ObjectiveThis study aimed to investigate whether Bushen Tongluo prescription inhibits macrophage polarization by regulating the Wnt3a/β-catenin signaling pathway， thereby reducing epithelial-mesenchymal transition and excessive extracellular matrix deposition， in order to elucidate the anti-pulmonary fibrosis mechanisms of Bushen Tongluo prescription and provide a new theoretical basis for the clinical treatment of pulmonary fibrosis. MethodsFifty male Sprague-Dawley （SD） rats were randomly divided into a blank group， model group， pirfenidone group， and high- and low-dose Bushen Tongluo prescription groups. Except for the blank group， the pulmonary fibrosis model was established by intratracheal instillation of bleomycin. Intervention was initiated on day 28 after modeling. The high- and low-dose Bushen Tongluo prescription groups were administered Bushen Tongluo prescription at doses of 30.88， 15.44 g·kg^-1， respectively， by intragastric gavage. The pirfenidone group was administered pirfenidone capsules at 110 mg·kg^-1 by intragastric gavage. The blank and model groups were given an equal volume of normal saline by gavage， once daily for 90 days. After treatment， the level of transforming growth factor-β₁ （TGF-β₁） in bronchoalveolar lavage fluid （BALF） was detected by enzyme-linked immunosorbent assay （ELISA）. Morphological changes in lung tissue and the collagen volume fraction were compared. The protein distribution and expression of E-cadherin， cytokeratin 19， α-smooth muscle actin （α-SMA）， vimentin， collagen type Ⅰ （Col Ⅰ）， and collagen type Ⅲ （Col Ⅲ） in lung tissue were detected by immunohistochemistry. The protein distribution and expression of CD68， arginase-1 （Arg-1）， inducible nitric oxide synthase （iNOS）， Wnt3a， and β-catenin in lung tissue were detected by immunofluorescence. The protein expression of Wnt3a and β-catenin in lung tissue was detected by Western blot， and the mRNA expression of Wnt3a and β-catenin was detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. ResultsCompared with the blank group， a large number of inflammatory cells infiltrated the airway walls， alveolar spaces， and interstitial tissue in the model group， with obvious fibrous tissue hyperplasia. The level of TGF-β₁ in BALF was significantly increased. The protein expression of E-cadherin and cytokeratin 19 in lung tissue was decreased， whereas the protein expression of α-SMA， Vimentin， Wnt3a， β-catenin， Col Ⅰ， and Col Ⅲ was increased. The fluorescence-positive area ratios of CD68， Arg-1， iNOS， Wnt3a， and β-catenin in lung tissue were increased. The protein and mRNA expression levels of Wnt3a and β-catenin in lung tissue were significantly increased （P<0.01）. Compared with the model group， all treatment groups showed varying degrees of improvement in inflammatory cell infiltration and fibrous tissue hyperplasia in the airway walls， alveolar spaces， and interstitial tissue， decreased TGF-β₁ levels in BALF， increased protein expression of E-cadherin and cytokeratin 19 in lung tissue， decreased protein expression of α-SMA， Vimentin， Col Ⅰ， and Col Ⅲ， decreased fluorescence-positive area ratios of CD68， Arg-1， iNOS， Wnt3a， and β-catenin in lung tissue， and decreased protein and mRNA expression levels of Wnt3a and β-catenin in lung tissue （P<0.05， P<0.01）. ConclusionBushen Tongluo prescription can improve bleomycin-induced pulmonary fibrosis in rats by inhibiting epithelial-mesenchymal transition and reducing excessive extracellular matrix deposition. The mechanism may be related to inhibition of the Wnt3a/β-catenin signaling pathway and the macrophage polarization mediated by this pathway.

Pulmonary sarcoidosis is an immune system disease with an unclear etiology. Guided by the yang-reinforcing method， it is believed that the fundamental pathogenesis of pulmonary sarcoidosis lies in the disharmony between water and fire and the reckless movement of the ministerial fire. The failure of the spleen and stomach to maintain warmth， leading to the production of phlegm and blood stasis， is an important pathogenesis. The invasion of external pathogenic toxins， deeply penetrating into the interior， is considered a triggering factor for the disease. The treatment focuses on supplementing the yang， consolidating the kidney， drawing fire back to its source， warming the yang， benefiting the kidney， and nourishing the spleen to generate metal. It also emphasizes unblocking the yang， transforming turbidity， and eliminating phlegm and blood stasis.

