OBJECTIVE To screen the quality biomarkers of Gnaphalium affine with anti-chronic obstructive pulmonary disease （COPD） effect and determine their contents. METHODS The effective components and targets of “G. affine” with anti- COPD effect were predicted by using network pharmacology as a search criterion. HPLC fingerprints for 10 batches of G. affine were established by using Similarity Evaluation System of TCM Chromatographic Fingerprint （2012 edition）； common peak identification and similarity evaluation were conducted； cluster analysis （CA）， principal component analysis （PCA）， and orthogonal partial least squares-discriminant analysis （OPLS-DA） were performed to screen differential components as quality maker that affected the quality of G. affine using variable importance projection （VIP）＞1 as the standard. The same HPLC method was adopted to determine the contents of the differential components in 10 batches of samples. RESULTS A total of 10 flavonoids （such as quercetin， luteolin， and chlorogenic acid） and organic acid components， were identified through network pharmacology search， with 91 targets closely related to anti-COPD. A total of 9 common peaks were identified in 10 batches of samples， with similarity greater than 0.90. Among them， the differential components included chlorogenic acid， caffeic acid， 1，3-O- dicaffeoylquinic acid and apigenin 7-O-β-D-glucopyranoside； S3， S4， S6， S7 and S10 were clustered into one category， S2， S5， S8 and S9 clustered into one category， and S1 clustered into one category. The contents of chlorogenic acid， caffeic acid， 1，3-O- dicaffeoylquinic acid， and apigenin 7-O-β-D-glucopyranoside in 10 batches of G. affine ranged 0.070-7.653， 0.010-0.097， 0.001- 0.036， 0.508-6.627 mg/g， respectively. CONCLUSIONS Chlorogenic acid， caffeic acid， 1，3-O-dicaffeoylquinic acid， apigenin 7- O-β-D-glucopyranoside can serve as the potential quality marker for the anti-COPD effect of G. affine， with the highest content of chlorogenic acid in G. affine produced in Ji’an， Jiangxi province， and the highest content of caffeic acid in G. affine produced in Ji’an， Jiangxi province and Sanming， Fujian province. The contents of the last two components are highest in G. affine produced in Chaoshan， Guangdong province.

Objective To study the clinical effect of Kinesio Tape for treating the lower limb function in children with spastic cerebral palsy accompanied by knee hyperextension.Methods Sixty children with spastic cerebral palsy treated by rehabilitation therapy in this hospital from August 2017 to December 2018 were se-lected as the study subjects and divided into the experiment group and control group,30 cases in each group.The control group adopted the conventional rehabilitation therapy,while the experiment group was combined with Kinesio Tape on the basis of conventional rehabilitation therapy.The treatment course lasted for 3 months.Before and after treatment,the children patients conducted the Gross Motor Function Measure-88(GMFM-88)scoring,Modified Ashworth Scale(MAS)grading on the triceps surae muscle in the affected side,surface electromyography,measurement of dorsiflexion angle of foot in knee extension position and meas-urement of maximum knee extension angle of knee joint.Results The GMFM-88 score,triceps surae muscle MAS grade in the affected side,foot dorsiflexion angle in Knee extension position,maximum knee extension angle in the erect position in the two groups were improved compared with those before treatment(P＜0.05).Furthermore,the above indicators in the experimental group were superior to those in the control group(P＜0.05).The surface electromyographic value had no statistical difference between the two groups(P＞0.05).No obvious adverse reactions occurred during the treatment process with good compliance.The chil-dren's parents in the experiment group filled in Kinesio Tape satisfaction questionnaire,and had 100％satis-faction.Conclusion Kinesio Tape combined with routine rehabilitation therapy could effectively improve the muscular tension,joint activity,knee excessive extension degree and exercise function in children with spastic cerebral palsy accompanied by knee hyperextension.

