ObjectiveTo address the limitations of the current quality standard for Polygalae Radix（PR）， which relies on a single component for quality assessment and struggles to holistically control its intrinsic quality， by constructing a comprehensive quality evaluation system integrating "macro-characterization of chemical profile， synchronous quantification of multiple index components， and quantitative analysis of multi-components by single marker（QAMS） for key component groups". This study aims to facilitate the scientific revision of the quality standard for PR. MethodsHigh performance liquid chromatography（HPLC） characteristic chromatograms were established for 11 batches of PR medicinal materials（YZ）， 10 batches of PR decoction pieces（YP）， and 10 batches of licorice-processed PR decoction pieces（ZYZ）， followed by similarity evaluation and identification of common peaks. HPLC-QAMS was developed for xanthones（sibiricaxanthone B， polygalaxanthone Ⅺ， polygalaxanthone Ⅲ） in the characteristic chromatograms. Simultaneously， the external standard method（ESM） was used to determine the contents of the corresponding xanthones and 3，6'-disinapoyl sucrose in YZ， YP， and ZYZ， followed by multivariate statistical analysis and Spearman correlation analysis. ResultsThe similarity between the characteristic chromatograms of 31 batches of PR samples and the reference chromatogram was>0.9. A total of 13 common peaks were identified， and 10 of these peaks were characterized through reference standard comparison. The successfully constructed QAMS method showed that the relative correction factors（RCFs） of sibiricaxanthone B and polygalaxanthone Ⅺ to polygalaxanthone Ⅲ were 0.76 and 0.88， and their relative retention times（RRTs） were 0.85 and 0.97， respectively. The results calculated by the QAMS method showed no significant difference from those obtained by the ESM. According to the limit standard for polygalaxanthone Ⅲ in the 2020 edition of the Pharmacopoeia of the People's Republic of China（hereinafter referred to as the Chinese Pharmacopoeia）， the pass rate of 31 batches of samples was only 19.35%. Multivariate statistical analysis indicated certain compositional differences between different batches of YZ and YP， as well as between YP and ZYZ， with 3，6'-disinapoyl sucrose identified as the main differentiating component. Furthermore， correlation analysis revealed that the content of polygalaxanthone Ⅲ was positively correlated with the contents of sibiricaxanthone B and polygalaxanthone Ⅺ， but showed no association with the content of 3，6'-disinapoyl sucrose. ConclusionIt is recommended that the content limit for polygalaxanthone Ⅲ in YZ，YP and ZYZ be revised to not less than 0.07%， or the total content of polygalaxanthone Ⅲ， sibiricaxanthone B and polygalaxanthone Ⅺ be not less than 0.18%. The newly established triple quality control model of "holistic control via characteristic chromatograms， precise quantification of oligosaccharide esters， and efficient detection of xanthones by QAMS" provides a systematic and precise solution for quality evaluation of PR and similar Chinese herbal medicines.

Currently,the fracture detection in wrist X-ray image has high misdiagnosis rates and faces the challenge of inadequate medical resources.To assist doctors in fracture diagnosis,an improved approach based on YOLOv8m for fracture detection in wrist X-ray image is proposed:(1)a large separable kernel attention mechanism is introduced to extract crucial feature information while suppressing insignificant ones;(2)residual block is integrated into the attention mechanism to enhance its effectiveness and the model's generalization ability;(3)switchable atrous convolution is combined with the C2f module to expand the model's receptive field,enabling it to capture multi-scale feature information.Experimental results demonstrate that compared with the improved model based on the advanced YOLOv8l,the proposed approach achieves a 1.3%increase in mAP50.Notably,by adopting the more compact YOLOv8m model as the basic model,parameter count is reduced by 14.3%,and the floating-point operations per second is lowered by 42.7%.The proposed model can effectively aid radiologists in detecting fractures in wrist X-ray image.

