Xiaohuang Qudan decoction (XHQDD) is a classical traditional Chinese medicine (TCM) formula widely used in the treatment of cholestatic liver injury. Despite its widespread use, the protective mechanism of XHQDD against cholestatic liver injury remains incompletely understood. The aim of this study was to investigate whether XHQDD mediates its beneficial effects by inhibiting the Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) pathway and regulating TH17/Treg balance. To this end, the researchers used Sprague-Dawley (SD) rats and established a cholestatic liver injury model by oral administration of alpha-naphthylisothiocyanate (ANIT). The experimental group was divided into six groups: Control (CON), ANIT, ursodeoxycholic acid (UDCA), XHQDD-low dose (XHQDD-L) group, XHQDD-medium dose (XHQDD-M) group, and XHQDD-high dose (XHQDD-H) groups. Then, after 7 d of treatment, various tests were performed to verify the results. Firstly, XHQDD and its drug-containing serum were analyzed by ultra-high performance liquid chromatography-mass spectrometry/mass spectrometry (UPLC-MS/MS), and 14 blood-entry components were identified. Then, bile flow was monitored and found to be significantly reduced in the model group, which was significantly reversed in the UDCA and XHQDD groups. To further assess ANIT-induced liver injury, hematoxylin and eosin (H&E) and Sirius red staining, alongside transmission electron microscopy (TEM), were employed to observe liver tissues, revealing hepatocellular injury, cholestasis, and hepatic fibrotic changes. Serum inflammatory factors and liver injury indicators were assessed using enzyme-linked immunosorbent assay (ELISA), indicating an inflammatory state in ANIT-induced liver injury rats. The expression levels of JAK2/STAT3-related genes and proteins in liver and intestinal tissues were measured via quantitative reverse transcription polymerase chain reaction (qRT-PCR), immunohistochemistry, immunofluorescence (IF) staining, and Western blottting (WB) assays. These studies revealed that the inflammatory state of liver-injured rats was inextricably linked to the inflammatory cascade associated with the JAK2/STAT3 pathway and that XHQDD may exert anti-inflammatory efficacy by inhibiting the JAK2/STAT3 pathway. Flow cytometry was used to determine the percentage of T helper 17 (Th17)/regulatory T (Treg) cells in serum and hepatocytes, and it was further found that XHQDD was able to regulate Th17/Treg immune homeostasis in liver-injured rats. The findings suggest that XHQDD markedly alleviates inflammation in ANIT rats, potentially treating cholestasis and liver injury through JAK2/STAT3 inhibition and Th17/Treg balance regulation.
Animals ; STAT3 Transcription Factor/immunology* ; Janus Kinase 2/immunology* ; Drugs, Chinese Herbal/pharmacology* ; Rats, Sprague-Dawley ; 1-Naphthylisothiocyanate/adverse effects* ; Male ; Rats ; Th17 Cells/immunology* ; Cholestasis/immunology* ; Signal Transduction/drug effects* ; T-Lymphocytes, Regulatory/immunology* ; Chemical and Drug Induced Liver Injury/immunology* ; Liver/drug effects*

Hyoid-related carotid artery diseases represent rare clinical entities,encompassing conditions such as carotid atherosclerotic plaque formation,mural thrombosis,carotid artery dissec-tion,carotid stenosis or occlusion,and carotid pseudoaneurysm.Unstable plaques and thrombi may dislodge under external force,leading to middle cerebral artery stenosis or embolism,triggering ische-mic cerebrovascular events.This study reported a related case and explored its clinical characteris-tics,pathogenic mechanisms,and potential risk factors through a review of relevant literature.

Professor Lau Wanyee, a member of the Chinese Academy of Sciences and a pro-fessor at the Chinese University of Hong Kong, actively advocates conducting clinical researches through "planting fruit trees" and "growing orchards", aiming to cultivate a team of dual-skilled talents in clinical practice and research, effectively improve the scientific and technological level of clinical medicine in China, make voice heard in the international medical science field, and better serve human health. He organized a clinical research training course in scholars′ forum for Hepatobiliary Young Expert Working Group of Chinese College of Surgeons. Throughout three sessions of the training course, a distinct theme was focused on how to enhance the level of clinical research in China and make voice heard by the international scholars. A group of multi-dimensional experts were gathered, including experts from surgery, methodology, and management, as well as both renowned experts and young talents. A lively teaching model was adopted, combining guided presentations with interactive discussion and debate sessions. A clean and upright academic spirit was strongly advocated, in which international rules were adopted to conduct in-depth analysis and sharp criticism of seven proposed clinical research projects and four published papers with high international influence to find quarrel in a straw. This clinical research training course provides a new model of guidance for young physicians in conducting clinical research. As a result, all attendees felt deeply educated and benefited greatly from the training session. This training activity not only laid a solid foundation for the development of scientization, standardization, and internationali-zation of clinical research in digestive surgery in China, but also demonstrated a correct path for cultivating a group of young and middle-aged clinical medical scientists with scientific spirit.

