This study aims to explore the scientific connotation of sinking Rehmanniae Radix has the best quality and compare the quality between floating and sinking fresh Rehmanniae Radix samples. Ultra-performance liquid chromatography tandem quadrupole electrostatic field Orbitrap high-resolution mass spectrometry(UHPLC-Q-Orbitrap HRMS) was employed to detect the chemical components in floating and sinking fresh Rehmanniae Radix samples. The fingerprint of fresh Rehmanniae Radix was established by high performance liquid chromatography(HPLC), and four index components were determined simultaneously. The cluster analysis, principal component analysis(PCA), and orthogonal partial least squares-discriminant analysis(OPLS-DA) were conducted to compare the quality of floating and sinking fresh Rehmanniae Radix samples. An evaporative light-scattering detector was used to compare the content of five sugars. The extract yield and drying rate were determined, and the quality connotation of sinking Rehmanniae Radix has the best quality was explained by multiple indicators. A total of 41 components were preliminarily identified from fresh Rehmanniae Radix by UHPLC-Q-Orbitrap HRMS, including 7 iridoid glycosides, 9 phenylethanol glycosides, 6 amino acids, 4 sugars, 3 phenolic acids, 5 nucleosides, 3 organic acids, 1 ionone, 1 furan, 1 coumarin, and 1 phenylpropanoid. The results showed that the main chemical components were consistent between floating and sinking fresh Rehmanniae Radix. Nine common peaks were identified in the fingerprints of 15 batches of floating and sinking fresh Rehmanniae Radix samples, and the similarity of fingerprints was greater than 0.9. The cluster analysis, PCA, and OPLS-DA classified floating and sinking fresh Rehmanniae Radix sasmples into two categories, indicating differences in the quality between them. The total content of catalpol, rehmannioside D, ajugol, and verbascoside in sinking fresh Rehmanniae Radix samples was higher than that in floating samples of the same batch and specification, and the main differential component was catalpol. The total content of fructose, glucose, sucrose, raffinose, and stachyose in sinking fresh Rehmanniae Radix samples was higher than that in floating samples of the same batch and specification, and the main differential component was stachyose. The extract yield and drying rate of the sinking samples were higher than those of floating samples. This study preliminarily showed that floating and sinking fresh Rehmanniae Radix samples had the same components but great differences in the content of medicinal substance basis. The total content of four glycosides and five sugars, extract yield, and drying rate of sinking fresh Rehmanniae Radix samples is higher than that of floating samples of the same batch and specification. These findings, to a certain extent, explains the scientificity of sinking Rehmanniae Radix has the best quality recorded in ancient books and provide a reference for the quality control and clinical application of fresh Rehmanniae Radix.
Chromatography, High Pressure Liquid/methods* ; Drugs, Chinese Herbal/chemistry* ; Rehmannia/chemistry* ; Chemometrics ; Mass Spectrometry/methods* ; Quality Control ; Principal Component Analysis ; Plant Extracts

Objective To explore the correlation between the systemic immune-inflammation index(SII)and the clinical and pathological characteristics of patients with IgA nephropathy(IgAN).Methods A total of 350 patients who underwent renal biopsy and were initially diagnosed with primary IgAN were selected.The clinical and pathological data of the patients were collected,and SII was calculated.According to the median SII level of 554.78 in peripheral blood,the IgAN patients were divided into the low SII group(SII≤554.78,175 cases)and the high SII group(SII>554.78,175 cases).Based on the presence or absence of endocapillary hyperplastic(E)lesion,350 patients were also divided into the E0 group(279 cases,79.7%)and the E1 group(71 cases,20.3%).Multivariate Logistic regression analysis was conducted to determine the influencing factors of E1 in IgAN patients.A predictive model was established,and the predictive value of the model was evaluated using the receiver operating characteristic(ROC)curve.Results There were higher systolic blood pressure(SBP),platelet count(PLT),neutrophil count(NEU),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),total cholesterol(TC),serum creatinine(Scr),serum C3 and 24-hour urine protein levels in the high SII group than those of the low SII group,while the lymphocyte count(LYM)was lower(P＜0.05).In terms of pathological manifestations,the proportion of E1 was higher in the high SII group than that of the low SII group(P＜0.05).There were lower PLT,NEU,NLR,PLR,Scr and 24-hour urine protein in patients of the E0 group than those of the E1 group,while higher Hb,LYM and ALB levels in the E0 group than those of the E1 group(P＜0.05).Multivariate Logistic regression analysis showed that elevated SII,Scr and 24-hour urine protein levels were independent risk factors for E1 lesion in IgAN patients(P＜0.05).The area under the curve(AUC)of the predictive model for E1 lesion in IgAN patients was 0.781(95%CI:0.722-0.840).Conclusion SII can reflect the clinical and pathological severity in IgAN patients,providing new insights for clinical evaluation of the disease progression in IgAN patients.

