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 evaluate the relationship between perioperative myocardial injury(PMI)and serum N/OFQ levels in elderly patients with coronary heart disease.Methods Totally 120 elderly patients who underwent hip fracture surgery under general anesthesia from January 2022 to May 2023 were included,including 60 patients with coronary heart disease(CHD group)and 60 patients without coronary heart disease(control group).The venous blood of patients was collected 10 minutes before anesthesia induction(T0),12 hours after surgery(T1)and 24 hours after surgery(T2)to detect the content of N/OFQ and high-sensitivity myocardial troponin I(hs-cTnI)in serum.Record perioperative adverse cardiovascular events(PACE)and the use of vasoactive drugs during surgery.Results Compared with the control group,the N/OFQ and hs cTnI levels at T0 and T1 in the CHD group were significantly increased(P<0.05).There was a positive correlation between N/OFQ and hs-cTnI levels at T1 and T2 in CHD and control group(P<0.05).The use of PACE and intraoperative vasoactive drugs in the CHD group was higher than that in the control group(P<0.05).Conclusion There is a correlation between the increased N/OFQ content and PMI in elderly patients with coronary heart disease after surgery,which may become an early predictive indicator of PMI.

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.

Objective To investigate the effects of volumetric modulated arc therapy (VMAT) with 6 MV and 10 MV X-ray photon energies in patients with cervical cancer. Methods From March 2019 to May 2020, 24 patients with cervical cancer who underwent radiation therapy in the Oncology Radiotherapy Department of our hospital were selected. VMAT plans with 6 MV and 10 MV photon energies were re-designed for each patient. The target parameters (D_98%, D_2%, D_mean), conformal index, and homogeneity index of the two groups were compared. The radiation doses received by the bladder, rectum, small intestine, left femoral head, right femoral head, and normal tissue other than planning target volume (Body-PTV), as well as monitor units and estimated total delivery time, were also compared. Results D_2%, D_mean, homogeneity index, and monitor units were significantly lower in the 10 MV group than in the 6 MV group (50.78 ± 0.33 Gy vs. 50.35 ± 0.29 Gy; 49.05 ± 0.2 Gy vs. 48.93 ± 0.17 Gy; 0.08 ± 0.01 vs. 0.07 ± 0.01; 1179.26 ± 110.55 vs. 1099.3 ± 80.9). Comparison of organs at risk showed that compared with the 10 MV group, the 6 MV group demonstrated significantly lower V_40Gy of the bladder, D_5% of the right femoral head, and D_2% and V_5Gy of Body-PTV (60.37 ± 13.66 vs. 60.84 ± 13.88; 37.09 ± 5.43 Gy vs. 38.03 ± 5.68 Gy; 41.71 ± 1.39 Gy vs. 42.16 ± 1.31 Gy; 47.88 ± 9.75 vs. 48.23 ± 9.74). There were no significant differences in other parameters between the two groups. Conclusion The VMAT plans with 6 MV and 10 MV X-ray photon energies both meet the clinical needs of cervical cancer radiotherapy. The cervical cancer VMAT plan with 6 MV photon energy is recommended due to better protection of the organs at risk.

Objective To elucidate the prediction ability of monocyte monolayer assay(MMA)used in hemolytic dis-ease of fetus and newborn(HDFN)caused by IgG anti-M.Methods Plasma from eight pregnant women containing IgG an-ti-M were collected,and were divided into two groups(4 cases with HDFN,with severe clinical symptoms such as fetal hy-drops,and 4 cases without HDFN)according to the clinical outcomes.M antigen positive cells were sensitized with dithioth-reitol(DTT)treated plasma from eight pregnant women respectively.MMA was performed by coincubation with monocytes and sensitized M cells,along with negative and positive control set up.T-test was conducted to compare the difference in phagocytic efficiency between two groups.Results The phagocytic efficiency in group with HDFN were 15.37%,13.05%,9.17%and 24.50%respectively,with the mean value of 15.52%,while the group without HDFN were 8.74%,11.07%,5.12%and 6.23%respectively,with the mean value of 7.79%.There was no significant difference in phagocytic efficiency between two groups(P>0.05).The mean values of both groups were not significantly different from the negative control(P>0.05),but both were significantly lower than positive control(P<0.05).Conclusion The low phagocytic efficiency couldn't convince that the MMA is an effective predictor for the HDFN caused by IgG anti-M,indicating that another mech-anism might be responsible for it rather than monocyte phagocytosis.The assessment of the peak systolic velocity in middle cerebral artery of the fetal should be considered in the management for pregnant women who produce IgG anti-M to estimate the situation of fetal anemia.

