ObjectiveTo explore the mechanism of Xianfang Huomingyin （XFHMY） in the treatment of type Ⅲ prostatitis （CP/CPPS） through network pharmacology， molecular docking， and animal experiments. MethodsThe traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） and the Swiss Target Prediction database were used to screen and sort out the active ingredients and corresponding targets of XFHMY. The potential therapeutic targets of CP/CPPS were collected from online databases， such as the Online Mendelian Inheritance in Man （OMIM）， GeneCards， and DisGeNET. The potential core targets of XFHMY for treating CP/CPPS were further screened by constructing a protein-protein interaction （PPI） network and performing topological analysis. Meanwhile， the DAVID database was chosen to perform enrichment analysis on the intersection targets. On this basis， the AutoDock software was used for molecular docking， and the data was subsequently imported into the GraphPad Prism 8 software to generate a heat map. SD rats were divided into seven groups： A blank group， a sham operation group， a model group， low-， medium-， and high-dose XFHMY groups （3.645， 7.29， 14.58 g·kg^-1）， and a tamsulosin hydrochloride group （0.018 mg·kg^-1）. Hematoxylin-eosin （HE） staining was used to evaluate the pathological changes in prostate tissue. The inflammatory factor indicators of rats in each group were detected via enzyme-linked immunosorbent assay （ELISA）. Real-time fluorescence quantitative reverse transcription polymerase chain reaction （Real-time PCR） and Western blot were used to evaluate the mRNA and protein expression levels of phosphatidylinositol 3-kinase （PI3K）， protein kinase B （Akt）， and nuclear transcription factor-κB （NF-κB） p65 in prostate tissue. ResultsThe HE staining showed no significant signs of inflammatory cell infiltration in the prostate of the sham operation group compared to the blank group， while the model group had significantly inflammatory cell infiltration. The ELISA results showed that compared to the blank group， TNF-α， IL-1β， and COX-2 in the sham operation group had no significant differences. However， they were significantly higher in the model group （P<0.01）， indicating successful CP/CPPS modeling in rats. Compared with the model group， the low-，medium-and high-dose XFHMY group and the tamsulosin hydrochloride group showed significant decreases in TNF-α， IL-1β， and COX-2 （P<0.05，P<0.01）. The Real-time PCR analysis revealed that compared to the model group， the low-dose XFHMY group had reduced Akt and NF-κB p65 mRNA expression（P<0.05，P<0.01）. In the medium-and high-dose XFHMY group and tamsulosin hydrochloride group， PI3K， Akt， and NF-κB p65 mRNA levels decreased significantly（P<0.05，P<0.01）. Western blot analysis showed that compared to the model group， the low-dose XFHMY group had lower p-NF-κB p65/NF-κB p65 （P<0.05）. The medium- and high-dose XFHMY group and the tamsulosin hydrochloride group showed significant decreases in p-PI3K/PI3K， p-Akt-ser473/Akt， p-Akt-thr308/Akt， and p-NF-κB p65/NF-κB p65 （P<0.01）. ConclusionXFHMY may exert therapeutic efficacy on CP/CPPS by inhibiting the PI3K/Akt/NF-κB signaling pathway and reducing inflammatory responses. Additionally， NF-κB activation may be related to the activation of ser473 and thr308 sites.

Objective:To investigate the high-risk factors for early postoperative recurrence in patients with colorectal cancer liver metastasis (CRLM).Methods:The clinical data of 156 CRLM patients who underwent hepatic metastasectomy at the Li Huili Hospital, Ningbo University from Jan 2015 to Dec 2021 was retrospectively analyzed.Results:Among 156 patients, the postoperative recurrence rate was 55.8% (87/156).There were significant differences ( P<0.05) in the primary tumor site, T stage, TBS score, preoperative concentrations of CEA, CA199 and CA125, the maximum diameter of metastatic tumors and the number of metastatic tumors between the group with recurrence in one year and the group without recurrence in one year. Multivariate analysis showed that preoperative CA125 concentration ( OR=1.021, P=0.020), CEA concentration ( OR=1.044, P=0.018), and tumor burden score ( OR=3.067, P=0.011) were high risk factors influencing early recurrence ( P<0.05). In the low TBS score group(≤4), among the 49 patients who underwent simultaneous resection, 13 suffered from recurrence within 1 year, with a recurrence rate of 26.5%. Meanwhile, among the 29 patients who underwent staged resection, 17 suffered from recurrence within 1 year, with a recurrence rate of 58.6% ( P<0.05). In the high TBS score group(>4), among the 51 patients who underwent simultaneous resection, 37 suffered from recurrence within 1 year, with a recurrence rate of 72.5%, while in the 27 patients who underwent staged resection, 20 suffered from recurrence within 1 year, with a recurrence rate of 74.1% ( P>0.05). Conclusions:Preoperative TBS score, preoperative CA125 concentration, and CEA concentration are high-risk factors for postoperative recurrence in patients with colorectal liver metastases, simultaneous resection in patients with a low TBS score can reduce the risk of recurrence within 1 year after surgery.

