Objective:To compare the effect of self-radiopaque markers guiding physician-modified fenestration, chimney technique and hybrid Ⅳb technique on reconstruction of left subclavian artery (LSA) in endovascular treatment of aortic dissection (TEVAR).Methods:The clinical and follow-up data of 312 TEVAR patients treated with LSA blood supply reconstruction technology from Jan 2016 to Dec 2019 at Fuwai hospital were retrospectively analyzed.Results:There were 35 patients in the hybrid Ⅳb technique group, 93 in the chimney technique group, and 184 in the in vitro fenestration group. The follow-up period ranged from 12 to 24 months. No artificial blood vessel and stent occlusion occurred in all patients during follow-up, and the LSA blood flow was unobstructed. A total of 19 patients had endoleak by the last follow-up, and there was no statistical difference between the three groups. Eleven patients underwent reintervention surgery, all were from chimney technique group and in vitro fenestration group, with no statistical difference ( P>0.05). Severe complications occurred in 28 patients during hospitalization, and the incidence of complications was the highest in the hybrid Ⅳb technique group ( P<0.01). During follow-up, 4 patients died in the bypass group, 6 died in the external window group, and 8 died in the chimney group, with no significant difference ( P>0.05). Conclusions:The safety and efficacy of the left subclavian artery flow reconstruction by in vitro fenestration and chimney technique were similar. The occurrences of early complications were lower than that of the hybrid Ⅳb technique, but the reintervention rate of endoleak was higher.

Hepatosplenic candidiasis (HSC) is a rare type of candidiasis that can occur in patients with hematologic malignancies, hematopoietic stem cell transplantation. At present, there is still a lack of studies on HSC in patients with hematologic disorders. Based on The Chinese Guidelines for the Diagnosis and Treatment of Invasive Fungal Disease in Patients with Hematological Disorders and Cancers (the 6th revision), We retrospectively analyzed the clinical characteristics and prognosis of patients with HSC treated in Peking University Institute of Hematology from 2008 to 2022. Finally, eighteen patients were included, with 1 (5.6%) proven, 2 (11.1%) probable, and 15 (83.3%) possible HSC. Among them, 3 (16.7%) patients occurred after haploid hematopoietic stem cell transplantation and 15 (83.3%) patients occurred after chemotherapy. 6 (33.3%) patients had positive blood cultures, including 4 cases of Candida tropicalis and 2 cases of Candida albicans. At 4 weeks of antifungal therapy, 10 (58.8%) patients achieved partial response (PR), At 8 weeks, 1 (6.3%) patients achieved complete response and 10 (62.5%) patients achieved PR. At 6 months after diagnosis, 3 (16.7%) patients died of hematopoietic recurrence, and none of them died of HSC. As a rare fungal infection disease, HSC has a low positive rate of microbiological and histological examinations, a persistent treat cycle, and has difficulty in remission, reminding us of the need for vigilance in patients with hematopoietic disorders and persistent fever.

Objective:To provide a scientific basis for the classification of Phyllanthi Fructus product grades. Method:A total of 30 batches of Phyllanthi Fructus currently available in the market were collected for quantification based on such appearance indexes as diameter， thickness， grain weight， and crust colour （L^*， a^*， and b^* values）. The contents of gallic acid， corilagin， chebulagic acid， and ellagic acid were measured by high performance liquid chromatography （HPLC）， followed by descriptive statistical analysis （DSA）， analysis of variance （ANOVA）， and principal component analysis （PCA） to determine the importance of each main index and explore the correlations between the appearance indexes and internal components. The classification standard of Phyllanthi Fructus product grades was formulated， and its scientificity was verified in hepatocelular carcinoma HepG2 cells. Result:The correlation analysis revealed that the crust colour L^*， a^*， and b^* values were significantly negatively correlated with corilagin， chebulagic acid， and ellagic acid （|r|>0.5， P<0.01）， but irrelevant to gallic acid （|r|<0.1）. Considering the variable coefficient of each index， PCA results， and the requirement of gallic acid as quality indicator for Phyllanthi Fructus in Chinese Pharmacopoeia， the crust colour L^*， a^*， and b^* values and gallic acid content were determined to be the classification indexes. The K-means cluster analysis confirmed that products with crust colour L^*<44， a^*<7， and b^*<10 and gallic acid content >1.6% could be classified into the first class， and those failing to meet the above requirements into the second class. The cell experiment demonstrated that the half-maximal inhibitory concentration （IC₅₀） of the first-class product against hepatocelular carcinoma HepG2 cells was lower than that of the second-class product. A colourimetric card was developed based on crust colour L^*， a^*， and b^* values to provide a visual tool for on-site evaluation of Phyllanthi Fructus products. Conclusion:This study has initially established the classification standard of Phyllanthi Fructus product grades， which contributes to guiding price negotiation of Phyllanthi Fructus products based on quality grade and thus ensuring high quality and high price.

