OBJECTIVE To analyze the chemical constituents and components absorbed into plasma of the extract of Ardisia crenata and to elucidate its possible pharmacodynamic material basis. METHODS Overall， 12 rats were randomly assigned to the blank group （n＝6） and A. crenata group （n＝6） by the paired comparison method. The drug was administered once daily in the morning and afternoon for three days. Serum samples were prepared from serum after redosing on 4th day. The UPLC-QE-HF-MS/ MS was used to analyze and identify the chemical constituents in A. crenata extract and serum samples. Compound Discoverer 3.0 was employed for retention time correction， peak identification， and peak extraction. According to the secondary mass spectrometry information， the Thermo mzCloud online and Thermo mzVault local databases， referring to the relevant literature and control quality spectrum information were used to preliminarily identify the chemical constituents and components absorbed into plasma of A. crenata. RESULTS A total of 34 compounds were identified from the extract of A. crenata， mainly coumarins， flavonoids， organic acids， amino acids， including bergenin， quercetin， gallic acid， L-pyroglutamic acid， etc. Besides， 5 components absorbed into plasma were identified from serum samples: L-pyroglutamic acid， syringic acid， bergenin， cinnabar root saponin A， and mycophenolic acid. CONCLUSIONS L-pyroglutamic acid， syringic acid， bergenin， cinnabar root saponin A， and mycophenolic acid may act as the pharmacodynamic material basis of A. crenata.

Purpose/Significance Disease description texts are analyzed to reach a deeper understanding of the current status of on-line consultations for sleep disorders and the thematic characteristics of users with sleep disorders.Method/Process Data about sleep dis-orders from"haodf.com"website is collected by using a web crawler.Furthermore,the main themes about patients'description are i-dentified by the latent Dirichlet allocation(LDA)model.Result/Conclusion The departments of sleep disorders are more dispersed,and the main treatment is drug therapy.Online consultations could improve 83.2％of patients'condition.The themes of patients's disease descriptions include medication and consultation,external environment,description of symptoms,surrogate questions and causes.It is suggested that the platform and doctors should pay attention to the prognosis of patients'medication and mental health status,and pay at-tention to the popularization of comorbidities.

Objective:To systematically evaluate the impact of sexual health education on the sexual quality of life, sexual satisfaction, anxiety, depression and the quality of life in breast cancer patients.Methods:A comprehensive search was conducted in Cochrane Library, Embase, PubMed, CNKI, Wanfang Data, VIP, and SinoMed databases for randomized controlled trials (RCTs) exploring the effects of sexual health education on sexual quality of life, sexual satisfaction, anxiety, depression and quality of life in breast cancer patients. The search covered studies up until November 8, 2023. Two researchers independently screened the literature, extracted data, and assessed the quality of the RCTs using the Cochrane Handbook 5.1.0 risk of bias tool. Meta-analysis was performed using RevMan 5.4 and R4.3.2 software.Results:A total of 17 articles with 1 695 patients were included. Sexual health education significantly improved sexual quality of life [ SMD=1.25, 95% CI (0.65, 1.84), P<0.05], sexual satisfaction [ SMD=0.85, 95% CI (0.53, 1.17), P<0.05], depression [ SMD=-1.16, 95% CI (-2.01, -0.30), P<0.05], and the quality of life [ SMD=1.53, 95% CI (0.09, 2.97), P<0.05] in breast cancer patients. However, the improvement in anxiety was not statistically significant [ SMD=-0.88, 95% CI (-2.06, 0.29), P<0.05] . Conclusions:Sexual health education can improve the sexual quality of life, sexual satisfaction, depression, and the quality of life in breast cancer patients. However, its impact on anxiety remains unclear, possibly due to the limited number of studies. Future RCTs should further explore the effect of sexual health education on anxiety in this population.

