Inflammation-to-tumor transition is one of the important mechanisms by which the cervical high-risk human papillomavirus(HR-HPV)infection develops into cervical cancer.Persistent cervical HR-HPV infection is an important cause of cervical cancer,and the focal uncontrolled inflammatory microenvironment caused by persistent cervical HR-HPV infection is the underlying mechanism of cervical cancer.The macroscopic and microscopic pathological process of inflammation-to-tumor transition is consistent with the pathogenesis evolution of damp-heat accumulation resulting into toxin in traditional Chinese medicine(TCM):the accumulation of damp-heat is the driving factor of inflammation-to-tumor transition,long-term retention of damp-heat leading to spleen deficiency and liver depression contributes to the characteristics of pathogenesis evolution,and long-term retention of damp-heat toxin causes the disorder of liver and spleen and then blood stasis accumulates in the cervical orifice,which eventually becomes cancer toxin.The process of inflammation-to-tumor transition caused by persistent cervical HR-HPV infection is due to the pathological factors of damp,heat,deficiency and toxin in TCM.Therefore,the regulation of inflammatory microenvironment caused by persistent cervical HR-HPV infection is the key approach to the prevention and treatment of cervical cancer.For the treatment of cervical cancer,methods of clearing heat and drying dampness,strengthening the spleen and soothing the liver are the key therapies.By intervention with the proper pathogen-eliminating methods and with simultaneous regulation of the interior and exterior,the process of inflammation-to-tumor transition can be interrupted.The exploration of inflammation-to-tumor transition caused by persistent cervical HR-HPV infection from the perspective of damp-heat accumulation resulting into toxin will provide thoughts for the prevention and treatment of cervical cancer with TCM and for Chinese medicine in intervening inflammation-to-tumor transition.

AIM To investigate the effects of Moluodan Dami Pills on chronic atrophic gastritis(CAG)rats and their mechanism.METHODS The rat models were randomly divided into the model group,the low-dose group and high-dose Moluodan Dami Pills groups(2.43 g/kg and 4.86 g/kg),and vitamin A group(0.32 g/kg),following the 16 weeks successful induction of CAG by five-factor modeling method,in contrast to another 10 normal rats of the control group.After 8 weeks corresponding administration,the rats of each group had their general physiological status and pH value of gastric juice assessed;their pathological changes of gastric mucosa observed by naked eyes combined with HE staining;their changes of gastrin-secreting cells(G cells)and somatostatin-secreting cells(D cells)in gastric mucosa observed by immunohistochemistry;and their serum levels of pepsinogen Ⅰ/pepsinogen Ⅱ(PG Ⅰ/PG Ⅱ)ratio,TNF-α and IL-6 detected by ELISA.RESULTS Compared with the model group,the groups intervened with Moluodan Damei Pills and vitamin A displayed lower pH values of gastric juice(P＜0.05),improved pathological changes of gastric mucosa,increased G and D cells counts(P＜0.05,P＜0.01),increased ratio of serum PGⅠ/PGⅡ,and decreased levels of IL-6 and TNF-α(P＜0.05,P＜0.01).CONCLUSION Moluodan Dami Pills can effectively improve the symptoms of CAG rats through its influence on the number and secretion abilityof G and D cells,the levels of serum PG Ⅰ/PG Ⅱ ratio and inflammatory factors.

Objective: To investigate the value of plasma cells for diagnosing lymph node diseases. Methods: Common lymphadenopathy (except plasma cell neoplasms) diagnosed from September 2012 to August 2022 were selected from the pathological records of Changhai Hospital, Shanghai, China. Morphological and immunohistochemical features were analyzed to examine the infiltration pattern, clonality, and IgG and IgG4 expression of plasma cells in these lymphadenopathies, and to summarize the differential diagnoses of plasma cell infiltration in common lymphadenopathies. Results: A total of 236 cases of lymphadenopathies with various degrees of plasma cell infiltration were included in the study. There were 58 cases of Castleman's disease, 55 cases of IgG4-related lymphadenopathy, 14 cases of syphilitic lymphadenitis, 2 cases of rheumatoid lymphadenitis, 18 cases of Rosai-Dorfman disease, 23 cases of Kimura's disease, 13 cases of dermal lymphadenitis and 53 cases of angioimmunoblastic T-cell lymphoma (AITL). The main features of these lymphadenopathies were lymph node enlargement with various degrees of plasm cell infiltration. A panel of immunohistochemical antibodies were used to examine the distribution of plasma cells and the expression of IgG and IgG4. The presence of lymph node architecture could help determine benign and malignant lesions. The preliminary classification of these lymphadenopathies was based on the infiltration features of plasma cells. The evaluation of IgG and IgG4 as a routine means could exclude the lymph nodes involvement of IgG4-related dieases (IgG4-RD), and whether it was accompanied by autoimmune diseases or multiple-organ diseases, which were of critical evidence for the differential diagnosis. For common lesions of lymphadenopathies, such as Castleman's disease, Kimura's disease, Rosai-Dorfman's disease and dermal lymphadenitis, the expression ratio of IgG4/IgG (>40%) as detected using immunhistochemistry and serum IgG4 levels should be considered as a standard for the possibility of IgG4-RD. The differential diagnosis of multicentric Castleman's diseases and IgG4-RD should be also considered. Conclusions: Infiltration of plasma cells and IgG4-positive plasma cells may be detected in some types of lymphadenopathies and lymphomas in clinicopathological daily practice, but not all of them are related to IgG4-RD. It should be emphasized that the characteristics of plasma cell infiltration and the ratio of IgG4/IgG (>40%) should be considered for further differential diagnosis and avoiding misclassification of lymphadenopathies.
Humans ; Castleman Disease/pathology* ; Plasma Cells/pathology* ; Immunoglobulin G4-Related Disease ; China ; Lymphadenopathy/pathology* ; Inflammation/pathology* ; Lymph Nodes/pathology* ; Diagnosis, Differential ; Lymphadenitis/pathology* ; Immunoglobulin G/metabolism*

