OBJECTIVE To explore the main factors influencing the blood concentration of duloxetine， and provide a scientific basis for the individualized use of duloxetine. METHODS Retrospective analysis was conducted on 434 inpatients with depressive disorders at the First Hospital of Hebei Medical University， who were treated with duloxetine and underwent blood concentration monitoring between January 2022 and April 2024. The study examined the impact of various factors， including gender， age， body mass index （BMI）， gene phenotypes， combined medication， drug type （original/generic）， and genotyping results of gene single nucleotide polymorphism loci， on blood concentration and the concentration-to-dose （C/D） after dose adjustment. RESULTS The blood concentration of duloxetine was 76.65 （45.57， 130.31） ng/mL， and C/D was 0.96 （0.63， 1.60） ng·d/（mL·mg）. The blood concentration of duloxetine was positively correlated with the daily dose of administration （R2＝0.253 7， P＜0.001）. Blood concentration of duloxetine in 38.94% of patients exceeded the recommended range specified in the guidelines. Gender， age， BMI， combined use of CYP2D6 enzyme inhibitors， and CYP2D6 and CYP1A2 phenotypes had significant effects on C/D of duloxetine （P＜0.05）. CONCLUSIONS The patient’s age， gender， BMI， combined medication， and genetic phenotypes are closely related to the blood concentration of duloxetine.

Radiomics provides quantitative support for the diagnosis,treatment strategy and prognosis evaluation of brain arteriovenous malformation(bAVM)through high-throughput analysis of imaging data,and it also shows significant advantages in clinical symptom prediction,personalized treatment and clinical outcome prediction.Emerging imaging techniques,such as blood oxygen level-dependent cerebrovascular reactivity imaging and ultrasound technology,provide a new perspective for evaluating the hemodynamic changes and epilepsy susceptibility associated with bAVM.In addition,advances in deep learning algorithms in automatic segmentation of bAVM lesions have greatly improved the accuracy and efficiency of segmentation.With the continuous progress of imaging technology,data analysis algorithms and software,radiomics is expected to play a greater role in precision medicine and individualized treatment,bringing better diagnosis and treatment services and better treatment effects for bAVM patients.

This study investigated the full-genome molecular characteristics of a rotavirus vaccine-derived strain,G1P[8]geno-type A group rotavirus RVA/Human-wt/CHN/HN1140/2021/G1P[8](referred to as HN1140).The gene fragments of the HN1140 strain were amplified with reverse transcription-polymerase chain reaction(RT-PCR)combined with whole-genome primers to obtain the full genome sequence.Genotyping was performed with the online genotyping tool RotaC 2.0,and similarity and genetic evolution analyses for each gene segment were conducted in DNAstar5.1 and MEGA11.0 software.The genotype of the HN1140 strain was deter-mined to be G1-P[8]-I2-R2-C2-M2-A3-N2-T6-E2-H3.Phylogenetic analysis demonstrated that all 11 genomic segments clus-tered closely with the RotaTeq vaccine strains,sharing 99.7%-100%nucleotide sequence similarity.Notably,VP1,VP2,VP6,and NSP2-NSP5 segments showed 100%nucleotide identity with RotaTeq strains.Comparative genomic analysis identified 13 nucleotide and 8 amino acid substitutions between HN1140 and RotaTeq strains,localized within the VP7,VP4,VP1,VP2,VP3,and NSP1 segments.The HN1140 strain exhibited the genotype G1-P[8]-A3-T6-H3,which was consistent with the typical profile of a vaccine-derived reassortant.This strain demonstrated high genetic similarity to RotaTeq vaccine strains,with nucleotide sequence identity ranging from 99.7%to 100%.These findings suggested that HN1140 evolved from RotaTeq vaccine strains through genetic reassortment.

