OBJECTIVE To optimize the preparation of Xiakucao Kaiyin Granules(XKG)and control the quality of its intermedi-ates.METHODS The physical characteristics of spray dry powder of XKG were determined by powder evaluation method,and the physical fingerprint composed of 9 secondary physical quality indexes,such as bulk density,tap density,angle of repose and Hausner ratio,was established to determine the stability of the previous process and the quality consistency of spray dry powder.Taking the parti-cle forming rate,dissolution rate,moisture absorption rate and angle of repose as evaluation indexes,dry granulation was carried out,and the auxiliary materials of XKG were screened.The mixture design experiment combined with G1-entropy weight method and neural network method were used to optimize the proportion of the selected excipients,and the best preparation technology of XKG was deter-mined by comparing the two methods.The physical fingerprint of particles was established to evaluate the consistency of particle quality among different batches.RESULTS The similarity of physical fingerprints of 9 batches of spray dry powder was greater than 0.970,and the physical properties were stable.The comprehensive score of the best proportion of auxiliary materials obtained through the anal-ysis of mixture design was higher than that obtained by neural network modeling and optimization,so it was finally determined that the proportion of medicine and auxiliary materials of XKG was 7:3 and 29%maltodextrin and 71%lactose were added for dry granulation.The similarity of physical fingerprints of five batches of granule was greater than 0.994.CONCLUSION The estab-lished physical fingerprint of intermediates can be used to control the quality process of XKG,and the optimized prescription of XKG can improve the physical properties of granules and improve the consistency of granule quality.

Objective To investigate the preparation and evaluation of animal models of depression associated with autoimmune thyroiditis,and to verify the NLRP3/Caspase-1/GSDMD pathway based on this condition.Methods 32 NOD.H-2H4 mice were randomly divided into a normal(N)group,depression(DP)group,autoimmune thyroiditis with depression(AIT+DP)group,autoimmune thyroiditis(AIT)group,with 8 animals in each group.The N group was fed normally,the DP group was subjected to chronic unpredictable mild stress(CUMS)for 5 weeks,the AIT group was given 0.05％sodium iodide water to establish an autoimmune thyroiditis model,and the AIT+DP group was subjected to 5 weeks of CUMS to establish the AIT animal model.We evaluated whether the mouse autoimmune thyroiditis model had been successfully prepared by observing the thyroid tissue structure,lymphocyte infiltration,and serum TGAb and TPOAb levels.Changes in body weight,sugar water preference rate,open field behavior(central quadrant time,central quadrant time proportion,standing rate,frequency of defecation,and hair grooming time),and hippocampal pathological changes were used to evaluate the depression status of the mice.When the model mice met the above-mentioned indicators related to depression and autoimmune thyroiditis,the AIT+DP animal model was considered successfully prepared.Results Compared with the levels in the N group,the AIT group's and AIT+DP group's serum TGAb and TPOAb levels were significantly increased(P＜0.01),and a large number of inflammatory cells had infiltrated the thyroid gland.The central quadrant time and central quadrant time proportion,standing rate,frequency of defecation,and hair grooming time were reduced to varying degrees in the DP group and AIT+DP group.In addition,the numbers of glial cells in the cerebral cortex increased and neuronal cells decreased,accompanied by some nuclear atrophy,and the expression levels of NLRP3,IL-1β,Caspase-1,and GSDMD-N significantly increased,especially in the AIT+DP group(P＜0.01).Conclusions 0.05％sodium iodide water and CUMS create autoimmune thyroiditis with depression model animals that better simulate the external performance and internal index changes of the diseases.These mice can provide an animal model reference for research into autoimmune thyroiditis with depression.

