Objective To optimize the spray drying process of Banlangen(Isatidis Radix)formula granules based on quality by design(QbD)concept.Methods Using powder yield and the contents of uridine,adenosine,guanosine,and(R,S)-goitron as the critical quality attributes(CQAs),Plackett-Burman design was used to screen out critical process parameters(CPPs)for inlet temperature,spray pressure,liquid temperature,pump speed,and liquid relative density.The central-composite design(CCD)test was used to optimize the CPPs,which were screened.Based on the quadratic polynomial regression model,the design space of spray drying process of Banlangen(Isatidis Radix)formula granules was established,and further validated by experiments.Results Plackett-burman test results show that liquid relative density and inlet velocity are the key parameters for the study.The variance analysis results of CCD test showed that the constructed model in a good prediction ability,since the P-values of model was less than 0.01 and P-values of items lack of fit was more than 0.05.The optimized design space of CPPs was the liquid relative density 1.05-1.08,and pump speed 30%-40%.Conclusion Based on the QbD concept,the design space for the spray drying process of Banlangen(Isatidis Radix)formula granules can improve the stability of its process and help ensure the consistency of product quality.

The intestinal dysbacteriosis is closely associated with the occurrence and progress of radiation-induced intestinal injury. However, the specific mechanism remains unclear. Symbiotic bacteria in the human body play a significant role in maintaining the homeostasis of the intestinal microenvironment while participating in various physiological and pathological processes such as metabolism, immunoregulation, inflammation, and tumorigenesis. Ionizing radiation can destroy the intestinal epithelial barrier, creating an oxidative stress microenvironment. Consequently, the composition and structure of microbiota change, leading to dysbacteriosis through downstream inflammatory factors. Dysbacteriosis can further exacerbate radiation-induced intestinal injury by weakening the resistance of the intestinal epithelial barrier, activating inflammatory signaling pathways, and upregulating radiation-induced apoptosis response. The probiotic supplementation and fecal bacteria transplantation can reduce radiation-induced intestinal injury by regulating the balance of intestinal microbiota. This study reviews the advances in research on the pathogenesis and clinical protection of radiation enteritis based on gut microbiota, in order to provide a theoretical basis and reference for the prevention and treatment of radiation enteritis.

Objective To investigate the content stability of polymyxin B sulfate in high concentration solution and its finished infusion,and to provide a scientific basis for clinical administration.Methods Polymyxin B sulfate was dissolved in 0.9%sodium chloride injection and 5%glucose solution to the concentrations of 0.5 mg·mL-1,1 mg·mL-1 and 5 mg·mL-1,respectively.The content of polymyxin B was determined at 0,2,4,6,8,12,16,20 and 24 h by high-performance liquid chromatography under storage conditions of 4℃and 25℃.Results Polymyxin B sulfate was stable in the concentrations of 0.5 mg·mL-1,1 mg·mL-1 and 5 mg·mL-1,respectively,in 0.9%sodium chloride injection or 5%glucose injection.Under the storage conditions of 4℃and 25℃,the content of polymyxin B1 and polymyxin B2 ranged from 97.23%to 101.26%and 97.30%to 102.63%,respectively.Conclusion Polymyxin B sulfate was stable within 24 h dissolved either in 0.9%sodium chloride injection or in 5%glucose injection with the concentrations of 0.5 mg·mL-1,1 mg·mL-1 and 5 mg·mL-1 under the storage condition of 4℃and 25℃.

Objective:To investigate the association between serum uric acid,pulmonary function and airflow obstruction in Chinese Taiwan healthy subjects.Methods:All the cross-sectional analysis was performed in the population over 40 years old using the physical examination data of Chinese Taiwan MJ Health Resource Center between 1996 and 2016 stratification by gender.The correlation analyses between serum uric acid were done and multivariate Logistic regression analysis was used to explore the effect of serum uric acid on airflow obstruction.Results:A total of 35 465 people were included in the study,in-cluding 16 411 men and 19 054 women.Among them,the serum uric acid concentration of men was higher than that of women,and the serum uric acid concentration of the people with airflow obstruction was higher than that of the people without airflow obstruction.There was a negative correlation between serum uric acid level and the forced expiratory volume in one second(FEV1)and the force vital capacity(FVC)in women(P＜0.05),but in men the correlation didn't exist(P＞0.05).After adjusting for age,education,smoking status,drinking status,work strength,body mass index,history of cough,his-tory of hypertension,history of diabetes,history of dyslipidemia,white blood cells and blood albumin,the airflow obstruction in women was more likely to exist with the serum uric acid elevated(OR=1.12,95％CI:1.02-1.22,P＜0.05).The results showed that women with hyperuricemia were more likely to have airflow obstruction than those without hyperuricemia(OR=1.36,95％CI:1.06-1.75,P＜0.05).There was no correlation between serum uric acid concentration and airflow obstruction in men(OR=1.04,95％CI:0.96-1.13,P＞0.05),also the hyperuricemia and airflow obstruction(OR=1.12,95％CI:0.89-1.39,P＞0.05).Conclusion:There is a negative correlation between serum uric acid and FEV1 and FVC in relatively healthy women,and there is an association between elevated serum uric acid and airflow obstruction in women,but not in men.Further prospective studies are needed to explore whether high serum uric acid level can increase the risk of airflow obstruction.

Myelodysplastic syndrome(MDS)is a malignant clonal disease with high heterogeneity in cytogenetics and molecular genetics,and the risk of progression to acute myeloid leukemia(AML)is extremely high.Transforming growth factor-β(TGF-β)is closely related to the pathogenesis of MDS.It is a key executor of immune homeostasis and immune tolerance,and can inhibit the expansion and function of many components of immune system.TGF-β signaling pathway can regulate hematopoietic cells and immune cells in microenvironment,inhibit their normal biological functions,and thus accelerate the progression of MDS.This study reviews regulatory effects of TGF-β signaling pathway on MDS blood cells,T lymphocytes,natural killer cells and macrophages in recent years,and provides a new perspective for the pathogenesis and treatment of MDS.

Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection with an extremely high mortality rate,and it is the main risk factor for acute lung injury(ALI).However,the pathophysiology and pathogenesis of sepsis-associated ALI are not fully understood,and effective drugs are extremely limited.Therefore,it is urgent that we explore the pathogenesis of sepsis-associated ALI and attempt to discover effective intervention measures to improve the prognosis of sepsis-associated ALI patients.In recent years,ferroptosis has been considered closely related to the pathological and physiological processes of sepsis-associated ALI,and inhibiting related cell ferroptosis can effectively slow down the occurrence and development of the disease.In this paper,therapeutic strategies targeting ferroptosis in related cells are reviewed to provide a reference for future research on ferroptosis in sepsis-associated ALI and provide a new perspective on potential treatments.

Objective:To establish a scientific and standardized evaluation index system of neonatal breastfeeding nursing quality under the state of mother-infant separation, in order to provide a tool for the detection and management of neonatal breastfeeding nursing quality under mother-infant separation, so as to promote the implementation of breastfeeding in China.Methods:A systematic and comprehensive search of Chinese and English databases was conducted to collect guidelines on neonatal breastfeeding in the state of mother-infant separation. Based on the "structure-process - result" three-dimensional quality structure model, the preliminary draft of evaluation indexes of neonatal breastfeeding nursing quality in the state of mother-infant separation was formed. The evaluation indexes of neonatal breastfeeding nursing quality in the state of mother-infant separation were constructed by Delphi expert correspondence method from July to October, 2023.Results:The effective recovery rates were 95.83% (23/24) and 91.30% (21/23), respectively. The expert authority coefficients were 0.895 and 0.870, respectively. The Kendall harmony coefficients of the whole index were 0.134 and 0.178 (both P<0.01), respectively. The final evaluation index system of neonatal breastfeeding nursing quality under the state of mother-infant separation includes 3 first-level indicators, 18 second-level indicators and 82 third-level indicators. Conclusions:The evaluation index system of neonatal breastfeeding nursing quality in the state of mother-infant separation established in this study is highly scientific and reliable, highlighting the characteristics of neonatal breastfeeding nursing work in the state of mother-infant separation, and can provide a reference for the evaluation of neonatal breastfeeding nursing quality in the state of mother-infant separation.

Purpose To investigate the value of MRI multimodal parameters in predicting sentinel lymph node(SLN)metastasis of breast cancer,and to develop an effective prediction model to reduce the unnecessary biopsy rate of SLN.Materials and Methods Preoperative MRI data of 310 patients with cN0 breast cancer confirmed by operation and pathology in Sir Run Run Shaw Hospital,Zhejiang University School of Medicine from January 2019 to December 2021 were retrospectively analyzed,and all patients were divided into positive group and negative group according to whether SLN metastasized.Imaging features of breast lesions were evaluated independently by two radiologists,differences in parameter between the two groups were compared,independent predictors were screened to build models and evaluate diagnostic efficacy.Results The breast lesions in SLN positive group were located in the upper quadrant(χ2=14.94),non-single(χ2=9.29),circular enhancement(χ2=9.23)and the positive rate of adjacent angiogenesis(χ2=9.91)were higher than those in SLN negative group.The lesions in SLN positive group were larger(Z=-2.97,-2.73),and the early enhancement rate was higher(t=-3.48).The minimum apparent diffusion coefficient and relative apparent diffusion coefficient(minimum apparent diffusion coefficient of lesions/apparent diffusion coefficient of glands,rADC)were lower(Z=-7.33,-10.74),all P<0.05.Logistic regression results showed lesion location(OR=4.17,95%CI 1.86-9.35,P=0.001),early enhancement rate(OR=1.01,95%CI 1.00-1.02,P=0.019)and rADC(OR=54.67,95%CI 23.72-126.02,P<0.001)were independent risk factors for SLN metastasis.The model combining lesion location and rADC had the best predictive performance,with a negative predictive value of 96.5%and a 46.1%reduction in unnecessary biopsies.Conclusion SLN preoperative prediction model(lesion location,rADC)based on conventional MRI characteristic parameters has reliable negative prediction value,which is expected to reduce the unnecessary biopsy of nearly half of the patients with stage cN0 breast cancer.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

OBJECTIVE: To explore the clinical phenotype and genetic basis for a Chinese pedigree affected with Oral-facial-digital syndrome type I (OFD1). METHODS: A pedigree with OFD1 who presented at Hebei General Hospital on March 17, 2021 was selected as the subject. Clinical data of the child was collected. Trio-whole exome sequencing (trio-WES) was carried out for the proband and members of her pedigree, and candidate variant was verified by Sanger sequencing. RESULTS: The proband has featured hypotelorism, broad nasal root, flat nasal tip, lobulated tongue, tongue neoplasia, camptodactyly of left fifth finger, syndactyly of right fourth and fifth fingers, and delayed intellectual and language development. Trio-WES revealed that the proband and her daughter, sister and mother have harbored a heterozygous c.224A>G (p.Asn75Ser) variant of the OFD1 gene. The same variant was not found among healthy members from her pedigree. CONCLUSION The c.224A>G (p.Asn75Ser) variant probably underlay the OFD1 in this pedigree. Above discovery has enriched the spectrum of OFD1 gene variants.
Humans ; Female ; Pedigree ; Orofaciodigital Syndromes/genetics* ; East Asian People ; Phenotype ; Heterozygote ; Mutation ; China