AIM To explore the clinical effects of Qutan Jiangni Pingchuan Formula combined with Compound Ipratropium Bromide on patients with acute exacerbation of chronic obstructive pulmonary disease.METHODS One hundred and ten patients were randomly assigned into control group(55 cases)for 2-week intervention of both Compound Ipratropium Bromide and conventional treatment,and observation group(55 cases)for 2-week intervention of Qutan Jiangni Pingchuan Formula,Compound Ipratropium Bromide and conventional treatment.The changes in clinical effects,relevant scores(TCM syndrome score,mMRC grade,CAT score),disappearance time for clinical symptoms(cough,wheezing,pulmonary wheeze),airway inflammatory indices(sICAM-1,IL-8,MCP-1),pulmonary function indices(FEV1,PEF25,TLC),sputum indices(24 h sputum volume,sputum viscosity)and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P＜0.05),along with shorter disappearance time for clinical symptoms(P＜0.05).After the treatment,the two groups displayed decreased relevant scores,airway inflammatory indices,24 h sputum volume(P＜0.05),and increased pulmonary function indices(P＜0.05),especially for the observation group(P＜0.05);the observation group demonstrated elevated number of people with grade Ⅰ sputum viscosity(P＜0.05),which was more obvious than that in the control group(P＜0.05).No significant difference in incidence of adverse reactions was found between the two groups(P＞0.05).CONCLUSION For the patients with acute exacerbation of chronic obstructive pulmonary disease,Qutan Jiangni Pingchuan Formula combined with Compound Ipratropium Bromide can safely and effectively improve clinical symptoms,reduce inflammatory levels,enhance lung functions,and promote sputum secretion in airways.

A method for determination and targeted screening of diflorasone components in health products using ultra performance liquid chromatography-quadrupole time of flight mass spectrometry(UPLC-Q-TOF/MS)was established.Four representative diflorasone and esters(diflorasone,diflorasone diacetate,diflorasone-17-propionate,and diflorasone-21-propionate)were selected to optimize the pretreatment conditions,and 10 mL of extraction solvent dosage,15 min of extraction time and 5 g of salting-out agent as the optimal conditions were selected by response surface methodology.The results showed that the four analytes exhibited good linearity within the concentration range of 2.0?100 μg/L with the chromatographic peak area,and the correlation coefficients(R2)were all greater than 0.9990,while the results of recovery and relative standard deviation could satisfy the requirements of determination.The common characteristic ions of diflorasone and esters werem/z121 andm/z335,and their specific structures were obtained by analyzing the cleavage pathway based on the optimized determination conditions.A targeted screening method for other esters of diflorasone based on characteristic ions guidance strategy was established.This method had many advantages such as high efficiency,high sensitivity and good reproducibility,and could be used for targeted screening of diflorasone and esters in health products.The developed characteristic ion guided strategy could be employed to construct mass spectral databases for various glucocorticoids,enabling comprehensive targeted screening across a broad range of compounds.

The clinical characteristics of a neonatal patient with movement disorder and arthrogryposis (NDEEMA) caused by gain-of-function mutation of the SCN1A gene were reported in this article. The 1-year-and-9-month-old boy started seizures since 2 hours after birth. He had funnel-breast, dislocation of the hip, and bipedal varus. Genetic testing showed SCN1A gene de novo missense mutation c.706A>G(p.Ile236Val), causing overall gain-of-function effect. The frequency of seizures decreased significantly after treatment of oxcarbazepine.

Epilepsy is a chronic neurological disorder caused by an imbalance between excitation and inhibition in the central nervous system.Recently,the role of the orexin system in the pathogenesis of epilepsy has garnered significant attention.Orex-in primarily regulates arousal states and enhances neuronal excit-ability through activation of OX1-R/OX2-R receptors.Studies have shown that elevated orexin levels lower the seizure thresh-old,while orexin receptor antagonists(ORAs)exhibit potential antiepileptic effects.ORAs suppress epileptiform discharges by reducing glutamate release,enhancing GABAergic inhibitory effects,and modulating the thalamocortical circuit.Animal ex-periments and preliminary clinical studies demonstrate that OX1R antagonists decrease excitatory synaptic transmission,whereas OX2 R antagonists primarily strengthen GABA-mediated inhibition.With the widespread application of ORAs in sleep disorders,exploring their clinical value as antiepileptic drugs will become a key focus for future research.This review summa-rizes the role of the orexin system in epileptogenesis and discus-ses the research progress and future directions of ORAs as poten-tial antiepileptic agents.

