Objective:To explore the risk factors of perioperative outcomes of lung transplantation and establish a predictive model for delayed extubation after lung transplantation.Methods:From January 1, 2020 to December 31, 2022, 104 lung transplantation recipients were retrospectively collected to identify the risk factors of early post-operative outcome.According to the timing of extubation post-lung transplantation, they were assigned into two groups of normal(77 cases)and delayed(27 cases). Baseline profiles, type of primary diagnosis, cold ischemic duration and lung transplantation approach were compared between two groups.The factors with significant difference were examined by univariate and multivariate Logistic regression.Furthermore, multivariate logistic model was visualized by a nomogram.Receiver operating characteristic(ROC)curve and decision curve analysis(DCA) were performed for evaluating the model's predictive performance and its value for clinical utilization.Results:The postoperative mortality rate was 9.6%.Delayed extubation was a strong predictor for postoperative mortality.Cold ischemic time outperformed others variates in terms of delayed extubation prediction.AUC of cold ischemic time and multivariate logistic model was 0.75(95% CI: 0.69-0.81)and 0.87(95% CI: 0.82-0.91). Conclusions:Delayed postoperative extubation is a key predictor of early post-lung transplantation mortality.The established predictive model may effectively identify high-risk patients for preventive intervention and survival improvement post-lung transplantation.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

Objective:To study the real-world outcome of China FDA-approved Sofosbuvir (SOF)/Velpatasvir (VEL) in Northwest China.Methods:In this multicenter, prospective, real-world cohort study, we recruited patients from 10 sites from Northwest China, who were chronically infected with HCV GTs 1-6 from 06/2018 to 09/2019. Patients received SOF (400mg)/VEL (100mg) for 12 weeks, and with ribavirin 900-1200 mg for GT3 cirrhosis and for any genotype decompensated cirrhosis. The primary endpoint was sustained virological response at 12-weeks post-treatment (SVR12) and safety. The secondary endpoint was the change of liver function after the achievement of SVR12.Results:Totally, 143 patients were enrolled in the study, four patients were lost to follow-up and one died during the follow-up, 138 patients were included in per-protocol analysis. Of the 138 patients, the mean age 53 years, 53.6% male, 94.2% Han nationality, 53.6% liver cirrhosis, 10.1% HBsAg +, 6.5% renal dysfunction, 5.1% treatment-experienced, and 16.7% patients received ribavirin treatment. The genotype distribution was as follows: 35.5% GT1, 42.8% GT2, 15.9% GT3, and 5.8% un-typed. The SVR12 rate was 96.5% (138/143, 95% CI: 93.5%-99.6%) for intention-to-treat analysis, and in per-protocol analysis, all 138 patients obtained SVR12 (100%). Compared with baseline, the serum total bilirubin, ALT and AFP levels decreased (all P < 0.05), as well as increased ALB and platelet count (all P < 0.001) at post-treatment 12-weeks. Overall adverse events (AEs) rate is 29.0%, and the most common AEs were anemia (14.5%) and fatigue (8.0%). Severe side effects (edema and fatigue) occurred in 2 patients, one of whom needed a short-term interruption of treatment due to fatigue. Conclusion:In this real-world cohort study, 12-week SOF/VEL regimen with or without ribavirin achieved high SVR12 rates (96.5%-100% overall) with excellent safety profile among patients with HCV GT1/2/3 infection including patients with GT3 and cirrhosis, and led to improvement of liver function.

OBJECTIVETo study the content of magnoflorine in main species of Epimedii Herba.

METHODUltrasonic extraction, HPLC analysis.

RESULTThe content of magnoflorine of Epimedium leaves range between 0.0029% and 1.688%.

CONCLUSIONThe content of magnoflorine of Epimedium show large differences between species but relatively stable within the species, E. koreanum Nakai is the highest one and E. brevicornu is the lowest.

Aporphines ; analysis ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; analysis ; Epimedium ; chemistry

OBJECTIVETo study the characteristics of the growth and periplocin accumulation of the adventitious roots of Periploca sepium, and on this basis, study the effect of Ag+ and La3+ elicitors on the growth and periplocin accumulation of the adventitious roots.

