OBJECTIVE To establish the UPLC fingerprint and the method for multi-component content determination in Jingangteng capsules， and to evaluate its quality by combining chemical pattern recognition analysis. METHODS An UPLC method was established. Separation was performed on a Zorbax SB-C 18 Rapid Resolution HD column， with acetonitrile-0.1% formic acid as the mobile phase for gradient elution.Using the Similarity Evaluation System for Chromatographic Fingerprints of Traditional Chinese Medicines （2012 edition）， UPLC fi ngerprints were established for 10 batches of Jingangteng capsules， and similarity was evaluated. SPSS 22.0 and SIMCA 14.1 software were used to perform hierarchial-cluster analysis and orthogonal partial least squares discriminant analysis （OPLS-DA）， respectively. The same UPLC method was employed to determine the contents of chlorogenic acid， 3，5-dihydroxy-2-methylbenzoic acid-3- O -glucoside （M1）， caffeic acid， astilbin， oxyresveratrol， quercitrin and resveratrol in the 10 batches of samples. RESULTS A total of 17 common peaks were identified in UPLC fingerprints of the 10 batches of samples， of which 7 were identified as chlorogenic acid， M1， caffeic acid， astilbin， oxyresveratrol， quercitrin， and resveratrol. The similarities of 10 batches of samples ranged from 0.820 to 0.985. The results of hierarchial-cluster analysis showed that 10 batches of samples were grouped into four categories： S1-S4 formed one group， S5 and S6 formed another， S7， S8 and S10 formed a third， and S9 formed a fourth， consistent with the OPLS-DA results； the variable importance projection values for peaks 7， 10， 2， 16 （resveratrol）， 13 （oxyresveratrol）， 11， 6 （caffeic acid）， 5 （M1） and 15 （quercitrin） were ＞1. Quantitative analysis results showed that the contents of chlorogenic acid， M1， caffeic acid， astilbin， oxyresveratrol， quercitrin， and resveratrol were 1.650 8-4.213 7， 0.636 2-2.161 7， 0.031 0-0.086 5， 0.239 1-1.069 3， 0.211 9-1.104 0， 0.488 8-2.399 2， and 0.164 0-0.699 8 mg/g， respectively. CONCLUSIONS UPLC fingerprint and content determination methods established in this study are simple to operate， accurate， reliable and reproducible； when combined with chemical pattern recognition analysis， they can be used to evaluate the quality of Jingangteng capsules. Nine components， such as resveratrol， oxyresveratrol， caffeic acid， M1 and quercitrin， may serve as markers of quality variation.

Genetically modified pigs for welfare assurance is crucial for conducting xenotransplantation. However, traditional experimental animal ethics principles cannot address the social benefits issues brought about by xenotransplantation, and there is a lack of ethical justification for the assurance of experimental animal welfare. Degrazia and Bechtel proposed six principles for the welfare of experimental animals: the principle of no alternative methods, the principle of expected net benefits, the principle of adequate defense of harm, the principle of no harm without necessity, the principle of basic needs and the principle of harm limit. This paper conducts an ethical-level argumentation on the six principles for the welfare of genetically modified pigs in xenotransplantation, and points out that these six principles are of great significance in closely integrating the social benefits of xenotransplantation with the welfare of genetically modified pigs, emphasizing the moral status of genetically modified pigs, and providing standards for the ethical review of the welfare of genetically modified pigs.

