Objective:To develop a culturally adapted Advance Care Planning (ACP) Decision Balance Scale for Family Members of Patients with Advanced Cancer in China, and to test its reliability and validity.Methods:Based on the transtheoretical model-decisional balance framework, the item pool was established through literature analysis, qualitative interviews, and research team discussions. After expert panel meetings and semantic debugging pre-surveys among family members of patients with advanced cancer, item screening was conducted to form the pilot scale. From October to December 2024, the scale was administered to 310 family members of inpatients with advanced cancer in five Class Ⅲ Grade A hospitals in Chongqing. SPSS and AMOS software were used for item analysis and reliability and validity testing, and the final formal scale was developed.Results:The ACP Decision Balance Scale for Family Members of Patients with Advanced Cancer consisted of 2 dimensions, perceived cost of choice and perceived benefit of choice, with a total of 12 items. The Cronbach's α coefficient of the scale was 0.875, the split-half reliability was 0.905, and the test-retest reliability was 0.856. The item-level content validity index ranged from 0.880 to 1.000, and the scale-level content validity index was 0.980. Exploratory factor analysis extracted 2 common factors, with a cumulative variance contribution rate of 65.365%. Confirmatory factor analysis showed χ 2/ df=1.743, and the model fit indices met the requirements. The scale also demonstrated good convergent validity and discriminant validity. Conclusions:The ACP Decision Balance Scale for Family Members of Patients with Advanced Cancer developed in this study demonstrated good reliability and validity. It can be used as a tool to assess the level of ACP decision-making participation of family members of patients with advanced cancer, and to systematically, comprehensively, and effectively evaluate, collect, and analyze their behavioral intentions and barriers regarding ACP decision-making.

Objective To investigate the effect of Zhuang medicine Adinandra nitida on blood pressure of hypertensive rats induced by N-nitro-L-arginine methyl ester(L-NAME).Methods L-NAME was used to induce hypertension rats model,they were divided into blank group,model group,captopril group,and high,medium,and low dose groups of Adinandra nitida.The rats were continuous gavaged for 4 weeks,and the blood pressures were measured once a week.Rats were anesthetized by intraperitoneal injection,blood samples and tissues were collected.Pathological changes of the rat thoracic aortic tissue were observed by hematoxylin eosin staining,the protein expression level of endothelial nitric oxide synthase(eNOS)in rat thoracic aorta was detected by western blotting,the content of eNOS in rat plasma was measured by enzyme linked immunosorbent assay and nitric oxide(NO)content in rat plasma was detected by one-step reduction method.Results Compared with model group,high and medium dose groups of Adinandra nitida and captopril group of rats showed significant reductions in systolic blood pressure and diastolic blood pressure(P<0.01),while there were no statistically significant change in heart rate(P>0.05).After 4 weeks of oral administration with Adinandra nitida,the damage of the vascular tissues of hypertensive rats induced by L-NAME had been improved,the expression of eNOS protein in thoracic aorta was significantly increased(P<0.01),and the contents of eNOS and NO in rat plasma were significantly increased(P<0.01).Conclusion Zhuang medicine Adinandra nitida has a hypotensive effect on L-NAME induced hypertensive rats,which may be related to the regulation of eNOS and NO.

