Wogonin, a natural flavonoid compound with significant anti-inflammatory properties,which is primarily derived from the traditional Chinese herb Scutellaria baicalensis (Huangqin). In studies of its anti-inflammatory effects, Wogonin has demonstrated potential in inhibiting inflammatory responses through multiple mechanisms. These mechanisms include suppressing the production of pro-inflammatory cytokines such as interleukin-1 (IL-1), IL-6, IL-2 and tumor necrosis factor-alpha (TNF-α), regulating inflammatory signaling pathways such as nuclear factor κB (NF-κB) and mitogen-activated protein kinase(MAPK) pathway, inducing apoptosis of inflammatory cells, and enhancing autophagy to clear damaged cells. Wogonin has shown therapeutic potential in various inflammatory diseases such as rheumatoid arthritis,inflammatory bowel disease, and atherosclerosis. This paper reviews the anti-inflammatory mechanisms of Wogonin and its application prospects in different diseases, providing a theoretical basis for future clinical applications.

Objective

To analyze the related factors of natural pregnancy outcome in infertile women after four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) examination by Cox regression analysis.

Methods

A total of 388 infertile female patients who underwent 4D-HyCoSy examinations in the Ultrasound Imaging Department of Hubei Provincial Maternal and Child Health Hospital from March 2015 to October 2023 were selected. Based on the patency of the bilateral fallopian tubes, patients were classified into types Ⅰ to Ⅵ. Based on the natural pregnancy outcomes within 12 months post-examination,patients were divided into a coneeption-success group (246 cases) and a conception-failure group (142 cases). Cox regression analysis was employed to identify factors associated with successful natural pregnancy.A scoring system for successful natural pregnancy following 4D-HyCoSy examinations had been established,categorizing the conception-success patients into low-score group (0-6 points), medium-score group (7-12 points), and high-score group (13-18 points). The Kaplan-Meier method was employed to calculate cumulative pregnancy rates and time to pregnancy, and the Log-rank test was used for intergroup comparisons.

Results

The cumulative natural pregnancy success rates for types Ⅰ to Ⅵ within 12 months were 32.99%(128/388), 6.19%(24/388), 10.57%(41/388), 8.76%(34/388), 3.61%(14/388), and 1.29%(5/388), respectively. Type Ⅰ showed significantly higher rates than other types (χ² =88.43, 57.22,68.87, 112.03, 137.17, all P<0.01). There were no statistically significant differences between types Ⅱ,Ⅲ, and Ⅳ, or types Ⅴ and Ⅵ (χ²=4.84, 3.52, all P>0.05). The cumulative natural pregnancy rates for the periods of 1-3 months, 4-6 months, 7-9 months, and 10-12 months were 19.59%(76/388),19.85%(77/388), 12.89%(50/388), and 11.08%(43/388), respectively. The cumulative pregnancy rate from 7 to 12 months was significantly lower than that from 1 to 6 months (χ²=21.41, P<0.01). Cox regression analysis revealed that the results of tubal patency, duration of preparation for pregnancy, and type of infertility were significant risk factors affecting natural conception. Compared with type Ⅵ, the type Ⅰ, Ⅱ,Ⅲ and Ⅳ had increased success rate of natural pregnancy after 4D-HyCoSy examination (HR=6.1, 95%CI: 2.5-14.9, P<0.01; HR=5.1, 95%CI: 2.0-13.4, P=0.001; HR=3.3, 95%CI: 1.3-8.4, P=0.012; HR=2.9, 95%CI: 1.1-7.4, P=0.028). Compared with primary infertility patients, secondary infertility patients had an increased success rate of natural pregnancy after 4D-HyCoSy examination (HR=2.3, 95%CI: 1.5-3.4, P=0.030). The success rate of natural pregnancy after 4D-HyCoSy examination in infertile women with preparation time <2 years was higher than that in infertile women with preparation time ≥2 years (HR=3.0, 95%CI: 2.1-4.2, P<0.01). The cumulative natural pregnancy rates over 12 months of low, medium, and high-score infertility groups were 20.00% (16/80), 63.16% (108/171),and 89.05% (122/137), respectively. The comparison of cumulative successful conception rates among the three groups showed statistically significant differences (χ² = 40.60, 104.00, 26.90, all P<0.01).

