BACKGROUND: Asthma is a common chronic inflammatory airway disease and intermittent hypoxia is increasingly recognized as a factor that may impact disease progression. The present study investigated whether intermittent hypoxia (IH) could aggravate asthma by promoting hypoxia-inducible factor-1α (HIF-1α)/nucleotide-binding oligomerization domain (NOD)-like receptor pyrin domain-containing protein 3 (NLRP3)/interleukin (IL)-1β-dependent pyroptosis and the inflammatory response and further elucidated the underlying molecular mechanisms involved. METHODS: A total of 49 patients diagnosed with severe bronchial asthma and diagnosed by polysomnography were enrolled at Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, between January 2022 and December 2022, and their general data and induced sputum were collected. BEAS-2B cells were treated with IL-13 and subjected to IH. An ovalbumin (OVA)-treated mouse model was also used to assess the effects of chronic intermittent hypoxia (CIH) on asthma. Pyroptosis, the inflammatory response, and related signalling pathways were assessed in vivo and in vitro . RESULTS: In this study, as the apnoea and hypopnea index (AHI) increased, the proportion of patients with uncontrolled asthma increased. The proportions of neutrophils and the levels of IL-6, IL-8, HIF-1α and NLRP3 in induced sputum were related to the AHI. NLRP3-mediated pyroptosis, which could be mediated by the HIF-1α signalling pathway, was activated in IL-13 plus IH-treated BEAS-2B cells and in the lungs of OVA/CIH mice. HIF-1α downregulation significantly reduced lung pyroptosis and ameliorated neutrophil inflammation by modulating the NLRP3/IL-1β pathway both in vitro and in vivo . Similarly, pretreatment with LW6, an inhibitor of HIF-1α, effectively blocked the generation of inflammatory cytokines in neutrophils. In addition, administration of the NLRP3 activator nigericin obviously increased lung neutrophil inflammation. CONCLUSIONS Obstructive sleep apnoea-hypopnea syndrome (OSAHS) is a risk factor for asthma exacerbation. IH aggravates neutrophil inflammation in asthma via NLRP3/IL-1β-dependent pyroptosis mediated by the HIF-1α signalling pathway, which should be considered a potential therapeutic target for the treatment of asthma with OSAHS.
NLR Family, Pyrin Domain-Containing 3 Protein/metabolism* ; Humans ; Asthma/metabolism* ; Animals ; Pyroptosis/physiology* ; Hypoxia-Inducible Factor 1, alpha Subunit/metabolism* ; Mice ; Signal Transduction/physiology* ; Male ; Hypoxia/metabolism* ; Female ; Interleukin-1beta/metabolism* ; Adult ; Inflammation/metabolism* ; Middle Aged ; Mice, Inbred C57BL

