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Arnebiae Radix (dried root of Arnebia euchroma (Royle) Johnst.) is a traditional Chinese medicine (TCM) used to treat macular eruptions, measles, sore throat, carbuncles, burns, skin ulcers, and inflammations. The Arnebiae Radix extract can exert anti-breast cancer effects through various mechanisms of action. This study aimed to rapidly screen potential estrogen receptor (estrogen receptor α and estrogen receptor β) ligands from the Arnebiae Radix extract. In this study, an analytical method based on affinity ultrafiltration coupled with UHPLC-Q-Exactive Orbitrap mass spectrometry was established for rapidly screening and identifying estrogen receptor ligands. Then, bindings of the components to the active site of estrogen receptor (estrogen receptor α and estrogen receptor β) were investigated via molecular docking. Moreover, surface plasmon resonance (SPR) experiments with six compounds were performed to verify the affinity. As a result, a total of 21 ligands were screened from Arnebiae Radix using affinity ultrafiltration. Among them, 14 and 10 compounds from Arnebiae Radix showed affinity with estrogen receptor α and estrogen receptor β, respectively. All of those ligands could have a good affinity for the multiple amino acid residues of the estrogen receptor based on molecular docking. In addition, six compounds display the great affinity by SPR. The method established in the study could be used to rapidly screen estrogen receptor ligands in Traditional Chinese medicine. The results demonstrated that the affinity ultrafiltration–UHPLC-Q-Exactive Orbitrap mass spectrometry method not only aids in the interpretation of the potential bioactive components and possible mechanisms of action of Arnebiae Radix but also provides a further effective basis for the quality control of this valuable herb medicine.

A 43-year-old woman presented to the dermatology clinic with an 8-year history of atrophic, telangiectatic yellow-brown plaques with irregular violaceous borders on both shins.

A 39-year-old man with HIV infection presented with recurrent penile ulcers. On examination, there were exophytic plaques with central ulceration and raised borders.

We aimed to identify predisposing factors that could help predict the therapeutic response of adenomyosis after uterine artery embolization (UAE). This was a retrospective, single-center study of patients admitted to the hospital for adenomyosis between 2013 and 2015. Sixty-eight patients with adenomyosis who underwent UAE with tris-acryl gelatin microspheres were divided into two groups based on their therapeutic response (complete or incomplete necrosis of lesions), and pre- and postprocedural pelvic magnetic resonance imaging (MRI) data. Patients were followed up for 12 months after UAE. Improvements in dysmenorrhea and menorrhagia were evaluated based on the symptom relief criteria. Improvement rates in both groups were analyzed and compared. Multivariate logistic regression analysis was used to identify the predisposing factors from retrospectively gathered baseline data that might affect the therapeutic response, including MRI features, clinical symptoms, biochemical index, and accompanying diseases of adenomyosis. Then, a prognostic model was established, and the receiver operating characteristic (ROC) curve of identified factors was drawn to determine their predictive value. Following UAE, 46 patients (67.6%) showed complete necrosis, while 22 patients (32.4%) showed incomplete necrosis. At 12-month follow-up, dysmenorrhea symptom improvement was seen in 94.7% of complete necrosis and 50% of incomplete necrosis group (P < 0.001); menorrhagia symptom improvement was seen in 96.2% of complete necrosis and 57.1% of incomplete necrosis groups (P = 0.004). Multivariate logistic regression analysis determined serum cancer antigen 125 (CA125) levels (odds ratio [OR], 1.006; 95% confidence interval [CI], 1.002-1.010; P = 0.005) and accompanying endometriosis (OR, 6.869; 95% CI, 1.881-25.016; P = 0.004) as predisposing factors. The areas under the ROC curve of CA125, endometriosis, and these two indicators combined were 0.785, 0.708, and 0.845, which corresponded to sensitivities of 95.5%, 66.7%, and 68.2% and specificities of 52.2%, 80.0%, and 87.0% at optimal cutoff values, respectively. Symptom relief of dysmenorrhea and menorrhagia for patients with complete necrosis was significantly better than that for patients with incomplete necrosis. Serum CA125 levels and accompanying endometriosis can effectively distinguish complete necrosis from incomplete necrosis.

