OBJECTIVE To optimize the honey processing technology of Phellinus igniarius. METHODS The key factors of honey processing technology of P. igniarius （honey-water ratio， the mass ratio of honey-water to P. igniarius， the frying temperature and the frying time） were investigated by orthogonal test combined with analytic hierarchy process to determine the optimal technological parameters， using the internal quality （the contents of ergosterol， protocatechuic aldehyde and protocatechuic acid） and appearance traits as evaluation indexes. RESULTS The optimal process of honey-roasting P. igniarius was to take raw P. igniarius （1 cm3 square block）， add the appropriate amount of auxiliary materials （with 25 kg of refined honey and water for every 100 kg of P. igniarius）， mix well， moisten for 2 h until the auxiliary materials were completely absorbed； put it in a frying container， fry at the frying temperature of 130-140 ℃ for 5 min； take it out， put it in an oven at 50 ℃ for 2 h； take it out， and let it cool. The RSD of the results of three validation experiments was 0.68%. CONCLUSIONS The optimized honey processing technology of P. igniarius is stable and feasible.

OBJECTIVE To optimize the honey processing technology of Phellinus igniarius. METHODS The key factors of honey processing technology of P. igniarius （honey-water ratio， the mass ratio of honey-water to P. igniarius， the frying temperature and the frying time） were investigated by orthogonal test combined with analytic hierarchy process to determine the optimal technological parameters， using the internal quality （the contents of ergosterol， protocatechuic aldehyde and protocatechuic acid） and appearance traits as evaluation indexes. RESULTS The optimal process of honey-roasting P. igniarius was to take raw P. igniarius （1 cm3 square block）， add the appropriate amount of auxiliary materials （with 25 kg of refined honey and water for every 100 kg of P. igniarius）， mix well， moisten for 2 h until the auxiliary materials were completely absorbed； put it in a frying container， fry at the frying temperature of 130-140 ℃ for 5 min； take it out， put it in an oven at 50 ℃ for 2 h； take it out， and let it cool. The RSD of the results of three validation experiments was 0.68%. CONCLUSIONS The optimized honey processing technology of P. igniarius is stable and feasible.

Pulmonary arterial hypertension(PAH)is a complex pulmonary vascular disease characterized by pro-gressive elevation of mean pulmonary artery pressure resulted from the pathological feature of pulmonary vascular re-modeling.Without medical intervention,PAH can eventually lead to right heart failure and death of patients.Up to the present,there are few treatment options for PAH are still mainly function through pulmonary vasodilation.Although these treatments can alleviate symptoms,the prognosis remains poor.In recent years,breakthroughs have been made in understanding the pathogenesis of PAH,thus support the development of new treatment strategies tar-geting at dysregulation of signaling pathways in PAH.This review focuses on five critical pathways and the relevant drugs those entered phase Ⅱ clinical trials and discusses their therapeutic potential,so to provide a basis for future research on targeting therapies for PAH patients.

Objective:To design a replaceable corneal scaler and explore its effect on improving the positive detection rate of corneal bacteria and the cure rate of patients with infectious keratitis.Methods:Totally 100 patients with infectious keratitis treated in the Eye&Ent Hospital of Fudan University in Shanghai from June 2020 to October 2021 were conveniently selected as the application object, 50 patients from June 2020 to January 2021 were selected as the control group, and 50 patients from February 2021 to October 2021 were selected as the experimental group. The control group used the traditional corneal scalpel for corneal scraping, and the experimental group used the replaceable corneal scalpel for corneal scraping. The positive detection rate of bacteria, the cure rate of patients as of the date of data collection, the comfort status of patients and the operation difficulty score of medical staff were compared between the two groups.Results:The 28 cases (56%) were positive in the experimental group, and 30 cases (60%) were cured as of the date of data collection; 16 cases (32%) were positive in the control group and 18 cases (36%) were cured as of the date of data collection. The difference between the two groups was statistically significant ( χ2=-2.47, -2.20, all P<0.05). The score of comfort in the experimental group was (83.92 ± 6.40) and that in the control group was (54.04 ± 10.69). The difference between the two groups was statistically significant ( t=17.14, P<0.01). The operation difficulty score of medical staff in the experimental group was (1.46 ± 0.54) and that of medical staff in the control group was (3.24 ± 0.72). The difference between the two groups was statistically significant ( t=-13.50, P<0.01). Conclusions:The use of replaceable corneal scalpel can not only improve the positive detection rate of patients, improve the treatment effect of patients, improve the comfort and satisfaction of patients, but also improve the work efficiency of medical staff and reduce the operational risk of medical staff, so as to improve the real professional value of medical staff.