Objective The kinetic parameters of Lin's squeezing-pressing adjustment manipulation were collected for the analysis of its mechanical characteristics,thus to establish a standardized operating procedure to guide clinical teaching of this technique.Methods Ten healthy male trainees(aged 20-30 years)from the Tuina Department of Guangdong Provincial of Chinese Medicine were selected as the subjects.A multi-point thin-film pressure testing system was used to collect mechanical parameters during the operation of Lin's squeezing-pressing adjustment manipulation.The mechanical characteristics were analyzed,and then a mathematical model of time-mechanics curve was constructed.Results(1)The kinetic parameters of Lin's squeezing-pressing adjustment manipulation were as follows:preload force averaged(279.45±19.36)N with a duration of(0.98±0.03)s,the valley value of preload force averaged(137.45±3.59)N,the maximum impact force was(495.56±7.33)N,the impact duration averaged(0.15±0.01)s,the impact velocity averaged(3 183.96±94.76)N/s,and the impulse was(57.16±1.82)N/s.(2)The fitting function of impact force showed large absolute values for both ascending and descending slopes,and the ascending slope was significantly greater than the descending slope,indicating that the Lin's manipulation stressed on rapid outburst of the strength and withdrawal of the strength.(3)One-way ANOVA revealed no statistically significant differences in the preload force and its duration and valley value,the maximum impact force,and impact time among different operators(P＞0.05).Conclusion The analysis of kinetic parameters demonstrates that skilled operators maintain relatively stable mechanical parameters when performing Lin's squeezing-pressing adjustment manipulation.This study provides a preliminary digital analysis of the mechanical characteristics of Lin's bone-setting manipulation in addressing"bone misalignment and tendon displacement",which supplies objective evaluation criteria for the technique.

Currently,the fracture detection in wrist X-ray image has high misdiagnosis rates and faces the challenge of inadequate medical resources.To assist doctors in fracture diagnosis,an improved approach based on YOLOv8m for fracture detection in wrist X-ray image is proposed:(1)a large separable kernel attention mechanism is introduced to extract crucial feature information while suppressing insignificant ones;(2)residual block is integrated into the attention mechanism to enhance its effectiveness and the model's generalization ability;(3)switchable atrous convolution is combined with the C2f module to expand the model's receptive field,enabling it to capture multi-scale feature information.Experimental results demonstrate that compared with the improved model based on the advanced YOLOv8l,the proposed approach achieves a 1.3%increase in mAP50.Notably,by adopting the more compact YOLOv8m model as the basic model,parameter count is reduced by 14.3%,and the floating-point operations per second is lowered by 42.7%.The proposed model can effectively aid radiologists in detecting fractures in wrist X-ray image.

The kidneys are one of the main excretory organs for drugs and when drugs are not excreted effectively, they can accumulate in the kidneys or in the interstitial tubules, leading to drug-induced kidney injury. The tubulointerstitium accounts for 80% of the volume of the kidney and is the primary site of response to various types of renal injury. This article focuses on drug-induced acute interstitial nephritis, highlighting its clinical symptoms, listing common induction drugs, analysing pathological features, and explaining its pathogenesis from the perspective of immune response, with the aim of providing a basic and clinical evidence for subsequent studies.

Objective:To explore the effect of insulin pump management led by diabetes specialist nurses in elderly diabetic patients.Methods:From January 2019 to December 2020, convenience sampling was used to select 149 patients with type 2 diabetes mellitus who used insulin pumps during hospitalization in the Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University. Among them, the patients from January to December 2019 were in the control group (71 cases) , and the patients from January to December 2020 were in the observation group (78 cases) . During the use of insulin pump, the two groups were treated with conventional insulin pump management and insulin pump management led by diabetes specialist nurses. The blood glucose fluctuation coefficient, the time to reaching blood glucose target, insulin pump-related negative events, and insulin pump-related knowledge and skills were compared between the two groups.Results:The blood glucose fluctuation coefficient of the observation group was lower than that of the control group, and the time to reaching blood glucose target was shorter than that of the control group, and the differences were statistically significant ( P<0.01) . The incidences of insulin pump-related negative events in the control group and the observation group were 57.75% (41/71) and 20.51% (16/78) , respectively, and the difference was statistically significant (χ 2=21.815, P<0.01) . After intervention, the insulin pump-related knowledge and skills in the observation group were better than those in the control group, and the difference was statistically significant ( P<0.01) . Conclusions:The insulin pump management led by diabetes specialist nurses is beneficial to patients' blood glucose control, can reduce the incidence of insulin pump-related negative events, and improve patients' insulin pump-related knowledge and skills.

