ObjectiveTo explore the potential mechanism of Huoxue Xiaoyi Formula （活血消异方， HXF） in treating ovarian endometriosis （OEM） from the perspective of T follicular helper （Tfh） cells and the Janus kinase/signal transducer and activator of transcription （JAK/STAT） signaling pathway. MethodsForty-five female SD rats with normal estrous cycles were randomly divided into three groups， HXF group， model group， and normal group， with 15 rats in each group. A rat model of OEM was established by autologous endometrial tissue implantation. After successful modeling， the treatment group received HXF at 5.85 g/（kg·d） by gavage for 14 consecutive days. The model group and normal group received 1 mL/d of normal saline by gavage. RNA-sequencing data from human proliferative-phase endometriotic and normal endometrial tissues were downloaded from the GEO database. Transcriptomic sequencing was used to analyze gene expression in rat ovarian ectopic tissues and normal uterine tissues， and comparisons were made with human data to verify JAK/STAT pathway activation in proliferative-phase ectopic tissues. Immunohistochemistry was used to detect the positive expression of CXC chemokine receptor 5 （CXCR5） and interleukin-21 （IL-21） in rat ovarian ectopic and normal uterine tissues. Western Blotting was performed to detect the protein levels of IL-21， IL-21 receptor （IL-21R）， Janus kinase 1 （JAK1）， signal transducer and activator of transcription 6 （STAT6）， and B-cell lymphoma 2 （Bcl-2）. Tfh cell infiltration was analyzed using immune cell infiltration methods. ResultsGene set enrichment analysis showed that the JAK/STAT pathway was significantly activated in human proliferative-phase endometriotic tissues compared to normal endometrial tissues. Similarly， the JAK/STAT pathway was markedly activated in rat ovarian ectopic tissues in the model group compared to the normal group， but suppressed in the HXF group compared to the model group. Compared with normal uterine tissues， ovarian ectopic tissues in the model group showed increased Tfh cell infiltration scores， higher CXCR5 and IL-21 expression， and elevated levels of IL-21， IL-21R， JAK1， STAT6， and Bcl-2 proteins. Compared with the model group， HXF group showed reduced CXCR5 and IL-21 expression and decreased protein levels of IL-21， IL-21R， JAK1， STAT6， and Bcl-2. ConclusionHXF may suppress activation of the JAK/STAT signaling pathway in ovarian endometriotic tissues by inhibiting IL-21 secretion from Tfh cells.

OBJECTIVE To systematically evaluate the association between human leukocyte antigen B(HLA-B) gene polymorphisms and lamotrigine-induced cutaneous adverse drug reactions(LTG-cADRs). METHODS CNKI, Wanfang Data, VIP, PubMed, Web of Science, Science Direct were comprehensively searched from the inception to July 15, 2022. The software RevMan 5.4 was used for the meta-analysis. RESULTS A total of 16 case-control studies were included, 331 patients with LTG-cADRs epilepsy, including 94 lamotrigine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis(LTG-SJS/TEN) patients, 232 lamotrigine-maculopapule(LTG-MPE) patients and 5 lamotrigine- drug rash with eosinophilia and systemic symptoms(LTG-DRESS) patients; 612 lamotrigine-tolerant patients. Meta-analysis results showed that the HLA-B*1502 allele was significantly associated with LTG-SJS/TEN(OR=3.03, 95%CI: 1.70−5.39, P=0.000 2). The HLA-B*1502, HLA-B*5801, HLA-B*1302 alleles were not significantly associated with LTG-MPE. CONCLUSION HLA-B*1502 allele is associated with LTG-SJS/TEN, which may be a risk gene for LTG-SJS/TEN. HLA-B*1502, HLA-B*5801, HLA-B*1302 are not associated with LTG-MPE.

