The changes in modern children’s lifestyles and dietary environments have led to children’s cold stagnation syndrome becoming one of the most common pediatric conditions. Traditional Chinese medicine attributes its internal causes primarily to lung-spleen deficiency and weak defensive functions， while external causes predominantly involve invasion by external pathogens such as wind or epidemic qi. The pathogenesis involves either initial food stagnation followed by external contraction or primary external contraction leading to secondary stagnation. Traditional Chinese medicine employs a syndrome differentiation and treatment system， utilizing targeted approaches such as internal therapies （Chinese herbal formulas or patent medicines， such as Youke shengjiang decoction， modified Dayuanyin formula， Huanghua shuangjie decoction， Sanyang qingjie decoction， Banxia xiexin decoction， Xiao’er chiqiao qingre granule， Baoji oral liquid， etc.）， external therapies （massage， acupuncture， acupoint applications）， combined therapies （integrating internal-external treatments or Chinese-Western medicine）， and preventive therapy at the pre-disease stage. These methods demonstrate unique advantages in alleviating clinical symptoms and improving treatment efficacy. However， limitations persist， including insufficient standardization in clinical research and a lack of in-depth mechanistic studies.

Objective Scutellaria baicalensis stems and leaves glucuronic hydrolase(sbsl GUS)was used to enzymatically hydrolyze scutellarin in Erigeron breviscapus(Vant.)Hand.Mazz.to prepare scutellarein,and the high-purity scutellarein was obtained through separation and purification.Methods Orthogonal experiments were used to optimize the process parameters for the extraction of Erigeron breviscapus(Vant.)Hand.Mazz..Using the rate of enzymatic hydrolysis conversion of scutellarin as the index,the amount of enzyme,pH,temperature,time and antioxidant were investigated,and the preparation process parameters of scutellarein were optimized.Ethanol extraction,activated carbon decolorization,and fractional crystallization were used to purify the crude extract.Results The extraction process was determined to be:segments of Erigeron breviscapus were decocted twice with 10 times water for 1 hour each time.The preparation process of scutellarein was as follows:the amount of sbsl GUS extract and Erigeron breviscapus decoction was 1∶10 based on crude drugs,0.5%sodium metabisulfite was added,pH value was about 6.0,the temperature was about 45℃,and the time was 20 hours.The crude extract of scutellarein with the content more than 60%was obtained.The crude extract was purified by fractional crystallization,refluxed with 80%ethanol,decolorized with activated carbon,concentrated and crystallized,and the scutellarein extract with content more than 85%was obtained.Conclusion sbsl GUS enzymatic hydrolysis technology,which was used to prepare scutellarein,is simple and feasible.This study provides a new way for the manufacture of scutellarein.

Objective:To evaluate the efficacy and safety of mitoxantrone hydrochloride liposome injection in the treatment of peripheral T-cell lymphoma (PTCL) in a real-world setting.Methods:This was a real-world ambispective cohort study (MOMENT study) (Chinese clinical trial registry number: ChiCTR2200062067). Clinical data were collected from 198 patients who received mitoxantrone hydrochloride liposome injection as monotherapy or combination therapy at 37 hospitals from January 2022 to January 2023, including 166 patients in the retrospective cohort and 32 patients in the prospective cohort; 10 patients in the treatment-na?ve group and 188 patients in the relapsed/refractory group. Clinical characteristics, efficacy and adverse events were summarized, and the overall survival (OS) and progression-free survival (PFS) were analyzed.Results:All 198 patients were treated with mitoxantrone hydrochloride liposome injection for a median of 3 cycles (range 1-7 cycles); 28 cases were treated with mitoxantrone hydrochloride liposome injection as monotherapy, and 170 cases were treated with the combination regimen. Among 188 relapsed/refractory patients, 45 cases (23.9%) were in complete remission (CR), 82 cases (43.6%) were in partial remission (PR), and 28 cases (14.9%) were in disease stabilization (SD), and 33 cases (17.6%) were in disease progression (PD), with an objective remission rate (ORR) of 67.6% (127/188). Among 10 treatment-na?ve patients, 4 cases (40.0%) were in CR, 5 cases (50.0%) were in PR, and 1 case (10.0%) was in PD, with an ORR of 90.0% (9/10). The median follow-up time was 2.9 months (95% CI 2.4-3.7 months), and the median PFS and OS of patients in relapsed/refractory and treatment-na?ve groups were not reached. In relapsed/refractory patients, the difference in ORR between patients with different number of treatment lines of mitoxantrone hydrochloride liposome injection [ORR of the second-line, the third-line and ≥the forth-line treatment was 74.4% (67/90), 73.9% (34/46) and 50.0% (26/52)] was statistically significant ( P = 0.008). Of the 198 PTCL patients, 182 cases (91.9%) experienced at least 1 time of treatment-related adverse events, and the incidence rate of ≥grade 3 adverse events was 66.7% (132/198), which was mainly characterized by hematologic adverse events. The ≥ grade 3 hematologic adverse events mainly included decreased lymphocyte count, decreased neutrophil count, decreased white blood cell count, and anemia; non-hematologic adverse events were mostly grade 1-2, mainly including pigmentation disorders and upper respiratory tract infection. Conclusions:The use of mitoxantrone hydrochloride liposome injection-containing regimen in the treatment of PTCL has definite efficacy and is well tolerated, and it is a new therapeutic option for PTCL patients.

