OBJECTIVE: To investigate the effects of Danmu Extract Syrup (DMS) on lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice and explore the mechanism. METHODS: Seventy-two male Balb/C mice were randomly divided into 6 groups according to a random number table (n=12), including control (normal saline), LPS (5 mg/kg), LPS+DMS 2.5 mL/kg, LPS+DMS 5 mL/kg, LPS+DMS 10 mL/kg, and LPS+Dexamethasone (DXM, 5 mg/kg) groups. After pretreatment with DMS and DXM, the ALI mice model was induced by LPS, and the bronchoalveolar lavage fluid (BALF) were collected to determine protein concentration, cell counts and inflammatory cytokines. The lung tissues of mice were stained with hematoxylin-eosin, and the wet/dry weight ratio (W/D) of lung tissue was calculated. The levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-6 and IL-1 β in BALF of mice were detected by enzyme linked immunosorbent assay. The expression levels of Claudin-5, vascular endothelial (VE)-cadherin, vascular endothelial growth factor (VEGF), phospho-protein kinase B (p-Akt) and Akt were detected by Western blot analysis. RESULTS: DMS pre-treatment significantly ameliorated lung histopathological changes. Compared with the LPS group, the W/D ratio and protein contents in BALF were obviously reduced after DMS pretreatment (P<0.05 or P<0.01). The number of cells in BALF and myeloperoxidase (MPO) activity decreased significantly after DMS pretreatment (P<0.05 or P<0.01). DMS pre-treatment decreased the levels of TNF-α, IL-6 and IL-1 β (P<0.01). Meanwhile, DMS activated the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) pathway and reversed the expressions of Claudin-5, VE-cadherin and VEGF (P<0.01). CONCLUSIONS DMS attenuated LPS-induced ALI in mice through repairing endothelial barrier. It might be a potential therapeutic drug for LPS-induced lung injury.
Mice ; Male ; Animals ; Proto-Oncogene Proteins c-akt/metabolism* ; Lipopolysaccharides ; Phosphatidylinositol 3-Kinases/metabolism* ; Interleukin-1beta/metabolism* ; Vascular Endothelial Growth Factor A/metabolism* ; Tumor Necrosis Factor-alpha/metabolism* ; Claudin-5/metabolism* ; Acute Lung Injury/chemically induced* ; Lung/pathology* ; Interleukin-6/metabolism* ; Drugs, Chinese Herbal

This study design of specific identification primers for the ITS2 sequence of F. ussuriensis. The reaction system and conditions were optimized, and PCR-nucleic acid test strips were constructed to realize the visual detection of F. ussuriensis Bark. Through molecular cloning and sequencing technology, we constructed a positive control for F. ussuriensis DNA and formulated quality standards. The established method was evaluated for sensitivity, specificity and reproducibility, and the authenticity of the commercially available samples was identified. Results demonstrated that based on the ITS2 sequences, F. ussuriensis and its mixed forgeries could be distinguished. The PCR products of the authentic F. ussuriensis on test strips showed two bands in the T and C lines, while the pseudo products and negative control showed only one band in the C line, which was consistent with the results of agarose gel electrophoresis. The specificity was 100%, and the sensitivity of the PCR-nucleic acid test strip was up to 0.1 ng·μL^-1, which was 10 times higher than that of the gel electrophoresis assay. 11 out of 16 commercially available samples of F. ussuriensis were qualified, and 5 were unqualified. Collectively, the PCR-nucleic acid test strip method established in this study is specific, rapid, accurate and visualized, which can provide a new technical idea for the detection of F. ussuriensis.

