Quercetin, a natural flavonoid, protects against hepatic ischemia-reperfusion injury via inhibiting Caspase-8/ASC dependent macrophage pyroptosis.

INTRODUCTION: Hepatic ischemia-reperfusion injury (IRI) is an inevitable adverse event following liver surgery, leading to liver damage and potential organ failure. Despite advancements, effective interventions for hepatic IRI remain elusive, posing a significant clinical challenge. The innate immune response significantly contributes to the pathogenesis of hepatic IRI by promoting an inflammatory cytotoxic cycle. We have reported that blocking GSDMD-induced pyroptosis in innate immunity cells protected hepatic IRI from inflammatory injury. However, the search for effective pyroptosis inhibitors continues. OBJECTIVES: This study aims to evaluate whether quercetin, a natural flavonoid, can inhibit GSDMD-induced pyroptosis and mitigate hepatic IRI. METHODS: We established the hepatic IRI murine model and cellular pyroptosis model to evaluate the efficacy of quercetin. RESULTS: Quercetin effectively alleviated hepatic IRI-induced tissue necrosis and inflammation. We found that during hepatic IRI, the cleavage of GSDMD occurred in hepatic macrophages, but not in other non-parenchymal cells. Quercetin inhibited the cleavage of GSDMD in macrophages. Moreover, we found that quercetin blocked the ASC assembly to inhibit the formation of NLRP3 inflammasomes and AIM2 inflammasomes, suppressing macrophage pyroptosis. Co-immunoprecipitation experiments confirmed that quercetin inhibited the interaction between ASC and Caspase-8, which is the mechanism of ASC complex and inflammasome formation. Overexpression of Caspase-8 abolished the anti-pyroptosis effect of quercetin in NLRP3 and AIM2 inflammasome signaling. Furthermore, we found that the hepatoprotective activity of quercetin was reduced in myelocytic GSDMD-deficient mice. CONCLUSION: Our findings suggest that quercetin has beneficial effects on hepatic IRI. Quercetin could attenuate hepatic IRI and target inhibition of macrophage pyroptosis via blocking Caspase-8/ASC interaction. We recommend that quercetin might serve as a targeted approach for the prevention and personalized treatment of hepatic IRI in perioperative patients.

Serine/threonine-protein kinase D2-mediated phosphorylation of DSG2 threonine 730 promotes esophageal squamous cell carcinoma progression.

Desmoglein-2 (DSG2) is a transmembrane glycoprotein belonging to the desmosomal cadherin family, which mediates cell-cell junctions; regulates cell proliferation, migration, and invasion; and promotes tumor development and metastasis. We previously showed serum DSG2 to be a potential biomarker for the diagnosis of esophageal squamous cell carcinoma (ESCC), although the significance and underlying molecular mechanisms were not identified. Here, we found that DSG2 was increased in ESCC tissues compared with adjacent tissues. In addition, we demonstrated that DSG2 promoted ESCC cell migration and invasion. Furthermore, using interactome analysis, we identified serine/threonine-protein kinase D2 (PRKD2) as a novel DSG2 kinase that mediates the phosphorylation of DSG2 at threonine 730 (T730). Functionally, DSG2 promoted ESCC cell migration and invasion dependent on DSG2-T730 phosphorylation. Mechanistically, DSG2 T730 phosphorylation activated EGFR, Src, AKT, and ERK signaling pathways. In addition, DSG2 and PRKD2 were positively correlated with each other, and the overall survival time of ESCC patients with high DSG2 and PRKD2 was shorter than that of patients with low DSG2 and PRKD2 levels. In summary, PRKD2 is a novel DSG2 kinase, and PRKD2-mediated DSG2 T730 phosphorylation promotes ESCC progression. These findings may facilitate the development of future therapeutic agents that target DSG2 and DSG2 phosphorylation. © 2024 The Pathological Society of Great Britain and Ireland.

Dislocation Does Not Seem To Be an Absolute Factor Effecting the Short- to Medium-Term Poor Prognosis of Patients with Acetabular Posterior Wall Fracture.

Dislocation is a complication of acetabular fractures involving the posterior wall, but whether dislocation is an absolute factor impacting the short- to medium-term prognosis of the hip joint remains controversial. This study aimed to compare the short- to medium-term clinical and radiological results among patients diagnosed with an acetabular fracture involving the posterior wall, with or without dislocation.Seventy-nine patients diagnosed with an acetabular fracture involving the posterior wall were retrospectively divided into posterior dislocation and non-dislocation groups. All fractures were open reduction + internal fixation with a plate screw combination through the single Kocher-Langenbeck approach. The short- to medium-term radiographic outcomes of follow-up were evaluated using the Matta radiologic grading system, while the clinical outcomes were evaluated using the modified Merle d'Aubigné-Postel evaluation system.The mean follow-up duration for all patients was 43.90 (range 24-75) months. Both groups achieved similar short- to medium-term clinical and radiographic results. There seems to be no significant differences between the two groups regarding the short- to medium-term assessment of clinical and radiographic results and the occurrence of postoperative complications (p > 0.05).In patients with acetabular fractures involving the posterior wall, hip dislocation is probably not an absolute determinant of a poor outcome. Even with early reduction, the short- to medium-term prognosis results appear similar to those of patients without dislocation.

