ObjectiveTo improve the efficacy of Astragalus membranaceus (Fisch.) Bunge (A. membranaceus, Huang Qi), and to further develop and utilize it, fermentation technology was applied to the stem and leaf of A. membranaceus to enhance its immune function.MethodsIn this study, we fermented A. membranaceus stem and leaf (ASL) with probiotics and investigated its immune function. Firstly, we screened suitable strains for ASL fermentation and optimized the fermentation process. Secondly, we determined the antioxidant capacity of fermented ASL and its effect on inflammation in mouse monocyte-macrophage cell. Finally, the immunocompromised mice were treated with fermented ASL to investigate the changes in their immune ability.ResultsAmong the 10 selected probiotics, Lactobacillus plantarum was the most suitable strain for ASL fermentation. After optimization of the fermentation process, the content of saponins in fermented ASL was significantly increased. The fermented ASL exhibited strong anti-inflammatory and antioxidant activities in vitro. The in vivo immune efficacy improved by promoting the development of the spleen and thymus, as well as raising the immunoglobulin M, tumor necrosis factor-α, and interleukin-1β levels of in the serum.ConclusionThis study contributes to developing the non-medicinal parts of A. membranaceus, expands its medicinal resources, highlights the potential of fermentation technology to enhance these parts, and provides a reference for further development. Based on this approach, we can promote using non-medicinal parts of herbal medicines, minimize drug waste, and offer a reference for developing non-medicinal components in Chinese herbal medicines.

Ionic liquids are materials with a lower melting point and higher solubility that can be regulated by changing their chemical structure.These materials can play a pharmacological role through transdermal,transmucosal and oral administration,so they can be used as carriers for drug delivery and can successfully deliver drugs to the lesion site.In addition,the ionic liquid itself also has anti-bacterial and anti-inflammatory properties,and can act as a drug itself.According to the above characteristics,ionic liquid has applica-tion prospect in the field of oral disease prevention and treatment.At present,it has the function of optimizing implant,oral antibacteri-al material,dental prosthesis and root canal therapy,and has a good therapeutic effect on oral diseases such as hand-foot-mouth disease and periodontitis,and is expected to become a clinical treatment strategy for oral diseases.In this review,the properties of ionic liquids and their applications in common oral diseases are illustrated,in order to provide new ideas for oral disease prevention and treatment.

Ionic liquids are materials with a lower melting point and higher solubility that can be regulated by changing their chemical structure.These materials can play a pharmacological role through transdermal,transmucosal and oral administration,so they can be used as carriers for drug delivery and can successfully deliver drugs to the lesion site.In addition,the ionic liquid itself also has anti-bacterial and anti-inflammatory properties,and can act as a drug itself.According to the above characteristics,ionic liquid has applica-tion prospect in the field of oral disease prevention and treatment.At present,it has the function of optimizing implant,oral antibacteri-al material,dental prosthesis and root canal therapy,and has a good therapeutic effect on oral diseases such as hand-foot-mouth disease and periodontitis,and is expected to become a clinical treatment strategy for oral diseases.In this review,the properties of ionic liquids and their applications in common oral diseases are illustrated,in order to provide new ideas for oral disease prevention and treatment.