Objective To explore the effects of gasless endoscopic thyroidectomy via axillary approach on neck function and aesthetic effect in patients with early thyroid tumor.Methods A prospective study was conducted on 116 patients with early thyroid tumor admitted to our hospital from December 2020 to December 2023.They were divided into the observation group and the control group according to block random method,with 58 cases in each group.Patients in the control group underwent open thyroidectomy,while patients in the observation group underwent gasless endoscopic thyroidectomy via axillary approach.The surgical indicators,neck function,cosmetic effect,and complications of patients in the two groups were compared.Results Compared with the control group,the observation group had a longer surgical time(P<0.05),less intraoperative bleeding and postoperative drainage volume(P<0.05).There were statistically significant differences in terms of the time point,inter-group and interaction effects of the neck injury index and the time point and inter-group effects of swallowing disorder index of patients between the two groups(P<0.05).Compared with 3 days after surgery,the neck injury index and swallowing disorder index at 6 months and 12 months after surgery of patients in both groups decreased(P<0.05),and the neck injury index and swallowing disorder index at 6 months and 12 months after surgery of patients in the observation group were lower than those in the control group(P<0.05).Compared with the control group,the observation group had better cosmetic effects(P<0.05).The total incidence of complications of patients in the observation group was lower than that in the control group(P<0.05).Conclusion Gasless endoscopic thyroidectomy via axillary approach has better efficacy for early thyroid tumor,which can effectively improve neck function and aesthetic effect,promote the recovery of patients,and has high safety and patient satisfaction.

