ObjectiveTo explore the mechanisms through which Si Junzitang （SJZD） ameliorates Alzheimer's disease （AD） induced by scopolamine （SCOP） in mice and the PC12 cell model induced by H₂O₂ based on the Kelch-like ECH-associated protein 1 （Keap1）/nuclear factor erythroid 2-related factor 2 （Nrf2）/heme oxygenase-1 （HO-1） signaling pathway. MethodsIn the animal experiments， an AD model was established in mice by intraperitoneal injection of SCOP （3 mg·kg^-1）. Morris water maze and open field tests （OFT） were conducted to assess learning and memory abilities. Hematoxylin-eosin （HE） staining and Nissl staining were performed to observe pathological changes in neurons. Immunofluorescence was used to detect amyloid β-protein_1-42 （Aβ_1-42） expression， and immunohistochemistry was employed to detect phosphorylated （p）-Tau expression. Transmission electron microscopy （TEM） was employed to observe ultrastructural changes in hippocampal neurons and synapses. Biochemical methods were used to measure the levels of acetylcholine （ACh）， acetylcholinesterase （AChE）， superoxide dismutase （SOD）， malondialdehyde （MDA）， catalase （CAT）， and lactate dehydrogenase （LDH）. Real-time PCR and Western blot were employed to measure the mRNA and protein levels of molecules in the Keap1/Nrf2/HO-1 pathway in the hippocampus. In the cell experiments， a PC12 cell model of oxidative damage model was established with H₂O₂. Cell count kit-8 （CCK-8） assays and flow cytometry were adopted to measure cell viability and apoptosis rates， and Western blot was employed to quantify the expression levels of proteins in the Keap1/Nrf2/HO-1 pathway. ResultsThe animal experiments showed that compared with the model group， the SJZD and donepezil groups showed shortened escape latency （P<0.01）， increased time in the target quadrant and platform crossings， and increased movement distance and duration in the central area of the open field （P<0.05， P<0.01）. HE and Nissl staining showed more organized neurons and increased Nissl bodies in the drug intervention groups （P<0.05， P<0.01）， and the Aβ_1-42 and p-Tau expression levels were downregulated （P<0.05， P<0.01）. TEM revealed reduced ultrastructural damage in hippocampal neurons and synapses in the drug intervention groups. In addition， the drug intervention groups showed declined levels of MDA， LDH， and AChE （P<0.05， P<0.01）， elevated levels of SOD， CAT， and ACh （P<0.05， P<0.01）， reduced Keap1 expression and increased Nrf2， HO-1， and NQO1 expression in the hippocampus （P<0.05， P<0.01）. The cell experiments showed that compared with the model group， the SJZD-containing serum increased the cell viability （P<0.05， P<0.01）， and decreased total apoptosis rates （P<0.05， P<0.01）. The drug intervention groups showed upregulated protein levels of Nrf2 and HO-1 and downregulated protein level of Keap1 （P<0.05， P<0.01）. ConclusionSJZD demonstrates protective effects against SCOP-induced AD in mice and H₂O₂-induced damage in PC12 cells through antioxidant mechanisms mediated by the Keap1/Nrf2/HO-1 pathway.

Objective To investigate the predictive value of the triglyceride glucose (TyG) index in major adverse cardiovascular events (MACE) in patients after coronary artery bypass grafting (CABG) surgery. Methods A retrospective collection of patients with coronary heart disease who underwent CABG treatment in the Department of Cardiac Surgery Ward 1, the 7th People’s Hospital of Zhengzhou, from 2015 to 2024 was conducted. The X-tile software was used to calculate the optimal cutoff value of the TyG index, and patients were divided into two groups based on this optimal cutoff value. The association between the TyG index and MACE was explored through univariate analysis, Kaplan-Meier survival curve analysis, and Cox regression analysis. The predictive ability of the TyG index was evaluated by important factor ranking and the area under the receiver operating characteristic curve (AUC). Results A total of 998 patients were included, with 630 patients having a TyG index ≤8.80, including 438 males and 192 females, with a median age of 60 (55, 65) years; and 368 patients with a TyG index >8.80, including 236 males and 132 females, with a median age of 63 (57, 69) years. Cumulative survival curves showed that the incidence of MACE in the TyG index≤8.80 group was significantly lower than that in the TyG index>8.80 group (log-rank test, P<0.001). Cox regression analysis indicated that TyG>8.80 was an independent risk factor for MACE [HR=2.581, 95%CI (1.201, 5.549), P<0.001]. In the important factor ranking, the TyG index had the greatest impact on MACE. The TyG index could enhance the predictive ability of the MACE prediction model, with the AUC increasing from 0.712 to 0.872. Conclusion The TyG index is independently associated with MACE after CABG, and may improve the discriminative performance of the predictive model in internal samples; however, prospective, multicenter studies and external validation are still required for confirmation.

