BACKGROUND:Studies have shown that mitochondrial oxidative stress has an important role in the development of knee osteoarthritis,and Hemin can regulate the expression of mitochondria-related proteins. OBJECTIVE:To study the regulatory effect of Hemin on oxidative stress in mouse chondrocytes and its interventional effect and mechanism in knee osteoarthritis. METHODS:(1)In vitro cell experiment:Primary chondrocytes from C57BL/6 mice were extracted and induced with 10 ng/mL interleukin-1β to construct an in vitro chondrocyte model of osteoarthritis.The optimal concentration of Hemin(0,1,10,20,40,80,and 160 μmol/L)for the intervention in mouse chondrocytes was determined by cell counting kit-8 method.Chondrocytes were randomly divided into control group,model group(interleukin-1β)and Hemin group(interleukin-1β+Hemin).Reactive oxygen species,mitochondrial membrane potential and apoptosis of chondrocytes in each group were detected.(2)In vivo experiment:Adult C57BL/6 mice were randomly divided into normal group,model group(osteoarthritis)and Hemin group(osteoarthritis+Hemin),with eight mice in each group.After 4 weeks of Hemin treatment,the behavioral test and histopathological observation of the knee joint were performed in each group.Changes in extracellular matrix-related protein expression and apoptosis in chondrocytes and the expression level of Nrf2/HO-1 protein in cartilage tissue were detected. RESULTS AND CONCLUSION:In vitro experiment:the optimal concentration of Hemin on primary chondrocytes was 40 μmol/L.Compared with the model group,the level of reactive oxygen species was significantly reduced,the mitochondrial membrane potential was significantly improved,and the apoptosis of chondrocytes was reduced in the hemin-treated interleukin-1β-induced chondrocytes.In vivo experiment:After 4 weeks of treatment,compared with the model group,the lower limb function of mice in the Hemin group was significantly improved,the histopathological score was significantly improved,and the apoptosis of knee chondrocytes was significantly reduced.All these findings indicate that Hemin can alleviate oxidative stress,restore mitochondrial function and reduce apoptosis in mouse chondrocytes induced by interleukin-1β.Hemin can improve extracellular matrix degradation,promote chondrocyte anabolism,reduce catabolism and reduce chondrocyte apoptosis in knee osteoarthritis.It may act by activating the chondrocyte Nrf2/HO-1 signaling pathway in the inflammatory environment.

Objective To explore the differential gene expression profile and small molecule drugs for chronic atrophic gastritis(CAG)by bioinformatics technology.Methods Two gene expression samples of CAG chips(GSE27411,GSE116312)were obtained through the Gene Expression Synthesis(GEO)database,screen the differentially expressed genes(DEGs)of CAG by R language,and CAG immune-related genes were obtained for gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis.Protein-protein interaction(PPI)network was constructed using STRING database to screen out core genes,further study on immune invasion of core genes based on GSE27411 dataset,small molecular compounds interacting with core genes were predicted,molecular docking was carried out by MOE2022,and survival analysis was carried out by GEPIA2 website.Results A total of 517 DEGs were screened out based on GEO database.GO function enrichment analysis found that it mainly involved in granulocyte chemotaxis、leukocyte chemotaxis and neutrophil chemotaxis biological processes.KEGG pathway enrichment analysis showed that it mainly involved in cytokine-cytokine receptor interaction、nuclear factor kappa B signaling pathway、interleukin-17 signaling pathway.Six key genes of NR1H4、CCK、CCL20、CXCL1、LCN2、SAA1 were obtained by PPI network,through relevant verification,NR1H4 was regarded as the core gene.Immune cell infiltration analysis showed that central memory CD8 T cell、effector memeory CD4 T cell、gamma delta T cell、natural killer T cell、neutrophil and other immune cells may be involved in the development of CAG,and the neutrophil was positively correlated with NR1H4.It was predicted that six small molecular drugs,corilagin,stigmasterol,geniposide,tangeretin,chenodeoxycholic acid and epigallocatechin 3-gallate,have good binding force with NR1H4.Conclusion The potential mechanism of CAG is preliminarily explored in this study,the key gene of NR1H4 and neutrophil may play an important role in the"inflammatory cancer transformation"process of CAG,which can provide a certain reference for the study of the"inflammatory cancer transformation"mechanism of CAG.

