ObjectiveTo explore the effect of different drying conditions on the appearance and intrinsic quality indicators of Pinelliae Rhizoma for screening suitable drying conditions， so as to provide reference for its standardized production and quality evaluation. MethodsDifferent dried samples of Pinelliae Rhizoma were prepared by lime-assisted sweating method and intermittent drying method. Visual analysis was employed to measure the color brightness values（L^*） of the surface， cross-section and powder of the samples， texture analyzer was used to determine the hardness of the samples under different drying conditions. The total starch content was calculated by measuring the contents of amylose and amylopectin in the samples with ultraviolet-visible spectroscopy. High performance liquid chromatography（HPLC） was used to determine the contents of seven nucleoside components（uracil， hypoxanthine， uridine， inosine， guanosine， β-thymidine and adenosine） in the samples. Pearson correlation analysis was conducted to explore the correlation between the external characteristics and intrinsic indicators of the different dried samples. Principal component analysis（PCA） was used to comprehensively rank the data of various indicators， and partial least squares-discriminant analysis（PLS-DA） was used to screen differential components with variable importance in the projection（VIP） value>1. Furthermore， the difference between the optimal drying condition for Pinelliae Rhizoma and the traditional sun-drying method was explored by independent samples t-test. ResultsWith the increase of temperature， the color of the intermittently dried samples gradually deepened， while their hardness gradually decreased. Concurrently， the contents of extract， total starch， uridine and adenosine exhibited an upward trend， whereas the contents of uracil， hypoxanthine and inosine displayed a downward trajectory. Compared with the intermittent drying group， the content of extract in the samples subjected to lime-assisted sweating increased. With the increase of lime dose， the hardness and the total content of nucleoside components in the samples showed a downward trend， while the total starch content showed an upward trend. Correlation analysis showed that the comprehensive score of L^* was negatively correlated with the contents of uracil， hypoxanthine and inosine， and positively correlated with the contents of uridine， guanosine and adenosine. Hardness was negatively correlated with adenosine content， and positively correlated with the contents of inosine， uracil and hypoxanthine. Through comprehensive consideration and comprehensive score of principal components， the method of 5% lime-mixed sweating for 6 days emerged as the top-ranking approach. Except for the extract， the results of independent samples t-test showed that there was no significant difference between the 5% lime-mixed sweating for 6 days and the traditional sun-drying in terms of other content indicators. ConclusionThe whiteness and firmness of Pinelliae Rhizoma exhibit significant correlations with its chemical composition， while uridine， uracil， guanosine， adenosine and inosine are the key constituents responsible for the quality difference of Pinelliae Rhizoma under different drying conditions. The lime-assisted sweating method optimized in this study can be proposed as a viable alternative to the traditional sun-drying method. This method not only ensures the quality of the medicinal material but also effectively reduces the drying time and prevents mold contamination， which provides a valuable reference for the standardization of drying conditions and the establishment of quality evaluation criteria for Pinelliae Rhizoma.

Objective:To develop a network-structured clinical pathway grouping rule based on the principles and methods of China healthcare security diagnosis related groups(CHS-DRG), for references for optimizing clinical pathway management.Methods:From August to November 2024, this study constructed a network-structured clinical pathway management framework, followed the grouping principles of CHS-DRG, and developed a network-structured clinical pathway grouping rule through literature analysis and expert discussions. 54 clinical specialists from the sample hospital were organized and grouped according to the rule for the normal magnification cases(139 218 cases) of DRG medical insurance settlement in the hospital in 2023. Using a stratified random sampling method, 205 physicians from 54 clinical specialties in the hospital were selected to quantitatively evaluate the rationality, homogeneity, and clarity of the grouping results. The Likert 5-level scoring method was wsed to assign scores.Results:The network-structured clinical pathway grouping rule and nomenclature was established. A total of 341 main pathways and 35 sub-pathways covering 169 adjacent diagnosis related groups were formed. The quantitative assessment scores for rationality, homogeneity, and clarity were 4.90, 4.87 and 4.87 points, respectively.Conclusions:The network-structured clinical pathway grouping rule based on CHS-DRG had good, feasibility and standardization, and could meet the practical needs of clinical applications.

