Immunoglobulin A nephropathy （IgAN） is the primary glomerulonephritis with the highest incidence rate in the world. It is also the main cause of end-stage renal disease （ESRD） in China， which has brought heavy economic burden to the society and patient families. Traditional Chinese medicine （TCM） has certain advantages in treating IgAN. In TCM， IgAN is classified into consumptive disease， hematuria， and edema categories， with the location in the kidney and involving the lung， liver， and spleen. Professor Ren Jixue， a master of TCM， believes that kidney deficiency and spleen deficiency are the root causes of IgAN， and the throat is the source of the disease. He proposed the theory of throat-kidney correlation and used the method of tonifying kidney and invigorating spleen as well as detoxifying and relieving sore-throat to treat IgAN， achieving significant therapeutic effects. Studies have shown that IgAN is closely related to mucosal immune defense. IgAN patients often experience recurrent and gradually worsening symptoms due to mucosal infections， and polymeric Ig receptor （PIgR） is an important component of mucosal defense function. The lack of PIgR leads to the accumulation of IgA molecules in the mucosal lamina propria， and the molecules enter the bloodstream in large quantities and ultimately deposit in the kidneys， causing kidney damage. Complement regulatory protein complement receptor type 1 （CR1） exists on red blood cells and glomeruli and has the function of inhibiting the activation and differentiation of B cells， clearing immune complexes， and inhibiting excessive activation of the complement system. Therefore， regulating the immune defense function through the mucosal-renal axis mediated by PIgR-CR1 will be an important target for preventing and treating IgAN. Based on the theory of throat-kidney correlation， this article explores the effects and molecular mechanisms of tonifying kidney and invigorating spleen as well as detoxifying and relieving sore-throat in preventing and treating IgAN by regulating the mucosal-kidney axis mediated by PIgR-CR1. It provides effective theoretical support and a scientific basis for TCM prevention and treatment of IgAN based on the theory of throat-kidney correlation.

Immunoglobulin A nephropathy （IgAN） is the primary glomerulonephritis with the highest incidence rate in the world. It is also the main cause of end-stage renal disease （ESRD） in China， which has brought heavy economic burden to the society and patient families. Traditional Chinese medicine （TCM） has certain advantages in treating IgAN. In TCM， IgAN is classified into consumptive disease， hematuria， and edema categories， with the location in the kidney and involving the lung， liver， and spleen. Professor Ren Jixue， a master of TCM， believes that kidney deficiency and spleen deficiency are the root causes of IgAN， and the throat is the source of the disease. He proposed the theory of throat-kidney correlation and used the method of tonifying kidney and invigorating spleen as well as detoxifying and relieving sore-throat to treat IgAN， achieving significant therapeutic effects. Studies have shown that IgAN is closely related to mucosal immune defense. IgAN patients often experience recurrent and gradually worsening symptoms due to mucosal infections， and polymeric Ig receptor （PIgR） is an important component of mucosal defense function. The lack of PIgR leads to the accumulation of IgA molecules in the mucosal lamina propria， and the molecules enter the bloodstream in large quantities and ultimately deposit in the kidneys， causing kidney damage. Complement regulatory protein complement receptor type 1 （CR1） exists on red blood cells and glomeruli and has the function of inhibiting the activation and differentiation of B cells， clearing immune complexes， and inhibiting excessive activation of the complement system. Therefore， regulating the immune defense function through the mucosal-renal axis mediated by PIgR-CR1 will be an important target for preventing and treating IgAN. Based on the theory of throat-kidney correlation， this article explores the effects and molecular mechanisms of tonifying kidney and invigorating spleen as well as detoxifying and relieving sore-throat in preventing and treating IgAN by regulating the mucosal-kidney axis mediated by PIgR-CR1. It provides effective theoretical support and a scientific basis for TCM prevention and treatment of IgAN based on the theory of throat-kidney correlation.

