ObjectiveTo investigate differential metabolites associated with browning in the post-harvest processing of Pinelliae Rhizoma， providing data support for elucidating the key metabolites and metabolic pathways involved in browning， and developing safe and efficient sulfur-free processing techniques. MethodsUltra-performance liquid chromatography-triple quadrupole/linear ion trap mass spectrometry（UPLC-QTRAP-MS/MS） was used to detect the metabolites of Pinelliae Rhizoma at different browning stages（0， 8， 16 h） for widely targeted metabolomics. Subsequently， Multivariate statistical analysis of metabolites was conducted using principal component analysis（PCA）， hierarchical cluster analysis（HCA）， orthogonal partial least squares-discriminant analysis（OPLS-DA）， and K-means cluster analysis. Differential metabolites at different browning stages were screened based on variable importance in the projection（VIP） value>1 and |log₂fold change（FC）|≥1， and metabolic pathway enrichment analysis was performed using Kyoto Encyclopedia of Genes and Genomes（KEGG）. ResultsA total of 1 416 metabolites were identified across the three browning stages of Pinelliae Rhizoma， predominantly comprising amino acids and their derivatives（239）， lipids（219）， alkaloids（156）， phenolic acids（121）， terpenoids（113）， and flavonoids（111）. A two-by-two comparison of the three browning phases， yielded 622 differential metabolites that were significantly enriched in the phenylpropanoid biosynthesis， flavone and flavonol biosynthesis， and purine metabolic pathway. Further analysis revealed that carbohydrates such as D-mannose and turanose， phenolic acids such as 1-O-caffeoyl-6-O-glucosyl-β-D-glucose， dicaffeoylshikimic acid， and flavonoids such as epigallocatechin gallate， vitexin-7-O-rutinoside， luteolin-7-O-（6″-malonyl）glucoside-5-O-arabinoside， catechin gallate， epicatechin gallate， isovitexin-7-O-glucoside-2″-O-rhamnoside， apigenin-7-O-rutinoside-4ʹ-O-sophoroside， 3，5，3ʹ，4ʹ，5ʹ-penta-hydroxyflavan-7-gallate may act as browning substrates and play important roles in the browning process. ConclusionCarbohydrates， phenolic acids， and flavonoids may serve as key substrates in the browning process of Pinelliae Rhizoma， involving pathways such as phenylpropanoid biosynthesis， flavone and flavonol biosynthesis， and purine metabolism， which can provide a theoretical basis for further exploration of the browning mechanism.

Objective:To evaluate the efficacy and safety of Nimotuzumab combined with concurrent chemoradiotherapy in elderly women with locally advanced cervical cancer.Methods:A retrospective analysis was conducted among elderly patients with cervical cancer who received nimotuzumab combined with concurrent chemoradiotherapy in the gynecology department of Beijing Hospital from November 2018 to March 2023.Efficacy assessments included the objective response rate(ORR), recurrence rates after 1-3 years of follow-up, and comparisons of the levels of squamous cell carcinoma antigen(SCC), carcino-embryonic antigen(CEA), and carbohydrate antigen 125(CA125)before and after treatment.Adverse reactions were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events(NCI-CTCAE)version 5.0.Results:A total of 47 elderly patients aged 60 years and older with stage ⅠB3-Ⅳa cervical cancer were included, with ages ranging from 60 to 76 years[mean age: (65.8±4.3) years; median age: 65(62, 70) years].The patients were divided into three age groups: 60-64 years(21 cases), 65-69 years(14 cases), and ≥70 years(12 cases).After treatment, SCC and CEA levels significantly decreased compared to pre-treatment levels, with statistically significant differences ( W=5.281 and 2.607, respectively; both P<0.05).However, there was no significant difference in CA125 levels before and after treatment( W=1.591, P=0.112).Among the 47 patients, 3 did not undergo post-treatment imaging examinations.Efficacy evaluation results were collected from 44 patients, including 21 cases of complete response(CR)(47.7%), 21 cases of partial response(PR)(47.7%), 1 case of stable disease(SD)(2.3%), and 1 case of progressive disease(PD)(2.3%).The ORR was 95.5%(42/44), and the diseae control rate was 97.7%(43/44).There were statistically significant differences in efficacy among different age groups(Fisher's exact test P=0.015).During the treatment process, a total of 36 patients experienced grade 3 or higher adverse reactions during treatment.Among them, 14 cases(29.8%)with grade 3 or higher acute hematological adverse reactions, 11 cases(23.4%)with grade 3 or higher acute gastrointestinal reactions, and 6 cases(12.8%)with grade 3 or higher acute urinary symptoms.Additionally, 2 cases of radiation cystitis and 3 cases of radiation proctitis were reported.There was no statistically significant difference in recurrence rates among different age groups(Fisher's exact test P=0.292).The highest recurrence rate among elderly patients was observed at the 2-3 year follow-up. Conclusions:For elderly patients with good organ function status, standard concurrent chemoradiotherapy combined with nimotuzumab may be an effective treatment for locally advanced cervical cancer.

