OBJECTIVE To form an expert consensus addressing clinical issues regarding the use of parenteral direct thrombin inhibitors （DTIs） in special populations. METHODS Led by the Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital（the Affiliated Hospital of UESTC）， a multidisciplinary working group was formed comprising experts from multiple fields， including clinical pharmacy， cardiac surgery， obstetrics， pediatrics and evidence-based medicine. Through literature review and the Delphi method， clinical questions regarding the efficacy and safety of parenteral DTIs used in special populations were identified. A structured design was adopted using the “Population-Intervention-Comparison-Outcome” （PICO） framework；systematic searches were conducted in CJFD， PubMed， Embase and other databases. Relevant evidence from randomized controlled trials，cohort studies and systematic reviews were included and synthesized. Evidence quality was assessed using the Grading of Recommendations Assessment，Development and Evaluation （GRADE） approach， and recommendations were formulated through three rounds of Delphi surveys and expert consensus meetings. RESULTS &CONCLUSIONS Seven clinical questions were ultimately selected （with a consensus rate exceeding 90%）， resulting in the formulation of seven recommendations on the use of parenteral DTIs in special populations， including children， pregnant women， patients with hepatic or renal impairment， patients with mesenteric venous thrombosis， and individuals with thrombophilia. These recommendations clarify the preferred agents， dosing ranges， monitoring parameters， and safety management strategies for parenteral DTIs in these special populations. This expert consensus， which is formulated based on the best available evidence， provides evidence-based guidance for standardized and individualized use of parenteral DTIs in special populations.

ObjectiveTo develop an assessment tool for apraxia of speech (AOS) of Chinese Putonghua speakers and test its reliability and validity. MethodsThe Chinese Apraxia of Speech Assessment and Diagnostic Tool (CAADT) was developed based on the Apraxia of Speech Rating Scale 3.5, combined with the linguistic characteristics of Chinese and clinical experience. The tool consistsed of eleven items across three sections: articulation, prosody and alternating motion rates. Six experts evaluated the content validity. From November, 2024 to May, 2025, 51 patients with post-stroke AOS (experimental group) and ten patients with post-stroke aphasia without AOS (control group) were recruited from Anhui Wannan Rehabilitation Hospital (the Fifth People's Hospital of Wuhu), and tested with CAADT. Reliability was assessed using Cronbach's α coefficient, Kendall's coefficient of concordance W and Pearson correlation coefficient. Validity was evaluated using the content validity index (CVI) and Spearman correlation coefficient. Discriminative effect was analyzed using the receiver operating characteristic (ROC) curve. ResultsThe Cronbach's α coefficients for the articulation and prosody sections and the total scale were all > 0.9, while it was 0.454 for the alternating motion rates. Inter-rater reliability was good (W ≥ 0.598, P < 0.001). Test-retest reliability showed high positive correlations for the three sections and the total score between the two assessments (r ≥ 0.84, P < 0.001). The scale-level CVI was 0.95, and the item-level CVI ≥ 0.83. The Spearman correlation coefficients among the sections ranged from 0.30 to 0.70. ROC analysis revealed an area under the curve of 0.953, with a cut-off value of 11, yielding a sensitivity of 0.92 and a specificity of 0.90. ConclusionCAADT demonstrates good reliability, validity and discriminative effect, which can be used for clinical assessment and auxiliary diagnosis of Chinese Putonghua speaking patients with post-stroke AOS.

To optimize the traditional refining process of Hydrargyrum Chloratum Compositum(HCC) and explore the change law of substances before and after refining, this study applied the hierarchical analysis method(AHP)-entropy weight method, using appearance, yield, and mercuric chloride content as evaluation indexes. The temperature and time of mild and strong fire were examined as single factors, and an L_9(3~4) orthogonal experiment was used to optimize the refining process. An infrared thermal imaging platform was set up to record the temperature changes on the surface of the tank, aiming to establish a standardized operating procedure for the refining process. Elemental changes, physical phase changes, and thermal property changes of the materials before and after refining were analyzed using atomic absorption spectrophotometry(AAS), X-ray diffraction(XRD) and differential scanning calorimetry(DSC). The results showed that the average overall score of the finished product obtained from the optimized HCC refining process(with mild fire temperature of 102 ℃, mild fire refining time of 30 min, strong fire temperature of 178 ℃, and strong fire refining time of 68 min) was 91.59, with an RSD of 0.076%, indicating that the process is stable and feasible. Combined with thermal imaging data and related research results, it was found that, at the strong fire temperature, mercury ions and nitrate ions generated mercuric chloride under the catalysis of other ions. The mercury content of mercurous chloride, mercuric chloride synthesized from nitric acid, HCC, and the pre-refined sample was 84.535%, 72.376%, 70.838%, and 41.334%, respectively. The highest intensity of the(120) diffraction peak for HCC appeared around 20.36°, but the residual fit value was larger. The synthesis of mercuric chloride from HCC and nitric acid showed an exothermic peak at 190-204 ℃, with the peak shape exhibiting a rightward trend. This study optimized the traditional refining process of HCC and analyzed the elemental changes, physical phase changes, and thermal property changes before and after refining. The findings provide experimental data for exploring the changing patterns in the refining process of HCC and its pharmacological value, as well as for standardizing the traditional refining process in clinical practice.
Drugs, Chinese Herbal/chemistry* ; X-Ray Diffraction ; Temperature ; Calorimetry, Differential Scanning ; Mercuric Chloride/chemistry*

