ObjectiveThrough qualitatively and quantitatively analysis of the differences in chemical composition between the combined decoction and single decoction of Huaganjian and comparison of their core efficacy， to explore the rationality of the flexible clinical application of Huaganjian compound preparations and single-flavored dispensing granules. MethodsUltra performance liquid chromatography-quadrupole-electrostatic field orbitrap high resolution mass spectrometry（UPLC-Q-Exactive Orbitrap MS） was used to qualitatively analyze the combined decoction and single decoction samples of Huaganjian， and meanwhile， the contents of four index components（geniposide， paeoniflorin， hesperidin and paeonol） were quantitatively analyzed by high performance liquid chromatography（HPLC）. Nonalcoholic fatty liver disease（NAFLD） rat model induced by high-fat diet was applied to compare the efficacy of combined decoction and single decoction of Huaganjian. A total of 30 male SD rats were randomly divided into the control group， model group， lovastatin group（1.8 mg·kg^-1）， combined decoction group（1.26 g·kg^-1） and single decoction group（1.18 g·kg^-1）. After successful modeling， lovastatin group， combined decoction group and single decoction group were given corresponding doses of drugs by intragastric administration every day， and the control group and model group were given equal amounts of normal saline by intragastric administration， after 4 weeks of administration， the serum and liver tissues were collected， and the contents of alanine aminotransferase（ALT）， aspartate aminotransferase（AST）， total cholesterol（TC）， triglyceride（TG）， low-density lipoprotein cholesterol（LDL-C） and high-density lipoprotein cholesterol（HDL-C） in serum of rats were detected， and the liver pathological examination was carried out by hematoxylin-eosin（HE） staining and oil red O staining， so as to compare differences of their efficacy. ResultsSeventy chemical components were initially identified and attributed from the lyophilized powder of the combined decoction and single decoction samples of Huaganjian， and there was no obvious difference in composition between the two. Further quantitative analysis showed that the contents of geniposide， paeoniflorin， hesperidin and paeonol in the combined decoction samples were significantly increased when compared with those of the single decoction samples（P<0.01）. The pharmacodynamic results showed that compared with the model group， both the combined and single decoction groups of Huaganjian could improve the liver index of NAFLD rats， reduce the serum levels of AST， ALT， TC， TG and LDL-C， increase the serum level of HDL-C， and ameliorate the pathological changes of liver cell steatosis and fat accumulation. However， there was no significant difference in pharmacodynamic effects between the combined decoction group and the single decoction group. ConclusionThere is no significant difference between the combined decoction and single decoction of Huaganjian in terms of chemical composition， but the contents of the four index components show significantly difference. Both of them can significantly improve the fat accumulation and liver function in NAFLD rats. This study provides a reference basis for the rational clinical application and evaluation of famous classical formula compound preparations and single-flavored dispensing granules.

Objective To explore the research hotspots on systemic lupus erythematosus(SLE)in pregnancy based on the bibliometric analysis of the related articles published from 2018 to 2023 and provide di-rections for the future research in this field.Methods PubMed,Web of Science,and Embase were searched for the articles on SLE in pregnancy that were published from January 1,2018 to December 31,2023.VOSviewer was used to visualize the high-frequency keywords in the selected articles.Results A total of 266 articles were selected,from which 25 high-frequency keywords were extracted.The bibliometric analysis showed that the available studies about SLE in pregnancy mainly focused on maternal complications,maternal and fetal outcomes,and medica-tions.The studies were limited regarding the predictors,autoimmunity,immunotherapy,and long-term outcomes of offspring.Conclusion Maternal complications,maternal and fetal outcomes,and medications are currently hotspots in the research on SLE in pregnancy,while predictors,autoimmunity,immunotherapy,and long-term outcomes of offspring may become future research directions.

Objective:To investigate the effect of oral glucocorticoid dose on maternal and infant outcomes in female patients with systemic lupus erythematosus(SLE), thus providing reference for clinical work.Methods:Clinical data of pregnant women with SLE admitted to Department of Obstetrics, Peking University People′s Hospital from July 2015 to June 2020 were retrospectively analyzed.According to the daily oral glucocorticoid dose during pregnancy(equivalent converted to Prednisone), pregnant women were divided into 2 groups: ≤7.5 mg group(67 cases) and >7.5 mg group(74 cases). The maternal and fetal outcomes of the 2 groups were analyzed by t-test or χ2 test or Fisher′ s exact probability method. Results:The neonatal birth weight, birth length, white blood cell count and platelet count in ≤7.5 mg group were significantly higher than those in >7.5 mg group[(2 990.69±532.20) g vs.(2 734.57±608.35) g, (48.97±2.34) cm vs.(47.43±3.38) cm, (17.69±6.16)×10 9/L vs.(15.11±6.00)×10 9/L, (276.92±74.51)×10 9/L vs.(240.05±69.29)×10 9/L], while the incidence of low birth weight and neonatal transfer rate were significantly lower(13.85% vs.30.43%, 12.31% vs.33.33%) ( t/ χ2=2.587, 3.068, 2.354, 2.841, 5.301, 8.321, all P<0.05). Meanwhile, the incidence of maternal complications like hypertension disorders in pregnancy and gestational diabetes mellitus in the ≤7.5 mg group were lower than those in the >7.5 mg group, but the incidence of anemia and postpartum hemorrhage increased, although no significant differences were detected (all P>0.05). Conclusions:The overall maternal and fetal outcomes of patients with SLE with oral Prednisone ≤7.5 mg/d were better those medicated >7.5 mg/d, but the incidence of anemia during pregnancy and postpartum hemorrhage was higher.An individual monitoring and treatment should be concerned to improve the maternal and infant outcomes.

