Hepatolenticular degeneration， also known as Wilson disease （WD）， is a hereditary disease caused by mutations in the ATP7B gene， leading to copper metabolism disorders. Gene mutations result in impaired synthesis of copper-binding protein， and abnormal excretion of copper through bile leads to pathological deposition of copper in various organs， ultimately causing multi-organ damage. The insidious onset and low specificity of symptoms make it difficult to diagnose this disease. On the basis of existing studies and the theory of latent toxin， this paper proposes that latent toxin in kidney collaterals is the main pathogenesis of renal injury in WD. It is pointed out that health Qi deficiency and latent pathogen are the premises for the occurrence of this disease， and the transformation of latent pathogen into toxin is the ley pathological process. Toxin damaging kidney collaterals is the ultimate result. According to the pathogenesis， this paper proposes the treatment principle of reinforcing healthy Qi and resolving toxin and treatment based on syndrome differentiation. This review provides new ideas for the diagnosis and treatment of renal injury in WD with traditional Chinese medicine.

Lung cancer has the highest incidence and mortality rate among all cancers in China， with its complex and variable nature， long treatment duration， and often poor prognosis. Currently， the treatment of lung cancer mainly employs classical therapies such as surgery， radiotherapy， and chemotherapy， but some patients may experience a series of adverse reactions， which affect their quality of life， survival period， and treatment outcomes. As reported， oxidative stress is one of the important pathogenic factors of lung cancer， affecting its occurrence and development. Oxidative stress is a state of imbalance between oxidative products and antioxidant defense mechanisms in the body. The intervention of oxidative stress in the occurrence and development of lung cancer is related to multiple signaling pathways， including the Kelch-like ECH-associated protein 1 （Keap1）-nuclear factor erythroid 2-related factor 2 （Nrf2） signaling pathway， phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR） signaling pathway， mitogen-activated protein kinase （MAPK） signaling pathway， and nuclear factor-κB （NF-κB） signaling pathway. Currently， researchers in China and abroad have conducted extensive studies on the occurrence and development of lung cancer and the pathophysiological mechanisms of drug intervention. The results have shown that oxidative stress plays an important role in the occurrence and development of lung cancer. Chinese medicine monomers and compounds can regulate oxidative stress levels and intervene in related signaling pathways， thereby inhibiting or delaying the occurrence and development of lung cancer. Based on this， this article mainly summarized the relevant signaling pathways regulating oxidative stress intervention in lung cancer in recent years， and also reviewed the latest research on Chinese medicine monomers and compounds in regulating oxidative stress to treat lung cancer， aiming to provide new ideas for research on drug treatment of lung cancer and clinical drug development， as well as to provide references and guidance for further in-depth mechanistic studies in the future.

To summarize Professor TU Jinwen's clinical experience in the treatment of severe influenza based on the “heat toxin theory”. He believed that “heat toxin” is the main disease mechanism of severe influenza， emphasized the pathogenesis process that toxin enters with the pathogenic qi， heat generates by the toxin， and changes initiate from the toxin， and proposed simultaneous treatment of warmth and toxin and combination of multiple methods as the treatment principles. Syndrome differentiation in clinic should combine with wei-qi-ying-blood. The disease in the early stage located in wei （defensive） and qi level， treated by clearing heat and resolving toxins， releasing the exterior and expelling pathogen， harmonizing the exterior and interior， dredging the bowels with diarrhea， and combining other methods to get rid of the heat and toxin， and modified Self-Prescribed Tuire No. 1 Formula （自拟退热1号方） is recommended； the disease in progression stage located in ying-blood， treated by relieving heat and resolving toxins， and clearing the ying level and cool the blood， with prescriptions as modified Self-Prescribed Tuire No. 1 Formula plus Qingying Decoction （清营汤）， or Xijiao Dihuang Decoction （犀角地黄汤）； the disease in the late stage with of yin fluid consumption， and heat toxin in the blood level， treated by eliminating heat and resolving toxins， and enriching yin and cooling the blood， with prescriptions as modified Shashen Maidong Decoction （沙参麦冬汤） and Zhuye Shigao Decoction （竹叶石膏汤）. At the same time， it is emphasised that heat-clearing and fire-draining method and harmonising methods are important， and that dispelling pathogen should not injure healthy qi， and that the selection of prescriptions and medicines need consider syndrome differentiation and treatment.

