ObjectiveTo study the bioactive secondary metabolites of Talaromyces sp. TP21 and their bioactivities. MethodThe secondary metabolites of Talaromyces sp. TP21 were isolated by high performance liquid chromatography （HPLC）， normal phase and reversed phase column chromatography combined with molecular networking and bioassay-guided fractionation， and their structures were determined by nuclear magnetic resonance （NMR） and high resolution mass spectrometry （HR MS）. The inhibitory effects of the compounds on the growth of the lung cancer cell line A549 and the liver cancer cell line Hep G2 were measured by themethyl thiazolyl tetrazolium （MTT） method. The antimicrobial activities of the compounds were measured with Staphylococcus aureus and human oral cavity-derived Saccharomyces cerevisiae as the indicator microorganisms. ResultSeventeen compounds were isolated from the secondary metabolites of Talaromyces sp. TP21 and identified as ergochrome C （1）， daldiniaeschsone A （2）， seco-blennolide B （3）， penitholabene （4）， penicichrysogene A （5）， orsellinic acid （6）， griseofulvin （7）， isorhodoptilometrin （8）， （+）-5-chloromitorubrinic acid （9）， penicillixanthone A （10）， pentacecilide B （11）， pentacecilide C （12）， chrodrimanin C （13）， chrodrimanin E （14）， chrodrimanin H （15）， chrodrimanin F （16）， and 3-hydroxypentacecilide A （17）. ConclusionCompounds 1-5， 11-12， and 17 were isolated from Talaromyces for the first time. Among them， compounds 4， 7， and 10-12 exhibited inhibitory activities against the growth of A549 and Hep G2 cells， with the median inhibitory concentration below 50 μmol·L^-1. Furthermore， compounds 9 and 10 showed inhibitory activities against S. aureus and human oral cavity-derived S. cerevisiae， with the minimum inhibitory concentration of 8-128 mg·L^-1.

Objective To explore the medication law of Professor Ding Ying in the treatment of Henoch-Sch?nlein purpura;To analyze Professor Ding Ying's academic thought and clinical experience in the treatment of Henoch-Sch?nlein purpura.Methods Professor Ding Ying's prescriptions for the treatment of Henoch-Sch?nlein purpura in The First Affiliated Hospital of Henan University of Chinese Medicine from January 2013 to January 2020 were selected.Through the analysis of the Integrated Platform for Inheriting Famous Doctors,drug-drug and drug-symptom networks were constructed,and in-depth analysis of its core drug groups and their associated patterns was conducted.Results Totally 195 cases were included in the study,involving 585 times of diagnosis and 585 prescriptions.153 kinds of Chinese materia medica were involved in the prescriptions,with a total frequency of 8 017 times.The medicinal properties were mainly cold,warm and neutral,the medicinal taste was mainly bitter,and the meridians are mainly liver meridian and heart meridian.The analysis of drug weight grade showed that Rehmanniae Radix,Angelicae Sinensis Radix,Forsythiae Fructus,Lonicerae Japonicae Caulis,Moutan Cortex,Arnebiae Radix,Chuanxiong Rhizoma,Kochia Fructus,Piperis Kadsurae Caulis,Trachelospermi Caulis et Folium,Cynanchi Paniculati Radix et Rhizoma,Tripterygium wilfordii,Coicis Semen,Scutellariae Radix,Bubali Cornu,Amomi Fructus,Paeoniae Radix Alba,Spirodelae Herba and Glycyrrhizae Radix et Rhizoma were the core prescriptions for the treatment of Henoch-Sch?nlein purpura.Drug-drug co-occurrence analysis showed that Rehmanniae Radix-Angelicae Sinensis Radix,Rehmanniae Radix-Moutan Cortex,Forsythiae Fructus-Moutan Cortex,Kochia Fructus-Lonicera Japonicae Caulis,Chuanxiong Rhizoma-Lonicera Japonicae Caulis,Lonicerae Japonicae Caulis-Angelicae Sinensis Radix,Kochia Fructus-Forsythiae Fructus,Moutan Cortex-Arnebiae Radix,Angelicae Sinensis Radix-Moutan Cortex,Rehmanniae Radix-Forsythiae Fructus,Forsythiae Fructus,Rehmanniae Radix-Lonicera Japonicae Caulis were commonly used in the treatment of Henoch-Sch?nlein purpura.Clustering analysis showed 10 potential drug groups.Conclusion Professor Ding Ying emphasizes the combination of disease,syndrome,and symptoms in the treatment of Henoch-Sch?nlein purpura,as well as the application of couplet medicines.Clinical treatment follows the concept of"dispelling pathogens and calming the collaterals",making good use of heat clearing and detoxifying drugs,heat clearing and wind dispelling drugs,and heat clearing and dampness dispelling drugs to"dispel pathogens",and making good use of blood activating and cooling drugs,as well as blood nourishing and unblocking drugs to"calm the collaterals".

