Based on spleen deficiency-phlegm dampness as the core pathogenesis of obesity， and integrating recent advances in modern medicine regarding the key role of immune inflammation in obesity， this paper proposes a multidimensional pathogenic network of "obesity-spleen deficiency-phlegm dampness-immune imbalance". Various traditional Chinese medicine （TCM） herbs that strengthen the spleen， regulate qi， and resolve phlegm and dampness can treat obesity by improving spleen-stomach transport and transformation， promoting water-damp metabolism， and regulating immune homeostasis. This highlights immune inflammation as an important entry point to elucidate the TCM concepts of "spleen deficiency-phlegm dampness" and the therapeutic principle of "strengthening the spleen and eliminating dampness to treat obesity". By systematically analyzing the intrinsic connection between "spleen deficiency generating dampness， internal accumulation of phlegm dampness" and immune dysregulation in obesity， this paper aims to provide theoretical support for TCM treatment of obesity based on dampness.

To investigate the protective effects and underlying mechanisms of Qin-Zhu-Liang-Xue decoction (QZLX) in atopic dermatitis (AD) and glucocorticoid resistance, we conducted a single-blinded, randomized controlled clinical trial to evaluate the efficacy and safety of this concoction. Network pharmacology analysis was performed and validated through clinical studies. The efficacy, safety, and mechanism of action of QZLX and glucocorticoid receptor (GR) α recombinant protein were assessed in AD mice induced by 2,4-dinitrofluorobenzene (DNFB). Correlation analysis was performed to determine the clinical relevance of GRα. The trial demonstrated that patients who received QZLX showed considerable improvements in their Scoring Atopic Dermatitis (SCORAD) and Dermatology Life Quality Index (DLQI) scores compared with those who received mizolastine at week 4. Network pharmacological analysis identified GRα as a key target for QZLX in AD treatment. QZLX administration increased the serum GRα expression in AD patients, alleviated AD symptoms in mice, decreased inflammatory cytokine expression, and increased GRα expression without affecting liver or kidney function. In addition, GRα recombinant protein improved AD-like skin lesions in DNFB-induced mice. A negative correlation was observed between GRα expression and clinical parameters, including SCORAD, DLQI, and serum IgE levels. QZLX alleviates AD symptoms through the upregulation of GRα and thus presents a novel therapeutic strategy for the prevention of glucocorticoid resistance in AD management.
Dermatitis, Atopic/drug therapy* ; Animals ; Drugs, Chinese Herbal/administration & dosage* ; Humans ; Mice ; Network Pharmacology ; Male ; Female ; Adult ; Receptors, Glucocorticoid/metabolism* ; Disease Models, Animal ; Single-Blind Method ; Middle Aged ; Young Adult

Syringa pinnatifolia, belonging to the family Oleaceae, is a species endemic to China. It is predominantly distributed in the Helan Mountains region of Inner Mongolia and Ningxia of China. The peeled roots, stems, and thick branches have been used as a distinctive Mongolian medicinal material known as "Shan-chen-xiang", which has effects such as suppressing "khii", clearing heat, and relieving pain and is employed for the treatment of cardiovascular and pulmonary diseases and joint pain. Over the past five years, significant increase was achieved in research on chemical constituents and pharmacological effects. There were a total of 130 new constituents reported, covering sesquiterpenoids, lignans, and alkaloids. Its effects of anti-myocardial ischemia, anti-cerebral ischemia/reperfusion, sedation, and analgesia were revealed, and the mechanisms of agarwood formation were also investigated. To better understand its medical value and potential of clinical application, this review updates the research progress in recent five years focusing on the chemical constituents and pharmacological effects of S. pinnatifolia, providing reference for subsequent research on active ingredient and support for its innovative application in modern medicine system.
Medicine, Mongolian Traditional ; Humans ; Drugs, Chinese Herbal/pharmacology* ; Animals ; Syringa/chemistry*

