The chemical constituents in dried roots of Atractylodes macrocephala were investigated in this study. Through utilizing normal-phase silica gel and ODS column chromatography, TLC, and semi-preparative HPLC, 4 new sesquiterpenoids were purified from the ethyl acetate extract of A. macrocephala. By various spectroscopic techniques, such as 1D and 2D NMR, HR-ESI-MS, IR, UV, and CD, their structures were identified as atractylmacron A (1), 9β-hydroxyasterolide (2), atractylenolide H (3), atractylenolide J (4). Compound 1 possesses a rare 6/7 bicyclic skeleton.

Objective To investigate the correlation of serum oxytocin(PRL)and interleukin-38(IL-38)with type 2 diabetes mellitus(T2DM)combined with non-alcoholic fatty liver disease(NAFLD).Methods A total of 172 patients with T2DM admitted to the Department of Gastroenterology in the hospital from January 2021 to January 2023 were selected as the T2DM group and were divided into the NAFLD group(88 cases)and the non-NAFLD group(84 cases)according to whether or not they were comorbid with NAFLD,and 67 physically examined healthy people during the same period were also selected as the control group.Serum PRL and IL-38 levels were measured by enzyme-linked immunosorbent assay.Logistic regression was used to ana-lyze the factors affecting T2DM combined with NAFLD,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum PRL and IL-38 for T2DM combined with NAFLD.Results Com-pared with the control group,serum PRL levels decreased and IL-38 levels increased in the T2DM group(P＜0.05).The NAFLD comorbidity rate was 51.16％(88/172)in 172 patients with T2DM.Compared with the non-NAFLD group,serum PRL levels decreased and IL-38 levels increased in the NAFLD group(P＜0.05).Increased body mass index,prolonged duration of T2DM,and elevated ghrelin aminotransferase,ghrelin amin-otransferase,total cholesterol,triacylglycerol,LDL cholesterol,and IL-38 were the independent risk factors for T2DM combined with NAFLD(P＜0.05),and elevated HDL cholesterol and PRL were the independent pro-tective factors(P＜0.05).The area under the curve for the combined prediction of serum PRL and IL-38 for T2DM combined with NAFLD was 0.897,which was greater than 0.779 and 0.782 of serum PRL and IL-38 alone(P＜0.05).Conclusion Reduced serum PRL levels and increased IL-38 levels in T2DM patients are in-dependent influencing factors for T2DM combined with NAFLD,and the combination of serum PRL and IL-38 has a high predictive value for T2DM combined with NAFLD.

Background: Triglyceride glucose (TyG) and TyG-body mass index (TyG-BMI) are reliable surrogate indices of insulin resistance and used for risk stratification and outcome prediction in patients with atherosclerotic cardiovascular disease (ASCVD). Here, we inserted estimated average glucose (eAG) into the TyG (TyAG) and TyG-BMI (TyAG-BMI) as derived parameters and explored their clinical significance in cardiovascular risk prediction. Methods: This was a population-based cohort study of 9,944 Chinese patients with ASCVD. The baseline admission fasting glucose and A1C-derived eAG values were recorded. Cardiovascular events (CVEs) that occurred during an average of 38.5 months of follow-up were recorded. We stratified the patients into four groups by quartiles of the parameters. Baseline data and outcomes were analyzed. Results: Distribution of the TyAG and TyAG-BMI indices shifted slightly toward higher values (the right side) compared with TyG and TyG-BMI, respectively. The baseline levels of cardiovascular risk factors and coronary severity increased with quartile of TyG, TyAG, TyG-BMI, and TyAG-BMI (all P<0.001). The multivariate-adjusted hazard ratios for CVEs when the highest and lowest quartiles were compared from low to high were 1.02 (95% confidence interval [CI], 0.77 to 1.36; TyG), 1.29 (95% CI, 0.97 to 1.73; TyAG), 1.59 (95% CI, 1.01 to 2.58; TyG-BMI), and 1.91 (95% CI, 1.16 to 3.15; TyAG-BMI). The latter two showed statistical significance. Conclusion This study suggests that TyAG and TyAG-BMI exhibit more information than TyG and TyG-BMI in disease progression among patients with ASCVD. The TyAG-BMI index provided better predictive performance for CVEs than other parameters.

Patient 1,a 12-day-old female infant,presented with fever,cough,dyspnea,and elevated infection markers,requiring respiratory support.Metagenomic next-generation sequencing(mNGS)of blood and bronchoalveolar lavage fluid revealed Legionella pneumophila(LP),leading to diagnoses of LP pneumonia and LP sepsis.The patient was treated with erythromycin for 15 days and azithromycin for 5 days,resulting in recovery and discharge.Patient 2,an 11-day-old female infant,presented with dyspnea,fever,elevated infection markers,and multiple organ dysfunction,requiring mechanical ventilation.mNGS of blood and cerebrospinal fluid indicated LP,leading to diagnoses of LP pneumonia,LP sepsis,and LP intracranial infection.The patient was treated with erythromycin for 19 days and was discharged after recovery.Neonatal LP pneumonia lacks specific clinical symptoms,and azithromycin is the preferred antimicrobial agent.The use of mNGS can provide early and definitive diagnosis for severe neonatal pneumonia of unknown origin.

