ObjectiveTo investigate the potential mechanism of Danggui Buxuetang （DBT） in the treatment of vascular dementia （VAD）. MethodsSixty male SD rats were randomly assigned to the sham-operated group， model group， DBT low-， medium-， and high-dose groups， and the donepezil group. Except for the sham-operated group， rats in all other groups underwent bilateral common carotid artery ligation. After successful modeling， DBT was administered at doses of 9.2， 18.4， 36.8 g·kg^-1 for the low-， medium-， and high-dose groups， respectively， while the donepezil group received 3 mg·kg^-1 donepezil solution by gavage once daily. After 4 consecutive weeks of drug treatment， rats underwent the Morris water maze test， novel object recognition test， Nissl staining to observe hippocampal neurons， and immunofluorescence staining to detect the expression of neuronal nuclear protein （NeuN） in the hippocampus. Western blot was used to assess the expression of PTEN-induced kinase 1 （PINK1）， Parkin， microtubule-associated protein 1 light chain 3Ⅱ （LC3Ⅱ）， B-cell lymphoma-2 （Bcl-2）， and Bcl-2-associated X protein （Bax）. Transmission electron microscopy was used to observe hippocampal neuronal ultrastructure. Real-time PCR was used to detect the expression of NADPH oxidase subunits p22^phox and p47^phox in hippocampal tissues. The levels of malondialdehyde （MDA）， glutathione （GSH）， superoxide dismutase （SOD）， and total antioxidant capacity were measured to evaluate oxidative stress levels. ResultsIn the Morris water maze test， escape latency changed significantly over time in all groups except the model group. Compared with the sham-operated group， the model group showed significantly prolonged escape latency （P<0.01）. Compared with the model group， rats in the DBT groups and the donepezil group exhibited significantly shorter escape latency （P<0.05， P<0.01）. The number of crossings over the original platform was significantly reduced in the model group compared with the sham-operated group （P<0.01）， whereas rats in the DBT and donepezil groups showed significantly increased platform crossings compared with the model group （P<0.05， P<0.01）. Compared with the sham-operated group， exploration time of new objects was significantly reduced in the model group （P<0.01）. Compared with the model group， exploration time of new objects increased significantly in the medium- and high-dose DBT groups and the donepezil group （P<0.05， P<0.01）， while no significant change was observed in the low-dose DBT group. Compared with the high-dose DBT group， rats in the donepezil group had significantly prolonged escape latency and reduced platform crossings and new-object exploration time （P<0.05）. Nissl staining showed decreased density of healthy neurons in the CA1 and CA3 regions of the hippocampus in the model group， with loss of Nissl bodies and nuclear atrophy or disappearance. In the high-dose DBT group， neuronal density in CA1 and CA3 increased， with neurons arranged closely and displaying normal morphology. Immunofluorescence showed that compared with the sham-operated group， the hippocampal NeuN⁺ cell count in the VAD model group was significantly decreased（P<0.01）， compared with the VAD model group， the hippocampal NeuN⁺ cell count in the high-dose DBT group was significantly increased（P<0.01）. Compared with the sham-operated group， the expression of PINK1， Parkin， LC3Ⅱ， and Bax proteins was significantly increased（P<0.01）， while the expression of Bcl-2 was significantly decreased in the VAD model group（P<0.01）. Compared with the VAD model group， the high-dose DBT group showed significantly decreased expression of PINK1， Parkin， LC3Ⅱ， and Bax proteins（P<0.01）and significantly upregulated Bcl-2 expression（P<0.01）. The medium-dose DBT group exhibited significantly reduced expression of Parkin， LC3Ⅱ， and Bax proteins（P<0.05，P<0.01） and significantly increased Bcl-2 expression（P<0.01）， while no statistically significant differences were observed in the low-dose DBT group. Transmission electron microscopy showed mitochondrial pyknosis， thickened cristae， increased electron density， and the presence of mitochondrial autophagy in the model group. In contrast， hippocampal neurons in the high-dose DBT group contained abundant mitochondria with intact morphology， clear cristae， and uniform matrix. Compared with the sham-operated group， total antioxidant capacity， SOD activity， and GSH levels were significantly decreased， while MDA levels were significantly increased in the model group （P<0.01）. Compared with the model group， total antioxidant capacity and antioxidant levels （SOD， GSH） increased significantly， and MDA decreased significantly in the medium- and high-dose DBT groups （P<0.01）， while no significant changes were observed in the low-dose DBT group. Compared with the sham-operated group， mRNA expression of p22^phox and p47^phox was significantly increased in the model group （P<0.01）. Compared with the model group， expression of p22^phox and p47^phox was significantly decreased in the DBT groups （P<0.05， P<0.01）. ConclusionDBT may exert neuroprotective effects by regulating PINK1/Parkin-mediated mitochondrial autophagy， thereby improving learning and memory abilities and treating VAD.

