OBJECTIVES: To investigate the effect of avitinib for suppressing NLRP3 inflammasome activation and alleviating septic shock and explore the underlying mechanism. METHODS: Mouse bone marrow-derived macrophages (BMDM), human monocytic leukemia cell line THP-1, and peripheral blood mononuclear cells (PBMC) isolated from healthy volunteers were pre-treated with avitinib, followed by activation of the canonical NLRP3 inflammasome using agonists including nigericin, monosodium urate (MSU) crystals, or adenosine triphosphate (ATP). Non-canonical NLRP3 inflammasome activation was induced via intracellular transfection of lipopolysaccharide (LPS). Western blotting was used to detect the secretory protein markers of NLRP3 inflammasome activation and assess pyroptosis, and the levels of inflammatory cytokines in cell culture supernatant were determined with ELISA. In a mouse model of LPS-induced septic shock, the effect of avitinib treatment on the levels of inflammatory cytokines in serum and peritoneal lavage fluid were examined with ELISA, and survival curves of the mice were plotted using the Kaplan-Meier method. RESULTS: Avitinib significantly inhibited NLRP3 inflammasome activation in multiple cell types, and dose-dependently reduced IL-1β secretion and caspase-1 cleavage while suppressing GSDMD-mediated pyroptosis without obviously affecting IL-6 or TNF-α levels. In the mouse models of LPS-induced septic shock, avitinib significantly lowered IL-1β levels in serum and peritoneal fluid and extended survival time of the mice. CONCLUSIONS Avitinib suppresses NLRP3 inflammasome activation and alleviates septic shock in mice.
Animals ; Shock, Septic/metabolism* ; Mice ; NLR Family, Pyrin Domain-Containing 3 Protein ; Inflammasomes/drug effects* ; Humans ; Macrophages/metabolism* ; Interleukin-1beta/metabolism* ; Lipopolysaccharides

Objective:To explore the therapeutic efficacy, adverse reactions, and factors influencing recurrence of botulinum toxin type A (BTX-A) in patients with trigeminal neuralgia (TN), and to provide clinical reference for the application of BTX-A in the treatment of TN.Methods:Clinical data and pre- and post-treatment Visual Analogue Scale (VAS) scores were collected from 198 patients with TN treated with BTX-A at the First Affiliated Hospital of Zhengzhou University from June 2020 to December 2022. Correlation analysis, univariate and multivariate Logistic regression were used to analyze factors influencing treatment efficacy, adverse reactions, and recurrence in patients. The predictive value of these factors for adverse reactions and recurrence was assessed using receiver operating characteristic curves.Results:Following BTX-A treatment, there were significant correlations between the frequency of TN attacks, time to peak efficacy, duration of efficacy, and VAS scores difference before and after treatment ( B=0.141, P=0.043; B=-0.134, P=0.023; B=-0.405, P0.001), as well as percentage difference in VAS score ( B=0.015, P=0.033; B=-0.011, P=0.034; B=-0.056, P0.001). Multiple branch involvement of the trigeminal nerve was an independent risk factor for the occurrence of TN adverse reactions ( OR=2.899, 95% CI 1.280-6.566, P=0.011). The area under the curve (AUC) for multiple branch involvement of the trigeminal nerve was 0.615 (95% CI 0.600-0.732). Multiple branch involvement of the trigeminal nerve ( OR=4.103, 95% CI 1.610-9.600, P=0.002) and peak onset time ( OR=0.950, 95% CI 0.922-0.978, P=0.001) were independent risk factors for TN recurrence and the combined AUC for these two factors was 0.713 (95% CI 0.600-0.827). Conclusions:The frequency of TN episodes, time to peak efficacy and maintenance duration of efficacy after BTX-A treatment were correlated with the difference in VAS scores and the percentage of difference. And the involvement of multiple branches of the trigeminal nerve was an independent risk factor affecting the occurrence of adverse reactions and TN recurrence.

