Objective:To investigate the nootropic components of Hovenia dulcis.Methods: Six saponins were isolated from Hovenia dulcis and Step-down test was used to examine the memory ability of mice.The escape latency and the times of wrong performance within 3 min were used to evaluate the memory ability of mice.To study the effects of saponins on learning and memory in mice,we divided the mice into 6 groups:youth group,aged group,aged plus piracetam(0.3 g/kg) group,aged plus saponins(0.6 g/kg) group,aged plus saponins(0.3 g/kg) group,and aged plus saponins(0.15 g/kg) group.To study the influence of saponins on impairment of memory acquirement,consolidation,and reoccurrence(induced by scopolamine,sodium nitrite and 40% ethanol,respectively),mice were also divided into the following 7 groups:control group,untreated group,piracetam group(0.3 g/kg),compound 3 group(0.3 g/kg),compound 4 group(0.3 g/kg),compound 5 group(0.3 g/kg),and compound 6 group(0.3 g/kg).Results: The chemical structures of six saponins were elucidated as 3-O-stigmasterol-(6-O-palmitoyl)-?-D-glucopyranoside(1),?-daucosterin(2),hovenidulcioside A1(3),hoduloside Ⅰ(4),hoduloside Ⅳ(5),and saponins C2(6).Among them,compounds 1 and 2 were isolated from this plant for the first time.Compounds 5 and 6 had enhancing effect on the learning and memory ability of natural senile mice,and they could improve the impairment of memory acquirement,consolidation and recurrence in mice induced by scopolamine,sodium nitrite and 40% ethanol,respectively.Conclusion: The aglycone of jujubogenin might be the main saponins contributing to the nootropic effect of total saponins from Hovenia dulcis.

Objective To study the etiology, clinical and pathological characteristics, therapy and prognosis of acute renal failure (ARF). Methods The literature of 80 treated children with ARF from 1988. 1 to 2003.10 was reviewed. Results Sixty three cases (78.8%)suffered from mtrarenal ARF;47 glomerulonephritls (58. 8%); 15(18. 8%)prerenal ARF;2(2 5%)postrenal obstructive ARF. Twenty three cases with renal biopsy,9(39. 1%)MsPGN;4 (17. 4% ) MPGN; 4 (17. 4%) crescentic glomerulonephntis; 3 (13% ) endocapillary glomerulonephritls;2(8 7% )proliferative and sclerosing glomerulonephritis; 1(1. 3% )minimal changes. According to the different etiologic and pathological characteristics,different therapies were applied,infusion,oral prednisone ,and intravenous pulses of methylprednisone and cyclosphosphamide ,dialysis, or diuretic therapy and lowering blood. Thirty one (38. 8% )cases recov-ered;27(33 8% )cases improved; 10( 12.5% ) cases gave up treatments;21 (26 3% )died. The mortality of ARF from 1996 to 2003 was significantly lower than that from 1988 to 1995(x2 = 7.85 P

OBJECTIVE Tostudytheeffectofmetforminonglucolipidmetabolicdisorderscaused byolanzapineorquetiapineinrats.METHODS Olanzapine1mg·kg-1·d-1wasgivenigorquetiapine 20 mg·kg -1·d -1 was given ig for 4 d,and the dose increased to 40 mg·kg -1·d -1 from the 5th day.Met-formin 100 mg·kg -1·d -1 was given ig from the 15th day.The treatment lasted 8 weeks.Body mass, fasting blood sugar (FBS)and postprandial 2 hours blood glucose (2hPBG)were measured at base-line,3 d,1 week,2 week,4 week,6 week and 8 week.At the end of the 8th week,serum cholesterol (TC),triglyceride (TG),low density lipoprotein (LDL-C),high density lipoprotein (HDL-C),fruc-tosamine(FA)andinsulin(IRS)weremeasured.RESULTS Therewasnosignificantstatisticaldiffer-ence between normal control group and metformin 1 00 mg·kg -1·d -1 group.At the end of the 6th week, compared with normal control group,the body mass and 2hPBG were significantly increased in olanzap-ine 1 mg·kg -1·d -1 group and quetiapine 40 mg·kg -1·d -1 group (P<0.05),respectively.At the end of the 8th week,body mass,2hPBG,INS,FA,TC,TG,LDL-C were significantly increased (P<0.05), and HDL-C decreased in olanzapine group and quetiapine group(P<0.05),respectively.FBS was increased only in olanzapine group(P<0.05).Compared with olanzapine group or quetiapine group, body mass,FBS,2hPBG,INS,FA,TC,TG,LDL-C were significantly decreased by metformin admin-istration(P<0.05).CONCLUSION Metformincaneffectivelypreventandtreatweightgainand glucolipid metabolic disorder caused by olanzapine or quetiapine.

Objective To explore value of detecting fetal thymus size with the thymic-thoracic ratio (TT-ratio).Methods Prenatal ultrasonography examinations were performed on totally 317 normal singleton healthy pregnancies from 18 to 39 gestational weeks.The normal thymus of fetus were observed on the three-vessel-trachea (3VT) view.The anteroposterior diameter of the thymus (T1) was measured between the anterior border of the aortic arch and posterior border of sternum.The intrathoracic mediastinal diameter (T2) was measured between the anterior border of thoracic vertebral body and posterior border of sternum.The TT-ratio was then calculated as the ratio of T1 to T2.Scatter plot between TT-ratio and gestational age was drawn.And the Spearman regression analysis was performed.Results The thymus of fetus was shown as an irregular homogenous structure in the anterior mediastinum on the 3VT view.The mean TT-ratio was 0.45± 0.03.There was no correlation between TT-ratio and gestation (rs =0.06,P=0.29).Conclusion Prenatal ultrasound can display the thymus obviously.TT-ratio could be applied to assess the fetal thymus size,which can provides clinical basis for the detection of absent or hypoplastic thymus in fetus.