Gingival recessions (GRs) result in root hypersensitivity, root surface caries, and esthetic problems. Various root coverage surgeries are being developed for periodontal plastic therapy. The tunnel technique (TUN) is one of the most widely applied surgeries due to its features of being minimally invasive, practical, excellent outcomes and long-term stability; however, there are still some limitations of this technique. The history and evolution from the envelope flap to TUN, including its efficiency when compared with coronally advanced flaps with a connective tissue graft (CTG), are reviewed in this paper. The limitations of TUN are discussed in consideration of our clinical experience; for example, there is high technique sensitivity when TUN is applied in GR>5 mm because of the great difficulty in covering the grafts. The advantages of surgical access, including vertical incisions in the vestibule, “W” type and pinhole access, are discussed for different situations. Mattress sutures and sling sutures in a single tooth or multiple teeth are applied in TUN. The different types of grafts, such as CTG, platelet-rich plasma, articular dermal matrix and xenogeneic collagen matrix, are described. Mechanical, chemical and biological conditioning of the root surface are recommended during surgery. Protecting the surgical area and taking antibiotics postoperatively are also very important. Finally, the modifications when TUN is applied with other kinds of techniques are discussed, including lateral closed TUN, laterally positioned flaps, double papilla flaps and frenuloplasty. Minimally invasive, esthetic, long-term stability and simplified techniques are the development trends of TUN in the future.

Type 2 diabetes mellitus （T2DM） is a chronic metabolic disease characterized by insulin resistance， hyperinsulinemia， and disturbance of glucose and lipid metabolism， with elevated blood glucose as the main clinical manifestation. Due to its complex etiology and pathogenesis， there is no effective treatment， which critically threatens human health and places a heavy burden on society and families. Saponins are a class of glycosides with complex structures that have the advantage of a wide range of sources， elevated safety， and low adverse effects. As an essential active ingredient in Chinese medicine， Chinese medicine saponins have a variety of biological activities such as hypoglycemia， hypoglycaemia， anti-inflammation， antioxidation， anti-tumor， and immune modulation. In recent years， numerous studies have shown that Chinese medicine saponins are effective in preventing and treating T2DM. Although there have been numerous studies on the hypoglycemic effects and mechanisms of Chinese medicine saponins， there has been no systematic review of the mechanisms of Chinese medicine saponins in the treatment of T2DM. Therefore， to provide a theoretical basis for an in-depth study of the hypoglycemic effects of Chinese medicine saponins and a scientific basis for the development and clinical application of drugs， this paper systematically summarized the hypoglycemic mechanisms of Chinese medicine saponins， such as improving islet β-cell function， improving insulin resistance， inhibiting glycosidase activity， reducing the inflammatory response， anti-oxidative stress， and regulating intestinal flora， and analyzed the current research problems and development trends.

Objective:To investigate application effect of light therapy in elderly patients with coronary heart disease combine with dsychological barriers.Methods:Totally, 112 coronary heart desease patients combine with dsychological barriers treated in Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University from October 2018 to December 2019 were selected, and they were divided into experimental group and control group according to random number table method, each group including 56 patients. The control group received routine care. On the basis of this, the experimental group received light therapy for 4 weeks. Before and after intervention, the effects were assessed by Symptom Checklist 90 (SCL-90) and Pittsburgh Sleep Quality Index (PSQI), respectively.Results:After intervention, the scores of somatization, compulsion, depression, anxiety, fear and total scores of SCL-90 in the experimental group were (1.26 ± 0.13), (1.43 ± 0.08), (1.17 ± 0.13), (1.14 ± 0.10), (1.34 ± 0.07), (120.55 ± 11.87) points, significantly lower than (1.83 ± 0.53), (1.66 ± 0.59), (1.71 ± 0.12), (1.76 ± 0.13), (1.41 ± 0.12), (130.69 ± 14.16) points in the control group, the differences were statistically significant ( t values were 2.88-27.79, all P<0.05); and the scores of subjective sleep quality, sleep duration, daytime dysfunction and total scores of PSQI in the experimental group were (0.96 ± 0.19), (1.74 ± 0.36), (1.12 ± 0.22), (10.22 ± 0.60) points, significantly lower than (1.12 ± 0.20), (1.89 ± 0.25), (1.33 ± 0.32), (10.81 ± 0.73) points in the control group, the differences were statistically significant ( t values were 2.44-4.54, all P<0.05). Conclusions:Light therapy can effectively alleviate the psychological stress response in elderly patients with coronary heart disease combine with dsychological barriers, and improve sleep quality.

