Objective To summarize the clinical characteristics of 2 cases of styloid-carotid syndrome(SCS)and review the literature to enhance understanding of the disease.Methods A retrospective analysis was conducted on the clinical manifestations,auxiliary examinations,and diagnosis and treatment of 2 patients with SCS admitted to the Neurology Department of Kaifeng Central Hospital.Additionally,relevant literature was searched through domestic and foreign databases such as PubMed,WOS,Embase,CNKI and VIP.The clinical characteristics of SCS were summarized based on the literature results.Results The 2 cases were diagnosed as transient cerebral ischemia(TIA)combined with SCS through head and neck CT angiography(CTA)and styloid process CT.Apart from the 2 cases treated in our hospital,a total of 11 cases of SCS have been reported in Chinese and English literature up to October 2023.Among the 13 cases,11 cases(84.6%)started with episodic TIA symptoms,and 11 cases(84.6%)had obvious inducing factors related to specific head position changes.Common clinical manifestations included unilateral limb weakness with or without sensory disturbance(10 cases,76.9%),slurred speech(7 cases,53.8%),unilateral limb sensation disorder(4 cases,30.7%),syncope(3 cases,23.1%)and amaurosis(2 cases,15.4%).All 13 cases underwent 64-row head and neck CTA examination,and 6 cases(46.2%)dynamically observed the changes in blood flow velocity through examinations such as transcranial Doppler ultrasound(TCD),cervical vascular ultrasound,and digital subtraction angiography(DSA).All patients were followed up for more than 3 months;and 10 cases(76.9%)achieved clinical cure after treatment,of which 8 cases underwent styloid process shortening surgery;3 cases(23.1%)achieved clinical symptom improvement after treatment.Conclusions For patients with recurrent TIA and/or cerebral infarction,it is necessary to identify whether there are inducing factors related to specific body position changes.For patients highly suspected of SCS,routine examinations such as styloid process CT and 64-row head and neck CTA should be performed,and if necessary,whole brain DSA,dynamic TCD and/or carotid ultrasound should be conducted to guide the diagnosis and treatment.When non-surgical treatment is ineffective,radical styloid process truncation can be considered as a treatment option.

Metabolic dysfunction-associated fatty liver disease (MAFLD) is an increasingly common liver disease worldwide. MAFLD is diagnosed based on the presence of steatosis on images, histological findings, or serum marker levels as well as the presence of at least one of the three metabolic features: overweight/obesity, type 2 diabetes mellitus, and metabolic risk factors. MAFLD is not only a liver disease but also a factor contributing to or related to cardiovascular diseases (CVD), which is the major etiology responsible for morbidity and mortality in patients with MAFLD. Hence, understanding the association between MAFLD and CVD, surveillance and risk stratification of MAFLD in patients with CVD, and assessment of the current status of MAFLD management are urgent requirements for both hepatologists and cardiologists. This Taiwan position statement reviews the literature and provides suggestions regarding the epidemiology, etiology, risk factors, risk stratification, nonpharmacological interventions, and potential drug treatments of MAFLD, focusing on its association with CVD.

Abstract：Objective To improve the replication level of varicella⁃zoster virus（VZV）in human diploid cell line MRC⁃5 and increase the yield of VZV vaccine by reducing the expression of interferon（IFN）related genes via optimizing the cell line MRC⁃5. Methods Interferon receptor 1（IFNAR1）silenced MRC⁃5 cell line（MRC⁃5IFNAR1⁃）was constructed by CRISPR／Cas9 gene editing technology，which was determined for the relative expression of IFNAR1 mRNA，and for those of mRNA of IFN related genes IFNβ and OAS1 after VZV infection by qRT⁃PCR to evaluate the effect of gene silencing. Gene mutation sequences were further identified by sequencing of the silenced sites. The replication of VZV in MRC⁃5 and MRC⁃5IFNAR1⁃ cell lines was compared 168 h after VZV infection by using qRT⁃PCR and plaque formation unit（PFU）assay， to evaluate the effect of MRC⁃5IFNAR1⁃cell line on VZV replication. Results The growth status of MRC⁃5IFNAR1⁃ cell line wasconsistent with that of MRC ⁃ 5 cells，and the relative expression of IFNAR1 mRNA decreased by 73%；The relative expressions of IFNβ and OAS1 mRNA in MRC⁃5IFNAR1⁃ cell line were 61% and 90% lower than those in MRC⁃ 5 cells respectively after VZV infection；In addition，168 h after VZV infection，the level of DNA replication and the titer of VZV increased by 5. 7 folds and 4 folds respectively. Conclusion The successful establishment of MRC⁃5IFNAR1⁃ cell line may be a potential scheme to increase the yield of vaccines based on human diploid cells，and provided a reference for expanding production of VZV vaccine.

