OBJECTIVE To optimize the extraction process of flavonoids from Potentilla discolor .METHODS Deep eutectic solvents （DESs） were used as the extraction solvent to prepare test sample solutions. The contents of rutin， quercitrin， and kaempferol were determined by ultra-performance liquid chromatography. The analytic hierarchy process combined with the criteria importance through intercriteria correlation weighting method was employed to assign comprehensive weights to the contents of the three flavonoids， and calculate the comprehensive score. The optimal DESs were screened based on the comprehensive score.Mean while， using the comprehensive score as the response variable and the liquid-to-solid ratio， ultrasonic time， and urltrasonic temperature as the influencing factors， the extraction technology of flavonoids from P.discolor was optimized by Box-Behnken response surface methodology and subsequently validated.RESULTS The comprehensive weight coefficients of rutin， quercitrin， and kaempferol were 0.646 7， 0.207 5， and 0.145 8， respectively. The optimal DESs were choline chloride-lactic acid （molar ratio 1∶4） with a water content of 40%. The optimal extraction conditions were determined as follows： liquid-to-solid ratio of 25∶1， ultrasonic time of 40 min， and ultrasonic temperature of 50 ℃. The validation results showed that the average comprehensive score of three batches of samples was 99.28， with an RSD of 0.54% （ n ＝3）.CONCLUSIONS The optimal extraction technology of flavonoids from P. discolor based on DESs obtained in this study was stable and feasible.

Objective:To investigate the alterations in the brain structural network properties related to cognitive emotion regulation strategies in young, first-episode and drug-naive (FEDN) patients with major depressive disorder (MDD).Methods:One hundred and twelve young patients who were diagnosed with FEDN MDD were enrolled in the Second Xiangya Hospital of Central South University between October 2019 and October 2023, and 143 healthy controls (HC) were recruited for reference during the same period. Clinical data and T 1 structural images of high-resolution magnetic resonance imaging were collected from all participants, and the cognitive emotion regulation was assessed using the Chinese version of the Cognitive Emotion Regulation Questionnaire (CERQ-C). The brain structural alterations related to cognitive emotion regulation strategies were explored using whole-brain voxel-based morphometry (VBM) group analysis and individual differential structural covariance network (IDSCN) analysis. Partial correlation analysis was performed between the IDSCN anomalous structural concatenated edge and subdimensions of the CERQ-C. Results:The scores on the sub-dimension of negative cognitive emotion regulation (self-condemnation, rumination, catastrophization, blaming others) in the young FEDN MDD patients in CERQ-C were significantly higher than those in HC (14.28±2.30 vs 12.45±2.00, t=6.501, P<0.001;14.40±2.97 vs 11.31±2.93, t=7.934, P<0.001;12.19±3.75 vs 7.59±2.58, t=10.553, P<0.001;10.26±3.00 vs 8.74±2.89, t=3.916, P<0.001; respectively). There was no statistically significant difference in the VBM group analysis (all P>0.05). However, IDSCN single sample t test results showed significant group differences between the left orbitofrontal inferior gyrus and the left supplementary motor area, the left orbitofrontal middle gyrus and the bilateral precuneus, and the left superior temporal gyrus and the bilateral hippocampus (all P<0.05). With controlling for age, sex, and other factors, partial correlation analysis results showed that the left orbital inferior frontal gyrus-left supplementary motor area connection in patients with MDD was positively correlated with the self-condemnation and acceptance scores of the CERQ-C ( r=0.226, P=0.027; r=0.216, P=0.035), while negatively correlated with the score of blaming others ( r=-0.252, P=0.013). Additionally, connections between the right hippocampus and left superior temporal gyrus were significantly associated with the scores on catastrophization subdimension of the CERQ-C ( r=0.229, P=0.025). Conclusion:Due to its sensitivity to individualized analyses, the IDSCN analysis found that abnormal topological property changes were mainly manifested in the limbic system, the sensorimotor system, and the default network in young FEDN MDD patients, and were linked to their negative cognitive emotion regulation strategies, even though the VBM group analysis did not yield any significant results.

