Objective To explore the association between the single nucleotide polymorphism（SNP）of the core clock genes（ARNTL rs6486122 and PER1 rs2253820）of the circadian molecular clockwork and the incidence of ischemic stroke. Methods Candidate SNP genotypes were determined using the SNaPshot method. Genotypes were set as categorical variables. Logistic regression analysis was performed to compare genotypes and genetic models between the disease group and the control group，adjusting for related risk factors including age，sex，dyslipidemia，and past medical history，and the adjusted odds ratios（OR）and 95% confidence intervals（CI）of different genotypes and genetic models were calculated. Results The multivariable logistic regression analysis showed that the risk of stroke increased significantly with the age of subjects（OR=6.704，95%CI 5.188-8.644，P<0.001）；patients with hypertension had a 2.565-fold increased risk of ischemic stroke compared with individuals without hypertension（OR=2.565，95%CI 1.971-3.338，P<0.001）；patients with dyslipidemia were 1.700 times more likely to have ischemic stroke than individuals with normal blood lipid levels（OR=1.700，95% CI 1.230-2.348，P=0.001）；and increased systolic and diastolic blood pressure levels also increased the risk of stroke. For the rs2253820 locus of the PER1 gene，using the wild-type homozygous TT genotype as the reference，the CT genotype，CC genotype，and dominant genetic model significantly increased the risk of stroke（CT vs TT：OR=1.552，95% CI 1.194-2.018，P=0.001；CC vs TT： OR=1.295，95% CI 1.035-1.621，P=0.024；and the dominant model：OR=1.563，95% CI 1.215-2.012，P=0.001，respectively）. For the rs6486122 locus of the ARNTL gene，there was no significant association of any genotype or the genetic model with the incidence of ischemic stroke after adjustment（P > 0.05）. Conclusion Genetic variation at PER1 rs2253820 can increase the risk of ischemic stroke，where the C allele poses a higher risk of ischemic stroke. There is no significant association between ARNTL rs6486122 and the occurrence of ischemic stroke.

Objective:To analyze the incidence and clinical phenotype of the concomitant extragenital malformations in the patients with female reproductive tract anomalies.Methods:A retrospective study was conducted using clinical data of hospitalized patients diagnosed with uterine, cervical, or vaginal malformations from January 2003 to December 2022 in Peking Union Medical College Hospital. The malformations were classified according to American Society for Reproductive Medicine müllerian anomalies classification 2021, and in each type, the incidence and specific manifestations of concomitant extragnital malformations were analyzed.Results:A total of 444 patients were included. The overall incidence of concomitant extragenital malformations was 43.5% (193/444), including urinary system, skeletal system, and other system malformations. Renal malformations on the obstructed side were present in all patients with oblique vaginal septum syndrome (100.0%, 78/78). The total incidence of concomitant extragnital malformations was as high as 8/11 in uterus didelphys, 43.5% (10/23) in unicornuate uterus, 33.6% (79/235) in Mayer-Rokitansky-Küster-Hauser syndrome, 18.8% (6/32) in septate uterus and 18.5% (12/65) in cervical agenesis. Urinary system malformations (30.6%, 136/444) and skeletal system malformations (13.5%, 60/444) were the most common concomitant malformations in all types, in which, unilateral renal agenesis and scoliosis were the most common.Conclusions:Urinary and skeletal system malformations are important features of female reproductive tract anomalies. Urologic ultrasonography and spinal roentgenogram are recommended for all patients with female reproductive tract anomalies.

ObjectiveTo evaluate the lipid-lowering activity of Quansanqi tablets（QSQ）， an innovative new drug of Panax notoginseng. MethodMice and golden hamsters were used to establish a hyperlipidemia model by injecting egg yolk milk and feeding high-fat diets. The levels of total cholesterol （TC），triglyceride （TG），low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C） were detected， and liver function indicators ［alanine aminotransferase （ALT）， aspartate amino-transferase （AST）， and alkaline phosphatase （ALP）］ of golden hamsters were detected. Hematoxylin-eosin （HE） staining was used to observe the degree of liver injury. In the experiments， a normal group， a model group， an atorvastatin calcium group， and low-， medium-， and high-dose QSQ groups （0.32， 0.64， 1.28 g·kg^-1 for mice， and 0.16， 0.32， 0.64 g·kg^-1 for golden hamsters） were set up. ResultCompared with the normal group， the acute hyperlipidemia model mice showed increased TC， TG， and LDL-C levels （P<0.01）， and the hyperlipidemia model mice showed increased TC and LDL-C levels （P<0.01）. Additionally， the hyperlipidemia model golden hamsters showed increased serum TC， TG， LDL-C， ALT， AST， and ALP levels （P<0.05， P<0.01）. HE staining indicated the presence of fat accumulation in the liver， accompanied by inflammatory reactions. Compared with the model group， QSQ of various doses could reduce TC， TG， and LDL-C levels in acute hyperlipidemia model mice （P<0.05， P<0.01）， and the high-dose QSQ could reduce TC and LDL-C levels （P<0.01） and increase HDL-C level （P<0.05） in hyperlipidemia model mice， as well as reduce TC， TG， and LDL-C levels in hyperlipidemia model golden hamsters （P<0.05， P<0.01）， especially in the first two weeks. In addition， atorvastatin calcium could further increase ALT， AST， and ALP levels （P<0.05， P<0.01） and aggravate liver function damage， while low-dose QSQ could reduce ALT， AST， and ALP （P<0.05）， and medium- and high-dose QSQ did not cause further liver function damage. ConclusionQSQ have a significant lipid-lowering effect on different hyperlipidemia model animals and can improve liver function and liver injury.

