The analysis presented here is based on the blood components of Guanxin Qiwei tablets, the key anti-atherosclerosis pathway of Guanxin Qiwei tablets was screened by network pharmacology, and the anti-atherosclerosis mechanism of Guanxin Qiwei tablets was clarified and verified by cell experiments. HPLC-Q-Exactive-MS/MS technique was used to analyze the components of Guanxin Qiwei tablets into blood, to determine the precise mass charge ratio of the compounds, and to conduct a comprehensive analysis of the components by using secondary mass spectrometry fragments and literature comparison. Finally, a total of 42 components of Guanxin Qiwei tablets into blood were identified. To better understand the interactions, we employed the Swiss Target Prediction database to predict the associated targets. Atherosclerosis (AS) disease targets were searched in disease databases Genecard, OMIM and Disgent, and 181 intersection targets of disease targets and component targets were obtained by Venny 2.1.0 software. Protein interactions were analyzed by String database. The 32 core targets were selected by Cytscape software. Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed in DAVID database. It was found that the anti-atherosclerosis pathways of Guanxin Qiwei tablets mainly include lipid metabolism and atherosclerosis and AGE-RAGE signaling pathway in diabetic complications and other signal pathways. The core targets and the core compounds were interlinked, and it was found that cryptotanshinone and tanshinone ⅡA in Guanxin Qiwei tablets were well bound to TNF, PPARγ, AKT1, PTG2 and other targets. The lipid metabolism and atherosclerotic pathway was verified using human hl-7702 hepatocytes. This study preliminarily identified the potential pharmacodynamic components of Guanxin Qiwei tablets in the treatment of AS diseases and predicted their pathways of action, and verified the relationship between regulating lipid metabolism and atherosclerosis of Guanxin Qiwei tablets in vitro, providing a reference for the further study of the pharmacodynamic material basis and mechanism of action of this prescription. This experiment was approved by the Medical Ethics Committee of Inner Mongolia Medical University (No. YKD202401262).

Amorphous solid dispersion (ASD) is one of the most effective formulation approaches to enhance the water solubility and oral bioavailability of poorly water-soluble drugs. However, maintenance of physical stability of amorphous drug is one of the main challenges in the development of ASD. Crystallization is a process of nucleation and crystal growth. The nucleation is the key factor that influences the physical stability of the ASD. However, a theoretical framework to describe the way to inhibit the nucleation of amorphous drug is not yet available. We reviewed the methods and theories of nucleation for amorphous drug. Meanwhile, we also summarized the research progress on the mechanism of additives influence on nucleation and environmental factors on nucleation. This review aims to enhance the better understanding mechanism of nucleation of amorphous drug and controlling over the crystal nucleation during the ASD formulation development.

The purpose of this study was to investigate the intervention effect and mechanism of Lycium barbarum leaves on letrozole-induced polycystic ovary syndrome (PCOS) mice. The PCOS model was prepared by letrozole combined with high-fat diet. After successful modeling, 40 mice were randomly divided into PCOS group, positive drug metformin group, low-dose Lycium barbarum leaves group, and high-dose Lycium barbarum leaves group. The corresponding drugs were given by gavage for 29 days. At the end of the experiment, the eyeballs were removed for blood collection and ovarian tissue was collected. The ovarian mass, fasting blood glucose (FBG), fasting insulin (FINS), testosterone (T), anti-Mullerian hormone (AMH), luteinizing hormone (LH), follicle stimulating hormone (FSH), and estradiol (E₂) levels were measured in each group. The morphology of ovarian tissue was observed by hematoxylin-eosin staining, and the oocytes, cystic follicles and corpus luteum were counted. Cecal contents of mice were collected for analysis of intestinal flora composition and differential flora. The animal experiment process was approved by the Animal Ethics Committee of Nanjing University of Traditional Chinese Medicine. The results showed that the estrous cycle of PCOS mice was disordered. Compared with the PCOS group, the Lycium barbarum leaves group can significantly reduce the ovarian damage of mice, reduce the number of cystic dilated follicles, and normalize the estrous cycle. After the intervention of Lycium barbarum leaves, the levels of FBG, FINS, T, AMH, LH, FSH and LH/FSH were significantly decreased (P < 0.05), while the level of E₂ was significantly increased (P < 0.001). In addition, Lycium barbarum leaves can regulate the disorder of intestinal flora diversity in PCOS mice, increase the abundance of Bacteroidetes, and reduce the abundance of Firmicutes, Ileibacterium, Romboutsia and Faecalibaculum. In summary, Lycium barbarum leaves can play a therapeutic role in PCOS mice by improving insulin resistance, regulating reproductive hormone disorders and gut microbiota imbalance. It provides scientific basis and useful reference for the rational utilization and development of Lycium barbarum leaves.

