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.

Based on a review of classical literature combined with modern anatomical and biomechanical research， this paper proposes the "four intersections" of channel sinew diseases from the perspective of structural interfaces， which involves sinew-bone， sinew-sinew， sinew-joint， and sinew-vessel intersections， and analyzes the corresponding pathological characteristics. It is believed that the dynamic evolution of channel sinew diseases can be summarized as "starting with mechanical imbalancew， with interface transmission as the pivot， compensation continuation as the variation， and neurological adaptation as the consolidation". Furthermore， the pathological changes at the "four intersections" structural interfaces correspond respectively to clinical manifestations of enthesial pain， referred pain， joint dysfunction and sensory abnormalities. Understanding channel sinew diseases based on the "four intersections" structural interface is conducive to deepening the understanding of the pathogenesis， thereby providing a reference for clinical identification and precise treatment.

OBJECTIVE To screen a single matrix， prepare dissolving microneedles of Pterocarya hupehensis total flavonoids（PHTF-MN）， and characterize it while evaluating its analgesic effects.METHODS Using microneedle morphology and puncture rate as evaluation indicators， the matrix was screened from polyvinyl alcohol （PVA）， polyvinylpyrrolidone K30 （PVP K30）， PVP K90， and sodium hyaluronate with relative molecular weights of 15 000 and 60 000 （HA 1.5w and HA 6w ）. PHTF-MN was prepared by the layer-by-layer casting method with the selected matrix， and the appearance and morphology， total flavonoid content， mechanical properties， puncture performance， dissolution properties， and drug release behavior of the obtained PHTF-MN were characterized. Using male BALB/c mice as test subjects and aspirin （ASA） as a positive control， the analgesic effects of the microneedles were evaluated using a formalin-induced pain model.RESULTS Blank microneedles prepared with 30% HA 1.5w exhibited optimal surface flatness and the membrane puncture rate （through 4 layers of parafilm membrane） reaching 78%. The PHTF-MNs （with PHTF contents of 10， 20， 30， 40， and 50 mg/g in the matrix） exhibited uniform arrays and intact tips， with RSDs for total flavonoid contents all below 7% （ n ＝8）. The single-needle puncture forces were 1.46 and 1.07 N （with PHTF contents of 30 and 50 mg/g in the matrix， respectively）. The skin penetration rate approached 100%， with visible puncture marks in the stratum corneum and drug residue （with a PHTF content of 50 mg/g in the matrix）. After 30 min of fixation， the needles had almost completely dissolved， and the skin retention rates all exceeded 90% （with PHTF contents of 10， 30， and 50 mg/g in the matrix， respectively）. The cumulative release within 8 h was （134.64±2.03） μg/cm 2 ， and the fit to the first-order kinetic equation （ R 2 ＝0.950 1） was highest （with a PHTF content of 50 mg/g in the matrix）. Low- and high-dose PHTF-MN （containing 85.26 and 145.03 μg of total flavonoids per patch， respectively； 1 patch/day） significantly shortened the cumulative time of phase Ⅱ pain response in mice （ P ＜0.05）， with pain inhibition rates （43.67% and 59.78%） comparable to those of ASA （53.70%）.CONCLUSIONS PHTF-MN using HA 1.5w as a single matrix was successfully prepared. This formulation features a simplified preparation process， uniform drug loading， favorable mechanical properties， resistance to fracture， and rapid dissolution. Its drug release behavior conforms to a first-order kinetic model， and its analgesic effect is comparable to that of ASA.

Objective:To construct a bedside handover management in surgical ward based on the intervention mapping theory and verify the practical effect, to provide a reference for further standardizing handover behavior and improving the efficiency of handover management.Methods:A quasi-experimental research method was adopted. From January 2022 to January 2023, nurses from the Department of Urology of Tongji Medical College Affiliated Union Hospital, Huazhong University of Science and Technology were selected by cluster sampling. From January to June 2022, routine bedside handover management was implemented. In July 2022, a one-month training on the bedside handover management in surgical ward based on the intervention mapping theory was conducted for urology nurses. From August 2022 to January 2023, the bedside handover management in surgical ward based on the intervention mapping theory was implemented. The incidence of handover problems among nurses, the evaluation of handover among nurses, the qualified rate of nurses' disease awareness, and the satisfaction of patients with handover were compared before and after the training.Results:A total of 48 nurses were included. They were the same batch of nurses before and after the training, including 2 males and 46 females, with an age of (32.23 ± 5.50) years. A total of 1 180 inpatients were included before the training, including 921 males and 259 females, with an age of (56.69 ± 17.24) years. After the training, 1 240 inpatients were included, including 946 males and 294 females, with an age of (55.50 ± 18.85) years. The incidence of handover problems among nurses after the training was 3.71% (46/1 240), which was lower than 9.92% (117/1 180) before the training, and the difference was statistically significant ( χ2=37.07, P<0.05). After the training, the total score of handover evaluation for nurses and the qualified rate of nurses' disease awareness were (80.08 ± 3.74) points and 91.67% (44/48) respectively, which were higher than (73.10 ± 3.53) points and 72.92% (35/48) before the training, and the differences were statistically significant ( t=-0.94, χ2=5.79, both P<0.05). The total score of satisfaction with bedside handover of patients after the training was (76.13 ± 4.50) points, which was higher than (67.92 ± 4.64) points before the training, and the difference was statistically significant ( t=-13.99, P<0.05). Conclusions:The bedside handover management plan based on the intervention mapping theory can effectively strengthen the quality of bedside handover, improve the satisfaction with bedside handover of patients, and deepen nursing quality.