Hongsheng Dan, historically referred to as the "surgical sacred medicine", is at risk of losing its refining technology in contemporary times. This study aimed to preserve and innovate this traditional non-heritage refining technology. By utilizing the analytic hierarchy process(AHP) combined with the entropy weight method, this study established the hierarchical structure model of refining process of Hongsheng Dan and conducted a single factor experiment and an L_9(3~4) orthogonal experiment to optimize the refining method of Hongsheng Dan. Additionally, the study employed infrared thermal imaging to monitor temperature variations of Hongsheng Dan during the refining process. The optimized refining parameters for Hongsheng Dan were established as follows: a slow fire temperature of 175 ℃ with a duration of 30 minutes, a strong fire temperature of 270 ℃ with a duration of 60 minutes, and a tail fire temperature of 180 ℃ with a duration of 15 minutes. The stability and feasibility of this optimized process were confirmed through validation tests. The research focused on the material transformation of Hongsheng Dan, starting from the material changes during the refining process of Hongsheng Dan and the synthesis of mercuric oxide from nitric acid. The study investigated elemental transformations, physical phase changes, and alterations in thermal properties. 78.98% of the mercury in Hongsheng Dan and 80.21% of the mercury in mercuric oxide from nitric acid were retained. The diffraction peak intensity of the(011) crystal plane of Hongsheng Dan was highest at approximately 30.07°, indicating that the(011) crystal plane had a preferred crystalline orientation. Furthermore, the temperature range for the alteration in thermal properties during the refining process of Hongsheng Dan was found to be between 80 ℃ and 130 ℃. This research not only optimized the refining technology of Hongsheng Dan but also pioneered the application of infrared thermal imaging to study temperature changes throughout the refining process. By exploring the material transformation patterns of Hongsheng Dan and the synthesis of mercuric oxide from nitric acid, the study provided technical support for the preservation and innovation of Hongsheng Dan.
Drugs, Chinese Herbal/standards* ; Temperature

Objective:To investigate the predictive value of color Doppler ultrasound combined with electrocardio-gram for right heart dys function in patients with pulmonary heart disease(PHD).Methods:A total of 100 PHD patients admitted in Dongcheng Branch of First Affiliated Hospital of Anhui Medical University between January 2020 and December 2023 were retrospectively analyzed.According to results of 6min walking test(6MWT),pa-tients were divided into good right heart function group(n=64,≥350m)and right heart dysfunction group(n=36,＜350m).The indexes of cardiac color ultrasound[isovolumic relaxation time(IVRT),isovolumetric contraction time(IVCT)and right ventricular Tei index],ECG[24h mean R-R interval standard deviation(SDNN),normal R-R interval standard deviation per 5min(SDANN)and the ratio of low frequency components to high frequency components(LF/HF)]were compared between two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of color Doppler ultrasound,ECG and their combination for right heart dys-function in PHD patients.Spearman correlation coefficient was used to analyze the association of color Doppler ul-trasound,ECG and their combination with right heart dysfunction in PHD patients.Results:Compared with those in good right heart function group,patients in right heart dysfunction group had significant higher IVRT[(120.64±14.08)ms vs.(97.87±10.93)ms],IVCT[(84.28±12.33)ms vs.(71.92±10.61)ms]and Tei index[(0.85±0.11)vs.(0.63±0.07)](P＜0.001 all),and significant lower SDNN[(75.52±12.58)ms vs.(85.58±11.75)ms],SDANN[(63.86±10.92)ms vs.(76.75±11.71)ms]and LF/HF[(1.33±0.19)vs.(1.84±0.27)](P＜0.001 all).ROC curve indicated that the AUC of color Doppler ultrasound combined ECG in diagnosing right heart dysfunction in PHD patients was 0.911(95％CI 0.838～0.959),which was significantly higher than those of color Doppler ultrasound[0.775(95％CI 0.681～0.853),Z=2.404,P=0.016]and ECG[0.688(95％CI 0.588～0.777),Z=3.968,P=0.001]alone.Spearman correlation analysis indicated that there was a significant positive correlation of color Doppler ultrasound(r=0.547),ECG(r=0.375)and their combination(r=0.810)with right heart dysfunction in PHD patients(P＜0.001 all),and the correlation between combined detection and right heart dysfunction in PHD patients was significantly higher.Conclusion:Color Doppler ultrasound combined with ECG possesses high diagnostic performance for right heart dysfunction in PHD patients.

