Objective To explore the feasibility of using high-definition thoracoscopy to identify sympathetic ganglia during thoracic sympathicotomy for primary palmar hyperhidrosis. Methods The clinical data of patients with primary palmar hyperhidrosis who underwent high-definition thoracoscopic sympathicotomy in Taikang Xianlin Drum Tower Hospital from June to July 2023 were retrospectively analyzed. Intraoperative visualization rates and anatomical variations of sympathetic ganglia were recorded, and the consistency between white-light thoracoscopy and near-infrared fluorescence imaging was compared. Additionally, surgical videos from previous fluorescence-guided procedures were reviewed. Results Finally 100 patients were collected, including 54 females and 46 males, with an average age of (21.92±6.56) years. All patients underwent endoscopic thoracic sympathicotomy at R3 level. The overall intraoperative ganglion visualization rate was 92.5% (740/800), with G2-G5 rates of 95.5% (191/200), 94.0% (188/200), 94.0% (188/200), and 86.5% (173/200), respectively. Ganglion variations occurred in 32.0% (237/740), predominantly at G3 (29.8%) and G4 (42.6%). In 5 indocyanine green-enhanced patients, the concordance rate between white-light and near-infrared fluorescence imaging was 100.0% (38/38). Video analysis of 14 near-infrared fluorescence-guided surgeries demonstrated a 99.1% (107/108) consistency rate. Postoperative palmar hyperhidrosis improvement reached 100.0% (100/100) with no Horner’s syndrome. Conclusion With the wide clinical application of high-definition thoracoscopy, accurate thoracic sympathicotomy has the feasibility of clinical application.

ObjectiveThis study aims to enhance of the farnesyl pyrophosphate（FPP） pool in Saccharomyces cerevisiae by heterologously expressing different farnesyl diphosphate synthases（FPSs） from various plants， thereby increasing the production of terpenoid compounds by the engineered yeast. MethodsRNA from mixed samples of roots， stems， and leaves of seven plants including Arabidopsis thaliana， Rosa rugosa， Artemisia annua， Centella asiatica， Humulus lupulus， Medicago sativa， and Panax ginseng was extracted by column chromatography and reverse transcribed into the first strand of complementary DNA（cDNA）， and based on the transcriptome data of the seven species of plants， sequence-specific primers were designed for CaFPS， RrFPS， MsFPS， HiFPS， PgFPS， AtFPS， and AaFPS， the full-length of the genes was cloned， and the genes were analyzed for bioinformatics in order to construct a pESC yeast shuttle vector. These seven plant-derived FPSs were further heterologously expressed in the previous constructed β-elemene-producing yeast， and the yield of β-elemene was indicated for their catalytic acivities. ResultsThe coding sequences of CaFPS， RrFPS， MsFPS， HiFPS， PgFPS， AtFPS， and AaFPS were all of 1 021 bp in length and encoding 301 amino acids， all of which were similarly related to the endogenous FPS-encoding gene（ERG20） in S. cerevisiae. After heterologous expression， RrFPS was identified as the most effective in catalyzing the synthesis of FPP from isopentenyl pyrophosphate（IPP） and dimethylallyl pyrophosphate（DMAPP）. Compared to the control strains， the RrFPS overexpressed yeast strains YB-1-Rr and YB-3-Rr increased the production of β-elemene by 231.25% and 189.3%， respectively. ConclusionBy comparing the functions of FPS-encoding genes from seven different plant sources， it is determined that the protein encoded by the RrFPS from R. rugosa has the best catalytic ability， which can provide key genetic elements for the construction of engineered yeast strain constructs with high terpenoid production.

