ObjectiveTo investigate the changes in chemical components of Gardeniae Fructus（GF） before and after being charred， providing data support for research on the material basis of GF Carbonisata（GFC）. MethodsUltra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry（UPLC-Q-Orbitrap MS/MS） was used to conduct a comprehensive analysis of the chemical components in GF and GFC under positive and negative ion modes with Compound Discoverer 3.3 software and online database. Then， principal component analysis and partial least squares-discriminant analysis in SIMCA14.1 software were used to analyze the MS data of each sample. Based on the principle of variable importance in the projection（VIP） value>1， differential secondary and primary metabolites before and after carbonization were screened. In addition， MetaboAnalyst website was used for pathway enrichment of Kyoto Encyclopedia of Genes and Genomes（KEGG）， so as to provide a reference for clarifying the processing mechanism. ResultsA total of 185 components were identified， including 96 secondary metabolites and 89 primary metabolites. These components were classified into nine categories， primarily including iridoid glycosides， flavonoids， and terpenoids， their fragmentation pathways were also analyzed. Simultaneously， multivariate statistical analysis was performed on the secondary and primary metabolites， identifying 70 and 59 differential metabolites， respectively. The secondary metabolites were enriched in two metabolic pathways， including C5-branched dibasic acid metabolism and flavonoid and flavonol biosynthesis， while the primary differential metabolites were enriched in seven pathways such as linoleic acid metabolism and tyrosine metabolism. ConclusionThe chemical components of GF change significantly after carbonization， with a significant decrease in the contents of iridoid glycosides and terpenoids such as hydroxyisogeniposide， crocin Ⅱ， crocetin， and jasminoside B. while the contents of 4-hydroxycoumarin， geniposidic acid， gentiopicroside， and gardenoside methyl ester increase significantly. This change is presumed to be associated with the enhanced cooling and hemostatic effects of the processed products. The identified key components provide a basis for elucidating the material basis underlying the efficacy changes before and after carbonization.

Traditional Chinese medicine （TCM） compound prescriptions serve as crucial practical embodiments of TCM theoretical frameworks， characterized by their complex multi-component composition and multi-target interactions. The research on the material basis of their pharmacological effects has gradually become the key to promoting the modernization of TCM. In recent years， new ideas and theories regarding the research on pharmacodynamic substance basis of TCM compound prescriptions have been continuously proposed. This review systematically summarizes and reviews analytical techniques such as targeted fishing technology， spectrum-effect relationship analysis， serum pharmacochemistry， network pharmacology， high-throughput screening， and cell membrane chromatography. It is found that these techniques exhibit unique advantages in areas including target-specific analysis， component-pharmacological effect correlation analysis， identification of the material basis in vitro and in vivo， prediction of multi-target mechanisms， efficient screening of active ingredients， and analysis of interactions between cell membrane receptors. These techniques compensate for the shortcomings of traditional research methods， enhance the systematicness and precision of research on pharmacodynamic substance based TCM compound prescriptions， and can provide theoretical support for the promotion and clinical application of TCM compound prescriptions.