Background The patients who have undergone successful surgery for retinal detachment (RD) cannot recover their vision quickly,and the reason is not very clearly now.Objective This study was to compare the ellipsoid zone integrity in macula and frequency and duration of subretinal fluid after scleral buckling and pars plana vitrectomy (PPV) in primary macula-off rhegmatogenous RD,and to discuss the sequent influence of subretinal fluid on postoperative visual acuity.Methods A retrospective analysis was carried out on 66 cases of rhegmatogenous RD in Peking University People's Hospital from January 2010 to January 2013.All the cases were divided into 2 groups:scleral buckling group and PPV group.The courses of disease,refractive status,best corrected visual acuity (BCVA) and complications were recorded.The duration of subretinal fluid and ellipsoid zone integrity in macula were observed and the occurrence rates of subretinal fluid were calculated 1 month after surgery.Results There were no statistic differences on age,gender,courses of disease,refractive status and LogMAR visual acuity (all at P＞0.05).The average duration of subretinal fluid was (96 ±60) days in scleral buckling group,and (21 ±6) days in PPV group,with a statistically significant difference between the two groups (t =7.966,P =0.000).The occurrence rate of subretinal fluid at 1 month after surgery was 78.6％ in the scleral buckling group and 12.5％ in the PPV group,with a statistically significant difference between the two groups (x2=26.891,P =0.000).The LogMAR visual acuity was significantly different between the patients with and without subretinal fluid at 1 month after scleral buckling surgery (t=3.185,P=0.003).The LogMAR visual acuity was not significantly different between the scleral buckling group and PPV group 6 months after scleral surgery (t =1.876,P =0.065).The LogMAR visual acuity was not significantly different between the patients with and without subretinal fluid at 6 month after scleral buckling surgery (t =1.755,P=0.087).After the subretinal fluid was reabsorbed,the LogMARs visual acuity were significantly different between the patients with intact ellipsoid zone and with disrupt ellipsoid zone in both groups (scleral buckling group:t=2.555,P=0.015;PPV group:t=4.005,P=0.001).Conclusions The disruption extent of the ellipsoid zone is related to the duration of RD,and the integrity affects the postoperative visual acuity distinctly.The subretinal fluid is removed more rapidly after PPV when compared with scleral buckling in macula-off rhegmatogenous RD.The subretinal fluid delays visual recovery postoperatively but the operation method does not influence final visual acuity seriously.

OBJECTIVETo determine the major factors affecting the conversion efficiency of naringin-HP-beta-CD that was enzymed to prepare naringenin were determined and select the process condition with high conversion efficiency, stable and suitable for industrial production.

METHODThe dropping method was used to prepare naringin-HP-beta-CD, which was hydrolyzed by snailase to obtain naringenin. With the bioconversion rate as the index, the effects of pH value, temperature, reaction time, dosage of enzyme and concentration of naringin-HP-beta-CD on conversion rate of naringenin were detected for the purpose of optimizing the preparation condition. the conversion efficiency of naringin-HP-beta-CD was verified by scanning calorimetry, and the Hydrolysis product was identified by H-NMR, and 13C-NMR.

RESULTThe optimum enzymolysis of naringin-HP-beta-CD with snailase was 98.4% under the conditions of 37 degrees C, a pH 5.0 acetic acid- sodium acetate buffer solution for 12 hours. The substrate concentration was 30 g x L(-1) and the weight ratio of enzyme and substrate was 3: 5. Under the optimum enzymolysis condition, the conversion rate of naringin-HP-beta-CD was higher than naringin that was not entrapped with HP-beta-CD, with 272.25 reaction product relative molecules. The structure of naringenin was confirmed by the analysis of 1H-NMR and 13C-NMR.

