ObjectiveTo investigate the effect of Danggui Shaoyaosan on ferroptosis in the rat model of non-alcoholic fatty liver disease （NAFLD） and explore the underlying mechanism based on the nuclear factor E₂-related factor 2 （Nrf2）/solute carrier family 7 member 11 （SLC7A11）/glutathione peroxidase 4 （GPX4） signaling pathway. MethodsThe sixty SD rats were randomly grouped as follows： control， model， Yishanfu （0.144 g·kg^-1）， and low-， medium-， and high-dose （2.44， 4.88， and 9.76 g·kg^-1， respectively） Danggui Shaoyaosan. A high-fat diet was used to establish the rat model of NAFLD. After 12 weeks of modeling， rats were treated with corresponding agents for 4 weeks. Then， the body weight and liver weight were measured， and the liver index was calculated. At the same time， serum and liver samples were collected. The levels or activities of total cholesterol （TC）， triglycerides （TG）， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， and Fe²⁺ in the serum and TC， TG， free fatty acids （FFA）， malondialdehyde （MDA）， superoxide dismutase （SOD）， glutathione peroxidase （GPX）， and Fe²⁺ in the liver were measured. Hematoxylin-eosin staining and oil red O staining were employed to observe the pathological changes in the liver. Immunofluorescence was used to assess the reactive oxygen species （ROS） content in the liver. Mitochondrial morphology was observed by transmission electron microscopy. The protein levels of Nrf2， SLC7A11， GPX4， transferrin receptor 1 （TFR1）， and divalent metal transporter 1 （DMT1） in the liver were determined by Western blot. ResultsCompared with the control group， the model group showed increases in the body weight， liver weight， liver index， levels or activities of TC， TG， ALT， AST， and Fe²⁺ in the serum， levels of TC， TG， FFA， MDA， Fe²⁺， and ROS in the liver， and protein levels of TFR1 and DMT1 in the liver （P<0.01）， and decreases in the activities of SOD， GPX and the protein levels of Nrf2， SLC7A11， and GPX4 in the liver （P<0.05， P<0.01）. Meanwhile， the liver tissue in the model group presented steatosis， iron deposition， mitochondrial shrinkage， and blurred or swollen mitochondrial cristae. Compared with the model group， all doses of Danggui Shaoyaosan reduced the body weight， liver weight， liver index， levels or activities of TC， TG， ALT， AST， and Fe²⁺ in the serum， levels of TC， TG， FFA， MDA， Fe²⁺， and ROS in the liver， and protein levels of TFR1 and DMT1 in the liver （P<0.01）， while increasing the activities of SOD and GPX and the protein levels of Nrf2， SLC7A11， and GPX4 in the liver （P<0.01）. Furthermore， Danggui Shaoyaosan alleviated steatosis， iron deposition， and mitochondrial damage in the liver. ConclusionDanggui Shaoyaosan may inhibit lipid peroxidation and ferroptosis by activating the Nrf2/SLC7A11/GPX4 signaling pathway to treat NAFLD.