Objective To evaluate the clinical efficacy of modified Yulinzhu Formula combined with plum-blossom needle tapping acupuncture in treating kidney-yang deficiency type of ovulatory dysfunction infertility(ODI).Methods A total of 100 ODI patients diagnosed at Hengshui Hospital of Traditional Chinese Medicine between January 2023 and January 2024 were enrolled and randomly divided into an observation group and a control group using a random number table,with 50 cases in each group.The control group received conventional western medical treatment,while the observation group received additional oral administration of modified Yulinzhu Formula and plum-blossom needle tapping acupuncture therapy.Treatment was administered for one menstrual cycle as a course,with three consecutive courses completed.After three months,clinical efficacy was assessed by comparing traditional Chinese medicine(TCM)syndrome scores,ovulation rate,pregnancy rate,proportion of type A endometrium,ovarian volume,antral follicle count(AFC),and adverse reactions between groups.Results(1)After treatment,the scores of TCM syndromes in the two groups were significantly improved(P＜0.05),and the improvement in the observation group was superior to that in the control group,the difference being significant(P＜0.05).(2)The total effective rate was 90.00％(45/50)in the observation group and 72.00％(36/50)in the control group.The curative effect of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).(3)The ovulation rate,pregnancy rate and the proportion of type A endometrium in the observation group were significantly superior to those in the control group,and the differences were statistically significant(P＜0.05).(4)After treatment,the ovarian volume and the number of antral follicles in the two groups were significantly improved(P＜0.05),and the improvement in the ovarian volume and the number of antral follicles in the observation group was superior to that in the control group,the difference being significant(P＜0.05).(5)The incidence of adverse reactions was 8.00％(4/50)in the observation group and 24.00％(12/50)in the control group.The incidence of adverse reactions in the observation group was significantly lower than that in the control group,the difference was statistically significant(P＜0.05).Conclusion Modified Yulinzhu Formula combined with plum-blossom needle tapping acupuncture effectively improves clinical symptoms,enhances ovulation/pregnancy rates,increases type A endometrium,optimizes ovarian volume and AFC,and reduces adverse reactions in kidney-yang deficiency ODI patients.

Objective:To evaluate the efficacy and safety of Nimotuzumab combined with concurrent chemoradiotherapy in elderly women with locally advanced cervical cancer.Methods:A retrospective analysis was conducted among elderly patients with cervical cancer who received nimotuzumab combined with concurrent chemoradiotherapy in the gynecology department of Beijing Hospital from November 2018 to March 2023.Efficacy assessments included the objective response rate(ORR), recurrence rates after 1-3 years of follow-up, and comparisons of the levels of squamous cell carcinoma antigen(SCC), carcino-embryonic antigen(CEA), and carbohydrate antigen 125(CA125)before and after treatment.Adverse reactions were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events(NCI-CTCAE)version 5.0.Results:A total of 47 elderly patients aged 60 years and older with stage ⅠB3-Ⅳa cervical cancer were included, with ages ranging from 60 to 76 years[mean age: (65.8±4.3) years; median age: 65(62, 70) years].The patients were divided into three age groups: 60-64 years(21 cases), 65-69 years(14 cases), and ≥70 years(12 cases).After treatment, SCC and CEA levels significantly decreased compared to pre-treatment levels, with statistically significant differences ( W=5.281 and 2.607, respectively; both P<0.05).However, there was no significant difference in CA125 levels before and after treatment( W=1.591, P=0.112).Among the 47 patients, 3 did not undergo post-treatment imaging examinations.Efficacy evaluation results were collected from 44 patients, including 21 cases of complete response(CR)(47.7%), 21 cases of partial response(PR)(47.7%), 1 case of stable disease(SD)(2.3%), and 1 case of progressive disease(PD)(2.3%).The ORR was 95.5%(42/44), and the diseae control rate was 97.7%(43/44).There were statistically significant differences in efficacy among different age groups(Fisher's exact test P=0.015).During the treatment process, a total of 36 patients experienced grade 3 or higher adverse reactions during treatment.Among them, 14 cases(29.8%)with grade 3 or higher acute hematological adverse reactions, 11 cases(23.4%)with grade 3 or higher acute gastrointestinal reactions, and 6 cases(12.8%)with grade 3 or higher acute urinary symptoms.Additionally, 2 cases of radiation cystitis and 3 cases of radiation proctitis were reported.There was no statistically significant difference in recurrence rates among different age groups(Fisher's exact test P=0.292).The highest recurrence rate among elderly patients was observed at the 2-3 year follow-up. Conclusions:For elderly patients with good organ function status, standard concurrent chemoradiotherapy combined with nimotuzumab may be an effective treatment for locally advanced cervical cancer.

