OBJECTIVE To observe the clinical efficacy， safety and recurrence of Kuntai capsules combined with Estradiol tablets/Estradiol dydrogesterone tablets in the treatment of diminished ovarian reserve （DOR） as well as their effects on ovarian reserve function， sex hormones， and lymphocyte subsets. METHODS A retrospective analysis was conducted on the clinical data of 165 DOR patients in Nanyang First People’s Hospital. Among them， 80 patients who received Estradiol tablets/Estradiol dydrogesterone tablets （take one tablet per day according to the medication sequence on the instruction） were included in the control group， while 85 patients who additionally took Kuntai capsules （2.0 g per dose， three times daily） were included in the observation group. The treatment duration for both groups was three months. Clinical efficacy， the incidence of adverse drug reaction （ADR）， recurrence rate， and changes in Traditional Chinese Medicine （TCM） syndrome scores， ovarian reserve function indicators [anti-Müllerian hormone （AMH）， inhibin B （INHB）， antral follicle count （AFC）， endometrial thickness， and ovarian volume]， sex hormones [follicle-stimulating hormone （FSH）， luteinizing hormone （LH）， and estradiol （E2）]， and T lymphocyte subsets （CD3 +， CD4 +， CD8 +， and CD4 +/CD8 +） were compared before and after treatment. RESULTS The cure and significant improvement rate in the observation group was significantly higher than in the control group （82.35% vs. 65.00%， P＜0.05）. Compared to baseline levels， both groups showed significant reductions in TCM syndrome scores， FSH， LH， CD3+ and CD8+ levels after treatment， while AMH， INHB， E2， CD4 +， CD4 +/CD8 +， AFC， endometrial thickness， and ovarian volume significantly increased （P＜0.05）. The degree of improvement in these indicators was significantly greater in the observation group than in the control group （P＜0.05）. There was no significant difference in the total incidence of ADR between the two groups（P＞ 0.05）. However， the recurrence rate within six months post-treatment was significantly lower in the observation group compared to the control group （5.88% vs. 21.25%， P＜0.05）. CONCLUSIONS Kuntai capsules combined with Estradiol tablets/ Estradiol dydrogesterone tablets have a significant therapeutic effect on DOR， which can improve ovarian reserve function of the patient， regulate sex hormone levels and T lymphocyte subsets， and reduce recurrence rates， with a high safety profile.

OBJECTIVE To assess the correlation between the steady-state minimal concentration （cmin） and 24 h area under the drug concentration-time curve （AUC24）/minimal inhibitory concentration （MIC） ratio （AUC24/MIC） of vancomycin in pediatric patients， and analyze independent risk factors for treatment failure. METHODS Data of hospitalized children treated with vancomycin and receiving therapeutic drug monitoring in our hospital from January 2021 to July 2024 were retrospectively collected and divided into success group and failure group according to whether the treatment was successful or not. Spearman correlation analysis was used to analyze the correlation between cmin and AUC24/MIC of vancomycin， and one-way and multifactorial Logistic regression analyses were used to screen the independent risk factors for vancomycin treatment failure. RESULTS A total of 59 children were included， with 41 in the success group and 18 in the failure group. Compared with the failure group， AUC24/MIC of vancomycin was significantly higher in the success group （P＝0.038）， but there was no statistically significant difference in the cmin of the two groups （P＞0.05）； cmin of vancomycin was significantly positively correlated with AUC24/MIC （r＝0.499， P＜0.001）， but it has a certain efficacy in predicting the achievement of the AUC24/MIC standard （≥400） （area under the receiver operator characteristic curve＝0.696）， with an optimal cutoff value of 6.05 mg/L determined by the Youden index. The efficacy of AUC24/ MIC in predicting treatment failure was superior to cmin （areas under the receiver operator characteristic curve were 0.671 vs. 0.523， P were 0.038 vs. 0.684）， with higher sensitivity （83.3% vs. 66.7%）. Hypoproteinemia and AUC24/MIC≤369.1 were independent risk factors for vancomycin treatment failure （P＜0.05）. The incidence of nephrotoxicity was 3.4%. CONCLUSIONS There is a significant positive correlation between cmin and AUC24/MIC of vancomycin in pediatric patients； hypoproteinemia and AUC24/MIC≤369.1 are independent risk factors for vancomycin treatment failure in children.

Objective To address the current blind spots in quality control and the risk of data distortion in radiological health technical service institutions, overcome the limitations of low efficiency and insufficient anomaly identification in manual verification, establish an automatic anomaly early warning mechanism based on AI algorithms, provide accurate clues for health supervision and law enforcement, and significantly enhance the efficiency of industry supervision. Methods On-site inspection data were collected via photographic imaging. Advanced image processing and object detection algorithms were employed to automatically extract and analyze key information from the images. Through data analysis, the system was used to calculate and assess the inspection results. A dynamic early warning engine was developed to automatically trigger alerts upon detection of deviations from standard thresholds or regulatory violations in radiological health technical services. These alerts were delivered through a regulatory information system. Results Following AI model training, the accuracy of the image processing and object detection algorithms reached 99% and the early warning accuracy reached 93%. Compared with the traditional supervision mode, the efficiency of anomaly detection was improved and the average response time was shortened. Conclusion The full-process supervision information system constructed in this study has realized the triple mechanism of pre-event standardization, in-event monitoring, and post-event traceability for radiological health technical services. In particular, the system has established a four-level quality control chain of “institutional self-inspection, intelligent recheck, expert judgment, and administrative action”, providing a technological innovation path for ensuring the radiation protection and safety of medical staff, patients, and the public.

