Liver cancer is one of the most common malignant tumors in the digestive system and ranks sixth among newly diagnosed malignant tumors worldwide. Transforming growth factor-β （TGF-β） regulates cell differentiation， proliferation， apoptosis， and other physiological and pathological mechanisms and exerts cancer-suppressive and pro-cancerous dual effects in the process of tumor development. In recent years， with the continuous exploration of the mechanism of liver cancer， it has been found that the conversion of the cancer-suppressive effect into a pro-cancerous effect of this pathway plays a key role in the development of liver cancer. Traditional Chinese medicine （TCM） provides a unique perspective for the classification， diagnosis， and treatment of liver cancer with its comprehensive regulatory effects of multi-components， multi-targets， and multi-pathways. This paper summarized that the cancer-suppressive mechanisms of the TGF-β signaling pathway included promoting cancer cell cycle arrest， apoptosis， autophagy， et al， while the pro-cancerous mechanisms included promoting cancer cell proliferation， invasion and metastasis， immunosuppression， angiogenesis， et al. The TCM compounds intervening this pathway were sorted out， including Jianpi Huayu compound， Fuyang Baoyuan compound， Yipi Yanggan compound， Fuzheng Jiedu compound， compound Astragalus and Salvia， Biejia Jianwan， Dahuang Zhechong pill， and Qingxiang powder. The single TCMs mainly included Schizocapsa plantaginea， Dendrobii Caulis， Gleditsia sinensis， and Dracaena cochinchinensis. The active ingredients of TCM are mainly concentrated on flavonoids， alkaloids， glycosides， phenolics， terpenoids， polysaccharides， and other kinds of compounds. At the same time， it summarized that the liver cancer inhibition mechanism of TCM by regulating this pathway mainly included promoting apoptosis of liver cancer cells， blocking the cell cycle， and inhibiting liver cancer cell proliferation， migration， invasion， angiogenesis， immune escape， etc. The mechanism aims to give full play to the advantages of TCM and precisely regulate the TGF-β signal， thereby exerting positive anti-tumor effects， opening up a new direction for the precise targeted treatment of liver cancer， and providing a scientific basis and a new strategy for the application of TCM in the treatment of liver cancer.

Liver cancer is one of the most common malignant tumors in the digestive system and ranks sixth among newly diagnosed malignant tumors worldwide. Transforming growth factor-β （TGF-β） regulates cell differentiation， proliferation， apoptosis， and other physiological and pathological mechanisms and exerts cancer-suppressive and pro-cancerous dual effects in the process of tumor development. In recent years， with the continuous exploration of the mechanism of liver cancer， it has been found that the conversion of the cancer-suppressive effect into a pro-cancerous effect of this pathway plays a key role in the development of liver cancer. Traditional Chinese medicine （TCM） provides a unique perspective for the classification， diagnosis， and treatment of liver cancer with its comprehensive regulatory effects of multi-components， multi-targets， and multi-pathways. This paper summarized that the cancer-suppressive mechanisms of the TGF-β signaling pathway included promoting cancer cell cycle arrest， apoptosis， autophagy， et al， while the pro-cancerous mechanisms included promoting cancer cell proliferation， invasion and metastasis， immunosuppression， angiogenesis， et al. The TCM compounds intervening this pathway were sorted out， including Jianpi Huayu compound， Fuyang Baoyuan compound， Yipi Yanggan compound， Fuzheng Jiedu compound， compound Astragalus and Salvia， Biejia Jianwan， Dahuang Zhechong pill， and Qingxiang powder. The single TCMs mainly included Schizocapsa plantaginea， Dendrobii Caulis， Gleditsia sinensis， and Dracaena cochinchinensis. The active ingredients of TCM are mainly concentrated on flavonoids， alkaloids， glycosides， phenolics， terpenoids， polysaccharides， and other kinds of compounds. At the same time， it summarized that the liver cancer inhibition mechanism of TCM by regulating this pathway mainly included promoting apoptosis of liver cancer cells， blocking the cell cycle， and inhibiting liver cancer cell proliferation， migration， invasion， angiogenesis， immune escape， etc. The mechanism aims to give full play to the advantages of TCM and precisely regulate the TGF-β signal， thereby exerting positive anti-tumor effects， opening up a new direction for the precise targeted treatment of liver cancer， and providing a scientific basis and a new strategy for the application of TCM in the treatment of liver cancer.

