ObjectiveThis paper aims to systematically collect and organize ancient and modern clauses and studies containing Xieqingwan， excavate and analyze the key information of Xieqingwan， and provide a reference for facilitating the development of the classic formula Xieqingwan. MethodsThe composition， dosage， decocting methods， usage， and other key information of Xieqingwan in ancient traditional Chinese medicine books were collected and analyzed by means of literature research and metrological methods. The modern clinical application of Xieqingwan was summarized. ResultsA total of 42 pieces of effective data involving 32 ancient traditional Chinese medicine books were collected. Xieqingwan was first recorded in Xiaoer Yaozheng Zhijue. The drug origin of this formula is basically clear in the ancient traditional Chinese medicine books. The modern drug usage and decocting method were as follows： Angelicae Sinensis Radix， Gentianae Radix et Rhizoma， Chuanxiong Rhizoma， Gardenia seeds， Radix et Rhizoma Rhei， Notopterygii Rhizoma et Radix， and Saposhnikoviae Radix were grounded to fine powder， decocted with honey， and finally formed into pills with the size of a chicken head （1.5 g）. It was suggested that half a pill or one pill were taken for one dose with warm Lophatheri decoction and sugar. The indications and clinical application had developed from the recordings in Xiaoer Yaozheng Zhijue and evolved from pediatrics to ophthalmic otolaryngology， neurology， dermatology， digestion， and respiratory diseases. The main pathogenesis of these diseases is heat in the liver meridian and is treated. The effect of Xieqingwan is "clearing away heat and toxicity， removing fire and relaxing the bowels， and dispersing swelling and relieving pain". It is recommended to use the corresponding preparation methods in the 2020 Edition of Pharmacopoeia of the People's Republic of China. Modern clinical studies are centered around the clinical application of Xieqingwan， which is often modified and used in treating Tourette syndrome， herpes， febrile convulsion， sleepwalking， and insomnia. ConclusionThis paper conducts a thorough textual research of the key information of Xieqingwan， induces its historic evolution， and confirms its key information， so as to provide a reference for the future development of Xieqingwan.

In recent years， hyperuricemia （HUA） has shown a rapidly increasing incidence and tends to occur in increasingly young people， with a wide range of cardiac， renal， joint， and cancerous hazards and all-cause mortality associations. Western medicine treatment has limitations such as large liver and kidney damage， medication restriction， and easy recurrence. The intestine is the major extra-renal excretion pathway for uric acid （UA）， and the intestinal microecology can be regulated to promote UA degradation. It offers great potential to develop UA-lowering strategies that target the intestinal microecology， which are promising to provide safer and more effective therapeutic approaches. Traditional Chinese medicine （TCM） can treat HUA via multiple targets and multiple pathways from a holistic view， with low toxicity and side effects. Studies have shown that intestinal microecology is a crucial target for TCM in the treatment of HUA. However， its specific mechanism of action has not been fully elucidated. Focusing on the key role of intestinal microecology in HUA， this review explores the relationship between intestinal microecology and HUA in terms of intestinal flora， intestinal metabolites， intestinal UA transporters， and intestinal barriers. Furthermore， we summarize the research progress in TCM treatment of HUA by targeting the intestinal microecology， with the aim of providing references for the development of TCM intervention strategies for HUA and the direction of future research.

ObjectiveTo discuss the clinical manifestations and image features of Neuromyelitis Optica Spectrum Disorder （NMOSD）with respiratory insufficiency. We present a retrospective review about the use of double filtration plasmapheresis in the treatment of the acute attack of NMOSD in these patients. MethodsAll of our patients with central respiratory insufficiency who suffered attacks of NMOSD were retrospectively considered for inclusion. Extended Disability Status Scale（EDSS）scores were compared within six months after double membrane filtration plasma exchange. ResultsThe clinical data of the six patients included were analyzed. Magnetic Resonance Imaging confirmed that the demyelinating plaques in our patients could involve the medulla oblongata and upper spinal cord. They were managed by plasma exchange given as an initial therapy. The clinical symptoms improved significantly and the patients were successfully withdrawn from the ventilator，with EDSS scores significantly reduced （P<0.001）. ConclusionDemyelination of medulla oblongata and upper spinal cord in NMOSD may lead to acute life-threatening respiratory compromise， and early initiation of double filtration plasmapheresis can be a safe and effective treatment.