Objective To understand the research hotspots and development trend of Hedyotidis Herba;To provide reference for related clinical studies.Methods The literature on Hedyotidis Herba was retrieved from CNKI,Wanfang Data,VIP and CBM from January 1,2003 to September 5,2023.NoteExpress 3.7 software was used to manage the bibliothems,and CiteSpace 6.2.R2 software was used to visualize the authors,institutions and keywords.Results Totally 2 713 articles were included,and the annual number of publications showed a fluctuating upward trend.There were 617 source journals,among which Shaanxi Journal of Traditional Chinese Medicine published the most articles(136).799 authors were involved,and the core authors included Liu Jian,Lin Jiumao,Peng Jun,etc.The main research institutions were Nanjing University of Chinese Medicine,Shandong University of Traditional Chinese Medicine,Guangzhou University of Chinese Medicine and so on.In recent years,high-frequency keywords were experience of famous doctors,data mining,medication law,apoptosis,lung cancer,liver cancer,etc.The research frontier involved the mechanism,data mining and molecular docking.Conclusion The study of the Hedyotidis Herba mainly focuses on disease treatment,compatibility application,component analysis,mechanism,and the experience summary of clinical application of the Hedyotidis Herba.Data mining for medication law of famous doctors,prediction of potential drug targets through network pharmacology and molecular docking technology and exploration of their mechanisms are the research trends in this field.

Objective To investigate the safety and efficacy of totally no tube three-port thoracoscopic surgery (TNTT) for thymic tumor via lateral thoracic approach. Methods The clinical data of patients with thymoma admitted to the Department of Thoracic Surgery of the General Hospital of Northern Theater Command from November 2021 to May 2022 were retrospectively analyzed. The patients were divided into a TNTT group and a single utility port video-assisted thoracic surgery (SVATS) group according to different surgical methods. The clinical data were compared between the two groups. Results A total of 111 patients were collected. There were 44 patients in the TNTT group, including 20 males and 24 females, with an average age of 60.11±8.64 years, and 67 patients in the SVATS group, including 30 males and 37 females, with an average age of 62.40±7.92 years. There was no significant difference between the two groups in the baseline data (P>0.05). The postoperative hospital stay and intraoperative blood loss were shorter or less in the TNTT group (P<0.05), and the visual analogue scale score 48 hours after the operation was smaller in the SVATS group (P<0.05). Conclusion TNTT has a good surgical safety, and can shorten postoperative hospital stay, reduce intraoperative blood loss, and has significant advantages in enhanced recovery after surgery, but SVATS can reduce postoperative pain in patients.

Objective To evaluate the efficacy and safety of Shenbao tablet in the treatment of kidney-yang deficiency syndrome.Methods Patients with kidney-yang deficiency syndrome,will were treated with Shenbao Tablets orally,3 tablets once,3 times a day,and the course of treatment was 56 days or 84 days,depending on the condition.By comparing the clinical efficacy,the changes of symptom scores and syndrome scores before and after treatment,and symptoms remission time,the effectiveness of Shenbao tablet in the treatment of kidney-yang deficiency syndrome was evaluated.The safety was evaluated by adverse reactions.Results There were 339 patients in the 56-day group and 345 patients in the 84-day group.After treatment,the clinical effective rates of the 56-day group and the 84-day group were 91.74％and 97.97％,respectively,and the difference was statistically significant(P＜0.05).In the 56-day group and the 84-day group,the excellent rate were 58.41％and 59.13％,clinical control rates were 18.58％and 27.54％,and the progress rates were 14.75％and 11.30％,respectively.After treatment,the symptom scores of kidney-yang deficiency syndrome were significantly reduced respectively within both groups(P＜0.05).In the 56-day group and the 84-day group,the nocturia scores of were 0.89±1.27 and 0.60±1.03,the soreness of waist scores were 1.31±1.19 and 0.72±1.00,the morning diarrhea scores were 0.28±0.74 and 0.19±0.61,the anaphrodisia scores were 0.65±1.13 and 0.53±0.98,the low spirits scores were 0.29±0.81 and 0.08±0.40,the cold limbs score were 1.09±1.20 and 0.55±0.93,the edema scores were 0.14±0.55 and 0.05±0.30,the bright pale complexion scores were 0.20±0.59 and 0.24±0.65,respectively.There were significant differences in the reduction of each symptom score between the two groups(P＜0.05);the 56-day group had a more significant decrease in the score of cold limbs than the 84-day group.The remaining symptom scores decreased more significantly in the 84-day group.After treatment,the syndrome scores of kidney-yang deficiency syndrome in the two groups were significantly lower than those before treatment(all P＜0.05);the change rates of score in the 56-day group and the 84-day group were(-72.33±24.57)％and(-78.77±19.53)％,respectively,and the difference was statistically significant(P＜0.05).The self-reported time to first symptom relief was(14.85±7.18)days in the 56-day group and(14.10±7.78)days in the 84-day group,with no significant difference(P＞0.05).The incidence of adverse reactions of Shenbao tablets was 5.37％,mainly reflected in hepatobiliary system diseases,gastrointestinal system diseases and various examination abnormalities.Conclusions After taking Shenbao tablets for 2 to 3 months,the clinical symptoms of kidney-yang deficiency were better improved,and the improvement was more significant after 3 months of treatment.The security of Shenbao Tablets was good.