OBJECTIVE To optimize the water extraction technology for Kaixin granules. METHODS UPLC-MS/MS method was established for the simultaneous determination of ginsenoside Rg1， ginsenoside Re， ginsenoside Rb1， tenuifolin， polygalaxanthone Ⅲ and 3， 6′-disinapoyl-sucrose. An orthogonal test was designed with extraction times， extraction duration， and the volume of added water as factors. Using the contents of the aforementioned six indicator components and the extract yield as evaluation indexes， analytic hierarchy process-entropy weight method was employed to determine the combined weights of each indicator. Subsequently， process optimization and validation were conducted by integrating grey relational analysis （GRA） and back propagation （BP） neural network. RESULTS The water extraction technology optimized by the orthogonal test and GRA was 10- fold water for the first decoction and 8-fold water for the subsequent two， extracting 3 times，extracting for 1 h each time； the average comprehensive score of the validation experiment was 91.10 （RSD＝0.31%， n＝3）. The water extraction technology optimized by BP neural network was extracting 3 times with 10-fold water added each time， extracting for 1.5 h each time； the average comprehensive score of the validation experiment was 95.89 （RSD＝0.73%， n＝3）. Considering practical production requirements， the optimal water extraction technology was extraction performed three times， with 10-fold water for the first decoction and 8-fold water for the subsequent two extractions， with an extraction time of 1 h each. CONCLUSIONS The optimized water extraction technology for Kaixin granules is stable and feasible.

ObjectiveTo investigate the characteristics of traditional Chinese medicine syndrome and the evolution of pathogenesis in different stages of atherosclerotic thrombotic cerebral infarction （ATCI）. MethodsClinical data of 3088 ATCI patients from 8 hospitals in 6 provinces and cities were collected from the hospital information system during January 1， 2015 to December 31， 2019. After staging and counting clinical symptoms， common factors were extracted using the principal component analysis method in factor analysis. Cluster analysis was then carried out on the basis of the factor analysis. The results of the combination of the evidence element identification， cluster analysis and expert discussion were used to discuss the evidence of the different disease stages of atherosclerotic cerebral infarction. ResultsOf the 3088 ATCI patients included， 2290 cases were in the acute phase and 798 in the non-acute phase. Excluding the main symptoms of ischaemic stroke， such as numbness and weakness of limbs， unfavourable movement， unfavourable speech and dizziness， we identified 84 indicators with a frequency ≥5% of the four diagnostic information variables. Of these， 36 indicators were observed in the acute phase and 35 in the non-acute phase. Factor analysis extracted 14 common factors from each phase. We selected factors with a loading coefficient ＞0.3 for evidence determination. These 14 groups of common factors were used as variables for clustering. After clustering， the acute， non-acute phase were each divided into 5 categories. Based on a combination of clinical practice and expert opinion， the symptoms identified in the acute period were syndrome of deficiency of both qi and yin， syndrome of blockade of wind-phlegm-static blood （36.07%）， syndrome of qi deficiency and blood stasis （20.74%）， syndrome of upward disturbance of wind-fire （15.15%）， syndrome of stirring wind due to yin deficiency （9.43%）， and syndrome of spleen deficiency and liver hyperactivity （3.80%）. In the non-acute phase， the symptoms were qi and yin deficiency with syndrome of qi stagnation and blood stasis （45.49%）， syndrome of deficiency of both qi and yin （20.05%）， syndrome of qi stagnation and blood stasis （16.42%）， spleen-kidney deficiency syndrome （8.52%）， and syndrome of hyperactivity of liver yang （4.89%）. ConclusionThe acute phase of AICI is mainly characterized by blood stasis， fire， internal wind， hyperactivity of yang， qi deficiency and yin deficiency， while the non-acute phase is characterized by yin deficiency， qi deficiency， blood stasis and qi stagnation. The main pathomechanism of ATCI involves deficiency of qi and yin， as well as obstruction of the channels by phlegm and blood stasis， and the fundamental pathomechanism is deficiency of qi and yin.

