Acute pancreatitis (AP) is a life-threatening gastrointestinal disorder for which no effective pharmacological treatments are currently available. One of the pharmacological targets that merits further research is the neurokinin 1 receptor (NK1R), which is found on pancreatic acinar cells and responds to the neuropeptide substance P (SP) that participates in AP. Although a few studies have stated the involvement of SP/NK1R in neurogenic inflammation in AP development, the regulatory mechanism remains unclear. In this study, we found that following activation of NK1R by SP, β-arrestin1, a scaffold protein of NK1R, down-regulated transcription of Adss, Adsl, and Ampd in the purine nucleotide cycle, thereby inhibiting mitochondrial function through fumarate depletion. Interestingly, we identified magnolol as a new and natural NK1R inhibitor with a non-nitrogenous biphenyl core structure. It exhibited a beneficial effect on AP by restoring purine nucleotide cycle metabolic enzymes and fumarate levels. Our study not only provides new therapeutic strategies, leading compounds, and drug translation possibilities for AP, but also provides important clues for the study of downstream mechanisms driven by SP in other diseases.

OBJECTIVE: Therapeutic angiogenesis has become a promising approach for treating ischemic heart disease (IHD). The present study aims to investigate the effects of Qishen Granule (QSG) on angiogenesis in myocardial ischemia (MI) and the potential mechanism. METHODS: In vivo study was conducted on rat model of myocardial infarction. QSG was performed daily at a dose of 2.352 g/kg for four weeks. Cardiac function was assessed by echocardiogram and pro-angiogenic effects were evaluated by Laser Doppler and CD31 expression. Oxygen-glucose deprivation (OGD) was applied in cultured human umbilical vein endothelial cells (HUVECs). Cell viability, wound healing and tube formation assay were used to test functions of HUVECs. ELISA and Western blots were used to assess protein expressions of bone morphogenetic protein 2-delta-like 4-notch homolog 1 (BMP2-Dll4-Notch1) signaling pathway. RESULTS: The results showed that QSG improved heart function, cardiac blood flow and microvessel density in myocardial ischemic rats. In vitro, QSG protected HUVECs by promoting the cell viability and tube formation. QSG upregulated bone morphogenetic protein-2 (BMP2) and downregulated delta-like 4 (Dll4) and notch homolog 1 (Notch1) expressions both in rats and HUVECs. CONCLUSION QSG protected against MI by promoting angiogenesis through BMP2-Dll4-Notch1 pathway. BMP2 might be a promising therapeutic target for IHD.

In this paper， the name， origin， producing area， harvesting， processing and functional indications of Arcae Concha were systematically combed and verified by consulting the ancient and modern literature， in order to provide a basis for the development of famous classical formulas containing Arcae Concha. Arcae Concha was first recorded in the name of Han in Bencao Shiyi， but later， due to the influence of LI Shizhen's error of combining Han item with Kuiha in the Ming dynasty， there were aliases such as Kuilu and Fulao， and Yizong Bidu began to include Walengzi as its correct name and has been used ever since. The textual descriptions and illustrations of the medicinal materials of Arcae Concha contained in the materia medica of the past generations were consistent with the modern Arca inflata， A. subcrenata and A. granosa. In ancient times， there were medicinal records of two parts of shell and meat， but now the shell is used as medicine， and the meat is mostly edible. In ancient times， Zhejiang， Shandong， Guangdong and Guangxi were the main producing areas， and Zhejiang was the best. It is now believed that A. inflata is mostly distributed in the northern part of the Huanghai Sea， A. granosa is mostly distributed in the coastal areas south of Shandong Peninsula in China， and A. subcrenata is widely distributed in the coastal areas of China. Its quality is better in a complete， white， no residual meat and sand. In ancient times， there was no clear harvesting period， and the processing was mainly based on vinegar quenching after calcination or powdering of calcined shell， but now the harvesting period is autumn and winter. After harvesting， it is directly washed and crushed for raw use or processed by calcined method. The records of the medicinal materials in the past dynasties on the properties of Arcae Concha were mainly warm， sweet， salty and mild， and it is now believed that Arcae Concha is salty in taste and mild in nature. In ancient times， it was believed that Arcae Concha were mainly used for coldness in the heart and abdomen， coldness in the waist and spine， benefiting the five internal organs， strengthening the stomach. Nowadays， it is believed that Arcae Concha can eliminate phlegm and remove blood stasis， soften the hardness and dissipate the lumps， produce acid and relieve pain. It can be used in the treatment of stubborn phlegm， gall tumor， scrofula and other symptoms. In conclusion， it is suggested that for the famous classical formulas containing Arcae Concha， the corresponding methods should be selected according to the processing requirements of the drug in the formulas， while those without processing requirements can be determined according to the functional position of the products.