Chronic atrophic gastritis （CAG） is a digestive system disease characterized by the reduction and atrophy of the intrinsic glands of the gastric mucosa. This disease is closely related to risk factors such as Helicobacter pylori （Hp） infection，long-term unhealthy eating habits and lifestyle. As CAG is a key link in the development of gastric cancer，effectively preventing its deterioration is of great significance for the prevention of gastric cancer. At present，Western medicine mainly uses symptomatic treatments such as eradicating Hp，protecting gastric mucosa， and promoting gastrointestinal motility. However， long-term use is prone to drug resistance and cannot reverse limitations such as gland atrophy， making it urgent to explore new intervention strategies. In recent years，with the deepening of CAG mechanism research，the phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway，as one of the classic signaling pathways，plays a significant role in the occurrence and development of CAG，while its systematic summary is still blank. Based on the regulatory advantages of "multi-target，multi-pathway，and low toxicity"，traditional Chinese medicine can improve the pathological process of CAG by intervening in key nodes of the PI3K/Akt pathway. In this paper，the research progress of traditional Chinese medicine regulating PI3K/Akt pathway to improve CAG was systematically reviewed for the first time. The expression of PI3K/Akt signaling pathway in CAG was discussed，including the regulation of inflammation and oxidative stress，cell proliferation and apoptosis，and autophagy. The traditional Chinese medicine flavonoids，alkaloids，terpenoids and other compounds that regulate this pathway were summarized. The traditional Chinese medicine compounds mainly include classic famous prescriptions such as Xiaochaihu Tang，Banxia Xiexin Tang，Morodan concentrated pills，Elian granules and other traditional Chinese patent medicines，as well as empirical prescriptions such as modified Leweiyin formula，and Qiling prescription. This study aims to give full play to the advantages of traditional Chinese medicine and lay a solid foundation for the wide application and further development of CAG treatment，and provide new ideas for clinical research and drug research on CAG.

Objective To study the mechanism of Kangxian Ruangan Granules in improving mouse liver fibrosis by regulating TGF-β1/Smad signaling pathway.Methods Eight out of 50 SPF grade male C57BL/6J mice were randomly selected as the normal group,and the remaining mice were intraperitoneally injected with 20%CCl4 olive oil solution(2 mL/kg,3 times a week for 4 weeks)to establish the liver fibrosis model.The successfully modeled mice were randomly divided into model group,silibinin group,and Kangxian Ruangan Granules low-,medium-and high-dosage groups using a random number table method,with 8 mice in each group.Each group of Kangxian Ruangan Granules was orally administered at dosages of 1.95,3.90 and 7.80 g/kg;the silibinin group was orally administered at a dosage of 100 mg/kg,while the normal group and model group were given equal volume of physiological saline by gavage,once a day for 8 weeks.The body mass and liver mass of mice were weighed and the liver index was calculated,the contents of serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),hydroxyproline(HYP),hyaluronic acid(HA),type Ⅲ procollagen(PC-Ⅲ),type Ⅳ collagen(ColⅣ)and laminin(LN)were detected by ELISA;liver tissue morphology was observed using HE,Masson and sirius red staining;immunohistochemistry,RT-qPCR and Western blot were used to detect the expressions of type Ⅰ collagen(ColⅠ),α-smooth muscle actin(α-SMA)and TGF-β1/Smad signaling pathway related factors in liver tissue.Results Compared with the normal group,the body mass of the model group mice decreased(P<0.01),while the liver mass and liver index increased(P<0.01);the contents of ALT,AST,HYP,HA,LN,PC-Ⅲ and ColⅣ were increased(P<0.01);the structure of liver lobules was disordered,with diffuse steatosis of liver cells,disordered arrangement of hepatic cords,infiltration of inflammatory cells,and significant fibrosis in the central and portal vein areas of liver lobules;the mRNA expressions of TGF-β1,Smad2 and Smad3 in liver tissue increased(P<0.05,P<0.01),and the protein expressions of ColⅠ,α-SMA,TGF-β1,Smad2,Smad3,p-Smad2 and p-Smad3 increased(P<0.05,P<0.01).Compared with the model group,the body mass of mice in silibinin group and each dosage of Kangxian Ruangan Granules increased(P<0.01),while the liver mass and liver index decreased(P<0.01);the contents of ALT,AST,HYP,HA,LN,PC-Ⅲ and ColⅣ in serum decreased(P<0.01);the hepatic steatosis in mice was reduced,the necrotic area was narrowed,the infiltration of inflammatory cells was reduced,the arrangement of hepatic cords tended to be regular,collagen deposition was reduced,and the structure of liver lobules was partially restored;the mRNA expressions of TGF-β1,Smad2 and Smad3 in liver tissue of silibinin group and Kangxian Ruangan Granules medium-dosage group decreased(P<0.05,P<0.01),while the protein expression of ColⅠ,α-SMA,TGF-β1,Smad2,Smad3,p-Smad2 and p-Smad3 decreased(P<0.05,P<0.01).Conclusion Kangxian Ruangan Granules can reduce the expressions of fibrosis related proteins,inhibit the deposition of extracellular matrix and improve liver fibrosis by inhibiting TGF-β1/Smad signaling pathway.

Objective To measure the Young's modulus values of the quadriceps muscles(rectus femoris,vastus intermedius,vastus lateralis,vastus medialis)and tendons in Parkinson's disease(PD)patients using real-time shear wave elastography(SWE)technology,and to analyze the changes in muscle and tendon tone.Methods A total of 60 clinically diagnosed PD patients from Yunnan University Affiliated Hospital between April 2023 and April 2024 were included in the study group.Based on the scores and ratings of PD rating scale,patients were divided into Group A(symptomatic side,n=60)and Group B(less symptomatic side,n=60).An additional 60 healthy subjects were selected as the control group.The shear wave elastography function of the ACUSON Sequoia ultrasound diagnostic device from Siemens USA was used to measure the Young's modulus values(kPa)of the quadriceps muscles and tendons in a relaxed state,and to analyze and compare the changes in muscle and tendon tone.Results The Young's modulus values of quadriceps muscles(rectus femoris,intermedius femoris,vastus lateralis,vastus medialis)in groups A and B were higher than those in control group(P<0.05).The Young's modulus values of the intermediate and lateral femoris muscles in group A were higher than that in group B(all P<0.05).The Young's modulus values of quadriceps tendon in groups A and B were higher than that in control group.(P<0.05).The Young modulus value of quadriceps tendon in group A was higher than that in group B(P<0.05).Conclusion Patients with Parkinson's disease exhibit increased muscle and tendon tone in the quadriceps.Notably,the muscle tone of the vastus intermedius and vastus lateralis on the symptomatic side is higher than that on the less symptomatic side,while there is no significant difference in muscle tone between the rectus femoris and vastus medialis on the symptomatic and less symptomatic sides.