Objective:To investigate the predictive value of maximum tumor diameter and the peripheral blood neutrophil to lymphocyte ratio (NLR) before radiotherapy for the occurrence of esophageal fistula after radiotherapy in patients with esophageal squamous cell carcinoma (ESCC) .Methods:A total of 98 patients with ESCC who underwent radiotherapy in Hefei Cancer Hospital, Chinese Academy of Sciences from February 2017 to February 2021 were selected, and the patients were divided into esophageal fistula group (13 cases) and no esophageal fistula group (85 cases) according to whether esophageal fistula occurred during the follow-up process. The prognostic nutritional index (PNI) , NLR, and systemic inflammatory response index (SIRI) were calculated. Univariate and multivariate logistic regression were used to analyze the influencing factors of esophageal fistula, and the predictive value of each indicator was evaluated by using the receiver operator characteristic (ROC) curve.Results:There were no statistically significant differences in age, smoking history, diabetes mellitus history, gender, concurrent chemotherapy and alcohol history between the esophageal fistula group and the no esophageal fistula group (all P>0.05) , while there were statistically significant differences in PNI ( t=2.24, P=0.041) , NLR ( t=3.75, P=0.001) , SIRI ( t=2.68, P=0.015) . Univariate analysis showed that tumor length ( OR=1.16, 95% CI: 1.01-1.35, P=0.043) , maximum tumor diameter ( OR=1.63, 95% CI: 1.11-2.39, P=0.012) , PNI ( OR=0.83, 95% CI: 0.71-0.98, P=0.023) , NLR ( OR=1.94, 95% CI: 1.20-3.12, P=0.007) and SIRI ( OR=1.82, 95% CI: 1.03-3.24, P=0.041) were related to esophageal fistula. Multivariate analysis showed that maximum tumor diameter ( OR=2.17, 95% CI: 1.02-4.94, P=0.033) and NLR ( OR=2.40, 95% CI: 1.89-6.59, P=0.018) were independent influencing factors for the development of esophageal fistula in patients with ESCC after radiotherapy. ROC curve analysis showed that the area under the curve of maximum tumor diameter before radiotherapy combined with NLR for predicting esophageal fistula in patients with esophageal squamous cell carcinoma after radiotherapy was 0.83 (95% CI: 0.74-0.90) , which was greater than that of maximum tumor diameter before radiotherapy (0.71, 95% CI: 0.63-0.81, Z=1.80, P=0.039) and NLR (0.74, 95% CI: 0.67-0.85, Z=1.64, P=0.046) alone. Conclusions:The maximum tumor diameter before radiotherapy and NLR are closely related to the occurrence of esophageal fistula in ESCC after radiotherapy, and these factors are expected to serve as key predictors of the occurrence of esophageal fistula.

It is believed that the endoscopic manifestations of interstitial cystitis/bladder pain syndrome （IC/BPS） such as extensive bleeding and Hunner's ulcers as well as its recurrent and prolonged condition are in line with the characteristics of sores and ulcers in traditional Chinese medicine （TCM）， and the treatment can be referred to TCM theory of sores and ulcers. The mechanism of IC/BPS is characterized by root deficiency and branch excess. The root cause is deficiency of the spleen and kidney qi， while the manifesting factors are dampness-heat and blood stasis. The treatment is based on the principles of promoting and supplementing， combining with resolving therapy， so that the symptoms could be relieved by promoting blood circulation and clearing heat， unblocking the collaterals and relieve pain. In clinical practice， modified Neituo Shengji Powder （内托生肌散） was commonly used to boost qi and invigorate blood， expel swollen sore and express toxin； combining with Sijunzi Decoction （四君子汤） or Suoquan Pill （缩泉丸） based on specific symptoms to strengthen the spleen and kidneys， thereby reinforcing healthy qi； according to concurrent symptoms like blood stasis， dampness heat， prescription with Sanleng （Cyperus rotundus）， Ezhu （Curcuma aromatica Salisb） to invigorate blood and dissolve stasis， or Yiyiren （Coix lacryma-jobi）， Zexie （Alisma plantago-aquatica） to clear heat and drain dampness.

Background: Overactive bladder (OAB) is a prevalent condition that substantially degrades patient quality of life. Acupuncture is recognized as an effective therapeutic approach for various urological diseases. However, there is limited evidence validating the effectiveness and safety of acupuncture for OABs. Objective: To assess the therapeutic efficacy of acupuncture for OAB and to investigate the potential mechanisms by analyzing its effects on relevant urinary biomarkers. Methods: This is a randomized, participants and outcome assessors blinded, sham acupuncture controlled trial. A total of 110 patients with OABs will be randomly divided in a 1:1 ratio between the acupuncture and sham acupuncture groups. Participants in the acupuncture group will undergo 30-min authentic acupuncture, while their counterparts in the sham acupuncture group will undergo sham acupuncture needling non-acupoints superficially three times weekly for a duration of 8 weeks. The two co-primary outcomes will be the change in the mean number of micturitions per 24 h from baseline to the end of the 8-week treatment and 20-week follow-up. The secondary outcomes will encompass the change in Overactive Bladder Symptom Score, Overactive Bladder Questionnaire Short Form, and average 24 h values of urgency, daytime micturition, nocturia, and mean volume voided per micturition from baseline to weeks 8 and 20. Urinary nerve growth factor, brain-derived neurotrophic factor, and monocyte chemoattractant protein-1 levels will be measured at baseline and week 8. Adverse events will also be documented. Discussion The results of this trial will provide evidence for the effectiveness and safety of acupuncture in the management of OAB.

