Ulcerative colitis (UC) is a chronic and non-specific inflammatory bowel disease (IBD). Huanglian Ganjiang decoction (HGD), derived from ancient book Beiji Qianjin Yao Fang, has demonstrated efficacy in treating UC patients traditionally. Previous research established that the compatibility of cold herb Coptidis Rhizoma + Phellodendri Chinensis Cortex (CP) and hot herb Angelicae Sinensis Radix + Zingiberis Rhizoma (AZ) in HGD synergistically improved colitis mice. This study investigated the compatibility mechanisms through which CP and AZ regulated inflammatory balance in colitis mice. The experimental colitis model was established by administering 3% dextran sulphate sodium (DSS) to mice for 7 days, followed by CP, AZ and CPAZ treatment for an additional 7 days. M1/M2 macrophage polarization levels, glucose metabolites levels and pyruvate dehydrogenase kinase 4 (PDK4) expression were analyzed using flow cytometry, Western blot, immunofluorescence and targeted glucose metabolomics. The findings indicated that CP inhibited M1 macrophage polarization, decreased inflammatory metabolites associated with tricarboxylic acid (TCA) cycle, and suppressed PDK4 expression and pyruvate dehydrogenase (PDH) (Ser-293) phosphorylation level. AZ enhanced M2 macrophage polarization, increased lactate axis metabolite lactate levels, and upregulated PDK4 expression and PDH (Ser-293) phosphorylation level. TCA cycle blocker AG-221 and adeno-associated virus (AAV)-PDK4 partially negated CP's inhibition of M1 macrophage polarization. Lactate axis antagonist oxamate and PDK4 inhibitor dichloroacetate (DCA) partially reduced AZ's activation of M2 macrophage polarization. In conclusion, the compatibility of CP and AZ synergistically alleviated colitis in mice through M1/M2 macrophage polarization balance via PDK4-mediated glucose metabolism reprogramming. Specifically, CP reduced M1 macrophage polarization by restoration of TCA cycle via PDK4 inhibition, while AZ increased M2 macrophage polarization through activation of PDK4/lactate axis.
Animals ; Drugs, Chinese Herbal/chemistry* ; Mice ; Macrophages/immunology* ; Glucose/metabolism* ; Pyruvate Dehydrogenase Acetyl-Transferring Kinase/genetics* ; Male ; Mice, Inbred C57BL ; Humans ; Colitis/drug therapy* ; Disease Models, Animal ; Colitis, Ulcerative/drug therapy* ; Metabolic Reprogramming

OBJECTIVES: This study aimed to use machine learning algorithms to build a prediction model of the first permanent molar caries of 9-year-old children in Suzhou and screen out risk factors. METHODS: Random stratified whole group sampling was applied to randomly select 9-year-old students from 38 primary schools in 14 townships and streets in Wuzhong District for oral examination and questionnaire survey. Multifactor Logistics regression was used to analyze the risk factors of tooth decay. The data set was randomly divided into training sets and verification sets according to 8∶2, and R 4.3.1 was used to build five machine learning algorithms: random forest, decision tree, extreme gradient boosting (XGBoost), Logistics regression, and lightweight gradient enhancement (LightGBM). The predictive effect of these five models was evaluated using the area under the characteristic curve (AUC). The marginal contribution of quantitative characteristics to the caries prediction model was determined through Shapley additive explanations (SHAP). RESULTS: This study included 7 225 samples that met the standard. The caries rate of the first permanent molar was 54.96%. Multifactor Logistic regression analysis showed that sweet drinks, dessert and candy, snack frequency, and snacks before going to bed after brushing teeth were correlated with the occurrence of first permanent molar caries (P<0.05). The AUC values of decision tree, Logistic regression, LightGBM, random forest, and XGBoost were 75.5%, 83.9%, 88.6%, 88.9%, and 90.1%, respectively. Compared with the variables after single heat coding, the SHAP value of high-frequency sweets (such as dessert candy ≥2 times a day, mother's sugary diet ≥2 times a day) and bad oral hygiene habits (such as frequent snacks before going to bed after brushing teeth and irregular brushing teeth) exhibited the highest positive. CONCLUSIONS XGBoost algorithm has a good prediction effect for first permanent molar caries in 9-year-old children. High-frequency sweet factors and bad oral hygiene habits have a strong positive impact on the risk of first permanent molar caries and are key drivers that can be used in the formulation of targeted interventions.
Humans ; Dental Caries/epidemiology* ; Child ; Machine Learning ; China/epidemiology* ; Molar ; Risk Factors ; Female ; Logistic Models ; Male ; Decision Trees ; Algorithms

