Objective To isolate endophytic fungi from Angelica sinensis and evaluate the bioactivity of their secondary metabolites.Methods Angelica sinensis and rhizosphere soil were utilized as materials.The tissue homogenization method was employed with six diverse culture media to isolate endophytic fungi.The antibacterial activity of secondary metabolites was gauged using a 96-well plate assay,while UV spectrophotometry was used to evaluate the inhibitory activity of four enzymes.Results A total of 153 fungal strains were isolated and purified from Angelica sinensis roots,stems,leaves,and soil.The samples exhibited specific inhibitory activities against adenosine deaminase(ADA),β-lactamase,xanthine oxidase(XO),and tyrosinase(TYR),with rates of 45.83%,52.78%,51.39%and 55.56%,respectively.Furthermore,1.39%of the samples displayed wide-ranging inhibitory effects against four indicator bacteria.Strain 6B also showcased the lowest inhibitory concentration values of 62.5 and 7.81 μg/mL against Escherichia coli ATCC25922 and ATCC35218,respectively,signifying its potential research significance.Conclusion Angelica sinensis has abundant endophytic fungal resources and is a good source for discovering active compounds,demonstrating certain research value.

Objective:To explore the diagnosis and treatment of intestinal endometriosis.Methods:The clinical data of 12 patients with intestinal endometriosis at the First Affiliated Hospital of Soochow University from Aug 2016 to Jan 2023 were retrospectively analyzed.Results:There were 8 cases of rectal endometriosis, 3 cases of sigmoid colon endometriosis and 1 case of ileal endometriosis. Nine cases underwent colonoscopy, 6 cases underwent CT examination, 3 cases underwent MRI examination, and 4 cases underwent transabdominal or vaginal ultrasnography. All 12 cases underwent operation, 8 cases were misdiagnosed as colorectal neoplasms and underwent intestinal resection, 1 case had right hemicolectomy because of ambiguous pathology, 2 cases with definite intestinal endometriosis underwent local intestinal resection, 1 case had transanal tumor excision with diagnosis confirmed by postoperative pathology; 5 cases underwent open surgery, 5 cases did laparoscopy, 1 case was done with robotic surgery, 1 case was by transanal surgery; 7 patients underwent more than 2 surgeries, with a maximal of 5 surgeries in one case. The hospital stay varied from 9 to 351 days, all 12 cases were cured, and follow-up found no recurrence.Conclusions:It is often difficult to make a clear diagnosis of intestinal endometriosis preoperatively.Many were misdiagnosed as colorectal neoplasms.Laparascopic exploration and biopsy help prevent inappropriate surgery.

The incidence of myopia is increasing year by year and the trend of younger age is obvious. The situation of myopia prevention and control is very serious. The sclera is the target organ for the development of myopia. When myopia occurs and develops, the ultrastructure of the sclera tissue will undergo pathological changes, resulting in a decrease in its tensile strength, then progressive axial growth and posterior sclera expansion. Scleral collagen cross-linking can effectively increase the hardness and tensile strength of scleral tissue, which may have great potential in the prevention and control of myopia, especially pathological myopia. At present, the effectiveness of scleral collagen cross-linking technology in the prevention and treatment of pathological myopia researches are still in the stage of animal experiments, and there are a lot of controversies on the safety. The development of any new technology to ensure safety is the primary condition. A comprehensive understanding of the safety of scleral collagen crosslinking in the prevention and control of myopia can provide more basis and guidance for the further study of scleral collagen crosslinking.

Herpes zoster ophthalmicus(HZO)is caused by the involvement of the ophthalmic division trigeminal nerve after reactivation of varicella-zoster virus(VZV)latent in the trigeminal ganglia, which usually occurs in the elderly and people with low immune function. The clinical manifestations of HZO are complex and diverse, which show not only keratoconjunctivitis and uveitis, but also retinal necrosis, optic neuropathy, and rare central nervous system lesions. Some cases do not have typical skin lesions, which can easily lead to missed diagnosis, misdiagnosis, and mistreatment, seriously affecting People's life quality. This article aimed to evaluate the clinical manifestations of HZO cases reported in the literature in recent years and comprehensively understand their diversity and complexity to better diagnose and treat the disease. This study also aimed to improve the diagnosis and cure rates of the disease, reduce the maximum number of visual damage, and provide more evidence for the precise diagnosis and treatment of HZO.