Digital measuring the ocular morphological parameters of guinea pig eye in vivo with Python.

AIM: To quantitatively measure ocular morphological parameters of guinea pig with Python technology. METHODS: Thirty-six eyeballs of eighteen 3-week-old guinea pigs were measured with keratometer and photographed to obtain the horizontal, coronal, and sagittal planes respectively. The corresponding photo pixels-actual length ratio was acquired by a proportional scale. The edge coordinates were identified artificially by ginput function. Circle and conic curve fitting were applied to fit the contour of the eyeball in the sagittal, coronal and horizontal view. The curvature, curvature radius, eccentricity, tilt angle, corneal diameter, and binocular separation angle were calculated according to the geometric principles. Next, the eyeballs were removed, canny edge detection was applied to identify the contour of eyeball in vitro. The results were compared between in vivo and in vitro. RESULTS: Regarding the corneal curvature and curvature radius on the horizontal and sagittal planes, no significant differences were observed among results in vivo, in vitro, and the keratometer. The horizontal and vertical binocular separation angles were 130.6°±6.39° and 129.8°±9.58° respectively. For the corneal curvature radius and eccentricity in vivo, significant differences were observed between horizontal and vertical planes. CONCLUSION: The Graphical interface window of Python makes up the deficiency of edge detection, which requires too much definition in Matlab. There are significant differences between guinea pig and human beings, such as exotropic eye position, oblique oval eyeball, and obvious discrepancy of binoculus. This study helps evaluate objectively the ocular morphological parameters of small experimental animals in emmetropization research.

Potential effects of different cell death inhibitors in protecting against ischemia-reperfusion injury in steatotic liver.

Liver ischemia-reperfusion injury (IRI) remains a common issue and with the increasing incidence of Nonalcoholic fatty liver disease (NAFLD), which are more sensitive to IRI, it is crucial to explore the possible strategy to alleviate the steatotic liver IRI. Several modes of cell death are involved in hepatocytes and immune cells during hepatic IRI, and the effects of different cell death inhibitors including apoptosis, necroptosis, pyroptosis, and ferroptosis in steatotic liver IRI have not been investigated. We established 70% IRI model on steatotic liver in mice. Apoptosis, necroptosis, pyroptosis and ferroptosis inhibitors were used to evaluate their effects on liver injury, inflammatory response, and immune cell infiltration. Immunofluorescence and immunohistochemical results demonstrated that there were apoptosis, necroptosis, pyroptosis, and ferroptosis in the progression of IRI in steatotic liver. All four types of cell death inhibitors showed protective effects, but ferroptosis inhibitor Fer-1 and pyroptosis inhibitor VX765 exerted better protective effects compared the apoptosis inhibitor Z-VAD and necroptosis inhibitor Nec-1. Further, we found that pyroptosis occurred mainly in macrophages and ferroptosis occured primarily in hepatocytes during steatotic liver IRI. Ferroptosis in heaptocytes and pyroptosis in macrophages are two major cell death types involved in steatotic liver IRI and inhibiting these cell death exerted good protective effects.

Study on the postoperative visual function recovery of children with concomitant exotropia based on an augmented reality plasticity model.

