ObjectiveTo investigate the efficacy of Poge Jiuxin decoction （PGJXD） on fluid resuscitation in septic shock patients and its effects on vascular endothelial function based on clinical randomized controlled trials （RCTs） and network pharmacology， and to reveal its molecular mechanisms and signaling pathways through network pharmacology. MethodsSeventy-two septic shock patients were enrolled and randomly assigned to either the treatment group or the control group （36 cases each） through a random number table. Both groups received conventional Western medical treatment for sepsis. Additionally， the treatment group received PGJXD （100 mL， twice daily） for 3 consecutive days. The two groups were compared in terms of the Sequential Organ Failure Assessment （SOFA） score， Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE Ⅱ） score， vascular endothelial function indicators ［endothelium-derived relaxing factor （EDRF）， nitric oxide （NO）， and 6-keto-prostaglandin F_1α （6-keto-PGF_1α）］， inflammation indicators ［tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， nuclear factor kappa-B （NF-κB）， and procalcitonin （PCT）］， perfusion indicators ［mean arterial pressure （MAP）， lactate （Lac）， and 72-hour lactate clearance rate （Lcr）］， fluid resuscitation target achievement time， vasopressor use duration， length of hospital stay， and 28-day mortality. Databases including TCMSP， HIT 2.0， and Uniprot were searched for active components of PGJXD and their targets. Gene targets for septic shock were obtained from GeneCards， OMIM， and DrugBank databases. Venny software was used to identify common targets between PGJXD and septic shock. Cytoscape software and the STRING database were utilized to construct a "drug-component-target-disease" network and a protein-protein interaction （PPI） network. Gene Ontology （GO） functional enrichment analysis， Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway analysis， and molecular docking were performed to explore the molecular mechanisms and signaling pathways of PGJXD in treating septic shock. ResultsFive patients withdrew from the treatment group and seven from the control group. After treatment， both groups showed decreases （P<0.01） in APACHE Ⅱ score， SOFA score， EDRF， 6-keto-PGF_1α， TNF-α， IL-6， NF-κB， PCT， MAP， and Lac， and increases in NO （P<0.01）. The treatment group exhibited more significant decreases （P<0.05， P<0.01） in APACHE Ⅱ score， SOFA score， 6-keto-PGF_1α， TNF-α， IL-6， NF-κB， MAP， Lac， Lcr， fluid resuscitation target achievement time， and vasopressor use duration than the control group. Differences in EDRF， NO， PCT， length of hospital stay， and 28-day mortality were not statistically significant. No significant adverse reactions were observed in either group during treatment. Network pharmacology identified 189 components and 257 potential targets of PGJXD， and 136 common targets shared by PGJXD and septic shock. GO enrichment analysis primarily involved positive regulation of cell migration， response to peptide， response to inorganic substance， etc. KEGG enrichment analysis mainly implicated signaling pathways such as NF-κB， VEGF， and Relaxin. ConclusionPGJXD can significantly ameliorate the condition of septic shock patients and enhance the efficacy of fluid resuscitation. Its key mechanism may involve protecting vascular endothelial cells by regulating the TNF-α/NF-κB signaling pathway and reducing the inflammatory response.

Objective To investigate the clinical efficacy and aesthetic outcome of liposuction combined with mammary adenectomy through a periareolar small incision in the management of gynecomastia(GYN).Methods From January 2019 to June 2023,18 patients with GYN were admitted.All of them were treated with small incision through the areola combined with liposuction.The postoperative aesthetic effect,occurrence of complications and patient satisfaction of the patients were evaluated.Results All 18 patients in this study were follwed up for a period of 3 to 18 months.No serious complications such as wound infection or necrosis of the nipple-areola occurred.Pathological examinations were consistent with the diagnosis of GYN.Except for one patient,who exhibited slight skin folds in the surgical area at the 12-month follow-up,the other patients all achieved symmetrical and smooth chest contours with noticeable aesthetic improvement,resulting in a 100％patient satisfaction rate.Conclusion The combined approach of liposuction combined with mammary adenectomy through a periareolar small incision for the treatment of GYN is straightforward,minimally invasive,and yields satisfactory therapeutic and aesthetic outcomes.

Objective To investigate the clinical efficacy and aesthetic outcome of liposuction combined with mammary adenectomy through a periareolar small incision in the management of gynecomastia(GYN).Methods From January 2019 to June 2023,18 patients with GYN were admitted.All of them were treated with small incision through the areola combined with liposuction.The postoperative aesthetic effect,occurrence of complications and patient satisfaction of the patients were evaluated.Results All 18 patients in this study were follwed up for a period of 3 to 18 months.No serious complications such as wound infection or necrosis of the nipple-areola occurred.Pathological examinations were consistent with the diagnosis of GYN.Except for one patient,who exhibited slight skin folds in the surgical area at the 12-month follow-up,the other patients all achieved symmetrical and smooth chest contours with noticeable aesthetic improvement,resulting in a 100％patient satisfaction rate.Conclusion The combined approach of liposuction combined with mammary adenectomy through a periareolar small incision for the treatment of GYN is straightforward,minimally invasive,and yields satisfactory therapeutic and aesthetic outcomes.

