OBJECTIVE To establish the high-performance liquid chromatography （HPLC） fingerprint of Sagina japonica ， and to establish a quantitative analysis of multi-components by single-marker （QAMS） method for simultaneous determination of six componen ts in S. japonica ， aiming to provide references for the quality control of this medicinal herb. METHODS HPLC method was used to establish the fingerprints of 12 batches （No. S1-S12） of S . japonica according to Similarity Evaluation System of Chromatographic Fingerprint of Traditional Chinese Medicine . The similarity evaluation and identification of common peaks were conducted， followed by cluster analysis （CA） and principal component analysis （PCA） for 12 batches of samples. Using vicenin-2 as internal reference， the contents of p-hydroxy cinnamic acid， apigenin-6-C-arabinoside-8-C-glucoside， isoorientin， vitexin and 20-hydroxyecdysone were determined by QAMS method. The results were then compared with those obtained by the external standard method. RESULTS The similarities of HPLC fingerprints for 12 batches of S . japonica ranged from 0.828-0.998. A total of 17 common peaks were calibrated， and 6 common peaks were identified. Specifically， peak 5 was identified as vicenin-2， peak 7 as p-hydroxycinnamic acid， peak 10 as apigenin-6-C-arabinoside-8-C-glucoside， peak 11 as isoorientin， peak 13 as vitexin， and peak 15 as 20-hydroxyecdysone. The results of CA showed that S1-S5， S7 and S9-S11 were clustered into one category， S6 was clustered into one category， and S8 and S12 were clustered into one category. The results of PCA revealed that the accumulative contribution rate of the four main components was 89.430%. The content ranges measured by QAMS method for p-hydroxy cinnamic acid， apigenin-6-C-arabinoside-8-C-glucoside， isoorientin， vitexin and 20-hydroxyecdysone were 0.017 4-0.269 4， 0.568 8-4.240 3， 0.503 2-5.040 3， 0.024 0-0.132 0 and 2.551 3-4.881 1 mg/g， respectively. There was no significant difference in the contents of components measured between QAMS method and the external standard method （ P ＞0.05）. CONCLUSIONS The established HPLC fingerprint and QAMS method can be used for quality evaluation and quality control of S . japonica.

AIM:To investigate the application value of contrast-enhanced ultrasound(CEUS)time parameters in the classification diagnosis of choroidal space-occupying lesions.METHODS: Patients with choroidal space-occupying lesions who underwent CEUS at Xi'an People's Hospital(Xi'an Fourth Hospital)between June 2020 and January 2024 were enrolled. According to the final clinical diagnosis and pathological findings, the patients were divided into a benign group(choroidal hemangioma), a malignant group(choroidal melanoma), and a hemorrhage group(subchoroidal hemorrhage). CEUS characteristics and contrast parameters, including rise time(RT), time to peak(TP), and washout time(WT), as well as the incidence of adverse reactions, were analyzed to evaluate the diagnostic value of CEUS.RESULTS:A total of 120 patients(120 eyes)with choroidal space-occupying lesions were included, with 40 patients(40 eyes)in each group. The patients in the benign group were aged 45-70(mean age 57.5±12.4 )y, including 19 males and 21 females; those in the malignant group were aged 43-72(mean age 56.9±13.1 )y, including 23 males and 17 females; and those in the hemorrhage group were aged 40-61(mean age 54.4±9.7 )y, including 22 males and 18 females. The benign group predominantly exhibited homogeneous hyperenhancement with a “fast-in, slow-out”perfusion pattern, whereas the malignant group mainly showed heterogeneous hyperenhancement with a “fast-in, fast-out”perfusion pattern. No obvious enhancement was observed in the hemorrhage group, exhibiting a “no-in, no-out” perfusion pattern. Significant differences were found among the three groups in CEUS characteristics and quantitative parameters, whereas no significant difference was observed in the incidence of adverse reactions.CONCLUSION: CEUS can significantly improve the diagnostic accuracy of choroidal space-occupying lesions and may serve as a useful reference for clinical decision-making, with a favorable safety profile.

The neuropsychiatric disorder course is among the most challenging subjects in medical education, currently facing the "three difficulties" of teaching, learning, and transition from theory to practice. This study attempts to carry out clinical thinking informatization technology-based teaching reform guided by clinical competence. A cognitive map for neuropsychiatric disorders was developed using a symptom-based framework. Leveraging this cognitive map and integrating artificial intelligence, a clinical thinking teaching application for neuropsychiatric disorders was designed and continuously refined. Reform initiatives were explored and summarized in areas such as theoretical teaching, practical teaching, standardized training for resident physicians, teaching assessment, and textbook reform. The reform improved the clinical thinking and clinical competence of students for neuropsychiatric disorders.