Objective: This study aimed to investigate the clinical application effect of an augmented reality (AR) plasticity model on the postoperative visual function recovery of children with concomitant exotropia. Methods: Between September 2019 and October 2021, 28 patients with concomitant exotropia who visited Shenzhen Children's Hospital (9 male and 19 female) were enrolled in this study. The average age of the patients was 6.4 ± 1.8 years. Postoperative rehabilitation training was conducted using a personalized AR binocular visual perception plasticity model developed based on the patient's examination results. After 1 month, 3 months, and 6 months of training, the patients returned to the hospital for examinations of perceptual eye position, static zero-order stereopsis, dynamic first-order fine stereopsis, and dynamic second-order coarse stereopsis to compare the changes in eye position control and stereovision function. Results: After 6 months of eye position training, the horizontal perception eye position of the 28 patients was significantly lower than that before training. The difference in eye position at the first and third months compared with that before training was not statistically significant (1st month: z = -2.255, p = 0.024 > 0.017; 3rd month: z = -2.277, p = 0.023 > 0.017; 6th month: z = -3.051, p = 0.002 < 0.017). The difference in vertical perceptual eye position after training compared with that before training was not statistically significant (1st month: z = -0.252, p = 0.801 > 0.017; 3rd month: z = -1.189, p = 0.234 > 0.017; 6th month: z = -2.225, p = 0.026 > 0.017). The difference in 0.8-m static zero-order stereopsis before and after training was not statistically significant (1st month: z = -2.111, p = 0.035 > 0.017; 3rd month: z = -1.097, p = 0.273 > 0.017; 6th month: z = -1.653, p = 0.098 > 0.017). The 1.5-m static zero-order stereopsis was improved after 1 month, 3 months, and 6 months of training compared with that before training (1st month: z = -3.134, p = 0.002 < 0.017; 3rd month: z = -2.835, p = 0.005 < 0.017; 6th month: z = -3.096, p = 0.002 < 0.017). Dynamic first-order fine stereopsis and dynamic second-order coarse stereopsis were measured in the 28 patients before and after training. Patients 1 and 18 had no dynamic first-order fine stereopsis before training, but both regained dynamic stereopsis after 1 month, 3 months, and 6 months of training. Patient 16 had no dynamic first-order fine stereopsis or dynamic second-order coarse stereopsis before training, but first-order and second-order stereopsis had been reconstructed after 1 month, 3 months, and 6 months of training. Conclusion: Concomitant exotropia surgery improved the basic problem of eye position at the ocular muscle level, but the patient's perceptual eye position and visual function defects at the brain visual level remained. This might partly explain the poor postoperative clinical effect. The AR plasticity model can improve patients' horizontal perceptual eye position and multi-dimensional stereoscopic function, and its clinical effect warrants further study.

Secreted proteins encoded by super enhancer-driven genes could be promising biomarkers for early detection of esophageal squamous cell carcinoma.

BACKGROUND: Early detection of cancer remains an unmet need in clinical practice, and high diagnostic sensitivity and specificity biomarkers are urgently required. Here, we attempted to identify secreted proteins encoded by super-enhancer (SE)-driven genes as diagnostic biomarkers for esophageal squamous cell carcinoma (ESCC). METHODS: We conducted an integrative analysis of multiple data sets including ChIP-seq data, secretome data, CCLE data and GEO data to screen secreted proteins encoded by SE-driven genes. Using ELISA, we further identified up-regulated secreted proteins through a small size of clinical samples and verified in a multi-centre validation stage (345 in test cohort and 231 in validation cohort). Receiver operating characteristic curves were used to calculate diagnostic accuracy. Artificial intelligence (AI) method named gradient boosting machine (GBM) were applied for model construction to enhance diagnostic accuracy. RESULTS: Serum EFNA1 and MMP13 were identified, and showed significantly higher levels in ESCC patients compared to normal controls. An integrated Five-Biomarker Panel (iFBPanel) established by combining EFNA1, MMP13, carcino-embryonic antigen, Cyfra21-1 and squmaous cell carcinoma antigen had AUCs of 0.881 and 0.880 for ESCC in test and validation cohorts, respectively. Importantly, the iFBPanel also exhibited good performance in detecting early-stage ESCC patients (0.872 and 0.864). Furthermore, the iFBPanel was further empowered by AI technology which showed excellent diagnostic performance in early-stage ESCC (0.927 and 0.907). CONCLUSIONS: Our study suggested that serum EFNA1 and MMP13 could potentially assist ESCC detection, and provided an easy-to-use detection model that might help the diagnosis of early-stage ESCC.

Safety and Efficacy of Oral Hydroxychloroquine in the Treatment of Ophthalmic Disease Associated with Sjögren's Syndrome.

Background: Dry eye disease is common among patients with primary Sjögren's syndrome (pSS). Hydroxychloroquine (HCQ), known for its immunomodulatory effects and minimal adverse effects, has emerged as a pivotal treatment option for pSS. Nonetheless, conflicting evidence exists regarding the therapeutic efficacy of HCQ in managing dry eye disease associated with pSS. Objectives: To evaluate the safety and efficacy of oral hydroxychloroquine in treating dry eye disease associated with pSS. Methods: A prospective randomized controlled study was conducted, enrolling pSS patients with moderate to severe dry eye disease. Participants were randomly assigned to an oral HCQ group and an observation group. Various scales (ESSDAI, ESSPRI, OSDI, and SPEED questionnaire score), dry eye-related tests (OSS score, TBUT, and Schirmer test I), ophthalmology-specific tests (BCVA, SD-OCT RT, field of view, latency and amplitudes for multifocal ERG ring 1 and ring 2), whole body protein levels (serum IgA, IgG, and IgM), and blood glucose were assessed before and after 12 months of treatment. Results: Pairwise comparison of the observed indicator baseline revealed no statistical significance (P > .05). After 12 months, the HCQ group exhibited notable improvements in ESSPRI, serum IgA, and Schirmer test I results compared to the control group (P < .05). Both groups demonstrated significant improvements in BCVA, OSDI, SPEED scores, and dry eye-associated examinations compared to baseline (P < .05). Serum IgG and IgM levels decreased in the HCQ group after 12 months of treatment, but without statistical significance (P > .05). None cases of HCQ retinopathy were reported during follow-up. Conclusions: Oral HCQ was demonstrated safety and efficacy in managing pSS-related dry eye disease. Treatment with Oral HCQ markedly reduced the ESSPRI score, improve patients' systemic dryness symptoms, and greatly decreased blood IgA levels. Combined with topical cyclosporin, HCQ improved Schirmer test I scores and alleviated ocular surface inflammation and dry eye signs and symptoms.

