Objective To optimize extraction technology of flavonesingredients from Herba Epimedii by uniform design. Methods Ultraviolet spectrophotometry was adopted to determine the content of total flavonoids. Content of epimedin A, epimedin B,epimedin C,icariin and baohuosideⅠ were determined by HPLC. U10?( 108 ) uniform design was used to conduct the multiple comprehensive evaluation of six ingredients and comprehensively analyze the influence of the concentration and amount of ethanol, extracting time on extraction of flavonesin gredients from Herba Epimedii. Results The uniform design experiment showed that 15-fold weight of 60% ethanol,extracting 2 times and each time with 165 min were the optimum extraction condition. Conclusion The method is easy and reasonable to handle,has stable and reliable results,and good repeatability and feasibility.It can be applied in industrial production.

Background and purpose:A pressing obstacle in clinical chemotherapy is drug resistance in breast cancer.A nano-delivery system,which has many advantages as a drug carrier,such as carrying anticancer drugs,can be used effectively to overcome drug resistance in tumors.This paper examined a new nano-delivery system,called calcium phosphate and glycerophosphocholine-mPEG(CAP/GPC-MPEG)composite nanoparticle and its influence on the cellular drug uptake of BCRP-over expressing mitoxantrone(MIT)-resistant breast cancer cell MCF-7/MIT.This paper will also examine its effect on overcoming drug resistance in the MCF-7/MIT cells.Methods:After the calcium phosphate and GPC-mPEG composite nanoparticles were designed and prepared,the entrapment efficiency and in vitro drug release of mitoxantrone-loaded nanoparticles were investigated.Quantitative comparisons were made between cellular uptake of drug-loaded nanoparticles and free drugs.Finally,a confocal laser scanning microscopy Was used to compare the subcellular distribution of drug-loaded nanoparticles and the free drugs.Results:Calcium phosphate and GPC-mPEG composite nanoparticles were nanoporous spherical particles with diameters between 50-100 mn.The MIT-loaded nanoparticles have an entrapment efficiency of(89.45±0.05)%.Although the drug-loaded nanoparticles showed an initial burst of drug release,it was followed by a more sustained release.The concentration of mitoxantrone was 1.89 times treated with MIT-loaded nanoparticles for 1 h compared to that treated with free mitoxantrone for 1 h in MCF-7/MIT cells.and which was 2.33 times in MCF-7 cells.Fluorescent red mitoxantrone appeared in the cytoplasm and nucleus of the MCF-7 and MCF-7,MIT cells treated with MlT-loaded nanoparticles whereas it is almost undetected in both cells treated with free mitoxantrone.Conclusion:Calcium phosphate and GPC-mPEG composite nanoparticles Can promote the cellular uptake and entering of mitoxantrone to the nucleus in MCF-7 and its corresponding BCRP-over expressing MIT-resistant MCF-7/MIT breast cancer cell lines.This nanoparticle is a potential nano-carrier for overcoming drug resistance in tumors.

Objective To investigate the correlations in target volumes based on positron emission tomography CT (PET/CT) and the end-expiration phase of four-dimensional CT (4D-CT) images for non-small cell lung cancer (NSCLC).Methods Seventeen patients with NSCLC sequentially underwent three-dimensional CT (3DCT),4D-CT and 18F-FDG PET/CT thoracic simulation scans.The gross target volume (GTV) was contoured on the end-expiration phase (50％) of 4D-CT and defined as GTV50％.The internal gross target volumes (IGTV) based on PET/CT images (IGTVPET) were determined by the standardized uptake value (SUV) 2.0 (IGTVPET2.0) and 20％ percentage of the maximal standardized uptake value (SUVmax) (IGTVPET20％).The following parameters were calculated to analyze the correlation between IGTVPET and GTV50％ in volume ratio (VR) and conformity index (CI):maximum transverse diameter of GTV50％,volume of GTV50％,the displacement of GTV in the cranial-caudal direction and 3D Vector calculated from 4D-CT dataset as well as the SUVmax.Results There was no significant correlation between the VR of IGTVPET2.0 to GTV50％ and the maximum transverse diameter of GTV50％,volume of GTV50％,the displacement of GTV in the cranial-caudal direction,3D Vector and the SUVmax (P ＞ 0.05).The VR between IGTVPET20％ and GTV50％ inversely related to maximum transverse diameter of GTV50％,volume of GTV50％ and SUVmax (r =-0.663,-0.669,-0.752,P ＜0.05).The CI between IGTVPET2.0 and GTV50％ positively related to volume of GTV50％ and maximum transverse diameter of GTV50％ (r =0.613,0.483,P ＜ 0.05).Conclusions 3D PET images provide a time-averaged image of the tumor during the numerous breathing cycle.They fail to include the full information of moving tumor.The target volumes based on 3D PET might not reflect the real IGTV of NSCLC.

