OBJECTIVE To establish a multi-index quantitative detection method， and to evaluate the quality difference of Gleditsia sinensis from different producing areas. METHODS The contents of protocatechuic acid， vanillic acid， isoscopoletin， scoparone， isovitexin， fustin， taxifolin， fisetin， quercetin， kaempferol， echinocystic acid， betulinic acid， β -sitosterol and stigmasterol were detected by high performance liquid chromatography-quantitative analysis of multi-components by single marker （HPLC-QAMS）. The chromatographic column was Kromasil C18， the mobile phase was 0.2% phosphoric acid-acetonitrile solution （gradient elution）， the detection wavelengths were 254， 360， 210 nm for different index components， the column temperature was 30 ℃ ， the flow rate was 1.0 mL/min， and the sample injection volume was 10 μL. The contents of extract and total ash were detected according to the method of Chinese Pharmacopoeia. The quality differences of 30 batches of G. sinensis （No. S1-S30） from different producing areas were evaluated by chemometrics， weighted technique for order preference by similarity to an ideal solution （TOPSIS） analysis and Logistic regression model. RESULTS The linear ranges of 14 components were 1.55-77.50， 0.71- 35.50， 0.28-14.00， 0.96-48.00， 1.77-88.50， 0.09-4.50， 4.65-232.50， 1.49-74.50， 0.37-18.50， 1.18-59.00， 7.35-367.50， 3.58- 179.00， 0.49-24.50 and 0.21-10.50 μg/mL， respectively （all r＞0.999）. The RSDs of precision， stability （24 h） and repeatability were less than 2.00%； the average recoveries were 96.99%-100.13% （all RSDs＜2.00%）， and the relative correction factor had good repeatability. The contents of extract and total ash were Δ 基金项目 湖北省中医药科研立项青年人才项目 （No. 4.2%-12.5% and 0.5%-2.3%， respectively. There was no ZY2019Q014） significant difference in the content of 14 components measured by QAMS method and external standard method （P＞0.05）. The results of chemometrics showed that 30 batches of samples were clustered into 3 categories： S1 to S11 form one category， S12 to S20 form another category， and S21 to S30 constitute the third category. Echinocystic acid， betulinic acid， taxifolin， kaempferol， isovitexin， scoparone and protocatechuic acid may be the differential components affecting the quality of G. sinensis from different producing areas. The analysis results of the weighted TOPSIS method revealed that relative closeness （Jb） for 30 batches of G. sinensis ranged from 0.144 5 to 0.721 8， with S27 achieving the highest value （Jb） of 0.721 8. The analysis results of the Logistic regression model showed that S21-S30 batches of samples were of superior grade， S1-S11 were of intermediate grade， and S12-S20 were of inferior grade. CONCLUSIONS The established HPLC-QAMS method is simple and accurate. The comprehensive evaluation method is objective and comprehensive， and can be used to evaluate the quality difference of G. sinensis from different producing areas.

Objective　To analyze the whole genome sequence characteristics of dengue serotype 2 virus (DENV-2) strains isolated from Guangzhou in 2023, providing new foundational data to support local dengue fever prevention and control efforts. Methods　Dengue viruses were isolated from serum samples of dengue fever patients using C6/36 cells. Whole genome sequencing of dengue virus was performed using Nanopore sequencing technology (Nanopore platform). The sequencing data were assembled utilizing IPH-NANO v1.0 software, and homology analysis, phylogenetic analysis, and amino acid site variation analysis of the dengue virus genome sequence were conducted using software such as BioEdit7.0.9.0, MEGA11, and iqTree1.6.12. Results　A total of 13 DENV-2 isolates were obtained from the serum samples of dengue fever patients in Guangzhou in 2023, all of which were derived from locally infected cases. The whole genome sequences obtained by sequencing and splicing ranged from 10 429-10 439 nt in length. The nucleotide (amino acid) homology among the 13 isolates was 99.7%-99.9% (99.6%-9.9%). A genome-wide phylogenetic analysis showed that the genotypes of all 13 Guangzhou isolates were identified as the Cosmopolitan genotype and were grouped in the same evolutionary clade as isolates from Réunion (French overseas territory), Djibouti, Kenya, and other regions. Compared with the reference sequence (NC001474), a total of 26 amino acid site variations were identified in the C/prM/E protein regions of the 13 isolates, including 4 variations in the C protein region, 8 in the prM protein region, and 14 in the E protein region. Conclusion　The DENV-2 strains isolated from Guangzhou in 2023 exhibited high homology, with closely related isolates primarily originating from countries or regions such as Réunion, Djibouti, and Kenya, it highlights the need for further assessment of the risk of dengue fever importation from East Africa, South Asia, and other regions.

