This paper explored the significance and value of building a doctor-patient narrative community in clinical practice.It was clarified that clinical practice guided by evidence-based medicine thinking is essentially a"narrative"process:patients narrate their illness stories,and doctors,through a series of humanistic narrative practices,strengthen trust and empathy between patients and doctors on an emotional and ethical level,while bridging cognitive gaps,enhancing diagnostic and treatment outcomes,and ultimately fostering a harmonious and efficient doctor-patient narrative community relationship.The realization of a doctor-patient narrative community not only optimizes the treatment process but also enhances patients'self-efficacy and doctors'professional satisfaction,which is conducive to saving medical costs,optimizing public health governance,and highlighting a harmonious social atmosphere.

Traditional Chinese medicine of Polygonum cuspidatum has been utilized in China for thousands of years. Its primary active compound, polydatin, exhibits a variety of pharmacological effects including the regulation of glucose and lipid metabolism, suppression of cough and asthma, as well as antibacterial and anti-inflammatory properties. However, conventional methods for polydatin production are inadequate to satisfy the market demand. This study aims to explore the green and efficient preparation of polydatin. With resveratrol as the substrate, we efficiently synthesized polydatin by using the triple mutant IGW (Y14I/I62G/M315W) of the glycosyltransferase UGT_BS based on a strategy of two-enzyme coupled with one-pot and realized the recycling of uridine diphosphate-glucose (UDPG). The conditions of the two-enzyme reaction were optimized. Under the conditions of 35 ℃, pH 8.0, IGW: AtSuSy1 activity ratio of 3:4, dimethyl sulfoxide (DMSO) volume fraction of 5%, uridine diphosphate (UDP) concentration of 0.10 mmol/L, and sucrose concentration of 0.6 mol/L, the conversion of 2 mmol/L resveratrol reached 80.6% within 1 h, and the proportion of polydatin was over 90%. This study achieved the recycling of UDPG via a two-enzyme coupling system and shortened the reaction time. At the same time, the fed-batch strategy was adopted, and the yield of polydatin reached 6.28 g/L after 24 h in the one-pot coupling reaction, which provided a new strategy for green and efficient preparation of polydatin.
Stilbenes/chemistry* ; Glucosides/biosynthesis* ; Resveratrol ; Fallopia japonica/chemistry* ; Glycosyltransferases/genetics*

Flavonoids are key bioactive components for evaluating the pharmacological activities of Chimonanthus praecox. Exploring the potential flavonoids and pharmacological mechanisms of C. praecox lays a foundation for the rational development and efficient utilization of this plant. This study employed ultra-performance liquid chromatography-tandem mass spectrometry-based widely targeted metabolomics to comprehensively identify the flavonoids in C. praecox. Network pharmacology was employed to explore the bioactive flavonoids and their mechanisms of action. Molecular docking was adopted to validate the predicted results. Finally, the content of bioactive flavonoids in different varieties of C. praecox was measured. The widely targeted metabolomics analysis identified 387 flavonoids in C. praecox, and the flavonoids varied among different varieties. Network pharmacology predicted 96 chemical components including 19 bioactive compounds, 181 corresponding targets and 2 504 disease targets, among which 99 targets were shared by the active components and the disease. Thirty-three core targets were predicted, involving 229 gene ontology terms and 99 pathways (P≤0.05), which indicated that the flavonoids components of C. praecox exhibited pharmacological activities including antioxidant, anti-inflammatory, antimicrobial, and antiviral activities. Topological analysis screened out five core components (salvigenin, laricitrin, isorhamnetin, quercetin, and 6-hydroxyluteolin) and five core targets (SRC, PIK3R1, AKT1, ESR1, and AKR1C3). The predicted bioactive flavonoids from C. praecox stably bound to key targets, which indicated that these flavonoids possessed potential bioactivities in their interactions with the targets. The flavonoids in C. praecox exerted pharmacological activities in a multi-component, multi-target, and multi-pathway manner. The combined application of metabolomics and network pharmacology provides a theoretical basis for in-depth studies on the pharmacological effects and mechanisms of C. praecox.
Flavonoids/metabolism* ; Network Pharmacology ; Metabolomics/methods* ; Molecular Docking Simulation ; Calycanthaceae/chemistry* ; Tandem Mass Spectrometry ; Drugs, Chinese Herbal/chemistry*

