OBJECTIVE: To evaluate the anti-hepatocellular carcinoma (HCC) activity of total alkaloids from Gelsemium elegans Benth. (TAG) in vivo and in vitro and to elucidate their potential mechanisms of action through transcriptomic analysis. METHODS: TAG extraction was conducted, and the primary components were quantified using high-performance liquid chromatography (HPLC). The effects of TAG (100, 150, and 200 µg/mL) on various tumor cells, including SMMC-7721, HepG2, H22, CAL27, MCF7, HT29, and HCT116, were assessed. Effects of TAG on HCC proliferation and apoptosis were detected by colony formation assays and cell stainings. Caspase-3, Bcl-2, and Bax protein levels were detected by Western blotting. In vivo, a tumor xenograft model was developed using H22 cells. Totally 40 Kunming mice were randomly assigned to model, cyclophosphamide (20 mg/kg), TAG low-dose (TAG-L, 0.5 mg/kg), and TAG high-dose (TAG-H, 1 mg/kg) groups, with 10 mice in each group. Tumor volume, body weight, and tumor weight were recorded and compared during 14-day treatment. Immune organ index were calculated. Tissue changes were oberseved by hematoxylin and eosin staining and immunohistochemistry. Additionally, transcriptomic and metabolomic analyses, as well as quatitative real-time polymerase chain reaction (RT-qPCR), were performed to detect mRNA and metabolite expressions. RESULTS: HPLC successfully identified the components of TAG extraction. Live cell imaging and analysis, along with cell viability assays, demonstrated that TAG inhibited the proliferation of SMMC-7721, HepG2, H22, CAL27, MCF7, HT29, and HCT116 cells. Colony formation assays, Hoechst 33258 staining, Rhodamine 123 staining, and Western blotting revealed that TAG not only inhibited HCC proliferation but also promoted apoptosis (P<0.05). In vivo experiments showed that TAG inhibited the growth of solid tumors in HCC in mice (P<0.05). Transcriptomic analysis and RT-qPCR indicated that the inhibition of HCC by TAG was associated with the regulation of the key gene CXCL13. CONCLUSION TAG inhibits HCC both in vivo and in vitro, with its inhibitory effect linked to the regulation of the key gene CXCL13.
Animals ; Apoptosis/drug effects* ; Liver Neoplasms/genetics* ; Carcinoma, Hepatocellular/genetics* ; Humans ; Alkaloids/therapeutic use* ; Gelsemium/chemistry* ; Cell Line, Tumor ; Cell Proliferation/drug effects* ; Mice ; Xenograft Model Antitumor Assays

Listeria brainstem encephalitis with myelitis is extremely rare in clinical practice.Since the clinical manifestations are non-specific,MRI is helpful for diagnosis.Positive cerebrospinal fluid culture is considered the gold standard for diagnosis.This article reports a case of an immunocompetent individual with listeria brainstem encephalitis with myelitis,aiming to enhance the awareness of this condition.
Humans ; Brain Stem/pathology* ; Diagnostic Errors ; Encephalitis/complications* ; Encephalomyelitis, Acute Disseminated/diagnosis* ; Listeriosis/complications* ; Myelitis/complications*

This study used kidney metabolomics to investigate the underlying mechanisms of Guilingji (GLJ) on mild cognitive impairment (MCI) rats. The rats were randomly divided into 6 groups (n = 8), i.e., control group, model group, positive drug (Ginkgo biloba tablet, donepezil) group, GLJ group (low and high dose group). The MCI rat model was replicated using subcutaneous injection of D-galactose into the back of the neck along with a semi-high-fat diet for a total of 8 weeks, and drug was administered from the 5th week for 4 weeks. The kidney function and renal pathological changes of each group of rats were tested. And LC-MS based kidney metabolomics coupled with multivariate data analysis were conducted to explore the potential biomarkers, and corresponding metabolic pathways were then determined. After administration of GLJ, the level of urea nitrogen was decreased compared with those of the model group, and the abnormalities of morphology in kidney tissues were improved. The positive drugs (ginkgo biloba tablet and donepezil) had no significant modulating effect on renal function indexes. Ginkgo biloba tablet can lessen the pathological injury of kidney tissue, and donepezil had no improvement on renal histopathology. A total of 23 MCI related differential metabolites were identified in kidney, and 17 metabolites were signifcantly restored by GLJ compared with those of the model group. Additionally, we found that the cysteine and methionine metabolism, nicotinate and nicotinamide metabolism, taurine and hypotaurine metabolism, glycerophospholipid metabolism were significantly involved in the regulatory effect of GLJ. The results illuminate the "cong shen zhi nao" mechanism of GLJ, and also provide a research basis for the clinical use of GLJ for the treatment of MCI. The animal experiment of this study was approved by the Ethics Committee of Shanxi University (approval number: 2020DW121).