Objective To explore the microstructural changes in white matter(WM)fibers of patients with post-stroke depression(PSD)by using automated fiber quantification(AFQ)and the relationship between changes in fibers and the Hamilton depression scale(HAMD).Methods The HAMD and MRI data were collected from stroke patients with a single anterior circulation infarction at 1-month follow-up.AFQ was used to extract the main fibers and calculate the fractional anisotropy(FA)of each node in each fiber.The difference of node FA in each fiber between groups and correlations between altered node FA and HAMD were then evaluated.Results Data were collected from 8 patients with PSD and 18 patients without PSD(non-PSD).Compared with that in non-PSD,the node FA in the callosum,left inferior longitudinal fasciculus,and uncinate fasciculus were significantly decreased in patients with PSD(P<0.05).The altered node FA values in the corpus callosum forceps minor(r=-0.418,P=0.047)and left uncinate fasciculus(r=-0.467,P=0.029)were negatively related to HAMD in patients with PSD.Conclusions AFQ can precisely measure the segmental microstructural damage of nerve fiber bundles in patients with PSD,of which segmental microstructural damage of the corpus callosum forceps and hook tracts is associated with the severity of depression.

Objective:To investigate the changes of blood glucose and blood lipid in gestational diabetes mellitus (GDM) patients with different insulin sensitivity during pregnancy and the effect of non-drug intervention.Methods:Data of 240 pregnant women with GDM and 240 healthy pregnant women were collected from July 1 to September 1, 2023 in Shijing People′s Hospital in Baiyun District and other five hospital. The insulin sensitivity index (ISI) was calculated by homeostasis model assessment 2(HOMA2) model, according to the 25th percentile of ISI of normal pregnant women, GDM patients were divided into insulin sensitive group (group A) and insulin sensitive deficiency group (group B), and group A and group B were divided into two groups according to 36-week blood glucose control: group A1 with good blood glucose control (group A1 and group B1) and group A2 with bad blood glucose control (group A2 and group B2). The age, body mass index (BMI) before pregnancy, fasting plasma glucose (FPG), blood lipids and blood glycated hemoglobin (HbA 1c ) in the first trimester, blood glucose and blood lipids in the second trimester were compared at the 28th, 32nd and 36th weeks of gestation, the number of cases, blood glucose, blood lipids and non-drug intervention were measured. Results:There were 166 cases in group A and 74 cases in group B. Blood glucose and blood lipid were normal in early pregnancy. There was no significant difference in blood glucose between group A and group B during the second trimester. The levels of blood lipids were significantly higher than those during the first trimester, and the levels of triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) were significantly higher than those during the first trimester. The number of pregnant women in group A1 was significantly more than that in group A2 in the third trimester ( P = 0.01), and the number of pregnant women in group B1 was more than that in group B2 at 28 weeks ( P = 0.01). At 32 weeks, the number of pregnant women in group B1 and group B2 was similar ( P = 0.31). At 36 weeks, the number of pregnant women in group B1 was significantly lower than that in group B2 ( P = 0.01). In the third trimester of pregnancy, the levels of blood glucose in group B2 were higher than those in group A2 ( P<0.05). The levels of TG and LDL-C in group A2 and group B2 were higher than those in group A1 and group B1 respectively, high-density lipoprotein cholesterol (HDL-C) was lower than that in group A1 and group B1( P<0.05), and there was no significant difference in TC between group A2 and group A1 at 28 and 32 weeks ( P>0.05), but it was significantly higher at 36 weeks ( P = 0.01). In the third trimester of pregnancy, diet control was the most common (91.7%, 87.7%, 81.6%, respectively) in group A ( P>0.05). The proportions of diet-only and diet-plus exercise interventions were similar in group B1 at 28 weeks and 32 weeks (52.9% vs. 47.1%, 45.7% vs. 54.3%)( P = 0.072, 0.113). At the 36 weeks, the main intervention was diet combined with exercise (73.3%). In group B2, dietary intervention (69.6%, 71.8%, 69.5%) was the main cause of poor control of blood glucose. Conclusions:In GDM patients with insulin sensitivity deficiency, the blood glucose and blood lipids in the second trimester are obviously increased, and the abnormality in the third trimester is even greater.

