This article systematically analyzed the historical evolution of the origin， scientific name， producing area， quality evaluation， harvesting and processing， and other aspects of Quisqualis Fructus by consulting the ancient materia medica， medical books， prescription books， local literature and combining with the modern literature and standards， summarized and explored the development rules of its medicinal properties and efficacy along with their underlying causes， in order to provide support for the development and utilization of famous classical formulas containing this herb. According to the textual research， Shijunzi was first recorded as Liuqiuzi in Nanfang Caomuzhuang of the Jin dynasty， and the name of Shijunzi was first used in Kaibao Bencao of the Song dynasty， which has been consistently used throughout subsequent dynasties， and there were also aliases such as Junziren， Sijunzi， and Dujilizi. The mainstream source of Quisqualis Fructus used in the past dynasties has been the dried mature fruits of Quisqualis indica， a plant belonging to the family Combretaceae. In modern times， its variety Q. indica var. villosa has also been recorded as the medicinal material of Quisqualis Fructus. In 2007， the Flora of China（English edition） designated Q. indica var. villosa as a synonym of Q. indica. Today， the accepted name of Shijunzi is updated to Combretum indicum. According to ancient herbal records， the producing areas of Quisqualis Fructus were Guangdong， Hong Kong， Macao， Guangxi， Hainan， Sichuan and Fujian， and then gradually expanded to Yunnan， Taiwan， Jiangxi and Guizhou. Since the Song dynasty， two major production regions have gradually emerged in Sichuan， Chongqing and Fujian. Currently， it is primarily cultivated in Chongqing， Guangxi and other areas， with Chongqing yielding the highest output. Since modern times， superior quality has been defined by large size， a purple-black surface， plump grains， and a yellowish-white kernel. According to ancient herbal records， the harvesting period of Quisqualis Fructus was the July and August of the lunar calendar， mostly used raw after shelling or with the shell intact， it underwent processing methods such as cleaning， slicing， mixing， steaming， roasting， stewing， and frying. Currently， the harvesting period is autumn， followed by sun-drying or low-heat drying， with processing methods including cleaning， stir-frying， and stewing. In ancient and modern literature， the records of the properties， functions and indications of Quisqualis Fructus are basically the same， that is， sweet in taste， warm in nature， predominantly non-toxic， belonging to the spleen and stomach meridians. It possesses effects of insecticide， decontamination and invigorating spleen for ascariasis， enterobiasis， abdominal pain due to worm accumulation and infantile malnutrition.The contraindications for use primarily include avoiding consumption by individuals without parasitic infestations， limiting use for those with spleen-stomach deficiency-cold， refraining from drinking hot tea during medication， and avoiding excessive intake. Based on the textual research， it is suggested that the dried mature fruits of Q. indica should be used as the medicinal material for the development of famous classical formulas containing Quisqualis Fructus. Processing methods may be chosen according to prescription requirements， and the raw products is recommended for medicinal use if not specified.

Objective To investigate the effect of rosa roxburghii Tratt polysaccharides(RRTP)on insulin resistance(IR)in rats with gestational diabetes mellitus(GDM)by regulating adenosine monophosphate-activated protein kinase(AMPK)/peroxlsome proliferator-activated receptor-γ coactlvator-1α(PGC-1α)signaling pathway.Methods Ten pregnant rats served as normal control(NC)group,and 50 GDM rats were randomly divided into GDM group,RRTP 100 mg/kg(RRTP 100)group,RRTP 200 mg/kg(RRTP 200)group,positive drug(PD)group,RRTP 200 mg/kg+Dorsomorphin(RRTP 200+Dorsomorphin)group.The indexes of glucose and lipid metabolism,superoxide dismutase(SOD),malondialdehyde(MDA),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and pathological changes were evaluated in each group,and Schmidt scoring shall be performed.Additionally,apoptosis and the expression of proteins related to the AMPK/PGC-1α pathway in tissues shall be detected.Results Fasting plasma glucose,fasting insulin,homeostatic model assessment-IR,total cholesterol,triglycerides,low-density lipoprotein cholesterol,MDA,IL-6,TNF-α,Schmidt score and apoptosis index were higher in GDM group than in NC group(P<0.05),while the expressions of high-density lipoprotein cholesterol,SOD,p-AMPK/AMPK,p-AMPK and PGC-1α protein were lower in GDM group than in NC group(P<0.05).The above indexes improved in RRTP 100,RRTP 200 and PD groups.In the RRTP 200+Dorsomorphin group,the ameliorative effect of RRTP on IR was reversed.Conclusions RRTP improve IR in GDM rats by activating the AMPK/PGC-1α signaling pathway.

