This study aims to investigate the protective effects and mechanisms of polysaccharide extract PCP1 from Polygonatum cyrtonema in ameliorating cerebral ischemia-reperfusion(I/R) injury in rats through modulation of the Toll-like receptor 4(TLR4)/NOD-like receptor protein 3(NLRP3) signaling pathway. In vivo, SD rats were randomly divided into the sham group, model group, PCP1 group, nimodipine(NMDP) group, and TLR4 signaling inhibitor(TAK-242) group. A middle cerebral artery occlusion/reperfusion(MCAO/R) model was established, and neurological deficit scores and infarct size were evaluated 24 hours after reperfusion. Hematoxylin-eosin(HE) and Nissl staining were used to observe pathological changes in ischemic brain tissue. Transmission electron microscopy(TEM) assessed ultrastructural damage in cortical neurons. Enzyme-linked immunosorbent assay(ELISA) was used to measure the levels of interleukin-1β(IL-1β), interleukin-6(IL-6), interleukin-18(IL-18), tumor necrosis factor-α(TNF-α), interleukin-10(IL-10), and nitric oxide(NO) in serum. Immunofluorescence was used to analyze the expression of TLR4 and NLRP3 proteins. In vitro, a BV2 microglial cell oxygen-glucose deprivation/reperfusion(OGD/R) model was established, and cells were divided into the control, OGD/R, PCP1, TAK-242, and PCP1 + TLR4 activator lipopolysaccharide(LPS) groups. The CCK-8 assay evaluated BV2 cell viability, and ELISA determined NO release. Western blot was used to analyze the expression of TLR4, NLRP3, and downstream pathway-related proteins. The results indicated that, compared with the model group, PCP1 significantly reduced neurological deficit scores, infarct size, ischemic tissue pathology, cortical cell damage, and the levels of inflammatory factors IL-1β, IL-6, IL-18, TNF-α, and NO(P<0.01). It also elevated IL-10 levels(P<0.01) and decreased the expression of TLR4 and NLRP3 proteins(P<0.05, P<0.01). Moreover, in vitro results showed that, compared with the OGD/R group, PCP1 significantly improved BV2 cell viability(P<0.05, P<0.01), reduced cell NO levels induced by OGD/R(P<0.01), and inhibited the expression of TLR4-related inflammatory pathway proteins, including TLR4, myeloid differentiation factor 88(MyD88), tumor necrosis factor receptor-associated factor 6(TRAF6), phosphorylated nuclear factor-kappaB dimer RelA(p-p65)/nuclear factor-kappaB dimer RelA(p65), NLRP3, cleaved-caspase-1, apoptosis-associated speck-like protein(ASC), GSDMD-N, IL-1β, and IL-18(P<0.05, P<0.01). The protective effects of PCP1 were reversed by LPS stimulation. In conclusion, PCP1 ameliorates cerebral I/R injury by modulating the TLR4/NLRP3 signaling pathway, exerting anti-inflammatory and anti-pyroptotic effects.
Animals ; Toll-Like Receptor 4/genetics* ; NLR Family, Pyrin Domain-Containing 3 Protein/genetics* ; Rats, Sprague-Dawley ; Rats ; Reperfusion Injury/genetics* ; Male ; Signal Transduction/drug effects* ; Polysaccharides/isolation & purification* ; Polygonatum/chemistry* ; Brain Ischemia/genetics* ; Drugs, Chinese Herbal/administration & dosage* ; Mice ; Humans

Inflammation plays a pivotal role in the etiology and progression of various diseases. In traditional Chinese medicine, the whole plants of Thesium chinense Turcz. and its preparations (e.g. Bairui Granules) have been employed to manage inflammatory conditions. While flavonoids were previously considered the primary anti-inflammatory components, other potentially active constituents have been largely overlooked and not thoroughly investigated. This study presents a novel finding that the total alkaloids of T. chinense (BC-Alk) are potent active substances underlying the traditional and clinical applications of T. chinense and Bairui Granules as anti-inflammatory agents. UPLC-MS/MS analysis identified the composition of BC-Alk as quinolizidine alkaloids. The anti-inflammatory efficacy of BC-Alk was evaluated using a lipopolysaccharide (LPS)-induced lung inflammation model in mice. Results demonstrated that BC-Alk significantly mitigated LPS-induced lung inflammation, attenuated the overproduction of IL-1β and the overproduction of inflammatory factors (TNF-α), and ameliorated lung tissue hyperplasia in mice in vivo. Mechanistic studies in vitro revealed that BC-Alk upregulated the expression of Nrf2 and its downstream proteins NQO1 and glutamate-cystine ligase and modifier subunit (GCLM), inhibited NF-κB phosphorylation, and suppressed NLRP3 activation. Collectively, these findings indicate that BC-Alk exerts potent inhibitory effects against lung inflammation by modulating Nrf2, NF-κB, and NLRP3 pathways. This study provides new insights into the anti-inflammatory constituents of T. chinense and Bairui Granules.
Animals ; Lipopolysaccharides/adverse effects* ; Alkaloids/pharmacology* ; NF-kappa B/metabolism* ; NF-E2-Related Factor 2/metabolism* ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism* ; Mice ; Signal Transduction/drug effects* ; Anti-Inflammatory Agents/pharmacology* ; Male ; Mice, Inbred C57BL ; Humans ; Drugs, Chinese Herbal/administration & dosage* ; Pneumonia/genetics*

