ObjectiveTo observe the effects of Hirudo， Notoginseng Radix et Rhizoma， and drug pair on renal pathological morphology and protein phosphatase 2A （PP2A）/adenylate activated protein kinase （AMPK）/mammalian target of rapamycin （mTOR） signal pathway in rats with chronic renal failure （CRF）. MethodThe 55 male SD rats were randomly divided into a normal group （n=11） and a modeling group （n=44）. The normal group was fed conventionally， and the modeling group was given 0.25 g·kg^-1·d^-1 adenine by gavage for 28 days to replicate the CRF model. After successful modeling， rats were randomly divided into model group， Hirudo group （3 g·kg^-1·d^-1）， Notoginseng Radix et Rhizoma group （3 g·kg^-1·d^-1）， and Hirudo + Notoginseng Radix et Rhizoma group （3 g·kg^-1·d^-1）， with 9 rats in each group. The normal group and model group were given a constant volume of normal saline by intragastric administration for 30 days. At the end of the experiment， the levels of serum creatinine （SCr） and urea nitrogen （BUN） in all groups were measured. The renal pathological morphology changes were observed by hematoxylin-eosin （HE） staining， Masson staining， and electron microscopy. The mRNA expressions of PP2A， AMPK， and mTOR were detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. The protein expression levels of PP2A， AMPK， phosphorylation（p）-AMPK， mTOR， and p-mTOR in renal tissue were detected by Western blot. ResultCompared with the normal group， the renal pathological structure changes were obvious， and the levels of SCr and BUN were significantly increased. The mRNA expression of PP2A， protein expression of PP2A， and p-mTOR/mTOR expression were significantly increased， and the p-AMPK/AMPK was significantly decreased in the model group （P<0.05）. Compared with the model group， the renal pathological morphology changes were significantly improved， and the levels of SCr and BUN were significantly decreased. The mRNA expression of PP2A， protein expression of PP2A， and p-mTOR/mTOR expression in the renal tissue were significantly decreased， and the p-AMPK/AMPK was significantly increased （P<0.05） in all groups after drug intervention. In addition， the effect in the Hirudo+Notoginseng Radix et Rhizoma group was better. The mRNA expression levels of AMPK and mTOR in the renal tissue were not significantly different among the normal group， model group， and other groups. ConclusionThe efficacy of Hirudo and Notoginseng Radix et Rhizoma pairs in improving renal fibrosis in rats with CRF is significantly better than that of the single drug， and its improvement on renal fibrosis in rats with CRF may be related to the regulation of PP2A/AMPK/mTOR signaling pathway.

Objective To evaluate the clinical effect of Tension-free laparoscopic lateral suspension with mesh for pelvic organ prolapse.Methods A total of 85 patients who underwent pelvic organ prolapse were selected as the study group,and 40 patients underwent Laparoscopic sacral fixation surgery(LSC)as the control group in Henan Provincial People's Hospital from March 1,2021 to October 31,2023.The patients were divided into two subgroups:uterine preservation group and uterine resection group and followed up until April 30,2024.The intra-operative conditions and postoperative complications were recorded and analyzed.POP quantitative staging(POP-Q)scores were used for evaluation.Preoperative and postoperative quality of life and therapeutic effect were evaluated using the pelvic floor distress inventory short form-20(PFDI-20),urinary distress inventory-6(UDI-6),colorectal-anal distress inventory-8(CRADI-8),pelvic organ prolapse distress inventory-6(POPDI-6),pelvic floor impact questionnaire-7(PFIQ-7),prolapse and Incontinence sexual function questionnaire short form(PISQ-12).Results The median follow-up time for patients in the study group is 13.13 months,with an objective cure rate of 96.47%and a reoperation rate of 1.18%.The perioperative complication rates are 6.45%for uterine resection and 4.35%for uterine preservation,while the mesh exposure rate is 1.61%for uterine resection.In comparison,the median follow-up time for patients in the control group is slightly longer at 13.76 months,with an objective cure rate of 92.5%and a reoperation rate of 2.5%.The perioperative complication rates are higher at 14.71%for uterine resection and as high as 33.33%for uterine preservation,while the mesh exposure rate is also elevated at 8.82%for uterine resection.Despite these differences,there was no significant disparity in objective cure rates or reoperation rates between the study group and the control group.Furthermore,it was observed that the study group experienced shorter operation times,less bleeding,faster postoperative recovery,shorter hospitalization periods,lower perioperative complications,and reduced mesh exposure rates-especially among patients with uterine preservation.Additionally,intra-group comparisons revealed significant improvements in all POP-Q indicators one year after surgery(P<0.05),along with significantly lower scores on PFDI-20,UDI-6,CRADI-8,POPDI-6,PFIQ-7,and PISQ-12 scales com-pared to pre-surgery levels(P<0.05).However,no significant inter-group differences were noted.Conclusions Tension-free laparoscopic lateral suspension with mesh proves to be an effective surgical approach for treating ante-riorand middle pelvic organ prolapse.It demonstrates few perioperative complications while significantly improving prolapse symptoms and enhancing patient qualityof life.It stands as a viable alternative to sacrocolpopexy,particu-larly beneficial for patients with a preserved uterus.