Intracytoplasmic sperm injection (ICSI) is an important treatment option for male infertility at pre-sent.However, a few patients still suffer from repeated ICSI fertilization failure because their sperm is unable to activate oocytes.Artificial oocyte activation (AOA) technology can improve the fertilization rate, pregnancy rate, live birth rate, etc., but it remains unknown whether AOA has short- and long-term effect on offspring.In this article, recent literature about the effect of AOA technology on perinatal outcomes, genetics, physical development and neurological development of offspring was summarized.This paper aims to provide reference for reproductive medicine workers and pediatricians in clinical practice.

Inositol 1,4,5-trisphosphate receptor 1 (ITPR1) is an important intracellular channel for releasing Ca²⁺. In order to investigate the effects of the ITPR1 overexpression on Ca²⁺ concentration and lipid content in duck uterine epithelial cells and its effects on calcium transport-related genes, the structural domain of ITPR1 gene of duck was cloned into an eukaryotic expression vector and transfected into duck uterine epithelial cells. The overexpression of the ITPR1 gene, the concentration of Ca²⁺, the lipid content, and the expression of other 6 calcium transport-related genes was determined. The results showed that the concentration of Ca²⁺ in uterine epithelial cells was significantly reduced after transfection (P<0.05), the triglyceride content was significantly increased (P<0.01), and the high-density lipoprotein content was significantly decreased (P<0.01). The correlation analysis results showed that the overexpression of the C-terminal half of the ITPR1 gene was significantly positively correlated with the total cholesterol content (P<0.01), which was significantly positively correlated with the low-density lipoprotein content (P<0.05). The overexpression of the N-terminal half of the ITPR1 gene was significantly positively correlated with the triglyceride content (P<0.01), which was significantly negatively correlated with the concentration of Ca²⁺ (P<0.05). RT-qPCR results of 6 calcium transport-related genes showed that the overexpression of the C-terminal half of the ITPR1 gene significantly inhibited the expression of the IP3R2, VDAC2 and CAV1 genes, and the overexpression of the N-terminal half of the ITPR1 gene significantly promoted the expression of the IP3R3 and CACNA2D1 genes. In conclusion, the ITPR1 gene overexpression can promote Ca²⁺ release in duck uterus epithelial cells, promote the synthesis of triglyceride, low-density lipoprotein and cholesterol, and inhibit the production of high-density lipoprotein, and the ITPR1 gene overexpression affected the expression of all 6 calcium transport-related genes.
Animals ; Calcium/metabolism* ; Ducks/genetics* ; Epithelial Cells ; Female ; Inositol ; Inositol 1,4,5-Trisphosphate Receptors ; Lipids ; Uterus

Objective:To investigate the effect of reproduction on maternal and infant outcomes in female patients with systemic lupus erythematosus (SLE).Methods:Clinical data of SLE patients complicated with pregnancy admitted in the Peking University People′s Hospital from July 2015 to December 2019 were analyzed retrospectively.According to the history of live birth, SLE patients complicated with pregnancy were divided into primiparity group (94 cases) and reproduction group (32 cases). Maternal and infant outcomes of the 2 groups were analyzed.Results:A total of 126 SLE patients complicated with pregnancy were included in the present study.The proportion of using immunosuppressants was significantly lower in reproduction group than that of primiparity group [3 cases (9.38%) vs.27 cases (28.72%)] ( χ2=4.927, P=0.026). Complications like lupus nephritis, thyroid disease and postpartum hemorrhage significantly increased in the reproduction group (all P<0.05), and the adverse neonatal outcomes like preterm infants, low birth weight infants and small for gestational age infants in the reproduction group were lower than those in primiparity group, but no significant differences were detected(all P>0.05). There were no significant diffe-rences in the results of the first blood routine examination of newborns and the incidence of neonatal pathological jaundice between the 2 groups (all P>0.05). Conclusions:For SLE patients complicated with reproductive pregnancy, although the incidence of some pregnancy complications increases, the incidence of adverse neonatal outcomes decreases.In addition, reducing the use of immunosuppressants may have positive implications on neonatal outcomes.

