Sepsis is one of the common severe diseases caused by the dysregulated host response to infection， which seriously threatens the life and health of human beings all over the world. The incidence and mortality of the disease are extremely high， and it has always been an urgent problem to be solved in the field of acute and critical diseases. At present， anti-infection， fluid resuscitation， mechanical ventilation and other programs are most used in clinic to treat sepsis， but their poor prognosis and high cost and other issues remain to be resolved. Therefore， it is necessary to explore a new， efficient， safe and inexpensive drug and treatment model at this stage. The treatment of traditional Chinese medicine （TCM） is based on syndrome differentiation and holistic concept. It can effectively regulate the progression of sepsis， maintain the homeostasis of the body， and has fewer adverse reactions. It has achieved good clinical results. In recent years， a large number of studies have shown that TCM can reduce the inflammatory response by regulating the Toll-like receptor 4（TLR4） signaling pathway， thereby reducing the severity and mortality of sepsis patients. However， there is still a lack of systematic exposition of TCM regulating TLR4 signaling pathway in the treatment of sepsis. Therefore， this article summarizes the relationship between TLR4 signaling pathway and sepsis and the mechanism of TCM in the disease by searching and consulting relevant literature in recent years. It is found that some Chinese medicine monomers and active ingredients， Chinese medicine compounds and Chinese medicine preparations can effectively reduce systemic inflammatory response， repair organ damage and improve the prognosis of sepsis by inhibiting the activation of TLR4 signaling pathway. However， due to various limitations， some studies have directly focused on the differential expression and function of TLR4， ignoring the downstream molecular expression and phenotypic effects of TLR4. The alternative mechanism， relationship and specific molecular mechanism of the pathway are still unclear. There are problems such as unclear pharmacokinetics and unclear mechanism in the pro- and anti-inflammatory balance， which need to be further studied and explored in order to provide new ideas for the potential treatment and drug development for sepsis.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Metabolic reprogramming is a hallmark of cancer, including lung cancer. However, the exact underlying mechanism and therapeutic potential are largely unknown. Here we report that protein arginine methyltransferase 6 (PRMT6) is highly expressed in lung cancer and is required for cell metabolism, tumorigenicity, and cisplatin response of lung cancer. PRMT6 regulated the oxidative pentose phosphate pathway (PPP) flux and glycolysis pathway in human lung cancer by increasing the activity of 6-phospho-gluconate dehydrogenase (6PGD) and α-enolase (ENO1). Furthermore, PRMT6 methylated R324 of 6PGD to enhancing its activity; while methylation at R9 and R372 of ENO1 promotes formation of active ENO1 dimers and 2-phosphoglycerate (2-PG) binding to ENO1, respectively. Lastly, targeting PRMT6 blocked the oxidative PPP flux, glycolysis pathway, and tumor growth, as well as enhanced the anti-tumor effects of cisplatin in lung cancer. Together, this study demonstrates that PRMT6 acts as a post-translational modification (PTM) regulator of glucose metabolism, which leads to the pathogenesis of lung cancer. It was proven that the PRMT6-6PGD/ENO1 regulatory axis is an important determinant of carcinogenesis and may become a promising cancer therapeutic strategy.

Objective:To investigate the relationship between the function of Schlemm canal and the efficacy of selective laser trabeculoplasty (SLT) in patients with primary open-angle glaucoma (POAG).Methods:An observational case series study was conducted.Seventeen POAG patients (25 eyes), including 12 males (18 eyes) and 5 females (7 eyes), were enrolled in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from March to December, 2017.The three-mirror contact lens was adopted to observe the presence of blood reflux in Schlemm canal before aerobic exercise, and positive referred to that blood reflux was observed in any region of Schlemm canal, and negative was defined as that no blood reflux was observed in Schlemm canal.The intraocular pressure (IOP) and blood pressure of subjects were measured before and after exercise test by the non-contact tonometer and automatic blood pressure monitor respectively.Positive referred to the IOP reduction ≥4.6 mmHg (1 mmHg=0.133 kPa) and negative was defined as the IOP reduction <4.6 mmHg.Optical coherence tomography (OCT) was used to observe whether Schlemm canal was dilated or not and the dilated area before and after exercise test.Positive referred to the opening clock position of Schlemm canal was larger and/or the Schlemm canal was dilated at one or more clock position.The subjects presenting positive in above three indicators were classified as the positive Schlemm canal function group (8 eyes). The subjects presenting positive in above one or two indicators were classified as the mixed Schlemm canal function group (11 eyes). The subjects presenting negative in above three indicators were classified as the negative Schlemm canal function group (6 eyes). All subjects received SLT treatment.The IOP was examined at postoperative 1 week, 2 weeks and 1 month.The IOP, IOP reduction and rate of IOP reduction were compared among the three groups at various time points.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (No.TJ-IRB20160306). Written informed consent was obtained from each subject.Results:The preoperative IOP and postoperative 1-week, 2-week and 1-month IOP were (20.33±9.22), (17.10±2.98), (19.00±3.94) and (19.33±4.32) mmHg of negative Schlemm canal function group, (25.75±9.03), (20.00±7.60), (19.18±4.46) and (18.00±3.63) mmHg of mixed Schlemm canal function group and (22.28±4.78), (18.75±8.53), (15.50±4.98) and (14.38±3.24) mmHg of positive Schlemm canal function group, respectively.There was no statistical significance in the IOP value among the three groups ( Fgroup=1.028, P=0.374). The difference in IOP before and after surgery was statistically significant ( Ftime=6.751, P=0.002). Compared with preoperative IOP, the postoperative 1-week IOP of the negative Schlemm canal function group, the postoperative 1-week, 2-week and 1-month IOP of the mixed Schlemm canal function group, and the postoperative 2-week and 1-month IOP of positive Schlemm canal function group were significantly decreased (all at P<0.05). There was no significant difference in IOP reduction or the rate of IOP reduction among the three groups after operation ( Fgroup=0.952, P=0.401; Ftime=0.828, P=0.402; Fgroup=1.840, P=0.182; Ftime=0.419, P=0.660). Conclusions:POAG patients with better function of Schlemm canal have a better IOP-lowering efficacy after SLT treatment.Blood reflux in Schlemm canal before exercise, reduced IOP and dilated Schlemm canal after exercise can be considered as indicators to evaluate Schlemm canal function.

