OBJECTIVE To establish a whole-process quality management index system for traditional Chinese medicine （TCM） reserved in the department of medical institutions， providing a reference for standardized management. METHODS An initial indicator framework was determined by collecting and analyzing relevant laws， regulations， policy documents， group standards， and literature on TCM management. Two rounds of Delphi expert consultation involving 20 experts were conducted to refine and optimize the indicator system. The analytic hierarchy process was used to construct judgment matrices and convert the indicator weights into a percentage-based system； an assessment was conducted on 14 departments with reserved TCM among the affiliated units of the Quality Management and Control Center for Traditional Chinese Medicine in Hebei Province. RESULTS The response rate for both rounds of consultation was 100%， with an expert authority coefficient of 0.89. The final quality management system of TCM reserved in the department included four first-level indicators： management （composite weight： 0.366 3）， processing （composite weight： 0.119 7）， storage （composite weight： 0.291 7） and usage （composite weight： 0.222 3）， and twenty-four second-level indicators， such as establishing an organizational structure for hospital drug quality management and having dedicated regulations for backup drugs in clinical departments. Kendall’s coefficient of concordance confirmed consistency across all levels of indicators. Based on the application of the indicator system for evaluation， the average score for the standardized management of reserved TCM in the department of medical institutions increased from 67.01 points to 85.15 points over three months. CONCLUSIONS The constructed indicator system meets the standardized management requirements for reserved TCM， enabling closed-loop management across the entire process of management， processing， storage and usage. It provides a reference for medical institutions to enhance the precision and standardization of reserved TCM management.

BACKGROUND: Preclinical studies have indicated that Angong Niuhuang Pills (ANP) reduce cerebral infarct and edema volumes. This study aimed to investigate whether ANP safely reduces cerebral infarct and edema volumes in patients with moderate to severe acute ischemic stroke. METHODS: This randomized, double-blind, placebo-controlled pilot trial included patients with acute ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) scores ranging from 10 to 20 in 17 centers in China between April 2021 and July 2022. Patients were allocated within 36 h after onset via block randomization to receive ANP or placebo (3 g/day for 5 days). The primary outcomes were changes in cerebral infarct and edema volumes after 14 days of treatment. The primary safety outcome was severe adverse events (SAEs) for 90 days. RESULTS: There were 57 and 60 patients finally included in the ANP and placebo groups, respectively for modified intention-to-treat analysis. The median age was 66.0 years, and the median NIHSS score at baseline was 12.0. The changes in cerebral infarct volume at day 14 were 0.3 mL and 0.4 mL in the ANP and placebo groups, respectively (median difference: -7.1 mL; interquartile range [IQR]: -18.3 to 2.3 mL, P = 0.30). The changes in cerebral edema volume of the ANP and placebo groups on day 14 were 11.4 mL and 4.0 mL, respectively ( median difference: 3.0 mL, IQR: -1.3 to 9.9 mL, P = 0.15). The rates of SAE within 90 days were similar in the ANP (3/57, 5%) and placebo (7/60, 12%) groups ( P = 0.36). Changes in serum mercury and arsenic concentrations were comparable. In patients with large artery atherosclerosis, ANP reduced the cerebral infarct volume at 14 days (median difference: -12.3 mL; IQR: -27.7 to -0.3 mL, P = 0.03). CONCLUSIONS: ANP showed a similar safety profile to placebo and non-significant tendency to reduce cerebral infarct volume in patients with moderate-to-severe stroke. Further studies are warranted to assess the efficacy of ANP in reducing cerebral infarcts and improving clinical prognosis. TRAIL REGISTRATION Clinicaltrials.gov , No. NCT04475328.
Aged ; Female ; Humans ; Male ; Middle Aged ; Double-Blind Method ; Drugs, Chinese Herbal/adverse effects* ; Ischemic Stroke/drug therapy* ; Pilot Projects ; Stroke/drug therapy* ; Treatment Outcome

