OBJECTIVES: To investigate the effect of Scleromitrion diffusum on gastric mucosal epithelial-mesenchymal transition (EMT) in rats with gastric precancerous lesion. METHODS: Fifty SD rats were randomly divided into blank control group (n=11), model control group (n=13), Scleromitrion diffusum (SD) group (n=13) and vitase group (n=13). Gastric precancerous lesion animal model was prepared by 1-methyl-3-nitro-1-nitrosoguanidine complex polyfactor method, and the drugs were administrated by gavage once a day for 6 weeks. The pathological changes of gastric mucosa were observed with hematoxylin and eosin staining, the expression of EMT marker proteins were detected with immunohistochemical staining and Western blotting. RESULTS: Compared with the model control group, the gastric mucosal injury was significantly attenuated in the Scleromitrion diffusum group, the mucosal tissue structure gradually recovered, the saccular expansion area was reduced, and the inflammatory infiltration was ameliorated. The expression of epithelial cadherin was higher, and the expression of neural cadherin and vimentin in the Scleromitrion diffusum group were lower than those of model control group (all P<0.05). CONCLUSIONS Scleromitrion diffusum can ameliorate gastric mucosal injury in rats with gastric precancerous lesion by reversing the EMT.
Animals ; Rats ; Rats, Sprague-Dawley ; Epithelial-Mesenchymal Transition/drug effects* ; Precancerous Conditions/metabolism* ; Gastric Mucosa/metabolism* ; Stomach Neoplasms/drug therapy* ; Male ; Cadherins/metabolism*

[This corrects the article DOI: 10.1016/j.apsb.2022.05.019.].

Objective To explore the functions of β-glucan-induced extracellular vesicles(EVs)released from J774A.1 cells.Methods EVs were extracted from the culture supernatant of J774A.1 cells,which were cultured with or without β-glucan,using differential centrifugation.The phenotype of extracellular vesicles was identified by transmission electron microscopy(TEM),nano-particle tracking analysis(NTA)and Western blotting(WB).The peritoneal macrophages(PMs)were harvested from C57BL/6J mice,and incubated with the control EVs(C-EVs)and theβ-glucan-induced EVs(G-EVs).Total RNA was extracted from the PMs and reversely transcribed to cDNA.The expression levels of the macrophage polarization-related genes were detected through real-time fluorescence quantitative PCR(qRT-PCR).Meanwhile,the culture supernatant of the PMs was collected and assayed by enzyme-linked immunosorbent assay(ELISA)to detect the expression levels of proinflammatory cytokines tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6).Results EVs of the control(C-EVs)and those from the β-glucan-induced(G-EVs)were isolated from J774A.1 cell culture medium.The results of TEM analysis showed that EVs had a membrane wrapped structure and the particle diameters ranged from 100 to 1000 nm.The NTA results showed that the average particle sizes were 162.4 and 175.6 nm respectively.The results of WB assay showed the expressions of characterized marker molecules such as CD81,CD9,CD63 and TSG101 were detected.qRT-PCR results showed that the expression levels of M1 polarization related genes such as Tnfa and inos were significantly increased in PM cells of the C-EVs treatment group,but those in the G-EVs treatment group were significantly lower than in the C-EVs treatment group.Meanwhile,the expression levels of M2 polarization indicators Cd206 and Arg-1 in the C-EVs treatment group were significantly decreased,while those in the G-EVs treatment group were significantly higher than those in C-EVs treatment group.Accordingly,the results of ELISA showed that the expression levels of TNF-α and IL-6 in the conditioned medium of the C-EVs treatment group were significantly increased,while those in the G-EVs treatment group were significantly lower than in the C-EVs treatment group.Conclusion Compared with the natural EVs from J774A.1 cells,the ability of β-glucan-induced EVs to drive M1 polarization of macrophages isdramatically compromised,with much fewer proinflammatory cytokines released,suggesting that β-glucan might contribute to immune regulation through EVs.

