ObjectiveTo investigate the possible mechanism of Shenfuhuang Formula （参附黄配方） in prevention and treatment of epsis-associated encephalopathy from the perspective of brain genomics. MethodsC57BL/6 mice were randomly divided into sham surgery group， sepsis group， and Shenfuhuang group， with 20 mice in each group. The sepsis group and Shenfuhuang group were induced to develop sepsis by cecal ligation and puncture （CLP） procedure. At 4 hours after modelling， Shenfuhuang group were gavaged with 2.5 g/（kg·d） of Shenfuhuang Formula， 0.5 ml each time， at 12 hours intervals， for a total of 4 times after modelling. Sepsis group and sham surgery group were given 0.5 ml of purified water orally. At 48 hours after modeling， the transcriptome sequencing was used to explore the differential gene expression in the effects of Shenfuhuang Formula on the brain regions of septic mice， and real-time PCR and ELISA were later used to further validate the differential gene and proteins expression. ResultsA total of 4605 genes were differentially expressed in Shenfuhuang group compared with sepsis group， of which 2353 genes were up-regulated and 2252 genes were down-regulated. According to the results of previous publications， six key genes were screened， including serine/threonine-protein kinase （Nek1）， myelin-associated glycoprotein （Mag）， endothelial cell-specific tyrosine kinase receptor （Tek）， a disintegrin and metalloproteinase with thrombospondin motifs 20 （Adamts20）， lymphocyte antigen 86 （Ly86）， and E3 ubiquitin-protein ligase （Traip）. Further genetic and protein validation revealed that， compared to the sham surgery group， the mRNA levels and corresponding protein levels of Nek1， Mag， Tek， Adamts20， Ly86， and Traip in the brain tissue of septic mice significantly reduced （P＜0.05）. In comparison to the sepsis group， Shenfuhuang group showed significantly increased mRNA levels and corresponding protein levels of Nek1， Mag， Tek， Adamts20， Ly86， and Traip （P＜0.05）. ConclusionThe potential therapeutic targets of Shenfuhuang Formula for treating sepsis-associated encephalopathy may be related to the Nek1， Mag， Tek， Adamts20， Ly86， and Traip genes and their encoded proteins.

Abstract Aspirin (ASA) is widely used for primary and secondary prevention of cardiovascular disease (CVD), but its strategy of application is highly controversial. Meanwhile, in terms of ASA prevention strategies for CVD, countries around the world are different. The United States is becoming increasingly cautious, while the European Union tends to focus on the benefits of ASA clinical use. China is concerned about the effectiveness of ASA in preventing CVD in the elderly. This article reviews relevant literature published domestically and internationally from 2005 to 2024 for the application of ASA in CVD prevention, ASA prevention strategies for CVD in main countries and the application of ASA in special groups such as chronic disease patients, which provides a basis for improving ASA prevention strategies for CVD and standardizing clinical application of ASA in China.

Objective:To evaluate the safety and feasibility of transumbilical single-port transabdominal preperitoneal hernioplasty plus cholecystectomy (SILS-TAPP+LC).Methods:The clinical data of 52 adult patients who underwent [SILS-(TAPP+LC)] from Mar, 2019 to Oct, 2021 at the Affiliated Hospital of Nantong University were retrospectively analyzed.The perioperative indicators, postoperative complications and follow-up data were analyzed.Results:All operations were successfully completed without conversion to open or multi-port laparoscopic surgery.The duration of surgery was (49.2 ± 7.5) min. Three patients experienced gallbladder rupture, and there was no bladder or intestinal injury during the surgery.During the 20-24 months of postoperative follow-up period,4 patient developed seroma in the postoperative period, 4 patients complained foreign body sense in the inguinal region, 3 patients reported chronic pain, but no other complications, such as biliary fistula, recurrence, mesh infection, or trocar hernia, were observed.Conclusion:SILS-(TAPP+LC) was a safe and feasible approach associated with little postoperative pain and rapid recovery.

