ObjectiveTo explore the mechanism of total saponins of Dioscoreae Nipponicae Rhizoma （TSDN） in treating gouty arthritis （GA） by regulating cyclooxygenase-2 （COX-2）-mediated M1 macrophage reprogramming by in vivo and in vitro experiments. MethodsIn vivo experiment： 24 male SD rats were randomly allocated into blank， model （GA）， TSDN， and celecoxib groups， with 6 rats in each group. After 7 days of administration， pathological changes in the ankle synovial tissue were observed via hematoxylin-eosin （HE） staining. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to quantify the mRNA levels of NOD-like receptor protein 3 （NLRP3） inflammasome， apoptosis-associated speck-like protein （ASC）， Caspase-1， COX-2， interleukin-1β （IL-1β）， and tumor necrosis factor-α （TNF-α） in the synovial tissue. Enzyme-linked immunosorbent assay （ELISA） was employed to measure the serum levels of inducible nitric oxide synthase （iNOS）， IL-1β， CD86， CD80， CD206， and arginase-1 （Arg-1）. In vitro experiment： The GA model was established by lipopolysaccharide （LPS） + MSU induction， and the inhibitor concentration was screened by the methyl thiazolyl tetrazolium （MTT） assay. RAW264.7 cells were allocated into blank， model， TSDN， dexamethasone， COX-2 inhibitor （celecoxib）， and TSDN + COX-2 inhibitor groups. The levels of iNOS， IL-1β， CD86， CD80， CD206， and Arg-1 in the cell supernatant of each group were determined by enzyme-linked immunosorbent assay （ELISA）. The mRNA and protein levels of NLRP3 inflammasome， COX-2， IL-1β， and TNF-α in each group were determined by Real-time PCR and Western blot， respectively. ResultsIn vivo experiment： compared with the model group， TSDN reduced the mRNA levels of NLRP3 inflammasome， COX-2， IL-1β， and TNF-α in the synovial tissue （P<0.05， P<0.01）. ELISA results showed that TSDN lowered the serum levels of iNOS， IL-1β， CD86， and CD80 （P<0.01） while increasing the serum levels of CD206 and Arg-1 （P<0.01）. In vitro experiment： compared with the model group， TSDN and inhibitor down-regulated the mRNA levels of NLRP3 inflammasome， COX-2， IL-1β， and TNF-α and the protein levels of NLRP3 inflammasome， COX-2， cleaved IL-1β， and TNF-α （P<0.01）. Compared with TSDN alone， TSDN + COX-2 inhibitor further reduced the mRNA and protein levels of the markers above （P<0.01）. Compared with the model group， TSDN and COX-2 inhibitor decreased the levels of IL-1β， iNOS， CD80， and CD86 （P<0.01） and increased the levels of CD206 and Arg-1 （P<0.01） in cells. Compared with TSDN alone， TSDN + COX-2 inhibitor reduced IL-1β， iNOS， CD80， and CD86 levels （P<0.05， P<0.01） and elevated CD206 and Arg-1 levels （P<0.01） in cells. ConclusionTSDN can alleviate GA by downregulating COX-2-mediated M1 macrophage reprogramming and suppressing the inflammatory factors.

