Polygonatum sibiricum， as a traditional Chinese medicine with both medicinal and edible properties， has attracted considerable attention due to its functions of nourishing Yin and moistening the lungs， tonifying the spleen and benefiting Qi， and nourishing the kidneys and filling essence. Recent studies have demonstrated that Polygonatum sibiricum plays a significant role in regulating the immune system， effectively enhancing and improving the morphology and function of immune organs， stimulating the proliferation and activation of immune cells， and regulating the secretion and release of immune factors， thereby enhancing the immune function of the body and improving various immune-related diseases. Although a large number of studies have explored the pharmacological effects and mechanisms of P. sibiricum， there has been no systematic review and summary of its immune regulatory activity and mechanisms. Therefore， this article comprehensively reviews the research achievements of P. sibiricum polysaccharides and saponins in the field of immune regulation in recent years， and further sorts out the immune regulatory mechanisms of P. sibiricum in multiple aspects： including increasing the organ index of the spleen and thymus， increasing the number and activity of tumor-suppressive bone marrow hematopoietic stem cells， improving intestinal flora imbalance， regulating the quantity and proportion of T lymphocyte subsets， increasing the level of immunoglobulin， promoting the proliferation of macrophages， enhancing the activity of natural killer cells， increasing the number of white blood cells， and promoting the maturation of dendritic cells， providing a solid theoretical basis and scientific evidence for the research and application of P. sibiricum， and promoting its development and application in traditional Chinese medicine immune enhancers and various functional products.

Objective:To investigate the effect of modified citrus pectin (MCP) on the glucose metabolism of rabbit articular chondrocytes.Methods:The third generation (P3) rabbit knee chondrocytes were extracted and cultured with 0 μg/ml (MCP0, control group) and 500 μg/ml of MCP (MCP500) for 3 days. Chondrocytes (P2-P7)were cultured continuously, and each generation of chondrocytes was treated with MCP0 and MCP500 medium for 3 days. Chondrocytes were treated with interleukin-1β (IL-1β) for 1 day and then treated with MCP0 and MCP500 medium for 3 days, respectively. Chondrocytes were treated with 2-deoxy-glucose (2DG) for 1 day and then treated with MCP0 and MCP500 medium for 3 days, respectively. After three days of culture, the proliferation of chondrocytes was calculated by CCK-8. Glucose uptake activity and lactate production of chondrocytes were measured by glucose and lactate detection kits. The synthesis of type Ⅱ collagen (COL2A1) in sequential chondrocytes was investigated by immunofluorescence staining. The gene expression of COL2A1, proteoglycan ( ACAN), SOX9, hypoxia-inducible factor-1α ( HIF-1α), glucose transporter-1 ( Glut-1), pyruvate kinase M2 ( PKM2), lactate dehydrogenase-A ( LDHA) and glucose transporter-1 ( Glut-3) were further detected by RT-qPCR. Results:Compared with the control group, MCP treatment could increase the glucose uptake activity and lactate production of chondrocytes, and enhance the gene expression ability of HIF-1α, Glut-1, PKM2 and ACAN. Besides, MCP treatment could stimulate chondrocyte proliferation, maintain chondrocyte phenotype, increase lactate production, and upregulate the expression of COL2A1, ACAN, SOX9, HIF-1α, Glut-1, PKM2 and LDHA. After the treatment with IL-1β, MCP treatment could increase glucose uptake activity and upregulate the expression of COL2A1, ACAN, HIF-1α and Glut-1. After treatment with 2DG, MCP treatment could increase glucose uptake activity and upregulate the expression of SOX9, HIF-1α, PKM2 and Glut-3 genes. Conclusions:MCP can enhance the glucose uptake capacity of chondrocytes and increase the level of chondrocyte glycolytic metabolism.

