ObjectiveBased on the concept of quality by design（QbD）， the processing process of calcined Pyritum was optimized， and its X-ray diffraction（XRD） fingerprint was established. MethodsThe safety， effectiveness and quality controllability of calcined Pyritum were taken as the quality profile（QTPP）， the color， hardness， metallic luster， phase composition， the contents of heavy metals and hazardous elements were taken as the critical quality attributes（CQAs）， and the calcination temperature， calcination time， paving thickness and particle size were determined as the critical process parameters（CPPs）. Differential thermal analysis， X-ray diffraction（XRD） and inductively coupled plasma mass spectrometry（ICP-MS） were used to analyze the correlation between the calcination temperature and CQAs of calcined Pyritum. Then， based on the criteria importance through intercriteria correlation（CRITIC）-entropy weight method， the optimal processing process of calcined Pyritum was optimized by orthogonal test. Powder XRD was used to analyze the phase of calcined Pyritum samples processed according to the best process， and the mean and median maps of calcined Pyritum were established by the superposition of geometric topological figures， and similarity evaluation and cluster analysis were carried out. ResultsThe results of single factor experiments showed that the physical phase of Pyritum changed from FeS₂ to Fe₇S₈ during the process of temperature increase， the color gradually deepened from dark yellow， and the contents of heavy metals and harmful elements decreased. The optimized processing process of calcined Pyritum was as follows：calcination temperature at 750 ℃， calcination time of 2.5 h， paving thickness of 3 cm， particle size of 0.8-1.2 cm， vinegar quenching 1 time［Pyritum-vinegar（10∶3）］. After calcination， the internal structure of Pyritum was honeycomb-shaped， which was conducive to the dissolution of active ingredients. XRD fingerprints of 13 batches of calcined Pyritum characterized by 10 common peaks were established. The similarities of the relative peak intensities of the XRD fingerprints of the analyzed samples were>0.96， and it could effectively distinguish the raw products and unqualified products. ConclusionTemperature is the main factor affecting the quality of calcined Pyritum. After processing， the dissolution of the effective components in Pyritum increases， and the contents of heavy metals and harmful substances decrease， reflecting the function of processing to increase efficiency and reduce toxicity. The optimized processing process is stable and feasible， and the established XRD fingerprint can be used as one of the quality control standards of calcined Pyritum.

ObjectiveBased on the concept of quality by design（QbD）， the processing process of calcined Pyritum was optimized， and its X-ray diffraction（XRD） fingerprint was established. MethodsThe safety， effectiveness and quality controllability of calcined Pyritum were taken as the quality profile（QTPP）， the color， hardness， metallic luster， phase composition， the contents of heavy metals and hazardous elements were taken as the critical quality attributes（CQAs）， and the calcination temperature， calcination time， paving thickness and particle size were determined as the critical process parameters（CPPs）. Differential thermal analysis， X-ray diffraction（XRD） and inductively coupled plasma mass spectrometry（ICP-MS） were used to analyze the correlation between the calcination temperature and CQAs of calcined Pyritum. Then， based on the criteria importance through intercriteria correlation（CRITIC）-entropy weight method， the optimal processing process of calcined Pyritum was optimized by orthogonal test. Powder XRD was used to analyze the phase of calcined Pyritum samples processed according to the best process， and the mean and median maps of calcined Pyritum were established by the superposition of geometric topological figures， and similarity evaluation and cluster analysis were carried out. ResultsThe results of single factor experiments showed that the physical phase of Pyritum changed from FeS₂ to Fe₇S₈ during the process of temperature increase， the color gradually deepened from dark yellow， and the contents of heavy metals and harmful elements decreased. The optimized processing process of calcined Pyritum was as follows：calcination temperature at 750 ℃， calcination time of 2.5 h， paving thickness of 3 cm， particle size of 0.8-1.2 cm， vinegar quenching 1 time［Pyritum-vinegar（10∶3）］. After calcination， the internal structure of Pyritum was honeycomb-shaped， which was conducive to the dissolution of active ingredients. XRD fingerprints of 13 batches of calcined Pyritum characterized by 10 common peaks were established. The similarities of the relative peak intensities of the XRD fingerprints of the analyzed samples were>0.96， and it could effectively distinguish the raw products and unqualified products. ConclusionTemperature is the main factor affecting the quality of calcined Pyritum. After processing， the dissolution of the effective components in Pyritum increases， and the contents of heavy metals and harmful substances decrease， reflecting the function of processing to increase efficiency and reduce toxicity. The optimized processing process is stable and feasible， and the established XRD fingerprint can be used as one of the quality control standards of calcined Pyritum.

