ObjectiveThrough qualitatively and quantitatively analysis of the differences in chemical composition between the combined decoction and single decoction of Huaganjian and comparison of their core efficacy， to explore the rationality of the flexible clinical application of Huaganjian compound preparations and single-flavored dispensing granules. MethodsUltra performance liquid chromatography-quadrupole-electrostatic field orbitrap high resolution mass spectrometry（UPLC-Q-Exactive Orbitrap MS） was used to qualitatively analyze the combined decoction and single decoction samples of Huaganjian， and meanwhile， the contents of four index components（geniposide， paeoniflorin， hesperidin and paeonol） were quantitatively analyzed by high performance liquid chromatography（HPLC）. Nonalcoholic fatty liver disease（NAFLD） rat model induced by high-fat diet was applied to compare the efficacy of combined decoction and single decoction of Huaganjian. A total of 30 male SD rats were randomly divided into the control group， model group， lovastatin group（1.8 mg·kg^-1）， combined decoction group（1.26 g·kg^-1） and single decoction group（1.18 g·kg^-1）. After successful modeling， lovastatin group， combined decoction group and single decoction group were given corresponding doses of drugs by intragastric administration every day， and the control group and model group were given equal amounts of normal saline by intragastric administration， after 4 weeks of administration， the serum and liver tissues were collected， and the contents of alanine aminotransferase（ALT）， aspartate aminotransferase（AST）， total cholesterol（TC）， triglyceride（TG）， low-density lipoprotein cholesterol（LDL-C） and high-density lipoprotein cholesterol（HDL-C） in serum of rats were detected， and the liver pathological examination was carried out by hematoxylin-eosin（HE） staining and oil red O staining， so as to compare differences of their efficacy. ResultsSeventy chemical components were initially identified and attributed from the lyophilized powder of the combined decoction and single decoction samples of Huaganjian， and there was no obvious difference in composition between the two. Further quantitative analysis showed that the contents of geniposide， paeoniflorin， hesperidin and paeonol in the combined decoction samples were significantly increased when compared with those of the single decoction samples（P<0.01）. The pharmacodynamic results showed that compared with the model group， both the combined and single decoction groups of Huaganjian could improve the liver index of NAFLD rats， reduce the serum levels of AST， ALT， TC， TG and LDL-C， increase the serum level of HDL-C， and ameliorate the pathological changes of liver cell steatosis and fat accumulation. However， there was no significant difference in pharmacodynamic effects between the combined decoction group and the single decoction group. ConclusionThere is no significant difference between the combined decoction and single decoction of Huaganjian in terms of chemical composition， but the contents of the four index components show significantly difference. Both of them can significantly improve the fat accumulation and liver function in NAFLD rats. This study provides a reference basis for the rational clinical application and evaluation of famous classical formula compound preparations and single-flavored dispensing granules.

ObjectiveTo establish a geographical origin identification model for Foeniculi Fructus from Haiyuan， providing a new technical reference for the protection of Haiyuan's geo-authentic medicinal materials and its designation as a national geographical indication agricultural product. MethodsSamples of Foeniculi Fructus were collected from eight producing areas， including Minqin （Gansu）， Bozhou （Anhui）， Qingdao （Shandong）， Dezhou （Shandong）， Urumqi （Xinjiang）， Nujiang （Yunnan）， Gutuo （Inner Mongolia）， and Haiyuan （Ningxia）. Gas chromatography-ion mobility spectrometry （GC-IMS） was used to detect the volatile organic compounds （VOCs） in samples from these geographic origins. VOCs were qualitatively analyzed through dual matching with the National Institute of Standards and Technology （NIST） mass spectral database and the IMS drift time database. Using the Reporter module and Gallery Plot visualization tools within the LAV analytical platform， VOC fingerprint profiles characterizing geographic origins were constructed. A non-targeted analytical strategy was adopted， and 97 VOCs detected via GC-IMS were subjected to principal component analysis （PCA） and partial least squares discriminant analysis （PLS-DA） based on their differential distribution patterns to construct an origin identification model for Foeniculi Fructus from Haiyuan region. Key discriminative markers were screened using variable importance in projection （VIP） values greater than 1. ResultsA total of 97 VOCs were identified， including alcohols， aldehydes， ketones， esters， organic acids， terpenoids， ethers， alkenes， and benzenes. The PLS-DA model， based on VOCs data obtained by GC-IMS， effectively distinguished Foeniculi Fructus in Haiyuan region from those of other origins. During cross-validation， the model achieved a prediction parameter （Q²） of 0.976 and a goodness-of-fit parameter （R²） of 0.936， with no overfitting observed in permutation testing. Twelve key flavor markers with VIP > 1 were identified as characteristic indicators of Haiyuan origin. ConclusionA stable and highly predictive origin identification model for Foeniculi Fructus from Haiyuan was successfully established using GC-IMS technology， PLS-DA， and VIP-based marker screening. This model provides a novel technical strategy for accurately distinguishing Foeniculi Fructus in Haiyuan region from other regional varieties and offers new technical support for its protection as a geo-authentic medicinal material and a nationally designated geographical indication agricultural product in China.

