Purpose To investigate the correlation and prognostic value of tumor-stroma ratio(TSR)combined with fi-brotic focus(FF)and stromal tumor-infiltrating lymphocytes(sTILs)with pathological complete response(pCR)after neoad-juvant therapy in triple-negative breast cancer(TNBC).Meth-ods The clinical data of 170 cases of TNBC were collected.Af-ter double-blind reading of the sections by two senior patholo-gists,the pathological examination results of all cases were re-viewed,and the results of TSR,FF,sTILs and the expression of CD4 and CD8 were evaluated.Then the relationship between the above information and PCR and prognosis was analyzed.Results 170 cases of TNBC after neoadjuvant therapy,57 patients a-chieved pCR,while 113 patients did not achieve pCR.Statistical analysis revealed the following findings:TSR,FF,sTILs,CD4,CD8,Ki67,vascular invasion,and lymph node metastasis exhib-ited significant differences between the pCR and non-pCR groups.There were also significant differences in TSR,FF and sTILs between different Miller-Payne(MP)grades.TSR,sTILs,TSR combined with FF,sTILs and Ki67 were positively correlated with PCR.Meanwhile,TSR,sTILs,TSR combined with FF and sTILs were also positively correlated with MP grade,while FF,intravascular tumor thrombus and lymph node metasta-sis were negatively correlated with PCR.At the same time,TSR and sTILs were also positively correlated with MP grade,and FF was also negatively correlated with MP grade.The prognosis of patients was optimal with TSR＞1,G0 FF and sTILs＞50％.When TSR combined with FF and sTILs,the prognosis of PCR group was better than that of non-PCR group.Conclusion TSR,FF,and sTILs are anticipated to serve as predictive bio-markers for assessing the efficacy and prognosis of neoadjuvant therapy in TNBC patients.These findings offer novel insights into the treatment and research strategies for TNBC.

[Objective]To investigate the protective effect of Zhuangtongyin on the Middle Cerebral Artery Occlusion(MCAO)model by modulating ferroptosis through the Nrf2-SCL7A11/xCT-Gpx4 pathway and its underlying mechanism.[Methods]C57BL/6J mice were randomly divided into Sham operation group(Sham),model group(MCAO),low-dose Zhuangtongyin group(ZTY-L),high-dose Zhuangtongyin group(ZTY-H),with 5 mice in each group.The MCAO group was modelled by silica gel embolization,the middle cerebral artery of mice was embolized for 1h,then the silica gel was pulled out and reperfusion was performed after 72 h;and the other operations in the Sham group were the same as those in the MCAO group except that the thread plug was not inserted.The neural function of mice was evaluated by Zea-Longa method.TTC staining was used to evaluate the volume of cerebral infarction.The level of brain injury was evaluated by HE staining and Nissl staining.Prussian blue staining and the expression of iron transport-related carrier receptors TfR1 and DMT1 on mRNA level was detected by qPCR to evaluate the iron ion deposition level in mice brain.The expression of lipid peroxidation-related gene ACSL4 on mRNA level was detected by qPCR,and the content of 4-HNE was detected by ELISA kit to evaluate the lipid peroxidation level of mice brain.The expressions of ferroptosis marker PTGS2 mRNA level was detected by qPCR.The expressions of Nrf2,SCL7A11/xCT,Gpx4 in mice brain tissue were detected by Western-blot and immunofluorescence.[Results]Zhuangtongyin improved the nerve function of mice after MCAO(P＜0.05)and the cerebral infarction volume of mice(P＜0.05)and alleviate the pathological injury of cerebral cortex cells after MCAO operation.Zhuangtongyin attenuated the accumulation of trivalent iron ions in the brain tissue of mice following MCAO.Additionally,Zhuangtongyin downregulated the expression of TfR1 and DMT1 mRNA(P＜0.001),a transporter associated with cellular iron ion uptake,in the brains of post-MCAO mice.Furthermore,Zhuangtongyin reduced levels of lipid peroxidation product 4-HNE(P＜0.001)and suppressed ACSL4 mRNA expression in brain tissue post-MCAO(P＜0.001).Besides,Zhuangtongyin downregulated the expression of PTGS2 mRNA(P＜0.001),in the brains of post-MCAO mice.Zhuangtongyin increased the expression of nrf2 into the nucleus(P＜0.001),and increased the expression of xCT and Gpx4 in neurons after MCAO(P＜0.001).[Conclusion]Zhuangtongyin can enhance the nerve function and reduce cerebral infarction volume in MCAO/R mice,alleviate the pathological damage of cerebral cortex cells,and modulate the expression of key signaling molecules in the Nrf2-SCL7A11/xCT-Gpx4 pathway.Therefore,it is suggested that the mechanism by which Zhuangtongyin improves MCAO/R injury in mice may involve regulating ferroptosis through the Nrf2-SCL7A11/xCT-GPX4 pathway.

