To investigate the protective effects and underlying mechanisms of Qin-Zhu-Liang-Xue decoction (QZLX) in atopic dermatitis (AD) and glucocorticoid resistance, we conducted a single-blinded, randomized controlled clinical trial to evaluate the efficacy and safety of this concoction. Network pharmacology analysis was performed and validated through clinical studies. The efficacy, safety, and mechanism of action of QZLX and glucocorticoid receptor (GR) α recombinant protein were assessed in AD mice induced by 2,4-dinitrofluorobenzene (DNFB). Correlation analysis was performed to determine the clinical relevance of GRα. The trial demonstrated that patients who received QZLX showed considerable improvements in their Scoring Atopic Dermatitis (SCORAD) and Dermatology Life Quality Index (DLQI) scores compared with those who received mizolastine at week 4. Network pharmacological analysis identified GRα as a key target for QZLX in AD treatment. QZLX administration increased the serum GRα expression in AD patients, alleviated AD symptoms in mice, decreased inflammatory cytokine expression, and increased GRα expression without affecting liver or kidney function. In addition, GRα recombinant protein improved AD-like skin lesions in DNFB-induced mice. A negative correlation was observed between GRα expression and clinical parameters, including SCORAD, DLQI, and serum IgE levels. QZLX alleviates AD symptoms through the upregulation of GRα and thus presents a novel therapeutic strategy for the prevention of glucocorticoid resistance in AD management.
Dermatitis, Atopic/drug therapy* ; Animals ; Drugs, Chinese Herbal/administration & dosage* ; Humans ; Mice ; Network Pharmacology ; Male ; Female ; Adult ; Receptors, Glucocorticoid/metabolism* ; Disease Models, Animal ; Single-Blind Method ; Middle Aged ; Young Adult

Background and Aims:Elderly patients undergoing laparoscopic radical resection of colon cancer often experience decreased sleep quality,which may hinder postoperative recovery.Although pharmacological interventions are commonly used in clinical practice to improve postoperative sleep,conventional medications may lead to adverse effects such as delirium and dependence.This study aimed to evaluate the effect of a non-pharmacological intervention—buccal acupuncture combined with ultrasound-guided stellate ganglion block(SGB)—on postoperative sleep quality in elderly patients.Methods:A total of 60 elderly patients who underwent laparoscopic radical resection of colon cancer at the Forth Hospital of Changsha from February to August 2024 were enrolled.Using a random number table,the patients were divided into two groups:30 in the control group(SGB alone)and 30 in the study group(SGB combined with buccal acupuncture).Perioperative mean arterial pressure(MAP),heart rate(HR),postoperative visual analogue scale(VAS)scores,Pittsburgh Sleep Quality Index(PSQI)scores,and the incidence of adverse events were recorded and analyzed.Results:There were no statistically significant differences in baseline characteristics between the two groups(all P>0.05).The study group showed significantly lower intraoperative and postoperative HR and MAP compared to the control group(all P<0.05).VAS scores at 6,24,and 48 h postoperatively,as well as PSQI scores on postoperative days 1,3,and 5,were significantly lower in the study group(all P<0.05).Additionally,the incidence of drowsiness was significantly reduced(P<0.05).No significant differences were found between the two groups in terms of nausea,vomiting,or agitation(all P>0.05).Conclusion:The combination of buccal acupuncture and SGB during the perioperative period can effectively improve postoperative sleep quality,alleviate pain,and reduce adverse reactions in elderly patients undergoing laparoscopic radical resection of colon cancer.This safe and effective non-pharmacological intervention holds promising clinical application value.

