OBJECTIVE: To optimize the process for extraction and purification of Schisandrin in Fructus Schisandra Chinensis. METHODS: The orthogonal test L9( 34) was adopted to optimize the water extraction process using Schisandrin and its extracts as indicators. The parallel test was used to optimize the parameters of the alcohol precipitation technique. RESULTS: The optimized process for extraction and purification of Schisandrin was as follows: extracting three times using 10- fold water, 1. 5h each time, with filter liquids concentrated to 1. 4g of crude drug mL- 1 then precipitated to 80% ; filtering alcohol liquids, and adjusting pH value to 7. CONCLUSIONS: This method can be used as a reference for the extraction of Fructus Schisandra Chinensis.

Objective: To establish the fingerprint chromatogram of Compound Renshen Injection (CRSI). Methods: HPLC with ZORBAX SB-C18[4.6(i.d)?250mm] column was used, the acetonitrile-water (gradient elution) as a mobile phase and detection wavelength at 203nm. Results: Indicating 27 peaks on the HPLC-fingerprint of CRSI. Conclusion: The method is simple and accurate with a good reproducibility and can be used as a quality control method for CRSI.

Objective:To investigate the risk factors for hemorrhagic transformation (HT) after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS), and the predictive value of Neutrophil to lymphocyte ratio (NLR).Methods:Consecutive patients with AIS received IVT in Zhengzhou People’s Hospital from January 2021 to December 2022 were retrospectively enrolled. HT was defined as no intracranial hemorrhage was found on the first imaging examination after admission, and new intracranial hemorrhage was found on the imaging examination 24 h after IVT or when symptoms worsened. sHT was defined as HT and the National Institutes of Health Stroke Scale (NIHSS) score increased by ≥4 compared to admission or required surgical treatment such as intubation and decompressive craniectomy. The baseline clinical and laboratory data of the patients were collected, and NLR, lymphocyte to monocyte ratio (LMR), and platelet to neutrophil ratio (PNR) were calculated. Multivariate logistic regression analysis was used to identify the independent predictors of HT and sHT, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of NLR for HT and sHT after IVT. Results:A total of 196 patients were included (age 65.37±13.10 years, 124 males [63.3%]). The median baseline NIHSS score was 4 (interquartile range: 2-10). Twenty patients (10.2%) developed HT, and 12 (6.1%) developed sHT. Univariate analysis showed that there were statistically significant differences in age, baseline NIHSS score, creatinine, NLR, and stroke etiology type between the HT group and the non-HT group (all P<0.05); there were statistically significant differences in age, NLR, PNR, creatinine, baseline NIHSS score, and stroke etiological type between the sHT group and the non-sHT group (all P<0.05). Multivariate logistic regression analysis showed that NLR was an independent predictor of HT (odds ratio [ OR] 1.375, 95% confidence interval [ CI] 1.132-1.670; P=0.001) and sHT ( OR 1.647, 95% CI 1.177-2.304; P=0.004) after IVT. The ROC curve analysis showed that the area under the curve for predicting HT by NLR was 0.683 (95% CI 0.533-0.833; P=0.007), the optimal cutoff value was 5.78, the sensitivity and specificity were 55.0% and 84.1%, respectively. The area under the curve for predicting sHT by NLR was 0.784 (95% CI 0.720-0.839; P=0.001), the optimal cutoff value was 5.94, the sensitivity and specificity were 66.67% and 84.24%, respectively. Conclusions:A higher baseline NLR is associated with an increased risk of HT and sHT after IVT in patients with AIS, and can serve as a biomarker for predicting HT and sHT after IVT.

Hepatoma is one of the most common malignant tumors of digestive system worldwide， and a main factor leading to cancer-related deaths. Its incidence is increasing year by year， posing a serious threat to human health. Currently， hepatoma is mainly treated by surgical resection， liver transplantation， radiation and drugs， but there are certain adverse reactions and problems of high recurrence rate and low survival rate. Chinese medicine has unique advantages in improving the comprehensive curative effect of hepatoma and reducing adverse reactions. With a variety of active ingredients， Chinese medicine can induce hepatoma cell apoptosis， inhibit the proliferation， migration and reverse multidrug resistance through multiple targets， thus exerting anti-hepatoma effect. It has become an important means for the prevention and treatment of hepatoma as well as a rich resource for anti-hepatoma drug research and development. Wnt/β-catenin signaling pathway， one of the most classical pathways in cancer， is involved in tumor cell proliferation， cell cycle， migration， invasion and tumor angiogenesis. Recently， many studies have reported that the active ingredients of Chinese medicine can play an anti-hepatoma role through this pathway. Therefore， this paper summarized the domestic and foreign literature in recent years， analyzed the relationship between wnt/β-catenin signaling pathway and the specific mechanism of hepatoma occurrence and development， and combed the literature on the effect of flavonoids， terpenoids， alkaloids， polysaccharides and other active ingredients of Chinese medicine on inducing hepatoma cell apoptosis， regulating cell cycle and inhibiting the invasion and metastasis through Wnt/β-catenin signaling pathway. In addition， the paper summarized the research progress of relevant active ingredients of Chinese medicine against hepatoma， to explore their specific mechanism against hepatoma through Wnt/β-catenin signaling pathway， so as to provide theoretical reference for further development of anti-hepatoma drugs.

Peking Union Medical College Hospital, as one of the most stressful medical institutions in China, is facing the problem of emergency department overcrowding. In order to effectively alleviate the emergency overcrowding, improve the medical quality and patients′ medical experience, the hospital firmly grasped the two incremental links of " throughput" and " output" factors, established a multidisciplinary and multi-department cooperation team, constructed a close medical alliance cooperation mode, and innovated and explored a harmonious emergency overcrowding relief mode with the goal of unblocking the " exit" of patients. The practice showed that the comprehensive measures could effectively alleviate the problem of emergency overcrowding, and improve the medical environment and medical quality.

Cryoablation (CRA) and microwave ablation (MWA) are two main local treatments for hepatocellular carcinoma (HCC). However, which one is more curative and suitable for combining with immunotherapy is still controversial. Herein, CRA induced higher tumoral PD-L1 expression and more T cells infiltration, but less PD-L1^highCD11b⁺ myeloid cells infiltration than MWA in HCC. Furthermore, CRA had better curative effect than MWA for anti-PD-L1 combination therapy in mouse models. Mechanistically, anti-PD-L1 antibody facilitated infiltration of CD8⁺ T cells by enhancing the secretion of CXCL9 from cDC1 cells after CRA therapy. On the other hand, anti-PD-L1 antibody promoted the infiltration of NK cells to eliminate PD-L1^highCD11b⁺ myeloid cells by antibody-dependent cell-mediated cytotoxicity (ADCC) effect after CRA therapy. Both aspects relieved the immunosuppressive microenvironment after CRA therapy. Notably, the wild-type PD-L1 Avelumab (Bavencio), compared to the mutant PD-L1 atezolizumab (Tecentriq), was better at inducing the ADCC effect to target PD-L1^highCD11b⁺ myeloid cells. Collectively, our study uncovered the novel insights that CRA showed superior curative effect than MWA in combining with anti-PD-L1 antibody by strengthening CTL/NK cell immune responses, which provided a strong rationale for combining CRA and PD-L1 blockade in the clinical treatment for HCC.