Objective:To establish a qualitative analysis of Rhodiola crenulata for determing six components inclu-ding gallic acid,salidroside,tyrosol,1,2,3,4,6-O-gallic glucose,rhodiosin,oxorlin-7-O-rhamnoside by HPLC,and to find out the feasibility of the method of linear calibration using two reference substances in qualitative analysis of chromatographic peaks.Methods:The real retention time of 6 components in Rhodiola crenulata on 19 chromatographic columns were determined.Gallic acid and rhodiosin were selected as the reference substances,and the method of linear calibration using these 2 substances was used to predict the retention time.Tyrosol was also chosen as the reference to predict the retention time with the relative retention time method(RRT method).Comparing the accuracy of these two methods.Results:Compared to the RRT method,the method of linear calibration with two reference substances was more accurate for predicting the retention time and more adapatable for many kinds of chromatographic columns.Conclusion:As a new alternative reference substance method,the method of linear calibration using two reference substances can assist chromatographic peak determination better and has broad application prospects.

Objective:To establish a qualitative analysis of Rhodiola crenulata for determing six components inclu-ding gallic acid,salidroside,tyrosol,1,2,3,4,6-O-gallic glucose,rhodiosin,oxorlin-7-O-rhamnoside by HPLC,and to find out the feasibility of the method of linear calibration using two reference substances in qualitative analysis of chromatographic peaks.Methods:The real retention time of 6 components in Rhodiola crenulata on 19 chromatographic columns were determined.Gallic acid and rhodiosin were selected as the reference substances,and the method of linear calibration using these 2 substances was used to predict the retention time.Tyrosol was also chosen as the reference to predict the retention time with the relative retention time method(RRT method).Comparing the accuracy of these two methods.Results:Compared to the RRT method,the method of linear calibration with two reference substances was more accurate for predicting the retention time and more adapatable for many kinds of chromatographic columns.Conclusion:As a new alternative reference substance method,the method of linear calibration using two reference substances can assist chromatographic peak determination better and has broad application prospects.

Sepsis is a life-threatening Organ Dysfunction disease caused by the dysregulated response of the body to infection.It is characterized by fever,chills,shortness of breath,altered consciousness,and even severe complications such as Multiple Organ Dysfunction Syndrome(MODS).The morbidity and mortality of this disease are high year after year,and there are problems such as large consumption of medical resources and poor prognosis,which seriously affect the quality of life and economic burden of patients.Therefore,it is important to explore new treatments with high efficiency,safety and low cost.The disease pathogenesis is complex,including inflammation imbalance is the main pathogenesis of sepsis.Mitogen-Activated Protein Kinases(MAPK)signaling pathway is a signaling pathway activated by environmental factors or inflammatory factors,which mediates proliferation,differentiation,inflammatory response and apoptosis,and plays a key role in the occurrence and development of sepsis.At present,antibiotics,fluid resuscitation and mechanical ventilation are the main methods for clinical treatment of sepsis.Although they can curb the progress of some diseases,some treatment effects are not good.A large amount of literature has confirmed that Chinese medicine intervention in sepsis has significant advantages,its through many channels,regulation and control of multiple targets,MAPK signaling pathways,inhibit inflammation,strengthening immune defense and effective in the treatment of sepsis,sepsis is current research hotspot.However,there is still a lack of systematic reviews on the regulation of MAPK signaling pathway by traditional Chinese medicine in the treatment of sepsis.Therefore,based on the retrieval database sepsis related literature at home and abroad in recent years,a systemic summary of MAPK signal pathway and sepsis relations and the role of traditional Chinese medicine in them,will be new drugs for the treatment of sepsis and development provides new theoretical support.

