Descurainiae Semen Lepidii Semen, also known as Tinglizi, originates from Brassicaceae plants Descurainia sophia or Lepidium apetalum. The former is commonly referred to as "Southern Tinglizi(Descurainiae Semen)", while the latter is known as "Northern Tinglizi(Lepidii Semen)". To scientifically and accurately identify the origin of Tinglizi medicinal materials and traditional Chinese medicine products, this study developed a specific DNA mini-barcode based on chloroplast genome sequences. By combining the DNA mini-barcode with DNA metabarcoding technology, a method for the qualitative and quantitative identification of Tinglizi medicinal materials and Chinese patent medicines was established. In this study, chloroplast genomes of Southern Tinglizi and Northern Tinglizi and seven commonly encountered counterfeit products were downloaded from the GenBank database. Suitable polymorphic regions were identified to differentiate these species, enabling the development of the DNA mini-barcode. Using DNA metabarcoding technology, medicinal material mixtures of Southern and Northern Tinglizi, as well as the most common counterfeit product, Capsella bursa-pastoris seeds, were analyzed to validate the qualitative and quantitative capabilities of the mini-barcode and determine its minimum detection limit. Additionally, the mini-barcode was applied to Chinese patent medicines containing Tinglizi to authenticate their botanical origin. The results showed that the developed mini-barcode(psbB) exhibited high accuracy and specificity, effectively distinguishing between the two authentic origins of Tinglizi and commonly encountered counterfeit products. The analysis of mixtures demonstrated that the mini-barcode had excellent qualitative and quantitative capabilities, accurately identifying the composition of Chinese medicinal materials in mixed samples with varying proportions. Furthermore, the analysis of Chinese patent medicines revealed the presence of the adulterant species(Capsella bursa-pastoris) in addition to the authentic species(Southern and Northern Tinglizi), indicating the occurrence of adulteration in commercially available Tinglizi-containing products. This study developed a method for the qualitative and quantitative identification of multi-origin Chinese medicinal materials and related products, providing a model for research on other multi-origin Chinese medicinal materials.
DNA Barcoding, Taxonomic/methods* ; Drugs, Chinese Herbal/chemistry* ; Drug Contamination ; Genome, Chloroplast ; Medicine, Chinese Traditional

Degenerative cervical myelopathy(DCM)is a group of diseases caused by cervical spine degeneration that compresses the spinal cord.It is a major cause of spinal cord dysfunction in adults,and its incidence is increasing globally.In the late stage,DCM could lead to paralysis due to spinal cord injury,which makes rapid,effective,and accurate medical diagnosis clinically significant.Deep learning(DL)technology can assist physicians in the rapid and accurate diagnosis of DCM by analyzing and processing a large amount of imaging data to extract features of the affected regions.In recent years,DL algorithm models have been leveraged for DCM-related research,which has become a focal point of intelligent medical development.In this review,domestic and international literature is surveyed,and the research progress and application of DL technology in the auxiliary diagnosis and prognosis evaluation of DCM are systematically summarized,aiming to provide a reference for intelligent diagnosis in clinical practice.

Objective To explore the safety and efficacy of radiofrequency catheter ablation(RCFA)in patients with persistent atrial fibrillation(AF)/atrial flutter(AFL)and heart failure(HF)with left ventricular ejection fraction≤35％.Methods This study is a retrospective study.Patients with persistent AF/AFL and HF with left ventricular ejection fraction≤ 35％admitted to Beijing Anzhen Hospital from January 2018 to March 2024 were enrolled.The perioperative characteristics and complications changes in echocardiographic parameters,and follow-up outcomes were analyzed.Results A total of 45 patients were enrolled with a mean age of(56±13)years and a mean LVEF of(28±4)％.The ablation strategy was circumferential pulmonary vein isolation and empirical linear ablation.The operation time and fluoroscopy time were 120(120,163)min and 5(4,10)min respectively.The patients mainly underwent linear ablation including circumferential pulmonary vein isolation(38,84.4％),cavotricuspid isthmus(37,82.2％),roofline(34,75.6％),mitral isthmus(34,75.6％).21(46.7％)patients underwent ehtanol infusion into the vein of Marshall.24(53.3％)patients underwent electrocardioversion.All patients restored sinus rhythm immediately after RFCA and had no perioperative complications.After a median follow-up of 22.9(7.8,31.0)months,2 patients died of cardiovascular disease,1 patient underwent heart transplantation,14(33.3％)patients were readmitted for cardiovascular disease,and 10 patients(23.8％)had recurrence of AF.The mean LVEF of the 28 patients who obtained LVEF at the last follow-up increased from(28±4)％to(51±14)％,and the average improvement of LVEF was(23±13)％(P＜0.0001).15 of these patients had complete recovery of left ventricular systolic function(LVEF≥ 50％).Conclusions RFCA is safe and effective for patients with persistent AF/AFL and HF with LVEF ≤ 35％,and can improve patient's cardiac function and significantly increase LVEF.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

