OBJECTIVE: To observe the clinical effect of needle cauterization on vitiligo with deficiency cold and blood stasis. METHODS: A total of 62 patients of vitiligo with deficiency cold and blood stasis were randomly divided into an observation group and a control group, 31 cases each group.On the basis of 308 nm excimer light irradiation combined with ironing with Chinese medicine, the control group was treated with tacrolimus ointment for external use, twice a day; the observation group was treated with needle cauterization at vitiligo spots, once a week.Both groups were treated for 10 weeks. Before and after treatment, the area of vitiligo spot, TCM syndrome score, serum levels of inflammatory indexes (interleukin[IL]-6 and IL-17) were observed in the two groups, and the clinical effect was evaluated. RESULTS: After treatment, the areas of vitiligo spot, TCM syndrome scores and serum levels of IL-6, IL-17 were decreased compared with those before treatment in both groups (P<0.05), and the above indexes in the observation group were lower than those in the control group (P<0.05). The total effective rate in the observation group was 93.5% (29/31), which was higher than 77.4% (24/31) in the control group (P<0.05). CONCLUSION Needle cauterization could reduce the areas of vitiligo spot in patients of vitiligo with deficiency cold and blood stasis, improve the clinical symptoms, its mechanism may be related to the reduction of serum levels of inflammatory indexes.
Humans ; Vitiligo/physiopathology* ; Male ; Female ; Adult ; Young Adult ; Middle Aged ; Adolescent ; Interleukin-6/blood* ; Interleukin-17/blood* ; Cautery ; Acupuncture Therapy/instrumentation* ; Needles ; Cold Temperature ; Treatment Outcome

This study was aimed at analyzing the biotypes and genetic diversity characteristics of five non-major Brucella species,to provide a scientific basis for understanding the species diversity of Brucella and strengthening pathogen monitoring and control.According to the biotypes(species,hosts,isolation locations,and time)and MLVA-16 genotypes(MLVA-16 lo-cus data,MLVA-11 genotypes)of five non-major pathogenic Brucella in the international MLVA database,we used Bionu-merics 8.0 software and PHYLOVIZ2.0 online software to analyze the geographical origin and genetic diversity characteristics of strains.A total of 227 strains were studied,including 121 Brucella ceti,47 B.pinnipedialis,37 Brucella ovis,11 B.mi-croti,and Brucella neotomae.The greatest host diversity was observed for B.ceti,followed by B.pinnipedialis and B.mi-croti.B.ceti was distributed in European and South American countries;B.pinnipedialiswas distributed in Europe;and B.microti.was distributed in the Czech Republic,Austria,and Hungary in Central Europe.B.ovis was widely distributed in Af-rica,Argentina,Australia,Brazil,Greece,the United States,Spain,and France.The MLVA-11 genotypes of different types of Brucella showed high polymorphism and large differences,thus suggesting that the strains have different geographical ori-gins.MST analysis indicated that the studied strains were divided into four branches(BCⅠ-Ⅳ),among which B.ceti was di-vided into two different branches(BC-Ⅰ and BC-Ⅱ),the strains of other types formed different branches(or sub-branches),and the strains of different types showed clear regional and dominant host characteristics.Genetic correlation analysis of strains of the Brucella genus revealed that non-major pathogenic Brucella had clear genetic,distribution,and host spectrum differ-ences with respect to four classical pathogenic Brucella species.Five non-major pathogenic Brucella strains presented unique genetic evolutionary patterns,geographical distributions,and host tropism characteristics,thereby providing new insight for understanding the biological and genetic diversity of those Brucella strains.

Objective To explore changes of topological properties and functional connectivity(FC)of global brain network in breast cancer(BC)patients accompanied by emotional disorders.Methods Forty-three female BC patients(BC group)and 43 age-and education-matched healthy controls(HC group)were prospectively enrolled.The scores of fear of cancer recurrence-total(FCR-total),fear of cancer recurrence inventory(FCRI),general anxiety disorder-7(GAD-7)and patient health questionnaire-9(PHQ-9)for 43 patients in BC group,as well as of anxiety sensitivity index-3(ASI-3),meta-cognitions about health questionnaire(MCQ-HA)and EuroQoL 5-dimension 5-level questionnaire(EQ-5D-5L)for 40 patients in BC group were obtained to evaluate emotional disorders.Meanwhile,the scores of GAD-7 and PHQ-9 were obtained in HC group to exclude for anxiety and depression.Using resting-state functional MRI(rs-fMRI),topological attributes and FC of global brain network were analyzed,and the topological attribute indicators of global brain network were compared between groups.Based on voxel-wise analysis,the regions in global brain related to FC strength(FCS)correlated with each clinical scale score in BC group were analyzed,and spatial similarity analysis of FCS was performed.The correlations of FCS at brain region level and clinical scale scores in BC group were observed.Results All patients in BC group were accompanied by emotional disorders.The clustering coefficient in BC group was lower than that in HC group(t=-2.261,P=0.027).Brain regions related to FCS values correlated with each clinical scale score in BC group were widely distributed in sensorimotor network and higher-order brain network,etc.,and their FCS values were correlated.FCS of ventrolateral nucleus of right thalamus and caudate nucleus were positively correlated with FCR-total(r=0.459,P=0.004)and FCRI(r=0.488,P=0.005).Conclusion BC patients with emotions disorders had dysfunction of brain functional segregation,as well as enhanced FCS in brain regions such as ventrolateral nucleus of right thalamus and caudate nucleus.