OBJECTIVE To explore the effect of Shilinqing granules on calcium oxalate nephrolithiasis in rats and its potential mechanisms through the silence information regulator 1 （SIRT1）/nuclear factor-κB （NF-κB）/nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 （NLRP3） signaling pathway. METHODS Sixty male SD rats were randomly assigned to control group， model group， and low- ， medium- ， high-dose groups of Shilinqing granules （6.5， 13， 26 g/kg， calculated based on crude drug）， and high-dose of Shilinqing granules+inhibitor group （Shilinqing granules 26 g/kg+SIRT1 inhibitor nicotinamide 5 mg/kg）， with 10 rats in each group. Except for the control group， the remaining groups of rats were given 1% ethylene glycol solution to drink freely and were intubated with 2% ammonium chloride solution 2 mL （once a day， for 4 weeks） to construct a calcium oxalate nephrolithiasis model. At the same time of modeling， the administration groups were intubated or （and） intraperitoneally injected with the corresponding drug solutions， while the control and the model groups were intubated with physiological saline and intraperitoneally injected with dimethyl sulfoxide. The body weight， kidney index， urine/ blood biochemical indicators [24-hour urine volume， urine pH， urinary calcium ion （Ca2+） and urinary oxalic acid （Ox） content， as well as blood creatinine （Scr）， blood urea nitrogen （BUN）， blood Ca2+ content]， serum inflammatory indicators [levels of interleukin-1β （IL-1β）， IL-18]， pathological changes in renal tissue， calcium oxalate crystallization， and crystal scoring were observed. The protein expressions of SIRT1， NLRP3， and NF-κB in renal tissue were detected. RESULTS Compared with the control group， the model group had severe renal tissue damage and a large number of calcium oxalate crystals， with significant decrease or downregulation in body weight， 24-hour urine volume， urine pH， and protein expression of SIRT1 in renal tissue （P＜ 0.05）； crystal score， kidney index， urinary contents of Ca2+ and Ox， serum contents of Scr， BUN and Ca2+， and serum levels of IL- 1β and IL-18， as well as the protein expressions of NF-κB， NLRP3 in renal tissue were significantly increased or upregulated （P＜0.05）. The pathological changes in the rats of 2024ZY2045） each dose group of Shilinqing granules were improved， the calcium oxalate crystals were reduced， and all quantitative indicators were significantly improved as compared with the model group （P＜0.05）； while the SIRT1 inhibitor could significantly reverse the improving effects of high-dose of Shilinqing granules on the above indicators （P＜0.05）. CONCLUSIONS Shilinqing granules can inhibit the formation of calcium oxalate nephrolithiasis in rats， reduce the levels of inflammatory indicators and its mechanism may be related to upregulating protein expression of SIRT1， and downregulating protein expressions of NF-κB and NLRP3.

The Choledochal cyst is an extremely rare congenital anomaly of the bile duct. Early cyst resection and Roux-en-Y hepatojejunostomy are the primary surgical methods for treating choledochal cyst. With the emergence of enhanced recovery after surgery, laparoscopic surgery has effectively reduced the incidence of biliary complications and wound infections, but it still does not meet people's requirements for minimally invasive surgery. Robotic surgery system has the potential to enhance surgical precision and the maneuverability of surgeons due to clear surgical visualization and flexible mechanical arms. The authors review the relevant literatures and conduct a Meta-analysis to evaluate the efficacy of robot-assisted surgery and laparoscopic surgery for choledochal cyst.

Objective To investigate the environmental contamination related to first patient with carbapenem-re-sistant Acinetobacter baumannii(CRAB)infection and the infection status of relevant patients in a newly established intensive care unit(ICU)of a hospital in Tibetan area,and analyze the transmission risk.Methods From the ad-mission in ICU of a patients who was first detected CRAB on November 15,2021 to the 60th day of hospitalization,all patients who stayed in ICU for＞48 hours were performed active screening on CRAB.On the 30th day and 60th day of the admission to the ICU of the first CRAB-infected patient,environment specimens were taken respectively 2 hours after high-frequency diagnostic and therapeutic activities but before disinfection,and after disinfection but before medical activities.CRAB was cultured with chromogenic culture medium.Results Among the 13 patients who were actively screened,1 case was CRAB positive,he was transferred from the ICU of a tertiary hospital to the ICU of this hospital on November 19th.On the 40th day of admission to the ICU,he had fever,increased frequency for sputum suction,and CRAB was detected.The drug sensitivity spectrum was similar to that of the first case,and he also stayed in the adjacent bed of the first case.64 environmental specimens were taken,and 9 were positive for CRAB,with a positive rate of 14.06％,8 sampling points such as the washbasin,door handle and bed rail were positive for CRAB after high-frequency diagnostic and therapeutic activities.After routine disinfection,CRAB was detected from the sink of the washbasin.Conclusion For the prevention and control of CRAB in the basic-level ICU in ethnic areas,it is feasible to conduct risk assessment on admitted patients and adopt bundled prevention and con-trol measures for high-risk patients upon admission.Attention should be paid to the contaminated areas(such as washbasin,door handle,and bed rail)as well as the effectiveness of disinfection of sink of washbasin.