Objective:To investigate the correlation between the clinical features and endoscopic ultrasound-guided portal pressure gradient (EUS-PPG) in patients with cirrhosis.Methods:A total of 148 patients with cirrhosis and portal hypertension who underwent EUS-PPG measurement at the Third Xiangya Hospital of Central South University from March 15, 2022 to June 20, 2023 were selected. The clinical data of patients collected before EUS-PPG measurement were analyzed. Variations in the EUS-PPG across different clinical data subgroups were analyzed. Multivariate linear regression analysis was used to explore the independent factors influencing EUS-PPG.Results:The EUS-PPG was significantly elevated in patients exhibiting red signs (16.62±5.33 mmHg VS 13.44±5.34 mmHg, t=3.616, P<0.001), gastroesophageal varices (15.78±5.30 mmHg VS 9.70±4.77 mmHg, t=4.247, P<0.001), hepatic encephalopathy (20.83±7.52 mmHg VS 14.92±5.35 mmHg, t=2.606, P=0.010), thrombocytopenia (15.66±5.39 mmHg VS 13.29±5.83 mmHg, t=2.136, P=0.034), hypoproteinemia (16.13±5.86 mmHg VS 14.12±5.03 mmHg, t=2.230, P=0.027), and an increased international normalized ratio (16.25±6.00 mmHg VS 14.40±5.11 mmHg, t=2.022, P=0.045). Conversely, the EUS-PPG was significantly reduced in patients with a history of splenectomy and devascularization (13.17±5.88 mmHg VS 15.73±5.34 mmHg, t=-2.379, P=0.019). The EUS-PPG in patients with varying degrees of ascites (no VS slight VS moderate or severe: 13.40±5.48 mmHg VS 15.90±5.49 mmHg VS 16.69±5.17 mmHg, F=5.188, P=0.007) and different Child-Pugh classifications (A VS B VS C: 14.07±5.05 mmHg VS 15.69±5.74 mmHg VS 17.64±5.99 mmHg, F=3.066, P=0.049) increased gradually. Multivariable linear regression analysis showed that red signs ( β=2.44, t=2.732, P=0.007), gastroesophageal varices ( β=4.45, t=2.990, P=0.003), ascites ( β=1.75, t=2.368, P=0.019), and hepatic encephalopathy ( β=5.82, t=2.644, P=0.009) were independent factors for the elevated EUS-PPG. Conclusion:There is a significant correlation between EUS-PPG and the clinical features related to the severity of cirrhotic portal hypertension, which indicates the feasibility of EUS-PPG in evaluating cirrhotic portal hypertension.