Objective:To investigate the correlation between lung ultrasound score(LUS)and oxygenation index(OI),and between it and the ratio of arterial oxygen partial pressure(PaO2)to fraction of inspired oxygen(PaO2/FiO2)in patients with acute respiratory distress syndrome(ARDS)in intensive care unit(ICU).Methods:The documents of 168 ARDS patients who admitted to ICU of People's Hospital of Ningxia Hui Autonomous Region from June 2023 to June 2024 were retrospectively selected.According to the patients'prognosis,they were divided into survival group(114 cases)and death group(54 cases).The clinical documents,laboratory indexes including PaO2/FiO2 and LUS results of patients in the surviving group and the death group were collected and compared,and the effects of LUS and PaO2/FiO2 on the prognosis of ARDS patients were analyzed by logistic regression.The predictive value of LUS and PaO2/FiO2 on the prognosis of ARDS patients was analyzed by the receiver operating characteristics(ROC)curve.Finally,the correlation between LUS and PaO2/FiO2 of patients was analyzed by using Pearson analysis.Results:There were significant differences in age,Acute Physiology and Chronic Health Evaluation II(APACHE II)score,mean arterial pressure(MAP),ratio of E peak to A peak of mitral valve velocity,positive end expiratory pressure(PEEP),tidal volume(VT),PaO2/FiO2,and LUS between the death group and the survival group,and the differences were statistically significant(t=8.456,2.073,6.780,3.361,3.204,2.925,7.801,12.210,P<0.05),respectively,in which the PaO2/FiO2 level[(180.67±25.61)mmHg]of the death group was significantly lower than that[(217.87±34.70)mmHg]of the survival group,and the LUS score[(21.00±3.97)point]was higher than that[(13.63±3.50)point]of the survival group.The PaO2/FiO2 was a protective factor for the prognosis of ARDS patients(OR=0.943,P<0.05),while LUS was a risk factor(OR=2.729,P<0.05).The area under curve(AUC)values of PaO2/FiO2 and LUS were respectively 0.802 and 0.919 in predicting the prognosis of ARDS patients.LUS and PaO2/FiO2 levels showed a negative correlation(R=-0.707,P<0.001).Conclusion:Both LUS and PaO2/FiO2 have better predictive effect for the prognosis of ARDS patients,and LUS can be used in the early prediction for the oxygenation status and the assessment about prognosis of ARDS patients,and the subsequent guideline for formulating therapeutic measures in clinical practice.

Aim To investigate the anti-acute lung injury(ALI)effect of Sterculiae Lychnophorae Semen(SLS)and its mechanism.Methods The main ac-tive components of SLS and their core targets and path-ways of action against ALI were obtained by network pharmacology methods.Subsequently,molecular doc-king technology and in vitro cellular experiments were applied for validation.Results A total of 19 core tar-gets were obtained,including HSP90AA1,CASP3,TNF,MAPK8 and MAPK14.The mechanisms may in-volve signaling pathways such as cancer,PI3K/Akt and MAPK.Molecular docking confirmed that the key targets of SLS formed a better binding activity with the relevant active ingredients.The in vitro results showed that SLS was able to protect the PM2.5-contaminated BEAS-2B cells,inhibit their NO,IL-1β and TNF-αlevels,and reduce the expression of p-p38 MAPK and p-JNK proteins.Conclusions The study successfully predicts the active ingredients,targets and signaling pathways of SLS against ALI,and in vitro experiments demonstrate that SLS might protect BEAS-2B cells from PM2.5 stimulus-induced inflammation and apoptosis by inhibiting the over-activation of p38 MAPK and JNK signaling pathways.