OBJECTIVE To comprehensively evaluate the quality of Yifei qinghua ointment by multi-component quantitative analysis combined with chemometrics and entropy weight-technique for order preference by similarity to ideal solution （TOPSIS） method. METHODS The contents of lobetyolin， syringin， calycosin 7-O-β-D-glucopyranoside， ononin， astraisoflavan-7-O-β-D- glucoside， isomucronulatol 7-O-glucoside， astragaloside Ⅳ ， deapi-platycoside E， platycoside E， platycodin D3， feretoside， asperulosidic acid， asperuloside， methylophiopogonanone A and methylophiopogonanone B in 14 batches of Yifei qinghua ointment （S1-S14） were determined by high-performance liquid chromatography method. Then， the quality of 14 batches of Yifei qinghua ointment was analyzed by chemometrics （principal component analysis and orthogonal partial least-squares discriminant analysis） and entropy weight TOPSIS method. RESULTS The results of chemometrics showed that 14 batches of Yifei qinghua ointment could be clustered into three categories， S1-S6 as the first category， S7-S10 as the second category， and S11-S14 as the third category. The values of variable importance for projection of calycosin 7-O-β-D-glucopyranoside， ononin， feretoside， astragaloside Ⅳ， astraisoflavan-7-O-β-D-glucoside， lobetyolin， methylophiopogonanone A and platycoside E were higher than 1. The results of the entropy weight TOPSIS method showed that the Euclidean closeness of the optimal solution of 14 batches of Yifei qinghua ointment were between 0.152 9 and 0.736 6， and that of sample S14 was the highest （0.736 6）. CONCLUSIONS Among 14 batches of Yifei qinghua ointment， sample S14 has the best quality， and 8 components such as calycosin 7-O-β-D-glucopyranoside and ononin may be differential markers affecting the quality of Yifei qinghua ointment.

In recent years,there have been active studies on intracranial hemorrhage associated with hematological malignancies,but the understanding of subarachnoid hemorrhage associated with hematological malignancies is still insufficient.We retrieve from PubMed and China National Knowledge Infrastructure(NCKI),and describes the understanding of hematological malignant tumor related subarachnoid hemorrhage.This article summarizes the clinical characteristics and possible pathogenesis of subarachnoid hemorrhage associated with hematological malignancies.At present,there is a lack of effective prevention and treatment measures for hematological malignant tumor-related subarachnoid hemorrhage,which mainly focuses on the active treatment of the primary disease while saving time for the treatment of complications,and the mortality is high.

Objectives:To investigate the clinical and genetic features of young Chinese patients with myeloproliferative neoplasms (MPN) .Methods:In this cross-sectional study, anonymous questionnaires were distributed to patients with MPN patients nationwide. The respondents were divided into 3 groups based on their age at diagnosis: young (≤40 years) , middle-aged (41-60 years) , and elderly (>60 years) . We compared the clinical and genetic characteristics of three groups of MPN patients.Results:1727 assessable questionnaires were collected. There were 453 (26.2%) young respondents with MPNs, including 274 with essential thrombocythemia (ET) , 80 with polycythemia vera (PV) , and 99 with myelofibrosis. Among the young group, 178 (39.3%) were male, and the median age was 31 (18-40) years. In comparison to middle-aged and elderly respondents, young respondents with MPN were more likely to present with a higher proportion of unmarried status (all P<0.001) , a higher education level (all P<0.001) , less comorbidity (ies) , fewer medications (all P<0.001) , and low-risk stratification (all P<0.001) . Younger respondents experienced headache (ET, P<0.001; PV, P=0.007; MF, P=0.001) at diagnosis, had splenomegaly at diagnosis (PV, P<0.001) , and survey (ET, P=0.052; PV, P=0.063) . Younger respondents had fewer thrombotic events at diagnosis (ET, P<0.001; PV, P=0.011) and during the survey (ET, P<0.001; PV, P=0.003) . JAK2 mutations were found in fewer young people (ET, P<0.001; PV, P<0.001; MF, P=0.013) ; however, CALR mutations were found in more young people (ET, P<0.001; MF, P=0.015) . Furthermore, mutations in non-driver genes (ET, P=0.042; PV, P=0.043; MF, P=0.004) and high-molecular risk mutations (ET, P=0.024; PV, P=0.023; MF, P=0.001) were found in fewer young respondents. Conclusion:Compared with middle-aged and elderly patients, young patients with MPN had unique clinical and genetic characteristics.