Objective:To investigate the predictive value of color Doppler ultrasound combined with electrocardio-gram for right heart dys function in patients with pulmonary heart disease(PHD).Methods:A total of 100 PHD patients admitted in Dongcheng Branch of First Affiliated Hospital of Anhui Medical University between January 2020 and December 2023 were retrospectively analyzed.According to results of 6min walking test(6MWT),pa-tients were divided into good right heart function group(n=64,≥350m)and right heart dysfunction group(n=36,＜350m).The indexes of cardiac color ultrasound[isovolumic relaxation time(IVRT),isovolumetric contraction time(IVCT)and right ventricular Tei index],ECG[24h mean R-R interval standard deviation(SDNN),normal R-R interval standard deviation per 5min(SDANN)and the ratio of low frequency components to high frequency components(LF/HF)]were compared between two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of color Doppler ultrasound,ECG and their combination for right heart dys-function in PHD patients.Spearman correlation coefficient was used to analyze the association of color Doppler ul-trasound,ECG and their combination with right heart dysfunction in PHD patients.Results:Compared with those in good right heart function group,patients in right heart dysfunction group had significant higher IVRT[(120.64±14.08)ms vs.(97.87±10.93)ms],IVCT[(84.28±12.33)ms vs.(71.92±10.61)ms]and Tei index[(0.85±0.11)vs.(0.63±0.07)](P＜0.001 all),and significant lower SDNN[(75.52±12.58)ms vs.(85.58±11.75)ms],SDANN[(63.86±10.92)ms vs.(76.75±11.71)ms]and LF/HF[(1.33±0.19)vs.(1.84±0.27)](P＜0.001 all).ROC curve indicated that the AUC of color Doppler ultrasound combined ECG in diagnosing right heart dysfunction in PHD patients was 0.911(95％CI 0.838～0.959),which was significantly higher than those of color Doppler ultrasound[0.775(95％CI 0.681～0.853),Z=2.404,P=0.016]and ECG[0.688(95％CI 0.588～0.777),Z=3.968,P=0.001]alone.Spearman correlation analysis indicated that there was a significant positive correlation of color Doppler ultrasound(r=0.547),ECG(r=0.375)and their combination(r=0.810)with right heart dysfunction in PHD patients(P＜0.001 all),and the correlation between combined detection and right heart dysfunction in PHD patients was significantly higher.Conclusion:Color Doppler ultrasound combined with ECG possesses high diagnostic performance for right heart dysfunction in PHD patients.

There are complex neural mechanisms involved in speech production,and being well understood by clinicians and speech therapists can help them identify the abnormal speech and predict the severity of disorders.Dysarthria is a typical speech production problem by nerve injury,which would reduce the speech charity and intel-libility,and seriously affects patients'social communication and reduces the quality of life.The author summarizes the characteristics of dysarthria,neural pathway of normal speech production and neuromechanism of dysarthria based on the theory of motion control.The aim of this paper is to provide theoretical basis to conduct effective clini-cal assessment,management and treatment of speech disorders for clinians and speech therapists.

There are complex neural mechanisms involved in speech production,and being well understood by clinicians and speech therapists can help them identify the abnormal speech and predict the severity of disorders.Dysarthria is a typical speech production problem by nerve injury,which would reduce the speech charity and intel-libility,and seriously affects patients'social communication and reduces the quality of life.The author summarizes the characteristics of dysarthria,neural pathway of normal speech production and neuromechanism of dysarthria based on the theory of motion control.The aim of this paper is to provide theoretical basis to conduct effective clini-cal assessment,management and treatment of speech disorders for clinians and speech therapists.

