Hypertension and osteoporosis(OP)are common diseases in middle-aged and elderly people,and the number of patients with both diseases has gradually increased in recent years.Because the onset of the disease is hidden,it is easy to cause fractures and serious complications of heart,brain and kidney in the later stage,which not only seriously damages the quality of life of patients,but also increases the difficulty of clinical treatment.Therefore,it is particularly necessary to strengthen the research on this disease.More and more studies have found that the disorder of intestinal flora will lead to the occurrence of OP,while the intestinal flora of patients with hypertension is obviously out of balance.Therefore,this paper thinks that intestinal flora may be the key influencing factor of hypertension complicated with OP,and the imbalance of intestinal flora will lead to the imbalance of short-chain fatty acid metabolism,immune inflammatory reaction and increased sympathetic nerve activity,thus causing the imbalance of bone homeostasis and promoting the occurrence of OP.Therefore,it is suggested that regulating intestinal flora may be a new way to intervene hypertension complicated with OP.

Eleven compounds were isolated and purified from the ethyl acetate part of 80% ethanol extract of Ferula feruloides root by a combination of normal-phase silica gel column chromatography, Sephadex LH-20 dextran gel column chromatography and semi-preparative liquid chromatography and then modern wave spectrometry methods (NMR, MS, UV, IR) were used to identify the structures of the compounds, which were identified as baigene D (1), baigene E (2), baigene F (3), β-kirialovin (4), α-kirialovin (5), falcarindiol (6), ammoresinol (7), dshamirone (8), 2,3-dihydro-7-hydroxy-2S*,3R*-dimethyl-3-[4-methyl-5-(4-methy1-2-furyl)-3(E)-pentenyl]-furo[3,2-c]coumarin (9), 2,3-dihydro-7-hydroxy-2S*,3R*-dimethyl-2-[4,8-dimethyl-3(E),7-nonadi-enyl]-furo[3,2-c]coumarin (10), and baigene C (11). Compounds 1-3 are new coumarin analogues, and compounds 4-6 are firstly isolated from F. feruloides. The anti-proliferative activity of compounds 5, 7-11 against human gastric cancer (MKN-45) cells was evaluated using MTT assay, which showed that compounds 7-11 exhibited strong inhibitory activity, and compound 5 exhibited weak inhibitory activity.

Objective:To investigate the feasibility, safety and reasonable operation of nasointestinal canal indwelling guided by miniature system in severe neurosurgery patients, and compare its advantages and disadvantages with traditional blind insertion.Methods:A prospective randomized controlled trial design was used to select 128 critically ill patients in need of enteral nutrition support at the Department of Neurosurgery, the First Affiliated Hospital of Nanjing Medical University from March 2022 to October 2023 by convenient sampling method. They were divided into blind insertion group and visualization group by random number table method, with 64 cases in each group. Nasointestinal canal indwelling was performed in the blind insertion group by traditional blind insertion method, and in the visualization group, nasointestinal canal indwelling was performed by indentations guided by the miniature visualization system. The success rate of initial catheterization, the time of catheterization, complications, changes of vital signs during catheterization and changes of nutritional indexes after catheterization were evaluated in 2 groups.Results:In the blind insertion group, there were 35 males and 29 females, aged (59.44 ± 13.84) years old. In the visualization group, there were 41 males and 23 females, aged (58.28 ± 12.08) years old. The success rate of the first catheter placement in the visual group was 96.8% (62/64), higher than that in the blind group 82.8% (53/64), and the difference was statistically significant ( χ2=6.94, P<0.05). The catheter placement time of the visualization group was (20.08 ± 2.69) min, which was shorter than that of the blind insertion group (38.19 ± 3.79) min, and the difference between the two groups was statistically significant ( t=29.99, P<0.05). There was no significant difference in the incidence of complications, changes of vital signs during catheterization and the changes of nutritional indexes after catheterization between two groups (all P>0.05). Conclusions:Compared with traditional blind nasointestinal canal indwelling, nasointestinal canal indwelling guided by the miniature visualization system can improve the success rate of the first catheterization and shorten the catheterization time. Although there is no difference in the complication rate, changes in vital signs during catheterization and changes in nutritional indexes after catheterization, it is believed that with the continuous development and upgrading of this technology, it will further reflect the advantages of this technology, which is worthy of further clinical trials and application.

