OBJECTIVE To investigate the improvement effects and mechanism of Achyranthes bidentata total saponins （ABS） extract on vascular endothelial dysfunction in spontaneously hypertensive rat （SHR） based on cytochrome P450 4A （CYP4A）/20-hydroxyeicosatetetraenoic acid （20-HETE）/G protein-coupled receptor 75 （GPR75） axis. METHODS Ten Wistar- Kyoto rats were taken as the normal control group. Forty SHR were first stratified by systolic blood pressure and then， within each stratum， randomly assigned using a random-number table to the model group （MOD group）， captopril positive control group （CAP group， 10 mg/kg）， ABS low- and high-dose extract groups （ABS-L group， ABS-H group， 60 and 120 mg/kg）， with 10 rats in each group. Animals in each group were given the corresponding drug or equal volume of pure water by gavage， once a day， for 28 consecutive days. After the last administration， systolic blood pressure of rats was measured. The levels of vasoactive substances， inflammatory factors and oxidative stress indicators in serum were measured. The pathological changes of rat thoracic aorta were observed. The level of reactive oxygen species （ROS） in aortic tissue was analyzed. The expressions of endothelial nitric oxide synthase （eNOS）， CYP4A， GPR75， nuclear factor-κB p65 （NF-κB p65）， phosphorylated NF-κB p65， p22phox， and reduced nicotinamide adenine dinucleotide phosphate oxidase 4（NOX4） in thoracic aorta tissue were detected. RESULTS After 28 d of treatment， compared with MOD group， the systolic blood pressure of rats in the ABS-L and ABS-H groups decreased significantly. The levels of 20-HETE， angiotensin Ⅱ， interleukin-1β， interleukin-6， tumor necrosis factor-α， intercellular cell adhesion molecule-1 and malondialdehyde in serum were significantly reduced （P＜0.05 or P＜0.01）， while the levels of nitric oxide， superoxide dismutase， glutathione peroxidase and catalase were significantly increased （P＜0.05 or P＜0.01）. Intimal damage of thoracic aorta was reduced， and endothelial cell morphology was improved. The expressions of ROS， CYP4A， GPR75， p22phox， NOX4 and the phosphorylation level of NF-κB p65 protein in thoracic aorta were down-regulated or reduced （P＜0.05 or P＜0.01）， while the expression of eNOS was up-regulated （P＜0.05 or P＜0.01）. CONCLUSIONS ABS extract may alleviate the inflammatory response and oxidative stress in SHR effectively by down-regulating the expression of CYP4A， reducing the production of 20-HETE， inhibiting the activation of GPR75， and subsequently suppressing the activation of downstream NF-κB and NOX4， thereby improving hypertension-related vascular endothelial dysfunction.

ObjectiveGastrodia elata has evolved ecological types with shortened rhizome internodes and diversified flower and fruit coloration in response to different altitudes. Studying the genetic mechanisms of different ecotype germplasm is significant for guiding variety breeding in different cultivation areas. MethodsThe bHLH gene family was identified based on the whole-genome datasets of G. elata f. elata and G. elata f. glauca. Subsequently， the gene family members were subject to analysis， including gene structure， chromosomal localization， cis-acting elements， gene synteny， and phylogeny. Combined with transcriptome data and quantitative Real-time PCR， the expression patterns of bHLH genes in the stems of the different G. elata ecotype germplasm were analyzed. Finally， correlation analysis was conducted between gene expression patterns and color to obtain the key bHLH genes regulating the color formation of stem. ResultsA total of 63 bHLH genes were identified in both G elata f. elata and G. elata f. glauca， unevenly distributed across 17 chromosomes and clustered into 16 subfamilies， with significant expansion in some family members. Obvious inversions of bHLH genes on the same chromosome and interchromosomal translocations were detected in the two ecotype germplasm. Among these genes， 12 bHLH genes （such as bHLH62-3 and bHLH74） were associated with the bright yellow color of G elata f. elata stem， while 9 bHLH genes （such as PIL13， UNE12， and bHLH130） were correlated with the red color of G. elata f. glauca stem. Compared to G. elata f. glauca， the bHLH48 expression level was significantly higher in flowers and scale leaves of G elata f. elata， and the bHLH62-3 expression level was significantly higher in all organs of G elata f. elata. ConclusionsFunctional pathway divergence of the bHLH family members has occurred across different chromosomes in G elata f. elata and G. elata f. glauca. Through synergism or antagonism with other genes， 21 bHLH genes participate in the coloration metabolic pathway regulation of stems， flowers， and fruits. Specifically， bHLH62-3 is involved in regulating stem color differentiation in the anthocyanin biosynthesis pathway of G. elata， thus relevant to the color formation of stem. Additionally， GebHLH48 positively regulates flowering-related pathways to promote the early-flowering phenotype of G. elata f. elata. These findings have laid the foundation for analyzing the genetic regulatory mechanisms underlying the color formation of the G. elata stem.

