Ophiopogon japonicus, a precious medicinal plant endemic to Zhejiang Province. Its tuberous roots are rich in bioactive components such as flavonoids, possessing anti-inflammatory, antioxidant, and immunomodulatory properties. To elucidate the impact of cadmium (Cd) stress on the accumulation and biosynthetic pathway of flavonoids in O. japonicus, this study exposed O. japonicus to different concentrations of Cd stress and explored the changes through integrated transcriptomics and metabolomics analysis. The results demonstrated that Cd stress (1 mg/L and 10 mg/L) significantly increased the content of flavonoids in O. japonicus in a concentration-dependent manner. The metabolomics analysis revealed a total of 110 flavonoids including flavones, flavanols, flavonols, flavone and flavonol derivatives, flavanones, isoflavonoids, chalcones and dihydrochalcones, and anthocyanins in O. japonicus, among which flavones, flavonols, flavone and flavonol derivatives, and anthocyanins increased under Cd stress. The transcriptomics analysis identified several key flavonoid biosynthesis-associated genes with up-regulated expression under Cd stress, including 14 genes encoding 4-coumarate CoA ligase (4CL), 2 genes encoding chalcone isomerase (CHI), and 14 genes encoding phenylalanine ammonia lyase (PAL). The gene-metabolite regulatory network indicated significant positive correlations of 4CL (Cluster-21637.5012, Cluster-21637.90648, and Cluster-21637.62637) and CHI (Cluster-21637.111909 and Cluster-21637.123300) with flavonoid metabolites, suggesting that these genes promoted the synthesis of specific flavonoid metabolites, which led to the accumulation of total flavonoids under Cd stress. These findings provide theoretical support for the cultivation and utilization of medicinal plants in Cd-contaminated environments and offered new perspectives for studying plant responses to heavy metal stress.
Cadmium/toxicity* ; Flavonoids/biosynthesis* ; Metabolomics ; Ophiopogon/drug effects* ; Stress, Physiological ; Transcriptome ; Gene Expression Profiling ; Gene Expression Regulation, Plant

Objective To investigate the clinical efficacy of fasting nasogastric administration of sesame oil combined with multi-frequency vibrational abdominal massage in stroke patients with consti-pation undergoing nasogastric feeding.Methods A total of 50 stroke patients with nasogastric feeding were selected as study subjects and randomly divided into control group and study group,with 25 pa-tients in each group.The control group received routine nursing care plus multi-frequency vibrational abdominal massage,while the study group received fasting nasogastric administration of 20 mL of sesa-me oil on the basis of the control group's treatment.After 15 days of intervention,the defecation condi-tions[constipation clinical symptom score(CSS),stool consistency(Bristol stool scale),and stool volume]were compared between the two groups.Results After treatment,the CSS score in the study group was lower than that in the control group[(6.52±2.52)versus(12.64±3.32),P＜0.05].The normal stool consistency(types Ⅳ and Ⅴ on the Bristol stool scale)in the study group was higher than that in the control group(76.0％versus 8.0％,P＜0.05).The stool volume in the study group was higher than that in the control group[(303.00±93.79)g versus(196.40±60.27)g,P＜0.05].The total effective rate of defecation in the study group was 96.0％,which was higher than 32.0％in the control group(P＜0.05).The Patient Assessment of Constipation-Quality of Life(PAC-QOL)score in the study group was lower than that in the control group[(40.07±5.67)versus(63.07±7.46),P＜0.05].Conclusion Fasting nasogastric administration of sesame oil com-bined with multi-frequency vibrational abdominal massage can promote the recovery of intestinal function and improve constipation symptoms in stroke patients with nasogastric feeding.

Objective To analyze the research status and predict the development trend of clinical comprehensive evaluation of drugs in China, and to provide reference for clinical comprehensive evaluation. Methods CNKI, Wanfang and VIP database were used to search the published articles of clinical comprehensive evaluation. Literature searching was set from the building time of the database to 2022, the basic information about the published articles was obtained for the evaluation of the literature quality. Bibliometrics and CiteSpace 6.1.R3 software were used to visualize the research authors, research institutions, and key words. Results After data screening, a total of 126 Chinese published articles were selected. The analysis showed that the numbers of published articles were rising continuously, and China Academy of Chinese Medical Sciences and Xie Yanming were the institute and the author with the maximum number of literatures, respectively. Conclusion The clinical comprehensive evaluation of drugs was conducted based on the clinical value of drugs, guided by the policy requirements. It is suggested that researchers should conduct the comprehensive evaluation according to the focus and requirements of government agencies, the pharmaceutical industry and the clinical applications.

Objective:To study the clinical efficacy of 3D total hip arthroplasty in elderly patients with acetabular fracture.Methods:A total of 43 patients with non-obsolete acetabular fractures admitted to Xining First People's Hospital from May 2016 to December 2018 were randomly divided into the control group (22 cases) and the observation group (21 cases) for a perspective study. The control group received routine surgery and the observation group was treated with total hip arthroplasty combined with 3D printing. The patient's operation time, intraoperative blood loss, and hospitalization time were recorded. The hip function was assessed by Harris Hip Scale (HHS) after 6 months of follow-up. The patient's quality of life was assessed using the short form 36 item health survey questionnaire (SF-36) before and 6 months after surgery. The complications of the patients during operation and follow-up were recorded.Results:The operation time, hospital stay and intraoperative blood loss were significantly lower in the observation group than those in the control group ( P<0.05). At 6 months after operation, the hip joint function of the observation group was significantly better than that of the control group ( P<0.05); the quality of life scores were significantly higher than the control group ( P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P<0.05). Conclusions:3D printed total hip arthroplasty can effectively improve the operation and hip function of elderly patients with non-obsolete acetabular fracture and the quality of life of patients without increasing adverse reactions.

