ObjectiveTo explore the mechanism of Sangpi Zhike prescription in treating cough after respiratory syncytial virus （RSV） infection through the "lung-intestine co-treatment" approach using network pharmacology and animal experimental validation. MethodsActive ingredients and targets of Sangpi Zhike prescription were retrieved from the Traditional Chinese Medicine Systems Pharmacology （TCMSP） database. Disease targets were obtained from GeneCards and Online Mendelian Inheritance in Man（OMIM） databases. Protein-protein interaction （PPI） networks and drug-component-target networks were constructed using overlapping targets between drugs and diseases to identify core targets. Gene ontology（GO） and Kyoto encyclopedia of genes and genomes（KEGG） pathway enrichment analyses were performed on the overlapping targets. Sixty mouse models were established： 10 as the normal group， and the remaining mice were infected with RSV via slow nasal drip of RSV suspension， with cough induced using capsaicin solution. After modeling， mice were divided into a model group， a Montelukast Sodium group （1 mg·kg^-1·d^-1）， and low， medium， and high dose groups of Sangpi Zhike prescription （4.875，9.75，and 19.5 g·kg^-1·d^-1）， with 10 mice per group. From day 14 after RSV infection， the normal and model groups received saline via gavage， while other groups received corresponding drug treatments once daily for 5 d. Hematoxylin-eosin（HE） staining was used to observe pathological changes in lung and intestinal tissue. The protein content of extracellular signal-regulated kinase 1/2 （ERK1/2） and phosphorylated （p）-ERK1/2 in the lung and colon tissue of mice was detected by Western blot. Real-time polymerase chain reaction（Real-time PCR） detected ERK1/2 mRNA expression in lung and intestinal tissue. Immunohistochemistry assessed p-MEK1/2， p-ERK1/2， p-c-Fos protein levels， and inflammatory cytokines interleukin（IL）-4 and （TNF）-α in lung and colon tissue. ResultsNetwork pharmacology identified 184 active ingredients and 684 targets in Sangpi Zhike prescription， with 1 344 RSV-related disease targets and 209 overlapping targets. Core targets included TNF， Fos， and Jun. KEGG enrichment revealed 179 pathways， primarily mitogen-activated protein kinase（MAPK）， cancer， TNF， and IL-17 signaling pathways. Animal experiments showed that， compared to those of the normal group， the lung tissue sections of the model group showed typical inflammatory damage， infiltration of inflammatory cells， rupture of alveolar septa， extensive alveolar fusion， and disruption of tight junctions between single-layer columnar epithelial cells in the intestinal tissue. The values of p-ERK1/2 and ERK1/2 in lung and intestinal tissue were significantly increased （P<0.01）， and the expression level of ERK1/2 mRNA was significantly elevated （P<0.01）. The levels of ERK1/2， p-MEK1/2， p-ERK1/2， p-c-Fos， IL-4， and TNF-α along the ERK pathway were significantly increased （P<0.05， P<0.01）. Compared to the model group， Sangpi Zhike prescription groups showed reduced lung and intestinal inflammation， decreased p-ERK1/2/ERK1/2 ratios （P<0.05，P<0.01）， lower ERK1/2 mRNA levels， and downregulated ERK pathway proteins （P<0.05，P<0.01）. ConclusionSangpi Zhike prescription alleviates cough and intestinal symptoms after RSV infection via the "lung-intestine co-treatment" mechanism by suppressing expression levels of ERK1/2， p-MEK1/2， p-ERK1/2， p-c-Fos， IL-4， and TNF-α on ERK pathway components， thereby mitigating lung and intestinal pathological damage.