Objective To analyze the core syndromes of patients with generalized anxiety disorder(GAD),explore the core pathogenesis,and offer innovative perspectives and practical strategies for the traditional Chinese medicine(TCM)diagnosis and treatment of GAD.Methods The basic information of GAD patients was collected,and depression symptoms were evaluated with Hamilton Anxiety Scale to evaluate anxiety symptoms,Hamilton Depression Scale,and the TCM psychiatric and somatic symptoms were evaluated with Traditional Chinese Medicine Symptom Observation Form.Based on the data collected from the Traditional Chinese Medicine symptom observation table,the systematic clustering method was used to cluster the symptoms with a frequency greater than 10％,determine the disease type syndrome and disease location syndrome,and form a syndrome symptom relationship table.According to this table,the traditional Chinese medicine syndrome score of each patient is calculated.The complex network analysis was carried out to evaluate core syndromes and analyze the relationships between core syndromes and psychiatric symptoms and core syndromes and other syndromes.Results A total of 517 patients with GAD were included.There were 81 symptoms with a frequency of more than 10％,including 21 psychological symptoms and 60 physical symptoms.The clustering analysis led to a total of 12 syndromes,including 6 pathological syndromes,namely yin deficiency,heat,phlegm dampness,qi stagnation,blood stasis,and qi deficiency,and 6 disease location syndromes,namely liver,spleen,kidney,gallbladder,stomach,and heart.The results of complex network analysis show that the core pathological syndrome of GAD is kidney,and the core pathological syndrome is yin deficiency.The joint analysis of pathological syndrome and pathological syndrome network suggests that yin deficiency is the core of the integrated network.The relationship between yin deficiency syndrome and various organs is in the order of kidney,spleen,gallbladder,liver,heart,and stomach.The syndrome element of yin deficiency has the highest correlation with being easily frightened,excessive thinking,indecisiveness,repetitive behavior,and groundless worry.The kidney syndrome has the highest correlation with the symptoms such as being easily scared,unfounded worry,repetitive actions,excessive rumination,and restlessness.Conclusion The core pathological pattern of GAD is kidney and the core pathological pattern is yin deficiency.Kidney yin deficiency may be the core pathogenesis of GAD.

This study investigated the full-genome molecular characteristics of a rotavirus vaccine-derived strain,G1P[8]geno-type A group rotavirus RVA/Human-wt/CHN/HN1140/2021/G1P[8](referred to as HN1140).The gene fragments of the HN1140 strain were amplified with reverse transcription-polymerase chain reaction(RT-PCR)combined with whole-genome primers to obtain the full genome sequence.Genotyping was performed with the online genotyping tool RotaC 2.0,and similarity and genetic evolution analyses for each gene segment were conducted in DNAstar5.1 and MEGA11.0 software.The genotype of the HN1140 strain was deter-mined to be G1-P[8]-I2-R2-C2-M2-A3-N2-T6-E2-H3.Phylogenetic analysis demonstrated that all 11 genomic segments clus-tered closely with the RotaTeq vaccine strains,sharing 99.7%-100%nucleotide sequence similarity.Notably,VP1,VP2,VP6,and NSP2-NSP5 segments showed 100%nucleotide identity with RotaTeq strains.Comparative genomic analysis identified 13 nucleotide and 8 amino acid substitutions between HN1140 and RotaTeq strains,localized within the VP7,VP4,VP1,VP2,VP3,and NSP1 segments.The HN1140 strain exhibited the genotype G1-P[8]-A3-T6-H3,which was consistent with the typical profile of a vaccine-derived reassortant.This strain demonstrated high genetic similarity to RotaTeq vaccine strains,with nucleotide sequence identity ranging from 99.7%to 100%.These findings suggested that HN1140 evolved from RotaTeq vaccine strains through genetic reassortment.

Objective To analyze the core syndromes of patients with generalized anxiety disorder(GAD),explore the core pathogenesis,and offer innovative perspectives and practical strategies for the traditional Chinese medicine(TCM)diagnosis and treatment of GAD.Methods The basic information of GAD patients was collected,and depression symptoms were evaluated with Hamilton Anxiety Scale to evaluate anxiety symptoms,Hamilton Depression Scale,and the TCM psychiatric and somatic symptoms were evaluated with Traditional Chinese Medicine Symptom Observation Form.Based on the data collected from the Traditional Chinese Medicine symptom observation table,the systematic clustering method was used to cluster the symptoms with a frequency greater than 10％,determine the disease type syndrome and disease location syndrome,and form a syndrome symptom relationship table.According to this table,the traditional Chinese medicine syndrome score of each patient is calculated.The complex network analysis was carried out to evaluate core syndromes and analyze the relationships between core syndromes and psychiatric symptoms and core syndromes and other syndromes.Results A total of 517 patients with GAD were included.There were 81 symptoms with a frequency of more than 10％,including 21 psychological symptoms and 60 physical symptoms.The clustering analysis led to a total of 12 syndromes,including 6 pathological syndromes,namely yin deficiency,heat,phlegm dampness,qi stagnation,blood stasis,and qi deficiency,and 6 disease location syndromes,namely liver,spleen,kidney,gallbladder,stomach,and heart.The results of complex network analysis show that the core pathological syndrome of GAD is kidney,and the core pathological syndrome is yin deficiency.The joint analysis of pathological syndrome and pathological syndrome network suggests that yin deficiency is the core of the integrated network.The relationship between yin deficiency syndrome and various organs is in the order of kidney,spleen,gallbladder,liver,heart,and stomach.The syndrome element of yin deficiency has the highest correlation with being easily frightened,excessive thinking,indecisiveness,repetitive behavior,and groundless worry.The kidney syndrome has the highest correlation with the symptoms such as being easily scared,unfounded worry,repetitive actions,excessive rumination,and restlessness.Conclusion The core pathological pattern of GAD is kidney and the core pathological pattern is yin deficiency.Kidney yin deficiency may be the core pathogenesis of GAD.

