The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis （GS/CACM 337-2023） was released by the China Association of Chinese Medicine on December 13^th， 2023. This expert consensus was developed by experts in methodology， pharmacy， and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine （CACM） and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine （pulmonary diseases） and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung， acute bronchitis， and acute attack of chronic bronchitis from the aspects of applicable populations， efficacy evaluation， usage， dosage， drug combination， and safety. It is expected to guide the rational drug use in medical and health institutions， give full play to the unique value of Qinbaohong Zhike oral liquid， and vigorously promote the inheritance and innovation of Chinese patent medicines.

It has been demonstrated that long-term space flights have a significantly greater impact on the cardiovascular, skeletal, and nervous systems of astronauts. The structural and functional alterations in the skeletal and muscular systems resulting from exposure to weightlessness can lead to the development of low back pain, significantly impairing the ability of astronauts to perform tasks and respond to emergencies. Both space flight and simulated microgravity have been shown to result in low back pain among astronauts, with the following factors identified as primary contributors to this phenomenon. The occurrence of intervertebral disc (IVD) edema results in the stimulation of type IV mechanoreceptors, which subsequently activate nociceptive afferents. The protrusion of an IVD causes compression of the spinal nerve roots. Furthermore, the elongation of the vertebral column and/or the diminished lumbar curvature of the spine exert traction on the dorsal root nerves. Paravertebral muscle degeneration leads to the inhibition of decreased nociceptive activity of the wide-dynamic range neurons of the spinal dorsal horn. Moreover, endogenous pain descending facilitation triggered by conditioning stimulation can be enhanced via the thalamic mediodorsal nuclei, while endogenous pain descending inhibition triggered by conditioning stimulation can be weakened via the thalamic ventromedial nuclei. Psychological factors may contribute to the development of low back pain. The mechanisms governing the generation, maintenance, and alleviation of low back pain in weightlessness differ from those observed in normal gravitational environments. This presents a significant challenge for space medicine research. Therefore, the elucidation of the occurrence and development mechanism of low back pain in weightlessness is important for the prevention and treatment during space flight. To reduce the incidence of low back pain during long-term missions on the space station, astronauts may choose to wear specialized space clothing that can provide axial physiological loads, designed to stimulate both musculature and skeletal structures, mitigating potential increases in vertebral column length, diminished lumbar curvature, and intervertebral disc edema and/or muscular atrophy. Additionally, assuming a “fetal tuck position” described as the knees to chest position may increase lumbar IVD hydrostatic pressure, subsequently reducing disc volume, rectifying diminished lumbar curvature, and alleviating dorsal root nerve tensions. Moreover, this position may reduce type IV mechanoreceptor facilitation and nerve impulse propagation from the sinuvertebral nerves of the annulus fibrosus. Elongated posterior soft tissues (apophyseal joint capsules and ligaments) with spinal flexion may potentially stimulate type I and II mechanoreceptors. It is also recommended to exercise the paraspinal muscles to prevent and alleviate the decrease in their cross-sectional area and maintain their structure and function. Photobiomodulation has been proved to be an effective means of activating the pain descending inhibition pathway of the central nervous system. In addition, astronauts should be encouraged to participate in mission-related activities and strive to avoid psychological problems caused by the long-term confinement in a small space station. The article presents a concise review of potential causes and targeted treatment strategies for low back pain induced by space flight or simulated microgravity in recent years. Its objective is to further elucidate the mechanisms underlying the occurrence and development of low back pain in weightless environments while providing scientific evidence to inform the development of guidelines for preventing, treating, and rehabilitating low back pain during long-term space flights.