Objective:To compare the differences in lung function between sanitation workers and the general population undergoing routine physical examinations, and to analyze the risk factors for restricted airflow and severity of the condition in sanitation workers.Methods:This study is a large cross-sectional study called "Shanxin Respiratory Health Screening for Ten Thousand People". A total of 1 036 sanitation workers (sanitation group) and 6 701 individuals from the general population undergoing routine physical examinations (control group) were selected as the original study subjects from June 2021 to April 2022 (before matching). Both groups underwent pre-bronchodilator lung function tests, and the differences in lung function characteristics between the two groups were compared. The sanitation group also completed a questionnaire survey. Multivariate and ordinal multinomial logistic regression analysis were used to analyze the risk factors for airflow limitation and its severity.Results:A total of 1 027 individuals from the sanitation group and 999 individuals from the control group were included in the study. There were no significant differences in age, gender, height, weight, and body mass index (BMI) between the two groups (all P>0.05). The rate of airflow restriction was significantly higher in the sanitation group compared to the control group (22.88% vs 8.81%, P<0.001). In the sanitation group, there was no statistically significant difference in a self-assessment test for chronic obstructive pulmonary disease (CAT) scores between individuals with airflow restriction (235 cases) and those without airflow restriction (792 cases) [(1.50±2.50) vs (1.15±2.03) points, P=0.084]. There were no statistically significant differences in forced vital capacity (FVC) as a percentage of predicted value (FVC%pred) between the two groups. However, the sanitation group had significantly lower %pred for forced expiratory volume in one second (FEV 1%pred), FVC/FEV 1 ratio (FEV 1/FVC%pred), forced expiratory flow at 50% of FVC (FEF 50%%pred), forced expiratory flow at 75% of FVC (FEF 75%%pred), and maximal mid-expiratory flow (MMEF%pred) compared to the control group (all P<0.05). The rates of abnormal FEF 50%%pred, FEF 75%%pred, and MMEF%pred were significantly higher in the sanitation group compared to the control group (17.62% vs 10.31%, 17.04% vs 10.01%, 27.26% vs 18.41%, all P<0.001). Small airway parameters and the rate of airflow restriction were significantly higher in past and current smokers of the sanitation group compared to never smokers (all P<0.05). Multifactorial analysis showed that high BMI ( OR=0.929, 95% CI: 0.885-0.974) was a protective factor for airflow restriction, while high smoking index was a risk factor ( OR=1.020, 95% CI: 1.011-1.030). Ordered multinomial logistic regression analysis showed that high BMI ( OR=0.925, 95% CI: 0.882-0.971) was a protective factor for the severity of airflow restriction, while high smoking index ( OR=1.020, 95% CI: 1.011-1.029) was a risk factor for the severity of airflow restriction. Conclusions:The incidences of airflow limitation and small airway abnormalities in sanitation workers are higher than that in general physical examination population. High smoking index and low BMI are independent risk factors for airflow limitation and its severity.