Objective To establish a normal three-dimensional model of the hip bone in adolescents aged 10-19 years old,analyze the morphology and positional parameters of the posterior superior iliac spine of the hip bone among different genders,sides,and ages,which can supplement the study of the anatomical morphology of the hip bone and to provide a reference for the diagnosis of the clinically relevant diseases and for the therapeutic manipulation and localization of the hip bone.Methods Forty adolescent patients aged 10-19 years without previous spinal pelvic diseases were selected,and the pelvic CT image data were collected and imported into Mimics 21.0 software to establish the model.The relative position parameters of the posterior superior iliac spine and the surrounding anatomical landmarks included the length from the posterior superior iliac spine to the anterior superior iliac spine(ab),the length from the tip of the posterior superior iliac spine to the sciatica(ac),the length from the tip of the posterior superior iliac spine to the pubic tubercle(ae),the length from the tip of the posterior superior iliac spine to the midpoint of the posterior margin of the auricular joint surfaces(af),the length from the tip of the posterior superior iliac spine to the iliac spine turn(ag),and the length from the sciatica tubercle to the highest point of the iliac spine(cd).The local parameters of the posterior superior iliac spine included the width(W0)and the thickness(H0)at point A.The maximum width of the posterior iliac spine(WMAX),its distance from point a(D0),and the width of the iliac spine were measured at 0.5,1,and 1.5 cm from point a,and were recorded sequentially as W1,W2,and W3.The width of the iliac spine at the turn of the iliac spine(point g)was measured(W4).The relative positions and parameters of the posterior superior iliac spine to the surrounding anatomical landmarks and the localized parameters of the posterior superior iliac spine were compared sequentially for different genders,sides,and age groups.Results In the measurement result of the parameters of the posterior superior iliac spine and the surrounding anatomical landmarks,the differences in the comparisons between different genders of the ac,ae,and af indexes were statistically significant(P＜0.05),and the differences in the comparisons between different genders of the ab,ag,and cd indexes were not statistically significant(P＞0.05).The differences in the comparisons between the right and left sides of the ab,ac,ae,af,ag,and cd indexes were not statistically significant(P＞0.05).The difference in comparison between different age groups of ab,ac,ae,af,ag,and cd indicators was statistically significant(P＜0.05).In the measurement result of the local parameters of the posterior superior iliac spine,the difference in the comparison between the sexes of the W0,W1,W2,WMAX,and H0 indexes was statistically significant(P＜0.05),and the difference in the comparison between the sexes of the W3,W4,and D0 indexes was not statistically significant(P＞0.05);And the difference in the comparison between the left and right sides of the W0,W1,W2,and the right and left sides of the W3,W4,WMAX,D0,and H0 indexes was not statistically significant(P＞0.05);The difference between W0,W1,W2,W3,W4,WMAX,D0,H0 indicators compared between different age groups was not statistically significant(P＞0.05).Conclusion Adolescent females have overall greater pelvic parameters than males,with wider and thicker tips of the posterior superior iliac spine in females and narrower and thinner tips of the posterior superior iliac spine in males;Pelvic parameters show a tendency to increase with age,while the width and thickness of the posterior superior iliac spine,as well as the width of the cephalic end to the iliac spine remain essentially unchanged.

