Eight previously undescribed lanostane triterpenoids, including five nortriterpenoids with 26 carbons, ganothenoids A-E (1-5), and three lanostanoids, ganothenoids F-H (6-8), along with 24 known ones (9-32), were isolated from the fruiting bodies of Ganodrma theaecolum. The structures of the novel compounds were elucidated using comprehensive spectroscopic methods, including electronic circular dichroism (ECD) and nuclear magnetic resonance (NMR) calculations. Compounds 1-32 were assessed for their neuroprotective effects against H₂O₂-induced damage in human neuroblastoma SH-SY5Y cells, as well as their inhibitory activities against protein tyrosine phosphatase 1B (PTP1B) and α-glucosidase. Compound 4 demonstrated the most potent neuroprotective activity against H₂O₂-induced oxidative stress by suppressing G₀/G₁ phase cell cycle arrest, reducing reactive oxygen species (ROS) levels, and inhibiting cell apoptosis through modulation of B-cell lymphoma 2 protein (Bcl-2) and Bcl-2 associated X-protein (Bax) protein expression. Compounds 26, 12, and 28 exhibited PTP1B inhibitory activities with IC₅₀ values ranging from 13.92 to 56.94 μmol·L^-1, while compound 12 alone displayed significant inhibitory effects on α-glucosidase with an IC₅₀ value of 43.56 μmol·L^-1. Additionally, enzyme kinetic analyses and molecular docking simulations were conducted for compounds 26 and 12 with PTP1B and α-glucosidase, respectively.
Humans ; Fruiting Bodies, Fungal/chemistry* ; Triterpenes/isolation & purification* ; Neuroprotective Agents/isolation & purification* ; Protein Tyrosine Phosphatase, Non-Receptor Type 1/metabolism* ; Ganoderma/chemistry* ; Apoptosis/drug effects* ; Hypoglycemic Agents/isolation & purification* ; Molecular Structure ; alpha-Glucosidases/metabolism* ; Cell Line, Tumor ; Reactive Oxygen Species/metabolism* ; Oxidative Stress/drug effects* ; Hydrogen Peroxide/toxicity* ; Molecular Docking Simulation

Objective To investigate the impact of hepatopancreatic ampulla features on difficult biliary cannulation during endoscopic retrograde cholangiopancreatography(ERCP).Methods A retrospective analysis was conducted on 800 patients who underwent ERCP from June 2023 to April 2024.Hepatopancreatic ampullary features were categorized endoscopically into four types:1)Non-protruding(n=544);2)Protruding(n=120);3)Diverticula or mucosal folds(n=96);4)Tortuosity or tumor involvement(n=40).Standard biliary cannulation was initiated in all cases,with failure defined as difficult cannulation.Advanced cannulation techniques were employed for all difficult cannulation cases[double-guidewire technique(DGT)or precutsphincterotomy(PST)].Success rates and procedural complications were recorded.Results Standard biliary cannulation outcomes,success rates 79.96％(435/544)in non-protruding vs.69.17％(83/120)in protruding,72.92％(70/96)in diverticula or mucosal folds,and 65.00％(26/40)in tortuosity or tumor groups(x2=10.90,P=0.012);Difficult cannulation rates 18.01％(98/544)in non-protruding vs.27.50％(33/120)in protruding,27.08％(26/96)in diverticula or mucosal folds,and 30.00％(12/40)in tortuosity or tumor groups(x2=10.41,P=0.015).In the subgroups,the rates of DGT intubation in the four groups were 11.95％(65/544),15.83％(19/120),12.50％(12/96),and 20.00％(8/40),respectively.There was no statistically significant difference in the success rate of DGT intubation between the groups(x2=6.96,P=0.073).In the subgroups,the PST intubation rates were 6.07％(33/544),11.67％(14/120),14.58％(14/96),and 10.00％(4/40),respectively.There was no statistically significant difference in the success rate of PST intubation between the groups(x2=5.54,P=0.136).Advanced cannulation techniques were used in 169 patients,DGT success rates of 94.23％(98/104)vs.PST at 89.23％(58/65)(x2=19.50,P=0.021);PEP incidence 18.34％(31/169)in difficult cannulation vs.2.61％(16/614)in standard group(x2=58.64,P=0.000);No significant difference in PEP between DGT(21.25％)and PST(13.85％)groups(x2=1.17,P=0.279).Conclusion Hepatopancreatic ampulla features influences biliary cannulation success.Non-protruding ampullae demonstrate optimal outcomes with standard techniques.Notably,DGT and PST are associated with elevated PEP risks in difficult cannulation.