ObjectiveTo explore the efficacy and mechanism of Danshen Zexie decoction in treating the rats with metabolic-associated fatty liver disease （MAFLD）. MethodSixty male SD rats were randomized into control group， model group， essentiale （polyene phosphatidylcholine capsules， 0.144 g·kg^-1） group， and low-， medium-， and high-dose Danshen Zexie decoction （1.16， 2.32， and 4.64 g·kg^-1， respectively） groups. The rat model of MAFLD was established with high fat diet， and 8-week therapy started at the induction of MAFLD. The serum levels of total cholesterol （TC）， triglyceride （TG）， alanine aminotransferase （ALT）， and aspartate aminotransferase （AST）， as well as the liver levels of TC， TG， free fatty acid （FFA）， superoxide dismutase （SOD）， glutathione （GSH）， and malondialdehyde （MDA）， were measured. The pathological changes of liver were observed by hematoxylin-eosin （HE） staining and oil red O staining， and the steatosis score and oil red O staining area were calculated. The level of reactive oxygen species （ROS） in the liver was detected by immunofluorescence. The protein levels of adenosine monophosphate-activated protein kinase （AMPK）， p-AMPK， nuclear factor E₂-related factor 2 （Nrf2）， glutamate-cysteine ligase catalytic subunit （GCLC）， glutamate-cysteine ligase modifier subunit （GCLM）， and nicotinamide adenine dinucleotide phosphate： quinine oxidoreductase （NQO1） in the liver were determined by Western blot. ResultCompared with control group， the modeling of MAFLD elevated the levels of TC， TG， ALT， and AST in the serum and TC， TG， FFA， MDA， and ROS in the liver （P<0.01）， lowered the levels of SOD and GSH and down-regulated the protein levels of phosphorylation（p）-AMPK， Nrf2， GCLC， GCLM， and NQO1 in the liver （P<0.05， P<0.01）. Further， a large number of lipid droplet vacuoles and balloon-like lesions appeared in the hepatocytes， and the steatosis score and oil red O staining area increased in the model group （P<0.01）. Compared with model group， Danshen Zexie decoction lowered the levels of TC， TG， ALT， and AST in the serum and TC， TG， FFA， MDA， and ROS in the liver （P<0.01）， increased the levels of SOD and GSH and up-regulated the protein levels of p-AMPK， Nrf2， GCLC， GCLM， and NQO1 in the liver （P<0.05， P<0.01）. Moreover， the decoction alleviated the degree of liver steatosis （P<0.05， P<0.01）. ConclusionDanshen Zexie decoction protects against MAFLD by activating AMPK/Nrf2 signaling pathway and suppressing oxidative stress.

国家自然科学基金项目(11932012、81400536),上海申康医院发展中心临床创新三年行动计划(SHDC2020CR3009A),上海交通大学医工(理)交叉基金(JYJC202130)

Objective:To discuss the mechanism of Yueju Pill in the treatment of functional dyspepsia (FD) based on network pharmacology and molecular docking.Methods:The chemical components and action targets of Yueju Pill were screened out by TCMSP platform and HERB, BATMAN-TCM database combined with literature were used to supplement effective components of Vietnam bow. The targets of FD were screened out by GeneCards database and OMIM database, and the intersection of the two targets was used to analyze the protein interactions using the STRING platform to construct the PPI network. Metascape platform was used for GO and KEGG pathway enrichment analysis, and Cytoscape 3.7.2 software was used to construct a network of "Yueju Pill components-functional dyspepsia targets-pathways". Online mapping tools were used to obtain the Venn plot of the intersection targets of Yueju Pill, FD and its related pathogenesis. Finally, AutoDock software was used for molecular docking.Results:The main active components of Yueju Pill in the treatment of FD are quercetin, wogonin, luteolin, kaempferol, etc. The main targets are AKT1, MAPK1, JUN, RELA, IL6, BCL2, BAX, MAPK8, EGFR, ESR1, etc. Molecular docking shows that the targets and the active components of the Yueju Pill have better binding abilit. The GO enrichment analysis result shows that there are 2 273 biological processes, 152 molecular functions and 91 cell components. KEGG enrichment analysis shows that there are 344 pathways associated with FD. According to literature review, the pathways related to FD include PI3K-Akt signaling pathway, AGE-RAGE signaling pathway, IL-17 signaling pathway, etc.Conclusion:Yueju Pill might act on AKT1, MAPK1, JUN, RELA, IL6, BCL2, BAX, MAPK8, EGFR, ESR1 and other targets to regulate PI3K-Akt signaling pathway, AGE-RAGE signaling pathways and IL-17 signaling pathway and it could treat FD.