Conclusions

For women with infertility, a 4D-HyCoSy examination can be conducted early to guide the subsequent treatment plan. The natural pregnancy success rate is lower in the low-score group, and it is recommended to promptly pursue assisted reproductive technology. The medium and high-score groups may opt for natural conception.

The classical Wnt signaling pathway， namely Wnt/β-catenin signaling pathway， is involved in promoting embryo and tissue development， neural function integration and other physiological effects. With the establishment of the complex pathway structure network in the study， the positive and negative regulatory mechanisms of the Wnt/β-catenin pathway in various pathophysiological processes have been gradually discovered. The biological effects of distinct ligands vary significantly， including neuroprotective effects， oxidative stress and neuroinflammatory regulation， autophagy and apoptosis， etc. It is widely present in the occurrence and development of neurological diseases such as ischemic stroke，Alzheimer disease and Parkinson disease. Studies have shown that targeted regulation of the Wnt/β-catenin signaling pathway shows significant potential in restoring neurobiological function and treating central nervous system diseases. This review focuses on the research progress of Wnt/β-catenin signaling pathway involved in central nervous system diseases.

Olfactory reference disorder （ORD） is a psychiatric condition characterized by a persistent and false belief that one emits a foul or unpleasant body odour. This belief leads significant distress and impaired social functioning. It is often accompanied by referential thinking and repetitive behaviours aimed at concealing， changing or avoiding the perceived odour. Its diagnosis should be distinguished from various physical diseases （such as periodontitis， trimethylaminuria， rectal abscess， anal fistula， and temporal lobe epilepsy）， social anxiety disorder， obsessive-compulsive disorder， body dysmorphic disorder， delusional disorder， and other primary psychotic disorders， mood disorder， avoidant personality disorder， and bodily distress disorder. Evidence for the treatment of ORD primarily comes from case reports， while large-sample randomized controlled studies are lacking. The treatment for ORD includes antidepressants， antipsychotic drugs， antipsychotic drugs combined with antidepressants， and psychotherapy. Multi-center， randomized controlled trials are needed to further validate the efficacy of these treatments. This paper systematically reviews the clinical characteristics， diagnosis， differential diagnosis and treatment of ORD， providing scientific evidence for the clinical diagnosis and treatment of ORD.

Objective

To explore the clinical features, diagnosis and treatment of patients with growth hormone deficiency (GHD) combined with thalassemia (TT).

Methods

The clinical and follow-up data of a male patient with GHD and TT admitted to the Department of Endocrinology, Genetics and Metabolism of the Affiliated Hospital of Jining Medical University on March 30, 2020, were retrospectively analyzed.

Results

The 12-year-old male patient, with a height of 137.2 cm (-2.0 SD) and a weight of 42 kg, had a genetic target height of 171.5 cm. His bone age was approximately 12.5 years (Greulich-Pyle atlas). The peak growth hormone levels in the levodopa and insulin hypoglycemia stimulation test were 0.059 μg/L and 0.959 μg/L, respectively. The serum insulin-like growth factor-1 level was 282 μg/L. The patient was treated with recombinant human growth hormone (rhGH). During the follow-up period, he was diagnosed with TT. Genetic testing confirmed α-thalassemia trait (--/αα), with hemoglobin (Hb) levels from repeated measures between 117 g/L and 127 g/L, and no special treatment was provided. After 21 months of rhGH treatment, his height increased to 153.7 cm (-1.69 SD), with a bone age of 14 years and a predicted adult height of 165.8 cm (-1.15 SD). Letrozole was added to delay bone age progression.After 51 months of follow-up, letrozole was discontinued. The height reached 170.5 cm (-0.26 SD), bone age was approximately 15 years, and the predicted adult height was 176.1 cm (0.57 SD). Hb level improved to 139 g/L, and thereafter, only growth hormone therapy was administered.

Conclusion

Letrozole can effectively delay bone age progression, improve Hb levels, and further enhance height outcomes in patients with GHD combined with TT.

Objective

To explore the diagnostic value of ¹⁸F-fluorodeoxyglucose （¹⁸F-FDG） positron emission tomography computed tomography （PET/CT） combined with enhanced CT in testicular malignant tumors.

