ObjectiveTo characterize the changes in the overall chemical profile and key index components during nine-time repeating steaming and sun-drying processing of Rhei Radix et Rhizoma， and to reveal the change law of its material basis. MethodsHigh performance liquid chromatography（HPLC） was used to analyze the changes in the overall chemical profile of Rhei Radix et Rhizoma decoction pieces， and the contents of 15 main active components such as chrysophanol-8-O-β-D-glucoside， chrysophanol and gallic acid in the process of nine-time repeating steaming and sun-drying were determined. Combined with chemometrics， the contents and quantity ratio relationships of the glycosides， aglycones and tannins during the processing of Rhei Radix et Rhizoma were analyzed， and the partial least squares-discriminant analysis（PLS-DA） and cluster analysis of the main components in different steaming times were conducted， the statistically significant differential markers were selected with the variable importance in the projection（VIP） value>1. ResultsIn the nine-time repeating steaming and sun-drying process of Rhei Radix et Rhizoma， there were certain regularity in the number and peak area of characteristic peaks and the steaming and sun-drying times， the anthraquinone glycosides and aglycones could be roughly divided into three stages， including rapid change stage， fluctuation change stage and stable stage， and the total amount of tannins showed a decreasing trend. However， the ratios between the three components mentioned above tended to stabilize after five rounds of steaming and sun-drying. The results of PLS-DA and cluster heatmap showed that the content of each component in Rhei Radix et Rhizoma fluctuated greatly during the 1-4 steaming and sun-drying processes， while the content of each component was relatively close during the 5-9 steaming and sun-drying processes. After screening， it was found that chrysophanol， emodin， chrysophanol-8-O-β-D-glucoside， rhein， physcion and emodin-8-O-β-D-glucoside could be used as the index components for distinguishing the processed products of Rhei Radix et Rhizoma with different steaming and sun-drying times. ConclusionThe changes in the properties and efficacy of Rhei Radix et Rhizoma caused by the processing of nine-time repeating steaming and sun-drying are due to the changes in the composition and ratio of various glycosides and complex tannins in this herb， which is also the key to the formation of its characteristic of "purgation with supplement". This study can provide a basis for the research on the processing mechanism of Rhei Radix et Rhizoma and the establishment of processing specifications.