Objective:To explore the expression of nuclear factor-κB (NF-κB) and β-catenin in skin lesions of condyloma acuminatum, and analyze their relationship with clinical prognosis.Methods:A prospective study was conducted to select 96 patients with condyloma acuminatum admitted to the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from December 2020 to June 2023 as the case group. Another 96 normal tissue samples from patients who underwent external genital plastic surgery or circumcision at the same time in the hospital were taken as the control group. All patients in the case group received 5-aminolevulinic acid photodynamic therapy (ALA-PDT) treatment, and the outcome was achieved at 6 months after follow-up. The case group was divided into recurrent subgroups and non- recurrent subgroups based on whether there was a recurrence. The expression of NF-κB and β-catenin in patients with different prognoses between the case group and the control group were compared. The Phi coefficient was used to analyze the correlation between NF-κB, β-catenin, and condyloma acuminatum. COX regression analysis were used to test the relationship between NF-κB, β-catenin and recurrence, and then receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of NF-κB, β-catenin for recurrence in patients with condyloma acuminatum.Results:The positive rates of NF-κB and β-catenin in the lesion tissues of the case group were higher than those in the control group: 55.21%(53/96) vs. 23.96%(23/96), 56.25%(54/96) vs. 36.46%(35/96), and there were statistical differences ( P<0.05). According to the Phi coefficient test, there was a positive correlation between NF-κB and β-catenin positivity and condyloma acuminatum ( r>0, P<0.05). After 6 months of follow-up, 35 of the 96 patients relapsed, with a recurrence rate of 36.46% (35/96). The positive rates of NF-κB and β-catenin in the recurrent subgroup were significantly higher than those in the non-recurrent subgroup: 85.71%(30/35) vs. 37.70%(23/61), 85.71%(30/35) vs. 39.34%(24/61), and there were statistical differences ( P<0.05). COX regression analysis showed that the positive expression of NF-κB and β-catenin was related to the recurrence of patients with condyloma acuminatum after treatment ( HR = 4.017, 3.898, 95% CI 1.516 - 10.646, 1.470 - 10.336, P<0.05). The ROC curve showed that NF-κB, β-catenin, and their combination had moderate predictive value for recurrence in patients with condyloma acuminatum after treatment. The area under the curve (AUC) was 0.740 and 0.732, respectively. Among them, the combined predictive value was the highest, with an AUC of 0.810 ( P<0.05). Conclusions:The positive rates of NF-κB and β-catenin in the skin lesions of patients with condyloma acuminatum are relatively high, and they have certain predictive value for the recurrence of patients after treatment.

Objective:To explore the expression of nuclear factor-κB (NF-κB) and β-catenin in skin lesions of condyloma acuminatum, and analyze their relationship with clinical prognosis.Methods:A prospective study was conducted to select 96 patients with condyloma acuminatum admitted to the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from December 2020 to June 2023 as the case group. Another 96 normal tissue samples from patients who underwent external genital plastic surgery or circumcision at the same time in the hospital were taken as the control group. All patients in the case group received 5-aminolevulinic acid photodynamic therapy (ALA-PDT) treatment, and the outcome was achieved at 6 months after follow-up. The case group was divided into recurrent subgroups and non- recurrent subgroups based on whether there was a recurrence. The expression of NF-κB and β-catenin in patients with different prognoses between the case group and the control group were compared. The Phi coefficient was used to analyze the correlation between NF-κB, β-catenin, and condyloma acuminatum. COX regression analysis were used to test the relationship between NF-κB, β-catenin and recurrence, and then receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of NF-κB, β-catenin for recurrence in patients with condyloma acuminatum.Results:The positive rates of NF-κB and β-catenin in the lesion tissues of the case group were higher than those in the control group: 55.21%(53/96) vs. 23.96%(23/96), 56.25%(54/96) vs. 36.46%(35/96), and there were statistical differences ( P<0.05). According to the Phi coefficient test, there was a positive correlation between NF-κB and β-catenin positivity and condyloma acuminatum ( r>0, P<0.05). After 6 months of follow-up, 35 of the 96 patients relapsed, with a recurrence rate of 36.46% (35/96). The positive rates of NF-κB and β-catenin in the recurrent subgroup were significantly higher than those in the non-recurrent subgroup: 85.71%(30/35) vs. 37.70%(23/61), 85.71%(30/35) vs. 39.34%(24/61), and there were statistical differences ( P<0.05). COX regression analysis showed that the positive expression of NF-κB and β-catenin was related to the recurrence of patients with condyloma acuminatum after treatment ( HR = 4.017, 3.898, 95% CI 1.516 - 10.646, 1.470 - 10.336, P<0.05). The ROC curve showed that NF-κB, β-catenin, and their combination had moderate predictive value for recurrence in patients with condyloma acuminatum after treatment. The area under the curve (AUC) was 0.740 and 0.732, respectively. Among them, the combined predictive value was the highest, with an AUC of 0.810 ( P<0.05). Conclusions:The positive rates of NF-κB and β-catenin in the skin lesions of patients with condyloma acuminatum are relatively high, and they have certain predictive value for the recurrence of patients after treatment.

