ObjectiveThis paper aims to investigate the material basis of the anti-inflammatory efficacy and mechanism of action of Bushen Tongdu prescription （BSTDP）. MethodsThe chemical components of BSTDP and its blood-absorbed components in vivo were systematically identified by using ultra-performance liquid chromatography-linear ion trap-electrostatic field orbitrap high-resolution mass spectrometry （UPLC-LIT-Orbitrap-MS）. Network pharmacology was employed to screen blood-absorbed bioactive components and potential targets of this formula. A protein-protein interaction （PPI） network of core targets was constructed to conduct enrichment analysis. Molecular docking was further utilized to verify the binding affinity between key components and targets. The inflammatory model was established and verified in vivo by using a transgenic zebrafish Tg （mpx： GFP）. At three days post-fertilization （3 dpf）， larvae of zebrafish were randomly assigned to blank group， model group， positive drug dexamethasone acetate group （75 μmol·L^-1）， and BSTDP groups with low， medium， and high doses （500， 1 000， and 2 000 mg·L^-1）. The distribution and quantity of neutrophils in the yolk sac region were observed under a fluorescence microscope. The mRNA expression levels of key genes in the toll-like receptor 4 （TLR4）/myeloid differentiation factor 88 （MyD88）/nuclear factor kappa-B （NF-κB） signaling pathway and inflammatory factors including interleukin （IL）-1β， IL-6， and tumor necrosis factor-α （TNF-α） were detected by Real-time quantitative polymerase chain reaction （Real-time PCR）. ResultsA total of 120 chemical components were identified in BSTDP， among which 26 original components were confirmed by using serum pharmacochemical methods. A total of 227 common targets linking rheumatoid arthritis （RA） and the blood-absorbed components were screened by network pharmacology. It is suggested that pseudobrucine， vomicine， sinapine， rehmannioside， cinnamyl alcohol glycoside， and methylephedrine exert anti-inflammatory effects by acting on core targets including protein kinase B1 （Akt1）， signal transducer and activator of transcription 3 （STAT3）， tumor necrosis factor （TNF）， TLR4， mitogen-activated protein kinase 14 （MAPK14）， and phosphatidylinositol-4，5-bisphosphate 3-kinase catalytic subunit α （PIK3CA）， thereby modulating multiple signaling pathways such as TLR4 and NF-κB. In vivo verification in zebrafish demonstrates that the maximum tolerable concentration of Bushen Tongdu Formula is 2 000 mg·L^-1. Compared to those in the blank group， zebrafish in the model group showed a significantly higher number of neutrophils in the yolk sac region （P<0.01） and rising mRNA levels of TLR4， MyD88， NF-κB， TNF-α， IL-6， and IL-1β （P<0.01）. Compared to that in the model group， the number of neutrophils was significantly reduced in BSTDP groups with medium and high doses， as well as the dexamethasone acetate group （P<0.05， P<0.01）. There was no statistically significant difference in the low dose group. The mRNA expression levels of TLR4， MyD88， NF-κB， TNF-α， IL-6， and IL-1β were significantly down-regulated （P<0.05， P<0.01）. ConclusionThis paper identifies the material basis of the efficacy of BSTDP， demonstrating that the formula can exert an anti-inflammatory effect through the TLR4/MyD88/NF-κB signaling pathway. The results provide scientific experimental evidence for its further clinical application.