Objective:To evaluate clinical efficacy and safety of immunotherapy by retrospectively analyzing clinical medica-tion of patients with recurrent pregnancy loss(RPL)complicated with abnormal immune factors.Methods:A retrospective cohort study was conducted on RPL cases in outpatient department of Hebei Reproductive Health Hospital from January 2021 to April 2022.Efficacy and safety of immunotherapy were evaluated from pregnancy outcome,adverse reactions and birth defects of offspring.Results:According to guidelines,192 cases with abnormal autoimmunity and/or immune indicators were included.Early abortion rate was 4.16%in group of two lost pregnancies,which was lower than that in group of three lost pregnancies(16.66%).Twelve week sus-tained pregnancy rate was 89.58%in the former group,and 28 week sustained pregnancy rate was 86.45%,which were significantly higher than those in the latter group(75.00%,71.87%).RPL patients were divided into groups according to their exposure to immuno-modulatory drugs before 12 weeks of pregnancy.There was no significant difference in pregnancy outcome,adverse reaction rate and birth defect rate of their offspring(P>0.05).Conclusion:Immunotherapy can effectively reduce risk of recurrent abortion and increase rate of persistent pregnancy in patients with immune RPL.Personalized immunotherapy can make RPL patients with immune factors achieve expected effect of fetal protection.

Objective To investigate the effect of constraint abstinence duration on regional homogeneity (ReHo) of heroin addicts in resting state.Methods Twenty heroin addicts abstinent for 6 months (PA6 group),sixteen heroin addicts abstinent for 11 months (PA11 group) and 30 demographically matched healthy controls (HC group) were enrolled.ReHo values were calculated and difference among three groups was analyzed.The relationship between ReHo values of differential brain regions and abstinent duration was performed with Pearson method.Results The results demonstrated statistically significant difference in ReHo values among three groups in the left parahippocampal gyrus,caudate,insula,cingulate gyrus,postcentral gyrus and right orbitofrontal cortex.Compared with the PA6 group,the PA11 group demonstrated lower ReHo value in left parahippocampal gyrus,caudate,insula,cingulate gyrus and postcentral gyrus,ReHos value were higher than PA6 and HC in right orbitofrontal cortex.Meanwhile,the ReHo values of left parahippocampal gyrus (r=0.53,P=0.000 8),caudate (r=0.54,P=0.000 6),insula (r=0.62,P＜0.000 1),cingulate gyrus (r=0.47,P=0.003 5) and postcentral gyrus (r=0.35,P 0.034 8) were negatively correlated with abstinence duration and ReHo value of right orbitofrontal cortex (r=0.66,P＜0.000 1) were positively correlated with abstinence duration.Conclusion During long-term abstinence,most of heroin addicts' damaged brain regions (mainly involved in craving,inhibitory control,learning and memory) tends to be normal,thus benefit reducing the risk of relapse,but motivation related brain region's (orbitofrontal cortex) neural activity increases abnormally,that may be one of the important reasons for relapse after abstinence.

Purpose:To assess the value and limitation of CT in staging colorectal carcinoma.Methods:CT was performed prior to surgery in 46 patients with 48 colorectal carcinomas for staging the tumor. The results were compared with those of surgical and pathological examinations in all cases in order to study the sensitivity of staging the tumor before operation.Results:(1) CT depicted 31 of 33 pathologically confirmed T4 lesions (beyond the serosa) in all 48 primary carcinomas,appearance of T4 lesion were defined as either strands of soft tissue or nodules into the peri-colorectal fat ,or hyperdensity of pericolorectal fat. (2)Pathologic examination of lymphatic metastases unfirmed 20 of 40 patients who underwent complete resections, and these lymph nodes were not larger than 1cm in 17 patients.The sensitivity is 70%(14/20)and the specificity 85%(17/20)respectively in detection of lymphatic metastases for CT. (3) The accuracy of CT staging was 81.25%,77.50% in T,N respectively in this group of patients,and CT showed all 4 cases of liver metastases and 6 of 7 peritoneal metastases. Conclusions:CT is accurate in detecting T4 stage of colorectal carcinoma. It is effective in depicting local extension and distant metastases. The value of CT for early T staging and N staging in colorectal carcinoma is limited.