Objective To prepare self-assembled thiolated chitosan derivatives gold nanoparticles (CS-GNRs) and carry out the feature tests.Methods CS-GNRs was prepared by chitosan derivatives and GNRs through strong metal sulfur chemical bond between thiols and gold on GNRs surface.Morphology features was tested by transmission electron microscope,dynamic light scattering was adopted to observe the size of nanoparticles.Ultraviolet-visible spectrophotometer was used to detect the optical properties and the property change.Meanwhile,the surface-enhanced Raman scattering (SERS) activity of CS-GNRs was investigated by using crystal violet (CV) as a probe molecular.Results CS-GNRs were in good shape,uniform particle size and good dispersion.The SERS of CV was enhanced,and the enhancement factor of CV adsorbed on CS-GNRs was up to 2×103.Conclusions The nanoparticles have potential application in molecular detection and Raman spectra detection.

Objective: To understand the nutritional literacy level and associated factors of primary and secondary school students in Beijing, so as to provide a scientific basis for improving student nutrition. Methods: From October 2022 to May 2023, a multi stage cluster random sampling method was employed to select a total of 14 568 primary, junior and senior high school students from 16 districts (ecluding the Economic Technological Development area) in Beijing. Through a survey questionnaire on nutritional literacy and dietary hehavior of school age children, basic information as well as data on nutritional literacy levels across four dimensions:nutrition related knowledge concepts, food selection, food preparation, and food intake dimensions were obtained. The Wilcoxon rank sum test, Kruskal-Wallis test, Spearman correlation analysis, Chi square test and binary Logistic regression were used for the analysis. Results: The median total score of nutritional literacy among primary and secondary school students in Beijing was 68.8. Approximately 26.0% of primary and secondary school students achieved nutritional literacy standards. The median scores and rates of meeting the standards for nutrition related knowledge concepts, food selection, food preparation and food intake dimensions were 23.0, 42.1%; 17.0, 27.4%; 6.5, 33.5%; 23.0, 33.3%, respectively. There were positive correlations between all pairs of the four dimensions ( r=0.33-0.49, P <0.05). The results of multiple Logistic regression analysis showed that primary school students, junior high school students, female students, suburban students, caregivers with a college education level and a bachelor s degree or above were the positive arrelation factors that promoted the achievement of nutritional literacy standards ( OR =2.21, 1.39, 1.18, 1.27, 1.42, 1.66, P <0.05). Conclusion The literacy level of primary and secondary school students in Beijing needs to be significantly improved. School stage, gender, region and caregiver s education level are associated factors.

Objective:To explore the effect of three-level delirium nursing management process on the treatment outcome and quality of care in the pediatric intensive care unit (PICU).Methods:Since January 2019, three-level delirium management process for PICU were developed. 75 children were randomly selected as the experimental group for 6 months, and 75 patients who received routine care between July and December 2018 were selected as the experimental group. The control group received routine nursing care, and compared the differences in the incidence, duration, and length of PICU stay in the intensive care unit (DICU) between the two groups of children. The family members' satisfaction with the quality of care and the evidence-based knowledge of PICU nurses were compared before and after implementation.Results:The incidence of DICU in the experimental group was 21.33% (16/75), the incidence of unsafe events related to DICU was 2.67% (2/75), and the control group was 40.00% (30/75), 12.00% (9/75). The difference was statistically significant ( χ2 values were 6.145, 4.807, P<0.05); the duration of the DICU in the test group (14.16±4.25) hours, and the length of ICU hospitalization (48.62 ± 8.85) hours were less than (17.37±5.36) hours and (52.03±8.10) hours in the control group, the difference was statistically significant ( t values were 2.070, 2.462, P<0.05); The score of Nursing Delirium Screening Scale (Nu-DESC) for nursing care of DICU patients in the two groups was not statistically significant ( P>0.05). The score of the test group after nursing was (1.72 ± 0.75) points, which was lower than (2.17±0.63) points of the control group. The difference was statistically significant ( t value was 2.159, P<0.05); The results of the nursing quality evaluation questionnaire showed that the satisfaction of family members in the test group with respect to nursing services was 93.33% (60/75), which was higher than 82.67% (52/75) in the control group, with a significant difference ( χ2 value was 4.040, P<0.05). After the implementation, the correct answer rate of the "risk factors for delirium" questionnaire in the deliberate evidence-based knowledge questionnaire was significantly higher than before the implementation ( P < 0.05). After 6 months of implementation, the score of evidence-based knowledge of delirium was (6.82 ± 1.74) points higher than (4.26 ± 0.85) points before implementation, the difference was statistically significant ( t value was 3.739, P<0.01). Conclusions:The three-level nursing management process in the PICU ward can better prevent the occurrence of paralysis, strengthen the quality of nursing services, and exercise the comprehensive quality of nursing staff.