【Objective】 To explore the effects of finasteride on the gene expression in patients with benign prostatic hyperplasia (BPH) through transcriptome analysis. 【Methods】 Postoperative prostate tissues from patients who underwent prostatectomy at Peking University Third Hospital during Oct.2020 and Oct.2021 were collected.The patients were divided into medication group and non-medication group based on whether they had taken finasteride for a long time before surgery, with 8 patients in either groups.Transcriptome sequencing analysis was performed and the results were validated with qPCR and immunohistochemistry analysis. 【Results】 Compared with the non-medication group, 857 up-regulated and 806 down-regulated genes were screened in the medication group.Pathway enrichment analysis showed that finasteride induced down-regulation of vascular endothelial growth factor D (VEGFD) expression in the focal adhesion pathway.Inter group network analysis suggested that the calcium signaling pathway was key in the entire process.GSEA enrichment analysis further revealed the up regulation of CD38 gene expression in the calcium signaling pathway.The qPCR and immunohistochemistry analysis supported the transcriptome results mentioned above, and found that androgen receptor (AR) expression was also increased. 【Conclusion】 Finasteride reduces prostate microvascular formation by downregulating the expression of VEGFD in the focal adhesion pathway, thereby reducing the risk of bleeding during prostate hyperplasia surgery. Long-term use of finasteride leads to the up regulation of CD38 expression in the calcium signaling pathway, which may lead to the development of finasteride resistance.

Objective This study aimed to understand the epidemic status and phylogenetic relationships of rotavirus group A(RVA)in the Pearl River Delta region of Guangdong Province,China. Methods This study included individuals aged 28 days-85 years.A total of 706 stool samples from patients with acute gastroenteritis collected between January 2019 and January 2020 were analyzed for 17 causative pathogens,including RVA,using a Gastrointestinal Pathogen Panel,followed by genotyping,virus isolation,and complete sequencing to assess the genetic diversity of RVA. Results The overall RVA infection rate was 14.59%(103/706),with an irregular epidemiological pattern.The proportion of co-infection with RVA and other pathogens was 39.81%(41/103).Acute gastroenteritis is highly prevalent in young children aged 0-1 year,and RVA is the key pathogen circulating in patients 6-10 months of age with diarrhea.G9P[8](58.25%,60/103)was found to be the predominant genotype in the RVA strains,and the 41 RVA-positive strains that were successfully sequenced belonged to three different RVA genotypes in the phylogenetic analysis.Recombination analysis showed that gene reassortment events,selection pressure,codon usage bias,gene polymorphism,and post-translational modifications(PTMs)occurred in the G9P[8]and G3P[8]strains. Conclusion This study provides molecular evidence of RVA prevalence in the Pearl River Delta region of China,further enriching the existing information on its genetics and evolutionary characteristics and suggesting the emergence of genetic diversity.Strengthening the surveillance of genotypic changes and gene reassortment in RVA strains is essential for further research and a better understanding of strain variations for further vaccine development.

