BACKGROUND:Research has shown that endoplasmic reticulum stress-induced autophagy of neurons in the ischemic penumbra is a key link in cerebral ischemia-reperfusion injury.Autophagy mediated by the dissociation and activation of endoplasmic reticulum transmembrane proteins PERK,IRE1 α,ATF6,and GRP78/BIP plays an important role in neuronal outcomes.Traditional Chinese medicine can regulate endoplasmic reticulum stress-autophagy,reduce neuronal damage or death,and exert neuroprotective effects.OBJECTIVE:To explore the role of endoplasmic reticulum stress-autophagy in cerebral ischemia-reperfusion injury and the research progress in the regulatory mechanisms of traditional Chinese medicine.METHODS:A literature retrieval was conducted in CNKI and PubMed for relevant literature related to endoplasmic reticulum stress,autophagy,cerebral ischemia-reperfusion injury,and regulation by traditional Chinese Medicine published from January 2015 to May 2024.The search terms were"cerebral ischemia-reperfusion injury,ischemic stroke,brain injury,endoplasmic reticulum stress,autophagy,traditional Chinese medicine,compounds,signaling pathways,saponins,polyphenols,alkaloids"in Chinese and English,respectively.Any literature that is inconsistent with the research content,outdated,or duplicated was excluded.A total of 1197 relevant literature were retrieved,and 71 articles were ultimately included.RESULTS AND CONCLUSION:(1)Numerous studies have suggested that endoplasmic reticulum stress-autophagy is closely related with cerebral ischemia-reperfusion injury.(2)The active ingredients and compound formulas of traditional Chinese medicine monomers can regulate the expression of endoplasmic reticulum stress-autophagy related proteins,alleviate neuronal damage,and exert neuroprotective effects by regulating signal pathways such as PERK-eIF2α-ATF4,IRE1α-ASK1-JNK,and IRE1α-XBP.

Objective:To observe the clinical efficacy of acupuncture combined with Chinese medicine in the treatment of pediatric cough variant asthma(CVA)and the effects on clinical symptoms and inflammatory factor levels.Methods:A total of 136 children with CVA were randomly divided into a treatment group and a control group using the random number table method,with 68 cases in each group.Patients in the control group were treated with Chinese medicine,while patients in the treatment group were treated with Jiang Qi Ping Chuan(Qi-descending and asthma-relieving)acupuncture therapy in addition to the intervention of the control group.The clinical efficacy,cough severity,secondary symptom score,levels of inflammatory factors in induced sputum,and adverse reactions were observed after 4 weeks of treatment.Results:The total effective rate of the treatment group was higher than that of the control group,and the difference was statistically significant(P<0.05).The daytime cough score,nighttime cough score,and total cough score decreased significantly after treatment in both groups(P<0.05),and were notably lower in the treatment group than in the control group(P<0.05);the secondary symptom score and induced sputum inflammatory factor levels[interleukin(IL)-5,nerve growth factor(NGF),and substance P(SP)]decreased significantly after treatment in both groups(P<0.05),and were notably lower in the treatment group than in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The efficacy of acupuncture combined with Chinese medicine in the treatment of pediatric CVA is better than that of Chinese medicine alone;this combined method can rapidly relieve clinical symptoms and effectively inhibit inflammatory responses,with high safety.

Objective To investigate the impact of anesthesia and surgery on hippocampal expression of Alzheimer’s disease (AD)-associated proteins in 5×FAD transgenic mice and explore potential sex differences. Methods 5×FAD mice were crossbred with C57BL/6J wild-type (WT) mice to generate offspring for genotypic confirmation. Four-month-old 5×FAD mice and littermate (LM) WT controls were allocated into 8 experimental groups (n＝8/group): female/male 5×FAD control group, female/male 5×FAD anesthesia/surgery group, female/male LM control group, and female/male LM anesthesia/surgery group. Anesthesia/surgery groups underwent laparotomy under 1.4% isoflurane anesthesia, while control groups received no intervention. Hippocampal tissues were collected 24 hours post-procedure for Western blotting analysis of β-catenin, glycogen synthase kinase 3 beta (GSK3β), and phosphorylated GSK3β (p-GSK3β) levels. Results Female 5×FAD mice demonstrated significant reductions in β-catenin levels and p-GSK3β expression compared to both sex-matched LM controls and male 5×FAD counterparts (P＜0.05). No significant differences in these proteins were observed in male 5×FAD mice following anesthesia/surgery. Conclusions These findings reveal sex-specific responses to perioperative stress in AD, suggesting that anesthesia and surgery may affect female AD patients through hippocampal β-catenin/GSK3β pathway modulation.