Vestibular schwannomas(VS)is a benign tumor originating from Schwann cells in the vestibular nerve sheath of the internal auditory canal,often causing symptoms such as hearing loss and tinnitus in patients.With the significant increase in early detection rate of tumors,treatment goals are shifting towards preserving and rebuilding neurological function,improving patients'quality of life,and individualized treatment strategies.For those with functional hearing,hearing preservation surgery(HPS)is preferred.For patients who failed to do HPS or have no functional hearing before surgery,auditory restoration can be performed simultaneously or later.In terms of restoration approaches,for individuals whose cochlear nerve can be preserved,cochlear implant(CI)may be a viable option.CI not only provides good auditory perception but also effectively suppresses tinnitus.When the cochlear nerve cannot be preserved,BoneBridge implantation are considered.Although BoneBridge implantation cannot completely restore normal auditory function,it significantly improves speech recognition and quality of life.For patients with bilateral acoustic neuromas(as seen in neurofibromatosis type 2),although the effect of artificial auditory brainstem implantation(ABI)on auditory reconstruction varies greatly,it can help most patients regain auditory perception and improve communication skills,which is of great significance.Further research is needed in the future to investigate the influencing factors of auditory preservation and reconstruction effects,in order to maximize the hearing recovery and quality of life improvement for each patient.

Sepsis is a life-threatening Organ Dysfunction disease caused by the dysregulated response of the body to infection.It is characterized by fever,chills,shortness of breath,altered consciousness,and even severe complications such as Multiple Organ Dysfunction Syndrome(MODS).The morbidity and mortality of this disease are high year after year,and there are problems such as large consumption of medical resources and poor prognosis,which seriously affect the quality of life and economic burden of patients.Therefore,it is important to explore new treatments with high efficiency,safety and low cost.The disease pathogenesis is complex,including inflammation imbalance is the main pathogenesis of sepsis.Mitogen-Activated Protein Kinases(MAPK)signaling pathway is a signaling pathway activated by environmental factors or inflammatory factors,which mediates proliferation,differentiation,inflammatory response and apoptosis,and plays a key role in the occurrence and development of sepsis.At present,antibiotics,fluid resuscitation and mechanical ventilation are the main methods for clinical treatment of sepsis.Although they can curb the progress of some diseases,some treatment effects are not good.A large amount of literature has confirmed that Chinese medicine intervention in sepsis has significant advantages,its through many channels,regulation and control of multiple targets,MAPK signaling pathways,inhibit inflammation,strengthening immune defense and effective in the treatment of sepsis,sepsis is current research hotspot.However,there is still a lack of systematic reviews on the regulation of MAPK signaling pathway by traditional Chinese medicine in the treatment of sepsis.Therefore,based on the retrieval database sepsis related literature at home and abroad in recent years,a systemic summary of MAPK signal pathway and sepsis relations and the role of traditional Chinese medicine in them,will be new drugs for the treatment of sepsis and development provides new theoretical support.

Objective:To analyze the clinical phenotype, sperm morphological characteristics and assisted reproductive therapy efficiency in patients with total globozoospermia.Methods:Four male patients with total globozoospermia were collected during November 2019 to May 2022 from Reproductive Medical and Genetic Center, the People's Hospital of Guangxi Zhuang Autonomous Region. Peripheral blood samples were collected for genetic detection and the whole exome sequencing to explore the pathogenic genes. Semen characteristics, sperm morphology and ultrastructure were analyzed. Four patients were treated with intracytoplasmic sperm injection (ICSI) combined with artificial oocyte activation (AOA). Conventional ICSI cycles ( n=9) were selected as control group, and the development dynamic parameters were monitored by Time-lapse. The fertilization and embryo development parameters, developmental dynamic parameters and clinical outcomes were analyzed between the two groups. Results:Four patients were complicated with low sperm motility and increased sperm DNA fragmentation. Sperm morphology analysis and acrosome fluorescence staining represented that all the spermatozoas were with a small round head lacked of acrosome. By the transmission electron microscope, it was observed that round-headed spermatozoas were lacked of acrosome completely, loose chromatin structure, vacuolation and other abnormal changes in the head, mitochondrial sheath in neck were reduced arranged in disorder, and the structure of "9+2" of the flagellar axial filament was incomplete. Of the 4 patients, 1 was homozygous deletion of DPY19L2 gene and 1 was homozygous frameshift mutation of DPY19L2 gene. There were no significance differences in fertilization rate, two pronuclei fertilization rate, day 3 high-quality embryo rate, day 6 blastocyst formation rate and day 6 high-quality blastocyst formation rate between total globozoospermia group and control group (all P>0.05). The developmental dynamic parameters as the time at which the second polar body is extruded, the time when both (or the last) PN disappear, two to six discrete cells in the total globozoospermia group were significantly earlier than those in control group, and the difference was statistically significant (all P<0.05). There was no significant difference in the embryo cleavage patterns between the two groups ( P>0.05). Among the 4 patients with total globozoospermia, 2 live births with signal healthy male baby were achieved by fresh embryo transfer, and 2 live births with one signal healthy male baby and one healthy female baby were achieved by frozen-thawed embryo transfer respectively. Conclusion:Abnormal morphology characteristics of spermatozoas from patients with total globozoospermia are obvious, patients with total globozoospermia could have favorable clinical outcomes following ICSI combined with AOA.

