Asthma is a chronic inflammatory airway disease,and airway inflammation,airway hyper-respon-siveness and airway remodeling are the major pathological alterations in asthma.Numerous studies have demon-strated sphingosine metabolism disorders exist in asthma patients,and sphingosine-1-phosphate(S1P)is the end product of sphingolipid metabolism,which has become the focus of research as an important mediator of immune and inflammatory diseases,and is closely related to the development of asthma.In this paper,we summarize the role of S1P in the pathological changes of asthma from the relationship between S1P and asthma as well as its application in the clinical diagnosis,treatment and efficacy assessment of asthma,with a view to exploring more directions in the diagnosis and treatment of asthma.

Respiratory syncytial virus(RSV)infection is a potential susceptibility factor for recurrent wheezing,which can affect the occurrence and development of asthma through immune damage,airway epithelial barrier damage,airway inflammatory infiltration,airway hyperresponsiveness,and high expression of induced susceptibility genes.Traditional Chinese medicine believes that asthma caused by RSV infection is mostly caused by the imbalance of the body's qi after infection and the retention of evil qi.By combing the mechanism of RSV infection in the occurrence and development of asthma and the research on traditional Chinese medicine intervention in recent years,it is hoped to provide ideas for the future application of combined Chinese and Western medicine to prevent and treat asthma.

Based on the physiological and pathological characteristics of"spleen is often insufficient"in Children,Professor Jiang Yuren put forward the academic view of"the health of the spleen is not replenished but regulated",and took"spleen regulation meth-od"as the first choice for the treatment of spleen-stomach diseases such as anorexia,diarrhea,infantile malnutrition,iron deficiency anemia.By systematically analyzing the academic connotation,clinical practice,inheritance and development of Professor Jiang Yuren's"spleen regulation method"and combining with the current research progress,this article interprets the internal molecular mechanism of"spleen regulation method"to provide scientific basis for further promoting the clinical application and modern research of Professor Jiang Yuren's"spleen regulation method".

This study was performed to investigate the features of HBV-specific CD8+T cell reactivity in patients with chronic hepatitis B(CHB),HBV-induced liver cirrhosis(LC)or hepatocellular carcinoma(HCC).A total of 124 CHB patients,36 LC patients,and 114 HCC patients were enrolled in this study.The reactive HBV-specific CD8+T cells in peripheral blood were enumerated using an innovative ELISPOT system.In addition,19 CHB patients and 20 HCC patients were longitudinally monitored with an interval of 3-5 months.Data showed that the numbers of reactive HBV-specific CD8+T cells in CHB group were not significantly different from that in LC group,but obviously lower than that in HCC group(P=0.009 9),especially HBsAg-,HBpol-and HBe/cAg-specific CD8+T cells.In CHB group,the patients with normal ALT level,AST level,or low HBV-DNA load showed significantly more reactive HBV-specific CD8+T cells than the patients with abnormal ALT level,abnormal AST level,or high HBV-DNA load.Furthermore,the duration of NUCs treatment had an impact on the HBV-specific CD8+T cell reactivity in CHB patients,while different NUCs at the same treatment duration did not bring different reactivity of HBV-specific T cells.In LC group,the HBeAg-positive patients presented much more reactive HBV-specific CD8+T cells than the HBeAg-negative patients did.In HCC group,the numbers of reactive HBV-specific CD8+T cells in the patients with normal AFP level or normal DCP level were significantly higher than that in the patients with abnormal AFP level or abnormal DCP level.Longitudinal monitoring results showed that HBV-specific CD8+T cell reactivity displayed a slow upward trend in the CHB patients undergoing NUCs treatment,and an obvious increasing in the HCC patients undergoing combined treatment of targeted drugs and immunotherapy.Taken together,the features of HBV-specific CD8+T cell reactivity are distinct among the CHB,LC and HCC patients,and are influenced by virological indicators,tumor markers and treatment regimens.Therefore,more attention should be paid to the changes of HBV-specific CD8+T cell reactivity during clinical treatment.

