INTRODUCTION:Yinzhilan formula (YZL) is an effective prescription for diabetic ulcers (DU) with clinical efficacy. This study aimed to explore the mechanism of YZL in ameliorating the healing delay of DU through network pharmacology and experimental validation. METHODS:Network pharmacology integrated with bioinformatics to screen the chemical composition of YZL, as well as its protein targets and disease targets. A mouse model of DU was established, and the efficacy of YZL was evaluated according to ulcer size and histopathological examination. The levels of inflammatory factors were detected by ELISA, and the changes in macrophage polarization were detected by immunofluorescence and flow cytometry. RESULTS:Network pharmacology identified 291 potential targets in YZL, which synergistically targeted PARP1 and STAT3 to exert their role in promoting wound healing. In vivo experiments showed that YZL accelerated wound closure, regulated the levels of inflammatory factors and macrophage polarization, and suppressed the mRNA and protein expression levels of PARP1 and STAT3. DISCUSSION:Bioinformatics studies suggested that HSP90AA1, IL6, PARP1, and STAT3 may be potential targets of YZL in the treatment of DU. Immune infiltration analysis suggested that macrophages may be related to the mechanism of action. CONCLUSION:YZL may accelerate DU healing by inhibiting PARP1 and STAT3 and reprogramming macrophage polarization towards the M2 phenotype.

Small nucleolar RNAs (snoRNAs) guide ribosomal RNA modification and regulate broader RNA-based programs, whereas snoRNA host gene-derived long non-coding RNAs, including SNHG-family transcripts, participate in post-transcriptional and epigenetic regulation. This review synthesizes evidence from skeletal stem/progenitor cells, osteoblast- and osteoclast-lineage models, chondrocytes, bone tumor systems, patient samples, and extracellular vesicle or circulating RNA studies to define how snoRNAs and SNHGs shape bone development, remodeling, and disease. Across osteoporosis, osteoarthritis, bone tumors, and fracture healing, these RNAs influence osteogenic differentiation, osteoclastogenesis, cartilage homeostasis, tumor progression, repair responses, and intercellular communication through ribosome-associated control, ceRNA networks, transcript stability, and chromatin- or protein-associated mechanisms. We also discuss their potential as biomarkers and RNA-targeted therapeutic candidates, together with challenges in annotation, functional validation, delivery, and clinical translation. This framework highlights snoRNAs and SNHGs as regulatory components of skeletal biology and disease.

This study aims to identify and evaluate the most common drugs associated with the risks of autoimmune hepatitis (AIH) using the FDA Adverse Event Reporting System (FAERS) database. Adverse drug events (ADEs) associated with drug-induced AIH (DI-AIH) were retrieved from the FAERS database (January 2004–June 2024). Disproportionality analysis was performed to identify drugs significantly linked to DI-AIH, and time-to-onset (TTO) analyses were conducted to evaluate the timing and risk profiles of DI-AIH adverse reactions. Our study identified 2,511 ADEs linked to autoimmune hepatitis. Disproportionality analysis identified 22 drugs significantly associated with AIH risk, including 4 antibiotics, 3 antivirals, 4 cardiovascular drugs, 5 antitumor agents, 2 immunomodulators, 2 nonsteroidal anti-inflammatory drugs, and 1 drug each from the respiratory and nervous system categories. The highest DI-AIH risks were observed with minocycline (ROR = 53.97), nitrofurantoin (ROR = 57.02), and doxycycline (ROR = 16.12). Antitumor drugs had the shortest median TTO (77.00 days), whereas cardiovascular drugs exhibited the longest (668.30 days). Through a comprehensive analysis of the FAERS database, our study identified drugs strongly associated with AIH. Preventing DI-AIH requires careful drug selection and monitoring. This study provides evidence-based insights into implicated drugs, aiming to optimize clinical management and mitigate risks.

