Two novel skeleton sesquiterpenoids (1 and 6), along with four new iphionane-type sesquiterpenes (2-5) and six new cyperane-type sesquiterpenes (7-11), were isolated from the whole plant of Artemisia hedinii (A. hedinii). The two novel skeleton compounds (1 and 6) were derived from the decarbonization of iphionane and cyperane-type sesquiterpenes, respectively. Their structures were elucidated through a comprehensive analysis of spectroscopic data, including high-resolution electrospray ionization mass spectrometry (HR-ESI-MS) and 1D and 2D nuclear magnetic resonance (NMR) spectra. The absolute configurations were determined using electronic circular dichroism (ECD) spectra, single-crystal X-ray crystallographic analyses, time-dependent density functional theory (TDDFT) ECD calculation, density functional theory (DFT) NMR calculations, and biomimetic syntheses. The biomimetic syntheses of the two novel skeletons (1 and 6) were inspired by potential biogenetic pathways, utilizing a predominant eudesmane-type sesquiterpene (A) in A. hedinii as the substrate. All compounds were evaluated in LX-2 cells for their anti-hepatic fibrosis activity. Compounds 2, 8, and 10 exhibited significant activity in downregulating the expression of α-smooth muscle actin (α-SMA), a protein involved in hepatic fibrosis.
Artemisia/chemistry* ; Sesquiterpenes/chemical synthesis* ; Molecular Structure ; Humans ; Liver Cirrhosis/genetics* ; Biomimetics ; Plant Extracts/pharmacology*

Acute respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had caused a global pandemic since 2019, and posed a serious threat to global health security. Traditional Chinese medicine (TCM) has played an indispensable role in the battle against the epidemic. Many components originated from TCMs were found to inhibit the production of SARS-CoV-2 3C-like protease (3CLpro) and papain-like protease (PLpro), which are two promising therapeutic targets to inhibit SARS-CoV-2. This study describes a systematic investigation of the roots and rhizomes of Sophora tonkinensis, which results in the characterization of 12 new flavonoids, including seven prenylated flavanones (1-7), one prenylated flavonol (8), two prenylated chalcones (9-10), one isoflavanone (11), and one isoflavan dimer (12), together with 43 known compounds (13-55). Their structures including the absolute configurations were elucidated by comprehensive analysis of MS, 1D and 2D NMR data, and time-dependent density functional theory electronic circular dichroism (TDDFT ECD) calculations. Compounds 12 and 51 exhibited inhibitory effects against SARS-CoV-2 3CLpro with IC₅₀ values of 34.89 and 19.88 μmol·L^-1, repectively while compounds 9, 43 and 47 exhibited inhibitory effects against PLpro with IC₅₀ values of 32.67, 79.38, and 16.74 μmol·L^-1, respectively.
Flavonoids/chemistry* ; SARS-CoV-2 ; Rhizome ; COVID-19 ; Peptide Hydrolases ; Antiviral Agents/chemistry*

We reported a clinical caseof gas gangrene in the lower back and buttocks due to local intramuscular injection. A 43-year-old male was treated by local private clinic for low back pain. He underwent local intramuscular injection in his lower back and buttocks. 5 or 6 hours after the treatment,he felt worsen of low back pain (VAS 5 points)with a fever. After one day of treatment, the lower back pain was even worse(VAS 8 points). And he had soy-sauce urine and a high fever. The results of laboratory examination and clinical manifestation suggested multiple organ failure within a short period of time. Imaging (CT) suggested large area of gas and muscle necrosis in the lower back and buttocks. Considering the progress of the disease, emergency surgery on lumbar back and right buttocks was performed after hospitalization. Rapid bacterial smear reported gram-positive coarse bacteria. Anaerobic culture suggested clostridium perfringens. Aerobic culture result did not show any bacterial growth. According to the clinical manifestation, imaging (CT), intraoperative judgment and postoperative anaerobic culture results, the clinical diagnosis was gas gangrene. Gas gangrene is a special infectious disease in clinic, which can be characterized by low morbidity, difficult early diagnosis,rapid disease progression and high mortality. Sinceintramuscular injection leaded to this disease in our case, the importance of standardized aseptic procedures should be emphasized.

Traditional Chinese Medicine (TCM) is an important reservoir for bioactive natural products. TCM extraction methods by water decoction and wine tincture are an integral part of TCM and essential for their widely acknowledged efficacy. In this study, we selected 6 common TCMs that are rich in chemistry to investigate whether the TCM extraction methods deliver molecules with drug-like physical chemical properties. Six TCM herbal materials were extracted by water, 95% ethanol, and sequential hexane, dichloromethane and methanol. The extracts were analyzed by HPLC and H NMR. Isolation on one of the extracts yielded 32 compounds, their physical chemical properties were analyzed by Instant JChem. Our results showed that ethanol extraction, which mimics TCM wine tincture, delivered compounds with physical chemical properties compliant to Lipinski's rule of 5.

