ObjectiveTo explore the changes in volatile components， total polysaccharides， enzyme activity， and chromaticity value of Myristicae Semen Koji（MSK） during the fermentation process， and conduct correlation analysis. MethodsBased on gas chromatography-mass spectrometry（GC-MS）， the changes of volatile components in MSK at different fermentation times were identified. The phenol sulfuric acid method， dinitrosalicylic acid method（DNS）， and carboxymethyl cellulose sodium salt method（CMC-Na） were used to investigate the total polysaccharide content， amylase activity， and cellulase activity during the fermentation process. Visual analysis technology was used to explore the changes in chromaticity values， revealing the fermentation process of MSK and the dynamic changes of various measurement indicators， partial least squares-discriminant analysis（PLS-DA） was used to explore the differential compounds of MSK at different fermentation degrees， and Pearson correlation analysis was used to explore the correlation between volatile components of MSK and total polysaccharides， enzyme activity， and chromaticity values. ResultsA total of 60 volatile compounds were identified from MSK， the relative contents of components such as （+）-α-pinene， β-phellandrene， β-pinene， （+）-limonene， and p-cymene obviously increased， while the relative contents of components such as safrole， methyl isoeugenol， methyleugenol， myristicin， and elemicin significantly decreased. During the fermentation process， the total polysaccharide content showed an upward trend， while the activities of amylase and cellulase showed an initial increase followed by a decrease， and reached their maximum value at 40 h. the overall brightness（L^*） and total color difference（ΔE^*） gradually increased， while the changes in red-green value（a^*） and yellow-blue value（b^*） were not obvious. PLS-DA results showed that MSK could be clearly distinguished at different fermentation times， and 13 differential biomarkers were screened out. Pearson correlation analysis results showed that the contents of α-terpinene， β-phellandrene， methyleugenol， β-cubebene and myristic acid had an obvious correlation with chromaticity values. ConclusionAfter fermentation， the volatile components， total polysaccharides， amylase activity， and cellulase activity of MSK undergo significant changes， and there is a clear correlation between them and chromaticity values， which reveals the dynamic changes in the fermentation process and related indicators of MSK， laying a foundation for the quality control.

Objective Exploring the antidiarrhea effect of new Ershen pills composed of nutmeg koji based on the spleen and kidney yang deficiency diarrhea mouse model.Methods KM mice were randomly divided into normal,model,Ershen pills Ⅰ(salt psoralen+bran-stewed nutmeg),Ershen pills Ⅱ(salt psoralen+nutmeg koji),Ershen pills Ⅲ(salt psoralen+nutmeg raw product),salt psoralen,and nutmeg koji groups.The combined modeling method of hydrocortisone+senna leaf was used to establish the diarrhea mouse model with spleen-kidney yang deficiency.General signs and pathological changes of each organ were observed.Various organ indexes,the small intestine propulsion rate,gastric residual rate,serum motilin(MTL),gastrin(GAS),adrenal ketone(CORT),thyroid stimulating hormone(TSH),testosterone(T),tumor necrosis factor-α(TNF-α),and interleukin 1β(IL-1β)were assessed.16S rDNA sequencing and data analysis were conducted for fecal microorganisms.Results After modeling,compared with the normal group,the weight and activity of mice in the model group were reduced,the small intestine propulsion rate was significantly increased,the gastric residual rate and organ indexes were significantly decreased,serum GAS,CORT,TSH,and T levels were significantly decreased,MTL,TNF-α,and IL-1β levels were significantly increased,and intestinal flora species diversity was decreased.After administration,the above indexes and symptoms were improved by various degrees in each administration group,and the Ershen pills Ⅱ group was better than Ershen pills Ⅰ,Ershen pills Ⅲ,salt-psoralea,and nutmeg koji groups.Conclusions Combined use of nutmeg koji and salt psoralen has a remarkable effect on diarrhea of spleen-kidney yang deficiency.Fermented nutmeg reduces its toxicity risk and enhances its effect of warming the spleen and preventing diarrhea,which facilitates the development of nutmeg koji.

