BACKGROUND:Duhuo Jisheng Decoction is a classic prescription for the treatment of rheumatoid arthritis,but its specific mechanism is not clear.Extracellular vesicles have the powerful function of inter-cell communication and signal transmission,and may be the signal carrier for the Decoction.OBJECTIVE:To explore the effects of serum extracellular vesicles treated with Duhuo Jisheng Decoction on the proliferation,migration,invasion,and apoptosis of rheumatoid arthritis fibroblast-like synovial cells.METHODS:The rheumatoid arthritis fibroblast-like synovial cell model was established by co-culturing with tumor necrosis factor-α in vitro.The experiment was divided into five groups:normal group,model group,serum treated with Duhuo Jisheng Decoction group,extracellular vesicles treated with Duhuo Jisheng Decoction group,and extracellular vesicles treated with normal saline group.The optimal concentration and time of drug-containing serum and extracellular vesicles were screened by CCK-8 assay.Expression of inflammatory cytokines in the supernatants of cells in each group was detected by ELISA.The migration ability of rheumatoid arthritis fibroblast-like synovial cells was detected by scratch assay.The invasive ability of cells was measured by Transwell Invasion assay.Hoechst staining was adoped to detect cell apoptosis.The expression levels of apoptosis-related genes and proteins were detected by qRT-PCR and western blot assay.RESULTS AND CONCLUSION:(1)The optimal volume fraction of serum treated with Duhuo Jisheng Decoction was 10%and optimal mass concentration of extracellular vesicles treated with Duhuo Jisheng Decoction was 10 ng/mL;the optimal time for the interaction between the two was 24 hours.(2)Compared with the model group,serum treated with Duhuo Jisheng Decoction,extracellular vesicles treated with Duhuo Jisheng Decoction,and extracellular vesicles treated with normal saline could suppress the expression of inflammatory factors of rheumatoid arthritis fibroblast-like synovial cells(P<0.05),scratch healing(P<0.05),migration and invasion(P<0.05).Moreover,the inhibition of extracellular vesicles treated with Duhuo Jisheng Decoction was more significant(P<0.05).(3)Drug-containing serum and extracellular vesicles treated with Duhuo Jisheng Decoction promoted the apoptosis of rheumatoid arthritis fibroblast-like synovial cells.(4)Compared with the model group,serum treated with Duhuo Jisheng Decoction,extracellular vesicles treated with Duhuo Jisheng Decoction,and extracellular vesicles treated with normal saline could increase the expression of proapoptotic factors Caspase-3,Caspase-9,and Bax(P<0.05)and decrease the expression of antiapoptotic factor Bcl-2(P<0.05).Moreover,extracellular vesicles treated with Duhuo Jisheng Decoction had a more significant regulatory effect on apoptosis-related factors.Above findings indicate that extracellular vesicles treated with Duhuo Jisheng Decoction can inhibit the excessive proliferation,migration,and invasion of rheumatoid arthritis fibroblast-like synovial cells and promote their apoptosis.

