Objective To establish quality evaluation method of Andrographis paniculata standard decoction by UPLC. Methods 21 batches of Andrographis paniculata standard decoctions were prepared according to the standardization method of TCM decoction pieces. The UPLC characteristic chromatograms analysis method was established. With andrographolide as a reference, quantitative analysis of multi-components by single marker （QAMS） was established for new neoandrographolide, 14 deoxyandrographolide and dehydrated andrographolide. The results were compared with the external standard method （ESM） to determine the accuracy of the method. Results Similarity Evaluation System for Chromatographic Fingerprint of TCM （2012 edition） was used to analyze and compare the characteristic chromatograms, and seven common peaks were determined and five were identified including luteolin-7-O-β-D-glucuronide, andrographolide, neoandrographolide, 14-deoxyandrographolide and dehydroandrographolide. The RSDs of content results of each component by QAMS and ESM were all within 3%. Conclusion The determination method was reliable and accurate, which could be used to reflect the intrinsic quality of Andrographis paniculata standard decoction comprehensively and provide the basis for the quality evaluation of Andrographis paniculata formula granules and other preparations.

Objective To analyze clinical efficacy of pentoxifylline combined with edaravone-dextrocamphenol in the treatment of acute cerebral infarction.Methods From June 2021 to January 2023,120 patients with acute cerebral infarction admitted to our hospital were collected as the research subjects.Patients were grouped into the combination group(n=60)and the single-agent group(n=60)using a random number table method.The single-agent group received intravenous infusion of edaravone-dextrocamphenol(15 mL edaravone-dextrocamphenol was injected within 0.5 h,twice a day),while the combination group received intravenous infusion of pentoxifylline based on single-agent group(0.1 g pentoxifylline was injected within 2 to 3 hours,with a maximum rate of less than 100 mg/h,twice/day).Changes of nerve function,hemodynamics and inflammatory factors before and after treatment were compared between the two groups.Results The total effective rate was significantly higher in the combination group than that of the single-agent group(95.0%vs.81.7%,P＜0.05).Compared with before treatment,the National Institutes of Health Stroke Scale(NIHSS)score,modified Rankin Scale(MRS)score,resistance index(RI),tumor necrosis factor-alpha(TNF-a)and interleukin-6(IL-6)were significantly decreased after treatment in both groups(P＜0.05),and the combined group was more lower(P＜0.05).Basel index,peak systolic flow velocity(Vs),peak diastolic flow velocity(Vd)and average blood flow velocity(Vm)were significantly increased in both groups(P＜0.05),and more higher in the combined group(P＜0.05).No apparent toxic reaction happened during treatment in both groups.Conclusion The combination of pentoxifylline and edaravone-dextrocamphenol has better therapeutic effect on acute cerebral infarction,which can optimize the neurological function and hemodynamics.