ObjectiveTo observe the clinical efficacy of Qushi Huayu granules in treating non-alcoholic fatty liver disease （NAFLD） with dampness-heat accumulation. MethodSixty NAFLD patients with the syndrome of dampness-heat accumulation treated in the outpatient and inpatient departments of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine from July 2018 to May 2020 were selected according to the diagnostic criteria and inclusion criteria of both traditional Chinese medicine （TCM） and Western medicine. The patients were assigned into a control group and an observation group by a random， controlled， double-blind， and double simulated method. The observation group was treated with Qushi Huayu granules combined with the mimetic agent of Dangfei Liganning capsules， and the control group was treated with Dangfei Liganning capsules combined with the mimetic agent of Qushi Huayu granules. The treatment course of both groups was 24 weeks. The TCM symptom scores， liver imaging parameters ［controlled attenuation parameter （CAP） in Fibroscan and liver-to-spleen ratio in upper abdominal computerized tomography （CT）］， serum levels of alanine aminotransferase （ALT） and γ-glutamyl transpeptidase （γ-GT）， and safety indicators of the two groups were measured. Result① The total response rate in terms of TCM symptoms in the observation group was 89.29% （25/28）， which was higher than that （48.15%， 13/27） in the control group （Z=-3.582，P<0.01）. The total score of the primary and secondary symptoms in both groups of patients declined after treatment （P<0.05）， and the observation group outperformed the control group in decreasing the total score of the main and secondary symptoms as well as the scores of right rib swelling pain， abdominal fullness and distension or pain， sticky stool， and yellow urine （P<0.05）. ② The response rate in terms of Fibroscan CAP of the liver in the observation group was 75.00% （21/28）， which was higher than that （48.15%， 13/27） in the control group （Z=-1.968，P<0.05）. ③ The response rate in terms of the serum enzyme levels in the observation group was 75.00% （21/28）， which was higher than that （44.44%， 12/27） in the control group （Z=-2.018，P<0.05）. The serum levels of ALT and γ-GT in the two groups declined after treatment （P<0.05， P<0.01） and were lower in the observation group than in the control group （P<0.05， P<0.01）. ④ The response rate in terms of liver CT in the observation group was 67.86% （19/28）， which was higher than that （30.77%，8/26） in the control group （Z=-2.507，P<0.05）. ConclusionQushi Huayu granules were safe and effective in the clinical treatment of NAFLD patients with the syndrome of dampness-heat accumulation， which improved the evidence in TCM treatment of NAFLD and was worthy of in-depth clinical research and promotion. Qushi Huayu granules outperformed Dangfei Liganning capsules in terms of TCM symptoms， serum levels of ALT and γ-GT， and liver imaging parameters.

