Objective:To evaluate the incidence, clinical features, factors affecting initial diagnosis, efficacy, and safety of therapy and prognosis of small intestinal Dieulafoy lesions (DL).Methods:Clinical data including clinical background, diagnosis, and treatment details of patients who were admitted to the Department of Gastroenterology, Air Force Medical Center, for suspected small bowel bleeding, diagnosed as having small bowel DL and treated with balloon-assisted enteroscopy (BAE) were retrospectively analyzed from November 2017 to March 2024.Results:Among 800 patients, 30 cases (3.75%, 30/800, 17 males and 13 females) were diagnosed as having small intestine DL with the mean age of 60.90 years. Clinical symptoms included melena (56.67%, 17/30), hematochezia (43.33%, 13/30), and hemodynamic instability (30.00%, 9/30). Active bleeding occurred in 23 (76.67%) patients. Comorbidities existed in 70.00% (21/30) and 33.33% (10/30) used long-term antithrombotic agents. Diagnosis was confirmed after a single BAE in 63.33% (19/30) and after multiple BAEs (mean 1.6 procedures) in 36.67% (11/30). Lesions were predominantly located at jejunal. All patients achieved successful treatment with a single BAE procedure. The median follow-up period was 12.25 months (range: 5.25-23.00 months). Five cases (16.67%) experienced recurrent bleeding, with one case transfered to surgical intervention. Two cases (6.67%) reported post-operative symptoms of dizziness and fatigue, which resolved after symptomatic management. Multivariate analysis showed that long-term oral anticoagulant therapy ( OR=0.06, 95% CI: 0.01-0.73) was an independent predictor of single-session diagnosis. Conclusion:Small intestinal DL is rare and challenging to diagnose. Antithrombotic therapy may facilitate the diagnosis of DL at the first BAE. Jejunal localization is common, and combined endoscopic therapy (including clipping) is effective and safe.

Objective To conduct a bibliometric analysis of domestic and international literature on the research of Sijunzi Decoction over the past 20 years,and to explore the research status,hotspots,and development trends of Sijunzi Decoction.Methods This article retrieved journal articles related to the research of Sijunzi Decoction from 2004 to 2024 in the CNKI,Wanfang,VIP,and Web of Science databases.Microsoft Excel was used for publication volume analysis,while CiteSpace software was employed for keyword co-occurrence,clustering,and burst analysis,and then the analysis results were visualized.Results After literature retrieval and screening,3 573 Chinese articles and 113 English articles were included.Over the past two decades,the publication volume showed a trend of steadily increasing.The most frequent keywords in Chinese and English literature on the research of Sijunzi Decoction were spleen deficiency syndrome and gene expression,while the keywords with strongest burst were experimental research and data mining.Conclusion The research of Sijunzi Decoction in the last 20 years was mainly through animal experiments and clinical applications,and the research hotspots focus on the treatment of diseases of spleen deficiency syndrome and on the improvement of immune function of cancer patients.The extraction and identification of active components in Sijunzi Decoction and the study on the therapeutic mechanism in diseases of spleen deficiency syndrome are probably the future research trends.

Objective:To evaluate the incidence, clinical features, factors affecting initial diagnosis, efficacy, and safety of therapy and prognosis of small intestinal Dieulafoy lesions (DL).Methods:Clinical data including clinical background, diagnosis, and treatment details of patients who were admitted to the Department of Gastroenterology, Air Force Medical Center, for suspected small bowel bleeding, diagnosed as having small bowel DL and treated with balloon-assisted enteroscopy (BAE) were retrospectively analyzed from November 2017 to March 2024.Results:Among 800 patients, 30 cases (3.75%, 30/800, 17 males and 13 females) were diagnosed as having small intestine DL with the mean age of 60.90 years. Clinical symptoms included melena (56.67%, 17/30), hematochezia (43.33%, 13/30), and hemodynamic instability (30.00%, 9/30). Active bleeding occurred in 23 (76.67%) patients. Comorbidities existed in 70.00% (21/30) and 33.33% (10/30) used long-term antithrombotic agents. Diagnosis was confirmed after a single BAE in 63.33% (19/30) and after multiple BAEs (mean 1.6 procedures) in 36.67% (11/30). Lesions were predominantly located at jejunal. All patients achieved successful treatment with a single BAE procedure. The median follow-up period was 12.25 months (range: 5.25-23.00 months). Five cases (16.67%) experienced recurrent bleeding, with one case transfered to surgical intervention. Two cases (6.67%) reported post-operative symptoms of dizziness and fatigue, which resolved after symptomatic management. Multivariate analysis showed that long-term oral anticoagulant therapy ( OR=0.06, 95% CI: 0.01-0.73) was an independent predictor of single-session diagnosis. Conclusion:Small intestinal DL is rare and challenging to diagnose. Antithrombotic therapy may facilitate the diagnosis of DL at the first BAE. Jejunal localization is common, and combined endoscopic therapy (including clipping) is effective and safe.

