Objective To evaluate the therapeutic efficacy for surgical treatments among patients with hepatic cystic echinococcosis in Gansu Province from 2006 to 2023, so as to provide insights into optimization of the diagnosis and treatment strategies against hepatic cystic echinococcosis. Methods The demographic and clinical data of all echinococcosis cases included in central government fiscal transfer payment program for echinococcosis control and undergoing surgical treatments in Gansu Province from 2006 to 2023 were captured. Hepatic cystic echinococcosis patients with complete medical records and follow-up data were included in the study, and patients’ characteristics, including hospital where patients received diagnosis and treatment, methods of case identification, year of surgery, classification of lesions, number of lesions, size of lesions, course of disease, surgical methods, and post-surgical follow-up data. The cure and recurrence of hepatic cystic echinococcosis were evaluated according to the Guidelines for Management of Echinococcosis Patients in the Central Government Fiscal Transfer Payment Program, and the cure and recurrent rates were calculated. Results Data were collected from 1 686 surgical patients with hepatic cystic echinococcosis. According to the inclusion and exclusion criteria, 1 222 hepatic cystic echinococcosis patients undergoing surgical treatments were included during the period from 2006 to 2022, including 1 166 cured patients (95.42%) and 88 patients with postsurgical recurrence (7.20%), and the cure rate of surgical treatments appeared a tendency towards a rise among patients with hepatic cystic echinococcosis from 2008 to 2022 (χ²_trend = 19.39, P < 0.05). The cure rates of hepatic cystic echinococcosis were 100% (177/177), 94.81% (128/135) and 94.62% (861/910) among patients detected through regular physical examinations, screened by the central government fiscal transfer payment program for echinococcosis control, and those who passively sought healthcare services, respectively (χ² = 9.95, P < 0.05). The cure rates of hepatic cystic echinococcosis were 95.96% (1 046/1 090) among patients with a disease course of 2 years and less and 90.90% (120/132) among patients with a disease course of over 2 years (χ² = 6.87, P < 0.05), and there were significant differences in the cure rates among patients with hepatic cystic echinococcosis in terms of number of lesions (χ² = 24.44, P < 0.05) and surgical methods (P < 0.05). The cure rate of hepatic cystic echinococcosis patients was significantly higher following initiation of the central government fiscal transfer payment program for echinococcosis control (96.06%, 1 096/1 141) than before the program (86.42%, 70/81) (χ² = 16.06, P < 0.05), and the cure rate of hepatic cystic echinococcosis patients was significantly higher in designated hospitals (96.48%, 741/768) than in non-designated hospitals (93.37%, 366/392) (χ² = 5.78, P < 0.05). The median follow-up period was 4 (interquartile range, 7) years among 1 222 hepatic cystic echinococcosis patients undergoing surgical treatments. The recurrent rate of hepatic cystic echinococcosis appeared a tendency towards a decline from 2008 to 2022 (χ²_trend = 36.86, P < 0.05), with a reduction from 23.08% (9/39) in 2008 to 1.85% (1/54) in 2021, and the post-surgical recurrence rate of hepatic cystic echinococcosis was lower following initiation of the central government fiscal transfer payment program for echinococcosis control (5.87%, 67 / 1 141) than before the program (25.93%, 21/81) (χ² = 45.51, P < 0.05). In addition, the post-surgical recurrence rate of hepatic cystic echinococcosis was higher in non-designated hospitals (10.46%, 41/392) than in designated hospitals (5.60%, 43/768) (χ² = 9.12, P < 0.05), and there was a significant difference in the post-surgical recurrence rate among patients with hepatic cystic echinococcosis in terms of surgical methods (P < 0.05), with the highest recurrence rate (11.54%) seen among patients undergoing percutaneous fine-needle aspiration of cyst fluids-based surgical procedures (P < 0.05). Conclusion Since the initiation of the central government fiscal transfer payment program for echinococcosis control in Gansu Province in 2006, an increase in the surgical cure rate and a reduction in the recurrence of hepatic cystic echinococcosis had been found among patients with hepatic cystic echinococcosis, indicating a high overall therapeutic efficacy.