Objective China is among the 30 countries with a high burden of tuberculosis(TB)worldwide,and TB remains a public health concern.Kashgar Prefecture in the southern Xinjiang Autonomous Region is considered as one of the highest TB burden regions in China.However,molecular epidemiological studies of Kashgar are lacking. Methods A population-based retrospective study was conducted using whole-genome sequencing(WGS)to determine the characteristics of drug resistance and the transmission patterns. Results A total of 1,668 isolates collected in 2020 were classified into lineages 2(46.0%),3(27.5%),and 4(26.5%).The drug resistance rates revealed by WGS showed that the top three drugs in terms of the resistance rate were isoniazid(7.4%,124/1,668),streptomycin(6.0%,100/1,668),and rifampicin(3.3%,55/1,668).The rate of rifampicin resistance was 1.8%(23/1,290)in the new cases and 9.4%(32/340)in the previously treated cases.Known resistance mutations were detected more frequently in lineage 2 strains than in lineage 3 or 4 strains,respectively:18.6%vs.8.7 or 9%,P<0.001.The estimated proportion of recent transmissions was 25.9%(432/1,668).Multivariate logistic analyses indicated that sex,age,occupation,lineage,and drug resistance were the risk factors for recent transmission.Despite the low rate of drug resistance,drug-resistant strains had a higher risk of recent transmission than the susceptible strains(adjusted odds ratio,1.414;95%CI,1.023-1.954;P = 0.036).Among all patients with drug-resistant tuberculosis(DR-TB),78.4%(171/218)were attributed to the transmission of DR-TB strains. Conclusion Our results suggest that drug-resistant strains are more transmissible than susceptible strains and that transmission is the major driving force of the current DR-TB epidemic in Kashgar.

OBJECTIVE To observe the curative effect of bacterial lysates(BLs)combined with intranasal corticosteroids(INCS)in the treatment of chronic rhinosinusitis(CRS).METHODS Cases diagnosed as CRS with nasal polyps(CRSwNP)and CRS without nasal polyps(CRSsNP)were collected and divided into four groups:CRSwNP with BLs group,CRSwNP control group,CRSsNP with BLS group and CRSsNP control group.All patients received surgical treatment,the control group received postoperative INCS therapy,and the BLs group received postoperative INCS+BLs oral therapy.Visual analogue scale(VAS),sino-nasal outcome test-20(SNOT-20),Lund-Kennedy score,Lund-Mackay score,eosinophilic(Eos)cell,IL-4,IgG,IgA,IgM and total IgE levels were evaluated before,1 month and 3 months after surgery.RESULTS Significant differences in IgG,IgA,IL-4 and Eos levels between CRSwNP and CRSsNP with BLs groups(P<0.05).There were significant differences in VAS and SNOT-20 between CRSwNP group and CRSsNP with BLs group at 1 and 3 months after treatment(P<0.05).At 1 month and 3 months after treatment,there were statistically significant differences in Lund-Kennedy score and Lund-Mackey score between the CRSwNP group and the CRSsNP with BLs group(P<0.05).The effective rate of disease control in the four groups after treatment was statistically significant(P<0.05).There were no serious complications directly related to the treatment.CONCLUSION The application of BLs can improve postoperative rhinorrhea,persistent inflammatory and mucosal recovery in patients with CRS,increase IgG and IgA levels,reduce Eos and IL-4 levels,reduce adverse reactions,and improve the therapeutic effect of CRS with high safety.

