Rheumatoid arthritis （RA） is a chronic autoimmune disease characterized by synovitis as its pathological basis. Although current therapeutic drugs can alleviate symptoms， they are often accompanied by a high risk of side effects. In recent years， the use of flavonoids from traditional Chinese medicine （TCM） in the treatment of RA has garnered significant attention. Studies have shown that the mechanisms by which flavonoids treat RA include inhibiting the release of pro-inflammatory factors， regulating multiple cellular signaling pathways， alleviating oxidative stress， modulating immune system functions， inhibiting bone destruction， and suppressing angiogenesis. Due to their notable anti-inflammatory， antioxidant， and immunomodulatory activities， flavonoids hold promise as potential therapeutic agents for RA. A substantial number of articles in this field have been published. By reviewing Chinese and international literature and applying bibliometric and visual analysis using CiteSpace， this paper explored research hotspots and frontiers in this field， systematically reviewed the structures and anti-RA mechanisms of TCM flavonoids， provided a theoretical basis for their use in RA treatment and clinical applications， and offered new perspectives and references for the discovery of novel TCM-based anti-RA drugs.

Rheumatoid arthritis （RA） is a chronic autoimmune disease characterized by synovitis as its pathological basis. Although current therapeutic drugs can alleviate symptoms， they are often accompanied by a high risk of side effects. In recent years， the use of flavonoids from traditional Chinese medicine （TCM） in the treatment of RA has garnered significant attention. Studies have shown that the mechanisms by which flavonoids treat RA include inhibiting the release of pro-inflammatory factors， regulating multiple cellular signaling pathways， alleviating oxidative stress， modulating immune system functions， inhibiting bone destruction， and suppressing angiogenesis. Due to their notable anti-inflammatory， antioxidant， and immunomodulatory activities， flavonoids hold promise as potential therapeutic agents for RA. A substantial number of articles in this field have been published. By reviewing Chinese and international literature and applying bibliometric and visual analysis using CiteSpace， this paper explored research hotspots and frontiers in this field， systematically reviewed the structures and anti-RA mechanisms of TCM flavonoids， provided a theoretical basis for their use in RA treatment and clinical applications， and offered new perspectives and references for the discovery of novel TCM-based anti-RA drugs.

The impact of plateau environment on cerebral venous thrombosis (CVT) is more complex and diverse than in plain areas. This article reviews the epidemiological characteristics, affected sites, and especially the pathogenesis of CVT in plateau areas.

Auditory neuropathy spectrum disorder (ANSD) represents a variety of sensorineural deafness conditions characterized by abnormal inner hair cells and/or auditory nerve function, but with the preservation of outer hair cell function. ANSD represents up to 15% of individuals with hearing impairments. Through mutation screening, bioinformatic analysis and expression studies, we have previously identified several apoptosis-inducing factor (AIF) mitochondria-associated 1 (AIFM1) variants in ANSD families and in some other sporadic cases. Here, to elucidate the pathogenic mechanisms underlying each AIFM1 variant, we generated AIF-null cells using the clustered regularly interspersed short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) system and constructed AIF-wild type (WT) and AIF-mutant (mut) (p.‍T260A, p.‍R422W, and p.‍R451Q) stable transfection cell lines. We then analyzed AIF structure, coenzyme-binding affinity, apoptosis, and other aspects. Results revealed that these variants resulted in impaired dimerization, compromising AIF function. The reduction reaction of AIF variants had proceeded slower than that of AIF-WT. The average levels of AIF dimerization in AIF variant cells were only 34.5%‍‒‍49.7% of that of AIF-WT cells, resulting in caspase-independent apoptosis. The average percentage of apoptotic cells in the variants was 12.3%‍‒‍17.9%, which was significantly higher than that (6.9%‍‒‍7.4%) in controls. However, nicotinamide adenine dinucleotide (NADH) treatment promoted the reduction of apoptosis by rescuing AIF dimerization in AIF variant cells. Our findings show that the impairment of AIF dimerization by AIFM1 variants causes apoptosis contributing to ANSD, and introduce NADH as a potential drug for ANSD treatment. Our results help elucidate the mechanisms of ANSD and may lead to the provision of novel therapies.
Humans ; Apoptosis Inducing Factor/metabolism* ; NAD/metabolism* ; Dimerization ; Apoptosis