ObjectiveTo investigate the efficacy and mechanism of saffron floral bio-residues（SFB） in the treatment of hyperuricemia（HUA） combined with gouty arthritis（GA） in a compound compatibility setting. MethodScreening candidate control Chinese medicines for compound and SFB based on network target distance calculation and data analysis. After adaptive feeding of 80 SD rats for 7 days， 10 rats were randomly selected as the blank group， while the remaining 70 rats were intraperitoneally injected with 3% potassium oxonate and orally administered with 1% adenine for 14 consecutive days. On the 13^th day， rats were injected with 2.5% sodium urate solution into the right ankle joint cavity to induce swelling of the joint capsule on the opposite side， inducing a HUA combined with GA model. At the same time， the modeling rats were randomly divided into 7 groups， including the model group， benzbromarone group（positive drug， 0.02 g·kg^-1）， Tongfengshu tablets group（9 g·kg^-1）， Tongfengshu granules group（9 g·kg^-1）， SFB granules group（3.6 g·kg^-1）， Plantaginis Semen granules group（3.6 g·kg^-1）， and new formula group（SFB replacing Plantaginis Semen in Tongfengshu granules， 9 g·kg^-1）， with 10 rats in each group. Each treatment group was orally administered with the corresponding drugs according to body weight， while the control and model groups were given equal volume of distilled water by gavage once a day for 14 consecutive days. After 14 days of synchronous administration and modeling， changes in gait， ankle joint swelling and mechanical pain threshold in rats were observed， and serum uric acid， creatinine， urea nitrogen and xanthine oxidase（XOD） were measured. Enzyme-linked immunosorbent assay（ELSIA） was used to detect the levels of tumor necrosis factor（TNF）-α， interleukin（IL）-1β and IL-6 in rat serum， hematoxylin-eosin（HE） staining was used to observe the pathological changes in the liver， kidney and ankle joints of rats， Western blot was used to detect the expression levels of uric acid transporter 1（URAT1）， glucose transporter 9 （GLUT9）， organic anion transporter 1（OAT1）， adenosine triphosphate（ATP） binding cassette transporter G2（ABCG2）， and liver XOD proteins. ResultThrough network pharmacology analysis， Plantaginis Semen was selected as a candidate control herb， and Tongfengshu tablets was used as a compound compatibility environment to explore the efficacy of SFB in reducing blood uric acid levels and treating GA. Animal experiments showed that compared with the blank group， the gait score and joint swelling degree of the model group were significantly increased， and the mechanical pain threshold was significantly decreased（P<0.01）. Compared with the model group， the gait score， joint swelling degree and mechanical pain threshold of rats in each medication group were improved to varying degrees. Biochemical indicators showed that compared with the blank group， the serum uric acid， creatinine， urea nitrogen and XOD levels of the model group were significantly increased（P<0.01）. Compared with the model group， the serum uric acid and XOD levels of rats in each treatment group were significantly decreased（P<0.01）. ELISA results showed that compared with the blank group， the levels of serum TNF-α， IL-1β and IL-6 in the model group were significantly increased（P<0.01）. Compared with the model group， the levels of TNF-α， IL-1β and IL-6 in the benzbromarone group， Tongfengshu tablets group， Tongfengshu granules group and new formula group were significantly reduced（P<0.05，P<0.01）. Western blot results showed that compared with the blank group， the expression levels of URAT1 and GLUT9 proteins in renal tissue and OXD protein in liver tissue of the model group were significantly increased， while the expression levels of renal OAT1 and ABCG2 were significantly decreased（P<0.01）. Compared with the model group， the expression levels of renal URAT1 and GLUT9 in the SFB granules group， Tongfengshu granules group and new formula group were significantly decreased， while the expression levels of renal OAT1 and ABCG2 were significantly increased， and the expression of XOD protein in liver tissue was significantly decreased（P<0.05， P<0.01）. Pathological analysis showed that focal infiltration of neutrophils， cell necrosis and nuclear fragmentation were observed in the liver tissue of the model group， sodium urate deposition crystals and tubular dilation appeared in renal tissue， synovial hyperplasia and inflammatory cell infiltration appeared in ankle joint. Compared with the model group， the abnormal degrees of liver， kidney and ankle joint tissue of rats in each treatment group were alleviated. ConclusionThe new formula of SFB replacing Plantaginis Semen has the same effect in the treatment of HUA combined with GA. This study proposes a new strategy to investigate the efficacy of new resources of Chinese medicine in a compound compatibility environment， which can provide a new demonstration for the research and development of new resources of Chinese medicine.

It has been over two years since the escalation of the Ukraine crisis.From the perspective of medical support,it not only continued the traditional pattern of combat casualties in mechanized warfare but also highlighted characteristics of modern warfare with precise strike on multi-domain battlefields.Specifically,it was manifested with masscasualties and severe and complex injury conditions,which reflected new changes in modern combat casualty treatment.This article sum-marized the basic situation of the organization and implementation of combat wound treatments,and analyzed the problems of treatments organization such as the efficiency of medical evacuation of the wounded,the allocation of first-line treatment forces,and combat wound treatment suppllies,as well as the technical application problems such as batch classification and assessment of the wounded,debridement and fixation,pain management,bacterial resistance,and the use of tourni-quet.Then proposes the key contents that should be paid attention to in the treatments of combat wound in large-scale armed conflicts in the future.

