Eleven sesquiterpenoids were isolated from the petroleum ether and ethyl acetate extracted fraction of 95% ethanol extract of fresh Centipeda minima by using modern chromatographic separation techniques such as silica gel, MCI, gel, and semi-preparative liquid chromatography. Their structures were identified using spectroscopy and nuclear magnetic resonance(NMR) calculation as minimin A(1), brevilin A(2), minimolide L(3), minimolide A(4), minimolide B(5), arnicolide D(6), microhelenin C(7), 2β-hydroxyl-2,3-dihydrogen-6-O-angeloylplenolin(8), 11α,13-dihydroarnifolin(9),(1S,2R,5R,6S,7S,8S,10R)-6-hydroxy-2-ethoxy-4-oxopseudoguai-11(13)-en-12,8-olide(10), and pulchellin-2-O-isovalerate(11), among which compound 1 was a new compound, and compounds 9-11 were isolated from Centipeda for the first time. The evaluation results of in vitro anti-inflammatory activity showed that compounds 1-11 possessed significant anti-inflammatory activity, with IC_(50) values ranging from(0.13±0.03) to(13.11±0.17) μmol·L~(-1).
Sesquiterpenes/pharmacology* ; Animals ; Asteraceae/chemistry* ; Mice ; Drugs, Chinese Herbal/pharmacology* ; Molecular Structure ; Magnetic Resonance Spectroscopy ; Macrophages/immunology*

In this study, serum metabolomics techniques and molecular biology methods were used to investigate the intervention effect of kaji-ichigoside F1 on chronic unpredictable mild stress(CUMS) depression mouse model and its mechanism. The CUMS depression mouse model was constructed, and the mice were divided into blank group, model group, escitalopram(ESC, 10 mg·kg~(-1)) group, and low-dose, medium-dose, and high-dose kaji-ichigoside F1 groups(1, 2, and 4 mg·kg~(-1)). CUMS modeling was performed on all mice except the blank group, and the cycle was four weeks. At the end of modelling, ESC and kaji-ichigoside F1 were administered by gavage once a day for 28 days. After the end of the administration, behavioral testing(sucrose preference test, open field test, forced swimming test, and tail suspension test) was conducted to evaluate the improvement of depression symptoms of different doses of kaji-ichigoside F1 on CUMS depression mouse model. The morphology of neurons and the number of Nissl bodies in the hippocampus were observed by Nissl staining. Metabolomics technique was used to analyze the changes in serum differential metabolites in mice. Protein expression levels of P2X7 purinergic receptor(P2X7R), adenosine A1 receptor(A1R), and adenosine receptor A2A(A2AR) in mouse hippocampus were detected by Western blot. The results showed that compared with that in the blank group, the body weight of mice in the model group was significantly decreased, and the sucrose preference rate was significantly decreased. The immobility time was significantly increased in the forced swimming and tail suspension tests, and the total moving distance was significantly decreased in the open field test. The number of Nissl bodies was significantly decreased, and the depression-like behavior and the number of Nissl bodies in the hippocampus of mice were significantly improved after administration of kaji-ichigoside F1. In the metabonomics analysis, the purine metabolism of serum after kaji-ichigoside F1 administration was involved in the metabolic passage of depression, and Western blot analysis verified the expression of P2X7R, A1R, and A2AR proteins in purine metabolic pathways. The results show that kaji-ichigoside F1 significantly decreases the expression of P2X7R and A2AR proteins in the hippocampus of CUMS model mice and increases the expression level of A1R proteins. It is suggested that kaji-ichigoside F1 may play an antidepressant role by regulating the expression of P2X7R, A1R, and A2AR proteins in the purine metabolism pathway.
Animals ; Mice ; Antidepressive Agents/administration & dosage* ; Metabolomics ; Depression/genetics* ; Male ; Drugs, Chinese Herbal/administration & dosage* ; Disease Models, Animal ; Hippocampus/metabolism* ; Behavior, Animal/drug effects* ; Humans

Objective To quantify the association between obesity and erectile dysfunction (ED) risk through a meta-analysis. Methods Following PRISMA guidelines, systematic searches of Chinese and English databases (up to March 2025) were conducted to include observational studies (cohort, cross-sectional, case-control). Adjusted effect sizes (OR and 95% CI) were extracted. Study quality was assessed using the Agency for Healthcare Research and Quality(AHRQ) scale, and a random-effects model was applied to pool effect sizes. Subgroup analyses (geographic region, obesity definitions) and sensitivity analyses were performed to validate robustness. Results Ten studies (n=230 744), including nine cross-sectional studies, were included. The meta-analysis revealed that obesity significantly increased ED risk (random-effects OR=1.80, 95% CI: 1.29-2.51), with high heterogeneity (I2=99.9%). Subgroup analyses indicated stronger associations in USA populations (OR=2.10, 95% CI: 1.23-3.60) than in Chinese populations (OR=1.16, 95% CI: 1.05-1.28). The highest effect size was observed when using BMI≥25 kg/m3 as the obesity threshold (OR=3.05, 95% CI: 2.06-4.51). Sensitivity analyses confirmed robust results (OR: 1.60-1.94 after excluding any single study). Conclusions Obesity is a critical risk factor for ED, with effect strength influenced by geographic region and obesity definitions. Interventions targeting BMI≥30 kg/m2 in Western populations and metabolic risks at BMI≥25 kg/m3 in Asian populations are recommended.

