ObjectiveMicrotube associated protein-2 （MAP-2）， alpha-tubulin （α-tubulin）， and synaptophysin （SYP） are important proteins in neuronal signal communication. This paper observed the effects of modified Zhigancao Tang on the expression of serum α-Synuclein （α-Syn） and its oligomers， MAP-2， α-tubulin， and SYP of patients with liver and kidney deficiency of Parkinson's disease （PD）， analyzed their correlation， and evaluated the therapeutic effect of modified Zhigancao Tang in patients with liver and kidney deficiency of PD based on α-Syn transmission pathway mediated by neuronal communication in vivo. MethodsA total of 60 patients with PD who met the inclusion criteria were randomly divided into a treatment group （30 cases） and a control group （30 cases）. Both groups were treated on the basis of PD medicine， and the treatment group was treated with modified Zhigancao Tang. Both groups were treated for 12 weeks. The changes in UPDRS score， TCM syndrome score， and expression of serum α-Syn and its oligomers， MAP-2， α-tubulin， and SYP were observed before and after 12 weeks of treatment in each group. The correlation between the above-mentioned serum biological indexes and the levels of serum α-Syn and its oligomers was analyzed. ResultsAfter treatment， the TCM syndrome score， UPDRS score， UPDRS-Ⅱ score， and UPDRS-Ⅲ score of the treatment group were significantly decreased （P<0.05， P<0.01）. The UPDRS score， UPDRS-Ⅱ score， and UPDRS-Ⅲ scores in the treatment group were significantly decreased compared with those in the control group after treatment （P<0.05）. After treatment， the total effective rate of the control group was 63.3% （19/30）， and that of the treatment group was 86.7% （26/30）. The clinical effect of the observation group was better than the control group （Z=-2.03， P<0.05）. The total effective rate of the observation group was better than that of the control group， and the difference was statistically significant （χ²=5.136， P<0.05）. After treatment， the oligomer level of serum α-Syn and MAP-2 level in the treatment group were significantly decreased （P<0.05， P<0.01）. The levels of serum α-Syn and its oligomers， as well as α-tubulin in the treatment group， were significantly decreased compared with those in the control group after treatment （P<0.05， P<0.01）. Serum α-Syn was correlated with serum MAP-2 and α-Syn oligomer in patients with PD （P<0.05， P<0.01） but not correlated with serum SYP . Serum α-Syn oligomers of patients with PD were correlated with serum MAP-2 and α-tubulin （P<0.05， P<0.01） but not correlated with serum SYP level. Serum SYP of patients with PD was correlated with serum MAP-2 （P<0.05）. ConclusionModified Zhigancao Tang has a therapeutic effect on patients with liver and kidney deficiency of PD by inhibiting the production of α-Syn oligomers and intervening α-Syn microtubule transport pathway in vivo.

Multiple system atrophy (MSA) is a rare neurodegenerative disease with complex clinical manifestations, presenting substantial challenges in clinical diagnosis and treatment. Its symptoms and the eight extraordinary meridians are potentially correlated; therefore, this article explores the association between MSA symptom clusters and the eight extraordinary meridians based on their circulation and physiological functions, as well as their treatment strategies. The progression from deficiency to damage in the eight extraordinary meridians aligns with the core pathogenesis of MSA, which is characterized by "the continuous accumulation of impacts from the vital qi deficiency leading to eventual damage". Liver and kidney deficiency and the emptiness of the eight extraordinary meridians are required for the onset of MSA; the stagnation of qi deficiency and the gradual damage to the eight extraordinary meridians are the key stages in the prolonged progression of MSA. The disease often begins with the involvement of the yin and yang qiao mai, governor vessel, thoroughfare vessel, and conception vessel before progressing to multiple meridian involvements, ultimately affecting all eight extraordinary meridians simultaneously. The treatment approach emphasizes that "the direct method may be used for joining battle, but indirect method will be needed in order to secure victory" and focuses on "eliminate pathogenic factors and reinforce healthy qi". Distinguishing the extraordinary meridians and focusing on the primary symptoms are pivotal to improving efficacy. Clinical treatment is aimed at the target, and tailored treatment based on careful clinical observation ensures precision in targeting the disease using the eight extraordinary meridians as the framework and core symptoms as the specific focus. Additionally, combining acupuncture, daoyin therapy, and other method may help prolong survival. This article classifies clinical manifestations based on the theory of the eight extraordinary meridians and explores treatment.

