Objective:To explore the protective effect of sesquiterpene lactones of Eupatorium lindleyanum DC.(SLEL)on lipopolysac-charide(LPS)-induced acute lung injury(ALI)in rats using metabolomics.Methods:Forty-eight male SD rats were randomly divided into a blank control group(CG),a model control group(MG),low-,medium-,and high-dose SLEL groups(50,100,and 200 mg/kg),and a positive control group(dexamethasone acetate tablets,5 mg/kg).CG and MG groups were given phosphate-buffered saline.All groups received intragastric administration at a dose volume of 10 mL/kg once a day for 7 consecutive days.One hour after the last ad-ministration,LPS(5 mg/kg)was instilled into the trachea of all groups except the CG group to establish the ALI rat model.Twenty-four hours after model establishment,blood was collected from the abdominal aorta and bronchoalveolar lavage fluid(BALF)was col-lected from the left lung.The total number of inflammatory cells,neutrophils,lymphocytes,and eosinophils in BALF was counted by Wright-Giemsa staining.The levels of interleukin-18(IL-18)and interferon-γ(IFN-γ)in serum and BALF were measured by enzyme-linked immunosorbent assay.The pathological changes of lung tissue were observed using hematoxylin-eosin staining.The ex-pression levels of tight junction protein-1(ZO-1)and occludin in lung tissue were determined by Western blot.The mRNA expression levels of IL-18,IFN-γ,ZO-1,and occludin in the lung were measured by real-time fluorescence quantitative PCR.Non-targeted me-tabolomics analysis of serum and lung tissue was performed using ultra-performance liquid chromatography-electrospray ionization-tandem mass spectrometry.Results:Compared with the MG group,all SLEL groups had significantly reduced wet/dry weight ratio of lung tissue,lung coefficient,and total number of inflammatory cells,neutrophils,lymphocytes,and eosinophils in BALF.SLEL signifi-cantly decreased the levels of IL-18 and IFN-γ in serum and BALF and the mRNA expression of IL-18 and IFN-γ in lung tissue,and significantly promoted the protein and mRNA expression of ZO-1 and occludin.Under light microscopy,the degree of lung tissue edema,alveolar hemorrhage,and inflammatory cell infiltration were significantly reduced,indicating a certain protective effect on ALI rats.The results of non-targeted metabolomics studies showed that there were 91 and 33 significantly different metabolites in the serum and lung tissue of rats treated with SLEL,respectively.Among them,the main differential metabolites in the serum were sphingosine,L-lactic acid,nicotinic acid,D-nucleotide,and mevalonate-5P,while the main differential metabolites in the lung tissue were tauro-cholic acid.This suggests that SLEL may mainly affect the metabolic pathways of sphingolipids,pyruvate,nicotinic acid,nicotinamide,and tryptophan in the serum and the metabolic pathways of taurine and hypotaurine in the lung tissue to improve ALI.Conclusion:SLEL has a significant protective effect on rats against LPS-induced ALI,and its mechanism of action may be related to the inhibition of inflammatory factors,improvement of lung barrier function,and regulation of related metabolic pathways.

Objective:To evaluate the clinical value of an obstetric intelligent assistant in predicting postpartum hemorrhage (PPH) after vaginal delivery.Methods:This retrospective cohort study included 4 832 women who delivered vaginally at ≥26 weeks of gestation at the Third Affiliated Hospital, Guangzhou Medical University between May 2023 and April 2025. Participants were categorized into PPH (382 cases, blood loss ≥500 ml within 24 h after delivery) and non-PPH groups (4 450 cases). Using traditional statistical methods combined with machine learning approaches, including support vector machines and extreme gradient boosting, supplemented with deep learning techniques, we developed a novel artificial neural network model—the obstetric intelligent assistant. This model provides a refined classification of PPH occurrence and estimated blood loss volume. The obstetric intelligent assistant integrates 70 antenatal and intrapartum risk factors through hospital information system interfacing to generate visualized risk probability outputs. Predictive performance was compared between the obstetric intelligent assistant and four conventional prediction tools (Chinese Labor Room Traffic Light System; Association of Women's Health, Obstetric and Neonatal Nurses; American College of Obstetrics and Gynecology Safe Motherhood Initiative; and California Maternal Quality Care Collaborative prediction tools) using receiver operating characteristic curve.Results:(1) For antenatal prediction, the obstetric intelligent assistant achieved an area under the curve of 0.826 (95% CI: 0.774-0.838), with sensitivity of 0.794 and specificity of 0.712, while the four conventional prediction tools showed area under the curve ranging from 0.569 to 0.586. (2) For intrapartum prediction, the obstetric intelligent assistant achieved an area under the curve of 0.786 (95% CI: 0.751-0.820), with sensitivity of 0.837 and specificity of 0.762, whereas the conventional tools showed area under the curve between 0.600 and 0.613. Conclusion:The obstetric intelligent assistant demonstrates superior performance in predicting PPH compared to conventional prediction tools.

