ObjectiveBased on the theory of "Yang transforming Qi while Yin constituting form"， this study aimed to evaluate the clinical efficacy and safety of Juanyin Xiefei prescription combined with noninvasive ventilation in patients with moderate-to-severe obstructive sleep apnea-hypopnea syndrome （OSAHS） with the phlegm-dampness obstruction pattern. MethodsA total of 84 patients with moderate-to-severe OSAHS with the phlegm-dampness obstruction pattern were enrolled and randomly assigned to a treatment group （42 cases） and a control group （42 cases）. The control group received noninvasive ventilation combined with lifestyle intervention， while the treatment group received Juanyin Xiefei prescription in addition to the same regimen. The treatment course lasted 8 weeks. The apnea-hypopnea index （AHI）， lowest oxygen saturation （LSpO₂）， Epworth Sleepiness Scale （ESS） score， traditional Chinese medicine （TCM） syndrome scores， and serum levels of interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， superoxide dismutase （SOD）， and testosterone were measured before and after treatment and statistically analyzed. ResultsTwo cases were lost to follow-up in each group. Thus， 40 patients in the treatment group and 40 in the control group were included in the final analysis. There were no significant differences between the two groups in sex， age， disease duration， or comorbidities at baseline， indicating comparability. Compared with pre-treatment levels， AHI， ESS scores， IL-6， and TNF-α were significantly reduced in both groups， while LSpO₂， SOD activity， and serum testosterone levels were significantly increased （P<0.01）. In the control group， TCM primary syndrome scores， partial secondary syndrome scores， and total TCM syndrome scores were significantly reduced （P<0.05）， whereas the improvement in the secondary symptom of "dry mouth without desire to drink" was not statistically significant. In the treatment group， all TCM syndrome scores were significantly reduced （P<0.05）. After treatment， compared with the control group， the treatment group showed more significant improvements in AHI， LSpO₂， ESS scores， and SOD activity （P<0.01）， whereas there were no significant differences between groups in IL-6， TNF-α， or serum testosterone. The improvements in all TCM syndrome scores were more pronounced in the treatment group （P<0.05）. In the control group， there were 1 case of clinical control， 13 markedly effective， 15 effective， and 11 ineffective cases， with a total effective rate of 72.5%. In the treatment group， there were 3 cases of clinical control， 24 markedly effective， 8 effective， and 5 ineffective cases， with a total effective rate of 87.5%. The difference in overall efficacy between the two groups was statistically significant （χ²=8.651，P<0.05）. No serious adverse events were observed in either group during treatment. ConclusionGuided by the theory of "Yang transforming Qi while Yin constituting form"， the application of Juanyin Xiefei prescription combined with noninvasive ventilation in patients with moderate-to-severe OSAHS with the phlegm-dampness obstruction pattern can significantly reduce AHI and improve airway obstruction and nocturnal hypoxia， while alleviating TCM symptoms such as snoring， apnea， and nocturnal suffocation caused by phlegm-dampness obstruction. The therapeutic mechanism may be related to regulating Yin-Yang dynamics to resolve phlegm and remove stasis， as well as modulating oxidative stress to attenuate pathological injury.

Natural polyphenols are a group of components widely found in traditional Chinese medicines and have been demonstrated to delay or prevent the development of aging and age-related diseases in recent years. As far as we know, the studies of natural polyphenols in aging and aging-related diseases have never been extensively reviewed. In the present paper, we reviewed recent advances of natural polyphenols in aging and common age-related diseases and the current technological methods to improve the bioavailability of natural polyphenols. The results showed that natural polyphenols have the potential to prevent or treat aging and common age-related diseases through multiple mechanisms. Nanotechnology, structural modifications, and matrix processing could provide strong technical support for the development of natural polyphenols to prevent or treat aging and age-related diseases. In conclusion, natural polyphenols have important potential in the prevention and treatment of aging and age-related diseases.

