Huanglian Jiedutang （HLJDT）， a traditional Chinese herbal formula， is known for its heat-clearing and detoxifying effects. This article reviewed the material basis， pharmacological mechanism of action， and research on HLJDT. Modern research has shown that HLJDT is rich in alkaloids， flavonoids， glycosides， and other active ingredients. In terms of pharmacological mechanisms of action， HLJDT has anti-inflammatory and antibacterial effects， and it can regulate intestinal flora and cell disorder， improve iron metabolism disorder， control glucose and lipid metabolism， and exert vascular endothelial functions， with anti-tumor effects， thus improving cerebral ischemia and reducing liver damage. Its therapeutic actions are multi-layered， multi-faceted， and multi-targeted， showing significant efficacy in treating various diseases. Interdisciplinary research， such as the combined application of network pharmacology with molecular docking technology， as well as metabolomics with proteomics， has revealed the potential mechanism of HLJDT in treating various diseases. However， the research on HLJDT still faces some challenges， including the need for an in-depth exploration of its complex pharmacological mechanism of action， evaluation of its efficacy and safety across different diseases and populations， and quality control of traditional Chinese medicine. Future research should integrate modern scientific and technological approaches with traditional Chinese medicine principles to further investigate HLJDT's complex pharmacological mechanism of action， providing theoretical and practical support for its clinical use.

Huanglian Jiedutang （HLJDT）， a traditional Chinese herbal formula， is known for its heat-clearing and detoxifying effects. This article reviewed the material basis， pharmacological mechanism of action， and research on HLJDT. Modern research has shown that HLJDT is rich in alkaloids， flavonoids， glycosides， and other active ingredients. In terms of pharmacological mechanisms of action， HLJDT has anti-inflammatory and antibacterial effects， and it can regulate intestinal flora and cell disorder， improve iron metabolism disorder， control glucose and lipid metabolism， and exert vascular endothelial functions， with anti-tumor effects， thus improving cerebral ischemia and reducing liver damage. Its therapeutic actions are multi-layered， multi-faceted， and multi-targeted， showing significant efficacy in treating various diseases. Interdisciplinary research， such as the combined application of network pharmacology with molecular docking technology， as well as metabolomics with proteomics， has revealed the potential mechanism of HLJDT in treating various diseases. However， the research on HLJDT still faces some challenges， including the need for an in-depth exploration of its complex pharmacological mechanism of action， evaluation of its efficacy and safety across different diseases and populations， and quality control of traditional Chinese medicine. Future research should integrate modern scientific and technological approaches with traditional Chinese medicine principles to further investigate HLJDT's complex pharmacological mechanism of action， providing theoretical and practical support for its clinical use.

Objective To observe the clinical effect of ulinastatin (UTI) combined with thymosin alpha 1 (Tαl) in the treatment of septic shock. Methods A retrospective analysis was conducted on the clinical data of 88 patients with septic shock admitted to our hospital from June 2021 to October 2023. The patients were divided into UTI group and UTI+Tα1 group according to different treatment methods, with 44 patients in each group. The treatment effects, clinical indicators, microcirculatory perfusion indicators[central venous oxygen saturation (S_cvO₂), lactate (LAC), capillary refill time (CRT), mean arterial pressure (MAP)], Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, Sequential Organ Failure Assessment (SOFA) score, immune indicators, plasma and serum inflammatory indicators[soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), procalcitonin (PCT), interleukin (IL)-6, tumor necrosis factor-α (TNF-α)], and prognosis were compared between the two groups. Results After 7 days of treatment, the effective rate of treatment in the UTI+Tα1 group was higher than that in the UTI group (P < 0.05). The duration of vasoactive drug use, mechanical ventilation time, ICU stay, and hospital stay were shorter in the UTI+Tα1 group than those in the UTI group (P < 0.05). After 24 and 72 hours of treatment, S_cvO₂ and MAP gradually increased, LAC gradually decreased, and CRT gradually shortened in both groups (P < 0.05). After 24 hours of treatment, S_cvO₂ and MAP were higher, and CRT was shorter in the UTI+Tα1 group than those in the UTI group (P < 0.05). After 72 hours of treatment, CRT was shorter, and MAP was higher in the UTI+Tα1 group than those in the UTI group (P < 0.05). After 7 days of treatment, both APACHE Ⅱ and SOFA scores decreased in both groups compared to treatment before, and their scores were lower in the UTI+Tα1 group than those in the UTI group (P < 0.05). After 7 days of treatment, the levels of CD3 + and CD4⁺ T lymphocytes increased in both groups compared to treatment before, and the levels were higher in the UTI+Tα1 group than those in the UTI group (P < 0.05). After 7 days of treatment, the levels of sTREM-1, PCT, IL-6, and TNF-α decreased in both groups compared to treatment before, and the levels were lower in the UTI+Tα1 group than those in the UTI group (P < 0.05). After a 28-day follow-up, there was no statistically significant difference in mortality between the two groups (P=0.398). Conclusion UTI combined with Tαl can effectively promote the recovery of patients with septic shock, improve microcirculatory perfusion, reduce plasma sTREM-1 and serum PCT levels, inhibit inflammatory responses, and improve prognosis.