OBJECTIVE To study the chemical constituents in the root bark of Schisandra sphenanthera and their cytotoxic activ-ities.METHODS The compounds were isolated and purified by silica,Sephadex LH-20 and semi preparative-HPLC and the chem-ical structures were identified by 1 H-NMR,13 C-NMR and MS data analysis.The cytotoxic activities of the compounds were deter-mined by MTT method.RESULTS Twenty lignans were isolated and deduced as:Matairesinol(1),2-Hydroxy-2-(3′,4′-di-hydroxyphenyl)methyl-3-(3″,4″-dimethoxyphenyl)methyl-gamma-butyrolactone(2),(+)-Nortrachelogenin(3),2-Hydroxy-2-(4′-O-β-D-glucopyranosyl-3′-hydroxyphenyl)methyl-3-(3″,4″-dimethoxyphenyl)methyl-γ-butyrolactone(4),Nortracheloside(5),Burselignan(6),(+)-Cycloolivil(7),5-Methoxy-(+)-isolariciresinol(8),(-)-Isolariciresinol 3α-O-β-D-glucopyranoside(9),(+)-9-O-β-D-Glucopyranosyl lyoniresinol(10),(-)-Secoisolariciresinol(11),Licarin A(12),Cedrusin(13),Mataires-inol 4′-O-β-D-glucopyranoside(14),Pregomisin(15),Meso-dihydroguaiaretic acid(16),7S,8R-Erythro-4,9,9′-trihydroxy-3,3′-dimethoxy-8-O-4′-neolignan-7-O-β-D-glucopyranoside(17),Gomisin M2(18),Gomisin M3(19),Pinoresinol(20).Com-pounds 1-3,12,15,16,18 and 19 showed cytotoxic activity against A549,HCT116 and SW620 cell lines with IC50 values ranging from 1.4 to 22.9 μmol·L-1.CONCLUSION Compounds 1-4,6-12,14,17-19 are isolated from the plant for the first time,com-pounds 1-3,12,15,16,18 and 19 exhibit cytotoxic activities.

Objective:To investigate the mediating effect of rehabilitation exercise self-efficacy in the relationship between psychological pain and quality of life among postoperative patients with osteoporotic fractures.Methods:A total of 203 patients with osteoporotic fractures who underwent surgical treatment in the Department of Orthopedics of the Affiliated Hospital of Jining Medical University from June 2023 to June 2024 were recruited using convenience sampling. Postoperatively, patients were assessed with the General Information Questionnaire, the Self-Efficacy Rehabilitation Outcome Scale (SER), the Psychological Pain Scale, and the World Health Organization on Quality of Life Brief Scale (WHOQOL-BREF). The mediating role of rehabilitation exercise self-efficacy was tested using the bootstrap method.Results:A total of 210 questionnaires were distributed, with 203 valid responses collected, yielding an effective response rate of 96.67%. The mean scores of rehabilitation exercise self-efficacy, psychological pain, and quality of life were (65.56±8.89), (26.68±5.57), and (85.90±5.59), respectively. Correlation analysis showed that rehabilitation exercise self-efficacy was negatively correlated with psychological pain ( r=-0.562, P<0.01), psychological pain was negatively correlated with quality of life ( r=-0.801, P<0.01), and rehabilitation exercise self-efficacy was positively correlated with quality of life ( r=0.741, P<0.01). Mediation analysis revealed that rehabilitation exercise self-efficacy partially mediated the relationship between psychological pain and quality of life, with an effect size of -0.231 ( P<0.01), accounting for 38.95% of the total effect. Conclusions:Psychological pain not only directly affects the quality of life in postoperative patients with osteoporotic fractures but also indirectly affects it through rehabilitation exercise self-efficacy. Clinical medical staff should adopt targeted interventions to alleviate psychological pain and enhance rehabilitation exercise self-efficacy, thereby improving patients' quality of life.