Objective:To explore more objective detection method for the performance of diagnostic equipment with ultrasound,so as to demonstrate that the subjectivity of the interpretation criteria will affect the results of resolution parameters of detection performance of ultrasonic equipment.Methods:A total of 77 conventional probes of 33 ultrasound equipment of Jiangsu Provincial Hospital were collected and sorted out.The resolution parameters of their performance were tested twice from 2022 to 2023 by the technical personnel of our institute and the tester of Jiangsu Institute of Metrology.The data was described by using the quartiles method.The resolution parameters of performances of ultrasound equipment and probes were paired to conduct Wilcoxon rank sum test,so as to compare the differences in same institute between different years,and in same year between different institute in testing the resolution parameters of performances of ultrasound equipment and probes.Results:For linear array probes,as long as the performance was tested in accordance with the standard method,there was no statistically significant difference in the resolution parameters measured between different institutes and between different times(P>0.05).For the convex array probe,in 2023,the lateral resolution[2(2,2)]of the 70mm target group,and the axial and lateral resolutions[1(1,1)and 3(3,3.25)]of the 120mm target group of our institute were different with the lateral resolution[2(1,2)]of the 70mm target group,and the axial and lateral resolutions[2(2,3)and 2(2,3)]of the 120mm target group of Jiangsu Institute of Metrology,and the differences of them between our institute and Jiangsu Institute of Metrology were significant(Z=-2.887,-2.53,-3.69,P<0.05),respectively.In our institute,the axial and lateral resolutions[1(1,2)and 2.5(2,3)]of the 70mm target group,and the axial resolution[1(1,2)]of the 120mm target group in 2022 were different with the axial and lateral resolutions[1(1,1)and 2(2,2)]of the 70mm target group,and the axial resolution[1(1,1)]of the 120mm target group in 2023,and the differences of them between two years were significant(Z=-3.317,-3.419,-2.982,P<0.05).In Jiangsu Institute of Metrology,the lateral resolutions of the 70mm target group,and the axial resolution[1(1,1)]of the 120mm target group in 2022 year were different with those in 2023 year,and the differences of them were significant(Z=-2.333,-3.051,P<0.05),respectively.Conclusion:The interpretation for lateral resolution of convex array probe in target group with high depth,the difference of subjective interpretation criteria will cause the essential difference of final results.This paper suggested that the key image should be retained when the resolution of the image of target group with high depth of the convex array probe is interpreted.At the later stage,artificial intelligence(AI)-assisted quality control can also be introduced to conduct objective interpretation by computers.

Objective To conduct a scoping review of the current state of research on the application of virtual reality technology in psychological interventions for cancer patients,clarifying its types,forms,contents,intervention effects,and outcome indicators,and to provide the improvement of mental health in cancer patients.Methods A literature search was conducted on PubMed,Embase,Web of Science,Scopus,Cochrane Library,China National Knowledge Infrastructure,and Wanfang Data up to October 11,2023.The selected literature was screened,included,and analyzed for content summary.Results A total of 22 studies were included,involving both non-immersive and immersive virtual reality technologies,with various systems or programs used for intervention.The primary interventions include virtual reality relaxation therapy,virtual reality exposure therapy,and virtual reality reminiscence therapy.The outcome indicators primarily include anxiety,depression,distress,pain,fatigue,sleep,quality of life,coping,and side effects of virtual reality.Conclusion The use of virtual reality technology for psychological interventions in cancer patients offers a variety of forms and rich content,which has a positive impact on improving the physical and mental health of cancer patients.However,there is significant heterogeneity in the content elements and outcome measure tools,leading to certain limitations in its application.In the future,the specific needs of cancer patients should be considered,and the procedural norms for virtual reality-based psychological interventions should be explored.

Objective:To investigate the effects and mechanisms of dendrobium officinale polysaccharides(DOP)on neural function and sleep in a rat model of ischemic stroke.Methods:Rats with ischemic stroke were modeled using middle cerebral artery occlusion(MCAO).The neurological function was assessed using the Longa scale.Sleep was monitored by electroencephalography.The hippocampal tissue damage was evaluated by TTC staining,HE staining,Nissl staining and TUNEL staining.The kits were used to detect reactive oxygen species(ROS),malondialdehyde(MDA),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),IL-1β,and IL-18 in the hippocampal tissue.West-ern blot analysis was conducted to detect the expression of microtubule-associated protein light chain 3(LC3)and Bec-lin1,NLRP3,apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),cleaved caspase-1(C-caspase-1),GSDMD-N-terminal domain(GSDMD-N),nuclear factor erythroid 2-related factor 2(Nrf2),and heme oxygenase-1(HO-1)in the hippocampal tissue.Results:DOP can improve sleep quality and neurological func-tion in rats with ischemic stroke,alleviate hippocampal tissue damage,inhibit oxidative stress and inflammation in the hippocampus,decrease the expression of Beclin1,NLRP3,ASC,C-caspase-1,GSDMD-N,cytosolic Nrf2 protein,and the LC3-Ⅱ/LC3-Ⅰ ratio in the hippocampus,while increasing the expression of HO-1 and nuclear Nrf2 protein.The Nrf2 inhibitor ML385 partially reversed the ameliorative effects of DOP.Conclusion:DOP may improve neurological function and sleep in rats with ischemic stroke by inhibiting autophagy and NLRP3 inflammasome-mediated pyroptosis through the activation of the Nrf2/HO-1 pathway,thereby alleviating oxidative stress and neuroinflammation.

