Gouty arthritis （GA） is an inflammatory disorder caused by monosodium urate （MSU） crystal deposition， accompanied by elevated oxidative stress and aberrant release of inflammatory cytokines， resulting in joint tissue damage and intense pain. Nuclear factor E₂-related factor 2 （Nrf2）， a key transcription factor regulating the antioxidant defence system， exerts cytoprotective effects through dissociation from Kelch-like ECH-associated protein 1 （Keap1） and activates downstream antioxidant response element （ARE）-mediated pathways. It can upregulate the expression of heme oxygenase-1 （HO-1）， NADH quinone oxidoreductase 1 （NQO1）， superoxide dismutase （SOD）， and glutathione transferase （GST） to preserve redox homeostasis. Moreover， Nrf2 can suppress activation of NOD-like receptor protein 3 （NLRP3） inflammasomes， reduce pro-inflammatory cytokine production and release， modulate nuclear factor-κB （NF-κB） transcriptional activity， regulate gut microbiota balance， enhance mitophagy， and inhibit apoptosis， so as to reduce joint inflammation and pain and promote body recovery. This review systematically examined recent advancements in traditional Chinese medicine （TCM） for GA prevention and treatment via regulating the Nrf2 signaling pathway. It delineated Nrf2's molecular mechanisms and its role in GA pathogenesis and elucidated how TCM intervenes in multiple pathways including Keap1/Nrf2/ARE， Nrf2/HO-1（NQO1）， and Nrf2/NF-κB/NLRP3 to exert therapeutic effects. The study demonstrated that TCM monomers and compounds effectively counteract oxidative damage， attenuate inflammatory responses， promote autophagy， and inhibit apoptosis via regulating the Nrf2 signaling pathway. These findings not only clarify the scientific basis of TCM in GA treatment but also offer strategic insights for developing novel Nrf2-targeted anti-gout drugs.

Extremely unbalanced data here refers to datasets where the values of independent or dependent variables exhibit severe unbalance in proportions, such as extremely unbalanced case-control ratio, very low incidence rate of disease, heavily censored time-to-event data, and low-frequency or rare variants. In such scenarios, the statistic derived from hypothesis test using the classical statistical method, e.g., logistic regression model and Cox proportional hazard regression model, might deviate from theoretical asymptotic distribution, resulting in inflation or deflation of type I error. With the increased availability and exploration of resources from large-scale population cohorts in genome-wide association study (GWAS), there is a growing demand for effective and accurate statistical approaches to handle extremely unbalanced data in independent and non-independent samples. Our study introduces classical statistical methods in genetic statistics firstly, then, summarizes the failure of classical statistical methods in dealing with extremely unbalanced data through simulation experiments to draw researchers' attention to the extremely unbalanced data in GWAS.

The activation of the P2X7 receptor as an ATP-gated ion channel,triggers the release of pro-inflammato-ry cytokines in tumor carring individuals and stimulate excitation of injury-causing neurons,thereby exacerbating the transmission of pain.In preclinical cancer pain models,it has the potential to serve as a new therapeutic target for cancer pain management.

Cryptogenic stroke refers to ischemic stroke that is not clear to the cause of the disease through routine examinations. With the development of medical technology, studies have found that most cryptogenic stroke is caused by embolism.Therefore,the concept of embolic stroke of undetermined source (ESUS) is proposed. The main causes of ESUS include subclinical atrial fibrillation, patent foramen ovale, aortic arch atherosclerotic plaque, non-stenotic complex carotid atherosclerotic plaques, and tumor-related embolism, etc. This article reviews the etiology and secondary prevention of ESUS.

Objective To propose a method to improve the efficiency and accuracy of the Pinnacle treatment planning system in searching for a certain patient. Methods The original Pinnacle system was modified by adding a button of"Search Patient" in the window of"Patient Select" to call a self-built window of"Search Patient by MRN or Name". After inputting the patient′s Medical Record Number or Name, a self-built script file was called to quickly find and locate the patient′s record. Results The patient′s MRN or Name was input in the window of"Search Patient by MRN or Name",and then input"Enter" or clicked the button of Search to rapidly identify the patient and enhance the search efficiency. Conclusion The openness and script of the Pinnacle system can be utilized to modify and improve and supplement the existing func-tions.

Objective To construct a prokaryotic expression vector in BL21 to secretorily expressα-Cyclodextrin Glycosyltransferase(α-CGTase). Methods α-CGT gene was amplified from Bacillus macerens genome by PCR.pET26b and α-CGT gene were connected after digested with Nco I, Xho I respectivly, and then transformed into Escherichia coli BL21 strain.α-CGTase was expressed in fermentation culture medium and AA-2G was prepared by using α-CGTase, VC and starch.Results α-CGTase was expressed secretorily and the enzyme activity was up to 120 U/mL.AA-2G was prepared by the biotransformation of VC and starch using α-CGTase which proved to be correct by HPLC.Conclusion AA-2G was prepared by using self-madeα-CGTase, after optimized the preparation conditions the yield of AA-2G was 17.46 g/L, and the conversion rate reached 58.2%(mg/mg).