Objective To investigate the screening results and factors affecting abnormal detection rates among high-risk groups of esophageal cancer and to explore effective intervention measures. Methods We investigated and collected the information on gender, education level, age, marital status, symptoms of reflux esophagitis (heartburn, acid reflux, belching, hiccup, foreign body sensation in the pharynx, and difficulty swallowing), consumption of pickled vegetables, salt use, and esophageal cancer incidence of villagers in a natural village in Wenfeng District, Anyang City, Henan Province. Changes in reflux esophagitis symptoms in the high-incidence area of esophageal cancer before and after 16 years were observed, and the relationship of such changes with esophageal cancer was analyzed. Results In 2008, 711 cases were epidemiologically investigated, including 213 cases with one of the symptoms of reflux esophagitis such as heartburn, acid reflux, belching, hiccups, foreign body sensation in the pharynx, and difficulty swallowing (sorted in accordance with the abovementioned symptoms; if there are multiple symptoms, then the former is taken); 55 cases with at least two related symptoms, among which the most symptom was heartburn in 108 cases (15.1%); followed by acid reflux, belching, etc. In 2024, the same group of people was investigated, and eight people were missing because of relocation. A total of 703 people were successfully investigated, of which 189 cases (26.8%) had one of the symptoms of reflux esophagitis, such as heartburn (sorted in accordance with relevant symptoms, if there are multiple symptoms, then the former will be selected); 167 cases (23.7%) had at least two related symptoms, among which the most symptom was heartburn in 139 cases (19.7%); followed by acid reflux. Over 16 years, among the 703 people investigated, 45 cases had esophageal cancer and they had one or more of the abovementioned symptoms. No significant differences in the reflux esophagitis-like symptoms were found between 2008 and 2024 (P=0.26); no significant differences in the composition of reflux esophagitis-like symptoms were found between 2008 and 2024 (P=0.299). Conclusion The detection rate of reflux esophagitis-related symptoms in the population in a high-risk area of esophageal cancer has not decreased in the past 16 years, and the high-risk factors still exist. Esophageal cancer is closely related to reflux esophagitis, and clinical practice can provide early diagnosis and treatment for high-risk population.

