Objective: To characterize perioperative dynamic changes in immune-cell phenotypes and inflammatory cytokines in patients undergoing CPB (cardiopulmonary bypass) cardiac surgery, and to explore their associations with postoperative outcomes. Methods: In this prospective cohort study, 120 adult patients who underwent elective cardiac surgery under CPB at West China Hospital from May 2022 to March 2023 were enrolled. Perioperative immune-cell phenotypes and concentrations of 40 inflammation-related cytokines were measured. The primary outcomes were the sequential organ failure assessment (SOFA) score at 24 h after surgery and ΔSOFA (the peak SOFA score within 48 h after surgery minus the preoperative SOFA score). Secondary outcomes included major adverse cardiovascular events (MACE), acute kidney injury (AKI), respiratory failure, severe liver injury, and infection. Results: The mean age of enrolled patients was 57±10 years. Of these, 52% (62/120) were male and 90% (108/120) underwent valve surgery. During the rewarming to the end of CPB, neutrophil counts rapidly increased (7.39×10 /L vs preoperative 3.07×10 /L, P<0.001), with significant upregulation of CD11b (7.30×10 /L vs preoperative 3.05×10 /L, P<0.001) and CD54 (7.15×10 /L vs preoperative 2.99×10 /L, P<0.001). Lymphocyte counts increased at the end of CPB (1.75×10 /L vs preoperative 1.12×10 /L, P<0.001) but decreased significantly at 24 h after surgery (0.59×10 /L vs preoperative 1.12×10 /L, P<0.001). Plasma analysis showed that multiple pro-inflammatory cytokines increased during CPB and remained elevated up to 24 h after surgery; five chemokines and the anti-inflammatory cytokine IL-10 peaked at the end of CPB. The SOFA score increased from 1 (1, 2) preoperatively to 7 (5, 10) at 24 h after surgery, with a ΔSOFA of 6 (4, 8). Within 30 days after surgery, 48 patients (40.0%) developed AKI, 17 (14.2%) developed infection, 4 (3.3%) developed severe liver injury, 3 (2.5%) developed respiratory failure, and 3 (2.5%) experienced MACE. During the 2-year follow-up, 8 patients (6.7%) experienced MACE and 5 (4.2%) died. Conclusion: Multi-organ dysfunction is common after cardiac surgery under CPB (median ΔSOFA, 6), accompanied by perioperative activation of multiple immune-cell subsets and upregulation of pro-inflammatory, anti-inflammatory, and chemotactic mediators. This study provides data-driven evidence and research clues for further investigation of the associations between CPB-related immune perturbations and postoperative organ dysfunction and clinical outcomes.

Various chromatographic methods were comprehensively applied to study the chemical composition of the ethyl acetate extract from Aucklandiae Radix. The structures of all compounds were identified by analyzing their physicochemical properties and using spectroscopic methods. Two new sesquiterpenoids, named auclappsines A and B(1 and 2) were isolated and identified. Through in vitro high content screening and with the use of a guggulsterone-induced L02 cells, the effects of 1 and 2 on farnesoid X receptor(FXR) protein expression were investigated. The results showed that 1 had a significant FXR activation effect, providing a scientific basis for the development of drugs for the treatment of liver and gallbladder diseases.
Receptors, Cytoplasmic and Nuclear/genetics* ; Humans ; Sesquiterpenes/isolation & purification* ; Drugs, Chinese Herbal/isolation & purification* ; Cell Line ; Molecular Structure

