In order to investigate the chemical constituents of glycosides in Aconitum tanguticum (Maxim.) Stapf, column chromatographic techniques such as silica gel, ODS, Sephadex LH-20, and semi-preparative high performance liquid chromatography were used to afford eight glycosides from the n-butanol fraction of the 85% ethanol extract of Aconitum tanguticum. Based on the physicochemical properties and spectral data, these compounds were identified as N-4-O-(β-D-glucopyranosyl)-phenethylbenzamide (1), N-(2'-β-D-glucopyranosyl-5'-methoxysalicyl)-4-hydroxy-3-methoxyanthranilic acid methyl ester (2), N-(2'-β-D-glucopyranosyl-5'-hydroxysalicyl)-4-hydroxy-3-methoxyanthranilic acid methyl ester (3), salidroside (4), benzyl primeveroside (5), phenethanol-β-D-xylose-(1''→6')-β-D-glucopyranoside (6), 4-dihydroxyphenethoxy-8-O-β-D-[6-O-(4-O-β-D-glucopyranosyl)-feruloyl]-glucopyranoside (7), phenethanol-α-L-arabinopyranosyl-(1''→6')-β-D-glucopyranoside (8). Among them, compounds 1 and 2 were new compounds, and compounds 5,6,8 were isolated from Aconitum tanguticum for the first time.

BACKGROUND: Epoxyeicosatrienoic acids (EETs), which are metabolites of arachidonic acid catalyzed by cytochrome P450 epoxygenase, are degraded into inactive dihydroxyeicosatrienoic acids by soluble epoxide hydrolase (sEH). Many studies have revealed that sEH gene deletion exerts protective effects against diabetes. Vascular calcification is a common complication of diabetes, but the potential effects of sEH on diabetic vascular calcification are still unknown. METHODS: The level of aortic calcification in wild-type and Ephx2-/- C57BL/6 diabetic mice induced with streptozotocin was evaluated by measuring the aortic calcium content through alizarin red staining, immunohistochemistry staining, and immunofluorescence staining. Mouse vascular smooth muscle cell lines (MOVAS cells) treated with β-glycerol phosphate (0.01 mol/L) plus advanced glycation end products (50 mg/L) were used to investigate the effects of sEH inhibitors or sEH knockdown and EETs on the calcification of vascular smooth muscle cells, which was detected by Western blotting, alizarin red staining, and Von Kossa staining. RESULTS: sEH gene deletion significantly inhibited diabetic vascular calcification by increasing levels of EETs in the aortas of mice. EETs (especially 11,12-EET and 14,15-EET) efficiently prevented the osteogenic transdifferentiation of MOVAS cells by decreasing nidogen-2 (NID2) expression. Interestingly, suppressing sEH activity by small interfering ribonucleic acid or specific inhibitors did not block osteogenic transdifferentiation of MOVAS cells induced by β-glycerol phosphate and advanced glycation end products. NID2 overexpression significantly abolished the inhibitory effect of sEH gene deletion on diabetic vascular calcification. Moreover, NID2 overexpression mediated by adeno-associated virus 9 vectors markedly increased insulin-like growth factor 2 (IGF2) and phospho-ERK1/2 expression in MOVAS cells. Overall, sEH gene knockout inhibited diabetic vascular calcification by decreasing aortic NID2 expression and, then, inactivating the downstream IGF2-ERK1/2 signaling pathway. CONCLUSIONS sEH gene deletion markedly inhibited diabetic vascular calcification through repressed osteogenic transdifferentiation of vascular smooth muscle cells mediated by increased aortic EET levels, which was associated with decreased NID2 expression and inactivation of the downstream IGF2-ERK1/2 signaling pathway.
Animals ; Mice ; Vascular Calcification/metabolism* ; Mice, Inbred C57BL ; Epoxide Hydrolases/metabolism* ; Diabetes Mellitus, Experimental/genetics* ; Male ; Gene Deletion ; MAP Kinase Signaling System/genetics* ; Cell Line ; Immunohistochemistry ; Muscle, Smooth, Vascular/metabolism* ; Signal Transduction/genetics* ; Mice, Knockout

