OBJECTIVE To establish the fingerprint of Pinghuo tea standard decoction and a method for determination of multi-component to clarify the transfer relationship of quantities and quality from pieces and standard decoction. METHODS Fifteen batches of Pinghuo tea standard decoction were prepared and the extract rate was determined； the fingerprint of the preparation was established by using high-performance liquid chromatography（HPLC）； the similarity evaluation and the determination of common peaks were performed， and chemometric analysis was performed； the same method was used to determine the content of indicator components and the transfer rate was calculated. The chromatographic column was Venusil C18 column with mobile phase consisted of acetonitrile-0.1% phosphoric acid solution （gradient elution）； the column temperature was 30 ℃， and the detection wavelengths were 238 nm （0-37 min， 85-102 min） and 330 nm （37-85 min） at a flow rate of 1.0 mL/min with an injection volume of 10 μL. RESULTS The similarity of HPLC fingerprints for 15 batches of Pinghuo tea standard decoction was not lower than 0.968. A total of 24 common peaks were calibrated and 9 peaks were recognized， which were as follows neochlorogenic acid （peak 3）， chlorogenic acid （peak 6）， geniposide （peak 9）， glycyrrhizin （peak 10）， galuteolin （peak 11）， isochlorogenic acid A （peak 14）， luteolin （peak 21）， kaempferol （peak 23） and glycyrrhizic acid （peak 24）. Cluster analysis， principal component analysis and orthogonal partial least squares discriminant analysis showed consistent results， all of which could classify the 15 batches of samples into three categories. The linear range of indicator components in 15 batches of Pinghuo tea standard decoction， such as geniposide， luteolin， isochlorogenic acid A， glycyrrhizin， and glycyrrhizic acid， were 0.020 580-0.411 600， 0.001 617-0.080 850， 0.006 076-0.607 600， 0.005 125-0.071 740， and 0.017 288-0.432 200 mg/mL， respectively； RSDs of precision， repeatability， stability and recovery rate tests were all not higher than 4% （n＝6）. The mass fractions ranged 3.227 9-10.002 2， 0.297 4-0.554 6， 3.350 1-6.159 6， 0.720 6-1.073 3， 2.003 1-3.030 1 mg/g； transfer rates from the pieces and standard decoction were 19.762 8%-35.840 5%， 12.123 3%-21.254 0%， 46.097 2%-82.869 4%， 58.708 8%-91.629 6%， 39.114 3%-63.710 6%. The transfer rates of the extract from 15 batches of Pinghuo tea standard decoction ranged from 61.15%-84.68%. CONCLUSIONS Established HPLC fingerprint and content determination methods in this study are simple and accurate， which can provide reference for the quantitative value transfer study， quality control， clinical application and the development of subsequent formulations of Pinghuo tea standard decoction.

Coronary heart disease is a chronic and lifelong disease， which places a dual burden on the physiological and psychological well-being of patients， and can easily lead to psychological distress and affect their prognosis and quality of life. This article provides a systematic review， in which the current status， evaluation tools， influencing factors and intervention methods of psychological distress in patients with coronary heart disease are explored， aiming to provide key information beneficial for identifying and preventing psychological distress， and to improve the overall management and treatment effectiveness of coronary heart disease patients. In this paper， 18 articles were included， and the demographic， physiological， psychological and social factors affecting the psychological distress of patients with coronary heart disease were systematically analyzed， thus to provide a deeper understanding of psychological distress and offering references for formulating targeted intervention strategies.