METHODThe adventitious roots were sampled every four days, and the dry weight and the contents of the periplocin were measured. The curves of the growth and periplocin accumulation of the roots were plotted. The Ag+ and La3+ elicitors with different concentrations were added to the medium when the adventitious roots grew in the stable phase to study the optimal concentration which was good to synthesize the periplocin. Besides, the optimal concentration of Ag+ and La3+ elicitors was added to the different growth phases to study the effect of the elicitors on the growth and periplocin synthesis of adventitious roots.

RESULTThe characteristics of the growth of adventitious roots of P. sepium showed a typical growth S-Curve, which displayed a half-coupling relationship with the metabolism of periplocin. The optimal concentrations of Ag+ and La3+ elicitors were both 0.05 mmol L(-1). Besides, it was the best period for the Ag+ and La3+ elicitors to elicit the synthesis of periplocin when in the terminally exponential phase.

CONCLUSIONThe growth of adventitious roots and the accumulation of periplocin show a half-coupling relationship. Besides, the concentration and additive time of Ag and La3+ elicitors obviously influences the growth of adventitious roots and synthesis of periplocin.

Drugs, Chinese Herbal ; analysis ; metabolism ; Lanthanum ; metabolism ; Periploca ; chemistry ; growth & development ; metabolism ; Plant Roots ; chemistry ; growth & development ; metabolism ; Saponins ; analysis ; metabolism ; Silver ; metabolism

Objective To increase the ultimate yield of periplocin in Periploca sepium adventitious root cultures by a two-stage culture based on nitrogen source.Methods Firstly,the effects of nitrogen source(NH<'+><,4>-NO<'-><,3>-)at different ratios and different total initial nitrogen amounts on the accumulation of biomass and secondary metabolites in adventitious root cultures of P sepium were investigated,and growth and production media for the two-stage culture based on the above results were established.Results The highest biomass and periplocin content were obtained in the culture medium of 15 mmol/L total nitrogen amount with NH<'+><,4>-NO<,3>(1:2)and 30 mmol/L total nitrogen amount with nitrate as the sole nitrogen source.By adopting a fed-batch cultivation strategy,the dry weight adventitious root,periplocin content and yield were increased by 136%,108%,and 389%,respectively when compared with those of the control,reaching up to 8.13 g/L,157.15 μg/g,and 1277.63 μg/L,respectively.Furthermore,it was found that in the process of two-stage culture,the adventitious roots grew thicker significantly after they were transferred into production medium directly.Conclusion The ultimate yield of periplocin in P.sepium adventitious root cultures could be significantly increased by a two-stage culture based on nitrogen source.

Numerical taxonomic studies were carried out in order to elucidate the taxonomic relationship among 17 species belonging to Paris. Eighteen characters including 10 morphological, 4 pollen morphological, 2 cytotalonomical and 2 habitat characters were used for the analysis. On basis of UPGMA clustering analysis, two subgenus and seven groups were recognized. The classification of the two subgenus was different from the opinion of subgenus Daiswa and subgenus Paris by Li Heng. The classification of sect. Dunnianae, sect. Axiparis and sect. Paris was correspondence with the classification of Li Heng. But sect. Fargesianae, sect. Marmoratae and sect. Thibeticae which were established based on the especially characters by Li Heng were put into cluster 2, cluster 3 and cluster 4.
Magnoliopsida ; anatomy & histology ; classification ; Phylogeny

