In the era of evidence-based medicine， the progress of medical science and technology has enriched medical diagnostic tools and treatment methods， but it has also led to the loss of medical warmth and the alienation of the doctor-patient relationships. William Osler emphasized that while medical technology advances， attention should also be paid to the practice of narrative medicine and the development of physician’s narrative literacy. The view of the physician he advocated reminds us that the core of medicine still lies in the narrative connection between doctors and patients， as well as a deep understanding of human nature. By exploring the relationship between Osler’s view of the physician and narrative medicine as well as physician’s narrative literacy， this paper analyzed the methods of cultivating physician’s narrative literacy， providing references for modern medical education and practice， and assisting in the harmony and unity of science and technology and humanity.

Objective:This study aims to explore whether there are specific behavioral deficits of response inhibition and emotional processing in patients with checking obsessive-compulsive disorder (OCD) and those with washing OCD.Methods:A cross-sectional study was conducted from January 2020 to December 2022, collecting clinical data from 75 OCD patients at the outpatient psychological consultation clinic of Xiangya Second Hospital and the clinical psychology department of Hunan Brain Hospital. The sample included 40 OCD patients with checking type (checking group, 24 males, 16 females, aged 14-34 years, mean age 22.1±5.0 years) and 35 OCD patients with washing type (washing group, 12 males, 23 females, aged 14-41 years, mean age 22.6±6.7 years). An age-matched healthy control group (control group) of 80 individuals (HCs, 37 males and 43 females, aged 14-25 years, mean age 20.8±1.9 years) was also recruited. All participants completed the Go/No-go task and Hariri task with behavioral data recorded. The Dimensional Yale-Brown Obsessive-Compulsive Scale was used to assess the severity of OCD symptoms. The Center for Epidemiologic Studies Depression Scale (CES-D) and State Anxiety Inventory (STAI) were used to assess the severity of depression and anxiety. A 3 (group: checking OCD, washing OCD and HC)×2 (task type: Go vs. No-go/Shape vs. Face) repeated-measures ANOVA was conducted to compare the behavioral performance across tasks.Results:Compared with HC group, both checking OCD group and washing OCD group had significantly higher scores in depression and anxiety ( F=85.43, 32.33,both P<0.05). When performing Go/No-go task, a significant group×task interaction effect was observed ( F3(2, 152)=3.23, P3=0.042, partialη32=0.04). In the checking OCD group, No-go accuracy was significantly lower than Go accuracy (accuracy=0.821 vs. 0.893, P<0.001); the checking OCD had significantly lower accuracy than HC in the No-go task (accuracy=0.821 vs. 0.876, P=0.005); there were no significant group differences between the washing OCD and HC in the No-go task ( P>0.05). When performing Hariri task, a significant group×task interaction effect was found ( F3(2, 152)=4.91, P3=0.009, partial η32=0.06). The washing OCD group showed significantly lower accuracy in matching emotional faces than the control group (0.879 vs. 0.936, P=0.001), whereas the checking OCD group showed no significant difference from the HC ( P>0.05); there were no significant group differences in shape matching task ( P>0.05). The accuracy of shape matching task was significantly higher than face matching task in the three groups (shape: checking OCD=0.936,washing OCD=0.929,HC=0.943; face:checking OCD=0.877,washing OCD=0.844,HC=0.917;all P>0.05). Conclusions:Checking OCD and washing OCD exhibit distinct behavioral impairment patterns in response inhibition and emotional processing. Checking-type OCD is primarily characterized by impaired response inhibition, whereas washing-type OCD is mainly associated with deficits in emotion processing.

