Objective To observe the influence of nasal washing with Bidouguan Perfusate (BP) on nasal mucosal cytokines of nasal polyp patients after operation. Methods Thirty-nine nasal polyp patients were randomized into BP group ( N=18) and normal saline group ( N=21). All patients received operation for nasal polyp and postoperative comprehensive treatment, and additionally, BP group was given washing with BP and normal saline group was washed with 0.9%normal saline for 3 months. The scores of SNOT-20 and Lund-Kennedy were observed for the evaluation of therapeutic effect. Enzyme-linked immunosorbent assay ( ELISA) was used for detection of interleukin 5 (IL-5), interleukin 8 (IL-8), interleukin 10 (IL-10), interferon gamma (IFN-γ), granulocyte-macrophage colony-stimulating factor (GM-CSF), tumor necrosis factor alpha (TNF-α) in nasal mucosa before operation and 3 months after operation. Results ( 1) SNOT-20 and Lund-Kennedy scores were decreased after operation ( P <0.05 compared with those before operation) , the difference being insignificant between the two group after operation ( P>0.05). ( 2) The expression levels of IL-5, IL-8, IL-10, IFN-γ, TNF-αand GM-CSF in the nasal mucosa were decreased in both groups 3 months after operation (P<0.05), and the decrease of IL-5, IL-8, IL-10 and IFN-γ in BP group was superior to that in the normal saline group ( P<0.05) . The differences of TNF-α and GM-CSF levels were insignificant between the two groups after operation ( P>0.05). Conclusion Nasal washing with BP has similar effect to normal saline on improving the quality of life and nasal mucosal histology 3 months after operation, but BP has better effect on regulating nasal mucosal IL-5, IL-8, IL-10 and IFN-γ.

Objective To investigate the changes in plasma very long chain fatty acids (VLCFAs),and to explore its relationship with obesity-related index in obese children.Methods One hundred and sixty-six obese children aged 7 to 12 years old were investigated and 148 health children matched with age and sex were selected as control group.Their height,weight,and waist circumference (WC) were measured.The percentage of body fat (PBF) was tested by dual-energy X-ray absorptiometry.Fasting blood triglycerides (TG),total cholesterol (TC),high density lipoprotein-cholesterol (HDL-C),low density lipoprotein-cholesterol (LDL-C) levels,fasting plasma glucose,and fasting insulin (FINS) were determined.The body mass index (BMI),BMI-Z score,waist to height ratio (WHtR),and homeostasis model assessment for insulin resistance (HOMA-IR) were calculated.The plasma VLCFAs were analyzed by gas chromatography-mass spectrometry.Results (1) Compared with normal control children,body weight,BMI,BMI-Z score,WC,WHtR,PBF,TG,TC,LDL-C,FINS,and HOMA-IR in obese children were increased (all P ＜ 0.05),and the level of HDL-C was decreased (P ＜ 0.05).(2) The plasma levels of docosamonoenoic acid (C22 ∶ 1 n-9) and arachidonic acid (C20 ∶ 4n-6) were decreased while the levels of arachicacid (C20 ∶ 0) and eicosapentaenoic acid (C20 ∶ 5n-3) increased in obese children compared to non-obese children.(3) The linear correlation analysis showed that PBF was positively correlated with C20 ∶ 0 and C20 ∶ 5n-3,and negatively correlated with C20 ∶ 4n-6.WHtR was negatively correlated with C22 ∶ 1 n-9 and positively correlated with C20 ∶ 0 (4) The multiple stepwise regression analysis showed that C20 ∶ 0 was the main factor for PBF,and C22 ∶ 1 n-9 and C20 ∶ 0 were the main factors for WHtR.Conclusion The metabolic abnormality of plasma very long chain fatty acids exists in obese children.The changes in C20 ∶ 0,C22 ∶ 1 n-9,and C20 ∶ 5n-3 may be associated with obesity in children.

