A comprehensive phytochemical investigation of the leaves and twigs of Physalis angulata. var. villosa resulted in the isolation of 23 withanolide derivatives, including one novel 13,20-γ-lactone withanolide derivative (1) and three new withanolide derivatives (2-4). Architecturally, physalinin A (1) represents the first identified type B withanolide featuring a 13,20-γ-lactone moiety. The molecular structures of all isolates were elucidated using an integrated approach combining nuclear magnetic resonance (NMR) spectroscopy, mass spectrometry (MS), infrared (IR) spectroscopy, and quantum chemical calculations to confirm structural assignments. The antiproliferative activities of all isolated withanolides were evaluated against four human cancer cell lines (HEL, HCT-116, Colo320DM, and MDA-MB-231). Among them, eight derivatives (2, 5-8, 14, 15, and 23) exhibited significant inhibitory effects, with half-maximal inhibitory concentration (IC₅₀) values of 0.18 ± 0.03 to 17.02 ± 0.21 μmol·L^-1. Structure-activity relationship (SAR) analysis suggested that the presence of an epoxide ring enhances anticancer activity, potentially through increased reactivity or specific interactions with molecular targets involved in cancer progression. These findings underscore the pharmacological potential of withanolides as promising lead compounds for the development of novel anticancer therapeutics.
Withanolides/isolation & purification* ; Physalis/chemistry* ; Humans ; Molecular Structure ; Cell Line, Tumor ; Antineoplastic Agents, Phytogenic/isolation & purification* ; Cell Proliferation/drug effects* ; Plant Leaves/chemistry* ; Plant Extracts/pharmacology*

Objective To investigate the rehabilitation outcome in hemiplegic stroke patients with upper limb dysfunction treated with electromyographic(EMG)biofeedback therapy in combination with an intelligent Tongluo therapeutic apparatus.Methods A total of 132 stroke patients with hemiplegia were chosen and divided into observation group and control group according to the rehabilitation strategies,with 66 cases in each group.Control group was treated with EMG biofeedback therapy,while observation group was given the integrated therapy of EMG biofeedback therapy and intelligent Tongluo therapeutic apparatus.The two groups were compared for motor function of the hemiplegic upper limb(shoulder,hand and wrist muscle),integrated electromyography(iEMG)in the affected limb flexion and extension(biceps brachii and triceps brachii),range of motion of the shoulder joint(abduction,external rotation,internal rotation)and Barthel index of activities of daily living(ADL).Results The differences in the iEMG of biceps brachii and triceps brachii of the elbow joint,motor function of the hemiplegic upper limb,range of motion of the shoulder joint and ADL between two groups before treatment were trivial(P>0.05).The treatment in observation group increased the iEMG of biceps brachii and triceps brachii in elbow flexion(P<0.05),decreased the iEMG of biceps brachii in elbow extension but increased the iEMG of triceps brachii in elbow extension(P<0.05),and these improvements were more significant than those in control group(P<0.05).After treatment,the scores for shoulder function,hand function,and wrist muscle function in observation group increased from(12.23±2.76)to(26.77±4.28),(6.54±1.34)to(15.35±2.46),and(2.36±0.46)to(8.13±2.52),and the scores of the above indexes were higher than those in control group(P<0.05).The shoulder abduction,external rotation and internal rotation ranges of motion in observation group after treatment were greater than those before treatment[(90.77±8.35)° vs(61.23±6.35)°,(45.36±5.33)° vs(26.33±4.65)°,(52.55±5.86)° vs(32.44±3.87)°],and the observation group had greater shoulder ranges of motion than control group(P<0.05).The ADL score in observation group after treatment was higher than that before treatment[(62.45±5.25)vs(33.35±4.85),P<0.05],and it was also higher than that in control group(P<0.05).Conclusion EMG biofeedback therapy combined with intelligent Tongluo therapeutic apparatus can effectively improve the iEMG in the affected limb flexion and extension,enhance the ranges of motion of the shoulder joint,and ultimately improve the upper limb motor function and life quality of hemiplegic stroke patients.