Objective To explore the active components,therapeutic targets,and molecular mechanisms of Shaoyao Decoction in the treatment of ulcerative colitis(UC)using network pharmacology techniques,bioinformatics methods,and experimental approaches.Methods Screening active components of Shaoyao Decoction and predicting their targets using databases such as PubChem,screening HCC-related disease targets through the NCBI database,constructing a PPI network,conducting GO functional enrichment and KEGG pathway analysis to identify potential biological processes and signaling pathways involved,and validating with molecular docking using AutoDock Tools.Forty male C57BL/6J mice were randomly divided into normal,model,Mesalazine,and Shaoyao Tang groups based on body weight.Except for the normal group,all other groups were induced with ulcerative colitis(UC)by providing 2.5%dextran sulfate sodium(DSS)in drinking water for 5 days.After continuous intragastric administration for 7 days,the mice were sacrificed.The levels of cytokines such as IL-2,IL-1β,IL-6,and TNF-α in colon tissues were measured by ELISA,and pathological sections of colon tissue samples were observed.Results The study identified 20 active components and 945 targets of Shaoyao Tang,among which 609 were related to UC.Through PPI network analysis,22 key targets including VEGFA,AKT1,PTGS2,and STAT3 were determined.GO analysis revealed 409 enriched terms,involving negative regulation of inflammatory response to antigenic stimulus,positive regulation of inflammatory response,etc.KEGG analysis discovered 136 significantly enriched pathways,including the NF-κB signaling pathway,Toll-like receptor signaling pathway(related to inflammation and immunity),VEGF signaling pathway,and ErbB signaling pathway(related to cell proliferation and apoptosis).Molecular docking revealed that the active ingredients exhibited strong affinity with target proteins such as IL-6,TNF,TLR4,IL-2,IL-1B,and PTGS2,forming stable conformations.The final ELISA results demonstrated that the levels of multiple inflammatory cytokines in the colon tissue of DSS-induced ulcerative colitis(UC)mouse models were significantly elevated,with notable upregulation of IL-2,IL-1β,IL-6,and TNF-α compared to the normal group(P<0.05).Following drug intervention,both the Mesalazine group and the Shaoyao Decoction group exhibited significant anti-inflammatory effects,effectively reducing the expression levels of the aforementioned inflammatory cytokines in the colon tissue(P<0.05).Notably,compared to the Mesalazine group,Shaoyao Decoction demonstrated a more pronounced regulatory effect on inflammatory cytokines(P<0.05).Conclusion In this study,the innovative integration of network pharmacology prediction,molecular docking validation and key inflammatory factor assay systematically elucidated the"multi-component-multi-target-multi-pathway"anti-inflammatory mode of Paeonia lactiflora broth in the treatment of UC.The experiments demonstrated that Paeonia lactiflora broth could regulate the release of pro-inflammatory cytokines by regulating the levels of IL-2,IL-1β,IL-6,TNF-α cytokines and other related cytokines to reduce the inflammation of the colon and improve the damage of colon tissues in mice with UC.

Objective:To analyze the current situation and hotspots of medication literacy research at home and abroad, and provide references for medication literacy research in China.Methods:The literature related to medication literacy in the Web of Science Core Collection Database, Scopus and China National Knowledge Infrastructure Database were retrieved (up to May 31, 2024). The CiteSpace software was used to analyze the number of published papers, countries, institutions, journals, authors and keywords, etc.Results:A total of 604 literature were included (361 in Chinese and 243 in English). The literature related to medication literacy were first seen in 2000, and the number grew slowly, which showed rapid growth after 2016, and reached a peak in 2023. The country with the largest number of published English literature was China (69 articles), followed by the United States (66 articles). The literature from the United States were cited 3 623 times, and those from China were cited 2 523 times. Central South University and the Third Xiangya Hospital of Central South University were tied for the first place in terms of the number of published articles as institutions (both 15 articles). The top 5 institutions in terms of the number of Chinese publications were Xiangya Third Hospital of Central South University, Central South University, Yanbian University, Affiliated Hospital of Yanbian University, and Tianjin Chest Hospital. The discipline with the largest number of published English literature was pharmacology/pharmacy (107 articles), followed by public environmental occupational health (88 articles) and general internal medicine (39 articles); the discipline with the largest number of Chinese published articles was clinical medicine (124 articles), followed by research on medical and health policies and regulations (56 articles), and medical education and marginal medical disciplines (34 articles). Keyword cluster analysis showed that the top 3 keywords in the English literature were medication errors, health education, and community pharmacy, while those in the Chinese literature were health literacy, self-management, and health education.Conclusions:Research on medication literacy has rapidly developed in recent years. China and the United States are the main countries for research related to medication literacy. Health education and medication errors are the mainstream of the research. Future research can focus on personalized assessment and intervention measures of medication literacy, so as to develop high-quality assessment tools for medication literacy.