Introduction Before tracheal intubation, it is essential to provide sufficient oxygen reserve for emergency patients with full stomachs. Recent studies have demonstrated that high-flow nasal oxygen (HFNO) effectively pre-oxygenates and prolongs apneic oxygenation during tracheal intubation. Despite its effectiveness, the use of HFNO remains controversial due to concerns regarding carbon dioxide clearance. The air leakage and unknown upper airway obstruction during HFNO therapy cause reduced oxygen flow above the vocal cords, possibly weaken the carbon dioxide clearance. Methods Patients requiring emergency surgery who had fasted < 8 h and not drunk < 2 h were randomly assigned to the high-flow group, who received 100% oxygen at 30–60 L/min through nasopharyngeal airway (NPA), or the mask group, who received 100% oxygen at 8 L/min. PaO 2 and PaCO 2 were measured immediately before pre-oxygenation ( T 0), anesthesia induction ( T 1), tracheal intubation ( T 2), and mechanical ventilation ( T 3). The gastric antrum’s cross-sectional area (CSA) was measured using ultrasound technology at T 0, T 1, and T 3. Details of complications, including hypoxemia, reflux, nasopharyngeal bleeding, postoperative pulmonary infection, postoperative nausea and vomiting (PONV), and postoperative nasopharyngeal pain, were recorded. The primary outcomes were PaCO 2 measured at T 1, T 2, and T 3. The secondary outcomes included PaO 2 at T 1, T 2, and T 3, CSA at T 1 and T 3, and complications happened during this trial. Results Pre-oxygenation was administered by high-flow oxygen through NPA ( n  = 58) or facemask ( n  = 57) to 115 patients. The mean (SD) PaCO 2 was 32.3 (6.7) mmHg in the high-flow group and 34.6 (5.2) mmHg in the mask group ( P  = 0.045) at T 1, 45.0 (5.5) mmHg and 49.4 (4.6) mmHg ( P  < 0.001) at T 2, and 47.9 (5.1) mmHg and 52.9 (4.6) mmHg ( P  < 0.001) at T 3, respectively. The median ([IQR] [range]) PaO 2 in the high-flow and mask groups was 404.5 (329.1–458.1 [159.8–552.9]) mmHg and 358.9 (274.0–413.3 [129.0–539.1]) mmHg ( P  = 0.007) at T1, 343.0 (251.6–428.7 [73.9–522.1]) mmHg and 258.3 (162.5–347.5 [56.0–481.0]) mmHg ( P  < 0.001) at T 2, and 333.5 (229.9–411.4 [60.5–492.4]) mmHg and 149.8 (87.0–246.6 [51.2–447.5]) mmHg ( P  < 0.001) at T 3, respectively. The CSA in the high-flow and mask groups was 371.9 (287.4–557.9 [129.0–991.2]) mm 2 and 386.8 (292.0–537.3 [88.3–1651.7]) mm 2 at T 1 ( P  = 0.920) and 452.6 (343.7–618.4 [161.6–988.1]) mm 2 and 385.6 (306.3–562.0 [105.5–922.9]) mm 2 at T 3 ( P  = 0.173), respectively. The number (proportion) of complications in the high-flow and mask groups is shown below: hypoxemia: 1 (1.7%) vs. 9 (15.8%, P  = 0.019); reflux: 0 (0%) vs. 0 (0%); nasopharyngeal bleeding: 1 (1.7%) vs. 0 (0%, P  = 1.000); pulmonary infection: 4 (6.9%) vs. 3 (5.3%, P  = 1.000); PONV: 4 (6.9%) vs. 4 (7.0%, P  = 1.000), and nasopharyngeal pain: 0 (0%) vs. 0 (0%). Conclusions Compared to facemasks, pre-oxygenation with high-flow oxygen through NPA offers improved carbon dioxide clearance and enhanced oxygenation prior to tracheal intubation in patients undergoing emergency surgery, while the risk of gastric inflation had not been ruled out. Trial registration This trial was registered prospectively at the Chinese Clinical Research Registry on 26/4/2022 (Registration number: ChiCTR2200059192).

