The 95% ethanol extract from bulbs of Narcissus tazetta var. chinensis(BNTC) was eluted with 30%, 60%, and pure methanol on D-101 macroporous resin. The elution fractions were isolated and purified by silica gel column chromatography, thin layer chromatography, D-101 macroporous resin, semi-preparative high performance liquid chromatography(HPLC), and HPLC. The purified compounds were identified using one-dimensional and two-dimensional spectroscopy, high-resolution mass spectrometry, and other techniques. A total of 15 compounds were isolated and identified as 5-(4-hydroxy-3-methoxyphenyl)-3-(4-hydroxyphenyl)-N-methyl-3,6-dihydropyridine-2(1H)-one(1), 3,5-di(hydroxyphenyl)-N-methyl-3,6-dihydropyridine-2(1H)-one(2), protocatechualdehyde(3), protocatechuic acid(4), 3,4-dihydroxyacetophenone(5), syringic acid(6), vanillic acid(7), p-hydroxybenzoic acid(8),(2S)-4'-hydroxy-7-methoxyflavan(9), 2,4,6-trimethoxyacetophenone(10), N-trans-ferulic acid p-hydroxyphenylethylamine(11), N-cis-p-coumaroyltyramine(12), N-trans-p-coumaroyltyramine(13), piscidic acid(14), 5-hydroxymethylfurfural(15). Compounds 1 and 2 are new compounds with similar structure that have not been reported yet, named narcissus A and narcissus B. Compounds 8-13 were isolated and identified from the genus Narcissus for the first time, and compounds 14 and 15 were isolated from BNTC for the first time. Compounds 1 and 2 inhibited the release of NO from RAW264.7 cells induced by lipopolysaccharide(LPS)(P<0.001), with compound 1 having an IC_(50) value of(72.76±2.97) μmol·L~(-1) and compound 2 having an IC_(50) value of(63.59±0.96) μmol·L~(-1).
Mice ; Animals ; Narcissus/chemistry* ; Drugs, Chinese Herbal/isolation & purification* ; Plant Roots/chemistry* ; Chromatography, High Pressure Liquid ; Macrophages/immunology* ; RAW 264.7 Cells

BACKGROUND: China is seeing a growing demand for rehabilitation treatments for post-stroke upper limb spastic paresis (PSSP-UL). Although acupuncture is known to be effective for PSSP-UL, there is room to enhance its efficacy. OBJECTIVE: This study explored a semi-personalized acupuncture approach for PSSP-UL that used three-dimensional kinematic analysis (3DKA) results to select additional acupoints, and investigated the feasibility, efficacy and safety of this approach. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This single-blind, single-center, randomized, controlled trial involved 74 participants who experienced a first-ever ischemic or hemorrhagic stroke with spastic upper limb paresis. The participants were then randomly assigned to the intervention group or the control group in a 1:1 ratio. Both groups received conventional treatments and acupuncture treatment 5 days a week for 4 weeks. The main acupoints in both groups were the same, while participants in the intervention group received additional acupoints selected on the basis of 3DKA results. Follow-up assessments were conducted for 8 weeks after the treatment. MAIN OUTCOME MEASURES: The primary outcome was the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) response rate (≥ 6-point change) at week 4. Secondary outcomes included changes in motor function (FMA-UE), Brunnstrom recovery stage (BRS), manual muscle test (MMT), spasticity (Modified Ashworth Scale, MAS), and activities of daily life (Modified Barthel Index, MBI) at week 4 and week 12. RESULTS: Sixty-four participants completed the trial and underwent analyses. Compared with control group, the intervention group exhibited a significantly higher FMA-UE response rate at week 4 (χ² = 5.479, P = 0.019) and greater improvements in FMA-UE at both week 4 and week 12 (both P < 0.001). The intervention group also showed bigger improvements from baseline in the MMT grades for shoulder adduction and elbow flexion at weeks 4 and 12 as well as thumb adduction at week 4 (P = 0.007, P = 0.049, P = 0.019, P = 0.008, P = 0.029, respectively). The intervention group showed a better change in the MBI at both week 4 and week 12 (P = 0.004 and P = 0.010, respectively). Although the intervention group had a higher BRS for the hand at week 12 (P = 0.041), no intergroup differences were observed at week 4 (all P > 0.05). The two groups showed no differences in MAS grades as well as in BRS for the arm at weeks 4 and 12 (all P > 0.05). CONCLUSION: Semi-personalized acupuncture prescription based on 3DKA results significantly improved motor function, muscle strength, and activities of daily living in patients with PSSP-UL. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2200056216. Please cite this article as: Huang XY, Liao OP, Jiang SY, Tao JM, Li Y, Lu XY, Li YY, Wang C, Li J, Ma XP. Three-dimensional kinematic analysis can improve the efficacy of acupoint selection for post-stroke patients with upper limb spastic paresis: A randomized controlled trial. J Integr Med. 2025; 23(1): 15-24.
Humans ; Male ; Female ; Middle Aged ; Acupuncture Points ; Upper Extremity/physiopathology* ; Biomechanical Phenomena ; Single-Blind Method ; Aged ; Stroke/therapy* ; Acupuncture Therapy/methods* ; Stroke Rehabilitation/methods* ; Adult ; Muscle Spasticity/therapy* ; Paresis/physiopathology* ; Treatment Outcome

