OBJECTIVE To explore the effects of piperacillin/tazobactam combined with acetylcysteine solution on severe pneumonia after cerebral infarction,and to analyze its impact on cardiopulmonary and neurological function.METHODS A total of 86 patients with severe pneumonia after cerebral infarction admitted to Yulin Xingyuan Hos-pital from Jan.2022 to Jun.2024 were selected and divided into a control group and a study group using the ran-dom number table method(single blind),with 43 cases in each group.The control group was treated with intrave-nous drip of piperacillin/tazobactam,while the study group received additional inhalation of acetylcysteine solution based on the control group's treatment.The levels of inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)],lung function indicators[forced vital capacity(FVC),peak expiratory flow rate(PEF),forced expiratory volume in one second(FEV1)and mean maximal expiratory flow rate(MMEF)],cardiac function indicators[left ventricular ejection fraction(LVEF),cardiac output(CO),cardiac index(CI)and stroke volume(SV)],NIH Stroke Scale(NIHSS)score,clinical efficacy,and the occurrence of adverse reactions were compared before and after treatment.RESULTS Compared with the control group,the study group had low levels of CRP,IL-6,PCT and NIHSS scores after treatment(P<0.05),and high levels of FVC,PEF,FEV1,MMEF,LVEF,CO,CI,and SV after treatment(P<0.05).The overall response rate in the study group was 95.35%,higher than 81.40%in the control group(χ2=4.074,P=0.044).There was no statistically significant difference in the incidence of adverse reactions between the control group and the study group during treatments(χ2=0.179,P=0.672).CONCLUSION Piperacillin/tazobactam combined with inhaled acetylcysteine solution for the treatment of severe pneumonia after cerebral infarction can improve clinical efficacy,reduce levels of inflamma-tory factors,and enhance cardiopulmonary and neurological functions in patients,which has a high safety profile.

OBJECTIVE To investigate the mechanism of action of Quzhuo Tongbi Granules(QZTB)in reducing uric acid and anti-inflammation in mice with hyperuricemia(HUA).METHODS The components of QZTB were identified by ultra-performance liquid chromatography-mass spectrometry(UPLC-MS).Sixty-four C57BL/6 mice were randomly divided into control group,model group,benzbromarone group,QZTB low-dose group,QZTB medium-dose group,QZTB high-dose group,MCC950 group,and MCC950+QZTB medium-dose group,with 8 mice in each group.Adenine(100 mg·kg-1)and potassium oxonate(500 mg·kg-1)were used to establish the HUA mouse model.Except for the control group,all other groups underwent 2 weeks of modeling followed by 4 weeks of treatment.After 2 weeks of modeling,blood was collected from the orbital venous plexus to measure serum uric acid(SUA)levels as the criterion for successful model induction.Mice were sacrificed after 4 weeks of continuous treatment for sample collection.An automatic biochemical analyzer was used to measure serum levels of SUA,urea nitrogen(BUN),and creatinine(Cr).Enzyme-linked immunosorbent assay(ELISA)was employed to detect serum levels of interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-18(IL-18),and tumor necrosis factor-α(TNF-α).The qPCR was used to assess mRNA expression of urate transporter 1(URAT1),ATP-binding cassette transporter G2(ABCG2),glucose transporter 9(GLUT9),and PDZ domain-contai-ning protein kinase 1(PDZK1)in kidney tissue.Western blot was performed to measure protein expression of urate transporters(URAT1,ABCG2,GLUT9,PDZK1),nuclear transcription factor κB(NF-κB)total protein,phosphorylated NF-κB(p-NF-κB),Nod-like receptor protein 3(NLRP3),Cleaved Caspase-1 and Pro-Caspase-1 proteins in kidney tissue.Immunohistochemistry was used to determine the expression levels of urate transporters(URAT1,ABCG2,PDZK1,GLUT9)in kidney tissue.RESULTS A to-tal of 9 representative active ingredients were identified in QZTB.Two weeks after modeling,SUA in the model group was significantly increased compared with that in the control group(P<0.000 1).Four weeks after administration,serum SUA,BUN and Cr in the model group were significantly increased(P<0.000 1),IL-1β,IL-6,IL-18 and TNF-α levels were increased(P<0.01,P<0.001),the expression of ABCG2 and PDZK1 proteins in renal tissue was decreased(P<0.01,P<0.001,P<0.000 1),and the ex-pression of URAT1,GLUT9,NLRP3,p-NF-κB p65/NF-κB p65 and Cleaved Caspase-1/Pro-Caspase-1 proteins was significantly increased(P<0.01,P<0.001,P<0.000 1).Compared with the model group,SUA,BUN and Cr in the benzbromarone group and the low-,medium-and high-dose QZTB intervention groups were reduced to varying degrees(P<0.001,P<0.000 1).QZTB could ef-fectively reduce the levels of serum inflammatory factors IL-1β,IL-6,IL-18 and TNF-α(P<0.05,P<0.01),increase the expres-sion of ABCG2 and PDZK1 proteins in renal tissue(P<0.05,P<0.01,P<0.000 1),and downregulate the expression of URAT1,GLUT9,NLRP3,p-NF-κB p65/NF-κB p65 and Cleaved Caspase-1/Pro-Caspase-1 proteins(P<0.05,P<0.01,P<0.001,P<0.000 1).Compared with the model group,the MCC950 group downregulated the protein expressions of NLRP3,p-NF-κB p65/NF-κB p65,and Cleaved Caspase-1/Pro-Caspase-1(P<0.01).Compared with the MCC950 group or the QZTB group,the MCC950+QZTB group downregulated the protein expressions of NLRP3,p-NF-κB p65/NF-κB p65,and Cleaved Caspase-1/Pro-Caspase-1(P<0.05,P<0.01,P<0.000 1).CONCLUSION QZTB can promote uric acid excretion by inhibiting the NF-κB/NLRP3 signaling pathway,thereby improving the symptoms of HUA.