Neurosyphilis (NS) is a central nervous system (CNS) infection caused by Treponema pallidum (T. pallidum). NS can occur at any stage of syphilis and manifests as a broad spectrum of clinical symptoms. Often referred to as “the great imitator,” NS can be easily overlooked or misdiagnosed due to the absence of standard diagnostic tests, potentially leading to severe and irreversible organ dysfunction. In this study, proteomic and machine learning model techniques are used to characterize 223 cerebrospinal fluid (CSF) samples to identify diagnostic markers of NS and provide insights into the underlying mechanisms of the associated inflammatory responses. Three biomarkers (SEMA7A, SERPINA3, and ITIH4) are validated as contributors to NS diagnosis through multicenter verification of an additional 115 CSF samples. We anticipate that the identified biomarkers will become effective tools for assisting in diagnosis of NS. Our insights into NS pathogenesis in brain tissue may inform therapeutic strategies and drug discoveries for NS patients. This study presents an innovative approach to diagnosing Neurosyphilis (NS), a complex central nervous system (CNS) infection. By analyzing 223 cerebrospinal fluid samples using proteomic techniques and machine learning models, researchers identifies three key biomarkers (SEMA7A, SERPINA3, and ITIH4) for NS. These findings, validated through multicenter research with additional 115 samples, offer new diagnostic tools and deepen understanding of NS pathogenesis.

To the Editor：Intraorbital electroacupuncture （IEA） therapy is highly effective in treating ocular motility disorders,but it has only rarely been used to treat thyroid-associated ophthalmopathy （TAO）.Herein,we report one successful case.A 54-year-old Chinese man was diagnosed with hyperthyroidism 4 years ago and received I[3] therapy.However,the result was unsatisfactory.He had to keep taking antithyroid drugs （ATDs）.His palpebral edema gradually worsened and he developed visual impairment during the ATD therapy.Glucocorticoid therapy was administered to relieve his symptoms.However,his condition worsened after a reduction in the glucocorticoid dosage.

Background： Successful antiretroviral therapy （ART） has been demonstrated to be effective in reducing the infectivity of human immunodeficiency virus （HIV）. We conducted a study to predict the potential effect of ART on the spread of HIV in Chaoyang District, Beijing, China, using the Asian Epidemic Model （AEM）. Methods： The AEM baseline workbook was used to determine the current infection status and to project the future spread of HIV under current conditions. We changed the input on the ART coverage from 2014 to 2025 and also modified the treatment eligibility in the AEM intervention workbook, in order to allow for analysis of the projected downstream impact of ART. Results： By gradually increasing the ART coverage rate from 29.7% （rate of 2013） to 40.0%, 50.0%, 60.0%, 70.0%, 80.0%, and 90.0% （at CD4＋ ≤350 cells/μl）, and by changing the dates of coverage from 2014 to 2020, the number of new infections showed a cumulative decline of 0.60%, 1.59%, 2.94%, 5.33%, 9.32%, and 14.98%, respectively. After 2020, the projected rates of infection rebounded slightly, so with the exception of the years with very high coverage （90.0%）, new infections continued to decrease. When we changed the initial threshold of therapy to CD4＋ cell counts ≤500 cells/μl, new infections decreased 6.00%, 11.64%, 15.92%, 21.11%, 26.92%, 33.05%, and 38.75%, respectively, under varying ART coverages. Conclusion： Our study demonstrates that the early initiation of ART for people living with HIV/acquired immune deficiency syndrome （AIDS） has a positive effect in slowing the spread of HIV.

[ Objective] The aim was to study the distribution of vegetation and its relationship with environmental factors in Yellow River estuarine wetland. [ Method] According to the data of the plant sample investigation and the related environmental factors in Yellow River Delta National Na- ture Reserve in 2009 -2010, the plant community changes and its relationship with environmental factors in temperate estuary wetland were ana- lyzed. [Result] There was little vegetation in the Yellow River delta and the distribution of plant was influenced by environment. Judging from the vegetation structure, the vertical structure of vegetation in the supralittoral zone zone vegetation cover included arbor layer, shrub layer and grass layer. The importance of grass was larger than shrub and arbor. In the intertidal zone, the vertical structure of plants was divided into shrub and herb layers. Judging from the variety, the species in the supralittoral zone was higher than that in the intertidal. The first principal component elected by Principal Component Analysis better reflects the salt of the study area, and the second principal component better reflects nutrient information. Regression analysis showed a positive correlation between importance value and the total salt content and electrical conductivity. In other words, if the total salt content and electrical conductivity increases, the importance value rose. However, the diversity index decreased as the total salt con- tent and electrical conductivity increased. [ Conclusion] The study provided theoretical basis for the ecological protection of vegetations and formula- tion of regional policies.