[Objective]To establish the high performance liquid chromatography(HPLC)characteristic chromatogram and multi-index contents determination method of Yunvjian,clarify the quantitative and qualitative transfer law from decoction pieces-references sample-granules.[Methods]The HPLC characteristic chromatogram of Yunvjian references sample and granules was established using Thermoscientific Syncronis aQ C18 chromatographic column(150 mm×4.6 mm,5 μm),acetonitrile(A)-0.1%phosphoric acid water(B)as mobile phase,detection wavelength as 240 nm,adopting gradient elution.Five index components,including rehmannioside D,neomangiferin,mangiferin,β-ecdysterone and acteoside,were selected to establish an HPLC method with detection wavelengths of 203 nm and 240 nm.The content of the index components and the transfer rate in different samples were calculated.[Results]The similarity of the HPLC characteristic chromatograms of 10 batches of the Yunvjian references samples and 3 batches of granules is all greater than 0.950.A total of 12 common peaks are attributed,and 6 of them are identified.All the 12 common peaks in the reference samples are stably transferred to the granules.The 5 index components showed excellent linearity(r≥0.9999)within their respective concentration ranges,and the average sample recovery rate is 99.16%～102.26%.The methodological investigation of the content determination meets the relevant requirements.During the process of preparing the Yunvjian from decoction pieces to granules,the transfer rates of the 5 components are 46.31%～52.30%,31.89%～41.46%,28.65%～33.85%,41.28%～48.59%and 49.59%～75.20%,respectively,all within the range of the average value±30%.[Conclusion]The HPLC characteristic chromatogram and content determination method established are accurate and reliable,and the quantitative and qualitative transfer law of decoction pieces-granules is relatively stable,which can provide an objective basis for the preparation development and quality control of Yunvjian.

[Objective]To establish the high performance liquid chromatography(HPLC)characteristic chromatogram and multi-index contents determination method of Yunvjian,clarify the quantitative and qualitative transfer law from decoction pieces-references sample-granules.[Methods]The HPLC characteristic chromatogram of Yunvjian references sample and granules was established using Thermoscientific Syncronis aQ C18 chromatographic column(150 mm×4.6 mm,5 μm),acetonitrile(A)-0.1%phosphoric acid water(B)as mobile phase,detection wavelength as 240 nm,adopting gradient elution.Five index components,including rehmannioside D,neomangiferin,mangiferin,β-ecdysterone and acteoside,were selected to establish an HPLC method with detection wavelengths of 203 nm and 240 nm.The content of the index components and the transfer rate in different samples were calculated.[Results]The similarity of the HPLC characteristic chromatograms of 10 batches of the Yunvjian references samples and 3 batches of granules is all greater than 0.950.A total of 12 common peaks are attributed,and 6 of them are identified.All the 12 common peaks in the reference samples are stably transferred to the granules.The 5 index components showed excellent linearity(r≥0.9999)within their respective concentration ranges,and the average sample recovery rate is 99.16%～102.26%.The methodological investigation of the content determination meets the relevant requirements.During the process of preparing the Yunvjian from decoction pieces to granules,the transfer rates of the 5 components are 46.31%～52.30%,31.89%～41.46%,28.65%～33.85%,41.28%～48.59%and 49.59%～75.20%,respectively,all within the range of the average value±30%.[Conclusion]The HPLC characteristic chromatogram and content determination method established are accurate and reliable,and the quantitative and qualitative transfer law of decoction pieces-granules is relatively stable,which can provide an objective basis for the preparation development and quality control of Yunvjian.