ObjectiveTo explore the mechanism of total saponins of Dioscoreae Nipponicae Rhizoma （TSDN） in treating gouty arthritis （GA） by regulating cyclooxygenase-2 （COX-2）-mediated M1 macrophage reprogramming by in vivo and in vitro experiments. MethodsIn vivo experiment： 24 male SD rats were randomly allocated into blank， model （GA）， TSDN， and celecoxib groups， with 6 rats in each group. After 7 days of administration， pathological changes in the ankle synovial tissue were observed via hematoxylin-eosin （HE） staining. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to quantify the mRNA levels of NOD-like receptor protein 3 （NLRP3） inflammasome， apoptosis-associated speck-like protein （ASC）， Caspase-1， COX-2， interleukin-1β （IL-1β）， and tumor necrosis factor-α （TNF-α） in the synovial tissue. Enzyme-linked immunosorbent assay （ELISA） was employed to measure the serum levels of inducible nitric oxide synthase （iNOS）， IL-1β， CD86， CD80， CD206， and arginase-1 （Arg-1）. In vitro experiment： The GA model was established by lipopolysaccharide （LPS） + MSU induction， and the inhibitor concentration was screened by the methyl thiazolyl tetrazolium （MTT） assay. RAW264.7 cells were allocated into blank， model， TSDN， dexamethasone， COX-2 inhibitor （celecoxib）， and TSDN + COX-2 inhibitor groups. The levels of iNOS， IL-1β， CD86， CD80， CD206， and Arg-1 in the cell supernatant of each group were determined by enzyme-linked immunosorbent assay （ELISA）. The mRNA and protein levels of NLRP3 inflammasome， COX-2， IL-1β， and TNF-α in each group were determined by Real-time PCR and Western blot， respectively. ResultsIn vivo experiment： compared with the model group， TSDN reduced the mRNA levels of NLRP3 inflammasome， COX-2， IL-1β， and TNF-α in the synovial tissue （P<0.05， P<0.01）. ELISA results showed that TSDN lowered the serum levels of iNOS， IL-1β， CD86， and CD80 （P<0.01） while increasing the serum levels of CD206 and Arg-1 （P<0.01）. In vitro experiment： compared with the model group， TSDN and inhibitor down-regulated the mRNA levels of NLRP3 inflammasome， COX-2， IL-1β， and TNF-α and the protein levels of NLRP3 inflammasome， COX-2， cleaved IL-1β， and TNF-α （P<0.01）. Compared with TSDN alone， TSDN + COX-2 inhibitor further reduced the mRNA and protein levels of the markers above （P<0.01）. Compared with the model group， TSDN and COX-2 inhibitor decreased the levels of IL-1β， iNOS， CD80， and CD86 （P<0.01） and increased the levels of CD206 and Arg-1 （P<0.01） in cells. Compared with TSDN alone， TSDN + COX-2 inhibitor reduced IL-1β， iNOS， CD80， and CD86 levels （P<0.05， P<0.01） and elevated CD206 and Arg-1 levels （P<0.01） in cells. ConclusionTSDN can alleviate GA by downregulating COX-2-mediated M1 macrophage reprogramming and suppressing the inflammatory factors.

Objective : To explore the mechanism of isorhamnetin (Iso) in the treatment of oral squamous cell carcinoma (OSCC) using network pharmacology and molecular docking methods and to verify it in vitro. Methods : The key targets were obtained by constructing the PPI protein interaction network based on the common intersection targets of Iso-OSCC. At the same time, gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) were used to analyze the related signaling pathways of the intersection targets. Iso and core targets were also analyzed through molecular docking and visualization. Colony formation assay and Transwell assay were used to identify the effect of Iso on the proliferation and invasion of Cal-27 cells. Western blot was used to analyze the regulatory effects of different concentrations of Iso on estrogen receptor-1 (ESR1), phosphoinositide-3-kinase regulatory subunit-1 (PIK3R1), Src tyrosine kinase (SRC), and phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway proteins. Results: A total of 269 potential intersection targets of Iso-regulated OSCC were obtained. According to the degree obtained by topological analysis, PIK3R1, AKT1, SRC, ESR1, and other core targets were screened out. KEGG analysis showed that 165 signaling pathways were enriched in the intersection targets of Iso-OSCC, among which the PI3K/AKT signaling pathway played an important role in the treatment of OSCC with Iso. Molecular docking results showed that the absolute value of binding energy between target proteins PIK3R1, AKT1, SRC, ESR1, and Iso was high. After Cal-27 cells were treated with Iso, the number of cell colony formations, the number of transmembrane cells, and the expression of PIK3R1, ESR1, SRC, p-PI3K, and p-AKT were negatively correlated with the increase in Iso concentration (P < 0.05). Conclusion Iso can inhibit PI3K/AKT signal transduction and influence the expression of PIK3R1, AKT1, SRC, and ESR1 proteins, thereby inhibiting the occurrence and development of OSCC.

Objective: To investigate the occupational health status of medical radiation workers in Hangzhou City, so as to provide the basis for their occupational health risk assessment. Methods: Data on medical radiological workers who underwent occupational health examinations from 2021 to 2022 were collected through the Physical Examination Information Management System of the Hangzhou Occupational Disease Prevention and Control Hospital. The physical examination data including blood routine, eye lens, thyroid ultrasound, thyroid function, liver function, renal function and blood lipid were collected, and the abnormal rates of occupational health examinations among workers with different genders, working years and occupational exposure types were analyzed. Results: A total of 3 968 medical radiation workers were investigated, including 2 310 males (58.22%) and 1 658 females (41.78%). There were 2 039 (51.39%), 821 (20.69%) and 1 108 (27.92%) workers with 1-<6, 6-<10 years and 10 years and above of work, respectively. Diagnostic radiology was the predomenant type of exposure, with 2 240 workers accounting for 56.45%. The abnormal rates of thyroid ultrasound and blood lipid were 47.73% and 45.21%, respectively, which were relatively higher than other items. The abnormal rates of micronucleus rate, thyroid ultrasound, thyroid function and renal function were higher in females than in males, while the abnormal rates of lymphocyte count, liver function and blood lipid in males were higher in males than in females (all P<0.05). With the increase of working years, the abnormal rates of micronucleus rate and blood lipid showed upward trends (both P<0.05). There were statistically significant differences in the abnormal rates of thyroid ultrasound, liver function and blood lipid among different occupational exposure types (all P<0.05). Conclusion Long-term low-dose ionizing radiation environment affects the thyroid, micronucleus rate and blood lipid of medical radiation workers in Hangzhou City, with differences observed among workers with different genders and occupational exposure types.