Objective:The differences of chemical compositions and pharmacological activities between the core and pulp of Phyllanthi Fructus were investigated by chemical analysis and in vitro test to explore the effect of the core on the quality of this medicinal material. Method:Literature， medicinal material standards and market research on the appearance of Phyllanthi Fructus were conducted based on existing databases. Ultra-high performance liquid chromatography-quadrupole-electrostatic field orbital trap high resolution mass spectrometry （UPLC-Q-Orbitrap HRMS） was used to identify the constituents of the core and pulp. The analysis was performed on Thermo Scientific Accucore C₁₈ column （2.1 mm×100 mm， 2.6 μm） with the mobile phase of 0.1% formic acid aqueous solution （A）-methanol （B） for gradient elution （0-25 min， 5%B； 25-30 min， 5%-95%B； 30-35 min， 95%-5%B）， the flow rate was 0.2 mL·min^-1， heating electrospray ionization （HESI） was adopted with positive and negative ion modes， and the scanning range was m/z 100-1 500. High performance liquid chromatography （HPLC） was used to determine the contents of gallic acid， corilagin， chebulagic acid and ellagic acid in the core and pulp of Phyllanthi Fructus. Analysis was performed on Welchrom C₁₈ column （4.6 mm×250 mm， 5 μm） with mobile phase of methanol （A）-0.05% phosphoric acid aqueous solution （B） for gradient elution （0-6 min， 5%A； 6-15 min， 5%-7%A； 15-20 min， 7%-15%A； 20-25 min， 15%-21%A； 25-31 min， 21%-22%A； 31-41 min， 22%A； 41-47 min， 22%-28%A； 47-51 min， 28%-32%A； 51-57 min， 32%-38%A； 57-70 min， 38%-45%A； 70-80 min， 45%-65%A； 80-85 min， 65%-5%A）， the detection wavelength was set at 270 nm. The antibacterial effects of the core and pulp of Phyllanthi Fructus on Escherichia coli and Staphylococcus aureus were investigated by filter paper method， and their antioxidant activities were compared by 1，1-diphenyl-2-picrylhydrazyl （DPPH） free radical scavenging assay. Result:A total of 47 compounds were identified in the core and pulp of Phyllanthi Fructus， mainly including tannins， flavonoids， phenolic acids， fatty acids， amino acids， organic acids， saccharides and glycosides， most of which were concentrated in the pulp， and the fatty acids in the core accounted for a higher proportion. The contents of gallic acid， corilagin， chebulagic acid， ellagic acid and other phenolic compounds in the pulp of 20 batches of Phyllanthi Fructus were much higher than those in the core. The results of antibacterial test showed that the core of Phyllanthi Fructus with different concentrations had no antimicrobial effect. The DPPH radical scavenging test showed that the antioxidant activity of the core ［half-inhibitory concentration （IC₅₀）=199.632 mg·L^-1］ was much less than that of the pulp （IC₅₀=12.688 mg·L^-1）. Conclusion:From the perspectives of polyphenol content， antibacterial and antioxidant activities， it is scientific to use Phyllanthi Fructus pulp in ancient and modern times， which may be to remove the secondary parts of Phyllanthi Fructus， so as to enhance the actual utilization rate and therapeutic effect of medicinal materials. In view of the large proportion of the core of Phyllanthi Fructus and its high content of fatty acids and other components， whether or not to use it remains to be further studied in clinical application.