Ischemic stroke (IS) is a prevalent neurological disorder often resulting in significant disability or mortality. Resveratrol, extracted from Polygonum cuspidatum Sieb. et Zucc. (commonly known as Japanese knotweed), has been recognized for its potent neuroprotective properties. However, the neuroprotective efficacy of its derivative, (E)-4-(3,5-dimethoxystyryl) quinoline (RV02), against ischemic stroke remains inadequately explored. This study aimed to evaluate the protective effects of RV02 on neuronal ischemia-reperfusion injury both in vitro and in vivo. The research utilized an animal model of middle cerebral artery occlusion/reperfusion and SH-SY5Y cells subjected to oxygen-glucose deprivation and reperfusion to simulate ischemic conditions. The findings demonstrate that RV02 attenuates neuronal mitochondrial damage and scavenges reactive oxygen species (ROS) through mitophagy activation. Furthermore, Parkin knockdown was found to abolish RV02's ability to activate mitophagy and neuroprotection in vitro. These results suggest that RV02 shows promise as a neuroprotective agent, with the activation of Parkin-mediated mitophagy potentially serving as the primary mechanism underlying its neuroprotective effects.
Animals ; Ubiquitin-Protein Ligases/genetics* ; Mitophagy/drug effects* ; Resveratrol/analogs & derivatives* ; Neuroprotective Agents/pharmacology* ; Humans ; Neurons/metabolism* ; Reactive Oxygen Species/metabolism* ; Ischemic Stroke/genetics* ; Male ; Quinolines/pharmacology* ; Mice ; Fallopia japonica/chemistry* ; Mitochondria/metabolism* ; Reperfusion Injury/metabolism* ; Rats ; Mice, Inbred C57BL ; Disease Models, Animal

Background:Ideal bowel preparation is the prerequisite for the successful diagnostic and therapeutic colonoscopy.The retention of intestinal bubbles can seriously affect the clarity of the intestinal mucosa and subsequently decrease the detection rate of colonoscopy.Aims:To investigate the application value of dyclonine hydrochloride mucilage in bowel preparation for colonoscopy.Methods:This study was a randomized double-blinded placebo-controlled trial.Patients who underwent colonoscopy from October 2020 to October 2023 at Hainan West Central Hospital were enrolled and randomly allocated into the dyclonine hydrochloride mucilage group and the control group.3 L polyethylene glycol(PEG)+dyclonine hydrochloride mucilage and 3 L PEG+placebo were given for bowel preparation,respectively.The quality of bowel preparation was evaluated by Boston bowel preparation scale(BBPS)score and bubble score.Furthermore,a questionnaire was conducted.The cecal intubation time,withdrawal time,adenoma detection rate and adverse reaction were compared between the two groups.Results:A total of 482 patients who underwent colonoscopy were included.No significant differences in clinical characteristics such as gender,age,body mass index(BMI)and main reasons for colonoscopy were found between the dyclonine hydrochloride mucilage group and the control group(all P>0.05).Compared with the control group,no significant differences existed in total BBPS score and segment scores for right,transverse,and left colon in the dyclonine hydrochloride mucilage group(all P>0.05),but the total bubble score and segment scores for right,transverse,and left colon were significantly decreased(all P<0.001).The withdrawal time in the dyclonine hydrochloride mucilage group was significantly decreased compared to the control group(P<0.001),and the adenoma detection rate was significantly increased(P=0.001).However,no significant differences in cecal intubation time and incidence of adverse reaction were found between the two groups(all P>0.05).Conclusions:Administration of dyclonine hydrochloride mucilage during bowel preparation for colonoscopy can reduce the formation of intestinal bubbles,shorten the withdrawal time and increase the adenoma detection rate.