Objective:To analyze the clinical phenotype, sperm morphological characteristics and assisted reproductive therapy efficiency in patients with total globozoospermia.Methods:Four male patients with total globozoospermia were collected during November 2019 to May 2022 from Reproductive Medical and Genetic Center, the People's Hospital of Guangxi Zhuang Autonomous Region. Peripheral blood samples were collected for genetic detection and the whole exome sequencing to explore the pathogenic genes. Semen characteristics, sperm morphology and ultrastructure were analyzed. Four patients were treated with intracytoplasmic sperm injection (ICSI) combined with artificial oocyte activation (AOA). Conventional ICSI cycles ( n=9) were selected as control group, and the development dynamic parameters were monitored by Time-lapse. The fertilization and embryo development parameters, developmental dynamic parameters and clinical outcomes were analyzed between the two groups. Results:Four patients were complicated with low sperm motility and increased sperm DNA fragmentation. Sperm morphology analysis and acrosome fluorescence staining represented that all the spermatozoas were with a small round head lacked of acrosome. By the transmission electron microscope, it was observed that round-headed spermatozoas were lacked of acrosome completely, loose chromatin structure, vacuolation and other abnormal changes in the head, mitochondrial sheath in neck were reduced arranged in disorder, and the structure of "9+2" of the flagellar axial filament was incomplete. Of the 4 patients, 1 was homozygous deletion of DPY19L2 gene and 1 was homozygous frameshift mutation of DPY19L2 gene. There were no significance differences in fertilization rate, two pronuclei fertilization rate, day 3 high-quality embryo rate, day 6 blastocyst formation rate and day 6 high-quality blastocyst formation rate between total globozoospermia group and control group (all P>0.05). The developmental dynamic parameters as the time at which the second polar body is extruded, the time when both (or the last) PN disappear, two to six discrete cells in the total globozoospermia group were significantly earlier than those in control group, and the difference was statistically significant (all P<0.05). There was no significant difference in the embryo cleavage patterns between the two groups ( P>0.05). Among the 4 patients with total globozoospermia, 2 live births with signal healthy male baby were achieved by fresh embryo transfer, and 2 live births with one signal healthy male baby and one healthy female baby were achieved by frozen-thawed embryo transfer respectively. Conclusion:Abnormal morphology characteristics of spermatozoas from patients with total globozoospermia are obvious, patients with total globozoospermia could have favorable clinical outcomes following ICSI combined with AOA.