Methods

A retrospective analysis was conducted on the clinical data， PET/CT and enhanced CT image results of 49 patients with testicular malignant tumors confirmed by biopsy or surgical pathology in Guangdong Provincial People′s Hospital from April 2008 to July 2020. The patients were divided into hematological testicular tumors （n=26） and non-hematological testicular tumors （n=23）. The Mann-Whitney U test was used to compare the differences in the maximum standard uptake value （SUVmax） of PET metabolic parameters and the SUVmax lesion/background ratio （SUVmax L/B） between the two groups. The chi-square test was used to compare the intergroup differences in enhanced CT features between patients with seminoma and those without seminoma.

Results

Among the 49 patients， the SUVmax level of patients with hematological systemic tumors was higher than that of patients with non-hematological tumors ［9.2（6.9，13.4），7.8（4.8，9.1）］， and the difference was statistically significant （Z=-2.02， P＜0.05）；SUVmax L/B values were ［3.5（1.9， 6.1）， 2.5（1.7， 3.1）］， there was no statistically significant difference （Z=-0.71， P＞0.05）. CT enhancement in 26 cases of hematological testicular tumors and 11 cases of seminoma showed uniform enhancement， no necrosis， clear boundaries， and varying degrees of increased FDG metabolism. CT enhancement in 12 cases of non-seminoma showed significantly heterogeneous enhancement， necrosis， unclear boundaries， and slightly increased FDG metabolism. The enhanced CT features of seminoma and non-seminoma were compared. There were statistically significant differences in the degree of the enhancement degrees ［6 cases （mild）， 4 cases （moderate）， 1 case （obvious）；0 case（mild）， 4 cases （moderate）， and 8 cases （obvious）， respectively］， necrosis （3 cases， 10 cases）， and unclear boundaries （0 cases， 5 cases） （χ²=11.42， 5.32， 11.24，all P＜0.05）. The SUVmax and SUVmax L/B of the two groups of patients were compared， and the differences were not statistically significant（Z=0.77， -0.92， all P＞0.05）. Among the 49 patients， 11 cases were in stage Ⅰ， 19 cases in stage Ⅱ，6 cases in stage Ⅲ， and 13 cases in stage Ⅳ.

Conclusion

¹⁸F-FDG PET/CT combined with contrastenhanced CT has high value in the diagnosis， differential diagnosis， and staging of testicular malignant tumors.

Diagnostics is a fundamental discipline for developing clinical reasoning and diagnostic skills in medical education， playing a crucial role in clinical education. The current instructional model mainly relies on classroom theoretical learning and clinical interships， which faces challenges such as limited opportunities for clinical practice and inadequate learner engagement. The virtual patient system （VPS）utilizes advanced computational technologies to simulate realistic clinical scenarios， allowing medical trainees to engage in repetitive training within controlled environments. This approach significantly enhances their clinical reasoning abilities and diagnostic skills. Additionally， the VPS feedback mechanism effectively assists educators in optimizing teaching plans. This systematic review assesses the implementation of the VPS in diagnostics education， aiming to better integrate the VPS into traditional teaching methods and improve the quality of diagnostics teaching.

Objective

To investigate the imaging characteristics of hepatic lipid-poor perivascular epithelioid cell tumor （PEComa）.

Methods

A retrospective analysis was conducted on the clinical， pathological and imaging data of 12 patients with hepatic lipid-poor PEComa diagnosed by surgical pathology in the Department of Hepatobiliary Surgery at Xiangyang Central Hospital from January 2016 to December 2024，and the relevant literatures were reviewed.