BACKGROUND:Duhuo Jisheng Decoction is a classic prescription for the treatment of rheumatoid arthritis,but its specific mechanism is not clear.Extracellular vesicles have the powerful function of inter-cell communication and signal transmission,and may be the signal carrier for the Decoction.OBJECTIVE:To explore the effects of serum extracellular vesicles treated with Duhuo Jisheng Decoction on the proliferation,migration,invasion,and apoptosis of rheumatoid arthritis fibroblast-like synovial cells.METHODS:The rheumatoid arthritis fibroblast-like synovial cell model was established by co-culturing with tumor necrosis factor-α in vitro.The experiment was divided into five groups:normal group,model group,serum treated with Duhuo Jisheng Decoction group,extracellular vesicles treated with Duhuo Jisheng Decoction group,and extracellular vesicles treated with normal saline group.The optimal concentration and time of drug-containing serum and extracellular vesicles were screened by CCK-8 assay.Expression of inflammatory cytokines in the supernatants of cells in each group was detected by ELISA.The migration ability of rheumatoid arthritis fibroblast-like synovial cells was detected by scratch assay.The invasive ability of cells was measured by Transwell Invasion assay.Hoechst staining was adoped to detect cell apoptosis.The expression levels of apoptosis-related genes and proteins were detected by qRT-PCR and western blot assay.RESULTS AND CONCLUSION:(1)The optimal volume fraction of serum treated with Duhuo Jisheng Decoction was 10%and optimal mass concentration of extracellular vesicles treated with Duhuo Jisheng Decoction was 10 ng/mL;the optimal time for the interaction between the two was 24 hours.(2)Compared with the model group,serum treated with Duhuo Jisheng Decoction,extracellular vesicles treated with Duhuo Jisheng Decoction,and extracellular vesicles treated with normal saline could suppress the expression of inflammatory factors of rheumatoid arthritis fibroblast-like synovial cells(P<0.05),scratch healing(P<0.05),migration and invasion(P<0.05).Moreover,the inhibition of extracellular vesicles treated with Duhuo Jisheng Decoction was more significant(P<0.05).(3)Drug-containing serum and extracellular vesicles treated with Duhuo Jisheng Decoction promoted the apoptosis of rheumatoid arthritis fibroblast-like synovial cells.(4)Compared with the model group,serum treated with Duhuo Jisheng Decoction,extracellular vesicles treated with Duhuo Jisheng Decoction,and extracellular vesicles treated with normal saline could increase the expression of proapoptotic factors Caspase-3,Caspase-9,and Bax(P<0.05)and decrease the expression of antiapoptotic factor Bcl-2(P<0.05).Moreover,extracellular vesicles treated with Duhuo Jisheng Decoction had a more significant regulatory effect on apoptosis-related factors.Above findings indicate that extracellular vesicles treated with Duhuo Jisheng Decoction can inhibit the excessive proliferation,migration,and invasion of rheumatoid arthritis fibroblast-like synovial cells and promote their apoptosis.

It is believed that retention due to deficient qi is an important pathogenesis of endometriosis （EMs）. Deficient qi is the root of the disease， mainly manifested as spleen deficiency， while retention is the branch pathogenesis of the disease， mainly with blood stasis， complicated with constraint， phlegm， heat， toxin and other pathological factors. Therefore， it is proposed to follow the treatment principle of supplementing deficiency and unblocking stagnation， and take the methods of replenishing qi and fortifying the spleen， removing stasis and eliminating concretions. Self-made Fuzheng Huayu Formula （扶正化瘀方） is taken as the basic formula， and can be modified with the symptoms in menstrual and non-menstrual periods. Additionally， the methods of moving qi， dispelling phlegm， clearing heat， relieving toxin and others can be combined， and it is recommended to treat the root and the branch simultaneously.

Objective To investigate the correlation between aCAS and the location and volume of cerebral WMH in the elderly people.Methods A total of 188 elderly WMH patients admitted to our hospital from September 2022 to September 2023 were enrolled and divided into no or mild(stenosis≤49％,137 cases),moderate(50％-69％,25 cases),and severe aCAS groups(≥70％,26 cases)according to the degree of carotid stenosis.All of the patients underwent cranial MRI scanning to assess total,periventricular,deep,and juxtacortical WMH volumes.Univariate and multivariate generalized linear model analyses were used.Results The moderate and severe aCAS groups had significantly older age,larger proportions of coronary heart disease and smoking,and higher total,peri ventricular,and juxtacortical WMH volumes than the no or mild aCAS group,and the deep WMH in the severe aCAS group was higher than that in the no or mild aCAS group(P＜0.05).Multivariate generalized linear model analysis showed that both moderate and severe aCAS were independent risk factors for total WMH volume(OR=325.629,95％CI:24.255-4371.608;OR=51.088,95％CI:4.135-631.128),periventricular WMH volume(OR=27.655,95％CI:5.168-147.976;OR=8.988,95％CI:1.754-46.051),deep WMH volume(OR=3.641,95％CI:1.511-8.774;OR=2.589,95％CI:1.105-6.064)and juxtacortical WMH volume(OR=3.005,95％CI:1.831-4.933;OR=2.199,95％CI:1.36-3.566)(P＜0.05,P＜0.01).Conclusion aCAS is an independent risk factor for WMH in the elderly population,and stenosis＞50％has a greater correlation with WMH volume.