Objective To investigate the distribution of the thalassemia genotypes and the characteristics of blood cell parameters in Changshou District,Chongqing.Methods Totally 4126 samples sent to our hospital were studied from June 2018 to March 2023.All samples were detected for thalassemia genotype and blood cells.The parameters of blood cells:redblood cell(RBC),hemoglobin(Hb),mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),mean corpuscular hemoglobin concentration(MCHC),red blood cell distribution width CV(RDW-CV),red blood cell distribution width SD(RDW-SD)were detected.Gap polymerase chain reaction(Gap-PCR)combined with reverse dot blot hybridization were used to detect alpha and beta thalassemia genotype.The rate and distribution characteristics of thalassemia gene in Changshou district were analyzed.Results Among 4126 samples,408 cases of α and β thalassemia were detected,accounting for 9.89%.Among these,there were 255 α-thalassemia cases.-α3.7/αα was the most common genotype.Two cases of--αSEA/-α3.7 and one cases of--SEA/HKαα were also detected.There were 153 cases of β-thalassemia and CD17 accounted for the highest proportion.The date of MCV,MCH,MCHC in-α3.7/αα,--SEA/αα,-α4.2/αα and ααCS/αα groups was significantly difference compared with control group(P<0.05).Parameters of MCV and MCH in CD17,CD41-42 and Ivs-2-654 groups were lower than those in control group(P<0.05),while RBC,RDW-CV and RDW-SD were higher than those in control group,the difference was statistically significant.Conclusion The most common genotype in thalassemia were-α3.7/αα,--SEA/αα,-α4.2/αα,CD17,CD41-42 and Ivs-2-654 in Changshou District,Chongqing.The parameters of MCV,MCHC,MCH,Hb,RBC,RDW-CV and RDW-SD have important clinical significance for the screening of thalassemia.

Lung cancer is the leading cause of cancer-related death， characterized by high invasiveness， early metastasis and poor prognosis. It has the highest incidence and mortality rates among cancers in China. Currently， the treatment of lung cancer is still dominated by the classic therapies such as surgery， radiotherapy， chemotherapy and targeted therapy. However， the classic therapies are not suitable for all patients with lung cancer， so new treatment strategies and methods are needed to prevent and treat lung cancer. In recent years， Ginseng Radix et Rhizoma has attracted wide attention in the field of anti-lung cancer research， and traditional Chinese medicine has a substantial theoretical and practical foundation in treating lung cancer. Ginseng Radix et Rhizoma ， as a commonly used Chinese herbal medicine， has the functions of replenishing vital Qi， replenishing veins， strengthening the spleen and lung， and nourishing body and blood. The main active components of Ginseng Radix et Rhizoma ， known as ginsenosides， exhibit anti-cancer and anti-inflammatory activities. Therefore， the mechanism and pharmacological activity of ginsenosides in the intervention of lung cancer have been extensively studied by researchers worldwide. The results show that ginsenosides can effectively inhibit the proliferation， invasion， migration， epithelial-mesenchymal transition and angiogenesis of lung cancer cells. Additionally， they inhibit drug resistance， enhance chemotherapy sensitivity and efficacy， and promote apoptosis and autophagy of lung cancer cells. Ginsenosides also modulate the tumor microenvironment and regulate immunity， thereby delaying the occurrence and development of lung cancer. The rapid advancements in related research have outpaced previous literature review， creating challenges for scholars seeking the latest information. Based on this， this article summarizes recent findings on the mechanism and pharmacological activities of ginsenosides in lung cancer intervention， aiming to provide new insights for the development of molecular biology， drug treatment research and clinical new drug research in lung cancer. It also provides the reference for further mechanism research.