Objective:To investigate the alterations in the brain structural network properties related to cognitive emotion regulation strategies in young, first-episode and drug-naive (FEDN) patients with major depressive disorder (MDD).Methods:One hundred and twelve young patients who were diagnosed with FEDN MDD were enrolled in the Second Xiangya Hospital of Central South University between October 2019 and October 2023, and 143 healthy controls (HC) were recruited for reference during the same period. Clinical data and T 1 structural images of high-resolution magnetic resonance imaging were collected from all participants, and the cognitive emotion regulation was assessed using the Chinese version of the Cognitive Emotion Regulation Questionnaire (CERQ-C). The brain structural alterations related to cognitive emotion regulation strategies were explored using whole-brain voxel-based morphometry (VBM) group analysis and individual differential structural covariance network (IDSCN) analysis. Partial correlation analysis was performed between the IDSCN anomalous structural concatenated edge and subdimensions of the CERQ-C. Results:The scores on the sub-dimension of negative cognitive emotion regulation (self-condemnation, rumination, catastrophization, blaming others) in the young FEDN MDD patients in CERQ-C were significantly higher than those in HC (14.28±2.30 vs 12.45±2.00, t=6.501, P<0.001;14.40±2.97 vs 11.31±2.93, t=7.934, P<0.001;12.19±3.75 vs 7.59±2.58, t=10.553, P<0.001;10.26±3.00 vs 8.74±2.89, t=3.916, P<0.001; respectively). There was no statistically significant difference in the VBM group analysis (all P>0.05). However, IDSCN single sample t test results showed significant group differences between the left orbitofrontal inferior gyrus and the left supplementary motor area, the left orbitofrontal middle gyrus and the bilateral precuneus, and the left superior temporal gyrus and the bilateral hippocampus (all P<0.05). With controlling for age, sex, and other factors, partial correlation analysis results showed that the left orbital inferior frontal gyrus-left supplementary motor area connection in patients with MDD was positively correlated with the self-condemnation and acceptance scores of the CERQ-C ( r=0.226, P=0.027; r=0.216, P=0.035), while negatively correlated with the score of blaming others ( r=-0.252, P=0.013). Additionally, connections between the right hippocampus and left superior temporal gyrus were significantly associated with the scores on catastrophization subdimension of the CERQ-C ( r=0.229, P=0.025). Conclusion:Due to its sensitivity to individualized analyses, the IDSCN analysis found that abnormal topological property changes were mainly manifested in the limbic system, the sensorimotor system, and the default network in young FEDN MDD patients, and were linked to their negative cognitive emotion regulation strategies, even though the VBM group analysis did not yield any significant results.

Objective:To investigate the protective effect of reduced glutathione (GSH) on diclo-fenac-induced acute kidney injury (AKI) in rats and its mechanism.Methods:Thirty-three male 8-week-old specified pathogen-free SD rats were randomly divided into control, model, and GSH groups (11 rats in each group) according to a random number table method. Diclofenac sodium solution (200 mg/kg) was intragastrically administered to rats in the model group and GSH group to establish the AKI model. Thirty minutes later, rats in the GSH group were treated with intragastric administration of GSH solution (500 mg/kg), while rats in the control and model groups were with 0.9% sodium chloride injection of equal volume. After 24 hours of administration, blood sample was collected and kidneys were isolated. Kidney function [blood urea nitrogen (BUN), serum creatinine (Scr)], kidney histopathology, and serum and kidney