Experimental Study on the Treatment of Gallbladder Distention by Dahuang Lingxian Prescription

Objective: To investigate the mechanism of inhibiting the secretion of “lithogenic bile” and treating gallbladder distention with the TCM prescription Dahuang Lingxian. Methods: Forty SPF-grade SD male mice were randomly divided into blank control group, model group, ursodeoxycholic acid group and TCM group, 10 mice in each group. The blank control group was kept normally, and the model group, ursodeoxycholic acid group and TCM group were established as gallbladder distention models. The blank control group and the model group were given 1.5 ml of saline by gavage daily;the ursodeoxycholic acid group was given 100 mg/kg/d of a mixture of saline and ursodeoxycholic acid capsules by gavage daily;the TCM group was given 39 g/kg/d of aqueous decoction of Dahuang Lingxian Prescription by gavage daily. After 6 weeks of continuous intervention, all mice were executed and the lithogenesis rate, ultrastructure and mRNA expression were observed. Results: The lithogenesis rate of mice in the TCM group was significantly reduced (P β1/Smads pathway was significantly improved (P < 0.05), which could achieve the same therapeutic effect as ursodeoxycholic acid capsules. Conclusion: Dahuang Lingxian Prescription can reduce the secretion of “lithogenic bile” by inhibiting the inflammatory reaction and fibrosis of biliary system. Dahuang Lingxian Prescription has certain advantages in the treatment of gallbladder distention.

Experimental Study of Moist Exposed Burn Therapy/Moist Exposed Burn Ointment Combined with Zhuang Medicine Detoxification for Chronic Refractory Wound Healing

Background: This is still a public problem that needs to be solved urgently: chronic and refractory wound healing with long course and complex pathological mechanism. At present, there is still a lack of effective clinical treatment. This study, therefore, aims at exploring moist exposed burn therapy/moist exposed burn ointment (MEBT/MEBO) combined with Zhuang medicine detoxification in the treatment of chronic refractory wound healing. Methodology: 100 SPF Wistar rats were randomly divided into blank control group, model control group, MEBO group, Zhuang medicine group and Combined group, with 20 rats in each group. Open wound model was established in blank control group, and chronic refractory wound model was established in other groups. Black control group and model control group were given food and water freely, MEBO group was given dressing change once a day, Zhuang medicine group was given intragastric administration once a day, and combined group was given dressing change and intragastric administration once a day. The effective rate of wound healing was observed after 12 days of continuous intervention. Conclusion: Skin regeneration medical technique combined with Zhuang medicine poison theory can effectively reduce the symptoms of bleeding and exudation, reduce the area of wound, shorten the healing time of wound, and achieve physiological healing of wound. It has a good effect on chronic refractory wound.

A performance-based hybrid deep learning model for predicting TBM advance rate using Attention-ResNet-LSTM

The technology of tunnel boring machine(TBM)has been widely applied for underground construction worldwide;however,how to ensure the TBM tunneling process safe and efficient remains a major concern.Advance rate is a key parameter of TBM operation and reflects the TBM-ground interaction,for which a reliable prediction helps optimize the TBM performance.Here,we develop a hybrid neural network model,called Attention-ResNet-LSTM,for accurate prediction of the TBM advance rate.A database including geological properties and TBM operational parameters from the Yangtze River Natural Gas Pipeline Project is used to train and test this deep learning model.The evolutionary polynomial regression method is adopted to aid the selection of input parameters.The results of numerical exper-iments show that our Attention-ResNet-LSTM model outperforms other commonly-used intelligent models with a lower root mean square error and a lower mean absolute percentage error.Further,parametric analyses are conducted to explore the effects of the sequence length of historical data and the model architecture on the prediction accuracy.A correlation analysis between the input and output parameters is also implemented to provide guidance for adjusting relevant TBM operational parameters.The performance of our hybrid intelligent model is demonstrated in a case study of TBM tunneling through a complex ground with variable strata.Finally,data collected from the Baimang River Tunnel Project in Shenzhen of China are used to further test the generalization of our model.The results indicate that,compared to the conventional ResNet-LSTM model,our model has a better predictive capability for scenarios with unknown datasets due to its self-adaptive characteristic.