Objective:To conduct performance tests on medical ultrasound probes repaired by the third party,and explore whether the key parameters of the probes of third-party repair can meet the requirements of clinical use for quality.Methods:A total of 79 ultrasound probes that had been repaired by the third party were selected from different medical institutions.The performance tests were conducted on multiple parameters of ultrasound probes of different models and brands in accordance with national technical standards and relevant industry norms.Then,the test results were analyzed,studied and evaluated.Results:The tested results of the temperature rise and the leakage current of the ultrasound probes,which were repaired by the third party,met the national standards.However,in the test for sound power,26.58%of the probes failed to meet the national standards,which outputted sound intensity that was calculated was higher than the specified value.Conclusion:The general performance of the probes that have been repaired by the third party is well,but the quality of the repair is uneven levels,and some indicators do not meet national standards or industry norms,which might lead to occur risks in ultrasound diagnosis of medical institutions.It is recommended to implement regular test for quality and performance of medical ultrasound equipment,and establish a method and system for quality monitoring and re-evaluation after sale of repair for medical ultrasound,so as to ensure the use and safety of the equipment.

Objective:To develop a training program for general practitioners (GPs) on carotid plaque screening using portable intelligent point-of-care ultrasonography (POCUS).Methods:A draft training program for GPs on carotid plaque screening using POCUS was initially formulated through focus group discussions involving experts in ultrasonography and general practice. Two rounds of Delphi consultation were conducted with 15 ultrasound experts from 6 secondary and tertiary public hospitals in Shanghai in February and April 2023. The analytic hierarchy process (AHP) was applied to assign weights to the indicators in the final program.Results:The final program consisted of 4 first-level indicators, 10 second-level indicators, and 47 third-level indicators. Among the first-level indicators,"training objects" had the lowest weight (7.69%), while the other three indicators were equally weighted (30.77% each). The top 3 third-level indicators by combined weight were "mastering key diagnostic points of carotid plaque"(10.26%),"mastering carotid plaque screening using portable POCUS"(6.84%), and "primary care hands-on training sessions"(6.39%).Conclusion:A structured training program for GPs has been successfully developed for carotid plaque screening using portable intelligent POCUS, comprising 4 first-level, 10 second-level, and 47 third-level indicators.

Under the background of breaking the " five only" evaluation criteria, continuously optimizing the scientific research performance evaluation system of hospitals to mobilize the enthusiasm and creativity of scientific researchers and guide the direction of scientific research development plays an important role in enhancing the overall scientific research capability of hospitals. Through literature analysis and expert consultation, a certain hospital has constructed a personal scientific research performance evaluation index system for medical staff in tertiary public hospitals, oriented towards innovation quality and member contributions, and began to implement it throughout the hospital in 2021. This index system included four categories of scientific research performance: vertical scientific research projects, academic influence, science and technology awards, and transformation of achievements, with a total of 20 indicators. The annual scientific research performance score of an individual would serve as the basis for the distribution of year-end scientific research performance and an important reference for applying for key and major projects within the hospital. After the application of this evaluation index system, the enthusiasm of medical staff for scientific research has been effectively stimulated. The average individual scientific research performance score increased from 0.974 in 2020 to 1.220 in 2023. All scientific research indicators involved in the evaluation system have shown growth, with a significant increase in high-quality results. This evaluation system can provide a reference for the scientific research performance evaluation of public hospitals under the background of breaking the " five only" evaluation criteria.

BACKGROUND: Arsenic trioxide (ATO) is indicated as a broad-spectrum medicine for a variety of diseases, including cancer and cardiac disease. While the role of ATO in hepatic ischemia/reperfusion injury (HIRI) has not been reported. Thus, the purpose of this study was to identify the effects of ATO on HIRI. METHODS: In the present study, we established a 70% hepatic warm I/R injury and partial hepatectomy (30% resection) animal models in vivo and hepatocytes anoxia/reoxygenation (A/R) models in vitro with ATO pretreatment and further assessed liver function by histopathologic changes, enzyme-linked immunosorbent assay, cell counting kit-8, and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay. Small interfering RNA (siRNA) for extracellular signal-regulated kinase (ERK) 1/2 was transfected to evaluate the role of ERK1/2 pathway during HIRI, followed by ATO pretreatment. The dynamic process of autophagic flux and numbers of autophagosomes were detected by green fluorescent protein-monomeric red fluorescent protein-LC3 (GFP-mRFP-LC3) staining and transmission electron microscopy. RESULTS: A low dose of ATO (0.75 μmol/L in vitro and 1 mg/kg in vivo ) significantly reduced tissue necrosis, inflammatory infiltration, and hepatocyte apoptosis during the process of hepatic I/R. Meanwhile, ATO obviously promoted the ability of cell proliferation and liver regeneration. Mechanistically, in vitro  studies have shown that nontoxic concentrations of ATO can activate both ERK and phosphoinositide 3-kinase-serine/threonine kinase (PI3K-AKT) pathways and further induce autophagy. The hepatoprotective mechanism of ATO, at least in part, relies on the effects of ATO on the activation of autophagy, which is ERK-dependent. CONCLUSION Low, non-toxic doses of ATO can activate ERK/PI3K-AKT pathways and induce ERK-dependent autophagy in hepatocytes, protecting liver against I/R injury and accelerating hepatocyte regeneration after partial hepatectomy.
Animals ; Arsenic Trioxide ; Autophagy/physiology* ; Reperfusion Injury/prevention & control* ; Mice ; Male ; Proto-Oncogene Proteins c-akt/physiology* ; Arsenicals/therapeutic use* ; Oxides/therapeutic use* ; Liver/metabolism* ; Extracellular Signal-Regulated MAP Kinases/metabolism* ; Mice, Inbred C57BL

