OBJECTIVE To explore the detoxification mechanism of Terminalia chebula Retz(TCR)soup-processed Euphorbia fischeriana Steud.(EFS)based on LC-MS and simulation processing.METHODS The changes of chemical composition of TCR soup-processed EFS,and dichloromethane extracts of crude EFS after simulation processing with TCR soup were analyzed by LC-MS.Mice were orally administered with alcoholic extracts of crude EFS,alcoholic extracts of water-processed EFS,alcoholic extracts of TCR soup,alcoholic extracts of TCR soup-processed EFS,dichloromethane extracts of crude EFS,dichloromethane extracts of TCR soup-processed EFS,and dichloromethane extracts of crude EFS after simulation processing with TCR soup,respectively.Toxicity changes in TCR soup-processed EFS and dichloromethane extracts of crude EFS after simulation processing with TCR soup were evalu-ated by fecal water contents,release levels of TNF-α and IL-1β,and intestinal pathology.RESULTS A total of 115 and 53 com-pounds were identified in EFS and TCR soup,respectively.The contents of 58 and 12 compounds significantly decreased and signifi-cantly increased respectively in EFS after processing with TCR soup.Compared to the blank control group,the fecal water contents and the release levels of TNF-α and IL-1β significantly increased in both the crude and water-processed EFS groups(P<0.01),and no-table intestinal injury was observed.Compared to the crude EFS group,the fecal water contents and the release levels of TNF-α and IL-1β significantly decreased in both the TCR soup group and the TCR soup-processed EFS group(P<0.01),and repaired intestinal injury was observed.After simulation processing for the dichloromethane extracts of crude EFS with TCR soup,the ion intensity change rates for diterpenoids and tannin phenolic acid compounds ranged from-6.75%to 8.09%and 66.06%to 100.00%,respectively.The ion intensity change rates of diterpenoids in the dichloromethane extracts of TCR soup-processed EFS ranged from-9.92%to 54.72%with almost no tannin phenolic acid compounds.Compared to the blank control group,the fecal water contents and the release levels of TNF-α and IL-1β significantly increased in both the dichloromethane extracts of crude and TCR soup-processed EFS groups(P<0.01),and severe intestinal injury was observed.Compared to the dichloromethane extracts of crude EFS group,the fecal water contents and the release levels of TNF-α and IL-1β significantly decreased in the group of the dichloromethane extracts of crude EFS after simulation processing with TCR soup(P<0.01),with no apparent intestinal injury.CONCLUSION TCR soup pro-cessing can alleviate the intestinal toxicity of EFS.The detoxification mechanism may involve the introduction of a large number of tan-nin phenolic acid compounds in TCR soup during the processing of EFS,which plays a pharmacological antagonistic role in the animal body.

Objective The contents of 11 nucleosides and base components in 10 batches of samples from 5 provinces(cities)including Chongqing,Yunnan and Shaanxi were determined,and the differences in nucleosides and base components in Fritillaria taipaiensis were compared by chemometric analysis,and the quality was comprehensively evaluated,so as to provide a reference for the cultivation of excellent varieties and the selection of medicinal materials.Methods Nucleoside and base components were extracted from Fritillaria taipaiensis by ultrasonication in aqueous solutions,and the content of each component was determined by HPLC-DAD method.The origin was classified by principal component analysis(PCA)and hierarchical cluster analysis(HCA).Partial least squares discriminant analysis(PLS-DA)was used to determine the differentiated index components in Fritillaria taipaiensis.Then the differences in the contents of the index components among samples from different origins were compared.Results It was found that 11 nucleoside and base components differed significantly among different origins of Fritillaria taipaiensis.Principal component analysis and hierarchical cluster analysis indicated that all samples could be clustered into 4 categories.Five characteristic components,including uracil,cytosine,uridine,inosine,and adenosine,were identified by PLS-DA.The nucleosides and bases in samples from Chongqing and Hubei were relatively high,and the quality of the samples was comparatively superior.Conclusion This method is simple,reproducible,accurate and reliable.It has screened out the index nucleoside and base components in the identification of Fritillaria taipaiensis of different origins,which can be used to initially elucidate the differences of samples between different origins.Additionally,it can better reflect the quality of Fritillaria taipaiensis,and can provide reference for the selection of procurement origin and the quality control for Fritillaria taipaiensis.