Objective: To explore the feasibility and the value of CT enterography (CTE) in the quantitative evaluation of Crohn's disease (CD). Methods: Retrospectively analyzed 49 patients diagnosed as CD by clinical, enteroscopy, pathology, and imaging from April 2016 to June 2017 in Zhongnan Hospital of Wuhan University. All patients underwent routine enteroscopy and standardized CTE. The interval between the two examinations was less than 2 weeks. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were measured at intervals. The ESR ranged from 2.0 to 97.0 mm/1 h, with an average of (30.6±26.5) mm/1 h, CRP from 0.3 to 143.3 mg/L, and a median of 27.7 mg/L. CD patients were classified into inactive, mild and moderate-severe according to Crohn's disease simplified endoscopic activity score(SES-CD) after enteroscopy. CTE evaluated the site of lesion, the thickness and enhanced patterns of the most severe lesions of the bowel wall, mural enhanced CT value in the portal vein phase, ΔCT value, stenosis, perienteric inflammation, mesenteric hypervascularity (comb sign), enlarged lymph nodes, abdominal abscesses, fistulas, etc. The Chi-square test was used to compare the differences of enhanced patterns among different groups. ANOVA (Analysis of Variance) was used to compare the differences in bowel wall thickness, plain CT values, mural enhanced CT value in the portal vein phase and ΔCT values among different groups. The correlation between CTE parameters and SES-CD or laboratory data was analyzed by Pearson (normal distribution data) or Spearman (skewed distribution data). Results: SES-CD ranged from 1 to 15, with an average of 5.1±2.6. Among 49 cases, 13 were inactive, 19 were mild, and 17 were moderate-severe. There were 25 cases of intestinal obstruction or stenosis, including 24 cases in the active group and 1 case in the non-active group, and the difference was statistically significant (χ²=13.3, P<0.01). The short diameter of lymph nodes was more than 10 mm in 7 patients, all of them were active patients; 32 cases were mesenteric hypervascularity, manifested as "comb sign" , among them, 28 cases were active and 4 cases were non-active, and the difference was statistically significant (χ²=9.3, P<0.01). Perienteric inflammation was manifested in 30 cases, including 27 cases in the active group and 3 cases in the non-active group, and the difference was statistically significant (χ²=10.8, P<0.01). The enhanced patterns of thickened bowel wall in the non-active was dominated by C and D types, while A and B types was mainly in the active group, and the difference was statistically significant (P<0.05); There were significant differences in bowel wall thickness, mural enhanced CT value in the portal vein phase and ΔCT values between different groups (P<0.05), however, the difference of plain CT values between different groups was not significant (P>0.05). Bowel wall thickness, mural enhanced CT value in the portal vein phase and ΔCT values were all moderately correlated with SES-CD (r were 0.564, 0.585, 0.533, respectively; P all <0.01). Bowel wall thickness was positively correlated with ESR and CRP(r were 0.542, 0.452, respectively; P all <0.01). Mural enhanced CT value in the portal vein phase and ΔCT values were not correlated with ESR or CRP (P>0.05). Conclusion The bowel wall thickness, mural enhanced CT value in the portal vein phase and the ΔCT value can be used to accurately assess the activity of CD lesions.