Objective To investigate the impact of hepatopancreatic ampulla features on difficult biliary cannulation during endoscopic retrograde cholangiopancreatography(ERCP).Methods A retrospective analysis was conducted on 800 patients who underwent ERCP from June 2023 to April 2024.Hepatopancreatic ampullary features were categorized endoscopically into four types:1)Non-protruding(n=544);2)Protruding(n=120);3)Diverticula or mucosal folds(n=96);4)Tortuosity or tumor involvement(n=40).Standard biliary cannulation was initiated in all cases,with failure defined as difficult cannulation.Advanced cannulation techniques were employed for all difficult cannulation cases[double-guidewire technique(DGT)or precutsphincterotomy(PST)].Success rates and procedural complications were recorded.Results Standard biliary cannulation outcomes,success rates 79.96％(435/544)in non-protruding vs.69.17％(83/120)in protruding,72.92％(70/96)in diverticula or mucosal folds,and 65.00％(26/40)in tortuosity or tumor groups(x2=10.90,P=0.012);Difficult cannulation rates 18.01％(98/544)in non-protruding vs.27.50％(33/120)in protruding,27.08％(26/96)in diverticula or mucosal folds,and 30.00％(12/40)in tortuosity or tumor groups(x2=10.41,P=0.015).In the subgroups,the rates of DGT intubation in the four groups were 11.95％(65/544),15.83％(19/120),12.50％(12/96),and 20.00％(8/40),respectively.There was no statistically significant difference in the success rate of DGT intubation between the groups(x2=6.96,P=0.073).In the subgroups,the PST intubation rates were 6.07％(33/544),11.67％(14/120),14.58％(14/96),and 10.00％(4/40),respectively.There was no statistically significant difference in the success rate of PST intubation between the groups(x2=5.54,P=0.136).Advanced cannulation techniques were used in 169 patients,DGT success rates of 94.23％(98/104)vs.PST at 89.23％(58/65)(x2=19.50,P=0.021);PEP incidence 18.34％(31/169)in difficult cannulation vs.2.61％(16/614)in standard group(x2=58.64,P=0.000);No significant difference in PEP between DGT(21.25％)and PST(13.85％)groups(x2=1.17,P=0.279).Conclusion Hepatopancreatic ampulla features influences biliary cannulation success.Non-protruding ampullae demonstrate optimal outcomes with standard techniques.Notably,DGT and PST are associated with elevated PEP risks in difficult cannulation.

Objective:This study aimed to investigate the clinical features and prognosis of Pseudomonas aeruginosa infection in patients with hematologic malignancies.Methods:This study retrospectively analyzed the clinical data of 197 patients with hematologic malignancies complicated with P. aeruginosa infection who were hospitalized in the Department of Hematology from January 01, 2019, to December 31, 2021. Patients were categorized into a susceptible group (CSPA infection group) and a drug-resistant group (CRPA infection group) based on their sensitivity to carbapenems, comparing the differences in clinical features between the two groups, and analyzing the risk factors and prognosis of CRPA infection.Results:Logistic regression analysis revealed that hospitalization days of >50 days ( P=0.010, OR=3.581, 95% CI 1.356-9.457), history of antibiotic exposure ( P=0.008, OR=4.394, 95% CI 1.358-6.238), more than two courses of chemotherapy before infection ( P=0.006, OR=2.911, 95% CI 1.358-6.238) were independent risk factors for developing CRPA. The mortality rates were 12.8% (18/140) and 28.1% (16/57) in patients with CRPA and CSPA, respectively ( P=0.010). Logistic regression analysis revealed that bloodstream infection (BSI) ( P=0.039, OR=5.286, 95% CI 1.091-25.621) was an independent risk factor for hematologic malignancies and death from CRPA infection. Conclusion:Hospitalization for >50 days, history of antibiotic exposure, and >2 courses of chemotherapy before infection were independent risk factors for CRPA infection. Hematologic malignancies with CRPA infection had a high mortality rate, of which BSI was an independent risk factor for 30-day mortality from hematologic malignancies with CRPA infection.