Objective To analyze the interactions between different structural types of volatile oil compo-nents(VOCs)and skin lipid molecules,and investigate the mechanism of volatile oil in Chi-nese materia medica(VOCMM)as penetration enhancers. Methods In this study,210 different structural types of VOCs were selected from the VOCMM penetration enhancer database,and the molecular docking experiments were conducted with three main lipid molecules of skin:ceramide 2(CER2),cholesterol(CHL),and free fatty acid(FFA).Each VOC was docked individually with each lipid molecule.Cluster analysis was used to explore the relationship between the binding energy of VOCs and their molecular struc-tures.Nine specific pathogen-free(SPF)Sprague Dawley(SD)rats were randomly divided in-to Control,Nootkatone,and 3-Butylidenephthalide groups for in vitro percutaneous experi-ments,with three rats in each group.The donor pool solutions were 3%gastrodin,3%gas-trodin+3%nootkatone,and 3%gastrodin+3%3-butylidenephthalide,respectively.The pen-etration enhancing effects of VOCs with higher binding energy were evaluated by comparing the 12-hour cumulative percutaneous absorption of gastrodin(Q12,μg/cm2). Results(i)Most of the VOCs were non-hydrogen bonded to the hydrophobic parts of CHL and FFA,and hydrogen bonded to the head group of CER2.Among them,sesquiterpene ox-ides showed the most pronounced binding affinity to CER2.The VOCs with 2-4 rings(in-cluding carbon rings,benzene rings,and heterocycles)demonstrated stronger binding affini-ty for three skin lipid molecules compared with the VOCs without intramolecular rings(P<0.01).(ii)According to the cluster analysis,most of the VOCs that bond well to CER2 had 2-3 intramolecular rings.The non-oxygenated VOCs were bonded to CER2 in a hydrophobic manner.The oxygenated VOCs were mostly bonded to CER2 by hydrogen bonding.(iii)The results of Franz diffusion cell experiment showed that the Q12 of Control group was 260.60±25.09 μg/cm2,and the transdermal absorption of gastrodin was significantly increased in Nootkatone group(Q12=5 503.00±1 080.00 μg/cm2,P<0.01).The transdermal absorption of gastrodin was also increased in 3-Butylidenephthalide group(Q12=495.40±56.98 μg/cm2,P>0.05).(iv)The type of oxygen-containing functional groups in VOCs was also an influencing factor of binding affinity to CER2. Conclusion The interactions between different types of VOCs with different structures in the VOCMM and three skin lipid molecules in the stratum corneum were investigated at the molecular level in this paper.This research provided theoretical guidance and data support for the screening of volatile oil-based penetration enhancers,and a simple and rapid method for studying the penetration-enhancing mechanism of volatile oils.

Objective:To analyze the current status of salary system reform in public hospitals in Mianyang City, Sichuan Province, and provide reference for the deepening of salary system reform in public hospitals.Methods:From April to May 2023, a self-designed survey questionnaire was used to conduct a survey of medical staff in five municipal tertiary public hospitals through the Wenjuanxing platform. The survey questionnaire mainly included the basic information of the survey subjects, the implementation status of the salary system, and employee satisfaction with salary. In May 2023, semi-structured interviews were conducted with relevant personnel from government departments and public hospitals involved in the reform. The interview content included the reform measures taken and their impact, changes in medical staff salaries after the reform, and the current difficulties faced by the reform. Descriptive analysis was conducted on the data, and Chi-square test was used to compare the count data. Kendall′s tau-b test was used to analyze the correlation between salary level and basic information of the survey subjects.Results:In the reform of the salary system in public hospitals in Mianyang City, measures such as system construction, total salary quota determination and dynamic control, and salary management for non-establishment employees have been mainly adopted. 826 valid questionnaires were collected, with an effective response rate of 94.5%. The annual income level was positively correlated with age, education level, years of work experience, and professional title level ( r=0.420, P<0.001; r=0.245, P<0.001; r=0.364, P<0.001; r=0.504, P<0.001). Compared with the personnel in the same positions at the same level of hospitals in other cities and states in Sichuan Province, 274 people (33.2%) were quite satisfied or very satisfied with the current salary level; 350 people (42.3%) were quite satisfied or very satisfied with the salary distribution mechanism, and 441 people (53.4%) were quite satisfied or very satisfied with non-economic salaries. The proportion of survey respondents who believe that the existing salary structure and performance evaluation methods could reflect their actual work value was 464 people (56.2%) and 423 people (51.2%), respectively. A total of 10 people were interviewed, with 4 individuals believing that the salary level has increased after the reform, but the change was not significant compared to before the reform; 8 individuals believed that the current reform does not involve the reform of the salary structure; 6 individuals believed that the internal performance based salary distribution mechanism in hospitals was not sound; 3 individuals believed that there was insufficient attention to the reform of non-economic compensation; 7 individuals believe that the difficulties in the salary system reform were mainly concentrated on the unified understanding of policies, how to determine the increase in the total salary quota, and how to reasonably distribute it internally. Conclusions:Mianyang City has scientifically determined the total salary and implemented dynamic control, enhancing the public welfare nature of public hospitals, while also taking into account the salary management of employees both inside and outside the establishment, promoting equal pay for equal work. However, there were also issues such as disagreements on the dynamic adjustment of the total salary, an imperfect internal distribution mechanism within hospitals, and an incomplete salary system reform. It is necessary to further strengthen top-level design, reasonably increase salary levels, improve the internal distribution mechanism, and optimize the salary structure to continue deepening the reform of the salary system in public hospital.