Objective:To explore the dual mediating effects of health belief and depression among health knowledge, social support, and health behaviors based on the capacity, opportunity, motivation-behavior (COM-B) model, and analyze the influencing factors of health behaviors in patients with ischemic stroke.Methods:This multi-center cluster sampling research recruited ischemic stroke patients ( n=1 696) who were hospitalized in neurology departments of five tertiary hospitals in Henan Province from October 2023 to October 2024. A cross-sectional investigation was conducted using the general information questionnaire, social support rating scale (SSRS), stroke prevention knowledge questionnaire(SPKQ), short form health belief model scale(SF-HBMS), health promoting lifestyle profile-Ⅱ (HPLP-Ⅱ), and patient health questionnaire-9(PHQ-9) to ultimately reveal the pathways and effect sizes among variables. Partial correlation analysis and multiple linear stepwise regression analysis were conducted to examine the relationships among social support, health knowledge, health belief, health behaviors, and depression in stroke patients by SPSS 26.0 software. Structural equation modeling was constructed using AMOS 28.0 software, and the mediating effect was tested using the Bootstrap method. Results:The scores of social support, health knowledge, health belief, and health behaviors among ischemic stroke patients were (37.46±9.94), (26.56±6.84), (75.62±12.62) and (130.79±26.27), respectively. The score of depression was 5.00 (2.00, 8.00). Health behaviors were positively correlated with health knowledge, social support, and health belief( r=0.333, 0.246, 0.267, all P<0.05), while negatively correlated with depression ( r=-0.146, P<0.05). Multiple linear stepwise regression analysis showed that health knowledge, social support, health belief, and depression were all influencing factors of health behaviors in ischemic stroke patients (all P<0.05). Health belief (effect value=0.068, 95% CI=0.048-0.093) and depression (effect value=0.009, 95% CI=0.003-0.018) both played partial mediating roles between health knowledge and health behaviors, accounting for 17.3%(0.077/0.446) of the total effect. Meanwhile, health belief (effect value=0.045, 95% CI=0.029-0.063) and depression (effect value=0.016, 95% CI=0.008-0.027) both played partial mediating roles between social support and health behaviors, accounting for 26.5%(0.061/0.230) of the total effect. Conclusion:Health knowledge and social support can not only directly influence health behaviors but also indirectly affect them through health belief and depression in patients with ischemic stroke.

Objective:To investigate the mediating effect of rehabilitation exercise self-efficacy in the relationship between psychological pain and quality of life among postoperative patients with osteoporotic fractures.Methods:A total of 203 patients with osteoporotic fractures who underwent surgical treatment in the Department of Orthopedics of the Affiliated Hospital of Jining Medical University from June 2023 to June 2024 were recruited using convenience sampling. Postoperatively, patients were assessed with the General Information Questionnaire, the Self-Efficacy Rehabilitation Outcome Scale (SER), the Psychological Pain Scale, and the World Health Organization on Quality of Life Brief Scale (WHOQOL-BREF). The mediating role of rehabilitation exercise self-efficacy was tested using the bootstrap method.Results:A total of 210 questionnaires were distributed, with 203 valid responses collected, yielding an effective response rate of 96.67%. The mean scores of rehabilitation exercise self-efficacy, psychological pain, and quality of life were (65.56±8.89), (26.68±5.57), and (85.90±5.59), respectively. Correlation analysis showed that rehabilitation exercise self-efficacy was negatively correlated with psychological pain ( r=-0.562, P<0.01), psychological pain was negatively correlated with quality of life ( r=-0.801, P<0.01), and rehabilitation exercise self-efficacy was positively correlated with quality of life ( r=0.741, P<0.01). Mediation analysis revealed that rehabilitation exercise self-efficacy partially mediated the relationship between psychological pain and quality of life, with an effect size of -0.231 ( P<0.01), accounting for 38.95% of the total effect. Conclusions:Psychological pain not only directly affects the quality of life in postoperative patients with osteoporotic fractures but also indirectly affects it through rehabilitation exercise self-efficacy. Clinical medical staff should adopt targeted interventions to alleviate psychological pain and enhance rehabilitation exercise self-efficacy, thereby improving patients' quality of life.