Objective To investigate the immediate brain effect of acupuncture at Fengchi using amplitude of low-frequency fluctuation(ALFF)and functional connectivity by the resting-state functional magnetic resonance imaging(rs-fMRI)in patients with posterior circulation ischemia vertigo(PCIV).Methods Twenty patients with PCIV were enrolled.The dizziness handicap inventory(DHI)was used to evaluate the severity of vertigo.The patients were randomly divided into acupuncture group and sham acupoint acupuncture group.Rs-fMRI scan was performed before and after acupuncture.MATLAB-based DPABI 6.1 software was used to analyze rs-fMRI data.Correlation analysis was used between the altered ALFF values and DHI scores.The regions of altered ALFF were taken as seeds to analyze functional connectivity.Results Compared with the sham acupoint acupuncture group,the increased ALFF values were mainly located on the left precuneus,left superior frontal gyrus and left caudate nucleus after acupuncture in the acupuncture group;the decreased ALFF values were mainly located on the left cerebellum and right inferior occipital gyrus.The ALFF value of the left superior frontal gyrus was negatively correlated with the DHI score(P=0.04).The increased functional connectivity was mainly found between left precuneus and the right middle frontal gyrus,the right superior frontal gyrus,the decreased functional connectivity was mainly found between left precuneus and the bilateral paracentral lobule and right cerebellum.Conclusion The ALFF value and functional connectivity are different before and after acupuncture,indicating that the vestibular network,visual and motor brain regions functional activities are changed after needling at Fengchi,which may be the brain functional basis of Fengchi for vertigo in PCIV.

Postoperative adhesion is a common phenomenon that occurs due to excessive inflammation and fibrin deposition during wound recovery after surgery. Postoperative adhesion can result in the adhesion of internal organs or tissues, which subsequently affects organ function and may even lead to postoperative complications. Currently, biofilm materials that prevent postoperative adhesion through physical barriers are considered the most effective strategy for managing this condition. In this paper, anti-postoperative adhesion biofilm materials derived from both natural and synthetic polymer sources are reviewed, and two emerging types of anti-adhesion biofilm materials are introduced, including nanoparticle films and drug-loaded biofilms, to provide a comprehensive reference for the future development of anti-postoperative adhesion biofilm materials.

Objective:To establish and internally validate a nomogram model for predicting complicated acute appendicitis (CA).Methods:The clinical data from 663 acute appendicitis patients from the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from October 2015 to October 2022 were retrospectively analyzed. There were 411 males and 252 females, aged ( M (IQR)) 41 (22) years (range: 18 to 84 years). There were 516 cases of CA and 147 cases of uncomplicated acute appendicitis. The minimum absolute contraction and selection operator regression model was used to screen the potential relative factors of CA, and the screened factors were included in the Logistic regression model for multivariate analysis. Software R was used to establish a preoperative CA nomogram prediction model, the receiver operating characteristic curve of the model was drawn, and the value of area under the curve (AUC) was compared to evaluate its identification ability, and the Bootstrap method was used for internal verification. Results:The elderly (age≥60 years) ( OR=2.428, 95% CI: 1.295 to 4.549), abdominal pain time (every rise of 1 hour) ( OR=1.089, 95% CI: 1.072 to 1.107), high fever (body temperature≥39 ℃) ( OR=1.122, 95% CI: 1.078 to 1.168), total bilirubin (every rise of 1 μmol/L) ( OR=2.629, 95% CI: 1.227 to 5.635) were independent relative factors of CA (all P<0.05). The AUC of this model was 0.935 (95% CI: 0.915 to 0.956). After internal verification using the Bootstrap method, the model still had a high discrimination ability (AUC=0.933), and the predicted CA curve was still in good agreement with the actual clinical CA curve. Conclusion:The clinical prediction model based on the elderly (age≥60 years), prolonged abdominal pain time, high fever (body temperature≥39 ℃), and increased total bilirubin can help clinicians effectively identify CA.

