ObjectiveTo characterize the quality differences among different germplasm and introduced varieties of Bupleurum scorzonerifolium roots（BSR）， and explore the underlying molecular mechanisms， providing a basis for high-quality production and quality control. MethodsWild BSR from Yulin（YLW） served as the quality reference， we conducted comparative analysis among YLW， locally domesticated wild germplasm in Yulin（YLC3）， Daqing germplasm introduced and cultivated in Yulin（YLDQC3）， and locally cultivated germplasm in Daqing（DQC3）. A combination of traditional pharmacognostic methods and modern multi-omics analyses was employed， including macroscopic traits（appearance， odor）， microscopic features（proportions of cork， phloem， xylem）， cell wall component contents（hemicellulose， cellulose， lignin）， carbohydrate contents（starch， water-soluble polysaccharides）， marker compound contents（ethanol-soluble extracts， total saponins， liposoluble extracts， and saikosaponins A， B₂， C， D）， metabolomics， and transcriptomics， in order to systematically characterize quality differences and investigate molecular mechanisms among these samples. ResultsMacroscopically， Yulin-produced BSR（YLW， YLC3， YLDQC3） exhibited significantly greater weight， length， and upper and middle diameters than Daqing-produced BSR（DQC3）. Odor-wise， YLW and YLC3 had a a fragrance taste， YLDQC3 had a rancid oil odor， and DQC3 had a sweet and fragrant taste. Microscopically， Yulin germplasm（YLW， YLC3） and Daqing germplasm（YLDQC3， DQC3） shared similar structural features， respectively. However， Yulin germplasm showed significantly higher proportions of cork and phloem， as well as stronger xylem vessel staining intensity compared to Daqing germplasm. Regarding various component contents， Yulin germplasm contained significantly higher levels of ethanol-soluble extracts， total saponins， and saikosaponins A， B₂， C， D， while Daqing germplasm had significantly higher levels of hemicellulose， starch， and liposoluble extracts. After introduction to Yulin， the Daqing germplasm（YLDQC3） showed increased starch， water-soluble polysaccharides and liposoluble extracts contents， decreased cell wall component content， but no significant difference in other component contents. Metabolomics revealed that saponins and terpenes accumulated significantly in Yulin germplasm， while alcohols and aldehydes accumulated predominantly in Daqing germplasm. Transcriptomics indicated similar gene expression patterns within the same germplasm but specificity between different germplasms. Integrative metabolomic-transcriptomic analysis identified 145 potential key genes associated with the saikosaponin biosynthesis pathway， including one acetyl-coenzyme A（CoA） acetyltransferase gene（ACAT）， one 3-hydroxy-3-methylglutaryl-coenzyme A synthase gene（HMGS）， two hydroxymethylglutaryl-CoA（HMG-CoA） reductase genes（HMG）， one phosphomevalonate kinase gene（PMK）， one 1-deoxy-D-xylose-5-phosphate synthase gene（CLA）， one hydroxymethylbuten-1-aldol synthase gene（HDR）， two farnesyl pyrophosphate synthase genes（FPPS）， one squalene synthase gene（SQS）， one β-amyrin synthase gene（BAS）， 102 cytochrome P450（CYP450） gene family members， and 32 uridine diphosphate-glucuronosyltransferase（UGT） gene family members. ConclusionAmong the three cultivated types， YLC3 most closely resembles YLW in appearance， microscopic features， contents of major bioactive constituents， metabolomic and transcriptomic profiles. Yulin germplasm exhibits superior saponin synthesis capability compared to Daqing germplasm， and Yulin region is more suitable for the growth of B. scorzonerifolium. Based on these findings， it is recommended that artificial cultivation in northern Shaanxi and similar regions utilize the local Yulin germplasm source cultivated for at least three years.