Prunus mume is an ecologically and economically valuable plant with both medicinal and edible values. However, drought severely limits the promotion and cultivation of P. mume in the arid and semi-arid areas in northern China. In this study, we treated P. mume 'Meiren' with natural drought and then assessed photosynthetic and physiological indexes such as osmoregulatory substances, photosynthetic parameters, and antioxidant enzyme activities. Furthermore, we employed transcriptome sequencing to explore the internal regulatory mechanism of P. mume under drought stress. As the drought stress aggravated, the levels of chlorophyll a (Chla), chlorophyll b (Chlb), chlorophyll (a+b)[Chl(a+b)], and soluble protein (SP) in P. mume first elevated and then declined. The net photosynthetic rate (Pn), stomatal conductance (Gs), transpiration rate (Tr), maximum photochemical efficiency (Fv/Fm), effective photochemical quantum yield [Y(Ⅱ)], photochemical quenching (qP), and relative electron transport rate (ETR) all kept decreasing, while the levels of malondialdehyde, superoxide dismutase (SOD), peroxidase (POD), and osmoregulatory substances rose. Transcriptome sequencing revealed a total of 24 853 high-quality genes. Gene ontology (GO) enrichment showed that differentially expressed genes (DEGs) were the most under severe drought. Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis showed that the DEGs during the four drought periods were mainly involved in the biosynthesis of secondary metabolites, plant-pathogen interaction, plant hormone signal transduction, starch and sucrose metabolism, and mitogen-activated protein kinase signaling pathways. Furthermore, we identified 16 key genes associated with the drought tolerance of P. mume 'Meiren'. This study discovered that P. mume might up-regulate or down-regulate the expression of drought tolerance-related genes such as SUS, P5CS, LEA, SOD, POD, SOD1, TPPD, and TPPA via transcription factors like MYB, ERF, bHLH, NAC, and WRKY to promote the accumulation of osmoregulatory substances like sucrose and enhance the activities of antioxidant enzymes such as SOD and POD, thus reducing the harm of reactive oxygen species and protecting the structure and function of the membrane system under drought stress. The findings provide theoretical references for further exploration of candidate genes of P. mume in response to drought stress and breeding of drought-tolerant varieties.
Droughts ; Photosynthesis/physiology* ; Gene Expression Regulation, Plant ; Stress, Physiological/genetics* ; Prunus/genetics* ; Chlorophyll/metabolism* ; Plant Proteins/genetics*

We studied the genetic diversity and established the DNA molecular identify for Prunus mume with both ornamental and edible values, aiming to collect, identify, evaluate, and breed new varities of this plant and promote the upgrading of the P. mume industry chain in northern China. We employed 13 pairs of primers with good polymorphism, clear bands, and good repeatability to analyze the genetic diversity and establish the molecular identify of 68 germplasm accessions of P. mume with both ornamental and edible values from Xingtai, Hebei Province. We then employed the unweighted pair-group method with arithmetic means (UPGMA) to perform the cluster analysis based on genetic distance. After that, we analyzed the genetic structure of the 68 germplasm accessions based on a Bayesian model. The 13 pairs of SSR primers amplified a total of 124 alleles from 68 P. mume germplasm accessions, with the mean number of alleles (Na) of 9.538 5, the minor allele frequency (MAF) of 0.369 3, the mean number of effective alleles (Ne) of 4.483 5, and the mean Shannon genetic diversity index (I) of 1.712 4. The mean Nei's gene diversity index (H) of 0.763 7, the mean observed heterozygosity (Ho) of 0.719 5, the mean expected heterozygosity (He) of 0.769 3, the mean polymorphism information content (PIC) of 0.733 6, and the mean genetic similarity (GS) of 0.772 9 suggested that there were significant genetic differences and rich genetic diversity among the studied P. mume germplasm accessions. The cluster analysis revealed that the 68 accessions were classified into three groups, with the mean genetic distance of 0.622 6. The population structure analysis classified the germplasm accessions into two populations. According to the PIC of primers, we selected primers for combination and constructed the combination with the fewest primers required for germplasm differentiation of P. mume with both ornamental and edible values. This study provides a theoretical basis for the innovation and industrial upgrading of P. mume with both ornamental and edible values in gardening and the improvement of breeding efficiency.
Prunus/classification* ; Microsatellite Repeats/genetics* ; Genetic Variation ; China ; Phylogeny ; Polymorphism, Genetic ; DNA, Plant/genetics* ; Alleles

