Objective To optimize the wine steamed Radix Rehmanniae processing technology.Methods The single factor experiment method was used to investigate the wine steamed Rehmannia glutinosa.Ultra-performance liquid chromatography-triple quadrupole tandem mass spectrometry(UPLC-QqQ-MS/MS)was used to determine the content of active ingredients such as stachyose tetrahydrate,manninotriose,melibiose,fructose,echinacoside,rhmannioside C,rhmannioside D,verbascoside,verbascoside,melittoside,monomelittoside,D(+)-raffinose pentahydrate,8-epicarnolic acid,catalpol,dihydrocatalpol,ajugol and so on.Through analytic hierarchy process and criteria importance through inter-criteria correlation(AHP-CRITIC),the content of the above chemical components and the color and sweetness values of rehmannia decoction pieces were used as evaluation indexes,and the amount of wine,steaming time and stuffiness time of steamed Rehmannia were investigated by a single-factor test method.The Box-Behnken response surface method was used to carry out the experimental design,and the divine Rehmannia processing process optimized.Results The optimal processing technology of wine steamed Radix Rehmanniae was as followed:20.6 g of alcohol per 100 g of herbs,1.5 h of stuffiness,and 6.5 h of steaming time.Conclusion The process of wine steamed rehmannia determined in this experiment is feasible,which can provide a reference for the research of processed rehmannia and provide certain guiding significance for the processed variety in industrial production.

Cirrhotic portal hypertension (CPH) is a manifestation of decompensated liver cirrhosis, with ascites, portal collateral circulation formation, hypersplenism and splenomegaly as the typical clinical symptoms. In recent years, the incidence of CPH has been increasing year by year, and the treatment of CPH has gradually become a hot issue in medical research. In order to further explore the diagnosis and treatment scheme of CPH. We briefly describe the pathophysiological mechanism and diagnosis of CPH, and the current situation of CPH treatment and the new progress of internal and external treatment were reviewed.

Objective:To evaluate the nutritional status of elderly inpatients with heart failure, and to analyze risk factors for malnutrition.Methods:A total of 221 patients with heart failure in our hospital from January 2018 to March 2019 were enrolled in the study.The demographic characteristics and medical record data were collected.All patients received Nutritional Risk Screening 2002(NRS-2002)and a questionnaire survey relating to heart failure.We investigated the effects of risk factors on the detection rate of malnutrition by using Mann-Whitney U test or Chi-square test, and the independent risk factors for malnutrition were analyzed by multivariate Logistic regression analysis.Results:The detection rate of nutritional risk was 45.2% in 221 patients.The detection rate of nutritional risk increased along with lower degree of education and worse cardiac function( P<0.05). The detection rate of nutritional risk was higher in patients with peripheral vascular disease and osteoporosis than in patients without them( P<0.05), and in patients with the increased numbers of complication and drugs( P<0.05). Patients with nutritional risk had a higher degree of frailty and a worse quality of activities of daily living( P<0.05). Multivariate Logistic regression analysis indicated that great age, ejection fraction, B-type natriuretic peptide(BNP), NYHA classification, numbers of drugs and diseases, frailty, low quality of life were independent risk factors for nutritional risk, and Digoxin was the independent protective factor for nutritional risk( P<0.05). Conclusions:The great age, severity of heart failure, numbers of drugs and diseases, frailty, low quality of daily life may be the independent risk factors for nutritional risk in elderly patients with heart failure, and oral Digoxin may be the independent protective factor for nutritional risk.

