OBJECTIVE To provide reference for basic analysis of the pharmacodynamic substance in Stahlianthus involucratus. METHODS Overall 24 SD male rats were randomly divided into blank group （purified water）， and administration group （ethanol extract of S. involucratus， 15.75 g/kg， calculated by crude drug）， with 12 rats in each group. They were given drug liquid/purified water intragastrically， twice a day， every 6-8 h， for consecutive 3 days. After medication， the blood， urine and fecal samples were collected from two groups of rats. UPLC-Q-Exactive-MS technology was used to identify the chemical constituents in the ethanol extract of S. involucratus， and metabolites in the blood， urine and fecal of rats after intragastrical administration of the ethanol extract of S. involucratus. Multivariate statistical analysis was employed to screen various serum metabolites. Metabolic pathways were analyzed by MetaboAnalyst 5.0 platform. RESULTS A total of 38 chemical constituents were identified from the ethanol extract of S. involucratus， including fourteen prototype components and three metabolites identified from 5 urine samples， nine prototype components identified from fecal samples， and ten prototype components and one metabolite identified from serum samples. A total of 71 differential metabolites were screened from two groups of rat serum samples， of which 44 differential metabolites， such as ferulic acid， glycyrrhizin， were up-regulated and 27 differential metabolites， such as arachidonic acid， phenylacetylglutamine， were down-regulated. The 71 differential metabolites were mainly enriched in 11 metabolic pathways， including phenylalanine metabolism， linoleic acid metabolism， arachidonic acid metabolism， and tryptophan metabolism. CONCLUSIONS Ferulic acid， liquiritigenin， isofraxidin and formononetin may be the material basis that directly exert pharmacological effects of S. involucratus. S. involucratus may exert anti-inflammatory effects by affecting metabolic pathways， including arachidonic acid metabolism and tryptophan metabolism.

Objective To investigate the application value of point-of-care lung ultrasound (POC-LUS) scoring in selecting respiratory support treatment modalities for neonatal infectious pneumonia (NIP). Methods A total of 89 NIP patients were selected as the study subjects and divided into control group (no assisted ventilation) with 46 cases, noninvasive group (noninvasive assisted ventilation) with 28 cases, and invasive group (invasive mechanical ventilation) with 15 cases based on the degree of dyspnea and blood gas analysis results. The POC-LUS scores of the three groups were compared, and the correlations of POC-LUS scores with arterial oxygen partial pressure [p_a(O₂)] and arterial carbon dioxide partial pressure [p_a(CO₂)] were analyzed. Receiver operating characteristic (ROC) curves were plotted to assess the predictive efficacy of POC-LUS scores for the need for noninvasive assisted ventilation or invasive mechanical ventilation in NIP patients. Results The POC-LUS scores of the noninvasive group and the invasive group were (31.7±7.3) and (42.1±8.0), respectively, which were higher than (21.5±7.3) of the control group. Additionally, the score of the invasive group was higher than that of the noninvasive group (P < 0.05). Correlation analysis revealed a significant negative correlation between POC-LUS scores and p_a(O₂) (r=-0.802, P < 0.05), and a significant positive correlation with p_a(CO₂) (r=0.807, P < 0.05). ROC curve analysis showed that the area under the curve (AUC) of POC-LUS scores for predicting the need for noninvasive assisted ventilation and invasive mechanical ventilation were 0.918 (95%CI, 0.862 to 0.973) and 0.938 (95%CI, 0.889 to 0.987), respectively. The sensitivity was 0.767 and 0.933, and the specificity was 0.935 and 0.824, with optimal cutoff values of 29.5 and 31.5, respectively. Conclusion POC-LUS scoring can quantitatively assess the severity of lung lesions in NIP patients and serves as a guiding tool for clinicians in selecting assisted ventilation treatment modalities.