Nonalcoholic fatty liver disease (NAFLD) is a leading cause of liver disease worldwide. The estimated global incidence of NAFLD is 47 cases per 1,000 population and is higher among males than females. The estimated global prevalence of NAFLD among adults is 32% and is higher among males (40%) compared to females (26%). The global prevalence of NAFLD has increased over time, from 26% in studies from 2005 or earlier to 38% in studies from 2016 or beyond. The prevalence of NAFLD varies substantially by world region, contributed by differing rates of obesity, and genetic and socioeconomic factors. The prevalence of NAFLD exceeds 40% in the Americas and South-East Asia. The prevalence of NAFLD is projected to increase significantly in multiple world regions by 2030 if current trends are left unchecked. In this review, we discuss trends in the global incidence and prevalence of NAFLD and discuss future projections.

Background/Aims: Nonalcoholic fatty liver disease (NAFLD) is closely associated with diabetes. The cumulative impact of both diseases synergistically increases risk of adverse events. However, present population analysis is predominantly conducted with reference to non-NAFLD individuals and has not yet examined the impact of prediabetes. Hence, we sought to conduct a retrospective analysis on the impact of diabetic status in NAFLD patients, referencing non-diabetic NAFLD individuals. Methods: Data from the National Health and Nutrition Examination Survey 1999–2018 was used. Hepatic steatosis was defined with United States Fatty Liver Index (US-FLI) and FLI at a cut-off of 30 and 60 respectively, in absence of substantial alcohol use. A multivariate generalized linear model was used for risk ratios of binary outcomes while survival analysis was conducted with Cox regression and Fine Gray model for competing risk. Results: Of 32,234 patients, 28.92% were identified to have NAFLD. 36.04%, 38.32% and 25.63% were non-diabetic, prediabetic and diabetic respectively. Diabetic NAFLD significantly increased risk of cardiovascular disease (CVD), stroke, chronic kidney disease, all-cause and CVD mortality compared to non-diabetic NAFLD. However, prediabetic NAFLD only significantly increased the risk of CVD and did not result in a higher risk of mortality. Conclusions Given the increased risk of adverse outcomes, this study highlights the importance of regular diabetes screening in NAFLD and adoption of prompt lifestyle modifications to reduce disease progression. Facing high cardiovascular burden, prediabetic and diabetic NAFLD individuals can benefit from early cardiovascular referrals to reduce risk of CVD events and mortality.

Background/Aims: Non-alcoholic fatty liver disease (NAFLD) is associated with the development of cardiovascular disease. While existing studies have examined cardiac remodeling in NAFLD, there has been less emphasis on the development of carotid atherosclerosis and stroke. We sought to conduct a meta-analysis to quantify the prevalence, risk factors, and degree of risk increment of carotid atherosclerosis and stroke in NAFLD. Methods: Embase and Medline were searched for articles relating to NAFLD, carotid atherosclerosis, and stroke. Proportional data was analysed using a generalized linear mixed model. Pairwise meta-analysis was conducted to obtain odds ratio or weighted mean difference for comparison between patients with and without NAFLD. Results: From pooled analysis of 30 studies involving 7,951 patients with NAFLD, 35.02% (95% confidence interval [CI], 27.36–43.53%) had carotid atherosclerosis with an odds ratio of 3.20 (95% CI, 2.37–4.32; P<0.0001). Pooled analysis of 25,839 patients with NAFLD found the prevalence of stroke to be 5.04% (95% CI, 2.74–9.09%) with an odds ratio of 1.88 (95% CI, 1.23–2.88; P=0.02) compared to non-NAFLD. The degree of steatosis assessed by ultrasonography in NAFLD was closely associated with risk of carotid atherosclerosis and stroke. Older age significantly increased the risk of developing carotid atherosclerosis, but not stroke in NAFLD. Conclusions This meta-analysis shows that a stepwise increment of steatosis of NAFLD can significantly increase the risk of carotid atherosclerosis and stroke development in NAFLD. Patients more than a third sufferred from carotid atherosclerosis and routine assessment of carotid atherosclerosis is quintessential in NAFLD.

Gastrodia Rhizoma, as a precious Chinese materia medica, has attracted the attention of Chinese materia medica experts in the past dynasties for the commercial specification and experimental identification, and has gradually formed a wealth of terms concerning commercial specification and experimental identification. Through combing the literatures of successive dynasties, this paper discussed the change of the commercial specification of the Gastrodiae Rhizoma and formation of its identifying terms. It has found that the Gastrodiae Rhizoma mainly came from the dried rhizomes of the Gastrodia elata f.elata before the Qing Dynasty. Since the Qing Dynasty, G. elata in Yunnan and Guizhou gradually arose and become one of sources of mainstream commodities. After that, G. elata f. glauca and G. elata f. elata were becoming the main sources of Gastrodiae Rhizoma. Before the large-scale cultivation of G. elata in the 1970 s, there is only wild G. elata over the country. In terms of commercial specification, they were often classified into Chunma and Dongma according to their harvest time. With the successful promotion of cultivation technology and the endangered wild resources of G. elata, the Dongma became the mainstream in the market. The adulterants of G. elata increased significantly in the 1960 s and 1970 s, in this period, the terms of experimental identification for G. elata also increased obviously. Experimental identification is distinctive in different times, therefore, studying experimental identification of medicinal materials helps to promote the development of the Chinese materia medica.
China ; Drugs, Chinese Herbal ; Gastrodia ; Materia Medica ; Rhizome

