Brain mechanism of acupuncture for children with anisometropic amblyopia: a resting functional magnetic resonance imaging study based on voxel-mirrored homotopic connectivity.

AIM: To explore the brain mechanism of acupuncture for children with anisometropic amblyopia using the voxel-mirror homotopic connectivity (VMHC) analysis method of resting functional magnetic resonance imaging (rs-fMRI) technology based on clinical effectiveness. METHODS: Eighty children with anisometropic monocular amblyopia were randomly divided into two groups: control (40 cases, 1 case of shedding) and acupuncture (40 cases, 1 case of shedding) groups. The control group was treated with glasses, red flash, grating, and visual stimulations, with each procedure conducted for 5min per time. Based on routine treatment, the acupuncture group underwent acupuncture of "regulating qi and unblocking meridians to bright eyes", Jingming (BL1), Cuanzhu (BL2), Guangming (GB37), Fengchi (GB20) acupoints were taken on both sides, with the needle kept for 30min each time. Both groups were treated once every other day, three times per week, for a total of 4wk. After the treatment, the overall curative effect of the two groups and the latency and amplitude changes of P100 wave of pattern visual-evoked potential were counted. At the same time, nine children with left eye amblyopia were randomly selected from the two groups and were scanned with rs-fMRI before and after treatment. The differences in the brain regions between the two groups were compared and analyzed with VMHC. RESULTS: Chi-square test showed a notable difference in the total efficiency rate between the acupuncture (94.87%) and control groups (79.49%). Regarding the P100 wave latency and amplitude, the acupuncture group had significantly shorter latency and higher amplitude of P100 wave than the control group. Moreover, the VMHC values of the bilateral temporal lobe, superior temporal gyrus, and middle temporal gyrus were notably increased in the acupuncture group after treatment. CONCLUSION: Acupuncture combined with conventional treatment can significantly improve the corrected visual acuity and optic nerve conduction in children with anisometropic amblyopia. Compared with the conventional treatment, the regulation of acupuncture on the functional activities of the relevant brain areas in the anterior cerebellum may be an effective acupuncture mechanism for anisometropic amblyopia.

Additive renal protective effects between arctigenin and puerarin in diabetic kidney disease.

Recent studies have shown that the combined use of renin angiotensin system inhibitor, SGLT2 inhibitors and/or mineralocorticoid receptor antagonist provides additional renal protection for patients with diabetic kidney disease (DKD). Similarly, in traditional Chinese medicine, the synergistic application of multiple herbs often brings more significant therapeutic effects. However, the synergistic or additive mechanisms of traditional Chinese medicine in combination therapy are not fully understood. In our previous studies, we show that arctigenin (ATG), a major component of Fructus Arctii, attenuates proteinuria and renal injury in diabetic mice by activating PP2A, and puerarin (a class of known isoflavones) can also reduce proteinuria and renal injury in diabetic mice via activation of Sirt1. Here, we further explored the potential additive renal protection of these two compounds in diabetic mice. Research has found that ATG and puerarin have a synergistic effect in reducing albuminuria in db/db mice. Mechanistically, we found that ATG reduced NF-κB p65 phosphorylation likely through activation of PP2A while puerarin reduced p65 acetylation via Sirt1 activation. Therefore, ATG and puerarin have additive inhibitory effects on the NF-κB activation, which is a key inflammatory pathway in DKD. RNA-sequencing analysis revealed distinct pathways activated by ATG and puerarin in the diabetic kidney, which may provide an additional mechanism for their additive effects in DKD. Our study suggests that ATG and puerarin could be a new combination therapy for DKD and reveals its underlined mechanisms.

Nontargeted screening method for detection of illicit adulterants in dietary supplements and herbal medicines using UHPLC-QTOF-MS with fine-tuned Spec2Vec-based spectral similarity and chemical classification filter.