ObjectiveThis paper aims to investigate the material basis of the anti-inflammatory efficacy and mechanism of action of Bushen Tongdu prescription （BSTDP）. MethodsThe chemical components of BSTDP and its blood-absorbed components in vivo were systematically identified by using ultra-performance liquid chromatography-linear ion trap-electrostatic field orbitrap high-resolution mass spectrometry （UPLC-LIT-Orbitrap-MS）. Network pharmacology was employed to screen blood-absorbed bioactive components and potential targets of this formula. A protein-protein interaction （PPI） network of core targets was constructed to conduct enrichment analysis. Molecular docking was further utilized to verify the binding affinity between key components and targets. The inflammatory model was established and verified in vivo by using a transgenic zebrafish Tg （mpx： GFP）. At three days post-fertilization （3 dpf）， larvae of zebrafish were randomly assigned to blank group， model group， positive drug dexamethasone acetate group （75 μmol·L^-1）， and BSTDP groups with low， medium， and high doses （500， 1 000， and 2 000 mg·L^-1）. The distribution and quantity of neutrophils in the yolk sac region were observed under a fluorescence microscope. The mRNA expression levels of key genes in the toll-like receptor 4 （TLR4）/myeloid differentiation factor 88 （MyD88）/nuclear factor kappa-B （NF-κB） signaling pathway and inflammatory factors including interleukin （IL）-1β， IL-6， and tumor necrosis factor-α （TNF-α） were detected by Real-time quantitative polymerase chain reaction （Real-time PCR）. ResultsA total of 120 chemical components were identified in BSTDP， among which 26 original components were confirmed by using serum pharmacochemical methods. A total of 227 common targets linking rheumatoid arthritis （RA） and the blood-absorbed components were screened by network pharmacology. It is suggested that pseudobrucine， vomicine， sinapine， rehmannioside， cinnamyl alcohol glycoside， and methylephedrine exert anti-inflammatory effects by acting on core targets including protein kinase B1 （Akt1）， signal transducer and activator of transcription 3 （STAT3）， tumor necrosis factor （TNF）， TLR4， mitogen-activated protein kinase 14 （MAPK14）， and phosphatidylinositol-4，5-bisphosphate 3-kinase catalytic subunit α （PIK3CA）， thereby modulating multiple signaling pathways such as TLR4 and NF-κB. In vivo verification in zebrafish demonstrates that the maximum tolerable concentration of Bushen Tongdu Formula is 2 000 mg·L^-1. Compared to those in the blank group， zebrafish in the model group showed a significantly higher number of neutrophils in the yolk sac region （P<0.01） and rising mRNA levels of TLR4， MyD88， NF-κB， TNF-α， IL-6， and IL-1β （P<0.01）. Compared to that in the model group， the number of neutrophils was significantly reduced in BSTDP groups with medium and high doses， as well as the dexamethasone acetate group （P<0.05， P<0.01）. There was no statistically significant difference in the low dose group. The mRNA expression levels of TLR4， MyD88， NF-κB， TNF-α， IL-6， and IL-1β were significantly down-regulated （P<0.05， P<0.01）. ConclusionThis paper identifies the material basis of the efficacy of BSTDP， demonstrating that the formula can exert an anti-inflammatory effect through the TLR4/MyD88/NF-κB signaling pathway. The results provide scientific experimental evidence for its further clinical application.

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.

With the accelerated global population aging and urbanization, cognitive dysfunction has become a major public health challenge. Epidemiological evidence indicates that long-term exposure to particulate matter and environmental noise are independent risk factors for cognitive decline, and recent studies suggest that their combined exposure may exert a synergistic amplifying effect. This review summarized the progress in epidemiological research on the impacts of particulate matter and noise exposure on cognitive function, specifically focusing on the synergistic effects of their combined exposure. Furthermore, it outlined common biological mechanisms such as neuroinflammation, oxidative stress, and vascular endothelial damage. However, while existing studies have preliminarily revealed the synergistic effects of combined particulate matter and noise exposure on cognitive function, the conclusions remain heterogeneous, and the investigation of underlying mechanisms is still insufficient. Future research should prioritize refined exposure assessment, long-term cohort studies, and specific high-exposure occupational scenarios, and carry out further in-depth investigations, thereby providing a basis for health risk assessment and the development of intervention strategies.

