OBJECTIVE To establish the UPLC fingerprint and the method for multi-component content determination in Jingangteng capsules， and to evaluate its quality by combining chemical pattern recognition analysis. METHODS An UPLC method was established. Separation was performed on a Zorbax SB-C 18 Rapid Resolution HD column， with acetonitrile-0.1% formic acid as the mobile phase for gradient elution.Using the Similarity Evaluation System for Chromatographic Fingerprints of Traditional Chinese Medicines （2012 edition）， UPLC fi ngerprints were established for 10 batches of Jingangteng capsules， and similarity was evaluated. SPSS 22.0 and SIMCA 14.1 software were used to perform hierarchial-cluster analysis and orthogonal partial least squares discriminant analysis （OPLS-DA）， respectively. The same UPLC method was employed to determine the contents of chlorogenic acid， 3，5-dihydroxy-2-methylbenzoic acid-3- O -glucoside （M1）， caffeic acid， astilbin， oxyresveratrol， quercitrin and resveratrol in the 10 batches of samples. RESULTS A total of 17 common peaks were identified in UPLC fingerprints of the 10 batches of samples， of which 7 were identified as chlorogenic acid， M1， caffeic acid， astilbin， oxyresveratrol， quercitrin， and resveratrol. The similarities of 10 batches of samples ranged from 0.820 to 0.985. The results of hierarchial-cluster analysis showed that 10 batches of samples were grouped into four categories： S1-S4 formed one group， S5 and S6 formed another， S7， S8 and S10 formed a third， and S9 formed a fourth， consistent with the OPLS-DA results； the variable importance projection values for peaks 7， 10， 2， 16 （resveratrol）， 13 （oxyresveratrol）， 11， 6 （caffeic acid）， 5 （M1） and 15 （quercitrin） were ＞1. Quantitative analysis results showed that the contents of chlorogenic acid， M1， caffeic acid， astilbin， oxyresveratrol， quercitrin， and resveratrol were 1.650 8-4.213 7， 0.636 2-2.161 7， 0.031 0-0.086 5， 0.239 1-1.069 3， 0.211 9-1.104 0， 0.488 8-2.399 2， and 0.164 0-0.699 8 mg/g， respectively. CONCLUSIONS UPLC fingerprint and content determination methods established in this study are simple to operate， accurate， reliable and reproducible； when combined with chemical pattern recognition analysis， they can be used to evaluate the quality of Jingangteng capsules. Nine components， such as resveratrol， oxyresveratrol， caffeic acid， M1 and quercitrin， may serve as markers of quality variation.

OBJECTIVE To investigate the antidepressant effect and underlying mechanism of total triterpenes from Poriae Cutis （PCTT）. METHODS UPLC-Q-TOF-MS technology was adopted to analyze the chemical constituents of PCTT. Network pharmacology was applied to screen the antidepressant active ingredients， key targets and signaling pathways of PCTT， and molecular docking was performed to verify the binding capacity between potential active ingredients and core targets. In animal experiment， mice were intragastrically administered PCTT at doses of 80， 160 and 320 mg/kg for 14 consecutive days. Lipopolysaccharide was used to establish an acute depression mouse model. Subsequently， behavioral assays were conducted. The levels of serum inflammatory factors， hippocampal neurotransmitters and brain-derived neurotrophic factor （BDNF） were detected. Western blot and qPCR assays were adopted to validate the antidepressant mechanism of PCTT. RESULTS A total of 101 chemical constituents were identified in PCTT. Network pharmacology screened out 10 potential active ingredients （including poriacosone B， poriacosone A， pachymic acid， etc.）， six core targets [including tumor necrosis factor （TNF）， peroxisome proliferator-activated receptor， caspase-3， etc.]， as well as multiple signaling pathways including TNF and interleukin-17 （IL-17）. All 10 potential active ingredients exhibited strong binding affinity to the six core targets. Animal experimental results demonstrated that 320 mg/kg PCTT markedly increased the movement distance and movement speed of depression model mice （P＜0.05）， and shortened immobility time in tail suspension test and forced swimming test （P＜0.05）. PCTT reduced serum levels of IL-6， IL-1β and TNF-α， decreased hippocampal glutamate level； it also downregulated the relative mRNA expression of TNF-α， tumor necrosis factor receptor-2 （TNFR2）， phosphoinositide 3-kinase （PI3K） and protein kinase B （AKT）， as well as TNFR2 protein expression and the ratios of phosphorylated-PI3K/PI3K，phosphorylated-AKT/AKT in the prefrontal cortex. Meanwhile， PCTT elevated the levels of 5- hydroxytryptamine， dopamine and BDNF in the hippocampus. CONCLUSIONS PCTT exerts antidepressant effects possibly by regulating the TNF-α/PI3K/AKT signaling pathway to downregulate the expression of pro-inflammatory factors， thereby modulating the release of neurotransmitters and BDNF.

