OBJECTIVE: Salt-processed Psoraleae Fructus (SPF) is widely used as a phytoestrogen-like agent in the treatment of osteoporosis. However, due to improper clinical use or misuse, resulting in liver damage. In this study, network pharmacology was employed to analyze the mechanism of cholestatic liver damage. An adeno-associated virus overexpressing SULT1E1 (rAAV8-SULT1E1) was constructed and the hepatotoxicity of SPF, psoralen, and isopsoralen was determined. METHODS: By utilizing three databases inclding TCMSP, TCMID, and BATMAN- TCM, the targets of the three databases were summarized, and a total of 45 psoralen compounds were included. Network pharmacology analysis was then performed. The adenoviral vectors were injected into the tail vein of C57BL6 mice to elucidate the role of SULT1E1 in SPF-induced cholestasis-mediated hepatotoxicity in vivo. SPF (10 g/kg), psoralen, and isopsoralen (50 mg/kg each) were intragastrically administered to mice for 30 d. B-ultrasound and samples were collected and examined for follow-up experiments. RESULTS: A total of 854 targets were predicted for 45 active components, with 151 cholestasis-mediated hepatotoxicity-related disease targets obtained for SPF. A total of 126 pathways were enriched based on KEGG pathway analysis, with the "estrogen signaling pathway" identified as one of the top 20 pathways. In terms of pathological hepatic changes, treated mice had visually swollen hepatocytes, dilated bile ducts, and elevated serum biochemical markers, which were more prominent in mice treated with isopsoralen than in those treated with other compounds. Notably, the overexpression of SULT1E1 could reverse liver damage in each treatment group. B-ultrasound was used to observe the size of the gallbladder in vivo. The size of the gallbladder was found to significantly increase on day 30 after treatment in the SPF-, psoralen-, and isopsoralen-treated groups, especially the SPF group. Compared with the expression levels in the negative control group (rAAV8-empty + con), the expression levels of FXR, Mrp2, Bsep, SULT1E1, SULT2A1, Ntcp, and Nrf2 decreased, whereas those of CYP7a1 and IL-6 increased in the SPF-, psoralen-, and isopsoralen-treated groups. CONCLUSION The overexpression of SULT1E1 could alleviate the decreased or increased expression of indicators, indicating that SULT1E1 is an important target gene for SPF-induced liver damage. The severity of liver damage was significantly lower in the rAAV8-SULT1E1 groups than in the rAAV8-empty groups.

Objective:To establish an environmental management strategy for the prevention of ventilator-associated pneumonia from the perspective of etiological characteristics and to verify its application effect.Methods:Based on a sampling survey, this study constructed preventive management strategies for ventilator-associated pneumonia by blocking pathogen characteristics from the perspective of both colonization and infection management in patients. From July 2021 to June 2023, a non-synchronous randomized controlled study was conducted, including a control group of 59 cases and an experimental group of 57 cases from ICU of Tianjin Teda Hospital, all of them were mechanically ventilated patients. The effectiveness of the strategy was confirmed.Results:In the control group, there were 35 males and 24 females, with an average age of (46.97 ± 18.84) years. In the experimental group, there were 39 males and 18 females, with an average age of (47.49 ± 13.85) years. During the study period, there were 9 cases of ventilator-associated pneumonia (VAP) in the control group and 2 cases in the experimental group, the difference between the two groups was statistically significant (exact odds ratio=0.031). The duration of mechanical ventilation in the experimental group (122.41 ± 18.36) h, which was shorter than that in the control group (187.62 ± 18.05) h, and the difference was statistically significant ( t=19.28, P<0.05). The length of ICU stay in the experimental group was (8.38 ± 0.79) d, in the control group was (10.99 ± 1.10) d, the difference between them was statistically significant ( t=14.66, P<0.05). On the 7th day, there were 7 cases of positive pathogenic bacteria in sputum culture in the experimental group, which was significantly different from the 29 cases in the control group ( χ2=16.73, P<0.05). Conclusions:The vector management strategy for preventing ventilator-associated pneumonia by blocking etiological characteristics can reduce the incidence of VAP, shorten the duration of mechanical ventilation and ICU stay, and reduce the pathogen load in the sputum of mechanically ventilated patients on the 7th day.

