Background: Xiaochaihu capsules are a widely used traditional Chinese patent medicine. The extraction process, a critical step in their production, necessitates online monitoring to determine the levels of key indicators, thereby informing subsequent processing stages. Objective: The objective of this study was to establish online quantitative models for 6 key indicators (solid content, liquiritin, baicalin, wogonoside, glycyrrhizic acid, and saikosaponin B ) during the extraction process of Xiaochaihu capsules. This approach aims to provide a technical foundation for enhanced process control and to serve as a methodological reference for the application of multisource information fusion in monitoring the extraction of multi-herb traditional Chinese medicine formulations. Methods: Online quantitative models were developed based on multiple sensors, ultraviolet-visible spectroscopy (UV-Vis), and near-infrared spectroscopy (NIR) to monitor 6 indicators during the extraction process of Xiaochaihu capsules. Different preprocessing methods for spectroscopic data were optimized, and data fusion strategies were integrated to improve the predictive performance of the online quantitative models. Results: The optimal modeling strategies for the 6 indicators were as follows: for solid content, a second-order polynomial model was established using the measurement results from 2 sensors (pH and conductivity), with a predictive coefficient of determination (R ) of 0.9821. For baicalin, the optimal model was developed using UV-Vis spectra pretreated with the first derivative (1stD), achieving a predictive R of 0.9841. For wogonoside, modeling was also conducted after 1stD preprocessing of the UV-Vis spectra, yielding a predictive R of 0.9929. For liquiritin, a high-level fusion strategy combining UV-based feature extraction via the random frog (RF) algorithm and NIR-based feature extraction via competitive adaptive reweighted sampling (CARS) was used, achieving an R of 0.9406 in the validation set. For glycyrrhizic acid, the optimal approach involved a combination of UV-CARS feature extraction and NIR-RF feature extraction, coupled with high-level data fusion, resulting in an R of 0.9859 in the validation set. For saikosaponin B , the optimal scheme utilized UV-RF feature extraction combined with NIR-CARS feature extraction and high-level fusion (R = 0.7702 in the validation set). Conclusion: The integration of process analytical technologies and data fusion strategies enabled the successful establishment of online quantitative models for 6 indicators during the extraction process of Xiaochaihu capsules. Overall, the established online quantitative models effectively captured and reflected the dynamic changes of these indicators throughout the extraction process.

The antidepressant activity and molecular mechanisms of Yueju Wan volatile oil were investigated. The Yueju Wan volatile oil was extracted by using supercritical CO_2. Gas chromatography-mass spectrometry(GC-MS) combined with network pharmacology identified 28 chemical constituents in Yueju Wan volatile oil, primarily terpenes and lactones. A total of 123 overlapping targets were associated with depression, including core targets of interleukin-1β(IL-1β), signal transducer and activator of transcription 3(STAT3), and caspase-3(CASP3). These targets were mainly involved in the prolactin, advanced glycation end products/receptor(AGE/RAGE), and phosphoinositide 3-kinase/protein kinase B(PI3K/Akt) signaling pathways. A reserpine-induced depression mouse model was established to evaluate the therapeutic effects and mechanisms of Yueju Wan volatile oil. The effects of Yueju Wan volatile oil on depression-like behavior in mice were evaluated by analyzing body mass, body temperature index, tail suspension immobility time, forced swimming immobility time, and sucrose preference. Hematoxylin-eosin(HE) staining revealed neuronal protection of Yueju Wan volatile oil in the brain of mice. Enzyme-linked immunosorbent assay(ELISA) and Western blot were employed to detect the protein expression of AGEs, IL-1β, phosphorylated PI3K(p-PI3K), Akt, phosphorylated Akt(p-Akt), nuclear factor κB(NF-κB), and brain-derived neurotrophic factor(BDNF). Behavioral evaluation showed that Yueju Wan volatile oil could effectively control the decline of body mass and body temperature of depressed mice, reduce tail suspension and swimming immobility time, and enhance their preference for sucrose. Histopathological examination showed that Yueju Wan volatile oil could alleviate the neuronal damage in CA1 and dentate gyrus(DG) of the hippocampus of mice. ELISA and Western blot results showed that Yueju Wan volatile oil could significantly increase the protein expression levels of PI3K, Akt, and BDNF and significantly decrease the protein expression levels of AGEs, IL-1β, p-PI3K, p-Akt, and NF-κB in the hippocampus of mice. Furthermore, the p-PI3K/PI3K and p-Akt/Akt ratios were significantly decreased at medium and high doses. These findings suggest that the aromatherapy of Yueju Wan volatile oil can significantly improve reserpine-induced depression-like behavior in mice, which may be related to reducing the expression of neuronal membrane protein AGEs, reducing the phosphorylation levels of PI3K and Akt, inhibiting NF-κB entry into the nucleus, and alleviating the release of pro-inflammatory factors and nerve injury.
Animals ; Antidepressive Agents/chemistry* ; Mice ; Proto-Oncogene Proteins c-akt/immunology* ; Phosphatidylinositol 3-Kinases/immunology* ; Oils, Volatile/chemistry* ; Male ; Drugs, Chinese Herbal/chemistry* ; Signal Transduction/drug effects* ; Depression/metabolism* ; Glycation End Products, Advanced/immunology* ; Humans