Objective:To establish a comprehensive and effective scoring model based on ultrasonic characteristics for predicting the restenosis risk after superficial femoral artery stenting, in order to assess the possibility of in-stent restenosis and to provide guidance for the selection of therapeutic strategies.Methods:A retrospective review of a database of 328 patients (381 limbs) undergoing superficial femoral artery stents in Xuanwu Hospital, Capital Medical University from January 2016 to January 2018 was made as a modeling group.In the modeling cohort, the multivariate logistic regression analysis was performed to screen independent risk factors for in-stent restenosis. A predictive scoring model of restenosis risk was established with weighted score of independent risk factors according to the odd ratio values. Based on the best cut-off value of the receiver operating characteristic (ROC) curves, the scoring table was divided into low-risk and high-risk groups of restenosis.Results:Multivariate logistic regression analysis showed that 8 factors were included in the score system to establish the scoring model of in-stent restenosis risk prediction including calcified plaque, peak systolic velocity of popliteal artery<40 cm/s, runoff scores≥4, ankle-brachial index<0.5, female (1 point each); complicated stroke, complicated chronic renal disease, total lesion length 15.0-24.9 cm (2 points each); total lesion length≥25.0 cm (3 points), a total of 12 points in the model. The validation indicated that the scoring system had good predictive value(AUC=0.775, 95% CI=0.727-0.824, P<0.001) and goodness of fit (Hosmer-Lemeshow χ 2=4.921, P=0.766). The agreement with digital subtraction angiography(DSA) was good (Kappa value=0.609). The scoring system was further divided into the low-risk restenosis (0-5 points) and high-risk restenosis (6-12 points) according to the best cut-off value of 5.5, with a sensitivity of 68.1%, a specificity of 74.6%, and the accuracy of 72.7%. Conclusions:The superficial femoral artery in-stent restenosis risk predicting score model based on ultrasonic characteristics may accurately predict the restenosis preoperatively. It provides a theoretical basis for the precise surgical plans.

Objective:To explore the role and molecular mechanism of hepatocyte nuclear factor 4γ (HNF4γ) in proliferation and stemness of gastric cancer.Methods:A total of 102 cases of paraffin-embedded gastric cancer tissues and matched adjacent gastric tissues and 42 cases of fresh-frozen tissues derived from gastric patients who received radical gastrectomy were collected from the First Affiliated Hospital of Zhengzhou University between 2012 to 2015. The expression of HNF4γ was tested by immunohistochemical staining, quantitative real-time polymerase chain reaction (qRT-PCR). HNF4γ overexpressed (AGS-HNF4γ) and shRNA silenced (HGC27-shHNF4γ) gastric cell lines were established. The effects of HNF4γ on cell proliferation and stemness were verified by XTT, clone formation and sphere formation assay. The expression of CD44 was detected by western blot.Results:The mRNA expression level of HNF4γ in fresh-frozen gastric cancer tissue was (12.43±2.702), which was significantly higher than (3.639±1.109) in normal tissue ( P<0.001). The high protein expression rate of HNF4γ in paraffin-embedded gastric cancer tissues was 41.2% (42/102), which was significantly higher than 8.8% (9/102) in normal gastric mucosa tissue ( P< 0.001). The protein expression of HNF4γ was closely related to the tumor differentiation, infiltration depth, lymph node metastasis and tumor stage ( P<0.05). The median survival interval of patients with HNF4γ high expression was 25 months, the 3-year survival rate was 4.8% (2/42), significantly lower than 38 months and 51.7% (31/60) of patients with normal HNF4γ expression ( P<0.001). The proliferation and CD44 protein expression of AGS-HNF4γ cells were significantly higher than those of the AGS-Vector cells. The number of clone formation, sphere formation rate of AGS-HNF4γ cells were 243.5±24.5 and (83.5±3.9)%, significantly higher than 81.0±16.0 and (21.8±5.6)% of AGS-Vector cells ( P=0.030 and P=0.010, respectively). The proliferation and CD44 protein expression of HGC27-shHNF4 cells were significantly lower than those of the HGC27-vector cells. The number of clone formation, sphere formation rate of HGC27-shHNF4 cells were 26.0±1.0 and (20.8±8.4)%, significantly higher than 83.5±4.5 and (72.5±4.8)% of HGC27-vector cells ( P=0.006 and P=0.030, respectively). Conclusions:HNF4γ is upregulated in the gastric cancer tissues and related with the poor prognosis of patients with gastric cancer. Overexpression of HNF4γ promotes the proliferation and remains the stemness of gastric cancer cells by upregulating the expression of CD44.