ObjectiveTo explore the mechanism of Buzhong Yiqitang in ameliorating inflammatory injury in autoimmune thyroiditis (AIT) mice based on the Toll-like receptor 4（TLR4）/nuclear transcription factor-kappa B（NF-κB）/absent in melanoma 2（AIM2）inflammasome signaling pathway. MethodThe 120 genetically susceptible 8-week-old NOD.H-2^h4 mice were selected and randomly divided into control group， model group， low， medium and high dose groups of Buzhong Yiqitang （4.78， 9.56， 19.12 g·kg^-1）， and western medicine group （selenium yeast tablets， 3.033×10^-5 g·kg^-1）. The AIT model mice in each group drank ad libitum 0.05% sodium iodide aqueous solution for 8 weeks to establish the AIT model， and the control group drank ad libitum distilled water. Eight weeks later， the mice in each dosing group were divided into groups and gavage. The swelling of thyroid tissue was observed with the naked eye， and the weight of spleen was weighed. The content of serum inflammatory factors interleukin-1β （IL-1β）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α） was measured by enzyme-linked immunosorbent assay （ELISA）， and Real-time PCR was used to detect the expression of HMGB1， TLR4， AIM2， NF-κB p65，apoptosis-associated speck-like protein（ASC），cysteinyl aspartate-specific protease-1（Caspase-1）， IL-1β mRNA. Western blot was used to detect the expression of high motility group protein 1 （HMGB1）， TLR4， AIM2， NF-κB p65， phosphorylation（p）-NF-κB p65， ASC， Caspase-1， and IL-1β proteins in thyroid tissue， and immunofluorescence staining was used to observe the protein expression of HMGB1， AIM2， and NF-κB p65 in thyroid tissue of mice. ResultCompared with the control group， the thyroid tissue of mice in the model group was significantly swollen， the spleen quality was significantly increased， and the expression of HMGB1， TLR4， NF-κB p65， AIM2， ASC， Caspase-1， IL-1β in thyroid tissue was significantly increased （P<0.01）. Compared with the model group， the swelling of thyroid tissue in mice in each dose group of Buzhong Yiqitang was improved， the quality of spleen was significantly reduced， and the expression of HMGB1， TLR4， AIM2， NF-κB p65， p-NF-κB p65， ASC， Caspase-1， IL-1β in thyroid tissue was significantly reduced （P<0.05， P<0.01）. ConclusionBuzhong Yiqitang can effectively improve the inflammatory injury of AIT， and regulating the abnormal activation of the TLR4/NF-κB/AIM2 inflammasome signal pathway may be one of its intervention mechanisms.

Objective To retrieve,evaluate and summarise the best evidence in management of perioperative hyperglycemia in adult non-diabetic kidney transplant recipients so as to provide a reference for clinical nursing practice.Methods According to the evidence resource pyramid"6S"model,the best clinical practices for perioperative glycemic management in adult non-diabetic kidney transplant patients were retrieved from sources including BMJ Best Practice,UpToDate,Joanna Briggs Institute Evidence-Based Practice Database,World Health Organization,the International Guideline Collaboration Network,the National Institute for Health and Clinical Excellence,the National Guidelines Clearinghouse,Yimaitong,MedSci,Canadian Registered Nurses Association,American Diabetes Association,Canadian Diabetes Association,International Diabetes Federation,Australian Diabetes Society,Chinese Diabetes Society,Chinese Urological Society,Chinese Organ Transplantation Society,Cochrane Library,CINAHL,Web of Science,PubMed,Embase,China National Knowledge Infrastructure(CNKI),VIP,Wanfang Data,and SinoMed.The literature was independently screened and evaluated by two researchers trained in evidence-based methodology,and the evidence was extracted and summarised with expert advices.Results A total of 14 articles were included,comprising 2 clinical decisions,5 guidelines,2 evidence summaries,4 expert consensus and 1 systematic review.A total of 27 pieces of the best evidence were summarised and integrated into 6 topics:evaluation and management,goals for control of blood glucose,blood glucose monitoring,prevention and intervention of hyperglycemia,discharge guidance,diagnosis and intervention of new-onset diabetes after kidney transplant.Conclusion This study summarises the best evidence for perioperative hyperglycemia management in adult non-diabetic kidney transplant recipients.Medical staff may apply the evidence individually in conjunction with the actual clinical situations to standardise the practice criteria.