Objective:To investigate the clinicopathological features and genetic mutation status of pulmonary intravascular large B cell lymphoma.Methods:The clinicopathological data of eight patients diagnosed with pulmonary intravascular large B cell lymphoma, from April 2018 to May 2023, were retrospectively analyzed. The genetic profile of six patients was detected via next-generation sequencing (NGS) and followed up.Results:All patients included one male and seven females, with a median age of 64 years (ranging from 45 to 66 years). Respiratory symptoms were the most common (7 cases), B symptoms in two cases, hemophagocytic syndrome in two cases. Multiple diffuse ground-glass opacities in both lungs were observed based on the high-resolution chest CT scan. Six cases of mild to moderate ventilation or diffusion dysfunction were observed based on the pulmonary function tests. Moreover, two cases of hypoxemia and two cases with type Ⅰ respiratory failure were recorded. The serum lactate dehydrogenase level increased (7/8), β2-MG level increased (2/8), neuron-specific enolase level increased (7/8), total number of peripheral blood lymphocytes decreased (7/8), and clinical stages were all stage Ⅳ. The neoplastic lymphoid cells were lodged in the lumina of venules and capillaries of the alveolar septum; the tumor cells were large, with prominent nucleoli and frequent mitotic figures. The malignant cells were detected in the extravascular surrounding lung tissue in all cases. The tumor cells expressed mature B cell-associated antigens CD20 and CD79a, and the vascular endothelial markers CD31 and CD34 showed that the tumor cells were filled in the blood vessels, infiltrated blood vessel walls, and perivascular areas. One case was germinal center-type, seven cases were non-germinal center-type, two cases were double-expressing lymphoma, and all cases were EBER-negative. Furthermore, the top five genes with mutation frequencies detected by NGS were MYD88 (5/6), PIM1 (5/6), CD79B (4/6), TCF3 (4/6), and TP53 (3/6). Of the eight cases, seven patients received R-CHOP-based chemotherapy, six cases had complete remission after chemotherapy, one case died, and one case was lost to follow-up.Conclusions:Pulmonary vascular large B cell lymphoma is rare, which shares similar patterns with interstitial lung disease on imaging. Transbronchial lung biopsy is an effective method to confirm the diagnosis. Immunochemotherapy with BTK inhibitors can provide a survival advantage for patients in the future based on molecular typing.

ObjectiveTo compare the effects of different processing methods in ancient and modern times on the chemical components of Lilii Bulbus decoction， and to provide experimental support for the origin processing， decoction piece processing and clinical application of this herb. MethodUltra high performance liquid chromatography tandem quadrupole electrostatic field orbitrap high resolution mass spectrometry（UHPLC-Q-Orbitrap HRMS） was used for structural identification of the compounds using excimer ions， secondary MS and characteristic fragment ions， and referring to relevant literature and database information. Principal component analysis（PCA） and orthogonal partial least squares discriminant analysis（OPLS-DA） were used to screen the main differential components， the differential components were quantitatively studied by high performance liquid chromatography（HPLC）， in order to compare the types and contents of chemical components in the decoction of different processing products of Lilii Bulbus. ResultA total of 24 chemical components were identified from the decoction of different processed products of Lilii Bulbus， water extract and scalding liquid of fresh Lilii Bulbus， including 17 phenols， 5 saponins and 2 alkaloids. Compared with the fresh Lilii Bulbus decoction， the contents of regaloside A， p-coumaric acid， colchicine and other components in the decoction of dry Lilii Bulbus processed by scalding method decreased， the content of regaloside C in the decoction of dry Lilii Bulbus processed by steaming method decreased， and the contents of regaloside A and regaloside C in the decoction of fresh Lilii Bulbus processed by water immersion also decreased. Compared with the decoction of dry Lilii Bulbus processed by scalding method， the overall content of components in the fresh Lilii Bulbus decoction and the decoction of fresh Lilii Bulbus processed by water immersion was higher， the contents of components in the decoction of dry Lilii Bulbus processed by steaming method was higher， except for the slightly lower content of regaloside C. ConclusionDifferent processing processes have a certain effect on the types and contents of chemical components in Lilii Bulbus decoction. Scalding process is beneficial to the preservation of Lilii Bulbus， but can cause the loss of effective components. Compared with scalding method， steaming method can prevent browning of Lilii Bulbus and reduce the loss of its active ingredients. The processing method of removing foam after overnight immersion proposed by ZHANG Zhongjing may be more conducive to the treatment of Baihe disease， which can provide reference for the clinical rational application and mechanism research of different processed products of Lilii Bulbus.