OBJECTIVE:To investigate the antipyretic effect of early treatment with Traditional Chinese Medicine (TCM) on coronavirus disease 2019 (COVID-19) patients. METHODS:We retrospectively analyzed 369 patients from January 26th, 2020 to April 15th, 2020, who had been diagnosed with COVID-19. Among 92 eligible cases, 45 cases were identified as treatment group Ⅰ ( 45) and 47 cases were identified as treatment group Ⅱ. Patients in the treatment group Ⅰ were treated with TCM herbal decoction within 5 d after admission. Patients in the treatment group Ⅱ were treated with TCM herbal decoction after the 6th admission day. The onset time of antipyretic effect, the antipyretic time, the time of negative oropharyngeal swab nucleic acid conversion, and the changes of cell count in blood routine test were compared. RESULTS:The treatment group I showed shorter average antipyretic duration (4 7 d; <0.05), and shorter average time for polymerase chain reaction (PCR) nucleic acid test results to turn negative (7 11 d; <0.05) than the treatment group II. For patients ( 54) with body temperature>38 ℃, patients in the treatment group I had shorter median onset time of antipyretic effect than those in the treatment group II (3 4 d; <0.05). The absolute lymphocyte (LYMPH) count and absolute eosinophil (EOS) count on the 3rd day after admission and the neutrophil/lymphocyte ratio on the 6th day after admission of patients in the treatment group I were notably different from those in the treatment group II at the same time point (0.05). Based on Spearman's rank correlation analysis, the change of body temperature on the 3rd day after admission was positively correlated with the increase of EOS count and the increase of EOS count and LYMPH counts on the 6th day after admission (0.01). CONCLUSIONS:Early TCM intervention within 5 d after hospital admission shortened the onset time of antipyretic effect and fever duration of COVID-19 patients, reduced the time required for PCR test results to turn negative. Moreover, early TCM intervention also improved the results of inflammatory markers for COVID-19 patients. LYMPH and EOS counts can be used as indicators of TCM antipyretic effect.

This study investigated the effects of estrogen and estrogen receptor alpha (ERα) on the pathogenesis of primary biliary cholangitis (PBC) in human intrahepatic bile duct epithelial cells (HiBECs). The researchers measured serum levels of ERα, oxidative stress indicators, and cytokines in PBC patients and healthy controls. They examined the expression of ERα, pyruvate dehydrogenase complex E2-component (PDC-E2), and apoptosis-related proteins in the small bile ducts. In vitro experiments with HiBECs showed that estrogen had a dual effect on cell viability, increasing it at low concentrations but reducing it at higher concentrations. ERα activation led to mitochondrial damage, apoptosis, and upregulation of ERα and PDC-E2 expression. These findings suggest that the high expression of ERα in the bile ducts contributes to mitochondrial damage, inflammation, and apoptosis in PBC. The study highlights ERα as a potential target for understanding and treating estrogen-mediated PBC pathogenesis.

仲景在《金匮要略》虚劳病篇中阐发虚劳义理,将中医哲学理念三大观——整体观、辩证观、恒动观融会于虚劳病辨治之中.在整体观思维指导下,仲景将血痹虚劳合论,务求完整阐释疾病发展,治法上兼顾五脏,同调阴阳.在辩证观思维指导下,仲景以对立统一的理念看待症状、脉象,透过现象抓住本质,并创造性地拓展了药物的治疗效用.在恒动观思维指导下,密切关注邪之深浅、证之缓急、阴阳之互损,认为证情恒动,治疗当随之而变.

原发性胆汁性胆管炎(primary biliary cholangitis,PBC),又称原发性胆汁性肝硬化,是一种少见的自身免疫性肝病,发病率低,发病机制不明确,无法治愈.研究表明外界环境因素导致发病率逐年升高,所以构建发病因素相似的动物模型研究PBC的发病和治疗都具有重要意义.现通过阅读20年来国内外相关文献,总结各种外源性物质(2-辛炔酸偶联牛血清白蛋白、聚肌苷酸胞嘧啶核苷酸、新鞘氨醇杆菌、抗线粒体抗体抗原、同源胆管蛋白)诱导PBC动物模型的方法,分析各种造模方式的特点.为研究者选择更合适的动物模型,探索PBC发病机制和研发新药提供参考.

