To improve the quality evaluation system of Hibisci Mutabilis Folium, this study established high performance liquid chromatography(HPLC) fingerprints of Hibisci Mutabilis Folium and evaluated the quality differences of medicinal materials from different places of production by chemometrics. Furthermore, a content measurement method of differential components was established based on quantitative analysis of multi-components by single-marker(QAMS). The fingerprints of 17 batches of Hibisci Mutabilis Folium from different places of production were constructed, with a total of 19 common peaks marked and seven components confirmed. The similarity between the sample fingerprints and the reference fingerprints ranged from 0.890 to 0.974. By utilizing principal component analysis(PCA), hierarchical cluster analysis(HCA), and orthogonal partial least squares-discriminant analysis(OPLS-DA), the chemical patterns of fingerprints were identified. Five components that could be used to evaluate the quality differences of Hibisci Mutabilis Folium were screened, namely peak 6(quercetin 3-O-β-robinobioside), peak 7(rutin), peak 9(kaempferol-3-O-β-robinobioside), peak 10(kaempferol-3-O-rutinoside), and peak 14(tiliroside). The relative correction factors of isoquercitrin, kaempferol-3-O-β-robinobioside, kaempferol-3-O-rutinoside, kaempferol-3-O-β-D-glucoside, and tiliroside were measured with rutin as the internal reference. The QAMS method was established for the content measurement of six flavonoids, and the results showed there was no significant difference compared to the results obtained by an external standard method. In summary, the HPLC fingerprints and QAMS method established in the study, demonstrating stability and accuracy, can provide a reference for the overall quality evaluation of Hibisci Mutabilis Folium.
Chromatography, High Pressure Liquid/methods* ; Drugs, Chinese Herbal/chemistry* ; Quality Control ; Principal Component Analysis

OBJECTIVE: To explore clinical effects of bone setting manipulation combined with pry reduction and Kirschner needle internal fixation in treating SandersⅡ-Ⅲ calcaneal fracture. METHODS: Clinical data of 52 patients with types Sanders Ⅱand Ⅲ calcaneal fracture (foot) treated with bone-setting manipulation combined with pry reduction and Kirscher needle internal fixation from July 2017 to July 2019 were retrospectively analyzed, including 43 males and 9 females, aged from 31 to 72 years old with an average of (50.83±10.48) years old; 15 patients with Sanders typeⅡ and 37 patients with Sanders type Ⅲ. The changes of Bühler angle, Gissane angle, calcaneus width and calcaneus height before operation and 24 months after operation were compared, and Maryland foot function score was performed to evaluate clinical effects. RESULTS: All patients were followed up from 24 to 60 months with an average of (41.50±9.86)months. The fracture healed normally and the healing time was (11.00±0.95) weeks. Bühler angle, Gissane angle, calcaneal bone width and calcaneal bone height were increased from (16.37±8.36)°, (96.27±9.62)°, (46.82±4.67) mm, (38.41±3.58) mm before operation to (31.48±8.24)°, (111.62±8.69)°, (42.06±4.83) mm, (44.21±3.82) mm at 24 months after operation, and the difference were statistically significant (P<0.01). Postoperative Maryland score at 24 months was (93.04±8.83), 40 patients got excellent result, 7 good and 5 fair. CONCLUSION Orthopedic manipulation combined with percutaneous reduction and Kirschner wire internal fixation could significantly improve Bühler angle, Gissane angle, width, and height of Sanders typeⅡ and Ⅲ calcaneal fractures, and the curative effect is satisfactory.
Humans ; Male ; Female ; Calcaneus/surgery* ; Middle Aged ; Fracture Fixation, Internal/methods* ; Adult ; Aged ; Fractures, Bone/therapy* ; Retrospective Studies ; Bone Wires ; Manipulation, Orthopedic/methods*

Compounds isolated from Epimedium include the total flavonoids of Epimedium , icariin, and its metabolites (icaritin, icariside I, and icariside II), which have similar molecular structures. Modern pharmacological research and clinical practice have proved that Epimedium and its active components have a wide range of pharmacological effects, especially in improving sexual function, hormone regulation, anti-osteoporosis, immune function regulation, anti-oxidation, and anti-tumor activity. To date, we still need a comprehensive source of knowledge about the pharmacological effects of Epimedium and its bioactive compounds on the male reproductive system. However, their actions in other tissues have been reviewed in recent years. This review critically focuses on the Epimedium , its bioactive compounds, and the biochemical and molecular mechanisms that modulate vital pathways associated with the male reproductive system. Such intrinsic knowledge will significantly further studies on the Epimedium and its bioactive compounds that protect the male reproductive system and provide some guidances for clinical treatment of related male reproductive disorders.
Male ; Epimedium/chemistry* ; Humans ; Genitalia, Male/drug effects* ; Flavonoids/therapeutic use* ; Animals