Objective To explore the safety and efficacy of radiofrequency catheter ablation(RCFA)in patients with persistent atrial fibrillation(AF)/atrial flutter(AFL)and heart failure(HF)with left ventricular ejection fraction≤35％.Methods This study is a retrospective study.Patients with persistent AF/AFL and HF with left ventricular ejection fraction≤ 35％admitted to Beijing Anzhen Hospital from January 2018 to March 2024 were enrolled.The perioperative characteristics and complications changes in echocardiographic parameters,and follow-up outcomes were analyzed.Results A total of 45 patients were enrolled with a mean age of(56±13)years and a mean LVEF of(28±4)％.The ablation strategy was circumferential pulmonary vein isolation and empirical linear ablation.The operation time and fluoroscopy time were 120(120,163)min and 5(4,10)min respectively.The patients mainly underwent linear ablation including circumferential pulmonary vein isolation(38,84.4％),cavotricuspid isthmus(37,82.2％),roofline(34,75.6％),mitral isthmus(34,75.6％).21(46.7％)patients underwent ehtanol infusion into the vein of Marshall.24(53.3％)patients underwent electrocardioversion.All patients restored sinus rhythm immediately after RFCA and had no perioperative complications.After a median follow-up of 22.9(7.8,31.0)months,2 patients died of cardiovascular disease,1 patient underwent heart transplantation,14(33.3％)patients were readmitted for cardiovascular disease,and 10 patients(23.8％)had recurrence of AF.The mean LVEF of the 28 patients who obtained LVEF at the last follow-up increased from(28±4)％to(51±14)％,and the average improvement of LVEF was(23±13)％(P＜0.0001).15 of these patients had complete recovery of left ventricular systolic function(LVEF≥ 50％).Conclusions RFCA is safe and effective for patients with persistent AF/AFL and HF with LVEF ≤ 35％,and can improve patient's cardiac function and significantly increase LVEF.

Objective To understand the epidemic characteristics of Norovirus infection in schools in Hefei City,and provide scientific basis for the prevention and control of Norovirus infection in schools.Methods The investiga-tion reports of Norovirus infection reported by the centers for disease control and prevention(CDC)of all counties(cities and districts)in Hefei City and the laboratory test results of Hefei CDC from 2018 to 2022 were analyzed by descriptive epidemiological methods.The related indicators of Norovirus infection,including the attack rate,timeli-ness of reporting,duration of epidemic,clinical symptoms,as well as GⅠ and G Ⅱ classification of Norovirus were compared.Results From 2018 to 2022,there were 217 school Norovirus infections outbreaks in Hefei City,with 3 002 cases and 314 006 affected people.The average annual attack rate ranged from 0.82％to 1.32％.Most cases were from kindergartens,there were 116 cases,accounting for 53.46％,with an average attack rate of 2.87％.The time distribution was bimodal,concentrated in March-June and September-December each year.The attack rate and duration of outbreaks were both significantly higher than those of clustering epidemics(both P＜0.001).Positive correlation existed between the timeliness of reporting and the number of outbreaks at the time of receiving the re-port as well as the duration of the epidemic(r=0.182,0.783,respectively,both P＜0.001).With the advance-ment of the academic stage,the symptom with diarrhea showed an increasing trend(x2trend=743.236,P＜0.001),the symptom with vomiting presented a decreasing trend(x2trend=386.888,P＜0.001),and the symptoms with both diarrhea and vomiting presented an increasing trend(x2trend=327.264,P＜0.001),while the symptom with fe-ver presented a decreasing trend(x2trend=15.717,P＜0.001).The positive detection rate of anal swab specimens(60.10％)was higher than that of vomit and environmental specimens(38.71％,14.29％,respectively,x2=135.685,P＜0.001).The laboratory identified 181 cases with Norovirus GⅠ and G Ⅱ subtypes,including 28 cases of G Ⅰsubtype,accounting for 15.47％,and 149 cases of G Ⅱ subtype,accounting for 82.32％.Conclusion Schools are locations with high incidence of Norovirus infection.At the beginning of the school season,various prevention and control measures should be strictly implemented to improve the monitoring sensitivity of symptoms like vomiting,diarrhea,and so on,so as to achieve early detection,early report and early treatment.

