OBJECTIVES: To investigate pharmacologically active components of Yiqi Zishen Formula (YZF) and their mechanisms for alleviating airway inflammation in mice with chronic obstructive pulmonary disease (COPD). METHODS: Ultra-high-performance liquid chromatography coupled with quadrupole-orbitrap mass spectrometry was employed to characterize the chemical components in YZF and YZF-medicated rat serum. A compound-disease target network was constructed based on serum components of YZF to screen the key pathways and targets using enrichment analysis. A mouse model of cigarette smoke-induced COPD was used to evaluate the anti-inflammatory effect of YZF and validate the expression of key proteins in network pharmacology-enriched pathways. Fifty male C57BL/6J mice were randomized equally into control group, COPD model group, high- and low-dose YZF treatment groups, and N-acetylcysteine treatment group. Pulmonary function of the mice was assessed using whole-body plethysmography, and lung histopathology, alveolar structure, and airway remodeling were analyzed using HE staining. The levels of IL-1β, IL-6, and TNF‑α in bronchoalveolar lavage fluid (BALF) were determined with ELISA, and pulmonary expressions of PI3K, Akt, phosphorylated Akt (p-Akt), p65, and phosphorylated p65 (p-p65) were detected using immunohistochemistry. RESULTS: We identified a total of 156 chemical components (including 26 flavonoids or flavonoid glycosides, 27 alkaloids, and 11 saponins) in YZF and 43 prototype components in medicated rat serum. Network pharmacology revealed 704 YZF-related targets and 1199 COPD-associated targets. Integrated analysis suggested that the anti-COPD effects of YZF were associated with the PI3K-Akt signaling pathway. In mouse models of COPD, YZF treatment significantly increased mean alveolar number and peak expiratory flow (P<0.05), reduced mean linear intercept, bronchial wall thickness, lung coefficient, and BALF cytokine levels, and suppressed the expressions of PI3K, Akt, p-Akt, p65, and p-p65 in the lung tissues. CONCLUSIONS YZF alleviates COPD symptoms and airway inflammation in mice possibly by inhibiting the PI3K/Akt/NF‑κB pathway through its multiple components that interact with multiple targets.
Animals ; Pulmonary Disease, Chronic Obstructive/metabolism* ; Drugs, Chinese Herbal/therapeutic use* ; Signal Transduction/drug effects* ; Male ; Mice, Inbred C57BL ; Mice ; Proto-Oncogene Proteins c-akt/metabolism* ; Phosphatidylinositol 3-Kinases/metabolism* ; NF-kappa B/metabolism* ; Inflammation/drug therapy* ; Rats

Chemotherapy-induced peripheral neurotoxicity (CIPN) is a severe dose-limiting adverse event of chemotherapy. Presently, the mechanism underlying the induction of CIPN remains unclear, and no effective treatment is available. In this study, through metabolomics analyses, we found that nab-paclitaxel therapy markedly increased serum serotonin [5-hydroxtryptamine (5-HT)] levels in both cancer patients and mice compared to the respective controls. Furthermore, nab-paclitaxel-treated enterochromaffin (EC) cells showed increased 5-HT synthesis, and serotonin-treated Schwann cells showed damage, as indicated by the activation of CREB3L3/MMP3/FAS signaling. Venlafaxine, an inhibitor of serotonin and norepinephrine reuptake, was found to protect against nerve injury by suppressing the activation of CREB3L3/MMP3/FAS signaling in Schwann cells. Remarkably, venlafaxine was found to significantly alleviate nab-paclitaxel-induced CIPN in patients without affecting the clinical efficacy of chemotherapy. In summary, our study reveals that EC cell-derived 5-HT plays a critical role in nab-paclitaxel-related neurotoxic lesions, and venlafaxine co-administration represents a novel approach to treating chronic cumulative neurotoxicity commonly reported in nab-paclitaxel-based chemotherapy.
Paclitaxel/toxicity* ; Animals ; Albumins/adverse effects* ; Serotonin/metabolism* ; Mice ; Humans ; Male ; Female ; Venlafaxine Hydrochloride/therapeutic use* ; Neurotoxicity Syndromes/metabolism* ; Middle Aged ; Schwann Cells/metabolism* ; Peripheral Nervous System Diseases/drug therapy* ; Antineoplastic Agents