Background: Alzheimer’s disease (AD) is the most prevalent neurodegenerative disorder. Cellular drug screening represents a key approach in the preclinical discovery of AD therapeutics. Moreover, selecting an appropriate cellular model is essential for exploring the mechanisms underlying AD pathogenesis. Objective: This study aimed to establish a progressive strategy integrating cell model construction, monomer evaluation, and effective component group-based drug discovery for the development of novel therapeutics targeting AD. Methods: A novel AD12 cell line stably expressing the double-transgenic genes amyloid precursor protein (APP)695/presenilin 1(PS1)-ΔE9 was first constructed and subjected to lipopolysaccharide (LPS) stimulation. The resulting LPS-induced neuroinflammatory response was characterized using metabolomic analysis. Subsequently, 16 alkaloids derived from traditional Chinese medicine(TCM) were screened with the LPS-AD12 cell model. Molecular docking was then performed to assess the binding affinity of benzoylaconitine (BAC) with APP and PS1 proteins. A targeted metabolomics approach focusing on amino acids and the tricarboxylic acid (TCA) cycle was applied to BAC-treated LPS-AD12 cells. Finally, aconite extract was administered to five-familial-AD-mutations(5xFAD) transgenic mice, and therapeutic efficacy was evaluated through phenotypic and metabolomic analyses. Results: LPS stimulation induced neuroinflammation in AD12 cells, characterized by elevated levels of interleukin-6, amyloid-β (Aβ ), and PS1. The primary metabolic pathways affected in AD12 cells included alanine, aspartate, and glutamate metabolism, as well as arginine biosynthesis. Notably, BAC significantly reduced the levels of Aβ and interleukin-6 in LPS-AD12 cells. Furthermore, molecular docking analyses revealed a strong binding affinity of BAC with APP and PS1 proteins. Targeted metabolomics analysis indicated that the pharmacological activity of BAC was primarily associated with its anti-inflammatory effects, modulation of the cholinergic signaling pathway, and regulation of energy metabolism. Behavioral experiments in 5xFAD mice, together with immunofluorescence assessments of brain tissues (amyloid-β, glial fibrillary acidic protein, and ionized calcium-binding adapter molecule 1), demonstrated that aconite extract treatment significantly alleviated AD-related symptoms. In addition, metabolomics-based mechanistic analyses revealed that serine, acetylcholine, ornithine, and gamma-aminobutyric acid exhibited consistent trends in both brain tissue and serum samples from treated mice. Conclusion: This study established a novel AD12 cell model and an effective, reliable LPS-induced cell-based screening system. Additionally, we proposed a new drug discovery strategy integrating cell model construction, monomer evaluation, and effective component group-based drug discovery. This screening system has the potential to accelerate the identification of anti-AD agents and provides a feasible framework for subsequent in-depth investigations into new drug development from TCM, thereby contributing to the modernization of TCM-derived therapeutics.

Objective To investigate the relationship between serum T cell immunoglobulin mucin mole-cule-3(TIM-3)and netrin-1(NTN-1)levels and the risk of recurrence of B-cell acute lymphoblastic leukemia(B-ALL).Methods A total of 60 children with B-ALL were selected from January 1,2021 to January 1,2023.According to the expression of fusion gene,the children were divided into fusion gene positive group(26 ca-ses)and fusion gene negative group(34 cases).The blood routine,inflammatory factor levels,TIM-3 and its ligand galectin-9(Gal-9),NTN-1 and its downstream protein phosphorylated protein kinase B(pAKT)and protein kinase B(AKT)levels were compared between the negative fusion gene group and the positive fusion gene group at admission.The patients were followed up for 1 year and the recurrence of B-ALL was counted.The difference of serum TIM-3 and NTN-1 levels between the children with recurrence and those without re-currence was compared,and the correlation between the levels of TIM-3 and NTN-1 and recurrence was ana-lyzed.Results Compared with before treatment,the levels of TIM-3 and Gal-9 in both groups decreased after treatment,and the differences were statistically significant(P＜0.05).Compared with before treatment,the levels of TIM-3 and Gal-9 in both groups were decreased after treatment,and the differences were statistically significant(P＜0.05).The levels of NTN-1 and pAKT in fusion gene positive group were significantly higher than those in fusion gene negative group,with statistical significance(P＜0.05),but there was no statistical significance in AKT comparison(P＞0.05).In the follow-up period,there were 9 cases(34.61％)of recur-rence in the fusion gene positive group and 2 cases(5.88％)in the fusion gene negative group.The recurrence rate in the fusion gene positive group was higher than that in the fusion gene negative group,and the differ-ence was statistically significant(P＜0.05).The levels of TIM-3 and NTN-1 in recurrent children were sig-nificantly higher than those in non-recurrent children,and the difference was statistically significant(P＜0.05).Multiple Logistic regression analysis showed that TIM-3 and NTN-1 were independent risk factors af-fecting the prognosis of children(P＜0.05).Serum TIM-3 and NTN-1 levels were positively correlated with the risk of recurrence of B-ALL(r=0.445,0.437,P＜0.05).Conclusion The levels of TIM-3 and NTN-1 are different in different types of B-ALL,which can reflect the risk of recurrence of B-ALL,and it is recom-mended to pay close attention to them.