BACKGROUND:Rev-erbα is involved in the regulation of inflammation,but pharmacological activation of Rev-erbα increases the risk for cardiovascular diseases.To reduce the relevant risk,an exploration on SR9009,a Rev-erbα agonist,combined with other drugs to relieve inflammation in skeletal myoblasts was conducted,laying the theoretical foundation for the treatment of inflammation-associated skeletal muscle atrophy. OBJECTIVE:To investigate the relationship of SR9009,indolepropionic acid and nuclear factor-κB signaling pathways in lipopolysaccharide-induced C2C12 myoblasts. METHODS:(1)C2C12 myoblasts were induced to differentiate in the presence of lipopolysaccharide(1 μg/mL).RNA-seq and KEGG pathway analysis were used to study signaling pathways.(2)C2C12 myoblast viability was assessed using the cell counting kit-8 assay to determine optimal concentrations of indolepropionic acid.Subsequently,cells were categorized into control group,lipopolysaccharide(1 μg/mL)group,SR9009(10 μmol/L)+lipopolysaccharide group,indolepropionic acid(80μmol/L)+lipopolysaccharide group,and SR9009+indolepropionic acid+lipopolysaccharide group.ELISA was employed to measure protein expression levels of interleukin-6 in the cultured supernatant.Real-time quantitative PCR were employed to measure mRNA expression levels of interleukin-6,tumor necrosis factor α,TLR4 and CD14.Western blot assay were employed to measure protein expression levels of NF-κB p65 and p-NF-κB p65.(3)After Rev-erbα was knocked down by siRNA,knockdown efficiency was assessed by RT-qPCR.And mRNA levels of interleukin-6 and tumor necrosis factor α were also measured. RESULTS AND CONCLUSION:Compared with the blank control group,lipopolysaccharide time-dependently inhibited myofibroblast fusion to form myotubes,the mRNA expression levels of interleukin-6 and tumor necrosis factor α were elevated,and the level of interleukin-6 in the cell supernatant was significantly increased.The results of KEGG pathway showed that the nuclear factor-κB signaling pathway was activated by lipopolysaccharide.Indolepropionic acid exhibited significant suppression of C2C12 myoblasts viability when its concentration exceeded 80 μmol/L.Indolepropionic acid and SR9009 inhibited the activation of NF-κB signaling pathway,thereby played an anti-inflammatory role,and suppressed the mRNA expression levels of interleukin-6,tumor necrosis factor α,TLR4 and CD14.Compared with the lipopolysaccharide group,the ratio of p-NF-κB p65/NF-κB p65 protein expression were downregulated.SR9009 combined with indolepropionic acid notably reduced lipopolysaccharide-induced inflammation,further downregulated the mRNA expression levels of interleukin-6,tumor necrosis factor α,TLR4 and CD14.The ratio of p-NF-κB p65/NF-κB p65 protein expression was significantly lower than that in the SR9009+lipopolysaccharide group or indolepropionic acid+lipopolysaccharide group.Rev-erbα increases time-dependently with lipopolysaccharide induction.The knockdown efficiency of Rev-erbα by siRNA reached over 58%,and lipopolysaccharide was added after Rev-erbα was successfully knocked down.Compared with the lipopolysaccharide group,the mRNA expression levels of interleukin-6 and tumor necrosis factor α were significantly up-regulated.These results conclude that Rev-erbα may act as a promising pharmacological target to reduce inflammation.SR9009 targeted activation of Rev-erbα combined with indolepropionic acid significantly inhibits the nuclear factor-κB signaling pathway and attenuates the inflammatory response of C2C12 myofibroblasts.Moreover,the combined anti-inflammatory effect is superior to that of the intervention alone.

OBJECTIVES: To compare the anti-inflammatory, antibacterial and analgesic effects of Yinqiao Powder (YQS) formulated granules and decoction. METHODS: We first evaluated the anti-inflammatory effects of the two dosage forms of YQS in a LPS-induced RAW 264.7 cell model using RT-qPCR and Western blotting. We further constructed zebrafish models of inflammation by copper sulfate exposure, caudal fin transection, or LPS and Poly (I:C) microinjection, and evaluated anti-inflammatory effects of YQS granules and decoction by examining neutrophil aggregation and HE staining findings. In a mouse model of acute lung injury (ALI) induced by intratracheal LPS instillation, the effects of YQS gavage at 10, 15, and 20 g/kg on lung pathologies were evaluated by calculating lung wet-dry weight ratio and using HE staining, ELISA and Western blotting. The microbroth dilution method was used to evaluate the antibacterial effect of YQS. Mouse pain models established by hot plate and intraperitoneal injection of glacial acetic acid were used to evaluate the analgesic effects of YQS at 10, 15, and 20 g/kg. RESULTS: Both YQS granules and decoction significantly reduced TNF-α, IL-6, and IL-1β expressions and p-STAT3 (Tyr 705) phosphorylation level in LPS-induced RAW 264.7 cells, and obviously inhibited neutrophil aggregation in the zebrafish models. In ALI mice, YQS granules and decoction effectively ameliorated lung injury, lowered lung wet-dry weight ratio, and reduced p-STAT3 (Tyr 705) expression and TNF-α and IL-6 levels. YQS produced obvious antibacterial effect at the doses of 15.63 and 31.25 mg/mL, and significantly reduced body torsion and increased pain threshold in the mouse pain models. CONCLUSIONS The two dosage forms of TQS have similar anti-inflammatory, antibacterial and analgesic effects with only differences in their inhibitory effect on TNF-α, IL-6 and IL-1β mRNA expressions in LPS-induced RAW 264.7 cells.
Animals ; Mice ; Drugs, Chinese Herbal/pharmacology* ; Anti-Inflammatory Agents/pharmacology* ; Analgesics/pharmacology* ; RAW 264.7 Cells ; Zebrafish ; Anti-Bacterial Agents/pharmacology* ; Powders ; Tumor Necrosis Factor-alpha/metabolism* ; Acute Lung Injury/drug therapy* ; Interleukin-6/metabolism* ; Lipopolysaccharides

