Silica gel column chromatography was used for the isolation and purification of the chemical constituents of the pericarp of Illicium macranthum. From dichloromethane-EtOAc (1:1) fraction and EtOAc fraction of the methanol extracts, eleven compounds were identified on the basis of chemical and spectral data. Two new compounds were elucidated to be 6-deoxyneomajucin (1) and 2-oxo-6-deoxyneomajucin (2), along with nine known compounds 6-deoxypseudoanisatin (3), pseudoanisatin (4), anisatin (5), pseudomajucin (6), protocatecheuic acid (7), shikimic acid (8), shikimic acid methylester (9), beta-sitosterol (10) and daucosterol (11). Compounds 1 and 2 are new majucin-type sesquiterpene lactones.

Objective To evaluate the effect of a nurse-lead rehabilitation training on quality of life and psychotic symptoms of schizophrenia inpatients. Methods Totally 190 schizophrenia inpatients were divided into the intervention group (96 cases) and the control group (94 cases). In addition to rehabilitation activities which can be chosen freely, the schizophrenia in the intervention group received rehabilitation training including medication training, life skills training, social skill training and physical training, while the schizophrenia in the control group could only chose rehabilitation activities freely. The quality of life and the psychotic symptoms of the schizophrenia while enrolled and discharged were evaluated. Results No significant difference was found in the score of Schizophrenia Quality of Life Scale (SQLS) and Brief Psychiatric Rating Scale (BPRS) between the two groups(P>0.05)while enrolled. The scores of SQLS, psychosocial and motivation/energy in the control group were 30.22 ± 17.21, 30.22 ± 17.21 and 18.28± 9.33, while 21.41±14.63,19.76± 18.85 and 15.95± 8.80 in the intervention group one month after intervention, the difference was significant (t=-2.14,-2.19,-1.99,P<0.05). The scores of BPRS and hostile suspiciousness in the control group were 26.39 ± 6.37 and 4.11 ± 1.87 , while 23.67 ± 6.37 and 3.44± 1.26 in the intervention group one month after intervention, the difference was significant (t=-2.33,-2.54, P<0.05). Conclusions The nurse-lead rehabilitation training can improve the quality of life and psychotic symptoms of schizophrenia inpatients.

Objective To develop the questionnaire of medication adherence in patients with schizophrenia.Methods Delphi method was used in this study.The questionnaire of medication adherence in patients with schizophrenia was developed based on two rounds of consultation among 14 experts.Results The questionnaire of medication adherence in patients with schizophrenia consisted of 3 dimensions,7 items of each dimension.Conclusions The questionnaire can be used as the tool of evaluation of medication adherence in patients with schizophrenia.Further theoretical and empirical study is needed to verify the questionnaire.

Objective To observe the antitumor activity of sedum lineare thunb(SLT) and it′s affection on antioxidation and tumor immunology in S180‐bearing mice .Methods S180‐bearing mice model were established by subcutaneously inoculating S180 ascitic tumor into the right armpit .From the second day ,the mice were treated with normal saline ,cyclophosphamide (50 g/kg) or two doses of SLT (4 ,8 g/kg) through intragastric administration ,and the process extent 14 d .After the last administration ,the mice body weight and the index of tumor ,spleen and thymus were calculated ,classification of white blood cells in peripheral blood was tested ,and the activity of SOD and GSH‐Px as well as the content of MDA and NO in serum were measured .Results The body weight of mice treatmented with SLT was dramaticlly higher than those of the CTX (P< 0 .05) .Compare with the model group ,SLT groups showed decreases in tumors index (P<0 .05) ,spleen index (P<0 .05) ,percentage of peripheral blood neutro‐phil (P<0 .05) and monocyte (P<0 .05) ,and increases in thymus index (P<0 .05) and percentage of lymphocyte (P< 0 .05) . The activity of SOD and GSH‐Px and NO level in the SLT groups mice′s serum were significantly higher than those of the model group (P<0 .05) ,while the content of MDA in the SLT groups mice′s serum was markedly lower than those of the model and CTX groups(P<0 .05) .Conclusion SLT has antitumor activity in S180‐bearing mice bysuppressing oxidative stress and modula‐ting tumor immune .