Objective:To explore the effect of Plantaginis semen on the expressions of AQP4 gene and protein in small intestine of diarrhea rats. Methods:Sixty Sprague-Dawley male rats were randomly divided into normal control group, model control group, hydrochlorothiazide group, and low-, medium-, and high-dose Plantaginis semen groups. Intragastric administration of Senna (20 ml/kg) was implemented in the morning for 5 groups except the normal group. The rats in the low-, medium-, and high-dose Plantaginis semen groups were intragastrically administered with 0.95, 1.9, 3.8 g/kg Plantaginis semen formula granule solution, while the rats in hydrochlorothiazide group were given hydrochlorothiazide suspension 9 mg/kg by gavage according to 1 ml/100 g body weight for 14 days. The loose stool rate, average ranking of loose stool, and diarrhea index were compared according to the fecal traits and stool times after 14 days of treatment, and the small intesine tissue were collected. Hematoxylin-eosin (HE) staining to observe the pathological morphological changes in small intestine, and Quantiative Real-time PCR and Western blot were applied to detect the gene and protein expressions of AQP4. Results:Compared with the model group, the loose stool rate (50.89% ± 6.17%, 41.14% ± 4.48%, 36.37% ± 4.81 % vs. 67.45% ± 7.35%), the average ranking of loose stool (2.16 ± 0.34, 1.73 ± 0.28, 1.52 ± 0.25 vs. 2.63 ± 0.29), and the diarrhea index (1.10 ± 0.19, 0.71 ± 0.11, 0.57 ± 0.12 vs. 1.77 ± 0.24) of rats in each group of Plantaginis semen significantly decreased ( P<0.05); the degree of intestinal mucosal injury, hyperemia and neutrophil infiltration were alleviated; the expressions of AQP4 mRNA (0.48 ± 0.10, 0.69 ± 0.12, 0.97 ± 0.15 vs. 0.21 ± 0.03), and the protein of AQP4 (0.59 ± 0.08, 0.64 ± 0.09, 0.78 ± 0.11 vs. 0.32 ± 0.05) in the small intestine tissue of Plantaginis semen groups significantly increased ( P<0.05). Conclusions:Plantaginis semen has antidiarrheal effect, and its mechanism is related to up-regulation the gene and protein expressions of AQP4, addition of water absorption and promotion of water and fluid metabolism.

[Abstract] Objective: To explore the key genes and molecular mechanisms of liver metastasis in colorectal cancer (CRC), and to provide potential targets and biomarkers for the treatment of CRC with liver metastasis. Methods: Based on the bioinformatics method, the gene data sets of CRC liver metastasis were downloaded from the GEO database to screen the differentially expressed genes (DEGs); the GO and KEGG enrichment analyses of DEGs were performed by using DAVID online tool, and the protein-protein interaction (PPI) network was constructed to screen out the key genes, and subsequently the prognosis was analyzed. Results: A total of 321 DEGs were selected from 183 CRC specimens and 39 liver metastasis specimens, including 153 up-regulated genes and 168 downregulated genes. The results of enrichment analysis of GO and KEGG showed that the functions of DEGs were mainly related to protein activation cascade, inflammatory response, extracellular matrix, platelet degranulation, complement and coagulation cascade reaction etc. 8 key CRC genes (ALB, APOB, FGA, F2, APOA1, SERPINC1, FGG and AHSG) were screened by PPI network. Survival analysis showed that patients with high expressions of SERPINC1 and FGG had poor prognosis(all P<0.05). Conclusion: The biological functions and signaling pathways of DEGs are related to the occurrence and development of liver metastasis. The 8 key genes may be the potential therapeutic targets of CRC liver metastasis, and SERPINC1 and FGG may be new prognostic markers.

Objective? To explore the effect of therapeutic touch(TT) combined with progressive muscle relaxation training(PMRT) on reducing perioperative stress response in patients with gastric cancer. Methods? By convenience sampling, 120 patients with gastric cancer admitted in the department of general surgery of a Class Ⅱ Grade A hospital in Jiangsu Province from May to October of 2018 were selected as research objects. According to the random number table, they were divided into the experimental group(n=60) and control group (n=60). Conventional nursing approach was adopted in the control group while TT combined with PMRT was adopted in the experimental group. The Self-rating Anxiety Scale (SAS), Numerical Rating Scale (NRS), and Nursing Satisfaction Questionnaire were used to evaluate the intervention effect. Results? The NRS score of the experimental group were lower than that of the control group at 24 and 48 hours after operation with statistical differences (P＜0.05). After intervention, SAS score of the experimental group was lower than that of the control group, and the difference was statistically significant (P＜ 0.01). At discharge, the nursing satisfaction of the experimental group was higher than that of the control group, and the difference was statistically significant (P＜0.05). Conclusions? The application of TT combined with PMRT is helpful to reduce the stress response in perioperative patients with gastric cancer.