Objective:To investigate the effect of dapagliflozin on non-dipper blood pressure in patients with diabetic kidney disease(DKD).Methods:A total of 104 patients with DKD treated in the Department of Nephrology of Henan Provincial Hospital of Tradi-tional Chinese Medicine from January 2023 to January 2024 were selected as the study subjects.The patients were divided into a dapa-gliflozin group and a control group by the random number table method,with 52 patients in each group.The control group was given conventional Western medicine treatment,and the dapagliflozin group was additionally given dapagliflozin(10 mg/dose,once a day)on the basis of the treatment in the control group.Both groups re-ceived continuous treatment for 12 weeks.The following indicators and the incidence of adverse reactions after treatment were com-pared between the two groups,including blood glucose indicators[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2 h PBG),and glycated hemoglobin(HbA1c)],renal function markers[serum cystatin C(CysC),blood urea nitrogen(BUN),se-rum creatinine(Scr),estimated glomerular filtration rate(eGFR),and urinary albumin/creatinine ratio(UACR)],24-h ambulatory blood pressure,proportion of non-dipper blood pressure and reversal rate of dipper blood pressure,blood electrolytes[potassium(K),sodium,chlorine,calcium,magnesium,and phosphorus],serum uric acid(SUA),and urine electrolytes[urine potassium,urine sodium(UNa),urine chlorine,urine calcium,urine magnesium(UMg),and urine phosphorus].Results:The FPG,2 h PBG,HbA1c,CysC,BUN,Scr,UACR,mean 24 h systolic blood pressure(24 h SBP),mean daytime systolic blood pressure,and mean nighttime diastolic blood pressure were decreased and the eGFR was elevated in both groups after treatment.The mean nighttime systolic blood pressure(nSBP),K,and SUA were decreased and the UNa and UMg were increased in the dapagliflozin group after treatment(P<0.05).Com-pared with the control group,the dapagliflozin group experienced decreases in CysC,BUN,Scr,UACR,24 h SBP,nSBP,K,and SUA and increases in eGFR,UNa,and UMg after treatment(P<0.05).The proportion of non-dipper blood pressure after treatment in the dapagliflozin group was lower than that in the control group and before treatment,and the reversal rate of dipper blood pressure was higher than that in the control group(P<0.05).During treatment,the incidence rates of adverse reactions was 3.85%in the dapa-gliflozin group and 5.77%in the control group(P=1.000).Conclusion:Dapagliflozin improves the renal function,decreases the noctur-nal blood pressure,and increases the reversal rate of dipper blood pressure in patients with DKD.Dapagliflozin promotes UNa excre-tion and decreases the SUA level,which may be the potential mechanism of reversing non-dipper blood pressure.

Background and objective Lung cancer is a leading cause of cancer-related deaths.Non-small cell lung cancer(NSCLC)is the most common pathological subtype,with adenocarcinoma being the predominant type.FAT atypical cadherin 1(FAT1)is a receptor-like protein with a high frequency of mutations in lung adenocarcinoma.The protein encoded by FAT1 plays a crucial role in processes such as cell adhesion,proliferation,and differentiation.This study aims to investigate the expression of FAT1 in lung adenocarcinoma and its relationship with immune infiltration.Methods Gene expression levels and relevant clinical information of 513 lung adenocarcinoma samples and 397 adjacent lung samples were obtained through The Cancer Genome Atlas(TCGA)and Genotype-Tissue Expression(GTEx)data.The mRNA expression levels of the FAT1 gene in lung adenocarcinoma tissues were analyzed,along with its association with the prognosis of lung adenocarcinoma patients.Pathway enrichment analysis was conducted to explore the signaling pathways regulated by the FAT1 gene.Immu-noblotting was used to detect the differential expression of FAT1 in lung epithelial cells and various lung cancer cell lines,while immunohistochemistry was employed to assess FAT1 expression in lung cancer and adjacent tissues.Results FAT1 gene muta-tions were identified in 14%of lung adenocarcinoma patients.TCGA database data revealed significantly higher FAT1 mRNA expression in lung adenocarcinoma tissues compared to adjacent lung tissues.Kaplan-Meier analysis indicated lower survival rates in lung adenocarcinoma patients with higher FAT gene expression.Pathway enrichment analysis suggested the involve-ment of FAT1 in tumor development pathways,and its expression was closely associated with immune cell infiltration.Immu-nohistochemical validation demonstrated significantly higher expression of FAT1 in cancer tissues compared to adjacent lung tissues.Conclusion FAT1 mRNA is highly expressed in lung adenocarcinoma tissues,and elevated FAT1 mRNA expression is associated with poor prognosis in lung adenocarcinoma patients.FAT1 may serve as a potential biomarker for lung cancer.