ObjectiveTo explore the effect and possible mechanism of Shenqi Pills （肾气丸） on cognitive impairment and hippocampal glucose energy metabolism in type 2 diabetes mellitus （T2DM）. MethodsSixty C57BL/6 mice were randomly divided into control group， model group， rosiglitazone group and Shenqi Pills low-， medium- and high-dose groups， with 10 mice in each group. T2DM model was induced by a high-fat diet combined with intraperitoneal injection of streptozotocin in all the groups except for the control group. After successful modeling， the high-， medium-， and low-dose Shenqi Pills groups were given 2.08， 1.04， and 0.52 g/（kg·d） of Shenqi Pills granules by gavage respectively， while the rosiglitazone group was given 3 mg/（kg·d） of rosiglitazone tablets by gavage， and the control group and model group were gavaged with 10 ml/（kg·d） of distilled water， all for 8 consecutive weeks. The body weight and fasting blood glucose （FBG） level were recorded every two weeks. The Morris water maze test was performed on the 8th week of medication. After 8-week medication， oral glucose tolerance test （OGTT） and fasting insulin level were measured， hippocampal glucose energy metabolism-related products were quantitatively detected by liquid chromatography tandem mass spectrometry， and KEGG annotation analysis was performed. ResultsCompared to those measured at the same timepoints in the control group， the body mass on week 6 and 8， as well as the FBG level on week 2， 4， 6 and 8 in the model group increased； the blood glucose level at 0， 30， 60 and 120 minutes of the OGTT test increased， while fasting insulin level after 8-week medication decreased. The escape latency of the model group was significantly prolonged on the 3rd and 4th days， and the escape latency time increased， while the total swimming distance， platform quadrant residence time and the number of platform crossings decreased （P＜0.05 or P＜0.01）. Compared to those measured at the same timepoints in the model group， the body mass on week 6 in the low-dose Shenqi Pills group， on week 6 and 8 in the medium- and high-dose groups， and on week 8 in the rosiglitazone group were significantly reduced； the FBG levels in all the Shenqi Pills groups and rosiglitazone group on week 6 and 8 decreased， while fasting insulin levels increased. In the OGTT test， blood glucose in the medium-dose group of Shenqi Pills at all timepoints decreased； in the Morris water maze test， the escape latency period of the medium- and high-dose Shenqi Pills groups was shortened on the 3rd and 4th days， while the escape latency time was reduced， and the total swimming distance， platform quadrant residence time， and number of platform crossings increased in the medium-dose Shenqi Pills group （P＜0.05 or P＜0.01）.The medium-dose Shenqi Pills showed best effect， therefore it was selected for the targeted quantitative detection of metabolites. The medium-dose Shenqi Pills group could regulate the disorder of glucose metabolism in the hippocampus of T2DM mice， and 13 differential metabolites were found，up-regulating α-ketoglutarate and 3-phosphoglyceric acid， and down-regulating fumaric acid， glutamatic acid， lactatic acid， inosine， malic acid， adenine， fructose 1,6-diphosphate and others. KEGG annotation of differential metabolites suggested that Shenqi Pills was closely related to the regulation of glucose metabolism disorder and insulin resistance in the hippocampus region of T2DM model mice， as well as neurodegenerative diseases and ABC transport， hypoxia-inducible factor 1 （HIF）， forkhead transcription factor （FoXO） and cyclic adenosine monophosphate （cAMP） signaling pathways. ConclusionShenqi Pills can improve learning and memory abilities and cognitive impairment in T2DM mice， and may act its role by regulating glucose energy metabolism in the hippocampus of T2DM.

