1.Mechanisms of Antidepressant Effect of Zhizi Houpotang and Its Herbal Pairs Based on NLRP3/GSDMD Signaling Pathway
Chang CHEN ; Ziwen GUO ; Tingyu SONG ; Yan WANG ; Baomei XIA ; Weiwei TAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(6):72-80
ObjectiveTaking classical herbal pair compatibility research as the entry point, this study aimed to deeply investigate the material basis and compatibility rules underlying the antidepressant effects of the traditional Chinese medicine (TCM) formula Zhizi Houpotang, and to elucidate its antidepressant mechanism, with a particular focus on its regulation of neuroinflammatory responses mediated by the NOD-like receptor protein 3 (NLRP3)/gasdermin D (GSDMD) signaling pathway and the consequent improvement of neuronal synaptic plasticity. MethodsC57BL/6J mice were randomly divided into a blank control group, a chronic unpredictable mild stress (CUMS) depression model group, a Zhizi Houpotang full-formula group (6 g·kg-1·d-1), a Magnoliae Officinalis Cortex (MOC)-Aurantii Fructus Immaturus (AFI) herbal pair group (4.2 g·kg-1·d-1), a Gardeniae Fructus (GF)-MOC herbal pair group (4.2 g·kg-1·d-1), a GF-AFI herbal pair group (3.6 g·kg-1·d-1), and a positive drug group (fluoxetine, 12 mg·kg-1·d-1). Depressive-like behaviors in mice were evaluated using behavioral tests. Immunofluorescence staining was used to label and quantify the expression of the microglial marker ionized calcium-binding adaptor molecule 1 (Ibal) and the purinergic receptor P2X ligand-gated ion channel 7 (P2RX7) in the prefrontal cortex (PFC). Enzyme-linked immunosorbent assay (ELISA) was applied to detect the levels of inflammatory cytokines interleukin-1β (IL-1β) and interleukin-18 (IL-18) in serum and PFC tissues. Western blot was employed to determine the expression of pannexin 1 (Panx1), P2RX7, NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), Caspase-1, GSDMD, postsynaptic density protein 95 (PSD95), and the presynaptic protein Synapsin 1 in PFC tissues. Golgi staining was used to assess dendritic spine density of neurons in the PFC. ResultsCompared with the blank control group, the depression model group exhibited significant depressive-like behaviors. In addition, the immunofluorescence areas of Ibal and P2RX7 in the PFC were significantly increased (P<0.01), the levels of IL-1β and IL-18 in serum and the PFC were significantly elevated (P<0.01), and the protein expression levels of Panx1, P2RX7, NLRP3, ASC, Caspase-1, and GSDMD in the PFC were significantly upregulated (P<0.01). In contrast, the protein expression levels of PSD95 and Synapsin 1 were significantly downregulated (P<0.01), and neuronal dendritic spine density was significantly reduced (P<0.01). Compared with the model group, the Zhizi Houpotang full-formula group and the GF-MOC herbal pair group showed significant improvement in all the above indicators (P<0.01). The GF-AFI herbal pair group improved all the above indicators except P2RX7, Caspase-1, GSDMD, and PSD95 (P<0.05, P<0.01). In contrast, the MOC-AFI herbal pair group showed no statistically significant improvement in any of the above indicators compared with the model group. ConclusionZhizi Houpotang and its key herbal pair, GF-MOC, can effectively ameliorate CUMS-induced depressive-like behaviors in mice. Its core antidepressant mechanism may involve inhibition of P2RX7/Panx1 signaling, thereby blocking the NLRP3/GSDMD-mediated pyroptosis pathway and significantly reducing the release of inflammatory cytokines IL-1β and IL-18. Simultaneously, it upregulates the expression of synapse-related proteins PSD95 and Synapsin 1 and increases dendritic spine density, promoting the recovery of synaptic plasticity. These results suggest that GF plays a key role in the antidepressant effects of this formula, and that the compatibility of GF with MOC may represent the principal herbal pair combination responsible for its core therapeutic action.