Objective To predict the potential suitable areas and change trend of the medicinal plant Mosla chinensis Maxim;To analyze the main environmental factors affecting the distribution of Mosla chinensis Maxim;To provide scientific strategies for promoting the cultivation of Mosla chinensis Maxim.Methods Based on the actual geographical distribution data and environmental factor data of Mosla chinensis Maxim,MaxEnt model was used to simulate the distribution of potential suitable areas in the current and four climate scenarios in future three periods.The model prediction results were tested for accuracy using the receiver operating characteristic curve method to identify the main environmental factors that affect the potential suitable area distribution of Mosla chinensis Maxim and analyze their distribution,changes and migration trends.Results The accuracy test of the model,indicated high reliability of the results;the main environmental factors affecting the distribution of potential suitable areas for the growth of Mosla chinensis Maxim were the lowest temperature in the coldest month,annual precipitation and temperature seasonality.Under the current climate scenario,the potential suitable areas of Mosla chinensis Maxim were mainly concentrated in Jiangsu,Anhui,Hubei,Chongqing,Zhejiang,Jiangxi,Hunan,Guizhou,Guangdong,Guangxi,Fujian and Taiwan,among which the high suitable areas were mainly in Jiangxi,Hunan,Fujian,Zhejiang,Guangdong,Guangxi and Taiwan.Under the future climate scenario,the geographical distribution pattern of potential suitable areas of Mosla chinensis Maxim will be relatively stable,and the suitable areas will change along the high latitude but the total area decreases.Under the current and future climate scenarios,the centroid and centroid migration trajectories of the potential suitable area of Mosla chinensis Maxim will be in Hunan.Conclusion This study predicted distribution of potential changes in the distribution of suitable growth areas for Mosla chinensis Maxim,which can provide references for the sustainable utilization and promotion of cultivation of Mosla chinensis Maxim resources.

Objective To investigate the effect of rosa roxburghii Tratt polysaccharides(RRTP)on insulin resistance(IR)in rats with gestational diabetes mellitus(GDM)by regulating adenosine monophosphate-activated protein kinase(AMPK)/peroxlsome proliferator-activated receptor-γ coactlvator-1α(PGC-1α)signaling pathway.Methods Ten pregnant rats served as normal control(NC)group,and 50 GDM rats were randomly divided into GDM group,RRTP 100 mg/kg(RRTP 100)group,RRTP 200 mg/kg(RRTP 200)group,positive drug(PD)group,RRTP 200 mg/kg+Dorsomorphin(RRTP 200+Dorsomorphin)group.The indexes of glucose and lipid metabolism,superoxide dismutase(SOD),malondialdehyde(MDA),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and pathological changes were evaluated in each group,and Schmidt scoring shall be performed.Additionally,apoptosis and the expression of proteins related to the AMPK/PGC-1α pathway in tissues shall be detected.Results Fasting plasma glucose,fasting insulin,homeostatic model assessment-IR,total cholesterol,triglycerides,low-density lipoprotein cholesterol,MDA,IL-6,TNF-α,Schmidt score and apoptosis index were higher in GDM group than in NC group(P<0.05),while the expressions of high-density lipoprotein cholesterol,SOD,p-AMPK/AMPK,p-AMPK and PGC-1α protein were lower in GDM group than in NC group(P<0.05).The above indexes improved in RRTP 100,RRTP 200 and PD groups.In the RRTP 200+Dorsomorphin group,the ameliorative effect of RRTP on IR was reversed.Conclusions RRTP improve IR in GDM rats by activating the AMPK/PGC-1α signaling pathway.