Objective:To explore the dual mediating effects of health belief and depression among health knowledge, social support, and health behaviors based on the capacity, opportunity, motivation-behavior (COM-B) model, and analyze the influencing factors of health behaviors in patients with ischemic stroke.Methods:This multi-center cluster sampling research recruited ischemic stroke patients ( n=1 696) who were hospitalized in neurology departments of five tertiary hospitals in Henan Province from October 2023 to October 2024. A cross-sectional investigation was conducted using the general information questionnaire, social support rating scale (SSRS), stroke prevention knowledge questionnaire(SPKQ), short form health belief model scale(SF-HBMS), health promoting lifestyle profile-Ⅱ (HPLP-Ⅱ), and patient health questionnaire-9(PHQ-9) to ultimately reveal the pathways and effect sizes among variables. Partial correlation analysis and multiple linear stepwise regression analysis were conducted to examine the relationships among social support, health knowledge, health belief, health behaviors, and depression in stroke patients by SPSS 26.0 software. Structural equation modeling was constructed using AMOS 28.0 software, and the mediating effect was tested using the Bootstrap method. Results:The scores of social support, health knowledge, health belief, and health behaviors among ischemic stroke patients were (37.46±9.94), (26.56±6.84), (75.62±12.62) and (130.79±26.27), respectively. The score of depression was 5.00 (2.00, 8.00). Health behaviors were positively correlated with health knowledge, social support, and health belief( r=0.333, 0.246, 0.267, all P<0.05), while negatively correlated with depression ( r=-0.146, P<0.05). Multiple linear stepwise regression analysis showed that health knowledge, social support, health belief, and depression were all influencing factors of health behaviors in ischemic stroke patients (all P<0.05). Health belief (effect value=0.068, 95% CI=0.048-0.093) and depression (effect value=0.009, 95% CI=0.003-0.018) both played partial mediating roles between health knowledge and health behaviors, accounting for 17.3%(0.077/0.446) of the total effect. Meanwhile, health belief (effect value=0.045, 95% CI=0.029-0.063) and depression (effect value=0.016, 95% CI=0.008-0.027) both played partial mediating roles between social support and health behaviors, accounting for 26.5%(0.061/0.230) of the total effect. Conclusion:Health knowledge and social support can not only directly influence health behaviors but also indirectly affect them through health belief and depression in patients with ischemic stroke.

Objective:To investigate the efficacy of radiotherapy in patients with advanced esophageal cancer receiving first-line chemoimmunotherapy.Methods:A retrospective analysis was conducted on the data of 137 patients with Stage Ⅳ esophageal squamous cell carcinoma (ESCC) treated at our hospital from January 2018 to May 2023. These patients were divided into two groups: a group treated with first-line chemoimmunotherapy combined with radiotherapy (chemoimmunotherapy + radiotherapy group, n = 43) and a group treated with only chemoimmunotherapy ( n = 94). Inverse probability of treatment weighting (IPTW) was applied to balance baseline characteristics between the groups. With overall survival (OS) and progression-free survival (PFS) as study endpoints, the survival data were analyzed using the Kaplan-Meier method, the log-rank test, and the Cox regression method. Results:Before calibration, the chemoimmunotherapy + radiotherapy group significantly outperformed the sole chemoimmunotherapy group in median PFS (13.6 months vs. 7.0 months; HR: 0.501, 95% CI: 0.309-0.811, P = 0.005). After calibration using the COX proportional-hazards model for age, gender, Eastern Cooperative Oncology Group (ECOG) performance status, smoking history, T/N/M stage, and tumor location, the chemoimmunotherapy + radiotherapy group still had significant advantages in PFS (14.7 months vs. 7.0 months; HR: 0.441, 95% CI: 0.261-0.745, P = 0.002). IPTW analysis further confirmed this trend (13.9 months vs. 7.0 months; HR: 0.492, 95% CI: 0.304-0.795, P < 0.001). Specifically, the median OS of the chemoimmunotherapy + radiotherapy group demonstrated significant improvement in all analyses: pre-calibration (29.5 months vs. 18.0 months; HR: 0.507, 95% CI: 0.297-0.867, P = 0.013), after calibration using the Cox model (27.5 months vs. 16.7 months; HR: 0.470, 95% CI: 0.266-0.830, P = 0.009), and after calibration using IPTW (29.5 months vs. 16.9 months; HR: 0.448, 95% CI: 0.262-0.764, P < 0.001). Conclusions:The combination of radiotherapy and first-line chemoimmunotherapy can significantly improve survival outcomes of patients with advanced ESCC, suggesting its potential as a standard treatment strategy.

