OBJECTIVE To analyze the differences in chemical components of Gardenia jasminoides before and after processing with ginger， and to evaluate the quality differences among different producing areas. METHODS Ultra-high performance liquid chromatography-tandem time-of-flight mass spectrometry was used to analyze the compositional differences of G. jasminoides before and after processing with ginger. The water content， total ash， and ethanol-soluble extract content of ginger- processed G. jasminoides were determined according to the 2020 edition of Chinese Pharmacopoeia. High performance liquid chromatography was adopted to determine the contents of genipin gentiobioside， geniposide， crocin Ⅰ and crocin Ⅱ in ginger- processed G. jasminoides. RESULTS A total of 49 chemical components were identified from raw G. jasminoides and ginger- processed G. jasminoides， including 14 flavonoids， 15 iridoids， 10 organic acids， 2 alkaloids and 8 other compounds. Among them， 42 components were detected in raw G. jasminoides， 28 in ginger-processed G. jasminoides， and 21 components were common to both. After processing with ginger， raw G. jasminoides lost 21 components （including iridoids， flavonoids， alkaloids， and others）， while 7 chemical components were added （including coumarins， organic acids， organic acid esters， and flavonoids）. For the 15 batches of ginger-processed G. jasminoides， the water content ranged from 5.64% to 7.11%， total ash from 2.92% to 4.87%， and ethanol-soluble extract from 40.61% to 58.02%. The average contents of genipin gentiobioside， geniposide， crocin Ⅰ and crocin Ⅱ were 0.108 7， 0.542 2， 0.565 0， and 0.012 5 mg/g， respectively. CONCLUSIONS After processing with ginger， G. jasminoides loses 21 components， while 7 new components are added. Differences are observed in the water content， total ash， ethanol-soluble extract， and the contents of genipin gentiobioside， geniposide， crocin Ⅰ， and crocin Ⅱ of ginger-processed G. jasminoides from different producing areas. Notably， samples from Fujian exhibit high contents of genipin gentiobioside and ethanol-soluble extract， while samples from Jiangxi have a high content of crocin Ⅰ.

Background Prior epidemiological studies suggest that exposure to pyrethroid insecticides may adversely affect children’s respiratory health. However, only limited studies are currently available on this topic in China. Objective To explore the association between exposure to pyrethroid insecticides and pulmonary function in children in Shanghai. Methods From August 2019 to January 2020, a cross-sectional study was conducted, recruiting 163 healthy school-aged children (aged 5–12 years) from Shanghai Children’s Hospital, Shanghai Jiao Tong University School of Medicine. Basic information, including age, height, weight, and family income, was collected. Urine samples from the children were collected and were analyzed for the levels of three pyrethroid insecticide metabolites: 3-phenoxybenzoic acid (3-PBA), cis-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid (CDCCA), and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid (TDCCA). Gas chromatography-tandem mass spectrometry (GC-MS/MS) was used for the analysis. Spirometry was used to assess pulmonary function and recorded following parameters: peak expiratory flow (PEF), forced expiratory flow between the 25th and 75th percentiles of forced vital capacity (FEF_25-75), forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), and FEV₁/FVC. Multiple linear regression and restricted cubic spline models were used to evaluate the associations between urinary pyrethroid insecticide metabolite levels and pulmonary function parameters. Results The study included 163 school-aged children, with an average age of (7.04 ± 2.08) years and an average body mass index (BMI) of (16.04 ± 2.72) kg·m⁻²; 75 (46.01%) of the participants were boys. The detection rates of 3-PBA, TDCCA, and CDCCA in urine were 85.28%, 17.79%, and 4.91%, respectively. The median creatinine-adjusted 3-PBA concentration was 0.150 μg·g⁻¹. After adjusting for confounders such as height, BMI, sex, age, delivery mode, annual family income, and maternal education level, the multiple linear regression model showed that urinary 3-PBA levels were negatively associated with both FVC [β=−0.030, 95% confidence interval (CI): −0.058, −0.003; P=0.031] and FEV₁ (β=−0.032, 95%CI: −0.064, 0.000; P=0.04998). The final restricted cubic spline model showed a nonlinear association between urinary 3-PBA levels and FVC, FEV₁, PEF, and FEF_25-75（P for nonlinear < 0.05；P for overall < 0.05）. Conclusion The level of pyrethroid insecticide exposure in school-aged children in Shanghai is relatively high. The urinary 3-PBA concentration is negatively associated with pulmonary function, indicating potential adverse effects of pyrethroid insecticide exposure on respiratory health of school-aged children.