Objective:To investigate the reliability of a tool based on the International Classification of Functioning, Disability and Health (ICF) in the assessment of functioning despite disability.Methods:A total of 371 patients were assessed using a tool based on the ICF rehabilitation set combined with a numerical rating scale ranging from 0 to 10. The internal consistency, inter-rater reliability and intra-rater reliability were analyzed.Results:The scale′s Cronbach′s alpha coefficient was 0.89. The inter-rater correlation coefficient was 0.85, and the correlations among the items ranged from 0.78 to 0.94. The intra-rater correlation coefficient with the scale was 0.95, with the item correlations ranging from 0.72 to 0.97. Only item b230 Hearing function did not correlate well.Conclusions:The functioning assessment tool based on the ICF rehabilitation set when combined with a numerical rating scale has internal consistency, inter-rater reliability and intra-rater reliability sufficient for use in clinical practice.

Objective To explore the application of Oxybuprocaine Hydrochloride Gel in colonoscopy examination. Methods 1000 patients received colonoscopy examination were randomly divided into experimental group and control group, 500 cases in each. Oxybuprocaine Hydrochloride Gel was applied on anal region in the experimental group before endoscopy for perianal anesthesia and lubrication. Paraffin oil was used in the control group to lubricate perianal and enteroscopy. The success rate of primary insertion, visual analogue pain score (VAS) score, examination time and postoperative complications were compared between the two groups. Results In the experimental group, the success rate of primary insertion (95%) was higher than that of the control group (76%), and the pain score was lower than that of the control group.The examination time was shortened, and the difference was statistically significant (P < 0.05). Conclusions Oxybuprocaine Hydrochloride Gel applied to colonoscopy can effectively reduce the patient's pain and discomfort, improve the success rate of primary insertion, shorten the examination time. And the method is worthy of clinical popularization and application.

Objective To evaluate the relationship between the early incidence of postoperative complications and renal pelvic pressure during minimally invasive percutaneous nephrolithotomy. Methods 133 renal calculi patients were monitored during MPCNL. Then the patients were separated into two groups according to the renal pelvic pressure,and the postoperative fever,the perirenal fluid and impairment of renal function were analyzed. Results The average body temperature was higher in high pelvic pressure group than that in low pelvic pressure group from the first day to the fourth day after operation(P<0. 05). The urinary protein of all patients raised obviously after the op-eration while it decreased gradually afterward. The urinary protein of the high pelvic pressure group was much higher than that of the low pel-vic pressure group in same day with a significant difference (P<0. 05). The incidence of perirenal fluid was much higher in high pelvic pres-sure group than that in low pelvic pressure group (P<0. 05). Conclusion The incidence of early postoperative complications was related to renal pelvic pressure during MPCNL.

Objective To investigate the effect of formative assessment on skill acquisition of basic life support (BLS) among medical students. Methods Totally 206 undergraduates were ran-domized into control group (C group) and interventional group (F group). A BLS lecture was given in both groups. And then, 45 min BLS training and BLS skill assessment (after training) were given in C group. Undergraduates in F group received BLS skill assessment (formative assessment) before training, and 15 min feedback was delivered based on the assessment, then 30 min BLS training was conducted. Skills assessment was conducted again in F group after the training. Student's-t-test was used to compare the difference of skills between the two groups and P<0.05 signifies statistically sig-nificant differences. Results Score of F group (85.2±7.3) were higher than that in C group (68.2± 13.2), with statistical difference. Conclusion A formative assessment could significantly improve skill acquisition of BLS among medical students.

Objective To observe clinical efficacy of intra-articular injection of sodium hyaluronate(SH) and betamethasone accompanied with Bulleyaconitin A or diclofenac sodium administration for severe knee osteoarthritis(KOA).Methods60 patients with severe KOA from 580 subjects with KOA were selected as observational subjects in the experiment. All patients were treated by intra-articular injection of sodium hyaluronate 2.5 ml and betamethasone administration once a week for five consecutive weeks as a therapeutic course, betamethasone only once. Bulleyaconitin A group was accompanied with Bulleyaconitin A 0.4 mg, t.i.d, p.o.; diclofenac sodium group was accompanied with diclofenac sodium 75 mg, b.i.d, p.o. According to knee joint comprehensive score table (Tegner rating systems), the function comprehensive scores for all the patients pre-treatment and post-treatment knee joints were assessed.ResultsThe function comprehensive scores improved significantly after treatment in two groups(P＜0.001). The side effects in Bulleyaconitin A group decreased significantly than in diclofenac sodium group(P＜0.01).ConclusionThe intra-articular injection of SH and betamethasone accompanied with Bulleyaconitin A administration was an effective and less side-effect therapeutic measure for the treatment of knee osteoarthritis, especially for the old patients with severe knee osteoarthritis.

Objective To explore the therapy for herpes zoster (HZ) after renal transplantation. Methods 12 renal transplantation recipients with herpes zoster were treated with acyclovir, ultraviolet rays and nerve block. The pain was assessed with visual analogue scale (VAS). Results The scores of VAS decreased from 9.3 to 2.1 after treatment (P<0.01). The total effective rate was 100%. Conclusion Acyclovir combined with ultraviolet rays and nerve block is a more safe and effective therapy for the herpes zoster in renal transplantation recipients.