Objective:To explore rehabilitation effect of hyperbaric oxygen chamber treatment on patients with sequelae of brain injury.Methods:From January 2023 to January 2024,a total of 80 patients with sequelae of brain injury were selected from The First Affiliated Hospital of Xinjiang Medical University,and they were randomly divided into control group and observation group,with 40 patients in each group.The control group received conventional treatment and intervention,while the observation group was treated with hyperbaric oxygen chamber on the basis of the conventional treatment and intervention of control group.The levels of serum oxidative stress indicators,neurotrophic factor indicator,as well as neurological function,cognitive function,motor function and quality of life of the two groups were evaluated.Results:After treatment,the levels of serum oxidative stress indicators such as neutrophil gelatinase-related lipocalin(NGAL),matrix metalloproteinase-9(MMP-9),reactive oxygen species(ROS)of observation group were significantly higher than those of control group(t=5.578,11.065,3.706,P<0.05),respectively,and the ubiquitin carboxy-terminal hydrolase L1(UCH-L1)of neurotrophic factor,neuron-specific enolase(NSE)and serum calcium-binding protein(S100-β)of observation group were significantly lower than those of control group,while cerebral extraction rate of oxygen(CERO2)of serum oxidative stress indicators of observation group was significant higher than that of control group,and the differences of them were significantly(t=5.170,4.277,4.130,2.260,P<0.05),respectively.After treatment,the score of National Institutes of Health Stroke Scale(NIHSS)of observation group was lower than that of control group,and the score of Mini-Mental State Examination(MMSE)of observation group was significantly higher than that of control group,and the differences of them were statistical significance(t=15.874,7.820,P<0.05),respectively.In additions,the scores of Loewenstein Occupational Therapy Cognitive Assessment(LOTCA),Simplified Fugl-Meyer Assessment(FMA)upper and lower limbs of observation group were significantly higher than those of control group,and the differences of them between two groups were significant(t=14.051,4.766,8.622,P<0.05),respectively.The scores of physiological,psychological,social and environment factor of World Health Oganization Quality of Life Scale(WHOQOL-BREF)in observation group were higher than those in control group,and the differences of them between two groups were statistically significant(t=19.968,21.979,18.077,19.695,P<0.05).Conclusion:The application of hyperbaric oxygen chamber in patients with sequelae of brain injury is beneficial to adjust the levels of serum oxidative stress indicator and neurotrophic factor indicator,which can improve the deficit of neurological function,and promote the recovery of cognitive and motor functions,and improve the quality of life.

Atractylodes macrocephala, a plant of the Asteraceae family, as a commonly used traditional Chinses medicine in clinic, has the efficacy of invigorating spleen and supplementing qi, eliminating dampness and inducing diuresis, and expelling wind and dispersing cold. Moreover, it was proved that it has many pharmacological effects such as anti-inflammation, anti-tumor, and improving immunical ability based on the scientific researches. Atractyloside is one of its active ingredients and characteristic ingredients. In this paper, using the search terms of Baizhu lactone, sesquiterpene lactone, quality evaluation, quality control, and chemical composition, the CNKI, Weipu and PubMed literature database were searched. And relevant literature results were compared and summarized. The catagories, structural formula of atractyloside and their transformation mechanism were summarized. It was found that the content of lactone components could be affected by different processing methods, different producing locations, different harvesting season, and different growth years. It was found that for the quality evaluation of Atractylodes macrocephala, the multivariate statistical analysis combined with content determination or fingerprint establishment could be more accurate, reliable and comprehensive, among which the supervised PLS-DA with OPLS-DA analysis was better than the unsupervised PCA analysis. This literature summary could provide a beneficial reference for the quality evaluation and utilization of Atractylodes macrocephala.