OBJECTIVE To explore the potential geographic distribution of Pinellia Ternata (Thunb.) Breit. in Gansu province, clarify its habitat requirements, and provide a theoretical basis for rational cultivation. METHODS Based on 100 geographic distribution points of Pinellia Ternata (Thunb.) Breit. and 39 environmental variables (including 19 bioclimatic variables, 17 soil variables and 3 topographic variables), the maximum entropy model(MaxEnt) and ArcGIS geographic information system software were used to make the habitat suitable for its evaluation and classification of suitable areas, the result of Jackknife test was used to evaluate the environmental variables that affect the habitat of Pinellia Ternata (Thunb.) Breit., the area under the ROC curve(AUC) was used to evaluate the degree of reliability of the prediction results. RESULTS The AUC was 0.993, indicating that the prediction results of the MaxEnt model were reliable. Monthly average daily temperature difference, isotherm, standard deviation of seasonal variation of temperature, annual precipitation, the wettest month precipitation, the driest month precipitation, the driest season precipitation, the coldest season precipitation and altitude were the main environmental variables affecting the growth of Pinellia Ternata (Thunb.) Breit.. The suitable areas for Pinellia Ternata (Thunb.) Breit. in Gansu were mainly concentrated in Longnan, Tianshui and Pingliang, where the areas of high, medium and low suitable areas were 16 180.4, 15 413.96, 21 204.84 km2, respectively. CONCLUSION The research results can provide a theoretical reference for the protection and standardized cultivation of Pinellia Ternata (Thunb.) Breit. resources.

Objective To analyze the hotspots and development trends in the international field of apraxia of speech(AOS). Methods Relevant literature on AOS was retrieved in the Web of Science Core Collection database from January,2004 to December,2023,and was analyzed with CiteSpace 6.2 R. Results A total of 893 articles were included,with a fluctuating upward trend in publication volume.The United States and Australia exhibited significant influence in the field of AOS research.Mayo Clinic and the University of Syd-ney showed high centrality in the network,while Joseph R Duffy ranked among the top authors in terms of publi-cation volume.Over the past five years,research hotspots mainly focused on Parkinson's disease,the classifica-tion of AOS,and studies on treatment intensity. Conclusion The research interest in AOS is on the rise.Significant progress has been made in areas such as neuroimag-ing,clinical acoustic assessment and articulatory-phonetic intervention.Further exploration is needed in the path-ological mechanisms and treatment methods of AOS.

Acute-on-chronic liver failure(ACLF)is a group of clinical syndromes related to severe acute liver function damage and multiple organ failure caused by various acute inducing factors on the basis of chronic liver disease.Due to its serious condition,rapid progression and high mortality,it has attracted more and more attention.Recent studies have shown that the pathogenesis of ACLF mainly includes direct injury and immune injury.As the main immune cells in the liver,the immunoregulatory role of liver macrophages in ACLF has been increasingly recognized.Liver macrophages have excellent phenotype conversion function and plasticity characteristics under the influence of epigenetic reprogramming or local microenvironment.This adaptive expression ability can use key mediators to promote the early conversion of anti-inflammatory phenotype to alleviate liver injury.A large number of studies have shown that liver macrophages have a certain potential in reversing the process of ACLF.Therefore,from the perspective of the plasticity characteristics of liver macrophages,this paper expounds the role of liver macrophages in ACLF and the research on the intervention of ACLF disease process,and summarizes its potential significance in the treatment of ACLF.