ObjectiveTo establish a geographical origin identification model for Foeniculi Fructus from Haiyuan， providing a new technical reference for the protection of Haiyuan's geo-authentic medicinal materials and its designation as a national geographical indication agricultural product. MethodsSamples of Foeniculi Fructus were collected from eight producing areas， including Minqin （Gansu）， Bozhou （Anhui）， Qingdao （Shandong）， Dezhou （Shandong）， Urumqi （Xinjiang）， Nujiang （Yunnan）， Gutuo （Inner Mongolia）， and Haiyuan （Ningxia）. Gas chromatography-ion mobility spectrometry （GC-IMS） was used to detect the volatile organic compounds （VOCs） in samples from these geographic origins. VOCs were qualitatively analyzed through dual matching with the National Institute of Standards and Technology （NIST） mass spectral database and the IMS drift time database. Using the Reporter module and Gallery Plot visualization tools within the LAV analytical platform， VOC fingerprint profiles characterizing geographic origins were constructed. A non-targeted analytical strategy was adopted， and 97 VOCs detected via GC-IMS were subjected to principal component analysis （PCA） and partial least squares discriminant analysis （PLS-DA） based on their differential distribution patterns to construct an origin identification model for Foeniculi Fructus from Haiyuan region. Key discriminative markers were screened using variable importance in projection （VIP） values greater than 1. ResultsA total of 97 VOCs were identified， including alcohols， aldehydes， ketones， esters， organic acids， terpenoids， ethers， alkenes， and benzenes. The PLS-DA model， based on VOCs data obtained by GC-IMS， effectively distinguished Foeniculi Fructus in Haiyuan region from those of other origins. During cross-validation， the model achieved a prediction parameter （Q²） of 0.976 and a goodness-of-fit parameter （R²） of 0.936， with no overfitting observed in permutation testing. Twelve key flavor markers with VIP > 1 were identified as characteristic indicators of Haiyuan origin. ConclusionA stable and highly predictive origin identification model for Foeniculi Fructus from Haiyuan was successfully established using GC-IMS technology， PLS-DA， and VIP-based marker screening. This model provides a novel technical strategy for accurately distinguishing Foeniculi Fructus in Haiyuan region from other regional varieties and offers new technical support for its protection as a geo-authentic medicinal material and a nationally designated geographical indication agricultural product in China.

