Acute lung injury (ALI) is a significant complication of sepsis, characterized by high morbidity, mortality, and poor prognosis. Neutrophils, as critical intrinsic immune cells in the lung, play a fundamental role in the development and progression of ALI. During ALI, neutrophils generate neutrophil extracellular traps (NETs), and excessive NETs can intensify inflammatory injury. Research indicates that Taohe Chengqi decoction (THCQD) can ameliorate sepsis-induced lung inflammation and modulate immune function. This study aimed to investigate the mechanisms by which THCQD improves ALI and its relationship with NETs in sepsis patients, seeking to provide novel perspectives and interventions for clinical treatment. The findings demonstrate that THCQD enhanced survival rates and reduced lung injury in the cecum ligation and puncture (CLP)-induced ALI mouse model. Furthermore, THCQD diminished neutrophil and macrophage infiltration, inflammatory responses, and the production of pro-inflammatory cytokines, including interleukin-1β (IL-1β), IL-6, and tumor necrosis factor α (TNF-α). Notably, subsequent experiments confirmed that THCQD inhibits NET formation both in vivo and in vitro. Moreover, THCQD significantly decreased the expression of peptidyl arginine deiminase 4 (PAD4) protein, and molecular docking predicted that certain active compounds in THCQD could bind tightly to PAD4. PAD4 overexpression partially reversed THCQD's inhibitory effects on PAD4. These findings strongly indicate that THCQD mitigates CLP-induced ALI by inhibiting PAD4-mediated NETs.
Extracellular Traps/immunology* ; Acute Lung Injury/immunology* ; Animals ; Sepsis/immunology* ; Drugs, Chinese Herbal/pharmacology* ; Mice ; Neutrophils/immunology* ; Male ; Protein-Arginine Deiminase Type 4/genetics* ; Mice, Inbred C57BL ; Humans ; Disease Models, Animal ; Cytokines/metabolism*

Objective To investigate the effect of spinal cord electrical stimulation on diabetic peripheral neuropathy.Methods A total of 120 patients with diabetic peripheral neuropathy were randomly assigned to three groups,with 40 cases in each group.Group A was treated with pregabalin.Group B received radiofrequency therapy of lumbar sympathetic ganglion.Group C was treated with spinal cord electrical stimulation.The treatment course was six months.Pain,EMG parameters,hemorheology indexes,quality of life,sleep quality,and HbA1c were compared among groups.Results Group C had higher therapeutic effective rate than groups A and B(P<0.05)after 6 months of treatment.After 1 week,3 months,6 months and 12 months of treatment,the visual analogue scale(VAS)scores and HbA1c levels of group C were lower than those of groups A and B(P<0.05).After 6 months of treatment,the motor nerve and sensory nerve conduction velocities of the median nerve and peroneal nerve in group C were higher than those in groups A and B(P<0.05).After 6 months of treatment,the whole blood viscosity and capillary plasma viscosity of group C were lower than those of groups A and B(P<0.05).After 6 months of treatment,the 36-item short form health survey(SF-36)score of group C was higher than that of groups A and B,and the Pittsburgh sleep quality Index(PSQI)score of group C was lower than that of groups A and B(P<0.05).The incidence of adverse reactions in group C was lower than that in groups A and B(P<0.05).Conclusion Compared with drugs and lumbar sympathetic ganglion radiofrequency therapy,spinal cord electrical stimulation has a better efficacy in the treatment of diabetic peripheral neuropathy.It can continuously relieve neuropathic pain,increase the velocity of motor and sensory nerve conduction,improve the hemorheology,HbA1c levels,quality of life and sleep quality,and has high safety and significant clinical value.

