Psoriasis is an incurable chronic inflammatory disease that requires new interventions. Here, we found that fibroblasts exacerbate psoriasis progression by promoting macrophage recruitment via CCL2 secretion by single-cell multi-omics analysis. The natural small molecule celastrol was screened to interfere with the secretion of CCL2 by fibroblasts and improve the psoriasis-like symptoms in both murine and cynomolgus monkey models. Mechanistically, celastrol directly bound to the low-density lipoprotein receptor-related protein 1 (LRP1) β-chain and abolished its binding to the transcription factor c-Jun in the nucleus, which in turn inhibited CCL2 production by skin fibroblasts, blocked fibroblast-macrophage crosstalk, and ameliorated psoriasis progression. Notably, fibroblast-specific LRP1 knockout mice exhibited a significant reduction in psoriasis like inflammation. Taken together, from clinical samples and combined with various mouse models, we revealed the pathogenesis of psoriasis from the perspective of fibroblast-macrophage crosstalk, and provided a foundation for LRP1 as a novel potential target for psoriasis treatment.

Natural products, and especially the active ingredients found in traditional Chinese medicine (TCM), have a thousand-year-long history of clinical use and a strong theoretical basis in TCM. As such, traditional remedies provide shortcuts for the development of original new drugs in China, and increasing numbers of natural products are showing great therapeutic potential in various diseases. This paper reviews the molecular mechanisms of action of natural products from different sources used in the treatment of inflammatory diseases and cancer, introduces the methods and newly emerging technologies used to identify and validate the targets of natural active ingredients, enumerates the expansive list of TCM used to treat inflammatory diseases and cancer, and summarizes the patterns of action of emerging technologies such as single-cell multiomics, network pharmacology, and artificial intelligence in the pharmacological studies of natural products to provide insights for the development of innovative natural product-based drugs. Our hope is that we can make use of advances in target identification and single-cell multiomics to obtain a deeper understanding of actions of mechanisms of natural products that will allow innovation and revitalization of TCM and its swift industrialization and internationalization.

Objective:To explore application value of logotherapy-based intervention on palliative care for middle aged patients with advanced lung cancer, in order to provide reference for assistant of their hospice.Methods:Totally, 72 middle aged patients with advanced lung cancer from October 2018 to April 2019 in the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Chest Hospital were divided into experimental group and control group according to the patients enrolled time, with 36 cases in each group. The patients in the control group recieved routine nursing, the experimental group carried out 3 times of logotherapy based on the routine nursing. Before and after intervention, the effects was assessed by Functional Assessment of Cancer Therapy-General (FACT-G), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp-12) and Hospital Anxiety and Depression Scale (HADS), respectively.Results:There was no significant difference in FACT-G, FACIT-Sp-12, HADS before intervention between the two groups( P>0.05). After intervention, the sociafamily condition, emotional condition demension scores and total scores in FACT-G were (12.75±3.55), (13.41±2.61), (43.31±4.23) points, the belief, meaning, peace demension scores as well as total scores in FACIT-Sp-12 were (11.78±1.58), (11.06±2.27), (10.19±2.33), (33.03±3.46) points in the experimental group, significantly higher than those in the control group (10.88±3.12), (11.45±3.06), (38.82±5.06), (9.73±1.39), (9.67±1.73), (8.70±2.24), (28.09±2.89) points ( t values were 2.260-6.259, P<0.05), the anxiety, depression subscale and total HADS scores were (9.19±2.36), (8.56±1.98), (17.75±3.12) points in the experimental group, significantly lower than those in the control group (10.42±1.84), (9.97±2.19), (20.39±2.50) points, the differences were statistically significant (t values were 2.352-3.776, P<0.05). Conclusions:Logotherapy-based intervention can promote quality of life and spiritual comfort and allivate nagetive emotion of middle aged patients with advanced lung cancer.

Purpose To evaluate the quality assessed by iconographic diagnostic test system using ROBIS. Materials and Methods"Diagnostic tests, system evaluation, Meta analysis, diagnoses*test, diagnoses*trial, systematic review, meta-analysis" were used as search term to retrieve relevant literatures recorded in CBM, CNKI, Wanfang Data, PubMed, Embase, and Cochrane Library from January. 1, 2014 to December. 31, 2016. After two independent researchers screened the literature and extracted the information, the quality of included literatures was evaluated using ROBIS. Results Totally 219 articles were included in the study, including 93 Chinese literatures and 126 English literatures. The results of subgroup analysis showed that the quality difference between Chinese and English documents was statistically significant (P=0.018); the quality difference between the Chinese literatures and those of other regions was statistically significant (P<0.001); there was no statistical significance in quality difference regarding the year of publication (P=0.34). The ROBIS evaluation results showed that there were only 15 literatures (6.85%) with low-risk, including 2 Chinese literatures and 13 English literatures. Conclusion The quality evaluated by Chinese and English diagnostic test system, which is publicly published in iconographic diagnostic test from 2014 to 2016, is generally low, and the quality of literatures published by domestic scholars and in Chinese is still behind international levels. The maker of system evaluation in this field should prepare their research plans in advance and fully report them in future research, adequately obtain evidence, minimize bias in respects of document screening, information extraction, and evaluation of original research bias, and take into account of results stability, based on which the quality of system evaluation in this field should be further improved.

