ObjectiveTo investigate the effect and underlying mechanism of the Wulao Qisun prescription on pathological new bone formation in ankylosing spondylitis （AS）. MethodsSynovial fibroblasts were isolated from the hip joints of AS patients and observed under a microscope to assess cell morphology. The cells were identified using immunofluorescence staining. The isolated AS fibroblasts were divided into blank group， low drug-containing serum group， medium drug-containing serum group， high drug-containing serum group， and positive drug group. After drug intervention， cell proliferation was measured using the cell counting kit-8 （CCK-8） assay to observe fibroblast growth and determine the optimal intervention time. Alkaline phosphatase （ALP） activity was measured using the alkaline phosphatase assay. Protein expression of osteocalcin （OCN）， osteopontin （OPN）， and runt-related transcription factor 2 （Runx2） was detected by Western blot. The mRNA expression levels of Wnt5a， β-catenin， and Dickkopf-1 （DKK-1） were measured by real-time quantitative polymerase chain reaction （Real-time PCR）. ResultsCompared with the blank group， each drug-containing serum group of Wulao Qisun prescription and the positive drug group inhibited the proliferation of AS fibroblasts and reduced ALP expression （P<0.01）. Compared with the blank group， the low drug-containing serum group of Wulao Qisun prescription downregulated β-catenin mRNA expression （P<0.05）. The medium and high drug-containing serum groups and the positive drug group significantly downregulated Wnt5a and β-catenin mRNA expression （P<0.05， P<0.01）， with the positive drug group showing the most pronounced effect （P<0.01）. The high drug-containing serum group and the positive drug group significantly upregulated DKK-1 mRNA expression （P<0.01）. Compared with the blank group， the low drug-containing serum group of Wulao Qisun prescription inhibited the expression of OPN and Runx2 proteins （P<0.05， P<0.01）， while the medium and high drug-containing serum groups and the positive drug group inhibited the expression of OCN， OPN， and Runx2 proteins （P<0.05， P<0.01）. ConclusionThe Wulao Qisun prescription can inhibit the proliferation and osteogenic differentiation of AS fibroblasts， thereby delaying the formation of pathological new bone in AS. The possible mechanism involves the regulation of Wnt/β-catenin-related gene expression， further inhibiting the transcription of downstream target genes.

ObjectiveTo compare the quality of two kinds of honey-processed Lilii Bulbus（HPLB） prepared by empirical and pharmacopoeial methods based on chemical analysis and intelligent sensory technology， and to improve and upgrade the quality standard of HPLB on the basis of excavating and inheriting the traditional experience of famous experts in traditional Chinese medicine（TCM）. MethodSamples of HPLB were prepared according to the method in the 2020 edition of Chinese Pharmacopoeia（honey was added before frying） and the empirical method of the old pharmacists（honey was added after frying）， and the appearance characteristics， thin layer chromatography（TLC） identification， inspection， leachables and other items of the two kinds of samples were detected according to the methods under the Lilii Bulbus in the 2020 edition of Chinese Pharmacopoeia. The fingerprints of HPLB with different honey addition methods were established by high performance liquid chromatography（HPLC）， and the contents of regaloside A， regaloside B and 5-hydroxymethylfurfural（5-HMF） were determined， the quality difference between the two HPLB samples was evaluated by multivariate statistical analysis. Meanwhile， electronic nose and electronic tongue were used to measure the sense of smell and taste， and combined with multivariate statistical analysis， the difference sensors were screened with the variable importance in the projection（VIP） value>1 in order to compare the differences between the two kinds of HPLB. ResultCompared with HPLB prepared by the pharmacopoeial method， the sample prepared by the empirical method had lower water content， slightly higher soluble extract content， better appearance and easy storage. HPLC fingerprints of two kinds of HPLB samples were established， and the similarity between them was≥0.999， indicating that the composition of two species was similar. And 29 common peaks were calibrated， among which peaks 8 and 18 were regaloside A and regaloside B. The quantitative analysis of the index components in the two kinds of HPLB samples showed that the difference in the contents of regaloside A and regaloside B was not statistically significant， whereas the content of 5-HMF in empirical HPLB was significantly higher than that of the pharmacopoeial HPLB（P<0.01）. The electronic tongue and electronic nose test results showed that the umami， umami richness and saltiness of the empirical HPLB were higher than those of the pharmacopoeial HPLB. The results of electronic nose detection showed that the four sensors W1W， W2S， W5S and W1S were the differential odor sensors of the two samples， among which the response values of W1S and W2S sensors were higher than those of the pharmacopoeial HPLB， which might be related to the content of 5-HMF. ConclusionCompared with the pharmacopoeial HPLB， the empirical sample is of better quality， but the two can be clearly distinguished by electronic nose and electronic tongue， which can provide a reference for excavating and inheriting the traditional experience of famous experts in TCM and further improving the processing methods and quality standards of HPLB.