Objective To explore the active components,therapeutic targets,and molecular mechanisms of Shaoyao Decoction in the treatment of ulcerative colitis(UC)using network pharmacology techniques,bioinformatics methods,and experimental approaches.Methods Screening active components of Shaoyao Decoction and predicting their targets using databases such as PubChem,screening HCC-related disease targets through the NCBI database,constructing a PPI network,conducting GO functional enrichment and KEGG pathway analysis to identify potential biological processes and signaling pathways involved,and validating with molecular docking using AutoDock Tools.Forty male C57BL/6J mice were randomly divided into normal,model,Mesalazine,and Shaoyao Tang groups based on body weight.Except for the normal group,all other groups were induced with ulcerative colitis(UC)by providing 2.5%dextran sulfate sodium(DSS)in drinking water for 5 days.After continuous intragastric administration for 7 days,the mice were sacrificed.The levels of cytokines such as IL-2,IL-1β,IL-6,and TNF-α in colon tissues were measured by ELISA,and pathological sections of colon tissue samples were observed.Results The study identified 20 active components and 945 targets of Shaoyao Tang,among which 609 were related to UC.Through PPI network analysis,22 key targets including VEGFA,AKT1,PTGS2,and STAT3 were determined.GO analysis revealed 409 enriched terms,involving negative regulation of inflammatory response to antigenic stimulus,positive regulation of inflammatory response,etc.KEGG analysis discovered 136 significantly enriched pathways,including the NF-κB signaling pathway,Toll-like receptor signaling pathway(related to inflammation and immunity),VEGF signaling pathway,and ErbB signaling pathway(related to cell proliferation and apoptosis).Molecular docking revealed that the active ingredients exhibited strong affinity with target proteins such as IL-6,TNF,TLR4,IL-2,IL-1B,and PTGS2,forming stable conformations.The final ELISA results demonstrated that the levels of multiple inflammatory cytokines in the colon tissue of DSS-induced ulcerative colitis(UC)mouse models were significantly elevated,with notable upregulation of IL-2,IL-1β,IL-6,and TNF-α compared to the normal group(P<0.05).Following drug intervention,both the Mesalazine group and the Shaoyao Decoction group exhibited significant anti-inflammatory effects,effectively reducing the expression levels of the aforementioned inflammatory cytokines in the colon tissue(P<0.05).Notably,compared to the Mesalazine group,Shaoyao Decoction demonstrated a more pronounced regulatory effect on inflammatory cytokines(P<0.05).Conclusion In this study,the innovative integration of network pharmacology prediction,molecular docking validation and key inflammatory factor assay systematically elucidated the"multi-component-multi-target-multi-pathway"anti-inflammatory mode of Paeonia lactiflora broth in the treatment of UC.The experiments demonstrated that Paeonia lactiflora broth could regulate the release of pro-inflammatory cytokines by regulating the levels of IL-2,IL-1β,IL-6,TNF-α cytokines and other related cytokines to reduce the inflammation of the colon and improve the damage of colon tissues in mice with UC.