BACKGROUND:Mangiferin is a biphenylpyridone compound extracted from mango leaves,bark and roots.Previous studies have shown that mangiferin can exert anti-systemic inflammatory effects through the activation of transcription factors such as NF-κB and JAK/STAT. OBJECTIVE:To investigate the effects and mechanisms of mangiferin on proliferation,migration and inflammatory factor release of rheumatoid arthritis fibroblast-like synovial cells(RA-FLS). METHODS:RA-FLS were divided into blank group,R848(TLR7/8 agonists)stimulated group,mangiferin low-,medium-,high-dose groups(2,4 and 8 μg/mL)and positive control group(Cu-CPT8,TLR8 pathway inhibitor).The cytotoxic effect of different mass concentrations of mangiferin was detected using cell counting kit-8 method and the final cellular dosing mass concentration was screened.The proliferation ability of RA-FLS was detected by cell clone formation assay,the migration ability of RA-FLS was detected by scratch assay and Transwell migration assay,and the expression of interleukin 1β,interleukin 6 and tumor necrosis factor α mRNA in RA-FLS was detected by qRT-PCR. RESULTS AND CONCLUSION:Compared with the blank group,the viability of RA-FLS was inhibited after treatment with mangiferin at 2-10 μg/mL,but there was no significant difference among groups(P>0.05),indicating that the toxic effect on RA-FLS was minimal.Compared with the R848-stimulated group,mangiferin decreased the number of cell clones,the scratch healing rate and the number of migrating cells in all dosing groups(P<0.01);and the expression of interleukin 1β,interleukin 6 and tumor necrosis factor α mRNA was also reduced in the mangostin medium-and high-dose groups(P<0.01).Compared with the R848-stimulated group,the number of cell clones,the scratch healing rate and the number of migrating cells as well as the expression levels of interleukin 6 and tumor necrosis factor α mRNA were significantly reduced in the positive control group(P<0.05,P<0.01).But there was no significant difference in the expression level of interleukin 1β.To conclude,mangiferin may exert its anti-rheumatoid arthritis effects through the TLR7/8 signaling pathway by inhibiting RA-FLS proliferation,migration,and inflammatory factor release.

Objective:To investigate the effect of Jiawei Zhuyu Decoction combined with oxytocin on uterine involvement and residual of placenta in postpartum patients.Methods:A total of 91 patients with postpartum placenta residue admitted to Baoji Central Hospital from January 2023 to January 2024 were selected as the study objects. According to random number table method, the patients were divided into observation group (45 cases) and control group (46 cases). The control group was treated with oxytocin, and the observation group was treated with Jiawei Zhuyu decoction. Treatment effect, Traditional Chinese Medicine (TCM) symptom score, Visual Analogue Scale (VAS) score, SF-36 score, uterine reversion, uterine residual area, levels of beta human chorionic gonadotropin (β-HCG), progesterone (P), estradiol (E 2), duration of vaginal bleeding, length of hospital stay and adverse reactions were compared between the two groups. Results:The total effective rate of the observation group was higher than that of the control group [95.6%(43/45) vs 78.3%(36/46), χ 2=5.943, P=0.015]. After treatment, TCM syndrome scores, VAS scores and SF-36 scores of 2 groups were significantly improved (all P<0.05), and TCM syndrome scores and VAS scores of observation group were lower than those of control group, and SF-36 scores were higher than those of control group (all P<0.05). After treatment, the sum of three diameters of uterus, endometrial thickness and area of uterine residue in both groups decreased (all P<0.05), and the sum of three diameters of uterus, endometrial thickness, rate of uterine decline and area of uterine residue in the observation group were smaller than those in the control group (all P<0.05). After treatment, the levels of β-HCG, P, E 2 in 2 groups were improved compared with before (all P<0.05), and the levels of β-HCG and P in observation group were lower than those in the control group, and E 2 levels were higher than those in the control group (all P<0.05). The duration of vaginal bleeding and hospitalization in the observation group were shorter than those in the control group (all P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group [6.67%(3/45) vs 21.7%(10/46), χ 2=4.220, P=0.040]. Conclusions:Jiawei Zhuyu Decoction combined with oxytocin has a good effect on postpartum placenta residue, can effectively reduce the intrauterine placenta residue, promote uterine involution, and accelerate the recovery of patients.

