ObjectiveTo reveal the compatibility rules of the core compound formula and traditional Chinese medicine （TCM） components for prevention and treatment of chronic atrophic gastritis （CAG） by Huazhuo Jiedu （turbidity-resolving and detoxifying） therapy through uniform design in view of the potential regulatory pathway of endogenous turbid-toxin retention in CAG， elucidate the potential pathway by which the compound formulas regulate the Wnt/β-catenin-connexin 43 （CX43） signaling axis， demonstrated the efficacy enhancement and toxicity attenuation among the components， thus providing experimental evidence for the scientific application of multi-component， multi-target compatibility in TCM compound formulas. MethodsA mouse model of CAG was established with N-methyl-N-nitrosourea （MNU）. Sixty mice were randomly allocated into 5 groups （n=12 per group）： blank control， model， low-dose Huazhuo Jiedu core compound formula （HXFF-L， 4.004 g·kg^-1）， high-dose Huazhuo Jiedu core compound formula （HXFF-H， 8.008 g·kg^-1）， and positive control （folic acid at 11 mg·kg^-1 + vitamin B₁₂ at 14 mg·kg^-1）. The therapeutic efficacy and molecular mechanism of the core compound formula were evaluated by hematoxylin-eosin （HE） staining， Alcian blue-periodic acid-Schiff （AB-PAS） staining， enzyme-linked immunosorbent assay （ELISA）， transmission electron microscopy （TEM）， immunofluorescence assay， and Western blot. The chemical components of the core compound formula were detected and effective components were screened by ultra-high performance liquid chromatography coupled with quadrupole-orbitrap high-resolution mass spectrometry （UHPLC-Q-Orbitrap HRMS）. Another 120 mice were randomized into blank control， model， and 8 HXFF component-combination groups with different dosages （uniform design groups 1-8， n=12 per group）. A uniform design was adopted， with pathological scores of mouse gastric tissue as well as serum levels of pepsinogen Ⅰ （PGⅠ）， pepsinogen Ⅱ （PGⅡ）， and gastrin 17 （GAS17） set as dependent variables. Multivariate linear regression analysis was performed to predict the optimal proportion of core components in the compound formula and explore its compatibility rules. ResultsPharmacodynamic validation showed that compared with the blank control group， the model group had decreased gastric weight index （P<0.01） and increased pathological damage score and inflammatory factor levels （P<0.01）. Compared with the model group， these indicators were reversed in the HXFF-L， HXFF-H， and positive control groups （P<0.05， P<0.01）. Immunofluorescence results showed that CX43 expression was downregulated in the model group compared with the blank control group （P<0.01） and upregulated in the HXFF-H and positive control groups compared with the model group （P<0.05， P<0.01）. Western blot results showed that compared with the blank control group， the model group demonstrated upregulated protein levels of Wnt and β-catenin in the gastric tissue （P<0.01）. Compared with those in the model group， the protein level of Wnt was downregulated in the HXFF-L， HXFF-H， and positive control groups （P<0.05， P<0.01）， while that of β-catenin was downregulated only in the HXFF-H group （P<0.05）. A total of 25 compounds were identified in the core compound formula， including 9 from Coptidis Rhizoma， 10 from Pogostemonis Herba， 2 from Scorpio， and 4 from Lilii Bulbus. According to the category and origin of compounds， Coptidis Rhizoma alkaloids， Pogostemonis Herba volatile oils， Scorpio peptides， and Lilii Bulbus alkaloids were finally selected for component research. The predicted optimal combination of TCM components was as follows： Coptidis Rhizoma alkaloids at 75 mg·kg^-1， Pogostemonis Herba volatile oils at 2.25 mg·kg^-1， Scorpio protein extract at 90 mg·kg^-1， and Lilii Bulbus alkaloids at 9 mg·kg^-1. Coptidis Rhizoma alkaloids， Scorpio protein extract， Pogostemonis Herba volatile oils， and Lilii Bulbus alkaloids can ameliorate pathological lesions of the gastric tissue. Scorpio protein extract exerted positive regulatory effects on the gastric function， while Pogostemonis Herba volatile oils and Lilii Bulbus alkaloids showed negative correlations with partial gastric function indicators. Further investigations are required to clarify their dose-effect relationships and safety profiles. ConclusionThis study， for the first time， predicts the optimal proportion and synergistic regulatory mechanism of the core compound formula of Huazhuo Jiedu therapy， revealing the synergistic compatibility logic of its components. It provides a novel strategy for the precise TCM treatment of CAG and the modern development of compound formulas.