Objective To investigate the serum S100 calcium-binding protein A4(S100A4)and fibronectin type Ⅲ domain-containing 5(FNDC5)levels in patients with gestational diabetes mellitus(GDM)and their relationship with pregnancy outcomes.Methods From June 2020 to June 2022,a total of 126 patients with GDM in the hospital were included into GDM group,and 126 healthy pregnant women who underwent prena-tal check ups during the same period were selected as the control group.According to the pregnancy outcome of GDM patients,they were grouped into a good pregnancy outcome group(76 cases)and a adverse pregnancy outcome group(50 cases).The levels of S100A4 and FNDC5 were detected by enzyme linked immunosorbent assay(ELISA).Multivariate Logistic regression analysis was applied to analyze the influencing factors of pregnancy outcome in GDM pregnant women.Receiver operating characteristic(ROC)curve was applied to e-valuate the value of serum S100A4 and FNDC5 in predicting adverse pregnancy outcomes in GDM pregnant women.Spearman correlation analysis was applied to analyze the correlation between serum S100A4,FNDC5 and adverse pregnancy outcomes.Results The serum S100A4 level in GDM group was higher than that in control group(P<0.05),while the serum FNDC5 level was lower than that in control group(P<0.05).The serum S100A4 level in the good pregnancy outcome group was lower than that in the adverse pregnancy out-come group(P<0.05),while the serum FNDC5 level was higher than that in the adverse pregnancy outcome group(P<0.05).Spearman correlation analysis showed that serum S100A4 level in GDM patients was posi-tively correlated with adverse pregnancy outcomes(P<0.05),while FNDC5 level was negatively correlated with adverse pregnancy outcomes(P<0.05).Logistic regression analysis showed that serum S100A4,fasting blood glucose,and HOMA-IR were risk factors for adverse pregnancy outcomes in GDM patients(P<0.05),and FNDC5 was a protective factor for adverse pregnancy outcomes in GDM patients(P<0.05).The area un-der the curve of the combination of serum S100A4 and FNDC5 in predicting pregnancy outcomes in GDM was greater than that of S100A4 alone(Z=2.045,P=0.041)and FNDC5 alone(Z=2.010,P=0.044).Conclu-sion The level of S100A4 in the serum of GDM patients is high,and the level of FNDC5 is low.Both have certain reference value for evaluating the pregnancy outcome of GDM pregnant women.

Objective To observe the therapeutic effect of fourteen bone-setting manipulations and small splint fixation combined with No.8 Orthopedics Prescription(mainly composed of Rehmanniae Radix,Salviae Miltiorrhizae Radix et Rhizoma,Persicae Semen,Caulis Akebiae,Carthami Flos,Corydalis Rhizoma,and Notoginseng Radix et Rhizoma)on distal radius fracture.Methods A retrospective study was carried out in the analysis of the clinical data of 124 patients with distal radius fractures treated by fourteen bone-setting manipulations and small splint fixation in the Department of Orthopedics,Foshan Hospital of Traditional Chinese Medicine from September 2021 to September 2023.The patients were divided into an observation group(63 cases)and a control group(61 cases)depending on the medication of No.8 Orthopedics Prescription or not.The control group was treated with fourteen bone-setting manipulations and small splint fixation,while the observation group was treated with fourteen bone-setting manipulations and small splint fixation combined with No.8 Orthopedics Prescription.The two groups were treated for s one month and then were followed up for more than six months.The changes in the range of motion(ROM)of wrist pronation and supination and palmar flexion in the two groups were observed before treatment and three months after treatment.The time for starting wrist function exercise,time for subsiding swelling of the affected limb and fracture healing time were compared between the two groups.After six months of treatment,the wrist function improvement effect of the two groups was evaluated.Results(1)After treatment,the time for starting wrist joint functional exercise,time for subsiding swelling of the affected limb and the time for fracture healing in the observation group were significantly shortened compared with those in the control group,and the differences were statistically significant between the two groups(P＜0.01).(2)After three months of treatment,the ROM of wrist pronation and supination and palmar flexion in the two groups were significantly improved compared with those before treatment(P＜0.05),and the improvement of ROM of wrist pronation and supination and palmar flexion in the observation group was significantly superior to that in the control group,the differences being statistically significant(P＜0.01).(3)After six months of treatment,the evaluation of the wrist joint function of the two groups showed that the excellent and good rate of the observation group was 55.56％(35/63),and that of the control group was 45.90％(28/61).There was no significant difference in the improvement of wrist function between the two groups(Z=1.075,P=0.282).Conclusion Both methods can achieve satisfactory efficacy in the treatment of distal radius fracture,and the wrist function of the patients has been effectively restored.The treatment of fourteen bone-setting manipulations and small splint fixation combined with No.8 Orthopedics Prescription can significantly shorten the time for subsiding swelling of the affected limb,promote fracture healing and bone regeneration,improve wrist function,and relieve the pain of patients.