Chronic urticaria （CU） is a common skin disease worldwide， and its incidence is increasing year by year in various regions. Clinical manifestations such as severe itching can affect normal work， sleep， and daily life and increase the negative psychological burden caused by stress， anxiety， and depression. Mast cell activation and degranulation induced by immunoglobulin（Ig）E hypersensitivity is one of the core pathogenic mechanisms of CU， and there is no cure. Antihistamines such as cetirizine and loratadine are preferred for the clinical treatment of CU. Although they can effectively improve clinical manifestations such as itchiness， long-term application can increase the risk of adverse reactions and drug resistance. The phosphatidylinositol kinase/serine-threonine protein kinase B（PI3K/Akt） signaling pathway， as a classical signaling pathway regulated by phosphatidylinositol and tyrosine kinase receptor （RTK）， is a key target regulating the production and release of cytokines in macrophages and affecting the migration of leukocytes and the activation of mast cells and inflammation， and it can be involved in a variety of metabolic processes， such as mast cell activation and degranulation induced by IgE hypersensitivity and abnormal activation of the complement system so that the PI3K/Akt molecular pathway could be an important target for the future eradication of CU. However， the mechanism and potential role of the PI3K/Akt signaling pathway in the treatment of CU are less reported in China. Now， this paper reviewed the molecular mechanism of PI3K/Akt signaling pathway regulation in the treatment of CU and provided corroborative evidence and therapeutic strategy choices for the treatment of CU with traditional Chinese medicine （TCM） from the perspectives of molecular regulation and network pharmacology analysis.

Objective To summarize the medication law of TCM in the treatment of chronic bronchitis;To provide reference for clinical medication.Methods Medical records of patients with chronic bronchitis who were hospitalized in the Respiratory Department of the First Affiliated Hospital of Henan University of Chinese Medicine from January 1,2016 to December 31,2021 were extracted based on HIS electronic medical record data.After screening,the TCM prescriptions used by patients with chronic bronchitis were input into Excel 2019 to establish a database.Based on the software Lantern 5.0,the latent structure model was learned,hidden variables and explicit variables were obtained,and the model was interpreted.SPSS Modeler 18.0 was used to establish model points with Apriori algorithm for Chinese materia medica with a frequency greater than 6%,to obtain the association rules between drugs,and to analyze the medication law of TCM in treating chronic bronchitis.Results A total of 3 410 cases were included,involving 423 kinds of Chinese materia medica,with a cumulative frequency of 82 766 times.Among them,109 kinds of Chinese materia medica with a frequency of>6 % had a cumulative frequency of 69 845 times.The top five commonly used medicines were Fritillariae Cirrhosae Bulbus,Poria,Atractyodis Macrocephalae Rhizoma,Asteris Radix et Rhizoma,Citri Reticulatae Pericarpium,mainly with medicines of reducing cough and phlegm,antiasthmatic medicine,tonifying deficiency,clearing heat,relieving superficies,promoting blood circulation and removing blood stasis.The medicinal properties were warming,cold and mild,and the main tastes were bitter,sweet and pungent,and the meridians were mainly lung,spleen,liver and stomach meridians.Through analysis of latent structure,49 hidden variables and 149 hidden classes were obtained.Combined with professional knowledge,10 comprehensive clustering models and 21 core formulas were deduced,such as Sangbaipi Decoction,Xuefu Zhuyu Decoction,Xiaoqinglong Decoction,Erchen Decoction,Shashen Maidong Decoction,Liuwei Dihuang Pills,Yinqiao Powder,Zhisou Powder,Yupingfeng Powder,Xuefu Zhuyu Decoction combined with Daotan Decoction,etc.It was concluded that the chronic bronchitis syndrome included phlegm-heat stagnation lung syndrome,qi stagnation blood stasis syndrome,cold fluid attacking lung syndrome,phlegm-dampness accumulation lung syndrome,lung qi and yin deficiency syndrome,kidney yin deficiency syndrome,wind heat attacking lung syndrome,wind cold attacking lung syndrome,lung qi and spleen deficiency syndrome,phlegm stasis interjunction syndrome.A total of 41 strong association rules were screened in the analysis of association rules,including 5 strong association rules for two and 36 strong association rules for three.The high confidence rules were Saposheikovize Radix + Angelicae Sinensis Radix →Atractyodis Macrocephalae Rhizoma,Saposheikovize Radix + Codonopsis Radix → Atractyodis Macrocephalae Rhizoma,Codonopsis Radix + Citri Reticulatae Pericarpium → Atractyodis Macrocephalae Rhizoma;the higher degree of improvement were Bupleuri Radix + Mori Cortex → Scutellariae Radix,Perillae Fructus + Belamcandae Rhizoma → Fritillariae Cirrhosae Bulbus,Armeniacae Semen Amarum + Pinelliae Rhizoma → Citri Reticulatae Pericarpium,etc.Conclusion In the treatment of chronic bronchitis,TCM is mainly used to reduce phlegm,relieve cough and asthma,and the method of promoting blood circulation and removing blood stasis is commonly used to help eliminate phlegm.In addition,TCM pays attention to the application of methods such as tonifying lung and securing the exterior,invigorating spleen and benefiting qi.