2.Treating diabetic kidney disease based on "using bitter herbs to nourish or purge" theory
Weimin JIANG ; Yaoxian WANG ; Shuwu WEI ; Jiale ZHANG ; Chenhui XIA ; Jie YANG ; Liqiao SUN ; Xinrong LI ; Weiwei SUN
Journal of Beijing University of Traditional Chinese Medicine 2025;48(1):1-7
The Huangdi Neijing proposes the " using bitter herbs to nourish or purge" theory to guide clinical prescription and formulation of herbal remedies based on the physiological characteristics and functions of the five zang viscera, along with the properties and flavors of medicinal herbs. This study explored diabetic kidney disease pathogenesis and treatment based on the " using bitter herbs to nourish or purge" theory. Kidney dryness is a key pathological factor in diabetic kidney disease, and the disharmony of kidney dryness is an essential aspect of its pathogenesis. Strengthening is the primary therapeutic principle, and kidney dryness is a persistent factor throughout the occurrence and progression of diabetic kidney disease. In the early stage, the pathogenesis involves heat-consuming qi and injuring yin, leading to kidney dryness. In the middle stage, the pathogenesis manifests as qi deficiency and blood stasis in the collaterals, resulting in turbidity owing to kidney dryness. In the late stage, the pathogenesis involves yin and yang deficiency, with kidney dryness and disharmony. This study proposes the staging-based treatment based on the " need for firmness" characteristic of the kidney. The aim is to provide new insights for clinical diagnosis and treatment in traditional Chinese medicine by rationally using pungent, bitter, and salty medicinal herbs to nourish and moisturize the kidney. This approach seeks to promote precise syndrome differentiation and personalized treatment for different stages of diabetic kidney disease, thereby enhancing clinical efficacy.
3.Efficacy and safety of modified Shenqi Maiwei Dihuang Decoction combined with Buzhong Yiqi Pill in treatment of cold and heat mixed type diabetic foot
Yinfeng XIA ; Weiwei CHEN ; Ping WU ; Yongsong CHEN ; Jie LIU ; Jianxiang PAN ; Zhiyong CHEN
Chongqing Medicine 2025;54(2):387-392
Objective To compare the therapeutic effects of modified Shenqi Maiwei Dihuang Decoction combined with Buzhong Yiqi Pill and Buzhong Yiqi pill alone in the patients with cold and heat mixed type di-abetic foot.Methods A total of 123 patients with cold and heat mixed type diabetic foot receiving the treat-ment in this hospital from April 2022 to December 2023 were selected and divided into the modified Shenqi Mai-Dihuang Decoction and Buzhong Yiqi Pill group(combined group,60 cases)and Buzhong Yiqi Pill group(monotherapy group,63 cases).The wound healing,mean blood flow amount of foot dorsal artery,blood glu-cose and changes in vascular diameter,inflammatory factors and vascular endothelial growth factor after 2 courses of treatment were compared betweeb the 2 groups.Results The ulcer reduction rate in the combina-tion group was significantly higher than that in the monotherapy group(P=0.001).The fasting blood glu-cose and 2 h postprandial blood glucose after treatment in the combination group all were lower than those in the monotherapy group(P=0.001).The average blood flow of foot dorsal artery after treatment in combina-tion group was higher than that in the monotherapy group,and the difference was statistically significant(P=0.013).There were 34 cases of Wagner grade 3 in the combined group and 33 cases of Wagner grade 3 in the monotherapy subgroup respectively.There was statistically significant difference in the CRP level between the two subgroups(P=0.045).Conclusion Shenqi Maiwei Dihuang Decoction combined with Buzhong Yiqi Pill in treating diabetic foot ulcer is more effective than Buzhong Yiqi Pill alone,moreover the safety is high.