Objective To investigate the mechanism by which fatty acid-binding protein 4(Fabp4)regulates neuroinflamma-tion after traumatic brain injury(TBI).Methods Adult wild-type C57 male mice were randomly divided into sham group and TBI group,with 6 mice in each group.Fabp4 knockout(Fabp4-/-)male mice were randomly divided into sham group and TBI group,with 6 mice in each group.Western blot was used to detect the expression levels of Fabp4,IL-1β,TNF-α,NLRP3,Caspase-1,and ASC proteins in brain tissue from each group.Brain water content was assessed using the wet-to-dry weight method,and neuronal damage was evaluated by Nissl staining.Immunofluorescence double staining was performed to detect the expression of microglial M1 polarization markers(CD86 and iNOS),M2 polarization marker(CD206),and astrocytic polarization marker(C3).Enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of pro-inflammatory factors IL-1βand TNF-α in the culture supernatant of BV2 cells.MitoSOX red fluorescence staining was used to assess mitochondrial ROS levels in BV2 cells,and ELISA was employed to determine the levels of malondialdehyde(MDA)and 8-hydroxy-2'-deox-yguanosine(8-OHdG)in brain tissue after TBI.Immunofluorescence was performed to detect NLRP3 protein expression in BV2 cells.Results In wild-type mice,the expression of Fabp4 protein in the injured brain region was significantly increased at 12 hours post-TBI compared to the sham group(P＜0.01)and peaked at 3 days post-injury(P＜0.01).Compared to the wild-type TBI group,protein expression levels of IL-1β and TNF-α were reduced(P＜0.01),and brain water content was decreased(P＜0.05)in Fabp4-/-mice from TBI group.Nissl staining revealed that the volume of brain damage following TBI was reduced af-ter Fabp4 deletion(P＜0.05).Immunofluorescence experiments showed that M1 polarization of microglia was inhibited after Fabp4 deletion(P＜0.01),and M2 polarization was promoted(P＜0.01).Fabp4 deletion had no significant effect on astrocytic polarization.BV2 cell experiments demonstrated that the levels of IL-1β and TNF-α in the culture supernatant were increased(P＜0.01)after Fabp4 overexpression,and mitochondrial ROS production was elevated(P＜0.01).After LPS stimulation,Fabp4 protein expression in BV2 cells was increased(P＜0.01),the levels of IL-1β and TNF-α(P＜0.05)as well as mitochondrial ROS(P＜0.01)were reduced after BMS309403 intervention.In the mouse model,the levels of MDA and 8-OHdG in the brain tissue of Fabp4-/-TBI mice were significantly lower than those of wild-type TBI mice(P＜0.01).The levels of NLRP3,ASC,and Caspase-1 proteins in BV2 cells were increased after Fabp4 overexpression(P＜0.01),while ROS scavenger treatment reversed this effect(P＜0.01,P＜0.05,P＜0.01).In the mouse model,the levels of NLRP3,ASC,and Caspase-1 proteins in Fabp4-/-TBI mice were significantly lower than those in wild-type TBI mice(P＜0.01,P＜0.05,P＜0.01).Conclusion Fabp4 pro-motes microglia-induced neuroinflammation after TBI by regulating mitochondrial ROS production and NLRP3 inflammasome formation.These findings suggest that Fabp4 may serve as a potential therapeutic target for TBI.

Purpose To investigate the diagnostic value of quantitative 123I-Metaiodobenzylguanidine(MIBG)xSPECT/CT imaging in bone metastases of neuroblastoma in children.Materials and Methods We retrospectively assessed 123I-MIBG xSPECT/CT images of 61 children with neuroblastoma confirmed by pathology analyzed the influencing factors of bone metastatic lesions and normal bone quantitative parameters from March 2022 to March 2023 in Beijing Friendship Hospital,Capital Medical University,and compared the differences in standard uptake value(SUV).We used receiver operating characteristics curves to determine the optimum maximum standard uptake value(SUVmax),average standard uptake value(SUVavg),minimum standard uptake value(SUVmin)and peak standard uptake value(SUVpeak)cut-off value to diagnose bone metastatic lesions.Results There was no statistically significant difference in normal bone SUV values among different physical parameters(r=-0.204-0.071,all P>0.05).SUVmax,SUVavg,SUVmin and SUVpeak of bone metastatic lesions were significantly higher than those of normal bone(Z=-10.118--9.703,all P<0.000 1),and there was no significant statistical difference in SUV measurements of bone metastatic lesions among different Curie score intervals(H=0.226,0.107,0.149,0.342,all P>0.05).The area under the curve of SUVmax,SUVavg,SUVmin and SUVpeak were 0.929(95%CI 0.884-0.974),0.948(95%CI 0.906-0.989),0.935(95%CI 0.890-0.981),0.942(95%CI 0.899-0.985);sensitivity was 90.9%,90.2%,93.7%,92.3%,and specificity was 86.9%,93.4%,85.2%,88.5%,respectively,with statistically significant differences(P<0.000 1).The optimal diagnostic thresholds for SUVmax,SUVavg,SUVmin and SUVpeak were 0.39 g/ml,0.33 g/ml,0.20 g/ml and 0.33 g/ml,respectively.Conclusion We demonstrate that SUVavg above 0.33 g/ml in neuroblastoma patients have best diagnostic efficacy in the diagnosis of bone metastasis of neuroblastoma.Quantitative indexes of xSPECT/CT increase the specificity of diagnosing bone metastases of neuroblastoma,demonstrating the high diagnostic efficiency of 123I-MIBG xSPECT/CT imaging quantitative analysis and its potential usefulness as a diagnostic aid for visual evaluation.

Objective:To screen for microRNAs(miRNAs)highly expressed in the serum exosomes(Exo)of esophageal squamous cell carcinoma(ESCC)patients and analyze their relationship with the clinicopathological characteristics of the patients,and to explore the potential of Exo-derived miRNAs as clinical auxiliary diagnostic markers for ESCC.Methods:Serum and relevant clinical data of 50 healthy subjects and 45 newly diagnosed ESCC patients admitted to the Fourth Hospital of Hebei Medical University between December 2021 and June 2023 were collected,serving as the control group and the ESCC group respectively.The Gene Expression Omnibus(GEO)database and qPCR were used to screen and identify the candidate miRNA for increased expression in the serum of ESCC patients-miR-1246.The diagnostic efficacy of serum miR-1246 for ESCC was analyzed by the receiver operating characteristic curve.The relationship between miR-1246 and the clinical feature progression of ESCC patients was analyzed by Logistic regression,and the relationship between miR-1246 and the clinicopathological characteristics of ESCC patients was analyzed by the χ2 test.Exosomes in the serum of the subjects were isolated,purified and characterized for verification.The expression of miR-1246 in Exo was detected by qPCR.ESCC KYSE150 and KYSE30 cells were routinely cultured.mimics-NC and miR-1246 mimics were transfected respectively into KYSE150 cells using Lipofectamine 2000.Inhibitor-NC and miR-1246 inhibitor were transfected into KYSE30 cells,which were respectively denoted as the minics-NC,miR-1246 mimics,inhibitor-NC and miR-1246-inhibitor groups.KYSE150 and KYSE30 cells were treated with Exo derived from KYSE150 cells in the mimics-NC and miR-1246 mimics groups.The proliferation,migration and invasion abilities of cells in each group were detected by the CCK-8 assay,scratch wound healing assay and Transwell chamber assay respectively.The expressions of Exo markers,epithelial-mesenchymal transition-related proteins,TET family methylcytosine dioxygenase 2(TET2)and cell adhesion molecule 1(CADM1)proteins in each group of cells were detected by WB assay.The targeting binding relationship between miR-1246 and TET2 and CADM1 was verified by the dual-luciferase reporter gene assay.Results:Bioinformatics screening showed that the miRNA with the most significant differential expression in the serum of ESCC patients was miR-1246.The serum Exo extracted from the patients conformed to the typical Exo characteristics.The expression level of serum Exo-miR-1246 in ESCC patients at stages Ⅰ-Ⅱ was significantly higher than that in healthy subjects(P<0.01);the level of serum Exo-miR-1246 in ESCC patients at stages Ⅲ-Ⅳ was significantly higher than that in patients at stages Ⅰ-Ⅱ(P<0.01).ROC curve analysis showed that Exo-miR-1246 in serum had a high value for auxiliary differential diagnosis of ESCC(P<0.05),and the auxiliary diagnostic efficacy of Exo-miR-1246 for the clinical progression of ESCC patients was higher than that of CEA and SCC-Ag(P<0.05).The combined detection of the three could further improve the efficacy of auxiliary diagnosis of patient staging(P<0.01).Exo-miR-1246 might be an independent risk factor for the clinical progression of ESCC patients(P<0.05).The expression level of serum Exo-miR-1246 was associated with the T-stage,N-stage and clinical stage of ESCC(P<0.01).Overexpression of miR-1246 could promote the proliferation,migration,invasion,epithelial-mesenchymal transition and inhibit apoptosis of ESCC cells,while inhibition of miR-1246 had the opposite effect.Database data analysis found that TET2 and CADM1 were the target genes of miR-1246.The dual-luciferase reporter gene assay confirmed that miR-1246 could directly bind to TET2 and CADM1 mRNA and inhibit their expressions(P<0.01).Treatment of KYSE150 and KYSE30 cells with Exo derived from cells overexpressing miR-1246 had the same effect as overexpressing miR-1246 in these cells.Conclusion:Exo-derived miR-1246 has the potential to be a clinical auxiliary diagnostic marker for ESCC.It may affect the occurrence and development of ESCC by regulating the expression levels of TET2 and CADM1.

