Lianpo Yin was first recorded in the Revised Treatise on Cholera from Suixi Residence by WANG Mengying. It is composed of seven medicinal herbs： Coptidis Rhizoma， Magnoliae Officinalis Cortex， Sojae Semen Praeparatum， Acori Tatarinowii Rhizoma， Pinelliae Rhizoma， Gardeniae Fructus， and Phragmitis Rhizoma. As one of the classic prescriptions for clearing heat， resolving dampness， regulating Qi， and harmonizing the middle energizer， it has been included in the Catalogue of Ancient Classic Prescriptions （Second Batch： Han Chinese Medicine） published by the National Administration of Traditional Chinese Medicine in 2023. Lianpo Yin is primarily indicated for cholera caused by the accumulation of dampness-heat， and it can promote digestion and eliminate phlegm. By summarizing the ancient literature records， chemical constituents of individual herbs and the compound formula， pharmacological effects， and modern clinical applications of Lianpo Yin， this paper discovers that the understandings of most ancient physicians are consistent with the original text. The pathogenesis treated by this prescription is generally attributed to the accumulation of dampness-heat in the middle energizer and disrupted ascending and descending of Qi. The main chemical components of this prescription include coptisine， trigonelline， genistein， palmatine， berberine， honokiol， and magnolol. Lianpo Yin exhibits pharmacological effects such as anti-inflammatory activity， regulation of apoptosis， modulation of mitochondrial autophagy， regulation of the hypothalamic-pituitary-adrenal （HPA） axis， promotion of gastrointestinal motility， improvement of the gastric mucosal barrier， regulation of intestinal flora and their metabolites， and antimicrobial activity. In modern clinical practice， this prescription is mainly used to treat digestive system diseases such as chronic superficial gastritis and Helicobacter pylori （Hp）-associated gastritis. Additionally， it demonstrates significant therapeutic effects on various diseases affecting the nervous， respiratory， dermatological， and cardiovascular systems. This study provides a detailed review of the ancient literature records， chemical components， pharmacological effects， and clinical applications of Lianpo Yin and its modified formulas， aiming to offer references for the dosage form development and broader clinical application of this classic prescription.

AIM: To investigate the effects of high-concentration glucose on the cell viability of retinal pigment epithelialcells(ARPE-19)/ human umbilical vein endothelial cells(HUVEC)cells, as well as on the expression levels of sirtuin 6(SIRT6).

METHODS:ARPE-19 and HUVEC cells were cultured for 48 h in media containing various glucose concentrations(5.5, 25, 50, 75, 100 mmol/L)and cellular morphology was observed under an optical microscope.Cell viability was assessed using the CCK-8 assay. Flow cytometry was utilized to evaluate apoptosis levels, and Western blot analysis was conducted to measure the expression of Bcl-2 and SIRT6. ARPE-19/HUVEC cells were treated with 50 mmol/L glucose for 48 h, after which immunofluorescence staining was performed to determine the subcellular localization and expression level of SIRT6 protein. In parallel, cells receiving the same treatment were harvested at different time points(0, 6, 12, 24, 36, 48, and 72 h), and the temporal changes in SIRT6 protein expression were assessed by Western blot analysis. SIRT6 overexpressing stable ARPE-19/HUVEC cell lines were constructed. Western blot was performed to detect the effects of SIRT6 overexpression on the expression levels of glucose transporters in ARPE-19/HUVEC cells treated with high glucose(50 mmol/L glucose).

