ObjectiveTo investigate the mechanism of action of Jiedu Huayu granules in improving liver injury in mice with acute liver failure （ALF） by observing its effect on a mouse model of ALF after prophylactic administration， and to provide a basis for clinical medication. MethodsA total of 60 specific pathogen-free male C57BL/6J mice were divided into normal group， model group， Jiedu Huayu granules group （JDHY group）， and farnesoid X receptor （FXR） agonist （GW4064） group using a random number table， with 15 mice in each group. The model of ALF was induced by a single intraperitoneal injection of D-galactosamine combined with lipopolysaccharide. The mice in the JDHY group were given prophylactic administration of 0.3 g/mL drug solution of Jiedu Huayu granules by gavage for 3 days before modeling， those in the normal group and the model group were given 0.9% NaCl solution by gavage， and those in the GW4064 group were given intraperitoneal injection of GW4064 for 3 consecutive days before modeling. The mice were sacrificed after modeling， and serum and liver tissue samples were collected. A veterinary automatic biochemical analyzer was used to measure the serum levels of total bilirubin （TBil）， total bile acids （TBA）， gamma-glutamyl transferase （GGT）， alanine aminotransferase （ALT）， and aspartate aminotransferase （AST） in mice from each group； HE staining was used to observe liver pathological changes； RT-PCR was used to measure the mRNA expression levels of FXR， fibroblast growth factor 15 （FGF15）， fibroblast growth factor receptor 4 （FGFR4）， small heterodimer partner （SHP）， and bile salt export pump （BSEP） in mice， and Western blot was used to measure the protein expression levels of FXR， FGF15， FGFR4， SHP， and BSEP. A one-way analysis of variance was used for comparison between groups， and the Dunett method was used for further comparison between two groups. ResultsCompared with the normal group， the model group had significant increases in the serum levels of TBil， ALT， AST， TBA， and GGT （all P<0.01）， and compared with the model group， the JDHY group and the GW4064 group had significant reductions in the serum levels of TBil， ALT， AST， TBA， and GGT （all P <0.01）. HE staining showed that compared with the model group， the JDHY group and the GW4064 group had milder pathological injury， a reduction in the area of hepatocyte necrosis， and alleviation of cellular swelling and edema. Compared with the normal group， the model group had significant reductions in the mRNA and protein expression levels of FXR， FGF15， FGFR4， SHP， and BSEP in liver tissue （all P <0.01）， and compared with the model group， the JDHY group and the GW4064 group had significant increases in the mRNA and protein expression levels of FXR， FGF15， FGFR4， SHP， and BSEP in liver tissue （all P <0.05）. ConclusionJiedu Huayu granules may alleviate liver injury in mice with ALF through the FXR/SHP axis.

Objective:To explore the value of the vesical imaging-reporting and data system (VI-RADS) score based on multiparametric MRI (mpMRI) combined with quantitative tumor MRI parameters in assessing the muscle invasion of bladder cancer.Methods:The study was a case-control study. The data of 87 bladder cancer patients confirmed by pathology who underwent mpMRI of the bladder were retrospectively collected from the First Medical Center of Chinese PLA General Hospital between January 2019 and April 2023 The pathological findings were used as the gold standard to categorize them into the muscle invasive bladder cancer (MIBC) group (29 cases) and non-muscle invasive bladder cancer (NMIBC) group (58 cases). Quantitative parameters were measured based on preoperative mpMRI images, including the length of tumor bladder wall contact, the perpendicular distance between the bladder tumor and the tangent of the bladder wall, the maximal diameter of the bladder tumor, and the volume of the bladder tumor. Bladder cancer was classified according to the VI-RADS scoring criteria. The Mann-Whitney U test was used for intergroup comparisons. Multivariate logistic regression analysis was performed to obtain the independent risk factors related to muscle invasion of bladder cancer and to establish the model. The receiver operating characteristic curves were analyzed for MRI quantitative parameters and logistic regression models, and area under the curve (AUC) comparisons were performed using the DeLong test. Results:The differences in tumor bladder wall contact length, perpendicular distance from the tumor to the tangent line of the bladder wall, maximum diameter, bladder tumor volume, and the VI-RADS scores were statistically significant between the MIBC group and the NMIBC group ( P<0.05). Multifactorial logistic regression analysis showed that tumor bladder wall contact length ( OR=21.07, 95% CI 3.56-124.89, P=0.001) and VI-RADS score ( OR=11.90, 95% CI 3.53-40.12, P<0.001) were the independent risk factors for evaluating the muscle invasion of bladder cancer. The difference between the VI-RADS score and the tumor bladder wall contact length for assessing muscular infiltration of bladder cancer had AUCs of 0.802 (95% CI 0.704-0.899) and 0.759 (95% CI 0.652-0.865). The combined model of VI-RADS score combined with tumor bladder wall contact length had an AUC of 0.891 (95% CI 0.812-0.970), which was higher than the diagnostic efficacy of applying tumor bladder wall contact length or VI-RADS score alone ( Z=3.05, 2.37, P=0.002, 0.018). Conclusion:Tumor contact length with the bladder wall is an independent risk factor for assessing muscle invasion of bladder cancer and the combination of VI-RADS score may enhances diagnostic accuracy.