OBJECTIVE To systematically evaluate the effectiveness of different treatment regimens as first-line treatment for metastatic urothelial carcinoma （UC） using a network meta-analysis （NMA） approach. METHODS Electronic databases including PubMed， the Cochrane Library， Embase， Wanfang Data， CNKI， and VIP were searched for randomized controlled clinical trials （RCTs） on first-line treatment for metastatic UC from January 1， 2010 to January 31， 2024. After literature screening and data extraction， a risk of bias assessment of included studies was conducted. R software （version 4.3.2） was used to perform the NMA. RESULTS A total of 11 RCTs involving 14 treatment interventions were included. No significant differences were noted in objective response rate among groups， with the combination of pembrolizumab， gemcitabine and cisplatin having the highest probability of ranking first. Regarding progression-free survival （PFS） and overall survival （OS）， no significant differences were observed among groups， while enfortumab vedotin combined with pembrolizumab showed a trend towards better PFS extension compared to gemcitabine combined with cisplatin [HR＝0.45， 95%CI（0.20，1.06）， P＝0.049]， and it had the highest probability of ranking first in both PFS and OS. CONCLUSIONS The combination of enfortumab vedotin and pembrolizumab may have an advantage in prolonging survival in the first-line treatments for metastatic UC.

ObjectiveTo study the expression changes of Lon protein and mitochondrial dynamics-related protein in the hippocampus of SAMP8 mice and provide a theoretical basis for the treatment of Alzheimer's disease by invigorating the spleen and supplementing Qi. MethodEight 3-month-old SAMR1 mice were used as the normal group， and 32 3-month-old SAPM8 mice were divided into model group， western medicine group （0.013 g·kg^-1）， low-dose Si Junziwan group （3.24 g·kg^-1）， and high-dose Si Junziwan group （12.56 g·kg^-1）， with 8 mice in each group. The western medicine group was gavaged with donepezil， and the Si Junziwan low- and high-dose groups were gavaged with Si Junziwan for 30 days. The positioning navigation experiment of the water maze was started on the 25^th day， and the space exploration experiment of the water maze was started on the 30^th day. On the 30^th day， the protein expression of mitofusin 2 （MFN2） was detected by immunohistochemistry， the expression of adenosine 5'-monophosphate （AMP）-activated protein kinase （AMPK） was detected by enzyme-linked immunosorbent assay （ELISA）， the content of ATP was detected by colorimetry， the microstructure of neuron mitochondria was detected by electron microscope， and the expressions of Aβ protein， Lon protein， dynamin-related protein 1 （DRP1） protein， and MFN1 protein were detected by Western blot. ResultAs compared with the normal group， the latency escape period increased， the number of crossings decreased， the expression of AMPK increased， and the content of ATP decreased in the model group. The expressions of Aβ protein and DRP1 protein increased （P<0.01）， whereas the expressions of Lon protein， MFN1 protein decreased in the model group （P<0.05，P<0.01）， and MFN2 protein decreased. The vacuolation of mitochondria increased and the cristae broke in the model group. As compared with model group， the time of the latent escape period decreased （P<0.01）， and the number of crossings increased in the low-dose and high-dose Si Junziwan groups （P<0.05）. The expression of AMPK （P<0.01） decreased， the content of ATP increased （P<0.01）， the expression of Aβ and DRP1 protein decreased （P<0.05， P<0.01）， and the expression of MFN1 protein was up-regulated （P<0.05） in high-dose Si Junziwan groups. The vacuolation was more obvious in the low-dose Si Junziwan group， whereas the vacuolation was restored and the ridge was clear in the high-dose Si Junziwan group. ConclusionSi Junziwan treats Alzheimer's disease by up-regulating the protein expression of Lon， correcting the disorder of mitochondrial division and fusion protein， and changing the memory function of SAMP8 mice.

ABSTRACT:Objective To investigate the efficacy and nursing of aerosol inhalation therapy of budesonide suspension combined with compound ipratropium bromide in the treatment of chil-dren with asthma.Methods A total of 70 children with asthma were randomly divided into obser-vation group and control group,35 cases in each group.The children in both groups were conduct-ed with conventional oxygen uptake,anti-infective and antiviral,spasmolysis,and elimination of phlegm and correction of fluid balance.The observation group was treated with aerosol inhalation therapy of budesonide suspension combined with compound ipratropium bromide on the basis of conventional treatment and the holistic nursing for aerosol inhalation therapy.The control group was treated with aerosol inhalation therapy of compound ipratropium bromide on the basis of con-ventional treatment and the conventional nursing.The clinical efficacy was compared after a course of treatment (5 days)between two groups.Results After treatment,the symptoms of children in both groups improved significantly,and the extinction time of cough and sputum,difficulty breathing,lung wheezing sound and moist crackles of observation group were significant shorter than those of the control group (P <0.05).The clinical total effective rate of observation group was significantly higher than that of the control group (P <0.01).The satisfactory degree toward nursing in the observation group was significantly higher than that in the control group (P <0.05).Conclusion Aerosol inhalation therapy of budesonide suspension combined with compoundipratropium bromide is effective in the treatment of children with asthma ,and it has a better safety in drug administration.Fully prepared nursing interventions for aerosol inhalation therapy are effective measures in improving clinical efficacy and reducing side effects.

