AIM To study the chemical constituents from the stems and leaves of Dendrobium formosum Roxb.ex Lindl.and their biological activities.METHODS The 95％ethanol extract from the stems and leaves of D.formosum was isolated and purified by silica gel,Sephadex LH-20 and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.Their inhibitory activities onα-glucosidase were determined by PNPG method,and their in vitro anti-inflammatory activities were evaluated by RAW264.7 model.RESULTS Fifteen compounds were isolated and identified as coniferyl p-coumarate(1),(-)-pinoresinol(2),2,5,7-trihydroxy-4-methoxy-9,10-dihydrophenanthrene(3),naringenin(4),spiropreussomerin A(5),7-hydroxy-14-de-O-methyl-lasiodiplodin(6),(4S,5S,6Z,8E)-5-hydroxydeca-6,8-dien-4-olide(7),(6S,9R)-blumenol C(8),p-hydroxybenzoic acid(9),m-hydroxybenzoic acid(10),p-hydroxy benzenepropanoic acid(11),5,7-dihydroxy-isobenzofuran(12),2-(4-hydroxyphenyl)-ethanol(13),β-sitostenone(14),β-sitosterol(15).The IC50 values of compounds 1 and 4 on α-glucosidase inhibition were(65.60±3.31)and(98.95±2.53)μmol/L,respectively.Compound 3 presented inhibitory activity on NO production in RAW 264.7 cells,with IC50 value of(3.97±0.12)μmol/L.CONCLUSION Compounds 5-6,8 and 12 are isolated from Orchidacae family for the first time,and 2-15 are first isolated from this plant.Compounds 1 and 4 have α-glucosidase inhibitory activities,and 3 has anti-inflammatory activity.

AIM To study the chemical constituents from the stems and leaves of Dendrobium formosum Roxb.ex Lindl.and their biological activities.METHODS The 95％ethanol extract from the stems and leaves of D.formosum was isolated and purified by silica gel,Sephadex LH-20 and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.Their inhibitory activities onα-glucosidase were determined by PNPG method,and their in vitro anti-inflammatory activities were evaluated by RAW264.7 model.RESULTS Fifteen compounds were isolated and identified as coniferyl p-coumarate(1),(-)-pinoresinol(2),2,5,7-trihydroxy-4-methoxy-9,10-dihydrophenanthrene(3),naringenin(4),spiropreussomerin A(5),7-hydroxy-14-de-O-methyl-lasiodiplodin(6),(4S,5S,6Z,8E)-5-hydroxydeca-6,8-dien-4-olide(7),(6S,9R)-blumenol C(8),p-hydroxybenzoic acid(9),m-hydroxybenzoic acid(10),p-hydroxy benzenepropanoic acid(11),5,7-dihydroxy-isobenzofuran(12),2-(4-hydroxyphenyl)-ethanol(13),β-sitostenone(14),β-sitosterol(15).The IC50 values of compounds 1 and 4 on α-glucosidase inhibition were(65.60±3.31)and(98.95±2.53)μmol/L,respectively.Compound 3 presented inhibitory activity on NO production in RAW 264.7 cells,with IC50 value of(3.97±0.12)μmol/L.CONCLUSION Compounds 5-6,8 and 12 are isolated from Orchidacae family for the first time,and 2-15 are first isolated from this plant.Compounds 1 and 4 have α-glucosidase inhibitory activities,and 3 has anti-inflammatory activity.