Ischemic stroke(IS)is a multifactorial and heterogeneous disease.Despite years of studies,effective strategies for the diagnosis,management and treatment of stroke are still lacking in clinical practice.Metabolomics is a growing field in systems biology.It is starting to show promise in the identification of biomarkers and in the use of pharmacometabolomics to help patients with certain disorders choose their course of treatment.The development of metabolomics has enabled further and more biological appli-cations.Particularly,metabolomics is increasingly being used to diagnose diseases,discover new drug targets,elucidate mechanisms,and monitor therapeutic outcomes and its potential effect on precision medicine.In this review,we reviewed some recent advances in the study of metabolomics as well as how metabolomics might be used to identify novel biomarkers and understand the mechanisms of IS.Then,the use of metabolomics approaches to investigate the molecular processes and active ingredients of Chinese herbal formulations with anti-IS capabilities is summarized.We finally summarized recent developments in single cell metabolomics for exploring the metabolic profiles of single cells.Although the field is relatively young,the development of single cell metabolomics promises to provide a powerful tool for unraveling the pathogenesis of IS.

Objective:To explore the correlation between dietary fiber intake and intestinal barrier function in patients with irritable bowel syndrome with diarrhea (IBS-D).Methods:IBS-D patients were recruited from May 2019 to October 2019 at the clinic of gastroenterology department in China-Japan Friendship Hospital and healthy controls (HCs) were recruited by advertisement. Clinical manifestations, psychological status and quality of life were assessed using standardized questionnaires. A food frequency questionnaire was used to assess dietary habits in the preceding year. Serum diamine oxidase (DAO) was measured via ELISA.Results:64 IBS-D patients and 35 HCs were enrolled, with no significant difference in sex ratio, age and BMI between the two groups. Second to health concern, food avoidance was the dominant impacting factor for quality of life in IBS-D patients. The intake frequency of dietary fiber was decreased in IBS-D patients, and the intake frequencies of dietary fiber-rich foods were significantly lower in IBS-D patients ( P < 0.01 for tubers, P = 0.002 for vegetables, P = 0.019 for fruits and P = 0.045 for legumes). On the other hand, the intake frequencies of processed meat ( P < 0.01), greasy food ( P = 0.009), barbecued food ( P = 0.002) and animal offal ( P = 0.003) were significantly higher in IBS-D patients compared with HCs, indicating the increased intake frequency of fat. Multivariate logistic regression showed that tubers might reduce the risk of IBS-D ( OR = 0.409,95% CI: 0.232 to 0.722, P = 0.002). The frequency of abdominal pain was positively associated with the intake frequency of greasy food in IBS-D patients. Serum DAO was measured in 37 IBS-D patients and 27 HCs. IBS-D patients had significantly higher serum DAO than HCs ( 77.0 [55.3, 100.6] μg/L vs 42.5 [28.0, 58.2] μg/L, P < 0.01). Among all the participants with serum DAO test results, the level of DAO was negatively associated with the intake frequencies of tubers, vegetables and fruits while positively associated with the intake frequencies of processed meat and barbecued food. Conclusions:Food avoidance was an important impacting factor for quality of life in IBS-D patients. IBS-D patients might have insufficient dietary fiber intake and excessive fat intake. Tubers could possibly reduce the risk of IBS-D. The decreased intake frequency of dietary fiber might have a role in intestinal barrier dysfunction in IBS-D patients.

Objective: To evaluate the effect of "healthy eating plate" based dietary management on diabetic inpatients. Methods: The patients with type 2 diabetes mellitus (T2DM) admitted to Daishan First People's Hospital from November 2019 to November 2020 were selected and randomly divided into two groups. The intervention group was given "healthy eating plate" based dietary management, while the control group was given routine dietary management. Demographic data and physical examination results were collected. Fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), triglyceride (TG) and total cholesterol (TC) were detected at admission, discharge and 3 months after discharge, and compared between the two groups by covariance and generalized estimating equation. Results: here were 52 patients aged (55.83±9.67) years in the intervention group, with 29 (55.77%) males and 23 (44.23%) females. There were 53 patients aged (57.54±11.09) years in the control group, with 32 (60.38%) males and 21 (39.62%) females. There were no significant differences in FPG, HbA1c, TG and TC levels between two groups at discharge (P>0.05). The level of HbA1c in the intervention group was significantly lower than that in the control group at 3 months after discharge (P<0.05); there were no significant differences in FPG, TG and TC levels (P>0.05). Conclusion The "healthy eating plate" based dietary management can better control the blood glucose of diabetic patients, and can help maintain the dietary treatment. It is worthy of promotion in diabetic patients.

