BACKGROUND:Chinese herbal prescription with head acupuncture exercise therapy has significant clinical efficacy in the treatment of limb spasticity after ischemic stroke;however,the exact mechanism is not clear.OBJECTIVE:To explore the possible mechanism of the combination of Chinese herbal prescription with head acupuncture exercise therapy in improving limb spasticity after stroke.METHODS:Seventy Sprague-Dawley rats were divided into blank,model,exercise therapy,head-acupuncture,Chinese herbal prescription,Chinese herbal prescription with head acupuncture exercise therapy,and sham-operation groups using the random number method,with 10 rats in each group.Except for the blank group and the sham-operation group,a rat model of cerebral ischemia/reperfusion injury was made by using the middle cerebral artery cable embolism method in the rest of the groups.Interventions in each group started on the 3rd day after modeling.In the Chinese herbal prescription group,rats were given 1.5 g/kg Yi'nao Fujian herbal prescription by gavage;in the head acupuncture group,acupuncture was applied to Baihui and 2 mm on the left and right sides of Baihui,and was left in place for 30 minutes;in the exercise therapy group,rats were exercised on a treadmill for 30 minutes;in the Chinese herbal prescription with head acupuncture exercise therapy group,1.5 g/kg Yi'nao Fujian herbal prescription was given by gavage followed by acupuncture treatment(identical to that in the head acupuncture group,and then the animals were exercised for 30 minutes on the treadmill while the acupuncture needles remained in place.Rats in the model and sham-operation groups were subjected to grasping under the same environmental conditions and placed on a rat immobilizer for 30 minutes,and the blank group did not have any intervention.The frequency of intervention in each group was once a day for 7 consecutive days.The neurological deficit score and muscle tone were evaluated in each group before and after treatment.Pathological changes in rat brain tissue were observed.Protein and mRNA expressions of glutamic acid decarboxylase 67,succinate semialdehyde dehydrogenase,and γ-aminobutyric acid transaminase in the cerebral cortex of the rats were detected.RESULTS AND CONCLUSION:(1)Compared with the model group,the Chinese herbal prescription with head acupuncture exercise therapy group had lower neurological deficit scores and modified Ashworth spasticity scale(MAS)muscle tone scores(P＜0.01),decreased expression of succinate semialdehyde dehydrogenase andγ-aminobutyric acid transaminase at protein and mRNA levels,and increased expression of expression of glutamic acid decarboxylase 67 at protein and mRNA levels(P＜0.01);the neuronal cell structure was relatively intact,with only some irregular cavities visible and reduced nuclear consolidation.(2)Compared with the Chinese herbal prescription with head acupuncture exercise therapy group,the neurological deficit scores and MAS muscle tone scores were higher in the exercise therapy group(P＜0.05),and the MAS muscle tone scores were higher in the head-acupuncture group and the Chinese herbal prescription group(P＜0.05,P＜0.01),while the expressions of glutamic acid decarboxylase 67 protein and succinate semialdehyde dehydrogenase andγ-aminobutyric acid transaminase mRNAs were increased in all the other intervention groups(P＜0.05,P＜0.01).Neuronal cells in the Chinese herbal prescription with head acupuncture exercise therapy group were more orderly arranged and clearly outlined,with less nuclear consolidation and shape irregularity compared with the other intervention groups.(3)The neurological deficit score and MAS muscle tone score in the Chinese herbal prescription with head acupuncture exercise therapy group were significantly lower after treatment(P＜0.01).To conclude,Yi'nao Fujian herbal prescription combined with head-acupuncture exercise therapy can improve post-stroke spasticity by affecting the expression of γ-aminobutyric acid transaminase in rats,which is more effective than Chinese herbal prescription alone,exercise therapy alone,and head-acupuncture alone.