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Objective To compare regional pulmonary ventilation and perfusion and ventilation/perfusion(V/Q)matching in different body positions using electrical impedance tomography(EIT).Methods Ten healthy experimental pigs were selected to collect their EIT lung ventilation and perfusion data in supine,prone,left lateral and right lateral positions.The EIT data underwent analysis and image reconstruction using MATLAB R2022b and EIDORS v3.9.The effective regions with ventilation and perfusion were determined and the V/Q matching regions were computed with the maximum pixel value 20％as the threshold.Comparisons were carried out over the V/Q matching indexes including V/Q match％,dead space％and shunt％and ventilation and perfusion distribution in regions of interest(ROIs)including ROI1,ROI2,ROI3 and ROI4 in different body positions.Results The differences in V/Q match％,dead space％and shunt％of the experimental animals in varied positions were not statistically significant(P＞0.05).The regional distribution of pulmonary ventilation and perfusion changed in different positions,and the regional distributions differed in ROIl,ROI2 and ROI3 for ventilation(P＜0.05)and in ROI1 and ROI2 for perfusion(P＜0.05).The ventilation and perfusion regions were distributed consistently with the gravity-dependent areas in supine and prone positions whereas conversely in the right and left lateral positions.Conclusion The V/Q matching indexes of one subject have high test consistency in different body positions;gravity-dependent areas varied with the changes of the body positions,which affected the distribution of pulmonary ventilation and perfusion regions;EIT can be used for measuring the changed pulmonary ventilation and perfusion due to different positions and determining the influences of position changes on pulmonary ventilation and perfusion and V/Q matching.[Chinese Medical Equipment Journal,2024,45(5):1-7]

AIM To explore the clinical effects of Danzhi Xiaoyao Powder combined with Hetiao Duren Anshen Acupuncture Method on patients with post-stroke depression.METHODS Ninety-eight patients were randomly assigned into control group(49 cases)for 4-week intervention of conventional treatment,and observation group(49 cases)for 4-week intervention of Danzhi Xiaoyao Powder,Hetiao Duren Anshen Acupuncture Method and conventional treatment.The changes in clinical effects,MoCA score,intestinal flora(Enterococcus,Lactobacillus,Escherichia coli,Bifidobacterium),immune function indices(IgM,IgG,IgA),depression status indices(HAMD score,SDS score)and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P＜0.05).After the treatment,the two groups displayed increased MoCA score,immune function indices(P＜0.05),decreased HAMD score,SDS score(P＜0.05),reduced Enterococcus,Escherichia coli(P＜0.05),and elevated Lactobacillus,Bifidobacterium(P＜0.05),especially for the observation group(P＜0.05).No significant difference in incidence of adverse reactions was found between the two groups(P＞0.05).CONCLUSION For the patients with post-stroke depression,Danzhi Xiaoyao Powder combined with Hetiao Duren Anshen Acupuncture Method can safely and effectively improve cognitive functions,humoral immunities,regulate intestinal flora,and alleviate depression symptoms.