Objective:To explore the therapeutic efficacy, adverse reactions, and factors influencing recurrence of botulinum toxin type A (BTX-A) in patients with trigeminal neuralgia (TN), and to provide clinical reference for the application of BTX-A in the treatment of TN.Methods:Clinical data and pre- and post-treatment Visual Analogue Scale (VAS) scores were collected from 198 patients with TN treated with BTX-A at the First Affiliated Hospital of Zhengzhou University from June 2020 to December 2022. Correlation analysis, univariate and multivariate Logistic regression were used to analyze factors influencing treatment efficacy, adverse reactions, and recurrence in patients. The predictive value of these factors for adverse reactions and recurrence was assessed using receiver operating characteristic curves.Results:Following BTX-A treatment, there were significant correlations between the frequency of TN attacks, time to peak efficacy, duration of efficacy, and VAS scores difference before and after treatment ( B=0.141, P=0.043; B=-0.134, P=0.023; B=-0.405, P0.001), as well as percentage difference in VAS score ( B=0.015, P=0.033; B=-0.011, P=0.034; B=-0.056, P0.001). Multiple branch involvement of the trigeminal nerve was an independent risk factor for the occurrence of TN adverse reactions ( OR=2.899, 95% CI 1.280-6.566, P=0.011). The area under the curve (AUC) for multiple branch involvement of the trigeminal nerve was 0.615 (95% CI 0.600-0.732). Multiple branch involvement of the trigeminal nerve ( OR=4.103, 95% CI 1.610-9.600, P=0.002) and peak onset time ( OR=0.950, 95% CI 0.922-0.978, P=0.001) were independent risk factors for TN recurrence and the combined AUC for these two factors was 0.713 (95% CI 0.600-0.827). Conclusions:The frequency of TN episodes, time to peak efficacy and maintenance duration of efficacy after BTX-A treatment were correlated with the difference in VAS scores and the percentage of difference. And the involvement of multiple branches of the trigeminal nerve was an independent risk factor affecting the occurrence of adverse reactions and TN recurrence.

Objective Starting from the actual numbers of health personnel of tertiary public hospitals of Traditional Chinese Medicine(TCM),to quantitatively analyze the influencing factors on the allocation of human resources and obtain a prediction model.Methods The balanced panel data from 517 Tertiary Public TCM Hospitals in the period of 2011-2020 were collected,and the two-way fixed effects model was used to empirically analyze the impact of scale,demand and other factors on the actual number of health personnel in these hospitals.Result The number of beds is a key factor affecting the human resource allocation of Public TCM Hospitals,and various factors such as de-mand,policy,price,efficiency,and administrative management also have significant impacts on the allocation.The demand for outpatient services,government financial support,and efficiency of resource utilization are all promoting factors,while the increase in human resource prices,income generation efficiency,and administrative manage-ment levels have negative effects.A prediction model is proposed.Conclusion The planning principle of matching bed numbers with human resources allocation is in line with the actual environment.When predicting the total personnel allocation or authorized strength,various factors should also be fully considered,which can provide reference for the formulation of human resource policies in Public TCM Hospitals.

