Advances in the management of arteriosclerosis of the lower extremity:Integrating Western and Chinese medicine approaches

This editorial provides a commentary on the recent article.The paper reviews current literature and explores innovative treatment strategies for lower extremity arteriosclerosis obliterans(LEASO)through an integrative approach.It highlights the effectiveness of combination therapies that merge traditional Chinese medicine(TCM)with Western medical practices,suggesting that such integrative methods may improve patient compliance and outcomes through personalized care.This paper stresses the importance of rigorous clinical trials to evaluate the efficacy and safety of TCM interventions within LEASO treatment protocols,advocating for evidence-based validation of these combined therapies.Our recommendations emphasize accurate diagnosis,appropriate pharmacological in-terventions,the use of advanced surgical and endovascular techniques,and the inclusion of TCM to address underlying dysfunctions.Additionally,continuous monitoring,patient education,and lifestyle modifications are essential to slow disease progression and achieve optimal patient outcomes.The paper concludes by calling for further research to develop standardized treatment protocols that effectively integrate both Western and Chinese medical approaches in managing LEASO.

Etiology analysis for term newborns with severe hyperbilirubinemia in eastern Guangdong of China

BACKGROUND Neonatal hyperbilirubinemia is one of the common diseases of newborns that typically presents with yellow staining of skin,resulting in sequelaes such as hearing loss,motor and intellectual development disorders,and even death.The pathogenic factors of neonatal hyperbilirubinemia are complex.Different cases of hyperbilirubinemia may have a single or mixed etiology.AIM To explore the etiological characteristics of severe hyperbilirubinemia in term newborns of eastern Guangdong of China.METHODS Term newborns with severe hyperbilirubinemia in one hospital from January 2012 to December 2021 were retrospectively analyzed.The etiology was determined according to the laboratory results and clinical manifestations.RESULTS Among 1602 term newborns with hyperbilirubinemia in eastern Guangdong of China,32.20%(580/1602)was severe hyperbilirubinemia.Among the causes of severe hyperbilirubinemia,neonatal hemolysis accounted for 15.17%,breast milk jaundice accounted for 12.09%,infection accounted for 10.17%,glucose-6-phosphate dehydrogenase(G6PD)deficiency accounted for 9.14%,and the coexistence of multiple etiologies accounted for 6.55%,unknown etiology accounted for 41.72%.ABO hemolysis and G6PD deficiency were the most common causes in the 20 cases with bilirubin encephalopathy.94 severe hyperbilirubinemia newborns were tested for uridine diphosphate glucuronosyl transferase 1A1(UGT1A1)*6 variant(rs4148323,c.211G>A,p.Arg71Gly),9 cases were 211 G to A homozygous variant,37 cases were 211 G to A heterozygous variant,and 48 cases were wild genotypes.CONCLUSION The main cause for severe hyperbilirubinemia and bilirubin encephalopathy in eastern Guangdong of China were the hemolytic disease of the newborns,G6PD deficiency and infection.UGT1A1 gene variant was also a high-risk factor for neonatal hyperbilirubinemia.Targeted prevention and treatment according to the etiology may reduce the occurrence of bilirubin encephalopathy and kernicterus.

Unraveling magnetic properties and martensitic transformation in Mn-rich Ni-Mn-Sn alloys:first-principles calculations and experiments

We have investigated the phase stability,magnetic properties,and martensitic transformation thermodynamics/kinetics of the Ni_(24-x)Mn_(18+x+y)Sn_(6-y)(x,y=0,1,2)system by combining the first-principles calculations and experiments.The calculation results show that the optimized lattice parameters are consistent with the experimental data.Respectively,we obtain the relation equation for the austenite formation energy(E_(form-A))and Mn content(X_(Mn)):E_(form-A)=507.358X_(Mn)-274.126,as well as for the six-layer modulated(6M)martensite formation energy(E_(form-6M))and Ni content(X_(Ni)):E_(form-6M)=-728.484X_(Ni)+264.374.The ternary phase diagram of the total magnetic moment was established.The excess Mn will reduce the total magnetic moment of 6M(Mag6M)and non-modulated(NM)(MagNM)martensites,with the following equations relating the total magnetic moment and Mn content:Mag_(6M)=-15.905X_(Mn)+7.902and Mag_(NM)=-14.781X_(Mn)+7.411,while the effect on austenite is complex.The variation of total magnetic moment is mainly dominated by the Mn atomic magnetic moment.The 3d electrons of Mn_(Sn)(Mn at Sn sublattice)play an important role in magnetic properties from the perspective of the electronic density of states.Based on the thermodynamics of martensitic transformation,the alloys will likely undergo austenite?6M?NM transformation sequence.Combining the thermodynamic and kinetic results,the martensitic transformation temperature decreases with x increasing and increases with y increasing.These results are expected to provide reference for predicting the phase stability and magnetic properties of NiMn-Sn alloys.