Objective:To understand the information needs and experiences of primary caregivers of patients in the emergency resuscitation room of the emergency department, and to provide a reference for clinical staff to meet caregivers′ information needs as well as to develop targeted and effective health information support for doctors and patients.Methods:A descriptive phenomenological research method was used to conduct semi-structured interviews with primary caregivers of 14 patients in the emergency resuscitation room of the First Affiliated Hospital of Nanjing Medical University from November 2023 to February 2024 through purposive sampling, and the Colaizzi 7-step analysis method was applied to summarize and analyze the interview data and refine the themes.Results:Totally 14 respondents aged 28-66, including 6 males and 8 females. Four themes were refined including diverse information needs, information access dilemma, integration of doctor-patient information for joint decision-making and communication, and desire for information and emotional support.Conclusions:The information needs of primary caregivers of patients in the emergency department were diverse, and caregivers were eager to seek patient-related information and crave emotional support and communication when faced with the onset of a patient's illness. Healthcare professionals should strengthen the assistance of caregivers′ information needs to improve the experience of patients and caregivers in medical consultation services and realize the sustainable development of the doctor-patient relationship.

Knee osteoarthritis(KOA)is a common chronic degenerative bone and joint disease characterized by degeneration and wear of knee cartilage.It is commonly found in middle-aged and elderly people and seriously impacts on their lower limb activity and quality of life.At present,the treatment of early and middle stage KOA mainly relies on the conservative methods such as oral medication,joint injection,topical patches and traditional Chinese medicine.Platelet rich plasma(PRP),as an autologous platelet concentrate,is rich in various growth factors and has no risk of immune rejection.In recent years,it has been widely used in the repair of bone,joint,and soft tissue injuries.However,the short biological half-life of growth factors in PRP and the fluidity of injection sites can result in insufficient binding force,short action time,poor target therapy efficacy,and the need for repeated injections in the joint cavity,which will increase the risk of iatrogenic infections.Hydrogels are cross-linked polymer networks containing water,and their high histocompatibility and drug release have attracted much attention.The slow and continuous release of drug is achieved by loading PRP onto hydrogel.Its unique adhesion reduces the flow of drug in the joint,thus extending the local action time of PRP and reducing the need for repeated injection.This article reviews the biological characteristics of PRP and hydrogel,the mechanism of action and clinical application of PRP loaded hydrogel in the treatment of KOA,and analyzes the existing problems and challenges,aiming to provide more effective treatment options for KOA patients through the in-depth discussion of this new treatment method.

Schizophrenia (SZ) stands as a severe psychiatric disorder. This study applied diffusion tensor imaging (DTI) data in conjunction with graph neural networks to distinguish SZ patients from normal controls (NCs) and showcases the superior performance of a graph neural network integrating combined fractional anisotropy and fiber number brain network features, achieving an accuracy of 73.79% in distinguishing SZ patients from NCs. Beyond mere discrimination, our study delved deeper into the advantages of utilizing white matter brain network features for identifying SZ patients through interpretable model analysis and gene expression analysis. These analyses uncovered intricate interrelationships between brain imaging markers and genetic biomarkers, providing novel insights into the neuropathological basis of SZ. In summary, our findings underscore the potential of graph neural networks applied to multimodal DTI data for enhancing SZ detection through an integrated analysis of neuroimaging and genetic features.
Humans ; Schizophrenia/pathology* ; Diffusion Tensor Imaging/methods* ; Male ; Female ; Adult ; Brain/metabolism* ; Young Adult ; Middle Aged ; White Matter/pathology* ; Gene Expression ; Nerve Net/diagnostic imaging* ; Graph Neural Networks