Vascular aging (VA) is a common etiology of various chronic diseases and represents a major public health concern. Intermittent hypoxia (IH) associated with obstructive sleep apnea-hypopnea syndrome (OSAHS) is a primary pathological and physiological driver of OSAHS-induced systemic complications. A substantial proportion of OSAHS patients, estimated to be between 40% and 80%, have comorbidities such as hypertension, heart failure, coronary artery disease, pulmonary hypertension, atrial fibrillation, aneurysm, and stroke, all of which are closely associated with VA. This review examines the molecular and cellular features common to both OSAHS and VA, highlighting decreased melatonin secretion, impaired autophagy, increased apoptosis, increased inflammation and pyroptosis, increased oxidative stress, accelerated telomere shortening, accelerated stem cell depletion, metabolic disorders, imbalanced protein homeostasis, epigenetic alterations, and dysregulated neurohormonal signaling. The accumulation and combination of these features may underlie the pathophysiological link between OSAHS and VA, but the exact mechanisms by which OSAHS affects VA may require further investigation. Taken together, these findings suggest that OSAHS may serve as a novel risk factor for VA and related vascular disorders, and that targeting these features may offer therapeutic potential to mitigate the vascular risks associated with OSAHS.
Humans ; Sleep Apnea, Obstructive/pathology* ; Aging/physiology* ; Oxidative Stress/physiology* ; Animals

Objective To evaluate the value of a nomogram model based on ultrasonographic features and inflammatory indicators in the preoperative noninvasive prediction of pathological grading of urothelial carcinoma of bladder(UCB).Methods A retrospective analysis was conducted on 471 patients with pathologically confirmed UCB,and the patients were assigned to high-grade group(401 cases)or low-grade group(70 cases).Basic clinical data(gender,age,macroscopic hematuria),ultrasonographic features(lesion location,blood flow signal,etc.),and blood inflammatory indicators(e.g.neutrophil-to-lymphocyte ratio[NLR])were collected.Independent predictors were screened using univariate and multivariate logistic regression,and a nomogram model was constructed.Model performance was evaluated using the receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA).Results Multivariate logistic analysis identified gender(odds ratio[OR]=2.68),age(OR=1.08),macroscopic hematuria(OR=3.19),lesion located in the trigone(OR=4.59),positive blood flow signal(OR=2.87),and NLR(OR=1.03)were independent predictors of high-grade UCB(all P＜0.05).The combined model(clinical features+ultrasonographic characteristics+inflammatory indicators)achieved an area under curve(AUC)of 0.892,which was significantly higher than the clinical feature-only model(AUC=0.799)and the clinical+ultrasonographic model(AUC=0.856).The calibration curve demonstrated good consistency between predicted and actual outcomes,and DCA confirmed its optimal clinical net benefit.Conclusion The nomogram model integrating clinical features,ultrasonographic characteristics,and inflammatory indicators can effectively discriminate UCB pathological grading,providing a reliable preoperative noninvasive assessment tool for personalized treatment decisions.

[Purpose]To analyze the incidence and mortality of female breast cancer in Zhejiang cancer registration areas in 2021 and the trends from 2000 to 2021.[Methods]The data of cancer inci-dence,mortality and population data reported by cancer registration areas in Zhejiang Province from 2000 to 2021 were collected.The crude incidence/mortality rates,age-standardized rates ad-justed by Chinese standard population(ASIRC,ASMRC)and world standard population(ASIRW,ASMRW),cumulative rates(0～74 years old),truncated rates(35～64 years old),proportion of fe-male breast cancer and age-specific rate were calculated.The average annual percentage change(AAPC)of female breast cancer incidence and mortality rates in Zhejiang from 2000 to 2021 was calculated using Joinpoint software.[Results]In 2021,there were 7 262 new cases of female breast cancer in Zhejiang cancer registration areas,accounting for 12.70％of all new female can-cer cases.The crude incidence rate,ASIRC and ASIRW were 65.71/105,42.03/105 and 39.22/105,respectively.The cumulative incidence rate(0～74 years old)was 4.26％,and the truncated rate(35～64 years old)was 98.34/105.The ASIRC in urban and rural areas were 43.15/105 and 40.15/105,respectively.There were 992 deaths of female breast cancer,accounting for 6.97％of all female cancer deaths.The crude mortality rate,ASMRC and ASMRW were 8.98/105,4.62/105 and 4.47/105,respectively.The cumulative mortality rate(0～74 years old)was 0.48％,and the truncated rate(35～64 years old)was 8.89/105.The ASMRC in urban and rural areas were 4.79/105 and 4.34/105,respectively.The incidence rate of female breast cancer reached the peak at the age group of 60～64 years old,and the mortality rate reached the peak at the age group of 85 years old and above.From 2000 to 2021,the crude incidence rate,ASIRC and ASIRW of female breast cancer in Zhejiang cancer registration areas showed significant increasing trends(all P＜0.05).The crude mortality rate and ASMRW of female breast cancer also showed significant increasing trends(all P＜0.05).[Conclusion]The incidence rate of female breast cancer in Zhejiang Province was higher than the national average,while the mortality rate was lower than the national average in 2021.Both the incidence and mortality rates showed increasing trends from 2000 to 2021.Fur-thermore,distinct urban-rural disparities existed in both incidence and mortality characteristics.