Discovery and Structural Optimization of 1,2,3,4-Tetrahydro-ß-carbolines as Novel Reactive Oxygen Species Inducers for Controlling Intractable Plant Bacterial Diseases.

Nowadays, reactive oxygen species (ROS) have been acknowledged as promising bactericidal targets against pesticide-resistant bacteria. Herein, to further excavate more excellent ROS inducers, simple 1,2,3,4-tetrahydro-ß-carboline derivatives containing a 3-aminopropanamide moiety were prepared and assessed for their antibacterial potency. Notably, three promising compounds displayed significant antibacterial potency. Compound I29 exhibits excellent in vitro bioactivity, with an EC50 value of 5.73 µg/mL, and admirable in vivo activities (protective activity of 55.74% and curative activity of 65.50%) toward Xanthomonas oryzae pv. oryzae. Compound I16 has good activity in vitro, with an EC50 of 3.43 µg/mL, and outstanding bioactivities in vivo (protective activity of 92.50% and curative activity of 59.68%) against Xanthomonas axonopodis pv. citri. Compound I6 shows excellent in vitro bioactivity (EC50 = 2.86 µg/mL) and significant protective activity (94.02%) for preventing Pseudomonas syringae pv. actinidiae. Antibacterial mechanism investigations indicate that these compounds disrupt the balance of the redox system to kill bacteria. These simple 1,2,3,4-tetrahydro-ß-carboline derivatives are promising leads to the discovery of bactericidal agents.

Pre-calving energy density and rumen protected lysine impacted blood metabolites and biomarkers of liver functions in dairy cows during the transition period.

Dairy cows usually face negative energy balance and disorders of normal organ function due to a mismatch between energy intake and energy demand. Negative energy balance directly affects liver function and blood metabolites because the liver is used as source of energy supply and a center of metabolic activity. This study was aimed to determine the effect of pre-calving energy density and rumen-protected lysine on blood metabolites and biomarkers of liver functions in the dairy cows during the transition period. Forty 3rd lactation Holstein cows going to enter their 4th lactation were randomly allocated to one of the four dietary treatments (high energy with rumen-protected lysine (HERPL) = 1.53NEL plus 40 g Lys, high energy without lysine (HECK) = 1.53NEL, low energy with rumen-protected lysine (LERPL) = 1.37NEL plus 40 g Lys, and low energy without lysine (LECK) = 1.37NEL arranged in a 2 × 2 factorial design. Blood samples were collected during the transition period, and concentrations of blood metabolites and biomarkers of liver function were measured. Interaction between pre-calving high-energy diet and rumen-protected lysine tended to increase plasma albumin, numerically increased glucose, decreased triglyceride, total bilirubin, and aspartate aminotransferase concentrations. The result revealed that pre-calving high-energy density increased insulin, albumin and decreased blood urea nitrogen and total bilirubin concentrations and substantial favor liver functions during the transition period.

Whole cell of pure Clostridium butyricum CBT-1 from anaerobic bioreactor effectively hydrolyzes agro-food waste into biohydrogen.