Hereditary tumor predisposition syndromes of the central nervous system(CNS)are a group of genetic disorders caused by germline mutations,which significantly increase the risk of CNS tumors in carriers.However,awareness of these syndromes remains limited in current clinical and pathological practice,leading to a high risk of un-derdiagnosis and missdiagnosis.Pathologists should integrate clinical history,family history,tumor morphology,and molecular testing results to identify underlying hereditary tumor predisposition syndromes.This approach not only helps assess multi-organ tumor risks and guide personalized treatment but also enables early intervention through genetic counseling and testing for family members,ultimately improving patient outcomes and aiding in disease prevention and reproductive decision-making.

Objective To investigate the capacity of low-intensity pulsed ultrasound(LIPUS)for promoting osteogenic differentiation of senescent bone marrow mesenchymal stem cell(BMMSC)in mice,also the potential mechanism of involving myocardin-related transcription factor-A(MRTF-A)during this process.Methods Five aged mice received LIPUS irradiation on the left femur for eight weeks.Micro CT and HE staining were employed to evaluate bone status of bilateral femur.Bone marrow cells were isolated from mouse long bones,BMMSC were cultured,and the cells were divided into H2O2+LIPUS group,H2O2 group and control group.Mouse BMMSC were subjected to H2O2 for 3 days,followed by reactive oxygen species fluorescence staining and senescence-associated β-galactosidase staining to assess cellular senescence.Immunofluorescence and phalloidin staining were performed to examine MRTF-A distribution and cytoskeletal status.Based on H2O2-induced senescence model,MRTF-A nuclear translocation inhibitor CCG-100602 was applied,and the cells were further divided into H2O2+CCG-100602+LIPUS group,H2O2+CCG-100602 group,H2O2+LIPUS group and H2O2 group.Immunofluorescence staining was used to assess MRTF-A distribution.Alkaline phosphatase(ALP)and alizarin red staining were conducted to evaluate osteogenic differentiation capacity.Results LIPUS resulted in increased trabecular bone in the left femur of aged mice compared to the right femur,with increased bone volume to total volume and trabecular number and decreased trabecular spacing(both P＜0.05).Compared with H2O2 group,H2O2+LIPUS group showed increased nuclear expression of MRTF-A and increased intracellular rigid actin filament density.The nuclear expression of MRTF-A in H2O2+CCG-100602+LIPUS group was significantly lower than that in H2O2+LIPUS group.Compared with the H2O2+CCG-100602+LIPUS group and H2O2 group,the ALP and alizarin red staining positive areas in H2O2+LIPUS group were significantly larger.Conclusion LIPUS could improve osteoporosis in aged mice.Nuclear translocation of MRTF-A was a key regulator to LIPUS for promoting osteogenic differentiation of senescent BMMSC.

Hereditary tumor predisposition syndromes of the central nervous system(CNS)are a group of genetic disorders caused by germline mutations,which significantly increase the risk of CNS tumors in carriers.However,awareness of these syndromes remains limited in current clinical and pathological practice,leading to a high risk of un-derdiagnosis and missdiagnosis.Pathologists should integrate clinical history,family history,tumor morphology,and molecular testing results to identify underlying hereditary tumor predisposition syndromes.This approach not only helps assess multi-organ tumor risks and guide personalized treatment but also enables early intervention through genetic counseling and testing for family members,ultimately improving patient outcomes and aiding in disease prevention and reproductive decision-making.

Objective:To develop a training program for general practitioners (GPs) on carotid plaque screening using portable intelligent point-of-care ultrasonography (POCUS).Methods:A draft training program for GPs on carotid plaque screening using POCUS was initially formulated through focus group discussions involving experts in ultrasonography and general practice. Two rounds of Delphi consultation were conducted with 15 ultrasound experts from 6 secondary and tertiary public hospitals in Shanghai in February and April 2023. The analytic hierarchy process (AHP) was applied to assign weights to the indicators in the final program.Results:The final program consisted of 4 first-level indicators, 10 second-level indicators, and 47 third-level indicators. Among the first-level indicators,"training objects" had the lowest weight (7.69%), while the other three indicators were equally weighted (30.77% each). The top 3 third-level indicators by combined weight were "mastering key diagnostic points of carotid plaque"(10.26%),"mastering carotid plaque screening using portable POCUS"(6.84%), and "primary care hands-on training sessions"(6.39%).Conclusion:A structured training program for GPs has been successfully developed for carotid plaque screening using portable intelligent POCUS, comprising 4 first-level, 10 second-level, and 47 third-level indicators.