OBJECTIVE To investigate the effects of Compound troxerutin and poreine cerebroside injection on the activity of cytochrome P450 （CYP450） enzyme in vivo and in vitro. METHODS Human liver microsomes were incubated with Compound troxerutin and poreine cerebroside injection （volume fraction 0.05%-10%） and the specific probe substrates of CYP1A2， CYP2B6， CYP2C8， CYP2C9， CYP2C19， CYP2D6 and CYP3A4 for 30 min. The production of corresponding metabolites was detected by ultra-high performance liquid chromatography-tandem mass spectrometry （UPLC-MS/MS）， and the half inhibitory concentration （IC50） was calculated. The relative mRNA expression （i.e. induction multiple） of CYP450 enzyme was determined by real-time fluorescence quantitative PCR after human primary hepatocytes were incubated with Compound troxerutin and poreine cerebroside injection （volume fraction 0.05%-10%） or 3 positive inducers of CYP1A2， CYP2B6， CYP3A4 for 48 hours. Male SD rats were randomly divided into control group （normal saline+probe substrates of CYP1A2， CYP2B6， CYP2C8， CYP2C9， CYP2C19， CYP2D6， CYP3A4 8， 2， 1， 1， 10， 10， 8 mg/kg） and experimental group （Compound troxerutin and poreine cerebroside injection 0.9 mL/kg+probe substrates of CYP1A2， CYP2B6， CYP2C8， CYP2C9， CYP2C19， CYP2D6， CYP3A4 8， 2， 1， 1， 10，10， 8 mg/kg）， with 6 rats in each group. The pharmacokinetic parameters of probe substrates were detected by UPLC-MS/MS and Cocktail probe drug method. RESULTS After the lzqpharm@126.com treatment of 0.05%-10% Compound troxerutin and poreine cerebroside injection， the activities of CYP2B6， CYP2C8 and CYP2C19 in human liver microsomes had no significant change， and IC50 could not be fitted； IC50 of CYP1A2， CYP2C9， CYP2D6 and CYP3A4 were 419.90%， 97.78%， 176.00%， 19.42%， respectively. After the treatment of 0.05%-10% Compound troxerutin and poreine cerebroside injection， the average induction multiple of CYP3A4 mRNA in human primary hepatocytes （No. MHK） was 4.88 （and the average induction multiples of 2 concentration points were higher than 2）. After the treatment of Compound troxerutin and poreine cerebroside injection， AUC0－t and AUC0－∞ of CYP2C8， CYP2C9 and CYP2C19 substrates were increased significantly， CL of CYP2C8 and CYP2C19 substrates were decreased significantly， while t1/2 of CYP2C9 substrate was prolonged significantly （P＜0.05）. CONCLUSIONS Compound troxerutin and poreine cerebroside injection has no obvious inhibitory effect on CYP1A2， CYP2B6， CYP2C8， CYP2C9， CYP2C19， CYP2D6 and CYP3A4 in human liver microsomes in vitro， but can induce the mRNA expression of CYP3A4 in human primary hepatocytes in vitro， and can inhibit the activities of CYP2C8， CYP2C9 and CYP2C19 in rats in vivo.