ObjectiveBased on the traditional quality evaluation methods summarized in previous dynasties， this paper systematically contrasted the quality differences between wild Polygalae Radix（WPR） and cultivated Polygalae Radix（CPR） from the aspects of character， microscope and chemical composition by modern scientific and technological means， providing a basis for high-quality production and quality control. MethodsCPR and local WPR in Yulin city， Shaanxi province from 1 to 6 years were collected， and a systematic comparative analysis was conducted using traditional pharmacognosy research methods combined with modern multi-omics analysis techniques， including character traits（length， weight， diameter）， cross-sectional microscopic features（proportions of cork， phloem， xylem， etc）， cell wall component content（hemicellulose， cellulose， lignin）， extracts content（water-soluble extract and alcohol-soluble extract）， carbohydrate content（starch， water-soluble polysaccharides）， contents of total flavonoids， total saponins and specific marker compounds（3，6′-disinapoyl sucrose， polygalaxanthone Ⅲ， tenuifoliside A， tenuifoliside C， sibiricose A₅ and A₆） and other indexes. Ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS） was employed to conduct comparative analysis of secondary metabolites in WPR and CPR， and multivariate statistical analysis such as principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA） were combined to screen the key differential components of them. ResultsIn terms of appearance， there were significant differences between WPR and CPR. The characteristics of WPR conformed to the "thick wrinkles on the epidermis" recorded in ancient books， featuring a wrinkled surface and grayish-brown appearance. However， CPR had a finer texture and a yellowish white appearance， with weight， length， and diameter increasing with longer cultivation periods. In terms of microscopy， WPR exhibited a thick cork layer with fissures in the phloem， whereas CPR had a thinner cork layer with uniformly arranged cork cells. Younger PR specimens showed numerous phloem fissures in cross-sections， while older specimens display progressively denser arrangements of phloem parenchyma cells. In terms of the contents of various major components， the contents of water-soluble extract， starch and total saponins in WPR were inversely proportional to the root diameter， while the contents of water-soluble extract， water-soluble polysaccharides and total saponins in CPR decreased with the increase of planting years. The content of xanthones in WPR was significantly higher than that of CPR， while the contents of other major components showed no significant change pattern. Among the six indicator components， the average content of sibiricose A₅ in WPR was significantly higher than that of CPR， followed by slightly higher content of tenuifoliside A. In CPR， the relative content of 3，6′-disinapoyl sucrose and tenuifoliside A was the highest. The former showed an increase in volatility with increasing cultivation years， while the latter showed a decrease in volatility. The results of differential compound analysis based on UPLC-Q-TOF-MS showed that there were significant differences in metabolites between WPR and CPR samples. Among them， the seven compounds with the largest differences among WPR samples of different thicknesses were polygalasaponins， and for CPR with different planting years， the main differential compounds were oligosaccharide esters. ConclusionThere are differences between WPR and CPR in character， microscopic structure and chemical composition， and some components are inversely proportional with the increase of diameter and cultivation duration due to the distribution characteristics. However， the longer the cultivation years of PR， the closer it is to the "thick wrinkles on the epidermis" of WPR， which has been respected by generations. It is suggested that this traditional character combined with modern component contents should be used as the index of artificial cultivation and quality control of PR.

OBJECTIVE: To evaluate the clinical efficacy of ultrasound-guided acupuncture at myofascial trigger points (MTrPs) on treating post-stroke foot drop. METHODS: Sixty patients with post-stroke foot drop were randomly assigned to an observation group 1 (20 cases, 1 case dropped out), an observation group 2 (20 cases, 2 casses dropped out), and a control group (20 cases). The control group received conventional acupuncture at Yanglingquan (GB34), Jiexi (ST41), Taichong (LR3), Zusanli (ST36), Xuanzhong (GB39), and Qiuxu (GB40) on the affected side, once daily. In addition to the treatment of the control group , the observation group 1 received acupuncture at the tibialis anterior and gastrocnemius MTrPs, once every other day, while the observation group 2 received ultrasound-guided acupuncture at the tibialis anterior and gastrocnemius MTrPs, once every other day. All groups were treated for two weeks. Three-dimensional gait analysis was performed using an infrared motion capture system, and the Holden walking scale was used to evaluate walking ability before and after treatment in the three groups. RESULTS: Compared before treatment, the patients in the observation groups 1 and 2 showed increased walking speed (P<0.05, P<0.01), and improved Holden walking scale grades (P<0.05, P<0.01) after treatment; the patients in the observation group 2 also showed increased ankle dorsiflexion angles (P<0.05). The walking speeds of the observation groups 1 and 2 were faster than those of the control group after treatment (P<0.05), the Holden walking scale grade in the observation group 2 was superior to that in the control group (P<0.05). CONCLUSION The ultrasound-guided acupuncture at MTrPs could effectively improve gait function in post-stroke foot drop patients.
Humans ; Acupuncture Therapy ; Male ; Female ; Middle Aged ; Stroke/physiopathology* ; Aged ; Trigger Points/physiopathology* ; Gait ; Acupuncture Points ; Adult ; Ultrasonography ; Treatment Outcome ; Gait Disorders, Neurologic/etiology*