AIM:The study aims to investigate the effects of Huayu-Qutan formula(HYQT)-medicated serum on oleic acid-induced lipid damage and endoplasmic reticulum stress(ERS)in HepG2 cells,and to explore the mecha-nism underlying the prevention and treatment of lipid metabolism disorders by HYQT.METHODS:The HepG2 cells were treated with various concentrations of oleic acid,and CCK8 assay,oil red O staining and ELISA were used to identify the optimal treatment concentration and time of oleic acid and HYQT-medicated serum.Moreover,the cells were divided into control,model,thapsigargin(Tg),and Tg+HYQT groups.Cellular lipid deposition was measured using oil red O staining,while triglyceride(TG)and free fatty acid(FFA)levels were assessed by ELISA.Transmission electron micros-copy was used to examine endoplasmic reticulum structures,and RT-qPCR and Wes fully automated protein quantification analysis system were used to measure the mRNA and protein expression of glucose-regulated protein 78(GRP78),sterol regulatory element binding protein 1c(SREBP1c),acetyl coenzyme A carboxylase(ACC1),fatty acid synthase(FAS)and stearoyl coenzyme A desaturase 1(SCD1)in different groups.RESULTS:Significant lipid deposition was induced in HepG2 cells after treatment with 1 000 μmol/L oleic acid,while treatment with serum containing 10%HYQT for 48 h was found to be optimal.Compared with control group,the cells in model group showed significant deposition of oil red O-stained lipid droplets in the cytoplasm,associated with endoplasmic reticulum expansion,ERS,and nuclear condensa-tion.The TG and FFA levels,and the mRNA and protein expression levels of GRP78,SREBP1c,ACC1,FAS and SCD1 were increased significantly(P<0.01).Compared with model group,the cells treated with HYQT-mediated serum showed marked decrease in the number of lipid droplets in the cytoplasm,with restored endoplasmic reticulum morphology.The TG and FFA levels were significantly reduced(P<0.01),and the mRNA and protein levels of factors related to ERS and de novo fatty acid synthesis were markedly decreased(P<0.01).Treatment with Tg,an ERS agonist,led to greater accu-mulation of cytoplasmic lipid droplets and increased endoplasmic reticulum expansion.Marked variations in the morpholo-gy and size of the endoplasmic reticulum were observed,with fusion and clustering of vacuoles.The TG and FFA levels,and the expression of ERS-and fatty acid synthesis-related factors were increased(P<0.01).Compared with Tg group,the cells treated with Tg+HYQT showed reduced number of cytoplasmic lipid droplets,attenuated endoplasmic reticulum dilation,and decreased number and volume of vacuoles,while the TG and FFA levels and the expression of ERS-and fatty acid synthesis-associated factors were significantly decreased(P<0.01).CONCLUSION:Serum containing HYQT alle-viates oleic acid-induced lipid damage in HepG2 cells by inhibiting ERS-induced de novo synthesis of fatty acids.

Objective To analyze the correlation between expression levels of protein arginine methyltransferase 2(PRMT2),TNF receptor associated factor 2(TRAF2)and metastasis-related genes in clear cell renal cell carcinoma(ccRCC)and their evaluation value for prognosis.Methods A total of 110 patients with ccRCC were selected.The expression levels of PRMT2,TRAF2 protein and mRNA,and the expression of metastasis-related genes[N-cadherin(N-cad),E-cadherin(E-cad),vascular endothelial growth factor A(VEGFA),vascular endothelial growth factor C(VEGFC)]were detected in cancer tissue and paracancer tissue.Pearson correlation analysis was used to analyze the correlation between PRMT2,TRAF2 mRNA and metastasis-related genes,and the effect of PRMT2 and TRAF2 expression on the prognosis of ccRCC patients.Results The mRNA expression levels of PRMT2,TRAF2,N-cad,VEGFA and VEGFC were higher in ccRCC cancer tissue than those in adjacent tissue,and E-cad was lower in ccRCC cancer tissue than that in adjacent tissue(P＜0.01).PRMT2 and TRAF2 mRNA were positively correlated with N-cad,VEGFA and VEGFC mRNA expression,and negatively correlated with E-cad mRNA expression in cancer tissue(P＜0.01).The positive rates of PRMT2 protein and TRAF2 protein in ccRCC cancer tissue were higher than those in adjacent tissue(P＜0.01).The positive rates of PRMT2 and TRAF2 protein in TNM stage III cancer tissue were higher than those in TNM stage I-II cancer tissue(P＜0.05).The 3-year progression-free survival rate of the PRMT2 and TRAF2 positive group was lower than that of the negative group(P＜0.05).TNM stage III,PRMT2 positive and TRAF2 positive were risk factors affecting the progression-free survival prognosis of ccRCC patients(P＜0.05).Conclusion The expression levels of PRMT2 and TRAF2 are up-regulated in ccRCC,which are related to the expression of metastasis-related genes and TNM stage of tumor,and can be used as the marker for evaluating the prognosis of ccRCC.