Objective To investigate the effects of volumetric modulated arc therapy (VMAT) with 6 MV and 10 MV X-ray photon energies in patients with cervical cancer. Methods From March 2019 to May 2020, 24 patients with cervical cancer who underwent radiation therapy in the Oncology Radiotherapy Department of our hospital were selected. VMAT plans with 6 MV and 10 MV photon energies were re-designed for each patient. The target parameters (D_98%, D_2%, D_mean), conformal index, and homogeneity index of the two groups were compared. The radiation doses received by the bladder, rectum, small intestine, left femoral head, right femoral head, and normal tissue other than planning target volume (Body-PTV), as well as monitor units and estimated total delivery time, were also compared. Results D_2%, D_mean, homogeneity index, and monitor units were significantly lower in the 10 MV group than in the 6 MV group (50.78 ± 0.33 Gy vs. 50.35 ± 0.29 Gy; 49.05 ± 0.2 Gy vs. 48.93 ± 0.17 Gy; 0.08 ± 0.01 vs. 0.07 ± 0.01; 1179.26 ± 110.55 vs. 1099.3 ± 80.9). Comparison of organs at risk showed that compared with the 10 MV group, the 6 MV group demonstrated significantly lower V_40Gy of the bladder, D_5% of the right femoral head, and D_2% and V_5Gy of Body-PTV (60.37 ± 13.66 vs. 60.84 ± 13.88; 37.09 ± 5.43 Gy vs. 38.03 ± 5.68 Gy; 41.71 ± 1.39 Gy vs. 42.16 ± 1.31 Gy; 47.88 ± 9.75 vs. 48.23 ± 9.74). There were no significant differences in other parameters between the two groups. Conclusion The VMAT plans with 6 MV and 10 MV X-ray photon energies both meet the clinical needs of cervical cancer radiotherapy. The cervical cancer VMAT plan with 6 MV photon energy is recommended due to better protection of the organs at risk.

Objective:To investigate the clinical effect of proper management of inferior pancreaticoduodenal artery (IPDA) in laparoscopic pancreaticoduodenectomy (LPD).Methods:This is a retrospective case series study. The clinical and pathological data of 70 patients who received LPD due to pancreatic head tumors, periampullary tumors, or distal common bile duct tumors in the Pancreatic Center of the Second Clinical College of Guangzhou University of Chinese Medicine from January to December 2022 were retrospectively collected. There were 47 males(67.1%) and 23 females(32.9%),aged (59.9±12.8)years(range:13 to 87 years).The procedure of IPDA exposure was as follows:a middle approach was utilized to expose the right half of superior mesenteric artery(SMA) and its right branches between the SMA and superior mesenteric vein(SMV) in superior colonic region. In the subcolonic region,SMA trunk exposure via dissection along the jejunal artery from feet to head and identification the association between IPDA and jejunal artery were prior to IPDA root ligation and dissection. The safety and efficacy of intraoperative IPDA handling were assessed based on surgical videos. Follow-up was carried out in outpatient clinic or by telephone, and outpatient follow-up was conducted once every 1 to 3 months after surgery.Results:The percentage of total LPD was 98.6%(69/70),with all patients achieving R0 resection. Nine cases(12.9%) were involved in combined vascular resection and reconstruction,with 1 case (1.4%) requiring additional upper abdominal incision for vascular and gastrointestinal reconstruction,while the remaining eight cases (11.4%) were completed laparoscopically. The operative time was (432.7±115.4)minutes(range:282 to 727 minutes), and the blood loss was (140.0±125.7)ml(range:20 to 800 ml). Only two patients(2.9%) received fresh frozen plasma transfusion,with an average volume of 650 ml. Reliable ligation and safe handling of the IPDA were achieved in 91.4%(64/70) of cases, with 8.6%(6/70) suffering from IPDA injury-related bleeding. No one was converted to opened surgery. Pathologically,the mean tumor size was (3.3±1.6)cm (range:1 to 7 cm),and the mean number of harvested lymph nodes was 17.0±7.3(range:0 to 46). Lymph node metastasis was observed in 13 cases (18.6%). Five cases (13.2%) developed grade B pancreatic fistula,while no grade C pancreatic fistula occurred. Other complications included bile leakage in one case(1.4%),delayed gastric emptying in two cases(2.9%), lymphatic leakage in 2 cases(2.9%),intra-abdominal infection in 9 cases(12.9%),and fat liquefaction of surgical incision in 1 case(1.4%). Two cases(2.9%) experienced postoperative intra-abdominal bleeding,one due to mesangial bleeding of lesser curvature of the stomach and the other due to oozing from the hepatic arterial sheath. These bleeding events were not concerned with IPDA. The average length of postoperative hospital stay was (15.2±4.6)days(range:9 to 28 days).Conclusion:Proper intraoperative management of IPDA in LPD might reduce IPDA-related bleeding during and after surgery and improve the safety of LPD.