Objective To investigate the efficacy of suprapatellar versus infrapatellar approach in tibial intramedullary nail fixation for tibial fracture. Methods Clinical trials that evaluated suprapatellar approach and infrapatellar approach for tibia intramedullary nailing fixation were searched in PubMed, EMBASE, Cochrane Central Register of Controlled Trials ( CENTRAL ) , Chinese Biology Medicine ( CBM) , Wanfang, Weipu and CNKI databases. Methodological qualities of the included studies were assessed using the Cochrane Collaboration tool and Newcastle-Ottawa Scale. Sensitivity analyses were performed to determine whether overall results were reliable. Publication bias was detected using Begg's test and Egger's test. Lysholm score, reoperation rate, Hospital for Special Surgery ( HSS ) score, operation time, intraoperative blood loss and hospital stay were selected to evaluate the clinical effect of suprapatellar approach and infrapatellar approach in tibial intramedullary nail fixation for tibial fracture. Results Two randomized controlled trials and six case-controlled studies involving 787 patients were included in the analysis. Sensitivity analyses indicated that the results were statistically significant. No significant publication bias was detected by Begg's test or Egger's test. Our meta-analysis indicated that suprapatellar approach had significantly higher Lysholm score ( MD=1. 04, 95％CI 0. 82 -1. 26, P<0. 05, I2 =10. 5％) and HSS score ( MD =0. 97, 95％CI 0. 65 -1. 30, P <0. 05, I2 =0 ) than infrapatellar approach ( P <0. 05 ) . Additionally, there were no statistical differences between the two procedures in reoperation rate, operation time, intraoperative blood loss and hospital stay (P>0. 05). Conclusion Compared with infrapatellar approach, suprapatellar approach in intramedullary nail fixation for tibial fracture can better relieve the pain, keep stability and motion of the knee joint and promote function recovery of knee joint.

Objective To investigate the current status of job burnout among anesthetists in Ningxia and to analyze its related risk factors.Methods A total of 310 anesthetists from 30 public hospitals in Ningxia were conducted to collect data on the job burnout by Maslach Burnout InventoryHuman Services Survey (MBI-HSS).The factors associated with severe job burnout and its three domains (high emotional exhaustion,high depersonalization and low personal accomplishment) were included in the multinomial logistic regression analysis.Results The incidence of job burnout and its three domains (high emotional exhaustion,depersonalization and low personal accomplishment) were 18 (5.81％) cases,134 (43.22％) cases,35 (11.29％) cases and 128 (41.29％) cases,respectively.Multinomial logistic regression analysis results indicated that the risk degree associated with job burnout was master and higher degree (OR=4.695,95％CI 1.556-4.172).The risk facts associated with three components of job burnout were work time per week [40-60 h (OR=4.420,CI 2.504-7.802);≥60 h (OR =7.469,95％CI 1.758-31.733)] and tertiary hospital (OR =1.847,95％oCI 1.112-3.069);master and higher degree (OR=2.306,95％CI 1.032-5.155),working years [6-15 years (OR=0.358,95％CI 0.135-0.949)] and cases of anesthesia per year [≥390 cases (OR =3.352,95％CI 1.301-8.639)];secondary hospital (OR =1.717,95％CI 1.045-2.823).Conclusion This survey indicates that job burnout exists among anesthetists in Ningxia and is mainly displayed in emotional exhaustion and low personal accomplishment domains.Master and higher degree tend to occur serve job burnout.