ObjectiveTo elucidate the chemical composition of the reference sample of Jinshui Liujunjian and its distribution characteristics in blood and tissues of rats. MethodsUltra performance liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry（UPLC-Q-TOF-MS/MS） was used to detect the reference sample solution， plasma， and tissue samples of Jinshui Liujunjian under positive and negative ion modes， respectively. Qualitative Analysis 10.0 software and a self-constructed database were employed for primary mass spectrum matching.Compound identification was further validated by comparing retention times， secondary mass spectral fragments， reference standards， and literature data to deduce fragmentation pathways. ResultsA total of 122 compounds were identified in the reference sample of Jinshui Liujunjian， including 47 flavonoids， 5 amino acids， 13 iridoids， 16 triterpenoid saponins， etc.， of which 42 compounds were confirmed by comparison with reference substances. A total of 21 prototype components were identified in blood components； 50 prototype components were identified in different tissues， among which 13， 10， 7， 21， 11， 6， 14， and 40 prototype components were identified in the heart， liver， spleen， lung， kidney， brain， large intestine， and stomach， respectively. Among them， 7 compounds such as ferulic acid， glycyrrhizic acid， and nobiletin were exposed in the target organs of lung and kidney. ConclusionThis study elucidates the material basis of the reference samples of Jinshui Liujunjian， primarily composed of flavonoids and triterpenoid saponins， along with their in vivo distribution characteristics. These findings provide a scientific basis for establishing quality evaluation indicators and offer references for subsequent pharmacodynamic and pharmacokinetic investigations.

ObjectiveTo elucidate the chemical composition of the reference sample of Jinshui Liujunjian and its distribution characteristics in blood and tissues of rats. MethodsUltra performance liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry（UPLC-Q-TOF-MS/MS） was used to detect the reference sample solution， plasma， and tissue samples of Jinshui Liujunjian under positive and negative ion modes， respectively. Qualitative Analysis 10.0 software and a self-constructed database were employed for primary mass spectrum matching.Compound identification was further validated by comparing retention times， secondary mass spectral fragments， reference standards， and literature data to deduce fragmentation pathways. ResultsA total of 122 compounds were identified in the reference sample of Jinshui Liujunjian， including 47 flavonoids， 5 amino acids， 13 iridoids， 16 triterpenoid saponins， etc.， of which 42 compounds were confirmed by comparison with reference substances. A total of 21 prototype components were identified in blood components； 50 prototype components were identified in different tissues， among which 13， 10， 7， 21， 11， 6， 14， and 40 prototype components were identified in the heart， liver， spleen， lung， kidney， brain， large intestine， and stomach， respectively. Among them， 7 compounds such as ferulic acid， glycyrrhizic acid， and nobiletin were exposed in the target organs of lung and kidney. ConclusionThis study elucidates the material basis of the reference samples of Jinshui Liujunjian， primarily composed of flavonoids and triterpenoid saponins， along with their in vivo distribution characteristics. These findings provide a scientific basis for establishing quality evaluation indicators and offer references for subsequent pharmacodynamic and pharmacokinetic investigations.

BACKGROUND: The protective effectiveness of an N95 respirator depends on the filtration efficiency of the material from which the N95 respirator is made of, as well as the wearers' facial fit. The facial fit of an N95 respirator mainly depends on the degree of matching between the wearers' facial dimension characteristics and the N95 respirator. Quantitative fit testing objectively evaluates the fit of N95 respirators; however, it is not easy to promote because of the limitations of testing conditions. The aim of this study is to establish a fit prediction model of N95 respirator based on facial images. METHODS: Facial images and fit factor (FF) value of 5 N95 respirators were gathered from 299 medical staffs in 10 hospitals in Beijing. Face geometry measurement was based on 3D face modelling, and the American TSI-8038 Porta Count Pro+ was used to conduct quantitative fit test. Multiple linear regression analysis was employed to identify facial dimensional features that significantly influenced the fit of N95 respirators. Through matching training of facial image and FF values, a fit prediction model has been established, enabling rapid recommendation of N95 respirators meeting the fit standard via facial image recognition. RESULTS: A fit prediction model for N95 respirators based on facial images has been developed, which enables the rapid recommendation of N95 respirators with acceptable FF value for healthcare personnel. The model demonstrated an accuracy of 55.93%, a precision of 98.43%, a recall of 51.65%, and an F1 score of 0.68. CONCLUSIONS It is feasible to utilize computer-based facial recognition technology to rapidly recommend N95 respirators for medical personnel. Given the high level of accuracy achieved, the model demonstrates significant potential for practical application.
Humans ; Face/anatomy & histology* ; N95 Respirators/standards* ; Male ; Adult ; Female ; Middle Aged ; Beijing

