This article systematically analyzes the historical evolution of the name， origin， quality evaluation， harvesting， processing and other aspects of Picrorhizae Rhizoma by referring to the medical books， prescription books， and other documents of the past dynasties， combined with relevant modern research materials， in order to provide a basis for the development and utilization of famous classical formulas containing this medicinal herb. The research results indicate that Picrorhizae Rhizoma was first recorded in New Revised Materia Medica from the Tang dynasty. Throughout history， Huhuanglian has been used as its official name， and there are also aliases such as Gehu Luze， Jiahuanglian and Hulian. The main source of past dynasties is the the rhizomes of Picrorhiza kurrooa and P. scrophulariiflora. In ancient times， Picrorhizae Rhizoma was mainly imported by foreign traders via Guangzhou and other regions， and also produced in China， mainly in Xizang. In ancient times， it was harvested and dried in early August of the lunar calendar， while in modern times， it is mostly harvested from July to September， with the best quality being those with thick and crispy rhizomes without impurities， and bitter taste. Throughout history， Picrorhizae Rhizoma was collected， washed， sliced， and dried before being used as a raw material for medicine， it has a bitter and cold taste， mainly used to treat bone steaming， hot flashes， infantile chancre fever， and dysentery. There is no significant difference in taste and efficacy between ancient and modern times. Based on the research results， it is recommended that the rhizomes of P. scrophulariiflora in the 2020 edition of Chinese Pharmacopoeia， or the rhizomes of P. kurrooa， can be used in famous classical formulas containing this medicinal herb， which can be processed according to the processing requirements marked by the original formula. For those without clear processing requirements， the dried raw products are used as medicine.

OBJECTIVE To obtain stronger cytotoxic activity of panaxadiol derivatives. METHODS The 3-amino panaxadiol was prepared by the bioelectronic isosteric principle, and then 18 derivatives of cinnamic acid, NO donor and other types of panaxadiol derivatives were synthesized, among them, 12 compounds had not been reported in the literature, and their structures had been confirmed by 1H-NMR, 13C-NMR and mass spectrometry. These compounds were evaluated for their cytotoxic activity by MTS assay against human leukemia cell line HL-60, liver cancer cell line SMMC-7721, lung cancer cell line A-549, breast cancer cell line MCF-7, and colon cancer cell line SW480. RESULTS These results showed that compounds 6c, 7 as well as 7j exhibited potent inhibitory activities against all five tumor cells, especially the IC50 values of compound 7 against HL-60 and SMMC-7721cells were 3.41 and 4.51 μmol·L−1, respectively. It was significantly superior to panaxadiol in cytotoxicity. CONCLUSION These results show that 7 and 7j can be used as promising lead compounds for further research.

Objective:To study the clinical value of enhanced recovery after surgery(ERAS) strategy combined with early intestinal fluid reinfusion among neonates receiving jejunostomy due to intestinal obstruction.Methods:From December 2018 to December 2022, neonates with intestinal obstruction receiving jejunostomy in the Department of Neonatal Surgery of our hospital were prospectively enrolled. They were randomly assigned into ERAS group and traditional treatment (TT) group after surgery. The ERAS group was treated with ERAS strategy plus early intestinal fluid reinfusion. The TT group was treated with conventional gastrointestinal decompression, analgesia as needed and enteric fluid reinfusion according to the amount of defecation. The postoperative parenteral nutrition (PN) duration (T pn), central venous catheter (CVC) duration (T cvc), daily weight gain, duration of postoperative hospital stay (T hos), complications and readmission rate within 30 days were compared between the two groups. Results:A total of 22 cases were included in the ERAS group and 20 cases were in the TT group. T pn [(22.6±9.4) d vs. (30.7±11.3) d], T cvc [(5.9±0.8) d vs. (9.9±2.1) d] and T hos [(26.8±9.8) d vs. (33.8±11.5) d] in the ERAS group were significantly shorter than the TT group ( P<0.05). No significant difference existed in daily weight gain between the two groups ( P>0.05). The incidence of postoperative gastrointestinal mucosal bleeding in the ERAS group was significantly lower than the TT group (13.6% vs. 45.0%)( P<0.05). No significant differences existed in the following items between the two groups: feeding intolerance, PN-associated cholestasis, CVC-related bloodstream infection, intestinal fluid reinfusion-related complications, premature closure of fistula and readmission rate within 30 days (all P>0.05). Conclusions:The application of ERAS strategy plus early intestinal fluid reinfusion in neonates with enterostomy is safe and feasible, which can reduce the postoperative durations of PN, CVC and hospital stay and accelerate the recovery.