Background: and Purpose To evaluate whether the thrombus enhancement sign (TES) can be used to differentiate embolic large vessel occlusion (LVO) from in situ intracranial atherosclerotic stenosis (ICAS)-related LVO in the anterior circulation of patients with acute ischemic stroke (AIS). Methods: Patients with LVO in the anterior circulation who underwent both non-contrast computed tomography (CT) and CT angiography and mechanical thrombectomy were retrospectively enrolled. Both embolic LVO (embo-LVO) and in situ ICAS-related LVO (ICAS-LVO) were confirmed by two neurointerventional radiologists after reviewing the medical and imaging data. TES was assessed to predict embo-LVO or ICAS-LVO. The associations between occlusion type and TES, along with clinical and interventional parameters, were investigated using logistic regression analysis and a receiver operating characteristic curve. Results: A total of 288 patients with AIS were included and divided into an embo-LVO group (n=235) and an ICAS-LVO group (n=53). TES was identified in 205 (71.2%) patients and was more frequently observed in those with embo-LVO, with a sensitivity of 83.8%, specificity of 84.9%, and area under the curve (AUC) of 0.844. Multivariate analysis showed that TES (odds ratio [OR], 22.2; 95% confidence interval [CI], 9.4–53.8; P<0.001) and atrial fibrillation (OR, 6.6; 95% CI, 2.8–15.8; P<0.001) were independent predictors of embolic occlusion. A predictive model that included both TES and atrial fibrillation yielded a higher diagnostic ability for embo-LVO, with an AUC of 0.899. Conclusion TES is an imaging marker with high predictive value for identifying embo- and ICAS-LVO in AIS and provides guidance for endovascular reperfusion therapy.

Objective:To assess the impact of the general education course entitled " The Basics of Radiation Protection" on enhancing undergraduates′ awareness of radiation safety, a questionnaire was utilized. Additionally, this study aims to propose novel strategies for improving health literacy among undergraduates, fostering the development of innovative, talented individuals with reasonable knowledge structures and strong practical abilities.Methods:From 2021 to 2022, 127 undergraduates from all colleges of Shandong University took the general course" The Basics of Radiation Protection". To compare the learning effects of the medical and non-medical students, invitations to participate in this study were extended to 101 (79.5%) students from School of Medicine and School of Electrical Engineering. A questionnaire survey was conducted to determine and compare the changes in the students’ basic cognition of radiation safety and protection before and after learning the course. The aim was to evaluate the teaching effectiveness and significance of the course.Results:From 2021 to 2022, 94 undergraduates from School of Medicine and School of Electrical Engineering accepted the invitation and voluntarily completed questionnaires twicely, accounting for 74.0% of the total number of selected students. The questionnaire survey showed that through course learning, the cognitive level of radiation protection among college students had significantly improved. The Likert quantification scores befroe taking the course were 3.59±1.35, 3.81±1.17, 3.45±1.16, 4.11±1.13, 3.62±1.05, 3.98±1.24 and after completing the course 4.94±0.32, 4.87±0.32, 4.96±0.21, 4.98±0.15, 4.81±0.39, 4.98±0.15, respectively, with the difference being statistically significant ( t=6.55, 5.50, 9.10, 5.36, 7.60, 5.34, P< 0.05). Further analysis revealed that different professional backgrounds affected students′ understanding of radiation safety and protection: before learning this course, medical students were superior to electrical engineering students in their knowledge of ionizing radiation ( t=5.69, 4.06, 6.46, 6.27, 7.78, P < 0.001). After taking the course, the cognitive level of students from both majors had considerably improved, but there was no significant difference ( P> 0.05). Feedback on the course learning showed that the awareness of " routine radiation protection" had significantly improved (96.8%), pseudoscience and pseudoinformation could be identified (93.6%), " nuclear power" -related fears had been dispelled (95.7%), and the concept of " cherishing life" had been effectively established (91.5%). Conclusions:The general education course " The Basics of Radiation Protection" has effectively improved the students′ awareness of radiation safety, strengthened their knowledge regarding radiation safety and protection, and provided a new avenue for cultivating innovative talents on a well-structured knowledge base. The course would be worth further promoting and applying in the education of undergraduates with different backgrounds and taking different majors.