Objective To assess the exposure levels of heavy metals,including lead,arsenic,mercury,and cadmium,in the local population in Sichuan and Chongqing,China,to compare and analyze the differences in reference intervals(RIs)obtained from direct and indirect sampling methods,and to explore the interchangeability and limitations of these two sampling methods.Methods RIs were obtained by the direct sampling method and the indirect sampling method.In the direct sample method,the levels of blood arsenic,urinary cadmium,urinary mercury,and blood lead levels of 5562 healthy participants aged 22-50 years in Sichuan and Chongqing,China were measured by atomic absorption spectrometry and inductively coupled plasma-mass spectrometry.Using the human biomonitoring(HBM)data,we established RIs for the population by a nonparametric method.On the other hand,in the indirect sampling method,RIs were established via a nonparametric method based on data from the laboratory information system(LIS)of a local hospital after stratifying healthy individuals using a Gaussian mixture model(GMM).Comparative analysis of the RIs derived from the two sampling methods were then conducted.Results The RI for blood arsenic was 0.11-1.3 μmol/L.The RI for urinary cadmium was 0.51-2.80 μmol/mol creatine for adults aged 22 to under 43 years and 0.66-2.96 μmol/mol creatine for adults aged 43-50 years.The RI for urinary mercury was 0.12-1.10 μmol/mol creatine.The RI for blood lead was 14.00-47.00 pg/L for adults aged 22 to under 41 year,16.00-53.38 pg/L for males aged 41-50 year,and 15.00-51.02 pg/L for females aged 41-50 year.Most of the RIs established by the direct sampling method had a narrower range compared to those established by the indirect sampling method,and the RIs established by both sampling methods were partially biased.Conclusions The RIs for blood arsenic,urine cadmium,urine mercury,and blood lead in healthy individuals aged 22-50 years in Sichuan and Chongqing,China were established using both direct and indirect sampling methods,which contributes to a better understanding of environmental exposure to metals in the general population and provides a reference for metal poisoning.For data from the same lab,the GMM-based indirect sampling method demonstrated relatively consistent performance in establishing RIs compared with the direct sampling method.

Cardiac surgery patients often present with multiple comorbidities,the risk of periop-erative complications and the complexity of postoperative rehabilitation have significantly increased,posing higher demands on comprehensive perioperative management.Preoperative exercise pre-reha-bilitation,as a multidisciplinary collaborative intervention strategy,has been demonstrated to signifi-cantly improve the clinical prognosis of patients undergoing elective cardiac surgery by enhancing their cardiopulmonary function,muscle strength,and overall physiological functional reserve,thereby in-creasing the body's tolerance to surgical stress.Although phase-specific research achievements have been made domestically and internationally in the field of exercise pre-rehabilitation,its standardized implementation and clinical translation on a global scale still face numerous obstacles,necessitating systematic review and in-depth exploration.Therefore,this study aimed to conduct a systematic re-view of the intervention protocols,clinical efficacy,safety,and feasibility of preoperative exercise pre-rehabilitation in patients undergoing elective cardiac surgery,with the goal of providing theoretical evidence and practical references for optimizing perioperative management pathways and promoting the implementation of enhanced recovery after surgery concepts.

Pulpotomy, which belongs to vital pulp therapy, has become a strategy for managing pulpitis in recent decades. This minimally invasive treatment reflects the recognition of preserving healthy dental pulp and optimizing long-term patient-centered outcomes. Pulpotomy is categorized into partial pulpotomy (PP), the removal of a partial segment of the coronal pulp tissue, and full pulpotomy (FP), the removal of whole coronal pulp, which is followed by applying the biomaterials onto the remaining pulp tissue and ultimately restoring the tooth. Procedural decisions for the amount of pulp tissue removal or retention depend on the diagnostic of pulp vitality, the overall treatment plan, the patient's general health status, and pulp inflammation reassessment during operation. This statement represents the consensus of an expert committee convened by the Society of Cariology and Endodontics, Chinese Stomatological Association. It addresses the current evidence to support the application of pulpotomy as a potential alternative to root canal treatment (RCT) on mature permanent teeth with pulpitis from a biological basis, the development of capping biomaterial, and the diagnostic considerations to evidence-based medicine. This expert statement intends to provide a clinical protocol of pulpotomy, which facilitates practitioners in choosing the optimal procedure and increasing their confidence in this rapidly evolving field.
Humans ; Calcium Compounds/therapeutic use* ; Consensus ; Dental Pulp ; Dentition, Permanent ; Oxides/therapeutic use* ; Pulpitis/therapy* ; Pulpotomy/standards*

