Aim To investigate the anti-acute lung injury(ALI)effect of Sterculiae Lychnophorae Semen(SLS)and its mechanism.Methods The main ac-tive components of SLS and their core targets and path-ways of action against ALI were obtained by network pharmacology methods.Subsequently,molecular doc-king technology and in vitro cellular experiments were applied for validation.Results A total of 19 core tar-gets were obtained,including HSP90AA1,CASP3,TNF,MAPK8 and MAPK14.The mechanisms may in-volve signaling pathways such as cancer,PI3K/Akt and MAPK.Molecular docking confirmed that the key targets of SLS formed a better binding activity with the relevant active ingredients.The in vitro results showed that SLS was able to protect the PM2.5-contaminated BEAS-2B cells,inhibit their NO,IL-1β and TNF-αlevels,and reduce the expression of p-p38 MAPK and p-JNK proteins.Conclusions The study successfully predicts the active ingredients,targets and signaling pathways of SLS against ALI,and in vitro experiments demonstrate that SLS might protect BEAS-2B cells from PM2.5 stimulus-induced inflammation and apoptosis by inhibiting the over-activation of p38 MAPK and JNK signaling pathways.

Objective To investigate the clinical characteristics of patients with clinical and subclinical Cushing's syndrome caused by primary bilateral macronodular adrenal hyperplasia(PBMAH).Methods A retrospective analysis was performed on the clinical data of 198 patients with Cushing's syndrome caused by PBMAH diagnosed in the First Medical Center of Chinese PLA General Hospital from January 2004 to October 2024.According to clinical manifestations,the patients were classified into clinical type Cushing's syndrome(n=61)and subclinical type Cushing's syndrome(n=137),and the clinical characteristics of the two types were compared.Results The mean age at diagnosis of patients with PBMAH-induced Cushing's syndrome was(53.5±10.4)years,including 118 males and 80 females,with a male-to-female ratio of 1.475:1.Compared with the subclinical type,the clinical type had a higher proportion of females,higher levels of serum cortisol,24-hour urine free cortisol(24 h UFC),and inhibited serum cortisol after low-dose dexamethasone suppression.Additionally,the clinical type had lower plasma ACTH,larger adrenal nodules and a higher risk of surgery(P<0.05)compared with those in subclinical type.The incidences of hypertension,dyslipidemia,obesity,diabetes mellitus,hypokalemia,vitamin D deficiency,osteoporosis,coronary heart disease,and cerebrovascular disease in patients with Cushing's syndrome caused by PBMAH were 87.9%,50.5%,37.1%,36.9%,27.8%,25.9%,18.7%,18.7%and 12.1%,respectively.Among them,compared with subclinical type patients,clinical type patients had higher incidence of hypokalaemia,vitamin D deficiency and osteoporosis(P<0.05),while there were no statistically significant differences in the incidences of other comorbidities between the two types(P>0.05).The results of postoperative follow-up for PBMAH patients showed that the short-term biochemical remission rate of unilateral total adrenalectomy was 41.5%(22/53)and the long-term biochemical remission rate was 32.0%(8/25).The short-term biochemical remission rate of unilateral partial(or nodular)adrenalectomy was 52.9%(9/17),and the long-term biochemical remission rate was 14.3%(1/7).All patients who underwent unilateral total adrenalectomy plus contralateral partial resection developed adrenal insufficiency(3/3),and 1 patient(1/3)relapsed 3.4 years after surgery.Conclusion Clinical and subclinical types of Cushing's syndrome caused by PBMAH have their distinct clinical characteristics.Surgery is an effective treatment for PBMAH,but a certain proportion of patients fail to achieve biochemical remission after non-bilateral total adrenalectomy.

Diaphragmatic dysfunction(DD)can be caused by various factors,including anesthesia,surgery,and patient-related conditions.It may lead to adverse events such as prolonged postoperative extubation,weaning failure,postoperative pulmonary complications(PPCs),which can eventually result in patients being transferred to the intensive care unit(ICU),having an extended hospital stay and an increased mortality rate.Thus,it is crucial that the function of the diaphragm be timely and accurately assessed,and its status be reasonably protected for the favorable outcomes of patients after anesthesia and surgery.Recently,point-of-care diaphragmatic ultrasound has been applied in the clinic.However,currently,the assessment of DD is mainly concentrated in the ICU,and its application during the perioperative period is relatively restricted.In the review,the mechanisms of postoperative DD after anesthesia and the application progress of ultrasonography evaluation are summarized.The static and dynamic functions of the diaphragm are monitored via various ultrasound examination methods,and the postoperative changes and recovery of diaphragm function in each patient are observed in real time.In this way,the occurrence of PPCs can be predicted,a reasonable anesthesia and surgery plan can be guided to be developed,the protection and even prerehabilitation of the target organ"diaphragm"can be promoted,DD can be ultimately prevented and treated in a timely manner,and postoperative recovery can be improved.