Objective:To investigate the association and predictive value of serum biomarkers with carotid atherosclerosis(CAS)in the elderly population.Methods:The data used in this study were obtained from the China Hainan Centenarian Cohort Study(CHCCS), a prospective cohort that includes elderly individuals from community populations in Hainan Province.The baseline survey was conducted between 2014 and 2019.A total of 737 elderly individuals aged 80 to 100 were included in the analysis.The study examined various factors including questionnaires, physical examination data, liver and kidney function indicators(albumin, aspartate aminotransferase, alanine aminotransferase, total bilirubin, and glomerular filtration rate), blood cell counts(red blood cells, white blood cells, platelets, neutrophil count, lymphocyte count, and monocyte count), inflammatory markers(high-sensitivity C-reactive protein), and lipid metabolism markers(total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein AI, and apolipoprotein B).The objective was to explore the lipids of serum biomarkers and diagnostic performance of carotid atherosclerosis.Results:The prevalence of CAS in the elderly population was found to be 80.7%.Spearman's correlation analysis and a fully adjusted multivariate logistic regression model were used to examine the relationship between CAS and various factors in elderly patients.Result showed that systolic blood pressure, heart rate, and serum apolipoprotein B levels were significantly correlated with CAS[ OR(95% CI): 1.012(1.004-1.021), 0.998(1.011-1.024); 15.796(4.914-50.772), respectively; all P<0.001].Additionally, ROC curve analysis demonstrated that the combined application of serum apolipoprotein B, systolic blood pressure, and heart rate improved the predictive value of CAS in the elderly(Area under the curve: 0.820, 95% CI: 0.782-0.858; Sensitivity: 78.8%; Specificity: 86.8%; Positive likelihood ratio: 5.97; Negative likelihood ratio: 0.24). Conclusions:Our study discovered that serum apolipoprotein B is an autonomous risk factor for CAS among the elderly.The utilization of a specific set of biomarkers, in conjunction with other risk markers, holds potential as a promising strategy for evaluating CAS in the elderly population.

Objective:To analyze and explore the clinical characteristics and risk factors related to nosocomial mortality in patients with liver cirrhosis combined with atrial arrhythmia.Methods:252 hospitalized patients with liver cirrhosis combined with atrial arrhythmia from January 2014 to December 2021 were enrolled, and their clinical characteristics were analyzed. The above-mentioned patients were divided into groups according to their nosocomial mortality rate. Among them, 45 nosocomial mortality cases were classified as the mortality group, and 207 survival cases were classified as the survival group. The differences in clinical data and laboratory data between the two groups were compared. The risk factors for nosocomial mortality in patients with liver cirrhosis combined with atrial arrhythmia were analyzed. The t-test, or rank-sum test, was used to compare measurement data. The chi-square test, or Fisher's exact probability method, was used to compare enumeration data. Multivariate analysis was performed by the logistic regression method.Results:Among the 252 cases, the male-to-female ratio was the same (male/female ratio: 126/126). The age range was 26 to 89 (66.77±10.46) years. Han ethnicity accounted for 79.5%. The main type of atrial arrhythmia was atrial fibrillation ( P ?

Objective:To investigate the effects of Sennoside A (SA) on the proliferation, migration, invasion, glycolysis and other malignant biological behaviors of gallbladder carcinoma cells, and to analyze the related mechanisms.Methods:Human gallbladder carcinoma cell lines, NOZ and SGC-996, were cultured in vitro and divided into control group, SA low dose group (L-SA, 25 μmol/L), SA medium dose group (M-SA, 50 μmol/L) and SA high dose group (H-SA, 100 μmol/L), and H-SA+ phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway activator 740Y-P group, respectively. The proliferation, migration, invasion, apoptosis and glycolysis of gallbladder cancer cells in each group were detected by cell counting assay, Transwell, flow cytometry and glycolysis kit. The protein levels of PI3K, p-PI3K, AKT and p-AKT were detected by Western blot assay. NOZ cells were used to construct tumor model of nude mice, and the mice were divided into saline treatment group and 10 mg/kg SA treatment group. The tumor formation ability of the two groups of mice was compared, and the expression level of Ki-67 in tumor of the two groups was detected by immunohistochemical assay.Results:Compared with control group, the proliferation, migration, invasion, glycolysis ability, the expression levels of p-PI3K and p-AKT were significantly decreased in SA treatment groups, while the apoptosis level was significantly up-regulated, all differences were statistically significant ( P<0.05). Compared with H-SA group, the proliferation, migration, invasion and glycolysis of H-SA+ 740Y-P group cells were up-regulated, while the apoptosis level was significantly decreased, all differences were statistically significant ( P<0.05). In vivo tumorigenesis experiments showed that, compared with the control group, the tumor volume of the SA-treated mice was reduced at day 28 [(1 051.32±130.29) mm 3 vs (575.07±170.54) mm 3, P=0.0003), the tumor weight was reduced [(1.04±0.24) g vs (0.58±0.13) g, P=0.0019], and the average optical density of Ki-67 expression was reduced [(77.00±7.00) vs (33.33±7.51), P=0.0018]. Conclusion:SA can inhibit the proliferation, migration, invasion and glycolysis of gallbladder carcinoma cells by regulating PI3K/AKT pathway.