BACKGROUND:The analgesic effect of stagnant moving needle on myofascial pain syndrome is remarkable,but the analgesic mechanism is still unclear.OBJECTIVE:To investigate the analgesic mechanism of stagnant moving needle acupuncture in the treatment of myofascial pain syndrome.METHODS:Fifty-four SD rats were randomly divided into a blank group(n=16)and a modeling group(n=38).The models of leftmyofascial pain syndrome in the modeling group were prepared by using the method of"striking combined with centrifugal movement".Twelve weeks after modeling,six mice were randomly selected to verify the success of the modeling.The rest of the 32 rats were randomly divided into the model group and the stagnant moving needle group,with 16 rats in each group.The stagnant needle moving group was treated by stagnant moving needle into the local excitation point nodule of the left medial vastus muscle fascia in rats,twice a week,for 4 weeks.The mechanical foot contraction reflex threshold of the leftfoot were measured weekly in the pre/post modeling and post-intervention groups of rats.At 4 weeks after treatment,hematoxylin-eosin staining was used to observe the morphological changes in the muscle tissue of the leftmedial femoral muscle of rats,ELISA was used to detect the levels of substance P and β-endorphin in the serum and the gray matter around the midbrain aqueduct.Immunohistochemistry was used to detect positive expression of microglia markers(Iba-1)and c-fos in the gray matter around the midbrain aqueduct.Western blot assay was used to detect the expression level of brain-derived neurotrophic factor protein in the periaqueductal gray.RESULTS AND CONCLUSION:Compared with the blank group,the mechanical pain threshold of the rats in the model group and the stagnant moving needle group decreased after modeling(P<0.05).After 4 weeks of treatment,the mechanical pain threshold of the rats in the stagnant moving needle group was higher than that in the model group(P<0.05).Hematoxylin-eosin staining results showed that in the model group,the muscle fibers of the leftlower limb medial femoral muscle of rats were disorganized,unequal in thickness,myocytes were enlarged,with inward movement of the nucleus,rounded contracture nodules and tension bands;whereas in the stagnant moving needle group,the muscle fibers were arranged in a neat way,the myocytes were angular,and the contracture nodules were occasionally seen.Compared with the blank group,the expression of substance P in the serum of the model group was significantly higher(P<0.05),while the levels of β-endorphin in serum and substance P and β-endorphin in brain were decreased(P<0.01).Compared with the model group,the level of serum substance P in the stagnant moving needle group was decreased(P<0.05),and the levels of serum β-endorphin and brain substance P and β-endorphin were increased(P<0.05).Compared with the blank group,the positive expression of c-fos and Iba-1 and the protein of brain-derived neurotrophic factor in the model group were increased(P<0.05).Compared with the model group,the positive expression of c-fos in the stagnant moving needle group was increased(P<0.05),and the positive expression of Iba-1 and the protein of brain-derived neurotrophic factor were decreased(P<0.05).These findings suggest that stagnant moving needle may indirectly promote the release of β-endorphin by microglia polarized to the M2 phenotype and increase the excitability of c-fos neurons by inhibiting the activity of microglia in the gray matter around the periaqueductal gray and downregulating the expression of brain-derived neurotrophic factor protein,thereby reducing the degree of central sensitization and effectively relieving myofascial pain syndrome.

Transient perivascular inflammation of the carotid artery(TIPIC)syndrome is a relatively rare disease,and ultrasound is the first screening method for initial diagnosis of the disease.Contrast-enhanced ultrasound(CEUS)has unique advantages in the follow-up of patients with TIPIC syndrome.This paper reports a patient with TIPIC syndrome who was treated with acute left neck pain.The inflammation was significantly re-lieved and subsided after treatment with non-steroidal anti-inflammatory drugs.The ultrasound changes of carotid artery lesions in this patient during follow-up were analyzed,and the application value of CEUS in the follow-up diagnosis of this disease was summarized,in the hope of providing clinical reference.

OBJECTIVE To establish HPLC fingerprints of three drying processes(Atmospheric pressure drying,Decompression drying,Freeze-drying)of Danggui Buxue granules,and combine them with antioxidant tests to determine the optimal drying process and main active components of Danggui Buxue granules.METHODS The fingerprints of multiple batches of Danggui Buxue granules were established by HPLC;the"Fingerprint Similarity Evaluation System of Traditional Chinese Medicine Chromatogram"was used to evaluate the similarity;Hierarchical Cluster Analysis(HCA)and Principal Component Analysis(PCA)were used to characterize the different drying processes of Danggui Buxue granules;evaluate the antioxidant activity of Danggui Buxue granules in different drying processes using 1,1-diphenyl-2-picrylhydrazy(DPPH)and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)diammonium salt(ABTS)free radical scavenging method;the spectrum-effect relationship between Danggui Buxue granules fingerprint and antioxi-dant activity was analyzed by grey correlation degree and Pearson,Spearman,Kendall's tau-b correlation analysis methods.RE-SULTS The results of fingerprint showed that there were 16 common peaks in 30 batches of Danggui Buxue granules,and 6 of them were identified by comparison.The results of Cluster Analysis and Principal Component Analysis showed that 30 batches of Danggui buxue granules were divided into 3 categories,and the difference between the groups of atmospheric pressure drying was the least.The results of oxidation test showed that different drying processes of Danggui Buxue granules had good antioxidant activity,and the atmos-pheric pressure drying had the lowest IC50 and the strongest antioxidant activity.Finally,combining the results of gray correlation anal-ysis and correlation analysis,the compounds F2,F10,F13(calycosin),F15(formononetin),F16 might be important characteristic peaks reflecting the antioxidant activity of Danggui Buxue granules.CONCLUSION Compared with other drying processes,atmos-pheric pressure drying has higher batch consistency and stronger antioxidant activity,and can be used as the preferred drying process for Danggui Buxue granules,and components 2,10,13,15 and 16 are the main active ingredients for Danggui Buxue granules to exert antioxidant effects.

