Repeated administrations of gangliosides extracted from Cervus nippon Temminek exerted remarkable facilitation action on the acquisition, retrieval and consolidation of memory in mice. It was able to increase the incorporations of [8H] Leucine into protein and [3H] Uridine into RNA in mouse brain tissue. It was suggested that the above-mentioned actions of gangliosides may be due to the promoting action for the synthesis of protein in brain tissue.

AIM　To investigate the chemical constituents of the rhizomes of Dioscorea panthaica Prain et Burkill and look for new active compounds. METHODS　The compounds were isolated with silica gel and HPLC, and their structures were elucidated on the basis of chemical evidences and spectral analysis (IR, ESI-MS, 1HNMR, 13CNMR, DEPT, 1H-1H COSY, HMQC, HMBC, NOESY). RESULTS　Three steroidal saponins were isolated from the rhizomes of Dioscorea panthaica. They were elucidated as 26-O-β-D-glucopyranosyl-3β,26-diol-23(S)-methoxy-25(R)-Δ5,20(22)-diene-furosta-3-O-［α-L-rhamnopyranosyl-(1→2)-O-α-L-rhamnopyranosyl-(1→4)］-β-D-glucopyranoside (I), pseudoprotodioscin (II), 26-O-β-D-glucopyranosyl-3β,26-diol-25(R)-Δ5,20(22)-diene-furosta-3-O-α-L-rhamnopyranosyl-(1→2)-O-β-D-glucopyranoside (III). CONCLUSION　Compound I is a new steroidal saponin and was named as dioscoreside C. Compound II and III were obtained from this genus for the first time.

Objective:To evaluate the effects of different growth conditions on E.faecalis growth in the microfluid chip and the penetration of E.faecalis into microtubes.Methods:Four units on the chip were randomly selected as control,BHI,nutrient-Tdeprived (PBS) and pH 10 groups.The growth of E.faecalis was monitored by microscope for a period of 72 h after the suspension of E.faecalis had been added into the chip.Results:The microscopic analysis showed a distinct variation in the growth rate and morphological feature under different experimental conditions.he depth of bacterial penetration was significantly greater in BHI group.Conclusion:This study demonstrated that environmental changes can significantly influence the growth and penetration of E.faecalis into the micro tubes.

Objective:To establish the quality standard for Shenyan Ⅱ granules. Methods:The characteristics of Folium Pyrrosiae were identified by microscopy. The three herbs in the preparation,rehmannia,madder and thistle were identified by TLC qualitatively. The content of ginsenoside in American ginseng was determined by HPLC. Chromatographic separation was carried out by using a WONDER CRACT ODS-2(150 mm × 46 mm,5 μm)column. The mobile phase consisted of acetonitrile-0. 1% phosphoric acid(28 ∶72)with gradient elution at a flow rate of 1. 0 ml·min -1 ,and the injection volume was 10 μl. The detection wavelength and the column temperature was 203 nm and 40 ℃,respectively. Results:The spots in TLC were clear without any interference. The linear range of ginsenoside was 38. 9- 194. 5 μg·ml -1(r = 0. 999 3). The average recovery was 98. 3% and RSD was 1. 9%(n = 6). Conclusion:The method is simple and highly specific with good repeatability,which can be used as the quality control method for Shenyan Ⅱ granules.

Objective To explore the application value of PACS virtual print server in optimizing the working procedure in the Department of Radiology, and expanding and extending the conventional function of PACS. Methods PACS vir-tual print server was established, original PACS system and imaging equipment were connected, and its economic and social benefits were observed. Results After the application of PACS virtual print server, the working process was im-proved. It provided convenience for the patients, and at the same time improved the working efficiency and service quality in the Department of Radiology, realizing the double achievements of economic benefits and social benefits. The saving rate of films reached up to 18%, and the saving rate of papers was around 6%. Diagnostic reports of X ray and CT in emergency were obtained within 30 min;reports of X ray were obtained within 1h for normal examination;reports of CT and MRI were obtained in the same day afternoon if the examination was in the morning, and were obtained the next day morning if the examination was in the afternoon. Conclusion The application of PACS virtual print server pro-vides new function and value for PACS by optimizing the working procedure in the Department of Radiology and achieving integrated printing with demand. It improves the service quality in the Department of Radiology and enhances patients and clinicians'satisfaction.

Objective:To construct a risk prediction model for chronic pain in elderly patients and verify its predictive value.Methods:From January 2020 to June 2021, 320 elderly patients admitted to the Pain Department of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School were selected by convenience sampling. The general information of patients was collected, and patients were divided into chronic pain group ( n=185) and non-chronic pain group ( n=135) according to whether they had chronic pain. The patients were investigated with the Numerical Rating Scale (NRS) , Self-Rating Anxiety Scale (SAS) , Self-Rating Depression Scale (SDS) , Pittsburgh Sleep Quality Index (PSQI) , Morse Fall Scale, Constipation Symptom and Efficacy Scale, and bioelectrical impedance method. The binomial Logistic regression analysis was used to explore the risk factors of chronic pain in elderly patients and establish a risk prediction model. The predictive value of the risk prediction model was evaluated by the receiver operating characteristic (ROC) curve. Results:The NRS score of 185 patients with chronic pain was (4.34±1.50) . Lower limbs, lumbosacral region and neck were the most common parts of chronic pain. Osteoarthritis and cervical spondylosis were the main diseases causing chronic pain. Binomial Logistic regression analysis showed that high SDS score, high Morse Fall Scale score, high constipation symptom score, high SAS score and low appendicular skeletal muscle mass index were independent risk factors for chronic pain in elderly patients ( P<0.05) . The area under the ROC curve of the risk prediction model for chronic pain in elderly patients was 0.878, the sensitivity was 92.53%, and the specificity was 67.04%. Conclusions:The risk prediction model based on anxiety, depression, falls, myasthenia and constipation has good clinical value in predicting chronic pain in elderly patients, and can provide support for early identification and intervention of chronic pain in elderly patients.