Objective To assess ocular biometric parameters among primary and secondary school students from Naxi,Bai and Han ethnic groups in Yunnan Province.Methods The school-based study was conducted in October 2020.A total of 724 second-,third-and seventh-graders were selected from Dali and Lijiang,where Bai and Naxi ethnic groups inhabit,using a stratified cluster sampling method to receive questionnaire surveys and eye examinations.Non-cycloplegic spherical equivalent(SE),axial length(AL),anterior chamber depth(ACD),corneal radius of curvature(CR),central corneal thickness(CCT),white-to-white(WTW)distance,and the AL/CR ratio were measured.Covariance analysis was used to examine the differences in SE and ocular biometric parameters in terms of ethnicity,sex and grade,while Pearson correlation was used to test the associations among the said indicators.Results There were no significant differences in daily outdoor time,screen time and sleep time among the three ethnic groups regardless of grades(all P＞0.05).The mean CCT of Naxi students was lower than that of Han and Bai students[grade 2 and grade 3:(542.48±39.76)μm vs.(553.81±31.83)μm and(559.27±32.79)μm;grade7:(538.86±34.91)μm vs.(547.41±33.55)μm and(548.26± 32.98)μm,all P＜0.05],while no significant differences were found in the other ocular biometric parameters among the three ethnic groups(all P＞0.05).Among the seventh-graders,the SE,AL and AL/CR ratio of Naxi students were signifi-cantly different from those of Han and Bai students(all P＜0.05).The AL,CR,ACD,CCT,WTW distance,and mean SE were lower in girls than in boys(all P＜0.05).Compared with grade 2 and grade 3,students of grade 7 had longer AL,deeper ACD and thinner CCT(all P＜0.05),while no significant differences were found in CR and WTW distance(all P＞0.05).Correlation analysis showed that the AL/CR ratio was highly correlated with SE(r=-0.78,P＜0.05).Conclu-sion Multiethnic primary and secondary school students may face similar environmental risks.Yet,disparities in ocular biometric parameters caused by ethnicity,sex and age should be noted.

In order to explore the chemical constituents of Sarcandra glabra(Thunb.)Nakai,10 compounds were isolated and identified from the water extraction of fresh aerial parts of Sarcandra glabra by silica gel column chromatography,polyamide column chromatography,gel column chromatography,and preparative high-performance liquid chromatography,including 2 elemane-type sesquiterpenoid glycosides,6 violet ketone sesquiterpenoid glycosides,and 2 phenolic acid compounds.Based on their physicochemical properties and NMR data,the above compounds have been identified as sarcaglaboside C(1),sarcaglaboside D(2),byzantionoside B(3),lauroside E(4),(4Z)-4-[(3S)-3-(β-D-glucopyranosyloxy)butylidene]-3,5,5-trimethyl-2-cyclohexen-1-one(5),dihydrovomifoliol-O-β-D-glucopyranoside(6),(+)-abscisyl-β-D-glucopyranoside(7),9ξ-O-β-D-glucopyranosyloxy-5-megastigmen-4-one(8),rosmarinic acid methyl ester(9)and methyl isorinate(10).Among them,compounds 3-5 and 8-9 were firstly isolated from S.glabra.The discovery of these compounds further enriches the structural types of compounds in S.glabra plants and provides an important material basis for subsequent pharmacological activity research.

In order to explore the chemical constituents of Sarcandra glabra(Thunb.)Nakai,10 compounds were isolated and identified from the water extraction of fresh aerial parts of Sarcandra glabra by silica gel column chromatography,polyamide column chromatography,gel column chromatography,and preparative high-performance liquid chromatography,including 2 elemane-type sesquiterpenoid glycosides,6 violet ketone sesquiterpenoid glycosides,and 2 phenolic acid compounds.Based on their physicochemical properties and NMR data,the above compounds have been identified as sarcaglaboside C(1),sarcaglaboside D(2),byzantionoside B(3),lauroside E(4),(4Z)-4-[(3S)-3-(β-D-glucopyranosyloxy)butylidene]-3,5,5-trimethyl-2-cyclohexen-1-one(5),dihydrovomifoliol-O-β-D-glucopyranoside(6),(+)-abscisyl-β-D-glucopyranoside(7),9ξ-O-β-D-glucopyranosyloxy-5-megastigmen-4-one(8),rosmarinic acid methyl ester(9)and methyl isorinate(10).Among them,compounds 3-5 and 8-9 were firstly isolated from S.glabra.The discovery of these compounds further enriches the structural types of compounds in S.glabra plants and provides an important material basis for subsequent pharmacological activity research.

In order to explore the chemical constituents of Sarcandra glabra(Thunb.)Nakai,10 compounds were isolated and identified from the water extraction of fresh aerial parts of Sarcandra glabra by silica gel column chromatography,polyamide column chromatography,gel column chromatography,and preparative high-performance liquid chromatography,including 2 elemane-type sesquiterpenoid glycosides,6 violet ketone sesquiterpenoid glycosides,and 2 phenolic acid compounds.Based on their physicochemical properties and NMR data,the above compounds have been identified as sarcaglaboside C(1),sarcaglaboside D(2),byzantionoside B(3),lauroside E(4),(4Z)-4-[(3S)-3-(β-D-glucopyranosyloxy)butylidene]-3,5,5-trimethyl-2-cyclohexen-1-one(5),dihydrovomifoliol-O-β-D-glucopyranoside(6),(+)-abscisyl-β-D-glucopyranoside(7),9ξ-O-β-D-glucopyranosyloxy-5-megastigmen-4-one(8),rosmarinic acid methyl ester(9)and methyl isorinate(10).Among them,compounds 3-5 and 8-9 were firstly isolated from S.glabra.The discovery of these compounds further enriches the structural types of compounds in S.glabra plants and provides an important material basis for subsequent pharmacological activity research.

