The traditional theory of "the spleen governs the dispersion of essence" refers to the spleen's pivotal role in distributing refined nutrients throughout the body. In traditional Chinese medicine （TCM）， lipids are categorized under "gaozhi （膏脂）"， and their transportation and metabolism via apolipoproteins are believed to be closely related to the spleen's dispersing function. The liver， which synthesizes apolipoproteins， is functionally linked to the spleen system in TCM. Impaired dispersion of essence by the spleen and disrupted transportation of gaozhi constitute the pathological mechanism of dyslipidemia due to spleen deficiency. Strengthening the spleen and resolving dampness is the core therapeutic principle. From the perspective of modern medicine， this may involve promoting hepatic functional recovery related to lipid metabolism， thereby enhancing lipid processing and reducing the levels of abnormally accumulated lipids in the bloodstream.

To investigate the anti-atherosclerotic effects of dietary hesperidin and naringin on ather-osclerosis in rabbits.Twenty-four adult healthy male New Zealand Large White rabbits were ran-domly assigned to four groups based on one factor:control(Con),model(Mod),hesperidin(HP),and naringenin(NG),each containing six rabbits and housed in solitary cages.During the experi-mental period,the control group received normal feed;the model group was fed high-fat for 30 d to establish the atherosclerosis,(AS)model and continued to be fed high-fat feed;the hesperidin and naringenin groups were fed high-fat for 30 d and then underwent AS modeling,and at a later stage,150 mg of hesperidin(or naringenin)was added to the diets at a rate of 1.5 mg per kg of di-et,respectively,for 30 d.Relative body quality,blood lipids,oxidation,and inflammatory factor lev-els were all assessed.At the end of the test period,the test rabbits were sacrificed to obtain the common carotid artery for histopathological section HE staining,Oil red O staining,and Sirius red staining in order to observe vascular tissue structure,lipid and inflammatory cell infiltration,and e-lastic plate and elastic fiber damage.The results indicated that the relative body quality of the mod-el,HP and NG groups increased rapidly,and the difference with the control group within the same period was highly significant(P＜0.01);The HP and NG interventions significantly decreased to-tal cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)levels(P＜0.01),while also leading to a significant increase in high-density lipoprotein cholesterol(HDL-C)levels(P＜0.01);MDA levels exhibited a significant decrease(P＜0.01),while SOD levels showed a notable in-crease(P＜0.01)following the HP and NG interventions;After HP and NG interventions,TNF-α and IL-1 were regressed(P＜0.01)and IL-10 was significantly elevated(P＜0.01);Compared with the control group,the model group showed approximately 41.8 and 2.5 fold thickening of the maximal endo-medial membrane,respectively,and the HP and NG interventions showed approxi-mately 13 and 15 fold thickening of the maximal endo-medial membrane,and both of the maximal medial membranes thickened by approximately 1.4 fold;Staining of pathological sections showed that HP and NG intervened to significantly reduce inflammatory cell infiltration,deposition of lipid components,slight thickening of the endothelium,and intact fibroblastic components.The results showed that the addition of HP and NG to diets could regulate blood lipids and exert anti-inflam-matory and antioxidant effects by inhibiting the expression of inflammatory factors and oxidizing factors,showing significant anti-AS effects,and the two effects were comparable.

Objective To investigate the occurrence of hemodialysis events in patients who received maintenance hemodialysis in outpatient setting in Liangshan Yi Autonomous Prefecture of Sichuan Province,and provide basis for the formulation of infection prevention and control strategies in this area.Methods Based on the standards from Center for Disease Control and Prevention-National Healthcare Safety Network(CDC-NHSN)as well as the WS/T 312-2023 standards,four public hospitals(two secondary and two tertiary hospitals)in three counties and one city of Liangshan Yi Autonomous Prefecture were selected,and prospective surveillance method was adopted.A total of 826 patients(n=8 675 cases)who received maintenance hemodialysis on the first two working day of each month from March 2024 to March 2025 were surveilled.Data were collected with standardized form by infection control teams in dialysis centers.Statistical analysis was conducted.Results During the surveillance period,the incidence of hemodialysis events was 5.15％(447/8 675).The incidence(16.67％,36/216)and mortality(10.00％,4/40)of hemodialysis events in patients with non-tunneled catheters were the highest among patients with all types of ac-cess.Patients with tunneled-catheters had the highest hospitalization rate(42.86％).Systemic use of antimicrobial agents accounted for 82.33％(368/447).Upper respiratory tract infection was the main infection(38.32％).In-fection at the puncture site of vascular access accounted for 16.78％(75/447).Four cases(0.89％,4/447)had positive blood culture.Conclusion Systemic antimicrobial use and infection at vascular access puncture site is the most frequent events in patients who receive maintenance hemodialysis in outpatient setting in Liangshan Yi Autono-mous Prefecture of Sichuan Province.Patients with non-tunneled catheters have the highest rate of hemodialysis events.