ObjectiveTo explore the possible mechanism of Bimin Formula （鼻敏方） in treating lung-spleen qi deficiency syndrome of allergic rhinitis （AR） with high mucin secretion. MethodsThirty-four SD rats were randomly divided into a blank group （8 rats）， a model group （8 rats）， a low-dose Bimin Formula group （8 rats）， and a high-dose Bimin Formula group （10 rats）. Except for the blank group， the other groups were subjected to AR lung-spleen qi deficiency rat models induced by smoking， gavage of Ginkgo biloba leaf extract， and ovalbumin. After modeling， rats in the low- and high-dose Bimin Formula groups were given Bimin Formula concentrate （concentration of 2.16 g/ml） by gavage at doses of 1.08 g/100 g and 2.16 g/100 g， respectively， while rats in the model group were given 0.5 ml/100 g of normal saline by gavage， once daily for 28 days； the blank group was not intervened. Behavioral assessments were performed after intervention. ELISA was used to detect the levels of peripheral blood total immunoglobulin E （IgE）. HE staining was used to observe the pathological changes of nasal mucosa epithelium in rats， while immunohistochemistry was used to detect the expression of transmembrane protein 16A （TMEM16A） and mucin 5AC （MUC5AC） protein in nasal mucosa. Western Blot was used to detect the expression of nuclear factor kappa B （NF-κB） protein， and RT-PCR was used to detect the expression of TMEM16A， MUC5AC， and NF-κB mRNA in nasal mucosa. ResultsHE staining showed that the nasal mucosa epithelial cell structure in the blank group was intact without shedding， swelling， or necrosis； the nasal mucosa epithelial tissue of rats in the model group was thickened and partially shed， with infiltration of eosinophils and lymphocytes visible； the pathological changes in nasal mucosa tissue of rats in the high- and low-dose Bimin Formulagroups were improved， and more improvement was showen in the high-dose group. Compared with those in the blank group， the behavioral scores and peripheral blood total IgE levels of rats in the model group significantly increased， as well as the expression of TMEM16A， MUC5AC， and NF-κB proteins and mRNA in nasal mucosa （P＜0.05 or P＜0.01）. Compared with those in the model group， the behavioral scores and peripheral blood total IgE levels of rats in the high-dose Bimin Formula group decreased， and the expression of TMEM16A， MUC5AC， and NF-κB proteins and mRNA in nasal mucosaalso decreased （P＜0.05 or P＜0.01）； the behavioral scores and peripheral blood total IgE levels of rats in the low-dose Bimin Formula group were reduced， and the expression of TMEM16A and MUC5AC proteins and mRNA in nasal mucosa， as well as the expression of NF-κB protein decreased （P＜0.05 or P＜0.01）， but the difference in NF-κB mRNA expression was not statistically significant （P＞0.05）. Compared with the low-dose Bimin Formula group， the expression of NF-κB protein in the high-dose group decreased （P＜0.01）. ConclusionBimin Formula may improve the symptoms and high mucus secretion of AR lung-spleen qi deficiency by regulating the TMEM16A/NF-κB/MUC5AC signaling pathway in nasalmucosa.

The immune system is the defender of human health,whose dysregulation is the source of various diseases.Re-duced immune defense and immune surveillance capabilities lead to difficulties in removing pathogens and malignant cells,thus increasing morbidity and mortality risk.Stress is a major factor in the decline of the immune system.In past studies,it has been demon-strated both in animal and humans that stress increases the levels of neuroendocrine hormones in the body,particularly glucocorticoids and catecholamines.Through the action of these stress hormones,stress has a number of detrimental effects on immune function,and this review combs through the progress of research on the regulation of immune cells by glucocorticoids.

Objective To study the application effect of quality control circle(QCC)in reducing the dissatisfaction rate of physical examination clients in health management center.Methods To establish QCC,selected the health check-up popula-tion in our hospital in September-2019 and March-2020,through the questionnaire investigation and analysis,compare the dis-satisfaction of the clients before and after the quality control circle.Results After carrying out QCC activities,the dissatisfaction of physical examination clients was significantly lower than that before QCC,and the difference was statistically significant(P＜0.05).Conclusion The activities of QCC in the health management center can effectively improve the quality of the physical examination work and reduce the dissatisfaction of the customers in the physical examination.It is of great significance to the health management.