ObjectiveTo discuss the characteristics of psychological assistance hotline calls and operators' coping strategies of before and after the COVID-19 outbreak， in order to further improve the assistance ability of the psychological crisis hotline. MethodsA retrospective study was conducted on the demographics characteristics， call problems， coping strategies， and call time trends recorded by Changchun psychological assistance hotline information registration platform before the epidemic in Changchun City （January 20， 2019-April 20， 2019） and during the epidemic period （January 20， 2020-April 20， 2020）. ResultsThe differences between gender， age， marital status， location， and occupation type before and during the epidemic were statistically significant （χ²=11.205， 234.240， 152.083， 265.458， 353.385， P<0.01）. The number of different help calls had a statistically significant difference before and during the epidemic （χ²=185.088，P<0.01）. The difference in the number of operators’ different coping strategies before and during the epidemic was statistically significant （χ²=226.810， P<0.01）. Before the epidemic， the main peak of incoming calls was concentrated at 16∶00 to 17∶00， and the secondary peak was concentrated at 22∶00 to 23∶00. During the epidemic， the main peak of incoming calls was also concentrated at 16∶00 to 17∶00， while the secondary peak was concentrated at 10∶00 to 11∶00. ConclusionDuring the COVID-19 epidemic， the number of calls to the psychological assistance hotline was higher than that before the outbreak. The main peak time for calls was the same， and the secondary peak was adjusted from 22∶00 to 23∶00 to 10∶00 to 11∶00. During the epidemic， the number of calls from male， 30 to 39 years old， married， local and staff in Changchun was the most， psychological problems counseling and operator referral strategy were the most before and after the epidemic.

Objective To investigate the changes of left ventricular systolic and diastolic function before left ventricular morphologic changes in obstructive sleep apnea syndrome (OSAS) patients.Methods A total of 111 OSAS patients were divided into left ventricular hypertrophy (LVH) group (n=29) and non-LVH group (n=82).Meanwhile,50 healthy subjects were enrolled as normal control group.Routine echocardiography and two-dimensional speckle tracking imaging (2D-STI) were performed.The differences of conventional echocardiography and 2D-STI parameters were compared among the three groups.The correlations between echocardiography and clinical parameters were analyzed.Results Compared with those of the other 2 groups,left ventricular mass index (LVMI),diastolic thickness of interventricular septum (IVST),diastolic ventricular posterior wall thickness (PWT),left ventricular internal diastolic dimension (LVIDd),the ratio between early diastolic peak velocity of mitral valve and early diastolic velocity of mitral annular (E/e') and left atrial volume index (LAVI) increased (all P＜0.05),and mitral annular early diastolic velocity (e') at interventricular septum and lateral wall decreased in LVH group (all P＜0.05).The mitral annular systolic velocity (s') in LVH group was less than that in normal control group (P =0.013).Compared with those of the other 2 groups,left ventricular global longitudinal systolic strain (S) and early diastolic strain rate (SRE) decreased (all P＜0.05),and the ratio of early diastolic peak velocity of mitral valve to SRE (E/SRE) increased in LVH group (both P＜0.05).Compared with normal control group,systolic strain rate (SRS) decreased in LVH group (P=0.001).S,SRS,SRE in non-LVH group were less than those in normal control group (all P＜0.05),and E/SRE was higher than that in normal control group (P＜0.001).S,E/SRE were independently associated with apnea hypopnea index (both P＜0.05).LVMI was independently associated with mean arterial oxygen saturation (β =-0.299,t =-3.273,P =0.001).Conclusion OSAS can affect the structure and functions of left ventricular independently.The systolic and diastolic functions of left ventricular have been impaired before morphology changed.