Auditory neuropathy spectrum disorder (ANSD) represents a variety of sensorineural deafness conditions characterized by abnormal inner hair cells and/or auditory nerve function, but with the preservation of outer hair cell function. ANSD represents up to 15％ of individuals with hearing impairments. Through mutation screening, bioinformatic analysis and expression studies, we have previously identified several apoptosis-inducing factor (AIF) mitochondria-associated 1 (AIFM1) variants in ANSD families and in some other sporadic cases. Here, to elucidate the pathogenic mechanisms underlying each AIFM1 variant, we generated AIF-null cells using the clustered regularly interspersed short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) system and constructed AIF-wild type (WT) and AIF-mutant (mut) (p.T260A, p.R422W, and p.R451Q) stable transfection cell lines. We then analyzed AIF structure, coenzyme-binding affinity, apoptosis, and other aspects. Results revealed that these variants resulted in impaired dimerization, compromising AIF function. The reduction reaction of AIF variants had proceeded slower than that of AIF-WT. The average levels of AIF dimerization in AIF variant cells were only 34.5％?49.7％ of that of AIF-WT cells, resulting in caspase-independent apoptosis. The average percentage of apoptotic cells in the variants was 12.3％?17.9％, which was significantly higher than that (6.9％?7.4％) in controls. However, nicotinamide adenine dinucleotide (NADH) treatment promoted the reduction of apoptosis by rescuing AIF dimerization in AIF variant cells. Our findings show that the impairment of AIF dimerization by AIFM1 variants causes apoptosis contributing to ANSD, and introduce NADH as a potential drug for ANSD treatment. Our results help elucidate the mechanisms of ANSD and may lead to the provision of novel therapies.

Objective:To analyze the clinical features of bronchiectasis in children after severe adenovirus pneumonia and to provide clinical clues for the early diagnosis of bronchiectasis in children after severe adenovirus pneumonia.Methods:A retrospective study was made to analyze the clinical data of 26 children with bronchiectasis after severe adenovirus pneumonia treated in Guangzhou Women and Children′s Medical Center, Guangzhou Medical University from May 2016 to May 2021.Results:A total of 26 cases were reported, including 18 males and 8 females.The median onset age of severe adenovirus pneumonia was 23.0 (15.0, 48.0) months.A total of 23 cases suffered concurrent infections, and bacterial co-infection was the most common (16 cases). High resolution computed tomography (HRCT) showed multiple lobar solids in the lung with/without pleural effusion.During the acute phase, most of the cases were treated with intravenous immunoglobulin (21 cases), mechanical ventilation (20 cases), and systemic glucocorticoids (19 cases). The median age at diagnosis of bronchiectasis was 29.5 (21.0, 56.8) months, and the median time that the patients took to develop into acute adenovirus pneumonia was 6.0 (3.3, 13.0) months.Six cases suffered bronchiectasis alone, and 20 cases had bronchiectasis combined with post-infectious bronchiolitis obliterans (PIBO). Of these 20 cases, 3 cases developed bronchiectasis and PIBO simultaneously, and the remaining 17 cases developed bronchiectasis after PIBO.In the included 26 cases, diffuse bronchiectasis predominated (24 cases), most frequently involving the left lower lobes (21 cases) and right lower lobes (21 cases). Cylindrical bronchiectasis was the most common type (23 cases). All the patients had recurrent cough and wheezing during follow-up, and only 3 cases coughed up pus sputum without hemoptysis.All children had acute exacerbations, which were mostly caused by bacteria (21 cases). Nineteen cases combined with PIBO and 1 case with only bronchiectasis were rehospitalized.There was no cases of surgical resection or death.Conclusions:Bronchiectasis after severe adenovirus pneumonia mostly occurs in patients with or without PIBO.Multiple lobe involvement and co-infection may be a risk factor for PIBO patients to develop bronchiectasis.The clinical manifestations are mostly recurrent cough and wheezing, while sputum and hemoptysis are less common.Pediatricians should promptly perform chest HRCT for early diagnosis of the disease.

