ObjectiveTo establish a high-performance liquid chromatography（HPLC） for the quantitative analysis of multiple components in Gegen Qinlian tablets， and to comprehensively evaluate the quality of samples from different manufacturers by integrating chemical pattern recognition and technique for order preference by similarity to ideal solution（TOPSIS）， in order to provide a reference basis for quality evaluation and control of Gegen Qinlian tablets. MethodsHPLC was employed to determine the contents of 10 components in 28 batches of Gegen Qinlian tablets collected from 6 manufacturers， and taking the detection results as variables， SIMCA 14.1 and SPSS 26.0 were employed for cluster analysis（CA）， principal component analysis（PCA）， and orthogonal partial least squares-discriminant analysis（OPLS-DA） to identify key components affecting the quality. Then， TOPSIS analysis was employed to rank the quality of Gegen Qinlian tablets from the 6 manufacturers and establish a comprehensive quality evaluation method. ResultsA quantitative method for Gegen Qinlian tablets was established. After methodological validation， the method was found to be stable and reliable， and could be used for the quantitative analysis of this preparation. The contents of 3′-hydroxy puerarin， puerarin， 3′-methoxy puerarin， daidzein， coptisine hydrochloride， epiberberine， jatrorrhizine hydrochloride， berberine hydrochloride， palmatine hydrochloride and baicalin in 28 batches of samples were 3.58-7.35， 24.88-42.32， 4.20-9.36， 4.33-7.60， 2.52-6.44， 0.93-4.10， 0.58-3.05， 10.68-22.92， 0.82-4.82， 11.73-60.16 mg·g^-1， respectively. Among them， puerarin， berberine hydrochloride and baicalin all met the limit requirements for this preparation specified in the 2025 edition of the Pharmacopoeia of the People's Republic of China. CA and PCA clustered the 28 batches of samples into 5 categories， PCA extracted 2 principal components with a cumulative variance contribution rate of 90.588%， and OPLS-DA screened out 4 differential markers with variable importance in the projection（VIP） values>1.0， namely baicalin， 3′-hydroxy puerarin， coptisine hydrochloride and palmatine hydrochloride， which might be the main components affecting the quality of Gegen Qinlian tablets. TOPSIS analysis showed that the comprehensive score of each evaluation index（C_i） values of different manufacturers were different. Among them， the C_i of manufacturer B was ranked higher， indicating potentially superior quality， while the C_i of manufacturer A was ranked lower， suggesting potentially inferior quality. ConclusionThis study establishes a quantitative method for Gegen Qinlian tablets， and the content uniformity of the same manufacturer is good， while there are differences in the contents of active components among different manufacturers. Through the chemical pattern recognition analysis， it is found that the content differences of Gegen Qinlian tablets may be related to baicalin， 3′-hydroxy puerarin， coptisine hydrochloride and palmatine hydrochloride.

