OBJECTIVE To establish an ultra-performance liquid chromatography-tandem mass spectrometry （UPLC-MS/MS） method for the simultaneous determination of the contents of six Aconitum alkaloids in Compound chondroitin sulfate tablets， and to perform quality evaluation of samples from different batches， thereby providing a reference for the quality control of this preparation.METHODS Chromatographic separation was performed on an Agilent SB-C 18 column using gradient elution with 0.2% formic acid （adjusted to pH 7.5 with ammonia） and acetonitrile as the mobile phases. The flow rate was 0.3 mL/min， the column temperature was 35 ℃， and the injection volume was 1 μL. Mass spectrometric analysis was performed using an AJS ESI + ion source in multiple reaction monitoring mode， with quantification by the external standard method. Method validation was performed. The established UPLC-MS/MS method was applied to determine the contents of the six Aconitum alkaloids in 64 batches of samples from three manufacturers， including three diester-type alkaloids （aconitine， hypaconitine， and mesaconitine） and three monoester-type alkaloids （benzoylaconine， benzoylhypaconine， and benzoylmesaconine）. Descriptive statistics， the Kruskal-Wallis H test， principal component analysis （PCA）， and Spearman’s rank correlation analysis were used to evaluate the content distribution of Aconitum alkaloids， differences among samples from different manufacturers， and correlations among the components.RESULTS Good linearity was observed for the six Aconitum alkaloids over their respective concentration ranges， with correlation coefficients （all r ＞0.99）. The relative standard deviations （RSDs） for precision， repeatability， and stability were all less than 5%. The limits of detection and quantification were no higher than 0.003 ng/mL and 0.01 ng/mL， respectively. The mean recoveries ranged from 96.43% to 102.30%， with RSDs ranging from 0.35% to 4.92%. Among the 64 batches of samples， the total content of monoester-type alkaloids （mean value of 0.034 9 mg/tablet） was markedly higher than that of diester-type alkaloids （mean value of 0.002 2 mg/tablet）. Benzoylmesaconine showed the highest content， with a mean value of 0.031 0 mg/tablet， whereas the other five components were present at relatively low levels and showed considerable inter-batch variation. No statistically significant differences were observed in the contents of the six components among samples from different manufacturers （ P ＞0.05）. PCA showed no obvious clustering trend， and significant correlations were observed among some components （ P ＜0.05）.CONCLUSIONS The established UPLC-MS/MS method enables the rapid and accurate simultaneous determination of the above-mentioned six Aconitum alkaloids in Compound chondroitin sulfate tablets. The quality evaluation of multiple batches of samples provides a reference for the quality control of this preparation.

Objective There are so many tongue diagnosis features that need to be analyzed in Traditional Chinese Medicine(TCM),including tongue color,coating color,tongue morphology,and tongue dynamics,with about 30 different categories.Different tongue diagnosis features are often analyzed by individual methods,which fails to fully utilize the correlation between diagnostic features and greatly increases the overall implementation complexity of the TCM analysis system.Methods Therefore,in this paper,a TCM tongue color and coating color collaborative classification method based on relation network has been proposed.Firstly,a dual branch lightweight convolutional neural network has been constructed.By designing low and high layer feature fusion modules and combining Coordinate Attention mechanism,high classification accuracy can be achieved with lower model complexity.Secondly,a network for the tongue color and coating color relationship leaning has been designed to model the correlation between the two labels.By the network,the nonlinear information can be learned,which is used as a supplement for collaborative classification.Results The experimental results on two self-established TCM tongue diagnosis feature analysis datasets show that,the accuracy of tongue color classification reaches 95.17%and 93.67%respectively,while that of coating color classification reaches 91.11%and 90.53%respectively.Conclusion The proposed collaborative classification method can improve the classification accuracy of the two tasks,but simultaneously,the overall model complexity is reduced by almost half.

Objective There are so many tongue diagnosis features that need to be analyzed in Traditional Chinese Medicine(TCM),including tongue color,coating color,tongue morphology,and tongue dynamics,with about 30 different categories.Different tongue diagnosis features are often analyzed by individual methods,which fails to fully utilize the correlation between diagnostic features and greatly increases the overall implementation complexity of the TCM analysis system.Methods Therefore,in this paper,a TCM tongue color and coating color collaborative classification method based on relation network has been proposed.Firstly,a dual branch lightweight convolutional neural network has been constructed.By designing low and high layer feature fusion modules and combining Coordinate Attention mechanism,high classification accuracy can be achieved with lower model complexity.Secondly,a network for the tongue color and coating color relationship leaning has been designed to model the correlation between the two labels.By the network,the nonlinear information can be learned,which is used as a supplement for collaborative classification.Results The experimental results on two self-established TCM tongue diagnosis feature analysis datasets show that,the accuracy of tongue color classification reaches 95.17%and 93.67%respectively,while that of coating color classification reaches 91.11%and 90.53%respectively.Conclusion The proposed collaborative classification method can improve the classification accuracy of the two tasks,but simultaneously,the overall model complexity is reduced by almost half.