Objective:This study aims to explore whether there are specific behavioral deficits of response inhibition and emotional processing in patients with checking obsessive-compulsive disorder (OCD) and those with washing OCD.Methods:A cross-sectional study was conducted from January 2020 to December 2022, collecting clinical data from 75 OCD patients at the outpatient psychological consultation clinic of Xiangya Second Hospital and the clinical psychology department of Hunan Brain Hospital. The sample included 40 OCD patients with checking type (checking group, 24 males, 16 females, aged 14-34 years, mean age 22.1±5.0 years) and 35 OCD patients with washing type (washing group, 12 males, 23 females, aged 14-41 years, mean age 22.6±6.7 years). An age-matched healthy control group (control group) of 80 individuals (HCs, 37 males and 43 females, aged 14-25 years, mean age 20.8±1.9 years) was also recruited. All participants completed the Go/No-go task and Hariri task with behavioral data recorded. The Dimensional Yale-Brown Obsessive-Compulsive Scale was used to assess the severity of OCD symptoms. The Center for Epidemiologic Studies Depression Scale (CES-D) and State Anxiety Inventory (STAI) were used to assess the severity of depression and anxiety. A 3 (group: checking OCD, washing OCD and HC)×2 (task type: Go vs. No-go/Shape vs. Face) repeated-measures ANOVA was conducted to compare the behavioral performance across tasks.Results:Compared with HC group, both checking OCD group and washing OCD group had significantly higher scores in depression and anxiety ( F=85.43, 32.33,both P<0.05). When performing Go/No-go task, a significant group×task interaction effect was observed ( F3(2, 152)=3.23, P3=0.042, partialη32=0.04). In the checking OCD group, No-go accuracy was significantly lower than Go accuracy (accuracy=0.821 vs. 0.893, P<0.001); the checking OCD had significantly lower accuracy than HC in the No-go task (accuracy=0.821 vs. 0.876, P=0.005); there were no significant group differences between the washing OCD and HC in the No-go task ( P>0.05). When performing Hariri task, a significant group×task interaction effect was found ( F3(2, 152)=4.91, P3=0.009, partial η32=0.06). The washing OCD group showed significantly lower accuracy in matching emotional faces than the control group (0.879 vs. 0.936, P=0.001), whereas the checking OCD group showed no significant difference from the HC ( P>0.05); there were no significant group differences in shape matching task ( P>0.05). The accuracy of shape matching task was significantly higher than face matching task in the three groups (shape: checking OCD=0.936,washing OCD=0.929,HC=0.943; face:checking OCD=0.877,washing OCD=0.844,HC=0.917;all P>0.05). Conclusions:Checking OCD and washing OCD exhibit distinct behavioral impairment patterns in response inhibition and emotional processing. Checking-type OCD is primarily characterized by impaired response inhibition, whereas washing-type OCD is mainly associated with deficits in emotion processing.