Objective:To conduct a scoping review of studies on the assessment content and early functional exercise of various functional disorders occurring in the limbs on the operated side after cardiac implantable electronic device implantation, so as to provide a reference for the future early identification of different functional disorders in the limbs on the operated side and the guidance of early rehabilitation and exercise in the postoperative period.Methods:According to the scoping review methodology,we systematically searched PubMed, Embase, Cochrane Library, Web of Science, CINAHL, CNKI, VIP, Wanfang and CBM. The retrieval time limit was from the establishment of the database to October 31, 2023. The included studies were summarized and analyzed.Results:Totally 15 studies were included. These included 7 randomized controlled trials and 6 cohort studies, and 2 case-control studies. Postoperative series of limb-related dysfunction on the operative side after cardiac implantable electronic device implantation including shoulder pain, limited range of motion of the shoulder, decreased grip strength, and scapular dyskinesia. Shoulder range of motion limitations included flexion, abduction, and internal and external rotation angle limitations. Shoulder pain and impaired active forward flexion had the highest prevalence, reaching 61% and 60% respectively. The most restricted population was ICD implanted patients. The assessment tools included subjective and objective tools. These tools included 3 types of scales to assess shoulder pain and goniometer for assessing shoulder range of motion and hydraulic hand dynamometer for evaluating grip strength, and tests and tape measures to assess scapular dyskinesia and 5 types of scales to assess overall limb function on the operative side.The various dysfunctions associated with the limb on the operated side basically appeared at 2 weeks postoperatively, and these dysfunctions began to improve at 3 months postoperatively and normalized at 12 months and fully recovered at 5 years.The longest duration was in patients with ICD implants. The rehabilitation exercise program consisted of five types, of which the pendulum exercise was a single program and the remaining four were comprehensive rehabilitation exercise programs, all of which were effective.Intervention time points included postoperative days 1 and 2, as well as postoperative weeks 1 and 2.Conclusions:We need to focus on the presence of serial related dysfunction in the operated limb after cardiac implantable electronic device implantation. Assessment tools are diverse and we need to choose appropriately based on measurement priorities. All of these dysfunctions are self-limiting, however, they still have a long time to heal themselves. All of these individuals need to be included in screening and comprehensive interventions at regular outpatient follow-up visits for one year after surgery. Conducting a comprehensive functional exercise program is beneficial in reducing the incidence and duration of different dysfunctions in the patient′s operated limb. These exercise programs have value for further clinical application. However, these exercise programs are not uniform.In order to provide early intervention for patients, the further validation of which types of activity programs or a combination of certain types of activity programs need to be further investigated. The timing of early functional exercise is not uniform and further work is needed to determine these times.

Objective:To explore the safety and effectiveness of medium-frequency electrotherapy for increasing the volume of the latissimus dorsi muscle.Methods:Fifteen adult New Zealand white rabbits were randomly divided into three groups, namely group A, group B, and group C, with 5 rabbits in each group. This was a self-control study, with the right latissimus dorsi muscle as the experimental group and the left latissimus dorsi muscle as the control group. The three groups corresponded to three different current intensity levels: 7.062 mA for group A (6th gear), 10.593 mA for group B (9th gear), and 14.124 mA for group C (12th gear). After the 12th, 24th, and 36th sessions of the experiment, ultrasonography was used to collect the thickness of the latissimus dorsi muscle. After the 36th electrostimulation, the latissimus dorsi muscle samples were collected to measure their in vivo muscle thickness and wet weight and were then sent for HE and MASSON staining.Results:After the 12th, 24th, and 36th electrostimulation sessions, ultrasonographic sampling in groups A and B showed an increase in the thickness of the right latissimus dorsi muscle compared to the left; for example, the thickness on the right of group B increased by 37.8%. The wet weight data collected after the 36th electrostimulation in groups A and B showed an increase in the right latissimus dorsi muscle compared to the left; for example, the wet weight on the right of group B increased by 5.04%.Conclusions:Different electrostimulation modes of medium-frequency therapy technology can induce muscle fiber thickening or atrophy. In this experiment, the 9th gear (10.593 mA) of medium-frequency therapy technology may be a suitable choice for inducing muscle fiber thickening, and the 12th gear (14.124 mA) may be a suitable choice for inducing skeletal muscle thinning.