Objective:To establish and internally validate a nomogram model for predicting complicated acute appendicitis (CA).Methods:The clinical data from 663 acute appendicitis patients from the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from October 2015 to October 2022 were retrospectively analyzed. There were 411 males and 252 females, aged ( M (IQR)) 41 (22) years (range: 18 to 84 years). There were 516 cases of CA and 147 cases of uncomplicated acute appendicitis. The minimum absolute contraction and selection operator regression model was used to screen the potential relative factors of CA, and the screened factors were included in the Logistic regression model for multivariate analysis. Software R was used to establish a preoperative CA nomogram prediction model, the receiver operating characteristic curve of the model was drawn, and the value of area under the curve (AUC) was compared to evaluate its identification ability, and the Bootstrap method was used for internal verification. Results:The elderly (age≥60 years) ( OR=2.428, 95% CI: 1.295 to 4.549), abdominal pain time (every rise of 1 hour) ( OR=1.089, 95% CI: 1.072 to 1.107), high fever (body temperature≥39 ℃) ( OR=1.122, 95% CI: 1.078 to 1.168), total bilirubin (every rise of 1 μmol/L) ( OR=2.629, 95% CI: 1.227 to 5.635) were independent relative factors of CA (all P<0.05). The AUC of this model was 0.935 (95% CI: 0.915 to 0.956). After internal verification using the Bootstrap method, the model still had a high discrimination ability (AUC=0.933), and the predicted CA curve was still in good agreement with the actual clinical CA curve. Conclusion:The clinical prediction model based on the elderly (age≥60 years), prolonged abdominal pain time, high fever (body temperature≥39 ℃), and increased total bilirubin can help clinicians effectively identify CA.

Objective: To analyze the clinical value of serum tumor markers CA19-9, CA242, CEA, CA724 and CA125 in the diagnosis and prognosis of gallbladder carcinoma patients. Methods: A retrospective analysis of the preoperative serum levels of CA19-9, CA242, CEA, CA724 and CA125 in 132 patients with gallbladder cancer admitted to Eastern Hepatobiliary Surgery Hospital from March 2009 to December 2013 for sensitivity comparison, Kaplan-Meier survival table was used for univariate survival analysis, and the log-rank method was compared for differences. The Cox regression model was used for multivariate survival analysis. Results: The sensitivities of CA19-9, CA242, CA125, CEA and CA724 were 67.4%, 63.6%, 42.4%, 24.2% and 22.7%, respectively. There were no significant differences of the sensitivity between CA19-9 and CA242 (P>0.05). However, whether CA19-9 or CA242, there were significant differences of diagnostic sensitivity compared to CEA or CA724 or CA125 (all P<0.05). When CA19-9 was combined with CA125 or CEA or CA724, respectively, the sensitivity was improved, but there was no significant difference compared with CA19-9 alone (all P>0.05). Similarly, CA242 also has such a situation when compared with CA242 alone (all P>0.05). Univariate survival analysis showed there were statistically significant differences in CA19-9, CA242, and CEA (all P<0.05). Cox regression suggested that CA242 is an independent prognostic factor for gallbladder carcinoma. CA242 is closely related to histological grade of gallbladder carcinoma, lymph node metastasis and TNM staging. Conclusions CA19-9 and CA242 have definite value in the diagnosis of gallbladder carcinoma. CA242 is an independent prognostic factor for gallbladder carcinoma.