Intentional tooth replantation (ITR) is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions. ITR is defined as the deliberate extraction of a tooth; evaluation of the root surface, endodontic manipulation, and repair; and placement of the tooth back into its original socket. Case reports, case series, cohort studies, and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery. However, variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials. This heterogeneity in protocols may cause confusion among dental practitioners; therefore, guidelines and considerations for ITR should be explicated. This expert consensus discusses the biological foundation of ITR, the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration, and the main complications of this treatment, aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies; the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.
Humans ; Tooth Replantation/methods* ; Consensus ; Periapical Periodontitis/surgery*

Objective:To explore the clinical and genetic characteristics of two children with Neurodevelopmental disorders (NDDs) due to variants of TANC2 gene. Methods:Clinical data of two children who were admitted to the Third Affiliated Hospital of Zhengzhou University respectively in April 2020 and April 2021 were retrospectively analyzed. Peripheral blood samples of the children and their parents were collected and subjected to whole exome sequencing. Candidate variants were verified by Sanger sequencing. By using " TANC2 gene", "Neurodevelopmental disorders", "Nervous system development disorders", " TANC2" as the key words, similar cases were searched from the CNKI, Wanfang database platform and PubMed database, with the search time set as from the establishment of the database to December 2023. This study was approved by Medical Ethics Committee of the Third Affiliated Hospital of Zhengzhou University (Ethics No. 2020-57). Results:Case 1 was a 1-year-and-3-month-old girl who had developed convulsions at 1 year old and had three episodes of seizures. Her epilepsy had resolved with the treatment of oxcarbazepine, which was stopped at the age of 2-year-and-7-month. Her language, movement and intelligence development were all normal. Case 2 was a 1-year-and-10-month-old boy, who had developed convulsions at 1 year old. His seizure type was myoclonus, and the frequency was dozens of times a day. His epilepsy had resolved with the treatment of sodium valproate. His language, movement and intelligence development was delayed for about half a year. Genetic analysis showed that both children had harbored novel variants of the TANC2 gene (NM_025185.4), including c. 3398G>A (p.Gly1133Glu) and c.2829+ 1G>A, respectively. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the former was rated as likely pathogenic (PS2+ PM2_Supporting+ PP3) and the latter was rated as pathogenic (PVS1+ PS2+ PM2_Supporting). Two previous reports were retrieved, which had involved 17 cases and 16 variants. Common features had included autism spectrum disorder (70.6%, 12/17), intellectual disability (94.1%, 16/17), language and motor retardation (88.2%, 15/17; 58.8%, 10/17), facial dysmorphism, epilepsy, ataxia, and thoracic and spinal deformities. Conclusion:Variants of the TANC2 gene probably underlay the epilepsy and development delay in these children with NDDs.