Qualitative and quantitative analysis methods for chemical components of different processed products of Corni Fructus were established to systematically characterize and identify these components, and the content of the main differential components was determined. The chemical components of different processed products of Corni Fructus were collected using ultra-high performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry(UPLC-Q-TOF-MS). Through analysis of self-built databases, literature, and reference standards, a total of 93 components were obtained, including 19 iridoids, 15 flavonoids, 16 organic acids, eight triterpenoids, eight tannins, four amino acids, two polysaccharides, five olefins, and 16 other compounds. Additionally, by using multivariate statistical methods, the differential components between different processed products of Corni Fructus were screened under the conditions of VIP>1.0 and FC<0.5 or FC>2.0 and P<0.05. The PCA and OPLS-DA results showed differences in the chemical components between different processed products of Corni Fructus. A total of 21 differential components were screened, including tartaric acid, morroniside, and rutin. On this basis, ultra-high performance liquid chromatography-triple quadrupole tandem mass spectrometry(UPLC-QqQ-MS/MS) was used to determine the content of 10 main common differential components, including gallic acid, morroniside, ursolic acid, loganin, swertiamarin, rutin, 5-hydroxymethylfurfural, cornuside Ⅰ, quercetin, and oleanolic acid. The above 10 components showed a good linear relationship within the determined concentration range, with the precision, stability, repeatability, and sample recovery rate all meeting the requirements. Compared with that in Corni Fructus, the content of iridoid glycosides in wine-prepared Corni Fructus and wine-and honey-prepared Corni Fructus decreased, while the content of gallic acid, rutin, quercetin, 5-hydroxymethylfurfural, ursolic acid, and oleanolic acid increased. Compared with wine-prepared Corni Fructus, wine-and honey-prepared Corni Fructus showed varying degrees of increase in all other components, except for a slight decrease in gallic acid content. In summary, this study clarified the influence of different processing methods on the chemical components of Corni Fructus, providing a theoretical basis for the scientific connotation, overall quality evaluation, and clinically rational application of Corni Fructus processing in the future.
Tandem Mass Spectrometry/methods* ; Chromatography, High Pressure Liquid/methods* ; Cornus/chemistry* ; Drugs, Chinese Herbal/chemistry* ; Fruit/chemistry*

OBJECTIVES: To explore the manifestations of sensory hypersensitivity in children with autism spectrum disorder (ASD) and individuals with subclinical autistic traits. METHODS: From September 2021 to April 2023, interviews were conducted on 18 college students with high levels of autistic traits and sensory hypersensitivity selected using the Adolescent/Adult Sensory Profile and the Autism Spectrum Quotient (as subclinical group). Interviews were also conducted on the parents of 11 children with ASD aged 6-13 years selected using the intensity sampling method (as clinical group). Qualitative content analysis and thematic analysis were performed on the interview texts to investigate the scenarios and impact of sensory hypersensitivity and coping strategies in the two groups. RESULTS: The Autism Spectrum Quotient score was significantly positively correlated with sensory hypersensitivity (r=0.504, P<0.001; n=225). Sensory modalities that triggered sensitive reactions were similar in the subclinical and clinical groups, with auditory hypersensitivity being the most prominent. Sensory hypersensitivity had significant negative impact on emotional wellbeing, cognitive ability, physical health, interpersonal relationships, and general adaptive functioning. These dimensions were interconnected, culminating in a holistic experience. Avoidance was the most commonly used coping mechanism for both groups (16 subclinical participants mentioned it 44 times; 8 clinical participants mentioned it 40 times). The clinical group required more support and help from their caregivers (18 times), while the subclinical group used more proactive coping strategies (e.g., facing sensitive scenarios, distracting attention) to alleviate the negative impact (51 times). CONCLUSIONS Sensory hypersensitivity is a common manifestation across the broad ASD phenotype, posing negative effects on multiple aspects of their lives. There is an urgent need for social tolerance and acceptance as well as the development of effective intervention measures.
Humans ; Child ; Autism Spectrum Disorder/physiopathology* ; Male ; Female ; Adolescent ; Adaptation, Psychological ; Autistic Disorder/psychology* ; Sensation Disorders/etiology* ; Qualitative Research

OBJECTIVE To analyze the dynamic changes of inhalant allergen sensitization profiles in patients with allergic rhinitis,asthma and allergic rhinitis combined with asthma in the Beijing area.METHODS A retrospective study was conducted on patients with allergic rhinitis,asthma,and allergic rhinitis combined with asthma who visited the Allergy Department of Beijing Shijitan Hospital from January 2021 to December 2024.All patients underwent skin prick tests for 27 inhalant allergens.RESULTS A total of 28 454 patients were included.The overall positive rate of SPT was 74.21%,with the highest positive rate in the 10-14 age group(84.09%).Spring pollen and summer-autumn pollen were the main allergens,with higher positive rates than dust mites and molds(P<0.05).Juniperus chinensis was the main sensitization in patients with allergic rhinitis,while in patients with allergic rhinitis combined with asthma,sensitization to weeds such as Chenopodium album,Humulus scandens,and Artemisia sieversiana were more common.In recent years,the positive rates of sensitization to spring pollen,summer-autumn pollen,and molds all showed an upward trend(P<0.05),with the most significant increase in molds.CONCLUSION In the Beijing area,pollen,dust mites and mold are the main allergens in spring and autumn.In recent years,the sensitization rates of Juniperus chinensis and Artemisia sieversiana pollen have decreased,but the positive rate of mold sensitization has been on the rise,which still needs to be taken seriously.