To develop vaccines for the prevention and control of porcine circovirus 2d genotype(PCV2d)and pseudorabies virus(PRV),the PCV2d ORF2 gene was amplified by PCR,and cloned into the BamH Ⅰ site of PRV transfer plasmid pG vector harboring the enhanced green fluorescent protein(EGFP)gene.The resulting recombinant transfer plasmid pG-PCV2d-EGFP was transfect-ed into ST cells infected with the three gene deleted PRV variant strain gE-/g-/TK-PRV NY to generate a recombinant virus rPRV-PCV2d-EGFP+,and then the EGFP gene was knocked out to harvest the rPRV-PCV2d using gene-editing technology termed CRISPR/Cas9 system.The recom-binant virus rPRV-PCV2d had similar genetic stability to the parental PRV as indicated by PCR and one-step growth curve test,and the expression of PCV2d capsid(Cap)protein was validated by Western blot.In animal experiment,higher PCV2-specific ELISA antibodies and detectable PCV2-specific neutralizing antibodies could be elicited in mice immunized with the recombinant vi-rus rPRV-PCV2d compared to commercial PCV2 inactivated vaccine.rPRV-PCV2d significantly re-duced the PCV2d loads in tissues such as the heart,liver and spleen of mice following virulent PCV2d challenge.Moreover,rPRV-PCV2d elicits PRV-specific immune responses in mice and can prevent PRV virulent infection in mice,indicating the recombinant virus rPRV-PCV2d has strong immunogenicity.

To develop vaccines for the prevention and control of porcine circovirus 2d genotype(PCV2d)and pseudorabies virus(PRV),the PCV2d ORF2 gene was amplified by PCR,and cloned into the BamH Ⅰ site of PRV transfer plasmid pG vector harboring the enhanced green fluorescent protein(EGFP)gene.The resulting recombinant transfer plasmid pG-PCV2d-EGFP was transfect-ed into ST cells infected with the three gene deleted PRV variant strain gE-/g-/TK-PRV NY to generate a recombinant virus rPRV-PCV2d-EGFP+,and then the EGFP gene was knocked out to harvest the rPRV-PCV2d using gene-editing technology termed CRISPR/Cas9 system.The recom-binant virus rPRV-PCV2d had similar genetic stability to the parental PRV as indicated by PCR and one-step growth curve test,and the expression of PCV2d capsid(Cap)protein was validated by Western blot.In animal experiment,higher PCV2-specific ELISA antibodies and detectable PCV2-specific neutralizing antibodies could be elicited in mice immunized with the recombinant vi-rus rPRV-PCV2d compared to commercial PCV2 inactivated vaccine.rPRV-PCV2d significantly re-duced the PCV2d loads in tissues such as the heart,liver and spleen of mice following virulent PCV2d challenge.Moreover,rPRV-PCV2d elicits PRV-specific immune responses in mice and can prevent PRV virulent infection in mice,indicating the recombinant virus rPRV-PCV2d has strong immunogenicity.

Objective:To evaluate the clinical value of an obstetric intelligent assistant in predicting postpartum hemorrhage (PPH) after vaginal delivery.Methods:This retrospective cohort study included 4 832 women who delivered vaginally at ≥26 weeks of gestation at the Third Affiliated Hospital, Guangzhou Medical University between May 2023 and April 2025. Participants were categorized into PPH (382 cases, blood loss ≥500 ml within 24 h after delivery) and non-PPH groups (4 450 cases). Using traditional statistical methods combined with machine learning approaches, including support vector machines and extreme gradient boosting, supplemented with deep learning techniques, we developed a novel artificial neural network model—the obstetric intelligent assistant. This model provides a refined classification of PPH occurrence and estimated blood loss volume. The obstetric intelligent assistant integrates 70 antenatal and intrapartum risk factors through hospital information system interfacing to generate visualized risk probability outputs. Predictive performance was compared between the obstetric intelligent assistant and four conventional prediction tools (Chinese Labor Room Traffic Light System; Association of Women's Health, Obstetric and Neonatal Nurses; American College of Obstetrics and Gynecology Safe Motherhood Initiative; and California Maternal Quality Care Collaborative prediction tools) using receiver operating characteristic curve.Results:(1) For antenatal prediction, the obstetric intelligent assistant achieved an area under the curve of 0.826 (95% CI: 0.774-0.838), with sensitivity of 0.794 and specificity of 0.712, while the four conventional prediction tools showed area under the curve ranging from 0.569 to 0.586. (2) For intrapartum prediction, the obstetric intelligent assistant achieved an area under the curve of 0.786 (95% CI: 0.751-0.820), with sensitivity of 0.837 and specificity of 0.762, whereas the conventional tools showed area under the curve between 0.600 and 0.613. Conclusion:The obstetric intelligent assistant demonstrates superior performance in predicting PPH compared to conventional prediction tools.