Objective:To explore the clinical characteristics and influencing factors intracranial hemorrhagic lesions in patients with intracranial venous sinus thrombosis (CVST).Methods:The 108 patients with CVST from January 2013 to December 2020 in the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed. Among them, 46 patients had intracranial hemorrhagic lesions (hemorrhagic lesion group), and 62 patients did not have intracranial hemorrhagic lesions (non hemorrhagic lesion group). The general medical history data, laboratory examination results, imaging examination results, National Institutes of Health stroke scale (NIHSS) score within 24 hours of admission and modified Rankin scale (mRS) score (2 to 6 scores indicating poor prognosis) at discharge (or on the 30th day of hospitalization) were recorded. Multivariate Logistic regression analysis was used to analyze the independent risk factors of intracranial hemorrhagic lesions in patients with CVST and the independent risk factors of prognosis in patients CVST combined with intracranial hemorrhagic lesions.Results:The NIHSS score, neutrophil to lymphocyte ratio (NLR), high sensitivity C-reactive protein (hs-CRP) and the proportions of changes in consciousness, epileptic seizures, poor prognosis, oral contraceptives, congenital protein C or S deficiency in hemorrhagic lesion group were significantly higher than those in non hemorrhagic lesion group: 4 (0, 10) scores vs. 0 (0, 5) scores, 4.62 (2.50, 8.58) vs. 3.46 (2.01, 5.00), 13.1 (5.6, 56.7) mg/L vs. 7.5 (2.8, 18.0) mg/L, 47.8% (22/46) vs. 29.0% (18/62), 39.1% (18/46) vs. 21.0% (13/62), 39.1% (18/46) vs. 21.0% (13/62), 32.6% (15/46) vs. 8.1% (5/62), 30.4% (14/46) vs. 12.9% (8/62), and there were statistical differences ( P<0.01 or <0.05). The incidences of straight sinus and multiple venous sinus thrombosis in hemorrhagic lesion group were significantly higher than those in non hemorrhagic lesion group: 43.5% (20/46) vs. 24.2% (15/62) and 82.6% (38/46) vs. 58.1% (36/62), and there were statistical differences ( P<0.05 or <0.01). Multivariate Logistic regression analysis result showed that the oral contraceptives, multiple venous sinus thrombosis and the elevated hs-CRP, NLR were independent risk factors of intracranial hemorrhagic lesions in patients with CVST ( OR = 6.950, 5.182, 1.026 and 1.137; 95% CI 1.453 to 33.243, 1.076 to 24.960, 1.007 to 1.046 and 1.004 to 1.287; P<0.05 or <0.01). Among 46 patients with CVST combined with intracranial hemorrhagic lesions, 28 patients had a good prognosis, and 18 patients had a poor prognosis. The NIHSS score, NLR, hs-CRP and the proportions of oral contraceptives, congenital protein C or S deficiency, changes in consciousness and epileptic seizures in patients with poor prognosis were significantly higher than those in patients with good prognosis: 9 (4, 28) scores vs. 0 (0, 6) scores, 7.43 (3.86, 12.99) vs. 3.3 (1.97, 6.77), 127.0 (96.5, 168.0) mg/L vs. 11.5 (3.3, 33.5) mg/L, 10/18 vs. 17.9% (5/28), 10/18 vs. 14.3% (4/28), 12/18 vs. 35.7% (10/28) and 11/18 vs. 25.0% (7/28), and there were statistical difference ( P<0.01 or <0.05). Multivariate Logistic regression analysis result showed that the elevated hs-CRP was the independent risk factor of prognosis in patients CVST combined with intracranial hemorrhagic lesions ( OR = 1.046, 95% CI 1.007 to 1.086, P<0.05). Conclusions:The patients with CVST combined with intracranial hemorrhagic lesions have more severe clinical symptoms, and the changes in consciousness, epileptic seizures, poor short-term prognosis are more common. The oral contraceptives, multiple venous sinus involvement and elevated NLR, hs-CRP are independent risk factors in patients with CVST combined with intracranial hemorrhagic lesions; moreover, the elevated hs-CRP is an independent risk factor for poor short-term prognosis in patients with CVST combined with intracranial hemorrhagic lesions.