Objective:To investigate the efficacy and safety of kidney sparing treatment based on Thulium laser ablation and systematic therapy in localized high-risk upper urinary tract urothelial carcinoma (UTUC).Methods:The data of 10 patients with UTUC who received combined treatment based on Thulium laser and systematic treatment from January 2020 to December 2021 in West China Hospital were retrospectively analysed. There were 5 males and 5 females with a median age of 76 (range 52 to 87)years old. Three cases were renal pelvis tumor and 7 cases were ureter tumor including 5 cases in lower ureter and 2 cases in upper and middle ureter. Five cases were with positive urine cytology and 6 cases were with hydronephrosis. One case was muscular invasion UTUC confirmed by biopsy(cT 2+), 7 cases were high-grade invasive urothelial carcinoma (cT 1+), and 2 cases were high-grade papillary urothelial carcinoma (cT a). Among 10 cases, 5 patients refused radical nephroureterectomy(RUN), among whom 3 patients were too old or in poor general condition to tolerate RNU. One case had a solitary kidney and 1 case had bilateral tumours. Patients were treated with Thulium laser tumor ablation under ureteroscopy combined with systemic therapy. The perioperative systemic treatment included platinum-based chemotherapy±immunotherapy, RC48+ immunotherapy, and immunotherapy alone. The postoperative treatment was immunotherapy maintenance±local radiotherapy. Strict follow-up was conducted after the completion of treatment. Results:Nine patients received systemic therapy before ablation. Four cycles of platinum-based chemotherapy (cisplatin in 2 cases, carboplatin in 1 case) were used in 3 cases, and platinum-based chemotherapy + immunotherapy (6 cycles of cisplatin + toripalimab in 1 case, 4 cycles of cisplatin + toripalimab in 1 case, 4 cycles of carboplatin+ trelizumab in 1 case) was used in 3 cases, four cycle of RC48 + immunotherapy (toripalimab or trelizumab) were used in 2 cases, and four cycles of immunotherapy (toripalimab) were used in 1 case. The operations of 10 cases were successfully completed without serious complications during the perioperative period and the laser working time (42.4 ± 15.2) min. Of the 10 cases, 4 achieved complete ablation at the first ablation, and 6 patients had incomplete ablation. Among them, 2 patients achieved clinical complete remission after 1-2 cycles of systemic therapy, and 4 patients achieved complete ablation after Thulium laser ablation again.All the 10 patients were treated with immunotherapy for 1 year, and 2 of them received additional adjuvant radiotherapy. The patients were followed-up for median 40 months(range 26 to 53 months). Recurrence occurred in 5 cases, of which 3 cases underwent salvage nephroureterectomy and 2 cases underwent Thulium laser ablation under ureteroscopy again. Five patients had no tumor recurrence. None of the 10 patients had distant metastasis. At the last follow-up, 1 patient died of complications and 6 patients kept the affected kidney alive. Perioperative complications including macroscopic hematuria (8 cases), fever (3 cases), the long-term complications of ureter stenosis (4 cases).Conclusions:For localized high-risk UTUC, local Thulium laser ablation combined with systemic therapy can achieve good tumor control while preserving the affected kidney in selected patients, and its potential application value should be further evaluated.

Objective:To investigate the knowledge and practice of the Sixth Chinese national consensus report on the management of Helicobacter pylori ( H. pylori) infection (treament excluded) (referred to as sixth national consensus)and 2022 Chinese national clinical practice guideline on H. pylori eradication treatment (referred to as guideline) among gastroenterologists in China, so as to provide out relevant training in the future. Methods:A questionnaire was designed according to sixth national consensus and guideline, including knowledge and practice of sixth national consensus and guideline, and the detection, indications of eradication, the relationship between infection and gastrointestinal microbiota, and eradication of H. pylori. From November 1 to 30 in 2023, the questionnaire-based survey was conducted among 1 506 gastroenterologists from secondary and tertiary hospitals of 24 provinces, autonomous regions and municipalities in China with convenience sampling method using the "Questionnaire Star" online questionnaire platform and the questionnaire link was sent by WeChat. Descriptive methods were used for statistical analysis. Results:A total of 1 442 valid questionnaires were collected. The awareness rate of sixth national consensus and guideline of gastroenterologists was 83.7% (1 207/1 442), and 47.2% (680/1 442) had read the relevant content in detail. Urea breath test (97.4%, 1 404/1 442) was the most commonly used method for diagnosing current H. pylori infection, however, more than half of the physicians chose serological test (53.3%, 769/1 442) for the diagnosis of current infection. The common indications of H. pylori eradication could be identified by 84.3%(1 215/1 442) of gastroenterologists. The most well-known eradication regimen was bismuth quadruple regimen (98.5%, 1 421/1 442), while some physicians still believed that the standard triple regimen (31.8%, 459/1 442) and sequential regimen (21.9%, 316/1 442) were recommended by the guideline. A further 20.2% (291/1 442) frequently prescribed a triple regimen combined with gastric mucosal protectants and the awareness rate of high-dose dual regimen was 59.1% (852/1 442). Amoxicillin + clarithromycin (65.4%, 943/1 442) and amoxicillin+ furazolidone (20.1%, 290/1 442) were commonly used antibiotic combinations in bismuth quadruple therapy. Potassium-competitive acid blockers and double-dose proton pump inhibitors were commonly used in bismuth quadruple therapy by 45.4% (655/1 442) and 46.0% (664/1 442) of physicians, respectively. For patients with multiple failed eradications, furazolidone was the most commonly used antibiotic for re-eradication(71.7%, 1 034/1 442). Conclusion:The knowledge and practice of gastroenterologists on H. pylori infection in China deviates from the new consensus and guideline, and more publicity and training should be carried out in future to improve the ability of gastroenterologists to standardise the diagnosis and treatment of H. pylori infection.