Objective To explore how to reduce and quickly deal with all kinds of alarm in the dialysis process, to ensure the safety of dialysis, improve the coping ability of nurses, improve the quality of nursing and the satisfaction of patients. Methods Various kinds of alarm and nurse processing time in hemopurification center of our hospital from 2013 to 2014 were recorded and analyzed, the emergency treatment measures were found out, the coping methods were developed, the coping process were improved, and the training of nurses was strengthened. The various parameters were rerecorded and compared after training (2015 to 2016). Results The most common alarm in dialysis process was venous pressure alarm, accounting for 16.45%(15925/96831) of the total alarm, the lowest limit was 10.34%(10020/96831), and the highest limit was 6.11%(5905/96831). The total conductivity alarm was 10.33%(9969/968310), the nurse' s alarm processing time of the lowest limit was (53.11 ± 12.84) s, the highest limit was (136.77 ± 42.88 ) s, the conductivity alarm was (54.17 ± 33.55) s. After the training of nurses, the alarm frequency was reduced (χ2=3.164, P<0.05), the venous pressure alarm accounts for 14.69% (15415/104913) of the total alarm , the lowest limit was 9.52% (9985/104913),and the highest limit was 5.18%(5430/104913), the total conductivity alarm was 7.54%(7913/104913). The alarm processing time was shortened:the lowest limit was (40.94 ± 10.38) s, the highest limit was (119.15 ± 38.79) s (t=3.944, 3.304, P<0.05). The work efficiency and patient satisfaction degree were improved. Conclusions Through the summary and training of all kinds of alarm in the dialysis process, it can effectively reduce the alarm frequency of the dialysis process, improve the work efficiency of nurses, and improve the satisfaction degree of patients.

Gastric cancer (GC) is a highly heterogenic disease, and it is the second leading cause of cancer death in the world. Common chemotherapies are not very effective for GC, which often presents as an advanced or metastatic disease at diagnosis. Treatment options are limited, and the prognosis for advanced GCs is poor. The landscape of genomic alterations in GCs has recently been characterized by several international cancer genome programs, including stud-ies that focused exclusively on GCs in Asians. These studies identiifed major recurrent driver mutations and provided new insights into the mutational heterogeneity and genetic proifles of GCs. An analysis of gene expression data by the Asian Cancer Research Group (ACRG) further uncovered four distinct molecular subtypes with well-deifned clini-cal features and their intersections with actionable genetic alterations to which targeted therapeutic agents are either already available or under clinical development. In this article, we review the ACRG GC project. We also discuss the implications of the genetic and molecular ifndings from various GC genomic studies with respect to developing more precise diagnoses and treatment approaches for GCs.

Objective To investigate the factors affecting the depression of patients with orthopedic trauma surgery and nursing countermeasures .Methods A total of 210 patients were chosen in our hospital from January 2012 to January 2013.The Self-rating Depression Scale (SDS), Social Support Rating Scale (SSRS) and general information questionnaires were used in the survey .Results A total of 190 cases of patients finished the investigation.83 patients (43.68%) did not had depression, 58 patients (30.53%) had mild depression, 29 patients (15.26%) had moderate depression, 20 (10.53%) patients had severe depression .The reason for depression in patients with univariate and multivariate Logistic regression analysis showed that self -financed medical care , diagnosis and treatment of worry , fear poor prognosis , bad attitude and other aspects of health care were the main factors in patients with depression , but a high degree of social support in patients with depression was the protective factors .Conclusions The incidence of depression in patients with orthopedic surgery was high.But intensive care from the medical staff , support from their families and intimate care from friends can help patients get rid of depression after orthopedic surgery .

