Parkinson's disease （PD） is a complex neurodegenerative disease involving multiple systems and neurotransmitters. Due to the high clinical heterogeneity of PD，it is urgent to establish a comprehensive and long-term traditional Chinese medicine （TCM） management model. In this paper，the conceptual framework of full-cycle management of PD is preliminarily constructed：based on the evolution of the pathophysiological mechanisms of protein deposition and neurotransmitter disorder in PD，the three-stage syndrome characteristics of the prodromal stage （predominant healthy Qi with subtle pathogenic factors），the early clinical stage （declining healthy Qi with growing pathogenic factors） and the middle and late stages （overwhelming pathogenic factors with deficient healthy Qi） are longitudinally described. Through the syndrome differentiation of visceral manifestations，the etiology and pathogenesis of PD motor and non-motor symptoms were comprehensively analyzed，while the matching treatment methods and prescriptions were inferred，and the modular scheme of the combining main symptoms，accompanying symptoms and secondary symptoms was proposed. The conceptual gap of TCM regarding motor complications （'variable syndrome'） and PD-related hyperpyrexia syndrome （'critical syndrome'） was explained. This framework reflects the characteristics of combination of disease and syndrome and overall constant motion，and provides new theories and research ideas for individualized and whole-process management of PD in TCM.

Parkinson's disease （PD） is a complex neurodegenerative disease involving multiple systems and neurotransmitters. Due to the high clinical heterogeneity of PD，it is urgent to establish a comprehensive and long-term traditional Chinese medicine （TCM） management model. In this paper，the conceptual framework of full-cycle management of PD is preliminarily constructed：based on the evolution of the pathophysiological mechanisms of protein deposition and neurotransmitter disorder in PD，the three-stage syndrome characteristics of the prodromal stage （predominant healthy Qi with subtle pathogenic factors），the early clinical stage （declining healthy Qi with growing pathogenic factors） and the middle and late stages （overwhelming pathogenic factors with deficient healthy Qi） are longitudinally described. Through the syndrome differentiation of visceral manifestations，the etiology and pathogenesis of PD motor and non-motor symptoms were comprehensively analyzed，while the matching treatment methods and prescriptions were inferred，and the modular scheme of the combining main symptoms，accompanying symptoms and secondary symptoms was proposed. The conceptual gap of TCM regarding motor complications （'variable syndrome'） and PD-related hyperpyrexia syndrome （'critical syndrome'） was explained. This framework reflects the characteristics of combination of disease and syndrome and overall constant motion，and provides new theories and research ideas for individualized and whole-process management of PD in TCM.

OBJECTIVE: To accurately measure human energy metabolism with high temporal resolution, a respiratory gas analysis system was designed using a breath-by-breath approach. METHODS: Firstly, indirect calorimetry was employed in respiratory gas analysis to measure the respiratory flow and concentration signals in real-time. Secondly, oxygen consumption QO2 and carbon dioxide production QCO2 were calculated through respiratory characteristic alignment and respiratory signal segmentation. Finally, metabolic indexes were calculated according to the Weir formula. Furthermore, a controlled trial was formulated for validation comparisons with the MGC ULTIMA SYSTEM PFX CARDIO2. RESULTS: The results indicate that the data points of metabolic indexes measured by this system all fall within the confidence interval when compared with those of the MGC. CONCLUSION The system has high consistency with the MGC measurement results. Thus, the system can accurately measure metabolism in real-time and provide data support for clinical nutrition assessment and therapy.
Humans ; Energy Metabolism ; Breath Tests/instrumentation* ; Calorimetry, Indirect/instrumentation* ; Equipment Design

Psoriasis is an incurable chronic inflammatory disease that requires new interventions. Here, we found that fibroblasts exacerbate psoriasis progression by promoting macrophage recruitment via CCL2 secretion by single-cell multi-omics analysis. The natural small molecule celastrol was screened to interfere with the secretion of CCL2 by fibroblasts and improve the psoriasis-like symptoms in both murine and cynomolgus monkey models. Mechanistically, celastrol directly bound to the low-density lipoprotein receptor-related protein 1 (LRP1) β-chain and abolished its binding to the transcription factor c-Jun in the nucleus, which in turn inhibited CCL2 production by skin fibroblasts, blocked fibroblast-macrophage crosstalk, and ameliorated psoriasis progression. Notably, fibroblast-specific LRP1 knockout mice exhibited a significant reduction in psoriasis like inflammation. Taken together, from clinical samples and combined with various mouse models, we revealed the pathogenesis of psoriasis from the perspective of fibroblast-macrophage crosstalk, and provided a foundation for LRP1 as a novel potential target for psoriasis treatment.