Objective To observe the therapeutic effect of Shenshuai Formula(composed of Pinelliae Rhizoma Praeparatum Cum Zingibere et Alumine,Citri Reticulatae Pericarpium,Poria,Atractylodis Macrocephalae Rhizoma,Bambusae Caulis in Taenia,Morindae Officinalis Radix,Centellae Herba,Rhei Radix et Rhizoma,etc.)on patients with chronic kidney disease(CKD)at stage 3-4 of spleen-kidney qi deficiency with internal accumulation of turbid-phlegm and stasis type.Methods Seventy patients with CKD at stage 3-4 of spleen-kidney qi deficiency with internal accumulation of turbid-phlegm and stasis type were randomly divided into a treatment group and a control group,with 35 patients in each group.The control group was given the conventional western medicine integrated treatment for CKD,and the treatment group was given the Chinese herbal decoction of Shenshuai Formula on the basis of treatment for the control group.The course of treatment for the two groups covered 8 weeks.The changes of traditional Chinese medicine(TCM)syndrome scores,renal function indicators of serum creatinine(Scr),blood urea nitrogen(BUN),serum cystatin C(CysC),blood uric acid(UA)and estimated glomerular filtration rate(eGFR),and the level of hypersensitive C-reactive protein(hs-CRP)in the two groups before and after the treatment were observed.Moreover,the TCM syndrome efficacy and clinical safety in the two groups were evaluated.Results(1)During the trial,5 cases in the treatment group and 3 cases in the control group fell off,and eventually a total of 62 patients were included in the trial,including 30 cases in the treatment group and 32 cases in the control group.(2)After 8 weeks of treatment,the total effective rate for TCM syndrome efficacy of the treatment group was 86.67%(26/30),and that of the control group was 59.38%(19/32).The intergroup comparison showed that the TCM syndrome efficacy in the treatment group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the scores of TCM syndromes in the two groups were significantly decreased when compared with those before treatment(P＜0.01),and the decrease in the treatment group was more obvious than that in the control group(P＜0.01).(4)After treatment,the renal function indicator levels of Scr,BUN,CysC and UA in the two groups were decreased when compared with those before treatment(P＜0.05),and the level of eGFR was increased when compared with that before treatment(P＜0.05).The intergroup comparison showed that the decrease in the levels of Scr,BUN,CysC and UA and the increase in the level of eGFR in the treatment group were superior to those in the control group(P＜0.05).(5)After treatment,the inflammatory factor level of serum hs-CRP in the two groups was improved when compared with that before treatment(P＜0.05),and the improvement in the treatment group was superior to that in the control group(P＜0.05).(6)During the treatment period,no significant changes in the safety indicators such as blood routine test,stool routine test and occult blood test,liver function,electrolyte,and electrocardiogram were presented in the two groups.Conclusion Shenshuai Formula exerts certain effect in the treatment of patients with CKD at stage 3-4 of spleen-kidney qi deficiency with internal accumulation of turbid-phlegm and stasis type.It can relieve the clinical symptoms of the patients to certain extent,effectively decrease the levels of Scr,BUN,CysC and UA,increase the eGFR,improve renal function,lower the level of serum hs-CRP,reduce the micro-inflammatory state of patients,and delay the progress of the disease.

Objective To investigate the risk factors of postoperative vertebral body refracture after percutaneous vertebroplasty(PVP)in the treatment of thoracolumbar osteoporotic compression fracture.Methods The radiological and clinical data of 1258 patients who underwent single-level PVP surgery for thoracolumbar vertebral compression fracture in our hospital from January 1,2015 to December 31,2020 were retrospectively analyzed.Gender,age,body mass index(BMI),bone mineral density(BMD),surgical approach,injection amount of cement,diffusion state of,leakage,vertebral height restores,kyphotic angle reduction,wedge angle reduction of vertebral body,postoperative anti-osteoporosis drug application and other radiological and clinical data of patients were collected and analyzed by univariate and multivariate analysis.The differences of these parameters in the refracture group and the non-refracture group were compared to evaluate the correlation between these factors and postoperative vertebral refracture.Results A total of 247 patients were included in this study.The incidence of refracture was 3.90％in 49 patients.Univariate analysis showed that large kyphotic angle,intravertebral cleft sign,endplate cortical disruption,small injection amount of bone cement,non-contact between bone cement and endplate,and high reduction rate of vertebral body were risk factors for vertebral refracture after PVP.Multivariate analysis of these factors showed that large injection amount of bone cement(OR=0.37,95％CI:0.19-0.55,P=0.018)was a protective factor for vertebral refracture after PVP,and preoperative endplate cortical disruption(OR=2.86,95％CI:1.14-7.53,P=0.026),preoperative intravertebral cleft sign(OR=18.15,95％CI:3.07-44.79,P=0.003),large vertebral reduction rate(OR=3.58,95％CI:1.38-8.40,P=0.007),and poor contact between bone cement and endplate(OR=3.01,95％CI:1.92-10.65,P=0.004)were independent risk factors for vertebral refracture after PVP.Conclusion In this study,it was found that small injection amount of bone cement,endplate cortical disruption before surgery,intravertebral cleft sign,large vertebral reduction rate,and poor contact between bone cement and endplate were independent risk factors for postoperative refracture after PVP treatment of osteoporotic compression fractures in the elderly thoracolumbar spine.