BACKGROUND: Valvular heart disease (VHD) has become increasingly common with the aging in China. This study aimed to evaluate regional differences in the clinical features, management strategies, and outcomes of patients with VHD across different regions in China. METHODS: Data were collected from the China-VHD Study. From April 2018 to June 2018, 12,347 patients who presented with moderate or severe native VHD with a median of 2 years of follow-up from 46 centers at certified tertiary hospitals across 31 provinces, autonomous regions, and municipalities in Chinese mainland were included in this study. According to the locations of the research centers, patients were divided into five regional groups: eastern, southern, western, northern, and central China. The clinical features of VHD patients were compared among the five geographical regions. The primary outcome was all-cause mortality or rehospitalization for heart failure. Kaplan-Meier survival analysis was used to compare the cumulative incidence rate. RESULTS: Among the enrolled patients (mean age, 61.96 years; 6877 [55.70%] male), multiple VHD was the most frequent type (4042, 32.74%), which was mainly found in eastern China, followed by isolated mitral regurgitation (3044, 24.65%), which was mainly found in northern China. The etiology of VHD varied significantly across different regions of China. The overall rate of valve interventions was 32.67% (4008/12,268), with the highest rate in southern China at 48.46% (205/423). In terms of procedure, the proportion of transcatheter valve intervention was relatively low compared to that of surgical treatment. Patients with VHD in western China had the highest incidence of all-cause mortality or rehospitalization for heart failure. Valve intervention significantly improved the outcome of patients with VHD in all five regions (all P  <0.05). CONCLUSIONS: This study revealed that patients with VHD in China are characterized by significant geographic disparities in clinical features, treatment, and clinical outcomes. Targeted efforts are needed to improve the management and prognosis of patients with VHD in China according to differences in geographical characteristics. REGISTRATION ClinicalTrials.gov , NCT03484806.
Aged ; Female ; Humans ; Male ; Middle Aged ; China/epidemiology* ; Heart Valve Diseases/therapy* ; Kaplan-Meier Estimate ; Tertiary Care Centers ; Treatment Outcome

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.

Objective To analyze the clinicopathological features and survival conditions of human epidermal growth factor receptor-2(Her-2)negative and low-expression breast cancer.Methods Aretrospective analysis was performed for the clinicopatho-logical and prognostic survival data of 327 patients of Her-2 negative or low-expression breast cancer who visited the First Affiliated Hospital of Xinjiang Medical University from April 2013 to November 2022,and were divided into the Her-2 low-expression group(n=217)and the Her-2 negative group(n=110).The clinicopathological features,and prognostic survival indicators such as recur-rence and metastasis after treatment,mortality,overall survival,and progression-free survival of the two groups were compared.Accord-ing to the hormone receptor(HR)status,the patients were divided into HR+and HR-cohorts,and the progression-free survival of patients with Her-2 negative or low-expression breast cancer in the two cohorts was compared.Results Breast cancer with Her-2 low-expression accounted for a high proportion in the clinic,most of them were estrogen receptor(ER)-positive manifested as Luminal type,the pathological prognosis stage was mostly stage Ⅰ,and ki-67 was low expression.However,Her-2 negative breast cancer was often combined with ER-negative manifestations as triple-negative type,the pathological prognosis stage was mostly stage Ⅲ,and ki-67 was highly expression,and more brain metastases and/or other organ metastases appeared after treatment,all the differences were sta-tistically significant(P＜0.05).However,There were no statistical differences in mortality,overall survival,and progression-free sur-vival between groups and the two cohorts(P＞0.05).Conclusion There is tumor heterogeneity between Her-2 negative and low-ex-pression breast cancer,Her-2 low-expression breast cancer has the advantages of high ER positive rate,low ki-67 expression,and early stage of pathological prognosis and stage,and the metastasis rate of the brain metastases and/or other organs is relatively low after treatment,but it has not converted into significant survival benefits.

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.