To explore the effects and processes of various hesperidin(HP)dosages on atherosclero-sis(AS)in rabbits caused by high-fat diet in conjunction with anhydrous ethanol arterial damage.A total of twenty-five healthy male rabbits,six months of age,were chosen,given a week to accli-mate and feed,and then randomly assigned to five groups:the model group,the control group,and the groups receiving low,middle,and high doses of HP.The control group received normal feed during the experiment;the model group received high-fat feed for 30 days,after which the common carotid artery was perfused with anhydrous ethanol to create a pathological model of AS;the HP low,middle,and high dose groups received high-fat feed continuously for 30 days based on the model group,with 100,150,and 200 mg/kg of HP added to the diets,respectively.The blood cell counts,including white blood cells(WBC),lymphocytes(lym),monocytes(Mon),red blood cells(RBC),hemoglobin concentration(HGB),platelet count(PLT),and granulocytes were measured using hematology analyzer.The serum total cholesterol(TC),triglycerides(TG),low density lipo-protein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)were analyzed u-sing biochemical analyzer.An ELISA kit was used to measure the expression of inflammatory factors and the level of oxidative factors,while a blood cell analyzer was used to measure the quan-tity of blood cells and a biochemical analyzer was used to measure the level of four kinds of blood lipids.At the end of the test,the test rabbits were sacrificed to take carotid arteries for pathological tissue sections HE,Oil Red O and Masson staining to observe the structure of the wall with lipid infiltration and other conditions.The results indicated a significant increase in body weight in the model group compared to the HP dose group(P＜0.01).In comparison to the model group,HP in-tervention significantly reduced the levels of WBC,Mon,PLT,and the percentage of Gran(P＜0.01).Additionally,HP intervention significantly decreased serum inflammatory cytokines,inclu-ding TG,TC,and LDL-C,while increasing HDL-C levels(P＜0.01).The plasma levels of TNF-αand IL-1 decreased significantly following HP intervention(P＜0.01),whereas the level of IL-10 increased significantly(P＜0.01).Furthermore,SOD activity was significantly higher(P＜0.01)and MDA content was significantly lower(P＜0.01)after HP intervention.Histological examina-tion revealed that HP intervention significantly reduced lipid deposition in tubular walls,inflamma-tory cell infiltration,and the extent of elastic fiber damage.These results suggest that HP may at-tenuate atherosclerosis in rabbits by modulating lipid levels,inflammatory factors,and oxidative stress.

Objective To investigate the occurrence of hemodialysis events in patients who received maintenance hemodialysis in outpatient setting in Liangshan Yi Autonomous Prefecture of Sichuan Province,and provide basis for the formulation of infection prevention and control strategies in this area.Methods Based on the standards from Center for Disease Control and Prevention-National Healthcare Safety Network(CDC-NHSN)as well as the WS/T 312-2023 standards,four public hospitals(two secondary and two tertiary hospitals)in three counties and one city of Liangshan Yi Autonomous Prefecture were selected,and prospective surveillance method was adopted.A total of 826 patients(n=8 675 cases)who received maintenance hemodialysis on the first two working day of each month from March 2024 to March 2025 were surveilled.Data were collected with standardized form by infection control teams in dialysis centers.Statistical analysis was conducted.Results During the surveillance period,the incidence of hemodialysis events was 5.15％(447/8 675).The incidence(16.67％,36/216)and mortality(10.00％,4/40)of hemodialysis events in patients with non-tunneled catheters were the highest among patients with all types of ac-cess.Patients with tunneled-catheters had the highest hospitalization rate(42.86％).Systemic use of antimicrobial agents accounted for 82.33％(368/447).Upper respiratory tract infection was the main infection(38.32％).In-fection at the puncture site of vascular access accounted for 16.78％(75/447).Four cases(0.89％,4/447)had positive blood culture.Conclusion Systemic antimicrobial use and infection at vascular access puncture site is the most frequent events in patients who receive maintenance hemodialysis in outpatient setting in Liangshan Yi Autono-mous Prefecture of Sichuan Province.Patients with non-tunneled catheters have the highest rate of hemodialysis events.

