ObjectiveTo observe the effect of gene mutation on the effectiveness of arsenic-containing Chinese herbal compound formulas in the treatment of myelodysplastic syndromes （MDS） of different traditional Chinese medicine （TCM） patterns， so as to provide the basis for the clinical application. MethodsClinical data of 442 MDS patients who were treated with arsenic-containing herbal compound formulas were retrospectively collected， including the baseline demographic and clinical characteristics of the patients. Based on the TCM four examinations， the patients were divided into the spleen-kidney deficiency group as well as the qi-yin deficiency group， and according to the results of the next-generation sequencing （NGS） test， they were divided into the group with and without gene mutation respectively. The influence of gene mutation on the clinical effectiveness of patients with different TCM patterns was analyzed， the baseline demographic and clinical characteristics of the patients with different outcomes of the two TCM patterns were compared， and multivariate Logistic regression analysis was conducted on the influencing factors of the effective rate of MDS patients with gene mutation. ResultsA total of 190 cases were included in the spleen-kidney deficiency group （119 cases with gene mutation） and 43 cases in the qi-yin deficiency group （23 cases with gene mutation）. No statistically significant differences were noted in effectiveness assessment， total effective rate， and total response rate between the spleen-kidney deficiency group and the qi-yin deficiency group （P＞0.05）. In the spleen-kidney deficiency group， the total effective rate of MDS with gene mutation was 65.55% （78/119）， which was lower than 80.28% （57/71） of MDS without gene mutation， with statistical significance （P = 0.033）， while no statistical differences in effectiveness assessment and total response rate were noted （P＞0.05）. In the qi-yin deficiency group， no statistical differences were observed in effectiveness assessment， total effective rate， and total response rate of the patients in with or without gene mutation （P＞0.05）. In the spleen-kidney deficiency group with gene mutation， the rate of complex karyotype （P = 0.031） and the mutation rate of CBL gene （P = 0.032） in the ineffective population were higher than those in the effective population， while the mutation rate of DDX41 gene in the effective population was higher than that in the ineffective population （P = 0.033）. No statistically significant differences were found in other gene mutations， age， gender distribution， number of gene mutations， bone marrow hyperplasia degree， blast cell range， reticular fiber tissue proliferation or not， and prognosis of chromosomal abnormalities between the effective and ineffective populations （P＞0.05）. In the qi-yin deficiency group with gene mutation， no statistically significant differences were found in various items between populations with different outcomes （P＞0.05）. Multivariate Logistic regression analysis showed that complex karyotype， CBL mutation， and DDX41 mutation were independently associated with the effective rate of MDS with spleen-kidney deficiency and gene mutation （P＜0.05）. DDX41 mutation was an independent protective factor in the spleen-kidney deficiency group （OR＞1）， while complex karyotype and CBL mutation were independent risk factors （OR＜1）. ConclusionThe arsenic-containing TCM compound formulas exhibited better effectiveness in MDS with spleen-kidney deficiency pattern without mutation； and in MDS with spleen-kidney deficiency pattern without complex karyotypes， CBL mutation， and with DDX41 mutations. Furthermore， DDX41 mutation was an independent protective factor in the spleen-kidney deficiency group， while complex karyotype and CBL mutation were independent risk factors. In MDS with qi-yin deficiency pattern， gene mutation-related factors showed no significant impact on the effectiveness of arsenic-containing TCM compound formulas.