Objective To compare the clinical and echocardiographic parameters in left heart failure patients with or without pulmonary edema by cardiopulmonary ultrasound.Methods All patients underwent transthoracic lung ultrasonography and echocardiography examination.The following echocardiographic parameters were determined:left ventricular end-diastolic and end-systolic diameters (LVEDD and LVESD),left ventricular end-diastolic and end-systolic volumes (LVEDV and LVESV),left ventricular ejection fraction (LVEF),left atrial volume index (LAVindex),systolic pulmonary artery pressure (SPAP) and the degree of mitral regurgitation,the peak Doppler velocities of early (E) and late (A) diastolic flow,early (e') diastolic velocity of the mitral annulus,and the average E/e'ratio was calculated.The NYHA functional classification and N-terminal pro B-type natriuretic peptide (NT-proBNP) were also recorded.Results A total of 113 heart failure patients,included 72 patients (63.7％) combined with pulmonary edema revealed by lung ultrasonography.Compared with patients without pulmonary edema,those with pulmonary edema were with higher plasma concentrations of NT-proBNP,NYHA functional class,left ventricular diastolic function classification,SPAP and E/e',larger LVEDD and the diameter of right ventricle,more severe mitral regurgitation,and lower LVEF(all P ＜0.05).By multivariate logistic regression analysis,E/e',SPAP and NT-proBNP were independent echocardiographic predictors of pulmonary edema in patients with heart failure.Conclusions Cardiopulmonary ultrasound can evaluate heart and pulmonary condition in patients with heart failure.Left ventricular diastolic function is an important determinant of pulmonary edema in patients with left heart failure.

Objective To evaluate the ability of high resolution pleuropulmonary ultrasonography and bedside chest X-ray in identifying different pathologic abnormalities in patients with dyspnea,using thoracic computed tomography (CT) as a gold standard.Methods Bedside pleuropulmonary ultrasonography was performed in 350 dyspneic patients in the emergency department and ICU,111 patients were enrolled in the study with pleuropulmonary ultrasonography,chest X-ray and chest CT examination performed within 24 hours.Pathologic entities were evaluated:pleural effusion,consolidation,atelectasis,pneumothorax,pulmonary interstitial fibrosis,and pulmonary edema.The sensitivity,specificity,negative and positive prediction value of pleuropulmonary ultrasonography and chest X-ray were compared with the corresponding CT scan results.Results Pleuropulmonary ultrasonography was highly concordant with chest X-ray.Overall ultrasonography exhibited higher sensitivity than chest X-ray and CT for pleural effusion.For atelectasis and pulmonary edema,the sensitivity of ultrasonography was up to 100%.In the diagnosis of pulmonary interstitial fibrosis,the sensitivity of pleuropulmonary ultrasonography was higher than that of chest X-ray,but the specificity was slightly lower.The sensitivity of pleuropulmonary ultrasonography was slightly higher than that of chest X-ray in pneumothorax,and the specificity was coincident with chest X-ray.Although the sensitivity of ultrasonography was slightly lower for consolidation,it was still higher than chest X-ray.The ability of chest X-ray for differentiating pleural effusion from atelectasis or consolidation was worse than that of ultrasonography.Conclusions Our study demonstrates a high concordance between ultrasonography with radiography.The diagnostic performance of bedside pleuropulmonary ultrasonography is better than that of chest X-ray.