Objective To understand the epidemic characteristics of Norovirus infection in schools in Hefei City,and provide scientific basis for the prevention and control of Norovirus infection in schools.Methods The investiga-tion reports of Norovirus infection reported by the centers for disease control and prevention(CDC)of all counties(cities and districts)in Hefei City and the laboratory test results of Hefei CDC from 2018 to 2022 were analyzed by descriptive epidemiological methods.The related indicators of Norovirus infection,including the attack rate,timeli-ness of reporting,duration of epidemic,clinical symptoms,as well as GⅠ and G Ⅱ classification of Norovirus were compared.Results From 2018 to 2022,there were 217 school Norovirus infections outbreaks in Hefei City,with 3 002 cases and 314 006 affected people.The average annual attack rate ranged from 0.82％to 1.32％.Most cases were from kindergartens,there were 116 cases,accounting for 53.46％,with an average attack rate of 2.87％.The time distribution was bimodal,concentrated in March-June and September-December each year.The attack rate and duration of outbreaks were both significantly higher than those of clustering epidemics(both P＜0.001).Positive correlation existed between the timeliness of reporting and the number of outbreaks at the time of receiving the re-port as well as the duration of the epidemic(r=0.182,0.783,respectively,both P＜0.001).With the advance-ment of the academic stage,the symptom with diarrhea showed an increasing trend(x2trend=743.236,P＜0.001),the symptom with vomiting presented a decreasing trend(x2trend=386.888,P＜0.001),and the symptoms with both diarrhea and vomiting presented an increasing trend(x2trend=327.264,P＜0.001),while the symptom with fe-ver presented a decreasing trend(x2trend=15.717,P＜0.001).The positive detection rate of anal swab specimens(60.10％)was higher than that of vomit and environmental specimens(38.71％,14.29％,respectively,x2=135.685,P＜0.001).The laboratory identified 181 cases with Norovirus GⅠ and G Ⅱ subtypes,including 28 cases of G Ⅰsubtype,accounting for 15.47％,and 149 cases of G Ⅱ subtype,accounting for 82.32％.Conclusion Schools are locations with high incidence of Norovirus infection.At the beginning of the school season,various prevention and control measures should be strictly implemented to improve the monitoring sensitivity of symptoms like vomiting,diarrhea,and so on,so as to achieve early detection,early report and early treatment.

OBJECTIVES: Restoration of blood circulation within "time window" is the principal treating goal for treating acute ischemic stroke. Previous studies revealed that delayed recanalization might cause serious ischemia/reperfusion injury. However, plenty of evidences showed delayed recanalization improved neurological outcomes in acute ischemic stroke. This study aims to explore the role of delayed recanalization on blood-brain barrier (BBB) in the penumbra (surrounding ischemic core) and neurological outcomes after middle cerebral artery occlusion (MCAO). METHODS: Recanalization was performed on the 3rd day after MCAO. BBB disruption was tested by Western blotting, Evans blue dye, and immunofluorescence staining. Infarct volume and neurological outcomes were evaluated on the 7th day after MCAO. The expression of fibroblast growth factor 21 (FGF21), fibroblast growth factor receptor 1 (FGFR1), phosphatidylinositol-3-kinase (PI3K), and serine/threonine kinase (Akt) in the penumbra were observed by immunofluorescence staining and/or Western blotting. RESULTS: The extraversion of Evans blue, IgG, and albumin increased surrounding ischemic core after MCAO, but significantly decreased after recanalization. The expression of Claudin-5, Occludin, and zona occludens 1 (ZO-1) decreased surrounding ischemic core after MCAO, but significantly increased after recanalization. Infarct volume reduced and neurological outcomes improved following recanalization (on the 7th day after MCAO). The expressions of Claudin-5, Occludin, and ZO-1 decreased surrounding ischemic core following MCAO, which were up-regulated corresponding to the increases of FGF21, p-FGFR1, PI3K, and p-Akt after recanalization. Intra-cerebroventricular injection of FGFR1 inhibitor SU5402 down-regulated the expression of PI3K, p-Akt, Occludin, Claudin-5, and ZO-1 in the penumbra, which weakened the beneficial effects of recanalization on neurological outcomes after MCAO. CONCLUSIONS Delayed recanalization on the 3rd day after MCAO increases endogenous FGF21 in the penumbra and activates FGFR1/PI3K/Akt pathway, which attenuates BBB disruption in the penumbra and improves neurobehavior in MCAO rats.
Animals ; Rats ; Blood-Brain Barrier/metabolism* ; Brain Ischemia ; Claudin-5/metabolism* ; Infarction, Middle Cerebral Artery/metabolism* ; Ischemic Stroke/metabolism* ; Occludin/metabolism* ; Phosphatidylinositol 3-Kinases/metabolism* ; Proto-Oncogene Proteins c-akt/metabolism* ; Rats, Sprague-Dawley ; Receptor, Fibroblast Growth Factor, Type 1/metabolism* ; Reperfusion Injury/metabolism*