Background and Aims:Elderly patients undergoing laparoscopic radical resection of colon cancer often experience decreased sleep quality,which may hinder postoperative recovery.Although pharmacological interventions are commonly used in clinical practice to improve postoperative sleep,conventional medications may lead to adverse effects such as delirium and dependence.This study aimed to evaluate the effect of a non-pharmacological intervention—buccal acupuncture combined with ultrasound-guided stellate ganglion block(SGB)—on postoperative sleep quality in elderly patients.Methods:A total of 60 elderly patients who underwent laparoscopic radical resection of colon cancer at the Forth Hospital of Changsha from February to August 2024 were enrolled.Using a random number table,the patients were divided into two groups:30 in the control group(SGB alone)and 30 in the study group(SGB combined with buccal acupuncture).Perioperative mean arterial pressure(MAP),heart rate(HR),postoperative visual analogue scale(VAS)scores,Pittsburgh Sleep Quality Index(PSQI)scores,and the incidence of adverse events were recorded and analyzed.Results:There were no statistically significant differences in baseline characteristics between the two groups(all P>0.05).The study group showed significantly lower intraoperative and postoperative HR and MAP compared to the control group(all P<0.05).VAS scores at 6,24,and 48 h postoperatively,as well as PSQI scores on postoperative days 1,3,and 5,were significantly lower in the study group(all P<0.05).Additionally,the incidence of drowsiness was significantly reduced(P<0.05).No significant differences were found between the two groups in terms of nausea,vomiting,or agitation(all P>0.05).Conclusion:The combination of buccal acupuncture and SGB during the perioperative period can effectively improve postoperative sleep quality,alleviate pain,and reduce adverse reactions in elderly patients undergoing laparoscopic radical resection of colon cancer.This safe and effective non-pharmacological intervention holds promising clinical application value.

Objective To observe the correlations of pontine biological indicators on fetal brain median sagittal MRI with gestational week.Methods Data of head MRI of 226 normal fetuses without obvious abnormalities of central nervous system(normal group)and 17 fetuses with abnormalities(abnormal group)at gestational age of 23 to 38 weeks were retrospectively analyzed.Pontine biological indicators based on median sagittal MRI were obtained,including pons anteroposterior diameter(PAD),total pons area(TPA),pontine basal anteroposterior length(AP),pontine basal cranio-caudal length(CC),basis pontis area(BPA)and pontine angle of midbrain(MAP).According to the gestational week,the fetuses of normal group were divided into 8 subgroups.The distributing ranges of pontine biological indicators at different gestational weeks were analyzed,and the correlations of pontine biological indicators with gestational week in normal group were explored,and the developmental status of fetal pons in abnormal group were assessed.Results In normal group,PAD,TPA,AP,CC and BPA all showed linear positive correlation(r=0.887,0.914,0.787,0.866,0.865,all P＜0.001),while MAP was not significantly correlated with gestational week(P＞0.05).Among 17 fetuses in abnormal group,abnormal PAD or TPA was found each in 8 fetuses,abnormal AP was observed in 14,abnormal CC was noticed in 3 and abnormal BPA was found in 11 fetuses.Conclusion Fetal pontine biological indicators such as PAD,TPA,AP,CC and BPA on median sagittal MRI were positively correlated with gestational week,hence being able to be used for evaluating fetal pontine development.