Objective To establish the drug use evaluation(DUE)criteria for aspirin enteric-coated tablets and provide a reference for the rationally clinical application of aspirin enteric-coated tablets.Methods DUE criteria for aspirin enteric-coated tablets were established from three aspects of indications,medications and medication results with reference to drug instructions of aspirin enteric-coated tablets,related guidelines,expert consensus and literature,and through Delphi method.A retrospective analysis was conducted to evaluate the medical records of patients who took aspirin enteric-coated tablets from January 2021 to June 2022 in Fuqing Hospital affiliated to Fujian Medical University.Results A total of 1 071 medical records were included.683 cases fully met the DUE criteria,with a rational rate of 63.77％.Irrational drug use mainly included inappropriate indications(6.26％),off-label drug use without approval(28.48％),contraindications(1.03％),inappropriate usage and dosage(1.68％),drug interactions with potential clinical significance(0.65％)and other inappropriate drug use(2.71％).Conclusion The established DUE standard for aspirin enteric-coated tablets has strong scientific practicability and feasibility.The irrational rate of aspirin enteric-coated tablets in this hospital is high.Corresponding intervention measures should be formulated to ensure the safety of clinical medication.

Objective To investigate the interventional effect and mechanism of a novel ampelopsis hydrogel on dampness-heat accumulation syndrome of gouty arthritis. Methods A total of 90 patients with gouty arthritis who met the diagnostic criteria of western medicine and were differentiated as damp-heat accumulation syndrome of traditional Chinese medicine(TCM) were randomly divided into treatment group, control group and blank group, with 30 patients in each group. The blank group was treated with etoricoxib only, the control group was treated with etoricoxib combined with ampelopsis hydrogel, and the treatment group was treated with etoricoxib combined with external application of ampelopsis hydrogel. The clinical efficacy, time to symptom improvement, safety, comfort, changes in syndrome scores of TCM, serum inflammatory factors[C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), erythrocyte sedimentation rate (ESR)], NF-κB signaling pathway-related proteins, Visual Analogue Scale (VAS) scores for pain, and joint mobility were compared among the three groups before and after treatment. Results The total effective rates in the treatment group and control group were 93.33% and 90.00%, respectively, which were higher than 70.00% in the blank group (P < 0.05). The time for improvement of pain, redness, tenderness, and limited joint mobility in the treatment group was shorter than that in the control group and blank group (P < 0.05). After 7 days of treatment, the TCM syndrome score in the treatment group was lower than that in the control group and blank group, and the levels of serum CRP, TNF-α, and ESR and the expressions of NF-κB signalingpathway-related proteins P50 and P65 in the treatment group and control group were lower than those in the blank group (P < 0.05). After 7 days of treatment, the VAS score in the treatment group was lower than that in the control group and blank group, and the comfort score in the treatment group was higher than that in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P>0.05). Conclusion The effect of ampelopsis hydrogel in treating gouty arthritis is better than that of ampelopsis paste, and its mechanism may be related to the regulation of the NF-κB pathway and inhibition of inflammatory factor expression. The hydrogel is easy to use, hygienic, and comfortable, and is expected to become a safe, effective, and convenient external medicine for gouty arthritis.

Objective:To summarize the research on the application of online health community-based user personain the field of cancer at home and abroad, so as to provide reference for the related research and application in this field in the future.Methods:Computer search of CNKI, China biomedical literature database, VIP, Wanfang, Web of Science, Embase, MEDLINE, PubMed, CINAHL, Cochrane Library, a total of 10 Chinese and English databases, focused on the relevant research on building user personas based on online health communities in the field of cancer, and the search time limit was from the establishment of the database to April 20, 2022. Literature was screened, data extracted and summarized.Results:Totally 11 literatures were included. The construction process of user persona based on online health community included data collection, tag extraction and persona presentation. The functional diversity and implementation feasibility were showed in the application content in the field of cancer. It can quickly identify the differences in health information needs of cancer patients, provide personalized decision support and nursing services, strengthen health information education, and improve patients′ self-management ability.Conclusions:The integration of user persona and cancer field based on online health community was in the initial exploration stage, and the feasibility and effectiveness of promoting patients′ health behavior were confirmed by existing studies. In the future, it is still necessary to be promoted in the empirical research on its application in clinical practice, so as to lay a foundation for providing targeted patient health management programs in the future.