Objective This study aimed to investigate the potential relationship between urinary metals copper (Cu), arsenic (As), strontium (Sr), barium (Ba), iron (Fe), lead (Pb) and manganese (Mn) and grip strength. Methods We used linear regression models, quantile g-computation and Bayesian kernel machine regression (BKMR) to assess the relationship between metals and grip strength.Results In the multimetal linear regression, Cu (β=-2.119), As (β=-1.318), Sr (β=-2.480), Ba (β=0.781), Fe (β= 1.130) and Mn (β=-0.404) were significantly correlated with grip strength (P < 0.05). The results of the quantile g-computation showed that the risk of occurrence of grip strength reduction was -1.007 (95％ confidence interval:-1.362, -0.652; P < 0.001) when each quartile of the mixture of the seven metals was increased. Bayesian kernel function regression model analysis showed that mixtures of the seven metals had a negative overall effect on grip strength, with Cu, As and Sr being negatively associated with grip strength levels. In the total population, potential interactions were observed between As and Mn and between Cu and Mn (Pinteractions of 0.003 and 0.018, respectively).Conclusion In summary, this study suggests that combined exposure to metal mixtures is negatively associated with grip strength. Cu, Sr and As were negatively correlated with grip strength levels, and there were potential interactions between As and Mn and between Cu and Mn.

Fibromyalgia syndrome （FMS） is a refractory， chronic non-articular rheumatic disease characterized by widespread pain throughout the body， for which there are no satisfactory therapeutic drugs or options. There are rich Chinese medical therapies， and some non-drug therapies， such as acupuncture， Tai Chi， and Ba-Duan-Jin， have shown satisfactory efficacy and safety and definite advantages of simultaneously adjusting mind and body. FMS is taken as a disease responding specifically to traditional Chinese medicine （TCM） by the National Administration of Traditional Chinese Medicine in 2018. In order to clarify the research progress in FMS and the clinical advantages of TCM/integrated Chinese and Western medicine， the China Academy of Chinese Medicine organized a seminar for nearly 20 experts in Chinese and Western medicine， including rheumatology， psychology， acupuncture and moxibustion， and encephalopathy， with the topic of difficulties in clinical diagnosis and treatment of FMS and advantages of TCM and Western medicine. The recommendations were reached on the difficulties in early diagnosis and solutions of FMS， mitigation of common non-specific symptoms， preferential analgesic therapy， TCM pathogenesis and treatment advantages， and direction of treatment with integrated Chinese and Western medicine. FMS is currently facing the triple dilemma of low early correct diagnosis， poor patient participation， and unsatisfactory benefit from pure Western medicine treatment. To solve the above problems， this paper suggests that rheumatologists should serve as the main diagnostic force of this disease， and they should improve patient participation in treatment decision-making， implement exercise therapy， and fully utilize the holistic and multidimensional features of TCM， which is effective in alleviating pain， improving mood， and decreasing adverse events. In addition， it is suggested that FMS treatment should rely on both TCM and Western medicine and adopt multidisciplinary joint treatment， which is expected to improve the standard of diagnosis and treatment of FMS in China.

Objective This study aimed to comprehensively analyze and compare the clinicopathological features and prognosis of Chinese patients with human epidermal growth factor receptor 2(HER2)-low early breast cancer(BC)and HER2-IHC0 BC. Methods Patients diagnosed with HER2-negative BC(N=999)at our institution between January 2011 and December 2015 formed our study population.Clinicopathological characteristics,association between estrogen receptor(ER)expression and HER2-low,and evolution of HER2 immunohistochemical(IHC)score were assessed.Kaplan-Meier method and log-rank test were used to compare the long-term survival outcomes(5-year follow-up)between the HER2-IHC0 and HER2-low groups. Results HER2-low BC group tended to demonstrate high expression of ER and more progesterone receptor(PgR)positivity than HER2-IHC0 BC group(P<0.001).The rate of HER2-low status increased with increasing ER expression levels(Mantel-Haenszel χ2 test,P<0.001,Pearson's R=0.159,P<0.001).Survival analysis revealed a significantly longer overall survival(OS)in HER2-low BC group than in HER2-IHC0 group(P=0.007)in the whole cohort and the hormone receptor(HR)-negative group.There were no significant differences between the two groups in terms of disease-free survival(DFS).The discordance rate of HER2 IHC scores between primary and metastatic sites was 36.84%. Conclusion HER2-low BC may not be regarded as a unique BC group in this population-based study due to similar clinicopathological features and prognostic roles.

