Objective To investigate the clinical efficacy of Xiaqi Decoction(mainly composed of Poria,Pinelliae Rhizoma Praeparatum,Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,Armeniacae Semen Amarum,Citri Grandis Exocarpium,Paeoniae Radix Alba,Polygoni Multiflori Radix,and Moutan Cortex)on patients with stage Ⅲ-Ⅳ colorectal cancer accompanied by cancer-related fatigue(CRF)after chemotherapy.Methods Sixty patients with stage Ⅲ-Ⅳ colorectal cancer accompanied by CRF after chemotherapy who admitted to Guangdong Second Traditional Chinese Medicine Hospital from January 2023 to March 2024 were randomly divided into chemotherapy group and Xiaqi Decoction group according to the random number table method,with 30 patients in each group.The chemotherapy group was given chemotherapy regimen of Avastin+mFOLFOX6/FOLFIRI,and Xiaqi Decoction group was given Xiaqi Decoction orally on the basis of treatment for the chemotherapy group.Two weeks constituted a course of treatment,and two consecutive courses of treatment were performed.Before and after treatment,the two groups were observed in the changes of Revised Piper Fatigue Scale(PFS-R)scores,EORTC Quality of Life Questionnaire-Core 30(QLQ-C30)scores,Patient-Generated Subjective Global Assessment(PG-SGA)scores,Karnofsky Performance Status(KPS)scores,poor appetite scores,and serum levels of interleukin 6(IL-6),tumor necrosis factor α(TNF-α),and interleukin 1β(IL-1β)were observed.After treatment,the clinical efficacy and safety between the two groups of patients were evaluated.Results(1)After two courses of treatment,the total effective rate of the Xiaqi Decoction group was 86.21%(25/29)and that of the chemotherapy group was 62.07%(18/29),and the intergroup comparison(tested by chi-square test)showed that the efficacy of Xiaqi Decoction group was significantly superior to that of chemotherapy group(P<0.05).(2)In the second and fourth weeks of chemotherapy,the PFS-R scores for evaluating the degree of fatigue of patients in the two groups were increased when compared with those in the day before chemotherapy(P<0.05),but the PFS-R scores in Xiaqi Decoction group were significantly lower than those in the chemotherapy group after chemotherapy(P<0.01).(3)In the second and fourth weeks of chemotherapy,the QLQ-C30 scores for evaluating the quality of life in the chemotherapy group was decreased when compared with that one day before chemotherapy(P<0.05),whereas the QLQ-C30 scores in the Xiaqi Decoction group showed no obvious changes when compared with that one day before chemotherapy(P>0.05).The intergroup comparison showed that the QLQ-C30 scores of the Xiaqi Decoction group were all significantly higher than those of the chemotherapy group after chemotherapy(P<0.01).(4)The evaluation of nutritional status showed that in the fourth week of chemotherapy,PG-SGA score and poor appetite score in the two groups as well as KPS score in Xiaqi Decoction group were increased when compared with those one day before chemotherapy(P<0.05),while the KPS score in the chemotherapy group was decreased when compared with that one day before chemotherapy(P<0.05).The intergroup comparison showed that PG-SGA score and poor appetite score of Xiaqi Decoction after chemotherapy were lower than those of the chemotherapy group,and the KPS score was higher than that of the chemotherapy group,the differences being statistically significant(P<0.05 or P<0.01).(5)In the chemotherapy group,the serum inflammatory factor levels of TNF-α and IL-6 in the second week of chemotherapy and the serum TNF-α,IL-1β and IL-6 levels in the fourth week of chemotherapy were all increased when compared with those one day before chemotherapy(P<0.05).In the Xiaqi Decoction group,the serum TNF-α,IL-1β,and IL-6 levels were all decreased when compared with those one day before chemotherapy,and significant differences were shown in the serum IL-6 level in the second week of chemotherapy and in the serum levels of IL-1β and IL-6 in the fourth week of chemotherapy when compared with those one day before chemotherapy(P<0.05).The intergroup comparison showed that serum TNF-α,IL-1β,and IL-6 levels in the Xiaqi Decoction group after chemotherapy were significantly lower than those in the chemotherapy group(P<0.05 or P<0.01).Conclusion Xiaqi Decoction is effective on relieving the clinical symptoms and enhancing the efficacy of patients receiving chemotherapy for stage Ⅲ-Ⅳ colorectal cancer.It can inhibit the expression of inflammatory factors,relieve the CRF and improve the nutritional status and the quality of life of the patients,with higher safety.