Based on the regulation of mitochondrial fatty acid β-oxidation through the PGC1α/PPARα/CPT1A pathway, this study investigated the effect of Jianpi Qinghua Formula on the mitochondrial fatty acid β-oxidation pathway in the livers of mice with metabolic-associated fatty liver disease(MAFLD) induced by a high-fat diet. MAFLD mice were fed a high-fat diet to establish the model, and after successful modeling, the mice were divided into the model group, the Jianpi Qinghua Formula group, and the metformin group, with an additional control group. Each group was treated with the corresponding drug or an equivalent volume of saline via gavage. Body mass and food intake were measured regularly during the experiment. At the end of the experiment, blood lipid levels and liver function-related indices were measured, liver pathological changes were observed, and protein expression levels of PGC1α, PPARα, PPARγ, and CPT1A were detected by Western blot. The results showed that, with no difference in food intake, compared to the model group, the body mass of the Jianpi Qinghua Formula group and the metformin group was reduced, liver weight and liver index decreased, and levels of cholesterol, triglycerides, and low-density lipoprotein cholesterol(LDL-C) were lowered. Additionally, a decrease in alanine aminotransferase(ALT) and aspartate aminotransferase(AST) was observed. Hematoxylin and eosin(HE) staining revealed reduced pathological damage to hepatocytes, while oil red O staining showed improvement in fatty infiltration. The liver disease activity score decreased, and transmission electron microscopy revealed improvement in mitochondrial swelling and restoration of internal cristae. Western blot analysis indicated that Jianpi Qinghua Formula significantly increased the expression of PGC1α, PPARα, and CPT1A proteins in the liver and reduced the expression of PPARγ. These results suggest that the Jianpi Qinghua Formula improves mitochondrial function, promotes fatty acid oxidation, and alleviates the pathological changes of MAFLD. In conclusion, Jianpi Qinghua Formula can improve MAFLD by mediating mitochondrial fatty acid β-oxidation through the PGC1α/PPARα/CPT1A pathway.
Animals ; PPAR alpha/genetics* ; Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha/genetics* ; Drugs, Chinese Herbal/administration & dosage* ; Mice ; Carnitine O-Palmitoyltransferase/genetics* ; Male ; Liver/metabolism* ; Fatty Liver/genetics* ; Humans ; Mice, Inbred C57BL ; Diet, High-Fat/adverse effects*

Objective:To evaluate the efficacy and safety of anlotinib neoadjuvant therapy for newly diagnosed locally advanced thyroid cancer (LATC).Methods:Twenty-four newly diagnosed LATC patients (10 males and 14 females, age (47.1±3.3) years) admitted to Affiliated Hospital of Integrated Traditional Chinese and Western Medicine of Nanjing University of Chinese Medicine were prospectively included from January 2023 to April 2024. Patients were given anlotinib neoadjuvant therapy (12mg/d, 2 weeks of medication, 1 week of discontinuation), and the efficacy of the treatment was evaluated by CT and multi-disciplinary treatment at the end of each treatment cycle. Patients assessed as suitable for surgery would be scheduled for surgery, while those who were not suitable for surgery would continue to receive neoadjuvant therapy and periodic evaluations. The primary endpoints were objective response rate (ORR) and disease control rate (DCR), and the R0/1 resection rate and adverse events (AE) after neoadjuvant therapy were observed. Paired- t test was used to analyze the differences between groups, and the Clopper-Person accurate method was used to calculate the bilateral 95% CI of ORR and other indicators. Results:Twenty-four patients received 2(2, 3) cycles of neoadjuvant therapy with anlotinib, of which 23 underwent surgery after anlotinib therapy. After neoadjuvant therapy, the mean maximum diameter of target lesions decreased by 23.5%(95% CI: 2.8%-44.3%) compared with baseline ( t=9.22, P<0.001). The ORR and DCR were 37.5%(95% CI: 18.8%-59.4%) and 100%(95% CI: 85.8%-100%), respectively. About 91.7%(95% CI: 73.0%-99.0%) of patients eventually underwent R0/1 resection. Hand and foot skin reactions, hypertension, oral mucositis, and leukopenia were common AE; grade 4 and 5 AE were not observed. Conclusion:Anlotinib can be safely used as neoadjuvant therapy for newly diagnosed LATC patients with good antitumor effects, providing better surgical opportunities for R0/1 resection.