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

The Healthy China 2030 Plan set the goal of reducing premature deaths from diabetes by 30% by 2030. However, there has been a lack of assessment of premature mortality for diabetes since the action plan was issued. This study used data from the Global Burden of Disease Study 2021, calculated the premature deaths for diabetes by sex, provinces, and subtypes from 1990 to 2021. We explored the temporal trend of premature mortality using the average annual percent change (AAPC) for different sexes, provinces, and subtypes from 1990 to 2021. Furthermore, we predicted premature mortality for diabetes through 2030 for China and its provinces according to the average annual change rate from 2010 to 2021. There was a first slow upward trend in premature mortality for diabetes from 0.5% in 1990 to 0.6% in 2004, and then a decline until 2021 with premature mortality of 0.4%. By 2030, only Fujian (30.3%) will achieve the desired level of reduction, with only seven provinces meeting the target for females and none for males. There is a large range in the degree of decline between inland and coastal regions, showing obvious geographic differences, and there should be a focus on balancing medical resources.
Humans ; China/epidemiology* ; Female ; Male ; Mortality, Premature/trends* ; Diabetes Mellitus/mortality* ; Goals ; Middle Aged ; Adult

Objective:To observe the effect of personalized airway clearance therapy on extubation of patients with trache-otomy in intensive rehabilitation care unit. Method:Totally 62 patients who met the inclusion criteria were divided into the control group and experimen-tal group,with 31 patients in each group.During the experimental period,one patient in the control group and experimental group dropped off.The control group was given the posture drainage combined with back tap-ping on the basis of routine rehabilitation,while the experimental group was given the personalized airway clearance therapy(including cough training,active cycles of breathing techriques,posture drainage,etc.)on the basis of routine rehabilitation.The observation period was 6 weeks,and the sputum volume,extubation time,extubation success rate and clinical pulmonary infection score were compared between the two groups. Result:After 6 weeks of training,the average sputum volume in the experimental group was significantly high-er than that in the control group(P＜0.05).At the first week of training,there was no significant difference in the average daily sputum volume between the two groups(P＞0.05),but at the second,fourth and sixth weeks,the average daily sputum volume in the experimental group was significantly lower than that in the control group(P＜0.05).Before training,there was no statistically significant difference in CPIS scores between the two groups(P＞0.05),but at the first,third and sixth weeks,CPIS scores in the experimental group were significantly lower than that in the control group(P＜0.05).The results of repeated measure ANOVA showed that the time effect,inter-group effect and interaction effect of daily expectoration volume and CPIS score in the two groups were statistically significant(P＜0.05).The extubation time in the experimental group was significantly shorter than that in the control group(P＜0.05),and the success rate of extubation in the ex-perimental group was 93.3％,which was significantly higher than 70.0％in the control group(P＜0.05). Conclusion:Personalized airway clearance technology can improve the pulmonary infection of patients with tra-cheotomy in ICU more effectively,shorten the time of tracheal tube removal,and improve the success rate of extubation.

Objective:To observe the effect of abdominal electrical stimulation combined with airway clearance on cough ability and success rate of extubation in patients with severe tracheotomy. Method:A randomized,double-blind,controlled trial was conducted.52 patients with tracheotomy who met the inclusion criteria were divided into a control group and an experimental group,with 26 cases in each group.The experimental group was treated with abdominal electrical stimulation on the basis of airway clear-ance technique.The observation period was 6 weeks.Before and after treatment,involuntary cough peak flow rate(ICPF),clinical pulmonary infection score(CPIS),tracheal tube extubation time and extubation success rate were used to compare the differences in clinical efficacy. Result:Before the training,there was no significant difference in ICPF between the two groups(P＞0.05),but at l,3 and 6 weeks,the ICPF score of the experimental group was significantly higher than that of the con-trol group(P＜0.05).Before training,there was no significant difference in CPIS score between the two groups(P＞0.05),but after 1,3 and 6 weeks,the CPIS score of the experimental group was significantly lower than that of the control group,and the difference was statistically significant(P＜0.05).Before training,there was no significant difference in abdominal muscle thickness between the two groups(P＞0.05).At the 3rd and 6th week,the abdominal muscle thickness of the experimental group was significantly higher than that of the control group,and the difference was statistically significant(P＜0.05).The extubation time of the experimental group was significantly shorter than that of the control group(P＜0.05).The success rate of extu-bation in the experimental group was 92％,which was significantly higher than that in the control group(76％),and the difference was statistically significant(P＜0.05). Conclusion:Abdominal electrical stimulation combined with airway clearance can significantly improve the cough ability of patients with severe tracheotomy,shorten the time of tracheal cannula removal,and improve the success rate of extubation.