BACKGROUND:It has been shown that Gushukang affects bone metabolism by regulating nucleotide and amino acid metabolism and immune mechanisms.Current research on the mechanism of Gushukang in the treatment of osteoporosis primarily focuses on osteoblast regulation and requires further improvement from the perspective of osteoclasts. OBJECTIVE:To investigate the mechanism by which Gushukang interferes with osteoclasts in the treatment of osteoporosis using RAW264.7 cells as the research model. METHODS:Twenty-four 8-week-old female Sprague-Dawley rats were randomly divided into four groups(n=6 per group):the three experimental groups were given 1,2 and 4 g/kg osteoporosis solution by gavage(2 times per day),and the control group was given an equal amount of distilled water by gavage(2 times per day).After 7 days of intragastric administration,aortic blood samples were extracted to collect serum samples using centrifugation,and serum samples from the same groups were combined to obtain the low-,medium-,and high-concentration Gushukang-containing and normal sera for the subsequent experiments.(1)RAW264.7 cells were cultured in six groups:normal serum was added to the control group;low,medium,and high concentration groups were added with low,medium,and high concentrations of Gushukang-containing serum,respectively;ML385,a nuclear factor erythroid 2-related factor 2(Nrf2)inhibitor was given in the Nrf2 inhibitor group;and t-BHQ,a Nrf2 activator,was added in the Nrf2 activator group.Cell viability was detected using the cell counting kit-8 assay.(2)The 3rd generation RAW 264.7 cells were cultured and divided into five groups:the blank control group was added with normal serum,the osteoclast group was added with receptor activator of nuclear factor κB ligand(RANKL),and the low-,medium-,and high-concentration groups were added with low-,medium-,and high-concentration Gushukang-containing serum based on the addition of RANKL.Tartrate-resistant acid phosphate staining was performed after 5 days of culture.(3)RAW264.7 cells were cultured and divided into five groups:blank control group was cultured with normal serum,osteoclast group cultured with normal serum and RANKL,high concentration+osteoclast group cultured with RANKL+high concentration Gushukang-containing serum,osteoclast+Nrf2 agonist group cultured with RANKL+t-BHQ,and high concentration+osteoclast+Nrf2 inhibitor group cultured with RANKL+high concentration Gushukang-containing serum+ML385.Western blot assay and determination of reactive oxygen content were performed after 5 days of culture. RESULTS AND CONCLUSION:The cell counting kit-8 results indicated that Gushukang-containing serum,NRF2 inhibitor or agonist had no significant effect on RAW264.7 cell viability.Tartrate-resistant acid phosphate staining results demonstrated that Gushukang-containing serum exhibited a concentration-dependent inhibitory effect on osteoclast differentiation.Western blot analysis and determination of reactive oxygen species revealed that compared with the blank control group,Nrf2 protein expression was decreased in the osteoclast group(P<0.05),while c-Fos and NFATc1 protein expression and reactive oxygen species content were elevated(P<0.05);compared with the osteoclast group,Nrf2 protein expression was elevated and reactive oxygen species content was decreased in the high-concentration+osteoclast group,osteoclast+Nrf2 agonist group,and high-concentration+osteoclast+Nrf2 inhibitor group(P<0.05),while c-Fos and NFATc1 protein expression was decreased in the high concentration+osteoclast group and osteoclast+Nrf2 agonist group(P<0.05);compared with the high concentration+osteoclast group,Nrf2 protein expression was decreased(P<0.05)and reactive oxygen species content was elevated(P<0.05)in the high concentration+osteoclast+Nrf2 inhibitor group.To conclude,Gushukang reduces reactive oxygen species production by activating Nrf2,thereby inhibiting downstream of the c-Fos/NFATc1 pathway and suppressing osteoclast differentiation.

Alzheimer's disease （AD）， a degenerative disease of the central nervous system， is characterized by progressive degradation of learning， memory， and cognitive functions. Currently， few drugs are available for treating AD， and their effects are limited. Berberine （BBR） is a natural isoquinoline （quaternary ammonium-like） with a wide range of pharmacological effects. Studies have proven that BBR has good potential in the treatment of AD. Specifically， BBR can inhibit the generation， aggregation， and neurotoxicity of amyloid-β and the hyperphosphorylation of Tau protein， promote the clearance of phosphorylated Tau protein， reduce the cholinesterase activity， neuroinflammation， and oxidative stress， regulate neuronal apoptosis， improve the mitochondrial function and glucose and lipid metabolism， suppress the monoamine oxidase activity， and modulate gut microbiota. In addition， researchers have ameliorated the low bioavailability of BBR. Probing into the potential targets is hoped to provide a reference for further research on the prevention and treatment of AD by BBR.

