This study investigated the protective effect of arbutin(Arb) in yam on lipopolysaccharide(LPS)-induced acute lung injury(ALI) in a mouse model and revealed its possible mechanism of action by metabolomics technology, providing a theoretical basis for clinical treatment of ALI. SPF BALB/c mice were randomly divided into normal control group, model group, resveratrol(Rv)-positive control group, Arb low-dose(15 mg·kg~(-1)) group, and Arb high-dose(30 mg·kg~(-1)) group. The LPS-induced ALI model was established in all groups except the normal control group. Hematoxylin-eosin(HE) staining, TUNEL staining, and WBP whole-body non-invasive pulmonary function testing were used to evaluate the degree of lung tissue damage and lung function changes. Enzyme-linked immunosorbent assay(ELISA) was used to detect the level of inflammatory factors in lung tissue. Flow cytometry was used to analyze the M1/M2 polarization status of macrophages in lung tissue. Western blot was used to detect the expression levels of the TLR4 signaling pathway and related apoptotic proteins. Liquid chromatograph-mass spectrometer(LC-MS) metabolomics was used to analyze the changes in serum metabolic profile after Arb intervention. The results showed that Arb pretreatment significantly alleviated LPS-induced lung tissue injury, improved lung function, reduced the levels of pro-inflammatory factors(IL-6, TNF-α, IL-18, and IL-1β), and regulated the polarization status of M1/M2 macrophages. In addition, Arb inhibited the activation of the TLR4 signaling pathway, reduced the expression of pro-apoptotic proteins such as Bax, caspase-3, and caspase-9, up-regulated the level of Bcl-2 protein, and inhibited apoptosis of lung cells. Metabolomic analysis showed that Arb significantly improved LPS-induced metabolic abnormalities, mainly involving key pathways such as galactose metabolism, phenylalanine metabolism, and lipid metabolism. In summary, Arb can significantly reduce LPS-induced ALI by regulating the release of inflammatory factors, inhibiting the activation of the TLR4 signaling pathway, improving metabolic disorders, and regulating macrophage polarization, indicating that Arb has potential clinical application value.
Animals ; Acute Lung Injury/chemically induced* ; Mice ; Mice, Inbred BALB C ; Arbutin/administration & dosage* ; Male ; Toll-Like Receptor 4/immunology* ; Apoptosis/drug effects* ; Lung/metabolism* ; Signal Transduction/drug effects* ; Protective Agents/administration & dosage* ; Humans ; Macrophages/immunology* ; Drugs, Chinese Herbal/administration & dosage*

Among numerous medical imaging modalities, diffusion weighted imaging (DWI) is extremely sensitive to acute ischemic stroke lesions, especially small infarcts. However, magnetic resonance imaging is time-consuming and expensive, and it is also prone to interference from metal implants. Therefore, the aim of this study is to design a medical image synthesis method based on generative adversarial network, Stroke-p2pHD, for synthesizing DWI images from computed tomography (CT). Stroke-p2pHD consisted of a generator that effectively fused local image features and global context information (Global_to_Local) and a multi-scale discriminator (M ²Dis). Specifically, in the Global_to_Local generator, a fully convolutional Transformer (FCT) and a local attention module (LAM) were integrated to achieve the synthesis of detailed information such as textures and lesions in DWI images. In the M ²Dis discriminator, a multi-scale convolutional network was adopted to perform the discrimination function of the input images. Meanwhile, an optimization balance with the Global_to_Local generator was ensured and the consistency of features in each layer of the M ²Dis discriminator was constrained. In this study, the public Acute Ischemic Stroke Dataset (AISD) and the acute cerebral infarction dataset from Yantaishan Hospital were used to verify the performance of the Stroke-p2pHD model in synthesizing DWI based on CT. Compared with other methods, the Stroke-p2pHD model showed excellent quantitative results (mean-square error = 0.008, peak signal-to-noise ratio = 23.766, structural similarity = 0.743). At the same time, relevant experimental analyses such as computational efficiency verify that the Stroke-p2pHD model has great potential for clinical applications.
Humans ; Tomography, X-Ray Computed/methods* ; Diffusion Magnetic Resonance Imaging/methods* ; Cerebral Infarction/diagnostic imaging* ; Stroke/diagnostic imaging* ; Neural Networks, Computer ; Image Processing, Computer-Assisted/methods* ; Algorithms