Schizophrenia (SZ) stands as a severe psychiatric disorder. This study applied diffusion tensor imaging (DTI) data in conjunction with graph neural networks to distinguish SZ patients from normal controls (NCs) and showcases the superior performance of a graph neural network integrating combined fractional anisotropy and fiber number brain network features, achieving an accuracy of 73.79% in distinguishing SZ patients from NCs. Beyond mere discrimination, our study delved deeper into the advantages of utilizing white matter brain network features for identifying SZ patients through interpretable model analysis and gene expression analysis. These analyses uncovered intricate interrelationships between brain imaging markers and genetic biomarkers, providing novel insights into the neuropathological basis of SZ. In summary, our findings underscore the potential of graph neural networks applied to multimodal DTI data for enhancing SZ detection through an integrated analysis of neuroimaging and genetic features.
Humans ; Schizophrenia/pathology* ; Diffusion Tensor Imaging/methods* ; Male ; Female ; Adult ; Brain/metabolism* ; Young Adult ; Middle Aged ; White Matter/pathology* ; Gene Expression ; Nerve Net/diagnostic imaging* ; Graph Neural Networks

OBJECTIVE To explore the impact and mechanism of curcumin on endometriosis （EMS） model rats based on Notch1 signaling pathway. METHODS Female SD rats with synchronized estrous cycles were implanted with autologous endometrium on the abdominal wall to construct EMS model. EMS rats were randomly divided into model group， low-， medium- and high-dose groups of curcumin （60， 120， 240 mg/kg）， and Notch 1 inhibitor DAPT group （7 mg/kg）. The sham surgery group was also established， with 10 rats in each group. Rats in each group received intragastric administration or injection via caudal veins with the corresponding drugs for 4 weeks. Endometriotic lesions were observed and measured using ultrasound and visual inspection， and their volumes were calculated. Histopathological morphology of the lesion tissues was observed. The levels of interleukin-1β （IL-1β）， IL-6， and tumor necrosis factor-α （TNF-α） in the abdominal cavity fluid， as well as the mRNA and protein expression levels of Notch1， matrix metalloproteinase-9 （MMP-9）， and vascular endothelial growth factor （VEGF） in the endometriotic lesions were measured. RESULTS Compared with the model group， the volume of endometriotic lesions in the low- ， medium- and high-dose groups of curcumin and the DAPT group was significantly decreased （P＜0.05）； atrophy or disappearance of columnar epithelium， cyst disappearance； the levels of IL-1β， IL-6， and TNF- α （except for the low-dose curcumin group） in the abdominal cavity fluid， as well as the mRNA （except for MMP-9 and VEGF in the low-dose curcumin group） and protein （except for MMP-9 in the low-dose curcumin group） expression levels of Notch1， MMP-9， and VEGF in the endometriotic lesions were significantly decreased （P＜0.05）. The curcumin high-dose group and DAPT group showed superior results in most indicators compared to the curcumin low- and medium-dose groups. CONCLUSIONS Curcumin has an improving effect on EMS， and its mechanism may be related to inhibiting Notch1 signaling pathway， reducting local inflammatory responses， and inhibiting ectopic endometrial invasion and angiogenesis.