目的：探究环状 RNA(circular RNA, circRNA）0072088 在非小细胞肺癌（non-small cell lung cancer，NSCLC）细胞中 的生物学功能及其作用机制。方法：在公共基因芯片数据库 Gene Expression Omnibus（GEO）中下载 GSE101684 数据集，通过 GEO2R 分析得到差异基因。通过 qPCR 检测 NSCLC 细胞 H165、H358、H460、H226 和 A549 细胞中 circ_0072088 的表达水平， 随后采用 CCK-8 法和 Transwell 小室法分别检测 circ_0072088 对 NSCLC 细胞增殖、迁移和侵袭的作用。通过 CircInteractome 和 TargetScan 数据库预测 circ_0072088 与 miR-545-3p、miR-545-3p 与 STAT3 之间的靶向关系，并通过双荧光素酶报告基因实 验和 RNA 结合蛋白免疫沉淀（RNA binding protein immunoprecipitation，RIP）实验验证 circ_0072088、miR-545-3p 与 STAT3 之 间的靶向关系。结果：circ_0072088 在 NSCLC 细胞系中的表达均显著上调（均 P<0.05）。过表达 circ_0072088 促进了 NSCLC 细胞的增殖、侵袭和迁移（均 P<0.05）；敲低 circ_0072088 抑制了 NSCLC 细胞的增殖、侵袭和迁移（均 P<0.05）。miR-545-3p 是 circ_0072088 的下游靶点，可以被 circ_0072088 吸附；STAT3 是 miR-545-3p 的靶基因，可以被 circ_0072088 间接正向调控。 结论：Circ_0072088 通过调节 miR-545-3p /STAT3 轴促进 NSCLC 细胞的增殖和转移。

Objective To explore the effect of standardized phase Ⅰ exercise rehabilitation on heart and lung function and quality of life in elderly patients with chronic heart failure, and to evaluate its clinical efficacy and significance. Methods A total of 100 elderly patients of department of cardiology into Fuxin Central Hospital with chronic heart failure (heart function NYHA Ⅱ-Ⅲ) were divided evenly into experimental and control groups by the method of random number table. In the experimental group, patients were undergoing routine treatment and nursing while undergoing standardized phase Ⅰ motor rehabilitation. In the control group, patients were treated with routine treatment and nursing only. The two groups of patients were assessed for heart and lung function by using the 6-minute walking distance test (6MWT) on the second day of admission and at hospital discharge; the quality of life was assessed by using the Minnesota Heart Failure Quality of Life Questionnaire (MLHFQ) on admission and 4 weeks after discharge. Results Cardio- pulmonary function: in the experimental group, the 6-minute walking distance (6MWD) was (367.92 ± 34.53) meters before intervene, and (469.72 ± 31.09) meters after. The difference had statistical significance (t=15.482 4, P<0.01). In the control group, the 6MWD was (366.36± 33.78) meters before intervene, and (390.68 ± 33.57) meters after. The difference had no statistical significance (t=2.126 2, P>0.01). Compared with the control group, the increase in the experimental group was more significant. The difference between two groups was statistically significant (t=-13.760 4, P< 0.01). Quality of life: In the experimental group, the Minnesota Heart Failure Quality of Life Questionnaire score was (36.28 ± 8.50) points before intervene, and (15.60 ± 4.57) points after. The difference had statistical significance (t=-15.152 3, P<0.01). In control group, the score was (38.20±8.93) points before intervene, and (37.24±11.21) points after. The difference had no statistical significance (t=-0.473 5, P>0.01). Comparing two groups after treatment, the experimental group was more significantly reduced than the control group. The difference between two groups was statistically significant (t=12.640 0, P<0.01). Conclusion The standardized phase Ⅰ exercise rehabilitation treatment significantly improves heart and lung function and quality of life in elderly patients with chronic heart failure.