Objective To assess the right atrial(RA) function using two-dimensional speckle-tracking echocardiography(2D-STE) and the value of predicting WHO functional class in patients with pulmonary hypertension(PH).Methods Fifty-four consecutive PH patients were studied and compared with a control group of 24 healthy volunteers.RA function was evaluated by 2D-STE,and the following parameters were recorded:an average longitudinal strain (LS) curve that included LSpos during RA filling and LSneg representing RA active contraction (their summation is LStot),the phasic RA volumes,total RA emptying fraction (TotEF),RA passive(PassEF) and active emptying fraction(ActEF).The associations between these indices and the results of invasive pulmonary hemodynamics,cardiac structure and function level were evaluated.Results LStot,TotEF,LSpos,PassEF were significantly lower in PH patients than in controls(all P<0.01).ActEF/TotEF were significantly higher in WHO functional class (WHO-FC) Ⅱ and WHO-FC Ⅲ patients than in controls(all P<0.05),while were lower in WHO-FCIV patients than in controls(P<0.001).Among PH patients,LStot was negatively correlated with greater RA size and RA pressure (all P<0.01).LStot was also associated with right ventricular (RV) functional and overload parameters.In receiver-operator characteristic analysis,RA LStot was of optimal accuracy for prediction of WHO-FC≥Ⅲ in PH patients (P=0.002).Conclusions PH is associated with impaired reservoir and conduit function,but active contract function of RA is enhanced in WHO-FC Ⅱ and WHO-FC Ⅲ patients,and reduced in WHO-FCIV patients.RA LStot confers an optimal predictive effect of poor WHO-FC in PH patients and indicating prognosis.

Objective To evaluate the application value of cardiopulmonary ultrasound(CPUS) in patients with interstitial lung diseases(ILD).Methods Ninety patients with clinically diagnosed interstitial lung diseases and 30 healthy subjects were included in this study.The conventional echocardiographic parameters and right ventricular free wall longitudinal strain (RVLS_FW) were measured in all patients and healthy subjects.The degree of pulmonary fibrosis or the disease severity of each ILD patient was scored using a semi-quantitative scoring method.Patients’ pulmonary function parameters and clinical outcome score (GAP score) were recorded.Fourteen patients belong to other types of ILD and 19 patients with incomplete clinical data were unable to perform GAP scoring,finally 57 patients' clinical and ultrasonographic parameters were measured.On the basis of the pulmonary arterial systolic pressure (PASP) obtained by Doppler echocardiography,90 patients were divided into two groups:ILD patients with pulmonary hypertension(ILDpH,PASP ≥36 mmHg,1 mmHg =0.133 kPa) and ILD patients without PH (ILDNpH,PASP＜ 36 mmHg).Comparsion between ILDpH,ILDNpH and healthy subjects were then evaluated.According to the GAP score,all cases were divided into three groups:low risk,moderate risk and high risk.Statistical analysis was performed to examine the relationship between CPUS parameters and clinical parameters.Results ①Compared with ILDNpH patients,ILDpH patients had significantly lower right ventricular function,wider basal right ventricular diameter (RVD),proximal right ventricular outflow diameter (DRvor1) and right pulmonary artery diameter (DRPA).Compared with healthy subjects,ILDNpH patients had mildly lower right ventricular function and wider left pulmonary artery diameter (DLPA) and right ventricular outflow tract dimensions at the distal or pulmonic valve (DRvoT2).②A good correlation was found between lung ultrasound (LUS) scores and pulmonary function parameters,especially diffusion capacity for carbon monoxide of the lung(DLco)(r =-0.68,P ＜0.001).③With the increased risk of patients,the right ventricular function was gradually decreased,DRVOT2,DRPA,DLPA were gradually widened,and the lung ultrasound score was gradually increased.A weak correlation was found between GAP scores with RVLS_FW,LUS scores,DRpA(r =0.44,0.34,0.31,P ＜0.05).Conclusions CPUS parameters are useful in the assessment of interstitial lung disease and could reflect the prognosis of ILD patients to some extent.Therefore,on the basis of GAP scores,addition of RVLS_FW and LUS score will be more helpful to evaluate the prognosis ofILD patients.