Objective:To evaluate the effectiveness and safety of enhanced recovery after surgery(ERAS)in perioperative period of liver transplantation.Methods:The authors searched systematically domestic and foreign databases to collect researches on applying ERAS for liver transplantation. The retrieval period was from database inception to November 2020. Quality assessment and data extraction were performed by two researchers according to the inclusion criteria. Meta-analysis of postoperative indicators(length of ICU stay, total length of hospital stay, postoperative complications, admission rate & mortality rate)was performed by RevMan 5.3.5 software.Results:3 Three randomized controlled studies (RCTs) and 4 cohort studies were selected with a total of 1 016 patients, including 404 in ERAS group and 612 in conventional group(traditional perioperative management). The results of Meta-analysis revealed that, as compared with control group, length of ICU stay was significantly shorter in ERAS group [weighted mean difference(WMD)=-2.20, 95% CI: -2.43~-1.97, P<0.05]; Total length of hospital stay was significantly shorter in ERAS group [WMD=-5.85, 95% CI: -8.20~-3.49, P<0.05]; The incidence of postoperative complications was significantly shorter in ERAS group [OR=0.61, 95% CI: 0.42~0.88, P<0.05]. However, no inter-group statistically significant differences existed between admission rate or mortality rate( P>0.05). Conclusions:In perioperative period of liver transplantation, using ERAS protocol can shorten length of ICU stay and total length of hospital stay, lower the incidence of postoperative complications and accelerate patient recovery.

Purpose: miR-205 is a tumor suppressor and plays an important role in tumor invasiveness. However, the role of miR-205 in human gastric cancer (GC) epithelial-mesenchymal transition (EMT) remains unclear. The aim of this study was to investigate the molecular mechanism of miR-205 in the regulation of EMT in GC invasion. Materials and Methods: Quantitative polymerase chain reaction (qPCR) was used to detect the expression of miR-205 in GC. Further, the correlation between the pathological parameters and prognosis of GC was statistically analyzed. A transwell model was used to evaluate the effect of miR-205-3p on the invasion and migration of GC cells. qPCR, western blotting, and luciferase assay were performed to analyze the relationship and target effects between miR-205-3p and the expression of zinc finger electron box binding homologous box 1 (ZEB1) and 2 (ZEB2). Results: We found that the levels of miR-205-3p were significantly lower (P<0.05) in GC tissues than in matched normal tissues. Additionally, the expression of miR-205-3p was related to the tumor invasion depth, lymph node metastasis, lymph node invasion, and tumor, node, metastasis stage. Patients with lower miR-205-3p expression levels in the tumors had a poorer prognosis. The in vitro assays indicated that miR-205-3p could affect the invasion ability and EMT of GC cells by targeting the expression of both ZEB1 and ZEB2. Conclusions miR-205-3p promotes GC progression and affects the prognosis of patients by targeting both ZEB1 and ZEB2 to directly influence EMT.

Objective To evaluate the safety of enhanced recovery after surgery (ERAS) programs in pancreas surgery.Methods A computer search was performed on databases which included the Wanfang,CNKI,VIP,PubMed,Cochrane Library,Embase and Sciencedirect for randomized controlled trials or case-control studies on ERAS programs in pancreatic surgery published between January 1995 and August 2017.Two researchers independently evaluated the quality of the studies which met the inclusion criteria and performed a meta-analysis using the RevMan5.3.5 software.Results Four randomized controlled trials and twenty one case-control studies which included 4 063 patients entered into the meta-analysis.These patients included the ERAS group (n =2 052) and the control group (n =2 011 who underwent traditional perioperative management).Compared with the control group,the ERAS group had a lower postoperative complication rate (OR =0.57,95％ CI:0.45 ～0.71,P ＜0.05),a lower delayed gastric emptying rate (OR =0.46,95％ CI:0.37 ～ 0.59,P ＜ 0.05),a lower abdominal infection rate (OR =0.68,95％ CI:0.53 ～ 0.88,P ＜ 0.05),a shorter hospital stay (WMD =-4.86,95％ CI:-6.10 ～-3.62,P ＜ 0.05)and intensive care stay (WMD =-1.04,95％ CI:-2.01 ～-0.08,P ＜ 0.05).No significant differences existed in the mortality,readmission and postoperative pancreatic fistula rates between the two groups.Conclusion Perioperative implementation of ERAS programs was safe and effective in pancreatic surgery,and decreased postoperative complication rates and promoted recovery.