AIM:The study aims to investigate the effects of Huayu-Qutan formula(HYQT)-medicated serum on oleic acid-induced lipid damage and endoplasmic reticulum stress(ERS)in HepG2 cells,and to explore the mecha-nism underlying the prevention and treatment of lipid metabolism disorders by HYQT.METHODS:The HepG2 cells were treated with various concentrations of oleic acid,and CCK8 assay,oil red O staining and ELISA were used to identify the optimal treatment concentration and time of oleic acid and HYQT-medicated serum.Moreover,the cells were divided into control,model,thapsigargin(Tg),and Tg+HYQT groups.Cellular lipid deposition was measured using oil red O staining,while triglyceride(TG)and free fatty acid(FFA)levels were assessed by ELISA.Transmission electron micros-copy was used to examine endoplasmic reticulum structures,and RT-qPCR and Wes fully automated protein quantification analysis system were used to measure the mRNA and protein expression of glucose-regulated protein 78(GRP78),sterol regulatory element binding protein 1c(SREBP1c),acetyl coenzyme A carboxylase(ACC1),fatty acid synthase(FAS)and stearoyl coenzyme A desaturase 1(SCD1)in different groups.RESULTS:Significant lipid deposition was induced in HepG2 cells after treatment with 1 000 μmol/L oleic acid,while treatment with serum containing 10%HYQT for 48 h was found to be optimal.Compared with control group,the cells in model group showed significant deposition of oil red O-stained lipid droplets in the cytoplasm,associated with endoplasmic reticulum expansion,ERS,and nuclear condensa-tion.The TG and FFA levels,and the mRNA and protein expression levels of GRP78,SREBP1c,ACC1,FAS and SCD1 were increased significantly(P<0.01).Compared with model group,the cells treated with HYQT-mediated serum showed marked decrease in the number of lipid droplets in the cytoplasm,with restored endoplasmic reticulum morphology.The TG and FFA levels were significantly reduced(P<0.01),and the mRNA and protein levels of factors related to ERS and de novo fatty acid synthesis were markedly decreased(P<0.01).Treatment with Tg,an ERS agonist,led to greater accu-mulation of cytoplasmic lipid droplets and increased endoplasmic reticulum expansion.Marked variations in the morpholo-gy and size of the endoplasmic reticulum were observed,with fusion and clustering of vacuoles.The TG and FFA levels,and the expression of ERS-and fatty acid synthesis-related factors were increased(P<0.01).Compared with Tg group,the cells treated with Tg+HYQT showed reduced number of cytoplasmic lipid droplets,attenuated endoplasmic reticulum dilation,and decreased number and volume of vacuoles,while the TG and FFA levels and the expression of ERS-and fatty acid synthesis-associated factors were significantly decreased(P<0.01).CONCLUSION:Serum containing HYQT alle-viates oleic acid-induced lipid damage in HepG2 cells by inhibiting ERS-induced de novo synthesis of fatty acids.

