The plants of the genus Caragana Fabr. are desert plants of the Leguminosae family, which are widely used in traditional ethnomedicine, with the effects of nourishing Yin and nourishing blood, dispelling wind and removing dampness, clearing heat and detoxifying toxins. The anti-inflammatory effect of Caragana Fabr. has attracted much attention, the research on the related mechanism has made some progress, but it lacks systematic collation. By summarising the anti-inflammatory effects of the active ingredients of Caragana Fabr., the authors found that they have good anti-inflammatory activities on different inflammatory cell models in vitro, and have good improvement effects on rheumatoid arthritis, colitis, complex nephritis, and acute lung injury and other disease models. The anti-inflammatory effects of the active components of this genus mainly include the reduction of the levels of a variety of pro-inflammatory factors, and the signalling pathways involved mainly include TLR4/NF-κB, TLR4/MAPK, TLR4/NF-κB/IRF3, JAK/STAT-1, ERK/STAT-1 and so on. Therefore, the paper mainly reviews the research progress on the anti-inflammatory effects and mechanisms of the Caragana Fabr. plants and their active components according to disease types, with a view to providing reference for the in-depth study of their anti-inflammatory activities and the development of new products with related functions.

Fecal microbiota transplantation (FMT) technology originated in China during the Eastern Jin Dynasty and has rapidly developed over the past two decades, becoming a primary method for studying the causal relationship between gut microbiota and the occurrence and progression of diseases. At the same time, the therapeutic effects of FMT in the field of gastrointestinal diseases have gained widespread recognition and are gradually expanding into other disease areas. The FMT procedure is relatively complex, and there is currently no standardized method; its success is influenced by various factors, including the donor, recipient, processing of the fecal material, and the method of implantation. Given the increasingly recognized relationship between gut microbiota and various diseases, FMT has become a research hotspot in both scientific studies and clinical applications, achieving a series of significant advancements. To help researchers better understand this technology, this paper will outline the development history of FMT, summarize common operational methods in research and clinical settings, review its application progress, and look forward to future development directions.

OBJECTIVE To evaluate the efficacy， safety and cost-effectiveness of serplulimab as a first-line treatment of small- cell lung cancer （SCLC）， and provide an evidence-based basis for drug selection in hospitals. METHODS Rapid health technology assessment was adopted； PubMed， Cochrane Library， Embase， CNKI， Wanfang， VIP and official websites of domestic and international health technology assessment agencies were systematically searched from the inception to Oct. 2024. Two reviewers independently screened the literature， assessed the quality of included studies and carried out the qualitative analysis according to the inclusion and exclusion criteria. RESULTS A total of 13 systematic reviews/meta-analyses and 9 economic studies were included， and the literature quality was generally good. In terms of effectiveness， compared with chemotherapy alone， serplulimab combined with chemotherapy significantly improved progression-free survival， overall survival， and objective response rate in patients with SCLC. In terms of safety， serplulimab combined with chemotherapy showed no significant difference in the incidence of ≥3 grade adverse events compared with chemotherapy alone in the treatment of SCLC， indicating a good safety profile； compared with combination therapies involving other immunosuppressive agents， the incidence rate of adverse events was also lower. In terms of cost-effectiveness， compared with chemotherapy alone， serplulimab combined with chemotherapy is not cost- effective， which may be related to the high price of serplulimab. CONCLUSIONS Serplulimab is effective and safe in the treatment of SCLC， but has no obvious advantage in terms of cost-effectiveness.

Six novel compounds,comprising three quinolones(1a,1b,and 2)and three flavanones(3-5),along with seven known analogs(6-13),were isolated from the 95％EtOH extract of the stems and leaves of Glycosmis craibii var.glabra.The structures of the new compounds were elucidated using HR-ESI-MS,UV,and 1D and 2D nuclear magnetic resonance(NMR)data analysis.The ab-solute configurations were determined through Mosher ester and electronic circular dichroism(ECD)spectral analysis.Compounds 2,6,9,and 10 demonstrated inhibition of nitric oxide(NO)production stimulated by lipopolysaccharide in BV-2 microglial cells,with IC50 values ranging from 13.5 to 20.1 μmol·L-1,comparable to the positive control,dexamethasone.