Artemisia argyi (A. argyi), a plant with a longstanding history as a raw material for traditional medicine and functional diets in Asia, has been used traditionally to bathe and soak feet for its disinfectant and itch-relieving properties. Despite its widespread use, scientific evidence validating the antifungal efficacy of A. argyi water extract (AAWE) against dermatophytes, particularly Trichophyton rubrum, Trichophyton mentagrophytes, and Microsporum gypseum, remains limited. This study aimed to substantiate the scientific basis of the folkloric use of A. argyi by evaluating the antifungal effects and the underlying molecular mechanisms of its active subfraction against dermatophytes. The results indicated that AAWE exhibited excellent antifungal effects against the three aforementioned dermatophyte species. The subfraction AAWE6, isolated using D101 macroporous resin, emerged as the most potent subfraction. The minimum inhibitory concentrations (MICs) of AAWE6 against T. rubrum, M. gypseum, and T. mentagrophytes were 312.5, 312.5, and 625 μg·mL^-1, respectively. Transmission electron microscopy (TEM) results and assays of enzymes linked to cell wall integrity and cell membrane function indicated that AAWE6 could penetrate the external protective barrier of T. rubrum, creating breaches ("small holes"), and disrupt the internal mitochondrial structure ("granary"). Furthermore, transcriptome data, quantitative real-time PCR (RT-qPCR), and biochemical assays corroborated the severe disruption of mitochondrial function, evidenced by inhibited tricarboxylic acid (TCA) cycle and energy metabolism. Additionally, chemical characterization and molecular docking analyses identified flavonoids, primarily eupatilin (131.16 ± 4.52 mg·g^-1) and jaceosidin (4.17 ± 0.18 mg·g^-1), as the active components of AAWE6. In conclusion, the subfraction AAWE6 from A. argyi exerts antifungal effects against dermatophytes by disrupting mitochondrial morphology and function. This research validates the traditional use of A. argyi and provides scientific support for its anti-dermatophytic applications, as recognized in the Chinese patent (No. ZL202111161301.9).
Antifungal Agents/chemistry* ; Arthrodermataceae ; Artemisia/chemistry* ; Molecular Docking Simulation ; Mitochondria ; Microbial Sensitivity Tests

ObjectiveMyelodysplastic syndromes （MDS） is a group of clonal hematopoietic stem cell disorders，and this study aims to investigate the expression of hypoxia-inducible factor-1α（HIF-1α） in the bone marrow cells of patients with MDS and its correlation with the clinical features of MDS，the therapeutic efficacy of arsenic-containing Chineseherbal compound，and the survival prognosis. MethodAccording to the inclusion and exclusion criteria，27 MDS patients treated with arsenic-containing Chinese herbal compound in the Department of Hematology，Xiyuan Hospital，China Academy of Chinese Medical Sciences from January 2022 to September 2022 were included，and their bone marrow samples were collected by myelotomy. HIF-1α expression level in bone marrow cells was detected by real-time polymerase chain reaction （PCR） to analyze its correlation with clinical features，and logistic and Cox regression was used to analyze the risk factors affecting the efficacy and prognostic survival of MDS patients. ResultThe HIF-1α mRNA expression level was lower in bone marrow cells of MDS patients than in healthy subjects. HIF-1α was positively correlated with the degree of myelodysplasia（r=0.384，P<0.05） and bone marrow granulocytic system%（G%）（r=0.560，P<0.01）. Logistic regression showed that HIF-1α was a risk factor for the prognosis in the follow-up of the efficacy of treatment（P<0.05）and Cox regression showed that HIF-1α was an independent factor affecting the survival prognosis of MDS patients ［odds ratio（OR）=398.968，95% confidence interval（CI）（1.281，116 858.743），P<0.05］. ConclusionThe level of HIF-1α expression in bone marrow cells of MDS patients was closely related to the degree of clinical myelodysplasia and G%，and HIF-1α was a risk factor for the efficacy for and survival prognosis of MDS patients.

Objective To compare the synergies between the transcutaneous needle electrodes and the ETT surface electrodes used for neurological surveillance in thyroidology,and explore how to identify and protect recurrent laryngeal nerve and vagus nerve when the patient is not suitable for oral plug or surface electrodes are failure.Methods To collect and analyze the clinical data of 32 patients undergoing surgical treatment for thyroid disease,a total of 40 neurons of the recurrent laryngeal nerves and vagus nerves were monitored,and the amplitude and latency were recorded using ETT surface electrodes and transcutaneous needle electrodes for nerve monitoring,respectively.SPSS 26.0 software was used for statistical analysis,paired t-tests were used to analyze and compare the latency periods,and the rank sum test was used to analyze whether there is a difference in the amplitude obtained from stimulation of transcutaneous needle electrodes and ETT surface electrodes.Results When the transcutaneous needle electrodes were used in thyroid surgery,we identified all the nerves,obtained two-phase electrical signals similar to the latency and amplitude of the ETT surface electrodes,and could effectively identify the recurrent laryngeal nerve and vagus nerve[(3.22±0.50)ms vs.(3.85±1.00)ms,P＜0.05]through the incapacity period,with no obvious difference in the monitoring effect from the ETT surface electrodes[(3.04±0.58)ms vs.(3.89±1.07)ms,P＜0.05].At the same time,the visualization and safety of transcutaneous needle electrodes were higher,with great advantages.Conclusion Transcutaneous needle electrodes can effectively assist in identifying and protecting the recurrent laryngeal nerve and vagus nerve,and thus are an important supplement to ETT surface electrodes.