The presence of magnetic fields in a magnetic resonance accelerator (MR-linac) can affect the reference dosimetry, and thus the existing Code of Practices (CoPs) are inadequate for MR-linac. In this article, the characteristics of adsorbed dose to water and ionization chamber response in the presence of magnetic fields were introduced and a formalism for reference dosimetry in MR-linac was developed based on the existing CoPs, aiming to provide reference for dosimetric quality control and research work of MR-linac in China.

Objective:To explore the impact of the two-way referral model on compliance and prognosis in patients with heart failure.Methods:This bidirectional cohort study enrolled chronic heart failure (CHF) patients treated at Qilu Hospital of Shandong University or designated primary hospitals between March 2018 and March 2022. Patients were categorized into two groups based on referral status: two-way referral group (participating in the referral model with≥1 follow-up visit at primary hospitals) and the core hospital group (receiving treatment and follow-up exclusively at Qilu Hospital). Baseline clinical characteristics were collected and compared between groups. Patients underwent followed-up, with primary endpoints including follow-up rate, drug (β-blockers, angiotension converting enzyme inhibitor (ACEI)/angiotensin Ⅱ receptor blockers (ARB)/angiotensin receptor-neprilysin inhibitor (ARNI), sodium-glucose cotransporter 2 inhibitors and mineralocorticoid receptor antagonists) utilization rate and target dose achievement rate. Secondary endpoints encompassed changes from baseline in left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), and N-terminal pro-brain natriuretic peptide (NT-proBNP), plus cardiovascular mortality and heart failure rehospitalization. Generalized linear mixed models analyzed longitudinal trends in LVEF, LVEDd, and NT-proBNP levels. Kaplan-Meier curves and Cox regression evaluated LVEF recovery rates, supplemented by subgroup analyses. Multivariate logistic regression was used to identify factors influencing target dose achievement rate for β-blockers and ACEI/ARB/ARNI therapies in CHF patients.Results:A total of 357 patients were enrolled, aged 53 (41, 63) years, including 256 males (71.7%). 157 patients were in the two-way referral group and 200 patients in the core hospital-treated group. Compared with the core hospital-treated group, the two-way referral group had lower baseline LVEF (28 (22, 34)% vs. 31 (23, 36)%, P=0.021) and systolic blood pressure (116 (104, 125) mmHg vs. 121 (109, 134) mmHg (1 mmHg=0.133 kPa), P=0.010). The 12-month follow-up rate of the two-way referral group was higher than the core hospital-treated group (73.8% vs. 56.0%, P=0.004). No significant between-group differences were observed in drug utilization rate of β-blockers, ACEI/ARB/ARNI, or sodium-glucose cotransporter 2 inhibitors during follow-up (all P>0.05), while mineralocorticoid receptor antagonists use showed a declining trend in both groups. Although the core hospital-treated group had higher target dose achievement rates for β-blockers (65.4% vs. 49.3%, P=0.042) and ACEI/ARB/ARNI (79.8% vs. 65.8%, P=0.046) than the two-way referral group, multivariate logistic regression indicated that the two-way referral model was not a negative predictor for these outcomes (all P>0.05). Both groups showed improved NT-proBNP, LVEDd, and LVEF from baseline (all P<0.001) with no significant difference in trends between groups (all P>0.05). There was no significant difference in the composite incidence (7.6% vs. 6.5%, P=0.674) and cumulative incidence (log-rank P=0.684) of cardiovascular death and heart failure rehospitalization at 12 months between two groups. Conclusion:The two-way referral model demonstrates advantages in improving medication adherence, drug utilization rates, and targetdoseachievement rates among CHF patients. This model not only promotes cardiac functional recovery but also reduces risks of cardiovascular mortality and heart failure rehospitalization, achieving comparable therapeutic and management outcomes to those observed in core hospital-treated patients.

Right ventricular-pulmonary artery coupling(RVPAC)refers to the relationship between right ventricular contractility and afterload.Normal RVPAC is maintained only when right ventricular function and pulmonary vascular resistance are appropriately matched.When right ventricular contractility cannot increase to match afterload,thus resulting in right ventricular dysfunction.RVPAC plays an important role in pathophysiology and progression of many cardiovascular diseases,which is crucial for the prognosis of patients.Therefore,early and accurate evaluation of RVPAC has great significance for patient's condition assessment,clinical decision-making,risk stratification and prognosis judgment.There are many evaluation methods currently,which can be divided into invasive and non-invasive methods,among which the non-invasive methods are mainly correlated with ultrasound.This review summarizes pathological mechanism and evaluation methods of RVPAC,advantages and disadvantages of each method and application value of RVPAC in various cardiovascular diseases.