Objective: To explore the characteristic of obesity in adolescents with major depressive disorder and its relationship with inflammatory cytokines. Methods : One hundred and forty adolescents with major depressive disorder were enrolled. According to the classification standard of body mass index(BMI) for adolescents in China, the patients were classified into underweight group, normal group, overweight group and obese group. The center for epidemiologic studies depression scale(CES-D) was used to evaluate symptoms of depression in patients, and ultrasensitive multiplex electrochemiluminescence detection technology was used to measure the levels of plasma inflammatory cytokines including interleukin(IL)-6,IL-17A,IL-1β,IL-6,IL-8 and tumour necrosis factor(TNF)-α. One-way ANOVA or Kruskal-WallisHtest and chi-square test were used for comparison between groups. Binary Logistic regression was used to analyze the influencing factors of obesity in adolescent patients with major depressive disorder. Results : Among the 140 adolescent patients with major depressive disorder, wasting were 9.3%(13/140), overweight were 17.9%(25/140) and obesity were 6.4%(9/140) respectively. There were statistically significant differences in gender(χ2=8.301,P<0.05) and inflammatory cytokines IL-6(H=16.217,P<0.01), IL-8(H=10.926,P<0.05) and TNF-α(H=7.879,P<0.05) among the four groups. Analysis of covariance showed that the difference in levels of the inflammatory cytokine IL-6(F=4.486,P<0.01) remained statistically significant after controlling for age, gender and antidepressant use. The results of multiple comparisons showed that compared with the wasting group, the plasma IL-6(Z=-3.843,PBonferroni calibrate<0.01) were higher in the obese group; compared with the normal group, the obesity rate of males was higher than that of females(χ2=8.812,PBonferroni calibrate<0.01), and the level of IL-6 in the obese group(Z=-3.023,PBonferroni calibrate<0.05) was higher. Binary Logistic regression analysis showed that plasma IL-6(OR=2.500,P<0.01) and gender(OR=11.292,P<0.01) were independent influencing factors for obesity in patients with adolescent depressive disorders. Conclusion There are gender differences in obesity rates in adolescents with depressive disorders, and obesity is associated with elevated levels of inflammatory cytokines.

Objective : To explore the predictive value of depression severity plasma thyroid-stimulating hormone(TSH) and brain-derived neurotrophic factor(BDNF) levels for agitated symptoms in patients with adolescent depressive disorder(MDD). Methods : Ninety-one patients with adolescent depressive disorder were enrolled, and the degree of agitation was assessed according to the modified outward aggressive behavior scale(MOAS); 24-item hamilton depression scale(HAMD24) was used to determine the severity of depression; chemiluminescence immunoassay(CLIA) was used to determine the plasma thyroid-stimulating hormone(TSH) level; and electrochemiluminescence immunoassay(ECL) was used to determine the plasma BDNF. SPSS 26.0 was used for statistical analysis of the data, Spearman correlation analysis was used to analyze the relationship between HAMD24and plasma TSH and BDNF levels and the degree of agitation, multiple linear regression analysis was used to analyze the factors influencing the degree of agitation in adolescents with MDD, and binary Logistic regression analysis and subjects′ work characteristic curves(ROC) were used to establish predictive models. Results: The degree of agitation in adolescent MDD patients was positively correlated with HAMD24total score(P<0.001); both HAMD24total score and plasma BDNF level were identified as risk factors for agitation severity(bothP<0.05); both HAMD24total score and plasma BDNF levels were risk factors for the degree of agitation(allP<0.05); HAMD24total score, plasma TSH, BDNF levels were all risk factors for concomitant agitation symptoms in adolescent MDD patients; ROC curve analysis showed that the three combined prediction models(AUC=0.889,P<0.001) had a higher predictive value than the single prediction model(P<0.01). Conclusion Concomitant agitation symptoms in adolescents with MDD are strongly associated with HAMD24total score and plasma TSH and BDNF levels, and the three combined models have good predictive power.