Viral myocarditis(VMC)is one of the most common acquired heart diseases in children and teenagers.However,its pathogenesis is still unclear,and effective treatments are lacking.This study aimed to investigate the regulatory pathway by which exosomes alleviate ferroptosis in cardiomyocytes(CMCs)induced by coxsackievirus B3(CVB3).CVB3 was utilized for inducing the VMC mouse model and cellular model.Cardiac echocardiography,left ventricular ejection fraction(LVEF),and left ventricular fractional shortening(LVFS)were implemented to assess the cardiac function.In CVB3-induced VMC mice,cardiac insufficiency was observed,as well as the altered levels of ferroptosis-related indicators(glutathione peroxidase 4(GPX4),glutathione(GSH),and malondialdehyde(MDA)).However,exosomes derived from human umbilical cord mesenchymal stem cells(hucMSCs-exo)could restore the changes caused by CVB3 stimulation.Let-7a-5p was enriched in hucMSCs-exo,and the inhibitory effect of hucMSCs-exolet-7a-5p mimic on CVB3-induced ferroptosis was higher than that of hucMSCs-exomimicNC(NC:negative control).Mothers against decapentaplegic homolog 2(SMAD2)increased in the VMC group,while the expression of zinc-finger protein 36(ZFP36)decreased.Let-7a-5p was confirmed to interact with SMAD2 messenger RNA(mRNA),and the SMAD2 protein interacted directly with the ZFP36 protein.Silencing SMAD2 and overexpressing ZFP36 inhibited the expression of ferroptosis-related indicators.Meanwhile,the levels of GPX4,solute carrier family 7,member 11(SLC7A11),and GSH were lower in the SMAD2 overexpression plasmid(oe-SMAD2)+let-7a-5p mimic group than in the oe-NC+let-7a-5p mimic group,while those of MDA,reactive oxygen species(ROS),and Fe2+increased.In conclusion,these data showed that ferroptosis could be regulated by mediating SMAD2 expression.Exo-let-7a-5p derived from hucMSCs could mediate SMAD2 to promote the expression of ZFP36,which further inhibited the ferroptosis of CMCs to alleviate CVB3-induced VMC.

Objective:To integrate and systematically evaluate the self-disclosure experience and feelings of cancer patients.Methods:Qualitative studies on self-disclosure of cancer patients in PubMed, Web of Science, Cochrane Library, Embase, EBSCO, SinoMed, China National Knowledge Infrastructure, Wanfang Data, and VIP searched by computer from the establishment of the databases to March 8, 2023. The literature was evaluated using the authenticity evaluation tool of qualitative studies by the Joanna Briggs Institute Evidence-based Health Care, and the results were summarized in an aggregative integration approach.Results:A total of eight literatures were included, 30 main results were extracted, and similar results were summarized into ten new categories. Finally, two integrated results were composed, which were the promoting factors and the hindering factors of self-disclosure.Conclusions:Self-disclosure can enhance the intimate relationship between cancer patients and others, thereby improving the self-acceptance and mental health of cancer patients.