Objective:To systematically analyze and integrate the real experience of puerpera in free delivery positions.Methods:Qualitative or mixed method studies on attitudes and emotional experiences of puerpera towards free delivery positions were retrieved through computer on PubMed, ScienceDirect, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, and WanFang Data. The search period was from database establishment to November 30, 2022. The quality of literature was evaluated using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center in Australia. The aggregation integration method was used to integrate the results.Results:A total of 5 articles were included and 28 results were extracted. The results were summarized into 10 categories, and 3 integrated results were formed, including factors that affected the choice of delivery position, the complex delivery experience of the puerpera, and the hope for much support.Conclusions:Hospitals, communities, and families should fully understand women's emotional experiences and needs for free delivery positions, provide sufficient support and guidance, and provide a reference basis for developing a reasonable delivery position plan and promoting a positive delivery experience.

Breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) is very rare. This 39-year-old female patient, more than 10 years after breast augmentation surgery, had suffered left breast swelling and pain for more than 1 year. The original implant (domestic anatomic shape silicone implant, 260 ml) was surgically removed and the capsule of the left breast implant was completely removed. Postoperative pathology confirmed the diagnosis of BIA-ALCL. The patient recovered well after the surgery. This case is the first reported in China mainland, suggest that doctors should attach great importance to the diseases, and diagnose and treat it timely and accurately.

Breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) is very rare. This 39-year-old female patient, more than 10 years after breast augmentation surgery, had suffered left breast swelling and pain for more than 1 year. The original implant (domestic anatomic shape silicone implant, 260 ml) was surgically removed and the capsule of the left breast implant was completely removed. Postoperative pathology confirmed the diagnosis of BIA-ALCL. The patient recovered well after the surgery. This case is the first one reported in China mainland, which suggest that doctors should attach great importance to the diseases, and diagnose and treat it timely and accurately.

Breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) is very rare. This 39-year-old female patient, more than 10 years after breast augmentation surgery, had suffered left breast swelling and pain for more than 1 year. The original implant (domestic anatomic shape silicone implant, 260 ml) was surgically removed and the capsule of the left breast implant was completely removed. Postoperative pathology confirmed the diagnosis of BIA-ALCL. The patient recovered well after the surgery. This case is the first reported in China mainland, suggest that doctors should attach great importance to the diseases, and diagnose and treat it timely and accurately.

Breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) is very rare. This 39-year-old female patient, more than 10 years after breast augmentation surgery, had suffered left breast swelling and pain for more than 1 year. The original implant (domestic anatomic shape silicone implant, 260 ml) was surgically removed and the capsule of the left breast implant was completely removed. Postoperative pathology confirmed the diagnosis of BIA-ALCL. The patient recovered well after the surgery. This case is the first one reported in China mainland, which suggest that doctors should attach great importance to the diseases, and diagnose and treat it timely and accurately.

The mitogen-activated protein kinase (MAPK) pathway controls intestinal epithelial barrier permeability by regulating tight junctions (TJs) and epithelial cells damage. Heme oxygenase-1 (HO-1) and carbon monoxide (CO) protect the intestinal epithelial barrier function, but the molecular mechanism is not yet clarified. MAPK activation and barrier permeability were studied using monolayers of Caco-2 cells treated with tissue necrosis factor α (TNF-α) transfected with FUGW-HO-1 or pLKO.1-sh-HO-1 plasmid. Intestinal mucosal barrier permeability and MAPK activation were also investigated using carbon tetrachloride (CCl 4) administration with CoPP (a HO-1 inducer), ZnPP (a HO-1 inhibitor), CO releasing molecule 2 (CORM-2), or inactived-CORM-2-treated wild-type mice and mice with HO-1 deficiency in intestinal epithelial cells. TNF-α increased epithelial TJ disruption and cleaved caspase-3 expression, induced ERK, p38, and JNK phosphorylation. In addition, HO-1 blocked TNF-α-induced increase in epithelial TJs disruption, cleaved caspase-3 expression, as well as ERK, p38, and JNK phosphorylation in an HO-1-dependent manner. CoPP and CORM-2 directly ameliorated intestinal mucosal injury, attenuated TJ disruption and cleaved caspase-3 expression, and inhibited epithelial ERK, p38, and JNK phosphorylation after chronic CCl 4 injection. Conversely, ZnPP completely reversed these effects. Furthermore, mice with intestinal epithelial HO-1 deficient exhibited a robust increase in mucosal TJs disruption, cleaved caspase-3 expression, and MAPKs activation as compared to the control group mice. These data demonstrated that HO-1-dependent MAPK signaling inhibition preserves the intestinal mucosal barrier integrity by abrogating TJ dysregulation and epithelial cell damage. The differential targeting of gut HO-1-MAPK axis leads to improved intestinal disease therapy.