Dendrobium huoshanense is a precious medicinal plant belonging to Dendrobium of Orchidaceae. It is a special medicinal material and extremely scarce in Huoshan county, Anhui province. At present, D. huoshanense has been greatly protected, which also makes it possible to industrialize relying on tissue culture and artificial cultivation technology. Three main planting methods were utilized for cultivating D. huoshanense including facility cultivation, under forest cultivation and simulative habitat cultivation. Firstly, the three cultivation modes and technical characteristics of D. huoshanense were compared and analyzed, and it was found that the ecological environment of D. huoshanense cultivated in the simulated environment was closer to that of wild D. huoshanense. Secondly, based on comparing the characters and quality of three cultivation modes, the results showed that the shape of D. huoshanense cultivated in simulated environment was more similar to that of "grasshopper thigh" recorded in Bencao Jing Jizhu, and its quality was better than that of facilities and under forest cultivation. The comprehensive benefit comparison of three modes showed that the simulated cultivation had high income, the lowest input-output ratio and significant economic benefit. The quality of cultivated D. huoshanense was further evaluated from four aspects of "excellent environment" "excellent shape" "high quality" "excellent effect", which summarized the comprehensive advantages of simulative habitat cultivation of D. huoshanense as follows: the original habitat and site environment of simulated wild D. huoshanense, the closer shape to the wild, the more content of main medicinal components, and higher economic benefit and better efficacy. The quality of D. huoshanense was improved by the use of simulative habitat cultivation, which has practical significance to guide its large-scale cultivation.
Dendrobium ; Ecosystem ; Forests ; Plants, Medicinal

Objective　We established a model by using microfluidic chip that is a horizontal side by side diffusion system through microporous separating three adjacent channels in a triple-culture using neurons,astrocytes,and bEnd.3.Methods　(1)In the in vitro microphysiological system of neurovascular unit,we identified the seed density,seed time,seed sequence and seed method.(2)We adopt the repeated measures data of ANOVA to see whether there is significant difference in the viability when the three cell types are tri-cultured and separately mono-cultured.Results　(1) In the novel in vitro NVU model,the seed density of the neurons,astrocytes and bEnd.3 is 5×10^6~10×10^6 /ml,3×10^5~8×10^5个/ml and 1×10^5~5×10^5/ml.The seed sequence is from neurons to astrocytes to bEnd.3.The seed time is that after the previous seeded cells enter the exponential phase,the next cells will be seeded.(2)We adopt the repeated measures data of ANOVA to see whether there is significant difference in the viability when the three cell types are tri-cultured and separately mono-cultured.Conclusion　In this study,neurons,astrocytes and bEnd.3 were tri-cultured by using microfluidic chip.In this tri-culture model,these three kinds of cells have high cell viability.

OBJECTIVE: To detect the expression of cartilage oligomeric matrix protein (COMP) in the synovial chondromatosis of the temporomandibular joint (TMJSC), and to discuss the possible interactions between COMP, transforming growth factor (TGF)-β3, TGF-β1 and bone morphogenetic protein-2 (BMP-2) in the development of this neoplastic disease. METHODS: Patients in Peking University School and Hospital of Stomatology from January 2011 to February 2020 were selected, who had complete medical records, TMJSC was verified histologically after operation. The expressions of COMP, TGF-β3, TGF-β1 and BMP-2 in the TMJSC of the temporomandibular joint were detected by immunohistochemistry and quantitative real-time PCR (RT-PCR) at the protein level and mRNA level respectively, compared with the normal synovial tissue of temporomandibular joint. The histological morphology, protein expression and distribution of TMJSC tissues were observed microscopically, and the positive staining proteins were counted and scored. SPSS 22.0 statistical software was used to analyze the expression differences between the related proteins in TMJSC tissue and the normal synovial tissue of temporomandibular joint and to compare their differences. P < 0.05 indicated that the difference was statistically significant. RESULTS: Immunohistochemical results showed that the positive expression of COMP in TMJSC tissues was mostly found in synovial tissues and chondrocytes adjacent to synovial tissues, and the difference was statistically significant, compared with the normal temporomandibular joint synovial tissues. The positive expression of COMP was significantly different between recurrent TMJSC and non-recurrent ones. The positive expressions of TGF-β3, TGF-β1 and BMP-2 were higher than the normal synovial tissue, and were also mostly found in the synovial cells and adjacent chondrocytes, which was further confirmed by Western blot. According to the RT-PCR results, the expressions of COMP, TGF-β3, TGF-β1 and BMP-2 in TMJSC were higher than those in the normal synovial tissue. CONCLUSION The expression of COMP in TMJSC of temporomandibular joint increased significantly, compared with the normal synovial tissue. There may be interactions between COMP and cytokines related to the proliferation and differentiation, like TGF-β3, TGF-β1 and BMP-2, which may play a potential role in the pathogenesis of TMJSC.
Cartilage Oligomeric Matrix Protein/genetics* ; Chondromatosis, Synovial ; Humans ; Synovial Membrane ; Temporomandibular Joint ; Transforming Growth Factor beta3