Objective To investigate the value of non-contrast CT(NCCT)-based radiomics for identifying acute unilateral middle cerebral artery occlusion(MCAO)with negative hyperdense artery sign(HAS).Methods All 80 patients with acute unilateral MCAO confirmed by angiography(MR angiography[MRA]or CT angiography[CTA]or DSA)and presenting with negative NCCT presentation for HAS were enrolled from January 2015 to June 2023 in the Emergency Department of Stroke Center of Affiliated Hospital of Yangzhou university.On the NCCT images,the occluded segment of the middle cerebral artery on the affected side of each case and the corresponding segment of the vessel on the normal side were used as the regions of interest,and a total of 108 radiomic features were extracted.The least absolute shrinkage and selection operator(LASSO)was used to screen the key features,construct and calculate the radiomics score,and four imaging histology models,support vector machine(SVM),light gradient boosting machine(LightGBM),GradientBoosting and adaptive boosting(AdaBoost),were built respectively to predict MCAO.Predictive performance was evaluated by the area under the receiver operating characteristic curves,and comparisons between the modeled receiver operating characteristic curves were made using the Delong test.Finally,the value of the application of radiological modeling was assessed by clinical decision curve analysis(DCA).Results The NCCT images based on 160 vessels were finally screened for 6 key features,including skewness,energy,gray level size zone matrix(GLSZM)-gray uneven,GLSZM-low gray area emphasis,GLSZM-size area non-uniform standardization,GLSZM-area entropy.The area under the curve(AUC)of the SVM-test was 0.688(95％CI 0.497-0.878)with an accuracy of 0.688;the AUC of the LightGBM-test was 0.787(95％CI 0.620-0.955)with an accuracy of 0.781;the AUC of the GradientBoosting-test was 0.654(95％CI 0.457-0.852)with an accuracy of 0.688;the AUC of the AdaBoost-test was 0.707(95％CI 0.515-0.899)with an accuracy of 0.750.The Delong test showed a statistically significant difference between LightGBM-test and GradientBoosting-test(P=0.040),and no statistically significant difference in performance between the remaining models(all P＞0.05).DCA showed that the LightGBM-test performed better.Conclusion NCCT-based radiomics has good diagnostic efficacy for identifying acute unilateral MCAO with negative HAS,and this conclusion needs to be further verified by multi-center and large sample studies.

Objective To explore the current status of medication literacy among urban elderly patients with chronic diseases in Anhui Province,aiming to reveal the factors influencing their medication literacy,and to propose targeted measures for improvement.Methods This research involved 381 participants aged 60 and above.It was conducted in Anhui province between December,2022 and January,2023,with data collected through face-to-face interviews by pharmacists.Single-factor analysis and ordinal multi-class logistic regression analysis were conducted to determine factors affecting medication literacy.Results Medication literacy cognition and medication literacy behavior were rated as good among urban older adults in Anhui province of the 294 valid questionnaires.Those who did not understood package insert exhibited significantly lower medication literacy behavior than those who fully understood[estimate=-1.224,95%CI=(-2.130,-0.317),P<0.01].Elderly patients with chronic diseases faced issues such as an inability to read or understand drug instructions in the investigation.90.48%of elderly patients with chronic diseases never heard or seldom heard of medication guidance services.Conclusion Medication literacy among urban elderly patients with chronic diseases is generally good in Anhui province.The ability to understood drug instructions significantly influenced the medication literacy of urban elderly patients with chronic diseases.Modifying the drug instructions to meet the reading needs of the elderly patients with chronic diseases and developing pharmaceutical care could effectively enhance rational drug use among this demographic.