Liquid chromatography-mass spectrometry (LC-MS) is a widely utilized technique for inspecting adulteration. Unscrupulous businesses persistently introduce novel illegal adulterants, making it necessary to develop methods to screen compounds not present in the current library. Conventional cosine similarity for mass spectral libraries matching is limited in their ability to identify structurally similar compounds. In our previous study, comparison of performance among four advanced similarity algorithms revealed that Spec2Vec exhibited the best performance in terms of both detection capability and false discovery rate, making it the chosen method for identifying illegal adulterants. However, Spec2Vec still exhibited worse performance compared to MS2DeepScore and entropy similarity in the aspects of detection capability and false discovery rate, respectively. In this study, our objective was to optimize the performance of spectral similarity for a specific compound class by fine-tuning a pretrained Spec2Vec model. Additionally, we implemented the chemical classification tool CANOPUS to address the issue of similarities in backbone structures between illegal adulterants and compounds found in herbal medicine, which can lead to false positives. We utilized glucocorticoids as potentially illicit adulterants to provide a proof-of-concept, and the results demonstrated that the fine-tuned Spec2Vec model not only exhibits a significant improvement in detection ability compared to the original model but also achieves comparable performance to MS2Deepscore. Moreover, the fine-tuned Spec2Vec model shows notably fewer false positives in comparison to MS2Deepscore. Overall, this proposed pipeline demonstrates high effectiveness and competitiveness in inspecting illegal adulterants, enhancing the analysis of large-scale MS data.

Arts therapies for mental disorders in COVID-19 patients: a comprehensive review.

Background and objective: The COVID-19 global pandemic has necessitated the urgency for innovative mental health interventions. We performed a comprehensive review of the available literature on the utility and efficacy of arts therapies in treating mental health problems, with special emphasis on their deployment during the COVID-19 pandemic, aiming to provide some evidence for the application of this therapy. Methods: The potential studies were systematically sourced from five authoritative databases: PubMed, Embase, the Cochrane Library, Web of Science, and the CNKI database. The evaluation of these studies was conducted based on stringent criteria, including validity, suitability, therapeutic potential, and consistency. Each piece of included literature was meticulously scored in accordance with these criteria, thus ensuring the inclusion of only the most robust studies in this review. The data from these Randomized Controlled Trials (RCTs) were carefully extracted using the PICO(S) framework, ensuring a comprehensive and systemic approach to data collection. In order to emphasize the variability in the effects of differing arts therapies on COVID-19-induced psychiatric disturbances, the sourced literature was systematically categorized and scrutinized based on distinct modalities. Results: Out of the 7,250 sourced articles, 16 satisfied the inclusion conditions. The therapies were predominantly meditation (n = 7), supplemented by individual studies on color therapy (n = 3), music therapy (n = 2), and single studies on horticultural therapy, dance therapy, mindfulness and music therapy, and yoga and music therapy (n = 4 collectively). These various forms of arts therapies had a positive short to medium-term impact on the mental health of COVID-19 patients. Besides improving patients' physical and mental health, these therapies can also be employed to mitigate mental health issues among healthcare professionals. Conclusion: The COVID-19 pandemic has profound and long-lasting implications for public mental health. Diverse forms of arts therapies are potentially effective in addressing related psychiatric symptoms. The integration of artificial intelligence might further enhance the efficacy and scalability of arts therapies in future implementations.

Ootheca mantidis mitigates renal fibrosis in mice by the suppression of apoptosis via increasing the gut microbe Akkermansia muciniphila and modulating glutamine metabolism.

Renal interstitial fibrosis (RIF), a progressive process affecting the kidneys in chronic kidney disease (CKD), currently lacks an effective therapeutic intervention. Traditional Chinese medicine (TCM) has shown promise in reducing RIF and slowing CKD progression. In this study, we demonstrated the dose-dependent attenuation of RIF by Ootheca mantidis (SPX), a commonly prescribed TCM for CKD, in a mouse model of unilateral ureteral obstruction (UUO). RNA-sequencing analysis suggested that SPX treatment prominently downregulated apoptosis and inflammation-associated pathways, thereby inhibiting the fibrogenic signaling in the kidney. We further found that transplantation of fecal microbiota from SPX-treated mice conferred protection against renal injury and fibrosis through suppressing apoptosis in UUO mice, indicating that SPX ameliorated RIF via remodeling the gut microbiota and reducing apoptosis in the kidneys. Further functional exploration of the gut microbiota combined with fecal metabolomics revealed increased levels of some probiotics, including Akkermansia muciniphila (A. muciniphila), and modulations in glutamine-related amino acid metabolism in UUO mice treated with SPX. Subsequent colonization of A. muciniphila and supplementation with glutamine effectively mitigated cell apoptosis and RIF in UUO mice. Collectively, these findings unveil a functionally A. muciniphila- and glutamine-involved gut-renal axis that contributes to the action of SPX, and provide important clue for the therapeutic potential of SPX, A. muciniphila, and glutamine in combatting RIF.