Objective:To study the iodine nutrition status of children aged 8 to 10 and pregnant women and thyroid of children in Fushun City, Liaoning Province, and to provide data for formulation of prevention and control programs on iodine deficiency disorders in Fushun.Methods:In 2021, according to population probability proportional sampling method (PPS), 1 street (township) was selected from 7 districts and counties (Dongzhou District, Wanghua District, Dongzhou District, Xinfu District, Fushun County, Xinbin County and Qingyuan County) in Fushun City according to 5 directions (east, south, west, north and middle) and 1 primary school was selected from each street (township). Forty to 50 children aged 8 to 10 from each primary school and 20 pregnant women were selected from each street (township). Urine samples and salt samples of children and pregnant women were collected for urine iodine and salt iodine levels detection, and thyroid gland of children was examined to calculate the goiter rate. Urine iodine was determined by "Determination of Iodine in Urine Part 1: Method for Determination of Iodine in Urine by As 3+-Ce 4+ Eatalytic Spectrophotometry", salt iodine was determined by "General Test Method in Salt Industry - Determination of Iodine", and children's thyroid was examined by Doppler B-ultrasound. Children iodine nutrition criteria: urinary iodine median < 100 μg/L was iodine deficiency; 100 - < 200 μg/L was suitable for iodine; 200 - < 300 μg/L was more than the appropriate amount of iodine; ≥300 μg/L was iodine excess. Pregnant women iodine nutrition criteria: urinary iodine median < 150 μg/L was iodine deficiency; 150 - < 250 μg/L was suitable for iodine. 250 - < 500 μg/L was more than the appropriate amount of iodine; ≥500 μg/L was iodine excess. Criteria for iodized salt: 18 - 33 mg/kg was qualified iodized salt; < 5 mg/kg was non-iodized salt; 5 - < 18 or > 33 mg/kg was unqualified iodized salt. Results:A total of 1 647 children aged 8 to 10 years were selected, including 829 males and 818 females. The median urinary iodine of children was 203.4 μg/L. The median urinary iodine of children by district and county ranged from 151.6 to 232.4 μg/L, and the difference was statistically significant ( H = 24.227, P < 0.001). A total of 700 urine samples were collected from pregnant women. The median urine iodine was 164.7 μg/L. The median urine iodine of pregnant women by district and county ranged from 131.3 to 193.0 μg/L, and the difference was statistically significant ( H = 48.516, P < 0.001). A total of 2 347 salt samples were collected, including 2 329 iodized salt samples, with iodized salt coverage rate of 99.23% (2 329/2 347). There were 2 254 qualified iodized salt samples, and the rate of qualified iodized salt was 96.04% (2 254/2 347). There was no correlation between total urinary iodine level and salt iodine content ( r = 0.129, P > 0.05). The thyroid gland of 1 439 children was examined, and 25 children of them had goiter, with an enlargement rate of 1.74% (25/1 439), lower than the national standard for elimination of iodine deficiency disorders (< 5%), and the difference between counties and districts was statistically significant (χ 2 = 31.692, P < 0.01). Conclusion:The iodine nutrition of 8 to 10 years old children and pregnant women in Fushun City, Liaoning Province in 2021 is basically at an appropriate level, the rate of qualified iodized salt is high, and the goiter rate of children conforms to the national elimination standards of iodine deficiency disorders.

Endometrial carcinoma is one of common malignant tumors in female reproductive system, but it is extremely rare in leptomeningeal metastasis. The clinical manifestations and signs of meningeal carcinomatosis are complex and not specific. It is difficult to get a precise diagnosis early, and it has high rate of misdiagnosis and missed diagnosis. Accurate diagnosis and treatment of a case of leptomeningeal metastasis from endometrial carcinoma by next-generation sequencing and cerebrospinal fluid cytology are reported. The patient is an elderly female with a history of endometrial cancer. The main manifestations were fever, headache and dizziness; cerebrospinal fluid cytology showed tumor cells; AKT1 gene and TP53 gene were detected in endometrial carcinoma tissue, plasma and cerebrospinal fluid by next-generation sequencing. After treatment with intrathecal chemotherapy, immunotherapy combined with anti angiogenesis, the patient′s condition still progressed gradually and died finally. The purpose of this case report is to raise clinical awareness of recognition and treatment in early meningeal metastasis of endometrial carcinoma.

