ObjectiveThis paper aims to systematically collect and organize ancient and modern clauses and studies containing Xieqingwan， excavate and analyze the key information of Xieqingwan， and provide a reference for facilitating the development of the classic formula Xieqingwan. MethodsThe composition， dosage， decocting methods， usage， and other key information of Xieqingwan in ancient traditional Chinese medicine books were collected and analyzed by means of literature research and metrological methods. The modern clinical application of Xieqingwan was summarized. ResultsA total of 42 pieces of effective data involving 32 ancient traditional Chinese medicine books were collected. Xieqingwan was first recorded in Xiaoer Yaozheng Zhijue. The drug origin of this formula is basically clear in the ancient traditional Chinese medicine books. The modern drug usage and decocting method were as follows： Angelicae Sinensis Radix， Gentianae Radix et Rhizoma， Chuanxiong Rhizoma， Gardenia seeds， Radix et Rhizoma Rhei， Notopterygii Rhizoma et Radix， and Saposhnikoviae Radix were grounded to fine powder， decocted with honey， and finally formed into pills with the size of a chicken head （1.5 g）. It was suggested that half a pill or one pill were taken for one dose with warm Lophatheri decoction and sugar. The indications and clinical application had developed from the recordings in Xiaoer Yaozheng Zhijue and evolved from pediatrics to ophthalmic otolaryngology， neurology， dermatology， digestion， and respiratory diseases. The main pathogenesis of these diseases is heat in the liver meridian and is treated. The effect of Xieqingwan is "clearing away heat and toxicity， removing fire and relaxing the bowels， and dispersing swelling and relieving pain". It is recommended to use the corresponding preparation methods in the 2020 Edition of Pharmacopoeia of the People's Republic of China. Modern clinical studies are centered around the clinical application of Xieqingwan， which is often modified and used in treating Tourette syndrome， herpes， febrile convulsion， sleepwalking， and insomnia. ConclusionThis paper conducts a thorough textual research of the key information of Xieqingwan， induces its historic evolution， and confirms its key information， so as to provide a reference for the future development of Xieqingwan.

Objective To compare the safety and efficacy of endovascular treatment(EVT)transradial approach and transfemoral approach in patients with acute ischemic stroke with large vessel occlusion in the posterior circulation.Methods Patients with acute ischemic stroke with large vessel occlusion in the posterior circulation admitted to the Stroke Center of Linyi People's Hospital,Shandong Second Medical University from February 2022 to April 2024 were retrospectively recruited.The baseline and clinical data were collected,including age,sex,past medical history(hypertension,diabetes mellitus,hyperlipidemia,atrial fibrillation,coronary artery disease,myocardial infarction and stroke),smoking,blood pressure at admission,National Institutes of Health stroke scale(NIHSS)score at admission,modified Rankin scale(mRS)score before the onset of stroke,Alberta stroke program early CT score(ASPECTS),whether intravenous thrombolysis was performed,volume of core infarct zone,volume of hypoperfused zone,occlusion location,etiology of stroke,time indexes(including time from onset to door,time from door to arterial puncture,arterial puncture to recanalization,and time from onset to revascularization),anesthesia modality,EVT first-line strategy,number of passes and whether with vascular access conversion.Clinical data included 90-day postoperative mRS scores,postoperative puncture site complications in 24 hours,symptomatic intracranial hemorrhage at 72 hours postoperatively,modified thrombolysis in cerebral infarction(mTICI)grade at the last angiography introperative and length of stay.The groups were categorized into transradial(TRA)and transfemoral(TFA)groups according to the final access route for EVT.The baseline and clinical data of the two groups were compared.Results A total of 129 patients underwent EVT with acute ischemic stroke with large vessel occlusion in the posterior circulation were finally included,including 47 patients in TRA group and 82 patients in TFA group.The differences about sex,age,past medical history,smoking,blood pressure at admission,NIHSS score at admission,mRS score before the onset of the stroke,ASPECTS,whether intravenous thrombolysis was performed,volume of core infarct zone,volume of hypoperfused zone,occlusion location,etiology of stroke,anesthesia modality,EVT first-line strategy,number of passes,mTICI grade at the last angiography introperative and other aspects were not statistically significant(all P＞0.05).The good prognosis rate at 90 d after surgery(53.2％[25/47]vs.48.8％[40/82],P=0.630),distribution of mRS scores at 90d postoperatively(P=0.991),all-cause mortality at 90 days after surgery(27.7％[13/47]vs.28.0％[23/82],P=1.000),rate of good recanalization(mTICI grade≥2b)on intraoperative last angiogram(97.9％[46/47]vs.95.1％[78/82],P=0.436),rate of complication of puncture site(4.3％[2/47]vs.12.2％[10/82],P=0.209)between the two groups were not statistically significant.The time from door to arterial puncture was significantly longer in the TRA group than in the TFA group,and the difference between the two groups was statistically significant(122.00[95.00,153.00]min vs.105.00[80.25,118.00]min,Z=-2.937,P=0.03);average length of stay in the TFA group was significantly longer than that of the TRA group,and the difference between the two groups was statistically significant(6.00[4.95,7.05]d vs.7.00[6.95,8.88]d,Z=-2.573,P=0.010).Conclusions Patients who underwent EVT via radial or femoral artery approach with acute ischemic stroke with large vessel occlusion in the posterior circulation had similar safety and efficacy,and the number of days of hospitalization was shorter via the TRA.However,more large prospective randomized controlled clinical trials are needed to validate the results of this study.