Objective To observe the therapeutic effect and mechanism of Xiaqi Decoction for mice with chemotherapy-induced cancer-related fatigue(CRF)in colon cancer.Methods The successfully constructed chemotherapy-induced CRF mouse model of colon cancer was randomly divided into the model control group and the Xiaqi Decoction group,with 10 mice in each group,and a blank control group was also set up.After each group was given the corresponding intervention,the mice exhaustive swimming time was determined,the tumor size was measured,the tumor inhibition rate was calculated,and the serum levels of inflammatory factors such as tumor necrosis factor(TNF)-α,interleukin(IL)-1β,IL-6 and other safety indicators such as alanine aminotransferase(ALT),aspartate aminotransferase(AST)and blood ureanitrogen(BUN)were detected by enzyme-linked immunosorbent assay(ELISA),the protein expression levels of Toll-like receptor 4(TLR4)and nuclear factor κB(NF-κB)p65 in the epithelial cells of tumor lumps(or axillary tissues)were detected by Western Blot.Results(1)Before treatment,the exhaustive swimming time of mice in the model control group was significantly less than that of the blank control group(P<0.01);after 28 days of treatment,the exhaustive swimming time of mice in the Xiaqi Decoction group was significantly longer than that of the model control group(P<0.01),and it was time-dependent.(2)The tumor size of mice in the Xiaqi Decoction group was gradually decreased from 4-28 days of treatment,and the tumor inhibition rate was 68.96%after 28 days of treatment.(3)The serum levels of TNF-α,IL-1β and IL-6 in the model control group were significantly higher than those in the blank control group(P<0.01);and the serum levels of TNF-α,IL-1β and IL-6 in the Xiaqi Decoction group were significantly lower than those in the model control group(P<0.05).(4)The serum levels of ALT,AST and BUN in the model control group were higher than those in the blank control group(P<0.05 or P<0.01);the serum levels of ALT,AST and BUN in the Xiaqi Decoction group were lower than those in the model control group(P<0.05).(5)The protein expression levels of TLR4 and NF-κB p65 in tumor epithelial cells of the model control group were higher than those of the blank control group(P<0.01);the protein expression levels of TLR4 and NF-κB p65 in tumor epithelial cells of the Xiaqi Decoction group were lower than those of the model control group(P<0.01).Conclusion Xiaqi Decoction can effectively promote physical recovery,and inhibit tumor growth in mice with chemotherapy-induced CRF of colon cancer,and its mechanism may be related to the inhibition of TLR4 and NF-κB p65 expression,thus to reduce the inflammatory response,with certain degree of safety.

Objective To investigate the mechanism of Gentianopsis paludosa xanthone(GPX)combined with probiotics in the intervention of colon inflammation-tumor transformation in rats by regulating TGF-β1/Smads pathway and inflammatory factors.Methods Ninety rats were divided into the normal group,the model group[drinking sodium dextran sulfate(DSS)for 3 days]and the intervention group by random number table method.The model group was subdivided into the inflammatory stage group,the pre-inflammatory cancer group(DMH injection for 4 weeks),the intermediate inflammatory cancer group(DMH injection for 13 weeks)and the advanced inflammatory cancer group(DMH injection for 21 weeks).The administration group was subdivided into the groups(after the first day of drinking DSS,drugs for each group were given by gavage once a day for 8 weeks)on the basis of the advanced inflammatory cancer group,including the GPX group(GPX 69.3 mg/kg),the probiotic group,the combined group(GPX+probiotics 400 mg/kg)and the thalidomide group(thalidomide 13.5 mg/kg).The disease activity index(DAI),colon length and wet mass index were compared between all groups.Characteristics of colon tumors were observed,and pathological changes of colon were observed by HE staining.The expression levels of transforming growth factor(TGF)-β1,Smad4,Smad7,interleukin(IL)-6 and tumor necrosis factor(TNF)-α were detected by Western blot assay and enzyme-linked immunosorbent assay,respectively.Results Compared with the advanced inflammatory cancer group,the administration groups showed an increase in colon length,the expression levels of TGF-β1 and Smad4 protein,a decrease in colon wall thickness,wet mass index,maximum tumor diameter,the levels of Smad7,IL-6,TNF-α,and DAI score decreased in the GPX group and the combined group(P＜0.05).The structure and morphology of intestinal mucosa were improved in the GPX group,the probiotic group and the combination group,and the structure of colonic crypt and goblet cell number were increased.Compared with the probiotic group and the GPX group,the colon wall thickness,colon wet mass index and tumor number were decreased,the protein expression levels of TGF-β1 and Smad4 were increased,and levels of IL-6 and TNF-α were decreased in the combination group(P＜0.05).Conclusion GPX combined with probiotics could inhibit the transformation of colon inflammation-tumor,and the mechanism may be related to the regulation of TGF-β1/Smads pathway and the inhibition of pro-inflammatory factors of IL-6 and TNF-α.