ObjectiveGastrodia elata has evolved ecological types with shortened rhizome internodes and diversified flower and fruit coloration in response to different altitudes. Studying the genetic mechanisms of different ecotype germplasm is significant for guiding variety breeding in different cultivation areas. MethodsThe bHLH gene family was identified based on the whole-genome datasets of G. elata f. elata and G. elata f. glauca. Subsequently， the gene family members were subject to analysis， including gene structure， chromosomal localization， cis-acting elements， gene synteny， and phylogeny. Combined with transcriptome data and quantitative Real-time PCR， the expression patterns of bHLH genes in the stems of the different G. elata ecotype germplasm were analyzed. Finally， correlation analysis was conducted between gene expression patterns and color to obtain the key bHLH genes regulating the color formation of stem. ResultsA total of 63 bHLH genes were identified in both G elata f. elata and G. elata f. glauca， unevenly distributed across 17 chromosomes and clustered into 16 subfamilies， with significant expansion in some family members. Obvious inversions of bHLH genes on the same chromosome and interchromosomal translocations were detected in the two ecotype germplasm. Among these genes， 12 bHLH genes （such as bHLH62-3 and bHLH74） were associated with the bright yellow color of G elata f. elata stem， while 9 bHLH genes （such as PIL13， UNE12， and bHLH130） were correlated with the red color of G. elata f. glauca stem. Compared to G. elata f. glauca， the bHLH48 expression level was significantly higher in flowers and scale leaves of G elata f. elata， and the bHLH62-3 expression level was significantly higher in all organs of G elata f. elata. ConclusionsFunctional pathway divergence of the bHLH family members has occurred across different chromosomes in G elata f. elata and G. elata f. glauca. Through synergism or antagonism with other genes， 21 bHLH genes participate in the coloration metabolic pathway regulation of stems， flowers， and fruits. Specifically， bHLH62-3 is involved in regulating stem color differentiation in the anthocyanin biosynthesis pathway of G. elata， thus relevant to the color formation of stem. Additionally， GebHLH48 positively regulates flowering-related pathways to promote the early-flowering phenotype of G. elata f. elata. These findings have laid the foundation for analyzing the genetic regulatory mechanisms underlying the color formation of the G. elata stem.

