Objective To compare the differences in alkaloids between Nelumbinis Semen and Nelumbinis Plumula and their inhibitory effects on the proliferation of HepG2 cells, and investigate the material basis for their anti-cancer activity differences. Methods Simultaneous Thermal Analysis was used to preliminarily compare the component differences between Nelumbinis Semen and Nelumbinis Plumula. Alkaloids were extracted from them by both using reflux extraction, and their contents were measured by UV and HPLC methods. The CCK-8 method was used to assess the in vitro inhibitory effects of the alkaloids on the HepG2 cells, and to verify pharmacological differences. Results Simultaneous thermal analysis revealed distinct peak shapes, positions, and sizes in the thermal analysis curves of Nelumbinis Semen and Nelumbinis Plumula at respective temperature stages. The contents of total alkaloids showed as follows: the total alkaloids in Nelumbinis Plumula > total extract of Nelumbinis Plumula > the total alkaloids in Nelumbinis Semen. The total alkaloids in Nelumbinis Plumula effectively inhibited HepG2 cell proliferation, while the total alkaloids in Nelumbinis Semen showed no impact. Conclusion Differences in the composition and content of alkaloids may be key factors underlying the biological activities differences between Nelumbinis Semen and Nelumbinis Plumula. This study provided a basis for exploring the material foundation of the differential efficacy and properties of Nelumbinis Semen and Nelumbinis Plumula, which could support their rational clinical application.

Objective To observe the effects of Yuebi Decoction on adriamycin-induced nephrotic syndrome(NS)and adhesion molecule levels in rats;To explore the possible mechanism of its inhibition of NS edema.Methods A NS rat model was established by a one-time tail vein injection of 6.5 mg/kg adriamycin.The rats were randomly divided into normal group,model group,prednisone group and Yuebi Decoction group.The prednisone group and Yuebi Decoction group were given 5 mg/kg prednisone and 22.2 g/kg Yuebi Decoction by gavage,respectively.The normal group and the model group were given an equal amount of normal saline by gavage,once a day for 2 consecutive weeks.The wet and dry weight ratios of skin and kidney were detected,24 hour urine total protein quantification(24 hUTP)and the contents of blood urea nitrogen(BUN),serum creatinine(SCr),total cholesterol(TC),albumin(ALB),hemoglobin(HB)were detected,HE and PAS staining was used to observe the morphology of renal tissue,ELISA was used to detect vascular cell adhesion molecule-1(VCAM-1)and intercellular adhesion molecule-1(ICAM-1)contents in renal tissue,the positive expressions of VCAM-1 and ICAM-1 were detected by immunohistochemistry,the expressions of VCAM-1,Rac1,signal transducer and activator of transcription 3(STAT3)and p-STAT3 proteins were detected by Western blot.Results Compared with the normal group,the wet dry weight ratio of the skin and kidney of the model group rats significantly increased(P<0.01),and the 24 hUTP,SCr,BUN and TC contents significantly increased(P<0.01),while the ALB and HB contents significantly decreased(P<0.01);with glomerular balloon atrophy,the renal tubules exhibit protein casts,inflammatory cell infiltration in renal interstitium,and significant increase in the contents of VCAM-1,ICAM-1 and protein expressions of VCAM-1,Rac1,p-STAT3 in renal tissue(P<0.01).Compared with the model group,the wet dry weight ratio of the skin and kidneys of rats in the prednisone group and Yuebi Decoction group was significantly reduced(P<0.05,P<0.01),and the 24 hUTP,SCr,BUN and TC were significantly reduced(P<0.01),while the contents of ALB and HB significantly increased(P<0.01);the infiltration of inflammatory cells in renal tissue was reduced,the protein casts decreased,and the contents of VCAM-1 and ICAM-1 in renal tissue,as well as the expressions of VCAM-1,Rac1 and p-STAT3 proteins significantly decreased(P<0.05,P<0.01).Conclusion Yuebi Decoction can alleviate edema,reduce urine protein,and improve capillary permeability in NS rats.Its mechanism is related to inhibiting the Rac1/STAT3 signaling pathway and reducing the expression of renal tissue adhesion molecules.

Forkhead box O(FOXO)transcription factors serve as critical signaling hubs,initiating downstream autophagy-related gene expression in response to various growth factors and participating in mito-chondrial autophagy,thereby influencing cellular damage and repairing processes in acute and chronic kidney diseases.This article reviews the regulatory mechanisms of FOXO transcription factors and their impacts on au-tophagy and mitochondrial autophagy,aiming to explore the prospects of FOXO-induced mitochondrial autophagy in the treatment of renal diseases.

