Objective To investigate the impact of different lymph node dissection(RLNLN)around the recurrent laryngeal nerve(RLN)on the clinical efficacy of esophagectomy(EC)with thoracoscopic radical surgery.Methods Ninety-eight EC patients were selected from 2022-01 to 2022-10 in our hospital and divided into the control group and the study group,each with 49 cases,using simple randomization method.Both groups underwent EC thoracoscopic radical surgery,with conventional RLNLN clearance in the control group and modified RLNLN clearance in the study group.The operation and postoperative recovery of the two groups were compared,as well as myeloid triggered receptor-1(TREM-1),tumor necrosis factor receptor-associated protein-1(TRAP1),and complications before and after the operation,and the recurrence rate and survival rate of the two groups were counted at 1 year after the operation.Results The RLNLN dissection time in the study group was(11.93±3.57)minutes,which was shorter than that in the control group(17.15±4.28)minutes.The number of RLNLN dissections on both sides was(7.19±1.24),which was higher than that in the control group(5.56±1.10),and the differences were statistically significant(P＜0.05).Three and seven days after surgery,the CD3+,CD4+/CD8+of the study group were higher than those of the control group,while CRP,PCT,TREM-1,and TRAP1 were lower than those of the control group,and the differences were statistically significant(P＜0.05).The postoperative complication and recurrence rates in the study group were 4.08％(2/49)and 10.87％(5/46),respectively,which were lower than the control group[18.37％(9/44),29.55％(13/44)].Conclusion Thoracoscopic radical resection of esophageal cancer with modified RLNLN dissection can can enhance the effect of lymph node clearance,down-regulate the expression of TREM-1 and TRAP1,reduce the inflammatory response of the body,regulate the immune function,reduce the risk of complications and recurrence,and improve the quality of life.

Objective To investigate the impact of different lymph node dissection(RLNLN)around the recurrent laryngeal nerve(RLN)on the clinical efficacy of esophagectomy(EC)with thoracoscopic radical surgery.Methods Ninety-eight EC patients were selected from 2022-01 to 2022-10 in our hospital and divided into the control group and the study group,each with 49 cases,using simple randomization method.Both groups underwent EC thoracoscopic radical surgery,with conventional RLNLN clearance in the control group and modified RLNLN clearance in the study group.The operation and postoperative recovery of the two groups were compared,as well as myeloid triggered receptor-1(TREM-1),tumor necrosis factor receptor-associated protein-1(TRAP1),and complications before and after the operation,and the recurrence rate and survival rate of the two groups were counted at 1 year after the operation.Results The RLNLN dissection time in the study group was(11.93±3.57)minutes,which was shorter than that in the control group(17.15±4.28)minutes.The number of RLNLN dissections on both sides was(7.19±1.24),which was higher than that in the control group(5.56±1.10),and the differences were statistically significant(P＜0.05).Three and seven days after surgery,the CD3+,CD4+/CD8+of the study group were higher than those of the control group,while CRP,PCT,TREM-1,and TRAP1 were lower than those of the control group,and the differences were statistically significant(P＜0.05).The postoperative complication and recurrence rates in the study group were 4.08％(2/49)and 10.87％(5/46),respectively,which were lower than the control group[18.37％(9/44),29.55％(13/44)].Conclusion Thoracoscopic radical resection of esophageal cancer with modified RLNLN dissection can can enhance the effect of lymph node clearance,down-regulate the expression of TREM-1 and TRAP1,reduce the inflammatory response of the body,regulate the immune function,reduce the risk of complications and recurrence,and improve the quality of life.

Nucleotide-binding oligomerization domain 1 (NOD1), a cytosolic pattern recognition receptor protein, plays a crucial role in innate immune responses. However, the functional expression of NOD1 in mesenchymal stem cells (MSCs) derived from endometriosis remains unclear. The aim of this study was to explore the functions of NOD1 in ectopic endometrial lesions. Tissues and MSCs were isolated from both normal endometrium and endometriosis.Immunohistochemistry and real time quantitative polymerase chain reaction (RT-qPCR) were used to determine the expression of NOD1 in the tissues/MSCs. Quantification of various cytokines was performed using RT-qPCR and enzyme-linked immunosorbent assay. To confirm the proliferation, invasion/migration, and apoptotic viabilities of the samples, Cell Counting Kit-8, clonogenic formation, transwell assays, and apoptotic experiments were conducted.Higher levels of NOD1 expression were detected in the ectopic-MSCs obtained from endometriosis compared to those from the endometrium. The expression of interleukin-8 was higher in the ectopic-MSCs than in the eutopic-MSCs.Pretreatment with NOD1 agonist significantly enhanced the proliferation and invasion/migration of eutopic-MSCs.Additionally, the NOD1 inhibitor ML-130 significantly reduced the proliferation, clone formation, invasion, and migration abilities of the ectopic-MSCs, having no effect on their apoptosis capacity. Our findings suggest that the expression of NOD1 in ectopic-MSCs may contribute to the progression of ectopic endometrial lesions.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