Objective To study the mechanism of Kangxian Ruangan Granules in improving mouse liver fibrosis by regulating TGF-β1/Smad signaling pathway.Methods Eight out of 50 SPF grade male C57BL/6J mice were randomly selected as the normal group,and the remaining mice were intraperitoneally injected with 20%CCl4 olive oil solution(2 mL/kg,3 times a week for 4 weeks)to establish the liver fibrosis model.The successfully modeled mice were randomly divided into model group,silibinin group,and Kangxian Ruangan Granules low-,medium-and high-dosage groups using a random number table method,with 8 mice in each group.Each group of Kangxian Ruangan Granules was orally administered at dosages of 1.95,3.90 and 7.80 g/kg;the silibinin group was orally administered at a dosage of 100 mg/kg,while the normal group and model group were given equal volume of physiological saline by gavage,once a day for 8 weeks.The body mass and liver mass of mice were weighed and the liver index was calculated,the contents of serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),hydroxyproline(HYP),hyaluronic acid(HA),type Ⅲ procollagen(PC-Ⅲ),type Ⅳ collagen(ColⅣ)and laminin(LN)were detected by ELISA;liver tissue morphology was observed using HE,Masson and sirius red staining;immunohistochemistry,RT-qPCR and Western blot were used to detect the expressions of type Ⅰ collagen(ColⅠ),α-smooth muscle actin(α-SMA)and TGF-β1/Smad signaling pathway related factors in liver tissue.Results Compared with the normal group,the body mass of the model group mice decreased(P<0.01),while the liver mass and liver index increased(P<0.01);the contents of ALT,AST,HYP,HA,LN,PC-Ⅲ and ColⅣ were increased(P<0.01);the structure of liver lobules was disordered,with diffuse steatosis of liver cells,disordered arrangement of hepatic cords,infiltration of inflammatory cells,and significant fibrosis in the central and portal vein areas of liver lobules;the mRNA expressions of TGF-β1,Smad2 and Smad3 in liver tissue increased(P<0.05,P<0.01),and the protein expressions of ColⅠ,α-SMA,TGF-β1,Smad2,Smad3,p-Smad2 and p-Smad3 increased(P<0.05,P<0.01).Compared with the model group,the body mass of mice in silibinin group and each dosage of Kangxian Ruangan Granules increased(P<0.01),while the liver mass and liver index decreased(P<0.01);the contents of ALT,AST,HYP,HA,LN,PC-Ⅲ and ColⅣ in serum decreased(P<0.01);the hepatic steatosis in mice was reduced,the necrotic area was narrowed,the infiltration of inflammatory cells was reduced,the arrangement of hepatic cords tended to be regular,collagen deposition was reduced,and the structure of liver lobules was partially restored;the mRNA expressions of TGF-β1,Smad2 and Smad3 in liver tissue of silibinin group and Kangxian Ruangan Granules medium-dosage group decreased(P<0.05,P<0.01),while the protein expression of ColⅠ,α-SMA,TGF-β1,Smad2,Smad3,p-Smad2 and p-Smad3 decreased(P<0.05,P<0.01).Conclusion Kangxian Ruangan Granules can reduce the expressions of fibrosis related proteins,inhibit the deposition of extracellular matrix and improve liver fibrosis by inhibiting TGF-β1/Smad signaling pathway.