Objective:To investigate the prevalence and predictors of delayed function independence (DFI) in patients with acute vertebrobasilar artery occlusion (VBAO) achieved successful recanalization after endovascular therapy.Methods:Patients with acute VBAO received endovascular treatment in the Departments of Neurology, the First Affiliated Hospital of University of Science and Technology and General Hospital of Eastern Theater Command, PLA from December 2015 to December 2018 were retrospectively enrolled. The demographic, clinical, laboratory and imaging data were collected. Early functional independence (EFI) was defined as the modified Rankin Scale score 0-2 at discharge, and DFI was defined as the modified Rankin Scale score 0-2 at 90 d after discharge for non-EFI patients. Multivariate logistic regression analysis was used to determine the independent predictors of DFI. Results:A total of 122 patients with acute VBAO were included. Their age was 61.8±11.9 years old and 91 (74.6%) were male. The median Glasgow Coma Scale (GCS) score was 7, the median National Institutes of Health Stroke Scale (NIHSS) score was 26.5, and the median posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) score was 9. Twenty-four patients (20.0%) had EFI; of the 98 patients with non-EFI, 18 (18.4%) had DFI. Multivariate logistic regression analysis showed that male (odds ratio [ OR] 0.038, 95% confidence interval [ CI] 0.002-0.658; P=0.025), cardiogenic embolism ( OR 0.116, 95% CI 0.023-0.579; P=0.009), baseline NIHSS score ( OR 1.136, 95% CI 1.040-1.242; P=0.005) and lung infection ( OR 6.089, 95% CI 1.451-25.562; P=0.014) were the independent predictors of DFI. Conclusions:Nearly 1/5 of the non-EFI patients have DFI. Male, cardiogenic embolism, lower baseline NIHSS score and without pulmonary infection are the independent predictors of DFI.

Objective:To investigate the occurrence of complications in domestic children's arterial blood specimen collection, analyze its influencing factors, so as to provide an improved basis for improving the quality of arterial blood specimen collection.Methods:This study adopted the cross-sectional research method. From July to September 2019, convenience sampling was used to select 2 235 children admitted to the Department of Pediatrics of 17 children's specialized hospitals and ClassⅢ Grade A hospitals across the country as the research object. The self-designed Childhood Arterial Blood Specimen Collection Complications Questionnaire was used to investigate the status of children's arterial blood specimen collection and the occurrence of complications, and its influencing factors were analyzed. Single factor analysis and binomial Logistic regression were used to analyze the influencing factors of complications in children's arterial blood specimen collection. A total of 2 235 questionnaires were issued, and 2 205 valid questionnaires were returned with the valid response rate of 98.7%.Results:The incidence of complications in the collection of arterial blood specimens in children was 73.2% (1 614/2 205) , mainly subcutaneous hemorrhage, accounting for 71.7% (1 581/2 205) . The incidence of single complications was 57.6% (1 269/2 205) . Binomial Logistic regression analysis showed that the angle of needle insertion, pressing time and the operator's working years were the influencing factors for the complications of arterial blood specimen collection in children, and the differences were statistically significant ( P<0.05) . Conclusions:The incidence of complications in the collection of arterial blood specimens in children is relatively high, which is related to the angle of needle insertion, pressing time, and the working years of the operator. It is necessary to establish standardized operating procedures and homogenized management to further improve the operating level and reduce the incidence of complications in the collection of arterial blood specimens in children.