Purpose To investigate the evaluation value of right-to-left shunt in atrial septal aneurysm(ASA)via contrast-enhanced transcranial Doppler,and analyze its clinical significance.Materials and Methods Forty patients with ASA who were performed on contrast-enhanced transcranial Doppler in Jiaozuo People's Hospital from June 2020 to July 2021,and 242 patients without ASA during the same period were enrolled.The overall incidence of right-to-left shunt was compared between the two groups in resting state and after Valsalva maneuver.All patients with right-to-left shunt were divided into small shunt group and large shunt group according to the number of microbubbles detected,comparing the incidence of small and big shunt,as well as alterations of shunt after Valsalva maneuver between the two groups.Results Contrast-enhanced transcranial Doppler in resting state:positive rate of ASA patients with right-to-left shunt was significantly higher than that of non-ASA patients via contrast-enhanced transcranial Doppler in resting state[47.5%(19/40)vs.29.8%(72/242);χ2=4.95,P=0.03].There were 14 ASA patients(73.7%)with small shunt and five ASA patients(26.3%)with large shunt.There were 61 non-ASA patients(84.7%)with small shunt and 11 non-ASA patients(15.3%)with large shunt.In resting state,there was no significant difference in ratio between small and large shunts,though there were mainly small shunt patients between the two groups(χ2=1.26,P=0.264).The positive rate of patients with or without ASA were significantly higher after Valsalva maneuver than those in resting state(positive rate of ASA patients was 77.5%,χ2=8.64,P=0.002;positive rate of non-ASA patients was 48.8%,χ2=80.49,P<0.001).The number of cases with massive shunt in ASA group were significantly higher than those in non-ASA group[64.5%(20/31)vs.47.5%(56/118);χ2=12.58,P<0.001].Conclusion ASA is often accompanied by right-to-left shunt,especially those with a substantial right-to-left shunt can trigger by the Valsalva maneuver.Therefore,attention should be paid to patients with ASA in clinical practice with standardized diagnosis and treatment.

Objective:To investigate the clinicopathological features and prognostic factors of breast cancer patients with low expression of human epidermal growth factor receptor 2 (human epidermal growth factor receptor-2, HER-2).Methods:Retrospective analysis was made on the clinical data of 823 cases of breast cancer with HER-2 non positive treated by surgery in the First Affiliated Hospital of Bengbu Medical College from January 1, 2013 to December 31, 2016. Collect general clinical indicators (age, site of onset, menstrual status, etc.), pathological features (tumor TNM staging, histological grading, pathological type, axillary lymph node status, Ki-67 index, and expression of HER-2, ER, PR), treatment plans (endocrine therapy, radiotherapy, and chemotherapy plans), survival status (pathological diagnosis time, surgery time, recurrence or metastasis time, and death time). To compare the clinicopathological characteristics of HER-2 non positive breast cancer patients with different hormone receptor status, and analyze the influencing factors of DFS and overall survival. Non normally distributed econometric data are represented by M( Q1, Q3), and Wilcoxon rank sum test is used for comparison between the two groups; Count data is represented as an example (%), and χ 2 test is used for inter group comparison; Use Kaplan Meier method to plot survival curves, and analyze the differences in disease-free survival rate and overall survival rate among different subgroups through Log rank test; Use univariate and multivariate Cox proportional risk models to analyze the influencing factors of prognosis. P<0.05 indicates a statistically significant difference. Results:Among 823 HER-2 non positive breast cancer patients, 657 (79.83%) were hormone receptor positive and 166 (20.17%) were negative; 287 cases (34.87%) had zero expression of HER-2, and 536 cases (65.13%) had low expression. Compared with the hormone receptor negative group, the hormone receptor positive group had a higher proportion of HER-2 low expression (68.49% (450/657) compared to 51.81% (86/166), χ 2=16.25, P<0.001), and a lower proportion of Ki-67>30% (32.57% (214/657) compared to 72.29% (120/166), χ 2=86.69, P<0.001). In the hormone receptor positive group, compared with the HER-2 zero expression subgroup, the HER-2 low expression subgroup had a lower proportion of patients with onset age ≥ 40 years old ( P=0.026), a higher proportion of premenopausal women ( P=0.045), a later pathological stage ( P=0.042), and a lower positive rate of axillary lymph nodes ( P=0.023). Multivariate analysis showed that primary tumor size stage T3-T4, Ki-67 > 30% and HER-2 zero expression were risk factors for 10-year DFS and total survival of hormone receptor positive HER-2 non positive breast cancer patients (10-year DFS: HR values were 2.840, 2.010, 2.652, 95% CI: 2.265－4.010, 1.563－2.471, 1.983－3.441, all P=0.001; Overall survival: HR values were 1.923, 1.954, 95% CI: 1.332－2.642, 1.774－2.531, with P values of 0.041 and 0.012, respectively; Primary tumor size stage T3-T4 and HER-2 zero expression are risk factors for 10-year DFS in hormone receptor negative HER-2 non positive breast cancer patients ( HR values are 2.096 1.885, 95% CI: 1.687－3.000, 1.452－2.774, P values are 0.026 and 0.005, respectively). Regional lymph node stage N1-N3 is a risk factor for 10-year overall survival ( HR=1.982, 95% CI: 1.230－2.710, P=0.001). Conclusions:Low HER2 expression in HR Positive patients with breast cancer is more common than in TNBC.There is heterogeneity between the clinicopathological features of patients with zero expression of HER-2 and low expression of HER-2. The survival prognosis of patients with breast cancer with low expression of HER-2 is better than that of patients with zero expression of HER-2, and the expression of HER2 has a significant effect on survival and prognosis.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Objective:To investigate the initial effectiveness of manual techniques versus navigation positioning system-assisted reconstruction for anterior cruciate ligament (ACL) injuries in children and adolescent populations.Methods:A retrospective analysis was conducted on 28 patients with ACL rupture who underwent primary total epiphyseal ACL reconstruction in the Sports Medicine Treatment Center of Honghui Hospital Affiliated to Xi'an Jiaotong University from January 2019 to October 2022. Patients were categorized into two groups based on the method of guide needle insertion: the manual group (guide needle insertion relying on the operator's expertise) and the robot-assisted group (guide needle insertion assisted by the Tianji robot navigation and positioning system). The manual group comprised 14 cases (9 males, 5 females) with an average age of 13.59±1.59 years, while the robot-assisted group included 14 patients (10 males, 4 females) with an average age of 13.27±1.66 years. The operation time, intraoperative fluoroscopy times, guide needle placement times, the distance between the central point of the internal articular opening of the tibial and femoral bone tunnel and the ideal point, the rate of epiphyseal inflammation, and the International Knee Documentation Committee (IKDC) subjective score, Lysholm score, KT-2000 ligament relaxation, lower limb force line were compared between the two groups.Results:The follow-up duration was 19.9±6.3 months for the manual group and 18.8±4.9 months for the robot group ( t=0.546, P=0.589). The manual group's operation duration was 123.0±12.6 min, significantly longer than the robot group's 96.4±12.9 min ( t=5.502, P<0.001). Intraoperative fluoroscopy was performed 11.8±3.1 times in the manual group, markedly more than the robot group's 3.7±0.8 times ( t=9.434, P<0.001). The robot group required only one guide needle placement for both femur and tibia, while the manual group had 5.7±1.2 placements on the femur side and 4.6±1.8 on the tibia side. The distance between the femoral joint's central point and the ideal point was 0.87±0.20 mm in the robot group, superior to the manual group's 1.92±0.64 mm ( t=5.816, P<0.001). Similarly, the distance between the central point and the ideal point was 1.15±0.34 mm for the robot group, better than the manual group's 1.94±0.55 mm ( t=4.582, P<0.001). No cases of epiphyseal irritation were observed in the robot group, while 21% (3/14) of the manual group experienced tibial or femoral epiphyseal plate involvement. At 3 months post-surgery, the robot group exhibited higher IKDC subjective scores (90.57±8.46) and Lysholm scores (86.29±5.09) compared to the manual group (83.50±6.19 and 80.93±5.93), respectively ( P<0.05). However, at the final follow-up, there were no significant differences in IKDC subjective scores, Lysholm scores, or KT-2000 ligament relaxation between the two groups ( P>0.05). Both groups showed normal lower limb force alignment and no abnormal growth or development. Conclusion:Tianji robot navigation and positioning system-assisted ACL reconstruction in children and adolescents offer advantages such as precise positioning, shorter operation times, reduced intraoperative fluoroscopy, faster recovery, and enhanced epiphyseal protection compared to manual methods.