4.Effect of over-expression of NR2F2 on biological behaviors of human ovarian cancer SKOV3 cells
Shuo ZHANG ; Yunxiu XIA ; Weiwei CHEN ; Hongliang DONG ; Bingjie CUI ; Cuilan LIU ; Zhiqiang LIU ; Fei WANG ; Jing DU
Journal of Jilin University(Medicine Edition) 2025;51(1):58-67
Objective:To investigate the effect of nuclear receptor subfamily 2 group F member 2(NR2F2)on the biological behaviors of human ovarian cancer SKOV3 cells,and to clarify its molecular mechauism and provide the new idea for treatment of ovarian cancer.Methods:Gene Expression Profiling Interactive Analysis(GEPIA)Database analyse the expression level of NR2F2 gene in ovarian tissue,and analyse its correlation with clinical prognosis of ovarian cancer patients.The human ovarian cancer SKOV3 cells were divided into control group and NR2F2 over-expression(NR2F2 OE)group,which were transfected with mCherry control virus and NR2F2 OE over-expression virus,respectively,when the cell deusity reached 70%,and the stable transfection SKOV3 cell lines were screened with puromycin(puro)48h lafter.Real-time fluorescence quantitative PCR(RT-qPCR)and Western blotting methods were used to detect the transfection efficiencies of the cells;RT-qPCR method was used to detect the expression levels of NR2F2 and sex-determining region Y-box 2(SOX2)mRNA in the cells in two groups;Western blotting method was used to detect the expression levels of NR2F2,ATP-binding cassette superfamily G member 2(ABCG2),and programmed cell death 1-ligand 1(PD-L1)protcins in the cells in two groups.CCK-8 assay was used to detect the proliferation activities of the cells in two groups;Wound assay was used to detect the migration rates of the cells in two groups;Transwell chamber assay was used to detect the number of transmembrane cells;Spheroidization assay was used to detect the numbers of spheroids in the cells;peripheral blood mononuclear cells(PBMCs)-mediated tumor cell killing assay was used to detect the relative densities of surviving tumor cells;CCK-8 assay was used to detect the half maximal inhibitory concentration(IC50)of paclitaxel(PTX)and carboplatin(CBP).Results:Compared with normal ovarian tissue,the expression level of NR2F2 gene in ovarian tumor tissue was decreased(P<0.05),and decreased with the improvement of clinical pathological grading of ovarian tumor.The patients with higher expression level of NR2F2 gene had better clincal prognosis.The SKOV3 cells with NR2F2 over-expresson were successfully constructed,and the expression levels of NR2F2 mRNA and protein in the cells in NR2F2 OE group were increased compared with control group(P<0.001).The CCK-8 assay results showed that compared with control group,the proliferation activities of the cells in NR2F2 OE group were decreased at different time points(1,2,3,and 4 d)(P<0.05 or P<0.01).The cell wound assay results showed that compared with control group,the migration rate of the cells in NR2F2 OE group was decreased(P<0.001).The Transwell assay results showed that compared with control group,the number of transmembrane cells in NR2F2 OE group was decreased(P<0.01).Compared with control group,the number of the spheroids in NR2F2 OE group was decreased(P<0.05),and the expression levels of SOX2 mRNA(P<0.01)and protein(P<0.001)were increased.Compared with control group,the relative density of surviving tumor cells in NR2F2 OE group was decreased,but the difference was not significant(P<0.05),and the expression level of PD-L1 protein was decreased(P<0.05).Compared with control group,the proliferation activities of cells in NR2F2 OE group were decreased(P<0.05),and the drug sensitivities of the cells to PTX and CBP were enhanced(P<0.05);the IC50 of PTX was significantly reduced,while the IC50of CBP could not be calculated due to excessively high drug concentration;the expression level of ABCG2 protein was decreased(P<0.05).Conclusion:The over-expression of NR2F2 may inhibit the proliferation,migration,and invasion of the human ovarian cancer SKOV3 cells,decrease the expression levels of SOX2,PD-L1 and ABCG2 proteins,suppress the stemness and immune evasion ability of the SKOV3 cells,and enhance the sensitivities of the SKOV3 cells to PTX and CBP.