BACKGROUND:Diabetic osteoporosis is gaining public attention.However,few studies have reported the effect of a high-glucose environment on the osteogenic differentiation of human umbilical cord mesenchymal stem cells and the corresponding therapeutic strategies. OBJECTIVE:To investigate whether vitamin D3 can restore the osteogenic differentiation potential of human umbilical cord mesenchymal stem cells in a high-glucose environment. METHODS:The viability of human umbilical cord mesenchymal stem cells was detected by CCK-8 assay to screen the appropriate vitamin D3 intervention concentration.Under the high-glucose environment,RT-qPCR,western blot assay,immunofluorescence,JC-1 mitochondrial membrane potential,alizarin red staining,and β-galactosidase staining were used to evaluate the osteogenic differentiation potential,intracellular reactive oxygen species accumulation,mitochondrial membrane potential alteration,and cell senescence of human umbilical cord mesenchymal stem cells after vitamin D3 intervention.The underlying mechanism was also discussed. RESULTS AND CONCLUSION:(1)Vitamin D3 significantly promoted the proliferation of human umbilical cord mesenchymal stem cells in the range of 0.1 μmol/L to 1 mmol/L.(2)High-glucose environment down-regulated the mRNA and protein level expressions of osteogenic-related genes α1-I collagen,alkaline phosphatase,Runt-associated transcription factor 2,and osteocalcin in human umbilical cord mesenchymal stem cells,which induced oxidative stress and cellular senescence.(3)Vitamin D3 at an intervention concentration of 10 μmol/L significantly restored the osteogenic phenotype of human umbilical cord mesenchymal stem cells under high-glucose conditions and attenuated intracellular oxidative stress and cellular senescence by activating the Nrf2/HO-1 signaling pathway.(4)These findings suggested that the osteogenic differentiation ability of human umbilical cord mesenchymal stem cells was reduced in the high-glucose environment,and vitamin D3 could partially improve their osteogenic differentiation ability and reduce cell damage.

BACKGROUND:Osteoporosis has a high incidence,leading to fracture and other complications.However,existing drugs have great side effects and are difficult to meet the clinical application. OBJECTIVE:To explore the effect and potential mechanism of fucoxanthin on osteoporosis induced by glucocorticoid. METHODS:Primary rat osteoblasts were inoculated in 6-well plates.When the cell fusion reached 80%,the cells were divided into four groups:the control group was cultured alone for 24 hours,the glucocorticoid group was intervened with dexamethasone for 24 hours,the fucoxanthin group was intervened with fucoxanthin for 24 hours,and the glucocorticoid + fucoxanthin group was intervened with dexamethasone and fucoxanthin at the same time for 24 hours.After intervention,cell proliferation,apoptosis,intracellular reactive oxygen species level,and protein expression of apoptosis-related proteins,bone formation-related proteins,and nuclear factor erythroid-2-related factor 2 were detected. RESULTS AND CONCLUSION:Cell counting kit-8 results showed that the cell viability was decreased in the glucocorticoid group compared with the control group(P＜0.05)but increased in the glucocorticoid+fucoxanthin group compared with the glucocorticoid group(P＜0.05).JC-1 mitochondrial membrane potential staining and flow cytometry assay showed that the percentage of apoptosis increased in the glucocorticoid group compared with the control group(P＜0.05)but decreased in the glucocorticoid+fucoxanthin group compared with the glucocorticoid group(P＜0.05).Western blot assay showed that compared with the control group,the protein expression of BAX and cleaved poly(ADP-ribose)polymerase was elevated in the glucocorticoid group(P＜0.05),and the protein expression of BCL2,type Ⅰ collagen α1 peptide chain,alkaline phosphatase,osteocalcin,and RUNX2 was decreased in the glucocorticoid group(P＜0.05).Compared with the glucocorticoid group,the protein expression of BAX and cleaved poly(ADP-ribose)polymerase was decreased(P＜0.05),and the protein expression of BCL2,type Ⅰ collagen α1 peptide chain,alkaline phosphatase,osteocalcin,and RUNX2 was elevated(P＜0.05)in the glucocorticoid+fucoxanthin group.Fluorescent probe assay showed an increase in reactive oxygen species level in the glucocorticoid group compared with the control group(P＜0.05)and a decrease in reactive oxygen species level in the glucocorticoid+fucoxanthin group compared with the glucocorticoid group(P＜0.05).Immunofluorescence staining and western blot assay showed that the protein expression of nuclear factor erythroid-2-related factor 2 in the glucocorticoid group was decreased compared with that in the control group(P＜0.05);and the protein expression of nuclear factor erythroid-2-related factor 2 in the glucocorticoid+fucoxanthin group was elevated compared with that in the glucocorticoid group(P＜0.05).To conclude,fucoxanthin can improve glucocorticoid-induced osteoblast apoptosis and the expression of bone formation-related molecules by activating nuclear factor erythroid-2-related factor 2.