[Molecular mechanism of resveratrol combined with irinotecan in treatment of colorectal cancer].

This study aimed to investigate the mechanism of resveratrol(RES) combined with irinotecan(IRI) in the treatment of colorectal cancer(CRC). The targets of RES, IRI, and CRC were obtained from databases, and the targets of RES combined with IRI in the treatment of CRC were acquired by Venn diagram. The protein functional cluster analysis, GO and KEGG enrichment analyses were performed. In addition, the protein-protein interaction(PPI) network was constructed. The core target genes were screened out and the target-signaling pathway network was set up. IGEMDOCK was used to dock the core target gene molecules. Besides, the relationship between the expression level of key target genes and the prognosis and immune infiltration of CRC was analyzed. Based on the in vitro cell experiment, the molecular mechanism of RES combined with IRI in the treatment of CRC was explored and analyzed. According to the results, 63 potential targets of RES combined with IRI were obtained for CRC treatment. Furthermore, cluster analysis revealed that protein functions included 23% transmembrane signal receptors, 22% protein modifying enzymes, and 14% metabolite converting enzymes. GO analysis indicated that BPs were mainly concentrated in protein autophosphorylation, CCs in receptor complex and plasma membrane, and MFs in transmembrane receptor protein tyrosine kinase activity. Moreover, KEGG signaling pathways were mainly enriched in central carbon metabolism in cancer. The key targets of RES combined with IRI in the treatment of CRC were PIK3CA, EGFR, and IGF1R, all of which were significantly positively correlated with the immune infiltration of CRC. As shown by the molecular docking results, PIK3CA had the most stable binding with RES and IRI. Compared with the results in the control group, the proliferation ability and EGFR protein expression of CRC cells in the RES-treated group, the IRI-treated group, and the RES+IRI treated group significantly decreased. Moreover, the cell proliferation ability and EGFR protein expression level of CRC cells in the RES+IRI treated group were remarkably lower than those in the IRI-treated group. In conclusion, PIK3CA, EGFR, and IGF1R are the key targets of RES combined with IRI in CRC treatment. In addition, RES can inhibit the proliferation of CRC cells and improve IRI chemoresistance by downregulating the EGFR signaling pathway.

Secreted phosphoprotein 1 regulates natural compound 3',4',5,7-tetrahydroxyflavone to inhibit mast cell-mediated allergic inflammation.

BACKGROUND: Mast cells (MCs) are important effector cells in anaphylaxis and anaphylactic disease. 3',4',5,7-tetrahydroxyflavone (THF) presents in many medicinal plants and exerts a variety of pharmacological effects. In this study, we evaluated the effect of THF on C48/80-induced anaphylaxis and the mechanisms underlying its effects, including the role of secreted phosphoprotein 1 (SPP1), which has not been reported to IgE-independent MC activation. RESULTS: THF inhibited C48/80-induced Ca2+ flow and degranulation via the PLCγ/PKC/IP3 pathway in vitro. RNA-seq showed that THF inhibited the expression of SPP1 and downstream molecules. SPP1 is involved in pseudo-anaphylaxis reactions. Silencing SPP1 affects the phosphorylation of AKT and P38. THF suppressed C48/80-induced paw edema, hypothermia and serum histamine, and chemokines release in vivo. CONCLUSIONS: Our results validated SPP1 is involved in IgE-independent MC activation anaphylactoid reactions. THF inhibited C48/80-mediated anaphylactoid reactions both in vivo and in vitro, suppressed calcium mobilization and inhibited SPP1-related pathways.

Citri Reticulatae Pericarpium-Reynoutria japonica Houtt. herb pair suppresses breast cancer liver metastasis by targeting ECM1-mediated cholesterol biosynthesis pathway.

