Objective To establish a quality evaluation method for Abri Mollis Herba based on its morphological characteristics, microscopic features, and the determination of principal component contents. Methods The morphological characteristics of Abri Mollis Herba were identified by morphological authentication methods. Microscopic techniques were employed to observe the microscopic features of both the powdered form and cross-sectional tissue of Abri Mollis Herba. Additionally, a high-performance liquid chromatography （HPLC） method was developed to establish the quantify the main components, abrine and soyasaponin Bb, in Abri Mollis Herba. Results The morphological characteristics of Abri Mollis Herba were defined by numerous long pubescence on both the upper and lower surfaces of the leaflets, with indistinct veins and vein islands. The microscopic features mainly included non-glandular hairs, prismatic crystals, and crystal-sheathed fibers in the powdered form. In the root cross-section, xylem bundles, rays, vessels, and stone cells were visible. The stem cross-section displayed rays, vessels, and a hollow pith, while the leaf cross-section revealed collateral vascular bundles, vessels, and prismatic crystals. Conclusion The quality of Abri Mollis Herba could be effectively evaluated by the combination of morphological identification, microscopic authentication, and the quantification of main components abrine and soyasaponin Bb .

Objective To study the protective effects and mechanism of sacubitril(Sac)/valsartan(Val)on cardiomyocytes of rabbits with heart failure induced by doxorubicin(DOX).Methods Thirty New Zealand rabbits were selected to establish DOX-induced heart failure rabbit model.Twenty-five rabbits with successful modeling were randomly assigned to model group(DOX group,n=9),DOX+Val group(n=8),and DOX+Sac/Val group(n=8);and another 8 New Zealand rabbits were selected as blank group.The DOX+Val group was gavaged with 4.65 mg/kg Val suspension each time,the DOX+Sac/Val group was gavaged with 9.3 mg/kg Sac/Val suspension each time,and the blank group and DOX group were gavaged with equal volume of distilled water each time.Each group was gavaged twice a day for 8 weeks.After 8 weeks of administration,echocardiography was used to measure left ventricular end-diastolic diameter(LVDD),left ventricular end-systolic diameter(LVSD),left ventricular ejection fraction(LVEF),and left ventricular fractional shortening(LVFS).The heart mass index(HMI)and left ventricular mass index(LVMI)were calculated.The pathological morphology and myocardial fibrosis of myocardial tissue were observed by hematoxylin-eosin(H-E)and Masson staining.The ultrastructure of cardiomyocytes was observed by transmission electron microscope.Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL)staining was used to observe cardiomyocytes apoptosis and apoptosis rate was calculated.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of N-terminal pro-brain natriuretic peptide(NT-proBNP),high-sensitivity cardiac troponin I(Hs-cTNI),angiotensin Ⅱ(Ang Ⅱ),aldosterone(ALD),atrial natriuretic peptide(ANP),brain natriuretic peptide(BNP),cyclic guanosine monophosphate(cGMP),and protein kinase G(PKG)in serum.Quantitative polymerase chain reaction(qPCR)was used to detect the expression of natriuretic peptide receptor A(NPR-A),cGMP-specific phosphodiesterase 5A(PDE5A[cGMP]),PKG,B-cell lymphoma 2(Bcl-2),Bcl-2 associated X protein(Bax),and cysteine aspartate protease 3(caspase 3)mRNA in myocardial tissue.Western blotting was used to detect the expression of phosphorylated cAMP response element-binding protein(p-CREB),phosphorylated Bcl-2 related death promoting factor(p-Bad),Bcl-2,Bax,and caspase 3 proteins in myocardial tissue.Results Compared with the blank group,the LVDD and LVSD in the DOX group were increased(both P<0.01),the LVEF and LVFS were decreased(both P<0.01)and the HMI and LVMI were increased(both P<0.01);the apoptosis and apoptosis rate of cardiomyocytes were increased(P<0.01);the levels of NT-proBNP,Hs-cTNI,Ang Ⅱ,ALD,ANP,BNP,cGMP and PKG and the expression of NPR-A,PDE5A(cGMP),PKG,p-CREB,Bax and caspase 3 were all increased(all P<0.01),while the expression of Bcl-2 was decreased(P<0.01),and