Objective:To develop a culturally adapted Advance Care Planning (ACP) Decision Balance Scale for Family Members of Patients with Advanced Cancer in China, and to test its reliability and validity.Methods:Based on the transtheoretical model-decisional balance framework, the item pool was established through literature analysis, qualitative interviews, and research team discussions. After expert panel meetings and semantic debugging pre-surveys among family members of patients with advanced cancer, item screening was conducted to form the pilot scale. From October to December 2024, the scale was administered to 310 family members of inpatients with advanced cancer in five Class Ⅲ Grade A hospitals in Chongqing. SPSS and AMOS software were used for item analysis and reliability and validity testing, and the final formal scale was developed.Results:The ACP Decision Balance Scale for Family Members of Patients with Advanced Cancer consisted of 2 dimensions, perceived cost of choice and perceived benefit of choice, with a total of 12 items. The Cronbach's α coefficient of the scale was 0.875, the split-half reliability was 0.905, and the test-retest reliability was 0.856. The item-level content validity index ranged from 0.880 to 1.000, and the scale-level content validity index was 0.980. Exploratory factor analysis extracted 2 common factors, with a cumulative variance contribution rate of 65.365%. Confirmatory factor analysis showed χ 2/ df=1.743, and the model fit indices met the requirements. The scale also demonstrated good convergent validity and discriminant validity. Conclusions:The ACP Decision Balance Scale for Family Members of Patients with Advanced Cancer developed in this study demonstrated good reliability and validity. It can be used as a tool to assess the level of ACP decision-making participation of family members of patients with advanced cancer, and to systematically, comprehensively, and effectively evaluate, collect, and analyze their behavioral intentions and barriers regarding ACP decision-making.

Objective To investigate the effect of Zhuang medicine Adinandra nitida on blood pressure of hypertensive rats induced by N-nitro-L-arginine methyl ester(L-NAME).Methods L-NAME was used to induce hypertension rats model,they were divided into blank group,model group,captopril group,and high,medium,and low dose groups of Adinandra nitida.The rats were continuous gavaged for 4 weeks,and the blood pressures were measured once a week.Rats were anesthetized by intraperitoneal injection,blood samples and tissues were collected.Pathological changes of the rat thoracic aortic tissue were observed by hematoxylin eosin staining,the protein expression level of endothelial nitric oxide synthase(eNOS)in rat thoracic aorta was detected by western blotting,the content of eNOS in rat plasma was measured by enzyme linked immunosorbent assay and nitric oxide(NO)content in rat plasma was detected by one-step reduction method.Results Compared with model group,high and medium dose groups of Adinandra nitida and captopril group of rats showed significant reductions in systolic blood pressure and diastolic blood pressure(P<0.01),while there were no statistically significant change in heart rate(P>0.05).After 4 weeks of oral administration with Adinandra nitida,the damage of the vascular tissues of hypertensive rats induced by L-NAME had been improved,the expression of eNOS protein in thoracic aorta was significantly increased(P<0.01),and the contents of eNOS and NO in rat plasma were significantly increased(P<0.01).Conclusion Zhuang medicine Adinandra nitida has a hypotensive effect on L-NAME induced hypertensive rats,which may be related to the regulation of eNOS and NO.

Objective·To systematically integrate relevant influencing factors of advanced cancer patients'engagement behavior in advance care planning(ACP).Methods·The systematic search of Chinese and English literature on factors influencing ACP engagement behavior in advanced cancer patients from inception to December 2022 in China National Knowledge Infrastructure(CNKI),Wanfang,China Biomedical Literature Database(Sinomed),PubMed,Cochrane Library,Embase,CINAHL,and PsycINFO was conducted.After the literature quality evaluation,content extraction and summary were conducted by two researchers,and the data of quantitative research and qualitative research were extracted and integrated respectively.The final influencing factors of ACP engagement behavior of advanced cancer patients were obtained.With the help of the theoretical domain,they were mapped to the capability,opportunity,motivation-behavior(COM-B)model step by step.Results·A total of 21 studies were included and 27 factors were summarized,including 9 theoretical domains.Mapping to the COM-B model included 9 capability factors(knowledge of ACP,education level,accurate knowledge of prognosis,knowledge of the time of disease diagnosis,prior experience,subjective life expectancy,age,cancer site,and disease symptom burden),13 opportunity factors(gender,marital status,race/ethnicity,religious belief,dependent children,family economic condition,place of living,housing type,family support,social support,doctor-patient relationship,acculturation,and whether or not to establish a hospice service center)and 5 motivational factors(ACP attitude,ACP belief,ACP motivation,anxiety and depression,and death attitude).Among them,doctor-patient relationship,religious belief,ACP attitude,educational level,marital status,family support,knowledge of ACP,accurate knowledge of prognosis,age,place of living,attitude toward death,prior experience,and race/ethnicity were more influential factors on ACP engagement behavior.Conclusion·Based on the COM-B model,the influencing factors of ACP engagement behavior in advanced cancer patients can be comprehensively summarized.Future studies can use the above factors as an entry point to design continuous,multifaceted,and comprehensive interventions based on the COM-B model to promote the practice of ACP engagement behavior in advanced cancer patients.