Objective To investigate the correlation between hemoglobin A1c(HbA1c)levels and excessive daytime sleepiness(EDS)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 132 T2DM patients and 40 healthy people(NC group)who were treated in the outpatient department of Nanjing Meishan Hospital from December 2020 to December 2022 were selected.General clinical data of the subjects were collected,and their Epworth sleepiness scale(ESS)scores,Pittsburgh sleep quality index(PSQI),and apnea-hypopnea index(AHI)were measured.Based on ESS scores,T2DM patients were divided into simple T2DM group(ESS score<9,n=99)and EDS group(ESS score≥9,n=33)according to ESS score.The baseline data were compared for each group.Spearman correlation analysis and multivariate logistic regression model were used to evaluate the correlation between HbA1c levels and EDS.The receiver operating characteristic(ROC)curve was used to calculate the area under the curve(AUC)to evaluate the predictive value of HbA1c levels for EDS.Results HbA1c,fasting plasma glucose,AHI index and PSQI score in EDS group were higher than those in T2DM and NC group(P<0.05).Spearman correlation analysis showed that ESS score was positively correlated with HbA1c in T2DM patients(P<0.05).Multivariate logistic regression analysis revealed that elevated HbA1c levels emerged as a significant and independent risk factor for the onset of EDS.The ROC curve indicated that the AUC of HbA1c for predicting EDS was 0.736.Conclusions There is an independent positive correlation between HbA1c levels and EDS in T2DM patients,which provides clues for early identification and treatment of EDS in clinical practice.

Objective To develop a risk management system for complications associated with peripheral venous indwelling needles and to evaluate its application effect in order to reduce the risk of related complications.Methods We designed a comprehensive risk management system for peripheral intravenous indwelling needle complications,integrating specialized evidence-based guidelines with clinical practice insights,including 5 modules:intelligent assessment and decision support,intelligent inspection reminders,educational modules,collaborative case management procedures,and a knowledge base.Patients admitted to the neurology and internal classification metabolism departments of a tertiary hospital in Jilin Province were conveniently selected as the research subjects.Patients were assigned to a control group(from May to July 2022,before the implementation of the system)and an experimental group(from September to December 2022,after the implementation of the system).The incidence of complications,duration of indwelling needle,compliance rate of core indicators for nursing quality and number of nursing consultations were compared between the groups.Additionally,a self-administered questionnaire was used to assess clinical nurses'evaluations of the system.Results A total of 189 patients were included in the experimental group and 177 patients in the control group.The incidence of complications associated with peripheral intravenous indwelling needles was lower than that in the control group.The duration of indwelling peripheral intravenous needles was longer than that in the control group.The quality compliance rate of peripheral venous indwelling needle care in the experimental group was higher than that in the control group,and the number of consultation cases in the experimental group was higher than that in the control group.Comparisons between the 2 groups showed statistically significant differences for all indicators(P＜0.05).The nurses'recognition rates for the system's user-friendliness,professional guidance,and patient benefit were 77.78％,81.74％,and 82.13％,respectively.Conclusion The application of a peripheral vein indwelling needle complication risk management system can reduce the incidence of complications,prolong the duration of indwelling,and improve nursing quality.Nurses have a high recognition of this system.