Objective:To summarize the clinical characteristics and drug sensitivity analysis of children with Salmonella enteritis in our hospital, explore the characteristics and drug resistance of Salmonella infection, and guide the rational clinical use of drugs. Methods:The clinical data of 90 pediatric Salmonella enteritis patients treated in our hospital from January 2015 to January 2020 were selected as the observation group of this retrospective study, and 90 patients with non-Salmonella enteritis were selected at the same time as a control group. Discuss the clinical characteristics of Salmonella, drug sensitivity analysis, infection characteristics, and drug resistance and guide the rational clinical use of drugs. Results:The susceptibility rates of 15 antibiotics from high to low were imipenem and meropenem, piperacillin, cefoperazone, compound trimethoprim, chloramphenicol, and ceftazidime. Salmonella strains were both resistant to imipenem and meropenem. Salmonella is sensitive and has a low rate of resistance to quinolones (ciprofloxacin) and a high rate of resistance to cephalosporins (ceftriaxone, cefotaxime, ceftazime, and cefpiramide), both reached more than 28%. Salmonella has the highest resistance to penicillin and erythromycin, both at 85.00% and above. Among 90 children with Salmonella enteritidis food poisoning, 32 were hospitalized, 21 cases were hospitalized less than 7 days, and 11 cases were 7-14 days. The longest hospital stay was 12 days, the shortest was 1 day, and the average was 6.1 days. Seven people stayed for observation and 51 people were discharged after treatment. All the children recovered without death. Conclusion:In clinical practice, antibiotics should be used rationally based on drug susceptibility results. In the case of poor efficacy of cephalosporins, amoxicillin and potassium clavulanate, piperacillin, tazobactam, or imipenem, cephalosporin antibiotics can be considered the first choice for clinical empiric medication.

通过梳理阐释《伤寒杂病论》中肝胆病辨治相关条文和方证,以期启发临床辨治肝胆病的思维与方法.拟从肝胆病证的条文着手,分析肝胆病的病因病机、理法方药,总结阐发仲景辨治肝胆疾病的思维、立法与组方,发现仲景辨治肝胆病较为系统完备.仲景辨治肝胆病的辨证思维、立法组方均可以较好的指导临床,应当予以继承和发扬.

系统总结叶天士辨治虚劳病的思路及用药特色.通过分析虚劳病篇医案和组方用药,发现叶氏辨证重视辨病因、脉象、奇经和体质;用药专注核心病机而非外症,重视脾胃,擅用柔剂阳药温养肝肾、通补奇经,使用药物剂型灵活多变,分时辨证服药;将整体观、辩证观、恒动观这种中医特有的辨治思维方式贯穿于整个虚劳病的辨治过程,为后世学者开拓思路.