Objective:To discuss the regulatory effect of berberine(BBR)on fatty acids in the human glioma T98G cells and its effect on the cell proliferation,migration,and invasion,and to clarify its potential mechanism.Methods:The T98G cells at logarithmic growth phase were divided into control group and different concentrations(25,50,and 100 mg·L-1)of BBR groups.Cell wound healing assay was used to detect the migration rates of the cells in various groups;Transwell chamber assay was used to detect the invasion rates of the cells in various groups.The T98G cells at logarithmic growth phase were divided into control group and 100 mg·L-1 BBR group,and Mass spectrometry was used to detect the fatty acid contents in the cells in two groups.The T98G cells at logarithmic growth phase were divided into control group and different concentrations(50,100,and 150 mg·L-1)of BBR groups;Western blotting method was used to detect the expression levels of phosphatidylinositol 3-kinase(PI3K),phosphorylated PI3K(p-PI3K),protein kinase B(AKT),phosphorylated AKT(p-AKT),sterol regulatory element-binding protein 1(SREBP-1),and fatty acid synthase(FASN)in the cells in various groups.The expression of FASN was suppressed by gene silencing technology,and the T98G cells at logarithmic growth phase were divided into control group,shFASN1 group,and shFASN2 group.Western blotting method was used to detect the expression levels of FASN protein in the cells in various groups;clone formation assay was used to detect the clone formation of the cells in various groups;cell wound healing assay was used to detect the migration rates of the cells in various groups.Results:Compared with control group,the migration rates and invasion rates of the cells in different concentrations of BBR groups were decreased in a concentration-dependent manner(P<0.01),and the fatty acid content in the cells in 100 mg·L-1 BBR group was significantly decreased(P<0.01).Compared with control group,the expression levels of p-PI3K,p-AKT,SREBP-1,and FASN proteins in the cells in 150 mg·L-1 BBR group were significantly decreased(P<0.05 or P<0.01),and the expression level of SREBP-1 protein in the cells in 100 and 150 mg·L-1 BBR groups were significantly decreased(P<0.01).After suppression of FASN expression,compared with control group,the expression levels of FASN protein in the cells in shFASN1 and shFASN2 groups were significantly decreased(P<0.01),and the expression level of FASN protein in the cells in shFASN2 group was lower than that in shFASN1 group(P<0.05);compared with control group,the numbers of clone formation and migration rates of the cells in shFASN1 and shFASN2 groups were significantly decreased(P<0.01),and the migration rate of the cells in shFASN2 group was significantly lower than that in shFASN1 group(P<0.05).Conclusion:BBR interferes with fatty acid synthesis in the glioma T98G cells by reducing the expression of the PI3K/AKT/SREBP-1/FASN pathway related proteins,and decrease their migration and invasion capabilities.

Objective:To assess a value of dual energy index(DEI)and effective atomic number(Zeff)of dual-energy computed tomography(DECT)combined with slope of energy spectrum curve in identifying the component of urinary tract stones.Methods:The clinical and DECT imaging data of 111 patients with urinary tract stones who admitted to Nantong Haimen People's Hospital from October 2019 to October 2022 were selected,and the diameters of the urinary tract stones of all patients were<5 mm.The components of outside body stones of all patients were analyzed by infrared spectrum.The accuracy,sensitivity and specificity of the DEI,Zeff,slope of energy spectrum curve and the combination of the them were respectively calculated in identifying the components of urinary tract stones.Results:In 111 patients,the patients with calcium oxalate stones were 75(67.57%),and ones with hydroxyapatite were 15 cases(13.51%),and ones with uric acid stones were 21 cases(18.92%),and there were no other type of stone included cysteine.The differences of CT values(F=487.691,P<0.001),DEI values(F=395.553,P<0.001),Zeff values(F=818.689,P<0.001)and the slopes of energy spectrum curves(H=19.615,P<0.001)were statistically significant among the three types of stones.The overall accuracies of DEI,Zeff and slope of energy spectrum curve were 87.39%(97/111),84.68%%(94/111)and 81.98%(91/111)in identifying the components of urinary tract stone.The range of diagnostic accuracies of DEI,Zeff and the slope of energy spectrum curve was between 80%and 100%for calcium oxalate stones,hydroxyapatite and uric acid stones.The overall accuracy of DEI,Zeff combined with slope of energy spectrum curve was 94.59%(105/111)in identifying the components of urinary tract stones.The diagnostic accuracies of DEI,Zeff combined with slope of energy spectrum curve were respectively 94.59%,94.59 and 100%for calcium oxalate stones,hydroxyapatite and uric acid stones.Conclusion:Compared with the single indicator of DECT,the DEI and Zeff combined with the slope of the energy spectrum curve showed better diagnostic accuracy in identifying the components urinary track stones.