OBJECTIVE To investigate the establishment and promotion of a new standardized management model for anti-osteoporosis medication after fragility fracture surgery by resident clinical pharmacists,and provide references for resident pharmacists to carry out clinical pharmaceutical services.METHODS From July 2023 to March 2024,595 post-brittle fracture surgery patients were enrolled.Using the PDCA(plan-do-check-act)cycle,resident clinical pharmacists identified issues and conducted investigations in clinical practice.Through integrating clinical pharmacist intervention services before,during and after treatment,a medication treatment pathway was developed,thereby establishing a standardized management model for anti-osteoporosis treatment following fragility fracture surgery.Leveraging the National Brittle Fracture Big Data Platform(under the National Clinical Research Center for Orthopedics and Sports Rehabilitation),a dedicated data module was constructed,providing big data support to evaluate the efficacy of this pharmaceutical care model.RESULTS Continuous PDCA cycle driven improvements significantly increased the proportion of osteoporosis diagnosis(from 9%before intervention to 81%)and proportion of drug treatment(from 4%to 75%).The proportions of bone density and bone metabolism testing also rose markedly,positively impacting long-term patient outcomes.CONCLUSIONS The establishment of a standardized management model for anti-osteoporosis treatment following fragility fracture surgery by resident clinical pharmacists has enhanced clinicians'diagnostic and therapeutic capabilities for osteoporosis,ensures rational medication use in osteoporosis patients,and demonstrates significant potential for widespread adoption and application.

Objective:To observe the clinical efficacy of acupuncture combined with Chinese medicine in the treatment of pediatric cough variant asthma(CVA)and the effects on clinical symptoms and inflammatory factor levels.Methods:A total of 136 children with CVA were randomly divided into a treatment group and a control group using the random number table method,with 68 cases in each group.Patients in the control group were treated with Chinese medicine,while patients in the treatment group were treated with Jiang Qi Ping Chuan(Qi-descending and asthma-relieving)acupuncture therapy in addition to the intervention of the control group.The clinical efficacy,cough severity,secondary symptom score,levels of inflammatory factors in induced sputum,and adverse reactions were observed after 4 weeks of treatment.Results:The total effective rate of the treatment group was higher than that of the control group,and the difference was statistically significant(P<0.05).The daytime cough score,nighttime cough score,and total cough score decreased significantly after treatment in both groups(P<0.05),and were notably lower in the treatment group than in the control group(P<0.05);the secondary symptom score and induced sputum inflammatory factor levels[interleukin(IL)-5,nerve growth factor(NGF),and substance P(SP)]decreased significantly after treatment in both groups(P<0.05),and were notably lower in the treatment group than in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The efficacy of acupuncture combined with Chinese medicine in the treatment of pediatric CVA is better than that of Chinese medicine alone;this combined method can rapidly relieve clinical symptoms and effectively inhibit inflammatory responses,with high safety.

Migraine is a common neurological disorder with a complex pathogenesis that is currently not fully understood;however,the role of mitochondrial function in migraine pathogenesis has recently attracted widespread attention.This review considers the latest research progress on the relationship between mitochondrial dysfunction and migraine,including mitochondrial energy metabolism,oxidative stress,calcium homeostasis,and neuroinflammation.We introduce the epidemiological and clinical characteristics of migraine,and provide a detailed exploration of the key role of mitochondria in these processes.Mitochondrial dysfunction may lead to increased neuronal excitability,abnormal vasoconstriction,and inflammatory responses,thereby inducing migraine.Based on the evidence of mitochondrial involvement in the pathogenesis of migraine,we propose future research directions and potential treatment strategies,with the aim of providing new ideas for the prevention and treatment of migraine.

