ObjectiveThis study aims to explore the mechanism by which Yishen Huoxue Tongqiao Formula improves metabolism-neuroplasticity and treats unilateral vestibular labyrinth destruction by regulating the metabolic balance of glutamate （Glu）/γ-aminobutyric acid （GABA）. Methods48 Sprague-Dawley （SD） adult rats were randomly divided into the sham operation group， model group， Yishen Huoxue Tongqiao Formula groups with low， medium， and high doses （9.20， 18.39， 36.78 g·kg^-1）， and betahistine group （1.62 mg·kg^-1）. A unilateral vestibular labyrinth destruction （vestibular dysfunction） model was established by intratympanic injection of chloroform into the right ear， while the control group received intratympanic injection of normal saline. Drugs were administered once daily for seven consecutive days. During the period， behavioral tests were performed to evaluate the behaviors of rats after unilateral vestibular labyrinth destruction. Hematoxylin-eosin （HE） staining and Nissl staining were used to observe the neuronal morphology in the medial vestibular nucleus. Golgi staining was employed to assess the number of dendritic spines of neurons in the medial vestibular nucleus. Ultra-performance liquid chromatography-tandem mass spectrometry （LC-ESI-MS/MS） was utilized to detect Glu/GABA. Immunofluorescence and immunohistochemistry were used to detect the expressions of neuronal nuclei （NeuN）， growth-associated protein 43 （GAP-43）， and glial fibrillary acidic protein （GFAP）. Western blot and real-time fluorescent quantitative polymerase chain reaction （Real-time PCR） were applied to determine the expressions of glutamate-immunoreactive （Glu-IR）， GABA， GFAP， postsynaptic density protein 95 （PSD-95）， and GAP-43. ResultsCompared with the sham operation group， the model group presented with head deviation， balance disorder， increased tail suspension score， nuclear consolidation of medial vestibular nerve neurons， and decreased Nissl bodies （P<0.01）. The number of dendritic spines in neurons and NeuN-positive cells decreased. The content of Glu decreased. The content of GABA increased （Glu/GABA decreased）. The expression of GAP-43 was down-regulated， and GFAP was up-regulated （P<0.05， P<0.01）. The expressions of Glu-IR， PSD-95， and GAP-43 proteins， as well as Glu-IR mRNA decreased， while the expressions of GABA and GFAP proteins and mRNA increased （P<0.05， P<0.01）. Compared with those in the model group， the head deviation， imbalanced behavior， and tail suspension scores in each treatment group decreased， with alleviated neuronal injury and recovered Nissl bodies （P<0.01）. The number of dendritic spines of neurons increased， and the number of NeuN-positive cells rebounded. The content of Glu increased， and the content of GABA decreased （Glu/GABA increased）. GFAP was down-regulated， and GAP-43 was up-regulated （P<0.05， P<0.01）. The expressions of Glu-IR， PMD-95， and GAP-43 proteins， as well as Glu-IR mRNA increased， while the expressions of GABA and GFAP proteins and mRNA decreased. The effect was more significant in the high-dose group （P<0.01）. ConclusionThe Yishen Huoxue Tongqiao Formula can alleviate vestibular dysfunction， and its mechanism may be associated with regulating the metabolic balance of Glu/GABA， mitigating neural damage， improving synaptic plasticity （promoting GAP-43 expression and inhibiting GFAP expression）， and facilitating vestibular compensation.

Subacute cholecystitis complicated by gallbladder perforation often manifests as inflammatory lesions around the gallbladder， and it is extremely rare for this condition to cause massive hemorrhage into the omental bursa with secondary infection and result in massive hemorrhagic abscess. This article reports a case of a female patient， aged 68 years， who experienced massive hemorrhagic abscess in the omental bursa due to localized perforation and bleeding caused by a stone impacted in the gallbladder neck. The patient had a history of gallstones for 30 years and was admitted to Tianjin Nankai Hospital， Tianjin Medical University， after tertiary referral due to aggravated abdominal pain， chills， and fever. After comprehensive assessment by a multidisciplinary team， the patient underwent emergency laparoscopic cholecystectomy and clearance of the hemorrhagic abscess in the omental bursa. The patient recovered well and was discharged on day 10 after surgery， with good conditions during follow-up.