Objective To investigate the risks of self-rated health in the ≥55-year elderly in Beijing and the occurrence of stroke.Methods The subjects (n=2 101;aged ≥55) from Beijing longitudinal study of aging (BLSA) were collected by Xuanwu Hospital,Capital Medical University from January 1992 to December 2016.One hundred and twenty-one subjects with stroke at baseline and 92 with incomplete information were excluded,and finally,1 888 elderly patients without cerebrovascular disease at baseline were included in the analysis.Based on the actual situation,the self-rated health was to identify an item that matched their current state from good,general to poor.The deadline for the survey was December 31,2012.The competitive risk model was used to assess the health self-rated status and the risk of stroke.Non-stroke deaths,including cancer and car accidents were treated as competitive events.Results Of the 1 888 subjects enrolled,946 (50.1%) self-rated health were good,616 (32.6%) were general,and 326 (17.3%) were poor;438 (23.2%) had stroke,751 (37.8%) had non-stroke death,and 699 (37.0%) were right censored data.Using the competing risk model and adjusting the age,sex,living area,marital status,education level,smoking,alcohol consumption,physical exercise,hypertension,diabetes mellitus,coronary heart disease,and body mass index,the occurrence of stroke in patients with poor self-rated health was 1.44 times (95%CI 1.11-1.87,P<0.01) as good as those who were good.Conclusion In the self-rated health of the elderly ≥55 years old in Beijing,the people with poor self-rated health increased the occurrence of stroke after considering the competitive risks.

Objective: To investigate the relationship between heart rate variability (HRV), blood pressure variability (BPV) and autonomic nerve function, blood vessel damage in patients with essential hypertension (EH) via synchronous monitoring. Methods: A total of 275 EH patients admitted to our hospital from 2011-04 to 2014-01 were enrolled. The vascular function was assessed by carotid-femoral pulse wave velocity (PWV). Based on PWV, the patients were divided into 2 groups: Normal PWV group (PWV<9m/s),n=185 and High PWV group (PWV≥9m/s),n=90. Synchronic 24h dynamic electrocardiogram (Holter) and 24h ambulatory blood pressure monitoring (ABPM) were performed in all patients. t-test, chi-square test, person liner correlation study and multi stepwise regression analysis were conducted to explore the relationship between HRV, PBV and PWV. Results: HRV and BPV in High PWV group had been changed unusually. Compared with Normal PWV group, High PWV group showed decreased standard deviation of the average of all normal-to-normal intervals in all 5-minute intervals (SDANN) (159.66±66.50) ms vs (194.36±119.29) ms and increased 24 h systolic blood pressure standard deviation (24h SSD) (14.40±3.65) mmHg vs (12.98±3.46) mmHg, all P<0.01; increased new index of night/day HR ratio (0.90±0.08) vs (0.87±0.06), P<0.01 and it had liner correlation to PWV (r=0.169, P=0.005). Multi stepwise liner regression analysis indicated that 24hSSD and HRV at low frequency (LF) portion had obvious and independent correlation to PWV (standard β value=0.352 and 0.212 respectively). Conclusion: ① EP patients were with decreased HRV (SDANN), increased BPV (24h SSD) and the higher incidence of arteriosclerosis; 24h SSD and HRV at LF portion were the most 2 important risk factors affecting PWV. ②Autonomic nerve dysfunction, vagus nerve over-excitatory were the independent risk factors for promoting the occurrence and development of arteriosclerosis in EH patients. ③Night/day HR ratio as a sensitive index for examining autonomic nerve function was independently related to hypertensive vessel damage. Synchronic monitoring of HRV and BPV is helpful to identify blood vessel damage in EH patients.

BACKGROUND:Although the mechanism why neuronal cels wil die after transient cerebral ischemia has not been completely elucidated, many researches nowadays have investigated the pathological mechanism in the level of celular organs, such as mitochondria.
OBJECTIVE:To summarize and discuss the functions of neuronal mitochondria and apoptosis signaling pathways in transient cerebral ischemia.
METHODS: A computer-based online retrieval was performed to search papers in CNKI and PubMed databases using the key words of “cerebral ischemia, mitochondrion, apoptosis, reactive oxygen species, reperfusion, superoxide dismutase, nitric oxide synthase, Bcl-2 protein family, review” in Chinese and English, respectively. Papers published recently or in the prestigious journals were selected in the same field. After excluding objective-independent papers and repeated studies, 50 papers were included for further analysis.
RESULTS AND CONCLUSION:Recently mitochondria are found to play an important role after transient cerebral ischemia by producing a lot of reactive oxygen species to activate many kinds of signaling pathways and regulate mitochondria-mediated apoptosis. Reactive oxygen cannot only induce biomacromolecule injury but also induce apoptosis signal transduction. Deeply investigation is needed on the pathological mechanism after transient cerebral ischemia.

