Primary liver cancer,particularly hepatocellular carcinoma,is one of the most common malignancies in China,and hepatectomy remains the primary curative treatment.However,the efficacy of hepatectomy is significantly limited due to the heterogeneity of liver cancer,its high recurrence rate,and the fact that most patients are diagnosed at advanced stages.In recent years,the development of precision medicine has brought new hope to liver cancer treatment,especially with notable advancements in preoperative assessment,systemic therapy,minimally invasive surgery,and personalized treatment strategies.Preoperative assessment,including imaging technologies such as three-dimensional visualization and molecular imaging,helps physicians accurately evaluate tumor characteristics and liver function,guiding the choice of treatment plan.The combined application of immunotherapy and targeted therapy has significantly improved survival rates for patients with advanced liver cancer.The strategy of combining systemic therapy with local treatment has provided new pathways for translational therapy,expanding the indications for hepatectomy.The optimal selection of patients based on tumor biological characteristics,especially molecular subtyping and liver function status,to maximize patient benefit still requires further exploration.The"seven-step"modular laparoscopic hepatectomy,by achieving scientific hepatectomy,demonstrates the clinical practice of maximizing patient benefit,further elucidating a multidisciplinary,personalized treatment model centered on surgical therapy.

The current classification methods for traditional Chinese medicine （TCM） visceral syndrome differentiation suffer from excessive generalization， which hinders their clinical application. Based on the analysis of the pattern of "one syndrome corresponding to multiple formulas"， this paper focused on the principle of syndrome-formula correspondence， and proposed that formula-syndromes are the smallest units for refining visceral syndromes. By establishing the correspondence between formula-syndromes and visceral syndromes， this study aims to further clarify the refined categories of syndromes and their treatment patterns， providing a new perspective for the standardization and objectification of TCM syndromes.

Chronic cerebral hypoperfusion (CCH) plays an important role in the occurrence and development of vascular dementia (VD). Recent studies have indicated that multiple stages of immune-inflammatory response are involved in the process of cerebral ischemia, drawing increasing attention to immune therapies for cerebral ischemia. This study aims to identify potential immune therapeutic targets for CCH using bioinformatics methods from an immunological perspective. We identified a total of 823 differentially expressed genes associated with CCH, and further screened for 9 core immune-related genes, namely RASGRP1, FGF12, SEMA7A, PAK6, EDN3, BPHL, FCGRT, HSPA1B and MLNR. Gene enrichment analysis showed that core genes were mainly involved in biological functions such as cell growth, neural projection extension, and mesenchymal stem cell migration. Biological signaling pathway analysis indicated that core genes were mainly involved in the regulation of T cell receptor, Ras and MAPK signaling pathways. Through LASSO regression, we identified RASGRP1 and BPHL as key immune-related core genes. Additionally, by integrating differential miRNAs and the miRwalk database, we identified miR-216b-5p as a key immune-related miRNA that regulates RASGRP1. In summary, the predicted miR-216b-5p/ RASGRP1 signaling pathway plays a significant role in immune regulation during CCH, which may provide new targets for immune therapy in CCH.
Humans ; Computational Biology/methods* ; Brain Ischemia/therapy* ; Immunotherapy ; MicroRNAs/genetics* ; Signal Transduction ; Dementia, Vascular/genetics* ; Chronic Disease

Objective:To investigate the effects and mechanism of Shenshuaikang Enema on hypoxia/reoxygenation (H/R) NRK-52E cells; To provide references for Shenshuaikang Enema to treat AKI.Methods:The H/R-induced NRK-52E cell model was established, and control group, model group, drug-containing serum group, drug-containing blood group +p53 agonist group, p53 agonist group, p53 inhibitor group were set up. Cell viability was detected by CCK8. The cell cycle distribution in each group was analyzed using flow cytometry, while cell senescence was assessed via β-galactosidase staining. The levels of IL-6, IL-1β, and TNF-α in the cell supernatant were evaluated using ELISA. Western Blot analyses were conducted to measure the protein expressions of p53, phosphorylated p53 (p-p53), and p21.Results:Compared with model group, NRK-52E cell vitality significantly increased in the drug-containing serum group and p53 inhibitor group ( P<0.01, P<0.05), S phase and G2/M phase percentage was significantly reduced ( P<0.01), β-galactoase staining decreased ( P<0.01), the levels of IL-1β, IL-6 and TNF-α decreased ( P<0.05, P<0.01), the protein expressions of p-p53 and p21 decreased ( P<0.01). Compared with the drug-containing serum group, NRK-52E cell vitality significantly decreased in the drug-containing serum+p53 agonist group and p53 agonist group ( P<0.01), S phase and G2/M phase percentage was significantly increased ( P<0.01), β-galactoase staining increased ( P<0.01), the levels of IL-1β, IL-6 and TNF-α increased ( P<0.01), the protein expressions of p-p53 and p21 increased ( P<0.01 or P<0.05). Conclusion:The drug-containing serum of Shenshuaikang Enema may promote cell proliferation, improve cell cycle arrest, inhibit pro-inflammatory and senescence related secretory phenotypes, and inhibit cell senescence by inhibiting p53/p21 signaling pathway, so as to promote H/ R-induced NRK-52E cell damage repair.