Objective To observe the expressions of nucleotide-binding oligomerization domain receptor 1(NOD1)and its mediated RIP2/NF-κB signaling pathway-related proteins and autophagy-related proteins in cerebral cortex of rats with cerebral ischemia-reperfusion injury(CIRI);To explore the possible mechanism of eye acupuncture alleviating CIRI.Methods SPF-grade male Wistar rats were randomly divided into blank control group(12 rats),sham-operation group(12 rats)and modeling group(36 rats).A CIRI model was established by improved suture method.The rats in the modeling group were randomly divided into the model group,eyeacupuncture group,outside the acupoint area group,with 12 rats in each group.Neurological deficits in rats were evaluated by Longa score,TTC staining was used to observe the cerebral infarction,HE staining was used to observe the morphology of ischemic brain tissue,electron microscopy was used to observe the formation of autophagosome in ischemic brain tissue,RT-qPCR was used to detect the mRNA expressions of NOD1,receptor interacting protein 2(RIP2),nuclear factor-κB(NF-κB)p65 in ischemic cerebral cortex,Western blot was used to detect the expressions of NOD1,RIP2,NF-κB p65 and autophagy related proteins in ischemic cerebral cortex.Results Compared with the sham-operation group,the neurological deficit score of rats in the model group significantly increased(P<0.01),the infarct volume significantly increased(P<0.01),the typical cribriform infarct foci and multiple autophagosomes appeared in the ischemic brain tissue,the mRNA expressions of NOD1,RIP2 and NF-κB p65 in ischemic cerebral cortex significantly increased(P<0.01),the protein expressions of NOD1,RIP2,p-NF-κB p65,Beclin1,LC3Ⅱ/LC3Ⅰ and ATG5 significantly increased(P<0.01),and the protein expression of p62 significantly decreased(P<0.01).Compared with the model group,the neurological deficit score in eye acupuncture group significantly decreased(P<0.01),the cerebral infarction volume significantly decreased(P<0.01),the area of cribriform reticular infarct and the number of autophagosomes in ischemic brain tissue significantly decreased,the mRNA expressions of NOD1,RIP2 and NF-κB p65 in ischemic cerebral cortex significantly decreased(P<0.01),the protein expressions of NOD1,RIP2,p-NF-κB p65,Beclin1,LC3Ⅱ/LC3Ⅰ and ATG5 significantly decreased(P<0.01),and the protein expression of p62 significantly increased(P<0.01).There was no statistical significance compared with outside the acupoint area group.Conclusion Eye acupuncture can attenuat the injury of neurons in CIRI rats,and its mechanism may be related to inhibiting the activation of RIP2/NF-κB signaling pathway mediated by NOD1,thereby reducing autophagy of neurons.

Acute gallstone pancreatitis (AGP) represents an acute inflammatory condition of the pancreas, of which etiology and prevention require systematic understanding from the molecular mechanisms of onset, combined with the foundations of pathological anatomy and pathophysiological processes. Main pancreatic duct obstruction and bile acid reflux are the primary causes of AGP. The duration of the obstruction is particularly crucial to its progression, and early intervention in pancreatic duct obstruction is key to preventing severe cases. The management strategy for AGP in its early stages includes endoscopic ultrasound, endoscopic retrograde cholangiopancreatography, and endoscopic sphincterotomy. The core of diagnosis and treatment involves promptly identifying the cause, relieving bile and pancreatic duct obstruction, reducing pressure in the pancreatic duct, implementing common bile duct drainage, and evaluating the effect of pancreatic duct stenting. Since gallstones are the only controllable factor, early cholecystectomy is the safest choice for preventing AGP. However, the timing and methods of etiological prevention and treatment of AGP still require further research. This article synthesizes insights into anatomical factor management, gallstone prevention, interruption of the onset process, and coordination of prevention mechanisms, aiming to provide a reference for AGP prevention and treatment.