There are significant individual differences in the antiplatelet effects of aspirin.Three single nucleotide polymorphisms (SNPs),rs5918,rs12041331 and rs730012,are reported to significantly correlate with the efficacy and side effects of aspirin.In the present study,the genotyping method of the three SNPs was established based on the combination of polymerase chain reaction and pyrosequencing technology.Amplification and sequencing primers were designed independently;the amplification conditions were optimized to amplify the three SNPs in the same condition.The sensitivity of the method was detected using original genome DNA at different concentrations.In order to testify the accuracy of the method,the proposed method and Sanger sequencing technology were both used to genotype the three SNPs in 20 blood samples.The results demonstrated that the genotyping method of aspirin-related SNPs was successfully established,with the detection limit being as low as 0.4 ng genome DNA.The genotype results of 20 samples by the proposed method were exactly the same as that of Sanger sequencing.It is evident that the proposed method is sensitive and accurate.

Objective To observe of different facemask pressure controlled ventilation yongon gastric insufflation evaluated by ultrasound in infants during anesthesia induction.Methods Sixty ASA Ⅰ infants aged 1-3 yr,undergoing elective surgery,were randomly assigned to three groups ac-cording to facemask ventilation pressure:10 cm H 2 O (P10),1 5 cm H 2 O (P1 5 )and 20 cm H 2 O (P20)with twenty in each group.Infants were injected with propofol 2 mg/kg,fentanyl 0.002 mg/kg,cis-atracurium 0.1 5 mg/kg for general anesthesia induction until consciousness lost,then face-mask pressure controlled ventilation was applied for 120 s.Some respiratory parameters (SpO 2 , PET CO 2 )were recorded at the time of loss of consciousness (T0 )and after facemask pressure con-trolled ventilation for 30 s(T1 ),60 s(T2 ),90 s(T3 ),120 s(T4 )and after tracheal intubation(T5 ). The cross-sectional transverse and longitudinal diameter and area were measured respectively using ul-trasound at T0 and T4 .Results In all groups,SpO 2 was greater than or equal to 99% at all time points.PET CO 2 at T1-T5 was significantly higher than that at T0 and PET CO 2 at T5 was higher than that at T4 in all three groups.There were statistically significant increases in the values of the antral cross sectional area before and after facemask pressure controlled ventilation in group P20 (P <0.05). Conclusion During anesthesia induction in infants,1 5 cm H 2 O facemask ventilation pressure can guarantee adequate ventilation,and avoid gastric insufflation.

Objective To explore the diagnostic significance of Xpert MTB/RIF in cerebrospinal fluid,and evaluate the application for early diagnosis of tuberculous meningitis(TBM).Methods Sixty cases of TBM and 30 cases of non-TBM patients were selected as our subjects.Xpert MTB/RIF and modified Ziehl-Neelsen stain were performed in cerebrospinal fluid.The detection rate of the system and the resistance of the patients were analyzed.Results Eleven cases were diagnosed as the positive cases in 60 cases with TBM,and 0 case was diagnosed as TBM in control group.Sensitivity and specificity of Xpert with TBM were 18.33％ and 100％,respectively.The difference of the two groups was statistically significant (P =0.014).The positive rate of definite group was 23.68％(9 cases),18.18％(2 cases) in probable group and 0％ in possible group,and the difference of the three groups was statistically significant(x2 =3.070,P＞0.05).The resistance rate was 36.36％ (4/11).Sensitivity of the modified Ziehl-Neelsen staín was 63.33％ (38/60).Eleven cases were detected positive by Xpert MTB/RIF,9 cases were positive with modified acid fast staining,and the positive rate was 18.33％,and the difference of the two methods was statistically significant (P =0.000).Conclusion Xpert MTB/RIF test is simple and rapid diagnostic method.The combination of Xpert MTB/RIF and modified ZiehlNeelsen stain will improve the efficiency of the early diagnosis of TBM.