Objective:To investigate the effects and mechanisms of dendrobium officinale polysaccharides(DOP)on neural function and sleep in a rat model of ischemic stroke.Methods:Rats with ischemic stroke were modeled using middle cerebral artery occlusion(MCAO).The neurological function was assessed using the Longa scale.Sleep was monitored by electroencephalography.The hippocampal tissue damage was evaluated by TTC staining,HE staining,Nissl staining and TUNEL staining.The kits were used to detect reactive oxygen species(ROS),malondialdehyde(MDA),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),IL-1β,and IL-18 in the hippocampal tissue.West-ern blot analysis was conducted to detect the expression of microtubule-associated protein light chain 3(LC3)and Bec-lin1,NLRP3,apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),cleaved caspase-1(C-caspase-1),GSDMD-N-terminal domain(GSDMD-N),nuclear factor erythroid 2-related factor 2(Nrf2),and heme oxygenase-1(HO-1)in the hippocampal tissue.Results:DOP can improve sleep quality and neurological func-tion in rats with ischemic stroke,alleviate hippocampal tissue damage,inhibit oxidative stress and inflammation in the hippocampus,decrease the expression of Beclin1,NLRP3,ASC,C-caspase-1,GSDMD-N,cytosolic Nrf2 protein,and the LC3-Ⅱ/LC3-Ⅰ ratio in the hippocampus,while increasing the expression of HO-1 and nuclear Nrf2 protein.The Nrf2 inhibitor ML385 partially reversed the ameliorative effects of DOP.Conclusion:DOP may improve neurological function and sleep in rats with ischemic stroke by inhibiting autophagy and NLRP3 inflammasome-mediated pyroptosis through the activation of the Nrf2/HO-1 pathway,thereby alleviating oxidative stress and neuroinflammation.

Objective To explore the therapeutic effect of precise disconnection of pargastric varices guided by endoscopic ultrasound in the treatment of esophagogastric variceal bleeding.Method A retrospective analysis was conducted on 20 patients with cirrhosis esophagogastric variceal bleeding treated with endoscopic ultrasound-guided precise disconnection of pargastric varices from January 1,2024 to December 31,2024.The efficacy was analyzed.Result All 20 patients successfully completed the precise disconnection of pargastric varices under the guidance of endoscopic ultrasound.The injection of tissue gel combined with the placement of spring coils(14 cases)and the injection of tissue gel alone(4 cases)successfully blocked the pargastric varices.All patients did not experience perforation,esophageal and cardia stenosis,massive bleeding,septicemia,or ectopic embolization.One patient who received tissue gel alone had slight bleeding from the pargastric varices after surgery and improved after 3 days of treatment to reduce portal vein pressure.Another one patient who received tissue gel alone had a low-grade fever and normal body temperature after 3 days of anti-infection treatment.Conclusion Precise disconnection of pargastric varices under the guidance of endoscopic ultrasound has a good therapeutic effect on esophagogastric variceal bleeding,with fewer complications such as ectopic embolization,massive bleeding,infection,and perforation.However,close follow-up observation is still needed to address the issue of pargastric varices.