ObjectiveTo reveal the compatibility rules of the core compound formula and traditional Chinese medicine （TCM） components for prevention and treatment of chronic atrophic gastritis （CAG） by Huazhuo Jiedu （turbidity-resolving and detoxifying） therapy through uniform design in view of the potential regulatory pathway of endogenous turbid-toxin retention in CAG， elucidate the potential pathway by which the compound formulas regulate the Wnt/β-catenin-connexin 43 （CX43） signaling axis， demonstrated the efficacy enhancement and toxicity attenuation among the components， thus providing experimental evidence for the scientific application of multi-component， multi-target compatibility in TCM compound formulas. MethodsA mouse model of CAG was established with N-methyl-N-nitrosourea （MNU）. Sixty mice were randomly allocated into 5 groups （n=12 per group）： blank control， model， low-dose Huazhuo Jiedu core compound formula （HXFF-L， 4.004 g·kg^-1）， high-dose Huazhuo Jiedu core compound formula （HXFF-H， 8.008 g·kg^-1）， and positive control （folic acid at 11 mg·kg^-1 + vitamin B₁₂ at 14 mg·kg^-1）. The therapeutic efficacy and molecular mechanism of the core compound formula were evaluated by hematoxylin-eosin （HE） staining， Alcian blue-periodic acid-Schiff （AB-PAS） staining， enzyme-linked immunosorbent assay （ELISA）， transmission electron microscopy （TEM）， immunofluorescence assay， and Western blot. The chemical components of the core compound formula were detected and effective components were screened by ultra-high performance liquid chromatography coupled with quadrupole-orbitrap high-resolution mass spectrometry （UHPLC-Q-Orbitrap HRMS）. Another 120 mice were randomized into blank control， model， and 8 HXFF component-combination groups with different dosages （uniform design groups 1-8， n=12 per group）. A uniform design was adopted， with pathological scores of mouse gastric tissue as well as serum levels of pepsinogen Ⅰ （PGⅠ）， pepsinogen Ⅱ （PGⅡ）， and gastrin 17 （GAS17） set as dependent variables. Multivariate linear regression analysis was performed to predict the optimal proportion of core components in the compound formula and explore its compatibility rules. ResultsPharmacodynamic validation showed that compared with the blank control group， the model group had decreased gastric weight index （P<0.01） and increased pathological damage score and inflammatory factor levels （P<0.01）. Compared with the model group， these indicators were reversed in the HXFF-L， HXFF-H， and positive control groups （P<0.05， P<0.01）. Immunofluorescence results showed that CX43 expression was downregulated in the model group compared with the blank control group （P<0.01） and upregulated in the HXFF-H and positive control groups compared with the model group （P<0.05， P<0.01）. Western blot results showed that compared with the blank control group， the model group demonstrated upregulated protein levels of Wnt and β-catenin in the gastric tissue （P<0.01）. Compared with those in the model group， the protein level of Wnt was downregulated in the HXFF-L， HXFF-H， and positive control groups （P<0.05， P<0.01）， while that of β-catenin was downregulated only in the HXFF-H group （P<0.05）. A total of 25 compounds were identified in the core compound formula， including 9 from Coptidis Rhizoma， 10 from Pogostemonis Herba， 2 from Scorpio， and 4 from Lilii Bulbus. According to the category and origin of compounds， Coptidis Rhizoma alkaloids， Pogostemonis Herba volatile oils， Scorpio peptides， and Lilii Bulbus alkaloids were finally selected for component research. The predicted optimal combination of TCM components was as follows： Coptidis Rhizoma alkaloids at 75 mg·kg^-1， Pogostemonis Herba volatile oils at 2.25 mg·kg^-1， Scorpio protein extract at 90 mg·kg^-1， and Lilii Bulbus alkaloids at 9 mg·kg^-1. Coptidis Rhizoma alkaloids， Scorpio protein extract， Pogostemonis Herba volatile oils， and Lilii Bulbus alkaloids can ameliorate pathological lesions of the gastric tissue. Scorpio protein extract exerted positive regulatory effects on the gastric function， while Pogostemonis Herba volatile oils and Lilii Bulbus alkaloids showed negative correlations with partial gastric function indicators. Further investigations are required to clarify their dose-effect relationships and safety profiles. ConclusionThis study， for the first time， predicts the optimal proportion and synergistic regulatory mechanism of the core compound formula of Huazhuo Jiedu therapy， revealing the synergistic compatibility logic of its components. It provides a novel strategy for the precise TCM treatment of CAG and the modern development of compound formulas.