Objective To investigate the efficacy of sophocarpine in rats with alcoholic liver disease and its effects on the expression of tumor necrosis factor (TNF)-α,interleukin (IL)-6 and transforming growth factor (TGF)-β1.Methods A total of 48 male Sprague-Dawley adult rats were evenly divided into healthy control group,model group,prevention group and treatment group.The rats in the healthy control group were gavaged with 0.9％NaCl every day for 12 weeks.The rats in the model group,prevention group and treatment group were gavaged with alcohol for 12 weeks to establish the model.The prevention group was injected with 20 mg · kg1 · d1 sophocarpine for 12 weeks.Since the fifth week,the treatment group was continuously injected with 20 mg · kg1 · d-1 sophocarpine for eight weeks.The histological changes were evaluated.The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase ( AST ), alkaline phosphatase (AKP),triglyceride (TG) and total cholesterol (TC) were examined.And the expression of TNF-α,IL-6 and TGF-β1 in liver tissue at mRNA and protein level were detected with immunohistochemistry and real-time polymerase chain reaction (PCR) assay.Comparison among groups was perform with single factor analysis of variance,pairwise comparisons with least significant difference method (LSD method),ranked data with Kruskal-Wallis H-test and multiple pairwise comparison with Nemenyi test.Results Compared with model group,hepatic steatosis and inflammatory cell infiltration were significantly improved in the treatment group and prevention group.The levels of ALT (41.40 U/L± 10.53 U/L and 40.75 U/L±6.94 U/L vs 58.37 U/I±5.35 U/L),AST(121.60 U/L±16.24 U/L and 109.50 U/L±9.23 U/L vs 156.63 U/L±32.47 U/L),AKP(114.88 U/L±40.37 U/L and 112.60 U/L±44.34 U/L vs 161.75 U/L±28.95 U/L),TG (4.19 mmol/L±0.99 mmol/L and 2.69 mmol/L± 1.35 mmol/L vs 4.50 mmol/L±0.99 mmol/L) and TC (1.48 mmol/L±0.28 mmol/L and 1.43 mmol/L±0.19 mmol/L vs 1.67 mmol/L±0.20 mmol/L) significantly decreased and the difference was statistically significant ( all P＜0.05).The expression of TNF-α,IL-6 and TGF-β1 at mRNA and protein level in liver tissue of model group were significantly higher than those of healthy control group,prevention group and treatment group.After treated with sophocarpine,the expression of TNF-α(mRNA:1.36 ± 0.08,1.16 ± 0.05 ; protein:3.38 ％ ± 0.82 ％,1.74 ％ ± 0.65 ％ ),IL-6 (mRNA:1.51 ± 0.05,1.39 ± 0.02; protein:5.89％ ± 0.96％,4.26％ ± 0.53％) and TGF-β1 (mRNA:1.39±0.04,1.37±0.02; protein:4.27％ ±0.97％,2.11％ ±0.83％) of treatment group and prevention group at mRNA and protein level significantly lower than those of model group (mRNA:1.81±0.16,1.95 ±0.13,1.84±0.22; protein:5.82％ ± 1.21％,7.63％ ±1.03％,5.33％± 1.12％) and the difference was statistically significant (all P＜0.01).Conclusion Sophocarpine significantly alleviates alcohol induced liver injury in rats,improves liver steatosis and inflammatory reaction degree,which may be related with the downregulation of TNF-α,TGF-β1 and IL-6 expression in liver tissue of ALD rats.

To investigate the role of ligustrazine on relaxation of the isolated rabbit corpus cavernosum tissue in vitro, the effects of ligustrazine on the corpus cavernosum were observed by using experimental method of smooth muscle strips. Concentration-responses to phenylephine (PE) and KCl were recorded. The results showed that ligustrazine concentration-dependently depressed the contraction response of smooth muscle strips induced by PE. The maximum percentage relaxation of cavernosal strips by ligustrazine was 74.1% +/- 6.2% (compared with control: 21.9% +/- 5.6%, P < 0.01). Ligustrazine concentration-dependently reduced the amplitude of the contraction induced by cumulative doses of PE or KCl, shifted the cumulative concentration response curves of PE and KCI to the right and depressed their maximal responses. It was concluded that ligustrazine could significantly relax the cavernosal muscle contraction induced by PE in vitro. The results suggested that ligustrazine inhibited calcium ion influx.
Calcium Channels/drug effects ; Muscle Contraction/*drug effects ; Muscle Relaxation/*drug effects ; Muscle, Smooth/*drug effects ; Muscle, Smooth/physiology ; Penis/*drug effects ; Penis/physiology ; Phenylephrine/pharmacology ; Potassium Chloride/pharmacology ; Pyrazines/*pharmacology

To investigate the role of ligustrazine on relaxation of the isolated rabbit corpus cavernosum tissue in vitro, the effects of ligustrazine on the corpus cavernosum were observed by using experimental method of smooth muscle strips. Concentration-responses to phenylephine (PE) and KCl were recorded. The results showed that ligustrazine concentration-dependently depressed the contraction response of smooth muscle strips induced by PE. The maximum percentage relaxation of cavernosal strips by ligustrazine was 74.1% ±6.2 % (compared with control: 21.9 % ±5.6 %, P ＜0.01). Ligustrazine concentration-dependently reduced the amplitude of the contraction induced by cumulative doses of PE or KCl, shifted the cumulative concentration response curves of PE and KCl to the right and depressed their maximal responses. It was concluded that ligustrazine could significantly relax the cavernosal muscle contraction induced by PE in vitro. The results suggested that ligustrazine inhibited calcium ion influx.