Objective To observe the expressions of nucleotide-binding oligomerization domain receptor 1(NOD1)and its mediated RIP2/NF-κB signaling pathway-related proteins and autophagy-related proteins in cerebral cortex of rats with cerebral ischemia-reperfusion injury(CIRI);To explore the possible mechanism of eye acupuncture alleviating CIRI.Methods SPF-grade male Wistar rats were randomly divided into blank control group(12 rats),sham-operation group(12 rats)and modeling group(36 rats).A CIRI model was established by improved suture method.The rats in the modeling group were randomly divided into the model group,eyeacupuncture group,outside the acupoint area group,with 12 rats in each group.Neurological deficits in rats were evaluated by Longa score,TTC staining was used to observe the cerebral infarction,HE staining was used to observe the morphology of ischemic brain tissue,electron microscopy was used to observe the formation of autophagosome in ischemic brain tissue,RT-qPCR was used to detect the mRNA expressions of NOD1,receptor interacting protein 2(RIP2),nuclear factor-κB(NF-κB)p65 in ischemic cerebral cortex,Western blot was used to detect the expressions of NOD1,RIP2,NF-κB p65 and autophagy related proteins in ischemic cerebral cortex.Results Compared with the sham-operation group,the neurological deficit score of rats in the model group significantly increased(P<0.01),the infarct volume significantly increased(P<0.01),the typical cribriform infarct foci and multiple autophagosomes appeared in the ischemic brain tissue,the mRNA expressions of NOD1,RIP2 and NF-κB p65 in ischemic cerebral cortex significantly increased(P<0.01),the protein expressions of NOD1,RIP2,p-NF-κB p65,Beclin1,LC3Ⅱ/LC3Ⅰ and ATG5 significantly increased(P<0.01),and the protein expression of p62 significantly decreased(P<0.01).Compared with the model group,the neurological deficit score in eye acupuncture group significantly decreased(P<0.01),the cerebral infarction volume significantly decreased(P<0.01),the area of cribriform reticular infarct and the number of autophagosomes in ischemic brain tissue significantly decreased,the mRNA expressions of NOD1,RIP2 and NF-κB p65 in ischemic cerebral cortex significantly decreased(P<0.01),the protein expressions of NOD1,RIP2,p-NF-κB p65,Beclin1,LC3Ⅱ/LC3Ⅰ and ATG5 significantly decreased(P<0.01),and the protein expression of p62 significantly increased(P<0.01).There was no statistical significance compared with outside the acupoint area group.Conclusion Eye acupuncture can attenuat the injury of neurons in CIRI rats,and its mechanism may be related to inhibiting the activation of RIP2/NF-κB signaling pathway mediated by NOD1,thereby reducing autophagy of neurons.

Acute gallstone pancreatitis (AGP) represents an acute inflammatory condition of the pancreas, of which etiology and prevention require systematic understanding from the molecular mechanisms of onset, combined with the foundations of pathological anatomy and pathophysiological processes. Main pancreatic duct obstruction and bile acid reflux are the primary causes of AGP. The duration of the obstruction is particularly crucial to its progression, and early intervention in pancreatic duct obstruction is key to preventing severe cases. The management strategy for AGP in its early stages includes endoscopic ultrasound, endoscopic retrograde cholangiopancreatography, and endoscopic sphincterotomy. The core of diagnosis and treatment involves promptly identifying the cause, relieving bile and pancreatic duct obstruction, reducing pressure in the pancreatic duct, implementing common bile duct drainage, and evaluating the effect of pancreatic duct stenting. Since gallstones are the only controllable factor, early cholecystectomy is the safest choice for preventing AGP. However, the timing and methods of etiological prevention and treatment of AGP still require further research. This article synthesizes insights into anatomical factor management, gallstone prevention, interruption of the onset process, and coordination of prevention mechanisms, aiming to provide a reference for AGP prevention and treatment.

Objective:To investigate the effect and mechanism of Grifola frondosa extract on inflammatory response of colon tissue in rats with ulcerative colitis(UC)by regulating interleukin-6(IL-6)/Janus kinase 2(JAK2)/signal transducer and activator of transcription 3(STAT3)signaling pathway.Methods:Forty SD rats were randomly divided into blank control group,UC model group,Grifola frondosa treatment group,western medicine treatment group and combined treatment group,with 8 rats in each group.After UC rats were established by free drinking 3%DSS for 7 days,the treatment group were given Grifola frondosa extract 10 mg/(kg·d),sulfasalazine 0.3 g/(kg·d),and the same amount of two drugs,for 14 consecutive days.During the experiment,general state of rats were observed,and the disease activity index(DAI)score was calculated;pathological changes of rats colon tissue were observed by HE staining;protein expression levels of IL-6,JAK2,STAT3 and p-STAT3 in rats colon tissue were detected by Western blot;content of IL-6 in rats serum was detected by ELISA;protein contents and expressions of IL-6R and MPO in rats colon tissue were determined by immunohistochemistry.Results:Compared with blank control group,general state of rats in UC model group was poor,DAI score was increased,obvious tissue mucosal defects and inflammatory cell infiltration were observed by HE staining;protein expression levels of IL-6,JAK2,STAT3 and p-STAT3 in rats colon tissue and contents of IL-6R and MPO were significantly increased(P<0.01);content of IL-6 in rats serum was significantly increased(P<0.01),the difference was statistically significant.Compared with UC model group,general condition of rats in each treatment group was improved,DAI score was decreased,HE staining showed that mucosal defects were improved to varying degrees,and occasionally inflammatory cell infiltration was observed;protein expression levels of IL-6,JAK2,STAT3 and p-STAT3 in colon tissue were significantly decreased(P<0.01),contents of IL-6R and MPO in colon tissue and content of IL-6 in serum were significantly decreased(P<0.01 or P<0.05),the differences were statistically significant.Conclusion:Grifola frondosa extract can reduce the inflammatory response in colon tissue of UC rats by regulating expressions of IL-6/JAK2/STAT3 signaling pathway related factors.