Objective:To compare the aortic remodeling of the Fabulous stent system and standard thoracic aortic endovascular repair (TEVAR) on distal aorta type B aortic dissection (TBAD). Methods:The prospective data collected between Dec 2017 and Oct 2019 from 134 patients with type B aortic dissection (TBAD) who underwent treatment with the "Fabulous" stent system, and retrospective data from 159 TBAD patients receiving standard TEVAR from corresponding multicenter. By using propensity score matching analysis, we compared the prognosis and aortic remodeling outcomes in patients undergoing Fabulous and standard TEVAR treatments during a 1-year postoperative follow-up.Results:In this study, 62 patients in Fabulous group and 62 patients in standard TEVAR were included.There were no significant statistical differences in baseline characteristics between the two groups. In terms of aortic remodeling in bare stent region, Fabulous group had better change trends of diameter of true lumen [10.6 (4.4, 14.5) mm vs. 4.7 (0.9, 10.7) mm, P=0.001] and false lumen [-24.2 (-30.5, -4.9) mm vs. 0.7 (-11.8, 2.3) mm, P<0.001] than those in the standard TEVAR group. The rate of complete false lumen thrombosis was also higher in the Fabulous group (62.9% vs. 37.1%, P=0.042). Conclusion:The Fabulous stent system, when compared to standard TEVAR surgery, demonstrates good aortic remodeling outcomes in the distal aorta.

Humans ; Endovascular Aneurysm Repair ; Stents ; Blood Vessel Prosthesis ; Aortic Dissection/surgery* ; Endovascular Procedures ; Aortic Aneurysm, Thoracic/surgery* ; Treatment Outcome ; Blood Vessel Prosthesis Implantation ; Retrospective Studies

Objective:To understand the status of continuing care needs of patients with cleft lip and palate after discharge, and to analyze the influencing factors.Methods:Using convenience sampling method, 401 patients with cleft lip and palate and their nursing families who underwent sequential treatment of cleft lip and palate in Peking university hospital of stomatology from April to August 2021 were selected as the research objects. The general information questionnaire and self-made continuous nursing needs assessment table were used to investigate patients with cleft lip and palate current situation of continuous nursing needs and analyze the influencing factors.Results:The total score of continuing care needs of patients with cleft lip and palate was (91.53±12.07). From high to low, the demand dimensions were health promotion demand, disease self-care demand, doctor-patient communication demand and psychosocial support demand. The results of multivariate linear regression analysis showed that the mode of payment, the number of operations, the intention of rehabilitation guidance, the mode of continuation service and the expected continuation service cycle were the influential factors for the continuing nursing needs of patients with cleft lip and palate ( R2=0.282, F=27.16, P<0.05). Conclusion:Patients with cleft lip and palate have a high demand for continuing nursing. Individualized and effective continuous nursing intervention measures should be developed according to the needs of patients to promote the rehabilitation of patients.

Objective To explore the effects of self-management intervention on the self-management ability and health service utilization of patients with chronic obstructive pulmonary disease (COPD). Methods A total of 84 COPD patients in stable condition with permission of being discharged in respiratory department of a tertiary comprehensive hospital in Wenzhou city,were selected as research objects from May to November 2014 by convenience sampling method,and were randomly divided into the intervention group (n=42) and the control group (n=42). Patients in the control group received routine care,while patients in the intervention group received self-management intervention and all patients were followed up. The self-management scale of chronic obstructive pulmonary disease was used investigate the self-management status of patients three months,six months and 12 months after intervention. The times of emergency services and the times of re-hospitalization were also recorded.Results The self-management ability of patients at the third month,sixth month and 12th month after intervention in the intervention group was significantly improved compared with the control group (P<0.05). There was no significant difference in the aspect of health service utilization at the third month after intervention between two groups (P>0.05);the times of health service utilization in the intervention group at the sixth month and 12th month after intervention were less than the control group (P<0.05).Conclusions Self-management intervention can improve the self-management ability of patients with COPD in stable period,and reduce the times of emergency visits and re-hospitalizations. It is an effective method for the management of chronic diseases.

Objective: To explore the effect of calcium channel blocker (CCB) treatment in patients of idiopathic pulmonary arterial hypertension (IPAH) with positive acute pulmonary vasodilator test, and to compare the hemodynamic differences between the positive and negative patients.
Methods: A total of 156 consecutive IPAH patients with acute pulmonary vasodilator test were studied. The patients were divided into 2 groups according to the testing result. Positive group, n=23 and Negative group, n=133. The positive patients were followed up by clinical or telephone visit to investigate their CCB dose, WHO PAH cardiac classiifcation and the survival conditions. Kaplan-meier curve was conducted to analyze the living condition and t test was used to compare the hemodynamic differences between the positive and negative patients.
Results: There were 43 male and 113 female patients at the male/female ratio of 1: 2.6, and 14.7% (23/156) positive patients. The average follow-up period for Positive group was (50.9 ± 3.8) months. There were 13 patients using diltiazem with the mean dose of (277 ± 108) mg/d at the range of (90-450) mg/d; 3 patients using amlodipine, 1 with the dose of 15mg/d and 2 with the dose of 7.5mg/d. The 1, 2 and 3 years survival rate for the positive patients were for 91.3%, 86.6% and 79.7% respectively. The mean pulmonary arterial pressure and pulmonary vascular resistance were lower, P=0.000, while the mixed venous oxygen saturation was higher in Positive group than Negative group, P=0.009.The NT-pro BNP level was lower in Positive group, P=0.001.
Conclusion: IPAH patients has lower ratio of positive acute pulmonary vasodilator test. The positive patients has the higher 1, 3 and 5 years survival rate and better hemodynamic parameters as the mean pulmonary arterial pressure, pulmonary vascular resistance and better level of NT-pro BNP.