Intrahepatic portal venous systems in adult patients with cavernous transformation of portal vein: Imaging features and a new classification

Background: Cavernous transformation of the portal vein(CTPV) due to portal vein obstruction is a rare vascular anomaly defined as the formation of multiple collateral vessels in the hepatic hilum. This study aimed to investigate the imaging features of intrahepatic portal vein in adult patients with CTPV and establish the relationship between the manifestations of intrahepatic portal vein and the progression of CTPV. Methods: We retrospectively analyzed 14 CTPV patients in Beijing Tsinghua Changgung Hospital. All patients underwent both direct portal venography(DPV) and computed tomography angiography(CTA) to reveal the manifestations of the portal venous system. The vessels measured included the left portal vein(LPV), right portal vein(RPV), main portal vein(MPV) and the portal vein bifurcation(PVB). Results: Nine males and 5 females, with a median age of 40.5 years, were included in the study. No significant difference was found in the diameters of the LPV or RPV measured by DPV and CTA. The visualization in terms of LPV, RPV and PVB measured by DPV was higher than that by CTA. There was a significant association between LPV/RPV and PVB/MPV in term of visibility revealed with DPV( P = 0.01), while this association was not observed with CTA. According to the imaging features of the portal vein measured by DPV, CTPV was classified into three categories to facilitate the diagnosis and treatment. Conclusions: DPV was more accurate than CTA for revealing the course of the intrahepatic portal vein in patients with CTPV. The classification of CTPV, that originated from the imaging features of the portal vein revealed by DPV, may provide a new perspective for the diagnosis and treatment of CTPV.

Assessing cutter-rock interaction during TBM tunnelling in granite:Large-scale standing rotary cutting tests and 3D DEM simulations

The widespread utilisation of tunnel boring machines(TBMs)in underground construction engineering requires a detailed investigation of the cutter-rock interaction.In this paper,we conduct a series of largescale standing rotary cutting tests on granite in conjunction with high-fidelity numerical simulations based on a particle-type discrete element method(DEM)to explore the effects of key cutting parameters on the TBM cutter performance and the distribution of cutter-rock contact stresses.The assessment results of cutter performance obtained from the cutting tests and numerical simulations reveal similar dependencies on the key cutting parameters.More specifically,the normal and rolling forces exhibit a positive correlation with penetration but are slightly influenced by the cutting radius.In contrast,the side force decreases as the cutting radius increases.Additionally,the side force shows a positive relationship with the penetration for smaller cutting radii but tends to become negative as the cutting radius increases.The cutter's relative effectiveness in rock breaking is significantly impacted by the penetration but shows little dependency on the cutting radius.Consequently,an optimal penetration is identified,leading to a low boreability index and specific energy.A combined Hertz-Weibull function is developed to fit the cutter-rock contact stress distribution obtained in DEM simulations,whereby an improved CSM(Colorado School of Mines)model is proposed by replacing the original monotonic cutting force distribution with this combined Hertz-Weibull model.The proposed model outperforms the original CSM model as demonstrated by a comparison of the estimated cutting forces with those from the tests/simulations.The findings from this work that advance our understanding of TBM cutter performance have important implications for improving the efficiency and reliability of TBM tunnelling in granite.

2023: Weather and Climate Extremes Hitting the Globe with Emerging Features

Globally,2023 was the warmest observed year on record since at least 1850 and,according to proxy evidence,possibly of the past 100000 years.As in recent years,the record warmth has again been accompanied with yet more extreme weather and climate events throughout the world.Here,we provide an overview of those of 2023,with details and key background causes to help build upon our understanding of the roles of internal climate variability and anthropogenic climate change.We also highlight emerging features associated with some of these extreme events.Hot extremes are occurring earlier in the year,and increasingly simultaneously in differing parts of the world(e.g.,the concurrent hot extremes in the Northern Hemisphere in July 2023).Intense cyclones are exacerbating precipitation extremes(e.g.,the North China flooding in July and the Libya flooding in September).Droughts in some regions(e.g.,California and the Horn of Africa)have transitioned into flood conditions.Climate extremes also show increasing interactions with ecosystems via wildfires(e.g.,those in Hawaii in August and in Canada from spring to autumn 2023)and sandstorms(e.g.,those in Mongolia in April 2023).Finally,we also consider the challenges to research that these emerging characteristics present for the strategy and practice of adaptation.