tissue oxidative stress indicators such as malondialdehyde (MDA), superoxide dismutase (SOD), and the inflammatory cytokines such as tumor necrosis factor (TNF)-α and interleukin 6 (IL-6) were examined. The results of each examination results among rats of the 3 groups were compared.Results:The BUN and Scr in rats of the model group were significantly higher than those in the control and GSH groups[BUN: (14.34±8.47) mmol/L vs. (7.89±2.20) and (8.46±3.58) mmol/L; Scr: (34.44±6.56) μmol/L vs. (24.77±9.50) and (29.28±4.33) μmol/L, all P<0.05]. Glomerular and tubular morphological changes were observed in both model and GSH rats, but the change in rats of GSH group was less severe than that of the model group. The mean levels of MDA, TNF-α, and IL-6 in both serum and kidney tissue in rats of GSH group were significantly lower than those of the model group[MDA: (9.5±0.2) nmol/ml vs. (10.2±0.6) nmol/ml, (3.6±0.3) nmol/ml vs. (4.0±0.2) nmol/ml; TNF-α: (2.9±2.5) pg/ml vs. (5.4±3.0) pg/ml, (420.9±40.3) pg/ml vs. (470.4±31.3) pg/ml; IL-6: (92.1±34.4) pg/ml vs. (123.9±16.6) pg/ml, (7 547±604) pg/ml vs. (8 047±470) pg/ml, all P<0.05], while the activity of SOD was significantly higher than that in the model group[(102.8±2.8) U/ml vs. (99.7±4.1) U/ml, (387.0±12.7) U/ml vs. (375.9±11.7) U/ml, all P<0.05]. Conclusion:GSH has a protective effect on diclofenac-induced acute kidney injury in rats, and its possible mechanism is to inhibit oxidative stress and inflammatory reactions.

Objective:To investigate the protective effect of reduced glutathione (GSH) on diclo-fenac-induced acute kidney injury (AKI) in rats and its mechanism.Methods:Thirty-three male 8-week-old specified pathogen-free SD rats were randomly divided into control, model, and GSH groups (11 rats in each group) according to a random number table method. Diclofenac sodium solution (200 mg/kg) was intragastrically administered to rats in the model group and GSH group to establish the AKI model. Thirty minutes later, rats in the GSH group were treated with intragastric administration of GSH solution (500 mg/kg), while rats in the control and model groups were with 0.9% sodium chloride injection of equal volume. After 24 hours of administration, blood sample was collected and kidneys were isolated. Kidney function [blood urea nitrogen (BUN), serum creatinine (Scr)], kidney histopathology, and serum and kidney tissue oxidative stress indicators such as malondialdehyde (MDA), superoxide dismutase (SOD), and the inflammatory cytokines such as tumor necrosis factor (TNF)-α and interleukin 6 (IL-6) were examined. The results of each examination results among rats of the 3 groups were compared.Results:The BUN and Scr in rats of the model group were significantly higher than those in the control and GSH groups[BUN: (14.34±8.47) mmol/L vs. (7.89±2.20) and (8.46±3.58) mmol/L; Scr: (34.44±6.56) μmol/L vs. (24.77±9.50) and (29.28±4.33) μmol/L, all P<0.05]. Glomerular and tubular morphological changes were observed in both model and GSH rats, but the change in rats of GSH group was less severe than that of the model group. The mean levels of MDA, TNF-α, and IL-6 in both serum and kidney tissue in rats of GSH group were significantly lower than those of the model group[MDA: (9.5±0.2) nmol/ml vs. (10.2±0.6) nmol/ml, (3.6±0.3) nmol/ml vs. (4.0±0.2) nmol/ml; TNF-α: (2.9±2.5) pg/ml vs. (5.4±3.0) pg/ml, (420.9±40.3) pg/ml vs. (470.4±31.3) pg/ml; IL-6: (92.1±34.4) pg/ml vs. (123.9±16.6) pg/ml, (7 547±604) pg/ml vs. (8 047±470) pg/ml, all P<0.05], while the activity of SOD was significantly higher than that in the model group[(102.8±2.8) U/ml vs. (99.7±4.1) U/ml, (387.0±12.7) U/ml vs. (375.9±11.7) U/ml, all P<0.05]. Conclusion:GSH has a protective effect on diclofenac-induced acute kidney injury in rats, and its possible mechanism is to inhibit oxidative stress and inflammatory reactions.