Objective To explore the genetic characteristics of fetuses with congenital heart diseases(CHD)diagnosed by prenatal ultrasound.Methods Data of 613 singletons with prenatal ultrasonic diagnosed CHD were retrospectively analyzed.The cardiac structural abnormalities were classified into 8 types.Whole-exome sequencing(WES)was performed for 40 fetuses since chromosomal karyotyping analysis and/or chromosomal microarray analysis(CMA)showed benign copy number variations(CNV)or variants of uncertain significance(VUS).Results Among 613 fetuses,479 fetuses underwent both chromosomal karyotyping analysis and CMA,genomic abnormalities were detected in 60 fetuses(60/479,12.53％).Among 134 fetuses underwent only CMA,genomic abnormalities were found in 4 fetuses(4/134,2.99％).According to results of chromosomal karyotyping analysis and/or CMA,abnormalities were noticed in 40 fetuses(40/568,7.04％)among 568 fetuses with isolated CHD,while in 15 fetuses(15/45,33.33％)among 45 fetuses with non-isolated CHD,respectively.Abnormality detection rate of chromosomal karyotyping analysis and/or CMA in fetuses with complex CHD(10/41,24.39％)was higher than that in fetuses with non-complex CHD(54/572,9.44％).Among complex CHD fetuses,abnormality detection rate was the highest in fetuses with conotruncal defect(CTD)combined with malformation of venous system(4/13,30.77％),while among fetuses with non-complex CHD,situs inversus viscerum had the highest detection rate(1/4,25.00％).Among 40 fetuses chromosomal karyotyping analysis and/or CMA showed benign CNV or VUS,WES indicated pathogenic CNV/likely pathogenic CNV(P/LP)in 3 fetuses,VUS in 3 fetuses and benign CNV in 34 fetuses.Conclusion Fetuses with CHD,especially extracardiac malformations had possibilities of genomic abnormalities.Fetuses with CTD combined with malformation of venous system had higher possibilities of genomic abnormalities.Compared with CMA alone,chromosomal karyotyping analysis combined with CMA was helpful for detecting genomic abnormalities.

Objectives:To investigate the genetic characteristics of the blaNDM-1-carrying plasmid of the multidrug resistant Enterobacter hormaechei subsp. hoffmannii clinical isolate C37, and constructing a phylogenetic tree of the 66 publicly available genomes of the Enterobacter hormaechei subsp. hoffmannii to explore its global epidemic situation. Methods:Carbapenem-resistant Enterobacter cloacae complex (CRECC) strains isolated from the First Affiliated Hospital of Sun Yat-sen University from August 2014 to August 2021 were collected. Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S rDNA Sanger sequencing were used for species identification. Micro broth dilution method was used for antibacterial susceptibility test. The polymerase chain reaction (PCR) was used to detect the β-lactamase resistance gene and plasmid-mediated quinolone resistance (PMQR) gene carried by the C37 strain. The conjugation experiment was used to confirm the conjugative metastasis of the resistance genes in C37 strain. Whole genome of the C37 strain was sequenced. Core genome was extracted and the phylogenetic analysis of 66 publicly available Enterobacter hormaechei subsp. hoffmannii was performed. Results:Enterobacter hormaechei subsp. hoffmannii C37 strain is resistant to third-generation cephalosporins, carbapenems, aminoglycosides and quinolones, and carries blaACT-5, blaNDM-1, qnrA1, aac(6′)-Ib-cr, oqxAB, fosA, dfrA15 and other resistance genes, as well as IncX3, IncX4, IncFIB and IncFII plasmids. Multilocus sequence typing (MLST) analysis showed that C37 strain belongs to the ST78 type of Enterobacter cloacae complex (ECC). Conclusions:ST78 type Enterobacter hormaechei subsp. hoffmannii is closely related to the spread of carbapenem resistance genes. It is a potential high-risk clone to spread carbapenem resistance genes. The prevalence and trends of ST78 type Enterobacter hormaechei subsp. Hoffmannii should be monitored.

Background: Androgenetic alopecia (AGA) leads to thinning of scalp hair and affects 60%~70% of the adult population worldwide. Developing more effective treatments and studying its mechanism are of great significance. Previous clinical studies have revealed that hair growth is stimulated by 650-nm red light. Objective: This study aimed to explore the effect and mechanism of 650-nm red light on the treatment of AGA by using ex vivo hair follicle culture. Methods: Human hair follicles were obtained from hair transplant patients with AGA. Hair follicles were cultured in Williams E medium and treated with or without 650-nm red light.Real-time RT-PCR and immunofluorescence staining were used to detect the expression level of genes and proteins in hair follicles, respectively. RNA-sequencing analysis was carried out to reveal the distinct gene signatures upon 650 nm treatment. Results: Low-level 650 nm red light promoted the proliferation of human hair follicles in the experimental cultured-tissue model. Consistently, 650 nm red light significantly delayed the transition of hair cycle from anagen to catagen in vitro. RNA-seq analysis and gene clustering for the differentially expressed genes suggests that leukocyte transendothelial migration, metabolism, adherens junction and other biological process maybe involved in stimulation of hair follicles by 650-nm red light treatment. Conclusion The effect of 650-nm red light on ex vivo hair follicles and the transcriptome set which implicates the role of red light in promoting hair growth and reversing of miniaturization process of AGA were identified.