Objective:To retrieve and evaluate the best evidence on the nutrition management of patients with cancer-related sarcopenia at domestic and abroad, and summarize it, so as to provide a basis for medical staff to carry out relevant practices.Methods:Systematically search Chinese and English databases, guidelines, and academic websites such as China national knowledge infrastructure, Wanfang Database, PubMed, Web of Science, with evidence retrieval up to April 30, 2024. The evidence was summarized by 2 researchers.Results:A total of 13 articles were included: 3 guides, 5 expert consensus, 3 systematic evaluations, 2 evidence summaries. 21 pieces of evidence were summarized in 7 categories: establish diagnosis of sarcopenia, multidisciplinary team, nutrition support methods, nutrient selection, dynamic monitoring, related symptom management and outpatient nutrition management.Conclusions:The best evidence for nutritional management of patients with cancer related sarcopenia is rigorous and scientific. Medical staff can carefully select the best evidence based on specific clinical scenarios to formulate relevant management strategies, improve the nutritional status of patients.

Objective:To retrieve and evaluate the best evidence on the nutrition management of patients with cancer-related sarcopenia at domestic and abroad, and summarize it, so as to provide a basis for medical staff to carry out relevant practices.Methods:Systematically search Chinese and English databases, guidelines, and academic websites such as China national knowledge infrastructure, Wanfang Database, PubMed, Web of Science, with evidence retrieval up to April 30, 2024. The evidence was summarized by 2 researchers.Results:A total of 13 articles were included: 3 guides, 5 expert consensus, 3 systematic evaluations, 2 evidence summaries. 21 pieces of evidence were summarized in 7 categories: establish diagnosis of sarcopenia, multidisciplinary team, nutrition support methods, nutrient selection, dynamic monitoring, related symptom management and outpatient nutrition management.Conclusions:The best evidence for nutritional management of patients with cancer related sarcopenia is rigorous and scientific. Medical staff can carefully select the best evidence based on specific clinical scenarios to formulate relevant management strategies, improve the nutritional status of patients.

Objective·To investigate the changes of adipose tissues in mice after high-fat diet before and during pregnancy and the potential effects on adipose tissues in their offspring.Methods·C57BL/6J female mice were randomly assigned to the normal diet(CON group,n=12)or the high-fat diet(HFD group,n=12)for 5 weeks.The two groups were further subdivided according to pregnancy:a normal diet non-pregnancy group(CON-UN group),a normal diet pregnancy group(CON-P group),a high-fat diet non-pregnancy group(HFD-UN group),and a high-fat diet pregnancy group(HFD-P group).The original diet was maintained during pregnancy and lactation.White adipose tissues(WAT)and brown adipose tissues(BAT)were collected from visceral and scapula of mice after 5 weeks of feeding or E18.5d.Offspring from both dietary groups were placed on a normal diet after weaning,and their adipose tissues were collected at the 11th week.H-E staining was used to observe the changes of adipocytes.Flow cytometry was employed to detect the proportions of CD4+T cells,CD8+T cells,total T cells,CD4+T/CD8+T and NK cells in WAT.RT-PCR was used to assess the expression of IL-6 and IL-1β mRNA in WAT.Results·After 5 weeks on a high-fat diet,the body weight of female mice in the HFD group was higher than that in the CON group(P<0.05).Both WAT and BAT weights were markedly increased in the HFD groups before and during pregnancy(both P<0.05).In the WAT from HFD-UN and HFD-P groups,the number of cells within the same visual field decreased,the size of adipose cells varied,the proportion of fat droplets increased and the cell volume expanded.The proportion of lipid drop area to total visual field in the HFD-UN group and HFD-P group was compared with the CON-UN group and CON-P group,respectively,and the difference was statistically significant(all P<0.05).BAT in the HFD-UN and HFD-P groups showed a relatively chaotic arrangement and varying adipocyte sizes,although cell volume remained unchanged.The proportions of CD8+T cells and total T cells in adipose tissues were elevated in the HFD-UN and HFD-P groups,accompanied by increased mRNA levels of IL-6 and IL-1β,respectively,compared with the CON-UN and CON-P groups,and the differences were statistically significant(all P<0.05).NK cells proportions decreased at reproductive age(HFD-UN group)but increased significantly during pregnancy(HFD-P group),showing a divergent trend.Despite a return to a normal diet after weaning,offspring from the high-fat diet group had significantly higher weight of body,WAT and BAT,compared to those of normal diet(all P<0.05),and the volume of WAT was significantly enlarged.Conclusion·A high-fat diet can induce the changes of adipocyte structure and immune cell ratio,and elevate inflammation levels in adipose tissues before and during pregnancy,which also impacts the adipose structure in offspring.Adipose tissue may be a new vector mediating the intergenerational transmission of obesity.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species (excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.