The extraction process of traditional Chinese medicine(TCM) is an important part in the production and processing of TCM products. The modeling of this process is of great significance for achieving intelligent production. This paper summarizes the modeling methods for the extraction process of TCM, which mainly include mechanism modeling, empirical formula modeling, data-driven modeling, and mixed modeling. Among them, mechanism modeling and data-driven modeling are widely used. Furthermore, this paper suggests that the future research on the modeling of the extraction process of TCM can be carried out from the following five aspects: in-depth research and development of the extraction process of TCM compound prescriptions, complete description of the whole extraction process of TCM, development of methods for accurate determination of the properties of TCM decoction pieces before extraction, development of adaptive self-optimization technology for models, and construction of models based on a new generation of artificial intelligence methods.
Drugs, Chinese Herbal/chemistry* ; Medicine, Chinese Traditional/methods* ; Models, Theoretical ; Artificial Intelligence ; Humans

OBJECTIVE: To explore clinical efficacy of membrane-induced technique combined with gastrocnemius muscle flap transposition in treating traumatic osteomyelitis of the upper tibia. METHODS: A retrospective analysis was conducted on 7 patients with traumatic osteomyelitis of the upper tibia who were treated with membrane-induced technique combined with gastrocnemius muscle flap transposition from January 2022 to December 2023. Among them, there were 4 males and 3 females; aged from 29 to 57 years old; 4 patients were treated after open fracture, 2 patients were treated after closed fracture, and 1 patient was treated after scalding; the courses of disease ranges from 2 weeks to 8 years; sinus tracts were present in all patients, and the lesion range of the tibia ranged from 5 to 9 cm. The results of deep tissue bacterial culture showed that 2 patients were negative, 3 patients were staphylococcus aureus, 1 patient was methicillin-resistant staphylococcus aureus, and 1 patient was pseudomonas aeruginosa and 1 patient was klebsiella pneumoniae. After debridement, the range of bone defect ranged from 8 to 12 cm, and the cortical defect accounted for approximately 30% of the circumference. The area of soft tissue defect ranged from 8.0 cm×2.0 cm to 10.0 cm×6.0 cm. At the first stage, vancomycin-loaded/meropenem/gentamicin-loaded bone cement was implanted. The gastrocnemius muscle flap was repositioned to cover the wound surface and free skin grafting was performed. After an interval of 7 to 10 weeks, the stageⅡsurgery was performed to remove bone cement. Autologous iliac bone mixed with vancomycin/gentamicin and calcium sulfate artificial bone was transplanted, and the wound was sutured. One patient retained the original internal plants, one patient removed the internal plants and replaced them with steel plate external fixation, one patient replaced the internal plants and added steel plate external fixation, and three patients were simply fixed with steel plate external fixation. One year after operation, the recovery of knee joint and ankle joint functions was evaluated by using Hospital for Special Surgery (HSS) knee joint score and Kofoed ankle joint function score respectively. RESULTS: All patients had their wounds closed simultaneously with bone cement implantation and healed well. All patients were followed up for 12 to 17 months after operation, and satisfactory bone healing was achieved at 6 months after stageⅡsurgery. Twelve months after operation, all patients had good bone healing without obvious limping was observed when walking. At 12 months after operation HSS knee joint score ranged from 93 to 100 points, and Kofoed ankle function score ranged from 96 to 100 points. CONCLUSION For traumatic osteomyelitis of the upper tibia, a staged treatment plan combining membrane-induced technique and gastrocnemius flap transposition on the basis of thorough debridement could safely cover the wound surface, effectively control bone infection and achieve satisfactory bone healing, without adverse effects on limb function.
Humans ; Male ; Female ; Middle Aged ; Osteomyelitis/surgery* ; Adult ; Surgical Flaps ; Retrospective Studies ; Tibia/injuries* ; Muscle, Skeletal/surgery*

