Ischemic stroke and hemorrhagic stroke have different pathogenic mechanisms,but share similarities in metabolic dysregulation,inflammatory responses and oxidative stress.This paper summarized 28 metabolic markers shared between ischemic stroke and hemorrhagic stroke with consistent trends through literature review.It also provided an overview of their involvement in abnormal energy metabolism,inflammatory responses,blood-brain barrier disruption,and neural damage in relation to stroke.The aim is to provide a scientific basis for future prognosis,curative efficacy evaluation and future homotherapy of ischemic stroke and hemorrhagic stroke,and provide insights for the development of new therapies and new drugs.

Ischemic stroke and hemorrhagic stroke have different pathogenic mechanisms,but share similarities in metabolic dysregulation,inflammatory responses and oxidative stress.This paper summarized 28 metabolic markers shared between ischemic stroke and hemorrhagic stroke with consistent trends through literature review.It also provided an overview of their involvement in abnormal energy metabolism,inflammatory responses,blood-brain barrier disruption,and neural damage in relation to stroke.The aim is to provide a scientific basis for future prognosis,curative efficacy evaluation and future homotherapy of ischemic stroke and hemorrhagic stroke,and provide insights for the development of new therapies and new drugs.

Objective To investigate the spatiotemporal expression pattern of metabotropic glutamate receptor 4(mGluR4)in the mouse cochlear basilar membrane and its dynamic changes during postnatal development until hair cell synaptic maturation.Methods Ten healthy 3-month-old C57BL/6L wild-type mice(5 males,5 females,25～35 g)were bred to obtain offspring.Cochlear samples from postnatal days 1～30(P1～P30)were analyzed.Frequency-specific auditory brainstem response(ABR)thresholds were measured at 45.2,32.0,22.6,16.0,11.3,8.0,5.6,and 4.0 kHz in P12,P14,P16,P21,and P30 mice.Immunofluorescence assay combined with confocal laser scanning microscopy was used to scan cochlear whole-mount preparations.Spatiotemporal co-localization profiling of mGluR4 and synaptic markers Ctbp2 and Snap25 was observed,and quantitative comparisons of fluorescent puncta density were performed.Results ABR testing revealed undifferentiated waveforms in all P12 mice,while 70%of P14 mice exhibited well-defined Wave I.In P14,P16,P21 and P30,mice undergoing ABR testing,50%failed to exhibit ABR waveforms when stimulated by 45.2 kHz tones,and 87.5%showed no response to 32.0 kHz stimuli.Auditory response thresholds for other frequencies progressively decreased with increasing postnatal age.Immunolocalization demonstrated stronger mGluR4 expression in inner hair cells(IHCs)versus outer hair cells(OHCs).Distinct mGluR4 puncta were observed at IHC presynaptic active zones(co-localized with Snap25)as early as P11,but showed minimal overlap with CtBP2-labeled ribbons.Quantitative analysis revealed significantly higher mGluR4 puncta density at P30 compared to P14 synapses(P<0.05).Conclusion Postnatal upregulation of mGluR4 at IHC synaptic regions correlates with functional maturation.These findings suggest mGluR4 may modulate vesicular exocytosis regulation and exert pharmacological inhibition on glutamate release,potentially influencing synaptic plasticity during auditory pathway refinement.

The literature on the characteristics, commodity grade specifications and chemical composition of Angelicae Sinensis Radix was reviewed. It was found that the main factors affecting the changes of traits and chemical composition of Angelicae Sinensis Radix included origin, altitude, climate, soil, cultivation methods, processing and processing methods and storage methods. Among them, the volatile oil types and ferulic acid content of Angelicae Sinensis Radix produced in Minxian County of Gansu Province were better than those in some non-authentic producing areas, but some component differences remained to be verified; direct seeding and film mulching cultivation could improve the yield, volatile oil and polysaccharide content of Angelicae Sinensis Radix; continuous cropping may lead to rhizosphere soil problems of Angelicae Sinensis Radix, and rotation or intercropping could be considered; drying in the shade and smoking drying could retain the oil and aroma of Angelicae Sinensis Radix; wine stir-frying method could increase the content of Z-ligustilide, but stir-frying carbon may reduce the content of ferulic acid; high temperature and high humidity storage may affect the content of ligustilide. In the future, the quality evaluation system of Angelicae Sinensis Radix should be strengthened and improved, genuine research should be strengthened, and scientific field management methods and appropriate harvesting and processing methods should be established, so as to ensure the good clinical efficacy and stable and controllable quality of Angelicae Sinensis Radix.