Objective:To investigate the optimization of inferior vena cava imaging using dual-layer spectral detector CT (DLCT) virtual monoenergetic images (VMI) combined with multiphase scanning.Methods:A retrospective analysis was conducted on the imaging data of 184 patients who underwent inferior vena cava imaging using dual-layer detector spectral CT at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2021 to October 2024. Each patient underwent multiphase scanning (60, 80, and 120 s after contrast injection were referred to as the first, second, and third phases, respectively). The images were reconstructed into conventional 120 kVp polyenergetic image (PI) and VMIs at 40, 50, 60, 70, and 80 keV. Image quality of 120 kVp PI and VMI for each phase was evaluated. The objective image quality indicators included CT value, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and noise. Comparisons of the above indictors within the same phase were performed using repeated measures ANOVA or the Friedman test, while comparisons between different phases were conducted using one-way ANOVA or the Kruskal-Wallis test.Results:At the same phase, the CT value, SNR, and CNR of the 40 keV VMI were higher than those of other energy level VMIs and PI (all P<0.001). The SNR of the 40 keV VMI in the third phase was significantly higher than in the first phase ( P<0.05), while there was no significant difference between the first and second phases ( P>0.05). The standard deviation (SD) of the 40 keV VMI in the third phase was significantly lower than that in the first and second phases (all P<0.05). The subjective scores for the 40 keV VMI were higher than those for other energy level VMIs and PI at the same phase ( P<0.001). The subjective scores for the 40 keV VMI in the third phase were higher than those in the second and first phases ( P<0.001). The percentage of scores≥4 in the third phase (77.17%,142/184) was significantly higher than those in the first phase (28.26%,52/184) and second phase (61.96%,114/184) ( P<0.001). Conclusion:In inferior vena cava imaging, the 40 keV VMI, combined with the optimal phase (120 s delay), effectively optimizes image quality.

Objective:To investigate the clinical and radiological differences in treating single-level cervical spondylosis using the Zero-profile interbody fusion cage (Zero-PVA) versus the titanium plate interbody fusion cage in anterior cervical discectomy and fusion (ACDF) and to analyze the correlation between clinical outcomes and radiological parameters.Methods:this retrospective study collected data from patients with cervical spondylosis who underwent single-level ACDF surgery at the First Affiliated Hospital of Kunming Medical University between January 2019 and June 2022. A total of 70 patients (32 males and 38 females) with an average age of 51.34 ± 8.62 years (range: 29 to 77 years) were included. Based on the type of interbody fusion device used, patients were divided into two groups: the cage-plate construct (CP) group (35 patients; average age: 51.51 ± 10.02 years, range: 29 to 77 years) and the zero-profile interbody fusion device with variable angle (ZP) group (35 patients; average age: 51.17±7.11 years, range: 38 to 68 years). Preoperative, one-week postoperative, and final follow-up (≥6 months postoperative) data were collected for visual analogue scale (VAS) scores, neck disability index (NDI) scores, and Japanese Orthopaedic Association (JOA) scores. Radiological parameters assessed included surgical segment intervertebral disc height, cervical lordosis angle, surgical segment Cobb angle, T 1 slope (T 1S), and C 2-C 7 sagittal vertical axis (C 2-C 7 SVA). Additional evaluations included Bazaz dysphagia ratings at one week and final follow-up, Odom surgical outcome ratings at final follow-up, fusion grades, adjacent vertebral ectopic ossification grades, and adjacent segment degeneration. Patients were further classified into a symptom relief group and an incomplete symptom relief group based on Odom ratings. Logistic regression analysis was performed to examine the correlation between radiological parameters and postoperative outcomes. Statistical methods such as ROC curves, Youden index, product index, and Euclidean index were used to determine optimal cut-off values for radiological parameters affecting postoperative outcomes. Results:There were no statistically significant differences between the two groups in terms of gender, age, follow-up duration, surgical segment, or classification ( P>0.05), confirming comparability. At both one-week post-operation and final follow-up, VAS, NDI, and JOA scores showed no significant differences between the groups ( P>0.05). However, the incidence of dysphagia in the CP group was 49% at one week post-operation and 20% at final follow-up, significantly higher than that in the ZP group (14% at one week and 0 at final follow-up; P<0.05). The intervertebral space height in the CP group was 9.16±0.84 mm at one