OBJECTIVE：To investigate the effects of gypenosides （GPs）on gene expression of major urinary proteins （Mups） in liver tissue of hypercholesterolemia model mice. METHODS ：C57BL/6J mice were divided into control （ND）group，model （HFD）group and GPs therapy （GP）group according to body weight （BW），with 11 mice in each group. Except for ND group ， other groups were given high-lipid diet to induce hypercholesterolemia model. From the 17th week of feeding ，ND group and HFD group were given constant volume of 0.1％CMC-Na solution intragastrically ；GP group were given GPs suspension （250 mg/kg） intragastrically，once a day ，for consecutive 22 weeks. BW ，the levels of blood glucose （BG）and blood lipid （TC，LDL-C）were detected in each group. Total RNA of liver tissue was extracted ，and reverse transcription library was constructed and RNA-seq sequencing was performed. The differentially expressed genes were screened by PCA ，volcano map and scatter plot. RT-qPCR was used for verification for differentially expressed genes. The correlation between the expression of differentially expressed genes and the above pharmacodynamic indexes was analyzed by bivariate analysis. RESULTS ：Compared with ND group ，BW，the levels of BG，TC and LDL-C in HFD group were increased significantly （P＜0.05）. Compared with HFD group ，above indexes of GP group were decreased significantly except for BW （P＜0.05）. PCA showed that the data of ND group and HFD group distributed in different quadrants ，and the data distribution of GP group was between above two groups. mRNA of Mup4，Mup5，Mup11，Mup15 and Mup21 in liver tissue of mice were increased significantly after treated with high-fat diet （P＜0.05）. mRNA of Mup3，Mup4， Mup5，Mup8，Mup12 and Mup21 were decreased significantly after treated with GPs （P＜0.05）. In ND group vs. HFD group and HFD group vs. GP group ，mRNA of Mup4，Mup5 and Mup21 genes changed significantly and the trend was opposite. Results of RT-qPCR verification showed that compared with ND group ，relative mRNA expression of Mup4，Mup5 and Mup21 gene were increased significantly in HFD group （P＜0.05）. Correlation analysis revealed that mRNA expression of Mup5 was positively correlated with the levels of TC and BG （r＝0.727 1，0.670 6，P＜0.05），mRNA expression of Mup4 and Mup21 were positively correlated with the level of BG （r＝0.737 8，0.721 5，P＜0.05）. CONCLUSIONS ：GPs can regulate the expression of Mups genes in liver tissue of hypercholesterolemia model mice ， and reduce glucose and lipid level through regulating the mRNA over-expression of Mup4，Mup5 and Mup21.

