Alzheimer's disease （AD）， a degenerative disease of the central nervous system， is characterized by progressive degradation of learning， memory， and cognitive functions. Currently， few drugs are available for treating AD， and their effects are limited. Berberine （BBR） is a natural isoquinoline （quaternary ammonium-like） with a wide range of pharmacological effects. Studies have proven that BBR has good potential in the treatment of AD. Specifically， BBR can inhibit the generation， aggregation， and neurotoxicity of amyloid-β and the hyperphosphorylation of Tau protein， promote the clearance of phosphorylated Tau protein， reduce the cholinesterase activity， neuroinflammation， and oxidative stress， regulate neuronal apoptosis， improve the mitochondrial function and glucose and lipid metabolism， suppress the monoamine oxidase activity， and modulate gut microbiota. In addition， researchers have ameliorated the low bioavailability of BBR. Probing into the potential targets is hoped to provide a reference for further research on the prevention and treatment of AD by BBR.

BACKGROUND:It has been shown that Gushukang affects bone metabolism by regulating nucleotide and amino acid metabolism and immune mechanisms.Current research on the mechanism of Gushukang in the treatment of osteoporosis primarily focuses on osteoblast regulation and requires further improvement from the perspective of osteoclasts. OBJECTIVE:To investigate the mechanism by which Gushukang interferes with osteoclasts in the treatment of osteoporosis using RAW264.7 cells as the research model. METHODS:Twenty-four 8-week-old female Sprague-Dawley rats were randomly divided into four groups(n=6 per group):the three experimental groups were given 1,2 and 4 g/kg osteoporosis solution by gavage(2 times per day),and the control group was given an equal amount of distilled water by gavage(2 times per day).After 7 days of intragastric administration,aortic blood samples were extracted to collect serum samples using centrifugation,and serum samples from the same groups were combined to obtain the low-,medium-,and high-concentration Gushukang-containing and normal sera for the subsequent experiments.(1)RAW264.7 cells were cultured in six groups:normal serum was added to the control group;low,medium,and high concentration groups were added with low,medium,and high concentrations of Gushukang-containing serum,respectively;ML385,a nuclear factor erythroid 2-related factor 2(Nrf2)inhibitor was given in the Nrf2 inhibitor group;and t-BHQ,a Nrf2 activator,was added in the Nrf2 activator group.Cell viability was detected using the cell counting kit-8 assay.(2)The 3rd generation RAW 264.7 cells were cultured and divided into five groups:the blank control group was added with normal serum,the osteoclast group was added with receptor activator of nuclear factor κB ligand(RANKL),and the low-,medium-,and high-concentration groups were added with low-,medium-,and high-concentration Gushukang-containing serum based on the addition of RANKL.Tartrate-resistant acid phosphate staining was performed after 5 days of culture.(3)RAW264.7 cells were cultured and divided into five groups:blank control group was cultured with normal serum,osteoclast group cultured with normal serum and RANKL,high concentration+osteoclast group cultured with RANKL+high concentration Gushukang-containing serum,osteoclast+Nrf2 agonist group cultured with RANKL+t-BHQ,and high concentration+osteoclast+Nrf2 inhibitor group cultured with RANKL+high concentration Gushukang-containing serum+ML385.Western blot assay and determination of reactive oxygen content were performed after 5 days of culture. RESULTS AND CONCLUSION:The cell counting kit-8 results indicated that Gushukang-containing serum,NRF2 inhibitor or agonist had no significant effect on RAW264.7 cell viability.Tartrate-resistant acid phosphate staining results demonstrated that Gushukang-containing serum exhibited a concentration-dependent inhibitory effect on osteoclast differentiation.Western blot analysis and determination of reactive oxygen species revealed that compared with the blank control group,Nrf2 protein expression was decreased in the osteoclast group(P<0.05),while c-Fos and NFATc1 protein expression and reactive oxygen species content were elevated(P<0.05);compared with the osteoclast group,Nrf2 protein expression was elevated and reactive oxygen species content was decreased in the high-concentration+osteoclast group,osteoclast+Nrf2 agonist group,and high-concentration+osteoclast+Nrf2 inhibitor group(P<0.05),while c-Fos and NFATc1 protein expression was decreased in the high concentration+osteoclast group and osteoclast+Nrf2 agonist group(P<0.05);compared with the high concentration+osteoclast group,Nrf2 protein expression was decreased(P<0.05)and reactive oxygen species content was elevated(P<0.05)in the high concentration+osteoclast+Nrf2 inhibitor group.To conclude,Gushukang reduces reactive oxygen species production by activating Nrf2,thereby inhibiting downstream of the c-Fos/NFATc1 pathway and suppressing osteoclast differentiation.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Objective:To analyze the prevalence and clinical features of respiratory syncytial virus (RSV) in Chengde city.Methods:From August 2022 to June 2023, throat swabs and clinical data of 478 hospitalized children with respiratory tract infection in the Chengde Central Hospital were collected. Real-time quantitative PCR was used to detect the molecular epidemiology of RSV-A and RSV-B subtypes and analyze the clinical features of patients with RSV infection.Results:Among the hospitalized children, 67.57% (323/478) tested positive for RSV. The outbreak of RSV infection was caused by RSV-A subtype. The peaks of RSV-A infection occurred from November to December, 2022 and May to June, 2023. There were 86.07% (278/323) of the RSV-A-positive cases had mixed infection with other pathogens, primarily bacterial pathogens with Streptococcus pneumoniae being the most common, followed by Klebsiella pneumoniae. Influenza virus A was the most common viral pathogens causing mixed infection. The level of lactate dehydrogenase was higher in the patients with single RSV-A infection than in those with mixed infection ( Z=2.396, P=0.017), and higher than the normal upper limit. Compared with the single infection group, the mixed infection group had higher white blood cell count ( Z=2.417, P=0.016), neutrophil ratio ( Z=3.218, P=0.001), C-reactive protein level ( Z=1.998, P=0.046) and creatinine level ( Z=2.107, P=0.035), and lower lymphocyte ratio ( Z=3.205, P=0.001), but they were all within the normal range. There were no significant differences in the clinical features between RSV-A-positive patients co-infected with bacteria or other viruses (all P>0.05). Conclusions:RSV-A is the leading cause of respiratory tract infection in children in Chengde from 2022 to 2023, and often co-detected with bacteria. The mixed infection with other respiratory pathogens is related to the clinical features of patients with RSV-A infection.

