(±)-Talapyrones A-F (1-6), six pairs of dimeric polyketide enantiomers featuring unusual 6/6/6 and 6/6/6/5 ring systems, were isolated from the fungus Talaromyces adpressus. Their structures were determined by spectroscopic analysis and HR-ESI-MS data, and their absolute configurations were elucidated using a modified Mosher's method and electronic circular dichroism (ECD) calculations. (±)-Talapyrones A-F (1-6) possess a 6/6/6 tricyclic skeleton, presumably formed through a Michael addition reaction between one molecule of α-pyrone derivative and one molecule of C₈ poly-β-keto chain. In addition, compounds 2/3 and 4/5 are two pairs of C-18 epimers, respectively. Putative biosynthetic pathways of 1-6 were discussed.
Polyketides/isolation & purification* ; Talaromyces/chemistry* ; Stereoisomerism ; Molecular Structure ; Circular Dichroism ; Pyrones/chemistry*

Objective To investigate the impact of type 2 inflammation markers blood eosinophils(EOS)and fractional exhaled nitric oxide(FeNO)on bronchodilator responsiveness(BDR)in patients with chronic obstructive pulmonary disease(COPD).Methods This study was conducted among 389 patients with an established diagnosis of COPD in our hospital from October,2019 to October,2023,who all underwent bronchial dilation test(BDT)of the large and small airways.Based on smoking history,blood EOS,and FeNO,these patients were divided group A(blood EOS<300/μL+FeNO<35 ppb+smoking history<20 pack-years),group B(blood EOS<300/μL+FeNO<35 ppb+smoking history≥20 pack-years),group C(blood EOS≥300/μL or FeNO≥35 ppb+smoking history≥20 pack-years),and group D(blood EOS≥300/μL or FeNO≥35 ppb+smoking history<20 pack-years)for analyzing the relationship between clinical indexes and BDR.Results BDR evaluation based on forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),and maximum mid-expiratory flow(MMEF)yielded consistent results,all showing a younger mean age,higher FeNO levels,and higher blood EOS counts and percentages in patients positive for BDT(P<0.05).The improvement value and improvement rate of FEV1 were significantly lower in group A than in group D.The improvement value and improvement rate of FEV1 as well as the improvement rate of MMEF were significantly lower in group B than in group D.In the overall patients,age and FeNO were significantly correlated with the improvement value and improvement rate of FEV1 and the improvement rate of MMEF(P<0.05).Conclusion Type 2 inflammation markers have different effects on BDR in the large and small airways of COPD patients,and their clinical significance needs further investigation.

Objective To investigate the effects of mindfulness-based parenting course on parenting burnout and parent-child relationship of adolescents' mothers.Methods A total of 203 mothers who volun-teered to participate in the mindfulness-based parenting course in a middle school in Chongqing City in May 2023 were recruited as the research subjects and divided into the intervention group (n=99) and control group (n=104).The intervention group attended the eight mindfulness parenting sessions twice a week,while the control group did not attended the course.The Parenting Burnout Assessment Scale,Parent-Child Relationship Self Evaluation Scale,Five Factors of Mindfulness scale and Satisfaction with Life Scale were used to evaluate the two groups before and after intervention.Results The scores of parent-child relationship and satisfaction with life had statistical difference between the two groups (P<0.05).Compared with before intervention,the parental burnout score of the intervention group was decreased,the scores of parent-child relationship,five fac-tors of mindfulness,scores of awareness,no judgment,no reaction dimensions and life satisfaction were in-creased,the differences were statistically significant (P<0.05).Compared with the control group,the scores of parent-child relationship,five factors of mindfulness,awareness dimension and life satisfaction after inter-vention in the intervention group were higher,while the score of conscious action dimension was lower,the differences were statistically significant (P<0.05).Conclusion The 4-week mindfulness-based parenting course could could decrease the parenting burnout,and improve the parent-child relationship and satisfaction with life.