In recent years, remarkable advances have been made in lung transplantation regarding donor evaluation, perioperative support, and immune regulation, laying a foundation for improving the long-term survival of recipients. The rational application of extended criteria donor lungs and the popularization of ex vivo lung perfusion technology have enhanced the utilization efficiency and safety of marginal donor lungs. Refined assessment of risk factors such as donors’ smoking history and infectious status has reduced the incidence of primary graft dysfunction and postoperative infection. In terms of recipient management, individualized assessment systems have been gradually optimized. The standardized application of intraoperative extracorporeal membrane oxygenation and the development of minimally invasive surgical techniques have effectively alleviated perioperative injuries. The optimization of postoperative immunosuppressive regimens and advances in rejection monitoring technologies have further improved the long-term survival of grafts. Nevertheless, chronic graft dysfunction and recurrent or refractory infections remain the major bottlenecks restricting long-term prognosis. Future research should focus on expanding donor sources, improving the repair quality of marginal donor lungs, promoting precise immunosuppression and anti-infection strategies, and comprehensively enhancing the long-term survival rate and quality of life of lung transplant recipients.

Objective To analyze the characteristics of postoperative hospital-acquired infections and drug sensitivity in lung transplant recipients over the past 5 years in a single center. Methods A total of 724 lung transplant recipients at Wuxi People's Hospital from January 2019 to December 2023 were selected. Based on the principles of hospital-acquired infection diagnosis, a retrospective analysis was conducted on the hospital infection situation and infection sites of lung transplant recipients, and an analysis of the distribution of hospital-acquired infection pathogens and their antimicrobial susceptibility test status was performed. Results Among the 724 lung transplant recipients, 275 cases of hospital-acquired infection occurred, with an infection rate of 38.0%. The case-time infection rate decreased from 54.2% in 2019 to 22.8% in 2023, showing a downward trend year by year (Z=30.98, P<0.001). The main infection site was the lower respiratory tract, accounting for 73.6%. The pathogens were mainly Gram-negative bacteria, with the top four being Acinetobacter baumannii (37.1%), Pseudomonas aeruginosa (17.3%), Klebsiella pneumoniae (13.7%), and Stenotrophomonas maltophilia (13.4%), with imipenem resistance rates of 89%, 53%, 58% and 100%, respectively. Gram-positive bacteria were mainly Staphylococcus aureus (3.6%), with a methicillin resistance rate of 67%. Conclusions Over the past 5 years, the hospital-acquired infections in lung transplant recipients have shown a downward trend, mainly involving lower respiratory tract infections, with the main pathogens being Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae, all of which have high resistance rates to imipenem.