Objective To investigate biological markers associated with psychotic symptoms in patients with bipolar disorder(BD)based on electronic medical records of patients,and to develop an interpretable risk prediction model that supports the identification of high-risk individuals and that facilitates decision-making for providing clinical intervention in a timely manner.Methods A total of 2 352 patients diagnosed with BD and admitted to West China Hospital,Sichuan University were enrolled using the electronic medical records system of the hospital.The participants were divided into two subgroups,the bipolar disorder depression(BDD)group and the bipolar disorder mania(BDM)group.The logistic regression algorithm was used to train and validate the prediction model,and interpretability methods were used to analyze the contribution of each feature to individuals and the effect of the features on specific target prediction decisions.Results The logistic regression model demonstrated robust predictive performance across the BD,BDD,and BDM cohorts,with areas under the curve(AUC)of the receiver operating characteristic curves always exceeding 81.6%.The core predictive features included platelet distribution width(PDW),fibrinogen(FIB),platelet large cell ratio(P-LCR),activated partial thromboplastin time(APTT),prothrombin time(PT),and triglyceride(TG).The logistic regression model exhibited strong interpretability and was combined with nomograms for intuitive risk quantification and individualized prediction.Conclusion The logistic regression model enables rapid and simple screening of BD patients with psychotic symptoms.Distinct patterns of changes observed in blood biomarkers of BDD and BDM subgroups enrich the understanding of the underlying pathophysiological mechanisms and highlight the importance of considering subtypes in the intervention and management of patients.

OBJECTIVE: To investigate the impact of bone mass and volume of low-density zones beneath the tibial plateau on the maximum von Mises stresses experienced by the cartilage and meniscus in the knee joint. METHODS: The study included one healthy adult volunteer, from whom CT scans were obtained, and one patient diagnosed with knee osteoarthrisis (KOA), for whom X-ray films were acquired. A static model of the knee joint featuring a low-density zone was established based on a normal knee model. In the finite element analysis, axial loads of 1 000 N and 1 800 N were applied to the weight-bearing region of the upper surface of the femoral head for model validation and subsequent finite element studies, respectively. The maximum von Mises stresses in the femoral cartilage, as well as the medial and lateral tibial cartilage and menisci, were observed, and the stress percentage of the medial and lateral components were concurrently analyzed. Additionally, HE staining, as well as alkaline magenta staining, were performed on the pathological specimens of patients with KOA in various low-density regions. RESULTS: The results of model validation indicated that the model was consistent with normal anatomical structures and correlated with previous calculations documented in the literature. Static analysis revealed that the maximum von Mises stress in the medial component of the normal knee was the lowest and increased with the advancement of the hypointensity zone. In contrast, the lateral component exhibited an opposing trend, with the maximum von Mises stress in the lateral component being the highest and decreasing as the hypointensity zone progressed. Additionally, the medial component experienced an increasing proportion of stress within the overall knee joint. HE staining demonstrated that the chondrocyte layer progressively deteriorated and may even disappear as the hypointensity zone expanded. Furthermore, alkaline magenta staining indicated that the severity of microfractures in the trabecular bone increased concurrently with the expansion of the hypointensity zone. CONCLUSION The presence of subtalar plateau low-density zone may aggravate joint degeneration. In clinical practice, it is necessary to pay attention to the changes in the subtalar plateau low-density zone and actively take effective measures to strengthen the bone status of the subtalar plateau low-density zone and restore the complete biomechanical function of the knee joint, in order to slow down or reverse the progression of osteoarthritis.
Humans ; Finite Element Analysis ; Knee Joint/physiology* ; Tibia/anatomy & histology* ; Cartilage, Articular/physiology* ; Menisci, Tibial/physiopathology* ; Tomography, X-Ray Computed ; Osteoarthritis, Knee/diagnostic imaging* ; Weight-Bearing ; Bone Density ; Adult ; Stress, Mechanical ; Male ; Middle Aged ; Biomechanical Phenomena ; Female