Objective:To explore the method of fertility preservation in severe β-thalassemia prepubertal boys who cannot produce sperm before gonadotoxicity therapy.Methods:Three cases of severe β-thalassemia patients who were going to undergo hematopoietic stem cell transplantation (HSCT) were reported. They were received testis cryopreservation by slow-rate freezing. The necessity of fertility preservation in prepubertal boys and the methods of fertility persevation, testicular cryopreservation and the downstream techniques were stated.Results:Totally 31, 31, 20 pieces of testicular tissue were frozen by slow-rate freezing in three boys respectively and the freezing process went smoothly.Conclusion:The cryopreservation of testicular tissue can preserve the fertility of severe β-thalassemia prepuberty boys who will receive HSCT, leaving hope for offspring.

Objective:To explore the method of fertility preservation in severe β-thalassemia prepubertal boys who cannot produce sperm before gonadotoxicity therapy.Methods:Three cases of severe β-thalassemia patients who were going to undergo hematopoietic stem cell transplantation (HSCT) were reported. They were received testis cryopreservation by slow-rate freezing. The necessity of fertility preservation in prepubertal boys and the methods of fertility persevation, testicular cryopreservation and the downstream techniques were stated.Results:Totally 31, 31, 20 pieces of testicular tissue were frozen by slow-rate freezing in three boys respectively and the freezing process went smoothly.Conclusion:The cryopreservation of testicular tissue can preserve the fertility of severe β-thalassemia prepuberty boys who will receive HSCT, leaving hope for offspring.

Objective:To explore the research status, research focus and development trend of nursing human resource allocation in nursing homes in China.Methods:The article on nursing human resource allocation in nursing homes in China was systematically retrieved from China National Knowledge Infrastructure (CNKI), VIP and WanFang Data, and the retrieval time limit was from the establishment of the database to June 2022. CiteSpace was used to analyze the amount of articles, authors, institutions, funds and keywords, and draw a knowledge map.Results:A total of 890 articles were included. The number of articles and the support of national level funds were growing. The cooperation network among authors was extensive but not deep enough, and a core group of authors was not formed. A core journal group was formed. The research institute with the largest number of articles was the School of Nursing of Peking University. The article was mainly distributed in Beijing, Shanghai, Guangzhou and other first tier cities. The high-frequency keywords were "combination of medical care and nursing care" "supply" "demand" "talent training" and " care service for the aged", which could be clustered into 11 tags. The keyword cluster atlas showed that the combination of medical care and nursing care had always been the mainstream research direction in the field of nursing human resource allocation in nursing homes in China. "Qualitative research" "rural care for the aged " "care model for the aged " and "care industry for the aged " would become the emerging development trend in this field.Conclusions:The research on the nursing human resource allocation in nursing homes in China is growing. The research focuses on the combination of medical care and nursing care, talent training, care industry for the aged, and the supply and demand of care service for the aged. In the future, we should take the combination of medical care and nursing care as the leading mode, constantly improve our elderly care service system, build a nursing human resource allocation mode with Chinese characteristics in nursing homes, and promote the healthy aging development of society.

ObjectiveThe internal transcribed spacer （ITS） 2 region of ribosomal gene， a DNA barcode， was employed to identify 12 medicinal Aconitum species and the genetic relationship among the species was analyzed. MethodA total of 30 samples of the 12 species were collected. The DNA was extracted with spin column plant genomic DNA kit and the universal primers of ITS2 sequence were used for polymerase chain reaction （PCR） amplification， followed by electrophoresis detection and bi-directional sequencing. The yielded sequences were aligned and spliced by CodonCode Aligner 17.0 and sequence variation was analyzed by MEGA 7.0. The secondary structure was predicted by ITS2 Database and the neighbor-joining （NJ） method was applied to generate the phylogenetic tree. ResultThe ITS2 sequences of the 12 species were 220-221 bp， with the average guanine and cytosine （GC） content of 64.09%， 140 variable sites， 137 informative sites， and 81 conservative sites. The intraspecific genetic distance （K2P） was smaller than the interspecific genetic distance. According to the secondary structures of ITS2 sequences and NJ cluster analysis， A. scaposum， A. sinomontanum， and A. barbatum had close genetic relationship， while the rest nine showed close kinship， particularly A. soongaricum and A. yinschanicum. ConclusionITS2 sequence is of great value for the molecular identification and genetic relationship determination of Aconitum， which provides a new method for the study of ethnomedicine.