OBJECTIVE To study the correlation between processing time, chroma value and UPLC fingerprint map of Dipsaci Radix. METHODS Established the UPLC fingerprint of Dipsaci Radix. Monitored the changes of chemical components in the processing process of wine and salt processed Dipsaci Radix, spectrophotometer was used to objectively quantify the chroma value of different processed products. SPSS 20.0 and SIMCA 14.0 statistical software was used to analyze the correlation between processing time and chroma value and fingerprint. RESULTS In the process of processing, the decoction pieces color of the powder deepened and L*, b* and E* values decreased. The correlation analysis showed that the processing time was significantly correlated with the chroma value and fingerprint of decoction pieces. CONCLUSION The method of UPLC fingerprint is stabled and reliabled, combines with the objective discriminant analysis of the chroma value of the Dipsaci Radix processed products, which lay the foundation for standardizing the processing technology of wine and salt processed products and evaluating the quality of Dipsaci Radix.

OBJECTIVE：To establish characteristic chromatogram of Cornus officinalis and its different wine-processedproducts，investigate the differences of chromaticity values，and analyze them with chemical pattern recognition technology.METHODS：UPLC method was adopted. Using loganin as reference，UPLC characteristic chromatograms were drawn for 10batches of C. officinalis and 20 batches of different wine-processed products （stewing with wine，steaming with wine）. TCMFingerprint Similarity Evaluation System（2012A edition）was used for similarity evaluation，and common peaks were confirmed.The chromaticity values [lightness（L），red and green tone value（a），yellow and blue tone value（b），color difference value（ΔE）]were determined by spectrophotometer. SPSS 20.0 and SIMCA 14.0 software were used for cluster analysis，principal componentanalysis and partial least squares-discriminant analysis；taking the area of characteristic peak and chromaticity value as indexes，andthe variable importance projection greater than 1 as the standard，the difference markers affecting its quality were screened.RESULTS：There were 6 common peaks in the chromatograms for decoction piece of C. officinalis，7 common peaks forwine-processed C. officinalis（stewing with wine）and wine-processed C. officinalis（steaming with wine）. Four components wereidentified as gallic acid，5-hydroxymethylfurfural，morroniside，loganin. 5-hydroxymethylfurfural was produced after processing.The similarity between C. officinalis and different wine-processed products （stewing and steaming with wine） was low（0.869-0.937，0.845-0.944），but the similarity between different wine-processed products was higher than 0.99. ΔL，Δa，Δb and ΔEof C. officinalis decoction pieces and wine-processed C. officinalis decoction pieces（stewing in wine）were －9.42-－3.58，－24.92- －15.00，－11.33- －7.00 and 17.01-28.12，respectively. ΔL，Δa，Δb and ΔE of C. officinalis decoction pieces and wine-processed C. officinalis（steaming in wine）decoction pieces were －8.58-－2.42，－25.08-－13.83，－10.92-－6.08，15.58-28.67. ΔL，Δa，Δb and ΔE of wine-processed C. officinalis decoction pieces（stewing and steaming with wine）were －2.17-3.00，－0.75-2.50， 0.25-1.42 and 1.25-3.83，respectively. Results of cluster analysis showed that 30 batches of sample were clustered into two categories，S1-S10 were clustered into one category，and S11-S30 were clustered into other category. Principal component analysis showed that cumulative contribution rate of former two main components was 83.147％. Results of partial least squares-discriminant analysis showed that morroniside，No.5 peak and chromaticity values（L，a，b）were the difference markers affecting its quality. CONCLUSIONS：Established UPLC characteristic chromatogram is stable and feasible，and can be used to rapidly identify C. officinalis and its different wine-processed products. Established chemical mode can be used to identify different wine-processed products.