Objective To predict the potential suitable areas and change trend of the medicinal plant Mosla chinensis Maxim;To analyze the main environmental factors affecting the distribution of Mosla chinensis Maxim;To provide scientific strategies for promoting the cultivation of Mosla chinensis Maxim.Methods Based on the actual geographical distribution data and environmental factor data of Mosla chinensis Maxim,MaxEnt model was used to simulate the distribution of potential suitable areas in the current and four climate scenarios in future three periods.The model prediction results were tested for accuracy using the receiver operating characteristic curve method to identify the main environmental factors that affect the potential suitable area distribution of Mosla chinensis Maxim and analyze their distribution,changes and migration trends.Results The accuracy test of the model,indicated high reliability of the results;the main environmental factors affecting the distribution of potential suitable areas for the growth of Mosla chinensis Maxim were the lowest temperature in the coldest month,annual precipitation and temperature seasonality.Under the current climate scenario,the potential suitable areas of Mosla chinensis Maxim were mainly concentrated in Jiangsu,Anhui,Hubei,Chongqing,Zhejiang,Jiangxi,Hunan,Guizhou,Guangdong,Guangxi,Fujian and Taiwan,among which the high suitable areas were mainly in Jiangxi,Hunan,Fujian,Zhejiang,Guangdong,Guangxi and Taiwan.Under the future climate scenario,the geographical distribution pattern of potential suitable areas of Mosla chinensis Maxim will be relatively stable,and the suitable areas will change along the high latitude but the total area decreases.Under the current and future climate scenarios,the centroid and centroid migration trajectories of the potential suitable area of Mosla chinensis Maxim will be in Hunan.Conclusion This study predicted distribution of potential changes in the distribution of suitable growth areas for Mosla chinensis Maxim,which can provide references for the sustainable utilization and promotion of cultivation of Mosla chinensis Maxim resources.

Objective To construct a predictive model for septic shock based on the propensity score matching (PSM) method and validate its effectiveness. Methods A total of 114 patients with sepsis were enrolled as study objects, and were divided into septic shock group (40 patients) and sepsis group (74 patients) according to whether they developed septic shock. PSM was performed with a ratio of septic shock to sepsis of 1∶2, resulting in the inclusion of 30 patients in the septic shock group and 60 patients in the sepsis group after matching. The levels of C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), serum amyloid A (SAA), soluble endothelial protein C receptor (sEPCR), endothelial cell-specific molecule 1 (ESM-1), clusterin (CLU), and the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score and Sequential Organ Failure Assessment (SOFA) score at admission were compared between the two groups. Cox proportional hazards regression analysis was used to identify the factors influencing septic shock, and a predictive model for septic shock was constructed and internally validated using the receiver operating characteristic (ROC) curve. Kaplan-Meier survival curves were plotted to analyze the differences in survival prognosis among patients with different expression levels of the indicators. Results After matching, there were no statistically significant differences in general information between the two groups (P>0.05). At admission, the septic shock group had higher levels of serum PCT, CRP, SAA, IL-6, sEPCR, ESM-1, and higher APACHE Ⅱ and SOFA scores, as well as a lower level of serum CLU compared with the sepsis group (P < 0.05). Cox regression analysis showed that PCT, CRP, SAA, IL-6, sEPCR, ESM-1, APACHE Ⅱ score, and SOFA score were independent risk factors for septic shock (P < 0.05), while CLU was an independent protective factor (P < 0.05). The predictive model for septic shock, constructed based on these factors, showed an internal validation accuracy of 94.44%, an area under the curve of 0.950, a sensitivity of 93.33%, and a specificity of 96.67%. Dead patients had higher levels of PCT, CRP, SAA, IL-6, sEPCR, ESM-1, and higher APACHE Ⅱ and SOFA scores, as well as a lower level of CLU at admission compared with survivors (P < 0.05). Compared with patients with low expression levels or low scores, patients with high expression levels of PCT, CRP, SAA, IL-6, sEPCR, ESM-1, and high APACHE Ⅱ and SOFA scores had higher fatality rates, while patients with high CLU expression levels had a lower fatality rate (P < 0.05). Conclusion The serum biomarkers including PCT, CRP, SAA, IL-6, sEPCR, ESM-1, CLU, and the APACHE Ⅱ and SOFA scores in sepsis patients are closely related to the occurrence of septic shock and survival prognosis. The predictive model constructed by combining these indicators can accurately predict the occurrence of septic shock.