Objective:To explore the role and molecular mechanism of hepatocyte nuclear factor 4γ (HNF4γ) in proliferation and stemness of gastric cancer.Methods:A total of 102 cases of paraffin-embedded gastric cancer tissues and matched adjacent gastric tissues and 42 cases of fresh-frozen tissues derived from gastric patients who received radical gastrectomy were collected from the First Affiliated Hospital of Zhengzhou University between 2012 to 2015. The expression of HNF4γ was tested by immunohistochemical staining, quantitative real-time polymerase chain reaction (qRT-PCR). HNF4γ overexpressed (AGS-HNF4γ) and shRNA silenced (HGC27-shHNF4γ) gastric cell lines were established. The effects of HNF4γ on cell proliferation and stemness were verified by XTT, clone formation and sphere formation assay. The expression of CD44 was detected by western blot.Results:The mRNA expression level of HNF4γ in fresh-frozen gastric cancer tissue was (12.43±2.702), which was significantly higher than (3.639±1.109) in normal tissue ( P<0.001). The high protein expression rate of HNF4γ in paraffin-embedded gastric cancer tissues was 41.2% (42/102), which was significantly higher than 8.8% (9/102) in normal gastric mucosa tissue ( P< 0.001). The protein expression of HNF4γ was closely related to the tumor differentiation, infiltration depth, lymph node metastasis and tumor stage ( P<0.05). The median survival interval of patients with HNF4γ high expression was 25 months, the 3-year survival rate was 4.8% (2/42), significantly lower than 38 months and 51.7% (31/60) of patients with normal HNF4γ expression ( P<0.001). The proliferation and CD44 protein expression of AGS-HNF4γ cells were significantly higher than those of the AGS-Vector cells. The number of clone formation, sphere formation rate of AGS-HNF4γ cells were 243.5±24.5 and (83.5±3.9)%, significantly higher than 81.0±16.0 and (21.8±5.6)% of AGS-Vector cells ( P=0.030 and P=0.010, respectively). The proliferation and CD44 protein expression of HGC27-shHNF4 cells were significantly lower than those of the HGC27-vector cells. The number of clone formation, sphere formation rate of HGC27-shHNF4 cells were 26.0±1.0 and (20.8±8.4)%, significantly higher than 83.5±4.5 and (72.5±4.8)% of HGC27-vector cells ( P=0.006 and P=0.030, respectively). Conclusions:HNF4γ is upregulated in the gastric cancer tissues and related with the poor prognosis of patients with gastric cancer. Overexpression of HNF4γ promotes the proliferation and remains the stemness of gastric cancer cells by upregulating the expression of CD44.

Objective: To explore the effect of hyperbaric oxygen preconditioning with different frequency on the survival rate of flap and ischemia-reperfusion injury in rats after transplantation, and to explore the best preconditioning conditions to improve the survival rate of rat flaps after transplantation. Methods: Thirty-six Sprague Dawley rats were randomly divided into four groups according to the random number table method, 9 groups in each group.Four groups of rats were pretreated with hyperbaric oxygen pretreatment for 0, 2, 4, and 6 days before the operation, control group, pretreatment 2 d group, pretreatment 4 d group, and pretreatment 6 d group. Taking the midline of the back of the rat as the axis, an ultra-long random flap with a pedicle at the tail end and about 1 cm from the superior iliac spine was designed and cut to a size of 10.0 cm×2.5 cm. The survival of the flaps in each group was observed and the final survival area and survival rate of the flaps were measured on the 7th day after surgery. On the 7th day after operation, the tissue was taken at a distance of 5 cm from the pedicle, and the histopathology was observed; The content of superoxide dismutase (SOD) and malondialdehyde (MDA) in flap tissue was detected by immunohistochemistry, and the expression rate of positive cells in each group was calculated. Immunofluorescence was used to detect the expression of interleukin-6 (IL-6) in the flap tissue. Results: On the 7th day after the operation, the survival area and survival rate of the transplanted flaps in the hyperbaric oxygen pretreatment group were significantly higher than those in the control group (P<0.05), and the pretreatment 4 d and 6 d groups were significantly higher than the pretreated 2 d group (P<0.05), but there was no significant difference between the pretreated 4 d group and the 6 d group (P=0.095). Pathological observation on the 7th day after operation showed that there was some necrosis in the control group, the vascular cells in the pretreated 2 d group had more vascular structures, and more neovascularization was observed in the pretreated 4 d group. The inflammatory cells were the least in the 6 d pretreatment group, and the neovascularization was the same as the pretreatment 4 d group. The absorbance A value of SOD in the control group was 0.009 7±0.000 3, and the positive expression rate was 20%, which was significantly lower than that in the hyperbaric oxygen pretreatment group. The difference was statistically significant (P<0.05). However, the absorbance A value of MDA in the control group was 0.055 1±0.003 0, and the positive expression rate was 55%, which was significantly higher than that in the hyperbaric oxygen pretreatment group. The difference was statistically significant (P<0.05). Among them, the SOD absorbance A value of the pretreated 2 d group was 0.023 8±0.003 0, and the positive expression rate was 30%, which was lower than the pretreatment 4 d group (absorbance A value 0.046 9±0.003 0, positive expression rate 35%) and 6 d group (absorbance A value 0.047 2±0.003 6, positive expression rate 40%), The MDA absorbance A value of the pretreated 2 d group was 0.037 2±0.003 2, and the positive expression rate was 30%, which was higher than the pretreatment 4 d group (absorbance A value 0.014 7±0.002 4, positive expression rate 5%) and 6 d group (absorbance A value 0.017 0±0.001 8, positive expression rate 10%), the difference was statistically significant (P<0.05). However, there was no significant difference in the expression of SOD and MDA between the pretreated 4 d group and the pretreated 6 d group (P>0.05). The expression of IL-6 in the hyperbaric oxygen pretreatment group was significantly lower than that in the control group (absorbance A value 44.937 0±0.594 0), the difference was statistically significant (P<0.05). The absorbance A value in the pretreated 2 d group was 41.698 0±0.724 0, which was significantly higher than the pretreatment 4 d group (absorbance A value 34.049 0±0.323 0) and 6 d group (absorbance A value 33.524 0±0.639 0). The difference was statistically significant (P<0.05). There was no significant difference in the expression of the pretreated 4 d group compared with the 6 d group (P=0.068). Conclusions Hyperbaric oxygen preconditioning can significantly promote the survival of rat flaps after transplantation. Preoperative hyperbaric oxygen preconditioning once daily for 4 consecutive days, can enhance the tolerance of flap tissue to ischemia and anoxia and reduce tissue ischemia-reperfusion injury.