This study was conducted retrospectively on a cohort of 68 patients with steroid 5 α-reductase 2 (SRD5A2) deficiency and 46,XY disorders of sex development (DSD). Whole-exon sequencing revealed 28 variants of SRD5A2 , and further analysis identified seven novel mutants. The preponderance of variants was observed in exon 1 and exon 4, specifically within the nicotinamide adenine dinucleotide phosphate (NADPH)-binding region. Among the entire cohort, 53 patients underwent initial surgery at Sichuan Provincial People's Hospital (Chengdu, China). The external genitalia scores (EGS) of these participants varied from 2.0 to 11.0, with a mean of 6.8 (standard deviation [s.d.]: 2.5). Thirty patients consented to hormone testing. Their average testosterone-to-dihydrotestosterone (T/DHT) ratio was 49.3 (s.d.: 23.4). Genetic testing identified four patients with EGS scores between 6 and 9 as having this syndrome; and their T/DHT ratios were below the diagnostic threshold. Furthermore, assessments conducted using the crystal structure of human SRD5A2 have provided insights into the potential pathogenic mechanisms of these novel variants. These mechanisms include interference with NADPH binding (c.356G>C, c.365A>G, c.492C>G, and c.662T>G) and destabilization of the protein structure (c.727C>T). The c.446-1G>T and c.380delG variants were verified to result in large alterations in the transcripts. Seven novel variations were identified, and the variant database for the SRD5A2 gene was expanded. These findings contribute to the progress of diagnostic and therapeutic approaches for individuals with SRD5A2 deficiency.
Humans ; 3-Oxo-5-alpha-Steroid 4-Dehydrogenase/genetics* ; Disorder of Sex Development, 46,XY/blood* ; Male ; Membrane Proteins/genetics* ; Child, Preschool ; Child ; Retrospective Studies ; Adolescent ; Female ; Mutation ; Testosterone/blood* ; Infant ; Dihydrotestosterone/blood*

Objective:To investigate the sex difference and symptom correlation of pituitary-thyroid axis and pituitary-adrenal axis function in patients with remitted schizophrenia.Methods:Using cross-sectional study method,243 patients with remitted schizophrenia at Changning District Mental Health Center of Shanghai from January 2019 to September 2021(schizophrenia group)were selected,and healthy individuals who underwent physical examinations during the same period(healthy control group)were also selected.The demographic data and HPT axis,HPA axis neuroendocrine indicators[serum thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroid hormone(FT4),triiodothyronine(TT3),thyroid hormone(TT4),adrenocorticotropic hormone(ACTH),and cortisol(COR)]between healthy control group and schizophrenia group were compared.Gender differences in HPT axis and HPA axis in schizophrenia patients were compared.The correlation between neuroendocrine indicators and gender,disease duration,positive and negative symptom scale(PANSS)scores in patients with schizophrenia were analyzed by linear regression method.Using stratified multiple linear regression,laboratory measured variables and age were included as predictive factors in the model to construct a regression prediction model for hormone levels between schizophrenia and healthy control group,as well as subgroups of schizophrenia gender.Generate receiver operating characteristic(ROC)curves based on the probability values of predictive factors,and determine the predictive value of the logistic regression model using the area under the curve(AUC).Results:TT3,TSH,TT4 in schizophrenia group were lower than those in the healthy control group(P＜0.05),while ACTH and COR were higher than those in the healthy control group(P＜0.05).There was a statistically significant difference in the negative symptom scores,TSH,TT3,FT3,ACTH,and COR levels between the female schizophrenia group and male schizophrenia group(P＜0.05).PANSS,total score of general psychopathology score were positively correlated with COR level,negative symptom score was negatively correlated with FT3 levels(all P＜0.05),but there was no linear relationship among the three(absolute value of r＜0.3).ROC curve results showed that,the schizophrenia hormone level model had good discrimination accuracy,with AUC=0.872(95％confidence interval 0.841-0.904),the optimal threshold(Yoden index)=0.651.ROC curve shows that the male and female subgroups of schizophrenia models also have good discrimination accuracy,with AUC=0.794(95％confidence interval 0.737-0.850)and the optimal cutoff value(Yoden index)=0.495.Conclusion:The changes of active T4 in schizophrenia patients may be one of the possible causes of the chronic pathological changes of schizophrenia.The level of high-functioning T3 hormone is significantly lower in female patients than that in male patients.The hierarchical regression model provides good identification accuracy for remitted schizophrenia and gender subgroups.