Objective:To investigate the preventive effect of Xiyanping injection on radioactive esophagitis in patients with radical radiotherapy and chemotherapy for esophageal cancer.Methods:A total of 70 patients with esophageal cancer undergoing radical radiotherapy and chemotherapy were selected from the Department of Radiation Oncology of Jiangsu Provincial People′s Hospital from January to September 2020. They were divided into experimental group ( n=35) and control group ( n=35) according to random number table method. The control group received standard concurrent radiotherapy and chemotherapy, and the experimental group received concurrent radiotherapy and chemotherapy combined with Xiyanping. The white blood cell count, neutrophil count, procalcitonin (PCT) and interleukin-6 (IL-6) levels before and after treatment were compared between the two groups, as well as the occurrences of radioactive esophagitis and radioactive pneumonia during radiotherapy. Results:Before treatment, there were no significant differences in white blood cell count [4.57 (2.52)×10 9/L vs. 5.59 (2.23)×10 9/L] and neutrophil count [2.95 (1.66)×10 9/L vs. 3.69 (1.56)×10 9/L] between the control group and experimental group ( Z=1.44, P=0.151; Z=1.52, P=0.130). After treatment, there were no statistically significant differences in white blood cell count [4.28 (2.50)×10 9/L vs. 4.25 (1.88)×10 9/L] and neutrophil count [2.99 (2.50)×10 9/L vs. 2.94 (1.61)×10 9/L] between the two groups ( Z=0.67, P=0.503; Z=0.69, P=0.489). There were no statistically significant differences in white blood cell count and neutrophil count between the patients after treatment and before treatment in the two groups ( Z=0.77, P=0.443; Z=1.08, P=0.279; Z =1.06, P=0.289; Z=0.68, P=0.495). Before treatment, there were no statistically significant differences in serum inflammation indexes PCT [0.02 (0.03) μg/L vs. 0.02 (0.05) μg/L] and IL-6 [0.04 (0.21) μg/L vs. 0.04 (0.12) μg/L] between the two groups ( Z=0.70, P=0.482; Z=0.77, P=0.439). After treatment, there were statistically significant differences in serum inflammation indexes PCT [0.06 (0.17) μg/L vs. 0.03 (0.08) μg/L] and IL-6 [0.10 (0.25) μg/L vs. 0.01 (0.08) μg/L] between the two groups ( Z=2.08, P=0.038; Z=2.92, P=0.003). There were no statistically significant differences in serum inflammation indexes PCT and IL-6 in the experimental groups after treatment compared with before treatment ( Z=1.20, P=0.230; Z=1.19, P=0.235). In the control group, the serum inflammation index PCT level increased after treatment compared with before treatment, with a statistically significant difference ( Z=2.82, P=0.005), and the serum inflammation index IL-6 level increased compared with before treatment, but with no statistically significant difference ( Z=1.41, P=0.158). During the treatment, the incidence of radioactive esophagitis in the two groups was mainly grade Ⅰ-Ⅱ, with 24 cases in the control group and 28 cases in the experimental group. There were 8 patients with grade Ⅲ-Ⅳ radioactive esophagitis in the control group and 1 in the experimental group. There was a statistically significant difference in the occurrence of radioactive esophagitis between the two groups ( χ2=10.34, P=0.035). During the treatment period, most patients with radioactive pneumonia were rated as grade 0. There were 10 cases of mild radioactive pneumonia (grade Ⅰ-Ⅱ) in the control group had and 6 cases in the experimental group. There were 2 cases of grade Ⅲ radioactive pneumonia in the control group and experimental group respectively. There was no grade Ⅳ radioactive pneumonia in either group. There was no significant difference in radioactive pneumonia between the two groups ( χ2=1.34, P=0.720). Conclusion:Xiyanping injection can prevent the rise of serum inflammatory index PCT and reduce the severity of radioactive esophagitis in patients with esophageal cancer after treatment.

OBJECTIVE：To optimize the extraction technology for total triterpenes from the leaves of Cornus officinalis . METHODS：Based on the full swelling of the leaves of C. officinalis ，total triterpenes was extracted with heating reflux method. The effects of ethanol concentration ，liquid-solid ratio ，extraction time and extraction times on the contents of total triterpenes from the leaves of C. officinalis were investigated by single factor test. Using oleanolic acid as control ，the contents of total triterpenes were detected by UV spectrometry. On the basis of single factor test ，fixing the times of extraction a s 3 times，taking the contents of total triterpenes as response value ，using ethanol volume fraction ，solid-liquid ratio and extraction time as factors ， Box-Behnken design-response methodology was used to optimize the extraction technology of total triterpenes from the leaves of C. officinalis，and the optimized extraction technology was validated. RESULTS ：The optimal extraction technology of total triterpenes from the leaves of C. officinalis were as follows as ethanol concentration of 73％，liquid-to-material ratio of 38 ∶ 1（mL/g）， extraction time of 60 min. Results of 3 validation tests showed that the contents of total triterpenes from the leaves of C. officinalis were 6.92％，6.91％，6.84％；the average content was 6.89％（RSD＝0.63％），relative error of which with the predicted value （7.28％）was 5.36％. CONCLUSIONS ：The optimized technology is stable and reliable ，and can be used for the extraction of total triterpenes from leaves of C. officinalis .