Tooth extraction is a common and widely employed therapeutic procedure in oral and maxillofacial surgery.Minimally invasive tooth extraction can reduce both physical and psychological trauma to the patients,and is widely recommended as a first-line clinical treatment.But currently no guidelines or consensus has been available to provide a systematic introduction of minimally invasive tooth extraction to guide the clinical practices.To address this issue,this consensus,based on a comprehensive literature review and clinical experiences of experts,systematically summarizes the indications,target patients,and contraindications of minimally invasive tooth extraction,the overall workflow of this procedure(preoperative preparation,surgical steps,postoperative management,postoperative instructions,medications,and follow-up),and its common postoperative complications to provide a comprehensive guidance for clinical application of this technique.

OBJECTIVE To evaluate the efficacy and safety of dimethyl fumarate （DMF） in the treatment of multiple sclerosis （MS）. METHODS Retrieved from CBM， Web of Science， PubMed， the Cochrane Library， Embase， CNKI， Wanfang Data， and VIP， randomized controlled trials （RCTs） about DMF （trial group） versus other drugs or placebo （control group） were collected. After data screening and extraction， quality evaluation， meta-analysis was conducted by using RevMan 5.3 software. RESULTS A total of 6 literature were included， involving 638 patients. Results of meta-analysis showed that the proportion of patients with lesion changes after treatment in the trial group was lower than control group [MD＝－0.65， 95%CI（－1.27， －0.02）， P＝0.04]； there was no statistical significance in recurrence rate [RR＝1.06， 95%CI（0.52，2.17）， P＝0.88]， the proportion of patients with new lesions after treatment [RR＝1.05， 95%CI（0.62，1.80）， P＝0.85]， expanded disability status scale after treatment [MD＝0.02，95%CI （－0.18， 0.23）， P＝0.82]， the incidence of adverse events [RR＝1.33， 95%CI（0.97， 1.84）， P＝0.08] or severe adverse events [RR＝0.95，95%CI（0.48，1.90），P＝0.89] between 2 groups. Results of sensitivity analysis showed the study obtained unstable recurrence rate and the incidence of adverse events， while other results were robust. CONCLUSIONS DMF can control the lesion progression in MS patients to some extent and doesn’t increase the incidence of adverse events and serious adverse events， but there is no significant advantage in reducing the recurrence rate and controlling the disability progression.

Tooth extraction is a common and widely employed therapeutic procedure in oral and maxillofacial surgery.Minimally invasive tooth extraction can reduce both physical and psychological trauma to the patients,and is widely recommended as a first-line clinical treatment.But currently no guidelines or consensus has been available to provide a systematic introduction of minimally invasive tooth extraction to guide the clinical practices.To address this issue,this consensus,based on a comprehensive literature review and clinical experiences of experts,systematically summarizes the indications,target patients,and contraindications of minimally invasive tooth extraction,the overall workflow of this procedure(preoperative preparation,surgical steps,postoperative management,postoperative instructions,medications,and follow-up),and its common postoperative complications to provide a comprehensive guidance for clinical application of this technique.

ObjectiveTo explore the related factors of troublemaking behaviors among patients with mental disorders induced by amphetamine-type stimulants （ATS）， and to provide references for the formulation of relevant intervention measures for ATS-induced mental disorders. MethodsA total of 105 patients who met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） for ATS-induced mental disorders were included， and classified into troublemaking group and non-troublemaking group. The general demographic data and clinical data of the selected individuals were collected， and all patients were assessed using Social Support Rating Scale （SSRS）. Then univariate analysis and multivariate Logistic regression model were used to screen the related factors of troublemaking behaviors. ResultsThe scores of SSRS， objective support dimension and social support utilization dimension were significantly lower in troublemaking group than those in non-troublemaking group， with statistical differences ［（24.10±6.59） vs. （28.94±5.59）， t=3.364， P=0.001； （5.50±1.96） vs. （8.20±2.13）， t=5.183， P<0.01； （4.60±2.26） vs. （6.28±1.90）， t=3.435， P=0.001］. Multivariate Logistic regression analysis showed that male （OR=6.061， P=0.014） was a risk factor， while high social support level （OR=0.873， P=0.018） was the protective factor for troublemaking behaviors among patients with ATS-induced mental disorders. ConclusionPatients with ATS-induced mental disorders of the males and with low social support level are at high risk of troublemaking behaviors.