Purpose To investigate the correlation and prognostic value of tumor-stroma ratio(TSR)combined with fi-brotic focus(FF)and stromal tumor-infiltrating lymphocytes(sTILs)with pathological complete response(pCR)after neoad-juvant therapy in triple-negative breast cancer(TNBC).Meth-ods The clinical data of 170 cases of TNBC were collected.Af-ter double-blind reading of the sections by two senior patholo-gists,the pathological examination results of all cases were re-viewed,and the results of TSR,FF,sTILs and the expression of CD4 and CD8 were evaluated.Then the relationship between the above information and PCR and prognosis was analyzed.Results 170 cases of TNBC after neoadjuvant therapy,57 patients a-chieved pCR,while 113 patients did not achieve pCR.Statistical analysis revealed the following findings:TSR,FF,sTILs,CD4,CD8,Ki67,vascular invasion,and lymph node metastasis exhib-ited significant differences between the pCR and non-pCR groups.There were also significant differences in TSR,FF and sTILs between different Miller-Payne(MP)grades.TSR,sTILs,TSR combined with FF,sTILs and Ki67 were positively correlated with PCR.Meanwhile,TSR,sTILs,TSR combined with FF and sTILs were also positively correlated with MP grade,while FF,intravascular tumor thrombus and lymph node metasta-sis were negatively correlated with PCR.At the same time,TSR and sTILs were also positively correlated with MP grade,and FF was also negatively correlated with MP grade.The prognosis of patients was optimal with TSR＞1,G0 FF and sTILs＞50％.When TSR combined with FF and sTILs,the prognosis of PCR group was better than that of non-PCR group.Conclusion TSR,FF,and sTILs are anticipated to serve as predictive bio-markers for assessing the efficacy and prognosis of neoadjuvant therapy in TNBC patients.These findings offer novel insights into the treatment and research strategies for TNBC.

ObjectiveTo investigate the therapeutic effect of Yupingfeng San on allergic rhinitis （AR） and its effect on Reactive oxygen species （ROS）/NOD-like receptor thermal protein domain associated protein 3 （NLRP3）/cysteinyl aspartate specific proteinase-1 （Caspase-1） pathway. MethodSPF mice were randomly divided into control group， model group， loratadine group （0.9 mg·kg^-1）， and low， medium， and high dose Yupingfeng San groups （6， 12， 24 mg·kg^-1）， with 10 mice in each group. The control group was given routine feeding， and the other groups were intraperitoneally injected with ［ovalbumin（OVA） + Al（OH）₃ + phosphate buffer solution（PBS）］ suspension once every other day for seven consecutive times. After seven days， 10% OVA solution was instilled in the nose， two times each day for seven consecutive days. After successful modeling， each administration group was intraperitoneally injected with different doses of Yupingfeng San Decoction， and the control group and model group were intraperitoneally injected with an equal volume of normal saline. Symptoms of sneezing， scratching， and runny nose were recorded and scored daily. The levels of ovalbumin specific immunoglobulin E （OVA-sIgE）， histamine， eosinophil cationic protein （ECP）， prostaglandin D₂ （PGD₂）， interleukin-1β （IL-1β）， interleukin-18 （IL-18）， interleukin-4 （IL-4）， and γ interferon （IFN-γ） in nasal lavage solution and serum of mice were detected by enzyme-linked immunosorbent assay （ELISA）. The damage status of the nasal mucosa was observed by hematoxylin-eosin （HE） staining. The number of goblet cells in the nasal mucosa of mice was observed by periodic acid-Schiff （PAS） staining. The expression of NLRP3 protein in the nasal mucosa of mice was detected by immunohistochemistry. Western blot was used to detect the expressions of NLRP3， cleaved Caspase-1， and cleaved gasdermin D （GSDMD） proteins in the nasal mucosa. The test kit was used to detect the changes in ROS in the nasal cavity of mice in each group. ResultCompared with the control group， the nasal symptoms of the model group were significantly aggravated， and the levels of inflammatory factors OVA-sIgE， histamine， ECP， PGD₂， IL-1β， IL-18， and IL-4 in serum and nasal lavage solution were increased （P<0.05，P<0.01）. The levels of IFN-γ were decreased （P<0.05，P<0.01）. The histopathological score， goblet cell number， and ROS content were significantly increased （P<0.01）， and the expressions of pyrodeath-related proteins NLRP3， cleaved Caspase-1， and cleaved GSDMD were increased （P<0.01）. Compared with the model group， the nasal symptoms of the loratadine group and Yupingfeng San groups were significantly relieved， and the levels of inflammatory factors OVA-sIgE， histamine， ECP， PGD₂， IL-1β， IL-18， and IL-4 in serum and nasal lavage solution were decreased （P<0.05，P<0.01）. The levels of IFN-γ were increased （P<0.05，P<0.01）. The histopathological scores， goblet cell number， and ROS content were significantly decreased （P<0.05，P<0.01）， and the expressions of pyrodeath-related proteins NLRP3， cleaved Caspase-1， and cleaved GSDMD were decreased （P<0.05，P<0.01）. Compared with the loratadine group， the curative effect of the high dose Yupingfeng San group was further increased （P<0.05，P<0.01）. ConclusionYupingfeng San has a therapeutic effect on AR， and its specific effect may be related to the inhibition of ROS/NLRP3/Caspase-1-induced cell pyroptosis.