Objective:A multi-center and large sample volume study was conducted on the verification and improvement of the early established criteria for intelligent routine urinalysis validation (including the microscopic review rules and manual validation rules, referred to as intelligent criteria for short), in order to improve the clinical application of this intelligent criteria.Methods:A total of 31 456 urine specimens were collected from the inpatients and outpatients in six hospitals in China, from March to September 2019. Firstly, 3105 specimens were analyzed for preliminary verification and improvement of the intelligent criteria based on the results of the microscopic examination and manual validation. Secondly, 28 351 specimens were used to verify the clinical application of the improved intelligent criteria. All samples were manually validated as reference.Results:The approval inconsistency rate of the manual validation rules in the original intelligent criteria was 8.59% (202/2 352), and the interception inconsistency rate was 8.84% (208/2 352). The false negative rate and the microscopic review rate of the microscopic review rules were similar to the previous results. Based on an in-depth analysis of big data and the discussions by senior technicians from eight hospitals, one microscopic review rules and four manual validation rules were added, meanwhile two manual validation rule was deleted. The manual validation standards were unified. Finally, the intelligent criteria was improved. Based on the improved intelligent criteria, for microscopic review rules, the false positive rate, false negative rate (misdiagnosis rate), and microscopic review rate did not change significantly, which were 14.72% (457/3 105), 4.06% (126/3 105), and 24.73% (768/3 105), respectively. The approval inconsistency rate and the interception inconsistency rate of manual validation rules were both reduced to 0; the total manual validation rate of the intelligent criteria was 50.89% (1 580/3 105), and the auto-validation rate was 49.11% (1 525/3 105). The large sample volume verification results were consistent with the preliminary verification results of the improved intelligent criteria.Conclusion:This multi-center and large sample volume study had shown that the improved intelligent criteria had better clinical performance.

Objective To investigate the molecular epidemiological characteristics and homology of Staphylococcus aureus (S. aureus)isolated from patients in intensive care units (ICUs)of a hospital,so as to provide laboratory basis for the effective control of healthcare-associated infection(HAI). Methods 62 S. aureus strains isolated from various specimens from ICU patients with infection in March-August 2013 were collected,7 housekeeping genes were amplified with polymerase chain reaction (PCR),the amplified products were sequenced,ST typing of strains was performed by multilocus sequence typing (MLST ), phylogenetic analysis of ST typing was conducted. Results 62S. aureus strains were amplified specific product of 7 housekeeping genes;there were 10 ST genotypes, in which 2 ST genotypes(STn1and STn2)were first discovered,1 ST genotype(ST675)was first discovered domes-tically. ST239 was the main ST type of S. aureus from ICU patients in this hospital,accounting for 74.20% ,which distributed in 6 ICUs,ST5 distributed in 3 ICUs. 62 strains formed 7 main branches in the phylogenetic tree,55 (88.71% )MRSA strains were detected. Conclusion S. aureus isolated from hospital ICUs has some homology, and the small number of types showed the trend of concentrated distribution.

AIM To investigate the effects of frost-like powder,steaming,stir-frying with wine,stir-frying with salt-water and stir-frying with vinegar on compositions and contents of fatty oils in Descurainiae Semen.METHODS Descurainiae Semen was processed by five methods,respectively.The fatty oils were extracted from various processed products by petroleum ether,which were then derivatized.GC-MS was adopted in the qualitative identification and quantitative determination.RESULTS Except for frost-like powder,various processing methods could increase the extraction rate of fatty oils.Compared with raw product,the quantities of fatty oils in various processed products were decreased,together with the increased contents.The main compositions of obtained fatty oils were unsaturated fatty acids,whose contents in various processed products (except stir-frying with vinegar product) were higher than those in the raw product.CONCLUSION The effects of different processing methods on compositions and contents of fatty oils in Descurainiae Semen show obvious differences,among which the processing effect of stir-frying with vinegar is not satisfactory.

Subarachnoid hemorrhage ( SAH) especially aneurismal SAH is a deadly cerebrovascular disorder with very high mortality and morbidity rates, but there is still no effective treatment in clinical practice.In recent years, more and more studies have suggested that early brain injury ( EBI) may be the main factor for poor prognosis of SAH.The pathogenesis of EBI after SAH includes a series of complicated pathophysiological changes.This paper reviews the related progress of EBI after SAH from the aspects of acute cerebral ischemia, the disruption of blood brain barrier, apoptosis, autophagy, oxidative stress, inflammation, and so on.