OBJECTIVE：To establish a method for the determination of 8 glycosides（astragaloside Ⅰ，Ⅱ，Ⅲ，Ⅳ and calycosin glucopyranoside ，2′-hydroxy-3′，4′-dimethoxy-isoflavan-glucoside and 9，10-dimethoxy-pterocarpan-glucoside） and 4 aglycones（calycosin，formononetin，7，2′-dihydroxy-3′，4′-dimethoxy-isoflavan and 3-hydroxy-9，10-dimethoxy-pterocarpan） in Astragalus membranaceus ，and to investigate the effects of different processing temperatures on the contents of above 12 components. METHODS ：The contents of 12 components in A. membranaceus and samples processed under different temperatures（120，140，160，180，200 ℃）were determined by UPLC-MS/MS. The determination was performed on ACQUITY UPLC HSS T 3 column with mobile phase consisted of 0.1 mol/L formic acid water solution -0.1 mol/L formic acid acetonitrile solution （gradient elution ）at the flow rate of 0.5 mL/min. The column temperature was 30 ℃. The detection wavel ength was 260 nm，and sample size was 2 μL. Electrospray ion source（ESI）was used under positive ion mode （ESI+）. The mass scanning range was mass ratio （m/z）of 50-1 500，with capillary voltage of 2 000 V and ion source temperature of 100 ℃. The desolvation temperature was 400 ℃；flow rate of atomizing gas （N2） was 40 L/h，and that of desolvation was 800 L/h；collision energy （CE）was 20-30 V；data acquisition rate was 0.5 s/scan. RESULTS：The linear range of astragaloside Ⅰ，astragaloside Ⅱ，astragaloside Ⅲ，astragaloside Ⅳ，calycosin-glucopyranoside， calycosin，ononin，formononetin，2′-hydroxy-3′，4′-dimethoxy-isoflavan-glucoside，7，2′-dihydroxy-3′，4′-dimethoxy-isoflavan，9， 10-dimethoxy-pterocarpan-glucoside and 3-hydroxy-9，10-dimethoxy-pterocarpan were 0.001 16-0.232 0，0.000 276-0.055 2， 0.000 22-0.044 0，0.000 225-0.045 0，0.000 734-0.587 0，0.001 17-0.234 0，0.000 742- 0.148 0，0.001 30-0.260，0.003 98-0.795 0， 0.000 476-0.476 0，0.001 89-0.378 0，0.000 336-0.336 0 μg（all R2≥0.999 2），respectively. The limits of detection were 6.2×10－6， 4.8×10－6，3.8×10－6，3.4×10－6，5.8×10－6，4.8×10－6，4.2×10－6，3.2×10－6，5.8×10－6，2.6×10－6，4.2×10－6，6.4×10－6 μg，respectively. The limits of quantitation were 12.6×10－6，16.2×10－6，14.4×10－6，14.8×10－6，18.8×10－6，16.4×10－6，15.4×10－6，10.8×10－6，20.2×10－6， 12.4×10－6，14.6×10－6，23.4×10－6 μg，respectively. RSDs of precision ，stability（24 h）and repetition tests were all lower than 3.0％（n＝6）. The average recoveries were 99.1％，100.2％，98.7％，101.9％，98.6％，102.1％，99.2％，100.3％，98.7％， 99.2％，99.3％ and 100.8％，with the RSDs of 1.9％，2.2％，2.4％，1.8％，2.1％，1.7％，2.3％，1.9％，2.4％，1.8％，2.2％ and 1.9％（n＝6），respectively. The results showed that the contents of astragaloside Ⅰ，Ⅱ and Ⅲ decreased gradually with the increase of processing temperature ；the content of astragaloside Ⅳ increased gradually with the increase of temperature. The content of flavonoid glycosides ，such as calycosin glucopyranoside ，ononin，2′-hydroxy-3′，4′-dimethoxy-isoflavan-glucoside and 9， 10-dimethoxy-pterocarpan-glucoside decreased with the increase of temperature ；the corresponding aglycone components as flavonoid glycosides ，formononetin，3-hydroxy-9，10-dimethoxy- pterocarpan increased firstly and then decreased with the increase ； the content of 7，2′-dihydroxy-3′，4′- dimethoxy-isoflavan decreased with the increase of temperature. CONCLUSIONS ：Established UPLC-MS/MS method can be used for determination of 12 components in A. membranaceus . After processed under different temperature，the contents of glycosides decreased in general ，while the contents of aglycones increased in general.