Objective To establish in vitro the small intestinal organoid culture system and to investigate the effect of lipopolysaccharide(LPS)on the growth of small intestinal organoids and the secretion of inflammatory factors.Methods In vitro,the small intestinal crypt cell mass of C57BL/6 mice was aseptically isolated,collected and embedded in organoid matrix.Under the support of complete medium,the small intestinal organoids with three-dimensional multi-leaf structure with small intestinal epithelioid structure were formed.The small intestinal organoids were subcultured after 5-7 d culture.On the third day after passage,the small intestinal organoids were randomly divided into different mass concentrations of LPS groups(0,150,175,200,225,250,275 and 300 mg/L).After 24 h and 48 h of LPS induction,morphological changes of small intestinal organoid growth and differentiation were observed.CCK-8 method was used to detect the effect of different time points and mass concentrations of LPS on the proliferative activity of small intestinal organoids after induction of inflammation.The effects of four different mass concentrations of LPS(0,175,200 and 225 mg/L)on expression levels of granulocyte-macrophage colony stimulating factor(GM-CSF),interleukin(IL)-1α,IL-6 and IL-10 in organoid culture supernatant at different times were detected by enzyme-linked immunosorbent assay(ELISA).Results The mouse small intestinal organoid culture system was preliminarily constructed.After different time and mass concentration of LPS induced inflammation of small intestinal organoids,it was observed by morphology that small intestinal organoids would have different degrees of expansion and apoptosis in lumen.The proliferation,differentiation and budding of damaged intestinal epithelial crypts or intestinal stem cells were also inhibited to varying degrees,indicating that the growth of small intestinal organoids would be limited to varying degrees after induced inflammation.The proliferation activity of small intestinal organoids decreased to varying degrees after 24 h and 48 h of LPS induction at 175-225 mg/L(P＜0.05),but the cell viability was still greater than 50%.The levels of IL-1α,IL-6 and GM-CSF partially increased after induction with 200 mg/L and 225 mg/L LPS for 24 h and 48 h(P＜0.05).The level of IL-10 decreased after induction with 200 mg/L LPS for 24 h and 48 h(P＜0.05).Conclusion In this study,a model of intestinal inflammatory injury in vitro induced by LPS with different mass concentrations and time points is preliminarily constructed,which provides a more reliable research platform for the mechanism research of intestinal diseases and the screening of effective drugs in the future.

Objective To compare the efficacy and safety of vaginal misoprostol induction and oxytocin infusion induction in primip-aras with term premature rupture of membranes(PROM)and unfavorable cervixes.Methods A total of 506 primiparas with PROM who delivered in Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January 2018 to December 2019 were retrospec-tively selected.All of the primiparas were with singleton cephalic presentation,reactive nonstress tests,2h≤PROM≤24h,cervical Bishop score＜6,and no previous uterine surgery.According to different methods of labor induction,the enrolled primiparas were divided into misoprostol group and oxytocin group.In the misoprostol group,misoprostol was placed vaginally to induce labor,and in the oxytocin group,oxytocin was intravenously injected to induce labor.The efficacy of induction,mode of delivery and m maternal and neonatal out-comes were compared between the two groups.Results The misoprostol group had more primiparas achieved the active phase than the ox-ytocin group(96.8％vs 89.1％,P=0.001).After 24h of induction,the misoprostol group showed a higher proportion of vaginal deliv-ery than the oxytocin group(60.6％vs 46.3％,P=0.001).The misoprostol group exhibited a significantly higher vaginal delivery rate and spontaneous vaginal delivery rate than the oxytocin group(87.1％vs 72.8％,P＜0.001;76.3％vs 64.2％,P=0.003).The ox-ytocin group had more primiparas who underwent cesarean section due to fetal distress(8.6％vs 3.6％,P=0.020)and failed labor in-duction(8.2％vs 1.6％,P=0.001)than the misoprostol group.The misoprostol group had a higher rate of uterine hyperstimulation than the oxytocin group(16.5％vs 9.7％,P=0.024).There were no significant differences in intrapartum chorioamnionitis,endome-tritis,postpartum hemorrhage,the incidence of neonatal asphyxia and admission to the neonatal intensive care unit between the two groups(P＞0.05).Conclusion Compared with oxytocin infusion,vaginal misoprostol induction in term PROM primiparas with unfavorable cervixes was associated with higher rates of cesarean and vaginal delivery within 24h.Vaginal misoprostol induction and oxytocin infusion had similar maternal and neonatal outcomes.