Recycling organic waste and converting them into renewable energy are a promising route for environment protection and effective biochemical reactions suitable for industrial hydrogen synthesis. This study targeted to isolate a pure anaerobic culture with potential to hydrolyze different biomass and production of biohydrogen. For this, a sample of full-scale anaerobic digester, fed with a multicomponent solid, was inoculated on Reinforced Clostridial Medium (RCM) in strict anaerobic conditions. An anaerobic Clostridium butyricum CBT-1 strain was isolated, identified from morphological and 16S rRNA sequence. The CBT-1 culture expressed amylase, cellulase and peroxidases activities. The strain exhibited visual decolorization of both Azure B and crystal violet dyes. In batch fermentation experiment, the CBT-1 produced highest of 3.06, 2.67 and 2.46 mol/mol H2 yield from glucose, starch and cellulose respectively, whereas, the CBT-1 showed low 0.43 mol H2/mol of substrate from untreated rice straw due to lignin in compact structure and comparatively high H2 yield of 1.91 and 2.01 mol H2/mol of substrate rice straw hydrolysate and kitchen food waste (KFWS) respectively. The cumulative volumetric yield of H2 was 358.15, 300.8 and 294.5NmL/gSub from glucose, starch and cellulose respectively. Similarly, the cumulative H2 volume was 76.7, 184.4, 237.2 NmL/gVS from untreated rice straw, rice straw hydrolysate and kitchen food waste. This study emphasizes the prospects to find similar robust anaerobic culture for hydrolyzing complex biomass. Such strains could be used as standard co-inoculum for biohydrogen obtaining and as the biocatalyst for commercial scale applications.

A calf tissue flap combined with antibiotic-loaded calcium sulfate for foot and ankle osteomyelitis / 中华创伤骨科杂志

Objective:To evaluate the efficacy of a calf tissue flap combined with antibiotic-loaded calcium sulfate (artificial bone or mixed iliac bone graft) in the treatment of foot and ankle osteomyelitis.Methods:A retrospective study was conducted to analyze the 11 cases of foot and ankle osteomyelitis which had been treated at Department of Hand and Microsurgery, The Third Hospital of Baoji from October 2018 to October 2021. There were 8 males and 3 females, aged (42.3±23.7) years. The chronic hypotoxic osteomyelitis was repaired and reconstructed after thorough debridement at one stage with a calf tissue flap combined with antibiotic-loaded calcium sulfate artificial bone to fill the cavity and cover the wound. The acute infected trauma was repaired and reconstructed after thorough debridement at the second stage with a calf tissue flap combined with antibiotic-loaded calcium sulfate artificial bone to fill the cavity and cover the wound only after the acute infection was controlled by local dressing, drainage or negative pressure therapy and systemic anti-infection treatment at the primary stage. The flap size ranged from 3.5 cm × 2.0 cm to 12.0 cm × 6.0 cm. Four cases were treated by a peroneal artery perforator flap combined with antibiotic-loaded calcium sulfate artificial bone, 3 cases by a flap with peroneal artery perforator and peroneal nerve trophic vessel combined with antibiotic-loaded calcium sulfate artificial bone, 3 cases by a posterior tibial artery perforator flap combined with antibiotic-loaded calcium sulfate artificial bone, and one by a peroneus longus muscle flap combined with antibiotic-loaded calcium sulfate artificial bone. Postoperatively, the flap survival, bone union time, ankle function and complications were observed; the therapeutic efficacy was evaluated by comparing infection control indexes at the final follow-up [clinical manifestations like local redness, swelling, pain, ulceration, and exudation, and white blood cell count (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and calcitoninogen (PCT)].Results:All the flaps survived except for one which developed necrosis at the distal 1/3 of the flap but responded to dressing change. All the patients were followed up for (22.6±11.5) months. The 6-month follow-up revealed that all the flaps were fine in shape and texture. Re-examinations showed that WBC, CRP, ESR and PCT were normal or close to normal, the local skin was free of redness, swelling or ulceration, and protective sensation was restored to varying degrees. X-ray at (12.1±2.3) months showed that lesions disappeared, bony union was achieved, the ankle joint regained basic flexion and extension, and the affected limb also regained weight-bearing and walking functions in all the patients but one whose X-ray at 18 months showed poor bony union but no other symptoms or signs.Conclusion:In the treatment of foot and ankle osteomyelitis, a calf tissue flap combined with antibiotic-loaded calcium sulfate artificial bone can promote bone healing and restore the function of the foot and ankle because it not only fills the cavity and covers the wound but also effectively controls the infection.

Optimal evidence analysis for the nursing management of limb spasm in patients with spinal cord injury / 中华创伤杂志

Objective:To explore the optimal evidence for the nursing management of limb spasm in patients with spinal cord injury.Methods:Based on the "6S" evidence model, the databases including CNKI, Wanfang, PubMed and Cochrane Library, the guideline websites such as the National Guideline Clearinghouse, Guidelines International Network and Registered Nurses′ Association of Ontario, and the websites of professional associations such as the Royal College of Physicians, American Spinal Injury Association and Canadian Spine Association were systematically searched. Search period of each database was set from the year of inception until July 2022. Two investigators independently screened the literatures related to the management of limb spasm in patients with spinal cord injury, and conducted quality evaluation and evidence recommendation level evaluation.Results:Totally 17 literatures consisting of 6 guidelines, 3 expert consensuses, 5 systematic reviews, 2 evidence summaries, and 1 clinical decision were included. Moreover, 30 pieces of evidence were summarized from 3 aspects, including evaluation and identification, drug therapy (chemical denervation, and oral medication), rehabilitation training (hydrotherapy, electrical stimulation, magnetic stimulation, vibration therapy, heat and cold therapy, body position, and exercise therapy).Conclusion:Nursing staff can set up a multidisciplinary team according to the clinical environment and take into consideration of the characteristics of spinal cord injury patients to provide personalized interventions involving evaluation and identification, drug therapy, rehabilitation training, etc., so as to alleviate the degree of limb spasm.