Acute gallstone pancreatitis (AGP) is a kind of acute pancreatitis caused by gallstones. The etiology of AGP is complex, and the anatomic basis and initiating factors have a synergistic effect on its pathogenesis, which needs to be studied jointly. The way of the confluence of pancreaticobiliary ducts, dilated main pancreatic duct, the relatively narrow opening of duodenal papilla and small stones or microlithiasis may be involved in the pathogenesis of AGP, in which small stones are the most important. Etiological diagnosis and clinical treatment of AGP should be carried out simultaneously. The timely selection of treatment methods for different causes can alleviate the patient's condition to the greatest extent and reduce the cost of treatment. At present, it is difficult to unify the prediction indexes of AGP. Meanwhile, the pathogenesis and related prophylaxis and treatment also need to be studied. In this paper, the anatomic basis, initiation factors, pathogenesis and self-defense of AGP were analyzed to provide a new perspective for its treatment.

Objective:To explore the value of amide proton transfer-weighted (APTw) imaging and intravoxel incoherent motion (IVIM) imaging for diagnosing and evaluating the pathological differentiation of cervix squamous cell carcinoma (CSCC).Methods:This study was a diagnostic trial. Totally 56 patients pathologically diagnosed with CSCC at the First Hospital of Lanzhou University from October 2021 to October 2022 were retrospectively collected, as the CSCC group. And 36 female healthy volunteers who underwent physical examinations at the First Hospital of Lanzhou University from October 2021 to October 2023 were recruited as the control group. CSCC patients were divided into well-moderately differentiated ( n=34) and poorly differentiated groups ( n=22). The region of interest was placed in the lesions of CSCC group and normal cervical stroma of control group, and the quantitative parameters for asymmetric magnetization transfer ratio (MTR asym) of APTw imaging and pure diffusion coefficient (D), false diffusion coefficient (D *) and perfusion fraction (f) for IVIM were obtained. The independent sample t test was used to compare the differences in quantitative parameters between the two groups, the logistic regression model was used to establish combined parameters for the quantitative parameters with statistical significance between the two groups. The receiver operator characteristic curve was used to evaluate the diagnostic efficacy of single quantitative parameters and combined parameters to distinguish the CSCC group from the control group, and the well-moderately differentiated group from the poorly differentiated group in CSCC patients. The area under the curve (AUC) was compared using the DeLong test. Results:There were significant differences in MTR asym, D and f between CSCC group and control group ( t=-9.79, 10.09, 11.35, P<0.001). Also, significant differences were found for MTR asym and D between the well-moderately differentiated and poorly differentiated group ( t=4.11, -3.76, P<0.001). There was no significant difference in other quantitative parameters ( P>0.05). When comparing the CSCC group and control group, the AUC (95% CI) of MTR asym, D, f and combined parameter (MTR asym+D+f) were 0.887 (0.804-0.944), 0.940 (0.871-0.979), 0.968 (0.909-0.993), 0.995 (0.950-1.000). The AUC of the combined parameter was higher than those of MTR asym and D, with statistical significance ( Z=3.07, 2.06, P=0.002, 0.040). When comparing the well-moderately differentiated and poorly differentiated group, the AUC (95% CI) of MTR asym, D, and combined parameter (MTR asym+D) were 0.789 (0.660-0.887), 0.775 (0.644-0.876), 0.852 (0.731-0.932). There was no significant difference between each two AUCs ( P>0.05). Conclusion:The quantitative parameters of APTw and IVIM imaging can be used to diagnose and preliminarily evaluate the pathological differentiation of CSCC. Joint parameters can improve the diagnostic efficiency of CSCC.

