Objective To investigate the efficacy and safety of low-dose ammonia sulfur-sulfur-resistant treatment.Methods 120 patients with initial depression were randomly divided into a group(40 cases), the estercalyptrin group(40)and the drug group(40).The treatment was treated by the treatment of the ammonia sulfonate, 20 mg/d, 20 mg/d, and 20 mg/d of escitaloplan tablet.The clinical efficacy and response scale(TESS)was evaluated with the Hamilton depression scale(TESS)in the treatment of 1, 2, 4 and 8 over the weekend.Results Three groups showed significant improvement(P<0.01)during the 8th weekend of treatment of the HAMD scores.Grade 1 and 2 weekend, combined treatment group compared with single drug group score had significant difference(P<0.01), and the contrast between the single drug groups had no significant difference, 4 score over the weekend, and comparison between the three way were significant differences(P<0.05), 8 scores over the weekend, and share with escitalopram phthalein general group is no difference, but tolbutamide will benefit group compared with the other two groups had significant difference(P<0.01).Conclusion Small doses of tolbutamide will benefit has antidepressant effect, but the long-term curative effect of treatment is better than the amount of escitalopram citalopram, and share small doses of escitalopram citalopram tolbutamide will benefit can obviously accelerate the antidepressant treatment work.

Objective　To study the clinicopathologic features of hepatic angiomyolipoma (AML) and to investigate the feasibility of a new antibody-A103 as a diagnostic aid for AML. Methods　Ten cases of AML were retrieved from hospital records and analyzed morphologically. Immunohistochemistry was performed on paraffin-embedded tissues with a panel of antibodies, including antibody-A103. Results　There were eight women and two men, with ages ranging from 38-58 years (median 45.7). Clinically, nine cases were asymptomatic and found by imaging techniques. None of the patients had associated tuberous sclerosis. All tumors were sharply demarcated from the surrounding liver parenchyma. Histologically they were composed of a heterogeneous mixture of three components: thick-walled blood vessels, spindle or epithelioid smooth muscle cells and adipose tissue. All tumors showed a strong immunoreactivity to A103, HMB-45 and smooth muscle actins. Follow-up information on all 10 cases showed a benign course with no signs of recurrence. Conclusions　Hepatic AML is a rare mesenchymal tumor of the liver. A103 is a promising marker for a pathologic diagnosis of hepatic AML.

Objective:To explore the psychological resilience trajectory of stroke patients and its influencing factors.Methods:From October 2018 to October 2020, convenience sampling was used to select 200 first-episode stroke patients admitted to the First Affiliated Hospital of Xinxiang Medical University as the research object. The General Information Questionnaire, Disease-related Information Questionnaire, and Connor-Davidson Resilience Scale (CD-RISC) were used to investigate the patients. A total of 200 questionnaires were distributed during hospitalization, and 200 valid questionnaires were recovered. After discharge, 7 patients were lost to follow-up at 1 month, 8 at 3 months, and 3 at 6 months. Finally, a total of 182 patients completed the study.Results:Finally, 4 types of trajectories of psychological resilience were obtained, namely, decreased psychological resilience, increased psychological resilience, stable psychological resilience, and decreased low level of psychological resilience. Logistic regression analysis showed that functional impairment, unattended care, religious belief, on-the-job work, living alone, and swallowing dysfunction were the influencing factors of the psychological resilience trajectory of stroke patients ( P<0.05) . Conclusions:Stroke patients can show different types of psychological resilience trajectories in the acute phase, recovery phase, and sequelae phase. Functional impairment, unattended care, religious belief, on-the-job work, living alone, and swallowing dysfunction are the influencing factors of the psychological resilience trajectory of stroke patients. In clinical practice, individualized intervention should be given according to the characteristics of different patients.

Malignant tumor is a serious threat to human survival and development, and the delay of medical treatment for cancer patients has an effect on the survival rate of patients. This paper summarizes the definition of delayed medical treatment and the current situation, influencing factors and prevention and control countermeasures of delayed medical treatment in cancer patients, so as to provide references for medical personnel to formulate relevant measures of delayed medical treatment.