The diagnosis of Parkinson's disease(PD)mainly relies on clinical appearance of patients,and the routine magnetic resonance scan has difficulty in finding the abnormality of that,which is not able to meet the requirement of early and precise quantification for the PD lesion area.Diffusion magnetic resonance imaging(dMRI)technique is a noninvasive method of examining the microstructure of living tissue.Diffusion weighted imaging(DWI)and diffusion tensor imaging(DTI)were the most widely used in clinical practice.However,the principles of them have limitation,which are not able to fully outline the microstructure of brain tissue.This paper discussed several new dMRI techniques that are able to make up conventional dMRI model,which included diffusion kurtosis imaging(DKI),neurite orientation dispersion and density imaging(NODDI)and diffusion tensor imaging index of perivascular space(DTI-ALPS).Moreover,this paper summarized the applications of above imaging technique in exploring the changes of the microstructure of brain tissue of PD patients,so as to provide more imaging information for the pathological changes of PD patients.

Malignant tumors have become one of the major diseases that seriously endanger human life.Early diagnosis and treatment can greatly improve the survival rate of patients.Imaging examinations based on fluorescence imaging,CT,photoacoustic imaging,MRI,and PET have been widely studied and applied in the diagnosis of tumors.However,early cancerous tissue and normal tissue have similar imaging signals,which is difficult to be accurately distinguished by conventional imaging.With the development and cross integration of physics,materials science,biology,and medicine,nanomaterials have shown broad application prospects in the diagnosis and treatment of diseases due to their unique physical and chemical properties.The enhanced permeability and retention effect in solid tumor,and the easy modification properties of nanomaterials allow them to accurately"recognize"tumor and accelerate its enrichment at the tumor site;the imaging characteristics allow them to be used as contrast agents to enhance the signal intensity of the tumor site;their responsiveness mechanism can also allow them to distinguish normal from cancerous cells according to the microenvironment in tumor cells.In addition,multimodality imaging based on nanomaterials can compensate for the shortcomings of single modality imaging and achieve real-time and omnidirectional imaging of tumors.With multiple functions integrated,nanomaterials are expected to enhance the imaging signals of early cancerous sites,improve signal-to-noise ratio,and achieve early diagnosis of tumors.

Non-invasive mechanical ventilation(NIV)is increasingly being used as a respiratory support technique in clinical practice.However,the pressure-related injuries should not be overlooked.In order to prevent local pressure injuries caused by NIV technology,a series of preventive measures have been adopted in clinical work.These measures include the use of dressings to provide pressure relief to the local skin.Currently,in clinical practice,when using preventive dressings,nurses need to cut them themselves based on the physiological structure of the patient's nose,forehead,or face.However,precise cutting can be challenging.If the dressing is cut too small,it may not provide adequate prevention,and if it's cut too large,it can cover too much skin,affecting the nurse's observation and the patient's comfort.Additionally,during NIV treatment,the preventive dressings used may become curled or displaced,requiring nurses to re-cut and replace them.This process inevitably leads to material wastage,increasing the cost of dressing use for patients.Moreover,the cutting tools used must meet infection control requirements,adding to the nursing workload and reducing the compliance of nurses in changing dressings.Our research team has designed a ready-made pressure injury prevention dressing component for use with NIV masks to prevent pressure injuries to the nasal and facial areas.It is precisely designed,flexible in composition,easy to use,and can provide multiple usage modes.It effectively combines emergency care with pressure relief measures,reducing the occurrence of pressure injuries to the patient's nasal and facial areas.This improves patient comfort and treatment compliance,facilitates technology-based nursing,and enhances clinical efficiency.It has significant clinical application value and has been granted a National Utility Model Patent(ZL 202020529121.6).

OBJECTIVE To find lead compounds with potent bioactivities from endophytic fungi Trichoderma sp. SHJN1 and Perenniporia sp. SHJG1 from the traditional Chinese medicine Lindera glauca. METHODS The fermentation of Trichoderma sp. SHJN1 and Perenniporia sp. SHJG1 were isolated and purificated by repeated silica gel, ODS, Sephadex LH-20, and semi-preparation HPLC. The structures of compounds were performed by NMR and ESI-MS. The preliminary evaluation of anti-tumor activity of these compounds was performed by human breast cancer cells(MCF-7) and human lung cancer cells(A549). RESULTS A total of 12 compounds were purified from the above two endophytic fungi and identified as alantrypinone(1), oryzalactam(2), phomoindene A(3), cis-gregatin B(4), huaspenone B(5), stigmasta-7,22-dien-3β,5α,6α-triol(6) and ergosterol(7), 1-deoxy-2-demethylviridiol (8), viridiol(9), trichodermamides A(10), chromone(11) and 4-hydroxyphenylacetic acid(12). The evaluation of antitumor activity showed that, compound 3 showed inhibitory activity on MCF-7 cell line with an IC50 value of (62.9±1.02)μmol·L-1[cisplatin(DDP) IC50=(30.1±1.67)μmol·L-1], while compound 8 and 9 showed inhibitory activities on A549 cell line with IC50 values of (34.6±1.57)μmol·L-1 and (44.9±1.74)μmol·L-1, respectively[DDP IC50=(20.6±1.42)μmol·L-1]. CONCLUSION Compounds 3, 8 and 9 show potent anti-tumor effects.