Objective:To improve the users’ comfort of steady-state visual evoked potential (SSVEP)-based brain-computer interface (BCI) through high-frequency stimulation and overcome the problem of accuracy decline caused by high frequency by combining dual-frequency encoding.Methods:Two dual-frequency high-frequency 60-instruction paradigms based on left and right visual fields and checkerboard stimuli were designed based on the 25.5 - 39.6 Hz frequency. Thirteen subjects participated in the experiment, and spectrum and spatial characteristics analyses were performed on SSVEP signals. The filter bank parameters were optimized based on the spectrum characteristics. Extended canonical correlation analysis (eCCA), ensemble task-related component analysis (eTRCA), and task-discriminant component analysis (TDCA) were used for SSVEP recognition.Results:Stable SSVEP was successfully induced in both the left and right visual fields and the checkerboard grid paradigm. The left and right visual fields had high signal-to-noise ratios for the fundamental frequency and its harmonics and weak signal-to-noise ratios for intermodulation components, whereas the intermodulation components of the 2 stimulus frequencies of the checkerboard grid, f1 + f2, had significantly higher signal-to-noise ratios than the second harmonic components above 30 Hz, and there was also a f2 ? f1 component and a 2 f1 ? f2 component. Combined with brain topography, it can be seen that the f1 and f2 response components of the left and right visual fields are located on opposite sides of the visual field, while the checkerboard grids are both concentrated in the center of the occipital region. Regarding the lateralization of brain topography amplitude and signal-to-noise ratio, the mean values of the PO3 and PO4 signal-to-noise ratios at the stimulation frequency of the left and right visual fields are consistent with the contralateral response characteristics. The 5 fb ? 1 method is the optimal filter set setting method, and the recognition correctness rate of TDCA for the left and right visual fields is the highest. However, the comparison of the recognition correctness rate of tessellated lattice eTRCA and TDCA is not statistically significant ( P > 0.05). The information transmission rates of the three algorithms all increase and then decrease with the increase in data length. Conclusions:The designed dual-frequency, high-frequency SSVEP-BCI paradigm is able to better balance performance and comfort and provides a basis for practical large instruction set BCI design methods.

Background/Aims: The accuracy of endosonographers in diagnosing gastric subepithelial lesions (SELs) using endoscopic ultrasonography (EUS) is influenced by experience and subjectivity. Artificial intelligence (AI) has achieved remarkable development in this field. This study aimed to develop an AI-based EUS diagnostic model for the diagnosis of SELs, and evaluated its efficacy with external validation. Methods: We developed the EUS-AI model with ResNeSt50 using EUS images from two hospitals to predict the histopathology of the gastric SELs originating from muscularis propria. The diagnostic performance of the model was also validated using EUS images obtained from four other hospitals. Results: A total of 2,057 images from 367 patients (375 SELs) were chosen to build the models, and 914 images from 106 patients (108 SELs) were chosen for external validation. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the model for differentiating gastrointestinal stromal tumors (GISTs) and non-GISTs in the external validation sets by images were 82.01%, 68.22%, 86.77%, 59.86%, and 78.12%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in the external validation set by tumors were 83.75%, 71.43%, 89.33%, 60.61%, and 80.56%, respectively. The EUS-AI model showed better performance (especially specificity) than some endosonographers.The model helped improve the sensitivity, specificity, and accuracy of certain endosonographers. Conclusions We developed an EUS-AI model to classify gastric SELs originating from muscularis propria into GISTs and non-GISTs with good accuracy. The model may help improve the diagnostic performance of endosonographers. Further work is required to develop a multi-modal EUS-AI system.

There are few researches on the modulation effect of transcranial direct current stimulation(tDCS) on complex spatial cognition. Especially, the influence of tDCS on the neural electrophysiological response in spatial cognition is not yet clear. This study selected the classic spatial cognition task paradigm (three-dimensional mental rotation task) as the research object. By comparing the changes in behavior and event-related potentials in different modes of tDCS before, during and after the application of tDCS, this study analyzed the behavioral and neurophysiological effects of tDCS on mental rotation. The comparison between active-tDCS and sham-tDCS showed no statistically significant difference in behavior between different stimulation modes. Still, the changes in the amplitudes of P2 and P3 during the stimulation were statistically significant. Compared with sham-tDCS, the amplitudes of P2 and P3 in active-tDCS mode showed a greater decrease during the stimulation. This study clarifies the influence of tDCS on the event-related potentials of the mental rotation task. It shows that tDCS may improve the brain information processing efficiency during the mental rotation task. Also, this study provides a reference for an in-depth understanding and exploration of the modulation effect of tDCS on complex spatial cognition.
Transcranial Direct Current Stimulation ; Cognition ; Evoked Potentials ; Brain