Tubulin has been shown to be an effective target for the development of cytotoxic agents against prostate cancer. Previously, we reported that Lx2-32c is an anti-tubulin agent with high binding affinity to tubulin. In this study, we investigated the potential of Lx2-32c to act as an effective cytotoxic agent in the treatment of prostate cancer. MTT assays showed that Lx2-32c was cytotoxic to all tested prostate cancer cell lines. The Lx2-32c-treated cells typically exhibited a rounded morphology associated with the onset of apoptosis, as evidenced by immunocytochemical staining. Human prostate cancer cell lines treated with Lx2-32c arrest in the G2/M phase of the cell cycle and the treatment is associated with an increased ratio of cells in the sub-G0/G1 phase as determined by flow cytometry. Furthermore, expression of the cleaved form of poly (ADP-ribose) polymerase in prostate cancer cell lines treated with Lx2-32c was shown by Western blotting assay. Xenograft implants of LNCaP and PC3-derived tumors in nude mice showed that Lx2-32c treatment significant inhibited tumor growth with effects equivalent to those of docetaxel. These findings demonstrate the potential of Lx2-32c as a candidate antitumor agent for the treatment of prostate cancer.

[Objective] To survey the compliance and related factors of our hospital stroke patients by acupuncture treatment in recent years. [Method] Selection of stroke patients with stable vital signs after rehabilitation treatment from Jan.1,2012 to Dec.31,2013 in our hospital as the objects of study, the demographic characteristics of patients were collected by hospital information system, the injury degree of living ability, depression and the degree of family support for patients were assessed by recovery scale, and the correlation between above factors and compliance were analyzed by comprehensive statistical software.[Result] In 168 patients, only 72 (42.86%) patients had a good compliance, the compliance of women was better than that of men(χ2=7.74, P=0.005), the compliance of better educated patients was better than that of less educated patients(P<0.05), the compliance of mental health patients was better than that of depressive patients(OR=1.731, P=0.031), the compliance of family support condition rated as good patients was better than that of other patients(OR=1.070, P=0.014), and other influence of factors on compliance had not a statistically significance(P>0.05). [Conclusion] The patients with better education, better family economic condition, milder depression and more families support, had the better compliance. In the course of daily acupuncture treatment, the medical staff should pay more attention to the health education to the patients and their families in order to help patients have a good attitude for treatment; the psychological care should be implemented and patients mentality should be adjusted at any time; a good family and social support system for patients should be built by the help of medical staff.

Objective To investigate the effect of unilateral electric stimulation of lower limbs movement on central nervous system. Methods 8 right-footed healthy men accepted electrical stimulation to evoke dorsiflexion of the right ankle, while the cerebral cortex activations were observed with functional magnetic resonance imaging. Results For electrical stimulation evoked contraction task, the significant activations were observed in the bilateral primary motor cortex, primary sensory area, secondary somatosensory cortex, cingulated gyrus; ipsilateral premotor area and contralateral supplementary motor area. Conclusion Unilateral electrical stimulation may result in activations of bilateral cerebral cortex.

OBJECTIVE: To evaluate the inhibited effect of matrine on human nasopharyngeal carcinoma CNE2 cells and the expression of apoptosis-related gene Caspase-3 mRNA, Caspase-3, Caspase-8, Caspase-9 protein. And to explore the inhibiting effect of matrine on the apoptosis of human nasopharyngeal carcinoma CNE2 cells. METHOD: In vitro experiments, MTT assay was used to detect the effect of matrine on CNE2 cell proliferation with different concentration. The expression levels of Caspase-3 were detected by real-time PCR. Western Blot was used to gauge the levels of Caspase-3, Caspase-8 and Caspase-9 protein. RESULT: MTT results showed significant inhibitory action of matrine on CNE2 cells proliferation in does-dependent manner, which could up-regulate the expression of Caspase-3 mRNA and Caspase-3, Caspase-8, Caspase-9 protein in a dose-dependent manner. CONCLUSION Matrine could inhibit CNE2 cells proliferation in a does-dependent,that was closely related to the up-regulation of Caspase-3 mRNA and Caspase-3, Caspase-8 and Caspase-9 protein expression, and to the cascade reaction of Caspase.
Alkaloids ; pharmacology ; Apoptosis ; drug effects ; Carcinoma ; Caspase 3 ; Caspase 8 ; Caspase 9 ; Caspases ; metabolism ; Cell Line, Tumor ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; enzymology ; pathology ; Quinolizines ; pharmacology

Hemiparalysis clinically can be divided into acute,spasm,comparative recovery and sequelae stages. Acupuncture and moxibustion and recovery should be differently administered under different stages. Spasm stage is the key time for the recovery treatment of acupuncture and moxibustion,i.e. the voluntary exercise of preventing contracture of and deformed joints,and recovering the normal limbs by applying acupuncture and collateral massage to strengthen Yin collateral treatment.