ObjectiveTo investigate the mechanism of salt processing of Psoraleae Fructus （PF） through modern analytical techniques and biotechnology， focusing on its effects related to hepatotoxicity and anti-osteoporosis activity. MethodsThe zebrafish model was utilized to evaluate the impact of PF and salt-processed Psoraleae Fructus （SPF） on the hepatotoxicity （using 134.17 ， 178.89， 268.34 mg·L^-1 as low， medium， and high dose groups of PF， 135.04， 180.06， 270.08 mg·L^-1 as low， medium， and high dose groups of SPF， respectively） and anti-osteoporotic activity （using 33.54 ， 67.08 and 134.17 mg·L^-1 as low， medium， and high dose groups of PF， 33.76， 67.52， 135.04 mg·L^-1 as low， medium， and high dose groups of SPF， respectively）， which was using alizarin red skull staining of zebrafish as an indicator of different batches of PF. The specific dosage of a batch of PF was taken as an example. Then ultra-performance liquid chromatography-quadrupole-time of flight-mass spectrometry（UPLC-Q-TOF-MS） analysis was employed to identify the chemical composition of PF before and after salt processing， and PCA， OPLS-DA， and independent sample t-test were used to elucidating the compositional changes associated with the effects of salt processing on hepatotoxicity and anti-osteoporosis activity. ResultsUnder specific conditions， PF induced notable hepatotoxicity in zebrafish while simultaneously demonstrating protective effect against prednisolone-induced osteoporosis. In comparison to PF， SPF showed alleviated hepatotoxicity while retaining significant anti-osteoporosis activity. UPLC-Q-TOF-MS analysis revealed that after salt processing， the overall chemical composition of PF showed a downward trend， with 69 components showing a decrease in content， represented by psoralen， and 13 components showing an increase， represented by 4′-O-methyl psoralen B. Further multivariate statistical analysis revealed 11 key differential components before and after salt processing of PF， including psoralen and bakuchiol. ConclusionSalt processing effectively diminishes hepatotoxicity without impairing therapeutic efficacy against osteoporosis of PF， which may be related to the compositional changes before and after salt processing of PF and provides key evidence to reveal the scientific significance of salt processing of PF.

Renal Fanconi syndrome (FS) is a rare renal manifestation of primary Sjögren's syndrome (pSS). This study aims to analyze the clinical and prognostic characteristics of patients with pSS-associated renal FS (pSS-FS) and provide insights for clinical management.

Objective To investigate the efficacy of preprocedural intracoronary injections of adenosine and sodium nitroprusside in patients with intravascular ultrasound-attenuated plaques(AP).Methods In total,200 patients with AP detected using intravascular ultrasound(IVUS)at Shijiazhuang People's Hospital from January 1,2022,to January 1,2024,were selected and randomly divided into conventional treatment and pretreatment groups,with 100 patients in each group.The conventional treatment group underwent standard percutaneous coronary intervention(PCI)procedures,whereas the pretreatment group underwent intracoronary injection of sodium nitro-prusside and adenosine through a guiding catheter prior to PCI.The observation parameters included intraoperative no-reflow(NR)inci-dence,post-PCI TIMI myocardial perfusion frame count(TMPFC),perioperative myocardial infarction(PMN),and 6-month major adverse cardiac and cerebrovascular events(MACCE).Results The pretreatment group exhibited a significantly lower intraoperative NR inci-dence,reduced postoperative TMPFC,and attenuated PMN severity than the conventional treatment group(P＜0.05).Conclusion Pre-procedural intracoronary administration of adenosine and sodium nitroprusside through a guiding catheter can effectively reduce PCI-re-lated NR occurrence,improve post-PCI TMPFC,and mitigate PMN in patients with AP,although no significant improvement in MACCE incidence can be observed at the 6-month follow-up.