OBJECTIVE To investigate the mechanism of action of Quzhuo Tongbi Granules(QZTB)in reducing uric acid and anti-inflammation in mice with hyperuricemia(HUA).METHODS The components of QZTB were identified by ultra-performance liquid chromatography-mass spectrometry(UPLC-MS).Sixty-four C57BL/6 mice were randomly divided into control group,model group,benzbromarone group,QZTB low-dose group,QZTB medium-dose group,QZTB high-dose group,MCC950 group,and MCC950+QZTB medium-dose group,with 8 mice in each group.Adenine(100 mg·kg-1)and potassium oxonate(500 mg·kg-1)were used to establish the HUA mouse model.Except for the control group,all other groups underwent 2 weeks of modeling followed by 4 weeks of treatment.After 2 weeks of modeling,blood was collected from the orbital venous plexus to measure serum uric acid(SUA)levels as the criterion for successful model induction.Mice were sacrificed after 4 weeks of continuous treatment for sample collection.An automatic biochemical analyzer was used to measure serum levels of SUA,urea nitrogen(BUN),and creatinine(Cr).Enzyme-linked immunosorbent assay(ELISA)was employed to detect serum levels of interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-18(IL-18),and tumor necrosis factor-α(TNF-α).The qPCR was used to assess mRNA expression of urate transporter 1(URAT1),ATP-binding cassette transporter G2(ABCG2),glucose transporter 9(GLUT9),and PDZ domain-contai-ning protein kinase 1(PDZK1)in kidney tissue.Western blot was performed to measure protein expression of urate transporters(URAT1,ABCG2,GLUT9,PDZK1),nuclear transcription factor κB(NF-κB)total protein,phosphorylated NF-κB(p-NF-κB),Nod-like receptor protein 3(NLRP3),Cleaved Caspase-1 and Pro-Caspase-1 proteins in kidney tissue.Immunohistochemistry was used to determine the expression levels of urate transporters(URAT1,ABCG2,PDZK1,GLUT9)in kidney tissue.RESULTS A to-tal of 9 representative active ingredients were identified in QZTB.Two weeks after modeling,SUA in the model group was significantly increased compared with that in the control group(P<0.000 1).Four weeks after administration,serum SUA,BUN and Cr in the model group were significantly increased(P<0.000 1),IL-1β,IL-6,IL-18 and TNF-α levels were increased(P<0.01,P<0.001),the expression of ABCG2 and PDZK1 proteins in renal tissue was decreased(P<0.01,P<0.001,P<0.000 1),and the ex-pression of URAT1,GLUT9,NLRP3,p-NF-κB p65/NF-κB p65 and Cleaved Caspase-1/Pro-Caspase-1 proteins was significantly increased(P<0.01,P<0.001,P<0.000 1).Compared with the model group,SUA,BUN and Cr in the benzbromarone group and the low-,medium-and high-dose QZTB intervention groups were reduced to varying degrees(P<0.001,P<0.000 1).QZTB could ef-fectively reduce the levels of serum inflammatory factors IL-1β,IL-6,IL-18 and TNF-α(P<0.05,P<0.01),increase the expres-sion of ABCG2 and PDZK1 proteins in renal tissue(P<0.05,P<0.01,P<0.000 1),and downregulate the expression of URAT1,GLUT9,NLRP3,p-NF-κB p65/NF-κB p65 and Cleaved Caspase-1/Pro-Caspase-1 proteins(P<0.05,P<0.01,P<0.001,P<0.000 1).Compared with the model group,the MCC950 group downregulated the protein expressions of NLRP3,p-NF-κB p65/NF-κB p65,and Cleaved Caspase-1/Pro-Caspase-1(P<0.01).Compared with the MCC950 group or the QZTB group,the MCC950+QZTB group downregulated the protein expressions of NLRP3,p-NF-κB p65/NF-κB p65,and Cleaved Caspase-1/Pro-Caspase-1(P<0.05,P<0.01,P<0.000 1).CONCLUSION QZTB can promote uric acid excretion by inhibiting the NF-κB/NLRP3 signaling pathway,thereby improving the symptoms of HUA.