Background: Nasopharyngeal carcinoma (NPC) is characterized by high programmed death-ligand 1 (PD-L1) expression and abundant infiltration of non-malignant lymphocytes, which renders patients potentially suitable candidates for immune checkpoint blockade therapies. Palate, lung, and nasal epithelium clone (PLUNC) inhibit the growth of NPC cells and enhance cellular apoptosis and differentiation. Currently, the relationship between PLUNC (as a tumor-suppressor) and PD-L1 in NPC is unclear. Methods: We collected clinical samples of NPC to verify the relationship between PLUNC and PD-L1. PLUNC plasmid was transfected into NPC cells, and the variation of PD-L1 was verified by western blot and immunofluorescence. In NPC cells, we verified the relationship of PD-L1, activating transcription factor 3 (ATF3), and β-catenin by western blot and immunofluorescence. Later, we further verified that PLUNC regulates PD-L1 through β-catenin. Finally, the effect of PLUNC on β-catenin was verified by co-immunoprecipitation (Co-IP). Results: We found that PLUNC expression was lower in NPC tissues than in paracancer tissues. PD-L1 expression was opposite to that of PLUNC. Western blot and immunofluorescence showed that β-catenin could upregulate ATF3 and PD-L1, while PLUNC could downregulate ATF3/PD-L1 by inhibiting the expression of β-catenin. PLUNC inhibits the entry of β-catenin into the nucleus. Co-IP experiments demonstrated that PLUNC inhibited the interaction of DEAD-box helicase 17 (DDX17) and β-catenin. Conclusions PLUNC downregulates the expression of PD-L1 by inhibiting the interaction of DDX17/β-catenin in NPC.

BACKGROUND: Biomarkers-based prediction of long-term risk of acute coronary syndrome (ACS) is scarce. We aim to develop a risk score integrating clinical routine information (C) and plasma biomarkers (B) for predicting long-term risk of ACS patients. METHODS: We included 2729 ACS patients from the OCEA (Observation of cardiovascular events in ACS patients). The earlier admitted 1910 patients were enrolled as development cohort; and the subsequently admitted 819 subjects were treated as validation cohort. We investigated 10-year risk of cardiovascular (CV) death, myocardial infarction (MI) and all cause death in these patients. Potential variables contributing to risk of clinical events were assessed using Cox regression models and a score was derived using main part of these variables. RESULTS: During 16,110 person-years of follow-up, there were 238 CV death/MI in the development cohort. The 7 most important predictors including in the final model were NT-proBNP, D-dimer, GDF-15, peripheral artery disease (PAD), Fibrinogen, ST-segment elevated MI (STEMI), left ventricular ejection fraction (LVEF), termed as CB-ACS score. C-index of the score for predication of cardiovascular events was 0.79 (95% CI: 0.76-0.82) in development cohort and 0.77 (95% CI: 0.76-0.78) in the validation cohort (5832 person-years of follow-up), which outperformed GRACE 2.0 and ABC-ACS risk score. The CB-ACS score was also well calibrated in development and validation cohort (Greenwood-Nam-D'Agostino: P = 0.70 and P = 0.07, respectively). CONCLUSIONS CB-ACS risk score provides a useful tool for long-term prediction of CV events in patients with ACS. This model outperforms GRACE 2.0 and ABC-ACS ischemic risk score.

OBJECTIVE: To evaluate the protective effects of gentiopicroside (GPS) against reactive oxygen species (ROS)-induced NOD-like receptor family, pyrin domain containing 3 (NLRP3) inflammasome activation in endothelial cells, aiming to reduce atherosclerosis. METHODS: Eight-week-old male ApoE-deficient mice were randomly divided into 2 groups (n=10 per group): the vehicle group and the GPS treatment group. Both groups were fed a high-fat diet for 16 weeks. GPS (40 mg/kg per day) was administered by oral gavage to the GPS group, while the vehicle group received an equivalent volume of the vehicle solution. At the end of the treatment, blood and aortic tissues were collected for assessments of atherosclerosis, lipid profiles, oxidative stress, and molecular expressions related to NLRP3 inflammasome activation, ROS production, and apoptosis. Additionally, in vitro experiments on human aortic endothelial cells treated with oxidized low-density lipoprotein (ox-LDL) were conducted to evaluate the effects of GPS on NLRP3 inflammasome activation, pyroptosis, apoptosis, and ROS production, specifically examining the role of the sirtuin 1 (SIRT1)/nuclear factor erythroid 2-related factor 2 (Nrf2) pathway. SIRT1 and Nrf2 inhibitors were used to confirm the pathway's role. RESULTS: GPS treatment significantly reduced atherosclerotic lesions in the en face aorta (P<0.01), as well as in the thoracic and abdominal aortic regions, and markedly decreased sinus lesions within the aortic root (P<0.05 or P<0.01). Additionally, GPS reduced oxidative stress markers and proinflammatory cytokines, including interleukin (IL)-1 β and IL-18, in lesion areas (P<0.05, P<0.01). In vitro, GPS inhibited ox-LDL-induced NLRP3 activation, as evidenced by reduced NLRP3 (P<0.01), apoptosis-associated speck-like protein containing a CARD, cleaved-caspase-1, and cleaved-gasdermin D expressions (all P<0.01). GPS also decreased ROS production, apoptosis, and pyroptosis, with the beneficial effects being significantly reversed by SIRT1 or Nrf2 inhibitors. CONCLUSION GPS exerts an antiatherogenic effect by inhibiting ROS-dependent NLRP3 inflammasome activation via the SIRT1/Nrf2 pathway.
NLR Family, Pyrin Domain-Containing 3 Protein/metabolism* ; Reactive Oxygen Species/metabolism* ; Iridoid Glucosides/therapeutic use* ; NF-E2-Related Factor 2/metabolism* ; Animals ; Atherosclerosis/metabolism* ; Inflammasomes/drug effects* ; Male ; Sirtuin 1/metabolism* ; Signal Transduction/drug effects* ; Humans ; Endothelial Cells/pathology* ; Mice ; Oxidative Stress/drug effects* ; Apoptosis/drug effects* ; Lipoproteins, LDL ; Mice, Inbred C57BL

