OBJECTIVE To provide a scientific basis for the quality evaluation and clinical application of Qingwen hufei granules. METHODS Fourteen batches of Qingwen hufei granules were used as samples to establish high-performance liquid chromatography （HPLC） fingerprints using the Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine （2012 Edition）. The chromatographic peaks were identified and the similarity was evaluated. Cluster analysis （CA）， principal component analysis （PCA）， and orthogonal partial least squares-discriminant analysis （OPLS-DA） were used to conduct chemical pattern recognition analysis on the 14 batches of samples. Meanwhile， the contents of neochlorogenic acid （NGA）， chlorogenic acid （CHA）， cryptochlorogenic acid （CGA）， forsythoside A （FTA）， 3，5-O-dicaffeoylquinic acid （3，5-O- DA）， 4，5-O-dicaffeoylquinic acid （4，5-O-DA）， and angoroside C （AGC） in the samples were determined by HPLC. RESULTS The methodological investigation results of both the fingerprint and the content determination complied with the relevant requirements. Fourteen common peaks were indicated in the HPLC fingerprints of the 14 batches of samples， and 7 of them were identified [NGA （peak 2）， CHA （peak 3）， CGA （peak 5）， FTA （peak 11）， 3，5-O-DA （peak 12）， 4，5-O-DA （peak 13）， and AGC （peak 14）]； the similarity of each sample was greater than 0.94. The results of CA and PCA showed that the samples could be classified into 3 categories； the results of OPLS-DA indicated that peak 4 （unknown）， peak 11 （FTA）， peak 8 （unknown）， peak 9 （unknown）， and peak 1 （unknown） were the differential components. The content ranges of NGA， CHA， CGA， 3，5-O-DA， FTA， 4，5-O-DA and AGC in the 14 batches of samples were 0.210 4-0.458 7， 0.269 1-0.506 3， 0.228 1-0.461 1， 0.443 9-1.044 6， 0.066 7-0.155 7， 0.062 8-0.143 8， and 0.057 4-0.105 7 mg/g， respectively. CONCLUSIONS The HPLC fingerprint and multi-component content determination methods established in this study are efficient and reliable， and can be used for the quality evaluation of Qingwen hufei granules.

Objective To explore the prevalence of depressive symptoms in postoperative patients with ovarian cancer and to analyze its influencing factors from multiple dimensions, including clinical characteristics, psychological factors, and laboratory indicators. Methods A cross-sectional study was conducted, which enrolled 235 postoperative patients with ovarian cancer. Depressive status was assessed using the patient health questionnaire, and the demographic, pathological, and medical record data of the patients were collected using the generalized anxiety disorder scale, Pittsburgh sleep quality index, European organization for research and treatment of cancer quality of life questionnaire core 30, and ECOG performance status score. Peripheral blood tumor marker (CA125), routine blood test, lymphocyte subsets, and serum cytokine levels were measured. Univariate and multivariate binary logistic regression analysis were used for statistical analysis. Results The prevalence of depression in postoperative patients with ovarian cancer was 39.15% (92/235). Univariate analysis showed that ECOG score ≥ 2 points, pain, anxiety, poor sleep quality, low quality of life, low life satisfaction, tumor recurrence, six or more cycles of chemotherapy, as well as higher levels of CA125, NLR, and NAR, and lower hemoglobin levels were significantly associated with depression (all P<0.05). Multivariate binary Logistic regression analysis showed that anxiety (OR=1.975, 95%CI: 1.231-3.170), sleep efficiency (OR=4.181, 95%CI: 1.211-14.43), sleep latency (OR=34.806, 95%CI: 4.258-284.542), ECOG performance status score, cognitive function (OR=0.918, 95%CI: 0.868-0.97), and life satisfaction were independent risk factors for depression (all P<0.05). Laboratory indicators were not independent influencing factors in the multivariate Logistic regression model. Conclusion Depression in postoperative patients with ovarian cancer is influenced by physiological, psychological, and social factors. Clinical management should focus on patients with anxiety, sleep disorders, poor physical condition, and low life satisfaction, and a comprehensive prevention and treatment strategy centered on psychological intervention and taking into account symptom management and social support should be implemented.

Objective:To investigate the application and effectiveness of the scaffolding teaching method in improving the teaching effect of septic shock and cultivating learning interest among medical students.Methods:A total of 52 medical students participating in intensive care internship were randomly divided into traditional teaching group and scaffolding teaching group,with 26 students in each group. The students in the traditional teaching group received traditional teaching,while those in the scaffolding teaching group received scaffolding teaching; assessments were performed in both groups. The two groups were compared in terms of theoretical assessment score,case assessment score,and degree of satisfaction with teaching. SPSS 25.0 was used to perform the t-test and the chi-square test. Results:There was no significant difference in theoretical assessment score at the time of department enrollment between the two groups [(5.31±1.05) vs. (5.35±0.94), P=0.890]. Compared with the traditional teaching group,the scaffolding teaching group had significantly higher scores in theoretical assessment [(7.19±1.17) vs. (6.39±1.20), P=0.017],specialized physical examination in case assessment [(7.15±0.66) vs. (6.29±0.59), P<0.001],and diagnosis and treatment regimen [(7.58±0.66) vs. (6.83±0.60), P<0.001],as well as significantly more interest in critical care medicine ( χ2=4.59, P=0.032). Conclusions:In the teaching process of the diagnosis and treatment of septic shock,building various types of scaffolds based on the basic knowledge of students can stimulate their interest and improve teaching effectiveness,which holds promise for further application in critical care medicine teaching.