5.Dual-modality imaging bionic nanoparticles for sonodynamic therapy on medullary thyroid carcinoma
Weiwei ZHU ; Zhengchao FAN ; Ying XU ; Jizhu XIA ; Xiangzhi ZHAO
Chinese Journal of Tissue Engineering Research 2025;29(16):3410-3419
BACKGROUND:Sonodynamic therapy represents an innovative antitumor treatment modality characterized by its non-invasiveness and precise spatiotemporal controllability.This approach offers broad prospects for the non-invasive treatment of medullary thyroid carcinoma.OBJECTIVE:To prepare lipid nanoparticles coated with a biomimetic cancer cell membrane capable of dual-modality imaging,and to detect the physicochemical properties,targeting ability,imaging efficacy,cytotoxicity,and anti-migration capabilities of the nanoparticles.METHODS:Dipalmitoyl phosphatidylcholine,dipalmitoyl phosphatidylglycerol,distearoyl phosphatidylethanolamine-PEG2000,cholesterol,hematoporphyrin monomethyl ether,and perflexane were used as raw materials.Nanoparticles HP@LNP were synthesized using a thin-film hydration-ultrasonication technique,encapsulating hematoporphyrin monomethyl ether within the hydrophobic layer and perflexane within the hydrophilic core of lipid nanostructures.Subsequently,the surface of these nanoparticles HP@LNP was coated with medullary thyroid carcinoma cell membrane,resulting in the creation of biomimetic lipid nanoparticles(MHP@LNP)with active targeting capabilities towards medullary thyroid carcinoma cells.The physicochemical properties,targeting ability,immune evasion capacity,imaging effect,cytotoxicity,and anti-migration properties of MHP@LNP nanoparticles were characterized.RESULTS AND CONCLUSION:(1)The synthesized MHP@LNP nanoparticles demonstrated a typical core-shell structure,with a diameter of 131.06 nm and an average zeta potential of-30.59 mV.Gel electrophoresis confirmed that the protein profile of the MHP@LNP nanoparticles closely matched that of the cancer cell membrane.Fluorescent colocalization studies indicated a significant overlap between the fluorescence signals of the nanoparticles and the cancer cell membrane.The encapsulation rate and drug loading rate of hematoporphyrin monomethyl ether in MHP@LNP nanoparticles were 87.8%and 14.6%respectively.Upon stimulation with low-intensity focused ultrasound,the MHP@LNP nanoparticles underwent a phase transition,forming microbubbles with ultrasound signal intensity peaking at 4 minutes.Under laser irradiation,the photoacoustic signal intensity was found to be linearly correlated with the mass concentration of the nanoparticles.The MHP@LNP nanoparticles exhibited homologous cell targeting and immune evasion capabilities.Prior to exposure to low-intensity focused ultrasound,the MHP@LNP nanoparticles showed good biocompatibility.However,following ultrasound irradiation,they produced cytotoxic reactive oxygen species,had lethal effect on medullary thyroid carcinoma cells,and inhibited the migration of medullary thyroid carcinoma cells.(2)These findings indicate that MHP@LNP nanoparticles can achieve sonodynamic therapy for the treatment of thyroid medullary carcinoma under ultrasound and photoacoustic dual-modality imaging guidance.
6.Effect and mechanism of Tamarix chinensis Lour.on streptozotocin-induced diabetic rats based on network pharmacology,molecular docking and experimental validation
Qian LI ; Zhenxiang WANG ; Yanting LIANG ; Weiwei MA ; Zhen ZHANG ; Xia WANG ; Qiong AN
Chinese Journal of Clinical Pharmacology and Therapeutics 2025;30(7):907-920
AIM:To investigate the mechanism of action of Tamarix chinensis Lour.on streptozotocin-induced type 2 diabetes mellitus(T2DM)through network pharmacology,molecular docking and ex-perimental validation.METHODS:Using the TCSMP database and Swiss Target Prediction tools screen the active components and predict potential tar-gets in Tamarix chinensis Lour..Retrieving potential disease targets associated with T2DM from data-bases such as GeneCards,OMIM,and DisGeNET.The intersection targets of Tamarix chinensis Lour.and T2DM disease was obtained through Venny platform.The STRING database was used to con-structed PPI network,and Cytoscape 3.8.0 soft-ware was use to visualized.GO function enrich-ment and KEGG pathway enrichment analysis were performed through the Metascape database.Dock-ing of important target proteins and compounds was carried out by AutoDock software.SPF grade male rats were randomly divided into normal group,model group,MET group(88.5 mg/kg),TE high-dose(800 mg/kg)group,TE medium-dose(400 mg/kg)group and TE low-dose(200 mg/kg)group(n=10).High-fat and high sugar feed com-bined with low dose STZ(45 mg/kg)was used to in-duce T2DM rat model,and the rats were adminis-tered orally for 5 weeks.Fasting blood glucose(FBG),insulin(FINS)level and HOMA-IR index,bio-chemical indicators[superoxide dismutase(SOD),malondialdehyde(MDA),glycosylated hemoglobin A1c(HbA1c)and inflammatory factor[interleukin-1β(IL-1β),tumor necrosis factor α(TNF-α),vascu-lar cell adhesion molecular(VCAM-1)levels of the rats were also observed;morphological changes of renal tissue was observe by HE staining.RESULTS:Based on the screening conditions of oral bioavail-ability(OB)≥ 30%and drug like properties(DL)≥0.18,a total of 19 main active ingredients with po-tential