AIM:The study aims to investigate the effects of Huayu-Qutan formula(HYQT)-medicated serum on oleic acid-induced lipid damage and endoplasmic reticulum stress(ERS)in HepG2 cells,and to explore the mecha-nism underlying the prevention and treatment of lipid metabolism disorders by HYQT.METHODS:The HepG2 cells were treated with various concentrations of oleic acid,and CCK8 assay,oil red O staining and ELISA were used to identify the optimal treatment concentration and time of oleic acid and HYQT-medicated serum.Moreover,the cells were divided into control,model,thapsigargin(Tg),and Tg+HYQT groups.Cellular lipid deposition was measured using oil red O staining,while triglyceride(TG)and free fatty acid(FFA)levels were assessed by ELISA.Transmission electron micros-copy was used to examine endoplasmic reticulum structures,and RT-qPCR and Wes fully automated protein quantification analysis system were used to measure the mRNA and protein expression of glucose-regulated protein 78(GRP78),sterol regulatory element binding protein 1c(SREBP1c),acetyl coenzyme A carboxylase(ACC1),fatty acid synthase(FAS)and stearoyl coenzyme A desaturase 1(SCD1)in different groups.RESULTS:Significant lipid deposition was induced in HepG2 cells after treatment with 1 000 μmol/L oleic acid,while treatment with serum containing 10%HYQT for 48 h was found to be optimal.Compared with control group,the cells in model group showed significant deposition of oil red O-stained lipid droplets in the cytoplasm,associated with endoplasmic reticulum expansion,ERS,and nuclear condensa-tion.The TG and FFA levels,and the mRNA and protein expression levels of GRP78,SREBP1c,ACC1,FAS and SCD1 were increased significantly(P<0.01).Compared with model group,the cells treated with HYQT-mediated serum showed marked decrease in the number of lipid droplets in the cytoplasm,with restored endoplasmic reticulum morphology.The TG and FFA levels were significantly reduced(P<0.01),and the mRNA and protein levels of factors related to ERS and de novo fatty acid synthesis were markedly decreased(P<0.01).Treatment with Tg,an ERS agonist,led to greater accu-mulation of cytoplasmic lipid droplets and increased endoplasmic reticulum expansion.Marked variations in the morpholo-gy and size of the endoplasmic reticulum were observed,with fusion and clustering of vacuoles.The TG and FFA levels,and the expression of ERS-and fatty acid synthesis-related factors were increased(P<0.01).Compared with Tg group,the cells treated with Tg+HYQT showed reduced number of cytoplasmic lipid droplets,attenuated endoplasmic reticulum dilation,and decreased number and volume of vacuoles,while the TG and FFA levels and the expression of ERS-and fatty acid synthesis-associated factors were significantly decreased(P<0.01).CONCLUSION:Serum containing HYQT alle-viates oleic acid-induced lipid damage in HepG2 cells by inhibiting ERS-induced de novo synthesis of fatty acids.

Objective To investigate the rehabilitation outcome in hemiplegic stroke patients with upper limb dysfunction treated with electromyographic(EMG)biofeedback therapy in combination with an intelligent Tongluo therapeutic apparatus.Methods A total of 132 stroke patients with hemiplegia were chosen and divided into observation group and control group according to the rehabilitation strategies,with 66 cases in each group.Control group was treated with EMG biofeedback therapy,while observation group was given the integrated therapy of EMG biofeedback therapy and intelligent Tongluo therapeutic apparatus.The two groups were compared for motor function of the hemiplegic upper limb(shoulder,hand and wrist muscle),integrated electromyography(iEMG)in the affected limb flexion and extension(biceps brachii and triceps brachii),range of motion of the shoulder joint(abduction,external rotation,internal rotation)and Barthel index of activities of daily living(ADL).Results The differences in the iEMG of biceps brachii and triceps brachii of the elbow joint,motor function of the hemiplegic upper limb,range of motion of the shoulder joint and ADL between two groups before treatment were trivial(P>0.05).The treatment in observation group increased the iEMG of biceps brachii and triceps brachii in elbow flexion(P<0.05),decreased the iEMG of biceps brachii in elbow extension but increased the iEMG of triceps brachii in elbow extension(P<0.05),and these improvements were more significant than those in control group(P<0.05).After treatment,the scores for shoulder function,hand function,and wrist muscle function in observation group increased from(12.23±2.76)to(26.77±4.28),(6.54±1.34)to(15.35±2.46),and(2.36±0.46)to(8.13±2.52),and the scores of the above indexes were higher than those in control group(P<0.05).The shoulder abduction,external rotation and internal rotation ranges of motion in observation group after treatment were greater than those before treatment[(90.77±8.35)° vs(61.23±6.35)°,(45.36±5.33)° vs(26.33±4.65)°,(52.55±5.86)° vs(32.44±3.87)°],and the observation group had greater shoulder ranges of motion than control group(P<0.05).The ADL score in observation group after treatment was higher than that before treatment[(62.45±5.25)vs(33.35±4.85),P<0.05],and it was also higher than that in control group(P<0.05).Conclusion EMG biofeedback therapy combined with intelligent Tongluo therapeutic apparatus can effectively improve the iEMG in the affected limb flexion and extension,enhance the ranges of motion of the shoulder joint,and ultimately improve the upper limb motor function and life quality of hemiplegic stroke patients.