Objective To study the predictive value of features of the hepatopancreatic ampulla on the success of endoscopic retrograde cholangiopancreatography(ERCP)cannulation and complication rates.Methods Clinical data of 400 patients who underwent ERCP from June 2023 to October 2023 at two hospitals in Eastern China were retrospectively analyzed,patients were divided into non-protruding group(n=184),protruding group(n=76),diverticulum,mucosal folds group(n=101)and twisted,tumour involved group(n=39)according to hepatopancreatic ampulla features.The frequency of nipple contact during intubation,time to successful intubation,and procedure-related complications were recorded separately.Results The highest mean number of contacts in the nipple contact frequency was found in the twisted,tumour-involved group(8.95±6.30)times,and the lowest number of contacts was found in the non-protruding group(4.01±2.42)times,the difference was statistically significant in four groups(F=31.06,P=0.000).Hepatopancreatic ampulla features were a significant factor influencing cannulation time,with prolonged cannulation time observed in the twisted,tumour-involved group(353.96±263.42)s and fastest cannulation in the non-protruding group(161.03±118.06)s,the difference was statistically significant in four groups(F=17.73,P=0.000).A total of 31 patients(7.75%)experienced complications,with the highest number of post-ERCP pancreatitis and no cases of perforation or death.Conclusion Hepatopancreatic ampulla features are a simple and feasible way to predict the success of ERCP cannulation and the incidence of complications.In the future,it could be used as a biological predictor of the difficulty of bile duct cannulation.

Objective To explore the utility of different endoscopic retrograde cholangiopancreatography(ERCP)complexity scales in the training of endoscopists.Methods Clinical data of 237 patients treated by ERCP completed by trainee physicians at two hospitals in Eastern China from February 2022 to February 2023 were prospectively collected.All ERCP cases were classified using previously proposed complexity grading scales,including the American Society of Gastrointestinal Endoscopy(ASGE),Morriston and HOUSE grading scales,compared with the hepatopancreatic ampulla features classification.Successful intubation,successful surgical treatment and complication rates within 48 h were recorded.Results Within each grading,subgroups were divided according to severity,and the comparison of intubation success rates between subgroups in the 3 different grades showed statistically significant differences(P = 0.000).The treatment success rate and intubation success rate had similar findings(P = 0.000).There was no correlation between the complication rate and ASGE grading(P = 0.361),Morriston grading(P = 0.332),and HOUSE grading(P = 0.586).When only cases with primitive papillae were considered,the intubation success rate depended on the complexity grading after the newly added classification of hepatopancreatic ampulla features.In the ASGE group,the success rate of intubation was compared between different subgroups,and the difference was statistically significant(P = 0.004);in the Morriston group,the success rate of intubation was compared between different subgroups,and the success rate of intubation was statistically significant(P = 0.002);in the HOUSE group,the success rate of intubation was compared between different subgroups,and the difference was statistically significant(P = 0.000);In the hepatopancreatic ampulla characteristics group,the difference in intubation success rate was statistically significant when compared between different subgroups(P = 0.000).Similar findings were also found for treatment success rate and intubation success rate(P = 0.000).There was no correlation between the complication rate and ASGE group(P = 0.586),Morriston group(P = 0.443),HOUSE group(P = 0.306),and hepatopancreatic ampulla characteristics group(P = 0.350).Conclusion The use of hepatopancreatic ampulla features as a classification of biliary cannulation complexity is feasible and could be an alternative or additional means of predicting successful biliary cannulation and surgical treatment success and could be used in the future to assess endoscopist training and learning progress and technical standards.

Objective:This study aimed to investigate the clinical features and prognosis of Pseudomonas aeruginosa infection in patients with hematologic malignancies.Methods:This study retrospectively analyzed the clinical data of 197 patients with hematologic malignancies complicated with P. aeruginosa infection who were hospitalized in the Department of Hematology from January 01, 2019, to December 31, 2021. Patients were categorized into a susceptible group (CSPA infection group) and a drug-resistant group (CRPA infection group) based on their sensitivity to carbapenems, comparing the differences in clinical features between the two groups, and analyzing the risk factors and prognosis of CRPA infection.Results:Logistic regression analysis revealed that hospitalization days of >50 days ( P=0.010, OR=3.581, 95% CI 1.356-9.457), history of antibiotic exposure ( P=0.008, OR=4.394, 95% CI 1.358-6.238), more than two courses of chemotherapy before infection ( P=0.006, OR=2.911, 95% CI 1.358-6.238) were independent risk factors for developing CRPA. The mortality rates were 12.8% (18/140) and 28.1% (16/57) in patients with CRPA and CSPA, respectively ( P=0.010). Logistic regression analysis revealed that bloodstream infection (BSI) ( P=0.039, OR=5.286, 95% CI 1.091-25.621) was an independent risk factor for hematologic malignancies and death from CRPA infection. Conclusion:Hospitalization for >50 days, history of antibiotic exposure, and >2 courses of chemotherapy before infection were independent risk factors for CRPA infection. Hematologic malignancies with CRPA infection had a high mortality rate, of which BSI was an independent risk factor for 30-day mortality from hematologic malignancies with CRPA infection.