Objective To investigate the impact of type 2 inflammation markers blood eosinophils(EOS)and fractional exhaled nitric oxide(FeNO)on bronchodilator responsiveness(BDR)in patients with chronic obstructive pulmonary disease(COPD).Methods This study was conducted among 389 patients with an established diagnosis of COPD in our hospital from October,2019 to October,2023,who all underwent bronchial dilation test(BDT)of the large and small airways.Based on smoking history,blood EOS,and FeNO,these patients were divided group A(blood EOS<300/μL+FeNO<35 ppb+smoking history<20 pack-years),group B(blood EOS<300/μL+FeNO<35 ppb+smoking history≥20 pack-years),group C(blood EOS≥300/μL or FeNO≥35 ppb+smoking history≥20 pack-years),and group D(blood EOS≥300/μL or FeNO≥35 ppb+smoking history<20 pack-years)for analyzing the relationship between clinical indexes and BDR.Results BDR evaluation based on forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),and maximum mid-expiratory flow(MMEF)yielded consistent results,all showing a younger mean age,higher FeNO levels,and higher blood EOS counts and percentages in patients positive for BDT(P<0.05).The improvement value and improvement rate of FEV1 were significantly lower in group A than in group D.The improvement value and improvement rate of FEV1 as well as the improvement rate of MMEF were significantly lower in group B than in group D.In the overall patients,age and FeNO were significantly correlated with the improvement value and improvement rate of FEV1 and the improvement rate of MMEF(P<0.05).Conclusion Type 2 inflammation markers have different effects on BDR in the large and small airways of COPD patients,and their clinical significance needs further investigation.

ObjectiveTo tentatively understand the status of radioactive contamination in nuclear medicine personnel. MethodsA total of 34 radiation staff engaged in nuclear medicine diagnosis and treatment were selected from two hospitals in Shanghai as the survey subjects.Among the 34 medical staff， 8 were nuclear medicine doctors， 14 were nuclear medicine technicians and 12 were nuclear medicine nurses. After surface contamination monitoring was first carried out to confirm that they had no surface radioactivity contamination， whole body scanning was performed with a whole body counter to determine whether they were internally contaminated with artificial radionuclides. ResultsThe α surface contamination was not detected in the nuclear medical staff. The β surface contamination of the nuclear medicine doctors， technicians and nurses was （13.8±0.8）， （14.1±0.8） and （14.0±0.7） times per second， respectively. There were 2， 2， and 4 nuclear medicine doctors who were contaminated with ¹⁸F， ^99mTc and ¹³¹I， 3， 5， and 2 nuclear medicine technicians who were contaminated with ¹⁸F， ^99mTc and ¹³¹I， and 6， 8， and 5 nuclear medicine nurses who were contaminated with ¹⁸F， ^99mTc and ¹³¹I， respectively. The ¹⁸F activity of nuclear medicine technicians was 1 997‒9 401 Bq， and the ^99mTc activity of nuclear medicine technicians and nurses was 3 699‒18 692 and 652‒388 22 Bq， respectively. One nuclear medicine nurse had a ^99mTc activity of 35 389 Bq. According to the preliminary estimation of ¹³¹I internal irradiation dose， the maximum committed effective dose of nuclear medicine doctors， technicians and nurses could reach 0.370， 0.018 and 0.584 mSv， respectively. ConclusionThe nuclear medicine staff are exposed to radioactive contamination， and it is important to monitor and evaluate their internal radiation doses.

Objective:To systematically analyze the concept evolution, defining attributes, cases, antecedents, and consequences of family resilience in children with chronic diseases, and to clarify the concept connotation of family resilience in children with chronic diseases from the perspective of nursing practice.Methods:The article on family resilience in children with chronic diseases was systematically searched in PubMed, Web of Science, Embase, Scopus, Cochrane Library, APA PsycNet, China National Knowledge Infrastructure, WanFang Data, VIP, and SinoMed. The retrieval period was from the establishment of the database to July 1, 2022. The Walker Avant concept analysis method was applied to the analysis.Results:Family resilience in children with chronic diseases had five defining attributes, including optimistic attitudes towards life, open communication styles, intimate family relationships, positive coping styles, and sufficient social support. The antecedents included demography characteristics, disease diagnosis, disease cognition, family rearing patterns and social and cultural environment. The consequences included both family and individual levels.Conclusions:Based on conceptual analysis, this study clarifies the conceptual attributes of family resilience in children with chronic diseases and its uniqueness compared to adult family resilience, providing a theoretical basis for constructing operational definitions, developing evaluation tools, and conducting precise interventions for future related research.