Purpose: This study aims to evaluate the efficacy and safety of trastuzumab biosimilar (HLX02) in combination with pertuzumab and chemotherapy in patients with human epidermal growth factor receptor 2 (HER2)–positive metastatic breast cancer (MBC) after progression of trastuzumab. Materials and Methods: In this prospective, single-arm, phase II study, patients with HER2-positive MBC after progression of trastuzumab received pertuzuamb, HLX02, and chemotherapy in Beijing Cancer Hospital from March 2020 to December 2022. The primary endpoint was progression-free survival (PFS), and secondary endpoints included objective response rate (ORR), disease control rate (DCR), overall survival (OS), and safety. The study was registered with ClinicalTrials.gov (NCT05188495). Results: A total of 45 patients were included in this study. Twelve patients (26.7%) were treated in second-line and 33 patients (73.3%) were in third-line and later setting. Eighty percent and 15.5% patients had previously received pyrotinib/lapatinib and T-DM1, respectively. With a median follow-up of 24.4 months (range, 1.2 to 43.9 months), the median PFS was 7.6 months (95% confidence interval, 4.3 to 10.9), OS was not reached, the ORR was 31.1%, and DCR was 91.1%. The treatment was well tolerated. Conclusion The combination of trastuzumab biosimilar HLX02, pertuzumab, and chemotherapy exhibited promising efficacy and a favorable safety profile as second- and beyond-line treatment in HER2-positive MBC.

A case of a 69-year-old female patient, with cough, expectoration, chest tightness and shortness of breath for 10 days accompanied by left pleural effusion, was reported. Initially, a large number of suspected malignant lymphoma cells were found in the patient′s pleural effusion through routine cell morphological examination after admission, which was the direction of clinical diagnosis and treatment in the next step. Then the patient was diagnosed as primary pulmonary diffuse large B-cell lymphoma (DLBCL) through imaging, bone marrow and lung biopsy pathology. Finally, the patient was treated effectively with R-CHOP regimen, but she died of respiratory failure 9 weeks later, because she did not receive regular follow-up and treatment after the sixth chemotherapy cycle. Primary pulmonary DLBCL, an extremely rare extranodal lymphoma' lacks specificity clinical manifestations and is easy to be missed and misdiagnosed. DLBCL with a large number of malignant pleural effusion progresses rapidly and has a poor prognosis. The routine cell morphology examination of pleural effusion is simple and intuitive, which can capture key information in the shortest time, preliminarily provide clinical diagnosis and treatment ideas, and provide accurate basis for disease diagnosis.

Liver function can reflect the severity of cirrhosis,and has important clinical value for disease monitoring,efficacy evaluation and surgical risk prediction.At present,the methods commonly used in clinical evaluation of liver function include blood biochemical examination,drug excretion test,comprehensive scoring system and routine imaging examination.All these methods have their limitations.Gd-EOB-DTPA is a hepatocellular specific contrast agent,which is taken up and excreted by liver cells and can directly reflect liver function.Therefore,it is expected to achieve non-invasive segental quantitative evaluation of liver function through enhanced MRI of Gd-EOB-DTPA,which is the focus of current research.In this paper,the methods of Gd-EOB-DTPA enhanced MRI for liver function assessment were reviewed,and the feasibility of Gd-EOB-DTPA in liver function assessment was discussed.

BACKGROUND: Corneal disease is second only to cataract considered as the leading cause of blindness in the world, with high morbidity. Construction of corneal substitutes In Vitro by tissue engineering technology to achieve corneal regeneration has become a research hotspot in recent years. We conducted in-depth research on the biocompatibility, physicochemical and mechanical properties of rat bone marrow mesenchymal stem cells (rBM-MSCs)-seeded gelatin methacrylate (GelMA) as a bioengineered cornea. METHODS: Four kinds of GelMA with different concentrations (7, 10, 15 and 30%) were prepared, and their physicchemical, optical properties, and biocompatibility with rBM-MSCs were characterized. MTT, live/dead staining, cell morphology, immunofluorescence staining and gene expression of keratocyte markers were performed. RESULTS: 7%GelMA hydrogel had higher equilibrium water content and porosity, better optical properties and hydrophilicity. In addition, it is more beneficial to the growth and proliferation of rBM-MSCs. However, the 30%GelMA hydrogel had the best mechanical properties, and could be more conducive to promote the differentiation of rBM-MSCs into keratocyte-like cells. CONCLUSION As a natural biological scaffold, GelMA hydrogel has good biocompatibility. And it has the ability to promote the differentiation of rBM-MSCs into keratocyte-like cells, which laid a theoretical and experimental foundation for further tissue-engineered corneal stromal transplantation, and provided a new idea for the source of seeded cells in corneal tissue engineering.