Objective To fully understand the medicinal plants of Fritillaria L. , the physicochemical properties of starch in two species of Fritillaria L. , F. thunbergii and F. ussurensis. were investigated by means of various analytical methods. Methods The properties of starch in the two different species of Fritillaria L. were compared by X-ray diffraction, scanning electron microscope (SEM) and themogravimetric analysis (TGA). Results The crystal type of starch in the two species of Fritillaria L.was the characteristic B-type which was in consistent with that of potato starch. The degrees of crystallinity of F. thunbergii starch and F. ussurensis starch were about 29.9% and 20.1%, respectively. However,the degree of crystallinity of the potato starch was 44.9%. From the crystallinity degree of the starch in two species of Fritillaria L. , it could be concluded that the content of amylose in F. ussurensis starch was higher than that in F. thunbergii starch. The granule size of the starch in two species of Fritillaria L.ranged from 5 to 40 μm, which were all smaller than that of the potato. The starch granule in two species of Fritillaria L. was in cycloidal or elliptic-shape. It could be concluded that the thermal stability of the starch in two species of Fritillaria L. was different due to the different structures of different starch in various plants by TGA. Conclusion The physicochemical properties of starch in two different species of Fritillaria L. differ a lot due to their geographical origin.

BACKGROUND: Temporal cortex is related to human and animal's learning and memory capability, it not only accepts the casting fibers of auditory sense, but also closely connects with many brain areas where are related to spatial cognition.OBJECTIVE: To observe the improving effect of thrombolytic capsule on spatial cognitive capability of rats with lateral temporal cortical infarction DESIGN: Completely randomized controlled study SETTING: Department of Neurology, the 175th Hospital of Chinese PLA;Department of Neurology, General Hospital of Chinese PLA; Institute of Psychology of Chinese Academy of Science MATERIALS: This experiment was carried out at Brain Function Laboratory of Institute of Psychology of Chinese Academy of Science from August 1998 to February 1999, 28 SD rats were randomly divided into 3 groups,namely brain stroke group with 10 rats, treatment group with 10 rats and sham operation group with 8 rats.METHODS: Brain infarction model was established on SD rats by using three-dimensional directional photochemistry induction. Rats were anaesthetized with hydrochloride and intravenously injected of rose pink solution in dosage of 20 mg/kg from tail vein. Then incision was made on the left temporal scalp to expose temporal bone, cold photosource with the guidance of optical fiber was used for directional illumination for 20 minutes in area of 2 mm2. Twenty minutes later, rats in treatment group were given intraperitoneal injection of thrombolytic capsule physiological saline of 40 g/L in dosage of 200 mg/kg, which replaced by the same volume of physiological saline in brain stroke group. Rats in sham-operation group received the same operative lamination and injected with the same volume of physiological saline from tail vein and intraperitoneal cavity.MAIN OUTCOME MEASURES: Achievement of Morris water labyrinth(edge type scored 1, randomize type of 2, trend type of 3 and straight-line type of 4).age response time: it was shortened in treatment group and sham operation group than brain infarction group [ on 1st day: 58,50,65 s; 2nd day: 24,27,46 s; 3rd day: 14,17,20 s; 4th day: 11,9,15 s, (P ＜ 0.01 )], but it was similar ing strategy grades: on the 1st day, scores were slightly higher in treatment group and sham operation group than infarction group, but were instable (F=1.167, P ＞ 0.05). On the 2nd day, it was higher in sham operation group than brain stroke group[2.9,2.3, (F=5.5 ,P ＜ 0.05)], but it was similar between treatment group and infarction group[2.6,2.3 scores, (F=3.34,P ＞ 0.05)]. on the 3rd and 4th day, it was higher in treatment group than infarction group [ 3.5,2.7 minutes; 3.7,3.3 minutes, (F=8.92, 14, P ＞ 0.05)]and similar between treatment group and sham operation group(P ＞ 0.05).CONCLUSION: Rat response time was reduced by thrombolytic capsule during the early time of cerebral infarction, changing searching tactics gradually from randomized and edge type to tendency type and straight line type, suggesting thrombolytic capsule can improve the post-ischemia cognitive function, raise training record of cerebral infarctional rats.

By means of HPLC,the changes of endogenous hormones in the process of releasing dormancy in Fritillaria thunbergii Miq. seeds were determined. The results indicated that the content of GA3 had a process of increase while the content of ABA was reduced in general. The content of IAA showed a downward -plateau-upward-downward curve in the process of releasing dormancy. When the dormancy of the seeds were released attemperatures 8~10℃ and 3~5℃,changing pattern of each of the three endogenous hormones were similar,but the duration spanning each change were different.