Background::Gastric cancer (GC), a malignant tumor with poor prognosis, is one of the leading causes of cancer-related deaths worldwide; consequently, identifying novel therapeutic targets is crucial for its corresponding treatment. NUF2, a component of the NDC80 kinetochore complex, promotes cancer progression in multiple malignancies. Therefore, this study aimed to explore the potential of NUF2 as a therapeutic target to inhibit GC progression. Methods::Clinical samples were obtained from patients who underwent radical resection of GC at Lanzhou University Second Hospital from 2016 to 2021. Cell count assays, colony formation assays, and cell-derived xenotransplantation (CDX) models were used to determine the effects of NUF2 on GC progression. Flow cytometry was used to detect the effect of NUF2 or quercetin on cell cycle progression and apoptosis. A live-cell time-lapse imaging assay was performed to determine the effect of NUF2 on the regulation of mitotic progression. Transcriptomics was used to investigate the NUF2-associated molecular mechanisms. Virtual docking and microscale thermophoresis were used to identify NUF2 inhibitors. Finally, CDX, organoid, and patient-derived xenograft (PDX) models were used to examine the efficacy of the NUF2 inhibitor in GC. Results::NUF2 expression was significantly increased in GC and was negatively correlated with prognosis. The deletion of NUF2 suppressed GC progression both in vivo and in vitro. NUF2 significantly regulated the mitogen-activated protein kinase (MAPK) pathway, promoted G2/M phase transition, and inhibited apoptosis in GC cells. Additionally, quercetin was identified as a selective NUF2 inhibitor with low toxicity that significantly suppressed tumor growth in GC cells, organoids, CDX, and PDX models. Conclusions::Collectively, NUF2-mediated G2/M phase transition and apoptosis inhibition promoted GC progression; additionally, NUF2 inhibitors exhibited potent anti-GC activity. This study provides a new strategy for targeting NUF2 to suppress GC progression in clinical settings.