Objective:To explore the implicit bias of body image measurement in young and middle-aged people using implicit relational assessment procedure (IRAP) .Methods:ProQuest, Scopus, EBSCO, Cochrane Library, Web of Science, PubMed, China National Knowledge Infrastructure, WanFang data, and VIP databases were systematically searched to collect articles on the use of IRAP to measure implicit bias in body image in young and middle-aged populations. The retrieval period was from the establishment of the databases to December 15, 2023. Meta-analysis was conducted using Review Manager 5.4 software.Results:A total of 11 articles were included. The results of the Meta-analysis showed that the score of D general (reaction time index of pro-thinness and anti-fat) was 0.09 (95% CI: 0.07~0.11, P<0.01), indicating that compared with overweight/obesity, young and middle-aged people had a strong sense of identification with thinness and a stronger desire for thinness. The score of D thin (reaction time index of pro-thinness) was 0.26 (95% CI: 0.12~0.39, P<0.01), indicating that young and middle-aged people' reaction speed was faster when they agreed with thinness and participants had the desire to be thin. The score of D fat (reaction time index of anti-obesity) was -0.09 (95% CI: -0.21~0.03, P>0.05), indicating that young and middle-aged people had no bias against overweight/obesity. Conclusions:Young and middle-aged people generally have the performance of implicit thinness, with a strong desire for thinness and no implicit bias towards overweight.

Objective To investigate the value of abdominal aortic combined with routine one-stop triple rule-out computed tomography angiography(TRO-CTA)in the examination of patients with acute chest pain.Methods A total of 1 482 patients with nontraumatic chest pain were included in this retrospective study.Of them 414 patients underwent the conventional TRO-CTA scanning while 1 068 patients underwent TRO-CTA that included the abdominal aorta(TRO-CTAwAA)under the request of clinicians.All scanning parameters were the same,except the scanning range for the third phase in TRO-CTA:conventional TRO-CTA covered only the thoracic aorta,while TRO-CTAwAA extended to the entire aorta.Patient etiology was investigated and the detection rates of major vessel abnormalities(aortic dissection,aneurysm,penetrating ulcer,intramural hematoma,vascular occlusion,and thrombosis)between the two groups was compared using chi square tests.The radiation dose(CTDIvol and DLP)and scanning time between the two groups were compared using analysis of variance(ANOVA).Results The TRO-CTAwAA had significantly higher detection rate of major artery abnormalities than the TRO-CTA group(35.1％vs.4.8％,P＜0.001).In the TRO-CTAwAA group,26.5％of the vascular anomalies were detected in both the thoracic and abdominal aortas,and another 8.6％were seen only in the abdominal aorta.With regard to the radiation dose between the two groups,the total DLP was significantly higher in the TRO-CTAwAA group than in the conventional TRO-CTA group(P＜0.001).The two groups did not significantly differ in scanning time(P=0.410).Conclusion TRO-CTA with scan range including the abdominal aorta significantly improves the detection rate for major vessel abnormalities in patients with chest pain without increasing the examination process.

BACKGROUND: Cholecystectomy is a standard surgery for patients suffering from gallbladder diseases, while the causal effects of cholecystectomy on colorectal cancer (CRC) and other complications are still unknown. METHODS: We obtained genetic variants associated with cholecystectomy at a genome-wide significant level ( P value <5 × 10 -8 ) as instrumental variables (IVs) and performed Mendelian randomization (MR) to identify the complications of cholecystectomy. Furthermore, the cholelithiasis was also treated as the exposure to compare its causal effects to those of cholecystectomy, and multivariable MR analysis was carried out to judge whether the effect of cholecystectomy was independent of cholelithiasis. The study was reported based on Strengthening the Reporting of Observational Studies in Epidemiology Using Mendelian Randomization guidelines. RESULTS: The selected IVs explained 1.76% variance of cholecystectomy. Our MR analysis suggested that cholecystectomy cannot elevate the risk of CRC (odds ratio [OR] =1.543, 95% confidence interval [CI]: 0.607-3.924). Also, it was not significant in either colon or rectum cancer. Intriguingly, cholecystectomy might decrease the risk of Crohn's disease (OR = 0.078, 95% CI: 0.016-0.368) and coronary heart disease (OR = 0.352, 95% CI: 0.164-0.756). However, it might increase the risk of irritable bowel syndrome (IBS) (OR = 7.573, 95% CI: 1.096-52.318). Cholelithiasis could increase the risk of CRC in the largest population (OR = 1.041, 95% CI: 1.010-1.073). The multivariable MR analysis suggested that genetic liability to cholelithiasis could increase the risk of CRC in the largest population (OR = 1.061, 95% CI: 1.002-1.125) after adjustment of cholecystectomy. CONCLUSIONS The study indicated that cholecystectomy might not increase the risk of CRC, but such a conclusion needs further proving by clinical equivalence. Additionally, it might increase the risk of IBS, which should be paid attention to in clinical practice.
Humans ; Mendelian Randomization Analysis ; Irritable Bowel Syndrome ; Colorectal Neoplasms/genetics* ; Cholelithiasis/complications* ; Cholecystectomy/adverse effects* ; Genome-Wide Association Study ; Polymorphism, Single Nucleotide