Objective To investigate the protective effect of Huishen Suxing decoction on intestinal mucosal barrier in rats with acute-on-chronic liver failure(ACLF)and elucidate its possible mechanism.Methods The rats were randomly divided into control group(Con group),model group,Bifico group(positive control),and HSD-L,M and H groups(low,medium and high dose of Huishen Suxing decoction).The ACLF model was established by CCl4 combined with D-galactosamine(D-Gal N).Intragastric administration of CCl4 was started on the 6th week of intraperitoneal injection,once daily for 6 weeks,and continued until the acute challenge with D-Gal N injection.The liver function of rats was detected by kits.HE staining was used to observe the pathological changes of liver tissue and ileum tissue.The levels of endotoxin(ET),diamine oxidase(DAO),IL-1β,IL-6,TNF-α in serum and secretory immunoglobulin A(sIgA)in ileum were detected by ELISA.Intestinal mucosal permeability was detected by FITC-Dextran tracer.Selective medium was used to detect the amount of intestinal flora.Western blotting was used to detect the protein expression levels of HMGB1,TLR4,NF-κB p65,p-NF-κB p65,Occludin and ZO-1 in ileum tissue of each group.Results Compared with the Con group,the liver tissue and ileum tissue of the Model group showed obvious pathological damage.The levels of ALT,AST,TBIL,ET,DAO,IL-1β,IL-6 and TNF-α in serum significantly increased(P<0.01).The content of sIgA in ileum tissue significantly decreased(P<0.01).The permeability of intestinal mucosa and the number of Enterobacter and Enterococcus in the intestine significantly increased(P<0.01).The amount of Bifidobacterium and Lactobacillus significantly decreased(P<0.01).The expressions of HMGB1,TLR4 protein and p-NF-κB p65/NF-κB p65 protein ratio in ileum tissue significantly increased(P<0.01),and the expressions of Occludin and ZO-1 protein significantly decreased(P<0.01).Compared with the model group,the Bifico group and HSD-L,M,H groups had significantly alleviated liver and ileum injury.The levels of ALT,AST,TBIL,ET,DAO,IL-1β,IL-6 and TNF-α in serum significantly decreased(P<0.01).The permeability of intestinal mucosa and the amount of Enterobacteriaceae and Enterococcus in the intestine significantly decreased(P<0.01),while the amount of Bifidobacterium and Lactobacillus significantly increased(P<0.01).The expressions of HMGB1,TLR4 protein and p-NF-κB p65/NF-κB p65 protein ratio in ileum tissue significantly decreased(P<0.01),and the expressions of Occludin and ZO-1 protein significantly increased(P<0.01).Conclusion Huishen Suxing decoction can reduce inflammatory response,regulate the structure of intestinal flora,improve the intestinal mucosal barrier,and thus alleviate liver injury in ACLF rats.The mechanism may be associated to the inhibition of HMGB1/TLR4/NF-κB signaling pathway activation.

Objective To investigate the prevalence of comorbidity of oral frailty and sarcopenia in elderly inpatients,and to explore their influencing factors,so as to provide a basis for formulating targeted interventions for patients with oral frailty and sarcopenia.Methods A total of 515 elderly patients hospitalized in 3 tertiary hospitals in Zhengzhou City and 1 second-class hospital in Shangqiu City from January 2024 to April 2024 were selected as the research subjects by convenience sampling,and the general information questionnaire,Oral Frailty Index-8,Sarcopenia Screen Questionnaire,Mini Nutritional Assessment Short Form,Social Support Rating Scale and Hospital Anxiety and Depression Scale(HADS)were used for investigation.Logistic regression was used to analyze the influencing factors of oral frailty and sarcopenia comorbidities in elderly inpatients.Results 508 valid questionnaires were collected.The prevalence of sarcopenia and oral frailty in elderly inpatients was 22.8％,and age,dysphagia,number of chronic diseases,and history of hypertension or stroke,multiple drug use,depression,bad nutrition and low level of social support were the risk factors(P＜0.05).Conclusion The incidence of oral frailty combined with sarcopenia was higher in elderly hospitalized patients.Nurses should take nursing measures according to its influencing factors to prevent and control the development of oral frailty combined with sarcopenia.