Objective:To summarize the clinical and genetic characteristics in patients with transthyretin familial amyloid polyneuropathy (TTR-FAP).Methods:Fourteen unrelated TTR-FAP patients diagnosed at Xuanwu Hospital, Capital Medical University from September 2014 to February 2022 were retrospectively reviewed. The clinical manifestation, electrophysiology, cardiac function, biopsy and gene mutation were analyzed.Results:In the 14 patients (13 males, 1 female) diagnosed as TTR-FAP, the mean age at onset was 53.9 years (range: 33.0-71.0 years), with a mean course from symptom-onset to diagnosis of 4.1 years. The late-onset type occurred in 9 cases. Seven patients had a family history of TTR-FAP. Distal paresthesia of lower limbs was the commonest initial symptom (8 cases), with sensorimotor neuropathy and autonomic dysfunction seen initially in 4 and 2 cases, respectively. Cardiac involvement occurred in 6/8 of the patients. Nerve conduction studies indicated extremely axonal impairment with demyelinating features. Sural nerve biopsies showed moderate to severe axonal loss of myelinated fibers and the positive rate of Congo red staining was 8/14. Of 8 different TTR mutations detected, V50M was the most common (appearing in 5 cases). No obvious neuropathy progression was seen in the 5 patients who received tafamidis and 2 patients died of dyscrasia. Conclusions:TTR-FAP is more common in males, with sensorimotor axonal polyneuropathy, autonomic dysfunction and cardiac subclinical damage as the predominant symptoms. V50M is the commonest mutation. Tafamidis can delay the progression of disability.

Objective:To explore the risk factors associated with a three-month prognosis in patients with aortic acute cerebral infarction.Methods:A prospective study was conducted on 191 patients with aorthropathic acute cerebral infarction included in the Department of Neurology from June 2018 to December 2019, and the patients were divided into good prognosis group (153 cases) and poor prognosis group (38 cases) according to the MRS score of the patient's 3-month prognosis, and the general data, past medical history and blood pressure variability evaluation index (BPV) between the two groups were correlated analysis. The t-test was used to compare the measurement data with normal distribution, the χ 2 test was used to compare the counting data, and the Logistic regression analysis was used to analyze the risk factors. Results:The proportion of patients with diabetes history in the poor prognosis group (20.3% (31/153)), admission NIHSS score ((3.03±2.01) points), standard deviation (SD) ((12.06±4.46) mmHg) and coefficient of variation (CV) ((8.61±3.08)%) of systolic blood pressure at 24 h were lower than those in the good prognosis group (47.4% (18/38), (5.61±3.84) points, (14.75±3.46) mmHg, (10.41±2.18)%), the differences were statistically significant (the statistical values were χ 2=11.73, t=4.01, t=3.46, t=3.38; P values were 0.001, <0.001, 0.001, and 0.001, respectively). Because 24 h systolic blood pressure SD and 24 h systolic blood pressure CV had obvious collinearity, they were respectively included in the Logistic regression model. Taking diabetes history, NIHSS score and 24 h systolic blood pressure SD into the variables, the multivariate Logistic regression results of adverse prognostic risk factors in patients with acute cerebral infarction showed that the history of diabetes mellitus ( OR=3.649, 95% CI: 1.545-8.648, P=0.003), NIHSS score ( OR=1.472, 95% CI: 1.247-1.725, P<0.001) and 24 h systolic blood pressure SD ( OR=1.201, 95% CI: 1.085-1.336, P<0.001). Taking diabetes history, NIHSS score and 24 h systolic blood pressure CV into consideration, multivariate Logistic regression results of adverse prognostic risk factors in patients with acute cerebral infarction showed that the history of diabetes mellitus ( OR=4.695, 95% CI: 1.873-11.766, P=0.001), admission NIHSS score ( OR=1.922, 95% CI: 1.513-2.441, P<0.001) and 24 h systolic blood pressure CV ( OR=1.220, 95% CI: 1.045-1.425, P=0.012). All are independent risk factors influencing the prognosis of patients. Conclusion:The effect of 24 h systolic blood pressure SD and 24 h systolic blood pressure CV on patient prognosis was more valuable in clinical prediction, and the prognosis value of controlling blood glucose levels in patients with diabetes was higher in patients with cerebral infarction.