The purpose of this study was to investigate the epidemiological characteristics and risk factors of influenza in Hainan province,to provide evidence to support influenza prevention and control efforts.Pathogen monitoring data of influenza-like illness(ILI)in six national sentinel hospitals in Hainan province from 2013 to 2021 were analyzed in SPSS 20.0 software.A total of 50 415 ILI cases were detected during the 2013-2021 season,of which 5 581 were positive for influenza viruses,with a positivity rate of 11.07％.The dominant strains were type B,type A(H1N1)pdm09 and type A(H3N2).The positivi-ty rate of influenza virus was highest in people 5-14 years of age(17.56％)and lowest in people 0-4 years of age(7.32％).Influenza activity showed both a summer peak and a winter-spring peak in the 2014-2016,2017-2018 and 2019-2020 sea-sons,and was concentrated in April to September,with a maximum peak of 53.64％,and in November to March of the next year,with a peak of 47.30％.The 2013-2014,2016-2017 and 2018-2019 seasons showed only a winter-spring peak concen-trated between October and March of the next year,with a maximum peak of 54.17％,but no obvious summer peak.The pre-dominant influenza viruses during the eight surveillance seasons varied among H1N1,H3N2 and type B.The positive detection rate of influenza virus steeply declined during the 2020-2021 season:the positive detection rate was only 0.25％,and no obvi-ous epidemic period was observed.The intensity of influenza epidemic varied among monitoring years,and the dominant strains changed rapidly in Hainan Province.People 5-14 years of age were the key population affected.Summer,winter and spring were the key periods for influenza prevention and control.Etiological surveillance of influenza should continue to be strength-ened,the roles of health education and publicity should be emphasized,and the dual measures of influenza vaccination and non-drug intervention should be actively promoted to decrease the occurrence of influenza.

ObjectiveThe purpose of this article is to explore the relationship between lymphocyte and the severity of immunocompromised host pneumonia， and to examine the effect of different doses of glucocorticoid on the survival outcome of severe group. MethodsThe clinical data of immunocompromised host pneumonia patients were collected. The patients were divided into severe group and non-severe group according to the official clinical practice guideline of the ATS/IDSA. Logistic regression analysis was used to search for independent risk factors of severe immunocompromised host pneumonia. Meanwhile， the receiver operating characteristic curves （ROCs） were created to evaluate the predictive value of each risk factor. Furthermore， the severe group were divided into three sub-groups according to the dose of glucocorticoid during hospitalization： severe+ high-dose glucocorticoid group （≥1 mg·kg^-1·d^-1 prednisolone or other equivalent dose of glucocorticoid）， severe+ low-dose glucocorticoid group （＜1 mg·kg^-1·d^-1 prednisolone or other equivalent dose of glucocorticoid）， and severe+ non-glucocorticoid group. The 28-day survival rates of the three groups were compared to evaluate the effect of glucocorticoid on severe immunocompromised host pneumonia. ResultsThe levels of lymphocyte absolute value， T lymphocytes percentage， T lymphocyte absolute value， CD4⁺T lymphocyte absolute value in severe pneumonia group were lower than those in non-severe pneumonia group. The results of logistic regression showed that the increase of CRP and PCT and the prolongation of PT were independent risk factors for the severe immunocompromised host pneumonia， while the increase of platelet and T lymphocyte absolute value were independent protective factors for the severe immunocompromised host pneumonia. The ROCs analysis showed that compared with other risk factors， the decrease of T lymphocyte absolute value had better predictive value for the risk assessment of immunocompromised host pneumonia. When the absolute value of T lymphocytes was lower than 874.65 cells /μL， the sensitivity and specificity were 90.9% and 43.5%， respectively. The area under the curve （AUC） was 0.723 ［95% confidence interval （0.649， 0.797）］. The survival rate of the severe + high-dose glucocorticoid group was 45.5%. The survival rate of the severe + low-dose glucocorticoid group was 66.7%. The survival rate of the severe + non-dose glucocorticoid group was 25.0%. The survival rate of the severe + low-dose glucocorticoid group was higher than the survival rate of the severe + non-dose（P＜0.05）. Meanwhile， the survival rate of the severe + low-dose glucocorticoid group was higher than the survival rate of the severe + high-dose glucocorticoid group， but no statistically significant difference was found （P>0.05）. ConclusionsThe increase of T lymphocyte absolute value is the independent protective factor for immunocompromised host pneumonia. The absolute value of T lymphocytes have a good predictive value for the severity of immunocompromised host pneumonia. When the absolute value of T lymphocytes is lower than 874.65 cells/μL， the sensitivity is up to 90.9% . Low-dose glucocorticoid therapy can improve the 28-day survival rate of patients with severe immunosuppressive host pneumonia.