Objective:To study the role and specific mechanisms of glucose-6-phosphate dehydrogenase (G6PD), a key enzyme for glycometabolism, mediated reduction stress in arsenic-induced malignant transformation of cells.Methods:Immortalized human skin keratinocyte-forming cells (HaCaT cells) were treated with sodium arsenite (NaAsO 2) at a concentration of 0.0 (control group) and 1.0 μmol/L (arsenic group), and malignant transformation indicators were tested using cell growth kinetics assay, cell scratch assay, and soft agar colony formation assay. At different stages of arsenic treatment (0, 1, 7, 14, 21, 28, 35 passages of cells), the effects of NaAsO 2 on glycometabolism in HaCaT cells were determined using corresponding reagent kits and Western blot, including glucose-6-phosphate (G6P), lactate, acetyl CoA, G6PD levels, as well as protein expression levels of hexokinase 2 (HK-2), 6-phosphofructose-2-kinase/fructose-2, 6-diphosphatase 3 (PFKFB3), pyruvate dehydrogenase kinase 1 (PDK1), 6-phosphoglucose dehydrogenase (PGD), and G6PD. Mitochondria were extracted, and the effects of NaAsO 2 on HaCaT cells and mitochondrial redox [reduced nicotinamide adenine dinucleotide phosphate (NADPH)/nicotinamide adenine dinucleotide phosphate (NADP +) ratio, reduced glutathione (GSH)/oxidized glutathione (GSSG) ratio] were determined using corresponding reagent kits. The effect of G6PD on reduction stress and NaAsO 2-induced malignant transformation of HaCaT cells was determined using small interfering RNA (siRNA) intervention method. Results:Compared 1.0 μmol/L NaAsO 2-cultured HaCaT cells up to 35 generations (T-HaCaT cells) with matching passage 0.0 μmol/L NaAsO 2-cultured HaCaT cells [(33.797 ± 0.280) h, 0.177 ± 0.015, 13.667 ± 2.625], the multiplication time [(24.042 ± 0.479) h] was shorter ( t = 30.45, P < 0.001), the cell migration rate (0.396 ± 0.039) was higher ( t = 9.08, P < 0.001), and the number of colonies formed in soft agar (73.667 ± 4.450) was higher ( t = 20.11, P < 0.001). Compared with matching passage control group cells and 0 generation of the same group, G6P level in the arsenic group was higher at passages 1, 7, 14, 21, 28 and 35 ( P < 0.05), lactate and G6PD levels were higher at passages 14, 21, 28 and 35 ( P < 0.05), acetyl CoA level was lower at passages 21, 28 and 35 ( P < 0.05), and protein expression levels of HK-2, PFKFB3, PDK1, PGD, and G6PD were higher at passages 7, 14, 21, 28 and 35 ( P < 0.05). The NADPH/NADP + ratio of cells was higher at passages 1, 14, 21, 28 and 35 ( P < 0.05), GSH/GSSG ratio was higher at passages 21, 28 and 35 ( P < 0.05). The ratio of mitochondrial NADPH/NADP + was higher at passages 1, 7, 21, 28 and 35 ( P < 0.05), the GSH/GSSG ratio was higher at passages 1, 7, 14, 21, 28 and 35 ( P < 0.05). G6PD expression was silenced by siRNA in T-HaCaT cells, compared with the T-HaCaT con siRNA-treated group, the T-HaCaT G6PD siRNA-treated group had lower NADPH/NADP + and GSH/GSSG ratios in both cells and mitochondria ( P < 0.05), longer cell multiplication time, lower cell migration rate, and fewer soft agar colonies ( P < 0.05). Conclusion:During the malignant transformation of HaCaT cells induced by NaAsO 2, G6PD and other enzymes related to glycometabolism are activated, leading to reprogramming of glycometabolism, resulting in an imbalance of cell redox homeostasis and enhanced reduction stress in cells and mitochondria, thereby promoting NaAsO 2 induced malignant transformation of HaCaT cells.

Objective To explore the medication regularity of prescriptions in Universal Relief:Cough Medicine in that to provide worthy reference for clinical treatment of cough.Methods The prescriptions in Universal Relief:Cough Medicine was collected and then established the database using Excel 2016 softwore,and carried out medication frequency analysis.SPSS Modeler 18.0 and Lantern 5.0 were used to perform association rules analysis and latent structure model analysis to explore medication rules of prescriptions in Universal Relief:Cough Medicine.Results 607 prescriptions were collected,involving 335 traditional Chinese medicines.A total of medication frequency is 3941,The most frequently used TCMs were ganca(glycyrrhizae radixet rhizoma)and shengjiang(zinglberis rhizoma recens)and kuxingren(armeniaeae semen amarum).The main efficacy of the medicine is to dissipate phlegm,relieve cough,relieve asthma,and replenish deficiency,and warm in nature,spicy,bitter,and sweet in taste and lung and spleen in meridian.14 strongly correlated material rules were sorted out by association rule analysis such as banxia(pinelliae rhizoma)+gancao(glycyrrhizae radixet rhizoma)→shengjiang(zinglberis rhizoma recens)、banxia(pinelliae rhizoma)→shengjiang(zinglberis rhizoma recens)and mahuang(ephedrae herba)+gancao(glycyrrhizae radixet rhizoma)→kuxingren(armeniaeae semen amarum).12 variables were obtained by latent structure model analysis,and according to professional knowledge inference,3 integrated cluster models and 1 single cluster and 4 core prescriptions were obtained.It was inferred that the common syndromes of Universal Relief:Cough Medicine were cold drink stoping in the lung,qi deficiency external phlegm dampness inside,phlegm heat blocking lung,and lung deficiency prolonged cough.Conclusion The medication rules of prescriptions in Universal Relief:Cough Medicine is mainly benefiting qi and resolving phlegm,cure both the symptoms and the disease,and in different situations combine with different treatment methods,such as warming the lung and resolving phlegm,clearing heat and resolving phlegm,tonifying qi and resolving external symptoms,and astringent lung qi.