BACKGROUND: Liver metastasis is a frequent event in breast cancer that causes low survival rate and poor prognosis. Citri Reticulatae Pericarpium-Reynoutria japonica Houtt. (CR), a traditional Chinese herb pair, is used for the treatment of breast cancer liver metastasis or cholesterol gallstone disease in clinics. PURPOSE: This study attempted to investigate the potential therapeutic target and mechanism of CR herb pair on breast cancer liver metastasis. METHODS: The anti-metastatic and cholesterol-lowering activities of CR extract were evaluated in triple-negative breast cancer (TNBC) cell lines and an experimental liver metastasis model. The role of extracellular matrix protein 1 (ECM1) in the cholesterol biosynthesis pathway was determined by the knockdown and overexpression of ECM1 gene of TNBC cells. Changes in the gene and protein expression levels of ECM1 and the cholesterol biosynthesis pathway after CR treatment were detected in vitro and in vivo by real-time PCR and Western blot. RESULTS: The invasive and metastatic potentials and hypercholesterol levels of TNBC cells were positively associated with ECM1 expression. ECM1 knockdown reduced tumor cholesterol levels via downregulating cholesterol biosynthesis genes, including ACAT2, HMGCS1, HMGCR, MVK, and MVD, whereas ECM1 overexpression elicited the opposite effects. CR herb pair exerts the potential therapeutic effects on TNBC liver metastasis, which is partially mediated by disrupting ECM1-activated cholesterol biosynthesis process in TNBC cells. CONCLUSION: This study reveals that ECM1 is a novel target for the activation of cholesterol biosynthesis to promote TNBC liver metastasis occurrence. CR herb pair, an ECM1 inhibitor, maybe be considered to serve as an adjuvant therapeutic drug for liver metastasis in clinical practice.

Activation of the brain during motor imagination task with auditory stimulation.

Introduction: Auditory stimulation is one of the most important influence factors in the cognitive process. It is an important guiding role in cognitive motor process. However, previous studies on auditory stimuli mainly focused on the cognitive effects of auditory stimuli on the cortex, while the role of auditory stimuli in motor imagery tasks is still unclear. Methods: In order to explore the role of auditory stimuli in motor imagery tasks, we studied the EEG power spectrum distribution characteristics, frontal parietal mismatch negative (MMN) wave characteristics, and the Inter trial phase locking consistency (ITPC) characteristics of the prefrontal cognitive cortex and parietal motor cortex. In this study, 18 subjects were hired to complete the motor imagery tasks, induced by auditory stimuli of task related verbs and task independent nouns. Results: EEG power spectrum analysis showed that the activity of the contralateral motor cortex was significantly increased under the stimulation of verbs, and the amplitude of mismatch negative wave was also significantly increased. ITPC is mainly concentrated in µ, α, and γ bands in the process of motor imagery task guided by the auditory stimulus of verbs, while it is mainly concentrated in the ß band under the nouns stimulation. This difference may be due to the impact of auditory cognitive process on motor imagery. Discussion: We speculate that there may be a more complex mechanism for the effect of auditory stimulation on the inter test phase lock consistency. When the stimulus sound has the corresponding meaning to the motor action, the parietal motor cortex may be more affected by the cognitive prefrontal cortex, thus changing its normal response mode. This mode change is due to the joint action of motor imagination, cognitive and auditory stimuli. This study provides new insight into the neural mechanism of motor imagery task guided by auditory stimuli, and provides more information on the activity characteristics of the brain network in motor imagery task by cognitive auditory stimulation.

Pinellia ternata-containing traditional Chinese medicine combined with 5-HT3RAs for chemotherapy-induced nausea and vomiting: A PRISMA-compliant systematic review and meta-analysis of 22 RCTs.