ObjectiveTo explore the effect of Scutellariae Barbatae Herba extract on on the cycle arrest of nasopharyngeal carcinoma cells and the possible mechanism by adding different concentration of Scutellariae Barbatae Herba extract （0.25， 0.5， 1 g·L^-1） in the culture medium， taking CNE1 （nasopharyngeal carcinoma cells） as the research object. MethodAfter the treatment of CNE1 by Scutellariae Barbatae Herba extract， cell counting kit-8 （CCK-8） was used to detect cell proliferation， and Giemsa staining was used to detect the clone formation rate. Flow cytometry was used to detect cell cycle distribution， and reverse transcription-polymerase chain reaction （ RT-PCR） assay and Western blot assay were used to detect the relative expression of messenger ribonucleic acid （mRNA） by small interfering RNA （siRNA） or overexpression. ResultAs compared with the blank group， the proliferation and colony formation rate of CNE1 in the Scutellariae Barbatae Herba extract group significantly decreased （P<0.05， P<0.01） in a dose and time-dependent manner， whereas the percentage of cells in the presynthetic phase （G₀/G₁） increased （P<0.05， P<0.01）. The expression level of S-phase kinase associated protein 2 （SKP2） in the Scutellariae Barbatae Herba extract group significantly decreased （P<0.01） as compared with the blank group. As compared with the Scutellariae Barbatae Herba extract group， the protein levels of p21 and p27 significantly decreased in the overexpressed SKP2+ Scutellariae Barbatae Herba extract group （P<0.01）. As compared with the blank group， the signal activation and the phosphorylation level of signal transducer and activator of transcription 3 （STAT3） of CNE1 in the S. barbata extract group significantly decreased （P<0.05， P<0.01）. ConclusionScutellariae Barbatae Herba extract effectively inhibits the proliferation of CNE1， and the mechanism may be related to its action on the STAT3/SKP2 pathway.

ObjectiveTo observe the clinical efficacy of modified Bufei Huangqitang combined with acupuncture on moderate-to-severe allergic rhinitis due to deficiency and cold in lung and kidney. MethodA total of 130 patients were divided into a control group （65 cases） and an observation group （65 cases） according to a random number table. The patients in the control group were treated with cetirizine hydrochloride tablets （10 mg per night） combined with mometasone furoate nasal spray （one press on each side，once a day），and those in the observation group were treated with acupuncture （once a day） combined with modified Bufei Huangqitang（1/2 dose each time，twice a day） for 15 days. The rhinoconjunctivitis quality of life questionnaire （RQLQ），total nasal symptom score （TNSS），nasal airway resistance （NAR），and traditional Chinese medicine （TCM） syndrome score of allergic rhinitis with deficiency and cold in lung and kidney syndrome were observed before and after treatment in two groups. The neuropeptide Y （NPY），vasoactive intestinal peptide （VIP），substance P （SP） in nasal secretions， and immune inflammatory markers ［eosinophil （EOS），eotaxin （EOT），immunoglobulin E （IgE），and interleukin-33 （IL-33）］ in serum were detected. Adverse reactions of the two groups were observed during the study period. ResultThe total effective rate was 96.9% （63/65） in the observation group， higher than 81.5% （53/65） in the control group （χ²=7.943，P<0.05）. After treatment，the RQLQ，TNSS，NAR， and TCM syndrome scores in the observation group were lower than those in the control group （P<0.05）. The nasal secretions NPY in the observation group was higher than that in the control group （P<0.05），while VIP and SP in the observation group were lower than those in the control group （P<0.05）. The serum EOS，IgE， and IL-33 in the observation group were lower than those in the control group （P<0.05）， while the serum EOT in the observation group was higher than those in the control group （P<0.05）. Adverse reactions occurred in two cases in the control group and one case in the observation group. The incidence of adverse reactions had no statistical significance between the two groups. ConclusionAcupuncture combined with modified Bufei huangqitang can significantly relieve the clinical symptoms of moderate-to-severe allergic rhinitis due to deficiency and cold in lung and kidney and improve the serum immune inflammatory markers， with good safety.

