BACKGROUND:Human periodontal ligament stem cells are potential functional cells for periodontal tissue engineering.However,long-term in vitro culture may lead to reduced stemness and replicative senescence of periodontal ligament stem cells,which may impair the therapeutic effect of human periodontal ligament stem cells. OBJECTIVE:To investigate the effect of oxymatrine on the stemness maintenance and osteogenic differentiation of periodontal ligament stem cells in vitro,and to explore the potential mechanism. METHODS:Periodontal ligament stem cells were isolated from human periodontal ligament tissues by tissue explant enzyme digestion and cultured.The surface markers of mesenchymal cells were identified by flow cytometry.Periodontal ligament stem cells were incubated with 0,2.5,5,and 10 μg/mL oxymatrine.The effect of oxymatrine on the proliferation activity of periodontal ligament stem cells was detected by CCK8 assay.The appropriate drug concentration for subsequent experiments was screened.Western blot assay was used to detect the expression of stem cell non-specific proteins SOX2 and OCT4 in periodontal ligament stem cells.qRT-PCR and western blot assay were used to detect the expression levels of related osteogenic genes and proteins in periodontal ligament stem cells. RESULTS AND CONCLUSION:(1)The results of CCK8 assay showed that 2.5 μg/mL oxymatrine significantly enhanced the proliferative activity of periodontal stem cells,and the subsequent experiment selected 2.5 μg/mL oxymatrine to intervene.(2)Compared with the blank control group,the protein expression level of SOX2,a stem marker of periodontal ligament stem cells in the oxymatrine group did not change significantly(P>0.05),and the expression of OCT4 was significantly up-regulated(P<0.05).(3)Compared with the osteogenic induction group,the osteogenic genes ALP,RUNX2 mRNA expression and their osteogenic associated protein ALP protein expression of periodontal ligament stem cells were significantly down-regulated in the oxymatrine+osteogenic induction group(P<0.05).(4)The oxymatrine up-regulated the expression of stemness markers of periodontal ligament stem cells and inhibited the bone differentiation of periodontal ligament stem cells,and the results of high-throughput sequencing showed that it may be associated with WNT2,WNT16,COMP,and BMP6.

Objective To investigate the protective effects of Wuling capsule on mice with autoimmune hepatitis(AIH).Methods Mice were randomly divided into control group,AIH model group,Wuling capsule low-dose group(0.5 g·kg-1·d-1),Wuling capsule middle-dose group(1.0 g·kg-1·d-1),and Wuling capsule high-dose group(2.0 g·kg-1·d-1),with 10 mice in each group.The Wuling capsule groups were administered with Wuling capsule suspension of different doses orally at a volume of 10 mL/kg once daily;the control group and AIH model group were given the same volume of saline by gavage.After 14 d of administration,mice in the AIH model group and Wuling capsule groups were injected with concanavalin A(20 mg/kg)via the tail vein,and the serum,liver,and spleen were collected 8 h after injection.Serum alanine transaminase(ALT)and aspartate transaminase(AST)levels were measured using an automatic biochemical analyzer;hematoxylin-eosin staining was used to observe the pathological structure of the liver tissue;the contents of interleukin(IL)-6,IL-4,and tumor necrosis factor(TNF)-α in liver were determined by enzyme-linked immunosorbent assay,and quantitative polymerase chain reaction was used to determine the relative mRNA expression levels of IL-6,IL-4,TNF-α,Toll-like receptor 4(TLR4),and nuclear factor κB(NF-κB)in the liver.Fluorescence immunoassay was used to analyze the expression and nuclear translocation of NF-κB p65 protein in the liver.Results Compared with the control group,the AIH model group showed abnormal liver morphology and structure,increased serum ALT and AST levels,increased contents of IL-4,IL-6,and TNF-α in the liver,upregulated mRNA expression levels of IL-6,IL-4,TNF-α,TLR4,and NF-κB in the liver,and increased nuclear entry of NF-κB p65.Wuling capsule significantly improved the pathological structure of the liver in AIH mice,reduced serum ALT and AST levels,decreased the contents of IL-4,IL-6,and TNF-α in the liver and the mRNA expression levels of TLR4,NF-κB,IL-4,IL-6,and inhibited the nuclear activation of NF-κB p65.Conclusion Wuling capsule has significant protective effects on AIH mice,which may be related to the TLR4/NF-κB signaling pathway.