Objective To investigate the role of cell adhesion molecule L1 like (CALL) in the genesis and development of esophageal squamous cell carcinoma (ESCC).Methods From July 2007 to December 2010,a total of 100 patients with ESCC who received radical resection of esophageal cancer were enrolled.The ESCC tissues and corresponding tumor-adjacent normal tissues were obtained.The expression of CALl was determined by tissue microarray technology and immunohistochemical staining.The CALL over-expressed esophageal cancer cell line was established.The effects of CALL on cell migration and invasion were detected by wound-healing assay and Transwell assay,respectively.The effects of CALL on actin microfilament was analyzed by filamentous actin (F-actin) staining.Chi square test,Fisher's exact test,multivariate analysis and t test were performed for statistical analysis.Results The positive expression rate of CALL in ESCC tissues was 56 ％ (56/100),which was lower than that of tumor-adjacent normal tissues (95％,95/100),and the difference was statistically significant (x2=41.114,P＜0.01).There were statistically significant differences in CALL expression at protein level among patients with ESCC of different differentiation degree,different pathological T stage,lymph node metastasis and different TNM stage (x2=13.702,5.317,21.453,Fisher's exact test;all P＜ 0.05).The five year disease related survival rate of ESCC patients with down-regulated expression of CALL was 0(0/49),which was lower than those with normal CALL expression (25.5％,13/51),and the difference was statistically significant (x2 =43.338,P＜0.01).The median survival time of CALL expression down-regulated group was 17 months,and that of normal expressed group was 38 months.CALL expression was an independent risk factor of disease special survival rate (hazard ratio (HR) 0.353,95％ confidence interval (CI) 0.188 to 0.666,P=0.001).The results of wound-healing assay showed that the migration ability of CALL overexpressed CALL-k30 cells was lower than that of Vec-k30 cells in control group on 24 hours after wound.The results of Transwell invasion test showed the number of migrating cells penetrating CALL k30 cells attached to the inferior surface of the membrane was 44.000±13.748,which was less than that of the Vec k30 cells (154.333±25.007),and the difference was statistically significant (t=5.136,P=0.036).The results of F-actin staining demonstrated that actin filaments of CALL-k30 cells was 234.667 ± 65.118,which was lower than that of Vec-k30 cells (597.000± 119.929),and the difference was statistically significant (t=4.707,P=0.042).Conclusions CALL lowers the migration and invasion abilities of esophageal cancer cells by inhibiting F-actin microfilaments.Its abnormal expression may play an important role in the genesis,development and prognosis of ESCC.