Inflammation plays a pivotal role in the etiology and progression of various diseases. In traditional Chinese medicine, the whole plants of Thesium chinense Turcz. and its preparations (e.g. Bairui Granules) have been employed to manage inflammatory conditions. While flavonoids were previously considered the primary anti-inflammatory components, other potentially active constituents have been largely overlooked and not thoroughly investigated. This study presents a novel finding that the total alkaloids of T. chinense (BC-Alk) are potent active substances underlying the traditional and clinical applications of T. chinense and Bairui Granules as anti-inflammatory agents. UPLC-MS/MS analysis identified the composition of BC-Alk as quinolizidine alkaloids. The anti-inflammatory efficacy of BC-Alk was evaluated using a lipopolysaccharide (LPS)-induced lung inflammation model in mice. Results demonstrated that BC-Alk significantly mitigated LPS-induced lung inflammation, attenuated the overproduction of IL-1β and the overproduction of inflammatory factors (TNF-α), and ameliorated lung tissue hyperplasia in mice in vivo. Mechanistic studies in vitro revealed that BC-Alk upregulated the expression of Nrf2 and its downstream proteins NQO1 and glutamate-cystine ligase and modifier subunit (GCLM), inhibited NF-κB phosphorylation, and suppressed NLRP3 activation. Collectively, these findings indicate that BC-Alk exerts potent inhibitory effects against lung inflammation by modulating Nrf2, NF-κB, and NLRP3 pathways. This study provides new insights into the anti-inflammatory constituents of T. chinense and Bairui Granules.
Animals ; Lipopolysaccharides/adverse effects* ; Alkaloids/pharmacology* ; NF-kappa B/metabolism* ; NF-E2-Related Factor 2/metabolism* ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism* ; Mice ; Signal Transduction/drug effects* ; Anti-Inflammatory Agents/pharmacology* ; Male ; Mice, Inbred C57BL ; Humans ; Drugs, Chinese Herbal/administration & dosage* ; Pneumonia/genetics*

Objective:To investigate whether biochanin A(BCA)has a protective effect against dextran sodium sulfate(DSS)-in-duced ulcerative colitis(UC)in mice.Methods:Thirty C57BL/6N mice were randomly divided into normal control group,DSS model group,sulfasalazine(SASP)-positive drug control group,and low/medium/high-dose(5 mg/kg,10 mg/kg,and 20 mg/kg)BCA groups.The mouse model of UC was induced by administering 2.5%DSS aqueous solution for 7 days.During the experimental period,both the normal control and model groups were given 0.5%carboxymethyl cellulose sodium solution daily by gavage.The positive control group was given 100 mg/kg SASP,while the BCA groups were given BCA suspensions at doses of 5 mg/kg,10 mg/kg,and 20 mg/kg.The ad-ministration lasted for 10 days.Body weight changes and fecal status of the mice were recorded every day;the colon was dissected,col-lected,and measured for its length.The colon was stained with Hematoxylin-Eosin for pathomorphological study.Quantitative poly-merase chain reaction was used to determine the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and interleukin-10(IL-10)in the colon.Immunofluorescence was used to determine the expression of tight junction proteins,zonula occluden-1(ZO-1)and occludin,in the colon.Results:It showed that 5 mg/kg and 10 mg/kg BCA significantly alleviated weight loss in mice with UC,while 5 mg/kg,10 mg/kg,and 20 mg/kg BCA reduced the disease activity index scores.Additionally,BCA showed similar effects to SASP in improving the structure and reducing the shortening of the colon in mice with UC.Compared with the model group,all BCA groups had significantly decreased TNF-α(P=0.024、P=0.060、P=0.003)and IL-6(P=0.002、P<0.001、P<0.001)and significantly increased IL-10(P=0.006、P=0.003、P<0.001),with varying degrees of up-regulated expression of tight junction proteins.Conclusion:BCA can effectively alleviate DSS-induced symptoms,reduce intes-tinal damage,and protect the intestinal barrier in mice with UC.