BACKGROUND: Pinellia ternata (P. ternata, Banxia)-containing traditional Chinese medicine (TCM) is widely used in China as an adjuvant treatment for chemotherapy-induced nausea and vomiting (CINV). However, evidence of its efficacy and safety remains limited. PURPOSE: To investigate the efficacy and safety of P. ternata-containing TCM combined with 5-hydroxytryptamine-3 receptor antagonists (5-HT3RAs) in the treatment of CINV. STUDY DESIGN: Systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS: All relevant RCTs were systematically retrieved from seven internet databases (up to February 10, 2023). P. ternata-containing TCM combined with 5-HT3RAs to treat CINV was included in all RCTs. The clinical effective rate (CER) was defined as the primary outcome, while appetite, quality of life (QOL), and side effects were secondary outcomes. RESULTS: The meta-analysis included 22 RCTs with 1,787 patients. Our results indicated that P. ternata-containing TCM combined with 5-HT3RAs significantly improved the CER of CINV (RR = 1.46, 95% CI = 1.37-1.57, p < 0.00001), appetite (RR = 1.77, 95% CI = 1.42-2.20, p < 0.00001), QOL (RR = 7.67, 95% CI = 1.56-13.78, p = 0.01), the CER of several 5-HT3RA medications (RR = 1.47, 95% CI = 1.37-1.57, p < 0.00001), and acute and delayed vomiting (RR = 1.23, 95% CI = 1.12-1.36, p < 0.0001) compared with the 5-HT3RAs alone, while the combination therapy decreased the incidence of side effects induced by 5-HT3RAs for CINV (RR = 0.50, 95% CI = 0.42-0.59, p < 0.00001). CONCLUSION: According to the findings of this systematic review and meta-analysis, P. ternata-containing TCM combined with 5-HT3RAs was safer and more effective than 5-HT3RAs alone for CINV patients. However, due to the limitations of the included studies, more high-quality clinical trials are required to further validate our findings.

Fast screening and identification of illegal adulteration in dietary supplements and herbal medicines using molecular networking with deep-learning-based similarity algorithms.

Liquid chromatography-high-resolution mass spectrometry (LC-HRMS) is a powerful analytical tool used for adulteration inspection. Nevertheless, it is a challenging task to identify illegal adulterants that are not included in the library or are unexpected from large MS data. Molecular networking is a good tool for exploring, visualizing, and organizing MS/MS spectra, and moreover, it employs shifted peak match to calculate spectral similarity, making it capable of identifying adulteration that is not included in the library. The key of molecular networking is spectral similarity algorithms, and therefore, in this study, we compared the performance of four cutting-edge similarity algorithms, modified cosine similarity (shifted peak match), entropy similarity, and two deep-learning-based algorithms, MS2DeepScore and Spec2Vec, in building molecular networking for identification of adulteration that is not included in the library. We conducted an analysis of excluded-query-compound on all MS/MS spectra in test library and performed a large-scale false discovery rate estimation to investigate whether the spectral similarity calculated by each algorithm could represent the actual structural similarity well. The obtained results demonstrated Spec2Vec exhibited good performance in both detection capability and false discovery rate. Further comprehensive evaluation of the performance of Spec2Vec in the identification of adulteration that is not included in the library or is unexpected in different matrices and in application to real samples proved the approach studied here is a promising and powerful tool for adulterant inspection and improved the capability of analyzing large MS data.

Ceftazidime-avibactam-based combination therapy for hospital-acquired central nervous system infections caused by carbapenem-resistant Klebsiella pneumoniae.

OBJECTIVES: Klebsiella pneumoniae (K. pneumoniae) is one of the most common bacteria in the hospital-acquired central nervous system (CNS) infections. Central nervous system infections caused by carbapenem-resistant K. pneumoniae (CRKP) are associated with significant mortality rates and high hospital costs due to limited antibiotic treatment options. This retrospective study aimed to evaluate the clinical efficacy of ceftazidime-avibactam (CZA) for the treatment of CNS infections caused by CRKP. METHODS: Twenty-one patients with hospital-acquired CNS infections caused by CRKP who received treatment with CZA for ≥ 72 hours were enrolled. The primary outcome was to assess the clinical and microbiology efficacy of CZA for the treatment of CNS infections caused by CRKP. RESULTS: A high burden of comorbidity was discovered in 20 of 21 patients (95.2%). Most patients had a history of craniocerebral surgery and 17 (81.0%) of the patients were in the intensive care unit with a median APACHE II score of 16 (IQR 9-20) and SOFA score of 6 (IQR 3-7). Eighteen cases were treated by CZA-based combination therapies, while the remaining three cases were treated with CZA alone. At the end of the treatment, the overall clinical efficacy was 76.2% (16 of 21) with a bacterial clearance rate of 81.0% (17 of 21) and all-cause mortality of 23.8% (five of 21). CONCLUSION: This study showed that CZA-based combination therapy is an effective treatment option for CNS infections caused by CRKP.