Objective To investigate the risk factors of complications after CT-guided percutaneous transthoracic needle biopsy(PTNB)in the plateau environment.Methods A total of 858 patients who underwent CT-guided PTNB were selected,and the clini-cal data of patients,imaging features of lesions,information related to puncture operation,complications,and pathological results were analyzed retrospectively,then the independent risk factors of postoperative pneumothorax and pulmonary hemorrhage were summarized.Results Among 858 patients with lung biopsy,816 cases(95.1％)were successfully sampled,including 203 cases(23.7％)in the pneumothorax and 140 cases(16.3％)in the pulmonary hemorrhage.The statistical analysis results of the pneumo-thorax revealed significant differences in lesion location and lesion size(P＜0.05).The statistical analysis results of the pulmonary hemorrhage showed significant differences in lesion location,lesion size,puncture angle and puncture depth(P＜0.05).Independent risk factors affecting pneumothorax and pulmonary hemorrhage were illustrated in a forest plot.Conclusion Because the oxygen partial pressure and climate temperature are relatively low in the plateau environment,the cardiopulmonary function of patients will be affected by the living environment.Therefore,on the premise of ensuring the success rate of CT-guided PTNB,the optimal path and timing should be selected to reduce the risk of complications.

Objective To investigate the efficacy of CT-guided percutaneous microwave ablation for the treatment of primary hepatocellular carcinoma.Methods A total of 132 patients with primary hepatocellular carcinoma were divided into control group and study group(66 cases in each group)according to different treatment plans.The control group received transcatheter arterial chemoembolization(TACE)treatment,while the study group received TACE combined with percutaneous microwave ablation under CT guidance.The changes in serum tumor markers and liver function indicators were observed before and after treatment in the two groups,and the efficacy(short-and long-term)and safety of the two groups were compared.Results The levels of serum carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP),carbohydrate antigen 125(CA125),and carbohydrate antigen 19-9(CA19-9)in both groups decreased significantly after treatment compared to those before treatment,and intergroup comparison showed that the levels of CEA,AFP,CA125,and CA1 9-9 in the study group were significantly lower those after treatment(P＜0.05).Compared with those before treatment,the levels of alanine transaminase(ALT)and aspartate transaminase(AST)were decreased,and the level of albumin(ALB)was increased of both groups after treatment.The intergroup comparison showed that the study groups ALT and AST levels were lower and ALB level was higher(P＜0.05).The total effective rate of the study group was clearly higher than that of the control group(75.76％vs 46.97％,P＜0.05).The 1-year survival rates of the two groups were similar(90.91％vs 81.82％,P＞0.05),however,the 2-year survival rate of the study group was clearly higher than that of the control group(84.85％vs 63.64％,P＜0.05).Conclusion CT-guided percutaneous microwave ablation for the adjuvant TACE treatment of primary hepatocellular carcinoma can effectively reduce tumor burden and lower tumor marker levels,its short-and long-term efficacy is significant,with a low incidence of adverse reactions and good safety.