Objective:To evaluate the associations of depression and anxiety statues with serum inflammatory biomarkers in elderly patients with chronic heart failure.Methods:From January 2018 to January 2020, 225 elderly patients with chronic heart failure were enrolled from our hospital. Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Anxiety Scale (SAS) were performed in all patients to determine if the patients were with depression and anxiety statues and evaluate the degrees of depression and anxiety. The differences in demographic and clinical data, geriatric comprehensive assessment indicators, and serum inflammatory markers were compared among patients in the control group (without depression and anxiety), depression group, anxiety group, and depression and anxiety group (with both depression and anxiety). Spearman correlation test was used to analyze the correlation between the levels of serum inflammatory markers and the degrees of depression and anxiety in patients with depression and anxiety. Binary Logistic regression analysis was used to determine the independent influencing factors for depression and anxiety.Results:(1) As compared with those in the control group, patients in the depression group, anxiety group, and depression and anxiety group had significantly increased scores of Chinese version of Tilburg Frailty Indicator, statistically decreased Mini Mental State Examination (MMSE) scores, significantly increased Minnesota Living with Heart Failure Questionnaire (MLWHFQ) scores, increased proportions of patients with 2-4 kinds of diseases and those taking 2-4 kinds of drugs, and decreased Basic Activity of Daily Living (BADL) scores ( P<0.05); as compared with those in the depression group and the anxiety group, the changes of the above indicators in the depression and anxiety group were more obvious with significant differences ( P<0.05). As compared with those in the control group, patients in the depression group, anxiety group, and depression and anxiety group had significantly increased serum interleukin (IL)-6 and C-reactive protein (CRP) levels, patients in the anxiety group and depression and anxiety group had statistically elevated serum homocysteine (Hcy) level, and patients in the depression group and depression and anxiety group had significantly increased serum tumor necrosis factor α (TNF-α) level ( P<0.05); the serum levels of CRP, Hcy and TNF-α in patients from the depression and anxiety group were significantly higher than those in depression group ( P<0.05); the levels of IL-6, CRP, Hcy and TNF-α in the depression and anxiety group were significantly higher than those in the anxiety group ( P<0.05). As compared with that in the control group, the proportion of patients with nutritional risk in the depression and anxiety group was statistically higher ( P<0.05). (2) The serum levels of IL-6, CRP and TNF-α in depression patients were positively correlated with the depression degrees ( P<0.05); the serum levels of IL-6, CRP and Hcy in anxiety patients were positively correlated with the anxiety degrees ( P<0.05). (3) Results of binary Logistic regression analysis showed that IL-6 was an independent risk factor for depression in elderly patients with chronic heart failure ( OR=1.093, 95%CI: 1.049-1.139, P=0.000); Hcy was an independent risk factor for anxiety in elderly patients with chronic heart failure ( OR=1.114, 95%CI: 1.030-1.205, P=0.007); CRP, TNF-α, IL-6 and Hcy were independent risk factors for depression and anxiety in elderly patients with chronic heart failure ( P<0.05). Conclusion:The depression and anxiety degrees and expressions of inflammatory markers in elderly patients with chronic heart failure have synergistic effects.

Objective:Through the investigation of the injured persons in explosion accidents, the impact of wearing the ear protectors device (anti-noise earplugs) on the auditory organs and hearing loss of the injured person was understood, which could provide reference for the clinical diagnosis, treatment and prevention of the explosive hearing impairment.Methods:A retrospective survey was conducted on 39 directly injured persons who were injured in 23 explosion accidents involving a steel plant from 1990 to 2016 as the explosive hearing loss, taking the time of the patient＇s injury and 3-6 months after the injury as the time of investigation and evidence collection, and according to whether to wear the ear protectors device for group comparison and statistical analysis.Results:There was no significant difference between the two groups in hearing loss, tinnitus, earache, headache, some patients with dizziness and craniocerebral injury, regardless of whether the injured person wore anti-noise earplugs or not ( P=0.444-1) , the shock (coma) patients in the non-protected group were more common (34.8%, 8/23) , and the difference was statistically significant ( P=0.012) ; Although auricle injury was detected in both groups and there was no significant difference between the two groups ( P=1) , but the external ear canal injury, tympanic membrane perforation were more common in the non-protected group, and there was no external ear canal and tympanic membrane perforation in the wearing earplug group, and the difference between the two groups was significant ( P=0.000) . After 3-6 months, the rehabilitation of auditory system and other symptoms in patients showed that the hearing loss, tinnitus, earache, headache, dizziness and other symptoms all disappeared in patients wearing earplugs, while the above symptoms in the non-protected group were improved but more persisted, and the difference between the two groups was statistically significant ( P=0.000-0.012) , and there was no significant difference in rehabilitation conditions such as craniocerebral injury between the two groups ( P=1) ; There were patients with unhealed auricle injury in both groups in 3-6 months after the injury, and there was no significant difference between the two groups ( P=1) , however, in the non-protected group, 69.57% (16/23) of the patients with external auditory canal injury were still unhealed and none of the patients with tympanic membrane perforation recovered, and the difference between the two groups was obvious ( P=0.000~0.001) ; Pure tone air conduction examination showed that the hearing of the earplugs wearers was well recovered at the time of the explosion, while irreversible hearing impairment was common in the non-protective group, the difference was statistically significant ( P=0.000) . Conclusion:Ear protector plays an important role in protecting the auditory organs and hearing of workers in explosion accident, and it is an effective protective measure to prevent and reduce the damage of external ear canal, perforation of tympanic membrane and explosive hearing loss caused by explosion accidents.