Objective Research has indicated that hydrogen sulfide(H2S) can regulate the function of N-methyl-D-aspartate re-ceptors(NMDARs) in the brain, but its effect on brain resuscitation requires further investigation.The study was to speculate the effect of H2 S on brain resuscitation as well as the underlying mechanism of neuroresuscitation by investigating the effects of hydrogen sulfide and hypo-thermia on the expression of NR2A, NR2B and phospho-cAMP response element binding protein (p-CREB) of NMDARs in the hippocampus after global cerebral ischemia following by reperfusion. Methods 100 male SD rats were randomly divided into five groups(n=20):sham operation group, model group, mild hypothermia group, NaHS group, NaHS combined mild hypothermia group.Pulsinelli-Brierley four-ves-sel occlusion method was induced to build the injury rat model by reperfusion after global cerebral ischemia .After 15 minutes'ischemia, im-mediate injection of 14μmol/kg NaHS was performed intraperitoneally on NaHS group and NaHS combined mild hypothermia group , while skin cooling(rectal temperature=32-33℃) was done on mild hypothermia group and NaHS combined mild hypothermia group .6 hours late,r hip-pocampus were extracted from rat heads.Respectively, spectrophotometer was applied to measure the content of H2S, Western blot for the expres-sions of NR2 A,NR2 B and pC-REB, and RTP-CR for mRNA level of brain derived neurotrophic (BDNF). HE staining was also performed on brain tissues 72hours after reperfusion on 4 rats from each group to evaluate the pathological changes of pyramidal neurons in CA1 region. R esul ts The content of H 2 S increased in each of the four groups after ischemia-reperfusion compared with sham operation group ( 15.2 ±2.0 nmol/g) (P<0.05).In comparison to model group (25.2 ±3.5 nmol/g), NaHS group (37.5 ±4.0 nmol/g) and NaHS combined mild hypothermia group (38.7 ±4.4nmol/g ) resulted in significant high content of H2S(P<0.05), while mild hypothermia group(26.5 ±3.5nmol/g ) got a mild increase(P>0.05).The gray values of NR2A and NR2B in each group increased compared with sham operation group(P<0.05), re-sulting in NR2A/NR2B<1 in model group and mild hypothermia group while NR2A/NR2B>1 in NaHS group and NaHS combined mild hy-pothermia group.Compared with the expression of p-CREB(0.55 ±0.06) in model group, there were significant increases in mild hypother-mia group(0.99 ±0.15), NaHS group(1.05 ±0.12), NaHS combined mild hypothermia group(1.02 ±0.15)(P<0.05).Compared with the expression of BNDF mRNA(0.83 ±0.12) in model group, there were significant increases in mild hypothermia group (1.11 ±0.13), NaHS group(1.27 ±0.16), NaHS combined mild hypothermia group(1.35 ±0.16)(P<0.05).In comparison to model group, there were signifi-cant alleviation in the injury of pyramidal neurons in hippocampal CA1 region in mild hypothermia group, NaHS group, NaHS combined mild hypothermia group, with the best effect in NaHS combined mild hypothermia group . Conclusion Hydrogen sulfide combined mild hypo-thermia can selectively activate synaptic NMDA receptors and trigger the prosurvival CREB signaling pathway to exert brain resuscitation .

The purpose of this study is to characterize the stress relax properties of PVA-H prosthetic nucleus via the four-parameter linear viscoelastic model and to analyze the influence of swelling ratio and initial PVA content upon the properties of dissipating compressive stress. The four-parameter linear viscoelastic model can simulate the viscoelastic property of prosthetic nucleus well (corr > 0.99) and be more effective than the three parameter linear viscoelastic model. From the parameters of this model we have obtained the following results: the prosthetic nucleus of higher water content can dissipate compressive stress more quickly than that of lower water content can do, but the quantity of stress relax can not be influenced by water content; the higher the initial PVA content,the slower and smaller the dissipation of compressive stress;the relax time of prosthetic nucleus is similar to that of human nucleus.
Compressive Strength ; Elasticity ; Intervertebral Disc ; physiology ; Linear Models ; Models, Biological ; Polyvinyl Alcohol ; chemistry ; Prostheses and Implants ; Viscosity ; Weight-Bearing ; physiology