OBJECTIVE To optimize the preparation of Xiakucao Kaiyin Granules(XKG)and control the quality of its intermedi-ates.METHODS The physical characteristics of spray dry powder of XKG were determined by powder evaluation method,and the physical fingerprint composed of 9 secondary physical quality indexes,such as bulk density,tap density,angle of repose and Hausner ratio,was established to determine the stability of the previous process and the quality consistency of spray dry powder.Taking the parti-cle forming rate,dissolution rate,moisture absorption rate and angle of repose as evaluation indexes,dry granulation was carried out,and the auxiliary materials of XKG were screened.The mixture design experiment combined with G1-entropy weight method and neural network method were used to optimize the proportion of the selected excipients,and the best preparation technology of XKG was deter-mined by comparing the two methods.The physical fingerprint of particles was established to evaluate the consistency of particle quality among different batches.RESULTS The similarity of physical fingerprints of 9 batches of spray dry powder was greater than 0.970,and the physical properties were stable.The comprehensive score of the best proportion of auxiliary materials obtained through the anal-ysis of mixture design was higher than that obtained by neural network modeling and optimization,so it was finally determined that the proportion of medicine and auxiliary materials of XKG was 7:3 and 29%maltodextrin and 71%lactose were added for dry granulation.The similarity of physical fingerprints of five batches of granule was greater than 0.994.CONCLUSION The estab-lished physical fingerprint of intermediates can be used to control the quality process of XKG,and the optimized prescription of XKG can improve the physical properties of granules and improve the consistency of granule quality.

Objective To retrieve,evaluate and summarise the best evidence in management of perioperative hyperglycemia in adult non-diabetic kidney transplant recipients so as to provide a reference for clinical nursing practice.Methods According to the evidence resource pyramid"6S"model,the best clinical practices for perioperative glycemic management in adult non-diabetic kidney transplant patients were retrieved from sources including BMJ Best Practice,UpToDate,Joanna Briggs Institute Evidence-Based Practice Database,World Health Organization,the International Guideline Collaboration Network,the National Institute for Health and Clinical Excellence,the National Guidelines Clearinghouse,Yimaitong,MedSci,Canadian Registered Nurses Association,American Diabetes Association,Canadian Diabetes Association,International Diabetes Federation,Australian Diabetes Society,Chinese Diabetes Society,Chinese Urological Society,Chinese Organ Transplantation Society,Cochrane Library,CINAHL,Web of Science,PubMed,Embase,China National Knowledge Infrastructure(CNKI),VIP,Wanfang Data,and SinoMed.The literature was independently screened and evaluated by two researchers trained in evidence-based methodology,and the evidence was extracted and summarised with expert advices.Results A total of 14 articles were included,comprising 2 clinical decisions,5 guidelines,2 evidence summaries,4 expert consensus and 1 systematic review.A total of 27 pieces of the best evidence were summarised and integrated into 6 topics:evaluation and management,goals for control of blood glucose,blood glucose monitoring,prevention and intervention of hyperglycemia,discharge guidance,diagnosis and intervention of new-onset diabetes after kidney transplant.Conclusion This study summarises the best evidence for perioperative hyperglycemia management in adult non-diabetic kidney transplant recipients.Medical staff may apply the evidence individually in conjunction with the actual clinical situations to standardise the practice criteria.