Objective:To explore the effect of hyperbaric oxygen (HBO) combined with Saccharomyces boulardii in ulcerative colitis (UC) and effect of serum asymmetric dimethylarginine (ADMA). Methods:A total of 100 patients with UC admitted to the First Hospital of Yulin from August 2021 to August 2023 were prospectively selected as the study objects and divided into control group and observation group according to random number table method, with 50 cases in each group. The control group was treated with mesalazine + Saccharomyces boulardii sachets, and the observation group was treated with mesalazine + Saccharomyces boulardii sachets + HBO, and both groups were treated for 60 d. The clinical efficacy and the levels of intestinal flora, ADMA, intestinal mucosal barrier function indexes, inflammatory factors and immune function indexes before and after treatment were compared between the two groups, and the occurrence of adverse reactions were compared between the two groups. Results:After treatment, the total effective rate in the observation group was higher than that in the control group: 74.00%(37/52) vs. 50.00%(26/52), there was statistical difference ( χ2 = 5.19, P<0.05). After treatment, the number of Enterococcus and Escherichia coli in the observation group were lower than those in the control group: (4.37 ± 0.91) lgcfu/g vs. (7.95 ± 1.32) lgcfu/g, (6.17 ± 0.92) lgcfu/g vs. (9.36 ± 1.35) lgcfu/g; and the number of Lactobacillus and Bifidobacterium were higher than those in the control group: (10.24 ± 2.57) lgcfu/g vs. (8.38 ± 1.48) lgcfu/g, (10.72 ± 3.15) lgcfu/g vs. (8.69 ± 2.64) lgcfu/g, there were statistical differences ( P<0.05). After treatment, the level of ADMA in the observation group was lower than that in control group: (0.51 ± 0.08) μmol/L vs. (0.85 ± 0.12) μmol/L; and the intestinal mucosal barrier function indexes of diamine oxidase, D-lactic acid and endotoxin were lower than those in the control group: (5.82 ± 1.13) U/L vs. (7.13 ± 1.89) U/L, (3.96 ± 0.42) mmol/L vs. (4.38 ± 0.85)mmol/L, (0.18 ± 0.02) kEU/L vs. (0.23 ± 0.04) kEU/L, there were statistical differences ( P<0.05). After treatment, the inflammatory factor C-reactive protein (CRP), interleukin (IL)-6 and tumor necrosis factor-α (TNF-α) in the observation group were lower than those in the control group: (4.84 ± 0.68) mg/L vs. (7.16 ± 0.82) mg/L, (13.24 ± 1.98) ng/L vs. (17.61 ± 2.25) ng/L, (22.13 ± 4.16) μg/L vs. (29.36 ± 5.37) μg/L; and IL-10 was higher than that in the control group:(15.35 ± 2.98) ng/L vs. (11.27 ± 3.26) ng/L, there were statistical differences ( P<0.05). After treatment, the immune function indexes CD 3+, CD 4+, CD 4+/CD 8+ in the observation group were higher than those in the control group: 0.563 ± 0.063 vs. 0.459 ± 0.052, 0.420 ± 0.049 vs. 0.383 ± 0.053, 1.35 ± 0.32 vs. 1.16 ± 0.26, there werestatistical differences ( P<0.05). The incidence of adverse reactions between the two groups had no statistical difference ( P>0.05). Conclusions:HBO combined with Saccharomyces boulardii can significantly improve clinical symptoms, reduce intestinal mucosal damage and improve intestinal microenvironment in UC patients.