Background As global environmental pollutants, chronic low-dose exposure to microplastics (MPs) is increasingly recognized for its potential risks to the nervous system. However, the molecular mechanisms linking MPs to major depressive disorder (MDD) remain unclear. Objective To investigate the mechanistic link between chronic environmentally relevant-dose MPs exposure and MDD using bioinformatics, machine learning, and molecular docking approaches, and to identify key targets and evaluate their diagnostic value. Methods Potential MPs-related targets were retrieved from the Comparative Toxicogenomics Database (CTD). Differentially expressed genes in MDD were identified using the GSE98793 dataset (128 patients and 64 healthy controls, aged 18-75 years) from the Gene Expression Omnibus (GEO). MDD-related targets were integrated from multiple databases and intersected with MPs-related genes to identify common targets. A protein-protein interaction network was constructed using the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING), and hub genes were identified via six algorithms in CytoHubba. Immune infiltration analysis was performed using single-sample gene set enrichment analysis (ssGSEA) with the Bindea signature to evaluate 19 immune cell types. A competitive endogenous RNA (ceRNA) network was constructed using multiple databases. Molecular docking was performed using AutoDock Vina to evaluate binding affinities between MPs monomers and hub gene-encoded proteins. A diagnostic model was developed and validated using the GSE76826 late-onset MDD cohort (94 patients and 47 controls, age ≥50 years). Least absolute shrinkage and selection operator (Lasso) regression was applied to identify core genes, followed by single-gene gene set enrichment analysis (SG-GSEA). Results A total of 52 common MPs-MDD targets were identified. Six key genes, namely interleukin-1β (IL1B), tumor necrosis factor (TNF), interleukin 6 (IL6), peroxisome proliferator-activated receptor gamma (PPARG), catenin beta 1 (CTNNB1), and chemokine ligand 2 (CCL2), were identified and found to be enriched in neuroinflammatory responses, lipid metabolism disorders, and the Wnt/β-catenin signaling pathway. Construction of the ceRNA network revealed that 32 microRNAs (miRNAs) and 27 circular RNAs (circRNAs) had regulatory relationships with these key genes. The immune infiltration analysis showed increased peripheral eosinophils and decreased Th17 cells in MDD patients (P < 0.05). The results of molecular docking demonstrated stable binding between bisphenol A (BPA) and PPARG (ΔG=–5.82 kcal·mol⁻¹), and between styrene and IL6 (ΔG=–5.61 kcal·mol⁻¹). The diagnostic model showed excellent performance for PPARG in late-onset MDD (AUC=0.942, 95%CI: 0.899, 1.000), with a combined model AUC of 0.954 (95%CI: 0.862, 1.000). The Lasso regression model further identified CCL2 and PPARG as core regulatory genes of MPs-MDD. The SG-GSEA indicated that CCL2 was associated with immune-inflammatory pathways and mitochondrial dysfunction, while PPARG was linked to neuroplasticity and proteostasis. Conclusion Chronic low-dose MPs exposure may contribute to MDD pathogenesis through a multidimensional "immune-metabolic-neural" regulatory network. CCL2 and PPARG may serve as potential biomarkers for environmentally associated MDD, providing new molecular insights into the link between environmental pollution and neuropsychiatric disorders.