the expression of p-Bad had no significant difference(P>0.05).Compared with the DOX group,the LVDD and LVSD of the DOX+Sac/Val group and DOX+Val group were decreased(all P<0.01),the LVEF and LVFS were increased(all P<0.01)and the HMI and the LVMI were decreased(all P<0.01);the apoptosis and apoptosis rate of cardiomyocytes were decreased(all P<0.01);the levels of NT-proBNP,Hs-cTNI,Ang Ⅱ,ALD,ANP,BNP,cGMP and PKG and the expression of NPR-A,PDE5A(cGMP),PKG,Bax and caspase 3 were all decreased(all P<0.01),while the expression of Bcl-2 was increased(P<0.01);and the expression of p-CREB and p-Bad was increased in the DOX+Sac/Val group(both P<0.01),but there was no significant difference in the DOX+Val group(both P>0.05).Compared with the DOX+Val group,the DOX+Sac/Val group showed a decrease in all indicators except for LVEF,LVFS,NPR-A,ANP,BNP,cGMP,PDE5A(cGMP),PKG,p-CREB,p-Bad,and Bcl-2,which were all elevated(all P<0.05).Myocardial pathology and transmission electron microscopy showed that Sac/Val effectively protected cardiomyocytes,reduced cardiomyocytes apoptosis and myocardial fibrosis,and these effects were significantly better than those of Val.Conclusion Sac/Val can effectively reduce cardiomyocytes apoptosis,improve cardiac function and reduce myocardial fibrosis in rabbits with heart failure,and these effects are superior to Val.Its mechanism may be related to activating the NPR-A/cGMP/PKG signaling pathway and inhibiting renin-angiotensin-aldosterone system.

Objective:To explore the potential profiles of health literacy in patients with chronic atrophic gastritis (CAG) and analyze their influencing factors.Methods:A cross-sectional study was conducted to select CAG patients admitted to Nanjing Hospital of Traditional Chinese Medicine or attending outpatient clinics from January 2023 to June 2024 by convenience sampling method, and all patients participated in this study two months after treatment. The General Information Questionnaire, the General Self-Efficacy Scale, and the All-around Health Literacy Measurement Scale (AAHLS) were used to conduct the questionnaire survey. The three dimensions of AAHLS were used as exogenous indicators for potential profile analysis, to compare the differences in general information and self-efficacy of patients with different potential profiles, and to analyze the influencing factors of different potential profiles of health literacy in CAG patients by multi classification Logistic regression.Results:The recovery rate of valid questionnaires was 97.71%(256/262). Among the 256 patients, there were 164 males and 92 females, with 86 patients aged 18-44 years old, 110 patients aged 45-59 years old, and 60 patients aged ≥ 60 years old. The health literacy of CAG patients was categorized into 3 potential profiles, including the high health literacy-appraisal and application competence group (14.84%, 38/256), the medium health literacy-appraisal and application competence group (32.81%, 84/256), and the low health literacy-appraisal and application competence group (52.34%, 134/256). The results of multi classification Logistic regression analysis showed that when the low health literacy-appraisal and application competence group was used as a reference, aged 18-44 years old ( OR=8.954, 95% CI 2.049-39.127), poor self-efficacy ( OR=0.089, 95% CI 0.027-0.293), duration of disease <5 years ( OR=0.049, 95% CI 0.014-0.169), per capita monthly household income<3 000 yuan ( OR=0.072, 95% CI 0.018-0.299), and primary school education or below ( OR=0.016, 95% CI 0.003-0.088) were independent influences in the the high health literacy-appraisal and application competence group (all P<0.05); poorer self-efficacy ( OR=0.458, 95% CI 0.251-0.834) and per capita monthly household income<3 000 yuan ( OR=0.212, 95% CI 0.100-0.453) were independent influences in the medium health literacy-appraisal and application competence group (both P<0.05). Conclusions:The health literacy of CAG patients is obviously heterogeneous, and healthcare professionals in clinical work should adopt targeted assessment and intervention according to the different characteristics of each category in order to improve the health literacy of CAG patients.