OBJECTIVE To explore the effects of piperacillin/tazobactam combined with acetylcysteine solution on severe pneumonia after cerebral infarction,and to analyze its impact on cardiopulmonary and neurological function.METHODS A total of 86 patients with severe pneumonia after cerebral infarction admitted to Yulin Xingyuan Hos-pital from Jan.2022 to Jun.2024 were selected and divided into a control group and a study group using the ran-dom number table method(single blind),with 43 cases in each group.The control group was treated with intrave-nous drip of piperacillin/tazobactam,while the study group received additional inhalation of acetylcysteine solution based on the control group's treatment.The levels of inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)],lung function indicators[forced vital capacity(FVC),peak expiratory flow rate(PEF),forced expiratory volume in one second(FEV1)and mean maximal expiratory flow rate(MMEF)],cardiac function indicators[left ventricular ejection fraction(LVEF),cardiac output(CO),cardiac index(CI)and stroke volume(SV)],NIH Stroke Scale(NIHSS)score,clinical efficacy,and the occurrence of adverse reactions were compared before and after treatment.RESULTS Compared with the control group,the study group had low levels of CRP,IL-6,PCT and NIHSS scores after treatment(P<0.05),and high levels of FVC,PEF,FEV1,MMEF,LVEF,CO,CI,and SV after treatment(P<0.05).The overall response rate in the study group was 95.35%,higher than 81.40%in the control group(χ2=4.074,P=0.044).There was no statistically significant difference in the incidence of adverse reactions between the control group and the study group during treatments(χ2=0.179,P=0.672).CONCLUSION Piperacillin/tazobactam combined with inhaled acetylcysteine solution for the treatment of severe pneumonia after cerebral infarction can improve clinical efficacy,reduce levels of inflamma-tory factors,and enhance cardiopulmonary and neurological functions in patients,which has a high safety profile.

It is proposed that the disease mechanism evolution of systemic lupus erythematosus can be summarized into four stages： initial invasion and latency， the pathogenesis remains concealing； latent toxin accumulation， the disease gradually becomes apparent； active toxin begins damaging， the disease manifests aggressively； damage resulting to deficiency， the disease course prolonged. Based on the stages of latent toxin evolution， the syndrome differentiation and treatment of systemic lupus erythematosus can be summarized as follows： during the initial latent stage， characterized by latent dampness and heat stagnation， modified Sanren Decoction （三仁汤） should be used； in the toxin outbreak stage， marked by intense heat toxin， modified Xijiao Dihuang Decoction （犀角地黄汤） combined with modified Qingwen Baidu Decoction （清瘟败毒饮） should be used； during the toxin damage stage， which presents as latent toxin damaging zang-fu organs， modified Qinghao Biejia Decoction （青蒿鳖甲汤） should be used； in the healthy qi deficiency stage， characterized by deficiencies of qi， blood， yin， and yang， modified Xieli Shiquan Ointment （燮理十全膏） should be used.