AIM To observe the effects of Yiqi Jiedu Tongluo Formula(YQJDTL)on renal microvascular endothelial function and prevention of renal injury in a rat model of type 2 diabetes mellitus(T2DM).METHODS The SD rats were randomly divided into a normal group and a model group.The model group was administered with high-fat diet combined with a single intraperitoneal injection of STZ to establish the T2DM model.The successfully modeled rats were randomly divided into the model group,the canagliflozin group(9 mg/kg),and the low-dose and high-dose YQJDTL groups(4.77,9.45 g/kg).The corresponding doses of the drug were administered by gavage for a total of 12 weeks,during which the rats underwent observation of their general condition and blood glucose changes.After the end of administration,the rats had their levels of renal index,24-hour UP,serum SCr,BUN,TC,TG,HDL-C,LDL-C,ET-1 and NOS measured;their changes in renal microvasculature and the degree of renal fibrosis observed using HE staining,Masson staining,PAS staining,and PASM staining;their ultrastructure of the glomeruli observed using transmission electron microscopy;their renal protein expressions of TGF-β,SMAD2,SMAD3,Col-1,VEGFA and PKC detected by immunohistochemical staining and Western blot;and their renal mRNA expressions of VEGFA,TGF-β,SMAD2 determined by RT-qPCR.RESULTS Compared with the model group,the high-dose YQJDTL group showed decreased levels of renal index,blood glucose,TG,TC,HDL,24 h UP,BUN,SCr and ET-1(P＜0.05,P＜0.01);increased LDL and NOS levels(P＜0.05,P＜0.01);reduced renal inflammatory infiltration and fibrosis degree,inhibited fusion of foot processes and thickening of basement membrane;decreased renal protein expressions of TGF-β,SMAD2,SMAD3,VEGFA,PKC and Col-1(P＜0.05,P＜0.01);and decreased mRNA expressions of VEGFA,TGF-β and SMAD2(P＜0.01).CONCLUSION In the rat models of T2DM,YQJDTL can reduce their levels of blood glucose and lipids by improving the renal indices levels and the renal microvascular endothelial functions to alleviate renal fibrosis and microangiopathy as well,and the mechanism may be associated with the down-regulated expressions of TGF-β/SMAD and VEGF pathway-related proteins.

Objective To explore method for improving the colonization efficiency of Helicobacter pylori(Hp)in the mouse stomach and to determine if the proton pump inhibitor(PPI)pantoprazole can act as a colonization adjuvant to enhance Hp colonization,with the aim of providing an effective tool for establishing an Hp infection mouse model.Methods The Hp Sydney strain 1(SS1)was introduced and solid plate and liquid culture systems were established.The effects of different doses of pantoprazole on gastric acid secretion in mice were compared.The impact of Hp inoculation,alone or combined with pantoprazole pretreatment,on Hp colonization efficiency was analyzed using rapid urease tests,bacterial plate cultures,and TaqMan quantitative polymerase chain reaction.Results PPI pretreatment inhibited gastric acid secretion and promoted Hp colonization in the mouse stomach,to some extent.Conclusions PPI can serve as colonization adjuvants to enhanc e the efficiency of constructing Hp infection mouse models.

Family with sequence similarity 3 member A(FAM3A),a novel mitochondrial protein,plays a pivotal role in hepatic glucose and lipid metabolism by enhancing ATP synthesis and secretion and mod-ulating the ATP-P2 receptor-Akt signaling pathway.Dysregulation of FAM3A is closely associated with the pathogenesis of non-alcoholic fatty liver disease(NAFLD)and type 2 diabetes mellitus(T2DM).In this study,targeting FAM3A as a therapeutic candidate,we conducted virtual screening to identify 47 small-molecule compounds with potential binding activity.Surface plasmon resonance(SPR)analysis re-vealed three compounds exhibiting high binding affinity to FAM3 A.Further structural characterization of the FAM3A-compound complexes,combined with intermolecular interaction analysis,elucidated the binding mode of the lead compound Index 2(taxifolin)to FAM3A at atomic resolution.These findings provide critical insights into the molecular mechanisms underlying ligand-FAM3A interactions and deliver valuable chemical scaffolds for the development of therapeutics targeting NAFLD and T2DM.This work establishes a foundation for advancing drug discovery efforts focused on FAM3A-mediated metabolic disor-ders.