Objective To investigate the value of transient elastography (FibroScan) and platelet count-to-spleen thickness (PC/ST) ratio in predicting the degree of esophageal and gastric varices (EGV) in liver cirrhosis. Methods A total of 210 patients with liver cirrhosis who underwent FibroScan, color Doppler ultrasound, electronic gastroscopy, and blood biochemical examination within three days after admission to The Fifth Affiliated Hospital of Zhengzhou University from January 2017 to September 2020 were enrolled, and according to the "gold standard" of gastroscopy, the patients were divided into none, mild, moderate, and severe EGV groups. A one-way analysis of variance or the Kruskal-Wallis H test were used for comparison of continuous data between multiple groups. Receiver operating characteristic (ROC) curves were plotted for liver stiffness measurement (LSM), PC/ST ratio, and LSM+PC/ST, and the diagnostic performance of these ROC curves was compared using the Delong method. Results There were significant differences between the none, mild, moderate, and severe EGV groups in LSM ( F =32.00, P < 0.01) and PC/ST ratio ( H =49.58, P < 0.01). For the mild EGV group, LSM, PC/ST ratio, and LSM+PC/ST had an area under the ROC curve (AUC) of 0.762, 0.656, and 0.770, respectively, with a positive predictive value of 75.4%, 60.2%, and 82.5%, respectively, and a negative predictive value of 75.0%, 75.8%, and 65.4%, respectively. For the moderate EGV group, LSM, PC/ST ratio, and LSM+PC/ST had an AUC of 0.841, 0.796, and 0.896, respectively, with a positive predictive value of 86.1%, 68.0%, and 74.1%, respectively, and a negative predictive value of 79.7%, 80.5%, and 90.2%, respectively. For the severe EGV group, LSM, PC/ST ratio, and LSM+PC/ST had an AUC of 0.834, 0.830, and 0.903, respectively, with a positive predictive value of 80.5%, 71.4%, and 79.5%, respectively, and a negative predictive value of 82.5%, 83.6%, and 85.0%, respectively. PC/ST ratio and LSM+PC/ST had significantly different AUC in predicting mild, moderate, and severe EGV ( Z =2.66, P =0.007; Z =2.71, P =0.007; Z =2.37, P =0.018). Conclusion LSM, PC/ST ratio, and LSM+PC/ST have a good predictive value for moderate-to-severe EGV in liver cirrhosis.

Objective:To explore the association between sleep duration, sleep quality and the prevalence of hypertension in the elderly aged 65 years and above.Methods:This study was conducted among the elderly in communities in Yiwu, China from April to July, 2019, and participants were recruited through physical examination in the hospital. Face-to-face interview was performed to obtain basic information. Sleep duration and sleep quality were evaluated by Pittsburgh Sleep Quality Index (PSQI). Associations between sleep duration, sleep quality and hypertension were evaluated by multivariate logistic regression analysis.Results:A total of 3 169 elderly persons, aged ≥65 years old, were included in the study. The overall prevalence of hypertension was 50.8%. The elderly with very poor sleep quality and short sleep duration accounted for 22.4% and 28.5%, respectively. After adjusting for demographic characteristics, socioeconomic status, lifestyle and health status, the OR of hypertension for the elderly with very poor sleep quality was 1.42 (95% CI: 1.12-1.80) compared with those with very good sleep quality. Compared with the elderly with sleep duration of 6-7 h a night, the OR of hypertension for those with sleep duration <6 h was 1.37 (95% CI: 1.15-1.65). As the sleep quality decreased, the risk for hypertension increased. An U-shaped association was found between sleep duration and risk of hypertension. Subgroup analyses showed that this association existed in both men and women, but only significant in the elderly aged <75 years. Conclusion:Poor sleep quality and short sleep duration were associated with risk for hypertension in the elderly.