Objective To compare the screening efficacy of the Water Swallow Test and the Standard-ized Swallowing Assessment for identifying swallowing disorder risk in elderly inpatients,providing reference for selecting appropriate clinical screening tools.Methods Using convenience sampling,240 elderly inpatients admitted from March to November 2023 were enrolled.Swallowing function was evaluated using the Water Swallow Test,Standardized Swallowing Assessment,and the Eating Assessment Tool.With the Eating As-sessment Tool as the diagnostic standard,Bayes discriminant analysis and receiver operating characteristic(ROC)curves were employed to compare the screening capabilities of the Water Swallow Test and Standard-ized Swallowing Assessment for swallowing disorder risk in elderly hospitalized patients.Results A total of 240 questionnaires were distributed,and 226 valid questionnaires were recovered,with an effective recovery rate of 94.17%.The incidence of swallowing disorders in elderly patients was screened using Water Swallow Test,Standardized Swallowing Assessment,and The Eating Assessment Tool,with rates of 6.2%,31.0%,and 14.2%,respectively;The Kappa values for consistency between Water Swallow Test and The Eating As-sessment Tool,and between Standardized Swallowing Assessment and The Eating Assessment Tool were 0.381 and 0.392,respectively(both P<0.01);The areas under the ROC curves for Water Swallow Test and Standardized Swallowing Assessment were 0.839(95%CI:0.784 to 0.884)and 0.821(95%CI:0.765 to 0.869),respectively,with no statistically significant difference(Z=0.326,P=0.744);The cross validation accuracy of risk prediction for swallowing disorders was 88.5%and 77.9%,respectively;The cutoff values were 1.5 grades and 18.5 points,respectively;The sensitivity was 0.875 and 0.813,the specificity was 0.737 and 0.773,and the Youden index was 0.612 and 0.586,respectively.Conclusion Water Swallow Test and Standardized Swallowing Assessment have average ability to screen for the risk of swallowing disorders in eld-erly patients;Water Swallow Test has higher predictive efficiency for the risk of swallowing disorders,making it more suitable for screening the risk of swallowing disorders in elderly patients.

Perimenopausal anxiety and depression state fall under the categories of"visceral agitation"and"perimenopausal syndrome"in traditional Chinese medicine(TCM).Grounded in the theory of"Yang transforms qi,yin shapes form",this study posits that the pathogenesis of this condition is complex,often presenting with concurrent deficiency and excess syndromes,and is closely associated with yang deficiency-induced stagnation and qi stagnation leading to mental decline.The pathological mechanism is summarized as yang deficiency being the root and qi stagnation the manifestation.This article proposes a"yang-oriented treatment"approach for perimenopausal anxiety-depression disorders,employing a stepwise integrated acupuncture protocol termed"One Needling,Two Moxibustion,Three Consolidation":"One Needling"prioritizes regulating qi flow via acupuncture to soothe the liver and harmonize the spirit;"Two Moxibustion"utilizes refined moxibustion to warm yang,resolve stagnation,and activate yang circulation;"Three Consolidation"combines bloodletting therapy to remove stasis and regenerate tissues with intradermal needle embedding to stimulate yang and regulate visceral functions.This synergistic protocol aims to nourish the heart-mind,awaken the orifices of consciousness,alleviate perimenopausal anxiety and depressive symptoms,and consolidate therapeutic efficacy.

Perimenopausal women are more susceptible to fire pathogen disturbances,often resulting in the restlessness of the mind owing to the deficiency and decline of the thoroughfare and conception vessels,as well as the insufficiency of the essence and blood of the viscera.CHENG Zhongling's theory of thief and child fire in Medical Insights proposes that thief fire primarily arises from exogenous pathogen invasion and improper diet,leading to syndromes such as food retention in the stomach or phlegm-fire stagnation.In contrast,child fire is generated endogenously,often owing to liver and kidney deficiency,resulting in an imbalance of water and fire and liver dysfunction,leading to excessive fire transformation.This theory provides a novel perspective for understanding the pathogenesis of perimenopausal insomnia.An in-depth exploration of the role of thief fire and child fire in perimenopausal insomnia is presented,along with a detailed discussion of corresponding treatment strategies.For the invasion of thief fire,therapeutic approaches include ascending and dispersing stagnant fire,clearing and moistening to remove interior heat,purging the heat accumulation to unblock the bowels,and subduing the fire and nourishing yin to eliminate depression.When child fire disturbs the spirit,treatment methods involve smoothing and relieving the liver qi to clear the stagnant heat,nourishing the true yin to restrain the yang,warming and nurturing the primordial qi and harmonizing the nutrient and defensive qi,and guiding and reducing the deficient heat to remove the floating fire.Clinical practice necessitates precise identification of thief and child fire,thorough investigation of exogenous pathogens and internal damage,and careful differentiation between deficiency and excess,as well as the superficial and internal aspects.Strict adherence to the treatment principle of"nourishing the child fire can drive out the thief fire,but driving out the thief fire should not harm the child fire"ensures a balanced approach.By harmonizing the yin and yang of the viscera and allowing the mind to be at ease,this strategy effectively alleviates perimenopausal insomnia.The application of these principles provides a practical and feasible theoretical foundation and practical guidance for the treatment of perimenopausal insomnia using traditional Chinese medicine.