Objective:To summarize the clinicopathologic characteristics of undifferentiated embryonal sarcoma of the liver.Methods:The clinical data of 16 patients with undifferentiated embryonal sarcoma of the liver admitted to Shandong Provincial Hospital and Yantai Yuhuangding Hospital from Jan 2000 to Jan 2023 was retrospectively analyzed.Results:The diagnosis of undifferentiated embryonal sarcoma in all the 16 patients was established by postoperative pathology. The clinical manifestations of the patients were mainly asymptomatic abdominal mass, abdominal pain and discomfort. The laboratory examination was mostly nonspecific, the image exam showed mostly solid cystic mass. 14 cases underwent radical surgical resection.The minimum survival time was 7 months, maximum survival time was 121 months with median survival time of 35.9 months.Conclusions:Undifferentiated embryonal sarcoma of the liver is an extremely rare malignant tumor of the liver. The disease lacks specific clinical manifestations. CT examination can assist in the diagnosis of the disease. Diagnosis of undifferentiated embryonal sarcoma of the liver depends on pathological examination. The prognosis of patients is poor, surgical resection of the tumor is an effective treatment.

Objective By population survey,to explore the epidemiological characteristics of gastric precancerous lesions in Lishui District of Nanjing and provide objective basis for the prevention and treatment of early gastric cancer.Methods From July 2021 to December 2022,21 977 patients who received endoscopy and/or 13C-UBT in Lishui District People's Hospital and 6 medical community units in Nanjing City were retrospectively analyzed for demography characteristics,detection rate of gastric precancerous lesions,and H.Pylori infection rate.Results(1)590 cases of gastric precancerous lesions were detected(detection rate 2.68%);(2)The total detection rate of precancerous lesions and three pathological types in males were all higher than those in females(all P<0.001);(3)The minimum age for the total detection rate of precancerous lesions in males and the mini-mum age for each pathological type were lower than in females(P<0.001,0.009,0.005,0.002);(4)The popu-lation total H.pylori infection rate was 23.10%,the H.pylori infection rate in patients with precancerous lesions was higher than that in non-precancerous lesions(P<0.001),both H.pylori infection rate of male and female in precancerous lesions were all higher than those of non-precancerous lesions of the same sex(all P<0.001),in addition,the H.pylori infection rate of male whether in precancerous or non-precancerous lesions was higher than that of female(all P<0.001);(5)The precancerous lesions detection rate in male,female,and the overall age range of 20～29 to 70～79 years is positively correlated with age growth(P<0.001),and rapidly decreases after the age of 79,the of H.pylori infection rate was also positively correlated with age growth(P<0.001),and the trend of age change(P<0.001)was parallel to the precancerous lesions detection rate.Conclusions The detec-tion rate of gastric precancerous lesions in this region is above the average level in China;the total H.pylori infec-tion rate is at a relatively low level in China;the H.pylori infection rate is parallel to the age trend of the detection rate of gastric precancerous lesions,and increases with age.

Objective: To investigate the effect of hypnotherapy on improving pain degree,pain catastrophizing,pain self efficacy,coping styles of female college students with primary dysmenorrhea, and to provide the theoretical support for psychological intervention. Methods: Fifty six female college students with primary dysmenorrhea were randomly divided into experimental group( n =28) and control group( n =28).Samples in the experimental group received 10 session structured hypnotherapy, while the control group received no intervention (the control group could receive the intervention when the intervention was proved to be effective) .The effects were evaluated with Numerical Rating Scale (NRS),Pain Catastrophizing Scale (PCS),Pain Self Efficacy Questionnaire（PSEQ）,was proved to be effective .The effects were evaluated with Numerical Rating Scale (NRS),Pain Catastrophizing Scale (PCS),Pain Self Efficacy Questionnaire（PSEQ）,Simplified Coping Style Questionnaire（SCSQ）in the pretest，protest and tracking test. Results: The time effect，group effect and time group interaction on the NRS,PCS,PSEQ scores of the two groups of female college students were all statistically significant ( F =12.83，21.77，13.65； 22.96，28.98，24.84；25.35，18.26，27.02， P < 0.01 ).Immediately after the intervention and 3 months after the intervention，the scores of SCSQ positive coping dimension of the experimental group（1.43±0.35，1.50±0.39）were significantly higher than those of the control group（1.22±0.19，1.20±0.21），and the scores of SCSQ negative coping dimension of the experimental group（1.59±0.38，1.52±0.49）were significantly lower than those of the control group（1.80±0.17，1.80±0.20）, the differences were all statistically significant ( P <0.05);There were statistical differences among time effect，group effect and timegroup interaction on the positive coping and negative coping scores of SCSQ ( F = 15.14 ， 4.29 ， 14.37 ；7.66，4.10，6.95， P <0.05). Conclusion Hypnotherapy intervention for female college students with primary dysmenorrhea can effectively alleviate pain degree，and improve the pain catastrophizing and coping styles,enhance their pain self efficacy. The hypnotherapy also shows long term effects.