Results

All 12 patients with hepatic lipid-poor PEComa were female， with a mean age of （48.58±10.96） years old. The tumors were all solitary， among which 4 cases were located in the left lobe of the liver， and 8 cases were located in the right lobe. The clinical manifestations included abdominal distension and discomfort （2 cases）， abdominal pain （1 case） and back pain （1 case）， and while 8 cases were asymptomatic. In terms of imaging， all cases showed significant enhancement during the arterial phase of enhanced scan. Among them， the enhancement degrees of 10 cases gradually diminished in the portal vein phase and delayed phase， which was in line with the typical "fast-in and fast-out" or "fast-in and slow-out" enhancement patterns. The remaining 2 cases showed persistent enhancement during the portal vein stage and the delayed stage， and were classified as the "persistent"enhancement pattern. In the arterial phase of enhanced scanning， thickened vascular shadows could be seen in or around the lesions in 9 patients with PEComa. Pathologically， the tumor tissue lacked mature adipocytes and was mainly composed of a large number of epithelioid cells， which were radially arranged around the vascular lumen. Immunohistochemical staining showed positive expressions of HMB-45， Melan-A and smooth muscle actin.

Conclusion

Hepatic lipid-poor PEComas exhibit unique imaging and pathological characteristics， which are of significant clinical value for the early diagnosis and differential diagnosis of this disease.

Objective

To investigate the clinical diagnostic features of mitochondrial encephalomyopathy(ME) caused by deletions in mitochondrial DNA(mtDNA).

Methods

The diagnosis and treatment process of a patient with leukoencephalopathy caused by multiple deletions in mtDNA, admitted to Hunan Brain Hospital in August 2018 was retrospectively analyzed. Relevant literature was reviewed, and the patient′s clinical manifestations, imaging characteristics and gene mutation were summarized.

Results

The patient in this case presented with recurrent headaches and seizures. From 2015 to 2018, multiple MRI scans of the brain indicated the presence of multifocal subcortical white matter lesions, with varying locations, and complete recovery occurred over a period of time. Genetic testing of skeletal muscle cell nuclei and mitochondrial genomes revealed three mtDNA deletion sites: m.5786_13923, m.7851_13614,and m.8616_15656. The diagnosis was that mtDNA multiple deletions lead to ME.

Conclusions

Seizures can be a common clinical manifestation of ME. When multiple lesions are present in the cortex or white matter, ME should be considered. For suspected cases, timely blood or muscle gene testing should be conducted to reduce the risk of missed or misdiagnosed cases.

Objective

To explore the application and effects of outcomes-based education （OBE）combined with the presentation-assimilation-discussion （PAD） teaching mode in the experimental teaching of diagnostics.

Methods

From September to December 2023， 168 students from classes 1 to 4 of the 2021 clinical majors at Hunan University of Chinese Medicine were selected as participants. Eighty-four students in classes 1 and 2 were assigned to the control group， and 84 students in classes 3 and 4 were selected as the experimental group. The control group were taught by the traditional teaching mode， and the experimental group were taught by OBE and PAD teaching mode. The final clinical skill assessment scores， classroom performance， and attendance rates of the 2 groups were compared. Additionally， the learning effects were analyzed， and the teaching satisfaction was investigated through multi-dimensional questionnaires.

Results

In the experimental group， the total score ［（86.94±5.35）points］， operational assessment score［（87.84±4.14）points］， and routine classroom performance ［（82.53±2.77）points］ were higher than those of the control group ［total score （68.26±4.73） points， operational assessment score （72.31±6.73）points， and routine classroom performance （41.25±2.03）points］， and the differences were all statistically significant （t=3.88， 2.60， 3.22， all P＜0.05）. There was no statistically significant difference in classroom attendance scores between the experimental group ［（92.41±2.36） points］ and the control group［（91.62±3.74） points］ （t=0.62， P＞0.05）. A total of 168 questionnaires were distributed and collected from 2 groups. The results showed that the experimental group outperformed the control group in increasing classroom engagement ［96.43%（81/84）， 76.19%（64/84）］， facilitating mastery of key knowledge points［95.24%（80/84）， 82.14%（69/84）］， maintaining a well-paced classroom environment ［91.67%（77/84）， 80.95%（68/84）］， promoting group interaction ［92.86%（78/84）， 77.38%（65/84）］， enhancing learning interest ［90.48%（76/84）， 79.76%（67/84）］， clarifying learning objectives ［94.05%（79/84），71.43%（60/84）］， improving clinical practice skills ［91.67%（77/84）， 78.57%（66/84）］， and stimulating divergent thinking ［91.67%（77/84）， 75.00%（63/84）］. All differences were statistically significant（χ²=8.31， 7.42， 8.52， 8.28， 11.24， 12.42， 8.53， 8.37， all P＜0.05）.