Objective:To analyze the current situation and hotspots of medication literacy research at home and abroad, and provide references for medication literacy research in China.Methods:The literature related to medication literacy in the Web of Science Core Collection Database, Scopus and China National Knowledge Infrastructure Database were retrieved (up to May 31, 2024). The CiteSpace software was used to analyze the number of published papers, countries, institutions, journals, authors and keywords, etc.Results:A total of 604 literature were included (361 in Chinese and 243 in English). The literature related to medication literacy were first seen in 2000, and the number grew slowly, which showed rapid growth after 2016, and reached a peak in 2023. The country with the largest number of published English literature was China (69 articles), followed by the United States (66 articles). The literature from the United States were cited 3 623 times, and those from China were cited 2 523 times. Central South University and the Third Xiangya Hospital of Central South University were tied for the first place in terms of the number of published articles as institutions (both 15 articles). The top 5 institutions in terms of the number of Chinese publications were Xiangya Third Hospital of Central South University, Central South University, Yanbian University, Affiliated Hospital of Yanbian University, and Tianjin Chest Hospital. The discipline with the largest number of published English literature was pharmacology/pharmacy (107 articles), followed by public environmental occupational health (88 articles) and general internal medicine (39 articles); the discipline with the largest number of Chinese published articles was clinical medicine (124 articles), followed by research on medical and health policies and regulations (56 articles), and medical education and marginal medical disciplines (34 articles). Keyword cluster analysis showed that the top 3 keywords in the English literature were medication errors, health education, and community pharmacy, while those in the Chinese literature were health literacy, self-management, and health education.Conclusions:Research on medication literacy has rapidly developed in recent years. China and the United States are the main countries for research related to medication literacy. Health education and medication errors are the mainstream of the research. Future research can focus on personalized assessment and intervention measures of medication literacy, so as to develop high-quality assessment tools for medication literacy.

There are a total of 16 couplet medicines of Paeoniae Radix Alba and Glycyrrhizae Radix et Rhizoma in the book FU Qingzhu Nüke, covering a wide range of diseases such as leukorrheal diseases, menopathy, pregnancy, and puerperal diseases, and there is a fine sense of the dosage, processing, and proportion of the couplet medicines. Through analyzing the cases of Paeoniae Radix Alba and Glycyrrhizae Radix et Rhizoma couplet medicines and the characteristics of dosage, processing, and proportion, we conclude that Paeoniae Radix Alba and Glycyrrhizae Radix et Rhizoma couplet medicines are mainly as followed: smoothing liver and strengthening spleen in treating leukorrheal diseases to remove dampness and stop leucorrhoea; regulating liver and tonifying spleen in menopathy to regulate menstruation and relieve pain; nourishing blood and benefiting qi in pregnancy to lower adverse qi and tranquilize fetus to prevent miscarriage; regulating and tonifying qi and blood in puerperal diseases to eliminate pathogenic factors and promote lactation; suppressing hyperactive liver for descending adverse qi, and relieving spasm and pain in cases of miscarriage due to rage. In terms of dosage, Paeoniae Radix Alba is mainly used for three to five qian, and Glycyrrhizae Radix et Rhizoma is primarily used for one qian, and the dosage of the two medicinals is adjusted according to the degree of primary and secondary liver stagnation and spleen deficiency. In terms of processing, wine Paeoniae Radix Alba and raw Glycyrrhizae Radix et Rhizoma are primarily used. Stir-frying with wine can help Paeoniae Radix Alba nourish blood and promote blood circulation, tonifying without stagnation, and it is used in most of the diseases caused by liver qi stagnation or qi and blood deficiency. Glycyrrhizae Radix et Rhizoma used in raw is tonifying without causing stagnation, and it can also have the effect of purging fire. In terms of proportion, the ratio of Paeoniae Radix Alba to Glycyrrhizae Radix et Rhizoma is 5∶1 for liver stagnation restraining spleen, 3∶1 for qi and blood deficiency, and 1∶1 for obvious fire-heat. This paper analyses the application of Paeoniae Radix Alba and Glycyrrhizae Radix et Rhizoma couplet medicines in FU Qingzhu Nüke, aiming to deeply study and inherit the academic thought of FU Qingzhu, and to provide new ideas and method for the precise application of Paeoniae Radix Alba and Glycyrrhizae Radix et Rhizoma couplet medicines in clinical practice and researches.