Objective:To explore more objective detection method for the performance of diagnostic equipment with ultrasound,so as to demonstrate that the subjectivity of the interpretation criteria will affect the results of resolution parameters of detection performance of ultrasonic equipment.Methods:A total of 77 conventional probes of 33 ultrasound equipment of Jiangsu Provincial Hospital were collected and sorted out.The resolution parameters of their performance were tested twice from 2022 to 2023 by the technical personnel of our institute and the tester of Jiangsu Institute of Metrology.The data was described by using the quartiles method.The resolution parameters of performances of ultrasound equipment and probes were paired to conduct Wilcoxon rank sum test,so as to compare the differences in same institute between different years,and in same year between different institute in testing the resolution parameters of performances of ultrasound equipment and probes.Results:For linear array probes,as long as the performance was tested in accordance with the standard method,there was no statistically significant difference in the resolution parameters measured between different institutes and between different times(P>0.05).For the convex array probe,in 2023,the lateral resolution[2(2,2)]of the 70mm target group,and the axial and lateral resolutions[1(1,1)and 3(3,3.25)]of the 120mm target group of our institute were different with the lateral resolution[2(1,2)]of the 70mm target group,and the axial and lateral resolutions[2(2,3)and 2(2,3)]of the 120mm target group of Jiangsu Institute of Metrology,and the differences of them between our institute and Jiangsu Institute of Metrology were significant(Z=-2.887,-2.53,-3.69,P<0.05),respectively.In our institute,the axial and lateral resolutions[1(1,2)and 2.5(2,3)]of the 70mm target group,and the axial resolution[1(1,2)]of the 120mm target group in 2022 were different with the axial and lateral resolutions[1(1,1)and 2(2,2)]of the 70mm target group,and the axial resolution[1(1,1)]of the 120mm target group in 2023,and the differences of them between two years were significant(Z=-3.317,-3.419,-2.982,P<0.05).In Jiangsu Institute of Metrology,the lateral resolutions of the 70mm target group,and the axial resolution[1(1,1)]of the 120mm target group in 2022 year were different with those in 2023 year,and the differences of them were significant(Z=-2.333,-3.051,P<0.05),respectively.Conclusion:The interpretation for lateral resolution of convex array probe in target group with high depth,the difference of subjective interpretation criteria will cause the essential difference of final results.This paper suggested that the key image should be retained when the resolution of the image of target group with high depth of the convex array probe is interpreted.At the later stage,artificial intelligence(AI)-assisted quality control can also be introduced to conduct objective interpretation by computers.

Objectives:The ORION-18 study has demonstrated that inclisiran can significantly reduce low-density lipoprotein cholesterol(LDL-C)and has good safety in Asian atherosclerotic cardiovascular disease(ASCVD)patients or ASCVD high-risk population.This subgroup analysis aims to further evaluate the efficacy and safety of inclisiran in Chinese mainland population.Methods:ORION-18 study is a multi-center,randomized,double-blind,placebo-controlled,phase Ⅲ clinical trial among Asian subjects,Chinese mainland subgroup included 232 ASCVD patients or ASCVD high-risk subjects who had already been treated with diet control and maximum tolerated doses of statins treatment(with or without other lipid-lowering treatments)but still had elevated LDL-C levels.Subjects were randomized in a 1:1 ratio to the inclisiran group and the placebo group(n=116 each),and received 300 mg of inclisiran or placebo respectively on day 0,90 and 270.The primary endpoint was the percentage change in LDL-C from baseline to day 330.The secondary endpoints included the time-adjusted percentage change and absolute change in LDL-C from baseline after day 90 and up to day 360,the absolute change in LDL-C from baseline to day 330,and the percentage changes from baseline to day 330 in proprotein convertase subtilisin/kexin type 9(PCSK9),total cholesterol,apolipoprotein B(ApoB),non-high-density lipoprotein cholesterol(non-HDL-C).Other secondary endpoints included the proportion of participants reaching LDL-C levels of<1.8 mmol/L at day 330,the proportion of participants with≥50%LDL-C reduction from baseline to day 330 and the proportion of participants who attained global lipid targets(the LDL-C target was<1.4 mmol/L for ASCVD patients and<1.8 mmol/L for ASCVD high-risk subjects)at day 330.Safety endpoints included adverse events during treatment,aboratory test abnormalities during treatment,serious adverse events,and assessed their severity and relation to treatment.Results:The inclisiran group showed a placebo-corrected percentage change in LDL-C from baseline to day 330 of-61.16%,and an absolute change of-1.73 mmol/L(both P<0.0001).Compared to the placebo group,the inclisiran group's time-adjusted percentage change in LDL-C from baseline between day 90 and day 360 was-58.51%,and an absolute change of was-1.64 mmol/L(both P<0.0001).At day 330,reductions from baseline were observed in the inclisiran group for PCSK9,total cholesterol,ApoB,non-HDL-C,with placebo-corrected percentage changes of-77.44%,-35.65%,-43.43%,-50.90%(all P<0.0001),respectively.At day 330,79.6%(74/93)of patients in the inclisiran group and 7.8%(6/77)in the placebo group achieved LDL-C levels<1.8 mmol/L,69.9%(65/93)of patients in the inclisiran group and 0%(0/77)in the placebo group achieved≥50%LDL-C reduction from baseline,66.7%(62/93)of patients in the inclisiran group and 2.6%(2/77)in the placebo group achieved their global LDL-C targets.The safety profile of inclisiran treatment over 12 months was comparable to that of the placebo,with no occurrence of treatment-related serious adverse events.Conclusions:In ASCVD patients or ASCVD high-risk subjects in Chinese mainland who have received diet control and maximum tolerable dose statins treatment(with or without other lipid-lowering treatments)and still have elevated LDL-C,inclisiran has a definite efficacy and good safety in reducing LDL-C.The efficacy and safety results of inclisiran assessed in Chinese mainland population are consistent with those of the general Asia population.