【Objective】 To investigate the suicidal attitude, ideation of adolescent patients with depression, and to analyze their relationships with family environment, in order to provide evidence for the clinical treatment of adolesent depression and to reduce the suicide rate. 【Methods】 Totally 376 adolescents diagnosed with depression in Lu′an area from March 2019 to October 2021 were selected as the case group, and 376 normal adolescents were selected as the control group.The suicide attitude questionnaire (QSA), Beck scale for suicide ideation (BSS) and family environment scale (FES-CV) were used to investigate the suicide attitude, suicidal ideation and family environment of adolescents in two groups. Logistic regression analysis was used to analyze the influencing factors of suicide attitude and ideation of adolescent depression patients.Pearson correlation test was used to analyze the correlations between suicidal attitude, ideation and family environment of adolescent patients with depression. 【Results】 The scores of QSA and BSS in the case group were significantly higher than those in the control group (t=43.352, 96.527, P<0.001).The scores of intimacy, emotional expression, knowledge and entertainment in FES-CV of the case group were lower than those of the control group (t=25.487, 14.573, 22.160, 18.906), the score of contradiction was higher than that of the control group (t=30.311), and the differences were statistically significant (P<0.001).Logistic regression analysis showed that age of 20 - 25 years old (OR=2.016,2.261), severe illness (OR=2.115, 2.192), dwelling in city (OR=2.442, 2.557) were all risk factors for suicidal attitude and ideation in adolescent depression patients (P<0.05).The scores of QSA and BSS in the case group were negatively correlated with the scores of intimacy, emotional expression, knowledge and entertainment in FES-CV (QSA: r=-0.891,-0.933,-0.788,-0.698, BSS: r=-0.901,-0.832,-0.725,-0.637, P<0.05), but they were positively correlated with the score of contradiction (r=0.848, 0.883, P<0.05). 【Conclusions】 The suicidal attitude, ideation of adolescents with depression are higher than those of normal adolescents. Age, illness and growth environment are all influencing factors for suicidal attitudes and ideation in adolescent depression patients, of which the suicide attitude, ideation of patients are closely related to family environment.