Objective To investigate the prevalence of comorbidity of oral frailty and sarcopenia in elderly inpatients,and to explore their influencing factors,so as to provide a basis for formulating targeted interventions for patients with oral frailty and sarcopenia.Methods A total of 515 elderly patients hospitalized in 3 tertiary hospitals in Zhengzhou City and 1 second-class hospital in Shangqiu City from January 2024 to April 2024 were selected as the research subjects by convenience sampling,and the general information questionnaire,Oral Frailty Index-8,Sarcopenia Screen Questionnaire,Mini Nutritional Assessment Short Form,Social Support Rating Scale and Hospital Anxiety and Depression Scale(HADS)were used for investigation.Logistic regression was used to analyze the influencing factors of oral frailty and sarcopenia comorbidities in elderly inpatients.Results 508 valid questionnaires were collected.The prevalence of sarcopenia and oral frailty in elderly inpatients was 22.8％,and age,dysphagia,number of chronic diseases,and history of hypertension or stroke,multiple drug use,depression,bad nutrition and low level of social support were the risk factors(P＜0.05).Conclusion The incidence of oral frailty combined with sarcopenia was higher in elderly hospitalized patients.Nurses should take nursing measures according to its influencing factors to prevent and control the development of oral frailty combined with sarcopenia.

Objective To investigate the protective effect of Huishen Suxing decoction on intestinal mucosal barrier in rats with acute-on-chronic liver failure(ACLF)and elucidate its possible mechanism.Methods The rats were randomly divided into control group(Con group),model group,Bifico group(positive control),and HSD-L,M and H groups(low,medium and high dose of Huishen Suxing decoction).The ACLF model was established by CCl4 combined with D-galactosamine(D-Gal N).Intragastric administration of CCl4 was started on the 6th week of intraperitoneal injection,once daily for 6 weeks,and continued until the acute challenge with D-Gal N injection.The liver function of rats was detected by kits.HE staining was used to observe the pathological changes of liver tissue and ileum tissue.The levels of endotoxin(ET),diamine oxidase(DAO),IL-1β,IL-6,TNF-α in serum and secretory immunoglobulin A(sIgA)in ileum were detected by ELISA.Intestinal mucosal permeability was detected by FITC-Dextran tracer.Selective medium was used to detect the amount of intestinal flora.Western blotting was used to detect the protein expression levels of HMGB1,TLR4,NF-κB p65,p-NF-κB p65,Occludin and ZO-1 in ileum tissue of each group.Results Compared with the Con group,the liver tissue and ileum tissue of the Model group showed obvious pathological damage.The levels of ALT,AST,TBIL,ET,DAO,IL-1β,IL-6 and TNF-α in serum significantly increased(P<0.01).The content of sIgA in ileum tissue significantly decreased(P<0.01).The permeability of intestinal mucosa and the number of Enterobacter and Enterococcus in the intestine significantly increased(P<0.01).The amount of Bifidobacterium and Lactobacillus significantly decreased(P<0.01).The expressions of HMGB1,TLR4 protein and p-NF-κB p65/NF-κB p65 protein ratio in ileum tissue significantly increased(P<0.01),and the expressions of Occludin and ZO-1 protein significantly decreased(P<0.01).Compared with the model group,the Bifico group and HSD-L,M,H groups had significantly alleviated liver and ileum injury.The levels of ALT,AST,TBIL,ET,DAO,IL-1β,IL-6 and TNF-α in serum significantly decreased(P<0.01).The permeability of intestinal mucosa and the amount of Enterobacteriaceae and Enterococcus in the intestine significantly decreased(P<0.01),while the amount of Bifidobacterium and Lactobacillus significantly increased(P<0.01).The expressions of HMGB1,TLR4 protein and p-NF-κB p65/NF-κB p65 protein ratio in ileum tissue significantly decreased(P<0.01),and the expressions of Occludin and ZO-1 protein significantly increased(P<0.01).Conclusion Huishen Suxing decoction can reduce inflammatory response,regulate the structure of intestinal flora,improve the intestinal mucosal barrier,and thus alleviate liver injury in ACLF rats.The mechanism may be associated to the inhibition of HMGB1/TLR4/NF-κB signaling pathway activation.