week post-operation and 8.19±1.11 mm at final follow-up, which was significantly higher than in the ZP group (8.22±1.23 mm at one week and 7.57±1.14 mm at final follow-up; P<0.05). The surgical segment Cobb angle in the CP group at final follow-up (7.34°±4.21°) was significantly greater than in the ZP group (4.63°±4.32°; t=2.661, P=0.010). Regarding heterotopic ossification (HO) of the superior vertebral body, in the CP group, 27 cases were grade 0, 7 cases were grade 1, and 1 case was grade 2. In the ZP group, 34 cases were grade 0 and 1 case was grade 1, with a statistically significant difference between the groups (χ 2=6.128, P=0.028). Binary logistic regression analysis revealed that a reduction in intervertebral space height of ≥0.63 mm at one week post-operation and final follow-up ( OR=2.913, P=0.021) and a heterotopic ossification grade of ≥1 ( OR=5.178, P=0.042) were correlated with incomplete symptom relief after single-level ACDF surgery. Conclusions:Both Zero-PVA and titanium plate interbody fusion devices demonstrated favorable clinical outcomes in single-level ACDF surgery. However, a reduction in intervertebral space height and heterotopic ossification of the superior vertebral body may be risk factors for incomplete symptom relief following single-level ACDF.

Objective To investigate the patterns of herbal formulas used for treating palpitation with Zhengchong in historical literature within the Zhonghua Yidian.Methods The term Zhengchong was used as the search keyword to conduct a full-text search of medical texts included in the Zhonghua Yidian.Formulas primarily indicated for Zhengchong were collected.A total of 392 prescriptions were included,with 303 drugs.Data mining analysis was performed using the Ancient and Modern Medical Case Cloud Platform,encompassing frequency,properties,efficacy,herb pairing patterns,core herbs/formulas,and herb cluster analysis.Results The key core formula comprises eight herbs:Renshen,fuling,fushen,suanzaoren,yuanzhi,maidong,danggui,gancao.Thirteen commonly used herb pairs were identified,including renshen,gancao,etc.Through cluster analysis,five primary functional herb groups were delineated:spleen-strengthening and Qi-replenishing group,blood-nourishing and mind-calming group,dampness-drying and phlegm-transforming group,heart-clearing and mind-tranquilizing group,and Qi-replenishing,Yin-nourishing,and blood-tonifying group.Conclusion In the Zhonghua Yidian,the treatment of palpitations focuses on the regulation of heart and spleen,with strengthening the spleen and benefiting Qi,nourishing blood and Yin,calming the heart and calming the mind as the core treatment method,and achieving the same treatment of symptoms and root causes through multi-level drug combination.

Objective To evaluate the impact of Jixiong Jiedu decoction on the efficacy of diabetic kidney disease in mice and its influence on intestinal flora and trimethylamine oxide(TMAO)levels.Methods Twelve 7-week-old male db/db mice were randomly assigned to the model group or Jixiong Jiedu decoction group(6 mice per group),while 6 male db/m mice were designated as the control group.Following 8 weeks of continuous gavage,we monitored the body weight and blood glucose levels of the mice at weeks 0,4,and 8.Additionally,we assessed urinary microalbumin,kidney injury molecule-1(KIM-1),creatinine(Scr),and urea nitrogen(BUN)levels in urine.Renal pathology was evaluated using HE and PAS staining.Furthermore,fecal samples underwent 16s RNA sequencing,and the serum TMAO levels were determined.Results Compared with the control group,the blood glucose,body weight,8-hour urinary microalbumin,KIM-1 and Scr in the model group were significantly increased,and the renal pathology showed that glomerular segmental mesangial matrix increased,glomerular volume hypertrophy and renal tubular epithelial cell swelling.The abundance of Lactobacillaceae and Lactobacillus in the model group was significantly increased(P<0.01).The abundance of Lachnospiraceae,Helicobacter and Oscillospira decreased significantly(P<0.01),the abundance of each bacterial group changed,and the serum TMAO content increased significantly.Compared with the model group,the 8h urinary microalbumin,KIM-1(P<0.01)and Scr(P<0.05)in the Jixiong Jiedu decoction group were significantly decreased,and there was no significant difference in BUN(P>0.05),and the renal pathological damage was significantly improved.The abundance of Lactobacillaceae and Lactobacillus in intestinal flora decreased significantly(P<0.01),while the abundance of Lachnospiraceae and Oscillospira increased significantly(P<0.01,P<0.05).The structure of gut microbiota,the abundance of dominant and non-dominant bacteria were positively adjusted,and the serum TMAO content was significantly decreased(P<0.01).Conclusion Jixiong Jiedu decoction effectively ameliorates intestinal flora disorders in db/db mice and regulates serum TMAO levels,thereby exerting a nephroprotective effect.