[Objective]To analyze the medication rules and mechanism in treatment of children with functional constipation(FC)by activating the spleen.[Methods]Collecting 562 cases of children with functional constipation,cluster analysis was conducted using SPSS Statistics 24.0 software,association rule analysis was performed using SPSS Modeler 18.0 software,and complex network analysis was carried out using Liquorice software to derive the core formula.The active ingredients and targets of the core formula were screened using Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)and Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine(BATMAN-TCM),the targets related to FC were screened by Genome Annotation Database Platform(GeneCards),and the predicted targets were obtained after taking the intersection.Based on the Search Tool for the Retrieval of Interacting Genes/Proteins(STRING)database,the target gene protein-protein interaction(PPI)network was constructed,Cytoscape 3.8.0 software was used to build the core formula component-constipation-target network map,and topology analysis was performed with the help of Network Analyzer tool to identify the core targets.Based on the STRING database,gene ontology(GO)functional enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis were performed by using R language 4.2.2.[Results]The cases contained 1 121 prescriptions.The improvement rate of symptoms in each course was 86％to 97％,and the improvement rate of the three main symptoms of constipation was around 90％.Drug properties were mainly cold and flat,mostly were bitter and sweet.The drugs commonly belonged to the stomach and spleen.The core formula was obtained by drug association,clustering and complex network analysis,and was composed of nine drugs.The main active ingredients of the core formula were quercetin,methylheptenone,bile triene,niacin,lignan,kaempferol and baicalin.The key targets included prostaglandin-endoperoxide synthase 2(PTGS2),V-Jun sarcoma virus 17 oncogene homolog(JUN),protein kinase B1(AKT1),phosphoinositide-3-kinase regulatory subunit 1(PIK3R1),phosphatidylinositol-4,5-bisphosphate-3-kinase catalytic subunit alpha isoform(PIK3CA),and the regulation of inflammation-related pathways such as phosphatidylinositol-3-kinase/protein kinase B(PI3K/AKT)may be the mechanism of action of the core formula relieving constipation.[Conclusion]The core formula for the treatment of pediatric constipation by activating-spleen includes Zhishi(Aurantii Fructus Immaturus),Houpo(Magnoliae Officinalis Cortex),Baizhu(Atractylodis Macrocephalae Rhizoma),Jineijin(Galli Gigerii Endothelium Corneum),Shanzha(Crataegi Fructus),Lianqiao(Forsythiae Fructus),Juemingzi(Cassiae Semen),Huomaren(Cannabis Fructus),Huhuanglian(Picrorhizae Rhizoma),whose main components may affect the level of inflammatory factors and repairing the intestinal mucosa to restore the function of the intestinal smooth muscle,which has certain implications for the clinical application of the method of activating the spleen and the Chinese medicine treatment of FC in children.

Objective To investigate the effect of esketamine on perioperative pain and depression in patients with thoracoscopic pulmonary nodule resection. Methods A total of 120 patients with selective thoracoscopic pulmonary nodule resection were randomly divided into low-dose esketamine group (group L), high-dose esketamine group (group H) and saline control group (group C), with 40 cases in each group. Before skin incisionafter anesthetic induction, 0.25 mg/kgesketamine, 0.50 mg/kg esketamine and the equivalent amount of saline were separately administered for patients in the three groups. Visual Analogue Scale (VAS) score for pain and the Self-rating Depression Scale (SDS) score were compared among the three groups at the time points of one day before surgery (T₀), one day after surgery (T₁), three days after surgery (T₂), and the day of discharge (T₃), and postoperative analgesia within 24 h and perioperative adverse reactions were also recorded. Results The VAS scores for rest and coughing at T₁ were significantly lower in group L and group H than group C (P < 0.05); compared with group C, the total press number of analgesic pump with in 24 h and effective press number were significantly decreased in group L and group H, and the dosage of sufentanil was also significantly decreased(P < 0.05). There were no significant differences in depression scores at different time points among the three groups (P>0.05). There were no significant differences in the incidence rates of nausea, vomiting, dizziness, hallucinations, and nightmares among the three groups (P>0.05). Conclusion Esketamine can effectively alleviate pain on the first day after operation and reduce the dosage of opioid analgesics without increasing the incidence of adverse reactions in patients with thoracoscopic pulmonary nodule resection; compared with 0.25 mg/kg esketamine, 0.50 mg/kg esketamine doesn't demonstrate better postoperative analgesia or improvement in perioperative depression.

Objective To explore the rules of acupoint selection and manipulation application of Tuina in the treatment of diabetes peripheral neuropathy(DPN)with data mining technology.Methods The clinical research literature of Tuina for DPN from October 2022 was selected by searching four Chinese databases that CNKI,WanFang,VIP and Chinese Biomedical Literature Database.Using the traditional Chinese medicine inheritance assistance platform software,analyze and summarize the rules of selecting acupoints and applying manipulations in the treatment of DPN with Tuina.Results A total of 110 articles were included,including 65 acupoints and 33 manipulations.The acupoints with the highest frequency are Zusanli(ST 36),Sanyinjiao(SP 6),Taixi(KI 3),Yongquan(KI 1),Taichong(LR 3),Yanglingquan(GB 34),etc.The meridians mainly include Taiyin Spleen Meridian of Foot,Yangming Stomach Meridian of Foot,Taiyang Bladder Meridian of Foot and Shaoyin Kidney Meridian of Foot.Five-shu Points,Lower He-sea Points and Yuan-primary Points are commonly used specific points.The acupoints are mostly distributed in the lower limbs.The categories of Tuina manipulations mainly include squeezing-pressing manipulations,pushing rolling manipulations and composite manipulations.The Tuina manipulations mainly include kneading manipulation,pressing manipulation,point-pressing manipulation,pressing-kneading manipulation and twisting manipulation with both palms.Conclusion The acupoint selection and manipulation application of Tuina in treating DPN have certain rules,and the main treatment principles are to regulate the organs and dredge collaterals,and to replenish qi and promote blood circulation,which can provide objective basis for clinical treatment.