OBJECTIVE To establish HPLC fingerprints of three drying processes(Atmospheric pressure drying,Decompression drying,Freeze-drying)of Danggui Buxue granules,and combine them with antioxidant tests to determine the optimal drying process and main active components of Danggui Buxue granules.METHODS The fingerprints of multiple batches of Danggui Buxue granules were established by HPLC;the"Fingerprint Similarity Evaluation System of Traditional Chinese Medicine Chromatogram"was used to evaluate the similarity;Hierarchical Cluster Analysis(HCA)and Principal Component Analysis(PCA)were used to characterize the different drying processes of Danggui Buxue granules;evaluate the antioxidant activity of Danggui Buxue granules in different drying processes using 1,1-diphenyl-2-picrylhydrazy(DPPH)and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)diammonium salt(ABTS)free radical scavenging method;the spectrum-effect relationship between Danggui Buxue granules fingerprint and antioxi-dant activity was analyzed by grey correlation degree and Pearson,Spearman,Kendall's tau-b correlation analysis methods.RE-SULTS The results of fingerprint showed that there were 16 common peaks in 30 batches of Danggui Buxue granules,and 6 of them were identified by comparison.The results of Cluster Analysis and Principal Component Analysis showed that 30 batches of Danggui buxue granules were divided into 3 categories,and the difference between the groups of atmospheric pressure drying was the least.The results of oxidation test showed that different drying processes of Danggui Buxue granules had good antioxidant activity,and the atmos-pheric pressure drying had the lowest IC50 and the strongest antioxidant activity.Finally,combining the results of gray correlation anal-ysis and correlation analysis,the compounds F2,F10,F13(calycosin),F15(formononetin),F16 might be important characteristic peaks reflecting the antioxidant activity of Danggui Buxue granules.CONCLUSION Compared with other drying processes,atmos-pheric pressure drying has higher batch consistency and stronger antioxidant activity,and can be used as the preferred drying process for Danggui Buxue granules,and components 2,10,13,15 and 16 are the main active ingredients for Danggui Buxue granules to exert antioxidant effects.

Objective:To analyze the correlation between bone metabolism marker β-CTX and metabolic dysfunction-associated fatty liver disease (MAFLD) in postmenopausal women with type 2 diabetes mellitus (T2DM).Methods:In this retrospective cohort study, a total of 279 postmenopausal women with T2DM who were admitted to the Endocrinology Department of Shanxi Bethune Hospital from February 2023 to February 2024 were included. Among them, 152 patients had MAFLD. The bone metabolism markers were measured in all the subjects. The logistic regression analysis was used to assess the correlation between β-CTX and the risk of MAFLD.Results:In postmenopausal T2DM women, serum β-CTX level in the MAFLD group [352.50 (248.60, 442.95)pg/ml ] was significantly lower than that in the non-MAFLD group [643.20 (446.10, 781.90) pg/ml]( Z=-10.896, P0.05). Binary logistic regression analysis revealed that reduced β-CTX( OR=0.986, 95% CI:0.981-0.991), BMI( OR=1.232, 95% CI: 1.046-1.451) and fasting insulin (FINS)( OR=1.155, 95% CI: 1.041-1.281) were independent risk factors for the risk of MAFLD in postmenopausal T2DM women (all P0.05), and β-CTX was negatively correlated with the occurrence of MAFLD ( β=-0.013, P0.001). Additionally, in postmenopausal T2DM women with MAFLD, serum β-CTX level was significantly negatively correlated with BMI ( r=-0.191) and TG ( r=-0.128) (both P0.05). Conclusions:The bone metabolism index β-CTX in postmenopausal women with T2DM is significantly negatively correlated with the risk of MAFLD.