Objective Establish the fingerprint of the group and optimize the extraction process of the Yunpi Huatan Tongqiao decoction.Methods The macroscopic characterization and similarity analysis of the extract fingerprint were carried out by applying the total statistical moment method.With baicalin,wogonin,rosmarinic acid,liquiritin,glycyrrhizic acid and paste yield as key quality attributes,and extraction time,water addition and extraction times as key process parameters,the optimal extraction process was selected by AHP-independent weight method,and the process was verified.Results Establishing a total statistical moment similarity evaluation method,and the average statistical moment similarity of the total amount of fingerprints of different extraction methods was 0.8807.The ANOVA results of the process evaluation model function are displayed that P<0.0001,R2=0.9904,indicating that the model was statistically significant.The best extraction process was determined as follows:adding 10-fold volume of water in the whole prescription,extracting for 1.5 h and extracting twice.Conclusion The total statistical moment analysis method that conforms to the fingerprint characteristics of the fingerprint of the extract was established,which was stable and reliable,which provided a reference basis for the quality control of the whole process of the subsequent process research.

AIM:This study aims to examine the ependymin-related protein 1(EPDR1)expression in various tissues from wild-type C57BL/6 mice and type 2 diabetes(db/db)mice.The impact of EPDR1 on lipid accumulation in al-pha mouse liver 12(AML12)hepatocytes was also investigated.METHODS:Western blot was used to detect EPDR1 protein expression in the heart,liver,spleen,lung,kidney,gastrocnemius,brown adipose and brain tissues of C57BL/6 mice.Western blot and immunohistochemical(IHC)staining were also used to compare EPDR1 protein expression in the liver,gastrocnemius muscle,heart and kidney tissues of db/db and C57BL/6 mice.To develop an AML12 cell lipid deposi-tion model,palmitic acid(PA)+oleic acid(OA)was used,and the cells were transfected with adenovirus overexpressing EPDR1 or treated with exogenous recombinant EPDR1 protein(rEPDR1).ELISA was conducted to determine intracellu-lar triglyceride(TG)content,and oil red O staining was employed to assess the effect of EPDR1 on lipid accumulation in AML12 cells.RESULTS:Western blot and IHC staining results revealed that EPDR1 was widely expressed in various tis-sues of wild-type mice,with the liver exhibiting the highest protein expression level.However,EPDR1 expression was down-regulated in the liver,gastrocnemius muscle,heart and kidney tissues in diabetic db/db mice compared with wild-type mice.Oil red O staining revealed that overexpression of EPDR1 in AML12 liver cells or rEPDR1 treatment led to re-duced lipid accumulation.Furthermore,the TG content significantly decreased compared with the model group(P<0.05).CONCLUSION:EPDR1 is expressed in various tissues of wild-type mice,but showed diminished expression in the liver tissues of diabetic mice.Nevertheless,enhancing the expression of EPDR1 can aid in reducing lipid accumula-tion in hepatocytes.These findings provide an experimental foundation for further exploration of the role of EPDR1 in the development of fatty liver in diabetic liver tissue.

Objective To collect data related to nursing quality,describe and analyze the application effect,and explore its application value by combining the contents of key contents of nursing quality control with information technology in clinical nursing work.Methods Based on the clinical nursing quality control information system currently operated in Yichun People's Hospital,actual contents of nursing quality control were incorporated into the system,focusing on key links of nursing quality control,such as patient identification management,medication safety management,doctor's order check management,nursing document writing,overall nursing responsibility system,and health education management.Additionally,the study compared the performance of these quality control points before and after the integration of information technology.Results Following the inte-gration of key quality control contents in nursing with information technology,all departments of the hospital achieved a signifi-cantly higher pass rates for patient identification management,medication safety management,doctor's order check management,health education management,and follow-up rates of discharged patients(P＜0.05),while they had a significant decrease in the incidence of fall injuries,in-hospital pressure injuries,and unplanned extubation among inpatients(P＜0.05).Additionally,the time for post-ward nursing data extraction,problem feedback,and correction cycle was significantly shortened after implemen-tation(P＜0.05).Conclusion The information-oriented key contents of nursing quality control yields effectiveness in enhancing the performance of various quality control measures and reducing the occurrence of adverse events such as fall injuries and pres-sure injuries.This integration allows for more accurate data collection,improves patient follow-up rates,and facilitates timely ad-justments in nursing practices.The study recommends utilizing scientific methods to extract reliable monitoring information,en-hance data accuracy,and minimize adverse events.