therapeutic effects on T2DM were screened from Tamarix chinensis Lour.,including ergosta-5,24(28)-dien-3,7,16-triol,quercetin-3,3'-dimethyl ether,kaempferol,quercetin,and others.By analyz-ing the potential targets of Tamarix chinensis Lour.for treating T2DM,a total of 185 potential target genes were screened,including SRC,EGFR,HSP90AA1,AKT1,ESR1,H1F1A,TNF,PIK3R1,etc,in-volving cancer signaling pathways,insulin resis-tance,MAPK signaling pathways,PI3K Akt signaling pathways,etc.Molecular docking results showed that the binding energies were all less than-5.0 kcal/mol,indicating that a strong binding abili-ty between the active ingredients screened by Tam-arix chinensis Lour.and the potential targets for the treatment of T2DM.The animal experiment re-sults showed that compared with the model group,the weight loss of rats in the MET and TE groups was slowed down,and the levels of FBG,FINS,MDA,HbA1c,IL-1β,TNF-α,VCAM-1,HOMA-IR in-dex were reduced,the SOD level was increased,and the differences were statistically significant(P<0.05,P<0.01),Renal tissue cellular morphology also showed notable improvement.Most importantly,all these results demonstrating dose-dependent ef-fects.CONCLUSION:Tamarix chinensis Lour.dis-plays a significant therapeutic effect on T2DM through multi-component,multi-target,and multi-pathway synergistic actions to improve blood glu-cose levels.The findings of this study provide a the-oretical basis for the clinical application of Tamarix chinensis Lour.in the treatment of T2DM.
7.Application of machine learning in the restoration of dentition defects
Xinxi YUAN ; Yekang XIA ; Han WANG ; Jian HU ; Laikui LIU ; Weiwei LIANG
STOMATOLOGY 2025;45(9):707-712,720
Machine learning,as a core branch of artificial intelligence,has gradually demonstrated significant potential in the field of dentition defect repair in recent years.By employing techniques such as data mining and pattern recognition,machine learning has been applied in various aspects including oral implant restoration,fixed bridge design,and fabrication of removable partial dentures.This paper seeks to provide a comprehensive review of machine learning applications within the aforementioned three aspects.It endeavors to assess the current developmental landscape and chart a course for future investigative endeavors,in hopes of offering a reference for re-search on machine learning in prosthodontics.
8.Attention of oral medicine residents in standardized training to oral aesthetic information and its influencing factors
Shanshan LIANG ; Yanlin XIA ; Hongqian SHI ; Weiwei XIAO ; Zhuan BIAN ; Tao ZHANG ; Cui HUANG
Chinese Journal of Medical Aesthetics and Cosmetology 2025;31(2):155-160
Objective:To investigate the attention level of oral medicine residents in standardized training (referred to as residency training) to oral aesthetic information and its influencing factors.Methods:This study was a cross-sectional study, which included 262 residents undergoing standardized training at Hospital of Stomatology, Wuhan University in January 2020. Among them, there were 73 males and 189 females, with an age range of 23-33 (26±2) years. A questionnaire survey method was used, and the questionnaire included the basic characteristics of the subjects (gender, grade, major, identity, and having training experience in prosthodontic base or not) as well as their attention to oral aesthetic information (facial proportions, facial midline, smile line, facial contour, E-line, nasolabial angle, tooth shape and contour, and tooth proportions). Differences in the attention to oral aesthetic information among residents with different basic characteristics were compared, and a multivariable logistic regression was used to identify the influencing factors.Results:Among the 262 oral medicine residents, 256 (97.7%) believed that it was necessary to pay attention to oral aesthetic information. The differences in attention to facial proportions between residents of different genders and between those with and without training experience in the prosthodontic base were statistically significant (both P<0.05). The results of the multivariate logistic regression showed that male residents were less likely to pay attention to facial proportions compared with female residents ( OR=0.45, 95% CI: 0.23-0.88). Compared with residents specializing in orthodontics, non-orthodontic residents were less likely to pay attention to the E-line ( OR=0.14-0.27, 95% CI: 0.04-0.68) and nasolabial angle ( OR=0.14-0.31, 95% CI: 0.04-0.81). Residents who were graduate students with integrated four certificates were more likely to pay attention to the E-line compared with industry-based personnel ( OR=1.88, 95% CI: 1.01-3.49). Residents without training experience in the prosthodontic base were less likely to pay attention to the facial proportion ( OR=0.44, 95% CI: 0.20-0.97) and tooth shape and contour ( OR=0.33, 95% CI: 0.11-0.98) compared with those with such training experience in prosthodontic base. Conclusions:Oral medicine residents have a high level of attention to oral aesthetic information. Gender, major, identity, and having training experience in the prosthodontic base or not are factors that influence their attention to oral aesthetic information.