Objective:To determine the changes of immune-associated molecules in serum of patients infected with respiratory syncytial virus subtype A (RSV-A).Methods:Serum specimens were collected from patients with respiratory infection at Department of Pediatrics of NO. 2 Clinical Teaching Hospital of Chengde Medical University during August 2022 to June 2023. The serum specimens were set as RSV-A single infection group and RSV-A coinfection group based on the detected pathogens in these patients. Serum levels of Th1 cytokines including interferon γ (IFN-γ) and tumor necrosis factor-α (TNF-α), and Th2 cytokines including interleukin 4 (IL-4) and IL-10, soluble toll-like receptor 2 (sTLR2) and 4 (sTLR4), soluble tumor necrosis factor receptor 1 (sTNFR1) and sTNFR2 were determined using enzyme-linked immunosorbent assay (ELISA) kits.Results:Serum levels of IFN-γ ( H=10.030, P=0.007) and IL-4 ( H=10.246, P=0.006) were significantly up-regulated in RSV-A single infection group and RSV-A coinfection group, however, levels of TNF-α ( F=1.154, P=0.322) and IL-10 ( F=1.738, P=0.188) were not significantly up-regulated. Area under the curve (AUC) of IFN-γ and IL-4 were 0.866 (95% CI: 0.767-0.966, P=0.002) and 0.986 (95% CI: 0.956-1.000, P=0.001), respectively. The levels of sTLR2 ( H=1.165, P=0.559) and sTLR4 ( H=1.657, P=0.437) were not significantly changed. Levels of sTNFR1 ( H=11.431, P=0.003) and sTNFR2 ( F=3.411, P=0.041) were significantly up-regulated in RSV-A coinfection group and the concentration of sTNFR2 was higher than sTNFR1. Concentration of sTNFR1 was peaked in RSV-A coinfected with bacterium group and RSV-A coinfected with dual bacteria group. AUC of sTNFR2 was 0.967 (95% CI: 0.911-1.000, P=0.002). Conclusions:Expressions of immune-associated molecules, including IFN-γ, IL-4, sTNFR1 and sTNFR2 were significantly changed in patients infected with RSV-A, and these immune-associated molecules maybe engage in the interaction and pathogenesis between RSV-A and host.