Objective:To investigate the clinical effects of vertical compression with hot dental cement versus IROOT SP single-cone technique for filling oval root canals. Methods:One hundred endodontic patients (100 affected teeth) who underwent oval root canal filling treatment at Jiaxing Maternity and Child Health Care Hospital between July 2022 and July 2023 were included in this study. A randomized controlled clinical research method was used. These patients were divided into an observation group ( n = 50) and a control group ( n = 50) using the random number table method. The control group underwent oval root canal filling using vertical compression with hot dental cement, while the observation group used the IROOT SP single-cone technique for their fillings. Clinical efficacy, clinical indicators, quality of life outcomes, and the incidence of adverse reactions were compared between the two groups. Results:The rate of successful filling in the observation group was significantly higher than that in the control group [90.00% (45/50) vs. 64.00% (32/50), χ2 = 9.54, P < 0.05]. The rate of overfilling in the observation group was significantly lower than that in the control group [2.00% (1/50) vs. 16.00% (8/50), χ2 = 4.40, P < 0.05]. The percentage of residual filling material (buccal-lingual and mesial-distal) and the operation time in the observation group were (0.23 ± 0.12)%, (0.37 ± 0.12)%, and (236.52 ± 27.12) seconds, respectively, all of which were significantly lower than those in the control group [(0.28 ± 0.12)%, (0.45 ± 0.16)%, and (284.56 ± 28.15) seconds, t = 2.08, 2.83, 8.69, all P < 0.05]. After 3 months of treatment, the Oral Health-Related Quality of Life score and the Numerical Rating Scale (NRS) score in the observation group were (9.96 ± 0.23) points and (1.23 ± 0.05) points, respectively, both of which were significantly lower than those in the control group [(25.65 ± 4.52) points, (4.56 ± 1.01) points, t = 24.51, 23.29, both P < 0.001]. The incidence of adverse reactions in the observation group was significantly lower than that in the control group [2.00% (1/50) vs. 30.00% (15/50), χ2 = 14.58, P < 0.001]. Conclusion:The IROOT SP single-cone technique demonstrates better clinical efficacy, more effectively alleviates clinical indicators, improves patients' quality of life, and reduces the occurrence of adverse reactions compared with vertical compression with hot dental cement.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Objective To investigate the diagnostic value of the medial plantar nerve in diabetic peripheral neuropathy(DPN).Methods A retrospective analysis was conducted in 114 patients with type 2 diabetes mellitus in our hospital.All the participants were divided into DPN group(n=73)and type 2 diabetes mellitus(T2DM)group(n=41)based on the presence of peripheral nerve damage.Simultaneously,35 healthy volunteers were chosen as the normal control(NC)group.General data,biochemical indexes,medial plantar nerve amplitude,conduction velocity,and abnormal rates were compared among the three groups.DPN patients were further divided into symptomatic and asymptomatic groups based on the presence of plantar paresthesia symptoms.The abnormal rate of the medial plantar nerve was compared with that of the superficial peroneal nerve and sural nerve in each group.Receiver operating characteristic(ROC)curve analysis was employed to assess the diagnostic value of the medial plantar nerve in DPN.Results The amplitude of the medial plantar nerve was significantly lower[(3.00±1.42)vs(6.64±3.76)vs(6.51±3.58)μV],the conduction velocity was markedly reduced[(46.57±7.42)vs(49.42±6.96)vs(51.22±5.34)m/s],and the abnormality rate was elevated(87.67%vs 12.20%)in T2DM group,than in NC groups(P<0.05).Spearman correlation analysis indicated a negative correlation between the medial plantar nerve amplitude and HbA1c(r=-0.267,P<0.05),while the conduction velocity showed a negative correlation with age(r=-0.157,P<0.05).In both symptomatic and asymptomatic DPN patients,the abnormal rate of the medial plantar nerve was higher than that of the superficial peroneal nerve and sural nerve(P<0.05).The area under the ROC curve was 0.942,signifying a reliable diagnostic value for DPN using the medial plantar nerve(P<0.05).Conclusions The medial plantar nerve proves valuable in the diagnosis of DPN,exhibiting higher sensitivity than the superficial peroneal nerve and sural nerve.