BACKGROUND: Arsenic trioxide (ATO) is indicated as a broad-spectrum medicine for a variety of diseases, including cancer and cardiac disease. While the role of ATO in hepatic ischemia/reperfusion injury (HIRI) has not been reported. Thus, the purpose of this study was to identify the effects of ATO on HIRI. METHODS: In the present study, we established a 70% hepatic warm I/R injury and partial hepatectomy (30% resection) animal models in vivo and hepatocytes anoxia/reoxygenation (A/R) models in vitro with ATO pretreatment and further assessed liver function by histopathologic changes, enzyme-linked immunosorbent assay, cell counting kit-8, and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay. Small interfering RNA (siRNA) for extracellular signal-regulated kinase (ERK) 1/2 was transfected to evaluate the role of ERK1/2 pathway during HIRI, followed by ATO pretreatment. The dynamic process of autophagic flux and numbers of autophagosomes were detected by green fluorescent protein-monomeric red fluorescent protein-LC3 (GFP-mRFP-LC3) staining and transmission electron microscopy. RESULTS: A low dose of ATO (0.75 μmol/L in vitro and 1 mg/kg in vivo ) significantly reduced tissue necrosis, inflammatory infiltration, and hepatocyte apoptosis during the process of hepatic I/R. Meanwhile, ATO obviously promoted the ability of cell proliferation and liver regeneration. Mechanistically, in vitro  studies have shown that nontoxic concentrations of ATO can activate both ERK and phosphoinositide 3-kinase-serine/threonine kinase (PI3K-AKT) pathways and further induce autophagy. The hepatoprotective mechanism of ATO, at least in part, relies on the effects of ATO on the activation of autophagy, which is ERK-dependent. CONCLUSION Low, non-toxic doses of ATO can activate ERK/PI3K-AKT pathways and induce ERK-dependent autophagy in hepatocytes, protecting liver against I/R injury and accelerating hepatocyte regeneration after partial hepatectomy.
Animals ; Arsenic Trioxide ; Autophagy/physiology* ; Reperfusion Injury/prevention & control* ; Mice ; Male ; Proto-Oncogene Proteins c-akt/physiology* ; Arsenicals/therapeutic use* ; Oxides/therapeutic use* ; Liver/metabolism* ; Extracellular Signal-Regulated MAP Kinases/metabolism* ; Mice, Inbred C57BL

Objective To assess the technical levels of computed tomography (CT) quality control testing capabilities among radiological health technology service institutions in Hubei Province, China. Methods Ten radiological health technology service institutions in Hubei Province were organized to participate in an inter-institutional capability comparison of selected indicators in CT quality control testing with reference to the Specification for testing of quality control in X-ray computed tomography (WS 519—2019). The robust Z-score method was employed to evaluate the results of the capability comparison data from the ten institutions. Results Six institutions achieved a "satisfactory" rating in all assessed indicators, with a satisfaction rate of 60%. Indicators rated as "unsatisfactory" or "questionable" included "positioning light accuracy", "uniformity", "noise", and "high-contrast resolution". Conclusion The CT quality control testing capabilities of some radiological health technology service institutions in Hubei Province require further enhancement. Improved training and education for testing personnel are recommended.