Objective:To explore the potential profiles of health literacy in patients with chronic atrophic gastritis (CAG) and analyze their influencing factors.Methods:A cross-sectional study was conducted to select CAG patients admitted to Nanjing Hospital of Traditional Chinese Medicine or attending outpatient clinics from January 2023 to June 2024 by convenience sampling method, and all patients participated in this study two months after treatment. The General Information Questionnaire, the General Self-Efficacy Scale, and the All-around Health Literacy Measurement Scale (AAHLS) were used to conduct the questionnaire survey. The three dimensions of AAHLS were used as exogenous indicators for potential profile analysis, to compare the differences in general information and self-efficacy of patients with different potential profiles, and to analyze the influencing factors of different potential profiles of health literacy in CAG patients by multi classification Logistic regression.Results:The recovery rate of valid questionnaires was 97.71%(256/262). Among the 256 patients, there were 164 males and 92 females, with 86 patients aged 18-44 years old, 110 patients aged 45-59 years old, and 60 patients aged ≥ 60 years old. The health literacy of CAG patients was categorized into 3 potential profiles, including the high health literacy-appraisal and application competence group (14.84%, 38/256), the medium health literacy-appraisal and application competence group (32.81%, 84/256), and the low health literacy-appraisal and application competence group (52.34%, 134/256). The results of multi classification Logistic regression analysis showed that when the low health literacy-appraisal and application competence group was used as a reference, aged 18-44 years old ( OR=8.954, 95% CI 2.049-39.127), poor self-efficacy ( OR=0.089, 95% CI 0.027-0.293), duration of disease <5 years ( OR=0.049, 95% CI 0.014-0.169), per capita monthly household income<3 000 yuan ( OR=0.072, 95% CI 0.018-0.299), and primary school education or below ( OR=0.016, 95% CI 0.003-0.088) were independent influences in the the high health literacy-appraisal and application competence group (all P<0.05); poorer self-efficacy ( OR=0.458, 95% CI 0.251-0.834) and per capita monthly household income<3 000 yuan ( OR=0.212, 95% CI 0.100-0.453) were independent influences in the medium health literacy-appraisal and application competence group (both P<0.05). Conclusions:The health literacy of CAG patients is obviously heterogeneous, and healthcare professionals in clinical work should adopt targeted assessment and intervention according to the different characteristics of each category in order to improve the health literacy of CAG patients.

Goniotomy (GT) is a safe and effective type of minimally invasive glaucoma surgery (MIGS) extensively utilized in China.It is particularly suited for treating primary open-angle glaucoma and advanced primary angle-closure glaucoma.Although GT is generally safe, hyphema and postoperative intraocular pressure (IOP) spikes remain common complications after GT.Currently, there is no standardized protocol for managing these issues, which can impact clinicians' assessment of surgical outcomes and potentially affect the prognosis.Therefore, it is crucial to establish comprehensive and detailed management protocols for perioperative hyphema and IOP spike following GT.This will guide clinical practitioners in managing complications appropriately and systematically, thereby promoting the further development and refinement of MIGS.To address these concerns, several domestic glaucoma treatment experts along with members of the Glaucoma Society of Ophthalmology, Guangdong Medical Association reviewed existing literature and held recommendation meetings to develop a guideline for managing perioperative hyphema and IOP spikes following GT.It includes defining perioperative hyphema in GT, discussing its high-risk factors and outcomes, exploring methods for prevention prior to surgery and techniques to reduce bleeding during the procedure, and managing postoperative hemorrhage.Additionally, it covers defining IOP spikes after GT, investigates their causes and contributing factors, and outlines management strategies and anticipated outcomes to provide a valuable resource for clinicians.

