ObjectiveTo investigate the mechanism of Si Junzitang in treating liver injury in rats with spleen Qi deficiency syndrome based on transcriptomics and to experimentally verify its effects. MethodsSixty male SD rats were randomly divided into blank group， model group， low-dose Si Junzitang （6 g·kg^-1·d^-1）， medium-dose Si Junzitang group （12 g·kg^-1·d^-1）， high-dose Si Junzitang group （24 g·kg^-1·d^-1）， and natural recovery group， with 10 rats in each group. A composite multifactorial modeling method （forced swimming + intragastric administration of Xiao Chengqitang + irregular diet） was used to establish a spleen Qi deficiency model. After 30 days of continuous intervention， body weight and 3-hour food intake were measured， and macroscopic symptom scores for spleen Qi deficiency syndrome were evaluated. Serum levels of aspartate aminotransferase （AST） and alanine aminotransferase （ALT） in each group were detected， and hematoxylin and eosin （HE） staining was used to observe histopathological changes in liver tissue. Transcriptome sequencing （RNA-Seq） was used to identify differentially expressed genes （DEGs） among the blank， model， and high-dose Si Junzitang groups. Gene ontology（GO） and Kyoto encyclopedia of genes and genome（KEGG） enrichment analyses were performed on the DEGs. Immunofluorescence （IF） and Western blot were used to detect NOD-like receptor protein 3 （NLRP3）， apoptosis-associated speck-like protein （ASC）， Caspase-1， and the N-terminal domain of gasdermin D （GSDMD-N）. Immunohistochemistry （IHC） was used to detect the expression of downstream inflammatory cytokines interleukin-1β （IL-1β）， interleukin-6 （IL-6）， and interleukin-18 （IL-18）. ResultsCompared with the blank group， the model group showed significantly reduced body weight and 3-hour food intake， significantly increased macroscopic symptom scores， and elevated serum AST and ALT levels （P<0.01）， with mild inflammatory liver injury observed histologically. Compared with the model group， Si Junzitang at all doses significantly improved these parameters and alleviated liver injury in a dose-dependent manner （P<0.05，P<0.01）. RNA-Seq analysis revealed 1 254 DEGs between the blank and model groups， and 842 DEGs between the model and high-dose Si Junzitang groups. GO and KEGG enrichment analyses indicated that the NOD-like receptor signaling pathway was activated in liver injury associated with spleen Qi deficiency， suggesting that the NLRP3 inflammasome may be a key target. Results from IF， IHC， and Westernblot showed that compared with the blank group， the expression of NLRP3， ASC， Caspase-1， GSDMD-N， and the downstream inflammatory cytokines IL-1β， IL-6， and IL-18 were significantly increased in the model group （P<0.01）， while these levels were markedly decreased in the high-dose Si Junzitang group （P<0.01）. ConclusionSi Junzitang effectively improves mild inflammatory liver injury in rats with spleen Qi deficiency syndrome in a dose-dependent manner. Its mechanism may be associated with inhibition of the NLRP3/ASC/Caspase-1 signaling pathway， downregulation of the pyroptosis executioner protein GSDMD-N， and reduction of pyroptosis-related inflammatory cytokine release.

The wind, phlegm, and blood stasis are important pathogenic factors of cough variant asthma in children, and they are also the pathological products in the occurrence and development of this disease. They have typical pathogenic characteristics. The main pathogenesis characteristics of cough caused by wind, phlegm and blood stasis are as follows that external wind attacks the lungs and induces internal wind, phlegm and dampness accumulates in the lungs, and the lungs fail to declare and descend, and blood stasis obstructs the collaterals and stagnation of Qi. The wind, phlegm, and blood stasis have their own pathogenic characteristics, and their cough-causing also have their own pathogenic characteristics and clinical characteristics. Based on the characteristics of wind, phlegm, and blood stasis, the application of medicine based on the differentiation of symptoms and signs can effectively prevent and treat this disease, and provide theoretical basis and treatment ideas for the treatment of cough variant asthma in children with Chinese medicine.

This paper reviewed the research on moral injury among foreign medical staff in the background of the COVID -19 pandemic. It was found that foreign medical staff bore multiple moral pressures and impacts in the face of the epidemic, including the collision between medical practice and utilitarian policy, the inability to meet personal needs, the rapid transformation of medical mode, and a variety of comprehensive factors. Therefore, the moral injury of foreign medical staff is particularly prominent. In order to avoid and reduce the occurrence of moral injury, it is necessary to strengthen the cultivation of moral resilience, provide psychological and social support, and carry out personalized treatment for medical staff.

Objective To study the correlations among lumbosacral anatomical structure variations and herniation of intervertebral disc.Methods Through analyzing lumbar CT images of 684 patients with lumbocrural pain between 15 to 24 years old, the anatomical variations of spondylolysis, scoliosis deformity, lumbosacral transitional vertebra, subfissure, lumbosacral angle and others (including vertebral muscles beside, spines, transverse process on both sides) were observed, and the correlations among these anatomical variations and herniation of intervertebral disc were analyzed.Results The correlations among these above mentioned anatomical variations and herniation of intervertebral disc were 93.6%,92.3%,87.5%,81.3%,72.1%,53.3% respectively.In 91.4% of patients, the lumbosacral anatomical structure variations suffered herniation of intervertebral disc at the same time.But only 36.2% of patients suffered herniation of intervertebral disc without lumbosacral anatomical structure variations.Conclusion Lumbosacral anatomical structure variation is the main reason of herniation of intervertebral disc on teenagers.CT examination,which can reflect the correlation between them.

Objective To investigate the effect of embryotrophic factors(ETF)from human oviductal cells on gene expression of mouse early developmental embryos and discuss the role of fallopian tube in early development of embryos.Methods ETF was isolated from conditioned medium of human oviductal cell line by sequential liquid chromatographic systems.Mouse embryos were treated by ETF in vitro.Using differential display RT-PCR,the gene expression of embryos treated by ETF was compared with embryos without ETF treatment.The differentially expressed genes were separated,re-amplified,cloned and sequenced.Results Gene expression profiles of embryos with ETF treatment was different from embryos without this treatment.Eight differentially expressed genes were cloned and sequenced.These genes functioned in RNA degradation,synthesis,splicing,protein trafficking,cellular differentiation and embryo development.Conclusion Embryotrophic factors from human oviductal cells affect gene expression of early developmental embryos.The human oviductal cells play wide roles in early developmental stages of embryos.