Cancer stem cells(CSCs)are a small group of cells found in tumors that have same self-renewing properties as nor-mal stem cells.In recent years,with continuous development of science and technology in various aspects,people's research on tumor diseases has been deepened.CSCs has been defined as a key factor in promoting tumor development,especially participating in pro-moting tumor recurrence,metastasis,chemotherapy resistance,etc.Currently,CD133 has become one of popular CSCs markers,and can be highly expressed in a variety of CSCs.CD133 is closely related to diagnosis of cancer diseases,and plays an important role in dignosis and drug targeting for gastric cancer,lung cancer,brain tumor,liver cancer,ovarian cancer and colorectal cancer.This article reviews structure,function,immune mechanism escape of CD133,signal pathway of CD133 in tumorigenesis,and correlation of CD133 with various tumors as well.

Objective To evaluate the efficacy of superselective embolization of the supplying arteries of uterine fibroids under the guidance of 3D angiography in treating uterine fibroids.Methods The clinical data of 14 patients with uterine fibroids,who received interventional embolization therapy at the Third Affiliated Hospital of Zhengzhou University of China,were retrospectively analyzed.Of the 14 patients,5 received microcatheter superselective embolization of the supplying arteries of uterine fibroids after the origin and path of the supplying arteries were clarified by 3D uterine artery angiography(group A),and 9 received embolization of the bilateral uterine arteries up to their main trunks because the fibroids had complex blood supply(group B).The sums of the preoperative and postoperative one-year maximum diameter of uterine fibroids,and the reduction rate of fibroid were statistically analyzed.Results The mean sum of the preoperative and postoperative one-year maximum diameter of uterine fibroids in group A were(85.00±43.35)mm and(35.20±25.96)mm respectively,and the difference was statistically significant(P=0.006),which in group B were(65.00±12.68)mm and(49.44±24.83)mm respectively,and the difference was not statistically significant(P=0.052).There was no statistically significant differences in the mean sum of the preoperative maximum diameter of uterine fibroids and in the postoperative one-year maximum diameter of uterine fibroids between the two groups(P=0.366 and P=0.331).The median reduction rate of uterine fibroids in group A and group B was 62％and 25％respectively,and the difference was statistically significant(P=0.031).Conclusion For the treatment of uterine fibroids,3D angiography-guided superselective embolization of the supplying arteries of uterine fibroids is superior to the embolization of the bilateral uterine arteries in clinical curative efficacy.(J Intervent Radiol,2024,33:533-536)

Objective To systematically evaluate the efficacy and safety of ciprofol for sedation and anesthesia outside the operating room.Methods Databases such as PubMed,Embase,Cochrane Library,Web of Science,CNKI,Wanfang Data,CBM,and VIP were searched for randomized controlled trials(RCTs)related to the efficacy and safety of ciprofol for sedation and anesthesia outside the operating room.The search covered all publications up to June 2023.Statistical analysis was performed using RevMan 5.4 software and Stata 15.0.Results Twelve RCTs were included,involving 2 192 patients,of which 1 154 were in the ciprofol group and 1 038 in the propofol group.Compared with the propofol group,the anesthesia induction time(MD=0.28 min,95％CI 0.08-0.47 min,P=0.006)and recovery time(MD=1.16 min,95％CI 0.44-1.87 min,P=0.001)were significantly longer in the ciprofol group,and the inci-dences of injection pain(OR=0.04,95％CI 0.02-0.06,P＜0.001),hypotension(OR=0.64,95％CI 0.49-0.83,P=0.0008),hypoxemia(OR=0.44,95％CI 0.21-0.91,P=0.03),and respirato-ry depression(OR=0.19,95％CI 0.11-0.32,P＜0.001)were significantly lower.There were no sta-tistically significant differences between the two groups in terms of sedation success rate,physician satisfac-tion,the difference in heart rate before and after anesthesia induction,incidence of body movement,brady-cardia,nausea and vomiting,and dizziness.Conclusion The anesthetic effect of cyclopofol and propofol is similar when used for anesthesia outside the operating room.Compared to propofol,ciprofol offers comparable anesthetic effects for sedation and anesthesia outside the operating room,with a lesser impact on respiratory function and more stable hemodynamics.Ciprofol also significantly lowers the incidence of adverse reactions such as injection pain,hypotension,hypoxemia,and respiratory depression.