OBJECTIVE: To explore the pathogenesis of two siblings (including a fetus) from a pedigree affected with Joubert syndrome. METHODS: Peripheral blood samples of the proband and his parents as well as amniotic fluid and abortion tissues of the fetus were collected. Part of the samples were used for the extraction of DNA, and whole exome sequencing (WES) was carried out to screen potential variants in the proband and his parents. Suspected variants were subjected to bioinformatics analysis with consideration of the clinical phenotype, and were verified by Sanger sequencing of the proband, fetus and their parents.The remainders were used for the extraction of RNA, and the mechanism of splicing variant was validated by reverse transcription-PCR (RT-PCR). RESULTS: WES showed that both patients have carried c.175C>T (p.R59X) and c.553+1G>A compound heterozygous variants of the TMEM237 gene. Among these, c.175C>T was a nonsense mutation inherited from the asymptomatic mother, while c.553+1G>A was an alternative splicing mutation inherited from the asymptomatic father. RT-PCR showed that this variant has resulted in aberrant splicing by exon skipping. CONCLUSION The compound heterozygous variants of the TMEM237 gene probably underlay the etiology of Joubert syndrome in this pedigree. Above finding has enriched the phenotype and variant spectrum of the TMEM237 gene, and facilitated genetic counseling and prenatal diagnosis for the family.
Abnormalities, Multiple/genetics* ; Cerebellum/abnormalities* ; Eye Abnormalities ; Female ; Genotype ; Humans ; Kidney Diseases, Cystic ; Mutation ; Pedigree ; Phenotype ; Pregnancy ; Retina/abnormalities*

Objective To understand the current situation of knowledge and attitude on depression in nurses in psychiatric and general hospitals of partial regions nationwide so as to provide targeted training on relevant knowledge for nurses.Methods A totals of 5497 nurses (2902 in psychiatric hospitals, 2595 in general hospitals) from 8 provinces were investigated with the adapted questionnaire of knowledge and attitude on depression.Results The scores of knowledge and attitude of nurses in psychiatric hospitals were (13.55±3.58) and (95.34±12.69), which were higher than those [(10.81±2.97), (89.02±15.31)] of nurses in general hospitals with significant differences (t=30.636, 16.824;P<0.01). The single factor analysis showed that there were statistically significant differences in the score of knowledge on depression of nurses between different departments, ages, marriages, educational background and working years (t=30.952, 23.217, 23.266, 40.065, 23.266, 40.065;P<0.05). Besides, there were statistically significant differences in the score of attitude on depression of nurses between different departments, ages, marriages, positional titles, educational background and working life (t=16.656,19.127,17.228,17.894,10.713,17.894;P<0.05). The regression analysis revealed that the influencial factors on knowledge were the property of department, educational background, positional titles and working years; the influencing factors for attitude were the property of department, educational background.Conclusions Clinical nurses are with low awareness of knowledge on depression along with negative attitudes with patients. Managers should draw up a training plan based on the property of department, educational background, positional titles, working years and so on for the nurses to strengthen the training on knowledge of disease and humanities, thus improving their service ability for patients with depression.

OBJECTIVE To observe the effect of Huangjing Jiangya Decoction on blood pressure and sleep in patients with hy-pertension of qi-deficiency type accompanied by insomnia.METHODS 73 patients with hypertension of qi-deficiency type accompa-nied by insomnia who met the inclusion criteria were selected and randomly divided into an observation group of 36 cases and a control group of 37 cases.The control group was treated with amlodipine besylate tablets,and the observation group was given Huangjing Jian-gya Decoction oral treatment on the basis of the control group.Both groups were treated continuously for 8 weeks.The changes in TCM syndrome scores,office blood pressure monitoring(OBPM),home blood pressure monitoring(HBPM),24-hour ambulatory blood pressure monitoring(ABPM),Pittsburgh Sleep Quality Index(PSQI)scores and clinical efficacy of the two groups of patients before and after treatment were observed.RESULTS After treatment,the TCM syndrome scores in the observation group were significantly decreased(P<0.05,P<0.01),which were better than the control group(P<0.01);OBPM and HBMP in both groups were signifi-cantly reduced(P<0.05,P<0.01),the observation group was better than the control group(P<0.05,P<0.01);the ABPM of the observation group was significantly reduced(P<0.01),which was better than the control group(P<0.05,P<0.01);the sleep quali-ty,sleep latency,sleep duration,daytime dysfunction score and PSQI total score of the observation group were significantly decreased(P<0.01),which were better than those in the control group(P<0.05,P<0.01);the clinical efficacy of hypertension and insomnia in the observation group was both better than the control group(P<0.01).CONCLUSION Huangjing Jiangya Decoction combined with amlodipine can improve the symptoms of patients with hypertension of qi-deficiency type accompanied by insomnia,lower blood pressure,improve sleep quality,shorten sleep latency,alleviate daytime dysfunction,and has good clinical efficacy.