Bronchial asthma is a heterogeneous chronic inflammatory airway disease.Its pathogenesis is closely associated with abnormal immune responses within T-helper(Th)cell subsets,characterized by excessive effector Th cell activation and impaired immunosuppression by regulatory T cells.The concept of natural harmony of yin-yang epitomizes the understanding of traditional Chinese medicine(TCM)of the body's inherent capacity for autonomous regulation and homeostasis maintenance.Building upon the description in the Inner Canon of Yellow Emperor regarding asthma as"internal yin qi contention,external yang qi interference,"this study aims to bridge the TCM macro-level etiology and pathogenesis of"yin-yang disharmony"with the Western micro-level mechanism of loss of immune homeostasis control.The core pathogenesis of bronchial asthma involves yin-yang disorder in the body,leading to internal-external imbalance.Yang deficiency with a hidden yin pathogen and intermingled phlegm with blood stasis in the lungs is the root of pathogenesis.Pathogenic invading qi and yang hyperactivity induce bronchial asthma.These align with the Western medical concepts of imbalanced immunometabolic self-stabilization and defective immunotolerance.Based on the above content,corresponding therapeutic principles are proposed according to the disease stage.In the acute phase,dispelling wind pathogens and relieving cough are recommended.In chronic persistent asthma,calming yang disturbance and resolving the yin conflict are emphasized.In the clinical remission phase,kidney yang should be warmed and invigorated,thereby consolidating body resistance.The corresponding treatment methods are implemented based on the above content.In the acute phase,self-made Mahuang Qingyang Decoction is administered to dispel wind pathogens and ventilate lung qi.In chronic persistent asthma,self-made Qingfei Xiegan Decoction is administered to clear liver-fire and purge the lungs,self-made Xuanfu Qingwei Decoction is employed to harmonize the stomach for descending adverse yang qi,modified Suzi Jiangqi Decoction is applied to conduct deficient yang back to its source,and modified Erchen Decoction and Taohong Siwu Decoction are utilized to expel phlegm and blood stasis.In the clinical remission phase,modified Sijunzi Decoction,modified Mahuang Fuzi Xixin Decoction,and Erxian Decoction are administered to invigorate the spleen and kidney.These approaches ward off yang disturbance and resolve yin contention to restore the body's normal immune homeostasis.The ultimate therapeutic aim is to achieve a state of natural harmony of yin-yang,thereby ceasing wheezing and coughing spontaneously,and to provide new ideas for clinical treatment of bronchial asthma.

Bronchial asthma is a heterogeneous chronic inflammatory airway disease.Its pathogenesis is closely associated with abnormal immune responses within T-helper(Th)cell subsets,characterized by excessive effector Th cell activation and impaired immunosuppression by regulatory T cells.The concept of natural harmony of yin-yang epitomizes the understanding of traditional Chinese medicine(TCM)of the body's inherent capacity for autonomous regulation and homeostasis maintenance.Building upon the description in the Inner Canon of Yellow Emperor regarding asthma as"internal yin qi contention,external yang qi interference,"this study aims to bridge the TCM macro-level etiology and pathogenesis of"yin-yang disharmony"with the Western micro-level mechanism of loss of immune homeostasis control.The core pathogenesis of bronchial asthma involves yin-yang disorder in the body,leading to internal-external imbalance.Yang deficiency with a hidden yin pathogen and intermingled phlegm with blood stasis in the lungs is the root of pathogenesis.Pathogenic invading qi and yang hyperactivity induce bronchial asthma.These align with the Western medical concepts of imbalanced immunometabolic self-stabilization and defective immunotolerance.Based on the above content,corresponding therapeutic principles are proposed according to the disease stage.In the acute phase,dispelling wind pathogens and relieving cough are recommended.In chronic persistent asthma,calming yang disturbance and resolving the yin conflict are emphasized.In the clinical remission phase,kidney yang should be warmed and invigorated,thereby consolidating body resistance.The corresponding treatment methods are implemented based on the above content.In the acute phase,self-made Mahuang Qingyang Decoction is administered to dispel wind pathogens and ventilate lung qi.In chronic persistent asthma,self-made Qingfei Xiegan Decoction is administered to clear liver-fire and purge the lungs,self-made Xuanfu Qingwei Decoction is employed to harmonize the stomach for descending adverse yang qi,modified Suzi Jiangqi Decoction is applied to conduct deficient yang back to its source,and modified Erchen Decoction and Taohong Siwu Decoction are utilized to expel phlegm and blood stasis.In the clinical remission phase,modified Sijunzi Decoction,modified Mahuang Fuzi Xixin Decoction,and Erxian Decoction are administered to invigorate the spleen and kidney.These approaches ward off yang disturbance and resolve yin contention to restore the body's normal immune homeostasis.The ultimate therapeutic aim is to achieve a state of natural harmony of yin-yang,thereby ceasing wheezing and coughing spontaneously,and to provide new ideas for clinical treatment of bronchial asthma.