Objective To investigate the association between polymorphisms at rs1044122 of the metalloprotease12(ADAM12)gene and rs1553005 of the calcitionin related peptide alpha(CALCA)gene and disease susceptibility in patients with knee osteoarthritisc(KOA).Methods A total of 188 KOA patients admitted to the First Hospital of Qinhuangdao from January 2022 to January 2024 were selected as the study objects.Another 100 healthy subjects in the same hospital during the same period were selected as the control group.The polymorphisms of ADAM12 rs1044122 and CALCA rs1553005 were analyzed by PCR+gel imaging system.The frequency distribution of alleles and genotypes was compared between control group and KOA group.Logistic regression model was used to analyze the relationship between ADAM12 rs1044122 and CALCA rs1553005 and susceptibility to KOA under three genetic models(co-dominant,dominant and recessive).Results The genotypes of ADAM12 rs1044122 and CALCA rs1553005 in control group and KOA group were consistent with Hardy-Weinberg equilibrium law(all P>0.05),indicating population representation.Compared with the control group,the allele C frequency(41.49%vs 32.00%)of ADAM12 rs1044122 and the allele C(42.55%vs 30.00%)and genotype CC(18.08%vs 9.00%)frequencies of CALCA rs1553005 in KOA group were significantly increased,with statistical significance(χ2=4.980,8.715,8.631,all P<0.05).Logistic regression model showed that in the co-dominant model(AA vs CC)of ADAM12 rs1044122,the risk of KOA occurrence in CC genotype was significantly higher than that in AA genotype(OR=1.656,P<0.05).In the dominant model(AC+CC vs AA),the risk of developing KOA was higher in patients with C allele than in patients with A allele(OR=1.458,P<0.05).Under the codominant model(GG vs CC)of CALCA rs1553005,the risk of KOA in CC genotype was significantly higher than that in GG genotype(OR=1.643,P<0.05).Under the dominant model(GC+CC vs GG)and recessive model(GC+GG vs CC),the risk of developing KOA with C allele was significantly higher than that with G allele(OR=1.491,0.795,all P<0.05).Conclusion ADAM12 gene rs1044122 allele C and CALCA gene rs1553005 allele C and genotype CC increased the risk of KOA.

Objective To investigate the prognostic value of vertebral CT parameters for early fusion sink after transforaminal lumbar interbody fusion(TLIF).Methods The clinical and imaging data of 178 patients with lumbar degenerative diseases treated by TLIF were retrospectively studied.The patients were divided into the sedimentation group(n=57)and the non-sedimentation(n=57)group according to the patient's fusion device settlement 3 months after surgery.The results of general data and CT image parameters were compared between the two groups.Multivariate Logistic regression was used to analyze risk factors of early fusion subsidence,and the prediction efficiency was analyzed.Results The incidence of the early fusion sink was 32.0%.Compared with the non-sedimentation group,the sedimentation group had a higher proportion of patients aged≥60 years,osteoporosis,L5-S1 and intervertebral space height,larger fusion contact area and segmental lordosis angle and lower lumbar CT value(P＜0.05).Logistic regression analysis showed that age≥60 years old,surgical level L5-S1,high intervertebral height and large segmental lordosis angle were independent risk factors for the early fusion after TLIF,while high lumbar CT value was protective factor(P＜0.05).Subject working characteristic curves showed that the area under the curve(AUC)of lumbar CT value,intervertebral height,segmental lordosis angle combined with AUC were higher than those of patients aged≥60 years,surgical segment L5-S1,lumbar CT value,intervertebral height,segmental lordosis angle applied alone(P＜0.05).Conclusion Vertebral CT parameters of lumbar CT value,intervertebral height and segmental lordosis angle have higher predictive value for the early fusion after TLIF,and the combined prediction value of the three parameters is higher.

Objective To fabricate wall-less vascular tissue mimicking materials(TMM)with different tube diameters that match the hemodynamic parameters of human carotid arteries,and to investigate their hemodynamic characteristics.Methods TMM with different diameters and blood mimicking fluids containing scattering particles were fabricated.The variation laws of hemodynamic parameters under different flow velocities and TMM phantom diameters were verified.Key hemodynamic parameters including peak systolic velocity(PSV),end-diastolic velocity(EDV),and resistance index were measured using Doppler ultrasound,and their clinical application value in carotid artery diseases was evaluated.Results The fabricated samples exhibited a sound velocity of(1506.2±0.1)m/s and an attenuation of(0.76±0.01)dB/cm,and the vascular diameters were 4.0 and 6.0 mm,which corresponded to the normal clinical range of the external and internal carotid arteries,respectively.For the 4.0 mm TMM,both PSV and EDV were linearly correlated with flow velocity(R2=0.77,P<0.001;R2=0.74,P=0.001),and Pearson correlation analysis confirmed strong positive correlations(r=0.89,95%CI:0.82-0.93;r=0.94,95%CI:0.90-0.97,all P<0.001).For the 6.0 mm TMM,PSV and EDV also demonstrated significant linear correlations with flow velocity(R2=0.70,P=0.001;R2=0.61,P=0.005),with Pearson correlation analysis revealing strong positive correlations(r=0.86,95%CI:0.78-0.91;r=0.79,95%CI:0.68-0.87).All the data were consistent with hemodynamic parameters and followed the variation law of hemodynamic parameters.Conclusion The fabricated TMM and blood mimicking fluids meet the requirements for clinical ultrasound research on hemodynamics,and their material ratios can be used as a reference for the subsequent researches with diverse objectives.