Objective: To investigate whether Tuina alleviates fibrotic symptoms in myofascial trigger points (MTrPs) by regulating transforming growth factor (TGF)-β1/Smad3 signaling pathway, thereby deactivating these points. Methods: This study comprised two experimental phases. In phase 1, 27 specific pathogen-free (SPF) grade female Sprague-Dawley (SD) rats were randomized into three groups: control 1, model 1, and Tuina 1 groups. Model 1 and Tuina 1 groups underwent an 8-week MTrPs modeling protocol involving blunt impact and eccentric exercise. After successful modeling, rats in Tuina 1 group received manual pressing on nodules or cord-like taut bands on the medial aspect of the left hindlimb. Pain sensitivity and tissue stiffness were evaluated via pressure pain threshold (PPT) and soft tissue tension (STT). Muscle histopathology and fibrosis were observed using hematoxylin and eosin (HE) and Masson staining. Inflammatory factors in muscle were measured by enzyme-linked immunosorbent assay (ELISA), while immunofluorescence (IF) and Western blot (WB) were used to detect the expression levels of α-smooth muscle actin (α-SMA), collagen Ⅲ, and TGF-β1. In phase 2, 45 SPF female SD rats were randomized into five groups: control 2, model 2, Tuina 2, TGF-β1 inhibitor (TI), and Tuina + TGF-β1 agonist (Tuina + TA) groups. All groups except control 2 underwent standardized MTrPs modeling. Rats in Tuina 2 group received consistent pressing manipulation. TI group received intraperitoneal injections of oxymatrine, while Tuina + TA group received intraperitoneal injections of SRI-011381 hydrochloride followed by the same pressing protocol as Tuina 2 group. WB was used to detect the expression of collagen I, collagen III, TGF-β1, and phosphorylated-Smad3 (p-Smad3)/Smad3. Results: In phase 1, Tuina significantly improved PPT and STT in MTrPs of rats (P < 0.01), reversed pathological damages including disorganized muscle fiber arrangement, abnormal myocyte morphology, and exacerbated fibrosis. In addition, in MTrPs of rats in model 1 group, expression levels of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, and fibrosis markers (α-SMA, collagen I, and collagen III) were upregulated, and all exhibited a significant downward trend after Tuina intervention (P < 0.05 or P < 0.01). This indicates that the therapeutic effects of Tuina are directly associated with reduced local inflammation and fibrosis in MTrPs. In phase 2, compared with model 2 group, rats in TI and Tuina 2 groups had decreased expression levels of TGF-β1 and p-Smad3/Smad3 in MTrPs, alongside reduced levels of inflammatory factors (IL-1β, IL-6, NF-κB, and TNF-α) and fibrosis markers (α-SMA, collagen I, and collagen III) (P < 0.05 or P < 0.01). When co-administered with TGF-β1 agonist, the therapeutic effects of Tuina were significantly attenuated, with rebounded TGF-β1 expression and p-Smad3/Smad3 in local MTrPs, and fibrosis and inflammatory responses were re-exacerbated (P < 0.05 or P < 0.01). Conclusion Tuina can effectively reduce inflammatory responses and fibrosis in MTrPs tissue, and its mechanism is closely related to the inhibition of the TGF-β1/Smad3 signaling pathway, which plays a critical role in Tuina-mediated regulation of MTrPs fibrosis.

This study identified six novel azaphilones, isochromophilones G-L (1-6), and three novel biosynthetically related congeners (7-9) from Diaporthe sp. SCSIO 41011. The structures and absolute configurations were elucidated through comprehensive spectroscopic analyses combined with experimental and calculated electronic circular dichroism (ECD) spectra. Significantly, three highly oxygenated azaphilones contain an acetyl group at the terminal chain (4) or linear conjugated polyenoid moieties (5 and 6), which occur infrequently in the azaphilone family. Additionally, several compounds demonstrated inhibition of lipopolysaccharide (LPS)-induced nuclear factor kappa-B (NF-κB) activation in RAW 264.7 macrophages at 20 μmol·L^-1. The novel compound (1) effectively inhibited receptor activator of NF-κB ligand (RANKL)-induced osteoclast differentiation without exhibiting cytotoxicity in bone marrow and RAW 264.7 macrophages, indicating its potential as a promising lead compound for osteolytic disease treatment. This research presents the first documented evidence of azaphilone derivatives as inhibitors of RANKL-induced osteoclastogenesis.
Animals ; Mice ; RANK Ligand/genetics* ; RAW 264.7 Cells ; Osteoclasts/metabolism* ; Benzopyrans/isolation & purification* ; Osteogenesis/drug effects* ; Macrophages/metabolism* ; Molecular Structure ; Pigments, Biological/isolation & purification* ; Ascomycota/chemistry* ; NF-kappa B/genetics* ; Cell Differentiation/drug effects*