Objective:To investigate differences in stratum corneum components between sensitive skin and normal skin by attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy, and to evaluate the value of ATR-FTIR spectroscopy in the study of pathogenesis of sensitive skin.Methods:From December 2018 to February 2019, 148 volunteers were recruited, who had lived in Shanghai for ≥ 6 years. Through questionnaire survey, lactic acid sting test and capsaicin test, the subjects were divided into normal skin group and sensitive skin group; meanwhile, total sting score and total burning score of the subjects were recorded in the lactic acid sting test and capsaicin test respectively. ATR-FTIR spectroscopy was performed to detect stratum corneum components, including natural moisturizing factor (NMF), stratum corneum lipids, free fatty acids (FFA) and β-sheet/α-helix (β/α) ratio; moreover, other non-invasive techniques were used to measure skin physiological parameters, including transepidermal water loss (TEWL), stratum corneum hydration (SCH) levels, stratum corneum lipids, skin pH, current perception thresholds of 3 peripheral sensory nerve fibers, and superficial skin blood flow perfusion. Spearman correlation coefficients between stratum corneum components and the total sting score as well as total burning pain score were analyzed, so were Pearson correlation coefficients between the stratum corneum components and skin physiological parameters.Results:A total of 73 volunteers completed all tests, including 15 males and 19 females aged 41.8 ± 8.9 years in the sensitive skin group, and 19 males and 20 females aged 42.8 ± 9.4 years in the normal skin group. Compared with the normal skin group, the sensitive skin group showed significantly decreased levels of stratum corneum NMF (30.90 ± 7.38 vs. 37.01 ± 8.77, t = 3.193, P < 0.01) and FFA (14.90 ± 6.75 vs. 20.45 ± 11.76, t = 2.422, P < 0.05), but significantly increased β/α ratio (3.17 ± 1.03 vs. 2.67 ± 0.56, t = -2.595, P < 0.05) ; there was no significant difference in stratum corneum lipid content between the two groups ( t = 1.458, P > 0.05). As far as the skin physiological parameters were concerned, the sensitive skin group showed significantly increased TEWL ( t = -3.496, P < 0.001), but significantly decreased current perception thresholds at a frequency of 5 Hz and epidermal density (both P < 0.05) compared with the normal skin group; no significant difference in stratum corneum lipid content was observed between the two groups ( P > 0.05). Correlation analysis revealed that NMF, FFA and β/α ratio were significantly correlated with TEWL ( r = -0.405, -0.562, 0.503, respectively, all P < 0.01) and total sting score ( rs = -0.401, -0.285, 0.316, respectively, P < 0.01 or 0.05) ; meanwhile, epidermal density was also significantly correlated with NMF ( r = 0.402, P < 0.01) and β/α ratio ( r = -0.369, P < 0.05). However, none of NMF, FFA and β/α ratio was correlated with stratum corneum lipid content, current perception thresholds of the 3 sensory nerve fibers, superficial skin blood flow perfusion or epidermal thickness (all P > 0.05) . Conclusions:NMF, FFA and β/α ratio in the stratum corneum significantly differed between the sensitive skin and normal skin, and were significantly correlated with some physiological parameters related to stratum corneum barrier function. ATR-FTIR spectroscopy is an effective method for evaluating barrier function of sensitive skin.

Objective To investigate the clinical diagnostic value of serum procalcitonin(PCT),D-dimer (DD),C-reactive protein(CRP)in acute-on-chronic liver failure(ACLF). Methods 124 ACLF patients, 63 chronic hepatitis B patients,32 chronic hepatitis C patients,24 chronic hepatitis E patients and 60 healthy controls from the second affiliated hospital of Nanchang University were enrolled in this study.PCT was detected by a sandwish immunodetection method. D-dimer was detected by Latex Turbidimetry. CRP was detected by rate nephenometry. The detection results were used for analyzing the clinical diagnostic value of ACLF with infection. Results(1)The level of PCT,DD and CRP in ACLF group were significantly higher than non-ACLF group and healthy controls(P<0.05).The levels of PCT,DD and CRP in the infection group were significantly higher than non-infection group(P<0.05).(2)The positive rates of PCT,DD and CRP in the infection group were 93.24%, 78.38%,89.19%,which were significantly higher than the non-infection group and healthy controls respectively (P < 0.05).(3)The sensitivity(93.24%)and specificity(90.00%)of PCT were the highest among all indexes. (4)The area under the ROC curve of PCT,DD,CRP were 0.892,0.715,0.755,respectively.PCT had the highest diagnostic value. Conclusion The levels of serum PCT,DD and CRP have a significant clinical value for the early diagnosis of ACLF with infection.