Objective:To discuss the regulatory effect of serum and glucocorticoid-induced protein kinase 1(SGK1)in the early development of fertilized eggs at G1 phase of the mice,and to clarify the related mechanism.Methods:Some female mice aged 4-6 weeks and weighed about 20 g,and several male mice aged over 8 weeks and weighed about 30 g were selected.The female mice were intraperitoneally injected with 10 IU of pregnant mare serum gonadotropin(PMSG),followed by 10 IU of human chorionic gonadotropin(HCG)after 48 h.After HCG injection,the female mice were caged overnight with the male mice at a ratio of 1∶1.The fertilized eggs at G1,S,G2,and M phases were collected at 12-21 h,21-26 h,26-28 h,and 28-30 h after injected with HCG,and their cellular morphology at different cell cycles were observed under light microscope.The mouse fertilized eggs at G1 phase after superovulation were collected,the mRNA was synthesized in vitro,and divided into no injection group,Tris-EDTA buffer injection group(TE injection group),and SGK1-mRNA injection group.The SGK1 antibodies were mixed with KSOM culture medium with the concentrations of 1∶25,1∶50,1∶100,1∶200,and 0 to culture the mouse fertilized eggs at G1 phase.Western blotting method was used to detect the expression levels of SGK1 protein in fertilized eggs of the mice in various groups and the dephosphorylation for phosphorylated SGK1-Threonine 256 site tyrosine15 site of cell diusion cyclin 2(Cdc2)(Cdc2-pTyr15)in the fertilized eggs of the mice in various groups and different concentrations of SGK1 antibody groups and the developmental states of the fertilized eggs in the fertilized eggs of the mice in various groups and different concentrations of SGK1 antibody groups were observed under phase contrast microscope;the expression levels of phosphorylated SGK1-Thr256(SGK1-pThr256)and Cdc2-pTyr15 proteins in fertilized eggs at different post-HCG injection times were detected by Western blotting method.Results:Compared with no injection and TE injection groups,the expression level of SGK1 protein in the cells in SGK1-mRNA injection group was significantly increased(P<0.01).27-28 h after injected with HCG,the phosphorylation signaling of Cdc2-pTyr15 in fertilized eggs of the mice in SGK1-mRNA injection group was gradually disappeared,and there was no phosphorylation signaling 29 h after injected with HCG.At 28-29 h after injected with HCG,the phosphorylation signaling of Cdc2-pTyr15 in fertilized eggs of the mice in no injection and TE injection groups gradually disappeared,completely disappeared at 30 h after injected with HCG.With the increasing of the concentration of SGK1 antibody,the disappearing time of the Cdc2-pTyr15 phosphorylation signaling was increased.At 27 h after injected with HCG,the fertilized eggs of the mice in SGK1-mRNA injection group was initiated cleavage;at 31 h after injected with HCG,nearly all the fertilized eggs turned into G2 phase;at 33 h after injected with HCG,all the fertilized eggs in 0 and 1∶200 SGK1 antibody groups underwent cleavage.However,with the increasing of SGK1 antibody concentration,the cleavage of the fertilized eggs in 1∶25,1∶50,and 1∶100 SGK1 antibody groups was gradually decreased,particularly at 1∶25 SGK1 antibody group.Compared with no injection and TE injection groups,the death rate of the fertilized eggs of the mice in SGK1-mRNA injection group was significantly decreased at 31 h after injected with HCG(P<0.05),and the cleavage rate was increased(P<0.05).With the increasing of the SGK1 antibody concentration,the death rates of the fertilized eggs in different concentrations of SGK1 antibody group were increased(P<0.05),with the extending of cleavage time was increased,and the cleavage rate of the fertilized eggs was decreased in a dose-dependent manner,and the cleavage rate of fertilized eggs in 1∶25 SGK1 antibody group was the lowest.The expression level of SGK1-pThr256 protein in fertilized eggs of the mice was gradually increased from 27 h after injected with HCG(P<0.05 or P<0.01)in a time-dependent manner;at 28 to 29 h after injected with HCG,the expression levels of Cdc2-Tyr15 protein were gradually decreased(P<0.05)in a time-dependent manner,and had completely disappeared at 30 h after injected with HCG.Conclusion:Both the over-expression and inhibition of SGK1 can affect the time for the fertilized eggs at G1 phase to entry into M phase,suggesting that SGK1 protein may be one of the regulatory factors in the early development of fertilized eggs at G1 phase of the mice,and it may regulate the development of the fertilized eggs at G1 phase through regulation of Cdc2.