This study investigated the effects and underlying mechanisms of vanillic acid(VA) against cardiac fibrosis(CF) induced by isoproterenol(ISO) in mice. Male C57BL/6J mice were randomly divided into control group, VA group(100 mg·kg~(-1), ig), ISO group(10 mg·kg~(-1), sc), ISO + VA group(10 mg·kg~(-1), sc + 100 mg·kg~(-1), ig), ISO + dynamin-related protein 1(Drp1) inhibitor(Mdivi-1) group(10 mg·kg~(-1), sc + 50 mg·kg~(-1), ip), and ISO + VA + Mdivi-1 group(10 mg·kg~(-1), sc + 100 mg·kg~(-1), ig + 50 mg·kg~(-1), ip). The treatment groups received the corresponding medications once daily for 14 consecutive days. On the day after the last administration, cardiac functions were evaluated, and serum and cardiac tissue samples were collected. These samples were analyzed for serum aspartate aminotransferase(AST), lactate dehydrogenase(LDH), creatine kinase-MB(CK-MB), cardiac troponin I(cTnI), reactive oxygen species(ROS), interleukin(IL)-1β, IL-4, IL-6, IL-10, IL-18, and tumor necrosis factor-α(TNF-α) levels, as well as cardiac tissue catalase(CAT), glutathione(GSH), malondialdehyde(MDA), myeloperoxidase(MPO), superoxide dismutase(SOD), total antioxidant capacity(T-AOC) activities, and cytochrome C levels in mitochondria and cytoplasm. Hematoxylin-eosin, Masson, uranium acetate and lead citrate staining were used to observe morphological and mitochondrial ultrastructural changes in the cardiac tissues, and myocardial injury area and collagen volume fraction were calculated. Flow cytometry was applied to detect the relative content and M1/M2 polarization of cardiac macrophages. The mRNA expression levels of macrophage polarization markers [CD86, CD206, arginase 1(Arg-1), inducible nitric oxide synthase(iNOS)], CF markers [type Ⅰ collagen(Coll Ⅰ), Coll Ⅲ, α-smooth muscle actin(α-SMA)], and cytokines(IL-1β, IL-4, IL-6, IL-10, IL-18, TNF-α) in cardiac tissues were determined by quantitative real-time PCR. Western blot was used to detect the protein expression levels of Coll Ⅰ, Coll Ⅲ, α-SMA, Drp1, p-Drp1, voltage-dependent anion channel(VDAC), hexokinase 1(HK1), NOD-like receptor protein 3(NLRP3), apoptosis-associated speck-like protein(ASC), caspase-1, cleaved-caspase-1, gasdermin D(GSDMD), cleaved N-terminal gasdermin D(GSDMD-N), IL-1β, IL-18, B-cell lymphoma-2(Bcl-2), B-cell lymphoma-xl(Bcl-xl), Bcl-2-associated death promoter(Bad), Bcl-2-associated X protein(Bax), apoptotic protease activating factor-1(Apaf-1), pro-caspase-3, cleaved-caspase-3, pro-caspase-9, cleaved-caspase-9, poly(ADP-ribose) polymerase-1(PARP-1), and cleaved-PARP-1 in cardiac tissues. The results showed that VA significantly improved cardiac function in mice with CF, reduced myocardial injury area and cardiac index, and decreased serum levels of AST, CK-MB, cTnI, LDH, ROS, IL-1β, IL-6, IL-18, and TNF-α. VA also lowered MDA and MPO levels, mRNA expressions of IL-1β, IL-6, IL-18, and TNF-α, and mRNA and protein expressions of Coll Ⅰ, Coll Ⅲ, and α-SMA in cardiac tissues, and increased serum levels of IL-4 and IL-10, cardiac tissue levels of CAT, GSH, SOD, and T-AOC, and mRNA expressions of IL-4 and IL-10. Additionally, VA ameliorated cardiac pathological damage, inhibited myocardial cell apoptosis, inflammatory infiltration, and collagen fiber deposition, reduced collagen volume fraction, and alleviated mitochondrial damage. VA decreased the ratio of F4/80~+CD86~+ M1 cells and the mRNA expressions of CD86 and iNOS in cardiac tissue, and increased the ratio of F4/80~+CD206~+ M2 cells and the mRNA expressions of CD206 and Arg-1. VA also reduced protein expressions of p-Drp1, VDAC, NLRP3, ASC, caspase-1, cleaved-caspase-1, GSDMD, GSDMD-N, IL-1β, IL-18, Bad, Bax, Apaf-1, cleaved-caspase-3, cleaved-caspase-9, cleaved-PARP-1, and cytoplasmic cytochrome C, and increased the expressions of HK1, Bcl-2, Bcl-xl, pro-caspase-3, pro-caspase-9 proteins, as well as the Bcl-2/Bax and Bcl-xl/Bad ratios and mitochondrial cytochrome C content. These results indicate that VA has a significant ameliorative effect on ISO-induced CF in mice, alleviates ISO-induced oxidative damage and inflammatory response, and its mechanism may be closely related to the inhibition of Drp1/HK1/NLRP3 and mitochondrial apoptosis signaling pathways, suppression of myocardial cell inflammatory infiltration and collagen fiber deposition, reduction of collagen volume fraction and CollⅠ, Coll Ⅲ, and α-SMA expressions, thus mitigating CF.
Animals ; Isoproterenol/adverse effects* ; Male ; Mice ; Signal Transduction/drug effects* ; Vanillic Acid/administration & dosage* ; Dynamins/genetics* ; Mice, Inbred C57BL ; Fibrosis/genetics* ; Apoptosis/drug effects* ; Mitochondria/metabolism* ; NLR Family, Pyrin Domain-Containing 3 Protein/genetics* ; Myocardium/metabolism* ; Humans

Objective To explore the effects of gasless endoscopic thyroidectomy via axillary approach on neck function and aesthetic effect in patients with early thyroid tumor.Methods A prospective study was conducted on 116 patients with early thyroid tumor admitted to our hospital from December 2020 to December 2023.They were divided into the observation group and the control group according to block random method,with 58 cases in each group.Patients in the control group underwent open thyroidectomy,while patients in the observation group underwent gasless endoscopic thyroidectomy via axillary approach.The surgical indicators,neck function,cosmetic effect,and complications of patients in the two groups were compared.Results Compared with the control group,the observation group had a longer surgical time(P<0.05),less intraoperative bleeding and postoperative drainage volume(P<0.05).There were statistically significant differences in terms of the time point,inter-group and interaction effects of the neck injury index and the time point and inter-group effects of swallowing disorder index of patients between the two groups(P<0.05).Compared with 3 days after surgery,the neck injury index and swallowing disorder index at 6 months and 12 months after surgery of patients in both groups decreased(P<0.05),and the neck injury index and swallowing disorder index at 6 months and 12 months after surgery of patients in the observation group were lower than those in the control group(P<0.05).Compared with the control group,the observation group had better cosmetic effects(P<0.05).The total incidence of complications of patients in the observation group was lower than that in the control group(P<0.05).Conclusion Gasless endoscopic thyroidectomy via axillary approach has better efficacy for early thyroid tumor,which can effectively improve neck function and aesthetic effect,promote the recovery of patients,and has high safety and patient satisfaction.

