OBJECTIVE To investigate the ameliorative effects and mechanisms of Miao medicine Euphorbia humifusa on hepatic fibrosis （HF） model rats. METHODS Thirty-eight rats were randomly assigned according to a random number table into control group （normal saline， n＝7）， model group （normal saline， n＝7）， E. humifusa low-， medium- and high-dose groups （0.675， 1.35， 2.70 g/kg， n＝6）， and silybin group （positive control， 18.9 mg/kg， n＝6）. All groups except the control group were subjected to HF induction via intraperitoneal injection of carbon tetrachloride. After modeling， rats were administered their respective drugs/normal saline by gavage， once a day， for 30 days. At the last medication， the liver index was calculated， and serum levels of tumor necrosis factor-α （TNF-α）， interleukin-17 （IL-17）， IL-1β， IL-6， alanine transaminase （ALT）， aspartate transaminase （AST）， and hydroxyproline （HYP） were measured. Liver morphology and HF changes were observed. Levels of transforming growth factor- β1 （TGF- β1） and α-smooth muscle actin （α-SMA）， as well as the expressions of α -SMA， proteins related to TNF- α/NF- κB signaling pathway， mRNA expressions of TNF-α and NF-κB p65 in liver tissue were determined. RESULTS Compared with model group， liver index， serum levels of TNF-α， IL-17， IL-1β， IL-6， ALT， AST and HYP， relative expression of NF-κB p65 mRNA， and the levels of TNF-α and α-SMA proteins and phosphorylated NF-κB p65 in liver tissues of rats from administration groups， the expressions of α-SMA and TGF-β1 in liver tissue of rats from E. humifusa medium-dose and high-dose groups， as well as positive staining percentage and mRNA expression of TNF- α in liver tissue of rats from E. humifusa high-dose group were all decreased significantly （P＜0.05 or P＜0.01）； IκBα protein expression from administration groups was significantly increased （P＜0.05 or P＜0.01）. Pathological changes and the degree of HF in the liver tissues of rats from administration groups were ameliorated to various extents. CONCLUSIONS E. humifusa may alleviate HF in rats by inhibiting the activation of the TNF-α/NF-κB signaling pathway.

To compare the therapeutic effects of short-term spinal cord stimulation (stSCS) and long-term spinal cord stimulation (ltSCS) on patients with prolonged disorders of consciousness(pDoC).

Objective To explore the causal association between gut microbes and non-alcoholic fatty liver disease(NAFLD)by Mendelian randomisation analysis.Methods Genetic instrumental variables for gut microbiota were identified from a gene-wide association study of 18 340 participants,and summary statistics for NAFLD were ob-tained from the FinnGen database,which provided data on 894 NAFLD cases and 217 898 controls using the IVW method as the primary analysis.In order to test the robustness of the results,MR-Egger method,WM method,Simple Mode method,Weighted Mode method were used for Mendelian randomisation analysis,and heterogeneity test,sensitivity analysis,and multiplicity analysis were performed.Results class Gammaproteobacteria IVW re-sults showed(OR=0.621,95％CI=0.412～0.934,P=0.022);family Enterobacteriaceae IVW results showed(OR=1.481,95％CI=1.069～2.053,P=0.018);genus Lachnospiraceae IVW results showed(OR=1.405,95％CI=1.036～1.904,P=0.029);genus Prevotella7 IVW results showed(OR=0.834,95％CI=0.714～0.974,P=0.021);genus Prevotella9 IVW results showed(OR=1.251,95％CI=1.025～1.527,P=0.027);order Desulfovibrionales IVW results showed(OR=0.714,95％CI=0.519～0.982,P=0.038);or-der Enterobacteriales IVW results showed(OR=1.481,95％CI=1.069～2.053,P=0.018).And there was no heterogeneity in the heterogeneity test,and the sensitivity analyses all showed robustness and no pleiotropy was found.Conclusion This study implicates class Gammaproteobacteria,family Enterobacteriaceae,genus Lachno-spiraceae,genus Prevotella7,genus Prevotella9,order Desulfovibrionales,order Enterobacteriales seven species of gut microorganisms have a causal relationship with NAFLD.