Objective:To analyze the clinical and imaging characteristics of pulmonary artery sling (PAS) in children and to explore its diagnosis and treatment strategies and risk factors.Method:s A retrospective study was performed in 98 pediatric patients with PAS who were admitted to Guangzhou Women and Children′s Medical Center, Guangzhou Medical University, from January 2011 to October 2018.All their clinical features, imaging examination, treatment and prognosis were reviewed and analyzed.Result:s (1) Among the 98 patients with PAS, 56 cases were male and 42 cases were female.The age range of onset was 0-19 months with the median age of 2 months, and the age range of diagnosis was 0-84 months with the median age of 4 months.(2) The main clinical manifestations were cough (61/98 cases, 62.24%), recurrent wheezing(47/98 cases, 47.96%), shortness of breath (43/98 cases, 43.88%), cyanosis (19/98 cases, 19.39%), and laryngeal stridor (8/98 cases, 8.16%) and so on.(3) Ninety-six patients underwent cardiac ultrasonography, and the diagnostic rate was 87.50%(84/96 cases), and 62 cases (62/96 cases, 64.58%) of them were found to be associated with other congenital cardiovascular anomalies, among which atrial septal defect was the most common (32/96 cases, 33.33%). (4) Chest CT and three-dimensional reconstruction were performed in 92 PAS children, and the diagnostic rate was 100.00%.Airway stenosis was mainly in the middle and lower sections of the main bronchus (76/92 cases, 82.61%), and bronchobridge was found in 13 cases (13/92 cases, 39.13%). Bronchoscopy was performed in 77 children with PAS, showing complete tracheal cartilage ring in 43 cases (43/77 cases, 55.84%), and tracheobronchomalacia in 13 cases (13/77 cases, 16.88%). (5) Among 67 cases who had received left pulmonary artery (LPA) reimplantation, 5 cases died after operation because of airway stenosis and weaning failure (LPA reconstruction was performed in 1 case, and both LPA reconstruction and tracheal intervention were performed in the other 4 cases), 24 cases lost to follow-up, 38 cases survived, and the respiratory symptoms were improved in 2 to 96 months of follow-up.There were 31 cases of non-surgical treatment, of which 18 cases died of respiratory failure, 7 cases lost to follow-up, and the rest 6 cases showed respiratory symptoms of different degrees in the follow-up period.(6) Multivariate regression analysis showed that conservative treatment was an independent risk factor affecting the prognosis of PAS ( OR=7.45, 95% CI: 1.23-48.68). Conclusions:The combination of cardiac ultrasound, chest CT and bronchoscopy is important to the diagnosis of PAS.LPA reconstruction is the main method to treat PAS, which can improve respiratory symptoms, but its fusion with tracheal intervention poses a high risk of death.Conservative treatment is an independent risk factor that affects the prognosis of PAS children.

Objective:To explore the effects of health education using new media in nursing outside the hospital among colon cancer patients.Methods:From January 2016 to December 2018, this study selected 86 colon cancer patients at Nanyang Central Hospital as subjects by convenience sampling. A total of 43 patients between January 2016 to June 2017 were in control group, and 43 patients from July 2017 to December 2018 were in observation group. Control group carried out health education outside the hospital, while observation group implemented health education using new media outside the hospital for six months. The effects were compared with the knowledge need questionnaire for cancer patients, Champion Health Belief Model Scale (CHBMS) and the Strategies Used by People to Promote Health (SUPPH) .Results:Six months after discharge, the scores of knowledge need questionnaire of patients in observation group and control group were (41.24±7.64) and (51.94±9.62) respectively ( t=5.712, P<0.01) ; the score of CHBMS of patients in observation group and control group were (118.10±31.53) and (92.20±28.23) respectively ( t=4.013, P<0.01) ; and the score of SUPPH of patients in observation group and control group were (98.37±17.17) and (80.45±17.45) respectively ( t=4.800, P<0.01) ; the differences were all statistical. Conclusions:The application of health education using new media in nursing outside the hospital among colon cancer patients can improve patients' health knowledge need, rebuild the health belief and increase self-management efficacy.