OBJECTIVE To study the correlation between SLCO1B1 （521T＞C and 388A＞G） gene polymorphisms and the efficacy and safety of rosuvastatin. METHODS Retrieved from PubMed， Embase， Cochrane Library， PharmGKB， CNKI database and Wanfang database， the studies about the effects of 521T＞C and 388A＞G gene polymorphisms on the efficacy and safety of rosuvastatin were collected during the inception to Dec. 2023. The included data were analyzed by using RevMan 5.3 software. RESULTS A total of 16 studies were included. The results of meta-analysis showed that 521T＞C gene polymorphism was significantly correlated with the efficacy of rosuvastatin. In the dominant gene model， compared with TT genotype， CC+TC genotype significantly improved the efficacy of rosuvastatin in raising high-density lipoprotein cholesterol （HDL-C） [MD＝2.38， 95%CI（0.61，4.16）， P＝0.009 0]. In the homozygous gene model， compared with TT genotype， CC genotype significantly improved the efficacy of rosuvastatin in reducing total cholesterol [MD＝－7.50，95%CI（－13.05， －1.95）， P＝0.008 0]. In heterozygous gene model， compared with TT genotype， TC genotype significantly improved rosuvastatin in reducing low-density lipoprotein cholesterol （LDL-C） [MD＝－5.14， 95%CI（－9.74， －0.53）， P＝0.03] and increasing HDL-C [MD＝5.67， 95%CI 232102311200） （2.61， 8.73）， P＝0.000 3]. 388A＞G gene polymorphism was also significantly correlated with the efficacy of rosuvastatin. In dominant or homozygous gene models， compared with AA E-mail：dushuzhang911@163.com genotype， GG+AG genotype [MD＝－6.88， 95%CI （－7.46，－6.30），P＜0.000 1] or GG genotype [MD＝－9.23， 95%CI（－9.41， 9.04）， P＜0.000 1] significantly improved the efficacy of rosuvastatin in lowering LDL-C. In the heterozygous gene model， compared with AA genotype， AG genotype significantly improved the efficacy of rosuvastatin in lowering LDL-C [MD＝－3.00， 95%CI（－3.19， －2.82）， P＜0.000 1]， total cholesterol [MD＝－5.80， 95%CI（－6.00， －5.59）， P＜0.000 1] and triglyceride [MD＝－11.79， 95%CI（－19.57， －4.02）， P＝0.003 0]. In the recessive gene model， compared with AA+AG genotype， GG genotype significantly improved the therapeutic efficacy of rosuvastatin in reducing LDL-C[MD＝－4.31， 95%CI（－8.47， －0.14）， P＝0.040 0] and elevating HDL-C [MD＝4.49， 95%CI （2.20， 6.77）， P＝0.000 1]. Under 4 gene models， there was a significant correlation between 521T＞C gene polymorphism and rosuvastatin-related ADR probability （P＜0.05）， but no significant correlation was found in 388A＞G gene polymorphism （P＞0.05）. CONCLUSIONS The polymorphism of 521T＞C gene is significantly related to the efficacy and safety of rosuvastatin in lowering lipid， and the C allele may be one of the factors leading to the increase of rosuvastatin in lipid-lowering efficacy and ADR. 388A＞ G gene polymorphism is significantly associated with the lipid-lowering efficacy of rosuvastatin， but not with its safety.

Ankylosing spondylitis （AS） is an inflammatory autoimmune disease with chronic low back pain as the main clinical manifestation， which mainly affects the axial joints， peripheral joints and various organs. In severe cases， the spine is stiff or deformed， which affects the quality of life and health of patients. The pathogenic factors of AS are complex， which are related to heredity， immunity and intestinal flora. The pathogenesis of AS is not clear yet. Among them， inflammatory reaction， bone destruction and heterotopic ossification are the main pathological features of AS， which play an important role in the disease process of AS. Traditional Chinese medicine has multi-target， multi-channel and multi-component pharmacological effects， which can prevent and treat AS by anti-inflammation， inhibiting bone destruction and preventing heterotopic ossification， and the clinical effect is remarkable， but there is no relevant literature report. Therefore， this review expounds the relationship between inflammatory reaction， bone destruction and heterotopic ossification and the occurrence and development of AS， and summarizes the latest research reports of traditional Chinese medicine in treating AS from anti-inflammatory， inhibiting bone destruction and preventing heterotopic ossification， aiming at providing reference and new ideas and directions for further research on the prevention and treatment of AS by traditional Chinese medicine.

Background and objective Lung cancer is the malignant tumor with the highest incidence rate and the heaviest disease burden in China.In recent years,lung cancer has shown a high incidence trend,seriously affecting the health of the population.In this paper,we analyze the characteristics of lung cancer incidence in 2019 and the trend of incidence rate from 2010-2019 in the tumor registration area of Gansu province,in order to provide a reference basis for the development of lung cancer prevention and control strategies in Gansu province.Methods By analyzing the cases of lung cancer incidence in the tumor registration area of Gansu province in 2019,we calculated the incidence rate,medium incidence rate,world in-cidence rate and other related indexes;we used Joinpoint to calculate the annual percentage change(APC)for trend analysis.Results In 2019,a total of 3757 new cases of lung cancer were reported in Gansu province,accounting for 14.96%of all new malignant tumors.The incidence rate,medium incidence rate and world incidence rate and world rate of lung cancer were 40.52/105,25.78/105,25.86/105;and the cumulative rate of 0-74 years old,and the truncation rate of 35-64 years old were 3.23%,40.03/105,respectively.The incidence of lung cancer rises with age,and is high in the age group of 40 years and above,and the incidence peaks in the male and female populations in the group of 75 years and above,and the group of 80 years and above,respectively.The crude incidence rate of lung cancer in the tumor registration area of Gansu province from 2010-2019 showed an overall increasing trend,and the rate of increase was relatively fast,with an APC 5.39%(P<0.05);Separately,accord-ing to gender,urban and rural areas,the incidence of lung cancer in all populations showed an increasing trend,and the APC of male,female,urban and rural populations were 4.98%,6.39%,6.26%,and 4.64%,respectively(all P<0.05).According to the trend analysis of lung cancer incidence rate by age group,only lung cancer incidence in the age group of 65 years and above increased at an annual average rate of 4.15%(P<0.05).Conclusion The incidence rate of lung cancer in the tumor registration area of Gansu province from 2010 to 2019 shows a rising trend year by year,and there are differences in the incidence of lung cancer in people of different genders,regions and age groups,so comprehensive prevention and control work should be carried out for the key populations of lung cancer incidence.