Objective:To explore the research status and hotspots of Shenling Baizhu Powder by using bibliometrics methods.Methods:The journal literature related to Shenling Baizhu Powder was retrieved by computer from CNKI, VIP, Wanfang Data and CBM from January 1, 2010 to December 31, 2022. NoteExpress 3.2 was used to merge and deduplicate, and the authors, institutions and keywords were analyzed visually by using VOSviewer 1.6.18 and CiteSpace 6.1.R6.Results:A total of 2 695 journal articles were included, and the annual number of articles showed an upward trend. The source journal with the most relevant articles was Chinese Clinical Research (72 articles). The main treatment diseases were digestive system diseases and respiratory system diseases. The author with most publications was Yang Qinhe (15 articles) from Jinan University. Jiangxi University of Chinese Medicine published the most articles (51 articles). In addition to search terms, the top three high-frequency keywords were clinical efficacy, TCM therapy and diarrhea. Keyword cluster analysis showed that the main research contents were applicable diseases, treatment methods, treatment principles, experimental models and literature types.Conclusion:Shenling Baizhu Powder mainly focuses on the treatment of digestive system diseases and respiratory system diseases in clinical application research, and the mechanism research focuses on immune function and intestinal flora.

Objective:To explore the predictive value of Epinephrine (EPI) level for Major adverse cardiovascular events (MACE) in patients with ST segment elevation myocardial infarction (STEMI) after emergency Percutaneous coronary intervention (PCI).Methods:A total of 107 patients with STEMI after emergency PCI in Northern Jiangsu People's Hospital of Jiangsu Province from September 2020 to November 2021 were selected. Baseline data, biochemical test data and coronary angiography data were collected. EPI level was measured by enzyme-linked immunosorbent assay. The following analysis was planned: ① Patients were divided into MACE group and non-MACE group, and various indicators of the two groups were compared; ② According to Receiver operating characteristic curve (ROC), the best cut-off values of EPI level which predict the occurrence of MACE were calculated respectively. Patients were respectively divided into high EPI level group and low EPI level group according to the best cut-off values, and the occurrence of MACE between the groups was compared respectively.③ Survival analysis (Kaplan-Meier method and log-rank test) was used to investigate the relationship between EPI level and MACE in patients with STEMI after emergency PCI. ④COX proportional hazard regression model was used to investigate the risk factors for MACE in patients with STEMI after emergency PCI.Results:①According to the inclusion and exclusion criteria, 107 patients with STEMI after emergency PCI were selected for the study, of which 19 patients had MACE and 88 patients did not have MACE. Compared with the non-MACE group, the patients in the MACE group were older, the proportion of Killip Ⅱ and above, NT-proBNP and EPI were higher, while FT3 was lower, and the differences were statistically significant ( P<0.05). The Gensini score of MACE group was significantly higher than that of non-MACE group ( P<0.01). ② According to ROC analysis, the Area under the curve (AUC) of EPI level for predicting MACE in patients with STEMI after emergency PCI was 0.699 (95% CI: 0.579-0.819, P=0.007), the best cut-off value of EPI level was 528.54, the sensitivity was 78.9%, and the specificity was 56.8%. The incidence of MACE in the high EPI level group was significantly higher than that in the low EPI group ( P=0.005).③ Kaplan-Meier survival curve showed that the higher the EPI level value, the higher the risk of MACE (log-rank test P=0.004). ④Multivariate COX regression analysis showed that age ( P=0.042), FT3 ( P<0.001), EPI level ( P<0.001) and Gensini score ( P=0.004) were independent risk factors for MACE. Conclusions:①EPI level significantly correlates with the occurrence of MACE in patients with STEMI after emergency PCI. EPI level has predictive value for MACE in patients with STEMI after emergency PCI. The higher the EPI value, the higher the risk of MACE. ②Multivariate COX regression analysis show that EPI level is independent risk factor for MACE in patients with STEMI after emergency PCI.