Objectives: To compare regional cerebral tissue oxygen saturation (rScO2) changes during cardiac surgery in children with ventricular septal defect (VSD) and tetralogy of Fallot (TOF). Methods: A total of 60 children aged 3~36 months were enrolled (28 in VSD group 32 in TOF group). rScO2was monitored by Fore-Sight near-infrared spectroscopy device. rScO2, pulse oxygen saturation (SpO2), systolic pressure, diastolic pressure, heart rate, stroke volume index, cardiac index, systemic vascular reststance index the maximal slope of systolic upstroke (dp/dt max) were obtained at following time points: after anesthesia induction (t0), pericardium opening (t1), 5 min after cardiopulmonary bypass (CPB) initiation (t2), 5 min before separation from CPB (t3), separation from CPB (t4), post-modified ultrafiltration (t5), end of surgery (t6). Results: (1) The lowest rScO2value was observed at separation from CPB (t4), and which was significantly lower than that at t0(P<0.05) for both groups; rScO2, stoke volume index, cardiac index, and dp/dt max at t5were significantly higher than at t4(all P<0.001) for both groups. (2) rScO2and SpO2were significantly higher at t5and t6than at t0(both P<0.05) in TOF group. rScO2at t0-t2was significantly lower in TOF group than in VSD group (both P<0.05). rScO2increased more significantly after modified ultrafiltration and rScO2was positively correlated with SpO2at t0and t1(r=0.35, P<0.05 and r=0.64,P<0.01) in TOF group. (3) In the total cohort, rScO2was positively correlated with age, weight at t0, t1, t3, t4, t5, t6(all P<0.01). After modified ultrafiltration, the increase in cardiac index was positively correlated with increase in rScO2(r=0.41, P<0.05), and the amount of cardiac index and rScO2increases were negatively correlated with age (r=-0.30;r=-0.34, both P<0.05). Conclusions: rScO2is closely related with age and weight. Cerebral oxygen delivery before biventricular surgical correction is lower in TOF group than in VSD group, and the cerebral oxygenation improves significantly after surgical repair. Modified ultrafiltration could significantly improve systemic hemodynamics and rScO2, and TOF children and younger children benefit more from modified ultrafiltration. Pre- and post-separation from CPB period is vulnerable to cerebral desaturation, it is therefore of importance to maintain the cerebral oxygen delivery-consumption balance at these periods for children with TOF and VSD undergoing surgical repair.

A sensitive method was proposed for determination of 13 kinds of sulfonylurea herbicides residues in aquatic products by solid phase extraction-ultra performance liquid chromatography coupled with electrospray ionization tandem mass spectrometry (SPE-UPLC-MS/MS). The edible part of carp, penaeus vannamei,crab,clam and sea cucumber were collected and homogenized. Analytes was extracted with ethyl acetate,and then cleaned up by MAX solid phase extraction column. Qualitation of the analytes was achieved with multiple reaction monitoring (MRM) and the external standard method was used for quantification. The 13 kinds of sulfonylurea herbicides showed good linearity in the concentration range of 5.0-100.0 μg/L respectively. The detection limits of the 13 analytes were 1.0 μg/kg, and the limit of quantification was 2.0 μg/kg. The average recoveries ranged from 75.4% to 118.3% with relative standard deviations from 2.1% to 14.5%. The 13 target analytes were not detected in grass carp,carp,sea cucumber,prawn,turbot of breeding and crabs from the market. The halosulfuron-methyl was detected in the edible tissues of crabs exposed to a 1.0 mg/L halosulfuron-methyl solution for 24,48 and 72 h,and the concentrations were 6.20, 12.1 and 16. 6 μg/kg respectively. The method can be stable and sensitive, and is applied to the determination of 13 kinds of sulfonylurea herbicides residues in aquatic products.