Objective To investigate the influence and threshold effect of preoperative intraocular pressure(IOP)on secondary glaucoma(SG)after pars plana vitrectomy(PPV).Methods A retrospective analysis was conducted on 88 patients with retinal detachment who developed SG after PPV(SG group)treatment at Hebei Eye Hospital from January 2020 to January 2024.Meanwhile,88 patients with retinal detachment who underwent PPV at the same hospital during the same period but did not develop SG postoperatively were selected as non-SG group in a 1:1 ratio.Univariate analysis was used to compare the differences in clinical data between the two groups.A stratified regression model was applied to analyze the correlation between postoperative characteristics and preoperative IOP.Multivariate logistic regression analysis was used to identify the factors affecting the occurrence of SG after PPV,with multicollinearity diagnosis and sensitivity analysis performed for the parameters.Additionally,the threshold effect of preoperative IOP on the risk of postoperative SG was analyzed.A predictive model was constructed based on the results of multivariate logistic regression.The receiver operating characteristic(ROC)curve was employed to evaluate the efficacy and accuracy of the predictive model,while the calibration curve and clinical decision curve were utilized to assess the consistency between the predictive model and actual conditions as well as the clinical practicality of the model.Results Compared with non-SG group,SG group had a higher proportion of patients with a history of diabetes,family history of glaucoma,a higher preoperative IOP,higher proportion of postoperative closed anterior chamber angle status,longer silicone oil tamponade duration(≥6 months),higher incidence of silicone oil emulsification(P<0.05).Postoperative anterior chamber angle status(closed)was significantly positively correlated with preoperative IOP levels(P<0.05).Multivariate logistic regression analysis showed that history of diabetes,family history of glaucoma,silicone oil emulsification,postoperative anterior chamber angle closure,silicone oil tamponade duration≥6 months,and preoperative IOP≥21 mmHg were independent risk factors for SG after PPV(P<0.05).Multicollinearity diagnosis indicated no significant collinearity among the above variables.Sensitivity analysis showed that the association tended to be null when E=5.014.With the increase of preoperative IOP,the probability of SG after PPV in patients showed an upward trend.The threshold effect analysis revealed that when preoperative IOP≥19 mmHg,the probability of SG after PPV increased significantly with the elevation of preoperative IOP(OR=2.942,95%CI 1.794-4.826,P<0.001).After adjusting for covariates,preoperative IOP remained an independent influencing factor for different degrees of SG after PPV(OR=7.392,95%CI 1.379-12.510,P=0.001).Before and after validation,the area under the ROC curves(AUCs)of the model for predicting SG after PPV were 0.987(95%CI 0.974-1.000,P<0.001)and 0.989(95%CI 0.969-1.000,P<0.001),with sensitivities of 0.9332 and 0.9545,and specificities of 0.9981 and 0.9773,respectively.Both the calibration curve and decision curve analysis demonstrated that the predictive model had good discrimination and accuracy.Conclusion Preoperative IOP is an influencing factor and a sensitive indicator for the development of SG after PPV in patients with retinal detachment.

The current situation of the construction and application of orthopaedic subspecialty nursing quality standards at home and abroad is reviewed, and the overview of orthopaedic subspecialty nursing quality standards, theoretical foundations, the content of the standard construction, the form and results of the application, and the shortcomings and outlooks are elaborated and illustrated, with a view to providing theoretical references for the further improvement and application of China′s orthopaedic subspecialty nursing quality standard system, and providing scientific suggestions and reflections for the promotion of the high-quality development of orthopaedic subspecialty nursing.