BACKGROUND: In the interim analysis of MONARCH plus, adding abemaciclib to endocrine therapy (ET) improved progression-free survival (PFS) and objective response rate (ORR) in predominantly Chinese postmenopausal women with HR+/HER2- advanced breast cancer (ABC). This study presents the final pre-planned PFS analysis. METHODS: In the phase III MONARCH plus study, postmenopausal women in China, India, Brazil, and South Africa with HR+/HER2- ABC without prior systemic therapy in an advanced setting (cohort A) or progression on prior ET (cohort B) were randomized (2:1) to abemaciclib (150 mg twice daily [BID]) or placebo plus: anastrozole (1.0 mg/day) or letrozole (2.5 mg/day) (cohort A) or fulvestrant (500 mg on days 1 and 15 of cycle 1 and then on day 1 of each subsequent cycle) (cohort B). The primary endpoint was PFS of cohort A. Secondary endpoints included cohort B PFS (key secondary endpoint), ORR, overall survival (OS), safety, and health-related quality of life (HRQoL). RESULTS: In cohort A (abemaciclib: n  = 207; placebo: n  = 99), abemaciclib plus a non-steroidal aromatase inhibitor improved median PFS vs . placebo (28.27 months vs . 14.73 months, hazard ratio [HR]: 0.476; 95% confidence interval [95% CI]: 0.348-0.649). In cohort B (abemaciclib: n  = 104; placebo: n  = 53), abemaciclib plus fulvestrant improved median PFS vs . placebo (11.41 months vs . 5.59 months, HR: 0.480; 95% CI: 0.322-0.715). Abemaciclib numerically improved ORR. Although immature, a trend toward OS benefit with abemaciclib was observed (cohort A: HR: 0.893, 95% CI: 0.553-1.443; cohort B: HR: 0.512, 95% CI: 0.281-0.931). The most frequent grade ≥3 adverse events in the abemaciclib arms were neutropenia, leukopenia, anemia (both cohorts), and lymphocytopenia (cohort B). Abemaciclib did not cause clinically meaningful changes in patient-reported global health, functioning, or most symptoms vs . placebo. CONCLUSIONS: Abemaciclib plus ET led to improvements in PFS and ORR, a manageable safety profile, and sustained HRQoL, providing clinical benefit without a high toxicity burden or reduced quality of life. TRIAL REGISTRATION ClinicalTrials.gov (NCT02763566).
Humans ; Female ; Fulvestrant/therapeutic use* ; Breast Neoplasms/metabolism* ; Aminopyridines/therapeutic use* ; Benzimidazoles/therapeutic use* ; Middle Aged ; Aromatase Inhibitors/therapeutic use* ; Aged ; Receptor, ErbB-2/metabolism* ; Adult ; Letrozole/therapeutic use* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Anastrozole/therapeutic use*

This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers

Objective:To explore the value of the vesical imaging-reporting and data system (VI-RADS) score based on multiparametric MRI (mpMRI) combined with quantitative tumor MRI parameters in assessing the muscle invasion of bladder cancer.Methods:The study was a case-control study. The data of 87 bladder cancer patients confirmed by pathology who underwent mpMRI of the bladder were retrospectively collected from the First Medical Center of Chinese PLA General Hospital between January 2019 and April 2023 The pathological findings were used as the gold standard to categorize them into the muscle invasive bladder cancer (MIBC) group (29 cases) and non-muscle invasive bladder cancer (NMIBC) group (58 cases). Quantitative parameters were measured based on preoperative mpMRI images, including the length of tumor bladder wall contact, the perpendicular distance between the bladder tumor and the tangent of the bladder wall, the maximal diameter of the bladder tumor, and the volume of the bladder tumor. Bladder cancer was classified according to the VI-RADS scoring criteria. The Mann-Whitney U test was used for intergroup comparisons. Multivariate logistic regression analysis was performed to obtain the independent risk factors related to muscle invasion of bladder cancer and to establish the model. The receiver operating characteristic curves were analyzed for MRI quantitative parameters and logistic regression models, and area under the curve (AUC) comparisons were performed using the DeLong test. Results:The differences in tumor bladder wall contact length, perpendicular distance from the tumor to the tangent line of the bladder wall, maximum diameter, bladder tumor volume, and the VI-RADS scores were statistically significant between the MIBC group and the NMIBC group ( P<0.05). Multifactorial logistic regression analysis showed that tumor bladder wall contact length ( OR=21.07, 95% CI 3.56-124.89, P=0.001) and VI-RADS score ( OR=11.90, 95% CI 3.53-40.12, P<0.001) were the independent risk factors for evaluating the muscle invasion of bladder cancer. The difference between the VI-RADS score and the tumor bladder wall contact length for assessing muscular infiltration of bladder cancer had AUCs of 0.802 (95% CI 0.704-0.899) and 0.759 (95% CI 0.652-0.865). The combined model of VI-RADS score combined with tumor bladder wall contact length had an AUC of 0.891 (95% CI 0.812-0.970), which was higher than the diagnostic efficacy of applying tumor bladder wall contact length or VI-RADS score alone ( Z=3.05, 2.37, P=0.002, 0.018). Conclusion:Tumor contact length with the bladder wall is an independent risk factor for assessing muscle invasion of bladder cancer and the combination of VI-RADS score may enhances diagnostic accuracy.