Visual hallucination(VH)is a common symptom of schizophrenia,the underlying mechanism has not been fully elucidated.It has been found that the dysfunction of dopamine(DA)system,the overactivation of α-amino-3-hydroxy-5-methyl-4-isoxazole-propionate(AMPA)receptor in glutamate system and the dysfunction of γ-aminobutyric acid(GABA)ergic neurons can induce VH in patients with schizophrenia.In addition,abnormalities in brain structural and functional networks and visual networks are also closely related to the occurrence of VH.The purpose of this paper is to review the neurochemistry and nerve injury mechanism of VH in schizophrenic patients to deeply understand the characteristics of VH,and make more accurate judgment in the early diagnosis,condition evaluation and treatment plan of schizophrenic patients.

The biofilms formed by pathogenic microorganisms seriously threaten human health and significantly enhance drug resistance, which urgently call for developing drugs specifically targeting on biofilms. Chitooligosaccharides extracted from shrimp and crab shells are natural alkaline oligosaccharides with excellent antibacterial effects. Nevertheless, their inhibition efficacy on biofilms still needs to be improved. Spirulina (SP) is a microalga with negatively charged surface, and its spiral structure facilitates colonization in the depth of the biofilm. Therefore, the complex of Spirulina and chitooligosaccharides may play a synergistic role in killing pathogens in the depth of biofilm. This research first screened chitooligosaccharides with significant bactericidal effects. Subsequently, Spirulina@Chitooligosaccharides (SP@COS complex was prepared by combining chitooligosaccharides with Spirulina through electrostatic adsorption. The binding of the complex was characterized by zeta potential, z-average size, and fluorescence labeling. Ultraviolet-visible spectroscopy (UV-Vis) showed the encapsulation efficiency and the drug loading efficiency reached up to 90% and 16%, respectively. The prepared SP@COS2 exhibited a profound synergistic inhibition effect on bacterial and fungal biofilms, which was mainly achieved by destroying the cell structure of the biofilm. These results demonstrate the potential of Spirulina-chitooligosaccharides complex as a biofilm inhibitor and provide a new idea for addressing the harm of pathogenic microorganisms.
Humans ; Spirulina ; Anti-Bacterial Agents/chemistry* ; Chitosan/pharmacology* ; Biofilms ; Chitin/pharmacology*

OBJECTIVES: This study aimed to observe the clinical and immune response characteristics of vaccinated persons infected with the delta variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Yangzhou, China. METHODS: We extracted the medical data of 129 patients with delta-variant infection who were admitted to Northern Jiangsu People's Hospital (Yangzhou, China) between August and September, 2021. The patients were grouped according to the number of vaccine doses received into an unvaccinated group: a one-dose group and a two-dose group. The vaccine used was SARS-CoV-2-inactivated vaccine developed by Sinovac. We retrospectively analyzed the patients' epidemiological, clinical, laboratory, and imaging data. RESULTS: Almost all patients with delta-variant infection in Yangzhou were elderly, and patients with severe/critical illness were over 70 years of age. The rates of severe/critical illness (P=0.006), fever (P=0.025), and dyspnea (P=0.045) were lower in the two-dose group than in the unvaccinated group. Compared to the unvaccinated group, the two-dose group showed significantly higher lymphocyte counts and significantly lower levels of C-reactive protein (CRP), interleukin-6 (IL-6), and D-dimer during hospitalization and a significantly higher positive rate of immunoglobulin G (IgG) antibodies at admission (all P<0.05). The cumulative probabilities of hospital discharge and negative virus conversion were also higher in the two-dose group than in the unvaccinated group (P<0.05). CONCLUSIONS Two doses of the SARS-CoV-2-inactivated vaccine were highly effective at limiting symptomatic disease and reducing immune response, while a single dose did not seem to be effective.
Aged ; Aged, 80 and over ; Humans ; COVID-19/prevention & control* ; COVID-19 Vaccines/adverse effects* ; Critical Illness ; Immunity ; Retrospective Studies ; SARS-CoV-2 ; Vaccines, Inactivated/adverse effects* ; Viral Vaccines/adverse effects*