The gut microbiota plays a pivotal role in the immunomodulatory and protumorigenic microenviron-ment of colorectal cancer(CRC).However,the effect of ginsenoside Rk3(Rk3)on CRC and gut microbiota remains unclear.Therefore,the purpose of this study is to explore the potential effect of Rk3 on CRC from the perspective of gut microbiota and immune regulation.Our results reveal that treatment with Rk3 significantly suppresses the formation of colon tumors,repairs intestinal barrier damage,and regulates the gut microbiota imbalance caused by CRC,including enrichment of probiotics such as Akkermansia muciniphila and Barnesiella intestinihominis,and clearance of pathogenic Desulfovibrio.Subsequent metabolomics data demonstrate that Rk3 can modulate the metabolism of amino acids and bile acids,particularly by upregulating glutamine,which has the potential to regulate the immune response.Furthermore,we elucidate the regulatory effects of Rk3 on chemokines and inflammatory factors associated with group 3 innate lymphoid cells(ILC3s)and T helper 17(Th17)signaling pathways,which inhibits the hyperactivation of the Janus kinase-signal transducer and activator of transcription 3(JAK-STAT3)signaling pathway.These results indicate that Rk3 modulates gut microbiota,regulates ILC3s immune response,and inhibits the JAK-STAT3 signaling pathway to suppress the development of colon tumors.More importantly,the results of fecal microbiota transplantation suggest that the inhibitory effect of Rk3 on colon tumors and its regulation of ILC3 immune responses are mediated by the gut microbiota.In summary,these findings emphasize that Rk3 can be utilized as a regulator of the gut microbiota for the prevention and treatment of CRC.

Hepatocellular carcinoma(HCC)is the third leading cause of cancer death worldwide.Ginsenoside Rk3,an important and rare saponin in heat-treated ginseng,is generated from Rg1 and has a smaller mo-lecular weight.However,the anti-HCC efficacy and mechanisms of ginsenoside Rk3 have not yet been characterized.Here,we investigated the mechanism by which ginsenoside Rk3,a tetracyclic triterpenoid rare ginsenoside,inhibits the growth of HCC.We first explored the possible potential targets of Rk3 through network pharmacology.Both in vitro(HepG2 and HCC-LM3 cells)and in vivo(primary liver cancer mice and HCC-LM3 subcutaneous tumor-bearing mice)studies revealed that Rk3 significantly inhibits the proliferation of HCC.Meanwhile,Rk3 blocked the cell cycle in HCC at the G1 phase and induced autophagy and apoptosis in HCC.Further proteomics and siRNA experiments showed that Rk3 regulates the phosphatidylinositol 3-kinase(PI3K)/protein kinase B(AKT)pathway to inhibit HCC growth,which was validated by molecular docking and surface plasmon resonance.In conclusion,we report the discovery that ginsenoside Rk3 binds to PI3K/AKT and promotes autophagy and apoptosis in HCC.Our data strongly support the translation of ginsenoside Rk3 into novel PI3K/AKT-targeting ther-apeutics for HCC treatment with low toxic side effects.

Panax ginseng is a traditional Chinese medicine with significant pharmaceutical effects and wide application. Through orientational modification and transformation of ginsenoside glycosyl, rare ginsenosides with high antitumor activities can be generated. Traditional chemical methods cannot be applied in clinic. because of extremely complex preparation technologies and very high cost Transformations using microorganisms and their enzymatic systems provide the most feasible methods for solving the main problems. At present, the key problems in enzymatic synthesis of ginsenosides include low specific enzyme activities, identity of enzymes involved in the enzymatic synthesis, and their catalytic mechanisms, as well as nonsystematic studies on structural bioinformatics; specificity of enzymatic hydrolysis for saponin glycosyl has been rarely studied. Many reviews have been reported on glycosidase molecular recognition, immobilization, and biotransformation in ionic liquids (ILs), whereas ginsenoside transformation and application have not been systematically studied. To evaluate theoretical and applied studies on ginsenoside-oriented biotransformation, by reviewing the latest developments in related fields and evaluating the widely applied biocatalytic strategy, this review aims to evaluate the ginsenoside-oriented transformation method with improved product specificity, increased biocatalytic efficiency, and industrial application prospect based on the designed transformations of enzyme and solvent engineering of ILs. Therefore, useful theoretical and experimental evidence can be obtained for the development of ginsenoside anticancer drugs, large-scale preparation, and clinical applications in cancer therapy.
Biocatalysis ; Ginsenosides ; Glycoside Hydrolases ; Panax ; Saponins