9.Discussion on the Mechanism of Ferroptosis in Diabetic Kidney Disease Based on the Theory of"Internal Heat Induced Disease"
Huixi CHEN ; Yaoxian WANG ; Huijuan ZHENG ; Weijing LIU ; Chenhui XIA ; Jiale ZHANG ; Jie LYU ; Weiwei SUN
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(3):24-28
Diabetic kidney disease(DKD)is one of the serious complications of diabetes.Ferroptosis causes pathological damage and is involved in the progression of DKD.How to inhibit ferroptosis and delay DKD is a new academic hotspot.The author's team further enriched and proposed the core pathogenesis theory of"internal heat induced disease"on the basis of the traditional DKD"yin deficiency and dryness-heat"theory,and explained the general development law of DKD.In this article,"internal heat"and"Zhengjia"in the theory of DKD"internal heat induced diseases"are used as the starting point to explore the relationship of the main pathological damage of ferroptosis such as activating inflammatory response,enhancing oxidative stress,promoting fibrosis and so on with the internal mechanism of the theory of"internal heat induced diseases",further explained the scientific connotation of DKD"internal heat induced diseases",in order to provide ideas and theoretical basis for the TCM prevention and treatment of DKD.
10.Establishement and ethical optimization of rat oral mucosa ulcer model
Xiang LI ; Kaiyan WANG ; Weiwei YU ; Xinyi HAO ; Ling LI ; Jianhong DUAN ; Bin FENG ; Qing LIU ; Lingyun XIA ; Lina NIU
Journal of Practical Stomatology 2025;41(1):26-33
Objective:To develop rat models of oral mucosa ulcer using distinct experimental methodologies,fulfilling research requirements and adhering to the ethical standards for animal care.Methods:96 SD rats were randomly allocated into groups.The rats in control group(n=8)were regularly fed without other treatment.Those in chemical cauterization groups were treated by 20%,40%,60%of glacial acetic acid(GAA)on oral mucosa(n=8);in mechanical damage groups by 30 000 r/min high speed drill induced trauma of 10,20 and 30 mm2 respectively(n=8);in ionizing radiation groups were treated with 10,12,15,20 and 30 Gy on the mucosa respectively(n=8).After the ulcer was appeared,the morphology of the mucosa were observed,the mucosal tissue lesions were examined by HE,Masson and immunofluorescence staining,the expression of TNF-α and IL-1β were detected by qPCR and ELISA respectively,and the body conditions such as diet and body weight of the rats were observed,the pain,dis-tress and discomfor of the rats were evaluated by MORTON&Griffits Guidelines.Results:40%and 60%GAA,20 mm2 and 30 mm2 friction damage and ionizing radiation of 12 Gy or greater may induce oral mucosa ulcer with a diseas coruse of 6-7 d in SD rats.TNF-α and IL-1β mRNA expression in the damaged tissue,the related protein expression in blood serum of the rats were in-creased.MORTON&Griffits Guidelines analysis showed 40%GAA,20 mm2 friction damage and 12 Gy ionizing radiation induced the lowest scores of pain,distress and discomfort of the rats with compatible oral mocosa ulcere induced by the relevat treatment.Conclusion:40%GAA,20 mm2 of friction damage and 12 Gy of ionizing radiation can reliably establish oral mucosa ulcer models and minimize adverse effects on SD rats,and accord with ethical standards of 3R for laboratory animal.


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