Right ventricular-pulmonary artery coupling(RVPAC)refers to the relationship between right ventricular contractility and afterload.Normal RVPAC is maintained only when right ventricular function and pulmonary vascular resistance are appropriately matched.When right ventricular contractility cannot increase to match afterload,thus resulting in right ventricular dysfunction.RVPAC plays an important role in pathophysiology and progression of many cardiovascular diseases,which is crucial for the prognosis of patients.Therefore,early and accurate evaluation of RVPAC has great significance for patient's condition assessment,clinical decision-making,risk stratification and prognosis judgment.There are many evaluation methods currently,which can be divided into invasive and non-invasive methods,among which the non-invasive methods are mainly correlated with ultrasound.This review summarizes pathological mechanism and evaluation methods of RVPAC,advantages and disadvantages of each method and application value of RVPAC in various cardiovascular diseases.

The presence of magnetic fields in a magnetic resonance accelerator (MR-linac) can affect the reference dosimetry, and thus the existing Code of Practices (CoPs) are inadequate for MR-linac. In this article, the characteristics of adsorbed dose to water and ionization chamber response in the presence of magnetic fields were introduced and a formalism for reference dosimetry in MR-linac was developed based on the existing CoPs, aiming to provide reference for dosimetric quality control and research work of MR-linac in China.

Objective:To explore the impact of the two-way referral model on compliance and prognosis in patients with heart failure.Methods:This bidirectional cohort study enrolled chronic heart failure (CHF) patients treated at Qilu Hospital of Shandong University or designated primary hospitals between March 2018 and March 2022. Patients were categorized into two groups based on referral status: two-way referral group (participating in the referral model with≥1 follow-up visit at primary hospitals) and the core hospital group (receiving treatment and follow-up exclusively at Qilu Hospital). Baseline clinical characteristics were collected and compared between groups. Patients underwent followed-up, with primary endpoints including follow-up rate, drug (β-blockers, angiotension converting enzyme inhibitor (ACEI)/angiotensin Ⅱ receptor blockers (ARB)/angiotensin receptor-neprilysin inhibitor (ARNI), sodium-glucose cotransporter 2 inhibitors and mineralocorticoid receptor antagonists) utilization rate and target dose achievement rate. Secondary endpoints encompassed changes from baseline in left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), and N-terminal pro-brain natriuretic peptide (NT-proBNP), plus cardiovascular mortality and heart failure rehospitalization. Generalized linear mixed models analyzed longitudinal trends in LVEF, LVEDd, and NT-proBNP levels. Kaplan-Meier curves and Cox regression evaluated LVEF recovery rates, supplemented by subgroup analyses. Multivariate logistic regression was used to identify factors influencing target dose achievement rate for β-blockers and ACEI/ARB/ARNI therapies in CHF patients.Results:A total of 357 patients were enrolled, aged 53 (41, 63) years, including 256 males (71.7%). 157 patients were in the two-way referral group and 200 patients in the core hospital-treated group. Compared with the core hospital-treated group, the two-way referral group had lower baseline LVEF (28 (22, 34)% vs. 31 (23, 36)%, P=0.021) and systolic blood pressure (116 (104, 125) mmHg vs. 121 (109, 134) mmHg (1 mmHg=0.133 kPa), P=0.010). The 12-month follow-up rate of the two-way referral group was higher than the core hospital-treated group (73.8% vs. 56.0%, P=0.004). No significant between-group differences were observed in drug utilization rate of β-blockers, ACEI/ARB/ARNI, or sodium-glucose cotransporter 2 inhibitors during follow-up (all P>0.05), while mineralocorticoid receptor antagonists use showed a declining trend in both groups. Although the core hospital-treated group had higher target dose achievement rates for β-blockers (65.4% vs. 49.3%, P=0.042) and ACEI/ARB/ARNI (79.8% vs. 65.8%, P=0.046) than the two-way referral group, multivariate logistic regression indicated that the two-way referral model was not a negative predictor for these outcomes (all P>0.05). Both groups showed improved NT-proBNP, LVEDd, and LVEF from baseline (all P<0.001) with no significant difference in trends between groups (all P>0.05). There was no significant difference in the composite incidence (7.6% vs. 6.5%, P=0.674) and cumulative incidence (log-rank P=0.684) of cardiovascular death and heart failure rehospitalization at 12 months between two groups. Conclusion:The two-way referral model demonstrates advantages in improving medication adherence, drug utilization rates, and targetdoseachievement rates among CHF patients. This model not only promotes cardiac functional recovery but also reduces risks of cardiovascular mortality and heart failure rehospitalization, achieving comparable therapeutic and management outcomes to those observed in core hospital-treated patients.

Tetralogy of Fallot is the most common cause of cyanotic congenital heart disease,and it is related with the high incidence of pulmonary regurgitation in repaired tetralogy of Fallot that usually requires pulmonary valve replacement.Transcatheter pulmonary valve replacement can replace traditional surgery in treating pulmonary regurgitation,which can make up for the shortcoming of large injury.Echocardiography is important in assessing ventricular function,however,conventional echocardiographic parameters have several limitations.This study reviewed the application of two-dimensional speckle tracking imaging in evaluating the right and left ventricular function after transcatheter pulmonary valve replacement in pulmonary valve regurgitation after repaired tetralogy of Fallot.