Objective:To explore the clinical application effects of tissue flaps prepared from the discarded limbs after amputation in patients with destructive wounds in the lower limbs.Methods:The study was a retrospective observational study. From March 2019 to March 2024, 7 male patients with destructive wounds in the lower limbs who met the inclusion criteria were admitted to the Department of Burns and Plastic Surgery of Xiangya Hospital of Central South University, aged 35 to 57 years. After clinical treatment, the damaged limbs were still difficult to preserve. Five patients with destructive wounds in the lower limbs were repaired with pedicled tissue flaps prepared from the discarded limbs after amputation, with wound areas of 15 cm×10 cm to 25 cm×15 cm and tissue flap incision areas of 15 cm×10 cm to 20 cm×15 cm. Two patients with destructive wounds in the lower limbs were repaired with free tissue flaps prepared from the discarded limbs after amputation, with wound areas of 22 cm×18 cm and 25 cm×15 cm and tissue flap incision areas of 23 cm×20 cm and 25 cm×18 cm. The survival of the tissue flap, the healing and appearance of wounds in the recipient site were followed up. At the last follow-up, the recovery status of the recipient site was evaluated according to the comprehensive flap evaluation scale, and the status of corrective prosthesis fitting was recorded.Results:During the follow-up of 6 to 24 months, all the tissue flaps successfully survived, with good healing and appearance of wounds in the recipient site. At the last follow-up, the scores of the recovery status of the recipient site ranged from 36 to 39 (with an average of 37.2). All amputated limbs were able to accommodate corrective prostheses with no distal ulceration.Conclusions:Utilizing tissue flaps prepared from the discarded limbs after amputation in patients with destructive wounds in the lower limbs to repair wounds effectively uses the discarded tissue and avoid creating new donor sites, which is a method to be considered for repairing multiple destructive wounds.

Objective To investigate the predictive value of dual-energy computed tomography(DECT)quantitative parameters in the diagnosis and pathological aggressiveness of lung adenocarcinoma.Methods A total of 174 patients with lung cancer were pro-spectively selected.All patients underwent DECT examination,and the types of lung cancer were determined according to the patho-logical tissue.According to the pathological classification,they were divided into lung adenocarcinoma group(n=99),lung squamous cell carcinoma group(n=47)and small cell lung cancer group(n=28).According to whether the lung adenocarcinoma patients had pathological aggressiveness,they were divided into invasive group(n=34)and non-invasive group(n=65).Receiver operating char-acteristic(ROC)curve was used to diagnose the predictive value of DECT quantitative parameters in the diagnosis and pathological aggressiveness of lung adenocarcinoma.Results The normalized iodine concentration(NIC)and k in venous phase of lung adenocar-cinoma group were higher than those in lung squamous cell carcinoma group and small cell lung cancer group(P<0.05).ROC curve analysis showed that the combined diagnosis value of NIC and k in venous phase was higher(P<0.05).The lobular proportion,vac-uolar proportion,pleural indentation proportion,vascular cluster proportion,effective atomic number(Eff-Z),NIC and k in arterial phase,and NIC and k in venous phase in invasion group were higher than those in non-invasion group(P<0.05).Logistic regression analysis showed that pleural indentation,NIC in arterial phase and NIC in venous phase were risk factors for pathological aggerssive-ness in lung adenocarcinoma patients(P<0.05).ROC curve analysis showed that the combination of NIC in arterial phase and NIC in venous phase had higher value in predicting the pathological aggressiveness of lung adenocarcinoma(P<0.05).Conclusion The combination of NIC and k in venous phase is effective in the diagnosis of lung adenocarcinoma,while NIC in arterial phase and NIC in venous phase have high predictive values for the aggressiveness of lung adenocarcinoma.