Objective:To explore the effects of Carolina care model in standardized training of nurses.Methods:Convenience sampling was used to select 35 nurses who entered the Department of Cardiology for standardized training (referred to as training nurses) from October 2018 to March 2019 in a Class Ⅲ Grade A hospital in Changchun as control group, and 37 nurses who entered the Department of Cardiology from May to October 2019 were selected as observation group. Control group carried out routine training, and observation group implemented a training plan based on the Carolina care model. Training effects were evaluated with the Nursing Caring Characters Assessment Tool, Clinical Communication Competence Scale and Patient Satisfaction Questionnaire.Results:After training, the scores of all dimensions of the Nursing Caring Characters Assessment Tool of nurses in observation group were higher than those in control group with statistically significant differences ( P<0.05) . After training, the scores of all dimensions of the Clinical Communication Competence Scale of nurses in observation group were higher than those in control group, and the differences were statistically significant ( P<0.05) . In observation group, patients' satisfaction with training nurses was higher than that in control group with a statistically significant difference ( P<0.05) . Conclusions:The application of Carolina care model in standardized training of nurses can not only improve nurses' humanistic care and communication competence, but also improve patient satisfaction.

Objective To evaluate an effective and feasible quantitative evaluation table of traditional Chinese medicine (TCM) syndrome differentiation, and to observe the effect of combination of TCM syndrome differentiation and standard bundle therapy in patients with septic shock. Methods A prospective randomized controlled trial was conducted. The septic shock patients with acute deficiency syndrome admitted to department of critical care medicine of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 1st, 2016 to December 31st, 2017 were enrolled. The patients were randomly divided into control group and Shenfu group. The patients in both groups received early application of standardized bundle therapy; those in Shenfu group received 60 mL Shenfu injection infusion in addition for 7 days. The TCM syndrome score was evaluated by classification and scoring method of TCM symptoms. The circulation and tissue perfusion, severity of disease, organ function, inflammation response, adjuvant treatment and 28-day mortality were compared between the two groups. Results A total of 50 patients with septic shock were enrolled in the analysis, 25 in control group and 25 in Shenfu group. The markedly effective rate of TCM symptoms score in Shenfu group was significantly higher than that in control group [60.0% (15/25) vs. 16.0% (4/25), P < 0.01]. There was no significant difference in all parameters before treatment between the two groups. After treatment, the observation indexes of both groups were improved. Compared with control group, the mean arterial pressure (MAP) in Shenfu group increased more significantly [mmHg (1 mmHg = 0.133 kPa): 13.0 (2.5, 28.5) vs. 6.0 (0, 13.5)], the lactate (Lac) and procalcitonin (PCT) decreased more significantly [Lac (mmol/L): 0.8 (0.1, 3.7) vs. 0.5 (-0.6, 1.7), PCT (μg/L): 2.0 (0.7, 32.3) vs. 0 (-1.8, 3.8)], activated partial thromboplastin time (APTT) was shortened more significantly [s: 8.5 (0, 12.9) vs. 0 (-7.2, 10.0)], and interleukins (IL-2 receptor and IL-6) levels decreased more significantly [IL-2 receptor (ng/L):1 031.0 (533.0, 1 840.0) vs. 525.5 (186.0, 1 166.8), IL-6 (ng/L): 153.1 (21.4, 406.8) vs. 35.1 (16.3, 110.1)] with significant differences (all P < 0.05). There was no significant difference in the use time of vasoactive drugs, duration of mechanical ventilation, severity of the disease or 28-day mortality between the two groups. However, the use time of vasoactive drugs in Shenfu group was shorter than that in control group (days: 5.48±4.81 vs. 8.28±7.83), and the 28-day mortality was decreased [8.0% (2/25) vs. 20.0% (5/25)]. Conclusions TCM syndrome score is helpful to evaluate the effect of TCM syndrome differentiation and treatment, and it is effective and feasible in clinical application. Septic shock patients treated with TCM syndrome differentiation and treatment combined with standard bundle therapy were significantly improved in circulation, tissue perfusion, coagulation function and inflammation reaction.