Tonifying herbs described in the Shen Nong Ben Cao Jing frequently possess well-defined efficacy in dispelling pathogenic factors, including eliminating pathogenic factors, eliminating severe wind-disorders, dispelling Bi syndrome, removing blood stasis and resolving hard masses, facilitating urination and defecation, relieving chills and fever, promoting digestion, regulating and smoothing qi movement, treating carbuncles and deep-rooted ulcers, killing the :three worms: (parasites), draining pus and alleviating pain, and treating bone fractures and traumatic injuries. These effects correspond to a broad spectrum of conditions, encompassing immune, digestive, and respiratory system disorders, as well as tumors. These effects are closely related to the taste and compatibility of drugs, and are supported by modern pharmacological studies (such as anti-inflammatory, anti-tumor, immune regulation, etc.). This study could provide a novel perspective for the rational clinical application of tonifying herbs and establish a foundation for in-depth research into the multi-efficacy mechanisms of Chinese materia medica.

Primary liver cancer,particularly hepatocellular carcinoma,is one of the most common malignancies in China,and hepatectomy remains the primary curative treatment.However,the efficacy of hepatectomy is significantly limited due to the heterogeneity of liver cancer,its high recurrence rate,and the fact that most patients are diagnosed at advanced stages.In recent years,the development of precision medicine has brought new hope to liver cancer treatment,especially with notable advancements in preoperative assessment,systemic therapy,minimally invasive surgery,and personalized treatment strategies.Preoperative assessment,including imaging technologies such as three-dimensional visualization and molecular imaging,helps physicians accurately evaluate tumor characteristics and liver function,guiding the choice of treatment plan.The combined application of immunotherapy and targeted therapy has significantly improved survival rates for patients with advanced liver cancer.The strategy of combining systemic therapy with local treatment has provided new pathways for translational therapy,expanding the indications for hepatectomy.The optimal selection of patients based on tumor biological characteristics,especially molecular subtyping and liver function status,to maximize patient benefit still requires further exploration.The"seven-step"modular laparoscopic hepatectomy,by achieving scientific hepatectomy,demonstrates the clinical practice of maximizing patient benefit,further elucidating a multidisciplinary,personalized treatment model centered on surgical therapy.

Objective Using data mining to analyze the medication patterns for treating insomnia,and applying network pharmacology to preliminarily analyze the mechanisms of drugs.Methods The prescriptions for the treatment of insomnia by Liang Hui from August 2022 to September 2023 were collected.A database was constructed using tools such as Excel software and the Traditional Chinese Medicine Inheritance Auxiliary Platform.The drugs were analyzed for frequencies,natures,drug associations,and clustering were analyzed.Core drug components and disease targets were retrieved,and the target genes for the treatment of insomnia were subjected to gene ontology and Kyoto Encyclopedia of Genes and Genomes analysises.Results A total of 300 insomnia-related prescriptions were collected,involving 96 flavors of drugs.The drug nature was mainly cold,and the drug flavor was mainly bitter.The core herbal combinations included Radix Bupleuri,Poria,Atractylodis Macrocephala,Radix Paeoniae Alba,Radix Curcumae,Fructus Gardeniae,Anemarrhenae,Poria cum Radix Pini,Sedum aizoon L.Critical drug targets for the treatment of insomnia encompassed albumin,serine/threonine kinase 1,epidermal growth factor receptor,B-cell lymphoma-2,estrogen receptor 1,cysteinyl aspartate specific proteinase-3,among others;The main enriched pathways included cancer pathway,lipid and atherosclerosis pathway,phosphoinositide 3-kinase(PI3K)/protein kinase B(PKB,also known as Akt)signaling pathway,Kaposi sarcoma-associated herpesvirus infection pathway,hypoxia-inducible factor-1(HIF-1)signaling pathway,etc.;The main biological processes included cell apoptosis,response to nicotine,mitogen-activated protein kinase cascade reactions,etc..Conclusion Liang Hui's treatment of insomnia follows the principle of treating symptoms with the same root cause,focusing on Qingli Sanjiao,regulating liver and strengthening spleen,smoothing the qi and organs,supplementes by nourishing the heart and calming the nerves,forming a core prescription integrating Radix Bupleuri,Poria,Rhizoma Atractylodis Macrocephalae,Radix Paeoniae Alba,Radix Curcumae,Fructus Gardeniae,Rhizoma Anemarrhenae,Poria cocos,Sedum aizoon L.Its pathways are related with PI3K/AKT,HIF-1 and so on.