Objective:To investigate the effect of sound insulation improvement on the noise exposure of workers in the operation room of hot rolling line for wide and heavy plate.Methods:From September 2019 to September 2017, based on the occupational health Survey, the data of 25 fixed operation rooms and workers in operation rooms of a steel rolling production line were collected retrospectively, the noise exposure levels before and after the improvement of sound insulation were statistically analyzed.Results:The noise exposure value of the workers, the qualified rate of 0 Grade 8 hours equivalent noise (L EX, 8 h) ≤85 dB (A) and the qualified rate of the design limit value of the operation room were all higher than those before the modification, the difference was statistically significant ( P<0.01) , after the renovation, the Class II and above noise hazards were eliminated, the equivalent continuous a sound level (L Aeq, 8 h) >75 dB (A) of the workers in the operation room was 8h, and the noise level in the operation room still did not meet the Ergonomics limit standard. Conclusion:The improvement of sound insulation can effectively improve the working environment of noise workplace operating room and reduce the workers'noise exposure level.

Objective:Through the investigation of the injured persons in explosion accidents, the impact of wearing the ear protectors device (anti-noise earplugs) on the auditory organs and hearing loss of the injured person was understood, which could provide reference for the clinical diagnosis, treatment and prevention of the explosive hearing impairment.Methods:A retrospective survey was conducted on 39 directly injured persons who were injured in 23 explosion accidents involving a steel plant from 1990 to 2016 as the explosive hearing loss, taking the time of the patient＇s injury and 3-6 months after the injury as the time of investigation and evidence collection, and according to whether to wear the ear protectors device for group comparison and statistical analysis.Results:There was no significant difference between the two groups in hearing loss, tinnitus, earache, headache, some patients with dizziness and craniocerebral injury, regardless of whether the injured person wore anti-noise earplugs or not ( P=0.444-1) , the shock (coma) patients in the non-protected group were more common (34.8%, 8/23) , and the difference was statistically significant ( P=0.012) ; Although auricle injury was detected in both groups and there was no significant difference between the two groups ( P=1) , but the external ear canal injury, tympanic membrane perforation were more common in the non-protected group, and there was no external ear canal and tympanic membrane perforation in the wearing earplug group, and the difference between the two groups was significant ( P=0.000) . After 3-6 months, the rehabilitation of auditory system and other symptoms in patients showed that the hearing loss, tinnitus, earache, headache, dizziness and other symptoms all disappeared in patients wearing earplugs, while the above symptoms in the non-protected group were improved but more persisted, and the difference between the two groups was statistically significant ( P=0.000-0.012) , and there was no significant difference in rehabilitation conditions such as craniocerebral injury between the two groups ( P=1) ; There were patients with unhealed auricle injury in both groups in 3-6 months after the injury, and there was no significant difference between the two groups ( P=1) , however, in the non-protected group, 69.57% (16/23) of the patients with external auditory canal injury were still unhealed and none of the patients with tympanic membrane perforation recovered, and the difference between the two groups was obvious ( P=0.000~0.001) ; Pure tone air conduction examination showed that the hearing of the earplugs wearers was well recovered at the time of the explosion, while irreversible hearing impairment was common in the non-protective group, the difference was statistically significant ( P=0.000) . Conclusion:Ear protector plays an important role in protecting the auditory organs and hearing of workers in explosion accident, and it is an effective protective measure to prevent and reduce the damage of external ear canal, perforation of tympanic membrane and explosive hearing loss caused by explosion accidents.