High-throughput screening system of citrus bacterial cankerassociated transcription factors and its application to the regulation of citrus canker resistance

One of the main diseases that adversely impacts the global citrus industry is citrus bacterial canker(CBC),caused by the bacteria Xanthomonas citri subsp.citri(Xcc).Response to CBC is a complex process,with both proteinDNA as well as protein–protein interactions for the regulatory network.To detect such interactions in CBC resistant regulation,a citrus high-throughput screening system with 203 CBC-inducible transcription factors(TFs),were developed.Screening the upstream regulators of target by yeast-one hybrid(Y1H)methods was also performed.A regulatory module of CBC resistance was identified based on this system.One TF(CsDOF5.8)was explored due to its interactions with the 1-kb promoter fragment of CsPrx25,a resistant gene of CBC involved in reactive oxygen species(ROS)homeostasis regulation.Electrophoretic mobility shift assay(EMSA),dual-LUC assays,as well as transient overexpression of CsDOF5.8,further validated the interactions and transcriptional regulation.The CsDOF5.8–CsPrx25 promoter interaction revealed a complex pathway that governs the regulation of CBC resistance via H2O2homeostasis.The high-throughput Y1H/Y2H screening system could be an efficient tool for studying regulatory pathways or network of CBC resistance regulation.In addition,it could highlight the potential of these candidate genes as targets for efforts to breed CBC-resistant citrus varieties.

Systematic analysis and functional verification of citrus glutathione S-transferases reveals that CsGSTF1 and CsGSTU18contribute negatively to citrus bacterial canker

Citrus bacterial canker(CBC) is resulted from Xanthomonas citri subsp. citri(Xcc) infection and poses a significant threat to citrus production.Glutathione S-transferases(GSTs) are critical in maintaining redox homeostasis in plants, especially in relation to abiotic and biotic stress responses. However, the function of GSTs in resisting CBC remains unclear. Here, citrus glutathione S-transferases were investigated applying a genome-wide approach. In total, 69 CsGSTs belonging to seven classes were identified, and the phylogeny, chromosomal distribution, gene structures and conserved motifs were analyzed. Several CsGSTs responded to Xcc infection, as observed in the upregulation of CsGSTF1 and CsGSTU18 in the CBC-sensitive ‘Wanjincheng' variety but not in the resistant ‘Kumquat' variety. CsGSTF1 and CsGSTU18 were localized at the cytoplasm. Transient overexpression of CsGSTF1 and CsGSTU18 mediated reactive oxygen species(ROS) scavenging, whereas the virus-induced gene silencing(VIGS) of CsGSTF1 and CsGSTU18 caused strong CBC resistance and ROS burst. The present study investigated the characterization of citrus GST gene family, and discovered that CsGSTF1 and CsGSTU18 negatively contributed to CBC through modulating ROS homeostasis. These findings emphasize the significance of GSTs in infection resistance in plants.

Magnetic and electronic properties of La-doped hexagonal 4H-SrMnO_(3)

As typical strongly correlated electronic materials, manganites show rich magnetic phase diagrams and electronic structures depending on the doped carrier density. Most previous relevant studies of doped manganites rely on the cubic/orthorhombic structures, while the hexagonal structure is much less studied. Here first-principles calculations are employed to investigate the magnetic and electronic structures of La-doped 4H-SrMnO_(3). By systematically analyzing the two kinds of La-doped positions, our calculations predict that the doped electron with lattice distortion would prefer to form polarons, which contribute to the local magnetic phase transition, nonzero net magnetization, and semiconducting behavior. In addition, the energy gap decreases gradually with increasing doping concentration, indicating a tendency of insulator–metal transition.