Objective To investigate changes and clinical significance of serum microRNA-155(miR-155)and microRNA-205-5p(miR-205-5p)levels in patients with hepatitis C virus(HCV)infection.Methods A total of 141 patients with HCV infection were collected and divided into the HCV-1b group(92 cases)and the non HCV-1b group(49 cases)according to their genotype,and another 141 healthy volunteers who underwent physical examinations in our hospital during the same period were collected as the control group.The general information,biochemical indicators and serum levels of miR-155 and miR-205-5p were compared between the three groups.According to the grading of hepatitis activity,HCV infected patients were classified into the G0,G1,G2,G3 and G4 groups,and serum levels of miR-155 and miR-205-5p were compared between the five groups.Receiver operating characteristics(ROC)curve was used to analyze clinical values of serum miR-155 and miR-205-5p in diagnosing hepatitis activity of G1-G4 in patients with HCV infection.Results The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL)were obviously higher in the HCV-1b group and the non HCV-1b group than those in the control group,while the level of ALB was obviously lower than that in the control group(P＜0.05).The serum level of miR-155 was increased in turn in the control group,the non-HCV-1b group and the HCV-1b group,and the serum level of miR-205-5p was decreased in turn(P＜0.05).The serum level of miR-155 increased in turn with the increased grading of hepatitis activity,while the serum miR-205-5p level decreased in turn(P＜0.05).The area under curve(AUC)values of serum miR-155,miR-205-5p and their combination in diagnosing hepatitis activity of G1-G4 in HCV infected patients were 0.855,0.793 and 0.913,respectively,and the combination of the two is superior to each individual diagnosis(P＜0.05).Conclusion The serum miR-155 level increases and miR-205-5p level decreases in HCV infected patients.The combination of the two has high efficacy in diagnosing hepatitis activity of G1-G4 in HCV infected patients.

OBJECTIVE: To observe the effect of Fu's subcutaneous needling in the treatment of non-acute idiopathic facial paralysis and its effect on serum levels of nitric oxide (NO) and endothelin (ET). METHODS: A total of 76 patients with non-acute idiopathic facial paralysis were randomly divided into an observation group (38 cases, 2 cases dropped out) and a control group (38 cases, 2 cases dropped out). The patients in the control group received basic treatment (mecobalamin tablets orally, specific electromagnetic spectrum irradiation, facial muscle rehabilitation training). The patients in the observation group were treated with Fu's subcutaneous needling on the basis of the control group. The needling points included brachioradialis muscle, sternocleidomastoid muscle, trapezius muscle, etc., and the needling was inserted around the affected muscle, and the reperfusion activity was carried out at the same time, once every other day, 3 times a week. Both groups were treated for 4 weeks. The House-Brackmann (H-B) grade and H-B symptom score were observed before treatment, after 2 and 4 weeks of treatment in the two groups. The facial disability index (FDI) score [including physical function (FDIP) score and social life function (FDIS) score] and the serum levels of NO and ET were compared before and after 4 weeks of treatment in the two groups. The clinical effect and safety of the two groups were assessed. RESULTS: After 2 and 4 weeks of treatment, the H-B grade of the two groups was lower than that before treatment, and the H-B symptom scores were higher than those before treatment (P<0.001, P<0.05); the H-B grade of the observation group was lower than that of the control group, and the H-B symptom score was higher than that of the control group (P<0.01, P<0.05). After 4 weeks of treatment, the FDIP scores of the two groups were higher than those before treatment, and the FDIS scores were lower than those before treatment (P<0.05 ); the FDIP score of the observation group was higher than that of the control group, and the FDIS score was lower than that of the control group (P<0.05). After 4 weeks of treatment, the serum level of NO in the observation group was higher than that before treatment, and the serum level of ET was lower than that before treatment (P<0.05); the increase of serum level of NO and the decrease of serum level of ET in the observation group were greater than those in the control group (P<0.05). The cure rate of the observation group was 55.6% (20/36), which was higher than 22.2% (8/36) of the control group (P<0.05). There were no serious adverse reactions in both groups. CONCLUSION Fu's subcutaneous needling combined with basic treatment can effectively improve the motor function of facial muscles in patients with non-acute idiopathic facial paralysis, which may be related to the regulation of serum NO and ET levels.
Humans ; Male ; Female ; Middle Aged ; Adult ; Acupuncture Therapy ; Aged ; Facial Paralysis/physiopathology* ; Young Adult ; Nitric Oxide/blood* ; Treatment Outcome ; Acupuncture Points ; Endothelins/blood* ; Adolescent