Objective To explore the clinical infection distribution and antifungal resistance characteristics of the Stephanoascusciferrii(S.ciferrii)complex.Methods Clinical fungal culture and isolation data from Nanjing Drum Tower Hospital from 2012 to 2023 were retrospectively analyzed.The annual isolation quantity,proportion,and distribution of infection sites of S.ciferrii were statistically analyzed.The minimum inhibitory concentrations(MICs)of isolated strains against common antifungal agents were detected by ATB Fungus 3 fungal susceptibility test kit,and their resistance was analyzed.Results From 2012 to 2023,a total of 26 602 fungal strains were isola-ted in this hospital,including 79 strains of the S.ciferrii complex.Compared with 2012-2017,the isolation rate of S.ciferrii complex increased from 2018 to 2023(0.06％vs 0.43％,P＜0.001).There were 69 cases of super-ficial infection,including infection of ear canal(n=67)and skin(n=2).92.75％(n=64)of the patients were im-munocompetent individuals.There were 10 cases of invasive infection,including infection of urinary tract(n=5),respiratory tract(n=2),biliary tract(n=1),pacemaker pouch(n=1),and vagina(n=1).70.00％of the pa-tients had other underlying diseases,including 3 cases of immunosuppressed patients who died due to combined in-fection with the S.ciferrii complex.The MICs detection results showed that the MIC50 and MIC90 of fluconazole were 32 μg/mL and 128 μg/mL,respectively;the MIC50 and MIC90 of amphotericin B were 0.5 μg/mL and 2 μg/mL,respectively.Conclusion S.ciferrii complex mainly causes ear canal infection and has the dual pathogenic ability to cause superficial and invasive infection.The isolated strains showed higher MIC values for fluconazole and lower MIC values for amphotericin B.The mortality is high in immunosuppressed patients combined with invasive infec-tion caused by S.ciferrii.

