The comprehensive detection and identification of active ingredients in complex matrices is a crucial challenge.Liquid chromatography coupled with high-resolution mass spectrometry(LC-HRMS)is the most prominent analytical platform for the exploration of novel active compounds from complex matrices.However,the LC-HRMS-based analysis workflow suffers from several bottleneck issues,such as trace content of target compounds,limited acquisition for fragment information,and uncertainty in interpreting relevant MS2 spectra.Lycibarbarspermidines are vital antioxidant active ingredients in Lycii Fructus,while the reported structures are merely focused on dicaffeoylspermidines due to their low content.To comprehensively detect the new structures of lycibarbarspermidine derivatives,a"depict"strategy was developed in this study.First,potential new lycibarbarspermidine derivatives were designed according to the biosynthetic pathway,and a comprehensive database was established,which enlarged the coverage of lycibarbarspermidine derivatives.Second,the polarity-oriented sample prep-aration of potential new compounds increased the concentration of the target compounds.Third,the construction of the molecular network based on the fragmentation pathway of lycibarbarspermidine derivatives broadened the comprehensiveness of identification.Finally,the weak response signals were captured by data-dependent scanning(DDA)followed by parallel reaction monitoring(PRM),and the efficiency of acquiring MS2 fragment ions of target compounds was significantly improved.Based on the integrated strategy above,210 lycibarbarspermidine derivatives were detected and identified from Lycii Fructus,and in particular,170 potential new compounds were structurally characterized.The integrated strategy improved the sensitivity of detection and the coverage of low-response components,and it is expected to be a promising pipeline for discovering new compounds.

【Objective】 To explore the safety and efficacy of a modified one-piece posterior laparoscopic total nephroureterectomy with cystic sleeve resection in the treatment of upper urinary tract uroepithelial carcinoma (UTUC). 【Methods】 A total of 24 patients treated during Jan. and Jun. 2022 were involved, including 16 males and 8 females, aged 62 to 90 (average 73) years. The UTUC was in the left side in 15 cases, and in the right side in 9 cases. There were 10 cases of renal pelvis tumor, 6 cases of upper ureteral tumor and 8 cases of lower ureteral tumor. 【Results】 All operations were successful without conversion to open surgery. The operation time ranged from 60 to 100 minutes, average (71.25±9.80) minutes. The intraoperative bleeding volume was 20 to 200 mL, average (30.03±8.13) mL. No significant intraoperative or postoperative complications occurred. The postoperative hospital stay was 4 to 7 days, average (5.83±1.44) days. Bladder perfusion chemotherapy was performed after surgery. 【Conclusion】 The modified one-piece posterior laparoscopic total nephroureterectomy plus cystic sleeve resection for UTUC is an effective and feasible procedure with satisfactory tumor control, which is worth further promotion in clinical practice.

【Objective】 To investigate the efficacy and safety of single position transabdominal and extraperitoneal laparoscopic radical nephroureterectomy in the treatment of upper tract urothelial carcinoma (UTUC). 【Methods】 Clinical data of 31 UTUC cases treated in our hospital during Nov.2018 and Jun.2022 were retrospectively analyzed, including 11 tumors in the right side, and 20 in left side. There were 14 cases of renal pelvic carcinoma, 16 cases of ureter carcinoma, and 1 case of renal pelvic carcinoma plus ureter carcinoma. 【Results】 All surgeries were successfully performed without conversion to open surgery. The mean operation time was (81.45±19.80) min, and the estimated blood loss was (69.03±24.13) mL. No serious perioperative complications were observed. The average postoperative hospital stay was (6.13±2.44) d, and the median follow-up was 28 (3.0-49.0) months. At the last follow-up, 2 patients died, 3 had recurrence, but no contralateral recurrence was observed. 【Conclusion】 Single position transabdominal and extraperitoneal laparoscopic radical nephroureterectomy is safe, effective and feasible in the treatment of UTUC. It is worth clinical popularization.