Objective:To explore the clinical phenotype and gene characteristics of a case of TSC2/PKD1 adjacency gene syndrome, so as to improve the clinical understanding of the disease.Methods:A case of TSC2/PKD1 adjacency gene syndrome diagnosed in the Department of Neurology of the Children′s Hospital Affiliated to Zhengzhou University was analyzed retrospectively. The clinical data, laboratory examination, imaging characteristics and gene variation characteristics of the child were summarized.Results:The patient was a 17 months old girl, with the main complaint of "intermittent convulsion with 17 months of underdevelopment". The clinical manifestations were epileptic seizures, which were in the form of a series of spastic seizures, absence seizures, focal seizures, and depigmentation spots can be seen in the trunk and neck. Cranial magnetic resonance imaging showed multiple patchy signals in the cortex and subcortical areas of the bilateral cerebral hemispheres, multiple small nodular shadows under the ependyma of the bilateral lateral ventricles, the heart color Doppler ultrasound showed patent foramen ovale and pericardial effusion, and the abdomen color Doppler ultrasound showed polycystic kidney. Ophthalmic color Doppler ultrasound showed that there were localized small swelling lesions around the optic disc of the left eye. The whole exon gene sequencing of the pedigree showed the proband had partial deletion of TSC2 gene (NM_000548) at chromosome position chr16: 2125799-2185690. The real-time quantitative detection system verified that exons 23-42 were deleted, and all exons of PKD1 gene were deleted (NM_001009944), and multiple ligation dependent probe amplification verified that exons 1-46 were deleted, and no downstream gene deletion was found. The overall deletion size was about 60 kb. Both of the girl's father and mother had normal phenotypes and were wild-type.Conclusions:TSC2/PKD1 adjacency gene syndrome is relatively rare. It can have clinical manifestations of tuberous sclerosis/autosomal dominant polycystic kidney disease. Most of the nervous system and kidney are seriously affected, and the prognosis is poor. TSC2/PKD1 gene deletion and variation is the genetic cause of the TSC2/PKD1 adjacency gene syndrome.

Objective : To analyze the length of hospital stay of patients with heart failure in a multicenter cohort in order to explore the influencing factors of length of stay and provide data support for further intervention. Methods: A total of 2 794 patients enrolled in the multicenter prospective heart failure cohort were divided into two groups: long hospital stay group (≥9 days) and short hospital stay group ( < 9 days) . The general data of the two groups were compared, and the factors with statistical difference in univariate analysis were included in Logistic multifactor regression analysis to explore the difference in length of hospital stay between the two groups. According to left ventricular ejection fraction(LVEF), patients were divided into heart failure with preserved reduced ejection fraction (HFpEF)group, heart failure with mildly reduced ejection fraction(HFmrEF)group and heart failure with reduced ejection fraction(HFrEF) group, and Logistic multifactor regression analysis was performed to find influencing factors. Results : Logistic multifactor regression analysis showed that LVEF, pneumonia, N⁃terminal pro⁃B⁃type natriuretic peptide(NT⁃proBNP), serum sodium, cardiac resynchronization therapy( CRT) or implantable cardioverter defibrillator(ICD)implantation, β blockers, aldosterone receptor antagonists, positive inotropic drugs and vasodilators were all factors influencing the hospitalization of HF patients. In the HFpEF, HFmrEF, and HFrEF groupsCRT/ICD implantation, positive inotonic drugs, and vasodilator use were suggested to be common factors affecting length of hospital stay in all three groups. Conclusion LVEF, pneumonia, NT⁃proBNP, serum sodium, CRT or ICD implantation, β blockers, aldosterone receptor antagonists, positive inotropic drugs and vasodilators are the influencing factors of hospitalization time in HF patients.

This paper reviews the related concepts of nurses' core competence and the research status of nurses' core competence in anesthesia recovery room and points out the imperfect problems in the construction of the evaluation index system of nurses' core competence in the anesthesia recovery room, in order to provide a theoretical basis for the construction of the evaluation index system of nurses' core competence in anesthesia recovery room.

Alanine Transaminase ; Amikacin ; Anti-Bacterial Agents ; Aztreonam ; Bilirubin ; Carbapenems ; Ceftazidime ; China ; Creatinine ; Cross Infection ; Escherichia coli ; Fibrosis ; Fungi ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Hemorrhage ; Hospitals, Teaching ; Humans ; International Normalized Ratio ; Klebsiella pneumoniae ; Length of Stay ; Leukocyte Count ; Linezolid ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Multivariate Analysis ; Prevalence ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Vancomycin