Objective To screen the differential markers affecting their quality,and sort their quality,a method for simultaneous detection of 9 components in Camptothecae Fructus from different producing areas was established.Methods Reflux extraction was performed on 18 batches of Camptothecae Fructus from 7 provinces,and the extracts were detected by HPLC.A orthogonal partial least squares discriminant analysis and weighted TOPSIS method were used to establish a quality evaluation model for Camptothecae Fructus,and the quality differences were comprehensively evaluated.Results When the 9 components were in the 0.51-12.75,0.23-5.75,3.21-80.25,4.45-111.25,1.88-47.00,0.41-10.25,2.05-51.25,0.34-8.50 and 7.95-198.75 μg·mL-1,their linear relationships were good(r>0.999).The average recovery were 96.95%-100.06%with the RSDs<2.0%.18 batches of samples were clustered into 3 categories.Vincosamide,10-hydroxycamptothecin,camptothecin 10-methoxycamptothecin and pumiloside may be the main potential markers affecting the quality of Camptothecae Fructus.The analysis results of the weighted TOPSIS method revealed that the closeness(Jb)for evaluating the quality of 18 batches of Camptothecae Fructus ranged from 0.1090 to 0.7385,with S14 achieving the highest value of 0.7385.Conclusion A method for simultaneous determination of 9 components in Camptothecae Fructus was established,which is simple and accurate.OPLS-DA and weighted TOPSIS method can be used to evaluate the quality difference of Camptothecae Fructus.

Objective:To analyze the efficacy and safety of a fully biodegradable occluder for the treatment of ventricular septal defects through percutaneous and transthoracic strategies.Methods:A case series study was conducted.The clinical data of 38 pediatric patients with a ventricular septal defect treated with a fully biodegradable occluder at Central China Fuwai Hospital from January 2023 to July 2024 were retrospectively analyzed.Among these patients, 15 received the percutaneous approach(percutaneous approach group) and the other 23 adopted the transthoracic approach(transthoracic approach group).The diagnosis was confirmed by transthoracic echocardiography before operation in all patients.The percutaneous approach was defined as establishing a venous-arterial track through X-ray and then placing an occluder under the guidance of transthoracic echocardiograph.The transthoracic approach was achieved by establishing a delivery track with a special hollow bougie through a small right subaxillary incision under the real-time guidance of esophageal ultrasound and then delivery and put an occluder.The clinical data of the patients, including general characteristics, electrocardiograms, echocardiograms and the biodegradable occluder system were collected and analyzed.Categorical variables were tested using the chi-square or Fisher′s exact test.Continuous variables were verified using the t-test or Mann-Whitney U test. Results:The patients were aged (5.7±3.9) years on average, with an average weight of 19.5(14.9, 25.9) kg.There were 39.5%(15 cases) of males among the patients included.The average size of the ventricular septal defect was 4.1(4.0, 5.0) mm.A simple perimembrane ventricular septal defect was detected in 29 patients (76.3%), concomitant membranous aneurysm in 4 patients (10.5%), an intracristal ventricular septal defect in 3 patients (7.9%), and a muscular ventricular septal defect in 2 patients (5.3%).Preoperative aortic and tricuspid valve regurgitations accounted for 5.3%(2/38) and 81.6%(31/38), respectively.The average age was (9.0±3.9) years in the percutaneous approach group and (3.6±1.9) years in the transthoracic approach group.In terms of the cardiac structure, the percutaneous approach group had smaller Z values of the left atrial anterior-to-posterior diameter (-0.5±0.6 vs.0.5±1.0, P<0.01) and the left ventricular end-diastolic diameter (-0.5±1.1 vs.0.8±0.8, P<0.01), and a smaller ventricular septal defect [4.0(3.9, 4.2) mm vs.4.5(4.0, 5.5) mm, P=0.01] than the transthoracic approach group.Regarding the operation, the percutaneous approach group had a larger difference between the waist diameter of the selected occluder and the diameter of the ventricular septal defect [2.8(2.0, 3.0) mm vs.2.0(1.5, 2.5) mm, P=0.02], shorter operative time [(61.5±27.3) minutes vs.(91.5±31.4) minutes, P=0.01], and a shorter hospital stay [8(5, 9) days vs.12(9, 15) days, P<0.01] than the transthoracic approach group.Both groups achieved immediate occlusion postoperatively, with no residual shunts and no grade Ⅲ atrioventricular conduction block.Five new cases of bundle branch blocks and 1 case of trivial aortic valve regurgitation occurred in the transthoracic approach group. Conclusions:Both percutaneous and transthoracic approaches are safe and effective in interventional closure of ventricular septal defects, but the former is more applicable to slightly older or heavier patients with a smaller ventricular septal defect, who need a larger occluder.