Taste is a critical sensory function for human as it supports sustenance and alerts the body to toxins. Taste dysfunction is a common side effect of radiotherapy for the head and neck cancers, which is often accompanied by oral mucositis in the early stage. It is associated with anorexia, anxiety and depression, leading to declined quality of life and treatment tolerance. The incidence of radiation-induced taste dysfunction is high, and its clinical manifestations include increased taste threshold, tastelessness, and persistent bitter, sour or metallic taste, which exert significant effect upon the quality of life. At present, effective therapeutic measures for radiation-induced taste dysfunction are still lacking. In this article, research progresses on clinical characteristics and the potential mechanisms of radiation-induced taste dysfunction were reviewed, aiming to provide reference for the mechanism, prevention and treatment for taste dysfunction.

Objective:To investigate the risk factors for futile recanalization in patients with acute anterior circulation large vessel occlusion after endovascular mechanical thrombectomy (EMT), and establish a nomogram model predicting futile recanalization in these patients.Methods:One hundred and eighty-eight patients with acute anterior circulation large vessel occlusion after EMT were enrolled from Department of Neurology, Zhongshan Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine from January 2018 to December 2021. Patients were divided into futile recanalization group and effective recanalization group according to whether futile recanalization occurred; futile recanalization was defined as successful recanalization showed by immediate postoperative DSA (modified thrombolysis in cerebral infarction [mTICI] ≥2b), but poor functional outcome (modified Rankin Scale [mRS] scores>2 90 d after surgery). The clinical data were compared between futile recanalization group and effective recanalization group. Multivariate Logistic regression analysis was used to screen the risk factors for futile recanalization. R software was used to establish a nomogram model for futile recanalization. C-index was used to evaluate the differentiation of the model, and correction curve was used to evaluate the accuracy of the line graph model prediction. Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficiency of the nomogram model.Results:Ninety-two patients had futile recanalization. Compared with the effective recanalization group, futile recanalization group had significantly older age, significantly higher hemoglobin A1c on admission, significantly longer time from puncture to vascular recanalization, significantly higher proportions of patients with hypertension history and poor collateral circulation, and significantly different severities of stroke and white matter hyperintensities (WMHs) and distribution of occlusive sites ( P<0.05). Multivariate Logistic regression analysis showed that age, history of hypertension, time from puncture to vascular recanalization, poor collateral circulation, severe WMHs, and moderate-severe stroke were independent risk factors for futile recanalization after EMT in patients with acute anterior circulation large vessel occlusion ( P<0.05). A nomogram model of futile recanalization was established according to the above 6 factors, with C-index of 0.862 ( 95%CI: 0.809-0.914); the calibration curve of the model was highly coordinated to the ideal model curve; area under the ROC curve of futile recanalization was 0.862 ( 95%CI: 0.809-0.914, P<0.001). Conclusions:Acute anterior circulation large vessel occlusion patients with older age, history of hypertension, longer time from puncture to vascular recanalization, poor collateral circulation, severe WMHs, and moderate-severe stroke trend to have futile recanalization after EMT. This nomogram can predict futile recanalization after EMT.

Objective:To explore the therapeutic characteristics of population with gout achieving treat-to-target (T2T) indicators through real-world research and evaluate their safety.Methods:A total of 3 287 patients diagnosed with gout by rheumatologists in 21 first-class tertiary hospitals in 10 provinces, municipalities, and autonomous regions in China from January 2015 to December 2021 were included in this polycentric cross-sectional study. The database included patients′ general information, disease characteristics, and clinical application of traditional Chinese and Western medicine treatment measures. SPSS and Excel software were used for data analysis. Frequency analysis, cluster analysis, and factor analysis were used to summarize the characteristics and rules of treatment measures for patients with gout who achieved the target after treatment. The occurrence of adverse events (AE) was recorded during treatment.Results:After treatment, 691 visits (7%) achieved the serum urate (SUA) target, and the most frequent use of urate-lowering therapy (ULT) was febuxostat, followed by benzbromarone. The most common treatment options were following: GroupⅠ: traditional Chinese medicine (TCM) decoction-TCM external treatment-physical exercise-proprietary Chinese medicine; GroupⅡ: ferulic acid-nonsteroidal anti-inflammatory drugs (NSAIDs); Group Ⅲ: allopurinol-sodium bicarbonate-benzbromarone; Group Ⅳ: glucocorticoid-colchicine; Group Ⅴ: febuxostat. A total of 5 898 visits (60%) chieved manifestations of joint pain VAS scores target, and the most frequently used drug to control joint symptoms was NSAIDs. The frequency of use of drugs to control joint symptoms were 2 118 times (usage rate reached 35.9%), while the frequency of ULT were 2 504 times (usage rate reached 42.5%), which was higher than the joint symptom control drug. The most common treatment options were following: Group Ⅰ: proprietary Chinese medicine-TCM decoction-TCM external treatment-physical exercise; Group Ⅱ: NSAIDs-colchicine hormones; Group Ⅲ: allopurinol, Group Ⅳ: benzbromarone; Group Ⅴ: febuxostat. A total of 59 adverse events occurred during treatment.Conclusion:The proportions of gout patients who reach target serum urate level & good control of joint symptoms are both very low, and ULT and anti-inflammatory prescription patterns are very different from international guidelines, so it is necessary to strengthen the standardized management of gout patients. At the same time, life intervention measures account for a certain proportion of the treatment plans for the T2T population, and further exploration is needed.