Systemic inflammatory index as a predictive marker for the severity of coronary artery disease in individuals with chronic kidney disease

Objective To evaluate the correlation between the inflammatory intensity,as indicated by the systemic inflammatory index(SII),and the severity of coronary artery disease(CAD)in patients with chronic kidney disease(CKD).Methods A total of 280 CKD patients who underwent coronary angiography were enrolled.CAD was evaluated using the Gen-sini score(GS).Patients were divided into the low,medium and high SII groups according to the tertiles of the SII values.Logist-ic regression analysis was conducted to analyze the relationship between SII and GS.The cutoff points for the sensitivity and spe-cificity of SII in predicting GS were estimated by performing the receiver operating characteristic curve analysis.Results Patients in the higher SII group had a higher prevalence of CAD(P=0.013).In addition,the high SII group had more pa-tients with complex CAD(triple-vessel disease and/or left main coronary artery stenosis)and chronic total occlusion lesions,and more patients required revascularization(P<0.05).Correlation analysis suggested a positive relationship between SII and GS,and in comparison to neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio,SII displayed a stronger correlation with GS(r=0.332,P<0.001).Multifactorial logistic regression analysis revealed that SII is independently associated with the severity of CAD(adjusted OR=1.14,95%CI:1.08-1.21,P<0.01),particularly among elderly patients(age≥65 years).Receiver operating charact-eristic curve analysis indicated that the optimal cutoff value for SII in predicting severe coronary artery stenosis(GS>60)was 6.01(sensitivity:76.30%,specificity:53.50%),with an area under the curve(AUC)of 0.705(95%CI:0.642-0.768,P<0.001),which was sta-tistically significantly better than platelet-to-lymphocyte ratio(AUC=0.646,95%CI:0.579-0.713,P<0.001)and neutrophil-to-lym-phocyte ratio(AUC=0.643,95%CI:0.574-0.712,P<0.001).Conclusions In patients with CKD,SII is independently associated with the severity of CAD,especially in individuals aged 65 ye-ars or older.Furthermore,SII functions as a predictive marker for the severity of coronary lesions.

A treatment recommendation for trichoepithelioma:Thoughts on selection of treatment timing and method

In this report,we present the case of a 55-year-old woman with a 30-year history of multiple familial trichoe-pithelioma(MFT),with facial surface tumors that progressively worsened,causing ventilation disorders.In order to improve the patient’s appearance and functional impairment,we performed a two-step surgical excision and skin grafting procedure post diagnosis through genetic testing.The 18-month follow-up confirmed that the effect was satisfactory without obvious recurrence.Based on this outcome,we have developed a diagnosis and treat-ment process for patients with MFT,aiming to provide a reference for standardized treatment of this rare disease.

Efficacy and safety of ulinastatin in the treatment of septic shock:a systematic review and meta-analysis

Background:Septic shock is a common systemic inflammatory response syndrome for critical patients in the intensive care unit.Ulinastatin is currently used for the treatment of septic shock.Our study sought to evaluate the efficacy and safety of ulinastatin in the treatment of septic shock patients.Methods:Three English databases(Embase,Medline,and Cochrane Library)and four Chinese databases(China National Knowledge Infrastructure,Wanfang data,SinoMed,and VIP)were searched for published randomized controlled trials.Stata 16.0 software was used to conduct the meta-analysis.Results:A total of 48 articles were included(Chinese article 47,1 in English).The results show that the treatment of ulinastatin could reduce mortality(risk ratio=0.63,95%confidence interval(CI)(0.55,0.72)),multiple organ dysfunction syndrome(risk ratio=0.6,95%CI(0.53,0.68)),length of intensive care unit stay(mean difference(MD)=-3.92,95%CI(-4.65,-3.18)),length of hospital stay(MD=-4.39,95%CI(-6.63,-2.15))and decrease Acute Physiology and Chronic Health Evaluation II score(MD=-4.55,95%CI(-5.63,-3.47))and Sequential Organ Failure Assessment score(MD=-2.02,95%CI(-2.59,-1.44))with P<0.001.Moreover,it lowers TNF-α(standardized mean difference(SMD)=-1.78,95%CI(-2.24,-1.32)),Interleukin-6(SMD=-1.17,95%CI(-1.55,-0.8)),C reactive protein(SMD=-1.49,95%CI(-1.99,-0.99)),hypersensitive C-reactive protein(SMD=-1.9,95%CI(-2.87,-0.94))and procalcitonin(SMD=-0.89,95%CI(-1.12,-0.67))levels in the body.Conclusions:Available evidence shows that ulinastatin reduces case mortality rate,multiple organ dysfunction syndrome,length of intensive care unit stay,and length of hospital stay and decreases Acute Physiology and Chronic Health Evaluation II score and Sequential Organ Failure Assessment score.Moreover,it also lowers TNF-α,Interleukin-6,C reactive protein,hypersensitive C-reactive protein,and procalcitonin levels in the body.