Objective We aimed to investigate the effects of Biejiajian Pills on MHCC-97H hepatoma cells and whether Biejiajian Pills regulate the epidermal growth factor receptor (EGFR)/mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK) signaling pathway through miR-885-5p.Methods SPF SD rats (n = 10) were randomly divided into the blank group and the Biejiajian Pills (1.1 g/kg) group to prepare blank and Biejiajian Pills-containing serum. MHCC-97H cells in the logarithmic growth phase were divided into the model group, blank serum groups with different concentrations (5％, 10％, 15％, and 20％), the serum containing Biejiajian Pills group, and the blank group without cells. Cell proliferation was detected by the CCK-8 assay, and the optimal intervention time and concentration of drug-containing serum were screened. MHCC-97H cells were divided into the blank control group (no intervention), the Biejiajian Pills-containing serum group (20％ Biejiajian Pills-containing serum), the miR-885-5p mimics group (transfected with miR-885-5p mimics), the miR-NC group (transfected with miR-885-5p NC), and the Biejiajian Pills-containing serum + miR-885-5p mimics group (treated with 20％ Biejiajian Pills-containing serum and transfected with miR-885-5p mimics). Cells in each group were cultured for 72 hours. A dual luciferase reporter assay was conducted to verify the targeting relationship between miR-885-5p and EGFR. Cell proliferation was detected by the CCK-8 assay, cell migration and invasion abilities were detected by the cell scratch assay and the Transwell invasion assay. Annexin V-APC/PI double staining was performed to detect the apoptosis level, and real-time fluorescence quantitative PCR (RT-qPCR) analysis was conducted to determine the mRNA expression levels of miR-885-5p, EGFR, MEK, and ERK1/2. The expression levels of EGFR, p-EGFR, MEK, p-MEK, ERK1/2, p-ERK1/2, matrix metalloproteinase 1 (MMP1), and CyclinD1 were determined by Western blotting analysis. The subcutaneous tumor model of MHCC-97H hepatoma cells in nude mice was established by subcutaneous injection to observe the inhibitory effect of Biejiajian Pills of different doses(0.55,1.1,2.2 g/kg).Results The optimal concentration and intervention time of Biejiajian Pills-containing serum were 20％ and 72 hours, respectively. Meanwhile, the dual luciferase reporter assay showed that miR-885-5p could directly target EGFR. No statistical significances between the blank control group and the miR-NC group were observed (P>0.05). Compared with the blank control group, the proliferation rates of MHCC-97H hepatoma cells in the Biejiajian Pills-containing serum group, the miR-885-5p mimics group, and the Biejiajian Pills-containing serum + miR-885-5p mimics group were significantly decreased (P<0.01), and their migration and invasion abilities were significantly decreased (P<0.05, P<0.01). At the same time, the protein expression levels of CyclinD1 and MMP1, which are closely related to cell proliferation and invasion, were significantly downregulated (P<0.05, P<0.01). The proportions of late apoptotic cells and the proportion of total apoptotic cells were significantly increased (P<0.01). In the Biejiajian Pills-containing serum group, the miR-885-5p mimics group, and the Biejiajian Pills-containing serum + miR-885-5p mimics group, miR-885-5p mRNA was significantly upregulated (P<0.01) and EGFR, MEK, and ERK1/2 were significantly downregulated at the mRNA level (P<0.05, P<0.01). EGFR, MEK, and ERK1/2 phosphorylation was inhibited (P<0.01), and the Biejiajian Pills-containing serum + miR-885-5p mimics group showed the best effect (P<0.05, P<0.01). The subcutaneous liver tumor model in nude mice verified that Biejiajian Pills can inhibit tumor growth in a dose-dependent manner. Conclusion Biejiajian Pills can promote apoptosis of MHCC-97H hepatoma cells and inhibit their proliferation, invasion, and migration. The mechanism may be related to the targeted regulation of the EGFR/MAPK/ERK signaling pathway by miR-885-5p.