Objective:To conduct a scoping review of the role responsibilities and competencies of oncology nurse specialist in the management of cutaneous immune-related adverse events (cirAEs), with a view to providing scientific guidance and reference for nursing practice in the field of oncology immunotherapy.Methods:Using the scoping review methodology as the framework, the relevant literatures on oncology nurse specialist in the management of cirAEs in databases including PubMed, Web of Science, CINAHL, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, and China Biology Medicine from their inception to September 20, 2024 were systematically searched. Two researchers independently screened the included literature, extracted information, and conducted a summary analysis.Results:A total of 24 articles were included. Based on the summary and categorization of the literature, six categories were identified, including dynamic monitoring and assessment, classification and intervention of cirAEs, precise symptom management, multidisciplinary management, continuity of care, and specialized training, along with 18 related responsibility items.Conclusions:Oncology nurse specialist plays a significant role in the management of cirAEs. In the future, it should draw on the training models and curricula of advanced practice oncology nurses from abroad to optimize oncology nurse specialist training and nursing practices, thereby enhancing the professionalism of nursing services and the quality of patient care.

Objective:To analyze the coordination between the growth of per capita health expenditure and per capita gross domestic product (GDP) in China from 2012 to 2021, and to explore the changes and regional disparities in the health consumption elasticity coefficient.Methods:Descriptive analysis was used to compare the average annual growth rates of per capita health expenditure and per capita GDP between 2012-2019, Pearson correlation analysis was conducted to test the relationship between the two variables. The health consumption elasticity coefficient was calculated as the ratio of the growth rates of health expenditure to GDP, and its temporal changes and regional distribution characteristics were analyzed.Results:After adjusting for price factors, the average annual growth rate of per capita health expenditure in China from 2012 to 2021 was 9.11%, higher than that of per capita GDP (6.11%), with no correlation between the two variables ( r=0.30, P>0.05). The national average health consumption elasticity coefficient was 1.49, lower than that in 2012-2019 (1.60), indicating an improvement in coordination. Compared with developed countries, China′s elasticity coefficient was at a moderate level. Conclusions:Overall, the growth of health expenditure in China remains faster than that of economic growth, with certain regional differences, but the degree of coordination has improved compared with the previous period.

Microglia are specialized immune cells in the brain, primarily responsible for clearing debris and responding to inflammation. One of the pathological features of Alzheimer's disease (AD) is the extensive activation of immune system in the brain, and the dynamic changes and dysfunction of microglia could become key factors for AD progression. This article reviews the research progress of regulated effect of microglial on AD pathology, and summarizes its potential value in AD treatment, in order to provide theoretical basis for exploring new therapeutic strategies and intervention targets for AD.

Ischemic stroke is a common cerebrovascular disease， characterized by hypoxia and nutritional deficiency in local brain tissue due to insufficient blood supply. Angiogenesis， the formation of new vascular networks on the basis of existing blood vessels， is of great significance for increasing blood flow in the ischemic area of brain tissue， restoring blood and oxygen supply， and improving disease prognosis. This complex process is regulated by various factors， including cytokines， growth factors， and signaling pathways. Among these， the phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway is considered a key regulatory pathway. It not only plays an important role in anti-apoptosis and promoting cell survival， but also regulates cell growth， differentiation， migration， and survival， while deeply participating in the regulation of angiogenesis. Chinese medicine offers unique advantages with its multi-component， multi-target， and multi-pathway approach in the treatment of stroke， showing significant potential in treating ischemic stroke. In recent years， it has been found that Chinese medicine can promote angiogenesis after ischemic stroke through the PI3K/Akt signaling pathway. This paper focuses on the PI3K/Akt signaling pathway as the research entry point， and explores in-depth the mechanisms by which Chinese medicine monomers， active components， extracts， derivatives， drug pairs， and Chinese medicine compounds promote angiogenesis after ischemic stroke. The research discusses the regulation of microRNAs （miRNA）， endothelial progenitor cells （EPCs）， apoptosis， upstream pro-angiogenic factors， and downstream target molecules. The paper also elaborates on related research progress， aiming to reveal how Chinese medicine can exert its potential utility in ischemic stroke treatment through this key signaling pathway， providing a theoretical basis for clinical treatment.