石羊河流域生态敏感性与社会经济发展相关性研究

本文探究了石羊河流域生态环境保护方法,以缓解生态与社会经济发展的矛盾。选取适合石羊河流域的8个生态敏感性评价因子,结合层次分析法以及GIS空间分析方法,对石羊河流域的生态敏感性进行定量分析。在此基础上选取GDP、人均GDP、人口密度这几项社会经济指标,通过Moran's I对区县域空间格局的生态敏感性与社会经济进行了相关性研究。结果表明:(1)石羊河流域的生态敏感性总体较好,研究区内低敏感、较低敏感、一般敏感性、较高敏感、高敏感性的面积占比分别为27.68%、19.64%、25.99%、18.23%、8.54%。土壤可蚀性、植被覆盖度与土地利用类型对石羊河流域的生态敏感性影响较强;(2)生态敏感性与各社会经济指标,呈现出较强的空间相关性,互相依存关系明显。生态敏感性与人口密度的空间相关性>生态敏感性与GDP的空间相关性>生态敏感性与人均GDP的空间相关性,Moran's I值分别为0.342、0.341、0.130。本研究为该区域提供差异化的发展与保护协调路径,并可为同类型区域提供借鉴。

Systematics and Species Validity of the Dabieshan Pit Viper Protobothrops dabieshanensis Huang et al. 2012: Evidence from a Mitochondrial Gene Sequence Analysis

Aimed to evaluate the phylogenetic position of the recently described Protobothrops dabieshanensis Huang et al. （2012）, phylogenic relationships of 12 species within Protobothrops based on four mtDNA gene fragments （12S RNA, 16S RNA, ND4 and Cyt b） were reconstructed in our study. The result indicates a clade composed ofP dabiesha- nensis, P. jerdonii and P xiangchengsis with strong support. The genetic distance among P dabieshanensis, P jerdonii and P xiangchengsis was much lower than other congeners. Based on the data from the phylogenetic analysis and pre- viously described morphological differences, we conclude that P dabieshanensis is a valid species with close affinities to P jerdonii and P xiangchengsis.

Research Progress of Ethnic Medicine in the Treatment of Cholelithiasis

In a broad sense, ethnic medicine includes Han traditional Chinese medicine, folk medicine and ethnic minority medicine;ethnic medicine in a narrow sense refers to ethnic minority medicine. It is a medicine developed by ethnic minorities in order to survive and reproduce and in the process of fighting diseases. Culture, based on its own language, life experience and cultural traditions, has its own understanding and theoretical system of disease naming, etiology and pathogenesis, treatment principles and treatment methods, which is a major feature of my country’s medical care. Among them, ethnic medicine has unique advantages and good clinical efficacy in the prevention and treatment of cholelithiasis. Therefore, this paper focuses on summarizing the characteristic theories and diagnosis and treatment experience of Tibetan medicine, Mongolian medicine, Miao medicine, Yao medicine, and Beijing medicine in ethnic medicine by sorting out and summarizing the relevant materials in this regard, so as to provide new ideas for improving the treatment of cholelithiasis and enriching clinical drug selection.

Medicinal Characteristics of Jing Medicine

In the long process of living, working and fighting against diseases, the Jing people have formed a medical system with their own characteristics, which has made great contributions to the hygiene and health of the ethnic group and is still playing an important role today. As an indispensable part of Chinese traditional medicine system, Jingzu medicine has its own unique advantages and characteristics, which need to be further explored and sorted out. In this paper, the characteristics and advantages of Peking medicine were summarized from the characteristics of medicine use.

Characteristics and Analysis of Dominant Diseases in Jing Nationality Medicine

Jing medicine occupies a very prominent position in the traditional culture of the Chinese nation and has unique advantages. Through the literature review of Jing medicine, the author has a deeper understanding of Jing medicine in Guangxi. This paper mainly shows the traditional characteristic medicine culture of the Jing nationality and discusses the characteristic therapy and medication characteristics of Jing nationality medicine, which is conducive to the improvement of people’s cognition of Jing nationality medicine and the development and innovation of Jing nationality medicine.