OBJECTIVE To investigate the effects and mechanism of polysaccharides from Hedyotis diffusa （HDP） on isoniazid （INH）-induced liver injury. METHODS Healthy transgenic zebrafish with liver-specific fluorescence were divided into normal group， model group （4 mmol/L INH）， HDP low-concentration group （4 mmol/L INH+50 mg/mL HDP） and HDP high- concentration group （4 mmol/L INH+100 mg/mL HDP）. After grouping treating， the liver fluorescence area， fluorescence intensity and pathological changes of liver tissue were observed. Human liver L02 cells were divided into normal group， model group （4 mmol/L INH）， HDP low-concentration group （4 mmol/L INH+2 mg/mL HDP）， and HDP high-concentration group （4 mmol/L INH + 4 mg/mL HDP）. After grouping treating， the cell viability was detected， and the levels of alanine transaminase （ALT）， aspartate transaminase （AST）， and the content of glutathione （GSH） as well as the expression levels of silent information regulator 1 （Sirt1）， nuclear factor-erythroid 2-related factor 2 （Nrf2）， heme oxygenase-1 （HO-1） and quinone oxidoreductase 1 （NQO1） proteins were detected. RESULTS Compared with the model group， the HDP low- and high-concentration groups showed varying degrees of increase in the fluorescence area and fluorescence intensity （except for HDP low-concentration group） of zebrafish liver （P＜0.05 or P＜0.01）， and the characteristics of liver injury and necrosis had been improved to varying degrees. Compared with model group， the survival rate of L02 cells， the content of GSH （except for HDP low-concentration group）， the protein expression levels of Sirt1 （except for HDP low-concentration group）， Nrf2， NQO1， HO-1 （except for HDP low-concentration group） were significantly increased in HDP low- and high-concentration groups （P＜0.05 or P＜0.01）， and the levels of ALT and AST （except for HDP low-concentration group） were significantly decreased （P＜0.05）； the number of survival cells significantly increased， while the number of damaged or dead cells significantly decreased. CONCLUSIONS HDP has a potential protective effect against INH-induced liver injury， the mechanism of which may be associated with activating Sirt1/Nrf2 signaling pathway， improving mitochondrial function and enhancing antioxidant capacity.

Humans ; Adolescent ; Acne Vulgaris/therapy* ; Skin Care ; Surveys and Questionnaires ; Cognition ; China ; Skin

Objective To study the effect of MT-1207 on blood glucose,blood lipids and atherosclerosis in mice.Methods The apolipoprotein E knockout(ApoE-/-)mice were fed with normal feed,drug feed containing losartan and drug feed containing MT-1207 at a dosage of 30 mg/kg.The body weight,blood glucose and blood lipids were detected,and the plaque area of atherosclerotic was evaluated.8-week-old male C57 mice were fed a high fat diet and given intragastric administration of MT-1207 and losartan at a dose of 30 mg/kg per day.The body weight,blood glucose and lipids levels were also examined to further evaluate the effects of MT-1207 on blood glucose and lipids levels.Results ApoE-/-mice treated with MT-1207 and losartan gained weight faster.There was no significant improvement in blood glucose and lipid levels,and no significant change in atherosclerotic plaque area.MT-1207 and losartan had no significant improvement effect on blood glucose and blood lipids of C57 mice.Conclusion MT-1207 and losartan couldn't improve the levels of blood glucose,blood lipids and atherosclerosis,and couldn't aggravate atherosclerosis.

Objective:To investigate the reasonable airflow organization and exhaust system facilities during the operation of the inspection workshop, and solve the problem of the accumulation of harmful gases such as ozone and nitrogen oxides in the workshop.Methods:In May 2023, computational fluid dynamics (CFD) technology was used to numerically simulate the diffusion of ozone and nitrogen oxides generated by industrial radiographic inspection operations, and the comparative detection method was used to analyze the ozone and nitrogen oxides concentrations before and after the renovation of the ventilation system of the inspection workshop.Results:After the renovation of ventilation system, the average concentration of ozone in the inspection workshop decreased from 0.81 mg/m 3 to 0.03 mg/m 3, and the average concentration of nitrogen oxides decreased from 0.42 mg/m 3 to 0.01 mg/m 3, and the differences were statistically significant ( t=20.51, 10.38, P<0.001) . Conclusion:The ventilation facilities of the inspection workshop are set up in the airflow organization mode of sending up and down the exhaust, and the ventilation pipes are scientifically designed through the calculation of ventilation hydraulic balance, which can effectively control the concentration of harmful gases in the inspection workshop.

