OBJECTIVE To investigate the mechanism of Xihuang pill （XHP） against diffuse large B-cell lymphoma （DLBCL）. METHODS The active ingredients of XHP and potential therapeutic targets for DLBCL were identified using TCMSP， GeneCards and DisGeNET databases. Protein-protein interaction networks were constructed using the String database and Cytoscape software to screen core components and core targets. Gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses were then performed. The clinical relevance of core targets was analyzed using the GEPIA and PanCanSurvPlot databases. Molecular docking and molecular dynamics （MD） simulation were conducted to verify the interactions between core components and core targets， and the binding free energy was calculated using the molecular mechanics Poisson-Boltzmann surface area （MM-PBSA） method. The effects of XHP on DLBCL and the related molecular mechanisms were validated using CCK-8 assay， flow cytometry and Western blot. RESULTS Network pharmacology analysis identified 108 active ingredients of XHP and 410 potential therapeutic targets for DLBCL. Six core components （e.g.， 17 beta-estradiol， quercetin） and ten core targets [e.g.， tumor protein 53 （TP53）， proto-oncogene tyrosine-protein kinase Src （SRC）] were obtained. Enrichment analysis indicated that the anti-DLBCL effects of XHP were primarily associated with the apoptotic signaling pathway， the phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway and so on. Clinical correlation analysis revealed that TP53 and SRC expression were significantly up-regulated in DLBCL tissues and associated with poor patient prognosis （P＜0.05）. Molecular docking， MD simulations and MM-PBSA calculations confirmed that the SRC-quercetin complex had a mail：stronger and more stable binding affinity. In vitro experiments demonstrated that XHP concentration-dependently inhibited the proliferation of DLBCL cells； compared with control group， XHP medium- and high-dose groups could significantly induce the apoptosis of SU-DHL2 and SU-DHL4 cells， and significantly down- regulated the expressions of SRC protein， phosphorylated （p）-PI3K/PI3K and p-Akt/Akt in SU-DHL4 cells （P＜0.05）. CONCLUSIONS XHP may inhibit the proliferation and induce the apoptosis of DLBCL cells by regulating the SRC/PI3K/Akt signaling pathway.

This paper summarizes the experience of professor LIU Shangyi in differentiating and treating rectal carcinoma from the perspective of "treating ulcers as tumors". It is believed that the manifestations of rectal cancer， such as anal itching， cauliflower-like or ulcerative tumors， and bloody stools， are similar to external skin itching， skin ulceration， swelling， and skin bleeding. Therefore， the treatment principles of sores and ulcers department can be applied to treat tumors. Following the diagnostic and treatment approach of dermatology regarding the clinical typical symptoms， for anal itching， the main treatment is to dispel wind and remove dampness， clear heat to relieve itching， using "skin medicinals" such as Difuzi （Fructus Kochiae） and Baixianpi （Cortex Dictamni）， as well as wind medicinals such as Shengma （Rhizoma Cimicifugae） and Fangfeng （Radix Saposhnikoviae）. For constipation， the method of clearing heat and resolving toxins， unblocking the bowels and discharging heat can be used， commonly using Baitouweng （Radix Pulsatillae）， Donglingcao （Herba Rabdosiae Rubescentis） and Dahuang （Radix et Rhizoma Rhei）. In terms of mucosal ulcers， it is critical to differentiate between yin and yang； the treatment of yang ulcers should focus on clearing heat and resolving toxins， commonly using modified Xianfang Huoming Beverage （仙方活命饮）； for yin ulcers， emphasis should be placed on removing dampness and resolving phlegm， commonly with modified Yiyi Fuzi Baijiang Powder （薏苡附子败酱散）. For bloody stool， differentiation is made between deficiency and excess， with the use of Diyu （Radix Sanguisorbae） and Huaihua （Flos Sophorae） for excess syndrome to cool and stop blee-ding， and both herbs dry-fried until charred combined with liver-tonifying medicinals for deficiency syndrome

