National biological standards for antibiotics are critical components of the antibiotic quality control system and serve as reference materials for measuring and calibrating the biological activity of antibiotics. This article systematically reviews the classification, definition of potency units, and current research status of commercially available national antibiotic biological standards in China. At present, these standards can be categorized based on chemical structure, number of components, and development methods. The definition of potency units has evolved from an early “arbitrarily assigned unit” to “being represented by the mass of the antibiotic salt” and, more recently, to the current mainstream approach of “being represented by the mass of the active ingredient”. This evolution reflects a shift in quality control philosophy from primarily biological analysis to a system dominated by chemical analysis supplemented by biological methods. Current research focuses on optimizing potency determination methods, studying the unification of content and potency, and implementing dual quality control of both the potency and the ratio/content of active components in multi-component antibiotics. For complex multi-component antibiotics, the microbiological assay based on biological activity remains irreplaceable in quality control. Future efforts should emphasize further method optimization, ensuring batch-to-batch consistency of standards, and advancing precision quality control as key research priorities for antibiotic biological standards.

Gentianopsis barbata (G. barbata) represents a significant plant species with considerable ornamental and medicinal value in China. This investigation sought to elucidate the primary constituents within the plant and investigate their pharmacological properties. Fifty triterpenoids (1-50), including nine previously undescribed compounds (1, 2, 7, 10, 20, 28, 29, 37, and 41) were isolated and characterized from the whole plants of G. barbata. Notably, compounds 1 and 2 exhibited the novel 3,4;9,10-diseco-24-homo-cycloartane triterpenoid skeleton. The isolated triterpenoids demonstrated substantial anti-inflammatory activity through inhibition of tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) cytokine secretion in LPS-induced RAW264.7 macrophages, and hepatoprotective effects by preventing tert-butyl hydroperoxide (t-BHP)-induced oxidative injury in HepG2 cells. These results demonstrate both the presence of diverse triterpenoids in G. barbata and their therapeutic potential for inflammatory and hepatic conditions, providing scientific evidence supporting the clinical application of this traditional Mongolian medicinal plant.
Triterpenes/isolation & purification* ; Mice ; Anti-Inflammatory Agents/isolation & purification* ; Animals ; Humans ; RAW 264.7 Cells ; Hep G2 Cells ; Interleukin-6/genetics* ; Tumor Necrosis Factor-alpha/genetics* ; Medicine, Mongolian Traditional ; Macrophages/immunology* ; Protective Agents/isolation & purification* ; Liver/drug effects* ; Gentianaceae/chemistry* ; Plant Extracts/chemistry* ; Molecular Structure

Objective:To screen differentially expressed genes (DEGs) associated with liver cancer by bioinformatics analysis method, and to investigate the mechanism of the minichromosome maintenance protein 2 ( MCM2) and replication factor C subunit 4 ( RFC4) genes in liver cancer in vitro. Methods:Gene expression profiling data of 80 and 36 hepatocellular carcinoma tissues and 307 and 13 cirrhotic tissues were obtained from the GSE25097 and GSE98620 datasets of the gene expression analysis (GEO) database, respectively. Gene expression profiling data of 374 liver cancer tissues and 50 normal liver tissues were downloaded from the cancer genome atlas (TCGA) database. Limma and DESeqs R software were used to process the gene expression profiling data, construct protein-protein interaction networks, and analysis the relevance of these genes to survival. Weighted gene co-expression network analysis was performed to screen out the core genes. Liver cancer SMMC7721 cells were transfected with MCM2 blank plasmid (MCM2 control group), MCM2 overexpression plasmid [MCM2 WT1 group, MCM2 WT2 (2-fold WT1) group], RFC4 blank plasmid (RFC4 control group), and RFC4 overexpression plasmid [RFC4 WT1 group, RFC4 WT2 (2-fold WT1) group], respectively. The expression of MCM2 and RFC4 in liver cancer cell lines and their transfection levels were detected by real-time fluorescence quantitative reverse transcription PCR and Western blotting. The effects of MCM2 and RFC4 on the proliferation of hepatocellular carcinoma cells were detected by MTT assay and cell cloning assay, respectively. The effects of MCM2 and RFC4 on the migration of liver cancer cells were determined by the scratch assay. The effects of MCM2 and RFC4 on liver cancer cell invasion were detected by Transwell assay.Results:By bioinformatic analysis, 9 HCC DEGs were selected, including ubiquitin conjugating enzyme E2 T ( UBE2T), aurora kinase A ( AURKA), targeting protein for Xklp2 ( TPX2), MCM2, RFC4, ribonucleoside-diphosphate reductase subunit M2 ( RRM2), serine peptidase inhibitory factor Kazal type 1 ( SPINK1), collagen type XV alpha 1 chain ( COL15A1) and C-C motif chemokine 25 ( CCL25). Among the six genes associated with clinical stages, the MCM2 and RFC4 genes were found to be strongly associated with prognosis in liver cancer. The relative protein expression of MCM2 and RFC4 in HepG2 cells (1.83±0.07, 1.44±0.09) and SMMC7721 cells (1.74±0.05, 1.43±0.08) was higher than that in MIHA cells (1.00±0.02, 1.00±0.03), and all the differences were statistically significant (all P<0.05). The relative gene expression of MCM2 and RFC4 in HepG2 cells (14.30±0.12, 5.10±0.18) and SMMC7721 cells (10.60±0.11, 7.60±0.07) was higher than that in MIHA cells (1.00±0.05, 1.00±0.03), and all the differences were statistically significant (all P<0.05). Compared with the MCM2 control group, the absorbance values [(0.28±0.01 and 0.21±0.01) vs 0.18±0.03], the number of clonal cells [(717±12 and 782±29) cells vs (389±17) cells], the percentage migration [(0.43±0.02 and 0.68±0.01) vs 0.15±0.06], and the number of cellular invasions [(933±21 and 821±11) cells vs (409±16) cells] were higher in the MCM2 WT1 and MCM2 WT2 groups, and the differences were all statistically significant (all P<0.05). Compared with the RFC4 control group, the absorbance values [(0.30±0.02 and 0.21±0.01) vs 0.17±0.02], the number of cloned cells [(571±11 and 728±9) cells vs (373±23) cells], the percentage migration [(0.75±0.11 and 0.67±0.04) vs 0.34±0.07], and the number of cell invasion [(835±26 and 818±18) cells vs (629±12) cells] were higher in the RFC4 WT1 and the RFC4 WT2 groups, and the differences were statistically significant (all P<0.05). Conclusions:MCM2 and R FC4 genes play a role in promoting tumorigenesis and growth in hepatocellular carcinoma.