Objective To observe the value of residual neural network(ResNet)-101-feature pyramid network(FPN)model based on CT for differentiating benign and malignant lung nodules.Methods Totally 2 040 lung nodules in 2 000 patients were retrospectively enrolled,including 1 150 benign and 890 malignant nodules.The nodules were divided into training set(n=1 632)and test set(n=408)at the ratio of 8∶2,the former including 881 benign and 751 malignant ones,while the latter including 269 benign and 139 malignant ones,respectively.Taken ResNet-101 as the backbone network,combined with FPN,a classification model was established based on chest CT,and the efficiency of this model alone and combined with evaluation of physicians for differentiating benign and malignant lung nodules were evaluated.Results Among 269 benign lung nodules in test set,ResNet-101-FPN model alone correctly diagnosed 214 nodules(214/269,79.55%),while combined with evaluation of physicians correctly diagnosed 230 ones(230/269,85.50%).For 139 malignant nodules in test set,ResNet-101-FPN model alone correctly diagnosed 124 nodules(124/139,89.21%),while combined with evaluation of physicians correctly diagnosed 131 ones(131/139,94.24%).The sensitivity,accuracy and precision of ResNet-101-FPN model combined with evaluation of physicians for distinguishing benign and malignant lung nodules were all higher,while the specificity of the combination was lower than those of ResNet-101-FPN model alone,but the differences were not significant(all P＞0.05).Conclusion ResNet-101-FPN model could be used to distinguish benign and malignant lung nodules based on CT.Combining with evaluation of physicians could improve diagnostic efficiency of this model.

Objective:To systematically retrieve, evaluate, and summarize evidence on insomnia screening and assessment in adult malignant tumor patients.Methods:The clinical decisions, guidelines, and expert consensus on screening and assessing insomnia in malignant tumor patients were systematically searched in clinical decision support systems, guideline websites, literature databases, and professional association websites. This study conducted methodological quality evaluation and evidence extraction, translation, and integration.Results:A total of 8 articles were included, including three clinical decisions, two evidence-based guidelines, and three expert consensuses. After extracting and summarizing evidence, 38 pieces of evidence were obtained from three aspects of general management principles, insomnia screening, and insomnia assessment.Conclusions:The insomnia screening and assessment in adult malignant tumor patients should be standardized according to evidence-based standards and combined with specific clinical situations in China.

Aim To investigate the effects of naringenin on atherosclerotic plaque extracellular matrix remodeling and plaque stability.Methods Murine vascular smooth muscle cells were isolated and treated with various doges of naringenin.ApoE-/-mice were fed with high-fat diet and received naringenin by lavage for 16 weeks.Intraplaque nec-rotic core,contents of collagen and fibrous cap thickness were measured by Sirius red-Haematoxylin staining.Elastin was detected by Van Gieson staining.Matrix metalloproteinase(MMP)activity was determined by gelatin zymography and fluorescence-gelatin staining.Results Naringenin(50 μmol/L)increased signal tansducer and activator of transciption 6(STAT6)phosphorylation and promoted tissue inhibitor of metalloproteinase-3(TIMP-3)expression by 3.1-fold(P＜0.001).After naringenin(80 mg/kg)treatment,compared with the control group,the area of plaque necrotic core in aor-tic root decreased by 53％(P＜0.01),the thickness of fibrous caps increased by nearly 50％(P＜0.05),and the degree of elastic fiber degradation decreased.At the same time,naringenin promoted the expression of TIMP-3 in plaques,and corre-spondingly reduced the activity of MMP in plaques.Lentivirus mediated inhibition of TIMP-3 expression in vivo could reduce the protective effect of naringenin on plaque stability.Conclusion Naringin can increase the expression of TIMP-3 in smooth muscle cells,improve the composition of extracellular matrix,and promote the stability of atherosclerotic plaque.

Glioma is the most common primary tumor of the brain,accounting for 81%of central nervous system(CNS)malignant tumors.The degree of malignancy is high,and the current treatment methods are limited.In recent years,with the in-depth study of intestinal flora and brain-gut axis,it has been found that the diversity of gut microbiota plays an important role in the regulation of glioma.The mechanism is that the intestinal flora affects the development of glioma through the role of immune regulation and metabolites.In addition,it has been con-firmed that there is a certain correlation between some probiotics and glioma,which provides a new application prospect for the treatment of glioma.This paper discusses the main intestinal bacteria that regulate gliomas as well as the role and regulatory mechanisms of intestinal flora in the development of gliomas,and provides ideas for the discovery of new targets for glioma treatment and further improvement of treatment options.