Objective:To analyze plaque characteristics of non-culprit coronary lesions with cholesterol crystals in patients with acute myocardial infarction(AMI) by using optical coherence tomography(OCT). We also investigated the potential association between cholesterol crystals with plaque rupture and healed plaque at non-culprit segment.Methods:This study was a retrospective cohort study. Between January 2017 and December 2017, patients with AMI who underwent 3-vessel OCT imaging were included in this study. Patients were divided into two groups according to the presence or absence of cholesterol crystals at the non-culprit lesions. All patients underwent coronary angiography and OCT examination, and non-culprit plaque characteristics were compared between the two groups. The generalized estimating equation log-binomial multirariate regression model was used to assess the relationship between non-culprit lesions with cholesterol crystals and plaque rupture and plaque healing. The follow-up data collection ended in October 2023. Kaplan-Meier survival curves were plotted, and log-rank tests were used to compare the cumulative incidence of major adverse cardiovascular events between the two groups.Results:A total of 173 AMI patients were included (aged (56.8±11.6) years; 124 men (71.7%)). Among 710 non-culprit lesions identified by OCT, there were 102 (14.4%) in cholesterol crystals group and 608 (85.6%) in non-cholesterol crystals group. Compared with non-culprit lesions without cholesterol crystals, those with cholesterol crystals had smaller minimum lumen diameter, severer diameter stenosis, and longer lesion length (all P<0.01). The prevalence of plaque rupture (17.6% (18/102) vs. 4.9% (30/608), P=0.001) and thin-cap fibroatheroma (31.4% (32/102) vs. 11.5% (70/608), P<0.01) was higher in the cholesterol crystals groups than in the non-cholesterol crystals group. In addition, vulnerable plaque characteristics such as (44.1% (45/102) vs. 25.8% (157/608), P<0.01), macrophages were more frequently observed in non-culprit lesions with cholesterol crystals. The generalized estimating equation log-binomial multivariate regression analyses showed that non-culprit cholesterol crystals were positively correlated with healed plaque ( OR=1.583, 95% CI: 1.004-2.495, P=0.048). Conversely, cholesterol crystals were not associated with plaque rupture ( OR=1.632, 95% CI: 0.745-3.576, P=0.221). The follow-up time was 2 142 (1 880, 2 198) days. Non-culprit cholesterol crystals were not related to the major adverse cardiovascular events in patients with AMI (log-rank P=0.558). Conclusions:Among AMI patients, non-culprit lesions with cholesterol crystals presented with severer luminal stenosis and increased plaque vulnerability. The presence of non-culprit cholesterol crystals was associated with rather than plaque rupture.

BACKGROUND:Recent studies have shown that research on naringin anti-osteoporosis mostly stays in in vitro and in vivo experiments.Understanding the mechanism of related signaling pathways and the expression of related proteins and some specific genes is an important way to deeply understand naringin anti-osteoporosis.At present,traditional Chinese medicine has been confirmed to have a significant role in anti-osteoporosis.Naringin is one of the main active ingredients in Rhizoma Drynariae.Its effectiveness and mechanism of action against osteoporosis have been gradually recognized by scholars,and its clinical and basic research has been gradually emphasized. OBJECTIVE:To analyze and summarize the research progress of naringin in anti-osteoporosis in vitro and in vivo,thereby providing some ideas for the next step to study its related mechanism of action. METHODS:The relevant literatures included in CNKI and PubMed database were searched with the Chinese search terms of"naringin,osteoporosis,traditional Chinese medicine compound,pathogenesis,signaling pathway,bone marrow mesenchymal stem cells,osteoblasts,osteoclasts"in Chinese and English,respectively.The corresponding criteria were established according to the research needs,and finally 69 articles were included for review. RESULTS AND CONCLUSION:Naringin blocks the increase in the number of osteoclasts and adipocytes,the decrease in the number of osteocytes and osteocalcin(+)cells induced by fructose-rich diet,and promotes the secretion of Sema3A from osteoblasts and osteocytes,thereby enhancing local bone formation and inhibiting osteoclast production by activating the Wnt/β-catenin pathway.Naringin is an important way to induce autophagy of osteoblasts,but autophagy-related proteins participate in osteoblast differentiation and bone formation.Lack of autophagy in osteoblasts reduces mineralization and leads to an imbalance in the number of osteoblasts and osteoclasts,which results in bone loss and decreased bone density.The composite scaffold loaded with naringin can be used as a necessary carrier for bone defect repair and has excellent bone repair properties.Naringin can also accelerate the growth of new bone tissue by increasing the local contents of bone morphogenetic protein 2 and vascular endothelial growth factor.Naringin can regulate bone metabolism and inhibit oxidative stress via ERK,PI3K/Akt and Wnt signaling pathways to improve osteoporosis,which can play a good role in preventing and controlling the disease.However,the depth and breadth of the relevant research is insufficient.Based on the mechanism of the current study,we should investigate the specific mechanisms by which naringin regulates different pathways and inter-pathway interactions in the future,which will be beneficial to the multifaceted development of naringin used in the treatment of osteoporosis..