Objective:To investigate the efficacy of laparoscopic right hemicolectomy using the left edge of the superior mesenteric artery (SMA) as the medial boundary for lymph node dissection, and its impact on patients' quality of life.Methods:Patients were included who had been clearly diagnosed with primary right colon cancer (located in the ileocecal region, ascending colon, and hepatic flexure of the colon) through endoscopic histopathological examination, were aged 80 years or younger, had completed laparoscopic complete mesocolic excision plus D3 radical resection for right colon cancer, and had complete quality of life assessments and follow-up records.A retrospective cohort study method was used. Clinical data of patients undergoing laparoscopic right hemicolectomy at Shengjing Hospital of China Medical University from January 2018 to December 2022 were collected.Based on the different medial boundaries of lymph node dissection, patients were divided into an arterial group (bounded by the left edge of the SMA, 119 cases) and a venous group (bounded by the left edge of the superior mesenteric vein, 89 cases).There were no statistically significant differences in baseline characteristics between the two groups (all P>0.05), and use theQuality of Life Questionnaire for Colorectal Cancer - 38 (QLQ-CR38) and the Diarrhea Assessment Scale(DAS)to evaluate the quality of life and diarrhea of patients one month, three months, and six months after surgery. Results:Compared with the venous group, more lymph nodes were dissected at the third station than in the arterial group (4.2±2.0 vs. 3.3±1.6, t=3.320, P<0.001). Additionally, the rates of positive lymph nodes at the third station (10.9% [13/119] vs. 3.4% [3/89], χ 2 =2.007, P=0.038) and the rates of positive lymph nodes at the third station among patients with Stage III disease (32.5% [13/40] vs. 8.6% [3/35], χ 2=2.507, P=0.012) were both significantly higher in the arterial group. These differences are all statistically significant ( P<0.05). There were no significant differences in the other perioperative data assessed between the two groups (all P<0.05). Application of generalized estimating equation analysis showed statistically significant differences between the two groups in terms of timing of gastrointestinal issues ( P=0.024) and defecation problems ( P<0.001). Further simple effects analysis of each of the assessed variables revealed that, one month after surgery, patients in the venous group had significantly less severe gastrointestinal symptoms ( M [ Q1, Q3]: 9 [7,13] vs. 11 [9,13], Z=2.416, P=0.016) and defecation dysfunction ( M [ Q1, Q3]: 13 [8,14] vs. 19 [16,22], Z=8.813, P<0.001) compared with the arterial group; these differences are all statistically significant (all P<0.05). Three months after surgery, the venous group showed significantly better defecation function than did the arterial group ( M [ Q1, Q3]:10 [6,13] vs. 11 [6,14], Z=2.591, P<0.001); this difference is statistically significant ( P<0.05). However, 6 months after surgery, there were no statistically significant differences between the two groups in any of the assessed variables (all P>0.05).Generalized estimating equation analysis revealed statistically significant differences between the two groups in terms of bowel frequency ( P=0.027), stool consistency ( P=0.046), urgency to defecate ( P=0.008), and total score ( P<0.001) with regard to the group-by-time interaction (all P<0.05). Further simple effects analysis of each of the assessed variables showed that 1 month after surgery, patients in the venous group had better outcomes than those in the arterial group in terms of bowel frequency ( M [ Q1, Q3]:0 [0,2] vs. 2 [1,3]) points, Z=3.479, P<0.001), stool consistency ( M [ Q1, Q3]:0 [0,1] vs. 1 [0,2] points, Z=3.377, P<0.001), urgency to defecate ( M [ Q1, Q3]:0 [0,2] vs. 2 [1,3] points, Z=2.798, P=0.005), and total score ( M [ Q1, Q3]:3 [2,5] vs. 5 [4,7] points, Z=5.318, P<0.001); all of these differences are statistically significant (all P<0.05). Three months after surgery, outcomes in patients in the venous group remained superior to those in the arterial group in terms of bowel frequency ( M [ Q1, Q3]: 1 [0,1] vs. 1 [0,2] points, Z=2.230, P=0.026), stool consistency ( M [ Q1, Q3]: 0 [0,1] vs. 1 [0,1] points, Z=2.699, P=0.007), and total score ( M [ Q1, Q3]:3 [2,4] vs. 3 [2,4] points, Z=2.530, P=0.011); all of these differences are statistically significant (all P<0.05). However, 6 months after surgery, there were no statistically significant differences between the two groups in any of the four assessed variables or the total score. The median duration of follow-up was 41 (9-64) months. The 3-year overall survival rates were 93.3% and 95.8% in the venous and arterial groups, respectively; this difference is not statistically significant ( P=0.403). However, the 3-year disease-free survival rate was 86.5% in the venous group, which is significantly lower than that in the arterial group (95.0%, P=0.027). Conclusion:Laparoscopic D3 lymph node dissection of the right colon using the left margin of the superior mesenteric artery as the medial boundary for lymph node dissection is safe and necessary, which can improve the disease-free survival time of patients. This surgical procedure affects the patient's quality of life in the short term,but gradually improves six months after surgery.