BACKGROUND:Disturbance of the gut microbiota may play a critical role in the progression of nonalcoholic fatty liver disease (NAFLD) induced by high-fat diet (HFD). Changes in gut microbiota were analyzed in a rat HFD-induced NAFLD model following treatment with Qinghua Fang (QHF), a Chinese herbal formula currently used in the clinical practice of traditional Chinese medicine.METHODS:Sixty Wistar rats were randomly divided into 6 groups (n=10): blank group [normal chow (NC) group], model group (HFD group), control group (BG group), Qinghua Fang high-dose group [QHF(H) group], QHF mid-dose group [QHF(M) group], QHF low-dose group [QHF(L) group]. The high, medium and low doses of QHF were used to intervene in the H, M, and L groups; the BG group was given berberine; the NC and HFD groups were given distilled water for 10 weeks. H&E staining, determination of serum liver function and blood lipid levels, and changes in the structure of rat intestinal flora through 16S rDNA denaturing gradient gel electrophoresis sequencing technology and ERIC-PCR fingerprinting were performed.RESULTS:The liver function and blood lipid levels of the rats in the HFD group were higher than those in the NC group; the alanine aminotransferase levels in the QHF-H group, QFH-M group and QHF-L group were lower than in the HFD group (P<0.05); the liver pathology of the QHF-M group and QHF-H group showed a small amount of fatty cell infiltration, but was significantly less than the hepatocyte inflammation and necrosis in the HFD group. The ERIC-PCR fingerprint and diversity analysis found that the composition of the intestinal flora of rats in the QHF-H group was significantly different from that of the NC and HFD groups. The flora of the QHF and NC groups was more diverse and richer than in the HFD group (P<0.05).CONCLUSIONS:QHF alleviated the liver dysfunction and increased blood lipid levels of NAFLD rats induced by HFD. It also effectively reduced the degree of liver steatosis and adjusted the number and structure of intestinal flora. Treatment with QHF had a significant effect on NAFLD.

基于“截断扭转”策略探讨新型冠状病毒肺炎的中医药证治.认为先证而治有利于快速控制病情,截止疾病的进展;常用治法如健脾助运、行气化湿、通腑攻下、凉血化瘀、化痰软坚、祛除疠气等.

探讨严世芸教授治疗心悸的临证经验及用药特色.严教授认为心悸的病因病机主要为外邪侵袭、七情过极、实邪痹阻、体弱久病;治疗上主张从阴阳、气血、心肾三个方面入手,究其本质,兼顾变证,随症化裁.附临诊验案1则.

目的 探讨下瘀血汤对高脂饮食诱导的非酒精性脂肪性肝炎(NASH)的干预作用及机制.方法 24只雄性C57/BL6小鼠随机分为低脂饮食(LFD)组(8只)、高脂饮食(HFD)组(16只),喂养6周.第7周始,HFD组随机分为HFD-water组(简称HFD组,8只)和下瘀血汤干预组(高脂饮食+下瘀血汤治疗组,简称XYX组,8只),灌胃共计16周.22周结束后,检测小鼠血清中丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、甘油三酯(TG)、总胆固醇(TC)含量;采用HE染色、油红O染色,观察小鼠肝脏组织形态、脂滴沉积;实时定量PCR检测肝组织中脂肪代谢途径相关因子固醇调节元件结合蛋白1(SREBP-1)、脂肪酸合成酶(FASN)、乙酰辅酶羧化酶α(ACCα),炎症因子肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、白细胞介素18(IL-18)、簇分化抗原68 (CD68)、单核细胞趋化蛋白-1(MCP-1)及核苷酸结合寡聚化结构域蛋白样受体3(NLRP3)炎性小体相关基因等;Western Blot、免疫组化检测NLRP3表达;天狼猩红染色、免疫组化检测a-SMA观察肝脏纤维化.结果 与LFD组比较,HFD组血清ALT活性、TC、TG含量显著升高(P＜0.05,P＜0.01).肝脏脂肪变明显,NAS评分显著升高(P＜0.05);SREBP-1、FANS、ACCα等脂肪代谢合成相关因子显著上调,CD68、MCP-1等炎症相关因子mRNA表达显著升高(P＜0.05);NL-RP3炎性小体相关基因的表达显著上调(P＜0.01,P＜0.05);与HFD组比较,XYX组的肝脏脂肪变改善,NAS评分下调,脂肪代谢合成相关因子、炎症因子的mRNA表达下调,NLRP3炎性小体相关基因下调和NLRP3蛋白表达下调(均P＜0.05).天狼猩红染色及α-SMA染色显示HFD组的染色面积较LFD组增加(P＜0.05),XYX组则较HFD组减少(P＜0.05).结论 下瘀血汤对HFD诱导小鼠NASH有显著改善作用;抑制NLRP3是下瘀血汤改善NASH的作用机制之一.