[Hydroxysafflor yellow A inhibits proliferation, migration, and chemoresistance of colorectal cancer cells through Akt/mTOR-autophagy pathway].

In recent years, the clinical treatment of colorectal cancer(CRC) has made great progress, but chemoresistance is still one of the main reasons for reducing the survival rate of patients with colorectal cancer. Therefore, ameliorating chemotherapy resis-tance is an urgent problem to be solved. The purpose of this study was to investigate the regulatory role and related molecular mechanisms of hydroxysafflor yellow A(HSYA) in colorectal cancer cell proliferation, migration, and 5-fluorouracil(5-FU) chemoresistance. In this study, HCT116 and HT-29 cells were used as research subjects. Firstly, methyl thiazolyl tetrazolium(MTT) assay and colony formation assay were used to detect and analyze the effect of HSYA on the proliferation of CRC cells. Secondly, the effect of HSYA on the cell cycle in CRC cells was analyzed by cell cycle assay. Furthermore, the effect of HSYA on the migration of CRC cells was analyzed by wound-healing assay and Transwell assay. Based on the above, the influences of HSYA on 5-FU chemoresistance of CRC cells and related molecular mechanisms were explored and analyzed. The results showed that HSYA significantly inhibited the proliferation and migration of CRC cells, and arrested the cell cycle in G_0/G_1 phase. In addition, HSYA significantly ameliorated the chemoresistance of CRC cells to 5-FU. The results of acridine orange staining and Western blot showed that the autophagy activity of CRC cells in the HSYA and 5-FU combined treatment group was significantly higher than that in the 5-FU single drug treatment group. As compared with the 5-FU single drug treatment group, the phosphorylation levels of protein kinase B(Akt) and mammalian target of rapamycin(mTOR) in the HSYA and 5-FU combined treatment group were significantly reduced, indicating that the Akt/mTOR signaling pathway in the combined treatment group was down-regulated in CRC cells. In conclusion, HSYA may upregulate autophagy activity through the Akt/mTOR signaling pathway, thereby inhibiting the proliferation and migration of CRC cells and ameliorating the chemoresistance to 5-FU.

Direct start-up of aerobic granular sludge system with dewatered sludge granular particles as inoculant.

Aerobic granular sludge (AGS) is a promising technology for engineering applications in the biological treatment of sewage. New objective is to skip the conventional granulation step to integrate it into a continuous-flow reactor directly. This study proposed a method for integrating spherical pelletizing granular sludge (SPGS) into a new patented aerobic granular sludge bed (AGSB), a continuous up-flow reactor. AGSB system could be startup directly, and after 120 days of operation, the SPGS maintained a relatively intact spherical structure and stability. With an initial high chemical oxygen demand (COD) volume loading of over 2.0 kg/(m3·d), this system achieved the desired effect as the same as a mature AGS system. The final mixed liquid suspended solids, and the ratio of 30 min-5 min sludge volume index (SVI30/SVI5) were 20,000 mg/L, and 0.84, respectively. Although hydraulic elution and filamentous bacteria (FBs) had a slightly negative impact on initial phase pollutant removal, the final removal rates for COD, total nitrogen (TN), ammonia nitrogen (NH4+-H), and total phosphorus (TP) were 90%, 70%, 95%, and 85%, respectively. The presence of specific functional microorganisms promoted the secretion of extracellular polymeric substances (EPS), from 90.65 to 209.78 mg/gVSS. The maturation process of SPGS altered the microbial community structures and reduced the species abundance of microbes in sludge.

Employment Intention of Chinese Medical Students During the COVID-19 Epidemic: A Cross-Sectional Survey.