Objective To explore the role and mechanism of peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) in remifentanil (REM) resistance to hepatic ischemia-reperfusion injury (HIRI). Methods Forty SD rats were randomly divided into sham surgery group, HIRI group, HIRI+REM group, HIRI+PGC-1α inhibitor SR-18292 (HIRI+SR-18292) group and HIRI+REM+SR-18292 group, 8 rats in each group. HIRI rat models were constructed using non-invasive arterial clip occlusion method, and REM or SR-18292 were intravenously injected before surgery. The liver function indicators and liver tissue adenosine triphosphate (ATP) levels in the serum of rats were detected by assay kits. The activity levels of mitochondrial respiratory chain complexes Ⅲ and Ⅳ (COX-Ⅲ, COX-Ⅳ) in rat liver tissue were assessed by colorimetric methods. The pathological changes in rat liver tissue were observed by hematoxylin-eosin staining. Reactive oxygen species (ROS) and oxidative stress-related indicators in rat liver tissue were measured using the fluorescent probe (DCFH-DA) method and colorimetric methods. The mitochondrial DNA (mtDNA) copies and the expression levels of PGC-1α, nuclear respiratory factor-1 (NRF-1) and mitochondrial transcription factor A (TFAM) messenger RNA (mRNA) in rat liver tissue were quantified by real-time fluorescent quantitative polymerase chain reaction (RT-qPCR). And the protein expression levels of PGC-1α, NRF-1 and TFAM in rat liver tissue were assessed by Western blotting. Results Compared with the sham group, rats in the HIRI group showed increased pathological scores and hepatic cell necrosis in liver tissue, elevated levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum, and increased levels of ROS and malondialdehyde (MDA) in liver tissue. Additionally, there was a decrease in ATP content and the activity levels of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), COX-Ⅲ and COX-Ⅳ in liver tissue, as well as a decrease in mtDNA copies and the expression levels of PGC-1α, NRF-1 and TFAM mRNA and protein (all P<0.05). Compared with the HIRI group, rats in the HIRI+REM group exhibited decreased pathological scores and hepatic cell necrosis, reduced levels of serum ALT and AST, and decreased levels of ROS and MDA in liver tissue. There was also an increase in ATP content and the activity levels of SOD, GSH-Px, COX-Ⅲ and COX-Ⅳ in liver tissue, as well as an increase in mtDNA copies and the expression levels of PGC-1α, NRF-1 and TFAM mRNA and protein (all P<0.05). In contrast, rats in the HIRI+SR-18292 group showed increased pathological scores and hepatic cell necrosis, elevated levels of serum ALT and AST, and increased levels of ROS and MDA in liver tissue. There was a decrease in ATP content and the activity levels of SOD, GSH-Px, COX-Ⅲ and COX-Ⅳ in liver tissue, as well as a decrease in mtDNA copies and the expression levels of PGC-1α, NRF-1 and TFAM mRNA and protein (all P<0.05). Compared with the HIRI+REM group, rats in the HIRI+REM+SR-18292 group had increased pathological scores and hepatic cell necrosis, elevated levels of serum ALT and AST, and increased levels of ROS and MDA in liver tissue. There was a decrease in ATP content and the activity levels of SOD, GSH-Px, COX-Ⅲ and COX-Ⅳ in liver tissue, as well as a decrease in mtDNA copies and the expression levels of PGC-1α, NRF-1 and TFAM mRNA and protein (all P<0.05). Conclusions PGC-1α plays a role in regulating the process of REM resistance to HIRI by promoting mitochondrial biogenesis and reducing the levels of oxidative stress.

Objective:To analyze the clinical characteristics and treatment outcomes of children with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR) antibody-mediated necrotizing myopathy, and to explore early identification and management strategies to provide reference for clinical diagnosis and treatment.Methods:A retrospective analysis was conducted on the clinical data and treatment outcomes of 10 pediatric patients with anti-HMGCR antibody-mediated necrotizing myopathy admitted to the Department of Rheumatology, Children′s Hospital of Fudan University from December 2020 to December 2024. Statistical description was performed using SPSS 22.0.Results:Among the 10 patients, the male-to-female ratio was 1:4, the age of onset was (7.2±4.0) years, and the disease duration at diagnosis was (22.2±19.6) months. None had a history of statin exposure. Six patients presented with muscle weakness, and4 were diagnosed due to asymptomatic elevation of creatine kinase (CK); 4 had dermatomyositis-like rashes. All patients showed significantly elevated CK levels [median 3 291(1 969, 8 776)U/L] and underwent muscle biopsy. Histopathological findings revealed myofiber degeneration, necrosis, and regeneration in all cases, with inflammatory infiltration in 9 cases, MHC-Ⅰ positivity in all, and C5b-9 positivity in 9 cases. The median follow-up duration was (15.7±6.3) months. At the last follow-up, muscle strength was normal or nearly normal, and the CK median value had decreased to 977.5 (211.0, 3 536.0) U/L.Conclusion:For patients with suspected idiopathic inflammatory myopathy and significantly elevated CK, muscle-specific antibody testing-including anti-HMGCR-and muscle biopsy should be performed promptly regardless of the presence of skin rash, to ensure accurate diagnosis and guide treatment, thereby avoiding misdiagnosis or missed diagnosis.