【Objective】 To explore the correlation between CSAG1 expression and the prognosis and tumor-infiltrating lymphocytes in renal clear cell carcinoma (RCCC), and to predict the survival and tumor progression. 【Methods】 The gene expression profiles and clinical information of CSAG1 were downloaded from the Cancer Genome Atlas (TCGA). Based on the differential mRNA expression, GO annotation and KEGG pathway analysis were performed. The relationship between CSAG1 and tumor immune infiltration was assessed with Tumor Immunoassay Resource (Timer 2.0) database. The mRNA expression of CSAG1 in human RCCC specimens was validated with qRT-PCR. 【Results】 CSAG1 expression was significantly higher in RCCC tissues than in normal tissues (P<0.05). The qRT-PCR results revealed that the mRNA level of CSAG1 was consistent with that predicted by bioinformatic analysis. The KEGG analysis and GO annotation indicated high GSAG1 expression in RCCC was related to transmembrane transport, tricarboxylic acid cycle and lysosome. CSAG1 expression was positively related to the infiltration of pDC, aDC, CD8⁺ T cells, cytotoxic cells, TFH, TH1 cells, Tem, NK CD56^dm cells, Treg and T cells, but negatively correlated with macrophage infiltration. 【Conclusion】 CSAG1 may be associated with poor prognosis of RCCC and become a potential immunotherapy target.

Objective? To explore the application effect of nursing path and risk management for emergency stroke patients. Methods? From January to June 2018, 92 stroke patients who were treated in Zhumadian Central Hospital of He'nan Province were selected as the experimental objects and set as the optimized emergency care group; from July to December 2017, 92 stroke patients who were treated in the hospital were selected as the experimental objects and set as the routine care group. Routine nursing group was given nursing care according to the routine. Optimized emergency nursing group was given the nursing risk management care on the clinical care pathway. The VAS scores, satisfaction degree, rate of intact rescue articles, rate of nursing defects and adverse reactions during hospitalization. Results? Compared with the routine nursing group, the optimized emergency nursing group had higher satisfaction, lower VAS score, higher intact rate of rescue items, lower incidence of nursing defects and adverse reactions, the differences were statistically significant (P＜ 0.05). Conclusions? Optimizing emergency care and building risk management can better reduce the degree of pain and adverse reactions of stroke patients, improve patients' satisfaction and reduce the occurrence of nursing defects.

Objective: To summarize the clinical presentations and imaging features of cerebral venous sinus thrombosis (CVST) in 5 newborns. Methods: The clinical data of 5 newborns with CVST admitted to Department of Neonatology of Maternal and Children Hospital of Hubei Province from February 2017 to April 2018 were analyzed retrospectively. The risk factors, clinical presentations, imaging manifestations and treatment of CVST were investigated. Results: Of the 5 full term neonates, 4 were males and 1 female, with 4 aged less than 7 days and 1 more than 7 days; one with the history of maternal gestational diabetes mellitus, one with maternal gestational hypertension. The clinical presentations included seizures (3 cases), fever (3 cases), dehydration (1 cases), lethargy (2 cases), hypoglycemia (2 cases), thrombocytopenia (2 cases). Electroencephalogram (EEG) showed electrical seizures in 3 cases. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) showed 4 cases of intracranial hemorrhage, 3 cases of cerebral parenchymal infarction. For the sites of the thrombi, 4 were in the superior sagittal sinus, 3 in straight sinus, 2 in transverse sinus and 1 in sinus confluence. CT showed intracranial hemorrhage in 2 cases and venous sinus dilatation in 2 cases. Doppler ultrasound showed 2 cases of intraventricular hemorrhage and 2 cases of changes of venous sinus blood flow. Three neonates were treated with anticoagulant and thrombolytic therapy, followed by recanalization of the veins and discontinuing of seizures. Conclusions Seizure is the main clinical presentation of CVST. The main radiologic manifestations are cerebral infarction and hemorrhage. Timely brain MRI and MRV are helpful in the early diagnosis and treatment of CVST.

