Objective To explore the medication law of TCM external treatment for chronic kidney disease-associated pruritus(CKD-aP)by data mining technology.Methods Literature of TCM external treatment for CKD-aP was retrieved from China Knowledge Network(CNKI),VIP Chinese Journal Service Platform(VIP),Wanfang Data Knowledge Service Platform(Wanfang Data),and China Biology Medicine(CBM)since the establishment of the databases to March 31,2023.After screening according to the inclusion criteria,the final inclusion in the literature was determined,effective prescriptions were extracted,and entered into Excel 2019 to establish a prescription database.Excel 2019,SPSS Modeler 18.0,Origin 2021,and Gephi 0.10 softwares were used to perform frequency statistics,gender and taste meridian statistics,association rule analysis,and clustering analysis on prescription drugs.Results Totally 103 effective prescriptions were included,involving 133 kind of Chinese materia medica,with a total frequency of 978 times and 28 drugs with frequency≥10.The top 10 drugs were Dictamni Cortex,Kochiae Fructus,Sophorae Flavescentis Radix,Angelicae Sinensis Radix,Cnidii Fructus,Rhei Radix et Rhizoma,Chuanxiaong Rhizoma,Smilacis Glabrae Rhizoma,Saposheikovize Radix and Schizonepetae Herba,with cold and warm as the main properties,bitter,pungent,and as the main sweet tastes,and liver,heart,stomach,and spleen meridians as the main meridians.The association rule analysis yielded 34 groups of commonly used drug pairs.Clustering analysis obtained 4 clusters of prescriptions.Conclusion TCM external treatment for CKD-aP is mostly based on draining wind and clearing heat,drying dampness and relieving itching,nourishing blood and dispelling wind.The commonly used drugs are Dictamni Cortex,Kochiae Fructus,Sophorae Flavescentis Radix,and Angelicae Sinensis Radix,and the commonly used prescriptions include modified Shechuangzi Powder,Danggui Yinzi Decoction,Mahuang Guizhi Decoction and Xijiao Dihuang Decoction.

Objective To explore the relationship between m6A RNA methylation regulators and prognosis of prostate cancer.Methods Clinicopathological and mRNA-related data of 496 cases of prostate cancer were downloaded from the Cancer Genome Atlas(TCGA)database,and 12 m6A regulators were identified:METTL3,METTL14,WTAP,RBM15,ZC3H13,YTHDC1,YTHDC2,YTHDF1,YTHDF2,HNRNPC,FTO,and ALKBH5.The m6A regulators differentially expressed in prostate cancer samples were screened.Unsupervised clustering of prostate cancer tissues was used to compare differences in overall survival.Multivariate Cox regres-sion analysis was used to divide patients into high-and low-risk groups according to the risk scores,and survival rates were compared.The risk score of clinicopathological factors was determined,and a multivariate Cox regression analysis model was constructed to evaluate the prognostic prediction value.Immunohistochemical staining was performed to detect METTL14 and FTO expression in prostate cancer tis-sues.Results Eight differentially expressed regulators were screened from 12 m6A regulators.Unsupervised cluster analysis divided the samples into Clusters 1,2,and 3 and found significant differences in survival time in all three groups.Multivariate Cox regression analyses revealed that METTL14and FTOwere strongly associated with the prognosis of patients with prostate cancer.A Cox regression model con-structed to score the risk of prostate cancer revealed that the high-and low-risk groups had survival differences,and the risk score could be used as an independent prognostic factor.The positive expression rates of METTL14 and FTO protein in prostate cancer tissues were significantly higher than those in adjacent tissues(P<0.05).Conclusion In this study,a prognostic prediction model based on m6A regulators of prostate cancer was constructed,in which the risk score could be used as an independent prognostic factor.METTL14and FTOcould be used as molecular markers for the diagnosis of prostate cancer and as potential targets for treatment.

Previous studies have shown that botulinum toxin A can significantly reduce headache frequency and intensity and headache-related dysfunction in patients with chronic migraine.Recent evidence has discovered that multiple monoclonal antibodies targeting the calcitonin gene-related peptide （CGRP） pathway can also significantly improve the clinical outcome of chronic migraine.Few studies have compared the preventive effects of the two treatments for chronic migraine.This review focuses on the efficacy and safety of botulinum toxin A and monoclonal antibodies against CGRP and CGRP receptor （CGRPr） in the treatment of chronic migraine，as well as the effectiveness of CGRPr monoclonal antibodies following a poor response to botulinum toxin A，aiming to provide a reference for clinical treatment selection.