AIM:The study aims to investigate the effects of Huayu-Qutan formula(HYQT)-medicated serum on oleic acid-induced lipid damage and endoplasmic reticulum stress(ERS)in HepG2 cells,and to explore the mecha-nism underlying the prevention and treatment of lipid metabolism disorders by HYQT.METHODS:The HepG2 cells were treated with various concentrations of oleic acid,and CCK8 assay,oil red O staining and ELISA were used to identify the optimal treatment concentration and time of oleic acid and HYQT-medicated serum.Moreover,the cells were divided into control,model,thapsigargin(Tg),and Tg+HYQT groups.Cellular lipid deposition was measured using oil red O staining,while triglyceride(TG)and free fatty acid(FFA)levels were assessed by ELISA.Transmission electron micros-copy was used to examine endoplasmic reticulum structures,and RT-qPCR and Wes fully automated protein quantification analysis system were used to measure the mRNA and protein expression of glucose-regulated protein 78(GRP78),sterol regulatory element binding protein 1c(SREBP1c),acetyl coenzyme A carboxylase(ACC1),fatty acid synthase(FAS)and stearoyl coenzyme A desaturase 1(SCD1)in different groups.RESULTS:Significant lipid deposition was induced in HepG2 cells after treatment with 1 000 μmol/L oleic acid,while treatment with serum containing 10%HYQT for 48 h was found to be optimal.Compared with control group,the cells in model group showed significant deposition of oil red O-stained lipid droplets in the cytoplasm,associated with endoplasmic reticulum expansion,ERS,and nuclear condensa-tion.The TG and FFA levels,and the mRNA and protein expression levels of GRP78,SREBP1c,ACC1,FAS and SCD1 were increased significantly(P<0.01).Compared with model group,the cells treated with HYQT-mediated serum showed marked decrease in the number of lipid droplets in the cytoplasm,with restored endoplasmic reticulum morphology.The TG and FFA levels were significantly reduced(P<0.01),and the mRNA and protein levels of factors related to ERS and de novo fatty acid synthesis were markedly decreased(P<0.01).Treatment with Tg,an ERS agonist,led to greater accu-mulation of cytoplasmic lipid droplets and increased endoplasmic reticulum expansion.Marked variations in the morpholo-gy and size of the endoplasmic reticulum were observed,with fusion and clustering of vacuoles.The TG and FFA levels,and the expression of ERS-and fatty acid synthesis-related factors were increased(P<0.01).Compared with Tg group,the cells treated with Tg+HYQT showed reduced number of cytoplasmic lipid droplets,attenuated endoplasmic reticulum dilation,and decreased number and volume of vacuoles,while the TG and FFA levels and the expression of ERS-and fatty acid synthesis-associated factors were significantly decreased(P<0.01).CONCLUSION:Serum containing HYQT alle-viates oleic acid-induced lipid damage in HepG2 cells by inhibiting ERS-induced de novo synthesis of fatty acids.

Objective To evaluate the efficacy and safety of enteric-coated metformin hydrochloride capsules(Junlida?)in patients with T2DM and poor glycemic control under lifestyle interventions.Methods In this study,419 patients with T2DM were recruited from 15 research centers from July 2020 to March 2022,and randomly divided into observation(Obs)group(n=209)and control group(Con,n=210)using a multicenter,randomized,double-blind,non-inferiority trial design.Patients in the Obs group were treated with enteric-coated Metformin hydrochloride capsules(Junlida?),and patients in the Con group were treated with Metformin hydrochloride tablets(Glucophage?).The optimal effective dose of 2 g/d was achieved within 4 weeks,and the reasonable dose was maintained until the end of treatment.The treatment period was 24 weeks.HbA1c and its compliance rate,FPG,and body weight were compared between the two groups in full analysis set(FAS)and protocol set(PPS).Safety and adverse events(AE)were evaluated in safety set(SS).Results A total of 414 participants were randomized(207 cases in Obs group and 207 cases in Con group).414 cases in FAS population(207 cases in Obs group and 207 cases in Con group),and 328 cases in PPS population(164 cases in Obs group and 164 cases in Con group),and 414 cases in SS population(207 cases in Obs group and 207 cases in Con group).After treatment,HbA1c,FPG and body weight were lower in both groups(P<0.05)in FAS and PPS.HbA1c compliance rate was not significantly different between the two groups in FAS and PPS(P>0.05).The results of non-inferiority test showed that the lower limit was>-0.4%in both FAS(-0.154,95%CI-0.384～0.069)and PPS(-0.139,95%CI-0.390～0.112),and the Obs group reached non-inferiority end point.The achievement rate,compliance rate,safety index and incidence of AE were not significantly different between the two groups(P>0.05).Conclusions Junlida? demonstrated non-inferiority to Glucophage? in glycemic control and can be safely and effectively used in patients with diabetes.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.