Kupffer cells (KCs), as residents and sentinels of the liver, are involved in the formation of hepatic fibrosis (HF). However, the biological functions of circular RNAs (circRNAs) in KCs to HF have not been determined. In this study, the expression levels of circRNAs, microRNAs, and messenger RNAs (mRNAs) in KCs from a mouse model of HF mice were investigated using microarray and circRNA-Seq analyses. circDcbld2 was identified as a candidate circRNA in HF, as evidenced by its up-regulation in KCs. Silver staining and mass spectrometry showed that Wtap and Igf2bp2 bind to cirDcbld2. The suppression of circDcbld2 expression decreased the KC inflammatory response and oxidative stress and inhibited hepatic stellate cell (HSCs) activation, attenuating mouse liver fibrogenesis. Mechanistically, Wtap mediated the N ⁶-methyladenosine (m6A) methylation of circDcbld2, and Igf2bp2 recognized m6A-modified circDcbld2 and increased its stability. circDcbld2 contributes to the occurrence of HF by binding miR-144-3p/Et-1 to regulate the inflammatory response and oxidative stress. These findings indicate that circDcbld2 functions via the m6A/circDcbld2/miR-144-3p/Et-1 axis and may act as a potential biomarker for HF treatment.

Since the concept of patient versions of guidelines （PVGs） was introduced into China， several PVGs have been published in China， but we found that there is a big difference between the concept of PVG at home and abroad， and the reason for this difference has not been reasonably explained， which has led to ambiguity and even misapplication of the PVG concept by guideline developers. By analyzing the background and purpose of PVGs， and the understanding of the PVG concept by domestic scholars， we proposed the term patient guidelines （PGs）. This refers to guidelines developed under the principles of evidence-based medicine， centered on health issues that concern patients， and based on the best available evidence， intended for patient use. Except for the general attribute of providing information or education， which is typical of common health education materials， PGs also provide recommendations and assist in decision-making， so PGs include both the patient versions of guidelines （PVG） as defined by the Guidelines International Network （GIN） and "patient-directed guidelines"， i.e. clinical practice guidelines resulting from the adaptation or reformulation of recommendations through clinical practice guidelines.

Objective:To evaluate the clinical efficacy of Chaihu Longgu Muli Decoction in the treatment of post-stroke depression.Methods:A total of 130 patients with post-stroke depression who met the inclusion criteria from April 2019 to December 2020 were enrolled in the study. The patients were randomly divided into two groups with 65 cases in each group. The control group was treated with Flupentixol and melitracen tablets on the basis of routine treatment, and the observation group was treated with Chaihu Longgu Muli Decoction on the basis of routine treatment. Both groups were treated for 4 weeks. TCM syndrome scores were performed before and after treatment. The levels of serum Hcy and hs CRP, Plasma 5-HT and brain-derived neurotrophic factor (BDNF) were detected by ELISA, and the ratio of neutrophils to lymphoblasts (NLR) was recorded.Results:The response rate was 92.3% (60/65) in the observation group and 75.4% (49/65) in the control group. There was significant difference between the two groups ( χ2=6.87, P=0.009). After treatment, the serum Hcy [(11.87±1.56) μmol/L vs. (16.69±1.77) μmol/L, t=16.47] and hs-CRP [(7.81±1.66) mg/L vs. (16.45±4.87) mg/L, t=13.54] in the observation group were significantly lower than those in the control group ( P<0.01), and Plasma 5-HT [(150.41±17.54) μg/L vs. (123.24±16.02) μg/L, t=9.22], BDNF [(19.45±2.48) μg/L vs. (12.56 ± 2.23) μg/L, t=16.66] were significantly higher than those in the control group ( P<0.01). After treatment, the NLR and TCM syndrome scores in the observation group were significantly lower than those in the control group ( t values were 6.03 and 7.15, respectively, all Ps<0.01). Conclusion:The Chaihu Longgu Muli Decoction combined with western medicine treatment can correct the levels of Hcy, hs-CRP, 5-HT, BDNF and NLR in peripheral blood, alleviate the state of depression and anxiety of patients with post-stroke depression.

Realtime xCELLigence analysis (RTCA) is a new cell detection technology to continuously monitor, record and analyze a variety of information generated by cell activity. In drug research, it plays an important role in assessing myocardial toxicity and cell biological activity. Here, we first introduce the underlying mechanisms and characteristics of RTCA. Then we review the applications of RTCA in the research of myocardial toxicity and cell biological activity, to provides the fundamental baseline for understanding and exploiting RTCA. With the real-time, unlabeled, non-invasive, high throughput, and high accuracy features, RTCA not only promotes drug research and development, but also has a broad and good application prospect in other fields.
Pharmaceutical Preparations