OBJECTIVE To study the inhibitory effect and mechanism of total flavonoids from Melicope pteleifolia （TF-MPL） on transplanted tumor of colorectal cancer in nude mice. METHODS The transplanted tumor model of colorectal cancer was induced by injecting 0.2 mL colorectal cancer cell LoVo subcutaneously via the right armpit of nude mice. After successful modeling， nude mice were randomly divided into model group， 5-fluorouracil group （positive control， 10 mg/kg）， TF-MPL high- dose and low-dose groups （25， 12.5 mg/kg）； a normal group （normal saline containing 0.3% carboxymethyl cellulose sodium） without modeling was additionally set up， with 6 mice in each group. Each group was intraperitoneally injected with the corresponding drug solution/solvent for 21 consecutive days. The inhibitory rate of the transplanted tumor， liver and spleen index， and the levels of tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） in serum were detected after the last medication； the morphological changes of tumor tissue were observed； immunohistochemical staining was used to detect protein expressions of Toll- like receptor 4 （TLR4） and nuclear factor-κB subunit p65 （NF-κB p65） in tumor tissue of nude mice. Western blot assay was used to detect protein expressions of TLR4， myeloid differentiation factor 88 （MyD88）， TNF receptor-associated factor 6 （TRAF6）， interleukin-1 receptor-associated kinase 1 （IRAK-1）， NF-κB p65 and caspase-3 in tumor tissue of nude mice. RESULTS Compared with the model group， TF-MPL high-dose group showed a significant decrease in tumor weight （inhibitory rate of 36.91%）， liver and spleen index， serum levels of TNF-α and IL-6 and protein expressions of TLR4， MyD88， TRAF6，IRAK-1 and NF- κB p65 （P＜0.05 or P＜0.01）； the expression of caspase-3 protein was increased significantly （P＜0.05）， and more tumor cell shrinkage and deformation， nuclear pyknosis and fragmentation were observed. CONCLUSIONS TF-MPL can significantly inhibit the growth of transplanted tumor of colorectal cancer in nude mice， the mechanism of which may be associated with reducing inflammatory response， inhibiting TLR4/MyD88/NF-κB signaling pathway， and promoting apoptosis in colorectal cancer cells.

OBJECTIVE To investigate the effect and mechanism of anwulignan on improving hepatic fibrosis in rats. METHODS Fifty SD rats were randomly divided into the normal group， model group， colchicine tablet group （0.1 mg/kg）， and anwulignan high-dose and low-dose groups （2.8 and 0.7 mg/kg）， with 10 rats in each group. Except for the normal group， all groups of rats were intraperitoneally injected with 50% CCl4 olive oil mixed solution to replicate the rat model of liver fibrosis. At the end of the modeling， rats in each group were given the corresponding drugs or distilled water intragastrically from the 9th week， once a day， for 4 weeks consecutively. During the experimental period， the general condition of the rats was observed； the liver index was calculated； the serum levels of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， superoxide dismutase （SOD） and malondialdehyde （MDA） were detected by colorimetric assay； the pathomorphology of the liver tissues and liver fibrosis were observed by HE staining and Masson staining； Western blot was used to detect the expression levels of phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） pathway and apoptosis-related proteins in liver tissues. RESULTS Compared with the normal group， the dietary amount of rats in the model group decreased， with sparse and disheveled fur， slow response， and a slower rate of weight growth or weight loss； the liver index was significantly increased （P＜0.01）； the serum levels of ALT， AST and MDA were significantly increased， and the SOD level was significantly decreased （P＜0.01）； HE and Masson staining showed that a large amount of fibrous proliferation was present in the liver tissues of the rats， and the collagen volume fraction was significantly increased （P＜0.01）； the protein expressions of PI3K， Akt， phosphorylated Akt and B-cell lymphoma （Bcl-2） were down-regulated significantly， while the protein expression of Bcl-2-associated X protein was increased significantly （P＜0.01）. Compared with the model group， the above indexes of the anwulignan high-dose and low-dose groups and the colchicine tablets group were all reversed significantly. CONCLUSIONS Anwulignan may reduce oxidative stress and inhibit hepatocyte apoptosis by activating the PI3K/Akt signaling pathway， and play the role of anti-hepatic fibrosis.