Metformin is currently a strong candidate anti-tumor agent in multiple cancers. However, its anti-tumor effectiveness varies among different cancers or subpopulations, potentially due to tumor heterogeneity. It thus remains unclear which hepatocellular carcinoma (HCC) patient subpopulation(s) can benefit from metformin treatment. Here, through a genome-wide CRISPR-Cas9-based knockout screen, we find that DOCK1 levels determine the anti-tumor effects of metformin and that DOCK1 is a synthetic lethal target of metformin in HCC. Mechanistically, metformin promotes DOCK1 phosphorylation, which activates RAC1 to facilitate cell survival, leading to metformin resistance. The DOCK1-selective inhibitor, TBOPP, potentiates anti-tumor activity by metformin in vitro in liver cancer cell lines and patient-derived HCC organoids, and in vivo in xenografted liver cancer cells and immunocompetent mouse liver cancer models. Notably, metformin improves overall survival of HCC patients with low DOCK1 levels but not among patients with high DOCK1 expression. This study shows that metformin effectiveness depends on DOCK1 levels and that combining metformin with DOCK1 inhibition may provide a promising personalized therapeutic strategy for metformin-resistant HCC patients.
Animals ; Antineoplastic Agents/therapeutic use* ; Carcinoma, Hepatocellular/metabolism* ; Cell Line, Tumor ; Clustered Regularly Interspaced Short Palindromic Repeats ; Genome ; Humans ; Liver Neoplasms/metabolism* ; Metformin/therapeutic use* ; Mice ; Phosphorylation ; Synthetic Lethal Mutations ; Transcription Factors/metabolism* ; rac GTP-Binding Proteins/metabolism*

Objective:To investigate the local consistency of inferior colliculus and ventrolateral orbital cortex by resting-state functional magnetic resonance imaging (fMRI) in rats with noise induced deafness and its relationship with anxiety- and depression-like behavior.Methods:Twenty-four clean grade male four-weeks old SD rats were randomly divided into noise group and control group with 12 rats in each group.Rats in the noise group were exposed to 122 dB broadband strong noise for 2 hours to induce severe bilateral hearing loss, while rats in the control group were placed in a quiet environment. Hearing thresholds were assessed by auditory brainstem response (ABR) test. The open field test (OFT) was conducted to examine anxiety-depression related behavior, and the local consistency in the rat brain was evaluated by fMRI.SPM12 software was used to process fMRI data, and Pearson correlation analysis was conducted by SPSS 22.0 software to calculate the correlation between fMRI data and behavior.Results:The results of ABR showed that the full band hearing threshold of rats in the noise group was higher than that of rats in the control group ((85.417±6.463) dB, (20.083±8.853) dB, t=46.168, P<0.001). And compared with control group, the rats in the noise group showed obvious anxiety-depression-like behavior in the open field test, that was, low activity level.The results of OFT showed that the total distance ((39.912±5.696) m, (47.993±10.820)m, t=-2.289, P=0.032), average moving speed ((13.306±1.900)cm/s, (15.998±3.607)cm/s, t=-2.290, P=0.032) and standing times ((13.333±5.960), (23.500±7.323), t=-3.730, P=0.001) of the rats in the noise group were all lower than those in the control group. Compared with the control group, the local consistency of hypothalamus in the noise group was significantly enhanced, while the local consistency of ventrolateral orbital cortex was significantly reduced, and the abnormal neural activity was lateralized. The correlation analysis showed that the neural activity of the inferior colliculus was negatively correlated with the total distance of rats in the noise group moving in the open field( r=-0.691, P=0.013), while the neural activity of the ventrolateral orbital cortex was not significantly correlated with the anxiety-depression-like behavior in the open field. Conclusions:The neural activity of inferior colliculus is closely related to anxious-depression behavior in rats with noise-induced deafness, while the ventrolateral orbital cortex may be related with other behaviors.