Background:Ideal bowel preparation is the prerequisite for the successful diagnostic and therapeutic colonoscopy.The retention of intestinal bubbles can seriously affect the clarity of the intestinal mucosa and subsequently decrease the detection rate of colonoscopy.Aims:To investigate the application value of dyclonine hydrochloride mucilage in bowel preparation for colonoscopy.Methods:This study was a randomized double-blinded placebo-controlled trial.Patients who underwent colonoscopy from October 2020 to October 2023 at Hainan West Central Hospital were enrolled and randomly allocated into the dyclonine hydrochloride mucilage group and the control group.3 L polyethylene glycol(PEG)+dyclonine hydrochloride mucilage and 3 L PEG+placebo were given for bowel preparation,respectively.The quality of bowel preparation was evaluated by Boston bowel preparation scale(BBPS)score and bubble score.Furthermore,a questionnaire was conducted.The cecal intubation time,withdrawal time,adenoma detection rate and adverse reaction were compared between the two groups.Results:A total of 482 patients who underwent colonoscopy were included.No significant differences in clinical characteristics such as gender,age,body mass index(BMI)and main reasons for colonoscopy were found between the dyclonine hydrochloride mucilage group and the control group(all P>0.05).Compared with the control group,no significant differences existed in total BBPS score and segment scores for right,transverse,and left colon in the dyclonine hydrochloride mucilage group(all P>0.05),but the total bubble score and segment scores for right,transverse,and left colon were significantly decreased(all P<0.001).The withdrawal time in the dyclonine hydrochloride mucilage group was significantly decreased compared to the control group(P<0.001),and the adenoma detection rate was significantly increased(P=0.001).However,no significant differences in cecal intubation time and incidence of adverse reaction were found between the two groups(all P>0.05).Conclusions:Administration of dyclonine hydrochloride mucilage during bowel preparation for colonoscopy can reduce the formation of intestinal bubbles,shorten the withdrawal time and increase the adenoma detection rate.

OBJECTIVE: To investigate the chemical constituents from the leaves of Jatropha curcas and evaluate their inhibition on lipopolysaccharide (LPS)-activated BV-2 microglia cells. METHODS: The n-BuOH extract of the leaves of J. curcas was isolated by macroporous adsorption resin, silica gel, ODS, column chromatography and semi-preparative HPLC. The structures of the compounds were identified by MS, NMR, ECD, and other spectroscopic methods. In addition, anti-neuroinflammatory effects of isolated compounds were evaluated by measuring the production of nitric oxide (NO) in over-activated BV-2 cells. RESULTS: Seventeen compounds, including (7R,8S)-crataegifin A-4-O-β-D-glucopyranoside ( 1), (8R,8'R)-arctigenin ( 2), arctigenin-4'-O-β-D-glucopyranoside ( 3), (-)-syringaresinol ( 4), syringaresinol-4'-O-β-D-glucopyranoside ( 5), (-)-pinoresinol ( 6), pinoresinol-4'-O-β-D-glucopyranoside ( 7), buddlenol D ( 8), (2R,3R)-dihydroquercetin ( 9), (2S,3S)-epicatechin ( 10), (2R,3S)-catechin ( 11), isovitexin ( 12), naringenin-7-O-β-D-glucopyranoside ( 13), chamaejasmin ( 14), neochamaejasmin B ( 15), isoneochamaejasmin A ( 16), and tomentin-5-O-β-D-glucopyranoside ( 17) were isolated and identified. Compounds 2, 4 and 8 significantly inhibited the release of NO in BV-2 microglia activated by LPS, with IC₅₀ values of 18.34, 29.33 and 26.30 μmol/L, respectively. CONCLUSION Compound 1 is a novel compound, and compounds 2, 3, 8, 14- 17 are isolated from Jatropha genus for the first time. In addition, the lignans significantly inhibited NO release and the inhibitory activity was decreased after glycosylation.