Objective:To evaluate the efficacy and safety of anlotinib neoadjuvant therapy for newly diagnosed locally advanced thyroid cancer (LATC).Methods:Twenty-four newly diagnosed LATC patients (10 males and 14 females, age (47.1±3.3) years) admitted to Affiliated Hospital of Integrated Traditional Chinese and Western Medicine of Nanjing University of Chinese Medicine were prospectively included from January 2023 to April 2024. Patients were given anlotinib neoadjuvant therapy (12mg/d, 2 weeks of medication, 1 week of discontinuation), and the efficacy of the treatment was evaluated by CT and multi-disciplinary treatment at the end of each treatment cycle. Patients assessed as suitable for surgery would be scheduled for surgery, while those who were not suitable for surgery would continue to receive neoadjuvant therapy and periodic evaluations. The primary endpoints were objective response rate (ORR) and disease control rate (DCR), and the R0/1 resection rate and adverse events (AE) after neoadjuvant therapy were observed. Paired- t test was used to analyze the differences between groups, and the Clopper-Person accurate method was used to calculate the bilateral 95% CI of ORR and other indicators. Results:Twenty-four patients received 2(2, 3) cycles of neoadjuvant therapy with anlotinib, of which 23 underwent surgery after anlotinib therapy. After neoadjuvant therapy, the mean maximum diameter of target lesions decreased by 23.5%(95% CI: 2.8%-44.3%) compared with baseline ( t=9.22, P<0.001). The ORR and DCR were 37.5%(95% CI: 18.8%-59.4%) and 100%(95% CI: 85.8%-100%), respectively. About 91.7%(95% CI: 73.0%-99.0%) of patients eventually underwent R0/1 resection. Hand and foot skin reactions, hypertension, oral mucositis, and leukopenia were common AE; grade 4 and 5 AE were not observed. Conclusion:Anlotinib can be safely used as neoadjuvant therapy for newly diagnosed LATC patients with good antitumor effects, providing better surgical opportunities for R0/1 resection.

OBJECTIVE: To evaluate the dynamic changes of glucocorticoid (GC) dose and the feasibility of GC discontinuation in rheumatoid arthritis (RA) patients under the background of Chinese medicine (CM). METHODS: This multicenter retrospective cohort study included 1,196 RA patients enrolled in the China Rheumatoid Arthritis Registry of Patients with Chinese Medicine (CERTAIN) from September 1, 2019 to December 4, 2023, who initiated GC therapy. Participants were divided into the Western medicine (WM) and integrative medicine (IM, combination of CM and WM) groups based on medication regimen. Follow-up was performed at least every 3 months to assess dynamic changes in GC dose. Changes in GC dose were analyzed by generalized estimator equation, the probability of GC discontinuation was assessed using Kaplan-Meier curve, and predictors of GC discontinuation were analyzed by Cox regression. Patients with <12 months of follow-up were excluded for the sensitivity analysis. RESULTS: Among 1,196 patients (85.4% female; median age 56.4 years), 880 (73.6%) received IM. Over a median 12-month follow-up, 34.3% (410 cases) discontinued GC, with significantly higher rates in the IM group (40.8% vs. 16.1% in WM; P<0.05). GC dose declined progressively, with IM patients demonstrating faster reductions (median 3.75 mg vs. 5.00 mg in WM at 12 months; P<0.05). Multivariate Cox analysis identified age <60 years [P<0.001, hazard ratios (HR)=2.142, 95% confidence interval (CI): 1.523-3.012], IM therapy (P=0.001, HR=2.175, 95% CI: 1.369-3.456), baseline GC dose ⩽7.5 mg (P=0.003, HR=1.637, 95% CI: 1.177-2.275), and absence of non-steroidal anti-inflammatory drugs use (P=0.001, HR=2.546, 95% CI: 1.432-4.527) as significant predictors of GC discontinuation. Sensitivity analysis (545 cases) confirmed these findings. CONCLUSIONS RA patients receiving CM face difficulties in following guideline-recommended GC discontinuation protocols. IM can promote GC discontinuation and is a promising strategy to reduce GC dependency in RA management. (Trial registration: ClinicalTrials.gov, No. NCT05219214).
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Arthritis, Rheumatoid/drug therapy* ; Glucocorticoids/therapeutic use* ; Medicine, Chinese Traditional ; Retrospective Studies

