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.

Objective:To establish a method for microbial limit test of carboxymethyl starch sodium.Methods:According to the requirements of General chapters 1105 and 1106 of the fourth part of the Chinese Pharmacopoeia 2020,the applicability of microbial limit method for carboxymethyl starch sodium was tested.Results:The test solution diluted with neutralizer to 1∶20 was counted by plate method.The recoveries of each test bacteria were in the range of 0.5-2.Escherichia coli was examined by direct inoculation with 1∶20 test solution,and the results met the requirements.Conclusion:The established neutralizer method is simple and feasible,and can effectively eliminate the bacteriostatic effect of carboxymethyl starch sodium.

Objective:To establish a method for microbial limit test of carboxymethyl starch sodium.Methods:According to the requirements of General chapters 1105 and 1106 of the fourth part of the Chinese Pharmacopoeia 2020,the applicability of microbial limit method for carboxymethyl starch sodium was tested.Results:The test solution diluted with neutralizer to 1∶20 was counted by plate method.The recoveries of each test bacteria were in the range of 0.5-2.Escherichia coli was examined by direct inoculation with 1∶20 test solution,and the results met the requirements.Conclusion:The established neutralizer method is simple and feasible,and can effectively eliminate the bacteriostatic effect of carboxymethyl starch sodium.

Objective:To evaluate the short-term efficacy and safety of Apollo stent in the treatment of symptomatic basilar artery stenosis.Methods:Patients with symptomatic basilar artery stenosis admitted to the Fourth Affiliated Hospital of China Medical University from January 2017 to May 2020 were selected and treated with Apollo stent implantation. The changes of clinical symptoms and the success rate of operation were evaluated. Postoperative complications included symptomatic intracranial hemorrhage, hyperperfusion, and new ischemic stroke, and follow-up results were evaluated 3 to 6 months later.Results:A total of 96 patients were included in this study, and all of them were confirmed by angiography to have severe basilar artery stenosis corresponding to the symptoms. Among them, 88 patients received stent implantation, with a success rate of 100%. Among the 88 patients, 86 received Apollo stent implantation, and 2 patients received self-Peng stent implantation. Among 86 patients with Apollo stent implantation, the lesions were located in the proximal segment in 73 cases (84.88%), in the middle segment in 10 cases (11.63%), and in the distal segment in 3 cases (3.49%). The degree of stenosis was (93.72±3.86)%, the length of stenosis was (8.50±2.65)mm, the residual stenosis rate was (1.76±4.87)%, and Mori type A lesions in 80 cases, type B lesions in 3 cases, and type C lesions in 3 cases. Among 86 patients with Apollo stent implantation, the incidence of perioperative neurological complications was 6.98%(6/86), including 1 case in the proximal part of the basilar artery (vascular rupture), 3 cases in the middle part of the basilar artery (perforating artery occlusion in 1 case, acute thrombosis artery occlusion in 2 cases), and 2 cases in the distal part (both acute vascular occlusion). Alteplase was injected into the microcatheter during the operation, and contact thrombolysis was performed. Immediately digital subtraction angiography (DSA) showed that the blood vessels were opened, and 1 case with neurological deficit was left. No hyperperfusion occurred in all patients. All patients were followed up for three months after operation. Among them, 58 patients had a good prognosis in the proximal segment of the basilar artery, 18 patients had a good prognosis in the middle segment, 4 patients had a good prognosis in the distal segment, and 6 patients had a bad prognosis (1 patient died). Postoperative stent restenosis occurred in 5 cases (5.81%), recurrent stroke in 3 cases (3.49%), and disabling stroke in 1 case (1.16%).Conclusions:Apollo stent is safe and effective in the treatment of symptomatic basilar artery stenosis, with good short-term prognosis, and long-term prognosis needs to be further studied.

Compulsive sexual behavior disorder is characterized by the inability to control one′s frequent sexual behaviors or fantasies. It will bring physical pain and psychological distress to the patients and increase the risk of venereal diseases. Research abroad on compulsive sexual behavior disorder is increasing, while domestic studies are rare due to in sufficient attention in clinical practice. To increase the understanding of compulsive sexual behavior disorder, this article reviewed the epidemiology, clinical features, evaluation, diagnosis, and treatment with medications and psychotherapy, providing more comprehensive information on compulsive sexual behavior disorder.

Compulsive sexual behavior disorder is characterized by the inability to control one′s frequent sexual behaviors or fantasies. It will bring physical pain and psychological distress to the patients and increase the risk of venereal diseases. Research abroad on compulsive sexual behavior disorder is increasing, while domestic studies are rare due to in sufficient attention in clinical practice. To increase the understanding of compulsive sexual behavior disorder, this article reviewed the epidemiology, clinical features, evaluation, diagnosis, and treatment with medications and psychotherapy, providing more comprehensive information on compulsive sexual behavior disorder.