Objective To analyze the effects of vascularized fibular flap combined with vacuum sealing drainage (VSD) in the repair of tibia defect.Methods Clinical data of 24 patients with chronic osteomyelitis of the tibia who accepted the operation of vascularized fibular flap combined with VSD were collected in the study.In the first operation, the lesions were completely debrided and the dead bone was removed, then the vascularized fibular was replaced from the other limb to repair the tibia defect.Later, vacuum-assisted closure was applied to cover the wound.Results All patients enrolled in the study were followed up for 13 to 50 months, with an average of 32.3 months.The sinus of 22 cases healed in 4 weeks and the healing rate was 91.7%.The other two patients received additional debridement for the sinus and they also healed soon after that.All flaps survived and the survival rate was 100%.The X-ray showed that the transplanted fibula was healed in all cases, with a healing rate of 100%.The healing time ranged from 4 to 7 months, with an average of 4.9 months.Based on the Enneking scoring system, the patients achieved an average score of 26 points out of 30 points, and the recovery rate of limb function was evaluated as 86.7%.Conclusion For patients with chronic osteomyelitis of the tibia, vascularized fibular flap combined with VSD can not only effectively repair bone defect, but also restore the continuity of limbs.The application of VSD can effectively control infection, shorten treatment course, and restore limb function.

Objective To evaluate the repair of lower abdominal wall defects with the pedicled sartorius flap and gracilis flap.Methods Among the 7 cases,5 cases were of post malignant tumor resection within the abdominal wall,leaving huge defect.2 cases of wound poor healing of the abdominal wall post-infection.Abdominal wall defects left over by tumor resection or debridement were repaired with the pedicled sartorius flap and gracilis flap.Results After the first phase of the operation,6 cases were healed by first intention without incision infection,dehiscence or hernia formation.One case suffering initial flap tip necrosis was healed by VSD and skin grafting.All patients were followed up for 9-18 months.There was no swelling and no abdominal hernia.Conclusion It is reliable to repair abdominal wall defects with the pedicled sartorius flap and gracilis flap.

BACKGROUND:Primary vascular endothelial cels are mostly harvested through aorta endothelial cel cultures and micro-artery endothelial cel cultures using enzyme digestion and tissue adhesion methods, and the quality and purity of harvested cels cannot meet the need for current scientific research.
OBJECTIVE:To investigate an improved extraction of primary vascular endothelial cels and the relevant identification method.
METHODS: A segment of rabbit aorta was cut to culture vascular endothelial cels using the improved extraction method in group A or using adhesion method in group B. In the group A, the vascular intima was striped out with microsurgical instruments, and digested enzymaticaly to acquire single primary cels folowed by culture in endothelial cel culture medium. In the group B, the whole vascular intima was adhered to the culture dish that was incubated in a 5%CO2, 37℃ incubator for 1 hour. Cel pelets in the two groups were culturedin vitro. Cel morphology was observed using a microscope; immunohistochemical staining was used to detect CD31, VIII factor and Vimentin protein for identification of vascular endothelial cels.
RESULTS AND CONCLUSION:The purity and number of vascular endothelial cels extracted by the improved method were higher than those by the adhesion method. Immunohistochemical findings showed positive expression of CD31 and VIII factor, but negative expression of Vimentin. These findings indicate that the improved extraction method can obtain more vascular endothelial cels with higher purity, which is of strong operability and practicality.

OBJECTIVETo determine carboxyatractyloside and atractyloside in Xanthii Fructus by HPLC.

METHODBy HPLC, Agilent ZORBAX SB-phenyl (4.6 mm x 250 mm, 5 microm) column was adopted, with acetonitrile-0.01 mol x L(-1) NaH2PO4 (pH 6) as the mobile phase for gradient elution at the flow rate of 1.0 mL x min(-1). The detection wavelength was 203 nm, and the temperature was set at 35 degrees C.

RESULTCarboxyatractyloside showed a good linearity within the range of 0.0972-1.944 microg and atractyloside showed a good linearity within the range of 0.1030-2.060 microg. The recovery rate of carboxyatractyloside was 100. 3% and that of atractyloside was 102.5%. The RSD were 0.67% and 1.4% (n=6).

CONCLUSIONThis method is so simple, practical and highly repeatable that is can be used for quality control of Xanthii Fructus.

Asteraceae ; chemistry ; Atractyloside ; analogs & derivatives ; analysis ; isolation & purification ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; analysis ; isolation & purification ; Fruit ; chemistry