Objective To investigate the 90%effective dose(ED90)of ciprofol combined with alfentanil in inhibiting gastroscopy insertion response in elderly patients.Methods 110 patients were selected to undergo painless gastroscopy examination on a scheduled basis.110 patients were randomly divided into ciprofol group alone(group H,n=57)and ciprofol group combined with alfentanil 5 μg/kg(group A,n=53).The trial was conducted according to the Biased coin design up-and-down(BCD-UDM)sequential.Patients in group H were given only intravenous infusion of ciprofol and patients in group A were pre-infused with intravenous alfentanil at 5μg/kg,followed by intravenous infusion of ciprofol,and gastroscopy was initiated when the modified observer's assessment of alertness/sedation scale(MOAA/S)was≤1 point.The initial dose of ciprofol was 0.200 mg/kg in all cases,and the adjacent isotropic dose was 0.030 mg/kg.If the patient's MOAA/S was still>1 or the patient had a response that interfered with the operative examination,such as choking or body movement,during gastroscopy placement,2.0 min after the intravenous infusion of ciprofol,was regarded as an ineffective response,then the next patient was elevated by one dose gradient.If the anesthetic effect of the previous patient was judged to be a valid response,the next patient was randomized to a dose according to the BCD-UDM,with an 11%(b=0.11)probability of decreasing the dose gradient by one dose,and an 89%(1-b=0.89)probability of remaining unchanged,and the experiment was terminated at the 45th effective response in each group.Probabilistic unit regression analysis was used to calculate the ED90,95%effective dose(ED95),and 95%confidence intervals(CI)for the inhibition of gastroscopy placement response with ciprofol alone and the combination of 5 μg/kg alfentanil in elderly patients.Results The ED90 of ciprofol in group A was 0.296 mg/kg(95%CI:0.275～0.338),and ED95 was 0.310 mg/kg(95%CI:0.291～0.383);The ED90 of ciprofol in group H was 0.407 mg/kg(95%CI:0.390～0.447),and ED95 was 0.420 mg/kg(95%CI:0.402～0.483).Compared with group H,the total amount of ciprofol was significantly reduced in group A,the time of awakening and time of leaving the hospital were significantly shorter,and the incidence of intraoperative hypotension and hypoxemia was significantly lower,the differences were statistically significant(P<0.05).Conclusion The ED90 of ciprofol combined with 5 μg/kg of alfentanil and ciprofol alone in inhibiting gastroscopy implantation in elderly patients are 0.296 mg/kg and 0.407 mg/kg respectively.

As endogenous chemical substances,neurotransmitters play a vital role in maintaining normal life activities.Abnormal levels of neurotransmitters can lead to physical,mental,and some neurodegenerative diseases.However,the ultralow concentration,complex chemical properties,and release modes of neurotransmitters make their accurate detection in vivo a great challenge.To accurately monitor neurotransmitters in the brain and accurately understand the release kinetics of neurotransmitters,we reviewed several method commonly used in the past five years to detect neurotransmitters in vivo and their research progress.The basic principle and applicability of microdialysis,electrochemical sensors,and fluorescence sensors are introduced in detail.

Objective:To explore the latent classes of emotional behavior of children with mental disorders, and their relationship with parents' sense of parenting competence and psychological distress.Methods:A survey of 327 parents of children with mental disorders was conducted from September to December 2022 using the general information questionnaire, the sense of parenting competence scale, the Kessler psychological distress scale, and the strengths and difficulties questionnaire (parent version). Mplus 8.0 and SPSS 25.0 softwares were used for statistical analysis.The latent class analysis was used to identify subgroups of children with mental disorders based on their emotional behavior.Multinomial logistic regression was used to analyze the related factors.Results:Latent class analysis showed that the emotional behaviors of children with mental disorders were divided into 3 categories: emotion-conduct problem prominent group (38.53%(126/327)), simple emotional problem group (44.65%(146/327)), and emotion-peer interaction significant group (16.82%(55/327)). The differences among the 3 latent classes were statistically significant (all P<0.05) in terms of parents' parenting competence, satisfaction, and psychological distress scores.Compared with the emotion-conduct problem prominent group, the higher the parental parenting knowledge and parenting competence, the emotional behavior of children with mental disorders tended to be in the simple emotional problem group ( B=0.699, OR=2.011, 95% CI=1.046-3.868; B=0.088, OR=1.092, 95% CI=1.017-1.173). Compared with the " emotion-conduct problem prominent group" , the emotional behavior of children with mental disorders aged 13 to 18 years old tended to be in the " emotion-peer interaction significant group" ( B=1.982, OR=7.255, 95% CI=1.637-32.141). Conclusion:The emotional behavior of children with mental disorders is heterogeneous, and there are differences in sense of parenting competence and psychological distress of parents among different latent classes of children with mental disorders.

Objective:To investigate the risk factors of central lymph node metastasis (CLNM) in cN0 paillary thyroicl microcarcinoma (PTMC) and to establish a nomogram model for predicting the probability of cN0 PTMC CLNM.Methods:The clinicopathological data of 192 patients with cN0 PTMC admitted to the Department of General Surgery of the Second Hospital of Lanzhou University from Aug. 2016 to Aug. 2020 were retrospectively analyzed. There were 41 males and 151 females, 50 with CLNM and 142 without CLNM. The patients were divided into 2 groups according to the presence or absence of pathologically confirmed CLNM. Patient’s age, gender, tumor diameter, multiple, with Hashimoto’s disease, with nodular goiter, with or without near the posterior dorsal membrane, aspect ratio >1, with or without extratumoral infiltration, with or without lymphadenopathy, TSH levels, and TG levels were statistically analyzed. Pearson chi-square test was used to analyze the count data of hypothesis test, and the R language software package was used for Logistic multivariate analysis. The entry conditions were screened by stepwise regression to establish a nomogram prediction model, and the Bootstrap method was used for model verification. P<0.05 was considered statistically significant. Results:Multivariate logistic analysis showed that extratumoral invasion ( P=0.032) , presence of lymphadenopathy ( P=0.010) , and TG>68 μg/L ( P=0.007) were risk factors for central lymph node metastasis. The optimal model was established by stepwise regression. The factors included tumor diameter ≥0.5 cm, nodular goiter, extratumoral invasion, lymphadenopathy and TG>68 μg/L (AIC: 212.27) . The nomogram model was established according to the above risk factors. The consistency index (c-index) was 0.711. The results of calibration graph drawing and internal and external validation demonstrated its good consistency and applicability. Conclusion:Extratumoral invasion, lymphadenopathy, and TG>68 μg/L are risk factors for cN0 PTMC CLNM, and the nomogram established in the study can effectively predict the CLNM rate in patients with cN0PTMC and contribute to clinicians’ diagnosis and treatment decisions.