Objective：To investigate the role and mechanism of chromosomal region maintenance 1 (CRM1) inhibitor sulforaphene (LFS-01) in killing triple negative breast cancer (TNBC) cells by inhibiting signal transducer and activator of transcription 3 (STAT3) signaling pathways. Methods: Whether LFS-01 could combine with the NES pocket of CRM1 was verified by molecular dynamics simulation techniques. The killing activity of LFS-01 on four different breast cancer cell lines was detected by CCK-8 method. TNBC MDA-MB-468 and MDA-MB-231 cells were treated with different concentrations of LFS-01, and the intracellular localization of CRM1 cargo protein STAT3 and protein with NES sequence was detected by immunofluorescence; WB was used to detect the effect of LFS-01 on the expression of STAT-3 signaling pathway and its downstream proteins; WB, cellular immunofluorescence and transmission electron microscopy were adopted to detect the occurrence of autophagy; the effect of LFS-01 on cell cycle and apoptosis was detected by flow cytometry. Results: Molecular dynamics simulations showed that LFS-01 can bind to the NES pocket of CRM1, indicating that it may structurally affect the latter's protein transport function. LFS-01 could specifically kill TNBC MDA-MB-468 and MDA-MB-231 cells. STAT3 and NES-tagged proteins were mainly blocked in the nucleus of TNBC cells after the treatment with 10 μmol/L LFS-01, while they were evenly distributed in the cytoplasm in the control group. The expressions of phosphorylated STAT3 protein, Bcl-xL and Cylin D1 were decreased in MDA-MB-468 and MDA-MB-231 cells with the increase of LFS-01 dose and the prolongation of treatment time; the expression of autophagy marker protein LC3B increased, and highdensity, multi-layered autophagosomes appeared at the same time; cell cycle arrest was observed in S phase and apoptosis rate was significantly increased (P<0.05 or P<0.01). Conclusion: LFS-01 blocks the export of CRM1 carrier protein, thereby inhibiting the activation of STAT3 signaling pathway and promoting autophagy, cell cycle arrest and apoptosis in TNBC MDA-MB-468 and MDAMB-231 cells.

Objective To discuss the surgical strategy and clinical effects of robotic assisted laparoscopic antegrade inguinal lymphadenectomy for penile cancer.Methods We retrospectively analyzed the clinical data and surgical strategy on the 7 cases,who undergoing robotic assisted laparoscopic antegrade inguinal lymphadenectomy,from August of 2016 to August of 2017.The mean age of 7 patients was (49.7 ± 7.5) years old,ranged from 40 to 62 years old,the mean BMI was (27.97 ± 3.86) kg/m2,ranged from 21.76 to 33.21 kg/m2 . There were 4 cases of T1,2 cases of T2,1 case of T3,1 case of N1,3 cases of N2,3 cases of N3 according to TNM stages.Preoperative preparation was as follows,preoperative cardiopulmonary assessment,inguinal and pelvic CT or MRI,ultrasound of lower extremity venous,bowel preparation.The patients were placed in a supine position,with an indwelling catheter,with the head positioned lower than the hip at an angle of about 15 degrees,legs were spread apart around 45 degrees,and both knees were slightly bent and externally rotated.The da Vinci robotic patient cart was pushed forward between legs of the patient.A blunt separation was carried out between Scarpa's fascia and the surface of the aponeurosis of the obliquus externus abdominis prior,then subcutaneous space was established by a self-made balloon dilatation.Results 7 cases were completed successfully without robot reposition without any conversion.Operative time of each side ranged from 50 to 90 min (70.0 ± 12.5)min.The blood loss of each side was less than 10 ml.In the 7 cases,the number of nodes removed from left inguinal region ranged from 7 to 18 (14.0 ±3.3).The number of nodes removed from right ranged from 5 to 21 (11.0 ± 3.3).Pelvic lymphadenectomy was completed in the meantime by original trocar site on 4 cases.Till now,no perioperative complications,such as flap necrosis,delayed healing of incision,cellulitis,occurred in inguinal region,except lymphorrhagia in 3 cases.During a follow-up within 3-14 months,there was no recurrence or metastasis in 6 cases except one died from tumor progression with systemic metastasis.Conclusions Antegrade inguinal lymphadenectomy for penile cancer by using Da Vinci robotic surgical system is safe and effective.This technique also appears to diminish the wound related complications associate with the standard open approach.Compared with the similar surgery,we conducted bilateral inguinal lymphadenectomy without patient cart reposition,which simplify the procedure and reduce the using of trocar.According to individual clinical conditions,pelvic lymphadenectomy also can be completed in the meantime by original trocar.

Objective To expand the influence and promotion effect of the grassroots health demonstration base of appropriate technology at county level,explore the practice model for full coverage.Methods Four consortium and eight units in the county were engaged into the whole process,the whole cycle,synchronous implementation;the promotion practices were divided into different stages with different focuses based on priority setting;Stratified training,classified promotion strategies were involved to carry out the appropriate technology for all 11 items covered.Results The technical promotion training,technical promotion applications were completed with full coverage in the county,gained high satisfaction from both medical staff and public.Enhanced the technology radiation ability,also the base's annual development was increasing year by year.Conclusions The base construction full coverage promotion experiences can be shared and learned by other areas which aims for the promotion of fit health techniques.

Objective To understand how Vibrio vulnificus hemolysin (VvhA) affects the viability of murine liver CD4+ T cells as well as its effects on the numbers of mitochondria and the expression of CD62L. Methods The primary murine liver monocytes (MNs) were isolated from C57BL/ 6 mice and then treated with recombinant VvhA (rVvhA) for 6 hours in vitro. The viability of murine liver CD4+T cells and the expression of CD62L were measured by staining with anti-mouse CD4, CD8, CD44, CD62L and cell via-bility fluorescent dye or fluorescent antibody. Moreover, the cells were simply incubated with MitoTracker or JC-1 probes to label mitochondria and mitochondrial membrane potential, which were further analyzed by using flow cytometry analysis. Results With the increase in the doses of rVvhA, the viability of murine liv-er CD4+T cells was decreased from 81. 5% to 15. 8% . The expression of CD62L on the surface of murine liver CD4+T cells was dramatically decreased. Both the murine liver na?ve and effector CD4+ T cells were sensitive to the cytotoxicity of rVvhA. Moreover, treating murine liver CD4+ T cells with rVvhA resulted in significantly decreased numbers of mitochondria and lower mitochondrial membrane potential. Conclusion The cytotoxicity of rVvhA to murine liver CD4+T cells might be achieved through inhibiting the expression of CD62L, decreasing the numbers of mitochondria and lowering mitochondrial membrane potential.