Biological clock proteins are involved in the regulation of many important physiological processes, including blood pressure. The deletion or mutation of core circadian clock genes may cause elevated blood pressure levels and disrupted blood pressure rhythms, exacerbating vascular function damage, and ultimately leading to the occurrence, development and poor outcome of ischemic stroke. This article reviews the molecular mechanism of biological clock rhythm, the relationship between biological clock gene and blood pressure regulation mechanism, the mechanism of circadian rhythm disorder in the occurrence and development of hypertension, and the relationship between blood pressure rhythm disorder and stroke.

Adrenal Glands ; Humans ; Hyperaldosteronism ; Retrospective Studies ; Singapore

Rhythm of blood pressure refers to the circadian variation of blood pressure, which is regulated by clock genes. However, the rhythm disorder of blood pressure increases the risk of stroke. Taking the process of blood pressure regulation as a clue and focusing on the clock gene pathway, this article explores the possible mechanism of period gene regulating renin-angiotensin-aldosterone system in rhythm of blood pressure, so as to provide reference for the in-depth study of the relevant mechanism of rhythm disorder of blood pressure and search for a new target for the primary prevention of cerebrovascular diseases.

INTRODUCTION: Image-guided thermal ablation, preferably with ultrasonography (US), is increasingly used for treatment of small liver tumours. Perfluorobutane-contrast-enhanced US (pCEUS) is a promising tool that may allow for targeting of tumours that are otherwise imperceptible on greyscale US. Although pCEUS has been reported to be effective, the literature has been limited outside of Japan and South Korea. We aimed to provide data that supports the use of pCEUS in the thermal ablation of sonographically occult liver tumours. METHODS: We conducted a retrospective single-centre study of 35 consecutive patients who underwent pCEUS-guided ablation of 48 liver tumours with a median size of 1.2 cm. Periprocedural, one-month post-treatment and relevant follow-up imaging studies were reviewed. Electronic records were also obtained, with long-term follow-up data of 12-28 months being available for 32 patients. RESULTS: 36 (75%) tumours that were imperceptible on greyscale US became visible with pCEUS. Overall, complete tumour ablation at one month was 89%. 1 (3%) patient developed a major complication following treatment, while 6 (17%) had minor post-treatment complaints. The local tumour progression rate was 17%, with a median time of 14 months. CONCLUSION pCEUS has a role in US-guided thermal ablation of liver tumours, offering a high technical success rate that is comparable to reported data. Additional benefits may include improved procedural time and freedom from ionising radiation.

Objective:To investigate the correlation between total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) ratio and unstable carotid plaque.Methods:From February 2021 to May 2021, adult patients with asymptomatic carotid atherosclerotic plaque admitted to the Department of Neurology, the First People's Hospital of Lianyungang were retrospectively enrolled. The demographic and related clinical data were collected. Carotid artery plaques were detected by ultrasound, and the subjects were divided into a stable plaque group and an unstable plaque group. Multivariate logistic regression analysis was used to assess the independent risk factors for unstable carotid plaques. Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of TC/HDL-C ratio for unstable carotid plaques. Results:A total of 362 patients with asymptomatic carotid atherosclerotic plaque were enrolled, including 226 (62.43%) in the stable plaque group and 136 (37.57%) in the unstable plaque group. Multivariate logistic regression analysis showed that after adjusting for confounding factors, only TC/HDL-C ratio was the independent risk factor for unstable carotid plaque (taking the 1 st quintile array of TC/HDL-C ratio as a reference, the 4 th quintile array: odds ratio 3.13, 95% confidence interval 1.50-6.55, P=0.002; the 5 th quintile array: odds ratio 6.75, 95% confidence interval 3.21-14.22, P<0.001). ROC curve analysis showed that the area under the curve of TC/HDL-C ratio for predicting unstable carotid plaque was 0.691 (95% confidence interval 0.634-0.748; P<0.001), the optimal cut-off value was 4.38, and the sensitivity and specificity were 50.0% and 82.7%, respectively. Conclusion:TC/HDL-C ratio is an independent risk factor for unstable carotid plaques and has a certain predictive value for unstable carotid plaques.

There are many chemical components in the volatile oil of Dictamni Cortex. The complex network relationship of "component-target-disease" can be revealed by using the network pharmacology method, and the mechanism of the efficacy of Dictamni Cortex can be revealed. In this study, we used Swiss Target Prediction database to predict the target of action, STRING database to build protein interaction network, and Cytoscape software to build "component-target-disease" network. The results showed that the antibacterial, anti-inflammatory and antiallergic effects of Dictamni Cortex were closely related to the components of thymol methyl ether, elemenol, anethole, and the related targets of each component were cross-linked to play a multi-target pharmacodynamic role. This study laid a foundation for the study of the effective substance basis and quality control evaluation of the Dictamni Cortex, and provided a scientific basis for further revealing its mechanism.
Dictamnus/chemistry* ; Drugs, Chinese Herbal/pharmacology* ; Oils, Volatile/pharmacology* ; Protein Interaction Maps ; Quality Control ; Software