Objective To evaluate the baseline characteristics and short-term safety of lecanemab in treatment of Alzheimer's disease(AD)in Chinese patients in a real-world study.Methods A mul-ticenter,retrospective,observational study was conducted on 646 AD patients who were continu-ously recruited and receved of lecanemab therapy in 84 medical centers from June 26,2024 to March 1,2025.Their clinical data,including baseline Mini-mental state examination(MMSE)score and clinical dementia rating(CDR)score before and after treatment,were collected,and the CDR-global score(CDR-GS)and CDR-sum of box score were calculated.The incidences of infu-sion-related reactions(IRR)and amyloid-related imaging abnormalities(ARIA),including ARIA with edema and effusion(ARIA-E)and ARIA with hemosiderin deposit(ARIA-H)within 3 months of treatment were observed and recorded.Apolipoprotein E(ApoE)genetic test was per-formed on 454 patients.Baseline characteristics and short-term safety of the patients were ana-lyzed.Results There were 301 patients(46.59％)having a baseline CDR-GS score of 0.5 and 345(53.41％)patients had a CDR score of 1.In the 454 patients receiving genetic test,the ApoEε4 carriers accounted for 31.27％(202 cases),including 17 cases of ApoEε4 homozygous carriers(8.42％).The incidence of IRR was 4.95％(32/646),which mainly occurred during the first infu-sion(90.63％,29/32),and there were 96.88％(31/32)of mild and 3.13％(1/32)of moderate IRR,with main manifestations of fever,dizziness,vomiting,etc.Sixteen patients(2.48％)experienced ARIA,including 5(31.25％)ARIA-E,10(62.50％)ARIA-H,and 1(6.25％)ARIA-E and ARIA-H.For the 5 patients with ARIA-E,2 were symptomatic,and in terms of radiographic severity,3 cases were mild and 2 cases were moderate ARIA-E.In the 10 patients with ARIA-H,all of them had no clinical symptoms,and in terms of radiographic severity,6 had mild and 4 had moderate ARIA-H.Among the 17 ApoEε4 homozygous patients,only one patient(5.88％)experi-enced ARIA-H with a moderate radiographic severity.Multivariate analysis showed that age in-creased the trend of ARIA risk,but no statistical difference was observed(P=0.056).Conclusion In this real-world study in China,AD patients receiving lecanemab treatment have the characteris-tics of being younger in age but higher disease severity.Short-term follow-up data suggest that lecanemab has good safety.

Objective:To investigate the factors affecting the efficacy of 131I treatment for Graves′ disease (GD) and to construct a predictive model for the treatment outcomes of 131I therapy. Methods:Retrospective analysis of the treatment efficacy was performed on 2 190 patients (547 males, 1 643 females, age (42.9±12.4) years) with GD, who received initial 131I treatment in Tianjin Medical University General Hospital between October 2013 and May 2018. Univariate analysis ( χ2 test, et al) and logistic regression were performed to analyze the possible factors affecting the efficacy of 131I treatment. An efficacy prediction model for 131I treatment of GD was constructed, and decision curve analysis (DCA) was used to evaluate the clinical utility of the prediction model. Results:The overall effectiveness rate of 131I treatment for GD patients was 99.95%(2 189/2 190), with a total cure rate of 83.74%(1 834/2 190), among which 94.11%(1 726/1 834) were cured after a single treatment. Pre-treatment thyroid mass was identified as an independent risk factor affecting the efficacy of initial 131I treatment (odds ratio ( OR)=0.983(95% CI: 0.977-0.989), P<0.001). The clinical cure rate was higher in patients who received an adequate dose of 131I compared with that in patients who didn′t receive an adequate dose (79.97%(1 537/1 922) vs 70.52%(189/268); χ2=12.57, P<0.001), but it did not increase the incidence of hypothyroidism within one year. A predictive model was constructed, and it was found that thyroid mass and disease duration had a relatively high impact on the clinical cure rate. The concordance index (C-index) of the predictive model was 0.623(95% CI: 0.593-0.654). DCA indicated that the predictive model offered substantial net benefits across a wide range of probability thresholds. Conclusions:131I treatment is effective in most patients with GD. The predictive model for efficacy of initial 131I treatment developed in this study can assist in evaluating treatment outcomes and help clinicians select the most suitable 131I treatment dose, enhancing clinical decision-making.