Objective:To explore the prevalence and independent associated factors of vascular calcification (VC) in non-dialysis chronic kidney disease (CKD) patients of stage 3-5.Methods:It was a single-center cross-sectional observational study. Non-dialysis stage 3-5 CKD patients ≥18 years old who were admitted to the Department of Nephrology, the First Affiliated Hospital of Sun Yat-sen University from May 1, 2022 to December 31, 2022 with VC evaluation were enrolled. The patients' general information, laboratory examination and imaging data were collected. Coronary artery calcification (CAC), thoracic aorta calcification (TAC), abdominal aorta calcification (AAC), carotid artery calcification and aortic valve calcification (AVC) were evaluated by cardiac-gated electron-beam CT (EBCT) scans, lateral lumbar x-ray, cervical macrovascular ultrasound and echocardiography, respectively. The differences in clinical data and the prevalence of VC at different sites of patients with different CKD stages were compared, and the prevalence of VC at different sites of patients in different age groups [youth group (18-44 years old), middle-aged group (45-64 years old) and elderly group (≥65 years old)] and patients with or without diabetes were compared. Multivariate logistic regression analysis was used to analyse the independent associated factors of VC for different areas.Results:A total of 206 patients aged (51±14) years were included, including 129 (62.6%) males. There were 44 patients with CKD stage 3 (21.4%), 51 patients with CKD stage 4 (24.8%), and 111 patients with CKD stage 5 (53.9%). CKD was caused by chronic glomerulonephritis [104 cases (50.5%)], diabetic kidney damage [35 cases (17.0%)], hypertensive kidney damage [29 cases (14.1%)] and others [38 cases (18.4%)]. Among 206 patients, 131 (63.6%) exhibited cardiovascular calcification, and the prevalence of CAC, TAC, AAC, carotid artery calcification, and AVC was 37.9%, 43.7%, 37.9%, 35.9% and 9.7%, respectively. The overall prevalence of VC in young, middle-aged and elderly patients was 24.6%, 73.6% and 97.4%, respectively. With the increase of age, the prevalence of VC in each site gradually increased, and the increasing trend was statistically significant (all P<0.001). The overall prevalence of VC in CKD patients with diabetes was 92.5% (62/67), and the prevalence of VC at each site in the patients with diabetes was significantly higher than that in the patients without diabetes (all P<0.001). Multivariate logistic regression analysis revealed that age (every 10 years increase, OR=2.51, 95% CI 1.77-3.56, P<0.001), hypertension ( OR=5.88, 95% CI 1.57-22.10, P=0.009), and diabetes ( OR=4.66, 95% CI 2.10-10.35, P<0.001) were independently correlated with CAC; Age (every 10 years increase, OR=6.43, 95% CI 3.64-11.36, P<0.001) and hypertension ( OR=6.09, 95% CI 1.33-27.84, P=0.020) were independently correlated with TAC; Female ( OR=0.23, 95% CI 0.07-0.72, P=0.011), age (every 10 years increase, OR=3.90, 95% CI 2.42-6.29, P<0.001), diabetes ( OR=5.37, 95% CI 2.19-13.19, P<0.001) and serum magnesium ( OR=0.01,95% CI 0-0.35, P=0.014) were independently correlated with AAC. Moreover, age and diabetes were independently correlated with carotid artery calcification, AVC and overall VC Conclusions:The prevalence of VC in non-dialysis CKD patients of stage 3-5 is 63.59%, of which CAC reaches 37.9%, TAC is the most common one (43.7%), while AVC is the least one (9.7%). Age and diabetes are the independent associated factors for VC of all sites except TAC, while hypertension is an independent associated factor for both CAC and TAC.

Objective This study aims to assess the clinical value of sputum and bronchoalveolar lavage fluid examination combined with acid-fast bacilli detection to provide a reference for the diagnosis and treatment of pulmonary tuberculosis.Methods We collected and analyzed relevant test data from patients who underwent smear and/or isolation of sputum and bronchoalveolar lavage fluid for acid-fast bacilli or Mycobacterium detection within the same week from January 2021 to July 2021.The test results'similarities and differences were analyzed.Results Of the 272 patients,the positive rates of sputum smear,alveolar lavage fluid smear,sputum isolation,alveolar lavage fluid isolation(hereinafter referred to as"A""B""C"and"D")were 14.71％(40/272),19.49％(53/272),25.00％(67/268)and 31.90％(74/232),respectively.The positive rate of the four tests as parallel tests was 37.50％(102/272).The result modes of A+C+,A-C+,A+C-,A-C-and A-CN(the"+""-"and"N"in the super-script stood for"positive""negative"and"undetected")accounted for 14.71％(40/272),13.97％(38/272),0,69.85％(190/272),1.47％(4/272)respectively,and the result modes of B+D+,B-D+,B+D-,B-D-and B-DN accounted for 19.12％(52/272),8.82％(24/272),0.37％(1/272),56.99％(155/272),14.71％(40/272).The percentages of these re-sult modes of A+B+,A+B-,A-B+and A-B-were 14.71％(40/272),0,4.78％(13/272),80.51％(219/272),respec-tively.The percentages of these result modes of A+D+,A+D-,A+DN,A-D+,A-D-,A-DN,AND+,AND-and ANDN were 19.12％(52/272),5.51％(15/272),4.04(11/272),8.09％(22/272),51.74％(140/272),10.29％(28/272),0.74％(2/272),0.37％(1/272),and 0.37％(1/272),respectively.Conclusion Compared with more common sputum tes-ting,for acid-fast bacteria,performing bronchoalveolar lavage fluid testing for acid-fast bacteria in alveolar lavage fluid can signifi-cantly improve etiological diagnostic performance for tuberculosis,which is worth promoting extensively in clinical practice.