Objective Using data mining to analyze the medication patterns for treating insomnia,and applying network pharmacology to preliminarily analyze the mechanisms of drugs.Methods The prescriptions for the treatment of insomnia by Liang Hui from August 2022 to September 2023 were collected.A database was constructed using tools such as Excel software and the Traditional Chinese Medicine Inheritance Auxiliary Platform.The drugs were analyzed for frequencies,natures,drug associations,and clustering were analyzed.Core drug components and disease targets were retrieved,and the target genes for the treatment of insomnia were subjected to gene ontology and Kyoto Encyclopedia of Genes and Genomes analysises.Results A total of 300 insomnia-related prescriptions were collected,involving 96 flavors of drugs.The drug nature was mainly cold,and the drug flavor was mainly bitter.The core herbal combinations included Radix Bupleuri,Poria,Atractylodis Macrocephala,Radix Paeoniae Alba,Radix Curcumae,Fructus Gardeniae,Anemarrhenae,Poria cum Radix Pini,Sedum aizoon L.Critical drug targets for the treatment of insomnia encompassed albumin,serine/threonine kinase 1,epidermal growth factor receptor,B-cell lymphoma-2,estrogen receptor 1,cysteinyl aspartate specific proteinase-3,among others;The main enriched pathways included cancer pathway,lipid and atherosclerosis pathway,phosphoinositide 3-kinase(PI3K)/protein kinase B(PKB,also known as Akt)signaling pathway,Kaposi sarcoma-associated herpesvirus infection pathway,hypoxia-inducible factor-1(HIF-1)signaling pathway,etc.;The main biological processes included cell apoptosis,response to nicotine,mitogen-activated protein kinase cascade reactions,etc..Conclusion Liang Hui's treatment of insomnia follows the principle of treating symptoms with the same root cause,focusing on Qingli Sanjiao,regulating liver and strengthening spleen,smoothing the qi and organs,supplementes by nourishing the heart and calming the nerves,forming a core prescription integrating Radix Bupleuri,Poria,Rhizoma Atractylodis Macrocephalae,Radix Paeoniae Alba,Radix Curcumae,Fructus Gardeniae,Rhizoma Anemarrhenae,Poria cocos,Sedum aizoon L.Its pathways are related with PI3K/AKT,HIF-1 and so on.

Objective:To explore the behavioral intentions of pediatric nurses towards using vascular visualization devices in light of the theory of planned behavior.Methods:This was a qualitative study. From March to November 2023, 20 pediatric nurses from Peking University First Hospital were selected using purposive sampling for semi-structured interviews. The interview data were analyzed and themes were extracted using Colaizzi 7-step analysis method.Results:The behavioral intentions of pediatric nurses towards the use of vascular visualization devices could be summarized into nine themes based on the theory of planned behavior. Attitudes towards behavior included positive evaluations, negative evaluations, and unclear information. Subjective norms involved peers' attitudes as well as expectations and pressures from patients. Perceived behavioral control encompassed workload, level of knowledge, more limited equipment performance, and external resource support.Conclusions:The behavioral intentions of pediatric nurses towards the use of vascular visualization devices are influenced by their attitudes towards the behavior, subjective norms, and perceived behavioral control. Nursing managers should conduct standardized training on vascular visualization devices to enhance nurses' knowledge and skills, while also valuing the sources of various supports to create a supportive environment for the use of vascular visualization devices. This will improve the usage experience of pediatric nurses and promote the use of vascular visualization devices in pediatric nursing practice.

Objective To explore whether voluntary wheel running affects liver oxidative stress by regulating the Nrf2/HO-1 pathway,thereby alleviating HFFC diet-related lipid deposition in the liver.Methods Eight-week-old C57BL/6J mice were randomly divided into a normal diet group(NC group,n=10)and high-fat,fructose,and cholesterol diet group(HFFC group,n=20)after 1 week of adaptive feeding.Ten weeks of feeding later,mice in the HFFC group were divided into a quiet group(HFFC group,n=10)and HFFC combined with exercise group(HFFC+EX group,n=10).HFFC+EX group mice were caged with voluntary running wheels for free movement,and the number of running wheels was recorded every day for 8 weeks.After the last treatment,the mice were sacrificed by fasting for 12 hours at an interval of 24 hours,and the blood and liver were collected for analysis.Results(1)Body weight,liver weight,and liver index of mice fed the HFFC diet were significantly higher than those of the NC group,which significantly decreased after exercise(P＜0.05).(2)Compared with the NC group,HDL-C and LDL-C in the HFFC group were significantly increased,and the LDL-C level was significantly decreased after 8 weeks of exercise(P＜0.05).(3)The liver fat droplet area and liver TG content in the HFFC group were significantly higher than those in the NC group,whereas those in HFFC+EX group were significantly decreased(P＜0.05).(4)Compared with the NC group,the content of oxidase MDA in the HFFC group were significantly increased,and nuclear translocation and gene expression of Nrf2 were significantly decreased.After exercise,the activities of SOD and T-AOC were significantly increased,and the nuclear translocation and gene expression of Nrf2 and expression levels of HO-1 and SOD-1 were significantly increased(P＜0.05).(5)The number of apoptotic hepatocytes and CHOP expression in the HFFC diet group were significantly higher than those in the NC group,whereas the number of apoptotic hepatocytes,and CHOP and Bax/Bcl-2 expression in the exercise group were significantly lower than those in the NC group(P＜0.05).Conclusions Voluntary wheel can alleviate HFFC diet induced liver lipid deposition by regulating the Nrf2/HO-1 pathway,thereby alleviating oxidative stress and reducing apoptosis in liver cells.