OBJECTIVE To investigate the effects and mechanism of quercetin （QUE） on inflammatory response in allergic rhinitis （AR） model rats based on Toll-like receptor 4/interleukin 1 （IL-1） receptor-associated kinase/nuclear factor κB （TLR4/ IRAK4/NF-κB） signaling pathway. METHODS AR model rats were constructed by ovalbumin sensitization method. A total of 48 successfully constructed rats were randomly divided into AR group， QUE-L and QUE-H groups （i.g administration， 17.5， 35 mg/kg） and QUE-H+TLR4 activator lipopolysaccharide （LPS） group （i.g administration of 35 mg/kg QUE+intravenous administration of 0.4 mg/kg LPS via tail vein）， with 12 rats in each group. Another 12 normal healthy rats were selected as control group， once a day， for 21 consecutive days. After the last medication， rhinitis symptoms of rats in each group were scored. The serum levels of immunoglobulin E （IgE）， histamine （HIS）， and inflammatory factors were all detected. The proportions of regulatory T cells （Treg） and helper T cells 17 （Th17） cells in blood were detected， the Th17/Treg ratio was calculated， and the pathological condition of nasal mucosal tissue was observed. The expressions of TLR4/IRAK4/NF-κB pathway related protein in nasal mucosal tissue were determined. RESULTS Compared with control group， nasal mucosal tissue damage in the AR group was more severe， with partial shedding of epithelial cells， the proliferation of goblet cells， and obvious inflammatory cell infiltration. The rhinitis symptom score， the levels of IgE， HIS and IL-17， Th17 proportion， Th17/Treg ratio，p-IRAK4/IRAK4 and p-NF-κB p65/NF-κB p65 ratios as well as relative expression of TLR4 protein were increased significantly （P＜0.05）， while IL-10 level and Treg proportion were decreased significantly （P＜0.05）. Compared with AR group， the pathological injuries of nasal mucosa and the above indexes in QUE-L and QUE-H groups were all improved significantly （P＜0.05）. LPS treatment could reverse the improvement effects of high-dose QUE on histopathological damage to nasal mucosa tissue and the aforementioned indicators （P＜ 0.05）. CONCLUSIONS QUE can inhibit the inflammatory response in AR rats by inhibiting TLR4/IRAK4/NF- κB signaling pathway.

OBJECTIVE To explore the mechanisms of the flavonoids from new "Zhe Eight Flavors" Quzhou Fructus Aurantii(PTFC) against hepatocellular carcinoma based on the prediction of network pharmacology and experimental verification. METHODS From TCMSP, TCMID, ETCM, BATMAN-TCM and SwissTargetPrediction databases, the potential target proteins of PTFC, including naringin, narirutin and neohesperidin were collected. Based on the GeneCards, CTD, Disgenet, and OMIM databases, a set of target proteins for hepatocellular carcinoma was constructed. Taking the intersection of potential target proteins of PTFC and target proteins of hepatocellular carcinoma, key target proteins were obtained and a protein-protein interaction network was established. Besides, GO function and KEGG pathway enrichment analysis on the core target proteins was performed and a Compounds-Targets-Pathways-Disease network was constructed. Through proliferation, cloning, wound healing, and migration experiments, the effects of PTFC on the viability of HepG2 liver cancer cells were analyzed. Using fluorescence probe staining the impacts of PTFC on the mitochondrial membrane potential and apoptosis of HepG2 were observed. Finally, the validation of the regulatory effect of PTFC on the key predicted target PRKCA were carried out through RT-qPCR. RESULTS Based on network pharmacology, a total of 217 potential target proteins for PTFC were screened, with 59 intersecting target proteins related to diseases, including ALB, ESR1, PRKCA, and others. GO functional and KEGG pathway enrichment analysis revealed that the PTFC target proteins were involved in 193 biological processes and 13 cancer-related signaling pathways. Experimental results demonstrated that PTFC could impact the proliferation, cloning, wound healing, and migration abilities of liver cancer cells, leading to a decrease in mitochondrial membrane potential and promoting cell apoptosis. The results of RT-qPCR confirmed a significant downregulation of PRKCA expression by PTFC, validating the predictions made by network pharmacology analysis. CONCLUSION This study has revealed the potential molecular mechanism of PTFC treating hepatocellular carcinoma via the PRKCA target, laying the foundation for clinical application of PTFC.