Type Ⅵ secretion system(T6SS)is a lethal weapon that releases effectors in direct contact to kill eukaryotic predators or prokaryotic competitors.T6SS is of great significance in bacterial environmental adaptability,pathogenicity,and gene horizontal transfer.T6SS has been identified in about 25％of Gram-negative bacteria.Because of its widespread existence,T6SS is considered the key factor of ecological competition.T6SS effectors exerting biological functions have high diversity and do not have conserved sequences,and the regulatory mechanisms involved are complex.Therefore,it is a hot and difficult topic in T6SS research.Vibrio fluvialis(V.fluvialis)as a newly emerging foodborne pathogen,has unique characteristics in the quantity,composition,and physiological function of T6SS,which is related to its wide environmental adaptability and pathoge-nicity.This article mainly reviews the research progress of V.fluvialis T6SS,including its composition,structure,functional activity,and regulatory mechanism.

The epicanthus is mainly manifested by a wide intercanthal distance and a short palpebral fissure,which affects the aesthetics of eyes.The epicanthus correction is of great significance in improving eye shape and facial aesthetics.However,scar formation and hyperplasia after surgery in the surgical area have been bothering doctors and patients,and how to prevent or alleviate scar after epicanthus correction is still a difficult problem to be solved in clinic.Therefore,this article summarizes the prevention and treatment of scar after epicanthus correction based on the current research status at home and abroad,in order to provide a reference for clinic.

Abstract Gurrently, healthy behaviors are the cornerstone of both physical and mental wellbeing,and more researches are focusing on improving behaviors to alleviate depression among children and adolescents. Based on the concept of 24 h movement behaviors proposed in recent years, the study examines the relationship among physical activity, sedentary behavior, sleep and depressive symptoms in children and adolescents. The research suggests that physical activity could effectively alleviate depression among children and adolescents, and its effectiveness is influenced by factors including type, intensity, duration and frequency of physical activity. Excessive sedentary behavior may increase depressive symptoms, and the impacts of different types, durations, and frequencies of sedentary behavior on depressive symptoms among children and adolescents vary. In addition to its direct impact on depression, sleep could also serve as a mediator among physical activity, sedentary behavior and depression, and there is also a crowdingout effect of time between physical activity and sedentary behavior. Future research should focus on the mechanisms and pathways underlying how 24 h movement behaviors affecting depression among children and adolescents, in order to provide more accurate solutions for the prevention and treatment of depression.