Nod-like receptor protein 3 (NLRP3) inflammasome, which is an important component of the innate immune system, can recognize a variety of pathogens and cell damage, induce the secretion of IL-1β and IL-18, and regulate imflammatory response.More and more studies in recent years have shown that Ca2+ signaling plays an important role in NLRP3 inflammasome activation induced by various NLRP3 inflammasome agonists, and is closely related to the occurrence of related diseases.The article reviews the literatures on Ca2+ and NLRP3 inflammasome, focusing on the potential role of Ca2+ signaling in the activation and regulation of NLRP3 inflammasome, to provide new ideas for the treatment of illness caused by NLRP3 inflammasome.

Caspases are a group of structurally related cysteine proteases present in cytosol. One of their important common points is that the active sites contain cysteine and can specifically break the peptide bonds after the aspartic acid residues. Caspases are broadly divided into two groups based on their functions, including inflammatory Caspases and apoptotic Caspases. Inflammatory Caspases include Caspase-1, Caspase-4, Caspase-5, Caspase-11 and Caspase-12, which play important roles in the process of innate immune defense. Unlike inflammatory Caspases, apoptotic Caspases(2/3/6/7/8/910)initiate and execute an immunologically silent form of programmed cell death known as apoptosis. However, ongoing investigations have uncovered essential functions of Caspase-8 in the regulation of immunity in cells and organisms. Accumulated studies have shown that Caspases play important roles in the occurrence and development of various immunity-related diseases. In order to comprehensively elucidate the relationship between Caspases and innate immunity, and to provide some scientific basis and theoretical reference for the treatment of various diseases, this article reviews the regulation of activity and inflammation mechanism of innate immunity-related Caspase-1/4/5/11/8/12.

Objective:To observe the effects of Shen Hong Bu Xue Granule(SHBXG) on the expression levels of erythropoietin(EPO)mRNA in kidney tissue and granulocyte-macrophage colony-stimulating factor (GM-CSF) mRNA in bone marrow tissue of the mice with blood deficiency,and to investigate the protective effect of SHBXG on the blood deficiency mice and its mechanism.Methods:The mouse model of blood deficiency was established with acetylphenylhydrazine(APH) and cytoxan(CTX).A total of 60 mice were divided into blank control group,model group,Compound E-jiao Slurry group and low,middle,high doses of SHBXG groups(n=10).The serum,kidney and bone marrow tissues from all the mice were collected after 14 d consecutive administration.The levels of red blood cells(RBC),hemoglobin level(HGB),hematocrit(HCT),leukocytes(WBC),and platelet(PLT) in blood of the mice were detected by automatic blood analyzer;the levels of serum EPO and GM-CSF of the mice in various groups mice were detected by ELISA method;the expression levels of EPO mRNA in kidney tissue and GM-CSF mRNA in bone marrow tissue of the mice were detected by RT-PCR method.Results:The results of automatic blood analyzer showed that the levels of RBC,HGB,HCT,and PLT of the mice in Compound E-jiao Slurry group and different doses of SHBXG groups were increased significantly compared with model group (P<0.05 or P<0.01);the levels of WBC of mice in Compound E-jiao Slurry group and high dose of SHBXG group were increased significantly compared with model group(P<0.05).The ELISA results showed that the levels of serum EPO and GM-CSF of the mice in Compound E-jiao Slurry group and different doses of SHBXG groups were increased significantly compared with model group(P<0.05).The PC-PCR results showed that the expression levels of EPO mRNA in kidney tissue and GM-CSF mRNA in bone marrow tissue of the mice in Compound E-jiao Slurry group and middle and high doses of SHBXG groups were increased significantly compared with model group(P<0.05 or P<0.01).Conclusion:SHBXG could improve the blood deficiency symptom in the mice with blood deficiency,and its mechanism may be related to increasing the expression levels of EPO mRNA in kidney tissue and GM-CSF mRNA in bone marrow tissue of the mice.