发热门诊是医院为发热病人和不明原因肺炎病人设置的专门就诊场所,随着2019年末开始的新型冠状病毒肺炎(简称"新冠肺炎")疫情发展,各级各地区发热门诊病人量明显增加,如何在有限的医疗资源情况下,高效高质量的完成发热病人筛选和救治工作,是各医疗机构面临的严峻挑战.健全完善发热门诊日常防控工作,标准化管理,将有助于防止交叉感染、规范工作制度流程;同时配合中医药防控措施将进一步提高临床疗效、保护高危人群 [1].以本次疫情为实例进行实施和考评,结果将有助于健全完善发热门诊的工作体系,提高发热门诊对感染性疾病的防控能力,并为其他医疗机构发热门诊防控工作提供借鉴.

细胞凋亡在肝脏疾病的发生发展及内环境稳定中发挥着重要作用.在原发性胆汁性胆管炎中,胆管上皮细胞可能导致线粒体自身抗原的直接特异性免疫应答.死亡受体的激活、氧化应激、感染和毒素等信号,均可使胆管上皮细胞在凋亡过程中受到免疫攻击的选择性损伤.细胞的生存调节失常,会引起小胆管以细胞凋亡为主要方式逐渐丧失,最终引起原发性胆汁性胆管炎.讨论了细胞凋亡在原发性胆汁性胆管炎发生发展中的作用.

脾胃病是临床常见病、多发病,具有虚实夹杂、病情复杂、迁延难愈等特点.笔者受《内经》"肾为胃之关"理论的影响,认为诊治脾胃病应注重培补先天之气,壮后天脾胃,应用该理论指导临床,收到满意的疗效,报道如下.

To investigate the differences in bone mineral density between patients with liver cirrhosis and healthy control, and to analyze the risk factors of hepatic osteoporosis in patients with HBV related liver cirrhosis.A total of 189 patients with liver cirrhosis and 207 health controls were enrolled. The bone mineral density of lumbar spine and femoral neck was examined by dual energy X-ray absorptiometry. -2.0 <T value <-1.0 defined as osteopenia, T value ≤-2.0 defined as osteoporosis.Bone mineral density in the cirrhotic group was significantly lower than that in the control group (lumbar: 1.02 ± 0.16 vs 1.08 ± 0.13, P < .001; femoral neck: 0.86 ± 0.14 vs 0.91 ± 0.14, P < .001). Both 2 groups showed a tendency that decrease bone density correlated with age and decrease body mass index (BMI). Multivariate correlation analysis showed that women (OR = 6.931, P = .002), age (OR = 1.096, P < .001), low BMI (OR = 0.874, P = .037), and high liver stiffness value (OR = 1.125, P = .046) were independent risk factors for osteopenia and low body weight (OR = 0.934, P = .006) and high liver stiffness value (OR = 1.246, P = .034) were independent risk factors for osteoporosis.Our study shows that bone mineral density in patients with liver cirrhosis decreased significantly, especially in the elderly and low BMI patient. For HBV-related cirrhosis with risk factors, a regular bone density screening should be given, and timely intervention should be taken into consideration.

笔者拟对脾虚气滞型功能性消化不良(FD)采取益火补土的治疗方法,探究其对FD的临床疗效.报道如下. 1 一般资料 选取2017年7月至2018年6月龙华医院脾胃病科门诊及病房脾虚气滞型功能性消化不良患者77例.采用随机表法分组,随机号单号为治疗组,双号为对照组.治疗组38例,男21例,女17例,平均年龄为36.83 ± 11.94岁;对照组39例,男16例,女23例,平均年龄为39.03 ± 12.02岁.两组一般资料无统计学差异(P>0.05),具有可比性.西医诊断标准参照2006年罗马Ⅲ学术委员会制定的FD诊断标准.中医诊断标准参照中华中医药学会脾胃病分会制定的《功能性消化不良中医诊疗专家共识意见(2017)》中脾虚气滞者.