Objective:To investigate the changes of serum complement C1q/tumor necrosis factor-associated protein 3 (CTRP3) in patients with rheumatoid arthritis (RA) and its clinical significance.Methods:A total of 60 RA patients admitted to Chongming Hospital affiliated to Shanghai University of Medicine & Health Sciences (Chongming Branch of Xinhua Hospital) from January 2023 to February 2024 were collected.They were divided into a plaque group (38 cases) and a plaque free group (22 cases) according to the results of carotid intima-media thickness (cIMT) by carotid artery ultrasonography. ESR, CRP, blood lipid, HOMA-IR, RF, CCP antibody and CTRP3 levels were detected, and the relationship between CTRP3 levels and disease activity and atherosclerosis in RA patients was analyzed. The statistical analysis was carried out with independent t-test, analysis of variance, Pearson correlation analysis and logistic regression. Results:Serum CTRP3 level in RA patients was lower than that in healthy control group [(116±44)ng/ml and (184±63)ng/ml, t=-6.54, P=0.004]. The CTRP3 level in RA group with plaque was lower than that in RA group without plaque [(98±28) ng/ml and (123±38)ng/ml, t=-5.57, P=0.008]. Serum CTRP3 levels in RA patients were correlated with LDL-C ( r=-0.68, P=0.011), HOMA-IR ( r=-0.74, P=0.001), RF ( r=-0.46, P=0.042), anti-CCP antibody( r=-0.54, P=0.037), DAS28 ( r=-0.66, P=0.024) were negatively correlated with cIMT ( r=-0.76, P=0.001), and positively correlated with DMARDs duration ( r=0.51, P=0.040) and flow-mediated di latatiton ( r=0.70, P=0.004). The CTRP3 level [( OR(95% CI)=0.683(0.355, 0.807), P=0.023] was an independent correlation factor affecting cIMT. Conclusion:CTRP3 level in RA patients is significantly lower than that in healthy control group, and is negatively correlated with insulin resistance, autoantibody level and disease activity, and has a protective effect on early atherosclerosis in RA patients.

Objective:To construct a preventive maintenance path based on risk control model for medical equipment in the operating room,and analyze its application effect in the management for medical equipment in the operating room.Methods:Based on 7 key factors included equipment characteristics,usage duration,startup frequency,operating efficiency,operator skills,maintenance frequency,and technical support in risk control model,we followed management mode of preventive maintenance,and constructed a preventive maintenance path from six dimensions which included management of equipment application,preventive maintenance and upkeep,predictive maintenance,fault repair,post upkeep,and quality monitoring.A total of 215 used medical equipment in operating room at Xiaolan People's Hospital of ZhongShan from January 2022 to December 2022 were selected,and the equipment during January and December 2022 received maintenance management by using conventional management method,and these during January and December 2023 received maintenance management by using preventive maintenance path method based on risk control model for medical equipment(model management method).The quality of management and operation for equipment between two kinds of management methods were compared.A self-designed questionnaire was adopted to investigate the operators'satisfaction for service quality of equipment in operating rooms.Results:The average standardization degree of using equipment,efficiency of maintenance,timely maintenance,and qualification rate of quality inspection of adopting model management method were respectively(94.43±4.26)%,(97.74±1.53)%,(86.78±6.72)%and(96.48±3.02)%,all of which were higher than those of adopting conventional method(t=22.583,34.738,14.820,18.577,P<0.05).The average rate of starting equipment and self-repair rate of the model management method were significantly higher than those of the conventional method,and the differences were statistically significant(t=10.355,7.624,12.811,P<0.05).The satisfaction scores of operators who used management for adopting model management method were higher than those for adopting conventional management method in applying and managing equipment,preventive upkeep,predictive maintenance,fault repair,post upkeep and quality monitoring,and the differences were statistically significant(t=18.653,22.942,18.752,23.673,40.055,37.120,P<0.05).Conclusion:The preventive maintenance path based on risk control model for medical equipment in operating room can improve the management quality for equipment in operating room,and enhance management effectiveness and operators'satisfaction.