RESULTS:Compared with the 5.5 mmol/L glucose group, cell number was decreased and cell viability was significantly reduced in ARPE19/HUVEC cells with increasing glucose concentrations(all P<0.01). Meanwhile, the protein expression level of SIRT6 was markedly downregulated(P<0.05). Such inhibitory effects exhibited both concentration-and time-dependent patterns(all P<0.05). Furthermore, high glucose induced cell apoptosis and downregulated the protein expression of Bcl-2(P<0.05). Immunofluorescence staining revealed that SIRT6 protein was predominantly localized in the nucleus after 48 h of high-glucose treatment, accompanied by pyknosis and nuclear fragmentation. After incubation with highg-lucose medium(50 mmol/L glucose)for different durations, long-term high-glucose intervention was found to reduce SIRT6 protein expression in ARPE19/HUVEC cells. Successful construction of the SIRT6-overexpressing stable ARPE-19/HUVEC cell lines was confirmed via immunofluorescence and Western blotting. Western blot analysis revealed that, compared with the HG+LV-con group, the HG+LV-SIRT6 group exhibited no significant differences in GLUT1 or GLUT4 expression in ARPE-19 cells, whereas GLUT3 expression was elevated(P<0.05). Compared with the HG+LV-con group, the HG+LV-SIRT6 group showed no significant change in GLUT1 expression, while GLUT3 and GLUT4 levels were increased(both P<0.05).

CONCLUSION:High-concentration glucose-reduce the proliferative activity of ARPE-19/HUVEC cells, induce apoptosis, and downregulate SIRT6 expression. SIRT6 may alleviate high glucose-induced retinal cell damage by promoting the expression of glucose transporters.

Objective: To understand the incidence risk and risk factors of tuberculosis (TB) among middle school students in Chongqing, so as to provide a basis for formulating TB prevention and control strategies. Methods: From September to December 2022, 32 181 middle school students were selected as the study cohort from 15 administrative districts in Chongqing by using the stratified cluster random sampling method. All cohort members were screened with the tuberculin skin test (TST), and relevant information was collected from January 1, 2023 to December 31, 2024. On the basis of active screening, the follow up data of the participants were compared with the National Tuberculosis Management Information System to obtain the incidence status of the study subjects. The Log rank test was used to compare the TB incidence rates among students with different characteristics, and a Cox proportional hazards model was established to analyze the incidence risk and risk factors of TB. Results: The TST screening rate of the cohort members was 93.0%. During the 2 year follow up period, a total of 36 TB cases occurred, with a cumulative incidence rate of 111.87/100 000 and an incidence density of 55.95/100 000. Among them, the cumulative incidence rate of students from public schools (170.44/ 100 000 ) was higher than that of students from private schools (41.16/100 000), the cumulative incidence rate of students in schools located in high epidemic areas (153.95/100 000) was higher than that in medium epidemic areas (69.00/100 000), and the difference was statistically significant ( χ 2=11.49, 4.73, both P <0.05). The Log-rank test for different TST results showed that the difference in TB comulative incidence rate between students with strongly positive TST results (216.55/ 100 000 ) and those with negative TST results (81.40/100 000) was statistically significant ( χ 2=5.85, P <0.05). Univariate analysis using the Cox proportional hazards model revealed that the risk of TB was lower in students from private schools ( HR=0.25, 95% CI = 0.10-0.59) and students in medium epidemic areas ( HR=0.46, 95%CI =0.23-0.94); whereas the risk of TB was increased in students with strongly positive TST results ( HR=1.39, 95%CI =1.05-1.84) (all P <0.05). Multivariate Cox regression analysis showed that the risk of TB in students from private schools was lower than that of students from public schools ( HR=0.23, 95%CI=0.08-0.62, P <0.05). Conclusions The annual average incidence rate of TB among middle school students in Chongqing is at a relatively high level. It is necessary to strengthen the management and intervention for student groups, including those in public schools, those in schools located in high epidemic areas, and those with strongly positive TST results, so as to reduce the incidence rate of TB.