Objective:To investigate the application value of intrathoracic double-flap tech-nique (Kamikawa anastomosis) in combined thoracoscopic and laparoscopic radical resection for esophagogastric junction cancer.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 10 patients with esophagogastric junction cancer who were admitted to the First Affiliated Hospital of Xiamen University between July 2022 and April 2023 were collec-ted. There were 7 males and 3 females, aged 62(range, 53-71)years. All the 10 patients underwent combined thoracoscopic and laparoscopic radical resection for esophagogastric junction cancer. Reconstruction was performed with an intrathoracic Kamikawa anastomosis. Observation indicators: (1) intraoperative and postoperative situations; (2) postoperative pathological examination; (3) follow-up and survival. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Intraoperative and postoperative situations. All the 10 patients underwent surgery successfully. The operation time and volume of intraoperative blood loss were (347±41)minutes and (91±41)mL. The time to postoperative fluid diet intake, time to removal of postoperative abdominal drainage tube, time to removal of postoperative chest drainage tube, duration of postoperative hospital stay were (4.3±1.1)days, (5.0±1.6)days, (10.5±3.9)days, (13.3±3.8)days. Six patients had postoperative complications, including 1 case of Clavien-Dindo grade ⅢB, 3 cases of Clavien Dindo grade Ⅱ, 2 cases of Clavien Dindo grade Ⅰ. An upper gastrointestinal contrast at postoperative day 7 showed no anastomotic leak or anastomotic stricture in the 10 patients. (2) Postoperative pathological examination. Results of postoperative pathological examination in the 10 patients showed negative surgical margin. The number of lymph node dissected was 22±6. There were 3 patients with 5 positive lymph nodes. The tumor diameter and distance from center of tumor to squamocolumnar mucosal junction were (3.3±0.5)cm and (1.9±1.4)cm. One patient had tumor differentiation degree as high and moderate differentiation, 5 cases as moderate differentiation, 3 cases as moderate and low differentiation, 1 case as low differentiation. There were 5 patients with squamous cell carcinoma of the esophagogastric junction and 5 patients with adenocarcinoma of the esophagogastric junction. (3) Follow-up and survival. All the 10 patients were followed up for 7(range, 3?12)months, achieving disease-free survival. The visick quality of life grade Ⅰ, Ⅱ, Ⅲ, Ⅳ were observed in 7, 3, 0, 0 patients. Postoperative gastroscopy was completed in 7 patients, in which mild anastomotic strictures were noted in 2 patients, but no treatment was required. There was no reflux esophagitis.Conclusion:Intrathoracic Kamikawa anastomosis in combined thoracoscopic and laparoscopic radical resection for esophagogastric junction cancer is safe and feasible, with satisfactory short-term efficacy.

Objective:To improve the understanding of indolent mantle cell lymphoma (MCL).Methods:The data of a patient with indolent leukemic MCL in the Second Affiliated Hospital of Nanjing Medical University in May 2013 were collected. The cell morphology was analyzed by using cell smear, the flow cytometry was used to make immunophenotype analysis, the karyotype analysis was performed by usig cytogenetic technique, and polymerase chain reaction (PCR) was used to make the immunoglobulin gene analysis. At the same time, lymph node pathology and immunohistochemistry were also analyzed. The related articles published were reviewed to sum up the characteristics and the treatment of indolent MCL.Results:The male patient aged 60 years was obviously asymptomatic accompanied with slow disease progression, leukemic manifestation and without lymphadenopathy. He received pathological biopsy because of located lymphadenopathy in 2008. Small cell morphology, Kappa light chain immunophenotype, t(11;14) translocation showed after the cytogenetic examination, clonal immune globulin gene rearrangement and low Ki-67 positive index were identified. In situ MCL was diagnosed by retrospective pathology.Conclusions:Indolent MCL is extremely rare. It is typically asymptomatic with none or minimal nodal involvement, indolent disease course, leukemic phase with mild lymphocytosis, Kappa light chain expression, simple karyotype, classical or small cell morphology of tumor cells and the positive index of Ki-67 <10%. In situ MCL can be seen in pathology examination. IgVH gene mutation positive and SOX11 negative expression are notable in indolent MCL. International prognostic index of MCL is probably not appropriate in the prognostic analysis of leukemic indolent MCL. It is emphasized that initial observation and having therapies only after the disease progression can be suited for indolent MCL.

Objective:To understand the mental health of residents and specialists during the COVID-19 outbreak and provide references for improving their mental health.Methods:An online questionnaire survey was conducted, using the Generalized Anxiety Disorder Scale and the Patient Health Questionnaire Depression Rating Scale, to evaluate the mental health of 302 residents and specialists in a top general hospital. SPSS 23.0 was used to perform t-test on the relevant data. Results:Among them, 32.5% (98/302) and 49.7% (150/302) of those physicians showed varying degrees of anxiety disorder and depression, of which 6.3% (19/302) and 18.6% (56/302) were moderate or higher anxiety and depression. After they were grouped according to work fatigue scores (boundary as 60 points), risk degree of infection with the COVID-19, frequency of duty, and sleep time (boundary as 7 h), there were statistically differences in the physician self-evaluation rates of anxiety and depression between the two groups ( P<0.05). After controlling the above variables, Logistic regression results showed that the physicians with high risk of infection with the COVID-19 were more likely to show anxiety ( OR=2.142, 95%CI=1.170-3.922) and depression ( OR=2.038, 95%CI=1.185-3.505) than those with low-risk. Conclusion:In the context of the COVID-19 outbreak, residents and specialists, especially those with high risk of infection with the COVID-19, show severe mental health problems such as anxiety disorders and depression, which requires special attention and support.