OBJECTIVE： To study the dose-time-effect relationship of Tibetan medicine Rannasangpei in cerebral ischemic- reperfusion injury model rats with intragastric administration. METHODS： The rats were randomly divided into sham operation group （normal saline， 10 mL/kg）， model control group （normal saline， 10 mL/kg）， positive control group （nimodipine， 30      mg/kg）， Rannasangpei different dose groups （0.52， 1.04， 2.08， 4.17， 8.33， 16.67， 33.34， 66.68， 133.36， 266.72 and 533.44    mg/kg）， with 18 rats in each group. Each group was given relevant medicine intragastrically once； 25 min after intragastric administration， cerebral ischemic-reperfusion injury model was established with suture-occluded method in those groups except for sham operation group. 24， 48， 72 h after cerebral ischemia， neuroethology of rats were graded in each group. The rate of cerebral infraction was detected to evaluate the optimal effective time， the optimal dose （Dmax） and maximal effect （the rate of minimum cerebral infraction， Emax） of Ratnasampil at different periods of cerebral ischemia. Dose-time-effect relationship of Rannasangpei dose with the rate of cerebral infraction was fitted with Thermo Kinetica 5.1 software. The area under curve （AUClast） and retention dose （MRTlast） of dose-effect curve were calculated， and detect the levels of SOD and MDA. RESULTS： Compared with sham operation group， the neurobehavior of model group was significantly abnormal （P＜0.05 or P＜0.01）， and the rate of cerebral infarction was significantly increased （P＜0.01）； the level of SOD was decreased significantly （P＜0.01， 48 h）， and the level MDA was increased significantly （P＜0.05， 48 h）. Compared with model control group， there was no significant change in neurobehavioral abnormalities in the nimodipine group （P＞0.05）， and the rate of cerebral infraction was decreased significantly （P＜0.01， 24， 48 h）. The level of SOD in rats were increased significantly （P＜0.01， 48 h）， while the level MDA decreased significantly （P＜0.05， 48 h）. Rannasangpei 2.08-33.34 mg/kg could significantly improved neurobehavioral abnormalities （P＜0.05， 24 h）； 24 h after cerebral ischemia， the rate of cerebral infraction was decreased significantly in Rannasangpei 4.17-133.36 mg/kg group （the lowest is 33.34 mg/kg group， P＜0.05 or P＜0.01）. The level of SOD in rats were increased significantly in 33.34-533.44 mg/kg groups （P＜0.05）. the level MDA was decreased significantly in 0.52-2.08， 8.33， 33.34， 266.72 and 533.44 mg/kg groups （P＜0.05）. Dmax was 33.34 mg/kg， Emax was 3.02％， AUClast was 5 141.76 mg/kg and MRTlast was 329.161 mg/kg. 48 h after cerebral ischemia， the rate of cerebral infraction was decreased significantly in Rannasangpei 2.08-133.36 mg/kg groups （the lowest is 66.68 mg/kg group， P＜0.05 or P＜0.01）， while the level of SOD was increased significantly in 1.04-533.44（except for 4.17）mg/kg groups （P＜0.05）. The level of MDA was decreased significantly in 16.67-66.68， 533.44 mg/kg groups （P＜0.05）， Dmax was 66.68 mg/kg， Emax was 2.13％， AUClast was    5 219.36 mg/kg and MRTlast was 340.521 mg/kg. 72 h after cerebral ischemia， the rate of cerebral infraction and the level of MDA had no significant decreased in Rannasangpei groups （P＞0.05）， and the levels of SOD had no significant increase （except for 0.52 mg/kg group， P＞0.05）. CONCLUSIONS： The optimal effective time of Rannasangpei for the treatment of cerebral ischemia-reperfusion injury in rats is 48 h， and the Dmax is 66.68 mg/kg. The improvement mechanism may be related to increase the level of SOD and decrease the level of MDA.