Sepsis is one of the common severe diseases caused by the dysregulated host response to infection， which seriously threatens the life and health of human beings all over the world. The incidence and mortality of the disease are extremely high， and it has always been an urgent problem to be solved in the field of acute and critical diseases. At present， anti-infection， fluid resuscitation， mechanical ventilation and other programs are most used in clinic to treat sepsis， but their poor prognosis and high cost and other issues remain to be resolved. Therefore， it is necessary to explore a new， efficient， safe and inexpensive drug and treatment model at this stage. The treatment of traditional Chinese medicine （TCM） is based on syndrome differentiation and holistic concept. It can effectively regulate the progression of sepsis， maintain the homeostasis of the body， and has fewer adverse reactions. It has achieved good clinical results. In recent years， a large number of studies have shown that TCM can reduce the inflammatory response by regulating the Toll-like receptor 4（TLR4） signaling pathway， thereby reducing the severity and mortality of sepsis patients. However， there is still a lack of systematic exposition of TCM regulating TLR4 signaling pathway in the treatment of sepsis. Therefore， this article summarizes the relationship between TLR4 signaling pathway and sepsis and the mechanism of TCM in the disease by searching and consulting relevant literature in recent years. It is found that some Chinese medicine monomers and active ingredients， Chinese medicine compounds and Chinese medicine preparations can effectively reduce systemic inflammatory response， repair organ damage and improve the prognosis of sepsis by inhibiting the activation of TLR4 signaling pathway. However， due to various limitations， some studies have directly focused on the differential expression and function of TLR4， ignoring the downstream molecular expression and phenotypic effects of TLR4. The alternative mechanism， relationship and specific molecular mechanism of the pathway are still unclear. There are problems such as unclear pharmacokinetics and unclear mechanism in the pro- and anti-inflammatory balance， which need to be further studied and explored in order to provide new ideas for the potential treatment and drug development for sepsis.

Vestibular schwannomas(VS)is a benign tumor originating from Schwann cells in the vestibular nerve sheath of the internal auditory canal,often causing symptoms such as hearing loss and tinnitus in patients.With the significant increase in early detection rate of tumors,treatment goals are shifting towards preserving and rebuilding neurological function,improving patients'quality of life,and individualized treatment strategies.For those with functional hearing,hearing preservation surgery(HPS)is preferred.For patients who failed to do HPS or have no functional hearing before surgery,auditory restoration can be performed simultaneously or later.In terms of restoration approaches,for individuals whose cochlear nerve can be preserved,cochlear implant(CI)may be a viable option.CI not only provides good auditory perception but also effectively suppresses tinnitus.When the cochlear nerve cannot be preserved,BoneBridge implantation are considered.Although BoneBridge implantation cannot completely restore normal auditory function,it significantly improves speech recognition and quality of life.For patients with bilateral acoustic neuromas(as seen in neurofibromatosis type 2),although the effect of artificial auditory brainstem implantation(ABI)on auditory reconstruction varies greatly,it can help most patients regain auditory perception and improve communication skills,which is of great significance.Further research is needed in the future to investigate the influencing factors of auditory preservation and reconstruction effects,in order to maximize the hearing recovery and quality of life improvement for each patient.

Objective:To summarize our experience in diagnosis and treatment of Budd-Chiari syndrome(BCS) accompanied with hepatic nodules.Methods:The clinical data of 33 patients with BCS accompanied with hepatic nodules who were treated at Henan Provincial People's Hospital from January 2012 to December 2018 were retrospectively analysed. A total of 33 patients were enrolled, including 17 males and 16 females, with an average age of 51 years. Analyze the treatment and prognosis of different types of nodules.Results:Of 33 patients, 27 were diagnosed to have hepatocellular carcinoma and 6 benign proliferative nodules. Treatment of patients with hepatocellular carcinoma included, transcatheter arterial chemoembolization ( n=1) and hepatectomy ( n=26). The survival time of these patients with hepatocellular carcinoma ranged from 10.0 to 78.0 months (mean 37.8 months). For the remaining 6 patients with benign nodules, the nodules were multiple and no malignant changes were observed on follow-up. Conclusion:For patients with BCS associated with benign nodules, no specific treatment was required. Hepatocellular carcinoma assocated with BCS had good prognosis. An aggressive surgical resectional approach is recommended to treat and to relieve the hepatic outflow obstruction.