OBJECTIVE: To investigate the effect of TBL1XR1 mutation on cell biological characteristics of diffuse large B-cell lymphoma (DLBCL). METHODS: The TBL1XR1 overexpression vector was constructed and DNA sequencing was performed to determine the mutation status. The effect of TBL1XR1 mutation on apoptosis of DLBCL cell line was detected by flow cytometry and TUNEL fluorescence assay; CCK-8 assay was used to detect the effect of TBL1XR1 mutation on cell proliferation; Transwell assay was used to detect the effect of TBL1XR1 mutation on cell migration and invasion; Western blot was used to detect the effect of TBL1XR1 mutation on the expression level of epithelial-mesenchymal transition (EMT) related proteins. RESULTS: The TBL1XR1 overexpression plasmid was successfully constructed. The in vitro experimental results showed that TBL1XR1 mutation had no significant effect on apoptosis of DLBCL cells. Compared with the control group, TBL1XR1 mutation enhanced cell proliferation, migration and invasion of DLBCL cells. TBL1XR1 gene mutation significantly increased the expression of N-cadherin protein, while the expression of E-cadherin protein decreased. CONCLUSION TBL1XR1 mutation plays a role in promoting tumor cell proliferation, migration and invasion in DLBCL. TBL1XR1 could be considered as a potential target for DLBCL therapy in future research.
Humans ; Lymphoma, Large B-Cell, Diffuse/pathology* ; Cell Proliferation ; Mutation ; Receptors, Cytoplasmic and Nuclear/genetics* ; Apoptosis ; Cell Line, Tumor ; Epithelial-Mesenchymal Transition ; Cell Movement ; Repressor Proteins/genetics* ; Nuclear Proteins/genetics* ; Cadherins/metabolism*

OBJECTIVE: To investigate the mechanism of electroacupuncture (EA) in treating diabetic gastroparesis (DGP) by inhibiting the activation of Nod-like receptor family pyrin domain-containing protein 3 (NLRP3) inflammasome and pyroptosis mediated via NLRP3/cysteinyl aspartate specific proteinase-1 (caspase-1)/gasdermin D (GSDMD) signaling pathway. METHODS: Forty Sprague-Dawley rats were randomly divided into 4 groups including the control, DGP model, EA, and MCC950 groups. The DGP model was established by a one-time high-dose intraperitoneal injection of 2% streptozotocin and a high-glucose and high-fat diet for 8 weeks. EA intervention was conducted at Zusanli (ST 36), Liangmen (ST 21) and Sanyinjiao (SP 6) with sparse-dense wave for 15 min, and was administered for 3 courses of 5 days. After intervention, the blood glucose, urine glucose, gastric emptying, and intestinal propulsive rate were observed. Besides, HE staining was used to observe histopathological changes in gastric antrum tissues, and TUNEL staining was utilized to detect DNA damage. Protein expression levels of NLRP3, apoptosis-associated speck-like protein containing CARD (ASC), pro-caspase-1, caspase-1 and GSDMD were measured by Western blot. Immunofluorescence staining was employed to assess the activity of GSDMD-N. Lactate dehydrogenase (LDH) levels were detected by using a biochemical kit. RESULTS: DGP rats showed persistent hyperglycemia and a significant decrease in gastrointestinal motility (P<0.05 or P<0.01), accompanied by pathological damage in their gastric antrum tissues. Cellular DNA was obviously damaged, and the expressions of NLRP3, ASC, pro-caspase-1, caspase-1 and GSDMD proteins were significantly elevated, along with enhanced fluorescence signals of GSDMD-N and increased LDH release (P<0.01). EA mitigated hyperglycemia, improved gastrointestinal motility in DGP rats and alleviated their pathological injury (P<0.05). Furthermore, EA reduced cellular DNA damage, lowered the protein levels of NLRP3, ASC, pro-caspase-1, caspase-1 and GSDMD, suppressed GSDMD-N activity, and decreased LDH release (P<0.05 or P<0.01), demonstrating effects comparable to MCC950. CONCLUSION EA promotes gastrointestinal motility and repairs the pathological damage in DGP rats, and its mechanism may be related to the inhibition of NLRP3 inflammasome and pyroptosis mediated by NLRP3/caspase-1/GSDMD pathway.
Animals ; Electroacupuncture ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism* ; Pyroptosis ; Rats, Sprague-Dawley ; Caspase 1/metabolism* ; Gastroparesis/physiopathology* ; Signal Transduction ; Male ; Diabetes Mellitus, Experimental/physiopathology* ; Phosphate-Binding Proteins/metabolism* ; Gastrointestinal Motility ; Rats ; Intracellular Signaling Peptides and Proteins/metabolism* ; Diabetes Complications/physiopathology* ; Gasdermins