LIN28 is an RNA binding protein with important roles in early embryo development, stem cell differentiation/reprogramming, tumorigenesis and metabolism. Previous studies have focused mainly on its role in the cytosol where it interacts with Let-7 microRNA precursors or mRNAs, and few have addressed LIN28's role within the nucleus. Here, we show that LIN28 displays dynamic temporal and spatial expression during murine embryo development. Maternal LIN28 expression drops upon exit from the 2-cell stage, and zygotic LIN28 protein is induced at the forming nucleolus during 4-cell to blastocyst stage development, to become dominantly expressed in the cytosol after implantation. In cultured pluripotent stem cells (PSCs), loss of LIN28 led to nucleolar stress and activation of a 2-cell/4-cell-like transcriptional program characterized by the expression of endogenous retrovirus genes. Mechanistically, LIN28 binds to small nucleolar RNAs and rRNA to maintain nucleolar integrity, and its loss leads to nucleolar phase separation defects, ribosomal stress and activation of P53 which in turn binds to and activates 2C transcription factor Dux. LIN28 also resides in a complex containing the nucleolar factor Nucleolin (NCL) and the transcriptional repressor TRIM28, and LIN28 loss leads to reduced occupancy of the NCL/TRIM28 complex on the Dux and rDNA loci, and thus de-repressed Dux and reduced rRNA expression. Lin28 knockout cells with nucleolar stress are more likely to assume a slowly cycling, translationally inert and anabolically inactive state, which is a part of previously unappreciated 2C-like transcriptional program. These findings elucidate novel roles for nucleolar LIN28 in PSCs, and a new mechanism linking 2C program and nucleolar functions in PSCs and early embryo development.
Animals ; Cell Differentiation ; Embryo, Mammalian/metabolism* ; Embryonic Development ; Mice ; Pluripotent Stem Cells/metabolism* ; RNA, Messenger/genetics* ; RNA, Ribosomal ; RNA-Binding Proteins/metabolism* ; Transcription Factors/metabolism* ; Zygote/metabolism*

Objective:To investigate the predictive value of regional leptomeningeal collateral (rLMC) score on CT angiography (CTA) for the outcome after endovascular therapy in patients with late window anterior circulation stroke.Methods:Patients with acute anterior circulation large vessel occlusive stroke received endovascular treatment 6 to 24 h after onset in the Department of Neurology, the First Affiliated Hospital of Soochow University from January 2018 to July 2021 were enrolled retrospectively. At 3 months after onset, the outcome was evaluated according to the modified Rankin Scale. A score of ≤ 2 was defined as good outcome, and a score of >2 was defined as poor outcome. The clinical data, non-enhanced CT and CTA parameters of the patients were collected. Multivariate logistic analysis was used to determine the independent influencing factors of poor outcomes after endovascular treatment. Results:A total of 74 patients with acute anterior circulation large vessel occlusive stroke treated with endovascular treatment in the late window were enrolled. Their age was 64.41±12.98 years, 43 were males (58.1%). The baseline National Institutes of Health Stroke Scale (NIHSS) score was 13.18±5.22, and the median time from onset to puncture was 527.5 min. Fifty-three patients (71.6%) chose direct thrombectomy and 21 (28.4%) chose intravenous thrombolysis and bridging thrombectomy. Thirty-six patients (48.6%) had a good outcome and 38 (51.4%) had a poor outcome, including 4 (5.4%) died. Univariate analysis showed that there were significant differences in age, atrial fibrillation, fasting blood glucose, NIHSS score, Alberta Stroke Program Early CT Score (ASPECTS), rLMC score and clot burden score between the good outcome group and the poor outcome group (all P<0.05). Multivariate logistic regression analysis showed that higher ASPECTS (odds ratio 0.352, 95% confidence interval 0.157-0.791; P=0.012) and rLMC score (odds ratio 0.550, 95% confidence interval 0.329-0.919; P=0.022) were the independent predictors of good outcomes after endovascular therapy. Conclusion:ASPECTS and rLMC scores were the independent predictors of clinical outcomes after endovascular therapy in patients with late window anterior circulation large vessel occlusive stroke. It had certain guiding value for the decision-making of endovascular treatment in such patients.