Objective To investigate the improvement effect of 18kD translocator protein(TSPO)ligand YL-IPA08 on lipopolysaccharide(LPS)-induced depressive,anxiety-like behaviors and cognitive dysfunction in mice and the related anti-inflammatory mechanism.Methods(1)50 male C57BL/6J mice were randomly divided into control group,LPS model group,LPS+YL-IPA08(1.0 or 3.0 mg/kg)group and YL-IPA08(3.0 mg/kg)group,with 10 mice in each group.Mice in LPS model group were intraperitoneally injected with LPS(0.5 mg/kg)once on day 1 and day 8.Mice in LPS+YL-IPA08(1 or 3 mg/kg)and YL-IPA08(3.0 mg/kg)groups were intragastrically administered YL-IPA08(1.0 or 3.0 mg/kg)for 13 consecutive days,once a day.From the 9th to 12th day,the open field test,tail suspension test,forced swimming test,novel object recognition test and elevated-plus maze test were used to evaluate the depressive,anxiety-like behaviors and cognitive function of mice.Western blotting was used to detect the expression levels of postsynaptic density protein 95(PSD95)and brain-derived neurotrophic factor(BDNF)in the prefrontal cortex of mice.(2)BV2 mouse microglia cells were divided into control group(phosphate buffered saline incubation for 1 h),LPS model group(incubated with 1.0 mg/L LPS for 6 h),LPS+YL-IPA08(0.5 or 1.0 μmol/L)group(incubated with 0.5 or 1.0 μmol/L YL-IPA08 for 1 h and then incubated with 1 mg/L LPS for 6 h),and YL-IPA08 group(incubated with 1.0 μmol/L YL-IPA08 for 1 h).ELISA was used to detect the expression levels of inflammatory factors interleukin-1β(IL-1β),interferon-γ(IFN-γ),IL-4,IL-10 and transforming growth factor-β1(TGF-β1).Western blotting was used to detect the expression levels of the members of Smad protein family(Smad2,Smad3)mediating signal transduction of TGF-β.Results(1)The results of behavioral experiments showed that there was no significant difference in the total movement distance of mice in each group in the open field test(P>0.05).Compared with the control group,the number of entries and duration time in the central area of mice in LPS model group were significantly decreased(P<0.05);the immobility time in the tail suspension test and the forced swimming test was significantly prolonged(P<0.05);the recognition index in the novel object recognition test,the percentage of entries into the open arms and the percentage of duration time in the open arm in the elevated-plus maze test were significantly decreased(P<0.05),and the expression levels of PSD95 and BDNF in the prefrontal cortex were significantly decreased(P<0.05).Compared with LPS model group,above behavioral and expression changes in LPS+YL-IPA08(3.0 mg/kg)group were significantly reversed(P<0.05).(2)Compared with control group,the expression levels of pro-inflammatory factors IL-1β and IFN-γ in BV2 cells in LPS model group were significantly increased(P<0.05),and the expressions of anti-inflammatory factors IL-4,IL-10 and TGF-β1 were significantly decreased(P<0.05),and the expression levels of Smad2 and Smad3 were significantly decreased(P<0.05).Compared with LPS model group,the expression level of IFN-γ in BV2 cells in LPS+YL-IPA08(0.5 μmol/L)group was significantly decreased,and the expression levels of IL-4 and TGF-β1 were significantly increased(P<0.05);the above changes were significantly reversed in LPS+YL-IPA08(1.0 μmol/L)group(P<0.05).Conclusion YL-IPA08 can significantly attenuate LPS-induced depressive and anxiety-like behaviors in mice and alleviate the decline in cognitive dysfunction,which mechanism may be related to improving neuroinflammation and regulating the TGF-β/Smad pathway.

Background In mainland China, patients with neovascular age-related macular degeneration (nAMD) have approximately an 40% prevalence of polypoidal choroidal vasculopathy (PCV). This disease leads to recurrent retinal pigment epithelium detachment (PED), extensive subretinal or vitreous hemorrhages, and severe vision loss. China has introduced various treatment modalities in the past years and gained comprehensive experience in treating PCV.Methods A total of 14 retinal specialists nationwide with expertise in PCV were empaneled to prioritize six questions and address their corresponding outcomes, regarding opinions on inactive PCV, choices of anti-vascular endothelial growth factor (anti-VEGF) monotherapy, photodynamic therapy (PDT) monotherapy or combined therapy, patients with persistent subretinal fluid (SRF) or intraretinal fluid (IRF) after loading dose anti-VEGF, and patients with massive subretinal hemorrhage. An evidence synthesis team conducted systematic reviews, which informed the recommendations that address these questions. This guideline used the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach to assess the certainty of evidence and grade the strengths of recommendations. Results The panel proposed the following six conditional recommendations regarding treatment choices. (1) For patients with inactive PCV, we suggest observation over treatment. (2) For treatment-na?ve PCV patients, we suggest either anti-VEGF monotherapy or combined anti-VEGF and PDT rather than PDT monotherapy. (3) For patients with PCV who plan to initiate combined anti-VEGF and PDT treatment, we suggest later/rescue PDT over initiate PDT. (4) For PCV patients who plan to initiate anti-VEGF monotherapy, we suggest the treat and extend (T&E) regimen rather than the pro re nata (PRN) regimen following three monthly loading doses. (5) For patients with persistent SRF or IRF on optical coherence tomography (OCT) after three monthly anti-VEGF treatments, we suggest proceeding with anti-VEGF treatment rather than observation. (6) For PCV patients with massive subretinal hemorrhage (equal to or more than four optic disc areas) involving the central macula, we suggest surgery (vitrectomy in combination with tissue-plasminogen activator (tPA) intraocular injection and gas tamponade) rather than anti-VEGF monotherapy. Conclusions Six evidence-based recommendations support optimal care for PCV patients' management.