The molecular mechanisms underlying the health-promoting effects of exercise remain to be fully elucidated. As a bridge between genetics, exercise and phenotype, metabolites can be detected in high throughput through metabolomics, offering valuable insights into mechanism elucidation and disease prediction. Metabolic homeostasis is intricately regulated by various factors, including enzyme activity and transporters. Integration of multiple omics technologies such as genomics, transcriptomics, and proteomics enables the comprehensive elucidation of the metabolic network modulated by exercise interventions and facilitates the identification of key metabolic markers. This review summarizes the current research advancements, biological functions, discovery methods, and applications of exercise-induced multi omics metabolic markers, furnishing a theoretical foundation for understanding the mechanisms of exercise-induced health benefits and enabling precision interventions. Relevant literatures from 2000 to 2025 were systematically retrieved from databases including PubMed, CNKI and other databases with the keywords such as “multi-omics”, “metabolic biomarkers”, “exercise”, “health”. Subsequently, the identified literature was meticulously screened to meet the specified criteria and was subsequently incorporated into the study. (1) Exercise induces profound alterations in metabolite levels within the body, with particular emphasis on markers associated with sugar, lipid, and protein metabolism being extensively investigated. As an intensity marker, lactate is implicated in the regulation of fat browning (UCP-1), angiogenesis (VEGF), mitochondrial function (PGC-1α) and metabolic homeostasis (HIF-1α/CES2). Following resistance training, pyruvate levels increase, and an aberrant pyruvate to lactate ratio (approximately 10) may indicate mitochondrial dysfunction. Supplementation with pyruvate has been shown to reduce weight and lipid levels. Ketone bodies regulate metabolism by inhibiting lipolytic enzyme activity and promoting insulin secretion. Plasma ketone body concentrations rise after high-intensity exercise, with levels positively associated with central fatigue. Carnitine levels elevate post-endurance training, and supplementation with carnitine has been linked to increased lean body mass and enhanced cognitive function in older individuals. Serum alanine levels rise following resistance training and, as a precursor of carnosine, supplementation can elevate carnosine concentration by 80%, exerting antioxidant and neuroprotective effects. Creatine, a pivotal molecule in phosphogen energy supply, exhibits a 93% increase in plasma levels post-marathon, with its metabolism intricately related to AMPK activation. (2) Metabolites play a crucial role in disease prediction, particularly in the context of cardiovascular disease where 18 metabolites including glycoprotein acetyl and ketone bodies have been shown to enhance the performance of prediction models. Similarly, in diabetes research, acylcarnitine and other metabolites can improve prediction model efficacy. The combination of multiple metabolites has been found to substantially enhance predictive capabilities for various conditions such as cancer, aging, and other risks, surpassing the predictive power of traditional indicators. (3) Genomics investigations have unveiled the genetic underpinnings of exercise-related metabolites. VO₂max, a significant exercise phenotype with heritability estimates ranging from 0.59 to 0.66, exhibits a negative correlation with the susceptibility to diabetes and cardiovascular disease. SNPs associated with VO₂max, such as variants in the FSHR gene, are positively linked to serum creatinine levels. Reduced creatinine levels have been associated with an elevated risk of T2DM. These findings suggest that creatinine serves as a potential marker of exercise metabolism. (4) Transcriptomic studies have elucidated the molecular mechanisms by which exercise modulates metabolites. Acute exercise induces rapid alterations in the expression profiles of 9 132 transcripts. Exercise elicits upregulation of genes involved in the fructose/mannose metabolic pathway (such as SORD, PFKFB3), suggesting these metabolites may serve as pivotal mediators in the beneficial effects of exercise on Parkinson’s disease. Altitude training enhances the expression of the PHOSPHO1 gene, which encodes an enzyme facilitating choline synthesis. Choline deficiency has been linked to insulin resistance. Choline supplementation has been shown to augment the effects of resistance training, underscoring the significance of choline as a key marker in exercise-mediated metabolic health promotion. (5) Proteomic analyses have unveiled the key mechanisms through which exercise modulates metabolism. Endurance training induces significant alterations in myofibrillar expression, with 237 slow muscles and 172 fast muscles proteins showing differential regulation, of which 65% are associated with metabolism, including ACSL1 and ECHS1. Various training modalities elicit distinct phosphorylation modifications, exemplified by the negative correlation between LDHA3 phosphorylation and lactate levels. Endurance training upregulates SLC25A15 expression in adipose tissue, enhancing arginine synthesis. The post-exercise elevation of plasma GPLD1 levels mimics the neuroprotective effects of exercise on the brain. These findings present novel targets for investigating exercise-related metabolic markers. The application of multi omics technologies has expedited the identification and mechanistic analysis of both established and novel sports-related metabolic markers like lactate. Integrated multi omics strategies (e.g., genome-metabolome) enable the simultaneous examination of metabolic markers and their regulatory mechanisms, facilitating the discovery of exercise-related genetic markers and pivotal regulatory proteins. However, challenges persist, including inadequate data integration and a lack of standardization. Future endeavors should focus on developing dynamic monitoring tools, integrating state-of-the-art approaches such as single-cell/spatial omics, and leveraging AI algorithms for optimized analysis to construct precise predictive models for maximizing health benefits in exercise.