Objective To observe the effect of hyolroxylsafflor(HSYA)on cyclooxygenase-2(COX-2)/prostaglandin E2(PGE2)signaling pathway,and to investigate the protective effect and mechanism of HSYA on cerebral ischemia-reperfusion injury(CIRI).Methods Totally 90 SD male rats were randomly divided into sham-operated group(S group),operation group(CIRI group),HSYA group and celecoxib group(C group),HSYA group subdivided into HSYA low dose group(HSYA-L group),HSYA medium dose group(HSYA-M group)and HSYA high dose group(HSYA-H group),15 rats in each group.CIRI model was prepared by thread embolism method.The rats in each group were given intraperitoneal injection 30 minutes before operation.HSYA groups were given HSYA 10 mg/kg,15 mg/kg,25 mg/kg respectirely;C group was given celecoxib 40 mg/kg;S group and CIRI group were given the same amount of normal saline.Neurofunctional scores of each group of rats were performed immediately after recovery from modeling,cerebral infarction volume was measured 24 hours after reperfusion;At the same time,neuronal injury was observed by Nissl staining,the changes of COX-2 mRNA and protein were detected by Real-time PCR and Western blotting,and the changes of PGE2,tumor necrosis factor α(TNF-α)and interleukin(IL)-1β were detected by ELISA.Results Compared with the S group,in the CIRI group,neurofunctional scores increased dramatically(P＜0.05),the volume of cerebral infarction increased dramatically(P＜0.05),the damage of neurons increased and the number of neurons decreased dramatically(P＜0.05),the expressions of COX-2 mRNA and protein increased dramatically(P＜0.05),meanwhile the expressions of PGE2,TNF-α and IL-1β were also found dramatically increased(P＜0.05);Compared with the CIRI group,in the HSYA group and C group,neurofunctional scores decreased dramatically(P＜0.05),the volume of cerebral infarction was reduced dramatically(P＜0.05),the damage of neurons decreased and the number of neurons increased dramatically(P＜0.05),the expressions of COX-2 mRNA and protein,PGE2,TNF-α and IL-1β decreased dramatically(P＜0.05).The differences between HSYA groups and both HSYA-L group and HSYA-M group compared with the C group were obvious(P＜0.05),while no obvious differences were found in HSYA-H group compared with the C group(P＞0.05).Conclusion HSYA alleviates reperfusion injury in ischemic stroke may be related to the inhibition of COX-2/PGE2 signaling pathway.

Objective To investigate the mechanism of neuronal apoptosis induced by cyclooxygenase-2(COX-2)after cerebral ischemia/reperfusion(CI/R)injury in rats.Methods Totally 45 male SD rats were divided into 3 groups by random number method,sham operation group(sham),model group(CI/R),COX-2 inhibitor group(NS-398).Blocking the middle cerebral artery to create a model,at the beginning of ischemia,NS-398 group was intraperitoneally injected with NS-398(20 mg/kg),while sham group and CI/R group were injected with the same amount of DMSO.Rats were performed for neurofunctional scores after 2 hours ischemia.After 24 hours reperfusion,2,3,5-triphenyltetrazolium chloride(TTC)staining was used to detect the infarct volume of rats.Meanwhile,cerebral tissue from penumbra area of frontal parietal cortex on ischemic side was taken,Nissl staining and TUNEL method were used to detect neuronal damage and apoptosis respectively,and finally Western blotting was used to detect the expression levels of COX-2,Bcl-2 and Bax proteins.Results The neurofunctional scores of rats,cerebral infarction volume,apoptosis index,the expressions of COX-2 and Bax in CI/R group were higher than those in the sham group(P＜0.05),the expression level of Bcl-2 and the number of neurons were lower than those in the sham group(P＜0.05);The neurofunctional scores of rats,cerebral infarction volume,apoptosis index,the expression levels of COX-2 and Bax in NS-398 group were lower than those in CI/R group(P＜0.05),the expression level of Bcl-2 and the number of neurons were higher than those in CI/R group(P＜0.05).Conclusion COX-2 may promote neuronal apoptosis after cerebral ischemia/reperfusion injury by regulating the expressions of Bcl-2 and Bax.