Objective:To explore the independent risk factors of lung infection in patients with esophageal cancer treated with chemoradiotherapy and to establish an individualized early warning model based on synthetic minority oversampling technique (SMOTE) algorithm.Methods:A total of 197 patients with esophageal cancer who received concurrent chemoradiotherapy in Nanchong Central Hospital of Sichuan Province from January 2016 to March 2022 were selected as the study objects. Patients were categorized into the infected group ( n=23) and the uninfected group ( n=174) according to whether they developed lung infection during treatment. The clinical data of patients in both groups were collected, and independent risk factors for lung infection were screened using univariate and binary logistic regression analysis, and a logistic regression model ( P1) was established, while an early warning model ( P2) was constructed based on the improved dataset with the SMOTE algorithm, and the predictive efficiency of the model was compared by receiver operator characteristic (ROC) curve. Results:The incidence of lung infection in 197 patients was 11.7% (23/197), Univariate analysis showed that there were statistically significant differences in the age ( t=3.53, P=0.001), the proportion of patients with a smoking index of ≥200 cigarette-years ( χ2=7.64, P=0.006), the proportion of patients with concomitant radiological lung injury ( χ2=5.41, P=0.020), the proportion of patients with comorbid diabetes mellitus ( χ2=6.71, P=0.010), the proportion of patients with chronic obstructive lung disease ( χ2=3.92, P=0.048) and forced expiratory volume in one second/forced vital capacity (FEV 1/FVC) ( t=3.93, P<0.001) of patients between the infected group and the uninfected group. Logistic regression multivariate analysis found that increasing patient age ( OR=1.09, 95% CI: 1.02-1.16, P=0.008), decreased FEV 1/FVC ( OR=0.92, 95% CI: 0.87-0.98, P=0.005), combined diabetes mellitus ( OR=3.29, 95% CI: 1.22-8.91, P=0.019), smoking index ≥200 cigarette-years ( OR=4.02, 95% CI: 1.42-11.41, P=0.009) and combined radiation lung injury ( OR=4.75, 95% CI: 1.26-17.85, P=0.021) were independent risk factors for the occurrence of lung infection during simultaneous chemoradiotherapy in patients with esophageal cancer. Probabilistic prediction model logit ( P1) =-2.760+0.084×age-0.081×FEV 1/FVC+1.191×diabetes+1.392×smoking index+1.558×radiation lung injury. The early warning model logit ( P2) =-1.544-0.127×age-0.115×FEV 1/FVC+1.599×diabetes+1.434×smoking index+1.748×radiation lung injury. ROC curve analysis showed that the sensitivity of P1 and P2 models were 0.826 and 0.897, the specificity were 0.747 and 0.793, and the Youden index were 0.573 and 0.690, respectively. The area under curve of P2 model was 0.903 (95% CI: 0.872-0.934), which was significantly higher than 0.843 (95% CI: 0.763-0.923) of P1 model, with a statistically significant difference ( Z=13.23, P=0.002) . Conclusion:Increasing patient age, decreased FEV 1/FVC, smoking index ≥200 cigarette-years, combined diabetes mellitus and radiation lung injury are strongly associated with the occurrence of lung infection during simultaneous chemoradiotherapy in patients with esophageal cancer. The individualized early warning model established by SMOTE algorithm can significantly improve the predictive efficacy of patients' occurrence of lung infection.

Objective To construct curcumin pyrazole derivative by the reaction of diketone of curcumin and benzylhydrazine based on the above structure-activity relationship,and to explore its antioxidant activity to provide experimental basis for the development of curcumin antioxidant derivative.Methods Curcumin-N-substituted pyrazole derivative was synthesized from curcumin and benzylhydrazine.The structures of the derivative were confirmed by infrared spectroscopy(IR),nuclear magnetic resonance spectroscopy(1H-NMR,13C-NMR)and LC-MS.The antioxidant activity in vitro of the derivative was evaluated by determination of curcumin and its pyrazole derivative scavenging ability for 2,2-diphenyl-1-picrylhydrazyl(DPPH)free radical and 2,2'-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid(ABTS)free radical.Results Curcumin pyrazole derivative was successfully synthesized.Curcumin and its pyrazole derivative showed good free radical scavenging effects in the range of 4.6-73.6,6.25-100 μg·mL-1,respectively,with a significant dose-effect relationship.The half-maximal inhibition(IC50)values of curcumin and its pyrazole derivatives determined by DPPH method were 14.24,40.37 μg·mL-1,respectively,while the IC50 values of curcumin and its pyrazole derivatives determined by ABTS method were 36.65,19.26 μg·mL-1,respectively.Conclusion The antioxidant activity of β-dione of curcumin was retained through the substitution of the pyrazole ring,and the curcumin pyrazole derivative deserves further investigation as a potential antioxidant.