The overall health condition of patients significantly affects the diagnosis,treatment,and prognosis of endodontic diseases.A systemic consideration of the patient's overall health along with oral conditions holds the utmost importance in determining the necessity and feasibility of endodontic therapy,as well as selecting appropriate therapeutic approaches.This expert consensus is a collaborative effort by specialists from endodontics and clinical physicians across the nation based on the current clinical evidence,aiming to provide general guidance on clinical procedures,improve patient safety and enhance clinical outcomes of endodontic therapy in patients with compromised overall health.

Background: Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The treatment of PHN remains a challenge for clinical pain management. Despite the effectiveness of anticonvulsants, antidepressants, and lidocaine patches in reducing PHN, many patients still face intractable pain disorders.In this randomized controlled study, we evaluated whether hydromorphone through intravenous patient-controlled analgesia (IV PCA) was effective in relieving PHN. Methods: Patients with PHN were randomly divided into two groups, one group received oral pregabalin with IV normal saline, another group received oral pregabalin with additional IV PCA hydromorphone for two weeks. Efficacy was evaluated at 1, 4, and 12 weeks after the end of the treatments. Results: Two hundred and one patients were followed up for 12 weeks. After treatment, numerical rating scale (NRS) score of patients in the hydromorphone group was significantly lower than that of the control group, and the difference of NRS scores between the two groups was statistically significant at 4 and 12 weeks after treatment. The frequency of breakthrough pain in the hydromorphone group was significantly lower than that in the control group 1 and 4 weeks after treatment.After treatment, the quality of sleep in the hydromorphone group was significantly improved compared with the control group. The most common adverse reactions in the hydromorphone group were dizziness and nausea, with no significant respiratory depression. Conclusions IV PCA hydromorphone combined with oral pregabalin provides superior pain relief in patients with PHN, which is worthy of clinical application and promotion.

Background: Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The treatment of PHN remains a challenge for clinical pain management. Despite the effectiveness of anticonvulsants, antidepressants, and lidocaine patches in reducing PHN, many patients still face intractable pain disorders.In this randomized controlled study, we evaluated whether hydromorphone through intravenous patient-controlled analgesia (IV PCA) was effective in relieving PHN. Methods: Patients with PHN were randomly divided into two groups, one group received oral pregabalin with IV normal saline, another group received oral pregabalin with additional IV PCA hydromorphone for two weeks. Efficacy was evaluated at 1, 4, and 12 weeks after the end of the treatments. Results: Two hundred and one patients were followed up for 12 weeks. After treatment, numerical rating scale (NRS) score of patients in the hydromorphone group was significantly lower than that of the control group, and the difference of NRS scores between the two groups was statistically significant at 4 and 12 weeks after treatment. The frequency of breakthrough pain in the hydromorphone group was significantly lower than that in the control group 1 and 4 weeks after treatment.After treatment, the quality of sleep in the hydromorphone group was significantly improved compared with the control group. The most common adverse reactions in the hydromorphone group were dizziness and nausea, with no significant respiratory depression. Conclusions IV PCA hydromorphone combined with oral pregabalin provides superior pain relief in patients with PHN, which is worthy of clinical application and promotion.

Objective: To analyze effect of fractured file removal from the middle third root canal on root fracture resistance using finite element analysis, which provides a theoretical basis for clinical prognosis evaluation. Methods: Two finite-element models were established, the fractured file removal model (fractured file located in the middle third of root canals, followed by ultrasonic file removal and root canal preparation) and the control model (root canal preparation only), and compressive displacement dependencies on compressive force was computed and compared with experimental data for validation. The validated finite-element models were used to analyze the stress distribution differences during the initiation, propagation and completion of the crack between fractured file removal specimen and control one. Results: The critical breaking force of the fractured file removal specimen was 406 N, and the finite element simulation result was 396 N. The critical breaking force of the control specimen was 502 N, and the finite element simulation result was 483 N. The position of crack initiation in the finite element simulation was basically consistent with that in the experiment. The experimental data of compressive test and the results of finite-element computation were in agreement, thus validating the finite-element model. In the process of continuous pressure, the stress distribution of the control root is relatively uniform, and the location of crack initiation and the direction of propagation have a certain unpredictability. Compared with the control root, the stress concentration on the root with fracture file removal was obvious, especially on edges, and the number of cracks are much more. Because of the thinner radicular wall, the crack propagation rate is faster too. Therefore, the overall root fracture resistant is decreased obviously. Conclusions During the fractured file removal procedure, amount of dentine removed should be minimized, and the edges and corners which caused by fractured file removal should be shaped to smooth in order to reduce the stress concentration and prevent the root from fracture.