Objective:To retrieve and summarize the evidence regarding the non-surgical treatment and management of patients with pelvic organ prolapse (POP) .Methods:According to the "6S" evidence pyramid model, clinical guidelines, expert consensus, systematic reviews, clinical decisions, and clinical best practices related to the non-surgical treatment and management of patients with POP were systematically searched in databases and websites such as UpToDate, National Institute for Health and Clinical Excellence, Australia Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, Guidelines International Network, National Guideline Clearinghouse, PubMed, China National Knowledge Infrastructure. The search period was from the establishment of the database to January 31, 2024. Two investigators independently conducted literature quality assessment and extracted relevant information according to the Appraisal of Guidelines for Research and EvaluationⅡ and the Australia JBI Evidence-Based Health Care Center evaluation tools. The Australia JBI quality level of evidence and grade of recommendation (2014 version) were used for evidence integration and grading.Results:A total of 15 papers were finally included, including three clinical decisions, eight guidelines, two best practices, one expert consensus, and one systematic review. A total of 39 pieces of best evidence were summarized in nine areas of examination and assessment, treatment plan, lifestyle, expectant therapy, functional exercise, physical therapy, pessary, drug therapy, and follow-up observation.Conclusions:This study summarizes the best evidence on the non-surgical treatment and management of POP patients, which is scientific and comprehensive, and provides an evidence-based basis for medical and nursing staff to develop non-surgical treatment and management protocols for POP patients and self-management of POP patients.

Chikungunya fever is spreading continuously worldwide，posing a growing public health challenge alongside other arboviral diseases. This article systematically reviews the epidemiological characteristics of chikungunya fever，analyzes the pandemic potential of Aedes mosquito-borne diseases and discusses integrated prevention and control strategies for China in the context of increasing importation risk，drawing on containment practices from multiple countries and regions.

Objective To screen the differential markers affecting their quality,and sort their quality,a method for simultaneous detection of 9 components in Camptothecae Fructus from different producing areas was established.Methods Reflux extraction was performed on 18 batches of Camptothecae Fructus from 7 provinces,and the extracts were detected by HPLC.A orthogonal partial least squares discriminant analysis and weighted TOPSIS method were used to establish a quality evaluation model for Camptothecae Fructus,and the quality differences were comprehensively evaluated.Results When the 9 components were in the 0.51-12.75,0.23-5.75,3.21-80.25,4.45-111.25,1.88-47.00,0.41-10.25,2.05-51.25,0.34-8.50 and 7.95-198.75 μg·mL-1,their linear relationships were good(r>0.999).The average recovery were 96.95%-100.06%with the RSDs<2.0%.18 batches of samples were clustered into 3 categories.Vincosamide,10-hydroxycamptothecin,camptothecin 10-methoxycamptothecin and pumiloside may be the main potential markers affecting the quality of Camptothecae Fructus.The analysis results of the weighted TOPSIS method revealed that the closeness(Jb)for evaluating the quality of 18 batches of Camptothecae Fructus ranged from 0.1090 to 0.7385,with S14 achieving the highest value of 0.7385.Conclusion A method for simultaneous determination of 9 components in Camptothecae Fructus was established,which is simple and accurate.OPLS-DA and weighted TOPSIS method can be used to evaluate the quality difference of Camptothecae Fructus.

Chikungunya fever is spreading continuously worldwide，posing a growing public health challenge alongside other arboviral diseases. This article systematically reviews the epidemiological characteristics of chikungunya fever，analyzes the pandemic potential of Aedes mosquito-borne diseases and discusses integrated prevention and control strategies for China in the context of increasing importation risk，drawing on containment practices from multiple countries and regions.

