The chemical constituents from the n-butanol fraction of ethanol extract of safflower (Carthamus tinctorius L.) were isolated and purified using chromatographic process including MCI Gel CHP-20, ODS, Sephadex LH-20 column chromatography, and semi-preparative HPLC method, and one alkyne and two phenylpropanoid derivants were obtained. Their structures were identified as (5R,E)-tetradecane-12-ene-8,10-diyne-1,5,14-triol (1), (E)-8-O-β-D-glucopyranosyl n-butyl cinnamate (2), and (7S,8S)-7-(4-hydroxy-3-methoxybenzene)-7-butyl-8,9-diol (3) by modern spectroscopy methods (1D NMR, 2D NMR, UV, IR and MS). 1-3 are all new compounds. Compounds 1-3 were screened for their anti-renal fibrosis activities in vitro, and none of them showed obvious effect.

Six compounds were isolated from the ethyl acetate fraction of Citri Sarcodactylis Fructus by using various column chromatographic methods, such as MCI Gel CHP-20, ODS, Sephadex LH-20, silica gel and semipreparative HPLC. Their structures were identified to be citrusin G (1), citrusin H (2), citrusin E (3), syringin (4), coniferin (5), methylconiferin (6) by NMR, HR-ESI-MS, UV, IR spectra. Compounds 1 and 2 were new secondary metabolism products and 3-6 were obtained from the titled material for the first time. Compound 1 showed anti-renal fibrosis activity in TGF-β1-induced kidney proximal tubular cells.

OBJECTIVE To explore the safety， effectiveness， and cost-effectiveness of elderly patients with sarcopenia receiving Shenling baizhu powder combined with nutrition and exercise intervention， providing a reference for rational clinical drug use. METHODS A total of 237 elderly sarcopenia patients were randomly assigned to an observation group （118 cases） and a control group （119 cases）. Both groups of patients received nutrition and exercise intervention； the observation group added Shenling baizhu powder （6 g each time， three times daily） on this basis. The safety， effectiveness， and cost-effectiveness of the two plans were compared after 3 months. RESULTS Both groups of patients completed the follow-up. Before intervention， no significant difference was observed in skeletal muscle index （SMI）， grip strength， and 6-minute walk test （6MWT） speed between the two groups （P＞0.05）. After intervention， the grip strength of the patients in the observation group was significantly greater than that of the control group （25.05 kg vs. 23.18 kg， P＜0.01）； the treatment response rate of sarcopenia， SMI， and 6MWT speed were higher than those of the control group， butthe differences were not statistically significant （P＞0.05）. The adverse reaction/event rate of the patients in the observation group was lower than that of the control group （14.41% vs. 16.81%， P＝0.611）， but the difference was not statistically significant. Compared with the control group’s plan， the cost of the observation group’s plan was higher （981.25 yuan vs. 913.94 yuan）， and the effect was better （effectiveness rate： 0.618 6 vs. 0.563 0）， with an incremental cost-effectiveness ratio of 1 210.61 yuan. The results of the sensitivity analysis were consistent with the cost-effectiveness analysis results. CONCLUSION Elderly patients with sarcopenia who receive Shenling baizhu powder combined with nutrition and exercise intervention can significantly strengthen grip strength without increasing the incidence of adverse reactions/events. Compared with the control group plan， the observation group needs to spend an additional 1 210.61 yuan for each additional effective patient with sarcopenia.