Objective To investigate the predictive value of serum Krüppel-like factor 4(KLF4)level com-bined with plasma atherogenic index(AIP)for prognosis in patients with acute middle cerebral artery occlu-sion(AMCAO)undergoing endovascular therapy(EVT).Methods A total of 187 AMCAO patients who un-derwent EVT in Baoji People's Hospital from January 2021 to August 2023 were selected as the AMCAO group.The AMCAO patients were further categorized based on one-year post-EVT outcomes into a poor prognosis group(n=64)and a good prognosis group(n=123).A total of 95 healthy volunteers who under-went physical examination in Baoji People's Hospital during the same period were selected as the control group.Serum KLF4 levels were measured using enzyme-linked immunosorbent assay,and the AIP was calcu-lated.Multivariate unconditional Logistic regression was applied to analyze the relationship between serum KLF4,AIP,and EVT prognosis,while receiver operating characteristic curves were used to evaluate the com-bined predictive value of KLF4 and AIP for prognosis in AMCAO patients.Results Compared with control group,AMCAO group had lower serum KLF4 levels and higher AIP(P<0.05).The 1-year poor prognosis rate of 187 AMCAO patients after EVT was 34.22%(64/187).Compared with good prognosis group,the poor prognosis group had lower KLF4 levels and higher AIP(P<0.05).High national institutes of health stroke scale score,delayed onset-to-recanalization time,and elevated AIP were independent risk factors for poor EVT prognosis in AMCAO patients,while high KLF4 was an independent protective factor(P<0.05).The combined detection of KLF4 and AIP of area under the curve in predicting EVT prognosis was 0.866,sig-nificantly higher than of KLF4(0.788)or AIP(0.769)alone(P<0.05).Conclusion Lower serum KLF4 levels and elevated AIP are associated with poor EVT prognosis in AMCAO patients.Combined measurement of serum KLF4 and AIP has high predictive value for EVT prognosis in these patients.

Objective To explore the effects of probiotic-assisted conventional treatment on in-testinal flora,blood glucose homeostasis and neurological function in patients with type 2 diabetes mellitus complicated with stroke.Methods A total of 93 patients with type 2 diabetes mellitus com-plicated by stroke were selected as the study subjects and randomly divided into control group(n=46)and experimental group(n=47)using random number table method.The control group received conventional therapy,while the experimental group received probiotics(oral Bifidobacterium,Lacto-bacillus,and Enterococcus triple viable tablets,4 tablets/time,twice daily)in addition to convention-al therapy.Both groups were treated continuously for 7 days.The intestinal flora(counts of Bifidobacterium,Lactobacillus and Bacteroides),inflammatory markers[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and high-sensitivity C-reactive protein(hs-CRP)],glycemic pa-rameters[fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),largest amplitude of glycemic excursions(LAGE),average blood glucose(BGL-ave),standard deviation of mean blood glucose(BGL-sd),and coefficient of variation of blood glucose(BG-cv)],and neurological function[National Institutes of Health Stroke Scale(NIHSS)score,improvement rate of neurological func-tion,proportion of patients with modified Rankin Scale(mRS)score ≤ 3,and Loewenstein Occupa-tional Therapy Cognitive Assessment(LOTCA)score]were compared between the two groups after treatment.Results After treatment,the counts of intestinal flora(Bifidobacterium,Lactobacillus,and Bacteroides)in both groups were higher than those before treatment,and the counts in the ex-perimental group were higher than those in the control group,with statistically significant differences(P＜0.05).The levels of TNF-α,IL-6 and hs-CRP in both groups were lower than those before treatment,and the levels in the experimental group were lower than those in the control group,with statistically significant differences(P＜0.05).The levels of FBG and HbA1c in both groups were lower than those before treatment.The FBG level,LAGE,BGL-sd,and BG-cv in the experimental group were lower than those in the control group,with statistically significant differences(P＜0.05),but there were no statistically significant differences in HbA1c and BGL-ave between the two groups(P＞0.05).After treatment,the NIHSS score in the experimental group was lower than that in the control group,while the LOTCA score and improvement rate of neurological function were higher than those in the control group,with statistically significant differences(P＜0.05).There was no statistically significant difference in the proportion of patients with an mRS score ≤3 between the two groups(P＞0.05).Conclusion Probiotic-assisted conventional treatment can regulate the number of intestinal flora in patients with type 2 diabetes mellitus complicated with stroke,relieve inflammatory responses,stabilize blood sugar levels,and improve neurological function.