ObjectiveTo determine the mechanism of Yitangkang in correcting excessive apoptosis of skeletal muscle cells to improve insulin resistance （IR） by inhibiting the advanced glycation end product （AGE）/receptor for the advanced glycation end product （RAGE） signaling pathway. Method① In vitro experiments. Yitangkang-medicated serum was prepared. C2C12 cells were divided into a blank group， a model group， high-， medium-， and low-dose Yitangkang-medicated serum groups （40， 20， and 10 g·kg^-1）， and a RAGE inhibitor group. The IR model was induced by palmitic acid in C2C12 cells except for those in the blank group. After the corresponding intervention methods were conducted，the cell viability and glucose consumption level of each group were determined. In addition，the apoptosis rate was determined using flow cytometry. The mRNA and protein expression levels of the important apoptotic proteins ［B-cell lymphoma 2 （Bcl-2）， Bcl-2-associated X protein （Bax）， p53， cysteinyl aspartate-specific protease-3 （Caspase-3）， and cysteinyl aspartate-specific protease-9 （Caspase-9）］ were determined using Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot. ② In vivo experiments. Ninety-six eligible Wistar rats were divided into a blank group， a model group， high-，medium-，and low-dose Yitangkang groups （40， 20， and 10 g·kg^-1）， and a western medicine group （pioglitazone hydrochloride，1.35 mg·kg^-1）. The IR model was induced using high-glucose and high-fat feed for diabetes combined with intraperitoneal injection of low-dose streptozotocin （STZ） in animals and verified by the hyperinsulinemic-euglycemic clamp （HEC） test. After the model was determined successfully， the rats in each group were given intragastric administration of drugs as required. Terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL） assay was performed to determine the number of positive apoptotic cells in the skeletal muscle tissues of rats in each group，while Real-time polymerase chain reaction（Real-time PCR） and Western blot were performed to determine the mRNA and protein expression levels of the important apoptotic proteins Bcl-2， Bax， p53， Caspase-3， and Caspase-9. Result① In vitro experiments. compared with the blank group， the model groups showed increased apoptosis rate of C2C12 cells and decreased cell viability and glucose consumption （P<0.01）. Compared with the model group， the Yitangkang-medicated serum groups and the RAGE inhibitor group showed decreased apoptosis rate of C2C12 cells and increased cell viability and glucose consumption （P<0.01）. Compared with the blank group， the model group showed decreased expression levels of Bcl-2 mRNA and protein in C2C12 cells and increased mRNA and protein expression levels of Bax， p53， Caspase-3， and Caspase-9 （P<0.01）. Compared with the model group， the Yitangkang-medicated serum groups and the RAGE inhibitor group showed increased expression levels of Bcl-2 mRNA and protein in C2C12 cells （P<0.01） and decreased mRNA and protein expression levels of Bax， p53， Caspase-3， and Caspase-9 （P<0.05， P<0.01）. ② In vivo experiments. The number of positive apoptotic cells in the skeletal muscle tissues of rats in the model group significantly increased as compared with that in the blank group （P<0.01）. The number of positive apoptotic cells in the skeletal muscle tissues of rats in the Yitangkang groups and the western medicine group decreased as compared with that in the model group （P<0.01）. Compared with the blank group， the model group showed decreased expression levels of Bcl-2 mRNA and protein in skeletal muscle tissues of rats and increased mRNA and protein expression levels of Bax， p53， Caspase-3， and Caspase-9 （P<0.01）. Compared with the model group， the Yitangkang groups and the western medicine group showed increased expression levels of Bcl-2 mRNA and protein in skeletal muscle tissues of rats （P<0.01） and decreased mRNA and protein expression levels of Bax， p53， Caspase-3， and Caspase-9 （P<0.05， P<0.01）. The medium-dose Yitangkang showed a similar effect as RAGE inhibitor， and the effect was equivalent to that of pioglitazone hydrochloride. ConclusionYitangkang can inhibit skeletal muscle cell apoptosis by inhibiting the AGE/RAGE signaling pathway.