Objective : To analyze the epidemiological characteristics and spatial clustering of brucellosis in Shanxi Province from 2019 to 2023, so as to provide a reference for formulating prevention and control measures of brucellosis. Methods: The case data of brucellosis in Shanxi Province from 2019 to 2023 were collected through the Infectious Disease Surveillance System of the Chinese Disease Prevention and Control Information System. The seasonal distribution, population distribution, and region distribution of brucellosis cases were described. Spatial autocorrelation analysis was applied to explore the spatial clustering characteristics of brucellosis. Results: A total of 21 241 human brucellosis cases were reported in Shanxi Province from 2019 to 2023, with an average annual reported incidence of 11.87/100 000, showing an upward trend (P<0.05). The peak incidence period was from March to August, with 14 163 cases reported cumulatively, accounting for 66.68% of the total. There were 16 336 male cases and 4 905 female cases, with a male-to-female ratio of 3.33:1. The high-incidence age group was 40-<70 years, with 15 675 cases accounting for 73.80%. The majority of patients were farmers, with 17 926 cases accounting for 84.39%. Spatial autocorrelation analysis showed that there was spatial clustering in the incidence of brucellosis from 2019 to 2023 (all Moran's I>0, P<0.05). The high-high clustering areas were mainly Datong City, and Shuozhou City in northern Shanxi, and Linfen City in the southern Shanxi. The low-low clustering areas were mainly Taiyuan City and Yangquan City in central Shanxi, and Changzhi City and Jincheng City in southeastern Shanxi. Conclusions From 2019 to 2023, the reported incidence of brucellosis in Shanxi Province showed an upward trend. The incidence peaked from March to August, and males, middle-aged and elderly people and farmers were the high-risk groups. There was spatial clustering and the high-high clustering areas gradually expanded from northern Shanxi to southern Shanxi.

Acute myocardial infarction and acute upper gastrointestinal bleeding are both critical internal medicine conditions. The incidence of acute upper gastrointestinal bleeding in patients with acute myocardial infarction ranges from 5.31% to 8.90%, with a mortality rate as high as 20.50% to 35.70%. The pathogenesis may be related to the use of antiplatelet and anticoagulant drugs, as well as stress-induced injury. In treatment, the contradiction between antiplatelet/anticoagulation therapy and bleeding has made this disease a significant challenge in modern medicine. Therefore, re-exploring the etiology, pathogenesis, treatment principles, and methods of traditional Chinese medicine(TCM) for acute myocardial infarction and acute upper gastrointestinal bleeding is of great clinical importance. The research team has been working year-round in the coronary care unit(CCU), managing a large number of such severe patients. By revisiting classic texts and delving into the foundational theories of TCM and historical medical literature, it has been found that this disease falls under the category of "distant blood" in the Synopsis of the Golden Chamber. In terms of etiology, it is primarily associated with weakness of healthy Qi and damage caused by drug toxicity. In terms of pathogenesis, in the acute stage, it mainly manifests as insufficient spleen Yang, deficiency of spleen Qi, and failure of the spleen to control blood. In the remission stage, it is characterized by deficiency of both heart Qi and spleen blood. For treatment, during the acute stage, Huangtu Decoction is used to warm Yang and restrain blood, while in the remission stage, Guipi Decoction is administered to tonify Qi and nourish blood. During the treatment process, for patients with acute myocardial infarction complicated with acute upper gastrointestinal bleeding, it is crucial to flexibly apply the treatment principles of "Nil per os" in western medicine and "where there is stomach Qi, there is life; where there is no stomach Qi, there is death" in TCM. Early intervention with Huangtu Decoction can also prevent bleeding, with large doses being key to achieving hemostasis. It is important to address the pathogenesis of heat syndrome in addition to the core pathogenesis of Yang deficiency bleeding and to emphasize the follow-up treatment with Guipi Decoction for a successful outcome.
Humans ; Gastrointestinal Hemorrhage/etiology* ; Myocardial Infarction/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Medicine, Chinese Traditional ; Acute Disease