Traditional Chinese Medicine (TCM), as a treasure of the Chinese nation, plays a significant role in maintaining public health. In 2019, the Central Committee of the Communist Party of China and the State Council proposed for the first time the establishment of a TCM registration and evaluation evidence system that integrates TCM theory, "personal experience" and clinical trials (referred to as the "Three-in-One" System) to promote the inheritance and innovation of TCM. Subsequently, the National Medical Products Administration issued several guiding principles to advance the improvement and implementation of this system. Owing to the complexity of its implementation, there are still differing understandings within the TCM industry regarding the positioning of the "Three-in-One" Registration and Evaluation Evidence System, as well as the connotation and value orientation of the "personal experience." To address this, Academician WANG Qi, President of the TCM Association, China International Exchange and Promotion Association for Medical and Healthcare and TCM master, led a group of academicians, TCM masters, TCM pharmacology experts and clinical TCM experts to convene a "Seminar on Promoting the Implementation of the ′Three-in-One′ Registration and Evaluation Evidence System for Chinese Medicinals." Through extensive discussions, an expert consensus was formed, clarifying the different roles of the TCM theory, "personal experience" and clinical trials within the system. It was further emphasized that the "personal experience" is the core of this system, and its data should be derived from clinical practice scenarios. In the future, the improvement of this system will require collaborative efforts across multiple fields to promote the high-quality development of the Chinese medicinal industry.

This study aims to investigate the scientificity and efficacy of the compatibility of Jinlingzi San from pharmacokinetics. Liquid chromatography-tandem mass spectrometry(LC-MS/MS) was utilized to determine the plasma concentrations of the active components: toosendanin, tetrahydropalmatine A, and tetrahydropalmatine B at various time points following the gavage of Jinlingzi San and its single medicines in rats. Subsequently, WinNonlin was employed to calculate pertinent pharmacokinetic parameters. The pharmacokinetic parameters in rat plasma were compared between the single medicines and the compound formula of Jinlingzi San. It was discovered that the area under the curve(AUC_(all)) and peak concentrations(C_(max)) of tetrahydropalmatine A, and tetrahydropalmatine B were significantly elevated in the compound formula group compared with the single medicine groups. Conversely, the AUC_(all )and C_(max) of toosendanin notably decreased. Furthermore, the compound formula group had longer mean residence time(MRT) and lower apparent clearance(CL/F) of all three active ingredients than the single medicine groups(P<0.05). These findings indicated that Jinlingzi San enhanced the absorption of tetrahydropalmatine A and tetrahydropalmatine B in vivo, facilitating their pharmacological actions. Concurrently, it inhibited the absorption of toosendanin, thereby preventing potential toxic reactions. Moreover, the compatibility prolonged the residence time of the active ingredients in the body. This study provides a reference for exploring the compatibility rationality of Jinlingzi San.
Animals ; Rats ; Tandem Mass Spectrometry/methods* ; Drugs, Chinese Herbal/administration & dosage* ; Male ; Rats, Sprague-Dawley ; Chromatography, Liquid/methods* ; Berberine Alkaloids/blood* ; Liquid Chromatography-Mass Spectrometry

The chemical composition of Paeoniae Radix Alba(PRA) is complex, with primary secondary metabolites including monoterpenoids, tannins, triterpenoids, and flavonoids. In previous studies on the material basis of PRA, it was found that, in addition to the widely studied characteristic monoterpene glycosides, tannic acid components also play an important role in the efficacy of PRA. However, their pharmacological effects have not been thoroughly investigated. This paper reviews the tannic acid components in PRA, including pentagaloyl glucose(PGG), tetragaloyl glucose(TGG), trigaloyl glucose(TriGG), and gallic acid, along with their structures, properties, and characteristics to provide a detailed discussion of their pharmacological activities and related mechanisms, aiming to offer a theoretical basis for the material basis research and clinical application of PRA.
Paeonia/chemistry* ; Tannins/chemistry* ; Humans ; Drugs, Chinese Herbal/chemistry* ; Animals ; Plant Extracts