Objective To compare the efficacy and safety of vaginal misoprostol induction and oxytocin infusion induction in primip-aras with term premature rupture of membranes(PROM)and unfavorable cervixes.Methods A total of 506 primiparas with PROM who delivered in Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January 2018 to December 2019 were retrospec-tively selected.All of the primiparas were with singleton cephalic presentation,reactive nonstress tests,2h≤PROM≤24h,cervical Bishop score＜6,and no previous uterine surgery.According to different methods of labor induction,the enrolled primiparas were divided into misoprostol group and oxytocin group.In the misoprostol group,misoprostol was placed vaginally to induce labor,and in the oxytocin group,oxytocin was intravenously injected to induce labor.The efficacy of induction,mode of delivery and m maternal and neonatal out-comes were compared between the two groups.Results The misoprostol group had more primiparas achieved the active phase than the ox-ytocin group(96.8％vs 89.1％,P=0.001).After 24h of induction,the misoprostol group showed a higher proportion of vaginal deliv-ery than the oxytocin group(60.6％vs 46.3％,P=0.001).The misoprostol group exhibited a significantly higher vaginal delivery rate and spontaneous vaginal delivery rate than the oxytocin group(87.1％vs 72.8％,P＜0.001;76.3％vs 64.2％,P=0.003).The ox-ytocin group had more primiparas who underwent cesarean section due to fetal distress(8.6％vs 3.6％,P=0.020)and failed labor in-duction(8.2％vs 1.6％,P=0.001)than the misoprostol group.The misoprostol group had a higher rate of uterine hyperstimulation than the oxytocin group(16.5％vs 9.7％,P=0.024).There were no significant differences in intrapartum chorioamnionitis,endome-tritis,postpartum hemorrhage,the incidence of neonatal asphyxia and admission to the neonatal intensive care unit between the two groups(P＞0.05).Conclusion Compared with oxytocin infusion,vaginal misoprostol induction in term PROM primiparas with unfavorable cervixes was associated with higher rates of cesarean and vaginal delivery within 24h.Vaginal misoprostol induction and oxytocin infusion had similar maternal and neonatal outcomes.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Objective:To investigate the awareness rate of " 1+ 1+ 1" contracted residents in the outer suburbs of Shanghai on the extended prescription policy of the family doctor contract service, and to analyze the influencing factors.Methods:From March to May, 2021, the cluster random sampling method was used to select one community health service center in Fengxian district, Shanghai, and a smart voice telephone assistant survey was conducted among the contracted residents aged 18 and above in the area, to understand their awareness of the extended prescription policy. χ2 Test was used for single factor analysis on the influence of different factors on the policy awareness of the contracted residents, while a multivariate analysis was performed by binary logistic regression, presenting P<0.05 as statistically significant. Results:A total of 13 495 " 1+ 1+ 1" contracted residents were surveyed via phone calls. Their awareness rate of extended prescription policy was 67.5% (9 115/13 495), while those with higher awareness rates were patients with ≥2 chronic diseases (92.3%), patients with 1 chronic disease (88.5%) and those aged 81 and above (88.4%). Logistic regression analysis showed that age, marital status, the number of chronic diseases and signing duration were all independent factors influencing the awareness of extended prescription policy (all P<0.05), while whether the residents were key population groups presented no significant influence on the awareness of extended prescription policy ( P=0.431). Conclusions:The awareness rate of " 1+ 1+ 1" contracted residents in the outer suburbs of Shanghai to the extended prescription policy needs to be further improved and publicity should also be strengthened to extend the policy benefit coverage.

Objective:To construct a training program of blood purification specialist nurses oriented by post competence, and to explore its application effects.Methods:230 blood purification specialist nurses from 4 ClassⅢ Grade A hospitals in Harbin were selected as research objects from July to December 2018. The lottery method was used to randomly select nurses from two hospitals in control group ( n=110) , and nurses from the other two hospitals in experimental group ( n=120) . Control group was treated with traditional training, and experimental group was given a training program oriented by post competence. The training effect was evaluated with the score of theoretical knowledge, operational skills and Post Competency Assessment Scale for Blood Purification Specialist Nurses. Results:After training, scores of theoretical knowledge and operational skills of experimental group were higher than those of control group with statistical differences ( t=7.81, 5.05; P<0.01) . After training, the total score of the Post Competency Assessment Scale for Blood Purification Specialist Nurses of experimental group was higher than that of control group also with a statistical difference ( t=10.03, P<0.01) . Conclusions:The training program of blood purification specialist nurses oriented by post competence helps to improve nurses' theoretical knowledge, operational skills and job competence.