Based on the discussion of "eight weak areas" in The Inner Canon of Yellow Emperor （《黄帝内经》）， combined with the typical rash manifestations of atopic dermatitis， it is believed that atopic dermatitis is mostly deficiency-excess complex， and that pathogens intruding eight weak areas are the core of its pathogenesis. The external cause is exterior deficiencies， with heat， wind， dampness and other pathogenic qi attacking. The heart， lungs， kidneys out of balance， and excess pathogen are the internal cause， in which fire constraint and excessive heat are the basis of the disease， the wind invading leads to the progress of the changes， dampness obstructing channels and colla-terals make the condition persistent. Internal and external pathogens combination and retention result to the course of the disease lingering and difficult to cure. The internal treatment is to regulate zang-fu organs， and the formula could use self-prescribed modified Qingrun Tongluo Decoction （清润通络汤）， clearing heart and reducing fire in order to clear the heat and cool the blood， moistening lungs and generating metal to consolidate the exterior and dispel the wind， and nourishing kidneys and draining water to dispel the dampness and activate the collaterals. The external treatment applies maceration， fire acupuncture， wrapping to dredge the eight weak areas and regulate qi and blood in channel， so as to expel pathogens.

Objective To investigate the mechanism and protective effect of Humanin(HN)on rotenone(Rot)-induced toxic damage for dopamine neurons.Methods The Rot-poisened PC12 cell model was constructed,and the control group,the Rot poisening group,the HN pretreated Rot poisening group,and the HN treatment group were set up.ELISA was used to detect the content of HN inside and outside of Rot-infected cells,CCK-8 assay was used to detect cell viability,and ATP detection kit was used to detect the intracellular ATP content.Dichloro-dihydro-fluorescein diacetate(DCFH-DA)assay was used to detect the level of reactive oxygen species(ROS)in cells.Western blotting was performed to detect the expression level of mitochondrial autophagy regulatory proteins Pink1,Parkin,p62,LC3,mitochondrial biogenesis regulatory protein PGC1α,division/fusion regulatory proteins OPA1,MFN2,DRP1,p-DRP1 and antioxidant stress regulatory proteins Keap1 and Nrf2.HBAD-mcherry-EGFP-LC3 adenovirus transfected cells was used to observed the number of autophagosomes and autophagolysosomes.Results The results showed that the intracellular concentration of HN in PC12 in the Rot poisening group was significantly higher than that in the control group(P＜0.05);Compared with the control group,the Rot poisening group had significantly decreased activity of PC12 cells,decreased ATP content and increased production of ROS.After the poisen of Rot in PC12 cells,the expression of Pink1 and p-Parkin,the ratio of LC3Ⅱ/LC3Ⅰ and the expression of p-DRP1 in mitochondrial fusion protein was increased,while the expression of p62,the expression of mitochondrial biogenesis protein PGC1 α,mitochondrial fusion proteins MFN2 and OPA1,and antioxidant stress proteins Keap1 and Nrf2 were decreased(all P＜0.05).The number of autophagosomes and autophagolysosomes in PC12 cells in the Rot poisening group was higher than that in the control group(P＜0.05),and HN pretreatment(20 μmol/L)could significantly improve the changes mentioned above caused by Rot poisening(P＜0.05).Conclusion HN ameliorates Rot-induced toxic damage for dopamine neurons by inhibiting mitophagy and mitochondrial division and promoting mitochondrial biogenesis and fusion,and anti-oxidative stress.

Objective:To optimize the preventive maintenance path of electric medical equipment by adopting multi-criteria decision analysis(MCDA),and to verify its optimization effect.Methods:The preventive maintenance paths for electric medical equipment were determined through literature research and management group discussions.An expert meeting was organized to discuss,determine,and demonstrate the preventive maintenance path evaluation criteria,and the weight of the criteria was set.Each preventive maintenance path was scored by experts based on criteria,the score of each maintenance path was calculated using the mean and sorted to form the optimal path.767 electric medical equipment of 7 categories in clinical use in the 960th Hospital of the PLA Joint Logistics Support Force from 2021 to 2022 were selected,conventional preventive maintenance management(referred to as conventional management mode)and preventive maintenance path management optimized by MCDA method(referred to as MCDA management mode)were adopted respectively according to different management modes.The changes in indicators such as failure rate,maintenance time,quality inspection pass rate and maintenance cost of electric medical equipment were compared between the two management models.Results:The failure occurrence rate of electric medical equipment of the MCDA management mode was 8.71%(67/767),which was lower than that of the conventional management mode,the difference was statistically significant(x2=3.960,P<0.05).The equipment maintenance time of the MCDA management mode was(2.24±1.17)days,which was lower than that of the conventional management mode,the difference was statistically significant(t=2.360,P<0.05).The quality inspection qualification rate of the MCDA management model was(96.57±2.74)%,which was higher than that of the conventional management mode,the difference was statistically significant(t=4.342,P<0.05).The average maintenance cost of equipment of the MCDA management model accounted for 2.37%of its assets,which was lower than that of the conventional management mode,the difference was statistically significant(x2=4.261,P<0.05).Conclusion:The MCDA method can provide a quantitative structural model for the optimization of preventive maintenance paths for electric medical equipment,and the optimized preventive maintenance paths can achieve efficient management of electric medical equipment,and focusing on the training of maintenance personnel's technical level can increase the self-repair rate and reduce the failure rate of medical equipment.