Objective: To analyze the association between different sleep behaviors and overweight and obesity of junior high school students in Yangzhou City, and to provide a basis for policies and interventions related to adolescent health management. Methods: A total of 1 589 students in grades 7-9 from two middle schools in Yangzhou City were selected using the cluster sampling method and were administered with sleep time, bedtime, social jetlag difference, and sleep habits. Results: Totally 64.38% were sleep deprived during the school days, 86.78% went to bed too late, 46.51% had a social jetlag of ≥1 h, and 37.44% took a nap every day(Incluldes holidays and school days). Social jetlag length was statistically different between grades( F =6.97, P < 0.01 ). Girls[(0.95±0.65)h] shown significantly higher social jetlag than the boys[(0.76±0.59)h]( t=6.19, P <0.01). Later bedtime on weekends, later wake up time on weekends and poor sleep behavior were risk factors for overweight and obesity in junior high school students( OR=1.20, 1.14, 1.04, P <0.05). Conclusion Junior high school students had less sleep and later bedtimes with the increase of grade, and weekend bedtimes,wake up times and poor sleep behavior were independently associated with the risk of overweight and obesity in junior high school students. Parents and schools should be instructed to pay attention to their sleep health and carry out adolescent sleep health guidance.

Objective To enhance the triage efficiency of patients with acute heart failure(AHF)by improving emergency severity index(ESI)score,and to achieve stratified care for patients with AHF.Additionally,the aim is to improve the combination of stratified scores and nursing care in emergency departments to address the limitations of current studies.Methods A retrospective nested cohort study was conducted on 120 patients with AHF admitted to the Affiliated Hospital of Guizhou Medical University from January 1,2019 to December 30,2021.According to the clinical outcomes of the patients,the patients were divided into subgroup A(71 cases,recovered after treatment,no serious complications during treatment),subgroup B[35 cases,discharged after treatment,multiple organ dysfunction syndrome(MODS),acute respiratory distress syndrome(ARDS),shock and other serious complications occurred during treatment],and subgroup C(14 cases,cardiac death during treatment).A prospective randomized controlled study involving 106 patients with AHF admitted to our hospital from January 1 to December 30,2022,was conducted,and the patients were divided into control group(53 cases)and stratified care group(53 cases)according to the random number table method.The control group received routine nursing care,while patients in the stratified care group received stratified care based on the ESI scoring clinical care pathway.The early warning score model of elderly patients with AHF was constructed with risk threshold as warning signal.The improved ESI scoring criteria were used to score AHF patients,with a total score of 25 points.The higher the score,the higher the risk.0-10 is divided into Ⅰ level risk,>10-20 is divided into Ⅱ level risk,>20 is divided into Ⅲ level risk.Implement nuring at grades Ⅲ,Ⅱ,and Ⅰ,respectively.The changes of modified ESI scores in subgroup A,subgroup B and subgroup C were observed,and Spearman correlation coefficient was used to evaluate the correlation between modified ESI scores and clinical outcomes of different severity of disease.Receiver operator characteristic curve(ROC curve)was drawn to evaluate the effectiveness of the risk threshold classification method of different nursing plan designs in the stratified nursing group and the control group,and to compare the efficiency differences of emergency nursing rescue time,rescue success rate,and stay time in the emergency department,and the incidence of complications such as MODS,ARDS,shock and nursing satisfaction during treatment between the stratified nursing group and the control group.Results The modified ESI score in subgroup C was the highest,significantly higher than that in subgroup B and A(19.6±1.7 vs.17.8±1.5,15.3±1.3,all P<0.05).Spearman correlation analysis showed that the modified ESI score was significantly positively correlated with the occurrence of complications,the occurrence of cardiac death,and the recovery after treatment(r values were 0.623,0.635,0.322,P values were 0.004,0.003,0.012,respectively).Therefore,an improved ESI score has a certain early warning effect on complications and cardiac death of patients.ROC curve analysis showed that the area under the ROC curve(AUC)of routine care for stratified care was 0.710 and 0.620,and the 95％ confidence interval(95％ CI)was 0.620-0.750 and 0.580-0.690,respectively,with Pvalues of 0.023 and 0.034.It shows that the difference between the two nursing methods is significant,and further indicates that the risk threshold classification method designed in this study is effective.With the increase of risk,the rescue time and emergency stay time of the two groups were gradually extended,and the success rate of rescue was gradually decreased,the rescue time and emergency stay time of grade Ⅲ risk were the longest and the success rate of rescue was the lowest,and the rescue time and emergency stay time of the stratified nursing group were significantly shorter than those of the control group(minutes:59.6±6.3 vs.76.5±7.2 and 57.6±5.4 vs.68.2±7.1,both P<0.05),the success rate of rescue was significantly increased[(68.7±6.1)％ vs.(54.6±5.2)％,P<0.05],and the difference of rescue time between grade Ⅰ risk and grade Ⅲ risk was the largest.There were significant differences in the success rate of rescue and the duration of emergency stay in grade Ⅲ risk.The incidence of complications such as MODS,ARDS and shock in stratified care group was significantly lower than that in control group[incidence of MODS:13.2％(7/53)vs.18.9％(10/53),incidence of ARDS:15.1％(8/53)vs.22.6％(12/53),incidence of shock:13.2％(7/53)vs.20.8％(11/53),all P<0.05],satisfaction of patients with service attitude,operation technique,comfort and timeliness were significantly improved compared with the control group[service attitude:28.3％(15/53)vs.18.9％(10/53),operation technology:30.2％(16/53)vs.20.8％(11/53),comfort:32.1％(17/53)vs.24.5％(13/53),timeliness:32.1％(17/53)vs.24.5％(13/53),all P<0.05].Conclusion Based on the modified ESI score,early risk warning thresholds are divided and stratified nursing is conducted,which is beneficial for timely intervention in AHF,effectively ensuring the clinical nursing value of patients during the implementation of medical measures,and has broad application prospects.