Objective The three-dimensional finite element analysis was done to analyze the mechanical stability of double screw internal fixation for talus neck fracture,the methods with different approaches and different placement methods as well as the optimal biomechanical environment of fracture section were discussed so as to provide reliable mechanical arguments for the selection of clinical internal fixators.Methods The acquired male adult ankle CT data were imported into Mimics for 3D reconstruction of the ankle joint model.After the model was fitted with the surface by Geomagic software,the model was imported into Solidwork software to establish the talus neck fracture model and the corresponding screw.The fixtures were assembled with the anterior-posterior parallel double screw,the anterior-posterior cross-double screw,the posterior-anterior parallel double screw,and the posterioranterior cross-double screw,respectively.The model data were imported to Abaqus 6.14 for analysis and calculation,followed by the meshing pretreatment using software Hypermesh 13.0.The Von Mises stress distribution of the lag screw and displacement of the fracture end were observed under different fixation modes.Results In the displacement and stress cloud diagrams of the fracture ends of the four groups,the displacement peaks of the fractures of the anterior to posterior double-screw parallel and cross-fixed groups were 0.399 3 mm and 0.418 6 mm,and the peak pressures were 7.721 MPa and 8.124 MPa,respectively.The displacement peaks of posterior to anterior double-screw parallel and cross-groups were 0.418 3 mm and 0.418 5 mm,the fracture end peak pressures were 4.848 MPa and 5.692 MPa,respectively.In the screw stress cloud diagram of the four internal fixation modes,the Von Mises stress peaks of the anterior-posterior parallel screw group and cross-screw group were 45.11 MPa and 50.18 MPa,and those of the posterior-anterior parallel screw group and cross-screw group were 30.65 MPa and 37.68 MPa,respectively.Conclusion In the posterior-anterior parallel screw fixation,the fracture end has the lowest stress,and the screw has dispersive stress and the stress peak is the lowest,which is superior to other three groups.Therefore,the posterior-anterior screw is better than anterior-posterior fixation,and the parallel fixation is better than cross fixation.

Objective? To explore the effects of health education under the concept of health quotient on self-management ability and medication compliance among ulcerative colitis patients. Methods? From December 2015 to December 2017, we selected 140 ulcerative colitis patients at Nanyang City Center Hospital of the Affiliated Hospital of Zhengzhou University as subjects by convenience sampling. All of the patients were divided into observation group and control group with the method of random number table, 70 cases in each group. Control group adopted routine health education, while observation group carried out health education under the concept of health quotient which implemented health education using five dimensions of health quotient concept as start points. The intervention effects of patients of two groups, self-management ability and medication compliance, were compared with the Adult Health Self-Management Skill Rating Scale (AHSMSRS) and Morisky Medication Adherence Scale before (on admission) and after (reexamining three months after discharge) intervention. Results? Before intervention, there were no statistical differences in the dimension scores of AHSMSRS of patients between two groups (P＞ 0.05). After intervention, the scores of AHSMSRS both groups all increased compared with those before intervention;the scores of diet management, sport management, responses to the diseases, resource usage, self-efficacy and environment self-management and the total score of AHSMSRS in observation group after intervention were higher than those in control group with statistical differences (P＜0.05). After intervention, the fine rate of medication compliance of observation group was 95.71% statistically higher than that (85.71%) of control group (P＜0.05). Conclusions? Health education under the concept of health quotient can improve self-management ability and medication compliance among ulcerative colitis patients which is worthy of being spread in clinical application.