Objective:To investigate the feasibility of using spectral CT chest enhancement venous phase images to obtain virtual non-contrast (VNC) images and virtual arterial phase images to achieve one phase scan instead of three phase scans.Methods:Imaging data of 100 patients who underwent spectral CT chest plain and dual-phase enhancement scans at the First Affiliated Hospital of Kunming Medical University from January to May 2022 were analyzed retrospectively. The venous phase images of all patients were post-processed to obtain virtual non contrast (VNC) and 40 keV virtual mono-energy images (VMI) for simulated arterial phase images (Vart). Image quality and lesion detection were compared between true non-contrast (TNC) and VNC images, and conventional arterial phase (CIart) and Vart images by paired t-test, Wilcoxon test and McNemar test. Objective evaluation indexes of image quality included thoracic aorta, all levels of pulmonary artery, T4 vertebral bone cancellous, chest wall fat CT value, background noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR); the subjective score of image quality was assessed by double-blind method on a 5-point scale; the assessment of lesion detection included the detection rate of calcified foci and pulmonary nodules size, density, volume, percentage of solid components and imaging characteristics. Results:Except for chest wall fat and T4 vertebral bone cancellous, the differences in CT values between VNC and TNC images were not statistically significant ( P>0.05); Except for right upper pulmonary artery and right lower pulmonary artery, the differences in background noise values and SNR between TNC images and VNC images were statistically significant ( P<0.05). Compared with CIart images, the CT values of chest wall fat were lower in Vart images ( P<0.05), and the CT values of the remaining sites were significantly higher ( P<0.05); the background noise values of all sites on Vart images were smaller than those on CIart images, and the SNR and CNR values were higher than those on CIart images ( P<0.05).The differences of subjective scores of images quality were not statistically significant between TNC and VNC images, between CIar and Vart images ( P>0.05). Taking TNC as the standard, the overall detection rate of VNC for calcification was 88.53% (301/340). Except for the short diameter of partially solid nodules, the differences of qualitative and quantitative assessment indexes of lung nodules between TNC and VNC images were not statistically significant ( P>0.05). Conclusions:Spectral CT chest venous phase 40 keV VMI can simulate arterial phase images in the diagnosis of vascular lesions, and venous phase VNC basically meets the standard of conventional plain scan, so it is feasible to replace plain scan, arterial phase and venous phase images in a certain range.

Glaucoma is one of the most common optic neuropathies, featuring progressive retinal ganglion cell damage and visual field loss (Tham et al., 2014; Xu et al., 2020). Currently, the only effective treatment for this condition is the reduction of intraocular pressure (IOP) (Palmberg, 2001; Heijl et al., 2002). Canaloplasty is a proven bleb-independent surgery with good efficacy and safety profiles in primary open-angle glaucoma (POAG) (Gołaszewska et al., 2021). However, early transient postoperative IOP elevation has been reported in up to 30% of cases (Riva et al., 2019), similar to that commonly observed in other internal drainage glaucoma surgeries such as implantation using iStent (0%-21.0%), CyPass (10.8%), and Hydrus (4.8%-6.5%) (Lavia et al., 2017). This complication may be a predictor of poor reserve in the outflow system and is potentially associated with surgical failure. Nonetheless, the exact pathophysiology of glaucoma remains unknown, and studies clarifying the risk factors for postoperative IOP elevation have been scarce.
Humans ; Intraocular Pressure ; Glaucoma, Open-Angle/surgery* ; Incidence ; Treatment Outcome ; Risk Factors

The impact of plateau environment on cerebral venous thrombosis (CVT) is more complex and diverse than in plain areas. This article reviews the epidemiological characteristics, affected sites, and especially the pathogenesis of CVT in plateau areas.