Objective To observe the protective effect of Yuebi Decoction on adriamycin(ADR)-induced mouse glomerular endothelial cells(MGEC),and to explore the possible mechanism of action.Methods MGEC were stimulated with ADR at a concentration of 1.25 μmol·L-1 for 12 h.MGEC were divided into five groups:normal group,model group,and Yuebi Decoction low,medium,and high dosage groups(5%,10%,and 20%of drug-containing serum);the viability of cells was detected by CCK-8 assay,the cell mobility was detected by Transwell assay.The relative expression levels of MGEC VCAM-1,Rac1,STAT3,and p-STAT3 were detected by Western blot.The expression of endothelial marker CD31,VCAM-1 and ICAM-1 was detected by immunofluorescence.Results Compared with the normal group,the endothelial cell migration rate was decreased in the model group(P<0.01),the protein expression levels of VCAM-1,ICAM-1,Rac1 and p-STAT 3 were significantly increased(P<0.05,P<0.01).The endothelial cell migration rate of the high-dose group of Yuebi Decoction was significantly increased compared with that of the model group(P<0.05).VCAM-1,ICAM-1,Rac1 and p-STAT3 protein expression levels of the drug-containing serum of Yuebi Decoction each group were significantly reduced(P<0.05,P<0.01).Conclusion Yuebi Decoction inhibited ADR-induced adhesion molecule expression in MGEC,alleviated endothelial injury,and improved endothelial cell migration rate.Its mechanism may be related to the inhibition of the Rac1/STAT3 signaling pathway.

Forkhead box O(FOXO)transcription factors serve as critical signaling hubs,initiating downstream autophagy-related gene expression in response to various growth factors and participating in mito-chondrial autophagy,thereby influencing cellular damage and repairing processes in acute and chronic kidney diseases.This article reviews the regulatory mechanisms of FOXO transcription factors and their impacts on au-tophagy and mitochondrial autophagy,aiming to explore the prospects of FOXO-induced mitochondrial autophagy in the treatment of renal diseases.

Objective To observe the effects of Yuebi Decoction on adriamycin-induced nephrotic syndrome(NS)and adhesion molecule levels in rats;To explore the possible mechanism of its inhibition of NS edema.Methods A NS rat model was established by a one-time tail vein injection of 6.5 mg/kg adriamycin.The rats were randomly divided into normal group,model group,prednisone group and Yuebi Decoction group.The prednisone group and Yuebi Decoction group were given 5 mg/kg prednisone and 22.2 g/kg Yuebi Decoction by gavage,respectively.The normal group and the model group were given an equal amount of normal saline by gavage,once a day for 2 consecutive weeks.The wet and dry weight ratios of skin and kidney were detected,24 hour urine total protein quantification(24 hUTP)and the contents of blood urea nitrogen(BUN),serum creatinine(SCr),total cholesterol(TC),albumin(ALB),hemoglobin(HB)were detected,HE and PAS staining was used to observe the morphology of renal tissue,ELISA was used to detect vascular cell adhesion molecule-1(VCAM-1)and intercellular adhesion molecule-1(ICAM-1)contents in renal tissue,the positive expressions of VCAM-1 and ICAM-1 were detected by immunohistochemistry,the expressions of VCAM-1,Rac1,signal transducer and activator of transcription 3(STAT3)and p-STAT3 proteins were detected by Western blot.Results Compared with the normal group,the wet dry weight ratio of the skin and kidney of the model group rats significantly increased(P<0.01),and the 24 hUTP,SCr,BUN and TC contents significantly increased(P<0.01),while the ALB and HB contents significantly decreased(P<0.01);with glomerular balloon atrophy,the renal tubules exhibit protein casts,inflammatory cell infiltration in renal interstitium,and significant increase in the contents of VCAM-1,ICAM-1 and protein expressions of VCAM-1,Rac1,p-STAT3 in renal tissue(P<0.01).Compared with the model group,the wet dry weight ratio of the skin and kidneys of rats in the prednisone group and Yuebi Decoction group was significantly reduced(P<0.05,P<0.01),and the 24 hUTP,SCr,BUN and TC were significantly reduced(P<0.01),while the contents of ALB and HB significantly increased(P<0.01);the infiltration of inflammatory cells in renal tissue was reduced,the protein casts decreased,and the contents of VCAM-1 and ICAM-1 in renal tissue,as well as the expressions of VCAM-1,Rac1 and p-STAT3 proteins significantly decreased(P<0.05,P<0.01).Conclusion Yuebi Decoction can alleviate edema,reduce urine protein,and improve capillary permeability in NS rats.Its mechanism is related to inhibiting the Rac1/STAT3 signaling pathway and reducing the expression of renal tissue adhesion molecules.