Objective To evaluate the therapeutic effect of Huangqin Decoction(HQD)on ulcerative colitis(UC)in mice and explore its mechanism.Methods Male Balb/c mice were randomly divided into normal control group,model group,mesalazine group(5-ASA,200 mg/kg),and low-,medium-and high-dose HQD groups(2.275,4.55 and 9.1 g/kg,respectively).With the exception of those in the normal control group,all the mice were exposed to 3%DSS solution in drinking water for 7 days to establish UC models.After treatment with the indicated drugs,the mice were assessed for colon injury and apoptosis using HE,AB-PAS and TUNEL staining,and the expression levels of inflammatory factors were detected with ELISA.Western blotting,immunohistochemistry and qRT-PCR were used to detect the changes in protein expressions associated with the intestinal chemical barrier,mechanical barrier and endoplasmic reticulum stress(ERS).Results HQD treatment significantly reduced DAI score and macro score of UC mice,decreased colonic epithelial cell apoptosis,lowered expressions of IL-6,TNF-α,IL-1β and IL-8,and enhanced the expressions of MUC2 and TFF3.HQD treatment also upregulated the protein expressions of claudin-1,occludin and E-cadherin,reduced the expressions of GRP78,CHOP,caspase-12 and caspase-3,decreased the phosphorylation levels of PERK,eIF2α and IRE1α,and increased the Bcl-2/Bax ratio in the colon tissues of UC mice.Conclusion HQD inhibits colonic epithelial cell apoptosis and improves intestinal barrier function in UC mice possibly by reducing ERS mediated by the PERK and IRE1α signaling pathways.

Objective:To investigate the distribution patterns of TCM syndrome elements and syndrome types in cancer-related fatigue (CRF).Methods:A cross-sectional survey was conducted on tumor patients attending the outpatient clinic and wards of the Department of Oncology, Xiyuan Hospital of China Academy of Chinese Medical Sciences from January to December 2021. Descriptive analysis was used to compare the distribution difference of TCM syndrome elements, symptoms and tongue symptoms of CRF and non-CRF patients. The TCM symptoms of CRF were clustered to summarize the common TCM syndromes of CRF.Results:A total of 306 tumor patients were finally included, of which 229 (75%) were CRF and 77 (25%) were non-CRF. Qi deficiency, blood deficiency, and cold-dampness were the most common deficiency and excess syndrome elements in CRF, and liver deficiency, yin deficiency, and blood stasis syndrome elements occurred more frequently in non-CRF than in CRF. TCM symptoms with a frequency greater than 50% in CRF patients, from high to low, were: fatigue > shortness of breath > insomnia or dreaminess > mental fatigue > forgetfulness>lazy speech > impatience, irritability, depression with sighing. The most frequent tongue symptoms, tongue coating, and pulse symptoms were respectively pale tongue, white and greasy coating or smooth white, and pulse deficiency. The symptoms with greater than 30% frequency in 77 non-CRF patients were, from highest to lowest: impatience and irritability or depression with sighing > insomnia or dreaminess > shortness of breath > dry mouth and throat > lumbar spine pain (excluding traumatic) > numbness of limbs > forgetfulness. The highest-ranked tongue, tongue coating, and pulse symptoms were pale tongue, red tongue or less coating, no coating, and thin pulse, respectively. Through clustering analysis, six common syndromes of CRF were obtained, including qi and blood deficiency syndrome, heart and liver blood deficiency syndrome, kidney yang deficiency syndrome, qi and yin deficiency syndrome, spleen deficiency and qi stagnation syndrome, and cold dampness and spleen stagnation syndrome.Conclusions:CRF is a common symptom of different types of tumors. Generally, deficiency syndrome is the main symptom. Qi deficiency and blood deficiency are the common syndrome elements. Common symptoms of high frequency and tongue and pulse are fatigue, shortness of breath, mental fatigue, forgetfulness, pale tongue and thin pulse. The common TCM syndrome types can be preliminarily summarized into 6 types: qi and blood deficiency syndrome, heart and liver blood deficiency syndrome, kidney yang deficiency syndrome, qi and yin deficiency syndrome, spleen deficiency and qi stagnation syndrome, cold dampness and spleen stagnation syndrome.