Objective:To investigate the clinical and radiological differences in treating single-level cervical spondylosis using the Zero-profile interbody fusion cage (Zero-PVA) versus the titanium plate interbody fusion cage in anterior cervical discectomy and fusion (ACDF) and to analyze the correlation between clinical outcomes and radiological parameters.Methods:this retrospective study collected data from patients with cervical spondylosis who underwent single-level ACDF surgery at the First Affiliated Hospital of Kunming Medical University between January 2019 and June 2022. A total of 70 patients (32 males and 38 females) with an average age of 51.34 ± 8.62 years (range: 29 to 77 years) were included. Based on the type of interbody fusion device used, patients were divided into two groups: the cage-plate construct (CP) group (35 patients; average age: 51.51 ± 10.02 years, range: 29 to 77 years) and the zero-profile interbody fusion device with variable angle (ZP) group (35 patients; average age: 51.17±7.11 years, range: 38 to 68 years). Preoperative, one-week postoperative, and final follow-up (≥6 months postoperative) data were collected for visual analogue scale (VAS) scores, neck disability index (NDI) scores, and Japanese Orthopaedic Association (JOA) scores. Radiological parameters assessed included surgical segment intervertebral disc height, cervical lordosis angle, surgical segment Cobb angle, T 1 slope (T 1S), and C 2-C 7 sagittal vertical axis (C 2-C 7 SVA). Additional evaluations included Bazaz dysphagia ratings at one week and final follow-up, Odom surgical outcome ratings at final follow-up, fusion grades, adjacent vertebral ectopic ossification grades, and adjacent segment degeneration. Patients were further classified into a symptom relief group and an incomplete symptom relief group based on Odom ratings. Logistic regression analysis was performed to examine the correlation between radiological parameters and postoperative outcomes. Statistical methods such as ROC curves, Youden index, product index, and Euclidean index were used to determine optimal cut-off values for radiological parameters affecting postoperative outcomes. Results:There were no statistically significant differences between the two groups in terms of gender, age, follow-up duration, surgical segment, or classification ( P>0.05), confirming comparability. At both one-week post-operation and final follow-up, VAS, NDI, and JOA scores showed no significant differences between the groups ( P>0.05). However, the incidence of dysphagia in the CP group was 49% at one week post-operation and 20% at final follow-up, significantly higher than that in the ZP group (14% at one week and 0 at final follow-up; P<0.05). The intervertebral space height in the CP group was 9.16±0.84 mm at one week post-operation and 8.19±1.11 mm at final follow-up, which was significantly higher than in the ZP group (8.22±1.23 mm at one week and 7.57±1.14 mm at final follow-up; P<0.05). The surgical segment Cobb angle in the CP group at final follow-up (7.34°±4.21°) was significantly greater than in the ZP group (4.63°±4.32°; t=2.661, P=0.010). Regarding heterotopic ossification (HO) of the superior vertebral body, in the CP group, 27 cases were grade 0, 7 cases were grade 1, and 1 case was grade 2. In the ZP group, 34 cases were grade 0 and 1 case was grade 1, with a statistically significant difference between the groups (χ 2=6.128, P=0.028). Binary logistic regression analysis revealed that a reduction in intervertebral space height of ≥0.63 mm at one week post-operation and final follow-up ( OR=2.913, P=0.021) and a heterotopic ossification grade of ≥1 ( OR=5.178, P=0.042) were correlated with incomplete symptom relief after single-level ACDF surgery. Conclusions:Both Zero-PVA and titanium plate interbody fusion devices demonstrated favorable clinical outcomes in single-level ACDF surgery. However, a reduction in intervertebral space height and heterotopic ossification of the superior vertebral body may be risk factors for incomplete symptom relief following single-level ACDF.