Objective:To investigate the clinical application of Bushen-Liyan Decoction combined with low frequency pulse acupoint electrical stimulation in the treatment of swallowing dysfunction of stroke patients in convalescent stage. Methods:From January 2018 to March 2020, 108 stroke patients with swallowing dysfunction in the Shandong Provincial Third Hospital were selected. They were randomly divided into two groups with 54 in each according to the random number table method. The control group was given low frequency pulse acupoint electrical stimulation on the basis of conventional treatment, and the study group was given Bushen-Liyan Decoction combined with low frequency pulse acupoint electrical stimulation on the basis of conventional treatment. Both groups were treated for 4 weeks. The National Institutes of Health Neurological Deficit Score (NIHSS) was used to assess the degree of neurological impairment, the Wada Drinking Water Test was used to assess the degree of swallowing dysfunction, and Barthel Index was used to assess the ability of daily living. The serum levels of brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1), VEGF, IL-18, IL-23, SOD and MDA were detected by ELISA. The adverse reactions during the treatment were observed and the clinical efficacy was evaluated.Results:The total effective rate was 92.6% (50/54) in the study group and 72.2% (39/54) in the control group, with significant difference between the two groups( χ2=7.728, P=0.005). After treatment, NIHSS score and Wata’s drinking water test score of the study group were lower than those in the control group ( t=8.383, 9.740, P<0.001), Barthel index of the study group was significantly higher than that of the control group ( t=4.064, P<0.01). The serum BDNF [(8.42 ± 0.72) μg/L vs. (6.69 ± 0.63) μg/L, t=13.288], IGF-1[(142.20 ± 12.29) μg/L vs. (118.35 ± 10.73) μg/L, t=10.742] and VEGF[(151.29 ± 12.26) ng/L vs. (102.21 ± 9.77) ng/L, t=23.006] were significantly higher than those in control group( P<0.01); The serum levels of IL-18, IL-23 and MDA were significantly lower than those in the control group( t=7.892, 9.897, 6.206, P<0.001), and the level of SOD was significantly higher than that of the control group ( t=18.510, P<0.001). During the treatment, no serious adverse events occurred in both groups. Conclusion:Bushen-Liyan Decoction combined with low-frequency pulse acupoint electrical stimulation can reduce the clinical symptoms, inflammatory reaction and brain tissue damage of stroke patients with dysphagia, improve the swallowing function and improve the clinical efficacy.

The objective research conclusions drawn from standardized clinical studies are important evidential basis for the formulation of consensus guidelines for the diagnosis and treatment of various diseases. In order to further improve the level of clinical research work and evidence quality, provide patients with more scientific treatment decision-making opinions, the author investigate the following aspects which should be paid attention to in the clinical study of biliary tract diseases including defining the evaluation system and quality standards evidence-based criteria for clinical studies, setting long-term research goals, strengthening the real-world research,"three elements"of surgical clinical research (surgical quality, pathological analysis and follow-up), and the database construction; emphasizing the significance and implementation of quantitative analysis research, the registration system and standardized clinical research.

Objective:To explore the effect of failure mode and effect analysis (FMEA) in the management of nosocomial infection, and provide reference for the effective prevention and control of nosocomial infection.Methods:Using FMEA to identify, analyze, evaluate and screen out the high-risk events of nosocomial infection in January 2020, from which two hospital level priority improvement projects of hand hygiene compliance and blood-borne occupational exposure were determined. After risk control and intervention measures, the effects before and after improvement were compared.Results:Except for the lack of incentive mechanism and insufficient communication between medical and nursing teams, the differences in hand hygiene compliance and blood-borne occupational exposure risk priority coefficients before and after the implementation of FMEA were statistically significant ( P<0.05) . After the implementation of FMEA, the hand hygiene compliance was 74.92% (79375/105953) , which was significantly higher than 68.40% (58361/85328) before the implementation of FMEA, and the difference was statistically significant (χ 2=996.55, P<0.01) . The incidence of blood-borne occupational exposure after the implementation of FMEA was 3.85% (80/2080) , which was lower than the 6.16% (123/1998) before the implementation of FMEA, and the difference was statistically significant (χ 2=11.49, P<0.01) . Conclusion:FMEA has a good effect in nosocomial infection management. It can identify and evaluate the risk of nosocomial infection prospectively, so as to control the risk effectively.