Objective:To explore the predictive value of C-reactive protein/albumin ratio (CAR) and systemic immune-inflammation index (SII) for opportunistic infection among acquired immune deficiency syndrome (AIDS) patients.Methods:From March 2020 to March 2022, a total of 220 AIDS patients treated in Honghu Center for Disease Control and Prevention were enrolled and they were divided into opportunistic infection group (178 cases) and non-infection group (42 cases) according to whether infection occurred; they were also assigned to bacterial infection group (22 cases), fungal infection group (63 cases) and mixed infection group (93 cases) according to different etiological characteristics. The general data were collected and CAR, SII were calculated according to laboratory indicators. Logistic regression was used to screen the risk factors affecting opportunistic infections or different etiological infections. The predictive value of CAR and SII on opportunistic infection and different etiological infections were compared by using receiver operating characteristic (ROC) curve.Results:The CD 4+T cell count, lymphocyte count were lower in the opportunistic infection group and the CRP, CAR, white blood cell count, neutrophil count, SII were higher in the opportunistic infection group compared with non-infection group, there were statistical differences ( P<0.05). The results of Logistic regression analysis showed that CAR and SII were the independent risk factors of opportunistic infection ( P<0.05). The area under the curve (AUC) of CAR to predict opportunistic infection was 0.886(95% CI 0.837 - 0.925), the specificity and sensitivity was 97.0% and 69.1%; the AUC of SII to predict opportunistic infection was 0.743(95% CI 0.680 - 0.799), the specificity and sensitivity was 52.4% and 88.2%. The results of Logistic regression analysis showed that CAR, monocyte count and SII were the independent risk factors for bacterial infection ( P<0.05). CAR and SII were the independent risk factors for fungal infection ( P<0.05). CD 4+ T cell count, CAR and SII were the independent risk factors for mixed infection ( P<0.05). The AUC of CAR to predict bacterial, fungal and mixed infection were 0.898(95% CI 0.797 - 0.960), 0.828(95% CI 0.742 - 0.895) and 0.923(95% CI 0.864 - 0.962), the optimum critical value were 0.49, 0.43, 0.40, the specificity were 98.7%, 95.2% and 92.9%, the sensitivity were 72.7%, 66.7% and 80.6%. The AUC of SII to predict bacterial, fungal and mixed infections were 0.627(95% CI 0.497 - 0.744), 0.782 (95% CI 0.633 - 0.811) and 0.780(95% CI 0.700 - 0.847), the optimum critical value were 385.13, 379.27, 390.10, the specificity were 55.4%, 52.4% and 54.8%, the sensitivity were 77.3%, 85.7% and 90.3%. Conclusions:CAR and SII can be used as predictors of AIDS opportunistic infection.

AIM: To explore the effect and mechanism of circZNF124 on the proliferation, migration and invasion of colorectal cancer SW620 cells. METHODS: The expression levels of circZNF124 and miR-4262 in colorectal cancer tissues were measured by qRT-PCR method. Human colorectal cancer cells SW620 were cultured in vitro, and were randomly grouped into si-NC group, si-circZNF124 group, miR-NC group, miR-4262 group, si-circZNF124 j anti-miR-NC group, si-circZNF124 j antimiR-4262 groups. CCK-8 method, plate clone formation test, scratch test and Transwell test respectively were used to detect cell proliferation, clone formation, migration and invasion of SW620 cells. The dual luciferase reporter experiment analyzed the targeted binding of circZNF124 to miR-4262. Western blot was used to detect the expression of E-cadherin and N-cadherin protein. RESULTS: The expression of circZNF124 in colorectal cancer tissue was increased by about 3.75 times compared with that in the adjacent tissue (P i 0.05), and the expression of miR-4262 was decreased by about 0.73 times compared with the adjacent tissue (P i 0.05). Compared with the si-NC group, the cell viability, scratch healing rate and the protein level of N-cadherin in the si-circZNF124 group were decreased (P i 0.05), the number of cell clone formation and the number of invasive cells were decreased (P i 0.05), while the protein level of E-cadherin was increased (P i 0.05). circZNF124 could negatively regulate the expression of miR-4262. Compared with the miR-NC group, the cell viability, scratch healing rate and the protein level of N-cadherin in the miR-4262 group were reduced (P i 0.05), the number of cell clones and the number of invasive cells were reduced (P i 0.05), while the protein level of E-cadherin was increased (P i 0.05). Inhibition of miR-4262 expression reversed the effect of interfering circZNF124 expression on the proliferation, migration and invasion of SW620 cells.CONCLUSION: Interference with the expression of circZNF124 can attenuate the proliferation, migration and invasion of colorectal cancer cells by targeting miR-4262.