Chinese expert consensus on emergency surgery for severe trauma and infection prevention during corona virus disease 2019 epidemic (version 2023) / 中华创伤杂志

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Effect of Jianpi Huoxue Jiedu recipe on upper limb edema of spleen deficiency and dampness stagnation, blood stasis and toxin internal knot type after modified radical operation of breast cancer / 中国医师杂志

Objective:To explore the therapeutic effect of Jianpi Huoxue Jiedu recipe on upper limb edema of spleen deficiency and dampness stagnation, blood stasis and toxin internal knot type after modified radical surgery for breast cancer.Methods:From January 2020 to May 2022, a total of 60 patients with upper limb edema of spleen deficiency and dampness stagnation, blood stasis and toxin internal knot type after modified radical surgery for breast cancer were selected and treated in Longyan Hospital of Traditional Chinese Medicine Affiliated to Xiamen University. They were divided into control group and observation group according to random number table, with 30 cases in each group. The control group was treated with routine western medicine comprehensive swelling reduction surgery, while the observation group was treated with a combination of Jianpi Huoxue Jiedu recipe (1 dose/day, warmly-taken in the morning and evening) for one month on the basis of the control group. The clinical efficacy, traditional Chinese medicine (TCM) syndrome score, edema diameter, breast cancer quality of life scale (FACT), and joint range of motion were compared between the two groups after treatment.Results:After one month of treatment, the total clinical effective rate of the observation group (93.33%) was significantly higher than that of the control group (70.00%, P<0.05). After treatment, the TCM syndrome scores (upper limb swelling, pain, fullness, sense of restraint, skin keratinization, itching, heaviness, stuffiness, and fatigue) of both groups of patients decreased compared to those before treatment, and the observation group was lower than the control group (all P<0.05). After treatment, the diameter of edema in the affected limbs was significantly reduced in both groups of patients, and the diameter of 10 cm above the wrist and elbow stripes in the observation group was smaller than that in the control group (all P<0.05). After treatment, the FACT scores of the two groups of patients significantly decreased, and the FACT scores of the observation group were lower than those of the control group (all P<0.05). After treatment, the joint activity of the two groups of patients significantly increased, and the joint activity of the observation group was greater than that of the control group (all P<0.05). Conclusions:The clinical efficacy of Jianpi Huoxue Jiedu recipe combined with western medicine in treating upper limb edema of spleen deficiency and dampness stagnation, blood stasis and toxin accumulation type after modified radical operation of breast cancer is better than that of western medicine alone. It can significantly improve the clinical symptoms, signs, quality of life, and joint mobility of upper limbs of patients, and reduce upper limb edema.

A circuit from dorsal hippocampal CA3 to parvafox nucleus mediates social novelty preference deficits induced by chronic social defeat stress / 中国药理学与毒理学杂志

OBJECTIVE The preference for social novelty is crucial to the social life of humans and rodents.However,the neural mechanisms underlying social novelty preference are poorly understood.Dorsal hippocampal CA3(dCA3)is an important brain area that responds to social defeat stress,and the neural circuitry of dCA3→lat-eral septum(LS)participates in the context-associated memory.Meanwhile,the parvafox nucleus(PFN)Foxb1+ neurons regulate the defensive reaction to life-threaten-ing situations.Therefore,we investigate a cell-specific cir-cuit of dCA3CaMKⅡα+→dorsal LSGABA+→PFNFoxb1+ in social novelty preference.METHODS Chronic social defeat stress(CSDS)and three-chamber social interaction test were performed in adult male C57BL/6J mice to detect social behaviors.Optogenetic and chemical-genetic experiments were conducted to regulate the circuit.RESULTS CSDS reduced the preference for social nov-elty in mice and the response of dCA3CaMKⅡα+ neurons dur-ing approach to an unfamiliar mouse was impaired by CSDS.Optogenetic inhibition of dCA3CaMKⅡα+→dLS pro-jection reduced the preference for the unfamiliar mouse versus a familiar mouse.Meanwhile,optogenetic activa-tion of dCA3CaMKⅡα+→dLS projection rescued the prefer-ence for social novelty of CSDS-treated mice.Manipula-tions dLSGABA+→PFN projection activation regulated the preference for social novelty in mice.Optogenetic activa-tion of PFNFoxb1+→lPAG projection reduced the prefer-ence for a familiar C57BL/6J mouse versus a novel object in control mice.CSDS decreased the excitability of dCA3CaMKⅡα+ neurons by up-regulation of Kir2.4(Kcnj14)expression.CONCLUSION Our present study suggest-ed that activation of a cell-specific circuit of dCA3CaMKⅡα+→dLSGABA+→PFNFoxb1+→lPAG reverses the deficits of social novelty preference in defeated mice,and inhibition of this circuit reduces the preference for social novelty.The cir-cuit that regulates the preference for social novelty deficits may provide a new information for the potential therapeu-tic targets for neuropsychiatric diseases.

