OBJECTIVE To evaluate the efficacy and safety of Weiyan Tongluo Granules in treating chronic atrophic gastritis(CAG)and explore its potential mechanisms.METHODS From June 2020 to December 2022,100 CAG patients with spleen defi-ciency and blood stasis syndrome were enrolled and randomly divided into a trial group(n=50)and a control group(n=50)using a random number table.The trial group received Weiyan Tongluo Granules plus a folic acid placebo,while the control group received fo-lic acid tablets plus a traditional Chinese medicine granule placebo.The treatment course for both groups was 24 weeks,with 8 and 10 dropouts in the trial and control groups,respectively.Post-treatment comparisons included OLGA/OLGIM staging reversal rates,low-grade intraepithelial neoplasia regression rate,SSDPRO-CG(Patient-Reported Outcome Scale for Chronic Gastritis in Spleen-Stomach Diseases)scores,TCM syndrome scores,and safety indicators.Serum levels of PG I,PGⅡ,PGR,and G-17 were measured via ELISA before and after treatment.Gastric mucosal p-NF-κB and CDX2 protein expression levels were analyzed by Western blot,while mRNA levels of IL-1β,IL-6,VIL1,and MUC2 were quantified via qPCR.RESULTS After treatment,the trial group showed sig-nificantly higher OLGA and OLGIM stage reversal rates than the control group(P<0.05,P<0.01),though no significant difference was observed in low-grade intraepithelial neoplasia regression.Both groups exhibited significant improvements in physiological domain scores and total SSDPRO-CG scores(P<0.01),with the trial group outperforming the control group in physiological,independence,psychological domains,and total scores(P<0.05,P<0.01).TCM syndrome scores(total and sub-items:gastric distension,pain,poor appetite,bloating)decreased significantly in both groups(P<0.01),while the trial group showed greater reductions in loose stools and dull complexion(P<0.01).After-treatment,the trial group had significantly lower TCM syndrome scores than the control group(P<0.05,P<0.01).Serum PG I,PGⅡ,PGR,G-17,gastric mucosal p-NF-κB,CDX2,and IL-1β,IL-6,VIL1,MUC2 mRNA levels improved significantly in the trial group(P<0.05,P<0.01),while the control group improved only in PGⅡ(P<0.05,P<0.01).The trial group's improvements in these biomarkers surpassed the control group's(P<0.05,P<0.01).No treatment-related adverse events occurred in either group.CONCLUSION Weiyan Tongluo Granules ameliorate gastric mucosal pathology,clinical symptoms,psychological state,and quality of life in CAG patients without significant adverse effects.Its mechanism may involve sup-pressing the NF-κB pathway to reduce IL-1β and IL-6 expression,downregulating CDX2 to inhibit VIL1 and MUC2 transcription,thereby reversing the vicious cycle of inflammation-intestinal metaplasia.

Objective To explore the diagnostic and prognostic values of procalcitonin(PCT),interleukin 6(IL-6)and cystatin C(CysC)combined detection in sepsis acute kidney injury(AKI).Methods A total of 100 patients with sepsis were divided into the AKI group(n=56)and the non AKI group(n=44)according to the occurrence of AKI.The prognosis of AKI patients was followed up,and patients were divided into the survival group(n=32)and the death group(n=24)according to the presence or absence of death.Enzyme-linked immunosorbent assay(ELISA)was used to detect PCT,IL-6 and CysC in different groups of patients.The Acute Physiological Function and Chronic Health Status Score(APACHEⅡ)was used to assess the condition of illness.ROC curve was used to analyze the predictive values of PCT,IL-6 and CysC in the diagnosis and death of sepsis combined with AKI.Results The male ratio,age,hypertension with diabetes ratio,APACHE Ⅱ score,serum creatinine(Scr),PCT,IL-6 and CysC levels were higher in the AKI group than those in the non AKI group,and the ratio of complications and onset time were lower in the AKI group than those in the non AKI group(P＜0.05).The ROC curve results showed that the area under the curve(AUC)of PCT,IL-6,and CysC combined for the diagnosis of sepsis complicated with AKI was 0.859,with a sensitivity of 91.07%and a specificity of 90.91%.The combined diagnostic efficacy was better than that of a single indicator.The APACHE Ⅱ score,PCT,IL-6 and CysC levels were higher in the death group than those in the survival group(P＜0.05).The ROC curve results showed that the AUC,sensitivity and specificity of PCT,IL-6 and CysC combined in predicting mortality in sepsis patients with AKI were 0.847,91.67%and 87.50%,respectively.The combined predictive efficacy was better than that of single indicator.Conclusion The combination of PCT,CysC and IL-6 indicators is more valuable in diagnosing and predicting prognosis of sepsis with AKI.