Objective To clarify the responsibilities and influencing factors of infection control liaison nurses(ICLNs)in general hospitals.Methods Relevant databases were systematically retrieved with scoping review method from establishment to March 18,2023,and the included literatures were reported standardizedly.Results A total of 36 literatures were included in the analysis.Responsibilities of ICLNs included admittance criteria,selec-tion methods,and job responsibilities.Influencing factors of ICLNs included training,empowerment,performance evaluation,continuous improvement measures,and personnel allocation.After the establishment of ICLNs,inci-dence of healthcare-associated infection and detection rate of multidrug-resistant organisms were reduced,compli-ance rate of health care workers'hand hygiene and monitoring rate of hospital environment were improved,and the cleaning and disinfection of hospital environment was standardized.Conclusion ICLNs play a role in preventing and controlling the occurrence of healthcare-associated infection.The management and application should be further standardized and improved,the effectiveness of ICLNs needs to be thoroughly studied,so as to promote the deve-lopment of ICLNs,and improve the quality of healthcare-associated infection management.

ObjectiveTo analyze the epidemiological characteristics and related factors of pesticide poisoning occurred in daily life in Tiantai County, Zhejiang Province from 2015 to 2023, and to provide a basis for the prevention and control of pesticide poisoning. MethodsThe information of pesticide poisoning cases was obtained from the occupational disease and occupational health information monitoring system of the China Disease Prevention and Control Information System, death data was obtained from the Zhejiang Province Chronic Disease Surveillance Information Management System, so that the poisoning incidence rate and the fatality rate were analyzed. ResultsA total of 439 cases of pesticide poisoning occurred in life were reported in Tiantai County from 2015 to 2023, of which mainly concentrated in the second quarter of each year, with an average annual incidence rate of 10.62/10⁵ and fatality rate of 14.81%.The main cause of poisoning in < 15 years old group was accidental ingestion, while the main cause in ≥15 years old group was self-poisoning, and the difference was statistically significant (χ²＝103.518, P<0.001).The average annual incidence of pesticide poisoning occurred in life in the urban area was significantly lower than that in the rural area, and the difference was statistically significant (χ²＝30.871, P<0.001).The main types of pesticide poisoning were insecticides (65.15%), and paraquat had the highest fatality rate (47.73%). The results of binary logistic regression analysis indicated that age and types of pesticide poisoning may be the independent risk factors affecting the fatality of pesticide poisoning in daily life. ConclusionPesticide poisoning occurred frequently in Tiantai County over the years, and mainly occurred in summer, rural areas. Except for <15 years old group who were accidental ingestion,the other cases were mainly self-poisoning. The elderly and herbicide users should be the focus of key intervention targets. It is suggested to take personalized preventive and curative measures to intervene by age, seasons, regions and types to reduce the incidence and fatality rate of pesticide poisoning in daily life, and strengthen psychological health interventions to the cases of attempting to suicide.

[Abstract] [Objective] To investigate the therapeutic effect of platelet-rich plasma (PRP) subcutaneous injection combined with gypenosides (GPs) oral administration on BALB/c mouse psoriatic inflammation and explore its mechanism of action. [Methods] The 6-8 week-old female SPF BALB/c mice were randomly divided into five groups: control, model, PRP, GPs and PRP+GPs group, with 5 mice in each group. Imiquimod (IMQ) was used to induce psoriasis-like skin inflammation on the back of mice except the control group. The onset and severity of psoriasis-like inflammation in different treatment groups were evaluated by observing skin lesions, skin thickness and measuring PASI score. HE staining and Ki67 staining were used to evaluate the pathological changes and proliferation of keratinocytes in psoriasis-like skin lesions. Blood cell count, enzyme-linked immunosorbent assay and Western blot were used to explore the changes in circulating white blood cell count, cytokines IL-17A and TNF-α, and related signaling pathway proteins p-STAT3 and p-P38. [Results] At the end of the experiment (on day 6), scale scores of model, PRP, GPs and PRP+GPs group were 3.6±0.49, 1.8±0.75, 1.8±0.75, 1.2±0.40, respectively; the ratios of skin thickness (μm) were 0.86±0.18, 0.59±0.10, 0.56±0.07 and 0.42±0.09; PASI scores were 10.6±1.02, 4.0±0.63, 4.0±1.10 and 3.2±0.75. Compared with the model group, the number of scales (P<0.01), patch thickness (P<0.01) and PASI score decreased (P<0.0001) showed a certain therapeutic effect, and PRP+GPs group had the best effect. Pathological examination showed that both the epidermal layer thickness (P<0.01) and epidermal cell proliferation (P<0.05) decreased in all treatment groups; IL-17A expression levels were 9.02±2.54, 16.56±3.49, 10.01±1.83, 11.12±2.48 and 10.50±2.16, and TNF-α expression levels were 223.36±70.34, 377.36±58.47, 265.42±45.14, 262.94±33.29 and 268.94±26.80 respectively. The expression of skin tissue IL-17A (P<0.05) and TNF-α (P<0.05) decreased, along with the decreased expression of related signaling pathway proteins p-STAT3 and p-P38. [Conclusion] PRP combined with GPs can reduce the expression of IL-17A and TNF-α through the STAT3 and P38 signaling pathways, thereby alleviating inflammation and inhibiting the overproliferation of keratinocytes, thus improving psoriasis-like skin inflammation in BALB/c mice.