Objective To develop a novel type of transparent simulation manikin as a surgical training model to meet the surgical treatment demand on the medical train.Methods A transparent manikin was developed with the steps of basic data collection,motherboard design and manufacture and module production and assembly.Firstly,basic data collection was carried out with reference to standardized human anatomy and parameters.Secondly,some software such as UG NX7.5 was used to construct the motherboard of the manikin.Finally,module production and assembly were performed with the materials of acrylic,transparent rubber,silicone and hydrogel and the technology of silicone infusion.Results The transparent manikin developed had its anatomy structure close to that of the real body and high visuality for its internal and external components,which simulated a variety of war wounds and thus could be integrated with the surgical training scenarios on the medical train effectively.Conclusion The transparent manikin developed is characterized by high visuality,modularity and blood flow,and meets the demands for surgical training on the medical train.[Chinese Medical Equipment Journal,2025,46(6):111-115]

Objective:To investigate the sex difference and symptom correlation of pituitary-thyroid axis and pituitary-adrenal axis function in patients with remitted schizophrenia.Methods:Using cross-sectional study method,243 patients with remitted schizophrenia at Changning District Mental Health Center of Shanghai from January 2019 to September 2021(schizophrenia group)were selected,and healthy individuals who underwent physical examinations during the same period(healthy control group)were also selected.The demographic data and HPT axis,HPA axis neuroendocrine indicators[serum thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroid hormone(FT4),triiodothyronine(TT3),thyroid hormone(TT4),adrenocorticotropic hormone(ACTH),and cortisol(COR)]between healthy control group and schizophrenia group were compared.Gender differences in HPT axis and HPA axis in schizophrenia patients were compared.The correlation between neuroendocrine indicators and gender,disease duration,positive and negative symptom scale(PANSS)scores in patients with schizophrenia were analyzed by linear regression method.Using stratified multiple linear regression,laboratory measured variables and age were included as predictive factors in the model to construct a regression prediction model for hormone levels between schizophrenia and healthy control group,as well as subgroups of schizophrenia gender.Generate receiver operating characteristic(ROC)curves based on the probability values of predictive factors,and determine the predictive value of the logistic regression model using the area under the curve(AUC).Results:TT3,TSH,TT4 in schizophrenia group were lower than those in the healthy control group(P＜0.05),while ACTH and COR were higher than those in the healthy control group(P＜0.05).There was a statistically significant difference in the negative symptom scores,TSH,TT3,FT3,ACTH,and COR levels between the female schizophrenia group and male schizophrenia group(P＜0.05).PANSS,total score of general psychopathology score were positively correlated with COR level,negative symptom score was negatively correlated with FT3 levels(all P＜0.05),but there was no linear relationship among the three(absolute value of r＜0.3).ROC curve results showed that,the schizophrenia hormone level model had good discrimination accuracy,with AUC=0.872(95％confidence interval 0.841-0.904),the optimal threshold(Yoden index)=0.651.ROC curve shows that the male and female subgroups of schizophrenia models also have good discrimination accuracy,with AUC=0.794(95％confidence interval 0.737-0.850)and the optimal cutoff value(Yoden index)=0.495.Conclusion:The changes of active T4 in schizophrenia patients may be one of the possible causes of the chronic pathological changes of schizophrenia.The level of high-functioning T3 hormone is significantly lower in female patients than that in male patients.The hierarchical regression model provides good identification accuracy for remitted schizophrenia and gender subgroups.