ObjectiveTo explore the syndrome elements and evolving patterns of patients with hepatitis B virus-related acute on chronic liver failure （HBV-ACLF） at different stages. MethodsClinical information of 1,058 hospitalized HBV-ACLF patients， including 618 in the early stage， 355 in the middle stage， and 85 in the late stage， were collected from 18 clinical centers across 12 regions nationwide from January 1， 2012 to February 28， 2015. The “Hepatitis B-related Chronic and Acute Liver Failure Chinese Medicine Clinical Questionnaire” were designed to investigate the basic information of the patients， like the four diagnostic information （including symptoms， tongue， pulse） of traditional Chinese medicine （TCM）， and to count the frequency of the appearance of the four diagnostic information. Factor analysis and cluster analysis were employed to determine and statistically analyze the syndrome elements and patterns of HBV-ACLF patients at different stages. ResultsThere were 76 four diagnostic information from 1058 HBV-ACLF patients， and 53 four diagnostic information with a frequency of occurrence ≥ 5% were used as factor analysis entries， including 36 symptom information， 12 tongue information， and 5 pulse information. Four types of TCM patterns were identified in HBV-ACLF， which were liver-gallbladder damp-heat pattern， qi deficiency and blood stasis pattern， liver-kidney yin deficiency pattern， and spleen-kidney yang-deficiency pattern. In the early stage， heat （39.4%， 359/912） and dampness （27.5%， 251/912） were most common， and the pattern of the disease was dominated by liver-gallbladder damp-heat pattern （74.6%， 461/618）； in the middle stage， dampness （30.2%， 187/619） and blood stasis （20.7%， 128/619） were most common， and the patterns of the disease were dominated by liver-gallbladder damp-heat pattern （53.2%， 189/355）， and qi deficiency and blood stasis pattern （27.6%， 98/355）； and in the late stage， the pattern of the disease was dominated by qi deficiency （26.3%， 40/152） and yin deficiency （20.4%， 31/152）， and the patterns were dominated by qi deficiency and blood stasis pattern （36.5%， 31/85）， and liver-gallbladder damp-heat pattern （25.9%， 22/85）. ConclusionThere are significant differences in the distribution of syndrome elements and patterns at different stages of HBV-ACLF， presenting an overall trend of evolving patterns as "from excess to deficiency， transforming from excess to deficiency"， which is damp-heat → blood stasis → qi-blood yin-yang deficiency.

A case of idiopathic hypertrophic spinal pachymeningitis is reported. The patient was a middle-aged female, with the course of disease more than 1 year. Clinical manifestations included recurrent fever,headache and backache, and the magnetic resonance imaging showed diffuse enhancement and thickening of the spinal dura mater. Dural biopsy pathology finally confirmed hypertrophic spinal pachymeningitis. After treatment with surgery and immunotherapy, the patient′s clinical symptoms improved.