Objective To investigate the correlation between the clinical characteristics of allergic rhinitis(AR)in adults located in Shenzhen area and the traditional Chinese medicine(TCM)constitutions.Methods A cross-sectional survey of adult AR patients in Shenzhen was conducted.From June 2022 to December 2023,adult AR patients admitted to the Department of Otolaryngology outpatient clinic of Bao'an Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine(Shenzhen Bao'an District Hospital of Traditional Chinese Medicine)were selected as the study subjects.The clinical baseline data,Total Nasal Symptoms Score(TNSS),and Total Non-Nasal Symptoms Score(TNNSS)of the patients were collected for the analysis of clinical characteristics,and TCM constitutions were differentiated based on the information collected by TCM constitutions questionnaire.After that,the correlation between the biased TCM constitutions and clinical characteristics were explored by using analysis of variance,non-parametric test and Logistic regression analysis.Results(1)A total of 215 cases of adult AR patients from Shenzhen were included.Most of the patients were male(60.93％),and the patients were usually aged 18-29 years old(accounting for 48.84％).AR in adults often arose in the spring(33.49％)and fall(30.70％).(2)Lung qi deficiency-cold syndrome was the predominated TCM syndrome type of AR in adults,accounting for 40.93％,and then came kidney yang deficiency syndrome(26.98％),spleen qi deficiency syndrome(20.00％),and heat accumulation in lung meridian syndrome(12.09％).Lung qi deficiency-cold syndrome and heat accumulation in lung meridian syndrome were more common in young males,and kidney yang deficiency syndrome was frequently seen in middle-aged and elderly males.(3)The leading three TCM constitution types of AR in adults were qi deficiency constitution(30.23％),yang deficiency constitution(24.65％),and inherited special constitution(15.81％).In adult AR patients with lung qi deficiency-cold syndrome,the commonly-seen TCM constitution types were qi deficiency constitution,inherited special constitution,and balanced constitution.In adult AR patients with spleen qi deficiency syndrome,the commonly-seen TCM constitution types were inherited special constitution,phlegm-damp constitution,and yang deficiency constitution.In adult AR patients with kidney yang deficiency syndrome,the commonly-seen TCM constitution types were yang deficiency constitution,qi stagnation constitution,and inherited special constitution.In adult AR patients with heat accumulation in lung meridian syndrome,the commonly-seen TCM constitution types were damp-heat constitution,yin deficiency constitution,and blood-stasis constitution.The leading five TNSS scores were shown in adult AR patients with inherited special constitution,qi deficiency constitution,yang deficiency constitution,phlegm-damp constitution,and qi stagnation constitution,respectively.And the leading five TNNSS scores were shown in adult AR patients with yang deficiency constitution,inherited special constitution,qi stagnation constitution,yin deficiency constitution,and damp-heat constitution,respectively.(4)The results of statistical analysis showed that the differences in gender among the adult AR patients with various TCM constitution types were not statistically significant(P＞0.05),but the differences in age groups,TCM syndrome types,TNSS scores and TNNSS scores were statistically significant(P＜0.01 or P＜0.001).(5)The results of Logistic regression analysis showed that the TNSS scores and TNNSS scores were all positively correlated with qi deficiency constitution,yang deficiency constitution,and inherited special constitution,and spleen qi deficiency syndrome was negatively correlated with damp-heat constitution,the differences being all statistically significant(P＜0.01 or P＜0.001).Conclusion The onset of AR in adults from Shenzhen area is closely related to age,gender,season,and TCM constitutions.The adult AR patients usually have the biased constitutions,in particular qi deficiency constitution,yang deficiency constitution,and inherited special constitution.In adult AR patients,higher TNSS scores are correlated with inherited special constitution,higher TNNSS scores are correlated with yang deficiency constitution,and the primary TCM syndrome type of lung qi deficiency-cold syndrome is correlated with qi deficiency constitution.