Objective:To investigate the effect of osimertinib combined with pemetrexed and carboplatinon in patients with advanced lung adenocarcinoma epidermal growth factor receptor (EGFR) mutation, and its impact on serum interleukin-6 (IL-6) and cancer antigen 72-4 (CA72-4) levels.Methods:A total of 73 patients with advanced lung adenocarcinoma with EGFR mutation admitted to Peking University Medical Luzhong Hospital from December 2023 to December 2024 were prospectively selected and divided into a single group 36 cases and a treatment group 37 cases by random digits table method. The single group was treated with pemetrexed and carboplatin, and the treatment group was treated with osimertinib on the basis of the single group. The efficacy and pre- and post-therapy cellular immune function (CD 3+, CD 4+ and CD 4+/CD 8+), tumor markers [cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), CA72-4, tumor specific growth factor (TSGF), carcinoembryonic antigen (CEA)], vascular endothelial growth factor (VEGF), IL-6 and untoward reactions were compared. Results:Objective remission rate (ORR) and disease control rate (DCR) in the treatment group were greater than those in the single group: 27.03% (10/37) vs. 8.33% (3/36), 75.68% (28/37) vs. 52.78% (19/36), P<0.05. After therapy, CD 3+, CD 4+ and CD 4+/CD 8+ in the treatment group were higher than those in the single group: 0.675 ± 0.078 vs. 0.618 ± 0.067, 0.335 ± 0.033 vs. 0.275 ± 0.035, 1.25 ± 0.22 vs. 1.06 ± 0.15; the levels of TSGF, CEA, CYFRA21-1, CA72-4, IL-6 and VEGF in the treatment group were lower than those in the single group: (61.39 ± 7.43) kU/L vs. (78.23 ± 9.24) kU/L, (12.64 ± 1.42) μg/L vs. (16.87 ± 2.66) μg/L, (3.58 ± 0.48) μg/L vs. (4.14 ± 0.63) μg/L, (5.43 ± 0.81) kU/L vs. (7.06 ± 1.21) kU/L, (6.17 ± 0.82) ng/L vs. (8.57 ± 1.19) ng/L, (152.19 ± 18.14) pg/L vs. (216.47 ± 23.35) pg/L, P<0.05. The untoward reactions showed no statistical difference between two groups ( P>0.05). Conclusions:The joint of osimertinib combined with pemetrexed in the treatment of advanced lung adenocarcinoma patients with EGFR mutation is beneficial for improving efficacy, enhancing immune function, reducing tumor markers, and has certain safety.