Objective To compare the efficacy of tegoprazan and esomeprazole in treatment of reflux esophagitis(RE)and analyze the influencing factors for treatment failure.Methods A total of 120 RE patients were selected as study subjects and divided into control group(treated with esome-prazole)and observation group(treated with tegoprazan)using random number table method,with 60 cases in each group.The clinical efficacy and gastroscopic efficacy of the two groups were com-pared.Based on the gastroscopic assessment results,the patients were divided into failure group(26 cases)and success group(94 cases).The clinical data of the failure group and the success group were collected and compared.Multivariate Logistic regression analysis was used to screen the influen-cing factors for treatment failure in RE patients.Results The total clinical effective rate in the ob-servation group was 93.33％(56/60),which was higher than 76.67％(46/60)in the control group(P＜0.05).The total effective rate under gastroscopy in the observation group was 88.33％(53/60),which was higher than 68.33％(41/60)in the control group,and the difference was statistically significant(P＜0.05).The proportions of patients with body mass index(BMI)＞28 kg/m2,diabe-tes,a family history,Helicobacter pylori(Hp)infection,Los Angeles classification(LA classifica-tion)of gastroesophageal reflux disease(GERD)grade C to D,and treated with esomeprazole in the failure group were all higher than those in the success group,and the differences were statistically significant(P＜0.05).Multivariate Logistic regression analysis showed that BMI＞28 kg/m2,con-comitant diabetes,LA classification grade C to D,and treatment with esomeprazole were all inde-pendent risk factors for treatment failure in RE patients(P＜0.05).Conclusion Tegoprazan has a significant clinical effect in treatment of RE,and its efficacy is superior to that of esomeprazole.BMI＞28 kg/m2,concomitant diabetes,LA classification grade C to D,and treatment with esome-prazole are all risk factors for treatment failure in RE patients.

Human genetic resources are an indispensable part of national natural science and technology resources,as well as an important strategic resource for safeguarding national security,public health,and social public interests.To promote the effective protection and rational utilization of human genetic resources,as well as improve and optimize the local human genetic resources management system in China,this paper summarized the current situation of administrative approval and supervision of national human genetic resources from 2004 to 2021 by sorting out the national human genetic resources management policies and regulations.Furthermore,the current situation and progress of local human genetic resources management in China were understood from three aspects,including development planning and programs of human genetic resources,administrative licensing and penalties,and the construction of management expert committees.The main problems of local human genetic resources management in China were discussed and analyzed,such as unclear supervision,difficulty in supervision and inspection,and capacity for services.Based on the causes of the problems and the local management work,specific countermeasures and suggestions were put forward from the perspective of clarifying the regulatory policies and procedures for human genetic resources,improving the supervision and inspection mechanisms,and improving the management and service capabilities.

Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.

Objective To construct a usability scale for smart hospital platforms based on Quality of Experience(QoE)theory,and provide scientific measurement tool for the construction,operation,and improvement of smart hospitals.Method Literature review,focus meeting method,and pre survey were used to screen and revise the scale items,forming a formal scale.Using convenience sampling method,1 000 users from 8 smart hospital platforms in Shandong Province were selected as the research subjects to evaluate the reliability and validity of the scale.Result The availability scale of the smart hospital platform includes 6 dimensions and 24 items.Exploratory factor extraction identified 6 common factors,with a cumulative variance contribution rate of 64.045%.The overall Cronbach's with a coefficient of 0.941 for 6 dimensions.The coefficient is between 0.782 and 0.963,and the retest reliability is 0.967.The Average Standardized Content Validity Index is 0.972,and the Item-level Content Validity Index is between 0.86 and 1.00.The correlation coefficient between the six dimensions of the scale and the System Usability Scale is 0.606-0.653,and the overall correlation coefficient is 0.647.Conclusion The usability scale of the smart hospital platform developed based on QoE theory has good reliability and validity,and can be used to measure the user experience of the smart hospital platform.

Objective To construct a usability scale for smart hospital platforms based on Quality of Experience(QoE)theory,and provide scientific measurement tool for the construction,operation,and improvement of smart hospitals.Method Literature review,focus meeting method,and pre survey were used to screen and revise the scale items,forming a formal scale.Using convenience sampling method,1 000 users from 8 smart hospital platforms in Shandong Province were selected as the research subjects to evaluate the reliability and validity of the scale.Result The availability scale of the smart hospital platform includes 6 dimensions and 24 items.Exploratory factor extraction identified 6 common factors,with a cumulative variance contribution rate of 64.045%.The overall Cronbach's with a coefficient of 0.941 for 6 dimensions.The coefficient is between 0.782 and 0.963,and the retest reliability is 0.967.The Average Standardized Content Validity Index is 0.972,and the Item-level Content Validity Index is between 0.86 and 1.00.The correlation coefficient between the six dimensions of the scale and the System Usability Scale is 0.606-0.653,and the overall correlation coefficient is 0.647.Conclusion The usability scale of the smart hospital platform developed based on QoE theory has good reliability and validity,and can be used to measure the user experience of the smart hospital platform.