ObjectiveTo investigate the association of the serum levels of Golgi protein 73 （GP73）， hypoxia-inducible factor-1α （HIF-1α）， and matrix metalloproteinase-9 （MMP-9） before and after transcatheter arterial chemoembolization （TACE） with the treatment outcome of patients with hepatitis B virus （HBV）-related hepatocellular carcinoma （HCC）. MethodsA total of 135 patients with HBV-related HCC who received TACE for the first time in The First Affiliated Hospital of Xinjiang Medical University from January 2023 to October 2025 were enrolled as subjects， and the serum levels of GP73， HIF-1α， and MMP-9 were measured before TACE and at 1 month after TACE. According to the treatment outcome after TACE， the patients were divided into remission group and non-remission group. The two groups were compared in terms of general information and the serum levels of GP73， HIF-1α， and MMP-9 before and after treatment. The Logistic regression analysis was used to investigate the influencing factors for the efficacy of TACE， and the receiver operating characteristic （ROC） curve was used to assess the value of the serum levels of GP73， HIF-1α， and MMP-9 before treatment used alone or in combination in predicting the efficacy of TACE. The independent-samples t test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. ResultsAmong the 135 patients after treatment， 78 （57.78%） were enrolled in the remission group and 57 （42.22%） were enrolled in the non-remission group. Before treatment， the remission group had significantly lower serum levels of GP73， HIF-1α， and MMP-9 than the non-remission group （all P<0.05）； after treatment， both groups had reductions in the serum levels of GP73， HIF-1α， and MMP-9， and the remission group had significantly lower levels than the non-remission group （all P<0.05）. The binary Logistic regression analysis showed that increases in the serum levels of GP73， HIF-1α， and MMP-9 before treatment were independent influencing factors for the efficacy of TACE （all P<0.05）. The ROC curve analysis showed that the serum levels of GP73， HIF-1α， and MMP-9 before treatment used alone had an area under the ROC curve （AUC） of 0.799， 0.835， and 0.777， respectively， in predicting the efficacy of TACE， among which HIF-1α showed the highest predictive value， and the combination of these three indicators had an AUC of 0.950， a Youden index of 0.787， an optimal cut-off value of 0.39， a sensitivity of 87.72%， and a specificity of 91.03%. ConclusionTACE can reduce the serum levels of GP73， HIF-1α， and MMP-9 in patients with HBV-related HCC， and patients with a good outcome tend to have greater reductions. The high serum levels of GP73， HIF-1α， and MMP-9 before treatment are independent risk factors for poor short-term efficacy of TACE， and the combination of these three indicators has a relatively high value in predicting the efficacy of TACE.

Lipid turbidity disease is a metabolic disease featuring lipid metabolism disorders caused by many factors such as social environment， diet， and lifestyle， which is closely related to many diseases in modern medicine， such as hyperlipidemia， obesity， fatty liver， atherosclerosis， metabolic syndrome， and cardiovascular and cerebrovascular diseases， with a wide range of influence and far-reaching harm. According to the Huangdi Neijing， lipid turbidity disease reflects the pathological change of the body's physiologic grease. Grease is the thick part of body fluids， which has the function of nourishing， and it is the initial state and source of important substances in the human body such as brain， marrow， essence， and blood. Once the grease of the human body is abnormal， it can lead to lipid turbidity disease. The Huangdi Neijing also points out the physiological relationship between the transportation and transformation of body fluids and the rise and fall of the spleen and stomach， which can deduce the pathological relationship between the occurrence of lipid turbidity disease and the abnormal rise and fall of the spleen and stomach functions. Lipid turbidity disease is caused by overconsumption of fatty and sweet foods or insufficient spleen and stomach endowments， leading to disorders of the function of promoting clear and reducing turbidity in the spleen and stomach. This leads to the transformation of thick grease in body fluids into lipid turbidity， which accumulates in the body's meridians， blood vessels， skin pores， and organs， forming various forms of metabolic diseases. The research team believed that the pathological basis of lipid turbidity disease was the abnormal rise and fall of the spleen and stomach and the obstruction of the transfer of grease. According to the different locations where lipid turbidity stays， it was divided into four common pathogenesis types： ''inability to distinguish between the clear and turbid， turbid stagnation in the Ying blood''， ''spleen not rising clear， turbid accumulation in the vessels''， ''spleen dysfunction， lipid retention in the pores''， ''spleen failure to transportation and transformation， and grease accumulation in the liver''. According to the pathogenesis， it could be divided into four common syndromes， namely， turbid stagnation in the Ying blood， turbid accumulation in the vessels， lipid retention in the pores， and grease accumulation in the liver， and the corresponding prescriptions were given for syndrome differentiation and treatment， so as to guide clinical differentiation and treatment of the lipid turbidity disease.