Objective:To investigate the knowledge, attitude and practice of ICU medical staff in in ICU children with delirium in children's hospitals and analyze its influencing factors.Methods:Using the convenient sampling method, ICU medical staff from 26 children's hospitals in China were selected as the research objects from April 20, 2020 to May 10, 2020. A self-designed ICU pediatric delirium knowledge-attitude-practice questionnaire was used to investigate knowledge, attitude and practice scores of ICU medical staff in children's hospitals. Multiple linear regression analysis was used to analyze the influencing factors. A total of 740 questionnaires were collected, of which 734 were effective, with the effective recovery of 99.2%.Results:Among 734 ICU staff in children's Hospital, 78 (10.6%, 78/734) had a good knowledge of delirium and only 236 (32.2%, 236/734) had received training on ICU delirium. 395 (53.8%, 395/734) medical staff carried out clinical delirium management in ICU. And the assessment implementers were mainly doctors, accounting for 63.5% (251/395) , and nurse evaluators accounted for 36.5% (144/395) . The item with the highest score of attitude of 734 pediatric ICU medical staff towards delirium was "the need to understand the relevant knowledge of ICU delirium in clinical nursing work", with a score of (4.22±0.83) . Multiple linear regression analysis showed that the identity of medical staff, department and whether to receive training were the influential factors for the level of knowledge, attitude and practice of delirium among ICU medical staff in children's hospital ( P<0.05) . Conclusions:Pediatric ICU medical staff have insufficient knowledge of delirium and positive attitude towards ICU delirium. They have insufficient initiative in nursing behavior and the clinical development of ICU pediatric delirium management is insufficient and lacks standardization. It is recommended to carry out a diversified training program on ICU delirium related knowledge for pediatric ICU medical staff, formulate an ICU pediatric delirium assessment process and normalize the delirium assessment into clinical practice, so as to identify early delirium in ICU children and take preventive measures to reduce occurrence of delirium.

Objective To investigate the safety and efficacy of ciprofol combined with oxycodone in elderly patients who underwent endoscopic gastric mucosal dissection.Methods A total of 204 elderly patients in the outpatient department of the Northern Theater General Hospital who were to undergo endoscopic gastric mucosal dissection from March 2022 to December 2022 were selected as study participants.They were aged 60-75 years,with a body mass index of 18-30 kg/m2,and ASA grade Ⅱ or Ⅲ,regardless of sex.They were randomly divided into propofol(group P),ciprofol(group C),and ciprofol+oxycodone(group CO)groups,with 68 patients in each group.During anesthesia induction,group P was given propofol(1-1.5 mg/kg);group C,ciprofol(0.2-0.5 mg/kg);and group CO,oxyco-done hydrochloride(0.1-0.2 mg/kg)and ciprofol(0.2-0.5 mg/kg).The injection time of the three groups was>30 s.During anesthesia maintenance,ciprofol[1-1.5 mg/(kg·h)]was continuously injected intravenously in groups C and CO,and propofol[2-5 mg/(kg·h)]was continuously injected intravenously in group P.The modified observer's assessment of alertness/sedation score was evaluated at 3 min after anesthesia induction.If the score was≤1,endoscopy was started.The mean arterial pressure(MAP),heart rate(HR),and blood oxygen saturation(SpO2)at times T0(before drug injection),T1(when eyelash reflex disappeared),T2(when endoscopy began),and T3(when endoscope was withdrawn);visual analogue scale(VAS)scores at 30 min and 1 h after resuscitation;and induction time,recovery time,intravenous pain,respiratory depression,and other adverse reactions were recorded in the three groups.Results There were no significant differences in MAP,HR,and SpO2 at T0 and T3 among the three groups(all P>0.05).At T1 and T2,compared with those in group P,MAP,HR,and SpO2 in groups C and CO were significantly increased(all P<0.05).MAP,HR,and SpO2 in the CO group were slightly lower than those in the C group;however,the differences were not statistically significant(all P>0.05).Compared with that in group P,the incidence of respiratory depression and injection pain in groups C and CO was significantly reduced(P<0.05),but there was no statistically significant difference between groups C and CO(P>0.05).The VAS score at 30 min and 1 h after awakening and inci-dence of body movement in the CO group were lower than those in the P and C groups(all P<0.05);however,there was no statistically significant difference between the P and C groups(all P>0.05).Conclusion Ciprofol combined with oxycodone had definite sedative and analgesic effects in elderly patients undergoing endoscopic gastric mucosal dissection.Compared with the use of propofol or ciprofol alone,with combination therapy,the respiratory cycle is more stable,patients have fewer adverse reactions,and it is worthy of clinical application.