Objective To investigate the diagnostic value of combining carotid intima-media thickness (cIMT) with serum Galectin-3 (Gal-3) and Pentraxin 3 (PTX3) in patients with psoriasis complicated with cardiovascular disease (CVD). Methods Thirty-eight patients with psoriasis complicated with CVD were included in CVD group, 51 patients with psoriasis alone were included in psoriasis group, and 60 healthy subjects were selected as control group. Clinical data were collected from each group. The cIMT was measured using carotid ultrasound, and serum Gal-3, PTX3, and inflammatory markers[high sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT), tumor necrosis factor-α (TNF-α)]were detected using enzyme-linked immunosorbent assay. Multivariate Logistic regression analysis was used to identify the influencing factors of CVD in patients with psoriasis. The receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of serum Gal-3, PTX3, and cIMT for CVD. Results The cIMT was greater in the CVD group and the psoriasis group than in the control group, and the CVD group was greater than the psoriasis group (P < 0.05). The serum levels of Gal-3, PTX3, hs-CRP, PCT, and TNF-α were higher in the CVD group and the psoriasis group than in the control group, and their levels were higher in the CVD group than in the psoriasis group (P < 0.05). The psoriasis area and severity index (PASI) score was higher in the CVD group than in the psoriasis group (P < 0.05). Pearson's correlation analysis showed that cIMT, Gal-3, and PTX3 were separately positively correlated with hs-CRP, PCT, and TNF-α (P < 0.05). Multivariate Logistic regression analysis showed that PASI score, cIMT, Gal-3, PTX3, hs-CRP, and TNF-α were independent influencing factors for CVD in patients with psoriasis (OR=1.250, 1.451, 1.432, 1.365, 1.413, 1.465; P < 0.05). The diagnostic model based on cIMT combined with serum Gal-3 and PTX3 had higher diagnostic value for CVD in patients with psoriasis than single diagnosis. The area under the curve was 0.922, with sensitivity and specificity of 0.91 and 0.85, respectively. Conclusion The cIMT, serum Gal-3, and serum PTX3 are independent influencing factors for CVD in patients with psoriasis. The combination of the three indicators has higher diagnostic value for CVD in patients with psoriasis.

Objective:To investigate the diagnostic efficiency of the 2020 Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) and the 2017 American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) in the diagnosis of benign and malignant thyroid nodules.Methods:A retrospective analysis of the two-dimensional ultrasound image results of 324 thyroid nodules in 289 patients with thyroid nodules and thyroid nodules were performed in the physical examination of the Health Management Department of the Guangdong Second Provincial General Hospital from January 2018 to January 2019. A superficial professional doctor with a senior professional title simultaneously uses the C-TIRADS and ACR-TIRADS methods to evaluate the above nodules. The results are all pathologically referenced for the χ2 test and the receiver operating characteristic curve is drawn. Results:The sensitivity of C-TIRADS in diagnosing benign and malignant thyroid nodules was 81.90%, specificity was 97.72%, accuracy was 92.59%, negative predictive value was 91.85%, positive predictive value was 84.51%; ACR-TIRADS diagnosis The sensitivity of benign and malignant thyroid nodules was 59.05%, specificity was 99.54%, accuracy was 86.42%, negative predictive value was 83.52%, and positive predictive value was 98.41%. The area under the ROC curve was 0.958 and 0.935( Z=2.31 P=0.021). Conclusion:C-TIRADS classification based on counting method is better than ACR-TIRADS classification based on sub-method in the diagnosis of thyroid nodules. It has better efficacy and is more suitable for the current status of diagnosis and treatment of thyroid nodules in China.