Objective To investigate the influence of rutin on neuroinflammation in rats with hydraulic shock brain injury by regulating thioredoxin-interacting protein(TXNIP)/NOD-like receptor protein 3(NLRP3)signaling pathway.Methods Rats were randomly separated into model group and sham operation group;the rats in the model group were established by hydraulic impact method.After modeling,they were randomly separated into rutin low(rutin-L,25 mg·kg-1 rutin)and medium(rutin-M,50 mg·kg-1 rutin).D),high(rutin-H,100 mg·kg-1 rutin)dose groups,model group and positive control group(dexamethasone group,0.1 mg·kg-1 dexamethasone),18 animals/group.Each group was intervened with drugs and normal saline once a day,and after continuous intervention for 3 days,the neurological deficit(neurological severity score,NSS)of the rats was scored;the rats were sacrificed by decapitation,the cerebral edema was determined,the brain tissue around the contusion was separated,and the histological changes,inflammatory cytokine indicators-tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)levels and TXNIP,NLRP3 protein expression levels were measured.Results The rats in the sham operation group had no injury.The integrity of brain tissue in model group was damaged,cell wrinkly nuclei were deeply stained,interstitial edema was accompanied by holes and the TNF-α and IL-1β levels,NSS score,cerebral edema,TXNIP and NLRP3 protein expression levels were all increased compared with those in the sham operation group(P<0.05);after rutin intervention,the pathological injury of rat brain tissue was relieved,and the TNF-α and IL-1β levels,NSS score,cerebral edema,TXNIP,and NLRP3 protein expression levels were all lower than those in the model group(P<0.05),there was no significant difference between the rutin-H group and the dexamethasone group(P>0.05).Conclusion Rutin can inhibit the inflammatory response of hydraulic shock brain injury rats,improve brain tissue injury and edema,which may be related to the inhibition of TXNIP/NLRP3 signaling pathway.

Objective To investigate the influence of rutin on neuroinflammation in rats with hydraulic shock brain injury by regulating thioredoxin-interacting protein(TXNIP)/NOD-like receptor protein 3(NLRP3)signaling pathway.Methods Rats were randomly separated into model group and sham operation group;the rats in the model group were established by hydraulic impact method.After modeling,they were randomly separated into rutin low(rutin-L,25 mg·kg-1 rutin)and medium(rutin-M,50 mg·kg-1 rutin).D),high(rutin-H,100 mg·kg-1 rutin)dose groups,model group and positive control group(dexamethasone group,0.1 mg·kg-1 dexamethasone),18 animals/group.Each group was intervened with drugs and normal saline once a day,and after continuous intervention for 3 days,the neurological deficit(neurological severity score,NSS)of the rats was scored;the rats were sacrificed by decapitation,the cerebral edema was determined,the brain tissue around the contusion was separated,and the histological changes,inflammatory cytokine indicators-tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)levels and TXNIP,NLRP3 protein expression levels were measured.Results The rats in the sham operation group had no injury.The integrity of brain tissue in model group was damaged,cell wrinkly nuclei were deeply stained,interstitial edema was accompanied by holes and the TNF-α and IL-1β levels,NSS score,cerebral edema,TXNIP and NLRP3 protein expression levels were all increased compared with those in the sham operation group(P<0.05);after rutin intervention,the pathological injury of rat brain tissue was relieved,and the TNF-α and IL-1β levels,NSS score,cerebral edema,TXNIP,and NLRP3 protein expression levels were all lower than those in the model group(P<0.05),there was no significant difference between the rutin-H group and the dexamethasone group(P>0.05).Conclusion Rutin can inhibit the inflammatory response of hydraulic shock brain injury rats,improve brain tissue injury and edema,which may be related to the inhibition of TXNIP/NLRP3 signaling pathway.