Diabetic nephropathy （DN） is one of the most common and severe microvascular complications of diabetes， with a complex pathogenesis involving immune inflammatory responses， oxidative stress， apoptosis， glomerulosclerosis， renal interstitial fibrosis， and other pathological processes. In recent years， numerous animal or cell model experiments have revealed that the transforming growth factor-β （TGF-β）/mothers against decapentaplegic homolog （Smad）， phosphoinositide 3-kinase （PI3K）/ protein kinase B （Akt）/mammalian target of rapamycin （mTOR）， mitogen-activated protein kinase （MAPK）， AMP-activated protein kinase （AMPK）， nuclear factor-κB （NF-κB）， Janus kinase （JAK）/signal transducer and activator of transcription （STAT）， neurogenic locus notch homolog protein （Notch）， nuclear factor E₂-related factor 2 （Nrf2）， secretory glycoprotein （Wnt）/β-catenin， and other classical signaling pathways play important roles in the occurrence and development of DN. Traditional Chinese medicines， as natural drugs， possess characteristics such as multiple components， multiple targets， and few adverse reactions， demonstrating unique advantages in regulating the aforementioned signaling pathways and improving renal pathological changes. This review summarized recent research progress on the intervention of DN through the regulation of the aforementioned signaling pathways by single compounds and formulas of traditional Chinese medicine， focusing on their mechanisms of action in regulating immune inflammatory responses， inhibiting renal fibrosis， oxidative stress， improving metabolic disorders， and other aspects. The aim is to provide theoretical references for a deeper understanding of the modern pharmacological basis and clinical application of traditional Chinese medicine in the treatment of DN.

ObjectiveTo investigate the effect of video-based educational intervention combined with maternal presence on perioperative adverse outcomes in preschool children undergoing general anesthesia， including cooperation in anesthesia induction， perioperative anxiety， pain and agitation during recovery. MethodsA total of 300 preschool children scheduled for general anesthesia in our hospital from June to December 2023 were randomly assigned to control group （n=150） and intervention group （n=150）. The control group received routine recovery care. For the intervention group， in addition to routine recovery care， a preoperative visit was scheduled one day before surgery. During this visit， mothers were guided to watch anesthesia videos with their children. During the waiting period in the operating room and 30 minutes after awakening， the mothers were guided to accompany the children for more than 30 minutes. Recovery conditions were recorded using the surgical anesthesia information system， and the children’s anesthetic induction compliance， perioperative anxiety， pain， and agitation were evaluated and recorded using the modified Yale Preoperative Anxiety Scale （m-YPAS）， the Induction Compliance Scale （ICC）， the Children’s Pain Behavior Scale （FLACC）， and the Pediatric Agitation and Emergence Delirium Scale （PAED）. ResultsOn the preoperative visit day， there were no statistically significant differences in baseline data between the two groups （P > 0.05）. For perioperative anxiety， the m-YPAS scores of the intervention group were significantly lower than those of the control group， both when entering the operating room waiting area （35.27±6.48 vs. 41.79±6.68， P < 0.05） and 30 minutes after postoperative recovery （20.13±7.05 vs. 35.75±9.51， P < 0.05）. In terms of anesthesia induction cooperation， the ICC scores of the intervention group were significantly lower than those of the control group （1.84±0.95 vs. 3.17±0.62， P < 0.05）， and the proportion of good induction cooperation was significantly higher than that of the control group （24.00% vs. 12.67%， P < 0.05）. There was no significant difference in awakening duration between the two groups， but the intervention group had a significantly shorter length of stay in the post-anesthesia care unit than the control group （0.90±0.29 hours vs. 1.29±0.42 hours， P < 0.001）. For perioperative agitation， the PAED scores of the intervention group were significantly lower than those of the control group （entering in the operating room waiting area： 8.5 vs. 9.2， P < 0.05； 30 minutes after postoperative recovery： 4.2 vs. 7.8， P < 0.05）. In terms of pain scores， the FLACC scores of the intervention group were also significantly lower than those of the control group， both when entering the operating room waiting area （ 5.3 vs. 6.7， P < 0.05； 30 minutes after postoperative recovery： 2.1 vs. 4.9， P < 0.05）. ConclusionsVideo-based educational intervention combined with maternal presence reduces the perioperative anxiety， pain and agitation of preschool children undergoing general anesthesia， and improved the compliance of anesthesia induction. It is recommended to promote this intervention measure in clinical practice.

Renal fibrosis （RF）， characterized by glomerulosclerosis and tubulointerstitial fibrosis， is a central pathological process in chronic kidney disease （CKD）. The nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 （NLRP3） inflammasome is closely linked to the occurrence and progression of RF. This review systematically elucidates the mechanisms of the NLRP3 inflammasome in RF， and summarizes the current research on the inhibition of NLRP3 inflammasome activation by single Chinese herbs， active components of traditional Chinese medicine， Chinese herbal compounds， and Chinese patent medicines for the prevention and treatment of RF. The existing studies have demonstrated that single Chinese herbs （Campanumoea lancifolia， Dioscorea zingiberensis）， active components of traditional Chinese medicine （morroniside， liquiritigenin， rosmarinic acid， magnoflorine， fucoidan， etc.）， Chinese herbal compounds （Bushen huoxue formula， Tongluo yishen decoction， Shizhi formula， Bixie fenqing drink）， and Chinese patent medicine （Suyin jiedu granule） can inhibit the activation of the NLRP3 inflammasome to counteract inflammatory damage. This affects multiple pathways（NLRP3/caspase-1/ gasdermin D， NLRP3/interleukin-1β/Smad， etc.） and related upstream and downstream targets of its activation， effectively reducing pyroptosis， mitigating oxidative stress， promoting mitochondrial autophagy， inhibiting fibroblast activation， and reducing excessive extracellular matrix deposition， thereby exerting anti-RF effects.