Objective:To investigate the radiosensitization effect and mechanism of low dose metformin on Hep-G2 tumor bearing mice.Methods:All mice were divided into four groups: control group, radiotherapy group, metformin treatment group and metformin combined with radiotherapy group.After different treatments, the tumor volume of mice in each group was recorded, and the tripling time (TT), tumor growth delay (TGD) and enhancement factor (EF) were calculated.After 21 days, all mice were killed, stripped and weighed, and the tumor inhibition rate was calculated.The effects of different treatments on cell cycle and apoptosis were detected by flow cytometry, and the influences of different treatments on STAT3 signaling pathway and apoptosis related protein expression were detected by immunoblotting.Results:Low dose metformin combined with radiotherapy could significantly inhibit the growth of tumor in mice, and had a better radiosensitization effect, with a sensitization coefficient of 1.52.In addition, the combined treatment group could significantly induce G2/M arrest and apoptosis of Hep-G2 cells[the combined group vs.The radiotherapy group: G2/M phase ratio, (28.4±5.3)% vs.(10.8±3.7)%, t=8.55, P<0.05; apoptosis rate, (28.4±5.3)% vs.(10.8±3.7)%, t=11.83, P<0.01]. Furthermore, compared with the single radiotherapy group, the combined group could significantly reduce the phosphorylation level of STAT3 ( t=10.71, P<0.01), and regulate the expression of apoptosis-related proteins. Conclusion:Metformin has antitumor and radiosensitizing effects on Hep-G2 hepatoma-bearing mice, the mechanism of which may be related to the induction of G2/M phase arrest and the inhibition of STAT3 signaling pathway.

Objective To investigate the effect of sevelamer hydrochloride combined hemodiafiltration on renal os-teodystrophy. Methods A total of 69 cases with renal osteodystrophy were selected from July 2012 to November 2013 in our hospital, they were divided into three groups according to the treatment ,23 cases in each group, the control A group received sevelamer hydrochloride oral treatment, the control B group accepted hemodiafiltration, the treatment group received oral secretary hydrochloride and hemodiafiltration. The efficacy and common biochemical parameters before and after treatment of the three groups were compared. Results The total effective rate of the treatment group was significantly higher than that of the control A group and control B group, the difference was significant(P<0.05). The serum Ca levels of three groups after treatment were higher than before treatment, P, calcium-phosphorus product, ALP, β-MG, PTH were lower than before treatment, the difference was significant (P<0.05). Ca levels in the treatment group were higher than that in the control A group and control B group, P, calcium-phosphorus product, ALP, β-MG, PTH were lower than the control A group and control B group, the difference was significant(P<0.05). Conclusion Seve-lamer hydrochloride combined treatment of renal osteodystrophy hemodiafiltration obvious effect, can clinical applica-tion.

OBJECTIVETo investigate the optimal separation of the total flavones from Herba Epimedii by macroporous adsorption resin.

METHODNine types of macroporous adsorption were evaluated for separating efficiency by measuring the adsorption ratio, eluting ratio of total flavones.

RESULTThe D-101 macroporous adsorption resin had the best separating efficiency. After enrichment and purification with it, the product purity of total flavones was up to 63.8%.

CONCLUSIONThis method is simple, feasible and fit for industry production.

Adsorption ; Epimedium ; chemistry ; Flavones ; isolation & purification ; Porosity ; Resins, Plant ; chemistry ; Ultrasonics

OBJECTIVETo investigate the effects of red orpiment on cell morphology, expression of promyelocytic leukemia (PML) mRNA and its protein localization in NB4 and HL-60 cell lines.

METHODSCell morphology was assayed by Wright's staining and fluorescence staining, while PML mRNA expression was determined by RT-PCR. PML protein localization by evaluated by immunofluorescence staining.

RESULTSThe typical apoptosis was found in NB4 and HL-60 cells after treatment with red orpiment. The fusion protein was no longer observed in NB4 cells, PML protein was relocated, and then degraded. In HL-60 cells, PML protein underwent a similar progress. The expression of promyelocytic leukemia (PML) mRNA was not changed in the treated cells.

CONCLUSIONRed orpiment inhibits the proliferation of leukemia cells by inducing them to undergo apoptosis.

Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Arsenicals ; pharmacology ; HL-60 Cells ; Humans ; Leukemia, Promyelocytic, Acute ; drug therapy ; metabolism ; pathology ; Medicine, Chinese Traditional ; Neoplasm Proteins ; analysis ; genetics ; Nuclear Proteins ; Promyelocytic Leukemia Protein ; RNA, Messenger ; analysis ; Transcription Factors ; analysis ; genetics ; Tumor Cells, Cultured ; Tumor Suppressor Proteins

OBJECTIVETo compare the gene expression status of NB4 cells before and after arsenic sulfide treatment by cDNA microarray.

METHODSTwo cDNA probes were made from mRNA of untreated or arsenic sulfide treated NB4 cells. The cells were labelled with Cy3 or Cy5 fluorescence dyes individually, hybridized with cDNA microarray, and scanned for fluorescent intensity. The altered gene expression was screened through the analysis of difference in gene expression profile.

RESULTSThirty four genes related to apoptosis, cell cycle and others expressed different after the treatment of arsenic sulfide, 28/34 were up-regulated, 6/34 down-regulated.

CONCLUSIONABC50, PNAS-2 and cyclin G(2) might take part in the process of NB4 cell apoptosis induced by arsenic sulfide.

Arsenicals ; pharmacology ; Gene Expression Regulation, Neoplastic ; drug effects ; Humans ; Oligonucleotide Array Sequence Analysis ; Sulfides ; pharmacology ; Tumor Cells, Cultured ; drug effects ; metabolism