OBJECTIVE:To evaluate therapeutic efficacy and safety of valaciclovir versus acyclovir in the treatment of herpes zoster,and to provide evidence-based reference in clinic.METHODS:Retrieved from PubMed,Medline,CJFD,VIP and Wanfang Database,randomized controlled trials (RCTs) about valaciclovir (trial group) versus acyclovir (control group) in the treatment of herpes zoster were included.The data was analyzed statistically by using Rev Man 5.3 software after data extraction and quality evaluation by Cochrane systematic reviewer manual 5.1.0.RESULTS:A total of 12 RCTs were included,involving 1 059 patients.The result of Meta-analysis showed that:total response rate [OR =4.64,95 ％ CI (2.99,7.20),P＜ 0.001] and cure rate [OR =2.93,95％CI(2.13,4.03),P＜0.001] of trial group were significantly higher than those of control group;the incidence of postherpetic neuralgia in trial group [OR=0.39,95％CI(0.22,0.69),P=0.001] was significantly lower than control group,with statistical significance.There was no statistical significance in the incidence of ADR between 2 groups [OR=0.79,95％CI(0.49,1.29),P=0.35].CONCLUSIONS:Therapeutic efficacy of valaciclovir is better than that of acyclovir in the treatment of herpes zoster,can significantly reduce the incidence of postherpetic neuralgia.Both have similar safety.

Objective To observe the effect of morroniside on cerebral infarction volume in focal cerebral ischemia-reperfusion rat model.Methods The animal model was induced by occlusion of middle cerebral artery with suture embolus, ischemia for 30 minutes, and reperfusion for 7 days. The infarction volume was measured by 2,3,5-triphenyltetrazolium chloride(TTC) staining technique.Results Compared with sham operation group, the cerebral infarction volume ratios increased obviously in model group and in the drug-treated（90 mg/kg，270 mg/kg）groups. Compared with model group, the cerebral infarction volume ratios decreased obviously in the morroniside-treated（90 mg/kg，270 mg/kg）group,while the cerebral infarction volume ratios in vitamin E-treated（35 mg/kg）group didn't change.Conclusion Morroniside may decrease the cerebral infarction volume after cerebral ischemia-reperfusion. It possesses protective effect against cerebral ischemia-reperfusion injury.