Objective To analyze the onset time and short-term clinical effect of rituximab(RTX)in the treatment of glomerular diseases.Methods All case data of rituximab used in the treatment of glomerular diseases in a tertiary hospital from January 2021 to December 2022 were extracted for retrospective study.The changes in blood routine,liver function,kidney function,immunity and other related indexes were analyzed after the treatment of RTX and the clinical effect in the short term was observed.Results A total of 52 patients were collected,of which 30 received RTX standardized therapy.During the follow-up period,plasma albumin showed an upward trend,and the 24-hour urine protein and B cell count showed a downward trend.The values of these indexes after 3 months and 6 months after treatment were significantly different from those before treatment,which was statistically significant(P<0.05).The clinical response rates after the first injection,the second injection,the third injection,the fourth injection,3 months later,and 6 months after RTX treatment were 26.92%,36.00%,51.85%,57.69%,76.92% and 81.82%,respectively.No serious adverse effects occurred during the follow-up period.Conclusions RTX can improve 24-hour urine protein,plasma albumin level and B cell count in glomerular-related diseases,stabilize renal functionand have good safety.

Objective To monitor the antifungal resistance of clinical isolates of Candida spp.in the East China region.Methods MALDI-TOF MS or molecular methods were used to re-identify the strains collected from January 2018 to December 2022.Antifungal susceptibility testing was performed using the broth microdilution method.The susceptibility test results were interpreted according to the breakpoints of 2022 Clinical and Laboratory Standards Institute(CLSI)documents M27 M44s-Ed3 and M57s-Ed4.Results A total of 3 026 strains of Candida were collected,65.33％of which were isolated from sterile body sites,mainly from blood(38.86％)and pleural effusion/ascites(10.21％).The predominant species of Candida were Candida albicans(44.51％),followed by Candida parapsilosis complex(19.46％),Candida tropicalis(13.98％),Candida glabrata(10.34％),and other Candida species(0.79％).Candida albicans showed overall high susceptibility rates to the 10 antifungal drugs tested(the lowest rate being 93.62％).Only 2.97％of the strains showed dose-dependent susceptibility(SDD)to fluconazole.Candida parapsilosis complex had a SDD rate of 2.61％and a resistance rate of 9.42％to fluconazole,and susceptibility rates above 90％to other drugs.Candida glabrata had a SDD rate of 92.01％and a resistance rate of 7.99％to fluconazole,resistance rates of 32.27％and 48.24％to posaconazole and voriconazole non-wild-type strains(NWT),respectively,and susceptibility rates above 90％to other drugs.Candida tropicalis had resistance rates of 29.55％and 26.24％to fluconazole and voriconazole,respectively,resistance rates of 76.60％and 21.99％to posaconazole and echinocandins non-wild-type strains(NWT),and a resistance rate of 2.36％to echinocandins.Conclusions The prevalence and species distribution of Candida spp.in the East China region are consistent with previous domestic and international reports.Candida glabrata exhibits certain degree of resistance to fluconazole,while Candida tropicalis demonstrates higher resistance to triazole drugs.Additionally,echinocandins resistance has emerged in Candida albicans,Candida glabrata,Candida tropicalis,and Candida parapsilosis.