Objective To observe the efficacy and safety of ultrasound-guided musculocutaneous nerve(MCN)block anesthesia in alleviating operative pain during percutaneous transluminal angioplasty(PTA)for hemodialysis internal fistula.Methods A total of 112 patients undergoing internal fistula PTA in the hemodi-alysis center of the nephrologic department of the Second Affiliated Hospital of Army Military Medical Uni-versity from February 2022 to February 2023 were selected.Among them,47 patients applied the ultrasound-guided MCN block anesthesia(MCN block group)and other 65 patients adopted perivascular local infiltration anesthesia in the injured blood vessel section(local anesthesia group).Anesthesia was independently operated by the vascular access doctor.The VAS score,analgesic satisfaction investigation and motor block evaluation were compared between the two groups,and the efficacy and safety of MCN block anesthesia were under-stood.Results The proportion of the patients with motor block score grade 1 in the MCN block group was the highest(93.6％),and there were no patients with the grade ≥3.The proportion of the patients with the VAS score(4-6)points in the local anesthesia group was the highest(52.3％),while the proportion of the patients with the VAS score(1-3)points in the MCN block group was the highest(76.6％);the proportions of(1-3)points,(4-6)points,(7-10)points and the patients with additional anesthesia had statistical differences between the MCN block group and local anesthesia group(P＜0.05).The satisfaction degree of postoperative analgesia in the local anesthesia group was 55.4％,which was lower than 85.1％in the MCN block group,and the difference was statistically significant(P＜0.05).Conclusion The upper arm MCN block anesthesia could effectively relief the operative pain in arteriovenous internal fistula PTA,and is an effective anesthesia method suitable for the independent operation of hemodialysis channel surgeons.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species (excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.

By reviewing the ancient materia medica， medical books and modern literature， this paper made a systematic textual research on Haliotidis Concha in famous classical formulas， including the name， origin， producing area， quality evaluation， harvesting and processing， in order to provide a basis for the development of famous classical formulas containing Haliotidis Concha. The textual research showed that Shijueming was the official name of Haliotidis Concha in past dynasties， and there were also aliases such as Qianliguang， Jiukongluo and Zhenzhumu named after its efficacy， properties and near-phonetic characters. Before the Tang dynasty， the original description of Haliotidis Concha was too concise， which could only be identified as the animal of genus Haliotis， family Haliotidae. During the Song， Yuan， Ming and Qing dynasties， the main varieties were H. diversicolor and H. discus hannai. At the beginning of the Republic of China， a variety of animals from genus Haliotis were used as Haliotidis Concha， and varieties were numerous and continued to this day. In ancient and modern times， the main producing areas in China are Hainan， Guangdong and Shandong， while the foreign producing areas are mainly Japan and Vietnam. The quality evaluation of Haliotidis Concha in ancient books was roughly determined by the number of openings of the expiratory orifice， and seven-hole and nine-hole abalone shells were preferred. In modern times， characters as big， neat， unbroken， clean inside and outside， lustrous， thick shells are preferred. Based on the textual research results and combined with the record years of the Shijueming San， it is suggested that the shells of H. diversicolor or H. discus hannai should be used in the development of this formula， and the raw products should be used as medicine.