To observe the effects of emodin ( Emo) on acute fatty liver in mice induced by DL-ethionine ( DL-Eth) or tetracyclin ( Tetra) and its potential mechanism, ICR mice of acute fatty liver model induced by DL-Eth were orally administered with Emo or positive control, ursodeoxycholic acid ( UDCA) for 7 days. On day 7, except that the control and Emo groups were treated with vehicle control, animals were orally administered with DL-Eth to induce acute fatty liver model. ICR mice of acute fatty liver model induced by Tetra were orally administered with Emo or positive control, Dong Bao Gan Tai ( DB) or total flavonoid C-glycosides from Abrus mollis extract ( AME) for 7 days. From day 4, except that the control group was treated with vehicle control, animals were injec-ted with Tetra intraperitoneally for 4 days to induce acute fatty liver model. Liver histopathological analyses were determined by HE staining. Serum aspartate transaminase ( AST) , alanine transaminase ( ALT) , serum triglyceride ( TG) , hepatic TG and hepatic total cholesteol ( TC) were detected. The expression of phosphorylated AMP-activa-ted kinase ( p-AMPK) , phosphorylated acetyl-CoA carboxylase ( p-ACC) , SREBP1 and fatty acid synthase ( FAS) were determined by Western blot. The expression of fatty acid translocase ( CD36 ) , peroxisome proliferator activa-ted receptor alpha ( PPARα) and microsomal triglyceride transfer protein ( MTTP ) in liver were determined by RT-PCR. Compared with model groups, Emo could improve hepatocyte swelling and hepatic steatosis induced by DL-Eth or Tetra. Serum AST, ALT, serum TG, hepatic TG and hepatic TC were decreased by Emo significantly. DL-Eth-induced increase of fatty acid synthetase-associated protein was down-regulated by Emo. Fatty acid uptake was down-regulated by Emo; fatty acid oxidation and secretion were increased by Emo. Emo might be effective in preventing acute fatty liver in mice induced by DL-Eth or Tetra.

BACKGROUND: Cardiac stem cells can differentiate into cardiomyocytes in vitro under induction of pilose antlerpolypeptides, which provides a new therapeutic idea for myocardial injury.OBJECTIVE: To explore the effect of pilose antler polypeptides on the apoptosis rate and membrane stability ofmitochondria in cardiac stem cells.METHODS: We chose healthy male Wistar rats born 2 days to extract cardiac stem cells. The culture dish was used asthe experimental unit, and extracted cells were divided into the following four groups (n=12). Blank control group: Thesame amount of buffer was added for induction; 5-azacytidine group: induced with 5-azacytidine (3 μmol/L); pilose antlerpolypeptides group: induced with pilose antler polypeptides (800 mg/L); combined group: induced with pilose antlerpolypeptides (800 mg/L) and 5-azacytidine (3 μmol/L). After 48 hours induction, apoptosis rate of cardiac stem cells ineach group was detected with flow cytometry. The membrane potential of mitochondria in cardiac stem cells wasdetected with immunofluorescence. The expression level of Nkx 2.5, GATA4, ATF-2, and MEF-2C in cardiac stem cellswas detected using western blot assay.RESULTS AND CONCLUSION: There were small, round and bright cells after 2 weeks culture, and cell colonies ofcardiac stem cells formed. The apoptosis rate of cardiac stem cells in the 5-azacytidine group increased significantly (P <0.05) and its membrane potential decreased significantly compared with the blank control group (P < 0.05). Theapoptosis rate of cardiac stem cells in the pilose antler polypeptides group and combined group decreased significantlycompared with the 5-azacytidine group (P < 0.05, P < 0.01), and their membrane potential increased significantly (P <0.05, P < 0.01). The results of western blot showed that the expression level of Nkx2.5 increased significantly in thepilose antler polypeptides group and combined group compared with the 5-azacytidine group (P < 0.05), while theexpression levels of GATA4 and ATF-2 in each group were low and there were no significant differences among groups(P > 0.05). The expression level of MEF-2C in each group was at a middle level, and there were no significantdifferences among groups (P > 0.05). To conclude, our experimental findings indicate that pilose antler polypeptidescould decrease the apoptosis rate and improve membrane stability of mitochondria in cardiac stem cells. Themechanism may be related to the increased expression of Nkx 2.5, but whether the mechanism is related to GATA4,ATF-2 and MEF-2C needs to be further studied.