Objective:To analyze the clinical efficacy of different treatment modalities and prognostic factors of patients with Masaoka-Koga stage Ⅲ thymoma.Methods:Clinical data of patients diagnosed with Masaoka-Koga stage Ⅲ thymoma admitted to Affiliated Cancer Hospital of Zhengzhou University from January 2000 to December 2018 were analyzed retrospectively. A total of 133 patients had complete treatment and follow-up data. Kaplan-Meier method was used to calculate the cumulative survival rate, log-rank method was used to compare the survival between two groups, and Cox regression model was used for multivariate analysis.Results:The median follow-up time was 50 months (3-221 months). The median overall survival (OS) was 51 (3-221) months, and the median disease-free survival (DFS) was 45 (2-221) months. The survival rate in the radical surgery group was better than that in the palliative surgery group. The 5- and 10-year OS rates in radical surgery group were 88.2% and 74.4% respectively, while in palliative surgery group were 51.8% and 32.4% respectively ( P<0.001). The 5- and 10-year DFS rates in radical surgery group were 72.2% and 45.5%, respectively, while in palliative surgery group were 32.3% and 16.1% respectively ( P=0.001). The OS in the surgery combined with radiotherapy group was better than that in the surgery alone group. The 5- and 10-year OS rates in the radical surgery group were 82.8% and 64.2% respectively, while in the palliative surgery group were 55.8% and 50.2% ( P=0.033). There was no significant difference in DFS between two groups ( P=0.176). Multivariate analysis showed that age < 50 years old ( HR=0.264, P=0.001), radical resection ( HR=0.134, P<0.001), surgery combined with radiotherapy ( HR=2.778, P=0.009) were independently associated with better OS. Age < 50 years old ( HR=0.550, P=0.046), radical resection ( HR=0.555, P=0.042), and invasion of single organ ( HR=0.111, P=0.003) were independently associated with better DFS. Conclusions:OS and DFS in patients undergoing radical surgery are significantly better than those in their counterparts treated with palliative surgery, which is the most important factor affecting prognosis. Surgery combined with radiotherapy yields better OS. It is necessary to design a rigorous and reasonable multicenter prospective study to evaluate the efficacy of various treatment modalities and prognostic factors.

Objective:To investigate the effect of peripheral blood neutrophil to lymphocyte ratio (NLR) and platelet distribution width (PDW) on the clinical prognosis of childhood medulloblastomaMethods:Clinical data and survival data of 76 pediatric patients who were diagnosed as medulloblastoma by post-operative pathology in the First Affiliated Hospital of Zhengzhou University from January 2009 to December 2016 were collected. Kaplan- Meier method was used to calculate the overall survival(OS) and progression free survival(EFS) rates, Log- rank test was employed to compare the survival rates of different groups, and Cox proportional hazards regression model was used for multivariate analysis. Results:The log- rank test revealed that 5-year PFS rate and OS rate (22.2%, 22.2%) in the high NLR group (NLR>4.94) were significantly lower than those in the low NLR group (NLR≤4.94) (45.6%, 55.7%), and the differences were statistically significant(PFS: P=0.009, OS: P=0.001), and the 5-year PFS and OS (52.3%, 66.5%) of the high PDW group (PDW>15.90) were significantly higher than those in the low PDW group (PDW ≤ 15.90) (27.1%, 32.5%), and the differences were statistically significant(PFS: P=0.032, OS: P=0.039). Univa-riate analysis showed that the extent of resection (PFS: P=0.006, OS: P=0.009), and postoperative radiotherapy (PFS: P=0.011, OS: P=0.001) and postoperative radiotherapy(PFS: P=0.011, OS: P=0.001) were the factors influencing the prognosis of children with medulloblastoma.Multivariate Cox proportional hazards regression model analysis suggested that no postoperative radiotherapy (PFS: P=0.048, OS: P=0.008), NLR>4.94 (PFS: P=0.023, OS: P=0.003) and PDW≤15.90 (PFS: P=0.028, OS: P=0.006) were the independent risk factors for the prognosis of childhood medulloblastoma. Conclusions:Increased NLR and decreased PDW indicate unfavorable prognosis of the childhood medulloblastoma.Therefore, preoperative NLR and PDW may be the potential prognostic markers for childhood medulloblastoma.