Polygala tenuifolia,commonly known as Yuanzhi(YZ)in Chinese,has been shown to possess anti-insomnia properties.However,the material basis and the mechanism underlying its sedative-hypnotic effects remain unclear.Herein,we investigated the active components and neurochemical mechanism of YZ extracts using liquid chromatography tandem mass spectrometry(LC-MS/MS)-based pharmaco-metabolomics and mass spectrometry imaging(MSI)-based spatial resolved metabolomics.According to the results,17 prototypes out of 101 ingredients in the YZ extract were detected in both the plasma and brain,which might be the major components contributing to the sedative-hypnotic effects.Network pharmacology analysis revealed that these prototypes may exert their effects through neuroactive ligand-receptor interaction,serotonergic synapse,dopaminergic synapse,and dopaminergic synapse,among other pathways.LC-MS/MS-based targeted metabolomics and Western blot(WB)revealed that tryptophan-serotonin-melatonin(Trp-5-HT-Mel)and tyrosine-norepinephrine-adrenaline(Tyr-Ne-Ad)are the key regulated pathways.Dopa decarboxylase(DDC)upregulation and phenylethanolamine N-methyltransferase(PNMT)downregulation further confirmed these pathways.Furthermore,MSI-based spatially resolved metabolomics revealed notable alterations in 5-HT in the pineal gland(PG),and Ad in the brainstem,including the middle brain(MB),pons(PN),and hypothalamus(HY).In summary,this study illustrates the efficacy of an integrated multidimensional metabolomics approach in unraveling the sedative-hypnotic effects and neurochemical mechanisms of a Chinese herbal medicine,YZ.

Objective: To determine the optimal dose of dexmedetomidine required to prevent nausea and vomiting when used for postoperative analgesia after gynecological laparoscopic surgery. Methods: A total of 135 patients, aged 18-60 yr, weighing 52-80 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective gynecological laparoscopic surgery, were divided into 3 groups (n=45 each) using a random number table method: control group (group C), dexmedetomidine 1 μg/kg group (group D₁) and dexmedetomidine 2 μg/kg group (group D₂). Immediately after anesthesia induction, dexmedetomidine 0.4 μg·kg^-1·h^-1 was injected intravenously until 30 min before the end of surgery in all the patients.When the patient was fully awake at the end of surgery, the tracheal tube was removed, and patients were sent to postanesthesia care unit and received patient-controlled intravenous analgesia (PCIA). The PCIA solution contained sufentanil 1.2 μg/kg and dezocine 20 mg in 100 ml of 0.9% normal saline.The PCIA pump was set up with a 0.5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 2 ml/h.Dexmedetomidine 1 and 2 μg/kg were added to PCIA solution in group D₁ and group D₂, respectively.The occurrence of nausea and vomiting was recorded in postanesthesia care unit stay period (P₁) and in 0-12 h (P₂), 12-24 h (P₃), 24-36 h (P₄) and 36-48 h (P₅) periods after patients returned to the ward.Ramsay sedation score was recorded at 12, 24, 36 and 48 h after patients returned to the ward.When visual analogue scale score >3, patients were told to press PCIA.Patients were followed up for 48 h after surgery, and patients′ satisfaction, pressing times of PCIA and occurrence of pruritus, respiratory depression, bradycardia and dizziness were recorded. Results: Compared with group C, the incidence of nausea was significantly decreased in P₂ period, and the pressing times of PCIA were reduced in P_{2, 3} period in D₁ and D₂ groups (P<0.05). There was no significant difference in Ramsay sedation score at each time point, patients′ satisfaction and incidence of bradycardia among the three groups (P>0.05). No patients developed pruritus, respiratory depression or dizziness in the three groups. Conclusion The optimal dose of dexmedetomidine required to prevent nausea and vomiting is 1 μg/kg when used for postoperative analgesia after gynecological laparoscopic surgery.