Objective This paper aims to address the challenges of hospital equipment management by implementing the life cycle management system in the medical laboratories of public hospitals.Methods Based on the three principles of standard-ization,refinement,and dynamism,this paper conducted data tracking and managed equipment analysis with specifications dur-ing the processes of planning,discussion,procurement,acceptance,operation,maintenance,performance evaluation,scrap-ping,and updating.Results After implementing life cycle management,the average risk level significantly decreased compared to pre-implementation(P＜0.05).Budget implementation efficiency increased by 14.53％from 2019 to 2023.The investment payback period was controlled within 2 years.Conclusion The application of the life cycle management system to equipment management in medical laboratories of public hospitals is of great significance for the high-quality development of hospitals.

Objective:To investigate the impact of air pollution on dynamic changes in lung function and further explore the association between genetic factors and lung function and its changes.Methods:Research data were from 14 506 participants in the United Kingdom Biobank with two complete baseline and follow-up lung function tests. Particulate matter [including particulate matter with aerodynamic diameter ≤2.5 μm and ≤10 μm (PM 2.5 and PM 10)], nitrogen dioxide (NO 2), and nitrogen oxides (NO x) concentrations were estimated using land-use regression models. Annual changes in lung function were calculated based on baseline and follow-up lung function tests. Polygenic risk scores (PRS) of lung function [forced expiratory volume in the first second (FEV 1), forced vital capacity (FVC), and the ratio of FEV 1 to FVC (FEV 1/FVC)] were constructed by genetic variations. The association between air pollution concentrations and lung function changes was analyzed by multiple linear regression models, and the impact of genetic factors on lung function and its changes was also assessed. Results:PM 2.5, PM 10, NO 2, and NO x showed a negative correlation with FVC changes [PM 2.5: -6.66 (95% CI: -9.92- -3.40) ml/year; PM 10: -0.40 (95% CI: -0.77- -0.03) ml/year; NO 2: -1.84 (95% CI: -2.60- -1.07) ml/year; NO x: -1.37 (95% CI: -2.27- -0.46) ml/year]. Additionally, PM 2.5, PM 10and NO 2 were also negatively correlated with changes in FEV 1 [PM 2.5: -3.19 (95% CI: -5.79- -0.59) ml/year; PM 10: -3.00 (95% CI: -5.92- -0.08) ml/year; NO 2: -0.95 (95% CI: -1.56- -0.34) ml/year]. PRS of lung function were positively correlated with baseline lung function (FVC, FEV 1, and FEV 1/FVC) and lung function changes (all β>0, all P<0.001). In different PRS stratification analyses, the effect of air pollution on lung function changes remained significant, and there was no apparent heterogeneity. Conclusions:PRS of lung function are significantly associated with baseline and lung function changes. Long-term exposure to air pollution accelerates the decline of lung function indicators such as FVC and FEV 1. The effects of air pollution are consistent in individuals with different genetic risk scores.