BACKGROUND:Chinese herbal prescription with head acupuncture exercise therapy has significant clinical efficacy in the treatment of limb spasticity after ischemic stroke;however,the exact mechanism is not clear.OBJECTIVE:To explore the possible mechanism of the combination of Chinese herbal prescription with head acupuncture exercise therapy in improving limb spasticity after stroke.METHODS:Seventy Sprague-Dawley rats were divided into blank,model,exercise therapy,head-acupuncture,Chinese herbal prescription,Chinese herbal prescription with head acupuncture exercise therapy,and sham-operation groups using the random number method,with 10 rats in each group.Except for the blank group and the sham-operation group,a rat model of cerebral ischemia/reperfusion injury was made by using the middle cerebral artery cable embolism method in the rest of the groups.Interventions in each group started on the 3rd day after modeling.In the Chinese herbal prescription group,rats were given 1.5 g/kg Yi'nao Fujian herbal prescription by gavage;in the head acupuncture group,acupuncture was applied to Baihui and 2 mm on the left and right sides of Baihui,and was left in place for 30 minutes;in the exercise therapy group,rats were exercised on a treadmill for 30 minutes;in the Chinese herbal prescription with head acupuncture exercise therapy group,1.5 g/kg Yi'nao Fujian herbal prescription was given by gavage followed by acupuncture treatment(identical to that in the head acupuncture group,and then the animals were exercised for 30 minutes on the treadmill while the acupuncture needles remained in place.Rats in the model and sham-operation groups were subjected to grasping under the same environmental conditions and placed on a rat immobilizer for 30 minutes,and the blank group did not have any intervention.The frequency of intervention in each group was once a day for 7 consecutive days.The neurological deficit score and muscle tone were evaluated in each group before and after treatment.Pathological changes in rat brain tissue were observed.Protein and mRNA expressions of glutamic acid decarboxylase 67,succinate semialdehyde dehydrogenase,and γ-aminobutyric acid transaminase in the cerebral cortex of the rats were detected.RESULTS AND CONCLUSION:(1)Compared with the model group,the Chinese herbal prescription with head acupuncture exercise therapy group had lower neurological deficit scores and modified Ashworth spasticity scale(MAS)muscle tone scores(P＜0.01),decreased expression of succinate semialdehyde dehydrogenase andγ-aminobutyric acid transaminase at protein and mRNA levels,and increased expression of expression of glutamic acid decarboxylase 67 at protein and mRNA levels(P＜0.01);the neuronal cell structure was relatively intact,with only some irregular cavities visible and reduced nuclear consolidation.(2)Compared with the Chinese herbal prescription with head acupuncture exercise therapy group,the neurological deficit scores and MAS muscle tone scores were higher in the exercise therapy group(P＜0.05),and the MAS muscle tone scores were higher in the head-acupuncture group and the Chinese herbal prescription group(P＜0.05,P＜0.01),while the expressions of glutamic acid decarboxylase 67 protein and succinate semialdehyde dehydrogenase andγ-aminobutyric acid transaminase mRNAs were increased in all the other intervention groups(P＜0.05,P＜0.01).Neuronal cells in the Chinese herbal prescription with head acupuncture exercise therapy group were more orderly arranged and clearly outlined,with less nuclear consolidation and shape irregularity compared with the other intervention groups.(3)The neurological deficit score and MAS muscle tone score in the Chinese herbal prescription with head acupuncture exercise therapy group were significantly lower after treatment(P＜0.01).To conclude,Yi'nao Fujian herbal prescription combined with head-acupuncture exercise therapy can improve post-stroke spasticity by affecting the expression of γ-aminobutyric acid transaminase in rats,which is more effective than Chinese herbal prescription alone,exercise therapy alone,and head-acupuncture alone.