Objective To explore the effect of the preservation of infrapatellar fat pad on pain,incision healing and function recovery in patients with knee osteoarthritis after joint replacement.Methods The clinical data of 127 patients with knee osteoarthritis who underwent joint replacement in the hospital from June 2019 to September 2022 were retrospectively collected.According to the preservation of infrapatellar fat pad,the subjects were divided into a control group(removing infrapatellar fat pad,67 cases)and an observation group(preserving infrapatellar fat pad,60 cases).The changes in length of patellar tendon,pain,knee function and range of motion were analyzed.The occurrence of adverse reactions was statistically analyzed.Results At 12 months after surgery,the length of patellar tendon was reduced.The length of patellar tendon in observation group[(38.8±6.24)mm]was longer than that in control group[(36.2±6.71)mm](P＜0.05).Observation group of patellar tendon length rate is lower than the control group[(4.1±1.18)％vs(10.7±3.01)％],there was statistical significance between the two groups(P＜0.05).Pain in both groups was alleviated at 1 month,3 months,6 months and 12 months after surgery.The changes in observation group were greater than those in control group(P＜0.05).During follow-up,the incidence of adverse reactions in observation group(6.67％)was lower than that in control group(14.93％)(P＞0.05).The range of motion and function of knee joint were improved at 12 months after surgery,and the improvement in observation group was greater than that in control group(P＜0.05).Conclusion Preserving infrapatellar fat pad is more beneficial to relieving postoperative pain and restoring knee function in patients with knee osteoarthritis after joint replacement.Therefore,the intact infrapatellar fat pad should be preserved as possible in clinical practice.

AIM:To study the effect of nicotinamide mononucleotide(NMN)on renal fibrosis in mice with Al-port syndrome(AS)through TGFβ/Smad3 pathway.METHODS:SPF grade female X-linked AS(COL4A5 KI)mice were divided into model group(AS group)and model drug administration group(AS+NMN group).while female C57BL/6 mice served as the wild-type(WT)group,with 7 to 8 mice in each group.The mice in the administration group were given oral administration at 8 weeks of age for 8 weeks to 16 weeks of age.The remaining mice were given saline intragastric ad-ministration.The ratio of urinary microalbumin to urinary creatinine(UACR)was measured by biochemical method.After sampling,the renal fibrosis was analyzed by Masson staining.The expression levels of desmin and α-smooth muscle actin(α-SMA)were detected by immunohistochemistry.The expressions of fibrosis-related proteins desmin,α-SMA,trans-forming growth factor β(TGFβ),Smad3,p-Smad3,and fibronectin were detected by Western blot.RESULTS:Com-pared with the model group,UACR(13 weeks,P＜0.01;15 weeks,P＜0.01)and fibrosis-related protein expression(P＜0.05)in AS mice were significantly decreased after NMN treatment.CONCLUSION:Treatment with NMN attenuates renal fibrosis in AS mice through TGFβ/Smad3 signaling pathway.

AIM:To evaluate the safety and toler-ability of single dose oral BTK inhibitor YZJ-3058 tablets under fasting conditions in healthy adults,as well as the pharmacokinetic and pharmacologi-cal characteristics of YZJ-3058 and its metabolites.METHODS:A total of 22 healthy subjects were en-rolled in this experiment and administered a single dose orally.They were divided into three groups:50 mg,100 mg,and 200 mg.Among them,2 sub-jects were enrolled in the 50 mg dose group,and 10 subjects were enrolled in the 100 mg and 200 mg dose groups,respectively.RESULTS:In healthy subjects,YZJ-3058 tablets were administered orally on an empty stomach at doses of 50,100,and 200 mg,with a median Tmax of 1.25 to 2.00 hours and an average Cmax of 62.85,89.44,and 99.20 ng/mL,re-spectively.The average AUC0-t was 183.87,297.72,and 453.98 h·ng-1·mL,respectively.The average AUC0-∞ was 189.30,321.33,and 551.44 h·ng-1·mL,and the median t1/2 was 1.16,5.06,and 7.97 hours,respectively.After a single oral administration of 50,100,and 200 mg YZJ-3058 tablets,the highest target occupancy rate was achieved at 4 hours.The average BTK occupancy rates at 24 hours after ad-ministration were 88.95％,96.73％,and 99.24％,re-spectively.The average BTK occupancy rates at 48 hours after administration were 75.65％,89.80％,and 96.68％,respectively.No serious adverse events or adverse events leading to withdrawal oc-curred,and all subjects had good tolerability.CON-CLUSION:YZJ-3058 tablets have good safety and tolerability for single oral administration on an empty stomach in healthy subjects within the dose range of 50-200 mg.Cmax and AUC increase with dose,with fast absorption and saturation.The ter-minal elimination rate gradually slows down with dose increase,and it has a significant and sus-tained occupying effect on BTK targets.