To investigate the in situ intestinal absorption characteristics and pharmacokinetic behavior of metformin-resveratrol compound water-in-oil nanoemulsion (MRCE) in rats, the in situ intestinal perfusion model was constructed in rats to study the intestinal absorption characteristics of MRCE in different intestinal segments. Male Sprague-Dawley rats were randomly divided into two groups. After intragastric administration of metformin and MRCE, blood was taken at a preset time point. The content of metformin in intestinal perfusion samples and blood samples at various time points was determined by HPLC. Plasma concentration-time profiles of free metformin and MRCE were calculated, and the main pharmacokinetic data were processed and analyzed by DAS 2.1.1 software. The absorption rate constant (Ka), the effective permeability (Peff) and the percentage of absorption (PA) of MRCE in each intestinal segment were significantly higher than those of metformin (P < 0.05). The area under the drug-time curve (AUC0-72 h), the half-life (t1/2) and mean residence time (MRT0-72 h) of MRCE were 1.68, 11.25 and 6.97 times of metformin, respectively (P < 0.01).The relative bioavailability of MRCE was 167.6%. The 90% confidence interval of AUC0-72 h was 156.9%-187.4%, which was not within the standard interval of bioequivalence. The intestinal absorption of MRCE was significantly better than that of free metformin; MRCE improved the oral bioavailability of metformin and was not bioequivalent to metformin.

To establish and verify a risk prediction nomogram for ipsilateral axillary lymph node metastasis in breast cancer stage T1 （mass ≤ 2 cm）. :The clinicopathological data of 907 patients with T1 breast cancer who underwent surgical treatment from January 2010 to June 2015 were collected，including 573 cases from the Second Affiliated Hospital of Zhejiang University School of Medicine （modeling group） and 334 cases from Zhejiang University Lishui Hospital （verification group）. The risk factors of ipsilateral axillary lymph node metastasis were analyzed by univariate and multivariate logistic regression. The influencing factors were used to establish a nomogram for predicting ipsilateral axillary lymph nodes metastasis in T1 breast cancer. The model calibration，predictive ability and clinical benefit in the modeling group and the verification group were analyzed by C index，receiver operating characteristic curve，calibration curve and decision curve analysis （DCA） curve，respectively. :Univariate analysis showed that lymph node metastasis was related with primary tumor size，vascular tumor thrombus，Ki-67，histopathological grade，and molecular type （<0.05 or <0.01）. Multivariate logistic regression analysis showed that the primary tumor > vascular tumor thrombus，Ki-67 positive，estrogen receptor （ER） positive，and histopathological grade 2-3 were independent risk factors of axillary lymph node metastasis （<0.05 or <0.01）. Based on the independent risk factors，a nomogram prediction model was established. The C indexes of the model group and the validation group were 0.739 （95%:0.693-0.785） and 0.736 （95%:0.678-0.793），respectively. The calibration curve and DCA curve of the modeling group and the verification group indicated that the model was consistent and had good clinical benefit. :Primary tumor size，histopathological grade，vascular tumor thrombus，Ki-67，and ER status are predictors of ipsilateral axillary lymph node metastasis in T1 breast cancer. The established prediction nomogram can effectively predict the risk of ipsilateral axillary lymph node metastasis in T1 breast cancer，which can be used as a reference for individualized axillary management.
Axilla ; Breast Neoplasms ; Female ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Nomograms ; Retrospective Studies