Objective:To discuss the regulatory effect of berberine(BBR)on fatty acids in the human glioma T98G cells and its effect on the cell proliferation,migration,and invasion,and to clarify its potential mechanism.Methods:The T98G cells at logarithmic growth phase were divided into control group and different concentrations(25,50,and 100 mg·L-1)of BBR groups.Cell wound healing assay was used to detect the migration rates of the cells in various groups;Transwell chamber assay was used to detect the invasion rates of the cells in various groups.The T98G cells at logarithmic growth phase were divided into control group and 100 mg·L-1 BBR group,and Mass spectrometry was used to detect the fatty acid contents in the cells in two groups.The T98G cells at logarithmic growth phase were divided into control group and different concentrations(50,100,and 150 mg·L-1)of BBR groups;Western blotting method was used to detect the expression levels of phosphatidylinositol 3-kinase(PI3K),phosphorylated PI3K(p-PI3K),protein kinase B(AKT),phosphorylated AKT(p-AKT),sterol regulatory element-binding protein 1(SREBP-1),and fatty acid synthase(FASN)in the cells in various groups.The expression of FASN was suppressed by gene silencing technology,and the T98G cells at logarithmic growth phase were divided into control group,shFASN1 group,and shFASN2 group.Western blotting method was used to detect the expression levels of FASN protein in the cells in various groups;clone formation assay was used to detect the clone formation of the cells in various groups;cell wound healing assay was used to detect the migration rates of the cells in various groups.Results:Compared with control group,the migration rates and invasion rates of the cells in different concentrations of BBR groups were decreased in a concentration-dependent manner(P<0.01),and the fatty acid content in the cells in 100 mg·L-1 BBR group was significantly decreased(P<0.01).Compared with control group,the expression levels of p-PI3K,p-AKT,SREBP-1,and FASN proteins in the cells in 150 mg·L-1 BBR group were significantly decreased(P<0.05 or P<0.01),and the expression level of SREBP-1 protein in the cells in 100 and 150 mg·L-1 BBR groups were significantly decreased(P<0.01).After suppression of FASN expression,compared with control group,the expression levels of FASN protein in the cells in shFASN1 and shFASN2 groups were significantly decreased(P<0.01),and the expression level of FASN protein in the cells in shFASN2 group was lower than that in shFASN1 group(P<0.05);compared with control group,the numbers of clone formation and migration rates of the cells in shFASN1 and shFASN2 groups were significantly decreased(P<0.01),and the migration rate of the cells in shFASN2 group was significantly lower than that in shFASN1 group(P<0.05).Conclusion:BBR interferes with fatty acid synthesis in the glioma T98G cells by reducing the expression of the PI3K/AKT/SREBP-1/FASN pathway related proteins,and decrease their migration and invasion capabilities.