BACKGROUND:Kinesio taping has been widely used as a means of sports protection,but its role as a means to correct abnormal biomechanical changes of the lower limbs during side-step cutting remains unclear. OBJECTIVE:To analyze and compare the changes in lower limb kinematics and dynamics when the subjects complete the side-step cutting of the knee joint under the conditions of kinesio taping,placebo taping and blank control. METHODS:Thirty-nine male college students majoring in basketball were recruited as subjects.Each subject was tested with kinesio taping,placebo taping or no taping.The mechanical correction method was used to patch the dominant knee joint of each subject.The run-up speed of 4.5-5.5 m/s was selected to complete the 45° side-step cutting motion,and the kinematics and kinetics data were collected synchronously by the three-dimensional dynamic capture system and the force measuring platform.The kinematics and kinetics parameters at the moment of initial touchdown and peak ground reaction force were selected for data analysis.SPSS 27.0 software was used for statistical analysis of the test data. RESULTS AND CONCLUSION:Kinematic indexes:compared with no taping and placebo taping,the hip abduction and knee valgus angles at the initial touchdown moment were significantly decreased when kinesio taping was used(P<0.05);at the moment of peak lateral ground reaction force,the angles of hip abduction,knee valgus and ankle plantar flexion decreased significantly(P<0.05),and the knee flexion angle was significantly increased(P<0.05).Kinetic indexes:Compared with no taping,both kinesio taping and placebo taping significantly reduced hip abduction and external rotation torque,knee valgus and external rotation torque at the moment of initial touchdown(P<0.05),and significantly reduced peak vertical ground reaction force and peak horizontal backward ground reaction force(P<0.05);in addition,kinesio taping significantly reduced peak lateral ground reaction force compared with no taping and placebo taping(P<0.05).These results indicate that kinesio taping of the knee joint may improve some kinematic and kinetic indexes associated with lower limb injury risk factors during the completion of the side-step cutting in basketball specialized college students to some extent,and may have a positive effect on the prevention of injury during the side-step cutting.In addition,the trends in the effects of placebo taping and kinesio taping on the knee joint are more consistent in terms of changes in some indexes,suggesting that there may be a placebo effect on the mechanism of action of kinesio taping.

Background Acute cadmium (Cd) exposure can cause damage to multiple tissues, with the kidney being the primary target organ. The development of Cd-induced acute kidney injury involves complex mechanisms, in which autophagy and oxidative stress play crucial roles. Objective To investigate the effect of 10-hydroxy-2-decenoic acid (10-HDA) on kidney injury in mice exposed to cadmium, and provide experimental basis for studying the pathogenesis and prevention of Cd poisoning. Methods Thirty-five male C57BL/6 mice were divided into 7 groups (each of 5 mice): control group (normal saline, intraperitoneal injection), CdCl₂ group (4 mg·kg⁻¹, intraperitoneal injection), intervention groups ( 4 mg·kg⁻¹ CdCl₂, intraperitoneal Injection + 50, 100, 150, or 200 mg·kg⁻¹ 10-HDA, oral gavage), and 10-HDA group (150 mg·kg⁻¹, oral gavage). All treatments were given for 14 d. Twenty-four hours after the last infection, physiological indicators [blood urea nitrogen (BUN), creatinine (CRE), malondialdehyde (MDA), and superoxide dismutase (SOD)], histopathological indicators, autophagy-related proteins (Atg7, Atg5, Beclin-1, and LC3), and mitochondrial autophagy-related proteins (PINK1 and Parkin) were detected to examine the effect of 10-HDA on kidney injury caused by CdCl₂. Results Compared with the control group, the body weight of mice in the CdCl₂ group was significantly reduced (P<0.01); compared with the CdCl₂ group, the body weight of mice after intervention with different concentrations of 10-HDA was significantly increased (P<0.01). CdCl₂ significantly increased BUN and CRE in the serum samples compared with the control group (P<0.01), which was significantly reduced to varying degrees after 100, 150, and 200 mg·kg⁻¹ 10-HDA intervention (P<0.01). MDA significantly increased and SOD significantly decreased in the renal cortex following CdCl₂ administration compared with the control group (P<0.01), which was resolved following 10-HDA administration at different concentrations (P<0.01). In histopathological studies, 10-HDA restored injured kidney tissues induced by CdCl₂. The expression levels of autophagy proteins Atg7 and LC3-II/I were significantly increased (P<0.05), and the expression level of Beclin-1 was significantly decreased (P<0.05) in the CdCl₂ group compared with the control group. The expression levels of Atg7 were reduced to varying degrees after treatment with designed concentrations of 10-HDA, the expression levels of LC3-II/I were also reduced in the 50, 150, and 200 mg·kg⁻¹ 10-HDA intervention groups, and the expression levels of Beclin-1 were increased in the 50, 100, and 150 mg·kg⁻¹ 10-HDA intervention groups (P<0.05). The expression levels of PINK1 and Parkin in the CdCl₂ group and the 50 mg·kg⁻¹ 10-HDA intervention group were lower than those in the control group (P<0.01). Compared with the CdCl₂ group, the expression levels of PINK1 increased to varying degrees after 100, 150, and 200 mg·kg⁻¹ 10-HDA intervention, and the expression levels of Parkin increased in all 10-HDA intervention groups (P<0.01). Conclusion The intervention using 10-HDA can lessen acute kidney injury caused by CdCl₂, reduce the expression of autophagy-related proteins, and increase the expression of mitochondrial autophagy-related proteins.