Aim To investigate the anti-acute lung injury(ALI)effect of Sterculiae Lychnophorae Semen(SLS)and its mechanism.Methods The main ac-tive components of SLS and their core targets and path-ways of action against ALI were obtained by network pharmacology methods.Subsequently,molecular doc-king technology and in vitro cellular experiments were applied for validation.Results A total of 19 core tar-gets were obtained,including HSP90AA1,CASP3,TNF,MAPK8 and MAPK14.The mechanisms may in-volve signaling pathways such as cancer,PI3K/Akt and MAPK.Molecular docking confirmed that the key targets of SLS formed a better binding activity with the relevant active ingredients.The in vitro results showed that SLS was able to protect the PM2.5-contaminated BEAS-2B cells,inhibit their NO,IL-1β and TNF-αlevels,and reduce the expression of p-p38 MAPK and p-JNK proteins.Conclusions The study successfully predicts the active ingredients,targets and signaling pathways of SLS against ALI,and in vitro experiments demonstrate that SLS might protect BEAS-2B cells from PM2.5 stimulus-induced inflammation and apoptosis by inhibiting the over-activation of p38 MAPK and JNK signaling pathways.

Objective To explore the research context,hotspots and development direction of eye acupuncture therapy through analysis on relevant literature about eye acupuncture therapy based on visualization analysis on knowledge map.Methods The literature related to eye acupuncture therapy was retrieved from CNKI,Wanfang Data,VIP and CBM from the establishment of the databases to 2022.NoteExpress 3.7.0.9296 was used to screen the titles.WPS 11.1.0.13703 was used to analyze the time of publications and the source journals,and CiteSpace 6.1.R6 was used to analyze the authors,institutions and keywords included in the literature.Results A total of 964 articles were included after screening.The total number of publications showed an increasing trend of fluctuation.187 journals were involved,and the journals with the highest number of articles were Liaoning Journal of Traditional Chinese Medicine,Chinese Acupuncture and Moxibustion,Practical Journal of Internal Medicine of Traditional Chinese Medicine;805 high-yield authors such as Wang Pengqin,Wang Jian and Wang Zhe were included.369 institutions including Liaoning University of Traditional Chinese Medicine,Guangzhou University of Traditional Chinese Medicine and Tianjin University of Traditional Chinese Medicine were included.A total of 637 keywords such as stroke,cerebral ischemia-reperfusion injury,and clinical research were included.Conclusion The research of eye acupuncture therapy has gradually developed from theoretical interpretation,case report,curative effect observation and experience of famous doctors to basic research and higher-level clinical research of dominant diseases.Post-stroke mental disorders and brain diseases excluding cerebrovascular diseases are the research trends in this field.

Traumatic dental injuries(TDIs)of teeth occur frequently in children and adolescents.TDIs that impact the periodontal tissues and alveolar tissue can be classified into concussion,subluxation,extrusive luxation,intrusive luxation,lateral luxation,and avulsion.In these TDIs,management of injured soft tissue,mainly periodontal ligament,and dental pulp,is crucial in maintaining the function and longevity of the injured teeth.Factors that need to be considered for management in laxation injuries include the maturation stage of the traumatic teeth,mobility,direction of displacement,distance of displacement,and whether there are alveolar fractures.In avulsion,the maturation stage of the permanent tooth,the out-socket time,storage media/condition of the avulsed tooth,and management of the PDL should also be considered.Especially,in this review,we have subdivided the immature tooth into the adolescent tooth(Nolla stage 9)and the very young tooth(Nolla stage 8 and below).This consensus paper aimed to discuss the impacts of those factors on the trauma management and prognosis of TDI to provide a streamlined guide for clinicians from clinical evaluation,diagnostic process,management plan decision,follow-up,and orthodontic treatment for tooth luxation and avulsion injuries.

Traumatic dental injuries(TDIs)of teeth occur frequently in children and adolescents.TDIs that impact the periodontal tissues and alveolar tissue can be classified into concussion,subluxation,extrusive luxation,intrusive luxation,lateral luxation,and avulsion.In these TDIs,management of injured soft tissue,mainly periodontal ligament,and dental pulp,is crucial in maintaining the function and longevity of the injured teeth.Factors that need to be considered for management in laxation injuries include the maturation stage of the traumatic teeth,mobility,direction of displacement,distance of displacement,and whether there are alveolar fractures.In avulsion,the maturation stage of the permanent tooth,the out-socket time,storage media/condition of the avulsed tooth,and management of the PDL should also be considered.Especially,in this review,we have subdivided the immature tooth into the adolescent tooth(Nolla stage 9)and the very young tooth(Nolla stage 8 and below).This consensus paper aimed to discuss the impacts of those factors on the trauma management and prognosis of TDI to provide a streamlined guide for clinicians from clinical evaluation,diagnostic process,management plan decision,follow-up,and orthodontic treatment for tooth luxation and avulsion injuries.

Humans ; Gemcitabine ; Neoplasms

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

COVID-19 has been prevalent for three years. The virulence of SARS-CoV-2 is weaken as it mutates continuously. However, elderly patients, especially those with underlying diseases, are still at high risk of developing severe infections. With the continuous study of the molecular structure and pathogenic mechanism of SARS-CoV-2, antiviral drugs for COVID-19 have been successively marketed, and these anti-SARS-CoV-2 drugs can effectively reduce the severe rate and mortality of elderly patients. This article reviews the mechanism, clinical medication regimens, drug interactions and adverse reactions of five small molecule antiviral drugs currently approved for marketing in China, so as to provide advice for the clinical rational use of anti-SARS-CoV-2 in the elderly.