To investigate the anti-atherosclerotic effects of dietary hesperidin and naringin on ather-osclerosis in rabbits.Twenty-four adult healthy male New Zealand Large White rabbits were ran-domly assigned to four groups based on one factor:control(Con),model(Mod),hesperidin(HP),and naringenin(NG),each containing six rabbits and housed in solitary cages.During the experi-mental period,the control group received normal feed;the model group was fed high-fat for 30 d to establish the atherosclerosis,(AS)model and continued to be fed high-fat feed;the hesperidin and naringenin groups were fed high-fat for 30 d and then underwent AS modeling,and at a later stage,150 mg of hesperidin(or naringenin)was added to the diets at a rate of 1.5 mg per kg of di-et,respectively,for 30 d.Relative body quality,blood lipids,oxidation,and inflammatory factor lev-els were all assessed.At the end of the test period,the test rabbits were sacrificed to obtain the common carotid artery for histopathological section HE staining,Oil red O staining,and Sirius red staining in order to observe vascular tissue structure,lipid and inflammatory cell infiltration,and e-lastic plate and elastic fiber damage.The results indicated that the relative body quality of the mod-el,HP and NG groups increased rapidly,and the difference with the control group within the same period was highly significant(P＜0.01);The HP and NG interventions significantly decreased to-tal cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)levels(P＜0.01),while also leading to a significant increase in high-density lipoprotein cholesterol(HDL-C)levels(P＜0.01);MDA levels exhibited a significant decrease(P＜0.01),while SOD levels showed a notable in-crease(P＜0.01)following the HP and NG interventions;After HP and NG interventions,TNF-α and IL-1 were regressed(P＜0.01)and IL-10 was significantly elevated(P＜0.01);Compared with the control group,the model group showed approximately 41.8 and 2.5 fold thickening of the maximal endo-medial membrane,respectively,and the HP and NG interventions showed approxi-mately 13 and 15 fold thickening of the maximal endo-medial membrane,and both of the maximal medial membranes thickened by approximately 1.4 fold;Staining of pathological sections showed that HP and NG intervened to significantly reduce inflammatory cell infiltration,deposition of lipid components,slight thickening of the endothelium,and intact fibroblastic components.The results showed that the addition of HP and NG to diets could regulate blood lipids and exert anti-inflam-matory and antioxidant effects by inhibiting the expression of inflammatory factors and oxidizing factors,showing significant anti-AS effects,and the two effects were comparable.