Objective To study the relationship between regional cerebral tissue oxygen saturation (rScO2) and hemodynamic parameters under different end-tidal carbon dioxide partial pressure (PetCO2) levels during anesthesia induction period in children undergoing ventricular septal defect(VSD) repair.Methods A total of 25 patients aged from 2 to 37 months (median 6 months) were enrolled,who received selective VSD repair at Beijing Anzhen Hospital from April to May 2017.After admission,anesthesia induction and intubation,invasive radial artery pressure were established routinely and hemodynamic device-MostCare was used,Fore-Sight was used to monitor rScO2 of the right frontal brain.By means of adjusting mechanical ventilation parameter,PetCO2 was maintained at 30 (T1),35 (T2),40 (T2),45 (T3) mmHg(1 mmHg =0.133 kPa) in sequence.Pulse oxygen saturation (SpO2),heart rate (HR),systolic pressure (SysP),difference between dicrotic pressure (DicP) and diastolic pressure (DiaP) (Pdic-a),stroke volume index (SVI),cardiac index (CI),systemic vascular resistance index (SVRI),and pulse pressure variation (PPV) were recorded at T1,T2,T3 and T4.Results (1) Comparison among groups:rScO2 at T4,T3,T2 and T1 were (80.5 ± 4.0) ％,(78.2 ± 4.6) ％,(74.4 ± 5.7) ％,(70.8 ± 6.5) ％,respectively,rScO2 at T2,T3 and T4 were higher than that at T1,and the differences were statistically significant (all P ＜ 0.05).SysP at T3 [(85 ± 9) mmHg] and T4 [(84 ± 10) mmHg] were lower than that at T1 [(92 ± 15) mmHg],and the differences were statistically significant (all P＜0.05).DicP at T2[(64 ± 12) mmHg],T3[(60 ± 10) mmHg],and T4 [(59 ±9) mmHg] were significantly lower than that at T1 [(68 ± 15) mmHg],and the differences were statistically significant (all P ＜ 0.05).DiaP at T2 [(44 ± 6) mmHg],T3[(41 ±6) mmHg],and T4 [(41 ±6) mmHg]were lower than that at T1 [(47 ±7) mmHg],and the differences were statistically significant(all P ＜ 0.01).SVRI at T4 [(1 382 ± 262) dyne · s cm-5 · m2] was significantly lower than those at T1 [(1 486 ± 241) dyne · s cm-5 · m2],T2 [(1 440 ± 279) dyne · s cm-5 · m2] and T3 [(1 418 ±266) dyne · s cm-5 · m2],and the differences were statistically significant (all P ＜ 0.05).PPV at T3 [(11 ± 4) ％] and T4 [(13 ± 5) ％] was significantly lower than that at T1 [(18 ± 12) ％],and the differences were statistically significant (all P ＜ 0.05).(2) Correlation analysis:in total population,PetCO2 was positively correlated with rScO2 (r =0.582,P ＜ 0.01).At T1,rScO2 was positively correlated with DiaP and DicP (r =0.600,0.658,all P ＜ 0.01),as well as SysP,CI,SVI,Pdic-a (r =0.460,0.424,0.522,0.534,all P ＜ 0.05),rScO2 was negatively correlated with HR and PPV (r =-0.450,-0.490,all P ＜ 0.05).At T2,rScO2 was positively correlated with DiaP and DicP (r =0.689,0.692,all P ＜ 0.01),as well as SysP,SVI (r =0.534,0.445,all P ＜ 0.05).At T3,rScO2 was positively correlated with SysP (r =0.495,P ＜ 0.05),and negatively correlated with PPV (r =-0.562,P ＜ 0.01).At T4,the rScO2 was not correlated with any hemodynamic parameters (P ＞ 0.05).Conclusions During anesthesia induction in ventricular septal defect children,rScO2 increases significantly with the increase in PetCO2.When PetCO2 is at 30 and 35 mmHg,rScO2 is mainly affected by hemodynamics.When PetCO2 is at 40 and 45 mmHg,rScO2 is mainly affected by PetCO2,but less affected by hemodynamics.