Aim To investigate the effects of Mdivi-1 on A1 astrocyte activation and its associated signaling molecules.Methods CTX-TNA2 astrocytes were di-vided into the control,ACM,and low-,medium-,and high-dose Mdivi-1 groups based on concentration screening via CCK-8 assay.ACM,a DMEM high-glu-cose medium containing preset concentrations of IL-1α,TNF-α,and C1q,was used to induce A1 activa-tion.The ACM group was stimulated with ACM for 24 hours.Mdivi-1 groups were pretreated with correspond-ing concentrations of Mdivi-1 for 2 hours,followed by ACM stimulation for 24 hours.Real-time quantitative PCR and Western blot were employed to assess mRNA levels and protein expression of IL-1β,C3,and iNOS in all groups.Immunofluorescence and Western blot were used to detect the expression of signaling molecules NLRP3,caspase-1,and ASC.DHE labeling was used to assess and flow cytometry was used to examine reac-tive oxygen species(ROS)levels.Results The CCK-8 assay identified 5,10,and 25 μmol·L-1as ap-propriate concentrations for Mdivi-1 intervention in CTX-TNA2 cells.Real-time quantitative PCR and Western blot results indicated that,compared to the control group,IL-1 β,C3,and iNOS mRNA levels and protein expression were significantly elevated in the ACM group(P＜0.05).In contrast,these levels were significantly reduced in the 10 and 25 μmnol·L-1 Mdi-vi-1 groups compared to the ACM group(P＜0.05).Immunofluorescence and Western blot results confirmed that ACM stimulation significantly activated the NLRP3 inflammasome in astrocytes,while Mdivi-1 intervention effectively reversed the ACM-induced upregulation of NLRP3,caspase-1,and ASC.DHE staining results demonstrated that 5,10,and 25 μmol·L-1Mdivi-1 in-terventions partially reversed the ACM-induced in-crease in ROS levels in a dose-dependent manner.Conclusion Mdivi-1 effectively inhibits A1 astrocyte activation,potentially through modulation of ROS and the NLRP3 inflammasomes.

Mitochondrial dynamics refer to two modes of move-ment:mitochondrial fission and mitochondrial fusion.Stimula-tion from internal and external sources promotes the occurrence of mitochondrial dynamic changes,supporting cellular functional changes to adapt to physiological and pathological changes.This article systematically reviews relevant literature,providing an o-verview of the dynamic changes in mitochondrial fission/fusion from both physiological and pathological perspectives.It summa-rizes the essence of these changes by highlighting functional al-terations,including ion homeostasis,redox balance,energy me-tabolism,and programmed death signaling,and reveals the un-derlying mechanisms of action.Additionally,by focusing on key cellular components in allergic diseases,it discusses the impact of functional alterations in mitochondrial dynamic division/fusion on allergic diseases.Progressively examining the concept,func-tional alterations,and impact on allergic diseases,this study es-tablishes a connection between mitochondrial fission/fusion dy-namics and key cellular components of allergic diseases.It con-structs a networked map that outlines how these dynamics modu-late the progression of allergic diseases through diverse cellular components,aiming to guide mechanistic studies and systematic treatments for these diseases.

Mitochondrial dynamics refer to two modes of move-ment:mitochondrial fission and mitochondrial fusion.Stimula-tion from internal and external sources promotes the occurrence of mitochondrial dynamic changes,supporting cellular functional changes to adapt to physiological and pathological changes.This article systematically reviews relevant literature,providing an o-verview of the dynamic changes in mitochondrial fission/fusion from both physiological and pathological perspectives.It summa-rizes the essence of these changes by highlighting functional al-terations,including ion homeostasis,redox balance,energy me-tabolism,and programmed death signaling,and reveals the un-derlying mechanisms of action.Additionally,by focusing on key cellular components in allergic diseases,it discusses the impact of functional alterations in mitochondrial dynamic division/fusion on allergic diseases.Progressively examining the concept,func-tional alterations,and impact on allergic diseases,this study es-tablishes a connection between mitochondrial fission/fusion dy-namics and key cellular components of allergic diseases.It con-structs a networked map that outlines how these dynamics modu-late the progression of allergic diseases through diverse cellular components,aiming to guide mechanistic studies and systematic treatments for these diseases.

To explore the application effectiveness of generative artificial intelligence(GAI) in the standardized training assessment of critical care medicine residents.