To explore the effects and processes of various hesperidin(HP)dosages on atherosclero-sis(AS)in rabbits caused by high-fat diet in conjunction with anhydrous ethanol arterial damage.A total of twenty-five healthy male rabbits,six months of age,were chosen,given a week to accli-mate and feed,and then randomly assigned to five groups:the model group,the control group,and the groups receiving low,middle,and high doses of HP.The control group received normal feed during the experiment;the model group received high-fat feed for 30 days,after which the common carotid artery was perfused with anhydrous ethanol to create a pathological model of AS;the HP low,middle,and high dose groups received high-fat feed continuously for 30 days based on the model group,with 100,150,and 200 mg/kg of HP added to the diets,respectively.The blood cell counts,including white blood cells(WBC),lymphocytes(lym),monocytes(Mon),red blood cells(RBC),hemoglobin concentration(HGB),platelet count(PLT),and granulocytes were measured using hematology analyzer.The serum total cholesterol(TC),triglycerides(TG),low density lipo-protein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)were analyzed u-sing biochemical analyzer.An ELISA kit was used to measure the expression of inflammatory factors and the level of oxidative factors,while a blood cell analyzer was used to measure the quan-tity of blood cells and a biochemical analyzer was used to measure the level of four kinds of blood lipids.At the end of the test,the test rabbits were sacrificed to take carotid arteries for pathological tissue sections HE,Oil Red O and Masson staining to observe the structure of the wall with lipid infiltration and other conditions.The results indicated a significant increase in body weight in the model group compared to the HP dose group(P＜0.01).In comparison to the model group,HP in-tervention significantly reduced the levels of WBC,Mon,PLT,and the percentage of Gran(P＜0.01).Additionally,HP intervention significantly decreased serum inflammatory cytokines,inclu-ding TG,TC,and LDL-C,while increasing HDL-C levels(P＜0.01).The plasma levels of TNF-αand IL-1 decreased significantly following HP intervention(P＜0.01),whereas the level of IL-10 increased significantly(P＜0.01).Furthermore,SOD activity was significantly higher(P＜0.01)and MDA content was significantly lower(P＜0.01)after HP intervention.Histological examina-tion revealed that HP intervention significantly reduced lipid deposition in tubular walls,inflamma-tory cell infiltration,and the extent of elastic fiber damage.These results suggest that HP may at-tenuate atherosclerosis in rabbits by modulating lipid levels,inflammatory factors,and oxidative stress.

Objective To develop and optimize the extraction method of exosomal miRNA and compare it with traditional methods. Methods The exosomal miRNA of MSC,NK and CIK cells was used as the research subject. The removal efficiency of genomic DNA from exosomal miRNA by gDNA removal column was detected by UV spectrophotometer and agarose gel electrophoresis. The lysates(exosome G2 lysate and exosome miRNA lysate)and aggregation reagents(absolute ethanol and isopropanol)were optimized by using concentration,purity and gene expression level(Ct value)as evaluation indexes.Exosomal miRNA of MSC,NK,CIK cells and healthy human serum was extracted by the developed method,Trizol method and Trizol magnetic beads method,and detected by RT-qPCR. Results The gDNA removal column effectively removed genomic DNA from exosomal miRNA. The concentrations of exosomal miRNA extracted from MSC,NK and CIK cells by using exosome miRNA lysate were significantly higher than those by using exosome G2 lysate(t = 6. 358,P = 0. 020). The purity of miRNA samples extracted by exosome G2 lysate was low,and there was foreign protein pollution,but exosome miRNA lysate effectively removed the pollution. The Ct values of miR-Let-7i,miR-16-1 and miR-150 genes in exosomal miRNA of CIK cells extracted by exosome miRNA lysate were significantly lower than those by exosome G2 lysate(t = 30. 120,P =0. 008). The concentration of exosomal miRNA extracted from MSC,NK and CIK cells by isopropanol was significantly higher than that by absolute ethanol(t = 8. 567,P = 0. 010),and the purity was significantly lower than that by absolute ethanol(t = 6. 214,P = 0. 020). The Ct values of miR-Let-7i,miR-16-1 and miR-150 genes in exosomal miRNA extracted from CIK cells by two aggregation reagents had no significant difference(t = 2. 297,P = 0. 120). Compared with Trizol method and Trizol magnetic beads method,the expression of miR-Let-7i,miR-16-1,miR-Let-7a and miR-150 genes in exosomal miRNA extracted from CIK,NK,MSC cells and healthy human serum by the developed method was more abundant,and the overall Ct value was lower. The dissolution peak was prominent and sharp,exhibiting a single main peak. Conclusion The exosomal miRNA extracted by the developed method has high concentration and purity with stable Ct value,and the method has high sensitivity and good specificity. This study lays a foundation for further research on exosomal miRNA.