Value of Zhuang medicine choerospondias axillaris bark for evaluating the expression of PTEN,VEGF in chronic wounds rats

Objective:To investigate the mechanism of treating chronic wounds in rats by using Zhuang medicine choerospondias axillaris bark.Methods: The whole layer skin defection 40 rats were used and randomly divided into 4 groups: normal group, model group, MEBO group, choerospondias group. The normal group and model group were given external deposited normal saline external application. MEBO group used MEBT/MEBO. Choerospondias group was given external deposited choerospondias axillaris bark water decoction external application. Detected cell ultrastructure, PTEN、VEGF mRNA after 12 d.Results: The organelle structure in MEBO group and choerospondias group were restored. In 12 d, PTEN in MEBO group and choerospondias group were lower, VEGF were higher than 1 d (P<0.05). PTEN in MEBO group and choerospondias group were lower, VEGF were higher than model group (P<0.05). MEBO group had no difference with choerospondias group (P>0.05). Conclusion: Choerospondias axillaris bark water decoction could remarkably improve the cell ultrastructure in chronic wounds, regulate the PTEN signal conduction effect, and promote wound healing.

Mechanoluminescent-Triboelectric Bimodal Sensors for Self-Powered Sensing and Intelligent Control

Self-powered flexible devices with skin-like multiple sensing ability have attracted great attentions due to their broad applications in the Internet of Things(IoT).Various methods have been proposed to enhance mechano-optic or electric performance of the flexible devices;however,it remains challenging to realize the display and accurate recognition of motion trajectories for intelligent control.Here,we present a fully self-powered mechanoluminescent-triboelectric bimodal sensor based on micronanostructured mechanoluminescent elastomer,which can patterned-display the force trajectories.The deformable liquid metals used as stretchable electrode make the stress transfer stable through overall device to achieve outstanding mechanoluminescence(with a gray value of 107 under a stimulus force as low as 0.3 N and more than 2000 cycles reproducibility).Moreover,a microstructured surface is constructed which endows the resulted composite with significantly improved triboelectric performances(voltage increases from 8 to 24 V).Based on the excellent bimodal sensing performances and durability of the obtained composite,a highly reliable intelligent control system by machine learning has been developed for controlling trolley,providing an approach for advanced visual interaction devices and smart wearable electronics in the future IoT era.

Safety of butylphthalide and edaravone in patients with ischemic stroke:a multicenter real-world study

BACKGROUND Butylphthalide(NBP)and edaravone(EDV)injection are common acute ischemic stroke medications in China,but there is a lack of large real-world safety studies on them.This study aimed to determine the incidence of adverse events,detect relevant safety signals,and assess the risk factors associated with these medications in real-world populations.METHODS In this study,data of acute ischemic stroke patients were extracted from the electronic medical record database of six tertiary hospitals between January 2019 and August 2021.Baseline confounders were eliminated using propensity score matching.The drugs’safety was estimated by comparing the results of 24 laboratory tests standards on liver function,kidney function,lipid level,and coagulation function.The drugs’relative risk was estimated by logistic regression.A third group with patients who did not receive NBP or EDV was constructed as a reference.Prescription sequence symmetry analysis was used to evaluate the associations between adverse events and NBP and EDV,respectively.RESULTS 81,292 patients were included in this study.After propensity score matching,the NBP,EDV,and third groups with 727patients in each group.Among the 15 test items,the incidence of adverse events was lower in the NBP group than in the EDV group,and the differences were statistically significant.The multivariate logistic regression equation revealed that NBP injection was not a promoting factor for abnormal laboratory test results,whereas EDV had statistically significant effects on aspartate transaminase,low-density lipoprotein cholesterol and total cholesterol.Prescription sequence symmetry analysis showed that NBP had a weak correlation with abnormal platelet count.EDV had a positive signal associated with abnormal results in gamma-glutamyl transferase,alanine aminotransferase,aspartate aminotransferase,prothrombin time,and platelet count.CONCLUSIONS In a large real-world population,NBP has a lower incidence of adverse events and a better safety profile than EDV or other usual medications.