Objective To investigate the effect of ulinastatin (UTI) preconditioning combined with ischemic preconditioning (IPC) on hepatic ischemia-reperfusion (IR) injury in rats and possible mechanism of action.Methods A total of 50 male Sprague-Dawley rats were randomly divided into sham-operation group,IR group,IPC group,UTI group,and UTI-IPC group (UCI group).Blood samples were collected from the inferior vena cava after surgery and liver tissue samples were also collected.The serum levels of aspartate aminotransferase (AST),alanine aminotransferase (ALT),and tumor necrosis factor-o (TNF-α),the levels of myeloperoxidase (MPO) and nuclear factor-kappa B (NF-κB) in the liver tissue,and wet/dry weight ratio were determined,and pathomorphological changes of the liver tissue were observed under a light microscope.A one-way analysis of variance was used for comparison of continuous data between groups,and the LSD-t-test was used for further comparison between two groups.Results The IR,IPC,UTI,and UCI groups had significantly higher serum levels of ALT,AST,and TNF-α,levels of MPO and NF-κB in the liver tissue,and wet/dry weight ratio than the sham-operation group (all P ＜ 0.05);the IPC,UTI,and UCI groups had significantly lower levels than the IR group (all P ＜ 0.05),the UTI group had significantly lower levels than the IPC group (all P ＜ 0.05),and the UCI group had significantly lower levels than the IPC and UTI groups (all P ＜ 0.05).Liver pathological examination showed that compared with the sham-operation group,the IR,IPC,UTI,and UCI groups had significantly greater liver injury (all P ＜0.05),while the IPC,UTI,and UCI groups had a significantly lower degree of liver injury than the IR group (all P ＜ 0.05),the UTI group had significantly slighter liver injury than the IPC group (P ＜ 0.05),and the UCI group had significantly slighter liver injury than the IPC and UTI groups (both P ＜ 0.05).Conclusion Both UTI and UCI have a protective effect against hepatic IR injury,and the combination of UTI and UCI significantly enhances such protective effect,possibly by inhibiting the expression of NF-κB,reducing the release of TNF-α and MPO,and alleviating liver inflammatory response.

Objective To evaluate the effect of sofren injection on acute lung injury (ALI) in septic mice.Methods Ninety-six pathogen-free made Kunming mice,aged 8-10 weeks,weighing 30-35 g,were divided into 4 groups (n =24 each) using a randon number table:sham operation group (group Sham),ALI group,vehicle group (group Vehicle) and sofren injection group (group Sofren).Sepsis was induced by cecal ligation and puncture.In Vehicle and Sofren groups,double distilled water and sofren injection 4 ml/kg were intraperitoneally injected,respectively,after the model was established,followed by repeated admninistration once every 12 h.At 12,24 and 48 h after operation,the animals were sacrificed and lungs were removed for mnicroscopic examination and for determination of wet to dry weight ratio (W/D ratio),malondialdehyde (MDA) content,superoxide dismutase (SOD) activity,and contents of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) in lung tissues (by enzyme-linked immunosorbent assay).The lung injury score (LIS) was calculated after haematoxylin and eosin staining.Results Compared with group Sham,the LIS,W/D ratio and contents of MDA,TNF-α and IL-6 were significantly increased,and the SOD activity was decreased at each time point in ALI and Vehicle groups (P＜0.05).Compared with group ALI,the LIS,W/D ratio and contents of MDA,TNF-α and IL-6 were significantly decreased,and the SOD activity was increased at each time point in group Sofren (P＜0.05),and no significant change was found in each parameter mentioned above in group Vehicle (P＞0.05).Conclusion Sofren injection can attenuate ALI in septic mice.

OBJECTIVE:To investigate the effects of sevoflurane combined with remifentanil on intraoperative related indica-tors and quality of postoperative recovery in patients with general anesthesia. METHODS:52 patients with elective abdominal sur-gery were randomly divided into observation group and control group. All patients were treated with etomidate 0.3 mg/kg+atracuri-um 0.5 mg/kg+remifentanil 1μg/kg for anesthesia induction;then observation group was received sevoflurane by inhalation and con-trol group was propofol by infusion. The SBP,DBP,HR and BIS in 2 groups were recorded before anesthesia induction(T0),after anesthesia induction(T1),time of intubation(T2),skin incision(T3),10 minutes after establishing pneumoperitoneum(T4),end of pneumoperitoneum(T5) and extubation(T6),respectively. Operation and anesthesia duration,recovery time and extubation time, MMSE score and incidence of adverse reactions were recorded. RESULTS:SBP and HR in T6 and DBP in T4-6 in 2 groups were sig-nificantly higher than T0 of same group,BIS in T1-5 was significantly lower than T0,the differences were statistically significant(P<0.05),however,there was no significant difference between 2 groups (P>0.05). Recovery time and extubation time in observa-tion group were significantly lower than control group(P<0.05),there was no significant difference in the operation and anesthesia duration between 2 groups(P>0.05). MMSE scores in 2 groups were significantly lower than before after 0.5 h and 1 h of extuba-tion,and control group was lower than observation group(P<0.05 or P<0.01);MMSE scores in 2 groups were significantly high-er than 0.5 h and 1 h after extubation(P<0.05),however,there was no significant difference between 2 groups and before(P>0.05). There was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Sevoflurane combined with remifentanil has satisfactory anesthesia,sevoflurane has better controllability,with good safety.