AIM: To investigate the mechanism of elemene synergistic bortezomib against multiple myeloma based on ROS-NF-κB-p38MAPK signaling pathway. METHODS: CCK-8 assay was used to detect cell activity. Nude mice were randomly divided into control group, bortezomib (BTZ) group, elemene (ELE) group and combination group. Each group was treated with BTZ, ELE and BTZ combined with ELE, respectively. Tunel staining was performed to observe the apoptosis of tumor tissues. The expressions of Caspase-3, Bcl-2, NF-κB and p38 MAPK were detected by Western Blot. Cell cycle, apoptosis and reactive oxygen species (ROS) expression were detected by flow cytometry using human myeloma U266 cells. RESULTS: When 4.0 μmol/L ELE combined with 50 nmol/L BTZ treated U266, the cell activity was significantly reduced compared with that of NC, BTZ and ELE groups (P< 0.05). The tumor volume of nude mice in BTZ group, ELE group and combined group was significantly reduced compared with the control group (P <0.05), and the combined group was the smallest. Tunel staining results showed that the apoptosis level in the control group was lower than that in the BTZ group, ELE group and the combined group (P<0.05), and the combined group had the lowest apoptosis level. Compared with the control group, the expressions of Caspase-3 and p38 MAPK in BTZ group, ELE group and combination group were significantly increased, while the expression of Bcl-2 was significantly decreased. The apoptosis level and expression of ROS in BTZ group, ELE group and the combined group was significantly increased compared with the control group (P<0.05). CONCLUSION: ELE can enhance the role of BTZ in promoting apoptosis of myeloma cells, which may be achieved by regulating ROS/NF-κB/p38 MAPK signaling pathway to enhance the level of apoptosis of tumor cells to achieve anti-tumor effect.

Objective:To explore the method of constructing an early mortality risk prediction model for patients with sepsis-induced cardiorenal syndrome by machine learning algorithm, so as to provide a basis for early clinical identification of high-risk patients and accurate treatment.Methods:Patients with sepsis-induced cardiorenal syndrome from January 1, 2015 to May 31, 2019 in Tongji Hospital, Tongji University were enrolled. Basic characteristics, laboratory indexes, hospitality treatment and other relevant baseline data were collected. Thirty-day mortality was defined as the primary end-point event after the enrolled patients were diagnosed. Python software was applied to establish different machine learning models, and the area under the receiver -operating characteristic curve ( AUC) was used to evaluate the predictive value of models. Disease-related risk factors were selected according to the most optimal model. Importantly, visualized decision tree and semi-naive Bayesian (sNB) models were established to further explore the interrelationship between these risk factors. Results:A total of 340 patients were included, of whom 114 patients (33.5%) died within 30 days after diagnosis. The AUC of support vector machine (SVM), random forest (RF), gradient boosting decision tree (GBDT), extreme gradient boosting (XGBoost), and light gradient boosting machine (LGBM) prediction models were 0.652, 0.868, 0.870, 0.754, and 0.852, respectively. The AUC of GBDT model had the most efficiency to predict end-point events, and the prediction AUC value was better. According to the feature ranking of GBDT model, the relevant influencing factors were selected, including total sequential organ failure assessment (SOFA) score, neural SOFA score, vasoactive drug application, cardiac troponin I (cTNI), age, myoglobin, circulation system SOFA score, chronic kidney disease, heart rate and baseline serum creatinine. Visualized decision tree model had 4 layers, 15 nodes and 8 terminal nodes as evidenced by total SOFA score, myoglobin, baseline serum creatinine and age. The total SOFA score, change rate of myoglobin, serum creatinine and age were included into the visualized decision model. The AUC value of the model for predicting end-point event was 0.690. sNB model revealed complex correlation between the risk factors, in which neural SOFA score was related to total SOFA score, vasoactive drug application was related to total SOFA score, and cTNI was related to baseline serum creatinine. Conclusions:A risk prediction model for patients with sepsis-induced cardiorenal syndrome is established and the model showes that high SOFA score remains the primary risk factor for patients with sepsis-induced cardiorenal syndrome based machine learning. Visualized decision tree and sNB models help clinicians to further identify the dependence and logic relationship among these risk factors clearly and provide a novel method to predict mortality risk for patients with sepsis-induced cardiorenal syndrome.