Objective To investigate the distribution and antimicrobial resistance profiles of the common pathogens isolated from urine from 2015 to 2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods The bacterial strains were isolated from urine and identified routinely in 51 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Antimicrobial susceptibility was determined by Kirby-Bauer method,automatic microbiological analysis system and E-test according to the unified protocol.Results A total of 261 893 nonduplicate strains were isolated from urine specimen from 2015 to 2021,of which gram-positive bacteria accounted for 23.8％(62 219/261 893),and gram-negative bacteria 76.2％(199 674/261 893).The most common species were E.coli(46.7％),E.faecium(10.4％),K.pneumoniae(9.8％),E.faecalis(8.7％),P.mirabilis(3.5％),P.aeruginosa(3.4％),SS.agalactiae(2.6％),and E.cloacae(2.1％).The strains were more frequently isolated from inpatients versus outpatients and emergency patients,from females versus males,and from adults versus children.The prevalence of ESBLs-producing strains in E.coli,K.pneumoniae and P.mirabilis was 53.2％,52.8％and 37.0％,respectively.The prevalence of carbapenem-resistant strains in E.coli,K.pneumoniae,P.aeruginosa and A.baumannii was 1.7％,18.5％,16.4％,and 40.3％,respectively.Lower than 10％of the E.faecalis isolates were resistant to ampicillin,nitrofurantoin,linezolid,vancomycin,teicoplanin and fosfomycin.More than 90％of the E.faecium isolates were ressitant to ampicillin,levofloxacin and erythromycin.The percentage of strains resistant to vancomycin,linezolid or teicoplanin was＜2％.The E.coli,K.pneumoniae,P.aeruginosa and A.baumannii strains isolated from ICU inpatients showed significantly higher resistance rates than the corresponding strains isolated from outpatients and non-ICU inpatients.Conclusions E.coli,Enterococcus and K.pneumoniae are the most common pathogens in urinary tract infection.The bacterial species and antimicrobial resistance of urinary isolates vary with different populations.More attention should be paid to antimicrobial resistance surveillance and reduce the irrational use of antimicrobial agents.

Objective To understand the distribution and changing resistance profiles of clinical isolates of Enterococcus in hospitals across China from 2015 to 2021.Methods Antimicrobial susceptibility testing was conducted for the clinical isolates of Enterococcus according to the unified protocol of CHINET program by automated systems,Kirby-Bauer method,or E-test strip.The results were interpreted according to the Clinical & Laboratory Standards Institute(CLSI)breakpoints in 2021.WHONET 5.6 software was used for statistical analysis.Results A total of 124 565 strains of Enterococcus were isolated during the 7-year period,mainly including Enterococcus faecalis(50.7％)and Enterococcus faecalis(41.5％).The strains were mainly isolated from urinary tract specimens(46.9％±2.6％),and primarily from the patients in the department of internal medicine,surgery and ICU.E.faecium and E.faecalis strains showed low level resistance rate to vancomycin,teicoplanin and linezolid(≤3.6％).The prevalence of vancomycin-resistant E.faecalis and E.faecium was 0.1％and 1.3％,respectively.The prevalence of linezolid-resistant E.faecalis increased from 0.7％in 2015 to 3.4％in 2021,while the prevalence of linezolid-resistant E.faecium was 0.3％.Conclusions The clinical isolates of Enterococcus were still highly susceptible to vancomycin,teicoplanin,and linezolid,evidenced by a low resistance rate.However,the prevalence of linezolid-resistant E.faecalis was increasing during the 7-year period.It is necessary to strengthen antimicrobial resistance surveillance to effectively identify the emergence of antibiotic-resistant bacteria and curb the spread of resistant pathogens.