Postoperative cognitive dysfunction(POCD)is the common postoperative complications in elderly patients,significantly affects their postoperative recovery and quality of life.With the intensification of population aging,how to effectively prevent and treat POCD has become an important topic in clinical re-search.Esketamine(ISLAT)serves as a new anesthetic drug and its potential in improving postoperative cog-nitive function has gradually attracted people's attention.Previous studies have shown that that esketamine can not only alleviate postoperative pain,but may also protect the neurons and reduce the incidence of POCD in elderly patients by regulating the balance of neurotransmitters and reducing inflammatory responses,and has potential clinical application value.However,the researches on the specific mechanisms of action and relat-ed signaling pathways of esketamine is still limited and requires further exploration.This article aims to inves-tigate the role of esketamine in reducing POCD in elderly patients and its related signaling pathway,clarifies the clinical usage strategy and precautions to provide a theoretical basis for clinical application.

Objective Through a non-inferiority trial design,to verify whether the efficacy of transcuta-neous electrical acupoint stimulation(TEAS)in intervening with nausea and vomiting after painless gastros-copy and colonoscopy was not inferior to that of ondansetron,and evaluate its effect on patient recovery.Meth-ods A total of 112 patients who experienced nausea and vomiting after painless gastroscopy and colonoscopy in the gastroscopy and colonoscopy center of the hospital from March 2022 to March 2023 were selected as the research subjects,and divided into the TEAS group(n=56)and the control group(n=56)according to the random number table method.The TEAS group received TEAS intervention,while the control group received ondansetron hydrochloride injection intervention.The non-inferiority margin was set at 10.0％.The interven-tion effective rate of nausea and vomiting after examination,as well as heart rate,blood pressure,length of stay,satisfaction,and visual analogue score(VAS)were compared between the two groups.Results The in-tervention effective rate of the TEAS group was close to that of the control group[82.4％(46/56)vs.80.4％(45/56)],risk difference(RD)=2.0％(95％CI:-9.8％to 13.8％),the lower limit of 95％CI(-9.8％)was higher than the preset cut-off value(-10.0％),and non-inferiority was established(P=0.032).Com-pared with before the examination,the heart rates of the two groups were slower,and the levels of systolic blood pressure(SEP)and diastolic blood pressure(DBP)were lower during the examination,and the differ-ences were statistically significant(P＜0.05).There was no statistically significant difference in the two groups of heart rate,SBP,DBP,length of stay[(69.9±14.2)min vs.(75.3±22.8)min],satisfaction score(9.8±0.6 vs.9.2±2.0),VAS(1.5±0.5 vs.2.1±0.5,P＞0.05).Conclusion The efficacy of TEAS in in-tervening with nausea and vomiting after painless gastroscopy and colonoscopy is not inferior to that of ondan-setron.

Objective To analyze the changes of serum inhibin B(INHB),anti-Müllerian hormone(AMH)and sex hormone levels in patients with infertility caused by polycystic ovary syndrome(PCOS).Methods A total of 302 patients with infertility caused by PCOS admitted to the hospital from June 2021 to June 2023 were selected as the experimental group,and 300 healthy women of childbearing age with normal menstrual cycle were selected as the control group.The levels of serum INHB,AMH and sex hormone indexes[serum luteinizing hormone(LH),follicle stimulating hormone(FSH),prolactin(PRL),progesterone(P),testoster-one(T),estradiol(E2)]and homeostasis model assessment of insulin resistance(HOMA-IR)were observed and compared between the two groups.Results The serum levels of AMH,INHB and HOMA-IR in test group were significantly higher than those in control group,with statistical significance(P＜0.05).Serum levels of LH/FSH,PRL,T and P in experimental groups were significantly higher than those in control group,and serum E2 levels were significantly lower than those in control group,with statistical significance(P＜0.05).With the passage of treatment time,serum AMH,INHB,LH/FSH,PRL,T and P levels gradually decreased,and E2 levels gradually increased(P＜0.05).The area under the curve(AUC)of AMH and INHB combined detection in the diagnosis of infertility caused by PCOS was 0.905,which was higher than the AUC of AMH or INHB detection alone(P＜0.05).Serum AMH and INHB levels were positively correlated with FSH,LH,T and HOMA-IR,PRL,P(P＜0.05),and negatively correlated with serum E2 levels(P＜0.05).Conclusion The levels of AMH and INHB in serum of infertility patients caused by PCOS are significantly increased,and AMH and INHB are correlated with sex hormone levels.Detection of serum AMH,INHB and sex hormone levels is helpful for the diagnosis of infertility caused by PCOS.