Objective To observe whether mesenchymal stem cells(MSCs) which have been induced by 5-azacytidine(5-aza) can differentiate into cardiac like cells. To find out the role of TITIN playing during the development of cardiomycytes among structure proteins. Methods To establish a recombinant plasmid vector involving a shRNA which matching the base pair of rat TITIN N2B region mRNA perfectly,transfect it into normal neonatal cardiomyocytes and MSCs which have been induced by 5-aza respectively and investigate the expression of TITIN Z band,MHC,ACTIN as well as cTnT by immunofluorescence. Results The expression of TITIN was weakened after recombinant plasmid has been transfected into neonatal cardiomyocytes.The same thing happened upon MSCs that have been induced by 5-aza. The expression of cTnT was weakened after TITIN been silenced by small interfering RNA (siRNA). But there was obvious change in MHC and ACTIN. Conclusion Our results demonstrate that MSCs can be induced into cardiomyocyte-like cells by 5-aza in vitro,although the degree of differentiation is still lower and can not form intact contractive structure. TITIN plays an important role in the development of structure proteins.

Objective:To generally evaluate the evaluation tools of post-stroke depression (PSD).Methods:Eight Chinese and English databases were retrieved, with a search deadline from the database establishment until December 31, 2022. Based on the theoretical framework of scope review, the relevant information was extracted and search results were analyzed.Results:44 articles were included, 20 of which were for the development of evaluation tools, and 24 were for the reliability, validity, sensitivity, and specificity tests of evaluation tools.Conclusions:At present, specific evaluation tools for patients with PSD have been available, but there is a lack of reliability and validity tests. In the future, the tests of specific evaluation tools should be strengthened. When choosing non-specific evaluation tools, high sensitivity evaluation tools should be selected. The evaluation results are influenced by many factors, and when selecting evaluation tools, it is necessary to generally evaluate factors such as the conditions of tool use, evaluator, and patient's own conditions.

Objective:To investigate the predictive value of controlled nutritional status (CONUT) score for overt hepatic encephalopathy (OHE) after transjugular intrahepatic portosys-temic stent-shunt (TIPSS) in Budd-Chiari syndrome patients.Method:The retrospective case-control study was conducted. The clinicopathological data of 48 Budd-Chiari syndrome patients who underwent TIPSS in the First Affiliated Hospital of Zhengzhou University from August 2014 to March 2021 were collected. There were 26 males and 22 females, aged (46±13)years. Observation indicators: (1) surgical situations and follow-up; (2) analysis of influencing factors of OHE after TIPSS; (3) predic-tion of OHE after TIPSS. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was performed using the t test. Measurement data with skewed distribution were represented by M( Q1, Q3), and comparison between groups was performed using the Mann-Whitney U test. Count data were expressed as absolute numbers or percentages, and comparison between groups was performed using the chi-square test or Fisher exact probability. Multivariate analysis was performed using the Logistic regression model with forward method. The receiver operating characteristic (ROC) curve was drawn and the area under the curve (AUC) was calculated to evaluate the efficacy. Comparison among AUC was performed using the Delong test. Results:(1) Surgical situations and follow-up. All 48 patients underwent TIPSS successfully, and the operation time of the 48 patients was (131±29)minutes. All patients were implanted with 8 mm covered stent. All 48 patients were followed up for 46(25,71)months, and there were 14 cases with OHE and 34 cases without OHE after TIPSS. Of the 14 cases with OHE, 12 cases were evaluated as West-Haven Ⅱ grade and 2 cases were evaluated as West-Haven Ⅲ grade. (2) Analysis of influencing factors of OHE after TIPSS. Results of multivariate analysis showed that history of hepatic encephalo-pathy and CONUT score were independent factors influencing the incidence of OHE of Budd-Chiari syndrome patients who underwent TIPSS ( odds ratio=8.36, 1.74, 95% confidence interval as 1.02?68.75, 1.12?2.69, P<0.05). (3) Prediction of OHE after TIPSS. Results of ROC curve showed that the AUC of the CONUT score, the Child-Pugh score of liver function and the integrated model of end-stage liver disease (iMELD) score in predicting the incidence of OHE after TIPSS was 0.77(95% confidence interval as 0.64?0.91, P<0.05), 0.71(95% confidence interval as 0.56?0.87, P<0.05) and 0.71(95% confidence interval as 0.53?0.88, P<0.05), respectively, and there was no significant difference between the AUC of the CONUT score and the Child-Pugh score of liver function or the iMELD score ( Z=0.84, 0.59, P>0.05). The optimal cutoff value of CONUT score in predicting the incidence of OHE after TIPSS was 7, with the sensitivity, specificity and Yodon index as 78.6%, 61.8% and 0.40, respectively. Conclusion:The CONUT score can be used to predict the incidence of OHE in Budd-Chiari syndrome patients who underwent TIPSS, and the discrimination of CONUT score is equivalent to the Child-Pugh score of liver function and the iMELD score.