Medicinal plants are a valuable source of essential medicines and herbal products for healthcare and disease therapy. Compared with chemical synthesis and extraction, the biosynthesis of natural products is a very promising alternative for the successful conservation of medicinal plants, and its rapid development will greatly facilitate the conservation and sustainable utilization of medicinal plants. Here, we summarize the advances in strategies and methods concerning the biosynthesis and production of natural products of medicinal plants. The strategies and methods mainly include genetic engineering, plant cell culture engineering, metabolic engineering, and synthetic biology based on multiple "OMICS" technologies, with paradigms for the biosynthesis of terpenoids and alkaloids. We also highlight the biosynthetic approaches and discuss progress in the production of some valuable natural products, exemplifying compounds such as vindoline (alkaloid), artemisinin and paclitaxel (terpenoids), to illustrate the power of biotechnology in medicinal plants.

Objective To investigate the predictive value of heart rate(HR),C-reactive protein(CRP),amino-probrain natriuretic hormone(NT-proBNP),myoglobin(MYO)and other clinical indicators for left ventricular systolic dysfunction(LVSD)in the patients with acute myocardial infarction(AMI)after percuta-neous coronary intervention(PCI)under different body mass index(BMI)stratification.Methods A total of 353 patients with AMI admitted and treated in the First Hospital of Lanzhou University from January 2020 to December 2020 were selected as the study subjects.The Simpson method was adopted to detect the left ven-tricular ejection fraction(LVEF).The study subjects with LVEF＜0.05 were included in the LVSD group,while those with LVEF ≥0.5 were included in the control group.The AMI patients were divided into the lean/normal type(BMI＜24 kg/m2)and overweight/obese type(BMI≥24 kg/m2)according to BMI.The general data of the patients,laboratory indexes and myocardial enzyme indicators were collected.The different groups with different BMI stratifications conducted the comparison.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were adopted to analyze the predictive efficiency of differ-ent indicators.Results There were 153 cases of lean/normal type AMI,in which there were 54 cases in the LVSD group and 99 cases in the control group.Among 200 cases of overweight/obese type AMI,60 cases were in the LVSD group and 140 cases were in the control group.In the patients with lean/normal AMI,HR,CRP,NT-proBNP,MYO and cTnl levels in the LVSD group were higher than those in the control group,and the differences were statistically significant(P＜0.05).In the patients with overweight/obese type AMI,HR,CRP,NEUT,PLT and NT-proBNP levels in the LVSD group were higher than those in the control group,the age was lower than that in the control group,and the differences were statistically significant(P＜0.05).In the patients with the lean/normal type AMI,HR was the best factor for single index prediction effect,AUC was 0.701(95％CI:0.612-0.790).HR+MYO+CRP was the best factors combination of com-bination prediction for LVSD in the patients with lean/normal type AMI.AUC was 0.769(95％CI:0.690-0.849).In the patients with overweight/obese AMI,NT-proBNP was the best factor for the best effect of sin-gle indicator prediction,AUC was 0.706(95％CI:0.613-0.786);NT-proBNP+CRP was the best factor combination in the combination for predicting LVSD in the patients with overweight/obese type AMI,AUC was 0.761(95％CI:0.687-0.833).Conclusion In the patients with different BMI stratifications of AMI,the combination prediction has a better predictive effect than the single indicator.HR+MYO+CRP has the better pre-dictive effect for LVSD in the patients with lean/normal type AMI,while NT-proBNP-+CRP has better predictive effect for LVSD in the patients with overweight/obese type AMI.