Objective:To analyze the efficacy and safety of a fully biodegradable occluder for the treatment of ventricular septal defects through percutaneous and transthoracic strategies.Methods:A case series study was conducted.The clinical data of 38 pediatric patients with a ventricular septal defect treated with a fully biodegradable occluder at Central China Fuwai Hospital from January 2023 to July 2024 were retrospectively analyzed.Among these patients, 15 received the percutaneous approach(percutaneous approach group) and the other 23 adopted the transthoracic approach(transthoracic approach group).The diagnosis was confirmed by transthoracic echocardiography before operation in all patients.The percutaneous approach was defined as establishing a venous-arterial track through X-ray and then placing an occluder under the guidance of transthoracic echocardiograph.The transthoracic approach was achieved by establishing a delivery track with a special hollow bougie through a small right subaxillary incision under the real-time guidance of esophageal ultrasound and then delivery and put an occluder.The clinical data of the patients, including general characteristics, electrocardiograms, echocardiograms and the biodegradable occluder system were collected and analyzed.Categorical variables were tested using the chi-square or Fisher′s exact test.Continuous variables were verified using the t-test or Mann-Whitney U test. Results:The patients were aged (5.7±3.9) years on average, with an average weight of 19.5(14.9, 25.9) kg.There were 39.5%(15 cases) of males among the patients included.The average size of the ventricular septal defect was 4.1(4.0, 5.0) mm.A simple perimembrane ventricular septal defect was detected in 29 patients (76.3%), concomitant membranous aneurysm in 4 patients (10.5%), an intracristal ventricular septal defect in 3 patients (7.9%), and a muscular ventricular septal defect in 2 patients (5.3%).Preoperative aortic and tricuspid valve regurgitations accounted for 5.3%(2/38) and 81.6%(31/38), respectively.The average age was (9.0±3.9) years in the percutaneous approach group and (3.6±1.9) years in the transthoracic approach group.In terms of the cardiac structure, the percutaneous approach group had smaller Z values of the left atrial anterior-to-posterior diameter (-0.5±0.6 vs.0.5±1.0, P<0.01) and the left ventricular end-diastolic diameter (-0.5±1.1 vs.0.8±0.8, P<0.01), and a smaller ventricular septal defect [4.0(3.9, 4.2) mm vs.4.5(4.0, 5.5) mm, P=0.01] than the transthoracic approach group.Regarding the operation, the percutaneous approach group had a larger difference between the waist diameter of the selected occluder and the diameter of the ventricular septal defect [2.8(2.0, 3.0) mm vs.2.0(1.5, 2.5) mm, P=0.02], shorter operative time [(61.5±27.3) minutes vs.(91.5±31.4) minutes, P=0.01], and a shorter hospital stay [8(5, 9) days vs.12(9, 15) days, P<0.01] than the transthoracic approach group.Both groups achieved immediate occlusion postoperatively, with no residual shunts and no grade Ⅲ atrioventricular conduction block.Five new cases of bundle branch blocks and 1 case of trivial aortic valve regurgitation occurred in the transthoracic approach group. Conclusions:Both percutaneous and transthoracic approaches are safe and effective in interventional closure of ventricular septal defects, but the former is more applicable to slightly older or heavier patients with a smaller ventricular septal defect, who need a larger occluder.

Objective:To retrieve and summarize the evidence regarding the non-surgical treatment and management of patients with pelvic organ prolapse (POP) .Methods:According to the "6S" evidence pyramid model, clinical guidelines, expert consensus, systematic reviews, clinical decisions, and clinical best practices related to the non-surgical treatment and management of patients with POP were systematically searched in databases and websites such as UpToDate, National Institute for Health and Clinical Excellence, Australia Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, Guidelines International Network, National Guideline Clearinghouse, PubMed, China National Knowledge Infrastructure. The search period was from the establishment of the database to January 31, 2024. Two investigators independently conducted literature quality assessment and extracted relevant information according to the Appraisal of Guidelines for Research and EvaluationⅡ and the Australia JBI Evidence-Based Health Care Center evaluation tools. The Australia JBI quality level of evidence and grade of recommendation (2014 version) were used for evidence integration and grading.Results:A total of 15 papers were finally included, including three clinical decisions, eight guidelines, two best practices, one expert consensus, and one systematic review. A total of 39 pieces of best evidence were summarized in nine areas of examination and assessment, treatment plan, lifestyle, expectant therapy, functional exercise, physical therapy, pessary, drug therapy, and follow-up observation.Conclusions:This study summarizes the best evidence on the non-surgical treatment and management of POP patients, which is scientific and comprehensive, and provides an evidence-based basis for medical and nursing staff to develop non-surgical treatment and management protocols for POP patients and self-management of POP patients.