Vaginal birth after cesarean (VBAC) can reduce the cesarean section rate and has many benefits for both mother and infant. Decision-making aids can promote communication between doctors and patients regarding childbirth methods and increase pregnant women's informed consent and decision-making participation in VBAC, thereby supporting pregnant women in making choices and improving the quality of childbirth decisions. This article summarizes the content of VBAC decision-making aids, evaluation of different VBAC decision-making aids, application of VBAC decision-making aids, and obstacles to the application of VBAC decision-making aids in China to provide reference for the development and application of domestic childbirth decision-making aids.

Objective:To conduct systematic review of mother-infant attachment measurement tools based on Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines.Methods:The researches on mother-infant attachment measurement tools in PubMed, Scopus, Embase, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, WanFang Data and VIP was searched by computer, and the search period was from establishment of the databases to October 30, 2023. Two reviewers trained in evidence-based methodology independently screened the literature, extracted and summarized the data, and systematically evaluated the attributes of the measurement tools using the COSMIN guideline bias risk list and good measurement attribute standards.Results:A total of 35 studies were included, including seven maternal-infant attachment measurement tools. Among them, the content validity quality of the Maternal-fetal Attachment Tool was sufficient (evidence quality was advanced), the structural validity quality was uncertain (evidence quality was intermediate), the internal consistency quality was sufficient (evidence quality was advanced) and the hypothesis testing quality was sufficient (evidence quality was advanced), which was recommended at level A.Conclusions:This study systematically evaluates seven measurement tools for maternal-infant attachment, among which the Maternal-fetal Attachment Tool is class A tool and is recommended for use.

This study investigated the epidemiological and genotypic characteristics of group A rotavirus(RVA)in children under 5 years of age with diarrhea at a viral diarrhea surveillance sentinel hospital in Guangdong Province from 2021 to 2022,to provide a basis for RVA prevention and control.A total of 1 858 fecal samples from children under 5 years of age with diarrhea in 2021-2022 were collected.Rotavirus antigen was detected with ELISA,and positive samples were further sequenced and categorized.Among the 1 858 samples,156 were RVA positive.The positivity rates in boys and girls were 8.76％and 7.87％,respectively.Significant differences were observed in the detection rates of RVA infection among age groups.The rate of RVA infection increased gradually from December to April of the following year.In 2021,the main endemic strains of RVA in the Guangdong region were of the G9P[8]subtype,and the rare G8P[8]subtype increased in China.In 2022,the G8P[8]subtype surpassed the G9P[8]subtype for the first time.In cases of diarrhea in infants younger than 5 years in Guangdong Province from 2021 to 2022,the RVA genotypes were diverse,the G9P[8]genotype significantly decreased,and the G8P[8]subtype became a dominant genotype.Continuous RVA genotype monitoring remains necessary to assess the risk of RVA-related disea-ses.