Objective:To investigate the ultrasonographic features and evolution of thyroid shrinking nodules in order to improve the differential diagnosis and management strategy and avoid unnecessary biopsy.Methods:A total of 245 patients with old bleeding of benign thyroid nodules diagnosed via fine needle aspiration cytology (FNAC) from May 2015 to July 2020 in the southern part of the Shanghai General Hospital Affiliated to the Medical College of Shanghai Jiaotong University, including 263 nodules. The sonographic parameters such as size, shape, aspect ratio, echo, edge, boundary, periphery, halo, calcification, posterior echo enhancement and posterior acoustic attenuation of nodules were analyzed retrospectively, and the ultrasonic appearances of nodules were classified; 41 nodules from 40 patients, who did ultrasound examinations more than twice and had both complete ultrasonographic data, were compared and then classified in order to explore the evolution rules of the nodules.Results:Two hundred and sixty-three thyroid shrinking nodules in 245 cases were classified into 4 types: "cystic wall shrinkage sign" type(71.48%, 188/263), "carcinoma-like" type (22.05%, 58/263), "inflammation-like" type(3.04%, 8/263) and "undefined atypical solid nodules" type(3.42%, 9/263). Of the 41 consecutive follow-up nodules, 37 cases showed obvious cystic wall shrinkage sign, and 7 of them developed into "carcinoma-like" type and 6 cases into "inflammation-like" type.Conclusions:The ultrasonographic appearance of thyroid shrinking nodules is a dynamic process, which can be divided into 4 types: "cystic wall shrinkage sign" , "carcinoma-like" , "inflammation-like" and "undefined atypical solid nodules" types. The "cystic wall shrinkage sign" type is typical and common. The "cystic wall shrinkage sign" type can develope into the "carcinoma-like" type or the "inflammation-like" type.