Pharmaceuticals were chosen as the entry point to analyze the status and characteristics of China′s pharmaceutical exports. An export competitiveness evaluation system was comprehensively constructed by selecting the scale, quality and progress of international trade as three dimensions. Net exports, export contribution rate, international market share, display comparative advantage index, competitive advantage index, Michaely index and export advantage growth index as seven indices. In order to avoid the discrepancy caused by the different angles of each index, the indicators were abstracted into two comprehensive ones through principal component analysis, to measure the export competitiveness of the world′s leading countries and regions in pharmaceuticals import and export directly. The result shows that China′s exporting competitiveness of pharmaceuticals ranks the sixth among the 10 major import and export countries in the world. On this basis, dialectical reference is made from Switzerland with strong export competitiveness of pharmaceutical products, in order to promote the long-term development of the export of pharmaceutical products in China.

This paper summarizes the current situation and existing problems of China's innovative drug market access policy from the basic aspects of innovative drug market access,such as intellectual property rights,drug pricing,medical insurance and bidding procurement.Based on the comprehensive analysis of Japan's innovative drug market access policy,through the comprehensive comparison of the two countries innovative drug market access policy differences,the paper put forward the practical measures to encourage the listing of innovative drugs in China,from the intellectual property rights,drug pricing,medical security and tender procurement in four areas.

Renal transplant recipients have a high rate of unplanned readmission, which will seriously affect the quality of life of recipients and their families, increase medical costs and the medical burden. Unplanned readmission of renal transplant recipients is the result of multiple factors, which is difficult to be well intervened by a single measure. This article reviews the status quo, related reasons, influencing factors and interventions of unplanned readmission of renal transplant recipients for reference in clinical practice.

Clinical pathway is an important quality management tool for regulating medical behavior both at home and abroad, and an important means of controlling medical costs in the reform of medical insurance payment methods.The author reviewed the current development status of clinical pathways both at home and abroad, focusing on summarizing the development experience of foreign countries, and analyzing the shortcomings in the development of clinical pathways in China from the perspectives of formulation, implementation, and evaluation. It is proposed that China should establish and improve the regulatory and incentive mechanisms for clinical pathways, accelerate the construction of supporting medical security systems, explore new incentive transmission models, attach importance to the role of patient participation in the formulation and implementation of clinical pathways, and so on, in order to provide reference for promoting the efficient development of clinical pathways in China.

Objective:To analyze the expression of cell division cycle associated protein 5 (CDCA5) in pancreatic cancer tissues and its correlation with prognosis based on the bioinformatics.Methods:The RNA sequencing data (HTSeq-FPKM) and corresponding clinical information of 168 pancreatic cancer samples from January to December 2021 were downloaded from the Cancer Genome Atlas (TCGA) database, and the data of 179 pancreatic patients from January to December 2021 were downloaded from the GEPIA2 database, and 171 normal pancreatic tissues from TCGA and GTEx databases were simultaneously integrated. The relative expression level of CDCA5 mRNA in pancreatic cancer patients in GEPIA2 database and its relationship with overall survival (OS) and disease-free survival (DFS) were explored. Combined with the clinical data of the patients, univariate and multivariate Cox regression model analysis was used to analyze the factors influencing the OS of pancreatic cancer patients. Gene set enrichment analysis (GSEA) was performed to investigate the possibly involved signal pathways of CDCA5 in pancreatic cancer.Results:In the GEPIA2 database, the relative expression level of CDCA5 mRNA in pancreatic cancer tissues was higher than that in normal pancreatic tissues, and the difference was statistically significant ( P < 0.05). The pancreatic cancer patients were divided into the high CDCA5 mRNA expression group (89 cases) and the low CDCA5 mRNA expression group (89 cases) according to the median of relative expression level of CDCA5 mRNA (the case equal to the median value was not subgrouped). Survival analysis showed that patients with high CDCA5 mRNA expression had shorter OS ( P = 0.024) and DFS ( P = 0.025) compared with those with low CDCA5 mRNA expression. Multivariate Cox analysis showed that in TCGA database, N staging ( HR = 2.15, 95% CI 1.24-3.72, P = 0.006) and CDCA5 expression ( HR = 1.71, 95% CI 1.23-2.38, P = 0.001) were independent influencing factors of OS for pancreatic cancer patients. The results of GSEA enrichment analysis indicated that high CDCA5 mRNA expression was enriched in 13 biological pathways [all P < 0.05, false discovery rate (FDR) < 0.005] including cell cycle, DNA replication, homologous recombination, pyrimidine metabolism, mismatch repair, pentose phosphate pathway, glycolysis gluconeogenesis and p53. The expression of CDCA5 mRNA was positively correlated with the expressions of HK2, PKM, PGK1, ALDOA, EN01 and LDHA (all P < 0.05). Conclusions:CDCA5 is highly expressed in pancreatic cancer tissues and is associated with poor prognosis of patients, and it can be used as a prognostic marker for pancreatic cancer.

China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.