Objective:To develop a network-structured clinical pathway grouping rule based on the principles and methods of China healthcare security diagnosis related groups(CHS-DRG), for references for optimizing clinical pathway management.Methods:From August to November 2024, this study constructed a network-structured clinical pathway management framework, followed the grouping principles of CHS-DRG, and developed a network-structured clinical pathway grouping rule through literature analysis and expert discussions. 54 clinical specialists from the sample hospital were organized and grouped according to the rule for the normal magnification cases(139 218 cases) of DRG medical insurance settlement in the hospital in 2023. Using a stratified random sampling method, 205 physicians from 54 clinical specialties in the hospital were selected to quantitatively evaluate the rationality, homogeneity, and clarity of the grouping results. The Likert 5-level scoring method was wsed to assign scores.Results:The network-structured clinical pathway grouping rule and nomenclature was established. A total of 341 main pathways and 35 sub-pathways covering 169 adjacent diagnosis related groups were formed. The quantitative assessment scores for rationality, homogeneity, and clarity were 4.90, 4.87 and 4.87 points, respectively.Conclusions:The network-structured clinical pathway grouping rule based on CHS-DRG had good, feasibility and standardization, and could meet the practical needs of clinical applications.

Psoriasis and atherosclerosis are both complex and refractory.Genetic susceptibility,inflammatory response and the role of adipokines may be the main mechanisms of their comorbidity.TCM believes that heat,toxicity,phlegm,and blood stasis are the basic pathological factors of the comorbidity,which intertwine and lead to a longer course of disease.TCM,starting from the holistic concept,has a certain efficacy in the treatment of psoriasis and atherosclerosis,and has received widespread attention.This article reviewed the pathogenesis of psoriasis and atherosclerosis comorbidity from the aspects of heredity,inflammatory response,and the role of adipokines,and combed the current situation of the research on the mechanism of the treatment of psoriasis and atherosclerosis comorbidity with TCM monomer and compounds,providing references for related mechanisms and clinical research.

OBJECTIVE: To analyze the clinical phenotype and genetic basis for a male neonate featuring hypoparathyroidism, sensorineural hearing loss, and renal dysplasia (HDR) syndrome. METHODS: The child was subjected to genome-wide copy number variation (CNVs) analysis and whole exome sequencing (WES). Clinical data of the patient was analyzed. A literature review was also carried out. RESULTS: The patient, a male neonate, had presented with peculiar facial appearance, simian crease and sacrococcygeal mass. Blood test revealed hypocalcemia, hypoparathyroidism. Hearing test suggested bilateral sensorineural deafness. Doppler ultrasound showed absence of right kidney. Copy number variation sequencing revealed a 12.71 Mb deletion at 10p15.3-p13 (chr10: 105 001_12 815 001) region. WES confirmed haploinsufficiency of the GATA3 gene. With supplement of calcium and vitamin D, the condition of the child has improved. CONCLUSION The deletion of 10p15.3p13 probably underlay the HDR syndrome in this patient.
DNA Copy Number Variations ; Hearing Loss, Sensorineural/genetics* ; Humans ; Hypoparathyroidism/genetics* ; Infant, Newborn ; Kidney/abnormalities* ; Male ; Syndrome ; Urogenital Abnormalities/genetics*

Objective:To analyze the effect of role standardized progressive nursing model on delivery fear and delivery outcome of primiparas.Methods:Using the convenient sampling method, a total of 200 primiparas who were admitted to Ruian Maternal and Child Health Hospital of Zhejiang Province from January to December 2020 were selected as the research objects. According to the random number table method, they were divided into the control group and the observation group, with 100 cases in each group. Patients in the control group were given routine nursing intervention, while patients in the observation group were given role standardization progressive nursing mode on the basis of the control group. Childbirth Attitude Questionnaire (CAQ) and Childbirth Self-Efficacy Inventory-32 (CBSEI-32) were used to investigate, and the outcomes of delivery in the two groups were counted.Results:Before intervention, there was no statistically significant difference in CAQ and CBSEI-32 scores between two groups ( P>0.05) . After intervention, the scores and total scores of all dimensions of CAQ in the observation group were lower than those in the control group, and the outcome expectation, delivery self-efficacy expectation score in CBSEI-32 were higher than those in the control group, and the differences were all statistically significant ( P<0.05) . There was no statistically significant difference in the incidence of postpartum hemorrhage, lateral perineal resection and premature rupture of membranes in the observation group ( P>0.05) . The cesarean section rate in the observation group was lower than that in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The role standardized progressive nursing model can alleviate the fear of delivery, improve the sense of self-efficacy during delivery and improve the outcome of delivery, which is worthy of clinical application.