Suppression of MyD88 disturbs gut microbiota and activates the NLR pathway and hence fails to ameliorate DsS-inducedcolitis

Background:Myeloid differentiation factor 88(MyD88)is the core adaptor for Toll-like receptors defending against microbial invasion and initiating a downstream immune response during microbiota-host interaction.However,the role of MyD88 in the pathogenesis of inflammatory bowel disease is controversial.This study aims to investigate the impact of MyD88 on intestinal inflammation and theunderlyingmechanism.Methods:MyD88 knockout(MyD88^(-/-))mice and the MyD88 inhibitor(TJ-M2010-5)were used to investigate the impact of MyD88 on acute dextran sodium sulfate(Dss)-induced colitis.Disease activity index,colon length,histological score,and inflammatory cytokines were examined to evaluate the severity of colitis.RNA transcriptome analysis and 16S rDNA sequencing were used to detect the potential mechanism.Results:In an acute DSS-colitis model,the severity of colitis was not alleviated in MyD88^(-/-)mice and TJ-M2010-5-treated mice,despite significantly lower levels of NF-kB activation being exhibited compared to control mice.Meanwhile,16S rDNA sequencing and RNA transcriptome analysis revealed a higher abundance of intestinal Proteobacteria and an up-regulation of the nucleotide oligomerization domain-like receptors(NLRs)signaling pathway in colitis mice following MyD88 suppression.Further blockade of the NLRs signaling pathway or elimination of gut microbiota with broad-spectrum antibiotics in DsS-induced colitis mice treated with TJ-M2010-5 ameiorated the disease severity,which was not improved solely by MyD88 inhibition.After treatment with broad-spectrum antibiotics,downregulation of the NLR signaling pathway was observed.Conclusion:Our study suggests that the suppression of MyD88 might be associated with unfavorable changes in the composition of gut microbiota,leading to NLR-mediated immune activation and intestinal inflammation.

Unfused-ring Acceptors with Dithienobenzotriazole Core for Efficient Organic Solar Cells

In recent years, non-fullerene acceptors(NFAs) with unfused-ring structure have received extensive attention due to their flexible combination of building blocks and relatively simple synthetic routes. In this work, three new A-D-C-D-A type unfused-ring acceptors(UFAs),named DTBTz EH-IC2F, DTBTz Me-IC2F and DTBTz Me-IC2Cl, were designed and synthesized with dithienobenzotriazole(DTBTz) as the core.Through modification of alkyl chain on the DTBTz unit and change of halogen atoms on the cyanoindanone end groups, the differences in optoelectronic properties of these three small molecule acceptors were investigated. The results show that changes in alkyl chain and halogen atom endow UFAs with different features, including shift in absorption, changes in energy level and molecular packing. When blended with donor PBDB-T, the organic solar cell based on DTBTz Me-IC2Cl achieves the highest device efficiency of 12.3%, while DTBTz EH-IC2F-based device obtains 11.5% efficiency and DTBTz Me-IC2F-based device obtains 12.0% efficiency. The stability tests show that all the devices obtain good efficiency retention rates. These results demonstrate that the introduction of a rigid aromatic ring DTBTz as an intermediate core not only effectively results in highly planar A-D-C-D-A small molecules, but also provides a new reference for the design and development of UFAs in OSCs.

Submucosal tunneling endoscopic biopsy and myotomy for management of unknown esophageal stenosis

Introduction Esophageal stenosis is usually congenital or secondary to esophageal injury,esophagitis,and esophageal neoplasia[1,2].The mainstay treatment for benign esophageal stenosis is dilatation with either balloons or esophageal bougienage[3,4].A self-expandable metal stent(SEMS)is recommended for malignant and refractory esophageal stenosis[5].The treatment can be distinct according to different etiology.Endoscopic ultrasonography-guided fine-needle aspiration/biopsy(EUS-FNA/FNB)may be conducive to clarifying the etiology of esophageal stenosis.However,the small amount of tissue obtained by EUS-FNA/FNB may provide less pathological information.Here we report a new technique—submucosal tunneling endoscopic biopsy and myotomy(STEBM)derived from the peroral endoscopic myotomy(POEM)procedure to relieve stenosis and get a sufficient amount of tissue to make a definite diagnosis.