Objective: To investigate the incidence and risk factors of systemic allergic reactions induced by subcutaneous immunotherapy (SCIT) in patients undergoing SCIT injections in Peking Union Medical College Hospital (PUMCH). Methods: This is a single center retrospective cohort study. Using the outpatient information system of PUMCH, the demographic information and injection-related reaction data of patients undergoing SCIT injection in Allergy Department of PUMCH from December 2018 to December 2022 were retrospectively analyzed to count the incidence and risk factors of systemic allergic reactions caused by SCIT. Mann-Whitney nonparametric test or chi-square test was used for single-factor analysis, and multiple logistic regression was used for multiple-factor analysis. Results: A total of 2 897 patients received 18 070 SCIT injections in Allergy Department during the four years, and 40 systemic allergic reactions occurred, with the overall incidence rate of 0.22%. The incidence of systemic allergic reaction was 0.37% when using imported dust mite preparation and 0.15% when using domestic multi-component allergen preparation. The risk factors significantly related with SCIT-induced systemic allergic reactions in patients using imported dust mite preparation were age less than 18 years old (OR=3.186,95%CI: 1.255-8.085), highest injection concentration (OR value could not be calculated because all patients with systemic reactions were injected with highest concentration), and large local reaction in previous injection (OR=22.264,95%CI: 8.205-60.411). The risk factors for SCIT-induced systemic allergic reactions in patients using domestic allergen preparation were 5 or more types of allergens (OR=3.455,95%CI: 1.147-10.402), highest injection concentration (OR=3.794,95%CI: 1.226-11.740) and large local reaction in previous injection (OR=63.577,95%CI: 22.248-181.683). However, SCIT injection in pollen allergic patients during the pollen season did not show a correlation with systemic allergic reaction. Conclusion: The incidence of SCIT-induced systemic allergic reactions was low in the Chinese patient population of this study. Patients with one or more risk factors, such as multiple allergen injection, highest injection concentration, large local reaction in previous injection, should be given high attention and vigilance against systemic allergic reactions.
Humans ; Allergens ; Asian People ; Desensitization, Immunologic/adverse effects* ; Hypersensitivity/epidemiology* ; Retrospective Studies

Objective: To investigate the association between the urinary arsenic level and serum total testosterone in Chinese men aged 18 to 79 years. Methods: A total of 5 048 male participants aged 18 to 79 years were recruited from the China National Human Biomonitoring (CNHBM) from 2017 to 2018. Questionnaires and physical examinations were used to collect information on demographic characteristics, lifestyle, food intake frequency and health status. Venous blood and urine samples were collected to detect the level of serum total testosterone, urinary arsenic and urinary creatinine. Participants were divided into three groups (low, middle, and high) based on the tertiles of creatinine-adjusted urinary arsenic concentration. Weighted multiple linear regression was fitted to analyze the association of urinary arsenic with serum total testosterone. Results: The weighted average age of 5 048 Chinese men was (46.72±0.40) years. Geometric mean concentration (95%CI) of urinary arsenic, creatinine-adjusted urinary arsenic and serum testosterone was 22.46 (20.08, 25.12) μg/L, 19.36 (16.92, 22.15) μg/g·Cr and 18.13 (17.42, 18.85) nmol/L, respectively. After controlling for covariates, compared with the low-level urinary arsenic group, the testosterone level of the participants in the middle-level group and the high-level group decreased gradually. The percentile ratio (95%CI) was -5.17% (-13.14%, 3.54%) and -10.33% (-15.68%, -4.63). The subgroup analysis showed that the association between the urinary arsenic level and testosterone level was more obvious in the group with BMI<24 kg/m² group (P_interaction=0.023). Conclusion: There is a negative association between the urinary arsenic level and serum total testosterone in Chinese men aged 18 to 79 years.
Humans ; Male ; Arsenic/urine* ; Creatinine ; East Asian People ; Testosterone/blood* ; Urinalysis ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged

Objective: To investigate the effect of targeted carboxylesterase 1f (Ces1f) gene knockdown on the polarization activity of Kupffer cells (KC) induced by lipopolysaccharide/D-galactosamine (LPS/D-GalN) in mice with acute liver failure. Methods: The complex siRNA-EndoPorter formed by combining the small RNA (siRNA) carrying the Ces1f-targeting interference sequence and the polypeptide transport carrier (Endoporter) was wrapped in β-1, 3-D glucan shell to form complex particles (GeRPs). Thirty male C57BL/6 mice were randomly divided into a normal control group, a model group (LPS/D-GalN), a pretreatment group (GeRPs), a pretreatment model group (GeRPs+LPS/D-GalN), and an empty vector group (EndoPorter). Real-time fluorescent quantitative PCR and western blot were used to detect Ces1f mRNA and protein expression levels in the liver tissues of each mouse group. Real-time PCR was used to detect the expression levels of KC M1 polarization phenotypic differentiation cluster 86(CD86) mRNA and KC M2 polarization phenotypic differentiation cluster 163 (CD163) mRNA in each group. Immunofluorescence double staining technique was used to detect the expression of Ces1f protein and M1/M2 polarization phenotype CD86/CD163 protein in KC. Hematoxylin-eosin staining was used to observe the pathological damage to liver tissue. A one-way analysis of variance was used to compare the means among multiple groups, or an independent sample nonparametric rank sum test was used when the variances were uneven. Results: The relative expression levels of Ces1f mRNA/protein in liver tissue of the normal control group, model group, pretreatment group, and pretreatment model group were 1.00 ± 0.00, 0.80 ± 0.03/0.80 ± 0.14, 0.56 ± 0.08/0.52 ± 0.13, and 0.26 ± 0.05/0.29 ± 0.13, respectively, and the differences among the groups were statistically significant (F = 9.171/3.957, 20.740/9.315, 34.530/13.830, P < 0.01). The percentages of Ces1f-positive Kupffer cells in the normal control group, model group, pretreatment group, and pretreatment model group were 91.42%, ± 3.79%, 73.85% ± 7.03%, 48.70% ± 5.30%, and 25.68% ± 4.55%, respectively, and the differences between the groups were statistically significant (F = 6.333, 15.400, 23.700, P < 0.01). The relative expression levels of CD86 mRNA in the normal control group, model group, and pretreatment model group were 1.00 ± 0.00, 2.01 ± 0.04, and 4.17 ± 0.14, respectively, and the differences between the groups were statistically significant (F = 33.800, 106.500, P < 0.01). The relative expression levels of CD163 mRNA in the normal control group, the model group, and the pretreatment model group were 1.00 ± 0.00, 0.85 ± 0.01, and 0.65 ± 0.01, respectively, and the differences between the groups were statistically significant (F = 23.360, 55.350, P < 0.01). The percentages of (F4/80(+)CD86(+)) and (F4/80(+)CD163(+)) in the normal control group and model group and pretreatment model group were 10.67% ± 0.91% and 12.60% ± 1.67%, 20.02% ± 1.29% and 8.04% ± 0.76%, and 43.67% ± 2.71% and 5.43% ± 0.47%, respectively, and the differences among the groups were statistically significant (F = 11.130/8.379, 39.250/13.190, P < 0.01). The liver injury scores of the normal control group, the model group, and the pretreatment model group were 0.22 ± 0.08, 1.32 ± 0.36, and 2.17 ± 0.26, respectively, and the differences among the groups were statistically significant (F = 12.520 and 22.190, P < 0.01). Conclusion: Ces1f may be a hepatic inflammatory inhibitory molecule, and its inhibitory effect production may come from the molecule's maintenance of KC polarization phenotypic homeostasis.
Animals ; Male ; Mice ; Carboxylesterase/genetics* ; Galactosamine ; Gene Knockdown Techniques ; Kupffer Cells ; Lipopolysaccharides/adverse effects* ; Liver Failure, Acute/chemically induced* ; Mice, Inbred C57BL ; RNA, Messenger