Objective TGF-β1 can promote EMT,then strengthen the invasion and metastasis ability of cancer ceils.However,the mechanism for TGF-β1 in gastric cancer still keeps unclear.Aim of this study was to investigate the expression of epithelial to mesenchymal transition (EMT)marker,LMO1 and metastasis related genes on the human gastric cancer cell cell line MKN28 treated with TGF-β1,and test whether down-regulate LMO1 expression can affect the pro-EMT and pro-metastatic roles of TGF-β1 in MKN28 cells.Methods Primary human gastric cancer cell line MKN28 was cultured in vitro.Cells were treated with TGF-β1 to induce cells to undergone EMT.Cells were divided into four groups:control group (5 ％ BSA),TGF-β1 induced group (10 μg/L),negative transfect group (TGF-β1 +negative transfect siRNA),and LMO1-siRNA transfect group (TGF-β1+ LMO1-siRNA).Real time-PCR and Western blot was used to examine the difference of EMT marker (E-cadherin and N-cadherin),LMO1 and metastasis related genes (MMP-9 and VEGF)expression.Transwell assays were performed to identify the differences and changes of invasive and metastatic ability in gastric cancer cell line MKN28.Western blot was used to examine the expression levels of MMP-9 and VEGF.Results TGF-β1 stimulation induced classical EMT morphological change,as was confirmed by E-cadherin decrease and N-cadherin,LMO1,MMP-9,VEGF increase (P＜0.01).Accompanied with the EMT,cell invasion and migration ability was markedly increased (P＜0.01).However,Down-regulation of LMO1 expression reversed the pro-migratory effect of TGF-β1 to a great degree (P＜0.01).Conclusion LMO1 played a central role in coordinating TGF-β1 induced EMT and pro-migratory effects in gastric cancer MKN28 cells.Using siRNA to downregulate the expression of LMO1 can inhibit the invasion and metastasis ability of gastric cancer MKN28 cells.

Objective To investigate the effects of cholinergic signal on neural stem cell(NSC)differenti-ation in peri-infarction region after ischemic stroke. Methods Mice were randomly assigned into sham + vehicle group,middle cerebral artery occlusion(MCAO)+ vehicle group,MCAO + donepezil group and MCAO + atro-pine group(n = 25). MCAO was induced by thread-occlusion method. Modified neurological severity score (mNSS)was used to evaluate neurological function recovery,and the brain water content was measured by dry-wet weight method. NeuN/5-bromodeoxyuridine(BrdU),CNPase/BrdU,GFAP/BrdU double-labeled cells were tested by immunofluorescence. Results Brain water content of MCAO + vehicle group was significantly higher than that of sham operation group(P < 0.05). Donepezil-treated MCAO mice had lower neurologic deficit scores and brain water content than of MCAO + vehicle group(P < 0.05). On day 14 and day 28 after MCAO,the NeuN/BrdU, CNPase/BrdU and GFAP/BrdU immune-positive cells of MCAO + vehicle group were markedly increased as com-pared with that of sham+vehicle group(P<0.05).Compared with that of MCAO+vehicle group,the number of NeuN/BrdU-positive cells,CNPase/BrdU-positive cells and GFAP/BrdU-positive cells was higher in MCAO+done-pezil group,and the number of NeuN/BrdU-positive cells and CNPase/BrdU-positive cells of MCAO + atropine group was lower(P < 0.05). Conclusions Cholinergic signal could promote NSCs differentiation in peri-infarc-tion region,a lleviate cerebral edema,and improve the brain function restoration after stroke.