Objective"Astragalus-Leech"medicine pair can reduce cerebral ischemia-reperfusion injury(CIRI),but its mechanism of action is not yet clear.Ferroptosis is a new target of CIRI.In this paper,the mechanism of the"Astragalus-Leech"medicine pair on regulating ferroptosis in the treatment of CIRI was investigated using the network pharmacology approach.Methods The active ingredients and targets of Astragalus-Leech were obtained by searching databases,such as PubChem,SwissTargetPrediction,Batman-TCM,UniProt,TCMSP and other databases,respectively;the CIRI-related targets were collected by searching GeneCards database;the Venny online tool was used to obtain the common targets of"Astragalus-Leech"medicine pairs for active ingredients and CIRI.Cytoscape software was used to construct a network of interrelationships between the active ingredients,disease and predicted targets of the"Astragalus-Leech"medicine pair,the protein interaction network was visualized,and CytoHubba plug-in was used to calculate the core targets.The GO analysis and KEGG analysis of the targets of"Astragalus-Leech"in the treatment of CIRI were performed using R language software.Using FerrDb database,the genes related to the regulation of ferroptosis were obtained,and the common genes among the active ingredients,CIRI and ferroptosis in the"Astragalus-Leech"medicine pair were analyzed to investigate their relationship and make predictions.AutoDockTools 1.5.7 and other softwares were used to verify the molecular docking between the active ingredients and key targets.Results Through searching the databases,28 active ingredients of"Astragalus-Leech"medicine pair,680 predicted gene targets of the drug pair,1513 targets related to CIRI,253 common targets of drug pair-disease,259 targets related to ferroptosis were obtained.28 potential targets,including PIK3CA,RELA,MAPK1,MAPK8,PTGS2,STAT3,SRC,NOS2,etc.on the regulation of ferroptosis and intervention in CIRI,and 279 signaling pathways including PI3K-Akt,Ras,TNF,MAPK,and HIF-1 were obtained through related prediction.Molecular docking showed that there was an interaction between the key components of the drug pair and the core targets.The"Astragalus-Leech"medicine pair may intervene in the development of CIRI by regulating ferroptosis and exert its therapeutic effects.Conclusion Using network pharmacology methods,the potential targets and related pathways of"Astragalus-Leech"on the active ingredients by regulating ferroptosis against CIRI were analyzed,suggesting that"Astragalus-Leech"may play its role in anti-CIRI through oxidative stress and anti-inflammatory pathways to regulate ferroptosis pathway,and provide a basis for further cell and animal experiments.

Didangtang is a classic formula for treating blood stasis and heat， as recorded in the Treatise on Febrile Diseases， and it has been highly praised by medical practitioners throughout history. It has been recorded in many traditional Chinese medical texts and used to this day. This article comprehensively examined the records of Didangtang in different ancient versions of Treatise on Febrile Diseases by excavating and sorting out related ancient medical books and modern literature. It also investigated the dosage unit measurement， preparation method， and content of the formula in medical books throughout history. The article provided a detailed summary and exploration of the origins and processing methods of rhubarb， peach kernels， leeches， and flies in the formula. At the same time， it reviewed the clinical practice of Didangtang by medical practitioners throughout history in relevant medical books， mainly including the adjustment of dosage forms， the increase or decrease in medicinal taste and dosage， the expansion of clinical application， and the creation and elucidation of similar formulas. Although there may be differences in the above information among medical practitioners throughout history， the basic idea of attacking blood stasis and heat is consistent. In addition， based on clinical practice， the author adhered to the principle of treating stasis and heat disease as the first reference when using Didangtang. It was suggested that blood should be circulated instead of stopping in the treatment of stasis and heat accumulation syndrome. At the same time， it was believed that the use of the method of attacking stasis and heat to regulate brain diseases and mental illnesses derives from the fact that removing stasis and generating new energy can nourish the heart and mind， providing ideas for the treatment of such diseases with Didangtang. On this basis， modern clinical and animal experiments have shown that Didangtang has certain effects in improving microcirculation disorders， regulating blood rheology and hemodynamics， enhancing insulin resistance， and inhibiting inflammatory reactions. This may be an important mechanism for the formula to ''conquer blood stasis and heat''. This article explored the textual research and clinical mechanism of Didangtang， presenting facts and evidence， so as to provide a reference for the clinical application of Didangtang and the research on other prescriptions.