Context: In the process of combating the coronavirus disease 2019 (COVID-19) epidemic, medical personnel were at the forefront of the fight. As the future medical workforce, medical students often experienced firsthand how their seniors and teachers had to commit to working hard in combating the epidemic. Many were directly involved in the front line of the fight and that experience could easily have affected their intention to seek employment in a medically related career. Objective: The study intended to evaluate the impact of the COVID-19 pandemic on Chinese medical students' employment intentions and the factors associated with them to put forward relevant suggestions to provide a basis for medical education in the future. Design: The research team conducted a cross-sectional study, using an anonymous online questionnaire. Setting: The study took place in many provinces and cities in China and was conducted in an online questionnaire. Participants: Participants were 1114 college students studying clinical medicine, college students studying nursing, and students interning during standardized resident training, medical interns. Outcome Measures: The participants completed a self-administered questionnaire, which investigated their psychological statuses related to anxiety and depression as well as COVID-19's impact on their intentions related to job searches, regarding their willingness to engage in clinical or basic research in epidemic-related specialties and epidemic-related work. Results: Compared to college students studying clinical medicine, the employment intentions of nursing students and medical interns were more vulnerable to the epidemic. Females and nursing students were more reluctant to choose clinical work, and the choice was associated with depression. Nursing college students and medical interns were significantly less willing to engage in infection medicine, respiratory medicine, and intensive care medicine (all P < .001). Medical students with a bachelor's degree and postgraduate degrees were significantly less willing to engage in infection medicine and respiratory medicine (all P < .001), but medical students from regions with stable epidemics were more willing to engage in intensive care medicine. Medical students with a bachelor's degree were significantly less likely to be involved in epidemiology-related work than undergraduate students, and students from severe epidemic regions were significantly less willing to work in isolation wards or to go to Wuhan as volunteers. Conclusions: Participants' psychological statuses related to anxiety and depression, genders, degrees, current educational statuses, and regions affected employment intentions during the epidemic.

Art therapy as an adjuvant treatment for schizophrenia: A protocol for an updated systematic review and subgroup meta-analysis of randomized clinical trials following the PRISMA guidelines.

BACKGROUND: The efficacy of art therapy as an adjuvant treatment for schizophrenia remains inconclusive, and variation in the effects of art therapy on schizophrenia by the type of schizophrenia, severity of schizophrenia, type of art therapy, follow-up duration, or different populations has never been systematically assessed. The objective of this study is to systematically evaluate the effects of art therapy on schizophrenia and to determine whether there are some potential influencing factors affecting the effects of art therapy. METHODS: Seven online databases will be searched from their inception until June 30, 2022. All the relevant randomized clinical trials (RCTs) comparing art therapy plus standardized treatment versus standardized treatment alone for schizophrenia will be selected and assessed for inclusion. The Cochrane risk-of-bias tool will be used to evaluate the methodological quality of the included RCTs. Review Manager 5.4 will be used to analyze all the data obtained. Mental health symptoms are defined as the primary outcome, and the secondary outcomes include the Global Assessment of Functioning score, quality of life, functional remission, and the level of self-esteem. Subgroup analyses will be performed based on the type of schizophrenia, severity of schizophrenia, type of art therapy, follow-up duration, or different populations. RESULTS: The results will be published in a peer-reviewed journal. CONCLUSIONS: This updated systematic review and subgroup meta-analysis will evaluate the effects of art therapy as adjunctive treatment to standardized treatment in patients with schizophrenia and determine whether there are some potential confounding variables affecting the effects of art therapy on the outcomes of schizophrenia patients, thus strengthening the evidence base for the clinical application of this combination therapy for schizophrenia.

Integrating Anti-Influenza Virus Activity and Chemical Pattern Recognition to Explore the Quality Evaluation Method of Lonicerae Japonicae Flos.

Lonicerae japonicae flos (LJF, Lonicera japonica Thunb.) is adopted as a core herb for preventing and treating influenza. However, the anti-influenza virus components of LJF and the impact of quality-affecting factors on the anti-influenza activity of LJF have not been systematically investigated. In this study, a strategy integrating anti-influenza virus activity, ultrahigh-performance liquid chromatography fingerprint and chemical pattern recognition was proposed for the efficacy and quality evaluation of LJF. As a result, six bioactive compounds were screened out and identified as neochlorogenic acid, chlorogenic acid, cryptochlorogenic acid, 4,5-Di-O-caffeoylquinic acid, sweroside and secoxyloganin. Based on the bioactive compounds, chemical pattern recognition models of LJF were established by a linear discriminant analysis (LDA). The results of the LDA models and anti-influenza virus activity demonstrated that cultivation pattern significantly affected the anti-influenza effect of LJF and that the neuraminidase inhibition rate of wild LJF was significantly higher than that of cultivated LJF. Moreover, the quality of LJF samples with different processing methods and geographical origins showed no obvious difference. Overall, the proposed strategy in the current study revealed the anti-influenza virus components of LJF and provided a feasible method for thequality evaluation of LJF, which has great importance for assuring the clinical effect against influenza of LJF.