OBJECTIVEOn the basic therapy, to assess the clinical effects of dynamic scalp acupuncture, scalp acupuncture combined with proprioceptive neuromuscular facilitation (PNF) therapy and simple PNF therapy for upper limb motor impairment in ischemic post-stroke spastic hemiplegia.

METHODSA total of 90 cases were randomly assigned into a PNF group, a dynamic scalp acupuncture group and a scalp acupuncture group, 30 cases in each group. Basic therapy and PNF therapy were applied in the three groups. PNF therapy was used during scalp acupuncture in the dynamic scalp acupuncture group. PNF therapy was applied after scalp acupuncture in the scalp acupuncture group. The points were the upper 1/5 and middle 2/5 of (MS 6) and (MS 7) at the lesion side, the hemiparalysis contralateral side. The treatment was given for 6 months, once a day and 1 month as a course. The modified Ashworth scale (MAS), the Fugl-Meyer motor assessment (FMA) and Barthel index (BI) were observed before treatment and 2 weeks, 1 month, 3 months, and 6 months after treatment.

RESULTSThe MAS 1 month, 3 months and 6 months after treatment were improved compared with those before treatment in the three groups ( all <0.05), and the MAS results in the dynamic scalp acupuncture group were better than those in the PNF and scalp acupuncture group (all <0.05). The FMA and BI scores 1 month, 3 months and 6 months after treatment were higher than those before treatment (all <0.05). The FMA Scores in the 3 time points and after treatment in the dynamic scalp acupuncture group were higher than those in the other two groups (all <0.05).

CONCLUSIONPNF therapy during scalp acupuncture can relieve the spasmodic condition of patients with upper limb motor impairment in ischemic post-stroke spasmodic hemiplegia, and improve the limb function and life activity, which is better than PNF therapy after scalp acupuncture and simple PNF therapy.

Acupuncture Therapy ; Brain Ischemia ; complications ; rehabilitation ; Combined Modality Therapy ; Hemiplegia ; rehabilitation ; therapy ; Humans ; Scalp ; Stroke ; complications ; Stroke Rehabilitation ; Treatment Outcome

Objective Through analyzing the scientific research performance of recruited doctors in Nanjing Drum Tower hospital,we can understand its current situation and problems,and then provide reasonable suggestions to promote the recruited doctors' scientific research capacity.Methods Descriptive statistics was used to analyze the projects application and outputs in scientific research.Results The proportion of recruited doctors who received National Natural Science Fund Youth Project has been increasing every year (the average growth rate is 16.46 ％).Many recruited doctors gained projects in the first year after admission(25.33％),but still 40.14％ of these doctors did not gained any project.Each recruited doctor published 1.58 SCI papers on average (19.33％).Conclusions We should innovate the training system,optimize the construction of scientific research platform,establish hospital science project,and implement scientific evaluation system to mobilize these youth talents comprehensively.

Objective Through investigating the current situation of scientific research in medicine graduate students, we can provide scientific basis for training postgraduates effectively and reference for graduate education reform. Methods A total of 243 medicine graduate students in Drum Tower Hospital were surveyed and asked to complete the designed questionnaires which included general situation, the objective to study, the situation of participation projects, the management of student, and achievements. Results 33.74％ (82) of students' purpose was confusion, 51.44％ of (125) graduate students engaged in clinical and basic research, the scientific research graduate students and doctoral students participated in the tutor research project more than the professional type graduate students and Postgraduate student (P<0.05). There were significant differences in the number of SCI related papers published by the postgraduates who differ in their ways of training and in different degrees (P<0.05). Conclusion Graduate students are an important part of high-level talents in China. They are the successors of future scientific research. The effectiveness of training postgraduates' scientific research ability will directly affect the future scientific research level of the country. So we should strengthen the cultivation of graduate students' scientific research accomplishment, construct a scientific training model, set up scientific training mode and supervision mech-anism, in order to promote the research level of medical graduate students.