Eight new diterpenoids, Isodons A-H (1-8), comprising seco-abietane and abietane-type structures, together with 13 known analogues (9-21), were isolated from Isodon lophanthoides (Buch.-Ham. ex D. Don) Hara. The compounds (+)-3/(-)-3, (+)-4/(-)-4, and (+)-5/(-)-5 were identified as three enantiomeric pairs. The planar structures and absolute configurations of 1-8 were determined through high-resolution electrospray ionization mass spectrometry (HR-ESI-MS), 1D & 2D nuclear magnetic resonance (NMR) spectroscopy, electronic circular dichroism (ECD) calculations, and X-ray diffraction crystallography. A cholesterol 7α-hydroxylase (Cyp7a1) luciferase reporter assay revealed significant anti-cholestatic activities for compounds 1, (+)-4, 6, 7, 12-14, and 16. Additionally, compound 6 demonstrated anti-cholestatic effects through the farnesoid X receptor (FXR)-associated signaling pathways in vitro and in vivo. These findings suggest potential applications for I. Lophanthoides in pharmaceutical development.
Abietanes/pharmacology* ; Molecular Structure ; Animals ; Isodon/chemistry* ; Humans ; Diterpenes/pharmacology* ; Plant Extracts/chemistry*

Objective:To establish a risk prediction model based on least absolute shrinkage and selection operator (LASSO) regression for procalcitonin (PCT), milk fat globule-epidermal growth factor 8 (MFG-E8) and CXC chemokine ligand 9 (CXCL9) in elderly patients with liver cancer after transcatheter arterial chemoembolization (TACE) .Methods:A total of 150 elderly patients with liver cancer who underwent TACE treatment in Shishi City Hospital, Fujian Province and 910th Hospital of the Chinese People's Liberation Army Joint Logistic Support Force from August 2020 to August 2023 were selected as the study subjects. Patients with infection after TACE were included in the infected group and those without infection were included in the non-infected group according to whether the patients had infection during the postoperative hospitalization. The baseline data of patients were collected and compared. LASSO regression was used to screen the factors that may affect the infection after TACE in elderly patients with liver cancer and binary logistic regression analysis was performed. According to the results of regression analysis, a nomogram model was constructed based on the regression analysis results and the nomogram was internally validated using Bootstrap and receiver operator characteristic (ROC) curves.Results:There were 18 cases of infection in 150 elderly patients with liver cancer after TACE, with an incidence of 12.00%. There were statistically significant differences in focal rupture and bleeding ( χ2=5.92, P=0.015), ascites ( χ2=6.70, P=0.010), skin or mucosal damage ( χ2=6.67, P=0.010) between the infected group ( n=18) and the non-infected group ( n=132). The levels of serum PCT [ (1.17±0.32 ) μg/L vs. (0.91±0.14) μg/L], MFG-E8 [ (194.29±45.85) pg/ml vs. (158.76±28.63) pg/ml] and CXCL9 [ (948.49±52.38) pg/ml vs. (886.05±50.07) pg/ml] were higher than those in the non-infected group, with statistically significant differences ( t=4.13, P<0.001; t=4.55, P<0.001; t=4.94, P<0.001). Four factors related to infection after TACE intervention in patients with liver cancer were finally selected by LASSO regression model, skin or mucosal damage, PCT, MFG-E8, CXCL9 levels. Binary logistic regression analysis showed that skin or mucosal damage ( OR=13.48, 95% CI: 1.29-140.47, P=0.030), high levels of serum PCT ( OR=1.13, 95% CI: 1.05-1.22, P=0.001), MFG-E8 ( OR=1.04, 95% CI: 1.01-1.07, P=0.003), CXCL9 ( OR=1.05, 95% CI: 1.02-1.08, P=0.001) were risk factors for infection after TACE in elderly patients with liver cancer. Based on skin or mucosa damage, PCT, MFG-E8 and CXCL9, a nomogram prediction model for postoperative infection in elderly patients with liver cancer after TACE intervention was established. Calibration curve showed that the C-index of postoperative infection predicted by the nomogram model in elderly patients with liver cancer after TACE intervention was 0.939, indicating the model had good discrimination. ROC curve analysis showed that the area under the curve (AUC) predicted by the nomogram model for infection after TACE intervention in elderly patients with liver cancer was 0.960 (95% CI: 0.926-0.995, P<0.001), which had certain predictive value. The specificity, sensitivity and Youden index were 0.864, 0.944 and 0.808, respectively. Conclusions:Skin or mucosal damage, high levels of serum PCT, CXCL9 and MFG-E8 are closely related to postoperative infection in elderly patients with liver cancer after TACE, and the prediction model constructed based on this has better predictive performance for postoperative infection.

Purpose To investigate the clinicopathological features,diagnosis and differential diagnosis of the primordial odontogenic tumour(POT).Methods Clinical data of 4 cases of jawbone POT were collected.Imaging examination,HE,and immunohistochemical EnVision two-step staining was used to an-alyze their clinical and pathological characteristics,and relevant literatures were reviewed.Results The age arranged from 5 years to 21 years.2 cases were male and 2 case were female.There were 2 cases in maxilla and 2 cases in mandible.The clinical presentation was a slow growing painless mass.Cut sur-face of the tumor was appeared grayish yellow and grayish white,the tumor involved the crown of an unerupted tooth.The tumour consisted of a proliferation of spindled and stellate cells in myx-oid stroma.Surfaced by cuboidal to columnar epithelium forming papillary structures and invaginations.Calcification was observed in 2 cases.Conclusion POT is a rare benign mixed odontogen-ic tumor that is more common in children and adolescents.Mas-tering its characteristic histological morphology can make a cor-rect diagnosis.Local complete resection of the tumor has a good prognosis.

Objective To establish an ultra-high liquid chromatography(UPLC)characteristic spectrum of Rheum tanguticum Maxim.ex Balf.water decoction and conduct chemical pattern recognition analysis,and to identify the medicinal materials of different origins and different processed products.Methods:UPLC was adopted to establish the characteristic spectra of 15 batches of Rheum tanguticum Maxim.ex Balf.Cluster analysis combined with principal component analysis was used to analyze their quality.Rhei Radix et Rhizoma from different origins and different processed products of Rheum tanguticum Maxim.ex Balf.were identified.Results:The characteristic spectrum of Rheum tanguticum Maxim.ex Balf.water decoction was established,18 common peaks were identi-fied,and 15 batches of Rheum tanguticum Maxim.ex Balf.were divided into 2 categories according to their origins by cluster analysis.The similarity between 15 batches of samples from different origins and the control spectrum was greater than 0.900.According to OPLS-DA analysis,a total of 6 markers(rhein-8-O-β-D-glu-cosid,resveratrol-4'-O-β-D-(6''-O-D-gallyl)glucopyranside,isolindleyin,rhein,epicatechin-3-O-D-gallate,and catechin)affecting the quality of Rheum tanguticum Maxim.ex Balf.water decoction samples were found.Rhei Radix et Rhizoma from different origins and different processed products of Rheum tanguticum Maxim.ex Balf.can be effectively distinguished.Conclusion:The established characteristic spectrum method is easy to operate and has good repeatability.It can be used for the quality control of Rheum tanguticum Maxim.ex Balf.water decoction,and can provide reference for the formulation of quality standard of formula granules of Rhei Radix et Rhizoma.

Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.