Objective To explore the safety of Yttrium-90 resin microsphere selective internal radiation therapy (⁹⁰Y-SIRT) on malignant liver tumors. Methods A retrospective analysis was conducted on 64 patients with malignant liver tumors who underwent ⁹⁰Y-SIRT from February 2023 to November 2024 at Weifang People’s Hospital. The clinical characteristics of the patients and the occurrence of adverse reactions after treatment were analyzed to assess the safety of ⁹⁰Y-SIRT. Results Among the 64 patients, there were 52 males (81.25%) and 12 females (18.75%); the average age was (56.29±11.08) years. Seven patients (10.94%) had tumors with maximum diameter of less than 5 cm, 38 patients (59.38%) had tumors with maximum diameter of 5-10 cm, and 19 patients (29.68%) had tumors with maximum diameter of greater than 10 cm. There were 47 cases (73.44%) of solitary lesions and 17 cases (26.56%) of multiple lesions; 53 cases (82.81%) were primary liver cancers and 11 cases (17.19%) were metastatic liver cancers. Of the 64 patients, 63 successfully completed the Technetium-99m macroaggregated albumin (^99mTc-MAA) perfusion test and received the ⁹⁰Y-SIRT; one patient received ⁹⁰Y-SIRT after the second ^99mTc-MAA perfusion test due to a work error. The most common adverse reactions included grade 1 alanine aminotransferase (ALT) elevation in 26 cases (40.62%) and grade 2 in 2 cases (9.37%), grade 1 aspartate aminotransferase (AST) elevation in 27 cases (42.18%) and grade 2 in 7 cases (10.93%); grade 1 nausea in 17 cases (26.56%) and grade 2 in 6 cases (9.37%); grade 1 abdominal pain in 12 cases (18.75%), grade 2 in 5 cases (7.81%), and grade 3 in 1 case (1.56%); grade 1 vomiting in 11 cases (17.18%), grade 2 in 5 cases (7.81%), and grade 3 in 1 case (1.56%). Conclusion The adverse reactions of ⁹⁰Y-SIRT for treating malignant liver tumors are mild, indicating good safety.

Objective:To establish the reference intervals (RIs) of systemic immune inflammatory index (SII), platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR) and monocyte to lymphocyte ratio (MLR) in healthy pregnant women in Henan province, China.Methods:A retrospective analysis was conducted on the data of the healthy pregnant women without a history of adverse pregnancy events who participated in health check-ups from August 2016 to February 2019. A total of 4 016 healthy pregnant women were selected for establishing RIs. Data from healthy adult control group were derived from the healthy adult cohort in Henan established earlier by our team, and the Propensity Score Matching analysis was used and 3 595 healthy adult women and 3 595 healthy pregnant women to compare the indicators between the two groups. The RIs of the above indicators were established using the indirect method with a 95% confidence interval. The Tukey Rule was used to identify and remove outliers. The RIs were stratified and grouped based on the differences in each indicator during the pregnancy: SII: 3 929 cases, including 712 in the first trimester, 1 947 in the second trimester, and 1, 270 in the third trimester; PLR: 3 927 cases, no grouping; NLR: 3 925 cases, including 712 in the first trimester and 3 213 in the second and third trimesters; LMR: 3 925 cases, including 723 in the first trimester, 1 942 in the second trimester, and 1 260 in the third trimester; MLR: 3 904 cases, including 721 in the first trimester, 1 928 in the second trimester, and 1 255 in the third trimester. After the RIs were established, another 396 healthy pregnant women without a history of adverse pregnancy events who participated in health check-ups from February to April 2019 were selected for the validation of the RIs.Results:SII, NLR, LMR, MLR, and PLR differ significantly between healthy adult women and healthy pregnant women. There were significant differences in SII, LMR, and MLR among the three trimesters ( P<0.05). NLR in the first trimester was significantly lower than that in the second and third trimesters ( P<0.05), while there was no significant difference between the second and third trimester ( P=0.124). PLR only showed significant differences between the second and third trimester ( P<0.05), while no significant differences were found among the other groups. Based on the above results, the stratified RIs of each index in healthy pregnant population were established and verified. SII: first trimester (341-1 426)×10 9/L, second trimester (437-1 680)×10 9/L, third trimester (379-1 580)×10 9/L; PLR: 73-215; NLR: first trimester 1.78-5.60, second and third trimester 2.21-6.74; LMR: first trimester 2.20-6.61, second trimester 1.85-5.42, third trimester 1.63-4.82; MLR: first trimester 0.14-0.42, second trimester 0.17-0.49, third trimester 0.18-0.55. The rejection rate of 396 cases was less than 10%. Conclusions:The RIs of SII, NLR, LMR, MLR and PLR for healthy pregnant women in Hernan province of China were established and validated, and4 could be used in clinical practice.