Objective:To investigate the effects of compression treatment on occurrence of seroma after tension-free inguinal hernia repair.Methods:The propensity score matching and retrospective cohort study was conducted. The clinical data of 6 600 patients with unilateral inguinal hernia who were admitted to 51 medical centers from January to December in 2017 were collected, including 917 in Beijing Chaoyang Hospital of Capital Medical University, 451 in East Hospital Affiliated to Tongji University, 363 in Huadong Hospital of Fudan University, 307 in Ruijin Hospital of Shanghai Jiaotong University School of Medicine, 254 in Sir Run Run Shan Hospital of Zhejiang University School of Medicine, 222 in Sichuan Provincial People′s Hospital, 221 in Beijing Luhe Hospital of Capital Medical University, 202 in Shengjing Hospital of China Medical University, 191 in Anhui Provincial Hospital, 181 in Affiliated Hospital of Zunyi Medical University, 174 in Tianjin People′s Hospital, 169 in the First Affiliated Hospital of Dalian Medical University, 155 in People′s Hospital of Changshou in Chongqing, 152 in Qilu Hospital of Shandong University, 146 in the First Affiliated Hospital of Fujian Medical University, 136 in Taiyuan Central Hospital of Shanxi Medical University, 134 in First Hospital of Wuhan, 122 in Xinjiang Uygur Autonomous People′s Hospital, 122 in the Second Affiliated Hospital of Chongqing Medical University, 118 in the Second Hospital Affiliated to Naval Medical University, 113 in Xuzhou Central Hospital, 112 in the First Affiliated Hospital of Harbin Medical University, 112 in the First Affiliated Hospital of Wenzhou Medical University, 102 in the Second Hospital of Shandong University, 100 in Tianjin Hospital of Itcwm Nankai Hospital, 99 in Shandong Provincial Hospital, 90 in Huashan Hospital of Fudan University, 88 in Henan Provincial People′s Hospital, 87 in West China Hospital of Sichuan University, 86 in Zhangjiakou First Hospital, 86 in the First Affiliated Hospital Soochow University, 77 in the Fourth Affiliated Hospital of China Medical University, 75 in Tianjin Medical University General Hospital, 72 in the First Affiliated Hospital of Hunan University of Medicine, 67 in First Affiliated Hospital of Xi′an Jiaotong University, 49 in the First Hospital of China Medical University, 49 in Hunan Provincial Hospital of Traditional Medicine, 48 in Xijing Hospital Affiliated to Air Force Medical University, 47 in Xinhua Hospital of Hubei Province, 46 in the First Hospital of Tsinghua University, 45 in the First Affiliated Hospital of Chongqing Medical University, 34 in the First Affiliated Hospital of Zhengzhou University, 29 in Peking University International Hospital, 28 in Jilin Yan′an Hospital, 25 in China-Japan Union Hospital of Jilin University, 22 in Peking University Third Hospital, 22 in Peking University First Hospital, 20 in the Fourth Affiliated Hospital of Harbin Medical University, 19 in Chengdu Fifth People′s Hospital, 8 in Chinese PLA General Hospital, 6 in Taikang Xianlin Drum Hospital. There were 5 850 males and 750 females, aged (57±16)years, with the range from 18 to 92 years. Of the 6 600 patients, 4 939 with compression treatment after tension-free inguinal hernia repair were divided into compression group and 1 661 without compression treatment after tension-free inguinal hernia repair were divided into non-compression group. Observation indicators: (1) the propensity score matching conditions and comparison of general data between the two groups after matching; (2) compression treatment of patients in the compression group after matching; (3) occurrence of seroma after tension-free inguinal hernia repair in the two groups after matching; (4) analysis of influencing factors for seroma after tension-free inguinal hernia repair. Follow-up using outpatient examination was performed at postoperative 14 days and 30 days to detect occurrence of seroma after tension-free inguinal hernia repair of patients up to January 2018. The propensity score matching was realized using the nearest neighbor method with 1∶1 ratio and caliper setting as 0.01. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analysed using the t test. Measurement data with skewed distribution were represented as M ( P25, P75) or M (range), and comparison between groups was analysed using the Wilcoxon rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was analysed using the chi-square test. Univariate analysis and multivariate analysis were conducted using the Logistic regression model. Results:(1) The propensity score matching conditions and comparison of general data between the two groups after matching: 3 322 of 6 600 patients had successful matching, including 1 661 in each group. Cases with smoking history, cases with coronary heart disease, cases with diabetes, cases with reducible hernia, irreducible hernia, incarcerated hernia, strangulated hernia (hernia grading), cases with Lichtenstein repair, cases with transabdominal preperitoneal patch repair, totally extraperitoneal repair(surgical methods), operation time, cases with emergency operation before propensity score matching were 1 110, 273, 333, 4 606, 63, 262, 8, 1 636, 2 515, 788, 60 minutes(50 minutes, 90 minutes), 155 in the compression group, and 233, 55, 87, 1 572, 28, 57, 4, 478, 941, 242, 60 minutes(45 minutes, 80 minutes), 29 in the non-compression group, respectively, showing significant differences in the above indicators between the two groups ( χ2=54.713, 12.927, 4.721, 11.218, 16.656, Z=-7.598, χ2=8.891, P<0.05). After propensity score matching, the above indicators were 231, 63, 82, 1 579, 20, 61, 1, 526, 826, 309, 60 minutes(45 minutes, 81 minutes), 34 in the compression group, and 233, 55, 87, 1 572, 28, 57, 4, 478, 941, 242, 60 minutes(45 minutes, 80 minutes), 29 in the non-compression group, respectively, showing no significant difference in the above indicators between the two groups ( χ2=0.018, 0.624, 0.157, 0.159, 0.240, Z=0.001, χ2=0.468, P>0.05). (2) Compression treatment of patients in the compression group after matching: of the 1 661 patients in the compression group after matching, 968 underwent compression treatment with 0.5 kg of sandbag or 500 mL of packed 0.9% sodium chloride solution, 109 underwent compression treatment with trusses, 112 underwent compression treatment with girdles, 311 underwent compression treatment with elastic underwear and 161 underwent compression treatment with elastic underwear combined with 0.5 kg of sandbag. (3) Occurrence of seroma after tension-free inguinal hernia repair in the two groups after matching: patients of the two groups after matching were followed up at postoperative 14 days and 30 days. Occurrence of seroma after matching were 44 and 15 in the compression group and non-compression group, respectively, showing a significant difference between the two groups ( χ2=13.299, P<0.05). (4) Analysis of influencing factors for seroma after tension-free inguinal hernia repair. Results of univariate analysis showed that cases with direct inguinal hernia, cases undergoing compression treatment with 0.5 kg of sandbag or 500 mL of packed 0.9% sodium chloride solution were related factors for occurrence of seroma after tension-free inguinal hernia repair ( odds ratio=0.518, 4.689, 95% confidence interval: 0.271-0.989, 2.730-8.055, P<0.05). Results of multivariate analysis showed that compared with no compression treatment, cases undergoing compression treatment with 0.5kg sandbag or 500 mL pack of 0.9% sodium chloride solution was an independent risk factor for occurrence of seroma after tension-free inguinal hernia repair ( odds ratio=4.698, 95% confidence interval: 2.734-8.073, P<0.05). Conclusion:Compared with no compression treatment, cases undergoing compression treatment with 0.5 kg of sandbag or 500 mL of packed 0.9% sodium chloride solution is an independent risk factor for occurrence of seroma after tension-free inguinal hernia repair.