Conclusion

The combined OBE and PAD teaching mode in diagnostics laboratory teaching effectively improves students′ academic performance， enhances the comprehensive quality of medical students， and elevates the quality of medical personnel talent training.

Objective

To explore the characteristics of glucose metabolism and influencing factors in patients with bipolar disorder （BD） comorbid with type 2 diabetes mellitus （T2DM）.

Methods

A randomized controlled study design and convenience sampling method were employed. A total of 50 hospitalized patients with BD comorbid with T2DM， who admitted to the Fifth People′s Hospital of Kaifeng from January 2024 to February 2025， were enrolled as the study group. Based on clinical subtypes of BD （BD-Ⅰ and BD-Ⅱ）， they were further divided into comorbidity group Ⅰ （n=24） and comorbidity group Ⅱ （n=26）.Concurrently， the inpatients hospitalized during the same period were recruited as the control group， subdivided into non-comorbidity group Ⅰ （n=25） and non-comorbidity group Ⅱ （n=25）. Demographic data and family history of mood disorders and/or T2DM in first-degree relatives were collected. Height， weight， waist circumference （WC）， fasting blood glucose （FBG）， fasting insulin （FINS）， and then body mass index（BMI）， homeostatic model assessment of insulin resistance （HOMA-IR）， and waist-to-height ratio（WHtR） were calculated. Cognitive function was assessed using the Montreal cognitive assessment（MoCA）. Statistical comparisons between comorbidity and non-comorbidity groups were performed using chi-square tests， t-tests， and Mann-Whitney U tests. Pearson or Spearman correlation analyses were conducted to examine associations between comorbidities and influencing factors.

Results

The comorbidity group exhibited significantly higher proportions of family history of mood disorders ［22.00%（11/50）］ and diabetes ［26.00%（13/50）］， as well as elevated WC ［（89.48±7.12）cm］， HOMA-IR（3.48±1.47），WHtR（0.53±0.05）， and FBG［（7.15±1.93）mmol/L］ compared to the non-comorbidity group ［6.00%（3/50）， 8.00%（4/50）， （85.26±8.16）cm， （2.59±1.12）， （0.51±0.05）， （5.46±0.57）mmol/L］，with statistically significant differences （χ²=5.316， 5.741， t=2.755， 3.383， 2.217， 5.943， all P＜0.05）. The comorbidity group had significantly lower scores than the non-comorbidity group on the MoCA scale in visuospatial and executive function ［2 （2， 3），3（2， 3）］， attention ［3.5（3， 4）， 4.5（4， 5）］，and total score ［18（16， 20）， 19（18， 22）］， with all differences being statistically significant （Z=-2.044， -4.105， -2.909， all P＜0.05）. No significant differences were observed in other MoCA domains（P＞0.05）. Within the comorbidity group， significant differences in WC ［（95.06±6.75）cm， （86.61±5.46）cm］， FBG［（8.19±2.29）mmol/L， （6.62±1.50）mmol/L］ and WHtR［0.56（0.53， 0.61）， 0.51（0.49， 0.54）］ were observed between patients with and without a family history of mood disorders and/or T2DM （t=-4.782， -2.905， Z=-3.687， all P＜0.05）. Correlation analysis in the comorbidity group revealed that family aggregation of mood disorders was positively associated with WC （r=0.423， P=0.002）， FBG（r=0.384， P=0.006）， WHtR（r=0.392， P=0.005）， and HOMA-IR（r=0.385， P=0.006）. Family aggregation of diabetes showed positive correlations with BMI（r=0.316， P=0.025）， FBG（r=0.305， P=0.031）， WC（r=0.548， P=0.000） and WHtR （r=0.499， P=0.000）. A significant positive association was found between family histories of diabetes and mood disorders （r=0.456， P=0.001）.

Conclusions

Patients with BD comorbid with T2DM demonstrate higher FBG， more pronounced insulin resistance， abdominal obesity， and worse cognitive function. First-degree relatives of comorbid patients should prioritize monitoring glucose metabolism and WC to mitigate the risk of mood disorders and T2DM. WHtR is recommended as a key monitoring indicator.