Objective:To discuss the role of serum and glucocorticoid-induced protein kinase 3(SGK3)in the resumption of the first meiotic division in the oocytes of the mice,and to preliminarily clarify the regulatory mechanism of SGK3 in the early development of mammalian oocytes.Methods:The germinal vesicle(GV)stage mouse oocytes were obtained by superovulation techniques.The SGK3 mRNA,obtained from in vitro transcription of expression plasmids,was injected into the GV stage oocytes by microinjection techniques.The oocytes were divided into control group,Tris-EDTA buffer(TE)group,and SGK3 mRNA group.Western blotting method was used to detect the expression levels of SGK3 protein in the oocytes in various groups;the germinal vesicle breakdown(GVBD)rates of the oocytes in various groups were observed and calculated at 1,2,3,and 4 h after microinjection of SGK3 mRNA;the morphological appearance of the oocytes in various groups was observed by SGK3 antibody dilution inhibition experiment;Western blotting method was used to detect the expression levels of phosphorylated SGK3(pSer48)(SGK3-pSer48)and phosphorylated cell division cycle protein 2(CDC2)(pTyr15)(CDC2-pTyr15)proteins in the oocytes cultured in vitro at different time points.Results:Compared with control group and TE group,the expression level of SGK3 protein in the oocytes in SGK3 mRNA group was increased(P＜0.01),and the GVBD rates at 1 and 2 h after microinjection were increased(P＜0.01).The SGK3 antibody dilution inhibition experiment results showed that as the increasing of concentration of SGK3 antibody,the GVBD rates of the oocytes in various groups were decreased in a concentration-dependent manner.After overexpressing SGK3,compared with control group,the time when CDC2-pTyr15 protein expression could not be detected in the oocytes in SGK3 mRNA group was advanced by at least 1 h.After treated with different concentrations of SGK3 antibody,compared with control group,as the increasing of concentration of SGK3 antibody and the extending of treatment time,the expression level of CDC2-pTyr15 protein in the oocytes was gradually decreased(P＜0.01),and the expression level of SGK3-pSer486 protein was gradually increased(P＜0.01).Conclusion:Over-expression of SGK3 can increase the GVBD rate of oocytes of the mice and accelerate the dephosphorylation of CDC2-pTyr15,while the dephosphorylation of CDC2-pTyr15 is later than the phosphorylation of SGK3-Ser486.SGK3 likely serves as an upstream regulator of CDC2 and participates in controlling the resumption of the first meiotic division in the oocytes of the mice.

Outpatient humanistic care refered to providing a full process of caring medical services to outpatients. In order to standardize the human caring services for outpatients in medical institutions, promote the comprehensive service level of outpatient services, and improve the patient′s medical experience, Chinese Association for Life Care issued the group standard of Management Norms for Human caring of Outpatients in April 2023. This standard clarified the relevant terms and definitions of human caring for outpatients, specified the basic requirements for human caring, the humanistic quality and care responsibilities of outpatient staff, the outpatient care environment and facilities, the outpatient care process and measures, and quality management. It designed standardized and personalized full process care service norms, providing references for medical institutions at all levels to promote the development of human caring for outpatients.