Objective:To evaluate the efficacy of different anti-reflux surgery combined with laparoscopic hiatal hernia repair in the treatment of gastroesophageal reflux disease (GERD) complicated with hiatal hernia.Methods:A retrospective analysis was conducted on 405 patients with GERD and hiatal hernia undergoing laparoscopic hiatal hernia repair combined with different anti-reflux surgery at the First Affiliated Hospital of Zhengzhou University from Jan 2013 to Jun 2019. The patients were divided into four groups based on the anti-reflux surgery: 38 patients underwent Nissen fundoplication (Nissen group), 67 patients underwent Toupet fundoplication (Toupet group), 101 patients underwent Dor fundoplication (Dor group), and 199 patients underwent His angle plasty (His group). The improvement of symptoms, the use of proton pump inhibitor (PPI), surgical outcomes, and postoperative complications were compared among the four groups at 5 years after surgery.Results:Compared with preoperative scores, the scores of acid regurgitation and heartburn in all four groups decreased significantly after surgery (Nissen group: Z=-4.974, -4.905; Toupet group: Z=-9.245, -9.413; Dor group: Z=-8.080, -8.225; His group: Z=-11.705, -11.619, all P<0.05), and there was no significant difference in postoperative symptom scores among the four groups (acid regurgitation: 2.2 vs. 2.0 vs. 1.9 vs. 1.9; heartburn: 2.0 vs. 1.7 vs. 1.7 vs. 1.8, all P>0.05). There was no significant difference in the total effective rate of treatment among the four groups (86.8% vs. 92.5% vs. 87.1% vs. 91.5%, χ2=2.314, P=0.510). Additionally, there was no significant difference in the PPI independence among the four groups (63.2% vs. 61.2% vs. 60.4% vs. 60.3%, χ2=0.120 P=0.989). The incidence of severe dysphagia and abdominal distension was higher in the three fundoplication groups (Nissen, Toupet, and Dor groups) than in the His group (all P<0.05). Conclusions:Laparoscopic hiatal hernia repair combined with different anti-reflux surgery is safe and effective in the long-term treatment of GERD complicated with hiatal hernia. His angle plasty has the advantages of simple surgical operation and low incidence of postoperative dysphagia and abdominal distension, and is a recommended new anti-reflux surgery.

BACKGROUND:The analgesic effect of stagnant moving needle on myofascial pain syndrome is remarkable,but the analgesic mechanism is still unclear.OBJECTIVE:To investigate the analgesic mechanism of stagnant moving needle acupuncture in the treatment of myofascial pain syndrome.METHODS:Fifty-four SD rats were randomly divided into a blank group(n=16)and a modeling group(n=38).The models of leftmyofascial pain syndrome in the modeling group were prepared by using the method of"striking combined with centrifugal movement".Twelve weeks after modeling,six mice were randomly selected to verify the success of the modeling.The rest of the 32 rats were randomly divided into the model group and the stagnant moving needle group,with 16 rats in each group.The stagnant needle moving group was treated by stagnant moving needle into the local excitation point nodule of the left medial vastus muscle fascia in rats,twice a week,for 4 weeks.The mechanical foot contraction reflex threshold of the leftfoot were measured weekly in the pre/post modeling and post-intervention groups of rats.At 4 weeks after treatment,hematoxylin-eosin staining was used to observe the morphological changes in the muscle tissue of the leftmedial femoral muscle of rats,ELISA was used to detect the levels of substance P and β-endorphin in the serum and the gray matter around the midbrain aqueduct.Immunohistochemistry was used to detect positive expression of microglia markers(Iba-1)and c-fos in the gray matter around the midbrain aqueduct.Western blot assay was used to detect the expression level of brain-derived neurotrophic factor protein in the periaqueductal gray.RESULTS AND CONCLUSION:Compared with the blank group,the mechanical pain threshold of the rats in the model group and the stagnant moving needle group decreased after modeling(P<0.05).After 4 weeks of treatment,the mechanical pain threshold of the rats in the stagnant moving needle group was higher than that in the model group(P<0.05).Hematoxylin-eosin staining results showed that in the model group,the muscle fibers of the leftlower limb medial femoral muscle of rats were disorganized,unequal in thickness,myocytes were enlarged,with inward movement of the nucleus,rounded contracture nodules and tension bands;whereas in the stagnant moving needle group,the muscle fibers were arranged in a neat way,the myocytes were angular,and the contracture nodules were occasionally seen.Compared with the blank group,the expression of substance P in the serum of the model group was significantly higher(P<0.05),while the levels of β-endorphin in serum and substance P and β-endorphin in brain were decreased(P<0.01).Compared with the model group,the level of serum substance P in the stagnant moving needle group was decreased(P<0.05),and the levels of serum β-endorphin and brain substance P and β-endorphin were increased(P<0.05).Compared with the blank group,the positive expression of c-fos and Iba-1 and the protein of brain-derived neurotrophic factor in the model group were increased(P<0.05).Compared with the model group,the positive expression of c-fos in the stagnant moving needle group was increased(P<0.05),and the positive expression of Iba-1 and the protein of brain-derived neurotrophic factor were decreased(P<0.05).These findings suggest that stagnant moving needle may indirectly promote the release of β-endorphin by microglia polarized to the M2 phenotype and increase the excitability of c-fos neurons by inhibiting the activity of microglia in the gray matter around the periaqueductal gray and downregulating the expression of brain-derived neurotrophic factor protein,thereby reducing the degree of central sensitization and effectively relieving myofascial pain syndrome.