Thoracolumbar spine fracture often leads to severe pain, functional impairments, and neurological deficits, for which open reduction and internal fixation can effectively restore the spinal structural stability. Open decompression and reduction with internal fixation can help relieve spinal cord compression and improve spinal function in cases of concomitant cord injury. Although spinal stability can be restored through surgery, patients often face chronic pain and functional impairments postoperatively. A postoperative rehabilitation program is critical in optimizing therapeutic outcomes, reducing complications, and minimizing the risk of secondary injuries. However, current rehabilitation methods, such as physical therapy, functional training, and pain management, are confronted with problems in clinical practice, including significant variation in efficacy, poor patient adherence, and prolonged rehabilitation period. There is an urgent need for a unified rehabilitation strategy to address these problems. To this end, the Spinal Trauma Group of the Orthopedic Physicians Branch of the Chinese Medical Association and the Spine Health Professional Committee of the Chinese Human Health Technology Promotion Association organized experts from relevant fields to formulate Evidence-based guidelines for rehabilitation treatment after internal fixation of thoracolumbar spine fracture in adults ( version 2025) by integrating evidences from clinical researches and advanced rehabilitation concepts at home and abroad. A total number of 14 recommendations concerning the rehabilitation treatment with multimodal analgesia, psychological intervention, deep vein thrombosis prevention, core muscle and extremity exercise, appropriate use of braces, early weight-bearing, device-aided rehabilitation exercise, neuroregulatory therapy, rehabilitation team were put forward, aiming to standardize the post-operative rehabilitation process following internal fixation, promote the functional recovery, and enhance patients′ quality of life.

Objective:To explore the clinical phenotype and genetic characteristics of four patients with Phelan-McDermid syndrome (PMS) due to variants of SHANK3 gene. Methods:Four patients diagnosed with PMS at Guangzhou Women and Children′s Medical Center Liuzhou Hospital from January 2020 to January 2025 were selected as the study subjects. Clinical data of the patients were collected. Peripheral venous blood samples were collected from each patient for the extraction of genomic DNA, followed by whole-exome sequencing (WES) and validation by Sanger sequencing. Pathogenicity of candidate variants was rated based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), and multiple bioinformatic tools were used to assess the pathogenic effects of the variants. The study was approved by the Ethics Committee of the Guangzhou Women′s and Children′s Medical Center Liuzhou Hospital (Ethics No. 2025-007).Results:All four patients had exhibited language delay and intellectual disability (IQ 35 ~ 65). Some also presented with autism spectrum disorder and schizophrenia, albeit with significant phenotypic heterogeneity. All patients were found to harbor deletions of 22q13.33 region, ranging from 55.46 kb to 112.64 kb, primarily involving the SHANK3 gene. Conclusion:PMS is typically caused by deletions or mutations of the SHANK3 gene. The clinical manifestations are diverse, with developmental delay and intellectual disability being the most common. Accurate diagnosis requires integration of genetic testing and standardized clinical assessment. Genetic screening for suspected patients and at-risk pregnant women is recommended to facilitate their genetic counseling.

Oral potentially malignant disorders (OPMD) refer to a group of diseases occurring on the oral mucosa that harbor the potential to progress into oral squamous cell carcinoma, including oral leukoplakia, oral erythroplakia, discoid lupus erythematosus of the oral mucosa, oral submucous fibrosis, oral lichen planus, actinic cheilitis, etc. Diabetes mellitus (DM) is one type of diseases characterized by chronic hyperglycemia, with a high incidence and mortality rate worldwide. Hyperglycemia is the characteristic metabolic change in DM patients and those in the pre-diabetic stage, playing a determinative role in many complications related to DM. A number of clinical studies had revealed an association between hyperglycemia and OPMD, as well as its malignant transformation. This article will review the potential regulatory effects and mechanisms of high glucose states, such as diabetes, on OPMD, and assess the correlation between hyperglycemia and the malignant transformation of OPMD.