Renal pelvic hemangioma is a rare benign tumor, presenting with intermittent, total, painless, gross hematuria, accompanied by low back pain, abdominal pain or other symptoms in some cases. Four cases of pyelonephric hemangioma were treated, which were misdiagnosed as malignancy before surgery. For middle-aged patients with intermittent hematuria, if the imaging data cannot rule out renal pelvic hemangioma, it is recommended to perform renoscopy, renal artery angiography or renal puncture biopsy. For patients diagnosed with renal pelvic hemangioma, either partial nephrectomy, ureteroscopic cauterization, or selective renal artery embolization can achieve good results.

Objective:To determine the alteration of miRNA profile of human tonsillar epithelial cells induced by enterovirus-A71 (EV-A71) infection.Methods:Human tonsillar epithelial cells UT-SCC-60B were infected with EV-A71 at multiplicities of infection (MOI) of 1 and total RNA was extracted using Trizol reagent. Small RNA library was constructed and high-throughput sequencing was performed using Illumina NextSeq 500. Differential significantly expressed known and novel miRNAs and putative targets were selected after the processing of raw data. Gene ontology (GO), kyoto encyclopedia of genes and genomes (KEGG) pathways were analyzed through online database. Kinds of miRNA could target EV-A71 genome was determined through psRNATarget. Validations of random selected miRNAs were done through real-time RT-PCR.Results:A total of 61 known significantly expressed miRNAs (21 miRNAs were down-regulated and 40 miRNAs were up-regulated) and 559 novel significantly expressed miRNAs were identified through high-throughput sequencing. Novel significantly expressed miRNA had typical "hairpin structure" of pre-miRNA. Fold changes of hsa-miR-517b-3p and hsa-miR-199a-5p which was determined by real-time RT-PCR had similar change trends with high-throughput sequencing. Putative targets of significantly expressed miRNA were referred to different biological processes and signaling pathways. A total of 24 significant miRNAs (5 known significantly expressed miRNAs and 19 novel significantly expressed miRNAs) had "seed sequence" in EV-A71 genome.Conclusions:Expression of miRNA profile in UT-SCC-60B was significantly changed by EV-A71 infection and the identified significantly expressed miRNAs potential target EV-A71 genome to regulate EV-A71 replication.

Objective:To research the metabolomic alterations of human lung bronchial epithelial cells infected with human rhinovirus 1B (HRV1B).Methods:Untargeted metabolomics was used to determine the metabolomic alterations in human lung bronchial epithelial cells (BEAS-2B) 6 h, 12 h and during the dynamic process (6 h∶12 h) after HRV1B infection.Results:A total of 93 differentially significant metabolites (DSMs) (47 DSMs were up-regulated and 46 DSMs were down-regulated) and 88 DSMs (37 DSMs were up-regulated and 51 DSMs were down-regulated) at post infection of HRV1B in BEAS-2B at 6 h or 12 h, respectively. A total of 30 DSMs (12 DSMs were up-regulated and 18 DSMs were down-regulated) in a dynamic process (6 h∶12 h) after HRV1B infection. Unknown metabolites took up most proportions. The trends of fatty acid, lipid, amino acid, nucleotide and carbohydrate were increased along with the prolonging of HRV1B infection. DSMs such as Diisononyl phthalate was co-detected DSMs among three groups.Conclusions:Metabolites such as fatty acid, lipid, amino acid, nucleotide and carbohydrate of BEAS-2B cells are changed induced by HRV1B infection.