Objective To evaluate the effect of donor gender on short-term survival rate of lung transplant recipients. Methods A retrospective analysis was conducted on the data of 1 066 lung transplant recipients. The log-rank test was used to evaluate the differences in short-term fatality among different donor gender groups and donor-recipient gender combination groups. Multivariate Cox regression, propensity score (PS) regression, and propensity score matching (PSM) were employed to control for confounding factors and further assess the differences in fatality. Subgroup analyses were also performed based on donor gender. Results Multivariate Cox regression analysis showed no statistically significant differences in fatality at 30 days, 1 year, 2 years and 3 years postoperatively between male and female donor groups (all P>0.05). After PS regression and PSM, univariate Cox regression analysis indicated that recipients from female donors had a higher fatality at 2 years postoperatively compared to those from male donors, with hazard ratios (95% confidence intervals) of 1.29 (1.01-1.65) and 1.36 (1.03-1.80) respectively. Multivariate Cox regression analysis also revealed no statistically significant differences in fatality at various follow-up time points among different donor-recipient gender combination groups (all P>0.05). Subgroup analyses based on donor sex showed no statistically significant differences in fatality among recipients of different gender within either male or female donor groups (all P>0.05). Conclusions Female donors may reduce the short-term postoperative survival rate of lung transplant recipients, but this negative impact is not sustainable in the long term. At present, there is no evidence to support the inclusion of sex as a factor in lung allocation rules.

HDAC7, a member of class IIa HDACs, plays a pivotal regulatory role in tumor, immune, fibrosis, and angiogenesis, rendering it a potential therapeutic target. Nevertheless, due to the high similarity in the enzyme active sites of class IIa HDACs, inhibitors encounter challenges in discerning differences among them. Furthermore, the substitution of key residue in the active pocket of class IIa HDACs renders them pseudo-enzymes, leading to a limited impact of enzymatic inhibitors on their function. In this study, proteolysis targeting chimera (PROTAC) technology was employed to develop HDAC7 drugs. We developed an exceedingly selective HDAC7 PROTAC degrader B14 which showcased superior inhibitory effects on cell proliferation compared to TMP269 in various diffuse large B cell lymphoma (DLBCL) and acute myeloid leukemia (AML) cells. Subsequent investigations unveiled that B14 disrupts BCL6 forming a transcriptional inhibition complex by degrading HDAC7, thereby exerting proliferative inhibition in DLBCL. Our study broadened the understanding of the non-enzymatic functions of HDAC7 and underscored the importance of HDAC7 in the treatment of hematologic malignancies, particularly in DLBCL and AML.

OBJECTIVES: To investigate the neuroprotective effects of electroacupuncture (EA) preconditioning against cerebral ischemia-reperfusion injury (CIRI) mediated by gut microbiota modulation, Nrf2/HO-1 pathway activation, and ferroptosis suppression. METHODS: Adult male SD rats were divided into sham operation group, CIRI model group, and EA preconditioning group. In the latter two groups, rat models of CIRI were established by middle cerebral artery occlusion (MCAO), and in EA preconditioning group, EA was applied at Baihui (DU20) and Zusanli (ST36) for 3 days before modeling. Neurological deficits, cerebral infarction, and hippocampal pathology of the rats were evaluated using behavioral tests, TTC staining, and Nissl and HE staining, and the oxidative stress markers (MDA, ROS, and SOD), apoptosis/ferroptosis-related proteins (Bax, Bcl-2, GPX4, and SLC7A11), and changes in gut microbiota were analyzed. RESULTS: EA preconditioning significantly reduced neurological deficits, decreased infarct volume, promoted hippocampal neuronal survival, and improved structural integrity of the hippocampal neurons in MCAO rats. EA preconditioning also significantly lowered MDA and ROS and increased SOD levels, upregulated Bcl-2, GPX4, and SLC7A11 expressions, and downregulated Bax expression in the hippocampal tissue of the rats, causing also activation of Nrf2/HO-1 signaling and improvement of gut microbiota composition. CONCLUSIONS EA preconditioning alleviates CIRI in rats by suppressing ferroptosis and apoptosis, enhancing antioxidant defenses via activating Nrf2/HO-1 signaling, and regulating the gut-brain axis.
Animals ; Electroacupuncture ; NF-E2-Related Factor 2/metabolism* ; Rats, Sprague-Dawley ; Signal Transduction ; Reperfusion Injury/therapy* ; Ferroptosis ; Male ; Rats ; Brain Ischemia ; Gastrointestinal Microbiome ; Heme Oxygenase (Decyclizing)/metabolism* ; Brain/metabolism* ; Oxidative Stress ; Heme Oxygenase-1/metabolism* ; Apoptosis