Objective:To explore the potential categories of post-traumatic stress disorder (PTSD) in patients undergoing replantation of severed fingers, and analyze their influencing factors.Methods:From January 2022 to December 2023, convenience sampling was used to select 335 patients who underwent replantation of severed fingers at the Hand and Foot Surgery of Taizhou Hospital of Zhejiang Province as research subjects. The survey was conducted using the General Information Questionnaire, PTSD Checklist-Civilian Version, Event Related Rumination Inventory, Chinese version of the Perceived Social Support Scale, and the Eysenck Personality Questionnaire-Revised, Short Scale for Chinese. Potential profile analysis was used to explore the potential categories of PTSD in patients undergoing replantation of severed fingers, and ordered Logistic regression was used to analyze the influencing factors of PTSD categories.Results:A total of 335 questionnaires were distributed, and 328 valid questionnaires were collected, with a valid response rate of 97.91%. Potential profile analysis showed that PTSD of 328 patients undergoing severed finger replantation were divided into three latent categories, including low PTSD-high avoidance type ( n=67, accounting for 20.43%), moderate PTSD-high alertness type ( n=178, accounting for 54.27%), and high PTSD-high alertness type ( n=83, accounting for 25.30%). There were statistically significant differences in the number of severed fingers, incidence of postoperative vascular crisis, rumination, perceived social support, and personality trait scores among patients with different types of severed finger replantation ( P<0.05). Taking low PTSD-high avoidance type as a reference, ordered Logistic regression analysis showed that invasive rumination, purposive rumination, and personality types (introversion, neuroticism, psychoticism) were potential influencing factors for the moderate PTSD-high alertness type ( P<0.05). The number of severed fingers, postoperative vascular crisis, invasive rumination, purposive rumination, perceived social support, and personality type (introversion, neuroticism, psychoticism) were potential influencing factors of high PTSD-high alertness type ( P<0.05) . Conclusions:There is significant population heterogeneity in PTSD among patients undergoing severed finger replantation, which can be divided into "low PTSD-high avoidance type", "moderate PTSD-high alertness type", and "high PTSD-high alertness type". Nursing staff should conduct targeted interventions in the early stage based on factors such as the number of severed fingers, whether vascular crisis occurs after operation, level of rumination, personality type, to prevent and improve the occurrence of PTSD.

AO type C thoracolumbar fractures are the most serious type of spinal fractures. Among them, the non-displaced type C fractures are easy to be misdiagnosed and mistreated because of their atypical imaging manifestations and few associated neurological symptoms, which ultimately lead to serious consequences such as treatment failure and paralysis. MRI examination is crucial for a correct diagnosis, but most orthopedic surgeons make a diagnosis largely based on the results of X-ray and CT examinations, in which type C fractures are easily misdiagnosed as type B. Non-displaced type C fractures involve three-column injuries and require surgical treatment, for which the key is to fully reconstruct the stability of the three columns. However, in the current clinical practice, it is common to use simple posterior fixation only, resulting in treatment failure. To this end, the authors conducted an in-depth discussion on the diagnosis and treatment of non-displaced AO type C thoracolumbar fractures, aiming to improve orthopedic clinicians ′ understanding and awareness of their significance.

Objective Explore the feasibility and accuracy of using deep learning techniques for gender inference in panoramic dental radiography images of Chinese Han population.Methods A total of 10,600 OPG images from Han individuals aged 18 to 70(5,300 males and 5,300 females)were collected and randomly divided into training set,validation set,and test set in an 8:1:1 ratio.MobileNetV2,Swin Transformer Small,and Swin Transformer Tiny models were trained,and the classification performance of the models was evaluated and visually displayed using accuracy,F1 score,and Grad-CAM algorithm.Results The accuracy of MobileNetV2,Swin Transformer Small,and Swin Transformer Tiny models was 97.57%,95.13%,and 96.28%respectively,with MobileNetV2 model showing the best overall performance.The Grad-CAM algorithm revealed that male OPG images mainly focused on the left and right mandibular branches and alveolar bone,while female OPG images mainly focused on the maxillary sinus,left mandibular branch,and posterior alveolar bone.Conclusion This study demonstrates that the gender inference model based on deep learning techniques for OPG images of Chinese Han population has high accuracy and generalization ability,providing a new approach for forensic gender determination in forensic medicine.