Objective:To investigate the application value of transanal endoscopic partial intersphincteric resection for ultra-low rectal cancer.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 9 ultra-low rectal cancer patients undergoing transanal endoscopic partial intersphincteric resection at the First Affiliated Hospital of Xiamen University from December 2017 to August 2020 were collected. There were 8 males and 1 female, aged from 39 to 62 years, with a median age of 58 years. Observation indicators: (1) surgical and postoperative situations; (2) postoperative pathological examination; (3) follow-up. Follow-up was conducted using outpatient examination and telephone interview to detect postoperative tumor local recurrence and distant metastasis, survival of patients, ileostomy closure, anus function at 3 months after ileostomy closure, male urinary and sexual function and female sexual function at 6 months after rectal surgery. The follow-up was up to February 2021. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1)Surgical and postoperative situations: all 9 patients underwent surgery successfully, without conversion to open surgery. Seven of the 9 patients underwent transanal endoscopic partial intersphincteric resection and the rest of 2 patients with tumor close to the dentate line underwent transanal endoscopic modified partial intersphincteric resection. The operation time and volume of intraoperative blood loss of 9 patients were (267±48)minutes and 50 mL(range, 30?60 mL), respectively. Five of the 9 patients underwent transanal specimen extraction, and 4 patients underwent specimen extraction by an abdominal incision. All 9 patients underwent transanal hand-sewn coloanal anastomosis and protective ileostomy, and two pelvic drainage tubes were indwelled. Transanal drainage tube was placed after anastomosis in 3 of 9 patients. Three cases had intraoperative adverse events and there were no intraoperative adverse event reported in the remaining 6 cases. The time to postoperative initial stoma exhausting and time to postoperative first semi-liquid food intake of 9 patients were 3 days(range, 2?4 days) and 5 days(range, 4?7 days), respectively. One case had Clavien-Dindo grade Ⅰ complication and 2 cases had Clavien-Dindo grade Ⅱ complication during postoperative 30 days and the rest of 6 cases had no postoperative complication. No anastomotic stricture, hemorrhage or urinary retention occurred in 9 patients. The duration of postoperative hospital stay and cost of hospitalization of 9 patients were 11 days(range, 9?23 days) and (6.8±1.3)×10 4 yuan, respectively. (2) Postoperative pathological examination: the diameter of tumor, the distance of distal resection margin, the number of lymph node dissected and the number of positive lymph node of 9 patients were (3.2±1.4)cm, 0.6 cm(range, 0.5?1.5 cm), 17±7 and 0(range, 0?7), respectively. The tumor histopathological type was adenocarcinoma with negative tumor nodule and nerve infiltration in all 9 patients. Only 1 case of 9 patients was found vascular tumor thrombus. The surgical specimens of all 9 patients showed negative for distal and circumferential margins and complete mesorectum. Results of postoperative pathological TNM staging showed that of 6 cases with preoperative T1-T2 staging tumors, 3 cases were classified as pT2N0M0 stage, and 3 cases were classified as pT2N1M0 stage, pT2N2M0 stage or pT3N1M0 stage, respectively. Three cases with preoperative T3 staging tumors were classified as ypT0N0M0 stage, ypT2N0M0 stage or ypT3N0M0 stage, respectively. (3) Follow-up: all 9 patients were followed up for 6 to 13 months, with a median follow-up time of 9 months. No local recurrence, distant metastasis or tumor-related death was found during follow-up. Of the 9 patients, only 1 case did not receive stoma closure and undergo anus function assessment, and the rest of 8 cases underwent stoma closure. Results of postoperative anus function assessment showed 5 cases of accessibility, 2 cases of mild impairment and 1 case of severe impairment. Results of urogenital function assessment showed 6 cases of the 8 male patients of mild impairment, 1 case of moderate impairment and 1 case of severe impairment in micturition function, respectively, and 3 cases of accessibility, 2 cases of mild impairment and 3 cases of moderate impairment in sexual function, respectively. The female patient underwent accessibility of sexual function and the six-item version of the female sexual function index was 25. Conclusion:Transanal endoscopic partial intersphincteric resection can be used for the treatment of ultra-low rectal cancer.