Objective:To investigate the construction status of clinical skills training centers of secondary and above comprehensive western hospitals in Yunnan Province, and to provide a basis for the scientific, specific and standardized construction and development of clinical skills training centers of hospitals at all levels in Yunnan Province.Methods:The evaluation index of the construction of clinical skills training center was established, and questionnaires were developed to investigate the current situation of the construction of clinical skills training center in the secondary and above comprehensive western hospitals in the whole province. SPSS 17.0 software was used for chi-square test.Results:According to the investigation, 79.1% (72/91) of secondary and above comprehensive western hospitals in Yunnan Province have established clinical skills centers of different scales, but 84.6% (77/91) of them have fewer than 50 teachers participating in clinical skills teaching each year, with weak faculty and big differences in the faculty of hospitals at all levels ( P<0.05). In 64.6% (84/130) of the centers, the simulated teaching courses are only single basic skill courses, and the training content is relatively single, with great differences in the current situation ( P<0.05). Only 33.0% (30/91) of the centers have initially established an internal quality control system, and there are statistically significant differences in the way of conducting quality evaluation ( P=0.023). Conclusion:The foundation of the connotation construction of the clinical skill center is to establish a complete, professional and gradient teaching team and a stepped clinical skills training curriculum system. The construction of a perfect internal quality control system is the vitality of the development of the clinical skill center, and scientific research is the source of the sustainable development of the center.

The clinical application of triptolide (TPL) in tumor therapy has been greatly limited by its toxicity and inefficient delivery. Herein, a localized and sustained-release thermo-sensitive hydrogel was developed for the intra-tumor administration of TPL. Based on the amphiphilic structure of poly (

Objective To investigate the perinatal independent risk factors and neonatal complications of discordant twins.Methods Clinical data of 152 (76 pairs) discordant twins and 552 (276 pairs) concordant twins were enrolled at the Obstetrics of Peking University People's Hospital from November 1,2011 to October 31,2016.The perinatal characteristics and the neonatal complications in 2 groups were analyzed and compared.Binary Logistic regression analysis was used to identify the independent risk factors associated with the occurrence of discordant twins.Results (1) The gestational age,the incidence of term infants and birth weight of the discordant twins were significantly lower than those of the concordant twins[(35.8 ±2.5) weeks vs.(36.7 ± 1.8) weeks,48.7％ vs.60.2％,(2 277.1 ± 575.7) g vs.(2 545.0 ± 413.4) g],and the differences were statistically significant (all P ＜ 0.05).The incidence of premature infants,the incidence of infants small for gestational age and the rate of transferring discordant twins to pediatric department were significantly higher than that of concordant twins (51.3％ vs.39.9％,40.8％ vs.13.2％,46.1％ vs.26.8％),and the differences were statistically significant (all P ＜ 0.05).(2) The incidence of neonatal asphyxia,neonatal respiratory distress syndrome,neonatal pneumonia,neonatal apnea,bronchopulmonary dysplasia,neonatal sepsis and neonatal intracranial hemorrhage were significantly higher than those of concordant twins (6.6％ vs.2.5％,7.2％ vs.3.1％,5.3％ vs.1.3％,9.2％ vs.3.3％,3.9％ vs.0.9％,3.3％ vs.0.7％,4.6％ vs.O.7％),and the differences were statistically significant(all P ＜ 0.05).(3) The birth weight in the twins with low body weight group was significantly lower than that in the twins with high body weight group [(1 926.7 ± 414.1) g vs.(2 618.7 ± 504.6) g],and the differences were statistically significant (P ＜ 0.05).The incidence of small for gestational age,the rate of conversion to pediatrics and the incidence of neonatal intracranial hemorrhage in the twins with low body weight group were significantly higher than those in the twins with high body weight group (65.8％ vs.6.6％,56.6％ vs.35.5 ％,9.2％ vs.0),and the differences were statistically significant (all P ＜ 0.05).(4) Logistic regression analysis showed that hypertensive disorder during pregnancy (OR =2.127,95％ CI:1.392-3.253) and gestational diabetes mellitus (OR =1.684,95％ CI:1.112-2.552) were independent risk factors for the occurrence of discordant twins.Conclusions Hypertensive disorder during pregnancy and gestational diabetes mellitus are independent risk factors for the occurrence of discordant twins,who are much more likely to develop various neonatal complications,particularly low-birth-weight infants.Timely surveillance and treatment of short-term complications and long-time follow-up are essential to discordant twins.

Traditional Chinese herbs (TCH) are currently gaining attention in disease prevention and health care plans. However, their general bitter taste hinders their use. Despite the development of a variety of taste evaluation methods, it is still a major challenge to establish a quantitative detection technique that is objective, authentic and sensitive. Based on the two-bottle preference test (TBP), we proposed a novel quantitative strategy using a standardized animal test and a unified quantitative benchmark. To reduce the difference of results, the methodology of TBP was optimized. The relationship between the concentration of quinine and animal preference index (PI) was obtained. Then the PI of TCH was measured through TBP, and bitterness results were converted into a unified numerical system using the relationship of concentration and PI. To verify the authenticity and sensitivity of quantified results, human sensory testing and electronic tongue testing were applied. The quantified results showed a good discrimination ability. For example, the bitterness of Coptidis Rhizoma was equal to 0.0579 mg/mL quinine, and Nelumbinis Folium was equal to 0.0001 mg/mL. The validation results proved that the new assessment method for TCH was objective and reliable. In conclusion, this study provides an option for the quantification of bitterness and the evaluation of taste masking effects.