In order to explore the chemical constituents of Sarcandra glabra(Thunb.)Nakai,10 compounds were isolated and identified from the water extraction of fresh aerial parts of Sarcandra glabra by silica gel column chromatography,polyamide column chromatography,gel column chromatography,and preparative high-performance liquid chromatography,including 2 elemane-type sesquiterpenoid glycosides,6 violet ketone sesquiterpenoid glycosides,and 2 phenolic acid compounds.Based on their physicochemical properties and NMR data,the above compounds have been identified as sarcaglaboside C(1),sarcaglaboside D(2),byzantionoside B(3),lauroside E(4),(4Z)-4-[(3S)-3-(β-D-glucopyranosyloxy)butylidene]-3,5,5-trimethyl-2-cyclohexen-1-one(5),dihydrovomifoliol-O-β-D-glucopyranoside(6),(+)-abscisyl-β-D-glucopyranoside(7),9ξ-O-β-D-glucopyranosyloxy-5-megastigmen-4-one(8),rosmarinic acid methyl ester(9)and methyl isorinate(10).Among them,compounds 3-5 and 8-9 were firstly isolated from S.glabra.The discovery of these compounds further enriches the structural types of compounds in S.glabra plants and provides an important material basis for subsequent pharmacological activity research.

In order to explore the chemical constituents of Sarcandra glabra(Thunb.)Nakai,10 compounds were isolated and identified from the water extraction of fresh aerial parts of Sarcandra glabra by silica gel column chromatography,polyamide column chromatography,gel column chromatography,and preparative high-performance liquid chromatography,including 2 elemane-type sesquiterpenoid glycosides,6 violet ketone sesquiterpenoid glycosides,and 2 phenolic acid compounds.Based on their physicochemical properties and NMR data,the above compounds have been identified as sarcaglaboside C(1),sarcaglaboside D(2),byzantionoside B(3),lauroside E(4),(4Z)-4-[(3S)-3-(β-D-glucopyranosyloxy)butylidene]-3,5,5-trimethyl-2-cyclohexen-1-one(5),dihydrovomifoliol-O-β-D-glucopyranoside(6),(+)-abscisyl-β-D-glucopyranoside(7),9ξ-O-β-D-glucopyranosyloxy-5-megastigmen-4-one(8),rosmarinic acid methyl ester(9)and methyl isorinate(10).Among them,compounds 3-5 and 8-9 were firstly isolated from S.glabra.The discovery of these compounds further enriches the structural types of compounds in S.glabra plants and provides an important material basis for subsequent pharmacological activity research.

In order to explore the chemical constituents of Sarcandra glabra(Thunb.)Nakai,10 compounds were isolated and identified from the water extraction of fresh aerial parts of Sarcandra glabra by silica gel column chromatography,polyamide column chromatography,gel column chromatography,and preparative high-performance liquid chromatography,including 2 elemane-type sesquiterpenoid glycosides,6 violet ketone sesquiterpenoid glycosides,and 2 phenolic acid compounds.Based on their physicochemical properties and NMR data,the above compounds have been identified as sarcaglaboside C(1),sarcaglaboside D(2),byzantionoside B(3),lauroside E(4),(4Z)-4-[(3S)-3-(β-D-glucopyranosyloxy)butylidene]-3,5,5-trimethyl-2-cyclohexen-1-one(5),dihydrovomifoliol-O-β-D-glucopyranoside(6),(+)-abscisyl-β-D-glucopyranoside(7),9ξ-O-β-D-glucopyranosyloxy-5-megastigmen-4-one(8),rosmarinic acid methyl ester(9)and methyl isorinate(10).Among them,compounds 3-5 and 8-9 were firstly isolated from S.glabra.The discovery of these compounds further enriches the structural types of compounds in S.glabra plants and provides an important material basis for subsequent pharmacological activity research.