Objective To explore the diagnostic and prognostic values of procalcitonin(PCT),interleukin 6(IL-6)and cystatin C(CysC)combined detection in sepsis acute kidney injury(AKI).Methods A total of 100 patients with sepsis were divided into the AKI group(n=56)and the non AKI group(n=44)according to the occurrence of AKI.The prognosis of AKI patients was followed up,and patients were divided into the survival group(n=32)and the death group(n=24)according to the presence or absence of death.Enzyme-linked immunosorbent assay(ELISA)was used to detect PCT,IL-6 and CysC in different groups of patients.The Acute Physiological Function and Chronic Health Status Score(APACHEⅡ)was used to assess the condition of illness.ROC curve was used to analyze the predictive values of PCT,IL-6 and CysC in the diagnosis and death of sepsis combined with AKI.Results The male ratio,age,hypertension with diabetes ratio,APACHE Ⅱ score,serum creatinine(Scr),PCT,IL-6 and CysC levels were higher in the AKI group than those in the non AKI group,and the ratio of complications and onset time were lower in the AKI group than those in the non AKI group(P＜0.05).The ROC curve results showed that the area under the curve(AUC)of PCT,IL-6,and CysC combined for the diagnosis of sepsis complicated with AKI was 0.859,with a sensitivity of 91.07%and a specificity of 90.91%.The combined diagnostic efficacy was better than that of a single indicator.The APACHE Ⅱ score,PCT,IL-6 and CysC levels were higher in the death group than those in the survival group(P＜0.05).The ROC curve results showed that the AUC,sensitivity and specificity of PCT,IL-6 and CysC combined in predicting mortality in sepsis patients with AKI were 0.847,91.67%and 87.50%,respectively.The combined predictive efficacy was better than that of single indicator.Conclusion The combination of PCT,CysC and IL-6 indicators is more valuable in diagnosing and predicting prognosis of sepsis with AKI.

OBJECTIVE To evaluate the efficacy and safety of Weiyan Tongluo Granules in treating chronic atrophic gastritis(CAG)and explore its potential mechanisms.METHODS From June 2020 to December 2022,100 CAG patients with spleen defi-ciency and blood stasis syndrome were enrolled and randomly divided into a trial group(n=50)and a control group(n=50)using a random number table.The trial group received Weiyan Tongluo Granules plus a folic acid placebo,while the control group received fo-lic acid tablets plus a traditional Chinese medicine granule placebo.The treatment course for both groups was 24 weeks,with 8 and 10 dropouts in the trial and control groups,respectively.Post-treatment comparisons included OLGA/OLGIM staging reversal rates,low-grade intraepithelial neoplasia regression rate,SSDPRO-CG(Patient-Reported Outcome Scale for Chronic Gastritis in Spleen-Stomach Diseases)scores,TCM syndrome scores,and safety indicators.Serum levels of PG I,PGⅡ,PGR,and G-17 were measured via ELISA before and after treatment.Gastric mucosal p-NF-κB and CDX2 protein expression levels were analyzed by Western blot,while mRNA levels of IL-1β,IL-6,VIL1,and MUC2 were quantified via qPCR.RESULTS After treatment,the trial group showed sig-nificantly higher OLGA and OLGIM stage reversal rates than the control group(P<0.05,P<0.01),though no significant difference was observed in low-grade intraepithelial neoplasia regression.Both groups exhibited significant improvements in physiological domain scores and total SSDPRO-CG scores(P<0.01),with the trial group outperforming the control group in physiological,independence,psychological domains,and total scores(P<0.05,P<0.01).TCM syndrome scores(total and sub-items:gastric distension,pain,poor appetite,bloating)decreased significantly in both groups(P<0.01),while the trial group showed greater reductions in loose stools and dull complexion(P<0.01).After-treatment,the trial group had significantly lower TCM syndrome scores than the control group(P<0.05,P<0.01).Serum PG I,PGⅡ,PGR,G-17,gastric mucosal p-NF-κB,CDX2,and IL-1β,IL-6,VIL1,MUC2 mRNA levels improved significantly in the trial group(P<0.05,P<0.01),while the control group improved only in PGⅡ(P<0.05,P<0.01).The trial group's improvements in these biomarkers surpassed the control group's(P<0.05,P<0.01).No treatment-related adverse events occurred in either group.CONCLUSION Weiyan Tongluo Granules ameliorate gastric mucosal pathology,clinical symptoms,psychological state,and quality of life in CAG patients without significant adverse effects.Its mechanism may involve sup-pressing the NF-κB pathway to reduce IL-1β and IL-6 expression,downregulating CDX2 to inhibit VIL1 and MUC2 transcription,thereby reversing the vicious cycle of inflammation-intestinal metaplasia.