Mechanism of saikogenin G against major depressive disorder determined by network pharmacology.

Many classic decoctions of Chinese medicine including Radix Bupleuri are used to treat major depressive disorder (MDD). Saikosaponin D is a representative bioactive ingredient discovered in Radix Bupleuri. The mechanism of saikogenin G (SGG) as a metabolite in MDD remains unclear to date. This study aims to elucidate the mechanism of SGG in treating MDD with network pharmacology. We evaluated the drug likeness of SGG with SwissADME web tool and predicted its targets using the SwissTargetPrediction and PharmMapper. MDD-related targets were identified from the following databases: DisGeNET, DrugBank, Online Mendelian Inheritance in Man, and GeneCards. The common targets of SGG and MDD were imported to the STRING11.0 database, and then a protein-protein interaction network was constructed. Gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment were analyzed with DAVID 6.8 database. The molecular weight of SGG was 472.7 g/mol, the topological polar surface area was 69.92 A2 <140 A2, the octanol/water partition coefficient (Consensus LogP0/W) was 4.80, the rotatable bond was 1, the hydrogen bond donors was 3, and the hydrogen bond acceptors was 4. A total of 322 targets of SGG were obtained and there were 1724 MDD-related targets. A total of 78 overlapping genes were selected as targets of MDD treatment including albumin, insulin-like growth factor I, mitogen-activated protein kinase 1, proto-oncogene tyrosine-protein kinase Src, and epidermal growth factor receptor. Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis suggested that proteoglycans in cancer, pathways in cancer, prostate cancer, hypoxia-inducible factor-1, central carbon metabolism in cancer, estrogen, PI3K-Akt, ErbB, Rap1, and prolactin signaling pathways played an important role(P < .0001). This study showed that SGG exhibits good drug-like properties and elucidated the potential mechanisms of SGG in treating MDD with regulating inflammation, energy metabolism, monoamine neurotransmitters, neuroplasticity, phosphocreatine-creatine kinase circuits, and so on.

Relationship between the Degree of Illness in Elderly Patients with Rheumatoid Arthritis and Parameters of Musculoskeletal Ultrasound and Oswestry Dysfunction Index and Clinical Value Analysis.

Objective: The aim of the study is to explore the relationship between the degree of illness in elderly patients with rheumatoid arthritis (RA) and parameters of musculoskeletal ultrasound (MSUS) and Oswestry Dysfunction Index (ODI) and its clinical value. Methods: The clinical data of 100 elderly patients with RA admitted to our hospital from May 2016 to May 2022 were retrospectively analyzed. The patients were divided into four groups, including the remission group (DAS28 ≤ 2.6, n = 25), low activity group (2.6 ≤ DAS28 ≤ 3.2, n = 25), middle activity group (3.2 ≤ DAS28 ≤ 5.1, n = 25), and high activity group (DAS > 5.1, n = 25) according to the disease activity score-28 (DAS28). All patients underwent ultrasonic detection to compare the relationship between the degree of illness in elderly patients with RA and parameters of MSUS and ODI. Results: The total semiquantitative score of MSUS and ODI score in the remission group were obviously lower than those in the other three groups (P < 0.001). The degree of illness in elderly patients with RA was positively correlated with parameters of MSUS (r = 0.886, P < 0.001). The degree of illness in elderly patients with RA was positively correlated with ODI (r = 0.907, P < 0.001). Conclusion: The degree of illness in elderly patients with RA is closely related to parameters of MSUS and ODI, and the parameters of MSUS have a higher evaluation value for the degree of illness in elderly patients with RA, which are correlated with ODI.