Objectives: To evaluate the positive rate of left posterior lymph nodes of the superior mesenteric artery (14cd-LN) in patients undergoing pancreaticoduodenectomy for pancreatic head carcinoma,to analyze the impact of 14cd-LN dissection on lymph node staging and tumor TNM staging. Methods: The clinical and pathological data of 103 consecutive patients with pancreatic cancer who underwent pancreaticoduodenectomy at Pancreatic Center,the First Affiliated Hospital of Nanjing Medical University from January to December 2022 were analyzed,retrospectively. There were 69 males and 34 females,with an age(M (IQR))of 63.0 (14.0) years (range:48.0 to 86.0 years). The χ² test and Fisher's exact probability method was used for comparison of the count data between the groups,respectively. The rank sum test was used for comparison of the measurement data between groups. Univariate and multivariate Logistic regression analyzes were used for the analysis of risk factors. Results: All 103 patients underwent pancreaticoduodenectomy successfully using the left-sided uncinate process and the artery first approach. Pathological examination showed pancreatic ductal adenocarcinoma in all cases. The location of the tumors was the pancreatic head in 40 cases,pancreatic head-uncinate in 45 cases,and pancreatic head-neck in 18 cases. Of the 103 patients,38 cases had moderately differentiated tumor and 65 cases had poorly differentiated tumor. The diameter of the lesions was 3.2 (0.8) cm (range:1.7 to 6.5 cm),the number of lymph nodes harvested was 25 (10) (range:11 to 53),and the number of positive lymph nodes was 1 (3) (range:0 to 40). The lymph node stage was stage N0 in 35 cases (34.0%),stage N1 in 43 cases (41.7%),and stage N2 in 25 cases (24.3%). TNM staging was stage ⅠA in 5 cases (4.9%),stage ⅠB in 19 cases (18.4%),stage ⅡA in 2 cases (1.9%),stage ⅡB in 38 cases (36.9%),stage Ⅲ in 38 cases (36.9%),and stage Ⅳ in 1 case (1.0%). In 103 patients with pancreatic head cancer,the overall positivity rate for 14cd-LN was 31.1% (32/103),and the positive rates for 14c-LN and 14d-LN were 21.4% (22/103) and 18.4% (19/103),respectively. 14cd-LN dissection increased the number of lymph nodes (P<0.01) and positive lymph nodes (P<0.01). As a result of the 14cd-LN dissection,the lymph node stage was changed in 6 patients,including 5 patients changed from N0 to N1 and 1 patient changed from N1 to N2. Similarly,the TNM stage was changed in 5 patients,including 2 patients changed from stage ⅠB to ⅡB,2 patients changed from stage ⅡA to ⅡB,and 1 patient changed from stage ⅡB to Ⅲ. Tumors located in the pancreatic head-uncinate (OR=3.43,95%CI:1.08 to 10.93,P=0.037) and the positivity of 7,8,9,12 LN (OR=5.45,95%CI:1.45 to 20.44,P=0.012) were independent risk factors for 14c-LN metastasis; while tumors with diameter >3 cm (OR=3.93,95%CI:1.08 to 14.33,P=0.038) and the positivity of 7,8,9,12 LN (OR=11.09,95%CI:2.69 to 45.80,P=0.001) were independent risk factors for 14d-LN metastasis. Conclusion: Due to its high positive rate in pancreatic head cancer,dissection of 14cd-LN during pancreaticoduodenectomy should be recommended,which can increase the number of lymph nodes harvested,provide a more accurate lymph node staging and TNM staging.
Male ; Female ; Humans ; Pancreaticoduodenectomy/methods* ; Retrospective Studies ; Prognosis ; Lymph Node Excision/methods* ; Lymph Nodes/pathology* ; Pancreatic Neoplasms/pathology* ; Neoplasm Staging