Objective To evaluate the clinical value of CT scan in the diagnosis of tracheoesophageal groove lymph node (TEGLN) metastasis of thoracic esophageal carcinoma. Methods Forty-six patients with thoracic esophageal carcinoma underwent esophagectomy with three-field dissection (3FD) of the cervical, mediastinal, and abdominal lymph nodes. CT findings of TEGLN were compared with that of pathological findings. Results Among the 46 patients who underwent esophagectomy with 3FD, 14 (30%) were found to have TEGLN metastases. Of the 277 TEGLNs excised by operation, 16 were found to have metastases. Primary sites of the thoracic esophageal carcinoma with TEGLN metastasis in upper, middle, or lower portion were 66.67%, 22.86%, and 40%, respectively. The difference between each portion was not statistically significant. The thoracic esophageal carcinoma with TEGLN metastasis in T 1, T 2, T 3 and T 4 staging were 50.00%, 25.00%, 28.57%, and 100.00%, respectively. There was no statistically significant difference between each T staging. 18 TEGLNs were found in CT scans. The average diameter of them was 1cm (0.3～2.5 cm). Sensitivity and specificity of CT examination were 87.50% and 98.47%, respectively. Positive predict value and negative predict value were 77.78% and 99.23%, respectively. Conclusion In patient with thoracic esophageal carcinoma, nodules appeared in tracheoesophageal groove could be diagnosed as lymph nodal metastases. Low cervical and mediastinal CT scan should be a conventional examination, and it was the basis of the radiation therapy plan. Dissection of TEGLN was very important for patient of thoracic esophageal carcinoma, but if bilateral tracheoesophageal grooves were negative in CT scans, and bilateral internal jugular chain and bilateral superclavicular lymph node were both negative in clinical examination. 3FD dissection, which could increase the rate of operative complication, was not conventionally used.

Objective To analyze the mammographic features of ductal carcinoma in situ (DCIS) of the breast and the correlation between the mammographic and pathologic findings, and try to provide clinical criteria for selecting patients for appropriate local treatment. Methods A retrospective study was performed to analyze the mammographic features and to correlate the mammographic and pathologic findings in 29 consecutive cases of DCIS including 8 cases of DCIS associated with small invasive foci. Results (1)There were various features in mammograms of DCIS, including cluster microcalcifications (20 cases), ill defined mass with calcifications (3 cases), mass (4 cases), nipple retraction associated with big ductal dilatation (1 case), and normal mammogram (1 case). (2)The shape of the calcification cluster distributed as V shaped in 7 cases, round in 8 cases, irregular in 5 cases, and scattered as many small areas in one quadrant in 3 cases.(3)1 lesion appeared as strip from the deep aspect of the breast to the nipple, and 3 masses were round. (4)The comedo subtype (7/9) and the high grade nuclei of DCIS (6/9), correlating with poor prognosis, were more likely to be accompanied by linear and branching calcification. Noncomedo DCIS (11/12) and low grade nuclei (11/12) were more likely to be associated with granular and punctate calcification when microcalcification were seen on mammogram. There was statistically significant difference between the two groups with P =0.002 and P =0.009 respectively (Chi square test, Fisher′s exact method). Conclusion The mammographic findings of DCIS were characteristic. They were closely associated with the pathologic features that were correlated with the biomolecular findings. To some extent, the choice of treatment could be based on these mammographic findings.

0.05,respectively. Chi-square test, Fisher′s exact method). Conclusion The mammographic features of mucinous breast carcinoma show differences in pure and mixed types of the tumor. The most common mammographic appearance of pure mucinous carcinomas with high volume of mucin is a mass with microlobulated margins. Pure type of carcinomas with small volume of mucin and mixed type carcinomas have more aggressive imaging characteristics.

Objective To evaluate the CT features and pathologic findings of MTC. Methods The CT features of 28 patients with MTC confirmed pathologically were analyzed retrospectively and correlated with pathologic findings. Results The tumor invaded one lobe of the thyroid in 22 cases(78.6%), two lobe in 6 cases(21.4%). 5(17.9%) of them presented with heterogeneous hypodense masses and 23(82.1%) of them presented with homogeneous hypodense solitary masses . 20 patients had metastatic lymph nodes. The thyroid masses were enhanced slightly, while the lymph nodes were enhanced obviously. Correlating with pathologic findings, the heterogeneous lesions composed of cystic areas and/or necrosis, while the homogeneous lesions composed of homogeneously distributed tumor cells with no cystic areas or necrosis. The metastatic lymph nodes were hypervascular. Conclusion The CT features of MTC may be described as homogeneous diffuse hypodense mass, with slight enhancement,and invasion of one thyroid lobe in most cases. The metastatic lymph nodes are characterized with enhancement.

Purpose: To determine breast carcinoma detection rate of a new mammographic computer-aided system (CAD) in order to assess its clinical usefulness. Methods: 467 cases of breast carcinoma proved by surgery and pathology were retrospectively analyzed. All the mammograms of the cases were reviewed by two radiologists working as a team and then analyzed by the CAD-system. The sensitivity for breast carcinoma detection (masses or calcification) was calculated respectively, and the results compared. Results: The sensitivity for breast carcinoma detection by the same radiologists without and with the CAD-system were 80. 94% , 88. 01% , respectively (P