Eighteen compounds were isolated from the methanol extract of the fruits of Litsea cubeba by silica gel, ODS, Sephadex LH-20 column chromatography, semi-preparative RP-HPLC, chiral HPLC and recrystallization. Their structures were elucidated by spectroscopic analyses and by comparison with reported spectroscopic data and physicochemical properties, and the absolute configurations of the enantiomers were established by experimental and calculated electronic circular dichroism spectra. These compounds were identified as (+)-(R)-4-hydroxypiperitenone (1a), (-)-(S)-4-hydroxypiperitenone (1b), (3S,4S,6R)-3,6-dihydroxy-1-menthene (2), (4S,5R)-4-hydroxy-5-isopropyl-2-methylcyclohex-2-en-1-one (3), (R)-6-hydroxy-3-(2-hydroxypropan-2-yl)-6-methylcyclohex-2-enone (4), (4S,6R)-4-hydroxy-6-isopropyl-3-methylcyclohex-2-enone (5), (1R,3S,4R)-3-hydroxy isopulegol (6), subamone (7), (6S)-3,7-dimethyl-7-hydroxy-2(Z)-octen-6-olide (8), (6S)-6,7-dihydroxy-3,7-dimethyloct-2(Z)-enoate (9), holostylactone (10), sesamin (11), dimethylmatairesinol (12), p-hydroxybenzoylcarbinol (13), syringaldehyde (14), p-hydroxybenzaldehyde (15), 4-hydroxy-3-methoxybenzaldehyde (16), 5,4ʹ-dihydroxy-7-methoxyflavone (17). Among them, compounds 1a and 1b were a pair of new monoterpenoid enantiomers, 8 and 9 were new natural products, 2-7, 10, 11 and 17 were isolated from Litsea genus for the first time. The in vitro anti-inflammatory effects of compounds 1-17 were evaluated using lipopolysaccharide-stimulated RAW264.7 cells, the results showed that compound 14 exhibited significant anti-inflammatory activity with NO inhibitory rate of 66.27% at a concentration of 40 μmol·L^-1.

Objective To explore the characteristics of speech prosody chunking,affect,focus and interaction function in patients with non-fluent aphasia after stroke. Methods From December,2023 to March,2024,patients with non-fluent aphasia after stroke(experimental group,n=25)and healthy subjects(control group,n=25)were recruited from Shanghai Fifth Rehabilitation Hospital,and the two groups were compared in terms of chunking,affect,focus and interaction performance using a self-ad-ministered speech prosody function assessment tool and acoustic analyzing instrument. Results In chunking prosody,there were differences in auditory discrimination(Z=-4.856,P<0.001),auditory recog-nition of"two chunks"(Z=-3.024,P=0.002),and subjective scores,total pause duration,average pause dura-tion,average syllabic duration and structural sonic rate(|Z|>2.911,P<0.001)of imitating"two chunks"and au-tonomously outputing"two chunks"and"three chunks"between two groups.In affect prosody,there were differ-ences in listening to distinguish different emotions(Z=-3.322,P=0.001),listening to identify"like emotion"(Z=-3.481,P=0.001),and the subjective score(Z=-6.214,P<0.001),average intensity(Z=-3.581,P<0.001)and standard deviation of intensity(Z=-3.181,P=0.001)of imitating"like emotion"between two groups;there were differences in the subjective score(Z=-5.510,P<0.001),average intensity(Z=-3.429,P=0.001),standard deviation of intensity(Z=-4.777,P<0.001)and fundamental frequency variation range(t=1.852,P=0.029)of autonomously outputing"like emotion"between two groups.In focus prosody,there were differences in listening to distinguish different focuses(Z=-2.658,P=0.008),listening to identify the"end of sentence"focus(Z=-2.023,P=0.011),and the peak stress intensity of imitating the"first sentence"focus(t=8.294,P<0.001);the subjective score(|Z|>5.102,P<0.001)and peak stress intensity(t>8.298,P<0.001)of imitating the"mid-sentence"and"end-sentence",and the subjective score(Z=-4.371,P<0.001)and peak stress intensity(t=8.842,P<0.001)of autonomously outputing the focus of the"first sentence"between two groups;there were differences in the subjective score(|Z|>4.970,P<0.001),peak stress intensity(t>9.373,P<0.001)and stress duration(|t|>2.912,P<0.01)of autonomously outputing the focus of the"mid-sentence"and"end-sentence".In the interaction prosody,there were no significant difference in auditory resolution and au-ditory recognition between two groups(P>0.05),however,there were significant differences in the subjective score(|Z|>4.938,P<0.001)and the fundamental frequency slope k(|t|>4.609,P<0.001)of the interrogative tone both in imitative output and autonomous output. Conclusion Patients with non-fluent aphasia showed significant abnormalities in the recognition and expression of"2 chunks""like emotion""sentence-final focus"and"questioning tone."