Objective:To analyze the correlation between bone metabolism marker β-CTX and metabolic dysfunction-associated fatty liver disease (MAFLD) in postmenopausal women with type 2 diabetes mellitus (T2DM).Methods:In this retrospective cohort study, a total of 279 postmenopausal women with T2DM who were admitted to the Endocrinology Department of Shanxi Bethune Hospital from February 2023 to February 2024 were included. Among them, 152 patients had MAFLD. The bone metabolism markers were measured in all the subjects. The logistic regression analysis was used to assess the correlation between β-CTX and the risk of MAFLD.Results:In postmenopausal T2DM women, serum β-CTX level in the MAFLD group [352.50 (248.60, 442.95)pg/ml ] was significantly lower than that in the non-MAFLD group [643.20 (446.10, 781.90) pg/ml]( Z=-10.896, P0.05). Binary logistic regression analysis revealed that reduced β-CTX( OR=0.986, 95% CI:0.981-0.991), BMI( OR=1.232, 95% CI: 1.046-1.451) and fasting insulin (FINS)( OR=1.155, 95% CI: 1.041-1.281) were independent risk factors for the risk of MAFLD in postmenopausal T2DM women (all P0.05), and β-CTX was negatively correlated with the occurrence of MAFLD ( β=-0.013, P0.001). Additionally, in postmenopausal T2DM women with MAFLD, serum β-CTX level was significantly negatively correlated with BMI ( r=-0.191) and TG ( r=-0.128) (both P0.05). Conclusions:The bone metabolism index β-CTX in postmenopausal women with T2DM is significantly negatively correlated with the risk of MAFLD.

Objective:To evaluate the efficacy of different anti-reflux surgery combined with laparoscopic hiatal hernia repair in the treatment of gastroesophageal reflux disease (GERD) complicated with hiatal hernia.Methods:A retrospective analysis was conducted on 405 patients with GERD and hiatal hernia undergoing laparoscopic hiatal hernia repair combined with different anti-reflux surgery at the First Affiliated Hospital of Zhengzhou University from Jan 2013 to Jun 2019. The patients were divided into four groups based on the anti-reflux surgery: 38 patients underwent Nissen fundoplication (Nissen group), 67 patients underwent Toupet fundoplication (Toupet group), 101 patients underwent Dor fundoplication (Dor group), and 199 patients underwent His angle plasty (His group). The improvement of symptoms, the use of proton pump inhibitor (PPI), surgical outcomes, and postoperative complications were compared among the four groups at 5 years after surgery.Results:Compared with preoperative scores, the scores of acid regurgitation and heartburn in all four groups decreased significantly after surgery (Nissen group: Z=-4.974, -4.905; Toupet group: Z=-9.245, -9.413; Dor group: Z=-8.080, -8.225; His group: Z=-11.705, -11.619, all P<0.05), and there was no significant difference in postoperative symptom scores among the four groups (acid regurgitation: 2.2 vs. 2.0 vs. 1.9 vs. 1.9; heartburn: 2.0 vs. 1.7 vs. 1.7 vs. 1.8, all P>0.05). There was no significant difference in the total effective rate of treatment among the four groups (86.8% vs. 92.5% vs. 87.1% vs. 91.5%, χ2=2.314, P=0.510). Additionally, there was no significant difference in the PPI independence among the four groups (63.2% vs. 61.2% vs. 60.4% vs. 60.3%, χ2=0.120 P=0.989). The incidence of severe dysphagia and abdominal distension was higher in the three fundoplication groups (Nissen, Toupet, and Dor groups) than in the His group (all P<0.05). Conclusions:Laparoscopic hiatal hernia repair combined with different anti-reflux surgery is safe and effective in the long-term treatment of GERD complicated with hiatal hernia. His angle plasty has the advantages of simple surgical operation and low incidence of postoperative dysphagia and abdominal distension, and is a recommended new anti-reflux surgery.