Objective:To investigate the characteristics and significance of insulin-like growth factor 1(IGF- 1) and insulin-like growth factor binding protein 2 (IGFBP2) expressions in ankle cartilage of patients with Kashin-Beck disease (KBD).Methods:In this case-control study, 10 KBD patients who were hospitalized in the Department of Orthopedics of Shaanxi Provincial People's Hospital from January 2010 to December 2016 were selected as KBD group, and 10 patients with ankle fracture caused by trauma but without talus injury during the same period were selected as control group, the cartilage tissues of the two groups were collected. IGF-1, IGFBP2 positive cells, the mRNA and protein expressions of IGF-1, IGFBP2 in the cartilage tissues were detected by immunohistochemistry, real-time fluorescent quantitative PCR and Western blotting, respectively. According to the expressions of IGF-1 and IGFBP2 in ankle cartilage of KBD patients, a patient with amputation caused by trauma was selected in Shaanxi Provincial People's Hospital, and ankle joint cartilage was taken to prepare chondrocytes for in vitro cell verification experiments. The chondrocyte were divided into control group (0 ng/ml T-2 toxin), T-2 treatment group (20 ng/ml T-2 toxin) and T-2+ IGFBP2 silenced group (20 ng/ml T-2 toxin+ 50 nmol/L IGFBP2 siRNA), the MTT method and dimethyl methylene blue staining were used to detect the activity of chondrocyte and the secretion of sulfated glycosaminoglycan (sGAG). Results:In the control group and the KBD group, the number of IGF-1[(47.26 ± 8.97), (68.15 ± 7.42) cells] and IGFBP2 positive cells [(27.56 ± 5.40), (71.85 ± 7.62) cells] in the cartilage tissues were significantly different ( t = 4.487, 9.402, P < 0.01). Compared with the control group, the IGF-1, IGFBP2 mRNA and protein expression levels in KBD group were significantly higher, the differences were significantly different ( t = 3.340, 20.700, 4.684, 8.699, P < 0.05 or < 0.01). In cell experiment, the chondrocyte activitives and sGAG contents of the control group, T-2 treatment group, and T-2+ IGFBP2 silenced group were significantly different ( F = 226.70, 80.66, P < 0.01); among them, the cell activitives and sGAG contents of the T-2 treatment group and T-2+ IGFBP2 silenced group were lower than those of control group ( P < 0.05), and the T-2+ IGFBP2 silenced group were higher than those of the T-2 treatment group ( P < 0.05). Conclusions:The expressions of IGF-1 and IGFBP2 in the ankle cartilage of KBD patients are significantly higher. Silencing IGFBP2 gene can reduce the inhibitory effect of T-2 toxin on chondrocyte activity and the secretion of sGAG.