Objective To investigate the effectiveness of evoked potential in monitoring cerebral perfusion during carotid endarterectomy by a retrospective cohort study.Methods A retrospective cohort survey of clinical data of 59 patients,who underwent carotid endarterectomy in our hospital from September 2013 to December 2016,was performed.All patients were monitored by transcranial doppler ultrasonography (TCD) and somatosensory evoked potential (SEP),motor evoked potential (MEP) for changes of cerebral blood flow;the monitoring of TCD was defaulted as "gold standard",recording monitoring results at different time points.By drawing the four table,the sensitivity,specificity,positive predictive value,negative predictive value of SEP and MEP during cerebral hypoperfusion were calculated,and correlation analyses between SEP and TCD,and between MEP and TCD were performed.Through receiver operating characteristic (ROC) curve,SEP monitoring threshold of cerebral hypoperfusion was predicted.Results The sensitivity,specificity,positive predictive value,and negative predictive value of SEP in predicting intra-operative cerebral hypoperfusion were 60.00％,91.84％,60.00％,and 91.84％ when SEP amplitude declined beyond 50％;the sensitivity,specificity,positive predictive value and negative predictive value of SEP in predicting intra-operative cerebral hypoperfusion were 70.00％,93.88％,70.00％ and 93.88％ when SEP latency extended beyond 10％.The sensitivity,specificity,positive predictive value,and negative predictive value of MEP in predicting intra-operative cerebral hypoperfusion were 30.00％,97.96％,75.00％,and 87.27％ when MEP amplitude declined beyond 50％.Decline of SEP and MEP amplitudes and extension of SEP latency have positive correlations with TCD.ROC indicated that the amplitude of somatosensory evoked potentials could predict intraoperative hypoperfusion when it decreased by 51.0％ than the baseline monitoring value after carotid artery occlusion,with sensitivity of 100.0％,specificity of 89.8％ and area under the curve of 0.918 (95％CI:0.846～0.990,P=0.024).ROC also showed that the latent phase of somatosensory evoked potentials could predict intraoperative hypoperfusion when it was prolonged ＞9.8％ compared to the baseline monitoring value after carotid artery occlusion,with sensitivity of 100.0％,specificity of 92.9％and area under the curve of 0.941 (95％CI 0.878～0.995,P=0.014).Conclusion Evoked potentials can real-time monitor intra-operative cerebral hypoperfusion continuously in carotid endarterectomy,enjoying high sensitivity and specificity;in addition,decline of SEP amplitude and extension of SEP latency have higher sensitivity than MEP.

Objective: To explore therapeutic effect of statins on patients with type 2 diabetes mellitus (T2DM) complicated atherosclerotic cardiovascular diseases.Methods: Clinical data of 103 T2DM patients with atherosclerotic cardiovascular diseases, who were treated in our hospital from Oct 2013 to Dec 2015, were retrospectively studied.According to usage of statins or not, patients were divided into routine treatment group (n=50,didn't use statins) and statin group (n=53,received statins based on routine treatment), both groups were treated for one year.Blood lipid levels before and after treatment, and incidence of cardio-and cerebrovascular events during treatment were measured and compared between two groups.Results: Compared with before treatment, after treatment, there were significant reductions in levels of triglyceride (TG), total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C), and significant rise in level of high density lipoprotein cholesterol (HDL-C) in statin group(P<0.01 all).Compared with routine treatment group after treatment, there were significant reductions in levels of TG [(2.13±0.37) mmol/L vs.(1.74±0.41) mmol/L], TC [(5.38±0.45) mmol/L vs.(4.34±0.73) mmol/L] and LDL-C [(3.63±0.72) mmol/L vs.(2.55±0.61) mmol/L], and significant rise in HDL-C level [(0.95±0.31)mmol/L vs.(1.34±0.35)mmol/L] in statin group, P<0.01 all.During one-year treatment, incidence rate of cardio-and cerebrovascular events in statin group was significantly lower than that of routine treatment group (18.18% vs.56.67%), P=0.002.Conclusion: Statins could effectively correct abnormal lipid metabolism and reduce risk of cardio-and cerebrovascular events in patients with type 2 diabetes mellitus complicated atherosclerosis cardiovascular diseases.

BACKGROUND:Stem cells have been shown to not only replace damaged cells, but also secrete trophic factors, bringing a bright future for the treatment of clinical spinal cord injury.
OBJECTIVE:To review the latest advances of bone marrow mesenchymal stem cells in animal and clinical research.
METHODS:A computer-based search of Kjmed and Wanfang databases was done for relevant articles published from April 2004 to April 2014 using the keywords of“stem cells, spinal cord injuries, embryonic stem cells, neural stem cells, mesenchymal stem cells”in English and Chinese, respectively.
RESULTS AND CONCLUSION:Total y 2 745 articles were initial y retrieved, and only 50 articles were included in result analysis. Bone marrow mesenchymal stem cells have become one of the most promising sources of stem cells in the treatment of spinal cord injury. Although the bone marrow mesenchymal stem cellin the treatment of spinal cord injury is stil in its infancy, it has certain effects on the repair of spinal cord injury. The mechanism of action of bone
marrow mesenchymal stem cells in the treatment of spinal cord injury is possibly related to the substitution effect, neurotrophic effects, suppression of the immune response and promoting axonal regeneration.

0.05).Compared with the control group,the weight and viscera coefficient of testis in high dosage group,the sperm counts of epididymides in medium and high dosage experiment groups were all decreased significantly(P0.05).The activities of succinate dehydrogenase(SDH) and nitric oxide synthase(NOS) of testis in high dosage group,the activities of acid phosphatase(ACP),alkaline phosphatase(AKP) and Ca-Mg-ATPase of testis in medium and high doseage groups were all decreased significantly compared with the control group(P