Internet hospitals played a huge role in meeting patients’ medical needs during the COVID-19 pandemic. As a new service model, it also brings new challenges to medical ethics. This paper analyzed the three key elements of behavior: actors, behavior process and action result, and found that apart from ethical challenges such as medical security, data security and privacy protection, different types of Internet hospitals show diversity due to different actors involved. The first type of Internet hospital represented the conflict of interest of doctors brought by the integration of offline and online working modes. The second type showed the challenge of fairness in medical treatment brought by the demand of personalized service provided by medical staff in public medical institutions. The third type manifested the medical security challenges brought by doctors with varying technical levels in an open platform environment. Combined with the current ethical governance of science and technology and the digital transformation of society, this paper put forward some countermeasures and suggestion, such as further clarifying the boundaries of rights and responsibilities of relevant subjects of Internet platform, formulating the code of conduct requirements for medical staff in Internet hospitals, and supervising doctors’ medical practice in Internet hospitals.

OBJECTIVE：To establish the method for the content det ermination of 4 components in Forsythia suspensa flowers by drying in shade ，vacuum freeze-drying ，oven（30，50，70 ℃）and sun ，so as to evaluate the effects of different drying methods on the main components of F. suspensa flowers and screen the optimal drying method. METHODS ：UPLC method was adopted. The determination was performed on Waters ACQUITY UPLC BEH C 18 column with mobile phase consisted of acetonitrile- 0.1％ phosphoric acid aqueous solution （gradient elution ）at the flow rate of 0.3 mL/min. The detection wavelength was set at 230 nm， and column was 35 ℃. The sample size was 1 μL. Euclidean closeness（C）i of different drying methods was calculated by TOPSIS comprehensive analysis method ，and the optimal drying method was defined. RESULTS ：The linear range of forsythiaside A ， rutin，forsythin，（+）-pinoresinol-4-O-β-D-glucopyranoside were 0.007 5-0.037 7，0.027 4-0.137 2，0.001 9-0.009 5，0.005 6-0.028 8 µg（all r＞0.999）. RSDs of precision ，stability（32 h）and reproducibility tests were all lower than 2％. The recoveries were 97.27％-102.53％，100.53％-104.11％，98.45％-104.02％，98.66％-104.82％，respectively；and all RSDs ＜3％（n＝3）. The contents were 1.645 8-4.987 9，11.730 2-20.978 0，0.875 5-2.005 0，2.366 0-5.535 7 mg/g. The content of forsythiaside A was the highest after drying at 30 ℃，rutin and （+）-pinoresinol-4- O-β-D-glucopyranoside were the highest after vacuum freeze-drying，forsythiaside was the highest after drying at 50 ℃ . Results of TOPSIS analysis showed that Ci of F. suspensa flowers by drying in shade ，vacuum freeze-drying ，oven（30，50，70 ℃）and sun were 0.079 9，0.553 5，0.495 4， 0.503 8，0.157 9，0.217 2，respectively；the order of Ci was vacuum freeze-drying ＞ 50 ℃ oven drying ＞ 30 ℃ oven drying＞sun drying ＞70 ℃ oven drying ＞ shade drying. CONCLUSIONS：Established method is simple ，reproducible and can be used for the content determination of 4 components in F. suspensa flowers. The samples are preferably dried by vacuum freeze-drying，followed by 50 ℃ oven drying ，30 ℃ oven drying ， and then dried in the sun and oven at 70 ℃ and finally in the shade.

Objective To explore the prognostic role of laminin (LN ) as a tumor biological marker in predicting the recurrence of hepatocellular carcinoma (HCC) related with HBV infection after liver transplantation (LT ) .Methods Tissue samples from 251 HBV-related HCC patients undergoing LT were immunohistochemically stained with anti-LN antibody .The relevant prognostic factors were analyzed using Spearman's rank test , Kaplan-Meier method , log-rank test and multivariate step-wise Cox regression analysis .Results The expressions of LN in tumor tissues were significantly positively correlated with tumor number (P=0 .00) ,microsatellite (P=0 .02) ,venous invasion (P=0 .048) ,pTNM tumor stage (P=0 .00) ,pre-LT serum α-fetoprotein (AFP) level (P=0 .00) ,HBV DNA level (P= 0 .02) ,HBeAg level (P= 0 .02) and tumor recurrence (P= 0 .00) respectively .Significant differences existed in 1/3/5-year overall survival or tumor recurrence-free survival rate post-LT among LN different expression (-,+ ,≥ + + ) in HBV-related HCC patients (P< 0 .05 ) . Multivariate analysis indicated that LN was a significantly independent predictor in predicting poor tumor recurrence-free survival post-LT (P=0 .01) .Conclusions LN may be a feasible marker in predicting HCC recurrence post-LT for HBV-related HCC patients .