Objective:To evaluate the effect of donor dexmedetomidine preconditioning on the renal function of patients undergoing living-related kidney transplantation.Methods:Sixty American Society of Anesthesiologists physical status Ⅲ-Ⅳ patients, regardless of gender, aged 20-64 yr, with body mass of 18.5-28.0 kg/m 2, undergoing living-related kidney transplantation, were selected.Sixty corresponding donors, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, regardless of gender, aged 20-64 yr, with body mass index of 18.5-28.0 kg/m 2, were selected.The patients and donors were divided into 2 groups using a random number table method: control group (group C) and dexmedetomidine group (group D), with 30 pairs in each group.Before induction of anesthesia, dexmedetomidine was intravenously infused over 10 min in a loading dose of 1 μg/kg followed by an intravenous infusion of 0.5 μg·kg -1·h -1 until the time point when the renal artery was blocked immediately in the donors of group D, while the equal volume of normal saline was given instead until the time point when the renal artery was blocked immediately in the donors of group C. In both groups, total intravenous anesthesia was applied in donors and recipients, Nacotrend values were maintained at 40-60 during operation, mean arterial pressure and heart rate were maintained within the normal range, and dopamine was intravenously infused when necessary.The warm ischemia time and cold ischemia time of donor kidneys were recorded in the two groups.Peripheral venous blood samples were collected from the donors immediately before renal artery occlusion and from the recipients before renal artery opening (T 0) and at 1, 12 and 24 h after renal artery opening (T 1-3) to determine the serum creatinine (Cr), urea nitrogen (BUN) and cysteine protease inhibitor C (CysC) concentrations.The intraoperative volume of fluid infused, urine volume and consumption of propofol, remifentanil and dopamine were recorded in the receptors of two groups. Results:There was no significant difference in the concentrations of Cr, BUN and CysC and warm ischemia time and cold ischemia time of kidneys in between the two groups of donors ( P>0.05). There was no significant difference in the consumption of propofol, remifentanil and dopamine, volume of fluid infused and urine volume during surgery between the two groups of recipients ( P>0.05). Compared with group C, the concentrations of Cr, BUN and CysC were significantly decreased in at T 1 in group D ( P<0.05). Conclusion:Donor dexmedetomidine preconditioning is helpful in improving the perioperative renal function of patients undergoing living-related kidney transplantation.

Objective:To detect the expression levels of interleukin (IL)-1β, insulin-like growth factors (IGF)-1 in serum and synovial fluid of patients with Kaschin-Beck disease (KBD) and osteoarthritis (OA) and analyze the relationship between IL-1β, IGF-1 levels and visual analogue scale (VAS) score.Methods:From January 2010 to December 2016, 60 patients visited the department of orthopedics of Shaanxi Provincial People's Hospital were selected, included 20 patients with KBD (arthroscopic debridement of ankle), 20 patients with OA (arthroscopic debridement of ankle), and 20 patients with ankle fracture (no talus injury) as control group. The peripheral blood and synovial fluid samples from the patients were collected. Enzyme-linked immunosorbent assay was used to detect the expression levels of IL-1β, IGF-1 in serum and synovial fluid. In each group, VAS score was calculated pre-operative and post-operative at 3, 7, 14 and 28 d. The relationship between IL-1β, IGF-1 levels and VAS score was evaluated by correlation analysis.Results:Synovial fluid IL-1β and IGF-1 levels in the KBD and OA groups were (67.32 ± 6.22), (56.46 ± 5.43) and (24.36 ± 6.22), (21.45 ± 4.35) pg/ml, respectively, which were higher than those in the control group [(27.01 ± 3.15), (10.21 ± 2.50) pg/ml, P < 0.05]. Meanwhile, serum IL-1β and IGF-1 levels in the KBD and OA groups were higher than those in the control group ( P < 0.05). Pearson correlation analysis showed that the expression levels of IL-1β and IGF-1 in serum pre-operative and post-operative at 3, 7, 14 and 28 d were positively correlated with VAS score in KBD and OA groups, respectively ( r = 0.427, 0.502, 0.562, 0.628, P < 0.05). Conclusion:The levels of IL-1β and IGF-1 in synovial fluid from ankle joints and serum are significantly increased in KBD group and OA group, and the levels of IL-1β and IGF-1 in serum are positively correlated with VAS score, respectively.