This article is based on ZHANG Jingyue's theory of yin-yang holism to explore the etiology， pathogenesis， and treatment of acute exacerbation of rheumatoid arthritis-associated interstitial lung disease （RA-ILD）. It is believed that the foundation of acute exacerbation of RA-ILD lies in real yin insufficiency and yin fail to control yang； external pathogen attacking is a common cause of acute exacerbation of RA-ILD. For treatment， it is important to first suppress ministerial fire by prescribing modified Yinhuo Decoction （引火汤）； if ministerial fire submerged， focus should be on nourishing both yin and yang； if real yin deficiency is the main issue， modified Zuogui Pill （左归丸） should be used； if real yang deficiency is prominent as well， modified Yougui Pill （右归丸） can be chosen. When yin and yang balanced， the disease could be solved.

Objective:To explore the feasibility and clinical efficacy of oblique lateral interbody fusion (OLIF) in the treatment of adjacent segment disease (ASDis).Methods:Retrospective analysis was conducted on the data of 31 patients with ASDis treated by OLIF in four medical centers from June 2015 to December 2018. There were 17 males and 14 females. The average age was (65.7±3.4) years (range, 59 to 75 years). 19 cases received single-segment fixed fusion, 11 cases received double-segment fixed fusion and 1 case received three-segment fixed fusion. Original fixed fusion site: 1 case of L 1, 2, 3 cases of L 3, 4, 11 cases of L 4, 5, 4 cases of L 5S 1, 6 cases of L 3-L 5, 5 cases of L 4-S 1, and 1 case of L 3-S 1. The time from the initial fixation and fusion to this admission was 82.5±45.5 months (rang, 24 to 180 months). ASDis occurred at the proximal end of the fixed fusion segment in 28 cases and at the distal end in 3 cases. The types of ASDis: degenerative disc disease in 11 cases, lumbar spinal stenosis in 15 cases, degenerative spondylolisthesis in 2 cases, and degenerative scoliosis in 3 cases. The location of ASDis: 6 cases of L 2, 3, 12 cases of L 3, 4, 6 cases of L 4, 5, 3 cases of L 1-L 3, 1 case of L 2-L 4, and 3 cases of L 1-L 4. At admission, 3 cases of lumbar internal fixation had been removed and 28 cases of internal fixation remained. Stand-alone OLIF was performed in 19 cases, OLIF combined with pedicle screw fixation in 8 cases, and OLIF combined with cortical screw fixation in 4 cases. Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate the low back pain and lumbar function before operation and at the last follow-up, and the imaging results and complications were observed. Results:All patients were followed up. The follow-up time was 23.6±9.6 months (range, 12 to 60 months). The operation time was 73.8±25.3 mins (range, 40 to 180 min), and the intraoperative blood loss was 86.2±67.4 ml (range, 20 to 310 ml). The average blood loss in each segment was 24.8 ml. During the operation, there were 1 case of segmental vein injury, 7 cases of endplate injury, 2 cases of transient iliopsoas muscle weakness, 1 case of thigh pain and numbness, and 1 case of incomplete intestinal obstruction. There was no incision necrosis and infection. The VAS score of low back pain decreased from 5.9±1.9 before operation to 1.4±0.6 at the last follow-up, with a statistically significant difference ( t=8.47, P<0.001). The ODI index recovered from 45.2%±5.7% before operation to 13.8%±4.7% at the last follow-up, with a statistically significant difference ( t=7.92, P<0.001). The height of intervertebral space increased from 8.7±1.6 mm before operation to 11.4±1.9 mm after operation and 9.9±1.8 mm at the last follow-up. There was a statistically significant difference between postoperative and preoperative height of intervertebral space ( F=4.15, P=0.007). There was a statistically significant difference between the last follow-up and postoperative height of intervertebral space ( P=0.011). During the follow-up, there were 13 cases of fusion cage subsidence, 1 case of fusion cage displacement, and no case of internal fixation loosening or fracture. The intervertebral fusion rate was 94%(29/31) and the complication rate was 42%(13/31). Conclusion:ASDis is a common complication after lumbar fixation and fusion, and requires surgical treatment. OLIF is a reliable method to treat ASDis as it has advantages of small trauma, high fusion rate and low complication rate.