ABSTRACT:Objective To investigate the efficacy and nursing of aerosol inhalation therapy of budesonide suspension combined with compound ipratropium bromide in the treatment of chil-dren with asthma.Methods A total of 70 children with asthma were randomly divided into obser-vation group and control group,35 cases in each group.The children in both groups were conduct-ed with conventional oxygen uptake,anti-infective and antiviral,spasmolysis,and elimination of phlegm and correction of fluid balance.The observation group was treated with aerosol inhalation therapy of budesonide suspension combined with compound ipratropium bromide on the basis of conventional treatment and the holistic nursing for aerosol inhalation therapy.The control group was treated with aerosol inhalation therapy of compound ipratropium bromide on the basis of con-ventional treatment and the conventional nursing.The clinical efficacy was compared after a course of treatment (5 days)between two groups.Results After treatment,the symptoms of children in both groups improved significantly,and the extinction time of cough and sputum,difficulty breathing,lung wheezing sound and moist crackles of observation group were significant shorter than those of the control group (P <0.05).The clinical total effective rate of observation group was significantly higher than that of the control group (P <0.01).The satisfactory degree toward nursing in the observation group was significantly higher than that in the control group (P <0.05).Conclusion Aerosol inhalation therapy of budesonide suspension combined with compoundipratropium bromide is effective in the treatment of children with asthma ,and it has a better safety in drug administration.Fully prepared nursing interventions for aerosol inhalation therapy are effective measures in improving clinical efficacy and reducing side effects.

BACKGROUND:Three-dimensional visualization technique has been widely used in clinical treatment. Preoperative visualization technique al ows safe demonstration on the complex spine fracture models, and also prepare screw placement scheme according to three-dimensional model of patients.
OBJECTIVE:To discuss the clinical result of treating short-segment lumbar vertebrae fracture with pedicle screw visualization.
METHODS:A total of 32 patients with lumbar vertebrae fracture were treated with 182 pedicle screws. Before the screw implantation, the structure of bilateral pedicle was observed using Mimics software and the implantation parameters were measured. The operation methods and related complications were told to the patients through the reconstructed three-dimensional images. The satisfaction of the patients, operation time, and the position of pedicle screws by postoperative CT scan were assessed. The percentages of anterior vertebral height and Cobb’s angle were measured before operation, 2 weeks after operation and 8 months after operation.
RESULTS AND CONCLUSION:The excellent satisfaction rate of the patients was 100%, the mean operation time was 185 minutes, and 173 pedicle screws (95.1%) were total y inserted within the pedicle. Al patients were fol owed up for 7-22 months. The results showed that the fracture healed wel . The percent of anterior vertebral height and Cobb’s angle at 2 weeks after operation were significantly decreased compared with them before operation (P<0.05). There were no significant difference about the percent of anterior vertebral height and Cobb’s angle between 2 weeks and 8 months fol ow-up (P>0.05). Single-segment lumbar vertebrae fracture was wel treated by the pedicle screw visualization technique. This method assists to make up preoperation plan, increase the rate of patients’ satisfaction, shorten operation time, and increase the accuracy of pedicle screw insertion.

Objective: TO explore the effect of VEGF-C gene transfection on the expression of VEGF-C in human cervical carcinoma HeLa cells and the mechanisms of its anti-apoptosis effect. Methods: The con-structed pcDNA3.1(+)NEGF-C vector was transformed into human cervical cancer HeLa cells and was select-ed by G418. The changes in the expression level of VEGF-C mRNA and protein were determined by semi-quantitive RT-PCR and ELISA. HeLa cells with overexpression of VEGF-C were named as HeLa/S1. The expression level of NF-KB and bcl-2 mRNA was determined by RT-PCR in transfected cells. Results: After transfection by liposome, the VEGF-C mRNA level and the expression of VEGF-C protein in transfected cells were higher than those in the control groups. HeLa/S1 cell line was successfully established. In HeLa/S1 cells, the expression of NF-κB (2.06±0.09 vs 1.35±0.02 vs 1.38±0.02 P<0.05) and bcl-2 gene mRNA (2.02± 0.67 vs 0.41±0.06 vs 0.37±0.06, P<0.05) level were higher than those in the control groups. Conclusion: VEGF-C gene transfection by liposome can increase the expression of VEGF-C in human cervical cancer HeLa cells. NF-κB is stimulated and induces the overexpression of bcl-2 gene in HeLa/S1 cells.