Anterior Cruciate Ligament Injuries ; Biomechanical Phenomena ; Humans ; Knee Joint/surgery* ; Posterior Cruciate Ligament/surgery* ; Posterior Cruciate Ligament Reconstruction ; Reconstructive Surgical Procedures ; Robotics

Objective: Harmonization method is one of the eight unique methods of traditional Chinese medicine with important application value in clinic. Based on the effect of harmonization method in regulating cold and heat, the mechanism of Huangliantang in treating chronic non-atrophic gastritis(CNAG) on rats were studied. Method: Rats were divided into normal group (n=10) and CNAG model group (n=50). The model of CNAG rats was induced by chemical stimulation combined with hunger and satiety. The model group was randomly divided into 5 groups, namely the model group, the Jinghua Weikang pill treatment group, and the high, middle and low-dose Huangliantang groups, with 8 rats in each group. After the model was successfully established, the Jinghua Weikang pill treatment group (0.04 g·kg^-1), the high, middle, low dose Huangliantang group (11.00,5.48,2.74 g·kg^-1), the blank group and the model group were given the same dose of saline for 4 weeks, and then the samples were collected. The histological changes of gastric mucosa were observed by hematoxylin-eosin (HE) staining. The serum levels of interleukin-6 (IL-6), interleukin-1β (IL-1β) and interleukin-8 (IL-8) were measured by enzyme-linked immunosorbent assay (ELISA). immunohistochemistry(IHC) was used to detect nuclear factor-κB (NF-κB) and its inhibitory protein receptor (IκBα), protein expression. Real-time quantitative fluorescence polymerase chain reaction (Real-time PCR) was used to detect IκBα, NF-κB mRNA expressions. Result: In the model group, the gastric mucosa was damaged, a large number of inflammatory cells were infiltrated, the serum inflammatory factors increased significantly, mRNA and protein expressions of IκBα decreased, and mRNA and protein expressions of NF-κB increased in the gastric tissue (P<0.01). In each treatment group, the inflammation of gastric mucosa was improved to some extent, the serum inflammatory factor was decreased, the mRNA expression of IκBα was up-regulated, IκBα protein was increased, while the expression of NF-κB mRNA was down-regulated, and NF-κB protein was decreased. The Jinghua Weikang pill treatment group and the high-dose Huangliantang group had the most obvious improvement (P<0.05, P<0.01). Conclusion: Huangliantang for regulating cold and heat based on the harmonization method can effectively alleviate the degree of gastric mucosal injury, and reduce serum inflammatory factors in CNAG rats. The mechanism is related to the up-regulation of IκBα mRNA expression, and the down-regulation of NF-κB mRNA expression and NF-κB protein expression in gastric mucosa.

Vinpocetine (VP) has been widely used to treat cerebrovascular disorders and nerve injury. Borneol (BN), as an important traditional Chinese medicine, is commonly used to promote the absorption and distribution of central nervous system drugs. In this work, a LC-MS/MS method was developed to determine the level of VP in rat plasma and tissues, and to evaluate the effect of co-administration of BN with VP by oral gavage on the absorption and tissue distribution of VP in rats. Rats were divided into VP (10 mg·kg^-1), VP (10 mg·kg^-1) + BN (75 mg·kg^-1) and VP (10 mg·kg^-1) + BN (150 mg·kg^-1) groups for pharmacokinetic study, and divided into VP (10 mg·kg^-1) and VP (10 mg·kg^-1) + BN (150 mg·kg^-1) groups for tissue distribution study. The animal experiment was approved by Ethics Committee of Hubei University, and complied with the guideline for caring and using of laboratory animals. Compared to VP group, the AUC_0-∞, MRT_0-∞ and t_1/2z of VP + BN (150 mg·kg^-1) group increased significantly, by 1.98-, 1.22- and 1.42-fold respectively, and the exposure in plasma, liver, kidney and brain increased by 2-, 1.5-, 1.5- and 1.3-fold respectively. The pharmacokinetic results suggested that co-administration of BN with VP is beneficial for overcoming the undesirable pharmacokinetic characteristics of VP, such as short residence time, low oral bioavailability and brain exposure in clinical usage.