Objective:To design an inspection system for quality of metabolism tester based on alcohol combustion mode for human body,so as to realize assessment for accuracy degree of human metabolism tester.Methods:According to the specific indicators that were measured by the metabolism tester for human body,a simulation of bidirectional controllable flow and a simulation of component concentration of exhaled breath were designed and realized.Then,the ratio of alcohol consumption to oxygen consumption and carbon dioxide production were calculated by the formula of alcohol combustion.Finally,the metabolic indexes(volume of gas flow,oxygen consumption,dioxide carbon production,rate of energy metabolism,respiratory quotient)that were outputted by the inspection system for quality were calculated according to Weir formula.Furthermore,the verification for precision of simulation modules of exhale and inhalation,and weighing device module was carried out,and an application test of inspection system for quality was also carried out.Results:The errors of the volume of gas flow and alcohol consumption that were outputted by simulation modules of exhale and inhalation,and weighing device module were all within±1%,and the errors between the reference value of the metabolic index of the inspection system for quality and the actually measured value of the metabolic index of the hood calorimeter were all within 10%.Conclusion:There was higher consistency between inspection system for quality of metabolism tester for human body and the actual measurement data of calorimeter,which can better simulate the process of respiratory metabolism of human body,and provide standardized testing means for the performance verification of metabolic tester.

Objective:To design an inspection system for quality of metabolism tester based on alcohol combustion mode for human body,so as to realize assessment for accuracy degree of human metabolism tester.Methods:According to the specific indicators that were measured by the metabolism tester for human body,a simulation of bidirectional controllable flow and a simulation of component concentration of exhaled breath were designed and realized.Then,the ratio of alcohol consumption to oxygen consumption and carbon dioxide production were calculated by the formula of alcohol combustion.Finally,the metabolic indexes(volume of gas flow,oxygen consumption,dioxide carbon production,rate of energy metabolism,respiratory quotient)that were outputted by the inspection system for quality were calculated according to Weir formula.Furthermore,the verification for precision of simulation modules of exhale and inhalation,and weighing device module was carried out,and an application test of inspection system for quality was also carried out.Results:The errors of the volume of gas flow and alcohol consumption that were outputted by simulation modules of exhale and inhalation,and weighing device module were all within±1%,and the errors between the reference value of the metabolic index of the inspection system for quality and the actually measured value of the metabolic index of the hood calorimeter were all within 10%.Conclusion:There was higher consistency between inspection system for quality of metabolism tester for human body and the actual measurement data of calorimeter,which can better simulate the process of respiratory metabolism of human body,and provide standardized testing means for the performance verification of metabolic tester.

BACKGROUND:Periprosthetic joint infection is one of the most unwanted complications for surgeons and patients after arthroplasty,and its recalcitrance and intractability have always been a headache for arthroplasty surgeons. OBJECTIVE:To review the latest domestic and international clinical treatments used in the treatment of periprosthetic joint infection after hip and knee arthroplasty in recent years,including antibiotic treatment,surgical treatment,biological treatment and Chinese medicine treatment,to promote the research progress in the treatment of periprosthetic joint infection in China. METHODS:The literature from January 2000 to October 2022 on CNKI,WanFang,VIP,and PubMed was retrieved by the first author.762 articles were obtained by reading the titles for initial screening,then 194 articles were obtained by reading the abstracts and excluding studies with duplicate contents,low data reliability,and outdated views.Finally,88 articles were included through intensive reading of the original text. RESULTS AND CONCLUSION:(1)Combined antibiotic regimens may help eradicate the infection in the treatment of periprosthetic infections.(2)Two-stage revision remained the golden indicator for the treatment of periprosthetic infection.(3)One-stage revision lacked large-sample clinical studies and required more clinical observation.(4)Phage therapy and newer drug delivery systems in biological therapy had been applied in small amounts in the clinic,showing their advantages in the prevention and eradication of periprosthetic infections.(5)Chinese medicine with antibiotics and surgical treatment methods can improve the prevention and treatment of periprosthetic joint infection,but high-level evidence-based medical evidence was lacking.