Objective To establish an ultra-high liquid chromatography(UPLC)characteristic spectrum of Rheum tanguticum Maxim.ex Balf.water decoction and conduct chemical pattern recognition analysis,and to identify the medicinal materials of different origins and different processed products.Methods:UPLC was adopted to establish the characteristic spectra of 15 batches of Rheum tanguticum Maxim.ex Balf.Cluster analysis combined with principal component analysis was used to analyze their quality.Rhei Radix et Rhizoma from different origins and different processed products of Rheum tanguticum Maxim.ex Balf.were identified.Results:The characteristic spectrum of Rheum tanguticum Maxim.ex Balf.water decoction was established,18 common peaks were identi-fied,and 15 batches of Rheum tanguticum Maxim.ex Balf.were divided into 2 categories according to their origins by cluster analysis.The similarity between 15 batches of samples from different origins and the control spectrum was greater than 0.900.According to OPLS-DA analysis,a total of 6 markers(rhein-8-O-β-D-glu-cosid,resveratrol-4'-O-β-D-(6''-O-D-gallyl)glucopyranside,isolindleyin,rhein,epicatechin-3-O-D-gallate,and catechin)affecting the quality of Rheum tanguticum Maxim.ex Balf.water decoction samples were found.Rhei Radix et Rhizoma from different origins and different processed products of Rheum tanguticum Maxim.ex Balf.can be effectively distinguished.Conclusion:The established characteristic spectrum method is easy to operate and has good repeatability.It can be used for the quality control of Rheum tanguticum Maxim.ex Balf.water decoction,and can provide reference for the formulation of quality standard of formula granules of Rhei Radix et Rhizoma.

Objective To optimize the preparation process of hydroxysafflor yellow A(HSYA)nanoparticle and conduct in vitro release evaluation.Methods HSYA nanoparticles were prepared with PLGA as carrier by modified compound emulsion method.The optimal preparation process of the experiment was selected by Plackett-Burman and Box-Behnken response surface method.The nanoparticles were characterized by using particle size analyzer,TEM scanning electron microscope,Fourier transform infrared spectroscopy(FT-IR),X-ray diffraction(XRD).Frozen(4℃)storage stability,stability in physiological medium,lyophilized protective agent and in vitro release rate were investigated.Results The optimal process prescription of nanoparticle is as follow:pH value is 6.95,the dosage is 2.8 mg,and carrier dosage is 18.2 mg.The size of nanoparticles obtained at optimum condition is(176.4±1.29)nm,the polydiseperse index(PDI)is 0.152±0.014,the Zeta potential is(-17.6±0.46)mV,the encapsulation rate is(78.5±0.49)％,drug loading is(7.3±0.07)％.These nanoparticles showed round and good dispersion.Good stability in 4℃ storage environment and different physiological media of nanoparticles were observed.The best lyophilized protective agent was 1％glucose and the in vitro release rate of nanoparticles at 48 hours was 85％.Conclusion The optimization method is reasonable and reliable.The obtained nanoparticles have good stability and sustained-release effect.The in vitro release behavior conformed to first-order kinetic model.

Objective:To investigate the application value of intervention mapping-based health education on therapeutic cognitive perception of pulmonary arterial hypertension patients.Methods:Totally, 60 patients with pulmonary arterial hypertension from January 2018 to January 2021 in Huazhong Fuwai Central Vascular Disease Hospital were assigned to the experimental group and control group according to admission time, with 30 cases in each group. The control group received routine health education, while the experimental group implemented intervention mapping-based health education. The intervention effects were assessed by Beliefs about Medicine Questionnaire-Specific (BMQ-S), Morisky Medication Adherence Scale (MMAS), 6MWT as well as Borg Scale (BS).Results:At 1 month and 3 months after discharge, the scores of MMAS in the experimental group were significantly higher than in the control group[(5.43±1.17) points, (5.57±1.17) points vs (4.60±1.54) points and (4.87±1.41) points], the differences were statistically significant ( t=2.36, 2.10, both P<0.05). At 3 months after discharge, the scores of necessity belief subscale in the experimental group were higher than those in the control group [(22.93±2.63) points vs (21.27±2.73) points], concern belief subscale scores lower than in the control group [(12.40±2.54) points vs (14.13±3.01) points], 6MWT distance in the experimental group higher than in the control group [(532.13±38.51) m vs (507.03±51.13) m], BS scores lower than in the control group [(3.53±1.20) points vs (4.10±0.84) points], the differences were statistically significant ( t values were 2.12-2.41, all P<0.05). Conclusions:Intervention mapping-based health education can improve therapeutic cognitive perception and medication adherence of pulmonary arterial hypertension, it is helpful to promote rehabilitation of patients.