OBJECTIVETo investigate the effect of estrogen (E2), progesterone(P4), and paclitaxel (taxol) on the growth of primary human ovarian cancer cells in vitro and the expression of Drosha.

METHODSHuman ovarian cancer cells were treated with estrogen, progesterone or in combination with paclitaxel in vitro. The inhibition rate of ovarian cancer cells was assessed by methyl thiazolyl tetrazolium (MTT) assay. Apoptosis rate and cell cycle were determined by FACS analysis. The relative abundence of Drosha expression was detected by real-time quantitative PCR (qRT-PCR) and Western blotting.

RESULTSThe inhibition rate of the estrogen group, progesterone group, paclitaxel group, E2(+)Taxol group, P4(+)Taxol group was (31.53 ± 8.21)%, (25.22 ± 15.50)%, (46.71 ± 4.25)%, (69.46 ± 3.71)%, and (47.35 ± 39.02)%, respectively, significantly higher than that of the control group (0%, P<0.05 for all). Relative to the ER (-) in ovarian cancer cells,Drosha mRNA expression level of estrogen group, progesterone group, paclitaxel group, E2(+) Taxol group,and P4(+)Taxol group was 1.62 ± 0.10,1.60 ± 0.10,1.75 ± 0.16,1.95 ± 0.20, and 1.53 ± 0.06, respectively, significantly higher than that of the control group (1.00, P<0.05 for all). Relative to the ER (+)in ovarian cancer cells,the Drosha mRNA expression level of estrogen group, progesterone group, paclitaxel group, E2(+)taxol group, and P4(+)Taxol group was 1.03 ± 0.14, 1.60 ± 0.09, 1.75 ± 0.16, 1.60 ± 0.10, 1.53 ± 0.06, respectively except estrogen group, significantly higher than that of the control group (1.00, P<0.05). Relative to the ER (-) in ovarian cancer cells, the Drosha protein expression levels of the control group, estrogen group, progesterone group, paclitaxel group, E2(+) taxol group, and P4(+) Taxol group were 0.25 ± 0.05, 0.87 ± 0.30, 0.85 ± 0.38, 1.30 ± 0.21, 1.75 ± 0.83, 1.62 ± 0.82, respectively, with a significant difference between the experimental groups and the control group (P<0.05). Relative to the ER(+)ovarian cancer cells, the Drosha protein expression levels in the estrogen group, progesterone group, paclitaxel group, E2(+) taxol group, and P4(+) taxol group, were 0.28 ± 0.16, 0.85 ± 0.38, 1.30 ± 0.21, 0.94 ± 0.18, and 1.62 ± 0.82, respectively except estrogen group, significantly higher than that of the control group (0.25 ± 0.05, P<0.05 for all).

CONCLUSIONSEstrogen and progesterone in combination with paclitaxel can inhibit the growth of human ovarian cancer cells in vitro, and affect the cell apoptosis rate. Estrogen and taxol can alter the cell cycle. Estrogen and progesterone combined with paclitaxel show tumor suppressing or sensitizing effect through upregulated Drosha expression, and are associated with the estrogen receptor expression.

Antineoplastic Agents, Phytogenic ; pharmacology ; Antineoplastic Combined Chemotherapy Protocols ; pharmacology ; Apoptosis ; Cell Cycle ; Cell Growth Processes ; drug effects ; Cell Line, Tumor ; Coloring Agents ; Drug Therapy, Combination ; Estrogens ; pharmacology ; Female ; Humans ; In Vitro Techniques ; Ovarian Neoplasms ; chemistry ; drug therapy ; metabolism ; pathology ; Paclitaxel ; pharmacology ; Progesterone ; pharmacology ; RNA, Messenger ; metabolism ; Receptors, Estrogen ; metabolism ; Ribonuclease III ; genetics ; metabolism ; Tetrazolium Salts ; Thiazoles ; Up-Regulation