Objective To evaluate the effect of different honey processing methods on the dissolution of Cynanchum salicifolia in vitro.Methods High performance liquid chromatography ① Carotene and β-Determination method of sitosterol content:chromatographic column:Dia monosil C18(250 mm×4.6 mm,5 μm).Mobile phase:methanol:0.05％phosphoric acid water=99∶1.Isocratic elution;Flow rate 1.0 mL·min-1;Detection wavelength 209 nm;Injection volume 10 μL.The column temperature is 30℃.②Determination method of glucose and fructose:the chromatographic column is Inspire NH2 sugar analysiscolumn(250 mm×4.6 mm,5 μm).The mobile phase was acetonitrile water(77∶23).The flow rate is 0.8 mL·min-1;The column temperature is 35℃;Injection volume 10 μL;Evaporative light scattering detector(ELSD):the drift tube temperature is 100℃,and the carrier gas flow rate is 2.8 L·min-1.Results ①The results showed that carotene and β-the determination of sitosterol showed a good linear relationship in the range of mass concentration(r＞0.9999).The average recoveries were 99.71％and 98.83％.The RSD of precision,stability and repeatability were all less than 2.0％.②The established method of glucose fructose showed a good linear relationship in the range of 0.05-0.50 mg·mL-1(r=0.9991).Conclusion The content determination method and in vitro dissolution test methodology of the study meet the requirements,which provides a scientific basis for the establishment of quality standards and modern research of honey roasted Paeonia salicifolia.

Background and purpose:Metabolic reprogramming occurs during tumor progression,and 1-acylglycerol-3-phosphate O-acyltransferase(AGPAT),as a key enzyme in the de novo synthesis of triacylglycerol(TAG),is closely associated with tumor progression.However,one of the isoforms,AGPAT5,has been studied in cancer in a very limited way,and this study aimed to provide a new perspective on the role of AGPAT5 in hepatocellular carcinoma and its potential molecular mechanisms,providing novel ideas for the diagnosis and treatment strategies of liver cancer.Methods:AGPAT5 was knocked down in a variety of hepatocellular carcinoma cell lines using lentiviral infection,and the effects of AGPAT5 on the functions of hepatocellular carcinoma cell proliferation,migration and resistance to anoikis were detected in vitro by experiments such as Taipan blue counting,scratching,transwell and plate cloning.The wild-type or enzyme activity-deficient form of AGPAT5 was rescued to investigate whether AGPAT5,as a metabolic enzyme,plays a classical role in regulating the migration of hepatocellular carcinoma cells.We constructed a tail vein metastasis model in nude mice to validate the cellular phenotype in vitro from the in vivo level.Immunoprecipitation mass spectrum(IP-MS)identified proteins interacting with AGPAT5 and verified by co-immunoprecipitation(coIP).Protein post-translational modification identification was performed to analyze the potential modification sites of AGPAT5,and in vitro experiments were performed to explore the effects of the point mutation before and after the point mutation on the migration of hepatocellular carcinoma cells.CoIP was performed to explore the binding of AGPAT5 to the interacting protein before and after the mutation of the site.We determined its role in cell phenotype by knocking down interacting proteins.Rescue experiments were used to verify whether AGPAT5 exerts its effects through the interacting protein.We detected the expression levels of AGPAT5 and the interacting protein in wild-type hepatocellular carcinoma cell lines to examine their correlation.Results:Knockdown of AGPAT5 increased the tolerance to serum-free starvation and promoted hepatocellular carcinoma cell migration,but did not affect proliferation and anoikis.However,deletion of enzyme activity did not affect the inhibition of hepatocellular carcinoma cell migration by AGPAT5.Knockdown of AGPAT5 promoted lung and liver metastasis of hepatocellular carcinoma cells in nude mice.AGPAT5 could interact with fibrillarin(FBL),and the interaction was strengthened under serum starvation conditions.Curbing FBL expression inhibited hepatocellular carcinoma cell migration,and the effect was similar to that of overexpression of AGPAT5.Inhibition of FBL expression weakened the promoting effect of AGPAT5 knockdown on hepatocellular carcinoma cell migration;In the hepatocellular carcinoma cell lines examined,AGPAT5 and FBL did not show any correlation at the protein level.The inhibitory effect of AGPAT5 on hepatocellular carcinoma cell migration was attenuated by the K201 site mutation,and the K201 site mutation attenuated the binding of AGPAT5 to FBL.Conclusion:Knockdown of AGPAT5 can significantly enhance the migratory ability of hepatocellular carcinoma cells.AGPAT5 can interact with FBL,and in the absence of serum starvation stimulation,AGPAT5 strengthen its binding to FBL through acetylation of the K201 site,thereby more effectively inhibiting FBL,consequently inhibiting the migration of hepatocellular carcinoma cells.But this inhibitory effect is not derived from the metabolic enzyme activity of AGPAT5,but driven by non-metabolic function.