Objective To investigate the effect of glutaminase 2(GLS2)on the proliferation and invasion ability of intrahepatic cholangiocarcinoma cells and its mechanism.Methods Human intrahepatic cholangiocarcinoma RBE cells in the logarithmic phase were randomly divided into a blank control group(Con group),a GLS2 overexpression negative control group(pcDNA-NC group),a pcDNA-GLS2 group,and a pcDNA-GLS2+phosphorylation Janus kinase(p-JAK)group.RBE cells in the Con group did not transfect any plasmid;RBE cells in the pcDNA-NC group were transfected with pcDNA-NC plasmid;RBE cells in the pcDNA-GLS2 group were transfected with pcDNA-GLS2 plasmid;RBE cells in the pcDNA-GLS2+p-JAK group were transfected with pcDNA-GLS2 plasmid and co-cultured with p-JAK peptide.Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression of GLS2 mRNA in each group of cells;cell counting kit-8 was used to detect the proliferation ability of cells in each group;flow cytometry was used to detect the apoptotic ability of cells in each group;Transwell assay was used to detect the invasion ability of cells in each group;Western blot was used to detect the relative expression levels of Janus kinase 2(JAK2),phosphorylation JAK2(p-JAK2),signal transducer and activator of transcription 3(STAT3),and phosphorylation STAT3(p-STAT3)proteins in cells.Results The relative expression level of GLS2 mRNA in the pcDNA-GLS2 group was significantly higher than that in the Con group and pcDNA-NC group(P＜0.05);the relative expression level of GLS2 mRNA in the pcDNA-GLS2+p-JAK group was significantly lower than that in the pcDNA-GLS2 group(P＜0.05).The survival rate of cells in the pcDNA-GLS2 group was significantly lower than that in the Con group(P＜0.05),and compared with the pcDNA-GLS2 group,the survival rate of cells in the pcDNA-GLS2+p-JAK group was significantly increased(P＜0.05).Compared with the Con group,the apoptosis rate of cells in the pcDNA-GLS2 group significantly increased(P＜0.05);the apoptosis rate of cells in the pcDNA-GLS2+p-JAK group was significantly lower than that in the pcDNA-GLS2 group(P＜0.05).The migration number of cells in the pcDNA-GLS2 group was significantly lower than that in the Con group(P＜0.05);compared with the pcDNA-GLS2 group,the pcDNA-GLS2+p-JAK group showed a significant increase in the cell migration number(P＜0.05).Compared with the Con group,the p-JAK2/JAK2 and p-STAT3/STAT3 ratios in the pcDNA-GLS2 group were significantly reduced(P＜0.05);the p-JAK2/JAK2 and p-STAT3/STAT3 ratios in the pcDNA-GLS2+p-JAK group were significantly higher than those in the pcDNA-GLS2 group(P＜0.05).Conclusion Overexpression of GLS2 can regulate the biological activity of intrahepatic cholangiocarcinoma cells by inhibiting the JAK2/STAT3 signaling pathway,inhibit the proliferation,invasion and migration of intrahepatic cholangiocarcinoma RBE cells,and induce the cell apoptosis.

Objective To compare the clinical efficacy of a new low notch plate system(Carmen synchronous adaptive cervical fusion system)and Zero-p in the treatment of single level cervical spondylotic radiculopathy(CSR).Methods Retrospective analysis was made on 48 patients with single level cervical spondylosis of nerve root type admitted from January 2015 to January 2020,including 26 patients with new low notch steel plate system(observation group)and 22 patients with Zero-P(control group).The operation duration,intraoperative blood loss,incidence of postoperative dysphagia,preoperative and postoperative JOA scores,cervical dysfunction index(NDI)Visual analog score of pain(VAS)and Cobb angle and intervertebral space height of postoperative imaging.Results There was no significant difference between the two groups in terms of operation time,intraoperative blood loss and the incidence of postoperative dysphagia(P＞0.05).All patients were followed up for 12-15 months,with an average of(12.6±0.7)months.There was no significant difference in JOA score,NDI index and VAS score of pain between the two groups before and 3 and 12 months after operation(P＞0.05).Conclusion The clinical efficacy of the new low notch plate system in the treatment of single segment cervical spondylotic radiculopathy is equivalent to Zero-P,and it is a reliable new type of anterior cervical internal fixation system.