Objective To verify the accuracy of a Non-Contact Sleep Monitoring Mattress(NCSMM)based on body movement during sleep in assessing sleep quality of patients before neurosurgery in order to provide a more portable and efficient assessment tool for clinical staff.Methods A single-arm trial was conducted on 114 inpatients admitted in our department selected with convenience sampling.Sleep quality data of 1 night were collected through 5 sleep quality assessment tools,including NCSMM,polysomnography(PSG),Patient-Reported Outcome Measurement Information System(PROMIS)Sleep Disturbance scale,Richards-Campbell Sleep Scale(RCSQ),and a wearable device(smart watch for body movements and sleep quality monitoring).The sleep efficiency(≤85%)obtained by PSG was used as the diagnostic standard for sleep disorders.The area under the receiver operating characteristic curve(AUC),sensitivity,specificity,positive predictive value,negative predictive value,and Youden index were calculated for the other 4 tools to evaluate and compare their diagnostic effectiveness.Results The AUC value for NCSMM,PROMIS,RCSQ and smart watch was 0.788(95%CI:0.687～0.888,P<0.001),0.664(95%CI:0.543～0.784,P=0.02),0.723(95%CI:0.600～0.846,P=0.001)and 0.750(95%CI:0.654～0.846,P<0.001),respectively.The diagnostic accuracy rate was 0.774,0.559,0.742 and 0.602,with corresponding Youden index value of 0.488,0.321,0.456,and 0.459.NCSMM demonstrated the best AUC value,sensitivity and Youden index when compared with the other 3 tools.Conclusion NCSMM shows high accuracy in assessing sleep quality in pre-neurosurgery inpatients,and it is a viable portable and efficient assessment tool in clinical practice.

Objective:To evaluate the effects of nasal endoscopy in curettage of large mandibular cyst.Methods:20 cases of large mandibular cyst admitted to Xianyang Hosptial of Yan'an University from January 2022 to December 2023 were included.The curet-tage of mandibular cyst was performed under general anesthesia through intraoral incision by nasal endoscopy-assisted illumination and enlargement of the lesion area during the operation.The application effects were evaluated from the aspects of surgical incision length,nerve injury and cyst recurrence.Results:During operation,the surgical filed of view was clear and the operation was suc-ceeded in all cases.There was no complication in and after the nasal endoscopy-assisted curettage,no cyst recurrence was observed during 1-year follow-up.Conclusion:Nasal endoscopy-assisted curettage of large mandibular cyst is effective and safe.

Objective:To investigate the correlation between peri-coronary fat attenuation index (FAI) and plaque formation in patients with myocardial bridge (MB) of the left anterior descending artery (LAD) using coronary computed tomography angiography (CCTA) and to develop an optimal predictive model to explore the potential application of FAI in the primary prevention of MB related atherosclerosis.Methods:In this retrospective study, prediction models associated with perivascular fat inflammation were developed and validated using both logistic regression and machine learning (ML) algorithm. A training dataset was collected from 253 patients who underwent ≥2 coronary computed tomography angiography (CCTA) with ≥3 months intervals from one tertiary hospital from January 2007 to April 2021 and had baseline CCTA showing no plaques in LAD MB. The median follow-up time was 3.2 years. According to the same criteria, a total of 75 LAD MB patients from four other hospitals were included to form an independent external validation dataset, with a median follow-up time of 1.8 years. Receiver operating characteristic (ROC) curve analysis with integrated discrimination improvement (IDI) and category net reclassification index (NRI) were used to compare the performance of the predictive models.Results:62 patients (24.5%) in the training dataset had proximal plaque formation in LAD MB, while 22 patients (29.3%) in the external validation dataset had plaque formation during the follow-up period. Baseline FAI within the longitudinal distance equal to 30 mm proximal to the MB entrance was an independent predictor ( OR=1.068, P=0.046). According to the model results, ROC curves were plotted. The AUC of Model 1 was 0.822, and the AUCs of Model 2 and 1 were 0.821 and 0.591 in the training dataset. After the DeLong test, the AUC of Model 1 was superior to that of Model 2 ( Z=2.839, P=0.005) and Model 1 ( Z=6.124, P<0.001). These findings were further validated in the external validation dataset, where ML-model 3 yielded the best predictive performance, outperforming the logistic regression-based Model 2 (categorical NRI=0.359, P=0.048; IDI=0.108, P=0.046). Conclusion:FAI measured within the 30 mm proximal to the entrance of MBs due to its prone to plaque development is an independent predictor for atherosclerotic plaque formation. The ML-prediction model based on a decision tree algorithm combines FAI, MB anatomical features, and patient risk factors, which is beneficial for patients undergoing routine CCTA examination to identify inflamed coronary arteries in advance and guide the clinical adoption of more targeted preventive treatment, including anti-inflammatory treatment.