Objective:To investigate the effect of sound insulation improvement on the noise exposure of workers in the operation room of hot rolling line for wide and heavy plate.Methods:From September 2019 to September 2017, based on the occupational health Survey, the data of 25 fixed operation rooms and workers in operation rooms of a steel rolling production line were collected retrospectively, the noise exposure levels before and after the improvement of sound insulation were statistically analyzed.Results:The noise exposure value of the workers, the qualified rate of 0 Grade 8 hours equivalent noise (L EX, 8 h) ≤85 dB (A) and the qualified rate of the design limit value of the operation room were all higher than those before the modification, the difference was statistically significant ( P<0.01) , after the renovation, the Class II and above noise hazards were eliminated, the equivalent continuous a sound level (L Aeq, 8 h) >75 dB (A) of the workers in the operation room was 8h, and the noise level in the operation room still did not meet the Ergonomics limit standard. Conclusion:The improvement of sound insulation can effectively improve the working environment of noise workplace operating room and reduce the workers'noise exposure level.

Objective To explore the construction method and physicochemical properties of disulfide?bonded hyaluronic acid?functionalized sodium?meter probe for hepatocellular carcinoma, and its biological evaluation in vitro and feasibility of MRI. Methods Synthesis of hyaluronic acid?disulfide?bonded?poly ε?caprolactone (HA?SS?PCL) by disulfide?bonded alkynyl?terminated polycaprolacton (alkyne?SS?PCL) and azido?terminated hyaluronic acid (HA?N3) by clicking chemical reaction, then doxorubicin (DOX) and superparamagnetic iron oxide (SPIO) were encapsulated in HA?SS?PCL core by dialysis method.HA?SS?PCL@DOX/SPIO was prepared and its particle size,DOX and SPIO loading rate were measured. With PBS as control group, the safety of HA?SS?PCL on human hepatocellular carcinoma cells HepG2 and normal liver cells LO2 was evaluated by the methylthiazolyl tetrazolium (MTT) assay, and the cytotoxicity of HA?PCL@DOX/SPIO and HA?SS?PCL@DOX/SPIO on human hepatocellular carcinoma cells HepG2 was evaluated. Immunofluorescence and flow cytometry were used to observe the expression of CD44 receptor on the surface of HepG2 cells in HA?PCL@DOX/SPIO and HA?SS?PCL@DOX/SPIO groups. Through in vitro MRI, PBS was used as the control group to observe the changes of T2 signal intensity of HA?PCL@DOX/SPIO and HA?SS?PCL@DOX/SPIO groups when SPIO concentration was 10, 20, 40, 80 μg / ml. One way ANOVA test and t test were used. Results HA?SS?PCL@DOX / SPIO sodium?meter probes were successfully constructed. The particle size of HA?SS?PCL@DOX/SPIO was (126.9±6.3) nm,and they were spherical with uniform size. The loading rates of DOX and SPIO were 61.4% and 58.7%. MTT assay showed that the survival rate of HepG2 and LO2 cells was more than 80% even at 500 μg/ml of HA?SS?PCL, 66.6% in HA?PCL@DOX/SPIO group and 55.2% in HA?SS?PCL@DOX/SPIO group. Immunofluorescence and flow cytometry showed that HA?PCL@DOX/SPIO and HA?SS?PCL@DOX/SPIO groups all have strong fluorescence, and the latter has stronger fluorescence intensity the former fluorescence intensity was 139.70±8.52,less than the latter 245.06±13.21. In vitro MRI showed that the T2 signal intensity of HA?PCL@DOX/SPIO and HA?SS?PCL@DOX/SPIO was significantly lower than that of the control group (F values were 613.591 and 569.234,P=0.000), the latter decline rate was more significant. Conclusion The disulfide?bonded hyaluronic acid?functionalized sodium?meter probe for hepatocellular carcinoma has excellent physicochemical properties, good targeting and MRI functions on human hepatoma cell HepG2 at the cellular level in vitro.