of beds and the total number of medical visits in 16 medical markets in Beijing from 2015 to 2019 showed a downward trend between 0.2 and 0.4,and the spatial global Moran index of the HHI index was all less than 0,showing a spatial negative correlation with the degree of competition in the medical market.Conclusion The medical market competition in Beijing is strengthened,the competition gap between urban and rural areas is large,and the competition in adjacent markets is mutually exclusive.It is suggested to strengthen the differentiated develop-ment of hospitals,strengthen the balanced layout between regions,and promote the low-competitive market with cross-regional medical association,forming a positive spillover effect.