Objective To study the effect of exosomes ( EXs) released from high expression of miR-132-3p mesenchymal stem cells (MSCs) on hypoxia/reoxygenation (H/R) injured endothelial cell function. Methods MSCs extracted from bone marrow of C57BL/6 mice were cultured primarily. MSCmiR-132-3p was obtained from MSCs infected with lentivirus loaded with miR-132-3p vector. At the same time,MSCNC was obtained by infecting MSCs with control lentivirus loaded with scramble sequence. EXs released from MSCNCand MSCmiR-132-3pwas isolated,and MSC-EXs and MSC-EXsmiR-132-3pwere obtained respectively. The obtained EXs and H/R damaged mouse brain microvascular endothelial cells (bend3) were co-cultured. According to culture conditions,the cells were divided into normal culture group (normal cell culture),H/R group (making a H/R model),MSC-EXs group (MSC-EXs co-culture),MSC-EXsmiR-132-3p group (MSC-EXsmiR-132-3pco-culture), and MSC-EXsmiR-132-3p+ LY294002 group ( before the cells and MSC-EXsmiR-132-3pwere co-cultured,treated by adding phosphatidyl alcohol 3 kinase [ PI3K] signaling pathway blocker LY294002 [20 μmol/L]). Quantitative real-time quantitative polymerase chain reaction was used to detect the expression of miR-132-3p in MSCs,MSC-EXs,and bend3 cells. Angiogenesis kit was used to detect angiogenic ability of bend3 cells,and 3-(4,5-dimethylthiazole-2)-2,5-diphenyltetrazolium bromide (MTT) assay was used to detect the proliferative capacity of bend3 cells. Scratch test was used to detect the migration ability of bend3 cells. hochest33258 staining showed cell apoptosis. Western blot was used to detect the phosphorylation level of protein kinase B ( Akt) . Results Compared with the H/R group, the MSC-EXs treatment group significantly improved the angiogenesis,proliferation,migration abilities, and Akt phosphorylation level of bend 3 cell damage induced by H/R (The H/R group were 3 ± 1,0. 275 ± 0. 020,147 ± 8 μm,and 0. 89 ± 0. 12,respectively;the MSC-EXs treatment group were 8 ± 3,0. 358 ± 0. 030,218 ± 10 μm, and 1. 37 ± 0. 25 μm,respectively;all P<0. 01). Apoptosis was significantly reduced (47 ± 2% vs. 63 ± 2%,all P<0. 01). Compared with the MSC-EXs treatment group,the angiogenesis,proliferation,migration abilities,and Akt phosphorylation level of bend 3 cells in the MSC-EXsmiR-132-3ptreatment group were increased (14 ±3,0. 444 ± 0.050,357±10μm,and1.67±0.23,respectively,all P<0.01).Apoptosis was significantly reduced (34±1%,all P<0. 01) . Compared with the MSC-EXsmiR-132-3ptreatment group, cell proliferation, migration, angiogenesis abilities,and Akt phosphorylation level in the MSC-EXsmiR-132-3p+LY294002 group were significantly reduced (5 ± 2,0. 304 ± 0. 050,175 ± 8 μm and 0. 95 ± 0. 11,respectively,all P<0. 01). Conclusion MSC-EXs with high expression of miR-132-3p may improve many physiological functions of H/R-induced damaged cerebrovascular endothelial cells by activating PI3K/Akt signaling pathway.