Purpose: We aimed to evaluate whether the addition of pemetrexed is effective in improving progression-free survival (PFS) in epidermal growth factor receptor (EGFR)–mutated patients with or without concomitant alterations. Materials and Methods: This multicenter clinical trial was conducted in China from June 15, 2018, to May 31, 2019. A total of 92 non–small cell lung cancer (NSCLC) patients harboring EGFR-sensitive mutations were included and divided into concomitant and non-concomitant groups. Patients in each group were randomly treated with EGFR–tyrosine kinase inhibitor (TKI) monotherapy or EGFR-TKI combined with pemetrexed in a ratio of 1:1. PFS was recorded as the primary endpoint. Results: The overall median PFS of this cohort was 10.1 months. There were no significant differences in PFS between patients with and without concomitant and between patients received TKI monotherapy and TKI combined with pemetrexed (p=0.210 and p=0.085, respectively). Stratification analysis indicated that patients received TKI monotherapy had a significantly longer PFS in non-concomitant group than that in concomitant group (p=0.002). In concomitant group, patients received TKI combined with pemetrexed had a significantly longer PFS than patients received TKI monotherapy (p=0.013). Molecular dynamic analysis showed rapidly emerging EGFR T790M in patients received TKI monotherapy. EGFR mutation abundance decreased in patients received TKI combined chemotherapy, which supports better efficacy for a TKI combined chemotherapy as compared to TKI monotherapy. A good correlation between therapeutic efficacy and a change in circulating tumor DNA (ctDNA) status was found in 66% of patients, supporting the guiding role of ctDNA minimal residual disease (MRD) in NSCLC treatment. Conclusion EGFR-TKI monotherapy is applicable to EGFR-sensitive patients without concomitant alterations, while a TKI combined chemotherapy is applicable to EGFR-sensitive patients with concomitant alterations. CtDNA MRD may be a potential biomarker for predicting therapeutic efficacy.

Objective:To investigate the reliability and repeatability of 3 classification systems for coronal fractures of distal humerus.Methods:Included were the imaging data (X-ray and CT scan) of the 64 patients with distal humeral coronal fracture who had been admitted to the outpatient and emergency departments of Beijing Jishuitan Hospital from January, 2015 to December, 2021. Four orthopedic surgeons (1 chief surgeon, 1 associate chief surgeon, 1 attending surgeon, and 1 resident surgeon) served as observers who classified the fractures by their imaging data respectively according to the Bryan-Morrey, Ring and Dubberley classifications. Four weeks later when the imaging data of 64 patients were renumbered, the 4 orthopedic surgeons performed the same classifications again. Inter-observer and intra-observer Kappa values were calculated for the 3 classifications. Landis and Koch Kappa's Benchmark Scale was used to interpret the results.Results:Interobserver confidence: The average agreement of the Bryan-Morrey classification was 75.0%, and its Kappa value was 0.546, indicating moderate agreement. The average consistency of Ring classification was 74.7%, and its Kappa value was 0.702, indicating high consistency. The average consistency of Dubberley classification was 84.1%, and its Kappa value was 0.785, indicating high consistency. Intra-observer repeatability: The average consistency of Bryan-Morrey classification was 89.9% and its Kappa value was 0.824 for the same observer. The average consistency of Ring classification was 91.0%, and its Kappa value was 0.884. The average consistency of Dubberley classification was 91.8%, and its Kappa value was 0.888.Conclusions:The 3 classification systems for distal humeral coronal fractures all demonstrate high reproducibility. As the Dubberley classification system is relatively more reliable, it has a certain guiding value for the treatment of coronal fractures of the distal humerus. However, in clinical practice, an optimal surgical strategy should take into account various factors that may affect fracture typing.