Objective:To improve awareness about infratentorial dural arteriovenous fistula (DAVF).Methods:Three cases of DAVF in the First Affiliated Hospital of Soochow University from September 2017 to September 2019 were retrospectively analyzed in terms of clinical features, cerebrospinal fluid (CSF) analysis, brain imaging and treatment, and followed up through telephone call.Results:Case 1: A 43-year-old woman, in chronic but acute aggravated course, presented with weakness of both lower limbs and urination and defecation dysfunction. Brain magnetic resonance imaging (MRI) revealed abnormal signal in medulla. CSF analysis demonstrated aquaporin-4 antibodies positive. Misdiagnosed as neuromyelitis optica spectrum disorders, the treatment was poor. Then digital subtraction angiography (DSA) showed DAVF at the left infratentorial area, and endovascular treatment was operated. Relapse was not observed in two-year follow up. Case 2: A 57-year-old woman, in chronic progressive course, mainly manifested as memory loss, but progressed with dysphagia, fever, coma. Treatment as “central nervous infection” was poor. Then DSA showed DAVF at the bilateral transverse-sigmoid sinus area, and endovascular treatment was operated with embolized partial fistulas. The patient died from lung infection within two months. Case 3: A 52-year-old man, in subacute course, was treated in the Gastroenterology Department with clinical manifestion of stubborn nausea and vomiting. Brain MRI revealed abnormal signal in medulla, with prominent vessel flow voids nearby. Then DSA showed DAVF at the craniocervical junction, and endovascular treatment was operated. Relapse was not observed in six-month follow up.Conclusions:DAVF has a variety of clinical manifestations, and infratentorial DAVF can manifest as acute neurological dysfunction involving the brain stem, cerebellum, spinal cord, which may be easily misdiagnosed. When brain MRI showed intracranial abnormal signal, the possibility of DAVF should be considered. DSA remains the gold standard to diagnose DAVF. Endovascular embolization is the main treatment of infratentorial DAVF at present. Prognosis depends on clinical presentation and fistula classification.

Objective The aim of this study was to investigate the relationship between STAT1,STAT3 gene promoter CpG island methylation status and prognosis of patients with colorectal cancer(CRC)and the prognostic factors of CRC patients. Methods The cohort study was conducted to biosamples and follow up 239 patients with primary colorectal cancer pathologically diagnosed in Cancer Hospital of Harbin Medical University(Tumor Hospital). The methylation status of STAT1,STAT3 gene promoter CpG island was analyzed by methylation specific high-resolution melting curve(MS-HRM). Results The survival rates of 239 patients with colorectal cancer at 1 year,3 years and 5 years were 94. 90% ,86. 00% and 67. 20% ,respectively. The methylation status of STAT1 and STAT3 genes was not associated with postoperative survival in colorectal cancer patients( STAT1:HR=0. 85,95% CI:0. 55 ~1. 30,P=0. 44;STAT3:HR=0. 75,95% CI:0. 36~1. 58,P=0. 45). Dukes stage(HR=1. 31,95% CI:1. 14~1. 51,P<0. 01)and intraoperative intestinal stapler use(HR=1. 98,95% CI:1. 25 ~3. 14,P<0. 01) were important factors affecting the prognosis of colorectal cancer patients. The risk of death in patients with stage D and Dukes was significantly higher than that in stages A and B (HR=1. 31,95% CI:1. 14~1. 51,P<0. 01). Intestinal anastomosis was used during operation. The patient′s prognosis was better than that of patients without an intestinal stapler. However,gender,age,tumor location,gross tumor type,histological classification and postoperative chemotherapy were not associated with the prognosis of colorectal cancer. Conclusion Dukes stage is an independent factor affecting the prognosis of colorectal cancer. The prognosis of patients with intestinal stapler is better than that of non-users. The methylation status of STAT1 and STAT3 in peripheral blood is not a biomarkers for the prognosis of patients with colorectal cancer.