OBJECTIVE To study the inhibitory effect and mechanism of curcumin and its derivatives A and B on TGF-β induced LX-2 cell fibrosis. METHODS Established the liver fibrosis model of LX-2 cells induced by TGF-β(10 ng·mL−1).The effects on cell proliferation were detected by CCK-8. The effects on cell apoptosis was detected by flow cytometry. The effects on fibrosis related factors(Collagen I, Collagen Ⅳ, Fibronectin, Vimentin, α-SMA, PDGFRβ, TGFβR1, TGFβR2, MMP2, MMP9, TIMP1 and TIMP2) protein expression and gene transcription levels were detected by Western blotting and q-PCR. RESULTS The curcumin and its derivative A and B had the inhibition effects on normal LX-2 cells, and the IC25 values were 15.7, 2.6, 10.2 μmol·L−1, respectively. Compared to the model group, the curcumin(15.7 μmol·L−1) and its derivative A(2.6 μmol·L−1) and B(10.2 μmol·L−1) had the significant inhibition effects on cell proliferation of the TGF-β induced LX-2 cells(P<0.05). The cell apoptosis rate of curcumin derivative B group was higher than the model group(P<0.05). Collagen I, Fibronectin, Vimentin, α-SMA, TGFβR1 and TIMP-1 protein expression levels in curcumin group were lower, while the protein expression level of MMP-9 was higher(P<0.05). The protein expression levels of Collagen I, Collagen IV, Fibronectin, Vimentin, α-SMA, TIMP-1 and TIMP-2 in curcumin derivative A group were lower, while the protein expression level of MMP-2 was higher(P<0.05). The protein expression levels of Collagen I, Collagen IV, Fibronectin, Vimentin, α-SMA, PDGFRβ, TGFβR1, TGFβR2, TIMP-1 and TIMP-2 in curcumin derivative B group were lower, while the protein expression level of MMP-2 was higher(P<0.05). The gene transcription levels of Collagen I, Fibronectin, α-SMA and TIMP-1 in curcumin group were lower(P<0.05). The gene transcription levels of Collagen I, Fibronectin and α-SMA in curcumin derivative A and B groups were lower(P<0.05). CONCLUSION Curcumin and its derivatives A and B inhibit the abnormal activation and proliferation of TGF-β-induced LX-2 cells, inhibit the excessive secretion and accumulation of its extracellular matrix components, and promote its degradation, thus playing an anti-fibrotic effect in vitro, especially the curcumin derivative B.

Objective To explore the effect of etomidate-propofol mixture anaesthesia in painless gastrointestinal endoscopy.Methods Eighty-two patients who underwent painless gastrointestinal endoscopy from September 2023 to November 2023 were divided into etomidate-propofol mixture group(observation group,n=41)and propofol group(control group,n=41)by using the random number table method.Morphine-benzedrine group(MBG)scores were recorded 30 min before the examination and before leaving the recovery room in both groups.Percutaneous arterial oxygen saturation(SpO2),heart rate(HR)and mean arterial pressure(MAP)were noted at anesthesia induction(T0),before entering the endoscope(T1),5 min after anesthesia induction(T2),and awakening(T3).Gastrointestinal endoscopy time,awakening time,recovery room stay time,total propofol consumption,and adverse reactions were also documented.Results MBG scores in both groups significantly increased before leaving the recovery room compared to 30 min before the examination,the observation group had lower MBG scores before leaving the recovery room in comparison with the control group,there were statistically significant(P＜0.05).From T1 to T3,MAP,SpO2,HR were higher in the observation group than those in the control group,there were statistically significant(P＜0.05).The observation group had shorter awakening time and recovery room stay time,there were statistically significant(P＜0.05).The observation group had lower total propofol consumption,there was statistically significant(P＜0.05).The observation group also exhibited a lower incidence of hypotension,hypoxemia,and injection pain,there were statistically significant(P＜0.05),with no statistically significant difference in the incidence of other adverse reactions(P＞0.05).Conclusion Etomidate-propofol combination anesthesia can reduce postoperative MBG scores in painless gastrointestinal endoscopy,contributing to a decreased risk of potential propofol addiction and abuse.Additionally,it stabilizes circulatory and respiratory functions,reduces adverse reactions rate,and shortens awakening time and recovery room stay time.Its application is worthy of further promotion.