Migraine is a common neurological disorder with a complex pathogenesis that is currently not fully understood;however,the role of mitochondrial function in migraine pathogenesis has recently attracted widespread attention.This review considers the latest research progress on the relationship between mitochondrial dysfunction and migraine,including mitochondrial energy metabolism,oxidative stress,calcium homeostasis,and neuroinflammation.We introduce the epidemiological and clinical characteristics of migraine,and provide a detailed exploration of the key role of mitochondria in these processes.Mitochondrial dysfunction may lead to increased neuronal excitability,abnormal vasoconstriction,and inflammatory responses,thereby inducing migraine.Based on the evidence of mitochondrial involvement in the pathogenesis of migraine,we propose future research directions and potential treatment strategies,with the aim of providing new ideas for the prevention and treatment of migraine.

BACKGROUND:Research has shown that endoplasmic reticulum stress-induced autophagy of neurons in the ischemic penumbra is a key link in cerebral ischemia-reperfusion injury.Autophagy mediated by the dissociation and activation of endoplasmic reticulum transmembrane proteins PERK,IRE1 α,ATF6,and GRP78/BIP plays an important role in neuronal outcomes.Traditional Chinese medicine can regulate endoplasmic reticulum stress-autophagy,reduce neuronal damage or death,and exert neuroprotective effects.OBJECTIVE:To explore the role of endoplasmic reticulum stress-autophagy in cerebral ischemia-reperfusion injury and the research progress in the regulatory mechanisms of traditional Chinese medicine.METHODS:A literature retrieval was conducted in CNKI and PubMed for relevant literature related to endoplasmic reticulum stress,autophagy,cerebral ischemia-reperfusion injury,and regulation by traditional Chinese Medicine published from January 2015 to May 2024.The search terms were"cerebral ischemia-reperfusion injury,ischemic stroke,brain injury,endoplasmic reticulum stress,autophagy,traditional Chinese medicine,compounds,signaling pathways,saponins,polyphenols,alkaloids"in Chinese and English,respectively.Any literature that is inconsistent with the research content,outdated,or duplicated was excluded.A total of 1197 relevant literature were retrieved,and 71 articles were ultimately included.RESULTS AND CONCLUSION:(1)Numerous studies have suggested that endoplasmic reticulum stress-autophagy is closely related with cerebral ischemia-reperfusion injury.(2)The active ingredients and compound formulas of traditional Chinese medicine monomers can regulate the expression of endoplasmic reticulum stress-autophagy related proteins,alleviate neuronal damage,and exert neuroprotective effects by regulating signal pathways such as PERK-eIF2α-ATF4,IRE1α-ASK1-JNK,and IRE1α-XBP.

Objective:To investigate the effectiveness and safety of the coaxial needle technique in percutaneous liver biopsy for patients with coagulation function abnormalities.Methods:Clinical data of 210 patients who underwent percutaneous liver biopsy using the coaxial needle technique under ultrasound guidance from December 2018 to May 2021 in 3 centers were collected. A retrospective analysis was conducted to compare the puncture success rate, number of samples obtained, pathology qualification rate, intraoperative and postoperative bleeding rates between the group with coagulation function abnormalities and the group with normal coagulation function.Results:After propensity score matching, there were 105 patients in each group, with a puncture success rate of 100% in both groups. The pathology qualification rate was 100% for all samples.Intraoperative bleeding occurred in 78 cases (74.3%, 78/105) in the coagulation function abnormalities group and in 64 cases (61.0%, 64/105) in the normal coagulation function group, with a statistically significant difference between the two groups ( P=0.006). Postoperative bleeding occurred in 3 cases (2.9%, 3/105) in the coagulation function abnormalities group and in 0 case in the normal coagulation function group, with no statistically significant difference between the two groups ( P=0.081). Conclusions:The use of the coaxial needle technique for percutaneous liver biopsy in patients with coagulation function abnormalities not only allows for obtaining an adequate tissue sample but also demonstrates good safety.

Oncocytoma is a benign tumor of the salivary gland.Its incidence is very low and very seldom documen-ted in literature.Clear-cell dominant oncocytoma is even less common.The tumor's clinical symptoms and imaging re-sults are nonspecific,so distinguishing other salivary gland tumors(such as oncocytic carcinoma)from clear-cell renal carcinoma is difficult,possibly leading to misdiagnosis and maltreatment.Here,a case of clear-cell dominant oncocyto-ma was presented,and the relevant literature was evaluated to investigate the diagnosis and management of clear-cell dominant oncocytoma.