Objective:To investigate the effects of differential torque of maxillary posterior teeth with clear aligner on anterior teeth 3D mechanics.Methods:4 maxillary models were designed for differential torque of posterior teeth on the basis of 3D me-chanical test model with first premolar extraction.The stereolithography models were made with the same size as the standard model by 3D printing.According to the torque of the 6 keys to normal occlusion of Andrews,the standard torque of Andrews was used in group A1.The posterior teeth with lingual-crown torque of 5° were used in groups A2,and those with buccal-crown torque of 5° and 10° were respecitvely used in group A3 and A4.4 sets of corresponding clear aligners were fabricated with a 0.75 mm thick thermoplastic material.Each group had 12 pairs of the same clear aligners.The anterior teeth underwent 0.25 mm activation for en-mass retraction.The six-axis force/torque transducer measurement system was used to measure the force applied by the clear align-ers on the anterior teeth in the 3D directions.Results:In buccolingual direction:in group A1,the 4 incisors received lingual force,in groups A2-A4,the anterior teeth received labial force,and the force on the central incisors was greater than that on later-al incisors.In mesiodistal direction:in group A1-A4,4 incisors received mesial force,and the force on lateral incisors was greater than that on central incisors;in group A1-A4,the canines received distal force;the force on canine in group A4 was greater than that in A2 or A3 groups(P＜0.05).The force in the vertical direction on the anterior teeth among the 4 groups(P＞0.05).Conclu-sion:When en-mass retraction of the anterior teeth with clear aligner,attention should be taken to the torque of the incisors and the tip of the canines.When the posterior teeth with standard torque,the activation of labial-crown overcorrection of the anterior teeth should be increased.When the posterior teeth with lingual-crown torque or buccal-crown torque,the activation of labial-crown over-correction of the anterior teeth should be appropriately reduced.Increasing the mesial overcorrection design of canines may avoid the extrusion of anterior teeth and the deepening of o-verbite due to the distal inclination of canines.

Objective:To analyze application effect of trend analysis for safe risk in management and control for infection of medical devices,so as to optimize the management path for medical devices.Methods:Focusing on the main factors affecting the safety risks of medical devices,the least squares method of linear regression was applied for trend analysis to optimize the device management path and strengthen management.A total of 70 clinically used medical devices in the First Affiliated Hospital of Xi'an Jiaotong University from January to December 2024 were selected.These devices were managed using two models:the conventional management model and the trend analysis management model,with 35 devices under each model.The infection risk rate of medical equipment and the equipment management quality score were compared between the two management models.Additionally,160 patients managed under the two models(80 patients per model)were included to compare the patient infection rate.Results:In the 450 diagnostic and treated records of sampling inspection and consultation for medical devices from treatment equipment,diagnosis equipment,auxiliary imaging equipment and surgical equipment,the rate of infectious risk of using management mode with trend analysis were respectively 1.78%(8/450),2.22%(10/450),2.22%(10/450)and 2.44%(11/450),all of which were significantly lower than these of using conventional management mode,and the differences were significant(x2=9.904,8.902,10.465,10.770,P＜0.05).The scores of cleaning quality,the quality of disinfection and sterilization,the quality of distribution,and the retrieving quality of the management mode with trend analysis for medical devices were significantly higher than those of the conventional management mode,and the differences were statistically significant(t=15.889,13.172,15.872,17.399,P＜0.05).The infection rate of patients in the trend analysis management mode was 6.25%(5/80),which was significantly lower than that in the conventional management mode[22.50(18/80)],and the difference was statistically significant(x2=11.006,P＜0.05).Conclusion:The trend analysis for safe risk can analyze the risk factors in use and operation for medical devices from multiple perspectives,and mining main factors and conduct intervention for the devices,and reduce the incidence of safe risks of medical devices and the patients'infection rate,and improve the quality of clinical services.