OBJECTIVE: To elucidate the modulation mechanism of Suanzaoren Decoction (SZRD) on basolateral amygdala (BLA) neuronal activity to alleviate chronic restraint stress (CRS)-related behavioral deficits. METHODS: The male C57BL/6J mice were assigned to 4 groups using the complete randomization method, including control (CON, n=19), CRS (n=19), SZRD (n=21), and fluoxetine (Flu, n=22) groups. Mice were restrained for 6 h per day, over a 21-d period to establish CRS models. The CON group remained in their cages without food or water during the 6-h matching period. SZRD and Flu groups received intragastric administration of SZRD (4.68 g/kg) and Flu (20 mg/kg) daily, respectively, 30 min before restraint for 21 consecutive days. The therapeutic effects of SZRD were evaluated using behavioral tests including the tail suspension test, elevated plus maze test, and forced swimming test. The cellular Fletcher B. Judson murine osteosarcoma proto-oncogene (c-Fos) expression in the BLA was measured using immunofluorescence, while action potential (AP) firing and synaptic transmission in BLA pyramidal neurons were evaluated using whole-cell patch-clamp recordings. RESULTS: SZRD administration significantly increased time spent in the open arms and open-arm entries while reducing immobility time (P<0.05 or P<0.01). It downregulated CRS-induced c-Fos expression and AP firing of pyramidal neurons in the BLA (P<0.01). Additionally, SZRD selectively attenuated excitatory (P<0.01), but not inhibitory, synaptic transmission onto BLA pyramidal neurons. CONCLUSION SZRD alleviated CRS-induced anxiety- and depression-like behaviors in mice by modulating the excitability and synaptic transmission of BLA pyramidal neurons.
Animals ; Drugs, Chinese Herbal/therapeutic use* ; Depression/complications* ; Pyramidal Cells/pathology* ; Male ; Mice, Inbred C57BL ; Basolateral Nuclear Complex/pathology* ; Restraint, Physical ; Anxiety/complications* ; Behavior, Animal/drug effects* ; Stress, Psychological/physiopathology* ; Mice ; Proto-Oncogene Proteins c-fos/metabolism* ; Action Potentials/drug effects* ; Synaptic Transmission/drug effects*