Objective To evaluate the relationship between the cytokine levels in the serum and cerebrospinal fluid and the brain injury in preterm infants. Methods From August of 2012 to August of 2013,51 preterm infants were included and 46 infants were survived. All of them were born at the Maternal and Child Hospital of Hubei Pro-vince,with GA≤32 weeks and high risk factors of intrauterine infection and suffering from early onset sepsis. Ac-cording to the screening findings of cerebral ultrasound and/or MRI,the infants were divided into normal group(n=28) and abnormal groups(n=18) with intracranial hemorrhage or white matter damage. The levels of interleukin(IL)-6,IL-1β and tumor necrosis factor-α( TNF-α) in the serum within 12 hours after birth and in cerebrospinal fluid within 72 hours after birth were investigated. The differences in cytokines between two groups were compared with t-test and Chi-square test,and high risk factors of brain injury were analyzed by Logistic regression models. Results The ab-normal group had higher incidence of clinical maternal chorioamnionitis[44. 44%(8/18 cases) vs 14. 29%(4/28 ca-ses),χ2=5.168,P=0.038] and higher white blood cell count[(11.51±9.03)×109/L vs(6.95±5.64)×109/L,t=-2. 107,P=0. 041]. In the abnormal group,the levels of serum IL-6 [(44. 83±16. 31) ng/L],and IL-6,IL-1βand TNF-αin cerebrospinal fluid [(51. 85±15. 65) ng/L,(11. 95±2. 58) ng/L and(193. 11±67. 25) ng/L] were higher than those in the normal group[(36.83±8.76) ng/L,(42.56±12.89) ng/L,(10.26±2.91) ng/L and(160.56± 29. 02) ng/L,respectively] with the statistical difference(t=-2. 687,-2. 250,0. 269,-2. 243,P=0. 010,0. 029,0. 044, 0. 030). Maternal chorioamnionitis,higher serum TNF-αand cerebrospinal fluid IL-6 were high risk factors for brain in-jury(P=0. 014,0. 031,0. 047). Conclusion Increased systemic and cerebrospinal fluid cytokine levels are possibly re-lated to the preterm brain injury when intrauterine infection occurred.

Objective To investigate the effect of estrogen( E2) ,progesterone( P4) , and paclitaxel ( taxol) on the growth of primary human ovarian cancer cells in vitro and the expression of Drosha. Methods Human ovarian cancer cells were treated with estrogen, progesterone or in combination with paclitaxel in vitro. The inhibition rate of ovarian cancer cells was assessed by methyl thiazolyl tetrazolium ( MTT) assay. Apoptosis rate and cell cycle were determined by FACS analysis.The relative abundence of Drosha expression was detected by real?time quantitative PCR ( qRT?PCR) and Western blotting. Results The inhibition rate of the estrogen group, progesterone group, paclitaxel group, E2 (+) Taxol group, P4 (+) Taxol group was (31.53±8.21)%, ( 25. 22 ± 15. 50)%, ( 46. 71 ± 4. 25)%, ( 69. 46 ± 3. 71)%, and ( 47. 35 ± 39. 02)%, respectively, significantly higher than that of the control group (0%, P<0.05 for all). Relative to the ER (-) in ovarian cancer cells,Drosha mRNA expression level of estrogen group, progesterone group, paclitaxel group, E2(+) Taxol group,and P4(+)Taxol group was 1.62±0.10,1.60±0.10,1.75±0.16,1.95±0.20, and 1.53±0.06, respectively, significantly higher than that of the control group (1.00,P<0.05 for all). Relative to the ER (+) in ovarian cancer cells,the Drosha mRNA expression level of estrogen group, progesterone group, paclitaxel group, E2(+)taxol group,and P4(+)Taxol group was 1.03±0.14,1.60±0.09,1.75±0.16, 1.60±0.10, 1.53±0.06, respectively except estrogen group, significantly higher than that of the control group ( 1.00, P<0.05) . Relative to the ER (-) in ovarian cancer cells, the Drosha protein expression levels of the control group, estrogen group, progesterone group, paclitaxel group, E2(+) taxol group, and P4(+) Taxol group were 0.25±0.05,0.87±0.30,0.85±0.38,1.30±0.21,1.75±0.83,1.62±0.82, respectively, with a significant difference between the experimental groups and the control group (P<0.05). Relative to the ER (+) ovarian cancer cells, the Drosha protein expression levels in the estrogen group, progesterone group, paclitaxel group, E2(+) taxol group, and P4(+) taxol group,were 0.28±0.16,0.85±0.38,1.30±0.21,0.94± 0.18, and 1.62±0.82, respectively except estrogen group, significantly higher than that of the control group (0.25±0.05, P<0.05 for all). Conclusions Estrogen and progesterone in combination with paclitaxel can inhibit the growth of human ovarian cancer cells in vitro, and affect the cell apoptosis rate. Estrogen and taxol can alter the cell cycle. Estrogen and progesterone combined with paclitaxel show tumor suppressing or sensitizing effect through upregulated Drosha expression, and are associated with the estrogen receptor expression.