Effect of hydroxysafflor yellow A on depressive-like behavior and expression of GABAAR protein in hippocampus of chronic restraint stress model mice / 中华行为医学与脑科学杂志

Objective:To investigate the effects of hydroxysafflor yellow A (HSYA) on depressive-like behavior and expression of type A γ-aminobutyric acid receptor(GABAAR)in hippocampus of chronic restraint stress model mice.Methods:The SPF grade male C57BL/6C mice were divided into Control group, HSYA group, Model group, Model + HSYA group and Model + fluoxetine group according to random number table method, with 12 mice in each group.Mice model of depression was established by chronic restraint stress.Mice in HSYA group and Model+ HSYA group were intraperitoneally injected with HSYA(20 mg/kg), mice in Model+ fluoxetine group were injected intraperitoneally with fluoxetine (10 mg/kg), and mice in Control group and Model group administered with 0.9% sodium chloride solution intraperitoneally once a day for 14 days.Then, the forced swimming test (FST) and tail suspension test (TST) were performed to evaluate the depressive-like behavior of mice, and the protein expression levels of different subtypes of GABAAR in the hippocampus of mice were determined by Western blot.SPSS 19.0 and GraphPad Prism 8.0 software were used for data statistical analysis and mapping.One-way ANOVA was used for comparison among groups, and Tukey-HSD test was used for further pairwise comparison.Results:(1) In the behavioral tests, there were significant differences in swimming immobility time of FST and tail suspension immobility time of TST among the five groups ( F=21.59, 20.81, both P<0.05). The swimming immobility time ((143.91±9.97) s) and tail suspension immobility time (( 107.00±6.54) s) in Model group were higher than those in Control group ((52.92±6.70) s, ( 43.50±5.96) s, both P<0.05). There were no significant difference in swimming immobility time and tail suspension immobility time between Model+ HSYA group ((26.17±7.69)s, ( 20.17±7.89)s) and Model+ fluoxetine group ((61.60±16.22)s, (34.14±10.74)s)(both P>0.05), but the swimming immobility time and tail suspension immobility time in these two groups were lower than those in Model group (both P<0.05). (2) The Western blot results showed that there were significant differences in the expression of GABAARβ1 and GABAARβ2 protein in hippocampus among the four groups ( F=12.21, 11.40, both P<0.05). The expression levels of GABAARβ1(45.60±10.76) and GABAARβ2 (46.27±4.82) protein in hippocampus of Model group were lower than those in Control group ((100.00±3.44), (100.00±3.26), both P<0.05). Compared to Model group, the expression of GABAARβ1 (79.91±5.00) and GABAARβ2 (79.08±5.53) protein in hippocampus of Model+ HSYA group were higher (both P<0.05). In addition, the expression of GABAARα1 and GABAARγ1 proteins in hippocampus were not significantly different among the four groups( F=0.23, 0.10, both P>0.05). Conclusion:HSYA can effectively alleviate depressive-like behavior in depression model mice, which may be related with the upregulation of GABAARβ1 and GABAARβ2 of hippocampus tissue.

The association between skeletal muscle measures, nutritional risk, cachexia, and chemotherapy-induced toxicity in lung cancer patients / 中华临床营养杂志