Objective:To evaluate the efficacy and safety of hypomethylating agents (HMA) in patients with myelodysplastic syndromes (MDS) .Methods:A total of 409 MDS patients from 45 hospitals in Zhejiang province who received at least four consecutive cycles of HMA monotherapy as initial therapy were enrolled to evaluate the efficacy and safety of HMA. Mann-Whitney U or Chi-square tests were used to compare the differences in the clinical data. Logistic regression and Cox regression were used to analyze the factors affecting efficacy and survival. Kaplan-Meier was used for survival analysis. Results:Patients received HMA treatment for a median of 6 cycles (range, 4-25 cycles) . The complete remission (CR) rate was 33.98% and the overall response rate (ORR) was 77.02%. Multivariate analysis revealed that complex karyotype ( P=0.02, OR=0.39, 95% CI 0.18-0.84) was an independent favorable factor for CR rate. TP53 mutation ( P=0.02, OR=0.22, 95% CI 0.06-0.77) was a predictive factor for a higher ORR. The median OS for the HMA-treated patients was 25.67 (95% CI 21.14-30.19) months. HMA response ( P=0.036, HR=0.47, 95% CI 0.23-0.95) was an independent favorable prognostic factor, whereas complex karyotype ( P=0.024, HR=2.14, 95% CI 1.10-4.15) , leukemia transformation ( P<0.001, HR=2.839, 95% CI 1.64-4.92) , and TP53 mutation ( P=0.012, HR=2.19, 95% CI 1.19-4.07) were independent adverse prognostic factors. There was no significant difference in efficacy and survival between the reduced and standard doses of HMA. The CR rate and ORR of MDS patients treated with decitabine and azacitidine were not significantly different. The median OS of patients treated with decitabine was longer compared with that of patients treated with azacitidine (29.53 months vs 20.17 months, P=0.007) . The incidence of bone marrow suppression and pneumonia in the decitabine group was higher compared with that in the azacitidine group. Conclusion:Continuous and regular use of appropriate doses of hypomethylating agents may benefit MDS patients to the greatest extent if it is tolerated.

120 extracted maxillary first premolars were endodontically treated and randomly divided into 5 groups(n=24).The teeth in group A had 4 walls of coronal tooth structure,in group B,C,D and E had only 3 walls,missing the palatal,buccal,mesial and distal wall,respectively.The teeth in group A0-E0(n=6)were restored without post,in group A1-E1(n=6)with buccal post,in group A2-E2(n=6)with palatal post,in group A3-E3(n=6)with buccal and palatal post,respectively.The fracture resistance of group A was higher than that of B,C,D and E groups(P＜0.05).The fracture resistance of fiber posts placed in the buccal root canal was higher than that in the palatal root canal(P＜0.05).The 360° complete ferrule can provide the best fracture resistance,When the ferrule is not complete,it is recommended to place buccal fiber post for repair.

Objective Sleep spindles play an important role in promoting cognition.This paper discusses the influencing factors of sleep spindles and provides objective evidence for clinical intervention and regulation of spindles to improve sleep and cognition.Methods Fifty patients with poor sleep quality were monitored overnight by sleep monitoring system,and physiological parameters of sleep structure,electroencephalography power spectrum,cardiovascular and respiratory function were obtained.The correlations between the parameters,age,sex and the spindle index and characteristics(frequency,duration and amplitude)of non rapid-eye-movement sleep(NREM)Ⅱphase were calculated.In Poincare diagram,SD1 represents the positive index of parasympathetic nerve activity,and SD2 represents the negative index of sympathetic nerve activity.Pulse transit time(PTT)decline index represents vascular sympathetic stability.Results SD1(β =-0.512,P＜0.05)and PTT decline index(β =-0.271,P＜0.05)were negatively correlated with spindle index respectively,while SD2 was positively correlated with spindle index(β =0.474,P＜0.05).The sleep change index,NREMⅠ phase proportion and cortical EEG microarousal index were negatively correlated with spindle index(r =-0.316,r =-0.359,r =-0.326;all P＜0.05).Age was negatively correlated with spindle index(β =-0.422,P＜0.05).δ power of deep sleep was negatively correlated with Spindle wave amplitude(β = 0.65,P＜0.001).No correlation was found between sex and sleep spindles.Conclusions The production of sleep spindles depends on good sleep and stable autonomic nerves.It is related to cognition and reflects the strength of synaptic connections,which provides evidence for clinical intervention and regulation of sleep spindles,and also provides a new physiological indicator for evaluating cognitive and brain function.