Objective:To investigate the high-risk factors for early postoperative recurrence in patients with colorectal cancer liver metastasis (CRLM).Methods:The clinical data of 156 CRLM patients who underwent hepatic metastasectomy at the Li Huili Hospital, Ningbo University from Jan 2015 to Dec 2021 was retrospectively analyzed.Results:Among 156 patients, the postoperative recurrence rate was 55.8% (87/156).There were significant differences ( P<0.05) in the primary tumor site, T stage, TBS score, preoperative concentrations of CEA, CA199 and CA125, the maximum diameter of metastatic tumors and the number of metastatic tumors between the group with recurrence in one year and the group without recurrence in one year. Multivariate analysis showed that preoperative CA125 concentration ( OR=1.021, P=0.020), CEA concentration ( OR=1.044, P=0.018), and tumor burden score ( OR=3.067, P=0.011) were high risk factors influencing early recurrence ( P<0.05). In the low TBS score group(≤4), among the 49 patients who underwent simultaneous resection, 13 suffered from recurrence within 1 year, with a recurrence rate of 26.5%. Meanwhile, among the 29 patients who underwent staged resection, 17 suffered from recurrence within 1 year, with a recurrence rate of 58.6% ( P<0.05). In the high TBS score group(>4), among the 51 patients who underwent simultaneous resection, 37 suffered from recurrence within 1 year, with a recurrence rate of 72.5%, while in the 27 patients who underwent staged resection, 20 suffered from recurrence within 1 year, with a recurrence rate of 74.1% ( P>0.05). Conclusions:Preoperative TBS score, preoperative CA125 concentration, and CEA concentration are high-risk factors for postoperative recurrence in patients with colorectal liver metastases, simultaneous resection in patients with a low TBS score can reduce the risk of recurrence within 1 year after surgery.

To investigate the associations of serum gamma-glutamyl transferase (GGT) levels with the risk of cardiovascular disease (CVD) and its subtypes in patients with type 2 diabetes mellitus (T2DM) in Jiangsu Province.Methods:The participants were enrolled in the Comprehensive Research project regarding 'Prevention and Control of Diabetes' in Jiangsu Province. The baseline survey was conducted from 2013 to 2014, and follow-up until December 31, 2021. After excluding the participants who self-reported with chronic liver disease/stroke/coronary heart disease at baseline survey and those with incomplete information on GGT, a total of 16 147 T2DM patients were included in the final analysis. Cox proportional hazard regression models were used to calculate the hazard ratio ( HR) and their 95% CI of GGT for CVD, myocardial infarction, and stroke. Restricted cubic spline models were applied to analyze the dose-response relationship between GGT and the risk of CVD and its subtypes. Results:During the median follow-up time of 8.02 years, 2 860 CVD cases were registered, including 196 cases of myocardial infarction and 2 730 cases of stroke. Multivariate Cox proportional risk regression model indicated that compared to the lowest serum GGT level group, the highest GGT level group had a 24% increased risk of CVD ( HR=1.24, 95% CI: 1.09-1.41) and a 23% increased risk of stroke ( HR=1.23, 95% CI: 1.08-1.40). The restricted cubic spline model showed a nonlinear dose-response relationship between GGT and the risk of CVD, myocardial infarction, and stroke in T2DM patients. Conclusions:High levels of GGT may be associated with an increased risk of cardiovascular disease in T2DM patients, which needs further exploration and validation in future clinical practice.