Objective To explore the effect of galangin(Gal)on inflammation in hepatitis B rats.Methods The rats were randomly divided into control group,hepatitis B group,Gal-L and Gal-H groups,positive drug lamivudine group and Gal-H+AMPK inhibitor(compound C)group with 12 in each.After modeling,medication treatment was performed once a day for 8 weeks.The level of alanine aminotransferase(ALT),total bilirubin(TBIL)and aspartate aminotransferase(AST)in the serum of rats were detected.HE staining microscopy was ap-plied to detect pathological changes in liver tissue.TUNEL staining microscopy was applied to detect cell apoptosis in liver tissue.Chromatin immuno-precipitation was applied to detect HBV viral load in liver tissue.ELISA was ap-plied to detect the levels of monocyte chemotactic protein-1(MCP-1),interleukin-12(IL-12),and tumor necrosis factor-α(TNF-α)in liver tissue.Western blot was applied to detect the expression of caspase-3,Bcl-2 associated X protein(Bax),p-AMPK and SIRT1 proteins in liver tissue.Results Compared with hepatitis B group,the liver damage of rats in the Gal-L group,Gal-H group and lamivudine group was alleviated;The level of serum AST,TBIL,and ALT,apoptosis rate,HBV viral load and the level of MCP-1,IL-12,TNF-α as well as the expression of caspase-3 and Bax proteins in liver tissue were all reduced.The expression of p-AMPK and SIRT1 proteins in liv-er tissue increased(P＜0.05).Compound C baffled inhibitory effects of high-dose Gal on inflammation,cell apopto-sis,and HBV viral load in liver tissue of hepatitis B rats.Conclusions The mechanism of Gal in inhibiting inflam-mation,cell apoptosis and HBV virus replication in hepatitis B rats is potentially attributed to up-regulation of the AMPK/SIRT1 pathway.

Objective:To evaluate the regeneration and biomechanical property recovery of semitendinosus tendon(ST)/gracilis tendon(GT) after anterior cruciate ligament(ACL) reconstruction using shear wave elastorgraphy (SWE) combined with high-frequency ultrasound(HFUS).Methods:Twenty-five patients who underwent ST/GT autograft reconstruction after ACL rupture at the People′s Hospital of Guangxi Zhuang Autonomous Region from January 2020 to June 2022 were prospectively enrolled. All patients underwent HFUS, SWE and flexion strength assessment at pre-operation and 1, 3, 6, 12, 24 months postoperatively. The morphology, length, cross-sectional area and SWE of ST/GT and flexion strength of knee were recorded at each time point. Repeated measures analysis of variance was employed to compare the cross-sectional area and elasticity value of regenerated ST/GT at different time points. Spearman correlation analysis was used to investigate the relationship between the elasticity value of regenerated ST/GT and flexion strength.Results:The regeneration rates of ST/GT after being harvested for ACL reconstruction were 88% and 92%. The length of the regenerated ST/GT were shorter than before operation(both P<0.05). Repeated measures analysis of variance revealed significant differences in the cross-sectional area of regenerated ST/GT, both in terms of time effect and inter-group effect ( F=27.264, 28.980; both P<0.001), but no significant difference was observed in the interaction effect ( F=0.670, P=0.652). The cross-sectional area of regenerated ST/GT was the largest at 3 months postoperatively ( P<0.05), and restored to the preoperative level at 12 and 24 months postoperatively (both P>0.05). Repeated measures analysis of variance showed that the elasticity values of the regenerated ST/GT were significantly different in terms of time effect, group effect, and interaction effect ( F=265.402, 33.015, 11.475; all P<0.001). The elasticity of regenerated ST/GT post-operation gradually increased over time. The flexion strength level of knee gradually improved post-operation(χ 2=34.83, P<0.001). The elasticity values of the regenerated ST and GT showed significant positive correlations with the flexion strength ( rs=0.755, 0.761; both P<0.001). Conclusions:HFUS discovers that most of ST/GT can be regenerated after being harvested for ACL reconstruction. The flexion strength and elasticity value of regenerated tendon recover gradually with time. It is suggested that the SWE can predict the recovery of biomechanical property of regenerated ST/GT.