Objective:To assess the prognostic impact of frailty on elderly inpatients with heart failure.Methods:This prospective cohort study enrolled 121 in elderly patients with heart failure from Beijing Hospital, the General Hospital of the People's Liberation Army, and Beijing Tsinghua Changgung Hospital between September 2018 and April 2019.Patients were assessed for frailty using the Fried frailty phenotype and categorized into frail and non-frail groups.Follow-ups were conducted at 3-, 6-, and 12-months post-enrollment through clinic visits or phone calls to record adverse events.Composite endpoints include all-cause mortality and rehospitalization duo to deterioration of heart failure.Results:The study included 121 patients with an average age of 78.0±7.4 years, of whom 71(58.7%)were male and 57(47.1%)were classified as frail.Compared to the non-frail group, the frail group had lower estimated glomerular filtration rates[49.5±20.7 ml/(min·1.73m 2) vs.(64.0±27.1)ml/(min·1.73m 2)], lower scores in Basic Activities of Daily Living[5.0(4.0, 6.0) vs.6.0(5.0, 6.0)], Instrumental Activities of Daily Living[2.0(1.3, 7.8) vs.7.0(5.0, 8.0)], and Mini-Mental State Examination[26.0(16.0, 28.0) vs.27.0(22.3, 29.0)], all P<0.05.They also experienced longer hospital stays[10.5(6.0, 18.8)days vs.8.0(6.0, 11.8)days, P=0.008].During the follow-up period, the incidence of composite endpoint events was significantly higher in the frail group(43.9% vs.25.0%, P=0.029).Kaplan-Meier survival analysis demonstrated that the one-year incidence of composite endpoint events was significantly higher in the frail group( P=0.013).Multivariable Cox regression analysisindicated that frailty was an independent risk factor for composite endpoint events( HR=2.201, 95% CI: 1.089-4.447, P=0.028). Conclusions:Frailty is an independent risk factor for poor outcomes in elderly hospitalized patients with heart failure and should be considered a crucial factor in clinical assessment and treatment strategies.

Objective To explore the mechanism of diabetic kidney disease(DKD)with Qigui Didang Decoction.Methods Using network pharmacology,the potential components and targets of Qigui Didang Decoction for DKD were obtained.The docking mode between the core target and key components was simulated with molecular docking technology.Finally,the effect of Qigui Didang Decoction on db/db mice was observed,and the mechanism of DKD improvement was verified from the level of in vivo experiment.Results 117 potential active ingredients,427 drug targets,and 2151 disease targets were obtained.KEGG enrichment analysis of 183 intersection targets revealed that the phosphatidylinositol 3 kinase(PI3K)/protein kinase B(PKB/Akt)signaling pathway may be one of the action pathways.Molecular docking revealed that AKT1 and TNF had strong binding forces with hederagenin,stigmasterol,and beta-sitosterol.In vivo,studies have shown that Qigui Didang Decoction improves the general conditions,renal function,blood glucose,and lipid levels in db/db mice,reverses kidney injury and necrosis,and significantly downregulates the protein expression of PI3K,p-Akt,and tumor necrosis factor-α(TNF-α)in db/db mice.Conclusion Qigui Didang Decoction plays a role in regulating glucose and lipid metabolism and inflammation,and promoting the activation of the PI3K/Akt signaling pathway may be an important mechanism.

Objective To explore the mechanism of diabetic kidney disease(DKD)with Qigui Didang Decoction.Methods Using network pharmacology,the potential components and targets of Qigui Didang Decoction for DKD were obtained.The docking mode between the core target and key components was simulated with molecular docking technology.Finally,the effect of Qigui Didang Decoction on db/db mice was observed,and the mechanism of DKD improvement was verified from the level of in vivo experiment.Results 117 potential active ingredients,427 drug targets,and 2151 disease targets were obtained.KEGG enrichment analysis of 183 intersection targets revealed that the phosphatidylinositol 3 kinase(PI3K)/protein kinase B(PKB/Akt)signaling pathway may be one of the action pathways.Molecular docking revealed that AKT1 and TNF had strong binding forces with hederagenin,stigmasterol,and beta-sitosterol.In vivo,studies have shown that Qigui Didang Decoction improves the general conditions,renal function,blood glucose,and lipid levels in db/db mice,reverses kidney injury and necrosis,and significantly downregulates the protein expression of PI3K,p-Akt,and tumor necrosis factor-α(TNF-α)in db/db mice.Conclusion Qigui Didang Decoction plays a role in regulating glucose and lipid metabolism and inflammation,and promoting the activation of the PI3K/Akt signaling pathway may be an important mechanism.

The incidence of augmented renal clearance (ARC) in intensive care patients (ICU) is exceptionally high, and these patients are often co-morbid with infection. The occurrence of ARC will significantly increase the clearance rate of antibiotics, making it difficult for conventional doses to reach effective therapeutic concentrations and affect the patient's anti-infective treatment effect and prognosis. It can be seen that it is crucial to formulate a reasonable dosing regimen for ICU patients with ARC. Regrettably, few reports in China about the adjustment strategy of antibiotic dosing regimens for ARC patients. Therefore, this article reviews the domestic and foreign literature for reference to provide evidence for medical personnel to adjust the dose of antibacterial drugs for such patients.