Objective To investigate the effect of Siwu Wuzi Decoction in the treatment of wet age-related macular degeneration(wAMD)on the levels of vascular endothelial growth factor(VEGF),transforming growth factor-β1(TGF-β1),and inflammatory factors in patients.Methods A total of 216 patients with wAMD were randomly divided into western medicine group(n=108)and integrated Chinese and western medicine group(n=108).The western medicine group received conbercept plus photodynamic therapy(PDT),while the integrated Chinese and western medicine group received con-bercept,PDT,and Siwu Wuzi Decoction.Both groups were treated for 3 months.The traditional Chi-nese medicine syndrome scores,best-corrected visual acuity(BCVA),intraocular pressure,VEGF,TGF-β1,inflammatory factor levels[interleukin(IL)-6,IL-13],quality of life[Chinese Low Vision Quality of Life Scale(CLVQOL)],and clinical efficacy were observed in both groups.Results After treatment,the traditional Chinese medicine syndrome scores decreased in both groups,with the scores in the integrated Chinese and western medicine group being lower than those in the western medicine group(P＜0.05).After treatment,BCVA decreased in both groups,with the BCVA in the integrated Chinese and western medicine group being lower than that in the western medicine group(P＜0.05).After treatment,intraocular pressure increased in both groups,but the intraocu-lar pressure in the integrated Chinese and western medicine group was lower than that in the western medicine group(P＜0.05).After treatment,VEGF and TGF-β1 levels decreased in both groups,with the levels in the integrated Chinese and western medicine group being lower than those in the western medicine group(P＜0.05).After treatment,IL-6 and IL-13 levels decreased in both groups,with the levels in the integrated Chinese and western medicine group being lower than those in the western medicine group(P＜0.05).After treatment,CLVQOL scores increased in both groups,with the scores in the integrated Chinese and western medicine group being higher than those in the western medicine group(P＜0.05).The total effective rate of treatment in the integrat-ed Chinese and western medicine group was 97.22％,which was higher than 85.19％in the west-ern medicine group(P＜0.05).Conclusion Siwu Wuzi Decoction has a good therapeutic effect on wAMD,which can alleviate symptoms,restore vision,reduce intraocular pressure,regulate VEGF,TGF-β1,and inflammatory factor levels,and improve quality of life.

G protein-coupled receptor 17(GPR17)is a G protein-coupled receptor whose func-tional diversity is regulated by multiple mechanisms,including receptor dimerization and epigenetic modifications.It is involved in the development of the nervous system,injury repair,and the progres-sion of various neurological diseases.This study integrated a three-dimensional functional network of neurodevelopment-injury repair-metabolic regulation to elucidate the normal developmental process and pathological progression of GPR17 in the nervous system.In the nervous system,GPR17 partici-pates in the fate regulation of oligodendrocyte lineage cells and the activation of microglia,and also affects the pluripotency regulation of neural precursor cells and adult neural tissues.Under neuro-pathological conditions such as demyelinating diseases,brain injuries,and gliomas,GPR17 expres-sion is abnormal.Inhibiting its expression can alleviate myelin sheath damage,while activating its ex-pression can induce the differentiation and apoptosis of glioma cells.Additionally,GPR17 is involved in the regulation of metabolism,aging,and cognitive dysfunction.Although significant progress has been made in current research,the signal transduction mechanisms during development and the spe-cific action pathways in neurological diseases still require further exploration.Given the multifunction-ality and key role of GPR17 in the nervous system,this field holds promise for providing novel ideas and therapeutic strategies for neural development,injury repair,and the treatment of related diseases.