ObjectiveTo investigate the effect and mechanism of Dahuang Zhechongwan （DHZCW） on adenine-induced renal fibrosis in rats from the perspective of intestinal flora. MethodThirty-six SD rats were randomly divided into a blank group， a model group， and high-， medium- and low-dose DHZCW groups （0.168， 0.084， 0.042 g·kg^-1）， and a pirfenidone group （200 mg·kg^-1）， with 6 rats in each group. Except for those in the blank group， rats in other groups were treated with adenine suspension （250 mg·kg^-1） by gavage for 28 days for renal fibrosis model induction. Subsequently， they received drug intervention for 4 weeks. Urine samples were collected from rats in metabolic cages， and renal function indicators including blood urea nitrogen （BUN）， urea， creatinine （Crea）， cystatin C （Cys C）， and 24-hour urine protein （24 h TP） were measured. Kidney samples were collected and subjected to hematoxylin-eosin （HE） staining and Masson's trichrome staining to observe the pathological changes in rat renal tissues. Western blot was used to detect the expression levels of key effector proteins α-smooth muscle actin （α-SMA）， type Ⅰ collagen （ColⅠ）， and type Ⅲ collagen （ColⅢ） in the kidneys. High-throughput sequencing of 16S rDNA was used to analyze the species diversity of rat intestinal flora. ResultCompared with the blank group， the model group showed increased BUN， urea， Crea， Cys C， and 24 h TP levels （P<0.01）. Compared with the model group， the high-， medium-， and low-dose DHZCW groups， as well as the pirfenidone group， showed significant reductions in BUN， urea， Crea， Cys C， and 24 h TP levels （P<0.01）， indicating that DHZCW intervention significantly improved renal function. In the model group， renal tissues exhibited significant fibrotic changes， and the protein levels of α-SMA， ColⅠ， and ColⅢ were significantly increased （P<0.01） compared to those in the blank group. Compared with the model group， the high-dose DHZCW group and the pirfenidone group had relatively normal tissue structure， with no significant pathological damage observed. However， fibrotic changes were observed in the medium- and low-dose DHZCW groups， with the changes being more significant in the low-dose group. The protein levels of α-SMA， ColⅠ， and ColⅢ were significantly decreased in the high-， medium-， and low-dose DHZCW groups， as well as the pirfenidone group （P<0.01）， indicating that DHZCW effectively reduced abnormal collagen deposition and inhibited renal fibrosis. From the perspective of intestinal flora， at the phylum level， compared with the blank group， the model group showed a significant increase in the abundance of Firmicutes and a decrease in Bacteroidetes， leading to a significant imbalance in their ratio. At the family level， the model group decreased the abundance of Lachnospiraceae， Prevotellaceae， and Bacteroidota_unclassified， and increased the abundance of Ruminococcaceae， Lactobacillaceae， and Oscillospiraceae. At the genus level， the model group showed significantly reduced abundance of Firmicutes_unclassified， Bacteroidota_unclassified， and Prevotellaceae_UCG-001， etc.， and increased abundance of UCG-005， Clostridia_UCG-014_unclassified， etc. Compared with the model group， DHZCW effectively reduced the abundance of potential pathogenic bacteria and increased the abundance of beneficial bacteria， regulating the intestinal flora. ConclusionDHZCW can effectively improve renal function and inhibit renal fibrosis， and its mechanism of action may be related to the regulation of intestinal flora.

Objective:To analyze the expression of endoplasmic reticulum lipid raft-associated protein 2 (ERLIN2) in glioblastoma tissues, and to analyze its correlation with the clinicopathological features and prognosis of patients with glioblastoma.Methods:The TCGA database was used to analyze the expression level of ERLIN2 mRNA in glioblastoma. KM-plotter was used to analyze the correlation between ERLIN2 expression and prognosis in patients with glioblastoma. The expression level of ERLIN2 protein in 78 cases of glioblastoma tissue was determined by immunohistochemical staining, and then the tissue samples were divided into high expression and low expression groups according to the ERLIN2 expression level. The clinical and pathological data of patients were collected, including age, gender, tumor laterality, recurrence, isocitrate dehydrogenase(IDH) mutation, and the correlation between ERLIN2 protein and clinicopathological characteristics was further analyzed.Results:The mRNA of ERLIN2 was significantly overexpressed in glioblastoma, and the overall survival rate of patients with high ERLIN2 expression was low, suggesting a poor prognosis. The results of immunohistochemistry and clinicopathological analysis showed that ERLIN2 protein was significantly overexpressed in glioblastoma, and its expression level was significantly related to tumor recurrence.Conclusions:ERLIN2 protein is significantly overexpressed in glioblastoma tissues, and its expression level is related to the clinicopathological characteristics and poor prognosis, suggesting that ERLIN2 can be used as a potential prognostic factor for glioblastoma.