Objective To explore the causal relationship between use of analgesic drugs and incidence of Clostridium difficile enteritis(CDE).Methods Univariate and multivariate Mendelian randomization(MR)methods were employed to investigate the potential causal relationship between use of analgesic drugs and incidence of CDE,using inverse variance weighted as the primary analytical approach.Results Univariate MR analysis indicated that use of nonsteroidal anti-inflammatory drug(NSAID)(OR=2.680,95％CI:1.689-4.252,P＜0.001)and aniline derivatives(OR=2.521,95％CI:1.503-4.229,P＜0.001)increased the risk of CDE,whereas use of opioids(OR=0.955,95％CI:0.818-1.114,P=0.556)and salicylates(OR=1.081,95％CI:0.820-1.425,P=0.579)were not identified as risk factors for CDE.The MR-Steiger test did not suggest the presence of reverse causality between exposure and outcome.After adjustment in the multivariate MR analysis,the use of NSAID was no longer a risk factor for CDE(OR=1.709,95％CI:0.864-3.308,P=0.123),while use of aniline derivatives remained a risk factor(OR=2.147,95％CI:1.239-3.721,P=0.003).Sensitivity analyses showed no evidence of heterogeneity,horizontal pleiotropy,or outliers,and no single nucleotide polymorphisms independently influenced the results.Conclusion The use of opioids does not increase the risk of CDE infection.The causal relationship between NSAID use and CDE remains inconclusive.However,the use of aniline derivatives within the NSAID class is a risk factor for CDE,while use of salicylates is not a risk factor for CDE.

Objective To explore the causal relationship between use of analgesic drugs and incidence of Clostridium difficile enteritis(CDE).Methods Univariate and multivariate Mendelian randomization(MR)methods were employed to investigate the potential causal relationship between use of analgesic drugs and incidence of CDE,using inverse variance weighted as the primary analytical approach.Results Univariate MR analysis indicated that use of nonsteroidal anti-inflammatory drug(NSAID)(OR=2.680,95％CI:1.689-4.252,P＜0.001)and aniline derivatives(OR=2.521,95％CI:1.503-4.229,P＜0.001)increased the risk of CDE,whereas use of opioids(OR=0.955,95％CI:0.818-1.114,P=0.556)and salicylates(OR=1.081,95％CI:0.820-1.425,P=0.579)were not identified as risk factors for CDE.The MR-Steiger test did not suggest the presence of reverse causality between exposure and outcome.After adjustment in the multivariate MR analysis,the use of NSAID was no longer a risk factor for CDE(OR=1.709,95％CI:0.864-3.308,P=0.123),while use of aniline derivatives remained a risk factor(OR=2.147,95％CI:1.239-3.721,P=0.003).Sensitivity analyses showed no evidence of heterogeneity,horizontal pleiotropy,or outliers,and no single nucleotide polymorphisms independently influenced the results.Conclusion The use of opioids does not increase the risk of CDE infection.The causal relationship between NSAID use and CDE remains inconclusive.However,the use of aniline derivatives within the NSAID class is a risk factor for CDE,while use of salicylates is not a risk factor for CDE.