Objective The biomechanical performance of Ilizarov fixator models with different configurations for humeral shaft defect was compared,so as to provide a biomechanical basis for selecting the appropriate circular external fixation structure for the clinical treatment of humeral shaft defects using Ilizarov technology.Methods Based on CT data of the humerus from a healthy volunteer,the external fixators with three configurations,namely,hybrid frame,semi-ring frame and 90° fan frame were established.The finite element method was used to simulate the displacement and stress distribution under different loading conditions,and the finite element results were validated by biomechanical tests.Results Finite element analysis results:in terms of displacement,under compression,tensile and torque conditions,the displacement of 90° fan model was smaller than that of hybrid and semi-ring models.In terms of stress,the 90° fan model had the smallest displacement under tensile condition.In compression and torque tests,the semi-annular model had the lowest stress.Biomechanical test results:the semi-ring model exhibited the smallest displacement under axial compression,but there was no significant difference between the three models(P＞0.05).Conclusions The semi-ring and 90° fan frames can achieve a similar stability as the traditional hybrid frame through the strategy of'reducing the ring and increasing the stem'.The unilateral structure of the 90° fan frame has the advantages of small size,light weight,and structural stability,as well as a small impact on the shoulder and elbow joints,which makes it more valuable in clinical applications.

Objective:To develop an ICU-acquired Swallowing Disorders Knowledge, Attitude and Practice Questionnaire for Nurses and to test its reliability and validity.Methods:The initial questionnaire was constructed through literature review, group discussion, Delphi expert consultation, and pilot-testing based on the theory of knowledge, attitude and practice. Convenience sampling was used to select 301 ICU nurses from Class Ⅲ Grade A hospitals in Honghe Hani and Yi Autonomous Prefecture, Beijing City, Yantai City, Wuhan City, and Xi'an City from January to February 2024 to examine the reliability and validity of the questionnaire.Results:The ICU-acquired Swallowing Disorders Knowledge, Attitude and Practice Questionnaire for Nurses consisted of three dimensions of knowledge, attitude, and practice with a total of 52 items. In the two rounds of consultation, the expert authority coefficients were all 0.871, and Kendall's harmony coefficient was 0.186 and 0.161, respectively ( P<0.01) . Exploratory factor analysis extracted three common factors with a cumulative variance contribution rate of 74.989%. The split-half reliability of the questionnaire was 0.835, and the Cronbach's α coefficient was 0.979, and the Cronbach's α coefficients for knowledge, attitude, and practice dimensions were 0.976, 0.989, and 0.972, respectively. The content validity index at the questionnaire level was 0.996, and the content validity index at the item level was 0.800 to 1.000. Conclusions:The ICU-acquired Swallowing Disorders Knowledge, Attitude and Practice Questionnaire for Nurses has good reliability and validity, and can be used as a tool to assess the knowledge, attitude and practice of nurses towards ICU acquired dysphagia.

Objective:To evaluate the effects of nasal endoscopy in curettage of large mandibular cyst.Methods:20 cases of large mandibular cyst admitted to Xianyang Hosptial of Yan'an University from January 2022 to December 2023 were included.The curet-tage of mandibular cyst was performed under general anesthesia through intraoral incision by nasal endoscopy-assisted illumination and enlargement of the lesion area during the operation.The application effects were evaluated from the aspects of surgical incision length,nerve injury and cyst recurrence.Results:During operation,the surgical filed of view was clear and the operation was suc-ceeded in all cases.There was no complication in and after the nasal endoscopy-assisted curettage,no cyst recurrence was observed during 1-year follow-up.Conclusion:Nasal endoscopy-assisted curettage of large mandibular cyst is effective and safe.