Objective To establish the pathogenic gene loci on 8q23.3-24.1 and 10p15 in this benigh adult familial myoclonic epilepsy (BAFME) pedigree.Methods After obtaining informed consent, peripheral blood samples were obtained from 7 BAFME patients and 13 control individuals;amplified polymerase chain reaction (PCR) and short tandem repeat (STR) method were employed to conduct linkage analysis;five STRs on chromosomal segments 8q23.3-q24.1 and three STRs on chromosomal segments 10p1 5 were chosen at genetic distances appropriate.Results Negative signal was all obtained for 8q23.3-q24.1 and 10p15 (LOD scores less than-2 for these STRs, respectively;θ=0.0), excluding involvement of these regions in the BAFME pedigree analyzed.Conclusion STR linkage analysis of 8q23.3-q24.1 and 10p 15 does not support linkage to these regions, indicating that the pathogenic gene in the pedigree we studied is not in these chromosome segments.

BACKGROUNDBased on the excellent medical care and management system for Chinese veterans, as well as the detailed medical documentation available, we aim to construct a Chinese Veteran Clinical Research (CVCR) platform on non-communicable diseases (NCDs) and carry out studies of the primary disabling NCDs.

METHODSThe Geriatric Neurology Department of Chinese People's Liberation Army General Hospital and veterans' hospitals serve as the leading and participating units in the platform construction. The fundamental constituents of the platform are veteran communities. Stratified typical cluster sampling is adopted to recruit veteran communities. A cross-sectional study of mental, neurological, and substance use (MNS) disorders are performed in two stages using screening scale such as the Mini-Mental State Examination and Montreal cognitive assessment, followed by systematic neuropsychological assessments to make clinical diagnoses, evaluated disease awareness and care situation.

RESULTSA total of 9 676 among 277 veteran communities from 18 cities are recruited into this platform, yielding a response rate of 83.86%. 8 812 subjects complete the MNS subproject screening and total response rate is 91.70%. The average participant age is (82.01±4.61) years, 69.47% of veterans are 80 years or older. Most participants are male (94.01%), 83.36% of subjects have at least a junior high school degree. The overall health status of veterans is good and stable. The most common NCD are cardiovascular disorders (86.44%), urinary and genital diseases (73.14%), eye and ear problems (66.25%), endocrine (56.56%) and neuro-psychiatric disturbances (50.78%).

CONCLUSIONWe first construct a veterans' comprehensive clinical research platform for the study of NCDs that is primarily composed of highly educated Chinese males of advanced age and utilize this platform to complete a cross-sectional national investigation of MNS disorders among veterans. The good and stable health condition of the veterans could facilitate the long-term follow-up studies of NCDs and provide prospective data to the prevention and management of NCDs.

Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cross-Sectional Studies ; Disease ; Female ; Health Status ; Humans ; Male ; Veterans ; statistics & numerical data

Objective To investigate the clinical results and related key points of surgical treatment for Hawkins Ⅲ talus neck fractures.Methods From March 2005 to March 2010,26 patients with Hawkins Ⅲ talus neck fracture were treated and 21 of them were followed,including 13 males and 8 females,with an average age of 37.6 years.The fractures occurred on the left side in 11 patients and on the right side in 10patients.The mechanism of injury included high falling injury in 13 patients,traffic accident injury in 7 patients and rolling down injury in 1 patient.Five cases were closed fractures and 6 cases were open fractures.A bilateral approach,the medial and lateral approaches,was used to perform the operation with cannulated screw fixation in emergency.After external fixation in functional position for 6 weeks without loading,ankle joints were allowed to take exercise with hinge brace and to bear partially basing on plain radiograph 12-16weeks later.The weight-bearing should be adjusted with follow-up.Functional results were assessed according to AOFAS (American Orthupaedic Foot and Ankle Society,AOFAS)score.Results The average duration of follow-up was 36.6 months (range,6-60 months).All fractures gained union and the average union time was 4.5 months.The average AOFAS score was 78.6.There were 4 cases in excellent results,10 in good,5 in fair and 2 in poor.The overall excellent and good rate was 67.8％.Traumatic arthritis occurred in 13 cases and avascular necrosis in 5 cases.Conclusion The effect of surgical treatment for Hawkins Ⅲtalus neck fracture via a bilateral approach is satisfactory.