Objective To evaluate the effect of different honey processing methods on the dissolution of Cynanchum salicifolia in vitro.Methods High performance liquid chromatography ① Carotene and β-Determination method of sitosterol content:chromatographic column:Dia monosil C18(250 mm×4.6 mm,5 μm).Mobile phase:methanol:0.05％phosphoric acid water=99∶1.Isocratic elution;Flow rate 1.0 mL·min-1;Detection wavelength 209 nm;Injection volume 10 μL.The column temperature is 30℃.②Determination method of glucose and fructose:the chromatographic column is Inspire NH2 sugar analysiscolumn(250 mm×4.6 mm,5 μm).The mobile phase was acetonitrile water(77∶23).The flow rate is 0.8 mL·min-1;The column temperature is 35℃;Injection volume 10 μL;Evaporative light scattering detector(ELSD):the drift tube temperature is 100℃,and the carrier gas flow rate is 2.8 L·min-1.Results ①The results showed that carotene and β-the determination of sitosterol showed a good linear relationship in the range of mass concentration(r＞0.9999).The average recoveries were 99.71％and 98.83％.The RSD of precision,stability and repeatability were all less than 2.0％.②The established method of glucose fructose showed a good linear relationship in the range of 0.05-0.50 mg·mL-1(r=0.9991).Conclusion The content determination method and in vitro dissolution test methodology of the study meet the requirements,which provides a scientific basis for the establishment of quality standards and modern research of honey roasted Paeonia salicifolia.

Objective: Recurrence is the most significant feature of depression and the relationship between iron and recurrent depression is still lack of direct evidence in vivo. Methods: Twenty-one patients with depression and twenty control subjects were included. Gradient-recalled echo, T1 and T2 images were acquired using a 3.0T MRI system. After quantitative susceptibility mapping were reconstructed and standardized, a whole-brain and the regions of interest were respectively analyzed. Results: Significant increases in susceptibility were found in multiple recurrent depression patients, which involved several brain regions (frontal lobes, temporal lobe structures, occipital lobes hippocampal regions, putamen, thalamus, cingulum, and cerebellum). Interestingly, no susceptibility changes after treatment compared to pre-treatment (all p>0.05) and no significant correlation between susceptibility and Hamilton Depression Rating Scale were found. Besides, it was close to significance that those with a higher relapse frequency or a longer mean duration of single episode had a higher susceptibility in the putamen, thalamus, and hippocampus. Further studies showed susceptibility across the putamen (ρ2=0.27, p<0.001), thalamus (ρ2=0.21, p<0.001), and hippocampus (ρ2=0.19, p<0.001) were strongly correlated with total course of disease onset. Conclusion Brain iron deposition is related to the total course of disease onset, but not the severity of depression, which suggest that brain iron deposition may be a sign of brain damage in multiple recurrent depression.