Chronic skin diseases have complex pathogeneses and prolonged courses, and have long adverse impacts on the physical and mental health, as well as the normal life of patients. It is necessary to develop evidence-based strategies and measures for effective prevention and control of chronic skin diseases. However, related studies are limited in China. This article proposes a population medicine research plan for health promotion and equity, and disease prevention, diagnosis, control, treatment, and rehabilitation to establish a collaborative platform for strengthening research on the prevention and treatment of chronic skin diseases in China.

Objective To explore the effect of Dong's extraordinary point acupuncture combined with medium frequency pulse electrotherapy on lumbar disc herniation.Methods Eighty patients with lumbar disc herniation who were admitted to Xiangshan Hospital of Traditional Chinese Medicine from January 2021 to October 2023 were selected and randomly divided into study group and control group,with 40 cases in each group.Twelve patients were lost during treatment,and eventually 68 patients were enrolled in this study,including 34 in the study group and 34 in the control group.The control group was treated with conventional acupuncture combined with medium frequency pulse electrotherapy,and the study group was treated with Dong's extraordinary point acupuncture with medium frequency pulse electrotherapy,both for 2 weeks,3 times a week.Visual Analogue Scale(VAS)score,Japanese Orthopaedic Society(JOA)score and Oswestry Disability Index(ODI)were compared between the two groups before and after treatment.Results VAS score and ODI were significantly decreased and JOA score was significantly increased after treatment in both groups(P<0.001).VAS score and ODI in the study group were lower than those in the control group after treatment,while JOA score in the study group was higher than that in the control group(P<0.001).Conclusion Dong's extraordinary point acupuncture combined with medium frequency pulse electrotherapy is superior to conventional acupuncture combined with medium frequency pulse electrotherapy in treatment of lumbar disc herniation.It can faster relieve clinical symptoms and restore lumbar disc function,and is worthy of clinical application with satisfactory safety.

【Objective】 To analyze the commonality and characteristics between voluntary blood donors and hematopoietic stem cell donors in this region, and explore the potential for integration and development between China Marrow Donors Program (CMDP) and voluntary blood donors, especially platelet donor databases, so as to improve recruitment success rate and inventory rate. 【Methods】 The database modeling and comparison methods were used to screen and stratify the matching and integration degree between the voluntary blood donors in recent 10 years and the marrow donors in the Shaanxi Branch of CMDP. The frequencies of HLA-A,-B alleles, HPA alleles and haplotypes were calculated with Arlequin 3. 5. 2. 2 software, and the matching probability of different platelet donor reserve pools was conducted according to the phenotypic frequencies. 【Results】 Among the voluntary donors with known HLA genotypes in this region, according to their blood donation behavior,the active blood donors excavated were divided into the first, second, third and fourth echelons of platelet donor reserve pools, with 696, 2 752, 9 092 and 12 028 donors, respectively. The first echelon had the highest proportion of 10-50 times of platelet donations and 10-20 times of whole blood donations, with 13.65% and 26.01%, respectively. The second echelon had 10-20 times of whole blood donations and 10-50 times of platelet donations, accounted for 15.04% and 1.38%, respectively, which were significantly different from other echelons' blood donation characteristics (P<0.05). With a database size of the existing platelet donor bank adding the first and second echelons (n=4 955), there was a 69.02% probability of matching at least one donor with matching HLA-A-B phenotype. When considering the matching ABO and HPA phenotypes, the probability of finding at least one donor with fully matching HLA, HPA and ABO isotype (type B as an example) was 48. 73%. 【Conclusion】 The three groups of whole blood donation, apheresis platelet donation and marrow donation in Xi'an area have a large cross-distribution. Compared with expanding the storage capacity from scratch, the active blood donors in CMDP database are the largest back-up force of platelet donors. While expanding the effective storage capacity, it can minimize the cost of building platelet donor bank and the demand for resources.