Objective:Chemotherapy is the main treatment for lung cancer. However, chemotherapy-related toxicity has a high incidence, which brings adverse experiences to patients and seriously affects treatment plans and quality of life. Low skeletal muscle mass (SMM), malnutrition, and cachexia are related to a higher incidence of chemotherapy toxicity in cancer patients. The main purpose of this study is to evaluate the relationship between baseline body composition, nutritional status, cachexia, and lung cancer chemotherapy toxicity and dose-limiting toxicity (DLT).Methods:This is a single-center prospective study of lung cancer patients receiving chemotherapy for the first time. Body composition was measured using multi-frequency bioelectrical impedance, and the skeletal muscle index (SMI) was calculated. Grip strength and gait speed were used to assess muscle strength and function. The Asian Working Group on Sarcopenia (2019) criteria were used to evaluate the presence of sarcopenia. Cachexia was defined based on muscle mass and weight loss, while nutritional risk and malnutrition were evaluated based on the Nutritional Risk Screening 2002 and Global Leadership Initiative on Malnutrition criteria, respectively. Chemotherapy toxicity and DLT were defined according to the Common Terminology Criteria for Adverse Events and were divided into hematological, non-hematological, and DLT. The association between muscle condition, nutritional status, cachexia, and toxicity was evaluated by univariate and multivariate regression models.Results:The study included and analyzed 126 patients, with a median follow-up of 17.9 months (12-25 months). During chemotherapy, 27.8% of patients experienced grade 3/4 hematological toxicity, 14.8% experienced any ≥2 grade non-hematological toxicity, and 26.1% had any DLT. Old age and multiple comorbidities were risk factors for hematological, non-hematological toxicity, and DLT. Insufficient muscle strength and function could increase the incidence of hematological toxicity [ OR 1.121, 95% CI 1.048~2.865, P=0.031], and high SMI was a protective factor for DLT [ OR 0.638, 95% CI 0.242~0.083, P=0.021]. Conclusions:Lung patients with low SMI, low muscle strength and function have an increased risk of DLT and grade 3/4 hematological toxicity during chemotherapy. At the same time, elderly age and multiple comorbidities are also risk factors for chemotherapy toxicity and DLT. In clinical work, assessments should be conducted to identify high-risk populations for chemotherapy toxicity and preventive measures should be taken. Future research could consider adjusting chemotherapy plans based on different muscle statuses.

The establishment and validation of the Chinese version of SARC-F scale for sarcopenia screening among elderly population: a multicenter study / 中华临床营养杂志

Objective:To establish the Chinese version of (strength, assistance with walking, rise from a chair, climb stairs and falls, SARC-F) scale using the standardized methods and to validate the reliability and validity for sarcopenia screening among elderly population.Methods:Following the recommended procedure by World Health Organization and European Union Geriatric Medicine Society Sarcopenia Special Interest Group, the translation process included forward translation, expert panel, back-translation, pre-testing and cognitive interviewing to generate the final version. In the pilot study, the test-retest reliability, inter-rater reliability, and internal consistency of the Chinese version of SARC-F scale were assessed. In the diagnostic test for clinical validation, the participants were consecutively recruited from communities and hospitals in Beijing and Tianjin between December 2021 and October 2022. The scale administration, anthropometry, and body composition measurement were conducted by trained investigators. Participants with the SARC-F score ≥ 4 were considered at risk of sarcopenia. Diagnostic tests and receiver operating characteristic curve analysis were performed against the definitions of sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP2) and Asian Working Group for Sarcopenia (AWGS2019), and the sensitivity, specificity, positive predictive value, negative predictive value and the area under curve were displayed.Results:The Chinese version of SARC-F scale was approved by the author that the translation has expressed the original meaning correctly. The Chinese version of SARC-F had good test-retest reliability (ICC = 0.914), inter-rater reliability ( r = 0.726), and internal consistency ( α = 0.729). There were altogether 1 882 participants included in the clinical validation. According to the diagnostic criteria of EWGSOP2 and AWGS2019, the Chinese version of SARC-F scale had low sensitivity (13.6% and 16.0%) and positive predictive value (44.6% and 35.4%), high specificity (95.1% and 94.7%) and negative predictive value (79.0% and 86.2%), and moderate AUC of 0.619 and 0.616 (all P < 0.001) for sarcopenia screening. Conclusions:The Chinese version of SARC-F scale was of good reliability and validity. The application of SARC-F in the primary healthcare settings would contribute to the early diagnosis of sarcopenia.

Operational recommendations on nutrition management for elderly inpatients with COVID-19 / 中华临床营养杂志

Elderly inpatients with coronavirus disease 2019 (COVID-19) are often at nutritional risk and at higher risk of critical disease. The standardized nutrition treatment could effectively improve the nutritional status, quality of life, and clinical outcomes of COVID-19 patients, and is an important component of the comprehensive management of COVID-19. The individualized nutrition diagnosis, treatment and monitoring should be conducted in compliance to standard procedures of medical nutrition therapy, with consideration of the clinical characteristics of elderly COVID-19 inpatients. The Department of Clinical Nutrition at Peking Union Medical College Hospital has integrated the latest clinical nutrition guidelines and clinical practice of nutrition support of COVID-19, with the aim to provide evidence-based, concise and practical recommendations on nutritional management for elderly inpatients with COVID-19. The recommendations here are to inform effective and standardized nutrition support practice.