Objective To investigate the association between polymorphisms at rs1044122 of the metalloprotease12(ADAM12)gene and rs1553005 of the calcitionin related peptide alpha(CALCA)gene and disease susceptibility in patients with knee osteoarthritisc(KOA).Methods A total of 188 KOA patients admitted to the First Hospital of Qinhuangdao from January 2022 to January 2024 were selected as the study objects.Another 100 healthy subjects in the same hospital during the same period were selected as the control group.The polymorphisms of ADAM12 rs1044122 and CALCA rs1553005 were analyzed by PCR+gel imaging system.The frequency distribution of alleles and genotypes was compared between control group and KOA group.Logistic regression model was used to analyze the relationship between ADAM12 rs1044122 and CALCA rs1553005 and susceptibility to KOA under three genetic models(co-dominant,dominant and recessive).Results The genotypes of ADAM12 rs1044122 and CALCA rs1553005 in control group and KOA group were consistent with Hardy-Weinberg equilibrium law(all P>0.05),indicating population representation.Compared with the control group,the allele C frequency(41.49%vs 32.00%)of ADAM12 rs1044122 and the allele C(42.55%vs 30.00%)and genotype CC(18.08%vs 9.00%)frequencies of CALCA rs1553005 in KOA group were significantly increased,with statistical significance(χ2=4.980,8.715,8.631,all P<0.05).Logistic regression model showed that in the co-dominant model(AA vs CC)of ADAM12 rs1044122,the risk of KOA occurrence in CC genotype was significantly higher than that in AA genotype(OR=1.656,P<0.05).In the dominant model(AC+CC vs AA),the risk of developing KOA was higher in patients with C allele than in patients with A allele(OR=1.458,P<0.05).Under the codominant model(GG vs CC)of CALCA rs1553005,the risk of KOA in CC genotype was significantly higher than that in GG genotype(OR=1.643,P<0.05).Under the dominant model(GC+CC vs GG)and recessive model(GC+GG vs CC),the risk of developing KOA with C allele was significantly higher than that with G allele(OR=1.491,0.795,all P<0.05).Conclusion ADAM12 gene rs1044122 allele C and CALCA gene rs1553005 allele C and genotype CC increased the risk of KOA.

Objective To investigate the prognostic value of vertebral CT parameters for early fusion sink after transforaminal lumbar interbody fusion(TLIF).Methods The clinical and imaging data of 178 patients with lumbar degenerative diseases treated by TLIF were retrospectively studied.The patients were divided into the sedimentation group(n=57)and the non-sedimentation(n=57)group according to the patient's fusion device settlement 3 months after surgery.The results of general data and CT image parameters were compared between the two groups.Multivariate Logistic regression was used to analyze risk factors of early fusion subsidence,and the prediction efficiency was analyzed.Results The incidence of the early fusion sink was 32.0%.Compared with the non-sedimentation group,the sedimentation group had a higher proportion of patients aged≥60 years,osteoporosis,L5-S1 and intervertebral space height,larger fusion contact area and segmental lordosis angle and lower lumbar CT value(P＜0.05).Logistic regression analysis showed that age≥60 years old,surgical level L5-S1,high intervertebral height and large segmental lordosis angle were independent risk factors for the early fusion after TLIF,while high lumbar CT value was protective factor(P＜0.05).Subject working characteristic curves showed that the area under the curve(AUC)of lumbar CT value,intervertebral height,segmental lordosis angle combined with AUC were higher than those of patients aged≥60 years,surgical segment L5-S1,lumbar CT value,intervertebral height,segmental lordosis angle applied alone(P＜0.05).Conclusion Vertebral CT parameters of lumbar CT value,intervertebral height and segmental lordosis angle have higher predictive value for the early fusion after TLIF,and the combined prediction value of the three parameters is higher.