It is the focus of higher education reform in the new era to comprehensively promote the con-struction of ideology and political education based on the characteristics of professional courses and en-hancing the effectiveness of ideology and political education.As an important basic course for medical students in colleges,molecular biology is closely related to basic medical disciplines and clinical medi-cine,and is a rapidly developing cutting-edge discipline,which has the natural advantage of serving as a carrier of ideology and political education.In this study,the innovative integration of project-based group study (PBGS) with the outcome-oriented behavior (OBE) of moral education is applied to the teaching of the ideology and politics of the medical molecular biology course,and the integration of the two has made a useful exploration to enhance the effectiveness of the ideology and politics teaching of the course.Taking students as the center,we have constructed an ideology and politics teaching system for medical molecular biology courses by combining on-line and off-line teaching activities through improving the teaching objectives,innovating the teaching design,digging into the case of ideology and politics,intro-ducing a variety of teaching methods,strengthening the management of teaching practice,and optimizing the evaluation mode.After two years of teaching practice,this model has effectively improved the teach-ing effect of the medical molecular biology course.The academic performance of the students in the prac-tice group has improved significantly,and the teachers and students have been given excellent evalua-tion.The results of the questionnaires before and after class showed that more than 80％ of the students believed that their horizons had been broadened and their knowledge had been increased through learn-ing.More than 50％ of the students believed that their learning ability and innovation consciousness had been improved;their scientific research quality had been improved;and their confidence in studying medicine had been strengthened.By strengthening the cultivation of students' scientific research and in-novation capabilities,we guided students to participate in subject competitions and won many national a-wards.Throughout the teaching process,we aim to expand the breadth and depth of ideology and political education,cultivate scientific spirits,innovation ability,moral cultivation,and humanistic qualities.In sum,our work provides experiences for the cultivation of high-quality medical talents.

Objective To observe the clinical study of left atrial appendage volume and statins on cardiac function after radiofrequency ablation of atrial fibrillation.Methods Patients who successfully completed radiofrequency ablation of atrial fibrillation were randomly divided into control group and treatment group,and were divided into recurrent group and non recurrent group based on the recurrence rate at 1 months after surgery.The control group was treated with 5 mg of warfarin anticoagulant therapy after surgery,qd;the treatment group was given rosuvastatin(10 mg)or atorvastatin(20 mg)orally after surgery,qd,and both groups were treated for one month.The levels of inflammatory indexes[interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)],blood lipid indexes[total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],cardiac function indexes[left atrial ejection fraction(LAEF),A peak,left atrial maximum strain value,left atrial volume(LAV),left atrial appendage volume(LAAV)]were compared between the two groups.Results A total of 88 patients were enrolled in this trial,including 45 in the control group and 43 in the treatment group.One months after ablation,the serum IL-6 levels in the treatment group and control group were(6.27±1.24)and(12.06±1.13)ng·L-1,respectively;the serum hs CRP levels were(1.42±0.37)and(9.25±0.91)ng·L-1,respectively;the LAEF were(59.12±1.65)％and(50.07±2.48)％,respectively;the A peak values were 69.74±1.65 and 62.49±2.67,respectively;the maximum strain values of the left atrium in the two groups were 36.89±1.94 and 31.42±2.26,respectively.The above indexes in the treatment group were significantly different from those in the control group(all P＜0.05).After treatment,the total effective rate of 95.35％in the treatment group was significantly higher than 80.00％in the control group(P＜0.05).The main adverse drug reactions of the treatment group were nausea,abdominal pain,dizziness,and muscle weakness,while the main adverse drug reactions of the control group were bleeding,nausea,vomiting,and diarrhea.The total incidence of adverse drug reactions in the treatment group and control group was 18.60％and 20.00％,respectively,with no statistically significant difference(P＞0.05).Multivariate logistic regression analysis showed that the larger LAAV was an independent risk factor for postoperative recurrence of atrial fibrillation and affecting cardiac function(P＜0.05).Conclusion The left atrial appendage volume and statins have a certain impact on the cardiac function of patients with atrial fibrillation after radiofrequency ablation.Patients can take statins to improve cardiac function after surgery,and targeted treatment is given to patients with larger left atrial appendage volume to reduce postoperative recurrence.