Objective To analyze the biomechanical responses after small incision lenticule extraction(SMILE)based on personalized biomechanical parameters of the human eye.Methods Through the results from the correlation analysis between corneal stromal elastic modulus and biomechanical parameters,the cornea elastic modulus was predicted and the material parameters were obtained.Based on clinical measurement data,52 personalized myopic human eye models were reconstructed to analyze the corneal biomechanical response after SMILE.Results The biomechanical response of the cornea varied from patients,and the vertex displacement and stress of the corneal surface increased or decreased after SMILE.On average,when residual stromal thickness(RST)ranged from 278 μm to 332 μm and IOP was 16-20 mmHg(1 mmHg=0.133 kPa),the change of vertex displacement and stress on the corneal surface after SMILE were less than those under IOP=11-16 mmHg.Under RST＞332 μm and IOP=11-16 mmHg,the corneal biomechanics was relatively stable.In addition,the corrected diopters of patients increased,and the deformation of corneal surface after SMILE was more drastic.Conclusions RST and IOP are important factors influencing corneal biomechanics.The material parameters of corneal tissues were predicted based on corneal biomechanical parameters.The cutting profiles and surgical parameters of SMILE may be optimized through analyzing the surgical effect after refractive surgery by reconstructing personalized finite element model of human eyes.

Objective To analyze the biomechanical responses after small incision lenticule extraction(SMILE)based on personalized biomechanical parameters of the human eye.Methods Through the results from the correlation analysis between corneal stromal elastic modulus and biomechanical parameters,the cornea elastic modulus was predicted and the material parameters were obtained.Based on clinical measurement data,52 personalized myopic human eye models were reconstructed to analyze the corneal biomechanical response after SMILE.Results The biomechanical response of the cornea varied from patients,and the vertex displacement and stress of the corneal surface increased or decreased after SMILE.On average,when residual stromal thickness(RST)ranged from 278 μm to 332 μm and IOP was 16-20 mmHg(1 mmHg=0.133 kPa),the change of vertex displacement and stress on the corneal surface after SMILE were less than those under IOP=11-16 mmHg.Under RST＞332 μm and IOP=11-16 mmHg,the corneal biomechanics was relatively stable.In addition,the corrected diopters of patients increased,and the deformation of corneal surface after SMILE was more drastic.Conclusions RST and IOP are important factors influencing corneal biomechanics.The material parameters of corneal tissues were predicted based on corneal biomechanical parameters.The cutting profiles and surgical parameters of SMILE may be optimized through analyzing the surgical effect after refractive surgery by reconstructing personalized finite element model of human eyes.

Objective To investigate the clinical features and genetic characteristics of patients with late-onset Pompe disease(LOPD).Methods A total of 13 patients diagnosed with LOPD in the First Affilia-ted Hospital of Zhejiang University School of Medicine from September 2020 to December 2023 were selected,and all patients were subjected to clinical investigation,GAA activity detection and GAA gene testing.Results Among the 13 patients,7 were males and 6 were females;5 were family patients and 8 were sporadic patients;and the median age of onset was 17 years(8-52 years),the median age of presentation was 24 years(10-52 years),and the median age of diagnosis was 31 years(14-58 years).In terms of the first symptoms,10 pa-tients presented with limb weakness and 3 patients presented with dyspnea.The average serum creatine kinase level was 552 U/L(55-1084 U/L),and the serum creatine kinase level was normal in one patient.All pa-tients had scoliosis and different degrees of restrictive ventilatory dysfunction.Neuroelectrophysiological exami-nations of 9 patients showed myogenic damage,and 8 of them had muscle tonic discharge.The mean value of GAA activity was 0.3 μmol/(L·h)[0.17-0.5 μmol/(L·h)].A total of 13 mutations were detected in GAA gene,and the most common mutation was c.2238G＞C(p.W746C).There were five new variant sites:c.543del(p.F181Lfs*40),c.839_840insCC(p.R281Pfs*34),c.1800_1823del(p.S601_R608del),c.2296T＞C(p.Y766H)and c.995C＞A(p.S332*).Conclusions LOPD is a rare disease that tends to delay diagnosis.Proximal limb weakness,decreased respiratory function,mild-to-moderate elevation of creatine kinase,scoliosis,and clinical inferior tonic discharge on electromyography are high-risk images of LOPD.c.2238G＞C(p.W746C)is a hotspot mutation,and the discovery of five new mutations enriches the GAA gene mutations lineage.

Objective:Evaluate the effects of brief mindfulness meditation training on improving negative e-motions,mindfulness attention awareness,and sleep quality in patients after percutaneous coronary intervention(PCI)for coronary heart disease.Methods:Eighty-four patients with coronary heart disease after PCI admitted to the cardiology department were selected.According to the principle of simple randomization,they were divided into an intervention group of 42 cases and a control group of 42 cases.The Self Rating Anxiety Scale/Self Rating De-pression Scale,Mindfulness Attention Awareness Scale,and Pittsburgh Sleep Quality Index Scale were used as eval-uation indicators before and after intervention.Results:The difference in total scores of anxiety,depression,and mindfulness attention awareness before and after intervention in the intervention group was higher than that in the control group(P＜0.05).The difference in total sleep score,sleep quality,time to fall asleep,sleep duration,use of hypnotic drugs,daytime dysfunction,and total sleep score before and after intervention was higher than that of the control group(P＜0.05).Conclusion:It suggests that brief mindfulness meditation training could alleviate negative emotions in patients with coronary heart disease after PCI,improve mindfulness awareness,and improve sleep quali-ty.