Using chemoproteomic techniques, we first identified EIF2AK2, eEF1A1, PRDX3 and VPS4B as direct targets of berberine (BBR) for its synergistically anti-inflammatory effects. Of them, BBR has the strongest affinity with EIF2AK2 via two ionic bonds, and regulates several key inflammatory pathways through EIF2AK2, indicating the dominant role of EIF2AK2. Also, BBR could subtly inhibit the dimerization of EIF2AK2, rather than its enzyme activity, to selectively modulate its downstream pathways including JNK, NF-κB, AKT and NLRP3, with an advantage of good safety profile. In EIF2AK2 gene knockdown mice, the inhibitory IL-1β, IL-6, IL-18 and TNF-α secretion of BBR was obviously attenuated, confirming an EIF2AK2-dependent anti-inflammatory efficacy. The results highlight the BBR's network mechanism on anti-inflammatory effects in which EIF2AK2 is a key target, and inhibition of EIF2AK2 dimerization has a potential to be a therapeutic strategy against inflammation-related disorders.

The lung is one of the most common sites for cancer metastasis. Collagens in the lung provide a permissive microenvironment that supports the colonization and outgrowth of disseminated tumor cells. Therefore, down-regulating the production of collagens may contribute to the inhibition of lung metastasis. It has been suggested that miR-29 exhibits effective anti-fibrotic activity by negatively regulating the expression of collagens. Indeed, our clinical lung tumor data shows that miR-29a-3p expression negatively correlates with collagen I expression in lung tumors and positively correlates with patients' outcomes. However, suitable carriers need to be selected to deliver this therapeutic miRNA to the lungs. In this study, we found that the chemotherapy drug cisplatin facilitated miR-29a-3p accumulation in the exosomes of lung tumor cells, and this type of exosomes exhibited a specific lung-targeting effect and promising collagen down-regulation. To scale up the preparation and simplify the delivery system, we designed a lung-targeting liposomal nanovesicle (by adjusting the molar ratio of DOTAP/cholesterol-miRNAs to 4:1) to carry miR-29a-3p and mimic the exosomes. This liposomal nanovesicle delivery system significantly down-regulated collagen I secretion by lung fibroblasts in vivo, thus alleviating the establishment of a pro-metastatic environment for circulating lung tumor cells.