Objective:To assess the association between body mass index (BMI) and major adverse cardiovascular and cerebrovascular events (MACCE) among patients with acute coronary syndrome (ACS).Methods:This was a multicenter prospective cohort study, which was based on the Improving Care for Cardiovascular Disease in China (CCC) project. The hospitalized patients with ACS aged between 18 and 80 years, registered in CCC project from November 1, 2014 to December 31, 2019 were included. The included patients were categorized into four groups based on their BMI at the time of admission: underweight (BMI<18.5 kg/m 2), normal weight (BMI between 18.5 and 24.9 kg/m 2), overweight (BMI between 25.0 and 29.9 kg/m 2), and obese (BMI≥30.0 kg/m 2). Multivariate logistic regression models was used to analyze the relationship between BMI and the risk of in-hospital MACCE. Results:A total of 71 681 ACS inpatients were included in the study. The age was (63.4±14.7) years, and 26.5% (18 979/71 681) were female. And the incidence of MACCE for the underweight, normal weight, overweight, and obese groups were 14.9% (322/2 154), 9.5% (3 997/41 960), 7.9% (1 908/24 140) and 7.0% (240/3 427), respectively ( P<0.001). Multivariate logistic regression analysis showed a higher incidence of MACCE in the underweight group compared to the normal weight group ( OR=1.30, 95% CI 1.13-1.49, P<0.001), while the overweight and obese groups exhibited no statistically significant difference in the incidence of MACCE compared to the normal weight group (both P>0.05). Conclusion:ACS patients with BMI below normal have a higher risk of in-hospital MACCE, suggesting that BMI may be an indicator for evaluating short-term prognosis in ACS patients.

Objective:To analyze the dosimetric differences between gamma knife stereotactic body radiation therapy (SBRT) and linear accelerator-based SBRT for lung tumors by comparison to provide a theoretical basis for the selection of treatment strategies.Methods:Seven patients who underwent SBRT for lung tumors in the Cancer Center of Affiliated Zhongshan Hospital of Dalian University from January 2022 to May 2023 were enrolled. Plans of gamma knife SBRT (γ_SBRT) or linear accelerator-based SBRT plans (X_SBRT) were designed for the 13 lesions in the patients, with adjacent lesions in the same patient sharing one plan. As a result, 10 γ_SBRT plans and 10 X_SBRT plans were obtained. All lesions received 30-50 Gy of radiation in 5-10 fractions. Then, dosimetric parameters were analyzed and compared between γ_SBRT and X_SBRT plans, including the target coverage, gradient index (GI), conformity index (CI), maximum dose ( Dmax); mean dose ( Dmean), and minimum dose ( Dmin) of planning target volumes (PTVs); lung volumes receiving 20 Gy or more ( V20), 10 Gy or more ( V10), 5 Gy or more ( V5), 100% of the prescription dose ( V100%), and 50% of the prescription dose ( V50%); Dmean and the percentages of lung volume receiving doses of 20 Gy or more (Lung_ V20) and 5 Gy or more (Lung_ V5) of ipsilateral lung; Dmean and Lung_ V5 of contralateral lung; and Dmax values of the esophagus, spinal cord, and heart. Results:Compared to X_SBRT plans, γ_SBRT plans exhibited superior GI, V20, V10, V5, V50%, the Dmean, Lung_ V20, and Lung_ V5 of ipsilateral lung, the Dmean and Lung_ V5 of the contralateral lung, and the Dmax of esophageal and heart ( z = -2.81 to -1.99, P < 0.05), higher Dmax and Dmean of PTVs ( z = -2.80, -2.80, P < 0.05), and longer delivery time ( z=-2.70, P<0.05). Meanwhile, there was no significant difference in target coverage, CI, and Dmax of the spinal cord ( P > 0.05). Conclusions:Gamma knife SBRT plans can achieve sharper dose falloff outside target volumes than linear accelerator-based SBRT plans. Gamma knife radiosurgery is expected to reduce the radiation dose to low-dose areas around PTVs and normal lung tissue in SBRT for lung tumors. However, it significantly prolongs the delivery time.