Objective:To investigate the efficacy and safety of endovascular therapy (EVT) guided by noncontrast CT (NCCT) in patients with large vessel occlusive stroke within a late window (6-24 hours after onset).Methods:Consecutive patients with acute large vessel occlusive stroke within a late window admitted to the General Hospital of Wanbei Coal-electricity Group Co., Ltd from July 1, 2023 to September 30, 2024 were included retrospectively. All patients completed CT angiography or magnetic resonance angiography to confirm the presence of anterior circulation large vessel occlusion and rule out intracranial hemorrhage (ICH). The Alberta Stroke Program Early CT Score (ASPECTS) ≥4 as assessed by NCCT images was used as the EVT screening criteria. The main outcome measure was the functional outcome assessed by the modified Rankin Scale at 90 days after onset, 0-2 was defined as good outcome. The secondary outcome measures were symptomatic ICH (sICH) and death within 90 days. Multivariate logistic regression analysis was used to determine the independent influencing factors of functional outcome. Results:A total of 74 patients with large vessel occlusive stroke within the late window were enrolled, including 42 males (56.8%), aged 68.69±11.62 years (range, 47-89 years), with a baseline National Institutes of Health Stroke Scale score 11.20±5.12 and a median baseline ASPECTS 7 (interquartile range, 6-8). Ten (13.5%) and 7 patients (9.5%) respectively experienced any ICH and sICH, and 7 (9.5%) died within 90 days after onset. Twenty-seven patients (36.5%) received EVT, 47 (63.5%) only received conventional drug treatment; 20 (27.0%) had good outcome, and 54 (73.0%) had poor outcome. Univariate analysis showed that the good outcome rate in the EVT group at 90 days was significantly higher than that in the non-EVT group (40.7% vs. 19.1%; χ2=4.054, P=0.044), and there was no significant difference in the proportion of patients in sICH (11.1% vs. 8.5%; χ2=0.701, P=0.505) and who died within 90 days (7.4% vs. 10.6%; χ2=1.000, P=0.495) compared to the non-EVT group. The proportion of patients receiving EVT in the good outcome group was significantly higher than that in the poor outcome group (60.0% vs. 27.8%; χ2=6.539, P=0.011). Multivariate logistic regression analysis showed that EVT was an independent influencing factor of good outcome (odds ratio 0.440, 95% confidence interval 0.144-0.987; P=0.041). Conclusion:Compared with the conventional drug treatment alone, EVT guided by NCCT evaluation can achieve better outcome in patients with large vessel occlusion stroke within late window, and does not increase the risk of sICH and death within 90 days.

Objective To analyze the development status of intelligent pharmaceutical services for traditional Chinese medicine,to summarize the practical experience of intelligent pharmaceutical services for traditional Chinese medicine,and to explore its technical requirements and development direction.Methods The Affiliated Hospital of Chengdu University of traditional Chinese medicine launched the Smart Traditional Chinese Medicine Room project in January 2018 and established a Smart Traditional Chinese Medicine Pharmacy to undertake pharmaceutical services such as outpatient dispensing,decoction,and distribution of traditional Chinese medicine decoction pieces.Results A total of 5.572 million pairs of traditional Chinese medicine decoction pieces were delivered until May 2023,and 231 400 patients were served in 2022.The service process was more straightforward;there was no need to wait for medication or go to the hospital again.The service efficiency was high,improving the patient's medical experience.Conclusions Intelligent pharmaceutical services for traditional Chinese medicine are developing rapidly.A comprehensive intelligent service system will be established based on technological progress in the future.