Objective:To study the intraoperative surgical factors which influenced non-immediate postoperative tracheal extubation (IPTE) after liver transplantation.Methods:The clinical data of all liver transplant recipients operated at the Qilu Hospital of Shandong University from January 2011 to July 2019 were reviewed. Patients who returned to a surgical ward with a tracheal cannula or who underwent re-intubation within 48 hours after IPTE because of hypoxemia were assigned to the cannula-preserving group (non-IPTE). The remaining liver recipients were assigned to the control group (IPTE). Univariate and multivariate logistic regression analysis were used to analyze the risk factors influencing IPTE.Results:Of 70 patients enrolled into this study, there were 30 patients in the cannula-preserving group (with 25 males, 5 females, and age of 51.8±7.3). And 40 patients in the control group (with 35 males, 5 females, and age of 48.4±9.6). Univariate logistic regression analysis showed anhepatic phase >45 min, blood loss >800 ml and intraoperative hypothermia were related with non-IPTE after liver transplantation(all P<0.05). Multivariate logistic regression analysis revealed anhepatic phase >45 min ( OR=3.972, 95% CI: 1.193-13.220, P=0.025) and intraoperative hypothermia ( OR=23.682, 95% CI: 2.434-230.438, P=0.006) increased the risk of unsuccessful IPTE. Conclusion:A long anhepatic phase and intraoperative hypothermia were surgical risk factors affecting non-IPTE after liver transplantation. Surgeons should avoid patients having hypothermia and a prolong anhepatic phase during liver transplantation.

Objective To investigate the long-term effect of inflammation on behavior,microglias and dopaminergic (DA) neurons in the substantia nigra of intracephalic inflammation rat models induced by intracerebroventricular injection of low-dose(10μg) lipopolysaccharide (LPS).To analyze the relationship between activation of microglias and DA neurons degeneration in order to explore the mechanism of inflammation in the progressive process of Parkinson' s disease (PD).Methods 50 healthy male SD rats were randomly assigned into saline-injected control group and 10μg LPS-injected group.All injections were made intracerebroventricularly on right side of rats with saline or LPS.Moving speed was measured at different time points.At 24 weeks and 40 weeks after saline or LPS injection,specific antibodies of OX-42 and OX-6 were used separately to detect the changes of microglia in the substantia nigra of rat.The changes in morphology and numbers of substantia nigra DA neurons were observed by tyrosine hydroxylase(TH) immunohistochemical staining.The expression and distribution of the degenerated neurons in substantia nigra were detected by using Fluoro-Jade B(FJB).Results ①Analysis of moving speed sho wed that the moving speed of 10μg LPS-injected group rats and saline-injected group rats was similar from 4 weeks to 36 weeks after injection.At 40 weeks post injection,moving speed of 10μg LPS-injected group rats decreased by 24.6％ compared with that of saline-injected group rats (P＞ 0.05 ).②At 24 weeks and 40 weeks after injection,there were many activated OX-42 positive microglias in the substantia nigra of 10μg LPS-injected group rats,but there was almost no significant activated OX-42 positive microglia in saline-injected group.OX-6 positive microglias were not found in the substantia nigra of both of two groups.③At 24 weeks and 40 weeks post injection,the number of TH-positive neurons in the substantia nigra of 10μg LPS-injected group rats decreasedby 24.2％ ( t=4.803,P＜0.01) and 27.6％ ( t=3.212,P＜0.01) respectively compared with those of salineinjected group.④ There was no FJB positive neurons in the substantia nigra of the two group rats.Conclusion Intraventricular injection of low-dose LPS ( l0μg) in rats may induce long-term activation of microglias and chronic degeneration of DA neurons in the subs tantia nigra of rats although the necrosis are not occurs to DA neurons till 40 weeks post LPS injection.Intraventricular injection of low-dose LPS in rats could be ideal model to study the mechanism of chronic degeneration of DA neurons in PD.