Objective:To investigate whether transplantation of gingival mesenchymal stem cells (GMSCs) can inhibit radiation-induced senescence of alveolar epithelial cells type Ⅱ (AECⅡ) and its role in the prevention of radiation-induced pulmonary fibrosis (RIPF).Methods:Mouse type Ⅱ alveolar epithelial cells (MLE12) were irradiated with 6 Gy X-rays and then co-cultured with GMSCs. The extent of cellular senescence of MLE12 cells was assessed by cell morphology, β-Gal staining, and senescence secretion-associated phenotype (SASP) assay. RIPF model was constructed by unilaterally irradiating the right chest of C57BL/6 mice with 17 Gy X-rays. GMSCs were transplanted 1 d after irradiation. At 180 d after irradiation, the pulmonary organ ratio, HE staining, and Masson staining were used to assess intra-pulmonary structure and interstitial collagen deposition in the lung. β-Gal immunohistochemistry and immunofluorescence co-localization with AECⅡ were measured to assess the degree of cellular senescence in the lung. The SASP expression changes in lung tissue were detected by qRT-PCR. The protein expressions in P53-P21 and P16 pathways were detected by Western blot assay. P21 expression in AECⅡ was detected by immunofluorescence co-localization assay.Results:GMSCs effectively inhibited radiation-induced senescence of MLE12 cells, reduced the ratio of radiation-elevated β-Gal positive cells by 11.8% ( t=6.72, P<0.05), and decreased the expressions of SASP (IL-6, IL-8, IL-1β) ( t=28.43, 28.43, 4.82, P<0.05). GMSCs transplantation improved the survival rate of irradiated mice, prevented radiation-induced alveolar structural collapse thickening and collagen deposition, reduced the number of senescent cells in the irradiated lung tissues by 23.9% ( t=21.83, P<0.05), and inhibited the expressions of SASP ( t=8.86, 20.63, P<0.05). GMSCs also inhibited the expression of P53-P21, P16-related proteins in MLE12 cells and lung tissues of mice after irradiation. Conclusions:GMSCs inhibit senescence-related P53-P21 and P16 pathways, prevent radiation-induced AECⅡ senescence, as well as the development of RIPF.

Objective: To investigate whether the transplantation of umbilical cord mesenchymal stem cells (UC-MSCs) can alleviate radiation-induced pulmonary fibrosis (RIPF) and attenuate intrapulmonary cellular senescence in mice with RIPF. Methods: The C57BL/6 mice were unilaterally irradiated with 17 Gy in the right lung to construct RIPF models. UC- MSCs were injected into the caudal vein at 3 months after radiation, and samples were taken at 6 months. The survival rate of mice was recorded, and the lung organ ratio was calculated. Lung structure and collagen deposition were observed by hem- atoxylin-eosin  staining  and  Masson  staining.  The  expression  of  senescence  secretion-associated  phenotype  (SASP)  was measured by quantitative real-time polymerase chain reaction. Intrapulmonary cellular senescence was assessed by β-Gal im- munohistochemistry. The expression of key proteins in the P53-P21 and P16 pathways was measured by Western blot. P21 expression in the lung was measured by tissue immunofluorescence. Results: Compared with the untreated group, RIPF mice treated with UC-MSCs showed an improved survivalrate, reduced collagen deposition, and an improvement incollapse and thickening of alveolar structure. Increased β-Gal-positive senescent cells and high expression of SASP (IL-6, IL-8, IL- 1β) in the lung of RIPF mice were all reduced after UC-MSC treatment. The abnormally increased levels of P53, p-P53, P21 and P16 proteins in RIPF mice were reduced by UC-MSC treatment. Conclusion UC-MSCs may reduce cellular senes- cence in fibrotic lungs and alleviate RIPF by inhibiting P53-P21 and P16 pathways, which is expected to be used for the treatment of radiation-induced lung injury.

Radiation-induced pulmonary fibrosis (RIPF) is a common complication of thoracic tumor radiotherapy. The main manifestation of radiation-induced pulmonary fibrosis is chronic progressive consolidation of pulmonary interstitium, which may cause the lung physiology function reduced or even lost. Furthermore, it can be lethal forrespiratory failure in severe cases. Recent studies have found that mesenchymal stem cells (MSC) play an important role in the modulation of proliferation and the activation of immune cells in lung inflammation. In addition, MSC can also play a part in the treatment of RIPF by differentiating into functional cells and secreting cytokines. Therefore, MSC has a good application prospect in RIPF as a cell therapy method. This article reviews the molecular mechanisms, influencing factors and current status of MSC therapy in RIPF.