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

To expound the basic strategies of translational medicine research based on clinical effect and scientific problems of acupuncture and moxibustion, and discuss the specific research ideas and methods of acupuncture translational medicine by taking acupuncture prevention and treatment of asthma as an example. The overall strategy of acupuncture translational medicine is to determine the effect of acupuncture first, then clarify the mechanism of acupuncture and transform the results into clinical practice. On the one hand, it is necessary to improve the objectivity and recognition of acupoints in experimental animals, and to realize the limitations and possible bias of animal experimental results; on the other hand, we should adhere to help and promote multidisciplinary research on the role of acupuncture.
Translational Science, Biomedical

Aim To investigate the effect and mechanism of Eucommiae ulmoides and Radix Dipsaci in the treatment of osteoporosis.Methods The active ingredients of Eucommiae ulmoides and Radix Dipsaci were obtained by TCMSP,BATMAN-TCM platform and the literature.Osteoporosis related genes were collected by GeneCards and OMIM.The compound target network was constructed with Cytoscape 3.7.2 software.The protein interaction network was constructed with STRING online website.DAVID was used to perform gene ontology(GO)enrichment analysis and kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment analysis.The synergistic effect of Eucommiae ulmoides and Radix Dipsaci was tested by osteo-blast proliferation,alkaline phosphatase expression and mineralized nodule formation experiments.The protein expressions of BMP2 and Wnt signaling pathway were investigated by Western blotting.Results A total of 44 active components of Eucommiae ulmoides and 17 active components of Radix Dipsaci were screened,and 80 targets were intersected by osteoporosis.GO analysis showed that the action mechanism of Eucommiae ulmoides and Radix Dipsaci in the treatment of osteoporosis was involved with 52 items of biological process,8 items of cell composition and 16 items of molecular function.The KEGG enrichment pathway was dominated by 6 major signaling pathways.Compared with the control group,the osteoblast proliferation,alkaline phosphatase expression and mineralized nodule formation significantly increased in Eucommiae ulmoides or Radix Dipsaci group(P<0.01).Western blotting showed that Eucommiae ulmoides mainly regulated the expression levels of Wnt signaling pathways(P<0.05 or P<0.01),and Radix Dipsaci up-regulated the expression levels of BMP2 signaling pathways(P<0.01).Meanwhile,Eucommiae ulmoides and Radix Dipsaci significantly enhanced these effects,respectively(P<0.01).Conclusions Although Eucommiae ulmoides and Radix Dipsaci have different active components,their main targets and pathways are the same in the treatment of osteoporosis.Eucommiae ulmoides and Radix Dipsaci can regulate the function of osteoblasts through BMP2 and Wnt signaling pathways,and the combination of the two drugs in the treatment of osteoporosis has synergistic effect.

Objective To investigate the status of health knowledge of patients after percutaneous coronary intervention (PCI) and its influencing factors, so as to provide a scientific basis for formulating targeted health education programs. Methods Using a self-designed questionnaire on health cognition after PCI, 433 patients with a history of PCI surgery at a Grade III, Class A hospital between January 2019 and December 2019 were selected as the research subjects to investigate their health cognition and the influencing factors by binary logistic regression analysis. Results The pass rate of health cognition of patients after PCI was 39%, and the total correct rate was 57.5%. The correct rate of drug knowledge and risk factors was the lowest (33.6% and 48.5%, respectively). Binary logistic regression showed that gender, age and cardiac function classification were risk factors for health cognition of patients after PCI, while education level, occupation category and recurrence of discomfort after PCI were protective factors. Conclusion The level of health cognition of patients after PCI is low. Gender, age, education level, occupation category, cardiac function classification and recurrence of discomfort after PCI are independent influencing factors. When implementing health education, medical staff should comprehensively consider the formulation of individualized health education to help.

Objective::To study the effect of different packaging methods and storage conditions on the quality of Notopterygii Rhizoma et Radix pieces, in order to determine the optimal packaging method and suitable storage conditions for Notopterygii Rhizoma et Radix pieces. Method::Different packaged Notopterygii Rhizoma et Radix pieces were stored in different environments in a one-year long-term stability experiment. The appearance, water content, extract content and volatile oil content of Notopterygii Rhizoma et Radix pieces were regularly observed. Result::During the 1-year storage period, the Notopterygii Rhizoma et Radix pieces under different packaging and storage conditions showed different degrees of quality changes. Among them, the samples packed in polyethylene plastic bags and polyethylene aluminum foil composite bags were better preserved. The fluctuations in water content of the sample packed in polyethylene plastic bags were relatively low, and the RSD value of water content during the month was less than 11.5%. The extracts and volatile oil contents of each sample were reduced to different degree, but the samples packed in plastic sealed bags and protected from light had the smallest annual loss of extracts (1.27%), with the lowest monthly loss rate of volatile oil (0.08%). Conclusion::The quality of Notopterygii Rhizoma et Radix pieces can be well preserved in plastic sealed bags and storage in dark and cool conditions, which is suitable for the storage of Notopterygii Rhizoma et Radix pieces.