Objective:To investigate the prediction of the tumor proliferation antigen(Ki-67) expression status in breast cancer patients based on ultrasound radiomics combined with clinicopathologic features.Methods:Breast cancer patients who underwent 2D ultrasound and Ki-67 examination from January 2018 to February 2022 in Changzhou Second People′s Hospital, Nanjing Medical University were retrospectively analyzed. Among them, 427 patients from Chengzhong campus were randomly divided into training and validation sets in the ratio of 8∶2, and 229 patients from Yanghu campus were used as an independent external test set. Radiomics features were extracted from the region of interest of 2D ultrasound images, and the Mann-Whitney U test, recursive feature elimination, and minimum absolute shrinkage and selection operators were used to perform feature dimensionality reduction and to establish a radiomics score(Rad-score). Subsequently, single/multifactor logistic regression regression analyses were used to construct a joint prediction model based on Rad-score and clinicopathological features. Model performance and utility were assessed using the subject operating characteristic area under the curve (AUC), calibration curve, and decision curve analyses. Results:The AUCs of the joint model for predicting Ki-67 expression status in breast cancer in the training, validation, and test sets were 0.858, 0.797, and 0.802, respectively, which were superior to those of the radiomics (0.772, 0.731, and 0.713) and clinical models (0.738, 0.750, and 0.707). Calibration curve and decision curve analyses indicated that the joint model had good calibration and clinical value.Conclusions:A joint model based on ultrasound radiomics and clinicopathological features can effectively predict the Ki-67 expression status of breast cancer, which is expected to become a non-invasive tool for Ki-67 detection and provide clinicians with an important auxiliary diagnostic and therapeutic decision-making basis.

Objective:To evaluate the feasibility of 3D reconstruction techniques based on multi-depth cameras for daily patient positioning in radiotherapy.Methods:Through region of interest (ROI) extraction, filtering, registration, splicing and other processes, multi-depth cameras (Intel RealSense D435i) were used to fuse point clouds in real-time manner to obtain the real optical 3D surface of patients. The reconstructed surface was matched with the external contour of the localization CT to complete the positioning. In this article, the feasibility of the system was validated by using multiple models. Clinical feasibility of 5 patients with head and neck radiotherapy, 10 cases of chest radiotherapy and 5 cases of pelvic radiotherapy was also validated. The data of each group were analyzed by paired t-test. Results:The system running time was 0.475 s, which met the requirement of real-time monitoring. The six-dimensional registration errors in the model experiment were (1.00±0.74) mm, (1.69±0.69) mm, (1.36±0.87) mm, 0.15°±0.14°, 0.25°±0.20°, 0.13°±0.13° in the x, y, z, rotational, pitch and roll directions, respectively. In the actual patient positioning, the mean positioning errors were (0.77±0.51) mm, (1.24±0.67) mm, (0.94±0.76) mm, 0.61°±0.41°, 0.69°±0.55°, and 0.52°±0.35° in the x, y, z, rotational, pitch and roll directions, respectively. The translational error was less than 2.8 mm, and the positioning error was the largest in the pelvic region. Conclusions:Real-time 3D reconstruction techniques based on multi-depth cameras is applicable for patient positioning during radiotherapy. The method is accurate in positioning and can detect the small movement of the patient's position, which meets the requirements of radiotherapy.