Objective: To explore the expression of KIF20A (kinesin family member 20A) in colorectal cancer (CRC) tissues and adjacent normal tissues, and to analyze the relationship between KIF20A expression level and clinicopathological factors in CRC patients. Meth-ods: Data from The Cancer Genome Atlas (TCGA) database were used to analyze KIF20A mRNA expression in CRC tissues and adjacent normal tissues. A total of 105 paraffin samples were obtained from CRC patients who had undergone surgery at Huai He Hospital of Henan University, from January 2011 to December 2012. Immunohistochemical staining (IHC) was performed to examine KIF20A pro-tein expression in tumor samples for which complete clinical and pathological data were available. Statistical analyses were applied to analyze the association between KIF20A expression and the clinical data, as well as with survival outcomes. Results: Bioinformatics analysis showed that the mRNA expression level of KIF20A was upregulated in CRC tissues and normal tissues (P<0.001). IHC revealed significantly higher expression of KIF20A in CRC tissues from 67 patients (64%) and lower or undetectable expression in 38 patients (36%). The difference was statistically significant (P<0.05). Overexpression of KIF20A in CRC tissues was significantly associated with depth of invasion, lymphatic node metastasis, distant metastasis, and TNM stage (all P<0.05). Kaplan-Meier survival analysis showed that patients with high levels of KIF20A expression had poor prognosis compared to patients with low levels of KIF20A expression. Cox proportional hazard regression analysis revealed that KIF20A was an independent prognostic factor in patients with CRC. Conclusions:KIF20A is upregulated in CRC tissues and could serve as a novel prognostic biomarker for CRC patients.

Objective To analyze the clinical and electrophysiological features in a family with spinal muscular atrophy (SMA), and assess the probable causative gene mutations for the family. Methods To identify the nosogenesis of the proband with weakness and atrophy in the double lower proximal limbs, clinical data of his 12 family members were collected, and the proband and his mother were selected for clinical examinations, including laboratory tests, electromyogram (EMG), F-wave, H-reflex, X-ray of the spine and double lower limbs, brain and spinal cord magnetic resonance imaging, etc. Moreover, human whole exome sequencing was performed on blood sample from the proband, then its deleterious effects were assessed according to the Standards and guidelines for the interpretation of sequence variants, a joint consensus recommendation of the American College of Medical Genomics (ACMG) and the Association for Molecular Pathology (AMP). Subsequently, the strong pathogenic mutation was validated by Sanger sequencing. Results Familial investigation showed seven of 12 family members presented with weakness in the double lower proximal limbs. Among them, three had the main manifestation of atrophy in the double lower proximal limbs, one had high arched foot as the main presentation, and the others had weakness in the double lower proximal limbs. EMG studies showed the abnormal results in the anterior horn of the spinal cord. The strong pathogenic mutation in DYNC1H1 gene (exon8, c.2327C＞T, p.P776L) was identified from the proband according to ACMG and AMP guidelines. Sanger sequencing revealed six patients had this variant and it was passed mainly from his maternal grandmother. Conclusions A pathogenic mutation of the DYNC1H1 p.P776L in six Chinese pedigrees which cosegregated with SMA was identified. There existed individual differences in clinical presentations. This finding may have important implications for the study of SMA in Chinese patients.

Chinese medicine processing is the main feature that distinguishes traditional Chinese medicine from natural medicine and plant medicine, and is the main feature in clinical medication of traditional Chinese medicine. The research of Chinese medicine processing technology is an important link to realize standardization and standardization of Chinese herbal pieces, with urgent need to attract high attention. At present, there are still many problems in the research of processing technology of Chinese herbal pieces, mainly including inconsistent processing technology, large differences in process technology parameters, and unstable production technology of Chinese herbal pieces, resulting in uncontrollable quality of Chinese herbal pieces and affecting the clinical efficacy of Chinese medicine. This paper focused on the establishment of a unified standard processing technology, and put forward the countermeasures for the processing technology of Chinese medicine based on a comprehensive analysis of the current situations of the processing technology of Chinese herbal pieces, with significance for guiding the establishment of a standardized processing technology of Chinese medicine.