Objective To develop a novel type of transparent simulation manikin as a surgical training model to meet the surgical treatment demand on the medical train.Methods A transparent manikin was developed with the steps of basic data collection,motherboard design and manufacture and module production and assembly.Firstly,basic data collection was carried out with reference to standardized human anatomy and parameters.Secondly,some software such as UG NX7.5 was used to construct the motherboard of the manikin.Finally,module production and assembly were performed with the materials of acrylic,transparent rubber,silicone and hydrogel and the technology of silicone infusion.Results The transparent manikin developed had its anatomy structure close to that of the real body and high visuality for its internal and external components,which simulated a variety of war wounds and thus could be integrated with the surgical training scenarios on the medical train effectively.Conclusion The transparent manikin developed is characterized by high visuality,modularity and blood flow,and meets the demands for surgical training on the medical train.[Chinese Medical Equipment Journal,2025,46(6):111-115]

Objective:To evaluate the application effect of mindfulness-based stress reduction(MBSR)therapy on the patients treated with image fusion-guided transperineal prostate biopsy.Methods:A total of 160 patients who underwent image fusion-guided transperineal prostate biopsy in the Urology Department from April 2023 to April 2024 were included.Patients were randomly assigned to a control group and an observation group,with 80 cases in each group.The control group received routine care,while the observa-tion group received combined MBSR on the basis of routine care.The surgical indicators,pain levels,psychological states,nursing satisfaction,and postoperative complication rates of both groups were compared.Results:There was no statistically significant differ-ence in general personal information and clinical data between the two groups(P＞0.05).The surgery duration,secondary fusion rate,and postoperative complication rate in the observation group were all lower than those in the control group([23.54±2.07]min vs[26.25±1.69]min,P＜0.05;8.75％vs 22.50％,P=0.017;17％vs 29％,P=0.036),and nursing satisfaction was higher in the observation group than in the control group(77％vs 69％,P=0.025).The VAS scores biopsy(5.11±0.93 vs 6.27±1.32,P=0.041),discharge(0.74±0.67 vs 1.85±0.95,P=0.004),and scores of SDS(47.76±2.06 vs 50.46±2.07,P=0.009)and SAS(46.89±2.68 vs 49.75±2.83,P=0.031)in the observation group were all lower than those in the control group.Conclusion:The application of MBSR in image fusion-guided prostate biopsy can synergistically utilize the advantages of minimally in-vasive technology,significantly optimize surgical indicators,and improve patients' psychological experiences,which is worthy of clinical application and promotion.

Objectives: As community-oriented public health in oral healthcare for older adults becomes increasingly emphasized, research into community-based oral function rehabilitation interventions is emerging. This study examined the feasibility of community adoption of a previously developed oral function rehabilitation exercise program using an expert-crafted Delphi survey. Methods: An eight-expert panel was formed to develop a Delphi survey instrument and conduct a survey based on the results of previous studies. To test the community applicability of oral function rehabilitation exercises derived from this systematic review, we asked questions related to ‘independent performance’, ‘education applicability for caregivers’, ‘facility program applicability’, ‘intervention methods’, and ‘outcome indicators’. Results: Except for ‘pharyngeal exercise’ and ‘salivation exercise’, the five main exercises met the validity criteria for ‘independent performance’, ‘education applicability for caregivers’, and ‘facility program applicability’. The validity of dental hygienists as intervention providers obtained consensus from the experts with a CVR value of 0.75 or higher, an agreement of 0.75-0.85, and a convergence of 0.5. Conclusions The application of oral function rehabilitation exercises in a community setting is feasible, and the dental community should be willing to promote it so that it can be provided to many community-dwelling older adults in the future. In addition, the use of dental hygienists as intervention providers is appropriate. However, their training as intervention providers for oral function rehabilitation exercises may need to be strengthened.

Objectives: As community-oriented public health in oral healthcare for older adults becomes increasingly emphasized, research into community-based oral function rehabilitation interventions is emerging. This study examined the feasibility of community adoption of a previously developed oral function rehabilitation exercise program using an expert-crafted Delphi survey. Methods: An eight-expert panel was formed to develop a Delphi survey instrument and conduct a survey based on the results of previous studies. To test the community applicability of oral function rehabilitation exercises derived from this systematic review, we asked questions related to ‘independent performance’, ‘education applicability for caregivers’, ‘facility program applicability’, ‘intervention methods’, and ‘outcome indicators’. Results: Except for ‘pharyngeal exercise’ and ‘salivation exercise’, the five main exercises met the validity criteria for ‘independent performance’, ‘education applicability for caregivers’, and ‘facility program applicability’. The validity of dental hygienists as intervention providers obtained consensus from the experts with a CVR value of 0.75 or higher, an agreement of 0.75-0.85, and a convergence of 0.5. Conclusions The application of oral function rehabilitation exercises in a community setting is feasible, and the dental community should be willing to promote it so that it can be provided to many community-dwelling older adults in the future. In addition, the use of dental hygienists as intervention providers is appropriate. However, their training as intervention providers for oral function rehabilitation exercises may need to be strengthened.