Objectives:To investigate the clinical feasibility of three-dimensional(3D)high-resolution late gadolinium enhancement(LGE)MRI in accessing left atrial myocardial fibrosis in patients with atrial fibrillation(AF). Methods:A total of 34 AF patients referred for hybrid surgical ablation were retrospectively enrolled in this study.3D-LGE-MRI images were acquired by Siemens 3.0 T machine and analyzed by ADAS post-processing software by two experienced radiologists to obtain parameters such as the area and the area percentage of LGE.Regional analysis was performed by one of the two radiologists at ten left atrial segments.The Kappa test was used to assess the agreement for scoring image quality,and the interclass correlation coefficient(ICC)was used to evaluate the interobserver agreement of LGE parameters.The parameters of left atrial morphology,area(and area percentage)of LGE,and location of LGE were compared between patients with persistent AF and paroxysmal AF. Results:Images of all 34 patients were considered to have diagnostic value.The scores of the overall image quality and the clarity of the left atrial wall evaluated by two radiologists were(2.88±0.64)points and(3.26±0.75)points(radiologist 1),(2.97±0.58)points and(3.24±0.70)points(radiologist 2),respectively.The corresponding Kappa values were 0.724 and 0.859.Both the area and the area percentage of LGE showed good consistency among observers,and the ICCs were 0.969 and 0.950,respectively.The difference in the area of LGE and the area percentage of LGE between patients with paroxysmal and persistent atrial fibrillation was similar(both P＞0.05).Compared with patients with paroxysmal AF,patients with persistent AF had a higher Utah stage and more severe myocardial fibrosis in the right inferior pulmonary vein antrum and the left atrial septum(all P＜0.05). Conclusions:3D high-resolution LGE-MRI provides a non-invasive way to visualize and quantify left atrial myocardial fibrosis.The extent of left atrial fibrosis in patients with persistent AF is more severe than that in patients with paroxysmal AF,with a preferential distribution in the right inferior pulmonary vein antrum and the left atrial septum.

Objective:To investigate the risk factors for postoperative fever in patients with negative preoperative urine culture undergoing flexible ureteroscopy (fURS), and construct a nomogram prediction model to predict the risk of postoperative fever.Methods:The clinical data of 308 patients who underwent flexible ureteroscopy (fURS) at the Second Affiliated Hospital of Zhengzhou University from January 2019 to March2023, were retrospectively analyzed. Among these patients, there were 235 males and 73 females, with an average age of (46.4±12.1) years old. Additionally, 86 cases had concomitant hypertension, 41 cases had diabetes, and 12 cases had coronary heart disease. A history of urinary stone surgery was present in 57 cases, and 91 cases exhibited severe hydronephrosis. The distribution of stones included 164 cases on the left side and 144 cases on the right side, with 88 cases of renal stones, 124 cases of ureteral stones, and 96 cases of renal-ureteral stones. Among them, 243 cases had ≤2 stones, while 65 cases had >2 stones, with a maximum stone diameter of 12.0 (9.0, 15.0) mm. Urine leukocyte-positive cases were 109, and urine leukocyte-negative cases were 199. Two cases were positive for nitrite, and 308 cases were negative. The occurrence of postoperative fever within 48 hours was recorded, and differences between the fever and non-fever groups were compared. Logistic regression analysis was employed to identify risk factors for post-fURS fever. A nomogram prediction model based on independent risk factors was constructed, and internal validation was conducted using 1 000 bootstrap resamples. The predictive performance of the model was evaluated using receiver operating characteristic (ROC) curves and the area under the curve (AUC). Model stability was assessed using calibration curves.Results:The surgeries for all 308 cases were successfully completed with a median operative time of 60.0 (40.0, 75.0) minutes. Complete stone clearance was achieved in 221 cases. Among them, 14 cases (4.5%) experienced postoperative fever, while 294 cases did not. The fever group had a higher proportion of females [57.1% (8/14) vs. 22.1% (65/294), P=0.007], more cases with comorbid diabetes [50.0% (7/14) vs. 11.6% (34/294), P<0.001], a higher proportion of renal stones [64.3% (9/14) vs. 26.9% (79/294), P=0.022], a lower intraoperative stone clearance rate [42.9% (6/14) vs. 73.1% (215/294), P=0.031], larger stone diameter [15.5 (12.5, 19.3) mm vs. 11.0 (9.0, 15.0) mm, P=0.004], longer operative time [87.5 (58.8, 106.3) min vs. 55.0 (40.0, 75.0) min, P<0.001], higher platelet count [267.0 (225.8, 354.0) ×10 9/L vs. 233.0 (197.8, 272.0) ×10 9/L, P=0.026], lower creatinine levels [67.5 (52.5, 72.3) umol/L vs. 73.0 (62.0, 84.0) umol/L, P=0.026], and a higher platelet lymphocyte ratio [148.8 (118.3, 189.3) vs. 119.5 (93.2, 156.0), P=0.030]. Results of univariate analysis showed that female gender, diabetes, stone location, incomplete stone clearance, maximum stone diameter, operative time, platelet count, creatinine, platelet lymphocyte ratio, and positive nitrite in urine (all P<0.05)were risk factors for postoperative fever. Multivariate regression analysis revealed that female gender ( OR=11.073, 95% CI 1.623-75.521, P=0.014), diabetes ( OR=5.995, 95% CI 1.441-24.952, P=0.014), and operative time ( OR=1.024, 95% CI 1.003-1.046, P=0.024) were independent risk factors for post-fURS fever. The nomogram exhibited excellent predictive performance (AUC=0.866, 95% CI 0.781-0.935), and the calibration curve demonstrated good consistency. Conclusions:Female gender, longer operative time, and diabetes are risk factors for post-fURS fever in patients with preoperative negative urine culture. The nomogram demonstrates excellent predictive performance.