Objective: To investigate serum level changes of heart-type fatty acid-binding protein(H-FABP)and S100 calcium-binding protein B(S-100B)protein in elderly patients with chronic heart failure and their clinical significance. Methods: A total of 160 patients with chronic heart failure treated at our hospital were recruited, and 80 healthy individuals receiving regular check-ups were enrolled as normal controls.Serum levels of H-FABP and S-100B and cardiac function index scores were compared between patients with different cardiac function grades.Correlations of serum H-FABP and S-100B levels with N-terminal pro-B-type natrlure tiepeptide(NT-proBNP)and with cardiac function index scores in heart failure patients were analyzed.The sensitivity, specificity and accuracy of serum H-FABP, S-100B and NT-proBNP for heart failure detection were compared. Results: Serum levels of H-FABP, S-100B and NT-proBNP in elderly patients with chronic heart failure were elevated with increased cardiac function grading(F=9.823, 11.573 and 13.056, P=0.013, 0.000 and 0.000), and serum levels of H-FABP, S-100B and NT-proBNP were higher in elderly patients with heart failure than in the control group(P<0.05). Serum levels of H-FABP and S-100B were positively correlated with serum NT-proBNP levels, cardiac function grading and left ventricular end-diastolic diameter(LVEDd)(r=0.527, 0.510 and 0.487, P=0.008, 0.003 and 0.002; r=0.604, 0.496 and 0.533, P=0.006, 0.005 and 0.003), and were negatively correlated with left ventricular ejection fraction(LVEF)(r=-0.536 and-0.528, P=0.005 and 0.008). The sensitivity, specificity and accuracy of serum H-FABP combined with S-100B for heart failure detection were 93.2%, 91.6% and 95.7%, respectively. Conclusions Serum levels of H-FABP and S-100B are high in elderly patients with heart failure, and they are correlated with serum NT-proBNP levels, cardiac function grading and LVEDd.H-FABP combined with S-100B has a high positive rate for heart failure detection.

Gut microbiota is composed of trillions of microorganisms inhabiting in the human gastrointestinal tract,profoundly influences many aspects of host physiology.The roles of gut microbiota have been investigated extensively in the gastrointestinal,endocrine,neurological,cardiovascular and immune systems.This article reviews the recent research progress on the function of microbes in healthy organisms,the common research methods for microbiota,and the roles of microbiota in rheumatic immune diseases.It is expected that gut microbiota would be a novel target of clinical diagnosis and treatment for rheumatic immune diseases.

Objective? To investigate the status of rehabilitation confidence level of stroke patients and analyze the influencing factors. Methods? A convenient sampling method was used to select 200 stroke patients who were admitted to a tertiary hospital in Beijing from December 2018 to March 2019. The general data questionnaire and the Chinese version of the Confidence after Stroke Measure (CaSM) were used in this cross study and the infuencing factors were analyzed. Results? A total of 200 questionaires were distributed and 195 questionaires were collected. The score of CaSM confidence of stroke patients was (47.32±11.44). The result of univariate analysis showed that age, marital status, education, occupation, family income, living status, accompanying type, personality type, episode times were the influencing factors of the level of rehabilitation confidence of stroke patients (P＜0.05). Using the scores of CaSM of stroke patients as dependent variables and the statistically significant variables in analysis of single factor variance as independent variables, a multiple stepwise regression analysis was performed. The result showed that living alone, occupation for farmers, staff, introverted personality and accompanying type were the influencing factors of the level of rehabilitation confidence of stroke patients, which accounted for 20.40% of the variance in rehabilitation confidence of stroke patients. Conclusions? Nursing staff should pay more attention to the individual characteristics of patients on the basis of overall nursing, and develop practical and feasible rehabilitation plans from person to person, to help patients recover their pre-disease roles or find new meaningful roles as early as possible, and comprehensively improve their confidence in rehabilitation from three aspects: social confidence, positive attitude and self-confidence.

Multiple myeloma (MM) is a kind of hematological malignant tumors characterized by the unnormal proliferation of plasma cell in the bone marrow, which often occurs in elderly patients and has an obvious increase of incidence. The treatment of MM has made a great progress in the 21st century. Furthermore, with the addition of effective therapies and wide application of remissive treatment combination, the therapeutic goal of MM needs to be reevaluated. Minimal residual disease (MRD) negative status has become increasingly important, and some even consider it as the primary endpoint for therapy.