Objective: To investigate the therapeutic effect and mechanism of isoliquiritigenin (ISL) on hepatic fibrosis (HF) ． Methods : SD rats were randomly divided into normal group，model group，colchicine tablet group (positive control，0. 1 mg / kg) ，and high-dose and low-dose ISL groups (40 ，10 mg / kg) ．Except for the normal group，the other groups were given intraperitoneal injection of 50% carbon tetrachloride ( CCl4 ) olive oil solution ( 1. 5 ml / kg) to establish liver fibrosis models，twice a week for 8 weeks．After modeling，rats in each group were given the corresponding drugs by gavage at a volume of 10 ml / kg per day for 4 weeks．After the last administration， the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the serum of rats were determined ; liver index was calculated ; HE and Masson staining were used to observe the pathological changes of liver tissue ; Real-time quantitative PCR was used to detect the mRNA expression levels of hypoxia-inducible factor-1α (HIF-1 α) and vascular endothelial growth factor ( VEGF) ; the expressions of HIF-1α and VEGF protein in liver tissue were detected by immunohistochemistry and Western blot. Results: Compared with the normal group，the serum ALT and AST contents of the rats in the model group increased (P＜0. 01) ，the liver index increased (P < 0. 01) ，the rat fibrous tissue hyperplasia，the collagen volume fraction increased (P＜0. 01) ，and the liver the expression levels of HIF-1 α and VEGF mRNA in the tissue increased (P＜0. 01) ．Immunohistochemistry and West- ern blot showed that the expression levels of HIF-1α and VEGF protein increased in the model group (P＜0. 01) . Compared with the model group，the ISL high and low dose groups could reduce the levels of ALT and AST in serum (P＜0. 01) ，the liver index (P＜0. 01) ，the proliferation of fibrotic tissue and the collagen volume fraction (P ＜0. 05) ，down-regulate the expression levels of HIF-1 α and VEGF genes (P＜0. 01) ．Immunohistochemical detection showed that the high and low dose groups of ISL could reduce the protein expression levels of HIF-1α (P < 0. 01，P＜0. 05) ，the expression level of VEGF protein decreased (P＜0. 01) ，Western blot detection showed that the high-dose group of ISL could reduce the protein expression levels of HIF-1α and VEGF (P＜0. 05) . Conclusion ISL has a significant therapeutic effect on CCl4 -induced HF model rats，and its mechanism may be related to the regulation of HIF-1α and VEGF protein expression levels.

Objective:To clarify the applicability of the Chinese version of Cornell Assessment of Pediatric Delirium Scale (CAPD) for neonatal delirium screening in Neonatal Intensive Care Units (NICU) .Methods:From March 2021 to May 2022, convenience sampling was used to select 210 newborns admitted to NICU at Zhuji Maternal and Child Health Care Hospital in Zhejiang Province as the study subject. This study used the American Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) as the gold standard to test the diagnostic validity of the Chinese version of CAPD in the assessment of neonatal delirium in NICU.Results:This study ultimately included 189 newborns. A total of 43 newborns with delirium were diagnosed by DSM-V, with an incidence rate of 22.75% (43/189). There was no statistically significant difference in the incidence of neonatal delirium among newborns with different gestational age, day age, gender, and disease diagnosis ( P>0.05). Compared with DSM-V, the consistency Kappa value between two results of scales was 0.72 ( P<0.01). When the CAPD diagnostic threshold was set at 15, the sensitivity of the Chinese version of CAPD was 86.01%, the specificity was 86.30%, and the maximum Youden index obtained was 0.723. Conclusions:The diagnostic validity of the Chinese version of CAPD for neonatal delirium assessment in NICU is good, and it can provide reliable tool support for neonatal delirium assessment.

OBJECTIVE：To study the mechanism of improvement effects of Fupi rougan granule （FRG）on hepatic fibrosis model rats. METHODS ：The rats were randomly divided into blank group ，model group ，Colchicine tablet group （chemical positive control ，0.2 mg/kg），Fuzheng huayu capsule group （TCM positive control ，0.415 g/kg），FRG low-dose ，medium-dose and high-dose groups （20，40，80 g/kg），with 10 rats in each group ，except for 11 rats in blank group and model group （one rat was used to judge whether the modeling was successful ）. Except for blank group ，other groups were given intraperitoneal injection of 50％ CCl4 olive oil solution and intragastric administration of 30％ ethanol to induce hepatic fibrosis model. After modeling ， administration groups were given relevant medicine intragastrically ；blank group and model group were given constant volume of normal saline intragastrically ，once a day ，for consecutive 4 weeks. After last administration ，morphology changes of liver tissue in rats were observed. The serum levels of HA ，LN，PCⅢ and Col Ⅳ in rats were detected ，and protein expression of Beclin- 1 and LC3-Ⅱin liver tissue were also determined. mRNA and protein expression of Akt ，AMPK，mTOR，p70S6K were detected in liver tissues of rats. RESULTS ：Compared with blank group ，the structure of hepatic lobules in the model group was disordered ，the proliferation of fibrous tissue was obvious ，and some pseudolobules were formed ；the serum levels of HA ，LN，PCⅢ and Col Ⅳ， the protein expression of Beclin- 1 and LC 3-Ⅱ in liver tissue as well as mRNA and protein expression of Akt ，AMPK，mTOR and p70S6K were increased significantly （P＜0.01）. Compared with model group ，the liver injury of rats in FRG groups was significantly relieved ，and the levels of the above indexes in serum and liver tissue （except for LN and PC Ⅲ in FRG low-dose group） were significantly reduced （P＜0.05 or P＜0.01）. CONCLUSIONS ：FRG can improve hepatic fibrosis in rats ，the mechanism of which may be associated with down-regulating the expression of autophagy associated protein and Akt/AMPK/mTOR/ p70S6K signaling pathway related protein.