Objective:To investigate the mechanism of inhibition for Janus tyrosine kinase,signal transducer and activator of transcription(JAK/STAT)on ferroptosis,myocardial remodeling,and JAK/STAT melatonin receptor 1-nuclear factor E2-related factor 2-glutathione peroxidase 4(MT1-Nrf2-GPX4)signaling axis in rats with heart failure(HF)under echocardiography.Methods:Forty SD rats were selected,and they were randomly divided into blank control group,model group,interleukin-6(IL-6)group and tyrosine phosphorylation inhibitor(AG490)group according to random number table,with 10 rats in each group.HF rat models were established in three groups except the blank control group.The expression levels of JAK/STAT mRNA in myocardial tissue among 4 groups were compared and analyzed.The small animal ultrasound imaging system was used to measure a series of cardiac function indexes included interventricular septum(IVS)thickness,left ventricular posterior wall(LVPWs)thickness,left ventricular posterior wall(LVPWd)thickness,left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and ejection fraction(EF).The Fe2+concentration and lesions of myocardial tissue,as well as the expressions of MT1,Nrf2 and GPX4 proteins,in the four groups were compared and analyzed.Results:The increases of JAK1 and STAT3 mRNA levels,and Fe2+concentration in the model group,IL-6 group and AG490 group were higher than those in the blank control group,and the protein expression levels of MT1,Nrf2 and GPX4 in them were lower than those in the blank control group,and the differences of the above indicators between the model group and the blank control group were statistically significant(t=11.810,16.250,17.150,10.460,9.272,11.180,P＜0.05),and the differences of the above indicators between the IL-6 group and the blank control group were statistically significant(t=9.834,19.030,16.320,14.450,13.250,14.070,P＜0.05),and the differences of them between the AG490 group and the blank control group were statistically significant(t=8.025,11.050,17.590,4.173,4.179,4.183,P＜0.05),respectively.The levels of STAT3 mRNA level and Fe2+concentration in IL-6 group were higher than those in the model group,and the expression levels of MT1,Nrf2 and GPX4 proteins in that were lower than those in the model group,and the differences were statistically significant(t=2.224,2.582,3.550,3.078,2.624,P＜0.05),respectively.The levels of JAK1,STAT3 mRNA and Fe2+concentration in the AG490 group were lower than those in the model group,and the levels of MT1,Nrf2 and GPX4 in that were higher than those in the model group,and the differences were statistically significant(t=4.052,6.930,8.598,6.247,5.055,6.799,P＜0.05),respectively.The IVS,LVPWs,LVPWd and EF of the model group,IL-6 group and AG490 group were lower than those of the blank control group,and the LVEDD and LVESD of them were higher than those of the blank control group,and the differences of these indicators between the model group and the blank control group were statistically significant(t=13.740,11.100,5.654,7.049,13.440,14.260,P＜0.05),and the differences of them between the IL-6 group and the blank control group were statistically significant(t=16.090,13.140,8.103,9.174,15.940,17.010,P＜0.05),and the differences of them between the AG490 group and the blank control group were statistically significant(t=5.474,4.947,2.682,4.071,8.608,13.300,P＜0.05),respectively.The LVPWd and EF in the IL-6 group were lower than those in the model group,and the LVEDD and LVESD in the IL-6 group were higher than those in the model group,and the differences of them were statistically significant(t=2.417,2.327,2.236,2.818,P＜0.05),respectively.The IVS,LVPWs,LVPWd and EF in the AG490 group were higher than those in the model group,and the LVEDD and LVESD in that were lower than those in the model group,and the differences were statistically significant(t=8.598,7.147,3.514,3.361,4.914,2.970,P＜0.05),respectively.Conclusion:Inhibition of JAK/STAT expression can improve the cardiac structure of HF rats,and relieve ventricular remodeling,and inhibit ferroptosis of cardiomyocyte,and promote the expression of MT1,Nrf2 and GPX4 proteins.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

In the past 50 years,Jiashan County had leveraged the platform of Zhejiang University and relied on its independent cancer prevention and treatment institute to vigorously carry out co-lorectal cancer prevention and control work,which made remarkable results and becoming a na-tional model for county-level cancer prevention and control.The paper summarized the develop-ment history of Jiashan Institute of Cancer Prevention and Treatment,the process of colorectal cancer prevention and treatment,the establishment and main results of tumor registry and three-level cancer prevention system,and looked forward to the future cancer prevention and control work in Jiashan County.

Objective To explore the predictive value of serum procalcitonin(PCT),peripheral blood complement C3,C4 and lymphocyte subsets CD3+,CD4+and CD8+cells for plastic bronchitis(PB)in children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods A total of 222 children with RMPP were selected and divided into the PB group(51 cases)and the non-PB group(171 cases)based on whether they were complicated with PB.The serum PCT level of the children at admission was detected by fluorescence immunoquantitative analyzer,and levels of complement C3 and C4 were detected by immunoturbidimetry.The proportions of CD3+,CD4+and CD8+T lymphocytes were detected by flow cytometry.Multivariate Logistic regression analysis was conducted to analyze influencing factors of PB in children with RMPP.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of the indicators.Results The levels of PCT and CD8+T cells and the duration of fever were higher in the PB group than those in the non-PB group,while the levels of complement C3 and CD4+T cells were lower than those in the non-PB group(P＜0.05).Elevated levels of PCT and CD8+T cells were risk factors for the occurrence of PB in children with RMPP,while elevated levels of complement C3 and CD4+T cells were protective factors for the occurrence of PB in children with RMPP(P＜0.05).The AUCs of PCT,complement C3,the proportion of CD4+T cells and the proportion of CD8+T cells predicted separately were 0.763,0.802,0.788 and 0.802 respectively,and the AUC of combined prediction was 0.915.The AUCs of individual predictions were all lower than those of the combined AUC(Z=3.199,2.825,3.112 and 2.514,P＜0.05).Conclusion PCT,complement C3,CD4+T cell ratio,and CD8+T cell ratio are influencing factors for the occurrence of PB in children with RMPP,and their combined detection is beneficial for the early prediction of PB.

Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91％of the total clinical isolates and 4.07％of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89％were isolated from children and 33.11％were isolated from adults.More than 90％of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79％in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06％were isolated from children and 19.94％isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0％.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.