AIM To establish an HPLC method for the simultaneous content determination of gallic acid,catechin,epicatechin,rhein 8-O-β-D-glucoside,chlorogenic acid,chrysophanol 8-O-β-D-glucoside,emodin-8-O-β-D-glucoside,emodin-3-methyl ether-8-O-β-D-glucoside,aloe emodin,rhein,cyperotundone,luteolin,α-cyperone,emodin,chrysophanol and emodin-3-methyl ether in Binglang Sixiao Pills.METHODS The analysis was performed on a 30℃thermostatic Kromasil C18 column(250 mm×4.6 mm,5 μm),with the mobile phase comprising of methanol-0.1%formic acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 260 nm.Subsequently,cluster analysis and principal component analysis were made.RESULTS Fifteen constituents showed good linear relationships within their own ranges(r＞0.999 0),whose average recoveries were 96.00%-101.00%%with the RSDs of 0.50%-1.50%.Various batches of samples were clustered into two categories,and four principal components demonstrated the accumulative variance contribution rate of 90.004%.CONCLUSION This simple,accurate and reproducible method can be used for the quality control of Binglang Sixiao Pills.

Objective To explore the data on the optimum ventilation cross section for the ultra-clean bench with finite element simulation software to meet the requirements of experimental personnel in normal conditions.Methods Firstly,a finite element model for the vertical flow ultra-clean bench was constructed with SolidWorks software,then fluid dynamics simulation for the model was carried out with Flow Simulation software to analyze the gas flow rate,ventilation volume and ventilation interference of the cross section in case of different openings of the adjustable baffle(the distance of the lower edge of the baffle from the clean desktop),finally the suitable baffle openning was determined through comprehensive analysis.Results Simulation results showed that the gas flow rate and ventilation interfence decreased with the increase of th baffle openning,and the ventilation volume peaked when the baffle openning was 225 mm and had the average value being 376.002 m3/h.Conclusion The ventilation interference,gas flow rate and ventilation volume prove to have optimum results in case the baffle openning is 225 mm and the ventilation cross-sectional area is 0.248 m2.[Chinese Medical Equipment Journal,2024,45(2):28-34]

Activation of nuclear factor erythroid 2-related factor 2(Nrf2)by Kelch-like ECH-associated protein 1(Keap1)alkylation plays a central role in anti-inflammatory therapy.However,activators of Nrf2 through alkylation of Keap1-Kelch domain have not been identified.Deoxynyboquinone(DNQ)is a natural small molecule discovered from marine actinomycetes.The current study was designed to investigate the anti-inflammatory effects and molecular mechanisms of DNQ via alkylation of Keap1.DNQ exhibited signif-icant anti-inflammatory properties both in vitro and in vivo.The pharmacophore responsible for the anti-inflammatory properties of DNQ was determined to be the α,β-unsaturated amides moieties by a chemical reaction between DNQ and N-acetylcysteine.DNQ exerted anti-inflammatory effects through activation of Nrf2/ARE pathway.Keap1 was demonstrated to be the direct target of DNQ and bound with DNQ through conjugate addition reaction involving alkylation.The specific alkylation site of DNQ on Keap1 for Nrf2 activation was elucidated with a synthesized probe in conjunction with liquid chromatography-tandem mass spectrometry.DNQ triggered the ubiquitination and subsequent degra-dation of Keap1 by alkylation of the cysteine residue 489(Cys489)on Keap1-Kelch domain,ultimately enabling the activation of Nrf2.Our findings revealed that DNQ exhibited potent anti-inflammatory capacity through α,β-unsaturated amides moieties active group which specifically activated Nrf2 signal pathway via alkylation/ubiquitination of Keap1-Kelch domain,suggesting the potential values of targeting Cys489 on Keap1-Kelch domain by DNQ-like small molecules in inflammatory therapies.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.