Objective: To investigate the effects of srtA on the oxidation tolerance of the Streptococcus mutans UA159 strain and to explore the potential mechanism. Methods: The oxidation tolerance in the planktonic state and biofilm state were compared among UA159, the srtA-deleted strain and the complementary strain through oxidative tolerance experiments. The RNA-sequencing data from both the exponential and stationary phases of UA159 and the srtA-deleted strain were obtained by using the Illumina HiSeq 4 000 sequencing platform to determine the impact of srtA knockout on S. mutans genomic transcription. We compared the differences in the transcriptional expression of oxidative tolerance-related genes between the UA159 strain and the srtA gene deletion strain and further explored the intrinsic relationship between the changes in oxidative tolerance and the genetic transcriptome. qPCR was used to verify the changes in the expression level of oxidation tolerance-related genes. Results : The oxidation tolerance of the srtA-deleted strain decreased significantly in both the planktonic state and the biofilm state compared to that of UA159 (P < 0.05). A total of 33 oxidation tolerance-related genes were differentially expressed according to transcriptome sequencing. There was no significant change in the expression of peroxide synthesis- and metabolic-related enzyme genes, but in the stationary phase samples, the two-component signal transcription systems lrgA, lrgB, and lytT were significantly downregulated (2.2- to 2.4-fold) in the srtA-deleted strain. qPCR further confirmed that in both the exponential and stationary phases, lrgB and lytT expression in the planktonic state was reduced 11.01-53.51-fold, while the expression of the other two-component system-encoding gene vicK was reduced by 6.57-10.88-fold (P < 0.001). Conclusion SrtA gene deletion did not change the expression level of peroxide synthesis-related and metabolic enzyme-encoding genes but downregulated the expression of the associated transcription regulation factors to reduce the oxidation tolerance of S. mutans.

Objective:To investigate the clinical effect of plasma exchange in the treatment of patients with severe hepatitis.Methods:From December 2011 to December 2018, 84 patients with severe hepatitis admitted to the Third People's Hospital of Linfen were selected, and they were divided into control group ( n=41) and observation group ( n=41)according to the random digital table method.The control group was treated with routine treatment, and the observation group was treated with plasma exchange at the same time.The therapeutic effect of the two groups was observed. Results:The total effective rate of the observation group was 73.17%(30/41), which was significantly higher than that of the control group[51.22%(21/41)] (χ 2=4.201, P<0.05). After treatment, the ALB, AST, ALT, TBIL levels in the control group were (36.74±4.25)g/L, (247.85±12.36)U/L, (214.57±10.14)U/L, (288.96±16.30)μmol/L, respectively, which in the observation group were (45.14±5.30)g/L, (162.65±8.30)U/L, (120.74±6.33)U/L, (241.74±15.02)μmol/L, respectively, the differences between the two groups were statistically significant( t=7.917, 36.642, 50.261, 13.641, all P<0.05). After treatment, the interferon gamma(IFN-γ), tumor necrosis factor alpha(TNF-α), interleukin 6(IL-6) levels in the control group were (318.96±92.15)ng/L, (334.74±102.58)ng/L, (65.89±6.33)ng/L, respectively, which in the observation group were (261.15±89.62)ng/L, (274.15±85.12)ng/L, (54.36±5.23)ng/L, respectively, the differences between the two groups were statistically significant( t=2.879, 2.910, 8.991, all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P>0.05). Conclusion:Plasma exchange in the treatment of severe hepatitis can improve the clinical therapeutic effect, improve its liver function, reduce the level of inflammatory cytokines, and has no adverse reactions.