Sepsis is an organ dysfunction that endangers a patient's life caused by an imbalanced infection response, and is a clinically critical illness. Despite a deep understanding of the pathogenesis of sepsis, there has been no significant improvement in sepsis mortality during clinical treatment at home and abroad. In recent years, the role of autophagy in the pathogenesis of sepsis has become a new research point in the field of medical research. Autophagy may protect the body by removing pathogenic microorganisms, neutralizing microbial toxins, and regulating cytokine release in sepsis. Studies have shown that autophagy plays a role in heart and lung organ dysfunction and inflammatory immune response in sepsis. Studies have also shown that hydrogen sulphide (H 2S) can activate autophagy through multiple signaling pathways, such as adenylate-activated protein kinase/mammalian target of rapamycin (AMPK/mTOR), phosphoinositide 3 kinase/Akt/mTOR (PI3K/Akt/mTOR), liver kinase B1/STE20 related adapter protein/mouse protein 25 (LKB1/STRAD/MO25) and microRNA-30c (miR-30c), etc. signaling pathways. This article reviewed the effects of H 2S on autophagy-related genes Beclin-1 and microtubule-associated protein light 3 chain (LC3) on intestinal function of sepsis in order to explore the H 2S-mediated autophagy gene expression in pus. The protective role of autophagy gene for intestinal dysfunction provides a new strategy for the treatment of sepsis in the future.

Sepsis is one of the main causes of death in critically ill patients. The intestinal tract is not only the organ easily involved in sepsis, but also the initial organ in the progression of sepsis, so the improvement of intestinal barrier function is the key of the treatment of sepsis. In recent years, it has been found that autophagy is involved in the pathological process of sepsis, maintaining mitochondrial function by clearing damaged organelles, inhibiting inflammation, oxidative stress and apoptosis, regulating immunity, maintaining intestinal homeostasis, and improving the condition and prognosis of sepsis. It is an effective target for the treatment of sepsis. As a new type of medical gas signal molecule, hydrogen sulfide (H 2S) can regulate autophagy by regulating multiple signal pathways, which has become a new target in the treatment of sepsis. This article reviews the signal pathway regulation mechanism of H 2S regulating autophagy in septic intestinal dysfunction.

BACKGROUND:Neural stem cells, as a hot topic in neuroscience research, have a wide application prospect in the treatment of neurological damage, but how to obtain a large number of terminally differentiated and purified nerve cells with homogeneous features is a difficult problem in this field. The use of intracellular fluorescence reporter system to track the process of neural stem cell differentiation and obtain a single kind of terminally differentiated and purified nerve cells provides a viable option. OBJECTIVE: To explore the value of GFAP promoter-driven fluorescence reporter system in tracing the neural differentiation of neural stem cells (NSCs). METHODS: Cerebral cortex of mouse embryos were primarily dissociated and sent for digesting and pipetting mechanically before suspension culture, followed by immunofluorescence staining of Nestin to identify their biological characteristics. Lentivirus carrying pLV/Final-neo-GFAP(promoter)-dTomato vector was employed to infect above-mentioned NSCs, and Geneticin (G418) was used to obtain purified NSCs at 14 days. Subsequently the purified cells were induced to differentiate into astrocyte-like cells; meanwhile red fluorescence changes in cells were observed by microscopy. The red fluorescent cells were then subjected to perform immunofluorescence staining at 13 days after induction. RESULTS AND CONCLUSION:The expression of Nestin in the isolated primary cells was strongly positive. Purified NSCs were obtained by lentivirus infection and subsequent G418 resistance selection at 14 days. After induced into astrocyte-like cells, the red fluorescence was observed in the cells under the microscope and furthermore, GFAP staining was also positive. Mouse NSCs carrying neo-GFAP(promoter)-dTomato were successfully obtained. The cells could express dTomato under the control of GFAP promoter, which provides a powerful tool for research on NSC differentiation mechanism, neural transplantation and tissue engineering product development.