Oncology involves a wide range of knowledge and a strong expertise. In the teaching process, we should strengthen the cultivation of students' innovation ability, clinical scientific research ability, basic scientific research ability and humanistic quality. The improvement of tumor teaching is not only related to the people's health and quality of life, but also the inevitable requirement of the development of tumor medicine. However, the construction and development of oncology discipline in China are limited by the lack of a unified oncology teaching materials and syllabus, the single teaching mode and the insufficient postgraduate training mode. In the process of exploring the construction of tumor teaching, cooperation of various links is needed, which is mainly reflected in the compilation of characteristic oncology teaching materials and Outlines, adjustment of tumor teaching mode, optimization of postgraduate training mode, grasping the latest tumor progress and strengthening the cultivation of humanistic quality and other specific measures.

恶性肿瘤居中国各类疾病死因之首，发病率与病死率呈逐年上升趋势。近几年来靶向治疗已广泛应用于临床，显示 出良好的抗肿瘤效果，新靶点的探索和鉴定在靶向药物研发过程中起着重要作用。E3泛素连接酶斑点型锌指结构蛋白（speckletype POZ protein，SPOP）作为治疗选择的潜在靶点，能特异性识别底物，使底物发生泛素化降解，广泛参与机体内多种生理、病理 过程。研究发现SPOP基因突变或表达水平改变，通过调控AR/ERG、Akt-mTORC1、Hedgehog/Gli2等多种信号通路影响恶性肿 瘤的发生发展，并与前列腺癌、肾癌、结直肠癌等多种恶性肿瘤细胞增殖及远处转移密切相关。目前，SPOP影响恶性肿瘤发生发 展的相关研究为靶向治疗恶性肿瘤奠定了基础，综述SPOP在恶性肿瘤的最新进展对抗肿瘤研究具有重要的意义。