Objective:To determine the changes of immune-associated molecules in serum of patients infected with respiratory syncytial virus subtype A (RSV-A).Methods:Serum specimens were collected from patients with respiratory infection at Department of Pediatrics of NO. 2 Clinical Teaching Hospital of Chengde Medical University during August 2022 to June 2023. The serum specimens were set as RSV-A single infection group and RSV-A coinfection group based on the detected pathogens in these patients. Serum levels of Th1 cytokines including interferon γ (IFN-γ) and tumor necrosis factor-α (TNF-α), and Th2 cytokines including interleukin 4 (IL-4) and IL-10, soluble toll-like receptor 2 (sTLR2) and 4 (sTLR4), soluble tumor necrosis factor receptor 1 (sTNFR1) and sTNFR2 were determined using enzyme-linked immunosorbent assay (ELISA) kits.Results:Serum levels of IFN-γ ( H=10.030, P=0.007) and IL-4 ( H=10.246, P=0.006) were significantly up-regulated in RSV-A single infection group and RSV-A coinfection group, however, levels of TNF-α ( F=1.154, P=0.322) and IL-10 ( F=1.738, P=0.188) were not significantly up-regulated. Area under the curve (AUC) of IFN-γ and IL-4 were 0.866 (95% CI: 0.767-0.966, P=0.002) and 0.986 (95% CI: 0.956-1.000, P=0.001), respectively. The levels of sTLR2 ( H=1.165, P=0.559) and sTLR4 ( H=1.657, P=0.437) were not significantly changed. Levels of sTNFR1 ( H=11.431, P=0.003) and sTNFR2 ( F=3.411, P=0.041) were significantly up-regulated in RSV-A coinfection group and the concentration of sTNFR2 was higher than sTNFR1. Concentration of sTNFR1 was peaked in RSV-A coinfected with bacterium group and RSV-A coinfected with dual bacteria group. AUC of sTNFR2 was 0.967 (95% CI: 0.911-1.000, P=0.002). Conclusions:Expressions of immune-associated molecules, including IFN-γ, IL-4, sTNFR1 and sTNFR2 were significantly changed in patients infected with RSV-A, and these immune-associated molecules maybe engage in the interaction and pathogenesis between RSV-A and host.

Objective:To analyze the prevalence and clinical features of respiratory syncytial virus (RSV) in Chengde city.Methods:From August 2022 to June 2023, throat swabs and clinical data of 478 hospitalized children with respiratory tract infection in the Chengde Central Hospital were collected. Real-time quantitative PCR was used to detect the molecular epidemiology of RSV-A and RSV-B subtypes and analyze the clinical features of patients with RSV infection.Results:Among the hospitalized children, 67.57% (323/478) tested positive for RSV. The outbreak of RSV infection was caused by RSV-A subtype. The peaks of RSV-A infection occurred from November to December, 2022 and May to June, 2023. There were 86.07% (278/323) of the RSV-A-positive cases had mixed infection with other pathogens, primarily bacterial pathogens with Streptococcus pneumoniae being the most common, followed by Klebsiella pneumoniae. Influenza virus A was the most common viral pathogens causing mixed infection. The level of lactate dehydrogenase was higher in the patients with single RSV-A infection than in those with mixed infection ( Z=2.396, P=0.017), and higher than the normal upper limit. Compared with the single infection group, the mixed infection group had higher white blood cell count ( Z=2.417, P=0.016), neutrophil ratio ( Z=3.218, P=0.001), C-reactive protein level ( Z=1.998, P=0.046) and creatinine level ( Z=2.107, P=0.035), and lower lymphocyte ratio ( Z=3.205, P=0.001), but they were all within the normal range. There were no significant differences in the clinical features between RSV-A-positive patients co-infected with bacteria or other viruses (all P>0.05). Conclusions:RSV-A is the leading cause of respiratory tract infection in children in Chengde from 2022 to 2023, and often co-detected with bacteria. The mixed infection with other respiratory pathogens is related to the clinical features of patients with RSV-A infection.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Renal pelvic hemangioma is a rare benign tumor, presenting with intermittent, total, painless, gross hematuria, accompanied by low back pain, abdominal pain or other symptoms in some cases. Four cases of pyelonephric hemangioma were treated, which were misdiagnosed as malignancy before surgery. For middle-aged patients with intermittent hematuria, if the imaging data cannot rule out renal pelvic hemangioma, it is recommended to perform renoscopy, renal artery angiography or renal puncture biopsy. For patients diagnosed with renal pelvic hemangioma, either partial nephrectomy, ureteroscopic cauterization, or selective renal artery embolization can achieve good results.