Objective:To quantitatively analyze the plaque components of carotid artery through energy spectrum computed tomography angiography(CTA),and to measure the blood flow perfusion in the blood-supply area of carotid artery through CT perfusion(CTP),so as to explore the relationship among plaque component,the degree of luminal stenosis and cerebral blood flow perfusion.Methods:A total of 68 patients with unilateral plaques of carotid artery and severe vascular stenosis who were screened and diagnosed by ultrasound and CTA in Xiyuan Hospital from December 2017 to July 2019 were selected,and all patients underwent CTA examination and CTP examination.North American symptomatic carotid endarterectomy test(NASCET)method was used to measure the degree of carotid stenosis.The GE AW 4.7 post-process workstation was used to conduct analyses of energy spectrum and cerebral perfusion for the plaque component.And then,the slope of energy spectrum curve and the effective atomic number were obtained.At the same time,the cerebral blood volume(CBV),cerebral blood flow(CBF),time to peak(TTP)and mean transit time(MTT)of contrast agent in blood-supplying area of anterior cerebral artery(ACA)and middle cerebral artery(MCA)at the side of lesion were measured.Results:A total of 68 measured plaques of 68 patients met the condition,including 44 vulnerable plaques(including lipid plaques and mixed plaques)and 24 stable plaques(fibrous plaques).The average slopes of the energy spectrum curves of vulnerable plaque and stable plaque were respectively 0.45±0.45 and 1.15±0.39,and the differences were significant(t=2.413,P<0.05).The averagely effective atomic numbers of vulnerable plaques and stable plaques were respectively 7.21±1.06 and 8.01±0.63,and the difference were significant(t=2.548,P<0.05).The average TTP values of the ACA at the side of lesion of vulnerable plaques and stable plaques were respectively(12.20±1.61)S and(13.59±2.79)S,and the difference was significant(t=-2.607,P<0.05).The mean MTT values of the ACA at the side of lesion of vulnerable plaques and stable plaques were respectively(5.07±1.66)S and(6.09±2.19)S,and the difference was significant(t=-2.177,P<0.05).The degree of vascular stenosis at the side of lesion was positively correlated with TTP and MTT in blood-supplying area of middle cerebral artery(MCA)at the side of lesion(r=0.537,0.465,P<0.05),and that was negatively correlated with CBF values in blood-supplying areas of ACA and MCA at the side of lesion(r=-0.281,-0.569,P<0.05),respectively.The slope of the energy spectrum curve of carotid plaque was positively correlated with the TTP values in blood-supplying areas of ACA and MCA at the side of lesion(r=0.242,0.246,P<0.05),respectively.Conclusion:CT spectral imaging can quantitatively analyze the displayed components of carotid atherosclerotic plaque,and the degree of vascular stenosis can affect the blood flow perfusion of cerebral tissue,and the delays of TTP and MTT are more easily caused by vulnerable plaque,and the TTP of them is more sensitivity.

Objective To observe the expression of phosphatidylinositol 3-kinase(PI3K)and protein kinase B(Akt)signal transducer in liver tissue of rats with bilateral ovarian castration(OVX)by electroacupuncture at Guanyuan(CV4)point,and explore the mechanism of electroacupuncture in up regulating PI3K/Akt signal pathway,regulating lipid metabolism,and reducing weight was investigated.Methods Thirty-two female SD rats were randomly divided into blank,sham operation,model and electroacupuncture group,with 8 rats in each group.Perimenopausal obesity(PMO)model was prepared by OVX in the model and the electroacupuncture group.After the model was successfully prepared,the electroacupuncture group was subjected to electroacupuncture at CV4(continuous wave,2 Hz,1 mA),once day,20 min once time,and for 14 consecutive days.The body mass of each group of rats was recorded during the whole experiment,and Lee's index was calculated during sampling.The pathological changes of liver were observed by HE staining.Serum levels of HDL,LDL and TG were detected by ELISA.Western blot analysis of PI3K,Akt,p-Akt protein expression and p-Akt/Akt in liver tissues.Results Compared with blank group and sham operation group,the body mass of rats in model group was significantly increased(P＜0.05),Lee's index was increased(P＜0.05),fat vacuoles appeared in liver,serum HDL level was decreased(P＜0.001),LDL and TG levels were increased(P＜0.01).PI3K,Akt,p-Akt,p-Akt/Akt were decreased in liver(P＜0.05).Compared with model group,body mass and Lee's index of rats in electroacupuncture group were decreased(P＜0.05),fat vacuoles in liver were decreased,HDL level was increased(P＜0.01),LDL and TG levels were decreased(P＜0.05,P＜0.01),PI3K,Akt and P-Akt were decreased(P＜0.05),and p-akt/Akt decreased(P＜0.01).Conclusion Electroacupuncture at CV4 can significantly up-regulate PI3K/Akt signaling pathway,improve lipid metabolism disorder and accumulation,and reduce body mass in OVX rats.