Objective To investigate the neuroprotective effect and antioxidation mechanism of tianmagouteng decoction on retinal ganglion cells (RGCs) in optic nerve crush model.Methods Optic nerve crush models were established using optic nerve clamping method in the right eyes of 50 SPF male Wistar rats.The rats were randomized into model group (17 rats),1.2 g/ml tianmagouteng decoction group (16 rats) and 2.4 g/ml tianmagouteng decoction group (17 rats).Ttianmagouteng decoction at the dose of 1.2 g/(ml· d) or 2.4 g/(ml · d) was intragastrically administered 2 hours after onset of optic nerve damage (10 ml/kg),respectively,based on grouping for consecutive 28 days,and equal volume of distilled water was used in the same way in the model group.Fluoro-gold (FG,3 μl,3％) was bilaterally injected into superior colliculus to retrogradely label RGCs 23 days following modeling.The rats were sacrificed at day 28 and retinal flatmounts were prepared to count RGCs.Retinal glutathione peroxidase (GSH-Px) activity in rat retinas was detected by chemical colorimetric analysis.Results The survival rate of RGCs was (59.67 ± 9.85) ％,(71.33 ± 9.14) ％ and (73.63 ± 8.33) ％ in the model group,1.2 g/ml tianmagouteng decoction group and 2.4 g/ml tianmagouteng decoction group,respectively,showing a significant difference among the three groups (F =5.322,P =0.014),and the survival rate of RGCs was evidently higher in the 1.2 g/ml tianmagouteng decoction group and 2.4 g/ml tianmagouteng decoction group than that in the model group (P =0.023,0.006).The GSH-Px activity was (222.20±76.67),(311.30 ±46.93) and (473.65 ± 117.73)μmol/(s · mg) in the model group,1.2 g/ml tianmagouteng decoction group and 2.4 g/ml tianmagouteng decoction group,respectively,with a significant difference among the three groups (F =20.005,P ＜ 0.001),and the GSH-Px activity in the 2.4 g/ml tianmagouteng decoction group is considerably increased as compared to the model group and 1.2 g/ml tianmagouteng decoction group (P ＜ 0.001;P =0.001).Conclusions Tianmagouteng decoction plays a neuroprotective effect on RGCs after optic nerve damage in rat,which may be achieved by improving the activity of the GSH-Px in retina,suggesting that antioxidation probably be one of the neuroprotective mechanisms of tianmagouteng decoction.

Objective:To construct a prediction model for the prognosis of breast cancer patients with long non-coding RNA expression characteristics.Methods:To construct a long non-coding RNA(LncRNA) model for predicting the prognosis of breast cancer patients.Methods Analyzing LncRNA expression profiles and clinical characteristics of 1 081 breast cancer patients in the cancer genome atlas (TCGA) database.Performing differential expression analysis and univariate analysis on 112 paired breast cancer and normal breast tissues′ transcriptome sequencing data in the TCGA database, and screened for differentially expressed (DELncRNAs) that significantly correlated with the prognosis of BRCA (To reduce batch effects, sequencing data has been normalized using the DESeq function). One thousand eighty-one breast cancer patients were randomly divided into two groups: training set (541) and validation set (540). Performing Cox proportional hazard regression using DELncRNAs and establishing a multi-LncRNA prognosis model in the training set, followed by proportional hazards assumption test(PH assumption test). Patients were divided into high-risk and low-risk groups based on calculated risk score.Kaplan-Meier method was used for survival analysis, and 540 patients′ data were used for validation.To evaluate the prognostic value of the model in patients with squamous cell carcinoma of the lung and hepatocarcinoma in TCGA database.Gene Set Enrichment Analysis (GSEA) was used to analyze the specific mechanism of lncrna affecting the survival of patients.Results:There were 2815 differentially expressed genes screened by transcriptome sequencing, 91 of which were significantly related to the prognosis of breast cancer patients ( P<0.05). Based on the Cox regression analysis of 91 delncrna expression data from 541 breast cancer patients in training set, a Cox proportional risk regression model was constructed based on 5 LncRNA (training set AUC=0.746, validation set AUC=0.650): AC004551.1, MTOR-AS1, KCNAB1-AS2, FAM230G and LINC01283, and PH assumption test( P=0.388). K-M survival analysis showed that the survival time of high-risk group was significantly worse than that of low-risk group (median survival time: 7.049 and 12.21 years, HR 0.367, 95% CI0.228-0.597, P<0.001), and the survival time of high-risk group was significantly shorter than that of low-risk group (median survival time: 7.57 and 10.85 years, HR 0.412, 95% CI0.214-0.793, P<0.001). Similar prediction results were also obtained in other cancer species of TCGA: lung squamous cell carcinoma ( HR 0.604, 95% CI0.383-0.951, P=0.007) and liver cell carcinoma ( HR 0.551, 95% CI0.307-0.987, P=0.011). GSEA results suggested that the expression patterns of the above five LncRNA were related to the cell cycle regulation of tumor cells. Conclusion:The prognostic model constructed based on expression profile of AC004551.1, MTOR-AS1, KCNAB1-AS2, FAM230G and LINC01283 can be used to predict the prognosis of breast cancer patients, which is helpful to further guide clinical treatment.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.