Objective To investigate the effect of estrogen( E2) ,progesterone( P4) , and paclitaxel ( taxol) on the growth of primary human ovarian cancer cells in vitro and the expression of Drosha. Methods Human ovarian cancer cells were treated with estrogen, progesterone or in combination with paclitaxel in vitro. The inhibition rate of ovarian cancer cells was assessed by methyl thiazolyl tetrazolium ( MTT) assay. Apoptosis rate and cell cycle were determined by FACS analysis.The relative abundence of Drosha expression was detected by real?time quantitative PCR ( qRT?PCR) and Western blotting. Results The inhibition rate of the estrogen group, progesterone group, paclitaxel group, E2 (+) Taxol group, P4 (+) Taxol group was (31.53±8.21)%, ( 25. 22 ± 15. 50)%, ( 46. 71 ± 4. 25)%, ( 69. 46 ± 3. 71)%, and ( 47. 35 ± 39. 02)%, respectively, significantly higher than that of the control group (0%, P<0.05 for all). Relative to the ER (-) in ovarian cancer cells,Drosha mRNA expression level of estrogen group, progesterone group, paclitaxel group, E2(+) Taxol group,and P4(+)Taxol group was 1.62±0.10,1.60±0.10,1.75±0.16,1.95±0.20, and 1.53±0.06, respectively, significantly higher than that of the control group (1.00,P<0.05 for all). Relative to the ER (+) in ovarian cancer cells,the Drosha mRNA expression level of estrogen group, progesterone group, paclitaxel group, E2(+)taxol group,and P4(+)Taxol group was 1.03±0.14,1.60±0.09,1.75±0.16, 1.60±0.10, 1.53±0.06, respectively except estrogen group, significantly higher than that of the control group ( 1.00, P<0.05) . Relative to the ER (-) in ovarian cancer cells, the Drosha protein expression levels of the control group, estrogen group, progesterone group, paclitaxel group, E2(+) taxol group, and P4(+) Taxol group were 0.25±0.05,0.87±0.30,0.85±0.38,1.30±0.21,1.75±0.83,1.62±0.82, respectively, with a significant difference between the experimental groups and the control group (P<0.05). Relative to the ER (+) ovarian cancer cells, the Drosha protein expression levels in the estrogen group, progesterone group, paclitaxel group, E2(+) taxol group, and P4(+) taxol group,were 0.28±0.16,0.85±0.38,1.30±0.21,0.94± 0.18, and 1.62±0.82, respectively except estrogen group, significantly higher than that of the control group (0.25±0.05, P<0.05 for all). Conclusions Estrogen and progesterone in combination with paclitaxel can inhibit the growth of human ovarian cancer cells in vitro, and affect the cell apoptosis rate. Estrogen and taxol can alter the cell cycle. Estrogen and progesterone combined with paclitaxel show tumor suppressing or sensitizing effect through upregulated Drosha expression, and are associated with the estrogen receptor expression.