Objective To evaluate the outcomes and prognostic factors of image-guided 125I seed implantation for locally recurrent soft tissue sarcoma(RSTS).Methods A total of 60 patients with RSTS who received image-guided 125I seed implantation in Peking University Third Hospital,from September 2002 to December 2015,were retrospectively analyzed.The enrollment criteria: KPS ＞60 points,refused or could not tolerate surgery or radiotherapy,the expecting survival time ＞3 months,relapsed after multiple treatment of soft tissue sarcoma,and underwent CT or ultrasound guided 125 I seed implantation treatment.In all,the median activity of seeds was 25.9×106Bq(range,11.1×106-29.6×106Bq),median number of implanted seeds was 58(range,3-133),and the median D90was 120 Gy(range,36.50-460.97 Gy).The local progression-free survival(LPFS)and overall survival(OS)were calculated using the Kaplan-Meier method.The log-rank test and Cox regression model were used for the univariate and multivariate analyses.Results The median follow-up was 18.75 months(range,1-146).The median OS was 18.5 months(95％CI 13.1-23.9).The 1-,3-and 5-year OS rate were 63.3％,33.0％and 29.5％,respectively.The 1-,3-and 5-year LPFS rate were 72.5％,63.7％and 59.7％,respectively.The general rate of pain relieving was 100％(6/6).8.3％(5/60)presented grade Ⅳskin toxicity.No fatal complications ocurred.The univariate analysis suggested that tumor size,tumor volume,KPS score,D90were prognostic factors of OS and LPFS.The multivariate analysis demonstrated that previous chemotherapy history and distant metastases were independent prognostic factors of survival.Conclusions Image-guided 125I seed implantation for recurrent soft tissue sarcoma is a safe treatment option with high efficacy and low morbidity.Tumor size and D90were the prognostic factors of OS and LPFS.

Objective To study the risk factors for children with acute central nervous system(CNS)viral in-fection,so that pediatrician may identify children with poor prognosis at early stages of the disease,and provide them with a theoretical basis for clinical treatment. Methods The clinical data of a cohort patients of acute CNS viral infec-tion who were hospitalized at the First Affiliated Hospital of Fujian Medical University between January 2010 and June 2013 were retrospectively collected and analyzed. According to Glasgow outcome scale on discharge,children were di-vided into good prognosis group and poor prognosis group. Clinical data and outcomes were analyzed by using univariate analysis and binary Logistic regression multivariate analysis. Results Three hundred and one cases were enrolled,278 (92. 36% )patients were assigned to the good prognosis group,and 23(7. 64% )patients were assigned to the poor prognosis group. By univariate analysis,the patients in the poor prognosis group had longer duration of sickness before admission,longer time of fever,lower white blood cell count in cerebrospinal fluid,a relatively lower calcium level,con-scious disturbance at the early stage,multiple seizures,convulsive status epilepticus,meningeal irritation sign,muscle weakness,severe changes in electroencephalogram(EEG),and abnormal neuroimaging findings(computed tomography or magnetic resonance imaging,or both)had significant differences between the good prognosis group and the poor short - term outcome groups(all P < 0. 05). By binary Logistic regression multivariate analysis,factors indicating a poor prognosis during the early stage were conscious disturbance at the early stage(0R = 4. 885,95% CI:1. 523 - 15. 670, P = 0. 008),multiple seizures(0R = 6. 352,95% CI:1. 905 - 21. 178,P = 0. 003),severe changes in EEG( 0R =4. 269,95% CI:1. 708 - 10. 666,P = 0. 002),and abnormal neuroimaging findings( 0R = 9. 740,95% CI:2. 360 -40. 192,P = 0. 002). Conclusions Conscious disturbance at the early stage,multiple seizures,severe changes in EEG and abnormal neuroimaging findings are risk factors for acute viral infection of CNS in children.