BACKGROUND:Stability of the support surface and visual input are important factors affecting static balance,but most of the studies on the balance ability of elderly with mild cognitive impairment have focused on the stable hard support surface,and the control of static balance on the unstable support surface under different visual input conditions is not known. OBJECTIVE:To investigate the static balance ability of the elderly with mild cognitive impairment on soft and hard support surfaces under different visual input conditions. METHODS:Twenty-one elderly people with mild cognitive impairment and nineteen elderly people with normal cognition were selected for the study,and the Kistler three-dimensional dynamometer was used to conduct four tests:standing with two feet on hard support surface with eyes open,standing with two feet on soft support surface with eyes open,standing with two feet on hard support surface with eyes closed,standing with two feet on soft support surface with eyes closed,and standing with two feet on soft support surface with eyes closed,and the duration of each test was 30 seconds.The plantar center of pressure data were collected and compared between the two groups under different visual conditions on the soft and hard support surfaces. RESULTS AND CONCLUSION:(1)Under the condition of visual input,the total excursions(soft support surface:P=0.003),the total excursions-medial-lateral sides(soft support surface:P=0.001,hard support surface:P<0.001)and the 95%confidence ellipse area(soft support surface:P=0.001,hard support surface:P<0.001)of the center of pressure in the elderly with mild cognitive impairment on the soft and hard support surfaces were significantly higher than those of the elderly with normal cognition.(2)In the absence of visual input,the root mean square distance(P=0.014),the root mean square distance-medial-lateral sides(P=0.014),and the 95%confidence ellipse area(P=0.001)of center of pressure in the elderly with mild cognitive impairment on the soft support surfaces were significantly higher than those of the elderly with normal cognition,but there were no significant differences between the groups on the hard support surface(P>0.05).(3)These findings confirm that compared with the elderly with normal cognition who could make full use of visual sensory input to maintain body balance on the soft and hard support surfaces,mild cognitive impairment elderly presented a deficit in balance function.In particular,mild cognitive impairment elderly relied more on ankle proprioception to maintain balance when visual interference was present,suggesting that mild cognitive impairment elderly should focus on strengthening ankle proprioceptive training.

The establishment of an intelligent audit system for hospital medical insurance is crucial for standardizing irrational practices and curbing the unwarranted escalation of medical insurance costs. A tertiary hospital has developed comprehensive prescription review rules in terms of indications, nutritional risk assessments, pain score evaluations, drug sensitivity test results, and target patient populations. When using medical insurance funds for settlement, both systematic and manual reviews are conducted, and three-level intervention measures such as " prompt, review, and interception" are implemented based on prescription issues. After the system was put into use, the hospital′s in-process information system supervision mode shifted from the previous focus on prompts to focus on audits. The medical insurance intelligent audit system provided timely prompts and interventions, and the number of unreasonable medical insurance prescriptions and deductions from medical insurance sampling prescriptions significantly decreased ( P<0.001), while the number of medical insurance medication prescription audits increased ( P<0.001). The application of the intelligent medical insurance medication audit system has improved the efficiency of prescription auditing and ensured the rationality of the use of medical insurance funds.

OBJECTIVE: To evaluate the prospective association between cumulative resting heart rate (cumRHR) and rapid renal function decline (RRFD) in a cohort of individuals aged 60 and older. METHODS: In the Tianjin Chronic Kidney Disease Cohort Study, the individuals who underwent three consecutive physical examinations between 2014 and 2017, with estimated glomerular filtration rate (eGFR) greater than 60 mL/min per 1.73 m² and aged 60 years or older were enrolled. A total of 27,564 patients were prospectively followed up from January 1, 2017 to December 31, 2020. The 3-year cumRHR was calculated. The primary outcome was RRFD, defined as an annualized decline in eGFR of 5 mL/min per 1.73 m² or greater. Logistic and restricted spline regression models and subgroup analysis were used to investigate the association of cumRHR with RRFD after adjusting for all confounders. RESULTS: During a median follow-up of 3.2 years, a total of 4,347 (15.77%) subjects developed RRFD. In fully-adjusted models, compared with the lowest quartile of cumRHR, the odds ratio (OR) for the highest was 1.44 (1.28-1.61), P < 0.001. Furthermore, each 1-standard deviation (27.97 beats/min per year) increment in cumRHR was associated with a 17% (P < 0.001) increased risk of RRFD, with a linear positive correlation (P for non-linear = 0.803). Participants with a 3-year cumRHR ≥ 207 (beats/min) * year (equivalent to ≥ 69 beats/min per year in 3 years) were found to be at a higher risk of RRFD. CONCLUSIONS The cumRHR is significantly associated with a higher risk of RRFD among older adults. These results might provide an effective goal for managing and delaying the decline of renal function in the older adults.