The key pathogenesis of coronary heart disease （CHD） is spleen deficiency and phlegm stasis， and dysfunctional high-density lipoprotein （dys-HDL） may be the biological basis for the occurrence of CHD due to spleen deficiency and phlegm stasis. Considering the biological properties and effects of high-density lipoprotein （HDL）， it is believed that the structure and components of HDL are abnormal in the state of spleen deficiency which led to dys-HDL； and dys-HDL contributes to the formation of atherosclerotic plaques through two major pathways， namely， mediating the dysfunction of endothelial cells and mediating the foaminess of macrophages and smooth muscle cells， thus triggering the development of CHD. It is also believed that dys-HDL is a microcosmic manifestation and a pathological product of spleen deficiency， and spleen deficiency makes foundation for the production of dys-HDL； dys-HDL is also an important biological basis for the phlegm-stasis interactions in CHD. The method of fortifying spleen， resolving phlegm， and dispelling stasis， is proposed as an important principle in the treatment of CHD by traditional Chinese medicine， which can achieve the therapeutic purpose by affecting the changes in the structure and components of dys-HDL， thus revealing the scientific connotation of this method， and providing ideas for the diagnosis and treatment of CHD by traditional Chinese medicine.

Objective To conduct Rh blood group serological testing and third-generation sequencing(TGS)on 22 RhD variant voluntary blood donors in Chongqing and explore the phenotypic distribution and genotyping of RhD variants in Chongqing.Methods From January to August 2023,individuals who participated in blood donation in our blood center were selected as the study objects.RhD variant phenotype identification was performed using routine serological methods.Once the RhD variants were identified,tests on different antigenic epitopes of RhD were conducted using a D-screen assay kit.Furthermore,after the genomic DNA from 22 RhD variant blood samples was extracted,imbraided primers design and multi-segment amplification and splicing were used to sequence the full-length RHD gene for TGS.The RHD gene sequence was analyzed using SnapGene software.Results Among the 22 RhD variants,8 were DVI type 3(36.36%),with the main mutation of RHD-CE(3-6)-D hybrid allele.Six cases(27.27%)showed partial weak D15 type,with the main mutation of c.845G>A.There were 6 cases of Asia type Del(27.27%),with the main mutation of c.1227G>A.One case was weak D17 type with a mutation of c.340C>T and 1 case speculated to be partial D(c.491A>T,p.Asp164Val,missense mutation).Conclusion The most common RhD variant phenotype among blood donors in Chongqing is DVI type 3,and the full-length haplotype sequence of RHD variant alleles can be obtained by Pacific Bioscience single-molecule real-time sequencing(SMRT).