Lung cancer has become the leading cause of death from malignant tumors worldwide. At the same time, statistics show that the incidence and mortality of lung cancer are increasing year by year. Because patients with lung cancer do not have typical symptoms in the early stage, this directly leads to the majority of patients who are already at advanced stage at the time of diagnosis, and the prognosis is not good. How to diagnose lung cancer early and accurately and find patients with potential risks and predict the prognosis is of great significance for the formulation of further treatment plans. In recent years, the field of artificial intelligence has been booming. As a branch of artificial intelligence, machine learning could learn efficiently from complex and large amounts of data. Besides, the learned model has good generalization ability. These characteristics can take greatly advance on the research about lung cancer

Coronary artery disease (CAD) is a chronic disease but causes the highest mortality and morbidity among the cardiovascular diseases worldwide. Correlations between CAD and gut microbiota have been observed. This suggests that the gut microbiota could become a vital diagnostic marker of CAD, and restoring the gut habitat may become a promising strategy for CAD therapy. The elevated level of trimethylamine-N-oxide (TMAO), a gut microbiota-derived metabolite, was found to be associated with the increased risk of cardiovascular disease and the all-cause mortality. Preclinical studies have shown that it has pro-arteriosclerosis properties. It is likely that regulating the production of TMAO by gut microbiota may become a promising strategy for anti-atherosclerosis therapy. This review summarizes the clinical and preclinical researches on the intervention of CAD by regulating the gut microbiota and the microbiota-derived metabolite TMAO, with the aim to provide new target for the therapy of CAD.
Coronary Artery Disease ; Gastrointestinal Microbiome ; Humans ; Methylamines ; Oxides

Objective: To investigate image quality and radiation dose of the third generation dual-source CT with low dose contrast agent dosage and low velocity. Methods Totally 120 patients who underwent CT coronary artery angiography scanning were analyzed prospectively. The patients were randomly assigned to the study group and control group (each n=60). In study group, the dose and injection flow rate of contrast agent were determined according to the formula: Contrast agent dose=patients' body mass×0.6 ml/kg, injection flow rate=contrast agent dose/(5+exposure time). In control group, the injection flow rate was 5.0 ml/s, and the volume of contrast medium was 50 ml. Patients in both groups underwent prospective ECG gated narrow window scanning. Quantitative parameters, qualitative visual parameters and radiation dose were compared between the groups. Results No statistical difference was found in the gender, age, body mass and body mass index (all P>0.05), while a significant difference was found in the amount of consumed iodine and the velocity of contrast agent between the two groups (P<0.001). No statistical difference of SNR, images quality nor the proportion of evaluable numbers to all coronary numbers was found between the two groups (all P>0.05). For different heart rates (HR; HR≤70 bpm,70 bpm 80 bpm), the effective dose had significant differences (all P<0.05). Conclusion: The individualization of injection method in the third generation dual-source CT coronary artery angiography could minimize the amount of contrast agent while meet clinical requirements.

OBJECTIVE： To optimize the formulation of Diosmin gel and to investigate its in vitro release property. METHODS： Diosmin gel were prepared by using Carbomer 940 as matrix. Using accumulative release rate as index， with the amount of Carbomer 940， ethanol， acetone and pH as factors， L9（34） orthogonal test was conducted. The formulation of Diosmin gel was optimized and validated. Using Diosmin ointment as reference， dialysis bag diffusion method was used to investigate in vitro release property of Diosmin gel prepared by optimal formulation. RESULTS： The optimal formulation of Diosmin gel included Carbomer 940 1.5 g， ethanol 15 mL， glycerol 8 g， pH 6. The gel prepared with optimal formulation was sticky brown-yellow semi solid， and had good coating and spreading properties. The average accumulative release rate （2 h） was （12.67±0.12）％. Results of drug release test showed that Diosmin gel released rapidly within 12 h， then gradually slowed down. The accumulative release rates were （71.93±0.42）％ （12 h） and （80.47±0.54）％ （24 h）， drug release of which were in line with Higuchi equation. Diosmin ointment was released slowly. The accumulative release rates were （41.74±0.18）％ （12 h） and （62.63±0.59）％ （24 h）. Drug release of it were in line with first-order equation. CONCLUSIONS： The formulation of Diosmin gel is optimized successfully. Prepared Diosmin gel has good drug release property.