[Abstract] Objective: To investigate the effect of HMGB1 gene on the growth of human epithelial ovarian cancer xenografts in nude mice, and to lay a foundation for finding new targets for the treatment of ovarian cancer. Methods: Human epithelial ovarian cancer SKOV3 cells in logarithmic growth phase were selected to establish a human epithelial ovarian cancer xenograft model in nude mice. Nude mice with successful model establishment were randomly divided into control group and HMGB1-siRNA group. On the 7th, 9th, 11th, 14th, and 16th days after cell inoculation, the same amount of saline and HMGB1-siRNA were respectively injected into two groups of mice under the armpit.After 3 weeks, the nude mice were sacrificed by cervical dislocation, the tumor tissues were separated, and the volume of the tumor was measured. The apoptosis of transplanted tumor cells was detected by Tunnel staining. The expressions of HMGB1, STAT3 and p-STAT3 were detected by Western blotting. The expression of vascular endothelial growth factorA(VEGF-A) and microvascularization were detected by immunohistochemistry. Results: Compared with the control group, the growth of tumor volume slowed down in HMGB1 siRNA group, and on the 21st day, the tumor volume of HMGB1-siRNA group was significantly smaller than that of the control group (P<0.05). HMGB1-siRNA successfully knocked down the expression of HMGB1 mRNA in transplanted tumor tissue. The apoptosis rate of tissue cells in HMGB1-siRNA group was significantly increased ([34±8]% vs [6±2]%, P=0.04), and the expressions of HMGB1 and p-STAT3 were significantly reduced (P<0.05). The expression of VEGF-Aand the number of microvessels were significantly lower than those of the control group (both P<0.05). Conclusion: Knockdown of HMGB1 gene reduces the expression of VEGF-A and microvessel formation possibly by inhibiting the HMGB1/STAT3 signaling pathway, thereby promoting the apoptosis of tumor tissues and slowing the growth of xenografts.

OBJECTIVE:To optimize the ethanol extraction process of anti-atherosclerosis effective fraction of Lindley eupatorium. METHODS:Using the contents of hyperin,quercetin,kaempferol and jaceosidin as indexes,the effects of ethanol volume fraction,liquid-solid ratio,extraction time and extraction times on ethanol extraction technology were investigated. By multiple index scoring method,orthogonal test was designed to optimize extraction technology,and validation test was conducted. RESULTS:The optimal extraction technology was 70% ethanol as extraction solvent with solid-liquid ratio of 12 : 1,reflux extracting for 3 times,2 h each time. Results of 3 batches of validation tests showed that the contents of 4 marker components were in high level,being 5.305 3,1.560 1,1.986 5,6.703 6 mg/g in average(RSD<1.1%,n=3). Results of validation tests were stable and reliable,and were in good agreement with the results of orthogonal tests. CONCLUSIONS:The optimized ethanol reflux extraction technology of L. eupatorium is stable and reliable,and performs well. Energy consumption and cost are suitable for industrial production.The results provide technology basis for further purification and enrichment of anti-atherosclerosis effective components of L.eupatorium.