Objective: To retrospectively compare the impact of different intraoperative transfusion strategies for platelets and cryoprecipitate on perioperative blood usage and clinical outcomes in patients undergoing orthotopic heart transplant (OHT), thereby providing a reference for perioperative patient blood management. Methods: The clinical data of 65 patients who had undergone OHT at our hospital between 2020 and 2025 were retrospective collected. Patient demographics, underlying chronic conditions, and perioperative (preoperative, intraoperative, and postoperative) laboratory blood test results were analyzed. The transfusion volumes of intraoperative red blood cells, plasma, platelets, and cryoprecipitate were examined. Univariate and multivariate logistic regression models were employed to identify factors associated with perioperative outcomes. Results: A total of 65 patients received allogeneic blood transfusion during the perioperative period. The ultilization of intraoperative platelets and cryoprecipitate was as follows: simultaneous transfusion of both platelets and cryoprecipitate (at a 1∶1 ratio) was administered in 42 patients (64.62%), platelets alone in 12 patients (18.46%), and cryoprecipitate alone in 11 patients (16.92%). Patients who received simultaneous transfusion of platelets and cryoprecipitate (1∶1) (n=42) had a shorter ICU length of stay (32.45±10.18 d), while those who received either platelets or cryoprecipitate alone (n=23) had a significantly longer ICU length of stay (68±15.97 d). Patients receiving simultaneous intraoperative transfusion of platelets and cryoprecipitate also required fewer units of allogeneic red blood cells intraoperatively (median=4 units) and had a lower mortality rate (16.7%) than those receiving either product alone (26.1%), with a statistically significant difference (P=0.023). Multivariate logistic regression analysis indicated that the volume of cryoprecipitate transfused was an independent protective factor against postoperative allogeneic red blood cell transfusion (OR=0.344, 95% CI [0.177, 0.829], P=0.0159). Multivariate logistic regression also identified cryoprecipitate transfusion volume as an independent protective factor for ICU length of stay (OR=0.877, 95% CI [0.719, 0.986], P=0.0008), which was in line with the multivariate Cox regression results. Conclusion: In patients undergoing OHT, the intraoperative transfusion strategy for platelets and cryoprecipitate influences the volume of perioperative allogeneic red blood cell transfusion and patient mortality. Intraoperative cryoprecipitate transfusion volume is an independent protective factor against both postoperative allogeneic red blood cell transfusion and prolonged ICU length of stay. The establishment of a multidisciplinary collaborative blood management model, combined with the modification of perioperative blood utilization practices and the implementation of a comprehensive patient blood management strategy, can holistically ensure perioperative patient safety.

Ferric oxide/nitrogen-doped carbon nanomaterials(Fe2O3/N-C)with high oxidase-like activity were successfully synthesized via the wet chemistry and pyrolysis method using pyrrole and 1,2,3,4-butanetetracarboxylic acid as raw materials and ferric chloride as the oxidant.The structure and morphology of Fe2O3/N-C were characterized by the techniques including scanning electron microscopy,surface scanning elemental analysis,X-ray diffraction,X-ray photoelectron spectroscopy,and Fourier transform infrared spectroscopy.It was revealed that Fe2O3/N-C could efficiently catalyze the conversion of colorless 3,3',5,5'-tetramethylbenzidine(TMB)into blue-colored oxidized TMB(oxTMB).Based on the principle that ascorbic acid(AA)could inhibit the catalytic color-development reaction of Fe2O3/N-C on TMB,resulting in a paler color and a reduction in the absorbance of the system,a colorimetric sensor for sensitive and accurate detection of AA was constructed.The linear range of the sensor for AA detection was 0.25-30.0 μmol/L,and the detection limit was 0.1 μmol/L.Moreover,it was successfully applied to determination of AA in beverage and tablet samples with satisfactory results.

Objective To investigate the association between birth weight and dementia risk and the mediating roles of chronic diseases,and to assess potential biological pathways underlying the birth weight-associated dementia risk based on large-scale proteomics.Methods We used data from 279 743 participants aged 40 to 69 years enrolled in the UK Biobank.Birth weight was categorized into low birth weight(≤2 500 g),normal birth weight(2 500-3 999 g),and macrosomia(≥4 000 g).Multivariable Cox proportional hazards regression models were used to assess the associations between birth weight categories and all-cause dementia and its subtypes(Alzheimer's disease and vascular dementia).Proteomics analyses were conducted to identify proteins and the potential pathways involved.Results Low birth weight was associated with higher risks for all-cause dementia and its subtypes.The hazard ratios were 1.18(95%CI,1.08-1.30)for all-cause dementia,1.14(95%CI,1.00-1.31)for Alzheimer's disease,and 1.22(95%CI,1.01-1.48)for vascular dementia.A non-linear relationship was observed between birth weight and dementia risk(P for nonlinearity<0.001).Certain cardiometabolic diseases in middle-aged adults,such as diabetes,stroke,hypertension,and dyslipidemia,played a significant mediating role in the relationship between low birth weight and dementia risk,with the mediation proportion being 6.3%to 15.8%.Proteomic analyses identified 21 proteins linked to both low birth weight and all-cause dementia risk,which were significantly enriched in the pathways for viral protein interaction with cytokines and cytokine receptors,adipocytokine signaling,and cytokine-cytokine receptor interaction.Conclusion Low birth weight is positively associated with dementia risk.Cardiometabolic diseases in middle-aged adults may mediate the relationship between low birth weight and dementia risk.A number of proteins and the associated pathways underscore the relationship between low birth weight and dementia risk.