Objective To explore the influence of biomechanical characteristics of badminton players on sports risk at the moment of foot and ankle landing, so as to provide references basis for avoiding the sports risk of high-frequency and high-intensity landing of ankle joint of beginners. Methods Using three-dimensional force measuring platform and motion capture system, the kinematic and dynamic data of 30 badminton beginners (experimental group) and 30 high-level athletes (control group) at the kick-off (1 step) moment during ankle landing were collected. Results The angles of metatarsal flexion and dorsiflexion in experimental group were significantly smaller than those in control group, and the angles of varus and internal rotation in experimental group were significantly larger than those in control group. The left-right forces in experimental group were significantly larger than those in control group, and there was no significant difference in anterior-posterior force and vertical force between experimental group and control group. The valgus and external rotation torque of experimental group were significantly higher than those of control group, and the internal rotation torque of control group was significantly higher than that of experimental group. Conclusions Compared with beginners, the ankle movement of professional athletes has good dynamic stability and flexibility, the cushioning task can be completed with a smaller range of movement and force in left-right direction, and the angle of metatarsal flexion and dorsiflexion of professional athletes is relatively increased. It is also the embodiment of good training effect, so that the buffer time is slightly longer to prevent the impact of sudden landing of the ankle.

Objective:To investigate the clinical characteristics and experience in the diagnosis and treatment of neonatal gastric perforation, and the factors influencing prognosis.Methods:This was a retrospective analysis involving 49 neonatal gastric perforation cases who underwent surgical treatment in the Neonatal Surgery Department of Shanxi Children's Hospital from January 2008 to December 2017. Their clinical data, including manifestations, auxiliary examinations, operations, and prognosis, were analyzed. According to the prognosis, these patients were divided into two groups, survival group, and fatality group. Independent sample t-test or continuity correction Chi-square (or Fisher's exact) test was used for statistical analysis. Results:(1) Of the 49 cases, 29 (59.2%) were boys, and 20 (40.8%) were girls. There were 30 (61.2%) premature and 19 (38.8%) full-term babies. Their birth weight ranged between 1 010 and 5 000 g with an average of (2 450±700) g. Low birth weight infants accounted for 59.2% (29/49). There were 11 cases (22.4%) having perinatal adverse events, 17 (34.7%) complicated by septic shock before the operation, and six (12.2%) with digestive tract malformation. Two cases (4.1%) underwent resuscitation due to postnatal asphyxia; two (4.1%) received mechanical ventilation due to respiratory distress syndrome; 12 (24.5%) received indwelling were indwelled gastric tube or gastric lavage. (2) The average onset time of neonatal gastric perforation in the 49 cases was (3.8±2.0) d after birth, and 47(95.9%) of them presented initial symptoms within one week, including 36 within four days. Twenty-five cases (51.0%) were operated within 12 h after the onset. (3) The common first symptoms include abdominal distention [69.4% (34/49)] and abdominal distension complicated with vomiting (24.5%, 12/49). Thirty-nine cases (79.6%) showed a large amount of free gas under the diaphragm, compressed and down-moving liver, and decreased or disappeared stomach bubble in the preoperative abdominal radiograph. (4) All cases received emergency laparotomy and primary gastric wall repair after admission. During the operation, 27 (55.1%) of all the cases had perforation at the greater curvature, five (10.2%) at the lesser curvature, 14 (28.6%) at the anterior wall, and three (6.1%) at the posterior wall. Perforation larger than 3 cm in diameter was found in 33 cases (67.3%). Three cases (6.1%) had postoperative wound infection; two (4.1%) developed anastomotic leakage; one was complicated by pneumohydrothorax 48 h after the operation due to esophageal duplication and perforation, which was confirmed by a second operation. (5) Of the 49 cases, 35 (71.4%) were due to congenital gastric wall muscular defect, four (8.2%) were caused by iatrogenic injury, and 10 (20.4%) were spontaneous perforation. (6) Among all cases, 36 (73.5%) survived, while eight (16.3%) died, and five (10.2%) withdraw treatment after the operation. After excluding the five cases giving up treatment after the operation, the proportion of patients who underwent operation within 12 h after onset or had the perforation <3 cm in diameter was higher in the survival group than in the fatality group [61.1% (22/36) vs. 1/8, χ2=4.404, P<0.05; 41.7% (15/36) vs. 0/8, P<0.05], and the incidence of septic shock before the operation was lower [22.2% (8/36) vs. 6/8, χ2=6.147, P<0.05]. Conclusions:Neonatal gastric perforation shows a high mortality rate, and its underlying pathologic etiology is congenital gastric wall muscle defect. Abrupt abdominal distension is the main clinical manifestation. Early operation is critical to improving neonatal prognosis.