To investigate the hypoglycemic effects of terpenes from Fructus Corni(TFC)on type 2 diabetes mellitus, the db/db diabetic mice were intragastrically administered with 25, 50, 100 mg/kg of TFC for 10 weeks. The fasting blood glucose, insulin(Ins), glycosylated serum protein(GSP), total cholesterol(TC)and triglyceride(TG)levels were determined. At weeks 8 and 10, intraperitoneal injections of glucose and gavage starch tolerance tests were performed, respectively. The db/db mice showed obvious obesity. Each dose of TFC could significantly reduce the body weight of db/db mice(P< 0. 05). After 4 weeks of administration, all doses of TFC significantly reduced the fasting blood glucose of db/db mice(P< 0. 05). The serum TC, TG levels were also significantly decreased in the TFC middle- and high-dose groups(P< 0. 05). In addition, middle- and high-dose of TFC could significantly reduce the level of GSP. Middle- and high-dose of TFC also significantly improve the glucose tolerance and gavage starch tolerance in db/db mice(P< 0. 05). These results suggest that TFC could improve diabetes-related symptoms via regulating glucose and lipids metabolism.

Objective To observe the expression of cytokeratin 14,15 (CK14,CK15) expression level in normal esophageal tissues and esophageal squamous cell carcinoma tissues of different differentiation degree and to analyze the relationship between occurrence,development of esophageal squamous cell carcinoma and CK14,CK15 expression level.Methods Esophageal squamous epithelial tissue from 55 cases of carcinoma tissues and 55 cases of adjacent tissues were collected.Immunohistochemical method was used to compare CK14,CK15 and PCNA expression levels in esophageal squamous carcinoma.Results Expression positive rates of CK14,CK15 and PCNA in esophageal squamous carcinoma were 72.7 ％ (40/55),63.6 ％ (35/55) and 65.5 ％ (36/55),respectively,and PCNA expression was correlated with CK14 or CK15 expression (C =0.585,P ＜ 0.001; C =0.405,P ＜ 0.001).CK14 and CK15 levels were higher in high differentiation carcinoma tissue than those in low differentiation carcinoma tissue,and PCNA expression level was increased in low differentiated carcinoma tissue.CK14,CK15 and PCNA were expressed located in base layer of esophageal squamous epithelial adjacent to carcinoma tissue,and their expression positive rates were 56.4 ％ (31/55),52.7 ％ (29/55) and 56.4 ％ (31/55).CK14 and CK15 levels were higher in esophageal squamous epithelial tissues of far-cut edge than those in tissues of near-cut edge (intraepithelial neoplasia).There were no associations between CK14,CK15 expression and the clinical parameters (P ＞ 0.05).Postoperative survival time in patients with CK14 or CK15 positive expression was shorter than that of patients with negative expression (P ＜ 0.05).Conclusions CK14 or CK15 positive expressions localized to base layer of esophageal squamous epithelial adjacent to carcinoma tissue may play some roles in generation and differentiation of esophageal squamous cell cancer.CK14 or CK15 positive expression in esophageal squamous carcinoma involves in differentiation process.Joint detection of CK14 and CK15 expression has clinical application value for early diagnosis,the degree of differentiation and prognostic judgment in esophageal squamous carcinoma.