Objective:To investigate the effect of osimertinib combined with pemetrexed and carboplatinon in patients with advanced lung adenocarcinoma epidermal growth factor receptor (EGFR) mutation, and its impact on serum interleukin-6 (IL-6) and cancer antigen 72-4 (CA72-4) levels.Methods:A total of 73 patients with advanced lung adenocarcinoma with EGFR mutation admitted to Peking University Medical Luzhong Hospital from December 2023 to December 2024 were prospectively selected and divided into a single group 36 cases and a treatment group 37 cases by random digits table method. The single group was treated with pemetrexed and carboplatin, and the treatment group was treated with osimertinib on the basis of the single group. The efficacy and pre- and post-therapy cellular immune function (CD 3+, CD 4+ and CD 4+/CD 8+), tumor markers [cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), CA72-4, tumor specific growth factor (TSGF), carcinoembryonic antigen (CEA)], vascular endothelial growth factor (VEGF), IL-6 and untoward reactions were compared. Results:Objective remission rate (ORR) and disease control rate (DCR) in the treatment group were greater than those in the single group: 27.03% (10/37) vs. 8.33% (3/36), 75.68% (28/37) vs. 52.78% (19/36), P<0.05. After therapy, CD 3+, CD 4+ and CD 4+/CD 8+ in the treatment group were higher than those in the single group: 0.675 ± 0.078 vs. 0.618 ± 0.067, 0.335 ± 0.033 vs. 0.275 ± 0.035, 1.25 ± 0.22 vs. 1.06 ± 0.15; the levels of TSGF, CEA, CYFRA21-1, CA72-4, IL-6 and VEGF in the treatment group were lower than those in the single group: (61.39 ± 7.43) kU/L vs. (78.23 ± 9.24) kU/L, (12.64 ± 1.42) μg/L vs. (16.87 ± 2.66) μg/L, (3.58 ± 0.48) μg/L vs. (4.14 ± 0.63) μg/L, (5.43 ± 0.81) kU/L vs. (7.06 ± 1.21) kU/L, (6.17 ± 0.82) ng/L vs. (8.57 ± 1.19) ng/L, (152.19 ± 18.14) pg/L vs. (216.47 ± 23.35) pg/L, P<0.05. The untoward reactions showed no statistical difference between two groups ( P>0.05). Conclusions:The joint of osimertinib combined with pemetrexed in the treatment of advanced lung adenocarcinoma patients with EGFR mutation is beneficial for improving efficacy, enhancing immune function, reducing tumor markers, and has certain safety.

Dental age estimation is a crucial aspect and one of the ways to accomplish forensic age estimation,and imaging technology is an important technique for dental age estimation.In recent years,some studies have preliminarily confirmed the feasibility of magnetic resonance imaging(MRI)in evaluating dental development,providing a new perspective and possibility for the evaluation of den-tal development,suggesting that MRI is expected to be a safer and more accurate tool for dental age estimation.However,further research is essential to verify its accuracy and feasibility.This article re-views the current state,challenges and limitations of MRI in dental development and age estimation,offering reference for the research of dental age assessment based on MRI technology.

ObjectiveTo investigate the relationship between mosquito density fluctuations and meteorological factors, so as to provide a scientific basis for mosquito surveillance analysis, risk assessment, and comprehensive prevention and control. MethodsMosquito surveillance and monitoring data of 2020‒2023 was obtained from on-site supervisory sampling by Songjiang Center for Disease Control and Prevention, and meteorological data was obtained from the Wheat A wheat malt-agro-meteorological big data system. Excel 2019 and SPSS 25.0 software were used to organize and analyze the mosquito number, species composition, and seasonal changes in mosquito density captured by the CO₂-light trap at rach monitoring site. Circular distribution method was used to calculate the peak time of mosquito density, combined with the meteorological data of the same period to explore the impact of meteorological factors on the results of mosquito surveillance. ResultsThere was a statistical difference in the overall distribution of mosquito quantity in different habitats(H=23.11, P<0.05), 2020‒2023. In addition, the results showed that July 28th was the peak day for mosquito density, and the duration from June 13th to September 11th was the seasonal peak period for mosquitoes. Pearson correlation analysis showed a positive correlation between mosquito density and average air temperature, average highest air temperature, average lowest air temperature, extreme maximum air temperature, extreme minimum air temperature, precipitation, and number of precipitation days (all P<0.01). While, there was no significant correlation between average wind speed and mosquito density (P>0.05). Multiple stepwise regression analysis resulted in the equation of Y=0.151X_{extreme minimum temperature}+0.321X_{number of precipitation days}+1.002X_{SQRT precipitation}-1.288 (F=102.635, P<0.05). ConclusionThe CO₂-light trap is advisable to monitor the habitats of farmers, livestock sheds, residential areas, parks, hospitals, and other external environments. Air temperature and precipitation have a significant impact on mosquito density. It is recommended to implement comprehensive prevention and control measures to reduce mosquito density and prevent mosquito-borne diseases before the peak period of mosquitoes.