Objective To investigate the clinical application of three-dimensional magnetic resonance(MR)visualization in difficult laparoscopic cholecystectomy.Methods A total of 100 patients with gallstones who were admitted to the Second People's Hospital of Shantou from January 2022 to December 2023 were selected as research objects.The patients met the criteria of"difficult gallbladder"and were assigned to two groups according to random number table.The control group(n=50)were treated with routine laparoscopic cholecystectomy.In the observation group(n=50),laparoscopic cholecystectomy was assisted by MR 3D visualization model.Surgical indexes,pain within 1 day after surgery,risk of intraoperative trauma,and incidence of postoperative complications were compared between the two groups.Results Surgical indexes and recovery indexes in the observation group were superior to those in the control group(P<0.05).The visual analogue scale(VAS)score within 1 d after operation was significantly lower than that before operation in both groups,and the improvement of VAS score in the observation group was better than that in the control group(P<0.05).The incidence of gallbladder rupture(0.00%vs 10.00%)and liver margin injury(0.00%vs 8.00%)in the observation group were lower than those in the control group(P<0.05).The incidence of complications in the observation group was significantly lower than that in the control group(2.00%vs 14.00%,P<0.05).Conclusion The construction of MR 3D visualization model can provide clearer surgical field for laparoscopic cholecystectomy,and enable the operator to clarify the anatomical structure of the gallbladder,avoid surgical trauma,improve the postoperative recovery,alleviate postoperative pain,and reduce the risk of complications.

Objective To investigate the effects of scutellarin(SCU)on apoptosis of nucleus pulposus cells and the Janus kinas 2/signal transducer and activator of transcription 3(JAK2/STAT3)signaling pathway in intervertebral disc degeneration(IVDD)model rats.Methods IVDD rats were randomly divided into IVDD group,SCU low and high dose groups(SCU-L,SCU-H groups),SCU high dose+JAK2 activator bispecific protein phosphatase 19(DUSP19)group(SCU-H+DUSP19 group)and control group.Enzyme-linked immunosorbent assay(ELISA)method was applied to detect inflammatory factors and oxidative stress level in intervertebral disc tissues.Eosin stai-ning(HE)staining microscopy was used to observe pathological damage of intervertebral disc tissue.Transferase mediated dUTP notch end labeling(TUNEL)staining microscopy was applied to detect apoptosis of nucleus pulpo-sus cells in intervertebral disc tissue.Western blot was applied to detect the expression of JAK2/STAT3 signaling pathway related proteins.Results Animals in the IVDD group were suffered from partial rupture of the fibrous ring in the intervertebral disc tissue,abnormal shrinkage of the nucleus pulposus structure with reduction of nucleus pul-posus cells and blurred boundary with the fibrous ring.The level of TNF-α,IL-1β,ROS and apoptosis rate of nu-cleus pulposus cells,the expression of Bax,cleaved caspase-3,p-JAK2/JAK2,p-STAT3/STAT3 were all elevated and the expression of SOD,type Ⅱ collagen,and polysaccharides decreased(P＜0.05).The morphology,cell structure,density of fibrous ring and nucleus pulposus in the intervertebral disc tissue of the SCU-L and SCU-H groups were improved as compared to IVDD group.The degeneration was alleviated to varying degrees.The level of TNF-α,IL-1β,ROS,apoptosis rate of nucleus pulposus cells and the expression of Bax,cleaved caspase-3,p-JAK2/JAK2,p-STAT3/STAT3 were all reduced and the expression of SOD,type Ⅱ collagen,and polysaccha-rides significantly increased(P＜0.05).DUSP19 partially reverses the effect of SCU on apoptosis of IVDD rats.Conclusions SCU may alleviate apoptosis of nucleus pulposus cells in IVDD rats.