Objective:To investigate the predictive value of visceral fat area (VFA) on multiple metabolic risk factors in obese patients undergoing bariatric surgery.Methods:The retrospective case-control study was conducted. The clinical data of 146 obese patients undergoing bariatric surgery in the West China Hospital of Sichuan University from June 2015 to May 2020 were collected. There were 57 males and 89 females, aged (33±9)years, with a range from 15 to 65 years. All patients underwent multi-slice spiral computed tomography (CT) examination, and the total fat area (TFA), VFA and subcutaneous fat area (SFA) were measured. Observation indicators: (1) CT findings of abdominal fat area and patients with multiple metabolic risk factors; (2) receiver operator characteristic(ROC) curve of different clinical indicators for predicting multiple metabolic risk factors; (3) relationship between different VFA and clinicopathological features in patients; (4) analysis of factors influencing multiple metabolic risk factors in patients. Measurement data with normal distribution were expressed as Mean± SD, and comparison between groups was analyzed by independent sample t test. Measurement data with skewed distribution were expressed as M (range) and comparison between groups was analyzed by nonparametric rank sum test. Count data were represented as absolute numbers, and comparison between groups was analyzed using the chi-square test. The ROC curve was used to analyze the predictive value of different clinical indicators for multiple metabolic risk factors in patients. Logistic regression analysis was used for univariate and multivariate analysis. Results:(1) CT findings of abdominal fat area and patients with multiple metabolic risk factors. CT findings of 146 patients showed that VFA was (212±122)cm 2, SFA was (419±147)cm 2, visceral-to-subcutaneous fat ratio (VSR) was 0.60±0.54. The levels of systolic blood pressure (SBP), diastolic blood pressure, fasting blood glucose (FBG), triglyceride and highdensity lipoprotein cholesterol (HDL-C) were (131±16)mmHg(1 mmHg=0.133 kPa), (86±12)mmHg, (6.4±2.5)mmol / L, 4.43 mmol /L(range, 1.23-9.99 mmol/L), (1.5±1.3)mmol/L, respectively. Among the 146 patients, 85 had impaired FBG or diabetes, 82 had hypertension, 139 had high triglyceride, 91 had low serum HDL-C; 128 had multiple metabolic risk factors. (2) ROC curve analysis of different clinical indicators for predicting multiple metabolic risk factors: the ROC curve showed that VFA had better ability to predict or diagnose multiple metabolic risk factors in patients ( hazard ratio=0.617, 95% confidence interval as 0.470-0.764, P<0.05). The cutoff value of VFA was 163.52 cm 2 by calculating Yoden index in ROC curve. (3) Relationship between different VFA and clinicopathological features in patients: according to the cutoff value of 163.52 cm 2 in ROC curve, 146 patients were divided into high VFA group (≥163.52 cm 2) and the low VFA group (<163.52 cm 2), with 49 cases and 97 cases respectively. Cases with hypertension, level of SBP, cases with impaired FBG or diabetes, cases with multiple metabolic risk factors were 64, (134±17)mmHg, 63, 90 for the high VFA group, versus 18, (127±13)mmHg, 22, 38 for the low VFA group; there were significant differences in above indicators between the two groups ( χ2=11.309, t=6.916, χ2=5.380, 6.988, P<0.05). (4) Analysis of factors influencing multiple metabolic risk factors in patients: results of univariate analysis showed that VFA was a related factor for multiple metabolic risk factors in patients ( hazard ratio=3.722, 95% confidence interval as 1.341-10.328, P<0.05). Results of multivariate analysis showed that the VFA≥163.52 cm 2 was an independent rsik factcor or multiple metabolic risk factors in patients ( hazard ratio=5.182, 95% confidence interval as 1.441-18.641, P<0.05). Conclusions:VFA is positively correlated with hypertension, systolic blood pressure, impaired FBG and diabetes. VFA≥163.52 cm 2 is an independent predictor for multiple metabolic risk factors in obese patients undergoing bariatric surgery.

Objective: To explore the application and choice of latissimus dorsi musculocutaneous flap and thoracodorsal artery perforator flap in different wound repair. Methods: From March 2012 to February 2018, 8 cases of different wounds were repaired with island latissimus dorsi myocutaneous flap pedicled with dorsal thoracic artery, free latissimus dorsi myocutaneous flap, or thoracodorsal artery perforator flap combined with scapular flap. The patients includes 4 cases of trauma, 2 cases of tumor and 2 cases of osteomyelitis. Among them, 5 cases received pedicled grafting, 2 cases had anastomotic vascular free grafting combined with antibiotic bone cement chain bead, 1 case had thoracodorsal artery perforator flap combined with scapular flap. Results: All 9 flaps of 8 patients survived. The size of the flaps ranged from 22.0 cm×7.5 cm to 28.0 cm×21.0 cm. All the donor and recipient areas healed well. After 2 months to 2 years follow up, all flaps have good blood supply, and the limbs′ function was normal. The appearance of flaps were satisfactory, with fully treated osteomyelitis, and no recurrence of the tumor was observed. Conclusions According to wound characteristics, selective application of thoracodorsal artery perforator flap, pedicled or free latissimus dorsi myocutaneous flap is effective for the repair of muscle, skin and soft tissue defects, as well as osteomyelitis, after tumor resection.