OBJECTIVE To explore the effect of paeoniflorin on glucose metabolism， inflammation and oxidative stress in rats with gestational diabetes mellitus （GDM） and its potential mechanism based on nuclear factor-erythroid 2-related factor 2 （Nrf2）/ heme oxygenase-1 （HO-1）/nicotinamide adenine dinucleotide phosphate：quinone oxidoreductase 1 （NQO1） signaling pathway. METHODS The female rats fed with high fat and high sugar diet and the male rats fed with an ordinary diet were caged， the successfully conceived rats were collected， and streptozotocin was injected intraperitoneally once to induce the GDM model. The successfully modeled rats were randomly divided into the model group， metformin hydrochloride group （200 mg/kg metformin by gavage）， paeoniflorin low-， high-dose groups （45， 90 mg/kg paeoniflorin by gavage， respectively）， paeoniflorin+ML385 group （90 mg/kg paeoniflorin by gavage and intraperitoneal injection of 30 mg/kg Nrf2 inhibitor ML385）， with 12 rats in each group； in addition， another 12 conceived rats fed with an ordinary diet were selected as the control group. The rats in each drug group were given the corresponding drug/normal saline， once a day， for 2 consecutive weeks. Glucose metabolism indexes [fasting blood glucose （FBG）， fasting insulin （FINS）， insulin resistance index （HOMA-IR）]， serum inflammatory factors [interleukin-6 （IL-6）， tumor necrosis factor- α （TNF- α）] and renal tissue oxidative stress indexes [superoxide dismutase （SOD）， malondialdehyde （MDA）， glutathione peroxidase （GSH-Px）] were detected； the pathological changes of renal tissue were observed， and the protein expressions of Nrf2， HO-1 and NQO1 in renal tissue were detected. RESULTS Compared with the control group， the renal tissue lesions of the model group were obvious， including glomerular atrophy， edema degeneration of renal tubular epithelial cells and a large number of inflammatory cell infiltration； the levels of FBG and FINS， HOMA-IR， the levels of IL-6 and TNF-α in serum， and the level of MDA in renal tissue were significantly increased （P＜0.05）， while the levels of SOD and GSH-Px and the protein expressions of Nrf2， HO-1 and NQO1 in renal tissue were significantly decreased （P＜0.05）. Compared with the model group， the renal tissue lesions of rats in paeoniflorin low-dose and high-dose groups were reduced， the above quantitative indexes were significantly improved， and the improvement effect was better in high-dose group （P＜0.05）， while ML385 could significantly reverse the improvement effect of paeoniflorin on the above indexes （P＜0.05）. CONCLUSIONS Paeoniflorin can improve the abnormal glucose metabolism， inflammation and oxidative stress damage of renal tissue in GDM rats， which may be related to the activation of Nrf2/HO-1/NOQ1 signaling pathway.

To improve the understanding of clinicians on the diagnostic criteria and treatment principlis of pulmonary alveolar proteinosis(PAP),which is a rare respiratory disease.European Respiratory Society published the first edition guidelines for PAP,including a systematic review of the literature and the application of the grading of recommendations,assessment,development and evaluation(GRADE)approach to assess the certainty of evidence and the strength of recommendations.Five questions of patient,intervention,comparison,outcome(PICO)and two narrative questions were developed.Recommendations and evidence-based evidence were given,including management of PAP,whole lung lavage,granulocyte-macrophage colony-stimulating factor(GM-CSF)therapy,rituximab,plasma exchange,and lung transplantation.In addition,recommendations were given for the use of GM-CSF antibody testing,bronchoalveolar lavage,and lung biopsy.This study is to interpret the main content of the guideline.