Objective:To analyze the 6-year operation faults of PHILIPS Brilliance big bore CT, identify the common problems, make corresponding maintenance plans, reduce the incidence of failures, and carry out simulation prediction of the occurrence rate of failures in the next few years.Methods:The failure data of Brilliance big bore CT from June 2012 to June 2018 were collected, and the curve estimation function in SPASS 19.0 software and the pareto diagram were used to analyze the relationship between the number of failures, time and failure types, and the prediction was made.Results:A total of 28 faults occurred during the 6-year opeation of Brilliance big bore CT. During the first half year, five times of faults occurred with the highest fault rate and then tended to stabilize. The linear function model was obtained using the curve estimation: y=-0.033 x+ 2.099( y for the number of fault, unit for times, x for the unit of time for half a year), the model of R2=0.003. In the next three years, approximately twice faults occurred within half year. The pareto chart showed that 16 faults occurred during data collection, including 3 faults in the treatment bed and 3 faults in the power supply system, respectively. The accumulative ratio of the above three faults was 71.4%, which were the main fault sources. Conclusion:The fault statistical analysis of Brilliance big bore CT is helpful for department maintenance personnel to better understand CT, develop effective maintenance programs, reduce the occurrence of faults, and predict the incidence of faults in the future.

Objective:To explore the relationship between the quality of professional life and depression tendency of nurses.Methods:From November 2018 to January 2019, 242 nurses from some third-class A hospitals were randomly selected as the subjects. The Quality of Professional Life Scale of Nurses were used to evaluate the status of nurses' professional life quality, and the depression state of nurses was measured by Self Rating Depression Scale, and the relationship between them was analyzed.Results:The total score of professional life of nurses was (156.86±26.60) , including family work balance (24.60±4.73) , working environment (77.30±14.78) , workload (36.34±6.11) and social environment (18.62±4.21) . The total score of depression tendency of nurses was (43.76±9.50) , the overall depression tendency rate was 64.46% (156/242) , and the incidence rates of moderate and severe depression tendency were 23.55% (57/242) and 10.74% (26/242) , respectively. There was negative correlation between the total score of professional quality of life and each dimension score with depression tendency ( P<0.05) ; Multiple linear regression analysis showed that high quality of professional life was the protective factor of depression tendency of nurses ( P<0.001) . Conclusion:The quality of professional life of nurses is related to depression tendency, and the high quality of professional life is not prone to depression.

Objective:To explore the relationship between occupational stress and metabolic syndrome (MS) in operating room nurses.Methods:In July 2019, 179 nurses in the operating room of a third-class A hospital in Shandong Province were selected as the research objects. The self-designed questionnaire was used to investigate the general situation, and "Nurse Job Stressor Scale" was used to investigate the occupational stress level of nursing staff. The height, weight, waist circumference, blood pressure, fasting blood glucose, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, ischemia-modified albumin, lipoprotein associated phospholipase A2 were measured. The nursing staff were divided into MS group and non-MS group, and the occupational stress levels of the two groups were compared. Chi square test or Fisher test were used to compare the counting data between groups; the measurement data were expressed by Mean±SD, and the comparison between groups was performed with t test. Multiple logistic regression analysis was used to analyze the influencing factors of MS.Results:The overall occupational stress level of nurses in operating room was (450.58±141.77) points, which was significantly lower than the norm score ( P<0.05) ; Compared with non-MS group, the overall occupational stress level, work nature, workload and patient related factors in MS group were significantly higher, and the differences were statistically significant ( P<0.05) ; The prevalence of abdominal obesity, hypertriglyceridemia, hyperglycemia and hypertension were significantly different among the groups with different occupational stress levels ( P<0.05) . After adjusting waist circumference, triglyceride, systolic blood pressure, high density lipoprotein, ischemia modified albumin and lipoprotein associated phospholipase A2, the total score of occupational stress was the risk factor of MS in operating room nurses ( P<0.05) . Conclusion:The occupational stress level of nurses in operating room is related to the prevalence of MS.