ObjectiveTo investigate the application of Mengchao Liver Disease-Brain System version 2.0 in clinical diagnosis and treatment. MethodsThis study was conducted among 160 patients who were admitted to the internal medicine and surgical departments from June 9 to 21， 2021， and their data were automatically captured by the intelligent information system of Southeast Big Data Institute of Hepatobiliary Health， Mengchao Hepatobiliary Hospital of Fujian Medical University. The completeness and accuracy of Mengchao Liver Disease-Brain System version 2.0 were evaluated based on the intelligent diagnostic tools such as auxiliary diagnosis of chronic hepatitis B， interpretation of liver fibrosis， staging model of chronic hepatitis B， auxiliary diagnosis of liver cirrhosis， auxiliary staining of liver cirrhosis， auxiliary diagnosis of primary liver cancer， BCLC stage of primary liver cancer， Chinese staging of primary liver cancer， Child-Pugh score， and APRI score. ResultsAll auxiliary diagnostic tools had a complete rate of 94.17% in terms of the extraction of correct key dimensions within the test period. The artificial intelligence report had a structured accuracy of 97.55% in capturing data and an accuracy rate of 91.61% in text processing. ConclusionMengchao Liver Disease-Brain System version 2.0 provides an innovative mode for the construction of big data platform in medical specialties and has a high accuracy as an auxiliary diagnostic tool in clinical diagnosis and treatment.

Objective:To investigate the prevention and risk factors of deep vein thrombosis (DVT) in the lower extremity after medial open wedge high tibial osteotomy (HTO).Methods:A total of 128 patients who underwent medial open wedge HTO in the Third Hospital of Hebei Medical University from January 2020 to October 2022 were retrospectively analyzed, including 45 males and 83 females, aged 59.3±6.8 years (range, 44-87 years). Postoperative anticoagulation with enoxaparin sodium was applied at a randomized dose of 4,000 AXaIU/d or 6,000 AXaIU/d. Gender, age, history of chronic diseases (hypertension, diabetes), smoking history, body mass index, and body fat percentage were collected. On admission, the risk of DVT was assessed using the Caprini scale and calf circumference was measured. Hemoglobin, D-dimer, antithrombin III, activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB), fibrinogen degradation products (FDP), glutathione, glutathione, urea, creatinine, uric acid were recorded. Patients were divided into DVT group and non-DVT group according to whether DVT occurred after operation. Binary logistic regression was used to analyze the independent risk factors of DVT after HTO. The receiver operating characteristic (ROC) curve was plotted, and the area under curve (AUC) was calculated to analyze the predictive value of the postoperative Caprini scale in the occurrence of DVT after HTO.Results:A total of 128 patients were enrolled, 83 patients were treated with enoxaparin sodium 4 000 AXaIU/d and 45 patients were treated with enoxaparin sodium 6 000 AXaIU/d. According to the results of color Doppler examination of bilateral lower extremity veins on the third day after operation, DVT occurred in 39% (50/128) of patients, including 39 cases of calf intermuscular thrombosis, 6 cases of peroneal vein thrombosis, 4 cases of posterior tibial vein thrombosis, and 1 case of popliteal vein thrombosis. DVT occurred in 36% (30/83) of patients receiving 4 000 AXaIU/d enoxaparin sodium and 44% (20/45) of patients receiving 6 000 AXaIU/d enoxaparin sodium, with no statistically significant difference (χ 2=0.84, P=0.358). Univariate analysis showed that smoking history, postoperative Caprini scale≥8, and female may be associated with the development of DVT after HTO ( P<0.05). They were included in the binary logistic regression, and the results showed that postoperative Caprini scale≥8 was an independent risk factor for DVT after HTO. The ROC curve of postoperative Caprini scale for predicting DVT after HTO was drawn, and the AUC was 0.847 (95% CI: 0.73, 0.96), the optimal cut-off value was 8, and the sensitivity and specificity were 84.2% and 77.6%, respectively. Conclusion:Caprini scale≥8 is an independent risk factor for DVT after medial open wedge HTO. Caprini scale has a good value in predicting the occurrence of DVT after HTO. The recommended dose of enoxaparin sodium is 4 000 AXaIU/d for the prevention of postoperative DVT, and increasing the dose is not associated with a decreased risk of DVT.