Objective:To evaluate the practical value of the up-converting phosphor technology (UPT) in the field fast detection of plague, and to provide scientific basis for its promotion and application in the field work of plague monitoring.Methods:In September 2020, a total of 116 samples (including 4 samples for epidemic determination) were collected at the plague epidemic site in Menghai County, Yunnan Province, including 24 human blood and lymphatic fluid samples, 83 rat liver and muscle samples, and 9 rat blood samples. In March 2023, a total of 12 rat liver and muscle samples were collected from Lijiang City for on-site monitoring of plague outbreak (all of them were outbreak determination samples). All of the above samples were tested for Yersinia pestis antibody and antigen using the up-converting phosphor technology. At the same time, haemagglutination test, real-time fluorescence quantitative PCR and bacterial culture were conducted to compare the detection process and results of different experimental methods, the advantages and disadvantages of the up-converting phosphor technology for detecting Yersinia pestis were analyzed, and the feasibility of using this detection method in the field of plague epidemic monitoring was judged. Results:The plague epidemic samples site in Menghai County, Yunnan Province were tested by up-converting phosphor technology, and 19 samples were found to be positive for Yersinia pestis (1 antibody-positive and 18 antigen-positive). Among the samples determined, 4 samples with positive results of Yersinia pestis were detected by up-converting phosphor technology, and the results of their haemagglutination test, real-time fluorescence quantitative PCR and bacterial culture were all positive. All samples from Lijiang City were tested by up-converting luminescence technology, two samples were positive for Yersinia pestis(antigen-positive). The results of haemagglutination test and real-time fluorescence quantitative PCR were positive, and one sample was positive for bacterial culture. The time required for up-converting phosphor technology, haemagglutination test, real-time fluorescence quantitative PCR, and bacterial culture were 0.5, 4.0, 2.5 and 72.0 h, respectively. Conclusions:The results of Yersinia pestis detection by up-converting phosphor technology are basically consistent with the results of haemagglutination test, real-time fluorescence quantitative PCR and bacterial culture, but the time used is relatively short. When the number of samples is large, this method can be used preferentially in the field work of plague outbreak monitoring, which can quickly complete the preliminary judgement of plague outbreak, and save a lot of time and economic resources for the next step of plague prevention and control work.

Objective:To explore the training needs for clinical core competence of master of nursing specialist (MNS) from the perspective of supervisors, providing reference for the development of future MNS clinical practice training programs.Methods:Using phenomenological research methods from qualitative research, purposive sampling was used to select 10 MNS supervisors from Jilin Province, Heilongjiang Province, Sichuan Province, and Zhejiang Province as research subjects for semi-structured interviews from May to July 2023. Colaizzi 7-step analysis method was used to extract themes.Results:Six themes were extracted, including the need to strengthen MNS ideological and political education, differences in clinical training needs and ability goals between fresh and non-fresh students, the need to enhance MNS clinical practice ability, clinical research should be a key training content, thinking ability training should be integrated throughout the entire clinical training process, and achievement transformation.Conclusions:Relevant training institutions should attach importance to the cultivation of MNS ideological and political education, specialized practical abilities, thinking abilities, clinical research, and achievement transformation abilities, distinguish the tendency of cultivating fresh and non-fresh students, and actively set up relevant courses to improve students' core competence and job competitiveness, and cultivate nursing expert talents that truly meet the needs of clinical development.

Objective:To develop a joint clinical practice teaching and assessment program tailored to the clinical training needs of master of nursing specialist (MNS) postgraduates which focuses on core competency requirements.Methods:Totally 10 MNS postgraduate supervisors were selected by convenience sampling for semi-structured interviews between May and July 2023. Subsequently, a Delphi method was employed with 22 MNS postgraduate supervisors over two rounds of consultations from October to December 2023.Results:A total of 22 experts participated in the Delphi consultations, with an effective response rate of 100.00% (22/22) in both rounds. The expert authority coefficients were 0.822 and 0.833, respectively, for the two rounds. The Kendall's W for various levels of indicators ranged from 0.097 to 0.243 and 0.159 to 0.256, respectively ( P<0.01). The final training program included five primary indicators, 10 secondary indicators, and 26 tertiary indicators. Conclusions:The development process for the joint clinical practice teaching and assessment program for MNS postgraduates is scientific and reliable. The program can serve as a reference for the clinical practice training of MNS postgraduates.