BACKGROUND:Previous studies have found that electroacupuncture can delay articular cartilage degeneration mediated by JAK-STAT signaling pathway through upregulating the expression level of transforming growth factor β1 as well as mRNA expression levels of STAT3, Smad3 and LepR. In the meanwhile, electroacupuncture can inhibit the mRNA expression of p38 and Fas mRNA mediated by MAPK signaling pathways, further inhibiting the apoptosis of chondrocytes. OBJECTIVE: To explore the effect of electroacupuncture on the degeneration of articular cartilage in rats with knee osteoarthritis based on Ras-Raf-MEK1/2-ERK1/2 signaling pathway. METHODS:120 male healthy Sprague-Dawley rats aged 2 months olds were selected and randomly divided into normal, model, 15-minite electroacupuncture and 30-minute electroacupuncture groups (n=30 per group). The rats in the latter three groups received the intra-articular injection of 4% papain bilaterally, and the remaining rats received no intervention. At 2 weeks after modeling, the latter two groups were respectively given 15- and 30-minute electroacupuncture, five times weekly for consecutive 12 weeks. The morphology of the cartilage was observed by hematoxylin-eosin staining, the expression level of interleukin-1β in the synovium was detected by ELISA assay, and the protein expression levels of Ras, Raf, MEK1/2, ERK1/2, C-MYC, C-FOS, and C-JUN were detected by western blot analysis. RESULTS AND CONCLUSION: Hematoxylin-eosin staining showed that: in the model group, the cartilage surface was rough, the cartilage layer became thinner, and the cartilage structure was damaged with incomplete tidal line; in the 15- and 30-minute electroacupuncture groups, the cartilage structure was complete with clear layers and complete tidal line. ELISA showed that the expression level of interleukin-1β in the model group was significantly higher than that in the normal group (P< 0.01), and the level in the 15- and 30-minute electroacupuncture groups was significantly lower than that in the model group (P < 0.05). Western blot assay found that compared with the normal group, the protein expression levels of Ras, Raf, MEK1/2, ERK1/2, C-MYC, C-FOS, and C-JUN were increased in the model group. However, all above protein levels except ERK1/2 in the 15- and 30-minute electroacupuncture groups were significantly lower than those in the model group (P < 0.01,P < 0.05). To conclude, electroacupuncture inhibits the degeneration of articular cartilage in osteoarthritisvia Ras-Raf-MEK1/2-ERK1/2 signaling pathway and downregulating the expression level of interleukin-1β.

OBJECTIVE:To provide reference for quality evaluation of Ejiao. METHODS:The contents of 17 amino acids in 18 batches of Ejiao from 18 manufacturers were analyzed by automatic amino acid analyzer;the content data was processed by prin-cipal component analysis (PCA) and hierarchical clustering analysis (HCA),in order to understand the relationship among these amino acids and categorize the Ejiao products. RESULTS:Except for a batch of Ejiao,the other 17 batches contained 17 various amino acids,including 7 necessary amino acids(Thr,Val,Met,Ile,Leu,Phe and Lys)for human being,especially the contents of Gly and Pro were higher. The total content of amino acids was arranged from 66.1% to 82.0%,showing great difference. Four main components were extracted by PCA,the cumulative contribution of which was 89.578%,and accordingly it may be consid-ered that Pro,Ala,Glu,Asp,Leu,Ile and Thr were characteristic amino acids of Ejiao products. In hierarchical clustering analy-sis,3 tree figures of commercial Ejiao product were achieved and Euclidean distance was varied among 0-25. CONCLUSIONS:There is great difference in total control of amino acid in commercial Ejiao product;Ejiao products from various manufacturers dif-fer in their amino acid contents. Ejiao is rich in collagen,and therefore,using amino acid determination would be helpful to moni-tor its quality.