Objective: To observe the effect of the respiratory rehabilitation and TCM exercises combined with conventional western medicine therapy for the patients with COPD. Methods: A total of 84 patients with COPD were randomized into the control group and observation group, 42 in each group. The control group were treated with conventional Western medicine treatment, and the observation group was treated with traditional Chinese exercises "sixth tactic" treatment on the basis of control group treatment. All patients were taken one year course of treatment. The changes in lung function, AECOPD occurrence, changes in symptom scores, Hamilton heart questionnaire integration were observed; and possible changes in the factors affecting the efficacy was analyzed by Logistic regression. Results: There were not significant differences in FEV1, FEV1/FVC, PEF and SpO₂ between the two groups before treatment. After 1 year of treatment, the FEV1 (1.58 ± 0.21 L vs.1.33 ± 0.22 L, t=8.092), FEV1/FVC (82.92% ± 8.42% vs. 62.81% ± 8.94%, t=10.013), PEF (358.27 ± 27.03 L/min vs. 324.13 ± 32.03, t=6.272), SpO₂ (99.58% ± 2.72% vs. 91.92% ± 2.89%, t=10.142) in the observation group were significantly higher than those in the control group (P<0.05). After treatment, Chinese medicine syndrome scores (6.3 ± 2.2 vs. 9.2 ± 2.0, t=4.652), HAMA score (6.0 ± 1.7 vs. 9.0 ± 2.0, t=4.563), HAMD score (6.1 ± 2.0 vs. 8.7 ± 1.7, t=5.094) in the observation group were superior to the subcontrol group (P<0.05). Regression analysis showed that there was a linear correlation between patient group, course of disease and outcome effect (P<0.05). Conclusions The respiratory rehabilitation and traditional Chinese medicine exercises "sixth tactic" combined with conventional treatment could release anxiety, depression and negative emotions, and improve clinical symptoms of the patients with COPD.

Objective To assess the clinical utility of P300 for the assessment of cognitive disorders in Chinese patients with Parkinson's disease (PD) by meta-analysis.Methods Studies comparing the P300 between PD patients with different cognitive disorders (dementia,mild cognitive impairment (MCI),and no cognitive impairment;the former two were “cognitive impairments”,while the latter two were “nondementia”) and healthy controls were retrieved by searching within major Chinese and English databases.Studies,whose case and control groups were matched for age and gender,were rated as high quality.Weighted mean differences (WMDs) in P300 latency and amplitude between groups were calculated by using meta-analysis.Results In total,23 studies were included and 20 of which were rated high quality.Demented PD patients had statistically significant longer P300 latency (WMD:56.14,95％ CI:19.06,93.23) and lower amplitude (WMD:-1.30,95％CI:-2.08,-0.51) than non-demented PD patients.PD patients with MCI had statistically significant longer P300 latency (WMD:13.71,95％CI:5.13,22.29) and lower amplitude (WMD:-1.25,95 ％ CI:-2.29,-0.21) than PD patients without cognitive disorders.However,no significant differences in P300 latency (WMD:4.16,95％ CI:-13.85,22.17) and amplitude (WMD:0.23,95％ CI:-1.72,2.17) were found between PD patients with dementia and MCI.Conclusion Among Chinese PD patients,there are significant P300 differences between those with dementia and without dementia,and between MCI and those without cognitive impairments,however,but no significant P300 differences between those with dementia and MCI.

Objective To investigate the value of ABCD3-I score in predicting the outcome of acute minor ischemic stroke. Methods Totally 255 patients were valued by ABCD, ABCD2, ABCD3, ABCD3-I and ESSEN score then the clinical characters, outcome and early progression of these patients were investigated. Results Forty-eight patients had poor outcome after 90 days. Univariate logistic regression indicated that the differences of hypertension, diabetes, cardiovascular disease, stenosis of criminal artery, abnormal signal in diffusion weighted imaging (DWI) and other clinical symptoms between poor outcome group and good outcome group were statistically significant (P<0.05). The AUC of ABCD, ABCD2, ABCD3, ABCD3-I and ESSEN score in predicting outcome of acute minor stroke was 0.791 0, 0.798 3, 0.827 9, 0.930 0 and 0.735 9 respectively. There was difference among patients with different ABCD3-I scores both in outcome and early progression. Conclusion ABCD3-I score can predict the outcome of acute minor stroke and supply a new method for personalized treatment.