Objective To investigate the clinical value of bone metabolism biochemical marker N-MID,TP1NP and beta-CTx combined with whole body bone scintigraphy in early diagnosis of bone metastasis of tumor.Methods The concentration of the 3 markers were measured by the electrochemical luminescence analysis method in 30 cases of healthy control group and 210 cases of patients with malignant tumor,which were divided into non bone metastasis group(45 cases) and bone metastasis group(165 cases).The bone metastasis group were divided into 4 grades(0-grade Ⅲ) by Soloway classification according to whole body bone imaging.Results The levels of serum N-MID,TP1NP and beta-CTx in 165 malignant tumor patients with bone metastasis were significantly higher than in 45 malignant tumor patients with bone metastasis and in 30 healthy control group,the difference was statistically significant(P<0.05).With the increase of the number of metastatic lesions in the bone metastasis group,the serum levels of N-MID,TP1NP,and beta-CTx were increased gradually,and they were positively correlated with the progression of the disease.According to the analysis of ROC curve,the cut-off value,sensitivity and specificity in the diagnosis of tumor bone metastasis were 17.59 ng/mL,70.3％,88.9％ for serum N-MID,43.04 ng/mL,78.2％,95.6％ for TP1NP,and 0.48 ng/mL,73.9％,93.3％ for beta-CTx.Under the ROC curve(AUC) was 0.831 for serum N-MID,0.890 for TP1NP,and 0.869 for beta-CTx.The sensitivity and specificity of three bone metabolic markers in the diagnosis of bone metastasis of malignant tumor were significantly higher.Conclusion Bone metabolism biochemical markers:Serum N-MID,TP1NP and beta-CTx for diagnosis of bone metastasis of malignant tumor are sensitive,accurate and simple,which can significantly improve the efficiency of diagnosis of bone metastasis,and can be combined with whole-body bone scintigraphy in early diagnosis of bone metastasis with malignant tumor.

Objective To summarize the perioperative nursing of huge malignant lobulated breast tumor, so as to promote the recovery of patients. Methods A total of 11 patients with huge malignant lobulated breast tumor patients were selected, assessed the preoperative status,finished breast tumor site nursing, strengthen psychological nutritional assessment, the adjustment of the respiratory system for the operation, prevent falls. In addition to do a good job in general nursing and postoperative pain management, but should also focus on the observation of the chest wall flap, drainage tube care, to prevent bleeding and infection, etc. Results By implementing the nursing plan, 1 case of breathing difficulties preoperative patients with respiratory function improved, 1 case of refuse treatment of patients accepted surgical treatment after psychological intervention, 2 cases of postoperative patients with skin flap necrosis, local treatment, after compression bandage, 1 case of good recovery, 1 case of poor treatment effect for the wound recovered well after back surgery graft;1 case of patients with subcutaneous effusion, to adjust the drainage tube, suction fluid, after compression bandage, partial treatment, recovering well. Patients were good recovery, discharged smoothly. Conclusions By constantly sum up experience, through positive assessment of patients after preoperative mental and physical health and attaches importance to patients' skin flap, bleeding, pain, completes the drainage tube nursing and prevention of infection, can effectively promote the recovery of patients.

Objective To observe the expression of high mobility group A 1(HMGA1)protein in pituitary adenoma(PA)and explore its relationship with the aggressiveness and recurrence of PA .Methods The labeling index(LI)of HMGA1, detected by immunohistochemistry staining , was compared between aggressive and non-ag-gressive PA, recurrent and non-recurrent PA.Results The expression of HMGA1 were observed in all 52 cases of PA and homogenously distributed in nuclear of tumor cells .The LI of HMGA1 showed no significant difference between functioning and nonfunctioning PA (P=0.79), as well as among different immunophenotypical variants of PA(P=0.28).The expression of HMGA1 was significantly higher in the aggressive PA than in the nonaggres-sive PA(0.50 ±0.20 vs 0.24 ±0.17, P=0.000).Patients with a recurrent PA had a higher value of HMGA 1 than patients with a non-recurrent PA(0.60 ±0.20 vs 0.24 ±0.18, P=0.000).The expression of HMGA1 in-creased stepwise with the tumor size, as the highest was present in macro-sized PA(0.52 ±0.20)and the lowest was in micro-sized PA(0.18 ±0.17).A similar trend was found in Hardy's grade I(0.18 ±0.17),II(0.30 ± 0.20)and III-IV(0.50 ±0.20)(P=0.003).The area under the ROC curve was 0.918(>0.90).When the LI reached 49.2%, the predicting specificity was 90.5%and the sensitivity was 71.4%.Conclusions The LI of HMGA1 has a positive correlation with the tumor size , aggressiveness and recurrence of PA and also has a valua-ble predicting efficacy for PA recurrence .The characteristics of HMGA 1 in PA can help pathologists make repro-ducible evaluation on prognosis of PA .