Objective:To investigate whether murine peroxidase reductase-5(mPRDX5)has anti-tumor activity in mice,so as to further confirm the anti-tumor activity and mechanism of recombinant peroxidase reductase-5.Methods:High purity mPRDX5 was obtained by heterologous expression and purification in vitro.Pancreatic cancer Pan02 cells were inoculated subcutaneously on the left axillary back of mice to establish a tumor bearing mouse model.Mice were randomly divided into PBS(solvent control)group,GEM(gemcitabine)50.0 mg/kg group and mPRDX5 10.0 mg/kg group,with 10 mice in each group,and the tumor related indexes were detected in mice.Results:Compared with PBS group,weight of tumor-bearing mice in GEM group was decreased obviously,while weight of mPRDX5 group was increased to a certain extent.Tumor growth was good in PBS group,according to tumor volume,com-pared with PBS group,tumor growth inhibition rates in D7 were 87.07%in GEM group and 52.82%in mPRDX5 10.0 mg/kg group,re-spectively;according to tumor weight,compared with PBS group,GEM group and mPRDX5 10.0 mg/kg group had tumor growth inhibi-tion rates of 95.39%and 48.33%in D7,respectively.Polarization state of macrophages in tumor tissues of mice in PBS group and mPRDX5 group was analyzed,and it was found that compared with PBS group,M1 macrophages expressing CD86 in tumor tissues of mice in mPRDX5 group were significantly increased,while M2 macrophages expressing CD206 were significantly decreased.Conclu-sion:mPRDX5 has significant anti-pancreatic cancer activity in mice,and the activity is exerted by promoting M1-type polarization of macrophages in the tumor microenvironment.

Objective:To analyze the value of C-reactive protein to prealbumin ratio (CRP/PA) combined with neutrophil CD64 (nCD64) index in evaluating the severity and prognosis of mycoplasma pneumonia (MPP) in children.Methods:The clinical data of 98 children with MPP admitted to Changzhou Maternal and Child Health Hospital from March to December 2023 were retrospectively analyzed. According to the severity of the patients, they were divided into mild children (60 cases) and severe children (38 cases). After 7 days of routine treatment, the patients were divided into good prognosis group (72 cases) and poor prognosis group (26 cases). The CRP/PA and nCD64 indices of children with different severity of disease were compared, and the relationship between CRP/PA and severity of disease was analyzed. The clinical data of children with different prognosis outcomes were compared, and the influencing factors of prognosis were analyzed. The area under receiver operating characteristic (ROC) curve (AUC) was used to analyze the prognostic value of CRP/PA and nCD64 index.Results:CRP/PA[(1.05±0.21) vs (0.77±0.15)] and nCD64 index [(4.11±0.82) vs (2.96±0.59)] in severe children were higher than those in mild children (all P<0.05). Pearson analysis showed that CRP/PA and nCD64 index were positively correlated with clinical pulmonary infection score (CPIS) ( r=0.587, 0.574, all P<0.05). Univariate analysis showed that the age of the poor prognosis group [(4.81±0.96)years vs (6.67±1.33)years] was smaller than that of the good prognosis group. The severity of the disease was severe [65.38%(17/26) vs 29.17%(21/72)], complicated complications [46.15%(12/26) vs 18.06%(13/72)], CRP/PA[(1.23±0.25) vs (0.74±0.15)] and nCD64 index [(4.48±0.89) vs (3.02±0.61)] were higher than those in good prognosis group (all P<0.05). Binary logistic regression analysis showed that the severity of disease ( OR=4.251, 95% CI: 1.682-10.742), CRP/PA ( OR=3.857, 95% CI: 1.886-7.887), nCD64 index ( OR=3.161, 95% CI: 1.382-7.228) were prognostic factors (all P<0.05). ROC curve showed that the sensitivity and specificity of CRP/PA, nCD64 index and their combination in predicting prognosis were 76.90%, 73.10% and 88.50%, respectively, and 73.60%, 72.20% and 90.30%, respectively. The AUC values were 0.809, 0.794 and 0.923 (all P<0.001). Conclusions:CRP/PA and nCD64 index are significantly positively correlated with the severity of MPP in children, and they are the influencing factors for the prognosis of children. The combined detection of CRP/PA and nCD64 index has good predictive value for the prognosis of children.