Objective:To evaluate the clinical efficacy of individualized postural management guided by lung ultrasound (LUS) in neonates with grade Ⅲ bronchopulmonary dysplasia (BPD).Methods:This prospective randomized controlled trial enrolled neonates diagnosed with grade Ⅲ BPD at Guangdong Second People's Hospital Affiliated to Jinan University from July 2022 to December 2024, who were randomly assigned to control or intervention groups. The control group received conventional postural management (head elevation 15°-30°, supine-left lateral-right lateral-prone positioning with 2-hour rotations), while the intervention group underwent additional LUS examinations every 12 hours for dynamic posture adjustment based on pulmonary findings. Outcomes included LUS signs (pleural line abnormalities, A-line disappearance, B-line increases, cystic hyperaeration, alveolar-interstitial syndrome, consolidation) and primary endpoints (post-diagnosis oxygen therapy duration, invasive mechanical ventilation duration, and hospital stay). Secondary outcomes comprised new complications (pulmonary hemorrhage, necrotizing enterocolitis, BPD-associated pulmonary hypertension, grade Ⅲ-Ⅳ intracranial hemorrhage, retinopathy of prematurity). Intergroup comparisons used two independent samples t-tests and Chi square tests. Results:Among 49 eligible neonates, 47 were randomized (intervention group=24; control group=23), with 40 completing the study (20 per group after exclusions). At day 7, the intervention group showed significantly lower rates of pleural line abnormalities [55% (11/20) vs. 90% (18/20), χ2=6.14, P=0.013], A-line disappearance [50% (10/20) vs. 80% (16/20), χ2=3.95, P=0.046], B-line increases [50% (10/20) vs. 85% (17/20), χ2=5.58, P=0.018], alveolar-interstitial syndrome [65% (13/20) vs. 95% (19/20), χ2=5.62, P=0.017], and consolidation [50% (10/20) vs. 80% (16/20), χ2=3.95, P=0.046]. The intervention group also demonstrated shorter invasive ventilation [(9.5±2.3) vs. (11.6±3.5) days, t=2.18, P=0.035] and hospital stay [(58.9±4.9) vs. (63.2±6.4) days, t=2.33, P=0.025] post-diagnosis, with no significant differences in new complication rates (all P>0.05). Conclusion:LUS-guided postural management improves pulmonary pathology, reduces respiratory support duration and hospitalization, without increasing complications in grade Ⅲ BPD neonates.

Objective:To understand the information needs and experiences of primary caregivers of patients in the emergency resuscitation room of the emergency department, and to provide a reference for clinical staff to meet caregivers′ information needs as well as to develop targeted and effective health information support for doctors and patients.Methods:A descriptive phenomenological research method was used to conduct semi-structured interviews with primary caregivers of 14 patients in the emergency resuscitation room of the First Affiliated Hospital of Nanjing Medical University from November 2023 to February 2024 through purposive sampling, and the Colaizzi 7-step analysis method was applied to summarize and analyze the interview data and refine the themes.Results:Totally 14 respondents aged 28-66, including 6 males and 8 females. Four themes were refined including diverse information needs, information access dilemma, integration of doctor-patient information for joint decision-making and communication, and desire for information and emotional support.Conclusions:The information needs of primary caregivers of patients in the emergency department were diverse, and caregivers were eager to seek patient-related information and crave emotional support and communication when faced with the onset of a patient's illness. Healthcare professionals should strengthen the assistance of caregivers′ information needs to improve the experience of patients and caregivers in medical consultation services and realize the sustainable development of the doctor-patient relationship.