Objective To observe the protective effect of Yuebi Decoction on adriamycin(ADR)-induced mouse glomerular endothelial cells(MGEC),and to explore the possible mechanism of action.Methods MGEC were stimulated with ADR at a concentration of 1.25 μmol·L-1 for 12 h.MGEC were divided into five groups:normal group,model group,and Yuebi Decoction low,medium,and high dosage groups(5%,10%,and 20%of drug-containing serum);the viability of cells was detected by CCK-8 assay,the cell mobility was detected by Transwell assay.The relative expression levels of MGEC VCAM-1,Rac1,STAT3,and p-STAT3 were detected by Western blot.The expression of endothelial marker CD31,VCAM-1 and ICAM-1 was detected by immunofluorescence.Results Compared with the normal group,the endothelial cell migration rate was decreased in the model group(P<0.01),the protein expression levels of VCAM-1,ICAM-1,Rac1 and p-STAT 3 were significantly increased(P<0.05,P<0.01).The endothelial cell migration rate of the high-dose group of Yuebi Decoction was significantly increased compared with that of the model group(P<0.05).VCAM-1,ICAM-1,Rac1 and p-STAT3 protein expression levels of the drug-containing serum of Yuebi Decoction each group were significantly reduced(P<0.05,P<0.01).Conclusion Yuebi Decoction inhibited ADR-induced adhesion molecule expression in MGEC,alleviated endothelial injury,and improved endothelial cell migration rate.Its mechanism may be related to the inhibition of the Rac1/STAT3 signaling pathway.

Objective:To explore the influencing factors for hypoglycemia in elderly patients during peri-colonoscopy, construct and validate a risk prediction model.Methods:The factors influencing hypoglycemia in elderly patients during the peri-colonoscopy period were identified through a literature review and semi-structured interviews. After two rounds of Delphi expert consultation, the survey questionnaire was determined. From January to September 2023, convenience sampling was used to select elderly patients who underwent colonoscopy in the Department of Gastroenterology at the Affiliated Hospital of Qingdao University as participants for a questionnaire survey. Univariate and multivariate Logistic regression was used to explore the influencing factors of hypoglycemia in elderly patients during the peri-colonoscopy period, and a nomogram model of hypoglycemia risk in elderly patients during the peri-colonoscopy period was drawn. The area under the receiver operating characteristic curve ( AUC) of the subjects and the Hosmer-Lemeshow goodness of fit test were used to evaluate the model's predictive performance. The clinical decision curve of DCA was implemented to evaluate the model's clinical benefit ability. Results:A total of 558 questionnaires were distributed (392 for the modeling group and 166 for the validation group) and 558 valid questionnaires were collected, with a valid response rate of 100.00%. Among 558 elderly patients, a total of 130 cases (89 in the modeling group and 41 in the validation group) experienced hypoglycemia during the peri-colonoscopy period, with an incidence of 23.30%. Multivariate Logistic regression analysis showed that serum albumin, age, previous hypoglycemia frequency, insulin use, fasting time, and nutritional risk were independent influencing factors (all P<0.05). The AUCs of the modeling and validation groups were 0.933 and 0.899, respectively. Hosmer Lemeshow test showed that the model had good calibration accuracy, and the DCA curve indicated that the model had good clinical effectiveness. Conclusions:The nomogram model has good predictive performance and can intuitively and concisely predict the risk of hypoglycemia in elderly patients during the peri-colonoscopy period, providing reference for medical and nursing staff.

Objective:To analyze and interpret the literature on intestinal preparation during colonoscopy in the elderly in China, and explore the research hotspots and development frontiers in this field, so as to provide theoretical reference for relevant institutions and researchers.Methods:Bibliometrics CiteSpace Ⅴ software was used to search CNKI, Wanfang Database, VIP, Chinese biomedical journal database, Chinese biomedical literature database from January 1, 2000 to April 30, 2022, and then statistical analysis was made on the number of published papers, distribution of institutions and regions, authors, journals, funding, and the maps of high-frequency keywords, clustering, and cooperation of authors, institutions and burst words were drawn.Results:A total of 281 literatures were included, and the characteristics of intestinal preparation, the effect of intestinal preparation for colonoscopy and nursing intervention of intestinal preparation for colonoscopy in the elderly were extracted as the research focus.Conclusions:The visualization analysis showed the research hotspots and trend of intestinal preparation during colonoscopy in the elderly. Intestinal preparation and comprehensive nursing intervention are still the focus of future research, and the cooperation among researchers and quality of published literature should be improved based on the research hotspots in the future.

Objective:To explore the research hotspots and trends of the second victim in China in recent years, so as to provide a reference for domestic researchers and institutions.Methods:CiteSpaceⅤ bibliometrics software was applied to retrieve literature on the second victim in China National Knowledge Infrastructure, WanFang Data, VIP Data, and China Biomedical Literature Database. The retrieval time limit was from January 1, 2015 to October 26, 2021. This article drew the knowledge map of the authors, institutions, and high-frequency keywords and conducted statistical analysis.Results:A total of 55 articles were included. After integrating high-frequency keywords, it was concluded that the research hotspots focused on nurses' experience as second victims, patient safety culture, and second victim support.Conclusions:The number of published articles on the second victim in China is small, and there is a lack of cooperation between authors and institutions, and there is a certain gap with foreign research. Further research can be carried out around the research hotspots of the second victim.