Acute respiratory distress syndrome (ARDS) is a common respiratory emergency, but current clinical treatment remains at the level of symptomatic support and there is a lack of effective targeted treatment measures. Our previous study confirmed that inhalation of hydrogen gas can reduce the acute lung injury of ARDS, but the application of hydrogen has flammable and explosive safety concerns. Drinking hydrogen-rich liquid or inhaling hydrogen gas has been shown to play an important role in scavenging reactive oxygen species and maintaining mitochondrial quality control balance, thus improving ARDS in patients and animal models. Coral calcium hydrogenation (CCH) is a new solid molecular hydrogen carrier prepared from coral calcium (CC). Whether and how CCH affects acute lung injury in ARDS remains unstudied. In this study, we observed the therapeutic effect of CCH on lipopolysaccharide (LPS) induced acute lung injury in ARDS mice. The survival rate of mice treated with CCH and hydrogen inhalation was found to be comparable, demonstrating a significant improvement compared to the untreated ARDS model group. CCH treatment significantly reduced pulmonary hemorrhage and edema, and improved pulmonary function and local microcirculation in ARDS mice. CCH promoted mitochondrial peripheral division in the early course of ARDS by activating mitochondrial thioredoxin 2 (Trx2), improved lung mitochondrial dysfunction induced by LPS, and reduced oxidative stress damage. The results indicate that CCH is a highly efficient hydrogen-rich agent that can attenuate acute lung injury of ARDS by improving the mitochondrial function through Trx2 activation.

Objective To investigate the association between gastroesophageal reflux disease(GERD)and the risk of incident chronic obstructive pulmonary disease(COPD)and explore potential effect modifiers influencing this association.Methods Clinical data from 476 175 participants in the UK Biobank(2006-2010)were collected.A Cox proportional hazards model was used to assess the relationship between GERD and the risk of incident COPD.Subgroup analyses were conducted to examine potential modifiers of the primary findings.Results A total of 11 587(2.43%)new COPD cases were diagnosed.The Cox proportional hazards model revealed that GERD was associated with an increased risk of incident COPD(HR=1.59,95%CI=1.46-1.74,P<0.001).GERD was linked to a higher risk of incident COPD in individuals aged<60 years(P<0.001)and non-smokers(P=0.011).No association was observed between GERD and the risk of incident COPD in current smokers with a daily cigarette consumption<10 cigarettes(P=0.261).Conclusion GERD may increase the risk of incident COPD.
Humans ; Pulmonary Disease, Chronic Obstructive/epidemiology* ; Gastroesophageal Reflux/epidemiology* ; Middle Aged ; Proportional Hazards Models ; Incidence ; Male ; Risk Factors ; Female ; Aged

OBJECTIVE: To evaluate the effects of posterior cruciate ligament(PCL) resection on soft tissue elasticity and knee stability in total knee arthroplasty(TKA). METHODS: Six adult cadaveric knee specimens (involving 10 knees) were included in the study. With the assistance of the robotic system(TiRobot Recon, TINAVI, Beijing), total knee arthroplasty (TKA) was performed sequentially using cruciate retaining (CR) prostheses and posterior stabilizing (PS) prostheses. Between the two surgical procedures, the femoral and tibial osteotomy surfaces were not altered;only the posterior cruciate ligament (PCL) was resected and the intercondylar fossa was treated. After installing the femoral trial component, a soft tissue balance solver was used to apply tension ranging from 30 N to 90 N in 5 N increments at 0°, 10°, and 90° of knee flexion. Meanwhile, the medial and lateral joint gaps were measured synchronously. Based on the tension-gap coupling data, the equivalent elastic coefficients of the medial and lateral soft tissue sleeves at different knee flexion angles, as well as the range of the joint line convergence angle (JLCA) under fixed varus-valgus stress, were calculated. Additionally, the gap balance status under 80 N of tension was analyzed. Self-control comparisons of each indicator were conducted before and after PCL resection to analyze the change patterns. RESULTS: After PCL resection, in the fully extended position (knee flexion 0°). The medial equivalent elastic coefficient was 32.2 (25.7, 63.3) N·mm^-1 for the CR prosthesis and 27.7 (22.0, 51.9) N·mm^-1 for the PS prosthesis, and the statistically significant difference (P=0.013). The range of JLCA was 0.41°(0.26, 0.55)° for the CR prosthesis, which was smaller than 0.75° (0.40, 0.98)° for the PS prosthesis, and the difference was statistically significant(P=0.041). At 90° of knee flexion, the medial joint gap was 10.7(10.1, 11.7) mm for the CR prosthesis, which was smaller than 12.1(10.9, 15.1) mm for the PS prosthesis, with a statistically significant difference(P=0.011). No statistically significant differences were observed in other joint gaps. CONCLUSION PCL resection reduces the rigidity of the medial soft tissues in the fully extended knee and increases the medial joint gap in the flexed position, thereby affecting knee stability and balance. This finding suggests that PS and CR prostheses may require different morphological designs, and there should be differences in indications and osteotomy strategies between CR-TKA and PS-TKA. CR-TKA is more suitable for patients with preoperative medial soft tissue laxity.
Humans ; Posterior Cruciate Ligament/physiopathology* ; Knee Joint/physiopathology* ; Arthroplasty, Replacement, Knee ; Elasticity ; Male ; Female ; Middle Aged ; Aged ; Biomechanical Phenomena ; Adult