Coronary heart disease （CHD） with atherosclerosis is a common chronic disease worldwide， and anxiety and depression are potential and crucial risk factors for adverse prognosis in CHD. Chaihu Longgu Mulitang （CLMT）， first mentioned in the Shang Han Lun （《伤寒论》）， is a classic prescription for treating Shaoyang diseases combined with disturbance of the mind and spirit， with the effects of harmonizing Shaoyang and calming the mind. Current research on mechanisms has shown that CLMT can play a role in CHD complicated with anxiety and depression through multiple pathways， including regulating related signaling pathways， inhibiting the expression of inflammatory factors， improving oxidative stress damage， modulating neurotransmitter levels， suppressing the hypothalamic-pituitary-adrenal axis， promoting mobilization of mesenchymal stem cells from the bone marrow， and inhibiting platelet activation. Clinical studies have demonstrated that CLMT significantly improves symptoms such as angina and insomnia caused by CHD complicated with anxiety and depression， effectively reduces negative emotions， improves traditional Chinese medicine （TCM） syndrome scores， and decreases levels of inflammatory factors. Furthermore， it has fewer adverse reactions and higher safety than conventional western medicine treatments. This article provides a review of the mechanisms and clinical studies of CLMT in the treatment of CHD complicated with anxiety and depression based on a comprehensive analysis of literature from the China National Knowledge Infrastructure （CNKI）， Wanfang Data， VIP， PubMed， and other databases in the past 15 years， in order to provide references for further research on the use of CLMT in the management of CHD complicated with anxiety and depression.

The many-banded krait, Bungarus multicinctus, has been recorded as the animal resource of JinQianBaiHuaShe in the Chinese Pharmacopoeia. Characterization of its venoms classified chief phyla of modern animal neurotoxins. However, the evolutionary origin and diversification of its neurotoxins as well as biosynthesis of its active compounds remain largely unknown due to the lack of its high-quality genome. Here, we present the 1.58 Gbp genome of B. multicinctus assembled into 18 chromosomes with contig/scaffold N50 of 7.53 Mbp/149.8 Mbp. Major bungarotoxin-coding genes were clustered within genome by family and found to be associated with ancient local duplications. The truncation of glycosylphosphatidylinositol anchor in the 3'-terminal of a LY6E paralog released modern three-finger toxins (3FTxs) from membrane tethering before the Colubroidea divergence. Subsequent expansion and mutations diversified and recruited these 3FTxs. After the cobra/krait divergence, the modern unit-B of β-bungarotoxin emerged with an extra cysteine residue. A subsequent point substitution in unit-A enabled the β-bungarotoxin covalent linkage. The B. multicinctus gene expression, chromatin topological organization, and histone modification characteristics were featured by transcriptome, proteome, chromatin conformation capture sequencing, and ChIP-seq. The results highlighted that venom production was under a sophisticated regulation. Our findings provide new insights into snake neurotoxin research, meanwhile will facilitate antivenom development, toxin-driven drug discovery and the quality control of JinQianBaiHuaShe.

Objective:To investigate the predictive value of mucosal vascular pattern (MVP) under narrow-band imaging (NBI) enteroscopy in patients with ulcerative colitis (UC) in clinical remission for histological healing and clinical recurrence.Methods:A total of 142 patients with UC in clinical remission who visited the First Affiliated Hospital of Weifang Medical University from January 2018 to January 2021 were included in the study and underwent colonoscopy. The white light and NBI endoscopic images were collected and biopsies were obtained. The Mayo endoscopic score (MES) was calculated based on white light images, and MVP staging was evaluated based on mucosal vascular patterns under NBI. Nancy index (NI) was used to evaluate histological healing and patients were followed up for 1 year. The Spearman correlation coefficients of MES and MVP with histological healing and recurrence were calculated. The receiver operator characteristic (ROC) curve was plotted and the area under curve (AUC) was applied to evaluate the accuracy of white light and NBI endoscopy for predicting histological healing of UC in clinical remission.Results:According to the MVP criteria, 47 were defined as clear, 63 blurred, and 32 invisible. Spearman correlation analysis showed a significant correlation between MVP under NBI and histological healing ( r=0.549, P<0.001) and a moderate correlation between MES under white light and histological healing ( r=0.462, P<0.001). Spearman correlation analysis showed a moderate correlation between MVP under NBI and clinical recurrence ( r=0.451, P<0.001) and a moderate correlation between MES under white light and clinical recurrence ( r=0.352, P<0.001). AUC of NBI for diagnosing histological healing of UC in clinical remission was 0.809 (95% CI: 0.738-0.879), with a sensitivity of 84.6% (77/91) and specificity of 64.7% (33/51), superior to the white light endoscopy, of which AUC, sensitivity and specificity were 0.763 (95% CI: 0.678-0.848), 81.3% (74/91) and 66.7% (34/51). Conclusion:MVP staging under NBI could predict histological healing of UC patients in clinical remission and is superior to white light endoscopy.