Exploratory experiment is the key to the experimental physiology,which is universally applicable training of innovative talents.More importantly,it is an important way to cultivate innovative talents of medicine.On the basis of the original multi-subject evaluation system,we have formed a comprehensive evaluation system through refining the scoring item for teachers and students,enriching the forms of student evaluation,and building the student self-assessment.This comprehensive evaluation system is set to promote the development of experimental physiology,especially the exploratory experiments.The practice of this evaluation system effectively improve the objectivity of the evaluation,provide a basis for reform of exploratory experiment,and then promote the training of innovative talents.

Objective To explore the value of two dimentional colour Doppler flow image (2D-CDFI) combined with three-dimensional color power angiography (3D-CPA) in diagnosis of placenta accreta.Methods A total of 43 pregnant women at risk of placenta accreta selected from September 2010 to August 2015 were enrolled,and underwent 2D-CDFI and 3D-CPA to scan entire placenta.Taking the results of clinical outcome and delivery pathology of the placenta as standard,the ultrasound characteristics of 2D-CDFI and 3D-CPA were analyzed.Results Taking the results of clinical outcome and delivery pathology of the placenta as standard,24 were proved with placenta increta,3 patients with adherent placenta,2 patients with placenta percreta,14 patients with no placenta implantation.Out of 43 cases,29 cases displayed the placental thickening and rich blood vessels in placenta,and at interface of placenta and bladder wall in 2D-CDFI.For 2D-CDFI,19 cases were correctly diagnosed with placenta accrete,while 6 cases were mis-diagnosed and 4 cases missed diagnosed,the diagnosis coincidence rate by 2D-CDFI was 65.5％ (19/29).The ultrasound characteristics displayed irregular arranged myometrial arcuate artery,rich blood vessels at interface of placenta and bladder wall in 3D-CPA.For 3D-CPA,23 cases were correctly diagnosed with placenta accrete,3 cases were misdiagnosed,the diagnosis coincidence rate by 3D-CPA was 79.3％ (23/29).For 3D-CPA combined 2D-CDFI,1 case missed diagnosed,the diagnosis coincidence rate by combination 2D-CDFI with 3D-CPA was 96.6％ (28/29).Conclusions Placenta accrete can all be prenatally diagnosed by characteristic ultrasonic features of 2D-CDFI and 3D-CPA.But 3D-CPA can clearly display the range of placenta accrete lesions and the depth of the blood vessels diffused,has more advantage than two-gray scale ultrasound and 2D-CDFI and has broad application in clinic.

Objective To investigate the differences in eNOS gene expression,activity and its metabolites before and after human bone marrow mesenchymal stem cells (hBMSCs) are induced into vascular endothelial cells.Methods hBMSCs were induced into vascular endothelial cells.The morphological changes of the cells were observed under inverted microscope.Transwell assay was used to detect the cells' migration ability.The protein expression of eNOS was detected by immunofluorescence and Western blot.The activity of eNOS was detected by ELISA and the content of NO in cell culture supernatant was determined by nitrate reduction method.Results Compared with those in the undifferentiated group,the morphological changes of the differentiated cells were obvious.Cell migration ability increased by 238.10％ (73.000±7.002 vs.21.000±4.359,P＜0.05).The expression of eNOS protein increased by 114.72％ (0.423±0.011 vs.0.197±0.079,P＜0.05).The activity of eNOS was enhanced by 157.49％ (4.967±0.073 vs.1.929±±0.103,P＜0.05).The synthesis and release of NO increased by 155.67％ (184.909±1.853 vs.72.323±0.426,P＜0.05).Conclusion After hBMSCs are induced into endothelial cells,the expression of eNOS gene increases,their activities increase,synthesis and release of the metabolite NO increase.It may provide a basis for prevention and treatment of cardiovascular diseases with stem cells.