Objective: To compare the clinical value of ultrasonic elastography (UE) and three common ultrasonic features in diagnosing papillary thyroid carcinoma (PTC). Methods: From January 2012 to December 2017, the clinical data of 105 cases with PTC which were confirmed by postoperative pathologic examination and 20 cases with benign thyroid nodules (BTN) in the Integration of Chinese and Western Medicine Hospital Affiliated to Nanjing University of Traditional Chinese Medicine were analyzed retrospectively.The UE and common ultrasonic features comprising a taller-than-wide shape, irregular margins and microcalcifications were analyzed.The sensitivity, specificity and area under curve (AUC) of PCT dingnosis with two different ultrasonic parameters are calculated. Results: Based on surgical pathology, the diagnostic sensitivity of irregular boundary is the highest amony the three paraneters of ordinary ultrasound.Although an irregular margin showed higher sensitivity than taller-than-wide shape and microcalcifications with 71.42% vs.59.04% vs.60.00%, but there was no statistically significant difference (χ²=4.3, P=0.116). There was also no statistically significant difference in specificity (χ²=0.134, P=0.935). The diagnostic efficiency of UE was higher than taller-than-wide shape (Z=3.046, P=0.002), irregular margin(Z=2.962, P=0.003) as well as microcalcifications(Z=3.942, P=0.000), the difference was statistically significant(P<0.05). The diagnostic efficiency of UE was higher than the combined three common ultrasonic features together (Z=3.125, P=0.001). Conclusion UE score shows a higher diagnostic efficiency, easy to perform, indicating the important application value in preoperative diagnosis of PTC, and is worthy of promoting in clinic.

Objective To develop a simple and fast UPLC-MS/MS method for determination of aconitine in biological human sample. Methods The biological human sample was treated by acetonitrile precipitation, and then analyzed on a UPLC C18(2.1mm×50mm, 1.7μm)column. The mobile phase consisted of acetonitrile-0.1% formic acid with gradient elution, at a flow rate of 0.4 mL/min, at 40℃. UPLC-MS/MS was performed in ESI source with MRM mode for quantification. Results The linear range of the concentration were 0.5~500ng/mL in blood and 1~1000ng/mL for aconitine in blood for aconitine (r>0.995). The relative recoveries of aconitine were in the range of 91.3%~110.2%, and the extraction recoveries were in the range of 72.8%~83.5%. The RSDs of intra-days and inter-day were both less than 14%. Conclusion The method is a simple, fast and could be used for determination of aconitine in biological human sample.

Objective To observe the myocardial protective effect of dexmedetomidine in patients undergoing open-heart surgery under cardiopulmonary bypass (CPB).Methods 50 patients of open-heart surgery under CPB were randomly divided into two groups equally, namely observation group and control group.Observation group was treated with injection of dexmedetomidine at 0.5 μg/kg for 15 min, and then maintained at 0.4 μg/kgoh.The control group was given equal volume of normal saline.Concentrations of IMA and cTnI were determined before anaesthesia (t0), after 30 minutes of CPB (t1) and after surgery (t2).Results IMA and cTnI concentrations of t1 and t2 in the observation group were significantly lower than those in the control group (P<0.05).Conclusion Dexmedetomidine has obvious protective effect on myocardium, which can reduce open-heart surgery of patients with myocardial ischemia reperfusion injury (MIRI).