Objective To investigate the value of magnetic resonance image-diffusion weighted imaging(MRI-DMI)combined with attenuation imaging(ATI)in the diagnosis of focal nodular lesions<2 cm in the back-ground of fatty liver.Methods The clinical data of 68 patients with fatty liver complicated with focal nodular lesions<2 cm were retrospectively analyzed from June 2022 to June 2023 in Huaihe Hospital of Henan University.All patients underwent MRI,pathology and ATI examination.According to the degree of fatty liver disease,68 patients were divided into severe group(n=24),moderate group(n=27)and mild group(n=17).The apparent diffusion coefficient(ADC)and acoustic attenuation coefficient(AC)values of patients with different focal lesions were compared with clinical data,and the ADC values and AC values of patients with different fatty liver lesions were compared with clinical data,and the correlation was analyzed by Pearson.To analyze the value of MRI-DWI combined with AC value in the diagnosis of malignant fatty liver disease with focal nodular disease<2 cm.Results Pathological diagnosis showed that 41 of the 68 patients were benign and 27 were malignant.There were no significant differences in low density lipoprotein cholesterol(LDL-C),age,triglyceride(TG),sex,total cholesterol(TC)and high density lipoprotein cholesterol(HDL-C)between benign nodule group and malignant nodule group(P>0.05).There was no difference in TG,age,HDL-C,sex,TC and LDL-C among mild,moderate and severe groups(P>0.05).The ADC value of malignant nodule group was lower than benign nodule group under different b values(P<0.05),and the AC value of malignant nodule group was higher than that of benign nodule group(P<0.05).ADC value under different b values in the severe group was lower than mild and moderate groups(P<0.05),ADC value under different b values in the moderate group was lower than mild group(P<0.05),AC value in the severe group was higher than mild and moderate groups(P<0.05),and AC value in the moderate group was higher than mild group(P<0.05).ADC values at different b values were negatively correlated with the degree of fatty liver disease(P<0.05),but not with TG,HDL-C,TC and LDL-C(P>0.05).AC was positively correlated with the degree of fatty liver disease(P<0.05),negatively correlated with HDL-C(P<0.05),but not with TG,TC and LDL-C(P>0.05).The area under the curve(AUC)values of MRI-DWI,AC and their combi-nation in the diagnosis of fatty liver complicated with focal nodule disease<2 cm into malignancy were 0.775,0.773 and 0.909,respectively(P<0.05),and the AUC value of the combination was higher(P<0.05).Conclusion MRI-DWI and ATI have important value in the differential diagnosis of benign and malignant lesions of focal nodular lesions<2 cm in the background of fatty liver,and the combination of MRI-DWI and ATI has higher diagnostic value.