Objective To evaluate the impact of Jixiong Jiedu decoction on the efficacy of diabetic kidney disease in mice and its influence on intestinal flora and trimethylamine oxide(TMAO)levels.Methods Twelve 7-week-old male db/db mice were randomly assigned to the model group or Jixiong Jiedu decoction group(6 mice per group),while 6 male db/m mice were designated as the control group.Following 8 weeks of continuous gavage,we monitored the body weight and blood glucose levels of the mice at weeks 0,4,and 8.Additionally,we assessed urinary microalbumin,kidney injury molecule-1(KIM-1),creatinine(Scr),and urea nitrogen(BUN)levels in urine.Renal pathology was evaluated using HE and PAS staining.Furthermore,fecal samples underwent 16s RNA sequencing,and the serum TMAO levels were determined.Results Compared with the control group,the blood glucose,body weight,8-hour urinary microalbumin,KIM-1 and Scr in the model group were significantly increased,and the renal pathology showed that glomerular segmental mesangial matrix increased,glomerular volume hypertrophy and renal tubular epithelial cell swelling.The abundance of Lactobacillaceae and Lactobacillus in the model group was significantly increased(P<0.01).The abundance of Lachnospiraceae,Helicobacter and Oscillospira decreased significantly(P<0.01),the abundance of each bacterial group changed,and the serum TMAO content increased significantly.Compared with the model group,the 8h urinary microalbumin,KIM-1(P<0.01)and Scr(P<0.05)in the Jixiong Jiedu decoction group were significantly decreased,and there was no significant difference in BUN(P>0.05),and the renal pathological damage was significantly improved.The abundance of Lactobacillaceae and Lactobacillus in intestinal flora decreased significantly(P<0.01),while the abundance of Lachnospiraceae and Oscillospira increased significantly(P<0.01,P<0.05).The structure of gut microbiota,the abundance of dominant and non-dominant bacteria were positively adjusted,and the serum TMAO content was significantly decreased(P<0.01).Conclusion Jixiong Jiedu decoction effectively ameliorates intestinal flora disorders in db/db mice and regulates serum TMAO levels,thereby exerting a nephroprotective effect.

Objective:To investigate the optimization of inferior vena cava imaging using dual-layer spectral detector CT (DLCT) virtual monoenergetic images (VMI) combined with multiphase scanning.Methods:A retrospective analysis was conducted on the imaging data of 184 patients who underwent inferior vena cava imaging using dual-layer detector spectral CT at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2021 to October 2024. Each patient underwent multiphase scanning (60, 80, and 120 s after contrast injection were referred to as the first, second, and third phases, respectively). The images were reconstructed into conventional 120 kVp polyenergetic image (PI) and VMIs at 40, 50, 60, 70, and 80 keV. Image quality of 120 kVp PI and VMI for each phase was evaluated. The objective image quality indicators included CT value, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and noise. Comparisons of the above indictors within the same phase were performed using repeated measures ANOVA or the Friedman test, while comparisons between different phases were conducted using one-way ANOVA or the Kruskal-Wallis test.Results:At the same phase, the CT value, SNR, and CNR of the 40 keV VMI were higher than those of other energy level VMIs and PI (all P<0.001). The SNR of the 40 keV VMI in the third phase was significantly higher than in the first phase ( P<0.05), while there was no significant difference between the first and second phases ( P>0.05). The standard deviation (SD) of the 40 keV VMI in the third phase was significantly lower than that in the first and second phases (all P<0.05). The subjective scores for the 40 keV VMI were higher than those for other energy level VMIs and PI at the same phase ( P<0.001). The subjective scores for the 40 keV VMI in the third phase were higher than those in the second and first phases ( P<0.001). The percentage of scores≥4 in the third phase (77.17%,142/184) was significantly higher than those in the first phase (28.26%,52/184) and second phase (61.96%,114/184) ( P<0.001). Conclusion:In inferior vena cava imaging, the 40 keV VMI, combined with the optimal phase (120 s delay), effectively optimizes image quality.