Ferroptosis is a newly discovered method of programmed cell death. Current studies have shown that activation of ferroptosis-related pathways can inhibit the growth and proliferation of tumor cells and reverse their drug resistance. Oral cancer is a common malignant tumor with a high recurrence rate and high drug resistance. Inducing ferroptosis is a potential treatment strategy. There are still many uncertainties in the application of ferroptosis in the treatment of oral cancer, which need to be further explored. This article systematically introduces the mechanism of ferroptosis and its recent progress in oral cancer treatment to provide new mechanisms and methods for the clinical treatment of oral cancer. Current research shows that the mechanism of ferroptosis is mainly related to amino acid metabolism, Fe2+ metabolism, and lipid metabolism. Ferroptosis in oral cancer cells can reverse drug resistance in cancer cells and improve the activity of immune cells. New drugs, such as curcumin analogs and triptolide, can induce ferroptosis in oral cancer, and the development of nanomaterials has improved the utilization rate of drugs. Inhibiting the expression of the ferroptosis-related factors SLC7A11, NF-E2-related factor 2 (Nrf2), and ferritin heavy chain 1 (FTH1) can promote ferroptosis in oral cancer cells. It is a potential target for the clinical treatment of oral cancer, but its translation into clinical practice still needs further research.

Basilar artery trunk aneurysms (BTAs) are relatively rare, with poor natural prognosis, high disability and mortality rates. The treatment options for BTAs includes conservative treatment, craniotomy, and endovascular treatment. Due to the deep anatomical structure, rich perforating vessels, and complex pathological structure of the basilar artery, craniotomy is more difficult. There is currently no consensus on the treatment of BTAs. This article reviews the current treatment status of BTAs, aiming to provide reference for clinical work.

Objective To use feature selection and Likert grading method to quantify the data of lung cancer medical records,to construct a deep extreme learning machine model optimized by the sparrow search algorithm,to classify and predict the syndrome types of traditional Chinese medicine medical record data of lung cancer,and to provide scientific and effective research on syndrome type classification of traditional Chinese medicine.means.Methods The medical records of 497 cases diagnosed with lung cancer from January 2015 to December 2021 were collected from the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,and 412 medical records were screened as the research objects.Syndromic factors of different syndromes were summarized by feature selection and feature importance ranking,and the syndrome factors were quantified by Likert grading method.Build a deep extreme learning machine optimized based on the sparrow search algorithm,and train and test the model.Finally,the model built in this paper is compared with other machine learning models according to three evaluation criteria.Results The average classification accuracy of the SSA-DELM model established in this paper was 88.44%,while the average accuracy of the support vector machine and Bayesian network was 83.39%and 84.53%,respectively.The recall rate and F1 value of the SSA-DELM model on the five syndrome types are mostly above 80%,which is also better than other traditional machine learning models.Conclusion The results of the study show that the use of feature selection combined with Likert grading method to quantify the lung cancer medical record data,compared with the 0-1 processing data,can show the characteristics of the data,improve the accuracy of the classification model,SSA-DELM new Compared with other traditional machine learning classification models,the model has better representation learning ability and learning speed.This model not only provides a scientific and technical means for the clinical treatment of lung cancer,but also provides a useful reference for the informatization and intelligent development of TCM syndrome differentiation and treatment.

Objective:To conduct quality evaluation and content analysis of adult postoperative nausea and vomiting (PONV) guidelines, so as to provide reference for management of clinical PONV.Methods:Web of Science, Embase, PubMed, UpToDate, SinoMed, Wanfang Database, China National Knowledge Infrastructure, VIP, domestic and foreign clinical practice guidelines and related professional association websites were systematically searched, and the search period was from database establishment to May 6, 2022. Four researchers independently evaluated the guidelines that met the inclusion and exclusion criteria using a clinical guideline research and evaluation system, and summarized the recommendations of the guidelines.Results:Finally, a total of 15 guidelines were included in this study. The overall quality evaluation of the guide was 3 A-level recommendations and 12 B-level recommendations. The average standardization percentages for 6 areas were 81.57% for scope and purpose, 49.91% for participants, 65.38% for rigor, 89.54% for clarity, 34.86% for applicability and 55.42% for independence. A total of 18 recommendations were summarized from five aspects, such as team and organizational management, PONV risk assessment, baseline risk reduction, multimodal prevention of PONV and effectiveness evaluation and monitoring.Conclusions:The guidelines for PONV management mainly come from foreign countries. It is recommended that clinical personnel should learn from foreign guidelines and combine them with domestic clinical situations to localize the recommended opinions and guide the development of clinical practice.