Objective:To assess the effects of low-dose ionizing radiation on the thyroid of medical radiation workers.Methods:Based on the inclusion and exclusion criteria, 27 articles, involving 22 937 individuals, were screened finally from relevant literature published from 1996 to 2022. Meta-analysis was carried out using Stata 16.0 for serum levels of triiodothyronine (T 3), free triiodothyronine (FT 3), thyroid hormone (T 4), free thyroid hormone (FT 4), thyrotropin-stimulating hormone (TSH) and thyroid nodule rates. As well, subgroup analysis were carried out of thyroid function in different types of radiation workers. Results:The standardized mean difference (SMD) at T 3 and T 4 levels for radiation workers was -0.19 (-0.37, -0.01) and -0.34 (-0.38, -0.30), lower than that of control group ( Z=2.07, -16.06, P<0.05). The SMD at FT 4 levels for radiation workers was 0.22 (0.06, 0.39), higher than control group ( Z=2.61, P<0.05). The relative risk of thyroid nodules in radiation workers was 1.47 (1.19, 1.82), higher than that of control group ( Z=-3.58, P<0.05). The analysis result for subgroup showed that the SMD for T 3, T 4 and TSH levels in the interventional radiology workers were -0.29 (-0.51, -0.07), -0.31 (-0.47, -0.15) and -0.43 (-0.73, -0.13) ( Z=-2.55, -3.86, -2.82, P<0.05), respectively, and the SMD for T 4 levels in the nuclear medicine workers was -0.26 (-0.45, -0.07), which meaned a reduced risk compared to the control group ( Z=-2.70, P<0.05). Conclusions:Long-term low doses of ionising radiation may have adverse effects on thyroid hormone and thyroid nodule in radiation workers, particularly in interventional radiology workers, and attention should be focused on their radiation protection.

Objective To investigate radiation resources in medical diagnosis and treatment and their use frequency in medical institutions in Hangzhou, China, and to provide a basis for relevant departments to rationally allocate and scientifically supervise the resources. Methods From April 1, 2019 to March 31, 2020, a survey was conducted on the basic information, radiation staff, equipment configuration, and frequency of radiation diagnosis and treatment of all medical institutions in Hangzhou using a questionnaire. Results There were 1001 institutions with radiation services in Hangzhou, with 6714 radiation staff members and 2742 pieces of radiation equipment. The frequency of conventional X-ray diagnosis was 788.43 per 1000 population. The frequency of computed tomography diagnosis was 531.93 per 1000 population. The frequency of mammography and dental photography diagnosis was 246.34 per 1000 population. The frequency of interventional diagnosis and treatment was 10.01 per 1000 population. The frequency of radiotherapy was 2.39 per 1000 population. The frequency of nuclear medicine diagnosis was 8.90 per 1000 population. The frequency of nuclear medicine treatment was 0.99 per 1000 population. Conclusion Medical institutions have developed rapidly in Hangzhou, but with an unbalanced situation. In order to better protect the health of examinees, we recommend relevant departments optimize resource allocation and strengthen supervision on radiation protection in medical institutions.

Objective To explore the absorbed dose to the common tissues of subjects in four clinical CT scanning modes and the spatial distribution of the radiation field in chest scanning, in order to provide a basis for the radiation protection of subjects and the space in the machine room. Methods A thermoluminescence detector (TLD) was used to measure the absorbed doses to the eye lens, thyroid gland, gonad, chest and abdominal skins of the anthropomorphic phantom in four CT scanning modes. The TLD was used to monitor the air kerma at different positions from the CT diagnostic table during chest spiral scanning. Results The absorbed doses to the eye lens, thyroid gland, gonad, chest and abdominal skins of the anthropomorphic phantom in four CT scanning modes were 0.040-64.818 mGy, 0.154-10.155 mGy, 0.028-0.154 mGy, 0.443-17.141 mGy, and 0.093-14.346 mGy, respectively. The maximum air kerma value of the space radiation field during chest scanning was 0.049 mGy, and the farther the distance from the CT tube, the smaller the value. Conclusion The absorbed doses to the common tissues of subjects examined by the four CT scanning modes generally do not exceed the threshold doses. The dose received by the companion of the subject during a single chest CT scan was small. In order to minimize radiation hazards, shielding measures can be taken in CT scanning to reduce the absorbed doses to the tissues of the subject, and the companion of the subject should appropriately increase the distance from the tube and the diagnostic table.