Objective:To investigate and analyze case reporting ethical review and patient informed consent reports published in the comprehensive journals of clinical medicine in China in 2022.Methods:According to the data from the 2022 Edition of the Chinese Science and Technology Journal of the Citation Reports(Extended Version),the case reports published in comprehensive journals of clinical medicine in 2022 were selected as the research objects.The information on ethics and patient informed consent was extracted from the case reports that met the selection criteria,and Microsoft Excel 2021 and SPSS 21.0 were used to sort out and analyze the data.Results:A total of 587 case reporting articles were published in the 42 included journals in 2022,of which 36(6.13%)reported on science and technology ethics and/or informed consent.Case reports reporting on science and technology ethics and/or informed consent mostly came from the key magazine of China technology(88.89%Vs.65.88%),and the proportion of manuscripts involving science and technology ethics on the official website of the journal was relatively high(86.11%Vs.63.88%),and the difference was statistically significant(P＜0.01).Conclusion:The proportion of case reports of science and technology ethics and/or informed consent in journals of comprehensive discipline classification of clinical medicine was relatively low.Currently,most international journals are required to obtain the informed consent of patients or legal guardians before publishing case reports.Compared with this,there are still certain gaps in China,which need to be paid great attention to.

[Objective]To investigate the effect of ivabradine,an inhibitor of peripheral HCN channel,on remifentanil-induced hyperalgesia in mice.[Methods]The model of remifentanil-induced hyperalgesia was established by intravenously infusing remifentanil 2 μg/(kg·min)for 1 h through tail vein of adult male C57/BL6 mice.To observe the effect of ivabradine on remifentanil induced hyperalgesia,ivabradine(5 mg/kg)was injected subcutaneously 30 minutes before remifentanil infusion.Forty mice were equally and randomly divided into 4 groups:saline group,remifentanil group,remifentanil+vehicle group and remifentanil+ivabradine group.In each group,six mice were used to test mechanical and thermal pain thresholds at 24 h before(baseline)and on 1 d,3 d,5 d after remifentanil or saline infusion.Four mice of each group were used to detected c-Fos positive cell in spinal dorsal horn by immunofluorescence on 1 d after remifentanil or saline infusion.[Results]Compared with the saline group,a significant decrease in mechanical or thermal threshold was observed on 1 d and 3 d after remifentanil infusion(P<0.001),and the number of c-Fos positive neurons in the lumbar dorsal horn increased significantly(P<0.001).Compared with vehicle group,subcutaneous injection of ivabradine effectively inhibited remifentanil induced hyperalgesia(P<0.001)and blocked the increase of c-Fos positive neurons in the lumbar dorsal horn on 1 d following remifentanil treatment(P<0.001).[Conclusions]Ivabradine could effectively prevent remifentanil-induced hyperalgesia in mice.The possible mechanism underlying this effect is that ivabradine suppresses the enhanced peripheral nociceptive input onto spinal cord neurons.

For Perihilar cholangiocarcinoma (pCCA), surgical resection is the only effective way to cure this disease. However, it has high postoperative mortality and high recurrence rate. Domestic and foreign scholars have constructed statistics-based evaluation methods to predict patients′ postoperative survival and complications, such as nomogram, scoring system and other prognostic models. Based on these methods, clinicians can better select patients who can benefit from surgery and choose the optimal? treatment for more severe patients. Through the adoption of other treatments or some ways to ameliorate some preoperative condition, to improve the patient′s mortality and survival. This article reviews the prognostic risk factors and prognostic models of pCCA in order to provide a reference for clinicians to predict the prognosis about the surgery.