Objective To investigate the expression of IL-6 and IL-18 in serum and its correlation with aspartate aminotransferase (AST),alanine aminotransferase (ALT),total bilirubin (TBil),albumin (ALB),creatinine (Cr) and plasma ammonia in patients with hepatic encephalopathy.Methods Forty patients with liver cirrhosis complicated with hepatic encephalopathy were aligned to group A,where 18 patients with grade Ⅲ to grade Ⅳ were divided into group A1 and 22 patients with grade Ⅰ to grade Ⅱ were divided into group A2.Twenty liver cirrhosis patients were aligned to group B and 20 healthy persons were aligned to group C.The concentration of IL-6 and IL-18 in serum was detected by enzyme-linked immunosorbent assay (ELISA).The correlation between IL-6 or IL-18 and AST,ALT,TBil,ALB,Cr or plasma ammonia was analyzed by Pearson' s correlation analysis.Results Serum IL-6 and IL-18 levels in both A1 and A2 groups were significantly higher than those of group B and C.The difference was statistically significant (P ＜0.05).Both IL-6 and IL-18 levels were positively correlated with the ammonia,but there were no significant correlation with AST,ALT,TBil,ALB and Cr (P ＞ 0.05).Conclusion Serum IL-6 and IL-18 levels significantly increased in patients with hepatic encephalopathy.IL-6 and IL-18 may have a synergistic effect with ammonia,which were jointly involved in the pathogenesis of hepatic encephalopathy.

Education reform and innovative education are the strong requirements of the times and social development.We developed immunological paper free examination system based on the optimized question bank,characteristics of immunological examination and information technology.This system can randomly develop electronic examination paper and can integrate the processes of exam registration,examination paper development,online examination,paper inspection,scores generation and printing into one system,which can save human resources,enhance the accuracy and fairness of the examination,making it conform to international standards.

Objective To investigate the association between the genetic polymorphisms of methylenetetrahydrofolate reductase (MTHFR) and ulcerative colitis (UC) of Han ethnic population in Zhejiang, China. Methods Two hundred and seventy-four consecutive patients with UC and 726 healthy controls (HC) were studied. The genetic polymorphisms of MTHFR (C677T and A1298C) were genotyped using PCR-RELP methods. Results The frequencies of variant allele and genotype in MTHFR A1298Cgene were higher in UC patients than in the HC (35.77% vs 29. 96%, P =0. 013; 52. 19% vs 44. 90%,P=0.039; respectively). However, there were no significant discrepancies of the allele and genotype frequencies in the MTHFR C677T gene between the UC patients and the HC (P ＞ 0. 05 ). In addition, the MTHFR 677Tr homozygote, T allele and 677CT/1298AC compound genotype were more prevalent in patients with extensive colitis than in those with distal colitis (37. 66% vs 14. 72% ,P = 0. 0002; 49. 35% vs 32.99% ,P =0. 0004; 29. 87% vs 15.23% ,P =0. 006; respectively). Furthermore,the variant allele in the MTHFR A1298C gene (C) in severe UC patients was significantly lower than in mild and moderate UC patients (18.97% vs 33. 88% ,P =0. 022). Conclusion The genetic polymorphisms of MTHFR C677T and A1298C are obviously associated with Han ethnic population with UC in Zhejiang province.

Tubulointerstitial fibrosis (TIF) is a common pathological feature of end-stage kidney disease. Previous studies showed that upregulation of TGFbeta1 notably contributed to the chronic renal injury and irbesartan halted the development of TIF in rats with 5/6 renal mass reduction. This study was to investigate the effects of irbesartan on chronic TIF and the mechanism involved TGFbeta1 in the rodent model of chronic renal failure involving 5/6 nephrectomy. The results showed that irbesartan significantly attenuated the rise in blood pressure and tubulointerstitial injury observed in this model. Masson staining of the renal tissue revealed that there appeared severe renal tubule atrophy and fibrosis in operation group, but the lesion was attenuated mostly in irbesartan-treated group. Immunohistochemistry showed that irbesartan treatment apparently decreased the protein expression of TGFbeta1 which was up-regulated in operation groups. Western blot showed that irbesartan treatment down-regulated the expression of TGFbeta1, phosphorylated smad2 (p-smad2), AT1R and phosphorylated p38 (p-p38) MAPK, but significantly up-regulated the protein expression of smad6 as compared with operation group. These findings suggest that irbesartan attenuates hypertension and reduces the development of TIF in rats with 5/6 renal mass reduction via changes in the expression of these proteins at least including smad6, TGF-beta1, p-smad2, AT1 and p-p38 MAPK.