Objective: This cross-sectional study aimed to investigate the characteristics of malocclusions in scoliotic patients through clinical examinations. Methods: Fifty-eight patients with idiopathic scoliosis (IS) and 48 patients with congenital scoliosis (CS) participated in the study. A randomly selected group of 152 orthopedically healthy children served as the control group. Standardized orthodontic and orthopedic examination protocols were used to record the occlusal patterns and type of scoliosis. Assessments were made by three experienced orthodontists and a spinal surgery team. The differences in the frequency distribution of occlusal patterns were evaluated by the chi-squared test. Results: In comparison with patients showing IS, patients with CS showed a higher incidence of Cobb angle ≥ 45° (p = 0.020) and included a higher proportion of patients receiving surgical treatments (p < 0.001). The distribution of the Angle Class II subgroup was significantly higher in the IS (p < 0.001) and CS (p = 0.031) groups than in the control group. In comparison with the healthy controls, the CS and IS groups showed significantly higher (p < 0.05) frequencies of asymmetric molar and asymmetric canine relationships, upper and lower middle line deviations, anterior deep overbite, unilateral posterior crossbite, and canted occlusal plane, with the frequencies being especially higher in CS patients and to a lesser extent in IS patients. Conclusions Patients with scoliosis showed a high frequency of malocclusions, which were most obvious in patients with CS.

Objective:To evaluate the related factors of gallstones related gallbladder intraepithelial neoplasia(GBIN) and establish the prediction models for gallstones related GBIN.Methods:The clinicopathological data of 750 patients who underwent cholecystectomy for gallstones at Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi′an Jiaotong University from January 2013 to December 2018 and the postoperative pathological examination showed chronic cholecystitis or GBIN were analyzed retrospectively,including 150 cases of gallstones with GBIN and 600 cases of gallstones with chronic cholecystitis.There were 264 males and 486 females with age of (51.3±14.5) years (range: 18 to 90 years).The related factors for gallstones related GBIN were screened by χ 2 test and Logistic regression model,and the prediction models were established based on independent related factors and internal validation was conducted.The original data were randomly divided into a training cohort(526 cases) and a validation cohort(224 cases) at a ratio of 7∶3,and the nomogram and tree augmented na?ve Bayes were conducted to establish the prediction model for gallstones related GBIN.The consistency index(C-index),calibration chart,area under the receiver operating characteristic curve(AUC) and confusion matrix were used to evaluate the prediction performance of the two models. Results:Univariate analysis showed that age,gallstones history(years),gallbladder size,whether the gallbladder mucosa smooth or not,whether the gallbladder wall thickened or not,gallstones diameter,and number of gallstones were related factors for the occurrence of gallstones related GBIN (χ2=19.957,8.599,9.724,9.301,8.341,15.288,9.169,all P<0.05).Multivariate analysis showed that age ( OR=2.23,95% CI:1.50-3.31, P<0.01),gallbladder size ( OR=2.11,95% CI:1.17-3.80, P=0.013),whether the gallbladder mucosa smooth or not ( OR=1.80,95% CI:1.13-2.88, P=0.014),gallstones diameter( OR=2.98,95% CI:1.71-5.21, P<0.01),and number of gallstones ( OR=2.14,95% CI:1.34-3.42, P<0.01) were independent related factors for the occurrence of gallstones related GBIN; the C-index of the nomogram in training cohort and validation cohort were 0.708 and 0.696,respectively.The AUC of the two models in training cohort were 70.60% and 70.73%,and in validation cohort were 68.14% and 67.47%,respectively.The accuracy of the two models in training cohort were 69.96% and 70.72%,and in validation cohort were 66.96% and 67.41%,respectively. Conclusion:Age,gallbladder size,whether the gallbladder mucosa smooth or not,gallstones diameter and number of gallstones are independent related factors for the occurrence of gallstones related GBIN,and the nomogram and tree augmented na?ve Bayes prediction models based on the above factors can be used to predict the occurrence of GBIN.