OBJECTIVE To compare the contents of schizandrin A, schizandrin B, schizandrin C, schisandrol A, schisandrol B, schisantherin A, anwuligan, and schisanhenol in Schisandrae Sphenantherae Fructus on market from 12 habitats. METHODS The samples were pre-treated by 96-well fitration plates. The assay was performed on ACE EXCEL 1.7 C18-AMIDE(100 mm×2.1 mm, 1.7 μm) column with 0.1% formic acid-water(A) and methanol(B), gradient elution, flow speed was 0.4 mL·min–1. Ion source was electric spray ion source, positive ion monitoring mode, multireaction monitoring mode for quantitative analysis. Linear, instrument precision, stability, repeatability, average recovery were investigated. RESULTS The content of schisantherin A in 10 of 12 producing areas reached the standard of ≥0.2% of Schisandrae Sphenantherae Fructus in 2020 Edition of Chinese Pharmacopoeia. CONCLUSION UHPLC-MS/MS is suitable for simultaneous determination of multiple components in Schisandrae Sphenantherae Fructus. The Schisandrae Sphenantherae Fructus in the market basically meet the national legal standards.

In the 21st century,surgery has entered the 4.0 era,also known as the era of surgical intelligence.As technology continues to improve and advance,robotic surgery has become an important direction of development in the field of minimally invasive surgery.With significant technical advantages such as high-definition 3D stereoscopic vision and the elimination of physiological tremors,robotic surgery is increasingly being applied in the field of hepatobiliary and pancreatic surgery,gradually becoming the primary surgical approach in this domain.Compared to traditional open surgery and laparoscopic surgical techniques,robotic hepatobiliary and pancreatic surgery demonstrates notable advantages in terms of precision and safety.It not only reduces intraoperative blood loss but also shortens postoperative hospitalization,thereby accelerating patient recovery.The authors'center is one of the largest robotic hepatobiliary and pancreatic surgery centers in the world.Since 2011,it has pioneered robotic hepatobiliary and pancreatic surgery and successfully performed nearly 10 000 cases,gaining a wealth of surgical experience.During this period,the authors'team established a complete robotic hepatobiliary and pancreatic surgery system.This article summarizes the latest research developments in the field of robotic hepatobiliary and pancreatic surgery at home and abroad,combining the rich clinical experience of the authors'center,to provide an in-depth review of the progress and and emerging surgical techniques in robotic pancreatic surgery,liver surgery,and biliary surgery,and also offer an outlook on future trends in robotic hepatobiliary and pancreatic surgery.

Objective To investigate the regulatory mechanism of Notch signaling pathway by YAP in non-alcoholic steatohep-atitis(NASH)liver fibrosis,and assess the intervention effect of Cigu Xiaozhi prescription in detoxification and phlegm treatment.Methods C57BL/6J mice were randomly divided into different groups,including a normal group,NASH liver fibrosis model group,verteporfin(VP)intervention group,VP+Chinese medicine(Cigu Xiaozhi prescription)low-dose group,VP+Chinese medicine high-dose group,and dimethyl sulfoxide control group.The methionine/choline-deficient diet combined with low-dose CCl4 was used to construct the NASH liver fibrosis model.The degree of liver fibrosis was evaluated using hematoxylin and eosin(HE)and Masson staining.Four protein factors associated with liver fibrosis were detected using enzyme-linked immunosorbent assay,and hydroxyproline levels in the mouse liver was determined using the alkaline water method.The localization of α-SMA,ColⅠ,YAP,and Notch1 proteins in the liver was determined using immunohistochemistry.Additionally,the mRNA and protein expression levels of the Notch signaling pathway molecules,namely Notch1/2,J agged1,and DLL4,were assessed using real-time quantitative PCR and Western blotting analyses,respectively.Results The HE and Masson staining results revealed that the liver cells of NASH liver fibrosis mice were swollen and the cytoplasm was transparent.Additionally,evident fibrosis was observed in the hepatic lobule,portal area,and sinus;it was accompanied by heightened levels of inflam-matory cell infiltration,a large number of fat droplets,and instances of local hepatocyte necrosis,dissolution,and cirrhosis.The four factors associated with liver fibrosis showed a substantial increase(P<0.01).α-SMA,ColⅠ,YAP,and Notch1 were localized in the cytoplasm of hepatocytes.YAP,Notch1/2,and Jagged1 were highly expressed in the liver(P<0.01)but were downregulated after intervention with VP and VP+high and low doses of Cigu Xiaozhi prescription(P<0.05).Meanwhile,DLL4 factor was upregulated in the VP+high-dose of Cigu Xiaozhi prescription group(P<0.05).Conclusion YAP may inhibit activation of the Notch pathway by downregulating Notch1/2 and Jagged1 and upregulating DLL4,thereby interfering with the occurrence of liver fibrosis in NASH.Treatment with Cigu Xiaozhi pre-scription may inhibit Notch signaling pathway activation by downregulating YAP,Notch1/2,and Jagged1 and upregulating DLL4 through its multi-components and multi-targets properties,ultimately slow the progression of liver fibrosis in NASH.