Objective To study the effectiveness of a management model based on the standards proposed by the Joint Commission on Accreditation of International Healthcare Organizations(JCI)in preventing disputes and investigate its impact on patient satisfaction.Methods A total of 102 patients between March 2022 to March 2024 were enrolled in the study.They were randomly divided into JCI standard group(n=51)and conventional group(n=51)using the random number method.The con-ventional group received the conventional management,while the JCI standard group followed the management based on the JCI standard.Occurrence of dispute events,patient satisfaction levels,management quality,and negative emotions before and after treatment were compared between the two groups.Results The total incidence of dispute events in JCI standard group was sig-nificantly lower than that in conventional group(1.96％vs 13.73％,P＜0.05).The JCI standard group scored significantly higher in satisfactions with all items(all P＜0.05)as well as in management quality(all P＜0.05)compared to the convention-al group.Following treatment,negative emotion scores decreased in both groups compared to pre-treatment,with the JCI standard group showing significantly lower scores than the conventional group(all P＜0.05).Conclusion Implementing the management model based on JCI standard notably can reduce the number of disputes,enhance patient satisfaction,improve management quali-ty,and alleviate negative emotions among patients.

Objective To compare the anti-inflammatory,antitumor and anti-bacterial effects of the single extract(in granules)and the prepared drug in pieces of Forsythia Suspense(Lianqiao,a traditional Chinese herbal medicine).Methods In zebrafish embryo models of CuSO4 exposure,tail transection and LPS microinjection-induced inflammation,the anti-inflammatory effects of 10 μg/mL DEX,single extract of Forsythia Suspense,and the water extract of the prepared drug(400,600,and 800 μg/mL)were evaluated by observing neutrophil counts,RT-qPCR,HE staining and survival analysis.Zebrafish embryo models bearing different human tumor cell xenografts were used to assess the anti-tumor effect of the drugs in different dosage forms by fluorescence staining and HE staining.The microbroth dilution method was used to evaluate the antibacterial efficacy of the drugs.Results In the zebrafish embryo models of inflammation,both of the two dosage forms of Forsythia Suspense significantly inhibited neutrophil aggregation,reduced the mRNA expressions of TNF-α,IL-6,P38,Jnk,Erk and P65,and increased the survival rate of zebrafish.They both showed obvious inhibitory effects against xenografts of different human cancer cells including colon cancer cells(HCT116),pancreas adenocarcinoma cells(PANC-1),lung cancer cells(A549),liver cancer cells(Hep3B)and cervical carcinoma cells(Hela)in zebrafish embryos,and exhibited strong anti-bacterial effects at the concentration of 15.63 mg/mL.Conclusion The two dosage forms of Forsythia Suspense have similar anti-inflammatory,antitumor and antibacterial effects,but their effects for inhibiting IL-6,P65,and Jnk mRNA expressions and HCT116 cell proliferation differ significantly at low doses in zebrafish.

Objective To compare the anti-inflammatory,antitumor and anti-bacterial effects of the single extract(in granules)and the prepared drug in pieces of Forsythia Suspense(Lianqiao,a traditional Chinese herbal medicine).Methods In zebrafish embryo models of CuSO4 exposure,tail transection and LPS microinjection-induced inflammation,the anti-inflammatory effects of 10 μg/mL DEX,single extract of Forsythia Suspense,and the water extract of the prepared drug(400,600,and 800 μg/mL)were evaluated by observing neutrophil counts,RT-qPCR,HE staining and survival analysis.Zebrafish embryo models bearing different human tumor cell xenografts were used to assess the anti-tumor effect of the drugs in different dosage forms by fluorescence staining and HE staining.The microbroth dilution method was used to evaluate the antibacterial efficacy of the drugs.Results In the zebrafish embryo models of inflammation,both of the two dosage forms of Forsythia Suspense significantly inhibited neutrophil aggregation,reduced the mRNA expressions of TNF-α,IL-6,P38,Jnk,Erk and P65,and increased the survival rate of zebrafish.They both showed obvious inhibitory effects against xenografts of different human cancer cells including colon cancer cells(HCT116),pancreas adenocarcinoma cells(PANC-1),lung cancer cells(A549),liver cancer cells(Hep3B)and cervical carcinoma cells(Hela)in zebrafish embryos,and exhibited strong anti-bacterial effects at the concentration of 15.63 mg/mL.Conclusion The two dosage forms of Forsythia Suspense have similar anti-inflammatory,antitumor and antibacterial effects,but their effects for inhibiting IL-6,P65,and Jnk mRNA expressions and HCT116 cell proliferation differ significantly at low doses in zebrafish.