ObjectiveTo investigate the content of trihalomethanes (THMs) in treated water after different water treatment processes and their correlations with premanganate index, so as to provide data support for the renovation of water production process and optimization of water quality improvement. MethodsFrom 2022 to 2023, seven centralized water supply units using raw water from Qingcaosha reservoir were selected as the testing sites, among which three units with the conventional treatment process, two units with the advanced treatment process, and two units with the advanced treatment process combined CO₂ treatment. Monthly water quality testing data were collected, focusing on testing the concentration variations of THMs, trichloromethane, dibromochloromethane, bromodichloromethane, bromoform, and permanganate index. ResultsThe comparison between conventional treatment process and advanced treatment process demonstrated that the conventional treatment process exhibited significantly higher concentrations of trihalomethanes, trichloromethane, bromodichloromethane, and permanganate index in water samples (all P<0.05). When comparing conventional treatment process with advanced treatment process combined with carbon dioxide treatment, the conventional treatment process showed significantly elevated levels of trihalomethanes, dibromochloromethane, bromodichloromethane, and permanganate index (all P<0.05). No statistically significant differences were observed in the comparison of various indicators between advanced treatment process and advanced treatment process combined with carbon dioxide treatment for any of the measured parameters (all P>0.05). Analysis of seasonal variations revealed that finished water during the high-temperature period (May to November) contained significantly higher concentrations of trihalomethanes, trichloromethane, bromodichloromethane, and tribromomethane compared to the low-temperature period (December to April of the following year) (all P<0.05). Significant positive correlations were identified between permanganate index and trihalomethanes (r=0.213, P=0.007), permanganate index and dibromochloromethane (r=0.186, P=0.019), permanganate index and bromodichloromethane (r=0.243, P=0.002), permanganate index and tribromomethane (r=0.193, P=0.014). ConclusionCompared to the conventional water treatment process, advanced treatment process and advanced treatment combined with CO₂ injection process can significantly reduce the concentrations of THMs in the treated effluent water. Besides, the generation of THMs is affected by seasonal temperatures, with higher concentrations of THMs, trichloromethane, bromodichloromethane, and bromoform being observed in the high-temperature season. Additionally, the permanganate index shows a significant positive correlation with THMs concentrations, indicating that the content of organic matter in the source of raw water contributes to the generation of THMs in the treated water.

Enhanced recovery after surgery (ERAS) is a series of perioperative optimization measures based on evidence-based medicine aimed at achieving rapid recovery. Existing studies have shown that ERAS can effectively reduce surgical stress, decrease the incidence of complications, shorten hospital stays, save medical costs, and improve patient satisfaction. Although lung transplantation techniques have become increasingly mature, lung transplant recipients still have a high incidence of complications during perioperative period. To further improve the perioperative survival rate of lung transplant recipients, introducing ERAS concept into the perioperative management strategy of lung transplantation is of great significance for reducing incidence of perioperative complications, promoting rapid recovery and long-term survival of lung transplant recipients. This article discusses the advances in application of ERAS concept in the perioperative management of lung transplantation, aiming to provide references for optimizing the perioperative management of lung transplant recipients and reducing perioperative complications.

Extraintestinal manifestations (EIM) of inflammatory bowel disease (IBD) may affect multiple organ systems, with approximately 50% of IBD patients presenting with at least one EIM during the course of their disease, with cutaneous involvement being particularly common. Cutaneous manifestations can present in various forms. This paper reports a case of ulcerative colitis (UC) complicated with bullous pemphigoid (BP), aiming to enhance clinicians' awareness of skin lesions associated with UC.