Objective To investigate the risk factors for early neurological deterioration (END) in patients with ischemic stroke. Methods The consecutive patients with new acute ischemic stroke within 24 h were enrol ed. They were divided into either an END or a non-END group. Their relevant medical history, baseline clinical data, imaging examinations and laboratory test results in both groups were compared. Results A total of 95 patients with acute ischemic stroke were enrol ed, including 32 in the END group and 63 in the non-END group. There were significant differences in the proportion of patients in diabetes mel itus (χ2 =6. 081, P=0. 014), baseline National Institutes of Health Stroke Scale (NIHSS) score >15 (χ2 =9. 851, P=0. 002), baseline infarct volume >30 cm3 (χ2 =10. 815, P=0. 001), and fever (χ2 =6. 642, P=0. 010), as wel as the fasting glucose (t=2. 632, P=0. 010), homocysteine (t =2. 997, P=0. 003), C-reactive protein (t=2. 349, P=0. 021), baseline NIHSS (Z=497. 5, P=0. 001), and baseline infarct volume (Z=544. 5, P<0. 001) between the 2 groups. Furthermore, there were significant differences in the proportions of patients in large artery atherosclerotic stroke (χ2 =24. 539, P<0. 001 ) and smal arterial occlusive stroke (χ2 = 27. 913, P< 0. 001 ) in the TOAST classification, as wel as the total anterior circulation stroke (χ2 =7. 578, P<0. 006) and partial anterior circulation stroke (χ2 =4. 818, P<0. 028) in the OSCP classification. Multivariate logistic regression analysis showed that fasting glucose >6. 0 mmol/L (odds ratio [OR] 6. 951, 95%confidence interval [CI] 2. 159-22. 348; P=0. 001), homocysteine >15 μmol/L (OR 3. 301, 95% CI 1. 028-10. 595; P=0. 045), NIHSS score >15 (OR 4. 174, 95% CI 1. 772-14. 870;P=0. 028), infarct volume >30 cm3 (OR 4. 996, 95% CI 1. 334-18. 717; P=0. 017), and fever (OR 4. 528, 95% CI 1. 334-15. 372;P=0. 015) were the independent risk factors for occurring END in patients with acute ischemic stroke. Conclusions The baseline glucose, NIHSS score, infarct volume, homocysteine, and increased body temperature are the independent risk factors for occurring EDN in patients with acute ischemic stroke.

Carcinoma ; radiotherapy ; Carcinoma, Papillary ; radiotherapy ; Humans ; Iodine Radioisotopes ; therapeutic use ; Male ; Middle Aged ; Thyroid Neoplasms ; radiotherapy

BACKGROUND:Chondrocytes co-cultured with bone marrow stromal stem cells on the scaffold of platelet-rich plasma are found to proliferate, and besides proliferative growth, bone marrow stromal cells exhibit a tendency of differentiating into chondrocytes. OBJECTIVE:To study the effect of platelet-rich plasma and human umbilical cord mesenchymal stem cells (hUCMSCs) on cartilage repair. METHODS:Forty healthy New Zealand white rabbits were selected to establish models of cartilage defects, and then randomly divided into normal saline group, platelet-rich plasma group, hUCMSCs group and combination group. Platelet-rich plasma was prepared by using double centrifugations to prepare passage 3 hUCMSCs. After modeling, intra-articular injection of normal saline (0.5 mL), 12.5%platelet-rich plasma (0.5 mL), 1×107 hUCMSCs (0.5 mL), 12.5%platelet-rich plasma+1×107 hUCMSCs (total y 0.5 mL) was done in corresponding groups, respectively. After 12 weeks of modeling, the injured cartilage was grossly observed, and hematoxylin-eosin staining was used to observe cartilage repair under light microscope;according to the O'Driscol histologic standard, histological examination was performed. RESULTS AND CONCLUSION:The repair effect in the normal saline group was significantly better that in the platelet-rich plasma group, hUCMSCs group, combination group (P<0.05), while the platelet-rich plasma group and combination group also exhibit better outcomes than the hUCMSCs group (P<0.05). These findings indicate that both platelet-rich plasma and hUCMSCs can promote cartilage repair;moreover, platelet-rich plasma with or without hUCMSCs is superior to hUCMSCs alone in the cartilage repair.

Objective To discusses the methods of the case selection and monitoring and diagnosis and treatment to selective non-operative management of closed splenic injuries .Methods The clinical data and results of 98 cases from October 1999 to Octo-ber 2011 with closed splenic injuries managed non-operative treatment were analyzed retrospectively .Results There were 90 cases (91 .8% ) conservative successfully ,5 cases(5 .1% ) transit operation because hematoma increase and bleeding continuously during therapeutic observation and 2 cases(3 .1% ) died from multiple injuries merge infection and multiple organ failure .Conclusion Most of the closed splenic injuries below level Ⅱcan be treated by non-operative management ,the effect and prognosis determined by the reasonable case selection and monitoring conditions and diagnosis and treatment .