Objective: To analyze the prevalence and related factors of HBV infection among people aged 18 years old and above in Mianyang city. Methods: A total of 260 950 residents, living in Mianyang city more than 6 months, aging 18 years old and above were employed by multi-stage random sampling method from November 2014 to September 2015. Questionnaire survey was conducted on participants using a self-designed questionnaire, including general demographic characteristics, family history of Hepatitis B, history of Hepatitis B vaccination and history of present illness, etc. 5ml blood was collected from all participants, and the blood samples were detected for HBsAg by enzyme-linked immunosorbent assay (ELISA). The multivariate unconditional logistic regression was performed to identify the related factors of positive HBsAg. Results: Among the 260 950 subjects, 113 184 were males (43.37%), 147 766 were females (56.63%), and the average age was (47.68±17.36) years old. The positive rate of HBsAg was 6.10%(15 822 cases). Subjects who were 25-34 years old (OR=1.23), 35-44 years old (OR=1.26), 45-54 years old (OR=1.23), and 55-64 years old (OR=1.34) were more likely to be HBsAg positive,65 years and older (OR=0.88) were less likely to be, compared with subjects aging 18-24 years old; males were more likely to be HBsAg positive compared with females (OR=1.35); people living in Fucheng district were more likely to be HBsAg positive compared with who living in Jiangyou district(OR=1.91); married people were more likely to be HBsAg positive compared with unmarried ones (OR=1.36); medical staff were less likely to be HBsAg positive compared with non-medical staff (OR=0.61); subjects with a surgery history were more likely to HBsAg positive compared with who without (OR=1.13); subjects with trauma history were more likely to HBsAg positive compared with who without (OR=1.13); people with history of Hepatitis B were more likely to HBsAg positive compared with who without (OR=4.21); people with Hepatitis B vaccination history were less likely to be HBsAg positive compared with who without (OR=0.48); all the P values above were less than 0.05. Conclusion The positive rate of HBsAg among adults in Mianyang city was very high, and we should pay more attention to people aging between 25 and 64 years old, male, medical staff, with surgery history, trauma history, and a family history of Hepatitis B and Hepatitis B vaccination history.

OBJECTIVETo identify the value of lymphography in the location and treatment decision of chyle leakage.

METHODSThe clinic data of 177 patients suffered from chyle leakage admitted in 6 medical centers in Shanghai from February 1998 to December 2014 was analyzed retrospectively. There were 94 male and 83 female patients aging from 9 to 84 years with a mean of 49 years, including 128 cases of chyluria, 34 cases of primary chylothorax and 15 cases of other chyle leakage. All patients had failed to conservative treatment more than 2 weeks. Pedal lymphography was performed in every patient to investigate the site and range of chyle leakage. Effect of surgical or conservative management was compared according to the different results of lymphography.

RESULTSNo serious complication was noticed. For all 177 patients, lymphography showed localized lymphatic diseases in 148 cases (83.6%), including 125 cases of lymphatic renal pelvic leaks, 14 cases of unilateral identified leak within thorax and 9 cases of chyle leakage in neck, heart, abdomen or scrotum. Among these patients, surgical treatment cured 129 and improved 3 patients but failed in 2 patients, while the remaining 14 cases had their leaks decreased after lymphography and cured by conservative management. For those 15 patients having disseminated lymphatic diseases or 14 with no abnormality under lymphography, surgery only cured 2 and improved 1 patient but failed in 8 patients (with 3 death), whereas continuous conservative treatment cured 11 patients, improved 5 patients but only failed in 2 patients (with one death). For localized leakage, surgical treatment showed better efficacy (98.5% vs. 3/11), whereas conservative treatment had significantly higher successful rate than surgical interventions in patients with disseminated lymphatic diseases or no abnormality under lymphography (16/18 vs. 3/11).

CONCLUSIONSLymphography could identify the location and range of complicate chyle leakage failed to primary conservative management. Patients with disseminated lymphatic diseases or no abnormality under lymphography would be better managed by continuous non-operative treatment partly due to therapeutic effect of lymphography, while surgical intervention could be a good option for patients having localized lymphatic etiology.

Abdominal Cavity ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Chyle ; Chylothorax ; diagnosis ; surgery ; Female ; Heart ; Humans ; Kidney Pelvis ; Lymphatic Diseases ; Lymphography ; Male ; Middle Aged ; Neck ; Retrospective Studies ; Scrotum ; Young Adult