Objective To explore the relationship between p-FGFR1Y654 expression and clinical pathological characteristics of esophageal squamous cell carcinoma patients and its prognostic value.Methods Tumor tissue samples from 103 cases of esophageal squamous cell carcinoma and 58 normal esophageal tissues were surgically collected in the General Hospital of Western Theater between January 2017 and July 2020.The expression of p-FGFR1Y654 in the tissues was detected using immunohistochemical assay,and its correlation with relevant clinicopathological parameters and prognosis was analyzed.Results The expression of p-FGFR1Y654 in esophageal squamous cell carcinoma tissues was significantly higher than that in normal tissue(P＜0.01).Its expression level was closely related to overall survival(OS,P＜0.05),but not related to age,gender,tumor stage or tumor size.Multivariate COX regression analysis showed that N-stage was identified as an independent prognostic factor for recurrence free survival(RFS)in esophageal squamous cell carcinoma patients.Survival analysis indicated that patients with low expression of p-FGFR1Y654 had significantly higher RFS and OS than those with high expression(P=0.032,95％CI:1.08～4.65;P=0.004,95％CI:2.14-11.51).Conclusion p-FGFR1Y654 is highly expressed in esophageal squamous cell carcinoma tissue,and is associated with poor prognosis in these patients.p-FGFR1Y654 may be a potential therapeutic target for esophageal squamous cell carcinoma.

The pathogenesis of depression is complex, and some existing monoamine antidepressants have problems such as drug resistance or off-target failure. Traditional Chinese medicine has the characteristics of "multi-component and multi-target", and has been used in the treatment of depression in clinical practice. Yueju pill is effective in the treatment of depression. Geniposide and ligustrazine, the active ingredients of Gardeniae fructus and Ligusticum sinense 'Chuanxiong', play a key role in the treatment of depression. In this study, based on the neuroprotective activity of genipin and the rapid antidepressant activity of tetramethylpyrazine, a series of novel genipin derivatives were designed and synthesized through pharmacophore assembly principle, and their neuroprotective activity and antidepressant effect were investigated. The results showed that the novel genipin derivatives had well neuroprotective activity on the glutamate-induced HT-22 cell model, with compounds W-1 and W-3 showing better protective activity. In behavioral despair depression (BDD) model mice, compound W-3 was found to have better antidepressant activity than W-1 in tail suspension test and forced swimming test. Further study on the behavior of chronic unpredictable mild stress (CUMS) model mice showed that W-3 could significantly improve the depression-like behavior of model mice. All animal experiments were approved by the Experimental Animal Ethics Committee of Anhui University of Chinese Medicine (approval number: AHUCM-mouse-2022027). The effects of the preferred compound W-3 on protein kinase A (PKA), cAMP response element binding protein (CREB), brain-derived neurotrophic factor (BDNF), 5-hydroxytryptamine 1A (5-HT_1A) receptor, N-methyl-D-aspartate ionic glutamate receptor 2A (GluN2A) and N-methyl-D-aspartate ionic glutamate receptor 2B (GluN2B) were analyzed by Western blot. W-3 treatment significantly up-regulated the protein expression of PKA, CREB, BDNF and 5-HT_1A, and down-regulated the protein expression of GluN2A and GluN2B. The results of qRT-PCR were consistent with those of Western blot. According to the above results, compound W-3 has a potential antidepressant effect, and its mechanism may be related to the activation of PKA-CREB-BDNF signaling pathway by regulating the expression of GluN2A, GluN2B and 5-HT_1A receptor proteins.

An improved U-Net model(channel attention module U-Net,CAMU-Net)is proposed to achieve precise segmentation of retinal vessels.CAMU-Net model enhances its understanding of regional features by employing residual enhancement convolution to extract important information from the regions,improves the global feature acquisition capability by introducing feature refinement module to promote feature extraction,realizes precise segmentation by adding channel attention module to capture image features accurately,and enhances its capability to perceive target boundaries and details through a multi-scale feature fusion structure.The ablation study on the DRIVE dataset validates the role of each module in retinal vessel segmentation.The comparison with other mainstream network models on DRIVE and STARE datasets verify that CAMU-Net model is superior to other models.