OBJECTIVE：To establish the HP LC fing erprints of Oxalis corniculata and to simultaneously determine the contents of isovitexin and swertisin. METHODS ：HPLC method was adopted. The determination was performed on ACE Excel- 5-C18column with mobile phase consisted of methanol- 0.1％ phosphoric acid water （gradient elution ）at the flow rate of 1 mL/min. The column temperature was 35 ℃，and detection wavelength was set at 280 nm. The sample size was 10 μL. Using isovitexin peak as reference，HPLC fingerprints of 12 batches of sample were drawn. The similarity evaluation was performed by using Similarity Evaluation System of Chromatogram Fingerprint of TCM （2012 edition）to determine common peaks. The contents of isovitexin and swertisin were determined by same method of above chromatogram. RESULTS ：There were 19 common peaks in HPLC chromatogram of 12 batches of O. corniculata ，with the similarity above 0.89. Two common peaks including isovitexin and swertisin were identified. The linear range of two components were 3.91-117.36 μg/mL（r＝0.999 4）and 9.88-118.56 μg/mL（r＝ 0.999 2），respectively. The limits of quantitation were 0.675 and 3.587 μg/mL；the limits of detection were 0.205 and 1.087 μg/mL， respectively. RSDs of precision ，stability and reproducibility tests were all lower than 2％. The recoveries were 95.46％-99.10％ （RSD＝1.23％ ，n＝6），95.34％ -101.23％（RSD＝2.74％ ，n＝6），respectively. The average contents were 0.227-1.654， 0.641-2.052 mg/g，respectively. CONCLUSIONS ：Established fingerprints can be used for the quality control of O. corniculata ； the content determination method is simple and accu rate，and can be used for simultaneous determination of two components.

Objective: To study the molecular prevalence and clinical characteristics of human metapneumovirus and human bocavirus in hospitalized children with community-acquired pneumonia. Methods: Total 333 throat swabs and clinical information of patients were collected between 2017 and 2018 at Department of Pediatrics of No.2 Clinical Teaching Hospital, Chengde Medical University. The IgM of adenovirus (AdV), respiratory syncytial virus (RSV), influenza virus-A/B (Influ-A/B), parainuenza viruses (PIVs)were tested by detection kit, and the positive samples of human metapneumovirus (hMPV), human bocavirus (HBoV), AdV, RSV and human coronavirus (HCoV) were detected by RT-PCR or PCR. Results: 43 cases, 19 cases, 3 cases and 2 cases were positive for Influ-B, PIV, RSV and AdV IgM, respectively. Total 80 cases were infected with hMPV (71 cases were single infection, 8 cases were double infection, and 1 case was triple infection), 22 cases were infected with HBoV (14 cases were single infection, 7 cases were double infection, and 1 case was triple infection), 6 cases were infected with AdV (4 cases were single infection, 1 case was double infection, and 1 case was triple infection), only 1 case was single infected with RSV or HCoV, respectively. 39 cases (11.7%) and 41 cases (12.3%) were distributed at <5 years group and ≥5 years group, respectively. 45.0%(18/40)in severe cases and 27.99%(82/293)in mild cases were positive for hMPV, HBoV, AdV, RSV and HCoV, the ratio of viral positive case was significant higher in severe cases than mild cases (P=0.042). The age (P=0.000), peak of fever (P=0.035), duration of hospitalization (P=0.000), neutrophils (P=0.000) and lymphocytes (P=0.000) were significant difference in severe cases compared with mild cases. Conclusions Multiple respiratory viruses can cause community-acquired pneumonia and more attention should be pay to the surveillance of hMPV and HBoV.