Objective To analyze the changes in the anterior talofibular ligament(ATFL)after injury in patients with ankle sprains.Methods A total of 97 ATFL injury patients with ankle sprains exceeding 3 months and clinical symptoms were selected as injury group from the outpatient department of Huzhou Central Hospital from January 2019 to December 2021.During the same period,A total of 112 healthy individuals were recruited as control group.The echo changes of ATFL on both sides of the enrolled patients were explored under the natural and stress states of the ankle joint,the length,width,and thickness of ATFL were measured.The ATFL data changes of the two groups of enrolled patients were statistically analyzed.Results The ATFL boundaries of patients in injury group were mostly unclear,and the ligament echoes were disordered;The ATFL boundaries of control group participants were clear,with uniform echoes.There were no statistically significant differences in the length,width,and thickness of ATFL on both sides(P>0.05).The comparison of ATFL on both sides of injury group patients showed an increase in the length and thickness of ATFL on the injured side,with statistical significance(P<0.05),while the difference in width was no statistically significant(P>0.05).The length and width of ATFL increased in injury group of patients with natural injury than those in control group,and the differences were statistically significant(P<0.01),while the difference in thickness was not statistically significant(P>0.05);The length and width of ATFL in injury group of patients increased under stress than those in control group,and the differences were statistically significant(P<0.01),while the difference in thickness was no statistically significant(P>0.05).The comparison of the difference in length,width,and thickness of ATFL between the two groups of participants under non stress and stress states showed that the differences in length and thickness of ATFL in injury group were statistically significant(P<0.01),while the difference in width change was no statistically significant(P>0.05).Conclusion The length of ATFL in patients with ankle sprains significantly increases under stress and natural conditions,and the difference in ATFL length changes was also more pronounced.

Issues caused by maxillofacial tumours involve not only dealing with tumours but also repairing jaw bone defects. In traditional tumour therapy, the systemic toxicity of chemotherapeutic drugs, invasive surgical resection, intractable tumour recurrence, and metastasis are major threats to the patients' lives in the clinic. Fortunately, biomaterial-based intervention can improve the efficiency of tumour treatment and decrease the possibility of recurrence and metastasis, suggesting new promising antitumour therapies. In addition, maxillofacial bone tissue defects caused by tumours and their treatment can negatively affect the physiological and psychological health of patients, and investment in treatment can result in a multitude of burdens to society. Biomaterials are promising options because they have good biocompatibility and bioactive properties for stimulation of bone regeneration. More interestingly, an integrated material regimen that combines tumour therapy with bone repair is a promising treatment option. Herein, we summarized traditional and biomaterial-mediated maxillofacial tumour treatments and analysed biomaterials for bone defect repair. Furthermore, we proposed a promising and superior design of dual-functional biomaterials for simultaneous tumour therapy and bone regeneration to provide a new strategy for managing maxillofacial tumours and improve the quality of life of patients in the future.
Biocompatible Materials ; Bone Regeneration ; Bone and Bones ; Humans ; Quality of Life

Objective:To evaluate the role of hippocampal histone deacetylases (HDACs) in perioperative neurocognitive disorders (PND) and the relationship with postsynaptic dense protein 95 (PSD95) in rats.Methods:Sixty clean-grade healthy male Sprague-Dawley rats, aged 10-14 weeks, weighing 250-280 g, were divided into 3 groups ( n=20 each) using a random number table method: control group (group C), surgery group (group S) and HDAC inhibitor MS-275 group (group MS-275). Exploratory laparotomy was performed under 3% sevoflurane anesthesia in group S. MS-275 10 mg/kg was intraperitoneally injected at 0.5 h before exploratory laparotomy in group MS-275.Morris water maze tests were performed on 1 day before surgery and 1, 3 and 7 days after surgery.Ten rats were sacrificed on 1 day after surgery, and hippocampal tissues were obtained for determination of the expression of HDAC1-3 and PSD95 protein and mRNA by Western blot and real-time polymerase chain reaction, respectively.The density of hippocampal neurons was determined by the Nissl staining. Results:Compared with group C, the postoperative escape latency was significantly prolonged, the number of crossing the original platform was decreased, the density of hippocampal neurons was decreased, the expression of HDAC2 protein and mRNA was up-regulated, and the expression of PSD95 protein and mRNA was down-regulated in group S ( P<0.05 or 0.01). Compared with group S, the postoperative escape latency was significantly shortened, the number of crossing the original platform was increased, the density of hippocampal neurons was increased, the expression of HDAC2 protein and mRNA was down-regulated, and the expression of PSD95 protein and mRNA was up-regulated in group MS-275 ( P<0.05 or 0.01). There was no significant difference in the expression of HDAC1 and HDAC3 protein and mRNA among the three groups ( P>0.05). Conclusion:HDAC2 is involved in the pathophysiological mechanism of PND by down-regulating the expression of PSD95 in rats.