Objective:To evaluate the oncologic outcomes of different laparoscopic radical hysterectomy.Methods:From January 2011 to December 2014, the laparoscopic operation cases of cervical cancer at stage Ⅰb1, Ⅰb2, Ⅱa1 and Ⅱa2, including the histologic subtypes of squamous-cell carcinoma, adenocarcinoma and adenosquamous carcinoma, were collected in five clinical centers. The data were divided into two groups according to the surgical procedures, that is, modified laparoscopic-vaginal radical hysterectomy (mLVRH) and total laparoscopic radical hysterectomy (TLRH). The overall survival rate (OS), disease-free survival rate (DFS) at 5 years were retrospectively analyzed in this study.Results:There were 674 cases in total, including 377 cases of mLVRH, 297 cases of TLRH. (1) The OS at 5 years: the mLVRH was 96.1% and the TLRH was 92.0%, and the mLVRH was higher than that of TLRH （ P=0.010）. Stratify analysis， including stage of disease （Ⅰb1 and Ⅱa1）， histologic subtypes （squamous-cell carcinoma, adenocarcinoma）， lymph node metastasis， revealed that, ① Stage of disease: in stage Ⅰb1, the OS at five years of mLVRH was higher than that in TLRH group （98.6% vs 93.6%, P=0.012）. In stage Ⅱa1, there was significant difference between the two groups, the OS at five years of mLVRH and TLRH were 93.6% and 77.6% （ P=0.007）. ② Histologic subtypes: for the OS at five years of squamous-cell carcinoma, mLVRH and TLRH were 96.1% and 92.3%, and there was significant difference （ P=0.046）； for adenocarcinoma, the OS at five years were 91.0% and 88.6%， and there was no difference between two groups （ P=0.230）. ③ Lymph node metastasis： the mLVRH and TLRH with lymph node metastasis, the OS at five years were 98.6% and 96.4%; the mLVRH and TLRH without lymph node metastasis, the OS at five years were 89.3% and 80.8%. There were no significant differences between the two groups,respectively ( P=0.156， P=0.093）. (2) The DFS at 5 years: there was no significant difference between mLVRH and TLRH (94.1% vs 90.9%, P=0.220). Stratify analysis for stage of disease, the mLVRH group was higher than that in the TLRH group in stage Ⅰb1 (97.0% vs 92.8%, P=0.039). However, for stage Ⅱa1, there was no significant difference between mLVRH and TLRH group （88.2% vs 75.8%, P=0.074）. Conclusions:The results of this retrospective study indicated that different laparoscopy surgical procedures had diverse oncologic outcomes. The OS at 5 years of the mLVRH is superior to the TLRH. The DFS at 5 years in Ⅰb1 stage, the mLVRH is higher than the TLRH. Therefore, the modified laparoscopy is still an alternative surgery for early cervical cancer patients when following the principle of no-tumor-exposure.

Objective: To effectively reduce the concentration of poisons in cleanroom, protect the health of workers, realize the optimization and automatic control of the new return air device. And the influence of initial concentration, air volume, temperature and relative humidity of formaldehyde on the purification effect of the new return air device was explored. Methods: The purification effect of the new return air device installed with the activated carbon and the photocatalyst purification net or ordinary activated carbon purification network was tested in a 60 m³ simulated cleanroom. The concentration of formaldehyde was determined by solution absorption-phenol reagent spectrophotometry. Based on the single factor experiment to determine the combination of two purification nets. The effects of air volume, initial formaldehyde concentration, temperature and relative humidity on the purification effect of the new return air device were investigated by orthogonal test. Then, the performance parameters of the return air device to purify formaldehyde were determined. Results: The formaldehyde purification efficiency of the two types of purification nets in the new return air device was higher than that of the ordinary activated carbon purification network (P<0.05) . The combination of activated carbon and photocatalyst purification net has no effect on the formaldehyde purification efficiency of the return air device (P>0.05) . According to the direct analysis and variance analysis, air volume was the most sensitive factor (F value is 18.894, P<0.05) , followed by initial concentration (F value is 16.128, P<0.05) , while temperature and relative humidity have little effect (F value is 0.041 and 0.599, respectively, P>0.05) . LSD analysis showed that there was no significant difference in the purification efficiency of formaldehyde between 475 m³/h and 626 m³/h (P>0.05) . From the perspective of formaldehyde purification efficiency and energy saving, when the air volume is set to 475 m³/h, the new return air device has higher purification efficiency for high concentration of formaldehyde. Conclusion The new return air device consisting of activated carbon and photocatalyst purification net can play a good purification role in cleanroom with different temperatures and different humidity. Its formaldehyde purification efficiency is affected by air volume and initial concentration.