Objective To explore the correlation between the systemic immune-inflammation index(SII)and the clinical and pathological characteristics of patients with IgA nephropathy(IgAN).Methods A total of 350 patients who underwent renal biopsy and were initially diagnosed with primary IgAN were selected.The clinical and pathological data of the patients were collected,and SII was calculated.According to the median SII level of 554.78 in peripheral blood,the IgAN patients were divided into the low SII group(SII≤554.78,175 cases)and the high SII group(SII>554.78,175 cases).Based on the presence or absence of endocapillary hyperplastic(E)lesion,350 patients were also divided into the E0 group(279 cases,79.7%)and the E1 group(71 cases,20.3%).Multivariate Logistic regression analysis was conducted to determine the influencing factors of E1 in IgAN patients.A predictive model was established,and the predictive value of the model was evaluated using the receiver operating characteristic(ROC)curve.Results There were higher systolic blood pressure(SBP),platelet count(PLT),neutrophil count(NEU),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),total cholesterol(TC),serum creatinine(Scr),serum C3 and 24-hour urine protein levels in the high SII group than those of the low SII group,while the lymphocyte count(LYM)was lower(P＜0.05).In terms of pathological manifestations,the proportion of E1 was higher in the high SII group than that of the low SII group(P＜0.05).There were lower PLT,NEU,NLR,PLR,Scr and 24-hour urine protein in patients of the E0 group than those of the E1 group,while higher Hb,LYM and ALB levels in the E0 group than those of the E1 group(P＜0.05).Multivariate Logistic regression analysis showed that elevated SII,Scr and 24-hour urine protein levels were independent risk factors for E1 lesion in IgAN patients(P＜0.05).The area under the curve(AUC)of the predictive model for E1 lesion in IgAN patients was 0.781(95%CI:0.722-0.840).Conclusion SII can reflect the clinical and pathological severity in IgAN patients,providing new insights for clinical evaluation of the disease progression in IgAN patients.

Epilepsy is a chronic neurological disorder caused by an imbalance between excitation and inhibition in the central nervous system.Recently,the role of the orexin system in the pathogenesis of epilepsy has garnered significant attention.Orex-in primarily regulates arousal states and enhances neuronal excit-ability through activation of OX1-R/OX2-R receptors.Studies have shown that elevated orexin levels lower the seizure thresh-old,while orexin receptor antagonists(ORAs)exhibit potential antiepileptic effects.ORAs suppress epileptiform discharges by reducing glutamate release,enhancing GABAergic inhibitory effects,and modulating the thalamocortical circuit.Animal ex-periments and preliminary clinical studies demonstrate that OX1R antagonists decrease excitatory synaptic transmission,whereas OX2 R antagonists primarily strengthen GABA-mediated inhibition.With the widespread application of ORAs in sleep disorders,exploring their clinical value as antiepileptic drugs will become a key focus for future research.This review summa-rizes the role of the orexin system in epileptogenesis and discus-ses the research progress and future directions of ORAs as poten-tial antiepileptic agents.

AIM To explore the clinical effects of Qutan Jiangni Pingchuan Formula combined with Compound Ipratropium Bromide on patients with acute exacerbation of chronic obstructive pulmonary disease.METHODS One hundred and ten patients were randomly assigned into control group(55 cases)for 2-week intervention of both Compound Ipratropium Bromide and conventional treatment,and observation group(55 cases)for 2-week intervention of Qutan Jiangni Pingchuan Formula,Compound Ipratropium Bromide and conventional treatment.The changes in clinical effects,relevant scores(TCM syndrome score,mMRC grade,CAT score),disappearance time for clinical symptoms(cough,wheezing,pulmonary wheeze),airway inflammatory indices(sICAM-1,IL-8,MCP-1),pulmonary function indices(FEV1,PEF25,TLC),sputum indices(24 h sputum volume,sputum viscosity)and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P＜0.05),along with shorter disappearance time for clinical symptoms(P＜0.05).After the treatment,the two groups displayed decreased relevant scores,airway inflammatory indices,24 h sputum volume(P＜0.05),and increased pulmonary function indices(P＜0.05),especially for the observation group(P＜0.05);the observation group demonstrated elevated number of people with grade Ⅰ sputum viscosity(P＜0.05),which was more obvious than that in the control group(P＜0.05).No significant difference in incidence of adverse reactions was found between the two groups(P＞0.05).CONCLUSION For the patients with acute exacerbation of chronic obstructive pulmonary disease,Qutan Jiangni Pingchuan Formula combined with Compound Ipratropium Bromide can safely and effectively improve clinical symptoms,reduce inflammatory levels,enhance lung functions,and promote sputum secretion in airways.