Objective To analyze the correlation between the number of oil chambers,the proportion of phloem at cross-section of Aucklandiae Radix and the contents of costunolide and dehydrocostuslactone,and the correlation between inulin quantity,vessel quantity and polysaccharide content in powder characteristics,so as to explore the scientific basis for Aucklandiae Radix"identifying the quality based on appearance differentiation".Methods The constant values of the microscopic features of oil chambers,inulin and vessels were determined by cross-sectional permanent slice method,chloral hydrate method and counting analysis method,and the contents of costunolide and dehydrocostuslactone as well as polysaccharide content were determined by the high-performance liquid chromatography(HPLC)and the phenol-sulfuric acid method,respectively,and the correlation in the two groups of data was analyzed by statistical methods.Results There was a significantly positive correlation between the number of oil chambers per unit area in the cross-section of Aucklandiae Radix and the number of oil chambers per unit area in the phloem and the contents of costunolide and dehydrocostuslactone;there was a significantly positive correlation between the quantity of inulin in the powder of Aucklandiae Radix and the polysaccharide content;there was no correlation between the quantity of vessels and the polysaccharide content.Conclusion This study initially established a new method and a new technology for quality evaluation of Chinese herbal medicines based on the determination of microscopic characteristic constants of Aucklandiae Radix,which can provide a new technical method for the quality control of Aucklandiae Radix.

ObjectiveTo investigate the mechanism of neferine（Nef） in promoting vascular regeneration against cerebral ischemia through modulation of mitochondrial calcium uniporter（MCU） ion channel. MethodTaking the area of subintestinal vessels in microvascular deficiency zebrafish as an index， the vascular regenerative efficacy of Nef was evaluated， and the median effective concentration（EC₅₀） was calculated. Rats were randomly divided into a sham operation group， a model group， a positive drug group（butylphthalide， 6 mg·kg^-1）， and Nef low， medium， and high dose groups（0.125， 0.625， 3.125 μg·kg^-1）. Except for the sham operation group， the middle cerebral artery occlusion（MCAO） model was established in other groups. After modeling， the groups were administered the corresponding dose of drugs by gavage， while the sham operation and model groups received equal volumes of saline， once a day for 7 consecutive days. Neurobehavioral scores were assessed for each group of rats， and the infarct rate of ischemic brain tissue was calculated by 2，3，5-triphenyltetrazolium chloride（TTC） staining. The regional cerebral blood flow（rCBF） of each group was measured using a speckle contrast imaging. Immunofluorescence and Western blot were conducted to detect the expression of vascular endothelial growth factor（VEGF）， platelet endothelial cell adhesion molecule-1（CD31）， and hypoxia-inducible factor-1α（HIF-1α） proteins in each group. Human umbilical vein endothelial cells（HUVECs） were divided into the normal group， model group， positive drug group（astragaloside Ⅳ， 10 μmol·L^-1）， and Nef group （32 nmol·L^-1）. In the verification of mitochondrial protection of Nef and its mechanism in promoting vascular regeneration， the spermine（MCU agonist） and Nef+spermine group were added. HUVECs model of oxygen-glucose deprivation（OGD） was established in all groups except the normal group， the cell viability was assessed using 3-（4，5-dimethylthiazol-2-yl）-2，5-diphenyltetrazolium bromide（MTT） assay， and cell migration ability was evaluated through scratch and tube formation assays. Fluorescent probes（Rhod-2 AM， Fluo-3 AM， JC-1， Calcein AM） and a cellular energy metabolism analyzer were used to analyze the mitochondrial protective effects of Nef. Molecular docking was performed to predict the binding ability of Nef with MCU and HIF-1α， and Western blot was used to detect the effects of Nef on the protein expressions of MCU， B-cell lymphoma-2 associated X protein（Bax）， Caspase-3 and HIF-1α in the OGD model HUVECs. ResultThe results of vascular regeneration in microvascular deficiency zebrafish showed that compared to the normal group， the area of subintestinal vessels in the model group significantly decreased（P<0.01）. Compared to the model group， different concentrations of Nef could significantly increase the area of subintestinal vessels（P<0.01）， with the maximum tolerated concentration of 10.24 μmol·L^-1 and the EC₅₀ of 0.23 μmol·L^-1. Anti-cerebral ischemia results on MCAO rats showed that compared to the sham operation group， the model group had a significant decrease in rCBF and a significant increase in infarct rate， while CD31 expression significantly decreased（P<0.01）， and VEGF and HIF-1α protein expressions significantly increased（P<0.05）. Compared to the model group， the treated groups showed significant increases in rCBF， significant reductions in infarct volume， and significant increases in CD31， VEGF， and HIF-1α protein expression（P<0.01）. Cell experiment results showed that compared to the normal group， the model group had decreased cell viability and migration ability， increased intracellular Ca²⁺ and mitochondrial Ca²⁺ levels， reduced mitochondrial permeability transition pore（MPTP） opening， and decreased mitochondrial energy metabolism capability， with increased expressions of MCU， Bax， Caspase-3 and HIF-1α proteins（P<0.05， P<0.01）. Compared to the model group， the Nef group showed increased cell viability and migration ability， decreased intracellular Ca²⁺ and mitochondrial Ca²⁺ levels， increased MPTP opening， enhanced mitochondrial energy metabolism capability， decreased expressions of MCU， Bax and Caspase-3 proteins， and increased HIF-1α protein expression（P<0.05， P<0.01）. ConclusionNef can stabilize mitochondrial membrane potential and inhibit mitochondrial apoptosis. By down-regulating the expression of MCU， it suppresses the activation of intracellular Bax and Caspase-3 while activating the HIF-1α signaling pathway， enhancing the expression of VEGF and CD31， thereby promoting vascular regeneration to treat ischemic brain injury.