Objective To investigate the incidence and severity of symptoms in patients with gastric cancer who received chemotherapy,we constructed a symptom network to explore core symptoms and bridge symptoms.Furthermore,the study explores the association between core symptoms and Traditional Chinese Medicine(TCM)constitutions.Methods Patients with gastric cancer who received chemotherapy in the medical oncology and surgical oncology department from March to August 2023 were selected for the study using a convenience sampling method.The MD Anderson Symptom Inventory Gastrointestinal Cancer was used for evaluating gastrointestinal symptoms and their severity among patients receiving chemotherapy for gastric cancer,as well as assessing the classification of TCM constitution among patients.The symptom network model was constructed using the R programming language,and the central index was analyzed to determine the core symptoms and bridge symptoms.Binary logistic regression analysis was employed to assess the association between different physical conditions and the occurrence of core symptoms.Results A total of 346 electronic questionnaires were collected,with 340 valid ones,and the effective recovery rate was 98.3％.The 3 most prevalent and severe symptoms among the 340 patients with gastric cancer were fatigue(85.59％),lack of appetite(82.35％),and taste alteration(81.18％).The centrality index results indicated that grief exhibited the highest intensity,medium,and compactness centrality values(rs=8.23,rb=2.00,rc=0.03),making it the core symptom of this condition.Sleep disorders,lack of appetite,drowsiness,and taste alteration were identified as bridging symptoms with bridge intensities of 0.74,0.76,0.99,and 0.94 respectively.The results of Spearman correlation analysis showed that there was a positive correlation between sadness and qi-deficiency constitution,phlegm-dampness constitution(P＜0.05).The phlegm-dampness constitution was positively correlated with the taste alterations(P＜0.05).Conclusion In patients with gastric cancer,fatigue emerges as the most prominent symptom,while sadness assumes the core symptom.Additionally,sleep disorder,lack of appetite,drowsiness,and taste alteration are bridge symptoms.According to the principles of TCM constitution,qi-deficiency and phlegm-dampness are constitutions associated with a higher risk of experiencing sadness,and phlegm-dampness is a constitution associated with a higher risk of taste changes.Nurses can integrate core symptoms and TCM constitutions characteristics to optimize the strategies for symptom intervention.

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on the intracranial pressure in patients undergoing laparoscopic hysterectomy by measuring the optic nerve sheath diameter (ONSD) via ultrasound.Methods:Forty-two American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients, aged 18-60 yr, with a body mass index of 18-28 kg/m 2, scheduled for elective laparoscopic hysterectomy, were divided into 2 groups ( n=21 each) using a random number table method: control group (group C) and TEAS group (group T). In group T, TEAS was applied to the Yintang (EX-HN3) and Taiyang (EX-HN5) acupoints at 30 min before anesthesia, the stimulation used alternating dense-disperse waves at a frequency of 2/100 Hz, with the current intensity starting at 1 mA and increasing to the maximum tolerable level just below the pain threshold, and stimulation was maintained at the Hegu (LI4), Quanliao (SI18), and Fengchi (GB20) acupoints during surgery until the procedure was completed. Patients had electrode pads applied to the corresponding acupoints without electrical stimulation in group C. The ONSD was measured upon entry into the operating room (T 0), 3 min after anesthesia induction (T 1), 5 min after trendelenburg position (T 2), 30 min after trendelenburg position (T 3), 60 min after trendelenburg position (T 4), and immediately after the end of operation (T 5). Results:Compared to the baseline at T 0, the ONSD was significantly increased at T 3-5 in group C and at T 4, 5 in group T ( P<0.05). The ONSD was significantly lower at T 4, 5 in group T than in group C ( P<0.05). Conclusions:TEAS can reduce the intracranial pressure to some extent in patients undergoing laparoscopic hysterectomy.

The standardized management of medical insurance settlement list is very important to ensure the rational use of medical insurance funds. In March 2024, this study summarized the problems in the design, implementation, and promotion of the medical insurance settlement list based on expert interviews on the management of the medical insurance fund settlement list, as well as on-site investigations of 46 designated medical institutions in a province. These issues included incomplete design of reporting items that do not fully meet actual needs, inconsistent data collection formats, unclear main responsibilities and workflow of designated medical institutions, inconsistent reporting and information interface standards across regions, limited functionality of medical insurance settlement lists, lack of unified pre verification rules, and incomplete supporting systems. In response to these issues, this study proposed to strengthen the standardization and design of the medical insurance settlement list, clarify the main responsibilities and expand the functions of the list, add pre quality control rules, and improve supporting systems, so as to provide references for promoting the standardized management of medical insurance settlement lists in medical institutions of China.