Objective:To evaluate left lateral position I-scope tracheal intubation for optimizing anesthesia time during the patient′s general anesthesia before endoscopic submucosal dissection.Methods:A total of 150 patients with early upper gastrointestinal cancer were enrolled in the study for endoscopic submucosal dissection in Beijing Friendship Hospital, Capital Medical University from March to December 2018. Patients were randomly divided into three groups with 50 patients in each group. The SL group underwent I-scope tracheal intubation in the left lateral position, SS group underwent I-scope tracheal intubation in the supine position, and MS group underwent Macintosh laryngoscope tracheal intubation in the supine position. Preoperative non-essential anesthesia time (the time between successful intubation and operation), attempts for tracheal intubation and complications related to intubation were analyzed.Results:The preoperative non-essential anesthesia time was 8.55±2.16 min in SL group, 10.44±2.43 min in SS group, and 10.56±3.20 min in MS group, with significant difference among three groups ( F=9.08, P<0.001), and the time in SL group was shorter than that in SS group ( P<0.001) and MS group ( P<0.001). However, there was no statistical difference in non-essential anesthesia time between the SS group and MS group ( P=0.819). The success rate of first attempt intubation was 96.0% (48/50) in SL group, 90.0% (45/50) in SS group, and 92.0% (46/50) in MS group, with no significant differences among three groups ( χ2=2.601, P=0.627). The incidences of cough and expectoration, dry mouth and mucosal injury showed no statistical differences among three groups during transference to the ward after tracheal catheter removal (all P>0.05). The incidence of sore throat in MS group (38.0%, 19/50) was higher than that in SL group (18.0%, 9/50, P<0.05) and SS group (18.0%, 9/50, P<0.05), while the difference was not statistically significant between SL group and SS group ( P>0.05). Conclusion:I-scope tracheal intubation in the left lateral position may shorten the preoperative anesthesia time in patients undergoing general anesthesia for the operation in the left lateral position, and optimize overall anesthesia time.

Objective To investigate competence factors in new teachers of medical schools and construct the competence model. Methods The competence questionnaire for new teachers of medical schools was designed based on the literature review, semi-structured interviews and delphi method, and the questionnaire survey was conducted in new teachers of 12 medical schools . Factors were extracted by principal component analysis. Results Cronbach's α of questionnaire was 0.95. There were six factors in the model: scientific research ability (38.282％), teaching ability (10.118％), professional ethics (7.150％), communication skills (5.707％), personal characteristics (4.707％) and self-improvement ability (4.218％). Conclusion Construction of competence model in new teachers of medical schools can optimize teachers' pre-job training and provide references to study related policies.

OBJECTIVE： To establish a method for content determination of N-（E）-p-coumaroyltyrosine in leaves of Abrus cantoniensis， and to optimize its purification technology. METHODS： HPLC method was adopted for the content determination of N-（E）-p-coumaroyltyrosine in A. cantoniensis. The determination was performed on Hypersil BDS C18 column with mobile phase consisted of 0.1％ formic acid water （A）-methanol （B） （gradient elution） at a flow rate of 1.0 mL/min. The column temperature was set at 25 ℃. The detection wavelength was set at 300 nm， and sample size was 10 μL. Using polyamide resin as material， the yield of N-（E）-p-coumaroyltyrosine as indicators， single factor test was used to optimize the purification technology of N-（E）-p-coumaroyltyrosine， such as concentration， sample size， stationary adsorption time. RESULTS： The linear range was 2.575-51.50 μg （r＝0.999 9） for N-（E）-p-coumaroyl-tyrosine. The limit of quantification was 0.000 618 μg， and the detection limit was 0.000 129 μg. RSDs of precision， stability and reproducibility tests were all lower than 3％. The recoveries were 97.04％-102.43％ （RSD＝2.06％， n＝6）. The optimal purification technology was as follows： the concentration of the sample solution was 0.04 g /mL （by the leaves of A. cantoniensis）； sample capacity 50 mL； the sample flow rate was 1.0 mL/min； the stationary adsorption time was 20 min； the eluting solvents were ammonia containing water （containing 0.1％ acetic acid）， 20％ ethanol （containing 0.1％ acetic acid） and ammonia（pH 10）. Average yield was 98.94％，average dry paste content was 61.17 mg/g， and average dry paste purity was 19.73％ by optimal purification technology. CONCLUSIONS： Established method is simple， accurate and stable. The optimized technology is stable and feasible.

Spinal bifida is one of the phenotypes of neural tube defects,which are influenced by genetic and environmental factors.There are many genes involved in the occurrence of spinal bifida,and the main genes and animal models are mainly concentrated in the signaling pathway.This article reviews the research progresses on pathogenesis of spinal bifida and relationship between key genes,and further clarifies the pathogenesis of spinal bifida,and achieves more effective prevention and control of neural tube defects.

Nurses from all medical environments have close contacts with asthma patients, it can recognize the early indicators of poor asthma control, and provide self-management education and play important roles in the promotion of asthma control. In order to improve the quality of nursing practice in adult asthma control, Registered Nurses＇ Association of Ontario(RNAO) in Canada published the guidelines of Adult Asthma Care: Promoting Control of Asthma (Second Version) in 2017 after summarizing the latest evidence in order to provide systematic guidance. This articles analyzed the suggestions in the nursing practice guidelines and introduce the suggestions from all sections including nursing assessment, planning, implementation and evaluation in nursing practice.

Dexmedetomidine( DEX) is a pure potent, highly se-lective and highly specific agonist ofα2-adrenergic receptors with sedative, analgesic and sympatholytic properties. The sedative effect mimics natural sleep of“arousable” and“cooperative” se-dation without respiratory depression. Due to the above properties and advantages, DEX has received adequate attention in clinical practice and its spectrum of application is also expanding. In re-cent years, it is proved that DEX is neuroprotective not only in animal researches but also in clinical studies. The neuroprotec-tion of DEX and its related mechanism will be briefly reviewed in this paper.