Gestational diabetes mellitus is one of the most common complications of pregnancy. Poor control of maternal blood glucose during pregnancy seriously threatens the short-term and long-term health of pregnant women and fetuses. Standardized blood glucose monitoring during pregnancy can significantly reduce the short-term and long-term complications of gestational diabetes mellitus mothers and infants, and blood glucose self-monitoring is currently the most widely used and most convenient blood glucose monitoring method in clinical practice. This article reviews the related concepts, main monitoring content, current situation, influencing factors and improvement strategies of blood glucose self-monitoring in patients with gestational diabetes mellitus. The aim is to raise the attention of medical and nursing staff to blood glucose self-monitoring in patients with gestational diabetes mellitus, and provide a theoretical basis for the prevention and treatment of adverse outcomes of gestational diabetes mellitus.

Objective: To explore the difference of personality characteristics of physicians, nurses, medical skills and administrative personnel in a general hospital and its influence on job burnout. Methods: Employee entered the hospital before 2018 were enrolled in the current study and the position was classified as physicians, nurses, medical technician and administrative staff. Minnesota Multiphasic Personality Inventory (MMPI) was completed by the employee at the time of entering the hospital. Status of job burnout was assessed in 2018 using the Maslach Burnout Inventory-General Survey (MBI-GS) . Results: Physicians have a higher rate of paranoia than others (P<0.05) , and administrative staff and medical technician have a slightly higher score than the other two categories of people (P<0.05) , and administrators lie at a higher rate than others (P<0.05) . Further analysis found that personality traits did not have a significant association with job burnout at the time of entry. Conclusion The administrative and medical staff is slightly more irritable, the administrative staff lying slightly higher score, the staff after the entry of job burnout is not affected by the personality characteristics of the onboarding.

Objective To explore the influence and relationship of job stress, working-family conflict and job satisfaction on turnover intention of nurses in Cardiology Department. Methods From June 2016 to June 2017, a total of 482 nurses of Cardiology Department of 9 Class Ⅲ Grade A hospitals in Jiangsu province were selected as the study subjects by random cluster sampling method. All the subjects were investigated with Job Stress Scale, Work Family Conflict Scale, Minnesota Job Satisfaction Scale and Turnover Intention Scale. Pearson correlation analysis was used to analyze the relationship between job stress, work-family conflict, job satisfaction and turnover intention of nurses in Cardiology Department. Multiple linear hierarchical regression analysis was used to analyze the factors influencing turnover intention. Results The total score of Turnover Intention Scale for 482 nurses of Cardiology Department was (2.44±0.73). The score of Job Stress Scale, Work Family Conflict Scale and Minnesota Job Satisfaction Scale Job was (86.06±4.87), (44.04±1.85) and (70.01±2.97) respectively. The result of Pearson analysis showed that job stress was positively related with turnover intention (r=0.434, P＜0.01), work-family conflict positively related with turnover intention (r=0.423, P＜ 0.01), and job satisfaction negatively related with turnover intention (r=-0.450, P＜ 0.01). Multivariate linear hierarchical regression analysis showed that job stress and work-family conflict had a positive impact on turnover intention, and job satisfaction had a negative impact on turnover intention. Conclusions Nurses in the Department of Cardiology have higher job stress, more conflicts between work and family, general job satisfaction and higher turnover intention, which are the main problems found in the current study. Therefore, the hospital should analyze the reasons of high turnover tendency of nurses in Cardiology Department from various angles, strengthen the support of organization, improve the satisfaction and reduce the turnover tendency. Li J, Zhang S, Liu S, et al. Study on the relationship between occupational stress and turnover intention in young clinical nurses [J].Chin J Mod Nurs,2014,20(21):2671-2673.