Objective To investigate the value of blend sign and/or black hole sign with CT scanning for predicting early hematoma enlargement in patients with primary intracerebral hemorrhage.Methods From July 2011 to July 2016,244 consecutive patients with primary intracerebral hemorrhage in the First Affiliated Hospital of Chongqing Medical University were enrolled prospectively.From the onset to the first CT time were all ≤ 6 h.They were randomly divided into either an early hematoma enlargement group (n =82) or a non-hematoma enlargement group (n =162) according to whether they had early hematoma enlargement or not.The general data of patients were collected and compared between the groups,including previous history,clinical features,Glasgow coma scale (GCS) at admission,imaging features (black hole sign,blend sign and black hole sign and/or blend sign),etc.Multivariate logistic regression analysis was performed on the factors influencing early hematoma enlargement.The predictive value of imaging signs of early hematoma enlargement was analyzed.Results (1) In patients with early hematoma enlargement,there were 27 (32.9％) patients had black hole sign,33 (40.2％) had blend sign,and 50(61.0％) had blend sign and/or black hole sign.(2) The volume of hematoma according to 1 ml,the first CT time from onset to admission according to 1 h,and GCS on admission according to 1,the black hole sign and blend sign were included in the multivariate logistic regression analysis.The results showed that both the blend sign (OR,14.04,95％ CI 5.16-38.18) and the black hole sign (OR,5.69,95％ CI 2.12-15.30) were the independent risk factors for early hematoma enlargement (all P ＜ 0.01).After further adjustment,it showed that the blend sign and/or black hole sign were also the independent risk factors for early hematoma enlargement (OR,14.08,95％ CI 5.99-33.08,P ＜0.01).(3) After the analysis of the receiver operating characteristic curve,the sensitivity,specificity,positive predictive value,negative predictive value,and Youden Index of the blend sign and/or black hole sign of predicting early hematoma enlargement were 61.0％,90.1％,76.0％,82.0％,and 0.511,respectively.Its Youden Index was closer to 1 than the black hole sign (Youden Index:0.280) and the blend sign (Youden Index:0.346).Conclusion Compared with the single sign,the blend sign combined with black hole sign has better predictive ability for early hematoma enlargement after intracerebral hemorrhage.

Survivin-D53A (SVV-D53A) is a dominant-negative mutant survivin, which represents a potential promising target for cancer gene therapy. The present study was designed to determine whether SVV-D53A plasmid encapsuled by DOTAP: Chol liposome would have the anti-tumor activity against SPC-A1 lung adenocarcinoma, and to detect the possible mechanisms. In our experiment, SPC-A1 cells were transfected in vitro with SVV-D53A plasmid and examined for protein expression by Western blot, then flow cytometric analysis was used to detect apoptosis. SPC-A1 lung adenocarcinoma xenografts were established in vivo in the nude mice, which received the i. v. administrations of SVV-D53A plasmid/liposome complexes. After mice were sacrificed, the paraffin-embedded tumor tissue sections were used for proliferating cell nuclear antigen (PCNA) expression and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. Compared with the control group, the mice treated with SVV-D53A plasmid had an obviously reduced tumor volume, with high level of apoptosis and decreased cell proliferation in tumor tissue. The research results proved that the administration of SVV-D53A plasmid resulted in significant inhibition of SPC-A1 cells both in vitro and in vivo. The functional mechanism is that the anti-tumor response causes and induces tumor cell apoptosis.
Adenocarcinoma ; pathology ; Animals ; Apoptosis ; Apoptosis Regulatory Proteins ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; Heterografts ; Humans ; Inhibitor of Apoptosis Proteins ; metabolism ; Liposomes ; Lung Neoplasms ; pathology ; Mice ; Mice, Nude ; Neoplasm Proteins ; metabolism ; Neoplasm Transplantation ; Plasmids ; Transfection ; Tumor Burden

AIM:To investigate the mammalian target of rapamycin ( mTOR) signaling pathway as the center playing a role in the crizotinib-induced apoptosis of non-small cell lung cancer (NSCLC) cell line H2228, which represents positive echinoderm microtubule-associated protein-like 4 (EML4)-anaplastic lymphoma kinase (ALK) fusion gene. METHODS:H2228 cells were processed according to different purposes .Fluorescence quantitative PCR is used to ob-serve the gene states .MTT assay is used to detect the cell inhibition rates .The cell apoptosis and cell cycle were analyzed by flow cytometry .The expression and activation levels of the key proteins in the mTOR signaling pathway were determined by Western blotting .RESULTS:Crizotinib promoted the apoptosis of H 2228 cells in a time-and dose-dependent manner . Crizotinib blocked the H2228 cells staying at the G1 phase.In apoptotic H2228 cells processed with crizotinib, the activa-tion level of mTOR was decreased , and the activation levels of the key proteins in upstream and downstream of mTOR path -way were both declined .The expression level of the fusion protein EML 4-ALK variant 3 was not affected , but its active form of p-ALK was significantly suppressed .CONCLUSION:mTOR signaling pathway has a certain relationship with the crizotinib-induced apoptosis of lung cancer cell H 2228, which represents positive EML4-ALK fusion gene.