Objective:To establish high performance liquid chromatography (HPLC) wavelength switching method to simultaneously determine the contents of chlorogenic acid, hydroxysafflor yellow A, ferulic acid, Nicotiflorin, Osthole and columbianadin in Tongluo Zhibi Prescription.Methods:The column was XBridge C18 column (250 mm × 4.6 mm, 5 μm); the mobile phase was acetonitrile (A)-0.1% phosphate water (B); gradient eluted, with flow rate: 1 ml/min, column temperature: 30 °C, detection wavelength 330 nm (0-14 min detection of chlorogenic acid, 15-80 min detection of ferulic acid, Nicotiflorin, Osthole, and columbianadin), 403 nm (14-15 min detection of hydroxysafflower yellow pigment A).Results:Chlorogenic acid, hydroxyrhodopsin A, ferulic acid, kaempferol 3-O-rutinoside, serpentin, and dihydroeurobicarpus angelicus acid ester showed good linearity ( R2 &ge; 0.999 8) within 0.029 7-1.485 0, 0.030 0-1.500 0, 0.009 9-0.495 0, 0.017 5-0.875 0, 0.028 4-1.420 0, 0.013 7-0.685 0 μg, respectively. The precision, stability (24 h), repeatability relative standard deviation ( RSD) were all <2%. The average spiked recoveries were all in the range of 95%-105%, and the RSDs were all in the range of 0.32%-1.67%. In 10 batches of test samples of Tongluo Zhibi Prescription, the content of the above six components, including chlorogenic acid, was determined to be 0.221 60, 0.314 30, 0.085 10, 0.032 95, 0.043 87, 0.026 21 mg/g in the following order. Conclusion:The established HPLC wavelength switching method is fast, simple and accurate, which can be used for simultaneous determination of the content of the above six components in Tongluo Zhibi Prescription, which provides reference for quality monitoring and new dosage form research of Tongluo Zhibi Prescription.

Objective:To explore the clinical phenotype and genetic etiology for seven children with CHARGE syndrome (CS).Methods:Clinical data of 7 children with CS diagnosed between March 2020 and December 2022 at the Children′s Hospital Affiliated to Zhengzhou University were analyzed. Genomic DNA was extracted from peripheral blood samples from the children and their parents, and subjected to whole exome sequencing. Candidate variants were verified by Sanger sequencing and pathogenicity analysis. This study was approved by the Medical Ethics Committee of the Children′s Hospital Affiliatedto Zhengzhou University (Ethics No. 2024-K-023).Results:The ages of the children had ranged from 1 day after birth to 12 years old, and all of them had shown growth retardation. The reasons for their admission had included postnatal breathing, swallowing and feeding difficulties in five cases. One child was found to have abnormal external genitalia in conjunct with hearing impairment, whilst another child had shown no secondary sexual characteristics during puberty. All of the children were found to harbor CHD7 gene variants, which included 3 nonsense variants, 2 frameshifting variants and 2 missense variants, i. e., c. 6292C>T (p.R2098*), c.2754G>A (p.W918*), c. 469C>T (p.R157*), c. 3308T>A (p.V1103D), c. 7111delC (p.Q2371Kfs), c. 6023delA (p.D2008Vfs) and c. 3565C>T (p.R1189C). All of the variants were de novo in origin. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the c. 3308T>A (p.V1103D) and c. 3565C>T (p.R1189C) variants were rated as likely pathogenic (PS2+ PM2_Supporting+ PP3), whilst the remainders were rated as pathogenic (PVS1+ PS2+ PM2_Supporting). Conclusion:There is strong clinical and genetic heterogeneity in CS. Early genetic testing may facilitate accurate diagnosis. The detection of novel variants has expanded the phenotypic spectrum of CS and the mutational spectrum of the CHD7 gene.