Viruses, the smallest microorganisms, continue to present an escalating threat to human health, being the leading cause of mortality worldwide. Over the decades, although significant progress has been made in the development of therapies and vaccines against viral diseases, the need for effective antiviral interventions remains urgent. This urgency stems from the lack of effective vaccines, the severe side effects associated with current drugs, and the emergence of drug-resistant viral strains. Natural plants, particularly traditionally-used herbs, are often considered an excellent source of medicinal drugs with potent antiviral efficacy, as well as a substantial safety profile. Scutellaria baicalensis, a traditional Chinese medicine, has garnered considerable attention due to its extensive investigation across diverse therapeutic areas and its demonstrated efficacy in both preclinical and clinical trials. In this review, we mainly focused on the potential antiviral activities of ingredients in Scutellaria baicalensis, shedding light on their underlying mechanisms of action and therapeutic applications in the treatment of viral infections.
Humans ; Antiviral Agents/therapeutic use* ; Scutellaria baicalensis ; Virus Diseases/drug therapy* ; Medicine, Chinese Traditional

Objective:To explore the surgical methods and treatment effects of adult anterior dislocation of the sacroiliac joint (AADSJ).Methods:A multi-center retrospective case series study was conducted to analyze the clinical data of 25 cases admitted in 5 clinical centers (affiliations of authors in this article) from January 2016 to January 2021. There were 18 males and 7 females, aged 38.8±15.5 years (range, 18-83 years). The AADSJ clinical classification system was formulated based on the radiographic morphology of anterior dislocation of the sacroiliac joint, which includes two types. Type I: complete anterior dislocation of the sacroiliac joint, and displacement of the entire iliac auricular surface to the front of the sacrum. Type II: fracture of the sacroiliac joint combined with anterior dislocation, subdivided into 3 subtypes. Type IIa: iliac fracture involves the anterior 1/3 of the sacroiliac joint, and dislocation of the ilium anterior to the sacrum. Type IIb: iliac fracture involves the posterior 2/3 of the sacroiliac joint, and dislocation of the ilium anterior to the sacrum. Type IIc: iliac fracture involves the posterior 2/3 of the sacroiliac joint, and dislocation of the ilium anteromedial to the sacrum. The reliability and repeatability of the clinical classification, Tile classification and Young-Burgess classification were performed based on the results of two-phase assessments in four observers. The operations were performed by the lateral-rectus approach and the ilioinguinal approach. The operation time and intraoperative bleeding were recorded. Pelvic X-ray and CT scan were rechecked after the operation. The quality of fracture reduction was evaluated according to Matta score. The postoperative functional rehabilitation was evaluated according to the Majeed rehabilitation standard at one-year follow-up.Results:Among 25 cases in this study, there were 3 cases of Type I, 5 cases of Type IIa, 9 cases of Type IIb and 8 cases of Type IIc according to the clinical classification system. The Kappa values of reliability tests for the clinical classification, Tile classification and Young-Burgess classification were 0.681, 0.328 and 0.383, respectively. The Kappa values of repeatability tests for the clinical classification, Tile classification and Young-Burgess classification were 0.690, 0.221 and 0.395, respectively. The reliability and repeatability of the AADSJ clinical classification were significantly better than other classifications. There were 14 cases underwent lateral rectus abdominis approach and 11 cases underwent ilioinguinal approach. The operative time for managing anterior dislocation of the sacroiliac joint was 122.0±50.7 min (range, 65-148 min) through the lateral rectus abdominis approach, and through the ilioinguinal approach was 178.0±49.9 min (range, 110-270 min), with a significant difference ( t=2.76, P=0.011). The amount of intraoperative blood loss through the lateral rectus approach was 680±330 ml (range, 350-2,120 ml), which was significantly less than that through the ilioinguinal approach (1,660±968 ml, 680-3,300 ml), with a significant difference ( t=3.55, P=0.002). The follow-up period was 1-3 years. At one week after surgery, the quality of fracture reduction evaluated by Matta score showed that the excellent and good reduction rate of the lateral-rectus approach was 79% (11/14), and that of the ilioinguinal approach was 73% (11/14), with no statistically significant difference ( P=1.000). At a one-year follow-up, according to Majeed's criteria, the overall excellent and good rate of the lateral-rectus approach was 64% (9/14), which is similar to 64% (7/11) of that of the ilioinguinal approach. No fracture reduction loss or internal fixation loosening failure occurred. Conclusion:The AADSJ clinical classification system can accurately describe the imaging features and clinical manifestations of AADSJ, with high reliability and repeatability. The AADSJ can be treated by the lateral-rectus approach or the ilioinguinal approach, with similar therapeutic effects but the former having less trauma.