ObjectiveTo establish a vaginal self-sampling HPV cervical cancer screening model in Hainan Province, to analyze the application of p16 protein detection in HPV positive and non-HPV16 /18 shunt screening. MethodsFrom January 2019 to September 2022, a total of 200 women from the targeted population was randomly selected for vaginal self-sampling HPV typing test to screen cervical cancer using randomized numeric table method, followed by cervical cytology sampling for cytology p16 protein detection. Postoperative pathological examination was used as the gold standard. Multivariate logistic regression analysis was used to analyze the influencing factors of HPV positive detection rate in cervical lesions, and the nomogram model was constructed simultaneously. The receiver operating characteristic(ROC) curve and calibration curve were used for evaluating the accuracy of the nomogram model. Differences in the distribution of self-sampled HPV-positive and HPV infected genotypes were recorded, and the application of p16 protein detection in HPV-positive and non-HPV16/18 shunt screening was analyzed. ResultsAged ≥40 years, BMI ≥28.00 kg·m^-2, number of sexual partners ≥2, frequency of sexual life ≥10 times·month^-1, bleeding from sexual intercourse, and age of first sexual intercourse <22 years were the risk factors for HPV positive of cervical lesions (all P<0.001). The results of ROC curve and calibration curve showed that the area under ROC curve (AUC) was 0.874 (95%CI: 0.823‒0.907, P<0.05), the sensitivity was 0.835, the specificity was 0.847, and the Youden index was 0.672, indicating a good fit of the model. Results of vaginal self-sampling HPV test showed that the positive rate of HPV was 86.50% (173/200). HPV high-risk infection types mainly included HPV16, 18, 31, 33, 35, 39, 45, 52, 56, 58, 59, 68, 73, and 82. Single HPV infection accounted for 95.95% (166/173), 2.89% (5/173) were infected with two types of HPV, and 1.16% (2/173) were infected with three or more types of HPV. Colposcopic pathologic diagnosis was used as the gold standard, and the results showed that the accuracy of p16 protein detection in the diagnosis of cervical cancer was 93.50% (187/200), with a sensitivity of 96.53% (167/173), and a specificity of 74.07% (20/27). The negative and positive predictive value were 76.92% (20/26) and 95.98% (167/174), respectively. The results of shunt screening showed that there were 80 cases infected with HPV16, 79 cases infected with HPV18 and 41 cases of non-HPV16/18, with a sensitivity of 90.91%, 90.32% and 86.67%, a specificity of 71.43%, 64.71% and 72.73%, a negative predictive value of 62.50%, 64.71% and 66.67%, a positive predictive value of 93.75%, 90.32% and 89.66%, and an accuracy of 87.50%, 84.81% and 82.93%, respectively. The specificity and accuracy of p16 positive screening for cervical cancer were significantly higher than that of HPV positive detection, but the false positive rate was significantly lower than that of HPV positive detection. The AUCs of HPV positive, p16 positive and combination of the two detection methods for cervical cancer were 0.603, 0.822 and 0.907, respectively. ConclusionVaginal self-sampling HPV testing is a widely accepted mode for cervical cancer screening. Cervical cytology p16 protein detection is important for self-sampled HPV positive and shunt screening of non-HPV16/18.

Objective:To explore the current situation and influencing factors of amputation decision-making dilemma of diabetic foot patients.Methods:From July to December 2023, 200 patients with diabetic foot in the Tianjin Medical University General Hospital and Tianjin Medical University Chu Hsien-I Memorial Hospital were selected as study subjects by convenience sampling. General Information Questionnaire, Decisional Conflict Scale (DCS), Family APGAR Index, and Hospital Anxiety and Depression Scale were used to conduct a cross-sectional survey. Pearson correlation was used to analyze the correlation between diabetic foot patients' amputation decision-making dilemma and family caring, anxiety and depression, and multiple linear regression was used to analyze the influencing factors of diabetic foot patients' amputation decision-making dilemma.Results:A total of 200 questionnaires were distributed, and 180 valid questionnaires were collected, with a valid response rate of 90.0% (180/200). The DCS score of 180 patients with diabetic foot was (30.04±9.77), 76.7% (138/180) patients scored ≥25.0, and they had decision-making dilemma, and 25.0% (45/180) of patients scored ≥37.5, indicating decision-making delay. Multiple linear regression analysis showed that occupational status, diabetes course, family caring, anxiety and depression were the influencing factors of amputation decision-making dilemma of diabetic foot patients ( P<0.05) . Conclusions:Diabetic foot patients face certain dilemmas in the process of amputation decision-making. Clinical medical and nursing staff should reasonably evaluate the patient's occupational status, disease course, family caring, and psychological state, and develop personalized decision support strategies to improve decision quality and prevent changes in the patient's condition caused by delayed decision-making.

Coronary heart disease is a physical and mental disease that is often combined with mental disorders such as depression,anxiety,sleep disorders,and stress,affecting the patient's prognosis.This review introduces the common mental disorders of patients with coronary heart disease,the types,characteristics and application status of digital and intelligent intervention technology,and analyzes the challenges of digital and intelligent intervention technology in the development of mental disorders in coronary heart disease,with a view to providing new information technology-driven nursing practice ideas and directions.