Objective:To compare the short-term outcomes and cost-effectiveness of laparoscopic and open ileostomy reversal.Methods:A retrospective cohort study was adopted. Clinical data of patients who underwent loop ileostomy reversal at the department of Colorectal Tumor Surgery of Shengjing Hospital Affiliated with China Medical University from January 2021 to November 2023 were reviewed. After excluding those who did not undergo reversal within 3 to 6 months of the initial surgery, patients with complications such as parastomal hernia requiring additional procedures, and those who underwent laparoscopic-to-open conversion, 150 were included for analysis. Patients were grouped according to type of reversal: open surgery (92 patients) and laparoscopic (58 patients). The primary outcome was cost-effectiveness. The success rate of ileostomy reversal was used as the health outcome. Hospitalization costs were collected via the hospital information system. The willingness-to-pay (WTP) threshold was set at three times the per capita gross domestic product. Differences in cost and success rates between open and laparoscopic procedures were compared. Incremental cost per successful reversal of ileostomy reversal and incremental cost-effectiveness ratios (ICER) were calculated (ICER < WTP indicates that laparoscopic ileostomy reversal is more cost-effective than open).Results:Compared with open reversal, the intraoperative blood loss volume was lower[ (35.5±12.6) ml vs.(57.7±19.0) ml, t=7.874, P<0.001] ; adhesion release rate was higher [82.8%(48/58) vs.46.7%(43/92), χ 2=19.341, P<0.001]; time to first flatus [(99.4±32.4) hours vs.(115.0±35.3) hours, t=2.734, P=0.007] and time to unassisted ambulation [42(18-71) hours vs. 51(25-78) hours, Z=-6.440, P<0.001] were earlier; postoperative hospitalization was shorter [(12.0±3.4) days vs.(15.0±3.6) days, t=5.010, P<0.001] ; visual analog scale pain score on postoperative day 2 was lower [3(3-4) vs. 4(4-4), Z=-6.488, P<0.001;3(2-3) vs. 3(3-4), Z=-4.810, P<0.001]; and incidence of postoperative complications was lower [8.6%(5/58) vs. 21.7%(20/92), χ 2=4.408, P=0.036] in the total laparoscopic group. The ICER of the total cost of the laparoscopic group relative to the open group was 38 221.89 CNY. Univariate sensitivity analysis showed that the success rate of laparoscopic reversal had the greatest impact on the results. The cost-effectiveness acceptability curve showed that when the WTP was 257 094 CNY, the probability of laparoscopic reversal being economical was 84.9%. Conclusion:Laparoscopic ileostomy reversal is more cost-effective than open and has superior short-term outcomes.

Background and Purpose:Previous studies have investigated the prognostic significance of skeletal muscle and adipose tissue composition and distribution in colorectal cancer patients,yet most have not differentiated between rectal and colon cancer patient cohorts.This study aimed to explore the relationship between body composition and long-term prognosis,and to develop a postoperative predictive model.Methods:Clinical data of rectal cancer patients who underwent surgical treatment at Qingdao University Affiliated Hospital from January 2018 to December 2021 were retrospectively collected.Inclusion criteria:①Age＞18 years;② Preoperative colonoscopy and pathological diagnosis of colorectal cancer;③ Complete surgical resection;④Abdominal computed tomography(CT)scan 1 month before surgery.Exclusion criteria:① Clinical data is missing;② Multiple metastases of tumors;③ Tumor T stage 0 or carcinoma in situ;④ Severe artifacts lead to poor quality CT imaging,making it difficult to distinguish between fat and muscle;⑤ Inability to obtain follow-up results.This study has been approved by the Medical Ethics Committee of the Affiliated Hospital of Qingdao University(approval number:QYFYWZLL30313),and informed consent has been waived in the ethical approval process.The skeletal muscle index(SMI)and subcutaneous adipose tissue index(SATI)were calculated by dividing the areas of skeletal muscle and subcutaneous fat observed on CT scans by the square of the patient's height.Univariate and multivariate COX regression analyses were conducted to identify risk factors influencing recurrence-free survival(RFS)and overall survival(OS)in rectal cancer patients.Based on the results of the multivariate analysis,a nomogram prediction model was developed,its predictive power and accuracy were assessed using the receiver operating characteristic(ROC)curve,calibration plots and decision curve analysis(DCA),and internal validation was conducted.Results:A total of 696 patients were included in this study,with 96(13.8%)patients experiencing postoperative recurrence and 89(12.8%)patients dying.Multivariate COX regression analysis showed that SMI,SATI,tumor T stage and N stage were independent factors affecting the postoperative RFS and OS of patients.Nomogram prediction models for RFS and OS in rectal cancer patients were constructed based on the above independent predictors.The area under ROC curve(AUC)for 3-,4-and 5-year RFS was 0.862,0.846 and 0.824,respectively;the AUC for 3-,4-and 5-year OS was 0.886,0.898 and 0.875,respectively.The models were evaluated using calibration curves and decision curves,and internal validation was performed,which showed that the prediction accuracy of the models was good.Conclusion:CT body composition is an independent predictor of RFS and OS in rectal cancer patients,and the nomogram model developed based on these factors demonstrates good predictive value for patient prognosis.