OBJECTIVES: Gastric cancer (GC) is the fifth most common cancer and the third leading cause of cancer-related death worldwide, posing a serious threat to public health. Prognostication of overall survival (OS) in patients undergoing radical gastrectomy remains a clinical priority. Evidence suggests that preoperative nutritional and inflammatory status correlated with postoperative outcomes. This study aims to evaluate the prognostic value of the skeletal muscle index at the third lumbar vertebra (L3-SMI) as a trichotomous variable and to compare the performance of commonly used nutritional and inflammation-related indicators in predicting postoperative survival in GC patients. METHODS: This retrospective study analyzed clinical data of patients who underwent radical gastrectomy with neoadjuvant chemotherapy between 2011 and 2018 at the Department of Gastrointestinal Surgery, Xiangya Hospital of Central South University. L3-SMI was measured by preoperative CT, and 8 preoperative nutritional/inflammatory indices were calculated from the latest laboratory tests before surgery: neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), pan-immune-inflammation value (PIV), albumin-globulin ratio (AGR), and prognostic nutritional index (PNI). L3-SMI was categorized into 3 groups using X-tiler software. ROC curves were used to determine optimal cut-off values for the other eight indices. Kaplan-Meier curves and univariate/multivariate Cox proportional hazards models were used to analyze the association between variables and OS. Concordance index (C-index) and subgroup analysis assessed predictive performance and consistency across patient subgroups. RESULTS: A total of 546 patients were included, with a minimum follow-up time of 36 months. Kaplan-Meier and univariate analysis showed that L3-SMI and the 8 indicators were significantly associated with OS (all P<0.01). After adjusting for age, gender, tumor site, differentiation, pTNM stage, type of surgery, anemia, CEA, and AFP, multifactorial Cox analysis revealed that L3-SMI (HR=0.676, 95% CI 0.523 to 0.872), AGR (HR=0.611, 95% CI 0.452 to 0.827), and PNI (HR=0.590, 95% CI 0.418 to 0.833) were independent predictors of OS. The full model confirmed the independent prognostic roles of L3-SMI, AGR, and PNI. Among all indicators, PNI had the highest C-index for 1-year OS prediction (0.632, 95% CI 0.568 to 0.695), while AGR showed the best performance at 3 years (0.585, 95% CI 0.548 to 0.622) and 5 years (0.578, 95% CI 0.542 to 0.613). Subgroup analysis indicated that higher L3-SMI, AGR, and PNI were associated with lower mortality risk in patients aged<65 years, with lower gastric tumors, poor differentiation, stage III pTNM, or who underwent subtotal gastrectomy. CONCLUSIONS Compared with other indicators, preoperative nutritional markers such as L3-SMI, AGR, and PNI demonstrated superior prognostic value for OS in gastric cancer patients undergoing radical gastrectomy. Assessing these indices can help identify patients at high risk of poor prognosis, thereby guiding targeted nutritional interventions and potentially improving survival outcomes.
Humans ; Stomach Neoplasms/mortality* ; Gastrectomy/methods* ; Retrospective Studies ; Female ; Male ; Middle Aged ; Prognosis ; Aged ; Adult ; Nutritional Status ; Inflammation ; Predictive Value of Tests ; Preoperative Period ; Survival Rate

Background: Nasopharyngeal carcinoma (NPC) is characterized by high programmed death-ligand 1 (PD-L1) expression and abundant infiltration of non-malignant lymphocytes, which renders patients potentially suitable candidates for immune checkpoint blockade therapies. Palate, lung, and nasal epithelium clone (PLUNC) inhibit the growth of NPC cells and enhance cellular apoptosis and differentiation. Currently, the relationship between PLUNC (as a tumor-suppressor) and PD-L1 in NPC is unclear. Methods: We collected clinical samples of NPC to verify the relationship between PLUNC and PD-L1. PLUNC plasmid was transfected into NPC cells, and the variation of PD-L1 was verified by western blot and immunofluorescence. In NPC cells, we verified the relationship of PD-L1, activating transcription factor 3 (ATF3), and β-catenin by western blot and immunofluorescence. Later, we further verified that PLUNC regulates PD-L1 through β-catenin. Finally, the effect of PLUNC on β-catenin was verified by co-immunoprecipitation (Co-IP). Results: We found that PLUNC expression was lower in NPC tissues than in paracancer tissues. PD-L1 expression was opposite to that of PLUNC. Western blot and immunofluorescence showed that β-catenin could upregulate ATF3 and PD-L1, while PLUNC could downregulate ATF3/PD-L1 by inhibiting the expression of β-catenin. PLUNC inhibits the entry of β-catenin into the nucleus. Co-IP experiments demonstrated that PLUNC inhibited the interaction of DEAD-box helicase 17 (DDX17) and β-catenin. Conclusions PLUNC downregulates the expression of PD-L1 by inhibiting the interaction of DDX17/β-catenin in NPC.