Perimenopausal women are more susceptible to fire pathogen disturbances,often resulting in the restlessness of the mind owing to the deficiency and decline of the thoroughfare and conception vessels,as well as the insufficiency of the essence and blood of the viscera.CHENG Zhongling's theory of thief and child fire in Medical Insights proposes that thief fire primarily arises from exogenous pathogen invasion and improper diet,leading to syndromes such as food retention in the stomach or phlegm-fire stagnation.In contrast,child fire is generated endogenously,often owing to liver and kidney deficiency,resulting in an imbalance of water and fire and liver dysfunction,leading to excessive fire transformation.This theory provides a novel perspective for understanding the pathogenesis of perimenopausal insomnia.An in-depth exploration of the role of thief fire and child fire in perimenopausal insomnia is presented,along with a detailed discussion of corresponding treatment strategies.For the invasion of thief fire,therapeutic approaches include ascending and dispersing stagnant fire,clearing and moistening to remove interior heat,purging the heat accumulation to unblock the bowels,and subduing the fire and nourishing yin to eliminate depression.When child fire disturbs the spirit,treatment methods involve smoothing and relieving the liver qi to clear the stagnant heat,nourishing the true yin to restrain the yang,warming and nurturing the primordial qi and harmonizing the nutrient and defensive qi,and guiding and reducing the deficient heat to remove the floating fire.Clinical practice necessitates precise identification of thief and child fire,thorough investigation of exogenous pathogens and internal damage,and careful differentiation between deficiency and excess,as well as the superficial and internal aspects.Strict adherence to the treatment principle of"nourishing the child fire can drive out the thief fire,but driving out the thief fire should not harm the child fire"ensures a balanced approach.By harmonizing the yin and yang of the viscera and allowing the mind to be at ease,this strategy effectively alleviates perimenopausal insomnia.The application of these principles provides a practical and feasible theoretical foundation and practical guidance for the treatment of perimenopausal insomnia using traditional Chinese medicine.

Objective:To establish a rapid quantitative PCR (qPCR) technique for Mycobacterium marinum skin infections, and to analyze its clinical diagnostic efficiency. Methods:DNA was extracted from Mycobacterium marinum colonies and serially diluted (10 -1 to 10 -8). Twelve pairs of previously reported primers and probes, as well as 6 pairs of newly designed primers and probes in this study, were used for qPCR amplification to identify the most sensitive primers and probes for the detection of Mycobacterium marinum. Skin lesion tissues were collected from 72 patients with confirmed Mycobacterium marinum infections (experimental group) and 68 with other mycobacterial infections (control group) at Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences in 2021. These skin tissues were subjected to qPCR amplification, interferon-gamma release assay (IGRA), acid-fast staining, and tissue culture to evaluate the diagnostic efficacy. Results:The newly designed primers and probes targeting the mycobacterial enhanced infection locus 2 (Mel2) demonstrated the highest sensitivity, with a detection limit of 0.86 copies/μl (cycle threshold value = 37) ; the qPCR amplification with the Mel2 primers/probes did not yield positive results when used for the detection of other mycobacteria (including Mycobacterium leprae and Staphylococcus spp) . Among the 72 patients in the experimental group, 44 were positive for qPCR with a sensitivity of 61.1% (95% CI: 49.6% - 71.5%), and 47 were positive for culture with a sensitivity of 65.2% (95% CI: 53.8% - 75.3%) ; all the 68 controls were negative for both qPCR and culture, with their specificities both being 100%. Among 65 patients subjected to IGRA, 31 were positive with a sensitivity of 47.7% (95% CI: 36.0% - 59.6%), while 16 out of 25 controls were negative for IGRA with a specificity of 64.0% (95% CI: 44.5% - 79.8%). Among 58 patients subjected to acid-fast staining, 37 were positive with a sensitivity of 63.8% (95% CI: 50.9% - 74.9%), and 52 out of 66 controls were negative for acid-fast staining with a specificity of 78.8% (95% CI: 67.5% - 86.9%). The combination of qPCR and culture resulted in a sensitivity of 93% and a specificity of 100% for the detection of Mycobacterium marinum. Conclusion:In this study, a highly sensitive qPCR assay was developed for the detection of Mycobacterium marinum, and its combination with culture could further improve the detection sensitivity.