Objective:To investigate the pharmacological basis and mechanism of Anti-cancer Essence Formula in the treatment of gastric cancer based on network pharmacology,and to provide bioinformatics basis for the clinical treatment of gastric cancer with traditional Chinese medicine.Methods:The active ingredients of Anti-cancer Essence Formula were searched in TCMSP database,and the targets of the active ingredients were further obtained using UniProt database.The targets of gastric cancer were obtained using GeneCards,OMIM and TTD databases.Cytoscape 3.9.1 software was used to build the"Disease-Component-Target"network.String database and Cytoscape 3.9.1 software were used to construct the PPI network.The transcript levels of the core genes were analyzed by UALCAN database,and the relationship between core gene expression and patient survival was analyzed by Kaplan-Meier plotter.GO function and KEGG pathway enrichment analyses were performed by DAVID database.Results:There were 236 active ingredients of Anti-Cancer Essence Formula,and 16 key targets were screened by PPI network.MAPK3,MAPK1,RELA,AKT1,TP53,FOS,MAPK14,RXRA,MAPK8 and EGFR were abnormally expressed in gastric cancer tissues(P＜0.05),and all of them showed correlation with the prognosis of gastric cancer patients(P＜0.05).GO analysis was mainly enriched in cell division,cell proliferation and apoptosis,and KEGG analysis was mainly enriched in cancer pathway,MAPK signaling pathway,Relaxin signaling pathway,TNF signaling pathway,T-cell receptor signaling pathway,Prolactin signaling pathway,and PI3K-Akt signaling pathway.Conclusion:Anti-cancer Essence Formula is characterized by the synergistic effect of multi-components,multi-targets,and multi-pathways.It mainly acts on the targets of MAPK3,MAPK1,RELA,AKT1,TP53,FOS,MAPK14,RXRA,MAPK8,and EGFR through the active ingredients such as quercetin,kaempferol,β-sitosterol,and racemic carvacrol.It also regulates the signaling pathways of MAPK,Relaxin,TNF,T-cell receptor,Prolactin,and PI3K-Akt.

Objective:To explore the mechanism of kidney-protecting spirit pill for the treatment of diabetic nephropathy(DN)based on the network pharmacology and molecular docking technology.Methods:The database of TCMSP and Swiss Target Prediction was searched to obtain the active ingredients and targets of kidney-protecting spirit pill,and the intersection with the disease targets was obtained.The protein-protein interaction(PPI)network of intersection targets was constructed,GO and KEGG enrichment were analyzed.The key targets and small molecules were obtained and their interactions were verified by molecular docking.Results:A total of 60 active ingredients and 112 therapeutic DN targets were predicted.The key components were Cerevisterol,3,9-di-O-methylnissolin,Jaranol,Palmidin A and 16α-Hydroxydehydrotrametenolic acid.The key targets were PIK3CA,MAPK1,AKT1,PIK3R1 and BCL2,which were closely related to cancer-related pathways,AGE-RAGE signaling pathway,endocrine resistance,lipids and atherosclerosis pathways in diabetic complications.Conclusion:The mechanism of kidney-protecting spirit pill in the treatment of DN is characterized by multi-components,multi-targets and multi-pathways,with synergistic effects between the herbs,which provides a basis for the study of the pharmacological effects of kidney-protecting spirit pill.

Objective:To investigate the anxiety and depression of elderly patients with lung cancer before and after chemotherapy.Methods:A total of 168 elderly patients diagnosed with lung cancer and eligible for chemotherapy in a Grade A tertiary hospital in Shenyang from Jan 2022 to Feb 2024 were selected as the study subjects.The basic data,self-rating depression scale(SDS),and self-rating anxiety scale(SAS)scores before and after chemotherapy were collected.The Spearman rank correlation test was used to analyze the correlation of the general data of patients with SDS and SAS scores before and after chemotherapy.Results:SDS and SAS scores of lung patients after chemotherapy were significantly higher than those before chemotherapy(P＜0.05).The proportion of patients with depression and anxiety after chemotherapy was also significantly higher than that before chemotherapy(P＜0.05).Results of Spearman's rank correlation test showed that,the increase of SDS and SAS scores was correlated with gender,pathological type,chemotherapy cycle,combined underlying diseases,and respiratory symptoms(P＜0.05).Conclusions:Chemotherapy increases the proportion of anxiety and depression in elderly patients with lung cancer.Gender,pathological type,chemotherapy cycle,combined underlying diseases,and respiratory system symptoms are correlated with the occurrence of anxiety and depression.