Objective:To compare and analyze the parameters of image quality of virtual mono-energetic images(VMIs)and conventional computed tomography(CT)images of dual-energy CT(DECT)imaging for the coracoclavicular ligament,and to optimize the image quality of DECT imaging for coracoclavicular ligament.Methods:The DECT image data of shoulder joints of 50 patients who received DECT scan in the First People's Hospital Affiliated to Shanghai Jiao Tong University were retrospectively analyzed.450 VMIs at energy levels of 40 to 120 keV were obtained through the Syngo.via VB20 workstation,and these VMIs were divided into three groups:low energy level(40,50,60 keV),medium energy level(70,80,90 keV),and high energy level(100,110,120 keV).The contrast-to-noise ratio(CNR),the direction of coracoclavicular ligament's rows,and the displayed subjective quality scores of attachment points of VMIs were compared with those of conventional CT images.The results of MRI examination were used as the"gold standard"to assess the effectiveness of VMIs in diagnosing coracoclavicular ligament injuries of patients with acromioclavicular joint dislocation.The diagnostic efficacies of VMIs'the three groups and conventional images were assessed by using receiver operating characteristic(ROC)curve.Results:The CNR values of diagonal ligament and conical ligament at 40 keV of low energy level group of VMIs for coracoclavicular ligament were respectively 14.09±3.27 and 13.9±3.06,and those of medium energy level group were respectively 11.89±4.01 and 12.17±4.08,and those of high energy level were respectively 9.69±4.25 and 9.78±4.33.The CNR value of low energy level group was significantly higher than that of medium and high energy level groups,and the differences were statistically significant(t=21.1,16.3,P<0.05),respectively.The results of ROC curve analysis indicated that the sensitivity,specificity and area under curve(AUC)value of the low energy level group were relatively higher in diagnosing coracoclavicular ligament injury,which were respectively 90.05%,91.95%and 0.965.There was high consistence in assessing coracoclavicular ligament injury between DECT's VMIs and MRI examination(Kappa=0.896).Conclusion:DECT's VMIs can better display the rows and attachment points of diagonal ligament and conical ligament,and the VMIs quality at low energy level(40 to 70 keV)is the best,which has better diagnostic efficacy in diagnosing coracoclavicular ligament injury.

Objective To analyze the clinical features of premature rupture of membrane(PROM)complicated with histologic chorioamnionitis(HCA),and to provide insights for clinical management of such pregnant women and their newborns.Methods A total of 202 cases of PROM pregnant women who gave birth and performed placental pathological examination in the Affiliated Hospital of Southwest Medical University from January to December 2021 were retrospectively analyzed.According to the histopathological results,the pregnant women were divided into HCA group(n=151)and control group(n=51),and the prenatal factors and short-term maternal-fetal pregnancy outcomes of two groups were compared and analyzed.Results The amniotic fluid contamination rate,white blood cell count,neutrophil count and serum amyloid A levels in HCA group were significantly higher than those in control group(P＜0.05).There was a higher incidence of early neonatal septicemia in HCA group than in control group(P＜0.05).Conclusion The risk of early-onset sepsis in neonates with PROM complicated with HCA significantly increases.It is necessary to strengthen the screening and early intervention in such cases.Amniotic fluid contamination and increased maternal infection indicators are associated with the occurrence of HCA,which may has potential value in predicting HCA occurrence.