Objective: To evaluate the long-term effect and safety of chrono-chemotherapy combined with intensity modulated radiotherapy (IMRT) in locally advanced nasopharyngeal carcinoma (NPC). Methods: 160 patients with locally advanced NPC were randomly divided into a chrono group and conventional group according to random number table. In the first stage, all patients underwent two cycles of induced chemotherapy, consisting of docetaxel, cisplatin and 5-Fu every 21 days. Notably, patients received chrono-moduated chemotherapy according to circadian rhythm in the chrono group, and conventional chemotherapy in the conventional group. Then, 21 days after the completion of first stage, three cycles of concurrent cisplatin chemotherapy every 21 days were given to all patients during IMRT. The median follow-up after the completion of radiotherapy was 31 months. Long-term side effects and the survival of patients were observed. Results: Patients in the chrono group had significantly lower rates of hearing loss (22.72%), dysphagia (0) and neck fibrosis (4.54%) compared with those in the conventional group (39.13%、8.69%, 15.94%, respectively, all P<0.05). Meanwhile, the 1- year overall survival rates (97.0% vs 92.8%), 3-year overall survival rates (80.3% vs 81.2%), 1-year progression free survival rates (95.5% vs 87.0%), 3-year progression free survival rates (71.2% vs 73.9%), 1-year locoregional relapse-free survival rates (97.0% vs 95.7%), 1-year locoregional relapse-free survival rates (92.4% vs 92.8%), 1-year distant metastasis-free survival rates (97.0% vs 98.6%) and 3-year distant metastasis-free survival rates (90.9% vs 91.3%) between the chrono group and the conventional group were not statistically significant (all P>0.05). Conclusions Compared with conventional chemotherapy, chrono-chemotherapy combined with IMRT didn′t affect long-term survival, but reducing the incidence of adverse events in patients with locally advanced NPC.

Objective:To investigate the therapeutic mechanism of high-frequency repetitive transcranial magnetic stimulation (rTMS) in treating mild amnestic cognitive impairment (aMCI).Methods:Twenty-five patients with aMCI were randomly divided into an observation group of 13 and a control group of 12. The observation group was given 10-Hz rTMS over the left dorsolateral prefrontal cortex at 80% of the motor threshold-400 pulses a day, 5 times a week for 4 consecutive weeks. The control group received sham stimulation on the same schedule. Before and after the experiment, both groups were evaluated using the Montreal cognitive assessment (MoCA) and received fMRI scans.Results:After the intervention, the average MoCA score of the observation group had improved significantly more compared with that of the control group and compared with before the intervention. According to the fMRI results, regional homogeneity in the right middle frontal gyrus of the observation group had increased significantly, while that of the control group both there and in the left precuneus had decreased significantly.Conclusions:High-frequency rTMS can effectively improve the cognitive function of patients with aMCI and synchronize neuron activity in cognition-related brain regions.

The expression or dysfunction of long non-coding RNAs (lncRNAs) is closely related to various hereditary diseases, autoimmune diseases, metabolic diseases and tumors. LncRNAs were also recently recognized as functional regulators of fibrosis, which is a secondary process in many of these diseases and a primary pathology in fibrosis diseases. We review the latest findings on lncRNAs in fibrosis diseases of the liver, myocardium, kidney, lung and peritoneum. We also discuss the potential of disease-related lncRNAs as therapeutic targets for the clinical treatment of human fibrosis diseases.
Autoimmune Diseases ; Fibrosis ; Genetic Diseases, Inborn ; Humans ; Kidney ; Liver ; Lung ; Metabolic Diseases ; Myocardium ; Pathology ; Peritoneum ; RNA, Long Noncoding

Currently,the BCG is used to prevent tuberculosis,but the immune effect is not ideal due to varied reasons.The existence of drug-resistant strains of tuberculosis and the increased prevalence and incidence of AIDS have leaded to the increased incidence of TB year by year.Therefore,the development of new tuberculosis vaccine is imminent In this paper,the latest research results in recent years for tuberculosis live vector vaccines were summarized,which provide a theoretical reference for further research and development of new TB vaccines.