After participating in the student selection training and on-site refereeing of the clinical examination skills competition for college students in Sichuan-Chongqing region twice in succession, the author combined the on-site performance and competition results of the participating students with pre-match training experience and normal teaching experience. A comprehensive analysis found that the students' proficiency in basic testing skills, psychological quality and humanistic quality have an important impact on the results of the competition. Teachers should not only pay attention to the quality of basic skills training and theoretical knowledge teaching in practical teaching, but also pay attention to the cultivation of students' teamwork ability and good working habits. Therefore, the clinical laboratory skills competition has a strong leading role in promoting the education and teaching reform of medical laboratory technology and improving the quality of professional practice teaching. It is hoped that more medical colleges and universities will pay attention to and participate in it, and further promote the development of practical teaching of medical laboratory technology.

Objective:To investigate the relationship between urate deposition on ultrasound and coronary artery calcification score in maintenance hemodialysis (MHD) patients.Methods:A total of 100 stable MHD patients undergoing hemodialysis for at least one year were enrolled in this study. All the patients had clinical and ultrasound examination at both knees, ankles and first metatarsophalangeal joints. Subgroup analysis was done depending on whether double contour sign (DCS) or tophus was found on ultrasound. The volume of coronary artery calcification (CAC) score were determined by a 64-slice CT. Main statistical analysis methods were t test, chi-square test, Spearman correlation and logistic regression model. Results:Among these 100 patients, DCS was found in 35 (35%) patients and tophus was found in 21 (21%) patients. The serum uric acid level, serum phosphate (P), parathyroid hormone (PTH), C-reactive protein (CRP) and incidence of CAC, CAC score of the DCS positive group [(629±61) μmol/L, (2.4±0.8) mmol/L, (658±56) pg/ml, (9.5±2.1) mg/L, 83%(29/35), (276±37), n=35] was significantly higher than the DCS negative group [(569±68) μmol/L, (2.0±0.6) mmol/L, (536±49) pg/ml, (7.9±3.1) mg/L, 59% (38/65), (219±42), n=65] ( t=4.322 6, P<0.01; t=2.712 6, P<0.01; t=11.293 1, P<0.01; t=2.700 3, P<0.01; t=5.070 1, P=0.024 3; t=6.827 6, P<0.01). The serum uric acid level was positively correlated with urate deposition on ultrasound ( r=0.317, P<0.05), which was positively correlated with CAC score ( r=0.302, P<0.05). The serum uric acid level, urate deposition on ultrasound and CAC score were all positively correlated with CRP ( r=0.298, P<0.05; r=0.345 , P<0.05; r=0.336, P<0.05) . Multivariate logistic regression analysis showed that the serum uric acid level and CRP were independent risk factors for positive DCS in MHD patients [ OR=3.040, 95% CI (1.507, 6.133); OR=3.438, 95% CI(1.822,6.489)]. Positive DCS and CRP were independent risk factors for CAC [ OR=3.504, 95% CI (1.414, 9.684); OR=3.885, 95% CI(1.364, 11.063)]. Conclusion:In MHD patients, positive DCS is related with high serum uric acid level and CRP. Positive DCS and CRP are independent risk factors for CAC.

Objective To explore the clinical effect of SaO2and heart rate(HR)for the diagnosis of acute mountain sickness (AMS).Methods A total of 1 062 male soldiers on garrison duty in rapidly entering to high altitude at 3 700-5 400 m from May 2013 to August 2015 were included as the research subjects.The demography data were collected and the AMS symptoms investiga-tion was performed.SaO2and HR were detected and the relationship between SaO2and HR at different altitudes with AMS symp-tom score was analyzed.Results The cut-off value of SaO2for diagnosing AMS in rapidly entering to high altitude at 3 700-<4 300 m was 84.5%(AUC=0.781)with the screening sensitivity of 78.31% and specificity of 72.02%;which of HR for diag-nosing AMS was 89.5 times/min(AUC=0.640)with the screening sensitivity of 71.27% and specificity of 54.63%.When SaO2 was serially connected with HR,its sensitivity was 58.87% and the specificity was 89.23%,while the parallel connection yielded a sensitivity of 90.70% and a specificity of 37.43%.In rapidly entering the altitude at above 5000 m,the cut-off value of SaO2for di-agnosing AMS was 80.5%(AUC=0.825)with the screening sensitivity of 84.62% and specificity of 68.85%;which of HR for di-agnosing AMS was 93.5 times/min(AUC= 0.718)with the screening sensitivity of 53.00% and specificity of 85.25%;when SaO2was serially connected with HR,its sensitivity for diagnosing AMS was 47.01% and specificity was 93.44%,while the paral-lel connection yielded a sensitivity of 90.60% and a specificity of 60.66%.Conclusion SaO2combined with HR can serve as an ob-jective index for the on-site diagnosis of AMS and is convenient for the AMS preliminary screening of large populations.