Objective To reveal the pharmacodynamic material basis of Kaixinsan by using high performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS)and the integrated analysis of"chemical component spectrum-plasma exposure component spectrum-mitochondrial function".Methods Through a review of literature,databases,and previous studies,the chemical components of ginseng,polygala,poria,and acorus were systematically cataloged.A qualitative analysis method for the chemical constituents in the aqueous extract of Kaixinsan was developed,allowing for the identification of its chemical components.A qualitative analysis for rat plasma based on HPLC-MS/MS was established,which was applied to analyze the plasma exposure component spectrum following oral administration of Kaixinsan aqueous extract in rats.Aerobic respiration was evaluated using a seahorse cell energy metabolism analyzer,and the effect of key components of Kaixinsan on mitochondrial aerobic respiration was assessed.Results Four main types of components were identified in the Kaixinsan aqueous extract,including saponins,oligosaccharide esters,xanthones,and triterpenes,comprising a total of 231 identified compounds.Analysis of rat plasma 30 minutes after gavage with Kaixinsan identified 55 compounds.The analysis revealed that ginsenoside Rg1,3,6'-disinapoylsucrose,polygalaxanthone Ⅲ and poricoic acid B could significantly enhance mitochondrial respiratory capacity using in vitro cellular assays to detect aerobic respiration of four main components entered blood.Conclusions Saponins,oligosaccharide esters,xanthones,and triterpenes may be the material basis for the pharmacological effect of Kaixinsan by improving mitochondrial function.The integrated analysis of"chemical component spectrum-plasma exposure component spectrum-mitochondrial function"provides a new approach for in-depth exploration of the material basis underlying the efficacy of traditional Chinese medicine.

Objective:To explore the effectiveness of blended learning in the clinical teaching of wound care clinic.Methods:Blended learning based on WeChat and offline CBL teaching method was constructed by applying evidence-based nursing. Totally 125 interns from the wound care clinic of our hospital were selected as subjects, among which 62 didn't receive the blended learning (control group), and 63 received the blended learning (observation group). At the end of the two-week practice, the effectiveness of the two teaching methods was compared. The objective evaluation was carried out in the forms of theory test, practice evaluation and comprehensive quality questionnaire combined with online self-test and offline practice. All data were analyzed by SPSS 20.0 statistical software.Results:The scores of theory test, practice evaluation and comprehensive quality assessment in the observation group were all higher than those in the control group ( P<0.001). Conclusion:The blended learning with WeChat as the medium can guide student active learning, consolidate the basic knowledge, improve the efficiency of teaching, stimulate the enthusiasm of practice, and improve the comprehensive quality. It's a clinical teaching method that can be used for reference.

Objective:To investigate the cognitive level of wearing and removing personal protective equipment in COVID-19 isolation wards of Wuhan Fangcang shelter hospital, and provide the scientific basis for the training of hospital protection. Methods:Cognitive level of wearing and removing personal protective equipment in Wuhan Fangcang shelter hospital were investigated by using a questionnaire which included 14 related scales, including putting on and off protective equipment, hand hygiene disinfection and so on.Results:The total scale score of non-medical workers was 48.82±9.65, which was lower than the total scale score of doctors (55.46±1.29) and nurses (55.0±2.36), P<0.05. The each score of 14 items in the scale of non-medical workers was all lower than those of doctors and nurses ( P<0.05). There were no significant differences in scale scores among doctors, nurses and medical technicians. The total score of the scale of non-medical workers in later period was 55.23±3.26, which was significantly higher than the total score of 44.50±10.14 in previous period, P<0.001. The total score of nurses and medical technicians in the later period was higher than those in the previous period, and the difference was statistically significant. There was no significant difference between the total score of the scale in the later period and that in the previous period. Conclusions:The cognition level of non-medical workers on wearing and removing personal protective devices was lower than those of doctors and nurses, strengthening the practice could improve cognition.

Objective: To investigate molecular markers associated with lymph node metastasis in esophageal squamous cell carcino-ma. Methods: Patients who meet the inclusion criteria were assigned into two groups, with and without lymph node metastasis. The statistically significant risk factors were evaluated using univariate analysis and multivariate Logistic regression analysis. The diagnostic threshold, sensitivity, and specificity were analyzed by Youden's index. The area under the ROC curve (AUC) was used to evaluate the power of test. Result: Univariate analysis and multivariate Logistic regression analysis showed that GC% of wild type base in the first somatic mutational position of the codons was a risk factor for lymph node metastasis [OR (95% CI): 0.931 (0.874-0.991), P<0.05]. AUC was 0.639 (P<0.05, 95% CI: 0.522-0.756). The Youden's index was 0.277, and the sensitivity and specificity were 56.6% and 71.1%, re-spectively. Conclusions: GC% of wild type base in the first somatic mutational position of the codons is significantly associated with lymph node metastasis in esophageal squamous cell carcinoma. The marker was found to be a protective factor for lymph node metas-tasis and has potential significance in clinical applications.