【Objective】 To investigate the central sedative and hypnotic effects and mechanisms of Shumian Capsule. 【Methods】 The blank control group, the positive drug diazepam group, and the low-, medium-, and high-dose groups of Shumian Capsule were designed in the experiments. Male Kunming mice were administered orally by gavage. We conducted the experiment of mouse autonomous activity, and assessed supra- and sub-threshold dose sleep with pentobarbital sodium, respectively. The levels of γ-aminobutyric acid (GABA) and glutamic acid (Glu) in the brain tissue of the mice were measured by enzyme-linked immunosorbent assay (ELISA) or colorimetric method. Male SD rats were injected intraperitoneally with p-chlorophenyl alanine [PCPA, 350 mg/(kg·d)] to establish an insomnia rat model, after which rats were continuously administered intragastrically for 7 days. The general status and body weight of the rats were observed. Total distance and standing times of rats were measured by open field test. Western blotting and immunohistochemistry assays were used to evaluate the protein expression of 5-HT1A receptor (5-HT1AR) in the rat hippocampus. 【Results】 Compared with the blank control group, the three dose groups of Shumian Capsule [1.6, 3.2, 6.4 mg/(kg·d)] for 14 consecutive days had significantly reduced the number of spontaneous activities and standing times in the mice (P<0.01). The high dose significantly prolonged the sleep duration of the mice induced by the supra-threshold dose of pentobarbital sodium (P<0.01). Compared with the blank control group, each dose group of Shumian Capsule had an increased GABA level in the mouse brain tissue in a dose-dependent manner (P<0.05); the medium- and high-dose groups had significantly reduced Glu levels in the hippocampus (P<0.05), while the high-dose group had significantly reduced Glu level in the cortex (P<0.05). In insomnia model rats, their activity was sluggish; their circadian activity rhythm disappeared; the hair became hard, rough and dull, with severe hair loss; and their weight reduced. After 7 consecutive days of the drug administration, the rats’ mental state in each Shumian Capsule dose group was improved. Compared with the blank control group, the rats’ body weight gains were significantly reduced after intraperitoneal injection of PCPA (P<0.01). Compared with the model group, each rat group of Shumian capsule treatment had significantly increased body weight gains (P<0.01). Compared with the blank control group, the distance of the rats in the model group increased in the open field test, and the expression level of 5-HT1AR protein in the hippocampus decreased. However, the distance of rats in diazepam group and each dose group of Shumian Capsule was significantly reduced (P<0.01), and the expression level of 5-HT1AR protein in the hippocampus of the high- and medium-dose groups of Shumian Capsule and diazepam group increased significantly (P<0.01). 【Conclusion】 Shumian Capsule has obvious effects of sedation, hypnosis and insomnia improvement, and its underlying mechanisms may be related to the increased GABA and decreased Glu contents in brain tissues, as well as up-regulated 5-HT1AR protein expression in the hippocampus.

Triterpenoids are a class of natural products of great commercial value that are widely used in pharmaceutical, health care and cosmetic industries. The biosynthesis of triterpenoids relies on the efficient synthesis of squalene epoxide, which is synthesized from the NADPH dependent oxidation of squalene catalyzed by squalene epoxidase. We screened squalene epoxidases derived from different species, and found the truncated squalene epoxidase from Rattus norvegicus (RnSETC) showed the highest activity in engineered Escherichia coli. Further examination of the effect of endogenous cytochrome P450 reductase like (CPRL) proteins showed that overexpression of NADH: quinone oxidoreductase (WrbA) under Lac promoter in a medium-copy number plasmid increased the production of squalene epoxide by nearly 2.5 folds. These results demonstrated that the constructed pathway led to the production of squalene epoxide, an important precursor for the biosynthesis of triterpenoids.
Animals ; Escherichia coli/genetics* ; NADPH-Ferrihemoprotein Reductase ; Protein Engineering ; Rats ; Repressor Proteins ; Squalene ; Squalene Monooxygenase/genetics*

Severe and critically ill patients with coronavirus disease 2019 (COVID-19) were usually with underlying diseases, which led to the problems of complicated drug use, potential drug-drug interactions and medication errors in special patients. Based on ( 6), and -19: , we summarized the experience in the use of antiviral drugs, corticosteroids, vascular active drugs, antibacterial, probiotics, nutrition support schemes in severe and critically ill COVID-19 patients. It is also suggested to focus on medication management for evaluation of drug efficacy and duration of treatment, prevention and treatment of adverse drug reactions, identification of potential drug-drug interactions, individualized medication monitoring based on biosafety protection, and medication administration for special patients.
Adrenal Cortex Hormones ; adverse effects ; therapeutic use ; Anti-Bacterial Agents ; therapeutic use ; Antiviral Agents ; adverse effects ; therapeutic use ; Betacoronavirus ; isolation & purification ; Coronavirus Infections ; drug therapy ; Critical Illness ; Drug Therapy ; Humans ; Nutritional Support ; Pandemics ; Pneumonia, Viral ; drug therapy ; Probiotics ; administration & dosage