CONCLUSIONNaringin which is entrapped with HP-beta-CD to prepare naringenin can significantly improve the conversion efficiency by shortening the reaction time, increasing the concentration of the substrate and reducing the amount of enzyme. Therefore, the process is stable and it was suitable for industrialization.

2-Hydroxypropyl-beta-cyclodextrin ; Flavanones ; chemistry ; isolation & purification ; Hydrolysis ; Solubility ; beta-Cyclodextrins ; chemistry

To investigate whether changes of amino acid neurotransmitter releases in the rostral ventrolateral medulla (rVLM) were related to acupuncture and to the antihypertensive effect of melatonin (Mel) microinjected into the anterior hypothalamic area (AHA) of rats with stress-induced hypertension (SIH), as well as to compare and analyze the relationship between the both antihypertensive mechanisms of acupuncture and of Mel in the AHA. Methods: Animal model of SIHR was made by electric foot shocks combined with noises. Electroacupuncture (EA) was used and Zusanli acupoint of both side was selected. The technique of drug microinjection into the brain was used to observe the change of blood pressure (BP), and synchronously, brain microdialysis was performed for collecting dialysate samples, and then the concentration of amino acid neurotransmitters in the dialysate samples was determined by high performance liquid chromatography combined with fluorescent detection (HPLC-FD). Results: After the animal received stress treatment, the BP elevated, synchronously, the release of glutamate (Glu) in the rVLM increased, and when EA was performed, the elevated BP of the rats with SIH decreased,simultaneously, the release of Glu in the rVLM decreased also. After Mel was microinjected of into the AHA of the SIHR, the elevated BP attenuated, meanwhile, the release of Glu decreased,and those of γ-aminobutyric acid (GABA) and taurine (Tau) increased in the rVLM.Administration ofbicuculline, an antagonist of GABAA receptor, into the rVLM prior to microinjection of Mel into the AHA could partially block the depressor effect of Mel in the AHA. Conclusion: The decrease in the release of Glu in the rVLM contributes to the antihypertensive effect of both acupuncture and Mel in the AHA in the rats with SIH, and the increase in the release of GABA and Tau in the rVLM is also important to Mel in the AHA.

OBJECTIVETo investigate the effect of fuzheng quxie granule (FQG) on immune cells and cytokines in populations with respiratory viral infection.

METHODSFifty-nine patients were randomly divided into 3 groups, that is, 19 patients treated with conventional western medicine (WM) plus FQG in the treated group, 19 patients treated with conventional western medicine alone in the WM group, and 21 patients treated with FQG alone in the TCM group. The levels of T lymphocyte subsets, interleukine-2,4,6,10 (IL-2, IL-4, IL-6, IL-10), tumor necrosis factor-alpha (TNF-alpha), interferon-gamma (INF-gamma) and Th1/Th2 were determined before treatment, and at the end of 1st and 2nd week of treatment respectively.

RESULTSBefore treatment, levels of TNF-alpha, IL-2, IL-6, IL-10 and INF-gamma in all patients were significantly higher than normal range (P < 0.05). After being treated for 1 week, the levels of serum TNF-alpha, IL-6, and IL-10 were significantly decreased in all groups (P < 0.05), serum IL-2 and INF-gamma decreased to the normal level in the WM group, but in the treated and the FQG group by the end of the 2nd week, the two indexes still remained at the rather higher level (P < 0.05). The ratio of Th1 and Th2 in the treated group and the FQG group increased significantly by the end of 2nd week, reached the level higher than that in the WM group and that before treatment (P < 0.05). No significant difference in, T lymphocytes subsets (CD3+ , CD4+ , CD8+) and percentage of B and NK cells before and after treatment was found in all the 3 groups.

CONCLUSIONFQG can positively regulate the immune function of patients with respiratory tract viral infection in certain degree.

Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Interleukin-10 ; blood ; Interleukin-6 ; blood ; Killer Cells, Natural ; immunology ; Male ; Middle Aged ; Phytotherapy ; Respiratory Tract Infections ; drug therapy ; immunology ; virology ; T-Lymphocyte Subsets ; immunology ; Tumor Necrosis Factor-alpha ; metabolism ; Virus Diseases ; drug therapy ; immunology