Objective To explore the clinical value of NOD-like receptor pyrin domain-containing protein 3(NLRP3)inflammasome levels combined with eosinophil cationic protein(ECP)/myeloperoxidase(MPO)ratio in predicting the recurrence of chronic rhinosinusitis after endoscopic sinus surgery.Methods 205 patients with chronic sinusitis who received treatment from the hospital from February 2018 to December 2022 after endoscopic sinus surgery were selected for prospective analysis.The patients were divided into non-recurrence group and recurrence group according to whether they relapsed one year after surgery.The factors influencing the recurrence of patients with chronic sinusitis after endoscopic sinus surgery were screened,and the predictive efficacy was evaluated by receiver operating characteristic curve(ROC).Results The NLRP3 inflammasome level,ECP/MPO ratio,sinus CT score,Lund-Kennedy score and immunoglobulin E in the relapsing group were higher than non-relapsing group(P<0.05).NLRP3 inflammasome level,ECP/MPO ratio,sinus CT score,Lund-Kennedy score and immu-noglobulin E were the influencing factors of postoperative recurrence in patients with chronic sinusitis(P<0.05).The area under the curve(AUC)values of NLRP3 inflammasome level,ECP/MPO ratio and combined prediction of postoperative recurrence in patients with chronic sinusitis were 0.823,0.815 and 0.899,respectively(P<0.05),and the AUC value of combined NLRP3 was higher(P<0.05).Conclusion NLRP3 inflammasome level combined with ECP/MPO ratio has a high value in predicting the risk of recurrence after nasal endoscopy.

MEK is a canonical effector of mutant KRAS; however, MEK inhibitors fail to yield satisfactory clinical outcomes in KRAS-mutant cancers. Here, we identified mitochondrial oxidative phosphorylation (OXPHOS) induction as a profound metabolic alteration to confer KRAS-mutant non-small cell lung cancer (NSCLC) resistance to the clinical MEK inhibitor trametinib. Metabolic flux analysis demonstrated that pyruvate metabolism and fatty acid oxidation were markedly enhanced and coordinately powered the OXPHOS system in resistant cells after trametinib treatment, satisfying their energy demand and protecting them from apoptosis. As molecular events in this process, the pyruvate dehydrogenase complex (PDHc) and carnitine palmitoyl transferase IA (CPTIA), two rate-limiting enzymes that control the metabolic flux of pyruvate and palmitic acid to mitochondrial respiration were activated through phosphorylation and transcriptional regulation. Importantly, the co-administration of trametinib and IACS-010759, a clinical mitochondrial complex I inhibitor that blocks OXPHOS, significantly impeded tumor growth and prolonged mouse survival. Overall, our findings reveal that MEK inhibitor therapy creates a metabolic vulnerability in the mitochondria and further develop an effective combinatorial strategy to circumvent MEK inhibitors resistance in KRAS-driven NSCLC.

Objective The correlation between Hb content,monocyte to high density lipoprotein cholesterol ratio(MHR)and post-stroke cognitive impairment(PSCI)was analyzed,and the application value of Hb and MHR in assisting diagnosis and evaluation of PSCI was discussed.Methods The clinical data of first-time stroke patients admitted to the Rehabilitation Department of the Second Affiliated Hospital of Nanjing Medical University from January 2021 to December 2022 were collected.The patients were divided into PSCI group and post-stroke no cognitive impairment(PSNCI)group by using MMSE scores.The differences in serum related indicators between the two groups were analyzed to find the risk factors of PSCI.Results There were a total of 81 stroke patients,including 43 in the PSCI group and 38 in the PSNCI group.There were no statistically significant differences in gender,age,history of hypertension,diabetes,smoking,drinking history,white blood cell count,neutrophil count,lymphocyte count,platelet count,total cholesterol,triglyceride,high density lipoprotein cholesterol and low density lipoprotein cholesterol between the two groups.The Hb content in PSCI group was significantly lower than that in PSNCI group,and the MHR was significantly higher than that in PSNCI group(P＜0.05).Spearman correlation analysis showed that Hb was positively correlated with MMSE score of stroke patients(rs = 0.353,P＜0.05),and MHR was negatively correlated with MMSE score of stroke patients(rs =-0.325,P＜0.05).According to whether PSCI occurred as the dependent variable,the analysis showed that lower Hb content and higher MHR were independent risk factors for PSCI(OR =1.056,95%CI:1.025-1.088,P＜0.05;OR =0.059,95%CI:0.006-0.577,P＜0.05).The area under ROC curve of Hb in predicting PSCI in stroke patients was 0.76(95%CI:0.656-0.865).The area under ROC curve of MHR for predicting PSCI in stroke patients was 0.62(95%CI:0.497-0.742).Conclusions Hb content and MHR are significantly correlated with PSCI.The decrease of Hb content and the increase of MHR are independent risk factors for PSCI.Hb content and MHR have certain reference value for the prediction and diagnosis of PSCI.