Objective To investigate the role of asctrocytes in the process of chronic degeneration of dopaminergic neurons in intracephalic inflammation rat model induced by intracerebroventricularly injection of lipopolysaccharide.Methods Sixty healthy male SD rats were assigned into lipopolysaccharide group or saline control group randomly.All injections were made intracerebroventricularly on right side of the rats.Ethovison software was used to measure the movement distance of rats within 30 minutes.Specific antibody for glial fibrillary acid protein (GFAP) was used in immunohistochemistry stain to detect the changes of asctrocytes in the substantia nigra of rats.Results Movement distance of lipopolysaccharide-injected rats decreased by 21.2% compared with saline-injected rats at 16 weeks after injection (t=2.54,P<0.05)by 27.0% (t=3.55,P<0.01) at 24 weeks and by 31.4% (t=3.91,P<0.01) at 28 weeks after lipopolysaccharide injection.The asctrocytes were activated obviously in the substantia nigra of lipopolysaccharide-injected group at 2 weeks,while the numbers of GFAP-positively stained cells (228.60 + 22.35) increased significantly compared with saline-injected group ( 165.20 ± 25.97) (t = 4.14,P< 0.05).The activation of asctrocytes was not found in lipopolysaccharide-injected group at 4 weeks and 12 weeks.The asctrocytes were re-activated in the substantia nigra of lipopolysaccharide-injected group at 24 weeks,while the numbers of GFAP-positively stained cells (220.00±21.01 ) increased significantly compared with saline-injected group (169.00± 19.00) (t= 4.03,P<0.05).The activation of asctrocytes was not seen at any time point in saline-injected group.Conclusions Intracephalic inflammation induces chronic degeneration of substantia nigral dopaminergic neurons in rats.The asctrocytes exhibite "acute activation-quiescing-reactivation" state,indicating that they might be involved in the mechanism of dopaminergic neurons degeneration.

Aim To investigate whether prostaglandin E2(PGE2)can increase endogenous Nurr1 expression in a dopamine-synthesizing cell line(MN9D) with immature characteristics and to study whether tyrosine hydroxylase(TH) expression is up-regulated in response to Nurr1-overexpression,in order to investigate the role of Nurr1 during dopaninergic neurons development.Methods MN9D cells were treated with 100 ?g?L-1 PGE2 for 2 h to 6 h.The morphology changes of MN9D cells were observed under phase-contrast microscope. The expression of Nurr1 and TH in MN9D cells was analyzed by using immunohistochemical staining and Western blot analysis.Results ① The morphology of MN9D cells did not change significantly following PGE2 treatment for 2 h,4 h and 6h compared with that of MN9D cells left untreated.② Nurr1-positive staining in MN9D cells treated with PGE2 for 2 h,4 h and 6 h was much stronger than that of untreated cells while the percent of TH-positive MN9D cells after PGE2 treatment for 2 h,4 h and 6 h was similar to that of untreated.③ The expression of Nurr1 protein in MN9D cells treatment with PGE2 for 6 h was significantly higher than that of untreated(P