Objective:To evaluate the related factors of gallstones related gallbladder intraepithelial neoplasia(GBIN) and establish the prediction models for gallstones related GBIN.Methods:The clinicopathological data of 750 patients who underwent cholecystectomy for gallstones at Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi′an Jiaotong University from January 2013 to December 2018 and the postoperative pathological examination showed chronic cholecystitis or GBIN were analyzed retrospectively,including 150 cases of gallstones with GBIN and 600 cases of gallstones with chronic cholecystitis.There were 264 males and 486 females with age of (51.3±14.5) years (range: 18 to 90 years).The related factors for gallstones related GBIN were screened by χ 2 test and Logistic regression model,and the prediction models were established based on independent related factors and internal validation was conducted.The original data were randomly divided into a training cohort(526 cases) and a validation cohort(224 cases) at a ratio of 7∶3,and the nomogram and tree augmented na?ve Bayes were conducted to establish the prediction model for gallstones related GBIN.The consistency index(C-index),calibration chart,area under the receiver operating characteristic curve(AUC) and confusion matrix were used to evaluate the prediction performance of the two models. Results:Univariate analysis showed that age,gallstones history(years),gallbladder size,whether the gallbladder mucosa smooth or not,whether the gallbladder wall thickened or not,gallstones diameter,and number of gallstones were related factors for the occurrence of gallstones related GBIN (χ2=19.957,8.599,9.724,9.301,8.341,15.288,9.169,all P<0.05).Multivariate analysis showed that age ( OR=2.23,95% CI:1.50-3.31, P<0.01),gallbladder size ( OR=2.11,95% CI:1.17-3.80, P=0.013),whether the gallbladder mucosa smooth or not ( OR=1.80,95% CI:1.13-2.88, P=0.014),gallstones diameter( OR=2.98,95% CI:1.71-5.21, P<0.01),and number of gallstones ( OR=2.14,95% CI:1.34-3.42, P<0.01) were independent related factors for the occurrence of gallstones related GBIN; the C-index of the nomogram in training cohort and validation cohort were 0.708 and 0.696,respectively.The AUC of the two models in training cohort were 70.60% and 70.73%,and in validation cohort were 68.14% and 67.47%,respectively.The accuracy of the two models in training cohort were 69.96% and 70.72%,and in validation cohort were 66.96% and 67.41%,respectively. Conclusion:Age,gallbladder size,whether the gallbladder mucosa smooth or not,gallstones diameter and number of gallstones are independent related factors for the occurrence of gallstones related GBIN,and the nomogram and tree augmented na?ve Bayes prediction models based on the above factors can be used to predict the occurrence of GBIN.

BACKGROUND: Zinc, an inorganic antibacterial material, has a suitable degradation rate and good antibacterial property. Adding alloying elements can improve the mechanical properties and biocompatibility of the material, which is the development direction of novel medical biodegradable metal materials. There is still lack a comparable research on the antibacterial properties among zinc-based materials. OBJECTIVE: To investigate the antibacterial properties of pure zine and zinc-based alloys in vivo. METHODS: Eighty Sprague-Dawley rats, SPF grade, were randomized into two groups (n=40/group) , and all rats were injected with Staphylococcus aureus or Escherichia coli solution to prepare infection models. Different materials (Zn, ZnAl, ZnSr, Zn3 Mg, Zn3 Ag, Zn3 Ca and Zn4 Cu; five rats for each material) were implanted into the medullary cavity of femur. The control group without any material was set. At 1, 4, 7 and 14 days after implantation, the changes of body temperature, white blood cell count, serum tumor necrosis factor α and serum zinc content in rats were detected. The secretions and tissues of the surgical site were collected to identify the bacterial species. RESULTS AND CONCLUSION: (1) The body temperature in all the rats was increased to different extents after bacterial infection, but the temperature of the rats implanted with zinc and zinc alloys was always lower than that in the control group at 7 and 14 days (P < 0.05) . The temperature in the Zn3 Ag group was significantly lower than that in the other groups at 7 and 14 days (P < 0.05) . (2) The white blood cell count and tumor necrosis factor α level in the zinc and zinc alloys groups were significantly lower than those in the control group at 7 and 14 days after implantation (P < 0.05) . The white blood cell count and tumor necrosis factor α level in the Zn3 Ag group were significantly lower than those in the other groups (P < 0.05) . (3) The serum zinc content in all groups has no significant difference (P> 0.05) . (4) The bacterial culture results showed S.aureus (+) in the Staphylococcus aureus infection group and E.coli (+) in the Escherichia coli infection group. (5) To conclude, degradable zinc-based alloys exert marked antibacterial effects, and Zn3 Ag alloys have the best antibacterial activity.